| Application finger splint static (29130) |
$55.25 |
$110.50 |
0.4× |
| Application long arm splint shoulder hand (29105) |
$101 |
$202 |
0.6× |
| Application long leg splint thigh ankle/toes (29505) |
$113.25 |
$226.50 |
0.7× |
| Application Short Arm Splint Dynamic (29126) |
$107.25 |
$214.50 |
0.8× |
| Application short arm splint forearm-hand static (29125) |
$84.75 |
$169.50 |
0.6× |
| Application short leg splint calf foot (29515) |
$87.25 |
$174.50 |
0.5× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$87.50 |
$175 |
0.3× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$106 |
$212 |
0.3× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$87.50 |
$175 |
0.3× |
| Aspirat/Injection Ganglion Cyst(S) (20612) |
$54.75 |
$109.50 |
0.2× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$77 |
$154 |
0.4× |
| Blood transfusion service (36430) |
$133.30 |
$266.60 |
0.3× |
| Change Cystostomy Tube Simple (51705) |
$117 |
$234 |
0.5× |
| Chemical Cautery Tissue (17250) |
$32 |
$64 |
0.2× |
| Chest tube placement (32551) |
$398.50 |
$797 |
0.3× |
| Closed Rx Radial Shaft Fx (25500) |
$347.50 |
$695 |
1.4× |
| Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) |
$547 |
$1,094 |
2.2× |
| Closed tx ankle dislocation w/o anesthesia (27840) |
$541 |
$1,082 |
2.2× |
| Closed tx metatarsal fracture w/o manipulation (28470) |
$287 |
$574 |
1.2× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
$247.75 |
$495.50 |
1.0× |
| Clsd tx clavicular fracture w/o manipulation (23500) |
$342.75 |
$685.50 |
1.4× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$325 |
$650 |
1.3× |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) |
$315 |
$630 |
1.3× |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) |
$340.50 |
$681 |
1.4× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$353 |
$706 |
1.4× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$463.50 |
$927 |
0.3× |
| Cltx fx grt toe phlx/phlg w/manj (28495) |
$201 |
$402 |
0.8× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
$190.50 |
$381 |
0.8× |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
$305 |
$610 |
1.2× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
$304 |
$608 |
1.2× |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) |
$302 |
$604 |
1.2× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
$234.75 |
$469.50 |
0.9× |
| Control Nasal Hemorrhage Anterior Complex (30903) |
$180.50 |
$361 |
1.4× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$116 |
$232 |
0.9× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$237 |
$474 |
1.8× |
| Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) |
$208.50 |
$417 |
0.9× |
| Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) |
$77 |
$154 |
0.2× |
| Debride nail 1-5 (11720) |
$30.50 |
$61 |
0.5× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$58.75 |
$117.50 |
0.1× |
| Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) |
$148.50 |
$297 |
0.2× |
| Destruction Benign Lesions Up To 14 (17110) |
$74 |
$148 |
0.4× |
| Destruction premalignant lesion 1st (17000) |
$77 |
$154 |
0.4× |
| Drain Ext Ear Absc/Blood,Complic (69005) |
$232 |
$464 |
0.1× |
| Drain Mouth Absc/Cyst/Hematoma,Simpl (40800) |
$153 |
$306 |
0.2× |
| Drain outer ear canal lesion (69020) |
$186.50 |
$373 |
0.3× |
| Drainage abscess/hematoma nasal int approach (30000) |
$157 |
$314 |
0.7× |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
$165 |
$330 |
0.2× |
| Drainage Finger Abscess Complicated (26011) |
$247 |
$494 |
0.1× |
| Drainage Finger Abscess Simple (26010) |
$185.50 |
$371 |
0.9× |
| Drainage of eyelid abscess (67700) |
$148.50 |
$297 |
0.5× |
| Drainage of hematoma/fluid (10140) |
$92 |
$184 |
0.1× |
| Drainage of scrotal wall abscess (55100) |
$216.50 |
$433 |
0.1× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
