| Acromiopl/Acromionect Partial (23130) |
— |
$16,288.69 |
— |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) |
— |
$16,288.69 |
— |
| Amputation toe interphalangeal joint (28825) |
— |
$16,288.69 |
— |
| Amputation toe metatarsophalangeal joint (28820) |
— |
$16,288.69 |
— |
| Ankle Arthroscopy/Surgery (29892) |
— |
$16,288.69 |
— |
| Anterior Tibial Tubercleplasty (27418) |
— |
$16,288.69 |
— |
Application cast elbow finger short arm (29075)
range across 2 matching MRF lines |
— |
$254.81–$450.70 |
— |
| Application Cast Finger (29086) |
— |
$190.59 |
— |
Application Finger Splint Dynamic (29131)
range across 2 matching MRF lines |
— |
$133.06–$138.38 |
— |
Application finger splint static (29130)
range across 2 matching MRF lines |
— |
$118.30–$123.03 |
— |
Application long arm splint shoulder hand (29105)
range across 2 matching MRF lines |
— |
$251.11–$264.76 |
— |
| Application Long Leg Splint (29505) |
— |
$244.67 |
— |
| Application multiplane external fixation system (20692) |
— |
$16,288.69 |
— |
| Application of long leg cast (29345) |
— |
$437.82 |
— |
| Application Short Arm Splint Dynamic (29126) |
— |
$210.40 |
— |
Application short arm splint forearm-hand static (29125)
range across 2 matching MRF lines |
— |
$169.73–$193.16 |
— |
| Application short leg splint calf foot (29515) |
— |
$251.11 |
— |
| Application uniplane external fixation system (20690) |
— |
$16,288.69 |
— |
Apply hand/wrist cast (29085)
range across 2 matching MRF lines |
— |
$264.76–$450.70 |
— |
Apply long arm cast (29065)
range across 2 matching MRF lines |
— |
$285.45–$450.70 |
— |
| Apply Short Leg Cast (29405) |
— |
$450.70 |
— |
| Apply short leg cast (29425) |
— |
$450.70 |
— |
| Arthrd Ant Interbody Decompress Cervical Belw C2 (22551) |
— |
$16,288.69 |
— |
| Arthrd Ant Min Discect Interbody Cerv Below C2 (22554) |
— |
$16,288.69 |
— |
| Arthrd midtarsl/tarsometatarsal mult/transvrs (28730) |
— |
$16,288.69 |
— |
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605)
range across 2 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
— |
$463.56 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
— |
$16,288.69 |
— |
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600)
range across 2 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
| Arthrodesis ankle open (27870) |
— |
$16,288.69 |
— |
| Arthrodesis great toe interphalangeal joint (28755) |
— |
$16,288.69 |
— |
| Arthrodesis great toe metatarsophalangeal joint (28750) |
— |
$16,288.69 |
— |
| Arthrodesis Pantalar (28705) |
— |
$16,288.69 |
— |
| Arthrodesis Posterior/Posterolateral Lumbar (22612) |
— |
$16,288.69 |
— |
| Arthrodesis sacroiliac joint percutaneous (27279) |
— |
$16,288.69 |
— |
| Arthrodesis subtalar (28725) |
— |
$16,288.69 |
— |
| Arthrodesis triple (28715) |
— |
$16,288.69 |
— |
| Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft) Facility (25810) |
— |
$16,288.69 |
— |
| Arthroplasty ankle revision total ankle (27703) |
— |
$16,288.69 |
— |
| Arthroplasty Ankle W/Implant (27702) |
— |
$16,288.69 |
— |
| Arthroplasty glenohumeral joint total shoulder (23472) |
— |
$16,288.69 |
— |
| Arthroplasty Glenohumrl Jt Hemiarthroplasty (23470) |
— |
$16,288.69 |
— |
| Arthroplasty interphalangeal joint each (26535) |
— |
$16,288.69 |
— |
| Arthroplasty interposition intercarpal or carpometacarpal joints (25447) |
— |
$16,288.69 |
— |
| Arthroplasty Patella W/Prosthesis (27438) |
— |
$16,288.69 |
— |
| Arthroplasty Radial Head W/Implant (24366) |
— |
$16,288.69 |
— |
| Arthroplasty, elbow; with distal humeral prosthetic replacement Facility (24361) |
— |
$16,288.69 |
— |
| Arthroscopy Ankle Surgical Debridement Extensive (29898) |
— |
$16,288.69 |
— |
| Arthroscopy Ankle Surgical Debridement Limited (29897) |
— |
$16,288.69 |
— |
| Arthroscopy Ankle Surgical W/Ankle Arthrodesis (29899) |
— |
$16,288.69 |
— |
| Arthroscopy ankle w/removal loose/foreign body (29894) |
— |
$16,288.69 |
— |
| Arthroscopy Elbow Surgical Debridement Extensive (29838) |
— |
$16,288.69 |
— |
| Arthroscopy Elbow Surgical Debridement Limited (29837) |
— |
$16,288.69 |
— |
| Arthroscopy Elbow Surgical Synovectomy Partial (29835) |
— |
$16,288.69 |
— |
| Arthroscopy hip w/femoroplasty (29914) |
— |
$16,288.69 |
— |
Arthroscopy knee diagnostic w/wo synovial bx spx (29870)
range across 2 matching MRF lines |
— |
$5,055.50–$16,288.69 |
— |
| Arthroscopy Knee Osteochondral Allograft (29867) |
— |
$16,288.69 |
— |
| Arthroscopy Knee Synovectomy 2/>Compartments (29876) |
— |
$16,288.69 |
— |
| Arthroscopy knee synovectomy limited spx (29875) |
— |
$16,288.69 |
— |
| Arthroscopy knee w/lysis adhesions w/wo manj spx (29884) |
— |
$16,288.69 |
— |
| Arthroscopy shoulder distal claviculectomy (29824) |
— |
$16,288.69 |
— |
| Arthroscopy shoulder surgical capsulorrhaphy (29806) |
— |
$16,288.69 |
— |
| Arthroscopy Wrist Surgical Synovectomy Complete (29845) |
— |
$16,288.69 |
— |
| Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial (29895) |
— |
$16,288.69 |
— |
| Arthroscopy, elbow, surgical; with removal of loose body or foreign body Facility (29834) |
— |
$16,288.69 |
— |
| Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty,… (29862) |
— |
$16,288.69 |
— |
| Arthroscopy, hip, surgical; with removal of loose body or foreign body Facility (29861) |
— |
$16,288.69 |
— |
| Arthroscopy, hip, surgical; with synovectomy Facility (29863) |
— |
$16,288.69 |
— |
| Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral… (29868) |
— |
$16,288.69 |
— |
| Arthroscopy, knee, surgical; with lateral release (29873) |
— |
$16,288.69 |
— |
| Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) Facility (29883) |
— |
$16,288.69 |
— |
| Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) |
— |
$16,288.69 |
— |
| Arthroscopy, shoulder, surgical; biceps tenodesis (29828) |
— |
$16,288.69 |
— |
| Arthroscopy, shoulder, surgical; debridement, extensive (29823) |
— |
$16,288.69 |
— |
| Arthroscopy, shoulder, surgical; debridement, limited (29822) |
— |
$16,288.69 |
— |
| Arthroscopy, shoulder, surgical; repair of slap lesion (29807) |
— |
$16,288.69 |
— |
| Arthroscopy, shoulder, surgical; synovectomy, complete Facility (29821) |
— |
$16,288.69 |
— |
| Arthroscopy, shoulder, surgical; with removal of loose body or foreign body (29819) |
— |
$16,288.69 |
— |
| Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) |
— |
$16,288.69 |
— |
| Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement Facility (29846) |
— |
$16,288.69 |
— |
| Arthroscopy, wrist, surgical; internal fixation for fracture or instability Facility (29847) |
— |
$16,288.69 |
— |
| Arthrotomy ankle w/expl drainage/removal fb (27610) |
— |
$16,288.69 |
— |
| Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body Facility (23040) |
— |
$16,288.69 |
— |
| Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft (27130) |
— |
$16,288.69 |
— |
| Arthrp Intercarpal/Carp/Mtcrpl Jt Suspension (25448) |
— |
$16,288.69 |
— |
| Arthrp Knee Condyle&Plateau Medial/Lat Cmprt (27446) |
— |
$16,288.69 |
— |
| Arthrp Mtcarphlngl Jt W/Prostc Implt Ea Jt (26531) |
— |
$16,288.69 |
— |
| Arthrp wrst w/wo interpos w/wo xtrnl/int fixj (25332) |
— |
$16,288.69 |
— |
| Arthrs aided ant cruciate ligm rpr/agmntj/rcnstj (29888) |
— |
$16,288.69 |
— |
| Arthrs Aided Pst Cruciate Ligm Rpr/Agmntj/Rcnstj (29889) |
— |
$16,288.69 |
— |
| Arthrs Ankle Exc Ostchndrl Dfct W/Drlg Dfct (29891) |
— |
$16,288.69 |
— |
| Arthrs Knee Abrasion Arthrp/Mlt Drlg/Microfx (29879) |
— |
$16,288.69 |
— |
| Arthrs knee debridement/shaving artclr crtlg (29877) |
— |
$16,288.69 |
— |
| Arthrs Knee Drlg Osteochond Dissecans Int Fixj (29887) |
— |
$16,288.69 |
— |
| Arthrs Knee W/Meniscectomy Med&Lat W/Shaving (29880) |
— |
$16,288.69 |
— |
| Arthrt ankle w/expl w/wo bx w/wo rmvl loose/fb (27620) |
— |
$16,288.69 |
— |
| Arthrt expl drg/rmvl loose/fb iphal jt ea (26080) |
— |
$16,288.69 |
— |
| Arthrt W/Exc Semilunar Crtlg Knee Medial/Lat (27332) |
— |
$16,288.69 |
— |
| Arthrt w/expl drg/rmvl loose/fb iphal jt (28024) |
— |
$16,288.69 |
— |
| Arthrt w/expl drg/rmvl loose/fb mttarphlngl jt (28022) |
— |
$16,288.69 |
— |
| Arthrt W/Expl Drg/Rmvl Loose/FB Ntrtrsl/Tars Jt (28020) |
— |
$16,288.69 |
— |
| Arthrt wrst w/jt expl w/wo bx w/wo rmvl loose/fb (25101) |
— |
$16,288.69 |
— |
| Autologous Chondrocyte Implantation Knee (27412) |
— |
$16,288.69 |
— |
Avulsion nail plate partial/complete simple 1 (11730)
range across 2 matching MRF lines |
— |
$251.11–$16,288.69 |
— |
| Biopsy bone open deep (20245) |
— |
$16,288.69 |
— |
| Bone Graft Any Donor Area Major/Large (20902) |
— |
$16,288.69 |
— |
| Bone Graft Any Donor Area Minor/Small (20900) |
— |
$16,288.69 |
— |
| Bone Marrow Harvest Autolog (38232) |
— |
$16,288.69 |
— |
| Capsul mttarphlngl jt w/wo tenorrhaphy ea jt spx (28270) |
— |
$16,288.69 |
— |
| Capsular contracture release (23020) |
— |
$16,288.69 |
— |
| Capsulectomy or capsulotomy; interphalangeal joint, each joint (26525) |
— |
$16,288.69 |
— |
| Capsulectomy/capsulotomy mtcarphlngl joint each (26520) |
— |
$16,288.69 |
— |
| Capsulorrhaphy Anterior W/Labral Repair (23455) |
— |
$16,288.69 |
— |
| Capsulorrhaphy Anterior With Bone Block (23460) |
— |
$16,288.69 |
— |
| Capsulotomy Iphal Joint Each Joint Spx (28272) |
— |
$16,288.69 |
— |
| Capsulotomy wrist (25085) |
— |
$16,288.69 |
— |
| Carpal Tunnel Surgery (64721) |
— |
$16,288.69 |
— |
| Carpectomy All Bones Proximal Row (25215) |
— |
$16,288.69 |
— |
| Cartilage graft; costochondral (20910) |
— |
$16,288.69 |
— |
| Cerv artific diskectomy (22856) |
— |
$16,288.69 |
— |
| Chest tube placement (32551) |
— |
$16,288.69 |
— |
| Claviculectomy partial (23120) |
— |
$16,288.69 |
— |
| Closed Rx Metacarpal Fx,Percut (26608) |
— |
$16,288.69 |
— |
| Closed tx ankle dislocation w/o anesthesia (27840) |
— |
$611.66 |
— |
| Closed tx knee dislocation w/o anesthesia (27550) |
— |
$837 |
— |
| Closed tx metatarsal fracture w/o manipulation (28470) |
— |
$16,288.69 |
— |
| Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) |
— |
$16,288.69 |
— |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
— |
$16,288.69 |
— |
Clsd tx shoulder dislc w/manipulation w/o anes (23650)
range across 2 matching MRF lines |
— |
$360.55–$16,288.69 |
