| 2d cephalometric image (D0340) |
— |
$283 |
— |
| Ablation, irreversible electroporation; 1 or more tumors, including fluoroscopic and ultrasound guidance, when… (0601T) |
— |
$26,235 |
— |
| Abltj perc cryoabltj img gdn lxtr/perph nerve (0441T) |
— |
$16,949 |
— |
| Abltj Perc Cryoabltj Img Gdn Nrv Plex/Trncl Nrv (0442T) |
— |
$16,949 |
— |
| Abltj perc cryoabltj img gdn uxtr/perph nerve (0440T) |
— |
$16,949 |
— |
| Adapt bhv tx prtcl modificaj ea 15 min tech time (0373T) |
— |
$129 |
— |
| Adm of soc dtr assess 5-15 m (G0136) |
— |
$43 |
— |
| Admin hepatitis b vaccine (G0010) |
— |
$319 |
— |
| Admin influenza virus vac (G0008) |
— |
$319 |
— |
| Admin pneumococcal vaccine (G0009) |
— |
$319 |
— |
| Alveoloplasty not w/extracts (D7321) |
— |
$1,926 |
— |
| Alveoloplasty w/extract 1-3 (D7311) |
— |
$359 |
— |
| Alveoplasty w/ extraction (D7310) |
— |
$411 |
— |
| Alveoplasty w/o extraction (D7320) |
— |
$1,926 |
— |
| Amalgam 4 or > surfaces perm (D2161) |
— |
$368 |
— |
| Amalgam one surface permanen (D2140) |
— |
$193 |
— |
| Amalgam three surfaces perma (D2160) |
— |
$302 |
— |
| Amalgam two surfaces permane (D2150) |
— |
$250 |
— |
| Anatomic guide 3d printed 1st anatomic guide (0561T) |
— |
$275 |
— |
| Anatomic Model 3D Printed 1St Compnt Antmc Strux (0559T) |
— |
$275 |
— |
| Ant resin-based cmpst crown (D2390) |
— |
$409 |
— |
| Apexification/recalc final (D3353) |
— |
$904 |
— |
| Apexification/recalc initial (D3351) |
— |
$655 |
— |
| Apexification/recalc interim (D3352) |
— |
$300 |
— |
| Apically positioned flap (D4245) |
— |
$871 |
— |
| Apicoectomy - anterior (D3410) |
— |
$1,300 |
— |
| Assessment of a patient (D0191) |
— |
$94 |
— |
| Behavior counsel obesity 15m (G0447) |
— |
$237 |
— |
| Bio mtrls to aid soft/os reg (D4265) |
— |
$550 |
— |
| Bitewings - three images (D0273) |
— |
$77 |
— |
| Bitewings four images (D0274) |
— |
$89 |
— |
| Bone replce graft first site (D4263) |
— |
$705 |
— |
| Brief alcohol misuse counsel (G0443) |
— |
$133 |
— |
| Ca screen;pelvic/breast exam (G0101) |
— |
$741 |
— |
| Chemo extend iv infus w/pump (G0498) |
— |
$1,767 |
— |
| Closd rductn splint alveolus (D7670) |
— |
$1,934 |
— |
| Comp periodontal evaluation (D0180) |
— |
$130 |
— |
| Complete occlusal adjustment (D9952) |
— |
$910 |
— |
| Comprehensve oral evaluation (D0150) |
— |
$120 |
— |
| Cone beam ct capt & interp (D0364) |
— |
$350 |
— |
| Cone beam ct capt mandible (D0381) |
— |
$389 |
— |
| Cone beam ct capt maxilla (D0382) |
— |
$389 |
— |
| Cone beam ct capture limited (D0380) |
— |
$350 |
— |
| Cone beam ct capture tmj (D0384) |
— |
$418 |
— |
| Cone beam ct interp both jaw (D0367) |
— |
$401 |
— |
| Cone beam ct interprete man (D0365) |
— |
$356 |
— |
| Cone beam ct interprete max (D0366) |
— |
$356 |
— |
| Cone beam ct interprete tmj (D0368) |
