| Abd paracentesis w/imaging (49083) |
— |
$3,981.12 |
— |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
— |
$2,706.57 |
— |
| Abdomen Surgery Procedure (22999) |
— |
$2,566 |
— |
| Ablate inf turbinate submuc (30802) |
— |
$2,566 |
— |
| Ablation Bone Tumor Rf Perq W/Img Gdn When Done (20982) |
— |
$2,566 |
— |
| Abltj Soft Tis Inferior Turbinates Uni/Bi Supfc (30801) |
— |
$2,566 |
— |
| Acetabuloplasty resection femoral head (27122) |
— |
$3,502 |
— |
| Acromiopl/Acromionect Partial (23130) |
— |
$3,502 |
— |
| Adjacent Tissue Transfer/Reargmt Trunk 10 Sqcm/< (14000) |
— |
$3,460 |
— |
| Adjnt tis transfr/rearrange trunk 10.1-30.0 sqcm (14001) |
— |
$4,020 |
— |
| Adjnt tis trnsfr/reargmt any area 30.1-60 sq cm (14301) |
— |
$4,020 |
— |
| Adjt tis trns/reargmt f/c/c/m/n/a/g/h/f 10sqcm/< (14040) |
— |
$3,460 |
— |
| Adjt Tis Trnsfr/Reargmt Scalp/Arm/Leg 10 Sq Cm/< (14020) |
— |
$4,020 |
— |
| Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) |
— |
$4,020 |
— |
| Adjt/Rearrgmt Scalp/Arm/Leg 10.1-30.0 Sq Cm (14021) |
— |
$4,020 |
— |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect Local Flap (26952) |
— |
$4,908 |
— |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) |
— |
$3,460 |
— |
| Amputate Thigh,Re-Amputatn (27596) |
— |
$8,927 |
— |
| Amputation follow-up surgery (27594) |
— |
$4,020 |
— |
| Amputation Foot Midtarsal (28800) |
— |
$4,908 |
— |
| Amputation foot transmetarsal (28805) |
— |
$4,020 |
— |
| Amputation metatarsal with toe single (28810) |
— |
$3,460 |
— |
| Amputation thigh through femur any level (27590) |
— |
$8,927 |
— |
| Amputation toe interphalangeal joint (28825) |
— |
$3,460 |
— |
| Amputation toe metatarsophalangeal joint (28820) |
— |
$3,460 |
— |
| Amputation, leg, through tibia and fibula; (27880) |
— |
$8,927 |
— |
| Amputation, leg, through tibia and fibula; open, circular (guillotine) Facility (27882) |
— |
$8,927 |
— |
| Amputation, leg, through tibia and fibula; re-amputation (27886) |
— |
$8,927 |
— |
| Amputation, leg, through tibia and fibula; secondary closure or scar revision (27884) |
— |
$4,020 |
— |
| Amputation, thigh, through femur, any level; open, circular (guillotine) Facility (27592) |
— |
$8,927 |
— |
| Ankle Arthroscopy/Surgery (29892) |
— |
$4,020 |
— |
| Anoplasty, plastic operation for stricture; adult Facility (46700) |
— |
$4,020 |
— |
| Anoscopy diagnostic (46600) |
— |
$2,566 |
— |
| Anoscopy; with biopsy, single or multiple (46606) |
— |
$2,566 |
— |
| Anoscopy; with dilation (eg, balloon, guide wire, bougie) (46604) |
— |
$2,566 |
— |
| Ant Vesicourethropexy/Urethropexy Smpl (51840) |
— |
$8,927 |
— |
| Anterior colporraphy rpr cystocele w/cysto (57240) |
— |
$3,502 |
— |
| Anterior Tibial Tubercleplasty (27418) |
— |
$4,020 |
— |
| Apheresis Platelets (36513) |
— |
$4,353.48 |
— |
| Appendectomy (44950) |
— |
$4,908 |
— |
| Appl Clubfoot Cast Molding/Manj Long/Short Leg (29450) |
— |
$2,890 |
— |
| Application cast elbow finger short arm (29075) |
— |
$2,890 |
— |
| Application Finger Splint Dynamic (29131) |
— |
$2,890 |
— |
| Application finger splint static (29130) |
— |
$2,890 |
— |
| Application long arm splint shoulder hand (29105) |
— |
$2,890 |
— |
| Application Long Leg Cast Brace (29358) |
— |
$2,890 |
— |
| Application Long Leg Splint (29505) |
— |
$2,890 |
— |
| Application multiplane external fixation system (20692) |
— |
$4,020 |
— |
| Application of long leg cast (29345) |
— |
$2,566 |
— |
| Application of rigid total contact leg cast (29445) |
— |
$2,890 |
— |
| Application Short Arm Splint Dynamic (29126) |
— |
$2,890 |
— |
| Application short arm splint forearm-hand static (29125) |
— |
$2,890 |
— |
| Application short leg splint calf foot (29515) |
— |
$2,890 |
— |
| Application uniplane external fixation system (20690) |
— |
$3,460 |
— |
| Apply hand/wrist cast (29085) |
— |
$2,890 |
— |
| Apply long arm cast (29065) |
— |
$2,890 |
— |
| Apply Short Leg Cast (29405) |
— |
$2,890 |
— |
| Apply short leg cast (29425) |
— |
$2,890 |
— |
| Aqueous Shunt Extraoc Equat Plate Rsvr W/Graft (66180) |
— |
$3,502 |
— |
| Arteriovenous Anastomosis Open Direct (36821) |
— |
$4,020 |
— |
| Arteriovenous anastomosis, open; by upper arm cephalic vein transposition Facility (36818) |
— |
$4,020 |
— |
| Arthrd Ant Interbody Decompress Cervical Belw C2 (22551) |
— |
$6,695 |
— |
| Arthrd Ant Min Discect Interbody Cerv Below C2 (22554) |
— |
$6,695 |
— |
| Arthrd midtarsl/tars mlt/transvrs w/osteot (28735) |
— |
$4,908 |
— |
| Arthrd midtarsl/tarsometatarsal mult/transvrs (28730) |
— |
$4,908 |
— |
| Arthrd W/Xtnsr Hallucis Longus Tr 1st Metar Nck (28760) |
— |
$4,908 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
— |
$1,305 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
— |
$1,673.88 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
— |
$1,612.98 |
— |
| Arthrodesis great toe interphalangeal joint (28755) |
— |
$4,908 |
— |
| Arthrodesis great toe metatarsophalangeal joint (28750) |
— |
$4,908 |
— |
| Arthrodesis knee any technique (27580) |
— |
$3,502 |
— |
| Arthrodesis Pantalar (28705) |
— |
$4,908 |
— |
| Arthrodesis Posterior Interbody Lumbar (22630) |
— |
$6,695 |
— |
| Arthrodesis Posterior/Posterolateral Lumbar (22612) |
— |
$6,695 |
— |
| Arthrodesis Posterior/Posterolateral Thoracic (22610) |
— |
$6,695 |
— |
| Arthrodesis sacroiliac joint percutaneous (27279) |
— |
$3,502 |
— |
| Arthrodesis subtalar (28725) |
— |
$4,908 |
— |
| Arthrodesis triple (28715) |
— |
$4,908 |
— |
| Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for… (22558) |
— |
$6,695 |
— |
| Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments Facility (22808) |
— |
$6,695 |
— |
| Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed Facility (27280) |
— |
$6,695 |
— |
| Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft) Facility (25810) |
— |
$3,502 |
— |
| Arthroplasty Ankle (27700) |
— |
$3,502 |
— |
| Arthroplasty Ankle W/Implant (27702) |
— |
$6,695 |
— |
| Arthroplasty glenohumeral joint total shoulder (23472) |
— |
$3,502 |
— |
| Arthroplasty Glenohumrl Jt Hemiarthroplasty (23470) |
— |
$3,502 |
— |
| Arthroplasty interphalangeal joint each (26535) |
— |
$3,502 |
— |
| Arthroplasty interposition intercarpal or carpometacarpal joints (25447) |
— |
$3,502 |
— |
| Arthroplasty Patella W/Prosthesis (27438) |
— |
$3,502 |
— |
| Arthroplasty radial head (24365) |
— |
$3,502 |
— |
| Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy Facility (27443) |
— |
$3,502 |
— |
| Arthroplasty, patella; without prosthesis (27437) |
— |
$4,908 |
— |
| Arthroplasty, temporomandibular joint, with allograft Facility (21242) |
— |
$3,502 |
— |
| Arthroplasty, temporomandibular joint, with prosthetic joint replacement Facility (21243) |
— |
$3,502 |
— |
| Arthroscopy Ankle Surgical Debridement Extensive (29898) |
— |
$4,020 |
— |
| Arthroscopy Ankle Surgical Debridement Limited (29897) |
— |
$4,020 |
— |
| Arthroscopy ankle w/removal loose/foreign body (29894) |
— |
$4,020 |
— |
| Arthroscopy hip w/femoroplasty (29914) |
— |
$4,908 |
— |
| Arthroscopy knee diagnostic w/wo synovial bx spx (29870) |
— |
$4,020 |
— |
| Arthroscopy Knee Synovectomy 2/>Compartments (29876) |
— |
$4,908 |
— |
| Arthroscopy knee synovectomy limited spx (29875) |
— |
$4,908 |
— |
| Arthroscopy knee w/lysis adhesions w/wo manj spx (29884) |
— |
$4,020 |
— |
| Arthroscopy shoulder distal claviculectomy (29824) |
— |
$3,502 |
— |
| Arthroscopy shoulder surgical capsulorrhaphy (29806) |
— |
$4,020 |
— |
| Arthroscopy Wrist Surgical Synovectomy Complete (29845) |
— |
$4,020 |
— |
| Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial (29895) |
— |
$4,020 |
— |
| Arthroscopy, elbow, surgical; synovectomy, complete Facility (29836) |
— |
$4,020 |
— |
| Arthroscopy, elbow, surgical; with removal of loose body or foreign body Facility (29834) |
— |
$4,020 |
— |
| Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty,… (29862) |
— |
$4,908 |
— |
| Arthroscopy, hip, surgical; with synovectomy Facility (29863) |
— |
$4,908 |
— |
| Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograftºs»)… (29866) |
— |
$4,020 |
— |
| Arthroscopy, knee, surgical; with lateral release (29873) |
— |
$4,020 |
— |
| Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) |
— |
$4,020 |
— |
| Arthroscopy, shoulder, surgical; biceps tenodesis (29828) |
— |
$4,020 |
— |
| Arthroscopy, shoulder, surgical; debridement, extensive (29823) |
— |
$4,020 |
— |
| Arthroscopy, shoulder, surgical; debridement, limited (29822) |
— |
$4,020 |
— |
| Arthroscopy, shoulder, surgical; repair of slap lesion (29807) |
— |
$4,020 |
— |
| Arthroscopy, shoulder, surgical; synovectomy, complete Facility (29821) |
— |
$4,020 |
— |
| Arthroscopy, shoulder, surgical; with removal of loose body or foreign body (29819) |
— |
$4,020 |
— |
| Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) |
— |
$3,502 |
— |
| Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement Facility (29846) |
— |
$4,020 |
— |
| Arthrotomy ankle w/expl drainage/removal fb (27610) |
— |
$3,460 |
— |
| Arthrotomy W/Biopsy Hip Joint (27052) |
— |
$4,020 |
— |
| Arthrotomy W/Meniscus Repair Knee (27403) |
— |
$4,908 |
— |
| Arthrotomy W/Synovectomy Ankle (27625) |
— |
$4,908 |
— |
| Arthrotomy wrist joint with synovectomy (25105) |
— |
$4,908 |
— |
| Arthrotomy, hip, with drainage (eg, infection) Facility (27030) |
— |
$4,020 |
— |
| Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial AND lateral Facility (27333) |
— |
$4,908 |
— |
| Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft (27130) |
— |
$6,695 |
— |
| Arthrp Knee Condyle&Plateau Medial/Lat Cmprt (27446) |
— |
$3,502 |
— |
| Arthrp Mtcarphlngl Jt W/Prostc Implt Ea Jt (26531) |
— |
$8,927 |
— |
| Arthrp wrst w/wo interpos w/wo xtrnl/int fixj (25332) |
— |
$3,502 |
— |
| Arthrs aided ant cruciate ligm rpr/agmntj/rcnstj (29888) |
— |
$4,020 |
— |
| Arthrs Aided Pst Cruciate Ligm Rpr/Agmntj/Rcnstj (29889) |
— |
$4,020 |
— |
| Arthrs Ankle Exc Ostchndrl Dfct W/Drlg Dfct (29891) |
— |
$4,020 |
— |
| Arthrs Knee Abrasion Arthrp/Mlt Drlg/Microfx (29879) |
— |
$4,020 |
— |
| Arthrs knee debridement/shaving artclr crtlg (29877) |
— |
$4,908 |
— |
| Arthrs Knee Drilling Osteochond Dissecans Lesion (29886) |
— |
$4,020 |
— |
| Arthrs Knee W/Meniscectomy Med&Lat W/Shaving (29880) |
— |
$4,908 |
— |
| Arthrt Acromclav Strnclav Jt Expl/Drg/Rmvl FB (23044) |
— |
$4,908 |
— |
| Arthrt ankle w/expl w/wo bx w/wo rmvl loose/fb (27620) |
— |
$4,908 |
— |
| Arthrt Elbow Capsular Excision Capsular Rls Spx (24006) |
— |
$4,908 |
— |
| Arthrt expl drg/rmvl loose/fb iphal jt ea (26080) |
— |
$4,908 |
— |
| Arthrt expl drg/rmvl loose/fb mtcarphlngl jt ea (26075) |
— |
$4,908 |
— |
| Arthrt Pst Capsul Rls Ankle W/WO Achll Tdn Lngth (27612) |
— |
$4,020 |
— |
| Arthrt W/Exc Semilunar Crtlg Knee Medial/Lat (27332) |
— |
$4,908 |
— |
| Arthrt w/expl drg/rmvl loose/fb mttarphlngl jt (28022) |
— |
$3,460 |
— |
| Arthrt W/Expl Drg/Rmvl Loose/FB Ntrtrsl/Tars Jt (28020) |
— |
$3,460 |
— |
| Arthrt w/synvct kne ant&post w/pop area (27335) |
— |
$4,908 |
— |
| Aspirate pleura w/ imaging (32555) |
— |
$3,476.52 |
— |
| Aspiration bladder insert suprapubic catheter (51102) |
— |
$6,516.30 |
— |
| Autologous Chondrocyte Implantation Knee (27412) |
— |
$4,020 |
— |
| Av fistula revision (36833) |
— |
$4,908 |
— |
| Av Fistula Revision Open (36832) |
— |
$4,908 |
— |
| Av Fuse Uppr Arm Basilic (36819) |
— |
$4,020 |
— |
| Av fusion/forearm vein (36820) |
— |
$4,020 |
— |
| Avulsion nail plate partial/complete simple 1 (11730) |
— |
$2,566 |
— |
| Axillary lymphadenectomy; complete (38745) |
— |
$4,908 |
— |
| Biopsy Abdominal Mass (49180) |
— |
$3,248.58 |
— |
| Biopsy bone open deep (20245) |
— |
$4,020 |
— |
| Biopsy bone open superficial (20240) |
— |
$3,460 |
— |
| Biopsy bone trocar/needle deep (20225) |
— |
$4,076.82 |
— |
| Biopsy Bone Trocar/Needle Superficial (20220) |
— |
$3,105.90 |
— |
| Biopsy External Auditory Canal (69105) |
— |
$8,927 |
— |
| Biopsy external ear (69100) |
— |
$8,927 |
— |
| Biopsy muscle percutaneous needle (20206) |
— |
$1,884.42 |
— |
| Biopsy Muscle Superficial (20200) |
— |
$3,460 |
— |
| Biopsy Nasopharynx Visible Lesion Simple (42804) |
— |
$2,566 |
— |
| Biopsy of breast; open, incisional (19101) |
— |
$3,460 |
— |
| Biopsy of floor of mouth (41108) |
— |
$2,566 |
— |
| Biopsy of intestine by capsule, tube, peroral (1 or more specimens) (44100) |
— |
$2,566 |
— |
| Biopsy of lip (40490) |
— |
$8,927 |
— |
| Biopsy of liver, needle; percutaneous (47000) |
— |
$3,206.82 |
— |
| Biopsy of palate, uvula (42100) |
— |
$2,566 |
— |
| Biopsy of penis; deep structures (54105) |
— |
$2,566 |
— |
| Biopsy of rectum (45100) |
— |
$2,566 |
— |
| Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad Facility (38520) |
— |
$3,460 |
— |
| Biopsy or excision of lymph node(s); open, internal mammary node(s) Facility (38530) |
— |
$3,460 |
— |
| Biopsy Oropharynx (42800) |
— |
$2,566 |
— |
| Biopsy ovary uni/bi separate procedure (58900) |
— |
$4,020 |
— |
| Biopsy Pleura Percutaneous Needle (32400) |
— |
$2,249.82 |
— |
| Biopsy Salivary Gland Incisional (42405) |
— |
$3,460 |
— |
| Biopsy Salivary Gland Needle (42400) |
— |
$2,349 |
— |
| Biopsy soft tissue neck/thorax (21550) |
— |
$3,926.31 |
— |
| Biopsy Soft Tissue Thigh/Knee Area Deep (27324) |
— |
$2,566 |
— |
| Biopsy soft tissue thigh/knee area superficial (27323) |
— |
$2,566 |
— |
| Biopsy Spinal Cord Percutaneous Needle (62269) |
— |
$2,566 |
— |
| Biopsy Testis Needle Separate Procedure (54500) |
— |
$2,566 |
— |
| Biopsy Tongue Anterior Two-Thirds (41100) |
— |
$2,566 |
— |
| Biopsy Tongue Posterior One-Third (41105) |
— |
$3,460 |
— |
| Biopsy Vaginal Mucosa Simple (57100) |
— |
$2,566 |
— |
| Biopsy Vulva/Perineum 1 Lesion Spx (56605) |
— |
$2,566 |
— |
| Biopsy, vestibule of mouth (40808) |
— |
$2,566 |
— |
| Biopsy/removal lymph nodes (38510) |
— |
$3,460 |
— |
| Bladder instillation anticarcinogenic agent (51720) |
— |
$321.27 |
— |
| Bladder Irrigation (51700) |
— |
$982.23 |
— |
| Bladder Scan (51798) |
— |
$2,890 |
— |
| Blepharoplasty Lower Eyelid (15820) |
— |
$4,020 |
— |
| Blepharoplasty Lower Eyelid Herniated Fat Pad (15821) |
— |
$4,020 |
— |
| Blepharoplasty upper eyelid (15822) |
— |
$4,020 |
— |
| Blepharoplasty Upper Eyelid W/Excessive Skin (15823) |
— |
$3,502 |
— |
| Blepharotomy drainage abscess eyelid (67700) |
— |
$2,566 |
— |
| Blood Transfusion Service (36430) |
— |
$1,859.19 |
— |
| Blood/Lymph System Procedure (38999) |
— |
$2,566 |
— |
| Bone Graft Any Donor Area Minor/Small (20900) |
— |
$4,020 |
— |
| Bone Marrow Biopsy (38221) |
— |
$3,359.07 |
— |
| Bone Marrow Harvest Autolog (38232) |
— |
$4,020 |
