| Abd paracentesis w/imaging (49083) |
— |
$958.50 |
— |
| Acne surgery (10040) |
— |
$23,016.45 |
— |
| Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm Age Under 21 (14001) |
— |
$8,204.43 |
— |
| Anesthesia inj anesthetic agent dig nrv (64455) |
— |
$232 |
— |
| Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic Age Under 21 (45990) |
— |
$8,469.45 |
— |
| Anoscopy diagnostic (46600) |
— |
$100 |
— |
| Application Finger Splint Dynamic (29131) |
— |
$50 |
— |
| Application finger splint static (29130) |
— |
$100 |
— |
| Application of long leg splint (thigh to ankle or toes) (29505) |
— |
$125.50 |
— |
| Application of short arm splint (forearm to hand); static (29125) |
— |
$100 |
— |
| Application of short leg splint (calf to foot) (29515) |
— |
$125.50 |
— |
| Apply hand/wrist cast (29085) |
— |
$125.50 |
— |
| Apply long arm splint (29105) |
— |
$125.50 |
— |
| Apply splint short arm dynamic (29126) |
— |
$100 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
— |
$292.50 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/us (20606) |
— |
$44,719.74 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
— |
$3,010.06 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
— |
$232 |
— |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
— |
$292.50 |
— |
| Arthrocnt aspir&/inj small jt/bursaw/us rec rprt (20604) |
— |
$330.50 |
— |
| Arthroplasty glenohumeral joint total shoulder (23472) |
— |
$61,897.40 |
— |
| Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction Age Under 21 (29888) |
— |
$32,497.04 |
— |
| Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) Age Under 21 (29883) |
— |
$11,400.81 |
— |
| Arthrp acetblr/prox fem prostc agrft/algrft (27130) |
— |
$76,216.87 |
— |
| Aspirate pleura w/o imaging (32554) |
— |
$480.50 |
— |
| Aspiration and/or injection of ganglion cyst(s) any location (20612) |
— |
$232 |
— |
| Avulsion of nail plate, partial or complete, simple; single (11730) |
— |
$159 |
— |
| Biopsy lymph node (38505) |
— |
$2,755.88 |
— |
| Biopsy muscle percutaneous needle (20206) |
— |
$1,250.50 |
— |
| Biopsy of lower large bowel using a flexible endoscope|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (45331) |
— |
$7,500.16 |
— |
| Biopsy or excision of lymph node(s); open, superficial (38500) |
— |
$5,787.12 |
— |
| Biopsy or removal of deep lymph nodes of underarm|LEFT SIDE|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF… (38525) |
— |
$5,043.04 |
— |
| Biopsy/removal lymph nodes (38510) |
— |
$8,278.57 |
— |
| Bladder irrigation (51700) |
— |
$331.50 |
— |
| Bx breast 1st lesion us imag (19083) |
— |
$1,160 |
— |
| Cast short arm (29075) |
— |
$215 |
— |
| Change Cystostomy Tube Simple (51705) |
— |
$237 |
— |
| Chemical cauterization of granulation tissue (17250) |
— |
$159 |
— |
| Chest tube placement (32551) |
— |
$1,249.50 |
— |
| Chromotubation Oviduct W/Materials|BILATERAL PROCEDURE (58350) |
— |
$37,465.47 |
— |
| Closed treatment of clavicular fracture; without manipulation (23500) |
— |
$183.50 |
— |
| Closed treatment of distal fibular fracture (lateral malleolus); with manipulation (27788) |
— |
$183.50 |
— |
| Closed treatment of distal fibular fracture (lateral malleolus); without manipulation (27786) |
— |
$183.50 |
— |
| Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction Age Under 21 (27502) |
— |
$1,237.50 |
— |
| Closed treatment of metacarpal fracture, single; with manipulation, each bone (26605) |
— |
$183.50 |
— |
| Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia Age Under 21 (26705) |
— |
$1,217 |
— |
