| Abd paracentesis w/imaging (49083) |
— |
$1,939.60 |
— |
| Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) |
— |
$1,628.75 |
— |
| Amputation Finger/Thumb (26951) |
— |
$2,606 |
— |
| Amputation metatarsal with toe single (28810) |
— |
$1,954.50 |
— |
| Amputation of finger/thumb (26952) |
— |
$1,303 |
— |
| Amputation toe interphalangeal joint (28825) |
— |
$1,954.50 |
— |
| Amputation Toe Metatarsophalangeal Joint (28820) |
— |
$1,303 |
— |
| Amputation, foot; transmetatarsal (28805) |
— |
$1,791.62 |
— |
| Amputation, leg, through tibia and fibula; (27880) |
— |
$2,424.72 |
— |
| Ankle Scope,Excis Osteochon Defct (29891) |
— |
$2,942 |
— |
| Anoscopy; with biopsy, single or multiple (46606) |
— |
$1,954.50 |
— |
| Anrct xm surg req anes general spi/edrl dx (45990) |
— |
$200.51 |
— |
| Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele (57240) |
— |
$2,768.88 |
— |
| Appendectomy (44950) |
— |
$1,203.46 |
— |
| Application cast elbow finger short arm (29075) |
— |
$206 |
— |
| Application cast shoulder hand long arm (29065) |
— |
$165 |
— |
| Application finger splint static (29130) |
— |
$238 |
— |
| Application long arm splint shoulder hand (29105) |
— |
$247 |
— |
| Application long leg splint thigh ankle/toes (29505) |
— |
$321 |
— |
| Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system (20690) |
— |
$819.68 |
— |
| Application short arm splint forearm-hand static (29125) |
— |
$112 |
— |
| Application short leg splint calf foot (29515) |
— |
$271 |
— |
| Apply short leg cast (29405) |
— |
$160 |
— |
| Arterial puncture (36600) |
— |
$135 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
— |
$118 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/us (20606) |
— |
$177 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
— |
$195 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
— |
$375 |
— |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
— |
$375.75 |
— |
| Arthrodesis ankle open (27870) |
— |
$4,886.25 |
— |
| Arthrodesis great toe interphalangeal joint (28755) |
— |
$3,257.50 |
— |
| Arthrodesis, great toe; metatarsophalangeal joint (28750) |
— |
$2,931.75 |
— |
| Arthrodesis; subtalar (28725) |
— |
$5,537.75 |
— |
| Arthroplasty glenohumeral joint total shoulder (23472) |
— |
$8,751.75 |
— |
| Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction (29888) |
— |
$3,257.50 |
— |
| Arthroscopy ankle; ext debridem (29898) |
— |
$1,961.33 |
— |
| Arthroscopy of joint (29999) |
— |
$1,875.75 |
— |
| Arthroscopy, knee, surgical; abrasion arthroplasty or multiple drilling or microfracture (29879) |
— |
$1,954.50 |
— |
| Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) (29877) |
— |
$2,378.75 |
— |
| Arthroscopy, knee, surgical; for removal of loose body or foreign body (29874) |
— |
$1,954.50 |
— |
| Arthroscopy, Knee, Surgical; Osteochondral Autograft(S) (Eg, Mosaicplasty) (Includes Harvesting Of The Autograft) (29866) |
— |
$2,171.68 |
— |
| Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (29875) |
— |
$2,138.86 |
— |
| Arthroscopy, knee, surgical; with lateral release (29873) |
— |
$1,206 |
— |
| Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty (29880) |
— |
$2,870.50 |
— |
| Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) |
— |
$3,909 |
— |
| Arthroscopy, shoulder, surgical; biceps tenodesis (29828) |
— |
$2,171.66 |
— |
| Arthroscopy, shoulder, surgical; capsulorrhaphy (29806) |
— |
$2,606 |
— |
| Arthroscopy, shoulder, surgical; debridement, extensive (29823) |
— |
$1,381.80 |
— |
| Arthroscopy, shoulder, surgical; debridement, limited (29822) |
— |
$1,132 |
— |
| Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (29824) |
— |
$2,275.58 |
— |
| Arthroscopy, shoulder, surgical; repair of slap lesion (29807) |
— |
$1,319.52 |
— |
| Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) |
— |
$2,280.25 |
— |
| Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies (27331) |
— |
$3,257.50 |
— |
| Arthrp intercarpal/carp/mtcrpl jt suspension (25448) |
— |
$3,612.41 |
— |
| Arthrt w/expl drg/rmvl loose/fb mttarphlngl jt (28022) |
— |
$1,873.06 |
— |
| Artificial insemination (58322) |
— |
$622.14 |
— |
| Aspirat/Injection Ganglion Cyst(S) (20612) |
— |
$272 |
— |
| Avulsion nail plate partial/complete simple 1 (11730) |
— |
$313 |
— |
| Biopsy bone open superficial (20240) |
— |
$488.63 |
— |
| Biopsy bone trocar/needle deep (20225) |
— |
$2,308 |
— |
| Biopsy Breast Open Incisional (19101) |
— |
$1,303 |
— |
| Biopsy Cervix Single/Mult/Excision Of Lesion Spx (57500) |
— |
$1,954.50 |
— |
| Biopsy muscle percutaneous needle (20206) |
— |
$2,580.94 |
— |
| Biopsy of uterus lining (58100) |
— |
$186 |
— |
| Biopsy or excision of lymph node(s); open, superficial (38500) |
— |
$1,954.50 |
— |
| Biopsy Salivary Gland,Needle (42400) |
— |
$2,221.91 |
— |
| Biopsy Soft Tissue Thigh/Knee Area Deep (27324) |
— |
$2,527.50 |
— |
| Biopsy/removal lymph nodes (38525) |
— |
$1,954.50 |
— |
| Bladder Irrigation Simple (51700) |
— |
$400 |
— |
| Bladder Scan (51798) |
— |
$141 |
— |
| Blood patch (62273) |
— |
$1,480 |
— |
| Blood transfusion service (36430) |
— |
$2,014 |
— |
| Bone Marrow Biopsy (38221) |
— |
$2,560.75 |
— |
| Bx abdl/retroperitoneal mass prq needle (49180) |
— |
$1,610.50 |
— |
| Bx breast 1st lesion strtctc (19081) |
— |
$3,908 |
— |
| Bx breast 1st lesion us imag (19083) |
— |
$2,240.50 |
— |
| Bx vulva/perineum 1 lesion (56605) |
— |
$170 |
— |
| Bx/exc lymph node needle superficial (38505) |
— |
$1,319.96 |
— |
| Canthotomy Separate Procedure (67715) |
— |
$2,174 |
— |
