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Saturday, September 29, 2007

CPT codes

10021 Fna w/o image $191.45
10022 Fna w/image $186.13
10040 Acne surgery $96.24
10060 Drainage of skin abscess $173.42
10061 Drainage of skin abscess $311.04
10080 Drainage of pilonidal cyst $248.37
10081 Drainage of pilonidal cyst $291.94
10120 Remove foreign body $195.74
10121 Remove foreign body $440.43
10140 Drainage of hematoma/fluid $193.47
10160 Puncture drainage of lesion $144.33
10180 Complex drainage, wound $402.06
11000 Debride infected skin $86.11
11001 Debride infected skin add-on $38.92
11010 Debride skin, fx $795.45
11011 Debride skin/muscle, fx $943.70
11012 Debride skin/muscle/bone, fx $1,376.58
11040 Debride skin, partial $74.51
11041 Debride skin, full $108.39
11042 Debride skin/tissue $154.19
11043 Debride tissue/muscle $422.45
11044 Debride tissue/muscle/bone $552.38
11055 Trim skin lesion $43.15
11056 Trim skin lesions, 2 to 4 $54.18
11057 Trim skin lesions, over 4 $66.58
11100 Biopsy, skin lesion $132.92
11101 Biopsy, skin add-on $54.71
11200 Removal of skin tags $132.19
11201 Remove skin tags add-on $33.36
11300 Shave skin lesion $108.31
11301 Shave skin lesion $142.30
11302 Shave skin lesion $170.66
11303 Shave skin lesion $204.47
11305 Shave skin lesion $109.58
11306 Shave skin lesion $150.34
11307 Shave skin lesion $176.00
11308 Shave skin lesion $207.87
11310 Shave skin lesion $133.34
11311 Shave skin lesion $165.84
11312 Shave skin lesion $191.15
11313 Shave skin lesion $250.05
11400 Exc tr-ext b9+marg 0.5 <> 4.0 cm $429.82
11420 Exc h-f-nk-sp b9+marg 0.5 < $198.47 11421 Exc h-f-nk-sp b9+marg 0.6-1 $253.70 11422 Exc h-f-nk-sp b9+marg 1.1-2 $283.84 11423 Exc h-f-nk-sp b9+marg 2.1-3 $336.99 11424 Exc h-f-nk-sp b9+marg 3.1-4 $384.19 11426 Exc h-f-nk-sp b9+marg > 4 cm $537.93
11440 Exc face-mm b9+marg 0.5 <> 4 cm $629.86
11450 Removal, sweat gland lesion $566.31
11451 Removal, sweat gland lesion $774.38
11462 Removal, sweat gland lesion $555.05
11463 Removal, sweat gland lesion $789.87
11470 Removal, sweat gland lesion $608.92
11471 Removal, sweat gland lesion $816.65
11600 Exc tr-ext mlg+marg 0.5 <> 4 cm $550.02
11620 Exc h-f-nk-sp mlg+marg 0.5 < $273.02 11621 Exc h-f-nk-sp mlg+marg 0.6-1 $324.19 11622 Exc h-f-nk-sp mlg+marg 1.1-2 $368.79 11623 Exc h-f-nk-sp mlg+marg 2.1-3 $434.46 11624 Exc h-f-nk-sp mlg+marg 3.1-4 $499.73 11626 Exc h-f-nk-sp mlg+mar > 4 cm $658.35
11640 Exc face-mm malig+marg 0.5 < $290.13 11641 Exc face-mm malig+marg 0.6-1 $378.15 11642 Exc face-mm malig+marg 1.1-2 $437.79 11643 Exc face-mm malig+marg 2.1-3 $506.50 11644 Exc face-mm malig+marg 3.1-4 $640.25 11646 Exc face-mm mlg+marg > 4 cm $862.44
11719 Trim nail(s) $30.25
11720 Debride nail, 1-5 $33.07
11721 Debride nail, 6 or more $44.35
11730 Removal of nail plate $147.01
11732 Remove nail plate, add-on $74.23
11740 Drain blood from under nail $87.52
11750 Removal of nail bed $292.06
11752 Remove nail bed/finger tip $416.20
11755 Biopsy, nail unit $175.96
11760 Repair of nail bed $251.87
11762 Reconstruction of nail bed $385.47
11765 Excision of nail fold, toe $132.07
11770 Removal of pilonidal lesion $347.09
11771 Removal of pilonidal lesion $843.64
11772 Removal of pilonidal lesion $1,042.25
11900 Injection into skin lesions $84.27
11901 Added skin lesions injection $106.55
11920 Correct skin color defects $264.44
11921 Correct skin color defects $315.18
11922 Correct skin color defects $64.12
11950 Therapy for contour defects $144.30
11951 Therapy for contour defects $196.25
11952 Therapy for contour defects $262.15
11954 Therapy for contour defects $314.03
11960 Insert tissue expander(s) $1,437.94
11970 Replace tissue expander $978.32
11971 Remove tissue expander(s) $656.46
11975 Insert contraceptive cap $201.15
11976 Removal of contraceptive cap $255.46
11977 Removal/reinsert contra cap $415.40
11980 Implant hormone pellet(s) $130.65
11981 Insert drug implant device $236.14
11982 Remove drug implant device $275.75
11983 Remove/insert drug implant $418.84
12001 Repair superficial wound(s) $270.13
12002 Repair superficial wound(s) $286.90
12004 Repair superficial wound(s) $336.96
12005 Repair superficial wound(s) $419.39
12006 Repair superficial wound(s) $474.36
12007 Repair superficial wound(s) $547.32
12011 Repair superficial wound(s) $285.97
12013 Repair superficial wound(s) $292.91
12014 Repair superficial wound(s) $364.90
12015 Repair superficial wound(s) $420.05
12016 Repair superficial wound(s) $493.09
12017 Repair superficial wound(s) $498.58
12018 Repair superficial wound(s) $587.35
12020 Closure of split wound $291.94
12021 Closure of split wound $265.08
12031 Layer closure of wound(s) $277.92
12032 Layer closure of wound(s) $359.95
12034 Layer closure of wound(s) $444.87
12035 Layer closure of wound(s) $528.67
12036 Layer closure of wound(s) $620.36
12037 Layer closure of wound(s) $711.99
12041 Layer closure of wound(s) $310.97
12042 Layer closure of wound(s) $389.71
12044 Layer closure of wound(s) $464.74
12045 Layer closure of wound(s) $537.80
12046 Layer closure of wound(s) $674.67
12047 Layer closure of wound(s) $766.30
12051 Layer closure of wound(s) $389.58
12052 Layer closure of wound(s) $432.30
12053 Layer closure of wound(s) $462.91
12054 Layer closure of wound(s) $511.64
12055 Layer closure of wound(s) $657.04
12056 Layer closure of wound(s) $873.80
12057 Layer closure of wound(s) $884.87
13100 Repair of wound or lesion $289.93
13101 Repair of wound or lesion $523.23
13102 Repair wound/lesion add-on $147.66
13120 Repair of wound or lesion $401.40
13121 Repair of wound or lesion $606.21
13122 Repair wound/lesion add-on $172.23
13131 Repair of wound or lesion $542.40
13132 Repair of wound or lesion $779.15
13133 Repair wound/lesion add-on $252.67
13150 Repair of wound or lesion $404.66
13151 Repair of wound or lesion $694.68
13152 Repair of wound or lesion $906.32
13153 Repair wound/lesion add-on $277.53
13160 Late closure of wound $974.53
14000 Skin tissue rearrangement $1,044.54
14001 Skin tissue rearrangement $1,342.85
14020 Skin tissue rearrangement $1,143.28
14021 Skin tissue rearrangement $1,497.67
14040 Skin tissue rearrangement $1,177.58
14041 Skin tissue rearrangement $1,618.56
14060 Skin tissue rearrangement $1,283.48
14061 Skin tissue rearrangement $1,749.90
14300 Skin tissue rearrangement $1,683.45
14350 Skin tissue rearrangement $1,251.99
15000 Skin graft $575.70
15001 Skin graft add-on $172.77
15050 Skin pinch graft $750.24
15100 Skin split graft $1,455.70
15101 Skin split graft add-on $399.68
15120 Skin split graft $1,512.87
15121 Skin split graft add-on $526.03
15200 Skin full graft $1,131.20
15201 Skin full graft add-on $176.00
15220 Skin full graft $1,344.17
15221 Skin full graft add-on $156.32
15240 Skin full graft $1,406.05
15241 Skin full graft add-on $245.93
15260 Skin full graft $1,456.02
15261 Skin full graft add-on $361.00
15342 Cultured skin graft, 25 cm $204.44
15343 Culture skn graft addl 25 cm $37.94
15350 Skin homograft $839.26
15351 Skin homograft add-on $143.85
15400 Skin heterograft $602.20
15401 Skin heterograft add-on $163.13
15570 Form skin pedicle flap $1,358.12
15572 Form skin pedicle flap $1,306.84
15574 Form skin pedicle flap $1,380.28
15576 Form skin pedicle flap $1,324.50
15600 Skin graft $635.22
15610 Skin graft $447.81
15620 Skin graft $744.82
15630 Skin graft $726.78
15650 Transfer skin pedicle flap $771.75
15732 Muscle-skin graft, head/neck $2,634.74
15734 Muscle-skin graft, trunk $2,633.35
15736 Muscle-skin graft, arm $2,537.48
15738 Muscle-skin graft, leg $2,650.96
15740 Island pedicle flap graft $1,465.05
15750 Neurovascular pedicle graft $1,520.94
15756 Free myo/skin flap microvasc $4,180.10
15757 Free skin flap, microvasc $4,262.33
15758 Free fascial flap, microvasc $4,258.45
15760 Composite skin graft $1,350.27
15770 Derma-fat-fascia graft $1,053.63
15775 Hair transplant punch grafts $302.52
15776 Hair transplant punch grafts $485.24
15780 Abrasion treatment of skin $1,047.20
15781 Abrasion treatment of skin $741.09
15782 Abrasion treatment of skin $626.47
15783 Abrasion treatment of skin $474.36
15786 Abrasion, lesion, single $160.96
15787 Abrasion, lesions, add-on $47.36
15788 Chemical peel, face, epiderm $390.49
15789 Chemical peel, face, dermal $817.92
15792 Chemical peel, nonfacial $360.57
15793 Chemical peel, nonfacial $570.77
15810 Salabrasion $382.29
15811 Salabrasion $514.67
15819 Plastic surgery, neck $1,227.30
15820 Revision of lower eyelid $867.79
15821 Revision of lower eyelid $936.86
15822 Revision of upper eyelid $740.14
15823 Revision of upper eyelid $1,075.42
15824 Removal of forehead wrinkles $1,514.77
15825 Removal of neck wrinkles $1,295.81
15826 Removal of brow wrinkles $1,094.72
15828 Removal of face wrinkles $3,704.15
15829 Removal of skin wrinkles $3,704.15
15831 Excise excessive skin tissue $1,544.24
15832 Excise excessive skin tissue $1,490.99
15833 Excise excessive skin tissue $1,408.70
15834 Excise excessive skin tissue $1,388.23
15835 Excise excessive skin tissue $1,701.47
15836 Excise excessive skin tissue $1,205.00
15837 Excise excessive skin tissue $1,204.90
15838 Excise excessive skin tissue $974.98
15839 Excise excessive skin tissue $1,275.82
15840 Graft for face nerve palsy $1,728.28
15841 Graft for face nerve palsy $2,882.64
15842 Flap for face nerve palsy $4,579.28
15845 Skin and muscle repair, face $1,614.51
15850 Removal of sutures $168.74
15851 Removal of sutures $184.70
15852 Dressing change not for burn $195.71
15860 Test for blood flow in graft $239.23
15876 Suction assisted lipectomy $893.57
15877 Suction assisted lipectomy $1,605.56
15878 Suction assisted lipectomy $893.57
15879 Suction assisted lipectomy $1,605.56
15920 Removal of tail bone ulcer $1,013.44
15922 Removal of tail bone ulcer $1,285.70
15931 Remove sacrum pressure sore $1,124.55
15933 Remove sacrum pressure sore $1,402.36
15934 Remove sacrum pressure sore $1,550.35
15935 Remove sacrum pressure sore $1,867.00
15936 Remove sacrum pressure sore $1,553.07
15937 Remove sacrum pressure sore $1,807.76
15940 Remove hip pressure sore $1,166.10
15941 Remove hip pressure sore $1,562.35
15944 Remove hip pressure sore $1,503.32
15945 Remove hip pressure sore $1,673.63
15946 Remove hip pressure sore $2,696.60
15950 Remove thigh pressure sore $583.09
15951 Remove thigh pressure sore $1,393.34
15952 Remove thigh pressure sore $1,437.51
15953 Remove thigh pressure sore $1,623.02
15956 Remove thigh pressure sore $1,972.35
15958 Remove thigh pressure sore $1,989.33
15999 Removal of pressure sore $0.00
16000 Initial treatment of burn(s) $92.81
16010 Treatment of burn(s) $113.15
16015 Treatment of burn(s) $263.92
16020 Treatment of burn(s) $131.36
16025 Treatment of burn(s) $182.42
16030 Treatment of burn(s) $314.33
16035 Incision of burn scab, initi $395.23
16036 Escharotomy; add’l incision $157.78
17000 Destroy benign/premlg lesion $113.03
17003 Destroy lesions, 2-14 $19.12
17004 Destroy lesions, 15 or more $372.87
17106 Destruction of skin lesions $623.85
17107 Destruction of skin lesions $1,222.96
17108 Destruction of skin lesions $1,254.91
17110 Destruct lesion, 1-14 $134.02
17111 Destruct lesion, 15 or more $145.01
17250 Chemical cautery, tissue $119.04
17260 Destruction of skin lesions $157.80
17261 Destruction of skin lesions $200.96
17262 Destruction of skin lesions $250.86
17263 Destruction of skin lesions $279.62
17264 Destruction of skin lesions $301.83
17266 Destruction of skin lesions $353.39
17270 Destruction of skin lesions $218.70
17271 Destruction of skin lesions $236.91
17272 Destruction of skin lesions $167.62
17273 Destruction of skin lesions $309.01
17274 Destruction of skin lesions $375.50
17276 Destruction of skin lesions $449.61
17280 Destruction of skin lesions $200.96
17281 Destruction of skin lesions $262.69
17282 Destruction of skin lesions $305.51
17283 Destruction of skin lesions $377.85
17284 Destruction of skin lesions $447.95
17286 Destruction of skin lesions $595.50
17304 1 stage mohs, up to 5 spec $1,088.42
17305 2 stage mohs, up to 5 spec $464.27
17306 3 stage mohs, up to 5 spec $481.32
17307 Mohs addl stage up to 5 spec $477.88
17310 Mohs any stage > 5 spec each $111.96
17340 Cryotherapy of skin $83.94
17360 Skin peel therapy $125.82
17380 Hair removal by electrolysis $128.11
17999 Skin tissue procedure $0.00
19000 Drainage of breast lesion $165.32
19001 Drain breast lesion add-on $55.98
19020 Incision of breast lesion $693.34
19030 Injection for breast x-ray $209.41
19100 Bx breast percut w/o image $235.27
19101 Biopsy of breast, open $568.60
19102 Bx breast percut w/image $428.86
19103 Bx breast percut w/device $667.85
19110 Nipple exploration $739.23
19112 Excise breast duct fistula $688.41
19120 Removal of breast lesion $753.09
19125 Excision, breast lesion $809.69
19126 Excision, addl breast lesion $300.68
19140 Removal of breast tissue $906.59
19160 Removal of breast tissue $709.45
19162 Remove breast tissue, nodes $1,505.02
19180 Removal of breast $1,041.11
19182 Removal of breast $940.22
19200 Removal of breast $1,771.16
19220 Removal of breast $1,808.29
19240 Removal of breast $1,830.22
19260 Removal of chest wall lesion $1,997.36
19271 Revision of chest wall $2,758.17
19272 Extensive chest wall surgery $3,032.43
19290 Place needle wire, breast $304.48
19291 Place needle wire, breast $163.83
19295 Place breast clip, percut $191.06
19316 Suspension of breast $1,367.00
19318 Reduction of large breast $2,005.97
19324 Enlarge breast $800.89
19325 Enlarge breast with implant $1,121.34
19328 Removal of breast implant $797.84
19330 Removal of implant material $1,017.55
19340 Immediate breast prosthesis $714.86
19342 Delayed breast prosthesis $1,502.49
19350 Breast reconstruction $1,459.56
19355 Correct inverted nipple(s) $1,277.14
19357 Breast reconstruction $2,388.32
19361 Breast reconstruction $2,333.08
19364 Breast reconstruction $4,846.59
19366 Breast reconstruction $2,453.94
19367 Breast reconstruction $3,174.07
19368 Breast reconstruction $3,957.11
19369 Breast reconstruction $3,720.38
19370 Surgery of breast capsule $1,114.54
19371 Removal of breast capsule $1,281.13
19380 Revise breast reconstruction $753.90
19396 Design custom breast implant $341.76
19499 Breast surgery procedure $0.00

