Surgery Center of Oklahoma QUALIFIED PROCEDURES Reimbursement Schedule - updated 4-21-2021 Services include: pre-op, post-op, surgeon(s), anesthesia, pathology, implants (unless specified otherwise) & facility fees. Total joint replacement includes physical therapy and home health.

CPT Procedure Fee

11401 Excision masses, shoulder, palm, breast x2 $2,365.00 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms 11402 $2,365.00 or legs; excised diameter 1.1 to 2.0 cm Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms 11403 $2,365.00 or legs; excised diameter 2.1 to 3.0 cm Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms 11404 $2,365.00 or legs; excised diameter 3.1 to 4.0 cm. Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms 11406 $2,365.00 or legs; excised diameter over 4.0 cm 11420 Excision masses, shoulder, palm, breast x2 $2,365.00 Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm benign lesion 11421 $2,365.00 including margins, except skin tag, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 11426 Excision Benign Lesion $1,900.00 11440 Excision Preauricular Pits $2,800.00 11441 Excision Preauricular Pits $2,800.00 11442 Excision Preauricular Pits $2,800.00 11443 Excision Preauricular Pits $2,800.00 11444 Excision Preauricular Pits $2,800.00 11446 Excision Preauricular Pits $2,800.00 11451 Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair. $2,365.00 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 11602 $1,900.00 cm 11620 Excision squamous cell carcinoma $4,000.00 11626 SKIN LESION $4,125.00 11642 Excision Malignant Lesion Lateral Nasal $4,300.00 11711 Excision of pilonidal cyst, extensive $3,400.00 11730 Avulsion of Digital Nail $2,350.00

11750 Removal of Toenail y; g $1,700.00 11750 x 4 hallux $2,365.00 11760 Repair of nail bed $2,805.00 11770 Pilonidal cyst $3,400.00 11771 Removal of Cyst Tailbone $3,400.00 13101 Scar Revision $1,900.00 13102 Scar Revision $1,900.00 14040 Small defect repair cheek or forehead $3,900.00 14041 Large defect repair check or forehead $5,250.00 14060 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less $4,000.00 15260 Full thickness skin graft to nose $3,000.00 15630 Forehead flap takedown $3,300.00 15732 Graft $5,060.00 15822 Blepharoplasty (bilateral, upper eyelid) $4,150.00 15823 Blepharoplasty (bilateral) $4,150.00 19112 Excision of lactiferous duct fistula $2,365.00 19120 Mass - Excision / Biospy $3,365.00 19120-50 Bilateral Mass- Excision/ Biospy $5,315.00 19125 Excision of breast lesion identified by preoperative placement of radiological marker, open; single $2,365.00 19300 Mastectomy for gynecomastia $3,600.00 19301 Mascetomy $6,505.00 19302 Mastectomy with or without Node Dissection $7,505.00 19302-50 Bilateral Masctectomy with Node Dissection $11,200.00 19303 Mastectomy with sentinel lymph node biopsy $6,505.00 19303-50 Bilateral Mastectomy with nipple-sparing $16,400.00 Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor 19307 $7,505.00 muscle, but excluding pectoralis major muscle 19316 Mastopexy (Single) $5,000.00 19318 Breast Reduction (one side) $5,900.00 19318-50 Bilateral Breast Reduction $9,500.00 19330 Removal Breast Implant Material $3,450.00 19340 Under Repair and/or Reconstruction Procedures on the Breast $5,555.00 19342 2nd stage; w/implant placement, single $4,235.00 19342-50 2nd stage: w/implant placement, bilateral $5,555.00 19350 Bilateral nipple reconstruction $3,000.00 19357 1st stage; reconstruction w/expanders $5,280.00 19357-50 1st stage; reconstruction w/expanders, bilateral $7,480.00 19361 Breast Recon w/ Latissuims Flap, single $11,400.00 20205 Tricep Muscle Biopsy $2,365.00 20605-50 TMJ Arthrocentesis Bilateral $3,200.00 20680 Hardware removal, Simple $2,530.00 20680 Hardware Removal, Complex $4,510.00 21014 Excision, tumor, soft tissue of face and scalp, subfacial, 2cm or greater $2,365.00 21029 Excision of frontal bone benign neoplasm $5,060.00 21121 Genioplsty (includes overnight; hardware is NOT included) $6,350.00 21141 Lefort 1, Simple (includes overnight; hardware is NOT included) $15,250.00 21196 Osteotomy Simple (includes overnight; hardware is NOT included) $14,600.00 21198 Osteotomy Complex (includes overnight; hardware is NOT included) $16,950.00 21240 TMJ Arthroplasty Unilateral $14,311.00 21240-50 TMJ Arthroplasty Bilateral $24,222.00 21242 TMJ Arthroplasty Unilateral $14,311.00 21242-50 TMJ Arthroplasty Bilateral $24,222.00 21310 Nasal Fracture Simple Closed $1,900.00 21320 Nasal Fracture w/Stabilization $1,900.00 21325 Nasal Fracture Complex Open $4,015.00 21330 Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation $4,015.00 21451 Fracture Simple, Closed (includes overnight; hardware is NOT included) $5,300.00 21461 Fracture Simple, Open (includes overnight; hardware is NOT included) $7,750.00 21462 Fracture Intermediate (includes overnight; hardware is NOT included) $12,200.00 21470 Fracture Complex (mandibular) (includes overnight; hardware is NOT included) $19,050.00 21552 