| Abd paracentesis (49082) |
$765.17 |
$900.20 |
0.8× |
| Abd paracentesis w/imaging (49083) |
$1,536.50 |
$1,807.65 |
1.7× |
| Acetabuloplasty; resection, femoral head (eg, girdlestone procedure) (27122) |
$8,965.97 |
$10,548.20 |
1.2× |
| Acne surgery (10040) |
$130.48 |
$153.50 |
0.6× |
| Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release Age Under 21 (23130) |
$3,027.45 |
$3,561.70 |
0.9× |
| Adenoidectomy, secondary; younger than age 12 Age Under 21 (42835) |
$873.72 |
$1,027.90 |
0.3× |
| Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm Age Under 21 (14301) |
$3,059.92 |
$3,599.90 |
0.8× |
| Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet;… (14040) |
$2,121.35 |
$2,495.70 |
1.0× |
| Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm Age Under 21 (14021) |
$2,065.33 |
$2,429.80 |
1.0× |
| Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less Age Under 21 (14000) |
$1,209.98 |
$1,423.50 |
0.6× |
| Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm Age Under 21 (14001) |
$2,173.88 |
$2,557.50 |
1.0× |
| Adjt tis trnsfr/reargmt scalp/arm/leg 10 sq cm/< (14020) |
$1,782.54 |
$2,097.10 |
0.8× |
| Amp f/th 1/2 jt/phalanx w/neurect w/dir clsr (26951) |
$1,986.54 |
$2,337.10 |
0.6× |
| Amputate metacarpal bone (26910) |
$2,979.34 |
$3,505.10 |
0.9× |
| Amputation Foot Transmetarsal|RIGHT SIDE (28805) |
$2,477.67 |
$2,914.90 |
0.7× |
| Amputation of finger/thumb (26952) |
$2,648.43 |
$3,115.80 |
0.8× |
| Amputation of fingers and part of hand at midhand bones (25927) |
$3,297.15 |
$3,879 |
1.0× |
| Amputation of toe (28820) |
$1,952.37 |
$2,296.90 |
0.6× |
| Amputation toe interphalangeal joint (28825) |
$1,673.06 |
$1,968.30 |
0.5× |
| Amputation, foot; midtarsal (eg, Chopart type procedure) (28800) |
$2,691.27 |
$3,166.20 |
0.8× |
| Amputation, metatarsal, with toe, single Age Under 21 (28810) |
$1,787.81 |
$2,103.30 |
0.5× |
| Amputation, thigh, through femur, any level; (27590) |
$4,832.76 |
$5,685.60 |
1.4× |
| Amputation, thigh, through femur, any level; re-amputation (27596) |
$4,297.86 |
$5,056.30 |
1.3× |
| Amputation, thigh, through femur, any level; secondary closure or scar revision Age Under 21 (27594) |
$1,712.50 |
$2,014.70 |
0.5× |
| Anesthesia inj anesthetic agent dig nrv (64455) |
$724.03 |
$851.80 |
2.3× |
| Anoscopy and biopsy (46606) |
$314.33 |
$369.80 |
0.3× |
| Anoscopy diagnostic (46600) |
$216.67 |
$254.90 |
1.6× |
| Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps,… (46615) |
$916.64 |
$1,078.40 |
0.3× |
| Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery Age Under 21 (46610) |
$494.70 |
$582 |
0.2× |
| Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when… (57240) |
$2,871.64 |
$3,378.40 |
0.6× |
| Anterior tibial tubercleplasty (27418) |
$5,660.15 |
$6,659 |
0.8× |
| App skn sub grft t/a/l area/<100scm /<1st 25 scm (15271) |
$513.06 |
$603.60 |
0.7× |
| Appendectomy (44950) |
$3,395.16 |
$3,994.30 |
0.5× |
| Application cast finger (29086) |
$157.59 |
$185.40 |
0.9× |
| Application finger splint static (29130) |
$130.48 |
$153.50 |
1.0× |
Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, Ilizarov,… (20692)
likely a partial charge — not the full procedure |
$2,303.42 |
$2,709.90 |
0.2× |
| Application of clubfoot cast with molding or manipulation, long or short leg Age Under 21 (29450) |
$106.84 |
$125.70 |
0.6× |
| Application of long leg cast (thigh to toes); (29345) |
$405.84 |
$477.45 |
1.4× |
| Application of long leg splint (thigh to ankle or toes) (29505) |
$269.62 |
$317.20 |
1.6× |
| Application of short arm splint (forearm to hand); static (29125) |
$162.86 |
$191.60 |
1.2× |
| Application of short leg cast (below knee to toes); (29405) |
$312.54 |
$367.70 |
1.1× |
| Application of short leg cast (below knee to toes); walking or ambulatory type (29425) |
$246.93 |
$290.50 |
0.9× |
| Application of short leg splint (calf to foot) (29515) |
$176.89 |
$208.10 |
1.1× |
| Application of walking cast covering thigh to toe|SERV DELIV PERSONALLY BY PT OR UNDER AN OP PLAN OF CARE (29355) |
$429 |
$504.70 |
1.5× |
Application uniplane external fixation system (20690)
likely a partial charge — not the full procedure |
$1,657.33 |
$1,949.80 |
0.2× |
| Application, cast; figure-of-eight Age Under 21 (29049) |
$352.84 |
$415.10 |
1.2× |
| Application, cast; shoulder to hand (long arm) (29065) |
$295.89 |
$348.10 |
1.0× |
| Apply hand/wrist cast (29085) |
$211.86 |
$249.25 |
1.3× |
| Apply long arm splint (29105) |
$192.61 |
$226.60 |
1.2× |
| Arthrd ant interbody min dsc crv below c2 (22554) |
$9,144.64 |
$10,758.40 |
0.7× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$222.36 |
$261.60 |
0.7× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$260.87 |
$306.90 |
0.8× |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
$260.87 |
$306.90 |
0.8× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$210.12 |
$247.20 |
0.7× |
Arthrodesis, ankle, open Age Under 21 (27870)
unusually low — confirm this is the full procedure |
$5,276.63 |
$6,207.80 |
0.4× |
Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for… (22558)
unusually low — confirm this is the full procedure |
$11,385.92 |
$13,395.20 |
0.4× |
| Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of… (22551) |
$11,129.39 |
$13,093.40 |
0.8× |
Arthrodesis, carpometacarpal joint, digit, other than thumb, each; Age Under 21 (26843)
unusually low — confirm this is the full procedure |
$3,224.48 |
$3,793.50 |
0.4× |
Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy… (22633)
unusually low — confirm this is the full procedure |
$13,570.25 |
$15,965 |
0.5× |
Arthrodesis, great toe; interphalangeal joint Age Under 21 (28755)
likely a partial charge — not the full procedure |
$1,699.32 |
$1,999.20 |
0.2× |
Arthrodesis, great toe; metatarsophalangeal joint (28750)
unusually low — confirm this is the full procedure |
$2,453.19 |
$2,886.10 |
0.3× |
| Arthrodesis, interphalangeal joint, with or without internal fixation; Age Under 21 (26860) |
$2,483.79 |
$2,922.10 |
0.7× |
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; Age Under 21 (28730)
likely a partial charge — not the full procedure |
$3,558.02 |
$4,185.90 |
0.3× |
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction) Age Under 21 (28735)
unusually low — confirm this is the full procedure |
$4,321.49 |
$5,084.10 |
0.3× |
Arthrodesis, midtarsal or tarsometatarsal, single joint Age Under 21 (28740)
unusually low — confirm this is the full procedure |
$2,967.10 |
$3,490.70 |
0.4× |
Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than… (22630)
unusually low — confirm this is the full procedure |
$10,228.48 |
$12,033.50 |
0.4× |
Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment Cervical Spinal Fusion (22600)
unusually low — confirm this is the full procedure |
$8,122.86 |
$9,556.30 |
0.5× |
| Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when… (22612) |
$10,228.48 |
$12,033.50 |
0.6× |
Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique,… (22610)
unusually low — confirm this is the full procedure |
$7,387.44 |
$8,691.10 |
0.4× |
| Arthrodesis, posterior technique, atlas-axis (C1-C2) Cervical Spinal Fusion (22595) |
$10,462.23 |
$12,308.50 |
0.8× |
Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg,… (28760)
unusually low — confirm this is the full procedure |
$2,310.47 |
$2,718.20 |
0.3× |
Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, Miller type procedure)… (28737)
likely a partial charge — not the full procedure |
$3,346.20 |
$3,936.70 |
0.3× |
| Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal) Age Under 21 (25820) |
$3,951.99 |
$4,649.40 |
0.5× |
| Arthrodesis, wrist; with autograft (includes obtaining graft) Age Under 21 (25825) |
$5,379.99 |
$6,329.40 |
0.7× |
Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft) Age Under 21 (25810)
unusually low — confirm this is the full procedure |
$5,196.99 |
$6,114.10 |
0.4× |
Arthrodesis; subtalar (28725)
unusually low — confirm this is the full procedure |
$4,068.44 |
$4,786.40 |
0.3× |
Arthroplasty glenohumeral joint total shoulder (23472)
unusually low — confirm this is the full procedure |
$7,908.40 |
$9,304 |
0.4× |
Arthroplasty, ankle; with implant (total ankle) (27702)
unusually low — confirm this is the full procedure |
$9,820.48 |
$11,553.50 |
0.4× |
| Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow) Age Under 21 (24363) |
$9,045.70 |
$10,642 |
0.5× |
| Arthroplasty, glenohumeral joint; hemiarthroplasty (23470) |
$6,959.38 |
$8,187.50 |
0.5× |
Arthroplasty, interphalangeal joint; with prosthetic implant, each joint Age Under 21 (26536)
unusually low — confirm this is the full procedure |
$3,213.09 |
$3,780.10 |
0.4× |
| Arthroplasty, knee, condyle and plateau; medial OR lateral compartment Age Under 21 (27446) |
$8,510.71 |
$10,012.60 |
0.6× |
Arthroplasty, metacarpophalangeal joint; each joint Age Under 21 (26530)
unusually low — confirm this is the full procedure |
$2,919.84 |
$3,435.10 |
0.4× |
Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint Age Under 21 (26531)
unusually low — confirm this is the full procedure |
$3,389.97 |
$3,988.20 |
0.5× |
Arthroplasty, patella; with prosthesis Age Under 21 (27438)
unusually low — confirm this is the full procedure |
$5,099.83 |
$5,999.80 |
0.4× |
| Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction Age Under 21 (29888) |
$10,274.04 |
$12,087.10 |
1.4× |
| Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction Age Under 21 (29889) |
$7,730.67 |
$9,094.90 |
0.6× |
| Arthroscopy knee osteochondral allograft (29867) |
$7,109.06 |
$8,363.60 |
0.5× |
| Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive Age Under 21 (29898) |
$4,740.88 |
$5,577.50 |
1.4× |
| Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited Age Under 21 (29897) |
$4,597.23 |
$5,408.50 |
1.4× |
| Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial Age Under 21 (29895) |
$4,289.95 |
$5,047 |
1.3× |
| Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect… (29891) |
$6,457.71 |
$7,597.30 |
1.9× |
| Arthroscopy, elbow, surgical; debridement, limited Age Under 21 (29837) |
$3,925.73 |
$4,618.50 |
1.2× |
| Arthroscopy, elbow, surgical; with removal of loose body or foreign body Age Under 21 (29834) |
$3,389.04 |
$3,987.10 |
1.0× |
| Arthroscopy, hip, surgical; with labral repair Age Under 21 (29916) |
$6,303.60 |
$7,416 |
0.9× |
| Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure) (29870) |
$2,398.87 |
$2,822.20 |
0.7× |
| Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or… (29879) |
$5,871.97 |
$6,908.20 |
1.8× |
| Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) Age Under 21 (29877) |
$5,108.59 |
$6,010.10 |
1.5× |
| Arthroscopy, knee, surgical; for infection, lavage and drainage (29871) |
$3,834.69 |
$4,511.40 |
1.1× |
| Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation,… (29874) |
$3,330.39 |
$3,918.10 |
1.0× |
| Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) Age Under 21 (29875) |
$4,790.77 |
$5,636.20 |
1.4× |
| Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure) Age Under 21 (29884) |
$4,671.69 |
$5,496.10 |
1.4× |
| Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including… (29880) |
$7,020.66 |
$8,259.60 |
2.1× |
| Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) Age Under 21 (29883) |
$5,935.04 |
$6,982.40 |
1.8× |
| Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) Age Under 21 (29882) |
$6,287.88 |
$7,397.50 |
1.9× |
| Arthroscopy, shoulder, surgical; capsulorrhaphy Age Under 21 (29806) |
$6,303.60 |
$7,416 |
0.9× |
| Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral… (29823) |
$5,115.56 |
$6,018.30 |
1.5× |
| Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular… (29822) |
$4,676.96 |
$5,502.30 |
1.4× |
| Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure) Age Under… (29824) |
$3,194.73 |
$3,758.50 |
1.0× |
| Arthroscopy, shoulder, surgical; repair of SLAP lesion Age Under 21 (29807) |
$6,702.85 |
$7,885.70 |
0.9× |
| Arthroscopy, shoulder, surgical; synovectomy, partial Age Under 21 (29820) |
$3,808.43 |
$4,480.50 |
0.5× |
| Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation Age Under 21 (29825) |
$4,384.47 |
$5,158.20 |
1.3× |
| Arthroscopy, shoulder, surgical; with removal of loose body or foreign body Age Under 21 (29819) |
$3,687.64 |
$4,338.40 |
1.1× |
| Arthroscopy, shoulder, surgical; with rotator cuff repair Age Under 21 (29827) |
$5,745.92 |
$6,759.90 |
0.8× |
| Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement Age Under 21 (29846) |
$4,566.63 |
$5,372.50 |
1.4× |
| Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure) Age Under 21 (24006) |
$2,899.69 |
$3,411.40 |
0.9× |
| Arthrotomy with meniscus repair, knee Age Under 21 (27403) |
$3,846.08 |
$4,524.80 |
0.5× |
| Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage Age… (23101) |
$3,208.75 |
$3,775 |
1.0× |
| Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body Age… (27620) |
$3,305.91 |
$3,889.30 |
1.0× |
| Arthrotomy, elbow, including exploration, drainage, or removal of foreign body Age Under 21 (24000) |
$3,513.39 |
$4,133.40 |
1.1× |
Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body Age Under 21 (23107)
unusually low — confirm this is the full procedure |
$3,195.58 |
$3,759.50 |
0.4× |
| Arthrotomy, hip, with drainage (eg, infection) (27030) |
$4,723.37 |
$5,556.90 |
0.6× |
| Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint… (28020) |
$2,104.69 |
$2,476.10 |
0.6× |
| Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies Age Under 21 (27331) |
$3,640.30 |
$4,282.70 |
1.1× |
| Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening Age Under 21 (27612) |
$3,330.39 |
$3,918.10 |
1.0× |
| Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body Age Under 21 (25040) |
$2,834.84 |
$3,335.10 |
0.8× |
| Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each Age Under… (26075) |
$2,003.11 |
$2,356.60 |
0.6× |
| Arthrotomy, with synovectomy, ankle; Age Under 21 (27625) |
$4,281.20 |
$5,036.70 |
1.3× |
| Arthrotomy, with synovectomy, ankle; including tenosynovectomy Age Under 21 (27626) |
$3,995.77 |
$4,700.90 |
1.2× |
| Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign… (25101) |
$1,954.15 |
$2,299 |
0.6× |
| Arthrp acetblr/prox fem prostc agrft/algrft (27130) |
$12,172.94 |
$14,321.10 |
0.9× |
| Arthrt expl drg/rmvl loose/fb iphal jt ea (26080) |
$1,603.02 |
$1,885.90 |
1.0× |
| Arthrt kne w/expl drg/rmvl fb (27310) |
$4,774.96 |
$5,617.60 |
1.4× |
| Arthrt w/expl drg/rmvl loose/fb iphal jt (28024) |
$979.71 |
$1,152.60 |
0.6× |
| Arthrt w/expl drg/rmvl loose/fb mttarphlngl jt (28022) |
$1,673.06 |
$1,968.30 |
0.5× |
| Aspirate pleura w/o imaging (32554) |
$1,888.45 |
$2,221.70 |
2.9× |
| Aspiration and/or injection of ganglion cyst(s) any location (20612) |
$189.56 |
$223 |
0.6× |
| Avulsion of nail plate, partial or complete, simple; single (11730) |
$284.12 |
$334.25 |
1.4× |
| Axillary lymphadenectomy; complete Age Under 21 (38745) |
$3,656.96 |
$4,302.30 |
0.6× |
Axillary lymphadenectomy; superficial Age Under 21 (38740)
unusually low — confirm this is the full procedure |
$2,713.20 |
$3,192 |
0.4× |
| Biopsy bone open superficial (20240) |
$939.42 |
$1,105.20 |
0.3× |
| Biopsy bone trocar/needle deep (20225) |
$640.44 |
$753.45 |
0.4× |
| Biopsy liver needle percutaneous (47000) |
$766.96 |
$902.30 |
0.5× |
| Biopsy lymph node (38505) |
$492.02 |
$578.85 |
0.3× |
| Biopsy muscle percutaneous needle (20206) |
$403.58 |
$474.80 |
0.2× |
| Biopsy of anorectal wall, anal approach (eg, congenital megacolon) (45100) |
$1,580.32 |
$1,859.20 |
0.6× |
| Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure) Age Under 21 (19100) |
$295.04 |
$347.10 |
0.2× |
| Biopsy of cervix (57500) |
$429 |
$504.70 |
0.5× |
| Biopsy of large bowel using an endoscope inserted through surgically created opening from large bowel to skin (44389) |
$1,976 |
$2,324.70 |
1.6× |
| Biopsy of lower large bowel using a flexible endoscope|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (45331) |