From 2

20000 Incision of abscess $327.17
20005 Incision of deep abscess $498.65
20100 Explore wound, neck $1,190.66
20101 Explore wound, chest $454.19
20102 Explore wound, abdomen $549.53
20103 Explore wound, extremity $703.72
20150 Excise epiphyseal bar $1,556.97
20200 Muscle biopsy $201.51
20205 Deep muscle biopsy $427.89
20206 Needle biopsy, muscle $277.22
20220 Bone biopsy, trocar/needle $253.74
20225 Bone biopsy, trocar/needle $482.84
20240 Bone biopsy, excisional $433.92
20245 Bone biopsy, excisional $1,036.28
20250 Open bone biopsy $708.01
20251 Open bone biopsy $802.96
20500 Injection of sinus tract $300.48
20501 Inject sinus tract for x-ray $248.99
20520 Removal of foreign body $300.26
20525 Removal of foreign body $513.22
20526 Ther injection, carp tunnel $123.19
20550 Inj tendon sheath/ligament $107.29
20551 Inj tendon origin/insertion $105.22
20552 Inj trigger point, 1/2 muscl $101.95
20553 Inject trigger points, =/> 3 $116.24
20600 Drain/inject, joint/bursa $95.75
20605 Drain/inject, joint/bursa $104.82
20610 Drain/inject, joint/bursa $127.14
20612 Aspirate/inj ganglion cyst $103.56
20615 Treatment of bone cyst $353.02
20650 Insert and remove bone pin $344.80
20660 Apply, rem fixation device $418.68
20661 Application of head brace $743.27
20662 Application of pelvis brace $859.98
20663 Application of thigh brace $764.34
20664 Halo brace application $1,146.85
20665 Removal of fixation device $147.70
20670 Removal of support implant $495.81
20680 Removal of support implant $489.96
20690 Apply bone fixation device $451.71
20692 Apply bone fixation device $759.41
20693 Adjust bone fixation device $853.58
20694 Remove bone fixation device $655.17
20802 Replantation, arm, complete $4,782.05
20805 Replant forearm, complete $6,305.55
20808 Replantation hand, complete $7,855.52
20816 Replantation digit, complete $5,127.99
20822 Replantation digit, complete $4,506.48
20824 Replantation thumb, complete $5,075.23
20827 Replantation thumb, complete $4,714.69
20838 Replantation foot, complete $4,892.69
20900 Removal of bone for graft $780.88
20902 Removal of bone for graft $1,079.23
20910 Remove cartilage for graft $908.11
20912 Remove cartilage for graft $915.36
20920 Removal of fascia for graft $655.17
20922 Removal of fascia for graft $992.55
20924 Removal of tendon for graft $655.17
20926 Removal of tissue for graft $655.17
20930 Spinal bone allograft $92.38
20931 Spinal bone allograft $213.25
20936 Spinal bone autograft $634.56
20937 Spinal bone autograft $326.69
20938 Spinal bone autograft $354.52
20950 Fluid pressure, muscle $194.24
20955 Fibula bone graft, microvasc $4,825.41
20956 Iliac bone graft, microvasc $4,878.17
20957 Mt bone graft, microvasc $4,581.90
20962 Other bone graft, microvasc $4,960.90
20969 Bone/skin graft, microvasc $5,345.75
20970 Bone/skin graft, iliac crest $5,182.05
20972 Bone/skin graft, metatarsal $4,956.93
20973 Bone/skin graft, great toe $5,345.40
20974 Electrical bone stimulation $92.76
20975 Electrical bone stimulation $330.75
20979 Us bone stimulation $101.03
20982 Ablate, bone tumor(s) perq $4,691.94
20999 Musculoskeletal surgery $0.00
21010 Incision of jaw joint $1,277.15
21015 Resection of facial tumor $796.62
21025 Excision of bone, lower jaw $1,484.57
21026 Excision of facial bone(s) $855.70
21029 Contour of face bone lesion $1,197.61
21030 Excise max/zygoma b9 tumor $830.90
21031 Remove exostosis, mandible $568.93
21032 Remove exostosis, maxilla $572.03
21034 Excise max/zygoma mlg tumor $2,196.16
21040 Excise mandible lesion $816.17
21044 Removal of jaw bone lesion $1,517.76
21045 Extensive jaw surgery $2,042.66
21046 Remove mandible cyst complex $1,884.80
21047 Excise lwr jaw cyst w/repair $2,386.67
21048 Remove maxilla cyst complex $1,941.42
21049 Excis uppr jaw cyst w/repair $2,280.84
21050 Removal of jaw joint $1,543.78
21060 Remove jaw joint cartilage $1,485.15
21070 Remove coronoid process $1,123.37
21076 Prepare face/oral prosthesis $1,931.94
21077 Prepare face/oral prosthesis $4,875.42
21079 Prepare face/oral prosthesis $3,260.97
21080 Prepare face/oral prosthesis $3,713.32
21081 Prepare face/oral prosthesis $3,363.89
21082 Prepare face/oral prosthesis $2,985.29
21083 Prepare face/oral prosthesis $2,852.12
21084 Prepare face/oral prosthesis $3,307.06
21085 Prepare face/oral prosthesis $1,284.66
21086 Prepare face/oral prosthesis $3,607.75
21087 Prepare face/oral prosthesis $3,594.60
21088 Prepare face/oral prosthesis $2,316.82
21089 Prepare face/oral prosthesis $0.00
21100 Maxillofacial fixation $708.86
21110 Interdental fixation $883.29
21116 Injection, jaw joint x-ray $339.92
21120 Reconstruction of chin $987.34
21121 Reconstruction of chin $1,311.18
21122 Reconstruction of chin $1,147.28
21123 Reconstruction of chin $1,448.57
21125 Augmentation, lower jaw bone $1,635.18
21127 Augmentation, lower jaw bone $1,860.13
21137 Reduction of forehead $1,266.74
21138 Reduction of forehead $1,610.46
21139 Reduction of forehead $1,805.02
21141 Reconstruct midface, lefort $2,372.54
21142 Reconstruct midface, lefort $2,350.94
21143 Reconstruct midface, lefort $2,467.35
21145 Reconstruct midface, lefort $2,547.38
21146 Reconstruct midface, lefort $2,705.74
21147 Reconstruct midface, lefort $2,738.87
21150 Reconstruct midface, lefort $2,898.87
21151 Reconstruct midface, lefort $3,426.02
21154 Reconstruct midface, lefort $3,865.59
21155 Reconstruct midface, lefort $4,330.73
21159 Reconstruct midface, lefort $5,123.66
21160 Reconstruct midface, lefort $5,324.62
21172 Reconstruct orbit/forehead $3,120.53
21175 Reconstruct orbit/forehead $3,947.07
21179 Reconstruct entire forehead $2,784.87
21180 Reconstruct entire forehead $3,073.27
21181 Contour cranial bone lesion $1,316.36
21182 Reconstruct cranial bone $3,858.18
21183 Reconstruct cranial bone $4,217.47
21184 Reconstruct cranial bone $4,574.01
21188 Reconstruction of midface $2,796.54
21193 Reconst lwr jaw w/o graft $2,234.83
21194 Reconst lwr jaw w/graft $2,504.92
21195 Reconst lwr jaw w/o fixation $2,247.81
21196 Reconst lwr jaw w/fixation $2,432.34
21198 Reconstr lwr jaw segment $1,849.90
21199 Reconstr lwr jaw w/advance $1,878.14
21206 Reconstruct upper jaw bone $1,837.51
21208 Augmentation of facial bones $1,798.11
21209 Reduction of facial bones $1,344.37
21210 Face bone graft $1,741.32
21215 Lower jaw bone graft $1,773.70
21230 Rib cartilage graft $1,432.56
21235 Ear cartilage graft $1,305.49
21240 Reconstruction of jaw joint $1,969.73
21242 Reconstruction of jaw joint $1,864.13
21243 Reconstruction of jaw joint $2,857.04
21244 Reconstruction of lower jaw $1,616.20
21245 Reconstruction of jaw $2,028.97
21246 Reconstruction of jaw $1,981.51
21247 Reconstruct lower jaw bone $3,013.65
21248 Reconstruction of jaw $1,794.02
21249 Reconstruction of jaw $2,505.18
21255 Reconstruct lower jaw bone $2,172.84
21256 Reconstruction of orbit $2,088.24
21260 Revise eye sockets $1,900.79
21261 Revise eye sockets $3,761.22
21263 Revise eye sockets $3,094.14
21267 Revise eye sockets $2,375.18
21268 Revise eye sockets $2,912.40
21270 Augmentation, cheek bone $1,611.91
21275 Revision, orbitofacial bones $1,482.10
21280 Revision of eyelid $878.77
21282 Revision of eyelid $590.66
21295 Revision of jaw muscle/bone $313.89
21296 Revision of jaw muscle/bone $633.97
21299 Cranio/maxillofacial surgery $0.00
21300 Treatment of skull fracture $221.40
21310 Treatment of nose fracture $206.48
21315 Treatment of nose fracture $326.17
21320 Treatment of nose fracture $436.93
21325 Treatment of nose fracture $551.65
21330 Treatment of nose fracture $784.41
21335 Treatment of nose fracture $1,137.47
21336 Treat nasal septal fracture $862.82
21337 Treat nasal septal fracture $427.89
21338 Treat nasoethmoid fracture $916.00
21339 Treat nasoethmoid fracture $1,099.64
21340 Treatment of nose fracture $1,437.05
21343 Treatment of sinus fracture $1,707.56
21344 Treatment of sinus fracture $2,485.23
21345 Treat nose/jaw fracture $1,427.81
21346 Treat nose/jaw fracture $1,733.56
21347 Treat nose/jaw fracture $1,665.75
21348 Treat nose/jaw fracture $2,084.82
21355 Treat cheek bone fracture $616.37
21356 Treat cheek bone fracture $1,127.37
21360 Treat cheek bone fracture $1,459.57
21365 Treat cheek bone fracture $1,979.07
21366 Treat cheek bone fracture $2,184.42
21385 Treat eye socket fracture $1,196.44
21386 Treat eye socket fracture $1,229.81
21387 Treat eye socket fracture $1,274.95
21390 Treat eye socket fracture $1,335.24
21395 Treat eye socket fracture $1,631.97
21400 Treat eye socket fracture $365.47
21401 Treat eye socket fracture $605.19
21406 Treat eye socket fracture $984.26
21407 Treat eye socket fracture $1,161.56
21408 Treat eye socket fracture $1,608.50
21421 Treat mouth roof fracture $1,083.56
21422 Treat mouth roof fracture $1,425.63
21423 Treat mouth roof fracture $1,399.08
21431 Treat craniofacial fracture $1,283.65
21432 Treat craniofacial fracture $1,091.01
21433 Treat craniofacial fracture $3,150.57
21435 Treat craniofacial fracture $2,246.75
21436 Treat craniofacial fracture $3,455.09
21440 Treat dental ridge fracture $765.12
21445 Treat dental ridge fracture $1,143.11
21450 Treat lower jaw fracture $578.78
21451 Treat lower jaw fracture $982.85
21452 Treat lower jaw fracture $416.49
21453 Treat lower jaw fracture $1,156.10
21454 Treat lower jaw fracture $954.55
21461 Treat lower jaw fracture $1,495.54
21462 Treat lower jaw fracture $1,731.26
21465 Treat lower jaw fracture $1,614.45
21470 Treat lower jaw fracture $2,042.96
21480 Reset dislocated jaw $181.87
21485 Reset dislocated jaw $718.86
21490 Repair dislocated jaw $1,619.92
21493 Treat hyoid bone fracture $294.48
21494 Treat hyoid bone fracture $878.82
21495 Treat hyoid bone fracture $853.36
21497 Interdental wiring $750.46
21499 Head surgery procedure $0.00
21501 Drain neck/chest lesion $622.10
21502 Drain chest lesion $955.95
21510 Drainage of bone lesion $849.47
21550 Biopsy of neck/chest $409.93
21555 Remove lesion, neck/chest $689.27
21556 Remove lesion, neck/chest $719.42
21557 Remove tumor, neck/chest $1,072.21
21600 Partial removal of rib $946.68
21610 Partial removal of rib $1,788.35
21615 Removal of rib $1,249.35
21616 Removal of rib and nerves $1,505.99
21620 Partial removal of sternum $956.09
21627 Sternal debridement $986.49
21630 Extensive sternum surgery $2,201.67
21632 Extensive sternum surgery $2,211.57
21685 Hyoid myotomy & suspension $1,716.08
21700 Revision of neck muscle $892.78
21705 Revision of neck muscle/rib $1,141.80
21720 Revision of neck muscle $832.92
21725 Revision of neck muscle $938.64
21740 Reconstruction of sternum $1,906.73
21742 Repair stern/nuss w/o scope $4,800.00
21743 Repair sternum/nuss w/scope $4,800.00
21750 Repair of sternum separation $1,281.36
21800 Treatment of rib fracture $220.04
21805 Treatment of rib fracture $448.00
21810 Treatment of rib fracture(s) $882.52
21820 Treat sternum fracture $282.83
21825 Treat sternum fracture $1,047.82
21899 Neck/chest surgery procedure $0.00
21920 Biopsy soft tissue of back $252.25
21925 Biopsy soft tissue of back $809.19
21930 Remove lesion, back or flank $770.15
21935 Remove tumor, back $2,118.65
22100 Remove part of neck vertebra $1,315.26
22101 Remove part, thorax vertebra $1,336.05
22102 Remove part, lumbar vertebra $1,348.45
22103 Remove extra spine segment $273.47
22110 Remove part of neck vertebra $1,678.94
22112 Remove part, thorax vertebra $1,678.35
22114 Remove part, lumbar vertebra $1,678.00
22116 Remove extra spine segment $270.25
22210 Revision of neck spine $3,018.44
22212 Revision of thorax spine $2,476.41
22214 Revision of lumbar spine $2,513.76
22216 Revise, extra spine segment $706.92
22220 Revision of neck spine $2,693.82
22222 Revision of thorax spine $2,531.27
22224 Revision of lumbar spine $2,717.49
22226 Revise, extra spine segment $706.23
22305 Treat spine process fracture $384.71
22310 Treat spine fracture $546.31
22315 Treat spine fracture $1,639.90
22318 Treat odontoid fx w/o graft $2,710.30
22319 Treat odontoid fx w/graft $3,011.82
22325 Treat spine fracture $2,308.81
22326 Treat neck spine fracture $2,490.34
22327 Treat thorax spine fracture $2,401.81
22328 Treat each add spine fx $527.90
22505 Manipulation of spine $215.67
22520 Percut vertebroplasty thor $4,621.17
22521 Percut vertebroplasty lumb $4,092.27
22522 Percut vertebroplasty add’l $451.17
22532 Lat thorax spine fusion $2,965.87
22533 Lat lumbar spine fusion $2,783.96
22534 Lat thor/lumb, add’l seg $697.05
22548 Neck spine fusion $3,221.01
22554 Neck spine fusion $2,381.42
22556 Thorax spine fusion $2,915.90
22558 Lumbar spine fusion $2,704.71
22585 Additional spinal fusion $645.43
22590 Spine & skull spinal fusion $2,602.03
22595 Neck spinal fusion $2,476.77
22600 Neck spine fusion $2,090.37
22610 Thorax spine fusion $2,084.21
22612 Lumbar spine fusion $2,671.76
22614 Spine fusion, extra segment $754.34
22630 Lumbar spine fusion $2,643.54
22632 Spine fusion, extra segment $610.99
22800 Fusion of spine $2,342.92
22802 Fusion of spine $3,826.11
22804 Fusion of spine $4,475.64
22808 Fusion of spine $3,257.83
22810 Fusion of spine $3,701.72
22812 Fusion of spine $4,004.67
22818 Kyphectomy, 1-2 segments $3,878.70
22819 Kyphectomy, 3 or more $4,311.39
22830 Exploration of spinal fusion $1,423.59
22840 Insert spine fixation device $1,467.12
22841 Insert spine fixation device Paid Elsewhere
22842 Insert spine fixation device $1,471.83
22843 Insert spine fixation device $1,546.82
22844 Insert spine fixation device $1,930.75
22845 Insert spine fixation device $1,404.15
22846 Insert spine fixation device $1,457.43
22847 Insert spine fixation device $1,612.79
22848 Insert pelv fixation device $703.95
22849 Reinsert spinal fixation $2,308.26
22850 Remove spine fixation device $1,254.49
22851 Apply spine prosth device $778.28
22852 Remove spine fixation device $1,197.49
22855 Remove spine fixation device $1,910.67
22899 Spine surgery procedure $0.00
22900 Remove abdominal wall lesion $682.19
22999 Abdomen surgery procedure $0.00
23000 Removal of calcium deposits $702.04
23020 Release shoulder joint $1,238.71
23030 Drain shoulder lesion $480.11
23031 Drain shoulder bursa $403.53
23035 Drain shoulder bone lesion $1,277.48
23040 Exploratory shoulder surgery $1,279.52
23044 Exploratory shoulder surgery $1,018.57
23065 Biopsy shoulder tissues $368.81
23066 Biopsy shoulder tissues $681.60
23075 Removal of shoulder lesion $342.98
23076 Removal of shoulder lesion $1,002.97
23077 Remove tumor of shoulder $2,015.57
23100 Biopsy of shoulder joint $874.89
23101 Shoulder joint surgery $818.92
23105 Remove shoulder joint lining $1,154.10
23106 Incision of collarbone joint $875.51
23107 Explore treat shoulder joint $1,201.11
23120 Partial removal, collar bone $1,017.13
23125 Removal of collar bone $1,278.22
23130 Remove shoulder bone, part $1,095.76
23140 Removal of bone lesion $920.17
23145 Removal of bone lesion $1,251.35
23146 Removal of bone lesion $1,120.79
23150 Removal of humerus lesion $1,159.34
23155 Removal of humerus lesion $1,403.56
23156 Removal of humerus lesion $1,204.22
23170 Remove collar bone lesion $984.03
23172 Remove shoulder blade lesion $995.26
23174 Remove humerus lesion $1,339.50
23180 Remove collar bone lesion $1,319.01
23182 Remove shoulder blade lesion $1,264.49
23184 Remove humerus lesion $1,407.95
23190 Partial removal of scapula $1,008.94
23195 Removal of head of humerus $1,322.99
23200 Removal of collar bone $1,579.52
23210 Removal of shoulder blade $1,638.00
23220 Partial removal of humerus $1,918.15
23221 Partial removal of humerus $2,241.53
23222 Partial removal of humerus $3,013.67
23330 Remove shoulder foreign body $282.01
23331 Remove shoulder foreign body $1,060.01
23332 Remove shoulder foreign body $1,574.06
23350 Injection for shoulder x-ray $205.08
23395 Muscle transfer,shoulder/arm $2,227.78
23397 Muscle transfers $2,080.45
23400 Fixation of shoulder blade $1,787.96
23405 Incision of tendon & muscle $1,153.19
23406 Incise tendon(s) & muscle(s) $1,444.63
23410 Repair rotator cuff, acute $1,646.35
23412 Repair rotator cuff, chronic $1,750.82
23415 Release of shoulder ligament $1,350.08
23420 Repair of shoulder $1,810.66
23430 Repair biceps tendon $1,360.81
23440 Remove/transplant tendon $1,412.53
23450 Repair shoulder capsule $1,755.48
23455 Repair shoulder capsule $1,874.01
23460 Repair shoulder capsule $2,018.89
23462 Repair shoulder capsule $1,972.70
23465 Repair shoulder capsule $2,026.60
23466 Repair shoulder capsule $1,918.93
23470 Reconstruct shoulder joint $2,212.64
23472 Reconstruct shoulder joint $2,653.92
23480 Revision of collar bone $1,501.63
23485 Revision of collar bone $1,759.79
23490 Reinforce clavicle $1,536.65
23491 Reinforce shoulder bones $1,878.94
23500 Treat clavicle fracture $417.94
23505 Treat clavicle fracture $662.34
23515 Treat clavicle fracture $1,044.00
23520 Treat clavicle dislocation $423.23
23525 Treat clavicle dislocation $604.39
23530 Treat clavicle dislocation $995.60
23532 Treat clavicle dislocation $1,120.46
23540 Treat clavicle dislocation $427.89
23545 Treat clavicle dislocation $568.63
23550 Treat clavicle dislocation $1,017.89
23552 Treat clavicle dislocation $1,178.78
23570 Treat shoulder blade fx $402.93
23575 Treat shoulder blade fx $705.12
23585 Treat scapula fracture $1,243.36
23600 Treat humerus fracture $523.79
23605 Treat humerus fracture $844.41
23615 Treat humerus fracture $1,349.93
23616 Treat humerus fracture $2,682.00
23620 Treat humerus fracture $330.36
23625 Treat humerus fracture $655.17
23630 Treat humerus fracture $1,044.34
23650 Treat shoulder dislocation $587.99
23655 Treat shoulder dislocation $648.53
23660 Treat shoulder dislocation $1,038.27
23665 Treat dislocation/fracture $755.90
23670 Treat dislocation/fracture $1,104.33
23675 Treat dislocation/fracture $1,005.82
23680 Treat dislocation/fracture $1,364.32
23700 Fixation of shoulder $360.93
23800 Fusion of shoulder joint $1,857.65
23802 Fusion of shoulder joint $2,039.10
23900 Amputation of arm & girdle $2,392.49
23920 Amputation at shoulder joint $1,863.72
23921 Amputation follow-up surgery $796.70
23929 Shoulder surgery procedure $0.00
23930 Drainage of arm lesion $419.50
23931 Drainage of arm bursa $309.54
23935 Drain arm/elbow bone lesion $910.69
24000 Exploratory elbow surgery $834.77
24006 Release elbow joint $1,276.38
24065 Biopsy arm/elbow soft tissue $305.74
24066 Biopsy arm/elbow soft tissue $810.25
24075 Remove arm/elbow lesion $657.50
24076 Remove arm/elbow lesion $848.94
24077 Remove tumor of arm/elbow $1,526.73
24100 Biopsy elbow joint lining $702.24
24101 Explore/treat elbow joint $895.09
24102 Remove elbow joint lining $1,114.04
24105 Removal of elbow bursa $588.55
24110 Remove humerus lesion $1,053.87
24115 Remove/graft bone lesion $1,272.06
24116 Remove/graft bone lesion $1,576.19
24120 Remove elbow lesion $936.67
24125 Remove/graft bone lesion $1,050.26
24126 Remove/graft bone lesion $1,137.05
24130 Removal of head of radius $911.62
24134 Removal of arm bone lesion $1,412.04
24136 Remove radius bone lesion $1,141.39
24138 Remove elbow bone lesion $1,174.74
24140 Partial removal of arm bone $1,388.88
24145 Partial removal of radius $1,168.23
24147 Partial removal of elbow $1,200.01
24149 Radical resection of elbow $1,922.96
24150 Extensive humerus surgery $1,759.55
24151 Extensive humerus surgery $2,055.91
24152 Extensive radius surgery $1,339.57
24153 Extensive radius surgery $1,288.04
24155 Removal of elbow joint $1,512.08
24160 Remove elbow joint implant $1,094.29
24164 Remove radius head implant $888.79
24200 Removal of arm foreign body $273.23
24201 Removal of arm foreign body $754.15
24220 Injection for elbow x-ray $486.66
24300 Manipulate elbow w/anesth $676.81
24301 Muscle/tendon transfer $1,377.20
24305 Arm tendon lengthening $1,055.94
24310 Revision of arm tendon $870.14
24320 Repair of arm tendon $1,361.45
24330 Revision of arm muscles $1,307.34
24331 Revision of arm muscles $1,444.17
24332 Tenolysis, triceps $1,040.49
24340 Repair of biceps tendon $1,108.75
24341 Repair arm tendon/muscle $1,167.33
24342 Repair of ruptured tendon $1,435.38
24343 Repr elbow lat ligmnt w/tiss $1,237.79
24344 Reconstruct elbow lat ligmnt $1,898.40
24345 Repr elbw med ligmnt w/tissu $1,230.90
24346 Reconstruct elbow med ligmnt $1,888.76
24350 Repair of tennis elbow $801.17
24351 Repair of tennis elbow $877.98
24352 Repair of tennis elbow $938.14
24354 Repair of tennis elbow $938.09
24356 Revision of tennis elbow $966.44
24360 Reconstruct elbow joint $1,633.67
24361 Reconstruct elbow joint $1,849.27
24362 Reconstruct elbow joint $1,883.84
24363 Replace elbow joint $2,414.24
24365 Reconstruct head of radius $1,159.85
24366 Reconstruct head of radius $1,245.38
24400 Revision of humerus $1,501.27
24410 Revision of humerus $1,901.44
24420 Revision of humerus $1,811.49
24430 Repair of humerus $1,700.76
24435 Repair humerus with graft $1,803.71
24470 Revision of elbow joint $1,227.28
24495 Decompression of forearm $1,266.75
24498 Reinforce humerus $1,596.45
24500 Treat humerus fracture $376.98
24505 Treat humerus fracture $917.06
24515 Treat humerus fracture $1,579.05
24516 Treat humerus fracture $1,563.22
24530 Treat humerus fracture $651.25
24535 Treat humerus fracture $1,129.68
24538 Treat humerus fracture $1,353.50
24545 Treat humerus fracture $1,419.99
24546 Treat humerus fracture $2,038.99
24560 Treat humerus fracture $554.45
24565 Treat humerus fracture $946.18
24566 Treat humerus fracture $1,184.93
24575 Treat humerus fracture $1,425.64
24576 Treat humerus fracture $427.89
24577 Treat humerus fracture $985.72
24579 Treat humerus fracture $1,539.52
24582 Treat humerus fracture $1,307.76
24586 Treat elbow fracture $1,986.98
24587 Treat elbow fracture $1,970.16
24600 Treat elbow dislocation $718.85
24605 Treat elbow dislocation $795.27
24615 Treat elbow dislocation $1,289.06
24620 Treat elbow fracture $978.52
24635 Treat elbow fracture $2,037.92
24640 Treat elbow dislocation $226.95
24650 Treat radius fracture $486.22
24655 Treat radius fracture $817.24
24665 Treat radius fracture $1,168.72
24666 Treat radius fracture $1,316.66
24670 Treat ulnar fracture $509.08
24675 Treat ulnar fracture $841.13
24685 Treat ulnar fracture $1,224.87
24800 Fusion of elbow joint $1,492.82
24802 Fusion/graft of elbow joint $1,809.49
24900 Amputation of upper arm $1,270.85
24920 Amputation of upper arm $1,279.79
24925 Amputation follow-up surgery $998.31
24930 Amputation follow-up surgery $1,332.40
24931 Amputate upper arm & implant $1,433.48
24935 Revision of amputation $1,805.63
24940 Revision of upper arm $3,777.84
24999 Upper arm/elbow surgery $0.00
25000 Incision of tendon sheath $748.67
25001 Incise flexor carpi radialis $551.76
25020 Decompress forearm 1 space $1,157.23
25023 Decompress forearm 1 space $1,964.68
25024 Decompress forearm 2 spaces $1,277.83
25025 Decompress forearm 2 spaces $2,012.27
25028 Drainage of forearm lesion $1,000.51
25031 Drainage of forearm bursa $655.17
25035 Treat forearm bone lesion $1,555.27
25040 Explore/treat wrist joint $1,080.54
25065 Biopsy forearm soft tissues $345.49
25066 Biopsy forearm soft tissues $826.36
25075 Removel forearm lesion subcu $717.04
25076 Removel forearm lesion deep $1,078.11
25077 Remove tumor, forearm/wrist $1,646.69
25085 Incision of wrist capsule $942.05
25100 Biopsy of wrist joint $683.53
25101 Explore/treat wrist joint $784.50
25105 Remove wrist joint lining $982.98
25107 Remove wrist joint cartilage $1,092.38
25110 Remove wrist tendon lesion $811.71
25111 Remove wrist tendon lesion $602.43
25112 Reremove wrist tendon lesion $733.67
25115 Remove wrist/forearm lesion $1,698.01
25116 Remove wrist/forearm lesion $1,499.09
25118 Excise wrist tendon sheath $753.04
25119 Partial removal of ulna $1,018.16
25120 Removal of forearm lesion $1,344.86
25125 Remove/graft forearm lesion $1,509.49
25126 Remove/graft forearm lesion $1,520.92
25130 Removal of wrist lesion $867.68
25135 Remove & graft wrist lesion $1,068.88
25136 Remove & graft wrist lesion $928.97
25145 Remove forearm bone lesion $1,367.43
25150 Partial removal of ulna $1,147.49
25151 Partial removal of radius $1,490.05
25170 Extensive forearm surgery $1,953.80
25210 Removal of wrist bone $948.80
25215 Removal of wrist bones $1,242.67
25230 Partial removal of radius $845.47
25240 Partial removal of ulna $901.92
25246 Injection for wrist x-ray $481.78
25248 Remove forearm foreign body $1,007.80
25250 Removal of wrist prosthesis $939.83
25251 Removal of wrist prosthesis $1,299.94
25259 Manipulate wrist w/anesthes $677.15
25260 Repair forearm tendon/muscle $1,578.84
25263 Repair forearm tendon/muscle $1,572.76
25265 Repair forearm tendon/muscle $1,798.49
25270 Repair forearm tendon/muscle $1,346.35
25272 Repair forearm tendon/muscle $1,477.35
25274 Repair forearm tendon/muscle $1,664.89
25275 Repair forearm tendon sheath $1,194.91
25280 Revise wrist/forearm tendon $1,473.23
25290 Incise wrist/forearm tendon $1,410.23
25295 Release wrist/forearm tendon $1,390.84
25300 Fusion of tendons at wrist $1,287.21
25301 Fusion of tendons at wrist $1,232.90
25310 Transplant forearm tendon $1,574.27
25312 Transplant forearm tendon $1,750.21
25315 Revise palsy hand tendon(s) $1,837.47
25316 Revise palsy hand tendon(s) $2,138.27
25320 Repair/revise wrist joint $1,629.06
25332 Revise wrist joint $1,534.65
25335 Realignment of hand $1,835.79
25337 Reconstruct ulna/radioulnar $1,574.28
25350 Revision of radius $1,686.41
25355 Revision of radius $1,843.46
25360 Revision of ulna $1,652.70
25365 Revise radius & ulna $2,090.15
25370 Revise radius or ulna $2,196.23
25375 Revise radius & ulna $2,199.53
25390 Shorten radius or ulna $1,858.58
25391 Lengthen radius or ulna $2,250.96
25392 Shorten radius & ulna $2,229.98
25393 Lengthen radius & ulna $2,492.10
25394 Repair carpal bone, shorten $1,399.69
25400 Repair radius or ulna $1,942.48
25405 Repair/graft radius or ulna $2,363.26
25415 Repair radius & ulna $2,230.25
25420 Repair/graft radius & ulna $2,586.64
25425 Repair/graft radius or ulna $2,571.67
25426 Repair/graft radius & ulna $2,462.48
25430 Vasc graft into carpal bone $1,235.44
25431 Repair nonunion carpal bone $1,368.06
25440 Repair/graft wrist bone $1,484.26
25441 Reconstruct wrist joint $1,717.80
25442 Reconstruct wrist joint $1,463.96
25443 Reconstruct wrist joint $1,423.74
25444 Reconstruct wrist joint $1,514.56
25445 Reconstruct wrist joint $1,316.80
25446 Wrist replacement $2,138.33
25447 Repair wrist joint(s) $1,416.39
25449 Remove wrist joint implant $1,881.30
25450 Revision of wrist joint $1,340.01
25455 Revision of wrist joint $1,532.21
25490 Reinforce radius $1,510.97
25491 Reinforce ulna $1,510.97
25492 Reinforce radius and ulna $1,510.97
25500 Treat fracture of radius $469.32
25505 Treat fracture of radius $913.86
25515 Treat fracture of radius $1,249.46
25520 Treat fracture of radius $1,014.27
25525 Treat fracture of radius $1,666.48
25526 Treat fracture of radius $1,977.84
25530 Treat fracture of ulna $452.42
25535 Treat fracture of ulna $882.81
25545 Treat fracture of ulna $1,241.29
25560 Treat fracture radius & ulna $471.67
25565 Treat fracture radius & ulna $957.25
25574 Treat fracture radius & ulna $1,053.39
25575 Treat fracture radius/ulna $1,485.69
25600 Treat fracture radius/ulna $518.21
25605 Treat fracture radius/ulna $1,019.57
25611 Treat fracture radius/ulna $1,232.67
25620 Treat fracture radius/ulna $1,187.28
25622 Treat wrist bone fracture $528.08
25624 Treat wrist bone fracture $843.47
25628 Treat wrist bone fracture $1,213.44
25630 Treat wrist bone fracture $545.13
25635 Treat wrist bone fracture $807.92
25645 Treat wrist bone fracture $1,046.53
25650 Treat wrist bone fracture $575.73
25651 Pin ulnar styloid fracture $800.43
25652 Treat fracture ulnar styloid $1,080.56
25660 Treat wrist dislocation $699.88
25670 Treat wrist dislocation $1,122.35
25671 Pin radioulnar dislocation $892.62
25675 Treat wrist dislocation $818.47
25676 Treat wrist dislocation $1,149.21
25680 Treat wrist fracture $798.96
25685 Treat wrist fracture $1,323.18
25690 Treat wrist dislocation $813.29
25695 Treat wrist dislocation $1,161.29
25800 Fusion of wrist joint $1,408.43
25805 Fusion/graft of wrist joint $1,608.25
25810 Fusion/graft of wrist joint $1,524.61
25820 Fusion of hand bones $1,137.88
25825 Fuse hand bones with graft $1,375.99
25830 Fusion, radioulnar jnt/ulna $1,813.59
25900 Amputation of forearm $1,604.11
25905 Amputation of forearm $1,606.82
25907 Amputation follow-up surgery $1,007.32
25909 Amputation follow-up surgery $1,591.08
25915 Amputation of forearm $2,716.21
25920 Amputate hand at wrist $1,242.10
25922 Amputate hand at wrist $1,058.10
25924 Amputation follow-up surgery $1,241.17
25927 Amputation of hand $1,535.08
25929 Amputation follow-up surgery $1,007.32
25931 Amputation follow-up surgery $1,449.13
25999 Forearm or wrist surgery $0.00
26010 Drainage of finger abscess $306.72
26011 Drainage of finger abscess $798.98
26020 Drain hand tendon sheath $755.82
26025 Drainage of palm bursa $752.90
26030 Drainage of palm bursa(s) $885.00
26034 Treat hand bone lesion $928.73
26035 Decompress fingers/hand $1,313.37
26037 Decompress fingers/hand $1,031.05
26040 Release palm contracture $541.89
26045 Release palm contracture $827.76
26055 Incise finger tendon sheath $1,045.39
26060 Incision of finger tendon $461.77
26070 Explore/treat hand joint $520.54
26075 Explore/treat finger joint $557.60
26080 Explore/treat finger joint $666.57
26100 Biopsy hand joint lining $574.10
26105 Biopsy finger joint lining $581.91
26110 Biopsy finger joint lining $555.05
26115 Removel hand lesion subcut $969.20
26116 Removel hand lesion, deep $848.25
26117 Remove tumor, hand/finger $1,163.56
26121 Release palm contracture $1,076.10
26123 Release palm contracture $1,343.06
26125 Release palm contracture $536.53
26130 Remove wrist joint lining $795.63
26135 Revise finger joint, each $994.93
26140 Revise finger joint, each $902.57
26145 Tendon excision, palm/finger $914.80
26160 Remove tendon sheath lesion $1,125.04
26170 Removal of palm tendon, each $716.12
26180 Removal of finger tendon $780.81
26185 Remove finger bone $825.96
26200 Remove hand bone lesion $804.41
26205 Remove/graft bone lesion $1,084.60
26210 Removal of finger lesion $779.26
26215 Remove/graft finger lesion $992.32
26230 Partial removal of hand bone $909.34
26235 Partial removal, finger bone $889.60
26236 Partial removal, finger bone $787.47
26250 Extensive hand surgery $1,040.36
26255 Extensive hand surgery $1,613.99
26260 Extensive finger surgery $981.23
26261 Extensive finger surgery $1,141.60
26262 Partial removal of finger $815.67
26320 Removal of implant from hand $609.29
26340 Manipulate finger w/anesth $525.38
26350 Repair finger/hand tendon $1,543.21
26352 Repair/graft hand tendon $1,718.26
26356 Repair finger/hand tendon $1,944.62
26357 Repair finger/hand tendon $1,820.22
26358 Repair/graft hand tendon $1,926.06
26370 Repair finger/hand tendon $1,665.71
26372 Repair/graft hand tendon $1,889.76
26373 Repair finger/hand tendon $1,810.55
26390 Revise hand/finger tendon $1,688.81
26392 Repair/graft hand tendon $2,032.66
26410 Repair hand tendon $1,235.47
26412 Repair/graft hand tendon $1,461.75
26415 Excision, hand/finger tendon $1,499.40
26416 Graft hand or finger tendon $1,795.87
26418 Repair finger tendon $1,228.80
26420 Repair/graft finger tendon $1,520.88
26426 Repair finger/hand tendon $1,439.13
26428 Repair/graft finger tendon $1,576.11
26432 Repair finger tendon $1,055.33
26433 Repair finger tendon $1,145.90
26434 Repair/graft finger tendon $1,313.83
26437 Realignment of tendons $1,289.19
26440 Release palm/finger tendon $1,376.12
26442 Release palm & finger tendon $1,790.93
26445 Release hand/finger tendon $1,302.46
26449 Release forearm/hand tendon $1,685.05
26450 Incision of palm tendon $814.05
26455 Incision of finger tendon $806.98
26460 Incise hand/finger tendon $779.78
26471 Fusion of finger tendons $1,259.41
26474 Fusion of finger tendons $1,240.16
26476 Tendon lengthening $1,194.60
26477 Tendon shortening $1,203.04
26478 Lengthening of hand tendon $1,306.97
26479 Shortening of hand tendon $1,291.13
26480 Transplant hand tendon $1,613.02
26483 Transplant/graft hand tendon $1,770.67
26485 Transplant palm tendon $1,715.27
26489 Transplant/graft palm tendon $1,616.22
26490 Revise thumb tendon $1,576.87
26492 Tendon transfer with graft $1,728.82
26494 Hand tendon/muscle transfer $1,615.41
26496 Revise thumb tendon $1,700.76
26497 Finger tendon transfer $1,723.37
26498 Finger tendon transfer $2,255.40
26499 Revision of finger $1,638.04
26500 Hand tendon reconstruction $1,306.20
26502 Hand tendon reconstruction $1,434.56
26504 Hand tendon reconstruction $1,487.43
26508 Release thumb contracture $1,313.36
26510 Thumb tendon transfer $1,245.96
26516 Fusion of knuckle joint $1,441.49
26517 Fusion of knuckle joints $1,659.54
26518 Fusion of knuckle joints $1,667.50
26520 Release knuckle contracture $1,429.04
26525 Release finger contracture $1,439.54
26530 Revise knuckle joint $948.95
26531 Revise knuckle with implant $1,113.01
26535 Revise finger joint $672.03
26536 Revise/implant finger joint $1,178.44
26540 Repair hand joint $1,363.30
26541 Repair hand joint with graft $1,641.42
26542 Repair hand joint with graft $1,394.59
26545 Reconstruct finger joint $1,429.16
26546 Repair nonunion hand $1,758.83
26548 Reconstruct finger joint $1,561.24
26550 Construct thumb replacement $2,908.55
26551 Great toe-hand transfer $6,065.53
26553 Single transfer, toe-hand $5,130.94
26554 Double transfer, toe-hand $7,035.91
26555 Positional change of finger $2,613.87
26556 Toe joint transfer $6,174.81
26560 Repair of web finger $1,133.46
26561 Repair of web finger $1,732.64
26562 Repair of web finger $2,370.15
26565 Correct metacarpal flaw $1,395.05
26567 Correct finger deformity $1,396.21
26568 Lengthen metacarpal/finger $1,830.69
26580 Repair hand deformity $2,378.20
26587 Reconstruct extra finger $1,637.51
26590 Repair finger deformity $2,014.62
26591 Repair muscles of hand $976.91
26593 Release muscles of hand $1,214.63
26596 Excision constricting tissue $1,323.92
26600 Treat metacarpal fracture $437.55
26605 Treat metacarpal fracture $590.05
26607 Treat metacarpal fracture $865.50
26608 Treat metacarpal fracture $866.87
26615 Treat metacarpal fracture $806.80
26641 Treat thumb dislocation $655.17
26645 Treat thumb fracture $770.83
26650 Treat thumb fracture $923.70
26665 Treat thumb fracture $1,075.07
26670 Treat hand dislocation $503.65
26675 Treat hand dislocation $797.99
26676 Pin hand dislocation $830.82
26685 Treat hand dislocation $990.90
26686 Treat hand dislocation $1,119.72
26700 Treat knuckle dislocation $609.35
26705 Treat knuckle dislocation $730.09
26706 Pin knuckle dislocation $758.43
26715 Treat knuckle dislocation $851.87
26720 Treat finger fracture, each $333.59
26725 Treat finger fracture, each $666.89
26727 Treat finger fracture, each $858.89
26735 Treat finger fracture, each $881.15
26740 Treat finger fracture, each $399.92
26742 Treat finger fracture, each $706.99
26746 Treat finger fracture, each $870.52
26750 Treat finger fracture, each $330.90
26755 Treat finger fracture, each $346.85
26756 Pin finger fracture, each $528.63
26765 Treat finger fracture, each $661.00
26770 Treat finger dislocation $339.83
26775 Treat finger dislocation $503.65
26776 Pin finger dislocation $528.63
26785 Treat finger dislocation $667.08
26820 Thumb fusion with graft $1,600.42
26841 Fusion of thumb $1,503.33
26842 Thumb fusion with graft $1,604.10
26843 Fusion of hand joint $1,481.34
26844 Fusion/graft of hand joint $1,639.31
26850 Fusion of knuckle $1,421.17
26852 Fusion of knuckle with graft $1,586.80
26860 Fusion of finger joint $1,169.38
26861 Fusion of finger jnt, add-on $203.22
26862 Fusion/graft of finger joint $1,465.49
26863 Fuse/graft added joint $457.70
26910 Amputate metacarpal bone $1,409.69
26951 Amputation of finger/thumb $1,096.51
26952 Amputation of finger/thumb $1,342.99
26989 Hand/finger surgery $0.00
26990 Drainage of pelvis lesion $1,121.19
26991 Drainage of pelvis bursa $628.02
26992 Drainage of bone lesion $1,637.51
27000 Incision of hip tendon $655.17
27001 Incision of hip tendon $980.34
27003 Incision of hip tendon $1,036.72
27005 Incision of hip tendon $1,317.30
27006 Incision of hip tendons $1,327.06
27025 Incision of hip/thigh fascia $1,480.89
27030 Drainage of hip joint $1,709.84
27033 Exploration of hip joint $1,759.55
27035 Denervation of hip joint $2,163.27
27036 Excision of hip joint/muscle $1,725.26
27040 Biopsy of soft tissues $402.93
27041 Biopsy of soft tissues $780.88
27047 Remove hip/pelvis lesion $982.34
27048 Remove hip/pelvis lesion $843.14
27049 Remove tumor, hip/pelvis $1,691.29
27050 Biopsy of sacroiliac joint $655.22
27052 Biopsy of hip joint $905.31
27054 Removal of hip joint lining $1,192.04
27060 Removal of ischial bursa $762.65
27062 Remove femur lesion/bursa $790.16
27065 Removal of hip bone lesion $852.80
27066 Removal of hip bone lesion $1,414.42
27067 Remove/graft hip bone lesion $1,846.44
27070 Partial removal of hip bone $1,528.59
27071 Partial removal of hip bone $1,656.80
27075 Extensive hip surgery $4,056.71
27076 Extensive hip surgery $2,786.11
27077 Extensive hip surgery $4,704.57
27078 Extensive hip surgery $1,789.14
27079 Extensive hip surgery $1,796.76
27080 Removal of tail bone $859.09
27086 Remove hip foreign body $285.23
27087 Remove hip foreign body $755.90
27090 Removal of hip prosthesis $1,490.78
27091 Removal of hip prosthesis $2,733.86
27093 Injection for hip x-ray $564.90
27095 Injection for hip x-ray $856.95
27096 Inject sacroiliac joint $692.97
27097 Revision of hip tendon $1,152.24
27098 Transfer tendon to pelvis $1,198.88
27100 Transfer of abdominal muscle $1,491.75
27105 Transfer of spinal muscle $1,579.40
27110 Transfer of iliopsoas muscle $1,687.96
27111 Transfer of iliopsoas muscle $1,599.20
27120 Reconstruction of hip socket $2,252.07
27122 Reconstruction of hip socket $1,954.32
27125 Partial hip replacement $1,902.38
27130 Total hip arthroplasty $2,526.26
27132 Total hip arthroplasty $2,938.19
27134 Revise hip joint replacement $3,508.88
27137 Revise hip joint replacement $2,652.84
27138 Revise hip joint replacement $2,765.01
27140 Transplant femur ridge $1,629.30
27146 Incision of hip bone $2,238.05
27147 Revision of hip bone $2,561.00
27151 Incision of hip bones $2,372.83
27156 Revision of hip bones $3,088.70
27158 Revision of pelvis $2,353.34
27161 Incision of neck of femur $2,173.95
27165 Incision/fixation of femur $2,323.77
27170 Repair/graft femur head/neck $2,067.37
27175 Treat slipped epiphysis $1,133.39
27176 Treat slipped epiphysis $1,586.19
27177 Treat slipped epiphysis $1,957.31
27178 Treat slipped epiphysis $1,541.78
27179 Revise head/neck of femur $1,726.87
27181 Treat slipped epiphysis $1,865.54
27185 Revision of femur epiphysis $1,260.12
27187 Reinforce hip bones $1,798.97
27193 Treat pelvic ring fracture $935.16
27194 Treat pelvic ring fracture $1,376.80
27200 Treat tail bone fracture $355.96
27202 Treat tail bone fracture $1,061.17
27215 Treat pelvic fracture(s) $1,299.20
27216 Treat pelvic ring fracture $1,890.81
27217 Treat pelvic ring fracture $1,831.55
27218 Treat pelvic ring fracture $2,412.14
27220 Treat hip socket fracture $755.90
27222 Treat hip socket fracture $1,700.12
27226 Treat hip wall fracture $1,742.89
27227 Treat hip fracture(s) $2,939.01
27228 Treat hip fracture(s) $3,390.83
27230 Treat thigh fracture $533.01
27232 Treat thigh fracture $1,350.36
27235 Treat thigh fracture $1,623.66
27236 Treat thigh fracture $2,006.11
27238 Treat thigh fracture $503.65
27240 Treat thigh fracture $1,646.99
27244 Treat thigh fracture $2,056.28
27245 Treat thigh fracture $2,575.56
27246 Treat thigh fracture $655.17
27248 Treat thigh fracture $1,402.72
27250 Treat hip dislocation $874.76
27252 Treat hip dislocation $1,208.78
27253 Treat hip dislocation $1,707.25
27254 Treat hip dislocation $2,293.79
27256 Treat hip dislocation $563.29
27257 Treat hip dislocation $610.65
27258 Treat hip dislocation $1,986.90
27259 Treat hip dislocation $2,705.66
27265 Treat hip dislocation $730.82
27266 Treat hip dislocation $1,033.10
27275 Manipulation of hip joint $328.84
27280 Fusion of sacroiliac joint $1,789.48
27282 Fusion of pubic bones $1,458.91
27284 Fusion of hip joint $2,866.87
27286 Fusion of hip joint $2,934.69
27290 Amputation of leg at hip $2,832.79
27295 Amputation of leg at hip $2,281.98
27299 Pelvis/hip joint surgery $0.00
27301 Drain thigh/knee lesion $982.34
27303 Drainage of bone lesion $1,162.99
27305 Incise thigh tendon & fascia $842.24
27306 Incision of thigh tendon $700.44
27307 Incision of thigh tendons $844.64
27310 Exploration of knee joint $1,264.09
27315 Partial removal, thigh nerve $884.84
27320 Partial removal, thigh nerve $854.44
27323 Biopsy, thigh soft tissues $328.24
27324 Biopsy, thigh soft tissues $688.99
27327 Removal of thigh lesion $721.27
27328 Removal of thigh lesion $757.26
27329 Remove tumor, thigh/knee $1,778.75
27330 Biopsy, knee joint lining $715.21
27331 Explore/treat knee joint $851.30
27332 Removal of knee cartilage $1,151.92
27333 Removal of knee cartilage $1,041.29
27334 Remove knee joint lining $1,207.08
27335 Remove knee joint lining $1,367.46
27340 Removal of kneecap bursa $647.28
27345 Removal of knee cyst $861.17
27347 Remove knee cyst $835.58
27350 Removal of kneecap $1,152.02
27355 Remove femur lesion $1,083.60
27356 Remove femur lesion/graft $1,303.18
27357 Remove femur lesion/graft $1,445.18
27358 Remove femur lesion/fixation $555.85
27360 Partial removal, leg bone(s) $1,526.26
27365 Extensive leg surgery $2,110.52
27370 Injection for knee x-ray $540.59
27372 Removal of foreign body $816.66
27380 Repair of kneecap tendon $1,074.56
27381 Repair/graft kneecap tendon $1,453.38
27385 Repair of thigh muscle $1,146.20
27386 Repair/graft of thigh muscle $1,500.09
27390 Incision of thigh tendon $787.87
27391 Incision of thigh tendons $1,034.18
27392 Incision of thigh tendons $1,268.51
27393 Lengthening of thigh tendon $916.56
27394 Lengthening of thigh tendons $1,183.55
27395 Lengthening of thigh tendons $1,587.78
27396 Transplant of thigh tendon $1,118.90
27397 Transplants of thigh tendons $1,528.02
27400 Revise thigh muscles/tendons $1,226.85
27403 Repair of knee cartilage $1,160.87
27405 Repair of knee ligament $1,208.86
27407 Repair of knee ligament $1,394.52
27409 Repair of knee ligaments $1,716.44
27418 Repair degenerated kneecap $1,480.43
27420 Revision of unstable kneecap $1,344.45
27422 Revision of unstable kneecap $1,341.75
27424 Revision/removal of kneecap $1,342.27
27425 Lat retinacular release open $797.21
27427 Reconstruction, knee $1,284.58
27428 Reconstruction, knee $1,888.74
27429 Reconstruction, knee $2,097.22
27430 Revision of thigh muscles $1,325.28
27435 Incision of knee joint $1,338.35
27437 Revise kneecap $1,169.20
27438 Revise kneecap with implant $1,481.95
27440 Revision of knee joint $1,247.01
27441 Revision of knee joint $1,326.04
27442 Revision of knee joint $1,561.85
27443 Revision of knee joint $1,468.85
27445 Revision of knee joint $2,262.87
27446 Revision of knee joint $2,040.89
27447 Total knee arthroplasty $2,721.43
27448 Incision of thigh $1,482.35
27450 Incision of thigh $1,852.47
27454 Realignment of thigh bone $2,271.48
27455 Realignment of knee $1,709.08
27457 Realignment of knee $1,762.99
27465 Shortening of thigh bone $1,822.93
27466 Lengthening of thigh bone $2,114.72
27468 Shorten/lengthen thighs $2,382.24
27470 Repair of thigh $2,105.57
27472 Repair/graft of thigh $2,299.60
27475 Surgery to stop leg growth $1,188.16
27477 Surgery to stop leg growth $1,321.17
27479 Surgery to stop leg growth $1,707.93
27485 Surgery to stop leg growth $1,218.91
27486 Revise/replace knee joint $1,480.17
27487 Revise/replace knee joint $3,160.23
27488 Removal of knee prosthesis $2,059.93
27495 Reinforce thigh $2,039.56
27496 Decompression of thigh/knee $881.22
27497 Decompression of thigh/knee $958.98
27498 Decompression of thigh/knee $1,056.68
27499 Decompression of thigh/knee $1,201.26
27500 Treatment of thigh fracture $956.87
27501 Treatment of thigh fracture $996.80
27502 Treatment of thigh fracture $1,407.95
27503 Treatment of thigh fracture $1,418.96
27506 Treatment of thigh fracture $2,271.55
27507 Treatment of thigh fracture $1,803.99
27508 Treatment of thigh fracture $947.40
27509 Treatment of thigh fracture $1,163.47
27510 Treatment of thigh fracture $1,226.79
27511 Treatment of thigh fracture $1,866.34
27513 Treatment of thigh fracture $2,391.99
27514 Treatment of thigh fracture $2,304.39
27516 Treat thigh fx growth plate $931.30
27517 Treat thigh fx growth plate $1,317.36
27519 Treat thigh fx growth plate $2,005.85
27520 Treat kneecap fracture $588.73
27524 Treat kneecap fracture $1,364.37
27530 Treat knee fracture $707.61
27532 Treat knee fracture $1,124.95
27535 Treat knee fracture $1,618.46
27536 Treat knee fracture $2,048.05
27538 Treat knee fracture(s) $877.45
27540 Treat knee fracture $1,702.45
27550 Treat knee dislocation $755.90
27552 Treat knee dislocation $1,083.08
27556 Treat knee dislocation $1,960.31
27557 Treat knee dislocation $2,251.40
27558 Treat knee dislocation $2,325.41
27560 Treat kneecap dislocation $685.15
27562 Treat kneecap dislocation $789.86
27566 Treat kneecap dislocation $1,620.97
27570 Fixation of knee joint $264.49
27580 Fusion of knee $2,571.49
27590 Amputate leg at thigh $1,441.55
27591 Amputate leg at thigh $1,623.61
27592 Amputate leg at thigh $1,248.80
27594 Amputation follow-up surgery $925.17
27596 Amputation follow-up surgery $1,338.57
27598 Amputate lower leg at knee $1,340.23
27599 Leg surgery procedure $0.00
27600 Decompression of lower leg $776.31
27601 Decompression of lower leg $795.87
27602 Decompression of lower leg $950.39
27603 Drain lower leg lesion $1,124.02
27604 Drain lower leg bursa $567.64
27605 Incision of achilles tendon $830.82
27606 Incision of achilles tendon $680.15
27607 Treat lower leg bone lesion $1,092.00
27610 Explore/treat ankle joint $1,155.77
27612 Exploration of ankle joint $1,009.80
27613 Biopsy lower leg soft tissue $428.12
27614 Biopsy lower leg soft tissue $1,052.12
27615 Remove tumor, lower leg $1,721.06
27618 Remove lower leg lesion $982.34
27619 Remove lower leg lesion $1,399.53
27620 Explore/treat ankle joint $858.76
27625 Remove ankle joint lining $1,117.32
27626 Remove ankle joint lining $1,197.28
27630 Removal of tendon lesion $1,001.33
27635 Remove lower leg bone lesion $1,095.03
27637 Remove/graft leg bone lesion $1,366.60
27638 Remove/graft leg bone lesion $1,426.14
27640 Partial removal of tibia $1,655.58
27641 Partial removal of fibula $1,347.58
27645 Extensive lower leg surgery $1,988.18
27646 Extensive lower leg surgery $1,788.75
27647 Extensive ankle/heel surgery $1,520.87
27648 Injection for ankle x-ray $434.63
27650 Repair achilles tendon $1,295.79
27652 Repair/graft achilles tendon $1,381.37
27654 Repair of achilles tendon $1,302.80
27656 Repair leg fascia defect $1,044.08
27658 Repair of leg tendon, each $1,031.28
27659 Repair of leg tendon, each $1,325.56
27664 Repair of leg tendon, each $1,083.08
27665 Repair of leg tendon, each $1,194.14
27675 Repair lower leg tendons $975.88
27676 Repair lower leg tendons $1,141.77
27680 Release of lower leg tendon $818.12
27681 Release of lower leg tendons $956.93
27685 Revision of lower leg tendon $1,080.72
27686 Revise lower leg tendons $1,465.30
27687 Revision of calf tendon $874.72
27690 Revise lower leg tendon $1,144.14
27691 Revise lower leg tendon $1,338.66
27692 Revise additional leg tendon $214.30
27695 Repair of ankle ligament $930.34
27696 Repair of ankle ligaments $1,112.33
27698 Repair of ankle ligament $1,232.94
27700 Revision of ankle joint $1,131.33
27702 Reconstruct ankle joint $1,809.36
27703 Reconstruction, ankle joint $2,039.69
27704 Removal of ankle implant $973.69
27705 Incision of tibia $1,399.91
27707 Incision of fibula $695.20
27709 Incision of tibia & fibula $1,361.67
27712 Realignment of lower leg $1,883.30
27715 Revision of lower leg $1,902.02
27720 Repair of tibia $1,598.11
27722 Repair/graft of tibia $1,583.48
27724 Repair/graft of tibia $2,300.74
27725 Repair of lower leg $2,071.46
27727 Repair of lower leg $1,837.52
27730 Repair of tibia epiphysis $1,804.84
27732 Repair of fibula epiphysis $1,221.23
27734 Repair lower leg epiphyses $1,109.82
27740 Repair of leg epiphyses $2,166.89
27742 Repair of leg epiphyses $1,692.38
27745 Reinforce tibia $1,372.64
27750 Treatment of tibia fracture $625.76
27752 Treatment of tibia fracture $977.40
27756 Treatment of tibia fracture $993.18
27758 Treatment of tibia fracture $1,565.42
27759 Treatment of tibia fracture $1,816.43
27760 Treatment of ankle fracture $602.34
27762 Treatment of ankle fracture $881.60
27766 Treatment of ankle fracture $1,164.83
27780 Treatment of fibula fracture $503.65
27781 Treatment of fibula fracture $755.90
27784 Treatment of fibula fracture $1,014.72
27786 Treatment of ankle fracture $577.95
27788 Treatment of ankle fracture $801.69
27792 Treatment of ankle fracture $1,090.54
27808 Treatment of ankle fracture $618.17
27810 Treatment of ankle fracture $890.32
27814 Treatment of ankle fracture $1,446.74
27816 Treatment of ankle fracture $574.80
27818 Treatment of ankle fracture $926.55
27822 Treatment of ankle fracture $1,605.28
27823 Treatment of ankle fracture $1,828.58
27824 Treat lower leg fracture $614.73
27825 Treat lower leg fracture $1,060.68
27826 Treat lower leg fracture $1,297.03
27827 Treat lower leg fracture $2,004.41
27828 Treat lower leg fracture $2,257.97
27829 Treat lower leg joint $907.21
27830 Treat lower leg dislocation $629.37
27831 Treat lower leg dislocation $670.14
27832 Treat lower leg dislocation $945.71
27840 Treat ankle dislocation $579.41
27842 Treat ankle dislocation $844.28
27846 Treat ankle dislocation $1,331.14
27848 Treat ankle dislocation $1,567.49
27860 Fixation of ankle joint $325.81
27870 Fusion of ankle joint, open $1,840.71
27871 Fusion of tibiofibular joint $1,133.02
27880 Amputation of lower leg $1,453.92
27881 Amputation of lower leg $1,606.14
27882 Amputation of lower leg $1,186.48
27884 Amputation follow-up surgery $1,071.74
27886 Amputation follow-up surgery $1,211.40
27888 Amputation of foot at ankle $1,296.72
27889 Amputation of foot at ankle $1,257.91
27892 Decompression of leg $989.52
27893 Decompression of leg $980.67
27894 Decompression of leg $1,379.58
27899 Leg/ankle surgery procedure $0.00
28001 Drainage of bursa of foot $370.35
28002 Treatment of foot infection $579.41
28003 Treatment of foot infection $719.12
28005 Treat foot bone lesion $1,132.28
28008 Incision of foot fascia $745.93
28010 Incision of toe tendon $365.36
28011 Incision of toe tendons $505.96
28020 Exploration of foot joint $886.54
28022 Exploration of foot joint $792.99
28024 Exploration of toe joint $773.77
28030 Removal of foot nerve $740.29
28035 Decompression of tibia nerve $790.26
28043 Excision of foot lesion $680.75
28045 Excision of foot lesion $798.79
28046 Resection of tumor, foot $1,453.88
28050 Biopsy of foot joint lining $737.20
28052 Biopsy of foot joint lining $725.76
28054 Biopsy of toe joint lining $676.10
28060 Partial removal, foot fascia $858.20
28062 Removal of foot fascia $1,012.34
28070 Removal of foot joint lining $818.55
28072 Removal of foot joint lining $810.36
28080 Removal of foot lesion $695.44
28086 Excise foot tendon sheath $1,037.70
28088 Excise foot tendon sheath $793.80
28090 Removal of foot lesion $766.70
28092 Removal of toe lesions $725.74
28100 Removal of ankle/heel lesion $1,087.56
28102 Remove/graft foot lesion $1,033.14
28103 Remove/graft foot lesion $1,100.34
28104 Removal of foot lesion $847.24
28106 Remove/graft foot lesion $891.76
28107 Remove/graft foot lesion $943.43
28108 Removal of toe lesions $706.04
28110 Part removal of metatarsal $739.32
28111 Part removal of metatarsal $893.77
28112 Part removal of metatarsal $819.83
28113 Part removal of metatarsal $851.86
28114 Removal of metatarsal heads $1,607.91
28116 Revision of foot $1,116.21
28118 Removal of heel bone $967.78
28119 Removal of heel spur $859.82
28120 Part removal of ankle/heel $1,027.88
28122 Partial removal of foot bone $1,126.62
28124 Partial removal of toe $803.78
28126 Partial removal of toe $649.99
28130 Removal of ankle bone $1,112.09
28140 Removal of metatarsal $1,118.58
28150 Removal of toe $737.99
28153 Partial removal of toe $664.58
28160 Partial removal of toe $690.86
28171 Extensive foot surgery $1,154.50
28173 Extensive foot surgery $1,267.94
28175 Extensive foot surgery $941.80
28190 Removal of foot foreign body $427.77
28192 Removal of foot foreign body $810.04
28193 Removal of foot foreign body $890.39
28200 Repair of foot tendon $776.06
28202 Repair/graft of foot tendon $1,107.49
28208 Repair of foot tendon $743.74
28210 Repair/graft of foot tendon $995.53
28220 Release of foot tendon $746.39
28222 Release of foot tendons $860.46
28225 Release of foot tendon $655.28
28226 Release of foot tendons $749.49
28230 Incision of foot tendon(s) $727.15
28232 Incision of toe tendon $453.71
28234 Incision of foot tendon $401.87
28238 Revision of foot tendon $1,169.78
28240 Release of big toe $735.07
28250 Revision of foot fascia $924.51
28260 Release of midfoot joint $1,126.37
28261 Revision of foot tendon $1,556.45
28262 Revision of foot and ankle $2,258.40
28264 Release of midfoot joint $1,417.63
28270 Release of foot contracture $785.05
28272 Release of toe joint, each $554.19
28280 Fusion of toes $915.80
28285 Repair of hammertoe $778.75
28286 Repair of hammertoe $761.36
28288 Partial removal of foot bone $840.55
28289 Repair hallux rigidus $1,182.31
28290 Correction of bunion $937.80
28292 Correction of bunion $1,102.44
28293 Correction of bunion $1,481.65
28294 Correction of bunion $1,212.47
28296 Correction of bunion $1,297.99
28297 Correction of bunion $1,366.15
28298 Correction of bunion $1,141.74
28299 Correction of bunion $1,439.66
28300 Incision of heel bone $1,667.74
28302 Incision of ankle bone $1,662.67
28304 Incision of midfoot bones $1,286.57
28305 Incise/graft midfoot bones $1,555.68
28306 Incision of metatarsal $965.47
28307 Incision of metatarsal $1,299.40
28308 Incision of metatarsal $842.71
28309 Incision of metatarsals $1,574.96
28310 Revision of big toe $780.88
28312 Revision of toe $503.65
28313 Repair deformity of toe $844.19
28315 Removal of sesamoid bone $790.30
28320 Repair of foot bones $1,202.64
28322 Repair of metatarsals $1,233.75
28340 Resect enlarged toe tissue $1,047.01
28341 Resect enlarged toe $1,173.73
28344 Repair extra toe(s) $808.85
28345 Repair webbed toe(s) $957.21
28360 Reconstruct cleft foot $1,795.40
28400 Treatment of heel fracture $467.97
28405 Treatment of heel fracture $745.93
28406 Treatment of heel fracture $974.62
28415 Treat heel fracture $2,195.18
28420 Treat/graft heel fracture $2,228.68
28430 Treatment of ankle fracture $447.60
28435 Treatment of ankle fracture $581.82
28436 Treatment of ankle fracture $784.61
28445 Treat ankle fracture $1,977.13
28450 Treat midfoot fracture, each $432.39
28455 Treat midfoot fracture, each $521.90
28456 Treat midfoot fracture $504.73
28465 Treat midfoot fracture, each $997.29
28470 Treat metatarsal fracture $425.68
28475 Treat metatarsal fracture $517.42
28476 Treat metatarsal fracture $614.07
28485 Treat metatarsal fracture $840.67
28490 Treat big toe fracture $239.04
28495 Treat big toe fracture $298.00
28496 Treat big toe fracture $579.41
28505 Treat big toe fracture $972.86
28510 Treatment of toe fracture $206.38
28515 Treatment of toe fracture $276.64
28525 Treat toe fracture $906.39
28530 Treat sesamoid bone fracture $227.85
28531 Treat sesamoid bone fracture $807.47
28540 Treat foot dislocation $359.88
28545 Treat foot dislocation $393.58
28546 Treat foot dislocation $801.04
28555 Repair foot dislocation $1,297.13
28570 Treat foot dislocation $332.19
28575 Treat foot dislocation $566.56
28576 Treat foot dislocation $1,032.78
28585 Repair foot dislocation $1,202.96
28600 Treat foot dislocation $377.59
28605 Treat foot dislocation $474.26
28606 Treat foot dislocation $1,183.80
28615 Repair foot dislocation $1,173.80
28630 Treat toe dislocation $218.14
28635 Treat toe dislocation $266.86
28636 Treat toe dislocation $645.70
28645 Repair toe dislocation $728.07
28660 Treat toe dislocation $207.15
28665 Treat toe dislocation $266.92
28666 Treat toe dislocation $622.68
28675 Repair of toe dislocation $841.42
28705 Fusion of foot bones $2,345.54
28715 Fusion of foot bones $1,723.44
28725 Fusion of foot bones $1,504.46
28730 Fusion of foot bones $1,447.55
28735 Fusion of foot bones $1,412.27
28737 Revision of foot bones $1,248.33
28740 Fusion of foot bones $1,442.73
28750 Fusion of big toe joint $1,479.87
28755 Fusion of big toe joint $850.88
28760 Fusion of big toe joint $1,175.75
28800 Amputation of midfoot $1,068.63
28805 Amputation thru metatarsal $1,072.09
28810 Amputation toe & metatarsal $819.50
28820 Amputation of toe $935.05
28825 Partial amputation of toe $780.88
28899 Foot/toes surgery procedure $0.00
29000 Application of body cast $393.10
29010 Application of body cast $392.35
29015 Application of body cast $395.77
29020 Application of body cast $391.28
29025 Application of body cast $411.54
29035 Application of body cast $379.65
29040 Application of body cast $357.12
29044 Application of body cast $431.94
29046 Application of body cast $419.16
29049 Application of figure eight $156.63
29055 Application of shoulder cast $336.33
29058 Application of shoulder cast $206.93
29065 Application of long arm cast $156.52
29075 Application of forearm cast $144.58
29085 Apply hand/wrist cast $154.11
29086 Apply finger cast $112.73
29105 Apply long arm splint $141.25
29125 Apply forearm splint $114.62
29126 Apply forearm splint $141.83
29130 Application of finger splint $70.38
29131 Application of finger splint $92.70
29200 Strapping of chest $100.74
29220 Strapping of low back $100.11
29240 Strapping of shoulder $114.29
29260 Strapping of elbow or wrist $75.76
29280 Strapping of hand or finger $75.76
29305 Application of hip cast $383.22
29325 Application of hip casts $417.95
29345 Application of long leg cast $228.78
29355 Application of long leg cast $236.08
29358 Apply long leg cast brace $249.61
29365 Application of long leg cast $204.10
29405 Apply short leg cast $149.57
29425 Apply short leg cast $162.49
29435 Apply short leg cast $197.90
29440 Addition of walker to cast $75.76
29445 Apply rigid leg cast $263.35
29450 Application of leg cast $156.38
29505 Application, long leg splint $133.10
29515 Application lower leg splint $115.78
29520 Strapping of hip $100.91
29530 Strapping of knee $97.86
29540 Strapping of ankle and/or ft $59.33
29550 Strapping of toes $65.38
29580 Application of paste boot $89.37
29590 Application of foot splint $93.58
29700 Removal/revision of cast $100.74
29705 Removal/revision of cast $98.17
29710 Removal/revision of cast $151.52
29715 Removal/revision of cast $152.11
29720 Repair of body cast $78.38
29730 Windowing of cast $75.76
29740 Wedging of cast $100.15
29750 Wedging of clubfoot cast $103.32
29799 Casting/strapping procedure $0.00
29800 Jaw arthroscopy/surgery $1,004.24
29804 Jaw arthroscopy/surgery $1,213.56
29805 Shoulder arthroscopy, dx $862.71
29806 Shoulder arthroscopy/surgery $1,907.41
29807 Shoulder arthroscopy/surgery $1,858.90
29819 Shoulder arthroscopy/surgery $1,071.03
29820 Shoulder arthroscopy/surgery $989.36
29821 Shoulder arthroscopy/surgery $1,080.22
29822 Shoulder arthroscopy/surgery $1,048.59
29823 Shoulder arthroscopy/surgery $1,145.14
29824 Shoulder arthroscopy/surgery $1,167.64
29825 Shoulder arthroscopy/surgery $1,069.31
29826 Shoulder arthroscopy/surgery $1,232.86
29827 Arthroscop rotator cuff repr $2,001.67
29830 Elbow arthroscopy $823.41
29834 Elbow arthroscopy/surgery $897.68
29835 Elbow arthroscopy/surgery $916.74
29836 Elbow arthroscopy/surgery $1,065.46
29837 Elbow arthroscopy/surgery $966.51
29838 Elbow arthroscopy/surgery $1,084.64
29840 Wrist arthroscopy $802.18
29843 Wrist arthroscopy/surgery $863.41
29844 Wrist arthroscopy/surgery $903.71
29845 Wrist arthroscopy/surgery $1,034.69
29846 Wrist arthroscopy/surgery $949.64
29847 Wrist arthroscopy/surgery $985.64
29848 Wrist endoscopy/surgery $813.29
29850 Knee arthroscopy/surgery $988.35
29851 Knee arthroscopy/surgery $1,716.56
29855 Tibial arthroscopy/surgery $1,445.70
29856 Tibial arthroscopy/surgery $1,860.63
29860 Hip arthroscopy, dx $1,116.90
29861 Hip arthroscopy/surgery $1,233.10
29862 Hip arthroscopy/surgery $1,373.77
29863 Hip arthroscopy/surgery $1,370.67
29870 Knee arthroscopy, dx $736.10
29871 Knee arthroscopy/drainage $921.28
29873 Knee arthroscopy/surgery $916.04
29874 Knee arthroscopy/surgery $972.74
29875 Knee arthroscopy/surgery $901.98
29876 Knee arthroscopy/surgery $1,110.30
29877 Knee arthroscopy/surgery $1,044.34
29879 Knee arthroscopy/surgery $1,126.14
29880 Knee arthroscopy/surgery $1,179.76
29881 Knee arthroscopy/surgery $1,093.19
29882 Knee arthroscopy/surgery $1,178.93
29883 Knee arthroscopy/surgery $1,491.27
29884 Knee arthroscopy/surgery $1,040.09
29885 Knee arthroscopy/surgery $1,268.21
29886 Knee arthroscopy/surgery $1,067.47
29887 Knee arthroscopy/surgery $1,262.41
29888 Knee arthroscopy/surgery $1,811.73
29889 Knee arthroscopy/surgery $2,122.40
29891 Ankle arthroscopy/surgery $1,180.90
29892 Ankle arthroscopy/surgery $1,246.00
29893 Scope, plantar fasciotomy $842.30
29894 Ankle arthroscopy/surgery $950.58
29895 Ankle arthroscopy/surgery $932.44
29897 Ankle arthroscopy/surgery $975.19
29898 Ankle arthroscopy/surgery $1,088.18
29899 Ankle arthroscopy/surgery $1,795.27
29900 Mcp joint arthroscopy, dx $826.60
29901 Mcp joint arthroscopy, surg $911.61
29902 Mcp joint arthroscopy, surg $976.54
29999 Arthroscopy of joint $0.00


