Procedures & surgery prices at Intermountain Health St. Mary's Regional Hospital

Grand Junction, CO · every code in this section with a posted price and a Medicare benchmark.

700 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abd paracentesis (49082) $2,873.75
Abd paracentesis w/imaging (49083) $4,880.25
Ablation 1/> liver tumor perq cryoablation (47383) $14,733.20
Ablation bone tumor rf perq w/img gdn when done (20982) $16,067.45
Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when… (32998) $12,068.20
Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when… (32994) $11,443.40
Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy (50593) $14,345.45
Ablatj bone tumor cryo perq w/img gdn when prfmd (20983) $20,633.15
Amniocentesis diagnostic (59000) $1,751.45
Amniocentesis therapeutic (59001) $798.20
Anchoring of extending tendon of fingers to wrist bone (25301) $8,340.15
Anoscopy diagnostic (46600) $378.80
Anoscopy remove for body (46608) $2,710.15
App skn sub grft t/a/l area/<100scm /<1st 25 scm (15271) $2,708.38
App skn subgrft t/a/l area/100sq cm 1st 100sq cm (15273) $4,178.12
Application cast finger (29086) $467.25
Application Finger Splint Dynamic (29131) $181.40
Application finger splint static (29130) $378.80
Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure) (20660) $4,765.80
Application of long leg cast (thigh to toes); (29345) $796.35
Application of long leg splint (thigh to ankle or toes) (29505) $467.25
Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic… (20697) $5,955.65
Application of short arm splint (forearm to hand); static (29125) $378.80
Application of short leg cast (below knee to toes); (29405) $796.35
Application of short leg cast (below knee to toes); walking or ambulatory type (29425) $843.65
Application of short leg splint (calf to foot) (29515) $467.25
Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or… (15277) $2,406.18
Application of vein wound compression bandages on lower leg ankle and foot|BILATERAL PROCEDURE |SERV DELIV PERSONALLY… (29581) $1,056.65
Application of walking cast covering thigh to toe|SERV DELIV PERSONALLY BY PT OR UNDER AN OP PLAN OF CARE (29355) $1,094.98
Application rigid total contact leg cast (29445) $843.65
Application, cast; shoulder to hand (long arm) (29065) $796.35
Apply hand/wrist cast (29085) $467.25
Apply long arm splint (29105) $467.25
Apply splint short arm dynamic (29126) $378.80
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $1,494.38
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) $2,427.55
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $1,828.62
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $4,060.45
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $1,045.72
Arthrocnt aspir&/inj small jt/bursaw/us rec rprt (20604) $2,768.82
Aspirate pleura w/o imaging (32554) $1,811.52
Aspiration and/or injection of ganglion cyst(s) any location (20612) $789.65
Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous Age Under 21 (50390) $10,231.90
Aspiration and/or injection thyroid cyst (60300) $1,707.55
Aspiration bladder insert suprapubic catheter (51102) $2,734.85
Aspiration bladder needle (51100) $732.85
Aspiration of fluid from cyst of spinal cord or fluid-filled cavity (62268) $3,254.20
Avulsion of nail plate, partial or complete, simple; single (11730) $243.55
Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent Age… (47556) $19,259.05
Biliary ndsc prq t-tube w/dil duct w/o stent (47555) $4,913.25
Biopsy bone trocar/needle deep (20225) $2,632.50
Biopsy liver needle percutaneous (47000) $7,488.35
Biopsy lymph node (38505) $3,547.70
Biopsy muscle percutaneous needle (20206) $3,884.05
Biopsy of anorectal wall, anal approach (eg, congenital megacolon) (45100) $6,541.45
Biopsy of cervix (57500) $1,751.45
Biopsy of salivary gland; needle (42400) $1,775.70
Biopsy of uterus lining (58100) $831.90
Biopsy pleura percutaneous needle (32400) $2,561.35
Biopsy soft tissue neck/thorax (21550) $4,333.65
Biopsy thyroid percutaneous core needle (60100) $1,707.55
Biopsy vaginal mucosa simple (57100) $2,383.85
Biopsy vulva/perineum 1 lesion (56605) $1,751.45
Biopsy, abdominal or retroperitoneal mass, percutaneous needle Age Under 21 (49180) $2,981.40
Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs) Age Under 21 (20220) $2,416.90
Bladder irrigation (51700) $882.85
Blepharotomy, drainage of abscess, eyelid Age Under 21 (67700) $1,187.75
Brain canal shunt procedure (61070) $2,044.65
Brnchsc ebus guided sampl 1/2 node station/strux (31652) $7,654.50
Brnchsc ebus guided sampl 3/> node station/strux (31653) $9,506.60
Bronch foreign body removal (31635) $5,032.85
Bx breast 1st lesion us imag (19083) $6,819.85
Bx pancreas ndl perc (48102) $4,190.15
Cardiac surg procedure unlist (33999) $24,598.38
Cast short arm (29075) $796.35
Cessation thrombolytic thrpy w/catheter removal (37214) $7,603.85
Change Cystostomy Tube Simple (51705) $1,150.65
Change g-tube to g-j perc (49446) $3,070.65
Change of cystostomy tube; complicated Age Under 21 (51710) $1,159.40
Change of windpipe airway (31502) $303.50
Chemical cauterization of granulation tissue (17250) $673.80
Chemodenervation muscle neck unilat for dystonia (64616) $894.10
Chemodervate facial/trigem/cerv musc migraine (64615) $877.65
Chest tube placement (32551) $1,989.85
Chng urtrost tube/xtrnlly accessible stent ileal (50688) $5,148.62
Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when… (47490) $3,674.40
Circumcision, Newborn (54150) $540
Closed rx acetabular fx (27220) $961.52
Closed rx humer epicondylr fx,manip (24565) $6,552.98
