| Abd paracentesis w/imaging (49083) |
$2,511.60 |
$8,372 |
2.8× |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
$478.80 |
$1,596 |
0.5× |
| Ablation 1/> liver tumor perq cryoablation (47383) |
$5,335.80 |
$17,786 |
0.5× |
| Anoscopy diagnostic (46600) |
$182.70 |
$609 |
1.4× |
| Anoscopy remove lesion (46610) |
$2,325.90 |
$7,753 |
0.8× |
| Anoscopy; with biopsy, single or multiple (46606) |
$998.70 |
$3,329 |
0.8× |
| Appl cranial tong/strtctc frame w/removal spx (20660) |
$843.30 |
$2,811 |
0.5× |
| Application Finger Splint Dynamic (29131) |
$243 |
$810 |
4.2× |
| Application finger splint static (29130) |
$243 |
$810 |
1.8× |
| Application long arm splint shoulder hand (29105) |
$309.90 |
$1,033 |
1.9× |
| Application Long Leg Splint (29505) |
$394.50 |
$1,315 |
2.5× |
| Application of rigid total contact leg cast (29445) |
$144 |
$480 |
0.5× |
| Application Short Arm Splint Dynamic (29126) |
$786.90 |
$2,623 |
6.0× |
| Application short arm splint forearm-hand static (29125) |
$454.50 |
$1,515 |
3.5× |
| Application short leg splint calf foot (29515) |
$278.10 |
$927 |
1.7× |
Apply Multlay Comprs Lwr Leg (29581) range across 4 matching MRF lines |
$204.30–$459.45 |
$681–$1,531.50 |
varies |
| Arterial puncture (36600) |
$132.30 |
$441 |
1.0× |
| Arteriovenous Anastomosis Open Direct (36821) |
$2,508.60 |
$8,362 |
0.8× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$490.20 |
$1,634 |
1.6× |
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) range across 2 matching MRF lines |
$945.60–$1,418.40 |
$3,152–$4,728 |
varies |
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) range across 2 matching MRF lines |
$818.40–$1,227.60 |
$2,728–$4,092 |
varies |
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) range across 2 matching MRF lines |
$1,040.70–$1,561.05 |
$3,469–$5,203.50 |
varies |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$369.30 |
$1,231 |
1.2× |
Aspirate pleura w/ imaging (32555) range across 3 matching MRF lines |
$1,752.30–$2,628.45 |
$5,841–$8,761.50 |
varies |
| Aspirate Pleura W/O Imaging (32554) |
$1,020 |
$3,400 |
1.6× |
| Aspiration bladder insert suprapubic catheter (51102) |
$4,823.10 |
$16,077 |
2.3× |
| Av Fistula Revision Open (36832) |
$3,777.90 |
$12,593 |
0.7× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$1,718.70 |
$5,729 |
8.7× |
| Biliary Endo Prq T-Tube Dx W/Collect Spec Brush (47552) |
$3,430.20 |
$11,434 |
0.5× |
| Biliary Endoscopy Prq via T-Tube W/Rmvl Calculus (47554) |
$5,454.60 |
$18,182 |
0.5× |
Biliary ndsc prq t-tube w/dil duct w/o stent (47555) unusually low: confirm this is the full procedure |
$2,969.40 |
$9,898 |
0.5× |
| Biopsy Abdominal Mass (49180) |
$1,227.90 |
$4,093 |
0.8× |
| Biopsy bone trocar/needle deep (20225) |
$2,178.30 |
$7,261 |
1.3× |
| Biopsy Bone Trocar/Needle Superficial (20220) |
$734.10 |
$2,447 |
0.4× |
| Biopsy external ear (69100) |
$219.60 |
$732 |
0.9× |
| Biopsy muscle percutaneous needle (20206) |
$974.40 |
$3,248 |
0.6× |
| Biopsy of liver, needle; percutaneous (47000) |
$1,152.30 |
$3,841 |
0.7× |
| Biopsy Pleura Percutaneous Needle (32400) |
$1,762.20 |
$5,874 |
1.1× |
| Biopsy Salivary Gland Needle (42400) |
$741 |
$2,470 |
1.1× |
| Biopsy soft tissue forearm&/wrist superficial (25065) |
$1,446.60 |
$4,822 |
0.9× |
| Biopsy soft tissue leg/ankle area superficial (27613) |
$1,533.30 |
$5,111 |
0.9× |
| Biopsy soft tissue neck/thorax (21550) |
$1,584 |
$5,280 |
1.0× |
| Biopsy Soft Tissue Pelvis&Hip Area Superficial (27040) |
$1,517.40 |
$5,058 |
0.9× |
| Biopsy soft tissue pelvis&hip deep/subfscal/im (27041) |
$1,667.10 |
$5,557 |
1.0× |
| Biopsy Soft Tissue Shoulder Superficial (23065) |
$1,667.10 |
$5,557 |
1.0× |
| Biopsy soft tissue thigh/knee area superficial (27323) |
$1,648.80 |
$5,496 |
1.0× |
| Bladder Irrigation (51700) |
$477.30 |
$1,591 |
1.9× |
| Bladder Scan (51798) |
$105.60 |
$352 |
1.8× |
| Blood Transfusion Service (36430) |
$796.50 |
$2,655 |
1.8× |
| Blood/Lymph System Procedure (38999) |
$471.90 |
$1,573 |
1.1× |
| Bone Marrow Biopsy (38221) |
$2,516.40 |
$8,388 |
1.5× |
| Brnchsc Brushing/Protected Brushings (31623) |
$1,186.20 |
$3,954 |
0.7× |
| Brnchsc Ebus Guided Sampl 1/2 Node Station/Strux (31652) |
$2,701.80 |
$9,006 |
0.7× |
Brnchsc Ebus Guided Sampl 3/> Node Station/Strux (31653) range across 2 matching MRF lines |
$3,088.20–$4,632.30 |
$10,294–$15,441 |
varies |
| Bronchoscopy Clear Airways (31645) |
$1,186.20 |
$3,954 |
0.7× |
| Bronchoscopy Reclear Airway (31646) |
$1,039.50 |
$3,465 |
2.7× |
| Bronchoscopy W/Biopsy(S) (31625) |
$1,407.60 |
$4,692 |
0.8× |
| Bronchoscopy w/transbronchial lung bx 1 lobe (31628) |
$2,702.10 |
$9,007 |
0.7× |
| Bronchoscopy/Needle Bx Each (31629) |
$2,807.10 |
$9,357 |
0.8× |
| Bx breast 1st lesion us imag (19083) |
$986.70 |
$3,289 |
0.6× |
| Cessj Therapy Cath Removal (37214) |
$2,563.80 |
$8,546 |
0.8× |
| Change Cystostomy Tube Complicated (51710) |
$958.20 |
$3,194 |
1.4× |
| Change Cystostomy Tube Simple (51705) |
$871.50 |
$2,905 |
3.5× |
| Chemical Cautery Tissue (17250) |
$491.40 |
$1,638 |
2.5× |
| Chemical Pleurodesis (32560) |
$894.30 |
$2,981 |
1.4× |
| Chemodenerv Parotid&Submandibl Salivary Glnds (64611) |
$318.30 |
$1,061 |
1.0× |
| Chemodenerv trunk musc 6/> (64647) |
$711 |
$2,370 |
1.0× |
| Chemodenervation of internal anal sphincter (46505) |
$1,989 |
$6,630 |
1.7× |
| Chest tube placement (32551) |
$858 |
$2,860 |
0.6× |
| Cholecystostomy Prq W/Imaging & Catheter Plmt (47490) |
$2,021.40 |
$6,738 |
0.6× |
| Cl Tx Scapular Fx; W Manip (23575) |
$726.60 |
$2,422 |
0.5× |
| Cl Tx Tib Shft Fx W Manip (27752) |
$1,371.90 |
$4,573 |
0.9× |
| Clear outer ear canal (69200) |
$427.80 |
$1,426 |
3.2× |
| Closed Rx Spontaneous Hip Disloc (27256) |
$454.20 |
$1,514 |
1.9× |
| Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) |
$1,700.40 |
$5,668 |
7.0× |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) |
$375.60 |
$1,252 |
1.5× |
| Closed Treatment Ulnar Styloid Fracture (25650) |
$195 |
$650 |
0.8× |
| Closed tx ankle dislocation w/o anesthesia (27840) |
$1,700.40 |
$5,668 |
7.0× |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) |
$1,748.10 |
$5,827 |
