| Ablate Heart Dysrhythm Focus (93650) |
$5,600 |
$14,000 |
0.8× |
| Acoustic Immit Test Tympanometry/Acoust Reflex/Decay (92570) |
$140 |
$350 |
1.2× |
| Acoustic Reflex Testing (92568) |
$30 |
$75 |
0.9× |
| Actigraphy Testing Recording Analysis I&R (95803) |
$56.80 |
$142 |
1.1× |
| Admn Sarscov2 Vacc 1 Dose (90480) |
$40 |
$100 |
1.1× |
| Aep Hearing Status Deter Broadband Stimuli I&R (92651) |
$140 |
$350 |
0.7× |
| Aep neurodiagnostic i&r (92653) |
$240 |
$600 |
1.2× |
| Aep threshold estimation mlt frequencies i&r (92652) |
$240 |
$600 |
1.2× |
| Airway Inhalation Treatment (94640) |
$192 |
$480 |
1.0× |
| Airway resistance by oscillometry (94728) |
$240 |
$600 |
2.1× |
| Allg test perq & ic drug/biol immed react w/ i&r (95018) |
$30 |
$75 |
0.9× |
| Allg tstg perq & ic venoms immed react w/i&r (95017) |
$25.20 |
$63 |
1.0× |
| Ambulatory bp mntr w/sw 24 hr+ recording only (93786) |
$100 |
$250 |
0.8× |
| Ambulatory bp mntr w/sw 24 hr+ scanning a/r (93788) |
$100 |
$250 |
0.8× |
| Analysis Cochlear Implt Pt <7 Yr Prgrmg (92601) |
$140 |
$350 |
1.2× |
| Analyze neurostim complex (95972) |
$80 |
$200 |
0.9× |
| Analyze neurostim no prog (95970) |
$100 |
$250 |
0.8× |
| Analyze Neurostim Simple (95971) |
$80 |
$200 |
0.9× |
| Analyze Pacemaker System (93724) |
$270 |
$675 |
1.0× |
| Anogenital Xm Magnify Child/Suspect Trauma W Img (99170) |
$160 |
$400 |
0.9× |
| Ans parasymp & symp w/tilt (95924) |
$270 |
$675 |
1.4× |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) |
$14 |
$35 |
1.0× |
| Application Modality 1/> Areas Diathermy (97024) |
$6.40 |
$16 |
0.9× |
| Application on-body injector (96377) |
$40 |
$100 |
0.9× |
| Arrhythmia Induction (93618) |
$1,000 |
$2,500 |
0.9× |
| Assessment of aphasia per hr (96105) |
$92.80 |
$232 |
1.0× |
| Assessment of tinnitus (92625) |
$140 |
$350 |
1.2× |
| Audiometry Air & Bone (92553) |
$140 |
$350 |
1.2× |
| Auditory Function, 60 Min (92620) |
$140 |
$350 |
1.2× |
| Basic vestibular evaluation (92540) |
$140 |
$350 |
0.7× |
| Behavral qualit analys voice (92524) |
$104 |
$260 |
0.9× |
| Bfb traing w/EMG &/manometry 1st 15 min cntct (90912) |
$74.40 |
$186 |
0.9× |
| Bfb training ea addl 15 min (90913) |
$30 |
$75 |
0.9× |
| Biofeedback training any modality (90901) |
$37.20 |
$93 |
0.9× |
| Bioimpedance Cv Analysis (93701) |
$100 |
$250 |
0.8× |
| Blink reflex test (95933) |
$50 |
$125 |
0.9× |
| Breath hydrogen/methane test (91065) |
$140 |
$350 |
0.7× |
| Brief Emotional/Behav Assmt (96127) |
$30 |
$75 |
0.9× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) |
$240 |
$600 |
0.7× |
| Bundle of his recording (93600) |
$4,800 |
$12,000 |
0.7× |
| C motor evoked uppr limbs (95928) |
$800 |
$2,000 |
1.0× |
| C motor evoked upr&lwr limbs (95939) |
$940 |
$2,350 |
1.2× |
| Caloric vestibular test w/rec bi monothermal (92538) |
$140 |
$350 |
0.7× |
| Caloric Vstblr Test W/Rec (92537) |
$140 |
$350 |
1.2× |
| Canalith repositioning proc (95992) |
$41.20 |
$103 |
1.0× |
Cardiac Stress Tst,Tracing Only (93017)
range across 3 matching MRF lines |
$240–$270 |
$600–$675 |
varies |
| Cardiopulmonary exercise testing (94621) |
$270 |
$675 |
0.8× |
| Cardiopulmonary resuscitation (92950) |
$270 |
$675 |
1.4× |
| Cardioversion (92960) |
$536.40 |
$1,341 |
0.9× |
| Cardioversion elective internal (92961) |
$536.40 |
$1,341 |
0.9× |
| Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) |
$22.80 |
$57 |
0.9× |
| Cath Place/Coron Angio, Img Super/Interp,R&L Hrt Cath, L Hrt Ventric (93460) |
$2,880 |
$7,200 |
1.0× |
| Cath Place/Coron Angio, Img Super/Interp,W Left Heart Ventriculography (93458) |
$2,880 |
$7,200 |
1.0× |
| Cbt 1st hour (94644) |
$100 |
$250 |
0.8× |
| Cervical & Ocular Vemp Testing W/I&R (92519) |
$270 |
$675 |
1.4× |
| Cervical Vemp Testing W/I&R (92517) |
$140 |
$350 |
1.2× |
| Chemo Admin Peritoneal Cavity (96446) |
