Visits & medical services prices at William P. Clements Jr. University Hospital (UT Southwestern)

Dallas, TX · every code in this section with a posted price and a Medicare benchmark.

303 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Acoustic immitance testing (92570) $207.50 $415 1.6×
Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of… (95803) $215 $430 3.6×
Administration of chemotherapy into artery using push technique (96420) $574 $1,148 1.7×
Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord (96450) $1,322 $2,644 4.0×
Aep neurodiagnostic interpretation and report (92653) $405.50 $811 1.9×
Aerosol inhalation pentamidine (94642) $634.50 $1,269 2.9×
Airway inhalation treatment (94640) $576.50 $1,153 2.6×
Appl modality 1+lllt po pain (97037) $160 $320 4.3×
Appl on-body injector for timed subq injection (96377) $115 $230 2.4×
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $51 $102
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $43.50 $87
Application of ultraviolet light to skin (96900) $139.50 $279 3.7×
Assessment of aphasia (96105) $189.50 $379
Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks… (97755) $80 $160
Basic vestibular evaluation (92540) $207.50 $415 1.0×
Behavioral & qualit analysis voice and resonance (92524) $331.50 $663
Biopsy of heart lining (93505) $3,041 $6,082 1.0×
Bipap initial day (94660) $1,302 $2,604 5.9×
Bis extracellular fluid alys lymphedema assmnt (93702) $331.50 $663 2.6×
Blink reflex test (95933) $75.50 $151 1.3×
Breath hydrogen/methane test (91065) $416 $832 1.9×
Breathing capacity test (94010) $355.50 $711 1.6×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $305 $610 0.8×
Bundle of his recording (93600)
likely a partial charge — not the full procedure
$669 $1,338 0.1×
Canalith repositioning (95992) $74.50 $149
Car seat/bed test inft thru 12 mo 60 min (94780) $149.50 $299 4.0×
Cardiopulmonary exercise testing (94621) $693.50 $1,387 1.9×
Cardiovascular procedure unlisted (93799) $164 $328 1.3×
Cardiovascular stress test (93017) $852 $1,704 3.9×
Cardioversion elective external (92960) $1,051.50 $2,103 1.6×
Caregiver training 1st 30 min (97550) $79 $158
Caregiver training ea addl 15 (97551) $39.50 $79
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary… (93460) $13,813.50 $27,627 4.2×
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary… (93459) $10,678.50 $21,357 3.3×
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary… (93458) $11,706 $23,412 3.6×
Chemo anti-neopl sq/im (96401) $323 $646 4.5×
Chemo hormon antineopl sq/im (96402) $233 $466 3.2×
Chemo intralesional over 7 (96406) $189 $378 0.9×
Chemo intralesional up to 7 (96405) $94.50 $189 1.3×
Chemo IV infus each addl seq (96417) $270 $540 3.7×
Chemo IV infusion addl hr (96415) $279 $558 3.9×
Chemo IV push addl drug (96411) $337.50 $675 4.7×
Chemother prolong infuse w/pump (96416) $517.50 $1,035 1.6×
Chemotherapy administration into the peritoneal cavity via implanted port or catheter (96446) $381 $762 1.1×
Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours),… (96425) $717.50 $1,435 2.2×
Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour (96422) $524 $1,048 1.6×
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) $450 $900 1.4×
Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) $405 $810 1.2×
Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents (96542) $180.50 $361 0.5×
Chest physiotherapy initial (94667) $120 $240 0.9×
Color/duplex Doppler, complete (93975) $768 $1,536 3.2×
Color/duplex Doppler, limited (93976) $445.50 $891 4.2×
Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or… (97537) $63.50 $127
Compre electrophysiologic w/o arrhyt induction (93619) $12,457.50 $24,915 1.6×
Compre ep eval abltj atr fib pulm vein isolation (93656) $40,106.50 $80,213 1.5×
Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with… (93620) $14,156 $28,312 1.8×
Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction… (93653) $42,906.50 $85,813 1.6×
Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction… (93654) $36,509.50 $73,019 1.4×
Comprehensive hearing test (92557) $236.50 $473 1.8×