with 3

30000 Drainage of nose lesion $399.38
30020 Drainage of nose lesion $340.86
30100 Intranasal biopsy $184.19
30110 Removal of nose polyp(s) $357.86
30115 Removal of nose polyp(s) $613.55
30117 Removal of intranasal lesion $546.79
30118 Removal of intranasal lesion $1,250.81
30120 Revision of nose $790.33
30124 Removal of nose lesion $448.33
30125 Removal of nose lesion $963.80
30130 Removal of turbinate bones $502.57
30140 Removal of turbinate bones $538.66
30150 Partial removal of nose $1,240.71
30160 Removal of nose $1,273.56
30200 Injection treatment of nose $152.00
30210 Nasal sinus therapy $233.48
30220 Insert nasal septal button $257.57
30300 Remove nasal foreign body $332.19
30310 Remove nasal foreign body $372.51
30320 Remove nasal foreign body $660.66
30400 Reconstruction of nose $1,396.88
30410 Reconstruction of nose $1,765.56
30420 Reconstruction of nose $2,090.87
30430 Revision of nose $1,121.05
30435 Revision of nose $1,649.72
30450 Revision of nose $2,424.64
30460 Revision of nose $1,311.91
30462 Revision of nose $2,479.85
30465 Repair nasal stenosis $1,435.90
30520 Repair of nasal septum $796.27
30540 Repair nasal defect $986.86
30545 Repair nasal defect $1,476.08
30560 Release of nasal adhesions $313.50
30580 Repair upper jaw fistula $1,013.05
30600 Repair mouth/nose fistula $912.72
30620 Intranasal reconstruction $861.52
30630 Repair nasal septum defect $977.68
30801 Cauterization, inner nose $234.23
30802 Cauterization, inner nose $344.34
30901 Control of nosebleed $187.76
30903 Control of nosebleed $312.58
30905 Control of nosebleed $399.07
30906 Repeat control of nosebleed $462.80
30915 Ligation, nasal sinus artery $958.19
30920 Ligation, upper jaw artery $1,277.44
30930 Therapy, fracture of nose $211.46
30999 Nasal surgery procedure $0.00
31000 Irrigation, maxillary sinus $289.66
31002 Irrigation, sphenoid sinus $339.75
31020 Exploration, maxillary sinus $511.43
31030 Exploration, maxillary sinus $847.12
31032 Explore sinus, remove polyps $894.96
31040 Exploration behind upper jaw $1,163.86
31050 Exploration, sphenoid sinus $719.47
31051 Sphenoid sinus surgery $956.28
31070 Exploration of frontal sinus $620.37
31075 Exploration of frontal sinus $1,206.08
31080 Removal of frontal sinus $1,464.61
31081 Removal of frontal sinus $1,678.02
31084 Removal of frontal sinus $1,738.38
31085 Removal of frontal sinus $1,824.29
31086 Removal of frontal sinus $1,675.05
31087 Removal of frontal sinus $1,698.43
31090 Exploration of sinuses $1,329.75
31200 Removal of ethmoid sinus $726.30
31201 Removal of ethmoid sinus $1,117.83
31205 Removal of ethmoid sinus $1,312.50
31225 Removal of upper jaw $2,436.66
31230 Removal of upper jaw $2,741.92
31231 Nasal endoscopy, dx $315.21
31233 Nasal/sinus endoscopy, dx $478.44
31235 Nasal/sinus endoscopy, dx $555.82
31237 Nasal/sinus endoscopy, surg $602.89
31238 Nasal/sinus endoscopy, surg $628.27
31239 Nasal/sinus endoscopy, surg $1,237.86
31240 Nasal/sinus endoscopy, surg $323.62
31254 Revision of ethmoid sinus $558.84
31255 Removal of ethmoid sinus $824.94
31256 Exploration maxillary sinus $402.62
31267 Endoscopy, maxillary sinus $652.70
31276 Sinus endoscopy, surgical $1,041.79
31287 Nasal/sinus endoscopy, surg $474.73
31288 Nasal/sinus endoscopy, surg $550.85
31290 Nasal/sinus endoscopy, surg $2,171.38
31291 Nasal/sinus endoscopy, surg $2,291.80
31292 Nasal/sinus endoscopy, surg $1,878.88
31293 Nasal/sinus endoscopy, surg $2,042.24
31294 Nasal/sinus endoscopy, surg $2,358.96
31299 Sinus surgery procedure $0.00
31300 Removal of larynx lesion $1,934.67
31320 Diagnostic incision, larynx $906.97
31360 Removal of larynx $2,283.36
31365 Removal of larynx $3,085.94
31367 Partial removal of larynx $2,893.61
31368 Partial removal of larynx $3,544.30
31370 Partial removal of larynx $2,830.58
31375 Partial removal of larynx $2,622.74
31380 Partial removal of larynx $2,618.96
31382 Partial removal of larynx $2,729.89
31390 Removal of larynx & pharynx $3,595.74
31395 Reconstruct larynx & pharynx $4,142.03
31400 Revision of larynx $1,486.73
31420 Removal of epiglottis $1,465.89
31500 Insert emergency airway $218.03
31502 Change of windpipe airway $152.84
31505 Diagnostic laryngoscopy $155.36
31510 Laryngoscopy with biopsy $287.24
31511 Remove foreign body, larynx $287.24
31512 Removal of larynx lesion $287.24
31513 Injection into vocal cord $183.00
31515 Laryngoscopy for aspiration $236.79
31520 Diagnostic laryngoscopy $308.53
31525 Diagnostic laryngoscopy $469.70
31526 Diagnostic laryngoscopy $319.94
31527 Laryngoscopy for treatment $383.57
31528 Laryngoscopy and dilation $283.32
31529 Laryngoscopy and dilation $326.09
31530 Operative laryngoscopy $398.66
31531 Operative laryngoscopy $436.66
31535 Operative laryngoscopy $384.30
31536 Operative laryngoscopy $433.05
31540 Operative laryngoscopy $497.98
31541 Operative laryngoscopy $544.37
31560 Operative laryngoscopy $641.00
31561 Operative laryngoscopy $697.50
31570 Laryngoscopy with injection $693.38
31571 Laryngoscopy with injection $511.53
31575 Diagnostic laryngoscopy $215.01
31576 Laryngoscopy with biopsy $401.83
31577 Remove foreign body, larynx $449.14
31578 Removal of larynx lesion $512.92
31579 Diagnostic laryngoscopy $436.91
31580 Revision of larynx $1,724.58
31582 Revision of larynx $2,874.32
31584 Treat larynx fracture $2,526.82
31585 Treat larynx fracture $679.57
31586 Treat larynx fracture $1,197.79
31587 Revision of larynx $1,622.13
31588 Revision of larynx $1,150.49
31590 Reinnervate larynx $1,146.87
31595 Larynx nerve surgery $1,174.45
31599 Larynx surgery procedure $0.00
31600 Incision of windpipe $769.79
31601 Incision of windpipe $513.59
31603 Incision of windpipe $441.97
31605 Incision of windpipe $362.23
31610 Incision of windpipe $1,194.79
31611 Surgery/speech prosthesis $846.53
31612 Puncture/clear windpipe $88.48
31613 Repair windpipe opening $730.60
31614 Repair windpipe opening $1,089.91
31615 Visualization of windpipe $342.97
31622 Dx bronchoscope/wash $500.53
31623 Dx bronchoscope/brush $568.58
31624 Dx bronchoscope/lavage $515.23
31625 Bronchoscopy w/biopsy(s) $627.15
31628 Bronchoscopy/lung bx, each $670.33
31629 Bronchoscopy/needle bx, each $340.39
31630 Bronchoscopy dilate/fx repr $434.55
31631 Bronchoscopy, dilate w/stent $477.34
31632 Bronchoscopy/lung bx, add’l $130.49
31633 Bronchoscopy/needle bx add’l $167.05
31635 Bronchoscopy w/fb removal $397.61
31640 Bronchoscopy w/tumor excise $545.37
31641 Bronchoscopy, treat blockage $533.17
31643 Diag bronchoscope/catheter $356.98
31645 Bronchoscopy, clear airways $324.08
31646 Bronchoscopy, reclear airway $282.27
31656 Bronchoscopy, inj for x-ray $230.19
31700 Insertion of airway catheter $243.95
31708 Instill airway contrast dye $147.62
31710 Insertion of airway catheter $148.36
31715 Injection for bronchus x-ray $125.91
31717 Bronchial brush biopsy $313.50
31720 Clearance of airways $108.83
31725 Clearance of airways $279.23
31730 Intro, windpipe wire/tube $371.84
31750 Repair of windpipe $1,809.53
31755 Repair of windpipe $2,213.39
31760 Repair of windpipe $2,473.05
31766 Reconstruction of windpipe $3,346.59
31770 Repair/graft of bronchus $2,484.52
31775 Reconstruct bronchus $2,693.79
31780 Reconstruct windpipe $2,152.08
31781 Reconstruct windpipe $2,679.78
31785 Remove windpipe lesion $2,047.02
31786 Remove windpipe lesion $2,787.37
31800 Repair of windpipe injury $917.84
31805 Repair of windpipe injury $1,540.89
31820 Closure of windpipe lesion $728.99
31825 Repair of windpipe defect $1,052.30
31830 Revise windpipe scar $741.10
31899 Airways surgical procedure $0.00
32000 Drainage of chest $333.24
32002 Treatment of collapsed lung $396.58
32005 Treat lung lining chemically $574.48
32020 Insertion of chest tube $411.03
32035 Exploration of chest $1,095.75
32036 Exploration of chest $1,218.64
32095 Biopsy through chest wall $1,037.49
32100 Exploration/biopsy of chest $1,739.07
32110 Explore/repair chest $2,527.07
32120 Re-exploration of chest $1,409.77
32124 Explore chest free adhesions $1,511.29
32140 Removal of lung lesion(s) $1,641.89
32141 Remove/treat lung lesions $1,639.54
32150 Removal of lung lesion(s) $1,650.08
32151 Remove lung foreign body $1,676.95
32160 Open chest heart massage $1,101.83
32200 Drain, open, lung lesion $1,796.85
32201 Drain, percut, lung lesion $395.00
32215 Treat chest lining $1,379.30
32220 Release of lung $2,784.35
32225 Partial release of lung $1,642.76
32310 Removal of chest lining $1,583.97
32320 Free/remove chest lining $2,734.07
32400 Needle biopsy chest lining $251.21
32402 Open biopsy chest lining $957.45
32405 Biopsy, lung or mediastinum $295.23
32420 Puncture/clear lung $224.39
32440 Removal of lung $2,862.09
32442 Sleeve pneumonectomy $3,105.72
32445 Removal of lung $2,971.99
32480 Partial removal of lung $2,697.55
32482 Bilobectomy $2,853.87
32484 Segmentectomy $2,435.31
32486 Sleeve lobectomy $2,823.02
32488 Completion pneumonectomy $3,001.41
32491 Lung volume reduction $2,567.64
32500 Partial removal of lung $2,567.35
32501 Repair bronchus add-on $478.81
32520 Remove lung & revise chest $2,510.93
32522 Remove lung & revise chest $2,759.62
32525 Remove lung & revise chest $2,995.67
32540 Removal of lung lesion $1,834.31
32601 Thoracoscopy, diagnostic $599.64
32602 Thoracoscopy, diagnostic $650.74
32603 Thoracoscopy, diagnostic $826.74
32604 Thoracoscopy, diagnostic $938.04
32605 Thoracoscopy, diagnostic $756.88
32606 Thoracoscopy, diagnostic $900.71
32650 Thoracoscopy, surgical $1,321.20
32651 Thoracoscopy, surgical $1,524.45
32652 Thoracoscopy, surgical $2,187.72
32653 Thoracoscopy, surgical $1,506.31
32654 Thoracoscopy, surgical $1,511.04
32655 Thoracoscopy, surgical $1,540.70
32656 Thoracoscopy, surgical $1,577.79
32657 Thoracoscopy, surgical $1,617.21
32658 Thoracoscopy, surgical $1,435.76
32659 Thoracoscopy, surgical $1,437.26
32660 Thoracoscopy, surgical $2,041.17
32661 Thoracoscopy, surgical $1,595.60
32662 Thoracoscopy, surgical $1,918.43
32663 Thoracoscopy, surgical $2,215.53
32664 Thoracoscopy, surgical $1,657.23
32665 Thoracoscopy, surgical $1,795.49
32800 Repair lung hernia $1,598.87
32810 Close chest after drainage $1,559.68
32815 Close bronchial fistula $2,604.15
32820 Reconstruct injured chest $2,543.57
32850 Donor pneumonectomy $4,441.53
32851 Lung transplant, single $5,008.52
32852 Lung transplant with bypass $5,626.96
32853 Lung transplant, double $6,018.72
32854 Lung transplant with bypass $6,473.59
32900 Removal of rib(s) $2,296.56
32905 Revise & repair chest wall $2,353.73
32906 Revise & repair chest wall $2,968.32
32940 Revision of lung $2,206.97
32960 Therapeutic pneumothorax $263.38
32997 Total lung lavage $601.43
32999 Chest surgery procedure $0.00
33010 Drainage of heart sac $153.52
33011 Repeat drainage of heart sac $153.52
33015 Incision of heart sac $525.78
33020 Incision of heart sac $1,116.59
33025 Incision of heart sac $1,186.37
33030 Partial removal of heart sac $1,395.73
33031 Partial removal of heart sac $2,023.81
33050 Removal of heart sac lesion $1,325.95
33120 Removal of heart lesion $2,761.67
33130 Removal of heart lesion $2,093.60
33140 Heart revascularize (tmr) $1,674.88
33141 Heart tmr w/other procedure $492.77
33200 Insertion of heart pacemaker $1,360.84
33201 Insertion of heart pacemaker $1,046.80
33206 Insertion of heart pacemaker $732.76
33207 Insertion of heart pacemaker $951.02
33208 Insertion of heart pacemaker $963.25
33210 Insertion of heart electrode $339.69
33211 Insertion of heart electrode $293.09
33212 Insertion of pulse generator $665.09
33213 Insertion of pulse generator $754.04
33214 Upgrade of pacemaker system $943.14
33215 Reposition pacing-defib lead $353.03
33216 Insert lead pace-defib, one $741.67
33217 Insert lead pace-defib, dual $741.49
33218 Repair lead pace-defib, one $635.05
33220 Repair lead pace-defib, dual $726.38
33222 Revise pocket, pacemaker $685.94
33223 Revise pocket, pacing-defib $819.28
33224 Insert pacing lead & connect $579.95
33225 L ventric pacing lead add-on $515.50
33226 Reposition l ventric lead $558.03
33233 Removal of pacemaker system $293.09
33234 Removal of pacemaker system $947.33
33235 Removal pacemaker electrode $1,201.61
33236 Remove electrode/thoracotomy $1,430.63
33237 Remove electrode/thoracotomy $1,535.31
33238 Remove electrode/thoracotomy $1,674.88
33240 Insert pulse generator $909.56
33241 Remove pulse generator $456.38
33243 Remove eltrd/thoracotomy $2,584.72
33244 Remove eltrd, transven $1,686.46
33245 Insert epic eltrd pace-defib $1,672.01
33246 Insert epic eltrd/generator $1,919.13
33249 Eltrd/insert pace-defib $1,678.57
33250 Ablate heart dysrhythm focus $1,744.67
33251 Ablate heart dysrhythm focus $2,233.17
33253 Reconstruct atria $3,000.82
33261 Ablate heart dysrhythm focus $1,988.92
33282 Implant pat-active ht record $365.84
33284 Remove pat-active ht record $265.66
33300 Repair of heart wound $1,674.88
33305 Repair of heart wound $2,302.96
33310 Exploratory heart surgery $1,674.88
33315 Exploratory heart surgery $2,542.11
33320 Repair major blood vessel(s) $1,891.56
33321 Repair major vessel $2,296.79
33322 Repair major blood vessel(s) $2,360.21
33330 Insert major vessel graft $2,413.47
33332 Insert major vessel graft $2,616.46
33335 Insert major vessel graft $3,317.87
33400 Repair of aortic valve $2,791.46
33401 Valvuloplasty, open $2,651.89
33403 Valvuloplasty, w/cp bypass $2,861.25
33404 Prepare heart-aorta conduit $3,268.83
33405 Replacement of aortic valve $3,084.87
33406 Replacement of aortic valve $3,279.97
33410 Replacement of aortic valve $3,070.61
33411 Replacement of aortic valve $3,210.18
33412 Replacement of aortic valve $3,210.18
33413 Replacement of aortic valve $3,559.12
33414 Repair of aortic valve $3,070.61
33415 Revision, subvalvular tissue $2,931.04
33416 Revise ventricle muscle $2,931.04
33417 Repair of aortic valve $3,000.82
33420 Revision of mitral valve $2,233.17
33422 Revision of mitral valve $3,000.82
33425 Repair of mitral valve $3,039.25
33426 Repair of mitral valve $3,140.40
33427 Repair of mitral valve $3,205.17
33430 Replacement of mitral valve $3,140.40
33460 Revision of tricuspid valve $2,667.62
33463 Valvuloplasty, tricuspid $2,935.48
33464 Valvuloplasty, tricuspid $3,117.85
33465 Replace tricuspid valve $2,861.25
33468 Revision of tricuspid valve $2,791.46
33470 Revision of pulmonary valve $2,093.60
33471 Valvotomy, pulmonary valve $2,268.06
33472 Revision of pulmonary valve $2,372.74
33474 Revision of pulmonary valve $2,582.10
33475 Replacement, pulmonary valve $3,000.82
33476 Revision of heart chamber $2,848.71
33478 Revision of heart chamber $2,931.04
33496 Repair, prosth valve clot $2,965.93
33500 Repair heart vessel fistula $2,442.53
33501 Repair heart vessel fistula $1,626.04
33502 Coronary artery correction $1,954.02
33503 Coronary artery graft $2,163.38
33504 Coronary artery graft $2,784.29
33505 Repair artery w/tunnel $2,960.44
33506 Repair artery, translocation $3,000.82
33508 Endoscopic vein harvest $18.84
33510 CABG, vein, single $2,931.04
33511 CABG, vein, two $3,345.08
33512 CABG, vein, three $3,349.76
33513 CABG, vein, four $3,559.12
33514 CABG, vein, five $3,768.48
33516 Cabg, vein, six or more $3,908.05
33517 CABG, artery-vein, single $263.12
33518 CABG, artery-vein, two $496.26
33519 CABG, artery-vein, three $728.03
33521 CABG, artery-vein, four $961.93
33522 CABG, artery-vein, five $956.07
33523 Cabg, art-vein, six or more $1,151.48
33530 Coronary artery, bypass/reop $583.28
33533 CABG, arterial, single $3,510.06
33534 CABG, arterial, two $3,360.30
33535 CABG, arterial, three $3,489.33
33536 Cabg, arterial, four or more $3,698.69
33542 Removal of heart lesion $3,201.04
33545 Repair of heart damage $3,698.69
33572 Open coronary endarterectomy $454.70
33600 Closure of valve $3,070.61
33602 Closure of valve $3,000.82
33606 Anastomosis/artery-aorta $3,140.40
33608 Repair anomaly w/conduit $3,210.18
33610 Repair by enlargement $3,140.40
33611 Repair double ventricle $3,349.76
33612 Repair double ventricle $3,419.54
33615 Repair, modified fontan $3,279.97
33617 Repair single ventricle $3,454.44
33619 Repair single ventricle $3,768.48
33641 Repair heart septum defect $2,369.14
33645 Revision of heart veins $2,582.10
33647 Repair heart septum defects $2,582.10
33660 Repair of heart defects $3,035.72
33665 Repair of heart defects $3,248.09
33670 Repair of heart chambers $3,349.76
33681 Repair heart septum defect $2,617.00
33684 Repair heart septum defect $3,070.61
33688 Repair heart septum defect $3,070.61
33690 Reinforce pulmonary artery $1,674.88
33692 Repair of heart defects $3,070.61
33694 Repair of heart defects $3,140.40
33697 Repair of heart defects $3,454.44
33702 Repair of heart defects $2,826.36
33710 Repair of heart defects $3,070.61
33720 Repair of heart defect $2,861.25
33722 Repair of heart defect $3,000.82
33730 Repair heart-vein defect(s) $2,861.25
33732 Repair heart-vein defect $2,791.46
33735 Revision of heart chamber $1,814.45
33736 Revision of heart chamber $2,163.38
33737 Revision of heart chamber $1,954.02
33750 Major vessel shunt $2,093.60
33755 Major vessel shunt $2,093.60
33762 Major vessel shunt $2,093.60
33764 Major vessel shunt & graft $1,814.45
33766 Major vessel shunt $2,093.60
33767 Major vessel shunt $2,275.04
33770 Repair great vessels defect $3,279.97
33771 Repair great vessels defect $3,419.54
33774 Repair great vessels defect $3,070.61
33775 Repair great vessels defect $3,175.29
33776 Repair great vessels defect $3,314.86
33777 Repair great vessels defect $3,266.02
33778 Repair great vessels defect $3,524.22
33779 Repair great vessels defect $3,545.17
33780 Repair great vessels defect $3,614.96
33781 Repair great vessels defect $3,573.06
33786 Repair arterial trunk $3,489.33
33788 Revision of pulmonary artery $2,093.60
33800 Aortic suspension $1,535.31
33802 Repair vessel defect $1,674.88
33803 Repair vessel defect $1,954.02
33813 Repair septal defect $1,954.02
33814 Repair septal defect $2,721.68
33820 Revise major vessel $1,395.73
33822 Revise major vessel $1,395.73
33824 Revise major vessel $1,744.67
33840 Remove aorta constriction $2,093.60
33845 Remove aorta constriction $2,302.96
33851 Remove aorta constriction $2,302.96
33852 Repair septal defect $2,442.53
33853 Repair septal defect $3,140.40
33860 Ascending aortic graft $3,559.12
33861 Ascending aortic graft $3,594.01
33863 Ascending aortic graft $3,768.48
33870 Transverse aortic arch graft $3,908.05
33875 Thoracic aortic graft $3,524.22
33877 Thoracoabdominal graft $3,698.69
33910 Remove lung artery emboli $2,651.89
33915 Remove lung artery emboli $1,884.24
33916 Surgery of great vessel $2,721.68
33917 Repair pulmonary artery $2,651.89
33918 Repair pulmonary atresia $2,826.36
33919 Repair pulmonary atresia $3,279.97
33920 Repair pulmonary atresia $3,245.08
33922 Transect pulmonary artery $2,582.10
33924 Remove pulmonary shunt $558.29
33930 Removal of donor heart/lung $1,674.88
33935 Transplantation, heart/lung $6,883.86
33940 Removal of donor heart $1,465.52
33945 Transplantation of heart $4,854.79
33960 External circulation assist $1,871.33
33961 External circulation assist $1,125.30
33967 Insert ia percut device $397.97
33968 Remove aortic assist device $66.37
33970 Aortic circulation assist $488.51
33971 Aortic circulation assist $708.53
33973 Insert balloon device $635.05
33974 Remove intra-aortic balloon $1,542.28
33975 Implant ventricular device $1,242.80
33976 Implant ventricular device $1,660.93
33977 Remove ventricular device $1,905.18
33978 Remove ventricular device $2,177.33
33979 Insert intracorporeal device $2,775.01
33980 Remove intracorporeal device $3,685.06
33999 Cardiac surgery procedure $0.00
34001 Removal of artery clot $907.23
34051 Removal of artery clot $1,751.21
34101 Removal of artery clot $725.79
34111 Removal of arm artery clot $725.79
34151 Removal of artery clot $1,595.68
34201 Removal of artery clot $1,088.67
34203 Removal of leg artery clot $1,106.52
34401 Removal of vein clot $1,509.99
34421 Removal of vein clot $821.91
34451 Removal of vein clot $1,722.08
34471 Removal of vein clot $698.64
34490 Removal of vein clot $684.98
34501 Repair valve, femoral vein $1,103.12
34502 Reconstruct vena cava $2,582.10
34510 Transposition of vein valve $1,279.02
34520 Cross-over vein graft $1,744.67
34530 Leg vein fusion $1,186.37
34800 Endovasc abdo repair w/tube $1,535.31
34802 Endovasc abdo repr w/device $1,674.88
34804 Endovasc abdo repr w/device $1,674.88
34805 Endovasc abdo repair w/pros $1,410.71
34808 Endovasc abdo occlud device $414.67
34812 Xpose for endoprosth, femorl $537.35
34813 Femoral endovas graft add-on $418.72
34820 Xpose for endoprosth, iliac $781.60
34825 Endovasc extend prosth, init $977.01
34826 Endovasc exten prosth, add’l $414.67
34830 Open aortic tube prosth repr $2,372.74
34831 Open aortoiliac prosth repr $2,582.10
34832 Open aortofemor prosth repr $2,651.89
34833 Xpose for endoprosth, iliac $740.35
34834 Xpose, endoprosth, brachial $343.51/td>
34900 Endovasc iliac repr w/graft $1,093.07
35001 Repair defect of artery $1,395.73
35002 Repair artery rupture, neck $1,744.67
35005 Repair defect of artery $2,018.81
35011 Repair defect of artery $1,256.16
35013 Repair artery rupture, arm $1,605.09
35021 Repair defect of artery $1,319.44
35022 Repair artery rupture, chest $1,605.09
35045 Repair defect of arm artery $1,256.16
35081 Repair defect of artery $1,808.05
35082 Repair artery rupture, aorta $2,457.39
35091 Repair defect of artery $2,248.30
35092 Repair artery rupture, aorta $2,851.21
35102 Repair defect of artery $2,093.60
35103 Repair artery rupture, groin $2,563.55
35111 Repair defect of artery $1,597.33
35112 Repair artery rupture,spleen $2,093.60
35121 Repair defect of artery $1,928.02
35122 Repair artery rupture, belly $2,226.30
35131 Repair defect of artery $1,616.72
35132 Repair artery rupture, groin $1,954.02
35141 Repair defect of artery $1,305.40
35142 Repair artery rupture, thigh $1,535.31
35151 Repair defect of artery $1,475.71
35152 Repair artery rupture, knee $1,744.67
35161 Repair defect of artery $1,273.74
35162 Repair artery rupture $1,336.80
35180 Repair blood vessel lesion $1,395.73
35182 Repair blood vessel lesion $1,919.87
35184 Repair blood vessel lesion $1,395.73
35188 Repair blood vessel lesion $1,535.31
35189 Repair blood vessel lesion $2,233.17
35190 Repair blood vessel lesion $1,452.98
35201 Repair blood vessel lesion $1,804.26
35206 Repair blood vessel lesion $1,485.89
35207 Repair blood vessel lesion $1,321.16
35211 Repair blood vessel lesion $2,302.96
35216 Repair blood vessel lesion $1,674.88
35221 Repair blood vessel lesion $1,884.24
35226 Repair blood vessel lesion $1,130.53
35231 Repair blood vessel lesion $1,814.45
35236 Repair blood vessel lesion $1,814.45
35241 Repair blood vessel lesion $2,582.10
35246 Repair blood vessel lesion $1,744.67
35251 Repair blood vessel lesion $2,268.06
35256 Repair blood vessel lesion $1,549.25
35261 Repair blood vessel lesion $1,162.05
35266 Repair blood vessel lesion $1,116.59
35271 Repair blood vessel lesion $2,233.17
35276 Repair blood vessel lesion $1,609.52
35281 Repair blood vessel lesion $1,783.38
35286 Repair blood vessel lesion $1,325.95
35301 Rechanneling of artery $2,071.61
35311 Rechanneling of artery $1,763.26
35321 Rechanneling of artery $1,633.01
35331 Rechanneling of artery $1,705.32
35341 Rechanneling of artery $1,645.11
35351 Rechanneling of artery $1,535.31
35355 Rechanneling of artery $1,605.09
35361 Rechanneling of artery $1,813.11
35363 Rechanneling of artery $1,941.30
35371 Rechanneling of artery $1,256.16
35372 Rechanneling of artery $1,325.95
35381 Rechanneling of artery $1,395.73
35390 Reoperation, carotid add-on $327.65
35400 Angioscopy $315.19
35450 Repair arterial blockage $683.92
35452 Repair arterial blockage $488.51
35454 Repair arterial blockage $586.21
35456 Repair arterial blockage $586.21
35458 Repair arterial blockage $617.34
35459 Repair arterial blockage $586.21
35460 Repair venous blockage $586.21
35470 Repair arterial blockage $668.33
35471 Repair arterial blockage $837.79
35472 Repair arterial blockage $488.51
35473 Repair arterial blockage $635.05
35474 Repair arterial blockage $763.60
35475 Repair arterial blockage $662.97
35476 Repair venous blockage $570.45
35480 Atherectomy, open $781.60
35481 Atherectomy, open $537.35
35482 Atherectomy, open $467.56
35483 Atherectomy, open $572.24
35484 Atherectomy, open $739.73
35485 Atherectomy, open $669.95
35490 Atherectomy, percutaneous $774.63
35491 Atherectomy, percutaneous $537.35
35492 Atherectomy, percutaneous $446.64
35493 Atherectomy, percutaneous $572.24
35494 Atherectomy, percutaneous $739.73
35495 Atherectomy, percutaneous $669.95
35500 Harvest vein for bypass $388.03
35501 Artery bypass graft $1,267.80
35506 Artery bypass graft $1,395.73
35507 Artery bypass graft $1,395.73
35508 Artery bypass graft $1,395.73
35509 Artery bypass graft $1,395.73
35510 Artery bypass graft $1,492.48
35511 Artery bypass graft $1,535.31
35512 Artery bypass graft $1,463.05
35515 Artery bypass graft $1,535.31
35516 Artery bypass graft $1,535.31
35518 Artery bypass graft $1,535.31
35521 Artery bypass graft $1,744.67
35522 Artery bypass graft $1,419.16
35525 Artery bypass graft $1,352.42/td>
35526 Artery bypass graft $2,233.17
35531 Artery bypass graft $2,292.53
35533 Artery bypass graft $1,814.45
35536 Artery bypass graft $2,020.09
35541 Artery bypass graft $1,686.78
35546 Artery bypass graft $1,814.45
35548 Artery bypass graft $1,814.45
35549 Artery bypass graft $1,954.02
35551 Artery bypass graft $2,023.81
35556 Artery bypass graft $1,814.45
35558 Artery bypass graft $1,535.31
35560 Artery bypass graft $2,051.49
35563 Artery bypass graft $1,674.88
35565 Artery bypass graft $1,814.45
35566 Artery bypass graft $1,814.45
35571 Artery bypass graft $1,744.67
35572 Harvest femoropopliteal vein $417.42
35582 Vein bypass graft $1,770.91
35583 Vein bypass graft $1,605.09
35585 Vein bypass graft $1,858.75
35587 Vein bypass graft $1,674.88
35600 Harvest artery for cabg $355.01
35601 Artery bypass graft $1,674.88
35606 Artery bypass graft $1,674.88
35612 Artery bypass graft $1,674.88
35616 Artery bypass graft $1,674.88
35621 Artery bypass graft $1,674.88
35623 Bypass graft, not vein $1,605.09
35626 Artery bypass graft $1,954.02
35631 Artery bypass graft $2,164.64
35636 Artery bypass graft $1,954.02
35641 Artery bypass graft $2,233.17
35642 Artery bypass graft $2,016.88
35645 Artery bypass graft $1,953.31
35646 Artery bypass graft $2,233.17
35647 Artery bypass graft $1,954.02
35650 Artery bypass graft $1,535.31
35651 Artery bypass graft $2,093.60
35654 Artery bypass graft $1,954.02
35656 Artery bypass graft $1,925.95
35661 Artery bypass graft $1,395.73
35663 Artery bypass graft $1,674.88
35665 Artery bypass graft $1,674.88
35666 Artery bypass graft $1,814.45
35671 Artery bypass graft $1,674.88
35681 Composite bypass graft $163.51
35682 Composite bypass graft $488.51
35683 Composite bypass graft $558.29
35685 Bypass graft patency/patch $272.17
35686 Bypass graft/av fist patency $223.31
35691 Arterial transposition $1,674.88
35693 Arterial transposition $1,674.88
35694 Arterial transposition $1,849.34
35695 Arterial transposition $1,849.34
35697 Reimplant artery each $185.40
35700 Reoperation, bypass graft $315.65
35701 Exploration, carotid artery $635.05
35721 Exploration, femoral artery $520.92
35741 Exploration popliteal artery $567.37
35761 Exploration of artery/vein $565.27
35800 Explore neck vessels $697.87
35820 Explore chest vessels $1,482.01
35840 Explore abdominal vessels $1,046.80
35860 Explore limb vessels $628.08
35870 Repair vessel graft defect $2,430.86
35875 Removal of clot in graft $942.12
35876 Removal of clot in graft $1,325.95
35879 Revise graft w/vein $1,221.27
35881 Revise graft w/vein $1,535.31
35901 Excision, graft, neck $977.01
35903 Excision, graft, extremity $1,116.59
35905 Excision, graft, thorax $2,268.06
35907 Excision, graft, abdomen $2,337.85
36000 Place needle in vein $55.09
36002 Pseudoaneurysm injection trt $210.50
36005 Injection ext venography $393.49
36010 Place catheter in vein $170.18
36011 Place catheter in vein $209.36
36012 Place catheter in vein $314.04
36013 Place catheter in artery $209.36
36014 Place catheter in artery $299.51
36015 Place catheter in artery $314.04
36100 Establish access to artery $279.15
36120 Establish access to artery $199.30
36140 Establish access to artery $198.96
36145 Artery to vein shunt $199.65
36160 Establish access to aorta $209.36
36200 Place catheter in aorta $301.91
36215 Place catheter in artery $466.77
36216 Place catheter in artery $524.65
36217 Place catheter in artery $630.41
36218 Place catheter in artery $101.58
36245 Place catheter in artery $471.93
36246 Place catheter in artery $527.40
36247 Place catheter in artery $627.66
36248 Place catheter in artery $101.92
36260 Insertion of infusion pump $661.91
36261 Revision of infusion pump $593.19
36262 Removal of infusion pump $411.75
36299 Vessel injection procedure $0.00
36400 Bl draw <> 3 yrs $23.92
36415 Routine venipuncture $13.69
36416 Capillary blood draw $14.52
36420 Vein access cutdown <> 1 yr $56.33
36430 Blood transfusion service $42.96
36440 Bl push transfuse, 2 yr or < $83.73 36450 Bl exchange/transfuse, nb $221.92 36455 Bl exchange/transfuse non-nb $255.80 36460 Transfusion service, fetal $669.58 36468 Injection(s), spider veins $269.28 36469 Injection(s), spider veins $76.76 36470 Injection therapy of vein $163.67 36471 Injection therapy of veins $251.70 36481 Insertion of catheter, vein $662.97 36488 Insertion of catheter, vein $104.68 36489 Insertion of catheter, vein $469.65 36490 Insertion of catheter, vein $160.52 36491 Insertion of catheter, vein $163.91 36493 Repositioning of cvc $143.21 36500 Insertion of catheter, vein $244.25 36510 Insertion of catheter, vein $204.78 36511 Apheresis wbc $108.73 36512 Apheresis rbc $108.73 36513 Apheresis platelets $108.73 36514 Apheresis plasma $114.29 36515 Apheresis, adsorp/reinfuse $109.56 36516 Apheresis, selective $128.62 36522 Photopheresis $1,329.40 36530 Insertion of infusion pump $558.29 36531 Revision of infusion pump $558.29 36532 Removal of infusion pump $363.76 36533 Insertion of access device $1,337.27 36534 Revision of access device $316.12 36535 Removal of access device $368.80 36536 Remove cva device obstruct $2,556.62 36537 Remove cva lumen obstruct $348.18 36540 Collect blood venous device $69.43 36550 Declot vascular device $27.92 36555 Insert non-tunnel cv cath $372.26 36556 Insert non-tunnel cv cath $355.73 36557 Insert tunneled cv cath $800.36 36558 Insert tunneled cv cath $782.37 36560 Insert tunneled cv cath $1,497.56 36561 Insert tunneled cv cath $1,483.05 36563 Insert tunneled cv cath $1,864.83 36565 Insert tunneled cv cath $1,195.53 36566 Insert tunneled cv cath $1,250.98 36568 Insert tunneled cv cath $428.67 36569 Insert tunneled cv cath $390.12 36570 Insert tunneled cv cath $1,913.61 36571 Insert tunneled cv cath $1,721.44 36575 Repair tunneled cv cath $180.54 36576 Repair tunneled cv cath $473.56 36578 Replace tunneled cv cath $603.91 36580 Replace tunneled cv cath $341.24 36581 Replace tunneled cv cath $714.00 36582 Replace tunneled cv cath $1,344.76 36583 Replace tunneled cv cath $789.31 36584 Replace tunneled cv cath $355.73/td>
36585 Replace tunneled cv cath $1,691.61
36589 Removal tunneled cv cath $197.73
36590 Removal tunneled cv cath $421.09
36595 Mech remov tunneled cv cath $980.83
36596 Mech remov tunneled cv cath $215.98
36597 Reposition venous catheter $187.02
36600 Withdrawal of arterial blood $57.63
36620 Insertion catheter, artery $104.80
36625 Insertion catheter, artery $119.93
36640 Insertion catheter, artery $141.99
36660 Insertion catheter, artery $97.71
36680 Insert needle, bone cavity $76.76
36800 Insertion of cannula $187.97
36810 Insertion of cannula $428.52
36815 Insertion of cannula $286.83
36819 Av fusion/uppr arm vein $1,270.11
36820 Av fusion/forearm vein $1,004.93
36821 Av fusion direct any site $1,030.49
36822 Insertion of cannula(s) $739.18
36823 Insertion of cannula(s) $1,385.27
36825 Artery-vein autograft $1,132.84
36830 Artery-vein nonautograft $1,208.67
36831 Open thrombect av fistula $541.53
36832 Av fistula revision, open $695.40
36833 Av fistula revision $783.48
36834 Repair A-V aneurysm $1,115.82
36835 Artery to vein shunt $868.34
36838 Dist revas ligation, hemo $1,371.13
36860 External cannula declotting $195.39
36861 Cannula declotting $177.54
36870 Percut thrombect av fistula $2,177.25
37140 Revision of circulation $2,163.38
37145 Revision of circulation $2,093.60
37160 Revision of circulation $2,163.38
37180 Revision of circulation $2,163.38
37181 Splice spleen/kidney veins $2,791.46
37182 Insert hepatic shunt (tips) $1,056.37
37183 Remove hepatic shunt (tips) $495.92
37195 Thrombolytic therapy, stroke $488.51
37200 Transcatheter biopsy $450.93
37201 Transcatheter therapy infuse $556.07
37202 Transcatheter therapy infuse $647.79
37203 Transcatheter retrieval $544.35
37204 Transcatheter occlusion $1,798.35
37205 Transcatheter stent $892.88
37206 Transcatheter stent add-on $416.06
37207 Transcatheter stent $872.49
37208 Transcatheter stent add-on $421.53
37209 Exchange arterial catheter $225.61
37250 Iv us first vessel add-on $160.52
37251 Iv us each add vessel add-on $104.68
37500 Endoscopy ligate perf veins $795.96
37501 Vascular endoscopy procedure $0.00
37565 Ligation of neck vein $907.23
37600 Ligation of neck artery $788.57
37605 Ligation of neck artery $892.31
37606 Ligation of neck artery $816.80
37607 Ligation of a-v fistula $725.79
37609 Temporal artery procedure $333.71
37615 Ligation of neck artery $725.79
37616 Ligation of chest artery $1,814.45
37617 Ligation of abdomen artery $1,409.88
37618 Ligation of extremity artery $630.13
37620 Revision of major vein $1,172.51
37650 Revision of major vein $635.05
37660 Revision of major vein $1,344.48
37700 Revise leg vein $436.67
37720 Removal of leg vein $704.09
37730 Removal of leg veins $873.17
37735 Removal of leg veins/lesion $1,214.59
37760 Ligation, leg veins, open $1,196.70
37765 Phleb veins - extrem - to 20 $526.70
37766 Phleb veins - extrem 20+ $643.40
37780 Revision of leg vein $300.65
37785 Ligate/divide/excise vein $394.01
37788 Revascularization, penis $1,402.10
37790 Penile venous occlusion $959.98
37799 Vascular surgery procedure $0.00
38100 Removal of spleen, total $1,564.04
38101 Removal of spleen, partial $1,651.71
38102 Removal of spleen, total $491.52
38115 Repair of ruptured spleen $1,699.08
38120 Laparoscopy, splenectomy $1,850.42
38129 Laparoscope proc, spleen $0.00
38200 Injection for spleen x-ray $263.22
38204 Bl donor search management $223.00
38205 Harvest allogenic stem cells $160.20
38206 Harvest auto stem cells $160.20
38207 Cryopreserve stem cells $361.00
38208 Thaw preserved stem cells $0.00
38209 Wash harvest stem cells $0.00
38210 T-cell depletion of harvest $0.00
38211 Tumor cell deplete of harvst $0.00
38212 Rbc depletion of harvest $0.00
38213 Platelet deplete of harvest $0.00
38214 Volume deplete of harvest $361.00
38215 Harvest stem cell concentrte $0.00
38220 Bone marrow aspiration $258.59
38221 Bone marrow biopsy $235.50
38230 Bone marrow collection $560.62
38240 Bone marrow/stem transplant $241.61
38241 Bone marrow/stem transplant $242.30
38242 Lymphocyte infuse transplant $182.77
38300 Drainage, lymph node lesion $338.20
38305 Drainage, lymph node lesion $675.56
38308 Incision of lymph channels $895.29
38380 Thoracic duct procedure $977.57
38381 Thoracic duct procedure $1,503.60
38382 Thoracic duct procedure $1,197.18
38500 Biopsy/removal, lymph nodes $527.02
38505 Needle biopsy, lymph nodes $235.55
38510 Biopsy/removal, lymph nodes $884.18
38520 Biopsy/removal, lymph nodes $801.90
38525 Biopsy/removal, lymph nodes $703.75
38530 Biopsy/removal, lymph nodes $928.28
38542 Explore deep node(s), neck $771.66
38550 Removal, neck/armpit lesion $819.16
38555 Removal, neck/armpit lesion $1,708.22
38562 Removal, pelvic lymph nodes $1,223.34
38564 Removal, abdomen lymph nodes $1,216.01
38570 Laparoscopy, lymph node biop $997.94
38571 Laparoscopy, lymphadenectomy $1,513.20
38572 Laparoscopy, lymphadenectomy $1,776.57
38589 Laparoscope proc, lymphatic $0.00
38700 Removal of lymph nodes, neck $1,196.25
38720 Removal of lymph nodes, neck $1,819.50
38724 Removal of lymph nodes, neck $1,926.46
38740 Remove armpit lymph nodes $1,120.88
38745 Remove armpit lymph nodes $1,440.29
38746 Remove thoracic lymph nodes $498.57
38747 Remove abdominal lymph nodes $500.65
38760 Remove groin lymph nodes $1,428.75
38765 Remove groin lymph nodes $2,165.94
38770 Remove pelvis lymph nodes $1,427.26
38780 Remove abdomen lymph nodes $1,872.90
38790 Inject for lymphatic x-ray $779.99
38792 Identify sentinel node $70.84
38794 Access thoracic lymph duct $572.84
38999 Blood/lymph system procedure $0.00
39000 Exploration of chest $808.53
39010 Exploration of chest $1,398.48
39200 Removal chest lesion $1,553.34
39220 Removal chest lesion $1,973.98
39400 Visualization of chest $781.93
39499 Chest procedure $0.00
39501 Repair diaphragm laceration $1,489.27
39502 Repair paraesophageal hernia $1,783.25
39503 Repair of diaphragm hernia $5,723.96
39520 Repair of diaphragm hernia $1,834.89
39530 Repair of diaphragm hernia $1,713.52
39531 Repair of diaphragm hernia $1,813.35
39540 Repair of diaphragm hernia $1,483.14
39541 Repair of diaphragm hernia $1,595.15
39545 Revision of diaphragm $1,585.64
39560 Resect diaphragm, simple $1,387.67
39561 Resect diaphragm, complex $2,033.34
39599 Diaphragm surgery procedure $0.00

with 4

40490 Biopsy of lip $132.53
40500 Partial excision of lip $750.15
40510 Partial excision of lip $835.55
40520 Partial excision of lip $870.14
40525 Reconstruct lip with flap $1,066.22
40527 Reconstruct lip with flap $1,255.44
40530 Partial removal of lip $874.38
40650 Repair lip $665.87
40652 Repair lip $781.00
40654 Repair lip $908.62
40700 Repair cleft lip/nasal $1,646.75
40701 Repair cleft lip/nasal $2,050.06
40702 Repair cleft lip/nasal $1,597.24
40720 Repair cleft lip/nasal $1,787.43
40761 Repair cleft lip/nasal $1,900.95
40799 Lip surgery procedure $0.00
40800 Drainage of mouth lesion $190.94
40801 Drainage of mouth lesion $381.87
40804 Removal, foreign body, mouth $190.94
40805 Removal, foreign body, mouth $381.87
40806 Incision of lip fold $118.16
40808 Biopsy of mouth lesion $188.86
40810 Excision of mouth lesion $170.80
40812 Excise/repair mouth lesion $261.99
40814 Excise/repair mouth lesion $496.92
40816 Excision of mouth lesion $622.68
40818 Excise oral mucosa for graft $496.92
40819 Excise lip or cheek fold $383.35
40820 Treatment of mouth lesion $170.53
40830 Repair mouth laceration $209.17
40831 Repair mouth laceration $305.99
40840 Reconstruction of mouth $1,274.46
40842 Reconstruction of mouth $1,275.52
40843 Reconstruction of mouth $1,685.09
40844 Reconstruction of mouth $2,213.08
40845 Reconstruction of mouth $2,535.10
40899 Mouth surgery procedure $0.00
41000 Drainage of mouth lesion $190.94
41005 Drainage of mouth lesion $190.94
41006 Drainage of mouth lesion $332.28
41007 Drainage of mouth lesion $316.30
41008 Drainage of mouth lesion $343.64
41009 Drainage of mouth lesion $367.34
41010 Incision of tongue fold $319.78
41015 Drainage of mouth lesion $405.60
41016 Drainage of mouth lesion $414.04
41017 Drainage of mouth lesion $411.35
41018 Drainage of mouth lesion $476.29
41100 Biopsy of tongue $181.71
41105 Biopsy of tongue $248.01
41108 Biopsy of floor of mouth $172.20
41110 Excision of tongue lesion $174.43
41112 Excision of tongue lesion $343.56
41113 Excision of tongue lesion $343.56
41114 Excision of tongue lesion $1,241.92
41115 Excision of tongue fold $222.94
41116 Excision of mouth lesion $479.95
41120 Partial removal of tongue $1,279.50
41130 Partial removal of tongue $1,440.31
41135 Tongue and neck surgery $2,811.60
41140 Removal of tongue $3,083.39
41145 Tongue removal, neck surgery $3,648.60
41150 Tongue, mouth, jaw surgery $2,853.65
41153 Tongue, mouth, neck surgery $2,941.49
41155 Tongue, jaw, & neck surgery $3,389.25
41250 Repair tongue laceration $267.65
41251 Repair tongue laceration $381.87
41252 Repair tongue laceration $517.80
41500 Fixation of tongue $536.85
41510 Tongue to lip surgery $478.02
41520 Reconstruction, tongue fold $491.97
41599 Tongue and mouth surgery $0.00
41800 Drainage of gum lesion $229.27
41805 Removal foreign body, gum $190.94
41806 Removal foreign body,jawbone $275.62
41820 Excision, gum, each quadrant $763.74
41821 Excision of gum flap $152.60
41822 Excision of gum lesion $278.42
41823 Excision of gum lesion $496.92
41825 Excision of gum lesion $196.25
41826 Excision of gum lesion $266.86
41827 Excision of gum lesion $496.92
41828 Excision of gum lesion $381.87
41830 Removal of gum tissue $381.87
41850 Treatment of gum lesion $114.22
41870 Gum graft $515.66
41872 Repair gum $519.72
41874 Repair tooth socket $554.06
41899 Dental surgery procedure $0.00
42000 Drainage mouth roof lesion $190.94
42100 Biopsy roof of mouth $166.71
42104 Excision lesion, mouth roof $190.94
42106 Excision lesion, mouth roof $343.56
42107 Excision lesion, mouth roof $762.10
42120 Remove palate/lesion $860.97
42140 Excision of uvula $248.01
42145 Repair palate, pharynx/uvula $1,078.79
42160 Treatment mouth roof lesion $232.24
42180 Repair palate $305.99
42182 Repair palate $572.80
42200 Reconstruct cleft palate $1,555.05
42205 Reconstruct cleft palate $1,668.62
42210 Reconstruct cleft palate $1,857.01
42215 Reconstruct cleft palate $1,217.46
42220 Reconstruct cleft palate $928.58
42225 Reconstruct cleft palate $1,269.89
42226 Lengthening of palate $1,318.70
42227 Lengthening of palate $1,244.31
42235 Repair palate $975.51
42260 Repair nose to lip fistula $1,146.45
42280 Preparation, palate mold $154.50
42281 Insertion, palate prosthesis $210.60
42299 Palate/uvula surgery $0.00
42300 Drainage of salivary gland $353.40
42305 Drainage of salivary gland $745.00
42310 Drainage of salivary gland $282.06
42320 Drainage of salivary gland $425.04
42325 Create salivary cyst drain $273.77
42326 Create salivary cyst drain $364.89
42330 Removal of salivary stone $239.25
42335 Removal of salivary stone $525.29
42340 Removal of salivary stone $710.70
42400 Biopsy of salivary gland $181.13
42405 Biopsy of salivary gland $515.66
42408 Excision of salivary cyst $700.02
42409 Drainage of salivary cyst $462.48
42410 Excise parotid gland/lesion $1,185.76
42415 Excise parotid gland/lesion $2,086.37
42420 Excise parotid gland/lesion $2,399.84
42425 Excise parotid gland/lesion $1,635.69
42426 Excise parotid gland/lesion $2,574.78
42440 Excise submaxillary gland $889.37
42450 Excise sublingual gland $748.00
42500 Repair salivary duct $708.62
42505 Repair salivary duct $953.98
42507 Parotid duct diversion $840.96
42508 Parotid duct diversion $1,188.51
42509 Parotid duct diversion $1,491.39
42510 Parotid duct diversion $1,052.18
42550 Injection for salivary x-ray $596.54
42600 Closure of salivary fistula $774.64
42650 Dilation of salivary duct $95.48
42660 Dilation of salivary duct $114.22
42665 Ligation of salivary duct $305.99
42699 Salivary surgery procedure $0.00
42700 Drainage of tonsil abscess $314.42
42720 Drainage of throat abscess $496.92
42725 Drainage of throat abscess $1,241.92
42800 Biopsy of throat $172.20
42802 Biopsy of throat $286.41
42804 Biopsy of upper nose/throat $221.82
42806 Biopsy of upper nose/throat $243.46
42808 Excise pharynx lesion $397.20
42809 Remove pharynx foreign body $248.01
42810 Excision of neck cyst $586.21
42815 Excision of neck cyst $922.31
42820 Remove tonsils and adenoids $541.80
42821 Remove tonsils and adenoids $585.32
42825 Removal of tonsils $493.16
42826 Removal of tonsils $482.26
42830 Removal of adenoids $379.84
42831 Removal of adenoids $407.16
42835 Removal of adenoids $359.34
42836 Removal of adenoids $462.91
42842 Extensive surgery of throat $1,142.82
42844 Extensive surgery of throat $1,800.51
42845 Extensive surgery of throat $2,992.70
42860 Excision of tonsil tags $349.92
42870 Excision of lingual tonsil $748.06
42890 Partial removal of pharynx $1,645.56
42892 Revision of pharyngeal walls $1,977.34
42894 Revision of pharyngeal walls $2,811.76
42900 Repair throat wound $662.15
42950 Reconstruction of throat $1,082.52
42953 Repair throat, esophagus $1,216.94
42955 Surgical opening of throat $961.33
42960 Control throat bleeding $318.89
42961 Control throat bleeding $460.24
42962 Control throat bleeding $687.86
42970 Control nose/throat bleeding $630.71
42971 Control nose/throat bleeding $745.00
42972 Control nose/throat bleeding $917.13
42999 Throat surgery procedure $0.00
43020 Incision of esophagus $1,024.61
43030 Throat muscle surgery $998.89
43045 Incision of esophagus $2,329.82
43100 Excision of esophagus lesion $1,149.77
43101 Excision of esophagus lesion $1,832.62
43107 Removal of esophagus $4,298.68
43108 Removal of esophagus $3,690.25
43112 Removal of esophagus $4,650.80
43113 Removal of esophagus $3,855.49
43116 Partial removal of esophagus $3,593.30
43117 Partial removal of esophagus $4,255.26
43118 Partial removal of esophagus $3,577.46
43121 Partial removal of esophagus $3,196.85
43122 Partial removal of esophagus $4,252.90
43123 Partial removal of esophagus $3,615.60
43124 Removal of esophagus $3,065.22
43130 Removal of esophagus pouch $1,444.45
43135 Removal of esophagus pouch $1,839.02
43200 Esophagus endoscopy $399.28
43201 Esoph scope w/submucous inj $484.46
43202 Esophagus endoscopy, biopsy $516.35
43204 Esoph scope w/sclerosis inj $394.35
43205 Esophagus endoscopy/ligation $396.19
43215 Esophagus endoscopy $285.35
43216 Esophagus endoscopy/lesion $266.63
43217 Esophagus endoscopy $691.25
43219 Esophagus endoscopy $309.93
43220 Esoph endoscopy, dilation $229.78
43226 Esoph endoscopy, dilation $252.52
43227 Esoph endoscopy, repair $376.83
43228 Esoph endoscopy, ablation $399.84
43231 Esoph endoscopy w/us exam $338.01
43232 Esoph endoscopy w/us fn bx $471.11
43234 Upper GI endoscopy, exam $514.29
43235 Uppr gi endoscopy, diagnosis $530.96
43236 Uppr gi scope w/submuc inj $659.01
43237 Endoscopic us exam, esoph $401.44
43238 Uppr gi endoscopy w/us fn bx $477.35
43239 Upper GI endoscopy, biopsy $604.33
43240 Esoph endoscope w/drain cyst $708.71
43241 Upper GI endoscopy with tube $277.72
43242 Uppr gi endoscopy w/us fn bx $748.53
43243 Upper gi endoscopy & inject $475.77
43244 Upper GI endoscopy/ligation $523.32
43245 Uppr gi scope dilate strictr $337.27
43246 Place gastrostomy tube $452.33
43247 Operative upper GI endoscopy $357.37
43248 Uppr gi endoscopy/guide wire $334.34
43249 Esoph endoscopy, dilation $308.79
43250 Upper GI endoscopy/tumor $339.10
43251 Operative upper GI endoscopy $388.77
43255 Operative upper GI endoscopy $499.60
43256 Uppr gi endoscopy w stent $455.55
43258 Operative upper GI endoscopy $474.96
43259 Endoscopic ultrasound exam $537.27
43260 Endo cholangiopancreatograph $614.67
43261 Endo cholangiopancreatograph $646.08
43262 Endo cholangiopancreatograph $758.62
43263 Endo cholangiopancreatograph $746.69
43264 Endo cholangiopancreatograph $911.30
43265 Endo cholangiopancreatograph $1,021.04
43267 Endo cholangiopancreatograph $757.93
43268 Endo cholangiopancreatograph $764.82
43269 Endo cholangiopancreatograph $837.42
43271 Endo cholangiopancreatograph $757.93
43272 Endo cholangiopancreatograph $758.62
43280 Laparoscopy, fundoplasty $1,863.24
43289 Laparoscope proc, esoph $0.00
43300 Repair of esophagus $1,165.30
43305 Repair esophagus and fistula $2,094.77
43310 Repair of esophagus $2,792.30
43312 Repair esophagus and fistula $3,085.32
43313 Esophagoplasty congenital $4,987.88
43314 Tracheo-esophagoplasty cong $5,494.69
43320 Fuse esophagus & stomach $2,190.08
43324 Revise esophagus & stomach $2,212.03
43325 Revise esophagus & stomach $2,172.58
43326 Revise esophagus & stomach $2,190.99
43330 Repair of esophagus $2,128.23
43331 Repair of esophagus $2,257.62
43340 Fuse esophagus & intestine $2,147.26
43341 Fuse esophagus & intestine $2,335.79
43350 Surgical opening, esophagus $1,809.74
43351 Surgical opening, esophagus $2,108.60
43352 Surgical opening, esophagus $1,772.61
43360 Gastrointestinal repair $3,829.31
43361 Gastrointestinal repair $4,334.60
43400 Ligate esophagus veins $2,270.91
43401 Esophagus surgery for veins $2,377.17
43405 Ligate/staple esophagus $2,221.86
43410 Repair esophagus wound $1,581.48
43415 Repair esophagus wound $2,755.83
43420 Repair esophagus opening $1,620.74
43425 Repair esophagus opening $2,342.71
43450 Dilate esophagus $279.30
43453 Dilate esophagus $525.85
43456 Dilate esophagus $763.74
43458 Dilate esophagus $686.67
43460 Pressure treatment esophagus $394.17
43496 Free jejunum flap, microvasc $9,551.73
43499 Esophagus surgery procedure $0.00
43500 Surgical opening of stomach $1,202.53
43501 Surgical repair of stomach $2,133.93
43502 Surgical repair of stomach $2,455.50
43510 Surgical opening of stomach $1,466.34
43520 Incision of pyloric muscle $1,144.78
43600 Biopsy of stomach $218.00
43605 Biopsy of stomach $1,297.78
43610 Excision of stomach lesion $1,562.59
43611 Excision of stomach lesion $1,910.81
43620 Removal of stomach $3,151.35
43621 Removal of stomach $3,219.04
43622 Removal of stomach $3,399.57
43631 Removal of stomach, partial $2,401.04
43632 Removal of stomach, partial $2,401.38
43633 Removal of stomach, partial $2,452.53
43634 Removal of stomach, partial $2,661.13
43635 Removal of stomach, partial $210.59
43638 Removal of stomach, partial $3,077.20
43639 Removal of stomach, partial $3,115.05
43640 Vagotomy & pylorus repair $1,833.71
43641 Vagotomy & pylorus repair $1,860.98
43651 Laparoscopy, vagus nerve $1,129.44
43652 Laparoscopy, vagus nerve $1,329.35
43653 Laparoscopy, gastrostomy $899.26
43659 Laparoscope proc, stom $0.00
43750 Place gastrostomy tube $535.53
43752 Nasal/orogastric w/stent $69.37
43760 Change gastrostomy tube $198.49
43761 Reposition gastrostomy tube $208.60
43800 Reconstruction of pylorus $1,473.99
43810 Fusion of stomach and bowel $1,567.02
43820 Fusion of stomach and bowel $1,639.01
43825 Fusion of stomach and bowel $2,049.98
43830 Place gastrostomy tube $1,075.34
43831 Place gastrostomy tube $930.87
43832 Place gastrostomy tube $1,685.11
43840 Repair of stomach lesion $1,679.02
43842 Gastroplasty for obesity $2,000.51
43843 Gastroplasty for obesity $2,012.92
43846 Gastric bypass for obesity $2,587.81
43847 Gastric bypass for obesity $2,875.07
43848 Revision gastroplasty $3,133.83
43850 Revise stomach-bowel fusion $2,604.10
43855 Revise stomach-bowel fusion $2,748.12
43860 Revise stomach-bowel fusion $2,638.43
43865 Revise stomach-bowel fusion $2,793.22
43870 Repair stomach opening $1,065.60
43880 Repair stomach-bowel fistula $2,604.39
43999 Stomach surgery procedure $0.00
44005 Freeing of bowel adhesion $1,734.18
44010 Incision of small bowel $1,355.64
44015 Insert needle cath bowel $267.21
44020 Explore small intestine $1,504.63
44021 Decompress small bowel $1,513.08
44025 Incision of large bowel $1,532.83
44050 Reduce bowel obstruction $1,506.94
44055 Correct malrotation of bowel $2,299.61
44100 Biopsy of bowel $230.63
44110 Excise intestine lesion(s) $1,284.73
44111 Excision of bowel lesion(s) $1,540.80
44120 Removal of small intestine $1,817.77
44121 Removal of small intestine $455.75
44125 Removal of small intestine $1,872.55
44126 Enterectomy w/o taper, cong $3,636.88
44127 Enterectomy w/taper, cong $4,161.13
44128 Enterectomy cong, add-on $456.09
44130 Bowel to bowel fusion $1,562.27
44132 Enterectomy, cadaver donor $0.00
44133 Enterectomy, live donor $0.00
44135 Intestine transplnt, cadaver No Data
44136 Intestine transplant, live $0.00
44139 Mobilization of colon $227.42
44140 Partial removal of colon $2,252.67
44141 Partial removal of colon $2,234.04
44143 Partial removal of colon $2,541.75
44144 Partial removal of colon $2,350.81
44145 Partial removal of colon $2,810.18
44146 Partial removal of colon $3,038.06
44147 Partial removal of colon $2,218.00
44150 Removal of colon $2,707.35
44151 Removal of colon/ileostomy $3,018.08
44152 Removal of colon/ileostomy $2,977.07
44153 Removal of colon/ileostomy $3,379.34
44155 Removal of colon/ileostomy $3,096.37
44156 Removal of colon/ileostomy $3,432.51
44160 Removal of colon $2,002.01
44200 Laparoscopy, enterolysis $1,566.07
44201 Laparoscopy, jejunostomy $1,093.27
44202 Lap resect s/intestine singl $2,351.33
44203 Lap resect s/intestine, addl $453.68
44204 Laparo partial colectomy $2,663.93
44205 Lap colectomy part w/ileum $2,361.37
44206 Lap part colectomy w/stoma $2,879.69
44207 L colectomy/coloproctostomy $3,127.09
44208 L colectomy/coloproctostomy $3,390.33
44210 Laparo total proctocolectomy $3,000.84
44211 Laparo total proctocolectomy $3,721.05
44212 Laparo total proctocolectomy $3,472.41
44238 Laparoscope proc, intestine $0.00
44239 Laparoscope proc, rectum $0.00
44300 Open bowel to skin $1,319.89
44310 Ileostomy/jejunostomy $1,699.55
44312 Revision of ileostomy $687.86
44314 Revision of ileostomy $1,617.56
44316 Devise bowel pouch $2,223.03
44320 Colostomy $1,898.64
44322 Colostomy with biopsies $1,540.78
44340 Revision of colostomy $630.71
44345 Revision of colostomy $1,673.80
44346 Revision of colostomy $1,827.74
44360 Small bowel endoscopy $276.35
44361 Small bowel endoscopy/biopsy $303.80
44363 Small bowel endoscopy $364.89
44364 Small bowel endoscopy $391.76
44365 Small bowel endoscopy $349.73
44366 Small bowel endoscopy $459.00
44369 Small bowel endoscopy $467.56
44370 Small bowel endoscopy/stent $503.27
44372 Small bowel endoscopy $460.37
44373 Small bowel endoscopy $368.33
44376 Small bowel endoscopy $544.49
44377 Small bowel endoscopy/biopsy $571.89
44378 Small bowel endoscopy $733.69
44379 S bowel endoscope w/stent $774.57
44380 Small bowel endoscopy $120.39
44382 Small bowel endoscopy $143.36
44383 Ileoscopy w/stent $313.16
44385 Endoscopy of bowel pouch $483.58
44386 Endoscopy, bowel pouch/biop $612.69
44388 Colonoscopy $572.01
44389 Colonoscopy with biopsy $688.11
44390 Colonoscopy for foreign body $759.94
44391 Colonoscopy for bleeding $924.25
44392 Colonoscopy & polypectomy $743.70
44393 Colonoscopy, lesion removal $847.06
44394 Colonoscopy w/snare $874.28
44397 Colonoscopy w/stent $504.46
44500 Intro, gastrointestinal tube $62.06
44602 Suture, small intestine $1,681.78
44603 Suture, small intestine $1,952.07
44604 Suture, large intestine $1,700.99
44605 Repair of bowel lesion $2,102.38
44615 Intestinal stricturoplasty $1,708.33
44620 Repair bowel opening $1,322.11
44625 Repair bowel opening $1,613.37
44626 Repair bowel opening $2,674.86
44640 Repair bowel-skin fistula $2,268.28
44650 Repair bowel fistula $2,359.70
44660 Repair bowel-bladder fistula $2,218.11
44661 Repair bowel-bladder fistula $2,574.07
44680 Surgical revision, intestine $1,651.20
44700 Suspend bowel w/prosthesis $1,712.17
44701 Intraop colon lavage add-on $313.04
44799 Unlisted procedure intestine $0.00
44800 Excision of bowel pouch $1,256.89
44820 Excision of mesentery lesion $1,324.57
44850 Repair of mesentery $1,188.31
44899 Bowel surgery procedure $0.00
44900 Drain app abscess, open $1,116.68
44901 Drain app abscess, percut $335.96
44950 Appendectomy $1,081.83
44955 Appendectomy add-on $114.22
44960 Appendectomy $1,335.31
44970 Laparoscopy, appendectomy $976.49
44979 Laparoscope proc, app $0.00
45000 Drainage of pelvic abscess $557.38
45005 Drainage of rectal abscess $458.59
45020 Drainage of rectal abscess $596.41
45100 Biopsy of rectum $452.32
45108 Removal of anorectal lesion $573.91
45110 Removal of rectum $3,042.11
45111 Partial removal of rectum $1,791.71
45112 Removal of rectum $3,187.64
45113 Partial proctectomy $3,241.62
45114 Partial removal of rectum $2,889.43
45116 Partial removal of rectum $2,609.13
45119 Remove rectum w/reservoir $3,250.71
45120 Removal of rectum $2,629.85
45121 Removal of rectum and colon $2,895.99
45123 Partial proctectomy $1,763.49
45126 Pelvic exenteration $4,835.08
45130 Excision of rectal prolapse $1,740.61
45135 Excision of rectal prolapse $2,084.06
45136 Excise ileoanal reservior $3,010.06
45150 Excision of rectal stricture $646.68
45160 Excision of rectal lesion $1,646.66
45170 Excision of rectal lesion $753.62
45190 Destruction, rectal tumor $1,080.34
45300 Proctosigmoidoscopy dx $131.64
45303 Proctosigmoidoscopy dilate $807.70
45305 Proctosigmoidoscopy w/bx $229.27
45307 Proctosigmoidoscopy fb $282.91
45308 Proctosigmoidoscopy removal $201.03
45309 Proctosigmoidoscopy removal $348.01
45315 Proctosigmoidoscopy removal $305.55
45317 Proctosigmoidoscopy bleed $284.10
45320 Proctosigmoidoscopy ablate $321.75
45321 Proctosigmoidoscopy volvul $134.50
45327 Proctosigmoidoscopy w/stent $175.52
45330 Diagnostic sigmoidoscopy $225.21
45331 Sigmoidoscopy and biopsy $288.97
45332 Sigmoidoscopy w/fb removal $381.87
45333 Sigmoidoscopy & polypectomy $381.87
45334 Sigmoidoscopy for bleeding $291.62
45335 Sigmoidoscopy w/submuc inj $343.56
45337 Sigmoidoscopy & decompress $254.69
45338 Sigmoidoscopy w/tumr remove $522.49
45339 Sigmoidoscopy w/ablate tumr $471.64
45340 Sig w/balloon dilation $381.87
45341 Sigmoidoscopy w/ultrasound $279.49
45342 Sigmoidoscopy w/us guide bx $422.19
45345 Sigmoidoscopy w/stent $306.84
45355 Surgical colonoscopy $369.12
45378 Diagnostic colonoscopy $699.63
45379 Colonoscopy w/fb removal $880.27
45380 Colonoscopy and biopsy $826.15
45381 Colonoscopy, submucous inj $881.90
45382 Colonoscopy/control bleeding $1,104.69
45383 Lesion removal colonoscopy $991.44
45384 Lesion remove colonoscopy $820.77
45385 Lesion removal colonoscopy $936.89
45386 Colonoscopy dilate stricture $1,289.64
45387 Colonoscopy w/stent $616.09
45500 Repair of rectum $814.11
45505 Repair of rectum $852.30
45520 Treatment of rectal prolapse $101.31
45540 Correct rectal prolapse $1,734.11
45541 Correct rectal prolapse $1,448.58
45550 Repair rectum/remove sigmoid $2,420.36
45560 Repair of rectocele $1,171.24
45562 Exploration/repair of rectum $1,680.04
45563 Exploration/repair of rectum $2,556.22
45800 Repair rect/bladder fistula $1,888.06
45805 Repair fistula w/colostomy $2,271.13
45820 Repair rectourethral fistula $1,956.23
45825 Repair fistula w/colostomy $2,307.01
45900 Reduction of rectal prolapse $306.75
45905 Dilation of anal sphincter $276.03
45910 Dilation of rectal narrowing $329.21
45915 Remove rectal obstruction $567.34
45999 Rectum surgery procedure $0.00
46020 Placement of seton $382.79
46030 Removal of rectal marker $152.60
46040 Incision of rectal abscess $586.55
46045 Incision of rectal abscess $539.34
46050 Incision of anal abscess $195.70
46060 Incision of rectal abscess $672.95
46070 Incision of anal septum $343.12
46080 Incision of anal sphincter $342.42
46083 Incise external hemorrhoid $281.47
46200 Removal of anal fissure $517.59
46210 Removal of anal crypt $381.87
46211 Removal of anal crypts $681.80
46220 Removal of anal tag $167.17
46221 Ligation of hemorrhoid(s) $268.67
46230 Removal of anal tags $246.28
46250 Hemorrhoidectomy $642.17
46255 Hemorrhoidectomy $735.80
46257 Remove hemorrhoids & fissure $627.19
46258 Remove hemorrhoids & fistula $681.43
46260 Hemorrhoidectomy $727.49
46261 Remove hemorrhoids & fissure $808.73
46262 Remove hemorrhoids & fistula $851.79
46270 Removal of anal fistula $612.62
46275 Removal of anal fistula $656.41
46280 Removal of anal fistula $694.27
46285 Removal of anal fistula $496.92
46288 Repair anal fistula $812.49
46320 Removal of hemorrhoid clot $272.02
46500 Injection into hemorrhoid(s) $190.27
46600 Diagnostic anoscopy $88.70
46604 Anoscopy and dilation $445.14
46606 Anoscopy and biopsy $210.50
46608 Anoscopy, remove for body $401.44
46610 Anoscopy, remove lesion $343.56
46611 Anoscopy $371.98
46612 Anoscopy, remove lesions $477.35
46614 Anoscopy, control bleeding $312.90
46615 Anoscopy $383.23
46700 Repair of anal stricture $996.27
46705 Repair of anal stricture $802.86
46706 Repr of anal fistula w/glue $271.04
46715 Repair of anovaginal fistula $819.06
46716 Repair of anovaginal fistula $1,727.09
46730 Construction of absent anus $2,907.50
46735 Construction of absent anus $3,442.54
46740 Construction of absent anus $3,229.03
46742 Repair of imperforated anus $3,985.91
46744 Repair of cloacal anomaly $5,475.63
46746 Repair of cloacal anomaly $6,179.73
46748 Repair of cloacal anomaly $6,541.20
46750 Repair of anal sphincter $1,143.51
46751 Repair of anal sphincter $1,065.73
46753 Reconstruction of anus $909.44
46754 Removal of suture from anus $416.26
46760 Repair of anal sphincter $1,601.24
46761 Repair of anal sphincter $1,483.86
46762 Implant artificial sphincter $1,359.91
46900 Destruction, anal lesion(s) $235.11
46910 Destruction, anal lesion(s) $197.54
46916 Cryosurgery, anal lesion(s) $214.49
46917 Laser surgery, anal lesions $466.06
46922 Excision of anal lesion(s) $224.81
46924 Destruction, anal lesion(s) $812.64
46934 Destruction of hemorrhoids $616.93
46935 Destruction of hemorrhoids $255.71
46936 Destruction of hemorrhoids $356.12
46937 Cryotherapy of rectal lesion $267.65
46938 Cryotherapy of rectal lesion $654.24
46940 Treatment of anal fissure $317.46
46942 Treatment of anal fissure $284.85
46945 Ligation of hemorrhoids $388.33
46946 Ligation of hemorrhoids $489.02
46999 Anus surgery procedure $0.00
47000 Needle biopsy of liver $370.10
47001 Needle biopsy, liver add-on $194.18
47010 Open drainage, liver lesion $1,809.45
47011 Percut drain, liver lesion $366.06
47015 Inject/aspirate liver cyst $1,683.00
47100 Wedge biopsy of liver $1,320.80
47120 Partial removal of liver $3,793.85
47122 Extensive removal of liver $5,748.15
47125 Partial removal of liver $5,153.93
47130 Partial removal of liver $5,577.03
47133 Removal of donor liver $8,787.99
47134 Partial removal, donor liver $4,004.78
47135 Transplantation of liver $8,622.80
47136 Transplantation of liver $7,295.15
47140 Partial removal, donor liver $5,539.60
47141 Partial removal, donor liver $6,686.07
47142 Partial removal, donor liver $7,355.13
47300 Surgery for liver lesion $1,666.62
47350 Repair liver wound $2,124.99
47360 Repair liver wound $2,881.35
47361 Repair liver wound $4,925.35
47362 Repair liver wound $2,036.26
47370 Laparo ablate liver tumor rf $2,066.60
47371 Laparo ablate liver cryosurg $2,067.29
47379 Laparoscope procedure, liver $0.00
47380 Open ablate liver tumor rf $2,397.09
47381 Open ablate liver tumor cryo $2,435.15
47382 Percut ablate liver rf $1,599.76
47399 Liver surgery procedure $0.00
47400 Incision of liver duct $3,430.78
47420 Incision of bile duct $2,159.82
47425 Incision of bile duct $2,155.41
47460 Incise bile duct sphincter $1,976.03
47480 Incision of gallbladder $1,252.83
47490 Incision of gallbladder $954.26
47500 Injection for liver x-rays $194.20
47505 Injection for liver x-rays $237.13
47510 Insert catheter, bile duct $943.63
47511 Insert bile duct drain $1,152.58
47525 Change bile duct catheter $630.71
47530 Revise/reinsert bile tube $745.53
47550 Bile duct endoscopy add-on $308.77
47552 Biliary endoscopy thru skin $633.01
47553 Biliary endoscopy thru skin $664.79
47554 Biliary endoscopy thru skin $939.03
47555 Biliary endoscopy thru skin $785.43
47556 Biliary endoscopy thru skin $883.51
47560 Laparoscopy w/cholangio $510.63
47561 Laparo w/cholangio/biopsy $552.94
47562 Laparoscopic cholecystectomy $1,217.52
47563 Laparo cholecystectomy/graph $1,306.45
47564 Laparo cholecystectomy/explr $1,531.80
47570 Laparo cholecystoenterostomy $1,361.80
47579 Laparoscope proc, biliary $0.00
47600 Removal of gallbladder $1,487.45
47605 Removal of gallbladder $1,598.20
47610 Removal of gallbladder $2,019.75
47612 Removal of gallbladder $2,012.97
47620 Removal of gallbladder $2,203.48
47630 Remove bile duct stone $1,028.87
47700 Exploration of bile ducts $1,737.85
47701 Bile duct revision $2,995.08
47711 Excision of bile duct tumor $2,488.63
47712 Excision of bile duct tumor $3,225.43
47715 Excision of bile duct cyst $2,051.99
47716 Fusion of bile duct cyst $1,826.97
47720 Fuse gallbladder & bowel $1,762.27
47721 Fuse upper gi structures $2,087.24
47740 Fuse gallbladder & bowel $2,025.34
47741 Fuse gallbladder & bowel $2,310.48
47760 Fuse bile ducts and bowel $2,770.72
47765 Fuse liver ducts & bowel $2,694.85
47780 Fuse bile ducts and bowel $2,846.44
47785 Fuse bile ducts and bowel $3,331.42
47800 Reconstruction of bile ducts $2,515.68
47801 Placement, bile duct support $1,733.29
47802 Fuse liver duct & intestine $2,355.07
47900 Suture bile duct injury $2,166.83
47999 Bile tract surgery procedure $0.00
48000 Drainage of abdomen $2,944.92
48001 Placement of drain, pancreas $3,682.44
48005 Resect/debride pancreas $4,221.86
48020 Removal of pancreatic stone $1,733.16
48100 Biopsy of pancreas, open $1,345.34
48102 Needle biopsy, pancreas $745.00
48120 Removal of pancreas lesion $1,713.04
48140 Partial removal of pancreas $2,459.51
48145 Partial removal of pancreas $2,565.89
48146 Pancreatectomy $2,901.25
48148 Removal of pancreatic duct $1,887.88
48150 Partial removal of pancreas $5,115.10
48152 Pancreatectomy $4,693.49
48153 Pancreatectomy $5,112.06
48154 Pancreatectomy $4,723.06
48155 Removal of pancreas $2,745.75
48160 Pancreas removal/transplant $0.00
48180 Fuse pancreas and bowel $2,639.17
48400 Injection, intraop add-on $193.79
48500 Surgery of pancreatic cyst $1,704.90
48510 Drain pancreatic pseudocyst $1,630.45
48511 Drain pancreatic pseudocyst $395.34
48520 Fuse pancreas cyst and bowel $1,685.69
48540 Fuse pancreas cyst and bowel $2,107.57
48545 Pancreatorrhaphy $1,976.09
48547 Duodenal exclusion $2,747.18
48550 Donor pancreatectomy $5,731.37
48554 Transpl allograft pancreas $3,876.81
48556 Removal, allograft pancreas $1,805.14
48999 Pancreas surgery procedure $0.00
49000 Exploration of abdomen $1,292.20
49002 Reopening of abdomen $1,174.79
49010 Exploration behind abdomen $1,375.56
49020 Drain abdominal abscess $2,319.58
49021 Drain abdominal abscess $335.28
49040 Drain, open, abdom abscess $1,488.19
49041 Drain, percut, abdom abscess $395.69
49060 Drain, open, retrop abscess $1,729.72
49061 Drain, percut, retroper absc $366.06
49062 Drain to peritoneal cavity $1,270.05
49080 Puncture, peritoneal cavity $294.05
49081 Removal of abdominal fluid $248.01
49085 Remove abdomen foreign body $1,324.20
49180 Biopsy, abdominal mass $361.20
49200 Removal of abdominal lesion $1,151.73
49201 Remove abdom lesion, complex $1,656.18
49215 Excise sacral spine tumor $3,570.46
49220 Multiple surgery, abdomen $1,632.66
49250 Excision of umbilicus $955.53
49255 Removal of omentum $1,266.35
49320 Diag laparo separate proc $582.42
49321 Laparoscopy, biopsy $606.89
49322 Laparoscopy, aspiration $654.41
49323 Laparo drain lymphocele $1,054.71
49329 Laparo proc, abdm/per/oment $0.00
49400 Air injection into abdomen $199.24
49419 Insrt abdom cath for chemotx $763.57
49420 Insert abdom drain, temp $248.37
49421 Insert abdom drain, perm $655.89
49422 Remove perm cannula/catheter $692.37
49423 Exchange drainage catheter $157.90
49424 Assess cyst, contrast inject $88.42
49425 Insert abdomen-venous drain $1,286.60
49426 Revise abdomen-venous shunt $1,088.62
49427 Injection, abdominal shunt $101.57
49428 Ligation of shunt $690.98
49429 Removal of shunt $822.28
49491 Rpr hern preemie reduc $1,224.29
49492 Rpr ing hern premie, blocked $1,529.60
49495 Rpr ing hernia baby, reduc $669.63
49496 Rpr ing hernia baby, blocked $994.57
49500 Rpr ing hernia, init, reduce $644.20
49501 Rpr ing hernia, init blocked $985.82
49505 Prp i/hern init reduc>5 yr $875.80
49507 Prp i/hern init block>5 yr $1,060.75
49520 Rerepair ing hernia, reduce $1,062.13
49521 Rerepair ing hernia, blocked $1,298.74
49525 Repair ing hernia, sliding $954.07
49540 Repair lumbar hernia $1,142.91
49550 Rpr rem hernia, init, reduce $960.96
49553 Rpr fem hernia, init blocked $1,045.53
49555 Rerepair fem hernia, reduce $1,003.56
49557 Rerepair fem hernia, blocked $1,217.55
49560 Rpr ventral hern init, reduc $1,262.68
49561 Rpr ventral hern init, block $1,534.03
49565 Rerepair ventrl hern, reduce $1,267.50
49566 Rerepair ventrl hern, block $1,550.73
49568 Hernia repair w/mesh $500.65
49570 Rpr epigastric hern, reduce $665.04
49572 Rpr epigastric hern, blocked $766.78
49580 Rpr umbil hern, reduc <> 5 yr $717.06
49587 Rpr umbil hern, block > 5 yr $850.78
49590 Repair spigilian hernia $951.83
49600 Repair umbilical lesion $1,234.66
49605 Repair umbilical lesion $6,456.80
49606 Repair umbilical lesion $2,013.54
49610 Repair umbilical lesion $1,176.62
49611 Repair umbilical lesion $1,191.25
49650 Laparo hernia repair initial $716.24
49651 Laparo hernia repair recur $930.79
49659 Laparo proc, hernia repair $0.00
49900 Repair of abdominal wall $1,398.62
49904 Omental flap, extra-abdom $2,638.64
49905 Omental flap, intra-abdom $672.09
49906 Free omental flap, microvasc $6,113.26
49999 Abdomen surgery procedure $0.00


