| Abd paracentesis w/imaging (49083) |
$1,380 |
$2,300 |
1.8× |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
$1,440 |
$2,400 |
1.8× |
| Amniocentesis diagnostic (59000) |
$840 |
$1,400 |
1.1× |
| Amputation Finger/Thumb (26951) |
$2,668.50 |
$4,447.50 |
0.9× |
| Appl Mlt-Layer Venous Wound Compress Below Knee (29581) |
$270 |
$450 |
1.9× |
| Application finger splint static (29130) |
$102 |
$170 |
0.9× |
| Application long arm splint shoulder hand (29105) |
$180 |
$300 |
1.3× |
| Application long leg splint thigh ankle/toes (29505) |
$180 |
$300 |
1.3× |
| Application Of Rigid Total Contact Leg Cast (29445) |
$378 |
$630 |
1.6× |
| Application short arm splint forearm-hand static (29125) |
$180 |
$300 |
1.6× |
| Application short leg splint calf foot (29515) |
$180 |
$300 |
1.3× |
| Apply multlay comprs arm/hand (29584) |
$273 |
$455 |
1.9× |
| Arterial puncture (36600) |
$63 |
$105 |
0.5× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$432 |
$720 |
1.6× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$432 |
$720 |
1.6× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
$432 |
$720 |
1.6× |
| Aspiration Bladder Insert Suprapubic Catheter (51102) |
$2,556 |
$4,260 |
1.4× |
| Aspiration bladder needle (51100) |
$381 |
$635 |
1.8× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$273.90 |
$456.50 |
1.6× |
| Blood patch (62273) |
$360 |
$600 |
0.6× |
| Blood transfusion service (36430) |
$432 |
$720 |
1.1× |
| Bx breast 1st lesion us imag (19083) |
$2,478 |
$4,130 |
1.7× |
| Chemical Cautery Tissue (17250) |
$282 |
$470 |
1.6× |
| Chest tube placement (32551) |
$873 |
$1,455 |
0.6× |
| Circumcision (54150) |
$996 |
$1,660 |
0.6× |
| Closed Rx Humeral Supracondylar Fx (24530) |
$366 |
$610 |
1.7× |
| Closed Rx Med Malleolus Fx (27760) |
$360 |
$600 |
1.7× |
| Closed Rx Shldr Disloc,Gr Tub Fx (23665) |
$810 |
$1,350 |
0.6× |
| Closed Rx Tibial Plateau Fx (27530) |
$366 |
$610 |
1.7× |
| Closed treatment of tarsometatarsal joint dislocation; without anesthesia (28600) |
$195 |
$325 |
0.9× |
| Closed tx metatarsal fracture w/o manipulation (28470) |
$600 |
$1,000 |
2.8× |
| Closed tx patellar dislocation w/o anesthesia (27560) |
$195 |
$325 |
0.9× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
$153 |
$255 |
0.7× |
| Clsd tx clavicular fracture w/o manipulation (23500) |
$195 |
$325 |
0.9× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$315 |
$525 |
1.5× |
| Cltx dstl fibular fx lat malls w/manj (27788) |
$315 |
$525 |
1.5× |
| Cltx dstl fibular fx lat malls w/o manj (27786) |
$366 |
$610 |
1.7× |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) |
$366 |
$610 |
1.7× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$366 |
$610 |
1.7× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$2,448 |
$4,080 |
1.8× |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) |
$372 |
$620 |
1.7× |
| Cltx fx grt toe phlx/phlg w/o manj (28490) |
$366 |
$610 |
1.7× |
| Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) |
$195 |
$325 |
0.9× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
$414 |
$690 |
1.9× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
$195 |
$325 |
0.9× |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
$195 |
$325 |
0.9× |
| Cltx metacarpal fx w/manipulation each bone (26605) |
$366 |
$610 |
1.7× |
| Cltx metacarpal fx w/o manipulation each bone (26600) |
$369 |
$615 |
1.7× |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) |
$195 |
$325 |
0.9× |
| Cltx prox fibula/shft fx w/o manj (27780) |
$420 |
$700 |
2.0× |
| Cltx prox tibfib jt dislc w/o anes (27830) |
$195 |
$325 |
0.9× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
$315 |
$525 |
1.5× |
| Colonoscopy thru stoma (44388) |
$1,395 |
$2,325 |
1.7× |
| Complex Drainage, Wound (10180) |
$3,702 |
$6,170 |