| Closed treatment of phalangeal shaft fracture, proximal/middle phalanx with manipulation each (26725) |
— |
$183.50 |
— |
| Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each (26720) |
— |
$183.50 |
— |
| Closed treatment of post hip arthroplasty dislocation; requiring general anesthesia (27266) |
— |
$1,237.50 |
— |
| Closed treatment of radial head or neck fracture; without manipulation (24650) |
— |
$183.50 |
— |
| Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation (24640) |
— |
$183.50 |
— |
| Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation Age Under 21 (23665) |
— |
$1,237.50 |
— |
| Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) |
— |
$183.50 |
— |
| Closed treatment of talus fracture; without manipulation (28430) |
— |
$183.50 |
— |
| Closed treatment of tibial fracture, proximal (plateau); without manipulation (27530) |
— |
$183.50 |
— |
| Closed treatment of ulnar fracture, proximal end; without manipulation (24670) |
— |
$183.50 |
— |
| Closed tx ankle dislocation w/o anesthesia (27840) |
— |
$175.50 |
— |
| Closed tx bimalleolar ankle fracture w/manj (27810) |
— |
$1,237.50 |
— |
| Closed tx patellar dislocation w/anesthesia (27562) |
— |
$217 |
— |
| Closed tx patellar dislocation w/o anesthesia (27560) |
— |
$183.50 |
— |
| CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee (25565) |
— |
$244 |
— |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
— |
$1,237.50 |
— |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
— |
$1,237.50 |
— |
| Cltx carpo/metacarpal dislocation thumb w/manj (26641) |
— |
$213 |
— |
| CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA TechFee (26755) |
— |
$183.50 |
— |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
— |
$183.50 |
— |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
— |
$1,237.50 |
— |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) |
— |
$183.50 |
— |
| Cltx grter humeral tuberosity fx w/manipulation (23625) |
— |
$1,237.50 |
— |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
— |
$183.50 |
— |
| Cltx metar fx w/manj (28475) |
— |
$183.50 |
— |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
— |
$1,237.50 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$1,237.50 |
— |
| Collect blood from catheter venous nos (36592) |
— |
$142 |
— |
| Collect blood from implant venous access device (36591) |
— |
$230.50 |
— |
| Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or… (44406) |
— |
$8,469.45 |
— |
| Colonoscopy thru stoma spx (44388) |
— |
$8,469.45 |
— |
| Colonoscopy w/fb removal (45379) |
— |
$8,469.45 |
— |
| Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids) (45398) |
— |
$3,794.52 |
— |
| Contrast injection perq radiologic eval gi tube (49465) |
— |
$241 |
— |
| Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image… (36598) |
— |
$7,393.83 |
— |
| Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method (30903) |
— |
$100 |
— |
| Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) |
— |
$100 |
— |
| Core needle bx lung/mediastinum perq w/img (32408) |
— |
$878 |
— |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
— |
$100 |
— |
| Ctrl nsl hemrrg pst nasal packs&/cautery subsq (30906) |
— |
$188 |
— |
| Cystourethroscopy (52000) |
— |
$31,396.33 |
— |
| Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography,… (52005) |
— |
$34,396.75 |
— |
| Debride skin at fx site (11010) |
— |
$15,866.33 |
— |
| DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee (11042) |
— |
$307.50 |
— |
| Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm… (11043) |
— |
$15,866.33 |
— |
| Declot vascular device (36593) |
— |
$386 |
— |
| Delivery of placenta (59414) |