with 5

50010 Exploration of kidney $1,224.17
50020 Renal abscess, open drain $1,732.71
50021 Renal abscess, percut drain $334.25
50040 Drainage of kidney $1,727.80
50045 Exploration of kidney $1,665.03
50060 Removal of kidney stone $2,038.81
50065 Incision of kidney $2,026.49
50070 Incision of kidney $2,144.57
50075 Removal of kidney stone $2,653.24
50080 Removal of kidney stone $1,673.09
50081 Removal of kidney stone $2,392.08
50100 Revise kidney blood vessels $1,818.00
50120 Exploration of kidney $1,709.31
50125 Explore and drain kidney $1,766.56
50130 Removal of kidney stone $1,839.85
50135 Exploration of kidney $2,028.12
50200 Biopsy of kidney $263.16
50205 Biopsy of kidney $1,242.58
50220 Remove kidney, open $1,838.66
50225 Removal kidney open, complex $2,136.12
50230 Removal kidney open, radical $2,309.65
50234 Removal of kidney & ureter $2,349.44
50236 Removal of kidney & ureter $2,701.05
50240 Partial removal of kidney $2,419.74
50280 Removal of kidney lesion $1,683.83
50290 Removal of kidney lesion $1,602.25
50300 Removal of donor kidney $13,324.12
50320 Removal of donor kidney $2,415.73
50340 Removal of kidney $1,430.58
50360 Transplantation of kidney $3,558.55
50365 Transplantation of kidney $4,166.46
50370 Remove transplanted kidney $1,592.90
50380 Reimplantation of kidney $2,535.34
50390 Drainage of kidney lesion $194.20
50392 Insert kidney drain $334.25
50393 Insert ureteral tube $410.39
50394 Injection for kidney x-ray $140.01
50395 Create passage to kidney $333.90
50396 Measure kidney pressure $177.41
50398 Change kidney tube $193.70
50400 Revision of kidney/ureter $2,035.48
50405 Revision of kidney/ureter $2,560.69
50500 Repair of kidney wound $2,122.94
50520 Close kidney-skin fistula $1,938.94
50525 Repair renal-abdomen fistula $2,422.67
50526 Repair renal-abdomen fistula $2,606.63
50540 Revision of horseshoe kidney $2,127.48
50541 Laparo ablate renal cyst $1,675.42
50542 Laparo ablate renal mass $2,107.22
50543 Laparo partial nephrectomy $2,664.52
50544 Laparoscopy, pyeloplasty $2,311.90
50545 Laparo radical nephrectomy $2,480.53
50546 Laparoscopic nephrectomy $2,155.11
50547 Laparo removal donor kidney $2,704.33
50548 Laparo remove w/ ureter $2,508.00
50549 Laparoscope proc, renal $0.00
50551 Kidney endoscopy $769.89
50553 Kidney endoscopy $1,740.88
50555 Kidney endoscopy & biopsy $1,822.50
50557 Kidney endoscopy & treatment $1,889.47
50559 Renal endoscopy/radiotracer $667.64
50561 Kidney endoscopy & treatment $1,802.16
50562 Renal scope w/tumor resect $1,112.96
50570 Kidney endoscopy $945.64
50572 Kidney endoscopy $1,027.05
50574 Kidney endoscopy & biopsy $1,093.95
50575 Kidney endoscopy $1,385.53
50576 Kidney endoscopy & treatment $1,088.27
50578 Renal endoscopy/radiotracer $1,124.44
50580 Kidney endoscopy & treatment $1,174.57
50590 Fragmenting of kidney stone $1,441.84
50600 Exploration of ureter $1,703.41
50605 Insert ureteral support $1,681.55
50610 Removal of ureter stone $1,730.36
50620 Removal of ureter stone $1,624.07
50630 Removal of ureter stone $1,603.17
50650 Removal of ureter $1,858.44
50660 Removal of ureter $2,074.33
50684 Injection for ureter x-ray $670.43
50686 Measure ureter pressure $258.29
50688 Change of ureter tube $210.26
50690 Injection for ureter x-ray $707.77
50700 Revision of ureter $1,672.56
50715 Release of ureter $2,100.41
50722 Release of ureter $1,830.58
50725 Release/revise ureter $2,010.28
50727 Revise ureter $989.36
50728 Revise ureter $1,395.10
50740 Fusion of ureter & kidney $1,983.01
50750 Fusion of ureter & kidney $2,075.47
50760 Fusion of ureters $1,972.38
50770 Splicing of ureters $2,074.44
50780 Reimplant ureter in bladder $1,959.65
50782 Reimplant ureter in bladder $2,180.32
50783 Reimplant ureter in bladder $2,231.95
50785 Reimplant ureter in bladder $2,174.63
50800 Implant ureter in bowel $1,602.09
50810 Fusion of ureter & bowel $2,227.58
50815 Urine shunt to intestine $2,155.02
50820 Construct bowel bladder $2,318.58
50825 Construct bowel bladder $2,978.17
50830 Revise urine flow $3,294.57
50840 Replace ureter by bowel $2,158.19
50845 Appendico-vesicostomy $2,220.52
50860 Transplant ureter to skin $1,661.71
50900 Repair of ureter $1,493.91
50920 Closure ureter/skin fistula $1,570.71
50930 Closure ureter/bowel fistula $2,024.34
50940 Release of ureter $1,581.36
50945 Laparoscopy ureterolithotomy $1,794.07
50947 Laparo new ureter/bladder $2,573.90
50948 Laparo new ureter/bladder $2,347.18
50949 Laparoscope proc, ureter $0.00
50951 Endoscopy of ureter $817.41
50953 Endoscopy of ureter $1,110.08
50955 Ureter endoscopy & biopsy $1,158.72
50957 Ureter endoscopy & treatment $1,154.97
50959 Ureter endoscopy & tracer $429.69
50961 Ureter endoscopy & treatment $1,331.43
50970 Ureter endoscopy $708.61
50972 Ureter endoscopy & catheter $686.16
50974 Ureter endoscopy & biopsy $907.69
50976 Ureter endoscopy & treatment $896.60
50978 Ureter endoscopy & tracer $507.41
50980 Ureter endoscopy & treatment $679.04
51000 Drainage of bladder $196.63
51005 Drainage of bladder $246.05
51010 Drainage of bladder $667.65
51020 Incise & treat bladder $791.83
51030 Incise & treat bladder $803.88
51040 Incise & drain bladder $536.73
51045 Incise bladder/drain ureter $803.87
51050 Removal of bladder stone $791.67
51060 Removal of ureter stone $1,000.49
51065 Remove ureter calculus $989.82
51080 Drainage of bladder abscess $710.70
51500 Removal of bladder cyst $1,141.80
51520 Removal of bladder lesion $1,046.77
51525 Removal of bladder lesion $1,507.33
51530 Removal of bladder lesion $1,361.06
51535 Repair of ureter lesion $1,403.47
51550 Partial removal of bladder $1,683.76
51555 Partial removal of bladder $2,246.23
51565 Revise bladder & ureter(s) $2,298.07
51570 Removal of bladder $2,557.31
51575 Removal of bladder & nodes $3,192.02
51580 Remove bladder/revise tract $3,273.83
51585 Removal of bladder & nodes $3,676.29
51590 Remove bladder/revise tract $3,402.13
51595 Remove bladder/revise tract $3,849.83
51596 Remove bladder/create pouch $4,110.49
51597 Removal of pelvic structures $3,999.70
51600 Injection for bladder x-ray $390.23
51605 Preparation for bladder xray $475.85
51610 Injection for bladder x-ray $133.26
51700 Irrigation of bladder $152.38
51701 Insert bladder catheter $149.54
51702 Insert temp bladder cath $151.24
51703 Insert bladder cath, complex $268.50
51705 Change of bladder tube $239.68
51710 Change of bladder tube $351.19
51715 Endoscopic injection/implant $564.57
51720 Treatment of bladder lesion $274.40
51725 Simple cystometrogram $515.51
51725.26 Simple cystometrogram $150.61
51726 Complex cystometrogram $447.39
51726.26 Complex cystometrogram $113.37
51736 Urine flow measurement $87.54
51736.26 Urine flow measurement $61.04
51741 Electro-uroflowmetry, first $143.64
51741.26 Electro-uroflowmetry, first $113.35
51772 Urethra pressure profile $355.04
51772.26 Urethra pressure profile $110.22
51784 Anal/urinary muscle study $355.02
51784.26 Anal/urinary muscle study $134.69
51785 Anal/urinary muscle study $437.48
51785.26 Anal/urinary muscle study $152.45
51792 Urinary reflex study $502.09
51792.26 Urinary reflex study $114.14
51795 Urine voiding pressure study $454.38
51795.26 Urine voiding pressure study $107.40
51797 Intraabdominal pressure test $335.98
51797.26 Intraabdominal pressure test $100.11
51798 Us urine capacity measure $27.53
51800 Revision of bladder/urethra $1,876.38
51820 Revision of urinary tract $1,976.15
51840 Attach bladder/urethra $1,217.76
51841 Attach bladder/urethra $1,452.94
51845 Repair bladder neck $1,086.85
51860 Repair of bladder wound $1,338.99
51865 Repair of bladder wound $1,633.68
51880 Repair of bladder opening $873.76
51900 Repair bladder/vagina lesion $1,431.28
51920 Close bladder-uterus fistula $1,311.95
51925 Hysterectomy/bladder repair $1,816.78
51940 Correction of bladder defect $3,052.58
51960 Revision of bladder & bowel $2,453.85
51980 Construct bladder opening $1,255.31
51990 Laparo urethral suspension $1,399.59
51992 Laparo sling operation $1,512.71
52000 Cystoscopy $387.61
52001 Cystoscopy, removal of clots $776.24
52005 Cystoscopy & ureter catheter $594.87
52007 Cystoscopy and biopsy $312.24
52010 Cystoscopy & duct catheter $310.86
52204 Cystoscopy $433.08
52214 Cystoscopy and treatment $377.12
52224 Cystoscopy and treatment $321.20
52234 Cystoscopy and treatment $468.53
52235 Cystoscopy and treatment $550.41
52240 Cystoscopy and treatment $976.29
52250 Cystoscopy and radiotracer $460.89
52260 Cystoscopy and treatment $400.03
52265 Cystoscopy and treatment $485.27
52270 Cystoscopy & revise urethra $345.20
52275 Cystoscopy & revise urethra $476.86
52276 Cystoscopy and treatment $508.21
52277 Cystoscopy and treatment $631.36
52281 Cystoscopy and treatment $727.84
52282 Cystoscopy, implant stent $647.16
52283 Cystoscopy and treatment $565.26
52285 Cystoscopy and treatment $560.37
52290 Cystoscopy and treatment $467.61
52300 Cystoscopy and treatment $540.65
52301 Cystoscopy and treatment $564.52
52305 Cystoscopy and treatment $536.52
52310 Cystoscopy and treatment $460.08
52315 Cystoscopy and treatment $527.68
52317 Remove bladder stone $674.50
52318 Remove bladder stone $921.23
52320 Cystoscopy and treatment $474.79
52325 Cystoscopy, stone removal $619.95
52327 Cystoscopy, inject material $526.18
52330 Cystoscopy and treatment $509.13
52332 Cystoscopy and treatment $291.51
52334 Create passage to kidney $492.76
52341 Cysto w/ureter stricture tx $615.57
52342 Cysto w/up stricture tx $662.89
52343 Cysto w/renal stricture tx $733.40
52344 Cysto/uretero, stone remove $786.57
52345 Cysto/uretero w/up stricture $835.95
52346 Cystouretero w/renal strict $938.67
52347 Cystoscopy, resect ducts $524.98
52351 Cystouretero & or pyeloscope $598.93
52352 Cystouretero w/stone remove $703.31
52353 Cystouretero w/lithotripsy $811.55
52354 Cystouretero w/biopsy $749.71
52355 Cystouretero w/excise tumor $897.38
52400 Cystouretero w/congen repr $1,007.04
52450 Incision of prostate $844.05
52500 Revision of bladder neck $924.96
52510 Dilation prostatic urethra $733.71
52601 Prostatectomy (TURP) $1,307.32
52606 Control postop bleeding $873.07
52612 Prostatectomy, first stage $874.60
52614 Prostatectomy, second stage $759.54
52620 Remove residual prostate $716.20
52630 Remove prostate regrowth $780.91
52640 Relieve bladder contracture $714.88
52647 Laser surgery of prostate $3,647.40
52648 Laser surgery of prostate $1,196.27
52700 Drainage of prostate abscess $744.85
53000 Incision of urethra $283.84
53010 Incision of urethra $487.22
53020 Incision of urethra $350.07
53025 Incision of urethra $222.30
53040 Drainage of urethra abscess $1,270.60
53060 Drainage of urethra abscess $305.82
53080 Drainage of urinary leakage $911.24
53085 Drainage of urinary leakage $1,318.51
53200 Biopsy of urethra $495.97
53210 Removal of urethra $1,382.48
53215 Removal of urethra $1,666.44
53220 Treatment of urethra lesion $804.53
53230 Removal of urethra lesion $1,072.55
53235 Removal of urethra lesion $1,126.02
53240 Surgery for urethra pouch $749.00
53250 Removal of urethra gland $686.20
53260 Treatment of urethra lesion $443.86
53265 Treatment of urethra lesion $367.90
53270 Removal of urethra gland $368.06
53275 Repair of urethra defect $506.16
53400 Revise urethra, stage 1 $1,407.39
53405 Revise urethra, stage 2 $1,561.58
53410 Reconstruction of urethra $1,762.67
53415 Reconstruction of urethra $2,009.49
53420 Reconstruct urethra, stage 1 $1,531.37
53425 Reconstruct urethra, stage 2 $1,717.31
53430 Reconstruction of urethra $1,751.41
53431 Reconstruct urethra/bladder $2,099.36
53440 Male sling procedure $1,461.59
53442 Remove/revise male sling $1,264.48
53444 Insert tandem cuff $1,442.39
53445 Insert uro/ves nck sphincter $1,582.90
53446 Remove uro sphincter $1,153.03
53447 Remove/replace ur sphincter $1,484.58
53448 Remov/replc ur sphinctr comp $2,263.32
53449 Repair uro sphincter $1,081.17
53450 Revision of urethra $707.27
53460 Revision of urethra $811.77
53500 Urethrlys, transvag w/ scope $1,366.97
53502 Repair of urethra injury $872.56
53505 Repair of urethra injury $862.59
53510 Repair of urethra injury $1,142.36
53515 Repair of urethra injury $1,443.25
53520 Repair of urethra defect $986.08
53600 Dilate urethra stricture $173.65
53601 Dilate urethra stricture $165.09
53605 Dilate urethra stricture $127.24
53620 Dilate urethra stricture $265.54
53621 Dilate urethra stricture $250.89
53660 Dilation of urethra $146.99
53661 Dilation of urethra $147.74
53665 Dilation of urethra $76.71
53850 Prostatic microwave thermotx $6,184.19
53852 Prostatic rf thermotx $5,107.35
53853 Prostatic water thermother $2,632.14
53899 Urology surgery procedure $0.00
54000 Slitting of prepuce $210.68
54001 Slitting of prepuce $465.42
54015 Drain penis lesion $451.32
54050 Destruction, penis lesion(s) $133.07
54055 Destruction, penis lesion(s) $204.01
54056 Cryosurgery, penis lesion(s) $265.74
54057 Laser surg, penis lesion(s) $155.92
54060 Excision of penis lesion(s) $416.06
54065 Destruction, penis lesion(s) $304.62
54100 Biopsy of penis $206.16
54105 Biopsy of penis $371.98
54110 Treatment of penis lesion $1,167.96
54111 Treat penis lesion, graft $1,505.01
54112 Treat penis lesion, graft $1,751.04
54115 Treatment of penis lesion $1,061.90
54120 Partial removal of penis $1,154.00
54125 Removal of penis $1,507.19
54130 Remove penis & nodes $2,177.60
54135 Remove penis & nodes $2,795.14
54150 Circumcision $209.14
54152 Circumcision $261.63
54160 Circumcision $268.13
54161 Circumcision $360.51
54162 Lysis penil circumic lesion $369.95
54163 Repair of circumcision $370.64
54164 Frenulotomy of penis $320.57
54200 Treatment of penis lesion $186.00
54205 Treatment of penis lesion $943.51
54220 Treatment of penis lesion $458.15
54230 Prepare penis study $180.60
54231 Dynamic cavernosometry $254.55
54235 Penile injection $159.08
54240 Penis study $172.85
54240.26 Penis study $130.17
54250 Penis study $236.32
54250.26 Penis study $220.49
54300 Revision of penis $1,198.15
54304 Revision of penis $1,411.98
54308 Reconstruction of urethra $1,335.51
54312 Reconstruction of urethra $1,541.15
54316 Reconstruction of urethra $1,856.39
54318 Reconstruction of urethra $1,299.34
54322 Reconstruction of urethra $1,458.38
54324 Reconstruction of urethra $1,824.90
54326 Reconstruction of urethra $1,761.58
54328 Revise penis/urethra $1,718.15
54332 Revise penis/urethra $1,861.00
54336 Revise penis/urethra $2,310.12
54340 Secondary urethral surgery $1,055.89
54344 Secondary urethral surgery $1,783.15
54348 Secondary urethral surgery $1,912.70
54352 Reconstruct urethra/penis $2,703.08
54360 Penis plastic surgery $1,345.38
54380 Repair penis $1,500.95
54385 Repair penis $1,761.77
54390 Repair penis and bladder $2,325.92
54400 Insert semi-rigid prosthesis $1,000.28
54401 Insert self-contd prosthesis $1,192.92
54405 Insert multi-comp penis pros $1,451.53
54406 Remove muti-comp penis pros $1,308.84
54408 Repair multi-comp penis pros $1,380.44
54410 Remove/replace penis prosth $1,654.27
54411 Remov/replc penis pros, comp $1,714.36
54415 Remove self-contd penis pros $924.41
54416 Remv/repl penis contain pros $1,205.32
54417 Remv/replc penis pros, compl $1,508.32
54420 Revision of penis $1,274.25
54430 Revision of penis $1,142.60
54435 Revision of penis $727.81
54440 Repair of penis $2,875.00
54450 Preputial stretching $162.80
54500 Biopsy of testis $106.64
54505 Biopsy of testis $399.08
54512 Excise lesion testis $949.00
54520 Removal of testis $599.74
54522 Orchiectomy, partial $1,072.42
54530 Removal of testis $958.64
54535 Extensive testis surgery $1,330.52
54550 Exploration for testis $868.96
54560 Exploration for testis $1,225.73
54600 Reduce testis torsion $789.78
54620 Suspension of testis $547.90
54640 Suspension of testis $796.36
54650 Orchiopexy (Fowler-Stephens) $1,267.18
54660 Revision of testis $605.23
54670 Repair testis injury $743.26
54680 Relocation of testis(es) $1,414.94
54690 Laparoscopy, orchiectomy $1,206.11
54692 Laparoscopy, orchiopexy $1,371.54
54699 Laparoscope proc, testis $0.00
54700 Drainage of scrotum $371.98
54800 Biopsy of epididymis $147.14
54820 Exploration of epididymis $603.34
54830 Remove epididymis lesion $627.12
54840 Remove epididymis lesion $595.78
54860 Removal of epididymis $718.99
54861 Removal of epididymis $987.02
54900 Fusion of spermatic ducts $1,443.20
54901 Fusion of spermatic ducts $1,933.68
55000 Drainage of hydrocele $153.70
55040 Removal of hydrocele $617.70
55041 Removal of hydroceles $875.96
55060 Repair of hydrocele $642.38
55100 Drainage of scrotum abscess $254.88
55110 Explore scrotum $658.58
55120 Removal of scrotum lesion $789.64
55150 Removal of scrotum $830.59
55175 Revision of scrotum $614.94
55180 Revision of scrotum $1,204.76
55200 Incision of sperm duct $706.90
55250 Removal of sperm duct(s) $677.57
55300 Prepare, sperm duct x-ray $359.78
55400 Repair of sperm duct $940.91
55450 Ligation of sperm duct $487.96
55500 Removal of hydrocele $651.39
55520 Removal of sperm cord lesion $700.74
55530 Revise spermatic cord veins $648.02
55535 Revise spermatic cord veins $744.13
55540 Revise hernia & sperm veins $868.28
55550 Laparo ligate spermatic vein $737.99
55559 Laparo proc, spermatic cord $0.00
55600 Incise sperm duct pouch $724.85
55605 Incise sperm duct pouch $916.13
55650 Remove sperm duct pouch $1,277.84
55680 Remove sperm pouch lesion $608.11
55700 Biopsy of prostate $419.47
55705 Biopsy of prostate $510.87
55720 Drainage of prostate abscess $859.89
55725 Drainage of prostate abscess $986.77
55801 Removal of prostate $1,879.64
55810 Extensive prostate surgery $2,339.47
55812 Extensive prostate surgery $2,888.23
55815 Extensive prostate surgery $3,177.97
55821 Removal of prostate $1,533.06
55831 Removal of prostate $1,669.77
55840 Extensive prostate surgery $2,398.63
55842 Extensive prostate surgery $2,568.13
55845 Extensive prostate surgery $2,964.51
55859 Percut/needle insert, pros $1,370.84
55860 Surgical exposure, prostate $1,554.89
55862 Extensive prostate surgery $1,966.03
55865 Extensive prostate surgery $2,407.94
55866 Laparo radical prostatectomy $3,161.45
55870 Electroejaculation $304.52
55873 Cryoablate prostate $2,114.87
55899 Genital surgery procedure $0.00
55970 Sex transformation, M to F $0.00
55980 Sex transformation, F to M $0.00
56405 I & D of vulva/perineum $204.93
56420 Drainage of gland abscess $266.95
56440 Surgery for vulva lesion $341.46
56441 Lysis of labial lesion(s) $280.30
56501 Destroy, vulva lesions, sim $243.66
56515 Destroy vulva lesion/s compl $389.21
56605 Biopsy of vulva/perineum $161.64
56606 Biopsy of vulva/perineum $77.21
56620 Partial removal of vulva $921.84
56625 Complete removal of vulva $1,032.24
56630 Extensive vulva surgery $1,451.41
56631 Extensive vulva surgery $1,892.66
56632 Extensive vulva surgery $2,259.23
56633 Extensive vulva surgery $1,895.95
56634 Extensive vulva surgery $2,066.91
56637 Extensive vulva surgery $2,501.70
56640 Extensive vulva surgery $2,490.45
56700 Partial removal of hymen $317.23
56720 Incision of hymen $80.37
56740 Remove vagina gland lesion $526.00
56800 Repair of vagina $455.94
56805 Repair clitoris $2,130.79
56810 Repair of perineum $482.81
56820 Exam of vulva w/scope $208.38
56821 Exam/biopsy of vulva w/scope $281.12
57000 Exploration of vagina $352.55
57010 Drainage of pelvic abscess $738.27
57020 Drainage of pelvic fluid $183.59
57022 I & d vaginal hematoma, pp $304.38
57023 I & d vag hematoma, non-ob $542.22
57061 Destroy vag lesions, simple $213.12
57065 Destroy vag lesions, complex $363.88
57100 Biopsy of vagina $169.46
57105 Biopsy of vagina $266.28
57106 Remove vagina wall, partial $787.35
57107 Remove vagina tissue, part $2,528.01
57109 Vaginectomy partial w/nodes $2,875.57
57110 Remove vagina wall, complete $1,627.86
57111 Remove vagina tissue, compl $2,995.58
57112 Vaginectomy w/nodes, compl $3,092.35
57120 Closure of vagina $902.91
57130 Remove vagina lesion $340.46
57135 Remove vagina lesion $366.30
57150 Treat vagina infection $71.94
57155 Insert uteri tandems/ovoids $778.91
57160 Insert pessary/other device $145.28
57170 Fitting of diaphragm/cap $132.54
57180 Treat vaginal bleeding $274.59
57200 Repair of vagina $509.59
57210 Repair vagina/perineum $642.73
57220 Revision of urethra $553.39
57230 Repair of urethral lesion $676.45
57240 Repair bladder & vagina $738.85
57250 Repair rectum & vagina $681.66
57260 Repair of vagina $985.70
57265 Extensive repair of vagina $1,309.51
57268 Repair of bowel bulge $821.33
57270 Repair of bowel pouch $1,383.53
57280 Suspension of vagina $1,690.06
57282 Repair of vaginal prolapse $1,062.80
57284 Repair paravaginal defect $1,488.86
57287 Revise/remove sling repair $1,208.83
57288 Repair bladder defect $1,416.08
57289 Repair bladder & vagina $1,320.58
57291 Construction of vagina $966.63
57292 Construct vagina with graft $1,510.04
57300 Repair rectum-vagina fistula $892.38
57305 Repair rectum-vagina fistula $1,515.38
57307 Fistula repair & colostomy $1,740.66
57308 Fistula repair, transperine $1,133.80
57310 Repair urethrovaginal lesion $792.57
57311 Repair urethrovaginal lesion $904.20
57320 Repair bladder-vagina lesion $927.08
57330 Repair bladder-vagina lesion $1,354.34
57335 Repair vagina $2,091.51
57400 Dilation of vagina $256.57
57410 Pelvic examination $275.59
57415 Remove vaginal foreign body $268.38
57420 Exam of vagina w/scope $218.61
57421 Exam/biopsy of vag w/scope $298.52
57425 Laparoscopy, surg, colpopexy $1,694.88
57452 Exam of cervix w/scope $212.52
57454 Bx/curett of cervix w/scope $300.65
57455 Biopsy of cervix w/scope $274.57
57456 Endocerv curettage w/scope $259.30
57460 Bx of cervix w/scope, leep $638.15
57461 Conz of cervix w/scope, leep $701.54
57500 Biopsy of cervix $259.69
57505 Endocervical curettage $191.14
57510 Cauterization of cervix $184.76
57511 Cryocautery of cervix $276.11
57513 Laser surgery of cervix $278.52
57520 Conization of cervix $653.72
57522 Conization of cervix $563.71
57530 Removal of cervix $612.98
57531 Removal of cervix, radical $3,100.59
57540 Removal of residual cervix $1,392.77
57545 Remove cervix/repair pelvis $1,486.63
57550 Removal of residual cervix $700.59
57555 Remove cervix/repair vagina $1,058.16
57556 Remove cervix, repair bowel $993.17
57700 Revision of cervix $491.49
57720 Revision of cervix $541.33
57800 Dilation of cervical canal $113.25
57820 D & c of residual cervix $234.49
58100 Biopsy of uterus lining $208.57
58120 Dilation and curettage $416.94
58140 Myomectomy abdom method $1,639.99
58145 Myomectomy vag method $965.78
58146 Myomectomy abdom complex $2,082.10
58150 Total hysterectomy $1,719.08
58152 Total hysterectomy $2,279.71
58180 Partial hysterectomy $1,719.72
58200 Extensive hysterectomy $2,390.71
58210 Extensive hysterectomy $3,185.33
58240 Removal of pelvis contents $4,237.58
58260 Vaginal hysterectomy $1,481.19
58262 Vag hyst including t/o $1,669.56
58263 Vag hyst w/t/o & vag repair $1,805.80
58267 Vag hyst w/urinary repair $1,912.32
58270 Vag hyst w/enterocele repair $1,608.76
58275 Hysterectomy/revise vagina $1,774.79
58280 Hysterectomy/revise vagina $1,901.81
58285 Extensive hysterectomy $2,427.71
58290 Vag hyst complex $2,081.45
58291 Vag hyst incl t/o, complex $2,289.79
58292 Vag hyst t/o & repair, compl $2,426.72
58293 Vag hyst w/uro repair, compl $2,533.30
58294 Vag hyst w/enterocele, compl $2,235.19
58300 Insert intrauterine device $177.30
58301 Remove intrauterine device $117.72
58321 Artificial insemination $151.99
58322 Artificial insemination $169.91
58323 Sperm washing $34.38
58340 Catheter for hysterography $378.44
58345 Reopen fallopian tube $529.97
58346 Insert heyman uteri capsule $800.28
58350 Reopen fallopian tube $182.81
58353 Endometr ablate, thermal $1,666.22
58400 Suspension of uterus $773.23
58410 Suspension of uterus $1,440.17
58520 Repair of ruptured uterus $1,354.88
58540 Revision of uterus $1,625.10
58545 Laparoscopic myomectomy $1,643.77
58546 Laparo-myomectomy, complex $2,094.84
58550 Laparo-asst vag hysterectomy $1,621.08
58552 Laparo-vag hyst incl t/o $1,805.12
58553 Laparo-vag hyst, complex $2,084.90
58554 Laparo-vag hyst w/t/o, compl $2,411.51
58555 Hysteroscopy, dx, sep proc $407.31
58558 Hysteroscopy, biopsy $516.01
58559 Hysteroscopy, lysis $666.09
58560 Hysteroscopy, resect septum $755.94
58561 Hysteroscopy, remove myoma $1,075.95
58562 Hysteroscopy, remove fb $562.06
58563 Hysteroscopy, ablation $666.78
58578 Laparo proc, uterus $0.00
58579 Hysteroscope procedure $0.00
58600 Division of fallopian tube $664.88
58605 Division of fallopian tube $603.22
58611 Ligate oviduct(s) add-on $150.27
58615 Occlude fallopian tube(s) $494.21
58660 Laparoscopy, lysis $1,252.07
58661 Laparoscopy, remove adnexa $1,223.83
58662 Laparoscopy, excise lesions $1,326.92
58670 Laparoscopy, tubal cautery $665.88
58671 Laparoscopy, tubal block $667.95
58672 Laparoscopy, fimbrioplasty $1,439.64
58673 Laparoscopy, salpingostomy $1,538.94
58679 Laparo proc, oviduct-ovary $0.00
58700 Removal of fallopian tube $1,338.52
58720 Removal of ovary/tube(s) $1,293.79
58740 Revise fallopian tube(s) $1,561.26
58750 Repair oviduct $1,679.58
58752 Revise ovarian tube(s) $1,650.33
58760 Remove tubal obstruction $1,499.25
58770 Create new tubal opening $1,578.83
58800 Drainage of ovarian cyst(s) $632.28
58805 Drainage of ovarian cyst(s) $706.07
58820 Drain ovary abscess, open $556.34
58822 Drain ovary abscess, percut $1,153.78
58823 Drain pelvic abscess, percut $336.31
58825 Transposition, ovary(s) $1,244.85
58900 Biopsy of ovary(s) $718.41
58920 Partial removal of ovary(s) $1,261.86
58925 Removal of ovarian cyst(s) $1,286.90
58940 Removal of ovary(s) $858.15
58943 Removal of ovary(s) $2,053.23
58950 Resect ovarian malignancy $1,911.33
58951 Resect ovarian malignancy $2,486.18
58952 Resect ovarian malignancy $2,786.76
58953 Tah, rad dissect for debulk $3,528.18
58954 Tah rad debulk/lymph remove $3,842.69
58960 Exploration of abdomen $1,666.09
58970 Retrieval of oocyte $437.33
58974 Transfer of embryo $2,076.69
58976 Transfer of embryo $483.13
58999 Genital surgery procedure $0.00
59000 Amniocentesis, diagnostic $172.06
59001 Amniocentesis, therapeutic $330.70
59012 Fetal cord puncture,prenatal $389.99
59015 Chorion biopsy $288.83
59020 Fetal contract stress test $111.90
59020.26 Fetal contract stress test $72.67
59025 Fetal non-stress test $75.36
59025.26 Fetal non-stress test $58.15
59030 Fetal scalp blood sample $143.93
59050 Fetal monitor w/report $97.76
59051 Fetal monitor/interpret only $81.74
59070 Transabdom amnioinfus w/ us $452.04
59072 Umbilical cord occlud w/ us $647.72
59074 Fetal fluid drainage w/ us $430.98
59076 Fetal shunt placement, w/ us $647.72
59100 Remove uterus lesion $1,458.41
59120 Treat ectopic pregnancy $1,373.21
59121 Treat ectopic pregnancy $1,393.53
59130 Treat ectopic pregnancy $1,508.83
59135 Treat ectopic pregnancy $1,636.98
59136 Treat ectopic pregnancy $1,537.57
59140 Treat ectopic pregnancy $805.44
59150 Treat ectopic pregnancy $1,337.23
59151 Treat ectopic pregnancy $1,334.09
59160 D & c after delivery $447.73
59200 Insert cervical dilator $147.78
59300 Episiotomy or vaginal repair $302.09
59320 Revision of cervix $290.45
59325 Revision of cervix $465.53
59350 Repair of uterus $539.48
59400 Obstetrical care $2,710.04
59409 Obstetrical care $1,472.98
59410 Obstetrical care $1,647.70
59412 Antepartum manipulation $196.14
59414 Deliver placenta $175.60
59425 Antepartum care only $687.39
59426 Antepartum care only $1,062.17
59430 Care after delivery $223.66
59510 Cesarean delivery $3,349.39
59514 Cesarean delivery only $1,738.25
59515 Cesarean delivery $1,965.59
59525 Remove uterus after cesarean $928.97
59610 Vbac delivery $3,121.52
59612 Vbac delivery only $1,652.77
59614 Vbac care after delivery $1,818.88
59618 Attempted vbac delivery $3,546.38
59620 Attempted vbac delivery only $1,903.86
59622 Attempted vbac after care $2,148.47
59812 Treatment of miscarriage $498.95
59820 Care of miscarriage $570.87
59821 Treatment of miscarriage $603.49
59830 Treat uterus infection $777.19
59840 Abortion $393.70
59841 Abortion $604.25
59850 Abortion $709.59
59851 Abortion $743.45
59852 Abortion $1,024.31
59855 Abortion $746.96
59856 Abortion $893.57
59857 Abortion $1,077.56
59866 Abortion (mpr) $453.77
59870 Evacuate mole of uterus $784.93
59871 Remove cerclage suture $296.00
59897 Fetal invas px w/ us $0.00
59898 Laparo proc, ob care/deliver $0.00
59899 Maternity care procedure $0.00


