| Abd paracentesis (49082) |
$464 |
$580 |
0.5× |
| Abd paracentesis w/imaging (49083) |
$476 |
$595 |
0.5× |
| Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release Age Under 21 (23130) |
$6,776 |
$8,470 |
2.0× |
| Adenoidectomy, primary; younger than age 12 Age Under 21 (42830) |
$11,189.60 |
$13,987 |
3.2× |
| Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet;… (14040) |
$2,468.40 |
$3,085.50 |
1.1× |
| Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm Age Under 21 (14001) |
$3,471.60 |
$4,339.50 |
1.6× |
| Amputation of toe (28820) |
$3,388 |
$4,235 |
1.0× |
| Amputation, leg, through tibia and fibula; secondary closure or scar revision Age Under 21 (27884) |
$5,160 |
$6,450 |
1.5× |
| Anesthesia inj anesthetic agent dig nrv (64455) |
$251.20 |
$314 |
0.8× |
| Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic Age Under 21 (45990) |
$1,245.60 |
$1,557 |
0.4× |
| App skn sub grft t/a/l area/<100scm /<1st 25 scm (15271) |
$367.20 |
$459 |
0.5× |
| Appendectomy (44950) |
$7,390.40 |
$9,238 |
1.1× |
| Application Finger Splint Dynamic (29131) |
$69.60 |
$87 |
1.1× |
| Application finger splint static (29130) |
$73.60 |
$92 |
0.5× |
| Application of long leg cast (thigh to toes); (29345) |
$320.80 |
$401 |
1.1× |
| Application of long leg splint (thigh to ankle or toes) (29505) |
$282.40 |
$353 |
1.6× |
| Application of short arm splint (forearm to hand); static (29125) |
$129.60 |
$162 |
0.9× |
| Application of short leg cast (below knee to toes); (29405) |
$149.60 |
$187 |
0.5× |
| Application of short leg cast (below knee to toes); walking or ambulatory type (29425) |
$178.80 |
$223.50 |
0.6× |
| Application of short leg splint (calf to foot) (29515) |
$121.20 |
$151.50 |
0.7× |
| Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or… (15277) |
$540 |
$675 |
0.2× |
| Application of vein wound compression bandages on lower leg ankle and foot|BILATERAL PROCEDURE |SERV DELIV PERSONALLY… (29581) |
$200.80 |
$251 |
1.2× |
| Application of vein wound compression bandages on upper arm forearm hand and fingers|SERV DELIV PERSONALLY BY PT OR… (29584) |
$288 |
$360 |
1.7× |
| Application, cast; shoulder to hand (long arm) (29065) |
$276.40 |
$345.50 |
0.9× |
| Apply long arm splint (29105) |
$198 |
$247.50 |
1.2× |
| Apply patella tendon bearing cast (29435) |
$255.20 |
$319 |
0.9× |
| Apply splint short arm dynamic (29126) |
$182.40 |
$228 |
1.3× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$271.60 |
$339.50 |
0.8× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$263.60 |
$329.50 |
0.8× |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
$490 |
$612.50 |
1.5× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$301.60 |
$377 |
0.9× |
| Arthrodesis, great toe; interphalangeal joint Age Under 21 (28755) |
$4,666.80 |
$5,833.50 |
0.6× |
| Arthrodesis, interphalangeal joint, with or without internal fixation; Age Under 21 (26860) |
$2,364 |
$2,955 |
0.7× |
| Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft) Age… (26862) |
$1,966.40 |
$2,458 |
0.6× |
Arthrodesis, metacarpophalangeal joint, with or without internal fixation; Age Under 21 (26850)
unusually low — confirm this is the full procedure |
$2,502 |
$3,127.50 |
0.3× |
| Arthroplasty glenohumeral joint total shoulder (23472) |
$9,864.80 |
$12,331 |
0.5× |
| Arthroplasty, glenohumeral joint; hemiarthroplasty (23470) |
$6,927.20 |
$8,659 |
0.5× |
| Arthroplasty, interphalangeal joint; with prosthetic implant, each joint Age Under 21 (26536) |
$14,056 |
$17,570 |
1.8× |
| Arthroplasty, patella; without prosthesis Age Under 21 (27437) |
$19,983.20 |
$24,979 |
2.6× |
| Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction Age Under 21 (29888) |
$7,400.80 |
$9,251 |
1.0× |
| Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited Age Under 21 (29897) |
$2,228 |
$2,785 |
0.6× |
| Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or… (29879) |
$3,650.40 |
$4,563 |
1.1× |
| Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) Age Under 21 (29877) |
$4,058.80 |
$5,073.50 |
1.2× |
| Arthroscopy, knee, surgical; injection of biocartilage, bone aspirate, or bone substitute into chondral defect and/or… (29999) |
$4,182 |
$5,227.50 |
16.1× |
| Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) Age Under 21 (29875) |
$3,630 |
$4,537.50 |
1.1× |
| Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including… (29880) |
$4,592.40 |
$5,740.50 |
1.3× |
| Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) Age Under 21 (29882) |
$5,121.20 |
$6,401.50 |
1.5× |
| Arthroscopy, shoulder, surgical; capsulorrhaphy Age Under 21 (29806) |
$6,814.40 |
$8,518 |
0.9× |
| Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral… (29823) |
$1,838 |
$2,297.50 |
0.5× |
| Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular… (29822) |
$4,215.20 |
$5,269 |
1.2× |
| Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure) Age Under… (29824) |
$3,917.60 |
$4,897 |
1.1× |
Arthroscopy, shoulder, surgical; repair of SLAP lesion Age Under 21 (29807)
unusually low — confirm this is the full procedure |
$3,654.80 |
$4,568.50 |
0.5× |
| Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation Age Under 21 (29825) |
$4,969.20 |
$6,211.50 |
1.4× |
| Arthroscopy, shoulder, surgical; with rotator cuff repair Age Under 21 (29827) |
$4,162 |
$5,202.50 |
0.5× |
| Arthrotomy with meniscus repair, knee Age Under 21 (27403) |
$4,763.60 |
$5,954.50 |
0.6× |
| Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each Age Under… (26075) |
$3,593.20 |
$4,491.50 |
1.0× |
| Arthrp acetblr/prox fem prostc agrft/algrft (27130) |
$7,956.40 |
$9,945.50 |
0.6× |
| Arthrt w/expl drg/rmvl loose/fb iphal jt (28024) |