— |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) |
— |
$360.55 |
— |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
— |
$611.66 |
— |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
— |
$16,288.69 |
— |
| Cltx dstl xtnsr tdn insj w/wo percutan pinning (26432) |
— |
$16,288.69 |
— |
| Cltx fx grt toe phlx/phlg w/o manj (28490) |
— |
$360.55 |
— |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
— |
$360.55 |
— |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) |
— |
$16,288.69 |
— |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
— |
$360.55 |
— |
Cltx metacarpal fx w/manipulation each bone (26605)
range across 2 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
| Cltx Metatarsophlngl Jt Dislc Req Anes (28635) |
— |
$16,288.69 |
— |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
— |
$16,288.69 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$16,288.69 |
— |
| Cltx trimalleolar ankle fx w/o manipulation (27816) |
— |
$16,288.69 |
— |
| Collection of venous blood by venipuncture (36415) |
— |
$15.36 |
— |
| Complex drainage wound (10180) |
— |
$16,288.69 |
— |
| Conv prev hip tot hip arthrp w/wo agrft/algrft (27132) |
— |
$16,288.69 |
— |
| Correction hammertoe (28285) |
— |
$16,288.69 |
— |
| Corrj hallux valgus w/sesmdc w/dist metar osteot (28296) |
— |
$16,288.69 |
— |
| Corrj hallux valgus w/sesmdc w/prox metar osteot (28295) |
— |
$16,288.69 |
— |
| Corrj Hlx Vlgs Bncty Sesmdc Joint Arthrodesis (28297) |
— |
$16,288.69 |
— |
| Corrj Hlx Vlgs Bncty Sesmdc Prox Phlx Osteot (28298) |
— |
$16,288.69 |
— |
| Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base (28292) |
— |
$16,288.69 |
— |
| Cysto Bladder W/Ureteral Catheterization (52005) |
— |
$1,179.63 |
— |
| Cystotomy, with insertion of ureteral catheter or stent (separate procedure) Facility (51045) |
— |
$16,288.69 |
— |
| Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) |
— |
$16,288.69 |
— |
| Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010) |
— |
$16,288.69 |
— |
| Dcmprn Fasct Leg Ant&/Lat Compartments Only (27600) |
— |
$16,288.69 |
— |
| Dcmprn Fasct Leg Ant&/Lat&Pst Cmprt (27602) |
— |
$16,288.69 |
— |
| Dcmprn fasct leg post compartment only (27601) |
— |
$16,288.69 |
— |
| Deb Musc/Fascia 20 Sq Cm/< (11043) |
— |
$16,288.69 |
— |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) |
— |
$16,288.69 |
— |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
— |
$16,288.69 |
— |
| Decompress Spinal Cord Lmbr (63056) |
— |
$16,288.69 |
— |
| Decompression of leg (27894) |
— |
$16,288.69 |
— |
| Destroy cerv/thor facet jnt (64633) |
— |
$16,288.69 |
— |
| Destroy lumb/sac facet jnt (64635) |
— |
$16,288.69 |
— |
| Destruction neurolytic agt genicular nerve w/img (64624) |
— |
$16,288.69 |
— |
| Drain Hand Tendon Sheath (26020) |
— |
$16,288.69 |
— |
| Drainage of hematoma/fluid (10140) |
— |
$16,288.69 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
— |
$463.56 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
— |
$476.44 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
— |
$257.55 |
— |
| Dstrj Neurolytic Agent Other Peripheral Nerve (64640) |
— |
$16,288.69 |
— |
| Epidural Blood Patch (62273) |
— |
$16,288.69 |
— |
| Evacuation of subungual hematoma (11740) |
— |
$251.11 |
— |
| Ex Tum/Vasc Mal Sft Tis Hand/Fngr Subfsc 1.5cm/> (26113) |
— |
$16,288.69 |
— |
| Ex tum/vasc malf sft tiss hand/fngr subq 1.5cm/> (26111) |
— |
$16,288.69 |
— |
| Exc arm/elbow les sc < 3 cm (24075) |
— |
$16,288.69 |
— |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) |
— |
$16,288.69 |
— |
| Exc Flxr Tdn W/Impltj Synth Rod Dlyd Tdn Grf H/F (26390) |
— |
$16,288.69 |
— |
| Exc Forearm Les Sc 3 Cm/> (25071) |
— |
$16,288.69 |
— |
| Exc Forearm Tum Deep 3 Cm/> (25073) |
— |
$16,288.69 |
— |
| Exc ganglion wrist recurrent (25112) |
— |
$16,288.69 |
— |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) |
— |
$16,288.69 |
— |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) |
— |
$16,288.69 |
— |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) |
— |
$16,288.69 |
— |
| Exc Hand Les Sc < 1.5 Cm (26115) |
— |
$16,288.69 |
— |
| Exc hand tum deep < 1.5 cm (26116) |
— |
$16,288.69 |
— |
| Exc Lesion Tendon Sheath/Capsule W/Synvct Foot (28090) |
— |
$16,288.69 |
— |
| Exc lesion tendon sheath/capsule w/synvct toe ea (28092) |
— |
$16,288.69 |
— |
| Exc Neurofibroma/Neurolemmoma Cutan Nrv (64788) |
— |
$16,288.69 |
— |
| Exc neurofibroma/neurolemmoma major prph nrv (64790) |
— |
$16,288.69 |
— |
| Exc neuroma hand/foot xcp digital nerve (64782) |
— |
$16,288.69 |
— |
| Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) |
— |
$16,288.69 |
— |
| Exc thigh/knee les sc 3 cm/> (27337) |
— |
$16,288.69 |
— |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) |
— |
$16,288.69 |
— |
| Exc tumor soft tiss forearm&/wrist subfasc <3cm (25076) |
— |
$16,288.69 |
— |
| Exc tumor soft tiss upper arm/elbw subfasc 5+cm (24073) |
— |
$16,288.69 |
— |
| Exc tumor soft tiss upr arm/elbow subfasc <5cm (24076) |
— |
$16,288.69 |
— |
| Exc Tumor Soft Tissue Forearm &/Wrist Subq <3Cm (25075) |
— |
$16,288.69 |
— |