Excision, tumor, soft tissue of neck or anterior thorax, subfascial, less than 3 cm or greater $2,365.00 21555 Excision, cyst, neck $2,365.00 21556 Excision, tumor, soft tissue of neck or anterior thorax, subfascial, less than 5 cm $2,700.00 21930 Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm $2,365.00 21931 Excision, tumor 3cm or larger (back) $2,365.00 21932 Excision Right Upper Back Mass $2,365.00 21933 Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater $3,740.00 22551 Anterior Cervical Discectomy with fusion 1 level $18,960.00 22552 Anterior Cervical Discetomy with fusion 2 level $25,360.00 22900 Excision mass abdomen $3,575.00 22902 Excision, tumor, soft tissue of abdominal wall, subcutaneous, less than 3 cm $2,365.00 22903 Excision mass lower abdomen $2,365.00 23071 Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greaterÿ $2,255.00 23120 Distal Clavicle Excision (Shoulder) $4,730.00 23170 Distal Clavicle Excision (Shoulder) $4,730.00 23410 Open Rotator Cuff Repair (Shoulder) $6,260.00 23430 Tenodesis of long tendon of biceps $4,950.00 23455 Bankhart Stabilization (Shoulder) $6,160.00 23466 Bankhart Stabilization (Shoulder) $6,160.00 23472 Total Shoulder Arthroplasty $15,499.00 23500 Closed treatment of clavicular fracture; without manipulation $400.00 23515 Open treatment of clavicular fracture, includes internal fixation, when performed. $6,375.00 23535 Open treatment of clavicular fracture, includes internal fixation, when performed. $ 6375 + implant fees 23552 Open AC Joint Reconstruction $6,375.00 23600 Open Reduction Internal Fixation, Simple $4,455.00 23615 Open Reduction Internal Fixation, Complex $6,375.00 23700 Manipulation shoulder / anesthesia $1,400.00 24105 Bursectomy $2,700.00 Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary 24341 $4,950.00 (excludes rotator cuff) (Shoulder) 24342 Distal biceps reattachment (includes hardware) $6,200.00 24357 Tennis Elbow (lateral debridement) $3,200.00 24358 Ulnar Nerve Trasposition / Epicondylectomy $4,510.00 24359 Tennis Elbow (lateral debridement) $4,300.00 24650 Closed treatment of radial head or neck fracture; without manipulation $400.00 24670 Closed treatment of ulnar fracture, proximal end; without manipulation $400.00 25000 Dupuytrens Contracture $2,950.00 25111 Ganglion Excision $2,750.00 25215 Proximal Row Carpectomy $5,400.00 25447 Suspenionplasty, Arthroplasty, interposition, intercarpal or carpometacarpal joints $4,650.00 25500 Closed treatment of radial shaft fracture; without manipulation $400.00 25530 Closed treatment of ulnar shaft fracture; without manipulation $400.00 25545 ORIF Ulnar Fx $4,455.00 25560 Closed treatment of radial and ulnar shaft fractures; without manipulation $400.00 25600 Closed treatment of distal radial fracture; without manipulation $400.00 25605 Closed Reduction and Casting $1,925.00 25608 open tx of distal radial intra-articular fracture w internal fixation 2 fragments $4,455.00 25622 Closed treatment of carpal scaphoid (navicular) fracture; without manipulation $400.00 25810 Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft) $8,300.00 26045 Fasciotomy, palmar (eg. Dupuytren's contracture); open, partial $2,950.00 26055 Trigger Finger $2,600.00 26110 Joint Arthrotomy Debridement $3,740.00 26113 excision mass of hand or finger, subfascial $2,750.00 26115 Excision masses, shoulder, palm, breast x2 $2,365.00 26116 Excision of tumor finger $2,750.00 Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin 26121 $2,950.00 grafting (includes obtaining graft). Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, 26123 $2,950.00 with or without Z-plasty, other local tissue rearrangement, or skin grafting Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each 26145 $2,950.00 tendon 26160 Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or f $2,750.00 26340 Manipulation, finger joint, under anesthesia, each joint. $2,750.00 26437 Extensor realignment band repair little finger $4,650.00 26540 Rt thumb ulnar collateral ligament repair $6,600.00 26600 Closed treatment of metacarpal fracture, single; without manipulation, each bone $400.00 26720 Closed treatment of phalangeal shaft fracture; without manipulation, each $400.00 Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with 26725 $1,925.00 manipulation, with or without skin or skeletal traction, each 26727 Percutaneous Pinning - finger 1-2 pins $2,805.00 Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, 26735 $4,455.00 includes internal fixation 26740 Closed treatment of articular fracture, inv metacarpo/inter joint; without manipulation, each $400.00 26750 Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each $400.00 26860 DIP fusion Index Finger $3,600.00 26952 Ray resection index finger $4,650.00 27033 Repair Gluteus Medius Tendon $5,300.00 27041 Excision Coccygeal Mass $3,400.00 27096 Sacroilliac Joint Injection $900.00 27130 Total Hip Arthroplasty $15,499.00 27299 Hip Decompression $9,750.00 27299-50 Hip Decompression (Bilateral) $14,000.00 27301 I & D Abscess right thigh $1,900.00 27305 Anterior compartment fascia release $3,740.00 27340 Excision Pre-patellar bursa $2,700.00 27347 Ganglion excision $2,750.00 27380 Left Patellar Tendon Repair $3,740.00 27405 Medial Collateral Ligament (Knee) $6,160.00 27409 Posterior cruciate ligament repair (Knee) $6,990.00 27420 (L) ks w/open patella realignment and exc. patella fragment $6,270.00 27447 Total Knee Arthroplasty $15,499.00 27455 Tibial Tubercle Osteotomy (Knee) $6,270.00 27520 Closed treatment of patellar fracture, without manipulation $400.00 Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy 27524 $4,455.00 and soft tissue repair 27570 Manipulation under anesthesia with block $1,400.00 27599 Unlisted procedure, femur or knee $4,510.00 27618 Under Excision Procedures on the Leg (Tibia and Fibula) and Ankle Joint. $2,365.00 27650 Achilles Repair $5,730.00 27680 Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon $2,475.00 27687 Gastrocnemius Recession $4,180.00 27698 Brostrum Repair, secondary, disrupted ligament, ankle, collateral $4,950.00 27702 Total Ankle Replacement $13,500.00 27870 Ankle scope, hardware removal, brostrum, peroneal tenolysis $7,900.00 27899 Total Ankle Replacement $13,500.00 28035 Tarsal tunnel $3,080.00 28043 Foot excision plantar granuloma $3,080.00 28045 Excision Plantar Arch of Foot $2,365.00 28060 Plantar Fasciotomy $3,080.00 28080 Neuroma Excision $2,750.00 Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or 28090 $2,750.00 ganglion); foot 28110 Ostectomy partial excision $4,125.00 28116 Ostectomy, excision of tarsal coalition $4,125.00 28119 Heel spur removal $3,550.00 28122 Right Foot Partial excision bone $3,550.00 28124 Simple Excision Fracture Fragment 2nd Digit Foot $2,950.00 28192 Foreign Body Removal $2,365.00 28208 Repair Tendon Foot Extensor $4,125.00 28238 Kidner procedure (reconstruction posterior tibial tendon) $4,125.00 28285 Hammertoe (1) $2,475.00 28285 Hammertoe (2) $2,860.00 28285 Hammertoe (3) $3,355.00 Hallux rigidus correction with cheilectomy, debridement and capsular release of the first 28289 $3,650.00 metatarsophalangeal joint 28292 Bunionectomy $4,125.00 28292-50 Bunionectomy-bilateral $6,000.00 28296 Bunionectomy $4,125.00 28306 Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatars $4,125.00 28308 Osteotomy $4,125.00 28315 Sesamoidectomy $2,475.00 28322 repair, nonunion or malunion; metatarsal, with or without bone graft $4,455.00 28415 Calcaneus Fracture Heel (Bilateral, includes overnight) $9,700.00 28470 Closed treatment of metatarsal fracture; without manipulation, each $400.00 28485 Left Foot 5th Metatarsal ORIF $4,455.00 28490 Closed treatment of fracture great toe, phalanx or phalanges; without manipulation $400.00 28510 Closed treatment of fracture, phalanges, other than great toe; without manipulations, each $400.00 28715 Arthrodesis; Triple $9,700.00 28750 Arthrodesis, great toe; metatarsophalangeal joint $4,125.00 28820 Amputation Toe (1) $2,900.00 28890 Extracorporeal shock wave Plantar Fascia – Right Heel $3,650.00 29806 Shoulder (Arthroscopy) $5,720.00 29822 Arthroscopic debridement shoulder $6,160.00 29823 Extensive debridement $6,160.00 29824 Distal Clavicle Excision $6,160.00 29826 Subacromial decompression $6,160.00 29827 Arthroscopic rotator cuff repair shoulder $8,260.00 29827 Arthroscopic rotator cuff repair shoulder Repair pectoralis muscle rupture $5,600.00 29828 Shoulder- Biceps Tenodesis Arthroscopically $8,260.00 29830 Elbow (Arthroscopy) $3,740.00 29836 Elbow Arthroscopy w/ or w/out Synovectomy $5,350.00 29840 Wrist (Arthroscopy) $4,300.00 29855 Knee Subchondroplasty + cost of Accufill $4,510.00 29862 Hip (Arthroscopy) $5,575.00 29863 Arthroscopic Trochanteric Bursectomy w/ IT Band $6,450.00 29870 Arthroscopy, knee, diagnostic, with or without synovial biopsy $3,740.00 29871 Knee (Arthroscopy) $3,740.00 29871-50 Knee (Arthroscopy) Bilateral $5,300.00 29873 Knee with lateral release or microfracture (Arthroscopy) $4,510.00 29874 Knee Scope w/ loose body removal and microfracturing $4,510.00 29876 Complete Synovectomy (Knee) $3,740.00 29877 Chondroplasty (Knee) $3,740.00 29879 Arthroscopy, knee, diagnostic, with or without synovial biopsy $3,740.00 29880 Med & lateral Meniscectomy (Knee) $3,740.00 29881 Med OR lateral Meniscectory (Knee) $3,740.00 29881-50 Med OR lateral Meniscectory (Knee) Bilateral $5,300.00 29882 Left Knee - meniscus repair $5,000.00 29884 Knee Scope w/Lysis Adhesions $3,740.00 29888 Anterior cruciate ligament repair (Knee) $6,790.00 29888 Anterior cruciate ligament w/allograft $9,790.00 29891 Ankle (Arthroscopy) - $3,740.00 29893 Endoscopic plantar fasciotomy $3,080.00 29894 Ankle Fusion local bone graft (includes overnight) $3,740.00 29906 Subtalar Joint Arthroscopy $3,740.00 29916 Hip arthroscopy, complex $9,475.00 30117 Excision Intranasal Lesion $1,900.00 30124 Sinus/Turbinates 1 side $3,795.00 30124-50 Sinus/Turbinates both sides $4,510.00 30125 Sinus/Turbinates 