| Airway Inhalation Treatment (94640) |
— |
$64.75 |
— |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) |
— |
$25 |
— |
| Assessment of aphasia per hr (96105) |
— |
$286 |
— |
| Audiometry Air & Bone (92553) |
— |
$125.65 |
— |
| Behavral qualit analys voice (92524) |
— |
$295.25 |
— |
| Brief Emotional/Behav Assmt (96127) |
— |
$15 |
— |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) |
— |
$475.35 |
— |
| Car seat/bed test 60 min (94780) |
— |
$45.15 |
— |
| Cardiac Stress Tst,Tracing Only (93017) |
— |
$314.40 |
— |
| Cardiopulmonary resuscitation (92950) |
— |
$340.30 |
— |
| Cardioversion (92960) |
— |
$451 |
— |
| Cbt 1st hour (94644) |
— |
$369 |
— |
| Chemo Anti-Neopl Sq/Im (96401) |
— |
$247 |
— |
| Chemo Hormon Antineopl Sq/Im (96402) |
— |
$206 |
— |
Chemo IV infusion addl hr (96415)
range across 2 matching MRF lines |
— |
$189.65–$230.65 |
— |
Chemo IV push addl drug (96411)
range across 2 matching MRF lines |
— |
$179.35–$289.60 |
— |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) |
— |
$298.20 |
— |
Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413)
range across 2 matching MRF lines |
— |
$457.10–$650 |
— |
Chemotx admn IV push tq 1/1st sbst/drug (96409)
range across 2 matching MRF lines |
— |
$260.15–$393.75 |
— |
Chest Wall Manipulation (94668)
range across 2 matching MRF lines |
— |
$150–$158 |
— |
| Chron Care Mgmt Srvc 20 Min (99490) |
— |
$118 |
— |
Color/duplex Doppler, complete (93975)
range across 4 matching MRF lines |
— |
$57.50–$568 |
— |
Color/duplex Doppler, limited (93976)
range across 5 matching MRF lines |
— |
$60.90–$322 |
— |
| Community/Work Reintegration Trainj Ea 15 Min (97537) |
— |
$66 |
— |
| Comprehensive Hearing Test (92557) |
— |
$202.10 |
— |
| Cont gluc mntr physician/qhp provided equiptment (95250) |
— |
$261 |
— |
| Cont Gluc Mntr Pt Prov Eqp (95249) |
— |
$107 |
— |
| Continuous Pulse Ox (94762) |
— |
$260 |
— |
Cpap Ventilation Cpap Initiation&Mgmt (94660)
range across 2 matching MRF lines |
— |
$162.95–$343.50 |
— |
Cpt initial (94667)
range across 2 matching MRF lines |
— |
$158–$217 |
— |
| Critical care first hour (99291) |
— |
$463 |
— |
Debridement Open Wound 20 Sq Cm< (97597)
range across 2 matching MRF lines |
— |
$162–$250 |
— |
Dup-scan aorta ivc iliac vascl/bpgs complete (93978)
range across 2 matching MRF lines |
— |
$87.90–$551.90 |
— |
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979)
range across 2 matching MRF lines |
— |
$60.90–$281.55 |
— |
Dup-scan lxtr art/artl bpgs compl bi study (93925)
range across 2 matching MRF lines |
— |
$87.90–$551.90 |
— |
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926)
range across 2 matching MRF lines |
— |
$60.90–$281.55 |
— |
Dup-Scan Xtr Veins Complete Bilateral Study (93970)
range across 2 matching MRF lines |
— |
$144.60–$313.65 |
— |
Dup-scan xtr veins unilateral/limited study (93971)
range across 2 matching MRF lines |
— |
$85.40–$297.90 |
— |
| Duplex up extrem art bilat (93930) |
— |
$160.60 |
— |
Duplex up extrem art unilat/ltd (93931)
range across 2 matching MRF lines |
— |
$48.70–$268 |
— |
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines |
— |
$940.85–$1,173.40 |
— |
| EEG awake and asleep (95819) |
— |
$644.90 |
— |
| Electrical Stimulation Ea 15 Min (97032) |
— |
$35 |
— |
| Electrocardiogram Tracing (93005) |
— |
$138.60 |
— |
Emergency Dept Visit Level 2 (99282)
range across 2 matching MRF lines |
— |
$73–$101 |
— |
Emergency Dept Visit Level 3 (99283)
range across 2 matching MRF lines |
— |
$111–$173.65 |
— |
Emergency Dept Visit Level 4 (99284)
range across 2 matching MRF lines |
— |
