| Adj tissue trans/rearrange scalp/arm/leg =<10sqcm (14020) |
$300 |
$300 |
0.1× |
| Adjt tis reargmt eye/nose/ear/lip 10.1-30.0 sqcm (14061) |
$340 |
$340 |
0.2× |
| Adjt tis trnsfr/rearrgmt e/n/e/l dfct 10 sq cm/< (14060) |
$340 |
$340 |
0.2× |
| Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) |
$320 |
$320 |
0.2× |
| Adjt/rearrgmt scalp/arm/leg 10.1-30.0 sq cm (14021) |
$300 |
$300 |
0.1× |
| Amputation metatarsal with toe single (28810) |
$9,252 |
$9,252 |
2.8× |
| Amputation Toe Metatarsophalangeal Joint (28820) |
$9,252 |
$9,252 |
2.8× |
| Amputation, foot; transmetatarsal (28805) |
$9,252 |
$9,252 |
2.8× |
| Appl Mlt-Layer Venous Wound Compress Below Knee (29581) |
$200 |
$200 |
1.2× |
| Application Cast Finger (29086) |
$267 |
$267 |
1.6× |
| Application Cast Hand & Lower Forearm Gauntlet (29085) |
$35 |
$35 |
0.2× |
| Application Cast Shoulder Spica (29055) |
$460 |
$460 |
1.6× |
| Application Finger Splint Dynamic (29131) |
$220 |
$220 |
3.7× |
| Application finger splint static (29130) |
$82.50 |
$82.50 |
0.6× |
| Application long arm splint shoulder hand (29105) |
$135 |
$135 |
0.8× |
| Application Long Leg Cast Walker/Ambulatory Type (29355) |
$460 |
$460 |
1.6× |
| Application long leg splint thigh ankle/toes (29505) |
$135 |
$135 |
0.8× |
| Application of hip spica cast; one and one-half spica or both legs (29325) |
$460 |
$460 |
1.6× |
| Application of long leg cast (29345) |
$220 |
$220 |
0.8× |
| Application of shoulder to hip body cast and thigh (29044) |
$267 |
$267 |
1.6× |
| Application short arm splint forearm-hand static (29125) |
$135 |
$135 |
1.0× |
| Application short leg splint calf foot (29515) |
$135 |
$135 |
0.8× |
| Apply long leg cast brace (29358) |
$40.45 |
$40.45 |
0.1× |
| Apply short leg cast (29405) |
$220 |
$220 |
0.8× |
| Apply short leg cast (29425) |
$460 |
$460 |
1.6× |
| Arterial puncture (36600) |
$500 |
$500 |
3.7× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$125 |
$125 |
0.4× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$135 |
$135 |
0.4× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$125 |
$125 |
0.4× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$220 |
$220 |
1.1× |
| Banding of hemorrhoids using a flexible endoscope (sigmoidoscope) (45350) |
$3,373 |
$3,373 |
2.8× |
| Biopsy Cervix Single/Mult/Excision Of Lesion Spx (57500) |
$2,298 |
$2,298 |
2.5× |
| Biopsy of uterus lining (58100) |
$300 |
$300 |
1.5× |
| Biopsy Soft Tissue Upper Arm/Elbow Superficial (24065) |
$1,400 |
$1,400 |
0.8× |
| Bladder Irrigation Simple (51700) |
$350 |
$350 |
1.4× |
| Bladder Scan (51798) |
$550 |
$550 |
9.3× |
| Blood transfusion service (36430) |
$776 |
$776 |
1.8× |
| Catheter Aspiration Nasotracheal Spx (31720) |
$800 |
$800 |
3.6× |
| Cerclage cervix pregnancy vaginal (59320) |
$8,936 |
$8,936 |
2.7× |
| Chemical Cautery Tissue (17250) |
$349.42 |
$349.42 |
1.7× |
| Chest tube placement (32551) |
$1,500 |
$1,500 |
0.9× |
| Close Rx Fingr Articular Fx,Manip (26742) |
$1,650 |
$1,650 |
1.0× |
| Closed Rx Humer Epicondylr Fx,Manip (24565) |
$1,500 |
$1,500 |
0.9× |
| Closed Rx Mid Humerus Fx,Manipulatn (24505) |
$1,400 |
$1,400 |
0.9× |
| Closed Rx Rad/Ulna Shaft Fx,Manip (25565) |
$1,400 |