1 side complex $6,350.00 30125-50 Sinus/Turbinates both sides complex $5,885.00 30140 Submucosal Resection of Turbinates (Bilateral) $2,700.00 30140-50 Submucosal Resection of Turbinates (Bilateral) $4,510.00 30520 Septoplasty $3,550.00 30520 Complex Septoplasty $3,900.00 30630 Repair Septal Perforation $3,050.00 30802 Submucosal Resection of Turninates (Bilateral) $2,700.00 31238 Nasal Endoscopy with control of epistaxis $1,700.00 31240 Nasal/sinus endoscopy, surgical; with concha bullosa resection $2,700.00 Nasal/sinus endoscopy, surgical, w/maxillary antrostomy; w/removal of tissue from maxillary 31267 $3,795.00 sinus 31510 Diagnostic Laryngoscopy with biopsy $2,970.00 31545 Diagnostic LaryngoscopyLaryngoscopy, direct, operative, with operating microscope or telescope, $4,455.00 31536 Laryngoscopy, direct with biopsy $2,970.00 Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or 31541 $2,970.00 epiglottis; with micro 31571 Larynoscopy, direct with injection into vocal cord. With operating microscope $2,970.00 31652 Endoscopy Procedures on the Trachea and Bronchi $7,113.18 31830 Excision & Repair Playtsma Cutaneous Adhesion $2,695.00 33206 Pacemaker placement (includes device/leads) $11,400.00 33214 Pacemake (powerpack) change (includes device) $7,600.00 33262 Implanted Defibrillator Power Pack Change (includes device) $20,570.00 33263 Implanted Defibrillator Power Pack Change (includes device) $20,570.00 33264 Implanted Defibrillator Power Pack Change (includes device) $20,570.00 35556 Femorial-popliteal bypass graft with saphenous vein $10,700.00 36561 Central IV Acess Port $3,190.00 36590 Porta-cath removal $1,850.00 36901 Primary dialysis arteriovenous fistula (without graft material) $5,850.00 38220 Bone Marrow Biopsy $5,800.00 38221 Bone Marrow Biopsy $5,800.00 38500 Lymph Node Excision / Biopsy $2,700.00 38510 Biopsy or excision of lymph node(s); open, deep cervical node(s) $2,255.00 38525 Biopsy or excision open deep axillary nodes $4,300.00 38724 Excision of neck mass $5,445.00 38740 Axillary lymphadenectomy; superficial. $4,300.00 38792 Sentinal Node Injection/Imaging (this procedure does not include pathology charges) $1,260.00 40812 Exc. Cyst Upper Lip $2,695.00 40814 Excision of lesion of mucosa and submucosa, vestibute of mouth; with complex repair $2,695.00 40819 Frenulectomy $1,600.00 41010 Frenotomy $1,600.00 41105 Biopsy Tongue Posterior $1,600.00 41110 Excision of the tongue/mouth $3,050.00 41112 Excision of lesion of tongue with closure; anterior two-thirds $2,365.00 41113 Excision Lesion Tongue w/ closure $3,050.00 41120 Partial Glossectomy $3,400.00 41135 Partial Glossectomy $10,450.00 42104 Excision Lesion of Palate / Uvula $2,695.00 42106 Excision, lesion of palate, uvula; with simple primary closure $3,750.00 42107 Excision, lesion of palate, uvula with local flap closure $3,750.00 42145 UPP $5,445.00 42335 Sialolithotomy, Submandibular Gland $3,800.00 42410 Parotidectomy, Lateral Lobe w/o Neck Dissection $5,060.00 42415 Parotidectomy with dissection and nerve preservation $7,000.00 42415 Parotidectomy with dissection and nerve preservation with overnight stay $8,000.00 42440 Excision Submandibular Gland $3,800.00 42505 Plastic repair of salivary duct, sialodochoplasty; secondary or complicated $3,800.00 42804 Nasopharyngeal Biopsy $1,900.00 42806 Nasopharyngeal Biopsy $1,900.00 42810 Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues $2,900.00 Excision brachial cleft cyst, vestige, or fistula, extending beneath subcutaneeous tissues and/or 42815 $3,800.00 into pharynx 42820 Tonsillectomy and Adenoidectomy $3,100.00 42821 Tonsillectomy and Adenoidectomy; age 12 and over $3,100.00 42825 Tonsillectomy $3,050.00 42826 Tonsillectomy $3,050.00 42830 Adenoidectomy $2,695.00 43200 Esophagoscopy w/ or w/o dialation/biopsy $2,150.00 43281 Linx $11,785.00 Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter 43284 $11,785.00 augmentation device, including cruroplasty when performed 43327 Laparoscopic Nissen (Reflux/GERD)(includes OVN) $11,785.00 43328 Laparoscopic Nissen (Reflux/GERD)(includes OVN) $11,785.00 43830 Gastrostomy Tube Insertion $3,250.00 44970 Laparoscopy, surgical, appendectomy $5,865.00 45560 Rectonele repair $5,200.00 46220 Excision of Single external papillae or tags, anus $3,300.00 46230 Exciseion of Multiple external papillae or tags, anus $3,300.00 46250 Hemorrhoidectomy, external $3,300.00 46270 Fistulotomy $3,300.00 46320 Hemorrhoidectomy; thrombosed, external $3,300.00 46505 Anal Fissure Removal $3,300.00 47562 Laparoscopic Cholecystectomy $5,865.00 47563 Laparoscopic Cholecystectomy $5,865.00 49204 Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas $4,300.00 49250 Exc. of growth in Umbilicus $2,365.00 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of 49320 $4,300.00 specimen(s) by brushing or washing (separate procedure) 49402 Foreign Body Removal $1,500.00 49421 Peritoneal dialysis catheter placement $4,800.00 49505 Inguinal hernia repair $3,060.00 