Procedures & surgery prices at Mount San Rafael Hospital

Trinidad, CO · every code in this section with a posted price and a Medicare benchmark.

991 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $892
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $583.75
Ablate inf turbinate submuc (30802) $712
Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method; superficial (30801) $548.50
Acne Surgery (10040) $209
Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release (23130) $1,918
Adjnt tis trnsfr/reargmt any area 30.1-60 sq cm (14301) $3,303.50
Amp thigh thru femur sec closure/scar revision (27594) $2,403
Amputate metacarpal bone (26910) $2,669
Amputate Thigh,Re-Amputatn (27596) $3,183.50
Amputation Finger/Thumb (26951) $2,184.75
Amputation metatarsal with toe single (28810) $1,509
Amputation thigh through femur any level (27590) $2,522
Amputation toe interphalangeal joint (28825) $3,226.25
Amputation Toe Metatarsophalangeal Joint (28820) $1,371
Amputation, foot; transmetatarsal (28805) $5,549.50
Amputation, leg, through tibia and fibula; (27880) $3,547
Ankle arthroscopy/surgery (29892) $6,639
Ankle Scope,Excis Osteochon Defct (29891) $3,101
Anoscopy (46611) $1,143.25
Anoscopy Ablation Lesion (46615) $507.25
Anoscopy control bleeding (46614) $899.50
Anoscopy diagnostic (46600) $136
Anoscopy W/Rmvl Foreign Body (46608) $559.25
Anoscopy w/rmvl lesion cautery (46610) $307
Anoscopy; with biopsy, single or multiple (46606) $293.50
Anrct xm surg req anes general spi/edrl dx (45990) $470
Ant Vesicourethropexy/Urethropexy Smpl (51840) $3,078.50
Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele (57240) $3,022
Appendectomy (44950) $5,091.75
Application cast elbow finger short arm (29075) $242
Application Cast Hand & Lower Forearm Gauntlet (29085) $239.50
Application finger splint static (29130) $250.25
Application long arm splint shoulder hand (29105) $286.50
Application long leg splint thigh ankle/toes (29505) $249.25
Application of a multiplane (pins or wires more than 1 plane), unilateral, external fixation (20692) $3,580.50
Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system (20690) $1,792
Application of long leg cast (29345) $303.50
Application short arm splint forearm-hand static (29125) $205
Application short leg splint calf foot (29515) $194.25
Apply long leg cast brace (29358) $508.50
Apply short leg cast (29405) $278.25
Arterial puncture (36600) $162
Arteriovenous Anastomosis Open Direct (36821) $2,785.50
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $216.50
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) $293.50
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $293.50
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $291
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $254.50
Arthrodesis, great toe; metatarsophalangeal joint (28750) $8,292.50
Arthroplasty knee fc/tp (27442) $3,899.50
Arthroplasty, patella; without prosthesis (27437) $2,913.50
Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction (29888) $3,158.50
Arthroscopy, knee, surgical; abrasion arthroplasty or multiple drilling or microfracture (29879) $3,509
Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) (29877) $1,993.50
Arthroscopy, knee, surgical; for infection, lavage and drainage (29871) $1,652
Arthroscopy, knee, surgical; for removal of loose body or foreign body (29874) $1,721.50
Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (29875) $1,589.50
Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty (29880) $1,801
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) $2,239.50
Arthroscopy, shoulder, surgical; biceps tenodesis (29828) $2,913.50
Arthroscopy, shoulder, surgical; debridement, limited (29822) $1,822
Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) $3,377
Arthrotomy, with synovectomy, ankle; (27625) $4,325
Arthrt w/expl drg/rmvl loose/fb mttarphlngl jt (28022) $5,549.50
Aspir/inj thyroid cyst (60300) $1,038.50
Aspirat/Injection Ganglion Cyst(S) (20612) $162
Aspiration Bladder Insert Suprapubic Catheter (51102) $1,328.75
Av fusion/forearm vein (36820) $3,221.50
Avulsion nail plate partial/complete simple 1 (11730) $334.75
Axillary lymphadenectomy superficial 38740 (38740) $2,543.50
Axillary lymphadenectomy; complete (38745) $3,239.50
Banding of hemorrhoids using a flexible endoscope (sigmoidoscope) (45350) $1,836.50
Biopsy bone open superficial (20240) $1,991
Biopsy Breast Open Incisional (19101) $1,467.50
Biopsy Cervix Single/Mult/Excision Of Lesion Spx (57500) $308
Biopsy external ear (69100) $507.50
Biopsy muscle deep (20205) $557.50
Biopsy Muscle Superficial (20200) $362.50
Biopsy of mouth lesion (40808) $404
Biopsy of penis (54100) $790
Biopsy of uterus lining (58100) $292
Biopsy or excision of lymph node(s); open, superficial (38500) $1,129.75
Biopsy Vaginal Mucosa Extensive (57105) $498
Biopsy Vaginal Mucosa Simple (57100) $260
Biopsy, Soft Tissue Of Pelvis And Hip Area; Superficial (27040) $774.50
Biopsy/removal lymph nodes (38525) $3,305.75
Biopsy/removal lymph nodes (38510) $1,666.50
Bladder Instillation Anticarcinogenic Agent (51720) $641.50
Bladder Irrigation Simple (51700) $350.75
Bladder Scan (51798) $182.75
Blood patch (62273) $299.50
Blood transfusion service (36430) $1,218
Bone graft, any donor area; major or large (20902) $724
Bone graft, any donor area; minor or small (eg, dowel or button) (20900) $1,919
Breast augmentation with implant (19325) $3,028.50
Bronchosc dx w/w/o fluor&wash (31622) $605.50
Bronchoscopy w/ther aspir trachbrncl tree 1st (31645) $661
Bx anorectal wall anal approach (45100) $1,100.50
Bx breast 1st lesion strtctc (19081) $381.50
Bx breast 1st lesion us imag (19083) $2,173
Bx breast needle core w/o imaging guidance spx (19100) $2,322
Bx vulva/perineum 1 lesion (56605) $284.50
Bx/exc lymph node needle superficial (38505) $2,038.75
Capsul mttarphlngl jt w/wo tenorrhaphy ea jt spx (28270) $3,142
Catheter Aspiration Nasotracheal Spx (31720) $206
Cautery Cervix Cryocautery Initial or Repeat (57511) $414.50
Cervical lymphadenectomy (complete) (38720) $5,462
Change Cystostomy Tube Complicated (51710) $412
Change Cystostomy Tube Simple (51705) $258
Chemical Cautery Tissue (17250) $230.50
Chest tube placement (32551) $710
Chg Collect Blood From Catheter Venous Nos (36592) $87.50
Chromotubation of oviduct, including materials (58350) $309
Circum 28 days or older (54161) $1,007
Circumcision (54150) $685.50
Circumcision Neonate (54160) $1,170
Claviculectomy; partial (23120) $1,871.50
Closed Rx Gr Tuberosity Hum Fx (23620) $654.50
Closed Rx Humeral Supracondylar Fx (24530) $759
Closed Rx Med Malleolus Fx (27760) $714
Closed Rx Med Malleolus Fx,Manip (27762) $991
Closed Rx Mid Humerus Fx,Manipulatn (24505) $1,111
Closed Rx Rad/Ulna Shaft Fx,Manip (25565) $1,794
