| 2d tee w or w/o fol w/con,in (C8925) |
— |
$4,183 |
— |
| 2d tte w or w/o fol w/con,co (C8923) |
— |
$3,198 |
— |
| 2d tte w or w/o fol w/con,fu (C8924) |
— |
$2,078 |
— |
| Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) |
— |
$9,297 |
— |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) |
— |
$11,822 |
— |
| Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T) |
— |
$11,822 |
— |
| Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) |
— |
$11,822 |
— |
| Admin hepatitis b vaccine (G0010) |
— |
$132 |
— |
| Admin influenza virus vac (G0008) |
— |
$69 |
— |
| Admin pneumococcal vaccine (G0009) |
— |
$132 |
— |
| Alcohol/subs interv 15-30mn (G0396) |
— |
$71 |
— |
Alcohol/subs interv >30 min (G0397)
range across 2 matching MRF lines |
— |
$396–$585 |
— |
| Ca screen;flexi sigmoidscope (G0104) |
— |
$1,789 |
— |
| Catheterize for urine spec (P9612) |
— |
$195 |
— |
Chemo extend iv infus w/pump (G0498)
range across 3 matching MRF lines |
— |
$1,358–$1,819 |
— |
| Colon ca scrn not hi rsk ind (G0121) |
— |
$3,149 |
— |
| Colorectal scrn; hi risk ind (G0105) |
— |
$3,653 |
— |
| CT breast w/3d rendering bi with contrast (0637T) |
— |
$7,909 |
— |
| CT breast w/3d rendering bi without contrast (0636T) |
— |
$7,046 |
— |
| CT breast w/3d rendering uni with contrast (0634T) |
— |
$5,697 |
— |
| CT breast w/3d rendering uni without contrast (0633T) |
— |
$4,602 |
— |
| CT brst w/3d rendering bi wo cntrst flwd cntrst (0638T) |
— |
$8,924 |
— |
| CT brst w/3d rendering uni wo cntrst flwd cntrst (0635T) |
— |
$6,982 |
— |
| Cysto, litho, vacuum kidney (C9761) |
— |
$17,555 |
— |
| Diab manage trn per indiv (G0108) |
— |
$190 |
— |
Diab manage trn ind/group (G0109)
range across 4 matching MRF lines |
— |
$62–$97 |
— |
Drug test def 1-7 classes (G0480)
range across 81 matching MRF lines |
— |
$75–$704 |
— |
Drug test def 22+ classes (G0483)
range across 3 matching MRF lines |
— |
$489–$1,222 |
— |
Drug test def 8-14 classes (G0481)
range across 3 matching MRF lines |
— |
$206–$515 |
— |
| Ed svc ckd grp per session (G0421) |
— |
$264 |
— |
| Ed svc ckd ind per session (G0420) |
— |
$264 |
— |
Eia hiv-1/hiv-2 screen (G0432)
range across 8 matching MRF lines |
— |
$125–$312 |
— |
| Ekg tracing for initial prev (G0404) |
— |
$171 |
— |
| Elec Alys Cplx Prgrmg Iins Sp/Sac Nrv 4+Param (0789T) |
— |
$243 |
— |
| Elec Alys Smpl Prgrmg Iins Sp/Sac Nrv 1-3 Param (0788T) |
— |
$241 |
— |
Elec stim other than wound (G0283)
range across 3 matching MRF lines |
— |
$188–$395 |
— |
Elisa hiv-1/hiv-2 screen (G0433)
range across 3 matching MRF lines |
— |
$125–$312 |
— |
| Esd endoscopy or colonoscopy (C9779) |
— |
$9,123 |
— |
| Extrnl counterpulse, per tx (G0166) |
— |
$739 |
— |
| Fecal blood scrn immunoassay (G0328) |
— |
$110 |
— |
| Fractional abl lsr fenestration first 100 sqcm (0479T) |
— |
$1,031 |
— |
| Group mnt 2 or more 30 mins (G0271) |
— |
$87 |
— |
| Hbot, full body chamber, 30m (G0277) |
— |
$1,349 |
— |
| Heart Symp Image Plnr (0331T) |
— |
$3,275 |
— |
Hep c screen high risk/other (G0472)
range across 3 matching MRF lines |
— |
$124–$309 |
— |
Hiv combination assay (G0475)
range across 3 matching MRF lines |
— |
$100–$250 |
— |
| Home sleep test/type 3 porta (G0399) |
— |
$1,246 |
— |
Hospital outpt clinic visit (G0463)
range across 62 matching MRF lines |
— |
$170–$814 |
— |
Inj for sacroiliac jt anesth (G0260)
range across 3 matching MRF lines |
— |
$2,347–$3,123 |
— |
| Injection of hiv prep drug (G0012) |
— |
$118 |
— |
| Insertion of substernal implantable defibrillator electrode (0572T) |
— |
$17,919 |
— |
| Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd (0408T) |
— |
$75,134 |
— |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) |
— |
$69,401 |
— |
| Ire Abltj 1+Tum Organ Perq (0600T) |
— |
$23,364 |
— |
| Mnt subs tx for change dx (G0270) |
— |
$87 |
— |
| Mra w/cont, chest (C8909) |
— |
$3,805 |
— |
| Mra w/cont, pelvis (C8918) |
— |
$4,452 |
— |
Mra w/o cont, abd (C8901)
range across 2 matching MRF lines |
— |
$3,276–$3,833 |
— |
| Mra w/o cont, pelvis (C8919) |
— |
$4,282 |
— |
Mra w/o fol w/cont, abd (C8902)
range across 2 matching MRF lines |
— |
$6,225–$6,724 |
— |
| Mra w/o fol w/cont, chest (C8911) |