with 6

60000 Drain thyroid/tongue cyst $213.96
60001 Aspirate/inject thyroid cyst $177.42
60100 Biopsy of thyroid $216.32
60200 Remove thyroid lesion $1,169.76
60210 Partial thyroid excision $1,250.74
60212 Partial thyroid excision $1,796.33
60220 Partial removal of thyroid $1,361.00
60225 Partial removal of thyroid $1,632.12
60240 Removal of thyroid $1,793.41
60252 Removal of thyroid $2,309.81
60254 Extensive thyroid surgery $3,083.44
60260 Repeat thyroid surgery $1,969.24
60270 Removal of thyroid $2,319.05
60271 Removal of thyroid $1,914.91
60280 Remove thyroid duct lesion $788.65
60281 Remove thyroid duct lesion $1,076.41
60500 Explore parathyroid glands $1,795.42
60502 Re-explore parathyroids $2,253.38
60505 Explore parathyroid glands $2,456.57
60512 Autotransplant parathyroid $461.95
60520 Removal of thymus gland $1,906.10
60521 Removal of thymus gland $2,166.56
60522 Removal of thymus gland $2,620.33
60540 Explore adrenal gland $1,854.79
60545 Explore adrenal gland $2,147.42
60600 Remove carotid body lesion $2,164.61
60605 Remove carotid body lesion $2,484.03
60650 Laparoscopy adrenalectomy $2,123.29
60659 Laparo proc, endocrine $0.00
60699 Endocrine surgery procedure $0.00
61000 Remove cranial cavity fluid $189.57
61001 Remove cranial cavity fluid $190.42
61020 Remove brain cavity fluid $216.33
61026 Injection into brain canal $231.85
61050 Remove brain canal fluid $204.99
61055 Injection into brain canal $260.07
61070 Brain canal shunt procedure $141.15
61105 Twist drill hole $698.57
61107 Drill skull for implantation $643.37
61108 Drill skull for drainage $1,335.35
61120 Burr hole for puncture $1,141.23
61140 Pierce skull for biopsy $1,998.39
61150 Pierce skull for drainage $2,172.20
61151 Pierce skull for drainage $1,567.55
61154 Pierce skull & remove clot $1,898.09
61156 Pierce skull for drainage $2,037.28
61210 Pierce skull, implant device $738.77
61215 Insert brain-fluid device $681.98
61250 Pierce skull & explore $1,333.25
61253 Pierce skull & explore $1,547.96
61304 Open skull for exploration $2,703.33
61305 Open skull for exploration $3,259.30
61312 Open skull for drainage $3,076.37
61313 Open skull for drainage $3,090.51
61314 Open skull for drainage $2,872.15
61315 Open skull for drainage $3,402.82
61316 Implt cran bone flap to abdo $160.87
61320 Open skull for drainage $3,144.07
61321 Open skull for drainage $3,460.32
61322 Decompressive craniotomy $3,401.14
61323 Decompressive lobectomy $3,525.49
61330 Decompress eye socket $2,795.91
61332 Explore/biopsy eye socket $3,284.06
61333 Explore orbit/remove lesion $3,254.91
61334 Explore orbit/remove object $2,223.53
61340 Subtemporal decompression $2,310.72
61343 Incise skull (press relief) $3,631.80
61345 Relieve cranial pressure $3,309.56
61440 Incise skull for surgery $3,199.12
61450 Incise skull for surgery $3,133.96
61458 Incise skull for brain wound $3,325.91
61460 Incise skull for surgery $3,464.54
61470 Incise skull for surgery $3,093.03
61480 Incise skull for surgery $3,260.27
61490 Incise skull for surgery $3,126.03
61500 Removal of skull lesion $2,217.66
61501 Remove infected skull bone $1,852.20
61510 Removal of brain lesion $3,514.00
61512 Remove brain lining lesion $4,272.20
61514 Removal of brain abscess $3,093.45
61516 Removal of brain lesion $3,025.67
61517 Implt brain chemotx add-on $145.72
61518 Removal of brain lesion $4,553.23
61519 Remove brain lining lesion $4,989.58
61520 Removal of brain lesion $6,603.85
61521 Removal of brain lesion $5,357.15
61522 Removal of brain abscess $3,550.55
61524 Removal of brain lesion $3,368.18
61526 Removal of brain lesion $6,206.79
61530 Removal of brain lesion $5,259.36
61531 Implant brain electrodes $1,839.92
61533 Implant brain electrodes $2,424.56
61534 Removal of brain lesion $2,571.94
61535 Remove brain electrodes $1,475.20
61536 Removal of brain lesion $4,293.03
61537 Removal of brain tissue $3,081.22
61538 Removal of brain tissue $3,280.41
61539 Removal of brain tissue $3,894.33
61540 Removal of brain tissue $3,714.28
61541 Incision of brain tissue $3,499.51
61542 Removal of brain tissue $3,814.16
61543 Removal of brain tissue $3,564.90
61544 Remove & treat brain lesion $3,061.15
61545 Excision of brain tumor $5,307.75
61546 Removal of pituitary gland $3,794.53
61548 Removal of pituitary gland $2,640.36
61550 Release of skull seams $1,622.09
61552 Release of skull seams $2,128.15
61556 Incise skull/sutures $2,594.02
61557 Incise skull/sutures $2,804.17
61558 Excision of skull/sutures $2,996.28
61559 Excision of skull/sutures $4,063.32
61563 Excision of skull tumor $3,240.41
61564 Excision of skull tumor $4,080.01
61566 Removal of brain tissue $3,733.00
61567 Incision of brain tissue $4,296.94
61570 Remove foreign body, brain $2,986.08
61571 Incise skull for brain wound $3,231.17
61575 Skull base/brainstem surgery $4,128.56
61576 Skull base/brainstem surgery $6,146.01
61580 Craniofacial approach, skull $4,131.43
61581 Craniofacial approach, skull $4,306.17
61582 Craniofacial approach, skull $4,479.23
61583 Craniofacial approach, skull $4,709.07
61584 Orbitocranial approach/skull $4,534.47
61585 Orbitocranial approach/skull $4,956.53
61586 Resect nasopharynx, skull $3,555.82
61590 Infratemporal approach/skull $5,275.87
61591 Infratemporal approach/skull $5,519.41
61592 Orbitocranial approach/skull $5,099.29
61595 Transtemporal approach/skull $3,881.10
61596 Transcochlear approach/skull $4,525.79
61597 Transcondylar approach/skull $4,692.06
61598 Transpetrosal approach/skull $4,289.03
61600 Resect/excise cranial lesion $3,424.97
61601 Resect/excise cranial lesion $3,713.93
61605 Resect/excise cranial lesion $3,816.80
61606 Resect/excise cranial lesion $4,913.64
61607 Resect/excise cranial lesion $4,583.99
61608 Resect/excise cranial lesion $5,319.01
61609 Transect artery, sinus $1,158.78
61610 Transect artery, sinus $3,266.42
61611 Transect artery, sinus $881.82
61612 Transect artery, sinus $3,145.48
61613 Remove aneurysm, sinus $5,204.03
61615 Resect/excise lesion, skull $4,154.19
61616 Resect/excise lesion, skull $5,502.31
61618 Repair dura $2,110.75
61619 Repair dura $2,533.04
61623 Endovasc tempory vessel occl $1,054.82
61624 Transcath occlusion, cns $2,027.23
61626 Transcath occlusion, non-cns $1,655.65
61680 Intracranial vessel surgery $3,745.31
61682 Intracranial vessel surgery $7,344.45
61684 Intracranial vessel surgery $4,815.19
61686 Intracranial vessel surgery $7,755.47
61690 Intracranial vessel surgery $3,570.35
61692 Intracranial vessel surgery $6,188.92
61697 Brain aneurysm repr, complx $6,129.40
61698 Brain aneurysm repr, complx $5,867.99
61700 Brain aneurysm repr, simple $6,110.49
61702 Inner skull vessel surgery $5,813.29
61703 Clamp neck artery $2,176.42
61705 Revise circulation to head $4,306.63
61708 Revise circulation to head $3,768.95
61710 Revise circulation to head $3,253.19
61711 Fusion of skull arteries $4,384.72
61720 Incise skull/brain surgery $2,085.61
61735 Incise skull/brain surgery $2,536.78
61750 Incise skull/brain biopsy $2,244.68
61751 Brain biopsy w/ct/mr guide $2,208.97
61760 Implant brain electrodes $2,454.47
61770 Incise skull for treatment $2,615.31
61790 Treat trigeminal nerve $1,294.54
61791 Treat trigeminal tract $1,831.51
61793 Focus radiation beam $2,129.66
61795 Brain surgery using computer $474.98
61850 Implant neuroelectrodes $1,546.76
61860 Implant neuroelectrodes $2,558.30
61862 Implant neurostimul, subcort $2,426.85
61863 Implant neuroelectrode $2,214.87
61864 Implant neuroelectrde, add’l $531.69
61867 Implant neuroelectrode $3,451.58
61868 Implant neuroelectrde, add’l $909.62
61870 Implant neuroelectrodes $1,860.52
61875 Implant neuroelectrodes $1,815.99
61880 Revise/remove neuroelectrode $839.82
61885 Implant neurostim one array $852.77
61886 Implant neurostim arrays $1,102.40
61888 Revise/remove neuroreceiver $687.84
62000 Treat skull fracture $1,352.29
62005 Treat skull fracture $1,910.26
62010 Treatment of head injury $2,453.32
62100 Repair brain fluid leakage $2,695.86
62115 Reduction of skull defect $2,607.22
62116 Reduction of skull defect $2,883.07
62117 Reduction of skull defect $3,276.40
62120 Repair skull cavity lesion $2,854.11
62121 Incise skull repair $2,589.22
62140 Repair of skull defect $1,690.58
62141 Repair of skull defect $1,856.35
62142 Remove skull plate/flap $1,374.98
62143 Replace skull plate/flap $1,634.89
62145 Repair of skull & brain $2,314.72
62146 Repair of skull with graft $1,990.41
62147 Repair of skull with graft $2,375.96
62148 Retr bone flap to fix skull $223.63
62160 Neuroendoscopy add-on $324.11
62161 Dissect brain w/scope $2,302.33
62162 Remove colloid cyst w/scope $2,925.97
62163 Neuroendoscopy w/fb removal $1,849.31
62164 Remove brain tumor w/scope $3,177.30
62165 Remove pituit tumor w/scope $2,514.35
62180 Establish brain cavity shunt $2,598.60
62190 Establish brain cavity shunt $1,404.83
62192 Establish brain cavity shunt $1,542.46
62194 Replace/irrigate catheter $587.52
62200 Establish brain cavity shunt $2,268.45
62201 Brain cavity shunt w/scope $1,865.76
62220 Establish brain cavity shunt $1,626.00
62223 Establish brain cavity shunt $1,636.25
62225 Replace/irrigate catheter $731.12
62230 Replace/revise brain shunt $1,320.51
62252 Csf shunt reprogram $164.36
62252.26 Csf shunt reprogram $87.25
62256 Remove brain cavity shunt $872.61
62258 Replace brain cavity shunt $1,806.34
62263 Epidural lysis mult sessions $1,292.49
62264 Epidural lysis on single day $869.79
62268 Drain spinal cord cyst $1,093.64
62269 Needle biopsy, spinal cord $1,267.40
62270 Spinal fluid tap, diagnostic $298.84
62272 Drain cerebro spinal fluid $359.66
62273 Treat epidural spine lesion $354.34
62280 Treat spinal cord lesion $657.32
62281 Treat spinal cord lesion $601.72
62282 Treat spinal canal lesion $744.39
62284 Injection for myelogram $455.10
62287 Percutaneous diskectomy $1,010.10
62290 Inject for spine disk x-ray $701.12
62291 Inject for spine disk x-ray $616.26
62292 Injection into disk lesion $922.76
62294 Injection into spinal artery $1,304.15
62310 Inject spine c/t $479.63
62311 Inject spine l/s (cd) $456.82
62318 Inject spine w/cath, c/t $486.95
62319 Inject spine w/cath l/s (cd) $472.12
62350 Implant spinal canal cath $813.37
62351 Implant spinal canal cath $1,308.87
62355 Remove spinal canal catheter $646.09
62360 Insert spine infusion device $390.80
62361 Implant spine infusion pump $693.76
62362 Implant spine infusion pump $862.17
62365 Remove spine infusion device $675.84
62367 Analyze spine infusion pump $352.13
62367.26 Analyze spine infusion pump $46.17
62368 Analyze spine infusion pump $212.98
62368.26 Analyze spine infusion pump $71.14
63001 Removal of spinal lamina $1,960.42
63003 Removal of spinal lamina $1,991.48
63005 Removal of spinal lamina $1,904.65
63011 Removal of spinal lamina $1,710.44
63012 Removal of spinal lamina $1,955.28
63015 Removal of spinal lamina $2,420.04
63016 Removal of spinal lamina $2,393.04
63017 Removal of spinal lamina $2,022.42
63020 Neck spine disk surgery $1,889.84
63030 Low back disk surgery $1,563.77
63035 Spinal disk surgery add-on $368.35
63040 Laminotomy, single cervical $2,332.99
63042 Laminotomy, single lumbar $2,208.87
63043 Laminotomy, add’l cervical $3,245.70
63044 Laminotomy, add’l lumbar $3,073.39
63045 Removal of spinal lamina $2,075.20
63046 Removal of spinal lamina $1,997.51
63047 Removal of spinal lamina $1,875.65
63048 Remove spinal lamina add-on $382.41
63055 Decompress spinal cord $2,713.53
63056 Decompress spinal cord $2,519.65
63057 Decompress spine cord add-on $607.40
63064 Decompress spinal cord $3,024.67
63066 Decompress spine cord add-on $384.47
63075 Neck spine disk surgery $2,433.15
63076 Neck spine disk surgery $475.74
63077 Spine disk surgery, thorax $2,619.56
63078 Spine disk surgery, thorax $378.41
63081 Removal of vertebral body $2,940.07
63082 Remove vertebral body add-on $513.05
63085 Removal of vertebral body $3,266.71
63086 Remove vertebral body add-on $370.99
63087 Removal of vertebral body $4,234.26
63088 Remove vertebral body add-on $504.56
63090 Removal of vertebral body $3,378.67
63091 Remove vertebral body add-on $345.29
63101 Removal of vertebral body $3,912.45
63102 Removal of vertebral body $3,912.45
63103 Remove vertebral body add-on $454.92
63170 Incise spinal cord tract(s) $2,469.65
63172 Drainage of spinal cyst $2,206.47
63173 Drainage of spinal cyst $2,708.01
63180 Revise spinal cord ligaments $2,292.23
63182 Revise spinal cord ligaments $2,442.30
63185 Incise spinal column/nerves $1,775.66
63190 Incise spinal column/nerves $2,129.62
63191 Incise spinal column/nerves $2,187.52
63194 Incise spinal column & cord $2,415.29
63195 Incise spinal column & cord $2,320.75
63196 Incise spinal column & cord $2,790.62
63197 Incise spinal column & cord $2,609.89
63198 Incise spinal column & cord $2,705.80
63199 Incise spinal column & cord $3,286.68
63200 Release of spinal cord $2,369.52
63250 Revise spinal cord vessels $4,734.70
63251 Revise spinal cord vessels $4,964.06
63252 Revise spinal cord vessels $4,929.28
63265 Excise intraspinal lesion $2,666.92
63266 Excise intraspinal lesion $2,757.95
63267 Excise intraspinal lesion $2,246.36
63268 Excise intraspinal lesion $2,229.77
63270 Excise intraspinal lesion $3,290.67
63271 Excise intraspinal lesion $3,313.38
63272 Excise intraspinal lesion $3,111.37
63273 Excise intraspinal lesion $3,011.73
63275 Biopsy/excise spinal tumor $2,910.83
63276 Biopsy/excise spinal tumor $2,884.02
63277 Biopsy/excise spinal tumor $2,583.20
63278 Biopsy/excise spinal tumor $2,552.36
63280 Biopsy/excise spinal tumor $3,481.05
63281 Biopsy/excise spinal tumor $3,442.84
63282 Biopsy/excise spinal tumor $3,246.99
63283 Biopsy/excise spinal tumor $3,088.49
63285 Biopsy/excise spinal tumor $4,364.56
63286 Biopsy/excise spinal tumor $4,324.24
63287 Biopsy/excise spinal tumor $4,458.75
63290 Biopsy/excise spinal tumor $4,525.67
63300 Removal of vertebral body $3,006.40
63301 Removal of vertebral body $3,338.78
63302 Removal of vertebral body $3,384.03
63303 Removal of vertebral body $3,654.04
63304 Removal of vertebral body $3,650.04
63305 Removal of vertebral body $3,854.33
63306 Removal of vertebral body $3,729.29
63307 Removal of vertebral body $3,691.10
63308 Remove vertebral body add-on $613.50
63600 Remove spinal cord lesion $1,470.38
63610 Stimulation of spinal cord $4,501.19
63615 Remove lesion of spinal cord $1,980.00
63650 Implant neuroelectrodes $744.14
63655 Implant neuroelectrodes $1,318.41
63660 Revise/remove neuroelectrode $735.91
63685 Implant neuroreceiver $851.14
63688 Revise/remove neuroreceiver $676.34
63700 Repair of spinal herniation $2,051.03
63702 Repair of spinal herniation $2,180.30
63704 Repair of spinal herniation $2,625.55
63706 Repair of spinal herniation $2,929.84
63707 Repair spinal fluid leakage $1,449.00
63709 Repair spinal fluid leakage $1,815.11
63710 Graft repair of spine defect $1,780.24
63740 Install spinal shunt $1,443.70
63741 Install spinal shunt $987.95
63744 Revision of spinal shunt $1,030.03
63746 Removal of spinal shunt $788.69
64400 N block inj, trigeminal $223.68
64402 N block inj, facial $215.88
64405 N block inj, occipital $206.65
64408 N block inj, vagus $217.85
64410 N block inj, phrenic $286.47
64412 N block inj, spinal accessor $278.13
64413 N block inj, cervical plexus $237.75
64415 N block inj, brachial plexus $309.48
64416 N block cont infuse, b plex $313.61
64417 N block inj, axillary $324.05
64418 N block inj, suprascapular $283.77
64420 N block inj, intercost, sng $333.90
64421 N block inj, intercost, mlt $500.67
64425 N block inj ilio-ing/hypogi $252.18
64430 N block inj, pudendal $291.80
64435 N block inj, paracervical $292.08
64445 N block inj, sciatic, sng $299.15
64446 N blk inj, sciatic, cont inf $327.36
64447 N block inj fem, single $150.55
64448 N block inj fem, cont inf $298.37
64449 N block inj, lumbar plexus $294.24
64450 N block, other peripheral $185.02
64470 Inj paravertebral c/t $477.56
64472 Inj paravertebral c/t add-on $230.97
64475 Inj paravertebral l/s $352.10
64476 Inj paravertebral l/s add-on $195.08
64479 Inj foramen epidural c/t $655.51
64480 Inj foramen epidural add-on $284.70
64483 Inj foramen epidural l/s $569.74
64484 Inj foramen epidural add-on $295.53
64505 N block, spenopalatine gangl $188.98
64508 N block, carotid sinus s/p $289.83
64510 N block, stellate ganglion $314.17
64517 N block inj, hypogas plxs $354.64
64520 N block, lumbar/thoracic $418.20
64530 N block inj, celiac pelus $393.03
64550 Apply neurostimulator $34.44
64553 Implant neuroelectrodes $365.59
64555 Implant neuroelectrodes $386.71
64560 Implant neuroelectrodes $365.19
64561 Implant neuroelectrodes $724.58
64565 Implant neuroelectrodes $365.50
64573 Implant neuroelectrodes $980.75
64575 Implant neuroelectrodes $525.41
64577 Implant neuroelectrodes $593.40
64580 Implant neuroelectrodes $559.90
64581 Implant neuroelectrodes $1,394.52
64585 Revise/remove neuroelectrode $962.42
64590 Implant neuroreceiver $695.52
64595 Revise/remove neuroreceiver $874.45
64600 Injection treatment of nerve $850.32
64605 Injection treatment of nerve $1,031.54
64610 Injection treatment of nerve $1,123.42
64612 Destroy nerve, face muscle $330.52
64613 Destroy nerve, spine muscle $354.96
64614 Destroy nerve, extrem musc $391.13
64620 Injection treatment of nerve $535.99
64622 Destr paravertebrl nerve l/s $713.29
64623 Destr paravertebral n add-on $242.94
64626 Destr paravertebrl nerve c/t $713.42
64627 Destr paravertebral n add-on $269.75
64630 Injection treatment of nerve $370.64
64640 Injection treatment of nerve $468.62
64680 Injection treatment of nerve $370.64
64681 Injection treatment of nerve $870.20
64702 Revise finger/toe nerve $599.39
64704 Revise hand/foot nerve $590.68
64708 Revise arm/leg nerve $822.74
64712 Revision of sciatic nerve $943.82
64713 Revision of arm nerve(s) $1,267.96
64714 Revise low back nerve(s) $1,088.21
64716 Revision of cranial nerve $856.94
64718 Revise ulnar nerve at elbow $886.70
64719 Revise ulnar nerve at wrist $694.55
64721 Carpal tunnel surgery $684.75
64722 Relieve pressure on nerve(s) $574.27
64726 Release foot/toe nerve $525.07
64727 Internal nerve revision $351.91
64732 Incision of brow nerve $603.49
64734 Incision of cheek nerve $680.46
64736 Incision of chin nerve $649.70
64738 Incision of jaw nerve $779.85
64740 Incision of tongue nerve $736.76
64742 Incision of facial nerve $818.53
64744 Incise nerve, back of head $691.94
64746 Incise diaphragm nerve $784.81
64752 Incision of vagus nerve $857.48
64755 Incision of stomach nerves $1,447.16
64760 Incision of vagus nerve $782.59
64761 Incision of pelvis nerve $733.65
64763 Incise hip/thigh nerve $909.40
64766 Incise hip/thigh nerve $1,049.62
64771 Sever cranial nerve $986.80
64772 Incision of spinal nerve $926.79
64774 Remove skin nerve lesion $672.32
64776 Remove digit nerve lesion $660.32
64778 Digit nerve surgery add-on $351.28
64782 Remove limb nerve lesion $755.23
64783 Limb nerve surgery add-on $424.30
64784 Remove nerve lesion $1,233.23
64786 Remove sciatic nerve lesion $1,922.32
64787 Implant nerve end $490.31
64788 Remove skin nerve lesion $604.69
64790 Removal of nerve lesion $1,407.69
64792 Removal of nerve lesion $1,799.10
64795 Biopsy of nerve $350.70
64802 Remove sympathetic nerves $1,074.47
64804 Remove sympathetic nerves $1,661.50
64809 Remove sympathetic nerves $1,458.40
64818 Remove sympathetic nerves $1,179.19
64820 Remove sympathetic nerves $1,310.74
64821 Remove sympathetic nerves $1,199.49
64822 Remove sympathetic nerves $1,193.99
64823 Remove sympathetic nerves $1,384.41
64831 Repair of digit nerve $1,236.53
64832 Repair nerve add-on $653.13
64834 Repair of hand or foot nerve $1,297.63
64835 Repair of hand or foot nerve $1,399.74
64836 Repair of hand or foot nerve $1,396.65
64837 Repair nerve add-on $723.39
64840 Repair of leg nerve $1,576.50
64856 Repair/transpose nerve $1,730.98
64857 Repair arm/leg nerve $1,815.55
64858 Repair sciatic nerve $2,084.17
64859 Nerve surgery $489.40
64861 Repair of arm nerves $2,350.11
64862 Repair of low back nerves $2,375.03
64864 Repair of facial nerve $1,539.98
64865 Repair of facial nerve $1,872.66
64866 Fusion of facial/other nerve $1,886.30
64868 Fusion of facial/other nerve $1,715.57
64870 Fusion of facial/other nerve $1,839.55
64872 Subsequent repair of nerve $233.59
64874 Repair & revise nerve add-on $342.61
64876 Repair nerve/shorten bone $355.89
64885 Nerve graft, head or neck $2,120.35
64886 Nerve graft, head or neck $2,496.74
64890 Nerve graft, hand or foot $1,889.62
64891 Nerve graft, hand or foot $1,785.98
64892 Nerve graft, arm or leg $1,770.71
64893 Nerve graft, arm or leg $1,917.37
64895 Nerve graft, hand or foot $2,185.35
64896 Nerve graft, hand or foot $2,362.32
64897 Nerve graft, arm or leg $2,206.90
64898 Nerve graft, arm or leg $2,379.12
64901 Nerve graft add-on $926.98
64902 Nerve graft add-on $1,339.91
64905 Nerve pedicle transfer $1,697.53
64907 Nerve pedicle transfer $2,338.55
64999 Nervous system surgery $0.00
65091 Revise eye $1,162.19
65093 Revise eye with implant $1,218.62
65101 Removal of eye $1,271.19
65103 Remove eye/insert implant $1,325.28
65105 Remove eye/attach implant $1,440.45
65110 Removal of eye $2,074.23
65112 Remove eye/revise socket $2,423.63
65114 Remove eye/revise socket $2,522.88
65125 Revise ocular implant $874.64
65130 Insert ocular implant $1,249.86
65135 Insert ocular implant $1,276.03
65140 Attach ocular implant $1,359.23
65150 Revise ocular implant $1,116.62
65155 Reinsert ocular implant $1,460.36
65175 Removal of ocular implant $1,143.24
65205 Remove foreign body from eye $95.70
65210 Remove foreign body from eye $115.05
65220 Remove foreign body from eye $96.39
65222 Remove foreign body from eye $123.49
65235 Remove foreign body from eye $1,076.73
65260 Remove foreign body from eye $1,621.72
65265 Remove foreign body from eye $1,831.56
65270 Repair of eye wound $409.01
65272 Repair of eye wound $631.03
65273 Repair of eye wound $719.66
65275 Repair of eye wound $799.02
65280 Repair of eye wound $1,146.11
65285 Repair of eye wound $1,835.43
65286 Repair of eye wound $999.00
65290 Repair of eye socket wound $859.33
65400 Removal of eye lesion $1,055.90
65410 Biopsy of cornea $230.59
65420 Removal of eye lesion $836.29
65426 Removal of eye lesion $915.21
65430 Corneal smear $271.79
65435 Curette/treat cornea $160.67
65436 Curette/treat cornea $433.27
65450 Treatment of corneal lesion $448.06
65600 Revision of cornea $646.60
65710 Corneal transplant $1,789.89
65730 Corneal transplant $1,902.49
65750 Corneal transplant $2,062.11
65755 Corneal transplant $2,047.36
65760 Revision of cornea $3,552.15
65765 Revision of cornea $3,964.11
65767 Corneal tissue transplant $3,171.76
65770 Revise cornea with implant $2,322.74
65771 Radial keratotomy $1,585.46
65772 Correction of astigmatism $819.08
65775 Correction of astigmatism $946.92
65780 Ocular reconst, transplant $1,165.01
65781 Ocular reconst, transplant $1,779.65
65782 Ocular reconst, transplant $1,536.97
65800 Drainage of eye $302.35
65805 Drainage of eye $302.35
65810 Drainage of eye $925.05
65815 Drainage of eye $960.86
65820 Relieve inner eye pressure $1,352.98
65850 Incision of eye $1,446.70
65855 Laser surgery of eye $651.97
65860 Incise inner eye adhesions $538.69
65865 Incise inner eye adhesions $872.84
65870 Incise inner eye adhesions $968.99
65875 Incise inner eye adhesions $1,010.15
65880 Incise inner eye adhesions $1,069.81
65900 Remove eye lesion $1,626.02
65920 Remove implant of eye $1,239.23
65930 Remove blood clot from eye $1,099.73
66020 Injection treatment of eye $284.65
66030 Injection treatment of eye $247.56
66130 Remove eye lesion $841.75
66150 Glaucoma surgery $1,311.63
66155 Glaucoma surgery $1,306.41
66160 Glaucoma surgery $1,508.00
66165 Glaucoma surgery $1,277.24
66170 Glaucoma surgery $1,783.62
66172 Incision of eye $2,186.97
66180 Implant eye shunt $1,904.58
66185 Revise eye shunt $1,184.36
66220 Repair eye lesion $1,193.91
66225 Repair/graft eye lesion $1,483.51
66250 Follow-up surgery of eye $983.49
66500 Incision of iris $633.60
66505 Incision of iris $681.54
66600 Remove iris and lesion $1,274.94
66605 Removal of iris $1,754.21
66625 Removal of iris $873.89
66630 Removal of iris $980.06
66635 Removal of iris $933.08
66680 Repair iris & ciliary body $829.91
66682 Repair iris & ciliary body $984.48
66700 Destruction, ciliary body $731.74
66710 Destruction, ciliary body $723.14
66720 Destruction, ciliary body $755.15
66740 Destruction, ciliary body $734.15
66761 Revision of iris $691.81
66762 Revision of iris $735.74
66770 Removal of inner eye lesion $810.84
66820 Incision, secondary cataract $785.09
66821 After cataract laser surgery $453.62
66825 Reposition intraocular lens $1,321.20
66830 Removal of lens lesion $1,112.41
66840 Removal of lens material $1,083.88
66850 Removal of lens material $1,227.87
66852 Removal of lens material $1,324.44
66920 Extraction of lens $1,186.82
66930 Extraction of lens $1,365.54
66940 Extraction of lens $1,231.98
66982 Cataract surgery, complex $1,712.92
66983 Cataract surg w/iol, 1 stage $1,112.87
66984 Cataract surg w/iol, 1 stage $1,304.55
66985 Insert lens prosthesis $1,153.80
66986 Exchange lens prosthesis $1,570.53
66990 Ophthalmic endoscope add-on $162.66
66999 Eye surgery procedure $0.00
67005 Partial removal of eye fluid $735.72
67010 Partial removal of eye fluid $863.01
67015 Release of eye fluid $1,059.53
67025 Replace eye fluid $1,501.08
67027 Implant eye drug system $1,051.49
67028 Injection eye drug $640.16
67030 Incise inner eye strands $837.43
67031 Laser surgery, eye strands $605.83
67036 Removal of inner eye fluid $1,549.68
67038 Strip retinal membrane $2,708.37
67039 Laser treatment of retina $1,969.82
67040 Laser treatment of retina $2,277.79
67101 Repair detached retina $1,251.73
67105 Repair detached retina $1,114.70
67107 Repair detached retina $2,013.33
67108 Repair detached retina $2,758.25
67110 Repair detached retina $1,729.76
67112 Rerepair detached retina $2,288.72
67115 Release encircling material $867.91
67120 Remove eye implant material $1,302.26
67121 Remove eye implant material $1,581.82
67141 Treatment of retina $894.26
67145 Treatment of retina $805.40
67208 Treatment of retinal lesion $919.86
67210 Treatment of retinal lesion $1,102.59
67218 Treatment of retinal lesion $2,376.27
67220 Treatment of choroid lesion $1,677.72
67221 Ocular photodynamic ther $606.27
67225 Eye photodynamic ther add-on $53.34
67227 Treatment of retinal lesion $940.50
67228 Treatment of retinal lesion $1,601.10
67250 Reinforce eye wall $1,374.65
67255 Reinforce/graft eye wall $1,432.16
67299 Eye surgery procedure $0.00
67311 Revise eye muscle $949.17
67312 Revise two eye muscles $1,171.19
67314 Revise eye muscle $1,073.00
67316 Revise two eye muscles $1,303.01
67318 Revise eye muscle(s) $1,124.15
67320 Revise eye muscle(s) add-on $464.74
67331 Eye surgery follow-up add-on $441.13
67332 Rerevise eye muscles add-on $481.85
67334 Revise eye muscle w/suture $427.59
67335 Eye suture during surgery $267.17
67340 Revise eye muscle add-on $528.82
67343 Release eye tissue $1,065.81
67345 Destroy nerve of eye muscle $526.71
67350 Biopsy eye muscle $348.55
67399 Eye muscle surgery procedure $0.00
67400 Explore/biopsy eye socket $1,607.22
67405 Explore/drain eye socket $1,369.71
67412 Explore/treat eye socket $1,619.82
67413 Explore/treat eye socket $1,599.67
67414 Explr/decompress eye socket $1,814.11
67415 Aspiration, orbital contents $188.21
67420 Explore/treat eye socket $2,822.67
67430 Explore/treat eye socket $2,128.40
67440 Explore/drain eye socket $2,065.10
67445 Explr/decompress eye socket $2,182.31
67450 Explore/biopsy eye socket $2,119.88
67500 Inject/treat eye socket $117.16
67505 Inject/treat eye socket $126.29
67515 Inject/treat eye socket $102.69
67550 Insert eye socket implant $1,625.49
67560 Revise eye socket implant $1,658.52
67570 Decompress optic nerve $1,893.16
67599 Orbit surgery procedure $0.00
67700 Drainage of eyelid abscess $323.40
67710 Incision of eyelid $252.87
67715 Incision of eyelid fold $323.40
67800 Remove eyelid lesion $224.34
67801 Remove eyelid lesions $307.77
67805 Remove eyelid lesions $356.27
67808 Remove eyelid lesion(s) $650.30
67810 Biopsy of eyelid $218.53
67820 Revise eyelashes $119.44
67825 Revise eyelashes $210.64
67830 Revise eyelashes $386.81
67835 Revise eyelashes $767.95
67840 Remove eyelid lesion $403.09
67850 Treat eyelid lesion $327.70
67875 Closure of eyelid by suture $353.16
67880 Revision of eyelid $954.43
67882 Revision of eyelid $1,144.46
67900 Repair brow defect $1,195.09
67901 Repair eyelid defect $974.43
67902 Repair eyelid defect $983.73
67903 Repair eyelid defect $1,267.67
67904 Repair eyelid defect $1,337.28
67906 Repair eyelid defect $1,151.00
67908 Repair eyelid defect $998.51
67909 Revise eyelid defect $1,057.22
67911 Revise eyelid defect $818.24
67912 Correction eyelid w/ implant $1,101.70
67914 Repair eyelid defect $841.75
67915 Repair eyelid defect $472.12
67916 Repair eyelid defect $1,216.09
67917 Repair eyelid defect $1,127.61
67921 Repair eyelid defect $841.75
67922 Repair eyelid defect $465.09
67923 Repair eyelid defect $1,229.73
67924 Repair eyelid defect $1,067.75
67930 Repair eyelid wound $841.75
67935 Repair eyelid wound $1,257.86
67938 Remove eyelid foreign body $301.04
67950 Revision of eyelid $1,014.21
67961 Revision of eyelid $1,137.05
67966 Revision of eyelid $1,077.10
67971 Reconstruction of eyelid $1,248.34
67973 Reconstruction of eyelid $1,620.08
67974 Reconstruction of eyelid $1,610.28
67975 Reconstruction of eyelid $1,175.31
67999 Revision of eyelid $0.00
68020 Incise/drain eyelid lining $297.88
68040 Treatment of eyelid lesions $238.02
68100 Biopsy of eyelid lining $268.89
68110 Remove eyelid lining lesion $331.29
68115 Remove eyelid lining lesion $563.15
68130 Remove eyelid lining lesion $935.72
68135 Remove eyelid lining lesion $420.39
68200 Treat eyelid by injection $86.85
68320 Revise/graft eyelid lining $860.48
68325 Revise/graft eyelid lining $1,001.15
68326 Revise/graft eyelid lining $977.90
68328 Revise/graft eyelid lining $1,110.56
68330 Revise eyelid lining $866.29
68335 Revise/graft eyelid lining $1,015.65
68340 Separate eyelid adhesions $954.43
68360 Revise eyelid lining $787.19
68362 Revise eyelid lining $1,090.89
68371 Harvest eye tissue, alograft $550.45
68399 Eyelid lining surgery $0.00
68400 Incise/drain tear gland $391.74
68420 Incise/drain tear sac $432.70
68440 Incise tear duct opening $246.80
68500 Removal of tear gland $1,545.62
68505 Partial removal, tear gland $1,608.16
68510 Biopsy of tear gland $558.66
68520 Removal of tear sac $1,109.43
68525 Biopsy of tear sac $286.01
68530 Clearance of tear duct $929.71
68540 Remove tear gland lesion $1,482.27
68550 Remove tear gland lesion $1,825.10
68700 Repair tear ducts $1,005.34
68705 Revise tear duct opening $319.49
68720 Create tear sac drain $1,252.81
68745 Create tear duct drain $1,225.41
68750 Create tear duct drain $1,259.67
68760 Close tear duct opening $243.98
68761 Close tear duct opening $257.38
68770 Close tear system fistula $1,412.96
68801 Dilate tear duct opening $136.63
68810 Probe nasolacrimal duct $305.04
68811 Probe nasolacrimal duct $342.09
68815 Probe nasolacrimal duct $806.60
68840 Explore/irrigate tear ducts $186.64
68850 Injection for tear sac x-ray $710.85
68899 Tear duct system surgery $0.00
69000 Drain external ear lesion $189.30
69005 Drain external ear lesion $367.87
69020 Drain outer ear canal lesion $276.93
69090 Pierce earlobes $110.78
69100 Biopsy of external ear $110.78
69105 Biopsy of external ear canal $166.15
69110 Remove external ear, partial $546.29
69120 Removal of external ear $587.01
69140 Remove ear canal lesion(s) $1,078.33
69145 Remove ear canal lesion(s) $276.93
69150 Extensive ear canal surgery $1,727.22
69155 Extensive ear/neck surgery $2,609.64
69200 Clear outer ear canal $172.57
69205 Clear outer ear canal $186.33
69210 Remove impacted ear wax $82.28
69220 Clean out mastoid cavity $134.05
69222 Clean out mastoid cavity $221.35
69300 Revise external ear $783.24
69310 Rebuild outer ear canal $1,412.40
69320 Rebuild outer ear canal $2,144.97
69399 Outer ear surgery procedure $0.00
69400 Inflate middle ear canal $134.88
69401 Inflate middle ear canal $82.96
69405 Catheterize middle ear canal $266.12
69410 Inset middle ear (baffle) $99.88
69420 Incision of eardrum $315.49
69421 Incision of eardrum $278.57
69424 Remove ventilating tube $127.93
69433 Create eardrum opening $330.71
69436 Create eardrum opening $305.04
69440 Exploration of middle ear $1,018.86
69450 Eardrum revision $776.93
69501 Mastoidectomy $1,189.37
69502 Mastoidectomy $1,596.18
69505 Remove mastoid structures $1,661.34
69511 Extensive mastoid surgery $1,726.04
69530 Extensive mastoid surgery $2,381.01
69535 Remove part of temporal bone $4,278.76
69540 Remove ear lesion $208.05
69550 Remove ear lesion $1,424.23
69552 Remove ear lesion $2,396.69
69554 Remove ear lesion $4,006.05
69601 Mastoid surgery revision $1,714.44
69602 Mastoid surgery revision $1,736.38
69603 Mastoid surgery revision $1,786.44
69604 Mastoid surgery revision $1,784.03
69605 Mastoid surgery revision $2,313.25
69610 Repair of eardrum $428.31
69620 Repair of eardrum $877.59
69631 Repair eardrum structures $1,304.47
69632 Rebuild eardrum structures $1,656.51
69633 Rebuild eardrum structures $1,582.50
69635 Repair eardrum structures $1,675.73
69636 Rebuild eardrum structures $1,946.95
69637 Rebuild eardrum structures $1,934.26
69641 Revise middle ear & mastoid $1,636.31
69642 Revise middle ear & mastoid $2,137.73
69643 Revise middle ear & mastoid $1,954.76
69644 Revise middle ear & mastoid $2,144.68
69645 Revise middle ear & mastoid $2,075.21
69646 Revise middle ear & mastoid $2,262.84
69650 Release middle ear bone $1,258.21
69660 Revise middle ear bone $1,513.87
69661 Revise middle ear bone $1,981.65
69662 Revise middle ear bone $1,938.94
69666 Repair middle ear structures $1,270.44
69667 Repair middle ear structures $1,271.52
69670 Remove mastoid air cells $1,484.41
69676 Remove middle ear nerve $1,261.87
69700 Close mastoid fistula $969.19
69710 Implant/replace hearing aid $969.19
69711 Remove/repair hearing aid $1,038.01
69714 Implant temple bone w/stimul $1,766.70
69715 Temple bne implnt w/stimulat $2,266.75
69717 Temple bone implant revision $1,819.21
69718 Revise temple bone implant $2,279.56
69720 Release facial nerve $1,854.28
69725 Release facial nerve $3,124.70
69740 Repair facial nerve $1,949.53
69745 Repair facial nerve $2,066.32
69799 Middle ear surgery procedure $0.00
69801 Incise inner ear $1,132.02
69802 Incise inner ear $1,674.72
69805 Explore inner ear $1,761.87
69806 Explore inner ear $1,587.74
69820 Establish inner ear window $1,337.16
69840 Revise inner ear window $1,266.82
69905 Remove inner ear $1,430.73
69910 Remove inner ear & mastoid $1,722.90
69915 Incise inner ear nerve $2,621.09
69930 Implant cochlear device $2,115.52
69949 Inner ear surgery procedure $0.00
69950 Incise inner ear nerve $3,136.00
69955 Release facial nerve $3,304.07
69960 Release inner ear canal $3,289.85
69970 Remove inner ear lesion $3,597.49
69979 Temporal bone surgery $0.00
69990 Microsurgery add-on $405.61