1.5× |
| Contrast Inj Cent Ven Cath, Inc Flouro (36598) |
$331.20 |
$552 |
1.8× |
| Control Nasal Hemorrhage Anterior Complex (30903) |
$151.80 |
$253 |
1.3× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$151.80 |
$253 |
1.3× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
$153 |
$255 |
1.3× |
| Debride nail 1-5 (11720) |
$84 |
$140 |
1.7× |
| Debride nail 6 or more (11721) |
$88.20 |
$147 |
1.7× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$360 |
$600 |
1.0× |
| Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) |
$324 |
$540 |
0.5× |
| Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) |
$306 |
$510 |
0.2× |
| Delivery placenta separate procedure (59414) |
$1,500 |
$2,500 |
0.5× |
| Destruction premalignant lesion 1st (17000) |
$151.20 |
$252 |
0.9× |
| Drainage Finger Abscess Complicated (26011) |
$1,521 |
$2,535 |
1.1× |
| Drainage Finger Abscess Simple (26010) |
$288 |
$480 |
1.7× |
| Drainage of eyelid abscess (67700) |
$132 |
$220 |
0.5× |
| Drainage of hematoma/fluid (10140) |
$2,364 |
$3,940 |
1.7× |
| Drainage of scrotal wall abscess (55100) |
$972 |
$1,620 |
0.7× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
$405 |
$675 |
1.2× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
$276 |
$460 |
1.6× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
$276 |
$460 |
1.6× |
| Epi Autogrft Face/Nck/Hnd/Ft/Gen <100 Sqcm (15115) |
$2,244 |
$3,740 |
1.3× |
| Epidrm agrft t/a/l 1st 100 cm/&/1% bdy inft/chld (15110) |
$2,244 |
$3,740 |
1.3× |
| Evacuation of subungual hematoma (11740) |
$109.80 |
$183 |
1.0× |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
$2,064 |
$3,440 |
1.5× |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) |
$813.99 |
$1,356.65 |
0.8× |
| Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) |
$1,077 |
$1,795 |
1.8× |
| Expl penetrating wound spx abdomen/flank/back (20102) |
$2,469 |
$4,115 |
1.4× |
| Exploration penetrating wound spx chest (20101) |
$2,469 |
$4,115 |
1.4× |
| Exploration penetrating wound spx extremity (20103) |
$1,521 |
$2,535 |
1.1× |
| Exploration Penetrating Wound Spx Neck (20100) |
$981 |
$1,635 |
2.1× |
| External Cephalic Version (59412) |
$3,420 |
$5,700 |
1.2× |
| Eye surgery procedure (66999) |
$1,080 |
$1,800 |
0.5× |
| Fetal Contraction Stress Test (59020) |
$225 |
$375 |
1.3× |
| Fetal non-stress test (59025) |
$225 |
$375 |
1.3× |
| Fine needle aspiration bx w/us gdn 1st lesion (10005) |
$972 |
$1,620 |
1.6× |
| Gastric Intubation/Aspiration, Therapeutic (43753) |
$177 |
$295 |
1.0× |
| I&d abscess simple (10060) |
$294 |
$490 |
1.7× |
| I&d perianal abscess superficial (46050) |
$723.60 |
$1,206 |
0.9× |
| I&d pilonidal cyst simple (10080) |
$1,026 |
$1,710 |
1.7× |
| Incision & drainage abscess complicated/multiple (10061) |
$582 |
$970 |
1.7× |
| Incision & drainage pilonidal cyst complicated (10081) |
$1,026 |
$1,710 |
1.7× |
| Incision & removal foreign body subq tiss compl (10121) |
$2,364 |
$3,940 |
1.7× |
| Incision & removal foreign body subq tiss simple (10120) |
$582 |
$970 |
1.7× |
| Incision and drainage of bartholin's gland abscess (56420) |
$228 |
$380 |
1.3× |
| Incision and drainage of vulva or perineal abscess (56405) |
$396 |
$660 |
1.5× |
| Incision of rectal abscess (46040) |
$1,806 |
$3,010 |
1.8× |
| Incision thrombosed hemorrhoid external (46083) |
$372 |
$620 |
1.7× |
| Incisional biopsy skin single lesion (11106) |
$816 |
$1,360 |
1.3× |
| Initial tx 1st degree burn local tx (16000) |
$111 |
$185 |
0.6× |
| Inj,Anes Agent,Brachial Plexus,Single (64415) |
$840 |
$1,400 |
1.1× |
| Inj,Anes Agent,Femoral Nerve,Single (64447) |
$132 |
$220 |
0.2× |
| Inject Nerv Blck,Intercostal,One (64420) |
$859.80 |
$1,433 |
1.4× |
| Inject Nerv Blck,Pudendal (64430) |
$1,089 |
$1,815 |
1.4× |