| Capsul mttarphlngl jt w/wo tenorrhaphy ea jt spx (28270) |
— |
$1,003.82 |
— |
| Capsulotomy; interphalangeal joint, each joint (28272) |
— |
$814.38 |
— |
| Catheter Aspiration Nasotracheal Spx (31720) |
— |
$244 |
— |
| Cerclage cervix pregnancy vaginal (59320) |
— |
$1,303 |
— |
| Chest tube placement (32551) |
— |
$1,000 |
— |
| Chromotubation of oviduct, including materials (58350) |
— |
$2,414.54 |
— |
| Circum 28 days or older (54161) |
— |
$3,257.50 |
— |
| Claviculectomy; partial (23120) |
— |
$1,516.65 |
— |
| Closed Rx Gr Tuberosity Hum Fx (23620) |
— |
$560 |
— |
| Closed Rx Humeral Supracondylar Fx (24530) |
— |
$745 |
— |
| Closed Rx Med Malleolus Fx (27760) |
— |
$650 |
— |
| Closed Rx Mid Humerus Fx,Manipulatn (24505) |
— |
$1,830.25 |
— |
| Closed Rx Rad/Ulna Shaft Fx,Manip (25565) |
— |
$1,491.50 |
— |
| Closed Rx Radial Shaft Fx (25500) |
— |
$246 |
— |
| Closed Rx Tibia Shaft Fx (27750) |
— |
$695 |
— |
| Closed Rx Tibial Plateau Fx (27530) |
— |
$805 |
— |
| Closed Rx Trimalleolar Fx (27816) |
— |
$1,201.81 |
— |
| Closed treatment of humeral condylar fracture, medial or lateral; without manipulation (24576) |
— |
$952.68 |
— |
| Closed Treatment Pst Malleolus Fracture W/O Manj (27767) |
— |
$600 |
— |
| Closed Treatment Ulnar Styloid Fracture (25650) |
— |
$979.64 |
— |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) |
— |
$2,197.66 |
— |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) |
— |
$640 |
— |
| Closed Tx Femoral Shaft Fx W/O Manipulation (27500) |
— |
$1,105 |
— |
| Closed tx knee dislocation w/o anesthesia (27550) |
— |
$876 |
— |
| Closed tx metatarsal fracture w/o manipulation (28470) |
— |
$890 |
— |
| Closed Tx Monteggia Fx Dislocation Elbow W/Manj (24620) |
— |
$2,464.66 |
— |
| Closed tx patellar dislocation w/o anesthesia (27560) |
— |
$834 |
— |
| Closed tx patellar fracture w/o manipulation (27520) |
— |
$625 |
— |
| Closed tx radial head/neck fx w/o manipulation (24650) |
— |
$485 |
— |
| Closed tx radial shaft fracture w/manipulation (25505) |
— |
$1,713 |
— |
| Closed tx scapular fracture w/o manipulation (23570) |
— |
$505 |
— |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
— |
$525 |
— |
| Closed Tx Ulnar Fracture Prox End W Manipulation (24675) |
— |
$1,498.37 |
— |
| Closed tx ulnar fracture prox end w/o manipulate (24670) |
— |
$555 |
— |
| Closed tx ulnar shaft fracture w/o manipulation (25530) |
— |
$485 |
— |
| Closure of gastrostomy surgical (43870) |
— |
$1,332.17 |
— |
| Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) |
— |
$1,954.50 |
— |
| Clsd tx clavicular fracture w/o manipulation (23500) |
— |
$460 |
— |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
— |
$1,795 |
— |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
— |
$696 |
— |
| Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) |
— |
$544.87 |
— |
| Cltx dstl fibular fx lat malls w/manj (27788) |
— |
$1,173 |
— |
| Cltx dstl fibular fx lat malls w/o manj (27786) |
— |
$615 |
— |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) |
— |
$787 |
— |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
— |
$555 |
— |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
— |
$1,557.03 |
— |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) |
— |
$1,645.60 |
— |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) |
— |
$1,706.50 |
— |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
— |
$382 |
— |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) |
— |
$660 |
— |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
— |
$765 |
— |
| Cltx metacarpal fx w/manipulation each bone (26605) |
— |
$943 |
— |
| Cltx metacarpal fx w/o manipulation each bone (26600) |
— |
$1,367.62 |
— |
| Cltx metacarpophalangeal dislc w/manj w/o anes (26700) |
— |
$736 |
— |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
— |
$735 |
— |
| Cltx post hip arthrp dislc w/o anes (27265) |
— |
$859 |
— |
| Cltx prox fibula/shft fx w/o manj (27780) |
— |
$580 |
— |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
— |
$388.50 |
— |
| Cltx tibial shaft fx w/manj w/wo skel tracj (27752) |
— |
$2,274 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$2,403.16 |
— |
| Colonoscopy flex w/rem forcep (45384) |
— |
$1,478.62 |
— |
| Colonoscopy Flexible With Decompression - Colonoscopy (45393) |
— |
$640 |
— |
| Colonoscopy w/ablation (45388) |
— |
$2,020 |
— |
| Colonoscopy w/band ligation (45398) |
— |
$2,240 |
— |
| Colonoscopy w/resection (45390) |
— |
$2,160 |
— |
| Colporrhaphy suture injury vagina (57200) |
— |
$6,820.95 |
— |
| Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) |
— |
$314 |
— |
| Colposcopy cervix vag loop eltrd bx cervix (57460) |
— |
$1,954.50 |
— |
| Colposcopy entire vagina w/cervix if present (57420) |
— |
$242 |
— |
| Colposcopy,Entire Vagina,W/Biopsy(S) (57421) |
— |
$324 |
— |
| Colsc Flexible W/Control Bleeding Any Method - Colonoscopy (45382) |
— |
$1,122.50 |
— |
| Colsc flx with directed submucosal njx any sbst (45381) |
— |
$1,200 |
— |
| Complex Drainage, Wound (10180) |
— |
$3,651.50 |
— |
| Conization of cervix (57520) |
— |
$4,303 |
— |
| Conization of cervix (57522) |
— |
$2,280.25 |
— |
| Control Nasal Hemorrhage Anterior Simple (30901) |
— |
$252.50 |
— |
| Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft (27132) |
— |
$5,916.96 |
— |
| Core Needle Bx Lung/Mediastinum Perq W/Img (32408) |
— |
$2,773.87 |
— |
| Correction hammertoe (28285) |
— |
$1,465.88 |
— |
| Correction of bunion (28298) |
— |
$1,791.62 |
— |
| Correction of bunion (28292) |
— |
$2,443.12 |
— |