| Exc tumor soft tissue leg/ankle subq <3cm (27618) |
— |
$16,288.69 |
— |
| Excise intraspinal lesion (63267) |
— |
$16,288.69 |
— |
| Excise tendon forearm/wrist (25109) |
— |
$16,288.69 |
— |
| Excision Distal Ulna Partial/Complete (25240) |
— |
$16,288.69 |
— |
| Excision lesion meniscus/capsule knee (27347) |
— |
$16,288.69 |
— |
| Excision lesion tendon sheath forearm&/wrist (25110) |
— |
$16,288.69 |
— |
| Excision of ganglion, wrist (dorsal or volar); primary (25111) |
— |
$16,288.69 |
— |
| Excision of neuroma; digital nerve, 1 or both, same digit (64776) |
— |
$16,288.69 |
— |
| Excision olecranon bursa (24105) |
— |
$16,288.69 |
— |
| Excision prepatellar bursa (27340) |
— |
$16,288.69 |
— |
| Excision synovial cyst popliteal space (27345) |
— |
$16,288.69 |
— |
| Excision tendon finger flexor/extensor each (26180) |
— |
$16,288.69 |
— |
| Excision tendon palm flexor/extensor single each (26170) |
— |
$16,288.69 |
— |
| Excision tumor soft tis foot/toe subq 1.5 cm/> (28039) |
— |
$16,288.69 |
— |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) |
— |
$16,288.69 |
— |
| Excision Tumor Soft Tissue Thigh/Knee Subq <3Cm (27327) |
— |
$16,288.69 |
— |
| Excision, interdigital (morton) neuroma, single, each (28080) |
— |
$16,288.69 |
— |
| Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater (27632) |
— |
$16,288.69 |
— |
| Excision/curettage cyst/tumor phalanx finger (26210) |
— |
$16,288.69 |
— |
| Excision; trochanteric bursa or calcification (27062) |
— |
$16,288.69 |
— |
| Exploration of knee joint (27310) |
— |
$16,288.69 |
— |
| Explore/Treat Elbow Joint (24101) |
— |
$16,288.69 |
— |
| Explore/Treat Knee Joint (27331) |
— |
$16,288.69 |
— |
| Fasciectomy Palm Only (26121) |
— |
$16,288.69 |
— |
| Fasct prtl palmar 1 dgt prox iphal jt w/wo rpr (26123) |
— |
$16,288.69 |
— |
| Fuse hand bones with graft (25825) |
— |
$16,288.69 |
— |
| Fusion Finger Joint (26860) |
— |
$16,288.69 |
— |
| Fusion of foot bones (28740) |
— |
$16,288.69 |
— |
| Fusion of hand bones (25820) |
— |
$16,288.69 |
— |
| Fusion of knuckle (26850) |
— |
$16,288.69 |
— |
| Fusion of knuckle with graft (26852) |
— |
$16,288.69 |
— |
| Gastrocnemius recession (27687) |
— |
$16,288.69 |
— |
| Grafting of autologous fat by lipo 50 cc or less (15771) |
— |
$16,288.69 |
— |
| Hallux rigidus w/cheilectomy 1st mp jt w/implt (28291) |
— |
$16,288.69 |
— |
| Hip arthro acetabuloplasty (29915) |
— |
$16,288.69 |
— |
| Hip arthro w/labral repair (29916) |
— |
$16,288.69 |
— |
| I&d abscess simple (10060) |
— |
$251.11 |
— |
| I&d deep absc bursa/hematoma thigh/knee region (27301) |
— |
$16,288.69 |
— |
| I&d shoulder deep abscess/hematoma (23030) |
— |
$16,288.69 |
— |
| I&d upper arm/elbow deep abscess/hematoma (23930) |
— |
$16,288.69 |
— |
| Implant neuroelectrodes (63650) |
— |
$16,288.69 |
— |
| Implant Periph/Gastric Neurostim/Receiver (64590) |
— |
$16,288.69 |
— |
| Incise finger tendon sheath (26055) |
— |
$16,288.69 |
— |
| Incise flexor carpi radialis (25001) |
— |
$16,288.69 |
— |
| Incise Wrist/Forearm Tendon (25290) |
— |
$16,288.69 |
— |
| Incision & drainage abscess complicated/multiple (10061) |
— |
$470.01 |
— |
| Incision & removal foreign body subq tiss compl (10121) |
— |
$16,288.69 |
— |
Incision & removal foreign body subq tiss simple (10120)
range across 2 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
| Incision extensor tendon sheath wrist (25000) |
— |
$16,288.69 |
— |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) |
— |
$16,288.69 |
— |
| Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) |
— |
$16,288.69 |
— |
Injection 1 tendon sheath/ligament aponeurosis (20550)
range across 2 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
— |
$16,288.69 |
— |
| Injection aa&/strd genicular nrv branches w/img (64454) |
— |
$16,288.69 |
— |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
— |
$16,288.69 |
— |
| Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) |
— |
$16,288.69 |
— |
| Injection anesthetic agent suprascapular nerve (64418) |
— |
$16,288.69 |
— |
| Injection enzyme palmar fascial cord (20527) |
— |
$463.56 |
— |
Injection single tendon origin/insertion (20551)
range across 2 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
Injection single/mlt trigger point 1/2 muscles (20552)
range across 2 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
Injection single/mlt trigger point 3/> muscles (20553)
range across 2 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
| Injection therapeutic carpal tunnel (20526) |
— |
$463.56 |
— |
| Injection, anesthetic agent; brachial plexus, single (64415) |
— |
$16,288.69 |
— |
| Injection, anesthetic agent; femoral nerve, single (64447) |
— |
$16,288.69 |
— |
Injection, anesthetic agent; other peripheral nerve or branch (64450)
range across 3 matching MRF lines |
— |
$463.56–$16,288.69 |
— |
| Insert and remove bone pin (20650) |
— |
$16,288.69 |
— |
| Insert Drug Implant Device (11981) |
— |
$16,288.69 |
— |
| Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including… (64596) |
— |
$16,288.69 |
— |
| Insj Stablj Dev W/O Dcmprn Lumbar Single Level (22869) |
— |