— |
$2,331.50 |
— |
| Destruction neurolytic agt genicular nerve w/img (64624) |
— |
$2,281 |
— |
| Diagnostic anoscopy (46601) |
— |
$8,469.45 |
— |
| Diagnostic exam of uterus using an endoscope|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (58555) |
— |
$7,239.39 |
— |
| Diagnostic lumbar spinal puncture w/fluor or CT (62328) |
— |
$564 |
— |
| Diagnostic sigmoidoscopy (45330) |
— |
$1,527.84 |
— |
| Drainage external ear, abscess or hematoma; simple (69000) |
— |
$553.50 |
— |
| Drainage finger abscess simple (26010) |
— |
$126.50 |
— |
| Drainage of tonsil abscess (42700) |
— |
$188 |
— |
| Dstr nrolytc agnt parverteb fct sngl crvcl/thora (64633) |
— |
$2,935 |
— |
| Dstr nrolytc agnt parverteb fct sngl lmbr/sacral (64635) |
— |
$2,888 |
— |
| Ed proc insert intraosseous IV (36680) |
— |
$241.50 |
— |
| Ed proc remve fb nasal- hospital (30300) |
— |
$100 |
— |
| Ed prof arthrocentesis sm - hospital (20551) |
— |
$243 |
— |
| Ed prof artl pnxr w/drawal bld dx (36600) |
— |
$225 |
— |
| Ed prof burn medium - hospital (16025) |
— |
$159 |
— |
| Ed prof burn small - hospital (16020) |
— |
$159 |
— |
| Ed prof catheterization/straight (51701) |
— |
$280.50 |
— |
| Ed prof closed tx post hip arthroplasty (27265) |
— |
$183.50 |
— |
| Ed prof insert foley cath simple (51702) |
— |
$304 |
— |
| Ed prof insert non tunnel cv cath >5 (36556) |
— |
$92 |
— |
| Ed prof int lac 12.6-20cm bd - hospital (12035) |
— |
$307.50 |
— |
| Ed prof int lac 7.6-12.5cm bd - hospital (12034) |
— |
$307.50 |
— |
| Ed prof interphalangeal dislocation- hospital (26770) |
— |
$183.50 |
— |
| Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) |
— |
$241.50 |
— |
| Egd us exam duodenum/jejunum (43259) |
— |
$45,199.14 |
— |
| Egd us fine needle bx/aspir (43242) |
— |
$45,199.14 |
— |
| Egd us transmural injxn/mark (43253) |
— |
$45,199.14 |
— |
| Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck Age Under 21 (51715) |
— |
$27,898.83 |
— |
| Endoscopic us exam esoph (43237) |
— |
$45,199.14 |
— |
| Endoscopy upper small intestine (44360) |
— |
$45,199.14 |
— |
| Er inj anesthetic agent, peripheral nerve or branch (64450) |
— |
$564 |
— |
| Esoph egd dilation <30 mm (43249) |
— |
$6,699.17 |
— |
| Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes… (43210) |
— |
$45,199.14 |
— |
| Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine… (43238) |
— |
$45,199.14 |
— |
| Evac subungual hematoma (11740) |
— |
$100 |
— |
| Exc h-f-nk-sp b9+marg 0.5/< (11420) |
— |
$15,866.33 |
— |
| Exc h-f-nk-sp b9+marg 0.6-1 (11421) |
— |
$15,866.33 |
— |
| Exc h-f-nk-sp b9+marg 1.1-2 (11422) |
— |
$15,866.33 |
— |
| Exc tr-ext b9+marg 1.1-2 cm (11402) |
— |
$7,429.90 |
— |
| Excision ganglion wrist dorsal/volar primary (25111) |
— |
$4,961.85 |
— |
| Excision of lesion of spermatic cord (separate procedure) Age Under 21 (55520) |
— |
$4,042.70 |
— |
| Excision of single external papilla or tag, anus (46220) |
— |
$5,074.93 |
— |
| Excision of superficial tracheostomy lesions and/or granulation tissue (31899) |
— |
$30,483.15 |
— |
| Excision pilonidal cyst/sinus complicated (11772) |
— |
$8,252.22 |
— |
| Excision tumor soft tissue foot/toe subq 1.5+cm (28039) |
— |
$15,866.33 |
— |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) |
— |
$15,866.33 |
— |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11423) |
— |
$15,866.33 |
— |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11426) |
— |
$15,866.33 |
— |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11424) |
— |
$15,866.33 |
— |
| Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater Age Under 21 (21552) |