with 7

70010 Contrast x-ray of brain $424.46
70010.26 Contrast x-ray of brain $118.11
70015 Contrast x-ray of brain $214.15
70015.26 Contrast x-ray of brain $117.77
70030 X-ray eye for foreign body $46.08
70030.26 X-ray eye for foreign body $17.17
70100 X-ray exam of jaw $54.40
70100.26 X-ray exam of jaw $17.92
70110 X-ray exam of jaw $68.58
70110.26 X-ray exam of jaw $24.52
70120 X-ray exam of mastoids $61.97
70120.26 X-ray exam of mastoids $17.92
70130 X-ray exam of mastoids $89.41
70130.26 X-ray exam of mastoids $33.31
70134 X-ray exam of middle ear $85.97
70134.26 X-ray exam of middle ear $33.31
70140 X-ray exam of facial bones $62.72
70140.26 X-ray exam of facial bones $18.66
70150 X-ray exam of facial bones $82.06
70150.26 X-ray exam of facial bones $25.95
70160 X-ray exam of nasal bones $53.66
70160.26 X-ray exam of nasal bones $17.17
70170 X-ray exam of tear duct $97.09
70170.26 X-ray exam of tear duct $29.63
70190 X-ray exam of eye sockets $64.90
70190.26 X-ray exam of eye sockets $20.84
70200 X-ray exam of eye sockets $83.55
70200.26 X-ray exam of eye sockets $27.45
70210 X-ray exam of sinuses $61.23
70210.26 X-ray exam of sinuses $17.17
70220 X-ray exam of sinuses $80.62
70220.26 X-ray exam of sinuses $24.52
70240 X-ray exam, pituitary saddle $47.58
70240.26 X-ray exam, pituitary saddle $18.66
70250 X-ray exam of skull $67.83
70250.26 X-ray exam of skull $23.77
70260 X-ray exam of skull $96.64
70260.26 X-ray exam of skull $33.31
70300 X-ray exam of teeth $30.53
70300.26 X-ray exam of teeth $11.25
70310 X-ray exam of teeth $46.71
70310.26 X-ray exam of teeth $17.80
70320 Full mouth x-ray of teeth $78.38
70320.26 Full mouth x-ray of teeth $22.28
70328 X-ray exam of jaw joint $52.34
70328.26 X-ray exam of jaw joint $17.92
70330 X-ray exam of jaw joints $84.01
70330.26 X-ray exam of jaw joints $23.77
70332 X-ray exam of jaw joint $203.48
70332.26 X-ray exam of jaw joint $54.78
70336 Magnetic image, jaw joint $940.41
70336.26 Magnetic image, jaw joint $146.31
70350 X-ray head for orthodontia $44.02
70350.26 X-ray head for orthodontia $17.86
70355 Panoramic x-ray of jaws $61.40
70355.26 Panoramic x-ray of jaws $20.79
70360 X-ray exam of neck $46.08
70360.26 X-ray exam of neck $17.17
70370 Throat x-ray & fluoroscopy $124.41
70370.26 Throat x-ray & fluoroscopy $31.81
70371 Speech evaluation, complex $232.42
70371.26 Speech evaluation, complex $83.72
70373 Contrast x-ray of larynx $170.88
70373.26 Contrast x-ray of larynx $43.87
70380 X-ray exam of salivary gland $64.67
70380.26 X-ray exam of salivary gland $17.17
70390 X-ray exam of salivary duct $165.02
70390.26 X-ray exam of salivary duct $38.01
70450 Ct head/brain w/o dye $419.38
70450.26 Ct head/brain w/o dye $84.47
70460 Ct head/brain w/dye $512.58
70460.26 Ct head/brain w/dye $111.91
70470 Ct head/brain w/o & w/ dye $626.98
70470.26 Ct head/brain w/o & w/ dye $125.46
70480 Ct orbit/ear/fossa w/o dye $461.82
70480.26 Ct orbit/ear/fossa w/o dye $126.90
70481 Ct orbit/ear/fossa w/dye $537.10
70481.26 Ct orbit/ear/fossa w/dye $136.43
70482 Ct orbit/ear/fossa w/o&w dye $644.56
70482.26 Ct orbit/ear/fossa w/o&w dye $143.04
70486 Ct maxillofacial w/o dye $447.58
70486.26 Ct maxillofacial w/o dye $112.66
70487 Ct maxillofacial w/dye $529.06
70487.26 Ct maxillofacial w/dye $128.39
70488 Ct maxillofacial w/o & w dye $641.63
70488.26 Ct maxillofacial w/o & w dye $140.11
70490 Ct soft tissue neck w/o dye $461.82
70490.26 Ct soft tissue neck w/o dye $126.90
70491 Ct soft tissue neck w/dye $537.10
70491.26 Ct soft tissue neck w/dye $136.43
70492 Ct sft tsue nck w/o & w/dye $644.56
70492.26 Ct sft tsue nck w/o & w/dye $143.04
70496 Ct angiography, head $926.49
70496.26 Ct angiography, head $173.35
70498 Ct angiography, neck $926.49
70498.26 Ct angiography, neck $173.35
70540 Mri orbit/face/neck w/o dye $920.06
70540.26 Mri orbit/face/neck w/o dye $132.82
70542 Mri orbit/face/neck w/dye $1,104.42
70542.26 Mri orbit/face/neck w/dye $159.52
70543 Mri orbt/fac/nck w/o & w dye $1,960.85
70543.26 Mri orbt/fac/nck w/o & w dye $212.18
70544 Mr angiography head w/o dye $912.62
70544.26 Mr angiography head w/o dye $118.52
70545 Mr angiography head w/dye $912.62
70545.26 Mr angiography head w/dye $118.52
70546 Mr angiograph head w/o&w dye $1,747.13
70546.26 Mr angiograph head w/o&w dye $178.46
70547 Mr angiography neck w/o dye $912.62
70547.26 Mr angiography neck w/o dye $118.52
70548 Mr angiography neck w/dye $912.62
70548.26 Mr angiography neck w/dye $118.52
70549 Mr angiograph neck w/o&w dye $1,747.13
70549.26 Mr angiograph neck w/o&w dye $178.46
70551 Mri brain w/o dye $941.10
70551.26 Mri brain w/o dye $147.00
70552 Mri brain w/ dye $1,129.75
70552.26 Mri brain w/ dye $176.97
70553 Mri brain w/o & w/ dye $1,998.83
70553.26 Mri brain w/o & w/ dye $234.05
70557 Mri brain w/o dye $2,270.75
70557.26 Mri brain w/o dye $286.77
70558 Mri brain w/ dye $2,559.81
70558.26 Mri brain w/ dye $316.75
70559 Mri brain w/o & w/ dye $2,889.34
70559.26 Mri brain w/o & w/ dye $317.43
71010 Chest x-ray $50.96
71010.26 Chest x-ray $17.92
71015 Chest x-ray $57.33
71015.26 Chest x-ray $20.84
71020 Chest x-ray $65.65
71020.26 Chest x-ray $21.59
71021 Chest x-ray $79.36
71021.26 Chest x-ray $26.70
71022 Chest x-ray $83.38
71022.26 Chest x-ray $30.72
71023 Chest x-ray and fluoroscopy $94.12
71023.26 Chest x-ray and fluoroscopy $38.01
71030 Chest x-ray $86.48
71030.26 Chest x-ray $30.38
71034 Chest x-ray and fluoroscopy $147.94
71034.26 Chest x-ray and fluoroscopy $46.05
71035 Chest x-ray $54.40
71035.26 Chest x-ray $17.92
71040 Contrast x-ray of bronchi $161.03
71040.26 Contrast x-ray of bronchi $57.76
71060 Contrast x-ray of bronchi $230.46
71060.26 Contrast x-ray of bronchi $73.84
71090 X-ray & pacemaker insertion $175.60
71090.26 X-ray & pacemaker insertion $55.47
71100 X-ray exam of ribs $62.21
71100.26 X-ray exam of ribs $21.59
71101 X-ray exam of ribs/chest $74.20
71101.26 X-ray exam of ribs/chest $26.70
71110 X-ray exam of ribs $82.81
71110.26 X-ray exam of ribs $26.70
71111 X-ray exam of ribs/ chest $95.15
71111.26 X-ray exam of ribs/ chest $31.81
71120 X-ray exam of breastbone $66.22
71120.26 X-ray exam of breastbone $20.10
71130 X-ray exam of breastbone $71.85
71130.26 X-ray exam of breastbone $21.59
71250 Ct thorax w/o dye $533.75
71250.26 Ct thorax w/o dye $114.84
71260 Ct thorax w/dye $623.71
71260.26 Ct thorax w/dye $122.19
71270 Ct thorax w/o & w/ dye $763.59
71270.26 Ct thorax w/o & w/ dye $136.43
71275 Ct angiography, chest $1,057.64
71275.26 Ct angiography, chest $189.15
71550 Mri chest w/o dye $933.09
71550.26 Mri chest w/o dye $143.79
71551 Mri chest w/dye $1,117.44
71551.26 Mri chest w/dye $170.83
71552 Mri chest w/o & w/dye $1,966.33
71552.26 Mri chest w/o & w/dye $223.14
71555 Mri angio chest w or w/o dye $974.00
71555.26 Mri angio chest w or w/o dye $179.90
72010 X-ray exam of spine $118.27
72010.26 X-ray exam of spine $45.30
72020 X-ray exam of spine $43.90
72020.26 X-ray exam of spine $14.99
72040 X-ray exam of neck spine $64.27
72040.26 X-ray exam of neck spine $21.59
72050 X-ray exam of neck spine $94.05
72050.26 X-ray exam of neck spine $30.72
72052 X-ray exam of neck spine $115.69
72052.26 X-ray exam of neck spine $35.83
72069 X-ray exam of trunk spine $57.04
72069.26 X-ray exam of trunk spine $22.62
72070 X-ray exam of thoracic spine $67.71
72070.26 X-ray exam of thoracic spine $21.59
72072 X-ray exam of thoracic spine $74.25
72072.26 X-ray exam of thoracic spine $21.59
72074 X-ray exam of thoracic spine $86.30
72074.26 X-ray exam of thoracic spine $21.59
72080 X-ray exam of trunk spine $69.43
72080.26 X-ray exam of trunk spine $21.93
72090 X-ray exam of trunk spine $75.29
72090.26 X-ray exam of trunk spine $27.79
72100 X-ray exam of lower spine $69.43
72100.26 X-ray exam of lower spine $21.93
72110 X-ray exam of lower spine $95.43
72110.26 X-ray exam of lower spine $30.72
72114 X-ray exam of lower spine $120.50
72114.26 X-ray exam of lower spine $36.52
72120 X-ray exam of lower spine $85.27
72120.26 X-ray exam of lower spine $21.93
72125 Ct neck spine w/o dye $533.75
72125.26 Ct neck spine w/o dye $114.84
72126 Ct neck spine w/dye $621.53
72126.26 Ct neck spine w/dye $120.01
72127 Ct neck spine w/o & w/dye $752.62
72127.26 Ct neck spine w/o & w/dye $125.46
72128 Ct chest spine w/o dye $533.75
72128.26 Ct chest spine w/o dye $114.84
72129 Ct chest spine w/dye $621.53
72129.26 Ct chest spine w/dye $120.01
72130 Ct chest spine w/o & w/dye $752.62
72130.26 Ct chest spine w/o & w/dye $125.46
72131 Ct lumbar spine w/o dye $533.75
72131.26 Ct lumbar spine w/o dye $114.84
72132 Ct lumbar spine w/dye $622.56
72132.26 Ct lumbar spine w/dye $121.04
72133 Ct lumbar spine w/o & w/dye $753.31
72133.26 Ct lumbar spine w/o & w/dye $126.15
72141 Mri neck spine w/o dye $952.81
72141.26 Mri neck spine w/o dye $158.71
72142 Mri neck spine w/dye $1,144.68
72142.26 Mri neck spine w/dye $191.90
72146 Mri chest spine w/o dye $1,039.21
72146.26 Mri chest spine w/o dye $158.02
72147 Mri chest spine w/dye $1,143.99
72147.26 Mri chest spine w/dye $191.21
72148 Mri lumbar spine w/o dye $1,028.18
72148.26 Mri lumbar spine w/o dye $147.00
72149 Mri lumbar spine w/dye $1,130.78
72149.26 Mri lumbar spine w/dye $178.00
72156 Mri neck spine w/o & w/dye $2,019.67
72156.26 Mri neck spine w/o & w/dye $254.89
72157 Mri chest spine w/o & w/dye $2,019.67
72157.26 Mri chest spine w/o & w/dye $254.89
72158 Mri lumbar spine w/o & w/dye $1,999.17
72158.26 Mri lumbar spine w/o & w/dye $234.39
72159 Mr angio spine w/o&w/dye $1,049.32
72159.26 Mr angio spine w/o&w/dye $185.35
72170 X-ray exam of pelvis $53.66
72170.26 X-ray exam of pelvis $17.17
72190 X-ray exam of pelvis $68.34
72190.26 X-ray exam of pelvis $20.84
72191 Ct angiograph pelv w/o&w/dye $1,023.26
72191.26 Ct angiograph pelv w/o&w/dye $178.87
72192 Ct pelvis w/o dye $527.15
72192.26 Ct pelvis w/o dye $108.24
72193 Ct pelvis w/dye $600.18
72193.26 Ct pelvis w/dye $114.84
72194 Ct pelvis w/o & w/dye $722.04
72194.26 Ct pelvis w/o & w/dye $120.70
72195 Mri pelvis w/o dye $933.43
72195.26 Mri pelvis w/o dye $144.13
72196 Mri pelvis w/dye $1,117.10
72196.26 Mri pelvis w/dye $170.49
72197 Mri pelvis w/o & w/dye $1,974.55
72197.26 Mri pelvis w/o & w/dye $223.14
72198 Mr angio pelvis w/o & w/dye $978.76
72198.26 Mr angio pelvis w/o & w/dye $184.66
72200 X-ray exam sacroiliac joints $53.66
72200.26 X-ray exam sacroiliac joints $17.17
72202 X-ray exam sacroiliac joints $62.72
72202.26 X-ray exam sacroiliac joints $18.66
72220 X-ray exam of tailbone $57.78
72220.26 X-ray exam of tailbone $17.17
72240 Contrast x-ray of neck spine $426.62
72240.26 Contrast x-ray of neck spine $89.63
72255 Contrast x-ray, thorax spine $395.30
72255.26 Contrast x-ray, thorax spine $88.95
72265 Contrast x-ray, lower spine $370.73
72265.26 Contrast x-ray, lower spine $81.59
72270 Contrast x-ray, spine $562.96
72270.26 Contrast x-ray, spine $130.29
72275 Epidurography $224.02
72275.26 Epidurography $71.89
72285 X-ray c/t spine disk $707.58
72285.26 X-ray c/t spine disk $113.81
72295 X-ray of lower spine disk $638.53
72295.26 X-ray of lower spine disk $82.28
73000 X-ray exam of collar bone $52.22
73000.26 X-ray exam of collar bone $15.73
73010 X-ray exam of shoulder blade $53.66
73010.26 X-ray exam of shoulder blade $17.17
73020 X-ray exam of shoulder $48.03
73020.26 X-ray exam of shoulder $14.99
73030 X-ray exam of shoulder $58.53
73030.26 X-ray exam of shoulder $17.92
73040 Contrast x-ray of shoulder $202.79
73040.26 Contrast x-ray of shoulder $54.09
73050 X-ray exam of shoulders $67.94
73050.26 X-ray exam of shoulders $20.44
73060 X-ray exam of humerus $57.78
73060.26 X-ray exam of humerus $17.17
73070 X-ray exam of elbow $51.47
73070.26 X-ray exam of elbow $14.99
73080 X-ray exam of elbow $57.78
73080.26 X-ray exam of elbow $17.17
73085 Contrast x-ray of elbow $203.48
73085.26 Contrast x-ray of elbow $54.78
73090 X-ray exam of forearm $52.22
73090.26 X-ray exam of forearm $15.73
73092 X-ray exam of arm, infant $50.16
73092.26 X-ray exam of arm, infant $15.73
73100 X-ray exam of wrist $51.19
73100.26 X-ray exam of wrist $16.76
73110 X-ray exam of wrist $54.34
73110.26 X-ray exam of wrist $17.17
73115 Contrast x-ray of wrist $166.99
73115.26 Contrast x-ray of wrist $54.78
73120 X-ray exam of hand $50.16
73120.26 X-ray exam of hand $15.73
73130 X-ray exam of hand $54.34
73130.26 X-ray exam of hand $17.17
73140 X-ray exam of finger(s) $41.72
73140.26 X-ray exam of finger(s) $12.80
73200 Ct upper extremity w/o dye $458.99
73200.26 Ct upper extremity w/o dye $108.24
73201 Ct upper extremity w/dye $533.75
73201.26 Ct upper extremity w/dye $114.84
73202 Ct uppr extremity w/o&w/dye $647.34
73202.26 Ct uppr extremity w/o&w/dye $121.04
73206 Ct angio upr extrm w/o&w/dye $948.90
73206.26 Ct angio upr extrm w/o&w/dye $178.18
73218 Mri upper extremity w/o dye $920.06
73218.26 Mri upper extremity w/o dye $132.82
73219 Mri upper extremity w/dye $1,104.42
73219.26 Mri upper extremity w/dye $159.52
73220 Mri uppr extremity w/o&w/dye $1,961.53
73220.26 Mri uppr extremity w/o&w/dye $212.86
73221 Mri joint upr extrem w/o dye $920.06
73221.26 Mri joint upr extrem w/o dye $132.82
73222 Mri joint upr extrem w/dye $1,104.42
73222.26 Mri joint upr extrem w/dye $159.52
73223 Mri joint upr extr w/o&w/dye $1,960.85
73223.26 Mri joint upr extr w/o&w/dye $212.18
73225 Mr angio upr extr w/o&w/dye $957.01
73225.26 Mr angio upr extr w/o&w/dye $178.74
73500 X-ray exam of hip $50.21
73500.26 X-ray exam of hip $17.17
73510 X-ray exam of hip $61.80
73510.26 X-ray exam of hip $21.19
73520 X-ray exam of hips $73.80
73520.26 X-ray exam of hips $26.30
73525 Contrast x-ray of hip $202.79
73525.26 Contrast x-ray of hip $54.09
73530 X-ray exam of hip $65.37
73530.26 X-ray exam of hip $28.88
73540 X-ray exam of pelvis & hips $61.06
73540.26 X-ray exam of pelvis & hips $20.44
73542 X-ray exam, sacroiliac joint $205.14
73542.26 X-ray exam, sacroiliac joint $56.45
73550 X-ray exam of thigh $57.78
73550.26 X-ray exam of thigh $17.17
73560 X-ray exam of knee, 1 or 2 $54.00
73560.26 X-ray exam of knee, 1 or 2 $17.51
73562 X-ray exam of knee, 3 $58.87
73562.26 X-ray exam of knee, 3 $18.26
73564 X-ray exam, knee, 4 or more $66.68
73564.26 X-ray exam, knee, 4 or more $22.62
73565 X-ray exam of knees $51.93
73565.26 X-ray exam of knees $17.51
73580 Contrast x-ray of knee joint $239.27
73580.26 Contrast x-ray of knee joint $54.09
73590 X-ray exam of lower leg $53.66
73590.26 X-ray exam of lower leg $17.17
73592 X-ray exam of leg, infant $50.84
73592.26 X-ray exam of leg, infant $16.42
73600 X-ray exam of ankle $50.16
73600.26 X-ray exam of ankle $15.73
73610 X-ray exam of ankle $54.34
73610.26 X-ray exam of ankle $17.17
73615 Contrast x-ray of ankle $203.48
73615.26 Contrast x-ray of ankle $54.78
73620 X-ray exam of foot $50.16
73620.26 X-ray exam of foot $15.73
73630 X-ray exam of foot $54.34
73630.26 X-ray exam of foot $17.17
73650 X-ray exam of heel $48.78
73650.26 X-ray exam of heel $15.73
73660 X-ray exam of toe(s) $41.72
73660.26 X-ray exam of toe(s) $12.80
73700 Ct lower extremity w/o dye $458.99
73700.26 Ct lower extremity w/o dye $108.24
73701 Ct lower extremity w/dye $533.75
73701.26 Ct lower extremity w/dye $114.84
73702 Ct lwr extremity w/o&w/dye $647.00
73702.26 Ct lwr extremity w/o&w/dye $120.70
73706 Ct angio lwr extr w/o&w/dye $957.69
73706.26 Ct angio lwr extr w/o&w/dye $186.97
73718 Mri lower extremity w/o dye $920.06
73718.26 Mri lower extremity w/o dye $132.82
73719 Mri lower extremity w/dye $1,104.42
73719.26 Mri lower extremity w/dye $159.52
73720 Mri lwr extremity w/o&w/dye $1,961.53
73720.26 Mri lwr extremity w/o&w/dye $212.86
73721 Mri jnt of lwr extre w/o dye $920.06
73721.26 Mri jnt of lwr extre w/o dye $132.82
73722 Mri joint of lwr extr w/dye $1,104.76
73722.26 Mri joint of lwr extr w/dye $159.86
73723 Mri joint lwr extr w/o&w/dye $1,960.85
73723.26 Mri joint lwr extr w/o&w/dye $212.18
73725 Mr ang lwr ext w or w/o dye $974.74
73725.26 Mr ang lwr ext w or w/o dye $180.65
74000 X-ray exam of abdomen $54.40
74000.26 X-ray exam of abdomen $17.92
74010 X-ray exam of abdomen $63.64
74010.26 X-ray exam of abdomen $23.03
74020 X-ray exam of abdomen $70.76
74020.26 X-ray exam of abdomen $26.70
74022 X-ray exam series, abdomen $84.48
74022.26 X-ray exam series, abdomen $31.81
74150 Ct abdomen w/o dye $518.43
74150.26 Ct abdomen w/o dye $117.77
74160 Ct abdomen w/dye $610.80
74160.26 Ct abdomen w/dye $125.46
74170 Ct abdomen w/o &w /dye $739.27
74170.26 Ct abdomen w/o &w /dye $137.93
74175 Ct angio abdom w/o & w/dye $1,031.36
74175.26 Ct angio abdom w/o & w/dye $186.97
74181 Mri abdomen w/o dye $933.77
74181.26 Mri abdomen w/o dye $144.47
74182 Mri abdomen w/dye $1,116.75
74182.26 Mri abdomen w/dye $170.14
74183 Mri abdomen w/o & w/dye $1,974.55
74183.26 Mri abdomen w/o & w/dye $223.14
74185 Mri angio, abdom w orw/o dye $972.56
74185.26 Mri angio, abdom w orw/o dye $178.46
74190 X-ray exam of peritoneum $140.14
74190.26 X-ray exam of peritoneum $47.55
74210 Contrst x-ray exam of throat $119.82
74210.26 Contrst x-ray exam of throat $35.83
74220 Contrast x-ray, esophagus $129.35
74220.26 Contrast x-ray, esophagus $45.36
74230 Cine/vid x-ray, throat/esoph $145.25
74230.26 Cine/vid x-ray, throat/esoph $52.66
74235 Remove esophagus obstruction $302.96
74235.26 Remove esophagus obstruction $117.77
74240 X-ray exam, upper gi tract $172.00
74240.26 X-ray exam, upper gi tract $68.73
74241 X-ray exam, upper gi tract $174.06
74241.26 X-ray exam, upper gi tract $68.73
74245 X-ray exam, upper gi tract $259.33
74245.26 X-ray exam, upper gi tract $90.32
74246 Contrst x-ray uppr gi tract $185.76
74246.26 Contrst x-ray uppr gi tract $68.73
74247 Contrst x-ray uppr gi tract $188.86
74247.26 Contrst x-ray uppr gi tract $68.73
74249 Contrst x-ray uppr gi tract $273.44
74249.26 Contrst x-ray uppr gi tract $90.32
74250 X-ray exam of small bowel $139.39
74250.26 X-ray exam of small bowel $46.80
74251 X-ray exam of small bowel $161.33
74251.26 X-ray exam of small bowel $68.73
74260 X-ray exam of small bowel $155.06
74260.26 X-ray exam of small bowel $49.73
74270 Contrast x-ray exam of colon $190.24
74270.26 Contrast x-ray exam of colon $68.73
74280 Contrast x-ray exam of colon $257.04
74280.26 Contrast x-ray exam of colon $98.36
74283 Contrast x-ray exam of colon $381.78
74283.26 Contrast x-ray exam of colon $200.05
74290 Contrast x-ray, gallbladder $84.48
74290.26 Contrast x-ray, gallbladder $31.81
74291 Contrast x-rays, gallbladder $49.01
74291.26 Contrast x-rays, gallbladder $20.10
74300 X-ray bile ducts/pancreas $190.91
74300.26 X-ray bile ducts/pancreas $35.83
74301 X-rays at surgery add-on $88.16
74301.26 X-rays at surgery add-on $20.84
74305 X-ray bile ducts/pancreas $97.79
74305.26 X-ray bile ducts/pancreas $41.69
74320 Contrast x-ray of bile ducts $277.48
74320.26 Contrast x-ray of bile ducts $53.40
74327 X-ray bile stone removal $195.11
74327.26 X-ray bile stone removal $69.48
74328 X-ray bile duct endoscopy $293.56
74328.26 X-ray bile duct endoscopy $69.48
74329 X-ray for pancreas endoscopy $293.56
74329.26 X-ray for pancreas endoscopy $69.48
74330 X-ray bile/panc endoscopy $313.66
74330.26 X-ray bile/panc endoscopy $89.58
74340 X-ray guide for GI tube $238.59
74340.26 X-ray guide for GI tube $53.40
74350 X-ray guide, stomach tube $299.42
74350.26 X-ray guide, stomach tube $75.34
74355 X-ray guide, intestinal tube $260.52
74355.26 X-ray guide, intestinal tube $75.34
74360 X-ray guide, GI dilation $278.17
74360.26 X-ray guide, GI dilation $54.09
74363 X-ray, bile duct dilation $520.07
74363.26 X-ray, bile duct dilation $87.39
74400 Contrst x-ray, urinary tract $168.42
74400.26 Contrst x-ray, urinary tract $48.29
74410 Contrst x-ray, urinary tract $187.01
74410.26 Contrst x-ray, urinary tract $48.29
74415 Contrst x-ray, urinary tract $198.37
74415.26 Contrst x-ray, urinary tract $48.29
74420 Contrst x-ray, urinary tract $221.02
74420.26 Contrst x-ray, urinary tract $35.83
74425 Contrst x-ray, urinary tract $128.42
74425.26 Contrst x-ray, urinary tract $35.83
74430 Contrast x-ray, bladder $107.19
74430.26 Contrast x-ray, bladder $32.15
74440 X-ray, male genital tract $117.18
74440.26 X-ray, male genital tract $37.32
74445 X-ray exam of penis $192.52
74445.26 X-ray exam of penis $112.66
74450 X-ray, urethra/bladder $136.17
74450.26 X-ray, urethra/bladder $32.90
74455 X-ray, urethra/bladder $145.11
74455.26 X-ray, urethra/bladder $32.90
74470 X-ray exam of kidney lesion $141.86
74470.26 X-ray exam of kidney lesion $53.40
74475 X-ray control, cath insert $342.54
74475.26 X-ray control, cath insert $53.40
74480 X-ray control, cath insert $342.54
74480.26 X-ray control, cath insert $53.40
74485 X-ray guide, GU dilation $278.17
74485.26 X-ray guide, GU dilation $54.09
74710 X-ray measurement of pelvis $108.69
74710.26 X-ray measurement of pelvis $33.65
74740 X-ray, female genital tract $130.61
74740.26 X-ray, female genital tract $38.01
74742 X-ray, fallopian tube $284.09
74742.26 X-ray, fallopian tube $60.01
74775 X-ray exam of perineum $165.39
74775.26 X-ray exam of perineum $62.13
75552 Heart mri for morph w/o dye $952.81
75552.26 Heart mri for morph w/o dye $158.71
75553 Heart mri for morph w/dye $991.97
75553.26 Heart mri for morph w/dye $197.87
75554 Cardiac MRI/function $977.56
75554.26 Cardiac MRI/function $183.46
75555 Cardiac MRI/limited study $970.84
75555.26 Cardiac MRI/limited study $176.74
75556 Cardiac MRI/flow mapping $1,942.44
75600 Contrast x-ray exam of aorta $565.74
75600.26 Contrast x-ray exam of aorta $50.36
75605 Contrast x-ray exam of aorta $603.95
75605.26 Contrast x-ray exam of aorta $114.04
75625 Contrast x-ray exam of aorta $706.79
75625.26 Contrast x-ray exam of aorta $113.35
75630 X-ray aorta, leg arteries $883.11
75630.26 X-ray aorta, leg arteries $179.09
75635 Ct angio abdominal arteries $1,201.22
75635.26 Ct angio abdominal arteries $238.07
75650 Artery x-rays, head & neck $706.79
75650.26 Artery x-rays, head & neck $147.74
75658 Artery x-rays, arm $706.79
75658.26 Artery x-rays, arm $132.58
75660 Artery x-rays, head & neck $706.79
75660.26 Artery x-rays, head & neck $130.52
75662 Artery x-rays, head & neck $1,060.55
75662.26 Artery x-rays, head & neck $168.01
75665 Artery x-rays, head & neck $706.79
75665.26 Artery x-rays, head & neck $130.17
75671 Artery x-rays, head & neck $883.11
75671.26 Artery x-rays, head & neck $165.26
75676 Artery x-rays, neck $706.79
75676.26 Artery x-rays, neck $130.86
75680 Artery x-rays, neck $1,057.80
75680.26 Artery x-rays, neck $165.26
75685 Artery x-rays, spine $706.79
75685.26 Artery x-rays, spine $129.83
75705 Artery x-rays, spine $1,076.98
75705.26 Artery x-rays, spine $217.51
75710 Artery x-rays, arm/leg $603.74
75710.26 Artery x-rays, arm/leg $113.69
75716 Artery x-rays, arms/legs $613.42
75716.26 Artery x-rays, arms/legs $129.83
75722 Artery x-rays, kidney $706.79
75722.26 Artery x-rays, kidney $114.73
75724 Artery x-rays, kidneys $883.11
75724.26 Artery x-rays, kidneys $151.88
75726 Artery x-rays, abdomen $777.37
75726.26 Artery x-rays, abdomen $112.66
75731 Artery x-rays, adrenal gland $706.79
75731.26 Artery x-rays, adrenal gland $112.66
75733 Artery x-rays, adrenals $953.64
75733.26 Artery x-rays, adrenals $129.83
75736 Artery x-rays, pelvis $706.79
75736.26 Artery x-rays, pelvis $112.66
75741 Artery x-rays, lung $650.11
75741.26 Artery x-rays, lung $129.83
75743 Artery x-rays, lungs $784.20
75743.26 Artery x-rays, lungs $163.88
75746 Artery x-rays, lung $603.12
75746.26 Artery x-rays, lung $112.66
75756 Artery x-rays, chest $605.81
75756.26 Artery x-rays, chest $117.14
75774 Artery x-ray, each vessel $557.44
75774.26 Artery x-ray, each vessel $36.52
75790 Visualize A-V shunt $278.86
75790.26 Visualize A-V shunt $182.48
75801 Lymph vessel x-ray, arm/leg $465.62
75801.26 Lymph vessel x-ray, arm/leg $81.13
75803 Lymph vessel x-ray,arms/legs $500.07
75803.26 Lymph vessel x-ray,arms/legs $115.59
75805 Lymph vessel x-ray, trunk $513.46
75805.26 Lymph vessel x-ray, trunk $80.79
75807 Lymph vessel x-ray, trunk $548.26
75807.26 Lymph vessel x-ray, trunk $115.59
75809 Nonvascular shunt, x-ray $102.90
75809.26 Nonvascular shunt, x-ray $46.80
75810 Vein x-ray, spleen/liver $603.33
75810.26 Vein x-ray, spleen/liver $113.00
75820 Vein x-ray, arm/leg $136.94
75820.26 Vein x-ray, arm/leg $69.48
75822 Vein x-ray, arms/legs $209.95
75822.26 Vein x-ray, arms/legs $105.31
75825 Vein x-ray, trunk $603.33
75825.26 Vein x-ray, trunk $113.00
75827 Vein x-ray, chest $603.12
75827.26 Vein x-ray, chest $112.66
75831 Vein x-ray, kidney $603.12
75831.26 Vein x-ray, kidney $112.66
75833 Vein x-ray, kidneys $624.17
75833.26 Vein x-ray, kidneys $147.74
75840 Vein x-ray, adrenal gland $603.53
75840.26 Vein x-ray, adrenal gland $113.35
75842 Vein x-ray, adrenal glands $623.76
75842.26 Vein x-ray, adrenal glands $147.06
75860 Vein x-ray, neck $604.16
75860.26 Vein x-ray, neck $114.38
75870 Vein x-ray, skull $604.16
75870.26 Vein x-ray, skull $114.38
75872 Vein x-ray, skull $603.12
75872.26 Vein x-ray, skull $112.66
75880 Vein x-ray, eye socket $136.94
75880.26 Vein x-ray, eye socket $69.48
75885 Vein x-ray, liver $620.90
75885.26 Vein x-ray, liver $142.29
75887 Vein x-ray, liver $620.90
75887.26 Vein x-ray, liver $142.29
75889 Vein x-ray, liver $603.12
75889.26 Vein x-ray, liver $112.66
75891 Vein x-ray, liver $603.12
75891.26 Vein x-ray, liver $112.66
75893 Venous sampling by catheter $883.11
75893.26 Venous sampling by catheter $53.40
75894 X-rays, transcath therapy $1,104.75
75894.26 X-rays, transcath therapy $130.17
75896 X-rays, transcath therapy $971.34
75896.26 X-rays, transcath therapy $131.21
75898 Follow-up angiography $238.86
75898.26 Follow-up angiography $163.82
75900 Arterial catheter exchange $920.97
75900.26 Arterial catheter exchange $48.29
75901 Remove cva device obstruct $166.93
75901.26 Remove cva device obstruct $48.29
75902 Remove cva lumen obstruct $157.40
75902.26 Remove cva lumen obstruct $38.76
75940 X-ray placement, vein filter $567.98
75940.26 X-ray placement, vein filter $54.09
75945 Intravascular us $364.44
75945.26 Intravascular us $40.88
75946 Intravascular us add-on $203.69
75946.26 Intravascular us add-on $40.88
75952 Endovasc repair abdom aorta $847.80
75952.26 Endovasc repair abdom aorta $466.67
75953 Abdom aneurysm endovas rpr $459.19
75953.26 Abdom aneurysm endovas rpr $158.36
75954 Iliac aneurysm endovas rpr $459.19
75954.26 Iliac aneurysm endovas rpr $158.36
75960 Transcatheter intro, stent $784.20
75960.26 Transcatheter intro, stent $82.91
75961 Retrieval, broken catheter $1,165.08
75961.26 Retrieval, broken catheter $420.55
75962 Repair arterial blockage $883.11
75962.26 Repair arterial blockage $54.78
75964 Repair artery blockage, each $630.29
75964.26 Repair artery blockage, each $35.83
75966 Repair arterial blockage $883.11
75966.26 Repair arterial blockage $131.89
75968 Repair artery blockage, each $630.63
75968.26 Repair artery blockage, each $36.18
75970 Vascular biopsy $600.21
75970.26 Vascular biopsy $83.66
75978 Repair venous blockage $701.81
75978.26 Repair venous blockage $53.40
75980 Contrast xray exam bile duct $526.78
75980.26 Contrast xray exam bile duct $142.29
75982 Contrast xray exam bile duct $574.28
75982.26 Contrast xray exam bile duct $141.60
75984 Xray control catheter change $210.38
75984.26 Xray control catheter change $71.66
75989 Abscess drainage under x-ray $341.16
75989.26 Abscess drainage under x-ray $117.08
75992 Atherectomy, x-ray exam $1,170.37
75992.26 Atherectomy, x-ray exam $54.09
75993 Atherectomy, x-ray exam $631.32
75993.26 Atherectomy, x-ray exam $36.86
75994 Atherectomy, x-ray exam $1,248.18
75994.26 Atherectomy, x-ray exam $131.89
75995 Atherectomy, x-ray exam $1,248.86
75995.26 Atherectomy, x-ray exam $132.58
75996 Atherectomy, x-ray exam $629.94
75996.26 Atherectomy, x-ray exam $35.49
75998 Fluoroguide for vein device $120.42
75998.26 Fluoroguide for vein device $39.04
76000 Fluoroscope examination $109.07
76000.26 Fluoroscope examination $16.48
76001 Fluoroscope exam, extensive $251.74
76001.26 Fluoroscope exam, extensive $66.55
76003 Needle localization by x-ray $145.99
76003.26 Needle localization by x-ray $53.40
76005 Fluoroguide for spine inject $149.78
76005.26 Fluoroguide for spine inject $57.19
76006 X-ray stress view $45.41
76010 X-ray, nose to rectum $54.40
76010.26 X-ray, nose to rectum $17.92
76012 Percut vertebroplasty fluor $275.18
76012.26 Percut vertebroplasty fluor $139.09
76013 Percut vertebroplasty, ct $353.43
76013.26 Percut vertebroplasty, ct $155.29
76020 X-rays for bone age $55.15
76020.26 X-rays for bone age $18.66
76040 X-rays, bone evaluation $83.84
76040.26 X-rays, bone evaluation $27.73
76061 X-rays, bone survey $115.52
76061.26 X-rays, bone survey $44.62
76062 X-rays, bone survey $155.29
76062.26 X-rays, bone survey $53.40
76065 X-rays, bone evaluation $121.80
76065.26 X-rays, bone evaluation $69.14
76066 Joint survey, single view $110.58
76066.26 Joint survey, single view $31.41
76070 Ct bone density, axial $233.80
76070.26 Ct bone density, axial $24.52
76071 Ct bone density, peripheral $227.10
76071.26 Ct bone density, peripheral $21.59
76075 Dexa, axial skeleton study $249.58
76075.26 Dexa, axial skeleton study $29.63
76076 Dexa, peripheral study $76.32
76076.26 Dexa, peripheral study $22.28
76078 Radiographic absorptiometry $74.14
76078.26 Radiographic absorptiometry $20.10
76080 X-ray exam of fistula $128.44
76080.26 X-ray exam of fistula $53.40
76082 Computer mammogram add-on $31.42
76082.26 Computer mammogram add-on $6.20
76083 Computer mammogram add-on $31.42
76083.26 Computer mammogram add-on $6.20
76085 Computer mammogram add-on $34.77
76085.26 Computer mammogram add-on $6.20
76086 X-ray of mammary duct $221.02
76086.26 X-ray of mammary duct $35.83
76088 X-ray of mammary ducts $304.50
76088.26 X-ray of mammary ducts $44.62
76090 Mammogram, one breast $144.52
76090.26 Mammogram, one breast $66.40
76091 Mammogram, both breasts $178.90
76091.26 Mammogram, both breasts $86.30
76092 Mammogram, screening $133.13
76092.26 Mammogram, screening $69.48
76093 Magnetic image, breast $1,409.76
76093.26 Magnetic image, breast $160.95
76094 Magnetic image, both breasts $1,855.17
76094.26 Magnetic image, both breasts $160.95
76095 Stereotactic breast biopsy $666.02
76095.26 Stereotactic breast biopsy $158.31
76096 X-ray of needle wire, breast $148.86
76096.26 X-ray of needle wire, breast $56.27
76098 X-ray exam, breast specimen $44.65
76098.26 X-ray exam, breast specimen $15.73
76100 X-ray exam of body section $146.23
76100.26 X-ray exam of body section $57.76
76101 Complex body section x-ray $158.96
76101.26 Complex body section x-ray $57.76
76102 Complex body section x-rays $182.02
76102.26 Complex body section x-rays $58.45
76120 Cine/video x-rays $113.05
76120.26 Cine/video x-rays $38.01
76125 Cine/video x-rays add-on $82.81
76125.26 Cine/video x-rays add-on $26.70
76140 X-ray consultation $88.16
76150 X-ray exam, dry process $28.91
76350 Special x-ray contrast study $63.67
76355 Ct scan for localization $705.46
76355.26 Ct scan for localization $120.30
76360 Ct scan for needle biopsy $699.32
76360.26 Ct scan for needle biopsy $114.15
76362 Ct guide for tissue ablation $1,015.81
76362.26 Ct guide for tissue ablation $368.97
76370 Ct scan for therapy guide $293.75
76370.26 Ct scan for therapy guide $84.47
76375 3d/holograph reconstr add-on $266.32
76375.26 3d/holograph reconstr add-on $15.73
76380 CAT scan follow-up study $345.45
76380.26 CAT scan follow-up study $97.62
76390 Mr spectroscopy $917.57
76390.26 Mr spectroscopy $139.30
76393 Mr guidance for needle place $941.91
76393.26 Mr guidance for needle place $149.18
76394 Mri for tissue ablation $1,247.55
76394.26 Mri for tissue ablation $420.21
76400 Magnetic image, bone marrow $952.12
76400.26 Magnetic image, bone marrow $158.02
76490 Us for tissue ablation $501.10
76490.26 Us for tissue ablation $393.29
76496 Fluoroscopic procedure $0.00
76496.26 Fluoroscopic procedure $0.00
76497 Ct procedure $0.00
76497.26 Ct procedure $0.00
76498 Mri procedure $0.00
76498.26 Mri procedure $0.00
76499 Radiographic procedure $0.00
76499.26 Radiographic procedure $0.00
76506 Echo exam of head $166.83
76506.26 Echo exam of head $65.63
76511 Echo exam of eye $199.27
76511.26 Echo exam of eye $98.42
76512 Echo exam of eye $173.54
76512.26 Echo exam of eye $70.28
76513 Echo exam of eye, water bath $179.74
76513.26 Echo exam of eye, water bath $70.28
76514 Echo exam of eye, thickness $22.91
76514.26 Echo exam of eye, thickness $17.83
76516 Echo exam of eye $142.90
76516.26 Echo exam of eye $57.88
76519 Echo exam of eye $149.10
76519.26 Echo exam of eye $57.88
76529 Echo exam of eye $142.04
76529.26 Echo exam of eye $60.12
76536 Us exam of head and neck $156.78
76536.26 Us exam of head and neck $55.58
76604 Us exam, chest, b-scan $146.74
76604.26 Us exam, chest, b-scan $54.15
76645 Us exam, breast(s) $129.13
76645.26 Us exam, breast(s) $54.09
76700 Us exam, abdom, complete $220.88
76700.26 Us exam, abdom, complete $80.79
76705 Echo exam of abdomen $160.40
76705.26 Echo exam of abdomen $59.20
76770 Us exam abdo back wall, comp $213.94
76770.26 Us exam abdo back wall, comp $73.84
76775 Us exam abdo back wall, lim $158.96
76775.26 Us exam abdo back wall, lim $57.76
76778 Us exam kidney transplant $213.94
76778.26 Us exam kidney transplant $73.84
76800 Us exam, spinal canal $211.39
76800.26 Us exam, spinal canal $110.19
76801 Ob us <>/= 14 wks, sngl fetus $248.44
76805.26 Ob us >/= 14 wks, sngl fetus $99.74
76810 Ob us >/= 14 wks, addl fetus $180.54
76810.26 Ob us >/= 14 wks, addl fetus $100.02
76811 Ob us, detailed, sngl fetus $348.58
76811.26 Ob us, detailed, sngl fetus $193.49
76812 Ob us, detailed, addl fetus $268.13
76812.26 Ob us, detailed, addl fetus $123.92
76815 Ob us, limited, fetus(s) $166.26
76815.26 Ob us, limited, fetus(s) $65.06
76816 Ob us, follow-up, per fetus $165.36
76816.26 Ob us, follow-up, per fetus $86.19
76817 Transvaginal us, obstetric $182.68
76817.26 Transvaginal us, obstetric $75.97
76818 Fetal biophys profile w/nst $221.25
76818.26 Fetal biophys profile w/nst $106.29
76819 Fetal biophys profil w/o nst $192.43
76819.26 Fetal biophys profil w/o nst $77.46
76825 Echo exam of fetal heart $308.51
76825.26 Echo exam of fetal heart $152.61
76826 Echo exam of fetal heart $133.92
76826.26 Echo exam of fetal heart $83.32
76827 Echo exam of fetal heart $182.37
76827.26 Echo exam of fetal heart $59.14
76828 Echo exam of fetal heart $137.50
76828.26 Echo exam of fetal heart $57.65
76830 Transvaginal us, non-ob $176.81
76830.26 Transvaginal us, non-ob $68.73
76831 Echo exam, uterus $180.43
76831.26 Echo exam, uterus $72.35
76856 Us exam, pelvic, complete $176.81
76856.26 Us exam, pelvic, complete $68.73
76857 Us exam, pelvic, limited $148.16
76857.26 Us exam, pelvic, limited $38.01
76870 Us exam, scrotum $171.70
76870.26 Us exam, scrotum $63.62
76872 Us, transrectal $200.56
76872.26 Us, transrectal $69.07
76873 Echograp trans r, pros study $302.98
76873.26 Echograp trans r, pros study $152.91
76880 Us exam, extremity $160.40
76880.26 Us exam, extremity $59.20
76885 Us exam infant hips, dynamic $181.92
76885.26 Us exam infant hips, dynamic $73.84
76886 Us exam infant hips, static $163.33
76886.26 Us exam infant hips, static $62.13
76930 Echo guide, cardiocentesis $176.70
76930.26 Echo guide, cardiocentesis $68.62
76932 Echo guide for heart biopsy $176.70
76932.26 Echo guide for heart biopsy $68.62
76936 Echo guide for artery repair $460.90
76936.26 Echo guide for artery repair $198.50
76937 Us guide, vascular access $59.90
76937.26 Us guide, vascular access $28.69
76940 Us guide, tissue ablation $307.53
76940.26 Us guide, tissue ablation $173.46
76941 Echo guide for transfusion $242.91
76941.26 Echo guide for transfusion $134.82
76942 Echo guide for biopsy $245.20
76942.26 Echo guide for biopsy $66.89
76945 Echo guide, villus sampling $175.32
76945.26 Echo guide, villus sampling $67.24
76946 Echo guide for amniocentesis $146.44
76946.26 Echo guide for amniocentesis $38.36
76948 Echo guide, ova aspiration $146.09
76948.26 Echo guide, ova aspiration $38.01
76950 Echo guidance radiotherapy $150.36
76950.26 Echo guidance radiotherapy $57.76
76965 Echo guidance radiotherapy $526.54
76965.26 Echo guidance radiotherapy $131.72
76970 Ultrasound exam follow-up $114.54
76970.26 Ultrasound exam follow-up $39.51
76975 GI endoscopic ultrasound $189.22
76975.26 GI endoscopic ultrasound $81.14
76977 Us bone density measure $64.31
76977.26 Us bone density measure $5.45
76986 Ultrasound guide intraoper $305.08
76986.26 Ultrasound guide intraoper $119.89
76999 Echo examination procedure $0.00
76999.26 Echo examination procedure $0.00
77261 Radiation therapy planning $141.31
77262 Radiation therapy planning $212.97
77263 Radiation therapy planning $317.08
77280 Set radiation therapy field $314.56
77280.26 Set radiation therapy field $68.79
77285 Set radiation therapy field $498.69
77285.26 Set radiation therapy field $103.53
77290 Set radiation therapy field $614.22
77290.26 Set radiation therapy field $152.63
77295 Set radiation therapy field $2,428.49
77295.26 Set radiation therapy field $447.89
77299 Radiation therapy planning $0.00
77299.26 Radiation therapy planning $0.00
77300 Radiation therapy dose plan $156.79
77300.26 Radiation therapy dose plan $61.44
77301 Radiotherapy dose plan, imrt $2,759.67
77301.26 Radiotherapy dose plan, imrt $779.07
77305 Teletx isodose plan simple $202.00
77305.26 Teletx isodose plan simple $69.48
77310 Teletx isodose plan intermed $269.10
77310.26 Teletx isodose plan intermed $103.53
77315 Teletx isodose plan complex $340.57
77315.26 Teletx isodose plan complex $152.63
77321 Special teletx port plan $380.73
77321.26 Special teletx port plan $94.00
77326 Brachytx isodose calc simp $259.45
77326.26 Brachytx isodose calc simp $91.82
77327 Brachytx isodose calc interm $382.26
77327.26 Brachytx isodose calc interm $136.49
77328 Brachytx isodose plan compl $556.04
77328.26 Brachytx isodose plan compl $205.28
77331 Special radiation dosimetry $121.07
77331.26 Special radiation dosimetry $85.96
77332 Radiation treatment aid(s) $148.06
77332.26 Radiation treatment aid(s) $52.71
77333 Radiation treatment aid(s) $217.62
77333.26 Radiation treatment aid(s) $83.03
77334 Radiation treatment aid(s) $351.78
77334.26 Radiation treatment aid(s) $121.50
77336 Radiation physics consult $211.35
77370 Radiation physics consult $247.15
77399 External radiation dosimetry $0.00
77399.26 External radiation dosimetry $0.00
77401 Radiation treatment delivery $126.32
77402 Radiation treatment delivery $126.32
77403 Radiation treatment delivery $126.32
77404 Radiation treatment delivery $126.32
77406 Radiation treatment delivery $126.32
77407 Radiation treatment delivery $148.01
77408 Radiation treatment delivery $148.01
77409 Radiation treatment delivery $148.01
77411 Radiation treatment delivery $148.01
77412 Radiation treatment delivery $165.57
77413 Radiation treatment delivery $165.57
77414 Radiation treatment delivery $165.57
77416 Radiation treatment delivery $165.57
77417 Radiology port film(s) $41.99
77418 Radiation tx delivery, imrt $1,247.20
77427 Radiation tx management, x5 $325.29
77431 Radiation therapy management $184.72
77432 Stereotactic radiation trmt $805.49
77470 Special radiation treatment $995.94
77470.26 Special radiation treatment $205.28
77499 Radiation therapy management $0.00
77499.26 Radiation therapy management $0.00
77520 Proton trmt, simple w/o comp $0.00
77522 Proton trmt, simple w/comp $0.00
77523 Proton trmt, intermediate $0.00
77525 Proton treatment, complex $0.00
77600 Hyperthermia treatment $369.82
77600.26 Hyperthermia treatment $153.66
77605 Hyperthermia treatment $495.44
77605.26 Hyperthermia treatment $207.00
77610 Hyperthermia treatment $369.83
77610.26 Hyperthermia treatment $153.66
77615 Hyperthermia treatment $493.73
77615.26 Hyperthermia treatment $205.28
77620 Hyperthermia treatment $370.17
77620.26 Hyperthermia treatment $154.01
77750 Infuse radioactive materials $575.86
77750.26 Infuse radioactive materials $481.20
77761 Apply intrcav radiat simple $544.31
77761.26 Apply intrcav radiat simple $366.01
77762 Apply intrcav radiat interm $817.39
77762.26 Apply intrcav radiat interm $561.64
77763 Apply intrcav radiat compl $1,158.25
77763.26 Apply intrcav radiat compl $840.54
77776 Apply interstit radiat simpl $577.82
77776.26 Apply interstit radiat simpl $423.27
77777 Apply interstit radiat inter $1,033.83
77777.26 Apply interstit radiat inter $733.67
77778 Apply interstit radiat compl $1,461.22
77778.26 Apply interstit radiat compl $1,097.38
77781 High intensity brachytherapy $1,602.69
77781.26 High intensity brachytherapy $163.19
77782 High intensity brachytherapy $1,684.63
77782.26 High intensity brachytherapy $245.13
77783 High intensity brachytherapy $1,804.70
77783.26 High intensity brachytherapy $365.20
77784 High intensity brachytherapy $1,989.49
77784.26 High intensity brachytherapy $549.99
77789 Apply surface radiation $142.15
77789.26 Apply surface radiation $110.48
77790 Radiation handling $138.64
77790.26 Radiation handling $103.53
77799 Radium/radioisotope therapy $0.00
77799.26 Radium/radioisotope therapy $0.00
78000 Thyroid, single uptake $88.19
78000.26 Thyroid, single uptake $19.35
78001 Thyroid, multiple uptakes $118.55
78001.26 Thyroid, multiple uptakes $25.95
78003 Thyroid suppress/stimul $101.40
78003.26 Thyroid suppress/stimul $32.56
78006 Thyroid imaging with uptake $217.99
78006.26 Thyroid imaging with uptake $48.98
78007 Thyroid image, mult uptakes $232.85
78007.26 Thyroid image, mult uptakes $49.73
78010 Thyroid imaging $168.53
78010.26 Thyroid imaging $38.76
78011 Thyroid imaging with flow $215.69
78011.26 Thyroid imaging with flow $44.62
78015 Thyroid met imaging $250.36
78015.26 Thyroid met imaging $67.24
78016 Thyroid met imaging/studies $329.03
78016.26 Thyroid met imaging/studies $82.57
78018 Thyroid met imaging, body $471.42
78018.26 Thyroid met imaging, body $86.25
78020 Thyroid met uptake $108.97
78020.26 Thyroid met uptake $59.95
78070 Parathyroid nuclear imaging $211.65
78070.26 Parathyroid nuclear imaging $81.88
78075 Adrenal nuclear imaging $460.39
78075.26 Adrenal nuclear imaging $75.22
78099 Endocrine nuclear procedure $0.00
78099.26 Endocrine nuclear procedure $0.00
78102 Bone marrow imaging, ltd $200.09
78102.26 Bone marrow imaging, ltd $55.53
78103 Bone marrow imaging, mult $300.05
78103.26 Bone marrow imaging, mult $75.28
78104 Bone marrow imaging, body $368.84
78104.26 Bone marrow imaging, body $79.70
78110 Plasma volume, single $86.81
78110.26 Plasma volume, single $19.35
78111 Plasma volume, multiple $205.40
78111.26 Plasma volume, multiple $22.28
78120 Red cell mass, single $146.60
78120.26 Red cell mass, single $23.03
78121 Red cell mass, multiple $237.65
78121.26 Red cell mass, multiple $31.81
78122 Blood volume $371.62
78122.26 Blood volume $45.31
78130 Red cell survival study $263.09
78130.26 Red cell survival study $61.38
78135 Red cell survival kinetics $409.56
78135.26 Red cell survival kinetics $64.31
78140 Red cell sequestration $339.85
78140.26 Red cell sequestration $60.69
78160 Plasma iron turnover $294.16
78160.26 Plasma iron turnover $34.28
78162 Radioiron absorption exam $273.86
78162.26 Radioiron absorption exam $47.03
78170 Red cell iron utilization $418.54
78170.26 Red cell iron utilization $41.97
78172 Total body iron estimation $276.33
78172.26 Total body iron estimation $52.66
78185 Spleen imaging $207.83
78185.26 Spleen imaging $40.19
78190 Platelet survival, kinetics $515.44
78190.26 Platelet survival, kinetics $110.65
78191 Platelet survival $580.11
78191.26 Platelet survival $60.69
78195 Lymph system imaging $409.03
78195.26 Lymph system imaging $119.89
78199 Blood/lymph nuclear exam $0.00
78199.26 Blood/lymph nuclear exam $0.00
78201 Liver imaging $211.50
78201.26 Liver imaging $43.87
78202 Liver imaging with flow $254.94
78202.26 Liver imaging with flow $51.16
78205 Liver imaging (3D) $490.51
78205.26 Liver imaging (3D) $71.60
78206 Liver image (3d) with flow $508.86
78206.26 Liver image (3d) with flow $96.81
78215 Liver and spleen imaging $256.89
78215.26 Liver and spleen imaging $48.98
78216 Liver & spleen image/flow $303.48
78216.26 Liver & spleen image/flow $57.02
78220 Liver function study $312.99
78220.26 Liver function study $48.98
78223 Hepatobiliary imaging $343.60
78223.26 Hepatobiliary imaging $83.72
78230 Salivary gland imaging $199.17
78230.26 Salivary gland imaging $44.62
78231 Serial salivary imaging $277.37
78231.26 Serial salivary imaging $52.60
78232 Salivary gland function exam $297.73
78232.26 Salivary gland function exam $47.14
78258 Esophageal motility study $277.62
78258.26 Esophageal motility study $73.84
78261 Gastric mucosa imaging $360.62
78261.26 Gastric mucosa imaging $70.11
78262 Gastroesophageal reflux exam $370.20
78262.26 Gastroesophageal reflux exam $68.67
78264 Gastric emptying study $370.79
78264.26 Gastric emptying study $78.21
78267 Breath tst attain/anal c-14 $21.96
78268 Breath test analysis, c-14 $188.22
78270 Vit B-12 absorption exam $130.24
78270.26 Vit B-12 absorption exam $20.10
78271 Vit b-12 absrp exam, int fac $137.13
78271.26 Vit b-12 absrp exam, int fac $20.10
78272 Vit B-12 absorp, combined $192.27
78272.26 Vit B-12 absorp, combined $27.39
78278 Acute GI blood loss imaging $444.30
78278.26 Acute GI blood loss imaging $99.05
78282 GI protein loss exam $273.25
78282.26 GI protein loss exam $38.01
78290 Meckel’s divert exam $284.15
78290.26 Meckel’s divert exam $67.99
78291 Leveen/shunt patency exam $305.63
78291.26 Leveen/shunt patency exam $88.08
78299 GI nuclear procedure $0.00
78299.26 GI nuclear procedure $0.00
78300 Bone imaging, limited area $239.05
78300.26 Bone imaging, limited area $62.13
78305 Bone imaging, multiple areas $342.51
78305.26 Bone imaging, multiple areas $82.63
78306 Bone imaging, whole body $388.81
78306.26 Bone imaging, whole body $85.90
78315 Bone imaging, 3 phase $441.03
78315.26 Bone imaging, 3 phase $101.98
78320 Bone imaging (3D) $523.76
78320.26 Bone imaging (3D) $104.85
78350 Bone mineral, single photon $75.63
78350.26 Bone mineral, single photon $21.59
78351 Bone mineral, dual photon $141.17
78399 Musculoskeletal nuclear exam $0.00
78399.26 Musculoskeletal nuclear exam $0.00
78414 Non-imaging heart function $910.04
78414.26 Non-imaging heart function $45.31
78428 Cardiac shunt imaging $240.33
78428.26 Cardiac shunt imaging $80.27
78445 Vascular flow imaging $181.50
78445.26 Vascular flow imaging $48.98
78455 Venous thrombosis study $355.69
78455.26 Venous thrombosis study $73.10
78456 Acute venous thrombus image $385.83
78456.26 Acute venous thrombus image $100.49
78457 Venous thrombosis imaging $264.71
78457.26 Venous thrombosis imaging $76.77
78458 Ven thrombosis images, bilat $376.65
78458.26 Ven thrombosis images, bilat $91.30
78459 Heart muscle imaging (PET) $7,645.03
78459.26 Heart muscle imaging (PET) $152.97
78460 Heart muscle blood, single $253.88
78460.26 Heart muscle blood, single $86.25
78461 Heart muscle blood, multiple $458.43
78461.26 Heart muscle blood, multiple $123.51
78464 Heart image (3d), single $610.79
78464.26 Heart image (3d), single $109.27
78465 Heart image (3d), multiple $982.63
78465.26 Heart image (3d), multiple $146.88
78466 Heart infarct image $255.30
78466.26 Heart infarct image $70.11
78468 Heart infarct image (ef) $340.27
78468.26 Heart infarct image (ef) $80.39
78469 Heart infarct image (3D) $462.48
78469.26 Heart infarct image (3D) $92.10
78472 Gated heart, planar, single $490.02
78472.26 Gated heart, planar, single $98.99
78473 Gated heart, multiple $732.11
78473.26 Gated heart, multiple $146.94
78478 Heart wall motion add-on $173.65
78478.26 Heart wall motion add-on $62.82
78480 Heart function add-on $173.65
78480.26 Heart function add-on $62.82
78481 Heart first pass, single $470.40
78481.26 Heart first pass, single $100.03
78483 Heart first pass, multiple $706.29
78483.26 Heart first pass, multiple $149.01
78491 Heart image (pet), single $7,645.03
78491.26 Heart image (pet), single $154.69
78492 Heart image (pet), multiple $7,645.03
78492.26 Heart image (pet), multiple $192.99
78494 Heart image, spect $617.92
78494.26 Heart image, spect $118.81
78496 Heart first pass add-on $329.72
78496.26 Heart first pass add-on $50.42
78499 Cardiovascular nuclear exam $0.00
78499.26 Cardiovascular nuclear exam $0.00
78580 Lung perfusion imaging $316.86
78580.26 Lung perfusion imaging $73.84
78584 Lung V/Q image single breath $325.20
78584.26 Lung V/Q image single breath $98.36
78585 Lung V/Q imaging $508.21
78585.26 Lung V/Q imaging $108.93
78586 Aerosol lung image, single $223.31
78586.26 Aerosol lung image, single $39.51
78587 Aerosol lung image, multiple $247.25
78587.26 Aerosol lung image, multiple $48.98
78588 Perfusion lung image $336.11
78588.26 Perfusion lung image $108.93
78591 Vent image, 1 breath, 1 proj $241.90
78591.26 Vent image, 1 breath, 1 proj $40.19
78593 Vent image, 1 proj, gas $293.37
78593.26 Vent image, 1 proj, gas $48.98
78594 Vent image, mult proj, gas $404.79
78594.26 Vent image, mult proj, gas $52.66
78596 Lung differential function $627.33
78596.26 Lung differential function $125.81
78599 Respiratory nuclear exam $0.00
78599.26 Respiratory nuclear exam $0.00
78600 Brain imaging, ltd static $247.65
78600.26 Brain imaging, ltd static $43.87
78601 Brain imaging, ltd w/flow $291.42
78601.26 Brain imaging, ltd w/flow $50.47
78605 Brain imaging, complete $294.29
78605.26 Brain imaging, complete $53.34
78606 Brain imaging, compl w/flow $338.65
78606.26 Brain imaging, compl w/flow $64.31
78607 Brain imaging (3D) $588.54
78607.26 Brain imaging (3D) $123.51
78608 Brain imaging (PET) $7,645.03
78609 Brain imaging (PET) $7,645.03
78610 Brain flow imaging only $142.53
78610.26 Brain flow imaging only $30.32
78615 Cerebral vascular flow image $316.02
78615.26 Cerebral vascular flow image $43.06
78630 Cerebrospinal fluid scan $424.93
78630.26 Cerebrospinal fluid scan $67.99
78635 CSF ventriculography $243.82
78635.26 CSF ventriculography $62.76
78645 CSF shunt evaluation $300.03
78645.26 CSF shunt evaluation $57.02
78647 Cerebrospinal fluid scan $509.52
78647.26 Cerebrospinal fluid scan $90.61
78650 CSF leakage imaging $389.76
78650.26 CSF leakage imaging $60.70
78660 Nuclear exam of tear flow $202.73
78660.26 Nuclear exam of tear flow $52.66
78699 Nervous system nuclear exam $0.00
78699.26 Nervous system nuclear exam $0.00
78700 Kidney imaging, static $260.78
78700.26 Kidney imaging, static $44.62
78701 Kidney imaging with flow $300.95
78701.26 Kidney imaging with flow $48.98
78704 Imaging renogram $354.38
78704.26 Imaging renogram $73.84
78707 Kidney flow/function image $412.45
78707.26 Kidney flow/function image $96.12
78708 Kidney flow/function image $436.97
78708.26 Kidney flow/function image $120.64
78709 Kidney flow/function image $456.38
78709.26 Kidney flow/function image $140.05
78710 Kidney imaging (3D) $484.71
78710.26 Kidney imaging (3D) $65.80
78715 Renal vascular flow exam $142.53
78715.26 Renal vascular flow exam $30.32
78725 Kidney function study $164.68
78725.26 Kidney function study $37.67
78730 Urinary bladder retention $139.78
78730.26 Urinary bladder retention $36.52
78740 Ureteral reflux study $206.41
78740.26 Ureteral reflux study $56.33
78760 Testicular imaging $255.12
78760.26 Testicular imaging $65.80
78761 Testicular imaging/flow $297.75
78761.26 Testicular imaging/flow $70.91
78799 Genitourinary nuclear exam $0.00
78799.26 Genitourinary nuclear exam $0.00
78800 Tumor imaging, limited area $306.75
78800.26 Tumor imaging, limited area $65.80
78801 Tumor imaging, mult areas $378.42
78801.26 Tumor imaging, mult areas $78.95
78802 Tumor imaging, whole body $478.65
78802.26 Tumor imaging, whole body $86.25
78803 Tumor imaging (3D) $574.30
78803.26 Tumor imaging (3D) $109.27
78804 Tumor imaging, whole body $386.19
78804.26 Tumor imaging, whole body $105.53
78805 Abscess imaging, ltd area $314.04
78805.26 Abscess imaging, ltd area $73.10
78806 Abscess imaging, whole body $542.33
78806.26 Abscess imaging, whole body $86.25
78807 Nuclear localization/abscess $574.99
78807.26 Nuclear localization/abscess $109.96
78810 Tumor imaging (PET) $3,531.78
78810.26 Tumor imaging (PET) $198.84
78890 Nuclear medicine data proc $97.70
78890.26 Nuclear medicine data proc $5.45
78891 Nuclear med data proc $195.41
78891.26 Nuclear med data proc $10.56
78990 Provide diag radionuclide(s) $388.80
78999 Nuclear diagnostic exam $0.00
78999.26 Nuclear diagnostic exam $0.00
79000 Init hyperthyroid therapy $363.65
79000.26 Init hyperthyroid therapy $178.47
79001 Repeat hyperthyroid therapy $197.50
79001.26 Repeat hyperthyroid therapy $104.91
79020 Thyroid ablation $364.40
79020.26 Thyroid ablation $179.21
79030 Thyroid ablation, carcinoma $394.31
79030.26 Thyroid ablation, carcinoma $209.13
79035 Thyroid metastatic therapy $437.73
79035.26 Thyroid metastatic therapy $252.54
79100 Hematopoetic nuclear therapy $317.48
79100.26 Hematopoetic nuclear therapy $132.30
79200 Intracavitary nuclear trmt $384.04
79200.26 Intracavitary nuclear trmt $198.85
79300 Interstitial nuclear therapy $160.78
79300.26 Interstitial nuclear therapy $160.78
79400 Nonhemato nuclear therapy $381.11
79400.26 Nonhemato nuclear therapy $195.92
79403 Hematopoetic nuclear therapy $488.10
79403.26 Hematopoetic nuclear therapy $230.95
79420 Intravascular nuclear ther $691.35
79420.26 Intravascular nuclear ther $148.89
79440 Nuclear joint therapy $386.79
79440.26 Nuclear joint therapy $201.60
79900 Provide ther radiopharm(s) $0.00
79999 Nuclear medicine therapy $0.00
79999.26 Nuclear medicine therapy $0.00


