| Amputation toe interphalangeal joint (28825) |
$6,885 |
$6,885 |
2.0× |
| Amputation toe metatarsophalangeal joint (28820) |
$6,885 |
$6,885 |
2.0× |
| Ankle Arthroscopy/Surgery (29892) |
$15,155 |
$15,155 |
2.0× |
| Anterior colporraphy rpr cystocele w/cysto (57240) |
$10,475 |
$10,475 |
2.0× |
| Anterior Tibial Tubercleplasty (27418) |
$15,155 |
$15,155 |
2.0× |
| Aqueous Shunt Extraoc Equat Plate Rsvr W/Graft (66180) |
$10,935 |
$10,935 |
2.0× |
| Arthrd Ant Interbody Decompress Cervical Belw C2 (22551) |
$36,875 |
$36,875 |
2.8× |
| Arthrd midtarsl/tarsometatarsal mult/transvrs (28730) |
$27,300 |
$27,300 |
2.0× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$1,165 |
$1,165 |
3.7× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$1,860 |
$1,860 |
5.8× |
| Arthrodesis ankle open (27870) |
$27,300 |
$27,300 |
2.0× |
| Arthrodesis great toe metatarsophalangeal joint (28750) |
$15,155 |
$15,155 |
2.0× |
| Arthrodesis subtalar (28725) |
$27,300 |
$27,300 |
2.0× |
| Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, Sauve-Kapandji… (25830) |
$15,415 |
$15,415 |
2.0× |
| Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft) Facility (25810) |
$27,300 |
$27,300 |
2.0× |
| Arthroplasty Ankle W/Implant (27702) |
$24,855 |
$24,855 |
0.9× |
| Arthroplasty glenohumeral joint total shoulder (23472) |
$24,560 |
$24,560 |
1.3× |
| Arthroplasty Glenohumrl Jt Hemiarthroplasty (23470) |
$27,300 |
$27,300 |
2.0× |
| Arthroplasty interposition intercarpal or carpometacarpal joints (25447) |
$7,450 |
$7,450 |
2.2× |
| Arthroplasty Radial Head W/Implant (24366) |
$27,300 |
$27,300 |
2.0× |
| Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without… (29851) |
$11,355 |
$11,355 |
6.8× |
| Arthroscopy Ankle Surgical Debridement Extensive (29898) |
$6,855 |
$6,855 |
2.0× |
| Arthroscopy Ankle Surgical Debridement Limited (29897) |
$8,210 |
$8,210 |
2.4× |
| Arthroscopy Elbow Surgical Debridement Extensive (29838) |
$6,995 |
$6,995 |
2.1× |
| Arthroscopy hip w/femoroplasty (29914) |
$15,155 |
$15,155 |
2.0× |
| Arthroscopy Knee Synovectomy 2/>Compartments (29876) |
$7,175 |
$7,175 |
2.1× |
| Arthroscopy knee synovectomy limited spx (29875) |
$6,770 |
$6,770 |
2.0× |
| Arthroscopy knee w/lysis adhesions w/wo manj spx (29884) |
$6,955 |
$6,955 |
2.0× |
| Arthroscopy shoulder distal claviculectomy (29824) |
$10,325 |
$10,325 |
3.0× |
| Arthroscopy shoulder surgical capsulorrhaphy (29806) |
$15,155 |
$15,155 |
2.0× |
| Arthroscopy, elbow, surgical; with removal of loose body or foreign body Facility (29834) |
$6,885 |
$6,885 |
2.0× |
| Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty,… (29862) |
$15,155 |
$15,155 |
2.0× |
| Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograftºs»)… (29866) |
$15,155 |
$15,155 |
2.0× |
| Arthroscopy, knee, surgical; with lateral release (29873) |
$6,855 |
$6,855 |
2.0× |
| Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) Facility (29883) |
$7,120 |
$7,120 |
2.1× |
| Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) |
$7,005 |
$7,005 |
2.1× |
| Arthroscopy, shoulder, surgical; biceps tenodesis (29828) |
$15,155 |
$15,155 |
2.0× |
| Arthroscopy, shoulder, surgical; debridement, extensive (29823) |
$10,320 |
$10,320 |
3.0× |
| Arthroscopy, shoulder, surgical; debridement, limited (29822) |
$7,170 |
$7,170 |
2.1× |
| Arthroscopy, shoulder, surgical; repair of slap lesion (29807) |
$15,155 |
$15,155 |
2.0× |
| Arthroscopy, shoulder, surgical; with removal of loose body or foreign body (29819) |
$10,135 |
$10,135 |
3.0× |
| Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) |
$15,155 |
$15,155 |
2.0× |
| Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement Facility (29846) |
$6,715 |
$6,715 |
2.0× |
| Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft (27130) |
$27,300 |
$27,300 |
2.0× |
| Arthrp Knee Condyle&Plateau Medial/Lat Cmprt (27446) |
$27,300 |
$27,300 |
2.0× |
| Arthrs aided ant cruciate ligm rpr/agmntj/rcnstj (29888) |
$17,280 |
$17,280 |
2.3× |