| Correction of bunion (28299) |
— |
$5,863.50 |
— |
| Correction of bunion (28297) |
— |
$4,886.25 |
— |
| Corrj hallux valgus w/sesmdc w/dist metar osteot (28296) |
— |
$1,954.50 |
— |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
— |
$481.42 |
— |
| Curettage postpartum (59160) |
— |
$2,606 |
— |
| Cystourethroscopy (52000) |
— |
$1,954.50 |
— |
| Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) |
— |
$3,196.99 |
— |
| Debride Assoc Open Fx/Disloc Skin/Subq (11010) |
— |
$660 |
— |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
— |
$1,351.50 |
— |
| Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) |
— |
$1,085.84 |
— |
| Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) |
— |
$2,151.50 |
— |
| Declot vascular device (36593) |
— |
$2,089.07 |
— |
| Decompression of tibia nerve (28035) |
— |
$1,628.75 |
— |
| Delay flap trunk (15600) |
— |
$689.88 |
— |
| Destroy cerv/thor facet jnt (64633) |
— |
$531.25 |
— |
| Destroy lumb/sac facet jnt (64635) |
— |
$532.50 |
— |
| Destruction Benign Lesions Up To 14 (17110) |
— |
$223 |
— |
| Destruction neurolytic agt genicular nerve w/img (64624) |
— |
$405 |
— |
| Diagnostic sigmoidoscopy (45330) |
— |
$2,020 |
— |
| Dilation & curettage dx&/ther nonobstetric (58120) |
— |
$868.68 |
— |
| Dilation esoph unguided sound/bougie 1/mult pass (43450) |
— |
$1,275.42 |
— |
| Dilation of anal sphincter (45905) |
— |
$1,303 |
— |
| Drain hand tendon sheath (26020) |
— |
$1,303 |
— |
| Drain/inj small joint/bursa w/us (20604) |
— |
$150 |
— |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
— |
$793 |
— |
| Drainage Finger Abscess Complicated (26011) |
— |
$3,495 |
— |
| Drainage Finger Abscess Simple (26010) |
— |
$626.24 |
— |
| Drainage of eyelid abscess (67700) |
— |
$3,235.50 |
— |
| Drainage of gum lesion (41800) |
— |
$479.08 |
— |
| Drainage of hematoma/fluid (10140) |
— |
$2,184.25 |
— |
| Drainage of scrotal wall abscess (55100) |
— |
$1,462.12 |
— |
| Draw blood off venous device (36591) |
— |
$1,063.50 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
— |
$731.50 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
— |
$382 |
— |
| Dstrj lesion anus simple chemical (46900) |
— |
$474 |
— |
| Egd Ablate Tumor Polyp/Lesion W/Dilation& Wire - Egd (43270) |
— |
$2,933 |
— |
| Egd Balloon Dil Esoph30 Mm/> (43233) |
— |
$2,220 |
— |
| Egd balloon dilation esophagus <30 mm diam (43249) |
— |
$1,537.94 |
— |
| Egd Dilation Gastric/Duodenal Stricture - Egd (43245) |
— |
$1,613.75 |
— |
| Egd flexible foreign body removal (43247) |
— |
$2,730 |
— |
| Egd place gastrostomy tube (43246) |
— |
$3,300 |
— |
| Egd remove lesion snare (43251) |
— |
$935.85 |
— |
| Egd Transoral Control Bleeding Any Method - Egd (43255) |
— |
$1,350.10 |
— |
| Egd tube/cath insertion (43241) |
— |
$271.58 |
— |
| Egd Varices Ligation (43244) |
— |
$1,761.32 |
— |
| Endometrial abltj thermal w/o hysteroscopic guid (58353) |
— |
$1,095.48 |
— |
| Ercp Duct Stent Placement (43274) |
— |
$1,250 |
— |
| Ercp lithotripsy calculi (43265) |
— |
$1,863.34 |
— |
| Ercp Remove Calculi/Debris Biliary/Pancreas Duct - Ercp (43264) |
— |
$1,875 |
— |
| Ercp remove forgn body duct (43275) |
— |
$2,500 |
— |
| Ercp Stent Exchange W/Dilate (43276) |
— |
$373.51 |
— |
| Ercp w/sphincterotomy/papillotomy (43262) |
— |
$814.67 |
— |
| Esophagogastroduodenoscopy submucosal injection (43236) |
— |
$848.62 |
— |
| Evacuation of subungual hematoma (11740) |
— |
$168 |
— |
| Ex tum/vasc malf sft tiss hand/fngr subq 1.5cm/> (26111) |
— |
$1,303 |
— |
| Exc abd les sc 3 cm/> (22903) |
— |
$1,303 |
— |
| Exc arm/elbow les sc < 3 cm (24075) |
— |
$1,303 |
— |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) |
— |
$1,162.64 |
— |
| Exc back les sc < 3 cm (21930) |
— |
$2,737.34 |
— |
| Exc back tum deep < 5 cm (21932) |
— |
$1,954.50 |
— |
| Exc face les sbq 2 cm/> (21012) |
— |
$1,776.82 |
— |
| Exc Face-Mm B9+Marg 0.5 Cm/< (11440) |
— |
$284 |
— |
| Exc hand les sc < 1.5 cm (26115) |
— |
$1,303 |
— |
| Exc hydrocele sprmatic cord uni spx (55500) |
— |
$2,606 |
— |
| Exc ischial pressure ulcer w/primary suture (15940) |
— |
$4,220 |
— |
| Exc neck tum deep < 5 cm (21556) |
— |
$1,068.78 |
— |
| Exc shoulder les sc 3 cm/> (23071) |
— |
$1,303 |
— |
| Exc shoulder tum deep 5 cm/> (23073) |
— |
$3,909 |
— |
| Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) |
— |
$296.20 |
— |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
— |
$393 |
— |
| Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg (11404) |
— |
$977.25 |
— |
| Exc Skin Benig >4 Cm Remaindr Body (11426) |
— |
$1,109.22 |
— |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
— |
$1,954.50 |
— |
| Exc Skin Malig >4 Cm Remaindr Body (11626) |
— |
$1,848.58 |
— |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) |
— |
$4,303 |
— |
| Exc thigh/knee les sc 3 cm/> (27337) |
— |
$1,954.50 |
— |
| Exc thigh/knee tum dep 5cm/> (27339) |
— |
$1,406.37 |
— |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) |
— |
$423 |
— |
| Exc tumor soft tiss back/flank subfascial 5 cm/> (21933) |
— |
$1,303 |
— |
| Exc Tumor Soft Tiss Forearm&/Wrist Subfasc <3Cm (25076) |
— |
$1,303 |
— |
| Exc tumor soft tiss shoulder subfasc <5cm (23076) |
— |
$1,195.52 |
— |
| Exc tumor soft tissue abdl wall subfascial <5cm (22900) |
— |
$2,606 |
— |
| Exc tumor soft tissue abdominal wall subq <3cm (22902) |
— |
$904.23 |
— |
| Exc tumor soft tissue foot/toe subfasc 1.5+cm (28041) |
— |
$4,954.50 |
— |
| Exc tumor soft tissue leg/ankle subq <3cm (27618) |
— |
$1,080.43 |
— |