Closed Rx Radial Shaft Fx (25500) $639
Closed Rx Shldr Disloc,Gr Tub Fx (23665) $1,151.50
Closed Rx Tibia Shaft Fx (27750) $909.25
Closed Rx Tibial Plateau Fx (27530) $924
Closed Rx Trimalleolar Fx (27816) $840.50
Closed Treat Vert Body Fract (22310) $1,814.50
Closed treat wrist dislocation (25660) $971
Closed Treatment Coccygeal Fracture (27200) $551.75
Closed treatment nasal fracture w/stabilization (21320) $4,235.50
Closed treatment of broken top of shin bone at knee (27538) $1,540
Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) $898.50
Closed treatment of humeral condylar fracture, medial or lateral; without manipulation (24576) $638
Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation (24560) $740.25
Closed treatment of talus fracture; without manipulation (28430) $679.75
Closed Treatment Sternum Fracture (21820) $557
Closed Treatment Ulnar Styloid Fracture (25650) $873
Closed tx ankle dislocation w/o anesthesia (27840) $662
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $1,338.50
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $418.50
Closed tx calcaneal fracture w/o manipulation (28400) $673.75
Closed tx knee dislocation w/anesthesia (27552) $1,628.50
Closed tx knee dislocation w/o anesthesia (27550) $770
Closed Tx Lunate Dislocation W/Manipulation (25690) $1,202.25
Closed Tx Mandibular Fracture W/O Manipulation (21450) $1,186
Closed tx metatarsal fracture w/o manipulation (28470) $540.50
Closed Tx Monteggia Fx Dislocation Elbow W/Manj (24620) $1,167
Closed tx nasal fracture w/o stabilization (21315) $548.75
Closed Tx Palatal/Maxillary Fx W/Fixation/Splint (21421) $2,360.50
Closed tx patellar dislocation w/anesthesia (27562) $1,604.50
Closed tx patellar dislocation w/o anesthesia (27560) $627.25
Closed tx patellar fracture w/o manipulation (27520) $746
Closed tx radial head/neck fx w/manipulation (24655) $1,152.25
Closed tx radial head/neck fx w/o manipulation (24650) $612.75
Closed tx radial shaft fracture w/manipulation (25505) $988.25
Closed tx scapular fracture w/o manipulation (23570) $569
Closed tx septal&nose fx (21337) $1,065
Closed tx talotarsal joint dislc w/o anes (28570) $540.50
Closed tx temporomandibular dislocation 1st/sbsq (21480) $450
Closed tx ulnar fracture prox end w/o manipulate (24670) $588
Closed tx ulnar shaft fracture w/o manipulation (25530) $673.75
Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) $1,012
Closure Of Rectovaginal Fistula; Vaginal Or Transanal Approach (57300) $2,130
Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) $539.25
Clsd tx clavicular fracture w/manipulation (23505) $703.50
Clsd tx clavicular fracture w/o manipulation (23500) $500.25
Clsd tx fx orbit except blowout w/o manipulation (21400) $774.75
Clsd tx shoulder dislc w/manipulation req anes (23655) $1,540
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $913.50
Clsd tx sternoclavicular dislc w/o manipulation (23520) $586.50
Cltx Carpo/Metacarpal Dislocation Thumb W/Manj (26641) $688.75
Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) $589
Cltx dstl fibular fx lat malls w/manj (27788) $890.50
Cltx dstl fibular fx lat malls w/o manj (27786) $1,088.50
Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) $534.50
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $398.50
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $920
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,731.50
Cltx Fem Fx Prox End Nck W/O Manj (27230) $1,071.75
Cltx fx grt toe phlx/phlg w/manj (28495) $507
Cltx fx grt toe phlx/phlg w/o manj (28490) $369.25
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $524.50
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $372
Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) $1,902.25
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $840.50
Cltx greater trochanteric fx w/o manj (27246) $1,360.50
Cltx grter humeral tuberosity fx w/manipulation (23625) $858.50
Cltx hip dislocation traumatic w/o anesthesia (27250) $1,193.50
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $339
Cltx Intr/Peri/Sbtrchntc Femoral Fx W/Manj (27240) $2,889
Cltx iphal jt dislc w/manj w/o anes (26770) $440.25
Cltx metacarpal fx w/manipulation each bone (26605) $731.50
Cltx metacarpal fx w/o manipulation each bone (26600) $828.50
Cltx metacarpophalangeal dislc w/manj w/o anes (26700) $594.25
Cltx metatarsophlngl jt dislc w/o anes (28630) $428
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $884.50
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $509.50
Cltx Post Hip Arthrp Dislc Req Anes (27266) $2,602
Cltx post hip arthrp dislc w/o anes (27265) $1,048.75
Cltx prox fibula/shft fx w/manj (27781) $774.50
Cltx prox fibula/shft fx w/o manj (27780) $611.75
Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) $1,123.25
Cltx prox tibfib jt dislc req anes (27831) $1,255
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $403.50
Cltx Tarsal Dislc Oth/Thn Talotarsal W/Anes (28545) $968
Cltx trans-scaphoprilunar typ fx dislc w/manj (25680) $1,318
Cltx trimalleolar ankle fx w/manipulation (27818) $1,558.50
Cmbnd anterpost colporraphy w/cysto w/ntrcl rpr (57265) $3,476
Colonoscopy flex w/rem forcep (45384) $1,086
Colonoscopy stoma w/biopsy (44389) $1,703
Colonoscopy stoma w/snare (44394) $1,387.75
Colonoscopy w/ablation (45388) $2,455.50
Colonoscopy w/band ligation (45398) $2,715.75
Colonoscopy w/endoscopic fnb (45392) $1,454
Colonoscopy w/fb removal (45379) $1,027.50
Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) (57283) $2,690
Colporrhaphy suture injury vagina (57200) $1,333.50
Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) $497.75
Colposcopy cervix upper/adjacent vagina (57452) $263
Colposcopy cervix vag eltrd conization cervix (57461) $720.50
Colposcopy cervix vag loop eltrd bx cervix (57460) $648
Colposcopy entire vagina w/cervix if present (57420) $356
Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix (57455) $494.50
Colposcopy vulva (56820) $368
Colposcopy vulva w/biopsy (56821) $454.50
Colposcopy,Cervix W/Adj Vagina, Curettag (57456) $411
Colposcopy,Entire Vagina,W/Biopsy(S) (57421) $484.50
Colpotomy; with exploration (57000) $5,184
Colsc Flexible W/Control Bleeding Any Method - Colonoscopy (45382) $4,280
Colsc Flexible W/Transendoscopic Balloon Dilat - Colonoscopy (45386) $1,838.25
Colsc flx with directed submucosal njx any sbst (45381) $1,003
Complex Cystometrogram (51726) $1,202
Complex Drainage, Wound (10180) $926.50
Composite skin graft (15760) $4,858
Conization of cervix (57520) $1,069
Conization of cervix (57522) $937
Construction of vagina (57291) $2,623.50
Control Nasal Hemorrhage Anterior Complex (30903) $473.75
Control Nasal Hemorrhage Anterior Simple (30901) $322.50
Correction hammertoe (28285) $4,346
