| Anoscopy W/Rmvl Foreign Body (46608) |
$210 |
$300 |
0.3× |
| Application finger splint static (29130) |
$52.50 |
$75 |
0.4× |
| Application long arm splint shoulder hand (29105) |
$87.50 |
$125 |
0.6× |
| Application long leg splint thigh ankle/toes (29505) |
$70 |
$100 |
0.5× |
| Application Short Arm Splint Dynamic (29126) |
$70 |
$100 |
0.6× |
| Application short arm splint forearm-hand static (29125) |
$70 |
$100 |
0.6× |
| Application short leg splint calf foot (29515) |
$70 |
$100 |
0.5× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$122.50 |
$175 |
0.7× |
| Bladder Irrigation Simple (51700) |
$140 |
$200 |
0.6× |
| Blood transfusion service (36430) |
$89.25 |
$127.50 |
0.2× |
| Bone marrow aspiration only (38220) |
$402.50 |
$575 |
0.3× |
| Catheter Aspiration Nasotracheal Spx (31720) |
$442.75 |
$632.50 |
2.2× |
| Clsd tx clavicular fracture w/manipulation (23505) |
$630 |
$900 |
0.4× |
| Colonoscopy flex w/rem forcep (45384) |
$3,531.50 |
$5,045 |
3.3× |
| Colonoscopy w/ablation (45388) |
$2,800 |
$4,000 |
2.6× |
| Colsc Flexible W/Control Bleeding Any Method - Colonoscopy (45382) |
$2,852.50 |
$4,075 |
2.6× |
| Colsc Flexible W/Transendoscopic Balloon Dilat - Colonoscopy (45386) |
$3,255 |
$4,650 |
3.0× |
| Colsc flx with directed submucosal njx any sbst (45381) |
$1,732.50 |
$2,475 |
1.6× |
| Curette/treat cornea (65435) |
$192.50 |
$275 |
0.2× |
| Declot vascular device (36593) |
$52.50 |
$75 |
0.2× |
| Delivery placenta separate procedure (59414) |
$210 |
$300 |
0.1× |
| Dilation esoph unguided sound/bougie 1/mult pass (43450) |
$535.50 |
$765 |
0.7× |
| Drain outer ear canal lesion (69020) |
$315 |
$450 |
0.5× |
| Drainage mouth roof lesion (42000) |
$157.50 |
$225 |
0.7× |
| Draw blood off venous device (36591) |
$35 |
$50 |
0.3× |
| Egd balloon dilation esophagus <30 mm diam (43249) |
$5,950 |
$8,500 |
3.4× |
| Egd flexible foreign body removal (43247) |
$2,450 |
$3,500 |
3.0× |
| Egd guide wire insertion (43248) |
$3,531.50 |
$5,045 |
4.3× |
| Egd place gastrostomy tube (43246) |
$1,645 |
$2,350 |
0.9× |
| Egd Transoral Control Bleeding Any Method - Egd (43255) |
$2,362.50 |
$3,375 |
1.4× |
| Egd Varices Ligation (43244) |
$1,435 |
$2,050 |
0.8× |
| Esophagogastroduodenoscopy submucosal injection (43236) |
$1,295 |
$1,850 |
1.6× |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) |
$420 |
$600 |
0.3× |
| Gastric Intubation/Aspiration, Therapeutic (43753) |
$253.40 |
$362 |
1.3× |
| I&d abscess simple (10060) |
$253.40 |
$362 |
1.4× |
| I&d epididymis tstis&/scrotal space (54700) |
$595 |
$850 |
0.3× |
| Incision & drainage abscess complicated/multiple (10061) |
$340.20 |
$486 |
0.9× |
| Incision and drainage of vulva or perineal abscess (56405) |
$262.50 |
$375 |
1.0× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$140 |
$200 |
0.5× |
| Injection single/mlt trigger point 3/> muscles (20553) |
$210 |
$300 |
0.8× |
| Insert Bladder Cath Complex (51703) |
$227.50 |
$325 |
2.0× |
| Insert non-tunnel cv cath (36556) |
$546 |
$780 |
0.2× |
| Insert Temp Bladder Cath (51702) |
$157.50 |
$225 |
1.3× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$105 |
$150 |
0.9× |
| Intubation endotracheal emergency procedure (31500) |
$673.75 |
$962.50 |
3.2× |
| Removal foreign body pharynx (42809) |
$385 |
$550 |
1.0× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$105 |
$150 |
2.0× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$192.50 |
$275 |
3.6× |
| Remove foreign body from eye (65210) |
$140 |
$200 |
0.3× |
| Remv Ext Canal Foreign Body (69200) |
$175 |
$250 |
1.5× |
| Remv F.B.,Eye,Superf Conjunc (65205) |
$105 |