$2,012.80 |
$2,516 |
1.2× |
| Aspirate pleura w/o imaging (32554) |
$188 |
$235 |
0.3× |
| Aspiration and/or injection of ganglion cyst(s) any location (20612) |
$86.40 |
$108 |
0.3× |
| Avulsion of nail plate, partial or complete, simple; single (11730) |
$124 |
$155 |
0.6× |
| Biopsy external ear (69100) |
$327.20 |
$409 |
1.3× |
| Biopsy lip (40490) |
$327.20 |
$409 |
1.3× |
| Biopsy of large bowel using an endoscope inserted through surgically created opening from large bowel to skin (44389) |
$1,081.60 |
$1,352 |
0.9× |
| Biopsy of tongue; anterior two-thirds Age Under 21 (41100) |
$1,162.40 |
$1,453 |
2.0× |
| Biopsy of uterus lining (58100) |
$324 |
$405 |
1.5× |
| Biopsy or excision of lymph node(s); open, superficial (38500) |
$2,907.60 |
$3,634.50 |
0.7× |
| Biopsy or removal of deep lymph nodes of underarm|LEFT SIDE|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF… (38525) |
$3,548.80 |
$4,436 |
0.9× |
| Biopsy/removal lymph nodes (38510) |
$3,718.80 |
$4,648.50 |
0.9× |
| Bladder irrigation (51700) |
$206 |
$257.50 |
0.8× |
| C/c 55831 lap, prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration… (55899) |
$516.80 |
$646 |
2.0× |
| Capslrhphy; metatrsphalngl joint w/wo tenrhphy or lgmnt rpr sngl joint (28899) |
$200 |
$250 |
0.8× |
| Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie,… (27036) |
$4,624.80 |
$5,781 |
0.6× |
| Cast short arm (29075) |
$229.20 |
$286.50 |
0.8× |
| Change Cystostomy Tube Simple (51705) |
$783.20 |
$979 |
3.0× |
| Chemical cauterization of granulation tissue (17250) |
$177.60 |
$222 |
0.8× |
| Chemodervate facial/trigem/cerv musc migraine (64615) |
$211.20 |
$264 |
0.7× |
| Chest tube placement (32551) |
$879.20 |
$1,099 |
0.5× |
| Claviculectomy; partial Age Under 21 (23120) |
$4,168.80 |
$5,211 |
1.2× |
| Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation Age Under 21 (27842) |
$1,032 |
$1,290 |
0.6× |
| Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia… (26675) |
$576.40 |
$720.50 |
0.3× |
| Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each (26750) |
$688.80 |
$861 |
2.6× |
| Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation Age Under 21 (27510) |
$1,423.20 |
$1,779 |
0.8× |
| Closed treatment of knee dislocation; without anesthesia (27550) |
$1,007.20 |
$1,259 |
3.9× |
| Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia Age Under 21 (26705) |
$804.80 |
$1,006 |
0.5× |
| Closed treatment of phalangeal shaft fracture, proximal/middle phalanx with manipulation each (26725) |
$519.60 |
$649.50 |
2.0× |
| Closed treatment of post hip arthroplasty dislocation; requiring general anesthesia (27266) |
$2,575.20 |
$3,219 |
1.5× |
| Closed treatment of proximal fibula or shaft fracture; with manipulation (27781) |
$836 |
$1,045 |
0.5× |
| Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation (24640) |
$162.40 |
$203 |
0.6× |
| Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) |
$636 |
$795 |
2.4× |
| Closed tx bimalleolar ankle fracture w/manj (27810) |
$883.20 |
$1,104 |
0.5× |
| Closed tx radial shaft fracture w/manipulation (25505) |
$1,028 |
$1,285 |
0.6× |
| CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee (25565) |
$1,028 |
$1,285 |
0.6× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
$844 |
$1,055 |
0.5× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$1,281.60 |
$1,602 |
0.8× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
$297.60 |
$372 |
1.1× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
$144 |
$180 |
0.6× |
| CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee (26700) |
$388 |
$485 |
1.5× |
| CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee (27752) |
$1,032 |
$1,290 |
0.6× |
| Collect blood from catheter venous nos (36592) |
$177.20 |
$221.50 |
1.3× |
| Collect blood from implant venous access device (36591) |
$148.80 |
$186 |
1.1× |
| Colonoscopy thru stoma spx (44388) |
$1,632.40 |
$2,040.50 |
1.7× |
| Colonoscopy w/ablation (45388) |
$2,471.20 |
$3,089 |
2.0× |
| Colonoscopy w/fb removal (45379) |
$1,237.20 |
$1,546.50 |
1.0× |
| Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps Age Under 21 (45384) |
$1,802 |
$2,252.50 |
1.4× |
| Colposcopy cervix (57452) |
$506.40 |
$633 |
2.4× |
| Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix Age Under 21 (57455) |
$610.40 |
$763 |
1.9× |
| Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage Age… (57454) |
$770.40 |
$963 |
2.4× |
| Colposcopy w/endocervical curettage (57456) |
$536.80 |
$671 |
1.7× |
| Colsc flx with directed submucosal njx any sbst (45381) |
$1,448 |
$1,810 |
1.1× |
| Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method (30903) |
$492 |
$615 |
3.5× |
| Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) |
$191.60 |
$239.50 |
1.4× |
| Correction of bunion (28292) |
$3,885.20 |
$4,856.50 |
1.1× |
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method Age… (28299)
likely a partial charge — not the full procedure |
$2,262 |
$2,827.50 |
0.3× |
| Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial… (28297) |
$18,983.20 |
$23,729 |
1.4× |
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any… (28298)
unusually low — confirm this is the full procedure |
$3,768.80 |
$4,711 |
0.5× |
| Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy) (28285) |
$2,758.40 |
$3,448 |
0.8× |
| Corrj hlx vlgs bncty sesmdc dstl metar osteot (28296) |
$4,506.40 |
$5,633 |
1.3× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$492 |
$615 |
3.5× |
| Ctrl nsl hemrrg pst nasal packs&/cautery subsq (30906) |
$492 |
$615 |
2.0× |
| Cystourethroscopy (52000) |
$1,077.20 |
$1,346.50 |
1.5× |