$1,400 |
0.9× |
| Closed Rx Tibial Plateau Fx (27530) |
$220 |
$220 |
0.9× |
| Closed treatment of broken top of shin bone at knee (27538) |
$220 |
$220 |
0.9× |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) |
$250 |
$250 |
1.0× |
| Closed Treatment Ulnar Styloid Fracture (25650) |
$220 |
$220 |
0.9× |
| Closed tx ankle dislocation w/o anesthesia (27840) |
$250 |
$250 |
1.0× |
| Closed tx carpal scaphoid fracture w/manj (25624) |
$220 |
$220 |
0.1× |
| Closed tx knee dislocation w/o anesthesia (27550) |
$250 |
$250 |
1.0× |
| Closed Tx Monteggia Fx Dislocation Elbow W/Manj (24620) |
$220 |
$220 |
0.1× |
| Closed tx patellar dislocation w/anesthesia (27562) |
$250 |
$250 |
1.0× |
| Closed tx radial shaft fracture w/manipulation (25505) |
$1,300 |
$1,300 |
0.8× |
| Closed tx scapular fracture w/o manipulation (23570) |
$220 |
$220 |
0.9× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
$250 |
$250 |
1.0× |
| Clsd tx clavicular fracture w/manipulation (23505) |
$220 |
$220 |
0.1× |
| Clsd tx clavicular fracture w/o manipulation (23500) |
$220 |
$220 |
0.9× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
$1,400 |
$1,400 |
0.9× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$250 |
$250 |
1.0× |
| Cltx ankle dislc req anes w/wo prq skel fixj (27842) |
$1,500 |
$1,500 |
0.9× |
| Cltx dstl fibular fx lat malls w/manj (27788) |
$250 |
$250 |
1.0× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$1,500 |
$1,500 |
0.9× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
$250 |
$250 |
1.0× |
| Cltx Interphalangeal Joint Dislocation Req Anes (28665) |
$300 |
$300 |
1.1× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
$250 |
$250 |
1.0× |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
$250 |
$250 |
1.0× |
| Cltx metacarpal fx w/manipulation each bone (26605) |
$250 |
$250 |
1.0× |
| Cltx metacarpophalangeal dislc w/manj w/anes (26705) |
$350 |
$350 |
0.2× |
| Cltx metacarpophalangeal dislc w/manj w/o anes (26700) |
$300 |
$300 |
1.2× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
$350 |
$350 |
1.4× |
| Cltx prox fibula/shft fx w/manj (27781) |
$1,400 |
$1,400 |
0.9× |
| Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) |
$1,400 |
$1,400 |
0.9× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
$250 |
$250 |
1.0× |
| Cltx scapular fx w/mnpj w/wo skeletal traction (23575) |
$220 |
$220 |
0.1× |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
$1,350 |
$1,350 |
0.8× |
| Cltx tibial shaft fx w/manj w/wo skel tracj (27752) |
$1,400 |
$1,400 |
0.9× |
| Cltx trans-scaphoprilunar typ fx dislc w/manj (25680) |
$431 |
$431 |
1.7× |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
$2,000 |
$2,000 |
1.2× |
| Colonoscopy flex w/rem forcep (45384) |
$3,373 |
$3,373 |
2.8× |
| Colonoscopy thru stoma (44388) |
$2,612 |
$2,612 |
2.8× |
| Colonoscopy w/ablation (45388) |
$3,373 |
$3,373 |
2.8× |
| Colporrhaphy suture injury vagina (57200) |
$8,936 |
$8,936 |
2.7× |
| Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix (57455) |
$917 |
$917 |
3.0× |
| Colsc Flexible W/Control Bleeding Any Method - Colonoscopy (45382) |
$3,373 |
$3,373 |
2.8× |
| Colsc flx with directed submucosal njx any sbst (45381) |
$3,373 |
$3,373 |
2.8× |