1.1× |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) |
$226.80 |
$756 |
0.9× |
| Closed tx knee dislocation w/o anesthesia (27550) |
$1,994.40 |
$6,648 |
8.2× |
| Closed tx patellar dislocation w/o anesthesia (27560) |
$1,820.10 |
$6,067 |
7.5× |
| Closed tx radial head/neck fx w/manipulation (24655) |
$1,700.40 |
$5,668 |
1.1× |
| Closed tx radial shaft fracture w/manipulation (25505) |
$1,820.10 |
$6,067 |
1.1× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
$2,437.50 |
$8,125 |
1.5× |
| Closed tx radial&ulnar shaft fractures w/o man (25560) |
$226.80 |
$756 |
0.9× |
| Closed tx septal&nose fx (21337) |
$2,437.50 |
$8,125 |
0.7× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
$1,700.40 |
$5,668 |
7.0× |
| Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) |
$226.80 |
$756 |
0.9× |
| Clsd tx acromioclavicular dislc w/manipulation (23545) |
$2,002.50 |
$6,675 |
8.2× |
| Clsd Tx Clavicular Fracture W/Manipulation (23505) |
$1,820.10 |
$6,067 |
1.1× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
$2,907.90 |
$9,693 |
1.8× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$1,518.30 |
$5,061 |
6.2× |
| Cltx ankle dislc req anes w/wo prq skel fixj (27842) |
$2,019.30 |
$6,731 |
1.3× |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
$2,033.40 |
$6,778 |
1.3× |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) |
$268.50 |
$895 |
1.1× |
| Cltx dstl fibular fx lat malls w/manj (27788) |
$1,748.10 |
$5,827 |
7.2× |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) |
$481.50 |
$1,605 |
2.0× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$326.40 |
$1,088 |
1.3× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$2,324.70 |
$7,749 |
1.5× |
| Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) |
$1,519.80 |
$5,066 |
1.0× |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) |
$1,984.50 |
$6,615 |
1.2× |
| Cltx fx grt toe phlx/phlg w/manj (28495) |
$452.40 |
$1,508 |
1.9× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
$294.30 |
$981 |
1.2× |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) |
$1,623.90 |
$5,413 |
1.0× |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) |
$223.50 |
$745 |
0.9× |
| Cltx Grter Humeral Tuberosity Fx W/Manipulation (23625) |
$2,239.80 |
$7,466 |
1.4× |
| Cltx hip dislocation traumatic req anesthesia (27252) |
$2,391.30 |
$7,971 |
1.5× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
$1,518.30 |
$5,061 |
6.2× |
| Cltx humeral condylar fx medial/lateral w/manj (24577) |
$1,820.10 |
$6,067 |
1.1× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
$285 |
$950 |
1.2× |
| Cltx Iphal Jt Dislc W/Manj Req Anes (26775) |
$883.50 |
$2,945 |
3.2× |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
$316.20 |
$1,054 |
1.3× |
| Cltx Med Ankle Fx W/Mnpj (27762) |
$1,664.40 |
$5,548 |
1.0× |
| Cltx metacarpal fx w/manipulation each bone (26605) |
$2,277.60 |
$7,592 |
9.3× |
| Cltx metacarpal fx w/o manipulation each bone (26600) |
$226.80 |
$756 |
0.9× |
| Cltx metacarpophalangeal dislc w/manj w/anes (26705) |
$1,602.60 |
$5,342 |
1.0× |
| Cltx Metatarsophlngl Jt Dislc Req Anes (28635) |
$1,512.90 |
$5,043 |
1.0× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
$447 |
$1,490 |
1.8× |
| Cltx post hip arthrp dislc req anes (27266) |
$2,464.80 |
$8,216 |
1.5× |
| Cltx post hip arthrp dislc w/o anes (27265) |
$1,144.50 |
$3,815 |
4.7× |
| Cltx prox fibula/shft fx w/manj (27781) |
$1,962.60 |
$6,542 |
1.2× |
| Cltx Rdcrpl/Intercarpl Dislc 1/> Bones W/Manj (25660) |
$166.50 |
$555 |
0.7× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
$375.90 |
$1,253 |
1.5× |
| Cltx Rdl Shft Fx&Cltx Dislc Dstl Rad/Uln Jt (25520) |
$1,561.80 |
$5,206 |
1.0× |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) |
$2,176.50 |
$7,255 |
1.4× |
| Cltx Shoulder Dislc W/Surg/Antmcl Neck Fx W/Manj (23675) |
$1,503 |
$5,010 |
0.9× |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
$1,820.10 |
$6,067 |
1.1× |
| Cltx tibial shaft fx w/o manipulation (27750) |
$275.10 |
$917 |
1.1× |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
$1,281.60 |
$4,272 |
0.8× |
| Collection of venous blood by venipuncture (36415) |
$24.90 |
$83 |
2.7× |
| Colonoscopy Flexible With Decompression (45393) |
$1,190.70 |
$3,969 |
1.0× |
| Colonoscopy Stoma Control Bleeding (44391) |
$1,076.10 |
$3,587 |
0.9× |
| Colonoscopy stoma rmvl les by hot biopsy forceps (44392) |
$792.90 |
$2,643 |
0.7× |
| Colonoscopy Stoma W/Endoscopic Mucosal Rescj (44403) |
$1,086 |
$3,620 |
0.9× |
| Colonoscopy Stoma W/Submucosal Injection (44404) |
$1,066.50 |
$3,555 |
0.9× |
| Colonoscopy through stoma; with biopsy, single or multiple (44389) |
$1,076.10 |
$3,587 |
0.9× |
| Colonoscopy thru stoma (44388) |
$815.40 |
$2,718 |
0.9× |
| Colonoscopy Thru Stoma,Lesn Rmvl W/Snare - Colonoscopy (44394) |
$1,076.10 |
$3,587 |
0.9× |
| Colonoscopy w/ablation (45388) |
$1,190.70 |
$3,969 |
1.0× |
| Colonoscopy W/Band Ligation (45398) |
$1,190.70 |
$3,969 |
1.0× |
| Colonoscopy w/fb removal (45379) |
$1,190.70 |
$3,969 |
1.0× |
| Colonoscopy W/Resection (45390) |
$2,465.10 |
$8,217 |
0.9× |
| Colonoscopy w/stent plcmt (45389) |
$5,026.20 |
$16,754 |
0.8× |
| Colonoscopy w/submucosal inj (45381) |
$1,190.70 |
$3,969 |
1.0× |
| Colsc Flexible W/Control Bleeding Any Method (45382) |
$1,190.70 |
$3,969 |
1.0× |
| Colsc Flexible W/Transendoscopic Balloon Dilat (45386) |
$1,190.70 |
$3,969 |
1.0× |
| Colsc flx w/removal lesion by hot bx forceps (45384) |
$1,190.70 |
$3,969 |
1.0× |
| Colsc Flx W/US Guid Ndl Aspir/Bx W/US Rctm Et Al (45392) |
$1,726.20 |
$5,754 |
1.5× |
| Complex drainage wound (10180) |
$1,550.10 |
$5,167 |
0.5× |
Control Nasal Hemorrhage Anterior Complex (30903) range across 2 matching MRF lines |
$1,518.30–$2,277.45 |
$5,061–$7,591.50 |
varies |
Control Nasal Hemorrhage Anterior Simple (30901) range across 2 matching MRF lines |
$1,822.50–$2,733.75 |
$6,075–$9,112.50 |
varies |
| Conversion ext bil drg cath (47535) |
$2,946.90 |
$9,823 |
0.8× |
| Convert gastrostomy-gastro-jejunostomy tube percutaneous (49446) |
$837.30 |
$2,791 |
0.4× |
| Convert Nephrostomy Catheter (50434) |
$2,257.80 |
$7,526 |
1.1× |
| Core Needle Bx Lung/Mediastinum Perq W/Img (32408) |