$185.50 |
$371 |
0.5× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
$114.50 |
$229 |
0.6× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
$84 |
$168 |
0.4× |
| Evacuation of subungual hematoma (11740) |
$42.50 |
$85 |
0.3× |
| Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) |
$153 |
$306 |
0.2× |
| Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) |
$156 |
$312 |
0.4× |
| Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) |
$212 |
$424 |
0.3× |
| Exc tr-ext b9+marg 0.5 cm or less (11400) |
$138.50 |
$277 |
0.2× |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) |
$134.50 |
$269 |
0.2× |
| Excision of nail fold toe (11765) |
$57 |
$114 |
0.1× |
| Fine needle aspiration without imaging guidance (10021) |
$77 |
$154 |
0.2× |
| Gastric Intubation/Aspiration, Therapeutic (43753) |
$104 |
$208 |
0.5× |
| I&d abscess simple (10060) |
$110 |
$220 |
0.5× |
| Incision & drainage abscess complicated/multiple (10061) |
$252 |
$504 |
0.6× |
| Incision & removal foreign body subq tiss compl (10121) |
$592 |
$1,184 |
0.4× |
| Incision & removal foreign body subq tiss simple (10120) |
$82.50 |
$165 |
0.2× |
| Incision and drainage of bartholin's gland abscess (56420) |
$154.50 |
$309 |
0.8× |
| Incision thrombosed hemorrhoid external (46083) |
$153 |
$306 |
0.6× |
| Initial tx 1st degree burn local tx (16000) |
$56.50 |
$113 |
0.3× |
| Inj tendon sheath/ligament (20550) |
$45 |
$90 |
0.1× |
| Inject Tendon Origin/Insert (20551) |
$48 |
$96 |
0.2× |
| Insert Bladder Cath Complex (51703) |
$126.25 |
$252.50 |
1.0× |
| Insert non-tunnel cv cath (36556) |
$382.25 |
$764.50 |
0.1× |
| Insert Temp Bladder Cath (51702) |
$82 |
$164 |
0.6× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$77.95 |
$155.90 |
0.6× |
| Intubation endotracheal emergency procedure (31500) |
$208.75 |
$417.50 |
0.9× |
| Late closure of wound (13160) |
$819 |
$1,638 |
0.2× |
| Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) |
$127 |
$254 |
0.3× |
| Perq replacement gtube not req revj gstrst trc (43762) |
$172.50 |
$345 |
0.7× |
| Punch biopsy skin single lesion (11104) |
$89 |
$178 |
0.2× |
| Puncture Aspiration (10160) |
$100.50 |
$201 |
0.2× |
| Puncture Aspiration Cyst Breast (19000) |
$92.50 |
$185 |
0.1× |
| Removal fb intranasal (30300) |
$112.50 |
$225 |
0.8× |
| Removal foreign body foot deep (28192) |
$181.50 |
$363 |
0.1× |
| Removal foreign body foot subcutaneous (28190) |
$137 |
$274 |
0.2× |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
$146.50 |
$293 |
0.1× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$26 |
$52 |
0.4× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$57.50 |
$115 |
1.0× |
| Removal of intrauterine device (iud) (58301) |
$84.50 |
$169 |
0.3× |
| Removal of nail bed (11750) |
$187.50 |
$375 |
0.5× |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
$80 |
$160 |
0.4× |
| Remove drug implant device (11982) |
$107.50 |
$215 |
0.2× |
| Remove foreign body from eye (65210) |
$98 |
$196 |
0.2× |
| Remv Ext Canal Foreign Body (69200) |
$77.50 |
$155 |
0.6× |
| Remv F.B.,Eye,Superf Conjunc (65205) |
$82.50 |
$165 |
0.6× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
$190.50 |
$381 |
0.3× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
$190.50 |
$381 |
0.3× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$190.50 |
$381 |
0.5× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$190.50 |
$381 |
0.5× |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
$190.50 |
$381 |
0.5× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$211.25 |
$422.50 |
0.5× |
| Repair complex trunk 1.1-2.5 cm (13100) |
$190.50 |
$381 |
0.3× |
| Repair complex trunk 2.6-7.5 cm (13101) |
$190.50 |
$381 |
0.3× |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
$181.50 |
$363 |
