| Abd paracentesis w/imaging (49083) |
— |
$958.50 |
— |
| Acne surgery (10040) |
— |
$23,016.45 |
— |
| Adjnt tis transfr/rearrange trunk 10.1-30.0 sqcm (14001) |
— |
$8,204.43 |
— |
| Anoscopy diagnostic (46600) |
— |
$100 |
— |
| Anrct Xm Surg Req Anes General Spi/Edrl Dx (45990) |
— |
$8,469.45 |
— |
| Application cast elbow finger short arm (29075) |
— |
$215 |
— |
| Application Finger Splint Dynamic (29131) |
— |
$50 |
— |
| Application finger splint static (29130) |
— |
$100 |
— |
| Application long arm splint shoulder hand (29105) |
— |
$125.50 |
— |
| Application Long Leg Splint (29505) |
— |
$125.50 |
— |
| Application Short Arm Splint Dynamic (29126) |
— |
$100 |
— |
| Application short arm splint forearm-hand static (29125) |
— |
$100 |
— |
| Application short leg splint calf foot (29515) |
— |
$125.50 |
— |
| Apply hand/wrist cast (29085) |
— |
$125.50 |
— |
| Arterial puncture (36600) |
— |
$225 |
— |
| 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 |
— |
| Arthroplasty glenohumeral joint total shoulder (23472) |
— |
$61,897.40 |
— |
| Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) Facility (29883) |
— |
$11,400.81 |
— |
Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft (27130)
range across 2 matching MRF lines |
— |
$69,432.64–$83,001.10 |
— |
Arthrs aided ant cruciate ligm rpr/agmntj/rcnstj (29888)
range across 2 matching MRF lines |
— |
$30,004.16–$34,989.91 |
— |
| Aspirate pleura w/ imaging (32555) |
— |
$960.50 |
— |
| Aspirate Pleura W/O Imaging (32554) |
— |
$480.50 |
— |
| Aspirate/Inj Ganglion Cyst (20612) |
— |
$232 |
— |
| Avulsion nail plate partial/complete simple 1 (11730) |
— |
$159 |
— |
| Biopsy muscle percutaneous needle (20206) |
— |
$1,250.50 |
— |
| Biopsy/removal lymph nodes (38510) |
— |
$8,278.57 |
— |
| Bladder Irrigation (51700) |
— |
$331.50 |
— |
| Bladder Scan (51798) |
— |
$50 |
— |
| Blood Transfusion Service (36430) |
— |
$2,489 |
— |
| Bx breast 1st lesion us imag (19083) |
— |
$1,160 |
— |
| Bx/exc lymph node open deep axillary node (38525) |
— |
$5,043.04 |
— |
| Bx/exc lymph node open superficial (38500) |
— |
$5,787.12 |
— |
| Change Cystostomy Tube Simple (51705) |
— |
$237 |
— |
| Chemical Cautery Tissue (17250) |
— |
$159 |
— |
| Chest tube placement (32551) |
— |
$1,249.50 |
— |
| Clear outer ear canal (69200) |
— |
$100 |
— |
| Closed tx ankle dislocation w/o anesthesia (27840) |
— |
$175.50 |
— |
| Closed Tx Bimalleolar Ankle Fracture W Manip (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 head/neck fx w/o manipulation (24650) |
— |
$183.50 |
— |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
— |
$244 |
— |
| Closed tx talus fracture w/o manipulation (28430) |
— |
$183.50 |
— |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
— |
$183.50 |
— |
| Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) |
— |
$183.50 |
— |
| Clsd tx clavicular fracture w/o manipulation (23500) |
— |
$183.50 |
— |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
— |
$1,237.50 |
— |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
— |
$183.50 |
— |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
— |
$1,237.50 |
— |
| Cltx dstl fibular fx lat malls w/manj (27788) |
— |
$183.50 |
— |
| Cltx dstl fibular fx lat malls w/o manj (27786) |
— |
$183.50 |
— |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (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 fem shft fx w/manj w/wo skin/skeletal tracj (27502) |
— |
$1,237.50 |
— |
| Cltx fx grt toe phlx/phlg w/manj (28495) |
— |
$183.50 |
— |
| Cltx Grter Humeral Tuberosity Fx W/Manipulation (23625) |
