| Abd paracentesis (49082) |
$901.35 |
$1,001.50 |
1.0× |
| Abd paracentesis w/imaging (49083) |
$850.05 |
$944.50 |
0.9× |
| Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency… (30801) |
$324.90 |
$361 |
0.2× |
| Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method; intramural (30802) |
$433.80 |
$482 |
0.3× |
Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type) (27120)
likely a partial charge — not the full procedure |
$2,794.50 |
$3,105 |
0.2× |
| Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release Age Under 21 (23130) |
$1,357.20 |
$1,508 |
0.4× |
| Adding walker to previously applied cast (29440) |
$207 |
$230 |
1.2× |
| Adenoidectomy, primary; age 12 or over Age Under 21 (42831) |
$508.50 |
$565 |
0.2× |
| Adenoidectomy, primary; younger than age 12 Age Under 21 (42830) |
$468 |
$520 |
0.1× |
| Adenoidectomy, secondary; age 12 or over Age Under 21 (42836) |
$539.10 |
$599 |
0.2× |
| Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less Age Under 21 (14060) |
$1,442.70 |
$1,603 |
0.7× |
| Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet;… (14041) |
$3,961.80 |
$4,402 |
1.9× |
| Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less Age Under 21 (14000) |
$1,096.20 |
$1,218 |
0.5× |
| Amniocentesis diagnostic (59000) |
$732.15 |
$813.50 |
0.8× |
| Amputation Foot Transmetarsal|RIGHT SIDE (28805) |
$1,520.10 |
$1,689 |
0.5× |
| Amputation of toe (28820) |
$380.70 |
$423 |
0.1× |
| Amputation, leg, through tibia and fibula; open, circular (guillotine) (27882) |
$1,247.40 |
$1,386 |
0.4× |
| Amputation, leg, through tibia and fibula; re-amputation (27886) |
$1,379.70 |
$1,533 |
0.4× |
| Anesthesia inj anesthetic agent dig nrv (64455) |
$71.10 |
$79 |
0.2× |
| Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic Age Under 21 (45990) |
$226.80 |
$252 |
0.1× |
| Anoscopy and biopsy (46606) |
$162 |
$180 |
0.1× |
| Anoscopy diagnostic (46600) |
$213.75 |
$237.50 |
1.6× |
Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when… (57240)
likely a partial charge — not the full procedure |
$1,316.70 |
$1,463 |
0.3× |
Anterior tibial tubercleplasty (27418)
likely a partial charge — not the full procedure |
$1,777.50 |
$1,975 |
0.2× |
| App skn sub grft t/a/l area/<100scm /<1st 25 scm (15271) |
$179.10 |
$199 |
0.2× |
| App skn subgrft t/a/l area/100sq cm 1st 100sq cm (15273) |
$409.50 |
$455 |
0.2× |
Appendectomy (44950)
likely a partial charge — not the full procedure |
$1,364.40 |
$1,516 |
0.2× |
| Application cast finger (29086) |
$108 |
$120 |
0.7× |
| Application Finger Splint Dynamic (29131) |
$74.70 |
$83 |
1.2× |
| Application finger splint static (29130) |
$62.10 |
$69 |
0.5× |
Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, Ilizarov,… (20692)
likely a partial charge — not the full procedure |
$2,452.50 |
$2,725 |
0.2× |
| Application of clubfoot cast with molding or manipulation, long or short leg Age Under 21 (29450) |
$297.45 |
$330.50 |
1.8× |
| Application of hip spica cast; 1 and one-half spica or both legs Age Under 21 (29325) |
$492.30 |
$547 |
1.7× |
| Application of hip spica cast; 1 leg Age Under 21 (29305) |
$471.60 |
$524 |
1.7× |
| Application of long leg brace-type cast from thigh to toe|RIGHT SIDE (29358) |
$410.40 |
$456 |
1.4× |
| Application of long leg cast (thigh to toes); (29345) |
$215.10 |
$239 |
0.8× |
| Application of long leg splint (thigh to ankle or toes) (29505) |
$114.30 |
$127 |
0.7× |
| Application of short arm splint (forearm to hand); static (29125) |
$161.10 |
$179 |
1.2× |
| Application of short leg cast (below knee to toes); (29405) |
$127.80 |
$142 |
0.4× |
| Application of short leg cast (below knee to toes); walking or ambulatory type (29425) |
$117.90 |
$131 |
0.4× |
| Application of short leg splint (calf to foot) (29515) |
$196.20 |
$218 |
1.2× |
| Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or… (15277) |
$471.60 |
$524 |
0.2× |
| Application of vein wound compression bandages on lower leg ankle and foot|BILATERAL PROCEDURE |SERV DELIV PERSONALLY… (29581) |
$297 |
$330 |
1.8× |
| Application of walking cast covering thigh to toe|SERV DELIV PERSONALLY BY PT OR UNDER AN OP PLAN OF CARE (29355) |
$402.75 |
$447.50 |
1.4× |
| Application rigid total contact leg cast (29445) |
$511.65 |
$568.50 |
1.8× |
| Application, cast; figure-of-eight Age Under 21 (29049) |
$374.85 |
$416.50 |
1.3× |
| Application, cast; shoulder spica Age Under 21 (29055) |
$449.10 |
$499 |
1.6× |
| Application, cast; shoulder to hand (long arm) (29065) |
$148.50 |
$165 |
0.5× |
| Apply hand/wrist cast (29085) |
$151.65 |
$168.50 |
0.9× |
| Apply long arm splint (29105) |
$186.30 |
$207 |
1.1× |
| Apply patella tendon bearing cast (29435) |
$291.60 |
$324 |
1.0× |
| Apply splint short arm dynamic (29126) |
$108 |
$120 |
0.8× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$287.10 |
$319 |
0.9× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$337.95 |
$375.50 |
1.1× |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
$1,651.95 |
$1,835.50 |
5.3× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$76.50 |
$85 |
0.2× |
Arthrodesis, ankle, open Age Under 21 (27870)
likely a partial charge — not the full procedure |
$2,178 |
$2,420 |
0.2× |
Arthrodesis, great toe; metatarsophalangeal joint (28750)
likely a partial charge — not the full procedure |
$1,251.90 |
$1,391 |
0.2× |
Arthrodesis, midtarsal or tarsometatarsal, single joint Age Under 21 (28740)
likely a partial charge — not the full procedure |
$1,340.10 |
$1,489 |
0.2× |
Arthrodesis; subtalar (28725)
likely a partial charge — not the full procedure |
$1,692.90 |
$1,881 |
0.1× |
Arthroplasty glenohumeral joint total shoulder (23472)
likely a partial charge — not the full procedure |
$3,101.40 |
$3,446 |
0.2× |
Arthroplasty, ankle; with implant (total ankle) (27702)
likely a partial charge — not the full procedure |
$2,079 |
$2,310 |
0.1× |
Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction Age Under 21 (29888)
likely a partial charge — not the full procedure |
$2,102.40 |
$2,336 |
0.3× |
| Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited Age Under 21 (29897) |
$1,073.70 |
$1,193 |
0.3× |
| Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure) (29870) |
$909.90 |
$1,011 |
0.3× |
| Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or… (29879) |
$1,443.60 |
$1,604 |
0.4× |
| Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) Age Under 21 (29877) |
$1,356.30 |
$1,507 |
0.4× |
| Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation,… (29874) |
$1,170.90 |
$1,301 |
0.4× |
| Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) Age Under 21 (29875) |
$1,087.20 |
$1,208 |
0.3× |
| Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure) Age Under 21 (29884) |
$1,352.70 |
$1,503 |
0.4× |
| Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including… (29880) |
$1,228.50 |
$1,365 |
0.4× |
| Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) Age Under 21 (29883) |
$1,820.70 |
$2,023 |
0.5× |
| Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) Age Under 21 (29882) |
$1,498.50 |
$1,665 |
0.4× |
| Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure) Age Under 21 (29805) |
$1,032.30 |
$1,147 |
0.3× |
| Arthroscopy, shoulder, surgical; capsulorrhaphy Age Under 21 (29806) |
$19,132.20 |
$21,258 |
2.6× |
| Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral… (29823) |
$1,293.30 |
$1,437 |
0.4× |
| Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular… (29822) |
$1,186.20 |
$1,318 |
0.4× |
| Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure) Age Under… (29824) |
$1,477.80 |
$1,642 |
0.4× |
Arthroscopy, shoulder, surgical; repair of SLAP lesion Age Under 21 (29807)
unusually low — confirm this is the full procedure |
$2,235.60 |
$2,484 |
0.3× |
| Arthroscopy, shoulder, surgical; synovectomy, complete Age Under 21 (29821) |
$1,297.80 |
$1,442 |
0.4× |
Arthroscopy, shoulder, surgical; with rotator cuff repair Age Under 21 (29827)
unusually low — confirm this is the full procedure |
$2,305.80 |
$2,562 |
0.3× |
| Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body Age… (24101) |
$1,110.60 |
$1,234 |
0.3× |
Arthrotomy, hip, with drainage (eg, infection) (27030)
likely a partial charge — not the full procedure |
$2,023.20 |
$2,248 |
0.3× |
| Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies Age Under 21 (27331) |
$1,052.10 |
$1,169 |
0.3× |
| Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each Age Under… (26075) |
$753.30 |
$837 |
0.2× |
| Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign… (25101) |
$901.80 |
$1,002 |
0.3× |
Arthrp acetblr/prox fem prostc agrft/algrft (27130)
likely a partial charge — not the full procedure |
$2,757.60 |
$3,064 |
0.2× |
| Arthrt expl drg/rmvl loose/fb iphal jt ea (26080) |
$1,185.75 |
$1,317.50 |
0.7× |
| Arthrt kne w/expl drg/rmvl fb (27310) |
$1,597.50 |
$1,775 |
0.5× |
| Aspirate pleura w/o imaging (32554) |
$379.80 |
$422 |
0.6× |
| Aspiration and injection for treatment of bone cyst Age Under 21 (20615) |
$346.50 |
$385 |
0.5× |
| Aspiration and/or injection of ganglion cyst(s) any location (20612) |
$88.20 |
$98 |
0.3× |
| Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous Age Under 21 (50390) |
$2,403.90 |
$2,671 |
3.3× |
| Avulsion of nail plate, partial or complete, simple; single (11730) |
$284.40 |
$316 |
1.4× |
Axillary lymphadenectomy; complete Age Under 21 (38745)
unusually low — confirm this is the full procedure |
$1,884.60 |
$2,094 |
0.3× |
| Biopsy bone trocar/needle deep (20225) |
$3,086.10 |
$3,429 |
1.8× |
| Biopsy intranasal (30100) |
$148.50 |
$165 |
0.1× |
| Biopsy liver needle percutaneous (47000) |
$1,980 |
$2,200 |
1.2× |
| Biopsy lymph node (38505) |
$1,732.50 |
$1,925 |
1.0× |
| Biopsy muscle percutaneous needle (20206) |
$4,505.40 |
$5,006 |
2.7× |
| Biopsy nail unit (11755) |
$402.30 |
$447 |
0.6× |
| Biopsy of anorectal wall, anal approach (eg, congenital megacolon) (45100) |
$658.80 |
$732 |
0.2× |
| Biopsy of cervix (57500) |
$161.10 |
$179 |
0.2× |
| Biopsy of large bowel using an endoscope inserted through surgically created opening from large bowel to skin (44389) |