49505-50 Inguinal-Bilateral hernia repair $4,325.00 49520-50 Recurrent Bilateral Inguinal Hernia $5,925.00 49520 Recurrent Inguinal hernia repair $3,860.00 49560 Incisional hernia repair $4,500.00 49565 Ventral Hernial repair $3,200.00 49568 Recurrent Incisional Hernia w/ mesh $5,300.00 49570 Epigastric $3,200.00 49585 Umbilical $3,190.00 49587 Hernia Repair, Ventricular/Umbilical $3,190.00 49590 Repair Spigelian Hernia $3,200.00 49650 Laparoscopic Inguinal Hernia Repair (one side) $4,400.00 49650-50 Laparoscopic Inguinal Hernia Repair Bilateral $7,450.00 49652 Laparoscopic Incision hernia $3,975.00 50590 Lithrotripsy $6,500.00 50590-50 ESWL w/ shockwave rental (bilateral) $8,550.00 52005 Cystoscopy with Stent $2,150.00 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder 52214 $2,800.00 neck, prostatic fossa, urethra, or periuretheral glands 52234 TURBT $2,800.00 52276 Cystourethroscopy With DVIU $2,150.00 52332 TURBT w stone/stint $3,600.00 52351 TURBT w/bilat ret. $2,150.00 52351-50 Cystoscopy w/ pyelography (bilateral) $2,150.00 52356 Cystoscopy w/ RGP w/ laser $3,450.00 52601 TURP $3,600.00 52648 Quanta Laser TURP $4,900.00 53445 Insertion of AMS 800 Urinary Sphincter $15,950.00 53450 Urethral Meatoplasty $2,900.00 53854 Transurethral radiofrequency generated water vapor thermotherapy $5,270.00 54160 Circumcision $2,000.00 54161 Circumcision - - 28 days or OLDER $2,000.00 54400 Penile Prosthesis $15,425.00 54400 Penile Prosthesis $5,410.00 54405 Penile Prosthesis $5,410.00 54420 Corpora Cavernosa Shunt $4,000.00 54500 Testicular biopsy $1,900.00 54520 Orchiectomy $3,600.00 54522 Orchiectomy $3,600.00 54530 Radical Orchiectomy $4,260.00 54600 Reduction of torsion of testis, surgical, with or without fixation of contralateral testis $5,060.00 54640 Orchiopexy $3,600.00 54640-50 Orchiopexy - Bilateral $4,200.00 54692 Laparoscopic Orchiopexy $7,350.00 54840 Excision Spermatocele $3,600.00 54840-50 Spermatocelectomy - Bilateral $4,300.00 54860 Epididymectomy - Total $4,100.00 54860 Epididymectonmy - Partial $3,600.00 54861 Total $4,100.00 55000 Incision Procedures on the Tunica Vaginalis $252.00 55000 Aspiration of Hydrocele $1,900.00 55040 Hydrocelectomy $3,600.00 55041 Hydrocelectomy-Bilateral $4,700.00 55400 Vasovasostomy $5,300.00 55535 Excision of varicocele or ligation of spermatic veins for varicocele $3,600.00 55700 Ultrasound guided prostate biopsy $3,050.00 56620 Vulvectomy simple; partial $2,550.00 56700 Hymenectomy $2,500.00 57240 Ant. Repair $4,400.00 57250 Post. Repair $6,180.00 57260 Anterior & Posterior Repair $5,300.00 57288 Mini-Arc Urethral Suspension $4,480.00 57425 Sacropexy $11,650.00 57513 Laser Ablation of Cervix $3,125.00 57520 LEEP Procedure $2,500.00 57522 Loop electrode excision, cervix $2,500.00 58120 Dilation & Curretage $1,600.00 58150 Total Abdominal Hysterectomy $9,000.00 58301 Hysteroscopy, Removal of Embedded IUD $1,600.00 58545 Laparoscopic Myomectomy $9,000.00 58546 Laparoscopic Myomectomy $9,000.00 58550 Laparoscopy, surgical, with vaginal hysterectomy for uterus 250 g or less $8,000.00 58552 Hysterectomy (includes overnight stay) $8,000.00 58555 Hysteroscopy $2,500.00 58558 Hsteroscopy, surgical; with biopsy of endometrium and/or polypectomy $2,500.00 58558 Hysteroscopy with biopsy, with or without D & C $2,500.00 58563 Hysteroscopy/Ablation $3,900.00 58660 Laparoscopy w/Lysis of Adhesion $5,865.00 58661 Removal of ovary(s) $5,865.00 58662 Removal of adhesions, lesion, systs on ovary(s) $5,865.00 58925 Ovarian Cystectomy $5,100.00 59820 Suction D&C $1,600.00 60210 Thyroidectomy Partial thyroid lobectomy, unilateral; with or without isthmuse $6,160.00 60220 Thyroidectomy Total thyroid lobectomy, unilateral; with or without isthmusectomy $6,160.00 Thyroidectomy Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, 60225 $6,160.00 including isthmusectomy 60240 Complex thyroidectomy (includes overnight) $9,000.00 60252 Thyroidectomy w/modified neck dissection $9,290.00 60270 Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach $9,000.00 60271 Total Thyroidectomy $6,160.00 60280 Thyroglassal duct cyst excision $3,800.00 60281 Thyroglassal duct cyst excision $3,800.00 60500 Parathyroidectomy or exploration of parathyroid $6,160.00 61885 Vagal Nerve Stimulator $7,400.00 62270 Spinal puncture, lumbar, diagnostic $ 700. + pathology 62270 Lumbar puncture with sedation and additional fee for labs. $1,100.00 62275 Epidural Blood Patch $1,100.00 62320 Cervical Epidural $1,100.00 62322 Lumbar Epidural Steroid $700.00 63030 Microdiscectomy $8,855.00 63047 Lumbar Laminectomy $9,900.00 64415 Reblock for Acute Postop pain $800.00 64416 Continuous Fusion, Regional Block (pain control catheter) $725.00 64446 Continuous Fusion, Regional Block (pain control catheter) $725.00 64447 Continuous Fusion, Regional Block (pain control catheter) $725.00 64448 Continuous Fusion, Regional Block (pain control catheter) $725.00 64510 Stellate Ganglion Block $1,100.00 64520 Lumbar Sympathetic $1,580.00 64561 