$494.70 |
$582 |
0.5× |
| Biopsy of nerve Age Under 21 (64795) |
$1,136.37 |
$1,336.90 |
0.6× |
| Biopsy of salivary gland; needle (42400) |
$609.32 |
$716.85 |
0.8× |
| Biopsy of tongue; anterior two-thirds Age Under 21 (41100) |
$503.46 |
$592.30 |
0.9× |
| Biopsy of uterus lining (58100) |
$253.05 |
$297.70 |
1.2× |
| Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad Age Under 21 (38520) |
$1,310.62 |
$1,541.90 |
0.3× |
| Biopsy or excision of lymph node(s); open, superficial (38500) |
$778.35 |
$915.70 |
0.2× |
| Biopsy or removal of deep lymph nodes of underarm|LEFT SIDE|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF… (38525) |
$1,361.45 |
$1,601.70 |
0.3× |
| Biopsy soft tissue neck/thorax (21550) |
$560.32 |
$659.20 |
0.3× |
| Biopsy Soft Tissue Pelvis&Hip Area Superficial (27040) |
$415.91 |
$489.30 |
0.2× |
| Biopsy thyroid percutaneous core needle (60100) |
$1,005.98 |
$1,183.50 |
1.4× |
| Biopsy vaginal mucosa simple (57100) |
$446.08 |
$524.80 |
0.5× |
| Biopsy vulva/perineum 1 lesion (56605) |
$288.92 |
$339.90 |
0.3× |
| Biopsy, abdominal or retroperitoneal mass, percutaneous needle Age Under 21 (49180) |
$805.46 |
$947.60 |
0.5× |
| Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft) Age Under 21 (20245) |
$1,702.89 |
$2,003.40 |
0.6× |
| Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs) Age Under 21 (20220) |
$559.47 |
$658.20 |
0.3× |
| Biopsy, soft tissue of back or flank; superficial Age Under 21 (21920) |
$308.21 |
$362.60 |
0.2× |
| Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular) Age Under 21 (27614) |
$1,759.76 |
$2,070.30 |
0.6× |
| Biopsy, soft tissue of shoulder area; deep Age Under 21 (23066) |
$1,273.90 |
$1,498.70 |
0.4× |
| Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular) Age Under 21 (27324) |
$1,994.36 |
$2,346.30 |
0.7× |
| Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular) Age Under 21 (24066) |
$1,336.03 |
$1,571.80 |
0.5× |
Biopsy, vertebral body, open; lumbar or cervical Age Under 21 (20251)
likely a partial charge — not the full procedure |
$2,127.47 |
$2,502.90 |
0.3× |
| Biopsy/removal lymph nodes (38510) |
$1,273.90 |
$1,498.70 |
0.3× |
| Bladder irrigation (51700) |
$211.91 |
$249.30 |
0.8× |
| Blepharotomy, drainage of abscess, eyelid Age Under 21 (67700) |
$361.59 |
$425.40 |
1.1× |
Bone graft, any donor area; major or large Age Under 21 (20902)
likely a partial charge — not the full procedure |
$2,089.81 |
$2,458.60 |
0.3× |
Bone graft, any donor area; minor or small (eg, dowel or button) Age Under 21 (20900)
likely a partial charge — not the full procedure |
$1,092.59 |
$1,285.40 |
0.1× |
| Breast Biopsy; Percutaneous, Needle Core (Not Using Imaging Guidance) Charge (19101) |
$1,132.03 |
$1,331.80 |
0.3× |
| Bronchoscopy w biopsy (31625) |
$1,371.90 |
$1,614 |
0.8× |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when… (31622) |
$1,111.04 |
$1,307.10 |
0.6× |
| Bx breast 1st lesion us imag (19083) |
$2,065.29 |
$2,429.75 |
1.2× |
| Cah artificial insemination intra-uterine (58322) |
$435.97 |
$512.90 |
2.1× |
| Cah reinsertion spinal fixation device (22849) |
$7,355.99 |
$8,654.10 |
0.6× |
| Capsular contracture release (eg, Sever type procedure) Age Under 21 (23020) |
$3,548.41 |
$4,174.60 |
1.1× |
| Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint Age Under 21 (26520) |
$2,468.91 |
$2,904.60 |
0.7× |
| Capsulodesis, metacarpophalangeal joint; single digit Age Under 21 (26516) |
$3,083.55 |
$3,627.70 |
0.9× |
| Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes… (25320) |
$5,229.37 |
$6,152.20 |
0.7× |
| Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant… (28262) |
$4,708.41 |
$5,539.30 |
0.6× |
| Care of miscarriage (59820) |
$1,515.47 |
$1,782.90 |
0.5× |
| Carpectomy; all bones of proximal row Age Under 21 (25215) |
$3,312.88 |
$3,897.50 |
1.0× |
| Cast short arm (29075) |
$224.58 |
$264.20 |
0.8× |
| Casting/strapping procedure (29799) |
$195.68 |
$230.20 |
1.2× |
| Cautery of cervix; electro or thermal Age Under 21 (57510) |
$486.80 |
$572.70 |
0.1× |
| Cervical lymphadenectomy (complete) (38720) |
$7,123.09 |
$8,380.10 |
1.0× |
| Change Cystostomy Tube Simple (51705) |
$749.45 |
$881.70 |
2.9× |
| Chemical cauterization of granulation tissue (17250) |
$227.63 |
$267.80 |
1.1× |
| Chemodenerv trunk musc 1-5 (64646) |
$618.12 |
$727.20 |
0.9× |
| Chest tube placement (32551) |
$1,013.80 |
$1,192.70 |
0.6× |
Chromotubation Oviduct W/Materials|BILATERAL PROCEDURE (58350)
likely a partial charge — not the full procedure |
$490.28 |
$576.80 |
0.1× |
| Circumcision, Newborn (54150) |
$439.96 |
$517.60 |
0.2× |
| Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) Age Under 21 (54160) |
$508.26 |
$597.95 |
0.7× |
| Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age Age Under 21 (54161) |
$451.78 |
$531.50 |
0.2× |
| Claviculectomy; partial Age Under 21 (23120) |
$3,027.45 |
$3,561.70 |
0.9× |
| Closed rx acetabular fx (27220) |
$1,409.56 |
$1,658.30 |
5.6× |
| Closed rx ulna shaft fx,manipulatn (25535) |
$1,419.16 |
$1,669.60 |
5.6× |
| Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation Age Under 21 (27842) |
$1,266.84 |
$1,490.40 |
0.8× |
| Closed treatment of articular fx,metacarpophalangeal or interphalangeal joint; w/o manip, each (26740) |
$766.11 |
$901.30 |
3.0× |
| Closed treatment of calcaneal fracture; without manipulation (28400) |
$898.28 |
$1,056.80 |
3.6× |
| Closed treatment of carpal bone fracture; without manipulation (25630) |
$976.23 |
$1,148.50 |
3.9× |
| Closed treatment of carpal scaphoid (navicular) fracture; without manipulation (25622) |
$1,074.28 |
$1,263.85 |
4.3× |
| Closed treatment of clavicular fracture; with manipulation (23505) |
$1,057.57 |
$1,244.20 |
0.6× |
| Closed treatment of clavicular fracture; without manipulation (23500) |
$674.99 |
$794.10 |
2.7× |
| Closed treatment of distal fibular fracture (lateral malleolus); with manipulation (27788) |
$1,276.92 |
$1,502.25 |
5.1× |
| Closed treatment of distal fibular fracture (lateral malleolus); without manipulation (27786) |
$931.56 |
$1,095.95 |
3.7× |
| Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each (26750) |
$435.12 |
$511.90 |
1.7× |
| Closed treatment of femoral fracture, proximal end, neck; without manipulation Age Under 21 (27230) |
$1,564.51 |
$1,840.60 |
6.2× |
| Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction Age Under 21 (27502) |
$3,277.86 |
$3,856.30 |
2.0× |
| Closed treatment of fracture great toe, phalanx or phalanges; without manipulation (28490) |
$380.89 |
$448.10 |
1.5× |
| Closed treatment of fracture, phalanx or phalanges, other than great toe w/o manipulation each (28510) |
$314.33 |
$369.80 |
1.2× |
| Closed treatment of hip dislocation, traumatic; requiring anesthesia (27252) |
$1,989.13 |
$2,340.15 |
1.2× |
| Closed treatment of humeral shaft fracture; without manipulation (24500) |
$900.92 |
$1,059.90 |
3.6× |
| Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with… (27240) |
$3,810.21 |
$4,482.60 |
2.3× |
| Closed treatment of knee dislocation; requiring anesthesia Age Under 21 (27552) |
$1,475.26 |
$1,735.60 |
0.9× |
| Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction Age Under 21 (27762) |
$1,678.33 |
$1,974.50 |
1.0× |
| Closed treatment of medial malleolus fracture; without manipulation (27760) |
$935.94 |
$1,101.10 |
3.7× |
| Closed treatment of metacarpal fracture, single; with manipulation, each bone (26605) |
$1,095.23 |
$1,288.50 |
4.3× |
| Closed treatment of metacarpal fracture, single; without manipulation, each bone (26600) |
$731.94 |
$861.10 |
2.9× |
| Closed treatment of patellar fracture, without manipulation (27520) |
$1,167.05 |
$1,373 |
4.6× |
| Closed treatment of phalangeal shaft fracture, proximal/middle phalanx with manipulation each (26725) |
$899.56 |
$1,058.30 |
3.6× |
| Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each (26720) |
$500.82 |
$589.20 |
2.0× |
| Closed treatment of post hip arthroplasty dislocation; requiring general anesthesia (27266) |
$2,196.62 |
$2,584.25 |
1.3× |
| Closed treatment of proximal fibula or shaft fracture; with manipulation (27781) |
$1,005.98 |
$1,183.50 |
0.6× |
| Closed treatment of proximal fibula or shaft fracture; without manipulation (27780) |
$768.66 |
$904.30 |
3.1× |
| Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without… (23605) |
$1,664.30 |
$1,958 |
1.0× |
| Closed treatment of proximal humeral fracture; without manipulation (23600) |
$963.05 |
$1,133 |
3.8× |
| Closed treatment of radial and ulnar shaft fractures; without manipulation (25560) |
$1,182.78 |
$1,391.50 |
4.7× |
| Closed treatment of radial head or neck fracture; without manipulation (24650) |
$388.71 |
$457.30 |
1.5× |
| Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation (24640) |
$392.66 |
$461.95 |
1.6× |
| Closed treatment of radial shaft fracture; without manipulation (25500) |
$885.11 |
$1,041.30 |
3.5× |
| Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation (25660) |
$1,465.14 |
$1,723.70 |
5.8× |
| Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation Age Under 21 (23665) |
$1,280.87 |
$1,506.90 |
0.8× |
| Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) |
$936.78 |
$1,102.10 |
3.7× |
| Closed treatment of talus fracture; with manipulation Age Under 21 (28435) |
$1,084.77 |
$1,276.20 |
0.7× |
| Closed treatment of talus fracture; without manipulation (28430) |
$911.37 |
$1,072.20 |
3.6× |
| Closed treatment of tibial fracture, proximal (plateau); without manipulation (27530) |
$711.79 |
$837.40 |
2.8× |
| Closed treatment of ulnar fracture, proximal end; without manipulation (24670) |
$731.94 |
$861.10 |
2.9× |
| Closed treatment of ulnar shaft fracture; without manipulation (25530) |
$948.18 |
$1,115.50 |
3.8× |
| Closed tx ankle dislocation w/o anesthesia (27840) |
$755.57 |
$888.90 |
3.0× |
| Closed tx bimalleolar ankle fracture w/manj (27810) |
$2,026.78 |
$2,384.45 |
1.2× |
| Closed tx bimalleolar ankle fracture w/o manip (27808) |
$1,074.28 |
$1,263.85 |
4.3× |
| Closed tx femoral shaft fx w/o manipulation (27500) |
$2,295.60 |
$2,700.70 |
9.1× |
| Closed tx metatarsal fracture w/o manipulation (28470) |
$747.66 |
$879.60 |
3.0× |
| Closed tx patellar dislocation w/anesthesia (27562) |
$1,232.67 |
$1,450.20 |
4.9× |
| Closed tx patellar dislocation w/o anesthesia (27560) |
$858.46 |
$1,009.95 |
3.4× |
| Closed tx radial shaft fracture w/manipulation (25505) |
$2,176.51 |
$2,560.60 |
1.3× |
| CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee (25565) |
$2,332.32 |
$2,743.90 |
1.4× |
| Closed tx scapular fracture w/o manipulation (23570) |
$802.83 |
$944.50 |
3.2× |
| Closed tx septal&nose fx (21337) |
$1,519.89 |
$1,788.10 |
0.4× |
| Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/o manip (24530) |
$1,011.25 |
$1,189.70 |
4.0× |
| Closed tx vert fx w/o manj (22310) |
$830.88 |
$977.50 |
3.3× |
| Closure of abnormal drainage tract from rectum to vagina through vagina or anus (57300) |
$2,878.61 |
$3,386.60 |
0.9× |
| Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) |
$540.18 |
$635.50 |
2.2× |
| Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) |
$641.75 |
$755 |
1.2× |
| Clsd tx nsl fx mnpj wo stblj (21315) |
$878.14 |
$1,033.10 |
0.6× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
$1,400.38 |
$1,647.50 |
0.9× |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
$1,130.25 |
$1,329.70 |
0.7× |
| CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA TechFee (26755) |
$667.17 |
$784.90 |
2.6× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$1,063.31 |
$1,250.95 |
4.2× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$1,628.43 |
$1,915.80 |
1.0× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
$464.87 |
$546.90 |
1.8× |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) |
$1,142.57 |
$1,344.20 |
4.5× |
| Cltx greater humeral tuberosity fx w/o mnpj (23620) |
$963.05 |
$1,133 |
3.8× |
| Cltx grter humeral tuberosity fx w/manipulation (23625) |
$1,345.64 |
$1,583.10 |
0.8× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
$1,508.08 |
$1,774.20 |
6.0× |
| CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ TechFee (24505) |
$1,605.70 |
$1,889.05 |
1.0× |
| Cltx interphalangeal joint dislocation w/o anes (28660) |
$432.52 |
$508.85 |
1.7× |
| CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee (26700) |
$667.17 |
$784.90 |
2.6× |
| Cltx metar fx w/manj (28475) |
$924.55 |
$1,087.70 |
3.7× |
| Cltx post ankle fx (27767) |
$875.50 |
$1,030 |
3.5× |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
$1,979.48 |
$2,328.80 |
1.2× |
| CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee (27752) |
$2,058.28 |
$2,421.50 |
1.3× |
| Cltx tibial shaft fx w/o manipulation (27750) |
$1,323.79 |
$1,557.40 |
5.3× |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
$2,224.62 |
$2,617.20 |
1.4× |
| Cltx trimalleolar ankle fx w/o manipulation (27816) |
$1,142.57 |
$1,344.20 |
4.5× |
| Collect blood from catheter venous nos (36592) |
$320.45 |
$377 |
2.4× |
| Collect blood from implant venous access device (36591) |
$320.45 |
$377 |
2.4× |
| Colonoscopy thru stoma spx (44388) |
$1,195.10 |
$1,406 |
1.3× |
| Colonoscopy w/ablation (45388) |
$1,864.82 |
$2,193.90 |
1.5× |
| Colonoscopy w/control bleed (45382) |
$1,933.07 |
$2,274.20 |
1.6× |
| Colonoscopy w/fb removal (45379) |
$1,561.03 |
$1,836.50 |
1.3× |
| Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps Age Under 21 (45384) |
$1,766.73 |
$2,078.50 |
1.4× |
| Colonoscopy, flexible; with transendoscopic balloon dilation Age Under 21 (45386) |
$1,759.76 |
$2,070.30 |
1.4× |
| Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) (57282) |
$4,660.30 |
$5,482.70 |
0.6× |
| Colporrhaphy, suture of injury of vagina (nonobstetrical) Age Under 21 (57200) |
$1,459.45 |
$1,717 |
0.4× |
| Colposcopy cervix (57452) |
$503.46 |
$592.30 |
2.4× |
| Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix Age Under 21 (57455) |
$697.77 |
$820.90 |
2.2× |
| Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage Age… (57454) |
$714.43 |
$840.50 |
2.3× |
| Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix Age Under 21 (57460) |
$2,086.33 |
$2,454.50 |
0.6× |
| Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix Age Under 21 (57421) |
$707.37 |
$832.20 |
0.8× |
| Colposcopy w/endocervical curettage (57456) |
$618.12 |
$727.20 |
2.0× |
| Colsc flx with directed submucosal njx any sbst (45381) |
$1,786.02 |
$2,101.20 |
1.5× |
| Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; Age Under 21 (57260) |
$3,766.44 |
$4,431.10 |
0.7× |
| Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair Age Under 21 (57265) |
$4,838.03 |
$5,691.80 |
0.9× |
| Complete replacement picc rs&i (36584) |
$621.61 |
$731.30 |
0.4× |
| Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop… (57522) |
$1,619.68 |
$1,905.50 |
0.5× |
| Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image… (36598) |
$318.24 |
$374.40 |
1.5× |
| Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method (30903) |
$415.91 |
$489.30 |
3.1× |
| Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) |
$288.07 |
$338.90 |
2.1× |
| Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention… (42962) |
$942.91 |
$1,109.30 |
0.3× |
| Control throat bleeding (42960) |
$448.29 |
$527.40 |
0.8× |
| Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft (27132) |
$13,521.21 |
$15,907.30 |
1.0× |
| Conz of cervix w/scope leep (57461) |
$1,427.07 |
$1,678.90 |
0.4× |
Coracoacromial ligament release, with or without acromioplasty Age Under 21 (23415)
unusually low — confirm this is the full procedure |
$3,149.17 |
$3,704.90 |
0.4× |
| Core needle bx lung/mediastinum perq w/img (32408) |
$653.14 |
$768.40 |
0.4× |
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method Age… (28299)
unusually low — confirm this is the full procedure |
$3,202.55 |
$3,767.70 |
0.4× |
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial… (28297)
likely a partial charge — not the full procedure |
