CPT is a registered trademark of the American Medical Association. CPT codes and descriptors are copyright 2017 the American Medical Association. All rights reserved. Applicable FARS/DFARS apply. This book is published under a license agreement with the American Medical Association.
ISBN: 978-1-946868-00-8 (print) 978-1-946868-01-5 (e-book)
Practice Management Information Corporation (PMIC) 4727 Wilshire Boulevard Los Angeles, California 90010 http://www.pmiconline.com
Printed in the United States of America
Copyright 2018 under the Uniform Copyright Convention. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic mechanical, photocopying, recording, or otherwise, without written permission from the publisher.
ii FOREWORD
Fee strategies are becoming more and more important as the very structure of health care delivery changes. It is absolutely critical to the success of your medical practice for you to carefully review, analyze and adjust your fees frequently. This comprehensive publication is designed to help you accomplish this formidable task accurately, quickly, and easily.
Medical Fees 2018, our 24th annual edition, is a listing of medical procedure codes, descriptions, UCR fees at the 50th, 75th and 90th percentiles, Medicare fees and Medicare relative value units. The UCR fees listed in this publication are derived from an analysis of over 600 million actual charges. The CPT codes and descriptions are from the official CPT 2018 as published by the American Medical Association. The Medicare fees and RVUS are taken from the Medicare Physician Fee Schedule for Calendar Year 2018 as published in the Federal Register.
As I have written in numerous publications over the past 30 years, for every single physician that anyone can find who may be “over-charging” for medical services and procedures, I can find nine who are not charging enough. Medical Fees 2018 provides complete, accurate, and statistically valid information regarding usual, customary and reasonable (UCR) as well as Medicare fees and provides an excellent resource for reviewing, adjusting and setting fees.
James B. Davis Publisher & Editor
iii DISCLAIMER
This publication is designed to offer basic information regarding medical fees and fee schedule management. The information presented is based upon extensive analysis of various fee databases and the experience and interpretations of the authors. Though all of the information has been carefully researched and checked for accuracy and completeness, neither the authors nor the publisher accepts any responsibility or liability with regard to errors, omissions, misuse or misinterpretation.
iv
CONTRIBUTORS
Medical Fees 2018 is the result of a publishing collaboration between ContexT4 Healthcare Inc. and Practice Management Information Corporation. Context4 Healthcare Inc.
Context4 Healthcare Inc. is a leading developer of reimbursement products for the health care industry. Perhaps best known for its CodeLink, Claims Editor and ICD-9-CM software programs, the firm also markets numerous fee, coding and regulatory database products. Context4 Healthcare Inc. products are used by thousands of health care organizations, from solo physician practices to Fortune 500 companies.
Context4 Healthcare Inc. usual, customary and reasonable (UCR) databases were developed over several years by a team of fee experts and mathematicians and were constructed using hundreds of millions of actual submitted charges evenly distributed throughout the United States. To ensure accuracy, charge data was obtained from a variety of sources including third-party payers, clearinghouses, practice management system vendors, billing services, universities, medical practices, hospitals and the Centers for Medicare and Medicaid Services (CMS). In addition to these sources, a database of more than 600 million submitted charges was utilized for reference.
Practice Management Information Corporation (PMIC)
PMIC is the nation's leading independent publisher and distributor of coding, payment and practice management books and software. The company is known for its innovative, high quality products and excellent customer service. Over 100,000 physicians, hospitals, insurance carriers, and other health care professionals regularly choose PMIC for their coding and compliance resources.
PMIC specializes in creating “tools for the business of medicine” by reviewing the work methods, work spaces, and content needs of its customers and then adapting its products to those needs. To create this publication, PMIC takes raw CPT/UCR data from Context4 Healthcare Inc., adds comprehensive introductory materials, full CPT descriptions, and then applies proprietary formulas to estimate fees for new medical services and procedures.
James B. Davis, Editor
Medical Fees has been edited since its inception by James B. Davis, founder and President of Practice Management Information Corporation (PMIC). Mr. Davis has worked with health care professionals for over 40 years and is a nationally known expert in the areas of medical coding, compliance and practice management. Prior to founding PMIC he was an executive with Cedars- Sinai Medical Center and later founded Professional Data Systems (PDS) where he was responsible for processing over $1 billion in medical claims. He is the author or editor of over 250 books on the subjects of medical coding, billing, reimbursement and practice management and has given seminars to hundreds of health care professionals nationwide.
v
TERMINOLOGY
Managing the medical fee schedule and Alternative Delivery System (ADS): A reimbursement process requires a fundamental system of delivering health care benefits that working knowledge of the words and is different from traditional indemnity acronyms used by health care professionals, systems. An HMO is an example of an ADS. government agencies, health insurance plans and third party payers to describe services, AMA: American Medical Association benefits and reimbursement policies. While glossaries are most often found in the back of Ambulatory Surgery: A surgical procedure books, we feel that readers should have an for which a patient is admitted, treated and opportunity to review and learn new discharged the same day; also referred to as terminology before they encounter it within outpatient surgery. the text. Ambulatory Surgery Center (ASC): Any AAPCC: Adjusted Average Per Capita Cost distinct entity that operates exclusively for the purpose of providing surgical services to Accident and health insurance: Insurance patients not requiring hospitalization. under which benefits are payable in case of disease, accidental injury, or accidental death. Annual deductible: See Deductible.
Actual charge: One of the factors Antitrust Laws: Laws that prohibit determining a physician’s payment for a institutional mergers and acquisitions, service under Medicare; equivalent to the exclusive contracts, joint ventures, and other billed or submitted charge. business dealings in areas that may substantially reduce competition or have a Adjusted average per capita cost (AAPCC): tendency to produce a monopoly, and An estimate of the average per capita cost consequently have a detrimental effect on incurred by Medicare for each beneficiary in consumer welfare. the fee-for-service system, adjusted by county for age, sex, program entitlement and Approved charge: Payment for a physician geographic cost difference. service under CPR. Includes Medicare payment and the beneficiary’s coinsurance, Adjusted historical payment basis (AHPB): but not any balance bill. Also called Allowed The AHPB for a service in a locality is the Charge or Reasonable Charge. average payment for that service under the current system. ASC: Ambulatory Surgical Center
Age/Sex rating: A method of structuring Assignment of benefits: A procedure capitation payments based on enrollee/ whereby the subscriber authorizes the carrier membership age and sex. to make payment of allowable benefits directly to the provider. AHPB: Adjusted Historical Payment Basis Assignment (Medicare): The term used to Allowed charge [approved charge]: The refer to a physician’s decision to accept amount Medicare approves for payment to a Medicare’s allowed charge as payment in full; physician. Typically, medicare pays 80 a guarantee not to balance bill. percent of the approved charge and the beneficiary pays the remaining 20 percent. Assistant-at-surgery: An individual who has Physicians may bill beneficiaries for an the necessary qualifications to participate in a additional amount above the approved charge.
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particular operation and actively assists in CF: Conversion Factor performing the surgery. Charge reduction [Medicare]: The Balance bill/extra bill: Physicians’ charges percentage difference between a provider’s exceeding the Medicare-allowed charge. billed charge and the Medicare allowed charge. Balance billing: Billing the patient or beneficiary for any fee in excess of the Claim: A demand to the carrier, by the amount allowed by the insurance carrier. insured person, for payment of benefits under a policy. Beneficiary: A person eligible to receive benefits under a health care plan. The term is Claim form: A form used to present claim commonly used with Medicare and Medicaid. information in an organized manner to the Under Part B of Medicare, Americans over carrier. See CMSl500. 65, many disabled individuals, and certain individuals with end-stage renal disease can Clinical Laboratory Improvement Act become beneficiaries by paying a monthly (CLIA): Set standards to be met by all clinical premium. laboratories, regardless of location, size, or type of laboratory. These standards are based BMAD: Part B Medicare Annual Data Files on the complexity of tests performed by the laboratory. Regulations define four levels of Bonus Payment: An additional amount paid testing complexity: waived, moderate by Medicare for services provided by complexity, and physician-performed physicians in Health Professional Shortage microscope procedures. The Health Care Areas (HPSAs). Financing Administration requires all laboratories to register in order to perform Bundling: The use of a single payment for a testing at any or all of these levels. group of related procedures or services. CMS: Centers for Medicare and Medicaid Capitation: A census-driven reimbursement Services. The government agency which system wherein a fixed amount is paid per administers the Medicare and Medicaid patient enrolled monthly to the physician to programs, formerly known as the Health Care cover services. Financing Administration (HCFA).
Carrier: The insurance company which CMS1500: A universal insurance claim form writes and administers the health insurance that is mandated for Medicare billing and policy. generally accepted by all insurance carriers.
Carrier [Medicare]: A private contractor COB: Coordination of Benefits who administers claims processing and payment for Part B Medicare services. See COBRA: Consolidated Omnibus Budget Part B [Medicare]. Reconciliation Act of 1985. P.L. 99-272, enacted April 1986. Case management: Monitoring and coordinating the delivery of health services for Coding: The process of choosing codes which individual patients to enhance care and properly identify and define medical services manage costs. Often used for patients with and procedures and diagnoses. specific diagnoses or who require high-cost or extensive health care services. Coinsurance: The portion of the balance of covered medical expenses which a beneficiary Case rate: A fixed fee for all care associated must pay after payment of the deductible. with a specific procedure. Under Medicare Part B, the beneficiary pays
xii TERMINOLOGY coinsurance of 20 percent of allowed charges. Conversion factor: The multiplicative factor See Deductible. applied to the relative value scale to produce a schedule of dollar amounts of payment for Competitive pricing: Pricing methods that physicians. use market information to establish payment rates that reflect the costs of an efficient HMO Conversion factor update: Annual or health care provider. One well-known percentage change to the Medicare Fee method is competitive bidding, which elicits Schedule conversion factor, established by the information on costs through a bidding Congress or the default formula under Volume process. Performance Standards.
Comprehensive medical insurance: A Coordination of Benefits (COB): A policy designed to give the protection offered provision in an insurance plan that when a by both a basic and a major medical health patient is covered under more than one group insurance policy. plan, benefits paid by all plans will be limited to 100 percent of the actual charge. Conditions of Participation (COP): COPs are statutory requirements that facilities must Copayment: A type of cost sharing where the meet in order to enter into various Medicare/ insured party is responsible for paying a fixed Medicaid contracts with CMS. These dollar amount per service. Sometimes used standards include those regarding the facility’s more generally as a synonym for cost sharing. governing body and management; its compliance with federal, state, and local laws Cost of practice index [Medicare]: A pertaining to health and safety; its procedure measurement of the differences across for protecting client rights and keeping client geographic areas of the cost of operating a records; and its staffing and provision of medical practice. services under arrangement with outside sources. Cost sharing: The portion of payment for health expenses that the beneficiary must pay, Consolidated Omnibus Budget including the deductibles, copayments, Reconciliation Act (COBRA): Requires an coinsurance, and balance bill. employer to offer employees and their dependents the opportunity to continue their Cost shifting: A situation wherein a health group health coverage under the employer’s care provider compensates for the effect of plan upon the occurrence of certain events that lower revenue from one payer by increasing otherwise would cause them to lose their charges to another payer. employment-related health plan coverage. COBRA imposes a host of rules governing the Coverage decision: A decision by a health obligations and duties of both employers and plan or insurer whether to pay for or provide a qualified beneficiaries involved in coverage- medical service or technology for particular continuation situations. Specific rules under clinical indications. COBRA, for example, address such issues as the length of the required coverage period, CPI: Consumer Price Index notification requirements for employers and plan administrators, procedures for electing CPR: Customary, Prevailing, and Reasonable. continuation coverage, premiums the The method used by Medicare to determine employer may require beneficiaries to pay, payments to providers prior to the Medicare and the circumstances under which an Fee Schedule. employer may terminate COBRA coverage short of the full continuation period. CPT [Current Procedural Terminology]: A system of procedure codes and descriptions, and rules and conventions used by medical
xiii MEDICAL FEES 2018 procedures to classify and report services and prospective payment system (PPS) for procedures. This procedure coding system is inpatient hospital services. accepted by virtually all commercial insurance carriers and is mandated by Federal law for Direct costs: The labor, supply and Medicare and Medicaid and other government equipment costs directly attributable to the health programs. provision of a specific service.
CQI: Continuous Quality Improvement DME: Durable Medical Equipment
Cross-over patient: A patient who has both DME-MAC: Durable Medical Equipment Medicare and Medicaid coverage. Medicare Administrative Contractor (formerly known as DMERC). Four contracted regional CRS: Congressional Research Service carriers which process Medicare claims for DME, orthotics, prosthetics and supplies. Current Procedural Terminology: See CPT. Providers are required to obtain supplier numbers and disclose ownership prior to Customary charge: One of the factors submitting claims. determining a physician’s payment for a service under Medicare. Calculated as the Down coding: A process used by insurance physician’s median charge for that service carriers to reduce the value of billed over a prior 12-month period. See Customary, procedures by changing the codes submitted Prevailing, And Reasonable. to ones of lower value. Procedure code and procedure description mismatch, and Customary, Prevailing, and Reasonable diagnosis code not supporting the level of care (CPR): The method of paying physicians are the two most common opportunities for under Medicare from 1965 until insurance carrier down coding. implementation of the Medicare Fee Schedule in January 1992. Payment for a service was DRG: Diagnosis Related Groups limited to the lowest of 2) the physician’s billed charge for the service; 2) the E/M: Evaluation and Management physician’s customary charge for the service; or 3) the prevailing charge for that service in Electronic claim: A claim form which is the community. Similar to the usual, processed and delivered from one computer to customary, and reasonable system used by another via some form of magnetic media private insurers. (magnetic tape, diskette) or via telecommunications (telephone link). Deductible: A stipulated amount which the covered person must pay toward the cost of EM: Evaluation and Management medical treatment before the benefits of the program go into effect. Medicare Part B has EMC: Electronic Media Claim an annual deductible of 100. EOB [Explanation of Benefits]: A form Deductible carryover: A feature of an included with a check from the insurance insurance plan whereby covered charges in the carrier which explains the benefits that were last three months of the year may be carried paid and/or charges that were rejected. over to be counted toward the next year’s deductible. EOMB: Explanation of Medicare Benefits
Diagnosis related groups (DRGs): A system Evaluation and Management (EM) of classifying medical cases for payment on services: Nontechnical services provided by the basis of diagnoses. Used under Medicare’s most physicians for the purpose of diagnosing
xiv TERMINOLOGY and treating diseases and counseling and adjustment factor for a service is created by evaluating patients. combining three separate adjustment factors, one for each component of the Medicare Fee Exclusions: Specific services or conditions Schedule: physician work, practice expense, which the policy will not cover or which are and malpractice expense. The adjustment covered at a limited rate. factors for physician work, practice expense, and malpractice are based on the same Explanation of Benefits: See EOB. measures that underlie the GPCI.
Fee-For-Service (FFS): Refers to paying Geographic Adjustment Method medical providers for individual services (Medicare): The method used to convert rendered. UCR, CPR, and Fee Schedules are Medicare U.S. average fee-for-service per examples of fee-for-service systems. capita costs (USPCCs) to the local adjusted average per capita costs (AAPCCs) used to Fee schedule payment areas: Geographic pay Medicare risk contracting HMOs. areas within which payment for a given service under the fee schedule will be the Geographic Practice Cost Index (GPCI): same. See Geographic Adjustment Factor. An index summarizing the prices of inputs to physician services in an area relative to Fee schedule: A list of predetermined national average prices. The GPCI as payments for medical services. originally defined is based on three components, reflecting the opportunity cost of FFS: Fee-for-Service physician work, the costs of goods and services that comprise practice expenses, and Fiscal Intermediary (FI): A private malpractice expenses. The GPCI is a single contractor who administers claims for Part A measure that combines these three fixed services (for example hospital and nursing shares, while the GAF of the Medicare Fee home) and some Part B services (such as Schedule allows for each service to reflect hospital outpatient departments). different shares, creating a GAF for each service. See Geographic Adjustment Factor. FY: Fiscal Year Global service: A group of clinically related GAF: Geographic Adjustment Factor services that are treated as a single unit for the purpose of coding, billing, and payment. Gaming: Gaining advantage by using improper means to evade the letter or intent of Global surgery policy: The payment policy a rule or system. in the Medicare Fee Schedule that specifies the surgical procedure and the related services Generalists: Physicians whose training and and visits which are included in a global practice is not limited by health condition or surgical fee. Separate payment is permitted for organ system, who provide comprehensive the initial evaluation, services for unrelated and continuous services, and who make problems, and return trips to the operating decisions about treatment for patients room because of complications. presenting with undifferentiated symptoms. Typically include family practitioners, general GPCI: Geographic Practice Cost Index internists, and general pediatricians. Harvard relative value study: A study Geographic Adjustment Factor (GAF): The completed by William Hsiao, Ph.D. at adjustment made to a service’s fee in the Harvard University to develop a resource- Medicare Fee Schedule to determine the based relative value scale and to be used to correct payment in each fee schedule payment develop the Medicare Fee Schedule. area. As defined in OBRA89, the geographic
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HCPCS: See Health Care Common Home Health Agency (HHA): An HHA is a Procedure Coding System. public or private agency or organization, or part of an agency or organization, that meets Health Care Common Procedure Coding the requirements for participation in Medicare, System (HCPCS): Coding system based on that provides services to a beneficiary at this CPT, but supplemented with additional codes or his or her place of residence, on his or her for nonphysician services; required for coding physician’s orders. by Medicare carriers. Home Health Care (HHC): HHC consists of Health Maintenance Organization (HMO): the services provided to a recipient at his place A type of managed-care plan that acts as both of residence on physician’s orders as part of a insurer and provider of a comprehensive set of written plan of care. These services include health care services to an enrolled population. nursing service, home health aide service, Benefits are financed through capitation with physical or occupational therapy, and speech limited copayments, and services are provided pathology and audiology services. Medical through a system of affiliated providers. supplies, equipment, and appliances suitable for use in the home are also covered under Health plan: An organization that acts as an HHC. insurer for an enrolled population. May be structured as a fee-for-service or managed HPSA: Health Professional Shortage Area care plan. HSA: Health Service Area Health Professional Shortage Areas (HPSAs): Replaces Health Manpower ICD-9-CM [International Classification of Shortage Areas (HMSAs). A Health Diseases – 9th Revision – Clinical Professional Shortage Area means any of the Modification]: A standardized system of following which the Secretary of the describing diagnoses by code numbers Department of Health and Human Services developed and maintained by the World determines has a shortage of health Health Organization. Replaced by ICD-10- professionals: (1) an urban or rural area CM in 2015. (which need not conform to the geographic boundaries of a political subdivision and ICD-10-CM [International Classification of which is a rational area for the delivery of Diseases – 10th Revision – Clinical health services); (2) a population group; (3) a Modification]: A standardized system of public or nonprofit private medical facility. describing diagnoses by code numbers Designated HPSAs can apply for National developed and maintained by the World Health Services Corps (NHSC) personnel, or Health Organization. Implemented nationwide be eligible for the NHSC scholarship program in 2015. or health profession student loan program. ICD-10-PCS [International Classification HHS: U.S. Department of Health and Human of Diseases- 10th Revisions – Procedure Services (also referred to as DHHS). Coding System]: A standardized system of describing procedures performed in the acute HI: Hospital Insurance hospital setting. Replaced ICD-9-CM Volume 3 Procedure Codes in 2015. HMO: An organization that provides comprehensive health services to its members Indemnity schedule: See Schedule of in return for a fixed prepaid fee. There are Allowances. four types of HMOs: group, staff, independent practice association, and network. Independent Practice Association (IPA): An HMO that contracts with individual physicians to provide services to HMO xvi TERMINOLOGY members in a negotiated per capita or fee-for- Long Term Care (LTC): Health care for service rate. Physicians maintain their own patients with chronic disabilities or who suffer offices and can contract with other HMO’s from chronic disease requiring assistance with and see other fee-for-service patients. routine activities of daily living.
Insurance clerk: One of the health care MAAC [Maximum Allowable Actual professional’s employees assigned the very Charge]: A limitation on billed charges for important job of managing insurance claims in Medicare services provided by non- the medical office. participating physicians. For physicians with charges exceeding 115 percent of the Insured: The person who represents the prevailing charge for nonparticipating family unit in relation to the insurance physicians, MAACs limit increases in actual program. Usually the employee whose charges to 1 percent a year. For physicians employment makes this coverage possible. whose charges are less than 115 percent of the prevailing, MAACs limit actual charge Insurer: See CARRIER. increases so they may not exceed 115 percent. See Actual Charge, Nonparticipating Intermediary: An insurance carrier, or data Physician. processing company, designed to receive and process Medicare or Medicaid claims on Major medical insurance: Health insurance behalf of the government. to finance the expense of major illnesses and injuries. Major medical policies usually International Classification of Diseases: See include a substantial deductible clause. Above ICD-10-CM. the initial deductible, major medical insurance is characterized by large benefit maximums. IPA: See Independent Practice Association. Malpractice expense: The cost of LCL: Lowest Charge Level Limit professional liability insurance incurred by the physicians. A component of the Medicare Level 2 codes: See HCPCS. relative value scale.
Limited License Practitioner (LLP): A Managed care: Any system of health service professional licensed to perform certain health payment or delivery arrangements where the services in independent practice (for example, health plan attempts to control or coordinate podiatrists, dentists, optometrists, and use of health services by its enrolled members chiropractors). in order to contain health expenditures, improve quality, or both. Arrangements often Limiting charge: The maximum amount that involve a defined delivery system of providers a nonparticipating physician is permitted to with some form of contractual arrangement charge a Medicare beneficiary for a service; a with the plan. limit on balance billing. Management Service Organization (MSO): LLP: Limited License Practitioner An entity which provides practice management and other support services to Local codes: See HCPCS. physicians. May include administrative support services such as marketing, billing, Locality [Medicare]: A geographic area for financial management, nursing pools, and which a carrier calculates prevailing charges. staff recruitment, etc. Some MSOs purchase Localities can be states, aggregations of the assets of physician practices outright, counties, parts of counties, metropolitan zip install office managers and other personnel, code areas, or townships. and hire physicians through professional service contracts.
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Maximum fee schedule: A compensation MEI: Medicare Economic Index arrangement in which a participating physician agrees to accept the Schedule of MFS: Medicare Fee Schedule Allowances as his total fee for covered services. Modifiers: Codes used to supplement CPT or HCPCS codes that permit payment to differ Maximums: The top limit of the amount a for a subset of services billed. They may carrier will pay for a specific benefit or policy indicate that the service has been changed in during a specified time period. some way.
Medicaid: A program of federal matching MSA: Metropolitan Statistical Area grants to the states to provide health insurance for the poor and medically indigent. States MSO: Management Services Organization share in financing the program and determine eligibility and benefits consistent with federal MSP: Medicare Secondary Payor standards. MUA: Medically Underserved Area Medicare cost contract: A contract between Medicare and a health plan under which the National Claims History (NCH) system: A plan is paid on the basis of reasonable costs to CMS data reporting system that combines provide some or all of Medicare-covered both Part A and Part B claims in a common services for enrollees. file.
Medicare Economic Index (MEI): An index National codes: See HCPCS. that tracks changes over time in physician practice costs and general earnings levels. National practitioner data bank: A Since 1975, increases in prevailing charge permanent record maintained by the U.S. screens have been limited increases in the Public Health Service of disciplinary actions MEI. See Prevailing Charge. taken against physicians and all payments made on behalf of physicians for actual or Medicare Fee Schedule (MFS): The potential malpractice claims. resource-based fee schedule currently used by Medicare to pay for physicians’ services. This NCH: National Claims History (Medicare) fee schedule is based on resource costs, and composed of factors representing physician NCQA: National Committee for Quality work and practice costs. Assurance
Medicare: A federal health insurance Non-participating physician [Medicare]: A program for people 65 or over and for physician who does not sign a Medicare disabled persons with chronic renal disorders. participation agreement, and therefore is not obligated to accept assignment on all Medigap insurance: Private health insurance Medicare claims. Frequently defined as policies designed to supplement Medicare Nonpar. See Participating Physician, coverage. Benefits may include payment of Participating Physician and Supplier Program. Medicare deductibles, coinsurance, and balance bills, and payment for services not Nonphysician Practitioner (NPP): A health covered by Medicare. care professional who is not a physician. Examples of NPPs are advance practice Mediplan Health Care Act: Health care nurses, physician assistants, and certified reform proposal introduced by Representative registered nurse anesthetists. Fortney “Pete” Stark (H.R. 2610). NPP: Nonphysician Provider
xviii TERMINOLOGY
Outcome: The consequence of a medical Participating Physician and Supplier intervention on a patient. Program (PAR): A program that provides financial and administrative incentives for Outcomes and effectiveness research: physicians and suppliers to agree in advance Medical or health services research that to accept assignment on all Medicare claims attempts to identify and understand the for a one-year period. clinical outcomes (including mortality, morbidity, and functional status) of the Participating physician: A physician who delivery of health care. signs a participation agreement, agreeing to accept assignment on all Medicare claims for Overvalued procedure: Procedures whose a period of one year. Frequently referred to as prevailing charges have been reduced because PAR. they were considered “overvalued” by historical CPR. Payment rate: The total amount paid for each unit of service rendered by a health care Paid amount: The portion of a submitted provider, including both the amount covered charge that is actually paid, by both third- by the insurer and the consumer’s cost party payers and the insured, including sharing. copayments and balance bills. For Medicare this amount may be less than the allowed Per diem: Method of reimbursement based charge if the submitted charge is less, or it upon a flat rate for each day of care to a may be more because of balance billing. patient.
PAR: Participating Physician and Supplier Percentile: A measure used in statistics Program (Medicare) indicating the value below which a given percentage of observations in a group of Part A [Medicare]: The Hospital Insurance observations fall. For example, the 50th program, which covers the cost of hospital and percentile is the value (or score) below which related posthospital services. As an 50% of the observations may be found. entitlement program, it is available without payment of a premium. Beneficiaries are Performance measure: A specific measure responsible for an initial deductible per spell of how well a health plan does in providing of illness and coinsurance for some services. health services to its enrolled population. Can be used as a measure of quality. Part B [Medicare]: The Supplementary Medical Insurance program (SMI); covers the Performance standard: The target rate of costs of physician services, outpatient expenditure growth set by the Volume laboratory and x-ray tests, durable medical Performance Standard system. equipment, outpatient hospital care, and certain other services. As a voluntary Periodic review of relative values: The program, Part B requires payment of a recalibration of Medicare’s relative value monthly premium. Beneficiaries are scale to account for changes that occur over responsible for a deductible and coinsurance time. CMS is required to conduct a periodic payment for most covered services. See review at least every five years. Beneficiary. PF: Provider File Partial capitation: An insurance arrangement where the payment made to a health plan is a PHP: Prepaid Health Plan combination of a capitated premium and payment based on actual use of services; the Physician-Hospital Organization (PHO): A proportions specified for these components separate legal entity owned by a hospital and determine the insurance risk faced by the plan. participating physicians which can contract
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with insurance companies, HMOs or self- physician assistants, and receptionists who are insured employers for the provision of employed by the physician, and the expenses medical services. The PHO may also associated with purchase and use of medical undertake utilization review, credentialing, equipment and supplies in the physician’s and quality assurance. Physicians retain office. ownership of their own practices, maintain significant business outside the PHO, and Practice guidelines: An explicit statement of typically continue in their traditional practice what is known and believed about the style. benefits, risks, and costs of particular courses of medical action. Intended to assist decisions Physician work: A measure of the by practitioners, patients and others about physician’s time, physical effort and skill, appropriate health care for specific clinical mental effort and judgement, and stress from conditions. iatrogenic risk associated with providing a medical service. Physician Work is a Preauthorization: See Precertification. component of the Medicare relative value scale. Precertification: The process of obtaining permission to perform a service from the PIN: A code used to report performing insurance carrier before the service is physicians and group numbers. PIN stands for performed. Provider Identification Number and is commonly known as the provider number. Predetermination: The process of obtaining an estimate of what an insurance carrier will Portability: The requirement that insurers pay for service(s) before the service(s) is/are waive any preexisting condition exclusion for performed. someone who was previously covered through other insurance as recently as 30 to 90 days Preexisting condition exclusion: A practice earlier. of some health insurers to deny coverage to individuals for a certain period, for example, POS: Point-of-Service six months, for health conditions that already exist when coverage is initiated. Point-of-service plan: A managed care plan that combines features of both prepaid and Preferred Provider Organization (PPO): A fee-for-service insurance. Health plan managed care health plan that contracts with enrollees decide whether to use network or networks or panels of providers to furnish non-network providers at the time care is services and be paid on a negotiated fee needed and usually are charged sizable schedule. Enrollees are offered a financial copayments for selecting the latter. incentive to use providers on the preferred list, but may use non-network providers as well. Policy holder: See Insured. Premium: An amount paid periodically to PPO: Preferred Provider Organization purchase medical insurance benefits.
PPRC: Physician Payment Review Preventive care: Treatment that aims to avoid Commission the development of illness.
PPS: Prospective Payment System Primary carrier: The insurance carrier which has first responsibility under Coordination of Practice expense: The cost of nonphysician Benefits. resources incurred by the physician to provide physician services. Examples are salaries and PRO: Peer Review Organization the cost of fringe benefits received by nurses,
xx TERMINOLOGY
Procedure coding: See Coding. Refinement: The correction of relative work values in Medicare’s relative value scale Professional component: The part of a which were initially set incorrectly. relative value or fee that represents the cost of a physician’s interpretation of a diagnostic test Reinsurance: An insurance arrangement or treatment planning for a therapeutic where an insurer pays a premium into a pool, procedure. and any claims paid by the insurer above a predefined dollar level are covered in whole ProPAC: Prospective Payment Assessment or in part by the pool. Commission RBRVS [Resource Based Relative Value Prospective Payment System (PPS): The Scale]: A government mandated relative value Medicare system used to pay hospitals for system, based on a study conducted at inpatient hospital services based on the DRG Harvard University, used for calculating classification system. national fee schedules for services provided to Medicare patients. Provider: The person in relation to the insurance program who provides covered Reasonable charge: The amount Medicare services and supplies to the beneficiary. will pay for a covered service. This is usually the lowest of the actual, customary and Provider contracting: Arrangements prevailing charges. between managed health care plans and provider in which provider agrees to provide Relative Value (RV): A value that reflects a services for plan members. comparison with an arbitrary standard.
Provider-Sponsored Organization (PSO): A Relative Value Scale (RVS): An index that PSO is a public or private entity established assigns specific numeric values to medical and operated by a health care provider, or a services. Multiplying the relative value by a network of affiliated health care providers, conversion factor results in a fee. that shares substantial financial risk with respect to the provision of those services and Relative Value Unit (RVU): The unit of has at least a majority financial interest in the measure for a relative value scale. RVUs must entity. PSOs must meet federal standards for be multiplied by a dollar conversion factor to quality and solvency, comply with Medicare become payment amounts. contractor requirements, and deliver a substantial portion of coordinated care Relative Work Value (RWV): An assigned through the affiliated network of providers. value that reflects the average work of a physician of average efficiency relative to a QA: Quality Assurance standard.
Quality assurance: A formal, systematic Release of information: The patient’s process to improve quality of care that signature indicating consent to the release of includes monitoring quality, identifying information necessary for settlement of his or inadequacies in delivery of care, and her insurance claim. correcting these inadequacies. Resource Based Relative Value Scale: See Rate setting: An approach to cost RBRVS. containment where the government establishes payment rates for all payers for various Resource costs: The costs of the inputs used categories of health services. by an efficient physician to provide a service or procedure, including both the costs of the physician’s own time and effort and the costs
xxi MEDICAL FEES 2018 of nonphysician inputs. The apparently specialists. Medicare does not recognize redundant use of “resource” with “costs” is a specialty differentials. convention used to indicate the average costs of an efficient physician, as distinguished Staff model HMO: An HMO in which from cost-based reimbursement such as that physicians practice solely as employees of the used for hospitals prior to the prospective HMO and usually are paid a salary. payment system. Standard benefit package: A defined set of Revenue share: The proportion of a health insurance benefits that all insurers are practice’s total revenue devoted to a particular required to offer. type of expense. For example, the practice expense revenue share is that proportion of Submitted charge: The charge submitted by revenue used to pay for practice expense. a provider to the patient or a payer.
RHC: Rural Health Center Subscriber: See Insured.
RUC: RVS Update Committee Superbill: A multi-part form which provides sufficient information so that patients may file RVS: Relative Value Scale their own insurance claim forms.
RVU: Relative Value Unit Supplemental health services: Benefits offered by an HMO that exceed their basic RWV: Relative Work Value health service requirements.
Schedule of allowances: A list of specific Supplemental Security Income (SSI): A amounts which the carrier will pay toward the federal income support program for low- cost of medical services provided. income disabled, aged, and blind persons. Eligibility for the monthly cash payments is Secondary carrier: The insurance carrier based on the individual’s current status which is second in responsibility under without regard to previous work or Coordination of Benefits. contributions to a trust fund.
Self-insured health plan: Employer-provided Supplementary Medical Insurance (SMI): health insurance in which the employer, not an The Medicare program that covers the costs of insurer, is at risk for its employees’ medical physicians’ services, outpatient laboratory and expenses. x-ray tests, durable medical equipment, outpatient hospital care, and certain other Severity modifier: An adjustment that services. This voluntary program requires reflects the effect of patient factors, such as payment of a monthly premium, which covers severity of illness, comorbidity, or risk of about 25 percent of program costs. complications, on the relative work required Beneficiaries are responsible for a deductible to deliver a service. and coinsurance payments for most covered services. Also called Part B coverage or Site-of-service differential: The difference in benefits. the amount paid when the same service is performed in different practice settings, for Supplier: Providers, other than practitioners, example, an outpatient visit in a physician’s of health care services. Suppliers under office or a hospital clinic. Medicare include independent labs, durable medical equipment providers, ambulance Specialty differential: The difference in the services, orthotists, prosthetists, and portable relative value or amount paid for the same x-ray providers. service when performed by different xxii TERMINOLOGY
Table of allowances: See Schedule of Volume [behavioral] offset: The change in Allowances. the volume of services that occurs in reaction to a change in fees. A 50 percent volume Technical component: The part of the offset means that half of the savings from fee relative value or fee for a procedure that reductions will be offset by increased volume represents the costs of doing the procedure of services. excluding physician work. Volume Performance Standard (VPS): A Third Party Administrator (TPA): An mechanism included in OBRA89 to adjust fee administrative organization other than the updates for the Medicare Fee Schedule based insurance company or health care provider on how annual increases in actual that collects insurance premiums, pays claims expenditures compare to previously and provides administrative services. determined performance standard rates of increase. TW: Total Work VPS: Volume Performance Standard UCR [Usual, Customary, and Reasonable]: A method of determining benefits by Workers’ compensation: State laws which comparing the physician’s charges to those of provide coverage of medical expenses for his or her peers in the same community and employees who are injured during specialty. Sometimes called Customary, performance of their work. Prevailing, and Reasonable.
Unbundling: The process of coding, billing, and requesting payment for services that are generally included in a global charge.
Upcoding: The process of selecting a code for a service that is more intense, extensive, or has a higher charge, than the service actually provided.
Update for new and revised codes: Yearly process of determining the relative values of new and revised codes for Medicare’s relative value scale.
UPIN: [Unique Physician Identification Number] A unique code number used to identify referring and ordering physicians who may bill the Medicare program.
UR: Utilization Review
Usual, Customary, and Reasonable: See UCR.
Utilization review: The process of reviewing services provided to determine if those services were medically necessary and appropriate. May be performed on a concurrent or a retrospective basis.
xxiii
INTRODUCTION
Setting fees for medical services and payment by all health insurance plans and procedures involves a lot more than simply third party payers in the near future. deciding the dollar amount associated with a particular service or procedure. Setting fees 3. Charging a fee less than what the health requires a knowledge of how health insurance insurance plan or third party payer would plans and third party payers process and pay pay benefits the health insurance plan or health insurance claims, a method for third party payer, not you or your patient. determining the value of your procedures and services, an awareness of the going rates in 4. Health insurance plans and third party your medical community, a comprehensive payers may be paying you 25-50% less knowledge of Medicare, Medicaid, and than they are paying your peers for Worker's Compensation laws, and non- exactly the same service, simply because governmental health insurance plan and third you have been careless in maintaining party payer billing rules and regulations. your fee schedule and provider profile.
In today's competitive market environment, it 5. Except for fees for elective plastic is important to understand that your fees are surgery, most medical fees are ultimately part of your marketing strategy. Fees must be negotiated or discounted, voluntarily or reviewed and adjusted periodically. The involuntarily. adjustment is usually in the form of raising fees; however, fee decreases are sometimes 6. Fee schedule management puts you in appropriate and may become more common as control of the payment process. competition increases. The objective of fee schedule management is to set a fair price for PRACTICE MANAGEMENT your procedures and services, and to be paid APPLICATIONS as much of that price as possible most of the time. However, neither setting your fees nor FEE SCHEDULE REVIEW getting paid is as simple as that. The primary application of the information KEY POINTS REGARDING contained in this publication is to review your SETTING FEES fees in comparison to the report in order to determine where your fees rank on a national 1. It is difficult to obtain fee information, basis. Your fees may then be adjusted, if profiles, relative values, or conversion appropriate, based upon the results of your factors from most non-governmental review and analysis. health insurance plans and/or third party payers. In addition, medical professionals BARGAINING WITH THIRD PARTY who are not in the same medical practice PAYERS are prevented by Federal antitrust legislation from discussing fees for It is important to your patients and your medical services and procedures or asking practice that health insurance plans and third what competing professionals are paid by party payers are paying you and/or your a health insurance plan. patients based upon current, and accurate, UCR data for your geographic area and 2. Some variation of the Medicare Fee specialty. Theoretically, the percentile Schedule (MFS) based on the Resource distribution of fees for a specific procedure or Based Relative Value Scale (RBRVS) service performed in a given geographic area will likely become the method used for should be identical for all health insurance
1 MEDICAL FEES 2018
plans and third party payers. However, in of the Evaluation & Management and reality these numbers vary considerably and appropriate specialty sections of the are also affected by the payment policies of publication will provide you with the fee data specific health insurance plans and third party you need to perform a cost/benefit analysis for payers. the associate. As above you would need to provide the estimated frequency for each Remember that under the usual, customary service and the cost of maintaining the human and reasonable concept, the health insurance resource. In either of these examples, you plan and/or third party payer will gladly pay would also have to adjust the forecast total you less than their allowable or customary charges by your average collection ratios to amount if that's what you billed them. In achieve an accurate forecast of revenues. addition, you can't increase your fees retroactively. However, if the health insurance SOURCES OF THE DATA plan and third party payer’s allowables or customary amounts are significantly below The usual, customary and reasonable (UCR) your fees, resulting in low payments to you fees listed in this book were developed over a and/or your patients, then you should compare period of several years. More than 400 million the codes that appear to be underpaid with the actual physician charges provides the basis for data in this publication. If you find that the listed fees, service bureaus, group practices, published data supports a higher payment, clinics, universities, and practice management then you should appeal the payment to the system vendors are among the many types of health insurance plan and/or third party payer. organizations that supplied the claims data utilized for fee schedule development. We strongly suggest that you support your appeal letter by attaching a photocopy of the Although the creation of a fee schedule may front cover of this book and the page(s) that seem rather straightforward, the process is include the codes and fees that you are basing actually quite complex. For example, many of your appeal on. We don't guarantee that this the codes listed in CPT are performed will work every time; however, our customers infrequently. Thus, even with the largest of have informed us that this does indeed work fee databases, there may be so few instances most of the time. of a particular code's usage that it is difficult to establish reliable percentile ranges. As COST BENEFIT ANALYSIS another example, some services as listed in CPT are considered variable in performance. This publication can be used to perform cost That is, when one physician reports the code, benefit analyses for both equipment and he/she may include items or services that human resources. For example, suppose your another physician does not provide. Clearly, group practice is considering installing its own this can significantly impact UCR fee levels. automated laboratory equipment or x-ray equipment. A careful review of the Radiology RELATIONSHIP TO PAYER and/or Laboratory sections of this publication ALLOWABLES will provide you with the fee data you need to perform a cost/benefit analysis for the Contrary to widespread belief, there is no equipment. You would need to supply the "secret" list of fees that health insurance plan estimated frequency for each service and the and third party payers use to determine the acquisition cost of the equipment to complete appropriateness of your charges. Many firms the analysis. sell fee databases to payers. Payers in turn may utilize one or more of these databases, as Likewise, you can perform a similar well as relative value systems, during the calculation based upon human resources. For payment adjudication process. This is example, suppose you are considering adding especially true for rarely performed services an associate to your practice. A careful review
2 INTRODUCTION for which reliable payment guidelines are upon actual claims has been obtained. At the lacking. Additionally, different payers set same time, we feel strongly that setting your payment limits at different levels. For fees for these new codes somewhere between example, one health insurance plan and/or the 75th and 90th percentiles is justified based third party payer may reimburse at the 90th upon the logic used to create the estimates. percentile, another at the 75th percentile, and yet another at the 80th percentile. HMOs and GEOGRAPHIC VARIABILITY other managed care groups typically negotiate th AND ADJUSTMENT fees that are closer to the 50 percentile for a given area. th th th The 50 , 75 and 90 percentile fees provided in this text are based on national averages and HOW WE ESTIMATE FEES FOR are generally reflective of payer allowables. NEW CPT CODES However; medical fees vary substantially by geographic area. In rural and smaller urban When new CPT codes are introduced at the areas the payer allowables may be beginning of each year, it takes several significantly lower than the percentiles months before health care providers begin presented in this text. Conversely, in large routinely submitting them on health insurance urban areas the payers may allow fees that are claims, before payers begin establishing much higher than the average fees shown. payment criteria, and before enough claims data becomes available to establish UCR fees The last chapter of this book includes a list of and percentiles. Thus, the UCR fees for new geographic adjustment factors for cities, CPT 2016 codes presented in herein are counties, areas, regions and states which may estimates, and should be viewed as such. be used to "fine tune" the data in this report. The Geographic Adjustment Factors (GAF) Two methods were used in preparing fee are calculated using a weighted average of the estimates for new CPT codes. The first work, practice expense and malpractice method uses a proprietary formula created by expense components of the GPCIs. The GAFs PMIC to estimate UCR fees by analyzing can be used to make reasonably reliable UCR and RVU data for related and/or similar geographic adjustments of the UCR fees and CPT codes and then applying the results to the Medicare fees. new code(s). A SHORT COURSE IN Second, in instances where Medicare has not assigned RVU values, Medicare Fee Schedule STATISTICS data was used. For example, most laboratory services covered by Medicare are under a non- The usual, customary and reasonable fees in RBRVS schedule. To estimate fees and values this publication are presented as percentiles. for the new lab codes, Medicare's 2016 Other publications use fee ranges or average laboratory fee schedule data was scaled to fees instead of percentiles. The use of UCR levels using methods similar to those percentiles is much better than using fee discussed above. In the case where no data ranges or averages. Presenting a fee range of existed that could be used to estimate the UCR lowest to highest is only of use to find out if percentiles for new codes, no fee data is listed. you are lower than the lowest or higher than the highest. It really doesn't help you The reader is reminded that all UCR fees determine where you should be within the listed for new codes are estimates. Even range. though these estimates have been created on a logical basis by using relative value data, there WHAT IS A PERCENTILE? is no way to determine the validity or A percentile is defined as a value on a scale of accuracy of the estimates until data based one hundred that indicates the percent of a
3 MEDICAL FEES 2018 distribution that is equal to or below it. To Sample Distribution of Fees for determine the percentile distribution of CPT code 99213 medical fees, you first have to sort all of the fees collected for each CPT code in numerical Sample fee #1 = $61 order. Then you review the distribution of fees on the percentage scale to determine what the Sample fee #2 = $63 fee values are at the desired percentages. The Sample fee #3 = $65 following simple list helps to illustrate how Sample fee #4 = $67 th the 50 percentile is determined. Sample fee #5 = $69
The easiest way to understand percentile Sample fee #6 = $71 distribution is by showing it as a curve as Sample fee #7 = $73 ◄50th percentile illustrated below. The curve is created by Sample fee #8 = $75 plotting the fees from a list of fees (see the Sample fee #9 = $77 example on the following page) to determine the percentiles. To illustrate this concept more Sample fee #10 = $79 clearly, let’s presume that we have a series of Sample fee #11 = $81 13 fees for a specific service or procedure that Sample fee #12 = $83 represent 13 different providers. The first step Sample fee #13 = $97 is to rank the fees in ascending order by dollar amount. Then we find the 50th percentile or median by counting down to the middle of the list.
The above Bell Curve illustrates the sample fee distribution for CPT code 99213
4 INTRODUCTION
50th Percentile WHERE YOUR FEES SHOULD BE
In the previous Bell curve illustration, the 50th The objective of your fee schedule percentile means that 50 percent of all fees for management program should be to keep your CPT code 99213 fall at or below $73.00. It fees at the high end of the percentile also means that 50 percent of all fees for CPT distribution while still considering other code 99213 fall at or above $73.00. You factors, such as local customs and market definitely do not want your fees to be on the considerations, which may require an left side of the curve because that means that occasional exception. If you find that your fee a) you are charging less than over half of all for a specific service or procedure is lower providers for the service and b) you are not than the 50th percentile fee, that means that getting the payment you deserve. more than 50 percent of all health care providers charge more than you do for this The 50th percentile is also known as the service. It also means your fee is too low and median. The 50th percentile or median is not you should raise it. the same as the average or mean. Likewise, if you find that your fee is higher 75th Percentile than the 90th percentile fee, then you are charging more than 90 percent of all health In the Bell curve on the previous page, the care providers for this service. It may also 75th percentile means that 75 percent of all mean that your fee is too high, but not fees for CPT code 99213 fall at or below necessarily. You may simply have done a $83.00. It also means that 25 percent of all better job at fee schedule management for a fees for CPT code 99213 fall at or above long enough time to get your fees up to a $83.00. Being within the 50th to the 75th maximum level. You may also be a member percentile range is better than being below the of a select group of super specialists who have 50th percentile. traditionally charged higher fees for certain procedures and consultations in particular. 90th Percentile GEOGRAPHIC VARIABILITY In the Bell curve on the previous page, the OF MEDICAL FEES 90th percentile means that 90 percent of all fees for CPT code 99213 fall at or below The percentile fees presented in this book are $97.00. It also means that 10 percent of all based on national fee data; however, medical fees for CPT code 99213 fall at or above fees vary substantially by geographic area. In $97.00. Being within the 75th to the 90th rural areas and smaller towns and cities, percentile range is better than being in the 50th medical fees may be significantly lower than to the 75th percentile range, unless market the percentiles presented in this book. forces dictate otherwise. For example, for Likewise, in larger cities, medical fees may be services that are frequently shopped by significantly higher than the fees presented. patients on price, such as total obstetrical care, There are two primary reasons for the it would be better to position your fee for this geographic variation in medical fees; namely, particular service closer to the 50th percentile the cost of running a medical practice and the in order to be competitive. cost of medical malpractice insurance.
If your fee is above the 90th percentile, you are The cost of practice includes rent, employee charging more than 90 percent of all costs, and other overhead costs, but not physicians for procedure. In most cases this medical malpractice costs. According to the would indicate that your fee is too high; cost of practice indexes published in the however, there are some exceptions. The Medicare Physicians Fee Schedule, San exceptions are usually based upon specialty Francisco has the highest cost of practice and differentials, i.e. the traditional thinking that a small eastern cities of Missouri have the service performed by a specialist is worth lowest cost of practice. The Medicare practice more than the same service performed by a expense for San Francisco is about 85% non-specialist.
5 MEDICAL FEES 2018 higher than the practice expense for a small practice expense and medical malpractice eastern city of Missouri. expense vary greatly from one area to another. The charts on the following two pages list the The second reason for the geographic ten highest and ten lowest locations for overall variation in medical fees is the cost of medical geographic adjustment factor, practice malpractice insurance. According to the expense and malpractice expense. The results malpractice expense indexes published in the are not surprising. The highest ranked Medicare Fee Schedule, Detroit has the locations are in the major metropolitan cities highest cost of medical malpractice insurance and the lowest ranked locations tend to be and South Dakota has the lowest cost of found in the southern and mid-western states. medical malpractice insurance. The Medicare malpractice expense for Detroit is over 750% HOW TO REVIEW YOUR FEES higher than the malpractice expense for South Dakota. The process of fee review includes gathering resource materials, reviewing the procedure These differences in the cost of practice and and diagnostic codes you use, reviewing the medical malpractice insurance are reflected in fees charged for each procedure, making the wide range of fees charged by doctors for decisions regarding fee adjustments, and identical services provided in different making sure that the resulting decisions are geographic locations. implemented and followed.
THE GEOGRAPHIC RESOURCE MATERIALS ADJUSTMENT FACTOR (GAF) Current Code Books
In order to help you improve the accuracy of Your fees for medical services and procedures your percentile medical fees in the area where are linked by common business practice and you practice, we have included an appendix of legislation to CPT, HCPCS and ICD-10-CM the Medicare Fee Schedule geographic cost of codes. For commercial health insurance plans practice indexes (GPCI) and a geographic and third party payers, these coding systems adjustment factor (GAF). define what you did and why you did it. Plus
their usual, customary and reasonable (UCR) The GAF is a sum of the weighted averages of statistics are maintained by procedure code. the three GPCIs for each locality. The For Medicare, the codes are an integral part of weighting factors are from the CMS report the Medicare Fee Schedule used to define the “Review of Alternative GPCI Payment relative values of each procedure and are Locality Structures – Final Report,” published mandated by the new HIPAA legislation. in 2010, which weights the physician work CPT, HCPCS and ICD-10-CM code books GPCI at 52 percent, the practice expense may be obtained from many sources, GPCI at 44 percent and the malpractice GPCI including your local medical bookstore. four percent. The GAF provides a quick and simple way to determine a more accurate fee Relative Value Data for a specific geographic location of a medical practice. The relative value reflects the complexity of a
service or procedure from a medical point of The appendix includes a list of geographic view. The most widely used source of relative adjustment factors for cities, counties, areas, value data is from the Resource-Based regions and states that can be used to “fine Relative Value Scale (RBRVS), a component tune” the fees listed in this book. of the annual Medicare Physician Fee
Schedule published by CMS. HIGHEST AND LOWEST GAFS
The amount of work involved in a medical service or procedure is relatively constant regardless of geographic location. However,
6 INTRODUCTION
TEN HIGHEST MEDICARE WEIGHTED GAF LOCATIONS (DESCENDING)
State/Locality name Carrier Loc Work PE MP GAF Alaska 02102 01 1.500 1.117 0.708 1.300 Santa Clara County, CA 01112 09 1.083 1.354 0.388 1.174 Queens, NY 13292 04 1.052 1.200 2.121 1.160 Alameda/Contra Costa County, CA 01112 07 1.075 1.325 0.421 1.159 San Francisco County, CA 01112 05 1.075 1.325 0.421 1.159 San Mateo County, CA 01112 06 1.075 1.325 0.421 1.159 NYC Suburbs/Long Island, NY 13202 02 1.041 1.205 2.149 1.157 Marin County, CA 01112 52 1.062 1.279 0.458 1.133 Manhattan, NY 13202 01 1.052 1.180 1.615 1.131 Washington, DC + MD/VA Suburbs 12202 01 1.045 1.205 1.261 1.124
TEN LOWEST MEDICARE WEIGHTED GAF LOCATIONS (ASCENDING)
State/Locality name Carrier Loc Work PE MP GAF Mississippi 07302 00 0.961 0.870 0.370 0.897 Arkansas 07102 13 0.971 0.872 0.576 0.912 Nebraska 05402 00 0.970 0.910 0.318 0.918 Idaho 02202 00 0.962 0.902 0.512 0.918 Rest Of Missouri 05302 99 0.961 0.863 0.993 0.919 Iowa 05102 00 0.969 0.907 0.423 0.920 Alabama 10102 00 0.979 0.890 0.492 0.920 Indiana 08102 00 0.969 0.919 0.379 0.923 Tennessee 10302 35 0.976 0.901 0.526 0.925 Kentucky 15102 00 0.974 0.880 0.819 0.926
TEN HIGHEST MEDICARE PRACTICE EXPENSE LOCATIONS (DESCENDING)
State/Locality name Carrier Loc Work PE MP GAF Santa Clara County, CA 01112 09 1.083 1.354 0.388 1.174 Alameda/Contra Costa County, CA 01112 07 1.075 1.325 0.421 1.159 San Francisco County, CA 01112 05 1.075 1.325 0.421 1.159 San Mateo County, CA 01112 06 1.075 1.325 0.421 1.159 Marin County, CA 01112 52 1.062 1.279 0.458 1.133 Napa, CA 01112 51 1.055 1.256 0.458 1.120 Vallejo-Fairfield, CA 01112 53 1.055 1.256 0.458 1.120 Washington, DC + MD/VA Suburbs 12202 01 1.045 1.205 1.261 1.124 NYC Suburbs/Long Island, NY 13202 02 1.041 1.205 2.149 1.157
7 MEDICAL FEES 2018
TEN LOWEST PRACTICE EXPENSE LOCATIONS (ASCENDING)
State/Locality name Carrier Loc Work PE MP GAF West Virginia 11402 16 0.966 0.857 1.296 0.931 Rest Of Missouri 05302 99 0.961 0.863 0.993 0.919 Mississippi 07302 00 0.961 0.870 0.370 0.897 Arkansas 07102 13 0.971 0.872 0.576 0.912 Kentucky 15102 00 0.974 0.880 0.819 0.926 Rest Of Louisiana 07202 99 0.977 0.887 1.199 0.946 Alabama 10102 00 0.979 0.890 0.492 0.920 Oklahoma 04312 00 0.961 0.891 0.954 0.930 Rest Of Georgia 10202 99 0.980 0.899 1.073 0.948 Tennessee 10302 35 0.976 0.901 0.526 0.925
TEN HIGHEST MALPRACTICE EXPENSE LOCATIONS (DESCENDING)
State/Locality name Carrier Loc Work PE MP GAF Miami, FL 09102 04 0.990 1.029 2.566 1.070 NYC Suburbs/Long Island, NY 13202 02 1.041 1.205 2.149 1.157 Queens, NY 13292 04 1.052 1.200 2.121 1.160 Chicago, IL 06102 16 1.008 1.034 1.925 1.056 Fort Lauderdale, FL 09102 03 0.983 1.012 1.797 1.028 East St. Louis, IL 06102 12 0.984 0.936 1.785 0.995 Detroit, MI 08202 01 1.000 0.989 1.691 1.023 Montana 03202 01 0.965 1.000 1.631 1.007 Manhattan, NY 13202 01 1.052 1.180 1.615 1.131 Suburban Chicago, IL 06102 15 1.009 1.053 1.565 1.051
TEN LOWEST MALPRACTICE EXPENSE LOCATIONS (ASCENDING)
State/Locality name Carrier Loc Work PE MP GAF Nebraska 05402 00 0.970 0.910 0.318 0.918 Wisconsin 06302 00 0.983 0.957 0.347 0.946 Minnesota 06202 00 0.998 1.011 0.362 0.978 Mississippi 07302 00 0.961 0.870 0.370 0.897 Indiana 08102 00 0.969 0.919 0.379 0.923 Santa Clara County, CA 01112 09 1.083 1.354 0.388 1.174 South Dakota 03402 02 0.961 1.000 0.389 0.955 Alameda/Contra Costa County, CA 01112 07 1.075 1.325 0.421 1.159 San Francisco County, CA 01112 05 1.075 1.325 0.421 1.159 San Mateo County, CA 01112 06 1.075 1.325 0.421 1.159
8 INTRODUCTION
RBRVS was originally developed for from your local Medicare carrier, the U.S. Medicare but is now widely used by government printing office, and private commercial insurance plans and other publishers. government payers. RBRVS originally included only those CPT codes most likely to INSURANCE CARRIER EXPLANATION be used by providers when treating Medicare OF BENEFITS (EOBS) patients, but has been expanded to include most CPT codes. You should collect sample copies of Explanation of Benefits (EOBs) from CMS depends heavily on the recommend- commercial health insurance plan and third actions of the Relative Value Update party payers for at least three months prior to Committee (RUC) of the American Medical your planned fee schedule review. Typically Association. The RUC consists of physicians this would be in the last quarter of each representing various specialty societies, calendar year. You don't need a copy of every geographic areas, and practice settings. The EOB you receive but you should keep copies committee performs a major review of the of those which include payment for your most relative values every five years, but every year common procedures and services. Plus, you the relative values are updated for all new or should keep copies from different commercial changed CPT codes. health insurance plans and third party payers even when they are paying for the same The specialty society advisors determine procedures or services. relative values based on time, mental effort and judgment, technical skill, physical effort REVIEW PROCEDURE AND SERVICE and stress due to patient risk required to CODES IN THE CURRENT CPT perform each service or procedure. The CODING REFERENCE Specialty Society makes recommendations to the RUC which in turn makes a proposal to Purchase a copy of the revised CPT codes CMS. About 95% of the RUC each year and review carefully for any recommendations are accepted by CMS each changes which may affect your practice. year. CMS publishes the relative values for Review each of the procedure codes from the next calendar year in the Federal Register, your code listing or superbill in your current usually in late November or early December. CPT coding reference. Pay particular attention to codes that have been added, changed or MEDICARE FEE SCHEDULE deleted. Your first step should be to review the summary of additions, changes and The revised Medicare Fee Schedule is deletions, typically included as an Appendix published in the Federal Register in late in most CPT coding references. This is the November or early December each year. You quickest way for you to first cross-reference may obtain a copy of the Medicare Fee the codes that you use frequently, and then Schedule from your local Medicare carrier, refer to the full text for make your changes. the U.S. government Printing Office, or from private publishers. ● All CPT codes in the new edition marked with a small black circle to the left of the GEOGRAPHIC COST OF PRACTICE code are NEW codes. Review all new INDEXES codes carefully to see if any of them can be used instead of UNLISTED procedure The Geographic Cost of Practice Indexes, codes or as replacements for HCPCS referred to more commonly as GPCIs, are an codes. integral part of the Medicare Fee Schedule. GPCIs are used to make geographic ▲ All CPT codes in the new edition with a adjustments to the fees calculated using the small black triangle to the left of the code fee schedule. Current GPCIs are available are CHANGED codes. Review the
9 MEDICAL FEES 2018
description of all changed codes carefully typically includes procedures that are to make sure that your superbills and performed on a high volume basis, such blood insurance forms have the same counts, urinalysis, etc., where a small increase descriptions. Not only will this improve in an individual fee can result in a significant your payment, it will also protect you increase in total payment. from audit liability. Medicine ( ) All CPT codes in the new edition enclosed in parentheses are deleted All medical practices should review this entire effective January 1st of the year following section to update injections, specialty publication. Most CPT coding references procedures and diagnostic procedures. include a referral to a replacement code for most codes that are deleted. Make REVIEW CURRENT HCPCS sure you substitute the replacement codes CODES on your superbills and coding lists. Purchase a copy of the revised HCPCS codes REVIEW ALL SECTIONS IN THE CPT each year and review carefully for any CODING REFERENCE changes which may affect your practice. Review your most current HCPCS coding Evaluation and Management reference, particularly the sections covering supplies, materials and injections. CMS Review this section carefully each year for revises these codes on an annual basis and changes in office, hospital, consultation, and most Medicare carriers make continual other location visit codes. revisions which are published in the form of newsletters. Use of the proper HCPCS codes Surgery can make a significant difference in your payment. Review all portions of this section of CPT which may be appropriate to your medical Remember that while HCPCS National Level practice. Non-surgical practices should review 2 codes are uniform throughout the United the sections on wound repair, trauma related States, the method of billing the codes may codes, and any other procedures commonly vary from one Medicare carrier to another. performed. Pay particular attention to, add-on Check with your local Medicare carrier for (+) procedures, and procedures classified as proper billing instructions. (separate) procedures.
Radiology REVIEW CURRENT ICD-10-CM CODES Medical practices providing and/or billing for radiology procedures should review this ICD-10-CM replaced ICD-9-CM on October section of CPT carefully. This section 1, 2015. Purchase a copy of the revised ICD- includes procedures that are typically 10-CM codes each year and review carefully performed on a high volume basis, such as for any changes which may affect your chest x-rays, where a small increase in an practice. It is important that you are using the individual fee can result in a significant most current diagnosis codes from the increase in total payment. International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10- Laboratory CM). This book is revised and published annually by PMIC and other publishers. Keep Medical practices providing and/or billing for track of the frequency of your ICD-10-CM laboratory procedures need to review this code usage. Add frequently used codes to your section of CPT carefully. This section reference listings and superbills.
10 INTRODUCTION
REVIEW ALL YOUR FEES STAND BY YOUR FEES
Review and compare each of your procedures Once your fees are set stand by them. Make carefully to determine if fees need to be few exceptions to your standard fees and increased, due to increased costs or to always document exceptions by posting full maintain your profile, or decreased, in charges followed by an adjustment. This response to changing market conditions or makes billing easier for everyone and provides decreased costs. Pay particular attention to the an accurate record of how much you are volume of procedures. Small increases in discounting. frequently performed procedures and large increases in infrequently performed RELATIVE VALUE ANALYSIS procedures can usually be implemented without negative results. Complete a relative value analysis to calculate a conversion factor for your practice. Then use REVIEW AND REVISE YOUR the calculated conversion factor to determine SUPERBILLS AND FEE SCHEDULES the appropriate fee for each of your procedures. To perform a relative value After you have reviewed all CPT, HCPCS, analysis, you need a current relative value and ICD-9-CM codes and descriptions and publication, and a list of your 25 most made any necessary revisions to your fees, commonly performed procedure codes from you need to carefully review all of your the Medicine, Surgery, Radiology and superbills and any other documents that may Pathology sections of CPT, and your fees for have codes, descriptions or fees printed on the procedures. Then complete the following them. Make the required changes and then six steps for each section. make sure that the revisions are made and the documents printed. 1. List 25 codes and fees for each section.
We strongly recommend that you limit the 2. Look up the relative value and add to quantity of superbills printed to no more than your list. a six month supply. Inevitably you will change procedure codes, diagnosis codes 3. Total all of the fees. and/or fees during a six month period and you want to reserve the ability to reprint your 4. Total all of the relative values. superbills without throwing too many away. We also recommend that you do not print fees 5. Divide the total relative values into the on your superbills. While it is easier than total fees. looking up fees at the cashier's or receptionist's desk, it also causes potential 6. The result is your average conversion billing errors for interim fee changes. factor.
Distribute copies of the revised superbills After you calculate your average conversion and/or fee schedules to all staff members. factor, you can then multiple the relative value Consider that not only billing personnel are for each of the listed procedures by the involved with codes and fees. The person who conversion factor to determine what the fee answers the telephone in response to fee should be. It is not unusual to find services inquiries from potential patients needs to be and procedures both under and over priced well informed about your current fee based on relative value analysis. Before schedules. raising your prices based on relative value analysis, consider that all health insurance plans and third party payers have a maximum dollar value, based on usual, customary and
11 MEDICAL FEES 2018
reasonable fees that they allow for a given COMPUTERIZED FEE procedure. However, the use of relative values SCHEDULES gives you a strong argument for a review of a disputed or underpaid claim. Several private companies maintain, publish or distribute computerized fee schedules. The SAMPLE RVS ANALYSIS FOR stated intent of these fee schedules is to make SELECTED OB/GYN PROCEDURES fee schedule review much easier by letting the computer do all the work. The usefulness of On the following page there is a sample any of these products depends mostly on the relative value analysis using 25 commonly quality of the database used to prepare the reported OB/GYN procedures. In addition to data and the degree to which the databases can the CPT code and description you will find the th be manipulated in terms of geographic 75 percentile fee and relative value from this location and medical specialty. The database publication. The conversion factor is used by PMIC to prepare this publication is calculated by dividing the total relative values from Context4 Healthcare Inc. into the total charges. Obviously a conversion factor calculated using fees at the 50th percentile would be lower and a conversion MULTIPLE FEE SCHEDULES factor using fees at the 90th percentile would be higher. It is essential to have multiple fee schedules in the well managed medical practice. The argument can certainly be made that any DETERMINING FEES FOR NEW service or procedure is worth the same, based PROCEDURES on relative value calculations. However, all of your potential payers do not use the same If you perform a service or procedure for the method to pay you, or to calculate the value of first time and need to determine a fee, the first the services and procedures you perform. place to look would be your relative value reference. If the procedure is listed and has a Fees charged for services provided to numeric value, then simply multiply the Medicare patients are highly regulated by relative value by your conversion factor to Federal law. Fees charged for services determine the appropriate fee. However, if the provided to Medicaid beneficiaries and procedure or service is unlisted, then you can't Worker's Compensation Carriers are generally calculate a fee by this method. The best based on fixed fee schedules published by alternative is to use a comparative procedure state agencies. Many HMOs and PPOs also as the basis for first determining approximate reimburse based on fee schedules. relative value and then to calculate the proper fee. Review some of the more common None of these rules and regulations or fee procedures you perform and try to find one schedules applies to services provided to that requires similar skills, about the same patients paying cash, services rendered to amount of time, and has the same level of patients in personal injury cases, or for complexity and risk as the new procedure. services covered by private health insurance companies and third party payers. A medical Use the relative value of the common practice with a typical patient mix including procedure as a basis for calculating the fee for Medicare, Medicaid, worker's compensation the new procedure. Watch insurance carrier and private health insurance patients would EOBs carefully to see how much they are need to use a minimum of two or three allowing for the new procedure and adjust different fee schedules for proper billing. your fee accordingly. You can also request the prevailing charge for the procedure from your local Medicare intermediary.
12 INTRODUCTION
SAMPLE RELATIVE VALUE ANALYSIS CODE DESCRIPTION 50TH RVU 56420 Drainage of gland abscess 364 3.47 56630 Extensive vulva surgery 2939 26.80 57061 Destruction vagina lesion(s) 270 3.24 57065 Destruction of vaginal lesion(s); extensive 575 5.55 57180 Treat vaginal bleeding 350 3.98 57265 Extensive repair vagina 2176 24.24 57500 Biopsy of cervix 307 3.61 58120 Dilation and curettage (D & C) 801 7.34 58150 Total hysterectomy 2820 28.95 58200 Extensive hysterectomy 3994 39.54 58293 Vaginal hysterectomy 3831 38.40 58301 Remove intrauterine device 217 2.70 58400 Suspension of uterus 1291 12.49 58600 Division of fallopian tube 1152 10.25 58800 Drainage of ovarian cyst(s) 730 8.97 58820 Drainage of ovarian abscess 922 8.78 58940 Removal of ovary(s) 1575 15.03 59000 Amniocentesis 461 3.61 59015 Chorion biopsy 597 4.49 59120 Treat ectopic pregnancy 2209 22.83 59400 Obstetrical care 4330 59.92 59510 Cesarean delivery 4805 66.46 59612 Vaginal delivery only, after previous cesarean delivery 2659 26.41 59812 Treatment of incomplete abortion, completed surgically 864 9.11 59840 Abortion by D & C 725 6.24 Totals 40,964 442.41 Average Conversion Factor (Total Fees/Total RVUs) 92.59
MEDICARE FEE SCHEDULE private health insurance patients, Medicaid patients, and, if you are participating, to Practices which are non-participating must Medicare patients also. use the Medicare billing limits when billing for services provided to Medicare patients. WORKER'S COMPENSATION Practices which are participating may charge their regular fees for services provided to This fee schedule is used to bill for services Medicare patients. related to treating illnesses and injuries related to employment. The fee schedules are STANDARD FEE SCHEDULE generally maintained and published by the state agency responsible for worker's This is your standard fee schedule represent- compensation cases. ing the fees that you charge for cash patients,
13 MEDICAL FEES 2018
CONTRACT FEE SCHEDULES conversion factors used by different payers need not be the same, the entity that You may have additional fee schedules, based determines rates would have a deliberate on participating agreements with HMOs, policy concerning how they would differ. PPOs, etc. that must be used to bill for Conversion factors could be updated through services provided to beneficiaries of these volume performance standards or a similar plans. mechanism. Balance billing would be limited, but again, the limits could differ by class of EXPANDING THE MEDICARE payer. The entity making these decisions FEE SCHEDULE (presumably the U.S. Government) would (try to) balance the interests of physicians, private The traditional development path in the areas payers, public payers, and patients. of coding and billing is that policies and procedures mandated by Medicare are HOW TO IMPLEMENT YOUR implemented shortly thereafter by Medicaid, NEW FEE SCHEDULE followed by private health insurance companies and third party payers. However, Regardless of how carefully you review and there are significant issues which must be set your fees, you will still have complaints dealt with before private health insurance from patients. While studies have continued to companies and third party payers can indicate that most patients do not choose implement a fee schedule. providers of medical care based on fees, it is important to keep in mind that many Private health insurance companies and third malpractice cases start out as fee disputes. Fee party payers have expressed interest in related complaints tend to fall under the five revising their methods of physician payment. general categories. Many support the objectives of Medicare payment reform but have yet to determine the FEE COMPARISON extent to which physician markets will permit changes in relative values. Although few plan Patients compare fees among each other. In to adopt the Medicare Fee Schedule in total, addition, many patients shop fees for elective many are contemplating at least marginal procedures or routine care. Patients may be changes in relative values to reflect the well informed regarding the going rates for direction of Medicare changes. Private health specific procedures and may ask why your fee insurance companies and third party payers is higher than that of other providers. Be face limits to the magnitude of change they prepared to explain your fees for common can institute. Insurers offering indemnity procedures. policies are concerned that balance billing for technical procedures will increase. Carriers FEE CONSISTENCY that contract with physicians are concerned about whether specialists whose fees would Patients may question what appear to be fall would agree to participate in sufficient inconsistencies in your fees from one visit to numbers. the next. Patients are not aware of the various levels of service defined by CPT and the fact More extensive or more rapid changes by that some services are packaged or bundled private health insurance companies and third and others are not. Make sure the patient party payers will require public regulation of understands exactly what is included in their payment policies. Under an all-payer bundled procedures, and is made aware of the system, the Medicare relative value scale levels of care if he/she questions your fees for could be used by each of the payers. A public visits. body would determine payment rates for the various physician services. While the
14 INTRODUCTION
Patients frequently consider the value of your knowledgeable of Medicare Fee Schedule services to be directly proportional to the time rules, regulations and formulas. you spent with them. This is logical thinking on the patient's part, as many professional ABILITY TO PAY services tend to be rendered and billed based on units of time. Prior to publication of the In the past it was quite common for health 1992 edition of CPT, there were very few care providers to charge patients based on services or procedures that included time ability to pay. Therefore, some patients were components. Therefore, you could explain charged a little more, some a little less, and simply to the patient that your fees are not some nothing at all. It was sort of a private based on the amount of time spent but rather Medicaid system. Now with most patients the complexity of the situation and the level of covered by insurance plans and, more care required. importantly, generally aware of basic fees for the most common procedures and services, the With publication of the 1992 CPT, time situation is different. If patients perceive that became part of the definition of the new you are charging them more because they can Evaluation and Management services. As the pay more, they will probably not come back. definition and understanding of the new Make sure that your discussion of fees coding system becomes widespread among includes assurances that your fees are not the patient population, you may expect some based on the patient's ability to pay, but rather patients to time your services and compare on the specific services provided. their time with the time associated with particular Evaluation and Management codes. DISCUSSING FEES WITH YOUR PATIENTS RELATIVE VALUE DISCUSSING FEES AT THE TIME OF Due to the lack of knowledge and under- APPOINTMENT SCHEDULING standing regarding anatomy, physiology and the difficulties involved in various medical Some practices discuss fees in advance with procedures, patients make inappropriate patients who call to make an appointment. comparisons of procedures. They may not While this may occasionally cause problems understand why a repair of a hip fracture costs when the bill turns out to be higher than more than life-saving treatment for an acute quoted on the phone, the major benefit is that myocardial infarction. Patients are not aware the patient has been informed that there will of the traditional discrepancy between the be a charge, and that they are expected to pay. value of cognitive procedures versus technical Any statements regarding fees or amounts procedures. of interest is the fact that patients made during telephone conversations should do not recognize any differences in value be noted on the appointment schedule. between cognitive and technical services. SMALL FEES CAN BE STATED AFTER This subjective attitude of the patient SERVICES HAVE BEEN RENDERED population is verified in part by the findings of the Harvard study of Resource Based Relative Services such as office visits, injections and Values. One of the objectives of the Medicare minor procedures can generally be provided Fee Schedule is to legislate away the without advance discussion of fees. The discrepancy by creating a payment system provider can fill out the charge slip or based upon measurable work and cost of superbill including fees and instruct the practice indexes. If patients question you on patient to give it to the receptionist, or the this issue, be prepared to explain how your provider can leave the fees blank to be filled fees for technical services are calculated. out by the receptionist. Expect some of your Medicare patients to be
15 MEDICAL FEES 2018
When the charge slip is totaled and presented matter of providing professional services with to the patient for payment, the patient has the the expectation of being paid for those opportunity to ask questions regarding the services. You always have the option to services provided and the fees charged. Even provide services at no charge if that is what if the patient does not pay at the time of you want to do. service, this presentation of the itemized charge slip makes the patient aware of the HOW TO INITIATE FEE fees, which will correspond to the bill DISCUSSIONS received. Not everyone is comfortable in discussing fees DISCUSS LARGER FEES BEFORE or money with patients. Many medical PROVIDING SERVICE professionals absolutely refuse to engage in such discussions. It is not necessary for the Numerous studies have confirmed that when medical professional to have this fee patients are about to undergo major discussion with the patient, although patient procedures that their first concern is outcome, surveys consistently reveal that the patient and their second concern is how much it is prefers to discuss fees directly with the going to cost and how are they going to pay medical professional. But it is important that for it. Unfortunately, most patients will never someone representing the practice, the office express this concern voluntarily. Most medical manager, insurance manager, or the financial professionals discuss their findings, treatment counselor, have a discussion with the patient plans and the probable outcome(s) of regarding the fees before major services are treatment with their patients; however, many rendered. neglect any discussion of fees or payment methods. In addition to appreciating the It is important to make the patient aware that information, discussing the potential cost your fees are within the going rates for the gives the patient the ability to make an community, that the fees to this patient are the informed decision regarding the service. In same as that for every patient, and, for order to gain a little perspective on this issue, bundled procedures, that your fee includes ask yourself the following questions: specific services and procedures. The following statements represent some of the • Would you order a meal in an expensive more successful approaches to this subject: restaurant from a menu without prices? My (our, the doctor's) usual charge for this • Would you allow a mechanic to perform service is.... major service on your car without an estimate of what it was going to cost? This lets the patient know what the charge will be and that they are being charged the same as • Would you allow a contractor to begin everyone else. construction on your new kitchen or bathroom without a bid? The going rate for this service (around here, in the community).... While you most likely answered "no" to each of the above questions, consider that many This opening gives you two options. Either it medical and surgical procedures have fees that assures the patient that your fees are in line are far in excess of repairing cars or adding with those of your colleagues, or it gives you additions to a house. Yet many medical the opportunity to explain why your fees are practices routinely expect the patient to higher. receive (and pay for) services without any advance knowledge of their cost. None of this has anything to do with ethics. It is simply a
16 INTRODUCTION
My (our, the doctor's) fee covers.... increase its profitability by raising some fees, lowering others, and maintaining enough This approach is often used when discussing flexibility to adjust specific fees in response to fees that are global in nature, primarily new opportunities. This process is known as surgical procedures which include a standard strategic pricing and incorporates the amount of routine follow-up care. Another following concepts: example would be prenatal care, uncomplicated vaginal delivery and the post- MARKET DRIVEN PROCEDURES partum visit. This lets the patient know that a single fee covers all of the service. Some procedures are price sensitive and patients do call to ask prices of some It is better to state your usual charge first and procedures or services, such as total then explain that any insurance proceeds will obstetrical care. It is important that fees for be applied against it. By mentioning insurance such services be kept comparatively low. On first, you risk the patient assuming that you the other hand, consumers know that some will scale your charges based upon insurance procedures are absolutely necessary for them payment. to maintain and they don't shop around for these procedures. Don't worry. We'll take your insurance as full payment.... In addition, if your practice provides services that are market driven you want to make sure What if the patient isn't covered, but doesn't that the person handling these telephone know it? What about deductibles and inquiries is a good salesperson. Ideally, the coinsurance? What about pre-existing prospective patient would be "sold" on how conditions and exclusions? You can be sued good the practice, doctor and/or service is by the patient for breach of contract if you before the requested fee is quoted. This simple make the above statement and then attempt to technique can significantly increase your new collect from the patient any unpaid balance patient volume. after insurance, even if the insurance pays you nothing! RELATIONSHIP BUILDING
Many health insurance companies and third Building a successful practice requires the party payers are helping you to protect development of long-term relationships with yourself by requiring pre-certification before patients and/or referral sources. Part of your covering services and providing benefits. pricing strategy should be based on attracting Many insurance contracts now require pre- new relationships with patients or referral authorization for non-emergency sources and on maintaining and develop hospitalization as well as for certain "abused" existing relationships. How much you charge, procedures such as Total Abdominal whether you charge, and how you bill are all Hysterectomy. Failure to obtain pre- considerations that may impact a relationship. authorization can result in outright denial of An example of this component of strategic claims and/or benefit reductions of up to 50 pricing is the "free" consultation that most percent with no appeal! In most cases, the pediatricians provide to parents who are patient does not even know that these interviewing potential physicians for their new requirements exist. (or about to be born) babies. An investment of 30 to 45 minutes late in an afternoon can STRATEGIC PRICING result in a patient relationship lasting for 20 years! More and more medical professionals In today's competitive environment the are making themselves available for patient successful practice will learn how to keep its interviews. existing patients, attract new patients, and
17 MEDICAL FEES 2018
PRICE SENSITIVITY services in order to keep track of your time better, and to make sure you are billing for all Patients are consumers and they expect prices your services. to increase, including yours. However, they do not react positively to sudden or large Maybe it’s time to bring in an associate to increases in fees. This happens most often take care of those referrals you have been when the practice has held down fees for a turning down. Or maybe you are considering long time and then increases fees suddenly, extended office hours one evening during the and by large amounts. This is easy to avoid by week and Saturday mornings to meet the using more frequent, small increases. increasing demands of your patients for more convenient (to them) hours. VOLUME CONSIDERATION Make sure that the time you spend with each Pay particular attention to volume when patient is appropriate for the level of care you considering fee increases. A large increase in need to provide. This means that you have to a fee that is infrequently performed or rarely provide exactly the right amount of your time, repeated on the same patient will likely go from your perspective, in order to keep your unnoticed. Likewise, a small increase in your schedule, and, the right amount of your time, fees for frequent procedures will also be from the patient's perspective, to provide the expected by most patients. perception of value received.