— |
$413 |
— |
| Core build-up incl any pins (D2950) |
— |
$315 |
— |
| Coronectomy (D7251) |
— |
$854 |
— |
| Crown 3/4 cast base metal (D2781) |
— |
$1,356 |
— |
| Crown 3/4 cast hi noble met (D2780) |
— |
$1,441 |
— |
| Crown 3/4 cast noble metal (D2782) |
— |
$1,400 |
— |
| Crown 3/4 porcelain/ceramic (D2783) |
— |
$1,482 |
— |
| Crown full cast base metal (D2791) |
— |
$1,373 |
— |
| Crown full cast high noble m (D2790) |
— |
$1,449 |
— |
| Crown full cast noble metal (D2792) |
— |
$1,399 |
— |
| Crown lengthen hard tissue (D4249) |
— |
$1,296 |
— |
| Crown porcelain fused base m (D2751) |
— |
$1,399 |
— |
| Crown porcelain w/ h noble m (D2750) |
— |
$1,502 |
— |
| Crown porcelain w/ noble met (D2752) |
— |
$1,432 |
— |
| Crown porcelain/ceramic (D2740) |
— |
$1,522 |
— |
| Crown resin-based indirect (D2710) |
— |
$602 |
— |
| Crtj Subq Insj Impltbl Glucose Sensor Sys Train (0446T) |
— |
$779 |
— |
| Cysto impl 4 or more (C9740) |
— |
$4,649 |
— |
| Cystoscopy prostatic imp 1-3 (C9739) |
— |
$6,532 |
— |
| Dental bitewing single image (D0270) |
— |
$39 |
— |
| Dental bitewings two images (D0272) |
— |
$63 |
— |
| Dental inlay resin 3/mre sur (D2652) |
— |
$782 |
— |
| Dental onlay metallic 3 surf (D2543) |
— |
$1,084 |
— |
| Dental onlay metl 4/more sur (D2544) |
— |
$1,127 |
— |
| Dental onlay porc 3/more sur (D2630) |
— |
$1,069 |
— |
| Dental onlay porc 4/more sur (D2644) |
— |
$1,188 |
— |
| Dental onlay porcelin 2 surf (D2642) |
— |
$1,039 |
— |
| Dental onlay porcelin 3 surf (D2643) |
— |
$1,120 |
— |
| Dental prophylaxis adult (D1110) |
— |
$133 |
— |
| Depression screen annual (G0444) |
— |
$37 |
— |
| Diab manage trn per indiv (G0108) |
— |
$759 |
— |
| Diab manage trn ind/group (G0109) |
— |
$449 |
— |
| Eia hiv-1/hiv-2 screen (G0432) |
— |
$616 |
— |
| Ekg tracing for initial prev (G0404) |
— |
$634 |
— |
| End thxpy, anterior tooth (D3310) |
— |
$1,053 |
— |
| End thxpy, molar tooth (D3330) |
— |
$1,600 |
— |
| End thxpy, premolar tooth (D3320) |
— |
$1,291 |
— |
| Endovascular Venous Arterialization Tibl/Prnl Vn (0620T) |
— |
$61,085 |
— |
| Ev Catheter Dir Chem Abltj Incmptnt Xtr Vein (0524T) |
— |
$11,884 |
— |
| Ev fempop artl revsc tcat plmt IV st grf & clsr (0505T) |
— |
$20,599 |
— |
| Excision benign lesion compl (D7412) |
— |
$2,156 |
— |
| Excision benign lesion>1.25c (D7411) |
— |
$1,951 |
— |
| Excision malig lesion<=1.25c (D7413) |
— |
$1,437 |
— |
| Exposure of unerupted tooth (D7280) |
— |
$824 |
— |
| Extensv oral eval prob focus (D0160) |
— |
$240 |
— |
| Extraction coronal remnants (D7111) |
— |
$189 |
— |
| Extraction erupted tooth/exr (D7140) |
— |
$251 |
— |
| Fern test (Q0114) |
— |
$47 |
— |
| Fixed bilat space maint, man (D1517) |
— |
$630 |
— |
| Fixed bilat space maint, max (D1516) |
— |
$630 |
— |
| Full mouth debridement (D4355) |
