| Abd paracentesis w/imaging (49083) |
$1,500 |
$3,000 |
1.7× |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
$1,450 |
$2,900 |
1.6× |
| Application cast elbow finger short arm (29075) |
$450 |
$900 |
1.6× |
| Application finger splint static (29130) |
$225 |
$450 |
1.7× |
| Application long arm splint shoulder hand (29105) |
$275 |
$550 |
1.7× |
| Application Long Leg Splint (29505) |
$275 |
$550 |
1.7× |
| Application of long leg cast (29345) |
$450 |
$900 |
1.6× |
| Application short arm splint forearm-hand static (29125) |
$225 |
$450 |
1.7× |
| Application short leg splint calf foot (29515) |
$275 |
$550 |
1.7× |
| Apply hand/wrist cast (29085) |
$275 |
$550 |
1.7× |
| Apply long arm cast (29065) |
$450 |
$900 |
1.6× |
| Apply Short Leg Cast (29405) |
$450 |
$900 |
1.6× |
| Apply short leg cast (29425) |
$450 |
$900 |
1.6× |
| Arterial puncture (36600) |
$225 |
$450 |
1.7× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$475 |
$950 |
1.6× |
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) range across 10 matching MRF lines |
$475–$1,500 |
$950–$3,000 |
varies |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
$475 |
$950 |
1.6× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$475 |
$950 |
1.6× |
| Aspirate pleura w/ imaging (32555) |
$1,050 |
$2,100 |
1.7× |
| Aspirate Pleura W/O Imaging (32554) |
$1,000 |
$2,000 |
1.6× |
| Aspirate/Inj Ganglion Cyst (20612) |
$475 |
$950 |
1.6× |
| Aspiration bladder insert suprapubic catheter (51102) |
$3,200 |
$6,400 |
1.5× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$325 |
$650 |
1.6× |
| Biopsy bone open superficial (20240) |
$4,525 |
$9,050 |
1.6× |
| Biopsy muscle percutaneous needle (20206) |
$2,650 |
$5,300 |
1.6× |
| Biopsy of breast; open, incisional (19101) |
$5,650 |
$11,300 |
1.5× |
Biopsy of liver, needle; percutaneous (47000) range across 3 matching MRF lines |
$2,700–$2,750 |
$5,400–$5,500 |
varies |
| Biopsy Vulva/Perineum 1 Lesion Spx (56605) |
$1,150 |
$2,300 |
1.3× |
| Bladder Scan (51798) |
$100 |
$200 |
1.7× |
| Blood Transfusion Service (36430) |
$800 |
$1,600 |
1.8× |
| Bx breast needle core w/o imaging guidance spx (19100) |
$2,550 |
$5,100 |
1.6× |
| Bx Cervix (57500) |
$1,150 |
$2,300 |
1.3× |
| Bx/exc lymph node open superficial (38500) |
$5,650 |
$11,300 |
1.5× |
| Cataract surgery complex (66982) |
$3,750 |
$7,500 |
1.6× |
| Catheter aspiration nasotracheal spx (31720) |
$350 |
$700 |
1.6× |
| Cautery Cervix Cryocautery Initial/Repeat (57511) |
$500 |
$1,000 |
1.7× |
| Change of Windpipe Airway (31502) |
$375 |
$750 |
1.6× |
| Chemical Cautery Tissue (17250) |
$350 |
$700 |
1.8× |
| Chest tube placement (32551) |
$2,500 |
$5,000 |
1.6× |
| Cholecystostomy Prq W/Imaging & Catheter Plmt (47490) |
$6,200 |
$12,400 |
1.7× |
| Circumcision 28 days or older (54161) |
$4,000 |
$8,000 |
1.9× |
| Circumcision w/clamp/oth dev w/block (54150) |
$3,200 |
$6,400 |
1.5× |
| Cl Tx Tib Shft Fx W Manip (27752) |
$2,500 |
$5,000 |
1.6× |
| Clear outer ear canal (69200) |
$200 |
$400 |
1.5× |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) |
$400 |
$800 |
1.6× |
| Closed tx ankle dislocation w/o anesthesia (27840) |
$400 |
$800 |
1.6× |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) |
$2,500 |
$5,000 |
1.6× |
| Closed tx patellar dislocation w/o anesthesia (27560) |
$400 |
$800 |
1.6× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
$2,500 |
$5,000 |
1.6× |
| Closed Tx Talus Fracture W/Manipulation (28435) |
$2,700 |
$5,400 |
1.7× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
$2,500 |
$5,000 |
1.6× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$400 |
$800 |
1.6× |
| Cltx ankle dislc req anes w/wo prq skel fixj (27842) |
$2,500 |
$5,000 |
1.6× |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
