| Abd paracentesis w/imaging (49083) |
— |
$2,250 |
— |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
— |
$800 |
— |
| Amputation Finger/Thumb (26951) |
— |
$1,882 |
— |
| Anoscopy diagnostic (46600) |
— |
$250 |
— |
| Appl Mlt-Layer Venous Wound Compress Below Knee (29581) |
— |
$250 |
— |
| Application cast shoulder hand long arm (29065) |
— |
$144 |
— |
| Application finger splint static (29130) |
— |
$81 |
— |
| Application long arm splint shoulder hand (29105) |
— |
$124 |
— |
| Application long leg splint thigh ankle/toes (29505) |
— |
$100 |
— |
| Application Of Rigid Total Contact Leg Cast (29445) |
— |
$238.23 |
— |
| Application short arm splint forearm-hand static (29125) |
— |
$125 |
— |
| Application short leg splint calf foot (29515) |
— |
$125 |
— |
| Arterial puncture (36600) |
— |
$327 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
— |
$65 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
— |
$470 |
— |
| Avulsion nail plate partial/complete simple 1 (11730) |
— |
$108.30 |
— |
| Bladder Irrigation Simple (51700) |
— |
$120 |
— |
| Blood transfusion service (36430) |
— |
$1,000 |
— |
| Bone marrow aspiration only (38220) |
— |
$495 |
— |
| Bx breast 1st lesion us imag (19083) |
— |
$4,050 |
— |
| Bx/exc lymph node needle superficial (38505) |
— |
$4,050 |
— |
| Catheter Aspiration Nasotracheal Spx (31720) |
— |
$675 |
— |
| Change Cystostomy Tube Simple (51705) |
— |
$156 |
— |
| Chemical Cautery Tissue (17250) |
— |
$82.83 |
— |
| Chest tube placement (32551) |
— |
$389.68 |
— |
| Cholecystostomy,Percutaneous, Complete (47490) |
— |
$9,400 |
— |
| Circumcision (54150) |
— |
$366.40 |
— |
| Close Rx Fingr Articular Fx,Manip (26742) |
— |
$679.52 |
— |
| Closed Rx Humer Epicondylr Fx,Manip (24565) |
— |
$850 |
— |
| Closed Rx Med Malleolus Fx,Manip (27762) |
— |
$618 |
— |
| Closed Rx Mid Humerus Fx,Manipulatn (24505) |
— |
$671 |
— |
| Closed Rx Rad/Ulna Shaft Fx,Manip (25565) |
— |
$1,242.50 |
— |
| Closed Rx Radial Shaft Fx (25500) |
— |
$696 |
— |
| Closed Rx Spontaneous Hip Disloc (27256) |
— |
$657 |
— |
| Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation (24560) |
— |
$350 |
— |
| Closed treatment of talus fracture; without manipulation (28430) |
— |
$443 |
— |
| Closed Treatment Ulnar Styloid Fracture (25650) |
— |
$383 |
— |
| Closed tx ankle dislocation w/o anesthesia (27840) |
— |
$543 |
— |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) |
— |
$935.31 |
— |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) |
— |
$676.02 |
— |
| Closed tx knee dislocation w/o anesthesia (27550) |
— |
$766 |
— |
| Closed tx metatarsal fracture w/o manipulation (28470) |
— |
$300 |
— |
| Closed tx nasal fracture w/o stabilization (21315) |
— |
$450 |
— |
| Closed tx patellar dislocation w/o anesthesia (27560) |
— |
$352 |
— |
| Closed tx radial head/neck fx w/o manipulation (24650) |
— |
$320 |
— |
| Closed tx radial shaft fracture w/manipulation (25505) |
— |
$825 |
— |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
— |
$99 |
— |
| Closed tx ulnar fracture prox end w/o manipulate (24670) |
— |
$370 |
— |
| Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) |
— |
$545 |
— |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
— |
$383 |
— |
| Cltx Carpo/Metacarpal Dislocation Thumb W/Manj (26641) |
— |
$352 |
— |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) |
— |
$860 |
— |
| Cltx Distal Femoral Epiphysl Separation W/O Manj (27516) |
— |
$737 |
— |
| Cltx dstl fibular fx lat malls w/manj (27788) |
— |
$400 |
— |
| Cltx dstl fibular fx lat malls w/o manj (27786) |
— |
$350 |
— |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) |
— |
$319 |
— |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) |
— |
$599.50 |
— |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
— |
$1,500 |
— |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) |
— |
$2,400 |