Correction of bunion (28298) $7,055
Correction of bunion (28292) $4,916
Correction of bunion (28299) $6,994.50
Correction of bunion (28297) $7,748
Corrj hallux valgus w/sesmdc w/dist metar osteot (28296) $8,437.50
Corrj hallux valgus w/sesmdc w/prox metar osteot (28295) $8,437.50
Cryosurgical ablation prostate w/us & monitori (55873) $5,506
Cryotherapy of skin (17340) $217.50
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $629.50
Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) $484.50
Curette/treat cornea (65435) $535
Cysto Bladder W/Ureteral Catheterization (52005) $663
Cysto insj urtrl gd wire prq nfros rtrgr (52334) $4,543
Cysto w fulg of minor lesions <0.5cm (52224) $6,237
Cysto w fulgertn lg bladder tumor(s) (52240) $2,230
Cysto w/destruction of lesions (52214) $878.50
Cysto w/removal of tumors small (52234) $1,326
Cysto W/Simple Removal Stone & Stent (52310) $1,847
Cysto w/ureter stricture tx (52341) $1,867
Cysto w/ureteroscopy w/rmvl/manj stones (52352) $1,836.50
Cysto w/urtroscopy w/tx ureteral stricture (52344) $1,875
Cysto/pyeloscopy bx&/fulguration pelivc lesion (52354) $1,730
Cysto/Uretero/Pyeloscopy W/Lithotripsy (52353) $9,449
Cystoscopy and treatment (52330) $1,318.50
Cystoscopy implant stent (52282) $1,679
Cystoscopy stone removal (52325) $1,456
Cystoscopy w/biopsy (52204) $2,589
Cystoscopy w/complex removal stone & stent (52315) $1,241
Cystoscopy,Dil Urethral Stricture (52281) $2,233.50
Cystoscopy,insert ureteral stent (52332) $816
Cystostomy Cystotomy W/Drainage (51040) $1,200
Cystotomy, with insertion of ureteral catheter or stent (separate procedure) (51045) $2,064
Cystotomy/cystostomy fulg&/insj radact matrl (51020) $1,866
Cystourethroscopy (52000) $1,198.75
Cystourethroscopy w/dil bladder general anesth (52260) $942
Cystourethroscopy W/Irrig & Evac Clots (52001) $1,753
Cystourethroscopy w/rmvl ureteral calculus (52320) $1,241
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic (52351) $1,699.50
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $194.75
Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) $2,078.75
Dcmprn fasct leg ant&/lat compartments only (27600) $1,625.50
Dcmprn fasct leg ant&/lat&pst cmprt (27602) $1,428.50
Debride Assoc Open Fx/Disloc Skin/Subq (11010) $1,543.50
Debride nail 1-5 (11720) $109.75
Debride skin musc at fx site (11011) $1,309.75
Debridement subcutaneous tissue 20 sq cm/< (11042) $301
Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) $607.25
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $914.25
Declot vascular device (36593) $840
Delivery placenta separate procedure (59414) $351.50
Destroy cerv/thor facet jnt (64633) $716.50
Destroy lumb/sac facet jnt (64635) $707.50
Destruction anal lesion(s) (46924) $751.50
Destruction benign lesions 15 or more (17111) $323.50
Destruction Benign Lesions Up To 14 (17110) $237.50
Destruction by neurolytic agent; other peripheral nerve or branch (64640) $298.50
Destruction Lesions Vulva Extensive (56515) $789
Destruction Lesions Vulva Simple (56501) $450
Destruction malignant lesion s/n/h/f/g 2.1-3.0cm (17273) $560.50
Destruction malignant lesion s/n/h/f/g 3.1-4.0cm (17274) $560.50
Destruction neurolytic agt genicular nerve w/img (64624) $297.50
Destruction premalignant lesion 1st (17000) $191.25
Destruction Vaginal Lesions Extensive (57065) $678
Destruction vaginal lesions simple (57061) $388.50
Diagnostic sigmoidoscopy (45330) $244
Dilat urethral strix/vesical nck dilat male anes (53605) $285.50
Dilate Urethra Stricture (53600) $439
Dilation & curettage dx&/ther nonobstetric (58120) $832.50
Dilation esoph unguided sound/bougie 1/mult pass (43450) $1,652
Dilation of anal sphincter (45905) $683.50
Dilation of cervical canal (57800) $2,843.75
Dilation of female urethra including suppository and/or instillation; initial (53660) $338
Division of fallopian tube (58600) $1,556
Drain Mouth Absc/Cyst/Hematoma,Simpl (40800) $337.25
Drainage External Ear Abscess/Hematoma Simple (69000) $379.50
Drainage Finger Abscess Complicated (26011) $1,285
Drainage Finger Abscess Simple (26010) $516
Drainage mouth roof lesion (42000) $396.25
Drainage of deep rectal abscess (45020) $2,100
Drainage of eyelid abscess (67700) $352.25
Drainage of gum lesion (41800) $506
Drainage of hematoma/fluid (10140) $452
Drainage of hydrocele (55000) $592
Drainage of lymph node abscess or lymphadenitis; simple (38300) $722
Drainage of ovarian cyst(s) (58800) $1,377
Drainage of scrotal wall abscess (55100) $642.75
Draw blood off venous device (36591) $87.50
Dressing change under anesthesia (15852) $148
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $603
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $443.75
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $206.75
Dstrj lesion anus simple chemical (46900) $520.50
Dstrj lesion anus simple surg excision (46922) $877.50
Dstrj lesion penis simple surg excision (54060) $547
Egd Ablate Tumor Polyp/Lesion W/Dilation& Wire - Egd (43270) $1,479.25
Egd balloon dilation esophagus <30 mm diam (43249) $700.50
Egd Dilation Gastric/Duodenal Stricture - Egd (43245) $2,272.50
Egd flexible foreign body removal (43247) $807
Egd guide wire insertion (43248) $724
Egd place gastrostomy tube (43246) $1,036.50
Egd rem tumr/polyp forcep (43250) $2,380
Egd remove lesion snare (43251) $834.50
Egd Transoral Control Bleeding Any Method - Egd (43255) $1,114
EMG stds anal/urtl sphnctr oth/thn ndl (51784) $918
Endocervical Curettage (57505) $324.50
Endometrial Cryoablation With Ultrasonic Guidance, Including Endometrial Curettage, When Performed (58356) $1,378
Endoscopic Injection/Implant (51715) $3,454
Enterorrhaphy single perforation (44602) $4,204
Epididymectomy unilateral (54860) $1,822
Episiotomy or vaginal repair (59300) $880
Escharotomy initial incision (16035) $808.50
Esoph endoscopy dilation (43226) $1,322
Esophagogastroduodenoscopy submucosal injection (43236) $1,461.50
Esophagosc dilate balloon 30 (43214) $722
Esophagoscopy flex biopsy (43202) $450
Esophagoscopy flexible removal foreign body (43215) $630
Esophagoscopy flexible transoral diagnostic (43200) $413
Esophagoscopy w/us needle bx (43232) $997.50
Evacuation of subungual hematoma (11740) $142.75
Ex tum/vasc malf sft tiss hand/fngr subq 1.5cm/> (26111) $1,288.50
Exc abd les sc 3 cm/> (22903) $1,755
Exc arm/elbow les sc 3 cm/> (24071) $1,438.50
Exc arm/elbow les sc < 3 cm (24075) $1,803.50
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $608
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) $1,009.50
Exc back les sc < 3 cm (21930) $1,734
Exc face les sbq 2 cm/> (21012) $1,079
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $395
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $837.25
Exc forearm les sc 3 cm/> (25071) $1,707.50
