| Actinotherapy Ultraviolet Light (96900) |
— |
$150.77 |
— |
| Aep neurodiagnostic i&r (92653) |
— |
$1,027.88 |
— |
| Airway Inhalation Treatment (94640) |
— |
$194.76 |
— |
| Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) |
— |
$281.85 |
— |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) |
— |
$92.36 |
— |
| Application on-body injector (96377) |
— |
$94.75 |
— |
| Assessment of aphasia per hr (96105) |
— |
$189.91 |
— |
| Behavral qualit analys voice (92524) |
— |
$461.77 |
— |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) |
— |
$177.50 |
— |
| Bfb training ea addl 15 min (90913) |
— |
$257.52 |
— |
| Biofeedback training any modality (90901) |
— |
$177.50 |
— |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) |
— |
$575.47 |
— |
| Canalith repositioning proc (95992) |
— |
$120.08 |
— |
| Cardiac Stress Tst,Tracing Only (93017) |
— |
$940.26 |
— |
| Cardiopulmonary resuscitation (92950) |
— |
$755.62 |
— |
| Cardioversion (92960) |
— |
$1,642.74 |
— |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) |
— |
$11,162.68 |
— |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) |
— |
$11,162.68 |
— |
| Cbt 1st hour (94644) |
— |
$530.13 |
— |
| Chemo Admin Peritoneal Cavity (96446) |
— |
$977 |
— |
| Chemo Anti-Neopl Sq/Im (96401) |
— |
$355.02 |
— |
| Chemo Hormon Antineopl Sq/Im (96402) |
— |
$355.02 |
— |
| Chemo Ia Push (96420) |
— |
$814 |
— |
| Chemo Intralesional Over 7 (96406) |
— |
$522 |
— |
| Chemo intralesional up to 7 (96405) |
— |
$222 |
— |
| Chemo IV infusion addl hr (96415) |
— |
$158.32 |
— |
| Chemo IV push addl drug (96411) |
— |
$502 |
— |
| Chemother Prolong Infuse W/Pump (96416) |
— |
$734.04 |
— |
| Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) |
— |
$522 |
— |
| Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) |
— |
$102 |
— |
Chemotherapy Into Cns (96450)
range across 2 matching MRF lines |
— |
$561.32–$977 |
— |
| Chemotherapy Intracavitary (96440) |
— |
$977 |
— |
| Chemotherapy Unspecified (96549) |
— |
$522 |
— |
| Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) |
— |
$814 |
— |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) |
— |
$391 |
— |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) |
— |
$875.57 |
— |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) |
— |
$561.32 |
— |
| Chest Wall Manipulation (94668) |
— |
$284 |
— |
| Color/duplex Doppler, complete (93975) |
— |
$534.07 |
— |
| Color/duplex Doppler, limited (93976) |
— |
$899.12 |
— |
| Community/Work Reintegration Trainj Ea 15 Min (97537) |
— |
$115.66 |
— |
| Cont gluc mntr physician/qhp provided equiptment (95250) |
— |
$549.32 |
— |
| Continuous Pulse Ox (94762) |
— |
$243.47 |
— |
| Coronary Art/Grft Angio S&I (93455) |
— |
$11,162.68 |
— |
| Coronary Artery Angio S&I (93454) |
— |
$11,162.68 |
— |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) |
— |
$659.66 |
— |
| Cpt initial (94667) |
— |
$160.72 |
— |
| Critical care first hour (99291) |
— |
$1,127 |
— |
| Debridement Open Wound 20 Sq Cm< (97597) |
— |
$441.27 |
— |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) |
— |
$6 |
— |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) |
— |
$891.10 |
— |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) |
— |
$522.94 |
— |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) |
— |
$918.68 |
— |
| Dup-scan xtr veins unilateral/limited study (93971) |
— |
$518.82 |
— |
| Duplex up extrem art bilat (93930) |
— |
$496.31 |
— |
| Duplex up extrem art unilat/ltd (93931) |
— |
$515.37 |
— |
| Echo Heart Xthoracic,Limited (93308) |
— |
$867.22 |
— |
| Echo transesophageal (93312) |
— |
$2,294.93 |
— |
| Eeg 41-60 Minutes (95812) |
— |
$728.03 |
— |
| EEG awake and asleep (95819) |
— |
$1,079.23 |
— |
| EEG awake drowsy (95816) |
— |
$709.97 |
— |
| EEG cerebral death evaluation (95824) |
— |
$768.81 |
— |
| EEG cont rec w/video by tech min 8 channels (95700) |
— |
$1,656.14 |
— |
| EEG extended monitoring 61-119 minutes (95813) |
— |
$728.03 |
— |
| Eeg Sleep Only (95822) |
— |
$728.03 |
— |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) |
— |
$1,656.14 |
— |
| EEG w/o vid ea 12-26hr intmt (95709) |
— |