with 8

80048 Basic metabolic panel $17.86
80050 General health panel $158.13
80051 Electrolyte panel $17.86
80053 Comprehen metabolic panel $29.10
80055 Obstetric panel $114.19
80061 Lipid panel $37.44
80069 Renal function panel $24.26
80074 Acute hepatitis panel $122.16
80076 Hepatic function panel $17.86
80100 Drug screen, qualitate/multi $40.64
80101 Drug screen, single $38.48
80102 Drug confirmation $37.02
80103 Drug analysis, tissue prep $40.09
80150 Assay of amikacin $42.12
80152 Assay of amitriptyline $50.02
80154 Assay of benzodiazepines $51.68
80156 Assay, carbamazepine, total $40.68
80157 Assay, carbamazepine, free $37.04
80158 Assay of cyclosporine $48.62
80160 Assay of desipramine $48.10
80162 Assay of digoxin $37.10
80164 Assay, dipropylacetic acid $37.86
80166 Assay of doxepin $43.32
80168 Assay of ethosuximide $45.66
80170 Assay of gentamicin $45.80
80172 Assay of gold $40.56
80173 Assay of haloperidol $40.68
80174 Assay of imipramine $48.10
80176 Assay of lidocaine $41.04
80178 Assay of lithium $18.48
80182 Assay of nortriptyline $37.86
80184 Assay of phenobarbital $32.02
80185 Assay of phenytoin, total $37.04
80186 Assay of phenytoin, free $38.46
80188 Assay of primidone $46.36
80190 Assay of procainamide $46.82
80192 Assay of procainamide $46.82
80194 Assay of quinidine $40.78
80196 Assay of salicylate $19.84
80197 Assay of tacrolimus $38.34
80198 Assay of theophylline $39.54
80200 Assay of tobramycin $45.04
80201 Assay of topiramate $33.32
80202 Assay of vancomycin $37.86
80299 Quantitative assay, drug $38.26
80400 Acth stimulation panel $79.84
80402 Acth stimulation panel $231.64
80406 Acth stimulation panel $207.40
80408 Aldosterone suppression eval $350.68
80410 Calcitonin stimul panel $224.46
80412 CRH stimulation panel $887.16
80414 Testosterone response $144.32
80415 Estradiol response panel $156.16
80416 Renin stimulation panel $368.76
80417 Renin stimulation panel $122.92
80418 Pituitary evaluation panel $1,596.96
80420 Dexamethasone panel $190.00
80422 Glucagon tolerance panel $128.76
80424 Glucagon tolerance panel $141.12
80426 Gonadotropin hormone panel $414.80
80428 Growth hormone panel $186.32
80430 Growth hormone panel $219.20
80432 Insulin suppression panel $377.46
80434 Insulin tolerance panel $254.40
80435 Insulin tolerance panel $287.70
80436 Metyrapone panel $242.08
80438 TRH stimulation panel $140.82
80439 TRH stimulation panel $187.76
80440 TRH stimulation panel $162.48
80500 Lab pathology consultation $47.09
80502 Lab pathology consultation $235.89
81000 Urinalysis, nonauto w/scope $8.86
81001 Urinalysis, auto w/scope $8.86
81002 Urinalysis nonauto w/o scope $7.14
81003 Urinalysis, auto, w/o scope $6.28
81005 Urinalysis $6.06
81007 Urine screen for bacteria $7.18
81015 Microscopic exam of urine $8.48
81020 Urinalysis, glass test $10.30
81025 Urine pregnancy test $17.68
81050 Urinalysis, volume measure $8.38
81099 Urinalysis test procedure $0.00
82000 Assay of blood acetaldehyde $34.62
82003 Assay of acetaminophen $56.56
82009 Test for acetone/ketones $12.62
82010 Acetone assay $22.84
82013 Acetylcholinesterase assay $31.22
82016 Acylcarnitines, qual $38.74
82017 Acylcarnitines, quant $40.74
82024 Assay of acth $107.94
82030 Assay of adp & amp $72.10
82040 Assay of serum albumin $11.46
82042 Assay of urine albumin $14.46
82043 Microalbumin, quantitative $16.18
82044 Microalbumin, semiquant $8.10
82055 Assay of ethanol $30.20
82075 Assay of breath ethanol $33.68
82085 Assay of aldolase $27.12
82088 Assay of aldosterone $113.88
82101 Assay of urine alkaloids $33.02
82103 Alpha-1-antitrypsin, total $37.54
82104 Alpha-1-antitrypsin, pheno $40.40
82105 Alpha-fetoprotein, serum $46.88
82106 Alpha-fetoprotein, amniotic $46.88
82108 Assay of aluminum $71.20
82120 Amines, vaginal fluid qual $10.50
82127 Amino acid, single qual $38.74
82128 Amino acids, mult qual $38.74
82131 Amino acids, single quant $47.14
82135 Assay, aminolevulinic acid $46.00
82136 Amino acids, quant, 2-5 $40.74
82139 Amino acids, quan, 6 or more $40.74
82140 Assay of ammonia $32.52
82143 Amniotic fluid scan $17.66
82145 Assay of amphetamines $33.02
82150 Assay of amylase $18.12
82154 Androstanediol glucuronide $80.58
82157 Assay of androstenedione $81.12
82160 Assay of androsterone $59.66
82163 Assay of angiotensin II $57.36
82164 Angiotensin I enzyme test $40.78
82172 Assay of apolipoprotein $13.16
82175 Assay of arsenic $53.02
82180 Assay of ascorbic acid $27.62
82190 Atomic absorption $40.54
82205 Assay of barbiturates $32.02
82232 Assay of beta-2 protein $45.22
82239 Bile acids, total $39.50
82240 Bile acids, cholylglycine $9.66
82247 Bilirubin, total $14.04
82248 Bilirubin, direct $14.04
82252 Fecal bilirubin test $12.70
82261 Assay of biotinidase $40.74
82270 Test for blood, feces $9.08
82273 Test for blood, other source $9.08
82274 Assay test for blood, fecal $36.18
82286 Assay of bradykinin $19.24
82300 Assay of cadmium $64.66
82306 Assay of vitamin D $82.72
82307 Assay of vitamin D $34.06
82308 Assay of calcitonin $74.82
82310 Assay of calcium $14.40
82330 Assay of calcium $19.76
82331 Calcium infusion test $14.46
82340 Assay of calcium in urine $11.46
82355 Calculus analysis, qual $24.44
82360 Calculus assay, quant $20.78
82365 Calculus spectroscopy $36.02
82370 X-ray assay, calculus $35.02
82373 Assay, c-d transfer measure $48.68
82374 Assay, blood carbon dioxide $9.66
82375 Assay, blood carbon monoxide $34.44
82376 Test for carbon monoxide $16.74
82378 Carcinoembryonic antigen $53.02
82379 Assay of carnitine $40.74
82380 Assay of carotene $25.78
82382 Assay, urine catecholamines $48.04
82383 Assay, blood catecholamines $66.32
82384 Assay, three catecholamines $70.56
82387 Assay of cathepsin-d $47.84
82390 Assay of ceruloplasmin $30.02
82397 Chemiluminescent assay $24.96
82415 Assay of chloramphenicol $35.40
82435 Assay of blood chloride $9.66
82436 Assay of urine chloride $9.66
82438 Assay, other fluid chlorides $13.66
82441 Test for chlorohydrocarbons $16.76
82465 Assay, bld/serum cholesterol $12.16
82480 Assay, serum cholinesterase $22.02
82482 Assay, rbc cholinesterase $21.48
82485 Assay, chondroitin sulfate $57.70
82486 Gas/liquid chromatography $48.68
82487 Paper chromatography $44.60
82488 Paper chromatography $59.70
82489 Thin layer chromatography $51.68
82491 Chromotography, quant, sing $48.68
82492 Chromotography, quant, mult $48.68
82495 Assay of chromium $56.68
82507 Assay of citrate $77.70
82520 Assay of cocaine $33.02
82523 Collagen crosslinks $52.22
82525 Assay of copper $34.68
82528 Assay of corticosterone $62.90
82530 Cortisol, free $46.70
82533 Total cortisol $39.92
82540 Assay of creatine $12.96
82541 Column chromotography, qual $48.68
82542 Column chromotography, quant $48.68
82543 Column chromotograph/isotope $48.68
82544 Column chromotograph/isotope $48.68
82550 Assay of ck (cpk) $18.20
82552 Assay of cpk in blood $37.42
82553 Creatine, MB fraction $17.18
82554 Creatine, isoforms $33.16
82565 Assay of creatinine $14.32
82570 Assay of urine creatinine $14.46
82575 Creatinine clearance test $26.40
82585 Assay of cryofibrinogen $23.96
82595 Assay of cryoglobulin $18.08
82600 Assay of cyanide $54.22
82607 Vitamin B-12 $42.12
82608 B-12 binding capacity $40.02
82615 Test for urine cystines $22.82
82626 Dehydroepiandrosterone $70.62
82627 Dehydroepiandrosterone $62.14
82633 Desoxycorticosterone $81.12
82634 Deoxycortisol $81.12
82638 Assay of dibucaine number $34.22
82646 Assay of dihydrocodeinone $57.70
82649 Assay of dihydromorphinone $71.82
82651 Assay of dihydrotestosterone $72.14
82652 Assay of dihydroxyvitamin d $107.56
82654 Assay of dimethadione $38.68
82657 Enzyme cell activity $48.68
82658 Enzyme cell activity, ra $48.68
82664 Electrophoretic test $81.12
82666 Assay of epiandrosterone $60.02
82668 Assay of erythropoietin $52.52
82670 Assay of estradiol $78.08
82671 Assay of estrogens $86.84
82672 Assay of estrogen $45.52
82677 Assay of estriol $67.58
82679 Assay of estrone $69.76
82690 Assay of ethchlorvynol $48.30
82693 Assay of ethylene glycol $41.64
82696 Assay of etiocholanolone $65.90
82705 Fats/lipids, feces, qual $4.92
82710 Fats/lipids, feces, quant $32.52
82715 Assay of fecal fat $33.02
82725 Assay of blood fatty acids $21.06
82726 Long chain fatty acids $48.68
82728 Assay of ferritin $38.06
82731 Assay of fetal fibronectin $107.99
82735 Assay of fluoride $51.82
82742 Assay of flurazepam $55.32
82746 Blood folic acid serum $41.08
82747 Assay of folic acid, rbc $47.20
82757 Assay of semen fructose $48.48
82759 Assay of rbc galactokinase $60.02
82760 Assay of galactose $31.28
82775 Assay galactose transferase $58.86
82776 Galactose transferase test $23.42
82784 Assay of gammaglobulin igm $23.42
82785 Assay of gammaglobulin ige $46.02
82787 Igg 1, 2, 3 or 4, each $12.48
82800 Blood pH $23.66
82803 Blood gases: pH, pO2 & pCO2 $48.34
82805 Blood gases W/02 saturation $79.30
82810 Blood gases, O2 sat only $24.40
82820 Hemoglobin-oxygen affinity $27.78
82926 Assay of gastric acid $15.22
82928 Assay of gastric acid $18.30
82938 Gastrin test $49.44
82941 Assay of gastrin $49.28
82943 Assay of glucagon $39.94
82945 Glucose other fluid $10.96
82946 Glucagon tolerance test $42.12
82947 Assay, glucose, blood quant $10.96
82948 Reagent strip/blood glucose $8.86
82950 Glucose test $13.28
82951 Glucose tolerance test (GTT) $35.98
82952 GTT-added samples $10.96
82953 Glucose-tolbutamide test $42.32
82955 Assay of g6pd enzyme $27.10
82960 Test for G6PD enzyme $16.94
82962 Glucose blood test $6.54
82963 Assay of glucosidase $60.02
82965 Assay of gdh enzyme $21.60
82975 Assay of glutamine $44.26
82977 Assay of GGT $20.12
82978 Assay of glutathione $39.82
82979 Assay, rbc glutathione $19.24
82980 Assay of glutethimide $51.20
82985 Glycated protein $42.12
83001 Gonadotropin (FSH) $51.94
83002 Gonadotropin (LH) $51.76
83003 Assay, growth hormone (hgh) $46.58
83008 Assay of guanosine $46.90
83010 Assay of haptoglobin, quant $28.38
83012 Assay of haptoglobins $48.04
83013 H pylori analysis $188.22
83014 H pylori drug admin/collect $21.96
83015 Heavy metal screen $52.62
83018 Quantitative screen, metals $25.60
83020 Hemoglobin electrophoresis $38.99
83020.26 Hemoglobin electrophoresis $38.99
83021 Hemoglobin chromotography $48.68
83026 Hemoglobin, copper sulfate $6.60
83030 Fetal hemoglobin, chemical $23.12
83033 Fetal hemoglobin assay, qual $16.66
83036 Glycated hemoglobin test $27.12
83045 Blood methemoglobin test $13.86
83050 Blood methemoglobin assay $20.46
83051 Assay of plasma hemoglobin $14.56
83055 Blood sulfhemoglobin test $13.74
83060 Blood sulfhemoglobin assay $19.76
83065 Assay of hemoglobin heat $19.24
83068 Hemoglobin stability screen $19.76
83069 Assay of urine hemoglobin $8.04
83070 Assay of hemosiderin, qual $13.28
83071 Assay of hemosiderin, quant $19.22
83080 Assay of b hexosaminidase $40.74
83088 Assay of histamine $81.12
83090 Assay of homocystine $47.14
83150 Assay of for hva $54.08
83491 Assay of corticosteroids $48.94
83497 Assay of 5-hiaa $36.02
83498 Assay of progesterone $75.90
83499 Assay of progesterone $70.44
83500 Assay, free hydroxyproline $63.30
83505 Assay, total hydroxyproline $60.76
83516 Immunoassay, nonantibody $32.24
83518 Immunoassay, dipstick $23.70
83519 Immunoassay, nonantibody $37.76
83520 Immunoassay, RIA $36.18
83525 Assay of insulin $31.96
83527 Assay of insulin $36.18
83528 Assay of intrinsic factor $40.56
83540 Assay of iron $18.10
83550 Iron binding test $24.42
83570 Assay of idh enzyme $24.72
83582 Assay of ketogenic steroids $39.60
83586 Assay 17- ketosteroids $32.98
83593 Fractionation, ketosteroids $23.42
83605 Assay of lactic acid $29.84
83615 Lactate (LD) (LDH) enzyme $16.88
83625 Assay of ldh enzymes $35.76
83632 Placental lactogen $56.48
83633 Test urine for lactose $6.56
83634 Assay of urine for lactose $16.66
83655 Assay of lead $33.82
83661 L/s ratio, fetal lung $52.90
83662 Foam stability, fetal lung $37.66
83663 Fluoro polarize, fetal lung $37.66
83664 Lamellar bdy, fetal lung $32.75
83670 Assay of lap enzyme $25.60
83690 Assay of lipase $10.66
83715 Assay of blood lipoproteins $31.46
83716 Assay of blood lipoproteins $45.26
83718 Assay of lipoprotein $22.88
83719 Assay of blood lipoprotein $32.52
83721 Assay of blood lipoprotein $26.66
83727 Assay of lrh hormone $48.04
83735 Assay of magnesium $18.72
83775 Assay of md enzyme $20.60
83785 Assay of manganese $68.72
83788 Mass spectrometry qual $48.68
83789 Mass spectrometry quant $48.68
83805 Assay of meprobamate $49.26
83825 Assay of mercury $45.44
83835 Assay of metanephrines $47.34
83840 Assay of methadone $45.62
83857 Assay of methemalbumin $30.02
83858 Assay of methsuximide $41.42
83864 Mucopolysaccharides $55.64
83866 Mucopolysaccharides screen $27.52
83872 Assay synovial fluid mucin $16.38
83873 Assay of csf protein $48.08
83874 Assay of myoglobin $36.08
83880 Natriuretic peptide $81.12
83883 Assay, nephelometry not spec $33.59
83885 Assay of nickel $68.46
83887 Assay of nicotine $66.18
83890 Molecule isolate $11.20
83891 Molecule isolate nucleic $11.20
83892 Molecular diagnostics $11.20
83893 Molecule dot/slot/blot $11.20
83894 Molecule gel electrophor $11.20
83896 Molecular diagnostics $11.20
83897 Molecule nucleic transfer $11.20
83898 Molecule nucleic ampli $46.84
83901 Molecule nucleic ampli $46.84
83902 Molecular diagnostics $39.66
83903 Molecule mutation scan $46.84
83904 Molecule mutation identify $46.84
83905 Molecule mutation identify $46.84
83906 Molecule mutation identify $46.84
83912 Genetic examination $38.30
83912.26 Genetic examination $38.30
83915 Assay of nucleotidase $31.16
83916 Oligoclonal bands $56.18
83918 Organic acids, total, quant $46.00
83919 Organic acids, qual, each $46.00
83921 Organic acid, single, quant $46.00
83925 Assay of opiates $54.38
83930 Assay of blood osmolality $18.48
83935 Assay of urine osmolality $15.34
83937 Assay of osteocalcin $83.42
83945 Assay of oxalate $35.98
83950 Oncoprotein, her-2/neu $179.98
83970 Assay of parathormone $115.34
83986 Assay of body fluid acidity $8.04
83992 Assay for phencyclidine $41.08
84022 Assay of phenothiazine $43.52
84030 Assay of blood pku $15.38
84035 Assay of phenylketones $10.22
84060 Assay acid phosphatase $20.64
84061 Phosphatase, forensic exam $22.12
84066 Assay prostate phosphatase $27.00
84075 Assay alkaline phosphatase $14.46
84078 Assay alkaline phosphatase $20.40
84080 Assay alkaline phosphatases $41.32
84081 Amniotic fluid enzyme test $46.18
84085 Assay of rbc pg6d enzyme $18.84
84087 Assay phosphohexose enzymes $28.84
84100 Assay of phosphorus $13.26
84105 Assay of urine phosphorus $14.46
84106 Test for porphobilinogen $11.98
84110 Assay of porphobilinogen $23.60
84119 Test urine for porphyrins $24.06
84120 Assay of urine porphyrins $41.10
84126 Assay of feces porphyrins $41.34
84127 Assay of feces porphyrins $17.60
84132 Assay of serum potassium $12.84
84133 Assay of urine potassium $9.66
84134 Assay of prealbumin $16.06
84135 Assay of pregnanediol $53.46
84138 Assay of pregnanetriol $47.86
84140 Assay of pregnenolone $57.78
84143 Assay of 17-hydroxypregneno $63.78
84144 Assay of progesterone $58.30
84146 Assay of prolactin $54.16
84150 Assay of prostaglandin $69.76
84152 Assay of psa, complexed $51.40
84153 Assay of psa, total $51.40
84154 Assay of psa, free $51.40
84155 Assay of protein, serum $10.24
84156 Assay of protein, urine $10.24
84157 Assay of protein, other $10.24
84160 Assay of protein, any source $14.46
84165 Electrophoreisis of proteins $38.99
84165.26 Electrophoreisis of proteins $38.99
84181 Western blot test $47.60
84181.26 Western blot test $47.60
84182 Protein, western blot test $50.30
84182.26 Protein, western blot test $50.30
84202 Assay RBC protoporphyrin $40.10
84203 Test RBC protoporphyrin $24.06
84206 Assay of proinsulin $49.78
84207 Assay of vitamin b-6 $78.50
84210 Assay of pyruvate $24.94
84220 Assay of pyruvate kinase $26.36
84228 Assay of quinine $32.52
84233 Assay of estrogen $179.98
84234 Assay of progesterone $181.28
84235 Assay of endocrine hormone $33.78
84238 Assay, nonendocrine receptor $102.18
84244 Assay of renin $61.46
84252 Assay of vitamin b-2 $56.56
84255 Assay of selenium $71.34
84260 Assay of serotonin $79.54
84270 Assay of sex hormone globul $60.72
84275 Assay of sialic acid $37.54
84285 Assay of silica $65.80
84295 Assay of serum sodium $12.22
84300 Assay of urine sodium $9.66
84302 Assay of sweat sodium $9.66
84305 Assay of somatomedin $46.20
84307 Assay of somatostatin $46.20
84311 Spectrophotometry $19.54
84315 Body fluid specific gravity $3.12
84375 Chromatogram assay, sugars $54.78
84376 Sugars, single, qual $6.56
84377 Sugars, multiple, qual $6.56
84378 Sugars, single, quant $16.66
84379 Sugars multiple quant $16.66
84392 Assay of urine sulfate $13.28
84402 Assay of testosterone $71.14
84403 Assay of total testosterone $72.16
84425 Assay of vitamin b-1 $59.34
84430 Assay of thiocyanate $26.00
84432 Assay of thyroglobulin $44.88
84436 Assay of total thyroxine $19.22
84437 Assay of neonatal thyroxine $18.08
84439 Assay of free thyroxine $25.20
84442 Assay of thyroid activity $40.56
84443 Assay thyroid stim hormone $46.94
84445 Assay of tsi $142.10
84446 Assay of vitamin e $39.62
84449 Assay of transcortin $50.30
84450 Transferase (AST) (SGOT) $14.44
84460 Alanine amino (ALT) (SGPT) $14.80
84466 Assay of transferrin $35.68
84478 Assay of triglycerides $16.08
84479 Assay of thyroid (t3 or t4) $18.08
84480 Assay, triiodothyronine (t3) $27.56
84481 Free assay (FT-3) $40.56
84482 T3 reverse $39.98
84484 Assay of troponin, quant $27.50
84485 Assay duodenal fluid trypsin $20.98
84488 Test feces for trypsin $20.40
84490 Assay of feces for trypsin $10.12
84510 Assay of tyrosine $29.06
84512 Assay of troponin, qual $21.52
84520 Assay of urea nitrogen $11.02
84525 Urea nitrogen semi-quant $10.50
84540 Assay of urine/urea-n $8.04
84545 Urea-N clearance test $16.12
84550 Assay of blood/uric acid $12.62
84560 Assay of urine/uric acid $13.28
84577 Assay of feces/urobilinogen $33.02
84578 Test urine urobilinogen $9.08
84580 Assay of urine urobilinogen $19.84
84583 Assay of urine urobilinogen $14.04
84585 Assay of urine vma $29.12
84586 Assay of vip $98.74
84588 Assay of vasopressin $81.12
84590 Assay of vitamin a $32.40
84591 Assay of nos vitamin $32.40
84597 Assay of vitamin k $38.30
84600 Assay of volatiles $44.90
84620 Xylose tolerance test $33.10
84630 Assay of zinc $13.26
84681 Assay of c-peptide $58.14
84702 Chorionic gonadotropin test $19.52
84703 Chorionic gonadotropin assay $19.52
84830 Ovulation tests $28.04
84999 Clinical chemistry test $0.00
85002 Bleeding time test $12.58
85004 Automated diff wbc count $18.08
85007 Bl smear w/diff wbc count $9.62
85008 Bl smear w/o diff wbc count $9.62
85009 Manual diff wbc count b-coat $10.38
85013 Spun microhematocrit $6.62
85014 Hematocrit $6.62
85018 Hemoglobin $6.62
85025 Complete cbc w/auto diff wbc $21.72
85027 Complete cbc, automated $18.08
85032 Manual cell count, each $12.02
85041 Automated rbc count $8.40
85044 Manual reticulocyte count $12.02
85045 Automated reticulocyte count $11.18
85046 Reticyte/hgb concentrate $15.60
85048 Automated leukocyte count $7.10
85049 Automated platelet count $12.50
85055 Reticulated platelet assay $74.82
85060 Blood smear interpretation $78.11
85097 Bone marrow interpretation $184.78
85130 Chromogenic substrate assay $24.06
85170 Blood clot retraction $6.56
85175 Blood clot lysis time $6.56
85210 Blood clot factor II test $36.28
85220 Blood clot factor V test $49.32
85230 Blood clot factor VII test $50.04
85240 Blood clot factor VIII test $50.04
85244 Blood clot factor VIII test $57.06
85245 Blood clot factor VIII test $64.12
85246 Blood clot factor VIII test $64.12
85247 Blood clot factor VIII test $64.12
85250 Blood clot factor IX test $53.20
85260 Blood clot factor X test $50.04
85270 Blood clot factor XI test $50.04
85280 Blood clot factor XII test $54.08
85290 Blood clot factor XIII test $45.66
85291 Blood clot factor XIII test $24.84
85292 Blood clot factor assay $52.92
85293 Blood clot factor assay $52.92
85300 Antithrombin III test $33.10
85301 Antithrombin III test $30.22
85302 Blood clot inhibitor antigen $33.60
85303 Blood clot inhibitor test $38.64
85305 Blood clot inhibitor assay $32.40
85306 Blood clot inhibitor test $42.82
85307 Assay activated protein c $42.82
85335 Factor inhibitor test $33.02
85337 Thrombomodulin $29.12
85345 Coagulation time $12.02
85347 Coagulation time $6.56
85348 Coagulation time $10.40
85360 Euglobulin lysis $23.48
85362 Fibrin degradation products $14.80
85366 Fibrinogen test $24.06
85370 Fibrinogen test $28.34
85378 Fibrin degrade, semiquant $19.94
85379 Fibrin degradation, quant $28.44
85380 Fibrin degradation, vte $28.44
85384 Fibrinogen $22.96
85385 Fibrinogen $22.96
85390 Fibrinolysins screen $29.27
85390.26 Fibrinolysins screen $29.27
85396 Clotting assay, whole blood $66.15
85400 Fibrinolytic plasmin $6.56
85410 Fibrinolytic antiplasmin $6.56
85415 Fibrinolytic plasminogen $48.04
85420 Fibrinolytic plasminogen $15.08
85421 Fibrinolytic plasminogen $28.46
85441 Heinz bodies, direct $11.76
85445 Heinz bodies, induced $19.04
85460 Hemoglobin, fetal $8.30
85461 Hemoglobin, fetal $18.52
85475 Hemolysin $24.80
85520 Heparin assay $33.02
85525 Heparin neutralization $27.42
85530 Heparin-protamine tolerance $39.62
85536 Iron stain peripheral blood $18.08
85540 Wbc alkaline phosphatase $24.04
85547 RBC mechanical fragility $16.66
85549 Muramidase $46.30
85555 RBC osmotic fragility $16.66
85557 RBC osmotic fragility $16.66
85576 Blood platelet aggregation $60.02
85576.26 Blood platelet aggregation $60.02
85597 Platelet neutralization $16.48
85610 Prothrombin time $10.98
85611 Prothrombin test $11.02
85612 Viper venom prothrombin time $16.66
85613 Russell viper venom, diluted $16.66
85635 Reptilase test $27.52
85651 Rbc sed rate, nonautomated $9.92
85652 Rbc sed rate, automated $7.54
85660 RBC sickle cell test $14.46
85670 Thrombin time, plasma $16.14
85675 Thrombin time, titer $19.16
85705 Thromboplastin inhibition $26.90
85730 Thromboplastin time, partial $16.76
85732 Thromboplastin time, partial $18.08
85810 Blood viscosity examination $32.64
85999 Hematology procedure $0.00
86000 Agglutinins, febrile $19.50
86001 Allergen specific igg $14.60
86003 Allergen specific IgE $14.60
86005 Allergen specific IgE $22.28
86021 WBC antibody identification $25.74
86022 Platelet antibodies $14.84
86023 Immunoglobulin assay $34.80
86038 Antinuclear antibodies $33.78
86039 Antinuclear antibodies (ANA) $31.20
86060 Antistreptolysin o, titer $20.40
86063 Antistreptolysin o, screen $10.66
86077 Physician blood bank service $282.78
86078 Physician blood bank service $282.78
86079 Physician blood bank service $245.27
86140 C-reactive protein $14.46
86141 C-reactive protein, hs $36.18
86146 Glycoprotein antibody $18.22
86147 Cardiolipin antibody $18.22
86148 Phospholipid antibody $44.88
86155 Chemotaxis assay $44.66
86156 Cold agglutinin, screen $15.88
86157 Cold agglutinin, titer $18.22
86160 Complement, antigen $33.56
86161 Complement/function activity $33.56
86162 Complement, total (CH50) $56.78
86171 Complement fixation, each $24.44
86185 Counterimmunoelectrophoresis $25.00
86215 Deoxyribonuclease, antibody $37.02
86225 DNA antibody $38.40
86226 DNA antibody, single strand $33.84
86235 Nuclear antigen antibody $50.12
86243 Fc receptor $57.36
86255 Fluorescent antibody, screen $39.68
86255.26 Fluorescent antibody, screen $39.68
86256 Fluorescent antibody, titer $38.99
86256.26 Fluorescent antibody, titer $38.99
86277 Growth hormone antibody $43.98
86280 Hemagglutination inhibition $22.88
86294 Immunoassay, tumor, qual $51.76
86300 Immunoassay, tumor, ca 15-3 $58.14
86301 Immunoassay, tumor, ca 19-9 $58.14
86304 Immunoassay, tumor, ca 125 $58.14
86308 Heterophile antibodies $14.46
86309 Heterophile antibodies $18.08
86310 Heterophile antibodies $20.60
86316 Immunoassay, tumor other $58.14
86317 Immunoassay,infectious agent $41.90
86318 Immunoassay,infectious agent $36.18
86320 Serum immunoelectrophoresis $62.64
86320.26 Serum immunoelectrophoresis $62.64
86325 Other immunoelectrophoresis $62.48
86325.26 Other immunoelectrophoresis $62.48
86327 Immunoelectrophoresis assay $63.40
86327.26 Immunoelectrophoresis assay $63.40
86329 Immunodiffusion $39.24
86331 Immunodiffusion ouchterlony $33.50
86332 Immune complex assay $68.10
86334 Immunofixation procedure $62.42
86334.26 Immunofixation procedure $62.42
86336 Inhibin A $41.90
86337 Insulin antibodies $59.84
86340 Intrinsic factor antibody $42.12
86341 Islet cell antibody $55.30
86343 Leukocyte histamine release $34.82
86344 Leukocyte phagocytosis $22.32
86353 Lymphocyte transformation $81.12
86359 T cells, total count $105.40
86360 T cell, absolute count/ratio $131.30
86361 T cell, absolute count $74.82
86376 Microsomal antibody $40.66
86378 Migration inhibitory factor $55.02
86382 Neutralization test, viral $47.24
86384 Nitroblue tetrazolium dye $31.82
86403 Particle agglutination test $28.48
86406 Particle agglutination test $29.74
86430 Rheumatoid factor test $15.86
86431 Rheumatoid factor, quant $15.86
86485 Skin test, candida $41.28
86490 Coccidioidomycosis skin test $54.81
86510 Histoplasmosis skin test $41.28
86580 TB intradermal test $22.07
86585 TB tine test $20.25
86586 Skin test, unlisted $0.00
86590 Streptokinase, antibody $30.82
86592 Blood serology, qualitative $11.92
86593 Blood serology, quantitative $11.46
86602 Antinomyces antibody $28.44
86603 Adenovirus antibody $28.58
86606 Aspergillus antibody $28.58
86609 Bacterium antibody $28.58
86611 Bartonella antibody $28.44
86612 Blastomyces antibody $28.58
86615 Bordetella antibody $28.58
86617 Lyme disease antibody $43.28
86618 Lyme disease antibody $28.58
86619 Borrelia antibody $28.58
86622 Brucella antibody $24.96
86625 Campylobacter antibody $28.58
86628 Candida antibody $28.58
86631 Chlamydia antibody $28.58
86632 Chlamydia igm antibody $28.58
86635 Coccidioides antibody $28.58
86638 Q fever antibody $28.58
86641 Cryptococcus antibody $28.58
86644 CMV antibody $40.22
86645 CMV antibody, IgM $28.58
86648 Diphtheria antibody $28.58
86651 Encephalitis antibody $28.58
86652 Encephalitis antibody $28.58
86653 Encephalitis antibody $28.58
86654 Encephalitis antibody $28.58
86658 Enterovirus antibody $28.58
86663 Epstein-barr antibody $36.66
86664 Epstein-barr antibody $42.76
86665 Epstein-barr antibody $50.22
86666 Ehrlichia antibody $28.44
86668 Francisella tularensis $28.58
86671 Fungus antibody $28.58
86674 Giardia lamblia antibody $41.12
86677 Helicobacter pylori $28.58
86682 Helminth antibody $36.34
86684 Hemophilus influenza $28.58
86687 Htlv-i antibody $23.44
86688 Htlv-ii antibody $39.14
86689 HTLV/HIV confirmatory test $54.10
86692 Hepatitis, delta agent $47.96
86694 Herpes simplex test $40.22
86695 Herpes simplex test $28.58
86696 Herpes simplex type 2 $54.10
86698 Histoplasma $28.58
86701 HIV-1 $24.82
86702 HIV-2 $37.76
86703 HIV-1/HIV-2, single assay $38.34
86704 Hep b core antibody, total $33.68
86705 Hep b core antibody, igm $32.88
86706 Hep b surface antibody $30.02
86707 Hep be antibody $13.00
86708 Hep a antibody, total $34.62
86709 Hep a antibody, igm $31.46
86710 Influenza virus antibody $37.88
86713 Legionella antibody $28.58
86717 Leishmania antibody $28.58
86720 Leptospira antibody $28.58
86723 Listeria monocytogenes ab $28.58
86727 Lymph choriomeningitis ab $28.58
86729 Lympho venereum antibody $28.58
86732 Mucormycosis antibody $28.58
86735 Mumps antibody $28.58
86738 Mycoplasma antibody $37.02
86741 Neisseria meningitidis $16.24
86744 Nocardia antibody $16.24
86747 Parvovirus antibody $38.38
86750 Malaria antibody $36.86
86753 Protozoa antibody nos $16.24
86756 Respiratory virus antibody $16.24
86757 Rickettsia antibody $54.10
86759 Rotavirus antibody $24.24
86762 Rubella antibody $40.22
86765 Rubeola antibody $36.00
86768 Salmonella antibody $28.58
86771 Shigella antibody $28.58
86774 Tetanus antibody $28.58
86777 Toxoplasma antibody $40.22
86778 Toxoplasma antibody, igm $28.58
86781 Treponema pallidum, confirm $37.00
86784 Trichinella antibody $28.58
86787 Varicella-zoster antibody $28.58
86790 Virus antibody nos $28.58
86793 Yersinia antibody $28.58
86800 Thyroglobulin antibody $44.44
86803 Hepatitis c ab test $39.88
86804 Hep c ab test, confirm $43.28
86805 Lymphocytotoxicity assay $146.10
86806 Lymphocytotoxicity assay $132.98
86807 Cytotoxic antibody screening $110.58
86808 Cytotoxic antibody screening $82.94
86812 HLA typing, A, B, or C $72.12
86813 HLA typing, A, B, or C $162.04
86816 HLA typing, DR/DQ $77.84
86817 HLA typing, DR/DQ $179.90
86821 Lymphocyte culture, mixed $157.76
86822 Lymphocyte culture, primed $102.14
86849 Immunology procedure $0.00
86850 RBC antibody screen $38.12
86860 RBC antibody elution $139.48
86870 RBC antibody identification $56.40
86880 Coombs test, direct $13.26
86885 Coombs test, indirect, qual $13.00
86886 Coombs test, indirect, titer $14.46
86890 Autologous blood process $204.82
86891 Autologous blood, op salvage $282.78
86900 Blood typing, ABO $8.34
86901 Blood typing, Rh (D) $19.16
86903 Blood typing, antigen screen $26.38
86904 Blood typing, patient serum $26.56
86905 Blood typing, RBC antigens $10.68
86906 Blood typing, Rh phenotype $21.66
86910 Blood typing, paternity test $258.72
86911 Blood typing, antigen system $61.50
86920 Compatibility test $61.16
86921 Compatibility test $75.03
86922 Compatibility test $70.57
86927 Plasma, fresh frozen $68.27
86930 Frozen blood prep $477.00
86931 Frozen blood thaw $477.00
86932 Frozen blood freeze/thaw $494.30
86940 Hemolysins/agglutinins, auto $22.92
86941 Hemolysins/agglutinins $33.84
86945 Blood product/irradiation $108.71
86950 Leukacyte transfusion $306.77
86965 Pooling blood platelets $81.72
86970 RBC pretreatment $129.79
86971 RBC pretreatment $64.50
86972 RBC pretreatment $64.50
86975 RBC pretreatment, serum $167.31
86976 RBC pretreatment, serum $167.31
86977 RBC pretreatment, serum $167.31
86978 RBC pretreatment, serum $200.99
86985 Split blood or products $101.94
86999 Transfusion procedure $0.00
87001 Small animal inoculation $24.44
87003 Small animal inoculation $47.04
87015 Specimen concentration $18.66
87040 Blood culture for bacteria $28.84
87045 Feces culture, bacteria $26.00
87046 Stool cultr, bacteria, each $23.00
87070 Culture, bacteria, other $24.06
87071 Culture bacteri aerobic othr $26.00
87073 Culture bacteria anaerobic $26.00
87075 Cultr bacteria, except blood $17.40
87076 Culture anaerobe ident, each $22.58
87077 Culture aerobic identify $22.58
87081 Culture screen only $18.52
87084 Culture of specimen by kit $24.06
87086 Urine culture/colony count $22.56
87088 Urine bacteria culture $22.62
87101 Skin fungi culture $21.54
87102 Fungus isolation culture $21.06
87103 Blood fungus culture $25.20
87106 Fungi identification, yeast $28.84
87107 Fungi identification, mold $28.84
87109 Mycoplasma $38.98
87110 Chlamydia culture $32.52
87116 Mycobacteria culture $30.20
87118 Mycobacteric identification $30.58
87140 Culture type immunofluoresc $15.58
87143 Culture typing, glc/hplc $16.66
87147 Culture type, immunologic $10.66
87149 Culture type, nucleic acid $56.04
87152 Culture type pulse field gel $14.62
87158 Culture typing, added method $14.62
87164 Dark field examination $36.23
87164.26 Dark field examination $36.23
87166 Dark field examination $31.56
87168 Macroscopic exam arthropod $11.92
87169 Macroscopic exam parasite $11.92
87172 Pinworm exam $11.92
87176 Tissue homogenization, cultr $16.44
87177 Ova and parasites smears $24.86
87181 Microbe susceptible, diffuse $13.28
87184 Microbe susceptible, disk $19.26
87185 Microbe susceptible, enzyme $13.28
87186 Microbe susceptible, mic $24.16
87187 Microbe susceptible, mlc $24.42
87188 Microbe suscept, macrobroth $18.54
87190 Microbe suscept, mycobacteri $15.80
87197 Bactericidal level, serum $23.02
87205 Smear, gram stain $11.92
87206 Smear, fluorescent/acid stai $15.00
87207 Smear, special stain $29.70
87207.26 Smear, special stain $29.70
87210 Smear, wet mount, saline/ink $11.92
87220 Tissue exam for fungi $11.92
87230 Assay, toxin or antitoxin $28.12
87250 Virus inoculate, eggs/animal $54.64
87252 Virus inoculation, tissue $49.90
87253 Virus inoculate tissue, addl $56.44
87254 Virus inoculation, shell via $54.64
87255 Genet virus isolate, hsv $82.34
87260 Adenovirus ag, if $33.52
87265 Pertussis ag, if $33.52
87267 Enterovirus antibody, dfa $33.52
87269 Giardia ag, if $33.52
87270 Chlamydia trachomatis ag, if $33.52
87271 Cryptosporidum/gardia ag, if $33.52
87272 Cryptosporidium ag, if $33.52
87273 Herpes simplex 2, ag, if $33.52
87274 Herpes simplex 1, ag, if $33.52
87275 Influenza b, ag, if $33.52
87276 Influenza a, ag, if $33.52
87277 Legionella micdadei, ag, if $33.52
87278 Legion pneumophilia ag, if $33.52
87279 Parainfluenza, ag, if $33.52
87280 Respiratory syncytial ag, if $33.52
87281 Pneumocystis carinii, ag, if $33.52
87283 Rubeola, ag, if $33.52
87285 Treponema pallidum, ag, if $33.52
87290 Varicella zoster, ag, if $33.52
87299 Antibody detection, nos, if $33.52
87300 Ag detection, polyval, if $33.52
87301 Adenovirus ag, eia $33.52
87320 Chylmd trach ag, eia $33.52
87324 Clostridium ag, eia $33.52
87327 Cryptococcus neoform ag, eia $33.52
87328 Cryptosporidium ag, eia $33.52
87329 Giardia ag, eia $33.52
87332 Cytomegalovirus ag, eia $33.52
87335 E coli 0157 ag, eia $33.52
87336 Entamoeb hist dispr, ag, eia $33.52
87337 Entamoeb hist group, ag, eia $33.52
87338 Hpylori, stool, eia $40.20
87339 H pylori ag, eia $33.52
87340 Hepatitis b surface ag, eia $17.94
87341 Hepatitis b surface, ag, eia $17.94
87350 Hepatitis be ag, eia $32.20
87380 Hepatitis delta ag, eia $45.88
87385 Histoplasma capsul ag, eia $33.52
87390 Hiv-1 ag, eia $49.30
87391 Hiv-2 ag, eia $49.30
87400 Influenza a/b, ag, eia $33.52
87420 Resp syncytial ag, eia $33.52
87425 Rotavirus ag, eia $33.52
87427 Shiga-like toxin ag, eia $33.52
87430 Strep a ag, eia $33.52
87449 Ag detect nos, eia, mult $33.52
87450 Ag detect nos, eia, single $26.78
87451 Ag detect polyval, eia, mult $26.78
87470 Bartonella, dna, dir probe $56.04
87471 Bartonella, dna, amp probe $98.08
87472 Bartonella, dna, quant $119.70
87475 Lyme dis, dna, dir probe $56.04
87476 Lyme dis, dna, amp probe $98.08
87477 Lyme dis, dna, quant $119.70
87480 Candida, dna, dir probe $56.04
87481 Candida, dna, amp probe $98.08
87482 Candida, dna, quant $116.66
87485 Chylmd pneum, dna, dir probe $56.04
87486 Chylmd pneum, dna, amp probe $98.08
87487 Chylmd pneum, dna, quant $119.70
87490 Chylmd trach, dna, dir probe $56.04
87491 Chylmd trach, dna, amp probe $98.08
87492 Chylmd trach, dna, quant $97.68
87495 Cytomeg, dna, dir probe $56.04
87496 Cytomeg, dna, amp probe $98.08
87497 Cytomeg, dna, quant $119.70
87510 Gardner vag, dna, dir probe $56.04
87511 Gardner vag, dna, amp probe $98.08
87512 Gardner vag, dna, quant $116.66
87515 Hepatitis b, dna, dir probe $56.04
87516 Hepatitis b, dna, amp probe $98.08
87517 Hepatitis b, dna, quant $119.70
87520 Hepatitis c, rna, dir probe $56.04
87521 Hepatitis c, rna, amp probe $98.08
87522 Hepatitis c, rna, quant $119.70
87525 Hepatitis g, dna, dir probe $56.04
87526 Hepatitis g, dna, amp probe $98.08
87527 Hepatitis g, dna, quant $116.66
87528 Hsv, dna, dir probe $56.04
87529 Hsv, dna, amp probe $98.08
87530 Hsv, dna, quant $119.70
87531 Hhv-6, dna, dir probe $56.04
87532 Hhv-6, dna, amp probe $98.08
87533 Hhv-6, dna, quant $116.66
87534 Hiv-1, dna, dir probe $56.04
87535 Hiv-1, dna, amp probe $98.08
87536 Hiv-1, dna, quant $237.78
87537 Hiv-2, dna, dir probe $56.04
87538 Hiv-2, dna, amp probe $98.08
87539 Hiv-2, dna, quant $119.70
87540 Legion pneumo, dna, dir prob $56.04
87541 Legion pneumo, dna, amp prob $98.08
87542 Legion pneumo, dna, quant $116.66
87550 Mycobacteria, dna, dir probe $56.04
87551 Mycobacteria, dna, amp probe $98.08
87552 Mycobacteria, dna, quant $119.70
87555 M.tuberculo, dna, dir probe $56.04
87556 M.tuberculo, dna, amp probe $98.08
87557 M.tuberculo, dna, quant $119.70
87560 M.avium-intra, dna, dir prob $56.04
87561 M.avium-intra, dna, amp prob $98.08
87562 M.avium-intra, dna, quant $119.70
87580 M.pneumon, dna, dir probe $56.04
87581 M.pneumon, dna, amp probe $98.08
87582 M.pneumon, dna, quant $116.66
87590 N.gonorrhoeae, dna, dir prob $55.76
87591 N.gonorrhoeae, dna, amp prob $98.08
87592 N.gonorrhoeae, dna, quant $119.70
87620 Hpv, dna, dir probe $56.04
87621 Hpv, dna, amp probe $98.08
87622 Hpv, dna, quant $116.66
87650 Strep a, dna, dir probe $56.04
87651 Strep a, dna, amp probe $98.08
87652 Strep a, dna, quant $116.66
87660 Trichomonas vagin, dir probe $56.04
87797 Detect agent nos, dna, dir $56.04
87798 Detect agent nos, dna, amp $98.08
87799 Detect agent nos, dna, quant $119.70
87800 Detect agnt mult, dna, direc $96.17
87801 Detect agnt mult, dna, ampli $196.14
87802 Strep b assay w/optic $33.52
87803 Clostridium toxin a w/optic $33.52
87804 Influenza assay w/optic $33.52
87810 Chylmd trach assay w/optic $33.52
87850 N. gonorrhoeae assay w/optic $33.52
87880 Strep a assay w/optic $33.52
87899 Agent nos assay w/optic $33.52
87901 Genotype, dna, hiv reverse t $719.38
87902 Genotype, dna, hepatitis C $719.38
87903 Phenotype, dna hiv w/culture $1,365.44
87904 Phenotype, dna hiv w/clt add $49.90
87999 Microbiology procedure $0.00
88000 Autopsy (necropsy), gross $650.24
88005 Autopsy (necropsy), gross $731.46
88007 Autopsy (necropsy), gross $812.53
88012 Autopsy (necropsy), gross $682.27
88014 Autopsy (necropsy), gross $682.27
88016 Autopsy (necropsy), gross $650.24
88020 Autopsy (necropsy), complete $812.53
88025 Autopsy (necropsy), complete $893.74
88027 Autopsy (necropsy), complete $974.95
88028 Autopsy (necropsy), complete $845.39
88029 Autopsy (necropsy), complete $845.39
88036 Limited autopsy $698.59
88037 Limited autopsy $569.11
88040 Forensic autopsy (necropsy) $2,113.09
88045 Coroner’s autopsy (necropsy) $0.00
88099 Necropsy (autopsy) procedure $0.00
88104 Cytopathology, fluids $94.83
88104.26 Cytopathology, fluids $59.72
88106 Cytopathology, fluids $81.11
88106.26 Cytopathology, fluids $56.40
88107 Cytopathology, fluids $108.86
88107.26 Cytopathology, fluids $70.29
88108 Cytopath, concentrate tech $98.96
88108.26 Cytopath, concentrate tech $59.72
88112 Cytopath, cell enhance tech $186.94
88112.26 Cytopath, cell enhance tech $103.09
88125 Forensic cytopathology $38.00
88125.26 Forensic cytopathology $28.02
88130 Sex chromatin identification $39.05
88140 Sex chromatin identification $22.34
88141 Cytopath, c/v, interpret $46.09
88142 Cytopath, c/v, thin layer $56.62
88143 Cytopath c/v thin layer redo $56.62
88147 Cytopath, c/v, automated $29.52
88148 Cytopath, c/v, auto rescreen $29.52
88150 Cytopath, c/v, manual $29.52
88152 Cytopath, c/v, auto redo $29.52
88153 Cytopath, c/v, redo $29.52
88154 Cytopath, c/v, select $29.52
88155 Cytopath, c/v, index add-on $16.74
88160 Cytopath smear, other source $61.23
88160.26 Cytopath smear, other source $31.90
88161 Cytopath smear, other source $94.49
88161.26 Cytopath smear, other source $50.59
88162 Cytopath smear, other source $105.63
88162.26 Cytopath smear, other source $81.53
88164 Cytopath tbs, c/v, manual $29.52
88165 Cytopath tbs, c/v, redo $29.52
88166 Cytopath tbs, c/v, auto redo $29.52
88167 Cytopath tbs, c/v, select $29.52
88172 Cytopathology eval of fna $91.62
88172.26 Cytopathology eval of fna $64.08
88173 Cytopath eval, fna, report $204.15
88173.26 Cytopath eval, fna, report $132.34
88174 Cytopath, c/v auto, in fluid $59.70
88175 Cytopath c/v auto fluid redo $71.76
88180 Cell marker study $126.37
88180.26 Cell marker study $38.24
88182 Cell marker study $130.40
88182.26 Cell marker study $63.22
88199 Cytopathology procedure $0.00
88199.26 Cytopathology procedure $0.00
88230 Tissue culture, lymphocyte $155.42
88233 Tissue culture, skin/biopsy $357.50
88235 Tissue culture, placenta $204.74
88237 Tissue culture, bone marrow $177.62
88239 Tissue culture, tumor $373.96
88240 Cell cryopreserve/storage $28.22
88241 Frozen cell preparation $28.22
88245 Chromosome analysis, 20-25 $382.15
88248 Chromosome analysis, 50-100 $483.92
88249 Chromosome analysis, 100 $483.92
88261 Chromosome analysis, 5 $480.87
88262 Chromosome analysis, 15-20 $348.28
88263 Chromosome analysis, 45 $390.36
88264 Chromosome analysis, 20-25 $300.96
88267 Chromosome analys, placenta $502.34
88269 Chromosome analys, amniotic $390.36
88271 Cytogenetics, dna probe $40.44
88272 Cytogenetics, 3-5 $74.82
88273 Cytogenetics, 10-30 $88.51
88274 Cytogenetics, 25-99 $87.40
88275 Cytogenetics, 100-300 $87.40
88280 Chromosome karyotype study $70.14
88283 Chromosome banding study $178.75
88285 Chromosome count, additional $48.35
88289 Chromosome study, additional $90.59
88291 Cyto/molecular report $18.78
88299 Cytogenetic study $0.00
88300 Surgical path, gross $25.94
88300.26 Surgical path, gross $9.07
88302 Tissue exam by pathologist $58.24
88302.26 Tissue exam by pathologist $14.18
88304 Tissue exam by pathologist $77.36
88304.26 Tissue exam by pathologist $23.66
88305 Tissue exam by pathologist $177.86
88305.26 Tissue exam by pathologist $80.10
88307 Tissue exam by pathologist $305.64
88307.26 Tissue exam by pathologist $168.64
88309 Tissue exam by pathologist $399.51
88309.26 Tissue exam by pathologist $242.54
88311 Decalcify tissue $32.38
88311.26 Decalcify tissue $25.84
88312 Special stains $80.58
88312.26 Special stains $34.52
88313 Special stains $93.65
88313.26 Special stains $25.84
88314 Histochemical stain $57.75
88314.26 Histochemical stain $28.84
88318 Chemical histochemistry $52.28
88318.26 Chemical histochemistry $26.87
88319 Enzyme histochemistry $102.65
88319.26 Enzyme histochemistry $33.66
88321 Microslide consultation $64.75
88323 Microslide consultation $121.62
88323.26 Microslide consultation $86.09
88325 Comprehensive review of data $86.28
88329 Path consult introp $84.43
88331 Path consult intraop, 1 bloc $159.42
88331.26 Path consult intraop, 1 bloc $126.38
88332 Path consult intraop, add’l $79.85
88332.26 Path consult intraop, add’l $62.64
88342 Immunohistochemistry $158.48
88342.26 Immunohistochemistry $90.32
88346 Immunofluorescent study $162.35
88346.26 Immunofluorescent study $89.37
88347 Immunofluorescent study $187.45
88347.26 Immunofluorescent study $90.38
88348 Electron microscopy $420.23
88348.26 Electron microscopy $95.74
88349 Scanning electron microscopy $448.80
88349.26 Scanning electron microscopy $48.92
88355 Analysis, skeletal muscle $193.17
88355.26 Analysis, skeletal muscle $117.58
88356 Analysis, nerve $257.78
88356.26 Analysis, nerve $190.24
88358 Analysis, tumor $159.24
88358.26 Analysis, tumor $147.49
88361 Immunohistochemistry, tumor $212.72
88361.26 Immunohistochemistry, tumor $85.53
88362 Nerve teasing preparations $422.31
88362.26 Nerve teasing preparations $205.69
88365 Tissue hybridization $134.20
88365.26 Tissue hybridization $59.43
88371 Protein, western blot tissue $50.22
88371.26 Protein, western blot tissue $50.22
88372 Protein analysis w/probe $50.22
88372.26 Protein analysis w/probe $50.22
88380 Microdissection $0.00
88380.26 Microdissection $0.00
88399 Surgical pathology procedure $0.00
88399.26 Surgical pathology procedure $0.00
88400 Bilirubin total transcut $8.42
89050 Body fluid cell count $13.22
89051 Body fluid cell count $15.40
89055 Leukocyte assessment, fecal $11.92
89060 Exam,synovial fluid crystals $23.81
89060.26 Exam,synovial fluid crystals $23.81
89100 Sample intestinal contents $76.07
89105 Sample intestinal contents $95.59
89125 Specimen fat stain $11.68
89130 Sample stomach contents $66.70
89132 Sample stomach contents $30.84
89135 Sample stomach contents $55.38
89136 Sample stomach contents $64.75
89140 Sample stomach contents $74.95
89141 Sample stomach contents $84.32
89160 Exam feces for meat fibers $9.30
89190 Nasal smear for eosinophils $12.60
89220 Sputum specimen collection $14.11
89225 Starch granules, feces $9.34
89230 Collect sweat for test $15.49
89235 Water load test $15.38
89240 Pathology lab procedure $0.00
89250 Cultr oocyte/embryo <4 days $1,218.51
89251 Cultr oocyte/embryo <4 days $400.00
89252 Assist oocyte fertilization $1,100.00
89253 Embryo hatching $575.00
89254 Oocyte identification $435.00
89255 Prepare embryo for transfer $350.00
89257 Sperm identification $0.00
89258 Cryopreservation; embryo(s) $600.00
89259 Cryopreservation, sperm $80.00
89260 Sperm isolation, simple $40.00
89261 Sperm isolation, complex $150.00
89264 Identify sperm tissue $0.00
89268 Insemination of oocytes $0.00
89272 Extended culture of oocytes $0.00
89280 Assist oocyte fertilization $0.00
89281 Assist oocyte fertilization $0.00
89290 Biopsy, oocyte polar body $0.00
89291 Biopsy, oocyte polar body $0.00
89300 Semen analysis w/huhner $24.90
89310 Semen analysis w/count $3.12
89320 Semen analysis, complete $24.44
89321 Semen analysis & motility $24.44
89325 Sperm antibody test $28.84
89329 Sperm evaluation test $58.60
89330 Evaluation, cervical mucus $27.66
89335 Cryopreserve testicular tiss $0.00
89342 Storage/year; embryo(s) $0.00
89343 Storage/year; sperm/semen $0.00
89344 Storage/year; reprod tissue $0.00
89346 Storage/year; oocyte $0.00
89350 Sputum specimen collection $27.73
89352 Thawing cryopresrved; embryo $0.00
89353 Thawing cryopresrved; sperm $0.00
89354 Thaw cryoprsvrd; reprod tiss $0.00
89355 Exam feces for starch $9.34
89356 Thawing cryopresrved; oocyte $0.00
89360 Collect sweat for test $22.65
89365 Water load test $15.38