— |
$7,157.93 |
— |
| Excison tumor soft tissue thigh/knee subq 3 cm/> (27337) |
— |
$5,458.76 |
— |
| Exploration penetrating wound spx extremity (20103) |
— |
$553.50 |
— |
| Explore wound abdomen (20102) |
— |
$1,522 |
— |
| Fasciectomy plantar fascia partial spx (28060) |
— |
$15,866.33 |
— |
| Fasciectomy, plantar fascia; radical (separate procedure) Age Under 21 (28062) |
— |
$15,866.33 |
— |
| Fine needle aspiration bx w/o img gdn 1st lesion (10021) |
— |
$307.50 |
— |
| Fine needle aspiration bx w/us gdn 1st lesion (10005) |
— |
$878 |
— |
| Ganglion impar nerve block (64999) |
— |
$232 |
— |
| Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation,… (43755) |
— |
$5,711.44 |
— |
| Gastric lavage (43753) |
— |
$5,711.44 |
— |
| Guide cathet fluid drainage (10030) |
— |
$1,201.50 |
— |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) |
— |
$8,602.98 |
— |
| Hemorrhoidectomy, external, 2 or more columns/groups (46250) |
— |
$8,891.24 |
— |
| Hysteroscopy biopsy (58558) |
— |
$13,103.63 |
— |
| Hysteroscopy, surgical; with removal of impacted foreign body Age Under 21 (58562) |
— |
$6,613.41 |
— |
| I&d abscess simple/single (10060) |
— |
$159 |
— |
| I&d hematoma/seroma/fluid (10140) |
— |
$1,250.50 |
— |
| I&d pilonidal cyst simple (10080) |
— |
$552.50 |
— |
| INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee (10061) |
— |
$85 |
— |
| Incision and drainage of Bartholin's gland abscess (56420) |
— |
$66 |
— |
| Incision and drainage of vulva or perineal abscess (56405) |
— |
$250.50 |
— |
| Incision and removal of foreign body, subcutaneous tissues; complicated (10121) |
— |
$866 |
— |
| Incision and removal of foreign body, subcutaneous tissues; simple (10120) |
— |
$307.50 |
— |
| Incision of rectal abscess (46040) |
— |
$921 |
— |
| Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22… (0202U) |
— |
$1,615 |
— |
| Initial treatment, first degree burn, when no more than local treatment is required (16000) |
— |
$159 |
— |
| Inj epidural blood or clot patch (62273) |
— |
$789.50 |
— |
| Inj paravert f jnt c/t 1 lev (64490) |
— |
$1,908.50 |
— |
| Inj paravert f jnt l/s 1 lev (64493) |
— |
$2,020.50 |
— |
| Inj tx nerve (64640) |
— |
$1,130 |
— |
| Inj,Anes Agent,Femoral Nerve,Single (64447) |
— |
$1,453 |
— |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
— |
$1,679 |
— |
| Injection aa&/strd genicular nrv branches w/img (64454) |
— |
$1,257.50 |
— |
| Injection aa&/strd greater occipital nerve (64405) |
— |
$533.50 |
— |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
— |
$1,035 |
— |
| Injection aa&/strd intercostal nrv single lvl (64420) |
— |
$930 |
— |
| Injection aa&/strd sciatic nerve w/img gdn (64445) |
— |
$564 |
— |
| Injection aa&/strd trigeminal nerve each branch (64400) |
— |
$232 |
— |
| Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) |
— |
$256 |
— |
| Injection(s); single or multiple trigger point(s), 3 or more muscle(s) (20553) |
— |
$326.50 |
— |
| Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) (20550) |
— |
$225 |
— |
| Injection, anesthetic agent; sphenopalatine ganglion Age Under 21 (64505) |
— |
$232 |
— |
| Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) |
— |
$9,688.39 |
— |
| Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous… (36566) |
— |
$9,688.39 |
— |
| Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older Age… (36561) |
— |
$9,299.17 |
— |
| Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or… (36558) |
— |
$9,688.39 |
— |
| Insertion picc w/o img gdn 5 yr/> (36569) |
— |
$445 |
— |
| Insertion picc w/rs&i 5 yr/> (36573) |
— |
$1,422.50 |