— |
$221 |
— |
| Gingival flap proc w/ planin (D4240) |
— |
$1,182 |
— |
| Gingival irrigation per quad (D4921) |
— |
$147 |
— |
| Gingivectomy/plasty 1 to 3 (D4211) |
— |
$415 |
— |
| Gingivectomy/plasty 4 or mor (D4210) |
— |
$933 |
— |
| Gngvl flap w rootplan 1-3 th (D4241) |
— |
$684 |
— |
| Gross pulpal debridement (D3221) |
— |
$250 |
— |
| Group behave couns 2-10 (G0473) |
— |
$237 |
— |
| Group mnt 2 or more 30 mins (G0271) |
— |
$98 |
— |
| Guided tiss regen nonresorb (D4267) |
— |
$933 |
— |
| Guided tiss regen resorble (D4266) |
— |
$726 |
— |
Hbot, full body chamber, 30m (G0277)
range across 2 matching MRF lines |
— |
$1,846–$2,363 |
— |
| Hiv prep counsel, clin staff (G0013) |
— |
$134 |
— |
| I&d absc intraoral soft tiss (D7510) |
— |
$441 |
— |
| Impact tooth rem bony w/comp (D7241) |
— |
$1,014 |
— |
| Impact tooth remov comp bony (D7240) |
— |
$807 |
— |
| Impact tooth remov part bony (D7230) |
— |
$687 |
— |
| Impact tooth remov soft tiss (D7220) |
— |
$516 |
— |
| Incision/drain abscess intra (D7511) |
— |
$667 |
— |
| Initial preventive exam (G0402) |
— |
$674 |
— |
| Injection of hiv prep drug (G0012) |
— |
$102 |
— |
| Inlay composite/resin one su (D2650) |
— |
$625 |
— |
| Inlay composite/resin two su (D2651) |
— |
$744 |
— |
| Inlay porcelain/ceramic 2 su (D2620) |
— |
$1,004 |
— |
| Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation… (0647T) |
— |
$6,672 |
— |
| Intens behave ther cardio dx (G0446) |
— |
$94 |
— |
| Interrogation Dev Eval Icds W/Ss Eltrd In Person (0576T) |
— |
$400 |
— |
| Intraor comprehensive series (D0210) |
— |
$209 |
— |
| Intraoral occlusal film (D0240) |
— |
$65 |
— |
| Intraoral periapical first (D0220) |
— |
$42 |
— |
| Ire Abltj 1+Tum Organ Perq (0600T) |
— |
$20,989 |
— |
| Labial veneer porc indirect (D2962) |
— |
$1,320 |
— |
| Labial veneer resin indirect (D2961) |
— |
$1,215 |
— |
| Limit oral eval problm focus (D0140) |
— |
$114 |
— |
| Limited occlusal adjustment (D9951) |
— |
$193 |
— |
| Mandible graft (D7950) |
— |
$931 |
— |
| Mnt subs tx for change dx (G0270) |
— |
$189 |
— |
| Non-auto graft 1st tooth (D4275) |
— |
$1,285 |
— |
| Obtaining screen pap smear (Q0091) |
— |
$162 |
— |
| Occ guard, hard, full arch (D9944) |
— |
$659 |
— |
| Occ guard, hard, part arch (D9946) |
— |
$659 |
— |
| Occ guard, soft, full arch (D9945) |
— |
$659 |
— |
| Oral antral fistula closure (D7260) |
— |
$2,825 |
— |
| Oral/facial photo images (D0350) |
— |
$84 |
— |
| Osseous surg 1 to 3 teeth (D4261) |
— |
$1,057 |
— |
| Osseous surgery 4 or more (D4260) |
— |
$1,969 |
— |
| Panoramic image (D0330) |
— |
$155 |
— |
| Part pulp for apexogenesis (D3222) |
— |
$231 |
— |
| Pathogen test for platelets (P9100) |
— |
$48 |
— |
| Pedicle soft tissue graft pr (D4270) |
— |
$1,399 |
— |
| Pemivibart infusion (M0224) |