| Injection aa&/strd sciatic nerve w/img gdn (64445) |
$600 |
$1,000 |
1.0× |
| Injection anes other peripheral nerve/branch (64450) |
$639 |
$1,065 |
1.1× |
| Injection for identification of sentinel node (38792) |
$588 |
$980 |
1.7× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$366 |
$610 |
1.4× |
| Injection therapeutic carpal tunnel (20526) |
$364.20 |
$607 |
1.4× |
| Insert cervical dilator (59200) |
$375 |
$625 |
1.4× |
| Insert non-tunnel cv cath (36556) |
$1,455 |
$2,425 |
0.5× |
| Insert Temp Bladder Cath (51702) |
$177 |
$295 |
1.5× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$177 |
$295 |
1.5× |
| Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) |
$240 |
$400 |
0.1× |
| Intubation endotracheal emergency procedure (31500) |
$189 |
$315 |
0.9× |
| Myelography Lumbar Injection (62305) |
$1,134 |
$1,890 |
1.7× |
| Myelography Lumbar Injection (62304) |
$1,134 |
$1,890 |
1.7× |
| Myelography Via Lumbar Injection Rs&I Cervical (62302) |
$1,134 |
$1,890 |
1.7× |
| Myelography via lumbar injection rs&i thoracic (62303) |
$1,134 |
$1,890 |
1.7× |
| Njx dx/ther sbst intrlmnr lmbr/sac w/o img gdn (62326) |
$1,089 |
$1,815 |
1.4× |
| Open Tx Distal Phalangeal Fracture Each (26765) |
$1,920 |
$3,200 |
0.7× |
| Perq device breast 1st imag (19281) |
$720 |
$1,200 |
0.5× |
| Perq replacement gtube not req revj gstrst trc (43762) |
$333 |
$555 |
1.5× |
| Punch biopsy skin single lesion (11104) |
$540 |
$900 |
1.5× |
| Puncture Aspiration (10160) |
$576 |
$960 |
1.6× |
| Removal fb intranasal (30300) |
$177 |
$295 |
1.5× |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
$1,153.80 |
$1,923 |
0.8× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$96.60 |
$161 |
1.9× |
| Removal of nail bed (11750) |
$557.10 |
$928.50 |
1.6× |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
$306 |
$510 |
1.8× |
| Removal/bivalving full arm/full leg cast (29705) |
$243 |
$405 |
1.0× |
| Removal/bivalving gauntlet boot/body cast (29700) |
$180 |
$300 |
0.7× |
| Remove foreign body from eye (65210) |
$210 |
$350 |
0.5× |
| Remv Ext Canal Foreign Body (69200) |
$96.60 |
$161 |
0.8× |
| Remv F.B.,Eye,Superf Conjunc (65205) |
$94.80 |
$158 |
0.8× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
$738 |
$1,230 |
1.2× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
$738 |
$1,230 |
1.2× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
$360 |
$600 |
1.0× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$738 |
$1,230 |
2.1× |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
$360 |
$600 |
1.0× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$738 |
$1,230 |
2.1× |
| Repair complex trunk 1.1-2.5 cm (13100) |
$738 |
$1,230 |
1.2× |
| Repair complex trunk 2.6-7.5 cm (13101) |
$738 |
$1,230 |
1.2× |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
$360 |
$600 |
1.0× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$360 |
$600 |
1.0× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$360 |
$600 |
1.0× |
| Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) |
$360 |
$600 |
1.0× |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
$360 |
$600 |
1.0× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
$360 |
$600 |
1.0× |
| Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) |
$360 |
$600 |
1.0× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
$360 |
$600 |
0.6× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$360 |
$600 |
1.0× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$360 |
$600 |
1.0× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$360 |
$600 |
0.6× |
| Repair intermediate n/h/f/xtrnl gent >30.0 cm (12047) |
$900 |
$1,500 |
0.5× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$738 |
$1,230 |
2.1× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$360 |
$600 |