$325.60 |
$814 |
1.1× |
| Chemo Anti-Neopl Sq/Im (96401) |
$120 |
$300 |
1.8× |
| Chemo Hormon Antineopl Sq/Im (96402) |
$64 |
$160 |
1.0× |
| Chemo Ia Push (96420) |
$325.60 |
$814 |
1.1× |
| Chemo Intralesional Over 7 (96406) |
$200 |
$500 |
1.0× |
| Chemo intralesional up to 7 (96405) |
$64 |
$160 |
1.0× |
| Chemo IV infusion addl hr (96415) |
$64 |
$160 |
1.0× |
| Chemo IV push addl drug (96411) |
$120 |
$300 |
1.8× |
| Chemother Prolong Infuse W/Pump (96416) |
$325.60 |
$814 |
1.1× |
| Chemotherapy Admin Intra-Arterial Infus </1 Hr (96422) |
$200 |
$500 |
0.7× |
| Chemotherapy Admn Intraarterial Infusion Ea Hr (96423) |
$40 |
$100 |
0.9× |
| Chemotherapy Into Cns (96450) |
$325.60 |
$814 |
1.1× |
| Chemotherapy Intracavitary (96440) |
$325.60 |
$814 |
1.1× |
| Chemotx Admn Ia Nfs >8 Hr Prtble Impltbl Pmp (96425) |
$325.60 |
$814 |
1.1× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) |
$64 |
$160 |
1.0× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) |
$325.60 |
$814 |
1.1× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) |
$209.20 |
$523 |
0.7× |
| Chemotx Njx Subarachnd/Intraventr Rsvr 1/Mult (96542) |
$200 |
$500 |
0.7× |
| Chest Wall Manipulation (94668) |
$116 |
$290 |
1.0× |
| Circadian Respiratry Pattern Rec 12-24 Hr Infant (94772) |
$400 |
$1,000 |
1.2× |
| Cmptr ophth dx img ant segmt (92132) |
$50 |
$125 |
0.9× |
| Colon Motility 6 Hr Study (91117) |
$240 |
$600 |
1.2× |
| Color/duplex Doppler, complete (93975) |
$260 |
$650 |
1.2× |
Color/duplex Doppler, limited (93976)
range across 2 matching MRF lines |
$390–$398.80 |
$975–$997 |
varies |
| Community/Work Reintegration Trainj Ea 15 Min (97537) |
$30 |
$75 |
0.9× |
| Comprehensive Hearing Test (92557) |
$140 |
$350 |
1.2× |
| Computerized dynamic posturography (92548) |
$100 |
$250 |
0.8× |
| Computerized Ophthalmic Imaging Optic Nerve (92133) |
$50 |
$125 |
0.9× |
| Computerized Ophthalmic Imaging Retina (92134) |
$50 |
$125 |
0.9× |
| Conditioning Play Audiometry (92582) |
$152.80 |
$382 |
1.3× |
| Cont gluc mntr physician/qhp provided equiptment (95250) |
$120 |
$300 |
1.0× |
| Cont Gluc Mntr Pt Prov Eqp (95249) |
$58.40 |
$146 |
1.1× |
| Continuous Pulse Ox (94762) |
$152.80 |
$382 |
1.3× |
| Coronary Art/Grft Angio S&I (93455) |
$2,880 |
$7,200 |
1.0× |
| Coronary Artery Angio S&I (93454) |
$2,880 |
$7,200 |
1.0× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) |
$192 |
$480 |
1.0× |
| Cpt initial (94667) |
$116 |
$290 |
1.0× |
| Critical care first hour (99291) |
$2,063.60 |
$5,159 |
2.8× |
| Ctr Motor Ep Std Transcrnl Motor Stimj Lwr Limbs (95929) |
$400 |
$1,000 |
1.2× |
| Debridement Open Wound 20 Sq Cm< (97597) |
$160 |
$400 |
0.9× |
| Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming Facility (92602) |
$140 |
$350 |
1.2× |
| Dialysis One Evaluation (90945) |
$371.60 |
$929 |
1.0× |
| Distrt prod evokd otoacoustic emsns comp/dx eval (92588) |
$299.20 |
$748 |
0.9× |
| Duodenal motility study (91022) |
$400 |
$1,000 |
1.2× |
| Dup-scan aorta ivc iliac vascl/bpgs complete (93978) |
$260 |
$650 |
1.2× |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) |
$398.80 |
$997 |
4.2× |
| Dup-Scan Artl Infl&Ven O/F Pen Vsl Compl (93980) |
$390 |
$975 |
4.1× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) |
$478.80 |
$1,197 |
2.2× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) |
$398.80 |
$997 |
4.2× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) |
$260 |
$650 |
1.2× |
| Dup-scan xtr veins unilateral/limited study (93971) |
$390 |
$975 |
4.1× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Bi Std (93985) |
$236 |
$590 |
1.1× |
| Duplex Scan Artl Infl&Ven O/F Hemo Compl Uni Std (93986) |
$390 |
$975 |
4.1× |
| Duplex Scan Hemodialysis Access (93990) |
$398.80 |
$997 |
4.2× |
| Duplex up extrem art bilat (93930) |
$478.80 |
$1,197 |
2.2× |