Promotional Pricing REDUCE YOUR DISCOUNT BUSINESS
Fees for certain services and procedures may In spite of the continuous national furor over be used to attract new patients to your medical fees, the truth is, that with very few practice. Many practices offer "free" exceptions, all medical practices are operated screenings, or reduced fees for physical as discount businesses. Typical discounts exams, pap smears, and other preventive include: services. In today's more health conscious society, patients are very receptive to these • Giving a discount for cash payment at the new marketing techniques. In addition, you or time of service your practice may have particular services, skills, methods, or special office hours that are • Discounting your services as a not offered elsewhere or close by. Patients do professional courtesy place special value on special services and abilities and are usually willing to pay more • Accepting insurance payment as payment for them. in full
OPTIONS TO INCREASING • Accepting payments on account without YOUR FEES interest charges
INCREASE PRACTICE • Referring accounts to a collection agency PRODUCTIVITY • Writing off an account as a bad debt This doesn't necessarily mean you have to work more, harder or longer. It means simply • Accepting a capitation or discounted that you need to look at how you work in payment from an HMO, IPA or PPO order to make sure you are using your time in the most profitable manner. You may need to • Participating in Medicare implement a more formal scheduling and record keeping system for out-of-the-office • Providing services to Medicaid patients
18 INTRODUCTION
You must take the time to review your practice by revenue sources in order to determine if the types of patients you are attracting and the associations you have with payers are profitable. This review process should include answering the following questions:
1. Is Medicare participation in the best interest of my practice?
2. Should I implement payment at the time of service?
3. Are the contracts I have with HMOs and PPOs profitable?
4. Do I have too many Medicaid patients?
5. If I reduce my nonprofitable patient categories, can I replace them with profitable ones?
Finding the right answers to these questions for your practice requires an in depth evaluation of your practice economics, patient demographics, the potential patient pool, patient attitudes, and the attitudes, practices and standards of your medical community.
19
MEDICAL FEES
FORMAT OF THE LISTINGS Description
The medical fees listings are presented in six The descriptions listed in this publication are sections, which correspond to the six sections the official CPT 2018 full descriptions. To of CPT 2018. Within each section are make sure that the reader correctly matches subsections with anatomic, procedural, the fee information with the proper CPT code, condition or descriptor subheadings. The the full description is presented for every CPT procedures and services are listed in numeric code listed. order with exception of the Evaluation and Management section. The Evaluation and UCR 50th Management section has been placed at the beginning of the medical fees listings, because Usual, customary and reasonable fee at the these CPT codes are used by most physicians 50th percentile in reporting a significant portion of their services. The amount listed in this column represents the 50th percentile of usual, customary, and Each entry includes the CPT code, a short reasonable fees for the specific service or description of the procedure or service, UCR procedure. The 50th percentile is that point fees at the 50th, 75th and 90th percentiles, the where 50 percent of fees for a given procedure national average Medicare fee and the are at or below the amount listed and 50 Medicare RVU. Some CPT codes are listed percent are higher than the amount listed. A twice. The second listing includes the zero in this column means that the procedure modifier -26 to indicate that the listing is for is an unlisted procedure or there is no data the "professional component" of the procedure with which to make the calculation or only. insufficient data to calculate the amount.
CPT UCR 75th
CPT procedure code Usual, customary and reasonable fee at the 75th percentile All procedure codes listed in this publication are CPT 2018 codes. CPT codes are revised The amount listed in this column represents and published annually by the American the 75th percentile of usual, customary, and Medical Association (AMA). reasonable fees for the specific service or procedure. The 75th percentile is that point Modifier -26 or –TC (No header) where 75 percent of fees for a given procedure are at or below the amount listed and 25 Certain medical procedures are a combination percent are higher than the amount listed. A of a physician, or professional, component and zero in this column means that the procedure a technical component. When the physician is an unlisted procedure or there is no data performs and reports both parts of the service, with which to make the calculation or the service is reported without modifier -26. insufficient data to calculate the amount. When the physician performs and reports only the professional component, the modifier -26 90th UCR is added to the basic procedure and the fee reduced accordingly. The technical Usual, customary, and reasonable fee at the component is usually reported by the hospital 90th percentile with the addition of the modifier –TC.
● New code (any UCR fees based on statistical formulas). CPT copyright 2012 American Medical Association. 21 MEDICAL FEES 2016
The amount listed in this column represents the 90th percentile of usual, customary, and reasonable fees for the specific service or procedure. The 90th percentile is that point where 90 percent of fees for a given procedure are at or below the amount listed and 10 percent are higher than the amount listed. A zero in this column means that the procedure is an unlisted procedure or there is no data with which to make the calculation or insufficient data to calculate the amount.
MFS 2018
Medicare Fee Schedule fee for 2018
The amount listed in this column was calculated by multiplying the total Medicare relative value units from the Medicare Fee Schedule times the proper conversion factor for the code. This amount is listed as a reference so that you can see the relative differences between the UCR and Medicare Fee Schedule amounts for a particular service.
MFS RVU
Medicare Fee Schedule Relative Value Units for 2018
The number listed in this column is the relative value unit from the Resource-Based Relative Value Scale (RBRVS), a component of the annual Medicare Physician Fee Schedule published by CMS. The relative value reflects the complexity of the procedure from a medical point of view. CPT codes for "unlisted" or "by report" services do not have assigned relative values in RBRVS for obvious reasons. Other services or procedures may be provided too infrequently for CMS to establish a relative value.
22 CPT copyright 2017 American Medical Association.
EVALUATION & MANAGEMENT SERVICES
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU OFFICE OR OTHER OUTPATIENT VISITS
99201 Office or other outpatient visit for the evaluation 79 98 125 45 1.24 and management of a new patient, which requires these 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99201 Office or other outpatient visit for the evaluation 77 95 121 45 1.26 and management of a new patient, which requires these 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent face-to-face with the patient and/or family.
99202 Office or other outpatient visit for the evaluation 130 160 206 76 2.12 and management of a new patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent face-to-face with the patient and/or family.
99203 Office or other outpatient visit for the evaluation 195 240 308 110 3.05 and management of a new patient, which requires these 3 key components: a detailed history; a detailed examination; medical
CPT copyright 2017 American Medical Association. 23 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
decision making of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent face-to-face with the patient and/or family.
99204 Office or other outpatient visit for the evaluation 291 359 461 167 4.65 and management of a new patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent face-to-face with the patient and/or family.
99205 Office or other outpatient visit for the evaluation 373 459 589 211 5.85 and management of a new patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent face-to- face with the patient and/or family.
99211 Office or other outpatient visit for the evaluation 45 55 71 22 0.61 and management of an established patient, that may not require the presence of a physician or other qualified health care professional. usually, the presenting problem(s) are minimal. typically, 5 minutes are spent performing or supervising these services.
99212 Office or other outpatient visit for the evaluation 80 98 127 45 1.24 and management of an established patient, which requires at least 2 of these 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making. counseling and/or coordination of care with other physicians, other
24 CPT copyright 2017 American Medical Association. EVALUATION & MANAGEMENT SERVICES
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent face-to-face with the patient and/or family.
99213 Office or other outpatient visit for the evaluation 125 154 198 74 2.06 and management of an established patient, which requires at least 2 of these 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity. counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent face-to- face with the patient and/or family.
99214 Office or other outpatient visit for the evaluation 183 225 290 109 3.04 and management of an established patient, which requires at least 2 of these 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent face-to-face with the patient and/or family.
99215 Office or other outpatient visit for the evaluation 258 318 410 148 4.10 and management of an established patient, which requires at least 2 of these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent face-to-face with the patient and/or family.
CPT copyright 2017 American Medical Association. 25 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
HOSPITAL OBSERVATION SERVICES
99217 Observation care discharge day management 160 207 322 75 2.07 (this code is to be utilized to report all services provided to a patient on discharge from outpatient hospital "observation status" if the discharge is on other than the initial date of "observation status." to report services to a patient designated as "observation status" or "inpatient status" and discharged on the same date, use the codes for observation or inpatient care services [including admission and discharge services, 99234-99236 as appropriate.])
99218 Initial observation care, per day, for the 200 259 403 102 2.83 evaluation and management of a patient which requires these 3 key components: a detailed or comprehensive history; a detailed or comprehensive examination; and medical decision making that is straightforward or of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the problem(s) requiring admission to outpatient hospital "observation status" are of low severity. typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit.
99219 Initial observation care, per day, for the 264 342 532 139 3.85 evaluation and management of a patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the problem(s) requiring admission to outpatient hospital "observation status" are of moderate severity. typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99220 Initial observation care, per day, for the 387 501 779 190 5.27 evaluation and management of a patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are
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provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the problem(s) requiring admission to outpatient hospital "observation status" are of high severity. typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
99221 Initial hospital care, per day, for the evaluation 214 269 340 103 2.87 and management of a patient, which requires these 3 key components: a detailed or comprehensive history; a detailed or comprehensive examination; and medical decision making that is straightforward or of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the problem(s) requiring admission are of low severity. typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit.
HOSPITAL INPATIENT SERVICES
99222 Initial hospital care, per day, for the evaluation 272 342 432 139 3.87 and management of a patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the problem(s) requiring admission are of moderate severity. typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99223 Initial hospital care, per day, for the evaluation 399 502 633 207 5.74 and management of a patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the problem(s) requiring admission are of high severity. typically, 70 minutes are spent at the
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bedside and on the patient's hospital floor or unit.
99224 Subsequent observation care, per day, for the 84 105 133 41 1.13 evaluation and management of a patient, which requires at least 2 of these 3 key components: problem focused interval history; problem focused examination; medical decision making that is straightforward or of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the patient is stable, recovering, or improving. typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.
99225 Subsequent observation care, per day, for the 146 184 232 75 2.07 evaluation and management of a patient, which requires at least 2 of these 3 key components: an expanded problem focused interval history; an expanded problem focused examination; medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the patient is responding inadequately to therapy or has developed a minor complication. typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
99226 Subsequent observation care, per day, for the 216 272 342 107 2.97 evaluation and management of a patient, which requires at least 2 of these 3 key components: a detailed interval history; a detailed examination; medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the patient is unstable or has developed a significant complication or a significant new problem. typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
99231 Subsequent hospital care, per day, for the 88 110 139 40 1.11 evaluation and management of a patient, which requires at least 2 of these 3 key components: a problem focused interval history; a problem focused examination; medical decision making
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that is straightforward or of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the patient is stable, recovering or improving. typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.
99232 Subsequent hospital care, per day, for the 146 184 232 74 2.06 evaluation and management of a patient, which requires at least 2 of these 3 key components: an expanded problem focused interval history; an expanded problem focused examination; medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the patient is responding inadequately to therapy or has developed a minor complication. typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
99233 Subsequent hospital care, per day, for the 216 272 342 106 2.95 evaluation and management of a patient, which requires at least 2 of these 3 key components: a detailed interval history; a detailed examination; medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the patient is unstable or has developed a significant complication or a significant new problem. typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
99234 Observation or inpatient hospital care, for the 280 352 443 136 3.77 evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: a detailed or comprehensive history; a detailed or comprehensive examination; and medical decision making that is straightforward or of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually the presenting problem(s) requiring admission are of
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low severity. typically, 40 minutes are spent at the bedside and on the patient's hospital floor or unit.
99235 Observation or inpatient hospital care, for the 372 468 590 172 4.79 evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually the presenting problem(s) requiring admission are of moderate severity. typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99236 Observation or inpatient hospital care, for the 578 727 916 222 6.18 evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually the presenting problem(s) requiring admission are of high severity. typically, 55 minutes are spent at the bedside and on the patient's hospital floor or unit.
99238 Hospital discharge day management; 30 minutes 155 195 246 75 2.07 or less
99239 Hospital discharge day management; more than 232 292 368 110 3.05 30 minutes
CONSULTATIONS
99241 Office consultation for a new or established 130 165 212 48 1.34 patient, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
self limited or minor. typically, 15 minutes are spent face-to-face with the patient and/or family.
99242 Office consultation for a new or established 200 254 327 91 2.52 patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and straightforward medical decision making. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of low severity. typically, 30 minutes are spent face-to-face with the patient and/or family.
99243 Office consultation for a new or established 261 331 425 124 3.45 patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision making of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate severity. typically, 40 minutes are spent face-to-face with the patient and/or family.
99244 Office consultation for a new or established 370 469 603 186 5.16 patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent face-to-face with the patient and/or family.
99245 Office consultation for a new or established 465 589 758 226 6.29 patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of
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moderate to high severity. typically, 80 minutes are spent face-to-face with the patient and/or family.
99251 Inpatient consultation for a new or established 154 194 257 50 1.38 patient, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are self limited or minor. typically, 20 minutes are spent at the bedside and on the patient's hospital floor or unit.
99252 Inpatient consultation for a new or established 201 253 334 76 2.11 patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and straightforward medical decision making. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of low severity. typically, 40 minutes are spent at the bedside and on the patient's hospital floor or unit.
99253 Inpatient consultation for a new or established 267 336 445 117 3.25 patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision making of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate severity. typically, 55 minutes are spent at the bedside and on the patient's hospital floor or unit.
99254 Inpatient consultation for a new or established 351 441 584 170 4.72 patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's
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needs. usually, the presenting problem(s) are of moderate to high severity. typically, 80 minutes are spent at the bedside and on the patient's hospital floor or unit.
99255 Inpatient consultation for a new or established 448 563 746 204 5.68 patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate to high severity. typically, 110 minutes are spent at the bedside and on the patient's hospital floor or unit.
EMERGENCY DEPARTMENT SERVICES
99281 Emergency department visit for the evaluation 117 146 189 22 0.60 and management of a patient, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are self limited or minor.
99282 Emergency department visit for the evaluation 189 237 306 42 1.17 and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of low complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of low to moderate severity.
99283 Emergency department visit for the evaluation 411 514 665 63 1.75 and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the
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problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of moderate severity.
99284 Emergency department visit for the evaluation 714 893 1156 120 3.32 and management of a patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision making of moderate complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician, or other qualified health care professionals but do not pose an immediate significant threat to life or physiologic function.
99285 Emergency department visit for the evaluation 1144 1432 1853 176 4.89 and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. usually, the presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function.
99288 Physician or other qualified health care 301 377 488 0 0.00 professional direction of emergency medical systems (ems) emergency care, advanced life support
CRITICAL CARE SERVICES
99291 Critical care, evaluation and management of the 672 1153 1620 279 7.76 critically ill or critically injured patient; first 30- 74 minutes
99292 Critical care, evaluation and management of the 374 641 901 125 3.47 critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)
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NURSING FACILITY SERVICES
99304 Initial nursing facility care, per day, for the 150 194 229 93 2.58 evaluation and management of a patient, which requires these 3 key components: a detailed or comprehensive history; a detailed or comprehensive examination; and medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the problem(s) requiring admission are of low severity. Typically, 25 minutes are spent at the bedside and on the patient’s facility floor or unit.
99305 Initial nursing facility care, per day, for the 210 269 319 133 3.69 evaluation and management of a patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the problem(s) requiring admission are of moderate severity. Typically, 35 minutes are spent at the bedside and on the patient’s facility floor or unit.
99306 Initial nursing facility care, per day, for the 265 341 403 170 4.72 evaluation and management of a patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the problem(s) requiring admission are of high severity. Typically, 45 minutes are spent at the bedside and on the patient’s facility floor or unit.
99307 Subsequent nursing facility care, per day, for the 75 97 115 45 1.26 evaluation and management of a patient, which requires at least 2 of these 3 key components: a problem focused interval history; a problem focused examination; straightforward medical decision making. Counseling and/or coordination of care with other physicians, other
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qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the patient is stable, recovering, or improving. Typically, 10 minutes are spent at the bedside and on the patient’s facility floor or unit.
99308 Subsequent nursing facility care, per day, for the 121 155 183 71 1.96 evaluation and management of a patient, which requires at least 2 of these 3 key components: an expanded problem focused interval history; an expanded problem focused examination; medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 15 minutes are spent at the bedside and on the patient’s facility floor or unit.
99309 Subsequent nursing facility care, per day, for the 159 205 242 93 2.59 evaluation and management of a patient, which requires at least 2 of these 3 key components: a detailed interval history; a detailed examination; medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the patient has developed a significant complication or a significant new problem. Typically, 25 minutes are spent at the bedside and on the patient’s facility floor or unit.
99310 Subsequent nursing facility care, per day, for the 225 289 342 139 3.85 evaluation and management of a patient, which requires at least 2 of these 3 key components: a comprehensive interval history; a comprehensive examination; medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 35
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minutes are spent at the bedside and on the patient’s facility floor or unit.
99315 Nursing facility discharge day management; 30 130 167 197 74 2.06 minutes or less
99316 Nursing facility discharge day management; 193 249 294 108 3.00 more than 30 minutes
99318 Evaluation and management of a patient 175 225 266 98 2.72 involving an annual nursing facility assessment, which requires these 3 key components: a detailed interval history; a comprehensive examination; and medical decision making that is of low to moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the patient is stable, recovering, or improving. Typically, 30 minutes are spent at the bedside and on the patient’s facility floor or unit.
DOMICILIARY, REST HOME (EG. BOARDING HOME) OR CUSTODIAL CARE SERVICES
99324 Domiciliary or rest home visit for the evaluation 84 108 128 56 1.56 and management of a new patient, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of low severity. Typically, 20 minutes are spent with the patient and/or family or caregiver.
99325 Domiciliary or rest home visit for the evaluation 126 161 191 82 2.27 and management of a new patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent with the patient and/or family or caregiver.
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99326 Domiciliary or rest home visit for the evaluation 204 262 310 142 3.94 and management of a new patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent with the patient and/or family or caregiver.
99327 Domiciliary or rest home visit for the evaluation 261 336 397 190 5.27 and management of a new patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent with the patient and/or family or caregiver.
99328 Domiciliary or rest home visit for the evaluation 275 354 419 222 6.17 and management of a new patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician attention. Typically, 75 minutes are spent with the patient and/or family or caregiver.
99334 Domiciliary or rest home visit for the evaluation 88 113 133 61 1.70 and management of an established patient, which requires at least 2 of these 3 key components: a problem focused interval history; a problem focused examination; straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s
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needs. Usually, the presenting problem(s) are self-limited or minor. Typically, 15 minutes are spent with the patient and/or family or caregiver.
99335 Domiciliary or rest home visit for the evaluation 140 180 213 96 2.68 and management of an established patient, which requires at least 2 of these 3 key components: an expanded problem focused interval history; an expanded problem focused examination; medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent with the patient and/or family or caregiver.
99336 Domiciliary or rest home visit for the evaluation 191 246 291 138 3.83 and management of an established patient, which requires at least 2 of these 3 key components: a detailed interval history; a detailed examination; medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent with the patient and/or family or caregiver.
99337 Domiciliary or rest home visit for the evaluation 228 293 347 197 5.47 and management of an established patient, which requires at least 2 of these 3 key components: a comprehensive interval history; a comprehensive examination; medical decision making of moderate to high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 60 minutes are spent with the patient and/or family or caregiver.
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DOMICILIARY, REST HOME (EG. ASSISTED LIVING FACILITY) OR HOME CARE PLAN OVERSIGHT SERVICES
99339 Individual physician supervision of a patient 265 341 403 79 2.19 (patient not present) in home, domiciliary or rest home (eg, assisted living facility) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient’s care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes.
99340 Individual physician supervision of a patient 171 220 261 111 3.07 (patient not present) in home, domiciliary or rest home (eg, assisted living facility) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient’s care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 30 minutes or more.
HOME SER VICES
99341 Home visit for the evaluation and management 364 431 514 56 1.55 of a new patient, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of low severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
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99342 Home visit for the evaluation and management 345 409 487 81 2.25 of a new patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99343 Home visit for the evaluation and management 338 400 477 133 3.69 of a new patient, which requires these 3 key components: a detailed history; a detailed examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99344 Home visit for the evaluation and management 352 416 496 186 5.17 of a new patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99345 Home visit for the evaluation and management 350 415 494 226 6.28 of a new patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; and medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician
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attention. Typically, 75 minutes are spent face- to-face with the patient and/or family.
99347 Home visit for the evaluation and management 78 92 110 56 1.56 of an established patient, which requires at least 2 of these 3 key components: a problem focused interval history; a problem focused examination; straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99348 Home visit for the evaluation and management 120 143 170 86 2.38 of an established patient, which requires at least 2 of these 3 key components: an expanded problem focused interval history; an expanded problem focused examination; medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99349 Home visit for the evaluation and management 193 229 273 131 3.64 of an established patient, which requires at least 2 of these 3 key components: a detailed interval history; a detailed examination; medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are moderate to high severity. Typically, 40 minutes are spent face- to-face with the patient and/or family.
99350 Home visit for the evaluation and management 293 347 414 182 5.06 of an established patient, which requires at least 2 of these 3 key components: a comprehensive interval history; a comprehensive examination; medical decision making of moderate to high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 60 minutes are spent face-to-face with the patient and/or family.
PROLONGED SERVICES
99354 Prolonged evaluation and management or 170 209 256 133 3.69 psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour (list separately in addition to code for office or other outpatient evaluation and management or psychotherapy service).
99355 Prolonged evaluation and management or 140 172 210 100 2.79 psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code for prolonged service).
99356 Prolonged service in the inpatient or observation 197 242 297 94 2.61 setting, requiring unit/floor time beyond the usual service; first hour (list separately in addition to code for inpatient evaluation and management service).
99357 Prolonged service in the inpatient or observation 195 239 293 94 2.62 setting, requiring unit/floor time beyond the usual service; each additional 30 minutes (list separately in addition to code for prolonged service).
99358 Prolonged evaluation and management service 200 245 301 114 3.16 before and/or after direct patient care; first hour
99359 Prolonged evaluation and management service 121 148 182 55 1.52 before and/or after direct patient care; each additional 30 minutes (list separately in addition to code for prolonged service)
99360 Standby service, requiring prolonged 203 249 305 63 1.74 attendance, each 30 minutes (eg, operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring EEG)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
CASE MANAGEMENT SERVICES
99366 Medical team conference with interdisciplinary 81 99 121 44 1.21 team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified health care professional
99367 Medical team conference with interdisciplinary 63 77 95 58 1.60 team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician
99368 Medical team conference with interdisciplinary 115 141 173 37 1.04 team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional
CARE PLAN OVERSIGHT SERVICES
99374 Supervision of a patient under care of home 121 148 181 71 1.98 health agency (patient not present) in home, domiciliary or equivalent environment (eg, Alzheimer's facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes.
99375 Supervision of a patient under care of home 169 208 255 107 2.96 health agency (patient not present) in home, domiciliary or equivalent environment (eg, Alzheimer's facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care,
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 30 minutes or more.
99377 Supervision of a hospice patient (patient not 164 201 246 71 1.98 present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes.
99378 Supervision of a hospice patient (patient not 195 240 294 107 2.96 present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 30 minutes or more.
99379 Supervision of a nursing facility patient (patient 101 124 152 71 1.98 not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical
CPT copyright 2017 American Medical Association. 45 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
therapy, within a calendar month; 15-29 minutes.
99380 Supervision of a nursing facility patient (patient 139 170 208 107 2.96 not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 30 minutes or more
PREVENTIVE MEDICINE SERVICES
99381 Initial comprehensive preventive medicine 177 217 266 113 3.13 evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)
99382 Initial comprehensive preventive medicine 184 226 277 118 3.27 evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years)
99383 Initial comprehensive preventive medicine 187 230 281 122 3.40 evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years)
99384 Initial comprehensive preventive medicine 206 253 310 138 3.84 evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures,
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new patient; adolescent (age 12 through 17 years)
99385 Initial comprehensive preventive medicine 239 293 359 134 3.72 evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years
99386 Initial comprehensive preventive medicine 261 320 392 156 4.32 evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years
99387 Initial comprehensive preventive medicine 275 337 413 168 4.68 evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older
99391 Periodic comprehensive preventive medicine 154 188 231 101 2.81 reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year)
99392 Periodic comprehensive preventive medicine 165 202 248 108 3.00 reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years)
99393 Periodic comprehensive preventive medicine 165 202 248 108 2.99 reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
99394 Periodic comprehensive preventive medicine 180 221 271 118 3.28 reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)
99395 Periodic comprehensive preventive medicine 201 246 302 121 3.35 reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years
99396 Periodic comprehensive preventive medicine 218 268 328 129 3.57 reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years
99397 Periodic comprehensive preventive medicine 233 286 350 139 3.85 reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/ risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older
99401 Preventive medicine counseling and/or risk 75 86 128 39 1.07 factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes
99402 Preventive medicine counseling and/or risk 120 138 205 64 1.78 factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes
99403 Preventive medicine counseling and/or risk 153 176 261 89 2.48 factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes
99404 Preventive medicine counseling and/or risk 150 172 255 115 3.19 factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
99406 Smoking and tobacco use cessation counseling 30 35 51 15 0.41 visit; intermediate, greater than 3 minutes up to 10 minutes
99407 Smoking and tobacco use cessation counseling 54 62 92 28 0.79 visit; intensive, greater than 10 minutes
99408 Alcohol and/or substance (other than tobacco) 56 64 95 36 1.00 abuse structured screening (eg, audit, DAST), and brief intervention (SBI) services; 15 to 30 minutes
99409 Alcohol and/or substance (other than tobacco) 79 90 134 70 1.94 abuse structured screening (eg, audit, DAST), and brief intervention (SBI) services; greater than 30 minutes
99411 Preventive medicine counseling and/or risk 25 29 43 18 0.51 factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes
99412 Preventive medicine counseling and/or risk 41 47 70 23 0.64 factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes
99415 Prolonged clinical staff service (the service 31 36 53 10 0.28 beyond the typical service time) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for outpatient evaluation and management service)
99416 Prolonged clinical staff service (the service 0 0 0 5 0.13 beyond the typical service time) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition to code for prolonged service)
99429 Unlisted preventive medicine service 0 0 0 0 0.00
NON-FACE-TO-FACE PHYSICIAN SERVICES
99441 Telephone evaluation and management service 40 46 68 14 0.40 by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
available appointment; 5-10 minutes of medical discussion
99442 Telephone evaluation and management service 40 47 69 27 0.76 by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
99443 Telephone evaluation and management service 45 52 77 40 1.12 by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion
99444 Online evaluation and management service 43 50 74 0 0.00 provided by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient or guardian, not originating from a related e/m service provided within the previous 7 days, using the internet or similar electronic communications network
99446 Interprofessional telephone/internet assessment 51 58 86 18 0.51 and management service provided by a consultative physician including a verbal and written report to the patient's treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review
99447 Interprofessional telephone/internet assessment 116 134 198 36 1.01 and management service provided by a consultative physician including a verbal and written report to the patient's treating/requesting physician or other qualified health care professional; 11-20 minutes of medical consultative discussion and review
99448 Interprofessional telephone/internet assessment 78 89 132 55 1.52 and management service provided by a consultative physician including a verbal and written report to the patient's treating/requesting physician or other qualified health care
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
professional; 21-30 minutes of medical consultative discussion and review
99449 Interprofessional telephone/internet assessment 142 164 243 73 2.03 and management service provided by a consultative physician including a verbal and written report to the patient's treating/requesting physician or other qualified health care professional; 31 minutes or more of medical consultative discussion and review
SPECIAL EVALUATION AND MANAGEMENT SERVICES
99450 Basic life and/or disability examination that 93 107 159 0 0.00 includes: measurement of height, weight, and bp; completion of a medical history following a life insurance pro forma; collection of blood sample and/or urinalysis complying with “chain of custody” protocols; and completion of necessary documentation/certificates.
99455 Work related or medical disability examination 176 202 300 0 0.00 by the treating physician that includes: completion of a medical history commensurate with the patient’s condition; performance of an examination commensurate with the patient’s condition; formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; development of future medical treatment plan; and completion of necessary documentation/certificates and report.
99456 Work related or medical disability examination 391 449 666 0 0.00 by other than the treating physician that includes: completion of a medical history commensurate with the patient’s condition; performance of an examination commensurate with the patient’s condition; formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; development of future medical treatment plan; and completion of necessary documentation/certificates and report.
NEWBORN CARE SERVICES
99460 Initial hospital or birthing center care, per day, 223 257 380 98 2.71 for evaluation and management of normal newborn infant
99461 Initial care, per day, for evaluation and 141 162 240 93 2.57 management of normal newborn infant seen in other than hospital or birthing center
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
99462 Subsequent hospital care, per day, for evaluation 113 130 193 42 1.18 and management of normal newborn
99463 Initial hospital or birthing center care, per day, 251 289 429 113 3.14 for evaluation and management of normal newborn infant admitted and discharged on the same date
DELIVERY/BIRTHING ROOM ATTENDANCE AND RESUSCITATION SERVICES
99464 Attendance at delivery (when requested by the 477 549 813 76 2.12 delivering physician or other qualified health care professional) and initial stabilization of newborn
99465 Delivery/birthing room resuscitation, provision 955 1098 1628 149 4.13 of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output
INPATIENT NEONATAL INTENSIVE CARE SERVICES AND PEDIATRIC AND NEONATAL CRITICAL CARE SERVICES
99466 Critical care face-to-face services, during an 1191 1370 2031 243 6.76 interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport
99467 Critical care face-to-face services, during an 843 969 1437 122 3.38 interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)
99468 Initial inpatient neonatal critical care, per day, 4403 5064 7506 937 26.04 for the evaluation and management of a critically ill neonate, 28 days of age or younger
99469 Subsequent inpatient neonatal critical care, per 2678 3080 4567 406 11.27 day, for the evaluation and management of a critically ill neonate, 28 days of age or younger
99471 Initial inpatient pediatric critical care, per day, 2654 3053 4525 811 22.54 for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age
99472 Subsequent inpatient pediatric critical care, per 2531 2911 4315 420 11.66 day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
99475 Initial inpatient pediatric critical care, per day, 1811 2083 3088 571 15.87 for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age
99476 Subsequent inpatient pediatric critical care, per 1250 1437 2131 352 9.78 day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age
99477 Initial hospital care, per day, for the evaluation 2420 2783 4126 356 9.88 and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services
99478 Subsequent intensive care, per day, for the 1101 1266 1877 140 3.88 evaluation and management of the recovering very low birth weight infant (present body weight less than 1500 grams)
99479 Subsequent intensive care, per day, for the 973 1120 1660 127 3.52 evaluation and management of the recovering low birth weight infant (present body weight of 1500-2500 grams)
99480 Subsequent intensive care, per day, for the 934 1075 1593 122 3.39 evaluation and management of the recovering infant (present body weight of 2501-5000 grams)
COGNITIVE ASSESSMENT AND CARE PLAN SERVICES
99483 Assessment of and care planning for a patient 471 542 803 242 6.72 with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination; medical decision making of moderate or high complexity; functional assessment (eg, basic and instrumental activities of daily living), including decision-making capacity; use of standardized instruments for staging of dementia (eg, functional assessment staging test [fast], clinical dementia rating [cdr]); medication reconciliation and review for high-risk medications; evaluation for neuropsychiatric and behavioral symptoms, including depression, including use of standardized screening instrument(s); evaluation of safety (eg, home), including motor vehicle operation; identification of caregiver(s), caregiver knowledge, caregiver needs, social supports, and the willingness of caregiver to
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
take on caregiving tasks; development, updating or revision, or review of an advance care plan; creation of a written care plan, including initial plans to address any neuropsychiatric symptoms, neuro-cognitive symptoms, functional limitations, and referral to community resources as needed (eg, rehabilitation services, adult day programs, support groups) shared with the patient and/or caregiver with initial education and support. Typically, 50 minutes are spent face-to-face with the patient and/or family or caregiver.
CARE MANAGEMENT SERVICES
99484 Care management services for behavioral health 95 109 161 49 1.35 conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales; behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes; facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and continuity of care with a designated member of the care team.
99485 Supervision by a control physician of 275 317 469 78 2.17 interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data interpretation and report; first 30 minutes
99486 Supervision by a control physician of 233 268 397 68 1.89 interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data interpretation and report; each additional 30 minutes (list separately in addition to code for primary procedure)
99487 Complex chronic care management services, 112 129 191 95 2.63 with the following required elements: multiple (two or more) chronic conditions expected to
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
last at least 12 months, or until the death of the patient, chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline, establishment or substantial revision of a comprehensive care plan, moderate or high complexity medical decision making; 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.;
99489 Complex chronic care management services, 56 64 95 47 1.31 with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline, establishment or substantial revision of a comprehensive care plan, moderate or high complexity medical decision making; 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure)
99490 Chronic care management services, at least 20 60 69 103 43 1.19 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline; comprehensive care plan established, implemented, revised, or monitored.
PSYCHIATRIC COLLABORATIVE CARE MANAGEMENT SERVICES
99492 Initial psychiatric collaborative care 314 361 535 161 4.48 management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating
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physician or other qualified health care professional; initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan; review by the psychiatric consultant with modifications of the plan if recommended; entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant; and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing
99493 Subsequent psychiatric collaborative care 251 289 428 129 3.58 management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation; participation in weekly caseload consultation with the psychiatric consultant; ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers; additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant; provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies; monitoring of patient outcomes using validated rating scales; and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment.
99494 Initial or subsequent psychiatric collaborative 130 149 221 67 1.85 care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separately in addition to code for primary procedure)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
TRANSITIONAL CARE MANAGEMENT SERVICES
99495 Transitional care management services with the 282 324 481 167 4.64 following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge medical decision making of at least moderate complexity during the service period face-to-face visit, within 14 calendar days of discharge
99496 Transitional care management services with the 358 412 610 237 6.57 following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge medical decision making of high complexity during the service period face-to- face visit, within 7 calendar days of discharge
ADVANCE CARE PLANNING
99497 Advance care planning including the 129 148 220 86 2.39 explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate
99498 Advance care planning including the 147 169 251 76 2.11 explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary procedure)
99499 Unlisted evaluation and management service 0 0 0 0 0.00
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58 CPT copyright 2017 American Medical Association.
SURGERY SERVICES
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU GENERAL 10021 Fine needle aspiration; without imaging 293 404 575 125 3.47 guidance
10022 Fine needle aspiration; with imaging guidance 300 414 589 144 4.00 INTEGUMENTARY SYSTEM
SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES
10022 Fine needle aspiration; with imaging guidance 300 414 589 144 4.00
10030 Image-guided fluid collection drainage by 621 858 1219 577 16.04 catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous
10035 Placement of soft tissue localization device(s) 581 801 1139 530 14.71 (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion
10036 Placement of soft tissue localization device(s) 902 1245 1770 464 12.90 (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (list separately in addition to code for primary procedure)
10040 Acne surgery (eg, marsupialization, opening or 178 246 350 113 3.13 removal of multiple milia, comedones, cysts, pustules)
10060 Incision and drainage of abscess (eg, carbuncle, 220 304 432 122 3.38 suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single
10061 Incision and drainage of abscess (eg, carbuncle, 491 678 964 211 5.87 suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple
10080 Incision and drainage of pilonidal cyst; simple 414 571 812 184 5.12
10081 Incision and drainage of pilonidal cyst; 760 1048 1490 276 7.68 complicated
10120 Incision and removal of foreign body, 292 402 572 158 4.38 subcutaneous tissues; simple
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
10121 Incision and removal of foreign body, 538 743 1056 282 7.83 subcutaneous tissues; complicated
10140 Incision and drainage of hematoma, seroma or 303 418 594 169 4.69 fluid collection
10160 Puncture aspiration of abscess, hematoma, 260 358 509 134 3.71 bulla, or cyst
10180 Incision and drainage, complex, postoperative 499 689 979 254 7.06 wound infection
11000 Debridement of extensive eczematous or 104 145 196 56 1.56 infected skin; up to 10% of body surface
11001 Debridement of extensive eczematous or 50 70 95 22 0.61 infected skin; each additional 10% of the body surface, or part thereof (list separately in addition to code for primary procedure)
11004 Debridement of skin, subcutaneous tissue, 1424 1981 2690 601 16.69 muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum
11005 Debridement of skin, subcutaneous tissue, 1896 2639 3583 815 22.64 muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure
11006 Debridement of skin, subcutaneous tissue, 1825 2540 3448 736 20.44 muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure
11008 Removal of prosthetic material or mesh, 728 1013 1376 287 7.96 abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue infection) (list separately in addition to code for primary procedure)
11010 Debridement including removal of foreign 984 1370 1860 519 14.43 material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues
11011 Debridement including removal of foreign 1197 1666 2262 557 15.48 material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle
11012 Debridement including removal of foreign 1810 2519 3420 729 20.25 material at the site of an open fracture and/or an open dislocation (eg, excisional debridement);
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
skin, subcutaneous tissue, muscle fascia, muscle, and bone
11042 Debridement, subcutaneous tissue (includes 200 278 378 121 3.35 epidermis and dermis, if performed); first 20 sq cm or less
11043 Debridement, muscle and/or fascia (includes 379 528 717 235 6.53 epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less
11044 Debridement, bone (includes epidermis, dermis, 624 868 1179 322 8.94 subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less
11045 Debridement, subcutaneous tissue (includes 76 106 144 42 1.18 epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)
11046 Debridement, muscle and/or fascia (includes 131 182 247 75 2.09 epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)
11047 Debridement, bone (includes epidermis, dermis, 229 319 433 127 3.54 subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)
11055 Paring or cutting of benign hyperkeratotic lesion 69 89 121 49 1.37 (eg, corn or callus); single lesion
11056 Paring or cutting of benign hyperkeratotic lesion 83 107 145 60 1.67 (eg, corn or callus); 2 to 4 lesions
11057 Paring or cutting of benign hyperkeratotic lesion 97 125 169 68 1.89 (eg, corn or callus); more than 4 lesions
11100 Biopsy of skin, subcutaneous tissue and/or 164 216 277 108 3.00 mucous membrane (including simple closure), unless otherwise listed; single lesion
11101 Biopsy of skin, subcutaneous tissue and/or 66 87 112 33 0.93 mucous membrane (including simple closure), unless otherwise listed; each separate/additional lesion (list separately in addition to code for primary procedure)
11200 Removal of skin tags, multiple fibrocutaneous 151 198 255 92 2.55 tags, any area; up to and including 15 lesions
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
11201 Removal of skin tags, multiple fibrocutaneous 46 61 79 20 0.55 tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)
11300 Shaving of epidermal or dermal lesion, single 139 178 232 100 2.79 lesion, trunk, arms or legs; lesion diameter 0.5 cm or less
11301 Shaving of epidermal or dermal lesion, single 172 221 288 123 3.42 lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm
11302 Shaving of epidermal or dermal lesion, single 200 257 335 145 4.03 lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm
11303 Shaving of epidermal or dermal lesion, single 230 295 385 160 4.45 lesion, trunk, arms or legs; lesion diameter over 2.0 cm
11305 Shaving of epidermal or dermal lesion, single 131 168 219 102 2.82 lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less
11306 Shaving of epidermal or dermal lesion, single 164 211 275 125 3.48 lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm
11307 Shaving of epidermal or dermal lesion, single 192 247 321 149 4.13 lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm
11308 Shaving of epidermal or dermal lesion, single 201 258 336 155 4.31 lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm
11310 Shaving of epidermal or dermal lesion, single 161 207 270 117 3.25 lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less
11311 Shaving of epidermal or dermal lesion, single 184 237 308 114 3.18 lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm
11312 Shaving of epidermal or dermal lesion, single 225 289 376 165 4.58 lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm
11313 Shaving of epidermal or dermal lesion, single 275 353 460 191 5.31 lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
11400 Excision, benign lesion including margins, 209 269 350 129 3.58 except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less
11401 Excision, benign lesion including margins, 250 321 419 154 4.27 except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm
11402 Excision, benign lesion including margins, 291 373 486 171 4.76 except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm
11403 Excision, benign lesion including margins, 354 454 591 198 5.50 except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm
11404 Excision, benign lesion including margins, 427 548 714 224 6.23 except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm
11406 Excision, benign lesion including margins, 645 828 1079 324 8.99 except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm
11420 Excision, benign lesion including margins, 215 276 360 126 3.50 except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
11421 Excision, benign lesion including margins, 266 342 445 161 4.48 except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm
11422 Excision, benign lesion including margins, 319 410 534 181 5.04 except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm
11423 Excision, benign lesion including margins, 390 501 652 207 5.74 except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm
11424 Excision, benign lesion including margins, 467 600 781 240 6.67 except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm
11426 Excision, benign lesion including margins, 685 880 1147 344 9.56 except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
11440 Excision, other benign lesion including margins, 243 312 407 139 3.87 except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less
11441 Excision, other benign lesion including margins, 301 387 504 173 4.80 except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm
11442 Excision, other benign lesion including margins, 359 460 600 193 5.37 except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm
11443 Excision, other benign lesion including margins, 442 567 739 230 6.38 except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm
11444 Excision, other benign lesion including margins, 552 708 923 289 8.02 except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm
11446 Excision, other benign lesion including margins, 800 1027 1338 401 11.14 except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm
11450 Excision of skin and subcutaneous tissue for 815 1046 1364 395 10.98 hidradenitis, axillary; with simple or intermediate repair
11451 Excision of skin and subcutaneous tissue for 1079 1385 1805 500 13.90 hidradenitis, axillary; with complex repair
11462 Excision of skin and subcutaneous tissue for 811 1041 1357 386 10.72 hidradenitis, inguinal; with simple or intermediate repair
11463 Excision of skin and subcutaneous tissue for 1055 1355 1765 506 14.05 hidradenitis, inguinal; with complex repair
11470 Excision of skin and subcutaneous tissue for 879 1128 1470 426 11.82 hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair
11471 Excision of skin and subcutaneous tissue for 1127 1446 1885 526 14.62 hidradenitis, perianal, perineal, or umbilical; with complex repair
11600 Excision, malignant lesion including margins, 302 395 515 199 5.52 trunk, arms, or legs; excised diameter 0.5 cm or less
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
11601 Excision, malignant lesion including margins, 340 444 580 235 6.53 trunk, arms, or legs; excised diameter 0.6 to 1.0 cm
11602 Excision, malignant lesion including margins, 376 491 640 255 7.08 trunk, arms, or legs; excised diameter 1.1 to 2.0 cm
11603 Excision, malignant lesion including margins, 450 588 767 292 8.11 trunk, arms, or legs; excised diameter 2.1 to 3.0 cm
11604 Excision, malignant lesion including margins, 535 699 912 324 8.99 trunk, arms, or legs; excised diameter 3.1 to 4.0 cm
11606 Excision, malignant lesion including margins, 850 1111 1449 463 12.86 trunk, arms, or legs; excised diameter over 4.0 cm
11620 Excision, malignant lesion including margins, 321 419 547 200 5.56 scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
11621 Excision, malignant lesion including margins, 365 477 622 236 6.56 scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm
11622 Excision, malignant lesion including margins, 407 531 693 264 7.32 scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm
11623 Excision, malignant lesion including margins, 512 669 872 309 8.59 scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm
11624 Excision, malignant lesion including margins, 661 864 1126 348 9.68 scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm
11626 Excision, malignant lesion including margins, 898 1174 1530 419 11.63 scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm
11640 Excision, malignant lesion including margins, 343 448 584 206 5.73 face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less
11641 Excision, malignant lesion including margins, 423 553 721 244 6.78 face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm
11642 Excision, malignant lesion including margins, 483 631 823 279 7.74 face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
11643 Excision, malignant lesion including margins, 605 791 1031 328 9.12 face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm
11644 Excision, malignant lesion including margins, 816 1066 1390 405 11.26 face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm
11646 Excision, malignant lesion including margins, 1100 1438 1875 528 14.66 face, ears, eyelids, nose, lips; excised diameter over 4.0 cm
NAILS
11719 Trimming of nondystrophic nails, any number 32 43 56 15 0.41
11720 Debridement of nail(s) by any method(s); 1 to 5 47 63 82 34 0.94
11721 Debridement of nail(s) by any method(s); 6 or 68 90 117 46 1.29 more
11730 Avulsion of nail plate, partial or complete, 156 208 270 108 3.01 simple; single
11732 Avulsion of nail plate, partial or complete, 78 104 135 32 0.90 simple; each additional nail plate (list separately in addition to code for primary procedure)
11740 Evacuation of subungual hematoma 110 147 190 51 1.43
11750 Excision of nail and nail matrix, partial or 373 497 646 157 4.37 complete (eg, ingrown or deformed nail), for permanent removal
11755 Biopsy of nail unit (eg, plate, bed, matrix, 208 277 360 135 3.75 hyponychium, proximal and lateral nail folds) (separate procedure)
11760 Repair of nail bed 559 745 968 193 5.35
11762 Reconstruction of nail bed with graft 360 480 623 287 7.97
11765 Wedge excision of skin of nail fold (eg, for 249 332 432 172 4.77 ingrown toenail)
PILONIDAL CYST
11770 Excision of pilonidal cyst or sinus; simple 642 855 1112 284 7.89
11771 Excision of pilonidal cyst or sinus; extensive 1247 1661 2160 594 16.49
11772 Excision of pilonidal cyst or sinus; complicated 1560 2078 2701 715 19.86
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
INTRODUCTION
11900 Injection, intralesional; up to and including 7 100 129 167 58 1.60 lesions
11901 Injection, intralesional; more than 7 lesions 143 184 238 72 2.01
11920 Tattooing, intradermal introduction of insoluble 526 675 874 177 4.91 opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less
11921 Tattooing, intradermal introduction of insoluble 679 872 1129 203 5.63 opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm
11922 Tattooing, intradermal introduction of insoluble 314 403 522 63 1.75 opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (list separately in addition to code for primary procedure)
11950 Subcutaneous injection of filling material (eg, 284 365 473 72 2.00 collagen); 1 cc or less
11951 Subcutaneous injection of filling material (eg, 196 252 326 104 2.88 collagen); 1.1 to 5.0 cc
11952 Subcutaneous injection of filling material (eg, 277 355 460 134 3.72 collagen); 5.1 to 10.0 cc
11954 Subcutaneous injection of filling material (eg, 371 476 617 160 4.45 collagen); over 10.0 cc
11960 Insertion of tissue expander(s) for other than 2701 3467 4491 985 27.35 breast, including subsequent expansion
11970 Replacement of tissue expander with permanent 2401 3082 3992 630 17.50 prosthesis
11971 Removal of tissue expander(s) without insertion 1070 1374 1779 483 13.42 of prosthesis
11976 Removal, implantable contraceptive capsules 260 334 432 148 4.10
11980 Subcutaneous hormone pellet implantation 220 282 366 98 2.71 (implantation of estradiol and/or testosterone pellets beneath the skin)
11981 Insertion, non-biodegradable drug delivery 280 360 466 146 4.05 implant
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
11982 Removal, non-biodegradable drug delivery 306 393 509 163 4.53 implant
11983 Removal with reinsertion, non-biodegradable 463 594 770 235 6.54 drug delivery implant
REPAIR (CLOSURE)
11983 Removal with reinsertion, non-biodegradable 463 594 770 235 6.54 drug delivery implant
12001 Simple repair of superficial wounds of scalp, 329 477 613 93 2.59 neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less
12002 Simple repair of superficial wounds of scalp, 418 606 778 113 3.15 neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm
12004 Simple repair of superficial wounds of scalp, 523 758 974 132 3.68 neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm
12005 Simple repair of superficial wounds of scalp, 661 959 1231 167 4.63 neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm
12006 Simple repair of superficial wounds of scalp, 785 1138 1461 198 5.50 neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm
12007 Simple repair of superficial wounds of scalp, 845 1225 1573 229 6.35 neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm
12011 Simple repair of superficial wounds of face, 417 605 777 114 3.16 ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
12013 Simple repair of superficial wounds of face, 478 693 890 119 3.31 ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
12014 Simple repair of superficial wounds of face, 562 814 1045 139 3.86 ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
12015 Simple repair of superficial wounds of face, 728 1056 1356 167 4.65 ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm
12016 Simple repair of superficial wounds of face, 921 1335 1715 211 5.86 ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm
12017 Simple repair of superficial wounds of face, 575 834 1070 158 4.39 ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm
12018 Simple repair of superficial wounds of face, 651 944 1212 179 4.97 ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm
12020 Treatment of superficial wound dehiscence; 549 796 1022 288 8.00 simple closure
12021 Treatment of superficial wound dehiscence; 351 508 653 168 4.67 with packing
12031 Repair, intermediate, wounds of scalp, axillae, 409 552 739 244 6.78 trunk and/or extremities (excluding hands and feet); 2.5 cm or less
12032 Repair, intermediate, wounds of scalp, axillae, 502 678 907 310 8.61 trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm
12034 Repair, intermediate, wounds of scalp, axillae, 637 860 1151 321 8.92 trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm
12035 Repair, intermediate, wounds of scalp, axillae, 909 1228 1643 391 10.85 trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm
12036 Repair, intermediate, wounds of scalp, axillae, 1065 1439 1925 434 12.06 trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm
12037 Repair, intermediate, wounds of scalp, axillae, 1223 1652 2210 494 13.72 trunk and/or extremities (excluding hands and feet); over 30.0 cm
12041 Repair, intermediate, wounds of neck, hands, 485 655 877 244 6.77 feet and/or external genitalia; 2.5 cm or less
12042 Repair, intermediate, wounds of neck, hands, 529 715 957 297 8.24 feet and/or external genitalia; 2.6 cm to 7.5 cm
12044 Repair, intermediate, wounds of neck, hands, 765 1033 1383 369 10.26 feet and/or external genitalia; 7.6 cm to 12.5 cm
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
12045 Repair, intermediate, wounds of neck, hands, 992 1340 1792 410 11.40 feet and/or external genitalia; 12.6 cm to 20.0 cm
12046 Repair, intermediate, wounds of neck, hands, 875 1182 1582 493 13.70 feet and/or external genitalia; 20.1 cm to 30.0 cm
12047 Repair, intermediate, wounds of neck, hands, 964 1302 1742 543 15.09 feet and/or external genitalia; over 30.0 cm
12051 Repair, intermediate, wounds of face, ears, 526 711 951 265 7.36 eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
12052 Repair, intermediate, wounds of face, ears, 574 775 1037 302 8.39 eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
12053 Repair, intermediate, wounds of face, ears, 719 970 1298 355 9.85 eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm
12054 Repair, intermediate, wounds of face, ears, 929 1255 1679 370 10.27 eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm
12055 Repair, intermediate, wounds of face, ears, 1230 1662 2223 478 13.27 eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm
12056 Repair, intermediate, wounds of face, ears, 1007 1360 1819 571 15.86 eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm
12057 Repair, intermediate, wounds of face, ears, 1075 1452 1943 606 16.83 eyelids, nose, lips and/or mucous membranes; over 30.0 cm
13100 Repair, complex, trunk; 1.1 cm to 2.5 cm 541 738 1072 343 9.54
13101 Repair, complex, trunk; 2.6 cm to 7.5 cm 673 918 1332 406 11.27
13102 Repair, complex, trunk; each additional 5 cm or 272 371 539 125 3.47 less (list separately in addition to code for primary procedure)
13120 Repair, complex, scalp, arms, and/or legs; 1.1 579 789 1146 359 9.98 cm to 2.5 cm
13121 Repair, complex, scalp, arms, and/or legs; 2.6 728 993 1441 438 12.16 cm to 7.5 cm
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
13122 Repair, complex, scalp, arms, and/or legs; each 280 381 553 136 3.79 additional 5 cm or less (list separately in addition to code for primary procedure)
13131 Repair, complex, forehead, cheeks, chin, mouth, 660 900 1306 395 10.98 neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm
13132 Repair, complex, forehead, cheeks, chin, mouth, 889 1212 1760 488 13.56 neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm
13133 Repair, complex, forehead, cheeks, chin, mouth, 396 540 784 183 5.08 neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (list separately in addition to code for primary procedure)
13151 Repair, complex, eyelids, nose, ears and/or lips; 765 1043 1514 432 12.01 1.1 cm to 2.5 cm
13152 Repair, complex, eyelids, nose, ears and/or lips; 1023 1395 2025 519 14.42 2.6 cm to 7.5 cm
13153 Repair, complex, eyelids, nose, ears and/or lips; 512 698 1013 198 5.51 each additional 5 cm or less (list separately in addition to code for primary procedure)
13160 Secondary closure of surgical wound or 1828 2493 3619 827 22.98 dehiscence, extensive or complicated
14000 Adjacent tissue transfer or rearrange, trunk; 1254 1814 3161 638 17.73 defect 10 sq cm or less
14001 Adjacent tissue transfer or rearrange, trunk; 1768 2557 4454 824 22.90 defect 10.1 sq cm to 30.0 sq cm
14020 Adjacent tissue transfer or rearrange, scalp, 1329 1922 3348 714 19.83 arms and/or legs; defect 10 sq cm or less
14021 Adjacent tissue transfer or rearrange, scalp, 1567 2267 3949 893 24.81 arms and/or legs; defect 10.1 sq cm to 30.0 sq cm
14040 Adjacent tissue transfer or rearrange, forehead, 1550 2242 3907 781 21.70 cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less
14041 Adjacent tissue transfer or rearrange, forehead, 1722 2491 4339 968 26.88 cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm
14060 Adjacent tissue transfer or rearrange, eyelids, 1600 2314 4032 797 22.14 nose, ears and/or lips; defect 10 sq cm or less
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
14061 Adjacent tissue transfer or rearrange, eyelids, 1987 2873 5006 1041 28.92 nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm
14301 Adjacent tissue transfer or rearrange, any area; 2579 3731 6500 1105 30.69 defect 30.1 sq cm to 60.0 sq cm
14302 Adjacent tissue transfer or rearrange, any area; 714 1033 1800 230 6.38 each additional 30.0 sq cm, or part thereof (list separately in addition to code for primary procedure)
14350 Filleted finger or toe flap, including preparation 1667 2411 4200 708 19.67 of recipient site
15002 Surgical preparation or creation of recipient site 900 1258 1838 357 9.93 by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children
15003 Surgical preparation or creation of recipient site 214 299 436 78 2.16 by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (list separately in addition to code for primary procedure)
15004 Surgical preparation or creation of recipient site 936 1308 1912 410 11.38 by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children
15005 Surgical preparation or creation of recipient site 400 559 817 128 3.56 by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (list separately in addition to code for primary procedure)
15040 Harvest of skin for tissue cultured skin 510 713 1041 258 7.16 autograft, 100 sq cm or less
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
15050 Pinch graft, single or multiple, to cover small 1157 1618 2363 575 15.97 ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter
15100 Split-thickness autograft, trunk, arms, legs; first 2008 2806 4100 880 24.45 100 sq cm or less, or 1% of body area of infants and children (except 15050)
15101 Split-thickness autograft, trunk, arms, legs; each 517 723 1056 190 5.28 additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15110 Epidermal autograft, trunk, arms, legs; first 100 1750 2446 3574 817 22.69 sq cm or less, or 1% of body area of infants and children
15111 Epidermal autograft, trunk, arms, legs; each 251 351 512 122 3.38 additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15115 Epidermal autograft, face, scalp, eyelids, mouth, 1670 2334 3411 808 22.45 neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children
15116 Epidermal autograft, face, scalp, eyelids, mouth, 434 607 886 175 4.85 neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15120 Split-thickness autograft, face, scalp, eyelids, 2271 3175 4639 872 24.21 mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)
15121 Split-thickness autograft, face, scalp, eyelids, 740 1034 1511 213 5.91 mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15130 Dermal autograft, trunk, arms, legs; first 100 sq 1683 2352 3436 677 18.80 cm or less, or 1% of body area of infants and children
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15131 Dermal autograft, trunk, arms, legs; each 257 359 525 103 2.87 additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15135 Dermal autograft, face, scalp, eyelids, mouth, 2045 2858 4176 871 24.19 neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children