$2,550 |
$5,100 |
1.6× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$2,500 |
$5,000 |
1.6× |
| Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) |
$2,700 |
$5,400 |
1.7× |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) |
$2,500 |
$5,000 |
1.6× |
| Cltx hip dislocation traumatic req anesthesia (27252) |
$2,500 |
$5,000 |
1.6× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
$400 |
$800 |
1.6× |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
$400 |
$800 |
1.6× |
| Cltx metacarpal fx w/manipulation each bone (26605) |
$400 |
$800 |
1.6× |
| Cltx metacarpal fx w/o manipulation each bone (26600) |
$375 |
$750 |
1.5× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
$375 |
$750 |
1.5× |
| Cltx post hip arthrp dislc req anes (27266) |
$2,500 |
$5,000 |
1.6× |
| Cltx post hip arthrp dislc w/o anes (27265) |
$400 |
$800 |
1.6× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
$400 |
$800 |
1.6× |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) |
$2,500 |
$5,000 |
1.6× |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
$2,700 |
$5,400 |
1.7× |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
$2,500 |
$5,000 |
1.6× |
| Collection of venous blood by venipuncture (36415) |
$20 |
$40 |
2.1× |
| Colonoscopy w/ablation (45388) |
$2,750 |
$5,500 |
2.3× |
| Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) |
$500 |
$1,000 |
1.7× |
| Colposcopy cervix upper/adjacent vagina (57452) |
$300 |
$600 |
1.5× |
| Colposcopy Cervix Uppr/Adjcnt Vagina W/Cervix Bx (57455) |
$500 |
$1,000 |
1.7× |
Colposcopy Cervix Vag Loop Eltrd Bx Cervix (57460) range across 3 matching MRF lines |
$4,700–$5,000 |
$9,400–$10,000 |
varies |
| Colposcopy entire vagina w/cervix if present (57420) |
$500 |
$1,000 |
1.7× |
| Colposcopy,Entire Vagina,W/Biopsy(S) (57421) |
$1,250 |
$2,500 |
1.4× |
| Colsc Flexible W/Control Bleeding Any Method (45382) |
$1,850 |
$3,700 |
1.6× |
| Control Nasal Hemorrhage Anterior Complex (30903) |
$225 |
$450 |
1.7× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$225 |
$450 |
1.7× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$225 |
$450 |
1.7× |
| Cystostomy Cystotomy W/Drainage (51040) |
$4,000 |
$8,000 |
1.9× |
| Deb Musc/Fascia 20 Sq Cm/< (11043) |
$1,000 |
$2,000 |
1.4× |
| Debride nail 1-5 (11720) |
$100 |
$200 |
1.7× |
| Debride nail 6 or more (11721) |
$100 |
$200 |
1.7× |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) |
$2,500 |
$5,000 |
1.5× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$650 |
$1,300 |
1.6× |
| Destruct B9 Lesion 1-14 (17110) |
$350 |
$700 |
1.8× |
| Destruction Lesions Vulva Simple (56501) |
$3,050 |
$6,100 |
1.5× |
| Destruction malignant lesion f/e/e/n/l/m 0.5cm/< (17280) |
$350 |
$700 |
1.8× |
| Destruction Premalignant Lesion 15/> (17004) |
$650 |
$1,300 |
1.6× |
| Destruction premalignant lesion 1st (17000) |
$325 |
$650 |
1.6× |
| Dilation & curettage dx&/ther nonobstetric (58120) |
$5,000 |
$10,000 |
1.6× |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
$1,150 |
$2,300 |
1.6× |
| Drainage of finger abscess simple (26010) |
$350 |
$700 |
1.8× |
| Drainage of hematoma/fluid (10140) |
$2,550 |
$5,100 |
1.6× |
| Drainage of skene's gland abscess or cyst (53060) |
$3,250 |
$6,500 |
1.6× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
$350 |
$700 |
1.8× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
$350 |
$700 |
1.8× |
| Dx lmbr spi pnxr w/fluor/CT (62328) |
$1,150 |
$2,300 |
1.6× |
| Egd remove lesion snare (43251) |
$2,750 |
$5,500 |
1.4× |
| Endocervical curettage (57505) |
$1,150 |
$2,300 |
1.3× |
| Endometrial Biopsy (58100) |
$300 |
$600 |
1.5× |
| Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed Facility (58356) |
$6,000 |
$12,000 |
1.2× |