$3,164.98 |
$3,723.50 |
0.2× |
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any… (28298)
unusually low — confirm this is the full procedure |
$2,923.32 |
$3,439.20 |
0.4× |
| Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy) (28285) |
$1,576.75 |
$1,855 |
0.5× |
| Corrj hlx vlgs bncty sesmdc dstl metar osteot (28296) |
$3,792.70 |
$4,462 |
1.1× |
| Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous… (36830) |
$3,814.55 |
$4,487.70 |
0.7× |
| Cryotherapy (CO2 slush, liquid N2) for acne (17340) |
$197.88 |
$232.80 |
3.3× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$802.83 |
$944.50 |
5.9× |
| Ctrl nsl hemrrg pst nasal packs&/cautery subsq (30906) |
$839.21 |
$987.30 |
3.5× |
| Curettage postpartum (59160) |
$993.74 |
$1,169.10 |
0.3× |
| Cylinder cast (29365) |
$348.42 |
$409.90 |
1.2× |
Cystorrhaphy, suture of bladder wound, injury or rupture; simple (51860)
unusually low — confirm this is the full procedure |
$3,534.39 |
$4,158.10 |
0.4× |
| Cystotomy, with insertion of ureteral catheter or stent (separate procedure) Age Under 21 (51045) |
$2,477.67 |
$2,914.90 |
1.2× |
| Cystourethroscopy (52000) |
$634.78 |
$746.80 |
0.9× |
| Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography,… (52005) |
$1,167.05 |
$1,373 |
0.5× |
| Dbrdmt w/rmvl fm fx&/dislc skn subq t/m/f musc (11011) |
$1,416.53 |
$1,666.50 |
2.0× |
| Dcmprn fasct leg ant&/lat&pst cmprt (27602) |
$2,885.67 |
$3,394.90 |
0.9× |
| Deb skin bone at fx site (11012) |
$2,076.72 |
$2,443.20 |
0.7× |
| Debride skin at fx site (11010) |
$1,441.09 |
$1,695.40 |
2.0× |
| Debridement of extensive eczematous or infected skin; up to 10% of body surface (11000) |
$227.63 |
$267.80 |
0.5× |
| Debridement of nail(s) by any method(s); 1 to 5 (11720) |
$125.63 |
$147.80 |
2.1× |
| DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee (11042) |
$683.36 |
$803.95 |
1.6× |
| Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm… (11044) |
$1,360.56 |
$1,600.65 |
0.8× |
| Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm… (11043) |
$1,076.87 |
$1,266.90 |
1.4× |
| Declot vascular device (36593) |
$249.56 |
$293.60 |
0.7× |
| Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; without debridement of nonviable… (25024) |
$2,747.29 |
$3,232.10 |
0.8× |
| Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; with debridement of nonviable muscle… (25023) |
$2,587.15 |
$3,043.70 |
0.8× |
| Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; without debridement of nonviable muscle… (25020) |
$2,158.15 |
$2,539 |
1.3× |
| Decompression fasciotomy, leg; anterior and/or lateral compartments only Age Under 21 (27600) |
$1,771.15 |
$2,083.70 |
0.5× |
| Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); Age Under 21 (27496) |
$1,870.94 |
$2,201.10 |
0.6× |
| Decompression fingers and/or hand, injection injury (eg, grease gun) (26035) |
$4,669.90 |
$5,494 |
1.4× |
| Decompressive fasciotomy, hand (excludes 26035) Age Under 21 (26037) |
$2,003.11 |
$2,356.60 |
0.6× |
| Deep incis foot bone infectn (28005) |
$1,912.08 |
$2,249.50 |
0.6× |
| Deep muscle biopsy (20205) |
$1,024.34 |
$1,205.10 |
0.3× |
| Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands,… (15620) |
$1,631.92 |
$1,919.90 |
0.8× |
| Delivery of placenta (59414) |
$640.90 |
$754 |
0.2× |
| Destroy nerve face muscle (64612) |
$562.96 |
$662.30 |
1.8× |
| Destroy vulva lesion/s compl (56515) |
$1,175.81 |
$1,383.30 |
0.6× |
| Destruct by neuro agent; plantar digital nerve (64632) |
$642.60 |
$756 |
2.0× |
| Destruct lesion 15 or more (17111) |
$352.84 |
$415.10 |
1.7× |
| Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions… (17000) |
$252.11 |
$296.60 |
1.2× |
| Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions… (17004) |
$435.97 |
$512.90 |
1.0× |
| Destruction benign lesions up to 14 (17110) |
$151.90 |
$178.70 |
0.7× |
| Destruction by neurolytic agent, intercostal nerve (64620) |
$761.69 |
$896.10 |
0.8× |
| Destruction lesions vulva simple (56501) |
$429 |
$504.70 |
0.2× |
| Destruction neurolytic agt genicular nerve w/img (64624) |
$2,816.48 |
$3,313.50 |
1.4× |
| Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm Age Under 21 (17106) |
$750.30 |
$882.70 |
1.8× |
| Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical… (46922) |
$1,856.06 |
$2,183.60 |
0.7× |
| Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple;… (46910) |
$225.85 |
$265.70 |
0.1× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17260) |
$232.05 |
$273 |
1.1× |
| Diagnostic bone marrow aspirations (38220) |
$551.57 |
$648.90 |
0.3× |
| Diagnostic bone marrow biopsies (38221) |
$621.61 |
$731.30 |
0.4× |
| Diagnostic bone marrow biopsies & aspirations (38222) |
$879.46 |
$1,034.65 |
0.3× |
| Diagnostic exam of uterus using an endoscope|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (58555) |
$1,501.53 |
$1,766.50 |
0.5× |
| Diagnostic lumbar spinal puncture w/fluor or CT (62328) |
$677.66 |
$797.25 |
0.9× |
| Diagnostic sigmoidoscopy (45330) |
$860.16 |
$1,011.95 |
0.9× |
| Diaphragm or cervical cap fitting with instructions (57170) |
$130.48 |
$153.50 |
0.6× |
| Dilation & Curettage Dx&/Ther Nonobstetric|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (58120) |
$948.18 |
$1,115.50 |
0.3× |
| Dilation of esophagus, by unguided sound or bougie, single or multiple passes Age Under 21 (43450) |
$478.04 |
$562.40 |
0.5× |
| Dilation of rectal stricture (separate procedure) under anesthesia other than local Age Under 21 (45910) |
$879.92 |
$1,035.20 |
0.7× |
| Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical,… (63075) |
$8,104.50 |
$9,534.70 |
1.1× |
| Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach Age Under 21 (43130) |
$3,530.90 |
$4,154 |
0.6× |
| Drain lower leg lesion (27603) |
$1,669.57 |
$1,964.20 |
0.6× |
| Drain neck/chest lesion (21501) |
$1,391.20 |
$1,636.70 |
0.5× |
| Drainage external ear, abscess or hematoma; simple (69000) |
$351.94 |
$414.05 |
0.5× |
| Drainage finger abscess simple (26010) |
$372.98 |
$438.80 |
1.8× |
| Drainage of abscess, cyst, hematoma, vestibule of mouth; simple (40800) |
$326.57 |
$384.20 |
0.5× |
| Drainage of finger abscess; complicated (eg, felon) (26011) |
$1,117.58 |
$1,314.80 |
0.7× |
| Drainage of hydrocele (55000) |
$77.01 |
$90.60 |
0.1× |
| Drainage of scrotal wall abscess (55100) |
$391.38 |
$460.45 |
0.2× |
| Drainage of scrotum (54700) |
$345.82 |
$406.85 |
0.2× |
| Drainage of tendon sheath, digit and/or palm, each Age Under 21 (26020) |
$2,003.11 |
$2,356.60 |
0.6× |
| Drainage of tonsil abscess (42700) |
$478.04 |
$562.40 |
2.0× |
| Dressing change (for other than burns) under anesthesia (other than local) (15852) |
$184.75 |
$217.35 |
0.2× |
| Dry needling (20999) |
$51.68 |
$60.80 |
0.2× |
| Dstr nrolytc agnt parverteb fct sngl crvcl/thora (64633) |
$2,334.95 |
$2,747 |
1.2× |
| Dstr nrolytc agnt parverteb fct sngl lmbr/sacral (64635) |
$2,200.99 |
$2,589.40 |
1.1× |
| Dx laryngoscopy excl nb (31525) |
$993.74 |
$1,169.10 |
0.5× |
| Ed proc insert intraosseous IV (36680) |
$316.03 |
$371.80 |
0.7× |
| Ed proc insj temp ndwellg bladder catheter complicated (51703) |
$759.31 |
$893.30 |
5.8× |
| Ed proc remve fb nasal- hospital (30300) |
$344.08 |
$404.80 |
2.5× |
| Ed prof arthrocentesis sm - hospital (20551) |
$222.36 |
$261.60 |
0.7× |
| Ed prof artl pnxr w/drawal bld dx (36600) |
$116.45 |
$137 |
0.9× |
| Ed prof burn - large - hospital (16030) |
$546.30 |
$642.70 |
1.3× |
| Ed prof burn medium - hospital (16025) |
$284.12 |
$334.25 |
1.4× |
| Ed prof burn small - hospital (16020) |
$217.09 |
$255.40 |
1.1× |
| Ed prof catheterization/straight (51701) |
$137.45 |
$161.70 |
1.0× |
| Ed prof closed tx post hip arthroplasty (27265) |
$1,600 |
$1,882.35 |
6.3× |
| Ed prof closed tx pst malleolus fx w/manipulation (27768) |
$1,372.75 |
$1,615 |
0.8× |
| Ed prof closed tx radial head/neck fx w/manipulation (24655) |
$1,201.64 |
$1,413.70 |
0.7× |
| Ed prof drain dental abscess-hospital (41800) |
$444.72 |
$523.20 |
3.3× |
| Ed prof insert foley cath simple (51702) |
$171.62 |
$201.90 |
1.3× |
| Ed prof insert non tunnel cv cath >5 (36556) |
$729.30 |
$858 |
0.2× |
Ed prof insertion of heart electr (33210)
likely a partial charge — not the full procedure |
$1,353.96 |
$1,592.90 |
0.2× |
| Ed prof int lac 12.6-20cm bd - hospital (12035) |
$825.61 |
$971.30 |
2.0× |
| Ed prof int lac 7.6-12.5cm bd - hospital (12034) |
$671.50 |
$790 |
1.6× |
| Ed prof interphalangeal dislocation- hospital (26770) |
$488.12 |
$574.25 |
1.9× |
| Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) |
$277.10 |
$326 |
0.6× |
| Egd percutaneous placement gastrostomy tube (43246) |
$1,860.48 |
$2,188.80 |
0.9× |
| Egd removal tumor polyp/other lesion snare tech (43251) |
$1,348.27 |
$1,586.20 |
0.7× |
| Egd transoral control bleeding any method (43255) |
$1,782.54 |
$2,097.10 |
0.9× |
Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm… (34101)
unusually low — confirm this is the full procedure |
$1,889.30 |
$2,222.70 |
0.3× |
| Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision (34201) |
$3,997.55 |
$4,703 |
0.7× |
| Endocervical curettage (57505) |
$485.01 |
$570.60 |
0.5× |
| Endometrial ablation, thermal, without hysteroscopic guidance Age Under 21 (58353) |
$2,674.70 |
$3,146.70 |
0.5× |
| Episiotomy or vaginal repair (59300) |
$926.25 |
$1,089.70 |
0.3× |
| Er inj anesthetic agent, peripheral nerve or branch (64450) |
$160.23 |
$188.50 |
0.2× |
| Esoph egd dilation <30 mm (43249) |
$1,503.65 |
$1,769 |
0.8× |
| Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)… (43245) |
$1,258.09 |
$1,480.10 |
0.6× |
| Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through… (43248) |
$1,310.62 |
$1,541.90 |
1.4× |
| Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body (43247) |
$1,657.80 |
$1,950.35 |
1.8× |
| Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy… (43250) |
$1,521.63 |
$1,790.15 |
0.8× |
| Esophagoscopy flexible removal foreign body (43215) |
$1,099.65 |
$1,293.70 |
0.6× |
| Esophagoscopy flexible transoral diagnostic (43200) |
$787.10 |
$926 |
0.8× |
| Esophagoscopy flexible transoral with biopsy (43202) |
$1,374.07 |
$1,616.55 |
0.7× |
| Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter) Age Under 21 (43220) |
$1,047.12 |
$1,231.90 |
0.5× |
| Evac subungual hematoma (11740) |
$173.78 |
$204.45 |
1.3× |
| Ex tum/vasc malf sft tiss hand/fngr subq 1.5cm/> (26111) |
$1,672.21 |
$1,967.30 |
1.0× |
Exc Branchial Cleft Cyst Below Subq Tiss&/Phrynx (42815)
unusually low — confirm this is the full procedure |
$2,911.93 |
$3,425.80 |
0.5× |
| Exc f/e/e/n/l mal+mrg 1.1-2 (11642) |
$1,293.96 |
$1,522.30 |
1.8× |
| Exc face tum deep < 2 cm (21013) |
$1,190.68 |
$1,400.80 |
0.7× |
| Exc forearm les sc 3 cm/> (25071) |
$2,292.03 |
$2,696.50 |
1.4× |
| Exc frenum labial/buccal (40819) |
$496.40 |
$584 |
0.3× |
| Exc h-f-nk-sp b9+marg 0.5/< (11420) |
$326.58 |
$384.20 |
0.2× |
| Exc h-f-nk-sp b9+marg 0.6-1 (11421) |
$382.59 |
$450.10 |
0.5× |
| Exc h-f-nk-sp b9+marg 1.1-2 (11422) |
$476.68 |
$560.80 |
0.3× |
| Exc lesion tendon sheath/capsule w/synvct foot (28090) |
$1,466.51 |
$1,725.30 |
0.9× |
| Exc lesion tendon sheath/capsule w/synvct toe ea (28092) |
$1,019.07 |
$1,198.90 |
0.6× |
| Exc neck tum deep < 5 cm (21556) |
$1,947.10 |
$2,290.70 |
0.7× |
| Exc neuroma dgtal nrv 1/bth sm dgt (64776) |
$1,372.75 |
$1,615 |
0.7× |
| Exc neuroma major peripheral nrv xcp sciatic (64784) |
$2,939.05 |
$3,457.70 |
1.5× |
| Exc rect tum transanal part (45171) |
$3,461.71 |
$4,072.60 |
1.2× |
| Exc tr-ext b9+marg 0.5 < cm (11400) |
$308.21 |
$362.60 |
0.4× |
| Exc tr-ext b9+marg 1.1-2 cm (11402) |
$373.41 |
$439.30 |
0.5× |
| Exc tum/vas mal sft tis hand/fngr subfasc<1.5cm (26116) |
$2,138.01 |
$2,515.30 |
1.3× |
| Exc tum/vasc mal sft tiss hand/fngr subq <1.5cm (26115) |
$1,337.73 |
$1,573.80 |
0.8× |
| Exc tumor soft tiss shoulder subfasc <5cm (23076) |
$2,061.85 |
$2,425.70 |
0.7× |
| Exc tumor soft tiss upr arm/elbow subfasc <5cm (24076) |
$2,064.40 |
$2,428.70 |
0.7× |
| Exc tumor soft tissue abdl wall subfascial 5cm/> (22901) |
$1,759.76 |
$2,070.30 |
0.6× |
| Exc Tumor Soft Tissue Abdl Wall Subfascial <5cm (22900) |
$1,669.57 |
$1,964.20 |
0.6× |
| Exc tumor soft tissue abdominal wall subq <3cm (22902) |
$1,320.22 |
$1,553.20 |
0.8× |
| Exc tumor soft tissue foot/toe subfasc <1.5cm (28045) |
$1,673.06 |
$1,968.30 |
0.6× |
| Exc tumor soft tissue forearm &/wrist subq <3cm (25075) |
$1,111.89 |
$1,308.10 |
0.7× |
| Exc tumor soft tissue leg/ankle subq <3cm (27618) |
$1,043.63 |
$1,227.80 |
0.6× |
| Exc tumor soft tissue pelvis & hip subfasc <5cm (27048) |
$3,653.47 |
$4,298.20 |
1.2× |
| Exc tumor soft tissue pelvis & hip subq <3cm (27047) |
$1,254.60 |
$1,476 |
0.4× |
| Exc tumor soft tissue upper arm/elbow subq 3cm/> (24071) |
$1,808.80 |
$2,128 |
0.6× |
| Excision bone mandible (21025) |
$3,297.15 |
$3,879 |
0.5× |
| Excision distal ulna partial or complete (eg, Darrach type or matched resection) Age Under 21 (25240) |
$2,414.60 |
$2,840.70 |
0.7× |
| Excision ganglion wrist dorsal/volar primary (25111) |
$1,851.73 |
$2,178.50 |
1.1× |
| Excision h/p/p/u simple/intermediate repair (11470) |
$1,775.48 |
$2,088.80 |
0.6× |
| Excision lesion tendon sheath forearm&/wrist (25110) |
$1,969.88 |
$2,317.50 |
1.2× |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) |
$524.45 |
$617 |
0.7× |
| Excision Mal Lesion Trunk/Arm/Leg 1.1-2.0 Cm (11602) |
$636.48 |
$748.80 |
1.5× |
| Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) |
$625.09 |
$735.40 |
0.9× |
| Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) |
$834.36 |
$981.60 |
1.2× |
| Excision malignant lesion s/n/h/f/g 0.5 cm/< (11620) |
$554.20 |
$652 |
0.3× |
| Excision Malignant Lesion S/N/H/F/G 0.6-1.0 Cm (11621) |
$772.23 |
$908.50 |
1.1× |
| Excision Malignant Lesion S/N/H/F/G 1.1-2.0 Cm (11622) |
$911.37 |
$1,072.20 |
1.3× |
| Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) |
$1,128.55 |
$1,327.70 |
0.7× |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) |
$1,115.37 |
$1,312.20 |
0.7× |
| Excision multiple external papillae/tags anus (46230) |
$316.97 |
$372.90 |
0.1× |
| Excision of bartholin's gland or cyst (56740) |
$2,400.66 |
$2,824.30 |
0.7× |
| Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep… (27066) |
$3,002.97 |
$3,532.90 |
0.9× |
Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial,… (27065)
unusually low — confirm this is the full procedure |
$2,571.34 |
$3,025.10 |
0.3× |
| Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion Age Under 21 (19125) |
$1,830.65 |
$2,153.70 |
0.5× |
| Excision of ganglion, wrist (dorsal or volar); recurrent Age Under 21 (25112) |
$1,973.36 |
$2,321.60 |
1.2× |
| Excision of hydrocele of spermatic cord, unilateral (separate procedure) Age Under 21 (55500) |
$1,414.83 |
$1,664.50 |
0.4× |
| Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee Age Under 21 (27347) |
$5,374.72 |
$6,323.20 |
1.6× |
| Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair (40812) |
$464.02 |
$545.90 |
0.3× |
| Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair (40810) |
$166.35 |
$195.70 |
0.0× |
| Excision of lesion of spermatic cord (separate procedure) Age Under 21 (55520) |
$1,406.07 |
$1,654.20 |
0.4× |
| Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle Age Under 21 (27630) |
$1,758.91 |
$2,069.30 |
0.5× |
| Excision of lesion of tendon sheath or joint capsule, hand or finger (26160) |
$1,537.40 |
$1,808.70 |
0.9× |
| Excision of lesion of tongue without closure Age Under 21 (41110) |
$216.24 |
$254.40 |
0.1× |
| Excision of neurofibroma or neurolemmoma; cutaneous nerve Age Under 21 (64788) |
$2,224.62 |
$2,617.20 |
1.1× |
| Excision of neuroma; cutaneous nerve, surgically identifiable Age Under 21 (64774) |
$1,336.03 |
$1,571.80 |
0.7× |
| Excision of pilonidal cyst or sinus; simple Age Under 21 (11770) |
$1,056.72 |
$1,243.20 |
0.4× |
Excision of rib, partial Age Under 21 (21600)
unusually low — confirm this is the full procedure |
$2,363.85 |