Computerized dynamic posturography sensory organization test (CDP-SOT), 6 conditions (ie, eyes open, eyes closed,… (92548) $111.50 $223 0.8×
Concurrent chemotherapy (96549) $71 $142 1.5×
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $57 $114 0.4×
Coronary art/grft angio s&i (93455) $9,130 $18,260 2.8×
Coronary artery angio s&i (93454) $7,870.50 $15,741 2.4×
Cpr (92950) $701.50 $1,403 3.2×
Critical care ill/injured patient init 30-74 min (99291) $2,122.50 $4,245 2.6×
Debridement open wound 20 sq cm< (97597) $201 $402 1.0×
Delivery/birthing room resuscitation (99465) $362 $724 0.5×
Diagnostic analysis with programming of auditory brainstem implant, per hour (92640) $131.50 $263 1.0×
Dialysis one evaluation (90945) $422 $844 1.0×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $111.50 $223 0.3×
Dup-scan artl infl&ven o/f pen vsl compl (93980) $484 $968 4.6×
Duplex hemodialysis access (93990) $311 $622 3.0×
Duplex scan artl infl&ven o/f hemo compl bi std (93985) $376.50 $753 1.6×
Duplex scan artl infl&ven o/f hemo compl uni std (93986) $258.50 $517 2.5×
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study Age Under 21 (93979) $284.50 $569 2.7×
Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study Age Under 21 (93981) $450 $900 4.3×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $737.50 $1,475 3.1×
Duplex scan of extracranial arteries; unilateral or limited study Age Under 21 (93882) $442.50 $885 4.2×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $922 $1,844 3.8×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $590 $1,180 5.6×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $569.50 $1,139 2.4×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $365 $730 3.5×
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) $364.50 $729 1.5×
Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) $233.50 $467 2.2×
Echo transesophageal (93312) $1,635 $3,270 3.0×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $1,345 $2,690 2.5×
Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional… (93318) $981 $1,962 1.8×
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed,… (93307) $885.50 $1,771 3.7×
EEG 41-60 minutes (95812) $1,409 $2,818 6.5×
EEG awake & asleep (95819) $890 $1,780 4.1×
EEG awake/drowsy (95816) $669 $1,338 3.1×
EEG coma or sleep only (95822) $897 $1,794 4.1×
EEG cont rec w/video by tech min 8 channels (95700) $467.50 $935 2.2×
EEG extended monitoring 61-119 minutes (95813) $1,691 $3,382 7.8×
EEG w/o vid tech ea incr 12-26 hr cont r-t mntr (95710) $884 $1,768 2.4×
EEG w/o video by tech 2-12hr continuous r-t mntr (95707) $467.50 $935 2.2×
EKG 12 lead tracing only (93005) $235.50 $471 4.0×
Elec alys implt npgt phys/qhp w/o programming (95970) $437 $874 3.3×
Elec alys implt smpl cn npgt prgrmg (95976) $421.50 $843 11.2×
Electrocochleography (92584) $191.50 $383 1.5×
Electroconvulsive therapy (90870) $1,166.50 $2,333 1.4×
Electrode stimulation brain (95961) $636 $1,272 0.7×
Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes… (93642) $1,926.50 $3,853 1.6×
Emergency department visit high mdm (99285) $1,879 $3,758 3.1×
Emergency department visit low mdm (99283) $770.50 $1,541 2.8×
Emergency department visit may not req phys/qhp (99281) $226 $452 2.7×
Emergency department visit moderate mdm (99284) $1,221.50 $2,443 2.9×
Emergency department visit straightforward mdm (99282) $470 $940 3.0×
EMG thoracic paraspinal (95869) $81 $162 0.4×
End tidal co2 mntrng (crbn dxde exp gas dtrmntn by infrared analyzer) (94799) $657.50 $1,315 5.1×
Endoscopy swallow (fees) vid (92612) $188 $376
Esoph balloon distension tst (91040) $1,021 $2,042 2.7×
Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s)… (91038) $1,155.50 $2,311 3.1×
Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s)… (91037) $924.50 $1,849 4.3×
Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and… (91010) $788.50 $1,577 2.1×
Esophageal recording (93615) $2,989 $5,978 2.4×
Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing without Cardiac Cath (93616) $3,288 $6,576 2.7×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $273.50 $547
