| Autolog prp not diab ulcer (G0460) |
$6,860 |
$17,150 |
3.3× |
| Ca screen;flexi sigmoidscope (G0104) |
$1,014.40 |
$2,536 |
1.1× |
| Ca screen;pelvic/breast exam (G0101) |
$94.40 |
$236 |
0.9× |
| Care manage beh svs 20mins (G0323) |
$50.40 |
$126 |
1.3× |
| Catheterize for urine spec (P9612) |
$44.80 |
$112 |
4.8× |
| Chemo extend iv infus w/pump (G0498) |
$1,024 |
$2,560 |
3.1× |
| Colon ca scrn not hi rsk ind (G0121) |
$1,507.60 |
$3,769 |
1.6× |
| Colorectal scrn; hi risk ind (G0105) |
$1,513.20 |
$3,783 |
1.6× |
| Computed tomography, breast, including 3D rendering, when performed, bilateral; with contrast material(s) (0637T) |
$1,331.60 |
$3,329 |
3.8× |
| Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast material(s) (0636T) |
$831.60 |
$2,079 |
3.5× |
| Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast… (0638T) |
$1,331.60 |
$3,329 |
3.8× |
| Computed tomography, breast, including 3D rendering, when performed, unilateral; with contrast material(s) (0634T) |
$645.60 |
$1,614 |
3.7× |
| Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast material (0633T) |
$394 |
$985 |
3.8× |
| Computed tomography, breast, including 3D rendering, when performed, unilateral; without contrast, followed by contrast… (0635T) |
$645.60 |
$1,614 |
3.7× |
| Covid-19 lab test non-cdc (U0002) |
$79.20 |
$198 |
1.5× |
| Dermal filler injection(s) (G0429) |
$6,860 |
$17,150 |
3.3× |
| Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater… (0419T) |
$1,208.40 |
$3,021 |
1.6× |
| Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities,… (0420T) |
$1,208.40 |
$3,021 |
1.6× |
| Ekg tracing for initial prev (G0404) |
$165.60 |
$414 |
5.7× |
| Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, open or… (0524T) |
$10,214.40 |
$25,536 |
3.2× |
| Esd endoscopy or colonoscopy (C9779) |
$8,646 |
$21,615 |
2.2× |
| Evasc ven artlz tibl/prnl vn (0620T) |
$26,706 |
$66,765 |
0.6× |
| Followup eval of foot pt lop (G0246) |
$154.80 |
$387 |
1.2× |
| Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part… (0479T) |
$1,233.20 |
$3,083 |
1.7× |
| Glaucoma scrn hgh risk direc (G0117) |
$134.40 |
$336 |
4.6× |
| Group behave couns 2-10 (G0473) |
$138.80 |
$347 |
3.7× |
| High dose rate electronic brachytherapy, interstitial or intracavitary treatment, per fraction, includes basic… (0395T) |
$552.40 |
$1,381 |
0.8× |
| Home sleep test/type 2 porta (G0398) |
$526 |
$1,315 |
2.4× |
| Home sleep test/type 3 porta (G0399) |
$526 |
$1,315 |
2.4× |
| Home sleep test/type 4 porta (G0400) |
$526 |
$1,315 |
2.4× |
| Initial foot exam pt lops (G0245) |
$129.20 |
$323 |
1.0× |
| Initial preventive exam (G0402) |
$112.80 |
$282 |
0.8× |
| Inj for sacroiliac jt anesth (G0260) |
$2,206.40 |
$5,516 |
3.1× |
| Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0517T) |
$13,254.40 |
$33,136 |
1.3× |
| Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when… (0410T) |
$13,254.40 |
$33,136 |
1.6× |
| Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when… (0409T) |
$34,539.20 |
$86,348 |
1.5× |
| Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when… (0411T) |
$13,254.40 |
$33,136 |
1.6× |
| Insj wcs lv compl sys (0515T) |
$34,539.20 |
$86,348 |
1.5× |
| Insj wcs lv eltrd only (0516T) |
$13,254.40 |
$33,136 |
1.3× |
| Insj/rplc car modulj sys pls gen transvns eltrd (0408T) |
$49,334.80 |
$123,337 |
1.6× |
| Insj/rplcmt compl iims (0525T) |
$11,702.40 |
$29,256 |
0.6× |
| Insj/rplcmt iims eltrd only (0526T) |
$13,254.40 |
$33,136 |
1.6× |
| Insj/rplcmt iims implt mntr (0527T) |
$13,254.40 |
$33,136 |
1.6× |
| Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and… (0418T) |
$128.80 |
$322 |
3.4× |
| Njx pltlt plasma w/img harvest/preparation (0232T) |
$1,444 |
$3,610 |
3.2× |
| Obtaining screen pap smear (Q0091) |