Closed rx radial shaft fx w/dislocation (25520) $6,552.98
Closed rx ulna shaft fx,manipulatn (25535) $961.52
Closed treatment of acromioclavicular dislocation; without manipulation (23540) $699.30
Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation Age Under 21 (27842) $6,552.98
Closed treatment of articular fx,metacarpophalangeal or interphalangeal joint; w/o manip, each (26740) $699.30
Closed treatment of calcaneal fracture; without manipulation (28400) $699.30
Closed treatment of carpal bone fracture; without manipulation (25630) $699.30
Closed treatment of carpal scaphoid (navicular) fracture; without manipulation (25622) $699.30
Closed treatment of clavicular fracture; with manipulation (23505) $6,552.98
Closed treatment of clavicular fracture; without manipulation (23500) $699.30
Closed treatment of dislocated joint between collar and chest bone with manipulation (23525) $961.52
Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction… (27517) $6,552.98
Closed treatment of distal fibular fracture (lateral malleolus); with manipulation (27788) $699.30
Closed treatment of distal fibular fracture (lateral malleolus); without manipulation (27786) $699.30
Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each (26750) $699.30
Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation Age Under 21 (27510) $6,552.98
Closed treatment of femoral fracture, proximal end, neck; without manipulation Age Under 21 (27230) $961.52
Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction Age Under 21 (27502) $6,552.98
Closed treatment of fracture of orbit, except blowout; without manipulation Age Under 21 (21400) $1,631.50
Closed treatment of greater trochanteric fracture, without manipulation Age Under 21 (27246) $699.30
Closed treatment of hip dislocation, traumatic; requiring anesthesia (27252) $6,552.98
Closed treatment of humeral shaft fracture; without manipulation (24500) $699.30
Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with… (27240) $13,105.95
Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation Age… (27238) $6,552.98
Closed treatment of knee dislocation; requiring anesthesia Age Under 21 (27552) $6,552.98
Closed treatment of knee dislocation; without anesthesia (27550) $961.52
Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction Age Under 21 (27762) $6,552.98
Closed treatment of medial malleolus fracture; without manipulation (27760) $699.30
Closed treatment of metacarpal fracture, single; with manipulation, each bone (26605) $699.30
Closed treatment of metacarpal fracture, single; without manipulation, each bone (26600) $699.30
Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of… (24620) $6,552.98
Closed treatment of patellar fracture, without manipulation (27520) $699.30
Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each (26720) $699.30
Closed treatment of post hip arthroplasty dislocation; requiring general anesthesia (27266) $6,552.98
Closed treatment of proximal fibula or shaft fracture; with manipulation (27781) $6,552.98
Closed treatment of proximal fibula or shaft fracture; without manipulation (27780) $699.30
Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without… (23605) $6,552.98
Closed treatment of proximal humeral fracture; without manipulation (23600) $699.30
Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia Age Under 21 (27831) $13,197.40
Closed treatment of radial and ulnar shaft fractures; without manipulation (25560) $699.30
Closed treatment of radial head or neck fracture; without manipulation (24650) $699.30
Closed treatment of radial shaft fracture; without manipulation (25500) $699.30
Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation (25660) $961.52
Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation Age Under 21 (23665) $6,552.98
Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) $961.52
Closed treatment of sternoclavicular dislocation; without manipulation Age Under 21 (23520) $6,552.98
Closed treatment of sternum fracture Age Under 21 (21820) $699.30
Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with… (27503) $6,552.98
Closed treatment of talotarsal joint dislocation; requiring anesthesia Age Under 21 (28575) $13,197.40
Closed treatment of talus fracture; with manipulation Age Under 21 (28435) $6,552.98
Closed treatment of talus fracture; without manipulation (28430) $961.52
Closed treatment of tibial fracture, proximal (plateau); without manipulation (27530) $699.30
Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation (25680) $961.52
Closed treatment of ulnar fracture, proximal end; without manipulation (24670) $699.30
Closed treatment of ulnar shaft fracture; without manipulation (25530) $699.30
Closed treatment of ulnar styloid fracture (25650) $699.30
Closed tx ankle dislocation w/o anesthesia (27840) $699.30
Closed tx bimalleolar ankle fracture w/manj (27810) $4,765.80
Closed tx bimalleolar ankle fracture w/o manip (27808) $699.30
Closed tx femoral fracture prox head w/manj (27268) $13,197.40
Closed tx femoral fracture prox head w/o manj (27267) $13,197.40
Closed tx femoral shaft fx w/o manipulation (27500) $699.30
Closed tx mandibular fracture w/manipulation (21451) $4,522.20
Closed tx mandibular fracture w/o manipulation (21450) $1,631.50
Closed tx mandibular fx w/interdental fixation (21453) $17,365.15
Closed tx metatarsal fracture w/o manipulation (28470) $699.30
Closed tx nose/jaw fx (21345) $4,522.20
Closed tx patellar dislocation w/anesthesia (27562) $961.52
Closed tx patellar dislocation w/o anesthesia (27560) $699.30