$363.60 |
$404 |
0.3× |
| Biopsy of lower large bowel using a flexible endoscope|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (45331) |
$154.80 |
$172 |
0.2× |
| Biopsy of salivary gland; needle (42400) |
$2,153.70 |
$2,393 |
3.0× |
| Biopsy or excision of lymph node(s); open, superficial (38500) |
$546.30 |
$607 |
0.1× |
| Biopsy or removal of deep lymph nodes of underarm|LEFT SIDE|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF… (38525) |
$946.80 |
$1,052 |
0.2× |
| Biopsy pleura percutaneous needle (32400) |
$1,502.10 |
$1,669 |
0.9× |
| Biopsy thyroid percutaneous core needle (60100) |
$1,413 |
$1,570 |
2.0× |
| Biopsy, abdominal or retroperitoneal mass, percutaneous needle Age Under 21 (49180) |
$3,716.10 |
$4,129 |
2.2× |
| Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft) Age Under 21 (20245) |
$729 |
$810 |
0.2× |
| Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs) Age Under 21 (20220) |
$3,013.20 |
$3,348 |
1.8× |
| Biopsy, muscle; superficial (20200) |
$204.30 |
$227 |
0.1× |
| Biopsy, soft tissue of thigh or knee area; superficial (27323) |
$382.50 |
$425 |
0.2× |
| Biopsy/removal lymph nodes (38510) |
$896.40 |
$996 |
0.2× |
| Bladder irrigation (51700) |
$454.50 |
$505 |
1.8× |
| Blepharotomy, drainage of abscess, eyelid Age Under 21 (67700) |
$554.40 |
$616 |
1.7× |
| Breast Biopsy; Percutaneous, Needle Core (Not Using Imaging Guidance) Charge (19101) |
$478.80 |
$532 |
0.1× |
| Bx breast 1st lesion us imag (19083) |
$3,411 |
$3,790 |
2.0× |
| Bx pancreas ndl perc (48102) |
$3,344.40 |
$3,716 |
2.0× |
| C/c 58300 insertion hormone iud for endometrial hyperplasia (58999) |
$8,940.60 |
$9,934 |
43.3× |
| Capsulotomy, posterior capsular release, knee Age Under 21 (27435) |
$1,759.50 |
$1,955 |
0.5× |
| Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure) Age Under 21 (28270) |
$736.20 |
$818 |
0.2× |
| Care of miscarriage (59820) |
$826.20 |
$918 |
0.2× |
| Cast short arm (29075) |
$137.70 |
$153 |
0.5× |
| Casting/strapping procedure (29799) |
$120.15 |
$133.50 |
0.7× |
| Cautery of cervix; cryocautery, initial or repeat Age Under 21 (57511) |
$317.70 |
$353 |
1.0× |
| Change Cystostomy Tube Simple (51705) |
$237.60 |
$264 |
0.9× |
| Change of cystostomy tube; complicated Age Under 21 (51710) |
$171.90 |
$191 |
0.2× |
| Chest tube placement (32551) |
$1,561.05 |
$1,734.50 |
1.0× |
Chromotubation Oviduct W/Materials|BILATERAL PROCEDURE (58350)
likely a partial charge — not the full procedure |
$204.30 |
$227 |
0.0× |
| Circumcision, Newborn (54150) |
$204.30 |
$227 |
0.1× |
| Claviculectomy; partial Age Under 21 (23120) |
$1,290.60 |
$1,434 |
0.4× |
| Closed rx humer epicondylr fx,manip (24565) |
$1,104.30 |
$1,227 |
0.7× |
| Closed rx shldr disloc,prox hum fx (23675) |
$1,110.60 |
$1,234 |
0.7× |
| Closed rx ulna shaft fx,manipulatn (25535) |
$1,020.60 |
$1,134 |
4.0× |
| Closed treatment of acromioclavicular dislocation; without manipulation (23540) |
$730.80 |
$812 |
2.9× |
| Closed treatment of calcaneal fracture; without manipulation (28400) |
$517.50 |
$575 |
2.1× |
| Closed treatment of carpal bone fracture; without manipulation (25630) |
$673.65 |
$748.50 |
2.7× |
| Closed treatment of carpal scaphoid (navicular) fracture; without manipulation (25622) |
$598.05 |
$664.50 |
2.4× |
| Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia… (26670) |
$711 |
$790 |
2.8× |
| Closed treatment of clavicular fracture; with manipulation (23505) |
$753.30 |
$837 |
0.5× |
| Closed treatment of clavicular fracture; without manipulation (23500) |
$522 |
$580 |
2.1× |
| Closed treatment of dislocated joint between collar and chest bone with manipulation (23525) |
$680.40 |
$756 |
2.7× |
| Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction… (27517) |
$1,514.70 |
$1,683 |
0.9× |
| Closed treatment of distal fibular fracture (lateral malleolus); with manipulation (27788) |
$859.50 |
$955 |
3.4× |
| Closed treatment of distal fibular fracture (lateral malleolus); without manipulation (27786) |
$647.10 |
$719 |
2.6× |
| Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each (26750) |
$437.40 |
$486 |
1.7× |
| Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation Age Under 21 (27510) |
$1,478.70 |
$1,643 |
0.9× |
| Closed treatment of femoral fracture, proximal end, neck; without manipulation Age Under 21 (27230) |
$1,865.25 |
$2,072.50 |
7.4× |
| Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction Age Under 21 (27502) |
$1,557.45 |
$1,730.50 |
0.9× |
| Closed treatment of fracture great toe, phalanx or phalanges; without manipulation (28490) |
$282.60 |
$314 |
1.1× |
| Closed treatment of fracture, phalanx or phalanges, other than great toe w/o manipulation each (28510) |
$352.80 |
$392 |
1.4× |
| Closed treatment of hip dislocation, traumatic; requiring anesthesia (27252) |
$1,615.50 |
$1,795 |
1.0× |
| Closed treatment of humeral shaft fracture; without manipulation (24500) |
$756.90 |
$841 |
3.0× |
| Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with… (27240) |
$2,067.30 |
$2,297 |
1.3× |
| Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation Age… (27238) |
$4,940.10 |
$5,489 |
3.0× |
| Closed treatment of knee dislocation; requiring anesthesia Age Under 21 (27552) |
$1,394.10 |
$1,549 |
0.8× |
| Closed treatment of knee dislocation; without anesthesia (27550) |
$1,348.20 |
$1,498 |
5.3× |
| Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction Age Under 21 (27762) |
$1,228.05 |
$1,364.50 |
0.7× |
| Closed treatment of medial malleolus fracture; without manipulation (27760) |
$902.70 |
$1,003 |
3.6× |
| Closed treatment of metacarpal fracture, single; with manipulation, each bone (26605) |
$673.20 |
$748 |
2.7× |
| Closed treatment of metacarpal fracture, single; without manipulation, each bone (26600) |
$656.10 |
$729 |
2.6× |
| Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia Age Under 21 (26705) |
$2,115.90 |
$2,351 |
1.3× |
| Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of… (24620) |
$1,768.95 |
$1,965.50 |
1.1× |
| Closed treatment of patellar fracture, without manipulation (27520) |
$682.20 |
$758 |
2.7× |
| Closed treatment of phalangeal shaft fracture, proximal/middle phalanx with manipulation each (26725) |
$627.30 |
$697 |
2.5× |
| Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each (26720) |
$433.80 |
$482 |
1.7× |
| Closed treatment of post hip arthroplasty dislocation; requiring general anesthesia (27266) |
$1,270.80 |
$1,412 |
0.8× |
| Closed treatment of proximal fibula or shaft fracture; with manipulation (27781) |
$902.70 |
$1,003 |
0.5× |
| Closed treatment of proximal fibula or shaft fracture; without manipulation (27780) |
$647.10 |
$719 |
2.6× |
| Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without… (23605) |
$952.20 |
$1,058 |
0.6× |
| Closed treatment of proximal humeral fracture; without manipulation (23600) |
$554.40 |
$616 |
2.2× |
| Closed treatment of radial and ulnar shaft fractures; without manipulation (25560) |
$591.30 |
$657 |
2.3× |
| Closed treatment of radial head or neck fracture; without manipulation (24650) |
$563.40 |
$626 |
2.2× |
| Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation (24640) |
$302.40 |
$336 |
1.2× |
| Closed treatment of radial shaft fracture; without manipulation (25500) |
$588.60 |
$654 |
2.3× |
| Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation Age Under 21 (23665) |
$1,179.45 |
$1,310.50 |
0.7× |
| Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) |
$555.30 |
$617 |
2.2× |
| Closed treatment of sternoclavicular dislocation; without manipulation Age Under 21 (23520) |
$1,353.15 |
$1,503.50 |
0.8× |
| Closed treatment of sternum fracture Age Under 21 (21820) |
$438.75 |
$487.50 |
1.7× |
| Closed treatment of talus fracture; with manipulation Age Under 21 (28435) |
$1,110.15 |
$1,233.50 |
0.7× |
| Closed treatment of talus fracture; without manipulation (28430) |
$515.25 |
$572.50 |
2.0× |
| Closed treatment of tibial fracture, proximal (plateau); without manipulation (27530) |
$657 |
$730 |
2.6× |
| Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation (25680) |
$1,179.90 |
$1,311 |
4.7× |
| Closed treatment of ulnar fracture, proximal end; without manipulation (24670) |
$608.40 |
$676 |
2.4× |
| Closed treatment of ulnar shaft fracture; without manipulation (25530) |
$558 |
$620 |
2.2× |
| Closed treatment of ulnar styloid fracture (25650) |
$693 |
$770 |
2.7× |
| Closed tx ankle dislocation w/o anesthesia (27840) |
$861.30 |
$957 |
3.4× |
| Closed tx bimalleolar ankle fracture w/manj (27810) |
$952.20 |
$1,058 |
0.6× |
| Closed tx bimalleolar ankle fracture w/o manip (27808) |
$738 |
$820 |
2.9× |
| Closed tx femoral shaft fx w/o manipulation (27500) |
$693.45 |
$770.50 |
2.8× |
| Closed tx metatarsal fracture w/o manipulation (28470) |
$462.60 |
$514 |
1.8× |
| Closed tx patellar dislocation w/anesthesia (27562) |
$1,088.10 |
$1,209 |
4.3× |
| Closed tx patellar dislocation w/o anesthesia (27560) |
$764.10 |
$849 |
3.0× |
| Closed tx radial shaft fracture w/manipulation (25505) |
$1,954.35 |
$2,171.50 |
1.2× |
| CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee (25565) |
$1,031.40 |
$1,146 |
0.6× |
| Closed tx scapular fracture w/o manipulation (23570) |
$388.35 |
$431.50 |
1.5× |
| Closed tx septal&nose fx (21337) |
$3,915.45 |
$4,350.50 |
1.2× |
| Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/o manip (24530) |
$640.80 |
$712 |
2.5× |
| Closed tx vert fx w/o manj (22310) |
$825.30 |
$917 |
3.3× |
| Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) |
$319.50 |
$355 |
1.3× |
| Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) |
$1,390.05 |
$1,544.50 |
2.5× |
| Clsd tx acromioclavicular dislc w/manipulation (23545) |
$731.70 |
$813 |
2.9× |
| Clsd tx nsl fx mnpj wo stblj (21315) |
$128.70 |
$143 |
0.1× |
| Clsd tx nsl fx w/mnpj&stablj (21320) |
$203.40 |
$226 |
0.1× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
$905.40 |
$1,006 |
0.6× |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
$753.30 |
$837 |
0.5× |
| CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA TechFee (26755) |
$622.80 |
$692 |
2.5× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$741.60 |
$824 |
2.9× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$1,134.90 |
$1,261 |
0.7× |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) |
$1,102.50 |
$1,225 |
4.4× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
$430.65 |
$478.50 |
1.7× |
| Cltx grter humeral tuberosity fx w/manipulation (23625) |
$2,575.35 |
$2,861.50 |
1.6× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
$745.65 |
$828.50 |
3.0× |
| Cltx humeral condylar fx medial/lat w/o manj (24576) |
$711.90 |
$791 |
2.8× |
| Cltx humeral epicondylar fx medial/lat w/o manj (24560) |
$445.50 |
$495 |
1.8× |
| CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ TechFee (24505) |
$1,007.10 |
$1,119 |
0.6× |
| Cltx interphalangeal joint dislocation w/o anes (28660) |
$206.10 |
$229 |
0.8× |
| CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee (26700) |
$707.40 |
$786 |
2.8× |
| Cltx metar fx w/manj (28475) |
$742.95 |
$825.50 |
2.9× |
| Cltx scapular fx w/mnpj w/wo skeletal traction (23575) |
$1,168.20 |
$1,298 |
0.7× |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
$2,993.40 |
$3,326 |
1.8× |
| Cltx tarsal dislc oth/thn talotarsal w/o anes (28540) |
$468 |
$520 |
1.9× |
| CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee (27752) |
$1,574.55 |
$1,749.50 |
1.0× |
| Cltx tibial shaft fx w/o manipulation (27750) |
$729 |
$810 |
2.9× |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
$978.30 |
$1,087 |
0.6× |
| Cltx trimalleolar ankle fx w/o manipulation (27816) |
$665.10 |
$739 |
2.6× |
| Collect blood from catheter venous nos (36592) |
$145.80 |
$162 |
1.1× |
| Collect blood from implant venous access device (36591) |
$132.30 |
$147 |
1.0× |
| Colonoscopy flexible with decompression (45393) |
$2,123.10 |
$2,359 |
1.7× |
| Colonoscopy thru stoma spx (44388) |
$330.30 |
$367 |
0.3× |
| Colonoscopy w/ablation (45388) |
$1,066.50 |
$1,185 |
0.9× |
| Colonoscopy w/control bleed (45382) |
$1,519.20 |
$1,688 |
1.2× |
| Colonoscopy w/fb removal (45379) |
$2,300.40 |
$2,556 |
1.9× |
| Colonoscopy w/resection (45390) |
$3,043.80 |
$3,382 |
1.1× |
| Colonoscopy w/stent plcmt (45389) |
$3,307.95 |
$3,675.50 |
0.5× |
| Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids) (45398) |
$1,782.90 |
$1,981 |
1.5× |
| Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps Age Under 21 (45384) |
$1,544.40 |
$1,716 |
1.3× |
| Colonoscopy, flexible; with transendoscopic balloon dilation Age Under 21 (45386) |
$2,349.90 |
$2,611 |
1.9× |
| Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle… (45392) |
$2,949.30 |
$3,277 |
2.4× |
| Colpocentesis (separate procedure) Age Under 21 (57020) |
$3,415.95 |
$3,795.50 |
0.7× |
Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) (57282)
likely a partial charge — not the full procedure |
$1,485.90 |
$1,651 |
0.2× |
Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) (57283)
likely a partial charge — not the full procedure |
$1,496.70 |
$1,663 |
0.2× |
| Colporrhaphy, suture of injury of vagina (nonobstetrical) Age Under 21 (57200) |
$114.30 |
$127 |
0.0× |
| Colposcopy cervix (57452) |
$195.30 |
$217 |
0.9× |
| Colposcopy entire vagina w/cervix if present (57420) |
$191.70 |
$213 |
0.6× |
| Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix Age Under 21 (57460) |
$341.10 |
$379 |
0.1× |
| Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix Age Under 21 (57421) |
$260.10 |
$289 |
0.3× |
| Colposcopy vulva (56820) |
$180 |
$200 |
0.9× |
| Colposcopy w/endocervical curettage (57456) |
$213.30 |
$237 |
0.7× |
| Colsc flx with directed submucosal njx any sbst (45381) |
$955.35 |
$1,061.50 |
0.8× |
Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; Age Under 21 (57260)
unusually low — confirm this is the full procedure |
$1,665.90 |
$1,851 |
0.3× |
| Conization of cervix (57520) |
$640.80 |
$712 |
0.2× |
| Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop… (57522) |
$550.80 |
$612 |
0.2× |
| Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image… (36598) |
$457.20 |
$508 |
2.1× |
| Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method (30903) |
$549.90 |
$611 |
4.0× |
| Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) |
$272.70 |
$303 |
2.0× |
| Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention… (42962) |
$1,122.30 |
$1,247 |
0.3× |
| Control throat bleeding (42960) |
$3,316.50 |
$3,685 |
6.0× |
Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft (27132)
likely a partial charge — not the full procedure |
$3,579.30 |
$3,977 |
0.3× |
| Conz of cervix w/scope leep (57461) |
$389.70 |
$433 |
0.1× |
| Core needle bx lung/mediastinum perq w/img (32408) |
$4,179.60 |
$4,644 |
2.5× |
| Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy) (28285) |
$853.20 |
$948 |
0.3× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$450 |
$500 |
3.3× |
| Ctrl nsl hemrrg pst nasal packs&/cautery subsq (30906) |
$276.30 |
$307 |
1.1× |
| Curettage postpartum (59160) |
$396.90 |
$441 |
0.1× |
| Cylinder cast (29365) |
$189 |
$210 |
0.7× |
| Cystourethroscopy (52000) |
$170.10 |
$189 |
0.2× |
| Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography,… (52005) |
$284.40 |
$316 |
0.1× |
| Dbrdmt w/rmvl fm fx&/dislc skn subq t/m/f musc (11011) |
$1,108.80 |
$1,232 |
1.5× |
| Dcmprn fasct leg ant&/lat&pst cmprt (27602) |
$1,007.10 |
$1,119 |
0.3× |
| Deb skin bone at fx site (11012) |
$2,380.05 |
$2,644.50 |
0.8× |
| Debride skin at fx site (11010) |
$2,567.70 |
$2,853 |
3.5× |
| Debridement of extensive eczematous or infected skin; up to 10% of body surface (11000) |
$343.80 |
$382 |
0.8× |
| Debridement of nail(s) by any method(s); 1 to 5 (11720) |
$122.40 |
$136 |
2.0× |
| Debridement of nail(s) by any method(s); 6 or more (11721) |
$124.65 |
$138.50 |
2.1× |
| DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee (11042) |
$1,514.70 |
$1,683 |
3.6× |
| Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm… (11044) |
$2,588.40 |
$2,876 |
1.5× |
| Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm… (11043) |
$805.50 |
$895 |
1.1× |
| Declot vascular device (36593) |
$434.70 |
$483 |
1.3× |
| Deep muscle biopsy (20205) |
$328.50 |
$365 |
0.1× |
| Delivery of placenta (59414) |
$189 |
$210 |
0.1× |
| Destruct lesion 15 or more (17111) |
$183.60 |
$204 |
0.9× |
| Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions… (17004) |
$214.20 |
$238 |
0.5× |
| Destruction neurolytic agt genicular nerve w/img (64624) |
$316.80 |
$352 |
0.2× |
| Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical… (46922) |
$298.80 |
$332 |
0.1× |
| Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) Age Under 21 (57061) |
$250.20 |
$278 |
0.1× |
| Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17281) |
$257.40 |
$286 |
1.3× |
| Diagnostic bone marrow aspirations (38220) |
$1,431.90 |
$1,591 |
0.8× |
| Diagnostic bone marrow biopsies (38221) |
$2,229.30 |
$2,477 |
1.3× |
| Diagnostic exam of uterus using an endoscope|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (58555) |
$324 |
$360 |
0.1× |
| Diagnostic sigmoidoscopy (45330) |
$1,323.90 |
$1,471 |
1.4× |
| Dilation & Curettage Dx&/Ther Nonobstetric|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (58120) |
$501.30 |
$557 |
0.2× |
| Drain lower leg lesion (27603) |
$845.10 |
$939 |
0.3× |
| Drainage external ear, abscess or hematoma; simple (69000) |
$272.70 |
$303 |
0.4× |
| Drainage finger abscess simple (26010) |
$506.25 |
$562.50 |
2.5× |
| Drainage of abscess of palate, uvula (42000) |
$238.50 |
$265 |
1.0× |
| Drainage of abscess, cyst, hematoma, vestibule of mouth; simple (40800) |
$262.80 |
$292 |
0.4× |
| Drainage of finger abscess; complicated (eg, felon) (26011) |
$405 |
$450 |
0.2× |
| Drainage of scrotal wall abscess (55100) |
$365.40 |
$406 |
0.2× |
| Drainage of scrotum (54700) |
$462.60 |
$514 |
0.2× |
| Drainage of tonsil abscess (42700) |
$796.50 |
$885 |
3.3× |
| Dstr nrolytc agnt parverteb fct sngl crvcl/thora (64633) |
$621 |
$690 |
0.3× |
| Dstr nrolytc agnt parverteb fct sngl lmbr/sacral (64635) |
$621.90 |
$691 |
0.3× |
| Ed proc insert intraosseous IV (36680) |
$855 |
$950 |
1.9× |
| Ed proc insj temp ndwellg bladder catheter complicated (51703) |
$349.20 |
$388 |
2.7× |
| Ed proc remve fb nasal- hospital (30300) |
$263.70 |
$293 |
1.9× |
| Ed prof arthrocentesis sm - hospital (20551) |
$81.90 |
$91 |
0.3× |
| Ed prof artl pnxr w/drawal bld dx (36600) |
$126 |
$140 |
0.9× |
| Ed prof burn - large - hospital (16030) |
$423.45 |
$470.50 |
1.0× |
| Ed prof burn medium - hospital (16025) |
$237.60 |
$264 |
1.2× |
| Ed prof burn small - hospital (16020) |
$120.60 |
$134 |
0.6× |
| Ed prof catheterization/straight (51701) |
$221.40 |
$246 |
1.6× |
| Ed prof closed tx post hip arthroplasty (27265) |
$926.10 |
$1,029 |
3.7× |
| Ed prof closed tx pst malleolus fx w/manipulation (27768) |
$999.90 |
$1,111 |
0.6× |
| Ed prof closed tx radial head/neck fx w/manipulation (24655) |
$1,195.65 |
$1,328.50 |
0.7× |
| Ed prof drain dental abscess-hospital (41800) |
$345.60 |
$384 |
2.5× |
| Ed prof insert foley cath simple (51702) |
$53.10 |
$59 |
0.4× |
| Ed prof insert non tunnel cv cath >5 (36556) |
$177.30 |
$197 |
0.1× |
| Ed prof int lac 12.6-20cm bd - hospital (12035) |
$732.15 |
$813.50 |
1.8× |
| Ed prof int lac 7.6-12.5cm bd - hospital (12034) |
$626.40 |
$696 |
1.5× |
| Ed prof interphalangeal dislocation- hospital (26770) |
$596.70 |
$663 |
2.4× |
| Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) |
$316.35 |
$351.50 |
0.7× |
| Egd percutaneous placement gastrostomy tube (43246) |
$422.10 |
$469 |
0.2× |
| Egd removal tumor polyp/other lesion snare tech (43251) |
$414 |
$460 |
0.2× |
| Egd transoral control bleeding any method (43255) |
$423.90 |
$471 |
0.2× |
| Endoscopic us exam esoph (43237) |
$413.10 |
$459 |
0.2× |
| Episiotomy or vaginal repair (59300) |
$309.60 |
$344 |
0.1× |
| Er inj anesthetic agent, peripheral nerve or branch (64450) |
$667.80 |
$742 |
0.9× |
| Esoph egd dilation <30 mm (43249) |