| Duplex up extrem art unilat/ltd (93931) |
$398.80 |
$997 |
4.2× |
| Dx aly prgrmg&verif aud oi sound processr 1st 60 (92622) |
$148.80 |
$372 |
1.3× |
| Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604) |
$140 |
$350 |
1.2× |
| Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) |
$140 |
$350 |
1.2× |
| ECG/monitoring and analysis (93271) |
$80 |
$200 |
0.9× |
| Echo Congenital Complete (93303) |
$520 |
$1,300 |
1.1× |
| Echo Heart Xthoracic,Limited (93308) |
$236 |
$590 |
1.1× |
| Echo r-t 2d w/probe placement only (93313) |
$520 |
$1,300 |
1.1× |
| Echo transesophag montr cardiac pump functj (93318) |
$520 |
$1,300 |
1.1× |
| Echo transesophageal (93312) |
$520 |
$1,300 |
1.1× |
| Echo Transesophageal - Congenital Tee Complete (93315) |
$520 |
$1,300 |
1.1× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) |
$520 |
$1,300 |
1.1× |
| Eeg 41-60 Minutes (95812) |
$270 |
$675 |
1.4× |
| EEG awake and asleep (95819) |
$270 |
$675 |
1.4× |
| EEG awake drowsy (95816) |
$270 |
$675 |
1.4× |
| EEG cerebral death evaluation (95824) |
$400 |
$1,000 |
1.2× |
| EEG cont rec w/video by tech min 8 channels (95700) |
$240 |
$600 |
1.2× |
| EEG extended monitoring 61-119 minutes (95813) |
$299.20 |
$748 |
1.5× |
| Eeg Sleep Only (95822) |
$270 |
$675 |
1.4× |
| Eeg W/O Vid 2-12 Hr Unmntr (95705) |
$240 |
$600 |
1.2× |
| EEG w/o vid 2-12hr cont mntr (95707) |
$240 |
$600 |
1.2× |
| EEG w/o vid ea 12-26hr intmt (95709) |
$400 |
$1,000 |
1.2× |
| Eeg W/O Vid Tech Ea Incr 12-26 Hr Cont R-T Mntr (95710) |
$500 |
$1,250 |
1.5× |
| EEG w/o video by tech 2-12 hr intermittent mntr (95706) |
$240 |
$600 |
1.2× |
| EEG wo vid ea 12-26hr unmntr (95708) |
$400 |
$1,000 |
1.2× |
| EKG signal averaged (93278) |
$50 |
$125 |
0.9× |
| Elec Alys Implt Cplx Cn Npgt Prgrmg (95977) |
$104 |
$260 |
1.2× |
| Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) |
$38 |
$95 |
1.1× |
| Electrical Stimulation Ea 15 Min (97032) |
$14 |
$35 |
1.0× |
| Electrocardiogram Tracing (93005) |
$64.40 |
$161 |
1.2× |
| Electrocochleography (92584) |
$140 |
$350 |
1.2× |
Electroconvulsive Therapy (90870)
range across 2 matching MRF lines |
$500–$800 |
$1,250–$2,000 |
varies |
| Electrogastrography, diagnostic, transcutaneous; Non-Facility (91132) |
$240 |
$600 |
1.2× |
| Electrogastrography, diagnostic, transcutaneous; with provocative testing Non-Facility (91133) |
$100 |
$250 |
0.8× |
| Electrophysiologic Follow-Up W/Pac/Rec W/Arrhyt (93624) |
$4,800 |
$12,000 |
0.7× |
| Electrophysiology Evaluation (93642) |
$1,000 |
$2,500 |
0.9× |
| Emergency Dept Visit Level 2 (99282) |
$376 |
$940 |
2.7× |
| Emergency Dept Visit Level 3 (99283) |
$860 |
$2,150 |
3.5× |
| Emergency Dept Visit Level 4 (99284) |
$1,817.60 |
$4,544 |
4.8× |
| Emg 3 Extremities (95863) |
$140 |
$350 |
1.2× |
| Emg 4 Extremities (95864) |
$142.80 |
$357 |
1.2× |
| Endomyocardial Biopsy (93505) |
$2,400 |
$6,000 |
0.8× |
| Ep & ablate supravent arrhyt (93653) |
$18,000 |
$45,000 |
0.8× |
| Ep & ablate ventric tachy (93654) |
$18,000 |
$45,000 |
0.8× |
| Ep Compre Electrophysiologic Arrhythmia Induction (93620) |
$6,208 |
$15,520 |
0.9× |
| Ep Compre Electrophysiologic W/O Arrhyt Induction (93619) |
$8,035.20 |
$20,088 |
1.1× |
| Ep Esophageal Recording Atria+Pacing (93616) |
$1,000 |
$2,500 |
0.9× |
| Er level 1 (99281) |
$196.40 |
$491 |
2.6× |
| Er level v (99285) |
$2,014.40 |
$5,036 |
3.7× |
| Esoph Atrial Electrogram (93615) |
$761.60 |
$1,904 |
0.7× |
| Esophageal Capsule Endoscopy (91111) |
$720 |
$1,800 |
0.9× |
| Esophagus acid perfusion test esophagitis (91030) |
$400 |
$1,000 |
1.2× |
| Esophgl Balo Distension Dx Std W/Provocation (91040) |
$400 |
$1,000 |
1.2× |
| Esophgl funcj g-esop rflx impd eltrd prolng (91038) |
$500 |
$1,250 |
1.5× |
| Eval aud funcj cand/po surg implt dev 1st hr (92626) |
$140 |
$350 |
1.2× |