Closed tx radial shaft fracture w/manipulation (25505) $4,765.80
CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee (25565) $4,765.80
Closed tx scapular fracture w/o manipulation (23570) $699.30
Closed tx septal&nose fx (21337) $9,547.05
Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/o manip (24530) $699.30
Closed tx talotarsal joint dislc w/o anes (28570) $961.52
Closed tx tarsometatarsal dislocation w/anes (28605) $699.30
Closed tx tarsometatarsal dislocation w/o anes (28600) $699.30
Closed tx temporomandibular dislc comp 1st/sbsq (21485) $6,218.02
Closed tx vert fx w/manj (22315) $9,598.10
Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) $724.30
Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) $1,631.50
Clsd tx acromioclavicular dislc w/manipulation (23545) $961.52
Clsd tx nsl fx mnpj wo stblj (21315) $4,522.20
Clsd tx nsl fx w/mnpj&stablj (21320) $9,547.05
Clsd tx pelvic ring fx (27197) $699.30
Clsd tx pelvic ring fx w/manipulation w/anes (27198) $699.30
Clsd tx shoulder dislc w/manipulation req anes (23655) $6,552.98
Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) $4,765.80
Cltx carpo/metacarpal dislocation thumb w/manj (26641) $699.30
Cltx distal femoral epiphysl separation w/o manj (27516) $699.30
CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA TechFee (26755) $699.30
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $699.30
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $4,765.80
Cltx fem fx dstl end medial/lat condyle w/o manj (27508) $699.30
Cltx fem fx prox end nck w/manj w/wo skel tracj (27232) $1,923.02
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $699.30
Cltx greater humeral tuberosity fx w/o mnpj (23620) $699.30
Cltx grter humeral tuberosity fx w/manipulation (23625) $6,552.98
Cltx hip dislocation traumatic w/o anesthesia (27250) $961.52
Cltx humeral condylar fx medial/lat w/o manj (24576) $699.30
Cltx humeral epicondylar fx medial/lat w/o manj (24560) $699.30
CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ TechFee (24505) $4,765.80
Cltx intercondylar spi&/tubrst fx kne w/wo man (27538) $699.30
Cltx interphalangeal joint dislocation req anes (28665) $796.35
Cltx interphalangeal joint dislocation w/o anes (28660) $699.30
CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee (26700) $699.30
Cltx metar fx w/manj (28475) $699.30
Cltx metatarsophlngl jt dislc req anes (28635) $4,765.80
Cltx post ankle fx (27767) $699.30
Cltx prox tibfib jt dislc w/o anes (27830) $961.52
Cltx scapular fx w/mnpj w/wo skeletal traction (23575) $6,552.98
Cltx sprcndylr/transcndylr humeral fx w/manj (24535) $6,552.98
Cltx sprcndylr/trnscndylr fem fx w/o manj (27501) $699.30
Cltx tarsal dislc oth/thn talotarsal w/o anes (28540) $961.52
CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee (27752) $4,765.80
Cltx tibial shaft fx w/o manipulation (27750) $699.30
Cltx trimalleolar ankle fx w/manipulation (27818) $8,340.15
Cltx trimalleolar ankle fx w/o manipulation (27816) $699.30
Collect blood from catheter venous nos (36592) $261.25
Collect blood from implant venous access device (36591) $190.75
Colposcopy cervix (57452) $414.20
Colposcopy entire vagina w/cervix if present (57420) $926.20
Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix Age Under 21 (57455) $1,059.90
Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage Age… (57454) $963.60
Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix Age Under 21 (57460) $5,505.40
Colposcopy vulva (56820) $457.35
Colposcopy w/endocervical curettage (57456) $1,059.90
Complete replacement picc rs&i (36584) $2,814.85
Complex cystometrogram voiding pressure studies (51728) $2,002.40
Contrast injection perq radiologic eval gi tube (49465) $1,209.25
Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image… (36598) $1,088
Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) $378.80
Conv ext bil drg cath to int-ext bil drg cath (47535) $8,549.35
Convert nephrostomy cath to nephrourtrl cath prq (50434) $3,511.45
Conz of cervix w/scope leep (57461) $6,056
Core needle bx lung/mediastinum perq w/img (32408) $9,334.75
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $378.80
Ctrl nsl hemrrg pst nasal packs&/cautery subsq (30906) $724.30
Curettage postpartum (59160) $9,270.50
Cystoscopy and treatment (52310) $4,025.05
Debridement of extensive eczematous or infected skin; up to 10% of body surface (11000) $1,862.35
Debridement of nail(s) by any method(s); 1 to 5 (11720) $174.25
Debridement of nail(s) by any method(s); 6 or more (11721) $174.25
DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee (11042) $1,223
Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm… (11044) $3,463.50
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm… (11043) $1,036.90
Declot vascular device (36593) $1,058.50
Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to… (62287) $12,125.80
Delivery of placenta (59414) $7,421.35
Destruction benign lesions up to 14 (17110) $367.55
Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus Age Under 21 (64680) $3,238.70
Destruction neurolytic agt genicular nerve w/img (64624) $5,581.15
Diagnostic bone marrow aspirations (38220) $2,339.88
Diagnostic bone marrow biopsies (38221) $2,442.02
Diagnostic bone marrow biopsies & aspirations (38222) $6,084.55
Diagnostic lumbar spinal puncture w/fluor or CT (62328) $6,884.70
Dilation of esophagus, by unguided sound or bougie, single or multiple passes Age Under 21 (43450) $2,688
Drain bladder by trocar/cath (51101) $3,100.30
Drain lower leg lesion (27603) $8,425.80
Drain neck/chest lesion (21501) $8,018.70
Drain shoulder lesion (23030) $8,425.80