Exc forearm les sc < 3 cm (25075) $1,269.50
Exc hand les sc < 1.5 cm (26115) $3,047.50
Exc hydrocele sprmatic cord uni spx (55500) $1,560.75
Exc lesion tendon sheath/capsule w/synvct toe ea (28092) $1,372.50
Exc neck tum deep < 5 cm (21556) $2,435
Exc rect tum transanal part (45171) $2,524.50
Exc shoulder les sc 3 cm/> (23071) $1,665.50
Exc skin abd (15830) $4,927
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $446
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $384
Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) $433.25
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $603.75
Exc Skin Benig 3.1- 4 Cm Face,Facial (11444) $871
Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg (11404) $621.50
Exc Skin Benig >4 Cm Face,Facial (11446) $1,443
Exc Skin Benig >4 Cm Remaindr Body (11426) $1,073.50
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $1,112.75
Exc Skin Malig 2.1-3 Cm Face,Facial (11643) $878.75
Exc Skin Malig >4 Cm Face,Facial (11646) $3,708
Exc Skin Malig >4 Cm Remaindr Body (11626) $1,159.50
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $1,375.75
Exc thigh/knee les sc 3 cm/> (27337) $1,770.75
Exc Thrombosed Hemorrhoid Xtrnl (46320) $520.50
Exc tr-ext b9+marg 0.5 cm or less (11400) $312.50
Exc tumor soft tiss back/flank subfascial 5 cm/> (21933) $2,795
Exc tumor soft tiss face&scalp subfascial < 2cm (21013) $2,500.50
Exc Tumor Soft Tiss Forearm&/Wrist Subfasc <3Cm (25076) $1,424
Exc tumor soft tissue abdl wall subfascial <5cm (22900) $1,677
Exc tumor soft tissue abdominal wall subq <3cm (22902) $1,317
Exc tumor soft tissue leg/ankle subq <3cm (27618) $1,407.75
Exc Tumor Soft Tissue Neck/Ant Thorax Subfascial 5+Cm (21554) $3,327
Exc Tumor Soft Tissue Neck/Ant Thorax Subq 3+Cm (21552) $1,786.50
Exc tumor soft tissue neck/ant thorax subq <3cm (21555) $1,537.50
Exc tumor soft tissue pelvis & hip subq <3cm (27047) $1,493.50
Exc tumor soft tissue thigh/knee subfasc <5cm (27328) $1,918
Exc/curtg bone cyst/b9 tumortarsal/metatarsal (28104) $1,608.50
Exc/Curtg Cst/B9 Tum Phalanges Foot (28108) $1,966.50
Excis Tendon Sheath Lesion, Hand/Finger (26160) $1,544
Excise excess skin & tissue (15839) $3,941
Excise lesion testis (54512) $2,008
Excise/repair mouth lesion (40812) $1,119.50
Excision Breast Lesion (19125) $1,733.50
Excision Chalazion Single (67800) $366
Excision external ear partial simple repair (69110) $2,128.50
Excision hidradenitis axillary complex repair (11451) $2,466
Excision hydrocele bilateral (55041) $2,052
Excision mal lesion trunk/arm/leg 0.5 cm/< (11600) $456.50
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $583
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $2,066.50
Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) $762.50
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $788
Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) $619.75
Excision malignant lesion f/e/e/n/l 0.6-1.0 cm (11641) $751.75
Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) $731
Excision Malignant Lesion F/E/E/N/L 3.1-4.0 Cm (11644) $1,383.75
Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) $465
Excision malignant lesion s/n/h/f/g 0.6-1.0 cm (11621) $589.50
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $678
Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) $803
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $2,605
Excision Multiple External Papillae/Tags Anus (46230) $647
Excision of bartholin's gland or cyst (56740) $3,382
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $509.50
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $690.50
Excision of ganglion, wrist (dorsal or volar); recurrent (25112) $1,446
Excision of hydrocele; unilateral (55040) $1,428.50
Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure (67840) $577.50
Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle (27630) $1,847.50
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $526
Excision of lesion other than skin tag </= 0.5 cm (11420) $338
Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cys (28090) $1,693.50
Excision of lingual tonsil (42870) $2,210.50
Excision of local lesion of epididymis (54830) $1,608.50
Excision of nail fold toe (11765) $313.50
Excision of pilonidal cyst or sinus; simple (11770) $694
Excision of single external papilla or tag, anus (46220) $695
Excision of skin/subcutaneous tissue for hidradenitis, axillary; w/ simple or interm repair (11450) $1,884
Excision of spermatocele, with or without epididymectomy (54840) $1,401.50
Excision of Umbilicus (49250) $2,220.25
Excision of vaginal cyst or tumor (57135) $663
Excision of vaginal septum (57130) $618.25
Excision olecranon bursa (24105) $1,131
Excision or fulguration; Skene's glands (53270) $665
Excision pilonidal cyst/sinus complicated (11772) $2,243
Excision Prepatellar Bursa (27340) $1,148
Excision soft tissue lesion, external auditory canal (69145) $1,865
Excision tumor soft tis back/flank subq 3 cm/> (21931) $1,866
Excision tumor soft tissue thigh/knee subq <3cm (27327) $1,472
Excision, sacral pressure ulcer, with primary suture; (15931) $2,758
Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater (22901) $2,939.50
Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm (21011) $1,750.50
Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater (28039) $5,509.50
Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater (27632) $1,651.75
Excision, tumor, soft tissue of leg or ankle area, subfascial (e g, intramuscular); 5 cm or greater (27634) $2,179.50
Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater (27043) $1,866
Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm (23075) $1,131
Excision/curettage cyst/tumor talus/calcaneus (28100) $4,916
Expl penetrating wound spx abdomen/flank/back (20102) $1,569.50
Expl retroperitoneum w/wo bx spx (49010) $3,834.50
Expl W/Removal Deep Foreign Body Forearm/Wrist (25248) $1,656
Explo/Drain Breast Abscess (19020) $1,135
Exploration for undescended testis (inguinal or scrotal area) (54550) $2,122
Exploration of ankle joint (27612) $8,135
Exploration penetrating wound spx chest (20101) $1,570.50
Exploration penetrating wound spx extremity (20103) $1,326
Explore & Treat Metacarpo-Phal Jt (26075) $1,588
Explore/treat ankle joint (27620) $8,084.50
Explore/treat ankle joint (27610) $8,360
Fasciotomy Hip Or Thigh Any Type (27025) $3,793
Fine needle aspiration without imaging guidance (10021) $276
Fitting of diaphragm/cap (57170) $225
Fixation of knee joint (27570) $483.50
Frmj direct/tubed pedicle w/wotr e/n/e/l/ntroral (15576) $6,434.50
Fth/Gft Fr W/Dir Clsr F/C/C/M/N/Ax/G/H/F 20 Cm/< (15240) $2,976.50
Fth/gft free w/direct closure s/a/l 20 cm/< (15220) $2,977.50
Fusion of foot bones (28735) $17,239.50
Gastric Intubation/Aspiration, Therapeutic (43753) $668
Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury (43840) $4,167.25
Gastrostomy opn w/o constj gstr tube spx (43830) $2,542.75
Graft ear crtlg autogenous nose/ear (21235) $2,223
Hemiarthroplasty Hip Partial (27125) $3,622.50
Hemorrhoidectomy (46255) $1,591.50
Hemorrhoidectomy external complete (46250) $1,608.75
Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling (46947) $1,454.25
Hysteroscopy ablation (58563) $5,202
Hysteroscopy biopsy (58558) $3,751.50
Hysteroscopy dx sep proc (58555) $755.50
Hysteroscopy Lysis Intrauterine Adhesions (58559) $1,339.75
Hysteroscopy Removal Impacted Foreign Body (58562) $1,144.25
Hysteroscopy, surgical; with removal of leiomyomata (58561) $2,117.25
I&D Abscess Peritonsillar (42700) $448
I&d abscess simple (10060) $355
I&d deep absc bursa/hematoma thigh/knee region (27301) $1,466.50
I&D Deep Absc/Hematoma Neck/Chest (21501) $1,209
I&d epididymis tstis&/scrotal space (54700) $1,024.75
I&D Forearm&/Wrist Deep Abscess/Hematoma (25028) $2,107.50
I&D Pelvis/Hip Jt Area Deep Abscess/Hematoma (26990) $5,876.50
I&d perianal abscess superficial (46050) $668
I&d pilonidal cyst simple (10080) $357
I&D Rectal Abscess + Fistulectomy (46060) $3,955.50
I&D Upper Arm/Elbow Bursa (23931) $817.75
I&d upper arm/elbow deep abscess/hematoma (23930) $820.50
Image Cath Fluid Peri/Retro (49406) $779.75
Immediate breast prosthesis (19340) $1,537
Incise finger tendon sheath (26055) $1,428.50
Incision & drainage abscess complicated/multiple (10061) $638
Incision & drainage leg/ankle abscess/hematoma (27603) $1,714
Incision & drainage pilonidal cyst complicated (10081) $978
Incision & removal foreign body subq tiss compl (10121) $1,082
Incision & removal foreign body subq tiss simple (10120) $311.50
Incision and drainage of abscess of pelvis (57010) $1,789
Incision and drainage of bartholin's gland abscess (56420) $395
Incision and drainage of vulva or perineal abscess (56405) $433.25
Incision extensor tendon sheath wrist (25000) $1,082
Incision of heel bone (28300) $9,547.50
Incision of metatarsal (28308) $3,806.75
Incision of rectal abscess (46040) $1,494
Incision of urethra (53020) $5,572
Incision thrombosed hemorrhoid external (46083) $389.50
Incisional biopsy eyelid skin & lid margin (67810) $383.25
Incisional biopsy skin single lesion (11106) $488.50
Initial tx 1st degree burn local tx (16000) $168
Inj paravert f jnt c/t 1 lev (64490) $419.50
Inj tendon sheath/ligament (20550) $236.50
Inj,Anes Agent,Brachial Plexus,Single (64415) $173.50
Inj,Anes Agent,Femoral Nerve,Single (64447) $173.50
Inject Nerv Blck,Ilioingu/Iliohyp (64425) $438
Inject Nerv Blck,Intercostal,One (64420) $579
Inject scleros soln in hemorrhoids (46500) $469
Inject Tendon Origin/Insert (20551) $162
Injection aa&/strd genicular nrv branches w/img (64454) $144
Injection aa&/strd sciatic nerve w/img gdn (64445) $173.50
Injection aa&/strd sciatic nrv cont nfs cath img (64446) $173.50
Injection aa&/strd trigeminal nerve each branch (64400) $258.50
Injection anes other peripheral nerve/branch (64450) $336
Injection for identification of sentinel node (38792) $163.50
Injection single/mlt trigger point 1/2 muscles (20552) $159.25
Injection single/mlt trigger point 3/> muscles (20553) $226
Injection therapeutic carpal tunnel (20526) $219.50
Injection, anesthetic agent; greater occipital nerve (64405) $922
Injx Anterior Chamber Eye Medication Spx (66030) $806
Injx/Infus Neurolyt Sbst Epidural Lumbar/Sacral (62282) $1,745
Insert Bladder Cath Complex (51703) $432
Insert Drug Implant Device (11981) $505
Insert Gastrostomy Tube Percutaneous (49440) $2,341.50
Insert non-tunnel cv cath (36556) $472.25
Insert Non-Tunnel Cv Cath < 5 Y/O (36555) $1,484.75
Insert pessary/other device (57160) $187.50
Insert picc cath (36569) $375.25
Insert Picc W/O Sub-Q Port <5 Y/O (36568) $443.50
Insert Temp Bladder Cath (51702) $281.50
Insert tunneled cv cath (36561) $6,709
Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) $1,353
Insert,Non-Indwelling Bladder Catheter (51701) $159
Insertion of a temporary prostatic urethral stent, including urethral measurement (53855) $319
Insertion subq cardiac rhythm monitor w/prgrmg (33285) $8,448.50
Insj prph ctr vad w/subq port age 5 yr/> (36571) $1,271.50
Insj tun vad req 2 cath 2 sits w/subq port (36566) $1,493.50
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $1,138.25
Intersex surgery; female to male Other Surgical Services (55980) $4,037.50
Intersex surgery; male to female Other Surgical Services (55970) $4,037.50
Intubation endotracheal emergency procedure (31500) $657
Knee arthroscopy/surgery (29883) $3,869.50
Knee arthroscopy/surgery (29876) $3,045.50
Lap ing hernia repair init (49650) $1,630.50
Laparo new ureter/bladder (50947) $6,763.50
Laparo-myomectomy complex (58546) $9,033.75
Laparoscopy , surgical , with vaginal hysterectomy, for uterus greater than 250 grams; (58553) $4,762.75
Laparoscopy , surgical , with vaginal hysterectomy, for uterus greater than 250 grams; with removal of tube(s) and/or… (58554) $7,999.25
Laparoscopy appendectomy (44970) $4,869.50
Laparoscopy biopsy (49321) $1,186
Laparoscopy gastrostomy (43653) $2,215
Laparoscopy Remove Adnexa (58661) $5,842.50
Laparoscopy salpingostomy (58673) $3,780
Laparoscopy surgical, with vaginal hysterectomy, for uterus 250 grams or less; with removal of tube(s) and/or ovary(s) (58552) $3,751.50
Laparoscopy tot hysterectomy >250 g w/tube/ovar (58573) $5,125
Laparoscopy tubal block (58671) $3,079.75
Laparoscopy Tubal Cautery (58670) $1,453
Laparoscopy ureterolithotomy (50945) $4,265
Laparoscopy w/lysis of adhesions (58660) $2,345
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of spec (49320) $5,796
Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) (44180) $3,435
Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures) (43280) $4,554
Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weigh (58545) $2,049
Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of… (43281) $5,944.50
Laparoscopy, surgical; cholecystectomy with cholangiography (47563) $5,910
Laparoscopy, surgical; cholecystectomy with exploration of common duct (47564) $3,810
Laparoscopy, surgical; repair recurrent inguinal hernia (49651) $2,192.25
Laps fulg/exc ovary viscera/peritoneal surface (58662) $2,694
Laps supracrv hysterect 250 gm/< rmvl tube/ovar (58542) $3,967
Laps surg retroperitoneal lymph node bx 1/mlt (38570) $2,351.50
Laps Surg W/Aspir Cavity/Cyst Single/Multiple (49322) $1,392.50
Laps Tx Ectopic Preg W/O Salping&/Oophorectomy (59150) $5,053.75
Laps vaginal hysterectomy uterus 250 gm/< (58550) $7,437
Laryngoscopy Direct Aspiration (31515) $1,187
Laryngoscopy Indirect Diagnostic Spx (31505) $268
Laryngoscopy indirect w/removal foreign body (31511) $888