$324.90 |
$361 |
0.2× |
| Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body (43247) |
$373.50 |
$415 |
0.4× |
| Esophagoscopy flexible removal foreign body (43215) |
$299.70 |
$333 |
0.2× |
Ethmoidectomy; intranasal, anterior Age Under 21 (31200)
likely a partial charge — not the full procedure |
$1,353.60 |
$1,504 |
0.2× |
| Evac subungual hematoma (11740) |
$145.35 |
$161.50 |
1.1× |
| Exc f/e/e/n/l mal+mrg 1.1-2 (11642) |
$668.70 |
$743 |
0.9× |
| Exc face les sbq 2 cm/> (21012) |
$738 |
$820 |
0.4× |
| Exc forearm les sc 3 cm/> (25071) |
$923.40 |
$1,026 |
0.5× |
| Exc frenum labial/buccal (40819) |
$441.90 |
$491 |
0.3× |
| Exc h-f-nk-sp b9+marg 0.5/< (11420) |
$855 |
$950 |
0.5× |
| Exc h-f-nk-sp b9+marg 0.6-1 (11421) |
$613.80 |
$682 |
0.8× |
| Exc h-f-nk-sp b9+marg 1.1-2 (11422) |
$913.95 |
$1,015.50 |
0.5× |
| Exc lesion tendon sheath/capsule w/synvct foot (28090) |
$678.60 |
$754 |
0.4× |
| Exc lesion tendon sheath/capsule w/synvct toe ea (28092) |
$600.30 |
$667 |
0.4× |
| Exc neck tum deep < 5 cm (21556) |
$1,145.70 |
$1,273 |
0.4× |
| Exc tr-ext b9+marg 0.5 < cm (11400) |
$789.75 |
$877.50 |
1.1× |
| Exc tr-ext b9+marg 1.1-2 cm (11402) |
$598.50 |
$665 |
0.8× |
| Exc tum/vasc mal sft tiss hand/fngr subq <1.5cm (26115) |
$738 |
$820 |
0.4× |
| Exc tumor soft tiss shoulder subfasc <5cm (23076) |
$1,186.20 |
$1,318 |
0.4× |
| Exc Tumor Soft Tissue Abdl Wall Subfascial <5cm (22900) |
$1,223.10 |
$1,359 |
0.4× |
| Exc tumor soft tissue foot/toe subfasc <1.5cm (28045) |
$765 |
$850 |
0.3× |
| Exc tumor soft tissue forearm &/wrist subq <3cm (25075) |
$1,041.30 |
$1,157 |
0.6× |
| Exc tumor soft tissue pelvis & hip subq <3cm (27047) |
$783.90 |
$871 |
0.3× |
| Exc tumor soft tissue upper arm/elbow subq 3cm/> (24071) |
$880.20 |
$978 |
0.3× |
| Exchng absc/cst drg cath rad gid spx (49423) |
$1,758.60 |
$1,954 |
0.9× |
| Excision aural polyp (69540) |
$280.80 |
$312 |
0.2× |
| Excision external ear partial simple repair (69110) |
$710.10 |
$789 |
0.2× |
| Excision ganglion wrist dorsal/volar primary (25111) |
$727.20 |
$808 |
0.4× |
| Excision hidradenitis axillary smpl/intrm rpr (11450) |
$2,452.50 |
$2,725 |
0.8× |
| Excision inferior turbinate, partial or complete, any method Age Under 21 (30130) |
$901.80 |
$1,002 |
0.3× |
| Excision lesion mouth roof (42104) |
$294.30 |
$327 |
0.1× |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) |
$565.65 |
$628.50 |
0.8× |
| Excision Mal Lesion Trunk/Arm/Leg 1.1-2.0 Cm (11602) |
$647.55 |
$719.50 |
1.6× |
| Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) |
$770.85 |
$856.50 |
1.1× |
| Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) |
$971.55 |
$1,079.50 |
1.3× |
| Excision malignant lesion f/e/e/n/l >4.0 cm (11646) |
$1,765.35 |
$1,961.50 |
0.6× |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) |
$2,724.30 |
$3,027 |
1.6× |
| Excision multiple external papillae/tags anus (46230) |
$375.30 |
$417 |
0.1× |
| Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion Age Under 21 (19125) |
$994.50 |
$1,105 |
0.2× |
| Excision of ganglion, wrist (dorsal or volar); recurrent Age Under 21 (25112) |
$869.40 |
$966 |
0.5× |
| Excision of lesion of spermatic cord (separate procedure) Age Under 21 (55520) |
$988.20 |
$1,098 |
0.3× |
| Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle Age Under 21 (27630) |
$789.30 |
$877 |
0.2× |
| Excision of lesion of tendon sheath or joint capsule, hand or finger (26160) |
$703.80 |
$782 |
0.4× |
Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve Age Under 21 (42415)
unusually low — confirm this is the full procedure |
$2,280.60 |
$2,534 |
0.4× |
| Excision of pilonidal cyst or sinus; simple Age Under 21 (11770) |
$5,224.05 |
$5,804.50 |
1.8× |
| Excision of single external papilla or tag, anus (46220) |
$263.70 |
$293 |
0.2× |
| Excision of thrombosed hemorrhoid, external (46320) |
$244.80 |
$272 |
0.2× |
| Excision of tongue fold (41115) |
$316.80 |
$352 |
0.2× |
| Excision of tonsil tags Age Under 21 (42860) |
$427.50 |
$475 |
0.1× |
| Excision of vaginal cyst or tumor (57135) |
$405 |
$450 |
0.1× |
| Excision olecranon bursa (24105) |
$803.70 |
$893 |
0.2× |
| Excision or curettage of bone cyst or benign tumor of femur; Age Under 21 (27355) |
$1,335.60 |
$1,484 |
0.4× |
| Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; Age Under 21 (24120) |
$1,176.30 |
$1,307 |
0.4× |
| Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; Age Under 21 (28104) |
$781.20 |
$868 |
0.2× |
| Excision or curettage of bone cyst or benign tumor, tibia or fibula; Age Under 21 (27635) |
$1,260 |
$1,400 |
0.4× |
| Excision pilonidal cyst/sinus complicated (11772) |
$5,068.35 |
$5,631.50 |
1.7× |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) |
$1,014.30 |
$1,127 |
0.6× |
| Excision tumor soft tissue back/flank subq <3cm (21930) |
$792.90 |
$881 |
0.5× |
| Excision tumor soft tissue foot/toe subq 1.5+cm (28039) |
$733.50 |
$815 |
0.2× |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) |
$571.50 |
$635 |
0.3× |
| Excision tumor soft tissue shoulder subq 3 cm/> (23071) |
$911.70 |
$1,013 |
0.5× |
| Excision tumor soft tissue thigh/knee subq <3cm (27327) |
$687.60 |
$764 |
0.4× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11423) |
$1,027.35 |
$1,141.50 |
0.6× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11426) |
$1,641.15 |
$1,823.50 |
0.6× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11424) |
$1,165.05 |
$1,294.50 |
0.7× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11401) |
$520.20 |
$578 |
1.3× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11404) |
$922.05 |
$1,024.50 |
0.5× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11403) |
$726.30 |
$807 |
1.0× |
| Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11406) |
$1,168.65 |
$1,298.50 |
0.7× |
Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy Age Under… (15830)
unusually low — confirm this is the full procedure |
$2,526.30 |
$2,807 |
0.4× |
| Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area - 15839 (15839) |
$1,596.60 |
$1,774 |
0.5× |
| Excision, interdigital (Morton) neuroma, single, each Age Under 21 (28080) |
$841.50 |
$935 |
0.5× |
| Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure… (15946) |
$3,432.60 |
$3,814 |
1.6× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less Age… (11640) |
$542.25 |
$602.50 |
0.7× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm Age Under… (11641) |
$573.30 |
$637 |
0.8× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm Age Under… (11643) |
$987.75 |
$1,097.50 |
0.6× |
| Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm Age Under… (11644) |
$1,247.40 |
$1,386 |
0.7× |
| Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm Age… (11626) |
$4,737.15 |
$5,263.50 |
1.6× |
| Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less (11600) |
$537.30 |
$597 |
0.7× |
| Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm Age Under 21 (11606) |
$1,237.50 |
$1,375 |
0.7× |
| Excision, nasal polyp(s), extensive Age Under 21 (30115) |
$1,008 |
$1,120 |
0.3× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11442) |
$633.15 |
$703.50 |
0.9× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11441) |
$550.35 |
$611.50 |
0.8× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11444) |
$1,191.15 |
$1,323.50 |
0.7× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11440) |
$522.45 |
$580.50 |
0.7× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11443) |
$937.80 |
$1,042 |
0.6× |
| Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11446) |
$1,694.70 |
$1,883 |
0.6× |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater Age Under 21 (22903) |
$950.40 |
$1,056 |
0.3× |
| Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater Age Under 21 (21014) |
$1,131.30 |
$1,257 |
0.4× |
| Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm Age Under 21 (21011) |
$573.30 |
$637 |
0.3× |
| Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater Age Under 21 (25073) |
$1,173.60 |
$1,304 |
0.4× |
| Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm Age Under 21 (25076) |
$1,140.30 |
$1,267 |
0.7× |
| Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater Age Under 21 (21552) |
$965.70 |
$1,073 |
0.3× |
| Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm (21555) |
$670.50 |
$745 |
0.4× |
| Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater Age Under 21 (21554) |
$1,573.20 |
$1,748 |
0.5× |
| Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater (27043) |
$1,012.50 |
$1,125 |
0.3× |
| Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm Age Under 21 (23075) |
$719.10 |
$799 |
0.4× |
| Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater Age Under 21 (27339) |
$1,628.10 |
$1,809 |
0.5× |
| Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm Age Under 21 (24075) |
$721.80 |
$802 |
0.4× |
| Excison tumor soft tissue thigh/knee subq 3 cm/> (27337) |
$910.80 |
$1,012 |
0.3× |
| Exploration penetrating wound spx extremity (20103) |
$739.80 |
$822 |
0.4× |
| Explore wound abdomen (20102) |
$4,625.55 |
$5,139.50 |
2.2× |
| Explore/treat ankle joint (27610) |
$1,405.80 |
$1,562 |
0.4× |
| Fasct prtl plmr 1 dgt prox iphal jt +-tiss (26123) |
$1,840.50 |
$2,045 |
0.6× |
| Fine needle aspiration bx w/CT gdn 1st lesion (10009) |
$1,523.25 |
$1,692.50 |
2.1× |
| Fine needle aspiration bx w/fluor gdn 1st lesion (10007) |
$1,210.50 |
$1,345 |
1.7× |
| Fine needle aspiration bx w/o img gdn 1st lesion (10021) |
$528.75 |
$587.50 |
1.3× |
| Fine needle aspiration bx w/us gdn 1st lesion (10005) |
$1,030.95 |
$1,145.50 |
1.4× |
| Fluid pressure muscle (20950) |
$887.40 |
$986 |
1.2× |
| Fna bx w/mr gdn 1st les (10011) |
$1,362.15 |
$1,513.50 |
1.9× |
| Fracture nasal inferior turbinate(s), therapeutic (30930) |
$387 |
$430 |
0.1× |
| Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae,… (15240) |
$1,726.20 |
$1,918 |
0.8× |
| Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis) (43754) |
$319.95 |
$355.50 |
1.5× |
| Gastric lavage (43753) |
$229.05 |
$254.50 |
1.0× |
| Gastrocnemius recession (27687) |
$996.30 |
$1,107 |