Drainage abscess or hematoma, nasal, internal approach (30000) $724.30
Drainage external auditory canal, abscess (69020) $2,086.30
Drainage external ear, abscess or hematoma; complicated Age Under 21 (69005) $4,807.55
Drainage external ear, abscess or hematoma; simple (69000) $2,086.30
Drainage finger abscess simple (26010) $593.65
Drainage of abscess of palate, uvula (42000) $724.30
Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated (40801) $1,631.50
Drainage of abscess, cyst, hematoma, vestibule of mouth; simple (40800) $2,086.30
Drainage of finger abscess; complicated (eg, felon) (26011) $4,807.55
Drainage of nose lesion (30020) $1,631.50
Drainage of scrotal wall abscess (55100) $4,807.55
Drainage of scrotum (54700) $6,039.70
Drainage of tonsil abscess (42700) $724.30
Ed proc insert intraosseous IV (36680) $935
Ed proc insj temp ndwellg bladder catheter complicated (51703) $483.75
Ed proc remve fb nasal- hospital (30300) $378.80
Ed prof artl pnxr w/drawal bld dx (36600) $260
Ed prof burn - large - hospital (16030) $1,182.40
Ed prof burn medium - hospital (16025) $260.60
Ed prof burn small - hospital (16020) $260.60
Ed prof catheterization/straight (51701) $378.80
Ed prof closed tx post hip arthroplasty (27265) $961.52
Ed prof closed tx pst malleolus fx w/manipulation (27768) $4,765.80
Ed prof closed tx radial head/neck fx w/manipulation (24655) $6,552.98
Ed prof drain dental abscess-hospital (41800) $378.80
Ed prof insert foley cath simple (51702) $333.55
Ed prof insert non tunnel cv cath >5 (36556) $5,628.50
Ed prof insertion of heart electr (33210) $14,159.95
Ed prof int lac 12.6-20cm bd - hospital (12035) $1,182.40
Ed prof int lac 7.6-12.5cm bd - hospital (12034) $1,182.40
Ed prof interphalangeal dislocation- hospital (26770) $699.30
Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) $549.30
Egd percutaneous placement gastrostomy tube (43246) $3,318.60
Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision (34201) $14,551.50
Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision (34203) $14,551.50
Endocervical curettage (57505) $1,751.45
Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective… (61623) $20,028.55
Endoven abltj incmptnt vein mchnchem 1st vein (36473) $13,918.65
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring,… (36478) $13,061.82
Er inj anesthetic agent, peripheral nerve or branch (64450) $2,176.68
Escharotomy 1st incision (16035) $1,182.40
Evac subungual hematoma (11740) $378.80
Exc h-f-nk-sp b9+marg 0.5/< (11420) $3,733.50
Exc tr-ext b9+marg 1.1-2 cm (11402) $2,086.30
Exchange biliary drg catheter prq w/img gid rs&i (47536) $8,549.35
Exchange nephrostomy catheter prq w/img gid rs&i (50435) $7,198.65
Exchange transfusion, blood; newborn Age Under 21 (36450) $1,778.75
Exchng absc/cst drg cath rad gid spx (49423) $4,993.85
Excision of superficial tracheostomy lesions and/or granulation tissue (31899) $604.25
Excision of thrombosed hemorrhoid, external (46320) $3,499.25
Exploration with removal of deep foreign body, forearm or wrist (25248) $6,552.98
External cannula declotting (separate procedure); with balloon catheter Age Under 21 (36861) $17,203.20
Fetal contraction stress test (59020) $1,019.90
Fine needle aspiration bx w/CT gdn 1st lesion (10009) $2,249.25
Fine needle aspiration bx w/fluor gdn 1st lesion (10007) $2,249.25
Fine needle aspiration bx w/o img gdn 1st lesion (10021) $1,393.30
Fine needle aspiration bx w/us gdn 1st lesion (10005) $2,877.45
Ganglion impar nerve block (64999) $927.80
Gastric lavage (43753) $787
Guide cathet fluid drainage (10030) $3,089.25
Harvest auto stem cells (38206) $2,176.20
I&d abscess simple/single (10060) $559.90
I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION TechFee (27301) $8,425.80
I&d hematoma/seroma/fluid (10140) $7,213.85
I&d pilonidal cyst simple (10080) $2,086.30
I&d upper arm/elbow deep abscess/hematoma (23930) $11,585.50
Image fluid collxn drainag cath transrec/vaginal (49407) $7,706.55
Image-guide fluid collxn drainage cath visc perq (49405) $4,841.85
Img-guide fluid collxn drainag cath periton perq (49406) $7,800.05
Incise external hemorrhoid (46083) $732.85
Incise/drain eyelid lining (68020) $4,127.95
INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee (10061) $1,329.55
Incision and drainage of Bartholin's gland abscess (56420) $590.90
Incision and drainage of pilonidal cyst; complicated (10081) $3,129.45
Incision and drainage of submucosal abscess, rectum (45005) $3,499.25
Incision and drainage of vulva or perineal abscess (56405) $951.30
Incision and drainage, complex, postoperative wound infection Age Under 21 (10180) $7,777.80
Incision and drainage, forearm and/or wrist; bursa Age Under 21 (25031) $6,552.98
Incision and drainage, forearm and/or wrist; deep abscess or hematoma Age Under 21 (25028) $13,197.40
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma Age Under 21 (26990) $20,446.85
Incision and drainage, perianal abscess, superficial (46050) $2,710.15
Incision and drainage, upper arm or elbow area; bursa Age Under 21 (23931) $6,610.40
Incision and removal of foreign body, subcutaneous tissues; complicated (10121) $4,807.55
Incision and removal of foreign body, subcutaneous tissues; simple (10120) $1,266.95
Incision of rectal abscess (46040) $3,499.25
Incision&drainage bursa foot (28001) $4,807.55
Incisional biopsy skin single lesion (11106) $2,169.65
Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22… (0202U) $1,549.18
Infusion of drug to dissolve blood clot in brain (37195) $1,309.35