15136 Dermal autograft, face, scalp, eyelids, mouth, 254 354 518 102 2.84 neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15150 Tissue cultured skin autograft, trunk, arms, legs; 1783 2492 3641 717 19.92 first 25 sq cm or less
15151 Tissue cultured skin autograft, trunk, arms, legs; 311 434 634 125 3.47 additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)
15152 Tissue cultured skin autograft, trunk, arms, legs; 404 564 824 162 4.51 each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15155 Tissue cultured skin autograft, face, scalp, 2046 2860 4178 823 22.86 eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less
15156 Tissue cultured skin autograft, face, scalp, 416 582 850 167 4.65 eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)
15157 Tissue cultured skin autograft, face, scalp, 464 649 949 187 5.19 eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15200 Full thickness graft, free, including direct 1752 2449 3578 855 23.74 closure of donor site, trunk; 20 sq cm or less
15201 Full thickness graft, free, including direct 400 559 817 152 4.21 closure of donor site, trunk; each additional 20
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sq cm, or part thereof (list separately in addition to code for primary procedure)
15220 Full thickness graft, free, including direct 1560 2180 3185 791 21.98 closure of donor site, scalp, arms, and/or legs; 20 sq cm or less
15221 Full thickness graft, free, including direct 355 496 725 140 3.88 closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)
15240 Full thickness graft, free, including direct 2023 2828 4133 958 26.60 closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less
15241 Full thickness graft, free, including direct 545 762 1113 189 5.24 closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)
15260 Full thickness graft, free, including direct 1860 2601 3800 1040 28.88 closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less
15261 Full thickness graft, free, including direct 600 839 1226 220 6.11 closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)
15271 Application of skin substitute graft to trunk, 293 410 599 145 4.03 arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
15272 Application of skin substitute graft to trunk, 65 91 133 28 0.78 arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)
15273 Application of skin substitute graft to trunk, 795 1111 1623 309 8.59 arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
15274 Application of skin substitute graft to trunk, 212 296 433 73 2.03 arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each
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additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15275 Application of skin substitute graft to face, 312 436 637 153 4.26 scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
15276 Application of skin substitute graft to face, 90 126 184 36 0.99 scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)
15277 Application of skin substitute graft to face, 1175 1643 2400 338 9.40 scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
15278 Application of skin substitute graft to face, 306 428 625 87 2.43 scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
15570 Formation of direct or tubed pedicle, with or 2092 2925 4273 939 26.08 without transfer; trunk
15572 Formation of direct or tubed pedicle, with or 2028 2834 4141 914 25.38 without transfer; scalp, arms, or legs
15574 Formation of direct or tubed pedicle, with or 2048 2863 4183 933 25.93 without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet
15576 Formation of direct or tubed pedicle, with or 1729 2417 3532 826 22.95 without transfer; eyelids, nose, ears, lips, or intraoral
15600 Delay of flap or sectioning of flap (division and 940 1314 1919 332 9.22 inset); at trunk
15610 Delay of flap or sectioning of flap (division and 985 1376 2011 365 10.14 inset); at scalp, arms, or legs
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15620 Delay of flap or sectioning of flap (division and 1200 1678 2451 447 12.42 inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet
15630 Delay of flap or sectioning of flap (division and 1118 1563 2284 469 13.04 inset); at eyelids, nose, ears, or lips
15650 Transfer, intermediate, of any pedicle flap (eg, 1283 1794 2621 516 14.34 abdomen to wrist, walking tube), any location
15730 Midface flap (ie, zygomaticofacial flap) with 3959 5534 8086 1593 44.24 preservation of vascular pedicle(s)
15731 Forehead flap with preservation of vascular 2855 3991 5831 1151 31.96 pedicle (eg, axial pattern flap, paramedian forehead flap)
15733 Muscle, myocutaneous, or fasciocutaneous flap; 2700 3774 5515 1086 30.17 head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)
15734 Muscle, myocutaneous, or fasciocutaneous flap; 4212 5888 8603 1568 43.56 trunk
15736 Muscle, myocutaneous, or fasciocutaneous flap; 4155 5808 8486 1275 35.42 upper extremity
15738 Muscle, myocutaneous, or fasciocutaneous flap; 3597 5028 7346 1371 38.08 lower extremity
15740 Flap; island pedicle requiring identification and 2722 3804 5559 1042 28.95 dissection of an anatomically named axial vessel
15750 Flap; neurovascular pedicle 2878 4023 5878 946 26.28
15756 Free muscle or myocutaneous flap with 8238 11514 16824 2384 66.23 microvascular anastomosis
15757 Free skin flap with microvascular anastomosis 8860 12384 18094 2344 65.12
15758 Free fascial flap with microvascular 8389 11726 17133 2368 65.77 anastomosis
15760 Graft; composite (eg, full thickness of external 2249 3144 4593 873 24.25 ear or nasal ala), including primary closure, donor area
15770 Graft; derma-fat-fascia 1857 2596 3793 686 19.05
15775 Punch graft for hair transplant; 1 to 15 punch 773 1081 1579 311 8.64 grafts
15776 Punch graft for hair transplant; more than 15 1235 1726 2522 497 13.80 punch grafts
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15777 Implantation of biologic implant (eg, acellular 685 957 1398 225 6.25 dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (list separately in addition to code for primary procedure)
15780 Dermabrasion; total face (eg, for acne scarring, 1808 2945 4783 963 26.75 fine wrinkling, rhytids, general keratosis)
15781 Dermabrasion; segmental, face 1010 1645 2672 571 15.85
15782 Dermabrasion; regional, other than face 1142 1861 3022 621 17.25
15783 Dermabrasion; superficial, any site (eg, tattoo 1426 2323 3772 499 13.86 removal)
15786 Abrasion; single lesion (eg, keratosis, scar) 559 911 1479 256 7.11
15787 Abrasion; each additional 4 lesions or less (list 146 238 386 51 1.42 separately in addition to code for primary procedure)
15788 Chemical peel, facial; epidermal 568 926 1503 475 13.19
15789 Chemical peel, facial; dermal 1621 2641 4288 573 15.91
15792 Chemical peel, nonfacial; epidermal 580 945 1535 450 12.49
15793 Chemical peel, nonfacial; dermal 912 1486 2413 507 14.08
15819 Cervicoplasty 2338 3809 6187 818 22.73
15820 Blepharoplasty, lower eyelid; 2139 3484 5659 573 15.93
15821 Blepharoplasty, lower eyelid; with extensive 2284 3721 6043 625 17.37 herniated fat pad
15822 Blepharoplasty, upper eyelid; 2875 4685 7608 459 12.74
15823 Blepharoplasty, upper eyelid; with excessive 1975 3218 5226 625 17.37 skin weighting down lid
15824 Rhytidectomy; forehead 0 0 0 0 0.00
15825 Rhytidectomy; neck with platysmal tightening 0 0 0 0 0.00 (platysmal flap, p-flap)
15826 Rhytidectomy; glabellar frown lines 0 0 0 0 0.00
15828 Rhytidectomy; cheek, chin, and neck 0 0 0 0 0.00
15829 Rhytidectomy; superficial musculoaponeurotic 0 0 0 0 0.00 system (SMAS) flap
15830 Excision, excessive skin and subcutaneous 3452 5625 9134 1216 33.79 tissue (includes lipectomy); abdomen, infraumbilical panniculectomy
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15832 Excision, excessive skin and subcutaneous 2854 4651 7553 943 26.19 tissue (includes lipectomy); thigh
15833 Excision, excessive skin and subcutaneous 2574 4193 6810 901 25.02 tissue (includes lipectomy); leg
15834 Excision, excessive skin and subcutaneous 2622 4272 6938 918 25.49 tissue (includes lipectomy); hip
15835 Excision, excessive skin and subcutaneous 2769 4512 7327 969 26.92 tissue (includes lipectomy); buttock
15836 Excision, excessive skin and subcutaneous 2331 3798 6168 816 22.66 tissue (includes lipectomy); arm
15837 Excision, excessive skin and subcutaneous 2542 4141 6725 890 24.71 tissue (includes lipectomy); forearm or hand
15838 Excision, excessive skin and subcutaneous 1882 3067 4981 659 18.30 tissue (includes lipectomy); submental fat pad
15839 Excision, excessive skin and subcutaneous 2088 3403 5526 906 25.16 tissue (includes lipectomy); other area
15840 Graft for facial nerve paralysis; free fascia graft 3206 5223 8482 1032 28.66 (including obtaining fascia)
15841 Graft for facial nerve paralysis; free muscle 5269 8586 13944 1844 51.23 graft (including obtaining graft)
15842 Graft for facial nerve paralysis; free muscle flap 8033 13089 21257 2812 78.10 by microsurgical technique
15845 Graft for facial nerve paralysis; regional muscle 2954 4813 7817 1034 28.72 transfer
15847 Excision, excessive skin and subcutaneous 1760 2868 4657 0 0.00 tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (list separately in addition to code for primary procedure)
15850 Removal of sutures under anesthesia (other than 123 201 326 91 2.54 local), same surgeon
15851 Removal of sutures under anesthesia (other than 150 244 397 102 2.83 local), other surgeon
15852 Dressing change (for other than burns) under 145 236 383 48 1.34 anesthesia (other than local)
15860 Intravenous injection of agent (eg, fluorescein) 340 555 901 112 3.12 to test vascular flow in flap or graft
15876 Suction assisted lipectomy; head and neck 0 0 0 0 0.00
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15877 Suction assisted lipectomy; trunk 3000 4889 7940 0 0.00
15878 Suction assisted lipectomy; upper extremity 0 0 0 0 0.00
15879 Suction assisted lipectomy; lower extremity 0 0 0 0 0.00
15920 Excision, coccygeal pressure ulcer, with 1394 1843 2498 626 17.40 coccygectomy; with primary suture
15922 Excision, coccygeal pressure ulcer, with 1796 2375 3219 807 22.42 coccygectomy; with flap closure
15931 Excision, sacral pressure ulcer, with primary 1540 2037 2760 712 19.79 suture;
15933 Excision, sacral pressure ulcer, with primary 1945 2572 3486 874 24.28 suture; with ostectomy
15934 Excision, sacral pressure ulcer, with skin flap 2153 2847 3859 968 26.88 closure;
15935 Excision, sacral pressure ulcer, with skin flap 2509 3318 4498 1128 31.33 closure; with ostectomy
15936 Excision, sacral pressure ulcer, in preparation 2080 2750 3728 920 25.55 for muscle or myocutaneous flap or skin graft closure;
15937 Excision, sacral pressure ulcer, in preparation 2210 2922 3961 1068 29.66 for muscle or myocutaneous flap or skin graft closure; with ostectomy
15940 Excision, ischial pressure ulcer, with primary 1638 2167 2937 721 20.02 suture;
15941 Excision, ischial pressure ulcer, with primary 2071 2739 3713 931 25.86 suture; with ostectomy (ischiectomy)
15944 Excision, ischial pressure ulcer, with skin flap 2040 2698 3657 917 25.47 closure;
15945 Excision, ischial pressure ulcer, with skin flap 2262 2992 4056 1017 28.25 closure; with ostectomy
15946 Excision, ischial pressure ulcer, with ostectomy, 3536 4676 6338 1689 46.91 in preparation for muscle or myocutaneous flap or skin graft closure
15950 Excision, trochanteric pressure ulcer, with 1365 1806 2448 614 17.05 primary suture;
15951 Excision, trochanteric pressure ulcer, with 2018 2669 3618 907 25.20 primary suture; with ostectomy
15952 Excision, trochanteric pressure ulcer, with skin 2077 2748 3724 934 25.94 flap closure;
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
15953 Excision, trochanteric pressure ulcer, with skin 2286 3023 4097 1027 28.54 flap closure; with ostectomy
15956 Excision, trochanteric pressure ulcer, in 2579 3411 4624 1191 33.07 preparation for muscle or myocutaneous flap or skin graft closure;
15958 Excision, trochanteric pressure ulcer, in 2071 2740 3713 1217 33.81 preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy
15999 Unlisted procedure, excision pressure ulcer 0 0 0 0 0.00
16000 Initial treatment, first degree burn, when no 172 228 308 71 1.96 more than local treatment is required
16020 Dressings and/or debridement of partial- 188 249 338 85 2.35 thickness burns, initial or subsequent; small (less than 5% total body surface area)
16025 Dressings and/or debridement of partial- 319 422 572 152 4.22 thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)
16030 Dressings and/or debridement of partial- 435 576 780 192 5.34 thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)
16035 Escharotomy; initial incision 375 496 672 202 5.61
16036 Escharotomy; each additional incision (list 156 206 280 85 2.36 separately in addition to code for primary procedure)
DESTRUCTION
17000 Destruction (eg, laser surgery, electrosurgery, 120 163 226 68 1.88 cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion
17003 Destruction (eg, laser surgery, electrosurgery, 19 25 35 5 0.15 cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)
17004 Destruction (eg, laser surgery, electrosurgery, 291 395 547 148 4.11 cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
17106 Destruction of cutaneous vascular proliferative 784 1063 1473 353 9.81 lesions (eg, laser technique); less than 10 sq cm
17107 Destruction of cutaneous vascular proliferative 1214 1646 2281 451 12.52 lesions (eg, laser technique); 10.0 to 50.0 sq cm
17108 Destruction of cutaneous vascular proliferative 1777 2409 3339 663 18.42 lesions (eg, laser technique); over 50.0 sq cm
17110 Destruction (eg, laser surgery, electrosurgery, 177 240 333 114 3.18 cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions
17111 Destruction (eg, laser surgery, electrosurgery, 232 315 436 135 3.76 cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions
17250 Chemical cauterization of granulation tissue (ie, 115 156 217 82 2.29 proud flesh)
17260 Destruction, malignant lesion (eg, laser surgery, 167 226 313 98 2.72 electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5 cm or less
17261 Destruction, malignant lesion (eg, laser surgery, 218 295 409 148 4.11 electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm
17262 Destruction, malignant lesion (eg, laser surgery, 265 359 498 180 5.00 electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm
17263 Destruction, malignant lesion (eg, laser surgery, 302 409 567 196 5.45 electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm
17264 Destruction, malignant lesion (eg, laser surgery, 345 468 649 211 5.85 electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm
17266 Destruction, malignant lesion (eg, laser surgery, 393 532 737 238 6.61 electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over 4.0 cm
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17270 Destruction, malignant lesion (eg, laser surgery, 224 304 422 155 4.31 electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less
17271 Destruction, malignant lesion (eg, laser surgery, 245 332 460 168 4.66 electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm
17272 Destruction, malignant lesion (eg, laser surgery, 283 383 531 192 5.32 electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm
17273 Destruction, malignant lesion (eg, laser surgery, 319 432 599 213 5.91 electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm
17274 Destruction, malignant lesion (eg, laser surgery, 383 519 720 252 6.99 electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm
17276 Destruction, malignant lesion (eg, laser surgery, 476 645 893 291 8.09 electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm
17280 Destruction, malignant lesion (eg, laser surgery, 220 298 413 145 4.03 electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less
17281 Destruction, malignant lesion (eg, laser surgery, 260 353 489 183 5.08 electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm
17282 Destruction, malignant lesion (eg, laser surgery, 312 424 587 210 5.82 electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm
17283 Destruction, malignant lesion (eg, laser surgery, 385 521 723 251 6.97 electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm
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17284 Destruction, malignant lesion (eg, laser surgery, 419 568 787 287 7.98 electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm
17286 Destruction, malignant lesion (eg, laser surgery, 516 699 969 366 10.18 electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 4.0 cm
17311 Mohs micrographic technique, including 1108 1502 2082 678 18.82 removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks
17312 Mohs micrographic technique, including 652 884 1225 399 11.07 removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; each additional stage after the first stage, up to 5 tissue blocks (list separately in addition to code for primary procedure)
17313 Mohs micrographic technique, including 1019 1382 1915 634 17.60 removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs; first stage, up to 5 tissue blocks
17314 Mohs micrographic technique, including 615 834 1156 381 10.57 removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg,
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hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs; each additional stage after the first stage, up to 5 tissue blocks (list separately in addition to code for primary procedure)
17315 Mohs micrographic technique, including 153 207 287 82 2.28 removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), each additional block after the first 5 tissue blocks, any stage (list separately in addition to code for primary procedure)
17340 Cryotherapy (co2 slush, liquid n2) for acne 100 136 188 54 1.50
17360 Chemical exfoliation for acne (eg, acne paste, 220 298 413 131 3.65 acid)
17380 Electrolysis epilation, each 30 minutes 0 0 0 0 0.00
17999 Unlisted procedure, skin, mucous membrane 0 0 0 0 0.00 and subcutaneous tissue
BREAST
19000 Puncture aspiration of cyst of breast; 221 307 394 115 3.20
19001 Puncture aspiration of cyst of breast; each 87 122 156 28 0.77 additional cyst (list separately in addition to code for primary procedure)
19020 Mastotomy with exploration or drainage of 953 1327 1700 488 13.56 abscess, deep
19030 Injection procedure only for mammary 308 429 550 168 4.68 ductogram or galactogram
19081 Biopsy, breast, with placement of breast 1173 1735 2447 707 19.63 localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance
19082 Biopsy, breast, with placement of breast 641 949 1338 584 16.21 localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
19083 Biopsy, breast, with placement of breast 1224 1811 2555 687 19.09 localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance
19084 Biopsy, breast, with placement of breast 869 1286 1813 560 15.56 localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)
19085 Biopsy, breast, with placement of breast 1665 2463 3474 1027 28.52 localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance
19086 Biopsy, breast, with placement of breast 846 1252 1766 832 23.11 localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)
19100 Biopsy of breast; percutaneous, needle core, not 342 505 713 154 4.29 using imaging guidance (separate procedure)
19101 Biopsy of breast; open, incisional 780 1154 1628 351 9.74
19105 Ablation, cryosurgical, of fibroadenoma, 5124 7581 10693 3031 84.20 including ultrasound guidance, each fibroadenoma
19110 Nipple exploration, with or without excision of 1038 1536 2166 501 13.93 a solitary lactiferous duct or a papilloma lactiferous duct
19112 Excision of lactiferous duct fistula 1200 1776 2505 474 13.16
19120 Excision of cyst, fibroadenoma, or other benign 1156 1710 2412 510 14.16 or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions
19125 Excision of breast lesion identified by 1300 1924 2714 564 15.68 preoperative placement of radiological marker, open; single lesion
19126 Excision of breast lesion identified by 496 734 1035 168 4.67 preoperative placement of radiological marker, open; each additional lesion separately
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
identified by a preoperative radiological marker (list separately in addition to code for primary procedure)
19260 Excision of chest wall tumor including ribs 3018 4466 6299 1248 34.67
19271 Excision of chest wall tumor involving ribs, 3230 4780 6741 1684 46.77 with plastic reconstruction; without mediastinal lymphadenectomy
19272 Excision of chest wall tumor involving ribs, 3526 5217 7358 1838 51.05 with plastic reconstruction; with mediastinal lymphadenectomy
19281 Placement of breast localization device(s) (eg, 399 591 833 246 6.83 clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance
19282 Placement of breast localization device(s) (eg, 215 318 449 171 4.74 clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (list separately in addition to code for primary procedure)
19283 Placement of breast localization device(s) (eg, 447 662 933 278 7.72 clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance
19284 Placement of breast localization device(s) (eg, 277 409 577 209 5.81 clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)
19285 Placement of breast localization device(s) (eg, 576 852 1202 530 14.73 clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance
19286 Placement of breast localization device(s) (eg, 506 748 1055 464 12.89 clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)
19287 Placement of breast localization device(s) (eg 1183 1750 2468 879 24.43 clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance
19288 Placement of breast localization device(s) (eg 1363 2017 2845 711 19.74 clip, metallic pellet, wire/needle, radioactive
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
seeds), percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)
19294 Preparation of tumor cavity, with placement of a 326 482 680 170 4.72 radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (list separately in addition to code for primary procedure)
19296 Placement of radiotherapy afterloading 9802 14503 20455 4074 113.16 expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy
19297 Placement of radiotherapy afterloading 250 370 521 99 2.74 expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; concurrent with partial mastectomy (list separately in addition to code for primary procedure)
19298 Placement of radiotherapy after loading 1966 2909 4103 1025 28.47 brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance
19300 Mastectomy for gynecomastia 1384 2048 2889 542 15.05
19301 Mastectomy, partial (eg, lumpectomy, 1612 2385 3364 676 18.77 tylectomy, quadrantectomy, segmentectomy);
19302 Mastectomy, partial (eg, lumpectomy, 2351 3478 4906 932 25.88 tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy
19303 Mastectomy, simple, complete 2364 3499 4935 995 27.63
19304 Mastectomy, subcutaneous 1506 2229 3144 598 16.60
19305 Mastectomy, radical, including pectoral 2891 4278 6034 1171 32.53 muscles, axillary lymph nodes
19306 Mastectomy, radical, including pectoral 2388 3533 4983 1245 34.57 muscles, axillary and internal mammary lymph nodes (urban type operation)
19307 Mastectomy, modified radical, including 2963 4384 6183 1241 34.46 axillary lymph nodes, with or without pectoralis
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
minor muscle, but excluding pectoralis major muscle
19316 Mastopexy 2579 4275 6823 796 22.12
19318 Reduction mammaplasty 3606 5978 9540 1140 31.66
19324 Mammaplasty, augmentation; without prosthetic 1671 2770 4420 548 15.23 implant
19325 Mammaplasty, augmentation; with prosthetic 2250 3730 5953 664 18.44 implant
19328 Removal of intact mammary implant 1398 2318 3699 513 14.24
19330 Removal of mammary implant material 1805 2993 4776 656 18.22
19340 Immediate insertion of breast prosthesis 2855 4733 7552 1037 28.81 following mastopexy, mastectomy or in reconstruction
19342 Delayed insertion of breast prosthesis following 2656 4402 7025 954 26.51 mastopexy, mastectomy or in reconstruction
19350 Nipple/areola reconstruction 2566 4254 6789 849 23.57
19355 Correction of inverted nipples 2364 3919 6254 776 21.55
19357 Breast reconstruction, immediate or delayed, 4202 6966 11117 1558 43.27 with tissue expander, including subsequent expansion
19361 Breast reconstruction with latissimus dorsi flap, 5001 8290 13229 1632 45.32 without prosthetic implant
19364 Breast reconstruction with free flap 15460 25628 40897 2858 79.39
19366 Breast reconstruction with other technique 4934 8178 13051 1464 40.66
19367 Breast reconstruction with transverse rectus 5585 9259 14775 1858 51.60 abdominis myocutaneous flap (tram), single pedicle, including closure of donor site;
19368 Breast reconstruction with transverse rectus 6952 11524 18390 2281 63.37 abdominis myocutaneous flap (tram), single pedicle, including closure of donor site; with microvascular anastomosis (supercharging)
19369 Breast reconstruction with transverse rectus 6451 10694 17066 2117 58.81 abdominis myocutaneous flap (tram), double pedicle, including closure of donor site
19370 Open periprosthetic capsulotomy, breast 1938 3212 5126 710 19.72
19371 Periprosthetic capsulectomy, breast 2726 4518 7210 811 22.52
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
19380 Revision of reconstructed breast 2711 4494 7172 800 22.23
19396 Preparation of moulage for custom breast 914 1515 2417 300 8.33 implant
19499 Unlisted procedure, breast 0 0 0 0 0.00
90 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
MUSCULOSKELETAL SYSTEM GENERAL
20005 Incision and drainage of soft tissue abscess, 651 870 1185 324 8.99 subfascial (ie, involves the soft tissue below the deep fascia)
20100 Exploration of penetrating wound (separate 1769 2363 3218 629 17.46 procedure); neck
20101 Exploration of penetrating wound (separate 936 1250 1703 465 12.91 procedure); chest
20102 Exploration of penetrating wound (separate 965 1289 1756 504 14.00 procedure); abdomen/flank/back
20103 Exploration of penetrating wound (separate 1514 2023 2755 602 16.72 procedure); extremity
20150 Excision of epiphyseal bar, with or without 2912 3890 5298 1048 29.12 autogenous soft tissue graft obtained through same fascial incision
20200 Biopsy, muscle; superficial 430 574 782 212 5.89
20205 Biopsy, muscle; deep 654 874 1190 298 8.27
20206 Biopsy, muscle, percutaneous needle 280 375 510 241 6.70
20220 Biopsy, bone, trocar, or needle; superficial (eg, 347 464 632 172 4.77 ilium, sternum, spinous process, ribs)
20225 Biopsy, bone, trocar, or needle; deep (eg, 617 825 1123 532 14.77 vertebral body, femur)
20240 Biopsy, bone, open; superficial (eg, sternum, 559 747 1017 158 4.38 spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)
20245 Biopsy, bone, open; deep (eg, humeral shaft, 1423 1901 2588 366 10.17 ischium, femoral shaft)
20250 Biopsy, vertebral body, open; thoracic 1272 1699 2314 403 11.20
20251 Biopsy, vertebral body, open; lumbar or 1695 2265 3084 442 12.27 cervical
20500 Injection of sinus tract; therapeutic (separate 253 337 460 108 3.00 procedure)
20501 Injection of sinus tract; diagnostic (sinogram) 160 213 290 121 3.35
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
20520 Removal of foreign body in muscle or tendon 416 556 757 211 5.85 sheath; simple
20525 Removal of foreign body in muscle or tendon 1078 1440 1962 493 13.69 sheath; deep or complicated
20526 Injection, therapeutic (eg, local anesthetic, 197 264 359 80 2.21 corticosteroid), carpal tunnel
20527 Injection, enzyme (eg, collagenase), palmar 219 293 399 87 2.41 fascial cord (ie, Dupuytren's contracture)
20550 Injection(s); single tendon sheath, or ligament, 135 180 245 54 1.51 aponeurosis (eg, plantar "fascia")
20551 Injection(s); single tendon origin/insertion 150 200 273 62 1.73
20552 Injection(s); single or multiple trigger point(s), 140 187 254 57 1.57 1 or 2 muscle(s)
20553 Injection(s); single or multiple trigger point(s), 175 234 318 65 1.81 3 or more muscles
20555 Placement of needles or catheters into muscle 402 537 731 338 9.39 and/or soft tissue for subsequent interstitial radioelement application (at the time of or subsequent to the procedure)
20600 Arthrocentesis, aspiration and/or injection, 120 160 218 49 1.37 small joint or bursa (eg, fingers, toes); without ultrasound guidance
20604 Arthrocentesis, aspiration and/or injection, 210 281 382 74 2.05 small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting
20605 Arthrocentesis, aspiration and/or injection, 137 183 250 52 1.44 intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance
20606 Arthrocentesis, aspiration and/or injection, 227 303 413 82 2.28 intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting
20610 Arthrocentesis, aspiration and/or injection, 181 242 329 62 1.72 major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance
92 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
20611 Arthrocentesis, aspiration and/or injection, 287 383 522 93 2.58 major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting
20612 Aspiration and/or injection of ganglion cyst(s) 150 200 273 62 1.72 any location
20615 Aspiration and injection for treatment of bone 528 706 961 247 6.87 cyst
20650 Insertion of wire or pin with application of 417 557 759 218 6.05 skeletal traction, including removal (separate procedure)
20660 Application of cranial tongs, caliper, or 828 1107 1507 256 7.12 stereotactic frame, including removal (separate procedure)
20661 Application of halo, including removal; cranial 1547 2067 2814 522 14.49
20662 Application of halo, including removal; pelvic 1416 1892 2576 530 14.72
20663 Application of halo, including removal; femoral 1350 1804 2456 486 13.50
20664 Application of halo, including removal, cranial, 2526 3375 4596 909 25.26 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)
20665 Removal of tongs or halo applied by another 334 446 608 111 3.07 individual
20670 Removal of implant; superficial (eg, buried 903 1206 1642 389 10.81 wire, pin or rod) (separate procedure)
20680 Removal of implant; deep (eg, buried wire, pin, 1437 1920 2614 636 17.68 screw, metal band, nail, rod or plate)
20690 Application of a uniplane (pins or wires in 1 1551 2072 2822 617 17.15 plane), unilateral, external fixation system
20692 Application of a multiplane (pins or wires in 2686 3588 4887 1158 32.18 more than 1 plane), unilateral, external fixation system (eg, Ilizarov, Monticelli type)
20693 Adjustment or revision of external fixation 1350 1803 2456 459 12.75 system requiring anesthesia (eg, new pin[s] or wire[s] and/or new ring[s] or bar[s])
20694 Removal, under anesthesia, of external fixation 1110 1483 2020 439 12.19 system
20696 Application of multiplane (pins or wires in 3176 4243 5779 1248 34.68 more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
(eg, spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s)
20697 Application of multiplane (pins or wires in 5319 7105 9676 2176 60.45 more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each
20802 Replantation, arm (includes surgical neck of 7968 10644 14496 2868 79.67 humerus through elbow joint), complete amputation
20805 Replantation, forearm (includes radius and ulna 9489 12676 17263 3416 94.88 to radial carpal joint), complete amputation
20808 Replantation, hand (includes hand through 11470 15322 20868 4129 114.69 metacarpophalangeal joints), complete amputation
20816 Replantation, digit, excluding thumb (includes 5972 7977 10864 2150 59.71 metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation
20822 Replantation, digit, excluding thumb (includes 5130 6852 9332 1846 51.29 distal tip to sublimis tendon insertion), complete amputation
20824 Replantation, thumb (includes carpometacarpal 5982 7990 10882 2153 59.81 joint to mp joint), complete amputation
20827 Replantation, thumb (includes distal tip to mp 5267 7035 9581 1896 52.66 joint), complete amputation
20838 Replantation, foot, complete amputation 7540 10073 13718 2632 73.11
20900 Bone graft, any donor area; minor or small (eg, 1049 1402 1909 428 11.89 dowel or button)
20902 Bone graft, any donor area; major or large 1298 1733 2361 297 8.24
20910 Cartilage graft; costochondral 1579 2109 2872 484 13.44
20912 Cartilage graft; nasal septum 1419 1896 2582 487 13.52
20920 Fascia lata graft; by stripper 1135 1516 2065 409 11.35
20922 Fascia lata graft; by incision and area exposure, 1622 2166 2950 609 16.92 complex or sheet
20924 Tendon graft, from a distance (eg, palmaris, toe 1402 1873 2551 525 14.58 extensor, plantaris)
20926 Tissue grafts, other (eg, paratenon, fat, dermis) 1300 1736 2365 437 12.13
94 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
20930 Allograft, morselized, or placement of 525 701 955 0 0.00 osteopromotive material, for spine surgery only (list separately in addition to code for primary procedure)
20931 Allograft, structural, for spine surgery only (list 483 645 879 118 3.27 separately in addition to code for primary procedure)
20936 Autograft for spine surgery only (includes 659 880 1199 0 0.00 harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (list separately in addition to code for primary procedure)
20937 Autograft for spine surgery only (includes 594 794 1081 176 4.90 harvesting the graft); morselized (through separate skin or fascial incision) (list separately in addition to code for primary procedure)
20938 Autograft for spine surgery only (includes 900 1203 1638 194 5.40 harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (list separately in addition to code for primary procedure)
20939 Bone marrow aspiration for bone grafting, 194 259 353 70 1.94 spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)
20950 Monitoring of interstitial fluid pressure 600 802 1092 256 7.12 (includes insertion of device, eg, wick catheter technique, needle manometer technique) in detection of muscle compartment syndrome
20955 Bone graft with microvascular anastomosis; 7141 9539 12991 2570 71.40 fibula
20956 Bone graft with microvascular anastomosis; 7663 10236 13941 2758 76.62 iliac crest
20957 Bone graft with microvascular anastomosis; 7438 9936 13532 2868 79.66 metatarsal
20962 Bone graft with microvascular anastomosis; 7043 9408 12813 2776 77.10 other than fibula, iliac crest, or metatarsal
20969 Free osteocutaneous flap with microvascular 8914 11908 16218 2841 78.93 anastomosis; other than iliac crest, metatarsal, or great toe
20970 Free osteocutaneous flap with microvascular 8288 11071 15078 2983 82.87 anastomosis; iliac crest
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
20972 Free osteocutaneous flap with microvascular 7903 10557 14377 2978 82.72 anastomosis; metatarsal
20973 Free osteocutaneous flap with microvascular 8104 10825 14743 3143 87.32 anastomosis; great toe with web space
20974 Electrical stimulation to aid bone healing; 406 543 739 79 2.20 noninvasive (nonoperative)
20975 Electrical stimulation to aid bone healing; 1053 1406 1915 186 5.17 invasive (operative)
20979 Low intensity ultrasound stimulation to aid 279 373 508 53 1.47 bone healing, noninvasive (nonoperative)
20982 Ablation therapy for reduction or eradication of 4396 5872 7997 4009 111.35 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency
20983 Ablation therapy for reduction or eradication of 17325 23142 31518 6143 170.65 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; cryoablation
20985 Computer-assisted surgical navigational 510 681 928 153 4.26 procedure for musculoskeletal procedures, image-less (list separately in addition to code for primary procedure)
20999 Unlisted procedure, musculoskeletal system, 0 0 0 0 0.00 general
HEAD
21010 Arthrotomy, temporomandibular joint 1974 2863 4489 790 21.95
21011 Excision, tumor, soft tissue of face or scalp, 771 1118 1753 357 9.91 subcutaneous; less than 2 cm
21012 Excision, tumor, soft tissue of face or scalp, 908 1317 2065 351 9.76 subcutaneous; 2 cm or greater
21013 Excision, tumor, soft tissue of face and scalp, 1273 1847 2896 534 14.84 subfascial (eg, subgaleal, intramuscular); less than 2 cm
21014 Excision, tumor, soft tissue of face and scalp, 1398 2028 3180 541 15.03 subfascial (eg, subgaleal, intramuscular); 2 cm or greater
96 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
21015 Radical resection of tumor (eg, sarcoma), soft 1574 2282 3579 733 20.35 tissue of face or scalp; less than 2 cm
21016 Radical resection of tumor (eg, sarcoma), soft 2600 3771 5913 1050 29.16 tissue of face or scalp; 2 cm or greater
21025 Excision of bone (eg, for osteomyelitis or bone 2351 3409 5345 915 25.43 abscess); mandible
21026 Excision of bone (eg, for osteomyelitis or bone 1799 2610 4092 634 17.61 abscess); facial bone(s)
21029 Removal by contouring of benign tumor of 2180 3162 4958 795 22.08 facial bone (eg, fibrous dysplasia)
21030 Excision of benign tumor or cyst of maxilla or 1075 1559 2445 535 14.86 zygoma by enucleation and curettage
21031 Excision of torus mandibularis 861 1248 1957 410 11.40
21032 Excision of maxillary torus palatinus 970 1407 2206 414 11.49
21034 Excision of malignant tumor of maxilla or 3357 4869 7634 1344 37.33 zygoma
21040 Excision of benign tumor or cyst of mandible, 1090 1581 2479 539 14.96 by enucleation and/or curettage
21044 Excision of malignant tumor of mandible; 2245 3255 5105 899 24.96
21045 Excision of malignant tumor of mandible; 4000 5801 9097 1262 35.06 radical resection
21046 Excision of benign tumor or cyst of mandible; 3547 5143 8065 1155 32.07 requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])
21047 Excision of benign tumor or cyst of mandible; 3830 5555 8710 1356 37.67 requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])
21048 Excision of benign tumor or cyst of maxilla; 3364 4879 7650 1177 32.69 requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])
21049 Excision of benign tumor or cyst of maxilla; 3087 4477 7021 1236 34.33 requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesion[s])
21050 Condylectomy, temporomandibular joint 2333 3383 5305 934 25.94 (separate procedure)
21060 Meniscectomy, partial or complete, 2121 3075 4822 849 23.58 temporomandibular joint (separate procedure)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
21070 Coronoidectomy (separate procedure) 1663 2411 3781 666 18.49
21073 Manipulation of temporomandibular joint(s) 829 1203 1886 397 11.03 (tmj), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)
21076 Impression and custom preparation; surgical 2274 3297 5170 1017 28.26 obturator prosthesis
21077 Impression and custom preparation; orbital 6397 9277 14547 2561 71.13 prosthesis
21079 Impression and custom preparation; interim 2763 4007 6283 1728 48.00 obturator prosthesis
21080 Impression and custom preparation; definitive 6001 8702 13646 1946 54.05 obturator prosthesis
21081 Impression and custom preparation; mandibular 3543 5138 8057 1790 49.71 resection prosthesis
21082 Impression and custom preparation; palatal 4210 6106 9575 1686 46.82 augmentation prosthesis
21083 Impression and custom preparation; palatal lift 4013 5819 9125 1606 44.62 prosthesis
21084 Impression and custom preparation; speech aid 4603 6676 10469 1843 51.19 prosthesis
21085 Impression and custom preparation; oral 1539 2232 3501 774 21.50 surgical splint
21086 Impression and custom preparation; auricular 5926 8594 13476 1900 52.77 prosthesis
21087 Impression and custom preparation; nasal 4753 6893 10808 1903 52.85 prosthesis
21088 Impression and custom preparation; facial 8549 12399 19442 0 0.00 prosthesis
21089 Unlisted maxillofacial prosthetic procedure 0 0 0 0 0.00
21100 Application of halo type appliance for 2056 2982 4677 744 20.66 maxillofacial fixation, includes removal (separate procedure)
21110 Application of interdental fixation device for 1475 2139 3355 822 22.84 conditions other than fracture or dislocation, includes removal
21116 Injection procedure for temporomandibular 421 610 957 168 4.68 joint arthrography
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
21120 Genioplasty; augmentation (autograft, allograft, 1733 2513 3941 708 19.68 prosthetic material)
21121 Genioplasty; sliding osteotomy, single piece 2786 4041 6336 793 22.02
21122 Genioplasty; sliding osteotomies, 2 or more 1913 2774 4351 823 22.85 osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)
21123 Genioplasty; sliding, augmentation with 2379 3450 5409 952 26.45 interpositional bone grafts (includes obtaining autografts)
21125 Augmentation, mandibular body or angle; 7874 11419 17906 3039 84.42 prosthetic material
21127 Augmentation, mandibular body or angle; with 10775 15627 24504 3888 107.99 bone graft, onlay or interpositional (includes obtaining autograft)
21137 Reduction forehead; contouring only 1948 2825 4430 780 21.66
21138 Reduction forehead; contouring and application 2380 3452 5413 953 26.47 of prosthetic material or bone graft (includes obtaining autograft)
21139 Reduction forehead; contouring and setback of 2917 4231 6634 1168 32.44 anterior frontal sinus wall
21141 Reconstruction midface, LeFort I; single piece, 6238 9046 14185 1412 39.21 segment movement in any direction (eg, for long face syndrome), without bone graft
21142 Reconstruction midface, LeFort I; 2 pieces, 5445 7896 12382 1451 40.31 segment movement in any direction, without bone graft
21143 Reconstruction midface, LeFort I; 3 or more 4881 7078 11099 1523 42.30 pieces, segment movement in any direction, without bone graft
21145 Reconstruction midface, LeFort I; single piece, 7400 10731 16828 1657 46.02 segment movement in any direction, requiring bone grafts (includes obtaining autografts)
21146 Reconstruction midface, LeFort I; 2 pieces, 4850 7034 11030 1727 47.98 segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)
21147 Reconstruction midface, LeFort I; 3 or more 8003 11607 18201 1821 50.58 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)
CPT copyright 2017 American Medical Association. 99 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
21150 Reconstruction midface, LeFort II; anterior 4314 6257 9811 1712 47.56 intrusion (eg, (No Suggestions) syndrome)
21151 Reconstruction midface, LeFort II; any 5001 7252 11373 1834 50.95 direction, requiring bone grafts (includes obtaining autografts)
21154 Reconstruction midface, LeFort III 5060 7339 11508 2026 56.27 (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I
21155 Reconstruction midface, LeFort III 5612 8139 12763 2247 62.41 (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I
21159 Reconstruction midface, LeFort III (extra and 6725 9753 15293 2692 74.78 intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I
21160 Reconstruction midface, LeFort III (extra and 7292 10576 16584 2919 81.09 intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with LeFort I
21172 Reconstruction superior-lateral orbital rim and 5407 7842 12297 2165 60.13 lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)
21175 Reconstruction, bifrontal, superior-lateral 8008 11613 18211 2294 63.73 orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)
21179 Reconstruction, entire or majority of forehead 3935 5707 8949 1575 43.76 and/or supraorbital rims; with grafts (allograft or prosthetic material)
21180 Reconstruction, entire or majority of forehead 4409 6394 10027 1765 49.03 and/or supraorbital rims; with autograft (includes obtaining grafts)
21181 Reconstruction by contouring of benign tumor 1916 2779 4358 767 21.31 of cranial bones (eg, fibrous dysplasia), extracranial
21182 Reconstruction of orbital walls, rims, forehead, 5512 7993 12534 2206 61.29 nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
21183 Reconstruction of orbital walls, rims, forehead, 6006 8711 13659 2404 66.79 nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cm
21184 Reconstruction of orbital walls, rims, forehead, 6615 9593 15043 2589 71.93 nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm
21188 Reconstruction midface, osteotomies (other 4370 6337 9937 1749 48.59 than LeFort type) and bone grafts (includes obtaining autografts)
21193 Reconstruction of mandibular rami, horizontal, 4186 6071 9520 1326 36.82 vertical, c, or l osteotomy; without bone graft
21194 Reconstruction of mandibular rami, horizontal, 3792 5500 8624 1518 42.17 vertical, c, or l osteotomy; with bone graft (includes obtaining graft)
21195 Reconstruction of mandibular rami and/or 3717 5390 8452 1488 41.33 body, sagittal split; without internal rigid fixation
21196 Reconstruction of mandibular rami and/or 7372 10691 16764 1533 42.59 body, sagittal split; with internal rigid fixation
21198 Osteotomy, mandible, segmental; 4205 6099 9563 1210 33.61
21199 Osteotomy, mandible, segmental; with 2795 4053 6356 1119 31.08 genioglossus advancement
21206 Osteotomy, maxilla, segmental (eg, Wassmund 3104 4502 7060 1243 34.52 or Schuchard)
21208 Osteoplasty, facial bones; augmentation 4442 6442 10101 1823 50.63 (autograft, allograft, or prosthetic implant)
21209 Osteoplasty, facial bones; reduction 2282 3310 5190 914 25.38
21210 Graft, bone; nasal, maxillary or malar areas 3180 4612 7232 2297 63.80 (includes obtaining graft)
21215 Graft, bone; mandible (includes obtaining graft) 4032 5847 9169 4004 111.22
21230 Graft; rib cartilage, autogenous, to face, chin, 2515 3648 5720 766 21.28 nose or ear (includes obtaining graft)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
21235 Graft; ear cartilage, autogenous, to nose or ear 1993 2891 4533 743 20.63 (includes obtaining graft)
21240 Arthroplasty, temporomandibular joint, with or 3877 5622 8816 1161 32.24 without autograft (includes obtaining graft)
21242 Arthroplasty, temporomandibular joint, with 2690 3901 6117 1077 29.91 allograft
21243 Arthroplasty, temporomandibular joint, with 5518 8002 12548 1774 49.27 prosthetic joint replacement
21244 Reconstruction of mandible, extraoral, with 4049 5873 9209 1092 30.34 transosteal bone plate (eg, mandibular staple bone plate)
21245 Reconstruction of mandible or maxilla, 3109 4509 7070 1245 34.57 subperiosteal implant; partial
21246 Reconstruction of mandible or maxilla, 2283 3311 5192 914 25.39 subperiosteal implant; complete
21247 Reconstruction of mandibular condyle with 4247 6160 9659 1700 47.23 bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)
21248 Reconstruction of mandible or maxilla, 2271 3294 5165 1139 31.63 endosteal implant (eg, blade, cylinder); partial
21249 Reconstruction of mandible or maxilla, 2301 3336 5232 1606 44.62 endosteal implant (eg, blade, cylinder); complete
21255 Reconstruction of zygomatic arch and glenoid 3687 5347 8385 1476 41.00 fossa with bone and cartilage (includes obtaining autografts)
21256 Reconstruction of orbit with osteotomies 3226 4678 7336 1291 35.87 (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)
21260 Periorbital osteotomies for orbital 3623 5254 8239 1461 40.59 hypertelorism, with bone grafts; extracranial approach
21261 Periorbital osteotomies for orbital 6124 8881 13927 2584 71.77 hypertelorism, with bone grafts; combined intra- and extracranial approach
21263 Periorbital osteotomies for orbital 5656 8202 12862 2390 66.39 hypertelorism, with bone grafts; with forehead advancement
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21267 Orbital repositioning, periorbital osteotomies, 4273 6197 9718 1711 47.52 unilateral, with bone grafts; extracranial approach
21268 Orbital repositioning, periorbital osteotomies, 5054 7329 11492 2139 59.43 unilateral, with bone grafts; combined intra- and extracranial approach
21270 Malar augmentation, prosthetic material 2627 3810 5974 1052 29.21
21275 Secondary revision of orbitocraniofacial 2168 3144 4931 868 24.11 reconstruction
21280 Medial canthopexy (separate procedure) 1896 2750 4312 588 16.33
21282 Lateral canthopexy 2070 3002 4708 393 10.93
21295 Reduction of masseter muscle and bone (eg, for 478 693 1086 191 5.31 treatment of benign masseteric hypertrophy); extraoral approach
21296 Reduction of masseter muscle and bone (eg, for 1097 1591 2495 425 11.80 treatment of benign masseteric hypertrophy); intraoral approach
21299 Unlisted craniofacial and maxillofacial 0 0 0 0 0.00 procedure
21310 Closed treatment of nasal bone fracture without 227 358 606 139 3.87 manipulation
21315 Closed treatment of nasal bone fracture; 611 962 1629 280 7.78 without stabilization
21320 Closed treatment of nasal bone fracture; with 744 1173 1986 259 7.20 stabilization
21325 Open treatment of nasal fracture; 1403 2210 3744 482 13.38 uncomplicated
21330 Open treatment of nasal fracture; complicated, 1732 2728 4620 581 16.14 with internal and/or external skeletal fixation
21335 Open treatment of nasal fracture; with 2398 3778 6399 739 20.53 concomitant open treatment of fractured septum
21336 Open treatment of nasal septal fracture, with or 2000 3151 5337 659 18.31 without stabilization
21337 Closed treatment of nasal septal fracture, with 975 1536 2602 413 11.47 or without stabilization
21338 Open treatment of nasoethmoid fracture; 1797 2831 4795 676 18.77 without external fixation
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21339 Open treatment of nasoethmoid fracture; with 2025 3190 5403 768 21.32 external fixation
21340 Percutaneous treatment of nasoethmoid 1916 3018 5112 760 21.12 complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus
21343 Open treatment of depressed frontal sinus 2911 4586 7768 1102 30.61 fracture
21344 Open treatment of complicated (eg, 3386 5333 9034 1414 39.29 comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches
21345 Closed treatment of nasomaxillary complex 1921 3026 5125 790 21.95 fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint
21346 Open treatment of nasomaxillary complex 2197 3460 5861 918 25.49 fracture (LeFort II type); with wiring and/or local fixation
21347 Open treatment of nasomaxillary complex 2726 4294 7273 1032 28.67 fracture (LeFort II type); requiring multiple open approaches
21348 Open treatment of nasomaxillary complex 2881 4539 7688 1104 30.66 fracture (LeFort II type); with bone grafting (includes obtaining graft)
21355 Percutaneous treatment of fracture of malar 1072 1689 2860 433 12.03 area, including zygomatic arch and malar tripod, with manipulation
21356 Open treatment of depressed zygomatic arch 1507 2374 4021 515 14.30 fracture (eg, Gillies approach)
21360 Open treatment of depressed malar fracture, 1727 2720 4607 554 15.40 including zygomatic arch and malar tripod
21365 Open treatment of complicated (eg, 3513 5534 9374 1150 31.94 comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches
21366 Open treatment of complicated (eg, 3166 4987 8448 1323 36.74 comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft)
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21385 Open treatment of orbital floor blowout 1894 2984 5054 791 21.98 fracture; transantral approach (Caldwell-Luc type operation)
21386 Open treatment of orbital floor blowout 2218 3493 5917 722 20.06 fracture; periorbital approach
21387 Open treatment of orbital floor blowout 1975 3111 5270 825 22.92 fracture; combined approach
21390 Open treatment of orbital floor blowout 2678 4219 7146 822 22.84 fracture; periorbital approach, with alloplastic or other implant
21395 Open treatment of orbital floor blowout 2504 3945 6682 1046 29.06 fracture; periorbital approach with bone graft (includes obtaining graft)
21400 Closed treatment of fracture of orbit, except 475 748 1267 198 5.51 blowout; without manipulation
21401 Closed treatment of fracture of orbit, except 1280 2016 3414 535 14.85 blowout; with manipulation
21406 Open treatment of fracture of orbit, except 1423 2241 3796 594 16.51 blowout; without implant
21407 Open treatment of fracture of orbit, except 2699 4252 7203 664 18.45 blowout; with implant
21408 Open treatment of fracture of orbit, except 2235 3520 5962 933 25.93 blowout; with bone grafting (includes obtaining graft)
21421 Closed treatment of palatal or maxillary 2022 3185 5394 761 21.15 fracture (LeFort i type), with interdental wire fixation or fixation of denture or splint
21422 Open treatment of palatal or maxillary fracture 2162 3406 5769 695 19.31 (LeFort i type);
21423 Open treatment of palatal or maxillary fracture 2216 3490 5912 815 22.63 (LeFort i type); complicated (comminuted or involving cranial nerve foramina), multiple approaches
21431 Closed treatment of craniofacial separation 1780 2803 4748 743 20.65 (LeFort III type) using interdental wire fixation of denture or splint
21432 Open treatment of craniofacial separation 1783 2809 4757 745 20.69 (LeFort III type); with wiring and/or internal fixation
21433 Open treatment of craniofacial separation 4324 6812 11538 1806 50.18 (LeFort III type); complicated (eg, comminuted
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or involving cranial nerve foramina), multiple surgical approaches
21435 Open treatment of craniofacial separation 3488 5495 9308 1457 40.48 (LeFort III type); complicated, utilizing internal and/or external fixation techniques (eg, head cap, halo device, and/or intermaxillary fixation)
21436 Open treatment of craniofacial separation 5076 7995 13543 2120 58.90 (LeFort III type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)
21440 Closed treatment of mandibular or maxillary 1577 2485 4208 598 16.60 alveolar ridge fracture (separate procedure)
21445 Open treatment of mandibular or maxillary 1878 2958 5010 800 22.21 alveolar ridge fracture (separate procedure)
21450 Closed treatment of mandibular fracture; 1478 2328 3944 582 16.17 without manipulation
21451 Closed treatment of mandibular fracture; with 2301 3624 6138 773 21.48 manipulation
21452 Percutaneous treatment of mandibular fracture, 1577 2484 4208 659 18.30 with external fixation
21453 Closed treatment of mandibular fracture with 2726 4294 7273 941 26.13 interdental fixation
21454 Open treatment of mandibular fracture with 1399 2203 3732 584 16.23 external fixation
21461 Open treatment of mandibular fracture; without 3775 5946 10072 2200 61.10 interdental fixation
21462 Open treatment of mandibular fracture; with 4494 7080 11992 2346 65.16 interdental fixation
21465 Open treatment of mandibular condylar fracture 2307 3634 6155 964 26.77
21470 Open treatment of complicated mandibular 4173 6573 11134 1246 34.62 fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints
21480 Closed treatment of temporomandibular 258 407 689 102 2.82 dislocation; initial or subsequent
21485 Closed treatment of temporomandibular 1917 3020 5116 801 22.25 dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent
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21490 Open treatment of temporomandibular 2277 3586 6075 951 26.42 dislocation
21497 Interdental wiring, for condition other than 1771 2790 4726 692 19.23 fracture
21499 Unlisted musculoskeletal procedure, head 0 0 0 0 0.00
NECK (SOFT TISSUES) AND THORAX
21501 Incision and drainage, deep abscess or 1000 1487 2435 466 12.94 hematoma, soft tissues of neck or thorax;
21502 Incision and drainage, deep abscess or 1261 1874 3070 522 14.50 hematoma, soft tissues of neck or thorax; with partial rib ostectomy
21510 Incision, deep, with opening of bone cortex (eg, 1105 1643 2691 458 12.71 for osteomyelitis or bone abscess), thorax
21550 Biopsy, soft tissue of neck or thorax 445 662 1084 269 7.47
21552 Excision, tumor, soft tissue of neck or anterior 1144 1701 2785 463 12.87 thorax, subcutaneous; 3 cm or greater
21554 Excision, tumor, soft tissue of neck or anterior 1893 2814 4609 758 21.05 thorax, subfascial (eg, intramuscular); 5 cm or greater
21555 Excision, tumor, soft tissue of neck or anterior 913 1357 2223 428 11.88 thorax, subcutaneous; less than 3 cm
21556 Excision, tumor, soft tissue of neck or anterior 1325 1969 3225 545 15.13 thorax, subfascial (eg, intramuscular); less than 5 cm
21557 Radical resection of tumor (eg, sarcoma), soft 2512 3733 6114 987 27.41 tissue of neck or anterior thorax; less than 5 cm
21558 Radical resection of tumor (eg, sarcoma), soft 3748 5571 9124 1392 38.67 tissue of neck or anterior thorax; 5 cm or greater
21600 Excision of rib, partial 1665 2475 4054 572 15.90
21610 Costotransversectomy (separate procedure) 3048 4531 7420 1262 35.05
21615 Excision first and/or cervical rib; 2029 3017 4940 639 17.76
21616 Excision first and/or cervical rib; with 1797 2671 4374 744 20.66 sympathectomy
21620 Ostectomy of sternum, partial 1510 2245 3677 523 14.52
21627 Sternal debridement 1559 2318 3796 558 15.51
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
21630 Radical resection of sternum; 3076 4572 7488 1273 35.37
21632 Radical resection of sternum; with mediastinal 3027 4500 7370 1253 34.81 lymphadenectomy
21685 Hyoid myotomy and suspension 2735 4065 6658 1012 28.10
21700 Division of scalenus anticus; without resection 1626 2417 3958 374 10.39 of cervical rib
21705 Division of scalenus anticus; with resection of 1351 2008 3288 559 15.53 cervical rib
21720 Division of sternocleidomastoid for torticollis, 1319 1961 3212 546 15.17 open operation; without cast application
21725 Division of sternocleidomastoid for torticollis, 1355 2014 3298 561 15.58 open operation; with cast application
21740 Reconstructive repair of pectus excavatum or 2595 3857 6317 1074 29.84 carinatum; open
21742 Reconstructive repair of pectus excavatum or 2124 3158 5172 0 0.00 carinatum; minimally invasive approach (Nuss procedure), without thoracoscopy
21743 Reconstructive repair of pectus excavatum or 5316 7903 12943 0 0.00 carinatum; minimally invasive approach (Nuss procedure), with thoracoscopy
21750 Closure of median sternotomy separation with 2272 3377 5531 710 19.71 or without debridement (separate procedure)
21811 Open treatment of rib fracture(s) with internal 1716 2551 4178 622 17.27 fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs
21812 Open treatment of rib fracture(s) with internal 2050 3047 4990 757 21.03 fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs
21813 Open treatment of rib fracture(s) with internal 2492 3705 6068 1032 28.66 fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs
21820 Closed treatment of sternum fracture 354 526 862 147 4.07
21825 Open treatment of sternum fracture with or 1500 2230 3652 558 15.51 without skeletal fixation
21899 Unlisted procedure, neck or thorax 0 0 0 0 0.00
BACK AND FLANK
21920 Biopsy, soft tissue of back or flank; superficial 354 526 861 264 7.34
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21925 Biopsy, soft tissue of back or flank; deep 1047 1556 2549 463 12.87
21930 Excision, tumor, soft tissue of back or flank, 1058 1573 2577 489 13.58 subcutaneous; less than 3 cm
21931 Excision, tumor, soft tissue of back or flank, 1226 1822 2984 488 13.56 subcutaneous; 3 cm or greater
21932 Excision, tumor, soft tissue of back or flank, 1630 2423 3969 687 19.08 subfascial (eg, intramuscular); less than 5 cm
21933 Excision, tumor, soft tissue of back or flank, 1926 2863 4690 766 21.28 subfascial (eg, intramuscular); 5 cm or greater
21935 Radical resection of tumor (eg, sarcoma), soft 2811 4178 6843 1066 29.61 tissue of back or flank; less than 5 cm
21936 Radical resection of tumor (eg, sarcoma), soft 4366 6491 10630 1472 40.90 tissue of back or flank; 5 cm or greater
SPINE (VERTEBRAL COLUMN)
22010 Incision and drainage, open, of deep abscess 2584 3842 6292 991 27.54 (subfascial), posterior spine; cervical, thoracic, or cervicothoracic
22015 Incision and drainage, open, of deep abscess 2548 3788 6204 984 27.32 (subfascial), posterior spine; lumbar, sacral, or lumbosacral
22100 Partial excision of posterior vertebral 2283 3393 5557 945 26.25 component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical
22101 Partial excision of posterior vertebral 2266 3369 5517 938 26.06 component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic
22102 Partial excision of posterior vertebral 4400 6541 10712 825 22.93 component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar
22103 Partial excision of posterior vertebral 537 798 1307 148 4.10 component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (list separately in addition to code for primary procedure)
22110 Partial excision of vertebral body, for intrinsic 2739 4072 6669 1087 30.20 bony lesion, without decompression of spinal
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cord or nerve root(s), single vertebral segment; cervical
22112 Partial excision of vertebral body, for intrinsic 2838 4219 6910 1175 32.64 bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic
22114 Partial excision of vertebral body, for intrinsic 2733 4063 6653 1175 32.64 bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar
22116 Partial excision of vertebral body, for intrinsic 548 815 1335 149 4.13 bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)
22206 Osteotomy of spine, posterior or posterolateral 7170 10657 17454 2552 70.90 approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic
22207 Osteotomy of spine, posterior or posterolateral 6927 10297 16864 2512 69.79 approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar
22208 Osteotomy of spine, posterior or posterolateral 2495 3709 6074 624 17.33 approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure)
22210 Osteotomy of spine, posterior or posterolateral 5141 7642 12515 1873 52.02 approach, 1 vertebral segment; cervical
22212 Osteotomy of spine, posterior or posterolateral 4762 7078 11593 1552 43.10 approach, 1 vertebral segment; thoracic
22214 Osteotomy of spine, posterior or posterolateral 4326 6430 10532 1556 43.21 approach, 1 vertebral segment; lumbar
22216 Osteotomy of spine, posterior or posterolateral 1117 1660 2719 382 10.61 approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure)
22220 Osteotomy of spine, including discectomy, 5513 8196 13422 1674 46.50 anterior approach, single vertebral segment; cervical
22222 Osteotomy of spine, including discectomy, 4156 6178 10119 1832 50.90 anterior approach, single vertebral segment; thoracic
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22224 Osteotomy of spine, including discectomy, 5102 7583 12420 1653 45.92 anterior approach, single vertebral segment; lumbar
22226 Osteotomy of spine, including discectomy, 1368 2033 3330 381 10.59 anterior approach, single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)
22310 Closed treatment of vertebral body fracture(s), 988 1468 2405 320 8.88 without manipulation, requiring and including casting or bracing
22315 Closed treatment of vertebral fracture(s) and/or 2478 3684 6034 915 25.43 dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction
22318 Open treatment and/or reduction of odontoid 4856 7218 11822 1714 47.61 fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting
22319 Open treatment and/or reduction of odontoid 4647 6908 11314 1924 53.44 fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting
22325 Open treatment and/or reduction of vertebral 4224 6279 10284 1504 41.78 fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar
22326 Open treatment and/or reduction of vertebral 4867 7235 11849 1563 43.41 fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical
22327 Open treatment and/or reduction of vertebral 4515 6711 10991 1570 43.61 fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic
22328 Open treatment and/or reduction of vertebral 1391 2068 3388 297 8.25 fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure)
22505 Manipulation of spine requiring anesthesia, any 163 243 397 137 3.81 region
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22510 Percutaneous vertebroplasty (bone biopsy 1760 2617 4285 1728 47.99 included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic
22511 Percutaneous vertebroplasty (bone biopsy 1870 2780 4554 1706 47.38 included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral
22512 Percutaneous vertebroplasty (bone biopsy 1073 1595 2612 978 27.18 included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (list separately in addition to code for primary procedure)
22513 Percutaneous vertebral augmentation, including 9001 13380 21914 7328 203.56 cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic
22514 Percutaneous vertebral augmentation, including 10060 14954 24491 7294 202.60 cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar
22515 Percutaneous vertebral augmentation, including 8402 12489 20454 4415 122.65 cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebral body (list separately in addition to code for primary procedure)
22526 Percutaneous intradiscal electrothermal 5791 8608 14098 2397 66.59 annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level
22527 Percutaneous intradiscal electrothermal 4892 7271 11909 2025 56.25 annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels (list separately in addition to code for primary procedure)
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22532 Arthrodesis, lateral extracavitary technique, 5073 7541 12351 1875 52.09 including minimal discectomy to prepare interspace (other than for decompression); thoracic
22533 Arthrodesis, lateral extracavitary technique, 3937 5853 9586 1733 48.14 including minimal discectomy to prepare interspace (other than for decompression); lumbar
22534 Arthrodesis, lateral extracavitary technique, 1039 1545 2530 379 10.53 including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure)
22548 Arthrodesis, anterior transoral or extraoral 6480 10527 17378 2066 57.39 technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process
22551 Arthrodesis, anterior interbody, including disc 5425 8814 14550 1790 49.71 space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2
22552 Arthrodesis, anterior interbody, including disc 1321 2146 3542 419 11.64 space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (list separately in addition to code for separate procedure)
22554 Arthrodesis, anterior interbody technique, 4117 6689 11041 1310 36.40 including minimal discectomy to prepare interspace (other than for decompression); cervical below C2
22556 Arthrodesis, anterior interbody technique, 4845 7872 12994 1745 48.47 including minimal discectomy to prepare interspace (other than for decompression); thoracic
22558 Arthrodesis, anterior interbody technique, 4489 7293 12040 1603 44.54 including minimal discectomy to prepare interspace (other than for decompression); lumbar
22585 Arthrodesis, anterior interbody technique, 1100 1788 2951 345 9.58 including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (list separately in addition to code for primary procedure)
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22586 Arthrodesis, pre-sacral interbody technique, 6581 10693 17651 2098 58.29 including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace
22590 Arthrodesis, posterior technique, craniocervical 5601 9100 15022 1653 45.92 (occiput-C2)
22595 Arthrodesis, posterior technique, atlas-axis (C1- 5057 8217 13564 1578 43.83 C2)
22600 Arthrodesis, posterior or posterolateral 4200 6823 11264 1348 37.45 technique, single level; cervical below C2 segment
22610 Arthrodesis, posterior or posterolateral 4039 6562 10833 1322 36.71 technique, single level; thoracic (with lateral transverse technique, when performed)
22612 Arthrodesis, posterior or posterolateral 4860 7896 13034 1660 46.10 technique, single level; lumbar (with lateral transverse technique, when performed)
22614 Arthrodesis, posterior or posterolateral 1310 2129 3515 411 11.43 technique, single level; each additional vertebral segment (list separately in addition to code for primary procedure)
22630 Arthrodesis, posterior interbody technique, 4335 7044 11627 1647 45.76 including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar
22632 Arthrodesis, posterior interbody technique, 939 1526 2518 339 9.42 including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace (list separately in addition to code for primary procedure)
22633 Arthrodesis, combined posterior or 5398 8769 14476 1939 53.87 posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar
22634 Arthrodesis, combined posterior or 1532 2490 4110 522 14.50 posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional
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interspace and segment (list separately in addition to code for primary procedure)
22800 Arthrodesis, posterior, for spinal deformity, 5050 8205 13544 1411 39.19 with or without cast; up to 6 vertebral segments
22802 Arthrodesis, posterior, for spinal deformity, 7413 12044 19883 2201 61.14 with or without cast; 7 to 12 vertebral segments
22804 Arthrodesis, posterior, for spinal deformity, 9734 15814 26106 2537 70.48 with or without cast; 13 or more vertebral segments
22808 Arthrodesis, anterior, for spinal deformity, with 5569 9048 14936 1942 53.95 or without cast; 2 to 3 vertebral segments
22810 Arthrodesis, anterior, for spinal deformity, with 6464 10502 17336 2061 57.25 or without cast; 4 to 7 vertebral segments
22812 Arthrodesis, anterior, for spinal deformity, with 7235 11755 19404 2307 64.08 or without cast; 8 or more vertebral segments
22818 Kyphectomy, circumferential exposure of spine 7108 11549 19065 2267 62.96 and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments
22819 Kyphectomy, circumferential exposure of spine 8586 13949 23027 2605 72.37 and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments
22830 Exploration of spinal fusion 2573 4181 6902 850 23.60
22840 Posterior non-segmental instrumentation (eg, 2507 4074 6725 800 22.22 Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (list separately in addition to code for primary procedure)
22841 Internal spinal fixation by wiring of spinous 1613 2620 4326 0 0.00 processes (list separately in addition to code for primary procedure)
22842 Posterior segmental instrumentation (eg, 2694 4376 7224 803 22.31 pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (list separately in addition to code for primary procedure)
22843 Posterior segmental instrumentation (eg, 2989 4857 8018 859 23.87 pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral
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segments (list separately in addition to code for primary procedure)
22844 Posterior segmental instrumentation (eg, 4055 6588 10875 1038 28.83 pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure)
22845 Anterior instrumentation; 2 to 3 vertebral 2703 4391 7248 769 21.35 segments (list separately in addition to code for primary procedure)
22846 Anterior instrumentation; 4 to 7 vertebral 2793 4537 7490 798 22.16 segments (list separately in addition to code for primary procedure)
22847 Anterior instrumentation; 8 or more vertebral 2659 4320 7131 848 23.55 segments (list separately in addition to code for primary procedure)
22848 Pelvic fixation (attachment of caudal end of 1187 1929 3184 378 10.51 instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure)
22849 Reinsertion of spinal fixation device 3870 6287 10379 1358 37.73
22850 Removal of posterior nonsegmental 2259 3671 6060 755 20.96 instrumentation (eg, Harrington rod)
22852 Removal of posterior segmental 2156 3503 5782 724 20.12 instrumentation
22853 Insertion of interbody biomechanical device(s) 823 1337 2208 262 7.29 (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (list separately in addition to code for primary procedure)
22854 Insertion of intervertebral biomechanical 1105 1795 2964 339 9.43 device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (list separately in addition to code for primary procedure)
22855 Removal of anterior instrumentation 3344 5433 8968 1158 32.16
116 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
22856 Total disc arthroplasty (artificial disc), anterior 5342 8679 14326 1713 47.57 approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical
22857 Total disc arthroplasty (artificial disc), anterior 5560 9033 14911 1768 49.11 approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar
22858 Total disc arthroplasty (artificial disc), anterior 1626 2642 4362 538 14.94 approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (list separately in addition to code for primary procedure)
22859 Insertion of intervertebral biomechanical 1000 1625 2682 339 9.43 device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (list separately in addition to code for primary procedure)
22861 Revision including replacement of total disc 7212 11717 19343 2453 68.15 arthroplasty (artificial disc), anterior approach, single interspace; cervical
22862 Revision including replacement of total disc 7658 12443 20540 2442 67.83 arthroplasty (artificial disc), anterior approach, single interspace; lumbar
22864 Removal of total disc arthroplasty (artificial 6863 11151 18408 2188 60.79 disc), anterior approach, single interspace; cervical
22865 Removal of total disc arthroplasty (artificial 6672 10839 17893 2127 59.09 disc), anterior approach, single interspace; lumbar
22867 Insertion of interlaminar/interspinous process 2920 4745 7833 972 27.01 stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
22868 Insertion of interlaminar/interspinous process 772 1254 2070 248 6.88 stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (list separately in addition to code for primary procedure)
CPT copyright 2017 American Medical Association. 117 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
22869 Insertion of interlaminar/interspinous process 1986 3227 5327 552 15.33 stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level
22870 Insertion of interlaminar/interspinous process 450 731 1206 143 3.96 stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (list separately in addition to code for primary procedure)
22899 Unlisted procedure, spine 0 0 0 0 0.00
ABDOMEN
22900 Excision, tumor, soft tissue of abdominal wall, 1275 2072 3420 586 16.28 subfascial (eg, intramuscular); less than 5 cm
22901 Excision, tumor, soft tissue of abdominal wall, 1700 2761 4558 692 19.22 subfascial (eg, intramuscular); 5 cm or greater
22902 Excision, tumor, soft tissue of abdominal wall, 990 1609 2655 453 12.57 subcutaneous; less than 3 cm
22903 Excision, tumor, soft tissue of abdominal wall, 1121 1822 3007 456 12.67 subcutaneous; 3 cm or greater
22904 Radical resection of tumor (eg, sarcoma), soft 3341 5429 8962 1092 30.33 tissue of abdominal wall; less than 5 cm
22905 Radical resection of tumor (eg, sarcoma), soft 3704 6018 9935 1386 38.50 tissue of abdominal wall; 5 cm or greater
22999 Unlisted procedure, abdomen, musculoskeletal 0 0 0 0 0.00 system
SHOULDER
23000 Removal of subdeltoid calcareous deposits, 1507 2133 3039 599 16.63 open
23020 Capsular contracture release (eg, sever type 2520 3568 5083 714 19.84 procedure)
23030 Incision and drainage, shoulder area; deep 943 1335 1902 461 12.80 abscess or hematoma
23031 Incision and drainage, shoulder area; infected 1245 1762 2510 431 11.96 bursa
23035 Incision, bone cortex (eg, osteomyelitis or bone 2034 2880 4103 704 19.55 abscess), shoulder area
118 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
23040 Arthrotomy, glenohumeral joint, including 2135 3023 4307 743 20.63 exploration, drainage, or removal of foreign body
23044 Arthrotomy, acromioclavicular, 1578 2233 3182 586 16.29 sternoclavicular joint, including exploration, drainage, or removal of foreign body
23065 Biopsy, soft tissue of shoulder area; superficial 287 406 579 224 6.23
23066 Biopsy, soft tissue of shoulder area; deep 1180 1671 2380 576 16.01
23071 Excision, tumor, soft tissue of shoulder area, 1076 1523 2170 436 12.11 subcutaneous; 3 cm or greater
23073 Excision, tumor, soft tissue of shoulder area, 1899 2688 3829 721 20.02 subfascial (eg, intramuscular); 5 cm or greater
23075 Excision, tumor, soft tissue of shoulder area, 901 1276 1817 487 13.52 subcutaneous; less than 3 cm
23076 Excision, tumor, soft tissue of shoulder area, 1477 2090 2978 560 15.55 subfascial (eg, intramuscular); less than 5 cm