| Arthrs Aided Pst Cruciate Ligm Rpr/Agmntj/Rcnstj (29889) |
$27,300 |
$27,300 |
2.0× |
| Arthrs Ankle Exc Ostchndrl Dfct W/Drlg Dfct (29891) |
$10,485 |
$10,485 |
3.1× |
| Arthrs Knee Abrasion Arthrp/Mlt Drlg/Microfx (29879) |
$6,970 |
$6,970 |
2.1× |
| Arthrs knee debridement/shaving artclr crtlg (29877) |
$6,900 |
$6,900 |
2.0× |
| Arthrs Knee Drlg Osteochond Dissecans Int Fixj (29887) |
$15,155 |
$15,155 |
2.0× |
| Arthrs Knee W/Meniscectomy Med&Lat W/Shaving (29880) |
$6,725 |
$6,725 |
2.0× |
| Arthrt ankle w/expl w/wo bx w/wo rmvl loose/fb (27620) |
$6,910 |
$6,910 |
2.0× |
| Arthrt w/expl drg/rmvl loose/fb mttarphlngl jt (28022) |
$6,885 |
$6,885 |
2.0× |
| Aspiration/Release Vitreous Subretinal/Choroidal (67015) |
$7,800 |
$7,800 |
3.3× |
| Autologous Chondrocyte Implantation Knee (27412) |
$21,100 |
$21,100 |
2.8× |
| Biopsy of conjunctiva (68100) |
$4,415 |
$4,415 |
1.8× |
| Biopsy of lacrimal gland (68510) |
$2,890 |
$2,890 |
1.2× |
| Biopsy Vulva/Perineum 1 Lesion Spx (56605) |
$2,880 |
$2,880 |
3.0× |
| Blepharoplasty upper eyelid (15822) |
$5,455 |
$5,455 |
2.5× |
| Blepharoplasty Upper Eyelid W/Excessive Skin (15823) |
$4,105 |
$4,105 |
1.9× |
| Blood Transfusion Service (36430) |
$1,430 |
$1,430 |
3.1× |
| Bone Graft Any Donor Area Minor/Small (20900) |
$15,155 |
$15,155 |
2.0× |
| Breast Reduction (19318) |
$13,840 |
$13,840 |
2.0× |
| Bx Cervix (57500) |
$1,845 |
$1,845 |
1.9× |
| Bx/exc lymph node open deep axillary node (38525) |
$8,300 |
$8,300 |
2.0× |
| Carpal Tunnel Surgery (64721) |
$4,000 |
$4,000 |
2.0× |
| Carpectomy All Bones Proximal Row (25215) |
$6,885 |
$6,885 |
2.0× |
| Cataract surgery complex (66982) |
$5,270 |
$5,270 |
2.2× |
| Cerv artific diskectomy (22856) |
$39,020 |
$39,020 |
2.1× |
| Ciliary body dstrj cyclophotocoag transsceral (66710) |
$3,980 |
$3,980 |
1.6× |
| Circumcision 28 days or older (54161) |
$6,100 |
$6,100 |
2.8× |
| Cjp Rcnstj Cul-De-Sac Buccal Grf/Xtnsv Rearrgmt (68326) |
$5,600 |
$5,600 |
1.4× |
| Claviculectomy partial (23120) |
$9,495 |
$9,495 |
2.8× |
| Closed Rx Metacarpal Fx,Percut (26608) |
$6,885 |
$6,885 |
2.0× |
| Closed Tx Nasal Bone Fx W/Mnpj W/Stabilization (21320) |
$6,880 |
$6,880 |
2.0× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
$3,395 |
$3,395 |
2.0× |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
$3,395 |
$3,395 |
2.0× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$3,990 |
$3,990 |
2.4× |
| Cltx Rdl Shft Fx&Cltx Dislc Dstl Rad/Uln Jt (25520) |
$3,395 |
$3,395 |
2.0× |
| Collection of venous blood by venipuncture (36415) |
$15 |
$15 |
1.6× |
| Colpopexy extraperitoneal (57282) |
$15,690 |
$15,690 |
2.0× |
| Colporrhaphy (57200) |
$6,745 |
$6,745 |
2.0× |
| Combined anteroposterior colporrhaphy; (57260) |
$10,475 |
$10,475 |
2.0× |
| Complex drainage wound (10180) |
$6,070 |
$6,070 |
2.0× |
| Conization cervix w/wo d&c rpr eltrd exc (57522) |
$6,745 |
$6,745 |
2.0× |
| Conjunctivoplasty w/grf/xtnsv rearrangement (68320) |
$4,690 |
$4,690 |
1.9× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$1,395 |
$1,395 |
10.1× |
| Conv prev hip tot hip arthrp w/wo agrft/algrft (27132) |
$23,915 |
$23,915 |
1.8× |
| Correction hammertoe (28285) |
$6,885 |
$6,885 |
2.0× |
| Corrj hallux valgus w/sesmdc w/dist metar osteot (28296) |
$6,860 |
$6,860 |
2.0× |
| Corrj Hlx Vlgs Bncty Sesmdc Joint Arthrodesis (28297) |
$7,780 |
$7,780 |
0.6× |
| Corrj Hlx Vlgs Bncty Sesmdc Prox Phlx Osteot (28298) |
$15,155 |
$15,155 |
2.0× |
| Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base (28292) |
$6,885 |
$6,885 |
2.0× |
| Create Tear Sac-Nasal Fistula (68720) |
$5,460 |
$5,460 |
1.3× |
| Cysto w/insert ureteral stent (52332) |
$7,320 |
$7,320 |
2.0× |
| Cysto w/removal of tumors small (52234) |
$7,320 |
$7,320 |
2.0× |
| Cysto W/Simple Removal Stone & Stent (52310) |
$5,210 |
$5,210 |
2.4× |
| Cysto w/ureteroscopy w/lithotripsy (52353) |
$14,200 |
$14,200 |
2.6× |
| Cysto w/ureteroscopy w/rmvl/manj stones (52352) |
$7,320 |
$7,320 |
2.0× |
| Cysto W/Urtroscopy&/Pyeloscopy Dx (52351) |