Evaluate pt use of inhaler (94664) $93.50 $187 0.4×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92608) $49.50 $99
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $51 $102
Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face… (92605) $117 $234
Evaluation of speech fluency (92521) $266.50 $533
Evaluation of speech sound production articulate (92522) $288 $576
Evoked auditory test limited (92587) $111.50 $223 0.5×
Fluidotherapy (97022) $42 $84
Gas dilut/washout lung vol w/wo distrib vent&vol (94727) $318 $636 1.5×
Gastroesophag reflx test w/cath ph eltrd plcmt (91034) $767.50 $1,535 2.0×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $1,251.50 $2,503 1.5×
Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and… (91110) $1,406.50 $2,813 1.5×
Gi transit & pres meas wireless capsule w/interp (91112) $1,125 $2,250 1.2×
Group caregiver training strategies & technique (97552) $39.50 $79
Hemodialysis procedure w/ phys/qhp evaluation (90935) $1,557.50 $3,115 2.3×
Hot/cold pack (97010) $38.50 $77
Imm admn sarscov2 vaccine single dose (90480) $65 $130 1.6×
Immunization administration (90471) $154 $308 2.1×
Induction of arrhythmia by electrical pacing without Cardiac Cath (93618) $2,643 $5,286 2.2×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $161.50 $323 3.4×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $213 $426 1.0×
Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes with Cardiac Cath (93503) $2,734.50 $5,469 1.7×
Interrog device eval heart (93289) $53.50 $107 1.4×
Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography (93152) $837.50 $1,675 2.7×
Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health… (93290) $46.50 $93 1.2×
Interrogation vad in prson w/phys/qhp analysis (93750) $209.50 $419 2.2×
Intra-atrial pacing (93610)
likely a partial charge — not the full procedure
$1,131.50 $2,263 0.1×
Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete… (93650) $9,903.50 $19,807 1.3×
Irrigaj implntd venous access drug delivery syst (96523) $201.50 $403 3.4×
IV infusion hydration each additional hour (96361) $216 $432 4.6×
IV infusion hydration initial 31 min-1 hour (96360) $315 $630 1.5×
IV infusion ther proph addl sequential to 1 hr (96367) $243 $486 3.4×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $342 $684 1.6×
IV tx, each additional hour (96366) $220.50 $441 4.7×
Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance… (93595) $7,121.50 $14,243 2.2×
Low frequency non-thermal us (97610) $229 $458 1.1×
Lwr xtr vasc stdy bilat (93924) $340.50 $681 1.6×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $96 $192 0.7×
Maximum voluntary ventilation (94200) $243.50 $487 4.1×
Measurement of brain wave activity (EEG) to evaluate brain death (95824) $276 $552 0.7×
Mechanical traction therapy (97012) $207 $414
Methacholine challenge (94070) $305 $610 0.8×
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $372.50 $745
Multiple sleep latency (95805) $946 $1,892 1.1×
Muscle test 3 limbs (95863) $374.50 $749 2.9×
Muscle test larynx (95865) $157 $314 1.2×
Nasopharyngoscopy (92511) $223.50 $447 1.1×
Ndl EMG 4 xtr w/wo related paraspinal areas (95864) $299.50 $599 2.3×
Needle electromyography 2 extremities with or without related paraspinal areas 95861 (95861) $312 $624 2.3×
Needle electromyography cranial nrv muscle uni (95867) $170 $340 0.8×
Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber… (95872) $191.50 $383 0.9×
Needle electromyography; 1 extremity with or without related paraspinal areas (95860) $249.50 $499 1.9×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $116.50 $233 0.9×
Needle measurement of electrical activity in muscles on both sides of body (95868) $272 $544 1.3×
Neg pressure wound therapy non dme </= 50 sq cm (97607) $168.50 $337 0.4×
Neg pressure wound therapy non dme >50 sq cm (97608) $204 $408 0.5×
Negative pressure wound therapy dme </= 50 sq cm (97605) $221.50 $443 1.1×
Negative pressure wound therapy dme >50 sq cm (97606) $268 $536 0.7×
Nerve conduction studies 1-2 studies (95907) $427.50 $855 2.0×
Nerve conduction studies 11-12 studies (95912) $1,169.50 $2,339 3.1×