| Complex Drainage, Wound (10180) |
$2,500 |
$2,500 |
0.9× |
| Control Nasal Hemorrhage Anterior Complex (30903) |
$220 |
$220 |
1.6× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$150 |
$150 |
1.1× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$200 |
$200 |
1.5× |
| Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) |
$400 |
$400 |
1.7× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$638.96 |
$638.96 |
1.6× |
| Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) |
$993.94 |
$993.94 |
1.3× |
| Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) |
$2,774.90 |
$2,774.90 |
1.7× |
| Destruction Benign Lesions Up To 14 (17110) |
$175 |
$175 |
0.9× |
| Destruction premalignant lesion 1st (17000) |
$135 |
$135 |
0.7× |
| Diagnostic sigmoidoscopy (45330) |
$2,612 |
$2,612 |
2.8× |
| Dilation of anal sphincter (45905) |
$3,373 |
$3,373 |
2.8× |
| Division of fallopian tube (58600) |
$8,936 |
$8,936 |
2.7× |
| Drain outer ear canal lesion (69020) |
$1,219 |
$1,219 |
1.7× |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
$1,219 |
$1,219 |
1.7× |
| Drainage Finger Abscess Simple (26010) |
$200 |
$200 |
1.0× |
| Drainage of hematoma/fluid (10140) |
$1,500 |
$1,500 |
0.9× |
| Drainage of scrotal wall abscess (55100) |
$1,700 |
$1,700 |
1.0× |
| Dressing change under anesthesia (15852) |
$993.94 |
$993.94 |
1.3× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
$640 |
$640 |
1.6× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
$250 |
$250 |
1.2× |
| Egd balloon dilation esophagus <30 mm diam (43249) |
$5,439 |
$5,439 |
2.8× |
| Egd flexible foreign body removal (43247) |
$2,591 |
$2,591 |
2.8× |
| Egd guide wire insertion (43248) |
$2,591 |
$2,591 |
2.8× |
| Egd place gastrostomy tube (43246) |
$5,439 |
$5,439 |
2.8× |
| Egd remove lesion snare (43251) |
$4,283 |
$4,283 |
2.2× |
| Egd Transoral Control Bleeding Any Method - Egd (43255) |
$5,439 |
$5,439 |
2.8× |
| Egd tube/cath insertion (43241) |
$1,600 |
$1,600 |
0.8× |
| Egd Varices Ligation (43244) |
$5,439 |
$5,439 |
2.8× |
| Endocervical Curettage (57505) |
$2,298 |
$2,298 |
2.5× |
| Endoscopy Upper Small Intestine - Enteroscopy (44360) |
$5,439 |
$5,439 |
2.8× |
| Esophagogastroduodenoscopy submucosal injection (43236) |
$2,591 |
$2,591 |
2.8× |
| Esophagoscopy flex biopsy (43202) |
$5,439 |
$5,439 |
2.8× |
| Esophagoscopy flexible transoral diagnostic (43200) |
$2,591 |
$2,591 |
2.8× |
| Esophagus Surg Procedure Unlisted (43499) |
$800 |
$800 |
0.9× |
| Evacuation of subungual hematoma (11740) |
$200 |
$200 |
1.5× |
| Exc abd les sc 3 cm/> (22903) |
$8,122 |
$8,122 |
2.8× |
| Exc arm/elbow les sc < 3 cm (24075) |
$4,634 |
$4,634 |
2.8× |
| Exc back tum deep < 5 cm (21932) |
$8,122 |
$8,122 |
2.8× |
| Exc neck tum deep < 5 cm (21556) |
$8,122 |
$8,122 |
2.8× |
| Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) |
$1,140 |
$1,140 |
2.8× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
$2,011 |
$2,011 |
2.8× |
| Exc Skin Benig >4 Cm Remaindr Body (11426) |
$8,122 |
$8,122 |
2.8× |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
$4,634 |
$4,634 |
2.8× |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) |
$1,250 |
$1,250 |
1.0× |
| Exc tr-ext b9+marg 0.5 cm or less (11400) |