| Evacuation of subungual hematoma (11740) |
$225 |
$450 |
1.7× |
| Exc arm/elbow les sc < 3 cm (24075) |
$2,700 |
$5,400 |
1.7× |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) |
$1,150 |
$2,300 |
1.6× |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) |
$2,550 |
$5,100 |
1.6× |
| Exc Back Les Sc < 3 Cm (21930) |
$2,650 |
$5,300 |
1.6× |
| Exc back tum deep < 5 cm (21932) |
$4,250 |
$8,500 |
1.5× |
| Exc Face-Mm B9+Marg 0.5 Cm/< (11440) |
$1,150 |
$2,300 |
1.6× |
| Exc Face-Mm B9+Marg 0.6-1 Cm (11441) |
$1,150 |
$2,300 |
1.6× |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) |
$1,150 |
$2,300 |
1.6× |
| Exc Face-Mm B9+Marg 2.1-3 Cm (11443) |
$2,550 |
$5,100 |
1.6× |
| Exc Face-Mm B9+Marg 3.1-4 Cm (11444) |
$2,550 |
$5,100 |
1.6× |
| Exc Forearm Les Sc 3 Cm/> (25071) |
$2,550 |
$5,100 |
1.6× |
| Exc Forearm Tum Deep 3 Cm/> (25073) |
$4,250 |
$8,500 |
1.5× |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) |
$2,550 |
$5,100 |
1.6× |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) |
$1,150 |
$2,300 |
1.6× |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) |
$2,550 |
$5,100 |
1.6× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
$1,150 |
$2,300 |
1.6× |
| Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) |
$2,550 |
$5,100 |
1.6× |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
$2,550 |
$5,100 |
1.6× |
| Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) |
$2,550 |
$5,100 |
1.6× |
| Exc Skin Malig >4 Cm Remaindr Body (11626) |
$4,250 |
$8,500 |
1.5× |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) |
$2,550 |
$5,100 |
1.6× |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) |
$650 |
$1,300 |
1.6× |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) |
$1,150 |
$2,300 |
1.6× |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) |
$2,550 |
$5,100 |
1.6× |
| Exc tumor soft tis neck/ant thorax subq 3 cm/> (21552) |
$4,500 |
$9,000 |
1.6× |
| Exc tumor soft tissue pelvis & hip subq <3cm (27047) |
$4,250 |
$8,500 |
1.5× |
| Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) |
$1,150 |
$2,300 |
1.6× |
| Excision Lingual Frenum Frenectomy (41115) |
$2,450 |
$4,900 |
1.6× |
| Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) |
$1,150 |
$2,300 |
1.6× |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) |
$1,150 |
$2,300 |
1.6× |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) |
$650 |
$1,300 |
1.6× |
| Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) |
$1,150 |
$2,300 |
1.6× |
| Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) |
$1,150 |
$2,300 |
1.6× |
| Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) |
$2,550 |
$5,100 |
1.6× |
| Excision Malignant Lesion F/E/E/N/L >4.0 Cm (11646) |
$5,000 |
$10,000 |
1.7× |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) |
$2,550 |
$5,100 |
1.6× |
| Excision of hydrocele; unilateral (55040) |
$5,000 |
$10,000 |
1.4× |
| Excision of vaginal cyst or tumor (57135) |
$5,000 |
$10,000 |
1.6× |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater (22903) |
$4,250 |
$8,500 |
1.5× |
| Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm (21011) |
$2,750 |
$5,500 |
1.7× |
| Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm (23075) |
$2,550 |
$5,100 |
1.6× |
| Expl penetrating wound spx abdomen/flank/back (20102) |
$3,050 |
$6,100 |
1.5× |
| Explo/Drain Breast Abscess (19020) |
$2,550 |
$5,100 |
1.6× |
| Exploration penetrating wound spx extremity (20103) |
$2,750 |
$5,500 |
1.7× |
| Fetal non-stress test (59025) |
$325 |
$650 |
1.6× |
| Fine needle aspiration without imaging guidance (10021) |
$1,500 |
$3,000 |
3.7× |
| Fna bx w/us gdn 1st les (10005) |
$1,150 |
$2,300 |
1.6× |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) |
$4,500 |
$9,000 |
1.6× |