| Exc tumor soft tissue neck/ant thorax subq <3cm (21555) |
— |
$1,368.12 |
— |
| Exc/Curtg Cst/B9 Tum Phalanges Foot (28108) |
— |
$1,303 |
— |
| Excis Tendon Sheath Lesion, Hand/Finger (26160) |
— |
$1,191.26 |
— |
| Excision Breast Lesion (19125) |
— |
$3,257.50 |
— |
| Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) |
— |
$868.66 |
— |
| Excision of bartholin's gland or cyst (56740) |
— |
$2,606 |
— |
| Excision of ganglion, wrist (dorsal or volar); recurrent (25112) |
— |
$1,303 |
— |
| Excision of hydrocele; unilateral (55040) |
— |
$1,085.83 |
— |
| Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle (27630) |
— |
$1,050.74 |
— |
| Excision of lesion of tongue without closure (41110) |
— |
$1,954.50 |
— |
| Excision of lesion other than skin tag 1.1-2.0 cm (11422) |
— |
$1,064.75 |
— |
| Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cys (28090) |
— |
$1,237.85 |
— |
| Excision of pilonidal cyst or sinus; simple (11770) |
— |
$4,303 |
— |
| Excision of single external papilla or tag, anus (46220) |
— |
$402.96 |
— |
| Excision of skin/subcutaneous tissue for hidradenitis, axillary; w/ simple or interm repair (11450) |
— |
$1,667.02 |
— |
| Excision of thyroglossal duct cyst or sinus; recurrent (60281) |
— |
$5,148.50 |
— |
| Excision of vaginal cyst or tumor (57135) |
— |
$1,954.50 |
— |
| Excision olecranon bursa (24105) |
— |
$1,303 |
— |
| Excision pilonidal cyst/sinus complicated (11772) |
— |
$2,279.08 |
— |
| Excision Prepatellar Bursa (27340) |
— |
$1,514.84 |
— |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) |
— |
$1,400.49 |
— |
| Excision tumor soft tissue thigh/knee subq <3cm (27327) |
— |
$1,954.50 |
— |
| Excision, interdigital (Morton) neuroma, single, each (28080) |
— |
$1,954.50 |
— |
| Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater (21014) |
— |
$1,947.10 |
— |
| Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm (21011) |
— |
$868.66 |
— |
| Excision, tumor, soft tissue of forearm and/or wrist area, subfa scial (eg, intramuscular); 3 cm or greater (25073) |
— |
$1,954.50 |
— |
| Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm (23075) |
— |
$1,303 |
— |
| Exploration penetrating wound spx extremity (20103) |
— |
$1,467.72 |
— |
| Explore & Treat Metacarpo-Phal Jt (26075) |
— |
$1,954.50 |
— |
| External Cephalic Version (59412) |
— |
$412.38 |
— |
| Fasciectomy, plantar fascia; radical (separate procedure) (28062) |
— |
$1,085.83 |
— |
| Fetal non-stress test (59025) |
— |
$1,122.50 |
— |
| Fine needle aspiration bx w/us gdn 1st lesion (10005) |
— |
$854.10 |
— |
| Fine needle aspiration without imaging guidance (10021) |
— |
$586 |
— |
| Fixation of knee joint (27570) |
— |
$2,963.05 |
— |
| Fluid pressure muscle (20950) |
— |
$299.87 |
— |
| Fusion of foot bones (28730) |
— |
$4,560.50 |
— |
| Fusion of foot bones (28740) |
— |
$2,225.96 |
— |
| Gastrocnemius Recession (27687) |
— |
$1,628.75 |
— |
| Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury (43840) |
— |
$6,348.54 |
— |
| Guide Cathet Fluid Drainage (10030) |
— |
$1,324.90 |
— |
| Hallux rigidus w/cheilectomy 1st mp jt w/implt (28291) |
— |
$3,909 |
— |
| Hemorrhoidectomy (46255) |
— |
$3,977.25 |
— |
| Hemorrhoidectomy external complete (46250) |
— |
$2,151.50 |
— |
| Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling (46947) |
— |
$3,583.25 |
— |
| Hysteroscopy ablation (58563) |
— |
$1,791.62 |
— |
| Hysteroscopy biopsy (58558) |
— |
$2,606 |
— |
| Hysteroscopy dx sep proc (58555) |
— |
$1,225.83 |
— |
| Hysteroscopy Removal Impacted Foreign Body (58562) |
— |
$977.25 |
— |
| I&D Abscess Peritonsillar (42700) |
— |
$768.36 |
— |
| I&d abscess simple (10060) |
— |
$743.62 |
— |
| I&d deep absc bursa/hematoma thigh/knee region (27301) |
— |
$2,674.70 |
— |
| I&d perianal abscess superficial (46050) |
— |
$1,954.50 |
— |
| I&d pilonidal cyst simple (10080) |
— |
$640 |
— |
| Image Cath Fluid Colxn Visc (49405) |
— |
$3,538 |
— |
| Image Cath Fluid Peri/Retro (49406) |
— |
$3,658 |
— |
| Implant neuroelectrodes (63650) |
— |
$1,377 |
— |
| Incise finger tendon sheath (26055) |
— |
$1,303 |
— |
| Incision & drainage abscess complicated/multiple (10061) |
— |
$1,303 |
— |
| Incision & drainage pilonidal cyst complicated (10081) |
— |
$1,954.50 |
— |
| Incision & removal foreign body subq tiss compl (10121) |
— |
$2,606 |
— |
| Incision & removal foreign body subq tiss simple (10120) |
— |
$962.50 |
— |
| Incision and drainage of bartholin's gland abscess (56420) |
— |
$517 |
— |
| Incision and drainage of vulva or perineal abscess (56405) |
— |
$977.25 |
— |
| Incision extensor tendon sheath wrist (25000) |
— |
$2,525.75 |
— |
| Incision of heel bone (28300) |
— |
$2,171.66 |
— |
| Incision of metatarsal (28308) |
— |
$2,704.50 |
— |
| Incision thrombosed hemorrhoid external (46083) |
— |
$736 |
— |
| Inj dupuytren cord w/enzyme (20527) |
— |
$140 |
— |
| Inj paravert f jnt c/t 1 lev (64490) |
— |
$312.50 |
— |
| Inj tendon sheath/ligament (20550) |
— |
$175 |
— |
| Inj,Anes Agent,Brachial Plexus,Single (64415) |
— |
$792 |
— |
| Inj,Anes Agent,Femoral Nerve,Cont Inf (64448) |
— |
$720 |
— |
| Inj,Anes Agent,Femoral Nerve,Single (64447) |
— |
$664 |
— |
| Inject Nerv Blck,Axillary Nerv (64417) |
— |
$1,647 |
— |
| Inject Nerv Blck,Ilioingu/Iliohyp (64425) |
— |
$220 |
— |
| Inject Nerv Blck,Intercost,Multpl (64421) |
— |
$420 |
— |
| Inject Nerv Blck,Intercostal,One (64420) |
— |
$150 |
— |
| Inject Nerv Blck,Paravert Sympath (64520) |
— |
$175 |
— |
| Inject Tendon Origin/Insert (20551) |
— |
$124 |
— |
| Injection aa&/strd genicular nrv branches w/img (64454) |