$2,011 |
$2,011 |
2.8× |
| Exc tumor soft tiss shoulder subfasc <5cm (23076) |
$8,122 |
$8,122 |
2.8× |
| Exc tumor soft tissue abdominal wall subq <3cm (22902) |
$4,634 |
$4,634 |
2.8× |
| Exc Tumor Soft Tissue Neck/Ant Thorax Subfascial 5+Cm (21554) |
$2,400 |
$2,400 |
0.8× |
| Excise excess skin & tissue (15839) |
$8,122 |
$8,122 |
2.8× |
| Excision exostosis(es), external auditory canal (69140) |
$4,900 |
$4,900 |
0.8× |
| Excision external ear partial simple repair (69110) |
$8,122 |
$8,122 |
2.8× |
| Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) |
$2,011 |
$2,011 |
2.8× |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) |
$4,634 |
$4,634 |
2.8× |
| Excision of bartholin's gland or cyst (56740) |
$8,936 |
$8,936 |
2.7× |
| Excision of lesion other than skin tag </= 0.5 cm (11420) |
$240 |
$240 |
0.1× |
| Excision of pilonidal cyst or sinus; simple (11770) |
$8,122 |
$8,122 |
2.8× |
| Excision soft tissue lesion, external auditory canal (69145) |
$2,400 |
$2,400 |
0.8× |
| Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater (22901) |
$8,122 |
$8,122 |
2.8× |
| Expl penetrating wound spx abdomen/flank/back (20102) |
$2,000 |
$2,000 |
1.0× |
| Explo/Drain Breast Abscess (19020) |
$4,634 |
$4,634 |
2.8× |
| Exploration penetrating wound spx chest (20101) |
$2,000 |
$2,000 |
1.0× |
| Exploration penetrating wound spx extremity (20103) |
$800 |
$800 |
0.5× |
| Exploration Penetrating Wound Spx Neck (20100) |
$883.34 |
$883.34 |
1.6× |
| Eye surgery procedure (66999) |
$2,500 |
$2,500 |
1.1× |
| Guide Cathet Fluid Drainage (10030) |
$1,219.88 |
$1,219.88 |
1.7× |
| Hysteroscopy biopsy (58558) |
$9,200 |
$9,200 |
2.8× |
| Hysteroscopy dx sep proc (58555) |
$8,936 |
$8,936 |
2.7× |
| I&d abscess simple (10060) |
$349.42 |
$349.42 |
1.7× |
| I&D Deep Absc/Hematoma Neck/Chest (21501) |
$2,400 |
$2,400 |
0.8× |
| I&d pilonidal cyst simple (10080) |
$700 |
$700 |
1.0× |
| I&d vaginal hematoma, non-ob (57023) |
$8,122 |
$8,122 |
2.8× |
| Incision & drainage abscess complicated/multiple (10061) |
$638 |
$638 |
1.6× |
| Incision & removal foreign body subq tiss simple (10120) |
$500 |
$500 |
1.2× |
| Incision and drainage of bartholin's gland abscess (56420) |
$200 |
$200 |
1.0× |
| Incision and drainage of vulva or perineal abscess (56405) |
$633.50 |
$633.50 |
2.1× |
| Incision of rectal abscess (46040) |
$1,200 |
$1,200 |
1.0× |
| Initial tx 1st degree burn local tx (16000) |
$200 |
$200 |
1.0× |
| Inject Tendon Origin/Insert (20551) |
$135 |
$135 |
0.4× |
| Injection anes other peripheral nerve/branch (64450) |
$650 |
$650 |
0.9× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$135 |
$135 |
0.4× |
| Insert Bladder Cath Complex (51703) |
$200 |
$200 |
1.5× |
| Insert non-tunnel cv cath (36556) |
$3,000 |
$3,000 |
0.9× |
| Insert Non-Tunnel Cv Cath < 5 Y/O (36555) |
$2,500 |
$2,500 |
0.8× |
| Insert picc cath (36569) |
$1,500 |
$1,500 |
0.9× |
| Insert Temp Bladder Cath (51702) |
$220 |
$220 |
1.6× |
| Insert tunneled cv cath (36561) |
$2,700 |
$2,700 |
0.9× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$220 |
$220 |
1.6× |
| Insertion indwelling tunneled pleural catheter (32550) |
$3,200 |
$3,200 |
0.9× |