| Evaluate pt use of inhaler (94664) |
$192 |
$480 |
1.0× |
| Evaluate Speech Production (92522) |
$105.60 |
$264 |
0.9× |
| Evaluate Swallowing Function (92610) |
$80 |
$200 |
0.9× |
| Evaluation of speech fluency (92521) |
$126 |
$315 |
0.9× |
| Evoked Auditory Test,Limited (92587) |
$299.20 |
$748 |
1.5× |
| Exercise test for bronchospasm (94617) |
$116 |
$290 |
1.0× |
| External ECG rec>48hr<7d recording (93242) |
$56.80 |
$142 |
1.7× |
| External ECG rec>7d<15d recording (93246) |
$50 |
$125 |
1.5× |
| External Ecg Scanning Analysis Report (93226) |
$100 |
$250 |
1.9× |
| Extracranial Bilat Study (93880) |
$260 |
$650 |
1.2× |
| Extracranial Uni/Ltd Study (93882) |
$398.80 |
$997 |
4.2× |
| F-up/limited tthrc echo congenital car anomaly (93304) |
$520 |
$1,300 |
1.1× |
| Facial nerve function studies (92516) |
$240 |
$600 |
1.2× |
| Filtered Speech Test (92571) |
$30 |
$75 |
0.9× |
| Flexible endoscopic eval swallow c/v rec (92612) |
$173.60 |
$434 |
0.9× |
| Funcjal Cort&Subcort Mapg Phys/Qhp Attnd Init Hr (95961) |
$800 |
$2,000 |
1.0× |
| Gastric motility studies (91020) |
$400 |
$1,000 |
1.2× |
| Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) |
$400 |
$1,000 |
1.2× |
| Gastroesophag Reflx Test W/Intrluml Imped Eltrd (91037) |
$240 |
$600 |
1.2× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) |
$400 |
$1,000 |
0.5× |
| Gi tract capsule endoscopy (91110) |
$800 |
$2,000 |
1.0× |
| Gi wireless capsule measure (91112) |
$720 |
$1,800 |
0.9× |
| Group Therapeutic Procedures (97150) |
$16.80 |
$42 |
0.9× |
| Heart catheterization, both sides, with coronary and bypass graft angiography (93461) |
$2,880 |
$7,200 |
1.0× |
Hemodialysis Procedure W/ Phys/Qhp Evaluation (90935)
range across 2 matching MRF lines |
$640–$668.80 |
$1,600–$1,672 |
varies |
| Holter monitor recording (93225) |
$116 |
$290 |
1.0× |
| Hypnotherapy (90880) |
$126.40 |
$316 |
1.4× |
| Icd Device Interrogate (93289) |
$38 |
$95 |
1.1× |
| Icd device progr eval dual (93283) |
$38 |
$95 |
1.1× |
| Icd Device Progr Eval Mult (93284) |
$38 |
$95 |
1.1× |
| Icm Device Eval (93290) |
$38 |
$95 |
1.1× |
| Ilr Device Eval Progr (93285) |
$38 |
$95 |
1.1× |
| Im Adm Intransl/Oral 1 Vaccine (90473) |
$64 |
$160 |
1.0× |
| Immunization administration (90471) |
$64 |
$160 |
1.0× |
| Inhlj Brncl Challenge Tstg W/Histam/Methachol (95070) |
$400 |
$1,000 |
1.2× |
| Insert/Place Heart Catheter (93503) |
$1,200 |
$3,000 |
0.8× |
| Interrogate Subq Defib (93261) |
$38 |
$95 |
1.1× |
| Interrogation eval in person wr defibrillator (93292) |
$38 |
$95 |
1.1× |
| Interrogation vad in person (93750) |
$80 |
$200 |
0.9× |
| Intra-atrial pacing (93610) |
$4,800 |
$12,000 |
0.7× |
| Intra-atrial recording (93602) |
$4,800 |
$12,000 |
0.7× |
| Intracranial Complete Study (93886) |
$478.80 |
$1,197 |
2.2× |
| Intracutaneous tests w/allergenic extracts (95024) |
$50 |
$125 |
0.9× |
| Intraventricular pacing (93612) |
$4,800 |
$12,000 |
0.7× |
| Io anal gast n-stim subsq (95981) |
$100 |
$250 |
1.9× |
| Io ga n-stim subsq w/reprog (95982) |
$38 |
$95 |
1.1× |
| Iontophoresis 15 min (97033) |
$18.80 |
$47 |
1.0× |
| Irrig Drug Delivery Device (96523) |
$56.80 |
$142 |
1.1× |
| IV infusion hydration each additional hour (96361) |
$40 |
$100 |
0.9× |
| IV infusion hydration initial 31 min-1 hour (96360) |
$211.20 |
$528 |
1.1× |
| IV infusion ther proph addl sequential to 1 hr (96367) |
$64 |
$160 |
1.0× |
| IV infusion therapy prophylaxis/dx ea hour (96366) |
$40 |
$100 |
0.9× |
| IV push initial (96374) |
$200 |
$500 |
1.0× |
| L Hrt Art/Grft Angio (93459) |
$2,880 |
$7,200 |
1.0× |
| L Hrt Cath Chd Img Cath Trgt Zon Nml/Abnl Nt Cnj (93595) |
$2,961.60 |
$7,404 |
1.0× |
| Liver Elastography W/O Imag W/I&R (91200) |
$140 |
$350 |
1.2× |
| Low frequency non-thermal us (97610) |
$183.60 |
$459 |
1.0× |