— |
| Insertion subq cardiac rhythm monitor w/prgrmg (33285) |
— |
$700 |
— |
| Insj intraperitoneal catheter w/img guid (49418) |
— |
$63,319.43 |
— |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
— |
$3,019 |
— |
| Insj tun vad req 2 cath 2 sits w/o subq port/pmp (36565) |
— |
$9,688.39 |
— |
| Insj tunneled ctr vad w/subq port under 5 yr (36560) |
— |
$9,688.39 |
— |
| Insj Tunneled Ctr Vad W/Subq Pump (36563) |
— |
$9,688.39 |
— |
| Intubation endotracheal (31500) |
— |
$784 |
— |
| Lap jejunostomy (44186) |
— |
$25,764.61 |
— |
| Laparoscopic partial gastrectomy with gastrocutaneous fistula takedown (43659) |
— |
$17,897.24 |
— |
| Laparoscopy Surg Rpr Initial Inguinal Hernia (49650) |
— |
$21,867.21 |
— |
| Laparoscopy, srgcl; repair femorl hernia, any age; incarcerated/strngltd (49659) |
— |
$40,888.02 |
— |
| Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; Age Under 21 (58570) |
— |
$30,702.50 |
— |
| Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) Age… (58571) |
— |
$34,760.52 |
— |
| Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)… (58573) |
— |
$36,399.58 |
— |
| Laparoscopy, surgical; cholecystectomy with cholangiography Age Under 21 (47563) |
— |
$20,419.85 |
— |
| Laparoscopy, surgical; cholecystectomy with exploration of common duct Age Under 21 (47564) |
— |
$45,719.60 |
— |
| Laparoscopy, surgical; with fulguration of oviducts (with or without transection) Age Under 21 (58670) |
— |
$14,103.71 |
— |
| Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by… (58662) |
— |
$31,135.82 |
— |
| Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) Age… (58661) |
— |
$23,882.20 |
— |
| Laps Rpr Paraesphgl Hrna Incl Fundplsty W/O Mesh (43281) |
— |
$36,375.86 |
— |
| Laps Surg Esopg/Gstr Fundoplasty (43280) |
— |
$27,264.68 |
— |
| Laps Surg Rpr Recurrent Inguinal Hernia (49651) |
— |
$18,313.85 |
— |
| Lumbar puncture (62270) |
— |
$564 |
— |
| Mastectomy partial (19301) |
— |
$13,762.88 |
— |
| Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding… (19307) |
— |
$25,212.52 |
— |
| Meas post-voiding residual urine&/bladder cap (51798) |
— |
$50 |
— |
| Nasal surg proc unlisted (30999) |
— |
$188 |
— |
| Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) |
— |
$1,624 |
— |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
— |
$1,560.50 |
— |
| Open Biopsy/Excision Inguinofemoral Nodes (38531) |
— |
$6,807.01 |
— |
| Open treatment of acromioclavicular dislocation, acute or chronic; Age Under 21 (23550) |
— |
$27,880.08 |
— |
| Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) Age… (23552) |
— |
$15,866.33 |
— |
| Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) Age… (23532) |
— |
$15,866.33 |
— |
| Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each… (28308) |
— |
$9,505.96 |
— |
| Partial hymenectomy or revision of hymenal ring (56700) |
— |
$7,755.35 |
— |
| Penile injection (54235) |
— |
$237 |
— |
| Perq dev breast 1st us imag (19285) |
— |
$219 |
— |
| Perq drainage pleura insert cath w/o imaging (32556) |
— |
$104 |
— |
| Preputial stretching (54450) |
— |
$237 |
— |
| Proctosigmoidoscopy dx (45300) |
— |
$8,469.45 |
— |
| Proctosigmoidoscopy, rigid; with biopsy, single or multiple Age Under 21 (45305) |
— |
$8,469.45 |
— |
| Punch biopsy skin single lesion (11104) |
— |
$103 |
— |
| Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) |
— |
$307.50 |
— |
| Puncture aspiration of cyst of breast (19000) |
— |
$346 |
— |
| Push enteroscopy w/ submucosal injection and enterocutaneous fistula closure (44799) |
— |
$45,199.14 |
— |
| Push transfusion, blood, 2 years or younger (36440) |
— |