| Hysteroscopy Removal Impacted Foreign Body (58562) |
$5,000 |
$10,000 |
1.6× |
| I&d abscess peritonsillar (42700) |
$400 |
$800 |
1.7× |
| I&d abscess simple (10060) |
$325 |
$650 |
1.6× |
| I&d deep absc bursa/hematoma thigh/knee region (27301) |
$4,250 |
$8,500 |
1.5× |
| I&d perianal abscess superficial (46050) |
$1,500 |
$3,000 |
1.6× |
| I&d pilonidal cyst simple (10080) |
$1,150 |
$2,300 |
1.6× |
| Incise external hemorrhoid (46083) |
$500 |
$1,000 |
2.0× |
| Incision & drainage abscess complicated/multiple (10061) |
$650 |
$1,300 |
1.6× |
| Incision & removal foreign body subq tiss compl (10121) |
$2,550 |
$5,100 |
1.6× |
| Incision & removal foreign body subq tiss simple (10120) |
$650 |
$1,300 |
1.6× |
| Incision and drainage of bartholin's gland abscess (56420) |
$325 |
$650 |
1.6× |
Incision and drainage of vulva or perineal abscess (56405) range across 3 matching MRF lines |
$500–$1,500 |
$1,000–$3,000 |
varies |
| Incision of labial frenum (frenotomy) (40806) |
$925 |
$1,850 |
1.7× |
| Incision of lingual frenum (frenotomy) (41010) |
$2,450 |
$4,900 |
1.6× |
| Incision of rectal abscess (46040) |
$1,850 |
$3,700 |
1.6× |
| Incisional biopsy skin single lesion (11106) |
$950 |
$1,900 |
1.3× |
| Initial Tx 1st Degree Burn Local Tx (16000) |
$350 |
$700 |
1.8× |
| Injection 1 tendon sheath/ligament aponeurosis (20550) |
$475 |
$950 |
1.6× |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
$1,500 |
$3,000 |
1.7× |
| Injection of sclerosing solution, hemorrhoids (46500) |
$2,750 |
$5,500 |
3.0× |
| Injection single tendon origin/insertion (20551) |
$475 |
$950 |
1.6× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$475 |
$950 |
1.6× |
| Injection single/mlt trigger point 3/> muscles (20553) |
$475 |
$950 |
1.6× |
| Injection therapeutic carpal tunnel (20526) |
$475 |
$950 |
1.6× |
| Injection, anesthetic agent; brachial plexus, single (64415) |
$1,500 |
$3,000 |
1.7× |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) |
$1,150 |
$2,300 |
1.6× |
| Injection, intralesional; up to and including 7 lesions (11900) |
$350 |
$700 |
1.8× |
| Insert Bladder Cath Complex (51703) |
$250 |
$500 |
2.0× |
| Insert cath pleura w/o image (32556) |
$3,150 |
$6,300 |
1.7× |
| Insert cervical dilator (59200) |
$500 |
$1,000 |
1.7× |
| Insert Drug Implant Device (11981) |
$200 |
$400 |
1.5× |
| Insert non-tunnel cv cath (36556) |
$5,150 |
$10,300 |
1.6× |
| Insert pessary/other device (57160) |
$325 |
$650 |
1.6× |
| Insert Temp Bladder Cath (51702) |
$200 |
$400 |
1.5× |
| Insert tunneled cv cath (36561) |
$5,150 |
$10,300 |
1.6× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$200 |
$400 |
1.5× |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) |
$2,500 |
$5,000 |
1.6× |
| Int hrhc by ligation single hroid w/o img gdn (46945) |
$4,000 |
$8,000 |
1.5× |
| Intubation endotracheal emergency procedure (31500) |
$400 |
$800 |
1.7× |
| Iridotomy/irridectomy laser surg per session (66761) |
$900 |
$1,800 |
1.7× |
| Laparoscopy fulguration oviducts (58670) |
$6,000 |
$12,000 |
1.0× |
| Laparoscopy w/rmvl adnexal structures (58661) |
$6,000 |
$12,000 |
1.0× |
| Laparoscopy, surgical, colpopexy (suspension of vaginal apex) (57425) |
$6,000 |
$12,000 |
0.6× |
| Laparoscopy, surgical; with biopsy (single or multiple) (49321) |
$6,000 |
$12,000 |
1.0× |
| Laps abd prtm&omentum dx w/wo spec br/wa spx (49320) |
$6,000 |
$12,000 |
1.0× |
| Laps fulg/exc ovary viscera/peritoneal surface (58662) |
$6,000 |
$12,000 |
1.0× |
| Late closure of wound (13160) |
$3,200 |
$6,400 |
0.9× |
| Ligation or biopsy temporal artery (37609) |
$2,500 |
$5,000 |
1.5× |
| Ligj Divj &/Excj Varicose Vein Cluster 1 Leg (37785) |
$5,150 |
$10,300 |
1.6× |
| Mast mod rad (19307) |
$6,000 |
$12,000 |
0.9× |