$7,320 |
$7,320 |
2.0× |
| Cysto/uretero w/lithotripsy (52356) |
$10,785 |
$10,785 |
1.9× |
| Cystoscopy and radiotracer (52250) |
$7,320 |
$7,320 |
2.0× |
| Cystourethroscopy inj chemodenervation bladder (52287) |
$4,770 |
$4,770 |
2.2× |
| Cystourethroscopy W/Dest &/Rmvl Med Bladder Tum (52235) |
$7,320 |
$7,320 |
2.0× |
| Cystourethroscopy W/Dest &/Rmvl Tumor Large (52240) |
$10,785 |
$10,785 |
1.9× |
| Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral Facility (52290) |
$6,590 |
$6,590 |
3.0× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$1,390 |
$1,390 |
3.3× |
| Decompress Spinal Cord Lmbr (63056) |
$11,450 |
$11,450 |
1.5× |
| Dilation & curettage dx&/ther nonobstetric (58120) |
$6,745 |
$6,745 |
2.0× |
| Drainage of eye (65800) |
$4,430 |
$4,430 |
1.8× |
| Drainage of hematoma/fluid (10140) |
$3,435 |
$3,435 |
2.0× |
| Dstrj lesion penis simple laser (54057) |
$3,885 |
$3,885 |
1.8× |
| Evacuate mole of uterus (59870) |
$7,000 |
$7,000 |
2.1× |
| Ex tum/vasc malf sft tiss hand/fngr subq 1.5cm/> (26111) |
$4,355 |
$4,355 |
2.5× |
| Exc abdl tum deep 5 cm/> (22901) |
$6,185 |
$6,185 |
2.1× |
| Exc arm/elbow les sc < 3 cm (24075) |
$3,435 |
$3,435 |
2.0× |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) |
$3,765 |
$3,765 |
5.1× |
| Exc Breast Les Preop Plmt Rad Marker Open 1 Les (19125) |
$8,125 |
$8,125 |
2.0× |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) |
$3,505 |
$3,505 |
4.8× |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) |
$3,960 |
$3,960 |
2.3× |
| Exc hydrocele sprmatic cord uni spx (55500) |
$7,320 |
$7,320 |
2.0× |
| Exc Lesion Eyelid W/O Clsr/W/Simple Dir Closure (67840) |
$4,025 |
$4,025 |
3.9× |
| Exc Lesion Tendon Sheath/Capsule W/Synvct Foot (28090) |
$5,415 |
$5,415 |
3.2× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
$3,805 |
$3,805 |
5.2× |
| Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) |
$3,980 |
$3,980 |
2.3× |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
$6,190 |
$6,190 |
3.6× |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) |
$1,390 |
$1,390 |
3.3× |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) |
$3,715 |
$3,715 |
5.1× |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) |
$3,440 |
$3,440 |
2.0× |
| Exc tumor soft tis neck/ant thorax subq 3 cm/> (21552) |
$6,225 |
$6,225 |
2.1× |
| Exc tumor soft tissue neck/ant thorax subq <3cm (21555) |
$6,105 |
$6,105 |
3.6× |
| Exc Varicocele/Ligation Spermatic Veins Spx (55530) |
$7,320 |
$7,320 |
2.0× |
| Exchange Intraocular Lens (66986) |
$5,645 |
$5,645 |
2.4× |
| Excise intraspinal lesion (63267) |
$11,045 |
$11,045 |
1.5× |
| Excision Distal Ulna Partial/Complete (25240) |
$6,885 |
$6,885 |
2.0× |
| Excision Excessive Skin & Subq Tissue Other Area (15839) |
$6,070 |
$6,070 |
2.0× |
| Excision H/P/P/U Simple/Intermediate Repair (11470) |
$6,070 |
$6,070 |
2.0× |
| Excision Lesion Conjunctiva </1 Cm (68110) |
$3,770 |
$3,770 |
1.5× |
| Excision Lesion Cornea Xcp Pterygium (65400) |
$3,190 |
$3,190 |
3.1× |
| Excision lesion meniscus/capsule knee (27347) |
$6,885 |
$6,885 |
2.0× |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) |
$2,600 |
$2,600 |
6.2× |
| Excision of bartholin's gland or cyst (56740) |
$6,745 |
$6,745 |
2.0× |
| Excision of ganglion, wrist (dorsal or volar); primary (25111) |
$4,220 |
$4,220 |
2.5× |
| Excision of hydrocele; unilateral (55040) |
$7,275 |
$7,275 |
2.0× |
| Excision of pilonidal cyst or sinus; simple (11770) |
$6,070 |
$6,070 |
2.0× |
| Excision of vaginal cyst or tumor (57135) |
$6,745 |
$6,745 |
2.0× |
| Excision olecranon bursa (24105) |
$6,885 |
$6,885 |
2.0× |
| Excision or curettage of bone cyst or benign tumor of femur; (27355) |
$6,885 |
$6,885 |
2.0× |
| Excision Pilonidal Cyst/Sinus Complicated (11772) |
$6,240 |
$6,240 |
2.1× |
| Excision prepatellar bursa (27340) |
$6,885 |
$6,885 |
2.0× |
| Excision Skin Abd Infraumbilical Panniculectomy (15830) |
$13,840 |
$13,840 |
2.0× |
| Excision spermatocele w/wo epididymectomy (54840) |
$6,100 |