— |
| Bone Marrow; Aspiration Only (38220) |
— |
$1,558.17 |
— |
| Breast augmentation with implant (19325) |
— |
$11,160 |
— |
| Breast Reduction (19318) |
— |
$4,908 |
— |
| Brnchsc Brushing/Protected Brushings (31623) |
— |
$4,326.51 |
— |
| Bronchoscopy Clear Airways (31645) |
— |
$4,326.51 |
— |
| Bronchoscopy Reclear Airway (31646) |
— |
$4,326.51 |
— |
| Bronchoscopy W/Biopsy(S) (31625) |
— |
$4,326.51 |
— |
| Bronchoscopy W/Removal Foreign Body (31635) |
— |
$4,326.51 |
— |
| Bronchoscopy w/transbronchial lung bx 1 lobe (31628) |
— |
$4,326.51 |
— |
| Bronchoscopy/Needle Bx Each (31629) |
— |
$3,460 |
— |
| Bx Arm/Elbow Soft Tissue,Deep (24066) |
— |
$3,460 |
— |
| Bx breast 1st lesion us imag (19083) |
— |
$8,902.71 |
— |
| Bx breast needle core w/o imaging guidance spx (19100) |
— |
$2,566 |
— |
| Bx Cervix (57500) |
— |
$2,566 |
— |
| Bx/exc lymph node open deep axillary node (38525) |
— |
$3,460 |
— |
| Bx/exc lymph node open superficial (38500) |
— |
$3,460 |
— |
| Canthoplasty (67950) |
— |
$3,460 |
— |
| Canthotomy Separate Procedure (67715) |
— |
$2,566 |
— |
| Capsul mttarphlngl jt w/wo tenorrhaphy ea jt spx (28270) |
— |
$4,020 |
— |
| Capsular contracture release (23020) |
— |
$3,460 |
— |
| Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie,… (27036) |
— |
$4,908 |
— |
| Capsulectomy or capsulotomy; interphalangeal joint, each joint (26525) |
— |
$4,020 |
— |
| Capsulectomy/capsulotomy mtcarphlngl joint each (26520) |
— |
$4,020 |
— |
| Capsulorrhaphy Anterior Putti-Platt/Magnuson (23450) |
— |
$3,502 |
— |
| Capsulorrhaphy Anterior W/Labral Repair (23455) |
— |
$8,927 |
— |
| Capsulotomy Iphal Joint Each Joint Spx (28272) |
— |
$3,460 |
— |
| Capsulotomy Midtarsal (28264) |
— |
$2,566 |
— |
| Capsulotomy wrist (25085) |
— |
$4,020 |
— |
| Capsulotomy, midfoot; medial release only (separate procedure) Facility (28260) |
— |
$4,020 |
— |
| Carpal Tunnel Surgery (64721) |
— |
$3,460 |
— |
| Cataract surg w/iol 1 stage (66983) |
— |
$10,040 |
— |
| Catheter aspiration nasotracheal spx (31720) |
— |
$2,566 |
— |
| Cautery Cervix Cryocautery Initial/Repeat (57511) |
— |
$2,566 |
— |
| Cerv artific diskectomy (22856) |
— |
$6,695 |
— |
| Cervical lymphadenectomy (complete) (38720) |
— |
$4,908 |
— |
| Change Cystostomy Tube Simple (51705) |
— |
$2,566 |
— |
| Change of Windpipe Airway (31502) |
— |
$1,343.28 |
— |
| Change ureter stent percut (50382) |
— |
$2,566 |
— |
| Chemical Cautery Tissue (17250) |
— |
$2,566 |
— |
| Chemodenervation of internal anal sphincter (46505) |
— |
$2,566 |
— |
| Chest tube placement (32551) |
— |
$2,228.94 |
— |
| Chng Urtrost Tube/Xtrnlly Accessible Stent Ileal (50688) |
— |
$2,566 |
— |
| Circumcision 28 days or older (54161) |
— |
$3,460 |
— |
| Cl Tx Tib Shft Fx W Manip (27752) |
— |
$2,566 |
— |
| Claviculectomy partial (23120) |
— |
$3,502 |
— |
| Clear outer ear canal (69200) |
— |
$8,927 |
— |
| Closed Rx Metacarpal Fx,Percut (26608) |
— |
$4,908 |
— |
| Closed rx talotarsal disloc,anesth (28575) |
— |
$2,566 |
— |
| Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) |
— |
$2,566 |
— |
| Closed Treatment Ulnar Styloid Fracture (25650) |
— |
$8,927 |
— |
| Closed tx ankle dislocation w/o anesthesia (27840) |
— |
$2,566 |
— |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) |
— |
$2,566 |
— |
| Closed Tx Calcaneal Fracture W/O Manipulation (28400) |
— |
$2,566 |
— |
| Closed Tx Knee Dislocation W/Anesthesia (27552) |
— |
$2,566 |
— |
| Closed tx knee dislocation w/o anesthesia (27550) |
— |
$2,566 |
— |
| Closed Tx Mandibular Fx W/Interdental Fixation (21453) |
— |
$4,020 |
— |
| Closed tx metatarsal fracture w/o manipulation (28470) |
— |
$2,566 |
— |
| Closed Tx Monteggia Fx Dislocation Elbow W/Manj (24620) |
— |
$3,460 |
— |
| Closed Tx Nasal Bone Fx W/Mnpj W/O Stabilization (21315) |
— |
$3,460 |
— |
| Closed Tx Nasal Bone Fx W/Mnpj W/Stabilization (21320) |
— |
$3,460 |
— |
| Closed tx patellar dislocation w/anesthesia (27562) |
— |
$2,566 |
— |
| Closed tx patellar dislocation w/o anesthesia (27560) |
— |
$2,566 |
— |
| Closed Tx Patellar Fracture W/O Manipulation (27520) |
— |
$2,566 |
— |
| Closed tx radial head/neck fx w/manipulation (24655) |
— |
$2,566 |
— |
| Closed tx radial head/neck fx w/o manipulation (24650) |
— |
$2,566 |
— |
| Closed tx radial shaft fracture w/manipulation (25505) |
— |
$2,566 |
— |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
— |
$3,460 |
— |
| Closed tx septal&nose fx (21337) |
— |
$3,460 |
— |
| Closed tx talotarsal joint dislc w/o anes (28570) |
— |
$2,566 |
— |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
— |
$2,566 |
— |
| Closed Tx Ulnar Fracture Prox End W Manipulation (24675) |
— |
$2,566 |
— |
| Closure Gastrostomy Surg (43870) |
— |
$2,566 |
— |
| Closure Laceration Vestibule Mouth 2.5 Cm/< (40830) |
— |
$8,927 |
— |
| Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) Facility (53520) |
— |
$3,460 |
— |
| Clsd tx acromioclavicular dislc w/manipulation (23545) |
— |
$2,566 |
— |
| Clsd tx clavicular fracture w/o manipulation (23500) |
— |
$2,566 |
— |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
— |
$2,566 |
— |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
— |
$2,566 |
— |
| Clsr Anal Fstl W/Rct Advmnt Flap (46288) |
— |
$4,908 |
— |
| Cltx ankle dislc req anes w/wo prq skel fixj (27842) |
— |
$2,566 |
— |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
— |
$3,460 |
— |
| Cltx Carpal Bone Fx W/Manj Each Bone (25635) |
— |
$2,566 |
— |
| Cltx dstl fibular fx lat malls w/manj (27788) |
— |
$2,566 |
— |
| Cltx dstl fibular fx lat malls w/o manj (27786) |
— |
$2,566 |
— |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) |
— |
$8,927 |
— |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) |
— |
$8,927 |
— |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
— |
$2,566 |
— |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
— |
$4,020 |
— |
| Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) |
— |
$2,566 |
— |
| Cltx Fem Fx Prox End Nck W/Manj W/WO Skel Tracj (27232) |
— |
$2,566 |
— |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) |
— |
$3,460 |
— |
| Cltx fx grt toe phlx/phlg w/o manj (28490) |
— |
$2,566 |
— |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
— |
$2,566 |
— |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) |
— |
$3,460 |
— |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) |
— |
$2,566 |
— |
| Cltx hip dislocation traumatic req anesthesia (27252) |
— |
$3,460 |
— |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
— |
$2,566 |
— |
| Cltx humeral condylar fx medial/lateral w/manj (24577) |
— |
$2,566 |
— |
| Cltx Humeral Epicondylar Fx Medial/Lat W/Manj (24565) |
— |
$3,460 |
— |
| Cltx Interphalangeal Joint Dislocation Req Anes (28665) |
— |
$2,566 |
— |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
— |
$2,566 |
— |
| Cltx Intr/Peri/Sbtrchntc Femoral Fx W/Manj (27240) |
— |
$2,566 |
— |
| Cltx Iphal Jt Dislc W/Manj Req Anes (26775) |
— |
$8,927 |
— |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
— |
$8,927 |
— |
| Cltx Med Ankle Fx W/Mnpj (27762) |
— |
$2,566 |
— |
| Cltx metacarpal fx w/manipulation each bone (26605) |
— |
$3,460 |
— |
| Cltx metacarpal fx w/o manipulation each bone (26600) |
— |
$8,927 |
— |
| Cltx metacarpophalangeal dislc w/manj w/anes (26705) |
— |
$3,460 |
— |
| Cltx Metatarsophlngl Jt Dislc Req Anes (28635) |
— |
$2,566 |
— |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
— |
$3,460 |
— |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) |
— |
$2,566 |
— |
| Cltx post hip arthrp dislc req anes (27266) |
— |
$3,460 |
— |
| Cltx post hip arthrp dislc w/o anes (27265) |
— |
$2,566 |
— |
| Cltx prox fibula/shft fx w/manj (27781) |
— |
$2,566 |
— |
| Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) |
— |
$3,460 |
— |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
— |
$8,927 |
— |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) |
— |
$3,460 |
— |
| Cltx Shoulder Dislc W/Surg/Antmcl Neck Fx W/Manj (23675) |
— |
$3,460 |
— |
| Cltx Sprcndylr/Trnscndylr Fem Fx W/Manj (27503) |
— |
$4,020 |
— |
| Cltx tibial shaft fx w/o manipulation (27750) |
— |
$2,566 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$2,566 |
— |
| Cmbnd anterpost colporraphy w/cysto w/ntrcl rpr (57265) |
— |
$8,927 |
— |
| Coccygectomy, primary (27080) |
— |
$3,460 |
— |
| Colonoscopy stoma rmvl les by hot biopsy forceps (44392) |
— |
$2,566 |
— |
| Colonoscopy Stoma W/Endoscopic Mucosal Rescj (44403) |
— |
$2,566 |
— |
| Colonoscopy through stoma; with biopsy, single or multiple (44389) |
— |
$2,566 |
— |
| Colonoscopy thru stoma (44388) |
— |
$2,566 |
— |
| Colonoscopy w/ablation (45388) |
— |
$3,460 |
— |
| Colonoscopy w/fb removal (45379) |
— |
$3,460 |
— |
| Colonoscopy W/Resection (45390) |
— |
$3,460 |
— |
| Colonoscopy w/submucosal inj (45381) |
— |
$3,460 |
— |
| Colpocleisis (le fort type) (57120) |
— |
$3,502 |
— |
| Colpopexy extraperitoneal (57282) |
— |
$3,502 |
— |
| Colpopexy vaginal intraperitoneal approach (57283) |
— |
$3,502 |
— |
| Colporrhaphy (57200) |
— |
$2,566 |
— |
| Colposcopy cervix upper/adjacent vagina (57452) |
— |
$3,460 |
— |
| Colposcopy cervix vag eltrd conization cervix (57461) |
— |
$4,020 |
— |
| Colposcopy Cervix Vag Loop Eltrd Bx Cervix (57460) |
— |
$3,460 |
— |
| Colpotomy; with exploration (57000) |
— |
$2,566 |
— |
| Colsc Flexible W/Control Bleeding Any Method (45382) |
— |
$3,460 |
— |
| Colsc flx w/removal lesion by hot bx forceps (45384) |
— |
$3,460 |
— |
| Combined anteroposterior colporrhaphy; (57260) |
— |
$3,502 |
— |
| Complex Cystometrogram (51726) |
— |
$2,566 |
— |
| Complex drainage wound (10180) |
— |
$3,460 |
— |
| Conization cervix w/wo d&c rpr eltrd exc (57522) |
— |
$3,460 |
— |
| Conization of cervix (57520) |
— |
$3,460 |
— |
| Conjunctival Flap Total (68362) |
— |
$3,460 |
— |
| Conjunctivoplasty w/grf/xtnsv rearrangement (68320) |
— |
$4,908 |
— |
| Contour cranial bone lesion (21181) |
— |
$8,927 |
— |
| Control Nasal Hemorrhage Anterior Complex (30903) |
— |
$2,566 |
— |
| Control Nasal Hemorrhage Anterior Simple (30901) |
— |
$2,566 |
— |
| Control oropharyngeal hemorrhage simple (42960) |
— |
$2,566 |
— |
| Conv prev hip tot hip arthrp w/wo agrft/algrft (27132) |
— |
$6,695 |
— |
| Convert gastrostomy-gastro-jejunostomy tube percutaneous (49446) |
— |
$3,292.08 |
— |
| Core Needle Bx Lung/Mediastinum Perq W/Img (32408) |
— |
$3,516.54 |
— |
| Corpora Cavernosa-Glans Penis Fstlj Priapism (54435) |
— |
$4,908 |
— |
| Corpora Cavernosa-Saphenous Vein Shunt Uni/Bi (54420) |
— |
$4,908 |
— |
| Correction hammertoe (28285) |
— |
$4,020 |
— |
| Corrj hallux valgus w/sesmdc w/dist metar osteot (28296) |
— |
$4,020 |
— |
| Corrj Hlx Vlgs Bncty Sesmdc Joint Arthrodesis (28297) |
— |
$4,020 |
— |
| Corrj Hlx Vlgs Bncty Sesmdc Prox Phlx Osteot (28298) |
— |
$4,020 |
— |
| Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base (28292) |
— |
$3,460 |
— |
| Corrj Hlx Vlgs Bncty Sesmdc W/Double Osteotomy (28299) |
— |
$3,502 |
— |
| Crtj Arven Fstl Xcp Dir Arven Anast Nonautog Grf (36830) |
— |
$15,246.75 |
— |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
— |
$2,566 |
— |
| Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) |
— |
$2,566 |
— |
| Ctrl Oropharyngeal Hemorrhage W/Sec Surg Ivntj (42962) |
— |
$3,460 |
— |
| Curettage postpartum (59160) |
— |
$4,020 |
— |
| Cysto Bladder W/Ureteral Catheterization (52005) |
— |
$3,460 |
— |
| Cysto calibration dilat urtl strix/stenosis (52281) |
— |
$3,460 |
— |
| Cysto w/complex removal stone & stent (52315) |
— |
$3,460 |
— |
| Cysto w/destruction of lesions (52214) |
— |
$3,460 |
— |
| Cysto w/insert ureteral stent (52332) |
— |
$3,460 |
— |
| Cysto w/irrig & evac multple obstructing clots (52001) |
— |
$3,460 |
— |
| Cysto w/removal of lesions small (52224) |
— |
$3,460 |
— |
| Cysto w/removal of tumors small (52234) |
— |
$3,460 |
— |
| Cysto W/Simple Removal Stone & Stent (52310) |
— |
$3,460 |
— |
| Cysto w/up stricture tx (52342) |
— |
$4,020 |
— |
| Cysto w/ureter stricture tx (52341) |
— |
$4,020 |
— |
| Cysto w/ureteroscopy w/lithotripsy (52353) |
— |
$4,908 |
— |
| Cysto w/ureteroscopy w/rmvl/manj stones (52352) |
— |
$4,908 |
— |
| Cysto w/urtroscopy w/tx ureteral stricture (52344) |
— |
$4,020 |
— |
| Cysto W/Urtroscopy&/Pyeloscopy Dx (52351) |
— |
$4,020 |
— |
| Cysto/uretero w/lithotripsy (52356) |
— |
$4,908 |
— |
| Cystolithotomy (51050) |
— |
$4,908 |
— |
| Cystorrhaphy suture of bladder wound injury or rupture simple (51860) |
— |
$3,460 |
— |
| Cystoscopy implant stent (52282) |
— |
$4,020 |
— |
| Cystostomy Cystotomy W/Drainage (51040) |
— |
$4,908 |
— |
| Cystourethroscopy (52000) |
— |
$2,566 |
— |
| Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or… (52325) |
— |
$4,908 |
— |
| Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus Facility (52330) |
— |
$3,460 |
— |
| Cystourethroscopy inj chemodenervation bladder (52287) |
— |
$3,460 |
— |
| Cystourethroscopy W/Dest &/Rmvl Med Bladder Tum (52235) |
— |
$4,020 |
— |
| Cystourethroscopy W/Dest &/Rmvl Tumor Large (52240) |
— |
$4,020 |
— |
| Cystourethroscopy w/dil bladder general anesth (52260) |
— |
$3,460 |
— |
| Cystourethroscopy w/rmvl ureteral calculus (52320) |
— |
$3,502 |
— |
| Cystourethroscopy with biopsy (52204) |
— |
$3,460 |
— |
| Cystourethroscopy with direct vision internal urethrotomy (52276) |
— |
$4,020 |
— |
| Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy,… (52334) |
— |
$4,020 |
— |
| Cystourethroscopy, with internal urethrotomy; male Facility (52275) |
— |
$3,460 |
— |
| Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral Facility (52290) |
— |
$3,460 |
— |
| Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) |
— |
$2,566 |
— |
| Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) |
— |
$3,460 |
— |
| Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010) |
— |
$3,460 |
— |
| Dcmprn Fasct F/Arm&/Wrst Flxr&Xtnsr W/O Db (25024) |
— |
$4,020 |
— |
| Dcmprn Fasct Leg Ant&/Lat&Pst Cmprt (27602) |
— |
$4,020 |
— |
| Deb Musc/Fascia 20 Sq Cm/< (11043) |
— |
$2,016.66 |
— |
| Debride nail 1-5 (11720) |
— |
$2,566 |
— |
| Debride nail 6 or more (11721) |
— |
$2,566 |
— |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) |
— |
$5,206.95 |
— |
| Debridement Mastoidectomy Cavity Cmplx (69222) |
— |
$3,460 |
— |
| Debridement Mastoidectomy Cavity Simple (69220) |
— |
$8,927 |
— |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
— |
$1,295.43 |
— |
| Decompress Spinal Cord Lmbr (63056) |
— |
$6,695 |
— |
| Decompression of tibia nerve (28035) |
— |
$4,908 |
— |
| Deep Muscle Biopsy (20205) |
— |
$4,020 |
— |
| Delay flap/sectioning flap f/c/c/n/ax/g/h/f (15620) |