$3,311.18 |
— |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) |
— |
$1,656.14 |
— |
| EEG wo vid ea 12-26hr unmntr (95708) |
— |
$3,311.18 |
— |
Electrical Stimulation Ea 15 Min (97032)
range across 2 matching MRF lines |
— |
$118.73–$188 |
— |
| Electrocardiogram Tracing (93005) |
— |
$187.10 |
— |
| Emergency Dept Visit Level 2 (99282) |
— |
$320 |
— |
| Emergency Dept Visit Level 3 (99283) |
— |
$480 |
— |
| Emergency Dept Visit Level 4 (99284) |
— |
$673 |
— |
| Er level 1 (99281) |
— |
$215 |
— |
| Er level v (99285) |
— |
$939 |
— |
| Evaluate Speech Production (92522) |
— |
$461.77 |
— |
| Evaluate Swallowing Function (92610) |
— |
$274.66 |
— |
| Evaluation of speech fluency (92521) |
— |
$461.77 |
— |
| External ECG rec>48hr<7d recording (93242) |
— |
$725 |
— |
| Extracranial Bilat Study (93880) |
— |
$888.45 |
— |
| Extracranial Uni/Ltd Study (93882) |
— |
$873.16 |
— |
| Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) |
— |
$755.62 |
— |
| Group Therapeutic Procedures (97150) |
— |
$63.57 |
— |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) |
— |
$11,162.68 |
— |
| Holter monitor recording (93225) |
— |
$1,103 |
— |
| Hubbard tank 15 min (97036) |
— |
$187.64 |
— |
| Immunization administration (90471) |
— |
$213.37 |
— |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) |
— |
$1,551.09 |
— |
| Intracranial Complete Study (93886) |
— |
$971.50 |
— |
Iontophoresis 15 min (97033)
range across 2 matching MRF lines |
— |
$135.52–$195 |
— |
| Irrig Drug Delivery Device (96523) |
— |
$127.14 |
— |
IV infusion hydration each additional hour (96361)
range across 2 matching MRF lines |
— |
$116.37–$301 |
— |
| IV infusion hydration initial 31 min-1 hour (96360) |
— |
$470.05 |
— |
IV infusion ther proph addl sequential to 1 hr (96367)
range across 2 matching MRF lines |
— |
$183.49–$402 |
— |
| IV infusion therapy prophylaxis/dx ea hour (96366) |
— |
$116.34 |
— |
| IV push initial (96374) |
— |
$470.10 |
— |
| L Hrt Art/Grft Angio (93459) |
— |
$11,162.68 |
— |
| Lung Function Test (Mbc/Mvv) (94200) |
— |
$171.46 |
— |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) |
— |
$52.78 |
— |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) |
— |
$86.10 |
— |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) |
— |
$39.74 |
— |
| Methacholine challenge (94070) |
— |
$1,366 |
— |
| Motion Fluoroscopy/Swallow (92611) |
— |
$274.66 |
— |
| Multiple Sleep Latency Test (95805) |
— |
$3,310.31 |
— |
| Muscle Test 2 Limbs (95861) |
— |
$321.43 |
— |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) |
— |
$458.16 |
— |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) |
— |
$979.90 |
— |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) |
— |
$979.90 |
— |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) |
— |
$293.28 |
— |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) |
— |
$441.37 |
— |
| Nerve Conduction Studies 1-2 Studies (95907) |
— |
$182.31 |
— |
| Nerve Conduction Studies 11-12 Studies (95912) |
— |
$337.03 |
— |
| Nerve conduction studies 13 or more studies (95913) |
— |
$337.03 |
— |
| Nerve Conduction Studies 3-4 Studies (95908) |
— |
$182.31 |
— |
| Nerve conduction studies 5-6 studies (95909) |
— |
$182.31 |
— |
| Nerve conduction studies 7-8 studies (95910) |
— |
$182.31 |
— |
| Nerve Conduction Studies 9-10 Studies (95911) |
— |
$337.03 |
— |
| Neuromuscular Reeducation (97112) |
— |
$130.72 |
— |
| Oral Function Therapy (92526) |
— |
$117.54 |
— |
| Oral Speech Device Eval (92597) |
— |
$525.34 |
— |
| Orthc/Prostc Mgmt Sbsq Enc (97763) |
— |
$117.54 |
— |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) |
— |
$121.14 |
— |
| Ot Contrast Bath Ea 15 Min (97034) |
— |
$61.17 |
— |
| Ot eval high complexity (97167) |
— |
$393.40 |
— |
| Ot Eval Low Complex (97165) |
— |
$393.40 |
— |
| Ot Eval Moderate Complexity (97166) |
— |
$393.40 |
— |
Ot manual therapy 15 min (97140)
range across 2 matching MRF lines |
— |
$130.15–$169 |
— |
| Ot paraffin bath (97018) |
— |
$91.16 |
— |
| Ot Prosthetic Training, Each 15 Min (97761) |
— |
$116.35 |
— |
| Ot Re-Eval Est Plan Care (97168) |
— |
$190.70 |
— |
| Ot rom hand (95852) |
— |