$1,519.20 |
$5,064 |
0.9× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$1,897.80 |
$6,326 |
14.4× |
| Cysto calibration dilat urtl strix/stenosis (52281) |
$2,043.90 |
$6,813 |
1.0× |
Cysto/uretero w/lithotripsy (52356) range across 2 matching MRF lines |
$9,491.70–$14,237.55 |
$31,639–$47,458.50 |
varies |
| Dcmprn Fasct Leg Ant&/Lat Compartments Only (27600) |
$3,234.90 |
$10,783 |
1.0× |
| Deb Musc/Fascia 20 Sq Cm/< (11043) |
$589.80 |
$1,966 |
0.8× |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) |
$900 |
$3,000 |
0.6× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$3,842.10 |
$12,807 |
9.5× |
| Declot vascular device (36593) |
$473.10 |
$1,577 |
1.4× |
| Destr W Neurolytic; Celiac Plexus (64680) |
$1,406.70 |
$4,689 |
1.6× |
| Destroy cerv/thor facet jnt (64633) |
$2,064.60 |
$6,882 |
1.1× |
| Destroy lumb/sac facet jnt (64635) |
$2,067.90 |
$6,893 |
1.1× |
| Destruction of rectal tumor transanal approach (45190) |
$2,228.70 |
$7,429 |
0.8× |
| Diagnostic sigmoidoscopy (45330) |
$946.80 |
$3,156 |
1.0× |
| Dilat Xst Trc New Access Rcs (50437) |
$6,340.80 |
$21,136 |
1.8× |
| Dilate Esophagus 1/Mult Pass (43450) |
$877.20 |
$2,924 |
1.0× |
| Drain Cerebro Spinal Fluid (62272) |
$491.40 |
$1,638 |
0.7× |
| Drain Spinal Cord Cyst (62268) |
$862.20 |
$2,874 |
1.0× |
| Drain/inj small joint/bursa w/us (20604) |
$405 |
$1,350 |
1.3× |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
$508.50 |
$1,695 |
0.7× |
| Drainage Finger Abscess Complicated (26011) |
$1,479 |
$4,930 |
0.9× |
| Drainage of finger abscess simple (26010) |
$410.10 |
$1,367 |
2.1× |
| Drainage of gum lesion (41800) |
$1,700.40 |
$5,668 |
12.9× |
| Drainage of hematoma/fluid (10140) |
$3,329.40 |
$11,098 |
2.0× |
| Drainage of hydrocele (55000) |
$665.10 |
$2,217 |
0.9× |
| Drainage of rectal abscess (45005) |
$1,702.80 |
$5,676 |
1.4× |
| Drainage of scrotal wall abscess (55100) |
$1,345.20 |
$4,484 |
0.8× |
| Draw Blood Off Venous Device (36591) |
$144.30 |
$481 |
1.1× |
| Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) |
$707.10 |
$2,357 |
1.0× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
$2,437.50 |
$8,125 |
6.1× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
$2,437.50 |
$8,125 |
12.3× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
$299.10 |
$997 |
1.5× |
| Dstrj lesion anus simple surg excision (46922) |
$2,674.20 |
$8,914 |
1.0× |
| Dstrj Neurolytic Agent Other Peripheral Nerve (64640) |
$1,175.10 |
$3,917 |
1.3× |
| Dstrj Trigeminal Nrv Supraorb Infraorb Branch (64600) |
$1,339.50 |
$4,465 |
1.5× |
| Dx Bone Marrow Bx & Aspir (38222) |
$2,767.80 |
$9,226 |
1.0× |
| Dx Bronchoscope/Lavage (31624) |
$1,407.60 |
$4,692 |
0.8× |
| Dx Bronchoscope/Wash (31622) |
$1,078.20 |
$3,594 |
0.6× |
| Dx lmbr spi pnxr w/fluor/CT (62328) |
$1,671 |
$5,570 |
2.4× |
| Egd Balloon Dil Esoph30 Mm/> (43233) |
$1,645.20 |
$5,484 |
0.9× |
| Egd Balloon Dilation Esophagus <30 Mm Diam (43249) |
$1,645.20 |
$5,484 |
0.9× |
| Egd cautery tumor polyp (43250) |
$1,645.20 |
$5,484 |
0.9× |
| Egd control bleeding any (43255) |
$1,645.20 |
$5,484 |
0.9× |
| Egd dilation gastric/duodenal stricture (43245) |
$1,645.20 |
$5,484 |
0.9× |
| Egd endo mucosal resection (43254) |
$1,645.20 |
$5,484 |
0.9× |
| Egd Endoscopic Stent Place (43266) |
$4,985.40 |
$16,618 |
0.8× |
| Egd Flexible Foreign Body Removal (43247) |
$1,676.40 |
$5,588 |
1.9× |
| Egd guide wire insertion (43248) |
$1,341 |
$4,470 |
1.5× |
| Egd Injection Sclerosis Esophgl/Gastric Varices (43243) |
$1,645.20 |
$5,484 |
0.9× |
| Egd Intrmural Needle Aspir/Biop Altered Anatomy (43242) |
$1,645.20 |
$5,484 |
0.9× |
| Egd intrmural us needle aspirate/biopsy esophags (43238) |
$1,645.20 |
$5,484 |
0.9× |
| Egd lesion ablation (43270) |
$1,645.20 |
$5,484 |
0.9× |
| Egd Partial/Compl Esophagogastric Fundoplasty (43210) |
$9,109.20 |
$30,364 |
0.9× |
| Egd place gastrostomy tube (43246) |
$1,993.80 |
$6,646 |
1.0× |
| Egd remove lesion snare (43251) |
$1,645.20 |
$5,484 |
0.9× |
| Egd Tube/Cath Insertion (43241) |
$1,645.20 |
$5,484 |
0.9× |
| Egd us exam duodenum/jejunum (43259) |
$1,645.20 |
$5,484 |
0.9× |
| Egd us transmural injxn/mark (43253) |
$1,645.20 |
$5,484 |
0.9× |
| Egd Varices Ligation (43244) |
$1,645.20 |
$5,484 |
0.9× |
| Egd W/Transmural Drain Cyst (43240) |
$3,325.20 |
$11,084 |
0.6× |
| Endoscopic us exam esoph (43237) |
$1,645.20 |
$5,484 |
0.9× |
| Endoscopy Upper Small Intestine (44360) |
$992.10 |
$3,307 |
0.5× |
| Endoscopy upper small intestine w/biopsy (44361) |
$1,475.70 |
$4,919 |
0.8× |
| Endoven abltj incmptnt vein xtr laser 1st vein (36478) |
$2,986.80 |
$9,956 |
1.0× |
| Endoven abltj incmptnt vein xtr rf 1st vein (36475) |
$3,383.10 |
$11,277 |
1.1× |
| Enterosc >2nd prtn w/ileum w/bx single/multiple (44377) |
$749.40 |
$2,498 |
0.4× |
| Enteroscopy > 2nd prtn w/plmt prq tube (44372) |
$1,662.60 |
$5,542 |
0.9× |
| Enteroscopy > 2nd Prtn W/Rmvl Lesion Snare (44364) |
$1,730.40 |
$5,768 |
0.9× |
| Epidural Blood Patch (62273) |
$2,368.50 |
$7,895 |
3.4× |
Ercp Destruction/Lithotripsy Calculi Any Method (43265) unusually low: confirm this is the full procedure |
$2,702.40 |
$9,008 |
0.4× |
| Ercp duct stent placement (43274) |
$3,620.40 |
$12,068 |
0.6× |
| Ercp Dx Collection Specimen Brushing/Washing (43260) |
$2,233.20 |
$7,444 |
0.6× |
| Ercp ea duct/ampulla dilate (43277) |
$2,456.70 |
$8,189 |
0.6× |
| Ercp remove calculi/debris biliary/pancreas duct (43264) |
$2,351.70 |
$7,839 |
0.6× |
| Ercp remove forgn body duct (43275) |
$2,456.70 |
$8,189 |
1.3× |
| Ercp Stent Exchange W/Dilate (43276) |
$3,620.40 |
$12,068 |
0.6× |
| Ercp Tumor/Polyp/Lesion Ablation W/Dilation&Wire (43278) |
$2,456.70 |
$8,189 |
0.6× |
| Ercp W/Biopsy Single/Multiple (43261) |
$2,456.70 |
$8,189 |
0.6× |
| Ercp,Sphincterotomy (43262) |
$2,456.70 |
$8,189 |
0.6× |
| Esoph Scope W/Submucous Inj (43201) |
$1,170 |
$3,900 |
0.6× |
| Esophagogastroduodenoscopy Submucosal Injection (43236) |
$1,341 |
$4,470 |
1.5× |
Esophagoscop Stent Placement (43212) unusually low: confirm this is the full procedure |
$2,738.40 |
$9,128 |
0.5× |
| Esophagoscopy Flex Balloon Dilat <30 Mm Diam (43220) |
$1,170 |
$3,900 |
0.6× |