$6,100 |
2.8× |
| Excision tumor soft tis foot/toe subq 1.5 cm/> (28039) |
$6,070 |
$6,070 |
2.0× |
| Excision, interdigital (morton) neuroma, single, each (28080) |
$5,550 |
$5,550 |
3.3× |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater (22903) |
$6,070 |
$6,070 |
2.0× |
| Excision/Transposition Pterygium W/Grafg (65426) |
$4,965 |
$4,965 |
2.0× |
| Exploration of knee joint (27310) |
$7,850 |
$7,850 |
2.3× |
| Exploration of spinal fusion (22830) |
$6,415 |
$6,415 |
0.9× |
| Exploration penetrating wound spx extremity (20103) |
$3,435 |
$3,435 |
2.0× |
| Extraction of lens (66940) |
$4,810 |
$4,810 |
2.0× |
| Eye Surg Ant Sgmt Proc Unlisted (66999) |
$5,255 |
$5,255 |
2.2× |
| Fasciectomy Palm Only (26121) |
$6,885 |
$6,885 |
2.0× |
| Fasciotomy Iliotibial Open (27305) |
$6,885 |
$6,885 |
2.0× |
| Fasciotomy, foot and/or toe (28008) |
$6,885 |
$6,885 |
2.0× |
| Fasct prtl palmar 1 dgt prox iphal jt w/wo rpr (26123) |
$6,885 |
$6,885 |
2.0× |
| Fstlj Sclera Glaucoma Trabeculect Ab Externo (66170) |
$5,155 |
$5,155 |
2.2× |
| Fstlj Sclera Glc Trbec Ab Externo Scarring (66172) |
$5,375 |
$5,375 |
2.2× |
| Fth/Gft Free W/Direct Closure N/E/E/L 20 Sq Cm/< (15260) |
$4,630 |
$4,630 |
2.2× |
| Fusion of foot bones (28740) |
$15,155 |
$15,155 |
2.0× |
| Fusion of knuckle (26850) |
$15,155 |
$15,155 |
2.0× |
| Fusion of knuckle joint (26516) |
$6,885 |
$6,885 |
2.0× |
| Gastrocnemius recession (27687) |
$6,735 |
$6,735 |
2.0× |
| Goniotomy (65820) |
$9,220 |
$9,220 |
2.1× |
| Hip arthro w/labral repair (29916) |
$15,155 |
$15,155 |
2.0× |
| Hysteroscopy Biopsy (58558) |
$6,745 |
$6,745 |
2.0× |
| Hysteroscopy Endometrial Ablation (58563) |
$11,410 |
$11,410 |
2.2× |
| Hysteroscopy Removal Impacted Foreign Body (58562) |
$6,745 |
$6,745 |
2.0× |
| Hysteroscopy, surgical; with removal of leiomyomata (58561) |
$10,285 |
$10,285 |
2.0× |
| I&d abscess simple (10060) |
$2,110 |
$2,110 |
10.1× |
| I&d pelvis/hip jt area deep abscess/hematoma (26990) |
$6,885 |
$6,885 |
2.0× |
| Immediate breast prosthesis (19340) |
$13,840 |
$13,840 |
1.6× |
| Implant Neuroelectrodes (64561) |
$8,180 |
$8,180 |
1.2× |
| Implant Periph/Gastric Neurostim/Receiver (64590) |
$19,805 |
$19,805 |
1.0× |
| Incise finger tendon sheath (26055) |
$3,360 |
$3,360 |
2.0× |
| Incision & drainage abscess complicated/multiple (10061) |
$2,835 |
$2,835 |
6.7× |
| Incision and drainage of vulva or perineal abscess (56405) |
$2,920 |
$2,920 |
9.2× |
| Incision extensor tendon sheath wrist (25000) |
$4,490 |
$4,490 |
2.7× |
| Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) |
$1,345 |
$1,345 |
1.8× |
| Injection, anesthetic agent; brachial plexus, single (64415) |
$2,165 |
$2,165 |
2.4× |
| Injection, anesthetic agent; femoral nerve, single (64447) |
$1,315 |
$1,315 |
1.8× |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) |
$1,710 |
$1,710 |
2.3× |
| Injx anterior chamber eye air/liquid spx (66020) |
$4,345 |
$4,345 |
1.8× |
| Insert Anter Drainage Dev W/O Extraoc Reservoir (66183) |
$8,940 |
$8,940 |
2.1× |
| Insert multi-comp penis pros (54405) |
$13,335 |
$13,335 |
0.6× |
| Insert tunneled cv cath (36561) |
$6,680 |
$6,680 |
2.0× |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) |
$4,350 |
$4,350 |
2.7× |
| Insj/rplcmt breast implant sep day mastectomy (19342) |
$8,530 |
$8,530 |
1.0× |
| Insj/Rplcmt Defib W/Lead(S) (33249) |
$17,810 |
$17,810 |
0.5× |
| Keratoplasty (corneal transplant); endothelial (65756) |
$9,170 |
$9,170 |
2.1× |
| Keratoplasty Pentrg Except Aphakia/Pseudophakia (65730) |
$9,260 |
$9,260 |
2.2× |
| Knee Arthroscopy/Surgery (29885) |
$15,155 |
$15,155 |
2.0× |
| Knee Arthroscopy/Surgery (29874) |
$6,695 |
$6,695 |
2.0× |
| Lam facetec & foramot lumbar (63047) |
$11,085 |
$11,085 |
1.5× |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63045) |
$11,270 |
$11,270 |
1.5× |
| Laminotomy Single Lumbar (63042) |
$11,370 |
$11,370 |
1.5× |
| Lap paraesoph her rpr w/mesh (43282) |
$22,090 |
$22,090 |
2.0× |
| Laparo new ureter/bladder (50947) |