23077 Radical resection of tumor (eg, sarcoma), soft 3423 4845 6903 1184 32.89 tissue of shoulder area; less than 5 cm
23078 Radical resection of tumor (eg, sarcoma), soft 3954 5598 7975 1494 41.50 tissue of shoulder area; 5 cm or greater
23100 Arthrotomy, glenohumeral joint, including 1501 2124 3026 519 14.42 biopsy
23101 Arthrotomy, acromioclavicular joint or 1366 1934 2756 473 13.13 sternoclavicular joint, including biopsy and/or excision of torn cartilage
23105 Arthrotomy; glenohumeral joint, with 1912 2706 3855 661 18.37 synovectomy, with or without biopsy
23106 Arthrotomy; sternoclavicular joint, with 1487 2105 2999 514 14.29 synovectomy, with or without biopsy
23107 Arthrotomy, glenohumeral joint, with joint 1930 2732 3893 685 19.03 exploration, with or without removal of loose or foreign body
23120 Claviculectomy; partial 1768 2503 3566 605 16.80
23125 Claviculectomy; total 2126 3010 4288 735 20.43
23130 Acromioplasty or acromionectomy, partial, 1965 2782 3963 631 17.54 with or without coracoacromial ligament release
CPT copyright 2017 American Medical Association. 119 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
23140 Excision or curettage of bone cyst or benign 1582 2239 3189 553 15.37 tumor of clavicle or scapula;
23145 Excision or curettage of bone cyst or benign 2082 2948 4199 720 20.01 tumor of clavicle or scapula; with autograft (includes obtaining graft)
23146 Excision or curettage of bone cyst or benign 1861 2634 3752 644 17.88 tumor of clavicle or scapula; with allograft
23150 Excision or curettage of bone cyst or benign 2043 2892 4120 687 19.09 tumor of proximal humerus;
23155 Excision or curettage of bone cyst or benign 2378 3366 4795 823 22.85 tumor of proximal humerus; with autograft (includes obtaining graft)
23156 Excision or curettage of bone cyst or benign 2030 2874 4095 702 19.51 tumor of proximal humerus; with allograft
23170 Sequestrectomy (eg, for osteomyelitis or bone 1680 2378 3387 581 16.14 abscess), clavicle
23172 Sequestrectomy (eg, for osteomyelitis or bone 1696 2401 3421 587 16.30 abscess), scapula
23174 Sequestrectomy (eg, for osteomyelitis or bone 2272 3216 4581 786 21.83 abscess), humeral head to surgical neck
23180 Partial excision (craterization, saucerization, or 1971 2790 3974 678 18.83 diaphysectomy) bone (eg, osteomyelitis), clavicle
23182 Partial excision (craterization, saucerization, or 1963 2778 3958 679 18.86 diaphysectomy) bone (eg, osteomyelitis), scapula
23184 Partial excision (craterization, saucerization, or 2185 3093 4407 756 21.00 diaphysectomy) bone (eg, osteomyelitis), proximal humerus
23190 Ostectomy of scapula, partial (eg, superior 1713 2425 3454 593 16.46 medial angle)
23195 Resection, humeral head 2265 3207 4569 784 21.77
23200 Radical resection of tumor; clavicle 4560 6455 9196 1578 43.82
23210 Radical resection of tumor; scapula 5359 7586 10808 1854 51.50
23220 Radical resection of tumor, proximal humerus 5887 8333 11872 2036 56.57
23330 Removal of foreign body, shoulder; 815 1153 1643 282 7.83 subcutaneous
120 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
23333 Removal of foreign body, shoulder; deep 1393 1972 2810 482 13.39 (subfascial or intramuscular)
23334 Removal of prosthesis, includes debridement 2828 4003 5703 1117 31.02 and synovectomy when performed; humeral or glenoid component
23335 Removal of prosthesis, includes debridement 3426 4850 6909 1329 36.93 and synovectomy when performed; humeral and glenoid components (eg, total shoulder)
23350 Injection procedure for shoulder arthrography 390 552 787 133 3.70 or enhanced ct/mori shoulder arthrography
23395 Muscle transfer, any type, shoulder or upper 3420 5145 8898 1330 36.94 arm; single
23397 Muscle transfer, any type, shoulder or upper 3591 5403 9344 1179 32.76 arm; multiple
23400 Scapulopexy (eg, Sprengels deformity or for 3069 4618 7986 1008 28.00 paralysis)
23405 Tenotomy, shoulder area; single tendon 1953 2939 5082 641 17.81
23406 Tenotomy, shoulder area; multiple tendons 2035 3062 5296 798 22.16 through same incision
23410 Repair of ruptured musculotendinous cuff (eg, 2722 4095 7082 851 23.64 rotator cuff) open; acute
23412 Repair of ruptured musculotendinous cuff (eg, 3000 4514 7807 883 24.53 rotator cuff) open; chronic
23415 Coracoacromial ligament release, with or 2038 3066 5303 722 20.05 without acromioplasty
23420 Reconstruction of complete shoulder (rotator) 3119 4693 8116 1005 27.92 cuff avulsion, chronic (includes acromioplasty)
23430 Tenodesis of long tendon of biceps 2289 3443 5955 770 21.40
23440 Resection or transplantation of long tendon of 2599 3910 6761 781 21.69 biceps
23450 Capsulorrhaphy, anterior; Putti-Platt procedure 2999 4512 7804 985 27.36 or Magnusson type operation
23455 Capsulorrhaphy, anterior; with labral repair (eg, 3053 4594 7945 1034 28.72 Bankart procedure)
23460 Capsulorrhaphy, anterior, any type; with bone 3354 5047 8728 1132 31.45 block
23462 Capsulorrhaphy, anterior, any type; with 3342 5028 8695 1105 30.70 coracoid process transfer
CPT copyright 2017 American Medical Association. 121 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
23465 Capsulorrhaphy, glenohumeral joint, posterior, 3297 4961 8579 1162 32.27 with or without bone block
23466 Capsulorrhaphy, glenohumeral joint, any type 3385 5093 8808 1168 32.44 multi-directional instability
23470 Arthroplasty, glenohumeral joint; 3496 5260 9097 1245 34.58 hemiarthroplasty
23472 Arthroplasty, glenohumeral joint; total shoulder 4372 6578 11376 1512 42.01 (glenoid and proximal humeral replacement (eg, total shoulder))
23473 Revision of total shoulder arthroplasty, 4472 6728 11636 1688 46.89 including allograft when performed; humeral or glenoid component
23474 Revision of total shoulder arthroplasty, 4796 7216 12479 1823 50.64 including allograft when performed; humeral and glenoid component
23480 Osteotomy, clavicle, with or without internal 2595 3904 6751 852 23.67 fixation;
23485 Osteotomy, clavicle, with or without internal 2701 4064 7029 986 27.40 fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation)
23490 Prophylactic treatment (nailing, pinning, 2725 4100 7091 895 24.86 plating or wiring) with or without methylmethacrylate; clavicle
23491 Prophylactic treatment (nailing, pinning, 3207 4826 8346 1053 29.26 plating or wiring) with or without methylmethacrylate; proximal humerus
23500 Closed treatment of clavicular fracture; without 594 799 1138 226 6.27 manipulation
23505 Closed treatment of clavicular fracture; with 880 1184 1686 364 10.10 manipulation
23515 Open treatment of clavicular fracture, includes 1940 2610 3716 745 20.70 internal fixation, when performed
23520 Closed treatment of sternoclavicular 645 868 1236 240 6.66 dislocation; without manipulation
23525 Closed treatment of sternoclavicular 1072 1441 2052 398 11.06 dislocation; with manipulation
23530 Open treatment of sternoclavicular dislocation, 1596 2146 3055 593 16.47 acute or chronic;
122 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
23532 Open treatment of sternoclavicular dislocation, 1741 2342 3334 647 17.97 acute or chronic; with fascial graft (includes obtaining graft)
23540 Closed treatment of acromioclavicular 610 821 1168 232 6.45 dislocation; without manipulation
23545 Closed treatment of acromioclavicular 949 1277 1818 353 9.80 dislocation; with manipulation
23550 Open treatment of acromioclavicular 1797 2417 3441 582 16.16 dislocation, acute or chronic;
23552 Open treatment of acromioclavicular 2047 2753 3920 677 18.81 dislocation, acute or chronic; with fascial graft (includes obtaining graft)
23570 Closed treatment of scapular fracture; without 619 833 1185 240 6.67 manipulation
23575 Closed treatment of scapular fracture; with 1117 1503 2139 415 11.53 manipulation, with or without skeletal traction (with or without shoulder joint involvement)
23585 Open treatment of scapular fracture (body, 2687 3615 5146 1016 28.22 glenoid or acromion) includes internal fixation, when performed
23600 Closed treatment of proximal humeral (surgical 857 1152 1641 337 9.36 or anatomical neck) fracture; without manipulation
23605 Closed treatment of proximal humeral (surgical 1254 1687 2402 478 13.27 or anatomical neck) fracture; with manipulation, with or without skeletal traction
23615 Open treatment of proximal humeral (surgical 2492 3352 4773 917 25.47 or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed;
23616 Open treatment of proximal humeral (surgical 3718 5001 7119 1287 35.75 or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement
23620 Closed treatment of greater humeral tuberosity 708 952 1356 278 7.72 fracture; without manipulation
23625 Closed treatment of greater humeral tuberosity 1049 1411 2009 390 10.83 fracture; with manipulation
CPT copyright 2017 American Medical Association. 123 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
23630 Open treatment of greater humeral tuberosity 2005 2697 3840 807 22.43 fracture, includes internal fixation, when performed
23650 Closed treatment of shoulder dislocation, with 889 1196 1703 325 9.02 manipulation; without anesthesia
23655 Closed treatment of shoulder dislocation, with 1070 1439 2049 415 11.52 manipulation; requiring anesthesia
23660 Open treatment of acute shoulder dislocation 1722 2317 3298 603 16.76
23665 Closed treatment of shoulder dislocation, with 1116 1501 2136 438 12.18 fracture of greater humeral tuberosity, with manipulation
23670 Open treatment of shoulder dislocation, with 2459 3308 4710 906 25.17 fracture of greater humeral tuberosity, includes internal fixation, when performed
23675 Closed treatment of shoulder dislocation, with 1522 2047 2915 566 15.71 surgical or anatomical neck fracture, with manipulation
23680 Open treatment of shoulder dislocation, with 2593 3487 4964 963 26.76 surgical or anatomical neck fracture, includes internal fixation, when performed
23700 Manipulation under anesthesia, shoulder joint, 662 891 1268 203 5.65 including application of fixation apparatus (dislocation excluded)
23800 Arthrodesis, glenohumeral joint; 2866 3855 5488 1065 29.58
23802 Arthrodesis, glenohumeral joint; with 3591 4831 6877 1335 37.07 autogenous graft (includes obtaining graft)
23900 Interthoracoscapular amputation (forequarter) 3885 5226 7439 1444 40.10
23920 Disarticulation of shoulder; 3154 4242 6039 1172 32.55
23921 Disarticulation of shoulder; secondary closure 1304 1754 2497 485 13.46 or scar revision
23929 Unlisted procedure, shoulder 0 0 0 0 0.00
HUMERUS (UPPER ARM) AND ELBOW
23930 Incision and drainage, upper arm or elbow area; 800 1188 2018 370 10.27 deep abscess or hematoma
23931 Incision and drainage, upper arm or elbow area; 662 983 1670 298 8.28 bursa
124 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
23935 Incision, deep, with opening of bone cortex (eg, 1540 2287 3885 522 14.51 for osteomyelitis or bone abscess), humerus or elbow
24000 Arthrotomy, elbow, including exploration, 1493 2217 3765 493 13.70 drainage, or removal of foreign body
24006 Arthrotomy of the elbow, with capsular 2246 3335 5665 735 20.43 excision for capsular release (separate procedure)
24065 Biopsy, soft tissue of upper arm or elbow area; 293 436 740 265 7.35 superficial
24066 Biopsy, soft tissue of upper arm or elbow area; 1400 2079 3531 640 17.78 deep (subfascial or intramuscular)
24071 Excision, tumor, soft tissue of upper arm or 1065 1582 2686 422 11.72 elbow area, subcutaneous; 3 cm or greater
24073 Excision, tumor, soft tissue of upper arm or 1924 2857 4852 720 19.99 elbow area, subfascial (eg, intramuscular); 5 cm or greater
24075 Excision, tumor, soft tissue of upper arm or 1033 1534 2606 507 14.08 elbow area, subcutaneous; less than 3 cm
24076 Excision, tumor, soft tissue of upper arm or 1482 2200 3737 564 15.67 elbow area, subfascial (eg, intramuscular); less than 5 cm
24077 Radical resection of tumor (eg, sarcoma), soft 3033 4503 7648 1076 29.89 tissue of upper arm or elbow area; less than 5 cm
24079 Radical resection of tumor (eg, sarcoma), soft 3688 5476 9300 1381 38.35 tissue of upper arm or elbow area; 5 cm or greater
24100 Arthrotomy, elbow; with synovial biopsy only 1219 1809 3073 432 12.01
24101 Arthrotomy, elbow; with joint exploration, with 1768 2626 4460 516 14.34 or without biopsy, with or without removal of loose or foreign body
24102 Arthrotomy, elbow; with synovectomy 2057 3054 5187 637 17.70
24105 Excision, olecranon bursa 1115 1656 2812 363 10.07
24110 Excision or curettage of bone cyst or benign 1977 2935 4985 607 16.87 tumor, humerus;
24115 Excision or curettage of bone cyst or benign 2155 3200 5435 765 21.24 tumor, humerus; with autograft (includes obtaining graft)
CPT copyright 2017 American Medical Association. 125 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
24116 Excision or curettage of bone cyst or benign 2521 3744 6358 895 24.85 tumor, humerus; with allograft
24120 Excision or curettage of bone cyst or benign 1837 2727 4632 549 15.24 tumor of head or neck of radius or olecranon process;
24125 Excision or curettage of bone cyst or benign 1812 2691 4570 643 17.86 tumor of head or neck of radius or olecranon process; with autograft (includes obtaining graft)
24126 Excision or curettage of bone cyst or benign 1896 2816 4782 673 18.69 tumor of head or neck of radius or olecranon process; with allograft
24130 Excision, radial head 1761 2614 4440 526 14.61
24134 Sequestrectomy (eg, for osteomyelitis or bone 2184 3244 5509 775 21.53 abscess), shaft or distal humerus
24136 Sequestrectomy (eg, for osteomyelitis or bone 1842 2736 4647 654 18.16 abscess), radial head or neck
24138 Sequestrectomy (eg, for osteomyelitis or bone 1970 2926 4969 699 19.42 abscess), olecranon process
24140 Partial excision (craterization, saucerization, or 2246 3335 5664 728 20.21 diaphysectomy) bone (eg, osteomyelitis), humerus
24145 Partial excision (craterization, saucerization, or 1729 2567 4360 613 17.04 diaphysectomy) bone (eg, osteomyelitis), radial head or neck
24147 Partial excision (craterization, saucerization, or 1954 2901 4928 645 17.91 diaphysectomy) bone (eg, osteomyelitis), olecranon process
24149 Radical resection of capsule, soft tissue, and 3471 5154 8753 1218 33.84 heterotopic bone, elbow, with contracture release (separate procedure)
24150 Radical resection of tumor, shaft or distal 4565 6778 11512 1620 44.99 humerus
24152 Radical resection of tumor, radial head or neck 3963 5885 9994 1406 39.06
24155 Resection of elbow joint (arthrectomy) 2497 3708 6297 886 24.61
24160 Removal of prosthesis, includes debridement 3566 5296 8994 1311 36.42 and synovectomy when performed; humeral and ulnar components
126 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
24164 Removal of prosthesis, includes debridement 1952 2899 4924 756 21.00 and synovectomy when performed; radial head
24200 Removal of foreign body, upper arm or elbow 433 643 1092 214 5.94 area; subcutaneous
24201 Removal of foreign body, upper arm or elbow 1204 1788 3036 569 15.80 area; deep (subfascial or intramuscular)
24220 Injection procedure for elbow arthrography 431 640 1087 161 4.47
24300 Manipulation, elbow, under anesthesia 1238 1838 3122 429 11.93
24301 Muscle or tendon transfer, any type, upper arm 2109 3131 5318 778 21.60 or elbow, single (excluding 24320-24331)
24305 Tendon lengthening, upper arm or elbow, each 1805 2680 4552 597 16.58 tendon
24310 Tenotomy, open, elbow to shoulder, each 1456 2161 3671 485 13.46 tendon
24320 Tenoplasty, with muscle transfer, with or 2283 3390 5757 810 22.50 without free graft, elbow to shoulder, single (Seddon-Brookes type procedure)
24330 Flexor-plasty, elbow (eg, Steindler type 2098 3116 5291 744 20.68 advancement);
24331 Flexor-plasty, elbow (eg, Steindler type 2299 3414 5798 816 22.66 advancement); with extensor advancement
24332 Tenolysis, triceps 1789 2656 4511 635 17.63
24340 Tenodesis of biceps tendon at elbow (separate 1929 2864 4865 634 17.62 procedure)
24341 Repair, tendon or muscle, upper arm or elbow, 2222 3299 5603 771 21.42 each tendon or muscle, primary or secondary (excludes rotator cuff)
24342 Reinsertion of ruptured biceps or triceps 2579 3829 6504 803 22.31 tendon, distal, with or without tendon graft
24343 Repair lateral collateral ligament, elbow, with 2182 3240 5502 731 20.31 local tissue
24344 Reconstruction lateral collateral ligament, 3193 4742 8054 1142 31.72 elbow, with tendon graft (includes harvesting of graft)
24345 Repair medial collateral ligament, elbow, with 2133 3167 5379 727 20.20 local tissue
CPT copyright 2017 American Medical Association. 127 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
24346 Reconstruction medial collateral ligament, 3319 4929 8371 1140 31.67 elbow, with tendon graft (includes harvesting of graft)
24357 Tenotomy, elbow, lateral or medial (eg, 1435 2131 3619 434 12.05 epicondylitis, tennis elbow, golfer's elbow); percutaneous
24358 Tenotomy, elbow, lateral or medial (eg, 1607 2387 4054 541 15.03 epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open
24359 Tenotomy, elbow, lateral or medial (eg, 2063 3064 5203 683 18.98 epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment
24360 Arthroplasty, elbow; with membrane (eg, 2631 3906 6635 933 25.93 fascial)
24361 Arthroplasty, elbow; with distal humeral 2944 4372 7425 1045 29.02 prosthetic replacement
24362 Arthroplasty, elbow; with implant and fascia 3103 4607 7825 1101 30.58 lata ligament reconstruction
24363 Arthroplasty, elbow; with distal humerus and 4324 6421 10905 1513 42.02 proximal ulnar prosthetic replacement (eg, total elbow)
24365 Arthroplasty, radial head; 1868 2774 4711 663 18.41
24366 Arthroplasty, radial head; with implant 2038 3026 5139 704 19.56
24370 Revision of total elbow arthroplasty, including 4520 6712 11399 1604 44.55 allograft when performed; humeral or ulnar component
24371 Revision of total elbow arthroplasty, including 5272 7828 13295 1871 51.96 allograft when performed; humeral and ulnar component
24400 Osteotomy, humerus, with or without internal 2813 4177 7094 849 23.59 fixation
24410 Multiple osteotomies with realignment on 3092 4592 7799 1097 30.48 intramedullary rod, humeral shaft (Sofield type procedure)
24420 Osteoplasty, humerus (eg, shortening or 2909 4319 7336 1032 28.67 lengthening) (excluding 64876)
24430 Repair of nonunion or malunion, humerus; 3087 4583 7784 1095 30.41 without graft (eg, compression technique)
128 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
24435 Repair of nonunion or malunion, humerus; with 3314 4921 8358 1115 30.97 iliac or other autograft (includes obtaining graft)
24470 Hemiepiphyseal arrest (eg, cubitus varus or 1960 2911 4943 696 19.32 valgus, distal humerus)
24495 Decompression fasciotomy, forearm, with 1763 2618 4447 764 21.22 brachial artery exploration
24498 Prophylactic treatment (nailing, pinning, 2530 3757 6381 898 24.94 plating or wiring), with or without methylmethacrylate, humeral shaft
24500 Closed treatment of humeral shaft fracture; 917 1208 1677 370 10.28 without manipulation
24505 Closed treatment of humeral shaft fracture; 1399 1842 2558 512 14.22 with manipulation, with or without skeletal traction
24515 Open treatment of humeral shaft fracture with 2534 3337 4634 908 25.22 plate/screws, with or without cerclage
24516 Treatment of humeral shaft fracture, with 2441 3214 4464 891 24.75 insertion of intramedullary implant, with or without cerclage and/or locking screws
24530 Closed treatment of supracondylar or 1059 1395 1937 393 10.91 transcondylar humeral fracture, with or without intercondylar extension; without manipulation
24535 Closed treatment of supracondylar or 1719 2264 3144 637 17.70 transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction
24538 Percutaneous skeletal fixation of supracondylar 2479 3264 4533 770 21.40 or transcondylar humeral fracture, with or without intercondylar extension
24545 Open treatment of humeral supracondylar or 2682 3532 4904 964 26.78 transcondylar fracture, includes internal fixation, when performed; without intercondylar extension
24546 Open treatment of humeral supracondylar or 3143 4139 5747 1078 29.94 transcondylar fracture, includes internal fixation, when performed; with intercondylar extension
24560 Closed treatment of humeral epicondylar 885 1166 1619 332 9.21 fracture, medial or lateral; without manipulation
CPT copyright 2017 American Medical Association. 129 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
24565 Closed treatment of humeral epicondylar 1718 2263 3142 552 15.32 fracture, medial or lateral; with manipulation
24566 Percutaneous skeletal fixation of humeral 2314 3047 4232 743 20.63 epicondylar fracture, medial or lateral, with manipulation
24575 Open treatment of humeral epicondylar 2289 3014 4186 760 21.12 fracture, medial or lateral, includes internal fixation, when performed
24576 Closed treatment of humeral condylar fracture, 936 1233 1712 351 9.76 medial or lateral; without manipulation
24577 Closed treatment of humeral condylar fracture, 1771 2332 3239 568 15.79 medial or lateral; with manipulation
24579 Open treatment of humeral condylar fracture, 2595 3417 4746 866 24.05 medial or lateral, includes internal fixation, when performed
24582 Percutaneous skeletal fixation of humeral 2409 3172 4404 838 23.27 condylar fracture, medial or lateral, with manipulation
24586 Open treatment of periarticular fracture and/or 3275 4312 5989 1125 31.24 dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius);
24587 Open treatment of periarticular fracture and/or 3536 4656 6465 1135 31.52 dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); with implant arthroplasty
24600 Treatment of closed elbow dislocation; without 1032 1359 1887 377 10.46 anesthesia
24605 Treatment of closed elbow dislocation; 1255 1653 2296 486 13.50 requiring anesthesia
24615 Open treatment of acute or chronic elbow 2160 2844 3950 738 20.51 dislocation
24620 Closed treatment of Monteggia type of fracture 1569 2066 2869 570 15.82 dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation
24635 Open treatment of Monteggia type of fracture 2511 3306 4591 698 19.38 dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed
130 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
24640 Closed treatment of radial head subluxation in 407 536 744 102 2.84 child, nursemaid elbow, with manipulation
24650 Closed treatment of radial head or neck 717 944 1311 270 7.51 fracture; without manipulation
24655 Closed treatment of radial head or neck 1214 1598 2220 452 12.55 fracture; with manipulation
24665 Open treatment of radial head or neck fracture, 1957 2577 3579 676 18.79 includes internal fixation or radial head excision, when performed;
24666 Open treatment of radial head or neck fracture, 2136 2812 3905 759 21.08 includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement
24670 Closed treatment of ulnar fracture, proximal 790 1040 1445 300 8.34 end (eg, olecranon or coronoid process[es]); without manipulation
24675 Closed treatment of ulnar fracture, proximal 1330 1752 2433 469 13.02 end (eg, olecranon or coronoid process[es]); with manipulation
24685 Open treatment of ulnar fracture, proximal end 2005 2640 3666 677 18.81 (eg, olecranon or coronoid process[es]), includes internal fixation, when performed
24800 Arthrodesis, elbow joint; local 2682 3532 4904 861 23.91
24802 Arthrodesis, elbow joint; with autogenous graft 3240 4266 5924 1040 28.88 (includes obtaining graft)
24900 Amputation, arm through humerus; with 2390 3148 4371 767 21.31 primary closure
24920 Amputation, arm through humerus; open, 2367 3116 4328 760 21.10 circular (guillotine)
24925 Amputation, arm through humerus; secondary 1785 2350 3263 580 16.12 closure or scar revision
24930 Amputation, arm through humerus; re- 2503 3295 4576 803 22.31 amputation
24931 Amputation, arm through humerus; with 2758 3631 5043 969 26.91 implant
24935 Stump elongation, upper extremity 3344 4403 6115 1196 33.23
24940 Cineplasty, upper extremity, complete 3100 4082 5669 0 0.00 procedure
24999 Unlisted procedure, humerus or elbow 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 131 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
FOREARM AND WRIST
25000 Incision, extensor tendon sheath, wrist (eg, de 1200 1906 3351 348 9.67 Quervain's disease)
25001 Incision, flexor tendon sheath, wrist (eg, flexor 1255 1994 3505 355 9.87 carpi radialis)
25020 Decompression fasciotomy, forearm and/or 1903 3023 5315 593 16.47 wrist, flexor or extensor compartment; without debridement of nonviable muscle and/or nerve
25023 Decompression fasciotomy, forearm and/or 3169 5034 8850 1148 31.88 wrist, flexor or extensor compartment; with debridement of nonviable muscle and/or nerve
25024 Decompression fasciotomy, forearm and/or 2195 3485 6128 803 22.30 wrist, flexor and extensor compartment; without debridement of nonviable muscle and/or nerve
25025 Decompression fasciotomy, forearm and/or 3596 5711 10041 1259 34.98 wrist, flexor and extensor compartment; with debridement of nonviable muscle and/or nerve
25028 Incision and drainage, forearm and/or wrist; 1446 2296 4036 544 15.10 deep abscess or hematoma
25031 Incision and drainage, forearm and/or wrist; 1190 1891 3324 364 10.12 bursa
25035 Incision, deep, bone cortex, forearm and/or 1929 3063 5386 605 16.81 wrist (eg, osteomyelitis or bone abscess)
25040 Arthrotomy, radiocarpal or midcarpal joint, 1924 3056 5373 582 16.17 with exploration, drainage, or removal of foreign body
25065 Biopsy, soft tissue of forearm and/or wrist; 337 535 941 261 7.26 superficial
25066 Biopsy, soft tissue of forearm and/or wrist; 1032 1639 2881 371 10.30 deep (subfascial or intramuscular)
25071 Excision, tumor, soft tissue of forearm and/or 1175 1867 3282 441 12.25 wrist area, subcutaneous; 3 cm or greater
25073 Excision, tumor, soft tissue of forearm and/or 1633 2593 4558 553 15.35 wrist area, subfascial (eg, intramuscular); 3 cm or greater
25075 Excision, tumor, soft tissue of forearm and/or 1037 1647 2896 494 13.71 wrist area, subcutaneous; less than 3 cm
132 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25076 Excision, tumor, soft tissue of forearm and/or 1563 2483 4365 537 14.91 wrist area, subfascial (eg, intramuscular); less than 3 cm
25077 Radical resection of tumor (eg, sarcoma), soft 3000 4764 8375 918 25.50 tissue of forearm and/or wrist area; less than 3 cm
25078 Radical resection of tumor (eg, sarcoma), soft 3405 5408 9508 1211 33.63 tissue of forearm and/or wrist area; 3 cm or greater
25085 Capsulotomy, wrist (eg, contracture) 1942 3085 5423 465 12.91
25100 Arthrotomy, wrist joint; with biopsy 1168 1855 3261 357 9.93
25101 Arthrotomy, wrist joint; with joint exploration, 1321 2097 3687 417 11.58 with or without biopsy, with or without removal of loose or foreign body
25105 Arthrotomy, wrist joint; with synovectomy 1682 2671 4696 498 13.84
25107 Arthrotomy, distal radioulnar joint including 1914 3039 5343 638 17.73 repair of triangular cartilage, complex
25109 Excision of tendon, forearm and/or wrist, flexor 1840 2923 5139 557 15.47 or extensor, each
25110 Excision, lesion of tendon sheath, forearm 1206 1916 3368 352 9.78 and/or wrist
25111 Excision of ganglion, wrist (dorsal or volar); 1082 1718 3021 331 9.20 primary
25112 Excision of ganglion, wrist (dorsal or volar); 1269 2015 3543 400 11.11 recurrent
25115 Radical excision of bursa, synovia of wrist, or 2627 4171 7334 786 21.84 forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); flexors
25116 Radical excision of bursa, synovia of wrist, or 2224 3532 6209 621 17.26 forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum
25118 Synovectomy, extensor tendon sheath, wrist, 1580 2510 4413 394 10.95 single compartment;
25119 Synovectomy, extensor tendon sheath, wrist, 1688 2681 4713 517 14.35 single compartment; with resection of distal ulna
CPT copyright 2017 American Medical Association. 133 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25120 Excision or curettage of bone cyst or benign 2029 3223 5666 514 14.27 tumor of radius or ulna (excluding head or neck of radius and olecranon process);
25125 Excision or curettage of bone cyst or benign 2006 3185 5600 614 17.05 tumor of radius or ulna (excluding head or neck of radius and olecranon process); with autograft (includes obtaining graft)
25126 Excision or curettage of bone cyst or benign 2020 3208 5639 618 17.17 tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft
25130 Excision or curettage of bone cyst or benign 1562 2481 4363 462 12.83 tumor of carpal bones;
25135 Excision or curettage of bone cyst or benign 1890 3002 5278 579 16.07 tumor of carpal bones; with autograft (includes obtaining graft)
25136 Excision or curettage of bone cyst or benign 1668 2649 4657 510 14.18 tumor of carpal bones; with allograft
25145 Sequestrectomy (eg, for osteomyelitis or bone 1749 2778 4884 535 14.87 abscess), forearm and/or wrist
25150 Partial excision (craterization, saucerization, or 1889 3000 5275 588 16.32 diaphysectomy) of bone (eg, for osteomyelitis); ulna
25151 Partial excision (craterization, saucerization, or 1984 3151 5540 603 16.75 diaphysectomy) of bone (eg, for osteomyelitis); radius
25170 Radical resection of tumor, radius or ulna 5026 7982 14034 1538 42.73
25210 Carpectomy; 1 bone 1536 2439 4288 504 14.00
25215 Carpectomy; all bones of proximal row 2180 3463 6088 639 17.76
25230 Radial styloidectomy (separate procedure) 1515 2406 4230 448 12.44
25240 Excision distal ulna partial or complete (eg, 1700 2700 4747 443 12.31 Darrach type or matched resection)
25246 Injection procedure for wrist arthrography 427 678 1193 165 4.59
25248 Exploration with removal of deep foreign body, 1269 2015 3542 426 11.84 forearm or wrist
25250 Removal of wrist prosthesis; (separate 1794 2849 5009 549 15.25 procedure)
25251 Removal of wrist prosthesis; complicated, 2437 3871 6805 746 20.72 including total wrist
134 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25259 Manipulation, wrist, under anesthesia 1196 1900 3341 430 11.94
25260 Repair, tendon or muscle, flexor, forearm 2431 3860 6787 652 18.10 and/or wrist; primary, single, each tendon or muscle
25263 Repair, tendon or muscle, flexor, forearm 2001 3177 5586 649 18.04 and/or wrist; secondary, single, each tendon or muscle
25265 Repair, tendon or muscle, flexor, forearm 2561 4067 7150 784 21.77 and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle
25270 Repair, tendon or muscle, extensor, forearm 1846 2931 5154 507 14.08 and/or wrist; primary, single, each tendon or muscle
25272 Repair, tendon or muscle, extensor, forearm 1957 3108 5464 577 16.02 and/or wrist; secondary, single, each tendon or muscle
25274 Repair, tendon or muscle, extensor, forearm 2277 3617 6359 697 19.36 and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle
25275 Repair, tendon sheath, extensor, forearm and/or 2102 3339 5870 695 19.30 wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)
25280 Lengthening or shortening of flexor or extensor 2317 3679 6469 583 16.20 tendon, forearm and/or wrist, single, each tendon
25290 Tenotomy, open, flexor or extensor tendon, 2027 3220 5661 451 12.54 forearm and/or wrist, single, each tendon
25295 Tenolysis, flexor or extensor tendon, forearm 1958 3110 5468 543 15.08 and/or wrist, single, each tendon
25300 Tenodesis at wrist; flexors of fingers 2334 3706 6516 714 19.84
25301 Tenodesis at wrist; extensors of fingers 2115 3359 5906 666 18.50
25310 Tendon transplantation or transfer, flexor or 2498 3968 6976 642 17.82 extensor, forearm and/or wrist, single; each tendon
25312 Tendon transplantation or transfer, flexor or 2341 3717 6536 743 20.64 extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon
CPT copyright 2017 American Medical Association. 135 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25315 Flexor origin slide (eg, for cerebral palsy, 2610 4145 7288 799 22.19 Volkmann contracture), forearm and/or wrist;
25316 Flexor origin slide (eg, for cerebral palsy, 3096 4917 8645 948 26.32 Volkmann contracture), forearm and/or wrist; with tendon(s) transfer
25320 Capsulorrhaphy or reconstruction, wrist, open 3037 4823 8480 1022 28.39 (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability
25332 Arthroplasty, wrist, with or without 3317 5268 9263 872 24.23 interposition, with or without external or internal fixation
25335 Centralization of wrist on ulna (eg, radial club 3196 5076 8924 978 27.17 hand)
25337 Reconstruction for stabilization of unstable 2798 4444 7814 925 25.69 distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint
25350 Osteotomy, radius; distal third 2155 3422 6017 698 19.40
25355 Osteotomy, radius; middle or proximal third 2595 4121 7245 794 22.06
25360 Osteotomy; ulna 2036 3233 5685 677 18.80
25365 Osteotomy; radius and ulna 3100 4922 8654 949 26.35
25370 Multiple osteotomies, with realignment on 3409 5414 9518 1043 28.98 intramedullary rod (Sofield type procedure); radius or ulna
25375 Multiple osteotomies, with realignment on 3229 5128 9016 988 27.45 intramedullary rod (Sofield type procedure); radius and ulna
25390 Osteoplasty, radius or ulna; shortening 2564 4072 7160 797 22.14
25391 Osteoplasty, radius or ulna; lengthening with 3375 5360 9423 1033 28.69 autograft
25392 Osteoplasty, radius and ulna; shortening 3436 5457 9594 1052 29.21 (excluding 64876)
25393 Osteoplasty, radius and ulna; lengthening with 3835 6090 1070 1174 32.60 autograft 7
25394 Osteoplasty, carpal bone, shortening 2656 4218 7416 813 22.58
136 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25400 Repair of nonunion or malunion, radius or ulna; 2636 4187 7361 833 23.13 without graft (eg, compression technique)
25405 Repair of nonunion or malunion, radius or ulna; 3320 5272 9269 1074 29.84 with autograft (includes obtaining graft)
25415 Repair of nonunion or malunion, radius and 3278 5206 9154 1003 27.87 ulna; without graft (eg, compression technique)
25420 Repair of nonunion or malunion, radius and 3962 6292 11062 1212 33.68 ulna; with autograft (includes obtaining graft)
25425 Repair of defect with autograft; radius or ulna 3262 5180 9108 998 27.73
25426 Repair of defect with autograft; radius and ulna 3812 6054 10645 1167 32.41
25430 Insertion of vascular pedicle into carpal bone 2476 3932 6914 758 21.05 (eg, Hori procedure)
25431 Repair of nonunion of carpal bone (excluding 2674 4246 7466 818 22.73 carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone
25440 Repair of nonunion, scaphoid carpal (navicular) 2484 3944 6935 797 22.14 bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)
25441 Arthroplasty with prosthetic replacement; distal 3174 5040 8861 971 26.98 radius
25442 Arthroplasty with prosthetic replacement; distal 2727 4330 7613 834 23.18 ulna
25443 Arthroplasty with prosthetic replacement; 2645 4201 7387 810 22.49 scaphoid carpal (navicular)
25444 Arthroplasty with prosthetic replacement; 2800 4446 7817 857 23.80 lunate
25445 Arthroplasty with prosthetic replacement; 2257 3584 6301 748 20.77 trapezium
25446 Arthroplasty with prosthetic replacement; distal 3974 6310 11095 1216 33.78 radius and partial or entire carpus (total wrist)
25447 Arthroplasty, interposition, intercarpal or 2849 4525 7956 858 23.83 carpometacarpal joints
25449 Revision of arthroplasty, including removal of 3495 5550 9758 1070 29.71 implant, wrist joint
25450 Epiphyseal arrest by epiphysiodesis or stapling; 1967 3124 5493 638 17.72 distal radius or ulna
CPT copyright 2017 American Medical Association. 137 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25455 Epiphyseal arrest by epiphysiodesis or stapling; 2455 3899 6855 751 20.87 distal radius and ulna
25490 Prophylactic treatment (nailing, pinning, 2435 3867 6799 745 20.70 plating or wiring) with or without methylmethacrylate; radius
25491 Prophylactic treatment (nailing, pinning, 2504 3977 6993 766 21.29 plating or wiring) with or without methylmethacrylate; ulna
25492 Prophylactic treatment (nailing, pinning, 3064 4866 8556 938 26.05 plating or wiring) with or without methylmethacrylate; radius and ulna
25500 Closed treatment of radial shaft fracture; 670 881 1315 282 7.84 without manipulation
25505 Closed treatment of radial shaft fracture; with 1330 1748 2609 513 14.24 manipulation
25515 Open treatment of radial shaft fracture, includes 1972 2592 3869 693 19.24 internal fixation, when performed
25520 Closed treatment of radial shaft fracture and 1597 2098 3132 588 16.32 closed treatment of dislocation of distal radioulnar joint (Galeazzi fracture/dislocation)
25525 Open treatment of radial shaft fracture, includes 2451 3221 4806 813 22.57 internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (Galeazzi fracture/ dislocation), includes percutaneous skeletal fixation, when performed
25526 Open treatment of radial shaft fracture, includes 2669 3508 5235 990 27.51 internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/ dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex
25530 Closed treatment of ulnar shaft fracture; 688 904 1350 271 7.54 without manipulation
25535 Closed treatment of ulnar shaft fracture; with 1275 1676 2501 501 13.92 manipulation
25545 Open treatment of ulnar shaft fracture, includes 1899 2496 3725 643 17.87 internal fixation, when performed
25560 Closed treatment of radial and ulnar shaft 725 953 1423 287 7.98 fractures; without manipulation
25565 Closed treatment of radial and ulnar shaft 1475 1938 2893 533 14.80 fractures; with manipulation
138 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25574 Open treatment of radial and ulnar shaft 1983 2606 3890 697 19.36 fractures, with internal fixation, when performed; of radius or ulna
25575 Open treatment of radial and ulnar shaft 2676 3517 5249 933 25.91 fractures, with internal fixation, when performed; of radius and ulna
25600 Closed treatment of distal radial fracture (eg, 849 1116 1666 339 9.42 Colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation
25605 Closed treatment of distal radial fracture (eg, 1547 2033 3034 559 15.54 Colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation
25606 Percutaneous skeletal fixation of distal radial 1973 2593 3870 686 19.06 fracture or epiphyseal separation
25607 Open treatment of distal radial extra-articular 2099 2758 4116 760 21.12 fracture or epiphyseal separation, with internal fixation
25608 Open treatment of distal radial intra-articular 2367 3111 4643 854 23.71 fracture or epiphyseal separation; with internal fixation of 2 fragments
25609 Open treatment of distal radial intra-articular 3053 4012 5988 1085 30.14 fracture or epiphyseal separation; with internal fixation of 3 or more fragments
25622 Closed treatment of carpal scaphoid (navicular) 826 1086 1621 315 8.76 fracture; without manipulation
25624 Closed treatment of carpal scaphoid (navicular) 1313 1725 2575 495 13.74 fracture; with manipulation
25628 Open treatment of carpal scaphoid (navicular) 2157 2835 4231 745 20.69 fracture, includes internal fixation, when performed
25630 Closed treatment of carpal bone fracture 800 1051 1568 316 8.77 (excluding carpal scaphoid [navicular]); without manipulation, each bone
25635 Closed treatment of carpal bone fracture 1251 1643 2453 471 13.09 (excluding carpal scaphoid [navicular]); with manipulation, each bone
25645 Open treatment of carpal bone fracture (other 1666 2189 3267 589 16.37 than carpal scaphoid [navicular]), each bone
25650 Closed treatment of ulnar styloid fracture 835 1097 1638 330 9.16
CPT copyright 2017 American Medical Association. 139 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25651 Percutaneous skeletal fixation of ulnar styloid 1377 1810 2702 501 13.92 fracture
25652 Open treatment of ulnar styloid fracture 1878 2469 3684 645 17.91
25660 Closed treatment of radiocarpal or intercarpal 1134 1490 2224 427 11.87 dislocation, 1 or more bones, with manipulation
25670 Open treatment of radiocarpal or intercarpal 1709 2246 3353 625 17.35 dislocation, 1 or more bones
25671 Percutaneous skeletal fixation of distal 1491 1960 2925 550 15.27 radioulnar dislocation
25675 Closed treatment of distal radioulnar 1132 1488 2221 447 12.41 dislocation with manipulation
25676 Open treatment of distal radioulnar dislocation, 2172 2854 4260 652 18.10 acute or chronic
25680 Closed treatment of trans-scaphoperilunar type 1063 1397 2084 539 14.96 of fracture dislocation, with manipulation
25685 Open treatment of trans-scaphoperilunar type 2220 2918 4355 762 21.18 of fracture dislocation
25690 Closed treatment of lunate dislocation, with 1319 1734 2588 497 13.81 manipulation
25695 Open treatment of lunate dislocation 1977 2598 3877 656 18.22
25800 Arthrodesis, wrist; complete, without bone 2300 3023 4512 759 21.07 graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)
25805 Arthrodesis, wrist; with sliding graft 2324 3055 4559 876 24.33
25810 Arthrodesis, wrist; with iliac or other autograft 2849 3744 5588 899 24.97 (includes obtaining graft)
25820 Arthrodesis, wrist; limited, without bone graft 2056 2703 4034 638 17.71 (eg, intercarpal or radiocarpal)
25825 Arthrodesis, wrist; with autograft (includes 2634 3462 5167 785 21.81 obtaining graft)
25830 Arthrodesis, distal radioulnar joint with 2616 3438 5130 986 27.38 segmental resection of ulna, with or without bone graft (eg, Sauve-Kapandji procedure)
25900 Amputation, forearm, through radius and ulna; 1940 2550 3806 731 20.31
25905 Amputation, forearm, through radius and ulna; 1928 2534 3781 726 20.18 open, circular (guillotine)
140 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
25907 Amputation, forearm, through radius and ulna; 1684 2213 3303 635 17.63 secondary closure or scar revision
25909 Amputation, forearm, through radius and ulna; 1882 2473 3691 709 19.70 re-amputation
25915 Krukenberg procedure 3144 4132 6166 1217 33.80
25920 Disarticulation through wrist; 1914 2515 3753 721 20.03
25922 Disarticulation through wrist; secondary 1574 2069 3087 633 17.58 closure or scar revision
25924 Disarticulation through wrist; re-amputation 1870 2457 3667 705 19.57
25927 Transmetacarpal amputation; 2226 2925 4366 839 23.30
25929 Transmetacarpal amputation; secondary closure 1639 2154 3215 618 17.16 or scar revision
25931 Transmetacarpal amputation; re-amputation 2045 2688 4012 771 21.41
25999 Unlisted procedure, forearm or wrist 0 0 0 0 0.00
HAND AND FINGERS
26010 Drainage of finger abscess; simple 573 891 1588 273 7.58
26011 Drainage of finger abscess; complicated (eg, 907 1410 2514 402 11.18 felon)
26020 Drainage of tendon sheath, digit and/or palm, 1365 2122 3782 448 12.44 each
26025 Drainage of palmar bursa; single, bursa 1336 2077 3703 436 12.11
26030 Drainage of palmar bursa; multiple bursa 1528 2376 4235 510 14.17
26034 Incision, bone cortex, hand or finger (eg, 1650 2566 4573 561 15.57 osteomyelitis or bone abscess)
26035 Decompression fingers and/or hand, injection 2522 3921 6990 889 24.70 injury (eg, grease gun)
26037 Decompressive fasciotomy, hand (excludes 1697 2639 4704 586 16.28 26035)
26040 Fasciotomy, palmar (eg, Dupuytren's 1009 1569 2796 322 8.95 contracture); percutaneous
26045 Fasciotomy, palmar (eg, Dupuytren's 1485 2308 4114 483 13.42 contracture); open, partial
26055 Tendon sheath incision (eg, for trigger finger) 1633 2539 4526 575 15.97
26060 Tenotomy, percutaneous, single, each digit 800 1244 2217 269 7.47
CPT copyright 2017 American Medical Association. 141 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26070 Arthrotomy, with exploration, drainage, or 933 1451 2586 330 9.16 removal of loose or foreign body; carpometacarpal joint
26075 Arthrotomy, with exploration, drainage, or 1239 1926 3434 344 9.55 removal of loose or foreign body; metacarpophalangeal joint, each
26080 Arthrotomy, with exploration, drainage, or 1320 2052 3658 404 11.21 removal of loose or foreign body; interphalangeal joint, each
26100 Arthrotomy with biopsy; carpometacarpal joint, 1031 1603 2858 347 9.63 each
26105 Arthrotomy with biopsy; metacarpophalangeal 1048 1629 2903 349 9.69 joint, each
26110 Arthrotomy with biopsy; interphalangeal joint, 1045 1625 2896 332 9.23 each
26111 Excision, tumor or vascular malformation, soft 1386 2155 3842 433 12.03 tissue of hand or finger, subcutaneous; 1.5 cm or greater
26113 Excision, tumor, soft tissue, or vascular 1728 2687 4788 568 15.79 malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater
26115 Excision, tumor or vascular malformation, soft 1455 2261 4031 519 14.43 tissue of hand or finger, subcutaneous; less than 1.5 cm
26116 Excision, tumor, soft tissue, or vascular 1642 2553 4551 546 15.17 malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm
26117 Radical resection of tumor (eg, sarcoma), soft 2406 3740 6667 773 21.46 tissue of hand or finger; less than 3 cm
26118 Radical resection of tumor (eg, sarcoma), soft 3248 5049 9000 1092 30.33 tissue of hand or finger; 3 cm or greater
26121 Fasciectomy, palm only, with or without z- 2469 3839 6842 619 17.19 plasty, other local tissue rearrange, or skin grafting (includes obtaining graft)
26123 Fasciectomy, partial palmar with release of 2951 4589 8179 864 23.99 single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrange, or skin grafting (includes obtaining graft);
26125 Fasciectomy, partial palmar with release of 1112 1728 3080 285 7.92 single digit including proximal interphalangeal
142 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft); each additional digit (list separately in addition to code for primary procedure)
26130 Synovectomy, carpometacarpal joint 1416 2201 3923 476 13.22
26135 Synovectomy, metacarpophalangeal joint 1750 2720 4849 570 15.84 including intrinsic release and extensor hood reconstruction, each digit
26140 Synovectomy, proximal interphalangeal joint, 1745 2713 4835 521 14.47 including extensor reconstruction, each interphalangeal joint
26145 Synovectomy, tendon sheath, radical 2000 3110 5543 530 14.72 (tenosynovectomy), flexor tendon, palm and/or finger, each tendon
26160 Excision of lesion of tendon sheath or joint 1631 2536 4520 592 16.44 capsule (eg, cyst, mucous cyst, or ganglion), hand or finger
26170 Excision of tendon, palm, flexor or extensor, 1331 2069 3689 420 11.68 single, each tendon
26180 Excision of tendon, finger, flexor or extensor, 1446 2249 4008 459 12.74 each tendon
26185 Sesamoidectomy, thumb or finger (separate 1696 2637 4700 570 15.84 procedure)
26200 Excision or curettage of bone cyst or benign 1474 2291 4084 465 12.91 tumor of metacarpal;
26205 Excision or curettage of bone cyst or benign 1854 2882 5137 623 17.31 tumor of metacarpal; with autograft (includes obtaining graft)
26210 Excision or curettage of bone cyst or benign 2102 3268 5824 457 12.70 tumor of proximal, middle, or distal phalanx of finger;
26215 Excision or curettage of bone cyst or benign 1929 2998 5344 583 16.20 tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft)
26230 Partial excision (craterization, saucerization, or 1506 2342 4174 517 14.37 diaphysectomy) bone (eg, osteomyelitis); metacarpal
26235 Partial excision (craterization, saucerization, or 1480 2301 4101 510 14.16 diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26236 Partial excision (craterization, saucerization, or 1360 2115 3769 456 12.67 diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger
26250 Radical resection of tumor, metacarpal 3308 5143 9166 1112 30.89
26260 Radical resection of tumor, proximal or middle 2480 3856 6872 834 23.16 phalanx of finger
26262 Radical resection of tumor, distal phalanx of 1955 3040 5418 657 18.26 finger
26320 Removal of implant from finger or hand 1225 1905 3395 358 9.95
26340 Manipulation, finger joint, under anesthesia, 1046 1462 2261 344 9.55 each joint
26341 Manipulation, palmar fascial cord (ie, 301 420 650 102 2.84 Dupuytren's cord), post enzyme injection (eg, collagenase), single cord
26350 Repair or advancement, flexor tendon, not in 2282 3190 4932 726 20.17 zone 2 digital flexor tendon sheath (eg, no man's land); primary or secondary without free graft, each tendon
26352 Repair or advancement, flexor tendon, not in 2381 3328 5146 835 23.20 zone 2 digital flexor tendon sheath (eg, no man's land); secondary with free graft (includes obtaining graft), each tendon
26356 Repair or advancement, flexor tendon, in zone 3129 4374 6763 820 22.79 2 digital flexor tendon sheath (eg, no man's land); primary, without free graft, each tendon
26357 Repair or advancement, flexor tendon, in zone 2686 3755 5805 919 25.52 2 digital flexor tendon sheath (eg, no man's land); secondary, without free graft, each tendon
26358 Repair or advancement, flexor tendon, in zone 2824 3948 6104 1017 28.26 2 digital flexor tendon sheath (eg, no man's land); secondary, with free graft (includes obtaining graft), each tendon
26370 Repair or advancement of profundus tendon, 2450 3425 5296 773 21.46 with intact superficialis tendon; primary, each tendon
26372 Repair or advancement of profundus tendon, 2580 3606 5576 905 25.14 with intact superficialis tendon; secondary with free graft (includes obtaining graft), each tendon
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26373 Repair or advancement of profundus tendon, 2475 3460 5350 868 24.12 with intact superficialis tendon; secondary without free graft, each tendon
26390 Excision flexor tendon, with implantation of 2460 3439 5318 856 23.77 synthetic rod for delayed tendon graft, hand or finger, each rod
26392 Removal of synthetic rod and insertion of 2920 4082 6312 997 27.70 flexor tendon graft, hand or finger (includes obtaining graft), each rod
26410 Repair, extensor tendon, hand, primary or 1769 2474 3825 576 16.01 secondary; without free graft, each tendon
26412 Repair, extensor tendon, hand, primary or 1985 2776 4292 699 19.42 secondary; with free graft (includes obtaining graft), each tendon
26415 Excision of extensor tendon, with implantation 2229 3116 4818 832 23.12 of synthetic rod for delayed tendon graft, hand or finger, each rod
26416 Removal of synthetic rod and insertion of 2582 3609 5581 906 25.16 extensor tendon graft (includes obtaining graft), hand or finger, each rod
26418 Repair, extensor tendon, finger, primary or 1918 2681 4145 588 16.34 secondary; without free graft, each tendon
26420 Repair, extensor tendon, finger, primary or 2223 3107 4805 730 20.29 secondary; with free graft (includes obtaining graft) each tendon
26426 Repair of extensor tendon, central slip, 1952 2730 4220 518 14.38 secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger
26428 Repair of extensor tendon, central slip, 2204 3081 4765 773 21.48 secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger
26432 Closed treatment of distal extensor tendon 1490 2084 3222 508 14.12 insertion, with or without percutaneous pinning (eg, mallet finger)
26433 Repair of extensor tendon, distal insertion, 1700 2376 3674 541 15.02 primary or secondary; without graft (eg, mallet finger)
26434 Repair of extensor tendon, distal insertion, 1886 2637 4077 662 18.38 primary or secondary; with free graft (includes obtaining graft)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26437 Realignment of extensor tendon, hand, each 1973 2758 4265 635 17.65 tendon
26440 Tenolysis, flexor tendon; palm or finger, each 2050 2866 4431 632 17.55 tendon
26442 Tenolysis, flexor tendon; palm and finger, each 2851 3986 6164 985 27.37 tendon
26445 Tenolysis, extensor tendon, hand or finger, 1899 2655 4105 588 16.33 each tendon
26449 Tenolysis, complex, extensor tendon, finger, 2088 2919 4513 712 19.77 including forearm, each tendon
26450 Tenotomy, flexor, palm, open, each tendon 1367 1911 2955 415 11.54
26455 Tenotomy, flexor, finger, open, each tendon 1476 2064 3191 412 11.44
26460 Tenotomy, extensor, hand or finger, open, each 1258 1758 2719 402 11.18 tendon
26471 Tenodesis; of proximal interphalangeal joint, 1901 2658 4110 629 17.47 each joint
26474 Tenodesis; of distal joint, each joint 1750 2446 3782 614 17.05
26476 Lengthening of tendon, extensor, hand or 1725 2412 3729 605 16.81 finger, each tendon
26477 Shortening of tendon, extensor, hand or finger, 1688 2360 3649 592 16.45 each tendon
26478 Lengthening of tendon, flexor, hand or finger, 2007 2806 4339 630 17.51 each tendon
26479 Shortening of tendon, flexor, hand or finger, 1823 2549 3942 640 17.77 each tendon
26480 Transfer or transplant of tendon, 2686 3754 5805 768 21.32 carpometacarpal area or dorsum of hand; without free graft, each tendon
26483 Transfer or transplant of tendon, 2706 3783 5850 860 23.89 carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), each tendon
26485 Transfer or transplant of tendon, palmar; 2316 3238 5006 822 22.84 without free tendon graft, each tendon
26489 Transfer or transplant of tendon, palmar; with 2730 3816 5900 958 26.60 free tendon graft (includes obtaining graft), each tendon
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26490 Opponensplasty; superficialis tendon transfer 2321 3245 5017 814 22.62 type, each tendon
26492 Opponensplasty; tendon transfer with graft 2575 3599 5565 903 25.09 (includes obtaining graft), each tendon
26494 Opponensplasty; hypothenar muscle transfer 2332 3261 5042 818 22.73
26496 Opponensplasty; other methods 2532 3539 5472 888 24.67
26497 Transfer of tendon to restore intrinsic function; 2525 3530 5459 886 24.61 ring and small finger
26498 Transfer of tendon to restore intrinsic function; 3340 4670 7220 1172 32.55 all 4 fingers
26499 Correction claw finger, other methods 2420 3383 5230 849 23.58
26500 Reconstruction of tendon pulley, each tendon; 1959 2738 4234 636 17.66 with local tissues (separate procedure)
26502 Reconstruction of tendon pulley, each tendon; 2066 2888 4465 726 20.16 with tendon or fascial graft (includes obtaining graft) (separate procedure)
26508 Release of thenar muscle(s) (eg, thumb 1833 2562 3962 643 17.86 contracture)
26510 Cross intrinsic transfer, each tendon 1730 2419 3740 607 16.86
26516 Capsulodesis, metacarpophalangeal joint; 2323 3247 5021 715 19.85 single digit
26517 Capsulodesis, metacarpophalangeal joint; 2 2404 3361 5197 843 23.43 digits
26518 Capsulodesis, metacarpophalangeal joint; 3 or 4 2438 3409 5270 855 23.76 digits
26520 Capsulectomy or capsulotomy; 1968 2751 4254 662 18.39 metacarpophalangeal joint, each joint
26525 Capsulectomy or capsulotomy; interphalangeal 2011 2811 4347 664 18.45 joint, each joint
26530 Arthroplasty, metacarpophalangeal joint; each 1807 2526 3905 557 15.46 joint
26531 Arthroplasty, metacarpophalangeal joint; with 1941 2714 4196 646 17.94 prosthetic implant, each joint
26535 Arthroplasty, interphalangeal joint; each joint 1750 2447 3783 440 12.23
26536 Arthroplasty, interphalangeal joint; with 2181 3049 4715 725 20.14 prosthetic implant, each joint
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26540 Repair of collateral ligament, 2196 3069 4746 670 18.62 metacarpophalangeal or interphalangeal joint
26541 Reconstruction, collateral ligament, 2513 3513 5432 818 22.72 metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)
26542 Reconstruction, collateral ligament, 2187 3058 4728 691 19.20 metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)
26545 Reconstruction, collateral ligament, 2084 2913 4504 715 19.85 interphalangeal joint, single, including graft, each joint
26546 Repair non-union, metacarpal or phalanx 2815 3935 6084 1015 28.20 (includes obtaining bone graft with or without external or internal fixation)
26548 Repair and reconstruction, finger, volar plate, 2439 3410 5272 777 21.58 interphalangeal joint
26550 Pollicization of a digit 4822 6741 10423 1692 46.99
26551 Transfer, toe-to-hand with microvascular 9721 13590 21013 3410 94.73 anastomosis; great toe wrap-around with bone graft
26553 Transfer, toe-to-hand with microvascular 9393 13132 20305 3387 94.09 anastomosis; other than great toe, single
26554 Transfer, toe-to-hand with microvascular 10998 15375 23773 3952 109.78 anastomosis; other than great toe, double
26555 Transfer, finger to another position without 4014 5612 8677 1408 39.12 microvascular anastomosis
26556 Transfer, free toe joint, with microvascular 10031 14023 21683 3519 97.75 anastomosis
26560 Repair of syndactyly (web finger) each web 1720 2404 3718 603 16.76 space; with skin flaps
26561 Repair of syndactyly (web finger) each web 3077 4302 6652 968 26.90 space; with skin flaps and grafts
26562 Repair of syndactyly (web finger) each web 3929 5493 8493 1378 38.29 space; complex (eg, involving bone, nails)
26565 Osteotomy; metacarpal, each 1936 2707 4185 697 19.37
26567 Osteotomy; phalanx of finger, each 2009 2809 4343 694 19.29
26568 Osteoplasty, lengthening, metacarpal or 2625 3670 5674 921 25.58 phalanx
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26580 Repair cleft hand 4433 6197 9582 1555 43.20
26587 Reconstruction of polydactylous digit, soft 3100 4334 6701 1077 29.92 tissue and bone
26590 Repair macrodactylia, each digit 4125 5767 8917 1447 40.20
26591 Repair, intrinsic muscles of hand, each muscle 1913 2675 4136 445 12.37
26593 Release, intrinsic muscles of hand, each muscle 1846 2581 3991 612 17.00
26596 Excision of constricting ring of finger, with 2229 3116 4818 782 21.72 multiple z-plasties
26600 Closed treatment of metacarpal fracture, single; 700 979 1513 303 8.43 without manipulation, each bone
26605 Closed treatment of metacarpal fracture, single; 823 1151 1779 332 9.21 with manipulation, each bone
26607 Closed treatment of metacarpal fracture, with 1160 1621 2507 474 13.16 manipulation, with external fixation, each bone
26608 Percutaneous skeletal fixation of metacarpal 1470 2055 3178 491 13.64 fracture, each bone
26615 Open treatment of metacarpal fracture, single, 1654 2313 3576 596 16.55 includes internal fixation, when performed, each bone
26641 Closed treatment of carpometacarpal 974 1362 2106 395 10.97 dislocation, thumb, with manipulation
26645 Closed treatment of carpometacarpal fracture 1260 1762 2724 442 12.28 dislocation, thumb (Bennett fracture), with manipulation
26650 Percutaneous skeletal fixation of 1520 2124 3285 492 13.66 carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation
26665 Open treatment of carpometacarpal fracture 1954 2732 4225 648 18.00 dislocation, thumb (Bennett fracture), includes internal fixation, when performed
26670 Closed treatment of carpometacarpal 897 1253 1938 352 9.79 dislocation, other than thumb, with manipulation, each joint; without anesthesia
26675 Closed treatment of carpometacarpal 1339 1872 2895 470 13.05 dislocation, other than thumb, with manipulation, each joint; requiring anesthesia
26676 Percutaneous skeletal fixation of 1525 2132 3297 517 14.37 carpometacarpal dislocation, other than thumb, with manipulation, each joint
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26685 Open treatment of carpometacarpal dislocation, 1725 2412 3730 596 16.56 other than thumb; includes internal fixation, when performed, each joint
26686 Open treatment of carpometacarpal dislocation, 1970 2754 4259 645 17.93 other than thumb; complex, multiple, or delayed reduction
26700 Closed treatment of metacarpophalangeal 811 1134 1753 333 9.26 dislocation, single, with manipulation; without anesthesia
26705 Closed treatment of metacarpophalangeal 1053 1473 2277 426 11.84 dislocation, single, with manipulation; requiring anesthesia
26706 Percutaneous skeletal fixation of 1293 1808 2795 454 12.60 metacarpophalangeal dislocation, single, with manipulation
26715 Open treatment of metacarpophalangeal 1726 2413 3731 593 16.46 dislocation, single, includes internal fixation, when performed
26720 Closed treatment of phalangeal shaft fracture, 550 769 1189 204 5.68 proximal or middle phalanx, finger or thumb; without manipulation, each
26725 Closed treatment of phalangeal shaft fracture, 898 1256 1941 347 9.63 proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each
26727 Percutaneous skeletal fixation of unstable 1500 2098 3243 485 13.46 phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each
26735 Open treatment of phalangeal shaft fracture, 1735 2426 3751 617 17.13 proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each
26740 Closed treatment of articular fracture, involving 628 878 1358 238 6.61 metacarpophalangeal or interphalangeal joint; without manipulation, each
26742 Closed treatment of articular fracture, involving 1029 1438 2224 382 10.60 metacarpophalangeal or interphalangeal joint; with manipulation, each
26746 Open treatment of articular fracture, involving 2151 3006 4649 768 21.34 metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26750 Closed treatment of distal phalangeal fracture, 498 696 1076 190 5.28 finger or thumb; without manipulation, each
26755 Closed treatment of distal phalangeal fracture, 800 1119 1730 324 9.00 finger or thumb; with manipulation, each
26756 Percutaneous skeletal fixation of distal 1265 1768 2734 429 11.93 phalangeal fracture, finger or thumb, each
26765 Open treatment of distal phalangeal fracture, 1500 2097 3243 517 14.37 finger or thumb, includes internal fixation, when performed, each
26770 Closed treatment of interphalangeal joint 695 971 1502 284 7.90 dislocation, single, with manipulation; without anesthesia
26775 Closed treatment of interphalangeal joint 908 1269 1962 393 10.92 dislocation, single, with manipulation; requiring anesthesia
26776 Percutaneous skeletal fixation of 1343 1878 2903 458 12.71 interphalangeal joint dislocation, single, with manipulation
26785 Open treatment of interphalangeal joint 1557 2176 3365 566 15.71 dislocation, includes internal fixation, when performed, single
26820 Fusion in opposition, thumb, with autogenous 2296 3209 4962 805 22.37 graft (includes obtaining graft)
26841 Arthrodesis, carpometacarpal joint, thumb, with 2197 3071 4749 740 20.55 or without internal fixation;
26842 Arthrodesis, carpometacarpal joint, thumb, with 2304 3221 4980 798 22.17 or without internal fixation; with autograft (includes obtaining graft)
26843 Arthrodesis, carpometacarpal joint, digit, other 2151 3007 4649 755 20.96 than thumb, each;
26844 Arthrodesis, carpometacarpal joint, digit, other 2388 3338 5162 838 23.27 than thumb, each; with autograft (includes obtaining graft)
26850 Arthrodesis, metacarpophalangeal joint, with or 2346 3279 5070 705 19.59 without internal fixation;
26852 Arthrodesis, metacarpophalangeal joint, with or 2431 3398 5254 812 22.56 without internal fixation; with autograft (includes obtaining graft)
26860 Arthrodesis, interphalangeal joint, with or 2006 2805 4337 576 16.00 without internal fixation;
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
26861 Arthrodesis, interphalangeal joint, with or 411 575 889 107 2.98 without internal fixation; each additional interphalangeal joint (list separately in addition to code for primary procedure)
26862 Arthrodesis, interphalangeal joint, with or 2321 3244 5016 741 20.59 without internal fixation; with autograft (includes obtaining graft)
26863 Arthrodesis, interphalangeal joint, with or 682 954 1475 239 6.65 without internal fixation; with autograft (includes obtaining graft), each additional joint (list separately in addition to code for primary procedure)
26910 Amputation, metacarpal, with finger or thumb 2070 2894 4475 739 20.52 (ray amputation), single, with or without interosseous transfer
26951 Amputation, finger or thumb, primary or 1831 2559 3957 665 18.48 secondary, any joint or phalanx, single, including neurectomies; with direct closure
26952 Amputation, finger or thumb, primary or 2013 2814 4352 657 18.26 secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (v-y, hood)
26989 Unlisted procedure, hands or fingers 0 0 0 0 0.00
PELVIS AND HIP JOINT
26990 Incision and drainage, pelvis or hip joint area; 1704 2540 3799 649 18.04 deep abscess or hematoma
26991 Incision and drainage, pelvis or hip joint area; 1914 2853 4267 732 20.32 infected bursa
26992 Incision, bone cortex, pelvis and/or hip joint 2611 3891 5820 993 27.58 (eg, osteomyelitis or bone abscess)
27000 Tenotomy, adductor of hip, percutaneous 1318 1964 2938 425 11.80 (separate procedure)
27001 Tenotomy, adductor of hip, open 1835 2735 4091 558 15.49
27003 Tenotomy, adductor, subcutaneous, open, with 2043 3045 4554 617 17.15 obturator neurectomy
27005 Tenotomy, hip flexor(s), open (separate 2226 3317 4961 749 20.80 procedure)
27006 Tenotomy, abductors and/or extensor(s) of hip, 2110 3145 4704 756 21.00 open (separate procedure)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
27025 Fasciotomy, hip or thigh, any type 2000 2981 4459 953 26.48
27027 Decompression fasciotomy(ies), pelvic 3019 4499 6729 912 25.34 (buttock) compartment(s) (eg, gluteus medius- minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral
27030 Arthrotomy, hip, with drainage (eg, infection) 2667 3975 5946 971 26.97
27033 Arthrotomy, hip, including exploration or 2757 4108 6145 1006 27.95 removal of loose or foreign body
27035 Denervation, hip joint, intrapelvic or 3920 5843 8739 1185 32.91 extrapelvic intra-articular branches of sciatic, femoral, or obturator nerves
27036 Capsulectomy or capsulotomy, hip, with or 3212 4787 7160 1049 29.13 without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas)
27040 Biopsy, soft tissue of pelvis and hip area; 519 773 1157 355 9.87 superficial
27041 Biopsy, soft tissue of pelvis and hip area; deep, 1450 2161 3232 720 19.99 subfascial or intramuscular
27043 Excision, tumor, soft tissue of pelvis and hip 1227 1829 2735 487 13.54 area, subcutaneous; 3 cm or greater
27045 Excision, tumor, soft tissue of pelvis and hip 1974 2942 4400 774 21.50 area, subfascial (eg, intramuscular); 5 cm or greater
27047 Excision, tumor, soft tissue of pelvis and hip 1205 1796 2686 480 13.34 area, subcutaneous; less than 3 cm
27048 Excision, tumor, soft tissue of pelvis and hip 1492 2224 3327 633 17.58 area, subfascial (eg, intramuscular); less than 5 cm
27049 Radical resection of tumor (eg, sarcoma), soft 4616 6879 1029 1395 38.75 tissue of pelvis and hip area; less than 5 cm 0
27050 Arthrotomy, with biopsy; sacroiliac joint 1377 2052 3070 416 11.56
27052 Arthrotomy, with biopsy; hip joint 1987 2961 4429 600 16.68
27054 Arthrotomy with synovectomy, hip joint 2051 3056 4571 709 19.69
27057 Decompression fasciotomy(ies), pelvic 3487 5196 7772 1054 29.27 (buttock) compartment(s) (eg, gluteus medius- minimus, gluteus maximus, iliopsoas, and/or
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
tensor fascia lata muscle) with debridement of nonviable muscle, unilateral
27059 Radical resection of tumor (eg, sarcoma), soft 5318 7926 11855 1895 52.65 tissue of pelvis and hip area; 5 cm or greater
27060 Excision; ischial bursa 1595 2377 3556 482 13.39
27062 Excision; trochanteric bursa or calcification 1361 2028 3034 472 13.10
27065 Excision of bone cyst or benign tumor, wing of 1780 2652 3967 538 14.94 ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed
27066 Excision of bone cyst or benign tumor, wing of 2818 4200 6283 836 23.21 ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed
27067 Excision of bone cyst or benign tumor, wing of 3552 5294 7918 1074 29.82 ilium, symphysis pubis, or greater trochanter of femur; with autograft requiring separate incision
27070 Partial excision, wing of ilium, symphysis 2897 4318 6458 876 24.32 pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial
27071 Partial excision, wing of ilium, symphysis 2720 4053 6062 950 26.39 pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); deep (subfascial or intramuscular)
27075 Radical resection of tumor; wing of ilium, 1 7241 10792 16142 2188 60.79 pubic or ischial ramus or symphysis pubis
27076 Radical resection of tumor; ilium, including 8770 13070 19549 2650 73.62 acetabulum, both pubic rami, or ischium and acetabulum
27077 Radical resection of tumor; innominate bone, 9782 14579 21806 2956 82.12 total
27078 Radical resection of tumor; ischial tuberosity 7140 10641 15917 2158 59.94 and greater trochanter of femur
27080 Coccygectomy, primary 1415 2108 3154 531 14.76
27086 Removal of foreign body, pelvis or hip; 1014 1511 2260 306 8.51 subcutaneous tissue
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
27087 Removal of foreign body, pelvis or hip; deep 1612 2403 3594 633 17.58 (subfascial or intramuscular)
27090 Removal of hip prosthesis; (separate procedure) 2138 3186 4766 860 23.89
27091 Removal of hip prosthesis; complicated, 4634 6907 10331 1659 46.09 including total hip prosthesis, methylmethacrylate with or without insertion of spacer
27093 Injection procedure for hip arthrography; 548 817 1221 192 5.33 without anesthesia
27095 Injection procedure for hip arthrography; with 633 944 1411 252 7.00 anesthesia
27096 Injection procedure for sacroiliac joint, 617 919 1375 163 4.53 anesthetic/steroid, with image guidance (fluoroscopy or ct) including arthrography when performed
27097 Release or recession, hamstring, proximal 2337 3483 5210 706 19.62
27098 Transfer, adductor to ischium 2379 3545 5303 719 19.97
27100 Transfer external oblique muscle to greater 2835 4225 6320 857 23.80 trochanter including fascial or tendon extension (graft)
27105 Transfer paraspinal muscle to hip (includes 2976 4435 6633 899 24.98 fascial or tendon extension graft)
27110 Transfer iliopsoas; to greater trochanter of 3328 4960 7419 1006 27.94 femur
27111 Transfer iliopsoas; to femoral neck 3089 4603 6885 933 25.93
27120 Acetabuloplasty; (eg, Whitman, colonna, 4473 6666 9971 1352 37.55 Haygroves, or cup type)
27122 Acetabuloplasty; resection, femoral head (eg, 3405 5074 7590 1142 31.71 Girdlestone procedure)
27125 Hemiarthroplasty, hip, partial (eg, femoral stem 3272 4877 7294 1178 32.71 prosthesis, bipolar arthroplasty)
27130 Arthroplasty, acetabular and proximal femoral 4310 6423 9608 1410 39.16 prosthetic replacement (total hip arthroplasty), with or without autograft or allograft
27132 Conversion of previous hip surgery to total hip 5139 7658 11455 1741 48.36 arthroplasty, with or without autograft or allograft
CPT copyright 2017 American Medical Association. 155 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
27134 Revision of total hip arthroplasty; both 5933 8842 13225 1993 55.36 components, with or without autograft or allograft
27137 Revision of total hip arthroplasty; acetabular 4450 6631 9919 1531 42.53 component only, with or without autograft or allograft
27138 Revision of total hip arthroplasty; femoral 4586 6835 10224 1591 44.20 component only, with or without allograft
27140 Osteotomy and transfer of greater trochanter of 2569 3829 5727 927 25.75 femur (separate procedure)
27146 Osteotomy, iliac, acetabular or innominate 4294 6400 9573 1332 36.99 bone;
27147 Osteotomy, iliac, acetabular or innominate 5063 7545 11286 1530 42.50 bone; with open reduction of hip
27151 Osteotomy, iliac, acetabular or innominate 5377 8014 11987 1657 46.03 bone; with femoral osteotomy
27156 Osteotomy, iliac, acetabular or innominate 6059 9030 13507 1787 49.63 bone; with femoral osteotomy and with open reduction of hip
27158 Osteotomy, pelvis, bilateral (eg, congenital 4827 7194 10760 1459 40.52 malformation)
27161 Osteotomy, femoral neck (separate procedure) 3521 5248 7850 1260 34.99
27165 Osteotomy, intertrochanteric or subtrochanteric 5228 7792 11655 1423 39.53 including internal or external fixation and/or cast
27170 Bone graft, femoral head, neck, 3303 4923 7364 1221 33.92 intertrochanteric or subtrochanteric area (includes obtaining bone graft)
27175 Treatment of slipped femoral epiphysis; by 2288 3410 5101 692 19.21 traction, without reduction
27176 Treatment of slipped femoral epiphysis; by 3288 4900 7329 953 26.47 single or multiple pinning, in situ
27177 Open treatment of slipped femoral epiphysis; 3832 5711 8542 1158 32.17 single or multiple pinning or bone graft (includes obtaining graft)
27178 Open treatment of slipped femoral epiphysis; 3137 4675 6992 953 26.47 closed manipulation with single or multiple pinning
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27179 Open treatment of slipped femoral epiphysis; 3354 4999 7478 1014 28.16 osteoplasty of femoral neck (Heyman type procedure)
27181 Open treatment of slipped femoral epiphysis; 4124 6146 9192 1168 32.44 osteotomy and internal fixation
27185 Epiphyseal arrest by epiphysiodesis or stapling, 2463 3671 5491 744 20.68 greater trochanter of femur
27187 Prophylactic treatment (nailing, pinning, 3151 4696 7023 1029 28.57 plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur
27197 Closed treatment of posterior pelvic ring 400 527 707 124 3.45 fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without manipulation
27198 Closed treatment of posterior pelvic ring 1004 1322 1775 311 8.64 fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; with manipulation, requiring more than local anesthesia (ie, general anesthesia, moderate sedation, spinal/epidural)
27200 Closed treatment of coccygeal fracture 537 706 949 188 5.23
27202 Open treatment of coccygeal fracture 1601 2107 2830 553 15.35
27215 Open treatment of iliac spine(s), tuberosity 1875 2468 3315 649 18.03 avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring, includes internal fixation, when performed
27216 Percutaneous skeletal fixation of posterior 2937 3866 5192 961 26.70 pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum)
27217 Open treatment of anterior pelvic bone fracture 2936 3864 5191 902 25.06 and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes
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pubic symphysis and/or ipsilateral superior/inferior rami)
27218 Open treatment of posterior pelvic bone 3799 5000 6716 1246 34.60 fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint and/or sacrum)
27220 Closed treatment of acetabulum (hip socket) 1423 1873 2515 550 15.28 fracture(s); without manipulation
27222 Closed treatment of acetabulum (hip socket) 2800 3685 4949 1009 28.02 fracture(s); with manipulation, with or without skeletal traction
27226 Open treatment of posterior or anterior 3245 4271 5737 1093 30.36 acetabular wall fracture, with internal fixation
27227 Open treatment of acetabular fracture(s) 4961 6529 8769 1726 47.95 involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation
27228 Open treatment of acetabular fracture(s) 5746 7562 10157 1960 54.44 involving anterior and posterior (two) columns, includes t-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation
27230 Closed treatment of femoral fracture, proximal 1280 1685 2263 492 13.67 end, neck; without manipulation
27232 Closed treatment of femoral fracture, proximal 2230 2935 3942 772 21.44 end, neck; with manipulation, with or without skeletal traction
27235 Percutaneous skeletal fixation of femoral 2937 3866 5192 944 26.21 fracture, proximal end, neck
27236 Open treatment of femoral fracture, proximal 3473 4571 6139 1242 34.50 end, neck, internal fixation or prosthetic replacement
27238 Closed treatment of intertrochanteric, 1211 1594 2141 476 13.22 peritrochanteric, or subtrochanteric femoral fracture; without manipulation
27240 Closed treatment of intertrochanteric, 2874 3782 5080 995 27.63 peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction
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27244 Treatment of intertrochanteric, peritrochanteric, 3405 4481 6019 1279 35.52 or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage
27245 Treatment of intertrochanteric, peritrochanteric, 3842 5056 6791 1279 35.52 or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage
27246 Closed treatment of greater trochanteric 1048 1380 1853 399 11.07 fracture, without manipulation
27248 Open treatment of greater trochanteric fracture, 2035 2679 3598 771 21.41 includes internal fixation, when performed
27250 Closed treatment of hip dislocation, traumatic; 1403 1847 2481 186 5.18 without anesthesia
27252 Closed treatment of hip dislocation, traumatic; 2040 2684 3606 784 21.79 requiring anesthesia