— |
$1,786 |
— |
| Periodic oral evaluation (D0120) |
— |
$68 |
— |
| Periodontal maint procedures (D4910) |
— |
$199 |
— |
| Periodontal scaling & root (D4341) |
— |
$323 |
— |
| Periodontal scaling 1-3teeth (D4342) |
— |
$225 |
— |
| Perq Sacral Augmt Bilat Inj (0201T) |
— |
$49,710 |
— |
| Perq Sacral Augmt Unilat Inj (0200T) |
— |
$48,464 |
— |
| Place direct restoration (D2940) |
— |
$140 |
— |
| Place intra-socket bio dress (D7922) |
— |
$100 |
— |
| Post 1 srfc resinbased cmpst (D2391) |
— |
$234 |
— |
| Post 2 srfc resinbased cmpst (D2392) |
— |
$306 |
— |
| Post 3 srfc resinbased cmpst (D2393) |
— |
$381 |
— |
| Post >=4srfc resinbase cmpst (D2394) |
— |
$466 |
— |
| Post and core cast + crown (D2952) |
— |
$554 |
— |
| Potassium hydroxide preps (Q0112) |
— |
$47 |
— |
| Ppps, initial visit (G0438) |
— |
$730 |
— |
| Ppps, subseq visit (G0439) |
— |
$488 |
— |
| Prefab post/core + crown (D2954) |
— |
$443 |
— |
| Prefab stainless steel crown (D2933) |
— |
$508 |
— |
| Prefab steel crown primary (D2934) |
— |
$508 |
— |
| Prefab stnlss steel crown pe (D2931) |
— |
$415 |
— |
| Prefab stnlss steel crwn pri (D2930) |
— |
$367 |
— |
| Prefabricated resin crown (D2932) |
— |
$443 |
— |
| Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) |
— |
$400 |
— |
| Primary closure sinus perf (D7261) |
— |
$1,177 |
— |
| Programming dev eval icds w/ss eltrd in person (0575T) |
— |
$400 |
— |
| Pulp cap direct (D3110) |
— |
$111 |
— |
| Pulp cap indirect (D3120) |
— |
$89 |
— |
| Pulp vitality test (D0460) |
— |
$94 |
— |
| Pulpal regeneration complete (D3357) |
— |
$100 |
— |
| Pulpal regeneration initial (D3355) |
— |
$655 |
— |
| Pulpal regeneration interim (D3356) |
— |
$294 |
— |
| Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) |
— |
$1,360 |
— |
| Quan mr alys tiss compj w/o MRI same sess 1orgn (0648T) |
— |
$1,811 |
— |
| Quan mr alys tiss composition w/MRI 1orgn (0649T) |
— |
$1,811 |
— |
| Quan mr alys tiss composition w/MRI mlt organs (0698T) |
— |
$1,360 |
— |
| Rad exc lesion up to 1.25 cm (D7410) |
— |
$1,232 |
— |
| Re-cement or re-bond crown (D2920) |
— |
$135 |
— |
| Re-eval post-op visit (D0171) |
— |
$80 |
— |
| Re-eval,est pt,problem focus (D0170) |
— |
$80 |
— |
| Recement cast or prefab post (D2915) |
— |
$133 |
— |
| Recement inlay onlay or part (D2910) |
— |
$133 |
— |
| Recement space maint - man (D1552) |
— |
$118 |
— |
| Recement space maint - max (D1551) |
— |
$118 |
— |
| Recement unilat space maint (D1553) |
— |
$79 |
— |
| Rem exostosis any site (D7471) |
— |
$4,216 |
— |
| Rem imp tooth w mucoper flp (D7210) |
— |
$412 |
— |
| Rem nonodonto cyst > 1.25 cm (D7461) |
— |
$1,684 |
— |
| Rem nonodonto cyst to 1.25cm (D7460) |
— |
$1,232 |
— |
| Rem odontogen cyst > 1.25 cm (D7451) |
— |
$1,684 |
— |
| Rem odontogen cyst to 1.25cm (D7450) |