— |
$231.25 |
— |
| Injection aa&/strd sciatic nerve w/img gdn (64445) |
— |
$250 |
— |
| Injection anes other peripheral nerve/branch (64450) |
— |
$317.50 |
— |
| Injection for identification of sentinel node (38792) |
— |
$1,626.30 |
— |
| Injection single/mlt trigger point 1/2 muscles (20552) |
— |
$486 |
— |
| Injection single/mlt trigger point 3/> muscles (20553) |
— |
$100 |
— |
| Injection therapeutic carpal tunnel (20526) |
— |
$140 |
— |
| Injection, anesthetic agent; greater occipital nerve (64405) |
— |
$191 |
— |
| Injection, anesthetic agent; sphenopalatine ganglion (64505) |
— |
$1,036 |
— |
| Injection, intralesional; up to and including 7 lesions (11900) |
— |
$400.75 |
— |
| Injx/Infus Neurolyt Sbst Epidural Lumbar/Sacral (62282) |
— |
$1,041.38 |
— |
| Ins New/Rplcmt Prm Pm W/Transv Eltrd Atrial&Vent (33208) |
— |
$37,279 |
— |
| Insert and remove bone pin (20650) |
— |
$1,058 |
— |
| Insert Drug Implant Device (11981) |
— |
$282 |
— |
| Insert non-tunnel cv cath (36556) |
— |
$2,447.50 |
— |
| Insert pessary/other device (57160) |
— |
$126 |
— |
| Insert picc cath (36569) |
— |
$2,234 |
— |
| Insert Temp Bladder Cath (51702) |
— |
$997.39 |
— |
| Insert tun ip cath perc (49418) |
— |
$6,688.86 |
— |
| Insert tunneled cv cath (36561) |
— |
$1,984.26 |
— |
| Insert,Non-Indwelling Bladder Catheter (51701) |
— |
$453 |
— |
| Insj tun vad req 2 cath 2 sits w/subq port (36566) |
— |
$8,790.52 |
— |
| Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) |
— |
$5,212 |
— |
| Insj/rplcmt temp transvns 1chmbr eltrd/pm cath (33210) |
— |
$25,310 |
— |
| Insrt/redo spine n generator (63685) |
— |
$754 |
— |
| Intubation endotracheal emergency procedure (31500) |
— |
$801 |
— |
| Knee arthroscopy/surgery (29883) |
— |
$2,606 |
— |
| Knee arthroscopy/surgery (29876) |
— |
$2,606 |
— |
| Lap ing hernia repair init (49650) |
— |
$2,774 |
— |
| Laparoscopy , surgical , with vaginal hysterectomy, for uterus greater than 250 grams; (58553) |
— |
$5,863.50 |
— |
| Laparoscopy , surgical , with vaginal hysterectomy, for uterus greater than 250 grams; with removal of tube(s) and/or… (58554) |
— |
$6,840.75 |
— |
| Laparoscopy appendectomy (44970) |
— |
$3,909 |
— |
| Laparoscopy Remove Adnexa (58661) |
— |
$2,606 |
— |
| Laparoscopy surgical, with vaginal hysterectomy, for uterus 250 grams or less; with removal of tube(s) and/or ovary(s) (58552) |
— |
$5,537.75 |
— |
| Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of spec (49320) |
— |
$2,234.30 |
— |
| Laparoscopy, surgical, colpopexy (suspension of vaginal apex) (57425) |
— |
$2,055 |
— |
| Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) (44180) |
— |
$4,560.50 |
— |
| Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures) (43280) |
— |
$5,148.50 |
— |
| Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh (43282) |
— |
$4,936.32 |
— |
| Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of… (43281) |
— |
$7,355 |
— |
| Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; (58570) |
— |
$3,677.50 |
— |
| Laparoscopy, surgical; cholecystectomy with cholangiography (47563) |
— |
$4,413 |
— |
| Laparoscopy, surgical; cholecystectomy with exploration of common duct (47564) |
— |
$5,548 |
— |
| Laparoscopy, surgical; repair recurrent inguinal hernia (49651) |
— |
$1,780.64 |
— |
| Laps fulg/exc ovary viscera/peritoneal surface (58662) |
— |
$3,309.75 |
— |
| Laps Gastric Restrictive Px Remove Device & Port (43774) |
— |
$3,257.50 |
— |
| Laps Surg W/Aspir Cavity/Cyst Single/Multiple (49322) |
— |
$2,396.86 |
— |
| Laps total hysterect 250 gm/< w/rmvl tube/ovary (58571) |
— |
$4,338.75 |
— |
| Laps vaginal hysterectomy uterus 250 gm/< (58550) |
— |
$4,040.12 |
— |
| Late closure of wound (13160) |
— |
$1,520.16 |
— |
| Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each Other Surgical… (27686) |
— |
$1,303 |
— |
| Ligation of hemorrhoid(s) (46221) |
— |
$504.30 |
— |
| Ligation or biopsy temporal artery (37609) |
— |
$4,560.50 |
— |
| Liver Biopsy (47000) |
— |
$1,735.50 |
— |
| Maniplatn palar fascial crd post inj single cord (26341) |
— |
$120 |
— |
| Marsup Bartholin Gland Cyst (56440) |
— |
$1,954.50 |
— |
| Mast mod rad (19307) |
— |
$4,780.75 |
— |
| Mastectomy partial (19301) |
— |
$2,280.25 |
— |
| Mastectomy simple complete (19303) |
— |
$3,909 |
— |
| Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) |
— |
$483 |
— |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
— |
$231.25 |
— |
| Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) |
— |
$237 |
— |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) |
— |
$219 |
— |
| Open rx distal radius fx, intra-articular, 2 frag (25608) |
— |
$4,560.50 |
— |
| Open Treatment Bimalleolar Ankle Fracture (27814) |
— |
$3,091.83 |
— |
| Open Treatment Medial Malleolus Fracture (27766) |
— |
$3,309.75 |
— |
| Open treatment metatarsal fracture each (28485) |
— |
$3,454.50 |
— |
| Open treatment of clavicular fracture, includes internal fixation, when performed (23515) |
— |
$3,257.50 |
— |
| Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed (27514) |
— |
$4,164.08 |
— |
| Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement (27236) |
— |
$4,056.84 |
— |
| Open treatment of humeral shaft fracture with plate/screws, with or without cerclage (24515) |
— |
$3,491.98 |
— |
| Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation (27536) |
— |
$5,212 |
— |
| Open treatment of trimalleolar ankle fracture; with fixation of posterior lip (27823) |
— |
$3,909 |
— |