| Lung Function Test (Mbc/Mvv) (94200) |
$56.80 |
$142 |
1.1× |
| Lwr Xtr Vasc Stdy Bilat (93924) |
$240 |
$600 |
1.2× |
| Measurement Lung Volumes Infant/Child/2 Yrs (94013) |
$400 |
$1,000 |
1.2× |
| Mechanical chest wall oscillation per session (94669) |
$192 |
$480 |
1.0× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) |
$14 |
$35 |
0.4× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) |
$24.80 |
$62 |
0.7× |
| Medical nutrition therapy grp2/ indiv ea 30 mi (97804) |
$16 |
$40 |
0.9× |
| Methacholine challenge (94070) |
$270 |
$675 |
0.8× |
| Microvolt T-Wave Assess (93025) |
$140 |
$350 |
1.2× |
| Motility study esophagus (91010) |
$400 |
$1,000 |
1.2× |
| Motion Fluoroscopy/Swallow (92611) |
$85.60 |
$214 |
0.9× |
Multiple Sleep Latency Test (95805)
range across 2 matching MRF lines |
$400–$525.20 |
$1,000–$1,313 |
varies |
| Muscle Test 2 Limbs (95861) |
$236 |
$590 |
2.0× |
| Muscle Test Hemidiaphragm (95866) |
$140 |
$350 |
1.2× |
| Muscle Test Nonparaspinal (95870) |
$100 |
$250 |
0.8× |
| Muscle Test One Limb (95860) |
$100 |
$250 |
0.8× |
| Narcosynthesis (90865) |
$126.40 |
$316 |
0.8× |
| Nasopharyngoscopy (92511) |
$168 |
$420 |
0.9× |
| Needle Electromyography Cranial Nrv Muscle Bi (95868) |
$240 |
$600 |
1.2× |
| Needle Electromyography Cranial Nrv Muscle Uni (95867) |
$240 |
$600 |
1.2× |
| Needle electromyography larynx (95865) |
$100 |
$250 |
0.8× |
| Needle Emg Thrc Paraspi Musc Excluding T1/T12 (95869) |
$140 |
$350 |
0.7× |
| Needle EMG w/1 fiber electrode quan meas jitter (95872) |
$140 |
$350 |
0.7× |
| Neg Pressure Wound Therapy Non Dme </= 50 Sq Cm (97607) |
$340 |
$850 |
0.9× |
| Neg Pressure Wound Therapy Non Dme >50 Sq Cm (97608) |
$340 |
$850 |
0.9× |
| Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) |
$183.60 |
$459 |
1.0× |
| Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) |
$353.20 |
$883 |
1.0× |
| Nerve Conduction Studies 1-2 Studies (95907) |
$140 |
$350 |
0.7× |
| Nerve Conduction Studies 11-12 Studies (95912) |
$500 |
$1,250 |
1.5× |
| Nerve conduction studies 13 or more studies (95913) |
$400 |
$1,000 |
1.2× |
| Nerve Conduction Studies 3-4 Studies (95908) |
$299.20 |
$748 |
1.5× |
| Nerve conduction studies 5-6 studies (95909) |
$240 |
$600 |
1.2× |
| Nerve conduction studies 7-8 studies (95910) |
$240 |
$600 |
0.7× |
| Nerve Conduction Studies 9-10 Studies (95911) |
$500 |
$1,250 |
1.5× |
| Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) |
$140 |
$350 |
1.2× |
| Neuromuscular Reeducation (97112) |
$32 |
$80 |
1.0× |
| Newborn resuscitation (99465) |
$600 |
$1,500 |
1.0× |
| Nitric oxide expired gas determination (95012) |
$30 |
$75 |
0.9× |
| Ocular Vemp Testing W/I&R (92518) |
$140 |
$350 |
1.2× |
| Ophth Medical Xm&Eval Compre New Pt 1/> Vst (92004) |
$116 |
$290 |
1.0× |
| Ophth medical xm&eval comprhnsv estab pt 1/> (92014) |
$116 |
$290 |
1.0× |
| Ophth medical xm&eval intermediate estab pt (92012) |
$116 |
$290 |
1.0× |
| Ophth Medical Xm&Eval Intermediate New Pt (92002) |
$116 |
$290 |
1.0× |
| Optokinetic Nystagmus Test (92544) |
$140 |
$350 |
1.2× |
| Oral Function Therapy (92526) |
$80 |
$200 |
1.0× |
| Oral Speech Device Eval (92597) |
$68.80 |
$172 |
1.0× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) |
$49.20 |
$123 |
1.0× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) |
$44.40 |
$111 |
1.0× |
| Oscillating Tracking Test (92545) |
$240 |
$600 |
1.2× |
| Ot Contrast Bath Ea 15 Min (97034) |
$14 |
$35 |
1.0× |
| Ot eval high complexity (97167) |
$95.20 |
$238 |
0.9× |
| Ot Eval Low Complex (97165) |
$95.20 |
$238 |
0.9× |
| Ot Eval Moderate Complexity (97166) |
$95.20 |
$238 |
0.9× |
| Ot manual therapy 15 min (97140) |
$25.60 |
$64 |
0.9× |
| Ot paraffin bath (97018) |
$5.20 |
$13 |
0.9× |
| Ot Prosthetic Training, Each 15 Min (97761) |
$38.40 |
$96 |
1.0× |
| Ot Re-Eval Est Plan Care (97168) |