Initial treatment, first degree burn, when no more than local treatment is required (16000) $593.65
Inj epidural blood or clot patch (62273) $2,472.50
Inj paravert f jnt c/t 1 lev (64490) $2,702.80
Inj paravert f jnt l/s 1 lev (64493) $2,702.80
Inj tx nerve (64640) $1,819.10
Inj,Anes Agent,Femoral Nerve,Single (64447) $1,677.35
Injctn, abdmnl abscss/fstla, w sft tsse sub (amnfx) w/wo img gdnc/cntrst (49999) $10,790.35
Injection aa&/strd axillary nerve w/img gdn (64417) $2,702.80
Injection aa&/strd brachial plexus w/img gdn (64415) $2,702.80
Injection aa&/strd greater occipital nerve (64405) $1,207.60
Injection aa&/strd ilioinguinal ih nerves (64425) $1,583.05
Injection aa&/strd intercostal nrv ea addl lvl (64421) $2,093.20
Injection aa&/strd intercostal nrv single lvl (64420) $1,614.65
Injection aa&/strd pudendal nerve (64430) $2,702.80
Injection aa&/strd sciatic nerve w/img gdn (64445) $2,050.65
Injection aa&/strd suprascapular nerve (64418) $2,050.65
Injection aa&/strd trigeminal nerve each branch (64400) $878.25
Injection aa&/strd vagus nerve (64408) $878.25
Injection for identification of sentinel node (38792) $2,473.42
Injection px prq tx extremity pseudoaneurysm (36002) $1,729.55
Injection sclerosant multiple incmptnt veins (36471) $1,074.45
Injection sclerosant single incmptnt vein (36470) $1,320.75
Injection therapeutic carpal tunnel (20526) $736.30
Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve Age Under 21 (64435) $2,819.62
Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) $933.60
Injection(s); single or multiple trigger point(s), 3 or more muscle(s) (20553) $942.35
Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) (20550) $1,360.35
Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring Age Under 21 (64530) $3,092.30
Ins cath ren art 1st bilat (36252) $16,385.45
Ins cath ren art 1st unilat (36251) $10,959.90
Ins cath ren art 2nd+ bilat (36254) $16,385.45
Ins cath ren art 2nd+ unilat (36253) $10,959.90
Ins intrvas vc filtr w/wo vas acs vsl selxn rs&i (37191) $24,272.25
Ins vag brachytx device (57156) $1,704.30
Ins/rplcmnt perm subq impltbl dfb w/subq eltrd (33270) $69,410.15
Insert and remove bone pin (20650) $9,598.10
Insert gastrostomy tube percutaneous (49440) $5,688.20
Insert heart pm atrial (33206) $26,977.85
Insert non-tunnel cv cath < 5 y/o (36555) $6,489.80
Insert pulse gen mult leads (33221) $29,481.85
Insert tun ip cath w/port (49419) $16,633.60
Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) $10,756.40
Insertion indwelling tunneled pleural catheter (32550) $11,388.65
Insertion of implantable defibrillator pulse generator only; with existing single lead Age Under 21 (33240) $44,675.40
Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular Age Under 21 (33207) $27,212.40
Insertion of pacemaker pulse generator only; with existing dual leads Age Under 21 (33213) $20,970.90
Insertion of pacemaker pulse generator only; with existing single lead Age Under 21 (33212) $20,081.80
Insertion of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein… (37182) $22,798.20
Insertion of tube into airway for aspiration of secretions (31720) $627.45
Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older Age… (36561) $12,398.40
Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or… (36558) $14,054.40
Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) Age Under 21 (33211) $14,165.70
Insertion picc w/o img gdn 5 yr/> (36569) $2,697.55
Insertion picc w/rs&i 5 yr/> (36573) $2,697.55
Insertion subq cardiac rhythm monitor w/prgrmg (33285) $13,456.20
Insertion tunnel intraperitoneal cath dial open (49421) $11,565.60
Insj 1 transvns eltrd perm pacemaker/impltbl dfb (33216) $12,582.55
Insj 2 transvns eltrd perm pacemaker/impltbl dfb (33217) $12,582.55
Insj eltrd car ven sys attch prev pm/dfb pls gen (33224) $15,786.30
Insj intraperitoneal catheter w/img guid (49418) $15,848.35
Insj of subq implantable defibrillator electrode (33271) $12,767.70
Insj/rplcmt perm dfb w/trnsvns lds 1/dual chmbr (33249) $52,837.10
Insrt heart pm atrial & vent (33208) $29,647.20
Insrt pulse gen w/dual leads (33230) $51,367.80
Insrt pulse gen w/mult leads (33231) $52,652
Intraoral i&d tongue/floor lingual (41000) $1,631.50
Intraoral i&d tongue/floor masticator space (41009) $1,631.50
Intraoral i&d tongue/floor sublngl supfc (41005) $724.30
Intraoral i&d tongue/floor submental space (41007) $4,522.20
Intraoral i&d tongue/floor submndblr space (41008) $9,547.05
Intro cath dialysis circuit dx angrph fluor s&i (36901) $2,342.90
Intro cath dialysis circuit w/tcat plmt IV stent (36903) $50,999.60
Intro cath dialysis circuit w/trluml balo angiop (36902) $17,185.90
Intubation endotracheal (31500) $1,856.95
Laryngoscopy flex diagnostic (31575) $486.70
Laryngoscopy flx rmvl foreign body(s) (31577) $1,210.80
Laryngoscopy w/foreign body removal (31530) $5,032.85
Long gi tube placement (44500) $1,656.75
Lumbar puncture (62270) $3,022.85
Marsupialization bartholin's gland cyst (56440) $9,270.55
Mastotomy expl drg absc dp (19020) $4,807.55
Meas post-voiding residual urine&/bladder cap (51798) $349.95
Mechanical removal obstructive material from nonvascular catheter/device (32999) $2,027.45
Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen… (36596) $2,814.85
Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate… (36595) $14,054.40
Medial canthopexy (21280) $699.30
Myelography via lumbar inject rs&i lumbosacral (62304) $6,031.75
Myelography via lumbar injection rs&i 2+ regions (62305) $6,031.75
Myelography via lumbar injection rs&i cervical (62302) $6,349.20
Myelography via lumbar injection rs&i thoracic (62303) $6,349.20