| Open treatment of ulnar shaft fracture, includes internal fixation, when performed (25545) |
— |
$3,257.50 |
— |
| Open Tx Distal Phalangeal Fracture Each (26765) |
— |
$2,694 |
— |
| Open tx distal radial intra-articular fx or epiphyseal separation; w/ int fix 3+ fragments (25609) |
— |
$3,813 |
— |
| Open tx fracture great toe/phalanx/phalanges (28505) |
— |
$651.50 |
— |
| Open Tx Humeral Epicondylar Fracture (24575) |
— |
$4,954.50 |
— |
| Open Tx Metacarpal Fracture Single Ea Bone (26615) |
— |
$1,981.01 |
— |
| Open tx of distal tibiofibular joint disruption, includes internal fixation, when performed (27829) |
— |
$1,871.72 |
— |
| Open tx of tarsometatarsal joint dislocation, includes internal fixation, when performed (28615) |
— |
$4,560.50 |
— |
| Open tx phalangeal shaft fracture prox/middle ea (26735) |
— |
$2,606 |
— |
| Open tx proximal humeral fx, incl int fixation, includes repair of tuberosity (23615) |
— |
$2,468.89 |
— |
| Open tx tarsal fracture xcp talus & calcaneus ea (28465) |
— |
$2,606 |
— |
| Optx fem shft fx w/insj imed implt w/wo screw (27506) |
— |
$5,148.50 |
— |
| Optx hum fx wo ntrcndylr xtn (24545) |
— |
$1,944.50 |
— |
| Ostectomy, complete excision; fifth metatarsal head (28113) |
— |
$1,954.50 |
— |
| Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) (28110) |
— |
$7,818 |
— |
| Partial Excision Bone Fibula (27641) |
— |
$1,050.71 |
— |
| Partial excision bone talus/calcaneus (28120) |
— |
$1,748.70 |
— |
| Partial Excision Bone Tibia (27640) |
— |
$1,050.71 |
— |
| Partial Excision Distal Phalanx Finger (26236) |
— |
$1,954.50 |
— |
| Partial excision of bone; tarsal or metatarsal bone, except talus or calcaneus (28122) |
— |
$1,427.30 |
— |
| Partial Excision Proximal/Middle Phalanx Finger (26235) |
— |
$1,464.11 |
— |
| Partial hymenectomy or revision of hymenal ring (56700) |
— |
$1,954.50 |
— |
| Partial Removal Foot Fascia (28060) |
— |
$1,465.88 |
— |
| Partial removal of thyroid (60220) |
— |
$5,148.50 |
— |
| Partical Excision Bone Phalanx Toe (28124) |
— |
$1,303 |
— |
| Pelvic exam under anesthesia (57410) |
— |
$488.62 |
— |
| Percutaneous skeletal fixation of femoral fracture, proximal end, neck (27235) |
— |
$3,425 |
— |
| Percutaneous Skeletal Fixation Of Metacarpal Fracture, Each Bone (26608) |
— |
$1,303 |
— |
| Percutaneous skeletal fixation of ulnar styloid fracture (25651) |
— |
$1,954.50 |
— |
| Peri-implant capsulectomy breast complete (19371) |
— |
$3,012.42 |
— |
| Perineoplasty rpr perineum nonobstetrical spx (56810) |
— |
$2,606 |
— |
| Perq dev breast 1st us imag (19285) |
— |
$1,830.40 |
— |
| Perq Drainage Pleura Insert Cath W/Imaging (32557) |
— |
$2,102.47 |
— |
| Perq Drainage Pleura Insert Cath W/O Imaging (32556) |
— |
$2,017.75 |
— |
| Perq vert agmntj cavity crtj uni/bi cannulation (22513) |
— |
$1,118 |
— |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) |
— |
$1,042 |
— |
| Phalangectomy toe each toe (28150) |
— |
$1,628.75 |
— |
| Pin finger fracture each (26756) |
— |
$1,303 |
— |
| PR Egd Partial/Compl Esophagogastric Fundoplasty (43210) |
— |
$1,838.75 |
— |
| Pr unlisted px laparoscopic robotic closure of enterovesical fistula:w/intestine and/or bladder resection (44238) |
— |
$4,721 |
— |
| Prq skel fixj fx grt toe phlx/phlg w/manj (28496) |
— |
$1,303 |
— |
| Prq skel fixj humrl cndylr fx medial/lat w/manj (24582) |
— |
$1,303 |
— |
| Prq skel fixj sprcndylr/transcndylr humeral fx (24538) |
— |
$1,954.50 |
— |
| Punch biopsy skin single lesion (11104) |
— |
$274 |
— |
| Puncture Aspiration (10160) |
— |
$305 |
— |
| Puncture Aspiration Cyst Breast (19000) |
— |
$1,209 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; 5 cm or greater (22905) |
— |
$5,212 |
— |
| Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) |
— |
$432 |
— |
| Rcnstj pst tibl tdn w/exc accessory tarsl navclr (28238) |
— |
$3,420.38 |
— |
| Realignment extensor tendon hand each tendon (26437) |
— |
$977.25 |
— |
| Reconstruc toe deform,soft tissue (28313) |
— |
$977.25 |
— |
| Reconstruct Shoulder Joint (23470) |
— |
$4,058.54 |
— |
| Reconstruct ulna/radioulnar (25337) |
— |
$3,909 |
— |
| Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft (24342) |
— |
$3,257.50 |
— |
| Release palm contracture (26121) |
— |
$2,375 |
— |
| Release wrist/forearm tendon (25295) |
— |
$1,954.50 |
— |
| Removal fb intranasal (30300) |
— |
$304.50 |
— |
| Removal foreign body foot deep (28192) |
— |
$1,954.50 |
— |
| Removal foreign body foot subcutaneous (28190) |
— |
$1,938.25 |
— |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
— |
$977.25 |
— |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
— |
$73.50 |
— |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
— |
$100 |
— |
| Removal Implant Deep (20680) |
— |
$2,931.75 |
— |
| Removal Implant Superficial Separate Procedure (20670) |
— |
$960.78 |
— |
| Removal Intact Mammary Implant (19328) |
— |
$1,628.75 |
— |
| Removal of anal fissure (46200) |
— |
$2,053 |
— |
| Removal of heel spur (28119) |
— |
$1,954.50 |
— |
| Removal of indwelling tunneled pleural catheter with cuff (32552) |
— |
$631.75 |
— |
| Removal of intrauterine device (iud) (58301) |
— |
$922.96 |
— |
| Removal of nail bed (11750) |
— |
$737 |
— |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
— |
$868.68 |
— |
| Removal of sperm cord lesion (55520) |
— |
$1,520.16 |
— |
| Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed (63661) |
— |
$730 |
— |
| Removal of testis (54520) |
— |
$3,257.50 |
— |
| Removal of tonsils (42826) |
— |
$2,704.50 |
— |
| Removal/bivalving full arm/full leg cast (29705) |