$64.80 |
$162 |
0.9× |
| Ot rom hand (95852) |
$16 |
$40 |
0.7× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) |
$139.20 |
$348 |
1.2× |
| Outpatient Cardiac Rehab W/O Cont Ecg Monitor (93797) |
$118.40 |
$296 |
1.0× |
| Oxygen Uptake Rest Indirect (94690) |
$50 |
$125 |
0.9× |
Patch/Application Test Specify Number Tests (95044)
range across 2 matching MRF lines |
$800 |
$94–$2,000 |
1.0× |
| Penile Vascular Study,Ltd or F/U (93981) |
$390 |
$975 |
4.1× |
| Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) |
$192 |
$480 |
1.0× |
| Percutaneous tests w/allergenic extracts (95004) |
$43.20 |
$108 |
0.1× |
| Peripheral arterial disease rehab per session (93668) |
$50 |
$125 |
0.9× |
| Perq transcath closure pda (93582) |
$16,402.40 |
$41,006 |
1.0× |
| Perq Transcath Cls Aortic (93591) |
$14,780 |
$36,950 |
0.9× |
| Perq Transcath Cls Mitral (93590) |
$14,780 |
$36,950 |
0.9× |
| Perq Trluml C Angioplasty 1 Maj C Art&/Branches (92920) |
$4,400 |
$11,000 |
0.9× |
| Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd (92943) |
$9,752.40 |
$24,381 |
0.9× |
| Phlebotomy therapeutic (99195) |
$116 |
$290 |
1.0× |
| Photo patch test(s) (95052) |
$50 |
$125 |
0.9× |
| Photochemotx Tar&Uvb/Petrolatum/Uvb (96910) |
$50 |
$125 |
0.9× |
| Physical Performance Test (97750) |
$31.20 |
$78 |
0.9× |
| Plethysmography (94726) |
$240 |
$600 |
0.7× |
| Pm device eval in person (93288) |
$38 |
$95 |
1.1× |
| Pm device progr eval dual (93280) |
$38 |
$95 |
1.1× |
| Pm device progr eval multi (93281) |
$38 |
$95 |
1.1× |
| Pm Device Progr Eval Sngl (93279) |
$38 |
$95 |
1.1× |
| Pm/Icd Remote Tech Serv (93296) |
$38 |
$95 |
1.1× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) |
$1,509.20 |
$3,773 |
1.9× |
| Polysom <6 yrs 4/> paramtrs (95782) |
$940 |
$2,350 |
1.2× |
| Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) |
$800 |
$2,000 |
1.0× |
| Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) |
$800 |
$2,000 |
1.0× |
| Positional nystagmus test (92542) |
$100 |
$250 |
0.8× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) |
$40 |
$100 |
0.9× |
| Prepj& Antigen Allergen Immunotherapy 1 Insect (95145) |
$40 |
$100 |
0.9× |
| Prgrmng Dev Eval Implantable in Persn 1 Ld Dfb (93282) |
$38 |
$95 |
1.1× |
| Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) |
$40 |
$100 |
0.9× |
| Prof svcs allg immntx x w/prv allgic xtrcs njxs (95117) |
$40 |
$100 |
0.9× |
| Prq Card Angio/Athrect 1 Art (92924) |
$8,000 |
$20,000 |
0.8× |
| Prq Card Stent W/Angio 1 Vsl (92928) |
$9,752.40 |
$24,381 |
0.9× |
| Prq Card Stent/Ath/Angio (92933) |
$14,780 |
$36,950 |
0.9× |
| Prq Revasc Byp Graft 1 Vsl (92937) |
$9,752.40 |
$24,381 |
0.9× |
| Prq Tcat Clsr Cgen Ventr Septal Dfct W/Implt (93581) |
$14,000 |
$35,000 |
0.8× |
| Prq trluml pulmonary art balloon angiop 1 vsl (92997) |
$9,752.40 |
$24,381 |
0.9× |
| Psych diag eval w/med srvcs (90792) |
$126.40 |
$316 |
0.8× |
| Psychiatric diagnostic evaluation (90791) |
$136 |
$340 |
0.8× |
| Psychoanalysis (90845) |
$126.40 |
$316 |
0.8× |
| Psytx Crisis Initial 60 Min (90839) |
$126.40 |
$316 |
0.8× |
| Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) |
$36 |
$90 |
1.0× |
| Pt Eval High Complex (97163) |
$94.40 |
$236 |
1.0× |
| Pt eval low complex 20 min (97161) |
$94.40 |
$236 |
1.0× |
| Pt Eval Mod Complex (97162) |
$94.40 |
$236 |
1.0× |
| Pt gait training 15 min (97116) |
$28 |
$70 |
1.0× |
| Pt group caregiver training (97552) |
$19.60 |
$49 |
0.9× |
| Pt mechanical traction (97012) |
$14 |
$35 |
1.0× |
| Pt Re-Eval Est Plan Care (97164) |
$64.80 |
$162 |
1.0× |
| Pulm function test by gas (94727) |
$140 |
$350 |
0.7× |
| Pulmonary service/procedure (94799) |
$142.80 |
$357 |
1.2× |
| Pulmonary Stress Testing (94618) |
$116 |
$290 |
1.0× |
| Pure Tone Audiometry Air (92552) |
$116 |
$290 |
1.0× |
| R Hrt Art/Grft Angio (93457) |