| Insj tunneled ctr vad w/subq port under 5 yr (36560) |
$2,700 |
$2,700 |
0.9× |
| Intubation endotracheal emergency procedure (31500) |
$400 |
$400 |
1.7× |
| Laparoscopy appendectomy (44970) |
$16,493 |
$16,493 |
2.7× |
| Laparoscopy Remove Adnexa (58661) |
$16,493 |
$16,493 |
2.7× |
| Laparoscopy Tubal Cautery (58670) |
$16,493 |
$16,493 |
2.7× |
| Laparoscopy w/lysis of adhesions (58660) |
$16,493 |
$16,493 |
2.7× |
| Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of spec (49320) |
$16,493 |
$16,493 |
2.7× |
Laparoscopy, surgical; cholecystectomy with cholangiography (47563)
likely a partial charge, not the full procedure |
$1,600 |
$1,600 |
0.3× |
| Laparoscopy, surgical; cholecystectomy with exploration of common duct (47564) |
$22,892 |
$22,892 |
2.1× |
| Laps fulg/exc ovary viscera/peritoneal surface (58662) |
$16,493 |
$16,493 |
2.7× |
| Ligation of hemorrhoid(s) (46221) |
$2,612 |
$2,612 |
2.8× |
| Marsup Bartholin Gland Cyst (56440) |
$8,936 |
$8,936 |
2.7× |
| Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) |
$700 |
$700 |
1.6× |
| Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) |
$7,148 |
$7,148 |
2.0× |
| Omntc Epiploectomy Rescj Omentum Spx (49255) |
$4,191 |
$4,191 |
0.6× |
| Ovarian cystectomy (58925) |
$14,217 |
$14,217 |
2.8× |
| Partial Excision Distal Phalanx Finger (26236) |
$4,594 |
$4,594 |
2.8× |
| Partial hymenectomy or revision of hymenal ring (56700) |
$8,936 |
$8,936 |
2.7× |
| Perineoplasty rpr perineum nonobstetrical spx (56810) |
$8,936 |
$8,936 |
2.7× |
| Peritoneal Lavage (49084) |
$850 |
$850 |
0.9× |
| Perq Drainage Pleura Insert Cath W/Imaging (32557) |
$1,600 |
$1,600 |
1.0× |
| Perq replacement gtube not req revj gstrst trc (43762) |
$583 |
$583 |
2.3× |
| Placement of needle for intraosseous infusion (36680) |
$430 |
$430 |
1.0× |
| Preputial Stretching (54450) |
$250 |
$250 |
1.0× |
| Punch biopsy skin single lesion (11104) |
$330 |
$330 |
0.8× |
| Puncture Aspiration (10160) |
$638 |
$638 |
1.6× |
| Rad resec prox/mid phalanx (26260) |
$2,500 |
$2,500 |
0.8× |
| Removal fb intranasal (30300) |
$220 |
$220 |
1.6× |
| Removal foreign body foot deep (28192) |
$220 |
$220 |
0.1× |
| Removal foreign body foot subcutaneous (28190) |
$220 |
$220 |
0.3× |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
$1,400 |
$1,400 |
0.8× |
| Removal foreign body pharynx (42809) |
$300 |
$300 |
0.7× |
| Removal foreign body, intranasal; requiring general anesthesia (30310) |
$3,000 |
$3,000 |
0.9× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$220 |
$220 |
3.7× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$70 |
$70 |
1.2× |
| Removal of arm foreign body (24200) |
$220 |
$220 |
0.1× |
| Removal of bone lesion (23140) |
$9,252 |
$9,252 |
2.8× |
| Removal of intrauterine device (iud) (58301) |
$135 |
$135 |
0.4× |
| Removal of nail bed (11750) |
$318.79 |
$318.79 |
0.8× |
| Removal of nose lesion (30124) |
$1,400 |
$1,400 |
0.9× |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
$155 |
$155 |
0.8× |
| Remove anal fist 2 stage (46285) |
$8,026 |
$8,026 |
2.9× |
| Remove foreign body from eye (65210) |
$700 |
$700 |
1.6× |
| Remv Ext Canal F.B.,Gen Anesth (69205) |
$1,500 |
$1,500 |
0.9× |
| Remv Ext Canal Foreign Body (69200) |