| Esophagoscopy Flex Transoral Injection Varices (43204) |
$952.50 |
$3,175 |
0.5× |
| Esophagoscopy Flexible Transoral Diagnostic (43200) |
$952.50 |
$3,175 |
1.1× |
| Esophagoscopy Flexible Transoral Ultrasound Exam (43231) |
$1,170 |
$3,900 |
0.6× |
| Esophagoscopy Flexible W/Bleeding Control (43227) |
$1,170 |
$3,900 |
0.6× |
| Esophagoscopy Intra/Transmural Needle Aspirat/Bx (43232) |
$1,170 |
$3,900 |
0.6× |
| Esophagoscopy, flexible, transoral; with biopsy, single or multiple (43202) |
$952.50 |
$3,175 |
0.5× |
| Esophagoscopy, flexible, transoral; with removal of foreign body(s) (43215) |
$1,170 |
$3,900 |
0.6× |
| Esophagoscp Rig Trnso Inject (43192) |
$1,482.60 |
$4,942 |
0.8× |
| Evacuation of subungual hematoma (11740) |
$106.50 |
$355 |
0.8× |
| Exc Rct Tum Incl Muscularis Propria (45172) |
$2,189.10 |
$7,297 |
0.8× |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) |
$2,467.80 |
$8,226 |
2.1× |
| Exchange Biliary Drg Catheter Prq W/Img Gid Rs&I (47536) |
$2,946.90 |
$9,823 |
0.8× |
Exchange Nephrostomy Catheter Prq W/Img Gid Rs&I (50435) range across 2 matching MRF lines |
$2,640.90–$3,961.35 |
$8,803–$13,204.50 |
varies |
| Exchng Absc/Cst Drg Cath Rad Gid Spx (49423) |
$1,363.20 |
$4,544 |
0.7× |
| Fine needle aspiration bx w/CT gdn 1st lesion (10009) |
$1,959.90 |
$6,533 |
2.8× |
| Fine needle aspiration without imaging guidance (10021) |
$871.50 |
$2,905 |
2.2× |
| Fluoro exam of g/colon tube (49465) |
$357.30 |
$1,191 |
1.5× |
| Fna Bx W/Fluor Gdn 1St Les (10007) |
$1,781.40 |
$5,938 |
2.5× |
| Fna bx w/us gdn 1st les (10005) |
$1,619.70 |
$5,399 |
2.3× |
| Foreskin manipulation (54450) |
$282.30 |
$941 |
1.1× |
| Glycine Receptor Alpha1 Igg Serum/CSF Lcba Qual (0431U) |
$640.50 |
$2,135 |
17.5× |
| Guide Cathet Fluid Drainage (10030) |
$1,514.10 |
$5,047 |
2.2× |
| Hemorrhoidectomy, internal, by rubber band ligation(s) (46221) |
$719.70 |
$2,399 |
0.8× |
| Hemorrhoidopexy by stapling (46947) |
$2,815.80 |
$9,386 |
1.0× |
| I&d abscess peritonsillar (42700) |
$1,820.10 |
$6,067 |
7.8× |
| I&d abscess simple (10060) |
$594.90 |
$1,983 |
3.0× |
| I&d perianal abscess superficial (46050) |
$2,056.20 |
$6,854 |
2.2× |
| I&d pilonidal cyst complicated (10081) |
$961.80 |
$3,206 |
1.4× |
| I&d pilonidal cyst simple (10080) |
$874.20 |
$2,914 |
1.2× |
| I&d shoulder deep abscess/hematoma (23030) |
$2,253.60 |
$7,512 |
0.8× |
| I&d upper arm/elbow deep abscess/hematoma (23930) |
$2,687.10 |
$8,957 |
0.9× |
| Icd Pocket Revision (33223) |
$1,672.50 |
$5,575 |
0.8× |
| Ileoscopy Stoma W/Balloon Dilation (44381) |
$1,181.70 |
$3,939 |
0.6× |
| Ileoscopy Stoma W/Bx Single/Multiple (44382) |
$1,404.60 |
$4,682 |
1.6× |
| Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd (44380) |
$994.80 |
$3,316 |
1.1× |
| Image Cath Fluid Colxn Visc (49405) |
$1,713.60 |
$5,712 |
1.0× |
| Image Cath Fluid Peri/Retro (49406) |
$1,713.30 |
$5,711 |
1.0× |
| Image Cath Fluid Trns/Vgnl (49407) |
$1,667.10 |
$5,557 |
1.0× |
| Implant cochlear device (69930) |
$35,111.10 |
$117,037 |
1.1× |
| Implant Spine Infusion Pump (62362) |
$19,787.10 |
$65,957 |
1.1× |
| Impltj revj/rpsg ithcl/edrl cath pmp w/o lam (62350) |
$4,379.10 |
$14,597 |
0.5× |
| Incise external hemorrhoid (46083) |
$583.50 |
$1,945 |
2.4× |
| Incision & drainage abscess complicated/multiple (10061) |
$1,762.80 |
$5,876 |
4.4× |
Incision & drainage leg/ankle abscess/hematoma (27603) range across 2 matching MRF lines |
$2,705.10–$4,057.65 |
$9,017–$13,525.50 |
varies |
| Incision & removal foreign body subq tiss compl (10121) |
$2,879.10 |
$9,597 |
1.8× |
| Incision & removal foreign body subq tiss simple (10120) |
$2,879.10 |
$9,597 |
7.2× |
| Incision and drainage of bartholin's gland abscess (56420) |
$358.20 |
$1,194 |
1.8× |
| Incision and drainage of vulva or perineal abscess (56405) |
$830.40 |
$2,768 |
2.8× |
| Incision of rectal abscess (46040) |
$3,171.90 |
$10,573 |
2.7× |
| Incision&Drainage Upper Arm/Elbow Bursa (23931) |
$1,722.30 |
$5,741 |
1.1× |
| Incisional biopsy skin single lesion (11106) |
$1,025.40 |
$3,418 |
1.4× |
| Initial Tx 1st Degree Burn Local Tx (16000) |
$161.10 |
$537 |
0.8× |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) |
$1,581 |
$5,270 |
1.8× |
| Inj W/Fluor Eval Cv Device (36598) |
$187.80 |
$626 |
0.9× |
| Inj,Anes Agent,Femoral Nerve,Cont Inf (64448) |
$2,569.20 |
$8,564 |
2.9× |
| Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) |
$1,328.40 |
$4,428 |
1.5× |
| Injection 1 tendon sheath/ligament aponeurosis (20550) |
$456.30 |
$1,521 |
1.5× |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
$651.60 |
$2,172 |
0.7× |
| Injection Aa&/Strd Brach Plex Cont Nfs Cath Img (64416) |
$1,787.70 |
$5,959 |
2.0× |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
$1,328.40 |
$4,428 |
1.5× |
| Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) |
$1,024.50 |
$3,415 |
1.5× |
| Injection Aa&/Strd Sciatic Nrv Cont Nfs Cath Img (64446) |
$822 |
$2,740 |
0.9× |
| Injection Anes Superior Hypogastric Plexus (64517) |
$1,406.70 |
$4,689 |
1.6× |
| Injection anesthetic agent suprascapular nerve (64418) |
$1,001.70 |
$3,339 |
1.4× |
| Injection for identification of sentinel node (38792) |
$1,396.50 |
$4,655 |
3.5× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$583.50 |
$1,945 |
1.9× |
| Injection single/mlt trigger point 3/> muscles (20553) |
$583.50 |
$1,945 |
1.9× |
| Injection, anesthetic agent; brachial plexus, single (64415) |
$1,624.80 |
$5,416 |
1.9× |
Injection, anesthetic agent; femoral nerve, single (64447) range across 4 matching MRF lines |
$651.60–$1,466.10 |
$2,172–$4,887 |
varies |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) |
$456.30 |
$1,521 |
0.7× |
| Injx/Infus Neurolyt Sbst Epidural Lumbar/Sacral (62282) |
$1,113.30 |
$3,711 |
1.3× |
| Ins cath ren art 1st bilat (36252) |
$1,738.80 |
$5,796 |
0.6× |
| Ins cath ren art 1st unilat (36251) |
$1,745.10 |
$5,817 |
0.6× |
Ins cath ren art 2nd+ unilat (36253) unusually low: confirm this is the full procedure |
$1,860.60 |
$6,202 |
0.3× |
| Ins endovas vena cava filtr (37191) |
$3,357.60 |
$11,192 |
0.6× |
| Ins/Rep Subq Defibrillator (33270) |
$28,887.90 |
$96,293 |
0.9× |