— |
$186.37 |
— |
| Removal/bivalving gauntlet boot/body cast (29700) |
— |
$275.01 |
— |
| Remove anal fist subq (46270) |
— |
$1,303 |
— |
| Remove drug implant device (11982) |
— |
$2,574.25 |
— |
| Remove femur lesion (27355) |
— |
$1,954.50 |
— |
| Remove in/ex hem groups 2+ (46260) |
— |
$3,128.75 |
— |
| Remove in/ex hem grps w/fist (46262) |
— |
$2,606 |
— |
| Remove Pilonidal Cyst Exten (11771) |
— |
$3,257.50 |
— |
| Remove wrist tendon lesion (25111) |
— |
$1,303 |
— |
| Remv Ext Canal Foreign Body (69200) |
— |
$275 |
— |
| Remv F.B.,Eye,Superf Conjunc (65205) |
— |
$247.66 |
— |
| Repair achilles tendon (27650) |
— |
$1,759.44 |
— |
| Repair arm tendon/muscle (24341) |
— |
$3,583.25 |
— |
| Repair Blood Vessel Direct Upper Extremity (35206) |
— |
$5,212 |
— |
| Repair collat ankle ligmnt,secondary (27698) |
— |
$1,672.18 |
— |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
— |
$1,536.35 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
— |
$1,520.17 |
— |
| Repair extensor tendon finger w/o graft each (26418) |
— |
$1,898.75 |
— |
| Repair finger/hand tendon (26350) |
— |
$2,041.25 |
— |
| Repair forearm tendon/muscle (25260) |
— |
$1,085.84 |
— |
| Repair hallux rigidus (28289) |
— |
$1,954.50 |
— |
| Repair hand tendon (26410) |
— |
$1,843 |
— |
| Repair initial femoral hernia, any age; incarcerated or strangulated (49553) |
— |
$4,413 |
— |
| Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated (49507) |
— |
$1,954.50 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
— |
$746 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
— |
$764 |
— |
| Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) |
— |
$2,942 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
— |
$724.05 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
— |
$809.58 |
— |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
— |
$1,205 |
— |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
— |
$770 |
— |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
— |
$786 |
— |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
— |
$1,016 |
— |
| Repair intrinsic muscles of hand (26591) |
— |
$1,978.02 |
— |
| Repair of ankle ligament (27695) |
— |
$1,961.34 |
— |
| Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie,… (49595) |
— |
$1,736 |
— |
| Repair of leg tendon each (27664) |
— |
$6,257.50 |
— |
| Repair of leg tendon each (27658) |
— |
$1,172.70 |
— |
| Repair of nail bed (11760) |
— |
$651.50 |
— |
| Repair of vagina (57260) |
— |
$2,907.16 |
— |
| Repair rectum & vagina (57250) |
— |
$1,520.18 |
— |
| Repair rotator cuff acute (23410) |
— |
$4,473.32 |
— |
| Repair secondary achilles tendon w/wo graft (27654) |
— |
$2,020.18 |
— |
| Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes… (27472) |
— |
$2,751.75 |
— |
| Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon (28200) |
— |
$2,280.25 |
— |
| Repair/graft achilles tendon (27652) |
— |
$2,704.50 |
— |
| Replace elbow joint (24363) |
— |
$4,000 |
— |
| Rerepair ing hernia reduce (49520) |
— |
$4,990.25 |
— |
| Resection of scrotum (55150) |
— |
$280 |
— |
| Revis reconst shoulder joint (23473) |
— |
$5,884 |
— |
| Revis shoulder arthrplsty humeral&glenoid compnt (23474) |
— |
$5,148.50 |
— |
| Revise median n/carpal tunnel surg (64721) |
— |
$1,140.12 |
— |
| Revise ulnar nerve at elbow (64718) |
— |
$1,414.60 |
— |
| Revision of foot (28116) |
— |
$7,942 |
— |
| Revision of lower leg tendon (27685) |
— |
$977.25 |
— |
| Revision of total knee arthroplasty with or without allograft; femoral and entire tibial component (27487) |
— |
$8,210.71 |
— |
| Revision or removal of implanted spinal neurostimulator pulse generator or receiver (63688) |
— |
$665 |
— |
| Revision spinal neurostim electrode perc array, incl fluoro (63663) |
— |
$1,500 |
— |
| Revj Ileostomy Simple Rls Superficial Scar Spx (44312) |
— |
$2,192.46 |
— |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
— |
$344 |
— |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
— |
$1,954.50 |
— |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
— |
$1,147.68 |
— |
| Rmvl w/rinsj non-biodegradable drug dlvr implt (11983) |
— |
$462 |
— |
| Rplcmt compl tun ctr vad w/subq port (36582) |
— |
$2,606 |
— |
| Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) |
— |
$3,420.38 |
— |
| Rpr aa hernia 1st 3-10 cm reducible (49593) |
— |
$2,606 |
— |
| Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) |
— |
$1,954.50 |
— |
| Rpr aa hernia 1st < 3 cm reducible (49591) |
— |
$2,774 |
— |
| Rpr Aa Hernia Recr 3-10 Cm Reducible (49615) |
— |
$2,931.75 |
— |
| Rpr Aa Hernia Recr < 3 Cm Reducible (49613) |
— |
$1,288.88 |
— |
| Rpr blood vessel direct lower extremity (35226) |
— |
$1,396.30 |
— |
| Rpr flexor tendon leg secondary w/o graft each (27659) |
— |
$1,330.16 |
— |
| Rpr Lac 2.5 Cm/< Pst One-Third Tongue (41251) |
— |
$607 |
— |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) |
— |
$807.96 |
— |
| Sigmoidoscopy & decompress (45337) |
— |
$394.66 |
— |
| Sigmoidoscopy flx w/biopsy single/multiple (45331) |
— |
$1,687.50 |
— |
| Simple Cystometrogram (51725) |
— |
$400 |
— |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
— |
$484.94 |
— |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
— |
$541.94 |
— |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
— |
$634 |
— |
| Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) |
— |
$549 |
— |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
— |
$416.86 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$457 |
— |