Needle insertion w/o injection 1 or 2 muscles (20560) $67.22
Needle insertion w/o injection 3 or more muscles (20561) $67.22
Nfct ds DNA untrgt ngnrj seq (0152U) $6,378.60
Njx aa&/strd tfrm epi c/t 1 (64479) $2,702.80
Njx cholangio prq w/img gid rs&i existing access (47531) $5,212.35
Njx cholangio prq w/img gid rs&i new access (47532) $5,463.85
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) $2,329.25
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62327) $2,702.80
Njx px antegrde nfrosgrm &/urtrgrm exstng acess (50431) $3,836.68
Njx px antegrde nfrosgrm &/urtrgrm new access (50430) $4,114.95
Non stress test (59025) $964.75
Nonslctv cath thor aorta angio intr/xtrcranl art (36221) $22,108.55
Obstructive material removal from gi tube (49460) $2,931.10
Onc Pan-Tumor DNA & RNA Next-Generation Sequencing Other Outpatient (0211U) $25,365
Open/perq placement intravascular stent initial (37236) $34,935.35
Open/perq placement intravascular stent same 1st (37238) $33,479.70
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions (11056) $353.70
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion (11055) $353.70
Perc rf ablate renal tumor (50592) $11,982.90
Percut ablate liver rf (47382) $14,733.20
Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic… (62267) $2,826.60
Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic… (37188) $30,711
Pericardiocentesis w/img guidance when performed (33016) $2,006.55
Perq breast loc device placemt 1st lesio mr guid (19287) $3,701.60
Perq dev breast 1st us imag (19285) $3,707.35
Perq dilation xst trc endourologic px w/img (50436) $20,249.38
Perq dilation xst trc new access renal coltj sys (50437) $21,169.80
Perq drainage pleura insert cath w/imaging (32557) $3,366.22
Perq drainage pleura insert cath w/o imaging (32556) $3,366.22
Perq replacement gtube not req revj gstrst trc (43762) $1,479.85
Perq thrmbc/nfs dial circuit tcat plmt IV stent (36906) $64,860.45
Perq thrmbc/nfs dial circuit trluml balo angiop (36905) $48,028.35
Perq thrmbc/nfs dialysis circuit img dx angrph (36904) $16,498.95
Perq vert agmntj cavity crtj uni/bi cannulation (22513) $15,218.10
Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) $21,876.05
Perq vertebroplasty uni/bi injection lumbosacral (22511) $11,183
Perq vertebroplasty uni/bi injx cervicothoracic (22510) $11,183
Phleb veins - extrem 20+ (37766) $7,005.10
Place duod/jej tube perc (49441) $5,435.20
Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous,… (49411) $5,350.85
Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via… (55876) $3,533.15
Plmt access thru biliary tree into small bwl new (47541) $8,599.60
Plmt bile duct stent prq existing access (47538) $9,040.65
Plmt bile duct stent prq new access w/o sep cath (47539) $9,323.20
Plmt bile duct stent prq new access w/sep cath (47540) $9,605.70
Plmt nephrostomy cath prq new access rs&i (50432) $22,889.90
Plmt nephroureteral cath prq new access rs&i (50433) $26,460.80
Plmt sft tiss loclzj dev perq 1st lesion (10035) $1,675.70
Plmt urtrl stent prq new access w/sep nfros cath (50695) $12,507.15
Plmt urtrl stent prq pre-existing nfros tract (50693) $11,702.62
Plmt urtrl stnt prq new acess w/o sep nfros cath (50694) $12,434.02
Pr closed treatment sesamoid fracture (28530) $961.52
Prim prq trluml mchnl thrmbc n-cor n-icra 1st (37184) $34,226.40
Proctosigmoidoscopy fb (45307) $8,325.90
Prq impltj nstim electrode array epidural (63650) $20,552.50
Prq plmt biliary drg cath w/img gid rs&i externl (47533) $8,549.35
Prq plmt biliary drg cath w/img gid rs&i int-ext (47534) $8,549.35
Prq transcatheter rtrvl intrvas fb with imaging (37197) $26,095.70
Prq transluminal mechanical thrombectomy vein (37187) $33,405.22
Punch biopsy skin single lesion (11104) $528.95
Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) $895.90
Puncture aspiration of cyst of breast (19000) $2,033.05
Pvb thoracic single injection site w/img gid (64461) $1,973.65
Radiant-neck/chest procedure unlisted (21899) $1,727.25
Relocate skin pocket implantable defibrillator (33223) $3,480.10
Relocation of skin pocket for pacemaker (33222) $3,480.10
Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including… (50382) $10,280.48
Removal biliary drg catheter req fluor gid rs&i (47537) $3,507.85
Removal foreign body foot complicated (28193) $6,610.40
REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS TechFee (28190) $2,086.30
Removal foreign body mouth (40804) $2,688
Removal foreign body shoulder subcutaneous (23330) $6,610.40
Removal foreign body upper arm/elbow deep (24201) $11,585.50
Removal impacted cerumen irrigation/lvg unilat (69209) $450.95
Removal impacted cerumen requiring instrumentation, unilateral (69210) $462.28
Removal implantable defib pulse generator only (33241) $4,364.55
Removal of cerclage suture under anesthesia (other than local) Age Under 21 (59871) $9,270.50
Removal of fecal impaction or foreign body (separate procedure) under anesthesia (45915) $1,930.90
Removal of foreign body in muscle or tendon sheath; simple (20520) $4,807.55
Removal of foreign body in scrotum (55120) $6,039.70
Removal of foreign body in voice box using an endoscope with mirror (31511) $587.35
Removal of foreign body of upper arm or elbow area, accessed beneath the skin (24200) $4,807.55
Removal of foreign body, external eye; conjunctival superficial (65205) $378.80
Removal of foreign body, external eye; corneal, without slit lamp (65220) $1,181.50
Removal of foreign body, foot; deep (28192) $4,807.55
Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular) Age Under 21 (27087) $13,197.40