— |
$4,908 |
— |
| Destr penis lesion(s) (54065) |
— |
$2,566 |
— |
| Destroy cerv/thor facet jnt (64633) |
— |
$2,566 |
— |
| Destroy lumb/sac facet jnt (64635) |
— |
$2,566 |
— |
| Destruct B9 Lesion 1-14 (17110) |
— |
$2,566 |
— |
| Destruction Internal Hemorrhoid Thermal Energy (46930) |
— |
$2,566 |
— |
| Destruction Lesions Vulva Extensive (56515) |
— |
$4,020 |
— |
| Destruction Lesions Vulva Simple (56501) |
— |
$2,566 |
— |
| Destruction mal lesion f/e/e/n/l/m 1.1-2.0cm (17282) |
— |
$2,566 |
— |
| Destruction mal lesion f/e/e/n/l/m 2.1-3.0cm (17283) |
— |
$2,566 |
— |
| Destruction mal lesion trunk/arm/leg > 4.0 cm (17266) |
— |
$3,460 |
— |
| Destruction malignant lesion f/e/e/n/l/m 0.5cm/< (17280) |
— |
$2,566 |
— |
| Destruction of lesion of lid margin (up to 1 cm) (67850) |
— |
$2,566 |
— |
| Destruction of rectal tumor transanal approach (45190) |
— |
$3,460 |
— |
| Destruction of skin lesions (17106) |
— |
$2,566 |
— |
| Destruction Premalignant Lesion 15/> (17004) |
— |
$2,566 |
— |
| Destruction premalignant lesion 1st (17000) |
— |
$2,566 |
— |
| Destruction Vaginal Lesions Simple (57061) |
— |
$2,566 |
— |
| Diagnostic sigmoidoscopy (45330) |
— |
$2,168.04 |
— |
| Dilate Esophagus 1/Mult Pass (43450) |
— |
$2,566 |
— |
| Dilate Urethra Stricture (53620) |
— |
$2,566 |
— |
| Dilate Urethra Stricture (53600) |
— |
$2,566 |
— |
| Dilation & curettage dx&/ther nonobstetric (58120) |
— |
$3,460 |
— |
| Dilation Cervical Canal (57800) |
— |
$2,566 |
— |
| Dir Rpr Ruptd Aneurysm Radial/Ulnar Artery (35045) |
— |
$8,927 |
— |
| Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch… (35011) |
— |
$8,927 |
— |
| Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical,… (63075) |
— |
$3,502 |
— |
| Dissection, deep jugular node(s) Facility (38542) |
— |
$3,460 |
— |
| Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access (steal syndrome) Facility (36838) |
— |
$4,908 |
— |
| Drain Cerebro Spinal Fluid (62272) |
— |
$1,827.87 |
— |
| Drain Hand Tendon Sheath (26020) |
— |
$3,460 |
— |
| Drainage abscess parotid simple (42300) |
— |
$2,566 |
— |
| Drainage external auditory canal abscess (69020) |
— |
$2,566 |
— |
| Drainage external ear abscess/hematoma cmplx (69005) |
— |
$2,566 |
— |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
— |
$2,566 |
— |
| Drainage of eye (65800) |
— |
$2,566 |
— |
| Drainage of finger abscess simple (26010) |
— |
$8,927 |
— |
| Drainage of gum lesion (41800) |
— |
$2,566 |
— |
| Drainage of hematoma/fluid (10140) |
— |
$4,713.66 |
— |
| Drainage of nose lesion (30000) |
— |
$2,566 |
— |
| Drainage of rectal abscess (45005) |
— |
$3,460 |
— |
| Drainage of scrotal wall abscess (55100) |
— |
$2,566 |
— |
| Drainage of scrotum (54700) |
— |
$3,460 |
— |
| Drainage of urethra abscess (53040) |
— |
$3,460 |
— |
| Drainage Ovarian Cyst Uni/Bi Spx Abdominal (58805) |
— |
$4,020 |
— |
| Dressing Change Under Anesthesia (15852) |
— |
$2,566 |
— |
| Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) |
— |
$8,927 |
— |
| Drg Absc Submaxillary/Sublingual Intraoral (42310) |
— |
$2,566 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
— |
$3,460 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
— |
$3,460 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
— |
$1,321.53 |
— |
| Dstrj Cutaneous Vascular Lesions 10.0-50.0 Sq Cm (17107) |
— |
$2,566 |
— |
| Dstrj les/scar vestibule mouth physical meths (40820) |
— |
$2,566 |
— |
| Dstrj Lesion Anus Extensive (46924) |
— |
$2,566 |
— |
| Dstrj lesion anus simple surg excision (46922) |
— |
$2,566 |
— |
| Dstrj Lesion Anus Smpl Eltrdsiccation (46910) |
— |
$3,460 |
— |
| Dstrj Lesion Penis Simple Electrodesiccation (54055) |
— |
$8,927 |
— |
| Dstrj lesion penis simple surg excision (54060) |
— |
$2,566 |
— |
| Dx Bronchoscope/Lavage (31624) |
— |
$4,326.51 |
— |
| Dx Bronchoscope/Wash (31622) |
— |
$4,326.51 |
— |
| Dx Laryngoscopy Excl Nb (31525) |
— |
$3,460 |
— |
| Dx laryngoscopy w/oper scope (31526) |
— |
$3,460 |
— |
| Egd Balloon Dilation Esophagus <30 Mm Diam (43249) |
— |
$3,460 |
— |
| Egd cautery tumor polyp (43250) |
— |
$3,460 |
— |
| Egd control bleeding any (43255) |
— |
$3,460 |
— |
| Egd dilation gastric/duodenal stricture (43245) |
— |
$3,460 |
— |
| Egd Endoscopic Stent Place (43266) |
— |
$4,020 |
— |
| Egd Flexible Foreign Body Removal (43247) |
— |
$3,460 |
— |
| Egd guide wire insertion (43248) |
— |
$3,460 |
— |
| Egd Injection Sclerosis Esophgl/Gastric Varices (43243) |
— |
$3,460 |
— |
| Egd Intrmural Needle Aspir/Biop Altered Anatomy (43242) |
— |
$3,460 |
— |
| Egd intrmural us needle aspirate/biopsy esophags (43238) |
— |
$3,460 |
— |
| Egd place gastrostomy tube (43246) |
— |
$3,460 |
— |
| Egd remove lesion snare (43251) |
— |
$3,460 |
— |
| Egd Tube/Cath Insertion (43241) |
— |
$3,460 |
— |
| Egd us exam duodenum/jejunum (43259) |
— |
$4,020 |
— |
| Egd Varices Ligation (43244) |
— |
$3,460 |
— |
| Elect Analys Implt Ithcl/Edrl Pump W/Reprgrmg (62368) |
— |
$3,460 |
— |
| Emblc/thrmbc ax brach innominate subcla art (34101) |
— |
$4,020 |
— |
| Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision Facility (34111) |
— |
$8,927 |
— |
| Endocervical curettage (57505) |
— |
$2,566 |
— |
| Endometrial ablation, thermal, without hysteroscopic guidance (58353) |
— |
$8,927 |
— |
| Endoscopic injection/implant (51715) |
— |
$4,020 |
— |
| Endoscopy Upper Small Intestine (44360) |
— |
$3,460 |
— |
| Enterorrhaphy single perforation (44602) |
— |
$8,927 |
— |
| Enterosc >2nd prtn w/ileum w/bx single/multiple (44377) |
— |
$3,460 |
— |
| Enterosc >2nd prtn w/ileum w/wo collj spec spx (44376) |
— |
$3,460 |
— |
| Enteroscopy > 2nd prtn conv gstrst tube (44373) |
— |
$3,460 |
— |
| Enteroscopy > 2nd prtn w/plmt prq tube (44372) |
— |
$3,460 |
— |
| Epididymectomy unilateral (54860) |
— |
$4,020 |
— |
| Epidural Blood Patch (62273) |
— |
$2,017.53 |
— |
| Ercp Destruction/Lithotripsy Calculi Any Method (43265) |
— |
$3,460 |
— |
| Ercp duct stent placement (43274) |
— |
$4,020 |
— |
| Ercp Dx Collection Specimen Brushing/Washing (43260) |
— |
$8,853.99 |
— |
| Ercp ea duct/ampulla dilate (43277) |
— |
$4,020 |
— |
| Ercp remove calculi/debris biliary/pancreas duct (43264) |
— |
$3,460 |
— |
| Ercp remove forgn body duct (43275) |
— |
$4,020 |
— |
| Ercp Stent Exchange W/Dilate (43276) |
— |
$4,020 |
— |
| Ercp W/Biopsy Single/Multiple (43261) |
— |
$3,460 |
— |
| Ercp,Sphincterotomy (43262) |
— |
$3,460 |
— |
| Esophagogastroduodenoscopy Submucosal Injection (43236) |
— |
$3,460 |
— |
| Esophagoscopy Flexible Transoral Diagnostic (43200) |
— |
$2,566 |
— |
| Esophagoscopy Flexible W/Bleeding Control (43227) |
— |
$3,460 |
— |
| Esophagoscopy, flexible, transoral; with biopsy, single or multiple (43202) |
— |
$2,566 |
— |
| Esophagoscopy, flexible, transoral; with removal of foreign body(s) (43215) |
— |
$2,566 |
— |
| Ethmoidectomy Intranasal Anterior (31200) |
— |
$3,460 |
— |
| Evacuation of subungual hematoma (11740) |
— |
$2,566 |
— |
| Ex Tum/Vasc Mal Sft Tis Hand/Fngr Subfsc 1.5cm/> (26113) |
— |
$4,020 |
— |
| Ex tum/vasc malf sft tiss hand/fngr subq 1.5cm/> (26111) |
— |
$4,020 |
— |
| Exc abdl tum deep 5 cm/> (22901) |
— |
$4,020 |
— |
| Exc arm/elbow les sc < 3 cm (24075) |
— |
$3,460 |
— |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) |
— |
$2,566 |
— |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) |
— |
$2,566 |
— |
| Exc Back Les Sc < 3 Cm (21930) |
— |
$3,460 |
— |
| Exc Back Tum Deep 5 Cm/> (21933) |
— |
$4,020 |
— |
| Exc back tum deep < 5 cm (21932) |
— |
$3,460 |
— |
| Exc Benign Tumor/Cyst Maxl Intra-Oral Osteot (21048) |
— |
$3,460 |
— |
| Exc Benign Tumor/Cyst Mndbl Intra-Oral Osteot (21046) |
— |
$3,460 |
— |
| Exc Branchial Cleft Cyst Below Subq Tiss&/Phrynx (42815) |
— |
$3,502 |
— |
| Exc Branchial Cleft Cyst Confined Skn&Subq Tis (42810) |
— |
$4,020 |
— |
| Exc Breast Les Preop Plmt Rad Marker Open 1 Les (19125) |
— |
$4,020 |
— |
| Exc Chalazion Anes Req Hospization Single/Mult (67808) |
— |
$3,460 |
— |
| Exc F/E/E/N/L Mal+Mrg 0.6-1 (11641) |
— |
$3,460 |
— |
| Exc F/E/E/N/L Mal+Mrg 1.1-2 (11642) |
— |
$3,460 |
— |
| Exc F/E/E/N/L Mal+Mrg 3.1-4 (11644) |
— |
$3,460 |
— |
| Exc Face Les Sbq 2 Cm/> (21012) |
— |
$2,566 |
— |
| Exc Face-Mm B9+Marg 0.5 Cm/< (11440) |
— |
$3,460 |
— |
| Exc Face-Mm B9+Marg 0.6-1 Cm (11441) |
— |
$3,460 |
— |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) |
— |
$2,566 |
— |
| Exc Face-Mm B9+Marg 2.1-3 Cm (11443) |
— |
$2,566 |
— |
| Exc Face-Mm B9+Marg 3.1-4 Cm (11444) |
— |
$2,566 |
— |
| Exc Forearm Les Sc 3 Cm/> (25071) |
— |
$4,020 |
— |
| Exc Frenum Labial/Buccal (40819) |
— |
$2,566 |
— |
| Exc ganglion wrist recurrent (25112) |
— |
$4,908 |
— |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) |
— |
$3,460 |
— |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) |
— |
$3,460 |
— |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) |
— |
$2,566 |
— |
| Exc Hand Les Sc < 1.5 Cm (26115) |
— |
$3,460 |
— |
| Exc hand tum deep < 1.5 cm (26116) |
— |
$3,460 |
— |
| Exc hydrocele sprmatic cord uni spx (55500) |
— |
$4,020 |
— |
| Exc Lesion Eyelid W/O Clsr/W/Simple Dir Closure (67840) |
— |
$3,460 |
— |
| Exc Lesion Palate Uvula W/Smpl Prim Closure (42106) |
— |
$3,460 |
— |
| Exc Lesion Tendon Sheath/Capsule W/Synvct Foot (28090) |
— |
$4,020 |
— |
| Exc Lesion Tongue W/Clsr Anterior Two-Thirds (41112) |
— |
$3,460 |
— |
| Exc Lesion Tongue W/Clsr Posterior One-Third (41113) |
— |
$3,460 |
— |
| Exc lesion tongue w/clsr w/local tongue flap (41114) |
— |
$3,460 |
— |
| Exc Lesion/Tumor Dentoalveolar Strux W/O Rpr (41825) |
— |
$2,566 |
— |
| Exc neurofibroma/neurolemmoma major prph nrv (64790) |
— |
$4,020 |
— |
| Exc neuroma hand/foot xcp digital nerve (64782) |
— |
$4,020 |
— |
| Exc neuroma major peripheral nrv xcp sciatic (64784) |
— |
$4,020 |
— |
| Exc Prtd Tum/Prtd Glnd Lat Lobe W/O Nrv Dsj (42410) |
— |
$4,020 |
— |
| Exc Rct Tum Incl Muscularis Propria (45172) |
— |
$3,460 |
— |
| Exc Rct Tum Not Incl Muscularis Propria (45171) |
— |
$2,566 |
— |
| Exc Shoulder Tum Deep 5 Cm/> (23073) |
— |
$4,020 |
— |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
— |
$2,566 |
— |
| Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) |
— |
$3,460 |
— |
| Exc Skin Benig >4 Cm Remaindr Body (11426) |
— |
$3,460 |
— |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
— |
$3,460 |
— |
| Exc Skin Benig >4cm Face,Facial (11446) |
— |
$3,460 |
— |
| Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) |
— |
$2,566 |
— |
| Exc Skin Malig >4 Cm Remaindr Body (11626) |
— |
$3,460 |
— |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) |
— |
$3,460 |
— |
| Exc tendon shth lesion leg/ankle (27630) |
— |
$4,020 |
— |
| Exc thigh/knee les sc 3 cm/> (27337) |
— |
$4,020 |
— |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) |
— |
$2,566 |
— |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) |
— |
$2,566 |
— |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) |
— |
$2,566 |
— |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) |
— |
$2,566 |
— |
| Exc tumor soft tis neck/ant thorax subq 3 cm/> (21552) |
— |
$4,020 |
— |
| Exc Tumor Soft Tiss Face&Scalp Subfascial 2+Cm (21014) |
— |
$2,566 |
— |
| Exc tumor soft tiss forearm&/wrist subfasc <3cm (25076) |
— |
$4,020 |
— |
| Exc tumor soft tiss neck/thorax subfascial <5cm (21556) |
— |
$3,460 |
— |
| Exc tumor soft tiss shoulder subfasc <5cm (23076) |
— |
$3,460 |
— |
| Exc tumor soft tiss upper arm/elbw subfasc 5+cm (24073) |
— |
$4,020 |
— |
| Exc tumor soft tiss upr arm/elbow subfasc <5cm (24076) |
— |
$3,460 |
— |
| Exc tumor soft tissue abdl wall subfascial <5cm (22900) |
— |
$4,908 |
— |
| Exc tumor soft tissue abdominal wall subq <3cm (22902) |
— |
$3,460 |
— |
| Exc tumor soft tissue foot/toe subfasc 1.5+cm (28041) |
— |
$4,020 |
— |
| Exc tumor soft tissue foot/toe subfasc <1.5cm (28045) |
— |
$4,020 |
— |
| Exc Tumor Soft Tissue Forearm &/Wrist Subq <3Cm (25075) |
— |
$3,460 |
— |
| Exc Tumor Soft Tissue Leg/Ankle Subfasc 5 Cm/> (27634) |
— |
$4,020 |
— |
| Exc Tumor Soft Tissue Leg/Ankle Subfascial <5cm (27619) |
— |
$4,020 |
— |
| Exc tumor soft tissue leg/ankle subq <3cm (27618) |
— |
$3,460 |
— |
| Exc Tumor Soft Tissue Neck/Ant Thorax Subfascial 5+Cm (21554) |
— |
$4,020 |
— |
| Exc tumor soft tissue neck/ant thorax subq <3cm (21555) |
— |
$3,460 |
— |
| Exc tumor soft tissue pelvis & hip subfasc <5cm (27048) |
— |
$4,020 |
— |
| Exc tumor soft tissue pelvis & hip subq <3cm (27047) |
— |
$3,460 |
— |
| Exc tumor soft tissue thigh/knee subfasc <5cm (27328) |
— |
$4,020 |
— |
| Exc Tumor Soft Tissue Upper Arm/Elbow Subq 3+Cm (24071) |
— |
$4,020 |
— |
| Exc Varicocele/Ligation Spermatic Veins Spx (55530) |
— |
$4,908 |
— |
| Exc/curtg bone cyst/b9 tumortarsal/metatarsal (28104) |
— |
$3,460 |
— |
| Exc/Curtg Cst/B9 Tum Phalanges Foot (28108) |
— |
$3,460 |
— |
| Exc/fulguration urethral caruncle (53265) |
— |
$3,460 |
— |
| Exchange Intraocular Lens (66986) |
— |
$6,695 |
— |
| Exchng Absc/Cst Drg Cath Rad Gid Spx (49423) |
— |
$2,566 |
— |
| Excis Mouth Mucosa/Sub,No Repair (40810) |
— |
$2,566 |
— |
| Excis Mouth Mucosa/Sub,Simpl Repair (40812) |
— |
$2,566 |
— |
| Excise excessive skin arm (15836) |
— |
$4,020 |
— |
| Excise intraspinal lesion (63267) |
— |
$3,502 |
— |
| Excise mandible lesion (21040) |
— |
$3,460 |
— |
| Excise Wrist Tendon Sheath (25118) |
— |
$3,460 |
— |
| Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) |
— |
$2,566 |
— |
| Excision & Repair Eyelid < One-Fourth Lid Margin (67961) |
— |
$4,020 |
— |
| Excision Aural Polyp (69540) |
— |
$3,460 |
— |
| Excision Chalazion Single (67800) |
— |
$2,566 |
— |
| Excision Distal Ulna Partial/Complete (25240) |
— |
$4,908 |
— |
| Excision Excessive Skin & Subq Tissue Other Area (15839) |
— |
$4,020 |
— |
| Excision External Ear Partial Simple Repair (69110) |
— |
$2,566 |
— |
| Excision gum each quadrant (41820) |
— |
$2,566 |
— |
| Excision H/P/P/U Simple/Intermediate Repair (11470) |
— |
$3,460 |
— |
| Excision Hidradenitis Axillary Complex Repair (11451) |
— |
$3,460 |
— |
| Excision Hidradenitis Inguinal Smpl/Intrm Rpr (11462) |
— |
$3,460 |
— |
| Excision Infected Graft Extremity (35903) |
— |
$8,927 |
— |
| Excision inferior turbinate partial/complete (30130) |
— |
$4,020 |
— |
| Excision Lesion Conjunctiva </1 Cm (68110) |
— |
$3,460 |
— |
| Excision lesion conjunctiva > 1 cm (68115) |
— |
$3,460 |
— |
| Excision lesion meniscus/capsule knee (27347) |
— |
$4,908 |
— |
| Excision lesion mouth roof (42104) |
— |
$3,460 |
— |
| Excision lesion tendon sheath forearm&/wrist (25110) |
— |
$4,020 |
— |
| Excision Lesion Tongue W/O Closure (41110) |
— |
$2,566 |