$18,025.53 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; 3 cm or greater Age Under 21 (28047) |
— |
$15,866.33 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm Age Under 21 (28046) |
— |
$15,866.33 |
— |
| Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) |
— |
$2,981 |
— |
| Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web Age Under 21 (28345) |
— |
$15,866.33 |
— |
| REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS TechFee (28190) |
— |
$553.50 |
— |
| Removal foreign body, intranasal; requiring general anesthesia Age Under 21 (30310) |
— |
$104 |
— |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
— |
$59.50 |
— |
| Removal impacted cerumen requiring instrumentation, unilateral (69210) |
— |
$50 |
— |
| Removal of appendix using an endoscope (44970) |
— |
$23,149.10 |
— |
| Removal of foreign body in muscle or tendon sheath; simple (20520) |
— |
$1,250.50 |
— |
| Removal of foreign body, external eye; conjunctival superficial (65205) |
— |
$100 |
— |
| Removal of foreign body, external eye; corneal, without slit lamp (65220) |
— |
$241.50 |
— |
| Removal of multiple hemorrhoid groups|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (46260) |
— |
$10,255.53 |
— |
| Removal of nail bed (11750) |
— |
$307.50 |
— |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
— |
$159 |
— |
| Removal tunneled cv cath (36590) |
— |
$9,976.39 |
— |
| Removal, non-biodegradable drug delivery implant (11982) |
— |
$342 |
— |
| Remove eyelid foreign body (67938) |
— |
$232 |
— |
| Remove lung catheter (32552) |
— |
$910.50 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
— |
$307.50 |
— |
| REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) |
— |
$465.50 |
— |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
— |
$465.50 |
— |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) |
— |
$307.50 |
— |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) |
— |
$307.50 |
— |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 7.6-12.5 CM (12054) |
— |
$307.50 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
— |
$307.50 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
— |
$307.50 |
— |
| REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) |
— |
$307.50 |
— |
| REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) |
— |
$307.50 |
— |
| Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes 5.1cm To 7.5cm (12053) |
— |
$307.50 |
— |
| Repair Intermediate Wounds Of Scalp, Underarms, Truck And/or Extremities Over 30.0cm (12037) |
— |
$204.50 |
— |
| Repair intrinsic muscles hand each muscle (26591) |
— |
$540 |
— |
| Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue (41250) |
— |
$241.50 |
— |
| Repair of nail bed (11760) |
— |
$164.50 |
— |
| Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm (13152) |
— |
$465.50 |
— |
| Repair, primary, disrupted ligament, ankle; both collateral ligaments Age Under 21 (27696) |
— |
$24,707.16 |
— |
| Replace tunneled cv cath (36582) |
— |
$12,655.12 |
— |
| Reset dislocated jaw (21480) |
— |
$183.50 |
— |
| RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) |
— |
$100 |
— |
| RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP TechFee (65222) |
— |
$100 |
— |
| Rmvl of access device (36589) |
— |
$124.50 |
— |
| Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) |
— |
$12,011.33 |
— |
| Rpr aa hernia 1st 3-10 cm reducible (49593) |
— |
$24,737.55 |
— |
| Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) |
— |
$18,468.72 |
— |
| Rpr aa hernia 1st < 3 cm reducible (49591) |
— |
$16,132.94 |
— |
| Rpr aa hernia recr 3-10 cm reducible (49615) |