— |
$1,237.50 |
— |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
— |
$183.50 |
— |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
— |
$183.50 |
— |
| Cltx metacarpal fx w/manipulation each bone (26605) |
— |
$183.50 |
— |
| Cltx metacarpophalangeal dislc w/manj w/anes (26705) |
— |
$1,217 |
— |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
— |
$183.50 |
— |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) |
— |
$183.50 |
— |
| Cltx post hip arthrp dislc req anes (27266) |
— |
$1,237.50 |
— |
| Cltx post hip arthrp dislc w/o anes (27265) |
— |
$183.50 |
— |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
— |
$183.50 |
— |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) |
— |
$1,237.50 |
— |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
— |
$1,237.50 |
— |
| Cltx tibial fx proximal w/o manipulation (27530) |
— |
$183.50 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$1,237.50 |
— |
| Collect Blood From Catheter Venous Nos (36592) |
— |
$142 |
— |
| Collection of venous blood by venipuncture (36415) |
— |
$53 |
— |
| Colonoscopy Stoma W/Endoscopic Ultrasound Exam (44406) |
— |
$8,469.45 |
— |
| Colonoscopy thru stoma (44388) |
— |
$8,469.45 |
— |
| Colonoscopy W/Band Ligation (45398) |
— |
$3,794.52 |
— |
| Colonoscopy w/fb removal (45379) |
— |
$8,469.45 |
— |
| Control Nasal Hemorrhage Anterior Complex (30903) |
— |
$100 |
— |
| Control Nasal Hemorrhage Anterior Simple (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 |
— |
| Cysto Bladder W/Ureteral Catheterization (52005) |
— |
$34,396.75 |
— |
| Cystourethroscopy (52000) |
— |
$31,396.33 |
— |
| Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010) |
— |
$15,866.33 |
— |
| Deb Musc/Fascia 20 Sq Cm/< (11043) |
— |
$15,866.33 |
— |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
— |
$307.50 |
— |
| Declot vascular device (36593) |
— |
$386 |
— |
| Delivery of placenta (59414) |
— |
$2,331.50 |
— |
| Destroy cerv/thor facet jnt (64633) |
— |
$2,935 |
— |
| Destroy lumb/sac facet jnt (64635) |
— |
$2,888 |
— |
| Destruction neurolytic agt genicular nerve w/img (64624) |
— |
$2,281 |
— |
| Diagnostic anoscopy (46601) |
— |
$8,469.45 |
— |
| Diagnostic sigmoidoscopy (45330) |
— |
$1,527.84 |
— |
| Drain/inj small joint/bursa w/us (20604) |
— |
$330.50 |
— |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
— |
$553.50 |
— |
| Drainage of finger abscess simple (26010) |
— |
$126.50 |
— |
| Drainage of hematoma/fluid (10140) |
— |
$1,250.50 |
— |
| Draw Blood Off Venous Device (36591) |
— |
$230.50 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
— |
$159 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
— |
$159 |
— |
| Dstrj Neurolytic Agent Other Peripheral Nerve (64640) |
— |
$1,130 |
— |
| Dx gastr intub w/asp specs (43755) |
— |
$5,711.44 |
— |
| Dx lmbr spi pnxr w/fluor/CT (62328) |
— |
$564 |
— |
| Egd Balloon Dilation Esophagus <30 Mm Diam (43249) |
— |
$6,699.17 |
— |
| Egd Intrmural Needle Aspir/Biop Altered Anatomy (43242) |
— |
$45,199.14 |
— |
| Egd intrmural us needle aspirate/biopsy esophags (43238) |
— |
$45,199.14 |
— |
| Egd Partial/Compl Esophagogastric Fundoplasty (43210) |
— |
$45,199.14 |
— |
| Egd us exam duodenum/jejunum (43259) |
— |
$45,199.14 |
— |
| Egd us transmural injxn/mark (43253) |
— |
$45,199.14 |
— |
| Endoscopic injection/implant (51715) |
— |
$27,898.83 |
— |
| Endoscopic us exam esoph (43237) |
— |
$45,199.14 |
— |
| Endoscopy Upper Small Intestine (44360) |
— |
$45,199.14 |
— |
| Endoscopy upper small intestine w/biopsy (44361) |