$2,781 |
0.3× |
| Excision of single external papilla or tag, anus (46220) |
$521.82 |
$613.90 |
0.4× |
| Excision of tendon, palm, flexor or extensor, single, each tendon Age Under 21 (26170) |
$1,715.98 |
$2,018.80 |
1.0× |
| Excision of thrombosed hemorrhoid, external (46320) |
$316.97 |
$372.90 |
0.3× |
| Excision of tongue lesion (41112) |
$749.45 |
$881.70 |
0.2× |
| Excision of vaginal cyst or tumor (57135) |
$972.24 |
$1,143.80 |
0.3× |
| Excision of vaginal septum (57130) |
$1,343.47 |
$1,580.55 |
0.4× |
| Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair Age Under 21 (55540) |
$2,989.88 |
$3,517.50 |
0.8× |
| Excision olecranon bursa (24105) |
$1,740.46 |
$2,047.60 |
0.5× |
| Excision or curettage of bone cyst or benign tumor of carpal bones; Age Under 21 (25130) |
$2,400.66 |
$2,824.30 |
0.7× |
| Excision or curettage of bone cyst or benign tumor of clavicle or scapula; Age Under 21 (23140) |
$1,879.69 |
$2,211.40 |
0.6× |
| Excision or curettage of bone cyst or benign tumor of femur; Age Under 21 (27355) |
$4,267.17 |
$5,020.20 |
1.3× |
| Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; Age Under 21 (24120) |
$3,101.91 |
$3,649.30 |
0.9× |
| Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; Age Under 21 (26210) |
$1,877.99 |
$2,209.40 |
1.1× |
| Excision or curettage of bone cyst or benign tumor, phalanges of foot Age Under 21 (28108) |
$1,336.03 |
$1,571.80 |
0.8× |
| Excision or curettage of bone cyst or benign tumor, talus or calcaneus; Age Under 21 (28100) |
$2,687.79 |
$3,162.10 |
0.8× |
Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft Age Under 21 (28103)
likely a partial charge — not the full procedure |
$2,161.64 |
$2,543.10 |
0.3× |
| Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; Age Under 21 (28104) |
$1,479.60 |
$1,740.70 |
0.4× |
| Excision or curettage of bone cyst or benign tumor, tibia or fibula; Age Under 21 (27635) |
$3,512.54 |
$4,132.40 |
1.1× |
| Excision pilonidal cyst/sinus complicated (11772) |
$2,800.75 |
$3,295 |
0.9× |
| Excision pilonidal cyst/sinus extensive (11771) |
$2,277.62 |
$2,679.55 |
0.8× |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) |
$1,957.64 |
$2,303.10 |
1.2× |
| Excision tumor soft tissue back/flank subq <3cm (21930) |
$2,271.97 |
$2,672.90 |
1.3× |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) |
$1,079.50 |
$1,270 |
0.6× |
| Excision tumor soft tissue shoulder subq 3 cm/> (23071) |
$1,327.28 |
$1,561.50 |
0.8× |
| Excision tumor soft tissue thigh/knee subq <3cm (27327) |
$1,356.18 |
$1,595.50 |
0.8× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11423) |
$825.60 |
$971.30 |
0.5× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11426) |
$991.95 |
$1,167 |
0.3× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11424) |
$819.48 |
$964.10 |
0.5× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11401) |
$355.47 |
$418.20 |
0.9× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11404) |
$625.09 |
$735.40 |
0.4× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11403) |
$443.02 |
$521.20 |
0.6× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11406) |
$842.69 |
$991.40 |
0.5× |
| Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy Age Under… (15830) |
$5,392.23 |
$6,343.80 |
0.8× |
| Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area - 15839 (15839) |
$2,864.67 |
$3,370.20 |
1.0× |
| Excision, interdigital (Morton) neuroma, single, each Age Under 21 (28080) |
$1,614.41 |
$1,899.30 |
1.0× |
| Excision, ischial pressure ulcer, with primary suture; Age Under 21 (15940) |
$1,994.36 |
$2,346.30 |
0.7× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less Age… (11640) |
$655.78 |
$771.50 |
0.9× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm Age Under… (11641) |
$1,019.07 |
$1,198.90 |
1.4× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm Age Under… (11643) |
$1,566.30 |
$1,842.70 |
0.9× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm Age Under… (11644) |
$1,842.04 |
$2,167.10 |
1.1× |
| Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm Age… (11626) |
$1,315.04 |
$1,547.10 |
0.4× |
| Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less (11600) |
$415.91 |
$489.30 |
0.6× |
| Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm Age Under 21 (11606) |
$1,167.05 |
$1,373 |
0.7× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11442) |
$610.22 |
$717.90 |
0.8× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11441) |
$436.44 |
$513.45 |
0.6× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11444) |
$879.92 |
$1,035.20 |
0.5× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11440) |
$410.64 |
$483.10 |
0.6× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11443) |
$661.90 |
$778.70 |
0.4× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11446) |
$1,104.92 |
$1,299.90 |
0.4× |
| Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; Age Under 21 (15936) |
$2,614.26 |
$3,075.60 |
1.2× |
| Excision, sacral pressure ulcer, with primary suture; Age Under 21 (15931) |
$2,580.09 |
$3,035.40 |
0.9× |
| Excision, trochanteric pressure ulcer, with primary suture; Age Under 21 (15950) |
$2,081.06 |
$2,448.30 |
1.2× |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater Age Under 21 (22903) |
$1,345.64 |
$1,583.10 |
0.5× |
| Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater Age Under 21 (21933) |
$2,764.80 |
$3,252.70 |
0.9× |
| Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm Age Under 21 (25076) |
$1,851.73 |
$2,178.50 |
1.1× |
| Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater Age Under 21 (27634) |
$3,504.64 |
$4,123.10 |
1.2× |
| Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater Age Under 21 (21552) |
$2,426.92 |
$2,855.20 |
0.8× |
| Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm (21555) |
$1,088.26 |
$1,280.30 |
0.6× |
| Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater Age Under 21 (21554) |
$2,662.37 |
$3,132.20 |
0.9× |
| Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm Age Under 21 (23075) |
$1,033.94 |
$1,216.40 |
0.6× |
| Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater Age Under 21 (27339) |
$4,359.14 |
$5,128.40 |
1.5× |
| Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm Age Under 21 (27328) |
$2,710.57 |
$3,188.90 |
0.9× |
| Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm Age Under 21 (24075) |
$1,130.25 |
$1,329.70 |
0.7× |
| Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5 cm or greater Age Under 21 (24073) |
$2,989.88 |
$3,517.50 |
1.0× |
| Excision/destruction intranasal lesion int appr (30117) |
$1,004.19 |
$1,181.40 |
0.3× |
| Excison tumor soft tissue thigh/knee subq 3 cm/> (27337) |
$2,269.33 |
$2,669.80 |
0.8× |
| Exploration of spinal fusion (22830) |
$10,715.27 |
$12,606.20 |
1.4× |
| Exploration penetrating wound spx extremity (20103) |
$1,815.77 |
$2,136.20 |
1.1× |
| Exploration with removal of deep foreign body, forearm or wrist (25248) |
$1,669.57 |
$1,964.20 |
1.0× |
| Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) (49010) |
$3,653.47 |
$4,298.20 |
0.6× |
| Explore wound abdomen (20102) |
$2,566.07 |
$3,018.90 |
1.2× |
| Explore wound chest (20101) |
$993.74 |
$1,169.10 |
0.5× |
| Explore wound neck (20100) |
$3,380.28 |
$3,976.80 |
6.1× |
| Explore/treat ankle joint (27610) |
$3,121.20 |
$3,672 |
0.9× |
| Explore/treat hand joint (26070) |
$2,003.11 |
$2,356.60 |
1.2× |
| Fasciectomy plantar fascia partial spx (28060) |
$1,724.74 |
$2,029.10 |
0.5× |
| Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes… (26121) |
$2,970.58 |
$3,494.80 |
0.9× |
| Fasciectomy, plantar fascia; radical (separate procedure) Age Under 21 (28062) |
$2,113.44 |
$2,486.40 |
0.6× |
| Fasciotomy, iliotibial (tenotomy), open Age Under 21 (27305) |
$1,829.80 |
$2,152.70 |
0.5× |
| Fasciotomy, palmar (eg, Dupuytren's contracture); open, partial Age Under 21 (26045) |
$1,976 |
$2,324.70 |
0.6× |
| Fasct prtl plmr 1 dgt prox iphal jt +-tiss (26123) |
$5,003.53 |
$5,886.50 |
1.5× |
| Fetal contraction stress test (59020) |
$489.82 |
$576.25 |
2.4× |
| Fine needle aspiration bx w/o img gdn 1st lesion (10021) |
$316.03 |
$371.80 |
0.8× |
| Fine needle aspiration bx w/us gdn 1st lesion (10005) |
$377.32 |
$443.90 |
0.5× |
| Fix collat lig,mc-p jt,i-p jt (26540) |
$2,919.84 |
$3,435.10 |
0.9× |
| Flap island pedicle (15740) |
$3,785.65 |
$4,453.70 |
1.8× |
| Fluid pressure muscle (20950) |
$757.35 |
$891 |
1.0× |
| Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae,… (15574) |
$3,164.98 |
$3,723.50 |
1.5× |
| Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae,… (15240) |
$3,177.22 |
$3,737.90 |
1.5× |
| Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less Age… (15220) |
$2,105.62 |
$2,477.20 |
1.0× |
Fusion of 3 bones of ankle|RIGHT SIDE (28715)
unusually low — confirm this is the full procedure |
$5,561.21 |
$6,542.60 |
0.4× |
Fusion of all bones of ankle and hindfoot (28705)
unusually low — confirm this is the full procedure |
$6,110.99 |
$7,189.40 |
0.3× |
| Ganglion impar nerve block (64999) |
$218.88 |
$257.50 |
0.7× |
| Gastric lavage (43753) |
$564.74 |
$664.40 |
2.6× |
| Gastrocnemius recession (27687) |
$2,143.19 |
$2,521.40 |
0.6× |
| Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury (43840) |
$3,935.42 |
$4,629.90 |
1.0× |
| Gastrostomy, open; without construction of gastric tube (eg, stamm procedure) (separate procedure) (43830) |
$2,711.42 |
$3,189.90 |
1.4× |
| Guide cathet fluid drainage (10030) |
$767.80 |
$903.30 |
1.1× |
| Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint;… (28289) |
$1,807.02 |
$2,125.90 |
0.5× |
| Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty) (27125) |
$8,650.79 |
$10,177.40 |
0.7× |
| Hemiphalangectomy/interphalangeal joint exc toe (28160) |
$1,268.63 |
$1,492.50 |
0.4× |
| Hemorrhoidectomy internal rubber band ligations (46221) |
$527.09 |
$620.10 |
0.6× |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) |
$2,093.30 |
$2,462.70 |
0.7× |
| Hemorrhoidectomy, external, 2 or more columns/groups (46250) |
$1,310.62 |
$1,541.90 |
0.5× |
| Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging… (46946) |
$569.08 |
$669.50 |
0.2× |
| Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging… (46945) |
$449.99 |
$529.40 |
0.2× |
| Hysteroscopy biopsy (58558) |
$2,686 |
$3,160 |
0.8× |
| Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)… (58563) |
$2,808.57 |
$3,304.20 |
0.5× |
| Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) Age Under 21 (58559) |
$2,714.05 |
$3,193 |
0.5× |
| Hysteroscopy, surgical; with removal of impacted foreign body Age Under 21 (58562) |
$3,067.74 |
$3,609.10 |
0.9× |
| Hysteroscopy, surgical; with removal of leiomyomata Age Under 21 (58561) |
$4,029.94 |
$4,741.10 |
0.8× |
| I&d abscess simple/single (10060) |
$277.10 |
$326 |
1.4× |
| I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION TechFee (27301) |
$1,674.84 |
$1,970.40 |
0.6× |
| I&d hematoma/seroma/fluid (10140) |
$351.52 |
$413.55 |
0.2× |
| I&d pilonidal cyst simple (10080) |
$230.69 |
$271.40 |
0.3× |
| I&d upper arm/elbow deep abscess/hematoma (23930) |
$1,290.47 |
$1,518.20 |
0.4× |
| Image-guide fluid collxn drainage cath visc perq (49405) |
$704.78 |
$829.15 |
0.4× |
| Implantation of donor cartilage cells into knee joint|RIGHT SIDE (27415) |
$8,598.26 |
$10,115.60 |
0.7× |
| Incise & drain bladder (51040) |
$2,831.35 |
$3,331 |
1.3× |
| Incise external hemorrhoid (46083) |
$277.10 |
$326 |
1.1× |
| Incise finger tendon sheath (26055) |
$1,737.91 |
$2,044.60 |
1.1× |
| INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee (10061) |
$583.10 |
$686 |
1.4× |
| Incision (eg, osteomyelitis or bone abscess), leg or ankle Age Under 21 (27607) |
$2,448.77 |
$2,880.90 |
0.7× |
| Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space Age Under 21 (28002) |
$1,336.03 |
$1,571.80 |
0.8× |
| Incision and drainage of Bartholin's gland abscess (56420) |
$337.96 |
$397.60 |
1.6× |
| Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia Age Under 21 (46045) |
$786.17 |
$924.90 |
0.3× |
| Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or… (46060) |
$2,224.62 |
$2,617.20 |
0.8× |
| Incision and drainage of pilonidal cyst; complicated (10081) |
$673.24 |
$792.05 |
0.9× |
| Incision and drainage of submucosal abscess, rectum (45005) |
$785.32 |
$923.90 |
0.6× |
| Incision and drainage of vulva or perineal abscess (56405) |
$478.04 |
$562.40 |
1.5× |
| Incision and drainage, complex, postoperative wound infection Age Under 21 (10180) |
$935 |
$1,100 |
0.3× |
| Incision and drainage, forearm and/or wrist; deep abscess or hematoma Age Under 21 (25028) |
$1,420.10 |
$1,670.70 |
0.4× |
| Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral (22015) |
$6,319.33 |
$7,434.50 |
0.9× |
| Incision and drainage, pelvis or hip joint area; deep abscess or hematoma Age Under 21 (26990) |
$1,541.73 |
$1,813.80 |
0.5× |
| Incision and drainage, perianal abscess, superficial (46050) |
$689.86 |
$811.60 |
0.7× |
| Incision and drainage, upper arm or elbow area; bursa Age Under 21 (23931) |
$1,290.47 |
$1,518.20 |
0.8× |
| Incision and removal of foreign body, subcutaneous tissues; complicated (10121) |
$728.88 |
$857.50 |
0.4× |
| Incision and removal of foreign body, subcutaneous tissues; simple (10120) |
$284.12 |
$334.25 |
0.7× |
| Incision bone cortex hand/finger (26034) |
$2,138.01 |
$2,515.30 |
1.3× |
| Incision extensor tendon sheath wrist (25000) |
$1,788.66 |
$2,104.30 |
1.1× |
| Incision into wrist joint with removal of joint lining tissue (25105) |
$3,069.52 |
$3,611.20 |
0.9× |
| Incision of connective tissue of foot and/or toe (28008) |
$1,057.57 |
$1,244.20 |
0.3× |
| Incision of connective tissue of hip or thigh (27025) |
$3,849.57 |
$4,528.90 |
1.2× |
| Incision of foot tendon(s) (28230) |
$999.86 |
$1,176.30 |
0.6× |
| Incision of knee joint with removal of cartilage of front or back of knee (27334) |
$5,010.50 |
$5,894.70 |
1.5× |
| Incision of lingual frenum (frenotomy) (41010) |
$492.92 |
$579.90 |
0.3× |
| Incision of rectal abscess (46040) |
$786.17 |
$924.90 |
0.6× |
| Incision of windpipe (31600) |
$1,273.90 |
$1,498.70 |
0.4× |
| Incision of windpipe (31603) |
$2,018.07 |
$2,374.20 |
1.3× |
Incision or partial removal of forearm bone on small finger side (25360)
unusually low — confirm this is the full procedure |
$3,316.36 |
$3,901.60 |
0.4× |
Incision or partial removal of forearm bone on thumb side near hand (25350)
unusually low — confirm this is the full procedure |
$3,664.86 |
$4,311.60 |
0.5× |
| Incision or partial removal of lower leg bone (27707) |
$2,143.19 |
$2,521.40 |
0.6× |
| Incision&drainage bursa foot (28001) |
$498.19 |
$586.10 |
0.3× |
Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess) Age Under 21 (25035)
unusually low — confirm this is the full procedure |
$2,601.09 |
$3,060.10 |
0.4× |
| Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess) (27303) |
$2,790.21 |
$3,282.60 |
0.8× |
| Incisional biopsy skin single lesion (11106) |
$273.15 |
$321.35 |
0.4× |
| Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22… (0202U) |
$919.28 |
$1,081.50 |
2.2× |
| Initial treatment, first degree burn, when no more than local treatment is required (16000) |
$136.60 |
$160.70 |
0.7× |
| Inj epidural blood or clot patch (62273) |
$880.77 |
$1,036.20 |
1.2× |
| Inj paravert f jnt c/t 1 lev (64490) |
$1,070.75 |
$1,259.70 |
1.2× |
| Inj paravert f jnt l/s 1 lev (64493) |
$1,415.68 |
$1,665.50 |
1.6× |
| Inj tx nerve (64640) |
$683.74 |
$804.40 |
0.8× |
| Inj,Anes Agent,Femoral Nerve,Single (64447) |
$724.03 |
$851.80 |
1.0× |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
$1,533.91 |
$1,804.60 |
1.7× |
| Injection aa&/strd brachial plexus w/img gdn (64415) |
$1,296.59 |
$1,525.40 |
1.4× |
| Injection aa&/strd genicular nrv branches w/img (64454) |
$1,251.97 |
$1,472.90 |
1.7× |
| Injection aa&/strd greater occipital nerve (64405) |
$838.70 |
$986.70 |
2.7× |
| Injection aa&/strd ilioinguinal ih nerves (64425) |
$1,054.09 |
$1,240.10 |