Removal of foreign body, shoulder; deep (subfascial or intramuscular) Age Under 21 (23333) $11,585.50
Removal of iud (58301) $951.30
Removal of nail bed (11750) $819.90
Removal of pm generator (33233) $14,159.95
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $383
Removal of transvenous pacemaker electrode(s); dual lead system Age Under 21 (33235) $4,473.65
Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular Age Under 21 (33234) $4,364.55
Removal of tunneled intraperitoneal catheter (49422) $10,076.55
Removal subcutaneous cardiac rhythm monitor (33286) $1,802.50
Removal tunneled cv cath (36590) $2,791.35
Removal, non-biodegradable drug delivery implant (11982) $1,181.50
Remove eyelid foreign body (67938) $1,187.75
Remove foreign body from eye (65210) $1,624.55
Remove hip foreign body (27086) $11,585.50
Remove lung catheter (32552) $2,027.45
Remove pharynx foreign body (42809) $1,181.50
Remove stent via transureth (50386) $7,722.40
Remove ureter stent percut (50384) $10,696.90
Remove vaginal foreign body (57415) $9,270.55
Remvl perm pm pls gen w/repl plse gen 2 lead sys (33228) $27,146.50
Remvl perm pm pls gen w/repl plse gen mult lead (33229) $29,481.85
Remvl perm pm plse gen w/repl plse gen sngl lead (33227) $33,625.75
Renal biopsy; percutaneous, by trocar or needle Age Under 21 (50200) $10,457.30
Repair blood vessel lesion (35226) $2,086.30
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $1,182.40
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) $1,862.35
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $1,862.35
Repair complex trunk 2.6-7.5 cm (13101) $1,862.35
Repair eyelid wound (67930) $9,527.72
Repair finger tendon (26418) $4,765.80
Repair forearm tendon/muscle (25260) $9,598.10
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) $1,182.40
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) $1,182.40
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 7.6-12.5 CM (12054) $1,182.40
Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) $1,182.40
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $1,862.35
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $1,182.40
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $1,182.40
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $1,862.35
REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) $1,182.40
REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) $1,182.40
REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM TechFee (12036) $1,862.35
Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes 5.1cm To 7.5cm (12053) $1,182.40
Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes20.1cm To 30.0cm (12056) $1,182.40
Repair Intermediate Wound Face,ears,eyelids,nose, Lips And Or Mucous Membranes Over 30.0cm (12057) $1,182.40
Repair Intermediate Wounds Of Scalp, Underarms, Truck And/or Extremities Over 30.0cm (12037) $5,407.55
Repair lac palate<2 cm (42180) $1,631.50
Repair lead pace-defib dual (33220) $13,141.60
Repair lead pace-defib one (33218) $13,141.60
Repair lip full thickness vermillion only - lac - lip rn (40650) $1,631.50
Repair lip, full thickness; up to half vertical height Age Under 21 (40652) $1,631.50
Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue (41250) $1,181.50
Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex (41252) $724.30
Repair of nail bed (11760) $1,862.35
Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or… (36575) $2,814.85
Repair palate (42182) $17,365.15
Repair tongue lacer,post 1/3 (41251) $724.30
Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm (13151) $1,862.35
Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm (13152) $1,862.35
Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm (13120) $1,862.35
Repair, complex, trunk; 1.1 cm to 2.5 cm (13100) $1,862.35
Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm (12047) $5,407.55
Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff) Age… (24341) $29,168.98
Replace duodenostomy/jejunostomy tube perq (49451) $2,931.10
Replace gastrostomy/cecostomy tube percutaneous (49450) $2,931.10
Replace tunneled cv cath (36582) $14,054.40
Replacement gastro-jejunostomy tube percutaneous (49452) $2,931.10
Reposition l ventric lead (33226) $4,459.10
Reposition venous catheter (36597) $2,814.85
Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition Age Under 21 (43761) $1,625.55
Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and… (37192) $15,186.20
Reset dislocated jaw (21480) $961.52
Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate… (36832) $18,269.10
Revj transvns intrhptc portosystemic shnt (tips) (37183) $22,798.20
Rmvl & rplcmt xtrnl accessible nephrourtrl cath (50387) $12,072.35
Rmvl embedded fb from dentalvlr struxs soft tiss (41805) $4,522.20
Rmvl embedded fb vestibule mouth comp (40805) $1,631.50
RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) $378.80
RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP TechFee (65222) $378.80
Rmvl foreign body muscle/tendon sheath deep/comp (20525) $8,425.80
Rmvl impltbl dfb pls gen w/rplcmt pls gen mlt ld (33264) $51,688.85
Rmvl impltbl dfb plse gen w/repl plse gen 1 lead (33262) $51,367.80
Rmvl impltbl dfb plse gen w/rplcmt plse gen 2 ld (33263) $55,240.95
Rmvl nfros tube req fluoro guidance (50389) $1,187.60
Rmvl of access device (36589) $2,791.35
Rmvl1/dual chmbr impltbl dfb eltrd transvns xtrj (33244) $4,364.55
Rplc gtube revj gstrst trc (43763) $1,627.80
Rplcmt compl non-tun cvc w/o subq port/pmp (36580) $2,814.85
Rplcmt compl tun cvc w/o subq port/pmp (36581) $13,351.70
Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) $1,862.35
Rpr lip fth>1half ver ht/cpx (40654) $4,522.20
Rpr tdn/musc xtnsr f/arm&/wrist prim 1 ea tdn (25270) $9,598.10
Rpsg prev implted pm/dfb r atr/r ventr electrode (33215) $4,270.10
Rtrvl intrvas vc filtr w/wo acs vsl selxn rs&i (37193) $18,223.45
Sclerotherapy fluid collection prq w/img gid (49185) $2,970.70
Sgl bloon entrscpy ercp w bloon dilation and stone removal (alt anatomy) (47999) $3,507.85
Sigmoidoscopy w/fb removal (45332) $3,499.25
SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) $593.65
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) $593.65
SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) $593.65
SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) $593.65
Simple repair f/e/e/n/l/m >30.0 cm (12018) $593.65
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) $593.65
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee (12007) $593.65
Simple Repair Superficial Wound F/e/,eyelids,n/l/ And Or Mucous Membranes 20.1cm To 30.0cm (12017) $1,182.40
Simple Repair Superficial Wound F/e/eyelids,n/l/ And Or Mucous Membranes 12.6cm To 20.0cm (12016) $1,182.40
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $593.65
Slctv cath carotid/innom art angio intrcranl art (36223) $37,940
Slctv cath carotid/innom art angio xtrcranl art (36222) $22,108.48
Slctv cath intrnl carotid art angio intrcrnl art (36224) $39,214.50
Slctv cath subclavian art angio vertebral artery (36225) $23,853.72
Slctv cath vertebral art angio vertebral artery (36226) $35,854.62
SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) $593.65
SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee (12005) $1,182.40
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $1,182.40
Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple… (15120) $4,152.10
Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children… (15100) $4,152.10
Stab phlebt varicose veins 1 xtr 10-20 stab incs (37765) $6,713.20
Strapping ankle (29540) $467.25
Strapping elbow or wrist (29260) $181.40
Strapping hand/finger (29280) $181.40
Strapping hip (29520) $520.85
Strapping of knee (29530) $378.80
Strapping of shoulder (29240) $378.80
Strapping of toes (29550) $181.40
Strapping unna boot (29580) $1,067.42
Sub grft f/s/n/h/f/g/m/d <100sq cm 1st 25 sq cm (15275) $2,708.38
Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full… (67935) $9,527.72
Tangential biopsy skin single lesion (11102) $528.95
Tcat insj/rpl perm leadless pacemaker rv w/img (33274) $24,788.55
Therapeutic apheresis; for plasma pheresis Age Under 21 (36514) $10,773
Therapeutic spinal pnxr drainage csf w/fluor/CT (62329) $2,928.45
Therapeutic spinal puncture drainage csf (62272) $2,782.05
Thermal dstrj intraosseous bvn 1st 2 lmbr/sac (64628) $39,026.40
Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) $4,007.75
Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); Age Under 21 (35875) $14,551.50
Thrombolysis art/venous infsn w/image subsq tx (37213) $7,603.85
Thrombolysis arterial infusion icra rs&i init tx (37211) $53,849.95
Thrombolysis venous infusion w/imaging init tx (37212) $62,448.55
Transcatheter biopsy (37200) $7,794.05
Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a… (61626) $20,028.55
Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a… (61624) $32,036.30
Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with… (58345) $18,820.70
Transfer of tendon to restore intrinsic function; ring and small finger Age Under 21 (26497) $90,743.80
Transfusion, blood or blood components (36430) $1,962.10
Transperineal plmt biodegradable matrl 1/mlt njx (55874) $8,808.85
Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy Age Under… (31730) $2,081.45
Treat craniofacial fracture (21431) $9,547.05
Treat dental ridge fracture (21440) $9,547.05
Treat foot dislocation (28545) $13,197.40
Treat hip socket fracture (27222) $1,923.02
Treat humerus fracture (24577) $6,552.98
Treat knee fracture (27532) $13,197.40
Treat lower leg fracture (27825) $6,552.98
Treat mouth roof fracture (21421) $9,547.05
Treat tail bone fracture (27200) $699.30
Treat thumb fracture (26645) $6,552.98
Treat toe dislocation (28630) $699.30
Treat ulnar fracture (24675) $6,552.98
Treat wrist bone fracture (25635) $6,552.98
Treat wrist bone fracture (25624) $6,552.98
Treat wrist dislocation (25690) $6,552.98
Treat wrist dislocation (25675) $961.52
TREATMENT CLOSED ELBOW DISLOCATION REQ ANES TechFee (24605) $6,552.98
Treatment of closed elbow dislocation; without anesthesia (24600) $699.30
Treatment of heel fracture (28405) $961.52
Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each (28450) $699.30
Trimming of nondystrophic nails, any number (11719) $134
Trlml balo angiop open/perq img s&i 1st art (37246) $31,280.85
Trlml balo angiop open/perq w/img s&i 1st vein (37248) $30,506.65
Tx superficial wound dehiscence simple closure (12020) $1,862.35
Tx superficial wound dehiscence w/packing (12021) $1,182.40
Tx tarsal bone fx xcp talus&calcn w/manj (28455) $4,765.80
Unlisted procedure anus (46999) $1,959.50
Unlisted procedure rectum (45999) $1,537.25
Upgrade of pacemaker system (33214) $23,559.40
Vaginal delivery (59409) $12,578.70
Vasc embolize/occlude bleed (37244) $28,075.10
Vascular embolization or occlusion arterial rs&i (37242) $26,980.20
Vascular embolization or occlusion venous rs&i (37241) $22,483.50
Vascular embolize/occlude organ tumor infarct (37243) $22,483.50
Vascular surgery procedure (37799) $8,878.75
Venipuncture (36415) $16.10
Version cephalic external (59412) $4,331.70
Wedge excision skin nail fold (11765) $1,182.40