$16,288.69 |
— |
| Insj/Rplcmt Spinal Npg/Rcvr Pocket Crtj&Connj (63685) |
— |
$16,288.69 |
— |
| Knee Arthroscopy/Surgery (29885) |
— |
$16,288.69 |
— |
| Knee Arthroscopy/Surgery (29874) |
— |
$16,288.69 |
— |
| Lam facetec & foramot lumbar (63047) |
— |
$16,288.69 |
— |
| Laminotomy Single Lumbar (63042) |
— |
$16,288.69 |
— |
| Late closure of wound (13160) |
— |
$16,288.69 |
— |
| Lateral retinacular release open (27425) |
— |
$16,288.69 |
— |
| Ligamentous Reconstruction Knee Extra-Articular (27427) |
— |
$16,288.69 |
— |
| Ligamentous reconstruction knee intra-articular (27428) |
— |
$16,288.69 |
— |
| Low Back Disk Surgery (63030) |
— |
$16,288.69 |
— |
| Lumbar spine fusion combined (22633) |
— |
$16,288.69 |
— |
| Manipulation Elbow Under Anesthesia (24300) |
— |
$16,288.69 |
— |
| Manipulation knee joint under general anesthesia (27570) |
— |
$16,288.69 |
— |
| Manj W/Anes Shoulder Joint W/Fixation Apparatus (23700) |
— |
$16,288.69 |
— |
| Muscle transfer, any type, shoulder or upper arm; multiple Facility (23397) |
— |
$16,288.69 |
— |
| N block inj intercost sng (64420) |
— |
$16,288.69 |
— |
| N Block Lumbar/Thoracic (64520) |
— |
$16,288.69 |
— |
| Ndsc wrst surg w/rls transvrs carpl ligm (29848) |
— |
$16,288.69 |
— |
| Needle insertion w/o injection 1 or 2 muscles (20560) |
— |
$60 |
— |
| Needle insertion w/o injection 3 or more muscles (20561) |
— |
$140 |
— |
| Nerve repair w/conduit each nerve (64910) |
— |
$16,288.69 |
— |
| Nerve Repair W/Nerve Allograft First Strand (64912) |
— |
$16,288.69 |
— |
| Neuroplasty and/or transposition; ulnar nerve at elbow (64718) |
— |
$16,288.69 |
— |
| Neurp Major Prph Nrv Arm/Leg Opn Oth/Thn Spec (64708) |
— |
$16,288.69 |
— |
| Neurp major prph nrv opn arm/leg sciatic nrv (64712) |
— |
$16,288.69 |
— |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
— |
$16,288.69 |
— |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321) |
— |
$16,288.69 |
— |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
— |
$16,288.69 |
— |
| Open Repair of Rotator Cuff Acute (23410) |
— |
$16,288.69 |
— |
| Open Treatment Bimalleolar Ankle Fracture (27814) |
— |
$16,288.69 |
— |
| Open treatment calcaneal fracture (28415) |
— |
$16,288.69 |
— |
| Open Treatment Fracture Distal Tibia & Fibula (27828) |
— |
$16,288.69 |
— |
| Open treatment fracture distal tibia only (27827) |
— |
$16,288.69 |
— |
| Open Treatment Grter Humeral Tuberosity Fracture (23630) |
— |
$16,288.69 |
— |
| Open Treatment Humeral Condylar Fracture (24579) |
— |
$16,288.69 |
— |
| Open Treatment Medial Malleolus Fracture (27766) |
— |
$16,288.69 |
— |
| Open treatment metatarsal fracture each (28485) |
— |
$16,288.69 |
— |
| Open treatment of acromioclavicular dislocation acute or chronic (23550) |
— |
$16,288.69 |
— |
| Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)… (23552) |
— |
$16,288.69 |
— |
| Open treatment of clavicular fracture, includes internal fixation, when performed (23515) |
— |
$16,288.69 |
— |
| Open Treatment of Ulnar Shaft Fracture (25545) |
— |
$16,288.69 |
— |
| Open Treatment Proximal Fibula/Shaft Fracture (27784) |
— |
$16,288.69 |
— |
| Open Treatment Proximal Humeral Fracture (23615) |
— |
$16,288.69 |
— |
| Open Treatment Radial Shaft Fracture (25515) |
— |
$16,288.69 |
— |
| Open Treatment Tarsal Bone Dislocation (28555) |
— |
$16,288.69 |
— |
| Open Tx Acute/Chronic Elbow Dislocation (24615) |
— |
$16,288.69 |
— |
| Open Tx Articular Fracture Mcp/Ip Joint Ea (26746) |
— |
$16,288.69 |
— |
| Open tx carpal scaphoid navicular fracture (25628) |
— |
$16,288.69 |
— |
| Open Tx Carpometacarpal Dislocate Not Thumb (26685) |
— |
$16,288.69 |
— |
| Open Tx Distal Fibular Fracture Lat Malleolus (27792) |
— |
$16,288.69 |
— |
| Open Tx Distal Phalangeal Fracture Each (26765) |
— |
$16,288.69 |
— |
| Open Tx Distal Tibiofibular Joint Disruption (27829) |
— |
$16,288.69 |
— |
| Open Tx Fracture Phalanx/Phalanges Not Great Toe (28525) |
— |
$16,288.69 |
— |
| Open Tx Humeral Epicondylar Fracture (24575) |
— |
$16,288.69 |
— |
| Open tx interphalangeal joint dislocation (26785) |
— |
$16,288.69 |
— |
| Open Tx Metacarpal Fracture Single Ea Bone (26615) |
— |
$16,288.69 |
— |
| Open Tx Phalangeal Shaft Fracture Prox/Middle Ea (26735) |
— |
$16,288.69 |
— |
| Open Tx Radial Head/Neck Fracture (24665) |
— |
$16,288.69 |
— |
| Open Tx Radial Head/Neck Fracture Prosth (24666) |
— |
$16,288.69 |
— |
| Open tx tarsal fracture xcp talus & calcaneus ea (28465) |
— |
$16,288.69 |
— |
| Open Tx Tibial Fracture Proximal Unicondylar (27535) |
— |
$16,288.69 |
— |
| Open tx trimalleolar ankle fx w/o fixj pst lip (27822) |
— |
$16,288.69 |
— |
| Open tx ulnar fx proximal end (24685) |
— |
$16,288.69 |
— |
| Optx dstl radl i-artic fx/epiphysl sep 2 frag (25608) |
— |
$16,288.69 |
— |
| Optx dstl radl i-artic fx/epiphysl sep 3 frag (25609) |
— |
$16,288.69 |
— |
| Optx fem fx prox end nck int fixj/prostc rplcmt (27236) |
— |
$16,288.69 |
— |
| Optx humeral shft fx w/plate/screws w/wocerclage (24515) |
— |
$16,288.69 |
— |
| Optx tibial fx prox bicondylar w/wo int fixj (27536) |
— |
$16,288.69 |
— |