| Skin sub graft face/nk/hf/g (15275) |
— |
$1,715.46 |
— |
| Skin sub graft trnk/arm/leg (15271) |
— |
$2,327.64 |
— |
| Skin Sub Grft T/Arm/Lg Child (15273) |
— |
$680.02 |
— |
| Skin tissue rearrangement (14040) |
— |
$1,954.50 |
— |
| Sling operation for stress incontinence (eg, fascia or synthetic) (57288) |
— |
$2,117.38 |
— |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
— |
$492.94 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
— |
$563 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
— |
$629 |
— |
| Spinal puncture lumbar diagnostic (62270) |
— |
$962 |
— |
| Strapping ankle (29540) |
— |
$278 |
— |
| Strapping elbow/wrist (29260) |
— |
$203.94 |
— |
| Strapping hand/finger (29280) |
— |
$252 |
— |
| Strapping knee (29530) |
— |
$239 |
— |
| Strapping shoulder (29240) |
— |
$244.62 |
— |
| Tenodesis long tendon biceps (23430) |
— |
$1,461.70 |
— |
| Tenolysis ext tendon,hand/finger,ea (26445) |
— |
$2,009.16 |
— |
| Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon (27680) |
— |
$1,520.16 |
— |
| Tenotomy shoulder area single tendon (23405) |
— |
$3,069.97 |
— |
| Tenotomy, open, tendon flexor; toe, single tendon (separate procedure) (28232) |
— |
$1,737.34 |
— |
| Thoracentesis Needle/Cath Pleura W/Imaging (32555) |
— |
$1,370.40 |
— |
| Thoracentesis needle/cath pleura w/o imaging (32554) |
— |
$1,116 |
— |
| Thyroidectomy, total or complete (60240) |
— |
$9,561.50 |
— |
| Tis trnfr trunk 10 sq cm/< (14000) |
— |
$1,954.50 |
— |
| Tonsillectomy and adenoidectomy; age 12 or over (42821) |
— |
$2,280.25 |
— |
| Total hip arthroplasty (27130) |
— |
$7,355 |
— |
| Total knee arthroplasty (27447) |
— |
$6,987.25 |
— |
| Tr/trnspl 1 tdn w/musc redirion/rerouting supfc (27690) |
— |
$2,171.68 |
— |
| Transection or avulsion of other spinal nerve, extradural (64772) |
— |
$1,240.54 |
— |
| Transplant forearm tendon (25310) |
— |
$3,257.50 |
— |
| Treat dislocation/fracture (23670) |
— |
$3,979.42 |
— |
| Treat dislocation/fracture (23680) |
— |
$5,863.50 |
— |
| Treat ectopic pregnancy (59151) |
— |
$3,309.75 |
— |
| Treat elbow fracture (24586) |
— |
$4,110.30 |
— |
| Treat Finger Fracture Each (26727) |
— |
$1,954.50 |
— |
| Treat Fracture Radius & Ulna (25560) |
— |
$500 |
— |
| Treat fracture radius/ulna (25575) |
— |
$3,257.50 |
— |
| Treat fx distal radial (25606) |
— |
$1,303 |
— |
| Treat fx rad extra-articul (25607) |
— |
$2,931.75 |
— |
| Treat humerus fracture (24500) |
— |
$680 |
— |
| Treat humerus fracture (23600) |
— |
$670 |
— |
| Treat knee fracture (27532) |
— |
$2,606 |
— |
| Treat kneecap dislocation (27566) |
— |
$2,280.25 |
— |
| Treat lower leg fracture (27828) |
— |
$9,515 |
— |
| Treat Metatarsal Fracture (28475) |
— |
$2,237 |
— |
| Treat ulnar fracture (24685) |
— |
$3,883.25 |
— |
| Treat wrist bone fracture (25622) |
— |
$570 |
— |
| Treat Wrist Bone Fracture (25630) |
— |
$585 |
— |
| Treatment closed elbow dislocation req anes (24605) |
— |
$2,078 |
— |
| Treatment closed elbow dislocation w/o anes (24600) |
— |
$871 |
— |
| Treatment of ankle fracture (27822) |
— |
$3,746.12 |
— |
| Treatment of ankle fracture (28436) |
— |
$476.27 |
— |
| Treatment of ankle fracture (27792) |
— |
$3,727.66 |
— |
| Treatment of intertrochanteric or subtrochanteric femoral fracture; w intramedullary implant (27245) |
— |
$3,467.50 |
— |
| Treatment of intertrochanteric, pertrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant,… (27244) |
— |
$4,396.66 |
— |
| Treatment of tibia fracture (27759) |
— |
$2,606 |
— |
| Treatment of tibia fracture (27756) |
— |
$5,606 |
— |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
— |
$2,606 |
— |
| Tx Missed Abortion First Trimester Surgical (59820) |
— |
$1,954.50 |
— |
| Tx Opn Tendon Flexor Foot Single/Mult Tendon Spx (28230) |
— |
$977.25 |
— |
| Tx Superficial Wound Dehiscence Simple Closure (12020) |
— |
$1,825 |
— |
| Unlisted hysteroscopy procedure, uterus (58579) |
— |
$3,000 |
— |
| Unlisted laparoscopy procedure, appendix (44979) |
— |
$2,206.50 |
— |
| Unlisted laparoscopy procedure, esophagus (43289) |
— |
$5,820.60 |
— |
| Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy (49659) |
— |
$4,413 |
— |
| Unlisted laparoscopy procedure, rectum (45499) |
— |
$1,100 |
— |
| Unlisted laparoscopy procedure, spermatic cord (55559) |
— |
$2,222.38 |
— |
| Unlisted laparoscopy px abd pertoneum & omentum (49329) |
— |
$2,606 |
— |
| Unlisted procedure anus (46999) |
— |
$1,303 |
— |
| Unlisted procedure colon (45399) |
— |
$8,634.60 |
— |
| Unlisted procedure femur or knee (27599) |
— |
$6,317 |
— |
| Unlisted procedure foot or toes (28899) |
— |
$2,595 |
— |
| Unlisted procedure humerus/elbow (24999) |
— |
$1,994 |
— |
| Unlisted Procedure Nervous System (64999) |
— |
$1,303 |
— |
| Unlisted procedure, abdomen, peritoneum and omentum (49999) |
— |
$1,800 |
— |
| Unlisted procedure, forearm or wrist (25999) |
— |
$4,106 |
— |
| Uvulectomy excision uvula (42140) |
— |
$2,803 |
— |
| Vag Hyst > 250 Gm Rmvl Tube&/Ovary (58291) |
— |
$4,234.75 |
— |
| Vag hyst w/enterocele repair (58270) |
— |
$4,706.50 |
— |
| Vaginal delivery only (59409) |
— |
$1,632 |
— |
| Vaginal hysterectomy (58260) |
— |
$4,234.75 |
— |
| Vaginal hysterectomy; with removal of tube(s), and/or ovary(s) (58262) |
— |
$3,257.50 |
— |
| Vasectomy (55250) |
— |
$2,606 |
— |
| Venipuncture (36415) |
— |
$287.01 |
— |
| Vulvectomy simple partial (56620) |
— |
$1,303 |
— |
| Wound prep trk/arm/leg 1st 100 sq cm (15002) |
— |
$2,784.14 |
— |
| Xfer single deep low leg tendon (27691) |
— |
$4,338.75 |
— |