Laryngoscopy W/Foreign Body Removal (31530) $2,108.75
Laryngoscopy,Direct,Diagnostic (31525) $792.50
Laser vaporization surgery prostate, complete (52648) $9,724.50
Late closure of wound (13160) $2,282.50
Ligate/strip long leg vein (37722) $2,135.75
Ligate/strip short leg vein (37718) $1,729
Ligation of hemorrhoid(s) (46221) $936
Ligation or biopsy temporal artery (37609) $1,325
Lithotripsy (50590) $2,445.50
Liver Biopsy (47000) $1,065.50
Lsh uterus 250 g or less (58541) $3,574
Lsh uterus above 250 g (58543) $3,890.50
Lsh w/t/o uterus above 250 g (58544) $5,580.50
Marsup Bartholin Gland Cyst (56440) $781.25
Mast mod rad (19307) $4,542
Mastectomy gynecomastia (19300) $1,538.25
Mastectomy partial (19301) $2,351.75
Mastectomy partial w/axillary lymphadenectomy (19302) $3,591.50
Mastectomy simple complete (19303) $744
Middle ear surgery proc unlisted (69799) $751.50
Muscle-skin graft trunk (15734) $4,922
Myomectomy 1-4 myomas 250 gm/< vaginal appr (58145) $2,158
Myringoplasty (69620) $5,327
Nasal/Sinus Endoscopy,W/Control Nasal Hem (31238) $789
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $143
Njx Cholangio Prq W/Img Gid Rs&I New Access (47532) $7,762.50
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $256.25
Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) $1,365.50
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn (62320) $173.50
Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) $833.25
Njx dx/ther sbst intrlmnr lmbr/sac w/o img gdn (62326) $769.50
Omntc Epiploectomy Rescj Omentum Spx (49255) $2,981.50
Open biopsy/excision inguinofemoral nodes (38531) $1,339
Open rx distal radius fx, intra-articular, 2 frag (25608) $2,639.50
Open Treatment Bimalleolar Ankle Fracture (27814) $2,469
Open treatment interphalangeal joint dislocation (28675) $1,834.50
Open Treatment Medial Malleolus Fracture (27766) $1,183.75
Open treatment metatarsal fracture each (28485) $3,017.50
Open treatment of clavicular fracture, includes internal fixation, when performed (23515) $2,304.50
Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement (27236) $3,839.50
Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal… (27511) $4,390
Open treatment of greater trochanteric fracture, includes internal fixation, when performed (27248) $2,390
Open treatment of humeral shaft fracture with plate/screws, with or without cerclage (24515) $2,816.50
Open treatment of patellar fracture, with internal fixation and/or patellectomy (27524) $2,414.50
Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones (25670) $2,733
Open treatment of tibial fracture, proximal; unicondylar, includes internal fixation (27535) $2,886.50
Open treatment of trimalleolar ankle fracture; with fixation of posterior lip (27823) $2,549
Open treatment of ulnar shaft fracture, includes internal fixation, when performed (25545) $1,900.50
Open treatment of ulnar styloid fracture (25652) $1,895.50
Open Treatment Radial Shaft Fracture (25515) $2,142.50
Open tx distal radial intra-articular fx or epiphyseal separation; w/ int fix 3+ fragments (25609) $3,364.50
Open tx fracture great toe/phalanx/phalanges (28505) $2,084
Open Tx Metacarpal Fracture Single Ea Bone (26615) $1,842.50
Open tx metatarsophalangeal joint dislocation (28645) $6,196.50
Open tx of distal tibiofibular joint disruption, includes internal fixation, when performed (27829) $2,230
Open tx proximal humeral fx, incl int fixation, includes repair of tuberosity (23615) $2,834.50
Orchiectomy radical tumor inguinal approach (54530) $2,288
Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) (54650) $2,916.50
Ostectomy of sternum partial (21620) $1,289.50
Ostectomy, complete excision; fifth metatarsal head (28113) $5,235
Ostectomy, complete excision; other metatarsal head (second, third or fourth) (28112) $750
Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) (28110) $3,101
Ovarian cystectomy (58925) $2,994
Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) (42145) $3,140
Partial Excision Distal Phalanx Finger (26236) $1,412.50
Partial excision of bone; tarsal or metatarsal bone, except talus or calcaneus (28122) $4,916
Partial hymenectomy or revision of hymenal ring (56700) $470
Partial removal of thyroid (60220) $2,939
Partial thyroid lobectomy, unilateral; with or without isthmusectomy (60210) $3,285.50
Partical Excision Bone Phalanx Toe (28124) $3,383
Pelvic exam under anesthesia (57410) $681.75
Percut Mech Thrombectomy, Venous (37187) $1,890
Percutaneous Skeletal Fixation Of Metacarpal Fracture, Each Bone (26608) $1,531
Percutaneous skeletal fixation of ulnar styloid fracture (25651) $1,564.50
Perineoplasty rpr perineum nonobstetrical spx (56810) $1,182
Peritoneal Lavage (49084) $807.75
Perq device breast 1st imag (19281) $1,640.50
Perq Drainage Pleura Insert Cath W/Imaging (32557) $1,795
Perq Drainage Pleura Insert Cath W/O Imaging (32556) $3,527
Phalangectomy toe each toe (28150) $1,575.50
Pin finger fracture each (26756) $1,329.50
Pin hand dislocation (26676) $1,359.50
Placement of implants to block fallopian tubes using an endoscope (58565) $1,726
Placement of needle for intraosseous infusion (36680) $361.50
Placement of seton (46020) $3,502
PR Egd Partial/Compl Esophagogastric Fundoplasty (43210) $7,306.50
Pr unlisted procedure laparoscopy, oviduct, ovary (laparoscopic resection (initial) of ovarian, tubal or primary… (58679) $3,175.50
Preputial Stretching (54450) $339
Proctopexy Perineal Approach (45541) $3,599
Proctosgmdsc Rigid Control Bleeding (45317) $438
Proctosgmdsc Rigid W/Rmvl Foreign Body (45307) $384.50
Proctosigmoidoscopy removal (45308) $314.50
Proctosigmoidoscopy removal (45315) $415.50
Proctosigmoidoscopy w/bx (45305) $293.50
Proctosigmoidoscopy, rigid; with decompression of volvulus (45321) $404
Proctosigmoidoscopy,Rigid,Diagnos - Endoscopy Sigmoid (45300) $396
Prostatectomy (turp) (52601) $10,701.50
Prq skel fixj fx grt toe phlx/phlg w/manj (28496) $1,465
Prq skel fixj sprcndylr/transcndylr humeral fx (24538) $6,332.25
Puncture Aspiration (10160) $304.25
Puncture Aspiration Cyst Breast (19000) $168
Rcnstj pst tibl tdn w/exc accessory tarsl navclr (28238) $9,547.50
Rebuild outer ear canal (69310) $4,108
Reconstruction of anus (46753) $2,149
Reconstruction of nail bed with graft (11762) $864.50
Reconstruction of urethra (53430) $4,256.50
Reconstruction of urethra (54308) $3,430.50
Reduce testis torsion (54600) $1,932
Reduction of rectal prolapse (45900) $754.50
Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft (24342) $2,489
Removal fb intranasal (30300) $221.50
Removal Foreign Body Deep Thigh/Knee (27372) $1,741
Removal foreign body foot subcutaneous (28190) $869.75
Removal Foreign Body Muscle/Tendon Sheath Simple (20520) $584.50
Removal foreign body pharynx (42809) $364