$199–$295.55 |
— |
Er level 1 (99281)
range across 2 matching MRF lines |
— |
$28–$49.60 |
— |
Er level v (99285)
range across 2 matching MRF lines |
— |
$288–$428.30 |
— |
| Evaluate pt use of inhaler (94664) |
— |
$84.55 |
— |
| Evaluate Speech Production (92522) |
— |
$295.25 |
— |
| Evaluate Swallowing Function (92610) |
— |
$282.50 |
— |
| Evaluation of speech fluency (92521) |
— |
$295.25 |
— |
Evoked Auditory Test,Limited (92587)
range across 2 matching MRF lines |
— |
$138.95–$145.90 |
— |
| External ECG rec>48hr<7d recording (93242) |
— |
$251 |
— |
| External ECG rec>7d<15d recording (93246) |
— |
$300 |
— |
Extracranial Bilat Study (93880)
range across 2 matching MRF lines |
— |
$96.10–$582.95 |
— |
| Extracranial Uni/Ltd Study (93882) |
— |
$57.90 |
— |
Group Therapeutic Procedures (97150)
range across 2 matching MRF lines |
— |
$52.15–$79.35 |
— |
| Im Adm Intransl/Oral 1 Vaccine (90473) |
— |
$31 |
— |
Immunization administration (90471)
range across 3 matching MRF lines |
— |
$21.32–$31 |
— |
| Inital newborn e/m (99460) |
— |
$165 |
— |
| Iontophoresis 15 min (97033) |
— |
$54 |
— |
| Irrig Drug Delivery Device (96523) |
— |
$151 |
— |
| IV infusion hydration each additional hour (96361) |
— |
$44.10 |
— |
| IV infusion hydration initial 31 min-1 hour (96360) |
— |
$121.25 |
— |
| IV infusion ther proph addl sequential to 1 hr (96367) |
— |
$331.35 |
— |
| IV infusion therapy prophylaxis/dx ea hour (96366) |
— |
$40.80 |
— |
| IV push initial (96374) |
— |
$94.40 |
— |
| Low frequency non-thermal us (97610) |
— |
$121 |
— |
| Lwr Xtr Vasc Stdy Bilat (93924) |
— |
$675 |
— |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) |
— |
$52.15 |
— |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) |
— |
$56.85 |
— |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) |
— |
$30 |
— |
| Methacholine challenge (94070) |
— |
$64 |
— |
| Motion Fluoroscopy/Swallow (92611) |
— |
$339.85 |
— |
| Multiple Sleep Latency Test (95805) |
— |
$1,460.85 |
— |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) |
— |
$676.65 |
— |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) |
— |
$733.40 |
— |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) |
— |
$60 |
— |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) |
— |
$70 |
— |
Neuromuscular Reeducation (97112)
range across 2 matching MRF lines |
— |
$59.10–$65 |
— |
| Newborn resuscitation (99465) |
— |
$252 |
— |
| Oral Function Therapy (92526) |
— |
$189.35 |
— |
| Orthc/Prostc Mgmt Sbsq Enc (97763) |
— |
$61.40 |
— |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) |
— |
$61.40 |
— |
| Osteopathic Manipulative Tx 1-2 Body Regions (98925) |
— |
$58 |
— |
Osteopathic manipulative tx 3-4 body regions (98926)
range across 2 matching MRF lines |
— |
$82–$115.25 |
— |
| Osteopathic manipulative tx 5-6 body regions (98927) |
— |
$106 |
— |
| Osteopathic manipulative tx 7-8 body regions (98928) |
— |
$126 |
— |
| Osteopathic manipulative tx 9-10 body regions (98929) |
— |
$139 |
— |
| Ot eval high complexity (97167) |
— |
$194.55 |
— |
| Ot Eval Low Complex (97165) |
— |
$194.55 |
— |
| Ot Eval Moderate Complexity (97166) |
— |
$194.55 |
— |
| Ot manual therapy 15 min (97140) |
— |
$50 |
— |
| Ot paraffin bath (97018) |
— |
$44.10 |
— |
| Ot Prosthetic Training, Each 15 Min (97761) |
— |
$63.70 |
— |
| Ot Re-Eval Est Plan Care (97168) |
— |
$164 |
— |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) |
— |
$215 |
— |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) |
— |
$200 |
— |
| Peripheral arterial disease rehab per session (93668) |
— |
$60 |
— |
| Phlebotomy therapeutic (99195) |