$2,880 |
$7,200 |
1.0× |
| R Hrt Cath Chd W/Img Cath Trgt Zon Abnl Nt Connj (93594) |
$2,961.60 |
$7,404 |
1.0× |
| R Hrt Cath Chd W/Img Cath Trgt Zone Nml Nt Connj (93593) |
$2,961.60 |
$7,404 |
1.0× |
| R hrt coronary artery angio (93456) |
$2,880 |
$7,200 |
1.0× |
| R&L Hrt Cath Chd Img Cath Trgt Zon Abnl Nt Connj (93597) |
$2,961.60 |
$7,404 |
1.0× |
| R&L Hrt Cath Chd Img Cath Trgt Zone Nml Nt Connj (93596) |
$2,961.60 |
$7,404 |
1.0× |
| R&L Hrt Cath W/Ventriclgrphy (93453) |
$2,880 |
$7,200 |
1.0× |
| Rapid Desensitization Procedure Each Hour (95180) |
$260 |
$650 |
0.6× |
| Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) |
$325.60 |
$814 |
1.1× |
| Refill/Maint Portable Pump (96521) |
$200 |
$500 |
1.0× |
| Refill/Maint Pump/Resvr Syst (96522) |
$200 |
$500 |
1.0× |
| Rem interrog icpms <30 d phys/qhp (93297) |
$38 |
$95 |
1.1× |
| Rem Interrog Scrms <30 D Phys/Qhp (93298) |
$38 |
$95 |
1.1× |
| Remote 30 Day Ecg Rev/Report (93270) |
$38 |
$95 |
1.1× |
| Remote 30 Day Ecg Tech Supp (93229) |
$139.60 |
$349 |
0.4× |
| Respiratory flow volume loop (94375) |
$299.20 |
$748 |
1.5× |
| Right Heart Cath (93451) |
$2,880 |
$7,200 |
1.0× |
| Right ventricular recording (93603) |
$1,000 |
$2,500 |
0.9× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) |
$160 |
$400 |
0.9× |
| Rom Meas&Reprt Ea Xtr Ex Hand/Ea Trnk Sctj Spi (95851) |
$18.80 |
$47 |
0.7× |
| Rx sp-genratj augmnt&comunicaj dev 1st hr (92607) |
$116.40 |
$291 |
1.0× |
| Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) |
$45.60 |
$114 |
1.0× |
| Rx/Physical Eeg Activaj Phys/Qhp Attendance (95954) |
$400 |
$1,000 |
1.2× |
| Select picture audiometry (92583) |
$56.80 |
$142 |
1.1× |
| Self Care Mngment Training (97535) |
$30.80 |
$77 |
1.0× |
| Sensory Integration Ea 15 Min (97533) |
$58 |
$145 |
1.0× |
Short-Latency Somatosens Ep Std Trnk/Head (95927)
range across 2 matching MRF lines |
$240–$291.20 |
$600–$728 |
varies |
| Short-latency somatosens ep std upr limbs (95925) |
$240 |
$600 |
1.2× |
| Sinusoidal Vertical Axis Rotational Testing (92546) |
$140 |
$350 |
1.2× |
| Sleep study attended (95807) |
$400 |
$1,000 |
1.2× |
| Sleep study unattended (95806) |
$280 |
$700 |
1.4× |
| Slp caregiver training 1st 30 min (97550) |
$49.20 |
$123 |
0.9× |
| Slp Stdy Unatnd W/Anal (95801) |
$100 |
$250 |
1.9× |
| Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) |
$140 |
$350 |
0.7× |
| Somatosensory Testing (95938) |
$500 |
$1,250 |
0.6× |
| Speech Audiometry Complete (92556) |
$56.80 |
$142 |
1.1× |
| Speech audiometry threshold (92555) |
$34.80 |
$87 |
0.7× |
| Speech sound lang comprehen (92523) |
$215.20 |
$538 |
1.0× |
| Spin/Brain Pump Refil & Main (95991) |
$264 |
$660 |
1.0× |
| Spirometry (94010) |
$140 |
$350 |
0.7× |
| Spontaneous Nystagmus Test (92541) |
$100 |
$250 |
0.8× |
| Ssep lower limbs (95926) |
$240 |
$600 |
1.2× |
| Staggered Spondaic Word Test (92572) |
$140 |
$350 |
1.2× |
| Standardized Cognitive Performance Testing (96125) |
$98 |
$245 |
1.0× |
| Stenger Test Speech (92577) |
$400 |
$1,000 |
1.2× |
| Stenger Test, Pure Tone (92565) |
$30 |
$75 |
0.6× |
Stress Tte Only (93350)
range across 2 matching MRF lines |
$520–$730.80 |
$1,300–$1,827 |
varies |
| Subcutaneous Infusion Each Additional Hour (96370) |
$40 |
$100 |
0.9× |
Subcutaneous infusion initial 1 hr w/pump set-up (96369)
range across 2 matching MRF lines |
$200–$209.20 |
$500–$523 |
varies |
| Subq Infusion Additional Pump Infusion Site (96371) |
$64 |
$160 |
1.0× |
| Surfactant Admin Thru Tube (94610) |
$192 |
$480 |
1.0× |
| Synthetic Sentence Identification Test (92576) |
$30 |
$75 |
0.9× |
| Temp transcutaneous pacing (92953) |
$536.40 |
$1,341 |
0.9× |
| Temperature Gradient Studies (93740) |
$140 |
$350 |
1.2× |
| Tensilon Test (95857) |
$240 |
$600 |
1.2× |