Nerve conduction studies 13/> studies (95913) $1,358 $2,716 3.6×
Nerve conduction studies 3-4 studies (95908) $522 $1,044 2.4×
Nerve conduction studies 5-6 studies (95909) $628.50 $1,257 2.9×
Nerve conduction studies 7-8 studies (95910) $427.50 $855 1.1×
Nerve conduction studies 9-10 studies (95911) $999.50 $1,999 2.7×
Neuromuscular junction test (95937) $199.50 $399 1.5×
Nitric oxide expired gas determination (95012) $408 $816 10.9×
Non-invasive physiologic study extremity 3 levels (93923) $267 $534 1.2×
Noninvasive ear/pulse oximetry overnight monitor (94762) $206.50 $413 1.6×
Occupational therapy eval high complex 60 mins (97167) $409 $818
Occupational therapy eval low complex 30 mins (97165) $208 $416
Occupational therapy eval mod complex 45 mins (97166) $324.50 $649
Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording (92544) $111.50 $223 0.9×
Oral function therapy (92526) $389 $778
Oral speech device eval (92597) $441.50 $883
Orthc/prostc mgmt sbsq enc (97763) $92.50 $185
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $157.50 $315
Ot manual therapy ea 15 min (97140) $128.50 $257
Ot neuromuscular re-education (97112) $120 $240
Ot paraffin bath (97018) $19.50 $39
Ot re-evaluation (97168) $204.50 $409
OT Therapeutic Activities Charges (97530) $114.50 $229
Ot wheelchair management (97542) $71 $142
Outpatient cardiac rehab w/cont ECG monitoring (93798) $133 $266 1.0×
Percutaneous balloon valvuloplasty; pulmonary valve without Cardiac Cath (92990) $16,696 $33,392 1.4×
Percutaneous transcatheter closure of a congenital ventricular septal defect with implant (93581) $19,181.50 $38,363 1.0×
Perq transcath closure pda (93582) $25,642 $51,284 1.4×
Perq transcath cls paravalvr leak 1 aortic valve (93591) $21,890 $43,780 1.2×
Perq transcath cls paravalvr leak 1 mitral valve (93590) $21,890 $43,780 1.2×
Phlebotomy therapeutic (99195) $162 $324 1.2×
Phy/qhp op pulm rhb w/mntr (94626) $355 $710 6.0×
Phy/qhp op pulm rhb w/o mntr (94625) $355 $710 6.0×
Physical therapy evaluation high complex 45 mins (97163) $306 $612
Physical therapy evaluation low complex 20 mins (97161) $214 $428
Physical therapy evaluation mod complex 30 mins (97162) $248.50 $497
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $2,035.50 $4,071 2.4×
Positional nystagmus test, minimum of 4 positions, with recording (92542) $169.50 $339 1.3×
Pr tympanometry and reflex threshold measurements (92550) $206.50 $413 1.0×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93283) $1,569.50 $3,139 41.9×
Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) $80.50 $161
Prq trluml coronary angio/atherect one art/brnch (92924) $16,155 $32,310 1.4×
Prq trluml coronary angioplasty one art/branch (92920) $8,445 $16,890 1.5×
Prq trluml coronary byp grft revasc one vessel (92937) $12,850.50 $25,701 1.1×
Prq trluml coronary stent w/angio one art/brnch (92928) $12,850.50 $25,701 1.1×
Prq trluml coronry chronic occlus revasc one vsl (92943) $9,668.50 $19,337 0.8×
Prq trluml coronry stent/ath/angio one art/brnch (92933) $13,340 $26,680 0.7×
Prq trluml pulmonary art balloon angiop 1 vsl (92997) $12,822.50 $25,645 1.1×
Psychiatric diagnostic evaluation (90791) $204 $408 1.1×
Psytx crisis initial 60 min (90839) $156 $312 0.9×
Pt gait training 15 min (97116) $102 $204
Pt physical performance test (97750) $52.50 $105
Pt re-evaluation (97164) $137 $274
Pulm funct tst plethysmograp (94726) $652 $1,304 1.7×
Pulmonary stress testing (94618) $243.50 $487 1.8×
R hrt art/grft angio (93457) $13,813.50 $27,627 4.2×
R hrt cath chd w/img cath trgt zon abnl nt connj (93594) $8,906.50 $17,813 2.7×
R hrt cath chd w/img cath trgt zone nml nt connj (93593) $8,906.50 $17,813 2.7×
R hrt coronary artery angio (93456) $12,174.50 $24,349 3.7×
R&l hrt art/ventricle angio (93461) $11,472 $22,944 3.5×
R&l hrt cath w/ventriclgrphy (93453) $9,819.50 $19,639 3.0×
Refill/maint pump/resvr syst (96522) $571 $1,142 2.7×
Refilling and maintenance of portable pump (96521) $502.50 $1,005 2.4×
Repet tms tx initial w/map/motr threshld/del&m (90867) $802.50 $1,605 3.7×
Repet tms tx subseq motr threshld w/deliv & mn (90869) $993.50 $1,987 4.6×