$150 |
0.9× |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
$553.70 |
$791 |
1.5× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$340.20 |
$486 |
0.9× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$396.20 |
$566 |
1.1× |
| Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) |
$618.80 |
$884 |
1.7× |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
$422.80 |
$604 |
1.2× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
$471.10 |
$673 |
1.3× |
| Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) |
$618.80 |
$884 |
1.7× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$482.30 |
$689 |
0.7× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$319.20 |
$456 |
0.9× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$376.60 |
$538 |
1.0× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$401.80 |
$574 |
0.6× |
| Repair intermediate n/h/f/xtrnl gent >30.0 cm (12047) |
$553.70 |
$791 |
0.3× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$471.10 |
$673 |
1.3× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$319.20 |
$456 |
0.9× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$368.20 |
$526 |
1.0× |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) |
$471.10 |
$673 |
0.7× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$396.20 |
$566 |
1.1× |
| Repair intermediate s/a/t/e >30.0 cm (12037) |
$553.70 |
$791 |
0.3× |
| Repair Tongue Laceration (41250) |
$350 |
$500 |
0.9× |
| Reposition gastrostomy tube (43761) |
$227.50 |
$325 |
1.0× |
| Rmvl embedded fb from dentalvlr struxs soft tiss (41805) |
$262.50 |
$375 |
0.2× |
| Rmvl Embedded Fb Vestibule Mouth Smpl (40804) |
$262.50 |
$375 |
0.3× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$157.50 |
$225 |
0.4× |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
$140 |
$200 |
1.2× |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
$553.70 |
$791 |
0.8× |
| Rpr Lac 2.5 Cm/< Pst One-Third Tongue (41251) |
$367.50 |
$525 |
1.7× |
| Rpr lac tongue floor mouth > 2.6 cm/cplx (41252) |
$472.50 |
$675 |
2.2× |
| Sgmdsc flx dired sbmcsl njx any sbst (45335) |
$665 |
$950 |
0.8× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
$511.70 |
$731 |
1.4× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$291.20 |
$416 |
1.6× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$340.20 |
$486 |
1.9× |
| Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) |
$553.70 |
$791 |
1.5× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$376.60 |
$538 |
2.1× |
| Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) |
$455 |
$650 |
2.5× |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
$553.70 |
$791 |
3.1× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$259.70 |
$371 |
1.4× |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
$503.30 |
$719 |
2.8× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$340.20 |
$486 |
1.9× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$180.60 |
$258 |
1.0× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$336 |
$480 |
0.9× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$503.30 |
$719 |
1.4× |
| Spinal puncture lumbar diagnostic (62270) |
$367.50 |
$525 |
0.6× |
| Spinal Puncture Therapeutic (62272) |
$455 |
$650 |
0.7× |
| Strapping unna boot (29580) |
$122.50 |
$175 |
0.8× |
| Thoracentesis needle/cath pleura w/o imaging (32554) |
$364 |
$520 |
0.6× |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
$542.50 |
$775 |
0.2× |
| Vaginal delivery only (59409) |
$1,715 |
$2,450 |
0.6× |
| Venipuncture (36415) |
$12.25 |
$17.50 |
1.3× |
| Venipuncture, cutdown; age 1 or over (36425) |
$87.50 |
$125 |
0.2× |