— |
| Excision Lingual Frenum Frenectomy (41115) |
— |
$2,566 |
— |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) |
— |
$2,566 |
— |
| Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) |
— |
$3,460 |
— |
| Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) |
— |
$3,460 |
— |
| Excision Malignant Lesion F/E/E/N/L >4.0 Cm (11646) |
— |
$3,460 |
— |
| Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) |
— |
$2,566 |
— |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) |
— |
$3,460 |
— |
| Excision Multiple External Papillae/Tags Anus (46230) |
— |
$2,566 |
— |
| Excision Nasal Polyp Extensive (30115) |
— |
$3,460 |
— |
| Excision nasal polyp(s) simple (30110) |
— |
$2,566 |
— |
| Excision of bartholin's gland or cyst (56740) |
— |
$4,020 |
— |
| Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage Facility (21030) |
— |
$3,460 |
— |
| Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep… (27066) |
— |
$3,502 |
— |
| Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection Facility (38555) |
— |
$4,908 |
— |
| Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection Facility (38550) |
— |
$4,020 |
— |
| Excision of extraparenchymal lesion of testis (54512) |
— |
$3,460 |
— |
| Excision of ganglion, wrist (dorsal or volar); primary (25111) |
— |
$4,020 |
— |
| Excision of hydrocele; bilateral (55041) |
— |
$3,502 |
— |
| Excision of hydrocele; unilateral (55040) |
— |
$4,020 |
— |
| Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair Facility (41827) |
— |
$3,460 |
— |
| Excision of local lesion of epididymis (54830) |
— |
$4,020 |
— |
| Excision of neuroma; digital nerve, 1 or both, same digit (64776) |
— |
$4,020 |
— |
| Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve Facility (42415) |
— |
$8,927 |
— |
| Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve Facility (42420) |
— |
$8,927 |
— |
| Excision of pilonidal cyst or sinus; simple (11770) |
— |
$4,020 |
— |
| Excision of single external papilla or tag, anus (46220) |
— |
$2,566 |
— |
| Excision of sublingual salivary cyst (ranula) (42408) |
— |
$4,020 |
— |
| Excision of submandibular (submaxillary) gland (42440) |
— |
$4,020 |
— |
| Excision of vaginal cyst or tumor (57135) |
— |
$3,460 |
— |
| Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach Facility (55535) |
— |
$4,908 |
— |
| Excision olecranon bursa (24105) |
— |
$4,020 |
— |
| Excision or curettage of bone cyst or benign tumor of femur; (27355) |
— |
$4,020 |
— |
| Excision or curettage of bone cyst or benign tumor, talus or calcaneus; Facility (28100) |
— |
$3,460 |
— |
| Excision Pilonidal Cyst/Sinus Complicated (11772) |
— |
$4,020 |
— |
| Excision Pilonidal Cyst/Sinus Extensive (11771) |
— |
$4,020 |
— |
| Excision prepatellar bursa (27340) |
— |
$4,020 |
— |
| Excision Radial Head (24130) |
— |
$4,020 |
— |
| Excision Skin Abd Infraumbilical Panniculectomy (15830) |
— |
$4,020 |
— |
| Excision soft tissue lesion, external auditory canal (69145) |
— |
$3,460 |
— |
| Excision spermatocele w/wo epididymectomy (54840) |
— |
$4,908 |
— |
| Excision synovial cyst popliteal space (27345) |
— |
$4,908 |
— |
| Excision tendon finger flexor/extensor each (26180) |
— |
$4,020 |
— |
| Excision Thyroglossal Duct Cyst/Sinus (60280) |
— |
$4,908 |
— |
| Excision Torus Mandibularis (21031) |
— |
$2,566 |
— |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) |
— |
$4,020 |
— |
| Excision tumor soft tis foot/toe subq 1.5 cm/> (28039) |
— |
$2,566 |
— |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) |
— |
$3,460 |
— |
| Excision tumor soft tissue shoulder subq 3 cm/> (23071) |
— |
$4,020 |
— |
| Excision Tumor Soft Tissue Thigh/Knee Subq <3Cm (27327) |
— |
$3,460 |
— |
| Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip Facility (15834) |
— |
$4,020 |
— |
| Excision, interdigital (morton) neuroma, single, each (28080) |
— |
$4,020 |
— |
| Excision, lesion of palate, uvula; with local flap closure Facility (42107) |
— |
$3,460 |
— |
| Excision, sacral pressure ulcer, with primary suture; Facility (15931) |
— |
$4,020 |
— |
| Excision, sacral pressure ulcer, with primary suture; with ostectomy Facility (15933) |
— |
$4,020 |
— |
| Excision, sacral pressure ulcer, with skin flap closure; with ostectomy Facility (15935) |
— |
$4,908 |
— |
| Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with… (15958) |
— |
$4,908 |
— |
| Excision, trochanteric pressure ulcer, with primary suture; Facility (15950) |
— |
$4,020 |
— |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater (22903) |
— |
$4,020 |
— |
| Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm (21011) |
— |
$2,566 |
— |
| Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater (27632) |
— |
$4,020 |
— |
| Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater (27043) |
— |
$4,020 |
— |
| Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater Facility (27045) |
— |
$4,020 |
— |
| Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm (23075) |
— |
$3,460 |
— |
| Excision/destruction intranasal lesion int appr (30117) |
— |
$4,020 |
— |
| Excision/destruction lesion pharynx any method (42808) |
— |
$3,460 |
— |
| Excision/Transposition Pterygium W/Grafg (65426) |
— |
$3,502 |
— |
| Excision/Transposition Pterygium W/O Graft (65420) |
— |
$3,460 |
— |
| Excision; trochanteric bursa or calcification (27062) |
— |
$3,502 |
— |
| Expl penetrating wound spx abdomen/flank/back (20102) |
— |
$8,927 |
— |
| Expl Po Hemrrg Thrombosis/Infctj Nck (35800) |
— |
$3,502 |
— |
| Expl po hemrrg thrombosis/infctj xtr (35860) |
— |
$4,908 |
— |
| Explo/Drain Breast Abscess (19020) |
— |
$3,460 |
— |
| Exploration maxillary sinus (31020) |
— |
$3,460 |
— |
| Exploration of hip joint (27033) |
— |
$4,020 |
— |
| Exploration of knee joint (27310) |
— |
$4,908 |
— |
| Exploration of spinal fusion (22830) |
— |
$4,908 |
— |
| Exploration penetrating wound spx chest (20101) |
— |
$8,927 |
— |
| Exploration penetrating wound spx extremity (20103) |
— |
$2,566 |
— |
| Exploration Penetrating Wound Spx Neck (20100) |
— |
$8,927 |
— |
| Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) (49010) |
— |
$4,908 |
— |
| Exploratory elbow surgery (24000) |
— |
$4,908 |
— |
| Explore epididymis (54865) |
— |
$2,566 |
— |
| Explore eye socket,drainage (67405) |
— |
$4,908 |
— |
| Explore for undescended testis (54550) |
— |
$4,908 |
— |
| Explore treat shoulder joint (23107) |
— |
$4,908 |
— |
| Explore/Treat Elbow Joint (24101) |
— |
$4,908 |
— |
| Explore/Treat Knee Joint (27331) |
— |
$4,908 |
— |
| Explore/Treat Wrist Joint (25040) |
— |
$3,502 |
— |
| Eye Surg Ant Sgmt Proc Unlisted (66999) |
— |
$2,566 |
— |
| Fasciectomy Plantar Fascia Partial Spx (28060) |
— |
$3,460 |
— |
| Fasciotomy Iliotibial Open (27305) |
— |
$3,460 |
— |
| Fasciotomy palmar open partial (26045) |
— |
$4,020 |
— |
| Fasciotomy Plantar Fascia Radical Spx (28062) |
— |
$4,020 |
— |
| Fasciotomy, foot and/or toe (28008) |
— |
$4,020 |
— |
| Fasciotomy, hip or thigh, any type (27025) |
— |
$3,460 |
— |
| Fasct prtl palmar 1 dgt prox iphal jt w/wo rpr (26123) |
— |
$4,908 |
— |
| Fine Needle Aspiration Orbital Contents (67415) |
— |
$2,566 |
— |
| Fine needle aspiration without imaging guidance (10021) |
— |
$2,566 |
— |
| Fixation contralateral testis separate procedure (54620) |
— |
$4,020 |
— |
| Foreskin manipulation (54450) |
— |
$2,566 |
— |
| Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs Facility (15572) |
— |
$4,020 |
— |
| Fracture Nasal Inferior Turbinate Therapeutic (30930) |
— |
$4,908 |
— |
| Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe Facility (20969) |
— |
$4,908 |
— |
| Frenulotomy of penis (54164) |
— |
$3,460 |
— |
| Frmj Direct/Tubed Pedicle W/Wotr E/N/E/L/Ntroral (15576) |
— |
$4,020 |
— |
| Fstlj Sclera Glaucoma Trabeculect Ab Externo (66170) |
— |
$4,908 |
— |
| Fth/Gft Free W/Direct Closure N/E/E/L 20 Sq Cm/< (15260) |
— |
$3,460 |
— |
| Fth/gft free w/direct closure s/a/l 20 cm/< (15220) |
— |
$3,460 |
— |
| Fth/Gft Free W/Direct Closure Trunk 20 Sq Cm/< (15200) |
— |
$4,020 |
— |
| Fuse hand bones with graft (25825) |
— |
$3,502 |
— |
| Fusion Finger Joint (26860) |
— |
$4,020 |
— |
| Fusion of foot bones (28740) |
— |
$4,908 |
— |
| Gastrocnemius recession (27687) |
— |
$4,020 |
— |
| Gastrorrhaphy sutr prf8 duol/gstr ulcer wnd/inj (43840) |
— |
$8,927 |
— |
| Gastrostomy Opn W/O Constj Gstr Tube Spx (43830) |
— |
$8,927 |
— |
| Graft Bone Nasal/Maxillary/Malar Areas (21210) |
— |
$8,927 |
— |
| Graft Ear Crtlg Autogenous Nose/Ear (21235) |
— |
$8,927 |
— |
| Graft, Bone; Mandible (Includes Obtaining Graft) (21215) |
— |
$8,927 |
— |
| Guide Cathet Fluid Drainage (10030) |
— |
$3,361.68 |
— |
| Hemiarthroplasty hip partial (27125) |
— |
$6,695 |
— |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) |
— |
$4,020 |
— |
| Hemorrhoidectomy, external, 2 or more columns/groups (46250) |
— |
$4,020 |
— |
| Hemorrhoidectomy, internal and external, 2 or more columns/groups; (46260) |
— |
$4,020 |
— |
| Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy Facility (46261) |
— |
$4,908 |
— |
| Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when… (46262) |
— |
$4,908 |
— |
| Hemorrhoidectomy, internal and external, single column/group; with fissurectomy (46257) |
— |
$4,020 |
— |
| Hemorrhoidectomy, internal, by rubber band ligation(s) (46221) |
— |
$2,566 |
— |
| Hip arthro acetabuloplasty (29915) |
— |
$4,908 |
— |
| Hip arthro w/labral repair (29916) |
— |
$4,908 |
— |
| Hrhc 1 Col/Grp W/Fstulectmy Incl Fssrectomy (46258) |
— |
$4,020 |
— |
| Hysteroscopy Bi Tube Occlusion W/Perm Implnts (58565) |
— |
$4,020 |
— |
| Hysteroscopy Biopsy (58558) |
— |
$4,020 |
— |
| Hysteroscopy Dx Sep Proc (58555) |
— |
$2,566 |
— |
| Hysteroscopy Endometrial Ablation (58563) |
— |
$3,502 |
— |
| Hysteroscopy Lysis Intrauterine Adhesions (58559) |
— |
$3,460 |
— |
| Hysteroscopy, surgical; with removal of leiomyomata (58561) |
— |
$4,020 |
— |
| I&D Absc Rtrphrngl/Parapharyngeal Intraoral (42720) |
— |
$2,566 |
— |
| I&d abscess peritonsillar (42700) |
— |
$2,566 |
— |
| I&d abscess simple (10060) |
— |
$1,048.35 |
— |
| I&D Below Fascia Foot 1 Bursal Space (28002) |
— |
$4,020 |
— |
| I&d deep absc bursa/hematoma thigh/knee region (27301) |
— |
$4,020 |
— |
| I&D Deep Absc/Hematoma Neck/Chest (21501) |
— |
$3,460 |
— |
| I&D Forearm&/Wrist Deep Abscess/Hematoma (25028) |
— |
$2,566 |
— |
| I&D Intramural Im/Absc Transanal Anes (46045) |
— |
$3,460 |
— |
| I&D Ischiorct/Intramural Absc W/WO Seton (46060) |
— |
$3,460 |
— |
| I&d pelvis/hip jt area deep abscess/hematoma (26990) |
— |
$2,566 |
— |
| I&d perianal abscess superficial (46050) |
— |
$2,566 |
— |
| I&d pilonidal cyst complicated (10081) |
— |
$2,566 |
— |
| I&d pilonidal cyst simple (10080) |
— |
$2,566 |
— |
| I&d shoulder deep abscess/hematoma (23030) |
— |
$2,566 |
— |
| I&d upper arm/elbow deep abscess/hematoma (23930) |
— |
$2,566 |
— |
| Icd Pocket Revision (33223) |
— |
$9,570 |
— |
| Ileoscopy Stoma W/Bx Single/Multiple (44382) |
— |
$2,566 |
— |
| Image Cath Fluid Colxn Visc (49405) |
— |
$4,430.91 |
— |
| Image Cath Fluid Peri/Retro (49406) |
— |
$4,430.91 |
— |
| Immediate breast prosthesis (19340) |
— |
$3,460 |
— |
| Implant neuroelectrodes (63650) |
— |
$3,460 |
— |
| Implant Periph/Gastric Neurostim/Receiver (64590) |
— |
$3,460 |
— |
| Implant Spine Infusion Pump (62362) |
— |
$3,460 |
— |
| Impltj revj/rpsg ithcl/edrl cath pmp w/o lam (62350) |
— |
$3,460 |
— |
| Incise external hemorrhoid (46083) |
— |
$2,566 |
— |
| Incise finger tendon sheath (26055) |
— |
$3,460 |
— |
| Incise Wrist/Forearm Tendon (25290) |
— |
$4,020 |
— |
| Incision & drainage abscess complicated/multiple (10061) |
— |
$2,078.43 |
— |
| Incision & drainage leg/ankle abscess/hematoma (27603) |
— |
$3,460 |
— |
| Incision & removal foreign body subq tiss compl (10121) |
— |
$3,460 |
— |
| Incision & removal foreign body subq tiss simple (10120) |
— |
$2,566 |
— |
| Incision and drainage of bartholin's gland abscess (56420) |
— |
$2,566 |
— |
| Incision and drainage of vulva or perineal abscess (56405) |
— |
$3,460 |
— |
| Incision bone cortex foot (28005) |
— |
$4,020 |
— |
| Incision extensor tendon sheath wrist (25000) |
— |
$4,020 |
— |
| Incision of eardrum (69421) |
— |
$4,020 |
— |
| Incision of eardrum (69420) |
— |
$4,020 |
— |
| Incision of fibula (27707) |
— |
$3,460 |
— |
| Incision of Foot Tendon (28234) |
— |
$3,460 |
— |
| Incision of labial frenum (frenotomy) (40806) |
— |
$2,566 |
— |
| Incision of lingual frenum (frenotomy) (41010) |
— |
$2,566 |
— |
| Incision of lymph channels (38308) |
— |
$3,460 |
— |
| Incision of rectal abscess (46040) |
— |
$4,020 |
— |
| Incision&Drainage Upper Arm/Elbow Bursa (23931) |
— |
$3,460 |
— |
| Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax Facility (21510) |
— |
$3,502 |
— |
| Incisional biopsy eyelid skin & lid margin (67810) |
— |
$2,566 |
— |
| Induced abortion dilation and curettage (59840) |
— |
$3,502 |
— |
| Induced abortion, by dilation and evacuation (59841) |
— |
$3,502 |
— |
| Initial Tx 1st Degree Burn Local Tx (16000) |
— |
$2,890 |
— |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) |
— |
$2,222.85 |
— |
| Inj W/Fluor Eval Cv Device (36598) |
— |
$2,132.37 |
— |
| Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) |
— |
$2,566 |
— |
| Injection 1 tendon sheath/ligament aponeurosis (20550) |
— |
$2,566 |
— |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
— |
$2,566 |
— |
| Injection aa&/strd nerves nrvtg si joint w/img (64451) |
— |
$2,141.07 |
— |
| Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) |
— |
$2,222.85 |
— |
| Injection for identification of sentinel node (38792) |
— |
$2,566 |
— |
| Injection of sclerosing solution, hemorrhoids (46500) |
— |
$8,927 |
— |
| Injection single tendon origin/insertion (20551) |
— |
$2,566 |
— |
| Injection single/mlt trigger point 1/2 muscles (20552) |
— |
$1,464.21 |
— |
| Injection single/mlt trigger point 3/> muscles (20553) |
— |
$2,566 |
— |
| Injection therapeutic carpal tunnel (20526) |
— |
$2,566 |
— |
| Injection, anesthetic agent; brachial plexus, single (64415) |
— |
$2,566 |
— |
| Injection, anesthetic agent; femoral nerve, single (64447) |
— |
$8,927 |
— |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) |
— |
$2,566 |
— |
| Injection, Intralesional; More Than 7 Lesions (11901) |
— |
$2,566 |
— |
| Injx/Infus Neurolyt Sbst Epidural Lumbar/Sacral (62282) |
— |
$2,566 |
— |
| Ins endovas vena cava filtr (37191) |
— |
$14,106.18 |
— |
| Insert and remove bone pin (20650) |
— |
$4,020 |
— |
| Insert Bladder Cath Complex (51703) |
— |
$2,566 |
— |
| Insert Drug Implant Device (11981) |
— |
$2,566 |
— |
| Insert Heart Pm Atrial (33206) |