— |
$45,199.14 |
— |
| Enterosc >2nd prtn w/ileum w/bx single/multiple (44377) |
— |
$45,199.14 |
— |
| Enterosc >2nd prtn w/ileum w/wo collj spec spx (44376) |
— |
$26,834.30 |
— |
| Enteroscopy > 2nd prtn conv gstrst tube (44373) |
— |
$45,199.14 |
— |
| Enteroscopy > 2nd prtn ileum control bleeding (44378) |
— |
$45,199.14 |
— |
| Enteroscopy > 2nd prtn tndsc stent plmt (44370) |
— |
$45,199.14 |
— |
| Enteroscopy > 2nd prtn w/plmt prq tube (44372) |
— |
$45,199.14 |
— |
| Enteroscopy > 2nd prtn w/rmvl foreign body (44363) |
— |
$45,199.14 |
— |
| Enteroscopy > 2nd Prtn W/Rmvl Lesion Cautery (44365) |
— |
$45,199.14 |
— |
| Enteroscopy > 2nd Prtn W/Rmvl Lesion Snare (44364) |
— |
$45,199.14 |
— |
| Epidural Blood Patch (62273) |
— |
$789.50 |
— |
| Evacuation of subungual hematoma (11740) |
— |
$100 |
— |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) |
— |
$15,866.33 |
— |
| 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 Skin Benig 3.1-4 Cm Remaindr Body (11424) |
— |
$15,866.33 |
— |
| Exc Skin Benig >4 Cm Remaindr Body (11426) |
— |
$15,866.33 |
— |
| Exc thigh/knee les sc 3 cm/> (27337) |
— |
$5,458.76 |
— |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) |
— |
$7,429.90 |
— |
| Exc tumor soft tis neck/ant thorax subq 3 cm/> (21552) |
— |
$7,157.93 |
— |
| Excision of ganglion, wrist (dorsal or volar); primary (25111) |
— |
$4,961.85 |
— |
| Excision of single external papilla or tag, anus (46220) |
— |
$5,074.93 |
— |
| Excision Pilonidal Cyst/Sinus Complicated (11772) |
— |
$8,252.22 |
— |
| Excision tumor soft tis foot/toe subq 1.5 cm/> (28039) |
— |
$15,866.33 |
— |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) |
— |
$15,866.33 |
— |
| Expl penetrating wound spx abdomen/flank/back (20102) |
— |
$1,522 |
— |
| Exploration penetrating wound spx extremity (20103) |
— |
$553.50 |
— |
| Fasciectomy Plantar Fascia Partial Spx (28060) |
— |
$15,866.33 |
— |
| Fasciotomy Plantar Fascia Radical Spx (28062) |
— |
$15,866.33 |
— |
| Fine needle aspiration without imaging guidance (10021) |
— |
$307.50 |
— |
| Fluoro exam of g/colon tube (49465) |
— |
$241 |
— |
| Fna bx w/us gdn 1st les (10005) |
— |
$878 |
— |
| Foreskin manipulation (54450) |
— |
$237 |
— |
| 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 |
— |
| Hemorrhoidectomy, internal and external, 2 or more columns/groups; (46260) |
— |
$10,255.53 |
— |
| Hysteroscopy Biopsy (58558) |
— |
$13,103.63 |
— |
| Hysteroscopy Dx Sep Proc (58555) |
— |
$7,239.39 |
— |
| Hysteroscopy Removal Impacted Foreign Body (58562) |
— |
$6,613.41 |
— |
| I&d abscess peritonsillar (42700) |
— |
$188 |
— |
| I&d abscess simple (10060) |
— |
$159 |
— |
| I&d pilonidal cyst simple (10080) |
— |
$552.50 |
— |
| Incision & drainage abscess complicated/multiple (10061) |
— |
$85 |
— |
| Incision & removal foreign body subq tiss compl (10121) |
— |
$866 |
— |
| Incision & removal foreign body subq tiss simple (10120) |
— |
$307.50 |
— |
| Incision and drainage of bartholin's gland abscess (56420) |
— |
$66 |
— |
| Incision and drainage of vulva or perineal abscess (56405) |
— |
$250.50 |
— |
| Incision of rectal abscess (46040) |
— |
$921 |
— |
| Initial Tx 1st Degree Burn Local Tx (16000) |
— |
$159 |
— |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) |
— |
$1,908.50 |
— |
| Inj W/Fluor Eval Cv Device (36598) |
— |
$7,393.83 |
— |
| Injection 1 tendon sheath/ligament aponeurosis (20550) |
— |
$225 |
— |
| 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 intercostal nrv ea addl lvl (64421) |
— |
$1,035 |
— |
| Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) |
— |
$564 |
— |
| Injection Anes Agent Sphenopalatine Ganglion (64505) |
— |
$232 |
— |
| Injection single tendon origin/insertion (20551) |
— |
$243 |
— |
| Injection single/mlt trigger point 1/2 muscles (20552) |
— |
$256 |
— |
| Injection single/mlt trigger point 3/> muscles (20553) |
— |
$326.50 |
— |
Injection, anesthetic agent; femoral nerve, single (64447)
range across 4 matching MRF lines |
— |
$564–$1,453 |
— |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) |
— |
$564 |
— |
| Insert cath pleura w/o image (32556) |
— |
$104 |
— |
| Insert non-tunnel cv cath (36556) |
— |
$9,688.39 |
— |
| Insert Temp Bladder Cath (51702) |
— |
$304 |
— |
| Insert tun ip cath perc (49418) |
— |
$63,319.43 |
— |
| Insert tunneled cv cath (36561) |
— |
$9,299.17 |
— |
| Insert tunneled cv cath (36563) |
— |
$9,688.39 |
— |
| Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) |
— |
$9,688.39 |
— |
| Insert,Non-Indwelling Bladder Catheter (51701) |
— |
$280.50 |
— |
| Insertion Picc W/Rs&I 5 Yr/> (36573) |
— |
$1,422.50 |
— |
| Insertion subq cardiac rhythm monitor w/prgrmg (33285) |
— |
$700 |
— |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
— |
$3,019 |
— |
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569)
range across 3 matching MRF lines |
— |
$445–$1,666 |
— |
| Insj tun vad req 2 cath 2 sits w/o subq port/pmp (36565) |
— |
$9,688.39 |
— |
| Insj Tun Vad Req 2 Cath 2 Sits W/Subq Port (36566) |
— |
$9,688.39 |
— |
| Insj Tunneled Ctr Vad W/Subq Port Under 5 Yr (36560) |
— |
$9,688.39 |
— |
| Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) |
— |
$9,688.39 |
— |
| Intubation endotracheal emergency procedure (31500) |
— |
$784 |
— |
| Lap paraesophag hern repair (43281) |
— |
$36,375.86 |
— |
| Laparoscopy fulguration oviducts (58670) |
— |
$14,103.71 |
— |
Laparoscopy Surg Rpr Initial Inguinal Hernia (49650)
range across 3 matching MRF lines |
— |
$18,050.70–$22,310.53 |
— |
| Laparoscopy tot hysterectomy >250 g w/tube/ovar (58573) |
— |
$36,399.58 |
— |
| Laparoscopy w tot hysterectuterus <=250 gram w tube/ovary (58571) |
— |
$34,760.52 |
— |
Laparoscopy w/rmvl adnexal structures (58661)
range across 2 matching MRF lines |
— |
$22,946.56–$24,817.85 |
— |
| Laparoscopy, surgical, appendectomy (44970) |
— |
$23,149.10 |
— |
| Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures) (43280) |
— |
$27,264.68 |
— |
| Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; (58570) |
— |
$30,702.50 |
— |
| Laparoscopy, surgical; cholecystectomy with cholangiography (47563) |
— |
$20,419.85 |
— |
| Laparoscopy, surgical; cholecystectomy with exploration of common duct (47564) |
— |
$45,719.60 |
— |
| Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding) (44186) |
— |
$25,764.61 |
— |
| Laparoscopy, surgical; repair recurrent inguinal hernia (49651) |
— |
$18,313.85 |
— |
| Laps fulg/exc ovary viscera/peritoneal surface (58662) |
— |
$31,135.82 |
— |
| Mast mod rad (19307) |
— |
$25,212.52 |
— |
Mastectomy partial (19301)
range across 2 matching MRF lines |
— |
$13,619.49–$13,906.26 |
— |
| N block inj intercost sng (64420) |
— |
$930 |
— |
| N Block Inj Plantar Digit (64455) |
— |
$232 |
— |
| Nasal surgery procedure (30999) |
— |
$188 |
— |
| Nasal/Orogastric W/Tube Plmt (43752) |
— |
$241.50 |
— |
| Needle Biopsy Lymph Nodes (38505) |
— |
$2,755.88 |
— |
| Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) |
— |
$1,615 |
— |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) |
— |
$232 |
— |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