— |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
— |
$275 |
— |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) |
— |
$766 |
— |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) |
— |
$333 |
— |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
— |
$600 |
— |
| Cltx inter/peri/subtrochanteric fem fx w/o manj (27238) |
— |
$650 |
— |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
— |
$103 |
— |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
— |
$300 |
— |
| Cltx metacarpal fx w/manipulation each bone (26605) |
— |
$370 |
— |
| Cltx metacarpal fx w/o manipulation each bone (26600) |
— |
$340 |
— |
| Cltx metacarpophalangeal dislc w/manj w/anes (26705) |
— |
$350 |
— |
| Cltx metacarpophalangeal dislc w/manj w/o anes (26700) |
— |
$300 |
— |
| Cltx metatarsophlngl jt dislc w/o anes (28630) |
— |
$300 |
— |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
— |
$350 |
— |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) |
— |
$250 |
— |
| Cltx post hip arthrp dislc w/o anes (27265) |
— |
$772.26 |
— |
| Cltx prox fibula/shft fx w/o manj (27780) |
— |
$336 |
— |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
— |
$260 |
— |
| Cltx shoulder dislc w/surg/antmcl neck fx w/manj (23675) |
— |
$456.67 |
— |
| Cltx tibial shaft fx w/manj w/wo skel tracj (27752) |
— |
$570 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$978.14 |
— |
| Complete replacement picc rs&i (36584) |
— |
$2,672 |
— |
| Control Nasal Hemorrhage Anterior Complex (30903) |
— |
$575.50 |
— |
| Control Nasal Hemorrhage Anterior Simple (30901) |
— |
$154 |
— |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
— |
$510 |
— |
| Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) |
— |
$299 |
— |
| Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) |
— |
$179 |
— |
| Dcmprn fasct leg ant&/lat compartments only (27600) |
— |
$8,000 |
— |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
— |
$169.81 |
— |
| Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) |
— |
$352.59 |
— |
| Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) |
— |
$526.92 |
— |
| Delivery placenta separate procedure (59414) |
— |
$5,299.29 |
— |
| Destruction premalignant lesion 1st (17000) |
— |
$77 |
— |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
— |
$300 |
— |
| Drainage Finger Abscess Simple (26010) |
— |
$383 |
— |
| Drainage mouth roof lesion (42000) |
— |
$300 |
— |
| Drainage of eyelid abscess (67700) |
— |
$323.37 |
— |
| Drainage of gum lesion (41800) |
— |
$412.14 |
— |
| Drainage of hematoma/fluid (10140) |
— |
$130 |
— |
| Drainage of lymph node abscess or lymphadenitis; simple (38300) |
— |
$242 |
— |
| Drainage of scrotal wall abscess (55100) |
— |
$256 |
— |
| Drainage skenes gland abscess (53060) |
— |
$282 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
— |
$224.48 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
— |
$191.60 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
— |
$106.64 |
— |
| Dx bone marrow bx & aspir (38222) |
— |
$6,900 |
— |
| Epi Autogrft Face/Nck/Hnd/Ft/Gen <100 Sqcm (15115) |
— |
$3,400 |
— |
| Epidrm agrft t/a/l 1st 100 cm/&/1% bdy inft/chld (15110) |
— |
$3,400 |
— |
| Evacuation of subungual hematoma (11740) |
— |
$71 |
— |
| Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) |
— |
$162 |
— |
| Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) |
— |
$900 |
— |
| Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) |
— |
$307 |
— |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) |
— |
$1,276 |
— |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) |
— |
$660 |
— |
| Excision of nail fold toe (11765) |
— |
$292.70 |
— |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) |
— |
$2,500 |
— |
| Explore/treat ankle joint (27610) |
— |
$2,168 |
— |
| Fetal non-stress test (59025) |
— |
$340 |
— |
| Fine needle aspiration bx w/us gdn 1st lesion (10005) |
— |
$1,800 |
— |