| Optx Tibial Shft Fx W/Plate/Screws W/WO Cerclage (27758) |
— |
$16,288.69 |
— |
| Ostectomy calcaneus (28118) |
— |
$16,288.69 |
— |
| Ostectomy Complete Other Metatarsal Head 2/3/4 (28112) |
— |
$16,288.69 |
— |
| Ostectomy, complete excision; fifth metatarsal head (28113) |
— |
$16,288.69 |
— |
| Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) (28110) |
— |
$16,288.69 |
— |
| Osteochondral allograft knee open (27415) |
— |
$16,288.69 |
— |
| Osteochondral talus autogrft (28446) |
— |
$16,288.69 |
— |
| Osteoplasty Humerus (24420) |
— |
$16,288.69 |
— |
| Osteoplasty Radius/Ulna Shortening (25390) |
— |
$16,288.69 |
— |
| Osteoplasty, femur; lengthening Facility (27466) |
— |
$16,288.69 |
— |
| Osteot w/wo lngth shrt/corrj 1st metar (28306) |
— |
$16,288.69 |
— |
| Osteot w/wo lngth shrt/corrj metar xcp 1st ea (28308) |
— |
$16,288.69 |
— |
| Osteotomy calcaneus w/wo internal fixation (28300) |
— |
$16,288.69 |
— |
| Osteotomy Clavicle W Bone Graft (23485) |
— |
$16,288.69 |
— |
| Osteotomy Phalanx Finger Each (26567) |
— |
$16,288.69 |
— |
| Osteotomy radius distal third (25350) |
— |
$16,288.69 |
— |
| Osteotomy Tibia (27705) |
— |
$16,288.69 |
— |
| Osteotomy Ulna (25360) |
— |
$16,288.69 |
— |
| Part remv talus or calcaneus (28120) |
— |
$16,288.69 |
— |
| Partial Excision Bone Humerus (24140) |
— |
$16,288.69 |
— |
| Partial Excision Bone Ulna (25150) |
— |
$16,288.69 |
— |
| Partial Excision Distal Phalanx Finger (26236) |
— |
$16,288.69 |
— |
| Partial Excision Proximal/Middle Phalanx Finger (26235) |
— |
$16,288.69 |
— |
| Partial removal of scapula (23190) |
— |
$16,288.69 |
— |
| Partial removal of tibia (27640) |
— |
$16,288.69 |
— |
| Partical Excision Bone Phalanx Toe (28124) |
— |
$16,288.69 |
— |
| Patellectomy or hemipatellectomy (27350) |
— |
$16,288.69 |
— |
| Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation Facility (28496) |
— |
$16,288.69 |
— |
| Perq Lumbosacral Injection (22511) |
— |
$16,288.69 |
— |
| Perq skel fixj distal radial fx/epiphysl sep (25606) |
— |
$16,288.69 |
— |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) |
— |
$16,288.69 |
— |
| Perq Vertebral Augmentation (22513) |
— |
$16,288.69 |
— |
| Pin Finger Dislocation (26776) |
— |
$16,288.69 |
— |
| Pin hand dislocation (26676) |
— |
$16,288.69 |
— |
| Prq Impltj Neurostimulator Eltrd Peripheral Nrv (64555) |
— |
$16,288.69 |
— |
| Prq Skel Fixj Dstl Phlngl Fx Fngr/Thmb Ea (26756) |
— |
$16,288.69 |
— |
| Prq skel fixj femoral fx prox end neck (27235) |
— |
$16,288.69 |
— |
| Prq skel fixj metar fx w/manj (28476) |
— |
$16,288.69 |
— |
| Prq Skel Fixj Tars Jt Dislc W/Manj (28606) |
— |
$16,288.69 |
— |
| Prq Skeletal Fix Carpo/Metacarpal Fx Dislc Thumb (26650) |
— |
$16,288.69 |
— |
| Prtl exc b1 tarsal/metar b1 xcp talus/calcaneus (28122) |
— |
$16,288.69 |
— |
| Quadricepsplasty (eg, Bennett or Thompson type) Facility (27430) |
— |
$16,288.69 |
— |
| Rad exc bursa synva wrst/f/arm tdn shths flxrs (25115) |
— |
$16,288.69 |
— |
| Rad exc bursa synva wrst/f/arm tdn shths xtnsrs (25116) |
— |
$16,288.69 |
— |
| Rad resect elbow caps/sr bone w rels (24149) |
— |
$16,288.69 |
— |
| Radical styloidectomy separate procedure (25230) |
— |
$16,288.69 |
— |
| Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) |
— |
$16,288.69 |
— |
| Rcnstj angular dfrm toe soft tiss px only (28313) |
— |
$16,288.69 |
— |
| Rcnstj Coltrl Ligm Mtcarphlngl 1 W/Local Tiss (26542) |
— |
$16,288.69 |
— |
| Rcnstj Coltrl Ligm Mtcarphlngl 1 W/Tdn/Fscal Grf (26541) |
— |
$16,288.69 |
— |
| Rcnstj Pst Tibl Tdn W/Exc Accessory Tarsl Navclr (28238) |
— |
$16,288.69 |
— |
| Realignment extensor tendon hand each tendon (26437) |
— |
$16,288.69 |
— |
| Realignment of knee (27457) |
— |
$16,288.69 |
— |
| Reconstruct elbow med ligmnt (24346) |
— |
$16,288.69 |
— |
| Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell,… (27422) |
— |
$16,288.69 |
— |
| Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate… (26502) |
— |
$16,288.69 |
— |
| Release of shoulder ligament (23415) |
— |
$16,288.69 |
— |
| Relieve Pressure on Nerve(S) (64722) |
— |
$16,288.69 |
— |
| Removal Foreign Body Deep Thigh/Knee (27372) |
— |
$16,288.69 |
— |
| Removal Foreign Body Foot Complicated (28193) |
— |
$16,288.69 |
— |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
— |
$16,288.69 |
— |
| Removal foreign body upper arm/elbow deep (24201) |
— |
$16,288.69 |
— |
| Removal Implant Deep (20680) |
— |
$16,288.69 |
— |
| Removal Implant Superficial Separate Procedure (20670) |
— |
$16,288.69 |
— |
| Removal of bone lesion (23140) |
— |
$16,288.69 |
— |
| Removal of heel spur (28119) |
— |
$16,288.69 |
— |
| Removal of hip prosthesis; (separate procedure) Facility (27090) |
— |
$16,288.69 |
— |
| Removal of implant from finger or hand (26320) |
— |
$16,288.69 |
— |
| Removal of nail bed (11750) |
— |
$16,288.69 |
— |
| Removal of posterior segmental instrumentation Facility (22852) |
— |
$16,288.69 |
— |
| Removal of sesamoid bone (28315) |
— |
$16,288.69 |
— |
| Removal of wrist bone (25210) |
— |
$16,288.69 |
— |
| Removal, under anesthesia, of external fixation system (20694) |
— |