— |
$30,933.72 |
— |
| Insert Heart Pm Ventricular (33207) |
— |
$32,712 |
— |
| Insert multi-comp penis pros (54405) |
— |
$4,020 |
— |
| Insert non-tunnel cv cath (36556) |
— |
$3,346.02 |
— |
| Insert pulse gen dual leads (33213) |
— |
$22,145.85 |
— |
| Insert Pulse Gen Sngl Lead (33212) |
— |
$21,261.93 |
— |
| Insert self-contd prosthesis (54401) |
— |
$4,020 |
— |
| Insert semi-rigid prosthesis (54400) |
— |
$4,020 |
— |
| Insert Temp Bladder Cath (51702) |
— |
$403.68 |
— |
| Insert tunneled cv cath (36561) |
— |
$12,735.93 |
— |
| Insert tunneled cv cath (36563) |
— |
$12,735.93 |
— |
| Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) |
— |
$3,460 |
— |
| Insert,Non-Indwelling Bladder Catheter (51701) |
— |
$403.68 |
— |
| Insertion of cannula (36800) |
— |
$4,020 |
— |
| Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type)… (36810) |
— |
$4,020 |
— |
| Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure… (36815) |
— |
$4,020 |
— |
| Insertion Picc W/Rs&I 5 Yr/> (36573) |
— |
$3,774.06 |
— |
| Insertion Tunnel Intraperitoneal Cath Dial Open (49421) |
— |
$3,460 |
— |
| Insj 2 Transvns Eltrd Perm Pacemaker/Impltbl Dfb (33217) |
— |
$12,601.95 |
— |
| Insj Io Lens Prosthesis Not W/Concurrent Rmvl (66985) |
— |
$6,695 |
— |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
— |
$12,343.56 |
— |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) |
— |
$3,774.06 |
— |
| Insj Stablj Dev W/Dcmprn (22867) |
— |
$3,502 |
— |
| Insj tun vad req 2 cath 2 sits w/o subq port/pmp (36565) |
— |
$4,020 |
— |
| Insj Tun Vad Req 2 Cath 2 Sits W/Subq Port (36566) |
— |
$4,020 |
— |
| Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) |
— |
$9,899.73 |
— |
| Insj/rplcmt breast implant sep day mastectomy (19342) |
— |
$4,020 |
— |
| Insj/Rplcmt Defib W/Lead(S) (33249) |
— |
$94,291.47 |
— |
| Insj/Rplcmt Spinal Npg/Rcvr Pocket Crtj&Connj (63685) |
— |
$3,460 |
— |
| Insj/rplcmt temp transvns 1chmbr eltrd/pm cath (33210) |
— |
$17,813.25 |
— |
| Insj/rplcmt temp transvns 2chmbr pacg eltrds spx (33211) |
— |
$18,347.43 |
— |
| Insrt heart pm atrial & vent (33208) |
— |
$35,556.03 |
— |
| Insrt Pulse Gen W/Singl Lead (33240) |
— |
$75,582.12 |
— |
| Int hrhc by ligation single hroid w/o img gdn (46945) |
— |
$3,460 |
— |
| Intmd Rpr Face/Mm 12.6-20 Cm (12055) |
— |
$3,460 |
— |
| Intmd Rpr Face/Mm 20.1-30.0 (12056) |
— |
$3,460 |
— |
| Intranasal Biopsy (30100) |
— |
$2,566 |
— |
| Intraoral i&d tongue/floor lingual (41000) |
— |
$2,566 |
— |
| Intraoral i&d tongue/floor submental space (41007) |
— |
$2,566 |
— |
| Intraoral i&d tongue/floor submndblr space (41008) |
— |
$2,566 |
— |
| Intro Cath Dialysis Circuit W/Trluml Balo Angiop (36902) |
— |
$15,605.19 |
— |
| Intro Gastrointestinal Tube (44500) |
— |
$1,866.15 |
— |
| Intubation endotracheal emergency procedure (31500) |
— |
$2,577.81 |
— |
| Irdec Crnlsclrl/Crnl Sctj Prph Glc Spx (66625) |
— |
$4,020 |
— |
| Iridotomy/irridectomy laser surg per session (66761) |
— |
$2,566 |
— |
| Irrigation maxillary sinus (31000) |
— |
$2,566 |
— |
| Irrigation of corpora cavernosa for priapism (54220) |
— |
$2,566 |
— |
| Knee arthroscopy/drainage (29871) |
— |
$4,020 |
— |
| Knee Arthroscopy/Surgery (29874) |
— |
$4,020 |
— |
| Lam facetec & foramot lumbar (63047) |
— |
$3,502 |
— |
| Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy… (63001) |
— |
$6,695 |
— |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63045) |
— |
$3,502 |
— |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63046) |
— |
$3,502 |
— |
| Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or… (63040) |
— |
$3,502 |
— |
| Laminotomy Single Lumbar (63042) |
— |
$3,502 |
— |
| Lap insert tunnel ip cath (49324) |
— |
$4,908 |
— |
| Laparo ligate spermatic vein (55550) |
— |
$6,695 |
— |
| Laparo-vag hyst incl t/o (58552) |
— |
$8,927 |
— |
| Laparoscope proc ureter (50949) |
— |
$3,502 |
— |
| Laparoscopic myomectomy (58545) |
— |
$6,695 |
— |
| Laparoscopy aspiration (49322) |
— |
$4,908 |
— |
| Laparoscopy Enterolysis Separate Procedure (44180) |
— |
$4,020 |
— |
| Laparoscopy fimbrioplasty (58672) |
— |
$3,502 |
— |
| Laparoscopy fulguration oviducts (58670) |
— |
$4,020 |
— |
| Laparoscopy salpingostomy (58673) |
— |
$3,502 |
— |
| Laparoscopy Surg Rpr Initial Inguinal Hernia (49650) |
— |
$4,908 |
— |
| Laparoscopy tot hysterectomy >250 g w/tube/ovar (58573) |
— |
$6,695 |
— |
| Laparoscopy w tot hysterectuterus <=250 gram w tube/ovary (58571) |
— |
$6,695 |
— |
| Laparoscopy W/Lysis Of Adhesions (58660) |
— |
$3,502 |
— |
| Laparoscopy w/rmvl adnexal structures (58661) |
— |
$3,502 |
— |
| Laparoscopy, surgical, appendectomy (44970) |
— |
$4,020 |
— |
| Laparoscopy, surgical, colpopexy (suspension of vaginal apex) (57425) |
— |
$3,502 |
— |
| Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only… (43772) |
— |
$4,020 |
— |
| Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight… (58546) |
— |
$8,927 |
— |
| Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; (58570) |
— |
$6,695 |
— |
| Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; (58550) |
— |
$6,695 |
— |
| Laparoscopy, surgical; cholecystectomy with cholangiography (47563) |
— |
$3,502 |
— |
| Laparoscopy, surgical; cholecystectomy with exploration of common duct (47564) |
— |
$8,927 |
— |
| Laparoscopy, surgical; partial nephrectomy (50543) |
— |
$8,927 |
— |
| Laparoscopy, surgical; pyeloplasty (50544) |
— |
$3,502 |
— |
| Laparoscopy, surgical; repair recurrent inguinal hernia (49651) |
— |
$8,927 |
— |
| Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) Facility (51992) |
— |
$3,502 |
— |
| Laparoscopy, surgical; urethral suspension for stress incontinence Facility (51990) |
— |
$3,502 |
— |
| Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single… (38572) |
— |
$11,160 |
— |
| Laparoscopy, surgical; with biopsy (single or multiple) (49321) |
— |
$4,908 |
— |
| Laps abd prtm&omentum dx w/wo spec br/wa spx (49320) |
— |
$4,020 |
— |
| Laps fulg/exc ovary viscera/peritoneal surface (58662) |
— |
$3,502 |
— |
| Laps Gastric Restrictive Px Remove Device & Port (43774) |
— |
$4,020 |
— |
| Laps supracrv hysterect 250 gm/< rmvl tube/ovar (58542) |
— |
$3,502 |
— |
| Laps surg retroperitoneal lymph node bx 1/mlt (38570) |
— |
$6,695 |
— |
| Laps Tx Ectopic Preg W/O Salping&/Oophorectomy (59150) |
— |
$4,908 |
— |
| Laps Vaginal Hysterect > 250 Gm Rmvl Tube&/Ovar (58554) |
— |
$8,927 |
— |
| Laryngoscopy and dilation (31528) |
— |
$3,460 |
— |
| Laryngoscopy diagnostic (31505) |
— |
$2,890 |
— |
| Laryngoscopy exc tum&/stripping cords/epiglott (31540) |
— |
$4,020 |
— |
| Laryngoscopy flexible diagnostic (31575) |
— |
$430.65 |
— |
| Laryngoscopy Flx Rmvl Foreign Body(S) (31577) |
— |
$3,460 |
— |
| Laryngoscopy Foreign Body Rmvl Micro/Telescope (31531) |
— |
$4,020 |
— |
| Laryngoscopy W/Biopsy (31535) |
— |
$3,460 |
— |
| Laryngoscopy w/biopsy microscope/telescope (31536) |
— |
$4,020 |
— |
| Laryngoscopy W/Foreign Body Removal (31530) |
— |
$3,460 |
— |
| Laryngoscopy w/wo tracheoscopy aspiration (31515) |
— |
$2,566 |
— |
| Larynscop w/tumr exc + scope (31541) |
— |
$4,908 |
— |
| Laser Surgery Anal Lesions (46917) |
— |
$2,566 |
— |
| Laser vaporization of prostate (52648) |
— |
$3,502 |
— |
| Late closure of wound (13160) |
— |
$3,460 |
— |
| Lateral Canthopexy (21282) |
— |
$3,502 |
— |
| Lateral retinacular release open (27425) |
— |
$8,927 |
— |
| Lig&div long saph vein saphfem junct/interrupj (37700) |
— |
$3,460 |
— |
| Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular Facility (27429) |
— |
$4,908 |
— |
| Ligamentous Reconstruction Knee Extra-Articular (27427) |
— |
$4,020 |
— |
| Ligamentous reconstruction knee intra-articular (27428) |
— |
$4,908 |
— |
| Ligate leg veins open (37761) |
— |
$4,020 |
— |
| Ligate/strip long leg vein (37722) |
— |
$4,020 |
— |
| Ligate/strip short leg vein (37718) |
— |
$4,020 |
— |
| Ligation Major Artery Abdomen (37617) |
— |
$8,927 |
— |
| Ligation of a-v fistula (37607) |
— |
$4,020 |
— |
| Ligation of femoral vein (37650) |
— |
$3,460 |
— |
| Ligation of hemorrhoids (46946) |
— |
$3,460 |
— |
| Ligation or biopsy temporal artery (37609) |
— |
$3,460 |
— |
| Ligj Divj &/Excj Varicose Vein Cluster 1 Leg (37785) |
— |
$4,020 |
— |
| Litholapaxy comp/lg > 2.5 cm (52318) |
— |
$3,460 |
— |
| Litholapaxy smpl/sm <2.5 cm (52317) |
— |
$2,566 |
— |
| Lithotripsy, extracorporeal shock wave (50590) |
— |
$11,160 |
— |
| Lmtd lmphadec staging spx pel¶-aortic (38562) |
— |
$8,927 |
— |
| Low Back Disk Surgery (63030) |
— |
$3,502 |
— |
| Lumbar spine fusion combined (22633) |
— |
$6,695 |
— |
| Lysis Intranasal Synechia (30560) |
— |
$3,460 |
— |
| Lysis of labial adhesions (56441) |
— |
$2,566 |
— |
| Lysis/excision penile postcircumcision adhesions (54162) |
— |
$3,460 |
— |
| Male sling procedure (53440) |
— |
$3,460 |
— |
| Manipulation Ankle Under General Anesthesia (27860) |
— |
$2,566 |
— |
| Manipulation hip joint general anesthesia (27275) |
— |
$3,460 |
— |
| Manipulation knee joint under general anesthesia (27570) |
— |
$2,566 |
— |
| Manipulation wrist under anesthesia (25259) |
— |
$2,566 |
— |
| Manipulation, finger joint, under anesthesia, each joint (26340) |
— |
$2,566 |
— |
| Manj W/Anes Shoulder Joint W/Fixation Apparatus (23700) |
— |
$2,566 |
— |
| Marsupialization of bartholin's gland cyst (56440) |
— |
$3,460 |
— |
| Mast mod rad (19307) |
— |
$3,502 |
— |
| Mastectomy for gynecomastia (19300) |
— |
$4,908 |
— |
| Mastectomy partial (19301) |
— |
$4,020 |
— |
| Mastectomy partial w/axillary lymphadenectomy (19302) |
— |
$8,927 |
— |
| Mastectomy simple complete (19303) |
— |
$4,908 |
— |
| Mastopexy (19316) |
— |
$4,908 |
— |
| Maternity Care Procedure (59899) |
— |
$3,460 |
— |
| Middle ear surgery proc unlisted (69799) |
— |
$2,566 |
— |
| Musc myocutaneous/fasciocutaneous flap uxtr (15736) |
— |
$4,020 |
— |
| Muscle transfer, any type, shoulder or upper arm; multiple Facility (23397) |
— |
$8,927 |
— |
| Muscle transfer, any type, shoulder or upper arm; single Facility (23395) |
— |
$3,502 |
— |
| Muscle, myocutaneous, or fasciocutaneous flap; lower extremity (15738) |
— |
$4,020 |
— |
| Muscle-skin graft trunk (15734) |
— |
$4,020 |
— |
| Myelography Lumbar Injection (62305) |
— |
$3,633.99 |
— |
| Myelography Lumbar Injection (62304) |
— |
$3,137.22 |
— |
| Myomectomy 1-4 Myomas 250 Gm/< Vaginal Appr (58145) |
— |
$3,502 |
— |
| N Block Inj Ilio-Ing/Hypogi (64425) |
— |
$2,566 |
— |
| N block inj intercost sng (64420) |
— |
$2,566 |
— |
| N Block Inj Pudendal (64430) |
— |
$2,566 |
— |
| N Block Lumbar/Thoracic (64520) |
— |
$2,566 |
— |
| Nasal surgery procedure (30999) |
— |
$2,566 |
— |
| Nasal/Orogastric W/Tube Plmt (43752) |
— |
$3,460 |
— |
| Nasal/Sinus Endoscopy W/Sphenoidotomy (31287) |
— |
$4,020 |
— |
| Nasal/Sinus Ndsc Surg W/Bx Polypect/Dbrdmt Spx (31237) |
— |
$3,460 |
— |
| Nasal/sinus ndsc w/partial ethmoidectomy (31254) |
— |
$4,908 |
— |
| Nasal/Sinus Ndsc W/Rmvl Tiss From Frontal Sinus (31276) |
— |
$4,020 |
— |
| Nasal/Sinus Ndsc W/Total Ethoidectomy (31255) |
— |
$3,502 |
— |
| Ndsc wrst surg w/rls transvrs carpl ligm (29848) |
— |
$4,020 |
— |
| Neck spine disk surgery (63020) |
— |
$4,020 |
— |
| Neck spine fusion (22600) |
— |
$6,695 |
— |
| Needle Biopsy Lymph Nodes (38505) |
— |
$1,892.25 |
— |
| Needle Biopsy Pancreas (48102) |
— |
$2,231.55 |
— |
| Neuroplasty and/or transposition; ulnar nerve at elbow (64718) |
— |
$3,460 |
— |
| Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus Facility (64714) |
— |
$3,460 |
— |
| Neurp Major Prph Nrv Arm/Leg Opn Oth/Thn Spec (64708) |
— |
$3,460 |
— |
| Nipple Exploration (19110) |
— |
$3,460 |
— |
| Nipple/areola reconstruction (19350) |
— |
$4,908 |
— |
| Njx anes stellate ganglion crv sympathetic (64510) |
— |
$2,566 |
— |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
— |
$2,222.85 |
— |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321) |
— |
$2,566 |
— |
| Njx dx/ther sbst intrlmnr crv/thrc w/o img gdn (62320) |
— |
$2,566 |
— |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62327) |
— |
$2,566 |
— |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
— |
$1,827.87 |
— |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn (62326) |
— |
$2,566 |
— |
| Nsl/sinus ndsc max antrost w/rmvl tiss max sinus (31267) |
— |
$4,020 |
— |
| Omntc Epiploectomy Rescj Omentum Spx (49255) |
— |
$4,908 |
— |
| Open biopsy/excision inguinofemoral nodes (38531) |
— |
$3,460 |
— |
| Open bowel to skin (44300) |
— |
$3,460 |
— |
| Open Implantation Nea Sacral Nerve (64581) |
— |
$4,020 |
— |
| Open Repair of Rotator Cuff Acute (23410) |
— |
$3,502 |
— |
| Open Treatment Bimalleolar Ankle Fracture (27814) |
— |
$4,020 |
— |
| Open treatment calcaneal fracture (28415) |
— |
$4,020 |
— |
| Open Treatment Fracture Distal Tibia & Fibula (27828) |
— |
$4,908 |
— |
| Open treatment fracture distal tibia only (27827) |
— |
$4,020 |
— |
| Open treatment greater trochanteric fracture (27248) |
— |
$3,502 |
— |
| Open Treatment Medial Malleolus Fracture (27766) |
— |
$4,020 |
— |
| Open treatment metacarpophalangeal dislocation (26715) |
— |
$4,908 |
— |
| Open treatment metatarsal fracture each (28485) |
— |
$4,908 |
— |
| Open treatment of acromioclavicular dislocation acute or chronic (23550) |
— |
$4,020 |
— |
| Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)… (23552) |
— |
$4,908 |
— |
| Open treatment of clavicular fracture, includes internal fixation, when performed (23515) |
— |
$4,020 |
— |
| Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including… (21365) |
— |
$3,502 |
— |
| Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation,… (21470) |
— |
$3,502 |
— |
| Open treatment of femoral shaft fracture with plate/screws, with or without cerclage Facility (27507) |
— |
$4,908 |
— |
| Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant,… (27506) |
— |
$3,502 |
— |
| Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal… (27513) |
— |
$3,502 |
— |
| Open treatment of fracture of orbit, except blowout; with implant Facility (21407) |
— |
$3,502 |
— |
| Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with… (24546) |
— |
$3,502 |
— |
| Open treatment of mandibular condylar fracture Facility (21465) |
— |
$4,908 |
— |
| Open treatment of mandibular fracture with external fixation Facility (21454) |
— |
$3,502 |
— |
| Open treatment of nasal fracture; uncomplicated Facility (21325) |
— |
$4,908 |
— |
| Open treatment of nasal fracture; with concomitant open treatment of fractured septum Facility (21335) |
— |
$8,927 |
— |
| Open treatment of nasal septal fracture, with or without stabilization Facility (21336) |
— |
$4,908 |
— |
| Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant Facility (21390) |
— |
$8,927 |
— |
| Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal… (25526) |
— |
$3,502 |
— |
| Open treatment of sesamoid fracture, with or without internal fixation Facility (28531) |
— |
$4,020 |
— |
| Open treatment of talotarsal joint dislocation, includes internal fixation, when performed Facility (28585) |
— |
$4,020 |
— |
| Open Treatment of Ulnar Shaft Fracture (25545) |
— |
$4,020 |
— |
| Open treatment of ulnar styloid fracture (25652) |
— |
$4,020 |
— |
| Open treatment posterior malleolus fracture (27769) |
— |
$4,020 |
— |
| Open Treatment Proximal Fibula/Shaft Fracture (27784) |
— |
$4,020 |
— |
| Open Treatment Proximal Humeral Fracture (23615) |
— |
$4,908 |
— |
| Open Treatment Radial Shaft Fracture (25515) |
— |
$4,020 |
— |
| Open Tx Articular Fracture Mcp/Ip Joint Ea (26746) |
— |
$3,502 |
— |
| Open Tx Distal Fibular Fracture Lat Malleolus (27792) |
— |
$4,020 |
— |
| Open Tx Distal Phalangeal Fracture Each (26765) |
— |
$4,908 |
— |
| Open Tx Distal Tibiofibular Joint Disruption (27829) |
— |
$3,460 |
— |
| Open Tx Femoral Fracture Distal Med/Lat Condyle (27514) |
— |
$3,502 |
— |
| Open tx femoral supracondylar fracture w/o xtn (27511) |
— |
$4,908 |
— |
| Open Tx Fracture Phalanx/Phalanges Not Great Toe (28525) |
— |
$4,020 |
— |
| Open Tx Humeral Epicondylar Fracture (24575) |
— |
$4,020 |
— |
| Open tx humeral supracondylar fracture w/o xtn (24545) |
— |
$4,908 |
— |
| Open tx interphalangeal joint dislocation (26785) |
— |
$3,460 |
— |
| Open Tx Mandibular Fx W/Interdental Fixation (21462) |
— |
$3,502 |
— |
| Open Tx Metacarpal Fracture Single Ea Bone (26615) |
— |
$4,908 |
— |
| Open Tx Phalangeal Shaft Fracture Prox/Middle Ea (26735) |
— |
$4,908 |
— |
| Open Tx Radial Head/Neck Fracture (24665) |
— |
$4,908 |
— |
| Open Tx Radial Head/Neck Fracture Prosth (24666) |
— |
$4,908 |
— |
| Open tx tarsal fracture xcp talus & calcaneus ea (28465) |
— |
$4,020 |
— |
| Open Tx Tibial Fracture Proximal Unicondylar (27535) |
— |
$4,020 |
— |
| Open tx trimalleolar ankle fx w/o fixj pst lip (27822) |
— |
$4,020 |
— |
| Open tx ulnar fx proximal end (24685) |
— |
$4,020 |
— |
| Optx dstl radl i-artic fx/epiphysl sep 2 frag (25608) |
— |
$3,502 |
— |
| Optx dstl radl i-artic fx/epiphysl sep 3 frag (25609) |
— |
$3,502 |
— |
| Optx fem fx prox end nck int fixj/prostc rplcmt (27236) |
— |
$3,502 |
— |
| Optx humeral shft fx w/plate/screws w/wocerclage (24515) |
— |
$4,908 |
— |
| Optx tibial fx prox bicondylar w/wo int fixj (27536) |
— |
$3,502 |
— |
| Optx Tibial Shft Fx W/Plate/Screws W/WO Cerclage (27758) |
— |
$4,908 |
— |
| Orbitotomy W/O Bone Flap W/Removal Lesion (67412) |
— |
$3,502 |
— |
| Orchiectomy partial (54522) |
— |
$4,020 |
— |
| Orchiectomy radical tumor inguinal approach (54530) |
— |
$4,908 |
— |
| Orchiopexy Ingun/Scrot Appr (54640) |
— |
$4,908 |
— |
| Ostc prtl exostc/condylc metar head (28288) |
— |
$4,020 |
— |
| Ostectomy calcaneus (28118) |
— |
$4,908 |
— |
| Ostectomy Complete Other Metatarsal Head 2/3/4 (28112) |
— |
$4,020 |
— |
| Ostectomy, complete excision; fifth metatarsal head (28113) |
— |
$4,020 |
— |
| Ostectomy, complete excision; first metatarsal head (28111) |
— |
$4,020 |
— |
| Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) (28110) |
— |
$4,020 |
— |
| Osteochondral allograft knee open (27415) |
— |
$4,020 |
— |
| Osteochondral knee autograft (27416) |
— |
$4,908 |
— |
| Osteoplasty Radius/Ulna Shortening (25390) |
— |
$4,020 |
— |
| Osteoplasty, tibia and fibula, lengthening or shortening Facility (27715) |
— |
$4,908 |
— |
| Osteot W/WO Lngth Shrt/Angular Corrj Metar Mlt (28309) |
— |
$4,908 |
— |
| Osteot w/wo lngth shrt/corrj 1st metar (28306) |
— |
$4,908 |
— |
| Osteot w/wo lngth shrt/corrj metar xcp 1st ea (28308) |
— |
$3,460 |
— |
| Osteotomy calcaneus w/wo internal fixation (28300) |
— |
$3,460 |
— |
| Osteotomy Clavicle W Bone Graft (23485) |
— |
$8,927 |
— |
| Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical Facility (22220) |
— |
$3,502 |
— |
| Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar Facility (22224) |
— |
$3,502 |
— |
| Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar Facility (22214) |
— |
$3,502 |
— |
| Osteotomy radius distal third (25350) |
— |
$4,020 |
— |
| Osteotomy Radius Middle/Proximal Third (25355) |
— |
$4,020 |
— |
| Osteotomy Tibia (27705) |
— |
$3,460 |
— |
| Osteotomy, clavicle, with or without internal fixation; Facility (23480) |
— |
$4,908 |
— |
| Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft… (28307) |
— |
$4,908 |
— |
| Ovarian cystectomy, unilateral or bilateral (58925) |
— |
$3,502 |
— |
| Palatopharyngoplasty (42145) |
— |
$3,502 |
— |
| Parathyroidectomy or exploration of parathyroid(s); (60500) |
— |
$8,927 |
— |
| Paravaginal defect repair (including repair of cystocele, stress urinary incontinence, and/or incomplete vaginal… (57284) |
— |
$3,502 |
— |
| Part exc bone femur prox tibia (27360) |
— |
$3,502 |
— |
| Part remv talus or calcaneus (28120) |
— |
$8,927 |
— |
| Partial Excision Bone Humerus (24140) |
— |
$4,020 |
— |
| Partial excision bone olecranon process (24147) |
— |
$3,460 |
— |
| Partial Excision Bone Ulna (25150) |
— |
$3,460 |
— |
| Partial Excision Distal Phalanx Finger (26236) |
— |
$4,020 |
— |
| Partial excision of lip (40520) |
— |
$3,460 |
— |
| Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion,… (22100) |
— |
$4,020 |
— |
| Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg,… (27071) |
— |
$3,502 |
— |
| Partial hymenectomy or revision of hymenal ring (56700) |
— |
$2,566 |
— |
| Partial removal of fibula (27641) |
— |
$3,460 |
— |
| Partial removal of lip (40530) |
— |
$3,460 |
— |
| Partial removal of rib (21600) |
— |
$3,460 |
— |
| Partial removal of thyroid (60220) |
— |
$3,460 |
— |
| Partial removal of tibia (27640) |
— |
$3,460 |
— |
| Partial removal of toe (28160) |
— |
$4,020 |
— |
| Partial thyroid excision (60212) |
— |
$4,908 |
— |
| Partial thyroid lobectomy, unilateral; with or without isthmusectomy (60210) |
— |
$4,908 |
— |
| Partical Excision Bone Phalanx Toe (28124) |
— |
$3,460 |
— |
| Patellectomy or hemipatellectomy (27350) |
— |
$4,908 |
— |
| Pelvic examination under anesthesia (other than local) (57410) |
— |
$3,460 |
— |
| Percut Drain/Inject Renal Cyst (50390) |
— |
$2,162.82 |
— |
| Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation Facility (28496) |
— |
$3,460 |
— |
| Pereyra procedure, including anterior colporrhaphy Facility (57289) |
— |
$3,502 |
— |
| Peri-Implant Capsulectomy Breast Complete (19371) |
— |
$4,908 |
— |
| Perineoplasty rpr perineum nonobstetrical spx (56810) |
— |
$3,502 |
— |
| Perq dev breast 1st strtctc (19283) |
— |
$4,915.50 |
— |
| Perq dev breast 1st us imag (19285) |
— |
$4,915.50 |
— |
| Perq device breast 1st imag (19281) |
— |
$4,731.06 |
— |
| Perq skel fixj distal radial fx/epiphysl sep (25606) |
— |
$4,020 |
— |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) |
— |
$22,966.26 |
— |
| Perq Vertebral Augmentation (22513) |
— |
$22,966.26 |
— |
| Pin knuckle dislocation (26706) |
— |
$3,460 |
— |
| Place Duod/Jej Tube Perc (49441) |
— |
$4,637.97 |
— |
| Placement of needle for intraosseous infusion (36680) |
— |
$2,566 |
— |
| Placement of seton (46020) |
— |
$4,020 |
— |
| Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy (57250) |
— |
$3,502 |
— |
| Probe Nasolacrimal Duct W/WO Irrg Insj Tube/Stnt (68815) |
— |
$3,460 |
— |
| Probe nasolacrimal duct w/wo irrig req gen anes (68811) |
— |
$3,460 |
— |
| Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300) |
— |
$2,566 |
— |
| Proctosgmdsc rigid w/dilation (45303) |
— |
$2,566 |
— |
| Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot… (45320) |
— |
$2,566 |
— |
| Prostate laser enucleation (52649) |
— |
$3,502 |
— |
| Prq Aspir Pulposus/Intervertebral Disc/Pvrt Tiss (62267) |
— |
$4,447.44 |
— |
| Prq Impltj Neurostimulator Eltrd Peripheral Nrv (64555) |
— |
$2,566 |
— |
| Prq Lysis Epidural Adhesions Mult Sessions 1 Day (62264) |
— |
$2,566 |
— |
| Prq Skel Fixj Dstl Phlngl Fx Fngr/Thmb Ea (26756) |
— |
$3,460 |
— |
| Prq skel fixj femoral fx prox end neck (27235) |
— |
$4,908 |
— |
| Prq skel fixj metar fx w/manj (28476) |
— |
$3,460 |
— |
| Prq Skeletal Fix Carpo/Metacarpal Fx Dislc Thumb (26650) |
— |
$3,460 |
— |
| Prq Skeletal Fixj Calcaneal Fracture W/Manj (28406) |
— |
$3,460 |
— |
| Prtl exc b1 tarsal/metar b1 xcp talus/calcaneus (28122) |
— |
$4,020 |
— |
| Puncture aspiration abscess hematoma bulla/cyst (10160) |
— |
$789.96 |
— |
| Puncture Aspiration Cyst Breast (19000) |
— |
$1,318.05 |
— |
| Puncture shunt tube/reservoir aspiration/inj px (61070) |
— |
$2,566 |
— |
| Quadricepsplasty (eg, Bennett or Thompson type) Facility (27430) |
— |
$4,908 |
— |
| Rad exc bursa synva wrst/f/arm tdn shths flxrs (25115) |
— |
$4,908 |
— |
| Rad exc bursa synva wrst/f/arm tdn shths xtnsrs (25116) |
— |
$4,908 |
— |
| Rad resect tumor soft tiss neck/ant thorax 5cm/> (21558) |
— |
$4,020 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; 5 cm or greater Facility (21936) |
— |
$4,020 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm Facility (28046) |
— |
$4,020 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm Facility (21557) |
— |
$3,460 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; 5 cm or greater Facility (24079) |
— |
$4,020 |
— |
| Radical resection of tumor; phalanx of toe Facility (28175) |
— |
$4,020 |
— |
| Radical resection of tumor; tarsal (except talus or calcaneus) Facility (28171) |
— |
$4,020 |
— |
| Radical Resection Tumor Metatarsal (28173) |
— |
$4,020 |
— |
| Rcnstj angular dfrm toe soft tiss px only (28313) |
— |
$3,460 |
— |
| Rcnstj Dislocating Patella (27420) |
— |
$4,020 |
— |
| Realignment extensor tendon hand each tendon (26437) |
— |
$4,020 |
— |
| Reconstruct elbow lat ligmnt (24344) |
— |
$10,040 |
— |
| Reconstruct finger joint (26545) |
— |
$4,908 |
— |
| Reconstruct Finger Joint (26548) |
— |
$4,908 |
— |
| Reconstruct ulna/radioulnar (25337) |
— |
$3,502 |
— |
| Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell,… (27422) |
— |
$8,927 |
— |
| Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate… (69310) |
— |
$4,020 |
— |
| Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate) Facility (21244) |
— |
$8,927 |
— |
| Reconstruction Toe Polydactyly (28344) |
— |
$4,908 |
— |
| Reconstruction Tongue Fold (41520) |
— |
$3,460 |
— |
| Reduction of rectal prolapse (45900) |
— |
$2,566 |
— |
| Reinsert spinal fixation (22849) |
— |
$6,695 |
— |
| Release foot/toe nerve (64726) |
— |
$2,566 |
— |
| Release of big toe (28240) |
— |
$3,460 |
— |
| Release of shoulder ligament (23415) |
— |
$3,502 |
— |
| Relocation Pocket Pacemaker (33222) |
— |
$7,973.55 |
— |
| Rem Endovas Vena Cava Filter (37193) |
— |
$21,723.03 |
— |
| Removal Anal Seton Other Marker (46030) |
— |
$2,566 |
— |
| Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same… (53447) |
— |
$2,566 |
— |
| Removal Embedded Foreign Body Eyelid (67938) |
— |
$2,566 |
— |
| Removal Foreign Body Deep Thigh/Knee (27372) |
— |
$8,927 |
— |
| Removal Foreign Body Foot Complicated (28193) |
— |
$4,908 |
— |
| Removal foreign body foot deep (28192) |
— |
$3,460 |
— |
| Removal Foreign Body Foot Subcutaneous (28190) |
— |
$3,460 |
— |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
— |
$3,460 |
— |
| Removal foreign body, intranasal; requiring general anesthesia (30310) |
— |
$2,566 |
— |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
— |
$2,566 |
— |
| Removal impacted vag fb spx w/anes oth/thn local (57415) |
— |
$3,460 |
— |
| Removal Implant Deep (20680) |
— |
$4,020 |
— |
| Removal Implant Superficial Separate Procedure (20670) |
— |
$2,566 |
— |
| Removal intact breast implant (19328) |
— |
$2,566 |
— |
| Removal of a lesion from the floor of the mouth (41116) |
— |
$2,566 |
— |
| Removal of adenoids (42831) |
— |
$4,908 |
— |
| Removal of adenoids (42830) |
— |
$4,908 |
— |
| Removal of anal fissure (46200) |
— |
$3,460 |
— |
| Removal of anterior instrumentation (22855) |
— |
$6,695 |
— |
| Removal of foot joint lining (28072) |
— |
$4,020 |
— |
| Removal of foreign body from pharynx (42809) |
— |
$2,566 |
— |
| Removal of heel spur (28119) |
— |
$4,908 |
— |
| Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of… (27091) |
— |
$4,020 |
— |
| Removal of implanted material, anterior segment of eye (65920) |
— |
$8,927 |
— |
| Removal of intranasal lesion (30118) |
— |
$4,020 |
— |
| Removal of knee prosthesis (27488) |
— |
$3,502 |
— |
| Removal of mammary implant material (19330) |
— |
$2,566 |
— |
| Removal of nail bed (11750) |
— |
$2,566 |
— |
| Removal of posterior segmental instrumentation Facility (22852) |
— |
$6,695 |
— |
| Removal of sesamoid bone (28315) |
— |
$4,908 |
— |
| Removal of sperm cord lesion (55520) |
— |
$4,908 |
— |
| Removal of tendon for graft (20924) |
— |
$4,908 |
— |
| Removal of testis (54520) |
— |
$4,020 |
— |
| Removal of thyroid (60271) |
— |
$4,908 |
— |
| Removal of tonsils (42825) |
— |
$4,908 |
— |
| Removal of tonsils (42826) |
— |
$4,908 |
— |
| Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical Facility (22864) |
— |
$6,695 |
— |
| Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar Facility (22865) |
— |
$6,695 |
— |
| Removal of tunneled intraperitoneal catheter (49422) |
— |
$2,566 |
— |
| Removal ppm generator only (33233) |
— |
$12,032.97 |
— |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) |
— |
$2,566 |
— |
| Removal Submand Stone,Complicated (42335) |
— |
$4,020 |
— |
| Removal sweat gland lesion (11450) |
— |
$3,460 |
— |
| Removal, under anesthesia, of external fixation system (20694) |
— |
$2,566 |
— |
| Remove Ankle Joint Lining (27626) |
— |
$4,908 |
— |
| Remove Elbow Joint Lining (24102) |
— |
$4,908 |
— |
| Remove Elctrd Transvenously (33244) |
— |
$6,518.91 |
— |
| Remove Forearm Foreign Body (25248) |
— |
$3,460 |
— |
| Remove foreign body from eye (65235) |
— |
$3,460 |
— |
| Remove foreign body from eye (65205) |
— |
$8,927 |
— |
| Remove humerus lesion (24110) |
— |
$3,460 |
— |
| Remove Intrauterine Device (58301) |
— |
$2,566 |
— |
| Remove knee joint lining (27334) |
— |
$4,908 |
— |
| Remove lamina/facets lumbar (63012) |
— |
$3,502 |
— |
| Remove Lower Leg Bone Lesion (27635) |
— |
$4,020 |
— |
| Remove muti-comp penis pros (54406) |
— |
$4,020 |
— |
| Remove Nasal Foreign Body (30300) |
— |
$8,927 |
— |
| Remove part lumbar vertebra (22102) |
— |
$4,020 |
— |
| Remove part thorax vertebra (22101) |
— |
$4,020 |
— |
| Remove prostate regrowth (52630) |
— |
$3,460 |
— |
| Remove Pulse Generator (33241) |
— |
$6,667.68 |