| Insert 1 Electrode Pm-Defib (33216) |
$5,475.60 |
$18,252 |
0.7× |
| Insert Bladder Cath Complex (51703) |
$429.60 |
$1,432 |
3.4× |
Insert cath pleura w/ image (32557) range across 2 matching MRF lines |
$2,080.80–$3,121.20 |
$6,936–$10,404 |
varies |
| Insert cath pleura w/o image (32556) |
$1,891.80 |
$6,306 |
1.0× |
| Insert Gastrostomy Tube Percutaneous (49440) |
$1,467 |
$4,890 |
0.8× |
| Insert Heart Pm Atrial (33206) |
$11,469.30 |
$38,231 |
1.1× |
| Insert Heart Pm Ventricular (33207) |
$9,300.30 |
$31,001 |
0.9× |
| Insert hepatic shunt (tips) (37182) |
$14,534.10 |
$48,447 |
0.8× |
| Insert non-tunnel cv cath (36556) |
$2,501.10 |
$8,337 |
0.8× |
| Insert Pacing Lead & Connect (33224) |
$16,577.40 |
$55,258 |
1.6× |
| Insert pulse gen mult leads (33221) |
$20,076.30 |
$66,921 |
1.1× |
| Insert Temp Bladder Cath (51702) |
$390.30 |
$1,301 |
3.0× |
| Insert tun ip cath perc (49418) |
$3,264.60 |
$10,882 |
0.9× |
| Insert tunneled cv cath (36561) |
$3,710.10 |
$12,367 |
1.2× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$159.90 |
$533 |
1.2× |
| Insertion indwelling tunneled pleural catheter (32550) |
$3,754.20 |
$12,514 |
1.1× |
| Insertion phrenic nerve stimulator system (33276) |
$47,331.30 |
$157,771 |
1.1× |
| Insertion Picc W/Rs&I 5 Yr/> (36573) |
$1,534.50 |
$5,115 |
1.0× |
| Insertion subq cardiac rhythm monitor w/prgrmg (33285) |
$9,422.40 |
$31,408 |
1.2× |
| Insj 2 Transvns Eltrd Perm Pacemaker/Impltbl Dfb (33217) |
$5,475.60 |
$18,252 |
0.7× |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) |
$1,822.50 |
$6,075 |
1.2× |
| Insj tun vad req 2 cath 2 sits w/o subq port/pmp (36565) |
$3,970.50 |
$13,235 |
1.3× |
| Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) |
$3,702.90 |
$12,343 |
1.2× |
| Insj/Rplcmt Defib W/Lead(S) (33249) |
$36,782.10 |
$122,607 |
1.2× |
| Insj/rplcmt temp transvns 1chmbr eltrd/pm cath (33210) |
$4,685.10 |
$15,617 |
0.6× |
| Insj/rplcmt temp transvns 2chmbr pacg eltrds spx (33211) |
$8,799 |
$29,330 |
1.1× |
| Insrt heart pm atrial & vent (33208) |
$11,469.30 |
$38,231 |
1.1× |
| Insrt Pulse Gen W/Mult Leads (33231) |
$34,415.10 |
$114,717 |
1.1× |
| Int hrhc by ligation single hroid w/o img gdn (46945) |
$3,217.80 |
$10,726 |
1.2× |
| Interstitial Dev Plmt Radiation Therapy 1/Mlt (49411) |
$1,256.70 |
$4,189 |
0.9× |
| Intro cath dialysis circuit (36901) |
$2,149.80 |
$7,166 |
1.4× |
| Intro cath dialysis circuit w/tcat plmt IV stent (36903) |
$13,062 |
$43,540 |
1.1× |
| Intro Cath Dialysis Circuit W/Trluml Balo Angiop (36902) |
$9,286.20 |
$30,954 |
1.6× |
| Intro Gastrointestinal Tube (44500) |
$849.90 |
$2,833 |
0.9× |
| Intubation endotracheal emergency procedure (31500) |
$382.20 |
$1,274 |
1.6× |
| Irrigation of corpora cavernosa for priapism (54220) |
$200.10 |
$667 |
0.8× |
| Lap paraesophag hern repair (43281) |
$9,732.30 |
$32,441 |
0.9× |
| Ligation of a-v fistula (37607) |
$2,928.90 |
$9,763 |
0.9× |
| Ligation of hemorrhoids (46946) |
$3,217.80 |
$10,726 |
1.2× |
| Lyse chest fibrin init day (32561) |
$392.10 |
$1,307 |
0.6× |
| Lyse Chest Fibrin Subq Day (32562) |
$392.10 |
$1,307 |
0.6× |
| Mech Remov Intralum Obstr Cv Dev Thru Lumen (36596) |
$894.60 |
$2,982 |
0.6× |
| Myelography Lumbar Injection (62305) |
$844.20 |
$2,814 |
1.1× |
| Myelography Lumbar Injection (62304) |
$844.20 |
$2,814 |
1.1× |
| Myelography via lumbar injection rs&i cervical (62302) |
$844.20 |
$2,814 |
1.1× |
| Myelography Via Lumbar Injection Rs&I Thoracic (62303) |
$771.60 |
$2,572 |
1.0× |
| N Block Inj Celiac Pelus (64530) |
$2,054.40 |
$6,848 |
2.3× |
| N Block Inj Ilio-Ing/Hypogi (64425) |
$421.20 |
$1,404 |
0.6× |
| N block inj intercost sng (64420) |
$682.20 |
$2,274 |
1.0× |
| N Block Lumbar/Thoracic (64520) |
$1,328.40 |
$4,428 |
1.5× |
| Nasal/Orogastric W/Tube Plmt (43752) |
$427.80 |
$1,426 |
1.0× |
| Ndsc Eval Intstinal Pouch Dx W/Collj Spec Spx (44385) |
$864.60 |
$2,882 |
0.9× |
| Ndsc eval intstinal pouch w/bx single/multiple (44386) |
$901.50 |
$3,005 |
1.0× |
| Needle Biopsy Lymph Nodes (38505) |
$2,803.20 |
$9,344 |
1.7× |
| Needle Biopsy Pancreas (48102) |
$2,427.90 |
$8,093 |
1.5× |
| Njx anes stellate ganglion crv sympathetic (64510) |
$1,488.60 |
$4,962 |
1.7× |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) |
$393 |
$1,310 |
1.3× |
| Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) |
$3,436.20 |
$11,454 |
1.0× |
| Njx Cholangio Prq W/Img Gid Rs&I New Access (47532) |
$2,308.80 |
$7,696 |
0.7× |
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) range across 2 matching MRF lines |
$1,908.90–$2,863.35 |
$6,363–$9,544.50 |
varies |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321) |
$759.30 |
$2,531 |
1.1× |
| Njx dx/ther sbst intrlmnr crv/thrc w/o img gdn (62320) |
$1,985.70 |
$6,619 |
2.8× |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
$2,368.20 |
$7,894 |
3.4× |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn (62326) |
$2,073.30 |
$6,911 |
2.4× |
Njx Px Antegrde Nfrosgrm &/Urtrgrm Exstng Acess (50431) range across 2 matching MRF lines |
$1,674–$2,511 |
$5,580–$8,370 |
varies |
| Njx Px Antegrde Nfrosgrm &/Urtrgrm New Access (50430) |
$1,674 |
$5,580 |
2.4× |
| Njx Sclrsnt 1 Incmptnt Vein (36470) |
$386.10 |
$1,287 |
1.0× |
| Njx Sclrsnt Mlt Incmptnt Vn (36471) |
$193.20 |
$644 |
0.5× |
| Njx Sclrsnt Spider Veins (36468) |
$188.70 |
$629 |
0.5× |
| Obstructive material removal from gi tube (49460) |
$490.20 |
$1,634 |
0.5× |
| Occipital Nerve Block (64405) |
$393 |
$1,310 |
1.3× |
| Open tx interphalangeal joint dislocation (26785) |
$3,199.80 |
$10,666 |
1.0× |
Open/Perq Place Stent 1St (37236) range across 2 matching MRF lines |
$10,978.50–$16,467.75 |
$36,595–$54,892.50 |
varies |
| Open/Perq Place Stent Same (37238) |
$10,978.50 |
$36,595 |
1.0× |
| Penile Injection (54235) |
$251.40 |
$838 |
1.0× |
| Perc Cryo Ablate Renal Tum (50593) |
$9,937.20 |
$33,124 |
0.9× |
| Perc Rf Ablate Renal Tumor (50592) |
$5,331 |
$17,770 |
0.9× |
| Percut Ablate Liver Rf (47382) |
$6,033.90 |
$20,113 |
1.0× |
| Percut Cath Occlusn Non Cns Lesn (61626) |
$12,508.80 |
$41,696 |
1.1× |
| Percut Drain/Inject Renal Cyst (50390) |
$1,319.70 |
$4,399 |
1.9× |
| Percut Mech Thrombectomy, Venous, Repeat (37188) |