$22,090 |
$22,090 |
2.0× |
| Laparo-vag hyst incl t/o (58552) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopic myomectomy (58545) |
$12,380 |
$12,380 |
2.0× |
| Laparoscopy fulguration oviducts (58670) |
$12,380 |
$12,380 |
2.0× |
| Laparoscopy Surg Rpr Initial Inguinal Hernia (49650) |
$12,380 |
$12,380 |
2.0× |
| Laparoscopy tot hysterectomy >250 g w/tube/ovar (58573) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopy w tot hysterectuterus <=250 gram w tube/ovary (58571) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopy W/Lysis Of Adhesions (58660) |
$12,380 |
$12,380 |
2.0× |
| Laparoscopy w/rmvl adnexal structures (58661) |
$12,380 |
$12,380 |
2.0× |
| Laparoscopy, surgical, appendectomy (44970) |
$12,380 |
$12,380 |
2.0× |
| Laparoscopy, surgical, colpopexy (suspension of vaginal apex) (57425) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures) (43280) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight… (58546) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; (58570) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopy, surgical; cholecystectomy with cholangiography (47563) |
$13,905 |
$13,905 |
2.2× |
| Laparoscopy, surgical; pyeloplasty (50544) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopy, surgical; repair recurrent inguinal hernia (49651) |
$12,380 |
$12,380 |
2.0× |
| Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy Facility (38571) |
$22,090 |
$22,090 |
2.0× |
| Laparoscopy, surgical; with biopsy (single or multiple) (49321) |
$12,380 |
$12,380 |
2.0× |
| Laps abd prtm&omentum dx w/wo spec br/wa spx (49320) |
$12,380 |
$12,380 |
2.0× |
| Laps fulg/exc ovary viscera/peritoneal surface (58662) |
$12,380 |
$12,380 |
2.0× |
| Laps supracrv hysterect 250 gm/< rmvl tube/ovar (58542) |
$22,090 |
$22,090 |
2.0× |
| Laps surg prst8ect smpl stot robotic assistance (55867) |
$22,090 |
$22,090 |
2.0× |
| Laser Surgery,Sever Vitreous Strands (67031) |
$1,200 |
$1,200 |
2.1× |
| Laser treatment of retina (67040) |
$9,690 |
$9,690 |
2.3× |
| Laser vaporization of prostate (52648) |
$12,010 |
$12,010 |
2.2× |
| Late closure of wound (13160) |
$5,020 |
$5,020 |
1.4× |
| Lateral retinacular release open (27425) |
$6,885 |
$6,885 |
2.0× |
| Ligamentous Reconstruction Knee Extra-Articular (27427) |
$16,400 |
$16,400 |
2.2× |
| Litholapaxy smpl/sm <2.5 cm (52317) |
$7,535 |
$7,535 |
2.1× |
| Low Back Disk Surgery (63030) |
$12,405 |
$12,405 |
1.6× |
| Lsh uterus 250 g or less (58541) |
$22,090 |
$22,090 |
2.0× |
| Lumbar spine fusion combined (22633) |
$39,020 |
$39,020 |
1.4× |
| Manipulation knee joint under general anesthesia (27570) |
$3,395 |
$3,395 |
2.0× |
| Manipulation, finger joint, under anesthesia, each joint (26340) |
$3,395 |
$3,395 |
2.0× |
| Mastectomy for gynecomastia (19300) |
$8,125 |
$8,125 |
2.0× |
| Mastectomy partial (19301) |
$8,125 |
$8,125 |
2.0× |
| Mastectomy partial w/axillary lymphadenectomy (19302) |
$13,840 |
$13,840 |
2.0× |
| Mastectomy simple complete (19303) |
$13,840 |
$13,840 |
2.0× |
| Neuroplasty and/or transposition; ulnar nerve at elbow (64718) |
$4,150 |
$4,150 |
2.0× |
| Open biopsy/excision inguinofemoral nodes (38531) |
$8,305 |
$8,305 |
2.0× |
| Open Implantation Nea Sacral Nerve (64581) |
$9,255 |
$9,255 |
1.4× |
| Open Repair of Rotator Cuff Acute (23410) |
$15,155 |
$15,155 |
2.0× |
| Open Treatment Bimalleolar Ankle Fracture (27814) |
$15,155 |
$15,155 |
2.0× |
| Open treatment calcaneal fracture (28415) |
$15,155 |
$15,155 |
2.0× |
| Open treatment fracture distal tibia only (27827) |
$14,605 |
$14,605 |
1.1× |
| Open Treatment Grter Humeral Tuberosity Fracture (23630) |
$15,155 |
$15,155 |
2.0× |
| Open treatment of acromioclavicular dislocation acute or chronic (23550) |
$15,155 |
$15,155 |
2.0× |
| Open treatment of clavicular fracture, includes internal fixation, when performed (23515) |
$15,155 |
$15,155 |
2.0× |
| Open Treatment of Ulnar Shaft Fracture (25545) |
$15,155 |
$15,155 |
2.0× |
| Open Treatment Proximal Fibula/Shaft Fracture (27784) |