27253 Open treatment of hip dislocation, traumatic, 2613 3438 4618 974 27.05 without internal fixation
27254 Open treatment of hip dislocation, traumatic, 3671 4831 6489 1319 36.64 with acetabular wall and femoral head fracture, with or without internal or external fixation
27256 Treatment of spontaneous hip dislocation 959 1261 1694 313 8.70 (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation
27257 Treatment of spontaneous hip dislocation 1328 1748 2348 378 10.50 (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia
27258 Open treatment of spontaneous hip dislocation 3334 4387 5893 1154 32.05 (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc);
27259 Open treatment of spontaneous hip dislocation 4669 6145 8254 1616 44.89 (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening
27265 Closed treatment of post hip arthroplasty 1274 1677 2252 412 11.45 dislocation; without anesthesia
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27266 Closed treatment of post hip arthroplasty 1565 2060 2767 602 16.71 dislocation; requiring regional or general anesthesia
27267 Closed treatment of femoral fracture, proximal 1292 1700 2284 447 12.42 end, head; without manipulation
27268 Closed treatment of femoral fracture, proximal 1613 2123 2852 558 15.51 end, head; with manipulation
27269 Open treatment of femoral fracture, proximal 3501 4607 6188 1292 35.89 end, head, includes internal fixation, when performed
27275 Manipulation, hip joint, requiring general 552 726 976 189 5.26 anesthesia
27279 Arthrodesis, sacroiliac joint, percutaneous or 1890 2488 3342 720 20.00 minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device
27280 Arthrodesis, open, sacroiliac joint, including 3126 4114 5526 1412 39.23 obtaining bone graft, including instrumentation, when performed
27282 Arthrodesis, symphysis pubis (including 2565 3376 4534 888 24.66 obtaining graft)
27284 Arthrodesis, hip joint (including obtaining 4872 6412 8612 1686 46.84 graft);
27286 Arthrodesis, hip joint (including obtaining 4973 6545 8791 1721 47.81 graft); with subtrochanteric osteotomy
27290 Interpelviabdominal amputation (hindquarter 4885 6430 8636 1691 46.97 amputation)
27295 Disarticulation of hip 3700 4869 6541 1316 36.55
27299 Unlisted procedure, pelvis or hip joint 0 0 0 0 0.00
FEMUR (THIGH REGION) AND KNEE JOINT
27301 Incision and drainage, deep abscess, bursa, or 1584 2331 3239 696 19.34 hematoma, thigh or knee region
27303 Incision, deep, with opening of bone cortex, 1788 2633 3657 661 18.37 femur or knee (eg, osteomyelitis or bone abscess)
27305 Fasciotomy, iliotibial (tenotomy), open 1350 1988 2762 495 13.75
27306 Tenotomy, percutaneous, adductor or 923 1359 1888 359 9.98 hamstring; single tendon (separate procedure)
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27307 Tenotomy, percutaneous, adductor or 1628 2396 3329 441 12.26 hamstring; multiple tendons
27310 Arthrotomy, knee, with exploration, drainage, 2168 3191 4433 757 21.03 or removal of foreign body (eg, infection)
27323 Biopsy, soft tissue of thigh or knee area; 369 543 755 281 7.80 superficial
27324 Biopsy, soft tissue of thigh or knee area; deep 969 1427 1983 415 11.53 (subfascial or intramuscular)
27325 Neurectomy, hamstring muscle 1687 2483 3449 577 16.04
27326 Neurectomy, popliteal (gastrocnemius) 1555 2289 3181 532 14.79
27327 Excision, tumor, soft tissue of thigh or knee 1015 1495 2076 473 13.15 area, subcutaneous; less than 3 cm
27328 Excision, tumor, soft tissue of thigh or knee 1506 2217 3081 645 17.93 area, subfascial (eg, intramuscular); less than 5 cm
27329 Radical resection of tumor (eg, sarcoma), soft 3251 4785 6649 1077 29.93 tissue of thigh or knee area; less than 5 cm
27330 Arthrotomy, knee; with synovial biopsy only 1255 1848 2568 430 11.94
27331 Arthrotomy, knee; including joint exploration, 1638 2412 3351 490 13.62 biopsy, or removal of loose or foreign bodies
27332 Arthrotomy, with excision of semilunar 1947 2867 3983 667 18.52 cartilage (meniscectomy) knee; medial or lateral
27333 Arthrotomy, with excision of semilunar 1772 2608 3624 607 16.85 cartilage (meniscectomy) knee; medial and lateral
27334 Arthrotomy, with synovectomy, knee; anterior 2001 2945 4092 708 19.67 or posterior
27335 Arthrotomy, with synovectomy, knee; anterior 1985 2923 4061 790 21.94 and posterior including popliteal area
27337 Excision, tumor, soft tissue of thigh or knee 1106 1628 2262 435 12.07 area, subcutaneous; 3 cm or greater
27339 Excision, tumor, soft tissue of thigh or knee 2062 3035 4216 782 21.71 area, subfascial (eg, intramuscular); 5 cm or greater
27340 Excision, prepatellar bursa 1214 1787 2482 384 10.67
27345 Excision of synovial cyst of popliteal space (eg, 1711 2518 3499 497 13.80 baker's cyst)
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27347 Excision of lesion of meniscus or capsule (eg, 1543 2272 3157 547 15.20 cyst, ganglion), knee
27350 Patellectomy or hemipatellectomy 1968 2897 4025 675 18.74
27355 Excision or curettage of bone cyst or benign 1954 2877 3997 625 17.35 tumor of femur;
27356 Excision or curettage of bone cyst or benign 2340 3444 4785 766 21.29 tumor of femur; with allograft
27357 Excision or curettage of bone cyst or benign 2467 3631 5045 845 23.46 tumor of femur; with autograft (includes obtaining graft)
27358 Excision or curettage of bone cyst or benign 850 1251 1738 291 8.08 tumor of femur; with internal fixation (list in addition to code for primary procedure)
27360 Partial excision (craterization, saucerization, or 2475 3644 5062 882 24.50 diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone abscess)
27364 Radical resection of tumor (eg, sarcoma), soft 5052 7438 10333 1628 45.22 tissue of thigh or knee area; 5 cm or greater
27365 Radical resection of tumor, femur or knee 4566 6721 9338 2149 59.70
27370 Injection of contrast for knee arthrography 284 418 581 159 4.41
27372 Removal of foreign body, deep, thigh region or 1300 1914 2659 613 17.04 knee area
27380 Suture of infrapatellar tendon; primary 1808 2662 3699 613 17.04
27381 Suture of infrapatellar tendon; secondary 2330 3429 4765 826 22.95 reconstruction, including fascial or tendon graft
27385 Suture of quadriceps or hamstring muscle 2023 2977 4137 594 16.50 rupture; primary
27386 Suture of quadriceps or hamstring muscle 2385 3511 4879 859 23.85 rupture; secondary reconstruction, including fascial or tendon graft
27390 Tenotomy, open, hamstring, knee to hip; single 1357 1998 2776 465 12.91 tendon
27391 Tenotomy, open, hamstring, knee to hip; 1733 2551 3544 593 16.48 multiple tendons, 1 leg
27392 Tenotomy, open, hamstring, knee to hip; 2158 3176 4413 739 20.52 multiple tendons, bilateral
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27393 Lengthening of hamstring tendon; single 1539 2266 3148 527 14.64 tendon
27394 Lengthening of hamstring tendon; multiple 1650 2429 3375 665 18.47 tendons, 1 leg
27395 Lengthening of hamstring tendon; multiple 3020 4446 6177 911 25.31 tendons, bilateral
27396 Transplant or transfer (with muscle redirection 1863 2743 3811 638 17.72 or rerouting), thigh (eg, extensor to flexor); single tendon
27397 Transplant or transfer (with muscle redirection 2779 4091 5684 951 26.43 or rerouting), thigh (eg, extensor to flexor); multiple tendons
27400 Transfer, tendon or muscle, hamstrings to 2102 3094 4299 720 19.99 femur (eg, egger's type procedure)
27403 Arthrotomy with meniscus repair, knee 2109 3105 4313 661 18.37
27405 Repair, primary, torn ligament and/or capsule, 2233 3288 4568 698 19.40 knee; collateral
27407 Repair, primary, torn ligament and/or capsule, 2400 3534 4910 822 22.83 knee; cruciate
27409 Repair, primary, torn ligament and/or capsule, 2926 4308 5985 1002 27.83 knee; collateral and cruciate ligaments
27412 Autologous chondrocyte implantation, knee 4753 6997 9721 1722 47.82
27415 Osteochondral allograft, knee, open 4161 6125 8510 1416 39.34
27416 Osteochondral autograft(s), knee, open (eg, 2559 3768 5234 1018 28.29 mosaicplasty) (includes harvesting of autograft[s])
27418 Anterior tibial tubercleplasty (eg, Maquet type 2578 3795 5273 854 23.73 procedure)
27420 Reconstruction of dislocating patella; (eg, 2265 3334 4632 769 21.37 Hauser type procedure)
27422 Reconstruction of dislocating patella; with 2399 3531 4906 769 21.36 extensor realignment and/or muscle advancement or release (eg, Campbell, Goldwaite type procedure)
27424 Reconstruction of dislocating patella; with 2266 3336 4634 776 21.55 patellectomy
27425 Lateral retinacular release, open 1898 2795 3883 464 12.88
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27427 Ligamentous reconstruction (augmentation), 2303 3391 4711 735 20.41 knee; extra-articular
27428 Ligamentous reconstruction (augmentation), 3518 5179 7196 1160 32.21 knee; intra-articular (open)
27429 Ligamentous reconstruction (augmentation), 3568 5253 7298 1290 35.82 knee; intra-articular (open) and extra-articular
27430 Quadricepsplasty (eg, Bennett or thompson 2205 3247 4511 766 21.27 type)
27435 Capsulotomy, posterior capsular release, knee 2697 3971 5517 836 23.23
27437 Arthroplasty, patella; without prosthesis 1815 2673 3713 685 19.03
27438 Arthroplasty, patella; with prosthesis 2414 3554 4938 869 24.15
27440 Arthroplasty, knee, tibial plateau; 2419 3562 4948 828 23.01
27441 Arthroplasty, knee, tibial plateau; with 2499 3679 5112 856 23.77 debridement and partial synovectomy
27442 Arthroplasty, femoral condyles or tibial 2432 3580 4974 901 25.02 plateau(s), knee;
27443 Arthroplasty, femoral condyles or tibial 2462 3625 5036 843 23.42 plateau(s), knee; with debridement and partial synovectomy
27445 Arthroplasty, knee, hinge prosthesis (eg, 4079 6005 8343 1301 36.13 Walldius type)
27446 Arthroplasty, knee, condyle and plateau; medial 3501 5153 7160 1204 33.45 or lateral compartment
27447 Arthroplasty, knee, condyle and plateau; medial 4412 6495 9023 1408 39.12 and lateral compartments with or without patella resurfacing (total knee arthroplasty)
27448 Osteotomy, femur, shaft or supracondylar; 2351 3461 4809 805 22.36 without fixation
27450 Osteotomy, femur, shaft or supracondylar; with 3277 4824 6702 1041 28.93 fixation
27454 Osteotomy, multiple, with realignment on 3948 5812 8075 1352 37.55 intramedullary rod, femoral shaft (eg, Sofield type procedure)
27455 Osteotomy, proximal tibia, including fibular 2774 4083 5673 978 27.16 excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock- knee]); before epiphyseal closure
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27457 Osteotomy, proximal tibia, including fibular 2847 4192 5824 987 27.41 excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock- knee]); after epiphyseal closure
27465 Osteoplasty, femur; shortening (excluding 3663 5393 7492 1254 34.84 64876)
27466 Osteoplasty, femur; lengthening 4922 7246 10067 1230 34.18
27468 Osteoplasty, femur; combined, lengthening and 4079 6004 8342 1396 38.79 shortening with femoral segment transfer
27470 Repair, nonunion or malunion, femur, distal to 3492 5140 7142 1221 33.91 head and neck; without graft (eg, compression technique)
27472 Repair, nonunion or malunion, femur, distal to 3741 5507 7650 1311 36.41 head and neck; with iliac or other autogenous bone graft (includes obtaining graft)
27475 Arrest, epiphyseal, any method (eg, 2624 3863 5367 686 19.05 epiphysiodesis); distal femur
27477 Arrest, epiphyseal, any method (eg, 2221 3269 4542 760 21.12 epiphysiodesis); tibia and fibula, proximal
27479 Arrest, epiphyseal, any method (eg, 2791 4108 5707 955 26.54 epiphysiodesis); combined distal femur, proximal tibia and fibula
27485 Arrest, hemiepiphyseal, distal femur or 2541 3741 5198 695 19.30 proximal tibia or fibula (eg, genu varus or valgus)
27486 Revision of total knee arthroplasty, with or 4047 5957 8277 1462 40.60 without allograft; 1 component
27487 Revision of total knee arthroplasty, with or 5351 7877 10943 1828 50.78 without allograft; femoral and entire tibial component
27488 Removal of prosthesis, including total knee 3299 4856 6747 1247 34.65 prosthesis, methylmethacrylate with or without insertion of spacer, knee
27495 Prophylactic treatment (nailing, pinning, 3373 4965 6898 1168 32.45 plating, or wiring) with or without methylmethacrylate, femur
27496 Decompression fasciotomy, thigh and/or knee, 1647 2424 3368 564 15.66 1 compartment (flexor or extensor or adductor);
27497 Decompression fasciotomy, thigh and/or knee, 1764 2597 3609 604 16.78 1 compartment (flexor or extensor or adductor);
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with debridement of nonviable muscle and/or nerve
27498 Decompression fasciotomy, thigh and/or knee, 1984 2921 4058 679 18.87 multiple compartments;
27499 Decompression fasciotomy, thigh and/or knee, 2121 3122 4338 726 20.17 multiple compartments; with debridement of nonviable muscle and/or nerve
27500 Closed treatment of femoral shaft fracture, 1580 2118 3137 537 14.91 without manipulation
27501 Closed treatment of supracondylar or 1514 2030 3007 522 14.50 transcondylar femoral fracture with or without intercondylar extension, without manipulation
27502 Closed treatment of femoral shaft fracture, with 2404 3223 4775 786 21.83 manipulation, with or without skin or skeletal traction
27503 Closed treatment of supracondylar or 2271 3044 4510 831 23.08 transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or without skin or skeletal traction
27506 Open treatment of femoral shaft fracture, with 3987 5345 7919 1390 38.60 or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws
27507 Open treatment of femoral shaft fracture with 3029 4060 6015 1009 28.04 plate/screws, with or without cerclage
27508 Closed treatment of femoral fracture, distal end, 1414 1896 2808 543 15.07 medial or lateral condyle, without manipulation
27509 Percutaneous skeletal fixation of femoral 1840 2467 3655 665 18.47 fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or without intercondylar extension, or distal femoral epiphyseal separation
27510 Closed treatment of femoral fracture, distal end, 1972 2643 3916 707 19.64 medial or lateral condyle, with manipulation
27511 Open treatment of femoral supracondylar or 3056 4097 6070 1035 28.75 transcondylar fracture without intercondylar extension, includes internal fixation, when performed
27513 Open treatment of femoral supracondylar or 3671 4921 7290 1289 35.80 transcondylar fracture with intercondylar extension, includes internal fixation, when performed
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27514 Open treatment of femoral fracture, distal end, 3058 4100 6074 1004 27.88 medial or lateral condyle, includes internal fixation, when performed
27516 Closed treatment of distal femoral epiphyseal 1554 2084 3087 525 14.59 separation; without manipulation
27517 Closed treatment of distal femoral epiphyseal 2102 2818 4175 710 19.73 separation; with manipulation, with or without skin or skeletal traction
27519 Open treatment of distal femoral epiphyseal 2742 3676 5446 927 25.74 separation, includes internal fixation, when performed
27520 Closed treatment of patellar fracture, without 833 1117 1654 334 9.27 manipulation
27524 Open treatment of patellar fracture, with 2238 3000 4445 779 21.64 internal fixation and/or partial or complete patellectomy and soft tissue repair
27530 Closed treatment of tibial fracture, proximal 963 1291 1913 312 8.68 (plateau); without manipulation
27532 Closed treatment of tibial fracture, proximal 1587 2128 3152 636 17.68 (plateau); with or without manipulation, with skeletal traction
27535 Open treatment of tibial fracture, proximal 2636 3534 5236 931 25.86 (plateau); unicondylar, includes internal fixation, when performed
27536 Open treatment of tibial fracture, proximal 3357 4501 6668 1235 34.31 (plateau); bicondylar, with or without internal fixation
27538 Closed treatment of intercondylar spine(s) 1228 1646 2439 490 13.61 and/or tuberosity fracture(s) of knee, with or without manipulation
27540 Open treatment of intercondylar spine(s) and/or 2633 3529 5228 837 23.25 tuberosity fracture(s) of the knee, includes internal fixation, when performed
27550 Closed treatment of knee dislocation; without 1181 1584 2346 529 14.70 anesthesia
27552 Closed treatment of knee dislocation; requiring 1526 2046 3031 645 17.92 anesthesia
27556 Open treatment of knee dislocation, includes 2697 3615 5355 911 25.31 internal fixation, when performed; without primary ligamentous repair or augmentation/ reconstruction
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27557 Open treatment of knee dislocation, includes 3226 4325 6407 1090 30.28 internal fixation, when performed; with primary ligamentous repair
27558 Open treatment of knee dislocation, includes 3680 4933 7308 1243 34.54 internal fixation, when performed; with primary ligamentous repair, with augmentation/reconstruction
27560 Closed treatment of patellar dislocation; 869 1165 1726 375 10.43 without anesthesia
27562 Closed treatment of patellar dislocation; 1482 1987 2943 501 13.91 requiring anesthesia
27566 Open treatment of patellar dislocation, with or 2521 3380 5007 929 25.80 without partial or total patellectomy
27570 Manipulation of knee joint under general 567 760 1125 156 4.33 anesthesia (includes application of traction or other fixation devices)
27580 Arthrodesis, knee, any technique 3929 5267 7803 1492 41.44
27590 Amputation, thigh, through femur, any level; 2212 2965 4393 830 23.06
27591 Amputation, thigh, through femur, any level; 2971 3983 5901 1004 27.89 immediate fitting technique including first cast
27592 Amputation, thigh, through femur, any level; 1962 2631 3897 707 19.65 open, circular (guillotine)
27594 Amputation, thigh, through femur, any level; 1345 1803 2672 523 14.54 secondary closure or scar revision
27596 Amputation, thigh, through femur, any level; 2052 2751 4076 748 20.79 re-amputation
27598 Disarticulation at knee 2232 2993 4434 743 20.65
27599 Unlisted procedure, femur or knee 0 0 0 0 0.00
LEG (TIBIA AND FIBULA) AND ANKLE JOINT
27600 Decompression fasciotomy, leg; anterior and/or 1269 1735 2675 419 11.65 lateral compartments only
27601 Decompression fasciotomy, leg; posterior 1255 1716 2645 464 12.88 compartment(s) only
27602 Decompression fasciotomy, leg; anterior and/or 1471 2011 3100 505 14.03 lateral, and posterior compartment(s)
27603 Incision and drainage, leg or ankle; deep 1216 1662 2563 546 15.16 abscess or hematoma
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27604 Incision and drainage, leg or ankle; infected 1085 1484 2287 494 13.72 bursa
27605 Tenotomy, percutaneous, Achilles tendon 935 1279 1971 357 9.92 (separate procedure); local anesthesia
27606 Tenotomy, percutaneous, Achilles tendon 954 1305 2012 290 8.06 (separate procedure); general anesthesia
27607 Incision (eg, osteomyelitis or bone abscess), leg 1748 2390 3684 629 17.46 or ankle
27610 Arthrotomy, ankle, including exploration, 1977 2703 4168 673 18.69 drainage, or removal of foreign body
27612 Arthrotomy, posterior capsular release, ankle, 1658 2267 3495 581 16.15 with or without Achilles tendon lengthening
27613 Biopsy, soft tissue of leg or ankle area; 341 466 719 262 7.27 superficial
27614 Biopsy, soft tissue of leg or ankle area; deep 1223 1672 2577 600 16.68 (subfascial or intramuscular)
27615 Radical resection of tumor (eg, sarcoma), soft 2579 3527 5437 1065 29.58 tissue of leg or ankle area; less than 5 cm
27616 Radical resection of tumor (eg, sarcoma), soft 4135 5654 8717 1322 36.71 tissue of leg or ankle area; 5 cm or greater
27618 Excision, tumor, soft tissue of leg or ankle area, 1057 1445 2228 465 12.93 subcutaneous; less than 3 cm
27619 Excision, tumor, soft tissue of leg or ankle area, 1427 1951 3008 481 13.37 subfascial (eg, intramuscular); less than 5 cm
27620 Arthrotomy, ankle, with joint exploration, with 1475 2017 3110 464 12.89 or without biopsy, with or without removal of loose or foreign body
27625 Arthrotomy, with synovectomy, ankle; 1643 2247 3464 601 16.69
27626 Arthrotomy, with synovectomy, ankle; 1867 2553 3936 626 17.38 including tenosynovectomy
27630 Excision of lesion of tendon sheath or capsule 1322 1807 2786 578 16.06 (eg, cyst or ganglion), leg and/or ankle
27632 Excision, tumor, soft tissue of leg or ankle area, 1148 1570 2420 430 11.94 subcutaneous; 3 cm or greater
27634 Excision, tumor, soft tissue of leg or ankle area, 1864 2548 3929 707 19.64 subfascial (eg, intramuscular); 5 cm or greater
27635 Excision or curettage of bone cyst or benign 1943 2657 4097 607 16.85 tumor, tibia or fibula;
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27637 Excision or curettage of bone cyst or benign 2207 3018 4653 793 22.03 tumor, tibia or fibula; with autograft (includes obtaining graft)
27638 Excision or curettage of bone cyst or benign 2374 3246 5004 802 22.28 tumor, tibia or fibula; with allograft
27640 Partial excision (craterization, saucerization, or 2656 3632 5600 863 23.97 diaphysectomy), bone (eg, osteomyelitis); tibia
27641 Partial excision (craterization, saucerization, or 2001 2736 4218 690 19.17 diaphysectomy), bone (eg, osteomyelitis); fibula
27645 Radical resection of tumor; tibia 5160 7056 10877 1854 51.50
27646 Radical resection of tumor; fibula 4476 6120 9435 1608 44.67
27647 Radical resection of tumor; talus or calcaneus 2945 4027 6208 1058 29.39
27648 Injection procedure for ankle arthrography 333 456 702 172 4.78
27650 Repair, primary, open or percutaneous, 2140 2926 4511 681 18.92 ruptured Achilles tendon;
27652 Repair, primary, open or percutaneous, 2185 2988 4606 702 19.49 ruptured Achilles tendon; with graft (includes obtaining graft)
27654 Repair, secondary, Achilles tendon, with or 2100 2872 4427 734 20.38 without graft
27656 Repair, fascial defect of leg 1831 2503 3859 658 18.27
27658 Repair, flexor tendon, leg; primary, without 1235 1688 2603 384 10.67 graft, each tendon
27659 Repair, flexor tendon, leg; secondary, with or 1405 1921 2962 491 13.64 without graft, each tendon
27664 Repair, extensor tendon, leg; primary, without 1224 1673 2580 374 10.40 graft, each tendon
27665 Repair, extensor tendon, leg; secondary, with or 1264 1728 2665 427 11.87 without graft, each tendon
27675 Repair, dislocating peroneal tendons; without 1427 1952 3009 507 14.08 fibular osteotomy
27676 Repair, dislocating peroneal tendons; with 1769 2419 3730 627 17.43 fibular osteotomy
27680 Tenolysis, flexor or extensor tendon, leg and/or 1300 1778 2741 441 12.26 ankle; single, each tendon
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
27681 Tenolysis, flexor or extensor tendon, leg and/or 1519 2077 3203 567 15.75 ankle; multiple tendons (through separate incision[s])
27685 Lengthening or shortening of tendon, leg or 1513 2069 3190 688 19.10 ankle; single tendon (separate procedure)
27686 Lengthening or shortening of tendon, leg or 1785 2441 3763 571 15.86 ankle; multiple tendons (through same incision), each
27687 Gastrocnemius recession (eg, strayer 1346 1841 2838 469 13.02 procedure)
27690 Transfer or transplant of single tendon (with 1873 2560 3947 658 18.27 muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)
27691 Transfer or transplant of single tendon (with 2201 3010 4640 773 21.47 muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot)
27692 Transfer or transplant of single tendon (with 358 490 755 109 3.02 muscle redirection or rerouting); each additional tendon (list separately in addition to code for primary procedure)
27695 Repair, primary, disrupted ligament, ankle; 1680 2297 3542 493 13.70 collateral
27696 Repair, primary, disrupted ligament, ankle; 1875 2564 3953 579 16.08 both collateral ligaments
27698 Repair, secondary, disrupted ligament, ankle, 2032 2778 4283 664 18.45 collateral (eg, Watson-Jones procedure)
27700 Arthroplasty, ankle; 1857 2539 3914 654 18.18
27702 Arthroplasty, ankle; with implant (total ankle) 2880 3938 6071 996 27.67
27703 Arthroplasty, ankle; revision, total ankle 3207 4384 6759 1148 31.90
27704 Removal of ankle implant 1630 2229 3437 591 16.41
27705 Osteotomy; tibia 2434 3328 5131 792 21.99
27707 Osteotomy; fibula 1245 1703 2625 412 11.45
27709 Osteotomy; tibia and fibula 3368 4605 7099 1213 33.69
27712 Osteotomy; multiple, with realignment on 3198 4373 6742 1149 31.92 intramedullary rod (eg, Sofield type procedure)
CPT copyright 2017 American Medical Association. 171 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
27715 Osteoplasty, tibia and fibula, lengthening or 4369 5973 9209 1113 30.91 shortening
27720 Repair of nonunion or malunion, tibia; without 2636 3604 5557 905 25.13 graft, (eg, compression technique)
27722 Repair of nonunion or malunion, tibia; with 2573 3518 5424 924 25.68 sliding graft
27724 Repair of nonunion or malunion, tibia; with 3272 4474 6897 1314 36.50 iliac or other autograft (includes obtaining graft)
27725 Repair of nonunion or malunion, tibia; by 3530 4827 7441 1268 35.23 synostosis, with fibula, any method
27726 Repair of fibula nonunion and/or malunion with 2852 3899 6012 997 27.70 internal fixation
27727 Repair of congenital pseudarthrosis, tibia 2919 3991 6153 1077 29.92
27730 Arrest, epiphyseal (epiphysiodesis), open; distal 1691 2313 3565 608 16.88 tibia
27732 Arrest, epiphyseal (epiphysiodesis), open; distal 1209 1653 2548 464 12.88 fibula
27734 Arrest, epiphyseal (epiphysiodesis), open; distal 1894 2589 3992 680 18.90 tibia and fibula
27740 Arrest, epiphyseal (epiphysiodesis), any 2043 2794 4307 734 20.39 method, combined, proximal and distal tibia and fibula;
27742 Arrest, epiphyseal (epiphysiodesis), any 2247 3073 4737 807 22.43 method, combined, proximal and distal tibia and fibula; and distal femur
27745 Prophylactic treatment (nailing, pinning, 2691 3679 5672 783 21.76 plating or wiring) with or without methylmethacrylate, tibia
27750 Closed treatment of tibial shaft fracture (with or 1046 1431 2206 358 9.94 without fibular fracture); without manipulation
27752 Closed treatment of tibial shaft fracture (with or 1547 2115 3261 553 15.36 without fibular fracture); with manipulation, with or without skeletal traction
27756 Percutaneous skeletal fixation of tibial shaft 1753 2397 3696 600 16.67 fracture (with or without fibular fracture) (eg, pins or screws)
172 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
27758 Open treatment of tibial shaft fracture (with or 2599 3553 5478 924 25.67 without fibular fracture), with plate/screws, with or without cerclage
27759 Treatment of tibial shaft fracture (with or 2946 4028 6209 1036 28.79 without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage
27760 Closed treatment of medial malleolus fracture; 846 1157 1784 344 9.56 without manipulation
27762 Closed treatment of medial malleolus fracture; 1388 1898 2926 485 13.47 with manipulation, with or without skin or skeletal traction
27766 Open treatment of medial malleolus fracture, 1884 2576 3971 629 17.47 includes internal fixation, when performed
27767 Closed treatment of posterior malleolus 705 964 1486 290 8.05 fracture; without manipulation
27768 Closed treatment of posterior malleolus 1269 1734 2674 456 12.66 fracture; with manipulation
27769 Open treatment of posterior malleolus fracture, 1992 2724 4200 758 21.06 includes internal fixation, when performed
27780 Closed treatment of proximal fibula or shaft 756 1033 1593 316 8.79 fracture; without manipulation
27781 Closed treatment of proximal fibula or shaft 1113 1521 2345 442 12.27 fracture; with manipulation
27784 Open treatment of proximal fibula or shaft 1873 2561 3949 737 20.48 fracture, includes internal fixation, when performed
27786 Closed treatment of distal fibular fracture 828 1132 1745 325 9.04 (lateral malleolus); without manipulation
27788 Closed treatment of distal fibular fracture 1120 1531 2361 434 12.06 (lateral malleolus); with manipulation
27792 Open treatment of distal fibular fracture (lateral 1965 2687 4143 673 18.70 malleolus), includes internal fixation, when performed
27808 Closed treatment of bimalleolar ankle fracture 884 1209 1863 345 9.58 (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation
27810 Closed treatment of bimalleolar ankle fracture 1420 1942 2994 481 13.35 (eg, lateral and medial malleoli, or lateral and
CPT copyright 2017 American Medical Association. 173 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
posterior malleoli or medial and posterior malleoli); with manipulation
27814 Open treatment of bimalleolar ankle fracture 2327 3182 4906 798 22.18 (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed
27816 Closed treatment of trimalleolar ankle fracture; 870 1190 1834 332 9.23 without manipulation
27818 Closed treatment of trimalleolar ankle fracture; 1441 1971 3038 499 13.87 with manipulation
27822 Open treatment of trimalleolar ankle fracture, 2525 3452 5322 889 24.69 includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip
27823 Open treatment of trimalleolar ankle fracture, 2941 4022 6200 1007 27.97 includes internal fixation, when performed, medial and/or lateral malleolus; with fixation of posterior lip
27824 Closed treatment of fracture of weight bearing 891 1218 1877 324 9.01 articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation
27825 Closed treatment of fracture of weight bearing 1545 2113 3257 565 15.70 articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation
27826 Open treatment of fracture of weight bearing 2332 3188 4915 875 24.30 articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only
27827 Open treatment of fracture of weight bearing 3224 4408 6795 1139 31.63 articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia only
27828 Open treatment of fracture of weight bearing 3791 5183 7991 1361 37.81 articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both tibia and fibula
27829 Open treatment of distal tibiofibular joint 1893 2589 3991 720 20.00 (syndesmosis) disruption, includes internal fixation, when performed
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
27830 Closed treatment of proximal tibiofibular joint 1100 1504 2319 395 10.98 dislocation; without anesthesia
27831 Closed treatment of proximal tibiofibular joint 1153 1577 2431 414 11.51 dislocation; requiring anesthesia
27832 Open treatment of proximal tibiofibular joint 2184 2987 4604 785 21.80 dislocation, includes internal fixation, when performed, or with excision of proximal fibula
27840 Closed treatment of ankle dislocation; without 1044 1427 2200 382 10.62 anesthesia
27842 Closed treatment of ankle dislocation; requiring 1290 1763 2719 510 14.18 anesthesia, with or without percutaneous skeletal fixation
27846 Open treatment of ankle dislocation, with or 2024 2767 4266 745 20.69 without percutaneous skeletal fixation; without repair or internal fixation
27848 Open treatment of ankle dislocation, with or 2429 3322 5121 829 23.02 without percutaneous skeletal fixation; with repair or internal or external fixation
27860 Manipulation of ankle under general anesthesia 600 820 1265 181 5.02 (includes application of traction or other fixation apparatus)
27870 Arthrodesis, ankle, open 3024 4135 6374 1067 29.64
27871 Arthrodesis, tibiofibular joint, proximal or 2142 2928 4514 709 19.69 distal
27880 Amputation, leg, through tibia and fibula; 2359 3226 4973 952 26.45
27881 Amputation, leg, through tibia and fibula; with 2320 3172 4890 899 24.98 immediate fitting technique including application of first cast
27882 Amputation, leg, through tibia and fibula; open, 1787 2444 3768 624 17.32 circular (guillotine)
27884 Amputation, leg, through tibia and fibula; 1592 2177 3356 594 16.51 secondary closure or scar revision
27886 Amputation, leg, through tibia and fibula; re- 1954 2672 4119 683 18.98 amputation
27888 Amputation, ankle, through malleoli of tibia 1953 2670 4117 702 19.49 and fibula (eg, Syme, Pirogoff type procedures), with plastic closure and resection of nerves
27889 Ankle disarticulation 1972 2696 4156 675 18.76
CPT copyright 2017 American Medical Association. 175 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
27892 Decompression fasciotomy, leg; anterior and/or 1562 2136 3293 580 16.11 lateral compartments only, with debridement of nonviable muscle and/or nerve
27893 Decompression fasciotomy, leg; posterior 1760 2406 3709 632 17.56 compartment(s) only, with debridement of nonviable muscle and/or nerve
27894 Decompression fasciotomy, leg; anterior and/or 2373 3244 5002 871 24.20 lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve
27899 Unlisted procedure, leg or ankle 0 0 0 0 0.00
FOOT AND TOES
28001 Incision and drainage, bursa, foot 359 536 1035 286 7.95
28002 Incision and drainage below fascia, with or 900 1343 2593 457 12.69 without tendon sheath involvement, foot; single bursal space
28003 Incision and drainage below fascia, with or 1265 1887 3643 725 20.14 without tendon sheath involvement, foot; multiple areas
28005 Incision, bone cortex (eg, osteomyelitis or bone 1275 1902 3672 595 16.54 abscess), foot
28008 Fasciotomy, foot and/or toe 953 1422 2746 450 12.49
28010 Tenotomy, percutaneous, toe; single tendon 520 776 1497 240 6.66
28011 Tenotomy, percutaneous, toe; multiple tendons 678 1012 1953 331 9.19
28020 Arthrotomy, including exploration, drainage, or 1265 1887 3644 563 15.65 removal of loose or foreign body; intertarsal or tarsometatarsal joint
28022 Arthrotomy, including exploration, drainage, or 1022 1525 2944 504 14.00 removal of loose or foreign body; metatarsophalangeal joint
28024 Arthrotomy, including exploration, drainage, or 790 1179 2276 478 13.27 removal of loose or foreign body; interphalangeal joint
28035 Release, tarsal tunnel (posterior tibial nerve 1422 2122 4096 550 15.28 decompression)
28039 Excision, tumor, soft tissue of foot or toe, 1271 1897 3662 525 14.59 subcutaneous; 1.5 cm or greater
28041 Excision, tumor, soft tissue of foot or toe, 1190 1776 3428 473 13.13 subfascial (eg, intramuscular); 1.5 cm or greater
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28043 Excision, tumor, soft tissue of foot or toe, 790 1179 2275 417 11.59 subcutaneous; less than 1.5 cm
28045 Excision, tumor, soft tissue of foot or toe, 1017 1518 2930 517 14.36 subfascial (eg, intramuscular); less than 1.5 cm
28046 Radical resection of tumor (eg, sarcoma), soft 1512 2255 4354 757 21.03 tissue of foot or toe; less than 3 cm
28047 Radical resection of tumor (eg, sarcoma), soft 2037 3039 5866 1091 30.31 tissue of foot or toe; 3 cm or greater
28050 Arthrotomy with biopsy; intertarsal or 1045 1560 3011 441 12.25 tarsometatarsal joint
28052 Arthrotomy with biopsy; metatarsophalangeal 1015 1515 2925 470 13.05 joint
28054 Arthrotomy with biopsy; interphalangeal joint 847 1264 2440 391 10.85
28055 Neurectomy, intrinsic musculature of foot 968 1445 2789 393 10.93
28060 Fasciectomy, plantar fascia; partial (separate 1121 1673 3230 540 15.00 procedure)
28062 Fasciectomy, plantar fascia; radical (separate 1257 1876 3621 609 16.93 procedure)
28070 Synovectomy; intertarsal or tarsometatarsal 1206 1799 3472 563 15.63 joint, each
28072 Synovectomy; metatarsophalangeal joint, each 1208 1802 3478 525 14.58
28080 Excision, interdigital (Morton) neuroma, single, 1155 1724 3327 546 15.17 each
28086 Synovectomy, tendon sheath, foot; flexor 1048 1563 3018 568 15.78
28088 Synovectomy, tendon sheath, foot; extensor 1039 1550 2993 467 12.98
28090 Excision of lesion, tendon, tendon sheath, or 1000 1492 2881 490 13.61 capsule (including synovectomy) (eg, cyst or ganglion); foot
28092 Excision of lesion, tendon, tendon sheath, or 919 1371 2647 442 12.27 capsule (including synovectomy) (eg, cyst or ganglion); toe(s), each
28100 Excision or curettage of bone cyst or benign 1562 2330 4498 638 17.72 tumor, talus or calcaneus;
28102 Excision or curettage of bone cyst or benign 1359 2028 3916 629 17.47 tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28103 Excision or curettage of bone cyst or benign 1218 1818 3509 405 11.25 tumor, talus or calcaneus; with allograft
28104 Excision or curettage of bone cyst or benign 1939 2893 5584 551 15.30 tumor, tarsal or metatarsal, except talus or calcaneus;
28106 Excision or curettage of bone cyst or benign 958 1429 2759 443 12.31 tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft (includes obtaining graft)
28107 Excision or curettage of bone cyst or benign 1159 1730 3339 536 14.90 tumor, tarsal or metatarsal, except talus or calcaneus; with allograft
28108 Excision or curettage of bone cyst or benign 1648 2459 4747 459 12.74 tumor, phalanges of foot
28110 Ostectomy, partial excision, fifth metatarsal 1097 1636 3158 484 13.44 head (bunionette) (separate procedure)
28111 Ostectomy, complete excision; first metatarsal 1044 1558 3008 512 14.21 head
28112 Ostectomy, complete excision; other metatarsal 1150 1716 3313 509 14.14 head (second, third or fourth)
28113 Ostectomy, complete excision; fifth metatarsal 1279 1909 3684 614 17.06 head
28114 Ostectomy, complete excision; all metatarsal 2340 3491 6738 1116 31.01 heads, with partial proximal phalangectomy, excluding first metatarsal (eg, Clayton type procedure)
28116 Ostectomy, excision of tarsal coalition 1853 2765 5338 804 22.33
28118 Ostectomy, calcaneus; 1453 2167 4184 621 17.25
28119 Ostectomy, calcaneus; for spur, with or without 1312 1958 3779 546 15.16 plantar fascial release
28120 Partial excision (craterization, saucerization, 1507 2248 4340 704 19.56 sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus
28122 Partial excision (craterization, saucerization, 1337 1994 3850 624 17.32 sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus
28124 Partial excision (craterization, saucerization, 981 1464 2826 497 13.81 sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28126 Resection, partial or complete, phalangeal base, 796 1188 2294 413 11.46 each toe
28130 Talectomy (astragalectomy) 1635 2439 4709 756 21.01
28140 Metatarsectomy 1274 1900 3669 621 17.25
28150 Phalangectomy, toe, each toe 860 1283 2478 442 12.27
28153 Resection, condyle(s), distal end of phalanx, 869 1296 2502 430 11.95 each toe
28160 Hemiphalangectomy or interphalangeal joint 949 1416 2734 435 12.08 excision, toe, proximal end of phalanx, each
28171 Radical resection of tumor; tarsal (except talus 2178 3250 6274 1161 32.25 or calcaneus)
28173 Radical resection of tumor; metatarsal 1688 2518 4861 781 21.69
28175 Radical resection of tumor; phalanx of toe 1075 1604 3097 494 13.72
28190 Removal of foreign body, foot; subcutaneous 537 873 1831 269 7.47
28192 Removal of foreign body, foot; deep 907 1474 3091 487 13.54
28193 Removal of foreign body, foot; complicated 1045 1698 3562 553 15.35
28200 Repair, tendon, flexor, foot; primary or 1200 1950 4090 514 14.28 secondary, without free graft, each tendon
28202 Repair, tendon, flexor, foot; secondary with 1161 1886 3955 624 17.34 free graft, each tendon (includes obtaining graft)
28208 Repair, tendon, extensor, foot; primary or 1095 1779 3731 500 13.89 secondary, each tendon
28210 Repair, tendon, extensor, foot; secondary with 1378 2238 4694 615 17.07 free graft, each tendon (includes obtaining graft)
28220 Tenolysis, flexor, foot; single tendon 882 1433 3005 469 13.03
28222 Tenolysis, flexor, foot; multiple tendons 910 1478 3100 531 14.76
28225 Tenolysis, extensor, foot; single tendon 1002 1627 3413 431 11.97
28226 Tenolysis, extensor, foot; multiple tendons 1289 2094 4391 637 17.70
28230 Tenotomy, open, tendon flexor; foot, single or 803 1305 2738 453 12.58 multiple tendon(s) (separate procedure)
28232 Tenotomy, open, tendon flexor; toe, single 787 1279 2683 403 11.19 tendon (separate procedure)
CPT copyright 2017 American Medical Association. 179 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28234 Tenotomy, open, extensor, foot or toe, each 853 1386 2906 424 11.77 tendon
28238 Reconstruction (advancement), posterior tibial 1624 2638 5534 698 19.38 tendon with excision of accessory tarsal navicular bone (eg, Kidner type procedure)
28240 Tenotomy, lengthening, or release, abductor 725 1178 2472 480 13.33 hallucis muscle
28250 Division of plantar fascia and muscle (eg, 1225 1991 4175 606 16.83 Steindler stripping) (separate procedure)
28260 Capsulotomy, midfoot; medial release only 1238 2012 4219 715 19.85 (separate procedure)
28261 Capsulotomy, midfoot; with tendon 2179 3540 7424 1059 29.41 lengthening
28262 Capsulotomy, midfoot; extensive, including 4293 6976 14630 1536 42.66 posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity)
28264 Capsulotomy, midtarsal (eg, Heyman type 2211 3593 7536 1052 29.21 procedure)
28270 Capsulotomy; metatarsophalangeal joint, with 1008 1638 3436 514 14.28 or without tenorrhaphy, each joint (separate procedure)
28272 Capsulotomy; interphalangeal joint, each joint 605 983 2061 409 11.37 (separate procedure)
28280 Syndactylization, toes (eg, webbing or Kelikian 1201 1951 4091 539 14.96 type procedure)
28285 Correction, hammertoe (eg, interphalangeal 1231 2001 4196 558 15.49 fusion, partial or total phalangectomy)
28286 Correction, cock-up fifth toe, with plastic skin 974 1582 3319 470 13.06 closure (eg, Ruiz-mora type procedure)
28288 Ostectomy, partial, exostectomy or 1422 2311 4846 630 17.50 condylectomy, metatarsal head, each metatarsal head
28289 Hallux rigidus correction with cheilectomy, 1652 2683 5628 775 21.53 debridement and capsular release of the first metatarsophalangeal joint; without implant
28291 Hallux rigidus correction with cheilectomy, 1750 2844 5964 756 21.01 debridement and capsular release of the first metatarsophalangeal joint; with implant
28292 Correction, hallux valgus (bunionectomy), with 1825 2966 6220 783 21.75 sesamoidectomy, when performed; with
180 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
resection of proximal phalanx base, when performed, any method
28295 Correction, hallux valgus (bunionectomy), with 2044 3322 6966 979 27.20 sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method
28296 Correction, hallux valgus (bunionectomy), with 1938 3148 6603 949 26.35 sesamoidectomy, when performed; with distal metatarsal osteotomy, any method
28297 Correction, hallux valgus (bunionectomy), with 2000 3250 6816 1088 30.23 sesamoidectomy, when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method
28298 Correction, hallux valgus (bunionectomy), with 1716 2789 5849 888 24.68 sesamoidectomy, when performed; with proximal phalanx osteotomy, any method
28299 Correction, hallux valgus (bunionectomy), with 2295 3728 7819 1048 29.12 sesamoidectomy, when performed; with double osteotomy, any method
28300 Osteotomy; calcaneus (eg, Dwyer or chambers 1938 3148 6603 674 18.73 type procedure), with or without internal fixation
28302 Osteotomy; talus 1591 2585 5422 743 20.63
28304 Osteotomy, tarsal bones, other than calcaneus 1942 3156 6619 861 23.92 or talus;
28305 Osteotomy, tarsal bones, other than calcaneus 1882 3058 6413 693 19.24 or talus; with autograft (includes obtaining graft) (eg, fowler type)
28306 Osteotomy, with or without lengthening, 1500 2438 5112 641 17.80 shortening or angular correction, metatarsal; first metatarsal
28307 Osteotomy, with or without lengthening, 1358 2207 4628 694 19.27 shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe)
28308 Osteotomy, with or without lengthening, 1321 2146 4502 591 16.42 shortening or angular correction, metatarsal; other than first metatarsal, each
28309 Osteotomy, with or without lengthening, 2500 4063 8520 927 25.74 shortening or angular correction, metatarsal; multiple (eg, Swanson type cavus foot procedure)
CPT copyright 2017 American Medical Association. 181 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28310 Osteotomy, shortening, angular or rotational 1203 1955 4101 570 15.82 correction; proximal phalanx, first toe (separate procedure)
28312 Osteotomy, shortening, angular or rotational 1140 1852 3885 527 14.65 correction; other phalanges, any toe
28313 Reconstruction, angular deformity of toe, soft 1224 1988 4170 544 15.11 tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)
28315 Sesamoidectomy, first toe (separate procedure) 1084 1762 3694 503 13.98
28320 Repair, nonunion or malunion; tarsal bones 1690 2746 5759 632 17.55
28322 Repair, nonunion or malunion; metatarsal, with 1813 2946 6179 821 22.81 or without bone graft (includes obtaining graft)
28340 Reconstruction, toe, macrodactyly; soft tissue 1289 2095 4394 602 16.72 resection
28341 Reconstruction, toe, macrodactyly; requiring 1495 2428 5093 698 19.38 bone resection
28344 Reconstruction, toe(s); polydactyly 1325 2152 4514 470 13.05
28345 Reconstruction, toe(s); syndactyly, with or 1592 2586 5424 543 15.09 without skin graft(s), each web
28360 Reconstruction, cleft foot 2323 3774 7915 1127 31.30
28400 Closed treatment of calcaneal fracture; without 665 908 1334 258 7.16 manipulation
28405 Closed treatment of calcaneal fracture; with 904 1234 1814 404 11.22 manipulation
28406 Percutaneous skeletal fixation of calcaneal 1548 2113 3105 538 14.95 fracture, with manipulation
28415 Open treatment of calcaneal fracture, includes 3071 4193 6162 1160 32.22 internal fixation, when performed;
28420 Open treatment of calcaneal fracture, includes 3163 4319 6346 1314 36.51 internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft)
28430 Closed treatment of talus fracture; without 628 857 1260 244 6.77 manipulation
28435 Closed treatment of talus fracture; with 777 1061 1558 375 10.41 manipulation
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28436 Percutaneous skeletal fixation of talus fracture, 1122 1532 2251 466 12.95 with manipulation
28445 Open treatment of talus fracture, includes 2772 3785 5562 1094 30.40 internal fixation, when performed
28446 Open osteochondral autograft, talus (includes 3064 4183 6146 1273 35.36 obtaining graft[s])
28450 Treatment of tarsal bone fracture (except talus 576 787 1156 222 6.18 and calcaneus); without manipulation, each
28455 Treatment of tarsal bone fracture (except talus 610 833 1224 298 8.27 and calcaneus); with manipulation, each
28456 Percutaneous skeletal fixation of tarsal bone 797 1088 1599 331 9.20 fracture (except talus and calcaneus), with manipulation, each
28465 Open treatment of tarsal bone fracture (except 1664 2271 3338 655 18.20 talus and calcaneus), includes internal fixation, when performed, each
28470 Closed treatment of metatarsal fracture; without 565 772 1134 227 6.30 manipulation, each
28475 Closed treatment of metatarsal fracture; with 605 826 1213 264 7.32 manipulation, each
28476 Percutaneous skeletal fixation of metatarsal 981 1340 1969 363 10.07 fracture, with manipulation, each
28485 Open treatment of metatarsal fracture, includes 1468 2004 2945 562 15.60 internal fixation, when performed, each
28490 Closed treatment of fracture great toe, phalanx 360 492 722 152 4.21 or phalanges; without manipulation
28495 Closed treatment of fracture great toe, phalanx 402 548 806 184 5.12 or phalanges; with manipulation
28496 Percutaneous skeletal fixation of fracture great 1038 1417 2083 477 13.25 toe, phalanx or phalanges, with manipulation
28505 Open treatment of fracture, great toe, phalanx 1452 1982 2912 694 19.28 or phalanges, includes internal fixation, when performed
28510 Closed treatment of fracture, phalanx or 305 417 612 129 3.57 phalanges, other than great toe; without manipulation, each
28515 Closed treatment of fracture, phalanx or 381 520 765 168 4.66 phalanges, other than great toe; with manipulation, each
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28525 Open treatment of fracture, phalanx or 1209 1650 2425 592 16.44 phalanges, other than great toe, includes internal fixation, when performed, each
28530 Closed treatment of sesamoid fracture 309 422 620 121 3.35
28531 Open treatment of sesamoid fracture, with or 859 1172 1723 357 9.91 without internal fixation
28540 Closed treatment of tarsal bone dislocation, 478 653 959 199 5.52 other than talotarsal; without anesthesia
28545 Closed treatment of tarsal bone dislocation, 743 1014 1490 309 8.57 other than talotarsal; requiring anesthesia
28546 Percutaneous skeletal fixation of tarsal bone 1450 1979 2908 602 16.73 dislocation, other than talotarsal, with manipulation
28555 Open treatment of tarsal bone dislocation, 2026 2766 4065 904 25.12 includes internal fixation, when performed
28570 Closed treatment of talotarsal joint dislocation; 510 697 1024 234 6.51 without anesthesia
28575 Closed treatment of talotarsal joint dislocation; 914 1248 1834 380 10.55 requiring anesthesia
28576 Percutaneous skeletal fixation of talotarsal joint 989 1350 1983 411 11.41 dislocation, with manipulation
28585 Open treatment of talotarsal joint dislocation, 1995 2724 4003 897 24.93 includes internal fixation, when performed
28600 Closed treatment of tarsometatarsal joint 460 628 923 225 6.26 dislocation; without anesthesia
28605 Closed treatment of tarsometatarsal joint 821 1120 1646 341 9.47 dislocation; requiring anesthesia
28606 Percutaneous skeletal fixation of 1250 1707 2508 416 11.55 tarsometatarsal joint dislocation, with manipulation
28615 Open treatment of tarsometatarsal joint 2086 2848 4185 834 23.17 dislocation, includes internal fixation, when performed
28630 Closed treatment of metatarsophalangeal joint 386 527 774 163 4.52 dislocation; without anesthesia
28635 Closed treatment of metatarsophalangeal joint 446 609 895 184 5.11 dislocation; requiring anesthesia
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28636 Percutaneous skeletal fixation of 827 1130 1660 339 9.41 metatarsophalangeal joint dislocation, with manipulation
28645 Open treatment of metatarsophalangeal joint 1409 1924 2828 679 18.87 dislocation, includes internal fixation, when performed
28660 Closed treatment of interphalangeal joint 408 557 818 120 3.34 dislocation; without anesthesia
28665 Closed treatment of interphalangeal joint 360 491 722 161 4.48 dislocation; requiring anesthesia
28666 Percutaneous skeletal fixation of 450 615 904 186 5.16 interphalangeal joint dislocation, with manipulation
28675 Open treatment of interphalangeal joint 1358 1854 2725 600 16.66 dislocation, includes internal fixation, when performed
28705 Arthrodesis; pantalar 3539 4832 7100 1295 35.98
28715 Arthrodesis; triple 2759 3767 5535 974 27.05
28725 Arthrodesis; subtalar 2289 3126 4593 807 22.43
28730 Arthrodesis, midtarsal or tarsometatarsal, 2162 2951 4336 763 21.19 multiple or transverse;
28735 Arthrodesis, midtarsal or tarsometatarsal, 1984 2709 3981 811 22.53 multiple or transverse; with osteotomy (eg, flatfoot correction)
28737 Arthrodesis, with tendon lengthening and 1958 2673 3927 721 20.03 advancement, midtarsal, tarsal navicular- cuneiform (eg, miller type procedure)
28740 Arthrodesis, midtarsal or tarsometatarsal, single 1938 2646 3888 880 24.45 joint
28750 Arthrodesis, great toe; metatarsophalangeal 2078 2837 4168 840 23.34 joint
28755 Arthrodesis, great toe; interphalangeal joint 1243 1697 2493 531 14.76
28760 Arthrodesis, with extensor hallucis longus 1754 2395 3520 828 23.00 transfer to first metatarsal neck, great toe, interphalangeal joint (eg, Jones type procedure)
28800 Amputation, foot; midtarsal (eg, Chopart type 1361 1859 2731 556 15.45 procedure)
28805 Amputation, foot; transmetatarsal 1680 2294 3371 756 21.00
CPT copyright 2017 American Medical Association. 185 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
28810 Amputation, metatarsal, with toe, single 1102 1505 2211 446 12.39
28820 Amputation, toe; metatarsophalangeal joint 1163 1588 2334 586 16.28
28825 Amputation, toe; interphalangeal joint 1149 1568 2305 561 15.57
28890 Extracorporeal shock wave, high energy, 850 1161 1705 340 9.44 performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia
28899 Unlisted procedure, foot or toes 0 0 0 0 0.00
APPLICATION OF CASTS AND STRAPPING
29000 Application of halo type body cast (see 20661- 959 1272 1793 362 10.05 20663 for insertion)
29010 Application of Risser jacket, localizer, body; 690 916 1291 284 7.88 only
29015 Application of Risser jacket, localizer, body; 820 1087 1532 305 8.47 including head
29035 Application of body cast, shoulder to hips; 713 946 1333 265 7.37
29040 Application of body cast, shoulder to hips; 720 955 1346 304 8.45 including head, Minerva type
29044 Application of body cast, shoulder to hips; 797 1057 1490 298 8.28 including 1 thigh
29046 Application of body cast, shoulder to hips; 834 1106 1559 327 9.08 including both thighs
29049 Application, cast; figure-of-eight 235 311 438 103 2.85
29055 Application, cast; shoulder spica 887 1176 1657 231 6.41
29058 Application, cast; plaster Velpeau 345 458 646 129 3.57
29065 Application, cast; shoulder to hand (long arm) 267 354 499 99 2.76
29075 Application, cast; elbow to finger (short arm) 229 304 429 90 2.49
29085 Application, cast; hand and lower forearm 242 320 451 99 2.74 (gauntlet)
29086 Application, cast; finger (eg, contracture) 158 210 295 82 2.29
29105 Application of long arm splint (shoulder to 266 353 497 91 2.52 hand)
186 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
29125 Application of short arm splint (forearm to 190 252 355 67 1.86 hand); static
29126 Application of short arm splint (forearm to 162 215 303 80 2.21 hand); dynamic
29130 Application of finger splint; static 111 147 207 43 1.19
29131 Application of finger splint; dynamic 123 163 229 54 1.50
29200 Strapping; thorax 80 106 150 32 0.89
29240 Strapping; shoulder (eg, Velpeau) 82 109 154 31 0.86
29260 Strapping; elbow or wrist 83 110 155 31 0.85
29280 Strapping; hand or finger 88 117 165 31 0.86
29305 Application of hip spica cast; 1 leg 715 954 1366 256 7.12
29325 Application of hip spica cast; 1 and one-half 771 1029 1474 284 7.89 spica or both legs
29345 Application of long leg cast (thigh to toes); 363 484 694 140 3.90
29355 Application of long leg cast (thigh to toes); 388 517 741 145 4.02 walker or ambulatory type
29358 Application of long leg cast brace 575 767 1099 166 4.62
29365 Application of cylinder cast (thigh to ankle) 316 421 603 127 3.53
29405 Application of short leg cast (below knee to 232 309 443 84 2.33 toes);
29425 Application of short leg cast (below knee to 246 328 470 81 2.24 toes); walking or ambulatory type
29435 Application of patellar tendon bearing (ptb) 309 412 591 122 3.39 cast
29440 Adding walker to previously applied cast 115 153 219 45 1.25
29445 Application of rigid total contact leg cast 294 393 563 135 3.74
29450 Application of clubfoot cast with molding or 382 509 730 150 4.18 manipulation, long or short leg
29505 Application of long leg splint (thigh to ankle or 257 343 491 88 2.44 toes)
29515 Application of short leg splint (calf to foot) 204 273 391 74 2.06
29520 Strapping; hip 99 132 190 34 0.94
29530 Strapping; knee 81 108 154 31 0.85
CPT copyright 2017 American Medical Association. 187 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
29540 Strapping; ankle and/or foot 70 93 134 27 0.75
29550 Strapping; toes 57 76 108 19 0.54
29580 Strapping; unna boot 108 144 206 63 1.75
29581 Application of multi-layer compression system; 144 192 275 87 2.42 leg (below knee), including ankle and foot
29584 Application of multi-layer compression system; 94 125 179 81 2.25 upper arm, forearm, hand, and fingers
29700 Removal or bivalving; gauntlet, boot or body 167 223 319 67 1.86 cast
29705 Removal or bivalving; full arm or full leg cast 201 268 384 68 1.90
29710 Removal or bivalving; shoulder or hip spica, 321 428 613 128 3.56 Minerva, or Risser jacket, etc.
29720 Repair of spica, body cast or jacket 221 295 422 88 2.45
29730 Windowing of cast 150 201 288 65 1.81
29740 Wedging of cast (except clubfoot casts) 245 328 469 103 2.86
29750 Wedging of clubfoot cast 278 371 531 112 3.10
29799 Unlisted procedure, casting or strapping 0 0 0 0 0.00
ENDOSCOPY/ARTHROSCOPY
29800 Arthroscopy, temporomandibular joint, 2034 3449 6046 548 15.22 diagnostic, with or without synovial biopsy (separate procedure)
29804 Arthroscopy, temporomandibular joint, surgical 3534 5993 10507 665 18.47
29805 Arthroscopy, shoulder, diagnostic, with or 1403 2379 4170 489 13.59 without synovial biopsy (separate procedure)
29806 Arthroscopy, shoulder, surgical; 3401 5767 10111 1101 30.59 capsulorrhaphy
29807 Arthroscopy, shoulder, surgical; repair of slap 3312 5616 9846 1076 29.88 lesion
29819 Arthroscopy, shoulder, surgical; with removal 2105 3569 6257 606 16.83 of loose body or foreign body
29820 Arthroscopy, shoulder, surgical; synovectomy, 2035 3451 6050 553 15.37 partial
29821 Arthroscopy, shoulder, surgical; synovectomy, 1750 2968 5204 606 16.84 complete
188 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
29822 Arthroscopy, shoulder, surgical; debridement, 2008 3406 5971 588 16.34 limited
29823 Arthroscopy, shoulder, surgical; debridement, 2410 4087 7165 641 17.80 extensive
29824 Arthroscopy, shoulder, surgical; distal 2287 3879 6800 691 19.19 claviculectomy including distal articular surface (Mumford procedure)
29825 Arthroscopy, shoulder, surgical; with lysis and 2180 3697 6482 597 16.59 resection of adhesions, with or without manipulation
29826 Arthroscopy, shoulder, surgical; decompression 1849 3135 5496 183 5.09 of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (list separately in addition to code for primary procedure)
29827 Arthroscopy, shoulder, surgical; with rotator 3444 5840 10238 1093 30.37 cuff repair
29828 Arthroscopy, shoulder, surgical; biceps 2962 5023 8806 943 26.20 tenodesis
29830 Arthroscopy, elbow, diagnostic, with or without 1504 2550 4470 473 13.15 synovial biopsy (separate procedure)
29834 Arthroscopy, elbow, surgical; with removal of 1952 3310 5803 504 14.00 loose body or foreign body
29835 Arthroscopy, elbow, surgical; synovectomy, 1857 3149 5521 527 14.65 partial
29836 Arthroscopy, elbow, surgical; synovectomy, 2270 3848 6747 604 16.78 complete
29837 Arthroscopy, elbow, surgical; debridement, 2118 3591 6296 543 15.08 limited
29838 Arthroscopy, elbow, surgical; debridement, 2433 4125 7232 610 16.94 extensive
29840 Arthroscopy, wrist, diagnostic, with or without 1549 2627 4606 469 13.02 synovial biopsy (separate procedure)
29843 Arthroscopy, wrist, surgical; for infection, 1867 3165 5549 503 13.97 lavage and drainage
29844 Arthroscopy, wrist, surgical; synovectomy, 1840 3121 5471 515 14.30 partial
CPT copyright 2017 American Medical Association. 189 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
29845 Arthroscopy, wrist, surgical; synovectomy, 1972 3345 5864 597 16.59 complete
29846 Arthroscopy, wrist, surgical; excision and/or 2350 3985 6987 540 15.00 repair of triangular fibrocartilage and/or joint debridement
29847 Arthroscopy, wrist, surgical; internal fixation 2446 4147 7270 564 15.68 for fracture or instability
29848 Endoscopy, wrist, surgical, with release of 1952 3310 5803 531 14.74 transverse carpal ligament
29850 Arthroscopically aided treatment of 2405 4078 7150 648 18.00 intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)
29851 Arthroscopically aided treatment of 2912 4939 8658 969 26.92 intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)
29855 Arthroscopically aided treatment of tibial 2308 3914 6861 812 22.56 fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 Arthroscopically aided treatment of tibial 3846 6521 11433 1036 28.78 fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)
29860 Arthroscopy, hip, diagnostic with or without 1873 3177 5570 693 19.25 synovial biopsy (separate procedure)
29861 Arthroscopy, hip, surgical; with removal of 2471 4190 7346 749 20.80 loose body or foreign body
29862 Arthroscopy, hip, surgical; with 2563 4346 7619 836 23.21 debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum
29863 Arthroscopy, hip, surgical; with synovectomy 2332 3954 6932 834 23.18
29866 Arthroscopy, knee, surgical; osteochondral 3253 5517 9672 1091 30.31 autograft(s) (eg, mosaicplasty) (includes harvesting of the autograft[s])
29867 Arthroscopy, knee, surgical; osteochondral 4032 6836 11985 1331 36.97 allograft (eg, mosaicplasty)
190 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
29868 Arthroscopy, knee, surgical; meniscal 5773 9790 17164 1743 48.43 transplantation (includes arthrotomy for meniscal insertion), medial or lateral
29870 Arthroscopy, knee, diagnostic, with or without 1475 2501 4385 597 16.58 synovial biopsy (separate procedure)
29871 Arthroscopy, knee, surgical; for infection, 1686 2859 5013 534 14.84 lavage and drainage
29873 Arthroscopy, knee, surgical; with lateral release 1908 3235 5672 545 15.13
29874 Arthroscopy, knee, surgical; for removal of 2149 3644 6388 556 15.45 loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)
29875 Arthroscopy, knee, surgical; synovectomy, 1926 3265 5724 514 14.28 limited (eg, plica or shelf resection) (separate procedure)
29876 Arthroscopy, knee, surgical; synovectomy, 2699 4577 8025 682 18.95 major, 2 or more compartments (eg, medial or lateral)
29877 Arthroscopy, knee, surgical; 2235 3791 6646 644 17.90 debridement/shaving of articular cartilage (chondroplasty)
29879 Arthroscopy, knee, surgical; abrasion 2472 4191 7348 687 19.09 arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880 Arthroscopy, knee, surgical; with 3266 5538 9709 584 16.21 meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed
29881 Arthroscopy, knee, surgical; with 2690 4561 7996 562 15.60 meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed
29882 Arthroscopy, knee, surgical; with meniscus 2717 4607 8076 726 20.16 repair (medial or lateral)
29883 Arthroscopy, knee, surgical; with meniscus 3165 5366 9408 876 24.32 repair (medial and lateral)
CPT copyright 2017 American Medical Association. 191 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
29884 Arthroscopy, knee, surgical; with lysis of 2221 3765 6601 636 17.68 adhesions, with or without manipulation (separate procedure)
29885 Arthroscopy, knee, surgical; drilling for 2706 4589 8045 783 21.75 osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)
29886 Arthroscopy, knee, surgical; drilling for intact 2495 4231 7417 662 18.39 osteochondritis dissecans lesion
29887 Arthroscopy, knee, surgical; drilling for intact 2537 4301 7541 779 21.65 osteochondritis dissecans lesion with internal fixation
29888 Arthroscopically aided anterior cruciate 3496 5928 10394 1022 28.38 ligament repair/augmentation or reconstruction
29889 Arthroscopically aided posterior cruciate 3884 6586 11547 1273 35.35 ligament repair/augmentation or reconstruction
29891 Arthroscopy, ankle, surgical, excision of 2263 3838 6728 696 19.33 osteochondral defect of talus and/or tibia, including drilling of the defect
29892 Arthroscopically aided repair of large 2186 3707 6499 708 19.66 osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)
29893 Endoscopic plantar fasciotomy 1387 2353 4125 635 17.65
29894 Arthroscopy, ankle (tibiotalar and fibulotalar 1967 3335 5847 509 14.13 joints), surgical; with removal of loose body or foreign body
29895 Arthroscopy, ankle (tibiotalar and fibulotalar 1730 2934 5144 487 13.52 joints), surgical; synovectomy, partial
29897 Arthroscopy, ankle (tibiotalar and fibulotalar 1908 3236 5674 521 14.46 joints), surgical; debridement, limited
29898 Arthroscopy, ankle (tibiotalar and fibulotalar 2101 3562 6245 583 16.20 joints), surgical; debridement, extensive
29899 Arthroscopy, ankle (tibiotalar and fibulotalar 3254 5518 9674 1072 29.78 joints), surgical; with ankle arthrodesis
29900 Arthroscopy, metacarpophalangeal joint, 1829 3101 5436 514 14.28 diagnostic, includes synovial biopsy
29901 Arthroscopy, metacarpophalangeal joint, 2056 3487 6113 554 15.39 surgical; with debridement
192 CPT copyright 2017 American Medical Association. SURGERY – MUSCULOSKELETAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
29902 Arthroscopy, metacarpophalangeal joint, 2118 3592 6298 589 16.35 surgical; with reduction of displaced ulnar collateral ligament (eg, Stener lesion)
29904 Arthroscopy, subtalar joint, surgical; with 2461 4174 7317 663 18.42 removal of loose body or foreign body
29905 Arthroscopy, subtalar joint, surgical; with 2376 4029 7063 570 15.83 synovectomy
29906 Arthroscopy, subtalar joint, surgical; with 2159 3661 6418 721 20.04 debridement
29907 Arthroscopy, subtalar joint, surgical; with 3382 5735 10054 911 25.31 subtalar arthrodesis
29914 Arthroscopy, hip, surgical; with femoroplasty 2880 4884 8563 1018 28.29 (ie, treatment of cam lesion)
29915 Arthroscopy, hip, surgical; with acetabuloplasty 3186 5402 9471 1044 29.00 (ie, treatment of pincer lesion)
29916 Arthroscopy, hip, surgical; with labral repair 2960 5019 8798 1050 29.18
29999 Unlisted procedure, arthroscopy 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 193 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
194 CPT copyright 2017 American Medical Association. SURGERY – RESPIRATORY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
RESPIRATORY SYSTEM NOSE
30000 Drainage abscess or hematoma, nasal, internal 464 652 995 232 6.45 approach
30020 Drainage abscess or hematoma, nasal septum 473 665 1014 234 6.51
30100 Biopsy, intranasal 289 407 620 141 3.93
30110 Excision, nasal polyp(s), simple 481 676 1030 232 6.44
30115 Excision, nasal polyp(s), extensive 1007 1415 2158 435 12.09
30117 Excision or destruction (eg, laser), intranasal 1854 2605 3973 882 24.51 lesion; internal approach
30118 Excision or destruction (eg, laser), intranasal 2078 2919 4452 781 21.69 lesion; external approach (lateral rhinotomy)
30120 Excision or surgical planing of skin of nose for 1423 1999 3049 532 14.77 rhinophyma
30124 Excision dermoid cyst, nose; simple, skin, 764 1074 1638 287 7.98 subcutaneous
30125 Excision dermoid cyst, nose; complex, under 1627 2287 3487 612 16.99 bone or cartilage
30130 Excision inferior turbinate, partial or complete, 1113 1564 2386 384 10.68 any method
30140 Submucous resection inferior turbinate, partial 1400 1968 3001 281 7.81 or complete, any method
30150 Rhinectomy; partial 2070 2909 4436 778 21.61
30160 Rhinectomy; total 2074 2914 4444 779 21.65
30200 Injection into turbinate(s), therapeutic 207 291 444 113 3.15
30210 Displacement therapy (Proetz type) 301 423 645 152 4.21
30220 Insertion, nasal septal prosthesis (button) 578 812 1238 304 8.45
30300 Removal foreign body, intranasal; office type 467 657 1001 181 5.02 procedure
30310 Removal foreign body, intranasal; requiring 557 783 1194 204 5.68 general anesthesia
30320 Removal foreign body, intranasal; by lateral 1210 1700 2592 455 12.63 rhinotomy
CPT copyright 2017 American Medical Association. 195 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
30400 Rhinoplasty, primary; lateral and alar cartilages 2913 4093 6242 1075 29.87 and/or elevation of nasal tip
30410 Rhinoplasty, primary; complete, external parts 3551 4990 7609 1267 35.20 including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip
30420 Rhinoplasty, primary; including major septal 4179 5872 8955 1383 38.41 repair
30430 Rhinoplasty, secondary; minor revision (small 2510 3528 5380 944 26.21 amount of nasal tip work)
30435 Rhinoplasty, secondary; intermediate revision 3228 4536 6918 1185 32.91 (bony work with osteotomies)
30450 Rhinoplasty, secondary; major revision (nasal 4552 6396 9755 1572 43.68 tip work and osteotomies)
30460 Rhinoplasty for nasal deformity secondary to 2689 3778 5762 839 23.31 congenital cleft lip and/or palate, including columellar lengthening; tip only
30462 Rhinoplasty for nasal deformity secondary to 4820 6773 1033 1610 44.72 congenital cleft lip and/or palate, including 0 columellar lengthening; tip, septum, osteotomies
30465 Repair of nasal vestibular stenosis (eg, spreader 2949 4144 6319 989 27.48 grafting, lateral nasal wall reconstruction)
30520 Septoplasty or submucous resection, with or 1945 2734 4169 627 17.43 without cartilage scoring, contouring or replacement with graft
30540 Repair choanal atresia; intranasal 2176 3058 4663 692 19.23
30545 Repair choanal atresia; transpalatine 2522 3544 5404 948 26.33
30560 Lysis intranasal synechia 550 773 1179 269 7.48
30580 Repair fistula; oromaxillary (combine with 2012 2827 4312 665 18.46 31030 if antrotomy is included)
30600 Repair fistula; oronasal 1796 2524 3849 598 16.62
30620 Septal or other intranasal dermatoplasty (does 1669 2346 3578 627 17.43 not include obtaining graft)
30630 Repair nasal septal perforations 1867 2624 4002 627 17.42
30801 Ablation, soft tissue of inferior turbinates, 502 705 1075 231 6.41 unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial
196 CPT copyright 2017 American Medical Association. SURGERY – RESPIRATORY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
30802 Ablation, soft tissue of inferior turbinates, 665 934 1425 292 8.10 unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)
30901 Control nasal hemorrhage, anterior, simple 244 343 522 139 3.87 (limited cautery and/or packing) any method
30903 Control nasal hemorrhage, anterior, complex 445 625 954 214 5.95 (extensive cautery and/or packing) any method
30905 Control nasal hemorrhage, posterior, with 577 811 1237 331 9.20 posterior nasal packs and/or cautery, any method; initial
30906 Control nasal hemorrhage, posterior, with 565 794 1211 344 9.55 posterior nasal packs and/or cautery, any method; subsequent
30915 Ligation arteries; ethmoidal 1543 2168 3307 580 16.11
30920 Ligation arteries; internal maxillary artery, 2239 3147 4799 842 23.38 transantral
30930 Fracture nasal inferior turbinate(s), therapeutic 433 608 928 125 3.46
30999 Unlisted procedure, nose 0 0 0 0 0.00
ACCESSORY SINUSES
31000 Lavage by cannulation; maxillary sinus (antrum 301 424 646 185 5.15 puncture or natural ostium)
31002 Lavage by cannulation; sphenoid sinus 579 813 1240 190 5.29
31020 Sinusotomy, maxillary (antrotomy); intranasal 1124 1580 2409 491 13.63
31030 Sinusotomy, maxillary (antrotomy); radical 1958 2751 4196 697 19.37 (Caldwell-Luc) without removal of antrochoanal polyps
31032 Sinusotomy, maxillary (antrotomy); radical 1768 2484 3788 581 16.13 (Caldwell-Luc) with removal of antrochoanal polyps
31040 Pterygomaxillary fossa surgery, any approach 2055 2887 4403 772 21.45
31050 Sinusotomy, sphenoid, with or without biopsy; 1298 1824 2781 488 13.55
31051 Sinusotomy, sphenoid, with or without biopsy; 1726 2425 3699 649 18.02 with mucosal stripping or removal of polyp(s)
31070 Sinusotomy frontal; external, simple (trephine 1174 1650 2516 441 12.26 operation)
CPT copyright 2017 American Medical Association. 197 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
31075 Sinusotomy frontal; transorbital, unilateral (for 2093 2941 4485 787 21.85 mucocele or osteoma, lynch type)
31080 Sinusotomy frontal; obliterative without 2758 3875 5909 1036 28.79 osteoplastic flap, brow incision (includes ablation)
31081 Sinusotomy frontal; obliterative, without 3846 5404 8242 1240 34.44 osteoplastic flap, coronal incision (includes ablation)
31084 Sinusotomy frontal; obliterative, with 3088 4339 6618 1161 32.24 osteoplastic flap, brow incision
31085 Sinusotomy frontal; obliterative, with 4105 5768 8796 1323 36.76 osteoplastic flap, coronal incision
31086 Sinusotomy frontal; nonobliterative, with 2999 4214 6427 1127 31.31 osteoplastic flap, brow incision
31087 Sinusotomy frontal; nonobliterative, with 2897 4071 6209 1089 30.25 osteoplastic flap, coronal incision
31090 Sinusotomy, unilateral, 3 or more paranasal 2441 3430 5231 1036 28.77 sinuses (frontal, maxillary, ethmoid, sphenoid)
31200 Ethmoidectomy; intranasal, anterior 1200 1687 2572 587 16.30
31201 Ethmoidectomy; intranasal, total 2154 3027 4616 754 20.94
31205 Ethmoidectomy; extranasal, total 2611 3668 5594 924 25.66
31225 Maxillectomy; without orbital exenteration 5068 7122 10860 1904 52.88
31230 Maxillectomy; with orbital exenteration (en 5579 7840 11956 2097 58.25 bloc)
31231 Nasal endoscopy, diagnostic, unilateral or 451 532 711 215 5.96 bilateral (separate procedure)
31233 Nasal/sinus endoscopy, diagnostic with 500 590 789 264 7.32 maxillary sinusoscopy (via inferior meatus or canine fossa puncture)
31235 Nasal/sinus endoscopy, diagnostic with 362 428 571 302 8.38 sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)
31237 Nasal/sinus endoscopy, surgical; with biopsy, 700 826 1104 267 7.43 polypectomy or debridement (separate procedure)
31238 Nasal/sinus endoscopy, surgical; with control 727 858 1147 267 7.41 of nasal hemorrhage
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31239 Nasal/sinus endoscopy, surgical; with 2512 2965 3962 632 17.56 dacryocystorhinostomy
31240 Nasal/sinus endoscopy, surgical; with concha 633 747 998 163 4.54 bullosa resection
31241 Nasal/sinus endoscopy, surgical; with ligation 1009 1191 1592 462 12.83 of sphenopalatine artery
31253 Nasal/sinus endoscopy, surgical with 1131 1335 1784 518 14.38 ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed
31254 Nasal/sinus endoscopy, surgical with 1565 1848 2469 415 11.54 ethmoidectomy; partial (anterior)
31255 Nasal/sinus endoscopy, surgical with 2341 2763 3692 334 9.29 ethmoidectomy; total (anterior and posterior)
31256 Nasal/sinus endoscopy, surgical, with maxillary 1321 1559 2083 186 5.17 antrostomy;
31257 Nasal/sinus endoscopy, surgical with 1007 1188 1588 461 12.80 ethmoidectomy; total (anterior and posterior), including sphenoidotomy
31259 Nasal/sinus endoscopy, surgical with 1067 1260 1684 489 13.57 ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus
31267 Nasal/sinus endoscopy, surgical, with maxillary 1800 2125 2840 274 7.62 antrostomy; with removal of tissue from maxillary sinus
31276 Nasal/sinus endoscopy, surgical, with frontal 2001 2361 3156 391 10.85 sinus exploration, including removal of tissue from frontal sinus, when performed
31287 Nasal/sinus endoscopy, surgical, with 1650 1948 2603 208 5.78 sphenoidotomy;
31288 Nasal/sinus endoscopy, surgical, with 2000 2361 3155 242 6.72 sphenoidotomy; with removal of tissue from the sphenoid sinus
31290 Nasal/sinus endoscopy, surgical, with repair of 3385 3995 5339 1177 32.70 cerebrospinal fluid leak; ethmoid region
31291 Nasal/sinus endoscopy, surgical, with repair of 3670 4332 5789 1260 35.01 cerebrospinal fluid leak; sphenoid region
CPT copyright 2017 American Medical Association. 199 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
31292 Nasal/sinus endoscopy, surgical; with medial or 3122 3686 4925 1013 28.14 inferior orbital wall decompression
31293 Nasal/sinus endoscopy, surgical; with medial 2401 2835 3788 1099 30.53 orbital wall and inferior orbital wall decompression
31294 Nasal/sinus endoscopy, surgical; with optic 2754 3251 4344 1259 34.97 nerve decompression
31295 Nasal/sinus endoscopy, surgical; with dilation 4420 5218 6973 2054 57.07 of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa
31296 Nasal/sinus endoscopy, surgical; with dilation 5879 6939 9273 2081 57.80 of frontal sinus ostium (eg, balloon dilation)
31297 Nasal/sinus endoscopy, surgical; with dilation 5239 6184 8264 2040 56.67 of sphenoid sinus ostium (eg, balloon dilation)
31298 Nasal/sinus endoscopy, surgical; with dilation 8639 10198 13628 3954 109.84 of frontal and sphenoid sinus ostia (eg, balloon dilation)
31299 Unlisted procedure, accessory sinuses 0 0 0 0 0.00
LARYNX
31300 Laryngotomy (thyrotomy, laryngofissure), with 3727 5066 6657 1323 36.75 removal of tumor or laryngocele, cordectomy
31360 Laryngectomy; total, without radical neck 5886 8001 10513 2149 59.70 dissection
31365 Laryngectomy; total, with radical neck 6400 8700 11432 2648 73.57 dissection
31367 Laryngectomy; subtotal supraglottic, without 6406 8707 11441 2274 63.16 radical neck dissection
31368 Laryngectomy; subtotal supraglottic, with 7121 9679 12718 2528 70.21 radical neck dissection
31370 Partial laryngectomy (hemilaryngectomy); 6024 8189 10760 2138 59.40 horizontal
31375 Partial laryngectomy (hemilaryngectomy); 5712 7764 10202 2027 56.32 laterovertical
31380 Partial laryngectomy (hemilaryngectomy); 5632 7655 10059 1999 55.53 anterovertical
31382 Partial laryngectomy (hemilaryngectomy); 6183 8405 11044 2195 60.97 antero-latero-vertical