| Debridement of extensive eczematous or infected skin; up to 10% of body surface (11000) |
$1,153.60 |
$1,442 |
2.7× |
| Debridement of nail(s) by any method(s); 1 to 5 (11720) |
$70.40 |
$88 |
1.1× |
| Debridement of nail(s) by any method(s); 6 or more (11721) |
$116.80 |
$146 |
1.9× |
| DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee (11042) |
$453.20 |
$566.50 |
1.1× |
| Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm… (11044) |
$3,482.40 |
$4,353 |
2.0× |
| Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm… (11043) |
$2,862.80 |
$3,578.50 |
3.7× |
| Declot vascular device (36593) |
$497.60 |
$622 |
1.4× |
Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas,… (27027)
unusually low — confirm this is the full procedure |
$3,173.60 |
$3,967 |
0.4× |
| Deep muscle biopsy (20205) |
$5,388.80 |
$6,736 |
1.8× |
| Delivery of placenta (59414) |
$86.40 |
$108 |
0.0× |
| Destroy nerve face muscle (64612) |
$592 |
$740 |
1.8× |
| Destruct lesion 15 or more (17111) |
$175.20 |
$219 |
0.8× |
| Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions… (17000) |
$110.40 |
$138 |
0.5× |
| Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions… (17004) |
$469.60 |
$587 |
1.1× |
| Destruction benign lesions up to 14 (17110) |
$110.40 |
$138 |
0.5× |
| Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical… (46922) |
$1,919.20 |
$2,399 |
0.7× |
| Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg,… (54065) |
$467.20 |
$584 |
0.2× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17282) |
$347.20 |
$434 |
1.6× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17281) |
$289.60 |
$362 |
1.4× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17261) |
$149.60 |
$187 |
0.7× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17263) |
$264.80 |
$331 |
1.3× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17272) |
$317.60 |
$397 |
1.5× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17262) |
$179.20 |
$224 |
0.8× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17264) |
$317.60 |
$397 |
0.7× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17271) |
$264.80 |
$331 |
1.3× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17283) |
$416.80 |
$521 |
1.0× |
| Diagnostic bone marrow biopsies (38221) |
$946.40 |
$1,183 |
0.5× |
| Diagnostic sigmoidoscopy (45330) |
$768 |
$960 |
0.8× |
| Dilation of esophagus, by unguided sound or bougie, single or multiple passes Age Under 21 (43450) |
$876.80 |
$1,096 |
0.9× |
| Drainage finger abscess simple (26010) |
$294.40 |
$368 |
1.4× |
| Drainage of finger abscess; complicated (eg, felon) (26011) |
$624.80 |
$781 |
0.4× |
| Drainage of scrotum (54700) |
$341.20 |
$426.50 |
0.2× |
| Ed proc insert intraosseous IV (36680) |
$271.20 |
$339 |
0.6× |
| Ed proc insj temp ndwellg bladder catheter complicated (51703) |
$492.80 |
$616 |
3.6× |
| Ed prof arthrocentesis sm - hospital (20551) |
$184.40 |
$230.50 |
0.6× |
| Ed prof artl pnxr w/drawal bld dx (36600) |
$69.60 |
$87 |
0.5× |
| Ed prof burn small - hospital (16020) |
$113.60 |
$142 |
0.5× |
| Ed prof catheterization/straight (51701) |
$346.40 |
$433 |
2.5× |
| Ed prof drain dental abscess-hospital (41800) |
$369.60 |
$462 |
2.6× |
| Ed prof insert foley cath simple (51702) |
$327.60 |
$409.50 |
2.3× |
| Ed prof insert non tunnel cv cath >5 (36556) |
$177.60 |
$222 |
0.1× |
| Ed prof int lac 12.6-20cm bd - hospital (12035) |
$649.60 |
$812 |
1.5× |
| Ed prof int lac 7.6-12.5cm bd - hospital (12034) |
$435.20 |
$544 |
1.0× |
| Ed prof interphalangeal dislocation- hospital (26770) |
$531.20 |
$664 |
2.0× |
| Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) |
$424 |
$530 |
0.9× |
| Egd percutaneous placement gastrostomy tube (43246) |
$2,427.20 |
$3,034 |
1.2× |
| Egd removal tumor polyp/other lesion snare tech (43251) |
$1,668.80 |
$2,086 |
0.8× |
| Egd transoral control bleeding any method (43255) |
$1,210 |
$1,512.50 |
0.6× |
| Endocervical curettage (57505) |
$663.20 |
$829 |
0.7× |
| Er inj anesthetic agent, peripheral nerve or branch (64450) |
$168.80 |
$211 |
0.2× |
| Esoph egd dilation <30 mm (43249) |
$1,815.60 |
$2,269.50 |
0.9× |
| Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy… (43250) |
$1,555.60 |
$1,944.50 |
0.8× |
| Evac subungual hematoma (11740) |
$67.20 |
$84 |
0.5× |
| Ex tum/vasc mal sft tis hand/fngr subfsc 1.5+cm (26113) |
$8,481.60 |
$10,602 |
4.9× |
| Exam with injections of chemical for destruction of bladder using an endoscope|DISC OP HOSP/AMB SURGR CENT (ASC) PROC… (52287) |
$2,581.60 |
$3,227 |
1.2× |
| Exc f/e/e/n/l mal+mrg 1.1-2 (11642) |
$2,188.80 |
$2,736 |
2.9× |
| Exc face les sbq 2 cm/> (21012) |
$1,513.60 |
$1,892 |
0.9× |
| Exc h-f-nk-sp b9+marg 0.5/< (11420) |
$518.40 |
$648 |
0.3× |
| Exc h-f-nk-sp b9+marg 0.6-1 (11421) |
$1,068 |
$1,335 |
1.4× |
| Exc h-f-nk-sp b9+marg 1.1-2 (11422) |
$1,255.20 |
$1,569 |
0.7× |
| Exc tr-ext b9+marg 0.5 < cm (11400) |
$344.80 |
$431 |
0.5× |
| Exc tr-ext b9+marg 1.1-2 cm (11402) |
$688.80 |
$861 |
0.9× |
| Exc tum/vas mal sft tis hand/fngr subfasc<1.5cm (26116) |
$2,796.80 |
$3,496 |
1.6× |
| Exc tumor soft tiss upr arm/elbow subfasc <5cm (24076) |
$3,814.80 |
$4,768.50 |
1.2× |
| Exc tumor soft tissue leg/ankle subq <3cm (27618) |
$4,000 |
$5,000 |
2.3× |
| Exc tumor soft tissue pelvis & hip subq <3cm (27047) |
$4,490.40 |
$5,613 |
1.5× |
| Excision ganglion wrist dorsal/volar primary (25111) |
$2,250.40 |
$2,813 |
1.3× |
| Excision lesion tendon sheath forearm&/wrist (25110) |
$2,127.20 |
$2,659 |
1.3× |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) |
$294.40 |
$368 |
0.4× |
| Excision Mal Lesion Trunk/Arm/Leg 1.1-2.0 Cm (11602) |
$484.40 |
$605.50 |
1.1× |
| Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) |
$1,063.20 |
$1,329 |
1.4× |
| Excision malignant lesion f/e/e/n/l >4.0 cm (11646) |
$2,515.20 |
$3,144 |
0.8× |
| Excision malignant lesion s/n/h/f/g 0.5 cm/< (11620) |
$866.40 |
$1,083 |
0.5× |
| Excision Malignant Lesion S/N/H/F/G 0.6-1.0 Cm (11621) |
$347.60 |
$434.50 |
0.5× |
| Excision Malignant Lesion S/N/H/F/G 1.1-2.0 Cm (11622) |
$1,232.80 |
$1,541 |
1.7× |
| Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) |
$1,416 |
$1,770 |
0.8× |
| Excision of ganglion, wrist (dorsal or volar); recurrent Age Under 21 (25112) |
$805.20 |
$1,006.50 |
0.5× |
| Excision of hydrocele of spermatic cord, unilateral (separate procedure) Age Under 21 (55500) |
$2,391.20 |
$2,989 |
0.6× |
| Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair (40812) |
$613.20 |
$766.50 |
0.4× |
| Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle Age Under 21 (27630) |
$2,724 |
$3,405 |
0.8× |
| Excision of lesion of tendon sheath or joint capsule, hand or finger (26160) |
$1,725.60 |
$2,157 |
1.0× |
| Excision of neuroma; hand or foot, except digital nerve Age Under 21 (64782) |
$3,537.60 |
$4,422 |
1.7× |
| Excision of pilonidal cyst or sinus; simple Age Under 21 (11770) |
$1,791.60 |
$2,239.50 |
0.6× |
| Excision of single external papilla or tag, anus (46220) |
$1,657.20 |
$2,071.50 |
1.3× |
| Excision olecranon bursa (24105) |
$3,664.80 |
$4,581 |
1.1× |
| Excision or transposition of pterygium; without graft Age Under 21 (65420) |
$2,751.20 |
$3,439 |
1.1× |
| Excision pilonidal cyst/sinus complicated (11772) |
$2,148.40 |
$2,685.50 |
0.7× |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) |
$1,604 |
$2,005 |
0.9× |
| Excision tumor soft tissue back/flank subq <3cm (21930) |
$2,805.20 |
$3,506.50 |
1.6× |
| Excision tumor soft tissue thigh/knee subq <3cm (27327) |
$2,182.40 |
$2,728 |
1.3× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11423) |
$560.80 |
$701 |
0.3× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11426) |
$4,905.20 |
$6,131.50 |
1.6× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11424) |
$1,530 |
$1,912.50 |
0.9× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11401) |
$421.20 |
$526.50 |
1.0× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11404) |
$1,470.40 |
$1,838 |
0.8× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11403) |
$972.80 |
$1,216 |
1.3× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11406) |
$2,834.40 |
$3,543 |
1.6× |
| Excision, interdigital (Morton) neuroma, single, each Age Under 21 (28080) |
$3,995.20 |
$4,994 |
2.4× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less Age… (11640) |
$1,151.20 |
$1,439 |
1.5× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm Age Under… (11643) |
$2,950.40 |
$3,688 |
1.7× |
| Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm Age… (11626) |
$4,197.20 |
$5,246.50 |
1.4× |
| Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm Age Under 21 (11606) |
$1,772.80 |
$2,216 |
1.0× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11442) |
$866.40 |
$1,083 |
1.2× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11441) |
$355.60 |
$444.50 |
0.5× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11444) |
$84 |
$105 |
0.0× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11440) |
$1,922 |
$2,402.50 |
2.6× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11443) |
$2,370.40 |
$2,963 |
1.4× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11446) |
$2,080 |
$2,600 |
0.7× |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater Age Under 21 (22903) |
$2,694.80 |
$3,368.50 |
0.9× |
| Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater Age Under 21 (21933) |
$1,845.60 |
$2,307 |
0.6× |
| Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater Age Under 21 (21014) |
$1,121.60 |
$1,402 |
0.4× |
| Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater Age Under 21 (27632) |
$1,831.60 |
$2,289.50 |
0.6× |
| Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater Age Under 21 (21552) |
$3,114.40 |
$3,893 |
1.0× |
| Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm (21555) |
$743.20 |
$929 |
0.4× |
| Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater (27043) |
$2,790 |
$3,487.50 |
0.9× |
| Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm Age Under 21 (23075) |
$1,834 |
$2,292.50 |
1.1× |
| Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm Age Under 21 (24075) |
$1,186.40 |
$1,483 |
0.7× |
| Excison tumor soft tissue thigh/knee subq 3 cm/> (27337) |
$2,412 |
$3,015 |
0.8× |
| Exploration penetrating wound spx extremity (20103) |
$724.80 |
$906 |
0.4× |
| Explore wound chest (20101) |
$5,056 |
$6,320 |
2.3× |
| Explore wound neck (20100) |
$2,753.60 |
$3,442 |
4.8× |
| Explore/treat hand joint (26070) |
$4,490.40 |
$5,613 |
2.6× |
| Fasct prtl plmr 1 dgt prox iphal jt +-tiss (26123) |
$3,537.60 |
$4,422 |
1.0× |
| Fetal contraction stress test (59020) |
$471.20 |
$589 |
2.2× |
| Fusion of thumb (26841) |
$5,354.40 |
$6,693 |
0.7× |
| Gastric lavage (43753) |
$45.60 |
$57 |
0.2× |
| Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint;… (28289) |
$3,350.40 |
$4,188 |
1.0× |
| Hallux rigidus w/cheilectomy 1st mp jt w/implt (28291) |
$4,302.80 |
$5,378.50 |
0.6× |
| Hemorrhoidectomy internal rubber band ligations (46221) |
$1,240.80 |
$1,551 |
1.3× |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) |
$2,619.20 |
$3,274 |
0.9× |
| Hemorrhoidectomy, internal and external, single column/group; with fissurectomy (46257) |
$2,756.80 |
$3,446 |
0.9× |
| Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging… (46946) |
$1,059.20 |
$1,324 |
0.4× |
| Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging… (46945) |
$900 |
$1,125 |
0.3× |
| Hysteroscopy biopsy (58558) |
$6,486.40 |
$8,108 |
1.9× |
| Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)… (58563) |
$4,490.40 |
$5,613 |
0.9× |
| I&d abscess simple/single (10060) |
$236.40 |
$295.50 |
1.1× |
| I&d hematoma/seroma/fluid (10140) |
$276 |
$345 |
0.2× |
| I&d pilonidal cyst simple (10080) |
$613.20 |
$766.50 |
0.8× |
| Implantation of donor cartilage cells into knee joint|RIGHT SIDE (27415) |
$19,983.20 |
$24,979 |
1.5× |
| Incise external hemorrhoid (46083) |
$507.60 |
$634.50 |
1.9× |
| Incise finger tendon sheath (26055) |
$2,588.80 |
$3,236 |
1.5× |
| INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee (10061) |
$332 |
$415 |
0.8× |
| Incision and drainage of Bartholin's gland abscess (56420) |
$191.20 |
$239 |
0.9× |
| Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess Age Under 21 (45020) |
$5,056 |
$6,320 |
1.7× |
| Incision and drainage, complex, postoperative wound infection Age Under 21 (10180) |
$2,886.40 |
$3,608 |
0.9× |
| Incision and drainage, pelvis or hip joint area; deep abscess or hematoma Age Under 21 (26990) |
$3,839.20 |
$4,799 |
1.1× |
| Incision and drainage, upper arm or elbow area; bursa Age Under 21 (23931) |
$536 |
$670 |
0.3× |
| Incision and removal of foreign body, subcutaneous tissues; complicated (10121) |
$761.60 |
$952 |
0.4× |
| Incision and removal of foreign body, subcutaneous tissues; simple (10120) |
$220.80 |
$276 |
0.5× |
| Incision extensor tendon sheath wrist (25000) |
$2,122.80 |
$2,653.50 |
1.3× |
| Incision of connective tissue of foot and/or toe (28008) |
$2,226.40 |
$2,783 |
0.6× |
| Incision of rectal abscess (46040) |
$1,504.40 |
$1,880.50 |
1.2× |
| Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis) Age Under 21 (25001) |
$1,500 |
$1,875 |
0.4× |
| Incisional biopsy skin single lesion (11106) |
$147.20 |
$184 |
0.2× |
| Infusion of drug to dissolve blood clot in brain (37195) |
$798.40 |
$998 |
2.3× |
| Inj epidural blood or clot patch (62273) |
$724.80 |
$906 |
1.0× |
| Inj paravert f jnt c/t 1 lev (64490) |
$1,622.80 |
$2,028.50 |
1.7× |
| Inj paravert f jnt l/s 1 lev (64493) |
$1,622.80 |
$2,028.50 |
1.7× |
| Inj,Anes Agent,Femoral Nerve,Single (64447) |
$1,388 |
$1,735 |
1.9× |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
$2,015.60 |
$2,519.50 |
2.2× |
| Injection aa&/strd brachial plexus w/img gdn (64415) |
$1,468 |
$1,835 |
1.6× |
| Injection aa&/strd greater occipital nerve (64405) |
$1,382.80 |
$1,728.50 |
4.3× |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
$1,680 |
$2,100 |
1.8× |
| Injection aa&/strd intercostal nrv single lvl (64420) |
$1,382.80 |
$1,728.50 |
1.9× |
| Injection aa&/strd nerves nrvtg si joint w/img (64451) |
$745.20 |
$931.50 |
1.0× |
| Injection aa&/strd sciatic nerve w/img gdn (64445) |
$1,388 |
$1,735 |
1.9× |
| Injection aa&/strd trigeminal nerve each branch (64400) |
$375.20 |
$469 |
1.2× |
| Injection for identification of sentinel node (38792) |
$88 |
$110 |
0.2× |
| Injection therapeutic carpal tunnel (20526) |
$166 |
$207.50 |
0.5× |
| Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter… (64448) |
$1,542 |
$1,927.50 |
1.7× |
| Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) |
$422.40 |
$528 |
1.3× |
| Injection(s); single or multiple trigger point(s), 3 or more muscle(s) (20553) |
$95.20 |
$119 |
0.3× |
| Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) (20550) |
$218.40 |
$273 |
0.7× |
| Injection, intralesional; up to and including 7 lesions (11900) |
$88 |
$110 |
0.4× |
| Insert pessary/other device (57160) |
$216.80 |
$271 |
1.0× |
| Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach Age Under 21 (66183) |
$3,492 |
$4,365 |
0.8× |
| Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older Age… (36561) |
$3,118.80 |
$3,898.50 |
0.9× |
| Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or… (36558) |
$548 |
$685 |
0.2× |
| Insertion picc w/o img gdn 5 yr/> (36569) |
$1,397.60 |
$1,747 |
0.8× |
| Insertion picc w/rs&i 5 yr/> (36573) |
$768 |
$960 |
0.5× |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
$1,329.60 |
$1,662 |
0.4× |
| Intubation endotracheal (31500) |
$358.80 |
$448.50 |
1.4× |
| Irrigation of corpora cavernosa for priapism (54220) |
$270.40 |
$338 |
1.0× |
| Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease (57150) |
$187.20 |
$234 |
3.0× |
| Laparoscopy Enterolysis Separate Procedure (44180) |
$4,585.20 |
$5,731.50 |
0.7× |
| Laparoscopy, surgical; cholecystectomy with cholangiography Age Under 21 (47563) |
$6,555.20 |
$8,194 |
1.0× |
| Laryngoscopy flex diagnostic (31575) |
$207.20 |
$259 |
1.0× |
| Lateral retinacular release open (27425) |
$3,884.40 |
$4,855.50 |
1.1× |
| Ligamentous reconstruction knee intra-articular (27428) |
$19,983.20 |
$24,979 |
1.5× |
| Lumbar puncture (62270) |
$413.60 |
$517 |
0.6× |
| Manipulation finger joint under anes each joint (26340) |
$1,380 |
$1,725 |
0.8× |
| Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) Age… (27570) |
$327.20 |
$409 |
0.2× |
| Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded) Age… (23700) |
$1,448.80 |
$1,811 |
0.9× |
| Mastectomy partial (19301) |
$4,963.60 |
$6,204.50 |
1.2× |
| Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding… (19307) |
$8,589.60 |
$10,737 |
1.2× |
| Meas post-voiding residual urine&/bladder cap (51798) |
$124 |
$155 |
2.0× |
Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331) Age Under 21 (24301)
likely a partial charge — not the full procedure |
$1,626 |
$2,032.50 |
0.2× |
| Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia Age Under 21 (69421) |
$1,965.60 |
$2,457 |
0.6× |
| Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) Age Under 21 (31231) |
$328.80 |
$411 |
1.6× |
| Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure) Age Under 21 (31237) |
$2,137.60 |
$2,672 |
1.1× |
| Needle insertion w/o injection 1 or 2 muscles (20560) |
$8 |
$10 |
0.3× |
| Needle insertion w/o injection 3 or more muscles (20561) |
$16 |
$20 |
0.5× |
| Neuroplasty &/transpos median nrv carpal tunne (64721) |
$2,242 |
$2,802.50 |
1.1× |
| Njx aa&/strd tfrm epi c/t 1 (64479) |
$2,262.80 |
$2,828.50 |
2.4× |
| Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) |
$1,962.40 |
$2,453 |
2.6× |
| Njx dx/ther sbst intrlmnr crv/thrc w/o img gdn (62320) |
$866.40 |
$1,083 |
1.2× |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
$1,748 |
$2,185 |
2.3× |
| Non stress test (59025) |
$448 |
$560 |
2.1× |
Omentectomy, epiploectomy, resection of omentum (separate procedure) (49255)
likely a partial charge — not the full procedure |
$1,685.60 |
$2,107 |
0.2× |
Open treatment bimalleolar ankle fracture (27814)
unusually low — confirm this is the full procedure |
$3,728.80 |
$4,661 |
0.5× |
| Open treatment medial malleolus fracture (27766) |
$4,407.20 |
$5,509 |
0.6× |
| Open treatment metatarsal fracture each (28485) |
$6,569.20 |
$8,211.50 |
0.9× |
| Open treatment of acromioclavicular dislocation, acute or chronic; Age Under 21 (23550) |
$14,056 |
$17,570 |
1.8× |
| Open treatment of clavicular fracture, includes internal fixation, when performed Age Under 21 (23515) |
$3,922.40 |
$4,903 |
0.5× |
| Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed Age… (27829) |
$4,828.40 |
$6,035.50 |
0.6× |
| Open treatment of nasal fracture; uncomplicated Age Under 21 (21325) |
$688.80 |
$861 |
0.2× |
| Open treatment tarsometatarsal joint dislocation (28615) |
$6,914 |
$8,642.50 |
0.9× |
Open tx distal fibular fracture lat malleolus (27792)
unusually low — confirm this is the full procedure |
$3,036.80 |
$3,796 |
0.4× |
| Open tx interphalangeal joint dislocation 1 (26785) |
$2,560.80 |
$3,201 |
0.7× |
| Or placement of amniotic membrane on the ocular surface; single layer, sutured (65779) |
$5,170.40 |
$6,463 |
1.2× |
| Or tentomy, abductors and/or extensor(s) of hip,open (separate procedure) (27006) |
$1,705.20 |
$2,131.50 |
0.5× |
| Ostectomy, calcaneus; Age Under 21 (28118) |
$4,262.40 |
$5,328 |
1.2× |
| Ostectomy, complete excision; other metatarsal head (second, third or fourth) Age Under 21 (28112) |
$1,878.40 |
$2,348 |
0.5× |
| Ostectomy, excision of tarsal coalition Age Under 21 (28116) |
$4,932 |
$6,165 |
1.4× |
| Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head Age Under 21 (28288) |
$3,132 |
$3,915 |
0.9× |
| Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining… (23485) |
$10,760 |
$13,450 |
0.8× |
Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal Age Under 21 (28306)
unusually low — confirm this is the full procedure |
$3,132 |
$3,915 |
0.4× |
| Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each… (28308) |
$1,922.80 |
$2,403.50 |
0.6× |
| Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions (11056) |
$150 |
$187.50 |
0.7× |
| Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion (11055) |
$102 |
$127.50 |
0.5× |
| Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing);… (28120) |
$6,776 |
$8,470 |
2.0× |
| Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing);… (28122) |
$3,911.20 |
$4,889 |
1.1× |
| Partical excision bone phalanx toe (28124) |
$1,545.20 |
$1,931.50 |
0.4× |
| Percutaneous Skeletal Fixation Of Metacarpal Fracture, Each Bone (26608) |
$1,876.40 |
$2,345.50 |
0.5× |
| Perq device breast 1st imag (19281) |
$342.80 |
$428.50 |
0.2× |
| Perq drainage pleura insert cath w/imaging (32557) |
$304 |
$380 |
0.2× |
| Perq drainage pleura insert cath w/o imaging (32556) |
$251.20 |
$314 |
0.1× |
| Perq replacement gtube not req revj gstrst trc (43762) |
$420 |
$525 |
1.6× |
| Pr inj. intralesional gt 7 lesions (11901) |
$151.20 |
$189 |
0.7× |
| Preputial stretching (54450) |
$314 |
$392.50 |
1.2× |
| Prineoplasty rpr pr nonobal spx (56810) |
$7,428 |
$9,285 |
2.2× |
| Punch biopsy skin single lesion (11104) |
$356 |
$445 |
0.8× |
| Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) |
$210.40 |
$263 |
0.5× |
| Puncture aspiration of cyst of breast (19000) |
$718.80 |
$898.50 |
1.0× |
| Pvb thoracic single injection site w/img gid (64461) |
$378.80 |
$473.50 |
0.5× |
| Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, Kidner type… (28238) |
$6,437.60 |
$8,047 |
0.8× |
| Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty) Age Under 21 (23420) |
$8,223.20 |
$10,279 |
1.1× |
Reconstruction of dislocating patella; (eg, Hauser type procedure) Age Under 21 (27420)
unusually low — confirm this is the full procedure |
$3,665.60 |
$4,582 |
0.5× |
| Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly… (28313) |
$1,426 |
$1,782.50 |
0.4× |
| Release of ligaments at outer side of knee joint using an endoscope (29873) |
$4,386.40 |
$5,483 |
1.3× |
| Release of tendon connecting biceps muscle and shoulder using an endoscope (29828) |
$3,916 |
$4,895 |
0.5× |
| Release, tarsal tunnel (posterior tibial nerve decompression) Age Under 21 (28035) |
$2,322.40 |
$2,903 |
1.1× |
| REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS TechFee (28190) |
$689.60 |
$862 |
0.9× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$29.60 |
$37 |
0.5× |
| Removal impacted cerumen requiring instrumentation, unilateral (69210) |
$140.40 |
$175.50 |
2.3× |
| Removal implant deep (20680) |
$3,048.80 |
$3,811 |
1.0× |
| Removal implant from finger/hand (26320) |
$1,269.20 |
$1,586.50 |
0.7× |