| Test to assess hearing loss using different tone pitches (92575) |
$30 |
$75 |
0.9× |
| Testing Autonomic Nervous System Function (95923) |
$116 |
$290 |
1.0× |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) |
$22 |
$55 |
1.0× |
| Ther Ivntj Ea Addl 15 Min (97130) |
$22 |
$55 |
1.0× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) |
$27.60 |
$69 |
0.9× |
| Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) |
$98 |
$245 |
1.0× |
| Ther/Prop/Diag Inj/Inf Proc (96379) |
$40 |
$100 |
0.9× |
| Ther/Proph/Diag Inj Ia (96373) |
$200 |
$500 |
1.0× |
| Ther/Proph/Diag Inj Sc/Im (96372) |
$69.20 |
$173 |
1.1× |
| Ther/Proph/Diag Iv Inf Init (96365) |
$200 |
$500 |
1.0× |
| Therapeutic Activities (97530) |
$34.40 |
$86 |
1.0× |
| Tilt table test with heart rhythm and blood pressure monitoring (93660) |
$400 |
$1,000 |
1.2× |
| Tobacco Use Cessation Intensive >10 Minutes (99407) |
$26.80 |
$67 |
0.8× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) |
$26.80 |
$67 |
0.8× |
| Transcath Closure of Asd (93580) |
$14,780 |
$36,950 |
0.9× |
| Transcranial Doppler Intracran Art Emboli Detect (93892) |
$390 |
$975 |
4.1× |
| Transcranial Doppler Stdy Intracranial Art Lmtd (93888) |
$398.80 |
$997 |
4.2× |
| Transtelephonic Rhythm Strip Pacemaker Eval (93293) |
$38 |
$95 |
1.1× |
| Tstg Ans Funcj Cardiovagal Innervaj Parasymp (95921) |
$140 |
$350 |
1.2× |
| Tstg ans funcj vasomotor adrenergic innervaj (95922) |
$100 |
$250 |
0.8× |
| Tte w/doppler, complete (93306) |
$520 |
$1,300 |
1.1× |
| Tte W/O Doppler Complete (93307) |
$236 |
$590 |
1.1× |
| Tx atrial fib pulm vein isol (93656) |
$18,000 |
$45,000 |
0.8× |
| Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) |
$72.80 |
$182 |
1.0× |
| Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) |
$22 |
$55 |
0.9× |
| Tx/Pro/Dx Inj New Drug Addon (96375) |
$40 |
$100 |
0.9× |
| Tympanometry (92567) |
$42.40 |
$106 |
1.3× |
| Tympanometry and reflex threshold measurements (92550) |
$140 |
$350 |
0.7× |
Unlisted cardiovascular service/procedure (93799)
range across 3 matching MRF lines |
$840–$4,766.80 |
$2,100–$11,917 |
varies |
| Unlisted Diagnostic Gastroenterology Procedure (91299) |
$140 |
$350 |
1.2× |
| Unlisted noninvasive vascular diagnostic study (93998) |
$25.20 |
$63 |
1.0× |
| Unlisted otorhinolaryngological service (92700) |
$25.20 |
$63 |
1.0× |
| Upr/L Xtremity Art 2 Levels (93922) |
$116 |
$290 |
1.0× |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) |
$140 |
$350 |
0.7× |
| Valvuloplasty aortic valve (92986) |
$4,400 |
$11,000 |
0.9× |
| Valvuloplasty mitral valve (92987) |
$8,000 |
$20,000 |
0.8× |
| Valvuloplasty pulmonary valve (92990) |
$8,000 |
$20,000 |
0.8× |
| Vasopneumatic device (97016) |
$11.20 |
$28 |
0.9× |
| Veeg 2-12 Hr Cont Mntr (95713) |
$500 |
$1,250 |
1.5× |
| Veeg 2-12 hr intmt mntr (95712) |
$240 |
$600 |
0.7× |
| Veeg 2-12 hr unmonitored (95711) |
$200 |
$500 |
1.0× |
| Veeg by tech ea incr 12-26 hr intermittent mntr (95715) |
$500 |
$1,250 |
1.5× |
| Veeg Ea 12-26 Hr Unmntr (95714) |
$400 |
$1,000 |
1.2× |
| Veeg ea 12-26hr cont mntr (95716) |
$940 |
$2,350 |
1.2× |
| Vent Mgmt Inpat Init Day (94002) |
$497.60 |
$1,244 |
0.9× |
| Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) |
$497.60 |
$1,244 |
0.9× |
| Visual Evoked Potential Test (95930) |
$240 |
$600 |
1.2× |
| Visual Field Exam Extended (92083) |
$100 |
$250 |
0.8× |
| Visual field xm uni/bi w/interp intermed exam (92082) |
$50 |
$125 |
0.9× |
| Visual field xm uni/bi w/interpretj limited exam (92081) |
$56.80 |
$142 |
1.1× |
| Visual reinforcement audiometry (vra) (92579) |
$152.80 |
$382 |
0.8× |
| Vital capacity, total (94150) |
$140 |
$350 |
1.2× |
| Wada Activation Test Hemispheric Function W/Eeg (95958) |
$800 |
$2,000 |
1.0× |
| Wheelchair Mgmt Ea 15 Min (97542) |
$30 |
$75 |
1.0× |
| Whirlpool Therapy (97022) |
$16 |
$40 |
1.0× |