$16,288.69 |
— |
| Remove Ankle Joint Lining (27626) |
— |
$16,288.69 |
— |
| Remove drug implant device (11982) |
— |
$16,288.69 |
— |
| Remove elbow lesion (24120) |
— |
$16,288.69 |
— |
| Remove Forearm Foreign Body (25248) |
— |
$16,288.69 |
— |
| Remove lamina/facets lumbar (63012) |
— |
$16,288.69 |
— |
| Remove Lower Leg Bone Lesion (27635) |
— |
$16,288.69 |
— |
| Remove Skin Nerve Lesion (64774) |
— |
$16,288.69 |
— |
| Remove spine eltrd plate (63662) |
— |
$16,288.69 |
— |
| Remove spine fixation device (22850) |
— |
$16,288.69 |
— |
| Remove Tendon Sheath Lesion (26160) |
— |
$16,288.69 |
— |
| Remove/graft finger lesion (26215) |
— |
$16,288.69 |
— |
| Remove/graft leg bone lesion (27637) |
— |
$16,288.69 |
— |
| Remove/Insert Drug Implant (11983) |
— |
$16,288.69 |
— |
| Repair Achilles Tendon (27650) |
— |
$16,288.69 |
— |
| Repair arm/leg nerve (64857) |
— |
$16,288.69 |
— |
| Repair Collat Ankle Ligmnt,Secondary (27698) |
— |
$16,288.69 |
— |
| Repair extensor tendon finger w/o graft each (26418) |
— |
$16,288.69 |
— |
| Repair Extensor Tendon Hand W/Graft Each (26412) |
— |
$16,288.69 |
— |
| Repair Finger Tendon (26433) |
— |
$16,288.69 |
— |
| Repair Finger/Hand Tendon (26350) |
— |
$16,288.69 |
— |
| Repair Flexor Tendon Leg Primary W/O Graft Each (27658) |
— |
$16,288.69 |
— |
| Repair Foot Dislocation (28615) |
— |
$16,288.69 |
— |
| Repair Forearm Tendon Sheath (25275) |
— |
$16,288.69 |
— |
| Repair Hallux Rigidus (28289) |
— |
$16,288.69 |
— |
| Repair Hand Joint (26540) |
— |
$16,288.69 |
— |
| Repair Hand Tendon (26410) |
— |
$16,288.69 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
— |
$386.32 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
— |
$470.01 |
— |
| Repair Nonunion/Malunion Tarsal Bones (28320) |
— |
$16,288.69 |
— |
| Repair of biceps tendon (24340) |
— |
$16,288.69 |
— |
| Repair of metatarsals (28322) |
— |
$16,288.69 |
— |
Repair of nail bed (11760)
range across 2 matching MRF lines |
— |
$251.11–$16,288.69 |
— |
| Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft) Facility (25405) |
— |
$16,288.69 |
— |
| Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique) Facility (25400) |
— |
$16,288.69 |
— |
| Repair of Ruptured Tendon (24342) |
— |
$16,288.69 |
— |
| Repair of shoulder (23420) |
— |
$16,288.69 |
— |
| Repair Rotator Cuff Chronic (23412) |
— |
$16,288.69 |
— |
| Repair secondary achilles tendon w/wo graft (27654) |
— |
$16,288.69 |
— |
| Repair shoulder capsule (23462) |
— |
$16,288.69 |
— |
| Repair Tendon Extensor Foot 1/2 Each Tendon (28208) |
— |
$16,288.69 |
— |
| Repair Tendon/Muscle Upper Arm/Elbow Ea (24341) |
— |
$16,288.69 |
— |
| Repair, extensor tendon, leg; secondary, with or without graft, each tendon Facility (27665) |
— |
$16,288.69 |
— |
| Repair, primary, disrupted ligament, ankle; collateral (27695) |
— |
$16,288.69 |
— |
| Repair, primary, torn ligament and/or capsule, knee; collateral (27405) |
— |
$16,288.69 |
— |
| Repair/graft achilles tendon (27652) |
— |
$16,288.69 |
— |
| Repair/Graft Wrist Bone (25440) |
— |
$16,288.69 |
— |
| Repair/Revise Wrist Joint (25320) |
— |
$16,288.69 |
— |
| Replace elbow joint (24363) |
— |
$16,288.69 |
— |
| Repr elbow lat ligmnt w/tiss (24343) |
— |
$16,288.69 |
— |
| Repr Elbw Med Ligmnt W/Tiss (24345) |
— |
$16,288.69 |
— |
| Rev/rmv prph sac/gstr npg/r (64595) |
— |
$16,288.69 |
— |
| Revis reconst shoulder joint (23473) |
— |
$16,288.69 |
— |
| Revis shoulder arthrplsty humeral&glenoid compnt (23474) |
— |
$16,288.69 |
— |
| Revise Hand/Foot Nerve (64704) |
— |
$16,288.69 |
— |
| Revise knuckle joint (26530) |
— |
$16,288.69 |
— |
| Revise lower leg tendon (27690) |
— |
$16,288.69 |
— |
| Revise Lower Leg Tendons (27686) |
— |
$16,288.69 |
— |
| Revise ulnar nerve at wrist (64719) |
— |
$16,288.69 |
— |
| Revise/Implant Finger Joint (26536) |
— |
$16,288.69 |
— |
| Revise/Repair Finger/Toe Nerve (64702) |
— |
$16,288.69 |
— |
| Revision of big toe (28310) |
— |
$16,288.69 |
— |
| Revision of foot (28116) |
— |
$16,288.69 |
— |
| Revision of knee joint (27442) |
— |
$16,288.69 |
— |
| Revision of lower leg tendon (27685) |
— |
$16,288.69 |
— |
| Revj incl rplcmt nstim eltrd prq ra incl fluor (63663) |
— |
$16,288.69 |
— |
| Revj tot hip arthrp bth w/wo agrft/algrft (27134) |
— |
$16,288.69 |
— |
| Revj Tot Knee Arthrp Fem&Entire Tibial Compone (27487) |
— |
$16,288.69 |
— |
| Revj Total Knee Arthrp W/WO Algrft 1 Component (27486) |
— |
$16,288.69 |
— |
| Revj/Rmvl Impl Spi Npg/Rcvr Dtch Connj Eltrd Ra (63688) |
— |
$16,288.69 |
— |
| Revj/rmvl peripheral neurostimulator electrode (64585) |
— |
$16,288.69 |
— |
| Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) |
— |
$16,288.69 |
— |
| Rmvl spinal nstim eltrd prq array incl fluor (63661) |
— |
$16,288.69 |
— |
| Rpr Disloc Peroneal Tendon W/O Fibular Osteotomy (27675) |
— |
$16,288.69 |
— |
| Rpr Extensor Tendon Leg Primary W/O Graft Each (27664) |
— |
$16,288.69 |
— |
| Rpr flexor tendon leg secondary w/o graft each (27659) |
— |
$16,288.69 |
— |
| Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms (27696) |
— |
$16,288.69 |
— |