Interstim Trial (includes kit) $3,430.00 64568 Vagal Nerve Stimulator $7,400.00 64585 Occipital Nerve Stimulator Removal $3,700.00 64620 Intercostal Nerve Block $1,580.67 64718 Ulnar Nerve Trasposition / Epicondylectomy $4,510.00 64721 Carpal Tunnel Release $2,750.00 64721-50 Carpal Tunnel Release - Bilateral $3,950.00 64831 Repair common digital nerve hand $3,900.00 64910 Thumb Radial Digital Nerve $4,650.00 67311 Eye Muscle, 1 muscle $3,300.00 37611-50 Eye Muscle, 1 muscle (bilateral) $4,000.00 67312 Eye Muscle, More than 2 muscles $4,840.00 67318 Eye muscle, oblique muscle $3,300.00 67400 Orbitotomy w/o bone flap $3,800.00 67808 Chalazion $1,870.00 67840 Excision cyst upper lid $2,750.00 67900 Repair of brown ptosis $3,500.00 67901 Repair Blepharoptosis, frontal muscle technique $2,700.00 67908 Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection $4,150.00 68520 Excision of Lacrimal Sac $3,450.00 68750 Endoscopic DCR and insertion of stent $4,200.00 68815 Nasolacrimal Duct Probe - Single $1,870.00 68815-50 Nasolacrimal Duct Probe - Bilateral $2,420.00 68816 Balloon Dacroplasty (Unilateral) $1,870.00 68816-50 Balloon Dacroplasty (Bilateral) $2,420.00 69145 Excision Soft Tissue Lesion, External Auditory Canal $1,700.00 69205 Foreign Body Removal $1,500.00 69436 Single Tube Placement $1,100.00 69436-50 Bilateral Myringotomy with tubes $1,700.00 69610 Single Tube Removal with paper patch $1,500.00 69610-50 Myringoplasty (Bilateral) $3,000.00 69620 Myringoplasty $2,500.00 69620-50 Myringoplasty (Bilateral) $3,000.00 69631 Tympanoplasty $5,060.00 69632 Ossicular Chain Reconstruction $5,390.00 69641 Tympanolplasty with mastoidectomy $9,200.00 69645 Tympanolplasty $5,060.00 69660 Inner Ear - Stapedectomy $5,390.00 69661 Ossiculoplasty $5,060.00 69714 Bone Anchored Hearing Aid BAHA device $9,950.00 69715 Mastoidectomy $6,640.00 69799 Eustachian Tube Dilation w/ balloon $4,600.00 69930 Cochlear implant $8,800.00 73222 MRI, upper extremity, joint; with contrast $850.00 76770 Ultrasound, retroperitoneal; complete $195.00 78195 Breast lymph node imaging $815.00 78195 Lymph Node Imaging $815.00 78227 Hida Scan $845.00 97110 *SEE PLAN FOR LIMITATIONS* $85.00

MUTIPLE CPT CODE PROCEDURES 11982, 76000 removal nexplanon device under flouro. $2,300.00 10140, 11008 Removal of Abdominal Seroma and Mesh Removal $6,550.00 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, 11422 x 2 and 11402 x 18 hands, feet, genitalia; excised diameter 1.1 to 2.0 cm $4,125.00 11422, 11423 Excision, benign lesion incl margins, scalp, neck, hands, feet, genitalia $2,365.00 Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, 15771, 15772 x 3 and/or legs; 50 cc or less injectate. $8,200.00 21554, 25076 Excision of tumor; 5 cm or greater. $3,740.00 21143, 21196 Maxillary & Mandibular Osteotomy $31,250.00 Excision, other benign lesion including margins. Except skin tag, face, ears, eyelids, nose, lips, 11446, 13132 mucous membrane excised diameter over 4.0 cm $7,100.00 19302, 36561 Masectomy unilateral with port placement $10,695.00 19307 & 19303 Left modified radical mastectomy; right simple mastecomy $10,200.00 19350x2, 13100, 13101, Bilateral Breast Reconstruction $9,500.00 13102x10 78227, A9537 HIDA Scan $1,155.00 24071, 25071 Excision of lipomas; bilateral arms $4,125.00 Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, 26123, 26125 $4,950.00 with or without Z-plasty 21235, 15004, 15576 Left Ear Reconstruction $6,900.00 23410, 23430 Open Rotator Cuff Repair & Biceps Tenodesis $7,449.00 23412, 23430 Open Rotator Cuff Repair & Biceps Tenodesis $7,449.00 23430, 23410, 29826, 29824Right Shoulder and Bicep Repair Surgery $7,449.00 26160, 26110 Excision Cyst w/ Joint Arthrotomy Debridement $3,740.00 27485, 27422, 27845 Reconstruction knee ligaments R Knee $8,000.00 27650, 28120 Ostectomy w/ achilles reattachment $5,730.00 27698, 29898 Ankle Arthroscopy with Brostrum Repair $7,200.00 278687, 28715 Ankle fusion with gastroc slide $9,700.00 27829, 27698, 29898 Brostrum Lig Reconstruction, Syndesmosis & Ankle Scope $7,200.00 28124, 28122 Ostectomy partial excision $5,060.00 28124, 11012 Partial excision bone; phalanx of toe $2,950.00 28485 x 4, 28730 Foot procedures without complications & comorbidity $7,900.00 29891, 27680, 27675 Ankle Arthroscopy, Tenolysis - flexor or extensor tendon, repair, dislocating peroneal tendons $5,060.00 28060, 64708 Plantar Fasciotomy & Baxter Nerve Release $3,550.00 Exc. ganglion cyst (R) dorsal midfoot, exostectomy bone (R) dorsal midfoot, decompression 28090, 28122, 64722 $5,060.00 deep peroneal nerve (R) foot 29898, 27698, 27680 Ankle Scope $7,200.00 61782, 30140, 30520, Complex 3D (image guidance) Sinus Surgery $11,900.00 31255, 31267, 31276 30140, 30520, 31256, Complex 3D (image guidance) Sinus Surgery $11,900.00 31254, 61782 31575, 30310 Nasal Endoscopy w/ foreign body removal $1,700.00 64581, 364590, 95972, Replacement Interstim Device $6,000 + Implants 76000-26 64708, 64721, 64718 Posterior Nerve Decompression, CTR, Cubital Tunnel Release $5,910.00 11400, 11406, 44000, 14001, 13100, 13101, $9,500.00 13102 x 5, 15877 Breast Reconstruction w/ implants CPT 28306, 28308 x3, 28285x5, 2800,28118, $8,000.00 20680, 28298 Foot Fusion 15732, 21235, 69666, 69667(L) round window fistula and oval window fistula w/perichondrial graft and fascia graft $5,060.00