$200 |
$200 |
1.5× |
| Remv F.B.,Eye,Superf Conjunc (65205) |
$150 |
$150 |
1.1× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
$650 |
$650 |
0.9× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
$550 |
$550 |
0.7× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$450 |
$450 |
1.1× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$700 |
$700 |
1.7× |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
$650 |
$650 |
1.6× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$650 |
$650 |
1.6× |
| Repair complex trunk 2.6-7.5 cm (13101) |
$550 |
$550 |
0.7× |
| Repair extensor tendon finger w/o graft each (26418) |
$1,700 |
$1,700 |
1.1× |
| Repair forearm tendon/muscle (25270) |
$3,000 |
$3,000 |
0.9× |
| Repair forearm tendon/muscle (25260) |
$3,000 |
$3,000 |
0.9× |
| Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated (49507) |
$9,889 |
$9,889 |
2.7× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$450 |
$450 |
1.1× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$400 |
$400 |
1.0× |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
$450 |
$450 |
1.1× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
$400 |
$400 |
1.0× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$450 |
$450 |
1.1× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$400 |
$400 |
1.0× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$700 |
$700 |
0.9× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$450 |
$450 |
1.1× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$400 |
$400 |
1.0× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$450 |
$450 |
1.1× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$400 |
$400 |
1.0× |
| Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie,… (49595) |
$9,889 |
$9,889 |
1.5× |
| Repair of nail bed (11760) |
$600 |
$600 |
0.8× |
| Repair of vagina (57260) |
$14,217 |
$14,217 |
2.8× |
| Repair Tongue Laceration (41250) |
$400 |
$400 |
0.9× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$220 |
$220 |
0.5× |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
$220 |
$220 |
1.6× |
| Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) |
$16,493 |
$16,493 |
2.7× |
| Rpr aa hernia 1st 3-10 cm reducible (49593) |
$9,889 |
$9,889 |
1.5× |
| Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) |
$16,493 |
$16,493 |
2.7× |
| Rpr aa hernia 1st < 3 cm reducible (49591) |
$9,889 |
$9,889 |
2.7× |
| Rpr Aa Hernia Recr < 3 Cm Ncrc8/Strangulated (49614) |
$16,493 |
$16,493 |
2.7× |
| Rpr lac tongue floor mouth > 2.6 cm/cplx (41252) |
$250 |
$250 |
1.1× |
| Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) |
$3,373 |
$3,373 |
2.8× |
| Sigmoidoscopy flx w/biopsy single/multiple (45331) |
$2,612 |
$2,612 |
2.8× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
$600 |
$600 |
1.5× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$143 |
$143 |
0.7× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$350 |
$350 |
1.7× |
| Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) |
$600 |
$600 |
1.5× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$350 |
$350 |
1.7× |
| Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) |
$350 |
$350 |
1.7× |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