0.3× |
| Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury (43840) |
$2,880 |
$3,200 |
0.7× |
| Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint;… (28289) |
$1,012.50 |
$1,125 |
0.3× |
| Hemiphalangectomy/interphalangeal joint exc toe (28160) |
$587.70 |
$653 |
0.2× |
| Hemorrhoidectomy internal rubber band ligations (46221) |
$422.10 |
$469 |
0.4× |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) |
$768.60 |
$854 |
0.3× |
| Hemorrhoidectomy, external, 2 or more columns/groups (46250) |
$694.80 |
$772 |
0.2× |
| Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging… (46946) |
$828.90 |
$921 |
0.3× |
| Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging… (46945) |
$745.20 |
$828 |
0.3× |
| Hysteroscopy biopsy (58558) |
$491.40 |
$546 |
0.1× |
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)… (58563)
likely a partial charge — not the full procedure |
$522 |
$580 |
0.1× |
Hysteroscopy, surgical; with removal of leiomyomata Age Under 21 (58561)
likely a partial charge — not the full procedure |
$757.80 |
$842 |
0.1× |
| I&d absc rtrphrngl/parapharyngeal intraoral (42720) |
$2,604.60 |
$2,894 |
0.8× |
| I&d abscess simple/single (10060) |
$621.45 |
$690.50 |
3.0× |
| I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION TechFee (27301) |
$1,109.70 |
$1,233 |
0.4× |
| I&d hematoma/seroma/fluid (10140) |
$2,710.35 |
$3,011.50 |
1.6× |
| I&d pilonidal cyst simple (10080) |
$877.95 |
$975.50 |
1.2× |
| Image-guide fluid collxn drainage cath visc perq (49405) |
$5,103.90 |
$5,671 |
3.0× |
| Img-guide fluid collxn drainag cath periton perq (49406) |
$5,567.40 |
$6,186 |
3.3× |
Implantation of donor cartilage cells into knee joint|RIGHT SIDE (27415)
likely a partial charge — not the full procedure |
$2,961 |
$3,290 |
0.2× |
| Incise external hemorrhoid (46083) |
$239.40 |
$266 |
0.9× |
| Incise finger tendon sheath (26055) |
$650.70 |
$723 |
0.4× |
| INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee (10061) |
$501.30 |
$557 |
1.2× |
| Incision and drainage of Bartholin's gland abscess (56420) |
$236.70 |
$263 |
1.1× |
| Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia Age Under 21 (46045) |
$953.10 |
$1,059 |
0.3× |
| Incision and drainage of pilonidal cyst; complicated (10081) |
$952.65 |
$1,058.50 |
1.3× |
| Incision and drainage of vulva or perineal abscess (56405) |
$275.40 |
$306 |
0.9× |
| Incision and drainage, complex, postoperative wound infection Age Under 21 (10180) |
$1,872.90 |
$2,081 |
0.6× |
| Incision and drainage, pelvis or hip joint area; deep abscess or hematoma Age Under 21 (26990) |
$1,476 |
$1,640 |
0.4× |
| Incision and drainage, perianal abscess, superficial (46050) |
$221.40 |
$246 |
0.2× |
| Incision and removal of foreign body, subcutaneous tissues; complicated (10121) |
$2,458.80 |
$2,732 |
1.5× |
| Incision and removal of foreign body, subcutaneous tissues; simple (10120) |
$732.15 |
$813.50 |
1.8× |
| Incision extensor tendon sheath wrist (25000) |
$773.10 |
$859 |
0.5× |
| Incision of connective tissue of foot and/or toe (28008) |
$647.10 |
$719 |
0.2× |
| Incision of labial frenum (frenotomy) Age Under 21 (40806) |
$65.70 |
$73 |
0.1× |
| Incision of lingual frenum (frenotomy) (41010) |
$238.50 |
$265 |
0.2× |
| Incision of rectal abscess (46040) |
$928.80 |
$1,032 |
0.8× |
| Incision of vein for insertion of needle or tube (1 year or older) (36425) |
$226.35 |
$251.50 |
0.5× |
| Incision of windpipe (31603) |
$672.30 |
$747 |
0.4× |
| Incisional biopsy skin single lesion (11106) |
$740.70 |
$823 |
1.0× |
| Infusion of drug to dissolve blood clot in brain (37195) |
$1,117.80 |
$1,242 |
3.3× |
| Initial treatment, first degree burn, when no more than local treatment is required (16000) |
$97.20 |
$108 |
0.5× |
| Inj epidural blood or clot patch (62273) |
$243 |
$270 |
0.3× |
| Inj paravert f jnt c/t 1 lev (64490) |
$340.20 |
$378 |
0.4× |
| Inj paravert f jnt l/s 1 lev (64493) |
$293.40 |
$326 |
0.3× |
| Inj tx nerve (64640) |
$259.20 |
$288 |
0.3× |
| Inj,Anes Agent,Femoral Nerve,Single (64447) |
$1,944 |
$2,160 |
2.7× |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
$137.70 |
$153 |
0.2× |
| Injection aa&/strd brachial plexus w/img gdn (64415) |
$815.40 |
$906 |
0.9× |
| Injection aa&/strd genicular nrv branches w/img (64454) |
$177.30 |
$197 |
0.2× |
| Injection aa&/strd greater occipital nerve (64405) |
$248.85 |
$276.50 |
0.8× |
| Injection aa&/strd ilioinguinal ih nerves (64425) |
$117 |
$130 |
0.2× |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
$52.20 |
$58 |
0.1× |
| Injection aa&/strd intercostal nrv single lvl (64420) |
$126 |
$140 |
0.2× |
| Injection aa&/strd nerves nrvtg si joint w/img (64451) |
$176.40 |
$196 |
0.2× |
| Injection aa&/strd sciatic nerve w/img gdn (64445) |
$153.90 |
$171 |
0.2× |
| Injection aa&/strd trigeminal nerve each branch (64400) |
$343.35 |
$381.50 |
1.1× |
| Injection anes lmbr/thrc paravertbrl sympathetic (64520) |
$274.50 |
$305 |
0.3× |
| Injection for identification of sentinel node (38792) |
$585.45 |
$650.50 |
1.4× |
| Injection px prq tx extremity pseudoaneurysm (36002) |
$1,431.90 |
$1,591 |
2.2× |
| Injection sclerosant multiple incmptnt veins (36471) |
$156.60 |
$174 |
0.4× |
| Injection sclerosant single incmptnt vein (36470) |
$80.10 |
$89 |
0.2× |
| Injection therapeutic carpal tunnel (20526) |
$121.50 |
$135 |
0.4× |
| Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) |
$580.50 |
$645 |
1.9× |
| Injection(s); single or multiple trigger point(s), 3 or more muscle(s) (20553) |
$262.35 |
$291.50 |
0.8× |
| Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) (20550) |
$83.70 |
$93 |
0.3× |
| Insert cervical dilator (59200) |
$1,137.60 |
$1,264 |
3.7× |
| Insert non-tunnel cv cath < 5 y/o (36555) |
$2,213.55 |
$2,459.50 |
0.7× |
| Insertion indwelling tunneled pleural catheter (32550) |
$428.40 |
$476 |
0.1× |
| Insertion of tube into airway for aspiration of secretions (31720) |
$220.95 |
$245.50 |
1.0× |
| Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older Age… (36561) |
$698.40 |
$776 |
0.2× |
| Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or… (36558) |
$547.20 |
$608 |
0.2× |
| Insertion picc w/o img gdn 5 yr/> (36569) |
$2,231.55 |
$2,479.50 |
1.4× |
| Insertion picc w/rs&i 5 yr/> (36573) |
$2,236.95 |
$2,485.50 |
1.4× |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
$658.80 |
$732 |
0.2× |
| Intubation endotracheal (31500) |
$622.35 |
$691.50 |
2.6× |
Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy Age Under 21 (59151)
likely a partial charge — not the full procedure |
$1,634.40 |
$1,816 |
0.3× |
Laparoscopy Enterolysis Separate Procedure (44180)
unusually low — confirm this is the full procedure |
$1,953 |
$2,170 |
0.3× |
Laparoscopy Surg Rpr Initial Inguinal Hernia (49650)
likely a partial charge — not the full procedure |
$1,397.70 |
$1,553 |
0.2× |
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or… (49320)
likely a partial charge — not the full procedure |
$706.50 |
$785 |
0.1× |
Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie,… (43284)
likely a partial charge — not the full procedure |
$1,393.20 |
$1,548 |
0.1× |
Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal… (58545)
unusually low — confirm this is the full procedure |
$1,926 |
$2,140 |
0.3× |
Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; Age Under 21 (58541)
likely a partial charge — not the full procedure |
$1,566.90 |
$1,741 |
0.1× |
Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)… (58542)
likely a partial charge — not the full procedure |
$1,774.80 |
$1,972 |
0.2× |
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or… (58544)
likely a partial charge — not the full procedure |
$1,935 |
$2,150 |
0.2× |
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; Age Under 21 (58570)
likely a partial charge — not the full procedure |
$1,731.60 |
$1,924 |
0.2× |
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) Age… (58571)
likely a partial charge — not the full procedure |
$1,945.80 |
$2,162 |
0.2× |
Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; Age Under 21 (58550)
unusually low — confirm this is the full procedure |
$1,888.20 |
$2,098 |
0.3× |
Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) Age… (58552)
likely a partial charge — not the full procedure |
$2,098.80 |
$2,332 |
0.2× |
Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or… (58554)
likely a partial charge — not the full procedure |
$2,780.10 |
$3,089 |
0.3× |
Laparoscopy, surgical; cholecystectomy with cholangiography Age Under 21 (47563)
likely a partial charge — not the full procedure |
$1,532.70 |
$1,703 |
0.2× |
Laparoscopy, surgical; with biopsy (single or multiple) Age Under 21 (49321)
likely a partial charge — not the full procedure |
$738 |
$820 |
0.1× |
Laparoscopy, surgical; with fulguration of oviducts (with or without transection) Age Under 21 (58670)
likely a partial charge — not the full procedure |
$797.40 |
$886 |
0.1× |
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by… (58662)
likely a partial charge — not the full procedure |
$1,525.50 |
$1,695 |
0.2× |
Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) Age Under 21 (58660)
likely a partial charge — not the full procedure |
$1,463.40 |
$1,626 |
0.2× |
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) Age… (58661)
unusually low — confirm this is the full procedure |
$2,090.70 |
$2,323 |
0.3× |
Laps Rpr Paraesphgl Hrna Incl Fundplsty W/O Mesh (43281)
likely a partial charge — not the full procedure |
$3,229.20 |
$3,588 |
0.3× |
Laps Surg Esopg/Gstr Fundoplasty (43280)
likely a partial charge — not the full procedure |
$2,278.80 |
$2,532 |
0.2× |
Laps Surg Rpr Recurrent Inguinal Hernia (49651)
likely a partial charge — not the full procedure |
$1,214.10 |
$1,349 |
0.2× |
Laps Surg W/Aspir Cavity/Cyst Single/Multiple (49322)
likely a partial charge — not the full procedure |
$800.10 |
$889 |
0.1× |
| Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope Age Under 21 (31526) |
$336.60 |
$374 |
0.2× |
| Laryngoscopy flex diagnostic (31575) |