1.5× |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
$509.58 |
$599.50 |
0.6× |
| Injection aa&/strd intercostal nrv single lvl (64420) |
$1,199.44 |
$1,411.10 |
1.7× |
| Injection aa&/strd nerves nrvtg si joint w/img (64451) |
$843.12 |
$991.90 |
1.2× |
| Injection aa&/strd pudendal nerve (64430) |
$861.48 |
$1,013.50 |
1.0× |
| Injection aa&/strd sciatic nerve w/img gdn (64445) |
$1,284.35 |
$1,511 |
1.8× |
| Injection aa&/strd suprascapular nerve (64418) |
$765.17 |
$900.20 |
1.1× |
| Injection aa&/strd trigeminal nerve each branch (64400) |
$923.70 |
$1,086.70 |
2.9× |
| Injection anes lmbr/thrc paravertbrl sympathetic (64520) |
$2,768.37 |
$3,256.90 |
3.1× |
| Injection for identification of sentinel node (38792) |
$507.36 |
$596.90 |
1.2× |
| Injection sclerosant single incmptnt vein (36470) |
$209.27 |
$246.20 |
0.5× |
| Injection therapeutic carpal tunnel (20526) |
$154.96 |
$182.30 |
0.5× |
| Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk (36468) |
$216.24 |
$254.40 |
0.5× |
| Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve Age Under 21 (64435) |
$984.98 |
$1,158.80 |
1.4× |
| Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) |
$233.75 |
$275 |
0.7× |
| Injection(s); single or multiple trigger point(s), 3 or more muscle(s) (20553) |
$379.10 |
$446 |
1.2× |
| Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) (20550) |
$216.24 |
$254.40 |
0.7× |
| Injection, anesthetic agent; sphenopalatine ganglion Age Under 21 (64505) |
$1,003.34 |
$1,180.40 |
3.2× |
| Injection, intralesional; up to and including 7 lesions (11900) |
$117.77 |
$138.55 |
0.6× |
| Insert and remove bone pin (20650) |
$531.42 |
$625.20 |
0.2× |
| Insert cervical dilator (59200) |
$433.42 |
$509.90 |
1.4× |
| Insert drug implant device (11981) |
$350.20 |
$412 |
2.6× |
| Insert pessary/other device (57160) |
$207.49 |
$244.10 |
1.0× |
| Insertion of tube into airway for aspiration of secretions (31720) |
$175.95 |
$207 |
0.8× |
| Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older Age… (36561) |
$1,905.11 |
$2,241.30 |
0.6× |
| Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or… (36558) |
$2,208.90 |
$2,598.70 |
0.7× |
| Insertion picc w/o img gdn 5 yr/> (36569) |
$861.90 |
$1,014 |
0.5× |
| Insertion picc w/rs&i 5 yr/> (36573) |
$1,124.17 |
$1,322.55 |
0.7× |
Insertion subq cardiac rhythm monitor w/prgrmg (33285)
likely a partial charge — not the full procedure |
$591.01 |
$695.30 |
0.1× |
Insj/rplcmt spinal npg/rcvr pocket crtj&connj (63685)
likely a partial charge — not the full procedure |
$3,094.94 |
$3,641.10 |
0.1× |
| Intubation endotracheal (31500) |
$861.94 |
$1,014.05 |
3.6× |
| Irrigation of corpora cavernosa for priapism (54220) |
$753.78 |
$886.80 |
3.0× |
Joint repair (arthroplasty) forearm bone on the thumb side (radius) at the elbow with and implant (24366)
likely a partial charge — not the full procedure |
$3,513.39 |
$4,133.40 |
0.3× |
| Knee arthroscopy/surgery (29876) |
$5,713.53 |
$6,721.80 |
1.7× |
| Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar (63267) |
$8,649.94 |
$10,176.40 |
1.2× |
Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural Age Under 21 (63655)
unusually low — confirm this is the full procedure |
$8,773.36 |
$10,321.60 |
0.4× |
| Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy… (63005) |
$8,342.67 |
$9,814.90 |
1.1× |
| Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve… (63012) |
$8,395.20 |
$9,876.70 |
1.1× |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63045) |
$9,745.17 |
$11,464.90 |
1.3× |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63046) |
$8,499.32 |
$9,999.20 |
1.1× |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63047) |
$9,488.64 |
$11,163.10 |
1.3× |
| Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or… (63042) |
$8,819.77 |
$10,376.20 |
1.2× |
| Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or… (63020) |
$8,104.50 |
$9,534.70 |
1.1× |
| Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or… (63030) |
$7,621.27 |
$8,966.20 |
1.0× |
| Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or… (63040) |
$8,743.61 |
$10,286.60 |
1.2× |
| Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy Age Under 21 (59151) |
$4,022.03 |
$4,731.80 |
0.7× |
| Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy Age Under 21 (59150) |
$3,537.02 |
$4,161.20 |
0.6× |
| Laparoscopy Enterolysis Separate Procedure (44180) |
$3,755.90 |
$4,418.70 |
0.6× |
Laparoscopy surg colpopexy (57425)
unusually low — confirm this is the full procedure |
$4,315.37 |
$5,076.90 |
0.4× |
Laparoscopy Surg Rpr Initial Inguinal Hernia (49650)
unusually low — confirm this is the full procedure |
$2,735.05 |
$3,217.70 |
0.4× |
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or… (49320)
unusually low — confirm this is the full procedure |
$2,713.20 |
$3,192 |
0.4× |
Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical (47371)
unusually low — confirm this is the full procedure |
$3,654.32 |
$4,299.20 |
0.3× |
| Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal… (58545) |
$4,675.17 |
$5,500.20 |
0.8× |
Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; Age Under 21 (58541)
unusually low — confirm this is the full procedure |
$5,274 |
$6,204.70 |
0.5× |
| Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)… (58542) |
$5,817.74 |
$6,844.40 |
0.5× |
| Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or… (58544) |
$6,591.67 |
$7,754.90 |
0.6× |
| Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) Age… (58571) |
$6,512.87 |
$7,662.20 |
0.6× |
| Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; Age Under 21 (58550) |
$5,407.11 |
$6,361.30 |
0.9× |
| Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) Age… (58552) |
$6,180.18 |
$7,270.80 |
0.6× |
| Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or… (58554) |
$7,227.30 |
$8,502.70 |
0.7× |
| Laparoscopy, surgical; cholcyststmy incldng cholangiography, when prfrmd (47579) |
$4,736.46 |
$5,572.30 |
0.8× |
| Laparoscopy, surgical; cholecystectomy with cholangiography Age Under 21 (47563) |
$5,428.10 |
$6,386 |
0.9× |
| Laparoscopy, surgical; cholecystectomy with exploration of common duct Age Under 21 (47564) |
$6,781.64 |
$7,978.40 |
0.6× |
Laparoscopy, surgical; with biopsy (single or multiple) Age Under 21 (49321)
unusually low — confirm this is the full procedure |
$2,368.27 |
$2,786.20 |
0.4× |
Laparoscopy, surgical; with fulguration of oviducts (with or without transection) Age Under 21 (58670)
unusually low — confirm this is the full procedure |
$2,379.58 |
$2,799.50 |
0.4× |
| Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by… (58662) |
$3,330.39 |
$3,918.10 |
0.5× |
| Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) Age Under 21 (58660) |
$3,330.39 |
$3,918.10 |
0.5× |
Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring) Age Under 21 (58671)
unusually low — confirm this is the full procedure |
$2,584.51 |
$3,040.60 |
0.4× |
| Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) Age… (58661) |
$3,466.13 |
$4,077.80 |
0.6× |
| Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple Age Under 21 (38570) |
$5,625.98 |
$6,618.80 |
0.9× |
Laps Surg Esopg/Gstr Fundoplasty (43280)
unusually low — confirm this is the full procedure |
$5,217.13 |
$6,137.80 |
0.5× |
| Laps surg gastrostomy w/o constj gstr tube spx (43653) |
$4,231.30 |
$4,978 |
0.7× |
Laps Surg W/Aspir Cavity/Cyst Single/Multiple (49322)
unusually low — confirm this is the full procedure |
$2,723.66 |
$3,204.30 |
0.4× |
| Laryngoscopy direct, with or without tracheoscopy; for aspiration Age Under 21 (31515) |
$686.38 |
$807.50 |
1.7× |
| Laryngoscopy flex diagnostic (31575) |
$462.23 |
$543.80 |
2.3× |
| Laryngoscopy indirect diagnostic (31505) |
$257.85 |
$303.35 |
1.3× |
| Lateral retinacular release open (27425) |
$4,316.22 |
$5,077.90 |
1.3× |
| Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each Age Under 21 (27686) |
$2,422.50 |
$2,850 |
0.7× |
| Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure) Age Under 21 (27685) |
$2,205.41 |
$2,594.60 |
0.7× |
| Ligamentous reconstruction (augmentation), knee; extra-articular (27427) |
$5,906.14 |
$6,948.40 |
0.8× |
| Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular Age Under 21 (27429) |
$8,343.52 |
$9,815.90 |
0.6× |
Ligamentous reconstruction knee intra-articular (27428)
unusually low — confirm this is the full procedure |
$6,102.24 |
$7,179.10 |
0.5× |
| Ligation of abdomen artery (37617) |
$5,089.29 |
$5,987.40 |
0.9× |
| Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg Age… (37760) |
$4,715.46 |
$5,547.60 |
1.5× |
| Ligation or biopsy, temporal artery (37609) |
$914.94 |
$1,076.40 |
0.5× |
| Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral Age Under 21 (58600) |
$2,543.37 |
$2,992.20 |
0.8× |
| Ligation, division, and stripping, short saphenous vein Age Under 21 (37718) |
$1,926.95 |
$2,267 |
0.6× |
| Ligation, division, and/or excision of varicose vein cluster(s), 1 leg Age Under 21 (37785) |
$1,182.78 |
$1,391.50 |
0.4× |
| Lumbar puncture (62270) |
$530.53 |
$624.15 |
0.7× |
| Lysis of labial adhesions (56441) |
$545.45 |
$641.70 |
0.2× |
| Manipulate wrist w/anesthes (25259) |
$882.47 |
$1,038.20 |
0.5× |
| Manipulation finger joint under anes each joint (26340) |
$1,168.84 |
$1,375.10 |
0.7× |
| Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus) Age Under… (27860) |
$864.11 |
$1,016.60 |
0.3× |
| Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) Age… (27570) |
$1,183.71 |
$1,392.60 |
0.7× |
| Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded) Age… (23700) |
$1,201.22 |
$1,413.20 |
0.7× |
| Manipulation, elbow, under anesthesia Age Under 21 (24300) |
$1,586.44 |
$1,866.40 |
1.0× |
| Manipulation, hip joint, requiring general anesthesia Age Under 21 (27275) |
$1,871.79 |
$2,202.10 |
1.1× |
| Marsupialization bartholin's gland cyst (56440) |
$1,019.07 |
$1,198.90 |
0.3× |
| Mastectomy gynecomastia (19300) |
$2,288.54 |
$2,692.40 |
0.6× |
| Mastectomy partial (19301) |
$1,922.62 |
$2,261.90 |
0.5× |
| Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding… (19307) |
$5,018.40 |
$5,904 |
0.7× |
| Mastotomy expl drg absc dp (19020) |
$1,025.19 |
$1,206.10 |
0.6× |
| Meas post-voiding residual urine&/bladder cap (51798) |
$123.04 |
$144.75 |
2.0× |
| Muscle transfer, any type, shoulder or upper arm; single Age Under 21 (23395) |
$6,229.23 |
$7,328.50 |
0.8× |
| Muscle, myocutaneous, or fasciocutaneous flap; lower extremity Age Under 21 (15738) |
$5,784.42 |
$6,805.20 |
1.6× |
| Muscle, myocutaneous, or fasciocutaneous flap; trunk Age Under 21 (15734) |
$6,709.82 |
$7,893.90 |
1.9× |
| Muscle, myocutaneous, or fasciocutaneous flap; upper extremity Age Under 21 (15736) |
$5,007.86 |
$5,891.60 |
2.4× |
| Myelography via lumbar inject rs&i lumbosacral (62304) |
$1,151.28 |
$1,354.45 |
1.4× |
| Myelography via lumbar injection rs&i 2+ regions (62305) |
$1,184.14 |
$1,393.10 |
1.5× |
| Myelography via lumbar injection rs&i cervical (62302) |
$1,151.28 |
$1,354.45 |
1.4× |
| Myelography via lumbar injection rs&i thoracic (62303) |
$1,129.40 |
$1,328.70 |
1.4× |
| Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less… (58145) |
$2,477.67 |
$2,914.90 |
0.7× |
| Ndsc wrst surg w/rls transvrs carpl ligm (29848) |
$3,575.53 |
$4,206.50 |
2.2× |
| Needle insertion w/o injection 1 or 2 muscles (20560) |
$89.34 |
$105.10 |
3.0× |
| Needle insertion w/o injection 3 or more muscles (20561) |
$135.75 |
$159.70 |
4.6× |
| Neuroplasty &/transpos median nrv carpal tunne (64721) |
$2,607.21 |
$3,067.30 |
1.3× |
| Neuroplasty, major peripheral nerve, arm or leg, open; other than specified Age Under 21 (64708) |
$3,499.37 |
$4,116.90 |
1.8× |
| Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve Age Under 21 (64712) |
$3,256.86 |
$3,831.60 |
1.6× |
| Neuroplasty; digital, 1 or both, same digit Age Under 21 (64702) |
$2,792.85 |
$3,285.70 |
1.4× |
| Neuroplasty; nerve of hand or foot Age Under 21 (64704) |
$2,224.62 |
$2,617.20 |
1.1× |
| Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct Age Under 21 (19110) |
$1,466.51 |
$1,725.30 |
0.4× |
| Njx aa&/strd tfrm epi c/t 1 (64479) |
$1,606.59 |
$1,890.10 |
1.8× |
| Njx anes stellate ganglion crv sympathetic (64510) |
$966.54 |
$1,137.10 |
1.1× |
| Njx cholangio prq w/img gid rs&i existing access (47531) |
$822.55 |
$967.70 |
0.2× |
| Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) |
$810.73 |
$953.80 |
1.1× |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
$801.13 |
$942.50 |
1.1× |
| Njx dx/ther sbst intrlmnr lmbr/sac w/o img gdn (62326) |
$1,554.06 |
$1,828.30 |
1.7× |
| Njx px antegrde nfrosgrm &/urtrgrm exstng acess (50431) |
$681.15 |
$801.35 |
1.0× |
| Non stress test (59025) |
$253.90 |
$298.70 |
1.2× |
| Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach Age Under 21 (58615) |
$2,407.63 |
$2,832.50 |
0.7× |
| Open Biopsy/Excision Inguinofemoral Nodes (38531) |
$1,361.45 |
$1,601.70 |
0.3× |
| Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured… (22327) |
$9,893.15 |
$11,639 |
0.8× |
| Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured… (22325) |
$10,075.22 |
$11,853.20 |
0.8× |
Open treatment bimalleolar ankle fracture (27814)
unusually low — confirm this is the full procedure |
$3,667.50 |
$4,314.70 |
0.5× |
Open treatment calcaneal fracture (28415)
unusually low — confirm this is the full procedure |
$3,567.71 |
$4,197.30 |
0.5× |
Open Treatment Distal Fracture (25608)
unusually low — confirm this is the full procedure |
$3,132.51 |
$3,685.30 |
0.4× |
Open treatment fracture distal tibia only (27827)
unusually low — confirm this is the full procedure |
$4,611.25 |
$5,425 |
0.4× |
Open treatment medial malleolus fracture (27766)
unusually low — confirm this is the full procedure |
$2,667.64 |
$3,138.40 |
0.4× |
| Open treatment metacarpophalangeal dislocation 1 (26715) |
$2,483.79 |
$2,922.10 |
0.7× |
Open treatment metatarsal fracture each (28485)
likely a partial charge — not the full procedure |
$2,174.73 |
$2,558.50 |
0.3× |
| Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both… (27228) |
$13,554.53 |
$15,946.50 |
1.8× |
Open treatment of acromioclavicular dislocation, acute or chronic; Age Under 21 (23550)
unusually low — confirm this is the full procedure |
$3,310.24 |
$3,894.40 |
0.4× |
| Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) Age… (23552) |
$4,000.19 |
$4,706.10 |
0.5× |
Open Treatment Of Acute Or Chronic Elbow Dislocation (24615)
unusually low — confirm this is the full procedure |
$3,291.03 |
$3,871.80 |
0.4× |
| Open treatment of acute shoulder dislocation Age Under 21 (23660) |
$4,609.55 |
$5,423 |
0.6× |
| Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or… (27848) |
$3,889.01 |
$4,575.30 |
0.5× |
| Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal… (26746) |
$3,046.74 |
$3,584.40 |
0.9× |
| Open treatment of carpal bone fracture (other than carpal scaphoid ºnavicular»), each bone Age Under 21 (25645) |
$2,212.38 |
$2,602.80 |
0.7× |
Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed Age Under 21 (25628)
unusually low — confirm this is the full procedure |
$3,063.40 |
$3,604 |
0.4× |
| Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint… (26685) |
$2,783.24 |
$3,274.40 |
0.8× |
Open treatment of clavicular fracture, includes internal fixation, when performed Age Under 21 (23515)
unusually low — confirm this is the full procedure |
$3,192.94 |
$3,756.40 |
0.4× |
| Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed (27519) |
$5,646.13 |
$6,642.50 |
0.8× |
Open treatment of distal radioulnar dislocation, acute or chronic Age Under 21 (25676)
unusually low — confirm this is the full procedure |
$2,360.37 |
$2,776.90 |
0.3× |
Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed Age… (27829)
unusually low — confirm this is the full procedure |
$2,641.38 |
$3,107.50 |
0.4× |
| Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed (27514) |
$7,011.91 |
$8,249.30 |
0.5× |
| Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed (27269) |
$7,831.39 |