Removal foreign body upper arm/elbow deep (24201) $1,451
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $163.50
Removal Implant Deep (20680) $1,966.50
Removal Implant Superficial Separate Procedure (20670) $549
Removal Implantable Contraceptive Capsules (11976) $395
Removal Intact Mammary Implant (19328) $2,122
Removal of anal fissure (46200) $1,465
Removal of anorectal lesion (45108) $1,496.50
Removal of arm foreign body (24200) $535
Removal of external bone stabilizing device under anesthesia (20694) $1,353
Removal of finger lesion (26210) $1,291.50
Removal of heel spur (28119) $5,549.50
Removal of intrauterine device (iud) (58301) $228.50
Removal of knee cartilage (27332) $2,848.50
Removal of nail bed (11750) $487
Removal of nose lesion (30124) $958.50
Removal of pressure sore (15999) $1,109.50
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $253
Removal of sperm cord lesion (55520) $1,920.25
Removal of testis (54520) $1,570.50
Removal of thyroid lesion (60200) $2,762
Removal of wrist bone (25210) $1,502.50
Removal/bivalving full arm/full leg cast (29705) $162
Removal/bivalving gauntlet boot/body cast (29700) $142
Remove anal fist 2 stage (46285) $1,426.50
Remove anal fist subq (46270) $1,302.50
Remove bladder stone (52318) $1,877
Remove by ligat int hem grps (46946) $809.25
Remove drug implant device (11982) $390.50
Remove Eyelid Foreign Body (67938) $245
Remove foreign body from eye (65210) $250
Remove in/ex hem groups 2+ (46260) $1,724
Remove Peritoneal Foreign Body (49402) $3,856.75
Remove Pilonidal Cyst Exten (11771) $1,549
Remove skin nerve lesion (64774) $1,789
Remove thyroid duct lesion (60280) $2,013.50
Remove wrist tendon lesion (25111) $1,131.50
Remv Ext Canal F.B.,Gen Anesth (69205) $441
Remv Ext Canal Foreign Body (69200) $214
Remv F.B.,Eye,Superf Conjunc (65205) $225.50
Repair achilles tendon (27650) $2,105.50
Repair anorectal fistula w/plug (46707) $5,025.50
Repair clitoris (56805) $5,220.50
Repair collat ankle ligmnt,secondary (27698) $2,843.50
Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) $821.50
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $1,639
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $712
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $1,819.50
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $972.50
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $1,391.75
Repair complex trunk 1.1-2.5 cm (13100) $809.25
Repair complex trunk 2.6-7.5 cm (13101) $1,099.50
Repair extensor tendon finger w/o graft each (26418) $1,912.50
Repair finger tendon (26433) $1,971.75
Repair finger/hand tendon (26350) $2,286.50
Repair forearm tendon/muscle (25270) $3,076
Repair forearm tendon/muscle (25260) $2,519
Repair hand tendon (26410) $2,327
Repair incomplete circumcision (54163) $2,512.50
Repair inguinal hernia, sliding, any age (49525) $6,724.50
Repair initial femoral hernia, any age; incarcerated or strangulated (49553) $2,398
Repair initial femoral hernia, any age; reducible (49550) $2,362.75
Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated (49507) $2,192
Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) $1,462
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $696.75
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $851.75
Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) $1,856.25
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $834.50
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $892.50
Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) $1,760.25
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $981.50
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $638
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $788
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $885.25
Repair intermediate n/h/f/xtrnl gent >30.0 cm (12047) $1,212
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $924.50
Repair intermediate s/a/t/e 2.5 cm/< (12031) $579.25
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $672
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $950.75
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $804
Repair intermediate s/a/t/e >30.0 cm (12037) $1,226.50
Repair kneecap tendon (27380) $2,901.50
Repair of ankle ligament (27695) $4,795.50
Repair of biceps tendon (24340) $1,963.50
Repair Of Foot Tendon (28208) $1,538.75
Repair of knee cartilage (27403) $2,055
Repair of leg tendon each (27664) $5,720.25
Repair of nail bed (11760) $816.25
Repair of nasal septum (30520) $4,452
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic (23412) $2,730
Repair of shoulder (23420) $3,107.50
Repair of thigh musc (27385) $1,853
Repair of urethra defect (53520) $2,458
Repair of urethra injury (53502) $2,037.25
Repair of vagina (57260) $3,278
Repair of windpipe (31750) $9,741
Repair rectum & vagina (57250) $2,653
Repair rotator cuff acute (23410) $2,634
Repair Tongue Laceration (41250) $452
Repair wrist joints (25447) $2,649.50
Repair/graft achilles tendon (27652) $6,686.25
Rerepair ing hernia reduce (49520) $2,352.50
Resect Inferior Turbinate (30140) $6,253.50
Resection, condyle(s), distal end of phalanx, each toe (28153) $4,726
Resection, partial or complete, phalangeal base, each toe (28126) $4,916
Revise knuckle joint (26530) $5,859
Revise median n/carpal tunnel surg (64721) $1,375.50
Revise ulnar nerve at elbow (64718) $1,900.50
Revise vag graft via vagina (57295) $3,866.75
Revise Vagina for Intersec State (57335) $5,056
Revision of colostomy simple (44340) $2,397.50
Revision of colostomy; with repair of paracolostomy hernia (separate procedure) (44346) $4,502.75
Revision of lower leg tendon (27685) $4,505.50
Revision of reconstructed breast (19380) $3,092.50
Revision of scrotum (55180) $2,920
Revision of scrotum (55175) $1,574.50
Revision of testis (54660) $1,569.50
Revision of total knee arthroplasty, with or without allograft; one component (27486) $3,698
Revision peri-implant capsule breast (19370) $2,744.50
Revj clst comp rcnstj in-depth spx (44345) $4,010.50
Rmvl Embedded Fb Vestibule Mouth Smpl (40804) $468.75
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $268
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $283
Rmvl fecal impaction/fb spx under anes (45915) $980.50
Rmvl foreign body muscle/tendon sheath deep/comp (20525) $1,677
Rmvl ruptured breast implant w/implant contents (19330) $2,425.50
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $816
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $654.50
Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) $3,327
Rpr aa hernia 1st 3-10 cm reducible (49593) $2,433
Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) $2,053
Rpr aa hernia 1st < 3 cm reducible (49591) $1,456.50
Rpr Aa Hernia Recr 3-10 Cm Reducible (49615) $1,603.50