| I&D Abscess Peritonsillar (42700) |
— |
$908 |
— |
| I&d abscess simple (10060) |
— |
$290 |
— |
| I&d perianal abscess superficial (46050) |
— |
$221.66 |
— |
| I&d pilonidal cyst simple (10080) |
— |
$198 |
— |
| Image Cath Fluid Colxn Visc (49405) |
— |
$494.05 |
— |
| Incision & drainage abscess complicated/multiple (10061) |
— |
$500 |
— |
| Incision & drainage pilonidal cyst complicated (10081) |
— |
$300 |
— |
| Incision & removal foreign body subq tiss compl (10121) |
— |
$275 |
— |
| Incision & removal foreign body subq tiss simple (10120) |
— |
$166 |
— |
| Incision and drainage of bartholin's gland abscess (56420) |
— |
$123 |
— |
| Incision and drainage of vulva or perineal abscess (56405) |
— |
$278 |
— |
| Incision of rectal abscess (46040) |
— |
$574 |
— |
| Incision thrombosed hemorrhoid external (46083) |
— |
$218 |
— |
| Incisional biopsy skin single lesion (11106) |
— |
$150 |
— |
| Infectious disease (bacterial or viral respiratory tract infection) pathogen-specific DNA and RNA, 21 targets,… (0225U) |
— |
$1,260 |
— |
| Initial tx 1st degree burn local tx (16000) |
— |
$92 |
— |
| Injection aa&/strd trigeminal nerve each branch (64400) |
— |
$160.92 |
— |
| Injection anes other peripheral nerve/branch (64450) |
— |
$162 |
— |
| Injection single/mlt trigger point 1/2 muscles (20552) |
— |
$256 |
— |
| Injection, anesthetic agent; greater occipital nerve (64405) |
— |
$300 |
— |
| Injection, anesthetic agent; sphenopalatine ganglion (64505) |
— |
$1,089 |
— |
| Ins cath ren art 1st bilat (36252) |
— |
$5,964.60 |
— |
| Insert Bladder Cath Complex (51703) |
— |
$400 |
— |
| Insert non-tunnel cv cath (36556) |
— |
$450 |
— |
| Insert picc cath (36569) |
— |
$300 |
— |
| Insert Temp Bladder Cath (51702) |
— |
$300 |
— |
| Intraoral i&d tongue/floor submndblr space (41008) |
— |
$700 |
— |
| Intubation endotracheal emergency procedure (31500) |
— |
$411.03 |
— |
| Irrigate corpora cavernosa for priapism (54220) |
— |
$500 |
— |
| Laryngoscopy Indirect Diagnostic Spx (31505) |
— |
$150 |
— |
| Laryngoscopy indirect w/removal foreign body (31511) |
— |
$300 |
— |
| Njx c/p/a cavernosa w/pharmacologic agt (54235) |
— |
$210 |
— |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
— |
$2,025 |
— |
| Perq device breast 1st imag (19281) |
— |
$1,725 |
— |
| Perq replacement gtube not req revj gstrst trc (43762) |
— |
$350 |
— |
| Place Cath Thoracic Aorta (36221) |
— |
$5,964.60 |
— |
| Placement of needle for intraosseous infusion (36680) |
— |
$134.09 |
— |
| Puncture Aspiration (10160) |
— |
$260 |
— |
| Puncture Aspiration Cyst Breast (19000) |
— |
$3,000 |
— |
| Removal fb intranasal (30300) |
— |
$118 |
— |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
— |
$194 |
— |
| Removal foreign body pharynx (42809) |
— |
$346 |
— |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
— |
$22.12 |
— |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
— |
$55 |
— |
| Removal of indwelling tunneled pleural catheter with cuff (32552) |
— |
$1,850 |
— |
| Removal of intrauterine device (iud) (58301) |
— |
$500 |
— |
| Remove foreign body from eye (65210) |
— |
$300 |
— |
| Remv Ext Canal Foreign Body (69200) |
— |
$67 |
— |
| Remv F.B.,Eye,Superf Conjunc (65205) |
— |
$275 |
— |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
— |
$459 |
— |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
— |
$560 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
— |
$450 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
— |
$400 |
— |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
— |
$265 |
— |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
— |
$459 |
— |
| Repair complex trunk 1.1-2.5 cm (13100) |
— |
$234 |
— |
| Repair complex trunk 2.6-7.5 cm (13101) |
— |
$510 |
— |
| Repair hand tendon (26410) |
— |
$1,500 |
— |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
— |
$928 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