— |
$2,020.50 |
— |
| 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 |
— |
| Occipital Nerve Block (64405) |
— |
$533.50 |
— |
| Open biopsy/excision inguinofemoral nodes (38531) |
— |
$6,807.01 |
— |
| Open treatment of acromioclavicular dislocation acute or chronic (23550) |
— |
$27,880.08 |
— |
| Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)… (23552) |
— |
$15,866.33 |
— |
| Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) Facility (23532) |
— |
$15,866.33 |
— |
| Osteot w/wo lngth shrt/corrj metar xcp 1st ea (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 |
— |
| Placement of needle for intraosseous infusion (36680) |
— |
$241.50 |
— |
| Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300) |
— |
$8,469.45 |
— |
| Proctosigmoidoscopy, rigid; with biopsy, single or multiple (45305) |
— |
$8,469.45 |
— |
| Punch biopsy skin single lesion (11104) |
— |
$103 |
— |
| Puncture aspiration abscess hematoma bulla/cyst (10160) |
— |
$307.50 |
— |
| Puncture Aspiration Cyst Breast (19000) |
— |
$346 |
— |
| Push Transfusion Blood 2 Yr/Under (36440) |
— |
$18,025.53 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; 3 cm or greater Facility (28047) |
— |
$15,866.33 |
— |
| Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm Facility (28046) |
— |
$15,866.33 |
— |
| Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) |
— |
$2,981 |
— |
| Removal Embedded Foreign Body Eyelid (67938) |
— |
$232 |
— |
| Removal Foreign Body Foot Subcutaneous (28190) |
— |
$553.50 |
— |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
— |
$1,250.50 |
— |
| Removal foreign body, intranasal; requiring general anesthesia (30310) |
— |
$104 |
— |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
— |
$59.50 |
— |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
— |
$50 |
— |
| Removal of nail bed (11750) |
— |
$307.50 |
— |
| Removal of sperm cord lesion (55520) |
— |
$4,042.70 |
— |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) |
— |
$159 |
— |
| Remove drug implant device (11982) |
— |
$342 |
— |
| Remove foreign body from eye (65205) |
— |
$100 |
— |
| Remove lung catheter (32552) |
— |
$910.50 |
— |
| Remove Nasal Foreign Body (30300) |
— |
$100 |
— |
| Reopen fallopian tube (58350) |
— |
$37,465.47 |
— |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
— |
$465.50 |
— |
| 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 (13132) |
— |
$465.50 |
— |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
— |
$465.50 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
— |
$307.50 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
— |
$307.50 |
— |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
— |
$307.50 |
— |
| Repair intermediate f/e/e/n/l&/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 12.6-20.0cm (12035) |
— |
$307.50 |
— |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
— |
$307.50 |
— |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
— |
$307.50 |
— |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
— |
$307.50 |
— |
| Repair intermediate s/a/t/e >30.0 cm (12037) |
— |
$204.50 |
— |
| Repair intrinsic muscles hand each muscle (26591) |
— |
$540 |
— |
| Repair of nail bed (11760) |
— |
$164.50 |
— |
| Repair tongue laceration (41250) |
— |
$241.50 |
— |
| Repair webbed toe(s) (28345) |
— |
$15,866.33 |
— |
| Rerepair ing hernia reduce (49520) |
— |
$13,922.84 |
— |
| Revj Colostomy Smpl Rls Supfc Scar Spx (44340) |
— |
$9,078.60 |
— |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
— |
$241.50 |