$149.40 |
$166 |
0.7× |
| Laryngoscopy indirect diagnostic (31505) |
$108 |
$120 |
0.5× |
| Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure) Age Under 21 (27685) |
$1,020.60 |
$1,134 |
0.3× |
Ligamentous reconstruction (augmentation), knee; extra-articular (27427)
likely a partial charge — not the full procedure |
$1,544.40 |
$1,716 |
0.2× |
Ligamentous reconstruction knee intra-articular (27428)
likely a partial charge — not the full procedure |
$2,424.60 |
$2,694 |
0.2× |
| Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral Age Under 21 (58600) |
$796.50 |
$885 |
0.2× |
| Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below Age… (37722) |
$950.40 |
$1,056 |
0.3× |
| Lumbar puncture (62270) |
$769.50 |
$855 |
1.1× |
| Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus) Age Under… (27860) |
$358.20 |
$398 |
0.1× |
| Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) Age… (27570) |
$510.30 |
$567 |
0.3× |
| Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded) Age… (23700) |
$428.40 |
$476 |
0.3× |
| Marsupialization bartholin's gland cyst (56440) |
$390.60 |
$434 |
0.1× |
| Mastectomy partial (19301) |
$1,408.50 |
$1,565 |
0.4× |
Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding… (19307)
unusually low — confirm this is the full procedure |
$2,513.70 |
$2,793 |
0.4× |
| Mastotomy expl drg absc dp (19020) |
$678.60 |
$754 |
0.4× |
| Meas post-voiding residual urine&/bladder cap (51798) |
$243.90 |
$271 |
4.0× |
| Muscle, myocutaneous, or fasciocutaneous flap; lower extremity Age Under 21 (15738) |
$2,705.40 |
$3,006 |
0.7× |
| Muscle, myocutaneous, or fasciocutaneous flap; trunk Age Under 21 (15734) |
$3,204.90 |
$3,561 |
0.9× |
| Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia Age Under 21 (69421) |
$329.40 |
$366 |
0.1× |
| Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) Age Under 21 (31231) |
$137.70 |
$153 |
0.7× |
Nasal/Sinus Endoscopy W/Sphenoidotomy (31287)
likely a partial charge — not the full procedure |
$429.30 |
$477 |
0.1× |
Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior) Age Under 21 (31255)
likely a partial charge — not the full procedure |
$687.60 |
$764 |
0.1× |
Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy Age Under 21 (31257)
likely a partial charge — not the full procedure |
$946.80 |
$1,052 |
0.1× |
Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when… (31276)
likely a partial charge — not the full procedure |
$803.70 |
$893 |
0.1× |
| Nasal/sinus endoscopy, surgical, with maxillary antrostomy; Age Under 21 (31256) |
$386.10 |
$429 |
0.1× |
Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus Age Under 21 (31288)
likely a partial charge — not the full procedure |
$498.60 |
$554 |
0.1× |
| Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure) Age Under 21 (31237) |
$343.80 |
$382 |
0.2× |
Nasal/Sinus Ndsc Tot W/Frnt Sins Expl Tiss Rmvl (31253)
likely a partial charge — not the full procedure |
$1,061.10 |
$1,179 |
0.1× |
Nasal/Sinus Ndsc Tot W/Sphendt W/Sphen Tiss Rmvl (31259)
likely a partial charge — not the full procedure |
$1,001.70 |
$1,113 |
0.1× |
Nasal/sinus ndsc w/partial ethmoidectomy (31254)
likely a partial charge — not the full procedure |
$518.40 |
$576 |
0.1× |
| Needle insertion w/o injection 1 or 2 muscles (20560) |
$32.40 |
$36 |
1.1× |
| Needle insertion w/o injection 3 or more muscles (20561) |
$48.60 |
$54 |
1.6× |
| Neuroplasty &/transpos median nrv carpal tunne (64721) |
$963 |
$1,070 |
0.5× |
| Njx aa&/strd tfrm epi c/t 1 (64479) |
$422.10 |
$469 |
0.5× |
| Njx anes stellate ganglion crv sympathetic (64510) |
$164.70 |
$183 |
0.2× |
| Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) |
$230.40 |
$256 |
0.3× |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
$213.30 |
$237 |
0.3× |
| Non stress test (59025) |
$160.65 |
$178.50 |
0.8× |
Open treatment bimalleolar ankle fracture (27814)
likely a partial charge — not the full procedure |
$1,659.60 |
$1,844 |
0.2× |
Open treatment calcaneal fracture (28415)
unusually low — confirm this is the full procedure |
$2,428.20 |
$2,698 |
0.3× |
Open Treatment Distal Fracture (25608)
likely a partial charge — not the full procedure |
$1,813.50 |
$2,015 |
0.2× |
Open treatment fracture distal tibia only (27827)
likely a partial charge — not the full procedure |
$2,424.60 |
$2,694 |
0.2× |
Open treatment medial malleolus fracture (27766)
likely a partial charge — not the full procedure |
$1,325.70 |
$1,473 |
0.2× |
Open treatment of acromioclavicular dislocation, acute or chronic; Age Under 21 (23550)
likely a partial charge — not the full procedure |
$1,251.90 |
$1,391 |
0.2× |
Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) Age… (23552)
likely a partial charge — not the full procedure |
$1,413 |
$1,570 |
0.2× |
Open treatment of clavicular fracture, includes internal fixation, when performed Age Under 21 (23515)
likely a partial charge — not the full procedure |
$1,573.20 |
$1,748 |
0.2× |
Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed Age… (27829)
likely a partial charge — not the full procedure |
$1,534.50 |
$1,705 |
0.2× |
Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed (27514)
likely a partial charge — not the full procedure |
$2,077.20 |
$2,308 |
0.2× |
Open treatment of femoral shaft fracture with plate/screws, with or without cerclage (27507)
likely a partial charge — not the full procedure |
$2,085.30 |
$2,317 |
0.3× |
| Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed Age Under 21 (28505) |
$1,085.40 |
$1,206 |
0.3× |
Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed Age Under 21 (23630)
likely a partial charge — not the full procedure |
$1,705.50 |
$1,895 |
0.2× |
Open treatment of greater trochanteric fracture, includes internal fixation, when performed (27248)
likely a partial charge — not the full procedure |
$1,611.90 |
$1,791 |
0.2× |
Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue… (27524)
likely a partial charge — not the full procedure |
$1,640.70 |
$1,823 |
0.2× |
Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (27535)
likely a partial charge — not the full procedure |
$1,930.50 |
$2,145 |
0.3× |
Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid processºes»), includes internal fixation,… (24685)
likely a partial charge — not the full procedure |
$1,434.60 |
$1,594 |
0.2× |
Open treatment radial shaft fracture (25515)
likely a partial charge — not the full procedure |
$1,471.50 |
$1,635 |
0.2× |
Open treatment tarsometatarsal joint dislocation (28615)
likely a partial charge — not the full procedure |
$1,804.50 |
$2,005 |
0.2× |
Open tx distal fibular fracture lat malleolus (27792)
likely a partial charge — not the full procedure |
$1,404.90 |
$1,561 |
0.2× |
| Open tx metacarpal fracture single ea bone (26615) |
$1,271.70 |
$1,413 |
0.4× |
Open tx prox humeral fx (23615)
likely a partial charge — not the full procedure |
$1,920.60 |
$2,134 |
0.1× |
Open tx tarsal fracture xcp talus &calcaneus ea (28465)
likely a partial charge — not the full procedure |
$1,407.60 |
$1,564 |
0.2× |
| Orchiectomy, radical, for tumor; inguinal approach Age Under 21 (54530) |
$176.40 |
$196 |
0.0× |
| Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head Age Under 21 (28288) |
$954.90 |
$1,061 |
0.3× |
Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining… (23485)
likely a partial charge — not the full procedure |
$2,061.90 |
$2,291 |
0.2× |
Ovarian cystectomy, unilateral or bilateral (58925)
unusually low — confirm this is the full procedure |
$1,646.10 |
$1,829 |
0.3× |
| Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions (11056) |
$276.30 |
$307 |
1.3× |
| Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion (11055) |
$200.25 |
$222.50 |
1.0× |
| Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus Age Under 21 (24140) |
$1,536.30 |
$1,707 |
0.5× |
| Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing);… (28122) |
$962.10 |
$1,069 |
0.3× |
| Partial excision distal phalanx finger (26236) |
$978.30 |
$1,087 |
0.6× |
Partial thyroid lobectomy, unilateral; with or without isthmusectomy (60210)
likely a partial charge — not the full procedure |
$1,519.20 |
$1,688 |
0.2× |
| Partical excision bone phalanx toe (28124) |
$738 |
$820 |
0.2× |
| Pelvic examination under anesthesia (other than local) Age Under 21 (57410) |
$226.80 |
$252 |
0.1× |
| Penile injection (54235) |
$193.05 |
$214.50 |
0.8× |
Percutaneous skeletal fixation of femoral fracture, proximal end, neck (27235)
likely a partial charge — not the full procedure |
$1,962.90 |
$2,181 |
0.3× |
| Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with… (26727) |
$1,053.90 |
$1,171 |
0.3× |
| Peritoneal lavage, including imaging guidance, when performed (49084) |
$6,059.70 |
$6,733 |
6.5× |
| Perq device breast 1st imag (19281) |
$325.80 |
$362 |
0.2× |
| Perq drainage pleura insert cath w/o imaging (32556) |
$261 |
$290 |
0.1× |
| Perq replacement gtube not req revj gstrst trc (43762) |
$78.30 |
$87 |
0.3× |
Perq vert agmntj cavity crtj uni/bi cannulation (22513)
likely a partial charge — not the full procedure |
$1,080 |
$1,200 |
0.1× |
Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514)
likely a partial charge — not the full procedure |
$1,008.90 |
$1,121 |
0.1× |
| Perq vertebroplasty uni/bi injection lumbosacral (22511) |
$865.80 |
$962 |
0.3× |
| Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous,… (49411) |
$4,419.90 |
$4,911 |
3.1× |
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy Age Under 21 (57250)
likely a partial charge — not the full procedure |
$1,320.30 |
$1,467 |
0.3× |
| Preputial stretching (54450) |
$203.40 |
$226 |
0.8× |
| Prineoplasty rpr pr nonobal spx (56810) |
$583.20 |
$648 |
0.2× |
| Proctosigmoidoscopy dx (45300) |
$103.50 |
$115 |
0.1× |
| Punch biopsy skin single lesion (11104) |
$874.35 |
$971.50 |
2.1× |
| Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) |
$576.90 |
$641 |
1.4× |
| Rad resection tumor soft tissue back/flank <5cm (21935) |
$2,174.40 |
$2,416 |
0.7× |
Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell,… (27422)