$6,091.80 |
$20,306 |
1.9× |
| Pericardiocentesis W/Imaging (33016) |
$1,516.20 |
$5,054 |
1.0× |
| Peritoneal Lavage (49084) |
$2,511.60 |
$8,372 |
2.8× |
| Perm Occlusion/Embolization,Percut,Cns (61624) |
$15,939.90 |
$53,133 |
0.9× |
| Perq Cervicothoracic Inject (22510) |
$4,406.70 |
$14,689 |
1.4× |
| Perq dilation xst trc endourologic px w/img (50436) |
$5,764.50 |
$19,215 |
1.7× |
| Perq Lumbosacral Injection (22511) |
$4,406.70 |
$14,689 |
1.4× |
| Perq sft tiss loc device plmt 1st les w/gdnce (10035) |
$673.50 |
$2,245 |
1.0× |
| Perq thrmbc/nfs dial circuit trluml balo angiop (36905) |
$13,078.50 |
$43,595 |
1.1× |
| Perq thrmbc/nfs dialysis circuit img dx angrph (36904) |
$5,875.80 |
$19,586 |
1.0× |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) |
$7,627.20 |
$25,424 |
1.1× |
| Perq Vertebral Augmentation (22513) |
$7,627.20 |
$25,424 |
1.1× |
| Phleb Veins - Extrem 20+ (37766) |
$3,133.50 |
$10,445 |
1.0× |
Place Cath Subclavian Art (36225) range across 2 matching MRF lines |
$2,541.30–$3,811.95 |
$8,471–$12,706.50 |
varies |
| Place Cath Thoracic Aorta (36221) |
$2,541.30 |
$8,471 |
0.8× |
| Place Cath Vertebral Art (36226) |
$4,155.90 |
$13,853 |
0.8× |
| Placement of needle for intraosseous infusion (36680) |
$296.10 |
$987 |
0.7× |
| Plmt Access Thru Biliary Tree Into Small Bwl New (47541) |
$3,737.70 |
$12,459 |
0.6× |
| Plmt Bile Duct Stent Prq Existing Access (47538) |
$5,309.10 |
$17,697 |
0.9× |
| Plmt Bile Duct Stent Prq New Access W/Sep Cath (47540) |
$5,574.60 |
$18,582 |
0.9× |
Plmt Nephrostomy Cath Prq New Access Rs&I (50432) range across 2 matching MRF lines |
$3,385.50–$5,078.25 |
$11,285–$16,927.50 |
varies |
Plmt Nephroureteral Catheter (50433) range across 2 matching MRF lines |
$3,385.50–$5,078.25 |
$11,285–$16,927.50 |
varies |
| Plmt Urtrl Stent Prq New Access W/Sep Nfros Cath (50695) |
$4,203.90 |
$14,013 |
1.2× |
| Plmt Urtrl Stent Prq Pre-Existing Nfros Tract (50693) |
$3,821.40 |
$12,738 |
1.1× |
Prim art mech thrombectomy (37184) range across 2 matching MRF lines |
$11,052.30–$16,578.45 |
$36,841–$55,261.50 |
varies |
| Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300) |
$449.40 |
$1,498 |
0.5× |
| Proctosgmdsc Rigid Control Bleeding (45317) |
$838.80 |
$2,796 |
0.7× |
| Proctosgmdsc Rigid W/Rmvl Foreign Body (45307) |
$1,233.90 |
$4,113 |
0.4× |
| Proctosigmoidoscopy, rigid; with biopsy, single or multiple (45305) |
$1,118.40 |
$3,728 |
0.9× |
| Prq Aspir Pulposus/Intervertebral Disc/Pvrt Tiss (62267) |
$728.10 |
$2,427 |
1.0× |
| Prq Plmt Biliary Drg Cath W/Img Gid Rs&I Externl (47533) |
$2,806.50 |
$9,355 |
0.8× |
| Prq Plmt Biliary Drg Cath W/Img Gid Rs&I Int-Ext (47534) |
$2,806.50 |
$9,355 |
0.8× |
| Pseudoaneurysm Injection Trt (36002) |
$696.30 |
$2,321 |
1.1× |
| Punch biopsy skin single lesion (11104) |
$1,025.40 |
$3,418 |
2.5× |
| Puncture aspiration abscess hematoma bulla/cyst (10160) |
$363 |
$1,210 |
0.9× |
| Puncture Aspiration Cyst Breast (19000) |
$1,488.30 |
$4,961 |
2.1× |
| Puncture shunt tube/reservoir aspiration/inj px (61070) |
$822 |
$2,740 |
1.2× |
| Relocation Pocket Pacemaker (33222) |
$1,743.90 |
$5,813 |
0.9× |
| Rem Endovas Vena Cava Filter (37193) |
$1,900.20 |
$6,334 |
0.6× |
| Removal Biliary Drg Catheter Req Fluor Gid Rs&I (47537) |
$897.90 |
$2,993 |
1.0× |
Removal Embedded Foreign Body Eyelid (67938) range across 2 matching MRF lines |
$182.70–$274.05 |
$609–$913.50 |
varies |
| Removal Foreign Body Foot Subcutaneous (28190) |
$1,563.30 |
$5,211 |
2.2× |
Removal impacted cerumen irrigation/lvg unilat (69209) range across 2 matching MRF lines |
$96.60–$144.90 |
$322–$483 |
varies |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$152.70 |
$509 |
2.6× |
| Removal of nail bed (11750) |
$449.10 |
$1,497 |
1.1× |
| Removal of tunneled intraperitoneal catheter (49422) |
$3,239.40 |
$10,798 |
1.0× |
| Removal Pacemaker Electrode (33235) |
$2,109.90 |
$7,033 |
0.6× |
| Removal ppm generator only (33233) |
$7,463.70 |
$24,879 |
0.9× |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) |
$924.30 |
$3,081 |
4.7× |
| Removal subcutaneous cardiac rhythm monitor (33286) |
$1,604.40 |
$5,348 |
2.3× |
| Remove drug implant device (11982) |
$425.10 |
$1,417 |
1.0× |
| Remove Elctrd Transvenously (33244) |
$2,384.40 |
$7,948 |
0.6× |
| Remove foreign body from eye (65205) |
$199.80 |
$666 |
1.5× |
| Remove Int Dwell Ureteral Stent Transurethral (50386) |
$2,177.70 |
$7,259 |
1.1× |
| Remove Intrauterine Device (58301) |
$3,279.60 |
$10,932 |
10.9× |
| Remove intrvas foreign body (37197) |
$3,101.40 |
$10,338 |
1.0× |
| Remove lung catheter (32552) |
$801.90 |
$2,673 |
1.3× |
| Remove Nasal Foreign Body (30300) |
$216.90 |
$723 |
1.6× |
| Remove Pulse Generator (33241) |
$1,829.40 |
$6,098 |
0.5× |
| Remove renal tube w/fluoro (50389) |
$1,011.60 |
$3,372 |
1.5× |
| Remove ureter stent percut (50384) |
$2,074.20 |
$6,914 |
1.0× |
| Remove&replace pm gen singl (33227) |
$5,510.70 |
$18,369 |
0.7× |
| Remv&replc cvd gen dual lead (33263) |
$21,693 |
$72,310 |
1.0× |
| Remv&replc cvd gen mult lead (33264) |
$21,693 |
$72,310 |
0.7× |
| Remv&replc cvd gen sing lead (33262) |
$21,693 |
$72,310 |
1.0× |
| Remv&replc pm gen dual lead (33228) |
$10,349.70 |
$34,499 |
1.0× |
| Remv&replc pm gen mult leads (33229) |
$18,708.90 |
$62,363 |
1.0× |
Renal Biopsy Perq (50200) range across 3 matching MRF lines |
$2,152.50–$3,228.75 |
$7,175–$10,762.50 |
varies |
| Repair blood vessel lesion (35266) |
$4,236 |
$14,120 |
0.8× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
$2,605.20 |
$8,684 |
3.6× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
$2,865.60 |
$9,552 |
3.9× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$3,348 |
$11,160 |
8.3× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$3,683.40 |
$12,278 |
9.2× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$2,691 |
$8,970 |
6.7× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$811.20 |
$2,704 |
2.0× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$891.60 |
$2,972 |
2.2× |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
$981.30 |
$3,271 |
2.4× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