— |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
— |
$100 |
— |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
— |
$9,976.39 |
— |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
— |
$124.50 |
— |
| Rplcmt compl tun ctr vad w/subq port (36582) |
— |
$12,655.12 |
— |
| Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) |
— |
$12,011.33 |
— |
| 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 aa hrn 1st 3-10 rdc (49593) |
— |
$24,737.55 |
— |
| Rpr aa hrn 1st < 3 ncr/strn (49592) |
— |
$18,468.72 |
— |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) |
— |
$159 |
— |
| Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms (27696) |
— |
$24,707.16 |
— |
| Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) |
— |
$6,950.75 |
— |
| Sigmoidoscopy flx tndsc us gid ndl aspir/bx (45342) |
— |
$8,469.45 |
— |
| Sigmoidoscopy W/Ultrasound (45341) |
— |
$8,469.45 |
— |
| Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) |
— |
$7,500.16 |
— |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
— |
$307.50 |
— |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
— |
$159 |
— |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
— |
$159 |
— |
| Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) |
— |
$307.50 |
— |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
— |
$159 |
— |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
— |
$159 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$159 |
— |
| Small bowel endoscopy (44366) |
— |
$45,199.14 |
— |
| Small Bowel Endoscopy,Ablate Lesn - Enteroscopy (44369) |
— |
$45,199.14 |
— |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent… (44379) |
— |
$45,199.14 |
— |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
— |
$159 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
— |
$307.50 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
— |
$307.50 |
— |
| Spinal puncture lumbar diagnostic (62270) |
— |
$564 |
— |
Strapping ankle (29540)
range across 4 matching MRF lines |
— |
$20–$78.50 |
— |
| Strapping Unna Boot (29580) |
— |
$45 |
— |
| Surg tx anal fistula subq (46270) |
— |
$4,302.12 |
— |
| Tooth extraction (41899) |
— |
$7,157.17 |
— |
| Total Knee Arthroplasty (27447) |
— |
$72,113.63 |
— |
| Transection/Avulsion Oth Spinal Nrv Xdrl (64772) |
— |
$11,489.59 |
— |
| Treat Metatarsal Fracture (28475) |
— |
$183.50 |
— |
| Treat Thumb Dislocation (26641) |
— |
$213 |
— |
| Treat toe dislocation (28630) |
— |
$66.50 |
— |
| Treatment Closed Elbow Dislocation Req Anes (24605) |
— |
$1,237.50 |
— |
| Treatment closed elbow dislocation w/o anes (24600) |
— |
$183.50 |
— |
| Tx Gastro Intub W/Asp (43753) |
— |
$5,711.44 |
— |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
— |
$2,331.50 |
— |
| Tx superficial wound dehiscence w/packing (12021) |
— |
$307.50 |
— |
| Unlisted laparoscopy procedure stomach (43659) |
— |
$17,897.24 |
— |
| Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy (49659) |
— |
$40,888.02 |
— |
| Unlisted laparoscopy procedure, intestine (except rectum) (44238) |
— |
$22,064.37 |
— |
| Unlisted procedure excision pressure ulcer (15999) |
— |
$15,866.33 |
— |
| Unlisted Procedure Intestine (44799) |
— |
$45,199.14 |
— |
| Unlisted procedure nervous system (64999) |
— |
$232 |
— |
| Unlisted Procedure Pharynx Adenoids/Tonsils (42999) |
— |
$188 |
— |
| Unlisted Procedure Trachea Bronchi (31899) |
— |
$30,483.15 |
— |
| Unlisted Procedure Vascular Surgery (37799) |
— |
$480.50 |
— |
| Vaginal delivery only (59409) |
— |
$2,331.50 |
— |
| Vasectomy uni/bi spx w/postop semen exams (55250) |
— |
$4,942.66 |
— |