Rfl&main implt pmp/rsvr dlvr spi/brn phy/qhp (95991) $174.50 $349 0.6×
Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to… (93597) $7,121.50 $14,243 2.2×
Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to… (93596) $7,121.25 $14,242.50 2.2×
Right heart cath o2 saturation & cardiac output (93451) $6,819 $13,638 2.1×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $102 $204
Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands,… (97533) $75.50 $151
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95938) $1,112.50 $2,225 1.3×
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95926) $191.50 $383 0.9×
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95925) $405.50 $811 1.9×
Sleep study unattended (95806) $531.50 $1,063 2.5×
Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or… (95800) $901 $1,802 4.2×
Speech audiometry threshold (92555) $49.50 $99 0.8×
Speech sound lang comprehen (92523) $724.50 $1,449
Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording (92541) $111.50 $223 0.8×
Standardized cognitive performance testing (96125) $186 $372
Stenger test pure tone (92565) $49.50 $99 0.8×
Stenger test speech (92577) $176.50 $353 0.5×
Surfactant administration (94610) $103.50 $207 0.5×
Tcd emboli detect wo inj (93892) $207 $414 2.0×
Tcd std icr art ven-artl shnt detcj IV mbubb njx (93893) $207 $414 2.0×
Test for ability to detect and repeat spoken words with speech recognition (92556) $49.50 $99 0.8×
Test for abnormal eye movement using a rotating chair (92546) $207.50 $415 1.6×
Test for hearing various pitches using earphone (92552) $54 $108 0.4×
Test for hearing various pitches using earphone and device placed against the bone (92553) $145 $290 1.1×
Test to assess defects in adaption to sounds (92563) $49.50 $99 1.3×
Test to assess hearing loss using different tone pitches (92575) $49.50 $99 1.3×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $71.50 $143
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $71.50 $143
Therap repetitive tms tx subseq delivery & mng (90868) $389 $778 1.8×
Therapeutic procedure(s), group (2 or more individuals) Other Outpatient (97150) $51.50 $103
Therapeutic prophylactic/dx injection subq/im (96372) $137.50 $275 1.9×
Therapeutic services for the use of speech-generating device, including programming and modification Other Outpatient (92609) $53 $106
Tilt table evaluation (93660) $712 $1,424 1.9×
Tobacco use cessation intensive >10 minutes (99407) $51 $102 1.4×
Trans care mgmt 14 day disch (99495) $88 $176 0.7×
Trans care mgmt 7 day disch (99496) $88 $176 0.7×
Transcath closure of asd (93580) $17,656 $35,312 1.0×
Transcranial doppler stdy intracranial art compl (93886) $1,150 $2,300 4.8×
Transcranial Doppler study of the intracranial arteries; limited study Age Under 21 (93888) $575 $1,150 5.5×
Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition,… (93315) $1,526.50 $3,053 2.8×
Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study Age Under 21 (93304) $1,433.50 $2,867 2.6×
Tte congenital complete (93303) $2,429.50 $4,859 4.4×
Tte f-up or lmtd (93308) $776.50 $1,553 3.2×
Tte w/doppler complete (93306) $1,899.50 $3,799 3.5×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $142.50 $285
Tx speech language voice commj auditry 2/>indiv (92508) $54 $108
Tympanometry (92567) $64.50 $129 1.7×
Unlisted diagnostic gastroenterology procedure (91299) $670 $1,340 5.2×
Upr/l xtremity art 2 levels (93922) $175.50 $351 1.3×
Valvuloplasty aortic valve (92986) $4,860.50 $9,721 0.9×
Valvuloplasty mitral valve (92987) $16,943.50 $33,887 1.5×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $884 $1,768 2.4×
Veeg by tech 2-12 hr intermittent monitoring (95712) $991.50 $1,983 2.6×
Veeg by tech ea incr 12-26 hr cont r-t mntr (95716) $1,669 $3,338 1.9×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $1,197 $2,394 3.2×
Ventilation ip/obs initial day (94002) $2,437 $4,874 3.9×
Ventilator subsequent day (94003) $2,014 $4,028 3.2×
Visual ep testing cns except glaucoma w/i&r (95930) $376 $752 1.7×
Wada activation test (95958) $291 $582 0.3×
Wound(s) care non-selective (97602) $190.50 $381 0.9×