| Removal implant superficial (20670) |
$3,252.80 |
$4,066 |
1.9× |
| Removal of appendix using an endoscope (44970) |
$4,787.20 |
$5,984 |
0.8× |
| Removal of foreign body of upper arm or elbow area, accessed beneath the skin (24200) |
$452 |
$565 |
0.3× |
| Removal of foreign body, external eye; conjunctival superficial (65205) |
$145.60 |
$182 |
1.0× |
| Removal of foreign body, external eye; corneal, without slit lamp (65220) |
$165.60 |
$207 |
0.4× |
| Removal of heel spur (28119) |
$2,565.20 |
$3,206.50 |
0.7× |
| Removal of multiple hemorrhoid groups|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (46260) |
$2,412.40 |
$3,015.50 |
0.8× |
| Removal of nail bed (11750) |
$363.60 |
$454.50 |
0.8× |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
$204 |
$255 |
1.0× |
| Removal or bivalving; full arm or full leg cast Age Under 21 (29705) |
$103.20 |
$129 |
0.3× |
| Removal or relocation of corneal conjunctiva with graft|BILATERAL PROCEDURE (65426) |
$4,413.60 |
$5,517 |
1.8× |
| Removal tunneled cv cath (36590) |
$2,034.40 |
$2,543 |
1.2× |
| Removal/revision of cast (29700) |
$139.60 |
$174.50 |
0.5× |
| Remove foreign body from eye (65210) |
$364.80 |
$456 |
0.8× |
| Remove pharynx foreign body (42809) |
$373.60 |
$467 |
0.8× |
| Repair achilles tendon (27650) |
$5,176.80 |
$6,471 |
0.7× |
| Repair blood vessel lesion (35226) |
$4,956 |
$6,195 |
6.6× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$545.60 |
$682 |
1.3× |
| REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) |
$738 |
$922.50 |
1.7× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$595.20 |
$744 |
1.4× |
| Repair complex trunk 2.6-7.5 cm (13101) |
$2,086.40 |
$2,608 |
2.7× |
| Repair elbow deb/attch open (24359) |
$3,277.20 |
$4,096.50 |
0.9× |
| Repair finger tendon (26418) |
$1,188 |
$1,485 |
0.7× |
| Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated Age Under 21 (49507) |
$5,924 |
$7,405 |
1.6× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) |
$420 |
$525 |
1.0× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) |
$452.80 |
$566 |
1.1× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 7.6-12.5 CM (12054) |
$443.20 |
$554 |
1.0× |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
$1,100 |
$1,375 |
2.6× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$1,129.60 |
$1,412 |
1.4× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$572.80 |
$716 |
1.3× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$926.40 |
$1,158 |
2.2× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$250.40 |
$313 |
0.3× |
| REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) |
$358.40 |
$448 |
0.8× |
| REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) |
$460.80 |
$576 |
1.1× |
| REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM TechFee (12036) |
$700.80 |
$876 |
0.9× |
| Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes 5.1cm To 7.5cm (12053) |
$674 |
$842.50 |
1.6× |
| Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes20.1cm To 30.0cm (12056) |
$1,209.60 |
$1,512 |
2.8× |
| Repair Intermediate Wound Face,ears,eyelids,nose, Lips And Or Mucous Membranes Over 30.0cm (12057) |
$1,332 |
$1,665 |
3.1× |
| Repair Intermediate Wounds Of Scalp, Underarms, Truck And/or Extremities Over 30.0cm (12037) |
$1,240 |
$1,550 |
0.6× |
| Repair of nail bed (11760) |
$251.20 |
$314 |
0.3× |
| Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute Age Under 21 (23410) |
$7,537.60 |
$9,422 |
1.0× |
| Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic Age Under 21 (23412) |
$5,873.60 |
$7,342 |
0.8× |
| Repair recurrent inguinal hernia, any age; incarcerated or strangulated Age Under 21 (49521) |
$5,308.40 |
$6,635.50 |
0.8× |
| Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm (13120) |
$581.60 |
$727 |
1.4× |
Repair, extensor tendon, leg; secondary, with or without graft, each tendon Age Under 21 (27665)
likely a partial charge — not the full procedure |
$1,291.60 |
$1,614.50 |
0.2× |
| Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm (12047) |
$1,544.80 |
$1,931 |
0.7× |
| Repair, primary, disrupted ligament, ankle; both collateral ligaments Age Under 21 (27696) |
$4,514 |
$5,642.50 |
0.6× |
| Repair, primary, disrupted ligament, ankle; collateral Age Under 21 (27695) |
$5,442.40 |
$6,803 |
0.7× |
| Repair, secondary, Achilles tendon, with or without graft Age Under 21 (27654) |
$7,016 |
$8,770 |
0.9× |
| Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure) Age Under 21 (27698) |
$8,089.60 |
$10,112 |
1.1× |
| Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor… (25275) |
$1,618 |
$2,022.50 |
0.5× |
| Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon Age Under 21 (28200) |
$4,259.20 |
$5,324 |
1.2× |
| Revise finger joint (26535) |
$4,312.40 |
$5,390.50 |
1.2× |
| Revise ulnar nerve at elbow (64718) |
$2,902.40 |
$3,628 |
1.4× |
Revision of total hip arthroplasty; both components, with or without autograft or allograft (27134)
unusually low — confirm this is the full procedure |
$6,468 |
$8,085 |
0.5× |
Revision of total knee arthroplasty, with or without allograft; 1 component (27486)
unusually low — confirm this is the full procedure |
$5,662.40 |
$7,078 |
0.4× |
| Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component (27487) |
$10,106 |
$12,632.50 |
0.5× |
| RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) |
$161.60 |
$202 |
1.2× |
| RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP TechFee (65222) |
$249.60 |
$312 |
1.8× |
| Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) |
$6,368 |
$7,960 |
1.0× |
| Rpr aa hernia 1st 3-10 cm reducible (49593) |
$5,932.80 |
$7,416 |
0.9× |
| Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) |
$4,520 |
$5,650 |
0.7× |
| Rpr aa hernia 1st < 3 cm reducible (49591) |
$7,856.80 |
$9,821 |
2.1× |
| Rpr Ingun Hernia Sliding Any Age (49525) |
$8,481.60 |
$10,602 |
2.2× |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
$1,242.40 |
$1,553 |
1.6× |
| Rpr Recrt Inguinal Hernia Any Age Reducible (49520) |
$4,943.60 |
$6,179.50 |
1.3× |
| Secondary Closure Of Surgical Wound Or Dehiscence, Extensive Or Complicated (13160) |
$3,129.60 |
$3,912 |
0.8× |
| Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less (11300) |
$175.20 |
$219 |
0.4× |
| Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm (11301) |
$96.80 |
$121 |
0.5× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) |
$92.80 |
$116 |
0.4× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam >2.0 Cm (11313) |
$181.60 |
$227 |
0.4× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) |
$92.80 |
$116 |
0.4× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) |
$354.40 |
$443 |
1.7× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) |
$188 |
$235 |
0.9× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) |
$236.80 |
$296 |
0.6× |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) |
$111.20 |
$139 |
0.5× |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) |
$157.60 |
$197 |
0.4× |
| Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) |
$106.40 |
$133 |
0.5× |
| Sigmoidoscopy & polypectomy (45333) |
$718.80 |
$898.50 |
0.7× |
| Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Age Under 21 (45338) |
$1,172.80 |
$1,466 |
0.9× |
| Simple complete removal of breast|BILATERAL PROCEDURE (19303) |
$7,300.80 |
$9,126 |
1.0× |
| SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) |
$240.80 |
$301 |
1.1× |
| SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) |
$311.20 |
$389 |
1.5× |
| SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) |
$164 |
$205 |
0.8× |
| SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) |
$393.60 |
$492 |
1.9× |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
$944.80 |
$1,181 |
4.5× |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) |
$135.20 |
$169 |
0.6× |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee (12007) |
$856.80 |
$1,071 |
4.0× |
| Simple Repair Superficial Wound F/e/,eyelids,n/l/ And Or Mucous Membranes 20.1cm To 30.0cm (12017) |
$859.20 |
$1,074 |
2.0× |
| Simple Repair Superficial Wound F/e/eyelids,n/l/ And Or Mucous Membranes 12.6cm To 20.0cm (12016) |
$180.80 |
$226 |
0.4× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$377.60 |
$472 |
1.8× |
| SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) |
$197.60 |
$247 |
0.9× |
| SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee (12005) |
$537.60 |
$672 |
1.3× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$644.80 |
$806 |
1.5× |
| Strapping ankle (29540) |
$37.60 |
$47 |
0.2× |
| Strapping of knee (29530) |
$108 |
$135 |
0.8× |
| Strapping of toes (29550) |
$40 |
$50 |
0.6× |
| Sub grft f/s/n/h/f/g/m/d <100sq cm 1st 25 sq cm (15275) |
$358.40 |
$448 |
0.5× |
| Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including… (15002) |
$1,626.80 |
$2,033.50 |
2.1× |
| Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including… (15004) |
$1,213.60 |
$1,517 |
2.8× |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or… (46280) |
$2,998.40 |
$3,748 |
1.0× |
| Suture or repair of testicular injury Age Under 21 (54670) |
$852.80 |
$1,066 |
0.2× |
| Tangential biopsy skin single lesion (11102) |
$83.20 |
$104 |
0.2× |
| Tenodesis long tendon biceps (23430) |
$6,391.60 |
$7,989.50 |
0.8× |
| Tenolysis ext tendon,hand/finger,ea (26445) |
$4,824 |
$6,030 |
1.4× |
| Tenotomy percutaneous toe single tendon (28010) |
$1,432 |
$1,790 |
0.8× |
| Therapeutic spinal puncture drainage csf (62272) |
$76.80 |
$96 |
0.1× |
| Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) |
$228 |
$285 |
0.3× |
| Tonsillectomy and adenoidectomy; age 12 or over Age Under 21 (42821) |
$4,574.40 |
$5,718 |
1.3× |
| Total knee arthroplasty (27447) |
$7,109.60 |
$8,887 |
0.5× |
| Tracheostomy, emergency procedure; cricothyroid membrane Age Under 21 (31605) |
$2,753.60 |
$3,442 |
11.0× |
| Transfusion, blood or blood components (36430) |
$704 |
$880 |
1.5× |
| Transurethral destruction of prostate tissue; by microwave thermotherapy Age Under 21 (53850) |
$7,121.60 |
$8,902 |
1.9× |
| Treat finger dislocation (26775) |
$654.80 |
$818.50 |
2.2× |
| Treat fx distal radial (25606) |
$3,953.60 |
$4,942 |
1.1× |
| Treatment of bladder lesion (51720) |
$365.60 |
$457 |
0.5× |
| Treatment of closed elbow dislocation; without anesthesia (24600) |
$428.80 |
$536 |
1.6× |
| Treatment of foot infection (28003) |
$2,670 |
$3,337.50 |
0.8× |
| Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or… (27257) |
$764 |
$955 |
0.5× |
| Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement (27236) |
$5,265.20 |
$6,581.50 |
0.7× |
| Trimming of nondystrophic nails, any number (11719) |
$28.80 |
$36 |
0.5× |
| Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch Age Under… (69610) |
$4,490.40 |
$5,613 |
2.7× |
| Tympanostomy (requiring insertion of ventilating tube), general anesthesia Age Under 21 (69436) |
$1,965.60 |
$2,457 |
1.2× |
| Vaginal delivery (59409) |
$682.40 |
$853 |
0.2× |
| Vasectomy (55250) |
$1,629.20 |
$2,036.50 |
0.7× |
| Venipuncture (36415) |
$36.80 |
$46 |
3.9× |
| Ventilating tube removal requiring general anesthesia (69424) |
$1,965.60 |
$2,457 |
0.6× |
| Wedge excision skin nail fold (11765) |
$292.40 |
$365.50 |
0.7× |
| Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp (66982) |
$7,614.40 |
$9,518 |
3.1× |