$350 |
$350 |
1.7× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$135 |
$135 |
0.7× |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
$175 |
$175 |
0.9× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$135 |
$135 |
0.7× |
| Skin sub graft face/nk/hf/g (15275) |
$1,800 |
$1,800 |
2.4× |
| Skin sub graft trnk/arm/leg (15271) |
$3,245.12 |
$3,245.12 |
4.4× |
| Skin Sub Grft T/Arm/Lg Child (15273) |
$4,626.96 |
$4,626.96 |
2.2× |
| Skin tissue rearrangement (14040) |
$320 |
$320 |
0.2× |
| Skn sub grft f/n/hf/g child (15277) |
$1,800 |
$1,800 |
0.9× |
| Small Bowel Endoscopy,Biopsy - Enteroscopy (44361) |
$5,439 |
$5,439 |
2.8× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$135 |
$135 |
0.7× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$175 |
$175 |
0.4× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$175 |
$175 |
0.4× |
| Spinal puncture lumbar diagnostic (62270) |
$650 |
$650 |
0.9× |
| Strapping ankle (29540) |
$200 |
$200 |
1.2× |
| Strapping elbow/wrist (29260) |
$37.72 |
$37.72 |
0.6× |
| Strapping hand/finger (29280) |
$150 |
$150 |
2.5× |
| Strapping Hip (29520) |
$150 |
$150 |
1.1× |
| Strapping knee (29530) |
$200 |
$200 |
1.5× |
| Strapping shoulder (29240) |
$220 |
$220 |
1.6× |
| Strapping thorax (29200) |
$270 |
$270 |
1.7× |
| Strapping toes (29550) |
$100 |
$100 |
1.7× |
| Tangential biopsy skin single lesion (11102) |
$250 |
$250 |
0.6× |
| Thoracentesis Needle/Cath Pleura W/Imaging (32555) |
$1,260 |
$1,260 |
2.0× |
| Thoracentesis needle/cath pleura w/o imaging (32554) |
$1,260 |
$1,260 |
2.0× |
| Thorsc dx lungs/pericar/med/pleural space w/o bx (32601) |
$4,900 |
$4,900 |
0.8× |
| Tis trnfr trunk 10 sq cm/< (14000) |
$300 |
$300 |
0.1× |
| Tis trnfr trunk 10.1-30sqcm (14001) |
$300 |
$300 |
0.1× |
| Trach Tube Change (31502) |
$400 |
$400 |
1.7× |
| Treat ectopic pregnancy (59151) |
$16,493 |
$16,493 |
2.7× |
| Treat finger dislocation (26775) |
$120 |
$120 |
0.4× |
| Treat humerus fracture (24500) |
$431 |
$431 |
1.7× |
| Treat knee fracture (27532) |
$220 |
$220 |
0.1× |
| Treat wrist bone fracture (25635) |
$220 |
$220 |
0.1× |
| Treat wrist bone fracture (25622) |
$220 |
$220 |
0.9× |
| Treat Wrist Bone Fracture (25630) |
$220 |
$220 |
0.9× |
| Treatment closed elbow dislocation req anes (24605) |
$1,700 |
$1,700 |
1.1× |
| Treatment closed elbow dislocation w/o anes (24600) |
$250 |
$250 |
1.0× |
| Treatment of missed abortion, completed surgically; second trimester (59821) |
$8,936 |
$8,936 |
2.7× |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
$9,200 |
$9,200 |
2.8× |
| Tx Missed Abortion First Trimester Surgical (59820) |
$8,936 |
$8,936 |
2.7× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) |
$660 |
$660 |
0.9× |
| Tx superficial wound dehiscence w/packing (12021) |
$500 |
$500 |
1.2× |
| Unlisted laparoscopy px abd pertoneum & omentum (49329) |
$16,493 |
$16,493 |
2.7× |
| Unlisted Procedure Dentoalveolar Structures (41899) |
$1,800 |
$1,800 |
7.6× |
| Urology Surgery Procedure (53899) |
$470 |
$470 |
1.9× |
| Venipuncture (36415) |
$10.98 |
$10.98 |
1.2× |
| Vulvectomy simple partial (56620) |
$8,936 |
$8,936 |
2.7× |
| Wound Prep F/N/Hf/G (15004) |
$750 |
$750 |
1.8× |