$15,155 |
$15,155 |
2.0× |
| Open Treatment Proximal Humeral Fracture (23615) |
$14,940 |
$14,940 |
1.1× |
| Open tx acute shoulder dislocation (23660) |
$15,155 |
$15,155 |
2.0× |
| Open Tx Distal Fibular Fracture Lat Malleolus (27792) |
$15,155 |
$15,155 |
2.0× |
| Open Tx Distal Phalangeal Fracture Each (26765) |
$8,445 |
$8,445 |
2.5× |
| Open Tx Distal Tibiofibular Joint Disruption (27829) |
$15,155 |
$15,155 |
2.0× |
| Open Tx Humeral Epicondylar Fracture (24575) |
$27,300 |
$27,300 |
2.0× |
| Open tx humeral supracondylar fracture w/o xtn (24545) |
$14,200 |
$14,200 |
1.1× |
| Open Tx Metacarpal Fracture Single Ea Bone (26615) |
$8,800 |
$8,800 |
2.6× |
| Open Tx Radial Head/Neck Fracture (24665) |
$15,155 |
$15,155 |
2.0× |
| Open tx ulnar fx proximal end (24685) |
$15,155 |
$15,155 |
2.0× |
| Opponensplasty; hypothenar muscle transfer Facility (26494) |
$6,885 |
$6,885 |
2.0× |
| Optx dstl radl i-artic fx/epiphysl sep 2 frag (25608) |
$15,155 |
$15,155 |
2.0× |
| Optx dstl radl i-artic fx/epiphysl sep 3 frag (25609) |
$15,155 |
$15,155 |
2.0× |
| Orbitotomy w/o bone flap expl w/wo biopsy (67400) |
$5,610 |
$5,610 |
1.4× |
| Orchiectomy radical tumor inguinal approach (54530) |
$7,490 |
$7,490 |
2.0× |
| Ostc prtl exostc/condylc metar head (28288) |
$6,885 |
$6,885 |
2.0× |
| Ostectomy calcaneus (28118) |
$6,885 |
$6,885 |
2.0× |
| Ostectomy Complete Other Metatarsal Head 2/3/4 (28112) |
$6,885 |
$6,885 |
2.0× |
| Ostectomy, complete excision; fifth metatarsal head (28113) |
$6,885 |
$6,885 |
2.0× |
| Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) (28110) |
$6,885 |
$6,885 |
2.0× |
| Osteochondral allograft knee open (27415) |
$27,300 |
$27,300 |
2.0× |
| Osteochondral knee autograft (27416) |
$15,155 |
$15,155 |
2.0× |
| Osteot w/wo lngth shrt/corrj metar xcp 1st ea (28308) |
$6,885 |
$6,885 |
2.0× |
| Osteotomy calcaneus w/wo internal fixation (28300) |
$15,155 |
$15,155 |
2.0× |
| Osteotomy Tibia (27705) |
$15,155 |
$15,155 |
2.0× |
| Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft… (28307) |
$15,155 |
$15,155 |
2.0× |
| Part remv talus or calcaneus (28120) |
$6,885 |
$6,885 |
2.0× |
| Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula Facility (23182) |
$15,155 |
$15,155 |
2.0× |
| Partial hymenectomy or revision of hymenal ring (56700) |
$6,745 |
$6,745 |
2.0× |
| Partical Excision Bone Phalanx Toe (28124) |
$6,885 |
$6,885 |
2.0× |
| Patellectomy or hemipatellectomy (27350) |
$15,155 |
$15,155 |
2.0× |
| Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation Facility (28496) |
$8,415 |
$8,415 |
2.5× |
| Perq skel fixj distal radial fx/epiphysl sep (25606) |
$8,450 |
$8,450 |
2.5× |
| Pin hand dislocation (26676) |
$6,885 |
$6,885 |
2.0× |
| Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy (57250) |
$10,475 |
$10,475 |
2.0× |
| Probe Nasolacrimal Duct W/WO Irrg Insj Tube/Stnt (68815) |
$4,225 |
$4,225 |
1.7× |
| Probe nasolacrimal duct w/wo irrig req gen anes (68811) |
$4,330 |
$4,330 |
1.8× |
| Proph Retinal Dtchmnt W/O Drg Photocoagulation (67145) |
$1,395 |
$1,395 |
2.4× |
| Prq skel fixj femoral fx prox end neck (27235) |
$15,155 |
$15,155 |
2.0× |
| Prtl exc b1 tarsal/metar b1 xcp talus/calcaneus (28122) |
$6,885 |
$6,885 |
2.0× |
| Rcnstj Pst Tibl Tdn W/Exc Accessory Tarsl Navclr (28238) |
$15,155 |
$15,155 |
2.0× |
| Reconstruct elbow lat ligmnt (24344) |
$14,730 |
$14,730 |
2.0× |
| Reconstruct elbow med ligmnt (24346) |
$27,300 |
$27,300 |
2.0× |
| Reconstruct Finger Joint (26548) |
$6,730 |
$6,730 |
2.0× |
| Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell,… (27422) |
$15,155 |
$15,155 |
2.0× |
| Release foot/toe nerve (64726) |
$4,005 |
$4,005 |
2.0× |
| Removal Implant Deep (20680) |
$6,070 |
$6,070 |
2.0× |
| Removal of anterior instrumentation (22855) |
$4,590 |
$4,590 |
0.6× |
| Removal of implanted material, anterior segment of eye (65920) |
$5,310 |
$5,310 |
2.2× |
| Removal of lens material (66852) |
$9,235 |
$9,235 |
2.2× |