$1,079.70 |
$3,599 |
2.7× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$900 |
$3,000 |
1.2× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$676.50 |
$2,255 |
1.7× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$743.40 |
$2,478 |
1.8× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$818.10 |
$2,727 |
1.1× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$2,033.40 |
$6,778 |
5.1× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$678.90 |
$2,263 |
1.7× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$1,030.80 |
$3,436 |
2.6× |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) |
$2,277.60 |
$7,592 |
3.1× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$2,033.40 |
$6,778 |
5.1× |
| Repair lead pace-defib dual (33220) |
$3,439.20 |
$11,464 |
0.9× |
| Repair Lead Pace-Defib One (33218) |
$5,475.60 |
$18,252 |
1.5× |
| Repair of nail bed (11760) |
$452.40 |
$1,508 |
0.6× |
| Repair tongue laceration (41252) |
$707.40 |
$2,358 |
3.0× |
| Repair tongue laceration (41250) |
$2,277.60 |
$7,592 |
5.2× |
| Replace duodenostomy/jejunostomy tube perq (49451) |
$557.10 |
$1,857 |
0.6× |
| Replace G-J Tube Perc (49452) |
$578.70 |
$1,929 |
0.6× |
| Replace g/c tube perc (49450) |
$1,134 |
$3,780 |
1.3× |
| Reposition Gastrostomy Tube (43761) |
$1,267.80 |
$4,226 |
5.1× |
| Reposition L Ventric Lead (33226) |
$2,140.80 |
$7,136 |
0.7× |
| Reposition Pacing-Defib Lead (33215) |
$1,829.40 |
$6,098 |
0.6× |
| Reposition Venous Catheter (36597) |
$1,518 |
$5,060 |
1.0× |
| Repositioning phrenic nrv stimulator transvns ld (33281) |
$3,475.50 |
$11,585 |
1.0× |
| Revj Transvns Intrahepatic Portosystemic Shunt (37183) |
$9,126.30 |
$30,421 |
1.6× |
| Revsc evasc fpvt angiop uni cplx les 1st vsl (37265) |
$5,233.50 |
$17,445 |
0.9× |
| Revsc evasc fpvt angiop uni sf les 1st vsl (37263) |
$5,233.50 |
$17,445 |
0.9× |
| Revsc evasc fpvt athrc uni cplx les 1st vsl (37273) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc fpvt athrc uni sf les 1st vsl (37271) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc fpvt st athrc uni cplx les 1st vsl (37277) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc fpvt st athrc uni sf les 1st vsl (37275) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc fpvt st plmt uni cplx les 1st vsl (37269) |
$10,614.90 |
$35,383 |
0.9× |
| Revsc evasc fpvt st plmt uni sf les 1st vsl (37267) |
$10,614.90 |
$35,383 |
0.9× |
| Revsc evasc imvt angiop uni cplx les 1st vsl (37298) |
$10,614.90 |
$35,383 |
0.9× |
| Revsc evasc imvt angiop uni sf les 1st vsl (37296) |
$10,614.90 |
$35,383 |
0.9× |
| Revsc evasc ivt angiop uni cplx les 1st vsl (37256) |
$5,233.50 |
$17,445 |
0.9× |
| Revsc evasc ivt angiop uni sf les 1st vsl (37254) |
$5,233.50 |
$17,445 |
0.9× |
| Revsc evasc ivt st plmt uni cplx les 1st vsl (37260) |
$10,614.90 |
$35,383 |
0.9× |
| Revsc evasc ivt st plmt uni sf les 1st vsl (37258) |
$10,614.90 |
$35,383 |
0.9× |
| Revsc evasc tpvt angiop uni cplx les 1st vsl (37282) |
$10,614.90 |
$35,383 |
0.9× |
| Revsc evasc tpvt angiop uni sf les 1st vsl (37280) |
$10,614.90 |
$35,383 |
0.9× |
| Revsc evasc tpvt athrc uni cplx les 1st vsl (37290) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc tpvt athrc uni sf les 1st vsl (37288) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc tpvt st athrc uni cplx les 1st vsl (37294) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc tpvt st athrc uni sf les 1st vsl (37292) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc tpvt st plmt uni cplx les 1st vsl (37286) |
$16,856.10 |
$56,187 |
0.9× |
| Revsc evasc tpvt st plmt uni sf les 1st vsl (37284) |
$16,856.10 |
$56,187 |
0.9× |
Rmvl & rplcmt xtrnl accessible nephrourtrl cath (50387) range across 2 matching MRF lines |
$1,841.10–$2,761.65 |
$6,137–$9,205.50 |
varies |
| Rmvl Embedded Fb Vestibule Mouth Smpl (40804) |
$886.20 |
$2,954 |
1.0× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$291.30 |
$971 |
0.7× |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
$343.20 |
$1,144 |
2.6× |
| Rmvl fecal impaction/fb spx under anes (45915) |
$1,118.40 |
$3,728 |
0.9× |
| Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) |
$4,843.20 |
$16,144 |
1.7× |
| Rmvl Foreign Body Upper Arm/Elbow Subcutaneous (24200) |
$1,531.50 |
$5,105 |
0.9× |
| Rmvl of subq implantable defibrillator electrode (33272) |
$3,294.30 |
$10,981 |
0.9× |
| Rmvl Phrenic Nrv Stimulator Pulse Generator Only (33280) |
$3,475.50 |
$11,585 |
1.0× |
| Rmvl phrnc nrv stimulator transvns stimj/snsg ld (33279) |
$3,475.50 |
$11,585 |
1.0× |
| Rmvl transvns pm eltrd 1 lead sys atr/ventr (33234) |
$1,859.40 |
$6,198 |
0.5× |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
$1,611.90 |
$5,373 |
1.0× |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
$2,853.60 |
$9,512 |
4.6× |
| Rmvl&rplcmt phrenic nrv stimulator pls generator (33287) |
$32,141.40 |
$107,138 |
1.1× |
| Rmvl&rplcmt phrnc nrv stim trnsvns stimj/snsg ld (33288) |
$21,281.10 |
$70,937 |
1.9× |
| Rplc Gtube No Revj Trc (43762) |
$2,271.60 |
$7,572 |
9.2× |
| Rplc gtube revj gstrst trc (43763) |
$3,044.10 |
$10,147 |
12.3× |
| Rplcmt cath ctr vad subq port/pmp (36578) |
$3,097.80 |
$10,326 |
1.0× |
| Rplcmt compl non-tun cvc w/o subq port/pmp (36580) |
$2,250.30 |
$7,501 |
1.4× |
| Rplcmt compl tun ctr vad w/subq port (36582) |
$5,468.10 |
$18,227 |
1.7× |
| Rplcmt compl tun cvc w/o subq port/pmp (36581) |
$3,097.80 |
$10,326 |
1.0× |
| Rpr ctr vad w/subq port/pmp ctr/prph insj sit (36576) |
$1,514.40 |
$5,048 |
1.0× |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) |
$625.80 |
$2,086 |
3.2× |
| Rpr Lip Full Thickness Half/< Vertical Height (40652) |
$476.70 |
$1,589 |
0.9× |
| Rpr Lip Full Thickness Vermilion Only (40650) |
$877.50 |
$2,925 |
1.6× |
| Rpr Lip Full Thkns >One-Half Vert Height/Comple (40654) |
$1,470 |
$4,900 |
1.0× |
| Rpr tun/non-tun ctr vad cath w/o subq port/pmp (36575) |
$585 |
$1,950 |
0.9× |
| Sclerotx Fluid Collection (49185) |
$1,611.30 |
$5,371 |
1.0× |
| Sgmdsc flx dired sbmcsl njx any sbst (45335) |
$1,056 |
$3,520 |
1.1× |
| Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) |
$1,056 |
$3,520 |
0.9× |
| Sigmoidoscopy & decompress (45337) |