| Rpr Tdn Flxr Foot 1/2 W/O Free Grafg Each Tendon (28200) |
— |
$16,288.69 |
— |
| Rpr Tendon Flxr Foot Sec W/Free Graft Ea Tendon (28202) |
— |
$16,288.69 |
— |
| Rpr/Advmnt Flxr Tdn N/Z/2 W/Fr Graft Ea Tendon (26352) |
— |
$16,288.69 |
— |
| Rpr/advmnt flxr tdn zone 2 w/fr graft ea tendon (26358) |
— |
$16,288.69 |
— |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) |
— |
$16,288.69 |
— |
| Rpr/advmnt tdn w/ntc supfcis tdn prim ea tdn (26370) |
— |
$16,288.69 |
— |
Shoulder arthroscopy diagnostic (29805)
range across 2 matching MRF lines |
— |
$5,055.50–$16,288.69 |
— |
| Shoulder Arthroscopy/Surgery (29825) |
— |
$16,288.69 |
— |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
— |
$270.41 |
— |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
— |
$276.85 |
— |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
— |
$251.11 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$263.97 |
— |
| Skin sub graft face/nk/hf/g (15275) |
— |
$16,288.69 |
— |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
— |
$257.55 |
— |
| Strapping ankle (29540) |
— |
$142.30 |
— |
| Strapping elbow or wrist (29260) |
— |
$148.91 |
— |
| Strapping hand/finger (29280) |
— |
$215.89 |
— |
| Strapping knee (29530) |
— |
$153.81 |
— |
| Strapping shoulder (29240) |
— |
$183.06 |
— |
| Suture digital nerve hand/foot 1 nerve (64831) |
— |
$16,288.69 |
— |
| Suture infrapatellar tendon primary (27380) |
— |
$16,288.69 |
— |
| Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft Facility (27381) |
— |
$16,288.69 |
— |
| Suture of quadriceps or hamstring muscle rupture primary (27385) |
— |
$16,288.69 |
— |
| Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft Facility (27386) |
— |
$16,288.69 |
— |
| Tendon transfer with graft (26492) |
— |
$16,288.69 |
— |
| Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon Facility (25310) |
— |
$16,288.69 |
— |
| Tenodesis distal joint each (26474) |
— |
$16,288.69 |
— |
| Tenodesis long tendon biceps (23430) |
— |
$16,288.69 |
— |
| Tenolysis flexor foot single tendon (28220) |
— |
$16,288.69 |
— |
| Tenolysis flexor tendon palm/finger each tendon (26440) |
— |
$16,288.69 |
— |
| Tenolysis flxr/xtnsr tendon leg&/ankle 1 each (27680) |
— |
$16,288.69 |
— |
| Tenolysis, extensor tendon, hand or finger, each tendon (26445) |
— |
$16,288.69 |
— |
| Tenotomy Percutaneous Toe Single Tendon (28010) |
— |
$16,288.69 |
— |
| Tenotomy Prq Achilles Tendon Spx General Anes (27606) |
— |
$16,288.69 |
— |
| Tenotomy shoulder area single tendon (23405) |
— |
$16,288.69 |
— |
| Thermal dstrj intraosseous bvn 1st 2 lmbr/sac (64628) |
— |
$16,288.69 |
— |
| Tibial Arthroscopy/Surgery (29855) |
— |
$16,288.69 |
— |
| Tnot elbow lateral/medial debride open (24358) |
— |
$16,288.69 |
— |
| Tnot elbow lateral/medial debride open tdn rpr (24359) |
— |
$16,288.69 |
— |
| Total Knee Arthroplasty (27447) |
— |
$16,288.69 |
— |
| Transection/Avulsion Oth Spinal Nrv Xdrl (64772) |
— |
$16,288.69 |
— |
| Transfer/transplant tendon palmar w/o graft each (26485) |
— |
$16,288.69 |
— |
| Transplant hand tendon (26480) |
— |
$16,288.69 |
— |
| Transplant/graft hand tendon (26483) |
— |
$16,288.69 |
— |
| Treat ankle fracture (28445) |
— |
$16,288.69 |
— |
| Treat Big Toe Fracture (28505) |
— |
$16,288.69 |
— |
| Treat dislocation/fracture (23670) |
— |
$16,288.69 |
— |
| Treat elbow fracture (24586) |
— |
$16,288.69 |
— |
| Treat Finger Fracture Each (26727) |
— |
$16,288.69 |
— |
| Treat fracture radius/ulna (25575) |
— |
$16,288.69 |
— |
| Treat Fx Rad Extra-Articul (25607) |
— |
$16,288.69 |
— |
| Treat kneecap dislocation (27566) |
— |
$16,288.69 |
— |
| Treat Kneecap Fracture (27524) |
— |
$16,288.69 |
— |
| Treat lower leg bone lesion (27607) |
— |
$16,288.69 |
— |
| Treat scapula fracture (23585) |
— |
$16,288.69 |
— |
| Treat thumb fracture (26665) |
— |
$16,288.69 |
— |
| Treatment closed elbow dislocation w/o anes (24600) |
— |
$611.66 |
— |
| Tx humral shaft fx w/insj imed implt w/w cerclge (24516) |
— |
$16,288.69 |
— |
| Tx open tendon flexor toe 1 tendon spx (28232) |
— |
$16,288.69 |
— |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj (28455) |
— |
$16,288.69 |
— |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) |
— |
$16,288.69 |
— |
| Tx tibl shft fx imed implt w/wo screws&/cercla (27759) |
— |
$16,288.69 |
— |
| Unlisted procedure arthroscopy (29999) |
— |
$16,288.69 |
— |
| Unlisted procedure femur or knee (27599) |
— |
$16,288.69 |
— |
| Unlisted procedure foot or toes (28899) |
— |
$16,288.69 |
— |
| Unlisted procedure forearm or wrist (25999) |
— |
$16,288.69 |
— |
| Unlisted procedure humerus/elbow (24999) |
— |
$16,288.69 |
— |
| Unlisted Procedure Leg/Ankle (27899) |
— |
$16,288.69 |
— |
| Unlisted Procedure Muscskeletal System General (20999) |
— |
$16,288.69 |
— |
| Unlisted procedure nervous system (64999) |
— |
$16,288.69 |
— |
| Unlisted procedure pelvis/hip joint (27299) |
— |
$16,288.69 |
— |
| Wrist arthroscopy (29840) |
— |
$16,288.69 |
— |
| Wrist arthroscopy with partial removal of joint lining (29844) |
— |
$16,288.69 |
— |
| Xfer Single Deep Low Leg Tendon (27691) |
— |
$16,288.69 |
— |