15770, 69310, 69642 Tympanoplasty with mastoidectomy with ossicular chain reconstruction. Reconstruction of $9,200.00 external auditory canal. Graft; derma-fat-fascia. 31570, 31630 $3,745.00 Laryngoscopy, Bronchoscopy 58552, 58570 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less and Hysterectomy $10,200.00 (includes overnight stay) 15770, 69633 Tympanoplasty without mastoidectomy; skin graft $5,390.00 42820, 30140 Tonsil & Adenoid w/ (B) Turbinate Reduction $4,510.00 42820, 30520 Tonsil and Adenoid w/ Septoplasty $4,650.00 42820, 69436, 30140 T&A, BMT & (B) Turbinates $5,400.00 42821, 30520 Tonsil and Adenoid w/ Septoplasty $4,650.00 42821, 30140 Tonsil & Adenoid w/ (B) Turbinate Reduction $4,510.00 42821, 69436, 30140 T&A, BMT & (B) Turbinates $5,400.00 42825, 30140 Tonsillectomy & (B) Turbinates $3,350.00 42825, 31535 Tonsillectomy & Direct Laryngoscopy $4,535.00 42826, 30140 Tonsillectomy & (B) Turbinates $3,350.00 42826, 31535 Tonsillectomy & Direct Laryngoscopy $4,535.00 42830, 30140 Adenoids & (B) Turbinates $3,350.00 42830, 69436, 30140 Adenoids, BMT & (B) Turbinates $3,300.00 42831, 30140 Adenoids & (B) Turbinates $3,350.00 42831, 69436, 30140 Adenoids, BMT & (B) Turbinates $3,300.00 46250, 49585 Hemorrhoidectomy & Umbilical Hernia Repair $5,050.00 46260, 49585 Hemorrhoidectomy & Umbilical Hernia Repair $5,050.00 47562, 47000 Laparoscopic Cholecystectomy w/ liver biopsy $6,465.00 47562, 47001 Laparoscopic Cholecystectomy w/ liver biopsy $6,465.00 47562, 49505 Laparoscopic Cholecystectomy w/ Inguinal hernia repair $8,215.00 47563, 47000 Laparoscopic Cholecystectomy w/ liver biopsy $6,465.00 47563, 47001 Laparoscopic Cholecystectomy w/ liver biopsy $6,465.00 47563, 49505 Laparoscopic Cholecystectomy w/ Inguinal hernia repair $8,215.00 49320, 57288 Diagnostic Laparoscopy w/ TOT $7,680.00 49500, 55060 Inguinal Hernia Repair and Hydrocelectomy $4,850.00 49505, 55040 Inguinal Hernia & Hydrocelectomy $4,160.00 49505-50, 49585 Bilateral Inguinal Hernia Repair & Umbilical Hernia Repair $5,575.00 49520, 21933 Umbilical Hernia Repair & Lesion Removal (flank) $5,865.00 49560, 49505 Ventral & Inguinal Hernia $5,550.00 49570, 49505 Epigastric & Inguinal Hernia Repair $5,550.00 49585, 49570 Umbilical & Epigastric Hernia Repair $3,990.00 68720, 68815 Endoscopic DCR and insertion of a stent $4,200.00 62322, 99152 Lumbar Epidural Steroid Injection (with sedation) $1,100.00 52287, J0585 Cystoscopy w/ botox injection $2,150.00 52351, 55700 Cystoscopy w/ RGP & TRUS $3,150.00 52441, 52442 Urolift (implants not included) $3,550.00 55700, 76942, 76872 MRI Guided Prostate Biopsy $4,100.00 Laparoscopic hysterectomy with bilateral salpingectomy & oophorectomy, sling operation for 57260, 57288, 58552 $10,650.00 stress incointinence & combined anteroposterior colporrhaphy 56620, 56810 Vulvectomy simple; partial and Perineoplasty, repair of perineum, nonobstetrical $4,550.00

58552, S2900, Robotic Hysterectomy (includes overnight stay) $12,250.00 57240, 57288 Anterior Repair & Mini Arc Urethral Suspension (TOT) $5,865.00 57240, 58550, Laparoscopic hysterectomy with anterior repair $9,310.00 58150, 88307 Hysterectomy - open, abdominal/Level V - Surgical pathology (pathology included) $14,089.00 57260, 57288 Mini-Arc Urethral Suspension; Colporrhaphy, posterior and anterior $7,395.00 Anterior colporrhaphy, repair of cystocele; Combined anteroposterior colporrhaphy w/Sling 57240, 57260, 57288 $7,395.00 operation for stress incontinence 52000, 55700 Cystourethroscopy and Biopsy, prostate; needle or punch, single or multiple, any approach $3,150.00

52352, 52356 Cystourethroscopy, with ureteroscopy $4,900.00 52353, 52310 Cystourethroscopy, with removal of foreign body from bladder; simple $3,450.00 Mini-Arc Urethral Suspension AND Colporrhaphy, posterior and anterior , Colpopexy, vaginal; 57260, 57282 $7,895.00 extra-peritoneal approach 57240, 57288 $5,865.00 Anterior Repair & Mini Arc Urethral Suspension (TOT) 58552, 57288 $10,200.00 LAVH W/ TOT (includes BLADDER SLING) 49000, 49203 Mini laparotomy and exc. Endomtriosis/mass subcutaneous tissue/ muscle flap $5,865.00 49000, 58925 Laparoscopy, surgical, Ovarian Cystectomy $5,865.00 43281, 49560, 49568 Laparascopic hiatal hernia repair and inscisional hernia repair w/mesh $11,785.00 42820, 99100 Tonsillectomy & Adenoidectomy w/anesthesia for patient of extreme age $4,100.00 42830, 69436 Adenoidectomy and BMT $3,300.00 42826, 69436 Tonsillectomy/BMT $3,600.00 42825, 69436 Tonsillectomy/BMT $3,600.00 42820, 69436 Tonsillectomy and Adenoidectomy and BMT $4,400.00 42825, 69620, 41115 Tonsillectomy/BMT/Excision of lingual frenum (frenectomy) $4,750.00 