$9,213.40 |
1.1× |
| Open treatment of femoral shaft fracture with plate/screws, with or without cerclage (27507) |
$5,988.42 |
$7,045.20 |
0.8× |
| Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant,… (27506) |
$7,070.56 |
$8,318.30 |
1.0× |
| Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal… (27513) |
$7,860.21 |
$9,247.30 |
0.6× |
Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal… (27511)
unusually low — confirm this is the full procedure |
$6,180.18 |
$7,270.80 |
0.5× |
Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond),… (27828)
unusually low — confirm this is the full procedure |
$5,526.19 |
$6,501.40 |
0.4× |
| Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed Age Under 21 (28505) |
$1,441.09 |
$1,695.40 |
0.4× |
Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed Age Under 21 (23630)
unusually low — confirm this is the full procedure |
$3,505.49 |
$4,124.10 |
0.5× |
| Open treatment of greater trochanteric fracture, includes internal fixation, when performed (27248) |
$4,029.09 |
$4,740.10 |
0.5× |
Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed Age Under 21 (24579)
likely a partial charge — not the full procedure |
$3,466.98 |
$4,078.80 |
0.3× |
Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed Age Under… (24575)
likely a partial charge — not the full procedure |
$2,915.42 |
$3,429.90 |
0.2× |
Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without… (24545)
likely a partial charge — not the full procedure |
$3,537.02 |
$4,161.20 |
0.3× |
Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with… (24546)
unusually low — confirm this is the full procedure |
$5,863.22 |
$6,897.90 |
0.4× |
| Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when… (27540) |
$4,965.87 |
$5,842.20 |
0.7× |
Open treatment of lunate dislocation Age Under 21 (25695)
unusually low — confirm this is the full procedure |
$2,512.69 |
$2,956.10 |
0.3× |
| Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of… (24635) |
$4,120.97 |
$4,848.20 |
0.6× |
| Open treatment of patellar dislocation, with or without partial or total patellectomy Age Under 21 (27566) |
$3,879.32 |
$4,563.90 |
0.5× |
| Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue… (27524) |
$4,490.47 |
$5,282.90 |
0.6× |
Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed Age Under 21 (27784)
unusually low — confirm this is the full procedure |
$2,612.48 |
$3,073.50 |
0.4× |
Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed,… (23616)
unusually low — confirm this is the full procedure |
$8,049.33 |
$9,469.80 |
0.4× |
| Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius AND ulna Age… (25575) |
$4,770.63 |
$5,612.50 |
0.6× |
Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed;… (24666)
likely a partial charge — not the full procedure |
$3,615.82 |
$4,253.90 |
0.3× |
| Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal… (25526) |
$4,574.53 |
$5,381.80 |
0.6× |
Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones Age Under 21 (25670)
unusually low — confirm this is the full procedure |
$2,948.65 |
$3,469 |
0.4× |
| Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed Age Under 21 (23585) |
$4,699.65 |
$5,529 |
0.6× |
Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when… (23670)
unusually low — confirm this is the full procedure |
$3,676.25 |
$4,325 |
0.5× |
| Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (27535) |
$4,982.45 |
$5,861.70 |
0.7× |
Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage… (27758)
unusually low — confirm this is the full procedure |
$4,721.58 |
$5,554.80 |
0.4× |
| Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral… (27823) |
$5,052.49 |
$5,944.10 |
0.7× |
Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid processºes»), includes internal fixation,… (24685)
unusually low — confirm this is the full procedure |
$3,027.45 |
$3,561.70 |
0.4× |
Open treatment of ulnar shaft fracture (25545)
unusually low — confirm this is the full procedure |
$3,270.89 |
$3,848.10 |
0.4× |
Open treatment posterior malleolus fracture (27769)
unusually low — confirm this is the full procedure |
$2,607.21 |
$3,067.30 |
0.4× |
Open treatment radial shaft fracture (25515)
unusually low — confirm this is the full procedure |
$3,270.89 |
$3,848.10 |
0.4× |
Open treatment talus fracture (28445)
unusually low — confirm this is the full procedure |
$3,567.71 |
$4,197.30 |
0.5× |
Open treatment tarsometatarsal joint dislocation (28615)
unusually low — confirm this is the full procedure |
$2,905.81 |
$3,418.60 |
0.4× |
Open tx distal fibular fracture lat malleolus (27792)
unusually low — confirm this is the full procedure |
$2,836.62 |
$3,337.20 |
0.4× |
| Open tx distal phalangeal fracture each (26765) |
$1,856.91 |
$2,184.60 |
0.6× |
| Open tx fracture phalanx/phalanges not great toe (28525) |
$1,482.23 |
$1,743.80 |
0.4× |
| Open tx interphalangeal joint dislocation 1 (26785) |
$1,856.91 |
$2,184.60 |
0.6× |
| Open tx metacarpal fracture single ea bone (26615) |
$2,550.34 |
$3,000.40 |
0.8× |
| Open tx phalangeal shaft fracture prox/middle ea (26735) |
$2,316.59 |
$2,725.40 |
0.7× |
Open tx prox humeral fx (23615)
unusually low — confirm this is the full procedure |
$4,469.47 |
$5,258.20 |
0.3× |
Open tx tarsal fracture xcp talus &calcaneus ea (28465)
unusually low — confirm this is the full procedure |
$2,559.10 |
$3,010.70 |
0.3× |
| Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach Age… (54520) |
$1,490.99 |
$1,754.10 |
0.4× |
| Ostectomy, calcaneus; Age Under 21 (28118) |
$2,510.05 |
$2,953 |
0.8× |
| Ostectomy, complete excision; fifth metatarsal head Age Under 21 (28113) |
$1,872.72 |
$2,203.20 |
0.6× |
| Ostectomy, complete excision; first metatarsal head Age Under 21 (28111) |
$1,722.10 |
$2,026 |
0.5× |
| Ostectomy, complete excision; other metatarsal head (second, third or fourth) Age Under 21 (28112) |
$1,679.18 |
$1,975.50 |
0.5× |
| Ostectomy, excision of tarsal coalition Age Under 21 (28116) |
$2,778.82 |
$3,269.20 |
0.8× |
| Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) Age Under 21 (28110) |
$1,653.85 |
$1,945.70 |
0.5× |
| Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head Age Under 21 (28288) |
$1,583.81 |
$1,863.30 |
0.5× |
| Osteochondral knee autograft (27416) |
$6,739.57 |
$7,928.90 |
0.9× |
Osteotomy and transfer of greater trochanter of femur (separate procedure) (27140)
unusually low — confirm this is the full procedure |
$3,208.75 |
$3,775 |
0.4× |
| Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar (22214) |
$11,819.25 |
$13,905 |
1.6× |
| Osteotomy tibia (27705) |
$4,051.78 |
$4,766.80 |
0.5× |
| Osteotomy, shortening, angular or rotational correction; other phalanges, any toe Age Under 21 (28312) |
$1,270.33 |
$1,494.50 |
0.4× |
Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft… (28307)
unusually low — confirm this is the full procedure |
$2,584.51 |
$3,040.60 |
0.3× |
| Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each… (28308) |
$1,741.40 |
$2,048.70 |
0.5× |
Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation Age Under 21 (28300)
unusually low — confirm this is the full procedure |
$2,798.12 |
$3,291.90 |
0.4× |
| Osteotomy; phalanx of finger, each Age Under 21 (26567) |
$2,336.74 |
$2,749.10 |
0.7× |
| Ovarian cystectomy, unilateral or bilateral (58925) |
$3,660.44 |
$4,306.40 |
0.7× |
| Parathyroidectomy or exploration of parathyroid(s); Age Under 21 (60500) |
$6,206.45 |
$7,301.70 |
1.0× |
| Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions (11056) |
$162.86 |
$191.60 |
0.8× |
| Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions Age Under 21 (11057) |
$175.10 |
$206 |
0.9× |
| Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion (11055) |
$143.57 |
$168.90 |
0.7× |
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle Age Under 21 (23180)
unusually low — confirm this is the full procedure |
$2,482.09 |
$2,920.10 |
0.3× |
| Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus Age Under 21 (24140) |
$3,831.21 |
$4,507.30 |
1.1× |
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus Age Under… (23184)
unusually low — confirm this is the full procedure |
$3,513.39 |
$4,133.40 |
0.5× |
| Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx… (26235) |
$2,058.28 |
$2,421.50 |
1.3× |
| Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg,… (27360) |
$3,719.09 |
$4,375.40 |
1.1× |
| Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna Age Under 21 (25150) |
$3,309.39 |
$3,893.40 |
1.0× |
| Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula Age Under 21 (27641) |
$3,670.98 |
$4,318.80 |
1.1× |
| Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing);… (28120) |
$2,331.47 |
$2,742.90 |
0.7× |
| Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing);… (28122) |
$2,388.33 |
$2,809.80 |
0.7× |
| Partial excision bone metacarpal (26230) |
$2,008.38 |
$2,362.80 |
0.6× |
| Partial excision bone tibia (27640) |
$4,197.13 |
$4,937.80 |
1.3× |
| Partial excision distal phalanx finger (26236) |
$1,903.36 |
$2,239.25 |
1.2× |
| Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg,… (27071) |
$4,168.23 |
$4,903.80 |
1.2× |
| Partical excision bone phalanx toe (28124) |
$1,477.81 |
$1,738.60 |
0.4× |
| Patellectomy or hemipatellectomy Age Under 21 (27350) |
$5,334.43 |
$6,275.80 |
0.7× |
| Pelvic examination under anesthesia (other than local) Age Under 21 (57410) |
$490.28 |
$576.80 |
0.1× |
Percutaneous skeletal fixation of calcaneal fracture, with manipulation Age Under 21 (28406)
unusually low — confirm this is the full procedure |
$2,232.53 |
$2,626.50 |
0.3× |
| Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint Age… (26676) |
$1,942.76 |
$2,285.60 |
0.6× |
| Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation Age… (26650) |
$2,352.46 |
$2,767.60 |
0.7× |
| Percutaneous skeletal fixation of femoral fracture, proximal end, neck (27235) |
$6,255.49 |
$7,359.40 |
0.8× |
| Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation Age Under 21 (28496) |
$898.28 |
$1,056.80 |
0.3× |
| Percutaneous Skeletal Fixation Of Metacarpal Fracture, Each Bone (26608) |
$2,460.16 |
$2,894.30 |
0.7× |
| Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each Age Under 21 (28476) |
$1,673.06 |
$1,968.30 |
0.5× |
| Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar… (24538) |
$3,794.40 |
$4,464 |
0.5× |
| Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation Age Under 21 (28606) |
$1,480.45 |
$1,741.70 |
0.4× |
Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws) Age… (27756)
unusually low — confirm this is the full procedure |
$3,335.66 |
$3,924.30 |
0.4× |
| Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with… (26727) |
$1,592.56 |
$1,873.60 |
0.5× |
| Perq dev breast 1st us imag (19285) |
$1,244.53 |
$1,464.15 |
1.7× |
| Perq device breast 1st imag (19281) |
$927.18 |
$1,090.80 |
0.5× |
| Perq drainage pleura insert cath w/o imaging (32556) |
$1,425.28 |
$1,676.80 |
0.7× |
| Perq replacement gtube not req revj gstrst trc (43762) |
$507.80 |
$597.40 |
2.0× |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) |
$22,150.15 |
$26,059 |
3.0× |
| Pf-as amputation leg through tibia & fibula (27880) |
$3,752.41 |
$4,414.60 |
0.5× |
| Pin finger fracture each (26756) |
$1,357.88 |
$1,597.50 |
0.4× |
| Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to… (15050) |
$1,639.82 |
$1,929.20 |
2.2× |
| Place duod/jej tube perc (49441) |
$5,754.67 |
$6,770.20 |
2.9× |
| Placement of seton (46020) |
$442.17 |
$520.20 |
0.2× |
| Placement of stabilizing device for broken base of forearm bone on small finger side at wrist (25651) |
$1,691.50 |
$1,990 |
0.5× |
| Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure) (44300) |
$3,058.13 |
$3,597.80 |
1.6× |
| Plastic repair of introitus Age Under 21 (56800) |
$1,422.73 |
$1,673.80 |
0.4× |
Plastic repair of salivary duct, sialodochoplasty; primary or simple Age Under 21 (42500)
likely a partial charge — not the full procedure |
$152.32 |
$179.20 |
0.0× |
| Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy Age Under 21 (57250) |
$2,864.67 |
$3,370.20 |
0.6× |
| Pr amputate lower leg at knee (27598) |
$5,243.40 |
$6,168.70 |
1.6× |
| Pr inj. intralesional gt 7 lesions (11901) |
$157.59 |
$185.40 |
0.8× |
| Pr resection partial/complete phalangeal base each (28126) |
$1,376.32 |
$1,619.20 |
0.4× |
| Prineoplasty rpr pr nonobal spx (56810) |
$1,357.03 |
$1,596.50 |
0.4× |
| Proctosigmoidoscopy dx (45300) |
$188.28 |
$221.50 |
0.2× |
| Proctosigmoidoscopy, rigid; with biopsy, single or multiple Age Under 21 (45305) |
$333.54 |
$392.40 |
0.3× |
| Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie) Age Under 21 (45303) |
$251.26 |
$295.60 |
0.2× |
| Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar… (45308) |
$596.19 |
$701.40 |
0.2× |
| Prq skel fixj iphal jt dislc 1 w/mnpj (26776) |
$1,130.25 |
$1,329.70 |
0.3× |
| Punch biopsy skin single lesion (11104) |
$195.25 |
$229.70 |
0.5× |
| Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) |
$435.97 |
$512.90 |
1.0× |
| Puncture aspiration of cyst of breast (19000) |
$420.24 |
$494.40 |
0.6× |
| Quadricepsplasty (eg, Bennett or Thompson type) Age Under 21 (27430) |
$3,845.23 |
$4,523.80 |
0.5× |
| Rad exc bursa synva wrst/f/arm tdn shths flxrs (25115) |
$4,419.49 |
$5,199.40 |
2.7× |
| Rad exc bursa synva wrst/f/arm tdn shths xtnsrs (25116) |
$3,571.19 |
$4,201.40 |
1.1× |
| Radial styloidectomy (separate procedure) Age Under 21 (25230) |
$2,342.01 |
$2,755.30 |
0.7× |
| Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure)… (24149) |
$4,915.98 |
$5,783.50 |
0.7× |
| Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater Age Under 21 (21558) |
$4,093.01 |
$4,815.30 |
1.4× |
| Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm Age Under 21 (21557) |
$7,109.06 |
$8,363.60 |
2.4× |
| Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) |
$1,821.04 |
$2,142.40 |
0.9× |
| Realignment of extensor tendon, hand, each tendon (26437) |
$2,336.74 |
$2,749.10 |
0.7× |
| Reattachment of shoulder joint capsule and cartilage without bone transfer with repair of shoulder rim (23455) |
$6,353.50 |
$7,474.70 |
0.9× |
| Reconstr mcp jnt col ligam w graft (26541) |
$3,701.58 |
$4,354.80 |
1.1× |
Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, Kidner type… (28238)
unusually low — confirm this is the full procedure |
$2,374.39 |
$2,793.40 |
0.3× |
| Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue… (25337) |
$4,879.17 |
$5,740.20 |
0.7× |
Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft) Age Under 21 (24346)
unusually low — confirm this is the full procedure |
$5,481.48 |
$6,448.80 |
0.4× |
| Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty) Age Under 21 (23420) |
$6,954.96 |
$8,182.30 |
0.9× |
| Reconstruction of dislocating patella; (eg, Hauser type procedure) Age Under 21 (27420) |
$5,146.16 |
$6,054.30 |
0.7× |
| Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell,… (27422) |
$4,946.58 |
$5,819.50 |
0.7× |
| Reconstruction of nail bed with graft Age Under 21 (11762) |
$1,070.75 |
$1,259.70 |
0.5× |
Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure) Age Under 21 (26500)
likely a partial charge — not the full procedure |
$2,064.40 |
$2,428.70 |
0.3× |
| Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly… (28313) |
$1,103.13 |
$1,297.80 |
0.3× |
| Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)… (26542) |
$4,316.22 |
$5,077.90 |
1.3× |
| Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft Age Under 21 (24342) |
$4,567.48 |
$5,373.50 |
0.6× |
| Release i-p jt contracture (26525) |
$2,336.74 |
$2,749.10 |
1.4× |
| Release of ligaments at outer side of knee joint using an endoscope (29873) |
$4,790.77 |
$5,636.20 |
1.4× |
| Release of tendon connecting biceps muscle and shoulder using an endoscope (29828) |
$6,251.07 |
$7,354.20 |
0.8× |
| Release, tarsal tunnel (posterior tibial nerve decompression) Age Under 21 (28035) |
$2,985.46 |
$3,512.30 |
1.5× |
| Relieve pressure on nerve(s) (64722) |