$29.99 |
— |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) |
— |
$275.73 |
— |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) |
— |
$16,532.33 |
— |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) |
— |
$25,110.34 |
— |
| Phlebotomy therapeutic (99195) |
— |
$122 |
— |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) |
— |
$125.94 |
— |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) |
— |
$125.94 |
— |
| Physical Performance Test (97750) |
— |
$123.54 |
— |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) |
— |
$3,834.43 |
— |
Prq Card Stent W/Angio 1 Vsl (92928)
range across 2 matching MRF lines |
— |
$25,110.34–$26,613.42 |
— |
| Prq Revasc Byp Graft 1 Vsl (92937) |
— |
$25,110.34 |
— |
| Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) |
— |
$145 |
— |
| Pt Eval High Complex (97163) |
— |
$255.47 |
— |
| Pt eval low complex 20 min (97161) |
— |
$255.47 |
— |
| Pt Eval Mod Complex (97162) |
— |
$255.47 |
— |
| Pt gait training 15 min (97116) |
— |
$81.56 |
— |
| Pt mechanical traction (97012) |
— |
$271 |
— |
| Pt Re-Eval Est Plan Care (97164) |
— |
$206.30 |
— |
| Pulm function test by gas (94727) |
— |
$239.88 |
— |
| Pulmonary Stress Testing (94618) |
— |
$265.06 |
— |
| R Hrt Art/Grft Angio (93457) |
— |
$11,162.68 |
— |
| R hrt coronary artery angio (93456) |
— |
$11,162.68 |
— |
| R&L Hrt Cath W/Ventriclgrphy (93453) |
— |
$11,162.68 |
— |
| Remote 30 Day Ecg Rev/Report (93270) |
— |
$285.45 |
— |
| Right Heart Cath (93451) |
— |
$11,162.68 |
— |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) |
— |
$293.84 |
— |
| Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) |
— |
$47.98 |
— |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) |
— |
$417.38 |
— |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) |
— |
$105.54 |
— |
| Self Care Mngment Training (97535) |
— |
$147.51 |
— |
| Sensory Integration Ea 15 Min (97533) |
— |
$110.35 |
— |
| Short-latency somatosens ep std upr limbs (95925) |
— |
$755.62 |
— |
| Sleep study unattended (95806) |
— |
$1,365 |
— |
| Somatosensory Testing (95938) |
— |
$776 |
— |
| Speech sound lang comprehen (92523) |
— |
$461.51 |
— |
| Spirometry (94010) |
— |
$584.10 |
— |
| Ssep lower limbs (95926) |
— |
$755.62 |
— |
| Standardized Cognitive Performance Testing (96125) |
— |
$252.27 |
— |
| Stress Tte Only (93350) |
— |
$940.26 |
— |
| Subcutaneous Infusion Each Additional Hour (96370) |
— |
$102 |
— |
| Subcutaneous infusion initial 1 hr w/pump set-up (96369) |
— |
$522 |
— |
| Subq Infusion Additional Pump Infusion Site (96371) |
— |
$158 |
— |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) |
— |
$82.98 |
— |
| Ther Ivntj Ea Addl 15 Min (97130) |
— |
$80.63 |
— |
| Ther Px 1/> Areas Each 15 Min Aqua Ther W/Xerss (97113) |
— |
$172.72 |
— |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) |
— |
$95.96 |
— |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) |
— |
$272.26 |
— |
| Ther/Proph/Diag Inj Ia (96373) |
— |
$522 |
— |
| Ther/Proph/Diag Inj Sc/Im (96372) |
— |
$342 |
— |
| Ther/Proph/Diag Iv Inf Init (96365) |
— |
$470 |
— |
| Therapeutic Activities (97530) |
— |
$131.93 |
— |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) |
— |
$1,279.74 |
— |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) |
— |
$837.18 |
— |
| Tte w/doppler, complete (93306) |
— |
$2,604.65 |
— |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) |
— |
$223.08 |
— |
| Tx/Pro/Dx Inj New Drug Addon (96375) |
— |
$116.34 |
— |
| Upr/L Xtremity Art 2 Levels (93922) |
— |
$381.68 |
— |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) |
— |
$425.51 |
— |
| Veeg 2-12 hr intmt mntr (95712) |
— |
$1,656.14 |
— |
| Veeg 2-12 hr unmonitored (95711) |
— |
$1,656.14 |
— |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) |
— |
$3,311.18 |
— |
| Veeg Ea 12-26 Hr Unmntr (95714) |
— |
$3,311.18 |
— |
| Vent Mgmt Inpat Init Day (94002) |
— |
$2,728 |
— |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) |
— |
$1,769.09 |
— |
| Visual Evoked Potential Test (95930) |
— |
$1,231.77 |
— |
| Wheelchair Mgmt Ea 15 Min (97542) |
— |
$64.77 |
— |
| Whirlpool Therapy (97022) |
— |
$197.90 |
— |