31295, 31296, 31297 Complex, balloon sinus surgery (cost of balloon not included) $8,200.00 30802, 31237 Turbinate Reduction & Nasal Polypectomy $4,510.00 11012, 21110, 21215, Reconstructive repair of pectus excavatum or carinatum; open (INCLUDES OVERNIGHT STAY $28,750.00 21740, 64716 AND ADDITIONAL DAY, IF NECESSARY) Submucous resection inferior turbinate, partial or complete, any method. Nasal/sinus endoscopy, surgical, with maxillary antrostomy. Laryngoscopy, direct, operative, with excision of tumor and/or 30140,30520, 31255, stripping of vocal cords or epiglottis. Nasal/sinus endoscopy, surgical with ethmoidectomy. $6,350.00 31267, 31540 Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft 30140, 30520, 31255, Septoplasty with turbinate resection, nasal/sinus endoscopy w/ethmoidectomy, maxillary $6,350.00 31256, 31276, 31287 antrostomy - Unilateral 30140, 30520, 31255, Septoplasty with turbinate resection, nasal/sinus endoscopy w/ethmoidectomy, maxillary $8,200.00 31256, 31267, 31287 antrostomy Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, 11423, 12031 hands, feet, genitalia; excised diameter 2.1 to 3.0 cm and Repair, intermediate, wounds of scalp, $3,100.00 axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm with Repair, 11442, 12051 $4,125.00 intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or 14060, 14301, 15731, less Complex forehead flap reconstruction of nose (ear graft, lining flap or septum) $6,900.00 21235 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq 14021, 14301 $6,350.00 cm. w/Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm. 14301, 15004, 15260 Complex forehead flap reconstruction with skin lesion excision and skin graft closure $6,900.00 14301, 15731 Simple forehead flap reconstruction of nose $4,400.00 14301, 15731, 21235 Complex forehead flap reconstruction of nose (ear graft) $5,200.00 15260, 21235, 30465 Full thickness skin graft to nose, complex (with ear graft) $3,900.00 15821, 67917 Bilateral Blepharoplasty and Extropaion Repair $5,650.00 21142 & 21147 Lefort 1, Complex (includes overnight; hardware is NOT included) $16,650.00 Open treatment of acromioclavicular dislocation, acute or chronic with fascial graft (includes 23550 & 23552 $6,375.00 obtaining graft) 20931, 22551, 22845 Single level ACDF with monitoring and interpretation $27,240.00 Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia; Transfer or 27606 & 27691 $5,730.00 transplant of single tendon (with muscle redirection or rerouting); deep 27687, 27691, 28118 & Transfer or transplant of single tendon, with ostectomy, tarsal bones, calcaneus, and $5,730.00 28304 gastrocnemius recession 28113, 28315 Partial removal of metatarsal, removal of sesamoid bone, sesamoidectomy $4,125.00 23412, 29826, 29824 Rotator Cuff Repair $6,149.00 20680, 27680, 29898, & Ankle scope w rem loose body $6,850.00 37698 30140, 31237 Turbinate Reduction & Nasal Polypectomy $4,510.00 21235, 30465 Nasal Valve Repair (batten grafts from ear) $3,600.00 30520, 20680 Hardware Removal, Complex/Complex Septoplasty $9,576.90 30140, 30420 Rhinoplasty, primary, including major septal repair with Submucous resection inferior turbinate $8,800.00 30124, 30520 Septoplasty and Sinus/Turbinates $5,060.00 20912, 30140, 30465, Complex Septoplasty with Cartilage Graft $5,800.00 30520 Correction, hallux valgus (bunion), w/wo sesamoidectomy; with metatarsal osteotomy, 28296, 28298, 28308, Correction, hallux valgus, w/ or w/o sesamoidectomy, by phalanx osteotomy and Osteotomy $6,600.00 28313 metatarsal 2nd-5th 30140, 30520, 31255, Complex 3D Image Sinus Surgery $9,400.00 31267, 31276, 61782 30140, 30520, 31256, Complex Septoplasty with turbinate resection, Nasal Endoscopy with Ethmoidectomy, $9,400.00 31254, 61782 Stereotactic computer-assisted 30140, 30520, 42826 Septoplasty and Sinus/Turbinates with Tonsillectomy $4,650.00 30140, 30520 Septoplasty and Sinus/Turbinates $5,060.00 20912, 30520, 30465 Complex Septoplasty with valve repair $5,800.00 30140-50, 30520, 31267- Septoplasty, Submucosal Turbinate Reduction, Endoscopic Maxillary Sinoscopy, Endoscopic 50, 31255-50, 31276-50, Complete Ethmoid, Endoscopic Maxillary Antrostomy w/ Tissue Removal, Endoscopic Frontal $8,200.00 31288, 31233 Sinus Exploration, Endoscopic Sphenoid w/ Tissue Removal Septoplasty, or Submucous Resection; Nasal/Sinus Endoscopy, Surgical with Maxillary 30140, 30520, 31267, Antrostomy with Removal of Ttissue from Maxillary Sinus and Dilation of Frontal Sinus Ostium $8,200.00 31237, 31296 (e.g. balloon dilation) 30140, 30520, 31255, Septoplasty with turbinate resection, nasal/sinus endoscopy w/ethmoidectomy, maxillary $8,200.00 31256, 31267, 31287 antrostomy 31254 x 2, 31295 x 2, Complex Septoplasty/Tonsillectomy $9,400.00 42825 31256 x2, 31276 x 2, 31240 x 2, 31255 x 2, Complex Septoplasty $11,900.00 30520 30140 49000, 58661 Exploratory laparotomy, exploratory celiotomy with or without biopsy, Laparoscopy, surgical; with removal of adnexal structures $8,000.00