| Muscle-skin graft trunk (15734) |
$5,700 |
$11,400 |
1.6× |
| N Block Inj Ilio-Ing/Hypogi (64425) |
$1,150 |
$2,300 |
1.6× |
| N Block Inj Plantar Digit (64455) |
$475 |
$950 |
1.6× |
| Nasal/Orogastric W/Tube Plmt (43752) |
$500 |
$1,000 |
1.1× |
| Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) |
$700 |
$1,400 |
1.7× |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) |
$475 |
$950 |
1.6× |
| Open biopsy/excision inguinofemoral nodes (38531) |
$5,650 |
$11,300 |
1.5× |
| Partial removal of thyroid (60220) |
$6,000 |
$12,000 |
1.0× |
| Perq skel fixj distal radial fx/epiphysl sep (25606) |
$5,200 |
$10,400 |
1.6× |
| Placement of needle for intraosseous infusion (36680) |
$500 |
$1,000 |
1.1× |
| Proctopexy Perineal Approach (45541) |
$5,000 |
$10,000 |
1.8× |
| Punch biopsy skin single lesion (11104) |
$650 |
$1,300 |
1.6× |
| Puncture aspiration abscess hematoma bulla/cyst (10160) |
$650 |
$1,300 |
1.6× |
| Removal Embedded Foreign Body Eyelid (67938) |
$500 |
$1,000 |
1.6× |
| Removal Foreign Body Foot Subcutaneous (28190) |
$1,150 |
$2,300 |
1.6× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$100 |
$200 |
1.7× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$100 |
$200 |
1.7× |
| Removal of nail bed (11750) |
$650 |
$1,300 |
1.6× |
| Removal or bivalving full arm or full leg cast (29705) |
$450 |
$900 |
1.6× |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) |
$325 |
$650 |
1.6× |
| Removal/bivalving gauntlet boot/body cast (29700) |
$450 |
$900 |
1.6× |
| Remove drug implant device (11982) |
$500 |
$1,000 |
1.1× |
| Remove foreign body from eye (65205) |
$200 |
$400 |
1.5× |
Remove Intrauterine Device (58301) range across 4 matching MRF lines |
$500–$1,500 |
$1,000–$3,000 |
varies |
| Remove lung catheter (32552) |
$1,000 |
$2,000 |
1.6× |
| Remove Nasal Foreign Body (30300) |
$225 |
$450 |
1.7× |
| Remove Tendon Sheath Lesion (26160) |
$2,750 |
$5,500 |
1.7× |
| Remove/Insert Drug Implant (11983) |
$500 |
$1,000 |
1.1× |
| Repair blood vessel lesion (35190) |
$9,150 |
$18,300 |
1.7× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
$900 |
$1,800 |
1.2× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
$950 |
$1,900 |
1.3× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$650 |
$1,300 |
1.6× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$950 |
$1,900 |
2.4× |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
$900 |
$1,800 |
2.2× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$900 |
$1,800 |
2.2× |
| Repair initial femoral hernia, any age; reducible (49550) |
$5,000 |
$10,000 |
1.4× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$650 |
$1,300 |
1.6× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$650 |
$1,300 |
1.6× |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
$650 |
$1,300 |
1.6× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
$650 |
$1,300 |
1.6× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$650 |
$1,300 |
1.6× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$650 |
$1,300 |
1.6× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$650 |
$1,300 |
1.6× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$650 |
$1,300 |
1.6× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$650 |
$1,300 |
1.6× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$650 |
$1,300 |
1.6× |
| Repair tongue laceration (41250) |
$500 |
$1,000 |
1.1× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$500 |
$1,000 |
1.1× |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
$200 |
$400 |
1.5× |
| Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) |
$500 |
$1,000 |
1.1× |
| Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) |
$4,500 |
$9,000 |
1.6× |
| Rmvl Foreign Body Upper Arm/Elbow Subcutaneous (24200) |