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31390 Pharyngolaryngectomy, with radical neck 8306 11290 14835 2948 81.90 dissection; without reconstruction
31395 Pharyngolaryngectomy, with radical neck 8792 11951 15703 3121 86.69 dissection; with reconstruction
31400 Arytenoidectomy or arytenoidopexy, external 2831 3848 5056 1005 27.91 approach
31420 Epiglottidectomy 2375 3229 4242 843 23.42
31500 Intubation, endotracheal, emergency procedure 531 722 948 146 4.06
31502 Tracheotomy tube change prior to 129 176 231 36 1.00 establishment of fistula tract
31505 Laryngoscopy, indirect; diagnostic (separate 177 241 316 84 2.33 procedure)
31510 Laryngoscopy, indirect; with biopsy 602 819 1076 214 5.94
31511 Laryngoscopy, indirect; with removal of 604 822 1080 215 5.96 foreign body
31512 Laryngoscopy, indirect; with removal of lesion 587 798 1049 208 5.79
31513 Laryngoscopy, indirect; with vocal cord 493 670 881 135 3.74 injection
31515 Laryngoscopy direct, with or without 736 1001 1315 208 5.78 tracheoscopy; for aspiration
31520 Laryngoscopy direct, with or without 615 836 1099 160 4.45 tracheoscopy; diagnostic, newborn
31525 Laryngoscopy direct, with or without 566 769 1011 256 7.11 tracheoscopy; diagnostic, except newborn
31526 Laryngoscopy direct, with or without 670 910 1196 161 4.47 tracheoscopy; diagnostic, with operating microscope or telescope
31527 Laryngoscopy direct, with or without 565 768 1009 201 5.57 tracheoscopy; with insertion of obturator
31528 Laryngoscopy direct, with or without 480 653 857 148 4.11 tracheoscopy; with dilation, initial
31529 Laryngoscopy direct, with or without 506 688 904 166 4.60 tracheoscopy; with dilation, subsequent
31530 Laryngoscopy, direct, operative, with foreign 722 982 1290 205 5.70 body removal;
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
31531 Laryngoscopy, direct, operative, with foreign 714 970 1275 218 6.06 body removal; with operating microscope or telescope
31535 Laryngoscopy, direct, operative, with biopsy; 675 918 1206 195 5.42
31536 Laryngoscopy, direct, operative, with biopsy; 863 1173 1542 216 6.01 with operating microscope or telescope
31540 Laryngoscopy, direct, operative, with excision 977 1328 1745 248 6.89 of tumor and/or stripping of vocal cords or epiglottis;
31541 Laryngoscopy, direct, operative, with excision 1136 1544 2029 271 7.52 of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope
31545 Laryngoscopy, direct, operative, with operating 1216 1652 2171 372 10.33 microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)
31546 Laryngoscopy, direct, operative, with operating 1592 2164 2844 565 15.70 microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft)
31551 Laryngoplasty; for laryngeal stenosis, with 4154 5647 7420 1475 40.96 graft, without indwelling stent placement, younger than 12 years of age
31552 Laryngoplasty; for laryngeal stenosis, with 4166 5663 7441 1479 41.08 graft, without indwelling stent placement, age 12 years or older
31553 Laryngoplasty; for laryngeal stenosis, with 4584 6231 8188 1627 45.20 graft, with indwelling stent placement, younger than 12 years of age
31554 Laryngoplasty; for laryngeal stenosis, with 4783 6501 8543 1698 47.16 graft, with indwelling stent placement, age 12 years or older
31560 Laryngoscopy, direct, operative, with 906 1231 1618 321 8.93 arytenoidectomy;
31561 Laryngoscopy, direct, operative, with 1356 1844 2422 351 9.76 arytenoidectomy; with operating microscope or telescope
31570 Laryngoscopy, direct, with injection into vocal 875 1190 1563 343 9.52 cord(s), therapeutic;
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31571 Laryngoscopy, direct, with injection into vocal 1006 1367 1796 256 7.11 cord(s), therapeutic; with operating microscope or telescope
31572 Laryngoscopy, flexible; with ablation or 1383 1879 2469 504 14.00 destruction of lesion(s) with laser, unilateral
31573 Laryngoscopy, flexible; with therapeutic 736 1000 1314 269 7.47 injection(s) (eg, chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral
31574 Laryngoscopy, flexible; with injection(s) for 2849 3873 5089 1037 28.80 augmentation (eg, percutaneous, transoral), unilateral
31575 Laryngoscopy, flexible; diagnostic 285 388 510 115 3.20
31576 Laryngoscopy, flexible; with biopsy(ies) 589 801 1052 270 7.49
31577 Laryngoscopy, flexible; with removal of 843 1145 1505 280 7.78 foreign body(s)
31578 Laryngoscopy, flexible; with removal of 984 1337 1757 306 8.51 lesion(s), non-laser
31579 Laryngoscopy, flexible or rigid telescopic, with 524 712 936 183 5.09 stroboscopy
31580 Laryngoplasty; for laryngeal web, with 3583 4870 6400 1272 35.33 indwelling keel or stent insertion
31584 Laryngoplasty; with open reduction and 3969 5394 7088 1409 39.13 fixation of (eg, plating) fracture, includes tracheostomy, if performed
31587 Laryngoplasty, cricoid split, without graft 3314 4505 5920 1176 32.68 placement
31590 Laryngeal reinnervation by neuromuscular 2517 3422 4496 894 24.82 pedicle
31591 Laryngoplasty, medialization, unilateral 3281 4459 5859 1064 29.55
31592 Cricotracheal resection 4882 6636 8720 1733 48.14
31595 Section recurrent laryngeal nerve, therapeutic 2170 2950 3876 770 21.40 (separate procedure), unilateral
31599 Unlisted procedure, larynx 0 0 0 0 0.00
TRACHEA AND BRONCHI
31600 Tracheostomy, planned (separate procedure); 1076 1453 2074 334 9.28
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
31601 Tracheostomy, planned (separate procedure); 1092 1475 2105 465 12.91 younger than 2 years
31603 Tracheostomy, emergency procedure; 737 995 1420 334 9.27 transtracheal
31605 Tracheostomy, emergency procedure; 655 885 1263 347 9.63 cricothyroid membrane
31610 Tracheostomy, fenestration procedure with skin 2000 2702 3856 970 26.95 flaps
31611 Construction of tracheoesophageal fistula and 1615 2181 3112 545 15.15 subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, blom-singer prosthesis)
31612 Tracheal puncture, percutaneous with 205 277 395 85 2.36 transtracheal aspiration and/or injection
31613 Tracheostoma revision; simple, without flap 1298 1753 2502 462 12.84 rotation
31614 Tracheostoma revision; complex, with flap 2173 2934 4188 765 21.24 rotation
31615 Tracheobronchoscopy through established 479 647 923 171 4.76 tracheostomy incision
31622 Bronchoscopy, rigid or flexible, including 647 874 1247 247 6.86 fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)
31623 Bronchoscopy, rigid or flexible, including 570 770 1099 279 7.75 fluoroscopic guidance, when performed; with brushing or protected brushings
31624 Bronchoscopy, rigid or flexible, including 617 833 1189 260 7.23 fluoroscopic guidance, when performed; with bronchial alveolar lavage
31625 Bronchoscopy, rigid or flexible, including 638 862 1230 340 9.45 fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites
31626 Bronchoscopy, rigid or flexible, including 1022 1381 1971 868 24.12 fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple
31627 Bronchoscopy, rigid or flexible, including 2341 3161 4512 1437 39.91 fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation
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(list separately in addition to code for primary procedure[s])
31628 Bronchoscopy, rigid or flexible, including 762 1029 1468 362 10.05 fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe
31629 Bronchoscopy, rigid or flexible, including 867 1171 1671 446 12.39 fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)
31630 Bronchoscopy, rigid or flexible, including 665 898 1282 207 5.75 fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture
31631 Bronchoscopy, rigid or flexible, including 758 1024 1461 237 6.59 fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required)
31632 Bronchoscopy, rigid or flexible, including 172 232 332 66 1.82 fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)
31633 Bronchoscopy, rigid or flexible, including 197 265 379 82 2.29 fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)
31634 Bronchoscopy, rigid or flexible, including 4405 5949 8491 1825 50.69 fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed
31635 Bronchoscopy, rigid or flexible, including 655 885 1263 288 8.00 fluoroscopic guidance, when performed; with removal of foreign body
31636 Bronchoscopy, rigid or flexible, including 697 941 1343 230 6.38 fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus
31637 Bronchoscopy, rigid or flexible, including 186 251 358 77 2.14 fluoroscopic guidance, when performed; each additional major bronchus stented (list separately in addition to code for primary procedure)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
31638 Bronchoscopy, rigid or flexible, including 792 1070 1527 260 7.21 fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required)
31640 Bronchoscopy, rigid or flexible, including 838 1132 1615 261 7.25 fluoroscopic guidance, when performed; with excision of tumor
31641 Bronchoscopy, rigid or flexible, including 827 1116 1593 267 7.42 fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy)
31643 Bronchoscopy, rigid or flexible, including 520 702 1002 184 5.11 fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application
31645 Bronchoscopy, rigid or flexible, including 568 767 1094 266 7.38 fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial
31646 Bronchoscopy, rigid or flexible, including 518 699 998 147 4.09 fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay
31647 Bronchoscopy, rigid or flexible, including 586 792 1130 221 6.13 fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe
31648 Bronchoscopy, rigid or flexible, including 488 660 941 202 5.62 fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe
31649 Bronchoscopy, rigid or flexible, including 169 229 327 70 1.95 fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)
31651 Bronchoscopy, rigid or flexible, including 186 251 358 77 2.14 fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure[s])
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
31652 Bronchoscopy, rigid or flexible, including 933 1260 1798 851 23.63 fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures
31653 Bronchoscopy, rigid or flexible, including 986 1332 1901 899 24.98 fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures
31654 Bronchoscopy, rigid or flexible, including 215 290 414 129 3.58 fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (list separately in addition to code for primary procedure[s])
31660 Bronchoscopy, rigid or flexible, including 534 721 1029 203 5.63 fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe
31661 Bronchoscopy, rigid or flexible, including 571 772 1101 215 5.96 fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes
31717 Catheterization with bronchial brush biopsy 665 898 1281 275 7.65
31720 Catheter aspiration (separate procedure); 130 176 251 51 1.43 nasotracheal
31725 Catheter aspiration (separate procedure); 344 464 663 82 2.28 tracheobronchial with fiberscope, bedside
31730 Transtracheal (percutaneous) introduction of 1499 2025 2890 1269 35.25 needle wire dilator/stent or indwelling tube for oxygen therapy
31750 Tracheoplasty; cervical 4513 6094 8697 1430 39.73
31755 Tracheoplasty; tracheopharyngeal fistulization, 4361 5889 8405 1806 50.18 each stage
31760 Tracheoplasty; intrathoracic 3442 4649 6635 1426 39.61
31766 Carinal reconstruction 4468 6034 8611 1851 51.41
31770 Bronchoplasty; graft repair 3347 4520 6450 1386 38.51
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
31775 Bronchoplasty; excision stenosis and 3514 4746 6774 1456 40.44 anastomosis
31780 Excision tracheal stenosis and anastomosis; 2951 3986 5688 1223 33.96 cervical
31781 Excision tracheal stenosis and anastomosis; 3480 4699 6707 1441 40.04 cervicothoracic
31785 Excision of tracheal tumor or carcinoma; 2642 3568 5092 1094 30.40 cervical
31786 Excision of tracheal tumor or carcinoma; 3624 4894 6985 1501 41.70 thoracic
31800 Suture of tracheal wound or injury; cervical 1799 2429 3467 745 20.70
31805 Suture of tracheal wound or injury; 2046 2763 3943 847 23.54 intrathoracic
31820 Surgical closure tracheostomy or fistula; 1077 1455 2076 441 12.24 without plastic repair
31825 Surgical closure tracheostomy or fistula; with 1594 2153 3072 609 16.91 plastic repair
31830 Revision of tracheostomy scar 1086 1467 2094 450 12.50
31899 Unlisted procedure, trachea, bronchi 0 0 0 0 0.00
LUNGS AND PLEURA
32035 Thoracostomy; with rib resection for empyema 1420 2062 3629 755 20.97
32036 Thoracostomy; with open flap drainage for 1511 2193 3861 803 22.31 empyema
32096 Thoracotomy, with diagnostic biopsy(ies) of 1855 2693 4740 836 23.22 lung infiltrate(s) (eg, wedge, incisional), unilateral
32097 Thoracotomy, with diagnostic biopsy(ies) of 1828 2654 4672 835 23.20 lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral
32098 Thoracotomy, with biopsy(ies) of pleura 1803 2617 4607 793 22.02
32100 Thoracotomy; with exploration 2540 3686 6489 841 23.36
32110 Thoracotomy; with control of traumatic 3867 5612 9880 1524 42.32 hemorrhage and/or repair of lung tear
32120 Thoracotomy; for postoperative complications 2487 3610 6355 905 25.15
32124 Thoracotomy; with open intrapleural 2270 3295 5801 963 26.74 pneumonolysis
208 CPT copyright 2017 American Medical Association. SURGERY – RESPIRATORY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
32140 Thoracotomy; with cyst(s) removal, includes 1942 2819 4962 1032 28.67 pleural procedure when performed
32141 Thoracotomy; with resection-plication of 3229 4686 8250 1584 44.00 bullae, includes any pleural procedure when performed
32150 Thoracotomy; with removal of intrapleural 2669 3873 6818 1041 28.93 foreign body or fibrin deposit
32151 Thoracotomy; with removal of intrapulmonary 1970 2860 5035 1047 29.09 foreign body
32160 Thoracotomy; with cardiac massage 2415 3505 6171 821 22.81
32200 Pneumonostomy, with open drainage of abscess 2229 3235 5696 1185 32.91 or cyst
32215 Pleural scarification for repeat pneumothorax 1574 2284 4020 836 23.23
32220 Decortication, pulmonary (separate procedure); 3679 5340 9401 1645 45.69 total
32225 Decortication, pulmonary (separate procedure); 2472 3587 6315 1033 28.69 partial
32310 Pleurectomy, parietal (separate procedure) 1784 2588 4557 948 26.33
32320 Decortication and parietal pleurectomy 4199 6095 10730 1658 46.06
32400 Biopsy, pleura, percutaneous needle 323 469 826 154 4.29
32405 Biopsy, lung or mediastinum, percutaneous 415 603 1061 401 11.13 needle
32440 Removal of lung, pneumonectomy; 4303 6245 10994 1625 45.15
32442 Removal of lung, pneumonectomy; with 6006 8716 15344 3192 88.66 resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)
32445 Removal of lung, pneumonectomy; extrapleural 6919 10042 17679 3677 102.15
32480 Removal of lung, other than pneumonectomy; 3629 5267 9272 1536 42.66 single lobe (lobectomy)
32482 Removal of lung, other than pneumonectomy; 2 3941 5720 10070 1643 45.65 lobes (bilobectomy)
32484 Removal of lung, other than pneumonectomy; 3733 5418 9538 1491 41.43 single segment (segmentectomy)
32486 Removal of lung, other than pneumonectomy; 4607 6686 11770 2448 68.01 with circumferential resection of segment of
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy)
32488 Removal of lung, other than pneumonectomy; 4700 6821 12008 2498 69.38 with all remaining lung following previous removal of a portion of lung (completion pneumonectomy)
32491 Removal of lung, other than pneumonectomy; 2840 4122 7257 1509 41.93 with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed
32501 Resection and repair of portion of bronchus 480 696 1225 255 7.08 (bronchoplasty) when performed at time of lobectomy or segmentectomy (list separately in addition to code for primary procedure)
32503 Resection of apical lung tumor (eg, Pancoast 3522 5112 9000 1872 52.00 tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s)
32504 Resection of apical lung tumor (eg, Pancoast 4013 5825 10254 2133 59.25 tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction
32505 Thoracotomy; with therapeutic wedge resection 2313 3356 5909 967 26.86 (eg, mass, nodule), initial
32506 Thoracotomy; with therapeutic wedge resection 513 744 1310 163 4.53 (eg, mass or nodule), each additional resection, ipsilateral (list separately in addition to code for primary procedure)
32507 Thoracotomy; with diagnostic wedge resection 376 546 961 163 4.53 followed by anatomic lung resection (list separately in addition to code for primary procedure)
32540 Extrapleural enucleation of empyema 3708 5382 9475 1796 49.88 (empyemectomy)
32550 Insertion of indwelling tunneled pleural 927 1345 2367 728 20.21 catheter with cuff
32551 Tube thoracostomy, includes connection to 554 804 1416 163 4.54 drainage system (eg, water seal), when performed, open (separate procedure)
32552 Removal of indwelling tunneled pleural 487 706 1244 189 5.25 catheter with cuff
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32553 Placement of interstitial device(s) for radiation 703 1020 1796 535 14.87 therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple
32554 Thoracentesis, needle or catheter, aspiration of 482 699 1231 208 5.78 the pleural space; without imaging guidance
32555 Thoracentesis, needle or catheter, aspiration of 416 603 1062 297 8.26 the pleural space; with imaging guidance
32556 Pleural drainage, percutaneous, with insertion 885 1284 2260 572 15.90 of indwelling catheter; without imaging guidance
32557 Pleural drainage, percutaneous, with insertion 624 906 1594 523 14.54 of indwelling catheter; with imaging guidance
32560 Instillation, via chest tube/catheter, agent for 392 569 1001 252 6.99 pleurodesis (eg, talc for recurrent or persistent pneumothorax)
32561 Instillation(s), via chest tube/catheter, agent for 226 328 577 96 2.66 fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial day
32562 Instillation(s), via chest tube/catheter, agent for 175 254 447 86 2.39 fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequent day
32601 Thoracoscopy, diagnostic (separate procedure); 920 1335 2350 321 8.92 lungs, pericardial sac, mediastinal or pleural space, without biopsy
32604 Thoracoscopy, diagnostic (separate procedure); 944 1370 2413 502 13.94 pericardial sac, with biopsy
32606 Thoracoscopy, diagnostic (separate procedure); 1413 2051 3611 481 13.37 mediastinal space, with biopsy
32607 Thoracoscopy; with diagnostic biopsy(ies) of 814 1181 2080 321 8.91 lung infiltrate(s) (eg, wedge, incisional), unilateral
32608 Thoracoscopy; with diagnostic biopsy(ies) of 1000 1452 2556 393 10.92 lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral
32609 Thoracoscopy; with biopsy(ies) of pleura 775 1125 1981 269 7.47
32650 Thoracoscopy, surgical; with pleurodesis (eg, 1824 2648 4661 692 19.21 mechanical or chemical)
32651 Thoracoscopy, surgical; with partial pulmonary 2774 4026 7088 1138 31.61 decortication
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
32652 Thoracoscopy, surgical; with total pulmonary 3902 5664 9971 1726 47.95 decortication, including intrapleural pneumonolysis
32653 Thoracoscopy, surgical; with removal of 2878 4177 7354 1101 30.57 intrapleural foreign body or fibrin deposit
32654 Thoracoscopy, surgical; with control of 4007 5815 1023 1198 33.28 traumatic hemorrhage 8
32655 Thoracoscopy, surgical; with resection- 2563 3720 6548 993 27.59 plication of bullae, includes any pleural procedure when performed
32656 Thoracoscopy, surgical; with parietal 2464 3576 6295 831 23.09 pleurectomy
32658 Thoracoscopy, surgical; with removal of clot or 1396 2026 3567 742 20.61 foreign body from pericardial sac
32659 Thoracoscopy, surgical; with creation of 2163 3140 5528 759 21.07 pericardial window or partial resection of pericardial sac for drainage
32661 Thoracoscopy, surgical; with excision of 1563 2269 3994 831 23.08 pericardial cyst, tumor, or mass
32662 Thoracoscopy, surgical; with excision of 2760 4005 7051 925 25.70 mediastinal cyst, tumor, or mass
32663 Thoracoscopy, surgical; with lobectomy (single 3739 5427 9553 1455 40.41 lobe)
32664 Thoracoscopy, surgical; with thoracic 1660 2410 4242 882 24.51 sympathectomy
32665 Thoracoscopy, surgical; with 2416 3507 6173 1284 35.67 esophagomyotomy (Heller type)
32666 Thoracoscopy, surgical; with therapeutic wedge 2511 3644 6415 904 25.12 resection (eg, mass, nodule), initial unilateral
32667 Thoracoscopy, surgical; with therapeutic wedge 460 668 1176 163 4.54 resection (eg, mass or nodule), each additional resection, ipsilateral (list separately in addition to code for primary procedure)
32668 Thoracoscopy, surgical; with diagnostic wedge 409 594 1045 163 4.54 resection followed by anatomic lung resection (list separately in addition to code for primary procedure)
32669 Thoracoscopy, surgical; with removal of a 4030 5848 10296 1398 38.83 single lung segment (segmentectomy)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
32670 Thoracoscopy, surgical; with removal of two 3140 4557 8022 1669 46.35 lobes (bilobectomy)
32671 Thoracoscopy, surgical; with removal of lung 3486 5060 8908 1853 51.47 (pneumonectomy)
32672 Thoracoscopy, surgical; with resection- 2992 4342 7644 1590 44.17 plication for emphysematous lung (bullous or non-bullous) for lung volume reduction (LVRS), unilateral includes any pleural procedure, when performed
32673 Thoracoscopy, surgical; with resection of 3887 5641 9930 1267 35.20 thymus, unilateral or bilateral
32674 Thoracoscopy, surgical; with mediastinal and 583 846 1490 224 6.23 regional lymphadenectomy (list separately in addition to code for primary procedure)
32701 Thoracic target(s) delineation for stereotactic 502 729 1283 223 6.20 body radiation therapy (srs/SBRT), (photon or particle beam), entire course of treatment
32800 Repair lung hernia through chest wall 1846 2679 4716 981 27.25
32810 Closure of chest wall following open flap 1764 2560 4507 937 26.04 drainage for empyema (Clagett type procedure)
32815 Open closure of major bronchial fistula 5455 7917 13937 2899 80.53
32820 Major reconstruction, chest wall 2667 3870 6813 1385 38.46 (posttraumatic)
32850 Donor pneumonectomy(s) (including cold 0 0 0 0 0.00 preservation), from cadaver donor
32851 Lung transplant, single; without 6440 9347 16455 3423 95.08 cardiopulmonary bypass
32852 Lung transplant, single; with cardiopulmonary 7005 10167 17899 3723 103.42 bypass
32853 Lung transplant, double (bilateral sequential or 8970 13018 22918 4767 132.42 en bloc); without cardiopulmonary bypass
32854 Lung transplant, double (bilateral sequential or 9514 13809 24309 5057 140.46 en bloc); with cardiopulmonary bypass
32855 Backbench standard preparation of cadaver 546 793 1396 0 0.00 donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; unilateral
CPT copyright 2017 American Medical Association. 213 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
32856 Backbench standard preparation of cadaver 674 979 1723 0 0.00 donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; bilateral
32900 Resection of ribs, extrapleural, all stages 3668 5324 9373 1474 40.95
32905 Thoracoplasty, Schede type or extrapleural (all 2620 3803 6694 1392 38.68 stages);
32906 Thoracoplasty, Schede type or extrapleural (all 3235 4695 8266 1719 47.76 stages); with closure of bronchopleural fistula
32940 Pneumonolysis, extraperiosteal, including 2420 3512 6182 1286 35.72 filling or packing procedures
32960 Pneumothorax, therapeutic, intrapleural 245 356 627 130 3.62 injection of air
32994 Ablation therapy for reduction or eradication of 1186 1722 3031 6306 175.1 1 or more pulmonary tumor(s) including pleura 5 1 7 7 or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation
32997 Total lung lavage (unilateral) 668 969 1706 355 9.86
32998 Ablation therapy for reduction or eradication of 4063 5896 10380 3705 102.91 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; radiofrequency
32999 Unlisted procedure, lungs and pleura 0 0 0 0 0.00
214 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
CARDIOVASCULAR SYSTEM HEART AND PERICARDIUM
33010 Pericardiocentesis; initial 367 484 685 112 3.12
33011 Pericardiocentesis; subsequent 294 388 550 113 3.14
33015 Tube pericardiostomy 1528 2015 2853 532 14.79
33020 Pericardiotomy for removal of clot or foreign 2530 3337 4725 915 25.43 body (primary procedure)
33025 Creation of pericardial window or partial 2245 2962 4194 830 23.06 resection for drainage
33030 Pericardiectomy, subtotal or complete; without 4614 6087 8618 2084 57.89 cardiopulmonary bypass
33031 Pericardiectomy, subtotal or complete; with 7317 9652 13666 2573 71.47 cardiopulmonary bypass
33050 Resection of pericardial cyst or tumor 2741 3616 5120 1052 29.23
33120 Excision of intracardiac tumor, resection with 5040 6648 9413 2182 60.61 cardiopulmonary bypass
33130 Resection of external cardiac tumor 3733 4924 6973 1433 39.81
33140 Transmyocardial laser revascularization, by 4267 5628 7969 1638 45.50 thoracotomy; (separate procedure)
33141 Transmyocardial laser revascularization, by 400 528 747 137 3.81 thoracotomy; performed at the time of other open cardiac procedure(s) (list separately in addition to code for primary procedure)
33202 Insertion of epicardial electrode(s); open 2212 2918 4132 809 22.46 incision (eg, thoracotomy, median sternotomy, subxiphoid approach)
33203 Insertion of epicardial electrode(s); endoscopic 2196 2897 4102 843 23.42 approach (eg, thoracoscopy, pericardioscopy)
33206 Insertion of new or replacement of permanent 1216 1603 2270 472 13.12 pacemaker with transvenous electrode(s); atrial
33207 Insertion of new or replacement of permanent 1367 1803 2553 503 13.97 pacemaker with transvenous electrode(s); ventricular
33208 Insertion of new or replacement of permanent 1496 1973 2794 545 15.13 pacemaker with transvenous electrode(s); atrial and ventricular
CPT copyright 2017 American Medical Association. 215 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33210 Insertion or replacement of temporary 507 669 947 172 4.78 transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)
33211 Insertion or replacement of temporary 497 656 928 177 4.93 transvenous dual chamber pacing electrodes (separate procedure)
33212 Insertion of pacemaker pulse generator only; 842 1111 1573 335 9.30 with existing single lead
33213 Insertion of pacemaker pulse generator only; 1000 1319 1868 350 9.73 with existing dual leads
33214 Upgrade of implanted pacemaker system, 1360 1794 2540 500 13.89 conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)
33215 Repositioning of previously implanted 750 990 1401 325 9.02 transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode
33216 Insertion of a single transvenous electrode, 967 1276 1807 387 10.75 permanent pacemaker or implantable defibrillator
33217 Insertion of 2 transvenous electrodes, 972 1281 1814 380 10.56 permanent pacemaker or implantable defibrillator
33218 Repair of single transvenous electrode, 1007 1328 1881 405 11.26 permanent pacemaker or implantable defibrillator
33220 Repair of 2 transvenous electrodes for 1065 1405 1990 409 11.36 permanent pacemaker or implantable defibrillator
33221 Insertion of pacemaker pulse generator only; 905 1194 1691 376 10.45 with existing multiple leads
33222 Relocation of skin pocket for pacemaker 832 1097 1554 352 9.79
33223 Relocation of skin pocket for implantable 998 1317 1864 427 11.86 defibrillator
33224 Insertion of pacing electrode, cardiac venous 1248 1646 2330 540 14.99 system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal,
216 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
insertion, and/or replacement of existing generator)
33225 Insertion of pacing electrode, cardiac venous 1127 1486 2104 492 13.67 system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (list separately in addition to code for primary procedure)
33226 Repositioning of previously implanted cardiac 1185 1564 2214 519 14.41 venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator)
33227 Removal of permanent pacemaker pulse 831 1096 1552 353 9.81 generator with replacement of pacemaker pulse generator; single lead system
33228 Removal of permanent pacemaker pulse 870 1148 1625 370 10.27 generator with replacement of pacemaker pulse generator; dual lead system
33229 Removal of permanent pacemaker pulse 911 1202 1702 391 10.87 generator with replacement of pacemaker pulse generator; multiple lead system
33230 Insertion of implantable defibrillator pulse 1061 1399 1981 399 11.09 generator only; with existing dual leads
33231 Insertion of implantable defibrillator pulse 1093 1441 2040 419 11.65 generator only; with existing multiple leads
33233 Removal of permanent pacemaker pulse 629 830 1175 240 6.67 generator only
33234 Removal of transvenous pacemaker 1178 1554 2200 507 14.08 electrode(s); single lead system, atrial or ventricular
33235 Removal of transvenous pacemaker 1614 2129 3015 667 18.52 electrode(s); dual lead system
33236 Removal of permanent epicardial pacemaker 2123 2800 3965 815 22.64 and electrodes by thoracotomy; single lead system, atrial or ventricular
33237 Removal of permanent epicardial pacemaker 2280 3007 4258 875 24.31 and electrodes by thoracotomy; dual lead system
33238 Removal of permanent transvenous electrode(s) 2555 3371 4773 981 27.25 by thoracotomy
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33240 Insertion of implantable defibrillator pulse 1125 1484 2102 382 10.61 generator only; with existing single lead
33241 Removal of implantable defibrillator pulse 627 827 1170 225 6.25 generator only
33243 Removal of single or dual chamber implantable 3719 4906 6946 1428 39.66 defibrillator electrode(s); by thoracotomy
33244 Removal of single or dual chamber implantable 2263 2985 4227 900 24.99 defibrillator electrode(s); by transvenous extraction
33249 Insertion or replacement of permanent 2463 3249 4601 959 26.63 implantable defibrillator system, with transvenous lead(s), single or dual chamber
33250 Operative ablation of supraventricular 3979 5248 7431 1527 42.43 arrhythmogenic focus or pathway (eg, Wolff- Parkinson-white, atrioventricular node re- entry), tract(s) and/or focus (foci); without cardiopulmonary bypass
33251 Operative ablation of supraventricular 4404 5809 8225 1691 46.96 arrhythmogenic focus or pathway (eg, Wolff- Parkinson-white, atrioventricular node re- entry), tract(s) and/or focus (foci); with cardiopulmonary bypass
33254 Operative tissue ablation and reconstruction of 3696 4875 6902 1419 39.41 atria, limited (eg, modified maze procedure)
33255 Operative tissue ablation and reconstruction of 4449 5868 8309 1708 47.44 atria, extensive (eg, maze procedure); without cardiopulmonary bypass
33256 Operative tissue ablation and reconstruction of 5280 6964 9861 2027 56.30 atria, extensive (eg, maze procedure); with cardiopulmonary bypass
33257 Operative tissue ablation and reconstruction of 1436 1894 2681 606 16.84 atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (list separately in addition to code for primary procedure)
33258 Operative tissue ablation and reconstruction of 1785 2354 3333 685 19.03 atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (list separately in addition to code for primary procedure)
33259 Operative tissue ablation and reconstruction of 2059 2715 3845 879 24.43 atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure),
218 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
with cardiopulmonary bypass (list separately in addition to code for primary procedure)
33261 Operative ablation of ventricular 4405 5810 8227 1691 46.97 arrhythmogenic focus with cardiopulmonary bypass
33262 Removal of implantable defibrillator pulse 953 1257 1779 389 10.81 generator with replacement of implantable defibrillator pulse generator; single lead system
33263 Removal of implantable defibrillator pulse 950 1253 1775 406 11.28 generator with replacement of implantable defibrillator pulse generator; dual lead system
33264 Removal of implantable defibrillator pulse 993 1310 1855 423 11.75 generator with replacement of implantable defibrillator pulse generator; multiple lead system
33265 Endoscopy, surgical; operative tissue ablation 3904 5149 7291 1415 39.31 and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary bypass
33266 Endoscopy, surgical; operative tissue ablation 4940 6516 9226 1922 53.39 and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass
33270 Insertion or replacement of permanent 1529 2017 2855 594 16.51 subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters, when performed
33271 Insertion of subcutaneous implantable 1301 1716 2430 478 13.27 defibrillator electrode
33272 Removal of subcutaneous implantable 952 1256 1778 365 10.15 defibrillator electrode
33273 Repositioning of previously implanted 1096 1446 2047 421 11.69 subcutaneous implantable defibrillator electrode
33282 Implantation of patient-activated cardiac event 729 962 1362 236 6.55 recorder
33284 Removal of an implantable, patient-activated 563 743 1052 207 5.74 cardiac event recorder
33300 Repair of cardiac wound; without bypass 6251 8245 11674 2552 70.88
CPT copyright 2017 American Medical Association. 219 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33305 Repair of cardiac wound; with cardiopulmonary 8835 11653 16500 4271 118.64 bypass
33310 Cardiotomy, exploratory (includes removal of 3194 4213 5965 1226 34.06 foreign body, atrial or ventricular thrombus); without bypass
33315 Cardiotomy, exploratory (includes removal of 4856 6405 9069 1989 55.26 foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass
33320 Suture repair of aorta or great vessels; without 2866 3780 5352 1100 30.56 shunt or cardiopulmonary bypass
33321 Suture repair of aorta or great vessels; with 3246 4281 6062 1246 34.61 shunt bypass
33322 Suture repair of aorta or great vessels; with 3766 4968 7034 1446 40.16 cardiopulmonary bypass
33330 Insertion of graft, aorta or great vessels; without 3894 5136 7272 1495 41.52 shunt, or cardiopulmonary bypass
33335 Insertion of graft, aorta or great vessels; with 5134 6772 9589 1971 54.75 cardiopulmonary bypass
33340 Percutaneous transcatheter closure of the left 1899 2505 3547 831 23.09 atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation
33361 Transcatheter aortic valve replacement 3516 4638 6567 1421 39.46 (tavr/TAVI) with prosthetic valve; percutaneous femoral artery approach
33362 Transcatheter aortic valve replacement 4040 5329 7545 1551 43.08 (tavr/TAVI) with prosthetic valve; open femoral artery approach
33363 Transcatheter aortic valve replacement 4190 5527 7825 1608 44.68 (tavr/TAVI) with prosthetic valve; open axillary artery approach
33364 Transcatheter aortic valve replacement 4413 5821 8242 1694 47.06 (tavr/TAVI) with prosthetic valve; open iliac artery approach
33365 Transcatheter aortic valve replacement 4854 6402 9066 1863 51.76 (tavr/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)
220 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33366 Transcatheter aortic valve replacement 5250 6924 9805 2015 55.98 (tavr/TAVI) with prosthetic valve; transapical exposure (eg, left thoracotomy)
33367 Transcatheter aortic valve replacement 1712 2259 3198 657 18.26 (tavr/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure)
33368 Transcatheter aortic valve replacement 2035 2684 3801 781 21.70 (tavr/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (list separately in addition to code for primary procedure)
33369 Transcatheter aortic valve replacement 2687 3544 5018 1031 28.65 (tavr/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (list separately in addition to code for primary procedure)
33390 Valvuloplasty, aortic valve, open, with 4925 6603 9898 1978 54.95 cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension)
33391 Valvuloplasty, aortic valve, open, with 5843 7833 11743 2347 65.19 cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty)
33404 Construction of apical-aortic conduit 4570 6127 9185 1836 50.99
33405 Replacement, aortic valve, open, with 5798 7773 11653 2362 65.62 cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve
33406 Replacement, aortic valve, open, with 7443 9978 14958 2989 83.04 cardiopulmonary bypass; with allograft valve (freehand)
33410 Replacement, aortic valve, open, with 6550 8781 13163 2650 73.60 cardiopulmonary bypass; with stentless tissue valve
33411 Replacement, aortic valve; with aortic annulus 7964 10677 16006 3490 96.94 enlargement, noncoronary sinus
33412 Replacement, aortic valve; with transventricular 8241 11048 16562 3310 91.94 aortic annulus enlargement (konzo procedure)
CPT copyright 2017 American Medical Association. 221 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33413 Replacement, aortic valve; by translocation of 8429 11300 16940 3385 94.04 autologous pulmonary valve with allograft replacement of pulmonary valve (Ross procedure)
33414 Repair of left ventricular outflow tract 5596 7502 11246 2247 62.43 obstruction by patch enlargement of the outflow tract
33415 Resection or incision of subvalvular tissue for 6909 9262 13885 2114 58.73 discrete subvalvular aortic stenosis
33416 Ventriculomyotomy (-myectomy) for idiopathic 6315 8466 12692 2111 58.65 hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)
33417 Aortoplasty (gusset) for supravalvular stenosis 4336 5812 8713 1741 48.37
33418 Transcatheter mitral valve repair, percutaneous 4686 6283 9418 1883 52.32 approach, including transseptal puncture when performed; initial prosthesis
33419 Transcatheter mitral valve repair, percutaneous 1251 1677 2515 445 12.36 approach, including transseptal puncture when performed; additional prosthesis(es) during same session (list separately in addition to code for primary procedure)
33420 Valvotomy, mitral valve; closed heart 3789 5079 7614 1522 42.27
33422 Valvotomy, mitral valve; open heart, with 4349 5830 8740 1747 48.52 cardiopulmonary bypass
33425 Valvuloplasty, mitral valve, with 7747 10385 15568 2848 79.10 cardiopulmonary bypass;
33426 Valvuloplasty, mitral valve, with 5827 7811 11710 2481 68.91 cardiopulmonary bypass; with prosthetic ring
33427 Valvuloplasty, mitral valve, with 6329 8485 12719 2547 70.74 cardiopulmonary bypass; radical reconstruction, with or without ring
33430 Replacement, mitral valve, with 6962 9334 13992 2912 80.90 cardiopulmonary bypass
33460 Valvectomy, tricuspid valve, with 6288 8429 12636 2525 70.15 cardiopulmonary bypass
33463 Valvuloplasty, tricuspid valve; without ring 9039 12118 18166 3215 89.31 insertion
33464 Valvuloplasty, tricuspid valve; with ring 6527 8751 13118 2543 70.65 insertion
222 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33465 Replacement, tricuspid valve, with 7270 9746 14610 2871 79.76 cardiopulmonary bypass
33468 Tricuspid valve repositioning and plication for 6380 8553 12822 2562 71.18 Ebstein anomaly
33470 Valvotomy, pulmonary valve, closed heart; 3246 4351 6523 1292 35.90 transventricular
33471 Valvotomy, pulmonary valve, closed heart; via 3469 4650 6971 1383 38.43 pulmonary artery
33474 Valvotomy, pulmonary valve, open heart, with 5667 7597 11388 2276 63.22 cardiopulmonary bypass
33475 Replacement, pulmonary valve 8581 11503 17245 2439 67.75
33476 Right ventricular resection for infundibular 3959 5308 7957 1590 44.17 stenosis, with or without commissurotomy
33477 Transcatheter pulmonary valve implantation, 4194 5622 8429 1427 39.65 percutaneous approach, including pre-stenting of the valve delivery site, when performed
33478 Outflow tract augmentation (gusset), with or 4091 5484 8221 1643 45.64 without commissurotomy or infundibular resection
33496 Repair of non-structural prosthetic valve 4350 5831 8742 1747 48.53 dysfunction with cardiopulmonary bypass (separate procedure)
33500 Repair of coronary arteriovenous or 4296 5951 9073 1638 45.50 arteriocardiac chamber fistula; with cardiopulmonary bypass
33501 Repair of coronary arteriovenous or 3068 4250 6478 1170 32.49 arteriocardiac chamber fistula; without cardiopulmonary bypass
33502 Repair of anomalous coronary artery from 3495 4842 7382 1333 37.02 pulmonary artery origin; by ligation
33503 Repair of anomalous coronary artery from 3633 5033 7673 1385 38.48 pulmonary artery origin; by graft, without cardiopulmonary bypass
33504 Repair of anomalous coronary artery from 4016 5564 8482 1531 42.54 pulmonary artery origin; by graft, with cardiopulmonary bypass
33505 Repair of anomalous coronary artery from 5659 7840 11952 2158 59.94 pulmonary artery origin; with construction of intrapulmonary artery tunnel (take chi procedure)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33506 Repair of anomalous coronary artery from 5636 7807 11902 2149 59.69 pulmonary artery origin; by translocation from pulmonary artery to aorta
33507 Repair of anomalous (eg, intramural) aortic 4727 6549 9984 1802 50.07 origin of coronary artery by unroofing or translocation
33508 Endoscopy, surgical, including video-assisted 45 62 95 17 0.47 harvest of vein(s) for coronary artery bypass procedure (list separately in addition to code for primary procedure)
33510 Coronary artery bypass, vein only; single 4972 6888 10500 2012 55.89 coronary venous graft
33511 Coronary artery bypass, vein only; 2 coronary 5374 7445 11350 2211 61.42 venous grafts
33512 Coronary artery bypass, vein only; 3 coronary 6088 8434 12857 2514 69.84 venous grafts
33513 Coronary artery bypass, vein only; 4 coronary 6264 8678 13229 2587 71.85 venous grafts
33514 Coronary artery bypass, vein only; 5 coronary 7192 9964 15190 2742 76.18 venous grafts
33516 Coronary artery bypass, vein only; 6 or more 7447 10318 15729 2840 78.88 coronary venous grafts
33517 Coronary artery bypass, using venous graft(s) 465 644 982 195 5.43 and arterial graft(s); single vein graft (list separately in addition to code for primary procedure)
33518 Coronary artery bypass, using venous graft(s) 982 1361 2074 429 11.93 and arterial graft(s); 2 venous grafts (list separately in addition to code for primary procedure)
33519 Coronary artery bypass, using venous graft(s) 1300 1801 2746 568 15.77 and arterial graft(s); 3 venous grafts (list separately in addition to code for primary procedure)
33521 Coronary artery bypass, using venous graft(s) 1654 2292 3494 680 18.90 and arterial graft(s); 4 venous grafts (list separately in addition to code for primary procedure)
33522 Coronary artery bypass, using venous graft(s) 1954 2707 4126 765 21.24 and arterial graft(s); 5 venous grafts (list
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
separately in addition to code for primary procedure)
33523 Coronary artery bypass, using venous graft(s) 2288 3169 4831 872 24.23 and arterial graft(s); 6 or more venous grafts (list separately in addition to code for primary procedure)
33530 Reoperation, coronary artery bypass procedure 1359 1882 2870 549 15.24 or valve procedure, more than 1 month after original operation (list separately in addition to code for primary procedure)
33533 Coronary artery bypass, using arterial graft(s); 4779 6620 10092 1946 54.06 single arterial graft
33534 Coronary artery bypass, using arterial graft(s); 2 5858 8116 12372 2290 63.60 coronary arterial grafts
33535 Coronary artery bypass, using arterial graft(s); 3 6675 9248 14098 2551 70.86 coronary arterial grafts
33536 Coronary artery bypass, using arterial graft(s); 4 7327 10150 15473 2740 76.11 or more coronary arterial grafts
33542 Myocardial resection (eg, ventricular 6610 9158 13961 2731 75.85 aneurysmectomy)
33545 Repair of postinfarction ventricular septal 8451 11708 17848 3222 89.51 defect, with or without myocardial resection
33548 Surgical ventricular restoration procedure, 8132 11266 17174 3101 86.13 includes prosthetic patch, when performed (eg, ventricular remodeling, SVR, saver, dor procedures)
33572 Coronary endarterectomy, open, any method, of 643 891 1358 240 6.67 left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (list separately in addition to primary procedure)
33600 Closure of atrioventricular valve (mitral or 4709 6524 9946 1796 49.88 tricuspid) by suture or patch
33602 Closure of semilunar valve (aortic or 4570 6331 9651 1742 48.40 pulmonary) by suture or patch
33606 Anastomosis of pulmonary artery to aorta 4872 6749 10289 1858 51.60 (Damus-Kaye-Stansel procedure)
33608 Repair of complex cardiac anomaly other than 9668 13394 20418 1881 52.25 pulmonary atresia with ventricular septal defect
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
by construction or replacement of conduit from right or left ventricle to pulmonary artery
33610 Repair of complex cardiac anomalies (eg, single 4864 6739 10273 1855 51.52 ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect
33611 Repair of double outlet right ventricle with 5354 7418 11308 2042 56.71 intraventricular tunnel repair;
33612 Repair of double outlet right ventricle with 5495 7613 11605 2095 58.20 intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction
33615 Repair of complex cardiac anomalies (eg, 5472 7581 11557 2087 57.96 tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple Fontan procedure)
33617 Repair of complex cardiac anomalies (eg, single 9595 13293 20265 2260 62.78 ventricle) by modified Fontan procedure
33619 Repair of single ventricle with aortic outflow 13841 19175 29231 2848 79.10 obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, Norwood procedure)
33620 Application of right and left pulmonary artery 6063 8399 12804 1726 47.94 bands (eg, hybrid approach stage 1)
33621 Transthoracic insertion of catheter for stent 2552 3536 5390 973 27.03 placement with catheter removal and closure (eg, hybrid approach stage 1)
33622 Reconstruction of complex cardiac anomaly 9660 13383 20401 3586 99.61 (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left pulmonary bands (eg, hybrid approach stage 2, Norwood, bidirectional Glenn, pulmonary artery debanding)
33641 Repair atrial septal defect, secundum, with 5495 7613 11606 1714 47.62 cardiopulmonary bypass, with or without patch
33645 Direct or patch closure, sinus venosus, with or 6787 9402 14333 1810 50.28 without anomalous pulmonary venous drainage
33647 Repair of atrial septal defect and ventricular 7011 9712 14806 1901 52.80 septal defect, with direct or patch closure
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33660 Repair of incomplete or partial atrioventricular 4818 6675 10175 1837 51.03 canal (ostium primum atrial septal defect), with or without atrioventricular valve repair
33665 Repair of intermediate or transitional 5250 7274 11089 2002 55.61 atrioventricular canal, with or without atrioventricular valve repair
33670 Repair of complete atrioventricular canal, with 10208 14142 21559 2063 57.32 or without prosthetic valve
33675 Closure of multiple ventricular septal defects; 5410 7495 11426 2063 57.30
33676 Closure of multiple ventricular septal defects; 5672 7858 11979 2117 58.82 with pulmonary valvotomy or infundibular resection (acyanotic)
33677 Closure of multiple ventricular septal defects; 5893 8164 12446 2199 61.09 with removal of pulmonary artery band, with or without gusset
33681 Closure of single ventricular septal defect, with 7207 9985 15221 1922 53.38 or without patch;
33684 Closure of single ventricular septal defect, with 5181 7178 10943 1976 54.88 or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)
33688 Closure of single ventricular septal defect, with 5290 7328 11171 1972 54.77 or without patch; with removal of pulmonary artery band, with or without gusset
33690 Banding of pulmonary artery 4441 6152 9379 1254 34.82
33692 Complete repair tetralogy of Fallot without 5496 7614 11608 2047 56.86 pulmonary atresia;
33694 Complete repair tetralogy of Fallot without 8570 11872 18098 2042 56.71 pulmonary atresia; with transannular patch
33697 Complete repair tetralogy of Fallot with 6154 8526 12997 2151 59.74 pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect
33702 Repair sinus of valsalva fistula, with 4237 5870 8949 1616 44.88 cardiopulmonary bypass;
33710 Repair sinus of valsalva fistula, with 5630 7800 11890 2147 59.63 cardiopulmonary bypass; with repair of ventricular septal defect
33720 Repair sinus of valsalva aneurysm, with 4241 5876 8957 1617 44.92 cardiopulmonary bypass
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33722 Closure of aortico-left ventricular tunnel 4456 6174 9412 1699 47.20
33724 Repair of isolated partial anomalous pulmonary 4222 5849 8917 1610 44.72 venous return (eg, scimitar syndrome)
33726 Repair of pulmonary venous stenosis 5579 7729 11782 2127 59.09
33730 Complete repair of anomalous pulmonary 7711 10683 16285 2096 58.21 venous return (supracardiac, intracardiac, or infracardiac types)
33732 Repair of cor triatriatum or supravalvular mitral 4514 6254 9533 1721 47.81 ring by resection of left atrial membrane
33735 Atrial septectomy or septostomy; closed heart 3550 4918 7497 1354 37.60 (Blalock-Hanlon type operation)
33736 Atrial septectomy or septostomy; open heart 5187 7186 10955 1468 40.79 with cardiopulmonary bypass
33737 Atrial septectomy or septostomy; open heart, 3556 4926 7509 1356 37.66 with inflow occlusion
33750 Shunt; subclavian to pulmonary artery (Blalock- 7013 9715 14811 1319 36.63 Taussig type operation)
33755 Shunt; ascending aorta to pulmonary artery 3642 5046 7692 1376 38.22 (Waterston type operation)
33762 Shunt; descending aorta to pulmonary artery 3564 4938 7527 1340 37.22 (Potts-smith type operation)
33764 Shunt; central, with prosthetic graft 3609 4999 7621 1376 38.22
33766 Shunt; superior vena cava to pulmonary artery 3708 5137 7831 1392 38.66 for flow to 1 lung (classical Glenn procedure)
33767 Shunt; superior vena cava to pulmonary artery 6485 8984 13696 1487 41.31 for flow to both lungs (bidirectional Glenn procedure)
33768 Anastomosis, cavopulmonary, second superior 1180 1634 2491 436 12.10 vena cava (list separately in addition to primary procedure)
33770 Repair of transposition of the great arteries with 5945 8236 12555 2214 61.50 ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect
33771 Repair of transposition of the great arteries with 6130 8493 12947 2279 63.30 ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33774 Repair of transposition of the great arteries, 4930 6830 10413 1880 52.22 atrial baffle procedure (eg, mustard or Senning type) with cardiopulmonary bypass;
33775 Repair of transposition of the great arteries, 5164 7154 10906 1937 53.81 atrial baffle procedure (eg, mustard or Senning type) with cardiopulmonary bypass; with removal of pulmonary band
33776 Repair of transposition of the great arteries, 5456 7559 11523 2048 56.89 atrial baffle procedure (eg, mustard or Senning type) with cardiopulmonary bypass; with closure of ventricular septal defect
33777 Repair of transposition of the great arteries, 5185 7184 10951 1977 54.92 atrial baffle procedure (eg, mustard or Senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction
33778 Repair of transposition of the great arteries, 9149 12675 19322 2456 68.21 aortic pulmonary artery reconstruction (eg, Jatene type);
33779 Repair of transposition of the great arteries, 6539 9059 13810 2432 67.56 aortic pulmonary artery reconstruction (eg, Jatene type); with removal of pulmonary band
33780 Repair of transposition of the great arteries, 6656 9221 14056 2477 68.82 aortic pulmonary artery reconstruction (eg, Jatene type); with closure of ventricular septal defect
33781 Repair of transposition of the great arteries, 6509 9018 13747 2418 67.18 aortic pulmonary artery reconstruction (eg, Jatene type); with repair of subpulmonic obstruction
33782 Aortic root translocation with ventricular septal 8849 12260 18690 3374 93.73 defect and pulmonary stenosis repair (ie, Nikaidoh procedure); without coronary ostium reimplantation
33783 Aortic root translocation with ventricular septal 9558 13242 20187 3645 101.24 defect and pulmonary stenosis repair (ie, Nikaidoh procedure); with reimplantation of 1 or both coronary ostia
33786 Total repair, truncus arteriosus (Rastelli type 6384 8845 13484 2380 66.11 operation)
33788 Reimplantation of an anomalous pulmonary 4275 5922 9028 1602 44.51 artery
CPT copyright 2017 American Medical Association. 229 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33800 Aortic suspension (aortopexy) for tracheal 2706 3749 5715 1032 28.66 decompression (eg, for tracheomalacia) (separate procedure)
33802 Division of aberrant vessel (vascular ring); 2971 4116 6275 1133 31.47
33803 Division of aberrant vessel (vascular ring); with 3154 4370 6662 1203 33.41 reanastomosis
33813 Obliteration of aortopulmonary septal defect; 3432 4755 7248 1295 35.97 without cardiopulmonary bypass
33814 Obliteration of aortopulmonary septal defect; 4175 5784 8817 1592 44.22 with cardiopulmonary bypass
33820 Repair of patent ductus arteriosus; by ligation 4830 6691 10200 1012 28.12
33822 Repair of patent ductus arteriosus; by division, 5180 7176 10939 1068 29.67 younger than 18 years
33824 Repair of patent ductus arteriosus; by division, 3232 4477 6825 1232 34.23 18 years and older
33840 Excision of coarctation of aorta, with or without 5358 7423 11316 1294 35.95 associated patent ductus arteriosus; with direct anastomosis
33845 Excision of coarctation of aorta, with or without 3657 5066 7723 1394 38.73 associated patent ductus arteriosus; with graft
33851 Excision of coarctation of aorta, with or without 3524 4882 7442 1329 36.92 associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement
33852 Repair of hypoplastic or interrupted aortic arch 3832 5309 8094 1461 40.59 using autogenous or prosthetic material; without cardiopulmonary bypass
33853 Repair of hypoplastic or interrupted aortic arch 9612 13317 20301 1916 53.21 using autogenous or prosthetic material; with cardiopulmonary bypass
33860 Ascending aorta graft, with cardiopulmonary 7654 10604 16166 3346 92.94 bypass, includes valve suspension, when performed
33863 Ascending aorta graft, with cardiopulmonary 7865 10896 16610 3282 91.18 bypass, with aortic root replacement using valved conduit and coronary reconstruction (eg, Bentall)
33864 Ascending aorta graft, with cardiopulmonary 9591 13288 20257 3362 93.38 bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
remodeling (eg, David procedure, Yacoub procedure)
33870 Transverse arch graft, with cardiopulmonary 9289 12869 19618 2628 73.01 bypass
33875 Descending thoracic aorta graft, with or without 7509 10403 15858 2863 79.53 bypass
33877 Repair of thoracoabdominal aortic aneurysm 9910 13729 20929 3779 104.96 with graft, with or without cardiopulmonary bypass
33880 Endovascular repair of descending thoracic 4924 6822 10399 1878 52.17 aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin
33881 Endovascular repair of descending thoracic 4219 5846 8911 1613 44.81 aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin
33883 Placement of proximal extension prosthesis for 3071 4255 6486 1171 32.53 endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); initial extension
33884 Placement of proximal extension prosthesis for 1141 1580 2409 435 12.08 endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); each additional proximal extension (list separately in addition to code for primary procedure)
33886 Placement of distal extension prosthesis(s) 2663 3690 5625 1016 28.21 delayed after endovascular repair of descending thoracic aorta
33889 Open subclavian to carotid artery transposition 2177 3016 4598 830 23.06 performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision, unilateral
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33891 Bypass graft, with other than vein, transcervical 2647 3668 5591 1009 28.04 retropharyngeal carotid-carotid, performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision
33910 Pulmonary artery embolectomy; with 6025 8347 12724 2746 76.28 cardiopulmonary bypass
33915 Pulmonary artery embolectomy; without 3791 5252 8006 1445 40.15 cardiopulmonary bypass
33916 Pulmonary endarterectomy, with or without 11560 16015 24414 4408 122.44 embolectomy, with cardiopulmonary bypass
33917 Repair of pulmonary artery stenosis by 9500 13161 20063 1523 42.30 reconstruction with patch or graft
33920 Repair of pulmonary atresia with ventricular 5058 7008 10683 1892 52.55 septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery
33922 Transection of pulmonary artery with 3806 5273 8038 1451 40.31 cardiopulmonary bypass
33924 Ligation and takedown of a systemic-to- 1229 1703 2596 300 8.33 pulmonary artery shunt, performed in conjunction with a congenital heart procedure (list separately in addition to code for primary procedure)
33925 Repair of pulmonary artery arborization 4713 6530 9954 1797 49.92 anomalies by unifocalization; without cardiopulmonary bypass
33926 Repair of pulmonary artery arborization 6790 9407 14341 2528 70.21 anomalies by unifocalization; with cardiopulmonary bypass
33927 Implantation of a total replacement heart system 6971 9657 14722 2658 73.83 (artificial heart) with recipient cardiectomy
33928 Removal and replacement of total replacement 0 0 0 0 0.00 heart system (artificial heart)
33929 Removal of a total replacement heart system 0 0 0 0 0.00 (artificial heart) for heart transplantation (list separately in addition to code for primary procedure)
33930 Donor cardiectomy-pneumonectomy (including 0 0 0 0 0.00 cold preservation)
33933 Backbench standard preparation of cadaver 1075 1490 2271 0 0.00 donor heart/lung allograft prior to
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and trachea for implantation
33935 Heart-lung transplant with recipient 13458 18644 28422 5131 142.54 cardiectomy-pneumonectomy
33940 Donor cardiectomy (including cold 0 0 0 0 0.00 preservation)
33944 Backbench standard preparation of cadaver 925 1282 1954 0 0.00 donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left atrium for implantation
33945 Heart transplant, with or without recipient 16529 22900 34910 5046 140.18 cardiectomy
33946 Extracorporeal membrane oxygenation 1028 1424 2171 323 8.96 (ECMO)/extracorporeal life support (ecls) provided by physician; initiation, veno-venous
33947 Extracorporeal membrane oxygenation 1169 1620 2469 360 9.99 (ECMO)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial
33948 Extracorporeal membrane oxygenation 827 1145 1746 250 6.94 (ECMO)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-venous
33949 Extracorporeal membrane oxygenation 879 1218 1857 242 6.73 (ECMO)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-arterial
33951 Extracorporeal membrane oxygenation 1169 1619 2469 446 12.38 (ECMO)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)
33952 Extracorporeal membrane oxygenation 1355 1878 2862 447 12.43 (ECMO)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33953 Extracorporeal membrane oxygenation 1836 2543 3877 498 13.84 (ECMO)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age
33954 Extracorporeal membrane oxygenation 1477 2047 3120 500 13.89 (ECMO)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older
33955 Extracorporeal membrane oxygenation 2440 3380 5152 873 24.25 (ECMO)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age
33956 Extracorporeal membrane oxygenation 2616 3624 5525 871 24.20 (ECMO)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older
33957 Extracorporeal membrane oxygenation 509 705 1075 194 5.39 (ECMO)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)
33958 Extracorporeal membrane oxygenation 510 706 1077 194 5.40 (ECMO)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)
33959 Extracorporeal membrane oxygenation 646 895 1364 246 6.84 (ECMO)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed)
33962 Extracorporeal membrane oxygenation 648 897 1368 247 6.86 (ECMO)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, 6 years and older (includes fluoroscopic guidance, when performed)
33963 Extracorporeal membrane oxygenation 1291 1788 2726 492 13.67 (ECMO)/extracorporeal life support (ecls)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes fluoroscopic guidance, when performed)
33964 Extracorporeal membrane oxygenation 1362 1887 2877 519 14.43 (ECMO)/extracorporeal life support (ecls) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic guidance, when performed)
33965 Extracorporeal membrane oxygenation 509 705 1075 194 5.39 (ECMO)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age
33966 Extracorporeal membrane oxygenation 815 1129 1721 248 6.89 (ECMO)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older
33967 Insertion of intra-aortic balloon assist device, 734 1017 1551 272 7.55 percutaneous
33968 Removal of intra-aortic balloon assist device, 100 139 211 35 0.98 percutaneous
33969 Extracorporeal membrane oxygenation 1010 1399 2132 287 7.98 (ECMO)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age
33970 Insertion of intra-aortic balloon assist device 972 1347 2053 371 10.31 through the femoral artery, open approach
33971 Removal of intra-aortic balloon assist device 1699 2354 3589 739 20.53 including repair of femoral artery, with or without graft
33973 Insertion of intra-aortic balloon assist device 1420 1967 2999 541 15.04 through the ascending aorta
33974 Removal of intra-aortic balloon assist device 2437 3376 5146 929 25.81 from the ascending aorta, including repair of the ascending aorta, with or without graft
33975 Insertion of ventricular assist device; 3978 5512 8402 1367 37.96 extracorporeal, single ventricle
33976 Insertion of ventricular assist device; 4379 6067 9248 1670 46.38 extracorporeal, biventricular
CPT copyright 2017 American Medical Association. 235 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33977 Removal of ventricular assist device; 3079 4265 6502 1174 32.61 extracorporeal, single ventricle
33978 Removal of ventricular assist device; 3674 5089 7759 1401 38.91 extracorporeal, biventricular
33979 Insertion of ventricular assist device, 7642 10587 16140 2039 56.63 implantable intracorporeal, single ventricle
33980 Removal of ventricular assist device, 8472 11737 17892 1864 51.79 implantable intracorporeal, single ventricle
33981 Replacement of extracorporeal ventricular assist 2294 3178 4845 875 24.30 device, single or biventricular, pump(s), single or each pump
33982 Replacement of ventricular assist device 5390 7467 11384 2055 57.09 pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass
33983 Replacement of ventricular assist device 6334 8775 13378 2415 67.09 pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass
33984 Extracorporeal membrane oxygenation 1008 1397 2129 298 8.28 (ECMO)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older
33985 Extracorporeal membrane oxygenation 1418 1965 2995 541 15.02 (ECMO)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age
33986 Extracorporeal membrane oxygenation 1432 1984 3025 546 15.17 (ECMO)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older
33987 Arterial exposure with creation of graft conduit 575 797 1214 219 6.09 (eg, chimney graft) to facilitate arterial perfusion for ECMO/ecls (list separately in addition to code for primary procedure)
33988 Insertion of left heart vent by thoracic incision 2144 2970 4528 818 22.71 (eg, sternotomy, thoracotomy) for ECMO/ecls
33989 Removal of left heart vent by thoracic incision 1362 1887 2877 519 14.43 (eg, sternotomy, thoracotomy) for ECMO/ecls
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
33990 Insertion of ventricular assist device, 1044 1446 2204 446 12.39 percutaneous including radiological supervision and interpretation; arterial access only
33991 Insertion of ventricular assist device, 1725 2390 3643 658 18.27 percutaneous including radiological supervision and interpretation; both arterial and venous access, with transseptal puncture
33992 Removal of percutaneous ventricular assist 500 693 1056 210 5.82 device at separate and distinct session from insertion
33993 Repositioning of percutaneous ventricular assist 450 624 951 183 5.09 device with imaging guidance at separate and distinct session from insertion
33999 Unlisted procedure, cardiac surgery 0 0 0 0 0.00
ARTERIES AND VEINS
34001 Embolectomy or thrombectomy, with or 2556 3234 4323 957 26.57 without catheter; carotid, subclavian or innominate artery, by neck incision
34051 Embolectomy or thrombectomy, with or 2715 3435 4592 1036 28.78 without catheter; innominate, subclavian artery, by thoracic incision
34101 Embolectomy or thrombectomy, with or 1720 2177 2910 627 17.43 without catheter; axillary, brachial, innominate, subclavian artery, by arm incision
34111 Embolectomy or thrombectomy, with or 1761 2229 2979 627 17.42 without catheter; radial or ulnar artery, by arm incision
34151 Embolectomy or thrombectomy, with or 3745 4738 6334 1462 40.61 without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision
34201 Embolectomy or thrombectomy, with or 2542 3217 4300 1079 29.96 without catheter; femoropopliteal, aortoiliac artery, by leg incision
34203 Embolectomy or thrombectomy, with or 2526 3196 4272 999 27.74 without catheter; popliteal-tibio-peroneal artery, by leg incision
34401 Thrombectomy, direct or with catheter; vena 4119 5211 6966 1542 42.82 cava, iliac vein, by abdominal incision
34421 Thrombectomy, direct or with catheter; vena 2056 2602 3478 770 21.38 cava, iliac, femoropopliteal vein, by leg incision
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
34451 Thrombectomy, direct or with catheter; vena 4260 5390 7205 1500 41.67 cava, iliac, femoropopliteal vein, by abdominal and leg incision
34471 Thrombectomy, direct or with catheter; 3011 3809 5092 1127 31.30 subclavian vein, by neck incision
34490 Thrombectomy, direct or with catheter; axillary 1728 2186 2922 647 17.96 and subclavian vein, by arm incision
34501 Valvuloplasty, femoral vein 2490 3151 4212 932 25.89
34502 Reconstruction of vena cava, any method 5337 6753 9027 1615 44.86
34510 Venous valve transposition, any vein donor 3114 3940 5267 1066 29.60
34520 Cross-over vein graft to venous system 2760 3492 4667 1033 28.69
34530 Saphenopopliteal vein anastomosis 2617 3312 4427 980 27.21
34701 Endovascular repair of infrarenal aorta by 3436 4347 5811 1286 35.72 deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/ stenting performed from the level of the renal arteries to the aortic bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34702 Endovascular repair of infrarenal aorta by 5133 6494 8681 1921 53.36 deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
34703 Endovascular repair of infrarenal aorta and/or 3872 4899 6548 1449 40.25 iliac artery(ies) by deployment of an aorto-uni- iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level
238 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34704 Endovascular repair of infrarenal aorta and/or 6440 8148 10892 2410 66.95 iliac artery(ies) by deployment of an aorto-uni- iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
34705 Endovascular repair of infrarenal aorta and/or 4265 5396 7214 1596 44.34 iliac artery(ies) by deployment of an aorto-bi- iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)
34706 Endovascular repair of infrarenal aorta and/or 6420 8123 10858 2403 66.74 iliac artery(ies) by deployment of an aorto-bi- iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
34707 Endovascular repair of iliac artery by 3204 4054 5419 1199 33.31 deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and
CPT copyright 2017 American Medical Association. 239 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation)
34708 Endovascular repair of iliac artery by 5157 6525 8722 1930 53.61 deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, traumatic disruption)
34709 Placement of extension prosthesis(es) distal to 902 1142 1526 338 9.38 the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (list separately in addition to code for primary procedure)
34710 Delayed placement of distal or proximal 2236 2830 3782 837 23.25 extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; initial vessel treated
34711 Delayed placement of distal or proximal 833 1054 1409 312 8.66 extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological
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supervision and interpretation, and treatment zone angioplasty/stenting, when performed; each additional vessel treated (list separately in addition to code for primary procedure)
34712 Transcatheter delivery of enhanced fixation 1911 2418 3233 715 19.87 device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation
34713 Percutaneous access and closure of femoral 360 455 608 135 3.74 artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)
34714 Open femoral artery exposure with creation of 755 955 1277 283 7.85 conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)
34715 Open axillary/subclavian artery exposure for 844 1067 1427 316 8.77 delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)
34716 Open axillary/subclavian artery exposure with 1047 1325 1772 392 10.89 creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)
34808 Endovascular placement of iliac artery 553 699 935 218 6.06 occlusion device (list separately in addition to code for primary procedure)
34812 Open femoral artery exposure for delivery of 914 1157 1546 217 6.02 endovascular prosthesis, by groin incision, unilateral (list separately in addition to code for primary procedure)
34813 Placement of femoral-femoral prosthetic graft 666 842 1126 248 6.88 during endovascular aortic aneurysm repair (list separately in addition to code for primary procedure)
34820 Open iliac artery exposure for delivery of 1280 1619 2164 370 10.27 endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (list
CPT copyright 2017 American Medical Association. 241 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
separately in addition to code for primary procedure)
34830 Open repair of infrarenal aortic aneurysm or 4921 6226 8323 1842 51.16 dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; tube prosthesis
34831 Open repair of infrarenal aortic aneurysm or 5399 6831 9132 2021 56.13 dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bi-iliac prosthesis
34832 Open repair of infrarenal aortic aneurysm or 5292 6696 8951 1981 55.02 dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral prosthesis
34833 Open iliac artery exposure with creation of 1590 2012 2690 424 11.78 conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)
34834 Open brachial artery exposure for delivery of 804 1017 1359 136 3.79 endovascular prosthesis, unilateral (list separately in addition to code for primary procedure)
34839 Physician planning of a patient-specific 0 0 0 0 0.00 fenestrated visceral aortic endograft requiring a minimum of 90 minutes of physician time
34841 Endovascular repair of visceral aorta (eg, 4348 5501 7354 0 0.00 aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery endoprosthesis (superior mesenteric, celiac or renal artery)
34842 Endovascular repair of visceral aorta (eg, 5087 6437 8604 0 0.00 aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
242 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
34843 Endovascular repair of visceral aorta (eg, 5718 7236 9672 0 0.00 aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including three visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
34844 Endovascular repair of visceral aorta (eg, 6380 8072 10790 0 0.00 aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including four or more visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
34845 Endovascular repair of visceral aorta and 5598 7084 9469 0 0.00 infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery endoprosthesis (superior mesenteric, celiac or renal artery)
34846 Endovascular repair of visceral aorta and 6336 8017 10717 0 0.00 infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
34847 Endovascular repair of visceral aorta and 6968 8817 11786 0 0.00 infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal
CPT copyright 2017 American Medical Association. 243 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including three visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
34848 Endovascular repair of visceral aorta and 7630 9654 12905 0 0.00 infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including four or more visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
35001 Direct repair of aneurysm, pseudoaneurysm, or 3138 3970 5307 1174 32.62 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision
35002 Direct repair of aneurysm, pseudoaneurysm, or 3167 4008 5357 1185 32.93 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, carotid, subclavian artery, by neck incision
35005 Direct repair of aneurysm, pseudoaneurysm, or 2939 3719 4971 1037 28.81 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery
35011 Direct repair of aneurysm, pseudoaneurysm, or 2658 3363 4496 1053 29.24 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision
35013 Direct repair of aneurysm, pseudoaneurysm, or 3517 4450 5948 1316 36.56 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision
35021 Direct repair of aneurysm, pseudoaneurysm, or 3520 4454 5954 1318 36.60 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, subclavian artery, by thoracic incision
244 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35022 Direct repair of aneurysm, pseudoaneurysm, or 4033 5103 6821 1509 41.93 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, innominate, subclavian artery, by thoracic incision
35045 Direct repair of aneurysm, pseudoaneurysm, or 2672 3380 4519 1032 28.66 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery
35081 Direct repair of aneurysm, pseudoaneurysm, or 4835 6117 8177 1822 50.62 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta
35082 Direct repair of aneurysm, pseudoaneurysm, or 5806 7346 9820 2296 63.77 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta
35091 Direct repair of aneurysm, pseudoaneurysm, or 5501 6960 9303 1873 52.04 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)
35092 Direct repair of aneurysm, pseudoaneurysm, or 7270 9199 12296 2721 75.58 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)
35102 Direct repair of aneurysm, pseudoaneurysm, or 5188 6565 8775 1971 54.76 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving iliac vessels (common, hypogastric, external)
35103 Direct repair of aneurysm, pseudoaneurysm, or 6271 7935 10607 2347 65.20 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external)
35111 Direct repair of aneurysm, pseudoaneurysm, or 3708 4692 6272 1388 38.55 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, splenic artery
CPT copyright 2017 American Medical Association. 245 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35112 Direct repair of aneurysm, pseudoaneurysm, or 4933 6242 8343 1708 47.44 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery
35121 Direct repair of aneurysm, pseudoaneurysm, or 4622 5848 7817 1730 48.05 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery
35122 Direct repair of aneurysm, pseudoaneurysm, or 5645 7142 9547 1976 54.88 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery
35131 Direct repair of aneurysm, pseudoaneurysm, or 3898 4932 6592 1459 40.52 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery (common, hypogastric, external)
35132 Direct repair of aneurysm, pseudoaneurysm, or 4563 5774 7718 1708 47.44 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery (common, hypogastric, external)
35141 Direct repair of aneurysm, pseudoaneurysm, or 2948 3730 4985 1158 32.18 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery (profunda femoris, superficial femoral)
35142 Direct repair of aneurysm, pseudoaneurysm, or 3521 4456 5956 1391 38.63 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery (profunda femoris, superficial femoral)
35151 Direct repair of aneurysm, pseudoaneurysm, or 3579 4529 6054 1302 36.16 excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery
35152 Direct repair of aneurysm, pseudoaneurysm, or 3901 4936 6599 1460 40.56 excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery
246 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35180 Repair, congenital arteriovenous fistula; head 2486 3146 4205 913 25.37 and neck
35182 Repair, congenital arteriovenous fistula; thorax 4986 6309 8434 1866 51.84 and abdomen
35184 Repair, congenital arteriovenous fistula; 2929 3706 4954 1007 27.98 extremities
35188 Repair, acquired or traumatic arteriovenous 3253 4116 5502 1357 37.69 fistula; head and neck
35189 Repair, acquired or traumatic arteriovenous 4212 5330 7124 1576 43.79 fistula; thorax and abdomen
35190 Repair, acquired or traumatic arteriovenous 1963 2483 3320 799 22.19 fistula; extremities
35201 Repair blood vessel, direct; neck 2952 3735 4993 982 27.27
35206 Repair blood vessel, direct; upper extremity 2500 3164 4229 818 22.71
35207 Repair blood vessel, direct; hand, finger 3388 4287 5731 786 21.82
35211 Repair blood vessel, direct; intrathoracic, with 3850 4872 6512 1441 40.03 bypass
35216 Repair blood vessel, direct; intrathoracic, 5991 7580 10132 2145 59.58 without bypass
35221 Repair blood vessel, direct; intra-abdominal 4378 5539 7404 1528 42.45
35226 Repair blood vessel, direct; lower extremity 2399 3035 4057 873 24.26
35231 Repair blood vessel with vein graft; neck 3461 4379 5853 1295 35.98
35236 Repair blood vessel with vein graft; upper 3137 3969 5305 1043 28.97 extremity
35241 Repair blood vessel with vein graft; 4048 5121 6846 1515 42.08 intrathoracic, with bypass
35246 Repair blood vessel with vein graft; 4385 5549 7417 1641 45.59 intrathoracic, without bypass
35251 Repair blood vessel with vein graft; intra- 4874 6167 8243 1824 50.67 abdominal
35256 Repair blood vessel with vein graft; lower 3015 3815 5100 1072 29.77 extremity
35261 Repair blood vessel with graft other than vein; 2949 3732 4988 1104 30.66 neck
35266 Repair blood vessel with graft other than vein; 2420 3062 4093 906 25.16 upper extremity
CPT copyright 2017 American Medical Association. 247 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35271 Repair blood vessel with graft other than vein; 3855 4878 6521 1443 40.08 intrathoracic, with bypass
35276 Repair blood vessel with graft other than vein; 4078 5160 6898 1526 42.40 intrathoracic, without bypass
35281 Repair blood vessel with graft other than vein; 4508 5704 7625 1687 46.87 intra-abdominal
35286 Repair blood vessel with graft other than vein; 2848 3603 4816 976 27.10 lower extremity
35301 Thromboendarterectomy, including patch graft, 2945 3726 4981 1187 32.97 if performed; carotid, vertebral, subclavian, by neck incision
35302 Thromboendarterectomy, including patch graft, 2970 3758 5023 1177 32.70 if performed; superficial femoral artery
35303 Thromboendarterectomy, including patch graft, 3059 3870 5173 1301 36.15 if performed; popliteal artery
35304 Thromboendarterectomy, including patch graft, 3319 4199 5613 1345 37.37 if performed; tibioperoneal trunk artery
35305 Thromboendarterectomy, including patch graft, 3229 4086 5461 1293 35.93 if performed; tibial or peroneal artery, initial vessel
35306 Thromboendarterectomy, including patch graft, 1248 1579 2110 467 12.97 if performed; each additional tibial or peroneal artery (list separately in addition to code for primary procedure)
35311 Thromboendarterectomy, including patch graft, 4366 5524 7384 1634 45.39 if performed; subclavian, innominate, by thoracic incision
35321 Thromboendarterectomy, including patch graft, 2650 3353 4481 933 25.93 if performed; axillary-brachial
35331 Thromboendarterectomy, including patch graft, 3733 4723 6314 1523 42.30 if performed; abdominal aorta
35341 Thromboendarterectomy, including patch graft, 3851 4873 6514 1441 40.04 if performed; mesenteric, celiac, or renal
35351 Thromboendarterectomy, including patch graft, 3223 4078 5450 1344 37.33 if performed; iliac
35355 Thromboendarterectomy, including patch graft, 2960 3745 5006 1082 30.06 if performed; iliofemoral
35361 Thromboendarterectomy, including patch graft, 4248 5375 7184 1590 44.16 if performed; combined aortoiliac
248 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35363 Thromboendarterectomy, including patch graft, 4929 6236 8336 1845 51.24 if performed; combined aortoiliofemoral
35371 Thromboendarterectomy, including patch graft, 2280 2885 3857 858 23.82 if performed; common femoral
35372 Thromboendarterectomy, including patch graft, 2606 3298 4408 1030 28.60 if performed; deep (profunda) femoral
35390 Reoperation, carotid, thromboendarterectomy, 419 530 709 167 4.64 more than 1 month after original operation (list separately in addition to code for primary procedure)
35400 Angioscopy (noncoronary vessels or grafts) 449 568 760 157 4.35 during therapeutic intervention (list separately in addition to code for primary procedure)
35500 Harvest of upper extremity vein, 1 segment, for 895 1040 1266 336 9.32 lower extremity or coronary artery bypass procedure (list separately in addition to code for primary procedure)
35501 Bypass graft, with vein; common carotid- 4030 4681 5702 1527 42.41 ipsilateral internal carotid
35506 Bypass graft, with vein; carotid-subclavian or 3517 4085 4976 1332 37.01 subclavian-carotid
35508 Bypass graft, with vein; carotid-vertebral 3665 4257 5185 1389 38.57
35509 Bypass graft, with vein; carotid-contralateral 3903 4533 5522 1479 41.07 carotid
35510 Bypass graft, with vein; carotid-brachial 3396 3944 4804 1286 35.73
35511 Bypass graft, with vein; subclavian-subclavian 3253 3778 4602 1171 32.54
35512 Bypass graft, with vein; subclavian-brachial 3667 4259 5188 1261 35.03
35515 Bypass graft, with vein; subclavian-vertebral 3863 4487 5465 1389 38.57
35516 Bypass graft, with vein; subclavian-axillary 3367 3911 4763 1275 35.43
35518 Bypass graft, with vein; axillary-axillary 3152 3661 4459 1194 33.17
35521 Bypass graft, with vein; axillary-femoral 3384 3931 4788 1282 35.61
35522 Bypass graft, with vein; axillary-brachial 3349 3890 4738 1269 35.24
35523 Bypass graft, with vein; brachial-ulnar or -radial 3526 4095 4988 1336 37.10
35525 Bypass graft, with vein; brachial-brachial 3156 3666 4465 1196 33.21
35526 Bypass graft, with vein; aortosubclavian, 4797 5572 6787 1817 50.48 aortoinnominate, or aortocarotid
CPT copyright 2017 American Medical Association. 249 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35531 Bypass graft, with vein; aortoceliac or 5632 6541 7967 2133 59.26 aortomesenteric
35533 Bypass graft, with vein; axillary-femoral- 4154 4825 5877 1574 43.71 femoral
35535 Bypass graft, with vein; hepatorenal 5253 6101 7431 1990 55.27
35536 Bypass graft, with vein; splenorenal 4663 5416 6597 1767 49.07
35537 Bypass graft, with vein; aortoiliac 6346 7370 8977 2179 60.53
35538 Bypass graft, with vein; aortobi-iliac 6439 7478 9109 2439 67.75
35539 Bypass graft, with vein; aortofemoral 6050 7027 8559 2292 63.66
35540 Bypass graft, with vein; aortobifemoral 6843 7948 9681 2554 70.95
35556 Bypass graft, with vein; femoral-popliteal 3772 4381 5337 1468 40.78
35558 Bypass graft, with vein; femoral-femoral 3424 3976 4843 1291 35.86
35560 Bypass graft, with vein; aortorenal 4703 5463 6654 1782 49.49
35563 Bypass graft, with vein; ilioiliac 4002 4648 5661 1382 38.40
35565 Bypass graft, with vein; iliofemoral 3662 4253 5180 1387 38.53
35566 Bypass graft, with vein; femoral-anterior tibial, 4570 5308 6465 1752 48.67 posterior tibial, peroneal artery or other distal vessels
35570 Bypass graft, with vein; tibial-tibial, peroneal- 4203 4882 5946 1592 44.23 tibial, or tibial/peroneal trunk-tibial
35571 Bypass graft, with vein; popliteal-tibial, - 3989 4633 5643 1391 38.63 peroneal artery or other distal vessels
35572 Harvest of femoropopliteal vein, 1 segment, for 761 884 1077 364 10.10 vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (list separately in addition to code for primary procedure)
35583 In-situ vein bypass; femoral-popliteal 4009 4656 5672 1517 42.13
35585 In-situ vein bypass; femoral-anterior tibial, 4472 5194 6327 1756 48.79 posterior tibial, or peroneal artery
35587 In-situ vein bypass; popliteal-tibial, peroneal 3788 4400 5359 1435 39.86
35600 Harvest of upper extremity artery, 1 segment, 750 871 1061 266 7.40 for coronary artery bypass procedure (list separately in addition to code for primary procedure)
250 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35601 Bypass graft, with other than vein; common 3904 5053 7040 1463 40.64 carotid-ipsilateral internal carotid
35606 Bypass graft, with other than vein; carotid- 3315 4291 5978 1230 34.18 subclavian
35612 Bypass graft, with other than vein; subclavian- 2911 3767 5249 1091 30.30 subclavian
35616 Bypass graft, with other than vein; subclavian- 3075 3980 5545 1152 32.01 axillary
35621 Bypass graft, with other than vein; axillary- 2931 3793 5284 1152 32.01 femoral
35623 Bypass graft, with other than vein; axillary- 3663 4741 6605 1373 38.13 popliteal or -tibial
35626 Bypass graft, with other than vein; 4421 5722 7972 1657 46.02 aortosubclavian, aortoinnominate, or aortocarotid
35631 Bypass graft, with other than vein; aortoceliac, 5558 7193 10021 1941 53.92 aortomesenteric, aortorenal
35632 Bypass graft, with other than vein; ilio-celiac 5041 6524 9089 1889 52.47
35633 Bypass graft, with other than vein; ilio- 5591 7236 10081 2095 58.20 mesenteric
35634 Bypass graft, with other than vein; iliorenal 4932 6383 8893 1848 51.34
35636 Bypass graft, with other than vein; splenorenal 4447 5756 8018 1666 46.29 (splenic to renal arterial anastomosis)
35637 Bypass graft, with other than vein; aortoiliac 4817 6234 8685 1805 50.14
35638 Bypass graft, with other than vein; aortobi-iliac 4458 5770 8038 1843 51.19
35642 Bypass graft, with other than vein; carotid- 2959 3830 5336 1030 28.62 vertebral
35645 Bypass graft, with other than vein; subclavian- 2814 3642 5073 989 27.46 vertebral
35646 Bypass graft, with other than vein; 4574 5919 8246 1800 50.00 aortobifemoral
35647 Bypass graft, with other than vein; aortofemoral 4089 5292 7372 1628 45.23
35650 Bypass graft, with other than vein; axillary- 3037 3930 5475 1138 31.61 axillary
35654 Bypass graft, with other than vein; axillary- 3650 4724 6582 1436 39.89 femoral-femoral
CPT copyright 2017 American Medical Association. 251 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35656 Bypass graft, with other than vein; femoral- 3028 3918 5459 1136 31.55 popliteal
35661 Bypass graft, with other than vein; femoral- 2986 3864 5384 1138 31.60 femoral
35663 Bypass graft, with other than vein; ilioiliac 3394 4393 6120 1272 35.33
35665 Bypass graft, with other than vein; iliofemoral 3105 4018 5598 1230 34.18
35666 Bypass graft, with other than vein; femoral- 3657 4733 6593 1327 36.86 anterior tibial, posterior tibial, or peroneal artery
35671 Bypass graft, with other than vein; popliteal- 3123 4042 5631 1170 32.51 tibial or -peroneal artery
35681 Bypass graft; composite, prosthetic and vein 258 334 465 84 2.34 (list separately in addition to code for primary procedure)
35682 Bypass graft; autogenous composite, 2 989 1279 1782 370 10.29 segments of veins from 2 locations (list separately in addition to code for primary procedure)
35683 Bypass graft; autogenous composite, 3 or more 1142 1478 2060 428 11.89 segments of vein from 2 or more locations (list separately in addition to code for primary procedure)
35685 Placement of vein patch or cuff at distal 572 740 1032 208 5.78 anastomosis of bypass graft, synthetic conduit (list separately in addition to code for primary procedure)
35686 Creation of distal arteriovenous fistula during 451 583 812 169 4.69 lower extremity bypass surgery (non- hemodialysis) (list separately in addition to code for primary procedure)
35691 Transposition and/or reimplantation; vertebral 2636 3412 4753 988 27.44 to carotid artery
35693 Transposition and/or reimplantation; vertebral 2324 3008 4190 871 24.19 to subclavian artery
35694 Transposition and/or reimplantation; subclavian 2751 3560 4959 1031 28.63 to carotid artery
35695 Transposition and/or reimplantation; carotid to 2857 3698 5152 1071 29.74 subclavian artery
35697 Reimplantation, visceral artery to infrarenal 422 546 761 156 4.32 aortic prosthesis, each artery (list separately in addition to code for primary procedure)
252 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35700 Reoperation, femoral-popliteal or femoral 431 557 776 160 4.45 (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (list separately in addition to code for primary procedure)
35701 Exploration (not followed by surgical repair), 1556 2014 2805 588 16.33 with or without lysis of artery; carotid artery
35721 Exploration (not followed by surgical repair), 1262 1633 2276 480 13.34 with or without lysis of artery; femoral artery
35741 Exploration (not followed by surgical repair), 1344 1740 2423 540 15.01 with or without lysis of artery; popliteal artery
35761 Exploration (not followed by surgical repair), 1554 2011 2801 410 11.38 with or without lysis of artery; other vessels
35800 Exploration for postoperative hemorrhage, 1723 2230 3107 748 20.79 thrombosis or infection; neck
35820 Exploration for postoperative hemorrhage, 5079 6574 9158 2100 58.33 thrombosis or infection; chest
35840 Exploration for postoperative hemorrhage, 2799 3622 5046 1250 34.71 thrombosis or infection; abdomen
35860 Exploration for postoperative hemorrhage, 1813 2346 3268 879 24.41 thrombosis or infection; extremity
35870 Repair of graft-enteric fistula 3469 4490 6255 1300 36.11
35875 Thrombectomy of arterial or venous graft (other 1687 2184 3042 625 17.37 than hemodialysis graft or fistula);
35876 Thrombectomy of arterial or venous graft (other 2563 3317 4621 995 27.65 than hemodialysis graft or fistula); with revision of arterial or venous graft
35879 Revision, lower extremity arterial bypass, 2562 3316 4620 972 26.99 without thrombectomy, open; with vein patch angioplasty
35881 Revision, lower extremity arterial bypass, 2851 3690 5141 1068 29.68 without thrombectomy, open; with segmental vein interposition
35883 Revision, femoral anastomosis of synthetic 3084 3991 5560 1264 35.10 arterial bypass graft in groin, open; with nonautogenous patch graft (eg, Dacron, ePTFE, bovine pericardium)
CPT copyright 2017 American Medical Association. 253 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
35884 Revision, femoral anastomosis of synthetic 3461 4480 6241 1297 36.03 arterial bypass graft in groin, open; with autogenous vein patch graft
35901 Excision of infected graft; neck 1334 1727 2406 491 13.64
35903 Excision of infected graft; extremity 1697 2197 3060 590 16.39
35905 Excision of infected graft; thorax 4777 6182 8613 1756 48.77
35907 Excision of infected graft; abdomen 5317 6882 9587 2006 55.71
36000 Introduction of needle or intracatheter, vein 71 96 123 27 0.74
36002 Injection procedures (eg, thrombin) for 383 519 669 165 4.59 percutaneous treatment of extremity pseudoaneurysm
36005 Injection procedure for extremity venography 461 625 806 332 9.22 (including introduction of needle or intracatheter)
36010 Introduction of catheter, superior or inferior 806 1092 1407 492 13.67 vena cava
36011 Selective catheter placement, venous system; 1526 2066 2664 847 23.52 first order branch (eg, renal vein, jugular vein)
36012 Selective catheter placement, venous system; 1698 2299 2964 868 24.12 second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)
36013 Introduction of catheter, right heart or main 1559 2111 2722 784 21.77 pulmonary artery
36014 Selective catheter placement, left or right 890 1205 1554 811 22.54 pulmonary artery
36015 Selective catheter placement, segmental or 968 1310 1689 882 24.51 subsegmental pulmonary artery
36100 Introduction of needle or intracatheter, carotid 985 1334 1720 496 13.77 or vertebral artery
36140 Introduction of needle or intracatheter, upper or 750 1016 1310 436 12.12 lower extremity artery
36160 Introduction of needle or intracatheter, aortic, 1145 1551 2000 503 13.97 translumbar
36200 Introduction of catheter, aorta 646 875 1128 572 15.90
36215 Selective catheter placement, arterial system; 2790 3779 4871 1031 28.64 each first order thoracic or brachiocephalic branch, within a vascular family
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
36216 Selective catheter placement, arterial system; 1803 2441 3147 1118 31.06 initial second order thoracic or brachiocephalic branch, within a vascular family
36217 Selective catheter placement, arterial system; 2082 2820 3636 1899 52.75 initial third order or more selective thoracic or brachiocephalic branch, within a vascular family
36218 Selective catheter placement, arterial system; 336 455 587 258 7.17 additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)
36221 Non-selective catheter placement, thoracic 1285 1740 2243 1048 29.11 aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed
36222 Selective catheter placement, common carotid 1353 1833 2363 1234 34.28 or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed
36223 Selective catheter placement, common carotid 1696 2296 2960 1546 42.95 or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed
36224 Selective catheter placement, internal carotid 2154 2917 3761 1964 54.56 artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed
36225 Selective catheter placement, subclavian or 1632 2210 2849 1488 41.33 innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
36226 Selective catheter placement, vertebral artery, 2088 2828 3646 1904 52.90 unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed
36227 Selective catheter placement, external carotid 496 671 866 263 7.31 artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)
36228 Selective catheter placement, each intracranial 1483 2009 2590 1353 37.57 branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (list separately in addition to code for primary procedure)
36245 Selective catheter placement, arterial system; 1466 1986 2560 1337 37.14 each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family
36246 Selective catheter placement, arterial system; 1059 1434 1848 840 23.32 initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family
36247 Selective catheter placement, arterial system; 1631 2209 2848 1530 42.51 initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family
36248 Selective catheter placement, arterial system; 232 315 406 156 4.33 additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)
36251 Selective catheter placement (first-order), main 1711 2317 2987 1412 39.23 renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when
256 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
performed, and flush aortogram when performed; unilateral
36252 Selective catheter placement (first-order), main 1885 2552 3290 1527 42.42 renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; bilateral
36253 Superselective catheter placement (one or more 2840 3847 4959 2255 62.64 second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; unilateral
36254 Superselective catheter placement (one or more 2950 3995 5150 2205 61.26 second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and interpretation, including pressure gradient measurements when performed, and flush aortogram when performed; bilateral
36260 Insertion of implantable intra-arterial infusion 1536 2080 2681 674 18.73 pump (eg, for chemotherapy of liver)
36261 Revision of implanted intra-arterial infusion 903 1224 1577 417 11.59 pump
36262 Removal of implanted intra-arterial infusion 722 977 1260 317 8.80 pump
36299 Unlisted procedure, vascular injection 0 0 0 0 0.00
36400 Venipuncture, younger than age 3 years, 50 68 88 27 0.75 necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein
CPT copyright 2017 American Medical Association. 257 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
36405 Venipuncture, younger than age 3 years, 60 82 106 24 0.66 necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein
36406 Venipuncture, younger than age 3 years, 40 54 70 17 0.47 necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein
36410 Venipuncture, age 3 years or older, 35 48 61 17 0.48 necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)
36415 Collection of venous blood by venipuncture 15 20 26 0 0.00
36416 Collection of capillary blood specimen (eg, 15 20 26 0 0.00 finger, heel, ear stick)
36420 Venipuncture, cutdown; younger than age 1 114 155 200 49 1.35 year
36425 Venipuncture, cutdown; age 1 or over 50 68 87 42 1.16
36430 Transfusion, blood or blood components 116 157 202 36 1.00
36440 Push transfusion, blood, 2 years or younger 122 166 214 53 1.46
36450 Exchange transfusion, blood; newborn 433 586 755 178 4.94
36455 Exchange transfusion, blood; other than 302 409 527 132 3.68 newborn
36456 Partial exchange transfusion, blood, plasma or 257 348 448 113 3.13 crystalloid necessitating the skill of a physician or other qualified health care professional, newborn
36460 Transfusion, intrauterine, fetal 1731 2344 3022 356 9.89
36465 Injection of non-compounded foam sclerosant 3699 5010 6459 1624 45.12 with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)
36466 Injection of non-compounded foam sclerosant 3865 5234 6748 1697 47.14 with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg
36468 Injection(s) of sclerosant for spider veins 305 413 532 0 0.00 (telangiectasia), limb or trunk
36470 Injection of sclerosant; single incompetent vein 351 476 614 108 3.00 (other than telangiectasia)
36471 Injection of sclerosant; multiple incompetent 380 514 663 194 5.39 veins (other than telangiectasia), same leg
36473 Endovenous ablation therapy of incompetent 4461 6041 7788 1542 42.82 vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated
36474 Endovenous ablation therapy of incompetent 645 874 1127 283 7.87 vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)
36475 Endovenous ablation therapy of incompetent 4360 5905 7612 1549 43.04 vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated
36476 Endovenous ablation therapy of incompetent 1040 1408 1815 301 8.36 vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)
36478 Endovenous ablation therapy of incompetent 3801 5147 6636 1236 34.34 vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated
36479 Endovenous ablation therapy of incompetent 1094 1482 1910 318 8.83 vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)
36481 Percutaneous portal vein catheterization by any 2202 2982 3845 2008 55.78 method
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
36482 Endovenous ablation therapy of incompetent 4924 6669 8598 2162 60.06 vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated
36483 Endovenous ablation therapy of incompetent 335 453 584 147 4.08 vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)
36500 Venous catheterization for selective organ 581 786 1014 191 5.31 blood sampling
36510 Catheterization of umbilical vein for diagnosis 388 526 678 84 2.32 or therapy, newborn
36511 Therapeutic apheresis; for white blood cells 293 397 512 112 3.12
36512 Therapeutic apheresis; for red blood cells 385 522 673 113 3.13
36513 Therapeutic apheresis; for platelets 506 685 883 116 3.21
36514 Therapeutic apheresis; for plasma pheresis 873 1182 1524 796 22.11
36516 Therapeutic apheresis; with extracorporeal 5885 7970 10275 2232 61.99 immunoadsorption, selective adsorption or selective filtration and plasma reinfusion
36522 Photopheresis, extracorporeal 2600 3522 4540 2540 70.57
36555 Insertion of non-tunneled centrally inserted 675 914 1179 190 5.27 central venous catheter; younger than 5 years of age
36556 Insertion of non-tunneled centrally inserted 545 738 951 215 5.97 central venous catheter; age 5 years or older
36557 Insertion of tunneled centrally inserted central 2532 3429 4420 959 26.63 venous catheter, without subcutaneous port or pump; younger than 5 years of age
36558 Insertion of tunneled centrally inserted central 1201 1626 2096 731 20.30 venous catheter, without subcutaneous port or pump; age 5 years or older
36560 Insertion of tunneled centrally inserted central 2876 3895 5022 1336 37.12 venous access device, with subcutaneous port; younger than 5 years of age
260 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
36561 Insertion of tunneled centrally inserted central 1809 2450 3159 1110 30.83 venous access device, with subcutaneous port; age 5 years or older
36563 Insertion of tunneled centrally inserted central 1500 2032 2620 1263 35.07 venous access device with subcutaneous pump
36565 Insertion of tunneled centrally inserted central 1200 1625 2096 906 25.17 venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, Tesio type catheter)
36566 Insertion of tunneled centrally inserted central 8090 10957 14126 5271 146.42 venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s)
36568 Insertion of peripherally inserted central venous 707 958 1235 223 6.20 catheter (PICC), without subcutaneous port or pump; younger than 5 years of age
36569 Insertion of peripherally inserted central venous 402 545 702 253 7.03 catheter (PICC), without subcutaneous port or pump; age 5 years or older
36570 Insertion of peripherally inserted central venous 3199 4332 5585 1429 39.70 access device, with subcutaneous port; younger than 5 years of age
36571 Insertion of peripherally inserted central venous 1856 2514 3241 1252 34.78 access device, with subcutaneous port; age 5 years or older
36575 Repair of tunneled or non-tunneled central 412 558 719 169 4.69 venous access catheter, without subcutaneous port or pump, central or peripheral insertion site
36576 Repair of central venous access device, with 793 1073 1384 323 8.96 subcutaneous port or pump, central or peripheral insertion site
36578 Replacement, catheter only, of central venous 934 1265 1631 460 12.79 access device, with subcutaneous port or pump, central or peripheral insertion site
36580 Replacement, complete, of a non-tunneled 301 408 526 219 6.09 centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access
36581 Replacement, complete, of a tunneled centrally 1846 2500 3223 722 20.05 inserted central venous catheter, without subcutaneous port or pump, through same venous access
CPT copyright 2017 American Medical Association. 261 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
36582 Replacement, complete, of a tunneled centrally 1872 2535 3268 1026 28.51 inserted central venous access device, with subcutaneous port, through same venous access
36583 Replacement, complete, of a tunneled centrally 2956 4003 5161 1298 36.05 inserted central venous access device, with subcutaneous pump, through same venous access
36584 Replacement, complete, of a peripherally 300 406 524 210 5.83 inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access
36585 Replacement, complete, of a peripherally 2469 3343 4310 1084 30.11 inserted central venous access device, with subcutaneous port, through same venous access
36589 Removal of tunneled central venous catheter, 452 612 789 168 4.68 without subcutaneous port or pump
36590 Removal of tunneled central venous access 723 979 1262 228 6.33 device, with subcutaneous port or pump, central or peripheral insertion
36591 Collection of blood specimen from a completely 60 81 105 24 0.68 implantable venous access device
36592 Collection of blood specimen using established 60 82 106 27 0.76 central or peripheral catheter, venous, not otherwise specified
36593 Declotting by thrombolytic agent of implanted 77 104 134 32 0.90 vascular access device or catheter
36595 Mechanical removal of pericatheter obstructive 1130 1530 1972 604 16.77 material (eg, fibrin sheath) from central venous device via separate venous access
36596 Mechanical removal of intraluminal 390 528 681 134 3.73 (intracatheter) obstructive material from central venous device through device lumen
36597 Repositioning of previously placed central 239 324 417 131 3.63 venous catheter under fluoroscopic guidance
36598 Contrast injection(s) for radiologic evaluation 304 411 530 114 3.18 of existing central venous access device, including fluoroscopy, image documentation and report
36600 Arterial puncture, withdrawal of blood for 76 103 133 33 0.93 diagnosis
262 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
36620 Arterial catheterization or cannulation for 321 435 561 46 1.27 sampling, monitoring or transfusion (separate procedure); percutaneous
36625 Arterial catheterization or cannulation for 455 616 794 109 3.04 sampling, monitoring or transfusion (separate procedure); cutdown
36640 Arterial catheterization for prolonged infusion 271 366 472 119 3.30 therapy (chemotherapy), cutdown
36660 Catheterization, umbilical artery, newborn, for 393 532 686 71 1.98 diagnosis or therapy
36680 Placement of needle for intraosseous infusion 331 448 577 61 1.69
36800 Insertion of cannula for hemodialysis, other 406 491 651 127 3.54 purpose (separate procedure); vein to vein
36810 Insertion of cannula for hemodialysis, other 571 690 915 221 6.14 purpose (separate procedure); arteriovenous, external (Scribner type)
36815 Insertion of cannula for hemodialysis, other 339 409 543 142 3.94 purpose (separate procedure); arteriovenous, external revision, or closure
36818 Arteriovenous anastomosis, open; by upper arm 1944 2350 3116 728 20.21 cephalic vein transposition
36819 Arteriovenous anastomosis, open; by upper arm 2179 2635 3493 766 21.29 basilic vein transposition
36820 Arteriovenous anastomosis, open; by forearm 2279 2755 3653 769 21.37 vein transposition
36821 Arteriovenous anastomosis, open; direct, any 1852 2239 2968 696 19.33 site (eg, Cimino type) (separate procedure)
36823 Insertion of arterial and venous cannula(s) for 3470 4195 5563 1453 40.37 isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) and repair of arteriotomy and venotomy sites
36825 Creation of arteriovenous fistula by other than 1843 2228 2954 836 23.22 direct arteriovenous anastomosis (separate procedure); autogenous graft
36830 Creation of arteriovenous fistula by other than 1920 2322 3079 698 19.40 direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft)
CPT copyright 2017 American Medical Association. 263 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
36831 Thrombectomy, open, arteriovenous fistula 1378 1666 2210 647 17.96 without revision, autogenous or nonautogenous dialysis graft (separate procedure)
36832 Revision, open, arteriovenous fistula; without 1758 2126 2819 793 22.03 thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)
36833 Revision, open, arteriovenous fistula; with 1909 2308 3060 851 23.65 thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)
36835 Insertion of Thomas shunt (separate procedure) 1186 1434 1902 497 13.80
36838 Distal revascularization and interval ligation 3107 3756 4981 1201 33.37 (DRIL), upper extremity hemodialysis access (steal syndrome)
36860 External cannula declotting (separate 377 456 605 227 6.30 procedure); without balloon catheter
36861 External cannula declotting (separate 346 418 554 145 4.02 procedure); with balloon catheter
36901 Introduction of needle(s) and/or catheter(s), 1378 1666 2209 611 16.98 dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report;
36902 Introduction of needle(s) and/or catheter(s), 3092 3738 4956 1272 35.34 dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty
36903 Introduction of needle(s) and/or catheter(s), 14963 18090 23986 5725 159.04 dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct
264 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment
36904 Percutaneous transluminal mechanical 4118 4979 6601 1849 51.36 thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s);
36905 Percutaneous transluminal mechanical 5762 6966 9237 2344 65.10 thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty
36906 Percutaneous transluminal mechanical 18016 21780 28880 6949 193.02 thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit
36907 Transluminal balloon angioplasty, central 1865 2255 2990 770 21.39 dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to
CPT copyright 2017 American Medical Association. 265 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
perform the angioplasty (list separately in addition to code for primary procedure)
36908 Transcatheter placement of intravascular 7443 8998 11931 2763 76.75 stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (list separately in addition to code for primary procedure)
36909 Dialysis circuit permanent vascular 5120 6190 8207 2008 55.78 embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention (list separately in addition to code for primary procedure)
37140 Venous anastomosis, open; portocaval 5776 6983 9259 2419 67.19
37145 Venous anastomosis, open; renoportal 5359 6479 8591 2244 62.34
37160 Venous anastomosis, open; caval-mesenteric 5502 6652 8821 2304 64.01
37180 Venous anastomosis, open; splenorenal, 5295 6402 8489 2218 61.60 proximal
37181 Venous anastomosis, open; splenorenal, distal 5776 6983 9259 2419 67.19 (selective decompression of esophagogastric varices, any technique)
37182 Insertion of transvenous intrahepatic 2725 3294 4368 860 23.90 portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation)
37183 Revision of transvenous intrahepatic 6507 7867 10432 5934 164.84 portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannulization/dilatation, stent placement and all associated imaging guidance and documentation)
37184 Primary percutaneous transluminal mechanical 2479 2997 3974 2261 62.80 thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel
266 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
37185 Primary percutaneous transluminal mechanical 788 953 1264 719 19.97 thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (list separately in addition to code for primary mechanical thrombectomy procedure)
37186 Secondary percutaneous transluminal 2986 3610 4787 1361 37.80 thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with another percutaneous intervention other than primary mechanical thrombectomy (list separately in addition to code for primary procedure)
37187 Percutaneous transluminal mechanical 3107 3756 4981 2025 56.24 thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance
37188 Percutaneous transluminal mechanical 1913 2313 3067 1708 47.44 thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy
37191 Insertion of intravascular vena cava filter, 3251 3931 5212 2618 72.72 endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed
37192 Repositioning of intravascular vena cava filter, 3722 4499 5966 1381 38.36 endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed
37193 Retrieval (removal) of intravascular vena cava 2114 2556 3389 1562 43.40 filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed
CPT copyright 2017 American Medical Association. 267 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
37195 Thrombolysis, cerebral, by intravenous infusion 1459 1764 2339 0 0.00
37197 Transcatheter retrieval, percutaneous, of 1829 2211 2932 1481 41.14 intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed
37200 Transcatheter biopsy 840 1016 1347 227 6.31
37211 Transcatheter therapy, arterial infusion for 1202 1453 1927 404 11.21 thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day
37212 Transcatheter therapy, venous infusion for 1070 1294 1716 354 9.82 thrombolysis, any method, including radiological supervision and interpretation, initial treatment day
37213 Transcatheter therapy, arterial or venous 756 913 1211 244 6.79 infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, or exchange, when performed;
37214 Transcatheter therapy, arterial or venous 436 527 699 128 3.56 infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, or exchange, when performed; cessation of thrombolysis including removal of catheter and vessel closure by any method
37215 Transcatheter placement of intravascular 3001 3628 4810 1050 29.18 stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection
37216 Transcatheter placement of intravascular 3126 3780 5012 1055 29.31 stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection
268 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
37217 Transcatheter placement of intravascular 2710 3277 4345 1135 31.53 stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation
37218 Transcatheter placement of intravascular 2031 2456 3256 851 23.63 stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation
37220 Revascularization, endovascular, open or 3746 4529 6005 3122 86.71 percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty
37221 Revascularization, endovascular, open or 5591 6759 8962 4631 128.63 percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
37222 Revascularization, endovascular, open or 1036 1253 1661 877 24.37 percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (list separately in addition to code for primary procedure)
37223 Revascularization, endovascular, open or 3001 3628 4810 2595 72.08 percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (list separately in addition to code for primary procedure)
37224 Revascularization, endovascular, open or 4502 5443 7218 3790 105.29 percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty
37225 Revascularization, endovascular, open or 25930 31348 41566 11130 309.18 percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed
37226 Revascularization, endovascular, open or 14218 17189 22792 9100 252.77 percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
37227 Revascularization, endovascular, open or 33004 39900 52906 15062 418.38 percutaneous, femoral, popliteal artery(s),
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed
37228 Revascularization, endovascular, open or 6422 7763 10294 5424 150.68 percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty
37229 Revascularization, endovascular, open or 25396 30703 40711 10976 304.89 percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty within the same vessel, when performed
37230 Revascularization, endovascular, open or 9992 12080 16018 8389 233.03 percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
37231 Revascularization, endovascular, open or 27592 33358 44232 13605 377.93 percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed
37232 Revascularization, endovascular, open or 1442 1744 2312 1210 33.62 percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (list separately in addition to code for primary procedure)
37233 Revascularization, endovascular, open or 3257 3938 5221 1464 40.68 percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy, includes angioplasty within the same vessel, when performed (list separately in addition to code for primary procedure)
37234 Revascularization, endovascular, open or 9477 11458 15193 3969 110.25 percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (list separately in addition to code for primary procedure)
37235 Revascularization, endovascular, open or 10016 12108 16055 4194 116.51 percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed (list separately in addition to code for primary procedure)
270 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
37236 Transcatheter placement of an intravascular 4302 5201 6897 3923 108.98 stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery
37237 Transcatheter placement of an intravascular 2707 3273 4340 2469 68.58 stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; each additional artery (list separately in addition to code for primary procedure)
37238 Transcatheter placement of an intravascular 10346 12508 16585 4250 118.06 stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein
37239 Transcatheter placement of an intravascular 4314 5215 6915 2058 57.16 stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (list separately in addition to code for primary procedure)
37241 Vascular embolization or occlusion, inclusive of 8196 9908 13138 4830 134.18 all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)
37242 Vascular embolization or occlusion, inclusive of 8196 9909 13139 7474 207.62 all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms, pseudoaneurysms)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
37243 Vascular embolization or occlusion, inclusive of 21854 26421 35033 9900 275.01 all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction
37244 Vascular embolization or occlusion, inclusive of 7568 9149 12132 6901 191.70 all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation
37246 Transluminal balloon angioplasty (except lower 5084 6147 8150 2182 60.61 extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery
37247 Transluminal balloon angioplasty (except lower 2354 2846 3774 882 24.49 extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; each additional artery (list separately in addition to code for primary procedure)
37248 Transluminal balloon angioplasty (except 3527 4264 5654 1514 42.05 dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein
37249 Transluminal balloon angioplasty (except 1573 1902 2522 648 17.99 dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (list separately in addition to code for primary procedure)
37252 Intravascular ultrasound (noncoronary vessel) 3441 4160 5515 1398 38.83 during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (list separately in addition to code for primary procedure)
272 CPT copyright 2017 American Medical Association. SURGERY – CARDIOVASCULAR SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
37253 Intravascular ultrasound (noncoronary vessel) 500 605 802 211 5.86 during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (list separately in addition to code for primary procedure)
37500 Vascular endoscopy, surgical, with ligation of 1587 1918 2544 665 18.46 perforator veins, subfascial (SEPS)
37501 Unlisted vascular endoscopy procedure 0 0 0 0 0.00
37565 Ligation, internal jugular vein 2050 2478 3286 755 20.97
37600 Ligation; external carotid artery 1791 2165 2870 750 20.83
37605 Ligation; internal or common carotid artery 1887 2281 3025 772 21.44
37606 Ligation; internal or common carotid artery, 1448 1750 2321 751 20.87 with gradual occlusion, as with Selverstone or crutch field clamp
37607 Ligation or banding of angioaccess 1089 1316 1745 392 10.90 arteriovenous fistula
37609 Ligation or biopsy, temporal artery 760 918 1218 318 8.83
37615 Ligation, major artery (eg, post-traumatic, 1301 1572 2085 545 15.13 rupture); neck
37616 Ligation, major artery (eg, post-traumatic, 2773 3353 4445 1161 32.26 rupture); chest
37617 Ligation, major artery (eg, post-traumatic, 3500 4232 5611 1398 38.83 rupture); abdomen
37618 Ligation, major artery (eg, post-traumatic, 1144 1383 1834 400 11.10 rupture); extremity
37619 Ligation of inferior vena cava 4298 5196 6890 1800 50.00
37650 Ligation of femoral vein 1144 1383 1834 479 13.31
37660 Ligation of common iliac vein 3279 3964 5256 1373 38.14
37700 Ligation and division of long saphenous vein at 594 718 952 258 7.16 saphenofemoral junction, or distal interruptions
37718 Ligation, division, and stripping, short 1420 1717 2277 451 12.53 saphenous vein
37722 Ligation, division, and stripping, long (greater) 1388 1678 2225 495 13.76 saphenous veins from saphenofemoral junction to knee or below
CPT copyright 2017 American Medical Association. 273 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
37735 Ligation and division and complete stripping of 1448 1750 2321 606 16.84 long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia
37760 Ligation of perforator veins, subfascial, radical 1787 2160 2864 645 17.92 (Linton type), including skin graft, when performed, open,1 leg
37761 Ligation of perforator vein(s), subfascial, open, 1750 2116 2806 568 15.78 including ultrasound guidance, when performed, 1 leg
37765 Stab phlebectomy of varicose veins, 1 1400 1693 2245 670 18.61 extremity; 10-20 stab incisions
37766 Stab phlebectomy of varicose veins, 1 1607 1943 2577 797 22.15 extremity; more than 20 incisions
37780 Ligation and division of short saphenous vein at 600 725 961 244 6.79 saphenopopliteal junction (separate procedure)
37785 Ligation, division, and/or excision of varicose 819 990 1313 364 10.10 vein cluster(s), 1 leg
37788 Penile revascularization, artery, with or without 3149 3807 5048 1319 36.63 vein graft
37790 Penile venous occlusive procedure 1215 1468 1947 509 14.13
37799 Unlisted procedure, vascular surgery 0 0 0 0 0.00
274 CPT copyright 2017 American Medical Association. SURGERY – HEMIC AND LYMPHATIC SYSTEMS
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
HEMIC AND LYMPHATIC SYSTEMS SPLEEN
38100 Splenectomy; total (separate procedure) 3150 4343 6660 1202 33.40
38101 Splenectomy; partial (separate procedure) 3236 4460 6840 1216 33.77
38102 Splenectomy; total, en bloc for extensive 860 1186 1818 275 7.65 disease, in conjunction with other procedure (list in addition to code for primary procedure)
38115 Repair of ruptured spleen (splenorrhaphy) with 3543 4883 7489 1331 36.97 or without partial splenectomy
38120 Laparoscopy, surgical, splenectomy 2977 4103 6292 1096 30.45
38129 Unlisted laparoscopy procedure, spleen 0 0 0 0 0.00
38200 Injection procedure for splenoportography 368 507 778 138 3.84
GENERAL
38204 Management of recipient hematopoietic 291 402 616 109 3.04 progenitor cell donor search and cell acquisition
38205 Blood-derived hematopoietic progenitor cell 255 351 539 87 2.41 harvesting for transplantation, per collection; allogeneic
38206 Blood-derived hematopoietic progenitor cell 333 459 703 86 2.40 harvesting for transplantation, per collection; autologous
38207 Transplant preparation of hematopoietic 134 185 283 49 1.36 progenitor cells; cryopreservation and storage
38208 Transplant preparation of hematopoietic 253 349 535 31 0.86 progenitor cells; thawing of previously frozen harvest, without washing, per donor
38209 Transplant preparation of hematopoietic 34 48 73 13 0.36 progenitor cells; thawing of previously frozen harvest, with washing, per donor
38210 Transplant preparation of hematopoietic 230 317 486 86 2.40 progenitor cells; specific cell depletion within harvest, t-cell depletion
38211 Transplant preparation of hematopoietic 208 287 440 78 2.17 progenitor cells; tumor cell depletion
38212 Transplant preparation of hematopoietic 138 190 292 52 1.44 progenitor cells; red blood cell removal
CPT copyright 2017 American Medical Association. 275 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
38213 Transplant preparation of hematopoietic 34 48 73 13 0.36 progenitor cells; platelet depletion
38214 Transplant preparation of hematopoietic 115 159 243 45 1.24 progenitor cells; plasma (volume) depletion
38215 Transplant preparation of hematopoietic 138 190 292 52 1.44 progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer
38220 Diagnostic bone marrow; aspiration(s) 407 561 860 174 4.84
38221 Diagnostic bone marrow; biopsy(ies) 422 582 892 157 4.36
38222 Diagnostic bone marrow; biopsy(ies) and 464 639 980 174 4.84 aspiration(s)
38230 Bone marrow harvesting for transplantation; 818 1127 1729 216 5.99 allogeneic
38232 Bone marrow harvesting for transplantation; 698 961 1475 207 5.76 autologous
38240 Hematopoietic progenitor cell (HPC); 2220 3060 4693 235 6.52 allogeneic transplantation per donor
38241 Hematopoietic progenitor cell (HPC); 1847 2545 3903 176 4.88 autologous transplantation
38242 Allogeneic lymphocyte infusions 602 829 1272 124 3.44
38243 Hematopoietic progenitor cell (HPC); HPC 309 426 654 112 3.11 boost
LYMPH NODES AND LYMPHATIC CHANNELS
38300 Drainage of lymph node abscess or 819 1129 1731 325 9.04 lymphadenitis; simple
38305 Drainage of lymph node abscess or 1033 1424 2184 502 13.95 lymphadenitis; extensive
38308 Lymphangiotomy or other operations on 1781 2455 3765 463 12.87 lymphatic channels
38380 Suture and/or ligation of thoracic duct; cervical 1546 2130 3267 581 16.13 approach
38381 Suture and/or ligation of thoracic duct; thoracic 2370 3267 5011 834 23.18 approach
38382 Suture and/or ligation of thoracic duct; 1862 2566 3936 699 19.43 abdominal approach
276 CPT copyright 2017 American Medical Association. SURGERY – HEMIC AND LYMPHATIC SYSTEMS
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
38500 Biopsy or excision of lymph node(s); open, 777 1070 1642 342 9.51 superficial
38505 Biopsy or excision of lymph node(s); by 301 415 636 129 3.58 needle, superficial (eg, cervical, inguinal, axillary)
38510 Biopsy or excision of lymph node(s); open, 1213 1672 2563 532 14.79 deep cervical node(s)
38520 Biopsy or excision of lymph node(s); open, 1107 1526 2340 481 13.36 deep cervical node(s) with excision scalene fat pad
38525 Biopsy or excision of lymph node(s); open, 1153 1589 2437 454 12.62 deep axillary node(s)
38530 Biopsy or excision of lymph node(s); open, 1433 1976 3030 580 16.12 internal mammary node(s)
38542 Dissection, deep jugular node(s) 1414 1949 2989 533 14.81
38550 Excision of cystic hygroma, axillary or 1407 1939 2974 528 14.68 cervical; without deep neurovascular dissection
38555 Excision of cystic hygroma, axillary or 2790 3846 5899 1048 29.12 cervical; with deep neurovascular dissection
38562 Limited lymphadenectomy for staging 2302 3173 4867 734 20.39 (separate procedure); pelvic and para-aortic
38564 Limited lymphadenectomy for staging 2110 2908 4460 732 20.32 (separate procedure); retroperitoneal (aortic and/or splenic)
38570 Laparoscopy, surgical; with retroperitoneal 1699 2342 3592 528 14.66 lymph node sampling (biopsy), single or multiple
38571 Laparoscopy, surgical; with bilateral total 2133 2940 4508 692 19.23 pelvic lymphadenectomy
38572 Laparoscopy, surgical; with bilateral total 2880 3970 6089 963 26.75 pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple
38573 Laparoscopy, surgical; with bilateral total 3219 4437 6804 1209 33.59 pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed
38589 Unlisted laparoscopy procedure, lymphatic 0 0 0 0 0.00 system
CPT copyright 2017 American Medical Association. 277 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
38700 Suprahyoid lymphadenectomy 2232 3077 4719 825 22.93
38720 Cervical lymphadenectomy (complete) 3697 5096 7815 1382 38.38
38724 Cervical lymphadenectomy (modified radical 4313 5945 9117 1490 41.38 neck dissection)
38740 Axillary lymphadenectomy; superficial 2031 2800 4294 723 20.07
38745 Axillary lymphadenectomy; complete 2411 3324 5097 913 25.35
38746 Thoracic lymphadenectomy by thoracotomy, 628 866 1327 224 6.23 mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)
38747 Abdominal lymphadenectomy, regional, 830 1145 1755 279 7.75 including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (list separately in addition to code for primary procedure)
38760 Inguinofemoral lymphadenectomy, superficial, 2302 3173 4866 876 24.34 including Cloquet's node (separate procedure)
38765 Inguinofemoral lymphadenectomy, superficial, 3214 4430 6794 1348 37.44 in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)
38770 Pelvic lymphadenectomy, including external 2641 3640 5582 842 23.40 iliac, hypogastric, and obturator nodes (separate procedure)
38780 Retroperitoneal transabdominal 4241 5846 8966 1068 29.68 lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)
38790 Injection procedure; lymphangiography 269 371 569 86 2.40
38792 Injection procedure; radioactive tracer for 131 181 277 41 1.14 identification of sentinel node
38794 Cannulation, thoracic duct 826 1139 1746 310 8.62
38900 Intraoperative identification (eg, mapping) of 402 554 849 144 3.99 sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)
38999 Unlisted procedure, hemic or lymphatic system 0 0 0 0 0.00
278 CPT copyright 2017 American Medical Association. SURGERY – MEDIASTINUM AND DIAPHRAGM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
MEDIASTINUM AND DIAPHRAGM MEDIASTINUM
39000 Mediastinotomy with exploration, drainage, 1520 2023 3261 516 14.33 removal of foreign body, or biopsy; cervical approach
39010 Mediastinotomy with exploration, drainage, 2368 3150 5079 818 22.72 removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy
39200 Resection of mediastinal cyst 2501 3328 5365 911 25.30
39220 Resection of mediastinal tumor 3425 4557 7347 1183 32.87
39401 Mediastinoscopy; includes biopsy(ies) of 914 1216 1960 324 9.00 mediastinal mass (eg, lymphoma), when performed
39402 Mediastinoscopy; with lymph node biopsy(ies) 1058 1408 2270 423 11.75 (eg, lung cancer staging)
39499 Unlisted procedure, mediastinum 0 0 0 0 0.00
DIAPHRAGM
39501 Repair, laceration of diaphragm, any approach 2594 3452 5566 884 24.56
39503 Repair, neonatal diaphragmatic hernia, with or 16629 22127 35673 6034 167.61 without chest tube insertion and with or without creation of ventral hernia
39540 Repair, diaphragmatic hernia (other than 2484 3306 5329 904 25.10 neonatal), traumatic; acute
39541 Repair, diaphragmatic hernia (other than 2753 3663 5906 976 27.10 neonatal), traumatic; chronic
39545 Imbrication of diaphragm for eventration, 2758 3670 5917 927 25.75 transthoracic or transabdominal, paralytic or nonparalytic
39560 Resection, diaphragm; with simple repair (eg, 2557 3402 5485 832 23.12 primary suture)
39561 Resection, diaphragm; with complex repair (eg, 3752 4993 8050 1293 35.91 prosthetic material, local muscle flap)
39599 Unlisted procedure, diaphragm 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 279 SURGERY – DIGESTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
DIGESTIVE SYSTEM LIPS
40490 Biopsy of lip 220 299 418 132 3.68
40500 Vermilionectomy (lip shave), with mucosal 1147 1559 2180 521 14.46 advancement
40510 Excision of lip; transverse wedge excision with 1195 1624 2271 497 13.80 primary closure
40520 Excision of lip; v-excision with primary direct 1195 1624 2271 504 13.99 linear closure
40525 Excision of lip; full thickness, reconstruction 1895 2576 3602 570 15.84 with local flap (eg, Estlander or fan)
40527 Excision of lip; full thickness, reconstruction 1336 1815 2538 631 17.54 with cross lip flap (abbe-Estlander)
40530 Resection of lip, more than one-fourth, without 1164 1582 2211 550 15.28 reconstruction
40650 Repair lip, full thickness; vermilion only 1267 1722 2408 454 12.61
40652 Repair lip, full thickness; up to half vertical 1530 2079 2907 508 14.11 height
40654 Repair lip, full thickness; over one-half vertical 1658 2253 3150 590 16.40 height, or complex
40700 Plastic repair of cleft lip/nasal deformity; 3256 4426 6189 1050 29.16 primary, partial or complete, unilateral
40701 Plastic repair of cleft lip/nasal deformity; 2630 3575 4999 1243 34.54 primary bilateral, 1-stage procedure
40702 Plastic repair of cleft lip/nasal deformity; 2208 3001 4196 1044 28.99 primary bilateral, 1 of 2 stages
40720 Plastic repair of cleft lip/nasal deformity; 3570 4853 6785 1072 29.79 secondary, by recreation of defect and reclosure
40761 Plastic repair of cleft lip/nasal deformity; with 2393 3252 4547 1131 31.42 cross lip pedicle flap (abbe-Estlander type), including sectioning and inserting of pedicle
40799 Unlisted procedure, lips 0 0 0 0 0.00
VESTIBULE OF MOUTH
40800 Drainage of abscess, cyst, hematoma, vestibule 372 506 707 220 6.12 of mouth; simple
CPT copyright 2017 American Medical Association. 281 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
40801 Drainage of abscess, cyst, hematoma, vestibule 621 845 1181 324 9.01 of mouth; complicated
40804 Removal of embedded foreign body, vestibule 416 566 792 190 5.27 of mouth; simple
40805 Removal of embedded foreign body, vestibule 700 951 1330 331 9.19 of mouth; complicated
40806 Incision of labial frenum (frenotomy) 270 367 514 107 2.98
40808 Biopsy, vestibule of mouth 351 477 667 193 5.35
40810 Excision of lesion of mucosa and submucosa, 450 612 855 213 5.93 vestibule of mouth; without repair
40812 Excision of lesion of mucosa and submucosa, 562 763 1067 299 8.30 vestibule of mouth; with simple repair
40814 Excision of lesion of mucosa and submucosa, 800 1087 1520 400 11.11 vestibule of mouth; with complex repair
40816 Excision of lesion of mucosa and submucosa, 914 1243 1737 416 11.56 vestibule of mouth; complex, with excision of underlying muscle
40818 Excision of mucosa of vestibule of mouth as 800 1087 1521 375 10.42 donor graft
40819 Excision of frenum, labial or buccal 575 781 1092 329 9.15 (frenumectomy, frenulectomy, frenectomy)
40820 Destruction of lesion or scar of vestibule of 575 782 1093 274 7.60 mouth by physical methods (eg, laser, thermal, cryo, chemical)
40830 Closure of laceration, vestibule of mouth; 2.5 1005 1365 1909 279 7.76 cm or less
40831 Closure of laceration, vestibule of mouth; over 1005 1365 1909 353 9.80 2.5 cm or complex
40840 Vestibuloplasty; anterior 1803 2451 3427 838 23.28
40842 Vestibuloplasty; posterior, unilateral 1741 2367 3309 817 22.70
40843 Vestibuloplasty; posterior, bilateral 2345 3187 4456 1108 30.79
40844 Vestibuloplasty; entire arch 2915 3962 5540 1378 38.28
40845 Vestibuloplasty; complex (including ridge 4086 5554 7765 1502 41.71 extension, muscle repositioning)
40899 Unlisted procedure, vestibule of mouth 0 0 0 0 0.00
282 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
TONGUE AND FLOOR OF MOUTH
41000 Intraoral incision and drainage of abscess, cyst, 325 442 618 168 4.66 or hematoma of tongue or floor of mouth; lingual
41005 Intraoral incision and drainage of abscess, cyst, 487 662 926 230 6.40 or hematoma of tongue or floor of mouth; sublingual, superficial
41006 Intraoral incision and drainage of abscess, cyst, 826 1123 1571 374 10.38 or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid
41007 Intraoral incision and drainage of abscess, cyst, 815 1107 1548 366 10.18 or hematoma of tongue or floor of mouth; submental space
41008 Intraoral incision and drainage of abscess, cyst, 821 1116 1561 395 10.96 or hematoma of tongue or floor of mouth; submandibular space
41009 Intraoral incision and drainage of abscess, cyst, 904 1228 1718 420 11.68 or hematoma of tongue or floor of mouth; masticator space
41010 Incision of lingual frenum (frenotomy) 460 625 874 208 5.77
41015 Extraoral incision and drainage of abscess, cyst, 973 1323 1849 443 12.31 or hematoma of floor of mouth; sublingual
41016 Extraoral incision and drainage of abscess, cyst, 976 1327 1855 458 12.73 or hematoma of floor of mouth; submental
41017 Extraoral incision and drainage of abscess, cyst, 1071 1456 2035 465 12.92 or hematoma of floor of mouth; submandibular
41018 Extraoral incision and drainage of abscess, cyst, 1210 1644 2299 528 14.66 or hematoma of floor of mouth; masticator space
41019 Placement of needles, catheters, or other 1040 1414 1977 492 13.66 device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application
41100 Biopsy of tongue; anterior two-thirds 379 515 721 174 4.83
41105 Biopsy of tongue; posterior one-third 388 528 738 177 4.92
41108 Biopsy of floor of mouth 303 412 576 153 4.26
41110 Excision of lesion of tongue without closure 446 607 848 219 6.08
CPT copyright 2017 American Medical Association. 283 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
41112 Excision of lesion of tongue with closure; 725 986 1378 347 9.63 anterior two-thirds
41113 Excision of lesion of tongue with closure; 838 1139 1593 379 10.54 posterior one-third
41114 Excision of lesion of tongue with closure; with 1458 1982 2771 657 18.24 local tongue flap
41115 Excision of lingual frenum (frenectomy) 536 728 1018 253 7.03
41116 Excision, lesion of floor of mouth 801 1089 1522 342 9.51
41120 Glossectomy; less than one-half tongue 2742 3727 5212 1116 31.01
41130 Glossectomy; hemiglossectomy 3564 4843 6772 1374 38.18
41135 Glossectomy; partial, with unilateral radical 5058 6874 9612 2259 62.74 neck dissection
41140 Glossectomy; complete or total, with or without 4798 6521 9118 2268 63.00 tracheostomy, without radical neck dissection
41145 Glossectomy; complete or total, with or without 6079 8263 11553 2874 79.83 tracheostomy, with unilateral radical neck dissection
41150 Glossectomy; composite procedure with 6111 8306 11613 2283 63.43 resection floor of mouth and mandibular resection, without radical neck dissection
41153 Glossectomy; composite procedure with 5236 7116 9950 2475 68.75 resection floor of mouth, with suprahyoid neck dissection
41155 Glossectomy; composite procedure with 6928 9416 13165 3136 87.12 resection floor of mouth, mandibular resection, and radical neck dissection (commando type)
41250 Repair of laceration 2.5 cm or less; floor of 663 901 1260 278 7.73 mouth and/or anterior two-thirds of tongue
41251 Repair of laceration 2.5 cm or less; posterior 651 885 1237 308 8.55 one-third of tongue
41252 Repair of laceration of tongue, floor of mouth, 1028 1397 1954 326 9.06 over 2.6 cm or complex
41500 Fixation of tongue, mechanical, other than 1030 1399 1957 487 13.52 suture (eg, k-wire)
41510 Suture of tongue to lip for micrognathia 996 1354 1893 471 13.08 (Douglas type procedure)
284 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
41512 Tongue base suspension, permanent suture 1442 1960 2741 682 18.94 technique
41520 Frenoplasty (surgical revision of frenum, eg, 952 1294 1810 358 9.95 with z-plasty)
41530 Submucosal ablation of the tongue base, 6521 8862 12392 998 27.72 radiofrequency, 1 or more sites, per session
41599 Unlisted procedure, tongue, floor of mouth 0 0 0 0 0.00
DENTOALVEOLAR STRUCTURES
41800 Drainage of abscess, cyst, hematoma from 618 840 1174 293 8.14 dentoalveolar structures
41805 Removal of embedded foreign body from 1000 1359 1901 292 8.10 dentoalveolar structures; soft tissues
41806 Removal of embedded foreign body from 854 1161 1624 404 11.22 dentoalveolar structures; bone
41820 Gingivectomy, excision gingiva, each quadrant 639 869 1215 0 0.00
41821 Operculectomy, excision pericoronal tissues 247 336 469 0 0.00
41822 Excision of fibrous tuberosities, dentoalveolar 672 913 1277 314 8.71 structures
41823 Excision of osseous tuberosities, dentoalveolar 1000 1359 1900 463 12.85 structures
41825 Excision of lesion or tumor (except listed 479 651 910 220 6.12 above), dentoalveolar structures; without repair
41826 Excision of lesion or tumor (except listed 653 888 1241 328 9.12 above), dentoalveolar structures; with simple repair
41827 Excision of lesion or tumor (except listed 1152 1566 2190 456 12.68 above), dentoalveolar structures; with complex repair
41828 Excision of hyperplastic alveolar mucosa, each 611 831 1162 327 9.07 quadrant (specify)
41830 Alveolectomy, including curettage of osteitis or 844 1147 1604 418 11.61 sequestrectomy
41850 Destruction of lesion (except excision), 0 0 0 0 0.00 dentoalveolar structures
41870 Periodontal mucosal grafting 895 1217 1701 0 0.00
41872 Gingivoplasty, each quadrant (specify) 805 1094 1530 359 9.98
CPT copyright 2017 American Medical Association. 285 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
41874 Alveoloplasty, each quadrant (specify) 850 1155 1614 399 11.07
41899 Unlisted procedure, dentoalveolar structures 0 0 0 0 0.00
PALATE AND UVULA
42000 Drainage of abscess of palate, uvula 495 693 1097 157 4.37
42100 Biopsy of palate, uvula 352 493 780 154 4.29
42104 Excision, lesion of palate, uvula; without 482 675 1068 222 6.16 closure
42106 Excision, lesion of palate, uvula; with simple 600 841 1331 284 7.88 primary closure
42107 Excision, lesion of palate, uvula; with local flap 1173 1645 2601 477 13.26 closure
42120 Resection of palate or extensive resection of 2523 3538 5595 1049 29.14 lesion
42140 Uvulectomy, excision of uvula 523 733 1159 259 7.20
42145 Palatopharyngoplasty (eg, uvulopalato- 2193 3074 4862 722 20.05 pharyngoplasty, uvulopharyngoplasty)
42160 Destruction of lesion, palate or uvula (thermal, 631 885 1399 238 6.61 cryo or chemical)
42180 Repair, laceration of palate; up to 2 cm 660 925 1463 249 6.91
42182 Repair, laceration of palate; over 2 cm or 867 1216 1922 327 9.08 complex
42200 Palatoplasty for cleft palate, soft and/or hard 3240 4542 7183 992 27.56 palate only
42205 Palatoplasty for cleft palate, with closure of 2743 3846 6082 1034 28.73 alveolar ridge; soft tissue only
42210 Palatoplasty for cleft palate, with closure of 4283 6006 9497 1152 31.99 alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)
42215 Palatoplasty for cleft palate; major revision 2129 2986 4721 754 20.95
42220 Palatoplasty for cleft palate; secondary 1651 2315 3660 622 17.29 lengthening procedure
42225 Palatoplasty for cleft palate; attachment 3631 5090 8050 1035 28.74 pharyngeal flap
42226 Lengthening of palate, and pharyngeal flap 3166 4438 7019 912 25.34
42227 Lengthening of palate, with island flap 2297 3220 5092 856 23.79
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42235 Repair of anterior palate, including vomer flap 2090 2930 4633 750 20.82
42260 Repair of nasolabial fistula 2257 3164 5004 829 23.03
42280 Maxillary impression for palatal prosthesis 416 584 923 181 5.02
42281 Insertion of pin-retained palatal prosthesis 622 871 1378 234 6.51
42299 Unlisted procedure, palate, uvula 0 0 0 0 0.00
SALIVARY GLAND AND DUCTS
42300 Drainage of abscess; parotid, simple 568 797 1260 214 5.95
42305 Drainage of abscess; parotid, complicated 1176 1649 2608 444 12.32
42310 Drainage of abscess; submaxillary or 486 681 1078 183 5.09 sublingual, intraoral
42320 Drainage of abscess; submaxillary, external 675 946 1497 255 7.07
42330 Sialolithotomy; submandibular (submaxillary), 520 729 1153 238 6.61 sublingual or parotid, uncomplicated, intraoral
42335 Sialolithotomy; submandibular (submaxillary), 850 1192 1885 384 10.66 complicated, intraoral
42340 Sialolithotomy; parotid, extraoral or 1269 1779 2813 478 13.29 complicated intraoral
42400 Biopsy of salivary gland; needle 225 315 498 107 2.98
42405 Biopsy of salivary gland; incisional 693 972 1537 306 8.50
42408 Excision of sublingual salivary cyst (ranula) 1014 1422 2249 514 14.29
42409 Marsupialization of sublingual salivary cyst 841 1179 1865 341 9.47 (ranula)
42410 Excision of parotid tumor or parotid gland; 1682 2358 3729 639 17.76 lateral lobe, without nerve dissection
42415 Excision of parotid tumor or parotid gland; 3025 4241 6707 1083 30.07 lateral lobe, with dissection and preservation of facial nerve
42420 Excision of parotid tumor or parotid gland; 3629 5088 8046 1216 33.78 total, with dissection and preservation of facial nerve
42425 Excision of parotid tumor or parotid gland; 2277 3193 5049 859 23.85 total, en bloc removal with sacrifice of facial nerve
42426 Excision of parotid tumor or parotid gland; 4255 5966 9435 1385 38.47 total, with unilateral radical neck dissection
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42440 Excision of submandibular (submaxillary) gland 1527 2140 3385 423 11.74
42450 Excision of sublingual gland 1259 1765 2792 465 12.93
42500 Plastic repair of salivary duct, sialodochoplasty; 1203 1687 2668 445 12.36 primary or simple
42505 Plastic repair of salivary duct, sialodochoplasty; 1798 2521 3986 570 15.82 secondary or complicated
42507 Parotid duct diversion, bilateral (Wilke type 1391 1950 3084 525 14.57 procedure);
42509 Parotid duct diversion, bilateral (Wilke type 2294 3217 5087 865 24.03 procedure); with excision of both submandibular glands
42510 Parotid duct diversion, bilateral (Wilke type 1734 2432 3846 643 17.85 procedure); with ligation of both submandibular (Wharton's) ducts
42550 Injection procedure for sialography 370 519 821 140 3.88
42600 Closure salivary fistula 1298 1821 2879 490 13.60
42650 Dilation salivary duct 181 254 401 85 2.37
42660 Dilation and catheterization of salivary duct, 330 463 732 134 3.72 with or without injection
42665 Ligation salivary duct, intraoral 851 1193 1886 321 8.91
42699 Unlisted procedure, salivary glands or ducts 0 0 0 0 0.00
PHARYNX, ADENOIDS AND TONSILS
42700 Incision and drainage abscess; peritonsillar 452 714 1460 194 5.39
42720 Incision and drainage abscess; retropharyngeal 1049 1658 3387 467 12.96 or parapharyngeal, intraoral approach
42725 Incision and drainage abscess; retropharyngeal 1854 2931 5987 845 23.48 or parapharyngeal, external approach
42800 Biopsy; oropharynx 374 591 1207 162 4.49
42804 Biopsy; nasopharynx, visible lesion, simple 444 701 1432 199 5.52
42806 Biopsy; nasopharynx, survey for unknown 488 772 1577 224 6.22 primary lesion
42808 Excision or destruction of lesion of pharynx, 579 915 1869 231 6.43 any method
42809 Removal of foreign body from pharynx 507 802 1638 207 5.76
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42810 Excision branchial cleft cyst or vestige, 1077 1703 3478 397 11.03 confined to skin and subcutaneous tissues
42815 Excision branchial cleft cyst, vestige, or fistula, 1765 2790 5699 572 15.88 extending beneath subcutaneous tissues and/or into pharynx
42820 Tonsillectomy and adenoidectomy; younger 904 1428 2917 297 8.25 than age 12
42821 Tonsillectomy and adenoidectomy; age 12 or 925 1462 2987 308 8.56 over
42825 Tonsillectomy, primary or secondary; younger 813 1284 2624 268 7.45 than age 12
42826 Tonsillectomy, primary or secondary; age 12 or 807 1275 2605 258 7.16 over
42830 Adenoidectomy, primary; younger than age 12 656 1037 2118 212 5.89
42831 Adenoidectomy, primary; age 12 or over 708 1119 2286 229 6.36
42835 Adenoidectomy, secondary; younger than age 592 936 1912 197 5.47 12
42836 Adenoidectomy, secondary; age 12 or over 727 1149 2347 247 6.85
42842 Radical resection of tonsil, tonsillar pillars, 2583 4082 8339 1047 29.08 and/or retromolar trigone; without closure
42844 Radical resection of tonsil, tonsillar pillars, 4340 6860 14013 1441 40.04 and/or retromolar trigone; closure with local flap (eg, tongue, buccal)
42845 Radical resection of tonsil, tonsillar pillars, 6976 11024 22521 2317 64.35 and/or retromolar trigone; closure with other flap
42860 Excision of tonsil tags 579 915 1869 192 5.34
42870 Excision or destruction lingual tonsil, any 1558 2463 5031 615 17.09 method (separate procedure)
42890 Limited pharyngectomy 3869 6115 12491 1488 41.32
42892 Resection of lateral pharyngeal wall or pyriform 5880 9292 18983 1953 54.24 sinus, direct closure by advancement of lateral and posterior pharyngeal walls
42894 Resection of pharyngeal wall requiring closure 6762 10687 21831 2462 68.40 with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis
42900 Suture pharynx for wound or injury 1045 1652 3374 347 9.64
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42950 Pharyngoplasty (plastic or reconstructive 2525 3991 8153 845 23.48 operation on pharynx)
42953 Pharyngoesophageal repair 3053 4824 9855 1014 28.16
42955 Pharyngostomy (fistulization of pharynx, 2402 3796 7755 798 22.16 external for feeding)
42960 Control oropharyngeal hemorrhage, primary or 425 671 1371 174 4.84 secondary (eg, post-tonsillectomy); simple
42961 Control oropharyngeal hemorrhage, primary or 987 1559 3185 432 11.99 secondary (eg, post-tonsillectomy); complicated, requiring hospitalization
42962 Control oropharyngeal hemorrhage, primary or 1273 2012 4111 533 14.80 secondary (eg, post-tonsillectomy); with secondary surgical intervention
42970 Control of nasopharyngeal hemorrhage, primary 1278 2020 4126 424 11.79 or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery
42971 Control of nasopharyngeal hemorrhage, primary 1410 2229 4553 468 13.01 or secondary (eg, postadenoidectomy); complicated, requiring hospitalization
42972 Control of nasopharyngeal hemorrhage, primary 1578 2494 5096 524 14.56 or secondary (eg, postadenoidectomy); with secondary surgical intervention
42999 Unlisted procedure, pharynx, adenoids, or 0 0 0 0 0.00 tonsils
ESOPHAGUS
43020 Esophagotomy, cervical approach, with removal 1374 1974 3064 580 16.11 of foreign body
43030 Cricopharyngeal myotomy 1703 2447 3797 533 14.80
43045 Esophagotomy, thoracic approach, with 3209 4612 7158 1355 37.64 removal of foreign body
43100 Excision of lesion, esophagus, with primary 1519 2183 3389 642 17.82 repair; cervical approach
43101 Excision of lesion, esophagus, with primary 2526 3630 5635 1048 29.10 repair; thoracic or abdominal approach
43107 Total or near total esophagectomy, without 7337 10543 16365 3109 86.35 thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)
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43108 Total or near total esophagectomy, without 11219 16122 25024 4637 128.81 thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es)
43112 Total or near total esophagectomy, with 7600 10922 16952 3643 101.20 thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, McKeown esophagectomy or tri-incisional esophagectomy)
43113 Total or near total esophagectomy, with 10730 15419 23933 4531 125.85 thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
43116 Partial esophagectomy, cervical, with free 12548 18031 27987 5179 143.86 intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction
43117 Partial esophagectomy, distal two-thirds, with 7322 10521 16331 3385 94.04 thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor Lewis)
43118 Partial esophagectomy, distal two-thirds, with 9112 13093 20323 3785 105.13 thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
43121 Partial esophagectomy, distal two-thirds, with 7061 10147 15750 2981 82.82 thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty
43122 Partial esophagectomy, thoracoabdominal or 6313 9071 14080 2665 74.04 abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty
43123 Partial esophagectomy, thoracoabdominal or 11320 16266 25248 4695 130.43 abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
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43124 Total or partial esophagectomy, without 9397 13503 20958 3968 110.21 reconstruction (any approach), with cervical esophagostomy
43130 Diverticulectomy of hypopharynx or esophagus, 2201 3163 4909 809 22.46 with or without myotomy; cervical approach
43135 Diverticulectomy of hypopharynx or esophagus, 3681 5289 8210 1554 43.17 with or without myotomy; thoracic approach
43180 Esophagoscopy, rigid, transoral with 1507 2165 3361 564 15.67 diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed
43191 Esophagoscopy, rigid, transoral; diagnostic, 364 523 812 160 4.45 including collection of specimen(s) by brushing or washing when performed (separate procedure)
43192 Esophagoscopy, rigid, transoral; with directed 414 594 922 175 4.85 submucosal injection(s), any substance
43193 Esophagoscopy, rigid, transoral; with biopsy, 577 830 1288 175 4.87 single or multiple
43194 Esophagoscopy, rigid, transoral; with removal 516 742 1151 201 5.57 of foreign body(s)
43195 Esophagoscopy, rigid, transoral; with balloon 561 806 1251 192 5.33 dilation (less than 30 mm diameter)
43196 Esophagoscopy, rigid, transoral; with insertion 574 824 1280 204 5.67 of guide wire followed by dilation over guide wire
43197 Esophagoscopy, flexible, transnasal; diagnostic, 550 790 1227 196 5.45 including collection of specimen(s) by brushing or washing, when performed (separate procedure)
43198 Esophagoscopy, flexible, transnasal; with 629 903 1402 216 6.01 biopsy, single or multiple
43200 Esophagoscopy, flexible, transoral; diagnostic, 667 959 1488 221 6.13 including collection of specimen(s) by brushing or washing, when performed (separate procedure)
43201 Esophagoscopy, flexible, transoral; with 656 943 1463 226 6.27 directed submucosal injection(s), any substance
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43202 Esophagoscopy, flexible, transoral; with biopsy, 633 910 1412 315 8.75 single or multiple
43204 Esophagoscopy, flexible, transoral; with 338 486 755 143 3.97 injection sclerosis of esophageal varices
43205 Esophagoscopy, flexible, transoral; with band 673 967 1501 149 4.15 ligation of esophageal varices
43206 Esophagoscopy, flexible, transoral; with optical 648 931 1445 274 7.60 endomicroscopy
43210 Esophagogastroduodenoscopy, flexible, 1111 1596 2478 469 13.03 transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed
43211 Esophagoscopy, flexible, transoral; with 588 845 1312 248 6.90 endoscopic mucosal resection