| Removal of tendon for graft (20924) |
$15,155 |
$15,155 |
2.0× |
| Removal sweat gland lesion (11450) |
$5,945 |
$5,945 |
2.0× |
| Remove drug implant device (11982) |
$2,280 |
$2,280 |
4.9× |
| Remove eye/attach implant (65105) |
$7,545 |
$7,545 |
1.8× |
| Remove foreign body from eye (65235) |
$4,740 |
$4,740 |
2.0× |
| Remove Intrauterine Device (58301) |
$2,435 |
$2,435 |
7.7× |
| Remove Lower Leg Bone Lesion (27635) |
$6,735 |
$6,735 |
2.0× |
| Remove Tendon Sheath Lesion (26160) |
$4,330 |
$4,330 |
2.6× |
| Repair Achilles Tendon (27650) |
$15,155 |
$15,155 |
2.0× |
| Repair Collat Ankle Ligmnt,Secondary (27698) |
$15,155 |
$15,155 |
2.0× |
| Repair Detached Retina (67101) |
$6,700 |
$6,700 |
2.8× |
| Repair detached retina (67105) |
$4,050 |
$4,050 |
7.1× |
| Repair Ectropion Extensive (67917) |
$5,250 |
$5,250 |
2.1× |
| Repair Entropion Extensive (67924) |
$4,435 |
$4,435 |
1.8× |
| Repair extensor tendon finger w/o graft each (26418) |
$3,375 |
$3,375 |
2.0× |
| Repair Hand Joint (26540) |
$6,885 |
$6,885 |
2.0× |
| Repair inguinal hernia, sliding, any age (49525) |
$8,870 |
$8,870 |
2.4× |
| Repair initial femoral hernia, any age; incarcerated or strangulated (49553) |
$7,490 |
$7,490 |
2.0× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$1,180 |
$1,180 |
2.8× |
| Repair Nonunion/Malunion Tibia W/O Graft (27720) |
$15,155 |
$15,155 |
2.0× |
| Repair of metatarsals (28322) |
$15,155 |
$15,155 |
2.0× |
| Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique) Facility (25400) |
$15,510 |
$15,510 |
2.1× |
| Repair of Ruptured Tendon (24342) |
$15,155 |
$15,155 |
2.0× |
| Repair retinal detach cplx (67113) |
$9,885 |
$9,885 |
1.8× |
| Repair Retinal Detachment Scleral Buckling (67107) |
$9,220 |
$9,220 |
2.1× |
| Repair Rotator Cuff Chronic (23412) |
$15,155 |
$15,155 |
2.0× |
| Repair secondary achilles tendon w/wo graft (27654) |
$15,155 |
$15,155 |
2.0× |
| Repair shoulder capsule (23462) |
$15,975 |
$15,975 |
2.1× |
| Repair Tendon/Muscle Upper Arm/Elbow Ea (24341) |
$15,155 |
$15,155 |
2.0× |
| Repair, primary, disrupted ligament, ankle; collateral (27695) |
$15,155 |
$15,155 |
2.0× |
| Repair, primary, torn ligament and/or capsule, knee; collateral (27405) |
$15,155 |
$15,155 |
2.0× |
| Repair/graft achilles tendon (27652) |
$15,155 |
$15,155 |
2.0× |
| Repair/Graft Wrist Bone (25440) |
$15,155 |
$15,155 |
2.0× |
| Replacement Tissue Expander W/Permanent Implant (11970) |
$15,155 |
$15,155 |
2.0× |
| Repositioning Io Lens Prosthesis Req Inc Spx (66825) |
$5,370 |
$5,370 |
2.2× |
| Repr Elbw Med Ligmnt W/Tiss (24345) |
$15,155 |
$15,155 |
2.0× |
| Revise ulnar nerve at wrist (64719) |
$3,880 |
$3,880 |
1.9× |
| Revision of foot (28116) |
$6,885 |
$6,885 |
2.0× |
| Revision of lower leg tendon (27685) |
$6,885 |
$6,885 |
2.0× |
| Revision of reconstructed breast (19380) |
$13,840 |
$13,840 |
2.0× |
| Revision Peri-Implant Capsule Breast (19370) |
$8,125 |
$8,125 |
2.0× |
| Revj Shunt Extraocular Reservoir W/O Graft (66184) |
$5,280 |
$5,280 |
2.2× |
| Revj/rpr oprative wound anterior segment (66250) |
$4,085 |
$4,085 |
1.7× |
| Rmvl Implt Matrl Posterior Segment Intraocular (67121) |
$8,710 |
$8,710 |
3.6× |
| Rmvl Lens Material Phacofragmentation Aspir (66850) |
$5,690 |
$5,690 |
2.4× |
| Rmvl/revj sling stress incontinence (57287) |
$6,745 |
$6,745 |
2.0× |
| Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) |
$12,380 |
$12,380 |
2.0× |
| Rpr Aa Hernia 1st < 3 Cm Reducible (49591) |
$7,490 |
$7,490 |
2.0× |
| Rpr Aa Hernia 1st > 10 Cm Reducible (49595) |
$13,240 |
$13,240 |
2.0× |
| Rpr aa hernia recr 3-10 cm reducible (49615) |
$13,240 |
$13,240 |
2.0× |
| Rpr Aa Hernia Recr < 3 Cm Ncrc8/Strangulated (49614) |
$12,380 |
$12,380 |
2.0× |
| Rpr Aa Hernia Recr < 3 Cm Reducible (49613) |
$10,260 |
$10,260 |
2.8× |
| Rpr aa hrn 1st 3-10 rdc (49593) |
$13,240 |
$13,240 |
2.0× |
| Rpr aa hrn 1st < 3 ncr/strn (49592) |
$12,380 |
$12,380 |
2.0× |
| Rpr blepharoptosis levator rescj/advmnt xtrnl (67904) |
$4,280 |
$4,280 |
1.7× |