$2,550 |
$5,100 |
1.6× |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
$2,600 |
$5,200 |
1.7× |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
$950 |
$1,900 |
1.5× |
| Rplc Gtube No Revj Trc (43762) |
$500 |
$1,000 |
2.0× |
| Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) |
$6,000 |
$12,000 |
1.0× |
| Rpr Aa Hernia 1st < 3 Cm Reducible (49591) |
$5,000 |
$10,000 |
1.4× |
| Rpr aa hrn 1st 3-10 rdc (49593) |
$5,000 |
$10,000 |
0.8× |
| Rpr Disloc Peroneal Tendon W/O Fibular Osteotomy (27675) |
$5,250 |
$10,500 |
1.6× |
| Rpr Lac 2.5 Cm/< Pst One-Third Tongue (41251) |
$407.50 |
$815 |
1.7× |
| Shave skin lesion 0.5 cm/< (11300) |
$650 |
$1,300 |
1.6× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) |
$325 |
$650 |
1.6× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam >2.0 Cm (11313) |
$650 |
$1,300 |
1.6× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) |
$325 |
$650 |
1.6× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) |
$325 |
$650 |
1.6× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) |
$325 |
$650 |
1.6× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) |
$650 |
$1,300 |
1.6× |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) |
$325 |
$650 |
1.6× |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) |
$650 |
$1,300 |
1.6× |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) |
$325 |
$650 |
1.6× |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) |
$650 |
$1,300 |
1.6× |
| Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) |
$325 |
$650 |
1.6× |
| Sigmoidoscopy & decompress (45337) |
$1,450 |
$2,900 |
1.6× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$350 |
$700 |
1.8× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$350 |
$700 |
1.8× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$350 |
$700 |
1.8× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$350 |
$700 |
1.8× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$350 |
$700 |
1.8× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$350 |
$700 |
1.8× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$650 |
$1,300 |
1.6× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$650 |
$1,300 |
1.6× |
| Spinal puncture lumbar diagnostic (62270) |
$1,150 |
$2,300 |
1.6× |
| Strapping ankle (29540) |
$255 |
$510 |
1.6× |
| Strapping knee (29530) |
$225 |
$450 |
1.7× |
| Strapping shoulder (29240) |
$225 |
$450 |
1.7× |
| Strapping toes (29550) |
$100 |
$200 |
1.7× |
| Strapping Unna Boot (29580) |
$255 |
$510 |
1.6× |
Tangential biopsy skin single lesion (11102) range across 3 matching MRF lines |
$325–$1,500 |
$650–$3,000 |
varies |
| Thyroid biopsy (60100) |
$1,150 |
$2,300 |
1.6× |
| Trachelorrhaphy Plstc Rpr Uterine Cervix Vag (57720) |
$5,000 |
$10,000 |
1.6× |
| Treat Knuckle Dislocation (26700) |
$400 |
$800 |
1.6× |
| Treat metacarpal fracture (26607) |
$5,400 |
$10,800 |
1.7× |
| Treatment Closed Elbow Dislocation Req Anes (24605) |
$2,500 |
$5,000 |
1.6× |
| Treatment closed elbow dislocation w/o anes (24600) |
$375 |
$750 |
1.5× |
| Trim skin lesion (11055) |
$325 |
$650 |
1.6× |
| Trim skin lesions 2 to 4 (11056) |
$325 |
$650 |
1.6× |
| Trim skin lesions over 4 (11057) |
$325 |
$650 |
1.6× |
| Trimming Nondystrophic Nails Any Number (11719) |
$100 |
$200 |
1.7× |
| Tx Gastro Intub W/Asp (43753) |
$500 |
$1,000 |
2.3× |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
$5,000 |
$10,000 |
1.6× |
| Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) |
$2,500 |
$5,000 |
1.6× |
| Tx superficial wound dehiscence w/packing (12021) |
$650 |
$1,300 |
1.6× |
| Unlisted procedure anus (46999) |
$2,750 |
$5,500 |
3.0× |
| Vaginal delivery only (59409) |
$5,000 |
$10,000 |
1.6× |
| Vulvectomy simple partial (56620) |
$5,250 |
$10,500 |
1.6× |