— |
$205.50 |
— |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) |
— |
$115.50 |
— |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) |
— |
$115.50 |
— |
| Physical Performance Test (97750) |
— |
$55 |
— |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) |
— |
$235 |
— |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) |
— |
$24.25 |
— |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) |
— |
$29.80 |
— |
| Psych diag eval w/med srvcs (90792) |
— |
$307 |
— |
| Psychiatric diagnostic evaluation (90791) |
— |
$278 |
— |
| Psychological tst eval svc phys/qhp first hour (96130) |
— |
$196 |
— |
| Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) |
— |
$72 |
— |
| Pt Eval High Complex (97163) |
— |
$155 |
— |
| Pt eval low complex 20 min (97161) |
— |
$159 |
— |
| Pt Eval Mod Complex (97162) |
— |
$159 |
— |
| Pt gait training 15 min (97116) |
— |
$50 |
— |
| Pt mechanical traction (97012) |
— |
$35 |
— |
| Pt Re-Eval Est Plan Care (97164) |
— |
$120.55 |
— |
| Pulm function test by gas (94727) |
— |
$65 |
— |
Pulmonary Stress Testing (94618)
range across 2 matching MRF lines |
— |
$60–$255 |
— |
| Pure Tone Audiometry Air (92552) |
— |
$74.15 |
— |
| Remote 30 Day Ecg Rev/Report (93270) |
— |
$125.30 |
— |
| Respiratory flow volume loop (94375) |
— |
$55 |
— |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) |
— |
$180 |
— |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) |
— |
$363 |
— |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) |
— |
$151.10 |
— |
| Same day nb discharge (99463) |
— |
$198.50 |
— |
Self Care Mngment Training (97535)
range across 2 matching MRF lines |
— |
$60–$66.65 |
— |
| Sensory Integration Ea 15 Min (97533) |
— |
$63.70 |
— |
| Sleep study unattended (95806) |
— |
$108 |
— |
| Slp Stdy Unatnd W/Anal (95801) |
— |
$457 |
— |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) |
— |
$533 |
— |
| Speech Audiometry Complete (92556) |
— |
$96 |
— |
| Speech audiometry threshold (92555) |
— |
$64.05 |
— |
| Speech sound lang comprehen (92523) |
— |
$295.25 |
— |
Spirometry (94010)
range across 2 matching MRF lines |
— |
$249.25–$262.50 |
— |
| Stress Tte Only (93350) |
— |
$1,539.95 |
— |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) |
— |
$90 |
— |
| Ther Ivntj Ea Addl 15 Min (97130) |
— |
$90 |
— |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) |
— |
$23.20 |
— |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) |
— |
$199.15 |
— |
| Ther/Proph/Diag Inj Sc/Im (96372) |
— |
$44.10 |
— |
| Ther/Proph/Diag Iv Inf Init (96365) |
— |
$431.55 |
— |
Therapeutic Activities (97530)
range across 2 matching MRF lines |
— |
$60–$67.80 |
— |
| Tobacco Use Cessation Intensive >10 Minutes (99407) |
— |
$49 |
— |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) |
— |
$28 |
— |
| Trans Care Mgmt 14 Day Disch (99495) |
— |
$329 |
— |
| Trans Care Mgmt 7 Day Disch (99496) |
— |
$444 |
— |
| Tte w/doppler, complete (93306) |
— |
$1,331.10 |
— |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) |
— |
$200.95 |
— |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) |
— |
$163.85 |
— |
| Tx/Pro/Dx Inj New Drug Addon (96375) |
— |
$44 |
— |
| Tympanometry (92567) |
— |
$74.15 |
— |
| Unlisted otorhinolaryngological service (92700) |
— |
$111.15 |
— |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) |
— |
$225 |
— |
| Vent Mgmt Inpat Init Day (94002) |
— |
$1,206.50 |
— |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) |
— |
$1,028 |
— |
Wheelchair Mgmt Ea 15 Min (97542)
range across 2 matching MRF lines |
— |
$66–$67 |
— |
| Whirlpool Therapy (97022) |
— |
$45 |
— |