| Rpr Retinal Dtchmnt W/Vitrectomy Any Meth (67108) |
$9,855 |
$9,855 |
2.3× |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) |
$6,885 |
$6,885 |
2.0× |
| Rpr/advmnt tdn w/ntc supfcis tdn prim ea tdn (26370) |
$6,885 |
$6,885 |
2.0× |
| Septoplasty/Submucous Resecj W/WO Cartilage Grf (30520) |
$7,380 |
$7,380 |
2.1× |
| Severing Ads Ant Seg Incal Spx Post Synechiae (65875) |
$4,755 |
$4,755 |
2.0× |
| Shoulder Arthroscopy/Surgery (29825) |
$10,275 |
$10,275 |
3.0× |
| Sling operation for stress incontinence (eg, fascia or synthetic) (57288) |
$10,195 |
$10,195 |
2.0× |
| Strabismus Recession/Rescj 1 Hrzntl Musc (67311) |
$5,020 |
$5,020 |
2.0× |
| Strabismus Recession/Rescj 1 Ver Musc (67314) |
$5,060 |
$5,060 |
2.0× |
| Strabismus Recession/Rescj 2 Hrzntl Musc (67312) |
$5,395 |
$5,395 |
1.3× |
| Submucous Rescj Inferior Turbinate Prtl/Compl (30140) |
$6,880 |
$6,880 |
2.0× |
| Suction assisted lipectomy; trunk (15877) |
$7,765 |
$7,765 |
2.1× |
| Suture digital nerve hand/foot 1 nerve (64831) |
$7,795 |
$7,795 |
3.8× |
| Suture infrapatellar tendon primary (27380) |
$15,155 |
$15,155 |
2.0× |
| Suture of quadriceps or hamstring muscle rupture primary (27385) |
$15,155 |
$15,155 |
2.0× |
| Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon Facility (25310) |
$7,595 |
$7,595 |
2.2× |
| Tenodesis long tendon biceps (23430) |
$15,155 |
$15,155 |
2.0× |
| Tenolysis flxr/xtnsr tendon leg&/ankle 1 each (27680) |
$7,225 |
$7,225 |
2.1× |
| Tibial Arthroscopy/Surgery (29855) |
$15,155 |
$15,155 |
2.0× |
| Tnot elbow lateral/medial debride open tdn rpr (24359) |
$6,965 |
$6,965 |
2.0× |
| Total Knee Arthroplasty (27447) |
$27,370 |
$27,370 |
2.1× |
| Transection/Avulsion Oth Spinal Nrv Xdrl (64772) |
$3,890 |
$3,890 |
1.9× |
| Translum Dil Eye Canal (66174) |
$10,880 |
$10,880 |
2.5× |
| Transur electr resection of prostate (52601) |
$10,720 |
$10,720 |
1.9× |
| Treat ankle fracture (28445) |
$15,155 |
$15,155 |
2.0× |
| Treat dislocation/fracture (23680) |
$14,510 |
$14,510 |
1.1× |
| Treat Finger Fracture Each (26727) |
$8,740 |
$8,740 |
2.6× |
| Treat Fx Rad Extra-Articul (25607) |
$15,155 |
$15,155 |
2.0× |
| Treat Kneecap Fracture (27524) |
$15,155 |
$15,155 |
2.0× |
| Treat scapula fracture (23585) |
$15,100 |
$15,100 |
2.0× |
| Treatment of ankle fracture (27823) |
$15,155 |
$15,155 |
2.0× |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
$6,745 |
$6,745 |
2.0× |
| Tx Missed Abortion First Trimester Surgical (59820) |
$6,745 |
$6,745 |
2.0× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) |
$1,570 |
$1,570 |
2.0× |
| Tympanic Memb Rpr W/WO Prepj Perfor Patch (69610) |
$3,255 |
$3,255 |
2.0× |
| Tympanostomy general anesthesia (69436) |
$3,285 |
$3,285 |
2.0× |
| Unlisted hysteroscopy procedure, uterus (58579) |
$5,955 |
$5,955 |
28.4× |
| Unlisted laparoscopy procedure, abdomen, peritoneum and omentum (49329) |
$12,380 |
$12,380 |
2.0× |
| Unlisted procedure arthroscopy (29999) |
$12,515 |
$12,515 |
48.9× |
| Unlisted procedure femur or knee (27599) |
$8,400 |
$8,400 |
32.8× |
| Unlisted Procedure Leg/Ankle (27899) |
$10,055 |
$10,055 |
39.3× |
| Unlisted Procedure Male Genital System (55899) |
$3,090 |
$3,090 |
11.9× |
| Unlisted procedure pelvis/hip joint (27299) |
$18,590 |
$18,590 |
72.6× |
| Unlisted procedure shoulder (23929) |
$7,385 |
$7,385 |
28.8× |
| Vasectomy uni/bi spx w/postop semen exams (55250) |
$6,005 |
$6,005 |
2.8× |
| Ventilating tube removal requiring general anesthesia (69424) |
$3,565 |
$3,565 |
1.0× |
| Vitrectomy mechanical pars plana (67036) |
$9,790 |
$9,790 |
2.3× |
| Vitrectomy pars plana remove int memb retina (67042) |
$10,235 |
$10,235 |
2.4× |
| Vitrectomy Pars Plana Remove Preretinal Membrane (67041) |
$10,030 |
$10,030 |
2.3× |
| Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation Facility (67039) |
$9,745 |
$9,745 |
2.3× |
| Xcapsl ctrc rmvl insj io lens prosth insj 1+ (66991) |
$8,920 |
$8,920 |
1.6× |
| Xfer Single Deep Low Leg Tendon (27691) |
$15,155 |
$15,155 |
2.0× |