likely a partial charge — not the full procedure |
$1,620.90 |
$1,801 |
0.2× |
Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft Age Under 21 (24342)
likely a partial charge — not the full procedure |
$1,685.70 |
$1,873 |
0.2× |
| REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS TechFee (28190) |
$288.90 |
$321 |
0.4× |
| Removal foreign body from external auditory canal; with general anesthesia Age Under 21 (69205) |
$206.10 |
$229 |
0.1× |
| Removal foreign body mouth (40804) |
$258.30 |
$287 |
0.3× |
| Removal foreign body, intranasal; requiring general anesthesia Age Under 21 (30310) |
$447.30 |
$497 |
0.1× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$124.65 |
$138.50 |
2.1× |
| Removal impacted cerumen requiring instrumentation, unilateral (69210) |
$68.40 |
$76 |
1.1× |
| Removal implant deep (20680) |
$911.70 |
$1,013 |
0.3× |
| Removal implant from finger/hand (26320) |
$776.70 |
$863 |
0.5× |
| Removal of anal fissure (46200) |
$742.50 |
$825 |
0.3× |
Removal of appendix using an endoscope (44970)
likely a partial charge — not the full procedure |
$1,287 |
$1,430 |
0.2× |
| Removal of external bone stabilizing device under anesthesia|RIGHT SIDE (20694) |
$752.40 |
$836 |
0.5× |
| Removal of fecal impaction or foreign body (separate procedure) under anesthesia (45915) |
$495.90 |
$551 |
0.4× |
| Removal of fluid collection in testicle and sperm reservoir|RIGHT SIDE (55040) |
$734.40 |
$816 |
0.2× |
| Removal of fluid-filled sac (bursa) or calcium deposit of pelvis (27062) |
$996.30 |
$1,107 |
0.3× |
| Removal of fluid-filled sac from joint at front of knee (27340) |
$831.60 |
$924 |
0.2× |
| Removal of foreign body in muscle or tendon sheath; simple (20520) |
$3,137.40 |
$3,486 |
1.9× |
| Removal of foreign body of upper arm or elbow area, accessed beneath the skin (24200) |
$313.20 |
$348 |
0.2× |
| Removal of foreign body, external eye; conjunctival superficial (65205) |
$187.65 |
$208.50 |
1.4× |
| Removal of foreign body, external eye; corneal, without slit lamp (65220) |
$449.55 |
$499.50 |
1.0× |
| Removal of foreign body, foot; deep (28192) |
$682.20 |
$758 |
0.4× |
| Removal of foreign body, shoulder; deep (subfascial or intramuscular) Age Under 21 (23333) |
$1,044 |
$1,160 |
0.4× |
Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of… (27091)
likely a partial charge — not the full procedure |
$3,415.50 |
$3,795 |
0.3× |
| Removal of iud (58301) |
$140.40 |
$156 |
0.5× |
Removal of magnetic band from base of esophagus using an endoscope (43285)
likely a partial charge — not the full procedure |
$1,430.10 |
$1,589 |
0.2× |
| Removal of multiple hemorrhoid groups|DISC OP HOSP/AMB SURGR CENT (ASC) PROC AFTER ADMIN OF ANESTHES (46260) |
$1,044 |
$1,160 |
0.4× |
| Removal of nail bed (11750) |
$326.70 |
$363 |
0.8× |
Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee (27488)
likely a partial charge — not the full procedure |
$2,588.40 |
$2,876 |
0.2× |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
$174.15 |
$193.50 |
0.8× |
| Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation) Age Under 21 (15851) |
$1,870.65 |
$2,078.50 |
0.9× |
| Removal or bivalving; full arm or full leg cast Age Under 21 (29705) |
$96.30 |
$107 |
0.3× |
| Removal tunneled cv cath (36590) |
$401.40 |
$446 |
0.2× |
| Removal, non-biodegradable drug delivery implant (11982) |
$507.15 |
$563.50 |
1.1× |
| Remove foreign body from eye (65210) |
$77.40 |
$86 |
0.2× |
| Remove pharynx foreign body (42809) |
$272.70 |
$303 |
0.6× |
| Renal biopsy; percutaneous, by trocar or needle Age Under 21 (50200) |
$3,947.40 |
$4,386 |
2.3× |
Repair achilles tendon (27650)
likely a partial charge — not the full procedure |
$1,440 |
$1,600 |
0.2× |
| Repair blood vessel, direct; hand, finger Age Under 21 (35207) |
$2,941.65 |
$3,268.50 |
0.9× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$521.10 |
$579 |
1.3× |
| REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) |
$909.45 |
$1,010.50 |
2.2× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$554.40 |
$616 |
1.3× |
| Repair complex trunk 2.6-7.5 cm (13101) |
$530.10 |
$589 |
0.7× |
| Repair extensor tendon hand w/o graft each (26410) |
$7,492.95 |
$8,325.50 |
4.6× |
Repair fibula nonunion/malunion w int fixation (27726)
likely a partial charge — not the full procedure |
$2,070.90 |
$2,301 |
0.3× |
| Repair finger tendon (26418) |
$3,265.20 |
$3,628 |
2.0× |
| Repair finger/hand tendon (26350) |
$7,585.20 |
$8,428 |
2.3× |
| Repair initial femoral hernia, any age; incarcerated or strangulated Age Under 21 (49553) |
$1,353.60 |
$1,504 |
0.4× |
| Repair initial femoral hernia, any age; reducible Age Under 21 (49550) |
$1,239.30 |
$1,377 |
0.3× |
| Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated Age Under 21 (49507) |
$1,259.10 |
$1,399 |
0.3× |
Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible Age… (49500)
likely a partial charge — not the full procedure |
$898.20 |
$998 |
0.1× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) |
$483.30 |
$537 |
1.2× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) |
$575.55 |
$639.50 |
1.4× |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 7.6-12.5 CM (12054) |
$882.90 |
$981 |
2.1× |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
$1,043.10 |
$1,159 |
2.5× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$923.40 |
$1,026 |
1.2× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$580.50 |
$645 |
1.4× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$661.95 |
$735.50 |
1.6× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$749.25 |
$832.50 |
1.0× |
| REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) |
$463.95 |
$515.50 |
1.1× |
| REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) |
$544.05 |
$604.50 |
1.3× |
| REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM TechFee (12036) |
$932.40 |
$1,036 |
1.2× |
| Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes 5.1cm To 7.5cm (12053) |
$682.65 |
$758.50 |
1.6× |
| Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes20.1cm To 30.0cm (12056) |
$1,246.95 |
$1,385.50 |
3.0× |
| Repair Intermediate Wound Face,ears,eyelids,nose, Lips And Or Mucous Membranes Over 30.0cm (12057) |
$1,396.80 |
$1,552 |
3.4× |
| Repair Intermediate Wounds Of Scalp, Underarms, Truck And/or Extremities Over 30.0cm (12037) |
$1,317.60 |
$1,464 |
0.6× |
| Repair lip full thickness vermillion only - lac - lip rn (40650) |
$1,429.20 |
$1,588 |
2.6× |
| Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue (41250) |
$576 |
$640 |
1.3× |
| Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex (41252) |
$1,147.05 |
$1,274.50 |
4.7× |
| Repair of nail bed (11760) |
$500.85 |
$556.50 |
0.7× |
Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s) Age Under 21 (30468)
likely a partial charge — not the full procedure |
$362.70 |
$403 |
0.1× |
Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft) Age Under 21 (24435)
likely a partial charge — not the full procedure |
$2,344.50 |
$2,605 |
0.2× |
Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft) (27724)
unusually low — confirm this is the full procedure |
$2,691.90 |
$2,991 |
0.4× |
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute Age Under 21 (23410)
likely a partial charge — not the full procedure |
$1,782 |
$1,980 |
0.2× |
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic Age Under 21 (23412)
likely a partial charge — not the full procedure |
$1,850.40 |
$2,056 |
0.2× |
| Repair vagina/perineum (57210) |
$846 |
$940 |
0.3× |
| Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm (13151) |
$748.80 |
$832 |
1.0× |
| Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm (13152) |
$921.60 |
$1,024 |
1.2× |
| Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm (13120) |
$743.40 |
$826 |
1.8× |
| Repair, complex, trunk; 1.1 cm to 2.5 cm (13100) |
$432 |
$480 |
0.6× |
| Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm (12047) |
$1,611.45 |
$1,790.50 |
0.8× |
Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique) (27470)
unusually low — confirm this is the full procedure |
$2,546.10 |
$2,829 |
0.3× |
Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft) Age Under 21 (28322)
likely a partial charge — not the full procedure |
$1,258.20 |
$1,398 |
0.2× |
Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure) Age Under 21 (27698)
likely a partial charge — not the full procedure |
$1,389.60 |
$1,544 |
0.2× |
Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff) Age… (24341)
likely a partial charge — not the full procedure |
$1,642.50 |
$1,825 |
0.2× |
| Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon Age Under 21 (28200) |
$717.30 |
$797 |
0.2× |
| Replace tunneled cv cath (36582) |
$604.80 |
$672 |
0.2× |
| Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition Age Under 21 (43761) |
$217.80 |
$242 |
0.9× |
| Reset dislocated jaw (21480) |
$66.60 |
$74 |
0.3× |
Revis shoulder arthrplsty humeral&glenoid compnt (23474)
likely a partial charge — not the full procedure |
$3,717.90 |
$4,131 |
0.3× |
| Revise ulnar nerve at elbow (64718) |
$1,325.70 |
$1,473 |
0.7× |
Revision of total hip arthroplasty; both components, with or without autograft or allograft (27134)
unusually low — confirm this is the full procedure |
$4,064.40 |
$4,516 |
0.3× |
Revision of total hip arthroplasty; femoral component only, with or without allograft (27138)
likely a partial charge — not the full procedure |
$3,259.80 |
$3,622 |
0.2× |
Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component (27487)
likely a partial charge — not the full procedure |
$3,752.10 |
$4,169 |
0.2× |
Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component (23473)
likely a partial charge — not the full procedure |
$3,446.10 |
$3,829 |
0.3× |
| Rmvl embedded fb from dentalvlr struxs soft tiss (41805) |
$1,210.50 |
$1,345 |
0.8× |
| Rmvl embedded fb vestibule mouth comp (40805) |
$791.10 |
$879 |
1.4× |
| RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) |
$102.60 |
$114 |
0.8× |
| RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP TechFee (65222) |