— |
$23,616.82 |
— |
| Rpr Aa Hernia Recr < 3 Cm Reducible (49613) |
— |
$5,847.72 |
— |
| Rpr Recrt Inguinal Hernia Any Age Reducible (49520) |
— |
$13,922.84 |
— |
| Sigmoidoscopy flx ndsc us xm (45341) |
— |
$8,469.45 |
— |
| Sigmoidoscopy w/us guide bx (45342) |
— |
$8,469.45 |
— |
| Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Age Under 21 (45338) |
— |
$6,950.75 |
— |
| SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) |
— |
$159 |
— |
| SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) |
— |
$159 |
— |
| SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) |
— |
$159 |
— |
| SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) |
— |
$159 |
— |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) |
— |
$159 |
— |
| Simple Repair Superficial Wound F/e/,eyelids,n/l/ And Or Mucous Membranes 20.1cm To 30.0cm (12017) |
— |
$307.50 |
— |
| Simple Repair Superficial Wound F/e/eyelids,n/l/ And Or Mucous Membranes 12.6cm To 20.0cm (12016) |
— |
$307.50 |
— |
| Simple revision of superficial scar tissue from surgically created opening of large bowel to skin (44340) |
— |
$9,078.60 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$159 |
— |
| Small bowel endoscopy (44366) |
— |
$45,199.14 |
— |
| Small bowel endoscopy (44376) |
— |
$26,834.30 |
— |
| Small bowel endoscopy/biopsy (44377) |
— |
$45,199.14 |
— |
| Small bowel endoscopy/biopsy (44361) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding… (44378) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent… (44379) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of… (44369) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of… (44373) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of… (44372) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign… (44363) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of… (44364) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of… (44365) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic… (44370) |
— |
$45,199.14 |
— |
| SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) |
— |
$159 |
— |
| SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee (12005) |
— |
$307.50 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
— |
$307.50 |
— |
| Strapping ankle (29540) |
— |
$49.25 |
— |
| Strapping unna boot (29580) |
— |
$45 |
— |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous Age Under 21 (46270) |
— |
$4,302.12 |
— |
| Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) |
— |
$960.50 |
— |
| Throat surgery procedure (42999) |
— |
$188 |
— |
| Total knee arthroplasty (27447) |
— |
$72,113.63 |
— |
| Transect othr spinal n,xtradural (aka hb transect other spinal n, xtradural) (64772) |
— |
$11,489.59 |
— |
| Transfusion, blood or blood components (36430) |
— |
$2,489 |
— |
| Treat big toe fracture (28495) |
— |
$183.50 |
— |
| Treat toe dislocation (28630) |
— |
$66.50 |
— |
| TREATMENT CLOSED ELBOW DISLOCATION REQ ANES TechFee (24605) |
— |
$1,237.50 |
— |
| Treatment of closed elbow dislocation; without anesthesia (24600) |
— |
$183.50 |
— |
| Treatment of miscarriage (59812) |
— |
$2,331.50 |
— |
| Tx superficial wound dehiscence w/packing (12021) |
— |
$307.50 |
— |
| Unlisted laparoscopy procedure, intestine (except rectum) (44238) |
— |
$22,064.37 |
— |
| Unlisted procedure, dentoalveolar structures (41899) |
— |
$7,157.17 |
— |
| Unlisted procedure, excision pressure ulcer (15999) |
— |
$15,866.33 |
— |
| Vaginal delivery (59409) |
— |
$2,331.50 |
— |
| Vascular surgery procedure (37799) |
— |
$480.50 |
— |
| Vasectomy (55250) |
— |
$4,942.66 |
— |
| Venipuncture (36415) |
— |
$53 |
— |