$40.80 |
$102 |
1.4× |
| Perc d-e cor revasc chro sin (C9607) |
$27,630.80 |
$69,077 |
1.5× |
| Perc d-e cor revasc t cabg s (C9604) |
$12,574 |
$31,435 |
1.1× |
| Perc d-e cor stent ather s (C9602) |
$27,630.80 |
$69,077 |
1.5× |
| Perc drug-el cor stent sing (C9600) |
$17,450.40 |
$43,626 |
1.5× |
| Pet not otherwise specified (G0235) |
$2,564.40 |
$6,411 |
6.4× |
| Place device/marker, non pro (C9728) |
$1,348 |
$3,370 |
1.0× |
| Prgrmg device evaluation cardiac modulj system (0417T) |
$128.80 |
$322 |
3.4× |
| Prostate biopsy, any mthd (G0416) |
$613.20 |
$1,533 |
1.7× |
| Psa screening (G0103) |
$110 |
$275 |
5.7× |
| Quantitative computed tomography (CT scan) tissue characterization with interpretation and report and concurrent CT… (0722T) |
$1,076.40 |
$2,691 |
1.7× |
| Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained without… (0721T) |
$1,076.40 |
$2,691 |
1.7× |
| Quantitative magnetic resonance (MR scan) imaging of gallbladder, bile ducts, pancreas and pancreatic duct… (0724T) |
$1,573.60 |
$3,934 |
1.7× |
| Quantitative magnetic resonance (MR scan) imaging of gallbladder, bile ducts, pancreas and pancreatic duct… (0723T) |
$1,573.60 |
$3,934 |
1.7× |
| Reloc skin pocket pls gen (0416T) |
$5,233.20 |
$13,083 |
2.5× |
| Removal and replacement of permanent cardiac contractility modulation system pulse generator only (0414T) |
$34,539.20 |
$86,348 |
1.5× |
| Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including… (0519T) |
$12,106 |
$30,265 |
1.2× |
| Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including… (0520T) |
$16,319.60 |
$40,799 |
1.6× |
| Removal complete iims (0530T) |
$12,106 |
$30,265 |
3.2× |
| Removal iims electrode only (0531T) |
$12,106 |
$30,265 |
3.2× |
| Removal iims implt mntr only (0532T) |
$12,106 |
$30,265 |
3.2× |
| Removal of permanent cardiac contractility modulation system; pulse generator only (0412T) |
$9,382.80 |
$23,457 |
2.5× |
| Removal of permanent cardiac contractility modulation system; transvenous electrode (atrial or ventricular) (0413T) |
$9,382.80 |
$23,457 |
2.5× |
| Removal of pulse generator components of wireless heart stimulator system for pacing of lower left chamber of heart (0518T) |
$12,106 |
$30,265 |
3.2× |
| Repositioning of previously implanted cardiac contractility modulation transvenous electrode (atrial or ventricular… (0415T) |
$2,508 |
$6,270 |
4.0× |
| Revasc intra lithotrip-ather (C9766) |
$13,475.20 |
$33,688 |
0.7× |
| Revasc intra lithotrip-stent (C9765) |
$27,630.80 |
$69,077 |
1.5× |
| Revasc intravasc lithotripsy (C9764) |
$17,966.40 |
$44,916 |
1.5× |
| Revasc lith-sten-ath tib/per (C9775) |
$20,192.40 |
$50,481 |
1.1× |
| Revasc lithotr-ather tib/per (C9774) |
$14,538.40 |
$36,346 |
0.8× |
| Revasc lithotr-stent tib/per (C9773) |
$14,496 |
$36,240 |
0.8× |
| Revasc lithotrip tibi/perone (C9772) |
$9,730.40 |
$24,326 |
0.8× |
| Revasc lithotrip-stent-ather (C9767) |
$17,845.20 |
$44,613 |
1.0× |
| Routine footcare pt w lops (G0247) |
$121.60 |
$304 |
0.6× |
| Tcat rmvl/debulk icar mass suction device perq (0644T) |
$8,705.20 |
$21,763 |
1.5× |
| Tpmt nudt15 genes (0034U) |
$268.40 |
$671 |
0.6× |
| Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes… (0278T) |
$162 |
$405 |
1.3× |
| Trauma respons w/hosp criti (G0390) |
$4,228.80 |
$10,572 |
3.2× |
| Trim nail(s) (G0127) |
$102.40 |
$256 |
1.7× |
| Trluml perip athrc abd aorta (0236T) |
$19,554 |
$48,885 |
1.7× |
| Trluml perip athrc brchiocph (0237T) |
$8,688.80 |
$21,722 |
0.7× |
Trluml perip athrc iliac art (0238T)
unusually low — confirm this is the full procedure |
$8,688.80 |
$21,722 |
0.5× |
| Trluml perip athrc renal art (0234T) |
$11,266.40 |
$28,166 |
1.0× |
| Unsched dialysis esrd pt hos (G0257) |
$946.80 |
$2,367 |
1.4× |