$2,784.94 |
$3,276.40 |
1.4× |
| Removal foreign body foot complicated (28193) |
$1,973.36 |
$2,321.60 |
1.2× |
| REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS TechFee (28190) |
$882.47 |
$1,038.20 |
1.2× |
| Removal foreign body, intranasal; requiring general anesthesia Age Under 21 (30310) |
$1,196.80 |
$1,408 |
0.4× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$62.14 |
$73.10 |
1.0× |
| Removal impacted cerumen requiring instrumentation, unilateral (69210) |
$158.02 |
$185.90 |
2.6× |
| Removal implant deep (20680) |
$1,336.03 |
$1,571.80 |
0.5× |
| Removal implant superficial (20670) |
$1,343.94 |
$1,581.10 |
0.8× |
| Removal implantable contraceptive capsules (11976) |
$382.59 |
$450.10 |
0.5× |
| Removal of anal fissure (46200) |
$1,361.45 |
$1,601.70 |
0.5× |
| Removal of ankle implant (27704) |
$2,572.19 |
$3,026.10 |
0.8× |
| Removal of appendix using an endoscope (44970) |
$3,921.39 |
$4,613.40 |
0.6× |
| Removal of cerclage suture under anesthesia (other than local) Age Under 21 (59871) |
$434.27 |
$510.90 |
0.1× |
| Removal of diseased or injured scrotum (55150) |
$2,120.50 |
$2,494.70 |
0.6× |
| Removal of external bone stabilizing device under anesthesia|RIGHT SIDE (20694) |
$1,173.17 |
$1,380.20 |
0.7× |
| Removal of fluid collection in testicle and sperm reservoir|RIGHT SIDE (55040) |
$1,889.30 |
$2,222.70 |
0.5× |
| Removal of fluid-filled sac (bursa) or calcium deposit of pelvis (27062) |
$1,990.02 |
$2,341.20 |
0.6× |
| Removal of fluid-filled sac from joint at front of knee (27340) |
$2,666.79 |
$3,137.40 |
0.8× |
| Removal of foreign body in muscle or tendon sheath; simple (20520) |
$596.19 |
$701.40 |
0.4× |
| Removal of foreign body of upper arm or elbow area, accessed beneath the skin (24200) |
$492.92 |
$579.90 |
0.3× |
| Removal of foreign body, deep, thigh region or knee area Age Under 21 (27372) |
$2,032.01 |
$2,390.60 |
0.7× |
| Removal of foreign body, external eye; conjunctival superficial (65205) |
$183 |
$215.30 |
1.3× |
| Removal of foreign body, external eye; corneal, without slit lamp (65220) |
$203.16 |
$239 |
0.4× |
| Removal of foreign body, foot; deep (28192) |
$1,376.32 |
$1,619.20 |
0.8× |
| Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular) Age Under 21 (27087) |
$1,760.61 |
$2,071.30 |
0.5× |
| Removal of growths or polyps of large bowel by electrical cautery using an endoscope inserted through surgically… (44392) |
$2,078.42 |
$2,445.20 |
1.7× |
| Removal of growths or polyps of large bowel by mechanical snare using an endoscope inserted through surgically created… (44394) |
$2,016.29 |
$2,372.10 |
1.6× |
| Removal of heel spur (28119) |
$2,387.48 |
$2,808.80 |
0.7× |
| Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of… (27091) |
$9,316.17 |
$10,960.20 |
0.7× |
| Removal of iud (58301) |
$217.09 |
$255.40 |
0.7× |
| Removal of multiple hemorrhoid groups|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (46260) |
$2,224.62 |
$2,617.20 |
0.8× |
| Removal of nail bed (11750) |
$504.31 |
$593.30 |
1.2× |
| Removal of peritoneal foreign body from peritoneal cavity Age Under 21 (49402) |
$3,481.01 |
$4,095.30 |
1.0× |
Removal of pm generator (33233)
likely a partial charge — not the full procedure |
$1,080.35 |
$1,271 |
0.1× |
| Removal of posterior nonsegmental instrumentation (eg, harrington rod) (22850) |
$3,742.81 |
$4,403.30 |
0.5× |
| Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total… (23335) |
$5,522.62 |
$6,497.20 |
0.7× |
Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee (27488)
unusually low — confirm this is the full procedure |
$6,300.97 |
$7,412.90 |
0.5× |
| Removal of segmental stabilizing device from back of spine (22852) |
$3,755.90 |
$4,418.70 |
0.5× |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
$250.41 |
$294.60 |
1.2× |
| Removal of small bone underlying long bone of foot at big toe joint (28315) |
$1,510.28 |
$1,776.80 |
0.5× |
| Removal of stabilizing device from front of spine (22855) |
$7,522.33 |
$8,849.80 |
1.0× |
| Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation) Age Under 21 (15851) |
$168.13 |
$197.80 |
0.1× |
| Removal of thyroid lobe on side of neck and partial removal of thyroid lobe on opposite side of neck including tissue… (60225) |
$6,099.60 |
$7,176 |
1.0× |
| Removal of wrist bone (25210) |
$2,490.84 |
$2,930.40 |
0.7× |
| Removal or bivalving; full arm or full leg cast Age Under 21 (29705) |
$125.63 |
$147.80 |
0.4× |
| Removal tunneled cv cath (36590) |
$695.13 |
$817.80 |
0.4× |
| Removal with reinsertion, non-biodegradable drug delivery implant (11983) |
$286.28 |
$336.80 |
0.6× |
| Removal, non-biodegradable drug delivery implant (11982) |
$286.28 |
$336.80 |
0.6× |
| Removal/revision of cast (29700) |
$79.22 |
$93.20 |
0.3× |
| Remove eyelid foreign body (67938) |
$238.17 |
$280.20 |
0.7× |
| Remove foreign body from eye (65210) |
$153.26 |
$180.30 |
0.3× |
| Remove lung catheter (32552) |
$895.65 |
$1,053.70 |
1.4× |
| Remove pharynx foreign body (42809) |
$460.53 |
$541.80 |
1.0× |
| Remove vaginal foreign body (57415) |
$751.15 |
$883.70 |
0.2× |
| Repair achilles tendon (27650) |
$3,793.55 |
$4,463 |
0.5× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$780.94 |
$918.75 |
1.9× |
| REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) |
$1,375.38 |
$1,618.10 |
3.3× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$1,033.94 |
$1,216.40 |
2.5× |
| Repair complex trunk 2.6-7.5 cm (13101) |
$746.81 |
$878.60 |
1.0× |
| Repair elbow deb/attch open (24359) |
$3,290.10 |
$3,870.70 |
1.0× |
| Repair extensor tendon hand w/o graft each (26410) |
$1,755.42 |
$2,065.20 |
1.1× |
| Repair fibula nonunion/malunion w int fixation (27726) |
$6,237.05 |
$7,337.70 |
0.8× |
| Repair finger tendon (26418) |
$1,930.52 |
$2,271.20 |
1.2× |
| Repair finger tendon (26433) |
$2,046.89 |
$2,408.10 |
0.6× |
| Repair finger/hand tendon (26350) |
$2,979.34 |
$3,505.10 |
0.9× |
| Repair forearm tendon/muscle (25260) |
$2,666.79 |
$3,137.40 |
0.8× |
| Repair initial femoral hernia, any age; incarcerated or strangulated Age Under 21 (49553) |
$3,967.80 |
$4,668 |
1.1× |
| Repair initial femoral hernia, any age; reducible Age Under 21 (49550) |
$3,027.45 |
$3,561.70 |
0.8× |
| Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated Age Under 21 (49507) |
$2,954.86 |
$3,476.30 |
0.8× |
| Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or… (49501) |
$2,818.26 |
$3,315.60 |
0.8× |
Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible Age… (49500)
unusually low — confirm this is the full procedure |
$2,713.20 |
$3,192 |
0.4× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) |
$645.66 |
$759.60 |
1.6× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) |
$684.21 |
$804.95 |
1.6× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 7.6-12.5 CM (12054) |
$1,158.30 |
$1,362.70 |
2.8× |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
$1,287.88 |
$1,515.15 |
3.1× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$916.64 |
$1,078.40 |
1.2× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$539.33 |
$634.50 |
1.3× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$618.98 |
$728.20 |
1.5× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$758.62 |
$892.50 |
1.0× |
| REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) |
$499.04 |
$587.10 |
1.2× |
| REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) |
$524.45 |
$617 |
1.3× |
| REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM TechFee (12036) |
$940.27 |
$1,106.20 |
1.2× |
| Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes 5.1cm To 7.5cm (12053) |
$903.51 |
$1,062.95 |
2.2× |
| Repair Intermediate Wounds Of Scalp, Underarms, Truck And/or Extremities Over 30.0cm (12037) |
$1,076.87 |
$1,266.90 |
0.5× |
| Repair lip full thickness vermillion only - lac - lip rn (40650) |
$1,217.80 |
$1,432.70 |
2.2× |
Repair lower leg tendons (27676)
unusually low — confirm this is the full procedure |
$3,173.73 |
$3,733.80 |
0.4× |
| Repair medial collateral ligament, elbow, with local tissue Age Under 21 (24345) |
$4,342.48 |
$5,108.80 |
0.6× |
| Repair of abnormal anal drainage tract with tissue glue (46706) |
$377.32 |
$443.90 |
0.1× |
| Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie,… (49595) |
$3,536.17 |
$4,160.20 |
0.5× |
| Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie,… (49614) |
$4,476.44 |
$5,266.40 |
0.7× |
| Repair of digit nerve (64831) |
$2,125.68 |
$2,500.80 |
1.1× |
| Repair of dislocating lower leg tendons without a cut through the lower leg bone on the outside of the leg (fibula) (27675) |
$2,016.29 |
$2,372.10 |
0.6× |
| Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining… (26428) |
$4,087.74 |
$4,809.10 |
1.2× |
| Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue (41250) |
$371.20 |
$436.70 |
0.8× |
| Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex (41252) |
$1,177.98 |
$1,385.85 |
4.9× |
| Repair of leg tendon each (27658) |
$2,143.19 |
$2,521.40 |
0.6× |
| Repair of nail bed (11760) |
$879.92 |
$1,035.20 |
1.2× |
| Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary… (25431) |
$5,542.77 |
$6,520.90 |
0.7× |
Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft) Age Under 21 (24435)
unusually low — confirm this is the full procedure |
$6,091.70 |
$7,166.70 |
0.5× |
Repair of nonunion or malunion, humerus; without graft (eg, compression technique) Age Under 21 (24430)
unusually low — confirm this is the full procedure |
$4,748.70 |
$5,586.70 |
0.4× |
| Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft) Age Under 21 (25405) |
$4,821.37 |
$5,672.20 |
0.7× |
| Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique) Age Under 21 (25400) |
$4,001.04 |
$4,707.10 |
0.5× |
| Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft) (27724) |
$7,188.71 |
$8,457.30 |
1.0× |
| Repair of nonunion or malunion, tibia; without graft, (eg, compression technique) Age Under 21 (27720) |
$5,541.92 |
$6,519.90 |
0.7× |
| Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft… (25440) |
$4,521.07 |
$5,318.90 |
0.6× |
| Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute Age Under 21 (23410) |
$4,567.48 |
$5,373.50 |
0.6× |
| Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic Age Under 21 (23412) |
$6,954.96 |
$8,182.30 |
0.9× |
| Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon Age Under 21 (26370) |
$3,502.85 |
$4,121 |
1.0× |
| Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); primary, without free… (26356) |
$4,036.06 |
$4,748.30 |
1.2× |
| Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); secondary, without… (26357) |
$4,316.22 |
$5,077.90 |
1.3× |
| Repair recurrent femoral hernia; reducible Age Under 21 (49555) |
$3,574.68 |
$4,205.50 |
1.0× |
| Repair recurrent inguinal hernia, any age; incarcerated or strangulated Age Under 21 (49521) |
$3,607.06 |
$4,243.60 |
0.5× |
| Repair wrist joints (25447) |
$3,534.39 |
$4,158.10 |
1.1× |
| Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm (13152) |
$1,621.46 |
$1,907.60 |
2.1× |
| Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm (13120) |
$691.65 |
$813.70 |
1.7× |
| Repair, complex, trunk; 1.1 cm to 2.5 cm (13100) |
$437.75 |
$515 |
0.6× |
| Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon Age Under… (26420) |
$2,777.97 |
$3,268.20 |
0.8× |
| Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon Age Under… (26412) |
$2,736.83 |
$3,219.80 |
0.8× |
| Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks… (49495) |
$2,745.59 |
$3,230.10 |
0.8× |
| Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks… (49496) |
$3,474.89 |
$4,088.10 |
0.9× |
| Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes… (27472) |
$7,861.14 |
$9,248.40 |
1.1× |
Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft) Age Under 21 (28322)
likely a partial charge — not the full procedure |
$1,919.13 |
$2,257.80 |
0.3× |
| Repair, primary, disrupted ligament, ankle; both collateral ligaments Age Under 21 (27696) |
$5,015.77 |
$5,900.90 |
0.7× |
Repair, primary, disrupted ligament, ankle; collateral Age Under 21 (27695)
unusually low — confirm this is the full procedure |
$3,487.98 |
$4,103.50 |
0.5× |
| Repair, primary, torn ligament and/or capsule, knee; collateral Age Under 21 (27405) |
$4,486.98 |
$5,278.80 |
0.6× |
| Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments Age Under 21 (27409) |
$6,038.32 |
$7,103.90 |
0.8× |
| Repair, secondary, Achilles tendon, with or without graft Age Under 21 (27654) |
$4,281.20 |
$5,036.70 |
0.6× |
| Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure) Age Under 21 (27698) |
$4,587.62 |
$5,397.20 |
0.6× |
| Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle Age Under 21 (25272) |
$2,414.60 |
$2,840.70 |
0.7× |
| Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff) Age… (24341) |
$4,374.02 |
$5,145.90 |
0.6× |
| Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor… (25275) |
$2,897.91 |
$3,409.30 |
0.9× |
| Repair, tendon, extensor, foot; primary or secondary, each tendon Age Under 21 (28208) |
$1,033.94 |
$1,216.40 |
0.3× |
| Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon Age Under 21 (28200) |
$2,006.68 |
$2,360.80 |
0.6× |
| Repair/graft achilles tendon (27652) |
$4,020.33 |
$4,729.80 |
0.5× |
| Replace duodenostomy/jejunostomy tube perq (49451) |
$2,573.12 |
$3,027.20 |
2.8× |
| Replace gastrostomy/cecostomy tube percutaneous (49450) |
$3,856.62 |
$4,537.20 |
4.2× |
| Replace tunneled cv cath (36582) |
$3,469.62 |
$4,081.90 |
1.1× |
| Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral… (36578) |
$2,137.07 |
$2,514.20 |
0.7× |
| Reposition venous catheter (36597) |
$490.28 |
$576.80 |
0.3× |
| Repositioning and suture of misplaced testicle|BILATERAL PROCEDURE (54640) |
$2,520.59 |
$2,965.40 |
0.7× |
| Repr elbow lat ligmnt w/tiss (24343) |
$4,342.48 |
$5,108.80 |
1.3× |
| Resection, condyle(s), distal end of phalanx, each toe Age Under 21 (28153) |
$1,495.32 |
$1,759.20 |
0.4× |
| Reset dislocated jaw (21480) |
$515.70 |
$606.70 |
2.0× |
| Revis shoulder arthrplsty humeral&glenoid compnt (23474) |
$7,666.75 |
$9,019.70 |
0.6× |
| Revise ulnar nerve at elbow (64718) |
$3,678.89 |
$4,328.10 |
1.8× |
| Revise ulnar nerve at wrist (64719) |
$2,630.92 |
$3,095.20 |
1.3× |
| Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace;… (22861) |
$15,890.33 |
$18,694.50 |
0.9× |
Revision of arthroplasty, including removal of implant, wrist joint Age Under 21 (25449)
unusually low — confirm this is the full procedure |
$3,618.45 |
$4,257 |
0.5× |
| Revision of cervix (59320) |
$1,593.41 |
$1,874.60 |
0.5× |
| Revision of colostomy; complicated (reconstruction in-depth) (separate procedure) (44345) |
$3,137.78 |
$3,691.50 |
0.9× |
| Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft (27137) |
$15,177.69 |
$17,856.10 |
1.2× |
| Revision of total hip arthroplasty; both components, with or without autograft or allograft (27134) |
$20,294.94 |
$23,876.40 |
1.5× |
| Revision of total hip arthroplasty; femoral component only, with or without allograft (27138) |
$9,521.11 |
$11,201.30 |
0.7× |
| Revision of total knee arthroplasty, with or without allograft; 1 component (27486) |
$8,744.46 |
$10,287.60 |
0.7× |
| Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component (27487) |
$11,230.03 |
$13,211.80 |
0.6× |
| Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component (23473) |
$8,059.87 |
$9,482.20 |
0.6× |
| Revj/rmvl impl spi npg/rcvr dtch connj eltrd ra (63688) |
$2,525.86 |
$2,971.60 |
0.7× |
| RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) |
$209.28 |
$246.20 |
1.5× |
| RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP TechFee (65222) |
$312.55 |
$367.70 |
2.3× |
| Rmvl foreign body muscle/tendon sheath deep/comp (20525) |
$1,115.37 |
$1,312.20 |
0.4× |
| Rmvl of access device (36589) |
$656.63 |
$772.50 |
1.0× |
| Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) |
$4,530.76 |
$5,330.30 |
0.7× |
| Rpr aa hernia 1st 3-10 cm reducible (49593) |
$3,375.10 |
$3,970.70 |
0.5× |
| Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) |
$4,315.37 |
$5,076.90 |
0.7× |
| Rpr aa hernia 1st < 3 cm reducible (49591) |
$3,214.87 |
$3,782.20 |
0.9× |
Rpr aa hernia recr 3-10 cm reducible (49615)
unusually low — confirm this is the full procedure |
$3,151.80 |
$3,708 |
0.5× |
| Rpr Aa Hernia Recr < 3 Cm Reducible (49613) |
$3,002.12 |
$3,531.90 |
0.8× |
| Rpr ctr vad w/subq port/pmp ctr/prph insj sit (36576) |
$885.11 |
$1,041.30 |
0.6× |
| Rpr Ingun Hernia Sliding Any Age (49525) |
$2,993.36 |
$3,521.60 |
0.8× |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
$1,184.56 |
$1,393.60 |
1.6× |
| Rpr lip fth>1half ver ht/cpx (40654) |
$1,919.98 |
$2,258.80 |
1.2× |
Rpr non-union mtcrpl/phalanx (26546)
unusually low — confirm this is the full procedure |
$3,607.91 |
$4,244.60 |
0.5× |
| Rpr Recrt Inguinal Hernia Any Age Reducible (49520) |
$2,939.05 |
$3,457.70 |
0.8× |
| Rpr tdn/musc xtnsr f/arm&/wrist prim 1 ea tdn (25270) |
$2,111.74 |
$2,484.40 |
0.6× |
| Rpr xtnsr tdn ctr slip 2 tiss w/lat band ea fngr (26426) |
$2,934.71 |
$3,452.60 |
0.9× |
| Rpr&rcnstj finger volar plate interphalangeal jt (26548) |
$3,213.09 |
$3,780.10 |
1.0× |
| Secondary Closure Of Surgical Wound Or Dehiscence, Extensive Or Complicated (13160) |
$1,591.24 |
$1,872.05 |
0.4× |
| Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less (11300) |
$273.15 |
$321.35 |
0.7× |
| Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm (11301) |
$320.45 |
$377 |
1.6× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) |
$363.38 |
$427.50 |
1.8× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam >2.0 Cm (11313) |
$414.97 |
$488.20 |
1.0× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) |
$280.16 |
$329.60 |
1.4× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) |
$298.52 |
$351.20 |
1.5× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) |
$348.42 |
$409.90 |
1.7× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) |
$457.05 |
$537.70 |
1.1× |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) |
$333.54 |
$392.40 |
1.6× |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) |
$383.44 |
$451.10 |
0.9× |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) |
$610.22 |
$717.90 |
1.5× |
| Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) |
$333.54 |
$392.40 |
1.6× |
| Sigmoidoscopy & polypectomy (45333) |
$527.09 |
$620.10 |
0.6× |
| Sigmoidoscopy w/fb removal (45332) |
$679.41 |
$799.30 |
0.6× |
| Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance Age Under 21 (45335) |
$1,057.57 |
$1,244.20 |
1.1× |
| Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Age Under 21 (45338) |
$727.52 |
$855.90 |
0.6× |
Simple complete removal of breast|BILATERAL PROCEDURE (19303)
unusually low — confirm this is the full procedure |
$3,347.05 |
$3,937.70 |
0.5× |
| Simple cystometrogram (CMG) (eg, spinal manometer) Age Under 21 (51725) |
$722.33 |
$849.80 |
2.8× |
| Simple partial removal of external female genitals (56620) |
$2,659.74 |
$3,129.10 |
0.8× |
| SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) |
$396.18 |
$466.10 |
1.9× |
| SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) |
$481.53 |
$566.50 |
2.3× |
| SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) |
$529.26 |
$622.65 |
2.6× |
| SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) |
$689.48 |
$811.15 |
3.4× |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) |
$366.86 |
$431.60 |
1.8× |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee (12007) |
$826.46 |
$972.30 |
4.0× |
| Simple Repair Superficial Wound F/e/eyelids,n/l/ And Or Mucous Membranes 12.6cm To 20.0cm (12016) |
$824.76 |
$970.30 |
2.0× |
| Simple revision of superficial scar tissue from surgically created opening of large bowel to skin (44340) |
$1,231.82 |
$1,449.20 |
0.3× |
| Simple revision of superficial scar tissue from surgically created opening of small bowel to skin (44312) |
$1,151.33 |
$1,354.50 |
0.3× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$645.66 |
$759.60 |
3.1× |
| Sling operation for stress incontinence (eg, fascia or synthetic) Age Under 21 (57288) |
$4,709.34 |
$5,540.40 |
0.9× |
| Slitting of prepuce (54001) |
$464.87 |
$546.90 |
0.2× |
| Small bowel endoscopy/biopsy (44361) |
$1,231.82 |
$1,449.20 |
0.6× |
| SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) |
$499.04 |
$587.10 |
2.4× |
| SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee (12005) |
$618.98 |
$728.20 |
1.5× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$874.65 |
$1,029 |
2.1× |
| Sphincterotomy, anal, division of sphincter (separate procedure) Age Under 21 (46080) |
$694.28 |
$816.80 |
0.2× |
| Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple… (15120) |
$2,745.59 |
$3,230.10 |
0.8× |
| Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children… (15100) |
$2,972.37 |
$3,496.90 |
1.4× |
| Strapping ankle (29540) |
$108.97 |
$128.20 |
0.7× |
| Strapping elbow or wrist (29260) |
$99.79 |
$117.40 |
1.7× |
| Strapping of knee (29530) |
$128.69 |
$151.40 |
0.9× |
| Strapping of shoulder (29240) |
$122.58 |
$144.20 |
0.9× |
| Strapping of toes (29550) |
$86.70 |
$102 |
1.4× |
| Strapping unna boot (29580) |
$151 |
$177.65 |
0.9× |
| Subcutaneous injection of filling material (eg, collagen); 1 cc or less Age Under 21 (11950) |
$348.42 |
$409.90 |
1.7× |
| Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc Age Under 21 (11951) |
$362.44 |
$426.40 |
0.5× |
| Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including… (15002) |
$934.15 |
$1,099 |
1.2× |
| Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including… (15004) |
$1,186.35 |
$1,395.70 |
2.9× |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric Age Under 21 (46275) |
$2,173.88 |
$2,557.50 |
0.8× |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage Age Under 21 (46285) |
$1,511.13 |
$1,777.80 |
0.5× |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous Age Under 21 (46270) |
$1,574.12 |
$1,851.90 |
0.6× |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or… (46280) |
$2,453.19 |
$2,886.10 |
0.9× |
| Suture 1 nerve ulnar motor (64836) |
$2,930.29 |
$3,447.40 |
0.8× |
| Suture of 1 nerve; hand or foot, common sensory nerve Age Under 21 (64834) |
$2,403.29 |
$2,827.40 |
0.7× |
Suture of infrapatellar tendon; primary Age Under 21 (27380)
unusually low — confirm this is the full procedure |
$3,049.38 |
$3,587.50 |
0.4× |
| Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft Age Under 21 (27381) |
$4,943.09 |
$5,815.40 |
0.7× |
| Suture of major peripheral nerve, arm or leg, except sciatic; including transposition Age Under 21 (64856) |
$4,631.40 |
$5,448.70 |
0.5× |
| Suture of major peripheral nerve, arm or leg, except sciatic; without transposition Age Under 21 (64857) |
$3,691.13 |
$4,342.50 |
1.1× |
| Suture of quadriceps or hamstring muscle rupture; primary Age Under 21 (27385) |
$3,741.87 |
$4,402.20 |
0.5× |
| Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft Age Under… (27386) |
$4,899.32 |
$5,763.90 |
0.7× |
| Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single… (44602) |
$4,592.04 |
$5,402.40 |
1.2× |
| Suture pharynx for wound or injury Age Under 21 (42900) |
$1,562.81 |
$1,838.60 |
1.0× |
| Synovectomy, extensor tendon sheath, wrist, single compartment; Age Under 21 (25118) |
$2,772.70 |
$3,262 |
1.7× |
| Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint Age Under 21 (26140) |
$2,303.42 |
$2,709.90 |
1.4× |
| Synovectomy, tendon sheath, foot; flexor Age Under 21 (28086) |
$2,133.59 |
$2,510.10 |
0.6× |
| Synvct tdn shth rad flxr tdn palm&/fngr ea tdn (26145) |
$2,671.13 |
$3,142.50 |
1.6× |
Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris) Age Under 21 (20924)
likely a partial charge — not the full procedure |
$988.47 |
$1,162.90 |
0.1× |
| Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon Age Under 21 (25310) |
$4,001.04 |
$4,707.10 |
1.2× |
| Tenodesis long tendon biceps (23430) |
$4,114.85 |
$4,841 |
0.6× |
| Tenolysis ext tendon,hand/finger,ea (26445) |
$1,813.14 |
$2,133.10 |
0.5× |
| Tenolysis flexor tendon palm/finger each tendon (26440) |
$2,043.40 |
$2,404 |
1.2× |
| Tenolysis flxr/xtnsr tendon leg&/ankle 1 each (27680) |
$1,838.55 |
$2,163 |
0.5× |
| Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon Age Under 21 (25295) |
$2,219.44 |
$2,611.10 |
0.7× |
| Tenolysis, flexor tendon; palm AND finger, each tendon Age Under 21 (26442) |
$3,308.54 |
$3,892.40 |
1.0× |
| Tenotomy adductor hip percutaneous spx (27000) |
$950.81 |
$1,118.60 |
0.6× |
| Tenotomy percutaneous toe single tendon (28010) |
$660.11 |
$776.60 |
0.4× |
| Tenotomy, adductor of hip, open Age Under 21 (27001) |
$1,927.89 |
$2,268.10 |
0.6× |
| Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or… (24358) |
$2,764.80 |
$3,252.70 |
0.8× |
| Tenotomy, flexor, finger, open, each tendon Age Under 21 (26455) |
$1,610.92 |
$1,895.20 |
1.0× |
| Tenotomy, flexor, palm, open, each tendon Age Under 21 (26450) |
$1,459.45 |
$1,717 |
0.4× |
| Tenotomy, open, extensor, foot or toe, each tendon Age Under 21 (28234) |
$611.07 |
$718.90 |
0.4× |
| Tenotomy, open, tendon flexor; toe, single tendon (separate procedure) Age Under 21 (28232) |
$506.01 |
$595.30 |
0.3× |
| Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia Age Under 21 (27606) |
$1,310.62 |
$1,541.90 |
0.4× |
Tenotomy, shoulder area; single tendon Age Under 21 (23405)
unusually low — confirm this is the full procedure |
$3,682.37 |
$4,332.20 |
0.5× |
| Therapeutic spinal pnxr drainage csf w/fluor/CT (62329) |
$739.80 |
$870.35 |
1.0× |
| Therapeutic spinal puncture drainage csf (62272) |
$554.20 |
$652 |
0.8× |
| Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) |
$1,350.91 |
$1,589.30 |
2.1× |
| Thyroidectomy Rmvl Remaining Tiss Flwg Prtl Rmvl|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (60260) |
$5,765.21 |
$6,782.60 |
1.0× |
| Thyroidectomy, total or complete (60240) |
$7,123.09 |
$8,380.10 |
1.2× |
| Thyroidectomy, total or subtotal for malignancy; with limited neck dissection (60252) |
$7,610.73 |
$8,953.80 |
1.3× |
| Tonsillectomy and adenoidectomy; age 12 or over Age Under 21 (42821) |
$1,883.18 |
$2,215.50 |
0.6× |
| Tonsillectomy, primary or secondary; age 12 or over Age Under 21 (42826) |
$1,804.38 |
$2,122.80 |
0.5× |
Tonsillectomy, primary or secondary; younger than age 12 Age Under 21 (42825)
likely a partial charge — not the full procedure |
$1,593.41 |
$1,874.60 |
0.3× |
| Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes… (22856) |
$11,425.28 |
$13,441.50 |
0.6× |
| Total knee arthroplasty (27447) |
$10,805.46 |
$12,712.30 |
0.8× |
| Total thyroid lobectomy, unilateral; with or without isthmusectomy Age Under 21 (60220) |
$5,428.10 |
$6,386 |
0.9× |
Trachelectomy (cervicectomy), amputation of cervix (separate procedure) Age Under 21 (57530)
likely a partial charge — not the full procedure |
$1,490.14 |
$1,753.10 |
0.3× |
| Trachelorrhaphy plstc rpr uterine cervix vag (57720) |
$1,635.40 |
$1,924 |
0.5× |
| Tracheostoma revision; simple, without flap rotation Age Under 21 (31613) |
$1,525.16 |
$1,794.30 |
0.5× |
| Transect othr spinal n,xtradural (aka hb transect other spinal n, xtradural) (64772) |
$1,885.81 |
$2,218.60 |
0.9× |
| Transfer of tendon to restore intrinsic function; ring and small finger Age Under 21 (26497) |
$4,409.89 |
$5,188.10 |
1.3× |
| Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior… (27691) |
$3,977.41 |
$4,679.30 |
0.5× |
Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial… (27690)
unusually low — confirm this is the full procedure |
$3,133.44 |
$3,686.40 |
0.4× |
| Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon Age Under 21 (26489) |
$4,612.10 |
$5,426 |
1.4× |
| Transfer or transplant of tendon, palmar; without free tendon graft, each tendon Age Under 21 (26485) |
$4,129.73 |
$4,858.50 |
1.2× |
| Transfusion, blood or blood components (36430) |
$643.07 |
$756.55 |
1.4× |
| Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral… (63056) |
$9,928.17 |
$11,680.20 |
1.3× |
| Transplant hand tendon (26480) |
$3,033.65 |
$3,569 |
0.9× |
| Treat big toe fracture (28495) |
$618.12 |
$727.20 |
2.5× |
| Treat finger dislocation (26775) |
$699.55 |
$823 |
2.4× |
| Treat fx distal radial (25606) |
$2,693.06 |
$3,168.30 |
0.8× |
Treat fx rad extra-articul (25607)
unusually low — confirm this is the full procedure |
$2,693.06 |
$3,168.30 |
0.4× |
| Treat knee fracture (27532) |
$2,034.65 |
$2,393.70 |
0.6× |
| Treat lower leg fracture (27825) |
$2,224.62 |
$2,617.20 |
1.4× |
Treat radius fracture (24665)
unusually low — confirm this is the full procedure |
$2,917.20 |
$3,432 |
0.4× |
| Treat thumb fracture (26665) |
$4,347.75 |
$5,115 |
1.3× |
| Treat wrist bone fracture (25624) |
$1,477.38 |
$1,738.10 |
0.9× |
| TREATMENT CLOSED ELBOW DISLOCATION REQ ANES TechFee (24605) |
$1,228.30 |
$1,445.05 |
0.7× |
| Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing… (25609) |
$3,952.93 |
$4,650.50 |
0.5× |
| Treatment of ankle fracture (27822) |
$4,277.71 |
$5,032.60 |
0.6× |
| Treatment of bladder lesion (51720) |
$738.91 |
$869.30 |
1.0× |
Treatment of broken base of forearm bone on small finger side at wrist (25652)
unusually low — confirm this is the full procedure |
$2,309.54 |
$2,717.10 |
0.3× |
Treatment of broken middle part of upper arm bone with placement of stabilizing device (plate/screws) (24515)
likely a partial charge — not the full procedure |
$3,765.50 |
$4,430 |
0.3× |
| Treatment of closed elbow dislocation; without anesthesia (24600) |
$884.68 |
$1,040.80 |
3.5× |
| Treatment of foot infection (28003) |
$1,794.78 |
$2,111.50 |
0.5× |
| Treatment of gum lesion (41850) |
$147.99 |
$174.10 |
0.1× |
Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking… (24516)
unusually low — confirm this is the full procedure |
$4,481.71 |
$5,272.60 |
0.3× |
| Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant,… (27245) |
$6,378.06 |
$7,503.60 |
0.9× |
| Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant,… (27244) |
$5,815.96 |
$6,842.30 |
0.8× |
| Treatment of miscarriage (59812) |
$1,336.03 |
$1,571.80 |
0.4× |
| Treatment of missed abortion, completed surgically; second trimester Age Under 21 (59821) |
$1,598.68 |
$1,880.80 |
0.5× |
| Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ (27176) |
$6,785.13 |
$7,982.50 |
2.0× |
| Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each (28450) |
$825.61 |
$971.30 |
3.3× |
Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without… (27759)
unusually low — confirm this is the full procedure |
$5,052.49 |
$5,944.10 |
0.4× |
| Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement (27236) |
$6,358.77 |
$7,480.90 |
0.9× |
| Trimming of nondystrophic nails, any number (11719) |
$85.77 |
$100.90 |
1.4× |
| Tx superficial wound dehiscence simple closure (12020) |
$545.44 |
$641.70 |
0.7× |
| Tx superficial wound dehiscence w/packing (12021) |
$568.23 |
$668.50 |
1.4× |
| Urology surgery procedure unlisted (53899) |
$4,030.79 |
$4,742.10 |
15.8× |
| Uterine evacuation & curettage hydatidiform mole (59870) |
$1,648.58 |
$1,939.50 |
0.5× |
| Vaginal delivery (59409) |
$2,533.68 |
$2,980.80 |
0.8× |
| Vaginal hysterectomy, for uterus 250 g or less; Age Under 21 (58260) |
$6,320.26 |
$7,435.60 |
1.2× |
| Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) Age Under 21 (58262) |
$6,658.22 |
$7,833.20 |
1.3× |
| Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele (58263) |
$5,631.25 |
$6,625 |
1.1× |
| Vaginal hysterectomy, for uterus greater than 250 g; (58290) |
$6,429.66 |
$7,564.30 |
0.8× |
| Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) (58291) |
$5,977.88 |
$7,032.80 |
1.2× |
| Vasectomy (55250) |
$1,107.51 |
$1,302.95 |
0.5× |
| Venipuncture (36415) |
$31.54 |
$37.10 |
3.4× |
| Version cephalic external (59412) |
$768.70 |
$904.35 |
0.2× |
| Wedge excision skin nail fold (11765) |
$447.36 |
$526.30 |
1.1× |
| Wedging of cast (29740) |
$146.67 |
$172.55 |
0.5× |
| Windowing of cast (29730) |
$96.31 |
$113.30 |
0.6× |