— |
$1,232 |
— |
| Removal fb skin/areolar tiss (D7530) |
— |
$758 |
— |
| Removal of fb reaction (D7540) |
— |
$840 |
— |
| Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision (0447T) |
— |
$817 |
— |
| Removal of sloughed off bone (D7550) |
— |
$524 |
— |
| Removal of torus palatinus (D7472) |
— |
$1,813 |
— |
| Remove bilat space main, man (D1527) |
— |
$765 |
— |
| Remove bilat space main, max (D1526) |
— |
$765 |
— |
| Remove torus mandibularis (D7473) |
— |
$1,710 |
— |
| Resin 4/> surf or w incis an (D2335) |
— |
$369 |
— |
| Resin one surface-anterior (D2330) |
— |
$200 |
— |
| Resin three surfaces-anterio (D2332) |
— |
$312 |
— |
| Resin two surfaces-anterior (D2331) |
— |
$255 |
— |
| Retreat root canal anterior (D3346) |
— |
$1,404 |
— |
| Retreat root canal molar (D3348) |
— |
$2,044 |
— |
| Retreat root canal premolar (D3347) |
— |
$1,652 |
— |
| Retrograde filling (D3430) |
— |
$407 |
— |
| Revasc intra lithotrip-ather (C9766) |
— |
$31,219 |
— |
| Revasc intra lithotrip-stent (C9765) |
— |
$31,219 |
— |
| Revasc intravasc lithotripsy (C9764) |
— |
$19,527 |
— |
| Revasc lith-sten-ath tib/per (C9775) |
— |
$31,219 |
— |
| Revasc lithotr-ather tib/per (C9774) |
— |
$31,219 |
— |
| Revasc lithotr-stent tib/per (C9773) |
— |
$31,219 |
— |
| Revasc lithotrip tibi/perone (C9772) |
— |
$19,527 |
— |
| Revasc lithotrip-stent-ather (C9767) |
— |
$31,219 |
— |
| Rmvl insj impltbl gluc sensor dif anatomic site (0448T) |
— |
$992 |
— |
| Root surgery molar (D3425) |
— |
$1,639 |
— |
| Root surgery premolar (D3421) |
— |
$1,446 |
— |
| Space maintainer fxd unilat (D1510) |
— |
$450 |
— |
| Splint extra-coronal (D4323) |
— |
$510 |
— |
| Splint intra-coronal (D4322) |
— |
$561 |
— |
| Surg reduct osseoustuberosit (D7485) |
— |
$1,526 |
— |
| Therapeutic pulpotomy (D3220) |
— |
$227 |
— |
| Tooth pin retention (D2951) |
— |
$79 |
— |
| Tooth reimplantation (D7270) |
— |
$883 |
— |
| Tooth root removal (D7250) |
— |
$435 |
— |
| Transcatheter Renal Sympath Denervation Bilat (0339T) |
— |
$91,601 |
— |
| Transcatheter renal sympath denervation unilat (0338T) |
— |
$46,075 |
— |
| Trauma respons w/hosp criti (G0390) |
— |
$19,513 |
— |
| Treatment of complications (D9930) |
— |
$161 |
— |
| Trim nail(s) (G0127) |
— |
$450 |
— |
| Trluml perip athrc abd aorta (0236T) |
— |
$19,776 |
— |
| Trluml Perip Athrc Brchiocph (0237T) |
— |
$19,776 |
— |
| Trluml Perip Athrc Iliac Art (0238T) |
— |
$18,877 |
— |
| Trluml Peripheral Atherectomy Renal Artery Ea (0234T) |
— |
$19,776 |
— |
| Ven blood coll snf/hha (G0471) |
— |
$144 |
— |
| Vestibuloplasty ridge extens (D7340) |
— |
$2,823 |
— |
| Visit esketamine 56m or less (G2082) |
— |
$2,552 |
— |
| Visit esketamine, > 56m (G2083) |
— |
$3,761 |
— |
| Wet mounts/ w preparations (Q0111) |
— |
$47 |
— |