with 9

90281 Human ig, im $17.00
90283 Human ig, iv By Report
90287 Botulinum antitoxin $0.00
90288 Botulism ig, iv $0.00
90291 Cmv ig, iv $0.00
90296 Diphtheria antitoxin $0.00
90371 Hep b ig, im $968.00
90375 Rabies ig, im/sc By Report
90376 Rabies ig, heat treated $0.00
90378 Rsv ig, im, 50mg $833.24
90379 Rsv ig, iv $0.00
90384 Rh ig, full-dose, im $149.45
90385 Rh ig, minidose, im $30.00
90386 Rh ig, iv $875.00
90389 Tetanus ig, im By Report
90393 Vaccina ig, im By Report
90396 Varicella-zoster ig, im By Report
90399 Immune globulin $0.00
90471 Immunization admin $12.76
90472 Immunization admin, each add $9.98
90473 Immune admin oral/nasal $18.97
90474 Immune admin oral/nasal addl $20.00
90476 Adenovirus vaccine, type 4 By Report
90477 Adenovirus vaccine, type 7 By Report
90581 Anthrax vaccine, sc $0.00
90585 Bcg vaccine, percut $200.00
90586 Bcg vaccine, intravesical $0.00
90632 Hep a vaccine, adult im $107.02
90633 Hep a vacc, ped/adol, 2 dose $75.68
90634 Hep a vacc, ped/adol, 3 dose $47.00
90636 Hep a/hep b vacc, adult im $152.84
90645 Hib vaccine, hboc, im $42.49
90646 Hib vaccine, prp-d, im $28.41
90647 Hib vaccine, prp-omp, im $54.12
90648 Hib vaccine, prp-t, im $40.15
90655 Flu vaccine, 6-35 mo, im $24.22
90657 Flu vaccine, 6-35 mo, im $15.25
90658 Flu vaccine, 3 yrs, im $18.32
90659 Flu vaccine, whole, im $19.98
90660 Flu vaccine, nasal $95.12
90665 Lyme disease vaccine, im By Report
90669 Pneumococcal vacc, ped <5 $119.17
90675 Rabies vaccine, im $149.00
90676 Rabies vaccine, id By Report
90680 Rotovirus vaccine, oral By Report
90690 Typhoid vaccine, oral $53.00
90691 Typhoid vaccine, im $78.00
90692 Typhoid vaccine, h-p, sc/id $54.91
90693 Typhoid vaccine, akd, sc $0.00
90698 Dtap-hib-ip vaccine, im $0.00
90700 Dtap vaccine, im $44.58
90701 Dtp vaccine, im $46.69
90702 Dt vaccine < 7, im $24.59
90703 Tetanus vaccine, im $23.39
90704 Mumps vaccine, sc $27.96
90705 Measles vaccine, sc $27.96
90706 Rubella vaccine, sc $27.96
90707 Mmr vaccine, sc $65.20
90708 Measles-rubella vaccine, sc $38.11
90710 Mmrv vaccine, sc $66.07
90712 Oral poliovirus vaccine $32.59
90713 Poliovirus, ipv, sc $45.11
90715 Tdap vaccine >7 im $80.00
90716 Chicken pox vaccine, sc $102.51
90717 Yellow fever vaccine, sc $97.65
90718 Td vaccine > 7, im $25.33
90719 Diphtheria vaccine, im $10.99
90720 Dtp/hib vaccine, im $56.29
90721 Dtap/hib vaccine, im $69.35
90723 Dtap-hep b-ipv vaccine, im $134.03
90725 Cholera vaccine, injectable $33.02
90727 Plague vaccine, im $16.07
90732 Pneumococcal vaccine $33.91
90733 Meningococcal vaccine, sc $114.67
90734 Meningococcal vaccine, im $0.00
90735 Encephalitis vaccine, sc $33.02
90740 Hepb vacc, ill pat 3 dose im $0.00
90743 Hep b vacc, adol, 2 dose, im $79.91
90744 Hepb vacc ped/adol 3 dose im $49.87
90746 Hep b vaccine, adult, im $93.44
90747 Hepb vacc, ill pat 4 dose im $121.36
90748 Hep b/hib vaccine, im $84.94
90749 Vaccine toxoid $0.00
90780 IV infusion therapy, 1 hour $152.51
90781 IV infusion, additional hour $45.74
90782 Injection, sc/im $21.04
90783 Injection, ia $33.02
90784 Injection, iv $60.34
90788 Injection of antibiotic $22.02
90799 Ther/prophylactic/dx inject $0.00
90801 Psy dx interview $175.23
90802 Intac psy dx interview $186.08
90804 Psytx, office, 20-30 min $75.28
90805 Psytx, off, 20-30 min w/e&m $101.77
90806 Psytx, off, 45-50 min $113.28
90807 Psytx, off, 45-50 min w/e&m $151.14
90808 Psytx, office, 75-80 min $169.20
90809 Psytx, off, 75-80, w/e&m $247.18
90810 Intac psytx, off, 20-30 min $83.63
90811 Intac psytx, 20-30, w/e&m $102.08
90812 Intac psytx, off, 45-50 min $122.13
90813 Intac psytx, 45-50 min w/e&m $148.88
90814 Intac psytx, off, 75-80 min $191.86
90815 Intac psytx, 75-80 w/e&m $222.49
90816 Psytx, hosp, 20-30 min $75.83
90817 Psytx, hosp, 20-30 min w/e&m $82.59
90818 Psytx, hosp, 45-50 min $114.21
90819 Psytx, hosp, 45-50 min w/e&m $140.39
90821 Psytx, hosp, 75-80 min $182.00
90822 Psytx, hosp, 75-80 min w/e&m $220.73
90823 Intac psytx, hosp, 20-30 min $86.71
90824 Intac psytx, hsp 20-30 w/e&m $105.08
90826 Intac psytx, hosp, 45-50 min $135.83
90827 Intac psytx, hsp 45-50 w/e&m $154.21
90828 Intac psytx, hosp, 75-80 min $210.25
90829 Intac psytx, hsp 75-80 w/e&m $228.70
90845 Psychoanalysis $133.69
90846 Family psytx w/o patient $114.70
90847 Family psytx w/patient $134.13
90849 Multiple family group psytx $62.99
90853 Group psychotherapy $45.83
90857 Intac group psytx $41.03
90862 Medication management $80.18
90865 Narcosynthesis $194.57
90870 Electroconvulsive therapy $117.90
90871 Electroconvulsive therapy $212.39
90875 Psychophysiological therapy $91.77
90876 Psychophysiological therapy $134.08
90880 Hypnotherapy $142.32
90882 Environmental manipulation $131.00
90885 Psy evaluation of records $59.16
90887 Consultation with family $101.01
90889 Preparation of report $100.00
90899 Psychiatric service/therapy $0.00
90901 Biofeedback train, any meth $46.05
90911 Biofeedback peri/uro/rectal $146.00
90918 ESRD related services, month $1,351.07
90919 ESRD related services, month $927.14
90920 ESRD related services, month $812.34
90921 ESRD related services, month $508.60
90922 ESRD related services, day $43.12
90923 Esrd related services, day $30.20
90924 Esrd related services, day $26.53
90925 Esrd related services, day $17.05
90935 Hemodialysis, one evaluation $138.60
90937 Hemodialysis, repeated eval $227.44
90939 Hemodialysis study, transcut $0.00
90940 Hemodialysis access study $0.00
90945 Dialysis, one evaluation $145.49
90947 Dialysis, repeated eval $233.24
90989 Dialysis training, complete $498.03
90993 Dialysis training, incompl $119.75
90997 Hemoperfusion $236.54
90999 Dialysis procedure $0.00
91000 Esophageal intubation $78.95
91000.26 Esophageal intubation $73.10
91010 Esophagus motility study $268.88
91010.26 Esophagus motility study $118.33
91011 Esophagus motility study $289.75
91011.26 Esophagus motility study $129.67
91012 Esophagus motility study $310.63
91012.26 Esophagus motility study $132.40
91020 Gastric motility $188.23
91020.26 Gastric motility $85.79
91030 Acid perfusion of esophagus $141.15
91030.26 Acid perfusion of esophagus $55.23
91032 Esophagus, acid reflux test $226.05
91032.26 Esophagus, acid reflux test $72.38
91033 Prolonged acid reflux test $233.59
91033.26 Prolonged acid reflux test $78.07
91052 Gastric analysis test $160.56
91052.26 Gastric analysis test $60.37
91055 Gastric intubation for smear $154.89
91055.26 Gastric intubation for smear $59.45
91060 Gastric saline load test $55.63
91060.26 Gastric saline load test $43.93
91065 Breath hydrogen test $150.91
91065.26 Breath hydrogen test $20.10
91100 Pass intestine bleeding tube $103.01
91105 Gastric intubation treatment $34.51
91110 Gi tract capsule endoscopy $1,303.44
91110.26 Gi tract capsule endoscopy $272.79
91122 Anal pressure record $333.76
91122.26 Anal pressure record $106.56
91123 Irrigate fecal impaction Paid Elsewhere
91132 Electrogastrography $36.10
91132.26 Electrogastrography $36.10/td>
91133 Electrogastrography w/test $48.77
91133.26 Electrogastrography w/test $48.77
91299 Gastroenterology procedure $0.00
91299.26 Gastroenterology procedure $0.00
92002 Eye exam, new patient $87.68
92004 Eye exam, new patient $147.83
92012 Eye exam established pat $72.36
92014 Eye exam & treatment $106.70
92015 Refraction $78.78
92018 New eye exam & treatment $217.84
92019 Eye exam & treatment $137.75
92020 Special eye evaluation $50.69
92060 Special eye evaluation $75.49
92060.26 Special eye evaluation $53.28
92065 Orthoptic/pleoptic training $65.49
92065.26 Orthoptic/pleoptic training $38.30
92070 Fitting of contact lens $107.28
92081 Visual field examination(s) $79.44
92081.26 Visual field examination(s) $34.65
92082 Visual field examination(s) $105.19
92082.26 Visual field examination(s) $43.19
92083 Visual field examination(s) $93.52
92083.26 Visual field examination(s) $38.12
92100 Serial tonometry exam(s) $93.68
92120 Tonography & eye evaluation $79.67
92130 Water provocation tonography $87.51
92135 Opthalmic dx imaging $80.52
92135.26 Opthalmic dx imaging $37.49
92136 Ophthalmic biometry $147.57
92136.26 Ophthalmic biometry $52.22
92140 Glaucoma provocative tests $61.44
92225 Special eye exam, initial $43.87
92226 Special eye exam, subsequent $39.44
92230 Eye exam with photos $160.47
92235 Eye exam with photos $264.79
92235.26 Eye exam with photos $86.59
92240 Icg angiography $341.34
92240.26 Icg angiography $69.94
92250 Eye exam with photos $91.59
92250.26 Eye exam with photos $28.18
92260 Ophthalmoscopy/dynamometry $35.24
92265 Eye muscle evaluation $191.30
92265.26 Eye muscle evaluation $80.45
92270 Electro-oculography $169.95
92270.26 Electro-oculography $85.27
92275 Electroretinography $200.28
92275.26 Electroretinography $100.32
92283 Color vision examination $70.53
92283.26 Color vision examination $17.86
92284 Dark adaptation eye exam $106.59
92284.26 Dark adaptation eye exam $14.68
92285 Eye photography $53.57
92285.26 Eye photography $12.88
92286 Internal eye photography $172.52
92286.26 Internal eye photography $42.95
92287 Internal eye photography $147.83
92310 Contact lens fitting $99.51
92311 Contact lens fitting $163.26
92312 Contact lens fitting $175.33
92313 Contact lens fitting $149.25
92314 Prescription of contact lens $116.59
92315 Prescription of contact lens $99.35
92316 Prescription of contact lens $119.97
92317 Prescription of contact lens $106.24
92325 Modification of contact lens $27.19
92326 Replacement of contact lens $68.98
92330 Fitting of artificial eye $156.72
92335 Fitting of artificial eye $103.49
92340 Fitting of spectacles $76.17
92341 Fitting of spectacles $68.59
92342 Fitting of spectacles $92.25
92352 Special spectacles fitting $68.28
92353 Special spectacles fitting $71.31
92354 Special spectacles fitting $369.30
92355 Special spectacles fitting $179.49
92358 Eye prosthesis service $68.50
92370 Repair & adjust spectacles $57.58
92371 Repair & adjust spectacles $43.37
92390 Supply of spectacles $116.06
92391 Supply of contact lenses $144.76
92392 Supply of low vision aids $156.98
92393 Supply of artificial eye $829.22
92395 Supply of spectacles $91.56
92396 Supply of contact lenses $111.54
92499 Eye service or procedure $0.00
92499.26 Eye service or procedure $0.00
92502 Ear and throat examination $115.78
92504 Ear microscopy examination $47.52
92506 Speech/hearing evaluation $237.29
92507 Speech/hearing therapy $117.32
92508 Speech/hearing therapy $51.74
92510 Rehab for ear implant $257.62
92511 Nasopharyngoscopy $197.76
92512 Nasal function studies $77.15
92516 Facial nerve function test $85.90
92520 Laryngeal function studies $92.55
92526 Oral function therapy $93.63
92531 Spontaneous nystagmus study $28.32
92532 Positional nystagmus test $39.07
92533 Caloric vestibular test $22.51
92534 Optokinetic nystagmus test $11.73
92541 Spontaneous nystagmus test $98.03
92541.26 Spontaneous nystagmus test $43.64
92542 Positional nystagmus test $98.65
92542.26 Positional nystagmus test $36.00
92543 Caloric vestibular test $44.64
92543.26 Caloric vestibular test $11.25
92544 Optokinetic nystagmus test $78.28
92544.26 Optokinetic nystagmus test $28.02
92545 Oscillating tracking test $72.60
92545.26 Oscillating tracking test $25.09
92546 Sinusoidal rotational test $146.61
92546.26 Sinusoidal rotational test $30.95
92547 Supplemental electrical test $74.60
92548 Posturography $175.36
92548.26 Posturography $37.41
92551 Pure tone hearing test, air $21.23
92552 Pure tone audiometry, air $31.67
92553 Audiometry, air & bone $47.50
92555 Speech threshold audiometry $26.85
92556 Speech audiometry, complete $41.30
92557 Comprehensive hearing test $86.04
92559 Group audiometric testing $40.07
92560 Bekesy audiometry, screen $22.51
92561 Bekesy audiometry, diagnosis $45.91
92562 Loudness balance test $17.51
92563 Tone decay hearing test $17.51
92564 Sisi hearing test $20.44
92565 Stenger test, pure tone $17.51
92567 Tympanometry $37.86
92568 Acoustic reflex testing $26.85
92569 Acoustic reflex decay test $28.91
92571 Filtered speech hearing test $17.51
92572 Staggered spondaic word test $6.54
92573 Lombard test $18.51
92575 Sensorineural acuity test $18.51
92576 Synthetic sentence test $19.20
92577 Stenger test, speech $31.18
92579 Visual audiometry (vra) $52.32
92582 Conditioning play audiometry $52.32
92583 Select picture audiometry $38.41
92584 Electrocochleography $154.39
92585 Auditor evoke potent, compre $186.03
92585.26 Auditor evoke potent, compre $53.17
92586 Auditor evoke potent, limit $132.86
92587 Evoked auditory test $85.56
92587.26 Evoked auditory test $11.69
92588 Evoked auditory test $144.60
92588.26 Evoked auditory test $38.93
92589 Auditory function test(s) $38.55
92590 Hearing aid exam, one ear $125.97
92591 Hearing aid exam, both ears $98.09
92592 Hearing aid check, one ear $45.79
92593 Hearing aid check, both ears $68.47
92594 Electro hearng aid test, one $45.91
92595 Electro hearng aid tst, both $68.47
92596 Ear protector evaluation $42.68
92597 Oral speech device eval $182.29
92601 Cochlear implt f/up exam < 7 $203.12
92602 Reprogram cochlear implt < 7 $140.70
92603 Cochlear implt f/up exam 7 > $133.88
92604 Reprogram cochlear implt 7 > $88.97
92605 Eval for nonspeech device rx Paid Elsewhere
92606 Non-speech device service Paid Elsewhere
92607 Ex for speech device rx, 1hr $190.46
92608 Ex for speech device rx addl $41.07
92609 Use of speech device service $94.81
92610 Evaluate swallowing function $200.28
92611 Motion fluoroscopy/swallow $200.28
92612 Endoscopy swallow tst (fees) $170.50
92613 Endoscopy swallow tst (fees) $68.47
92614 Laryngoscopic sensory test $158.10
92615 Eval laryngoscopy sense tst $68.47
92616 Fees w/laryngeal sense test $221.79
92617 Interprt fees/laryngeal test $91.00
92700 Ent procedure/service $0.00
92950 Heart/lung resuscitation cpr $359.06
92953 Temporary external pacing $33.35
92960 Cardioversion electric, ext $629.99
92961 Cardioversion, electric, int $493.85
92970 Cardioassist, internal $342.98
92971 Cardioassist, external $182.47
92973 Percut coronary thrombectomy $338.55
92974 Cath place, cardio brachytx $311.09
92975 Dissolve clot, heart vessel $743.37
92977 Dissolve clot, heart vessel $572.08
92978 Intravasc us, heart add-on $509.26
92978.26 Intravasc us, heart add-on $185.70
92979 Intravasc us, heart add-on $310.61
92979.26 Intravasc us, heart add-on $147.80
92980 Insert intracoronary stent $1,554.08
92981 Insert intracoronary stent $431.79
92982 Coronary artery dilation $1,153.30
92984 Coronary artery dilation $307.48
92986 Revision of aortic valve $2,472.67
92987 Revision of mitral valve $2,568.44
92990 Revision of pulmonary valve $1,993.01
92992 Revision of heart chamber $8,235.99
92993 Revision of heart chamber $8,744.63
92995 Coronary atherectomy $1,268.19
92996 Coronary atherectomy add-on $338.08
92997 Pul art balloon repr, percut $1,254.58
92998 Pul art balloon repr, percut $612.14
93000 Electrocardiogram, complete $48.84
93005 Electrocardiogram, tracing $31.67
93010 Electrocardiogram report $17.17
93012 Transmission of ecg $253.21
93014 Report on transmitted ecg $52.60
93015 Cardiovascular stress test $196.79
93016 Cardiovascular stress test $45.65
93017 Cardiovascular stress test $120.13
93018 Cardiovascular stress test $31.01
93024 Cardiac drug stress test $199.92
93024.26 Cardiac drug stress test $120.07
93025 Microvolt t-wave assess $623.66
93025.26 Microvolt t-wave assess $76.66
93040 Rhythm ECG with report $26.40
93041 Rhythm ECG, tracing $10.67
93042 Rhythm ECG, report $15.73
93224 ECG monitor/report, 24 hrs $296.98
93225 ECG monitor/record, 24 hrs $88.12
93226 ECG monitor/report, 24 hrs $155.58
93227 ECG monitor/review, 24 hrs $53.29
93230 ECG monitor/report, 24 hrs $316.26
93231 Ecg monitor/record, 24 hrs $108.42
93232 ECG monitor/report, 24 hrs $154.55
93233 ECG monitor/review, 24 hrs $53.29
93235 ECG monitor/report, 24 hrs $230.84
93236 ECG monitor/report, 24 hrs $185.19
93237 ECG monitor/review, 24 hrs $45.65
93268 ECG record/review $343.99
93270 ECG recording $88.12
93271 Ecg/monitoring and analysis $253.21
93272 Ecg/review, interpret only $52.60
93278 ECG/signal-averaged $108.84
93278.26 ECG/signal-averaged $25.90
93303 Echo transthoracic $406.17
93303.26 Echo transthoracic $131.84
93304 Echo transthoracic $214.68
93304.26 Echo transthoracic $75.97
93307 Echo exam of heart $369.19
93307.26 Echo exam of heart $94.86
93308 Echo exam of heart $193.44
93308.26 Echo exam of heart $54.72
93312 Echo transesophageal $492.99
93312.26 Echo transesophageal $222.10
93313 Echo transesophageal $87.46
93314 Echo transesophageal $398.30
93314.26 Echo transesophageal $127.42
93315 Echo transesophageal $980.06
93315.26 Echo transesophageal $281.94
93316 Echo transesophageal $89.52
93317 Echo transesophageal $784.09
93317.26 Echo transesophageal $185.18
93318 Echo transesophageal intraop $618.12
93318.26 Echo transesophageal intraop $199.04
93320 Doppler echo exam, heart $161.58
93320.26 Doppler echo exam, heart $39.05
93321 Doppler echo exam, heart $95.53
93321.26 Doppler echo exam, heart $15.67
93325 Doppler color flow add-on $215.19
93325.26 Doppler color flow add-on $7.64
93350 Echo transthoracic $276.77
93350.26 Echo transthoracic $150.45
93501 Right heart catheterization $1,514.90
93501.26 Right heart catheterization $311.21
93503 Insert/place heart catheter $270.63
93505 Biopsy of heart lining $594.78
93505.26 Biopsy of heart lining $452.28
93508 Cath placement, angiography $1,350.43
93508.26 Cath placement, angiography $457.89
93510 Left heart catheterization $3,113.74
93510.26 Left heart catheterization $481.94
93511 Left heart catheterization $3,116.10
93511.26 Left heart catheterization $554.18
93514 Left heart catheterization $3,319.25
93514.26 Left heart catheterization $757.32
93524 Left heart catheterization $4,100.70
93524.26 Left heart catheterization $752.61
93526 Rt & Lt heart catheters $4,093.39
93526.26 Rt & Lt heart catheters $653.39
93527 Rt & Lt heart catheters $4,136.01
93527.26 Rt & Lt heart catheters $787.92
93528 Rt & Lt heart catheters $4,317.80
93528.26 Rt & Lt heart catheters $969.71
93529 Rt, lt heart catheterization $3,873.73
93529.26 Rt, lt heart catheterization $525.64
93530 Rt heart cath, congenital $1,662.33
93530.26 Rt heart cath, congenital $458.64
93531 R & l heart cath, congenital $4,328.80
93531.26 R & l heart cath, congenital $888.81
93532 R & l heart cath, congenital $4,409.68
93532.26 R & l heart cath, congenital $1,061.59
93533 R & l heart cath, congenital $4,058.96
93533.26 R & l heart cath, congenital $710.87
93539 Injection, cardiac cath $41.23
93540 Injection, cardiac cath $44.16
93541 Injection for lung angiogram $29.57
93542 Injection for heart x-rays $29.57
93543 Injection for heart x-rays $30.26
93544 Injection for aortography $25.90
93545 Inject for coronary x-rays $41.23
93555 Imaging, cardiac cath $529.30
93555.26 Imaging, cardiac cath $83.89
93556 Imaging, cardiac cath $787.23
93556.26 Imaging, cardiac cath $86.07
93561 Cardiac output measurement $86.90
93561.26 Cardiac output measurement $49.04
93562 Cardiac output measurement $39.14
93562.26 Cardiac output measurement $15.73
93571 Heart flow reserve measure $509.25
93571.26 Heart flow reserve measure $185.69
93572 Heart flow reserve measure $311.97
93572.26 Heart flow reserve measure $149.15
93580 Transcath closure of asd $1,880.72
93581 Transcath closure of vsd $2,507.66
93600 Bundle of His recording $359.31
93600.26 Bundle of His recording $219.91
93602 Intra-atrial recording $299.77
93602.26 Intra-atrial recording $220.25
93603 Right ventricular recording $339.35
93603.26 Right ventricular recording $219.22
93609 Map tachycardia, add-on $721.58
93609.26 Map tachycardia, add-on $528.48
93610 Intra-atrial pacing $409.65
93610.26 Intra-atrial pacing $312.58
93612 Intraventricular pacing $427.89
93612.26 Intraventricular pacing $312.58
93613 Electrophys map 3d, add-on $733.60
93615 Esophageal recording $116.61
93615.26 Esophageal recording $93.89
93616 Esophageal recording $165.30
93616.26 Esophageal recording $142.58
93618 Heart rhythm pacing $724.54
93618.26 Heart rhythm pacing $442.29
93619 Electrophysiology evaluation $1,330.97
93619.26 Electrophysiology evaluation $781.96
93620 Electrophysiology evaluation $3,918.60
93620.26 Electrophysiology evaluation $1,223.28
93621 Electrophysiology evaluation $4,310.65
93621.26 Electrophysiology evaluation $219.44
93622 Electrophysiology evaluation $4,310.65
93622.26 Electrophysiology evaluation $342.56
93623 Stimulation, pacing heart $1,110.22
93623.26 Stimulation, pacing heart $296.10
93624 Electrophysiologic study $661.66
93624.26 Electrophysiologic study $520.19
93631 Heart pacing, mapping $1,231.66
93631.26 Heart pacing, mapping $785.61
93640 Evaluation heart device $873.40
93640.26 Evaluation heart device $363.29
93641 Electrophysiology evaluation $1,124.61
93641.26 Electrophysiology evaluation $614.49
93642 Electrophysiology evaluation $1,033.89
93642.26 Electrophysiology evaluation $523.77
93650 Ablate heart dysrhythm focus $1,112.34
93651 Ablate heart dysrhythm focus $1,684.47
93652 Ablate heart dysrhythm focus $1,831.81
93660 Tilt table evaluation $311.53
93660.26 Tilt table evaluation $194.48
93662 Intracardiac ecg (ice) $691.95
93662.26 Intracardiac ecg (ice) $302.31
93668 Peripheral vascular rehab $0.00
93701 Bioimpedance, thoracic $83.61
93701.26 Bioimpedance, thoracic $17.86
93720 Total body plethysmography $67.42
93721 Plethysmography tracing $50.94
93722 Plethysmography report $16.48
93724 Analyze pacemaker system $786.40
93724.26 Analyze pacemaker system $504.15
93727 Analyze ilr system $54.66
93731 Analyze pacemaker system $81.79
93731.26 Analyze pacemaker system $46.68
93732 Analyze pacemaker system $131.34
93732.26 Analyze pacemaker system $94.86
93733 Telephone analy, pacemaker $70.17
93733.26 Telephone analy, pacemaker $17.86
93734 Analyze pacemaker system $63.83
93734.26 Analyze pacemaker system $39.05
93735 Analyze pacemaker system $108.26
93735.26 Analyze pacemaker system $76.60
93736 Telephonic analy, pacemaker $61.11
93736.26 Telephonic analy, pacemaker $15.67
93740 Temperature gradient studies $26.40
93740.26 Temperature gradient studies $15.04
93741 Analyze ht pace device sngl $114.85
93741.26 Analyze ht pace device sngl $72.87/td>
93742 Analyze ht pace device sngl $140.93
93742.26 Analyze ht pace device sngl $93.43
93743 Analyze ht pace device dual $158.15
93743.26 Analyze ht pace device dual $105.83
93744 Analyze ht pace device dual $168.66
93744.26 Analyze ht pace device dual $121.16
93760 Cephalic thermogram $313.47
93762 Peripheral thermogram $392.04
93770 Measure venous pressure $18.14
93770.26 Measure venous pressure $15.73
93784 Ambulatory BP monitoring $136.12
93786 Ambulatory BP recording $63.00
93788 Ambulatory BP analysis $35.46
93790 Review/report BP recording $37.67
93797 Cardiac rehab $39.26
93798 Cardiac rehab/monitor $54.99
93799 Cardiovascular procedure $0.00
93799.26 Cardiovascular procedure $0.00
93875 Extracranial study $134.83
93875.26 Extracranial study $22.28
93880 Extracranial study $346.31
93880.26 Extracranial study $60.98
93882 Extracranial study $246.36
93882.26 Extracranial study $41.22
93886 Intracranial study $393.38
93886.26 Intracranial study $97.73
93888 Intracranial study $265.19
93888.26 Intracranial study $63.85
93922 Extremity study $156.69
93922.26 Extremity study $25.55
93923 Extremity study $249.41
93923.26 Extremity study $45.64
93924 Extremity study $306.84
93924.26 Extremity study $51.10
93925 Lower extremity study $392.32
93925.26 Lower extremity study $58.80
93926 Lower extremity study $278.66
93926.26 Lower extremity study $39.44
93930 Upper extremity study $313.48
93930.26 Upper extremity study $46.74
93931 Upper extremity study $226.22
93931.26 Upper extremity study $31.41
93965 Extremity study $159.00
93965.26 Extremity study $35.08
93970 Extremity study $339.88
93970.26 Extremity study $68.67
93971 Extremity study $241.14
93971.26 Extremity study $45.30
93975 Vascular study $554.32
93975.26 Vascular study $180.18
93976 Vascular study $341.26
93976.26 Vascular study $120.30
93978 Vascular study $309.76
93978.26 Vascular study $65.74
93979 Vascular study $225.25
93979.26 Vascular study $44.90
93980 Penile vascular study $436.84
93980.26 Penile vascular study $124.31
93981 Penile vascular study $361.57
93981.26 Penile vascular study $43.87
93990 Doppler flow testing $262.71
93990.26 Doppler flow testing $25.55
94010 Breathing capacity test $59.85
94010.26 Breathing capacity test $16.48
94014 Patient recorded spirometry $92.87
94015 Patient recorded spirometry $41.65
94016 Review patient spirometry $51.22
94060 Evaluation of wheezing $102.66
94060.26 Evaluation of wheezing $30.38
94070 Evaluation of wheezing $254.78
94070.26 Evaluation of wheezing $58.57
94150 Vital capacity test $29.29
94150.26 Vital capacity test $5.74
94200 Lung function test (MBC/MVV) $39.54
94200.26 Lung function test (MBC/MVV) $10.62
94240 Residual lung capacity $69.67
94240.26 Residual lung capacity $25.27
94250 Expired gas collection $45.66
94250.26 Expired gas collection $9.04
94260 Thoracic gas volume $50.67
94260.26 Thoracic gas volume $12.80
94350 Lung nitrogen washout curve $72.77
94350.26 Lung nitrogen washout curve $25.27
94360 Measure airflow resistance $69.32
94360.26 Measure airflow resistance $25.27
94370 Breath airway closing volume $64.15
94370.26 Breath airway closing volume $23.15
94375 Respiratory flow volume loop $66.18
94375.26 Respiratory flow volume loop $30.38
94400 CO2 breathing response curve $90.10
94400.26 CO2 breathing response curve $38.47
94450 Hypoxia response curve $78.06
94450.26 Hypoxia response curve $38.82
94620 Pulmonary stress test/simple $218.52
94620.26 Pulmonary stress test/simple $62.25
94621 Pulm stress test/complex $253.35
94621.26 Pulm stress test/complex $137.70
94640 Airway inhalation treatment $22.72
94642 Aerosol inhalation treatment $130.97
94656 Initial ventilator mgmt $174.75
94657 Continued ventilator mgmt $132.20
94660 Pos airway pressure, CPAP $103.56
94662 Neg press ventilation, cnp $73.96
94664 Evaluate pt use of inhaler $23.40
94667 Chest wall manipulation $38.89
94668 Chest wall manipulation $32.36
94680 Exhaled air analysis, o2 $151.94
94680.26 Exhaled air analysis, o2 $25.27
94681 Exhaled air analysis, o2/co2 $199.78
94681.26 Exhaled air analysis, o2/co2 $20.10
94690 Exhaled air analysis $142.58
94690.26 Exhaled air analysis $6.95
94720 Monoxide diffusing capacity $90.66
94720.26 Monoxide diffusing capacity $25.27
94725 Membrane diffusion capacity $208.70
94725.26 Membrane diffusion capacity $23.45
94750 Pulmonary compliance study $111.84
94750.26 Pulmonary compliance study $22.34
94760 Measure blood oxygen level $3.44
94761 Measure blood oxygen level $6.88
94762 Measure blood oxygen level $30.97
94770 Exhaled carbon dioxide test $114.41
94770.26 Exhaled carbon dioxide test $12.69
94772 Breath recording, infant $313.72
94772.26 Breath recording, infant $313.72
94799 Pulmonary service/procedure $0.00
94799.26 Pulmonary service/procedure $0.00
95004 Percut allergy skin tests $7.23
95010 Percut allergy titrate test $20.56
95015 Id allergy titrate-drug/bug $19.55
95024 Id allergy test, drug/bug $10.67
95027 Id allergy titrate-airborne $10.67
95028 Id allergy test-delayed type $12.84
95044 Allergy patch tests $14.01
95052 Photo patch test $10.95
95056 Photosensitivity tests $8.56
95060 Eye allergy tests $18.18
95065 Nose allergy test $14.80
95070 Bronchial allergy tests $158.35
95071 Bronchial allergy tests $202.42
95075 Ingestion challenge test $129.46
95078 Provocative testing $18.59
95115 Immunotherapy, one injection $23.00
95117 Immunotherapy injections $28.35
95120 Immunotherapy, one injection $18.78
95125 Immunotherapy, many antigens $34.82
95130 Immunotherapy, insect venom $59.89
95131 Immunotherapy, insect venoms $52.28
95132 Immunotherapy, insect venoms $98.24
95133 Immunotherapy, insect venoms $110.66
95134 Immunotherapy, insect venoms $122.99
95144 Antigen therapy services $15.15
95145 Antigen therapy services $20.40
95146 Antigen therapy services $35.12
95147 Antigen therapy services $33.74
95148 Antigen therapy services $44.76
95149 Antigen therapy services $60.59
95165 Antigen therapy services $17.07
95170 Antigen therapy services $14.46
95180 Rapid desensitization $256.46
95199 Allergy immunology services $0.00
95250 Glucose monitoring, cont $196.36
95805 Multiple sleep latency test $764.37
95805.26 Multiple sleep latency test $112.94
95806 Sleep study, unattended $399.30
95806.26 Sleep study, unattended $162.85
95807 Sleep study, attended $590.66
95807.26 Sleep study, attended $101.69
95808 Polysomnography, 1-3 $1,045.44
95808.26 Polysomnography, 1-3 $251.39
95810 Polysomnography, 4 or more $1,453.88
95810.26 Polysomnography, 4 or more $348.90
95811 Polysomnography w/cpap $1,573.53
95811.26 Polysomnography w/cpap $375.94
95812 Eeg, 41-60 minutes $355.34
95812.26 Eeg, 41-60 minutes $113.35
95813 Eeg, over 1 hour $474.79
95813.26 Eeg, over 1 hour $179.78
95816 Eeg, awake and drowsy $297.31
95816.26 Eeg, awake and drowsy $112.27
95819 Eeg, awake and asleep $339.85
95819.26 Eeg, awake and asleep $114.03
95822 Eeg, coma or sleep only $319.02
95822.26 Eeg, coma or sleep only $93.60
95824 Eeg, cerebral death only $421.24
95824.26 Eeg, cerebral death only $79.35
95827 Eeg, all night recording $272.71
95827.26 Eeg, all night recording $109.56
95829 Surgery electrocorticogram $1,578.82
95829.26 Surgery electrocorticogram $381.65
95830 Insert electrodes for EEG $337.01
95831 Limb muscle testing, manual $44.66
95832 Hand muscle testing, manual $39.21
95833 Body muscle testing, manual $66.42
95834 Body muscle testing, manual $79.92
95851 Range of motion measurements $37.77
95852 Range of motion measurements $26.46
95857 Tensilon test $82.26
95858 Tensilon test & myogram $192.56
95858.26 Tensilon test & myogram $164.34
95860 Muscle test, one limb $173.58
95860.26 Muscle test, one limb $101.98
95861 Muscle test, 2 limbs $216.88
95861.26 Muscle test, 2 limbs $163.87
95863 Muscle test, 3 limbs $264.59
95863.26 Muscle test, 3 limbs $197.81
95864 Muscle test, 4 limbs $338.26
95864.26 Muscle test, 4 limbs $210.90
95867 Muscle test cran nerv unilat $125.77
95867.26 Muscle test cran nerv unilat $84.46
95868 Muscle test cran nerve bilat $174.85
95868.26 Muscle test cran nerve bilat $124.94
95869 Muscle test, thor paraspinal $54.82
95869.26 Muscle test, thor paraspinal $38.99
95870 Muscle test, nonparaspinal $54.82
95870.26 Muscle test, nonparaspinal $38.99
95872 Muscle test, one fiber $200.13
95872.26 Muscle test, one fiber $157.10
95875 Limb exercise test $186.43
95875.26 Limb exercise test $115.53
95900 Motor nerve conduction test $121.21
95900.26 Motor nerve conduction test $44.79
95903 Motor nerve conduction test $129.48
95903.26 Motor nerve conduction test $63.39
95904 Sense nerve conduction test $102.84
95904.26 Sense nerve conduction test $36.06
95920 Intraop nerve test add-on $320.70
95920.26 Intraop nerve test add-on $228.11
95921 Autonomic nerv function test $117.46
95921.26 Autonomic nerv function test $91.30
95922 Autonomic nerv function test $126.76
95922.26 Autonomic nerv function test $100.60
95923 Autonomic nerv function test $185.76
95923.26 Autonomic nerv function test $82.23
95925 Somatosensory testing $121.56
95925.26 Somatosensory testing $56.85
95926 Somatosensory testing $122.24
95926.26 Somatosensory testing $57.53
95927 Somatosensory testing $123.62
95927.26 Somatosensory testing $58.91
95930 Visual evoked potential test $125.28
95930.26 Visual evoked potential test $36.81
95933 Blink reflex test $117.72
95933.26 Blink reflex test $61.27
95934 H-reflex test $69.75
95934.26 H-reflex test $53.92
95936 H-reflex test $74.11
95936.26 H-reflex test $58.28
95937 Neuromuscular junction test $91.91
95937.26 Neuromuscular junction test $67.81
95950 Ambulatory eeg monitoring $438.69
95950.26 Ambulatory eeg monitoring $160.25
95951 EEG monitoring/videorecord $2,277.49
95951.26 EEG monitoring/videorecord $632.47
95953 EEG monitoring/computer $774.87
95953.26 EEG monitoring/computer $322.93
95954 EEG monitoring/giving drugs $484.49
95954.26 EEG monitoring/giving drugs $259.36
95955 EEG during surgery $243.73
95955.26 EEG during surgery $102.26
95956 Eeg monitoring, cable/radio $1,180.47
95956.26 Eeg monitoring, cable/radio $312.76
95957 EEG digital analysis $330.97
95957.26 EEG digital analysis $209.12
95958 EEG monitoring/function test $569.59
95958.26 EEG monitoring/function test $444.65
95961 Electrode stimulation, brain $412.80
95961.26 Electrode stimulation, brain $320.21
95962 Electrode stim, brain add-on $435.20
95962.26 Electrode stim, brain add-on $342.61
95965 Meg, spontaneous $2,007.55
95965.26 Meg, spontaneous $844.80
95966 Meg, evoked, single $1,180.47
95966.26 Meg, evoked, single $423.23
95967 Meg, evoked, each add’l $927.73
95967.26 Meg, evoked, each add’l $357.67
95970 Analyze neurostim, no prog $46.68
95971 Analyze neurostim, simple $79.92
95972 Analyze neurostim, complex $159.83
95973 Analyze neurostim, complex $98.29
95974 Cranial neurostim, complex $319.01
95975 Cranial neurostim, complex $179.95
95990 Spin/brain pump refil & main $105.33
95991 Spin/brain pump refil & main $94.81
95999 Neurological procedure $0.00
96000 Motion analysis, video/3d $172.97
96001 Motion test w/ft press meas $206.68
96002 Dynamic surface emg $41.63
96003 Dynamic fine wire emg $38.64
96004 Phys review of motion tests $228.64
96100 Psychological testing $128.03
96105 Assessment of aphasia $128.03
96110 Developmental test, lim $19.25
96111 Developmental test, extend $273.99
96115 Neurobehavior status exam $128.03
96117 Neuropsych test battery $128.03
96150 Assess lth/behave, init $51.10
96151 Assess hlth/behave, subseq $44.81
96152 Intervene hlth/behave, indiv $46.74
96153 Intervene hlth/behave, group $10.56
96154 Interv hlth/behav, fam w/pt $45.99
96155 Interv hlth/behav fam no pt $45.94
96400 Chemotherapy, sc/im $90.15
96405 Intralesional chemo admin $120.79
96406 Intralesional chemo admin $164.32
96408 Chemotherapy, push technique $137.01
96410 Chemotherapy,infusion method $217.59
96412 Chemo, infuse method add-on $66.04
96414 Chemo, infuse method add-on $224.90
96420 Chemotherapy, push technique $125.34
96422 Chemotherapy,infusion method $223.66
96423 Chemo, infuse method add-on $97.51
96425 Chemotherapy,infusion method $204.66
96440 Chemotherapy, intracavitary $456.90
96445 Chemotherapy, intracavitary $453.00
96450 Chemotherapy, into CNS $388.51
96520 Port pump refill & main $171.61
96530 Syst pump refill & main $127.00
96542 Chemotherapy injection $253.43
96545 Provide chemotherapy agent $90.20
96549 Chemotherapy, unspecified $0.00
96567 Photodynamic tx, skin $68.84
96570 Photodynamic tx, 30 min $109.33
96571 Photodynamic tx, addl 15 min $55.53
96900 Ultraviolet light therapy $33.73
96902 Trichogram $48.17
96910 Photochemotherapy with UV-B $55.79
96912 Photochemotherapy with UV-A $63.38
96913 Photochemotherapy, UV-A or B $125.98
96920 Laser tx, skin < 250 sq cm $370.64
96921 Laser tx, skin 250-500 sq cm $374.42
96922 Laser tx, skin > 500 sq cm $448.31
96999 Dermatological procedure $0.00
97001 Pt evaluation $129.24
97002 Pt re-evaluation $69.97
97003 Ot evaluation $132.48
97004 Ot re-evaluation $86.80
97005 Athletic train eval $123.87
97006 Athletic train reeval $67.41
97010 Hot or cold packs therapy $8.27
97012 Mechanical traction therapy $28.65
97014 Electric stimulation therapy $26.87
97016 Vasopneumatic device therapy $26.87
97018 Paraffin bath therapy $12.40
97020 Microwave therapy $8.95
97022 Whirlpool therapy $28.18
97024 Diathermy treatment $11.02
97026 Infrared therapy $8.95
97028 Ultraviolet therapy $11.14
97032 Electrical stimulation $30.03
97033 Electric current therapy $39.38
97034 Contrast bath therapy $27.04
97035 Ultrasound therapy $23.60
97036 Hydrotherapy $43.97
97039 Physical therapy treatment $22.16
97110 Therapeutic exercises $53.97
97112 Neuromuscular reeducation $53.31
97113 Aquatic therapy/exercises $59.98
97116 Gait training therapy $47.08
97124 Massage therapy $41.59
97139 Physical medicine procedure $29.79
97140 Manual therapy $50.62
97150 Group therapeutic procedures $33.24
97504 Orthotic training $50.50
97520 Prosthetic training $49.88
97530 Therapeutic activities $44.23
97532 Cognitive skills development $47.66
97533 Sensory integration $49.72
97535 Self care mngment training $45.64
97537 Community/work reintegration $52.54
97542 Wheelchair mngment training $53.22
97545 Work hardening $202.20
97546 Work hardening add-on $55.94
97601 Wound(s) care, selective $72.79
97602 Wound(s) care non-selective $37.54
97703 Prosthetic checkout $47.58
97750 Physical performance test $54.94
97755 Assistive technology assess $51.94
97780 Acupuncture w/o stimul $51.75
97781 Acupuncture w/stimul $96.41
97799 Physical medicine procedure $0.00
97802 Medical nutrition, indiv, in $29.40
97803 Med nutrition, indiv, subseq $26.04
97804 Medical nutrition, group $13.42
98925 Osteopathic manipulation $48.41
98926 Osteopathic manipulation $78.14
98927 Osteopathic manipulation $60.87
98928 Osteopathic manipulation $71.76
98929 Osteopathic manipulation $82.44
98940 Chiropractic manipulation $35.75
98941 Chiropractic manipulation $41.93
98942 Chiropractic manipulation $56.48
98943 Chiropractic manipulation $30.83
99000 Specimen handling $17.02
99001 Specimen handling $13.51
99002 Device handling $9.77
99024 Postop follow-up visit $35.00
99025 Initial surgical evaluation $27.11
99026 In-hospital on call service $46.86
99027 Out-of-hosp on call service $23.39
99050 Medical services after hrs $45.97
99052 Medical services at night $39.86
99054 Medical servcs, unusual hrs $38.91
99056 Non-office medical services $22.55
99058 Office emergency care $67.01
99070 Special supplies $43.18
99071 Patient education materials $15.61
99075 Medical testimony $164.91
99078 Group health education $45.12
99080 Special reports or forms $23.29
99082 Unusual physician travel $0.00
99090 Computer data analysis $105.71
99091 Collect/review data from pt $52.73
99100 Special anesthesia service $5.00
99116 Anesthesia with hypothermia $23.39
99135 Special anesthesia procedure $27.71
99140 Emergency anesthesia $59.04
99141 Sedation, iv/im or inhalant $193.65
99142 Sedation, oral/rectal/nasal $68.60
99170 Anogenital exam, child $151.11
99172 Ocular function screen $0.00
99173 Visual acuity screen $20.60
99175 Induction of vomiting $59.89
99183 Hyperbaric oxygen therapy $303.95
99185 Regional hypothermia $27.26
99186 Total body hypothermia $83.20
99190 Special pump services $405.22
99191 Special pump services $301.40
99192 Special pump services $200.53
99195 Phlebotomy $28.06
99199 Special service/proc/report $0.00
99201 Office/outpatient visit, new $66.14
99202 Office/outpatient visit, new $89.06
99203 Office/outpatient visit, new $122.56
99204 Office/outpatient visit, new $174.13
99205 Office/outpatient visit, new $239.68
99211 Office/outpatient visit, est $39.28
99212 Office/outpatient visit, est $53.51
99213 Office/outpatient visit, est $72.09
99214 Office/outpatient visit, est $110.89
99215 Office/outpatient visit, est $164.24
99217 Observation care discharge $125.87
99218 Observation care $127.25
99219 Observation care $212.80
99220 Observation care $290.28
99221 Initial hospital care $128.62
99222 Initial hospital care $214.18
99223 Initial hospital care $298.99
99231 Subsequent hospital care $64.31
99232 Subsequent hospital care $106.00
99233 Subsequent hospital care $150.62
99234 Observ/hosp same date $215.15
99235 Observ/hosp same date $275.58
99236 Observ/hosp same date $317.48
99238 Hospital discharge day $121.03
99239 Hospital discharge day $167.29
99241 Office consultation $94.26
99242 Office consultation $153.13
99243 Office consultation $203.09
99244 Office consultation $324.14
99245 Office consultation $335.53
99251 Initial inpatient consult $68.21
99252 Initial inpatient consult $136.42
99253 Initial inpatient consult $186.50
99254 Initial inpatient consult $269.76
99255 Initial inpatient consult $370.93
99261 Follow-up inpatient consult $43.06
99262 Follow-up inpatient consult $86.19
99263 Follow-up inpatient consult $127.53
99271 Confirmatory consultation $69.94
99272 Confirmatory consultation $103.35
99273 Confirmatory consultation $142.24
99274 Confirmatory consultation $193.07
99275 Confirmatory consultation $246.44
99281 Emergency dept visit $31.52
99282 Emergency dept visit $52.77
99283 Emergency dept visit $117.37
99284 Emergency dept visit $182.77
99285 Emergency dept visit $285.96
99288 Direct advanced life support $329.09
99289 Ped crit care transport $336.89
99290 Ped crit care transport addl $168.88
99291 Critical care, first hour $415.90
99292 Critical care, add’l 30 min $207.86
99293 Ped critical care, initial $1,087.15
99294 Ped critical care, subseq $591.16
99295 Neonate crit care, initial $1,649.92
99296 Neonate critical care subseq $781.82
99298 Ic for lbw infant < 1500 gm $273.50
99299 Ic, lbw infant 1500-2500 gm $213.49
99301 Nursing facility care $101.63
99302 Nursing facility care $139.75
99303 Nursing facility care $197.20
99311 Nursing fac care, subseq $67.84
99312 Nursing fac care, subseq $91.21
99313 Nursing fac care, subseq $110.26
99315 Nursing fac discharge day $112.47
99316 Nursing fac discharge day $133.03
99321 Rest home visit, new patient $69.85
99322 Rest home visit, new patient $105.23
99323 Rest home visit, new patient $135.17
99331 Rest home visit, est pat $41.57
99332 Rest home visit, est pat $87.27
99333 Rest home visit, est pat $107.03
99341 Home visit, new patient $84.04
99342 Home visit, new patient $105.23
99343 Home visit, new patient $142.60
99344 Home visit, new patient $186.97
99345 Home visit, new patient $244.79
99347 Home visit, est patient $75.62
99348 Home visit, est patient $92.00
99349 Home visit, est patient $134.91
99350 Home visit, est patient $205.88
99354 Prolonged service, office $172.80
99355 Prolonged service, office $169.65
99356 Prolonged service, inpatient $172.78
99357 Prolonged service, inpatient $104.08
99358 Prolonged serv, w/o contact $136.18
99359 Prolonged serv, w/o contact $67.45
99360 Physician standby services $126.42
99361 Physician/team conference $84.04
99362 Physician/team conference $151.76
99371 Physician phone consultation $11.77
99372 Physician phone consultation $34.39
99373 Physician phone consultation $50.52
99374 Home health care supervision $81.41
99375 Home health care supervision $143.62
99377 Hospice care supervision $79.23
99378 Hospice care supervision $159.09
99379 Nursing fac care supervision $79.03
99380 Nursing fac care supervision $143.62
99381 Prev visit, new, infant $116.31
99382 Prev visit, new, age 1-4 $135.62
99383 Prev visit, new, age 5-11 $141.76
99384 Prev visit, new, age 12-17 $133.82
99385 Prev visit, new, age 18-39 $153.38
99386 Prev visit, new, age 40-64 $159.72
99387 Prev visit, new, 65 & over $230.14
99391 Prev visit, est, infant $93.04
99392 Prev visit, est, age 1-4 $106.73
99393 Prev visit, est, age 5-11 $113.39
99394 Prev visit, est, age 12-17 $111.16
99395 Prev visit, est, age 18-39 $122.81
99396 Prev visit, est, age 40-64 $129.30
99397 Prev visit, est, 65 & over $143.45
99401 Preventive counseling, indiv $47.32
99402 Preventive counseling, indiv $80.26
99403 Preventive counseling, indiv $111.27
99404 Preventive counseling, indiv $142.93
99411 Preventive counseling, group $23.94
99412 Preventive counseling, group $36.22
99420 Health risk assessment test $134.56
99429 Unlisted preventive service $0.00
99431 Initial care, normal newborn $115.25
99432 Newborn care, not in hosp $151.76
99433 Normal newborn care/hospital $60.75
99435 Newborn discharge day hosp $148.49
99436 Attendance, birth $145.74
99440 Newborn resuscitation $287.97
99450 Life/disability evaluation $159.88
99455 Disability examination $74.04
99456 Disability examination $252.85
99499 Unlisted e&m service $0.00
99500 Home visit, prenatal $95.00
99501 Home visit, postnatal $50.00
99502 Home visit, nb care $50.00
99503 Home visit, resp therapy By Report
99504 Home visit mech ventilator $0.00
99505 Home visit, stoma care By Report
99506 Home visit, im injection $0.00
99507 Home visit, cath maintain $80.00
99509 Home visit day life activity $42.00
99510 Home visit, sing/m/fam couns $0.00
99511 Home visit, fecal/enema mgmt $0.00
99512 Home visit for hemodialysis $0.00
99551 Home infus, pain mgmt, iv/sc $65.00
99554 Home infus, hormone/platelet $80.00
99555 Home infuse, chemotheraphy $80.00
99556 Home infus, antibio/fung/vir $80.00
99558 Home infuse, immunotherapy $80.00
99561 Home infuse, hydration tx $80.00
99562 Home infus, parent nutrition $170.00
99567 Home infuse, sympath agent $80.00
99568 Home infus, misc drug, daily $466.00
99569 Home infuse, each addl tx $80.00
99600 Home visit nos By Report
99601 Home infusion/visit, 2 hrs $75.00
99602 Home infusion, each addtl hr $75.00

1 Comments:

Blogger PapaGrannyFox said...

Great information. Explains why the insurance company says was overcharged by $150. Now i can go fight about the excessive charges

November 20, 2008 at 6:12 PM  

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