— |
$205 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
— |
$265 |
— |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
— |
$356 |
— |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
— |
$510 |
— |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
— |
$327 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
— |
$153 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
— |
$216 |
— |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
— |
$265 |
— |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
— |
$257 |
— |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
— |
$200 |
— |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
— |
$450 |
— |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) |
— |
$347 |
— |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
— |
$250 |
— |
| Repair of nail bed (11760) |
— |
$1,400 |
— |
| Repair Tongue Laceration (41250) |
— |
$162 |
— |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
— |
$275 |
— |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
— |
$347 |
— |
| Rpr Lac 2.5 Cm/< Pst One-Third Tongue (41251) |
— |
$205 |
— |
| Rpr lac tongue floor mouth > 2.6 cm/cplx (41252) |
— |
$635 |
— |
| Rpr Lip Full Thickness Vermilion Only (40650) |
— |
$554 |
— |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
— |
$356 |
— |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
— |
$123 |
— |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
— |
$176 |
— |
| Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) |
— |
$459 |
— |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
— |
$205 |
— |
| Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) |
— |
$257 |
— |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
— |
$510 |
— |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
— |
$350 |
— |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
— |
$383 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$350 |
— |
| Skin splt grft trnk/arm/leg (15100) |
— |
$1,621.82 |
— |
| Skin sub graft face/nk/hf/g (15275) |
— |
$1,200 |
— |
| Skin sub graft trnk/arm/leg (15271) |
— |
$1,000 |
— |
| Skn splt a-grft fac/nck/hf/g (15120) |
— |
$1,580.01 |
— |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
— |
$350 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
— |
$350 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
— |
$350 |
— |
| Spinal puncture lumbar diagnostic (62270) |
— |
$271.25 |
— |
| Strapping unna boot (29580) |
— |
$87.50 |
— |
| Tangential biopsy skin single lesion (11102) |
— |
$325 |
— |
| Thoracentesis Needle/Cath Pleura W/Imaging (32555) |
— |
$1,850 |
— |
| Thoracentesis needle/cath pleura w/o imaging (32554) |
— |
$1,000 |
— |
| Tracheostomy emergency cricothyroid membrane (31605) |
— |
$450 |
— |
| Tracheostomy Emergency Procedure Transtracheal (31603) |
— |
$672 |
— |
| Treat humerus fracture (24500) |
— |
$350 |
— |
| Treat humerus fracture (24577) |
— |
$471.75 |
— |
| Treat knee fracture (27532) |
— |
$1,721.76 |
— |
| Treat Metatarsal Fracture (28475) |
— |
$572.55 |
— |
| Treatment closed elbow dislocation w/o anes (24600) |
— |
$917.73 |
— |
| Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each (28450) |
— |
$275 |
— |
| Trim skin lesion (11055) |
— |
$36.30 |
— |
| Trim skin lesions 2 to 4 (11056) |
— |
$51.27 |
— |
| Trim skin lesions over 4 (11057) |
— |
$67.05 |
— |
| Trimming Of Nondystrophic Nails, Any Number (11719) |
— |
$17.37 |
— |
| Tx superficial wound dehiscence w/packing (12021) |
— |
$400 |
— |
| Unlisted Procedure Dentoalveolar Structures (41899) |
— |
$265 |
— |
| Unlisted Procedure Nervous System (64999) |
— |
$783 |
— |
| Vaginal delivery only (59409) |
— |
$5,425 |
— |
| Venipuncture (36415) |
— |
$9 |
— |
| Wound Prep F/N/Hf/G (15004) |
— |
$616.06 |
— |
| Wound prep trk/arm/leg 1st 100 sq cm (15002) |
— |
$515.10 |
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