1.0× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$360 |
$600 |
1.0× |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) |
$738 |
$1,230 |
1.2× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$360 |
$600 |
1.0× |
| Repair intermediate s/a/t/e >30.0 cm (12037) |
$900 |
$1,500 |
0.5× |
| Repair Tongue Laceration (41250) |
$153 |
$255 |
0.4× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$210 |
$350 |
0.5× |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
$966 |
$1,610 |
0.7× |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
$966 |
$1,610 |
1.8× |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
$360 |
$600 |
0.6× |
| Rpr Lac 2.5 Cm/< Pst One-Third Tongue (41251) |
$460.20 |
$767 |
2.3× |
| Rpr lac tongue floor mouth > 2.6 cm/cplx (41252) |
$1,014 |
$1,690 |
5.0× |
| Sigmoidoscopy flx w/biopsy single/multiple (45331) |
$1,380 |
$2,300 |
1.7× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
$153 |
$255 |
0.4× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$153 |
$255 |
0.9× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$153 |
$255 |
0.9× |
| Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) |
$153 |
$255 |
0.4× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$145.20 |
$242 |
0.8× |
| Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) |
$153 |
$255 |
0.9× |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
$153 |
$255 |
0.9× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$153 |
$255 |
0.9× |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
$153 |
$255 |
0.9× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$153 |
$255 |
0.9× |
| Skin sub graft face/nk/hf/g (15275) |
$2,640 |
$4,400 |
4.1× |
| Skin sub graft trnk/arm/leg (15271) |
$2,640 |
$4,400 |
4.1× |
| Skin Sub Grft T/Arm/Lg Child (15273) |
$4,980 |
$8,300 |
2.8× |
| Skn sub grft f/n/hf/g child (15277) |
$2,640 |
$4,400 |
1.5× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$153 |
$255 |
0.9× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$153 |
$255 |
0.4× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$360 |
$600 |
1.0× |
| Spinal puncture lumbar diagnostic (62270) |
$619.50 |
$1,032.50 |
1.0× |
| Strapping ankle (29540) |
$133.50 |
$222.50 |
1.0× |
| Strapping elbow/wrist (29260) |
$78 |
$130 |
1.5× |
| Strapping hand/finger (29280) |
$105 |
$175 |
2.1× |
| Strapping Hip (29520) |
$180 |
$300 |
1.6× |
| Strapping knee (29530) |
$120 |
$200 |
1.0× |
| Strapping shoulder (29240) |
$60 |
$100 |
0.5× |
| Strapping thorax (29200) |
$60 |
$100 |
0.4× |
| Strapping toes (29550) |
$90 |
$150 |
1.8× |
| Strapping unna boot (29580) |
$204 |
$340 |
1.5× |
| Tangential biopsy skin single lesion (11102) |
$282 |
$470 |
0.8× |
| Thoracentesis needle/cath pleura w/o imaging (32554) |
$543 |
$905 |
1.0× |
| Tracheostomy emergency cricothyroid membrane (31605) |
$981 |
$1,635 |
4.8× |
| Tracheostomy Emergency Procedure Transtracheal (31603) |
$981 |
$1,635 |
0.7× |
| Treat finger dislocation (26775) |
$1,692 |
$2,820 |
7.0× |
| Treat Fracture Radius & Ulna (25560) |
$195 |
$325 |
0.9× |
| Treat humerus fracture (24500) |
$480 |
$800 |
2.3× |
| Treat humerus fracture (23600) |
$312 |
$520 |
1.5× |
| Treatment closed elbow dislocation w/o anes (24600) |
$315 |
$525 |
1.5× |
| Treatment of missed abortion, completed surgically; second trimester (59821) |
$1,800 |
$3,000 |
0.6× |
| Trim skin lesion (11055) |
$282 |
$470 |
1.6× |
| Trim skin lesions 2 to 4 (11056) |
$282 |
$470 |
1.6× |
| Trim skin lesions over 4 (11057) |
$282 |
$470 |
1.6× |
| Trimming Of Nondystrophic Nails, Any Number (11719) |
$84 |
$140 |
1.7× |
| Tx Missed Abortion First Trimester Surgical (59820) |
$1,800 |
$3,000 |
0.6× |
| Vaginal delivery only (59409) |
$3,286.50 |
$5,477.50 |
1.2× |
| Venipuncture (36415) |
$7.20 |
$12 |
0.8× |