— |
$6,949 |
— |
Mra w/o fol w/cont, lwr ext (C8914)
range across 6 matching MRF lines |
— |
$5,180–$11,367 |
— |
| Mra w/o fol w/cont, pelvis (C8920) |
— |
$6,288 |
— |
| Mra, w/dye, spinal canal (C8931) |
— |
$4,814 |
— |
Mra, w/o&w/dye, upper extr (C8936)
range across 3 matching MRF lines |
— |
$2,850–$5,114 |
— |
| Mri hyperpolarized xenon129 (C9791) |
— |
$3,252 |
— |
Mri w/o fol w/cont, breast, (C8908)
range across 3 matching MRF lines |
— |
$5,827–$9,441 |
— |
Mri w/o fol w/cont, brst, un (C8905)
range across 5 matching MRF lines |
— |
$1,697–$6,295 |
— |
| Myocrd Symp Innervaj Img Plnr Qual&Quant W/Spect (0332T) |
— |
$3,033 |
— |
| Ncntc R-T Fluor Wnd Img 1st (0598T) |
— |
$758 |
— |
Neuro csf prion prtn qual (0035U)
range across 3 matching MRF lines |
— |
$721–$1,801 |
— |
| Njx platelet plasma (0232T) |
— |
$1,768 |
— |
| Noninvasive prostate cancer estimation map (0898T) |
— |
$2,543 |
— |
| Obtaining screen pap smear (Q0091) |
— |
$107 |
— |
Onc aml DNA gntyp int tandem dup detcj/nondetcj (0023U)
range across 6 matching MRF lines |
— |
$630–$1,690 |
— |
| Oth resp proc, group (G0239) |
— |
$302 |
— |
| Oth resp proc, indiv (G0238) |
— |
$392 |
— |
| Perc d-e cor revasc chro sin (C9607) |
— |
$84,067 |
— |
| Perc d-e cor revasc t cabg s (C9604) |
— |
$66,643 |
— |
| Perc d-e cor stent ather s (C9602) |
— |
$61,705 |
— |
| Perc drug-el cor stent sing (C9600) |
— |
$45,521 |
— |
| Perq Sacral Augmt Bilat Inj (0201T) |
— |
$10,781 |
— |
| Perq Sacral Augmt Unilat Inj (0200T) |
— |
$11,860 |
— |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) |
— |
$17,105 |
— |
| Place device/marker, non pro (C9728) |
— |
$1,811 |
— |
| Potassium hydroxide preps (Q0112) |
— |
$165 |
— |
| Prgrmg dev eval iims ip (0528T) |
— |
$96 |
— |
| Prostate biopsy, any mthd (G0416) |
— |
$1,446 |
— |
| Provide inr test mater/equip (G0249) |
— |
$896 |
— |
Psa screening (G0103)
range across 3 matching MRF lines |
— |
$190–$475 |
— |
| Quan mr alys tiss composition w/MRI 1orgn (0649T) |
— |
$3,126 |
— |
Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U)
range across 3 matching MRF lines |
— |
$807–$2,016 |
— |
| Removal Ss Dfb Electrode (0573T) |
— |
$7,878 |
— |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) |
— |
$7,878 |
— |
| Revasc intra lithotrip-ather (C9766) |
— |
$45,072 |
— |
| Revasc intra lithotrip-stent (C9765) |
— |
$45,101 |
— |
| Revasc intravasc lithotripsy (C9764) |
— |
$15,214 |
— |
Scr c/v cyto,thinlayer,rescr (G0145)
range across 3 matching MRF lines |
— |
$127–$318 |
— |
| Screen cerv/vag thin layer (G0123) |
— |
$232 |
— |
| Sim ang w/prs cath rad emb (C8004) |
— |
$24,548 |
— |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) |
— |
$49,840 |
— |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) |
— |
$46,414 |
— |
| Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) |
— |
$6,813 |
— |
| Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) |
— |
$41,281 |
— |
| Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T) |
— |
$15,110 |
— |
| Tee w or w/o fol w/cont, mon (C8927) |
— |
$4,321 |
— |
| Tee w or w/o fol w/cont,cong (C8926) |
— |
$5,315 |
— |
Therapeutic procd strg endur (G0237)
range across 2 matching MRF lines |
— |
$229–$252 |
— |
| Tomosynthesis, mammo (G0279) |
— |
$584 |
— |
Transcatheter Renal Sympath Denervation Bilat (0339T)
range across 2 matching MRF lines |
— |
$5,258–$13,570 |
— |
Transcatheter renal sympath denervation unilat (0338T)
range across 2 matching MRF lines |
— |
$5,258–$13,570 |
— |
| Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater than… (0867T) |
— |
$12,709 |
— |
| Trauma respons w/hosp criti (G0390) |
— |
$20,561 |
— |
| Trim nail(s) (G0127) |
— |
$186 |
— |
| Tte w or w/o contr, cont ecg (C8930) |
— |
$4,278 |
— |
| Tte w or w/o fol w/cont, com (C8921) |
— |
$3,913 |
— |
| Tte w or w/o fol w/cont, f/u (C8922) |
— |
$1,969 |
— |
| Tte w or wo fol wcon,doppler (C8929) |
— |
$3,848 |
— |
| Unsched dialysis esrd pt hos (G0257) |
— |
$3,265 |
— |
| Vasc emb/occ w/prs cath (C9797) |
— |
$18,285 |
— |
| Visit to determ ldct elig (G0296) |
— |
$192 |
— |
Wet mounts/ w preparations (Q0111)
range across 3 matching MRF lines |
— |
$79–$196 |
— |