$1,056 |
$3,520 |
1.1× |
| Sigmoidoscopy & Polypectomy (45333) |
$1,712.40 |
$5,708 |
1.9× |
| Sigmoidoscopy Flx Ablation Tumor Polyp/Oth Les (45346) |
$1,161.90 |
$3,873 |
1.0× |
| Sigmoidoscopy flx tndsc balo dilat (45340) |
$1,056 |
$3,520 |
0.9× |
| Sigmoidoscopy flx tndsc us gid ndl aspir/bx (45342) |
$1,161.90 |
$3,873 |
1.0× |
| Sigmoidoscopy Flx With With Band Ligation(S) (45350) |
$1,056 |
$3,520 |
0.9× |
| Sigmoidoscopy w/fb removal (45332) |
$1,056 |
$3,520 |
0.9× |
| Sigmoidoscopy w/plcmt stent (45347) |
$5,026.20 |
$16,754 |
0.8× |
| Sigmoidoscopy W/Resection (45349) |
$2,465.10 |
$8,217 |
0.9× |
| Sigmoidoscopy W/Ultrasound (45341) |
$1,056 |
$3,520 |
1.1× |
| Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) |
$1,712.40 |
$5,708 |
1.9× |
| Sigmoidoscopy,Flex,W/Control,Bleeding (45334) |
$1,056 |
$3,520 |
0.9× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
$688.80 |
$2,296 |
1.7× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$336.60 |
$1,122 |
1.7× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$370.20 |
$1,234 |
1.9× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$445.20 |
$1,484 |
2.2× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$392.10 |
$1,307 |
2.0× |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
$632.10 |
$2,107 |
3.2× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$474.90 |
$1,583 |
2.4× |
| Skin sub graft face/nk/hf/g (15275) |
$1,035.60 |
$3,452 |
1.4× |
| Skin sub graft trnk/arm/leg (15271) |
$1,035.60 |
$3,452 |
1.4× |
| Skin sub grft t/arm/lg child (15273) |
$1,952.10 |
$6,507 |
1.0× |
Slctv Cath Carotid/Innom Art Angio Intrcranl Art (36223) unusually low: confirm this is the full procedure |
$2,541.30 |
$8,471 |
0.5× |
Slctv cath carotid/innom art angio xtrcranl art (36222) range across 2 matching MRF lines |
$2,541.30–$3,811.95 |
$8,471–$12,706.50 |
varies |
| Slctv Cath Intrnl Carotid Art Angio Intrcrnl Art (36224) |
$4,155.90 |
$13,853 |
0.8× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$430.80 |
$1,436 |
2.2× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$522 |
$1,740 |
1.3× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$573.90 |
$1,913 |
1.4× |
| Spinal puncture lumbar diagnostic (62270) |
$1,518.30 |
$5,061 |
2.2× |
| Stab phlebt varicose veins 1 xtr 10-20 stab incs (37765) |
$3,014.10 |
$10,047 |
1.0× |
| Strapping elbow or wrist (29260) |
$191.40 |
$638 |
3.3× |
| Strapping hand/finger (29280) |
$191.40 |
$638 |
3.3× |
| Strapping shoulder (29240) |
$191.40 |
$638 |
1.5× |
| Strapping toes (29550) |
$170.10 |
$567 |
2.9× |
Strapping Unna Boot (29580) range across 2 matching MRF lines |
$190.80–$286.20 |
$636–$954 |
varies |
| Tangential biopsy skin single lesion (11102) |
$1,025.40 |
$3,418 |
2.5× |
| Tcat Impl Wrls P-Art Prs Snr L-T Hemodyn Mntr (33289) |
$37,411.50 |
$124,705 |
1.3× |
| Tcat Insj/Rpl Perm Ldls Pm (33274) |
$19,223.40 |
$64,078 |
1.0× |
| Tcat Rmvl Perm Ldls Pm (33275) |
$4,513.20 |
$15,044 |
1.4× |
| Ther Spi Pnxr Csf Fluor/Ct (62329) |
$759.30 |
$2,531 |
1.1× |
| Therapeutic plasma exchange (36514) |
$1,844.70 |
$6,149 |
1.2× |
| Thrmbc/Nfs Dialysis Circuit (36906) |
$16,854.30 |
$56,181 |
0.9× |
| Thromblytic art/ven therapy (37213) |
$2,563.80 |
$8,546 |
0.8× |
Thrombolytic Art Therapy (37211) range across 2 matching MRF lines |
$5,033.70–$7,550.55 |
$16,779–$25,168.50 |
varies |
| Thrombolytic Therapy Stroke (37195) |
$320.40 |
$1,068 |
1.0× |
| Thrombolytic Venous Therapy (37212) |
$1,149.60 |
$3,832 |
0.4× |
| Thyroid biopsy (60100) |
$539.40 |
$1,798 |
0.8× |
| Tprnl Plmt Biodegrdabl Matrl (55874) |
$4,758.30 |
$15,861 |
0.9× |
| Tracheostomy Emergency Procedure Transtracheal (31603) |
$894.60 |
$2,982 |
0.6× |
Transcatheter biopsy (37200) unusually low: confirm this is the full procedure |
$2,307.30 |
$7,691 |
0.4× |
| Transoral lower esophageal myotomy (43497) |
$3,310.50 |
$11,035 |
0.6× |
| Treat humerus fracture (24500) |
$1,619.70 |
$5,399 |
6.6× |
| Treat Humerus Fracture (24505) |
$1,820.10 |
$6,067 |
1.1× |
| Treat knee fracture (27532) |
$3,054.90 |
$10,183 |
0.9× |
| Treat Knuckle Dislocation (26700) |
$273.30 |
$911 |
1.1× |
| Treat Thumb Dislocation (26641) |
$243 |
$810 |
1.0× |
| Treat toe dislocation (28630) |
$271.50 |
$905 |
1.1× |
| Treatment Closed Elbow Dislocation Req Anes (24605) |
$2,033.40 |
$6,778 |
1.3× |
| Treatment closed elbow dislocation w/o anes (24600) |
$1,700.40 |
$5,668 |
7.0× |
| Trim skin lesion (11055) |
$108.60 |
$362 |
0.5× |
| Trluml Balo Angiop 1St Art (37246) |
$15,308.40 |
$51,028 |
2.7× |
Trluml Balo Angiop 1St Vein (37248) range across 2 matching MRF lines |
$7,203–$10,804.50 |
$24,010–$36,015 |
varies |
| Tx Gastro Intub W/Asp (43753) |
$376.80 |
$1,256 |
1.8× |
| Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) |
$2,787.60 |
$9,292 |
1.8× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) |
$2,118.30 |
$7,061 |
2.9× |
| Unlisted Procedure Biliary Tract (47999) |
$954.90 |
$3,183 |
1.1× |
| Unlisted procedure breast (19499) |
$3,618.90 |
$12,063 |
0.9× |
| Unlisted procedure colon (45399) |
$816 |
$2,720 |
0.9× |
| Unlisted Procedure Endocrine System (60699) |
$5,416.20 |
$18,054 |
0.9× |
| Unlisted Procedure Esophagus (43499) |
$976.20 |
$3,254 |
1.1× |
| Unlisted Procedure Intestine (44799) |
$2,157.30 |
$7,191 |
2.4× |
| Unlisted procedure nervous system (64999) |
$341.10 |
$1,137 |
1.1× |
| Unlisted procedure stomach (43999) |
$976.20 |
$3,254 |
1.1× |
Unlisted Procedure Vascular Surgery (37799) range across 2 matching MRF lines |
$609–$2,199.90 |
$2,030–$7,333 |
varies |
| Unlisted px female genital system nonobstetrical (58999) |
$3,014.10 |
$10,047 |
15.1× |
| Vasc embolize/occlude artery (37242) |
$12,382.80 |
$41,276 |
0.7× |
| Vasc Embolize/Occlude Bleed (37244) |
$12,382.80 |
$41,276 |
1.1× |
| Vasc Embolize/Occlude Organ (37243) |
$12,382.80 |
$41,276 |
1.1× |
| Vasc embolize/occlude venous (37241) |
$12,382.80 |
$41,276 |
1.1× |
Venous Mech Thrombectomy (37187) range across 2 matching MRF lines |
$5,692.80–$8,539.20 |
$18,976–$28,464 |
varies |
| Wedge excision skin nail fold (11765) |
$237.90 |
$793 |
0.6× |
| Wound Prep F/N/Hf/G (15004) |
$348.60 |
$1,162 |
0.9× |