$169.65 |
$188.50 |
1.2× |
Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594)
likely a partial charge — not the full procedure |
$1,569.60 |
$1,744 |
0.3× |
Rpr aa hernia 1st 3-10 cm reducible (49593)
likely a partial charge — not the full procedure |
$1,206.90 |
$1,341 |
0.2× |
Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592)
likely a partial charge — not the full procedure |
$1,003.50 |
$1,115 |
0.2× |
| Rpr aa hernia 1st < 3 cm reducible (49591) |
$722.70 |
$803 |
0.2× |
Rpr aa hernia recr 3-10 cm reducible (49615)
likely a partial charge — not the full procedure |
$1,346.40 |
$1,496 |
0.2× |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
$1,028.70 |
$1,143 |
1.4× |
| Rpr Recrt Inguinal Hernia Any Age Reducible (49520) |
$1,353.60 |
$1,504 |
0.4× |
| Secondary Closure Of Surgical Wound Or Dehiscence, Extensive Or Complicated (13160) |
$1,716.30 |
$1,907 |
0.5× |
| Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft Age Under 21 (30520) |
$1,451.70 |
$1,613 |
0.4× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) |
$130.05 |
$144.50 |
0.6× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) |
$143.55 |
$159.50 |
0.7× |
Simple complete removal of breast|BILATERAL PROCEDURE (19303)
unusually low — confirm this is the full procedure |
$2,044.80 |
$2,272 |
0.3× |
| Simple removal of skin debris and drainage of mastoid cavity|BILATERAL PROCEDURE (69220) |
$110.70 |
$123 |
0.5× |
| SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) |
$297 |
$330 |
1.4× |
| SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) |
$312.75 |
$347.50 |
1.5× |
| SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) |
$358.65 |
$398.50 |
1.7× |
| SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) |
$402.30 |
$447 |
2.0× |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
$654.75 |
$727.50 |
3.2× |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) |
$272.70 |
$303 |
1.3× |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee (12007) |
$724.95 |
$805.50 |
3.5× |
| Simple Repair Superficial Wound F/e/,eyelids,n/l/ And Or Mucous Membranes 20.1cm To 30.0cm (12017) |
$588.15 |
$653.50 |
1.4× |
| Simple Repair Superficial Wound F/e/eyelids,n/l/ And Or Mucous Membranes 12.6cm To 20.0cm (12016) |
$471.15 |
$523.50 |
1.1× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$346.95 |
$385.50 |
1.7× |
| Sinusotomy maxillary antrotomy intranasal (31020) |
$748.80 |
$832 |
0.2× |
Sling operation for stress incontinence (eg, fascia or synthetic) Age Under 21 (57288)
unusually low — confirm this is the full procedure |
$1,597.50 |
$1,775 |
0.3× |
| SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) |
$317.25 |
$352.50 |
1.5× |
| SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee (12005) |
$448.20 |
$498 |
1.1× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$527.40 |
$586 |
1.3× |
| Sphincterotomy, anal, division of sphincter (separate procedure) Age Under 21 (46080) |
$340.20 |
$378 |
0.1× |
| Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple… (15120) |
$1,488.60 |
$1,654 |
0.4× |
| Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children… (15100) |
$1,541.70 |
$1,713 |
0.7× |
| Stab phlebt varicose veins 1 xtr 10-20 stab incs (37765) |
$558.90 |
$621 |
0.2× |
| Strapping ankle (29540) |
$101.70 |
$113 |
0.6× |
| Strapping elbow or wrist (29260) |
$85.50 |
$95 |
1.4× |
| Strapping hand/finger (29280) |
$116.55 |
$129.50 |
1.9× |
| Strapping hip (29520) |
$138.60 |
$154 |
1.0× |
| Strapping of chest (29200) |
$258.30 |
$287 |
1.6× |
| Strapping of knee (29530) |
$145.80 |
$162 |
1.1× |
| Strapping of shoulder (29240) |
$38.70 |
$43 |
0.3× |
| Strapping of toes (29550) |
$23.40 |
$26 |
0.4× |
| Strapping unna boot (29580) |
$125.10 |
$139 |
0.8× |
| Submucous resection inferior turbinate, partial or complete, any method Age Under 21 (30140) |
$573.30 |
$637 |
0.2× |
| Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including… (15002) |
$468 |
$520 |
0.6× |
| Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including… (15004) |
$556.20 |
$618 |
1.3× |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous Age Under 21 (46270) |
$876.60 |
$974 |
0.3× |
| Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or… (46280) |
$1,045.80 |
$1,162 |
0.4× |
Suture of infrapatellar tendon; primary Age Under 21 (27380)
likely a partial charge — not the full procedure |
$1,358.10 |
$1,509 |
0.2× |
Suture of quadriceps or hamstring muscle rupture; primary Age Under 21 (27385)
likely a partial charge — not the full procedure |
$1,326.60 |
$1,474 |
0.2× |
| Syndactylization, toes (eg, webbing or Kelikian type procedure) Age Under 21 (28280) |
$746.10 |
$829 |
0.2× |
| Tangential biopsy skin single lesion (11102) |
$165.15 |
$183.50 |
0.4× |
Tenodesis long tendon biceps (23430)
likely a partial charge — not the full procedure |
$1,620.90 |
$1,801 |
0.2× |
| Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or… (24358) |
$1,170.90 |
$1,301 |
0.4× |
| Tenotomy, open, tendon flexor; toe, single tendon (separate procedure) Age Under 21 (28232) |
$530.10 |
$589 |
0.3× |
| Tenotomy, percutaneous, adductor or hamstring; multiple tendons Age Under 21 (27307) |
$906.30 |
$1,007 |
0.3× |
Tenotomy, shoulder area; single tendon Age Under 21 (23405)
likely a partial charge — not the full procedure |
$1,340.10 |
$1,489 |
0.2× |
| Therapeutic spinal puncture drainage csf (62272) |
$2,147.85 |
$2,386.50 |
3.0× |
| Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) |
$883.35 |
$981.50 |
1.4× |
Thyroidectomy, total or complete (60240)
unusually low — confirm this is the full procedure |
$1,958.40 |
$2,176 |
0.3× |
| Tonsillectomy and adenoidectomy; age 12 or over Age Under 21 (42821) |
$662.40 |
$736 |
0.2× |
| Tonsillectomy, primary or secondary; age 12 or over Age Under 21 (42826) |
$559.80 |
$622 |
0.2× |
Tonsillectomy, primary or secondary; younger than age 12 Age Under 21 (42825)
likely a partial charge — not the full procedure |
$589.50 |
$655 |
0.1× |
Total knee arthroplasty (27447)
likely a partial charge — not the full procedure |
$2,754 |
$3,060 |
0.2× |
Total thyroid lobectomy, unilateral; with or without isthmusectomy Age Under 21 (60220)
likely a partial charge — not the full procedure |
$1,517.40 |
$1,686 |
0.2× |
| Tracheostomy, emergency procedure; cricothyroid membrane Age Under 21 (31605) |
$1,872.45 |
$2,080.50 |
7.7× |
| Transfusion, blood or blood components (36430) |
$1,001.70 |
$1,113 |
2.2× |
| Treat big toe fracture (28495) |
$531 |
$590 |
2.1× |
| Treat finger dislocation (26775) |
$800.10 |
$889 |
2.8× |
| Treat fx distal radial (25606) |
$1,474.20 |
$1,638 |
0.4× |
Treat fx rad extra-articul (25607)
likely a partial charge — not the full procedure |
$1,629 |
$1,810 |
0.2× |
| Treat hip socket fracture (27222) |
$2,123.10 |
$2,359 |
8.4× |
| Treat knee fracture (27532) |
$2,828.70 |
$3,143 |
0.8× |
| Treat lower leg fracture (27825) |
$1,089.90 |
$1,211 |
0.7× |
| Treat tail bone fracture (27200) |
$405 |
$450 |
1.6× |
| Treat toe dislocation (28630) |
$337.05 |
$374.50 |
1.3× |
| Treat ulnar fracture (24675) |
$931.50 |
$1,035 |
0.6× |
| Treat wrist bone fracture (25635) |
$1,831.95 |
$2,035.50 |
1.1× |
| Treat wrist bone fracture (25624) |
$1,242.45 |
$1,380.50 |
0.8× |
| Treat wrist dislocation (25690) |
$1,627.65 |
$1,808.50 |
1.0× |
| TREATMENT CLOSED ELBOW DISLOCATION REQ ANES TechFee (24605) |
$1,055.70 |
$1,173 |
0.6× |
Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing… (25609)
unusually low — confirm this is the full procedure |
$2,296.80 |
$2,552 |
0.3× |
Treatment of ankle fracture (27822)
likely a partial charge — not the full procedure |
$1,890.90 |
$2,101 |
0.3× |
Treatment of broken middle part of upper arm bone with placement of stabilizing device (plate/screws) (24515)
likely a partial charge — not the full procedure |
$1,915.20 |
$2,128 |
0.1× |
| Treatment of closed elbow dislocation; without anesthesia (24600) |
$767.70 |
$853 |
3.0× |
Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant,… (27245)
unusually low — confirm this is the full procedure |
$2,641.50 |
$2,935 |
0.4× |
Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant,… (27244)
unusually low — confirm this is the full procedure |
$2,645.10 |
$2,939 |
0.4× |
| Treatment of miscarriage (59812) |
$653.40 |
$726 |
0.2× |
| Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or… (27256) |
$513.90 |
$571 |
2.0× |
| Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each (28450) |
$445.05 |
$494.50 |
1.8× |
Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without… (27759)
likely a partial charge — not the full procedure |
$2,156.40 |
$2,396 |
0.2× |
Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement (27236)
unusually low — confirm this is the full procedure |
$2,571.30 |
$2,857 |
0.3× |
| Trimming of nondystrophic nails, any number (11719) |
$50.40 |
$56 |
0.8× |
| Tx superficial wound dehiscence simple closure (12020) |
$1,759.05 |
$1,954.50 |
2.3× |
| Tx tarsal bone fx xcp talus&calcn w/manj (28455) |
$511.20 |
$568 |
0.3× |
| Tympanostomy (requiring insertion of ventilating tube), general anesthesia Age Under 21 (69436) |
$434.25 |
$482.50 |
0.3× |
| Unlisted autologous blood injection into eye bleb (most like cpt 66020) (66999) |
$7,559.10 |
$8,399 |
3.2× |
| Uterine evacuation & curettage hydatidiform mole (59870) |
$1,140.30 |
$1,267 |
0.3× |
| Vaginal delivery (59409) |
$1,673.10 |
$1,859 |
0.5× |
Vaginal hysterectomy, for uterus 250 g or less; Age Under 21 (58260)
unusually low — confirm this is the full procedure |
$1,793.70 |
$1,993 |
0.4× |
Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) Age Under 21 (58262)
unusually low — confirm this is the full procedure |
$1,982.70 |
$2,203 |
0.4× |
| Vasectomy (55250) |
$501.30 |
$557 |
0.2× |
| Venipuncture (36415) |
$16.20 |
$18 |
1.7× |
| Ventilating tube removal requiring general anesthesia (69424) |
$133.20 |
$148 |
0.0× |
| Version cephalic external (59412) |
$2,253.60 |
$2,504 |
0.7× |
| Wedge excision skin nail fold (11765) |
$378.45 |
$420.50 |
0.9× |