Rpr Aa Hernia Recr < 3 Cm Reducible (49613) $1,824.50
Rpr Coltrl Ligm Mtcarphlngl/Iphal Jt (26540) $3,173.50
Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) $1,123.50
Rpr lac cjnc w/wo nonperfor lac sclera dir clsr (65270) $1,112
Rpr lac tongue floor mouth > 2.6 cm/cplx (41252) $1,510.50
Rpr Lip Full Thickness Half/< Vertical Height (40652) $1,343
Rpr Lip Full Thickness Vermilion Only (40650) $1,094.25
Rpr Lip Full Thkns >One-Half Vert Height/Comple (40654) $1,778.50
Rpsg previously placed cvc under fluor gdnce (36597) $1,507.50
Scrotal exploration (55110) $1,655.50
Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) $256
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) $129.50
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) $201
Shaving skin lesion 1 trunk/arm/leg diam 0.5cm/< (11300) $115.25
Shoulder arthroscopy (29805) $1,513.50
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $237.50
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) $243
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) $201
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) $294.50
Sigmoidoscopy & decompress (45337) $567.50
Sigmoidoscopy Flx Ablation Tumor Polyp/Oth Les - Endoscopy Sigmoid (45346) $2,153.50
Sigmoidoscopy Flx Control Bleeding - Endoscopy Sigmoid (45334) $1,721.75
Sigmoidoscopy Flx Tndsc Balo Dilat - Endoscopy Sigmoid (45340) $2,028.50
Sigmoidoscopy flx w/biopsy single/multiple (45331) $299.50
Sigmoidoscopy flx w/rmvl tumor by hot bx forceps (45333) $438
Sigmoidoscopy w/us guide bx (45342) $910
Simple Cystometrogram (51725) $737.25
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $692
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $446.25
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $542
Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) $967.75
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $725
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $927.50
Simple repair f/e/e/n/l/m >30.0 cm (12018) $1,023.75
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $382.50
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $1,196.50
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $629
Skin pinch graft (15050) $1,108.25
Skin splt grft trnk/arm/leg (15100) $2,714.50
Skin tissue rearrangement (14040) $3,965.50
Skn splt a-grft fac/nck/hf/g (15120) $3,628.50
Sling operation for stress incontinence (eg, fascia or synthetic) (57288) $2,981.75
Slitting of prepuce (54001) $601
Small bowel endoscopy (44376) $927.50
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $402.75
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $764.50
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $930.50
Spinal puncture lumbar diagnostic (62270) $435
Spinal Puncture Therapeutic (62272) $373
Strapping ankle (29540) $167
Strapping elbow/wrist (29260) $159.50
Strapping hand/finger (29280) $116.50
Strapping knee (29530) $189.25
Strapping shoulder (29240) $246.25
Strapping thorax (29200) $222.50
Strapping toes (29550) $64
Suprahyoid lymphadenectomy (38700) $3,043.50
Surgical opening of throat (42955) $3,118.50
Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric (46275) $1,627.50
Suspension of testis (54640) $2,013.50
Suspension of testis (54620) $1,315
Sutr Quadriceps/Hamstring Musc Rpt 2 Rcn (27386) $3,953
Tenodesis long tendon biceps (23430) $5,238.50
Tenotomy Open Extensor Foot/Toe Each Tendon (28234) $5,235
Thoracentesis Needle/Cath Pleura W/Imaging (32555) $904.25
Thoracentesis needle/cath pleura w/o imaging (32554) $401
Throat Surgery Procedure (42999) $508.50
Thrombolytic Therapy, Stroke (37195) $1,282.50
Thyroid biopsy (60100) $1,321
Thyroidectomy, total or complete (60240) $4,139
Tis trnfr trunk 10 sq cm/< (14000) $2,071
Total hip arthroplasty (27130) $4,353
Total knee arthroplasty (27447) $10,096.50
Trach Tube Change (31502) $402.75
Tracheostomy emergency cricothyroid membrane (31605) $1,569.50
Transplant forearm tendon (25310) $1,984
Transurethral resection of bladder neck (52500) $2,402
Treat ectopic pregnancy (59151) $5,149.75
Treat Finger Fracture Each (26727) $1,498.50
Treat Fracture Radius & Ulna (25560) $816.75
Treat fracture radius/ulna (25575) $2,793
Treat fx distal radial (25606) $2,122
Treat fx rad extra-articul (25607) $3,162
Treat humerus fracture (23630) $2,504
Treat humerus fracture (24500) $691.50
Treat humerus fracture (24577) $1,161.75
Treat humerus fracture (23600) $688
Treat knee fracture (27532) $1,763
Treat Lower Leg Fracture (27827) $3,404
Treat Metatarsal Fracture (28475) $517.25
Treat toe fracture (28525) $873.50
Treat ulnar fracture (24685) $2,097.50
Treat wrist bone fracture (25622) $784.25
Treat Wrist Bone Fracture (25630) $648.50
Treatment closed elbow dislocation req anes (24605) $1,637
Treatment closed elbow dislocation w/o anes (24600) $742.75
Treatment of ankle fracture (27822) $2,750.50
Treatment of ankle fracture (27792) $2,203
Treatment of fibula fracture (27784) $2,277
Treatment of intertrochanteric or subtrochanteric femoral fracture; w intramedullary implant (27245) $3,953.50
Treatment of missed abortion, completed surgically; second trimester (59821) $1,540
Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each (28450) $632.50
Treatment of tibia fracture (27759) $3,069
Trim skin lesion (11055) $104.50
Trim skin lesions 2 to 4 (11056) $142
Trimming Of Nondystrophic Nails, Any Number (11719) $79
Tx anal fstl trans/supra/xtrasphnctrc incl seton (46280) $3,445.25
Tx Incomplete Abortion Any Trimester Surgical (59812) $1,126
Tx Missed Abortion First Trimester Surgical (59820) $1,329.50
Tx Superficial Wound Dehiscence Simple Closure (12020) $957.25
Tx superficial wound dehiscence w/packing (12021) $667
Unlisted laparoscopic procedure liver (47379) $4,329
Unlisted laparoscopy procedure, appendix (44979) $3,904
Unlisted laparoscopy procedure, biliary tract (47579) $2,458
Unlisted procedure anus (46999) $866.50
Unlisted procedure, forearm or wrist (25999) $611
Ureter endoscopy & treatment (50980) $1,581
Urine Flow Measurement (51736) $137.25
Vag Hyst > 250 Gm Rmvl Tube&/Ovary (58291) $4,303.50
Vag hyst complex (58290) $5,122.75
Vag hyst w/enterocele repair (58270) $3,505.25
Vaginal delivery only (59409) $3,028.50
Vaginal hysterectomy (58260) $3,283.50
Vaginal hysterectomy; with removal of tube(s), and/or ovary(s) (58262) $3,524.50
Vaginal hysterectomy; with removal of tube(s), and/or ovary(s), with repair of enterocele (58263) $3,429.50
Vasectomy (55250) $1,266
Venipuncture (36415) $29
Venipuncture, cutdown; age 1 or over (36425) $173.50
Ventilating tube removal requiring general anesthesia (69424) $3,608.50
Vulvectomy simple partial (56620) $1,969
Windowing of cast (29730) $134.50
Wound Prep F/N/Hf/G (15004) $1,103.50
Wound prep trk/arm/leg 1st 100 sq cm (15002) $1,013