— |
| Remove renal tube w/fluoro (50389) |
— |
$2,749.20 |
— |
| Remove sacrum pressure sore (15937) |
— |
$4,908 |
— |
| Remove self-contd penis pros (54415) |
— |
$4,020 |
— |
| Remove Shoulder Foreign Body (23330) |
— |
$2,566 |
— |
| Remove shoulder joint lining (23105) |
— |
$4,908 |
— |
| Remove Skin Nerve Lesion (64774) |
— |
$3,460 |
— |
| Remove spine eltrd plate (63662) |
— |
$2,566 |
— |
| Remove spine fixation device (22850) |
— |
$6,695 |
— |
| Remove spine lamina 1/2 lmbr (63005) |
— |
$3,502 |
— |
| Remove spine lamina 1/2 thrc (63003) |
— |
$6,695 |
— |
| Remove Tendon Sheath Lesion (26160) |
— |
$4,020 |
— |
| Remove thigh pressure sore (15956) |
— |
$4,020 |
— |
| Remove thyroid lesion (60200) |
— |
$3,460 |
— |
| Remove tissue expander (11971) |
— |
$2,566 |
— |
| Remove wrist joint cartilage (25107) |
— |
$4,020 |
— |
| Remove/replace penis prosth (54410) |
— |
$4,020 |
— |
| Remv&replc cvd gen dual lead (33263) |
— |
$39,972.15 |
— |
| Remv&replc cvd gen mult lead (33264) |
— |
$53,665.95 |
— |
| Remv&replc cvd gen sing lead (33262) |
— |
$39,972.15 |
— |
| Remv&replc pm gen dual lead (33228) |
— |
$38,477.49 |
— |
| Renal Biopsy Perq (50200) |
— |
$4,039.41 |
— |
| Reopen fallopian tube (58350) |
— |
$4,020 |
— |
| Repair Achilles Tendon (27650) |
— |
$4,020 |
— |
| Repair Anorectal Fistula Plug (46707) |
— |
$8,927 |
— |
| Repair Bladder-Vagina Lesion (57320) |
— |
$4,020 |
— |
| Repair Blood Vessel Direct Hand Finger (35207) |
— |
$4,908 |
— |
| Repair blood vessel direct neck (35201) |
— |
$3,502 |
— |
| Repair Blood Vessel Direct Upper Extremity (35206) |
— |
$4,908 |
— |
| Repair blood vessel lesion (35190) |
— |
$8,927 |
— |
| Repair blood vessel lesion (35266) |
— |
$6,695 |
— |
| Repair brow ptosis (67900) |
— |
$4,908 |
— |
| Repair Collat Ankle Ligmnt,Secondary (27698) |
— |
$3,460 |
— |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
— |
$4,020 |
— |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
— |
$4,020 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
— |
$3,460 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
— |
$4,020 |
— |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
— |
$3,460 |
— |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
— |
$4,020 |
— |
| Repair complex trunk 1.1-2.5 cm (13100) |
— |
$3,460 |
— |
| Repair complex trunk 2.6-7.5 cm (13101) |
— |
$4,020 |
— |
| Repair Ectropion Excision Tarsal Wedge (67916) |
— |
$4,908 |
— |
| Repair Ectropion Extensive (67917) |
— |
$4,908 |
— |
| Repair Ectropion Suture (67914) |
— |
$4,020 |
— |
| Repair Entropion Excision Tarsal Wedge (67923) |
— |
$4,908 |
— |
| Repair Entropion Extensive (67924) |
— |
$4,908 |
— |
| Repair Entropion Suture (67921) |
— |
$4,020 |
— |
| Repair extensor tendon finger w/o graft each (26418) |
— |
$4,908 |
— |
| Repair Eyelid Wound (67935) |
— |
$3,460 |
— |
| Repair Finger Tendon (26433) |
— |
$4,020 |
— |
| Repair Finger/Hand Tendon (26350) |
— |
$2,566 |
— |
| Repair Fistula Oromaxillary (30580) |
— |
$4,908 |
— |
| Repair Flexor Tendon Leg Primary W/O Graft Each (27658) |
— |
$2,566 |
— |
| Repair Forearm Tendon Sheath (25275) |
— |
$4,908 |
— |
| Repair Hallux Rigidus (28289) |
— |
$4,020 |
— |
| Repair Hand Joint (26540) |
— |
$4,908 |
— |
| Repair Hand Tendon (26410) |
— |
$4,020 |
— |
| Repair humerus with graft (24435) |
— |
$4,908 |
— |
| Repair incomplete circumcision (54163) |
— |
$3,460 |
— |
| Repair inguinal hernia, sliding, any age (49525) |
— |
$4,908 |
— |
| Repair initial femoral hernia, any age; incarcerated or strangulated (49553) |
— |
$4,908 |
— |
| Repair initial femoral hernia, any age; reducible (49550) |
— |
$3,502 |
— |
| Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated (49507) |
— |
$4,908 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
— |
$2,566 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
— |
$2,566 |
— |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
— |
$2,566 |
— |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
— |
$3,460 |
— |
| Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) |
— |
$3,460 |
— |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
— |
$3,460 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
— |
$2,566 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
— |
$2,566 |
— |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
— |
$3,460 |
— |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
— |
$3,460 |
— |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
— |
$2,566 |
— |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
— |
$2,566 |
— |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) |
— |
$3,460 |
— |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
— |
$3,460 |
— |
| Repair intermediate s/a/t/e >30.0 cm (12037) |
— |
$3,460 |
— |
| Repair iris ciliary body (66680) |
— |
$4,020 |
— |
| Repair nasal septal perforations (30630) |
— |
$8,927 |
— |
| Repair Nasal Vestibular Stenosis (30465) |
— |
$8,927 |
— |
| Repair Non/Malunion Humerus W/O Graft (24430) |
— |
$4,020 |
— |
| Repair Nonunion Hand (26546) |
— |
$4,908 |
— |
| Repair Nonunion/Malunion Tibia W/O Graft (27720) |
— |
$3,502 |
— |
| Repair of anal fistula with fibrin glue (46706) |
— |
$2,566 |
— |
| Repair of arm tendon (24320) |
— |
$4,020 |
— |
| Repair of biceps tendon (24340) |
— |
$4,020 |
— |
| Repair of enterocele, vaginal approach (separate procedure) (57268) |
— |
$4,020 |
— |
| Repair of fibula nonunion and/or malunion with internal fixation (27726) |
— |
$4,020 |
— |
| Repair of hammertoe (28286) |
— |
$4,908 |
— |
| Repair of hydrocele (55060) |
— |
$4,908 |
— |
| Repair of metatarsals (28322) |
— |
$4,908 |
— |
| Repair of nail bed (11760) |
— |
$2,566 |
— |
| Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft) Facility (25405) |
— |
$4,908 |
— |
| Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique) Facility (25400) |
— |
$4,020 |
— |
| Repair of rectocele (45560) |
— |
$3,460 |
— |
| Repair of rectum (45505) |
— |
$3,460 |
— |
| Repair of Ruptured Tendon (24342) |
— |
$4,020 |
— |
| Repair of shoulder (23420) |
— |
$8,927 |
— |
| Repair of sternum separation (21750) |
— |
$4,908 |
— |
| Repair of windpipe defect (31825) |
— |
$3,460 |
— |
| Repair paravag defect lap (57423) |
— |
$3,502 |
— |
| Repair paravag defect vag (57285) |
— |
$4,908 |
— |
| Repair recurrent femoral hernia; reducible Facility (49555) |
— |
$3,502 |
— |
| Repair recurrent inguinal hernia, any age; incarcerated or strangulated (49521) |
— |
$4,908 |
— |
| Repair Rotator Cuff Chronic (23412) |
— |
$8,927 |
— |
| Repair secondary achilles tendon w/wo graft (27654) |
— |
$4,020 |
— |
| Repair shoulder capsule (23466) |
— |
$8,927 |
— |
| Repair Tendon Extensor Foot 1/2 Each Tendon (28208) |
— |
$4,020 |
— |
| Repair Tendon/Muscle Upper Arm/Elbow Ea (24341) |
— |
$4,020 |
— |
| Repair Toe Dislocation (28645) |
— |
$4,020 |
— |
| Repair tongue laceration (41252) |
— |
$3,460 |
— |
| Repair tongue laceration (41250) |
— |
$3,460 |
— |
| Repair Tooth Socket (41874) |
— |
$2,566 |
— |
| Repair, primary, disrupted ligament, ankle; collateral (27695) |
— |
$3,460 |
— |
| Repair, primary, torn ligament and/or capsule, knee; collateral (27405) |
— |
$4,908 |
— |
| Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle Facility (25272) |
— |
$4,020 |
— |
| Repair/graft achilles tendon (27652) |
— |
$4,020 |
— |
| Repair/graft femur head/neck (27170) |
— |
$4,908 |
— |
| Repair/Revise Wrist Joint (25320) |
— |
$4,020 |
— |
| Replace duodenostomy/jejunostomy tube perq (49451) |
— |
$1,841.79 |
— |
| Replace G-J Tube Perc (49452) |
— |
$2,841.42 |
— |
| Replace g/c tube perc (49450) |
— |
$1,333.71 |
— |
| Replace/Revise Brain Shunt (62230) |
— |
$3,460 |
— |
| Replacement Tissue Expander W/Permanent Implant (11970) |
— |
$4,020 |
— |
| Reposition Gastrostomy Tube (43761) |
— |
$2,031.45 |
— |
| Reposition Pacing-Defib Lead (33215) |
— |
$6,538.92 |
— |
| Reposition Venous Catheter (36597) |
— |
$3,198.99 |
— |
| Repositioning Io Lens Prosthesis Req Inc Spx (66825) |
— |
$4,908 |
— |
| Repr elbow lat ligmnt w/tiss (24343) |
— |
$4,908 |
— |
| Repr torn cruciate knee ligam (27407) |
— |
$4,908 |
— |
| Rerepair ing hernia reduce (49520) |
— |
$4,908 |
— |
| Resect leg/ankle tum < 5 cm (27615) |
— |
$4,020 |
— |
| Resect shoulder tumor < 5 cm (23077) |
— |
$4,020 |
— |
| Resection, condyle(s), distal end of phalanx, each toe Facility (28153) |
— |
$4,020 |
— |
| Resection, partial or complete, phalangeal base, each toe (28126) |
— |
$4,020 |
— |
| Resection/transplantation long tendon biceps (23440) |
— |
$4,908 |
— |
| Rev/rmv prph sac/gstr npg/r (64595) |
— |
$2,566 |
— |
| Revis reconst shoulder joint (23473) |
— |
$3,502 |
— |
| Revise eyelashes (67825) |
— |
$8,927 |
— |
| Revise finger joint each (26140) |
— |
$3,460 |
— |
| Revise Hand/Foot Nerve (64704) |
— |
$2,566 |
— |
| Revise knuckle joint (26530) |
— |
$4,020 |
— |
| Revise lower leg tendon (27690) |
— |
$4,908 |
— |
| Revise Lower Leg Tendons (27686) |
— |
$4,020 |
— |
| Revise Spine Eltrd Plate (63664) |
— |
$2,566 |
— |
| Revise ulnar nerve at wrist (64719) |
— |
$3,460 |
— |
| Revise/Repair Finger/Toe Nerve (64702) |
— |
$2,566 |
— |
| Revision of big toe (28310) |
— |
$4,020 |
— |
| Revision of colostomy; with repair of paracolostomy hernia (separate procedure) Facility (44346) |
— |
$4,908 |
— |
| Revision of foot and ankle (28262) |
— |
$4,908 |
— |
| Revision of foot bones (28737) |
— |
$3,502 |
— |
| Revision of foot fascia (28250) |
— |
$4,020 |
— |
| Revision of humerus (24400) |
— |
$4,908 |
— |
| Revision of knee joint (27442) |
— |
$3,502 |
— |
| Revision of lower leg tendon (27685) |
— |
$4,020 |
— |
| Revision of reconstructed breast (19380) |
— |
$3,502 |
— |
| Revision of scrotum (55180) |
— |
$3,460 |
— |
| Revision of total hip arthroplasty; femoral component only, with or without allograft (27138) |
— |
$6,695 |
— |
| Revision of tracheostomy scar (31830) |
— |
$3,460 |
— |
| Revision of urethra (57220) |
— |
$4,020 |
— |
| Revj Aqueous Shunt Extraocular Reservoir W/Graft (66185) |
— |
$3,460 |
— |
| Revj Colostomy Smpl Rls Supfc Scar Spx (44340) |
— |
$4,020 |
— |
| Revj tot hip arthrp bth w/wo agrft/algrft (27134) |
— |
$6,695 |
— |
| Revj Tot Knee Arthrp Fem&Entire Tibial Compone (27487) |
— |
$6,695 |
— |
| Revj Total Knee Arthrp W/WO Algrft 1 Component (27486) |
— |
$6,695 |
— |
| Revj/Rmvl Impl Spi Npg/Rcvr Dtch Connj Eltrd Ra (63688) |
— |
$2,566 |
— |
| Revj/rmvl peripheral neurostimulator electrode (64585) |
— |
$2,566 |
— |
| Revj/rpr oprative wound anterior segment (66250) |
— |
$3,460 |
— |
| Rhinoplasty primary w/major septal repair (30420) |
— |
$3,502 |
— |
| Rhinoplasty Secondary Intermediate Revision (30435) |
— |
$3,502 |
— |
| Rhinp Prim Complete Xtrnl Parts (30410) |
— |
$3,502 |
— |
| Rhinp Prim Lat&Alar Crtlgs&/Elvtn Nasal Ti (30400) |
— |
$4,908 |
— |
| Rhytidectomy Neck W/Platysmal Tightening (15825) |
— |
$4,020 |
— |
| Rib cartilage graft (21230) |
— |
$8,927 |
— |
| Rmvl Embedded Fb Vestibule Mouth Smpl (40804) |
— |
$8,927 |
— |
| Rmvl FB Xtrnl Auditory Canal Anes (69205) |
— |
$2,566 |
— |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
— |
$8,927 |
— |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
— |
$8,927 |
— |
| Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) |
— |
$8,927 |
— |
| Rmvl fecal impaction/fb spx under anes (45915) |
— |
$2,566 |
— |
| Rmvl Foreign Body Intranasal Lateral Rhinotomy (30320) |
— |
$3,460 |
— |
| Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) |
— |
$4,020 |
— |
| Rmvl foreign body pelvis/hip subcutaneous tiss (27086) |
— |
$2,566 |
— |
| Rmvl Foreign Body Upper Arm/Elbow Subcutaneous (24200) |
— |
$8,927 |
— |
| Rmvl Implt Matrl Posterior Segment Intraocular (67121) |
— |
$3,460 |
— |
| Rmvl spinal nstim eltrd prq array incl fluor (63661) |
— |
$2,566 |
— |
| Rmvl Subq Rsvr/Pump Intrathecal/Epidural Infus (62365) |
— |
$3,460 |
— |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
— |
$6,068.25 |
— |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
— |
$3,338.19 |
— |
| Rmvl Vitreous Ant Appr Partial Removal (67005) |
— |
$4,908 |
— |
| Rmvl Vitreous Ant Appr Subtot Rmvl Mech Vitrect (67010) |
— |
$4,908 |
— |
| Rmvl/revj sling stress incontinence (57287) |
— |
$3,502 |
— |
| Rplc Gtube No Revj Trc (43762) |
— |
$1,512.93 |
— |
| Rplcmt cath ctr vad subq port/pmp (36578) |
— |
$8,206.71 |
— |
| Rplcmt compl non-tun cvc w/o subq port/pmp (36580) |
— |
$2,559.54 |
— |
| Rplcmt Compl Prph Ctr Vad W/Subq Port (36585) |
— |
$4,020 |
— |
| Rplcmt Compl Prph Cvc W/O Subq Port/Pmp (36584) |
— |
$3,774.06 |
— |
| Rplcmt compl tun ctr vad w/subq port (36582) |
— |
$6,946.08 |
— |
| Rplcmt compl tun cvc w/o subq port/pmp (36581) |
— |
$7,294.08 |
— |
| Rpr Blepharoptosis Levator Rescj/Advmnt Internal (67903) |
— |
$4,908 |
— |
| Rpr blood vessel direct lower extremity (35226) |
— |
$4,908 |
— |
| Rpr ctr vad w/subq port/pmp ctr/prph insj sit (36576) |
— |
$2,599.56 |
— |
| Rpr Disloc Peroneal Tendon W/O Fibular Osteotomy (27675) |
— |
$3,460 |
— |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) |
— |
$2,566 |
— |
| Rpr flexor tendon leg secondary w/o graft each (27659) |
— |
$3,460 |
— |
| Rpr ing hernia init reduce (49500) |
— |
$4,908 |
— |
| Rpr Lac Cornea Nonperfor W/WO Rmvl Foreign Body (65275) |
— |
$4,908 |
— |
| Rpr Lip Full Thickness Half/< Vertical Height (40652) |
— |
$4,020 |
— |
| Rpr Non/Mal Tibia W/Iliac/Oth Agrft (27724) |
— |
$3,502 |
— |
| Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms (27696) |
— |
$3,460 |
— |
| Rpr Tdn Flxr Foot 1/2 W/O Free Grafg Each Tendon (28200) |
— |
$4,020 |
— |
| Rpr Tdn/Musc Flxr F/Arm&/Wrst Prim 1 Ea Tdn/Mu (25260) |
— |
$4,908 |
— |
| Rpr Tdn/Musc Xtnsr F/Arm&/Wrist Prim 1 Ea Tdn (25270) |
— |
$4,908 |
— |
| Rpr tun/non-tun ctr vad cath w/o subq port/pmp (36575) |
— |
$3,460 |
— |
| Rpr Wnd Extraocular Muscle Tendon&/Tenon Capsu (65290) |
— |
$4,020 |
— |
| Rpr xtnsr tdn cntrl slip tiss w/lat band ea fngr (26426) |
— |
$4,020 |
— |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) |
— |
$4,908 |
— |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26357) |
— |
$4,908 |
— |
| Rpr/advmnt tdn w/ntc supfcis tdn prim ea tdn (26370) |
— |
$4,908 |
— |
| Scrotal exploration (55110) |
— |
$3,460 |
— |
| Scrotoplasty Simple (55175) |
— |
$2,566 |
— |
| Septoplasty/Submucous Resecj W/WO Cartilage Grf (30520) |
— |
$4,908 |
— |
| Severing Ads Ant Seg Incal Spx Ant Synechiae (65870) |
— |
$4,908 |
— |
| Severing Ads Ant Seg Incal Spx Post Synechiae (65875) |
— |
$4,908 |
— |
| Severing tarsorrhaphy (67710) |
— |
$2,566 |
— |
| Sgmdsc flx dired sbmcsl njx any sbst (45335) |
— |
$2,566 |
— |
| Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) |
— |
$2,566 |
— |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) |
— |
$8,927 |
— |
| Shoulder arthroscopy (29820) |
— |
$4,020 |
— |
| Shoulder arthroscopy diagnostic (29805) |
— |
$4,020 |
— |
| Shoulder Arthroscopy/Surgery (29825) |
— |
$4,020 |
— |
| Shoulder joint surgery (23101) |
— |
$8,927 |
— |
| Sialot Submndblr Sublngl/Prtd Uncomp Intraoral (42330) |
— |
$2,566 |
— |
| Sigmoidoscopy & Polypectomy (45333) |
— |
$2,566 |
— |
| Sigmoidoscopy flx tndsc balo dilat (45340) |
— |
$2,566 |
— |
| Sigmoidoscopy Flx With With Band Ligation(S) (45350) |
— |
$2,566 |
— |
| Sigmoidoscopy w/fb removal (45332) |
— |
$2,566 |
— |
| Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) |
— |
$2,566 |
— |
| Sigmoidoscopy,Flex,W/Control,Bleeding (45334) |
— |
$2,566 |
— |
| Simple Cystometrogram (51725) |
— |
$2,566 |
— |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
— |
$3,460 |
— |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
— |
$8,927 |
— |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
— |
$8,927 |
— |
| Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) |
— |
$3,460 |
— |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
— |
$2,566 |
— |
| Simple Repair F/E/E/N/L/M >30.0 Cm (12018) |
— |
$3,460 |
— |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
— |
$2,566 |
— |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
— |
$3,460 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$2,566 |
— |
| Sinusotomy Maxillary Rad W/O Rmvl Antroch Polyps (31030) |
— |
$4,020 |
— |
| Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) with removal of antrochoanal polyps Facility (31032) |
— |
$4,908 |
— |
| Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid) Facility (31090) |
— |
$3,502 |
— |
| Skin Full Grft Face/Genit/Hf (15240) |
— |
$4,020 |
— |
| Skin sub graft face/nk/hf/g (15275) |
— |
$3,460 |
— |
| Skin sub graft trnk/arm/leg (15271) |
— |
$3,460 |
— |
| Skin Tissue Procedure (17999) |
— |
$2,566 |
— |
| Sling operation for stress incontinence (eg, fascia or synthetic) (57288) |
— |
$3,502 |
— |
| Slitting of prepuce (54001) |
— |
$3,460 |
— |
| Small Bowel Endoscopy,Ablate Lesn - Enteroscopy (44369) |
— |
$3,460 |
— |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
— |
$8,927 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
— |
$3,460 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
— |
$3,460 |
— |
| Sphincterotomy anal division sphincter spx (46080) |
— |
$4,020 |
— |
| Spinal puncture lumbar diagnostic (62270) |
— |
$1,331.10 |
— |
| Split Agrft F/S/N/H/F/G/M/D Gt 1st 100 Cm/</1 % (15120) |
— |
$3,460 |
— |
| Split Agrft T/a/L 1st 100 Cm/&/1% Bdy Inft/Chld (15100) |
— |
$3,460 |
— |
| Stab phlebt varicose veins 1 xtr 10-20 stab incs (37765) |
— |
$4,020 |
— |
| Strabismus Recession/Rescj 1 Hrzntl Musc (67311) |
— |
$4,020 |
— |
| Strapping ankle (29540) |
— |
$2,890 |
— |
| Strapping elbow or wrist (29260) |
— |
$2,890 |
— |
| Strapping hand/finger (29280) |
— |
$2,890 |
— |
| Strapping Hip (29520) |
— |
$2,890 |
— |
| Strapping knee (29530) |
— |
$2,890 |
— |
| Strapping shoulder (29240) |
— |
$2,890 |
— |
| Strapping toes (29550) |
— |
$2,890 |
— |
| Submucosal abltj tongue rf 1/> sites pr session (41530) |
— |
$2,566 |
— |
| Submucous Rescj Inferior Turbinate Prtl/Compl (30140) |
— |
$3,460 |
— |
| Suction assisted lipectomy; trunk (15877) |
— |
$4,020 |
— |
| Suction assisted lipectomy; upper extremity (15878) |
— |
$4,020 |
— |
| Suction Lipectomy Lwr Extrem (15879) |
— |
$4,020 |
— |
| Surg Clsr Tracheostomy/Fistula W/O Plastic Rpr (31820) |
— |
$2,566 |
— |
| Surg Implnt Neuroelect,Epidural (63655) |
— |
$6,695 |
— |
| Surg Tx Anal Fistula 2nd Stage (46285) |
— |
$2,566 |
— |
| Surg tx anal fistula subq (46270) |
— |
$4,020 |
— |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric (46275) |
— |
$4,020 |
— |
| Suture digital nerve hand/foot 1 nerve (64831) |
— |
$4,908 |
— |
| Suture infrapatellar tendon primary (27380) |
— |
$2,566 |
— |
| Suture Iris Ciliary Body Spx Retrieval Suture (66682) |
— |
$3,460 |
— |
| Suture of facial nerve; extracranial Facility (64864) |
— |
$4,020 |
— |
| Suture of quadriceps or hamstring muscle rupture primary (27385) |
— |
$4,020 |
— |
| Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft Facility (27386) |
— |
$4,020 |
— |
| Suture of; lumbar plexus Facility (64862) |
— |
$4,020 |
— |
| Suture/repair testicular injury (54670) |
— |
$4,020 |
— |
| Synovectomy Tendon Sheath Foot Flexor (28086) |
— |
$3,460 |
— |
| Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit Facility (26135) |
— |
$4,908 |
— |
| Synvct tdn shth rad flxr tdn palm&/fngr ea tdn (26145) |
— |
$4,020 |
— |
| Talectomy (astragalectomy) Facility (28130) |
— |
$4,020 |
— |
| Tenodesis long tendon biceps (23430) |
— |
$4,908 |
— |
| Tenolysis extensor foot single tendon (28225) |
— |
$2,566 |
— |
| Tenolysis flexor foot single tendon (28220) |
— |
$3,460 |
— |
| Tenolysis flexor tendon palm&finger each tendo (26442) |
— |
$4,020 |
— |
| Tenolysis flexor tendon palm/finger each tendon (26440) |
— |
$4,020 |
— |
| Tenolysis, extensor tendon, hand or finger, each tendon (26445) |
— |
$4,020 |
— |
| Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon (25295) |
— |
$4,020 |
— |
| Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incisionºs») Facility (27681) |
— |
$3,460 |
— |
| Tenotomy Hip Abd/Ext Open (27006) |
— |
$4,908 |
— |
| Tenotomy Percutaneous Toe Single Tendon (28010) |
— |
$3,460 |
— |
| Tenotomy shoulder area single tendon (23405) |
— |
$3,460 |
— |
| Tenotomy, Percutaneous, Toe; Multiple Tendons (28011) |
— |
$4,020 |
— |
| Therapeutic plasma exchange (36514) |
— |
$4,353.48 |
— |
| Therapeutic pneumothorax (32960) |
— |
$8,927 |
— |
| Thoracoscopy w/bx pleura (32609) |
— |
$4,020 |
— |
| Thrmbc Artl/Ven Grf Oth/Thn Hemo Grf/Fstl (35875) |
— |
$11,189.94 |
— |
| Thrmbc Opn Arven Fstl W/O Revj Dial Grf (36831) |
— |
$8,927 |
— |
| Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral (35372) |
— |
$3,502 |
— |
| Thrombolytic Art Therapy (37211) |
— |
$12,171.30 |
— |
| Thrombolytic Therapy Stroke (37195) |
— |
$1,152.75 |
— |
| Thumb fusion with graft (26842) |
— |
$4,908 |
— |
| Thyroid biopsy (60100) |
— |
$1,095.33 |
— |
| Thyroidectomy, total or complete (60240) |
— |
$8,927 |
— |
| Thyroidectomy, total or subtotal for malignancy; with limited neck dissection (60252) |
— |
$8,927 |
— |
| Tis Trnfr E/N/E/L 10 Sq Cm/< (14060) |
— |
$4,020 |
— |
| Tissue Expander Placement Breast Reconstruction (19357) |
— |
$3,502 |
— |
| Tlh uterus over 250 g (58572) |
— |
$6,695 |
— |
| Tnot elbow lateral/medial debride open (24358) |
— |
$4,020 |
— |
| Tnot elbow lateral/medial debride open tdn rpr (24359) |
— |
$4,020 |
— |
| Tonsillectomy and adenoidectomy; age 12 or over (42821) |
— |
$3,502 |
— |
| Tooth extraction (41899) |
— |
$2,566 |
— |
| Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than… (22857) |
— |
$6,695 |
— |
| Total Knee Arthroplasty (27447) |
— |
$6,695 |
— |
| Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy Facility (60225) |
— |
$4,020 |
— |
| Trabeculoplasty by laser surgery (65855) |
— |
$3,460 |
— |
| Tracheobrnchsc Thru Est Trachs Inc (31615) |
— |
$2,566 |
— |
| Tracheostoma Revj Cplx W/Flap Rotation (31614) |
— |
$3,460 |
— |
| Tracheostoma revj smpl w/o flap rotation (31613) |
— |
$3,460 |
— |
| Tracheostomy Emergency Cricothyroid Membrane (31605) |
— |
$2,566 |
— |
| Tracheostomy Emergency Procedure Transtracheal (31603) |
— |
$2,566 |
— |
| Tracheostomy Fenestration W/Skin Flaps (31610) |
— |
$8,927 |
— |
| Tracheostomy planned (31600) |
— |
$3,460 |
— |
| Transection/Avulsion Oth Spinal Nrv Xdrl (64772) |
— |
$3,460 |
— |
| Transfer skin pedicle flap (15650) |
— |
$3,502 |
— |
| Transfusion Intrauterine Fetal (36460) |
— |
$2,566 |
— |
| Transrectal abltj mal prst8 tissue hifu w/us (55880) |
— |
$3,460 |
— |
| Transur electr resection of prostate (52601) |
— |
$4,908 |
— |
| Transurethral resection bladder neck (52500) |
— |
$4,020 |
— |
| Treat ankle fracture (28445) |
— |
$4,020 |
— |
| Treat Big Toe Fracture (28505) |
— |
$4,020 |
— |
| Treat ectopic pregnancy (59151) |
— |
$4,908 |
— |
| Treat elbow fracture (24586) |
— |
$4,908 |
— |
| Treat Finger Fracture Each (26727) |
— |
$8,927 |
— |
| Treat fracture radius/ulna (25575) |
— |
$4,020 |
— |
| Treat Fx Rad Extra-Articul (25607) |
— |
$3,502 |
— |
| Treat Humerus Fracture (24505) |
— |
$2,566 |
— |
| Treat humerus fracture (23600) |
— |
$2,566 |
— |
| Treat knee fracture (27532) |
— |
$2,566 |
— |
| Treat Kneecap Fracture (27524) |
— |
$4,020 |
— |
| Treat Knuckle Dislocation (26700) |
— |
$8,927 |
— |
| Treat Metatarsal Fracture (28475) |
— |
$2,566 |
— |
| Treat Thumb Dislocation (26641) |
— |
$8,927 |
— |
| Treat thumb fracture (26665) |
— |
$4,908 |
— |
| Treat toe dislocation (28630) |
— |
$2,566 |
— |
| Treatment Closed Elbow Dislocation Req Anes (24605) |
— |
$3,460 |
— |
| Treatment closed elbow dislocation w/o anes (24600) |
— |
$2,566 |
— |
| Treatment mouth roof lesion (42160) |
— |
$2,566 |
— |
| Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant,… (27244) |
— |
$3,502 |
— |
| Treatment of nose fracture (21330) |
— |
$3,502 |
— |
| Treatment of tibia fracture (27756) |
— |
$4,020 |
— |
| Trim skin lesion (11055) |
— |
$2,566 |
— |
| Trim skin lesions 2 to 4 (11056) |
— |
$2,566 |
— |
| Trim skin lesions over 4 (11057) |
— |
$2,566 |
— |
| Trimming Nondystrophic Nails Any Number (11719) |
— |
$8,927 |
— |
| Trluml Balo Angiop 1St Art (37246) |
— |
$15,605.19 |
— |
| Trnsplj Hematopoietic Cell Boost (38243) |
— |
$2,566 |
— |
| Tubal ligation (58600) |
— |
$3,460 |
— |
| Tx anal fstl trans/supra/xtrasphnctrc incl seton (46280) |
— |
$4,908 |
— |
| Tx humral shaft fx w/insj imed implt w/w cerclge (24516) |
— |
$4,908 |
— |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
— |
$3,502 |
— |
| Tx inter/pr/subtrchntric fem fx imed impltscrew (27245) |
— |
$3,502 |
— |
| Tx Missed Abortion First Trimester Surgical (59820) |
— |
$3,502 |
— |
| Tx open tendon flexor toe 1 tendon spx (28232) |
— |
$3,460 |
— |
| Tx Opn Tendon Flexor Foot Single/Mult Tendon Spx (28230) |
— |
$3,460 |
— |
| Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) |
— |
$4,020 |
— |
| Tx Superficial Wound Dehiscence Simple Closure (12020) |
— |
$2,566 |
— |
| Tx superficial wound dehiscence w/packing (12021) |
— |
$2,566 |
— |
| Tx tibl shft fx imed implt w/wo screws&/cercla (27759) |
— |
$4,908 |
— |
| Tympanic Memb Rpr W/WO Prepj Perfor Patch (69610) |
— |
$4,020 |
— |
| Tympanoplasty (69631) |
— |
$3,502 |
— |
| Tympanostomy general anesthesia (69436) |
— |
$4,020 |
— |
| Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) Facility (49250) |
— |
$4,908 |
— |
| Unlisted Cardiac Surgery (33999) |
— |
$8,927 |
— |
| Unlisted Craniofacial & Maxillofacial Procedure (21299) |
— |
$8,927 |
— |
| Unlisted laparoscopic procedure liver (47379) |
— |
$3,502 |
— |
| Unlisted laparoscopy procedure oviduct ovary (58679) |
— |
$4,020 |
— |
| Unlisted laparoscopy procedure, abdomen, peritoneum and omentum (49329) |
— |
$2,566 |
— |
| Unlisted laparoscopy procedure, biliary tract (47579) |
— |
$4,020 |
— |
| Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy (49659) |
— |
$3,502 |
— |
| Unlisted laparoscopy procedure, lymphatic system (38589) |
— |
$4,020 |
— |
| Unlisted laparoscopy procedure, uterus (58578) |
— |
$4,020 |
— |
| Unlisted procedure anus (46999) |
— |
$2,566 |
— |
| Unlisted procedure arthroscopy (29999) |
— |
$2,566 |
— |
| Unlisted Procedure Biliary Tract (47999) |
— |
$8,927 |
— |
| Unlisted Procedure Casting/Strapping (29799) |
— |
$786 |
— |
| Unlisted Procedure Conjunctiva (68399) |
— |
$8,927 |
— |
| Unlisted Procedure Endocrine System (60699) |
— |
$7,506.36 |
— |
| Unlisted Procedure Esophagus (43499) |
— |
$2,566 |
— |
| Unlisted procedure excision pressure ulcer (15999) |
— |
$8,927 |
— |
| Unlisted Procedure External Ear (69399) |
— |
$8,927 |
— |
| Unlisted procedure femur or knee (27599) |
— |
$2,566 |
— |
| Unlisted procedure foot or toes (28899) |
— |
$2,566 |
— |
| Unlisted procedure forearm or wrist (25999) |
— |
$2,566 |
— |
| Unlisted Procedure Hands/Fingers (26989) |
— |
$2,566 |
— |
| Unlisted procedure humerus/elbow (24999) |
— |
$2,566 |
— |
| Unlisted Procedure Intestine (44799) |
— |
$2,698.74 |
— |
| Unlisted procedure larynx (31599) |
— |
$2,566 |
— |
| Unlisted Procedure Leg/Ankle (27899) |
— |
$2,566 |
— |
| Unlisted procedure lungs and pleura (32999) |
— |
$8,927 |
— |
| Unlisted Procedure Male Genital System (55899) |
— |
$3,460 |
— |
| Unlisted Procedure Muscskeletal System General (20999) |
— |
$1,184.94 |
— |
| Unlisted procedure nervous system (64999) |
— |
$14,259.30 |
— |
| Unlisted Procedure Palate Uvula (42299) |
— |
$8,927 |
— |
| Unlisted procedure pelvis/hip joint (27299) |
— |
$2,566 |
— |
| Unlisted Procedure Pharynx Adenoids/Tonsils (42999) |
— |
$2,566 |
— |
| Unlisted Procedure Rectum (45999) |
— |
$8,927 |
— |
| Unlisted procedure shoulder (23929) |
— |
$2,566 |
— |
| Unlisted procedure spine (22899) |
— |
$2,566 |
— |
| Unlisted procedure stomach (43999) |
— |
$2,566 |
— |
| Unlisted Procedure Tongue Floor Mouth (41599) |
— |
$8,927 |
— |
| Unlisted Procedure Trachea Bronchi (31899) |
— |
$2,566 |
— |
| Unlisted Procedure Vascular Surgery (37799) |
— |
$3,460 |
— |
| Unlisted procedure, abdomen, peritoneum and omentum (49999) |
— |
$3,239.01 |
— |
| Unlisted Procedure, Urinary System (53899) |
— |
$2,566 |
— |
| Unlisted procedure, vestibule of mouth (40899) |
— |
$3,502 |
— |
| Unlisted px female genital system nonobstetrical (58999) |
— |
$2,566 |
— |
| Unlisted Px Salivary Glands/Ducts (42699) |
— |
$2,566 |
— |
| Urethrlys Transvag W/ Scope (53500) |
— |
$3,502 |
— |
| Uvulectomy excision of uvula (42140) |
— |
$3,460 |
— |
| Vaginal delivery only (59409) |
— |
$2,566 |
— |
| Vaginal hysterectomy, for uterus 250 g or less; (58260) |
— |
$3,502 |
— |
| Vaginal hysterectomy; with removal of tube(s), and/or ovary(s) (58262) |
— |
$3,502 |
— |
| Vasectomy uni/bi spx w/postop semen exams (55250) |
— |
$3,460 |
— |
| Venous Cutdown >1 Y/O (36425) |
— |
$963.96 |
— |
| Venous Mech Thrombectomy (37187) |
— |
$13,529.37 |
— |
| Venous valve transposition, any vein donor Facility (34510) |
— |
$8,927 |
— |
| Ventilating tube removal requiring general anesthesia (69424) |
— |
$2,566 |
— |
| Vulvectomy simple partial (56620) |
— |
$3,502 |
— |
| Wedge excision skin nail fold (11765) |
— |
$2,566 |
— |
| Wound Prep F/N/Hf/G (15004) |
— |
$3,460 |
— |
| Wound Prep Trk/Arm/Leg (15002) |
— |
$3,460 |
— |
| Xfer Single Deep Low Leg Tendon (27691) |
— |
$4,908 |
— |