0.4× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$177.75 |
$355.50 |
0.4× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$181.50 |
$363 |
0.4× |
| Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) |
$181.50 |
$363 |
0.4× |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
$181.50 |
$363 |
0.4× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
$181.50 |
$363 |
0.4× |
| Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) |
$181.50 |
$363 |
0.4× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$181.50 |
$363 |
0.2× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$181.50 |
$363 |
0.4× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$181.50 |
$363 |
0.4× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$181.50 |
$363 |
0.2× |
| Repair intermediate n/h/f/xtrnl gent >30.0 cm (12047) |
$181.50 |
$363 |
0.1× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$213 |
$426 |
0.5× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$181.50 |
$363 |
0.4× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$180.50 |
$361 |
0.4× |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) |
$181.50 |
$363 |
0.2× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$188.25 |
$376.50 |
0.5× |
| Repair intermediate s/a/t/e >30.0 cm (12037) |
$181.50 |
$363 |
0.1× |
| Repair Tongue Laceration (41250) |
$202 |
$404 |
0.5× |
| Reposition gastrostomy tube (43761) |
$110.50 |
$221 |
0.4× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$112.75 |
$225.50 |
0.3× |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
$181.50 |
$363 |
0.2× |
| Shaving skin lesion 1 trunk/arm/leg diam 0.5cm/< (11300) |
$61.50 |
$123 |
0.2× |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) |
$86 |
$172 |
0.4× |
| Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) |
$92 |
$184 |
0.5× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
$143.25 |
$286.50 |
0.4× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$106.25 |
$212.50 |
0.5× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$107.25 |
$214.50 |
0.5× |
| Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) |
$155.50 |
$311 |
0.4× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$116.50 |
$233 |
0.6× |
| Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) |
$126 |
$252 |
0.6× |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
$155.50 |
$311 |
0.8× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$92 |
$184 |
0.5× |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
$155.50 |
$311 |
0.8× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$115.50 |
$231 |
0.6× |
| Skin sub graft face/nk/hf/g (15275) |
$104.55 |
$209.10 |
0.1× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$138.50 |
$277 |
0.7× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$126.25 |
$252.50 |
0.3× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$175.25 |
$350.50 |
0.4× |
| Spinal puncture lumbar diagnostic (62270) |
$234.50 |
$469 |
0.3× |
| Strapping ankle (29540) |
$77.50 |
$155 |
0.5× |
| Strapping elbow/wrist (29260) |
$37.40 |
$74.80 |
0.6× |
| Strapping shoulder (29240) |
$62 |
$124 |
0.5× |
| Strapping toes (29550) |
$56.50 |
$113 |
1.0× |
| Tangential biopsy skin single lesion (11102) |
$89 |
$178 |
0.2× |
| Tracheostomy emergency cricothyroid membrane (31605) |
$335 |
$670 |
1.4× |
| Tracheostomy Emergency Procedure Transtracheal (31603) |
$679.50 |
$1,359 |
0.4× |
| Treat Vaginal Bleeding (57180) |
$190.50 |
$381 |
0.9× |
| Treatment closed elbow dislocation w/o anes (24600) |
$386.75 |
$773.50 |
1.6× |
| Trim skin lesion (11055) |
$69.50 |
$139 |
0.3× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) |
$178.25 |
$356.50 |
0.2× |
| Tx superficial wound dehiscence w/packing (12021) |
$155.50 |
$311 |
0.4× |
| Venipuncture (36415) |
$7.75 |
$15.50 |
0.8× |