43212 Esophagoscopy, flexible, transoral; with 616 885 1374 200 5.56 placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)
43213 Esophagoscopy, flexible, transoral; with 1662 2388 3707 1178 32.71 dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed)
43214 Esophagoscopy, flexible, transoral; with 650 934 1450 203 5.64 dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)
43215 Esophagoscopy, flexible, transoral; with 740 1063 1650 369 10.26 removal of foreign body(s)
43216 Esophagoscopy, flexible, transoral; with 743 1068 1657 367 10.20 removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
43217 Esophagoscopy, flexible, transoral; with 923 1326 2058 390 10.82 removal of tumor(s), polyp(s), or other lesion(s) by snare technique
43220 Esophagoscopy, flexible, transoral; with 1204 1731 2686 1098 30.51 transendoscopic balloon dilation (less than 30 mm diameter)
43226 Esophagoscopy, flexible, transoral; with 621 893 1386 325 9.02 insertion of guide wire followed by passage of dilator(s) over guide wire
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43227 Esophagoscopy, flexible, transoral; with control 804 1155 1793 646 17.95 of bleeding, any method
43229 Esophagoscopy, flexible, transoral; with 832 1195 1855 665 18.47 ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
43231 Esophagoscopy, flexible, transoral; with 603 867 1345 343 9.54 endoscopic ultrasound examination
43232 Esophagoscopy, flexible, transoral; with 862 1239 1923 416 11.56 transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)
43233 Esophagogastroduodenoscopy, flexible, 729 1047 1625 242 6.71 transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)
43235 Esophagogastroduodenoscopy, flexible, 646 928 1441 263 7.31 transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
43236 Esophagogastroduodenoscopy, flexible, 750 1078 1673 338 9.38 transoral; with directed submucosal injection(s), any substance
43237 Esophagogastroduodenoscopy, flexible, 668 959 1489 208 5.77 transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures
43238 Esophagogastroduodenoscopy, flexible, 837 1203 1867 246 6.84 transoral; with transendoscopic ultrasound- guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)
43239 Esophagogastroduodenoscopy, flexible, 803 1153 1790 352 9.78 transoral; with biopsy, single or multiple
43240 Esophagogastroduodenoscopy, flexible, 1171 1683 2612 415 11.53 transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when performed)
43241 Esophagogastroduodenoscopy, flexible, 605 869 1349 150 4.18 transoral; with insertion of intraluminal tube or catheter
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43242 Esophagogastroduodenoscopy, flexible, 1135 1631 2531 278 7.73 transoral; with transendoscopic ultrasound- guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis)
43243 Esophagogastroduodenoscopy, flexible, 783 1125 1747 251 6.97 transoral; with injection sclerosis of esophageal/gastric varices
43244 Esophagogastroduodenoscopy, flexible, 835 1200 1863 260 7.21 transoral; with band ligation of esophageal/gastric varices
43245 Esophagogastroduodenoscopy, flexible, 793 1140 1770 568 15.78 transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)
43246 Esophagogastroduodenoscopy, flexible, 800 1150 1785 212 5.88 transoral; with directed placement of percutaneous gastrostomy tube
43247 Esophagogastroduodenoscopy, flexible, 752 1081 1678 359 9.98 transoral; with removal of foreign body(s)
43248 Esophagogastroduodenoscopy, flexible, 773 1110 1723 359 9.98 transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire
43249 Esophagogastroduodenoscopy, flexible, 1146 1647 2556 1045 29.03 transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)
43250 Esophagogastroduodenoscopy, flexible, 950 1365 2119 409 11.35 transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
43251 Esophagogastroduodenoscopy, flexible, 912 1311 2035 453 12.58 transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
43252 Esophagogastroduodenoscopy, flexible, 998 1434 2225 311 8.65 transoral; with optical endomicroscopy
43253 Esophagogastroduodenoscopy, flexible, 782 1124 1744 278 7.73 transoral; with transendoscopic ultrasound- guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum
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or a surgically altered stomach where the jejunum is examined distal to the anastomosis)
43254 Esophagogastroduodenoscopy, flexible, 901 1295 2010 286 7.95 transoral; with endoscopic mucosal resection
43255 Esophagogastroduodenoscopy, flexible, 885 1272 1974 683 18.98 transoral; with control of bleeding, any method
43257 Esophagogastroduodenoscopy, flexible, 958 1377 2138 246 6.83 transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease
43259 Esophagogastroduodenoscopy, flexible, 900 1293 2008 239 6.65 transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis
43260 Endoscopic retrograde 993 1427 2215 342 9.49 cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
43261 Endoscopic retrograde 1074 1544 2396 359 9.97 cholangiopancreatography (ERCP); with biopsy, single or multiple
43262 Endoscopic retrograde 1280 1839 2855 378 10.50 cholangiopancreatography (ERCP); with sphincterotomy/papillotomy
43263 Endoscopic retrograde 1038 1491 2315 378 10.51 cholangiopancreatography (ERCP); with pressure measurement of sphincter of Oddi
43264 Endoscopic retrograde 1477 2123 3295 386 10.71 cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s)
43265 Endoscopic retrograde 1547 2223 3450 458 12.73 cholangiopancreatography (ERCP); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)
43266 Esophagogastroduodenoscopy, flexible, 731 1051 1631 231 6.41 transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)
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43270 Esophagogastroduodenoscopy, flexible, 1005 1444 2241 685 19.04 transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
43273 Endoscopic cannulation of papilla with direct 319 459 712 126 3.51 visualization of pancreatic/common bile duct(s) (list separately in addition to code(s) for primary procedure)
43274 Endoscopic retrograde 1367 1965 3050 490 13.61 cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent
43275 Endoscopic retrograde cholangiopancreato- 1139 1637 2541 399 11.08 graphy (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s)
43276 Endoscopic retrograde cholangiopancreato- 1489 2139 3320 510 14.17 graphy (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged
43277 Endoscopic retrograde cholangiopancreato- 1155 1660 2577 401 11.14 graphy (ERCP); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, each duct
43278 Endoscopic retrograde cholangiopancreato- 1300 1868 2900 459 12.74 graphy (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed
43279 Laparoscopy, surgical, esophagomyotomy 3451 4959 7697 1344 37.34 (Heller type), with fundoplasty, when performed
43280 Laparoscopy, surgical, esophagogastric 3060 4398 6826 1127 31.31 fundoplasty (eg, Nissen, Toupet procedures)
43281 Laparoscopy, surgical, repair of paraesophageal 4520 6496 10082 1610 44.72 hernia, includes fundoplasty, when performed; without implantation of mesh
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43282 Laparoscopy, surgical, repair of paraesophageal 4415 6344 9847 1810 50.29 hernia, includes fundoplasty, when performed; with implantation of mesh
43283 Laparoscopy, surgical, esophageal lengthening 448 644 999 166 4.60 procedure (eg, Collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)
43284 Laparoscopy, surgical, esophageal sphincter 1605 2307 3581 678 18.83 augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed
43285 Removal of esophageal sphincter augmentation 1576 2264 3514 649 18.04 device
43286 Esophagectomy, total or near total, with 7764 11156 17317 3278 91.06 laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy)
43287 Esophagectomy, distal two-thirds, with 8867 12742 19777 3744 104.00 laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic esophagogastrostomy (ie, laparoscopic thoracoscopic esophagectomy, Ivor Lewis esophagectomy)
43288 Esophagectomy, total or near total, with 9252 13294 20635 3906 108.51 thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngo- gastrostomy or esophagogastrostomy (ie, thoracoscopic, laparoscopic and cervical incision esophagectomy, McKeown esophagectomy, tri-incisional esophagectomy)
43289 Unlisted laparoscopy procedure, esophagus 0 0 0 0 0.00
43300 Esophagoplasty (plastic repair or 1252 2307 4603 630 17.50 reconstruction), cervical approach; without repair of tracheoesophageal fistula
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43305 Esophagoplasty (plastic repair or 2229 4107 8193 1118 31.05 reconstruction), cervical approach; with repair of tracheoesophageal fistula
43310 Esophagoplasty (plastic repair or 3026 5576 11124 1547 42.97 reconstruction), thoracic approach; without repair of tracheoesophageal fistula
43312 Esophagoplasty (plastic repair or 3289 6061 12092 1666 46.28 reconstruction), thoracic approach; with repair of tracheoesophageal fistula
43313 Esophagoplasty for congenital defect (plastic 5492 10119 20188 2849 79.13 repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula
43314 Esophagoplasty for congenital defect (plastic 5787 10663 21274 3066 85.18 repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula
43320 Esophagogastrostomy (cardioplasty), with or 2825 5205 10384 1457 40.47 without vagotomy and pyloroplasty, transabdominal or transthoracic approach
43325 Esophagogastric fundoplasty, with fundic patch 3124 5757 11485 1417 39.37 (Thal-Nissen procedure)
43327 Esophagogastric fundoplasty partial or 2416 4452 8882 857 23.80 complete; laparotomy
43328 Esophagogastric fundoplasty partial or 2308 4252 8484 1177 32.69 complete; thoracotomy
43330 Esophagomyotomy (Heller type); abdominal 2696 4967 9909 1394 38.71 approach
43331 Esophagomyotomy (Heller type); thoracic 2734 5038 10050 1399 38.85 approach
43332 Repair, paraesophageal hiatal hernia (including 3081 5678 11328 1210 33.60 fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis
43333 Repair, paraesophageal hiatal hernia (including 3373 6215 12399 1318 36.61 fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis
43334 Repair, paraesophageal hiatal hernia (including 2548 4695 9367 1303 36.19 fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis
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43335 Repair, paraesophageal hiatal hernia (including 2731 5033 10040 1398 38.83 fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis
43336 Repair, paraesophageal hiatal hernia, (including 3074 5663 11299 1569 43.58 fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis
43337 Repair, paraesophageal hiatal hernia, (including 3303 6087 12143 1616 44.88 fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis
43338 Esophageal lengthening procedure (eg, Collis 237 436 871 121 3.37 gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)
43340 Esophagojejunostomy (without total 2767 5098 10171 1439 39.97 gastrectomy); abdominal approach
43341 Esophagojejunostomy (without total 2860 5270 10513 1461 40.58 gastrectomy); thoracic approach
43351 Esophagostomy, fistulization of esophagus, 2618 4824 9624 1371 38.08 external; thoracic approach
43352 Esophagostomy, fistulization of esophagus, 2175 4008 7996 1112 30.88 external; cervical approach
43360 Gastrointestinal reconstruction for previous 4807 8858 17671 2351 65.32 esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty
43361 Gastrointestinal reconstruction for previous 5197 9576 19104 2811 78.09 esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)
43400 Ligation, direct, esophageal varices 3011 5549 11070 1589 44.13
43401 Transection of esophagus with repair, for 3163 5828 11628 1640 45.56 esophageal varices
43405 Ligation or stapling at gastroesophageal 2969 5472 10916 1517 42.14 junction for pre-existing esophageal perforation
43410 Suture of esophageal wound or injury; cervical 2134 3932 7844 1054 29.27 approach
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43415 Suture of esophageal wound or injury; 5262 9696 19344 2693 74.82 transthoracic or transabdominal approach
43420 Closure of esophagostomy or fistula; cervical 2063 3802 7585 1042 28.95 approach
43425 Closure of esophagostomy or fistula; 2928 5394 10762 1506 41.82 transthoracic or transabdominal approach
43450 Dilation of esophagus, by unguided sound or 328 604 1204 161 4.48 bougie, single or multiple passes
43453 Dilation of esophagus, over guide wire 1026 1891 3772 936 25.99
43460 Esophagogastric tamponade, with balloon 437 805 1605 226 6.27 (Sengstaken type)
43496 Free jejunum transfer with microvascular 3964 7303 14570 0 0.00 anastomosis
43499 Unlisted procedure, esophagus 0 0 0 0 0.00
STOMACH
43500 Gastrotomy; with exploration or foreign body 1953 3057 5186 818 22.71 removal
43501 Gastrotomy; with suture repair of bleeding ulcer 3052 4777 8103 1401 38.93
43502 Gastrotomy; with suture repair of pre-existing 4843 7580 12857 1592 44.22 esophagogastric laceration (eg, Mallory-Weiss)
43510 Gastrotomy; with esophageal dilation and 3000 4695 7964 986 27.39 insertion of permanent intraluminal tube (eg, celestin or Mousseau-Barbin)
43520 Pyloromyotomy, cutting of pyloric muscle 2231 3492 5924 712 19.78 (Fredet-Ramstedt type operation)
43605 Biopsy of stomach, by laparotomy 2503 3918 6646 872 24.22
43610 Excision, local; ulcer or benign tumor of 2512 3931 6668 1020 28.33 stomach
43611 Excision, local; malignant tumor of stomach 3335 5220 8855 1277 35.46
43620 Gastrectomy, total; with esophagoenterostomy 6270 9814 16646 2061 57.25
43621 Gastrectomy, total; with roux-en-y 6293 9849 16706 2367 65.75 reconstruction
43622 Gastrectomy, total; with formation of intestinal 7345 11497 19501 2414 67.07 pouch, any type
43631 Gastrectomy, partial, distal; with 3672 5747 9748 1511 41.96 gastroduodenostomy
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43632 Gastrectomy, partial, distal; with 4746 7428 12600 2120 58.88 gastrojejunostomy
43633 Gastrectomy, partial, distal; with roux-en-y 4720 7387 12530 2004 55.66 reconstruction
43634 Gastrectomy, partial, distal; with formation of 6756 10575 17936 2221 61.69 intestinal pouch
43635 Vagotomy when performed with partial distal 334 523 887 118 3.28 gastrectomy (list separately in addition to code[s] for primary procedure)
43640 Vagotomy including pyloroplasty, with or 3739 5852 9926 1229 34.14 without gastrostomy; truncal or selective
43641 Vagotomy including pyloroplasty, with or 3818 5976 10136 1255 34.86 without gastrostomy; parietal cell (highly selective)
43644 Laparoscopy, surgical, gastric restrictive 5355 8381 14216 1805 50.15 procedure; with gastric bypass and roux-en-y gastroenterostomy (roux limb 150 cm or less)
43645 Laparoscopy, surgical, gastric restrictive 5728 8965 15207 1923 53.41 procedure; with gastric bypass and small intestine reconstruction to limit absorption
43647 Laparoscopy, surgical; implantation or 2009 3145 5334 0 0.00 replacement of gastric neurostimulator electrodes, antrum
43648 Laparoscopy, surgical; revision or removal of 2021 3164 5367 0 0.00 gastric neurostimulator electrodes, antrum
43651 Laparoscopy, surgical; transection of vagus 2075 3248 5510 682 18.95 nerves, truncal
43652 Laparoscopy, surgical; transection of vagus 2425 3795 6437 797 22.14 nerves, selective or highly selective
43653 Laparoscopy, surgical; gastrostomy, without 1869 2926 4963 597 16.58 construction of gastric tube (eg, Stamm procedure) (separate procedure)
43659 Unlisted laparoscopy procedure, stomach 0 0 0 0 0.00
43752 Naso- or oro-gastric tube placement, requiring 140 220 372 42 1.18 physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)
43753 Gastric intubation and aspiration(s) therapeutic, 73 115 195 23 0.63 necessitating physician's skill (eg, for
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gastrointestinal hemorrhage), including lavage if performed
43754 Gastric intubation and aspiration, diagnostic; 297 465 789 138 3.83 single specimen (eg, acid analysis)
43755 Gastric intubation and aspiration, diagnostic; 429 672 1140 141 3.92 collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium, secretin), includes drug admin
43756 Duodenal intubation and aspiration, diagnostic, 647 1013 1718 213 5.91 includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture)
43757 Duodenal intubation and aspiration, diagnostic, 917 1435 2434 301 8.37 includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug admin
43760 Change of gastrostomy tube, percutaneous, 517 809 1373 508 14.10 without imaging or endoscopic guidance
43761 Repositioning of a naso- or oro-gastric feeding 320 501 850 121 3.37 tube, through the duodenum for enteric nutrition
43770 Laparoscopy, surgical, gastric restrictive 3477 5442 9230 1168 32.45 procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components)
43771 Laparoscopy, surgical, gastric restrictive 3747 5864 9947 1330 36.94 procedure; revision of adjustable gastric restrictive device component only
43772 Laparoscopy, surgical, gastric restrictive 2324 3637 6169 994 27.62 procedure; removal of adjustable gastric restrictive device component only
43773 Laparoscopy, surgical, gastric restrictive 4267 6679 11328 1333 37.03 procedure; removal and replacement of adjustable gastric restrictive device component only
43774 Laparoscopy, surgical, gastric restrictive 3001 4696 7966 1000 27.79 procedure; removal of adjustable gastric restrictive device and subcutaneous port components
43775 Laparoscopy, surgical, gastric restrictive 4521 7076 12002 1164 32.33 procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)
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43800 Pyloroplasty 2308 3613 6128 968 26.89
43810 Gastroduodenostomy 3232 5058 8580 1062 29.51
43820 Gastrojejunostomy; without vagotomy 3264 5108 8664 1400 38.89
43825 Gastrojejunostomy; with vagotomy, any type 4156 6505 11034 1366 37.95
43830 Gastrostomy, open; without construction of 1865 2920 4952 729 20.24 gastric tube (eg, Stamm procedure) (separate procedure)
43831 Gastrostomy, open; neonatal, for feeding 2073 3245 5503 619 17.20
43832 Gastrostomy, open; with construction of gastric 2687 4206 7135 1080 29.99 tube (eg, Janeway procedure)
43840 Gastrorrhaphy, suture of perforated duodenal or 3148 4927 8357 1417 39.37 gastric ulcer, wound, or injury
43842 Gastric restrictive procedure, without gastric 3785 5924 10048 1244 34.56 bypass, for morbid obesity; vertical-banded gastroplasty
43843 Gastric restrictive procedure, without gastric 4065 6363 10793 1336 37.12 bypass, for morbid obesity; other than vertical- banded gastroplasty
43845 Gastric restrictive procedure with partial 6901 10802 18322 2052 57.00 gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)
43846 Gastric restrictive procedure, with gastric 5032 7877 13360 1687 46.87 bypass for morbid obesity; with short limb (150 cm or less) roux-en-y gastroenterostomy
43847 Gastric restrictive procedure, with gastric 5724 8960 15198 1882 52.27 bypass for morbid obesity; with small intestine reconstruction to limit absorption
43848 Revision, open, of gastric restrictive procedure 6186 9682 16422 2007 55.75 for morbid obesity, other than adjustable gastric restrictive device (separate procedure)
43850 Revision of gastroduodenal anastomosis 5173 8096 13732 1700 47.23 (gastroduodenostomy) with reconstruction; without vagotomy
43855 Revision of gastroduodenal anastomosis 5365 8398 14244 1764 48.99 (gastroduodenostomy) with reconstruction; with vagotomy
43860 Revision of gastrojejunal anastomosis 4368 6837 11597 1707 47.41 (gastrojejunostomy) with reconstruction, with
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or without partial gastrectomy or intestine resection; without vagotomy
43865 Revision of gastrojejunal anastomosis 5430 8499 14415 1785 49.58 (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy
43870 Closure of gastrostomy, surgical 2189 3426 5812 740 20.55
43880 Closure of gastrocolic fistula 5070 7935 13459 1666 46.29
43881 Implantation or replacement of gastric 2196 3436 5829 0 0.00 neurostimulator electrodes, antrum, open
43882 Revision or removal of gastric neurostimulator 2707 4237 7186 0 0.00 electrodes, antrum, open
43886 Gastric restrictive procedure, open; revision of 1149 1798 3050 378 10.49 subcutaneous port component only
43887 Gastric restrictive procedure, open; removal of 1036 1622 2751 341 9.46 subcutaneous port component only
43888 Gastric restrictive procedure, open; removal and 1453 2275 3858 481 13.35 replacement of subcutaneous port component only
43999 Unlisted procedure, stomach 0 0 0 0 0.00
INTESTINES (EXCEPT RECTUM)
44005 Enterolysis (freeing of intestinal adhesion) 2628 3367 4739 1142 31.73 (separate procedure)
44010 Duodenotomy, for exploration, biopsy(s), or 2156 2762 3887 897 24.91 foreign body removal
44015 Tube or needle catheter jejunostomy for enteral 447 573 807 149 4.13 alimentation, intraoperative, any method (list separately in addition to primary procedure)
44020 Enterotomy, small intestine, other than 2501 3204 4509 1014 28.17 duodenum; for exploration, biopsy(s), or foreign body removal
44021 Enterotomy, small intestine, other than 2268 2905 4089 1016 28.21 duodenum; for decompression (eg, baker tube)
44025 Colotomy, for exploration, biopsy(s), or foreign 2588 3316 4667 1024 28.45 body removal
44050 Reduction of volvulus, intussusception, internal 2460 3151 4435 974 27.05 hernia, by laparotomy
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44055 Correction of malrotation by lysis of duodenal 4128 5288 7443 1554 43.18 bands and/or reduction of midgut volvulus (eg, Ladd procedure)
44100 Biopsy of intestine by capsule, tube, peroral (1 252 323 454 114 3.16 or more specimens)
44110 Excision of 1 or more lesions of small or large 2369 3035 4272 886 24.61 intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy
44111 Excision of 1 or more lesions of small or large 2510 3215 4525 1023 28.43 intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies
44120 Enterectomy, resection of small intestine; single 3139 4022 5661 1277 35.47 resection and anastomosis
44121 Enterectomy, resection of small intestine; each 746 956 1345 253 7.03 additional resection and anastomosis (list separately in addition to code for primary procedure)
44125 Enterectomy, resection of small intestine; with 3389 4342 6111 1230 34.18 enterostomy
44126 Enterectomy, resection of small intestine for 7721 9892 13922 2574 71.51 congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering
44127 Enterectomy, resection of small intestine for 7299 9351 13162 2977 82.69 congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering
44128 Enterectomy, resection of small intestine for 626 802 1128 255 7.09 congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)
44130 Enteroenterostomy, anastomosis of intestine, 3376 4325 6087 1369 38.03 with or without cutaneous enterostomy (separate procedure)
44132 Donor enterectomy (including cold 0 0 0 0 0.00 preservation), open; from cadaver donor
44133 Donor enterectomy (including cold 0 0 0 0 0.00 preservation), open; partial, from living donor
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44135 Intestinal allotransplantation; from cadaver 0 0 0 0 0.00 donor
44136 Intestinal allotransplantation; from living donor 0 0 0 0 0.00
44137 Removal of transplanted intestinal allograft, 3135 4017 5653 0 0.00 complete
44139 Mobilization (take-down) of splenic flexure 359 460 647 127 3.53 performed in conjunction with partial colectomy (list separately in addition to primary procedure)
44140 Colectomy, partial; with anastomosis 3295 4221 5941 1399 38.87
44141 Colectomy, partial; with skin level cecostomy 4042 5179 7288 1905 52.93 or colostomy
44143 Colectomy, partial; with end colostomy and 3936 5043 7098 1737 48.25 closure of distal segment (Hartmann type procedure)
44144 Colectomy, partial; with resection, with 4197 5377 7567 1846 51.27 colostomy or ileostomy and creation of mucofistula
44145 Colectomy, partial; with coloproctostomy (low 4165 5336 7510 1729 48.04 pelvic anastomosis)
44146 Colectomy, partial; with coloproctostomy (low 4865 6233 8773 2212 61.44 pelvic anastomosis), with colostomy
44147 Colectomy, partial; abdominal and transanal 4447 5697 8018 2026 56.27 approach
44150 Colectomy, total, abdominal, without 4541 5818 8188 1951 54.19 proctectomy; with ileostomy or ileoproctostomy
44151 Colectomy, total, abdominal, without 5529 7084 9970 2255 62.64 proctectomy; with continent ileostomy
44155 Colectomy, total, abdominal, with proctectomy; 5218 6685 9409 2172 60.34 with ileostomy
44156 Colectomy, total, abdominal, with proctectomy; 5923 7588 10680 2416 67.10 with continent ileostomy
44157 Colectomy, total, abdominal, with proctectomy; 5613 7191 10121 2289 63.59 with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed
44158 Colectomy, total, abdominal, with proctectomy; 5756 7375 10379 2348 65.21 with ileoanal anastomosis, creation of ileal
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reservoir (s or j), includes loop ileostomy, and rectal mucosectomy, when performed
44160 Colectomy, partial, with removal of terminal 3229 4137 5823 1295 35.98 ileum with ileocolostomy
44180 Laparoscopy, surgical, enterolysis (freeing of 2360 3024 4256 959 26.63 intestinal adhesion) (separate procedure)
44186 Laparoscopy, surgical; jejunostomy (eg, for 1804 2312 3254 678 18.82 decompression or feeding)
44187 Laparoscopy, surgical; ileostomy or 2947 3775 5313 1152 31.99 jejunostomy, non-tube
44188 Laparoscopy, surgical, colostomy or skin level 3027 3878 5457 1279 35.53 cecostomy
44202 Laparoscopy, surgical; enterectomy, resection 3695 4734 6663 1444 40.12 of small intestine, single resection and anastomosis
44203 Laparoscopy, surgical; each additional small 773 990 1393 256 7.10 intestine resection and anastomosis (list separately in addition to code for primary procedure)
44204 Laparoscopy, surgical; colectomy, partial, with 3785 4850 6825 1605 44.59 anastomosis
44205 Laparoscopy, surgical; colectomy, partial, with 3383 4334 6099 1396 38.77 removal of terminal ileum with ileocolostomy
44206 Laparoscopy, surgical; colectomy, partial, with 4003 5128 7217 1827 50.76 end colostomy and closure of distal segment (Hartmann type procedure)
44207 Laparoscopy, surgical; colectomy, partial, with 4561 5843 8223 1899 52.76 anastomosis, with coloproctostomy (low pelvic anastomosis)
44208 Laparoscopy, surgical; colectomy, partial, with 5076 6503 9152 2072 57.56 anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy
44210 Laparoscopy, surgical; colectomy, total, 4904 6283 8843 1859 51.65 abdominal, without proctectomy, with ileostomy or ileoproctostomy
44211 Laparoscopy, surgical; colectomy, total, 6432 8241 11598 2233 62.02 abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (s or j), with loop ileostomy, includes rectal mucosectomy, when performed
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44212 Laparoscopy, surgical; colectomy, total, 5555 7117 10017 2134 59.27 abdominal, with proctectomy, with ileostomy
44213 Laparoscopy, surgical, mobilization (take- 514 659 927 197 5.47 down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)
44227 Laparoscopy, surgical, closure of enterostomy, 4045 5182 7293 1737 48.26 large or small intestine, with resection and anastomosis
44238 Unlisted laparoscopy procedure, intestine 0 0 0 0 0.00 (except rectum)
44300 Placement, enterostomy or cecostomy, tube 2007 2571 3619 878 24.40 open (eg, for feeding or decompression) (separate procedure)
44310 Ileostomy or jejunostomy, non-tube 2629 3368 4741 1089 30.26
44312 Revision of ileostomy; simple (release of 1487 1906 2682 617 17.13 superficial scar) (separate procedure)
44314 Revision of ileostomy; complicated 2608 3341 4702 1048 29.11 (reconstruction in-depth) (separate procedure)
44316 Continent ileostomy (Kock procedure) (separate 3619 4637 6526 1476 41.00 procedure)
44320 Colostomy or skin level cecostomy; 2864 3669 5163 1253 34.81
44322 Colostomy or skin level cecostomy; with 2559 3278 4614 1044 28.99 multiple biopsies (eg, for congenital megacolon) (separate procedure)
44340 Revision of colostomy; simple (release of 1517 1944 2736 650 18.05 superficial scar) (separate procedure)
44345 Revision of colostomy; complicated 2466 3160 4447 1097 30.48 (reconstruction in-depth) (separate procedure)
44346 Revision of colostomy; with repair of 2797 3583 5043 1235 34.30 paracolostomy hernia (separate procedure)
44360 Small intestinal endoscopy, enteroscopy beyond 598 834 1371 152 4.22 second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
44361 Small intestinal endoscopy, enteroscopy beyond 808 1126 1852 168 4.66 second portion of duodenum, not including ileum; with biopsy, single or multiple
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
44363 Small intestinal endoscopy, enteroscopy beyond 691 963 1583 203 5.65 second portion of duodenum, not including ileum; with removal of foreign body(s)
44364 Small intestinal endoscopy, enteroscopy beyond 943 1314 2160 217 6.02 second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
44365 Small intestinal endoscopy, enteroscopy beyond 1272 1772 2914 192 5.33 second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery
44366 Small intestinal endoscopy, enteroscopy beyond 840 1170 1923 254 7.06 second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
44369 Small intestinal endoscopy, enteroscopy beyond 819 1141 1876 260 7.22 second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
44370 Small intestinal endoscopy, enteroscopy beyond 851 1186 1949 282 7.83 second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation)
44372 Small intestinal endoscopy, enteroscopy beyond 828 1154 1897 254 7.05 second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube
44373 Small intestinal endoscopy, enteroscopy beyond 760 1059 1742 203 5.65 second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube
44376 Small intestinal endoscopy, enteroscopy beyond 642 894 1470 301 8.36 second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
44377 Small intestinal endoscopy, enteroscopy beyond 1536 2140 3518 317 8.81 second portion of duodenum, including ileum; with biopsy, single or multiple
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44378 Small intestinal endoscopy, enteroscopy beyond 1247 1737 2856 407 11.31 second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
44379 Small intestinal endoscopy, enteroscopy beyond 1307 1822 2995 433 12.03 second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation)
44380 Ileoscopy, through stoma; diagnostic, including 347 483 794 173 4.80 collection of specimen(s) by brushing or washing, when performed (separate procedure)
44381 Ileoscopy, through stoma; with transendoscopic 2860 3985 6552 948 26.32 balloon dilation
44382 Ileoscopy, through stoma; with biopsy, single or 597 833 1369 271 7.54 multiple
44384 Ileoscopy, through stoma; with placement of 488 680 1118 162 4.49 endoscopic stent (includes pre- and post- dilation and guide wire passage, when performed)
44385 Endoscopic evaluation of small intestinal pouch 600 836 1375 197 5.48 (eg, Kock pouch, ileal reservoir [s or j]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
44386 Endoscopic evaluation of small intestinal pouch 819 1142 1877 294 8.16 (eg, Kock pouch, ileal reservoir [s or j]); with biopsy, single or multiple
44388 Colonoscopy through stoma; diagnostic, 791 1103 1813 297 8.25 including collection of specimen(s) by brushing or washing, when performed (separate procedure)
44388-53 0 0 0 148 4.10
44389 Colonoscopy through stoma; with biopsy, single 901 1256 2064 390 10.83 or multiple
44390 Colonoscopy through stoma; with removal of 1168 1628 2676 387 10.75 foreign body(s)
44391 Colonoscopy through stoma; with control of 1035 1442 2370 712 19.79 bleeding, any method
44392 Colonoscopy through stoma; with removal of 940 1310 2154 362 10.05 tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
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44394 Colonoscopy through stoma; with removal of 1077 1501 2468 415 11.54 tumor(s), polyp(s), or other lesion(s) by snare technique
44401 Colonoscopy through stoma; with ablation of 9891 13782 22659 3277 91.02 tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)
44402 Colonoscopy through stoma; with endoscopic 837 1166 1917 277 7.70 stent placement (including pre- and post- dilation and guide wire passage, when performed)
44403 Colonoscopy through stoma; with endoscopic 971 1354 2226 322 8.94 mucosal resection
44404 Colonoscopy through stoma; with directed 1073 1496 2459 373 10.37 submucosal injection(s), any substance
44405 Colonoscopy through stoma; with 1665 2320 3814 552 15.32 transendoscopic balloon dilation
44406 Colonoscopy through stoma; with endoscopic 735 1024 1683 243 6.76 ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures
44407 Colonoscopy through stoma; with 881 1228 2019 292 8.11 transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures
44408 Colonoscopy through stoma; with 741 1033 1698 246 6.82 decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed
44500 Introduction of long gastrointestinal tube (eg, 78 109 179 20 0.56 miller-Abbott) (separate procedure)
44602 Suture of small intestine (enterorrhaphy) for 3254 4535 7455 1472 40.90 perforated ulcer, diverticulum, wound, injury or rupture; single perforation
44603 Suture of small intestine (enterorrhaphy) for 3827 5332 8767 1691 46.97 perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations
44604 Suture of large intestine (colorrhaphy) for 2787 3883 6384 1104 30.67 perforated ulcer, diverticulum, wound, injury or
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rupture (single or multiple perforations); without colostomy
44605 Suture of large intestine (colorrhaphy) for 4105 5721 9405 1360 37.78 perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy
44615 Intestinal stricturoplasty (enterotomy and 3015 4201 6907 1121 31.15 enterorrhaphy) with or without dilation, for intestinal obstruction
44620 Closure of enterostomy, large or small intestine; 2153 3000 4933 905 25.14
44625 Closure of enterostomy, large or small intestine; 2812 3918 6442 1061 29.46 with resection and anastomosis other than colorectal
44626 Closure of enterostomy, large or small intestine; 3879 5405 8886 1671 46.43 with resection and colorectal anastomosis (eg, closure of Hartmann type procedure)
44640 Closure of intestinal cutaneous fistula 3552 4949 8137 1462 40.60
44650 Closure of enteroenteric or enterocolic fistula 3809 5307 8726 1508 41.88
44660 Closure of enterovesical fistula; without 2915 4061 6677 1394 38.71 intestinal or bladder resection
44661 Closure of enterovesical fistula; with intestine 3887 5417 8906 1619 44.96 and/or bladder resection
44680 Intestinal plication (separate procedure) 3340 4655 7652 1107 30.74
44700 Exclusion of small intestine from pelvis by 2242 3124 5137 1054 29.29 mesh or other prosthesis, or native tissue (eg, bladder or omentum)
44701 Intraoperative colonic lavage (list separately in 369 514 845 179 4.96 addition to code for primary procedure)
44705 Preparation of fecal microbiota for instillation, 347 484 796 118 3.27 including assessment of donor specimen
44715 Backbench standard preparation of cadaver or 1048 1461 2402 0 0.00 living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein
44720 Backbench reconstruction of cadaver or living 925 1290 2120 288 7.99 donor intestine allograft prior to transplantation; venous anastomosis, each
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
44721 Backbench reconstruction of cadaver or living 1215 1693 2783 402 11.18 donor intestine allograft prior to transplantation; arterial anastomosis, each
44799 Unlisted procedure, small intestine 0 0 0 0 0.00
MECKEL’S DIVERTICULUM AND THE MESENTERY
44800 Excision of Meckel's diverticulum 2071 2886 4745 796 22.10 (diverticulectomy) or omphalomesenteric duct
44820 Excision of lesion of mesentery (separate 2661 3708 6097 882 24.49 procedure)
44850 Suture of mesentery (separate procedure) 2687 3744 6155 780 21.67
44899 Unlisted procedure, Meckel's diverticulum and 0 0 0 0 0.00 the mesentery
APPENDIX
44900 Incision and drainage of appendiceal abscess, 2330 3247 5339 808 22.45 open
44950 Appendectomy; 1715 2390 3930 669 18.58
44955 Appendectomy; when done for indicated 264 368 605 88 2.44 purpose at time of other major procedure (not as separate procedure) (list separately in addition to code for primary procedure)
44960 Appendectomy; for ruptured appendix with 2333 3251 5345 911 25.31 abscess or generalized peritonitis
44970 Laparoscopy, surgical, appendectomy 1660 2313 3803 626 17.40
44979 Unlisted laparoscopy procedure, appendix 0 0 0 0 0.00
COLON AND RECTUM
45000 Transrectal drainage of pelvic abscess 1125 1538 2265 444 12.33
45005 Incision and drainage of submucosal abscess, 541 739 1089 285 7.93 rectum
45020 Incision and drainage of deep supralevator, 1233 1686 2483 599 16.63 pelvirectal, or retrorectal abscess
45100 Biopsy of anorectal wall, anal approach (eg, 873 1193 1757 312 8.66 congenital megacolon)
45108 Anorectal myomectomy 993 1357 1999 385 10.69
45110 Proctectomy; complete, combined 4889 6682 9843 1926 53.49 abdominoperineal, with colostomy
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45111 Proctectomy; partial resection of rectum, 3142 4295 6327 1132 31.45 transabdominal approach
45112 Proctectomy, combined abdominoperineal, pull- 5083 6948 10234 1952 54.23 through procedure (eg, colo-anal anastomosis)
45113 Proctectomy, partial, with rectal mucosectomy, 5695 7784 11467 1982 55.06 ileoanal anastomosis, creation of ileal reservoir (s or j), with or without loop ileostomy
45114 Proctectomy, partial, with anastomosis; 4896 6692 9858 1898 52.72 abdominal and transsacral approach
45116 Proctectomy, partial, with anastomosis; 4212 5756 8479 1631 45.31 transsacral approach only (Kraske type)
45119 Proctectomy, combined abdominoperineal pull- 5133 7016 10334 1990 55.27 through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy when performed
45120 Proctectomy, complete (for congenital 4284 5856 8625 1661 46.13 megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, Swenson, Duhamel, or soave type operation)
45121 Proctectomy, complete (for congenital 4682 6399 9426 1815 50.41 megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies
45123 Proctectomy, partial, without anastomosis, 3005 4107 6050 1171 32.53 perineal approach
45126 Pelvic exenteration for colorectal malignancy, 7383 10091 14865 2862 79.50 with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof
45130 Excision of rectal procidentia, with 2676 3657 5387 1136 31.55 anastomosis; perineal approach
45135 Excision of rectal procidentia, with 3556 4860 7159 1362 37.84 anastomosis; abdominal and perineal approach
45136 Excision of ileoanal reservoir with ileostomy 4885 6677 9835 1894 52.60
45150 Division of stricture of rectum 1095 1497 2205 432 12.00
45160 Excision of rectal tumor by proctotomy, 2751 3760 5538 1066 29.62 transsacral or transcoccygeal approach
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45171 Excision of rectal tumor, transanal approach; 1613 2204 3247 627 17.41 not including muscularis propria (ie, partial thickness)
45172 Excision of rectal tumor, transanal approach; 2249 3074 4529 847 23.53 including muscularis propria (ie, full thickness)
45190 Destruction of rectal tumor (eg, electro- 3001 4101 6042 724 20.12 desiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach
45300 Proctosigmoidoscopy, rigid; diagnostic, with or 243 332 489 129 3.58 without collection of specimen(s) by brushing or washing (separate procedure)
45303 Proctosigmoidoscopy, rigid; with dilation (eg, 1763 2410 3551 925 25.70 balloon, guide wire, bougie)
45305 Proctosigmoidoscopy, rigid; with biopsy, single 380 519 765 148 4.11 or multiple
45307 Proctosigmoidoscopy, rigid; with removal of 449 614 905 171 4.75 foreign body
45308 Proctosigmoidoscopy, rigid; with removal of 428 585 862 166 4.61 single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery
45309 Proctosigmoidoscopy, rigid; with removal of 445 608 896 172 4.79 single tumor, polyp, or other lesion by snare technique
45315 Proctosigmoidoscopy, rigid; with removal of 492 673 991 191 5.30 multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique
45317 Proctosigmoidoscopy, rigid; with control of 632 864 1273 189 5.26 bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
45320 Proctosigmoidoscopy, rigid; with ablation of 477 652 961 185 5.14 tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser)
45321 Proctosigmoidoscopy, rigid; with 278 380 559 108 2.99 decompression of volvulus
45327 Proctosigmoidoscopy, rigid; with 317 433 638 123 3.41 transendoscopic stent placement (includes predilation)
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45330 Sigmoidoscopy, flexible; diagnostic, including 302 413 608 173 4.81 collection of specimen(s) by brushing or washing, when performed (separate procedure)
45331 Sigmoidoscopy, flexible; with biopsy, single or 408 557 821 265 7.36 multiple
45332 Sigmoidoscopy, flexible; with removal of 525 717 1056 259 7.19 foreign body(s)
45333 Sigmoidoscopy, flexible; with removal of 591 807 1189 302 8.40 tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
45334 Sigmoidoscopy, flexible; with control of 684 935 1377 567 15.74 bleeding, any method
45335 Sigmoidoscopy, flexible; with directed 508 694 1023 241 6.69 submucosal injection(s), any substance
45337 Sigmoidoscopy, flexible; with decompression 444 607 894 122 3.38 (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed
45338 Sigmoidoscopy, flexible; with removal of 665 909 1339 276 7.68 tumor(s), polyp(s), or other lesion(s) by snare technique
45340 Sigmoidoscopy, flexible; with transendoscopic 743 1016 1496 444 12.34 balloon dilation
45341 Sigmoidoscopy, flexible; with endoscopic 502 686 1010 130 3.62 ultrasound examination
45342 Sigmoidoscopy, flexible; with transendoscopic 717 981 1444 180 4.99 ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)
45346 Sigmoidoscopy, flexible; with ablation of 3499 4783 7045 3149 87.47 tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
45347 Sigmoidoscopy, flexible; with placement of 532 726 1070 163 4.53 endoscopic stent (includes pre- and post- dilation and guide wire passage, when performed)
45349 Sigmoidoscopy, flexible; with endoscopic 645 882 1299 211 5.85 mucosal resection
45350 Sigmoidoscopy, flexible; with band ligation(s) 745 1018 1500 542 15.06 (eg, hemorrhoids)
CPT copyright 2017 American Medical Association. 317 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
45378 Colonoscopy, flexible; diagnostic, including 900 1230 1812 325 9.02 collection of specimen(s) by brushing or washing, when performed (separate procedure)
45378-53 0 0 0 163 4.52
45379 Colonoscopy, flexible; with removal of foreign 1067 1458 2148 419 11.63 body(s)
45380 Colonoscopy, flexible; with biopsy, single or 1046 1430 2106 416 11.55 multiple
45381 Colonoscopy, flexible; with directed 1015 1388 2044 398 11.05 submucosal injection(s), any substance
45382 Colonoscopy, flexible; with control of bleeding, 1164 1591 2344 741 20.57 any method
45384 Colonoscopy, flexible; with removal of 1113 1522 2241 462 12.83 tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
45385 Colonoscopy, flexible; with removal of 1205 1646 2425 437 12.13 tumor(s), polyp(s), or other lesion(s) by snare technique
45386 Colonoscopy, flexible; with transendoscopic 1257 1718 2531 601 16.69 balloon dilation
45388 Colonoscopy, flexible; with ablation of 3675 5024 7400 3303 91.76 tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
45389 Colonoscopy, flexible; with endoscopic stent 1032 1410 2077 307 8.53 placement (includes pre- and post-dilation and guide wire passage, when performed)
45390 Colonoscopy, flexible; with endoscopic 1214 1660 2445 352 9.79 mucosal resection
45391 Colonoscopy, flexible; with endoscopic 980 1340 1973 273 7.58 ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures
45392 Colonoscopy, flexible; with transendoscopic 879 1202 1770 322 8.95 ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures
45393 Colonoscopy, flexible; with decompression (for 871 1190 1754 267 7.43 pathologic distention) (eg, volvulus,
318 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
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megacolon), including placement of decompression tube, when performed
45395 Laparoscopy, surgical; proctectomy, complete, 5049 6901 10166 2063 57.30 combined abdominoperineal, with colostomy
45397 Laparoscopy, surgical; proctectomy, combined 5663 7740 11401 2247 62.42 abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy, when performed
45398 Colonoscopy, flexible; with band ligation(s) 1264 1728 2545 702 19.50 (eg, hemorrhoids)
45399 Unlisted procedure, colon 0 0 0 0 0.00
45400 Laparoscopy, surgical; proctopexy (for 2820 3854 5678 1191 33.08 prolapse)
45402 Laparoscopy, surgical; proctopexy (for 3454 4721 6954 1585 44.03 prolapse), with sigmoid resection
45499 Unlisted laparoscopy procedure, rectum 0 0 0 0 0.00
45500 Proctoplasty; for stenosis 1487 2032 2994 576 16.01
45505 Proctoplasty; for prolapse of mucous membrane 1621 2216 3264 616 17.12
45520 Perirectal injection of sclerosing solution for 201 275 405 161 4.47 prolapse
45540 Proctopexy (eg, for prolapse); abdominal 2629 3593 5293 1102 30.61 approach
45541 Proctopexy (eg, for prolapse); perineal approach 2500 3417 5034 981 27.25
45550 Proctopexy (eg, for prolapse); with sigmoid 3326 4546 6696 1522 42.27 resection, abdominal approach
45560 Repair of rectocele (separate procedure) 1650 2255 3321 713 19.80
45562 Exploration, repair, and presacral drainage for 2997 4096 6034 1162 32.27 rectal injury;
45563 Exploration, repair, and presacral drainage for 4439 6067 8938 1721 47.80 rectal injury; with colostomy
45800 Closure of rectovesical fistula; 3353 4582 6750 1300 36.10
45805 Closure of rectovesical fistula; with colostomy 3937 5381 7926 1526 42.39
45820 Closure of rectourethral fistula; 3402 4650 6849 1319 36.63
45825 Closure of rectourethral fistula; with colostomy 4109 5617 8274 1593 44.25
CPT copyright 2017 American Medical Association. 319 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
45900 Reduction of procidentia (separate procedure) 567 774 1141 220 6.10 under anesthesia
45905 Dilation of anal sphincter (separate procedure) 500 683 1007 176 4.89 under anesthesia other than local
45910 Dilation of rectal stricture (separate procedure) 623 851 1254 201 5.59 under anesthesia other than local
45915 Removal of fecal impaction or foreign body 702 959 1413 346 9.60 (separate procedure) under anesthesia
45990 Anorectal exam, surgical, requiring anesthesia 300 410 604 112 3.10 (general, spinal, or epidural), diagnostic
45999 Unlisted procedure, rectum 0 0 0 0 0.00
ANUS
46020 Placement of seton 665 879 1220 286 7.94
46030 Removal of anal seton, other marker 354 467 648 145 4.02
46040 Incision and drainage of ischiorectal and/or 1143 1509 2094 556 15.45 perirectal abscess (separate procedure)
46045 Incision and drainage of intramural, 983 1298 1802 450 12.51 intramuscular, or submucosal abscess, transanal, under anesthesia
46050 Incision and drainage, perianal abscess, 487 643 893 210 5.83 superficial
46060 Incision and drainage of ischiorectal or 1196 1579 2192 495 13.76 intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton
46070 Incision, anal septum (infant) 592 782 1085 267 7.42
46080 Sphincterotomy, anal, division of sphincter 580 766 1063 258 7.17 (separate procedure)
46083 Incision of thrombosed hemorrhoid, external 395 521 724 184 5.12
46200 Fissurectomy, including sphincterotomy, when 1000 1321 1833 463 12.86 performed
46220 Excision of single external papilla or tag, anus 463 611 848 214 5.94
46221 Hemorrhoidectomy, internal, by rubber band 545 720 999 278 7.72 ligation(s)
46230 Excision of multiple external papillae or tags, 650 858 1191 283 7.86 anus
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
46250 Hemorrhoidectomy, external, 2 or more 921 1217 1689 481 13.35 columns/groups
46255 Hemorrhoidectomy, internal and external, 1138 1503 2086 525 14.58 single column/group;
46257 Hemorrhoidectomy, internal and external, 1105 1459 2024 442 12.27 single column/group; with fissurectomy
46258 Hemorrhoidectomy, internal and external, 1187 1567 2175 484 13.45 single column/group; with fistulectomy, including fissurectomy, when performed
46260 Hemorrhoidectomy, internal and external, 2 or 1355 1789 2484 495 13.75 more columns/groups;
46261 Hemorrhoidectomy, internal and external, 2 or 1519 2006 2784 545 15.13 more columns/groups; with fissurectomy
46262 Hemorrhoidectomy, internal and external, 2 or 1566 2068 2870 575 15.97 more columns/groups; with fistulectomy, including fissurectomy, when performed
46270 Surgical treatment of anal fistula 1147 1515 2102 527 14.63 (fistulectomy/fistulotomy); subcutaneous
46275 Surgical treatment of anal fistula 1277 1687 2341 559 15.53 (fistulectomy/fistulotomy); intersphincteric
46280 Surgical treatment of anal fistula 1364 1801 2500 489 13.57 (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed
46285 Surgical treatment of anal fistula 1212 1600 2221 557 15.47 (fistulectomy/fistulotomy); second stage
46288 Closure of anal fistula with rectal advancement 1565 2067 2869 570 15.84 flap
46320 Excision of thrombosed hemorrhoid, external 406 536 744 191 5.31
46500 Injection of sclerosing solution, hemorrhoids 419 554 769 195 5.41
46505 Chemodenervation of internal anal sphincter 725 957 1328 296 8.22
46600 Anoscopy; diagnostic, including collection of 205 271 376 92 2.55 specimen(s) by brushing or washing, when performed (separate procedure)
46601 Anoscopy; diagnostic, with high-resolution 689 910 1263 140 3.88 magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed
CPT copyright 2017 American Medical Association. 321 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
46604 Anoscopy; with dilation (eg, balloon, guide 954 1260 1749 643 17.85 wire, bougie)
46606 Anoscopy; with biopsy, single or multiple 428 566 785 235 6.53
46607 Anoscopy; with high-resolution magnification 1409 1861 2582 197 5.48 (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple
46608 Anoscopy; with removal of foreign body 547 722 1002 247 6.85
46610 Anoscopy; with removal of single tumor, polyp, 452 597 828 237 6.59 or other lesion by hot biopsy forceps or bipolar cautery
46611 Anoscopy; with removal of single tumor, polyp, 374 494 685 184 5.11 or other lesion by snare technique
46612 Anoscopy; with removal of multiple tumors, 632 835 1158 285 7.92 polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique
46614 Anoscopy; with control of bleeding (eg, 502 663 921 134 3.73 injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
46615 Anoscopy; with ablation of tumor(s), polyp(s), 0 0 0 149 4.14 or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
46700 Anoplasty, plastic operation for stricture; adult 1800 2377 3299 682 18.94
46705 Anoplasty, plastic operation for stricture; infant 1272 1680 2331 574 15.94
46706 Repair of anal fistula with fibrin glue 406 536 744 183 5.09
46707 Repair of anorectal fistula with plug (eg, 1202 1587 2203 502 13.95 porcine small intestine submucosa [sis])
46710 Repair of ileoanal pouch fistula/sinus (eg, 2555 3374 4683 1153 32.02 perineal or vaginal), pouch advancement; transperineal approach
46712 Repair of ileoanal pouch fistula/sinus (eg, 5157 6810 9451 2326 64.62 perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach
46715 Repair of low imperforate anus; with 1247 1647 2286 563 15.63 anoperineal fistula (cut-back procedure)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
46716 Repair of low imperforate anus; with 2789 3682 5110 1258 34.94 transposition of anoperineal or anovestibular fistula
46730 Repair of high imperforate anus without fistula; 4532 5985 8306 2044 56.79 perineal or sacroperineal approach
46735 Repair of high imperforate anus without fistula; 5230 6906 9584 2359 65.53 combined transabdominal and sacroperineal approaches
46740 Repair of high imperforate anus with 4955 6542 9079 2235 62.08 rectourethral or rectovaginal fistula; perineal or sacroperineal approach
46742 Repair of high imperforate anus with 6113 8072 11202 2588 71.89 rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches
46744 Repair of cloacal anomaly by 8133 10738 14903 3668 101.90 anorectovaginoplasty and urethroplasty, sacroperineal approach
46746 Repair of cloacal anomaly by 8960 11831 16420 4042 112.27 anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;
46748 Repair of cloacal anomaly by 9714 12827 17802 4382 121.72 anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps
46750 Sphincteroplasty, anal, for incontinence or 1819 2402 3334 781 21.69 prolapse; adult
46751 Sphincteroplasty, anal, for incontinence or 1503 1984 2754 678 18.83 prolapse; child
46753 Graft (Thiersch operation) for rectal 1408 1859 2580 635 17.64 incontinence and/or prolapse
46754 Removal of Thiersch wire or suture, anal canal 706 933 1294 319 8.85
46760 Sphincteroplasty, anal, for incontinence, adult; 2528 3337 4632 1140 31.67 muscle transplant
46761 Sphincteroplasty, anal, for incontinence, adult; 2740 3618 5022 954 26.49 levator muscle imbrication (park posterior anal repair)
46762 Sphincteroplasty, anal, for incontinence, adult; 2134 2818 3911 963 26.74 implantation artificial sphincter
CPT copyright 2017 American Medical Association. 323 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
46900 Destruction of lesion(s), anus (eg, condyloma, 411 543 753 250 6.95 papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical
46910 Destruction of lesion(s), anus (eg, condyloma, 602 795 1103 266 7.40 papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation
46916 Destruction of lesion(s), anus (eg, condyloma, 400 528 733 238 6.62 papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery
46917 Destruction of lesion(s), anus (eg, condyloma, 900 1189 1649 466 12.94 papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery
46922 Destruction of lesion(s), anus (eg, condyloma, 583 769 1068 277 7.69 papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision
46924 Destruction of lesion(s), anus (eg, condyloma, 1179 1557 2161 540 15.00 papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
46930 Destruction of internal hemorrhoid(s) by 585 772 1072 215 5.96 thermal energy (eg, infrared coagulation, cautery, radiofrequency)
46940 Curettage or cautery of anal fissure, including 600 792 1100 236 6.56 dilation of anal sphincter (separate procedure); initial
46942 Curettage or cautery of anal fissure, including 719 950 1318 225 6.26 dilation of anal sphincter (separate procedure); subsequent
46945 Hemorrhoidectomy, internal, by ligation other 645 851 1182 320 8.88 than rubber band; single hemorrhoid column/group
46946 Hemorrhoidectomy, internal, by ligation other 717 947 1315 325 9.03 than rubber band; 2 or more hemorrhoid columns/groups
46947 Hemorrhoidopexy (eg, for prolapsing internal 1003 1324 1838 398 11.05 hemorrhoids) by stapling
46999 Unlisted procedure, anus 0 0 0 0 0.00
LIVER
47000 Biopsy of liver, needle; percutaneous 435 640 977 314 8.71
47001 Biopsy of liver, needle; when done for indicated 304 446 682 109 3.03 purpose at time of other major procedure (list
324 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
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separately in addition to code for primary procedure)
47010 Hepatotomy, for open drainage of abscess or 2562 3765 5751 1254 34.84 cyst, 1 or 2 stages
47015 Laparotomy, with aspiration and/or injection of 2101 3087 4717 1212 33.68 hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es)
47100 Biopsy of liver, wedge 2101 3087 4717 879 24.42
47120 Hepatectomy, resection of liver; partial 6962 10232 15632 2428 67.44 lobectomy
47122 Hepatectomy, resection of liver; 8923 13114 20035 3565 99.04 trisegmentectomy
47125 Hepatectomy, resection of liver; total left 8966 13177 20131 3207 89.08 lobectomy
47130 Hepatectomy, resection of liver; total right 9863 14496 22145 3444 95.67 lobectomy
47133 Donor hepatectomy (including cold 0 0 0 0 0.00 preservation), from cadaver donor
47135 Liver allotransplantation, orthotopic, partial or 28882 42447 64848 5579 154.98 whole, from cadaver or living donor, any age
47140 Donor hepatectomy (including cold 6442 9468 14465 3718 103.29 preservation), from living donor; left lateral segment only (segments ii and iii)
47141 Donor hepatectomy (including cold 7691 11303 17268 4439 123.31 preservation), from living donor; total left lobectomy (segments ii, iii and iv)
47142 Donor hepatectomy (including cold 8473 12452 19023 4890 135.84 preservation), from living donor; total right lobectomy (segments v, vi, vii and viii)
47143 Backbench standard preparation of cadaver 2041 3000 4584 0 0.00 donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; without trisegment or lobe split
47144 Backbench standard preparation of cadaver 817 1200 1834 0 0.00 donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena
CPT copyright 2017 American Medical Association. 325 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegment split of whole liver graft into 2 partial liver grafts (ie, left lateral segment [segments ii and iii] and right trisegment [segments i and iv through viii])
47145 Backbench standard preparation of cadaver 794 1167 1783 0 0.00 donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe split of whole liver graft into 2 partial liver grafts (ie, left lobe [segments ii, iii, and iv] and right lobe [segments i and v through viii])
47146 Backbench reconstruction of cadaver or living 598 879 1343 345 9.59 donor liver graft prior to allotransplantation; venous anastomosis, each
47147 Backbench reconstruction of cadaver or living 695 1021 1560 401 11.14 donor liver graft prior to allotransplantation; arterial anastomosis, each
47300 Marsupialization of cyst or abscess of liver 2040 2998 4581 1178 32.71
47350 Management of liver hemorrhage; simple suture 3557 5227 7986 1427 39.64 of liver wound or injury
47360 Management of liver hemorrhage; complex 4375 6430 9824 1958 54.40 suture of liver wound or injury, with or without hepatic artery ligation
47361 Management of liver hemorrhage; exploration 8092 11892 18168 3151 87.53 of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver
47362 Management of liver hemorrhage; re- 3410 5012 7656 1512 42.01 exploration of hepatic wound for removal of packing
47370 Laparoscopy, surgical, ablation of 1 or more 3145 4622 7061 1301 36.13 liver tumor(s); radiofrequency
47371 Laparoscopy, surgical, ablation of 1 or more 2271 3338 5099 1311 36.41 liver tumor(s); cryosurgical
47379 Unlisted laparoscopic procedure, liver 0 0 0 0 0.00
47380 Ablation, open, of 1 or more liver tumor(s); 3786 5565 8501 1500 41.68 radiofrequency
326 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
47381 Ablation, open, of 1 or more liver tumor(s); 2677 3934 6011 1545 42.92 cryosurgical
47382 Ablation, 1 or more liver tumor(s), 5423 7971 12177 4946 137.38 percutaneous, radiofrequency
47383 Ablation, 1 or more liver tumor(s), 12168 17882 27319 7023 195.08 percutaneous, cryoablation
47399 Unlisted procedure, liver 0 0 0 0 0.00
BILIARY TRACT
47400 Hepaticotomy or hepaticostomy with 6515 8905 13129 2249 62.47 exploration, drainage, or removal of calculus
47420 Choledochotomy or choledochostomy with 3383 4624 6817 1396 38.77 exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty
47425 Choledochotomy or choledochostomy with 4133 5649 8329 1427 39.63 exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty
47460 Transduodenal sphincterotomy or 3833 5239 7724 1323 36.75 sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)
47480 Cholecystotomy or cholecystostomy, open, with 2200 3008 4434 913 25.36 exploration, drainage, or removal of calculus (separate procedure)
47490 Cholecystostomy, percutaneous, complete 1392 1903 2806 343 9.52 procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation
47531 Injection procedure for cholangiography, 350 478 705 324 9.00 percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access
47532 Injection procedure for cholangiography, 2067 2825 4165 815 22.64 percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)
CPT copyright 2017 American Medical Association. 327 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
47533 Placement of biliary drainage catheter, 3372 4608 6795 1260 35.01 percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external
47534 Placement of biliary drainage catheter, 1651 2257 3327 1506 41.82 percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external
47535 Conversion of external biliary drainage catheter 2787 3810 5617 1040 28.88 to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation
47536 Exchange of biliary drainage catheter (eg, 773 1057 1558 705 19.59 external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation
47537 Removal of biliary drainage catheter, 1017 1390 2049 375 10.42 percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation
47538 Placement of stent(s) into a bile duct, 11650 15923 23477 4422 122.83 percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; existing access
47539 Placement of stent(s) into a bile duct, 14193 19399 28602 4899 136.09 percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new
328 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
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access, without placement of separate biliary drainage catheter
47540 Placement of stent(s) into a bile duct, 14503 19823 29226 5006 139.06 percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access, with placement of separate biliary drainage catheter (eg, external or internal- external)
47541 Placement of access through the biliary tree and 3479 4755 7011 1201 33.36 into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access
47542 Balloon dilation of biliary duct(s) or of ampulla 485 663 978 473 13.13 (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (list separately in addition to code for primary procedure)
47543 Endoluminal biopsy(ies) of biliary tree, 3342 4568 6736 488 13.55 percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (list separately in addition to code for primary procedure)
47544 Removal of calculi/debris from biliary duct(s) 2818 3852 5679 1100 30.55 and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)
47550 Biliary endoscopy, intraoperative 413 564 832 173 4.80 (choledochoscopy) (list separately in addition to code for primary procedure)
47552 Biliary endoscopy, percutaneous via t-tube or 932 1274 1879 322 8.94 other tract; diagnostic, with collection of
CPT copyright 2017 American Medical Association. 329 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
specimen(s) by brushing and/or washing, when performed (separate procedure)
47553 Biliary endoscopy, percutaneous via t-tube or 919 1256 1852 317 8.81 other tract; with biopsy, single or multiple
47554 Biliary endoscopy, percutaneous via t-tube or 1563 2137 3150 540 14.99 other tract; with removal of calculus/calculi
47555 Biliary endoscopy, percutaneous via t-tube or 1248 1705 2515 339 9.43 other tract; with dilation of biliary duct stricture(s) without stent
47556 Biliary endoscopy, percutaneous via t-tube or 1408 1925 2838 384 10.68 other tract; with dilation of biliary duct stricture(s) with stent
47562 Laparoscopy, surgical; cholecystectomy 2047 2798 4125 685 19.04
47563 Laparoscopy, surgical; cholecystectomy with 2106 2879 4245 744 20.67 cholangiography
47564 Laparoscopy, surgical; cholecystectomy with 2817 3851 5677 1160 32.21 exploration of common duct
47570 Laparoscopy, surgical; cholecystoenterostomy 2342 3202 4720 809 22.46
47579 Unlisted laparoscopy procedure, biliary tract 0 0 0 0 0.00
47600 Cholecystectomy; 2638 3606 5317 1112 30.89
47605 Cholecystectomy; with cholangiography 2598 3551 5235 1171 32.53
47610 Cholecystectomy with exploration of common 3117 4261 6282 1308 36.32 duct;
47612 Cholecystectomy with exploration of common 3843 5253 7745 1327 36.85 duct; with choledochoenterostomy
47620 Cholecystectomy with exploration of common 4167 5696 8398 1439 39.96 duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography
47700 Exploration for congenital atresia of bile ducts, 3178 4343 6404 1097 30.47 without repair, with or without liver biopsy, with or without cholangiography
47701 Portoenterostomy (eg, kasai procedure) 5243 7166 10565 1810 50.27
47711 Excision of bile duct tumor, with or without 4697 6420 9466 1621 45.04 primary repair of bile duct; extrahepatic
47712 Excision of bile duct tumor, with or without 6047 8265 12186 2087 57.98 primary repair of bile duct; intrahepatic
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
47715 Excision of choledochal cyst 4020 5495 8102 1388 38.55
47720 Cholecystoenterostomy; direct 3486 4765 7026 1203 33.43
47721 Cholecystoenterostomy; with gastroenterostomy 4093 5595 8249 1413 39.25
47740 Cholecystoenterostomy; roux-en-y 3967 5423 7995 1369 38.04
47741 Cholecystoenterostomy; roux-en-y with 4463 6100 8993 1540 42.79 gastroenterostomy
47760 Anastomosis, of extrahepatic biliary ducts and 5309 7256 10699 2354 65.40 gastrointestinal tract
47765 Anastomosis, of intrahepatic ducts and 9187 12557 18514 3171 88.09 gastrointestinal tract
47780 Anastomosis, roux-en-y, of extrahepatic biliary 6948 9497 14002 2581 71.69 ducts and gastrointestinal tract
47785 Anastomosis, roux-en-y, of intrahepatic biliary 8893 12156 17922 3373 93.70 ducts and gastrointestinal tract
47800 Reconstruction, plastic, of extrahepatic biliary 5400 7380 10881 1645 45.69 ducts with end-to-end anastomosis
47801 Placement of choledochal stent 3230 4415 6509 1115 30.97
47802 U-tube hepaticoenterostomy 4614 6306 9298 1593 44.24
47900 Suture of extrahepatic biliary duct for pre- 4153 5676 8369 1434 39.82 existing injury (separate procedure)
47999 Unlisted procedure, biliary tract 0 0 0 0 0.00
PANCREAS
48000 Placement of drains, peripancreatic, for acute 5707 7800 11500 1970 54.72 pancreatitis;
48001 Placement of drains, peripancreatic, for acute 6983 9545 14073 2411 66.96 pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy
48020 Removal of pancreatic calculus 3558 4864 7171 1228 34.12
48100 Biopsy of pancreas, open (eg, fine needle 2307 3154 4650 924 25.67 aspiration, needle core biopsy, wedge biopsy)
48102 Biopsy of pancreas, percutaneous needle 920 1258 1854 545 15.15
48105 Resection or debridement of pancreas and 7246 9903 14601 2966 82.38 peripancreatic tissue for acute necrotizing pancreatitis
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
48120 Excision of lesion of pancreas (eg, cyst, 3331 4553 6713 1150 31.94 adenoma)
48140 Pancreatectomy, distal subtotal, with or without 4497 6147 9063 1630 45.28 splenectomy; without pancreaticojejunostomy
48145 Pancreatectomy, distal subtotal, with or without 4938 6750 9951 1705 47.35 splenectomy; with pancreaticojejunostomy
48146 Pancreatectomy, distal, near-total with 5681 7765 11448 1961 54.47 preservation of duodenum (child-type procedure)
48148 Excision of ampulla of VATER 3776 5162 7610 1304 36.21
48150 Pancreatectomy, proximal subtotal with total 9015 12322 18167 3243 90.09 duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipplei-type procedure); with pancreatojejunostomy
48152 Pancreatectomy, proximal subtotal with total 8725 11926 17583 3012 83.66 duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipplei-type procedure); without pancreatojejunostomy
48153 Pancreatectomy, proximal subtotal with near- 8902 12167 17939 3227 89.65 total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipplei-type procedure); with pancreatojejunostomy
48154 Pancreatectomy, proximal subtotal with near- 8761 11975 17656 3024 84.01 total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipplei-type procedure); without pancreatojejunostomy
48155 Pancreatectomy, total 5489 7502 11061 1895 52.63
48160 Pancreatectomy, total or subtotal, with 0 0 0 0 0.00 autologous transplantation of pancreas or pancreatic islet cells
48400 Injection procedure for intraoperative 326 446 658 113 3.13 pancreatography (list separately in addition to code for primary procedure)
48500 Marsupialization of pancreatic cyst 3478 4754 7009 1201 33.35
48510 External drainage, pseudocyst of pancreas, open 3316 4533 6683 1145 31.80
48520 Internal anastomosis of pancreatic cyst to 3298 4507 6646 1138 31.62 gastrointestinal tract; direct
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
48540 Internal anastomosis of pancreatic cyst to 3964 5418 7989 1368 38.01 gastrointestinal tract; roux-en-y
48545 Pancreatorrhaphy for injury 4069 5562 8201 1405 39.02
48547 Duodenal exclusion with gastrojejunostomy for 5424 7414 10931 1872 52.01 pancreatic injury
48548 Pancreaticojejunostomy, side-to-side 5016 6857 10109 1732 48.10 anastomosis (Puestow-type operation)
48550 Donor pancreatectomy (including cold 0 0 0 0 0.00 preservation), with or without duodenal segment for transplantation
48551 Backbench standard preparation of cadaver 685 936 1381 0 0.00 donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and y-graft arterial anastomoses from iliac artery to superior mesenteric artery and to splenic artery
48552 Backbench reconstruction of cadaver donor 715 978 1442 247 6.86 pancreas allograft prior to transplantation, venous anastomosis, each
48554 Transplantation of pancreatic allograft 7686 10506 15489 2653 73.70
48556 Removal of transplanted pancreatic allograft 3849 5261 7757 1329 36.91
48999 Unlisted procedure, pancreas 0 0 0 0 0.00
ABDOMEN, PERITONEUM AND OMENTUM
49000 Exploratory laparotomy, exploratory celiotomy 2018 2837 4570 802 22.27 with or without biopsy(s) (separate procedure)
49002 Reopening of recent laparotomy 2745 3859 6216 1090 30.27
49010 Exploration, retroperitoneal area with or 2504 3520 5670 971 26.98 without biopsy(s) (separate procedure)
49020 Drainage of peritoneal abscess or localized 3926 5519 8891 1657 46.03 peritonitis, exclusive of appendiceal abscess, open
49040 Drainage of subdiaphragmatic or subphrenic 2364 3323 5353 1041 28.93 abscess, open
49060 Drainage of retroperitoneal abscess, open 2662 3742 6028 1146 31.82
49062 Drainage of extraperitoneal lymphocele to 1764 2479 3994 780 21.68 peritoneal cavity, open
CPT copyright 2017 American Medical Association. 333 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
49082 Abdominal paracentesis (diagnostic or 398 560 902 200 5.56 therapeutic); without imaging guidance
49083 Abdominal paracentesis (diagnostic or 408 573 923 302 8.40 therapeutic); with imaging guidance
49084 Peritoneal lavage, including imaging guidance, 281 395 637 113 3.15 when performed
49180 Biopsy, abdominal or retroperitoneal mass, 385 542 873 168 4.66 percutaneous needle
49185 Sclerotherapy of a fluid collection (eg, 1993 2801 4512 969 26.92 lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed
49203 Excision or destruction, open, intra-abdominal 3241 4556 7339 1248 34.66 tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less
49204 Excision or destruction, open, intra-abdominal 4272 6004 9673 1598 44.38 tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1- 10.0 cm diameter
49205 Excision or destruction, open, intra-abdominal 4882 6862 11055 1834 50.95 tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter
49215 Excision of presacral or sacrococcygeal tumor 6501 9138 14721 2316 64.33
49220 Staging laparotomy for Hodgkin's disease or 2289 3217 5183 1013 28.13 lymphoma (includes splenectomy, needle or open biopsies of both liver lobes, possibly also removal of abdominal nodes, abdominal node and/or bone marrow biopsies, ovarian repositioning)
49250 Umbilectomy, omphalectomy, excision of 1402 1971 3176 611 16.98 umbilicus (separate procedure)
49255 Omentectomy, epiploectomy, resection of 1985 2790 4495 824 22.90 omentum (separate procedure)
49320 Laparoscopy, abdomen, peritoneum, and 1075 1511 2434 339 9.43 omentum, diagnostic, with or without collection
334 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
of specimen(s) by brushing or washing (separate procedure)
49321 Laparoscopy, surgical; with biopsy (single or 1092 1535 2473 359 9.98 multiple)
49322 Laparoscopy, surgical; with aspiration of cavity 1189 1671 2692 385 10.69 or cyst (eg, ovarian cyst) (single or multiple)
49323 Laparoscopy, surgical; with drainage of 1772 2490 4012 663 18.41 lymphocele to peritoneal cavity
49324 Laparoscopy, surgical; with insertion of 1012 1422 2291 405 11.25 tunneled intraperitoneal catheter
49325 Laparoscopy, surgical; with revision of 1110 1561 2515 431 11.96 previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed
49326 Laparoscopy, surgical; with omentopexy 507 713 1148 197 5.48 (omental tacking procedure) (list separately in addition to code for primary procedure)
49327 Laparoscopy, surgical; with placement of 308 433 698 136 3.79 interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (list separately in addition to code for primary procedure)
49329 Unlisted laparoscopy procedure, abdomen, 0 0 0 0 0.00 peritoneum and omentum
49400 Injection of air or contrast into peritoneal cavity 346 486 784 139 3.85 (separate procedure)
49402 Removal of peritoneal foreign body from 2085 2931 4723 892 24.79 peritoneal cavity
49405 Image-guided fluid collection drainage by 906 1274 2053 827 22.96 catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous
49406 Image-guided fluid collection drainage by 829 1165 1876 826 22.95 catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous
49407 Image-guided fluid collection drainage by 1191 1675 2698 668 18.55 catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal
CPT copyright 2017 American Medical Association. 335 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
49411 Placement of interstitial device(s) for radiation 1005 1413 2276 494 13.73 therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or multiple
49412 Placement of interstitial device(s) for radiation 195 274 442 86 2.40 therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed, single or multiple (list separately in addition to code for primary procedure)
49418 Insertion of tunneled intraperitoneal catheter 1853 2605 4197 1394 38.71 (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, contrast injection when performed, and radiological supervision and interpretation, percutaneous
49419 Insertion of tunneled intraperitoneal catheter, 1273 1790 2884 463 12.85 with subcutaneous port (ie, totally implantable)
49421 Insertion of tunneled intraperitoneal catheter for 984 1383 2227 239 6.65 dialysis, open
49422 Removal of tunneled intraperitoneal catheter 1059 1488 2398 396 10.99
49423 Exchange of previously placed abscess or cyst 613 862 1389 559 15.54 drainage catheter under radiological guidance (separate procedure)
49424 Contrast injection for assessment of abscess or 173 244 393 149 4.15 cyst via previously placed drainage catheter or tube (separate procedure)
49425 Insertion of peritoneal-venous shunt 1683 2365 3810 744 20.68
49426 Revision of peritoneal-venous shunt 1445 2031 3272 639 17.76
49427 Injection procedure (eg, contrast media) for 108 152 245 48 1.33 evaluation of previously placed peritoneal- venous shunt
49428 Ligation of peritoneal-venous shunt 1050 1477 2379 450 12.51
49429 Removal of peritoneal-venous shunt 1082 1521 2450 479 13.30
49435 Insertion of subcutaneous extension to 307 432 696 125 3.46 intraperitoneal cannula or catheter with remote chest exit site (list separately in addition to code for primary procedure)
336 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
49436 Delayed creation of exit site from embedded 436 613 988 194 5.38 subcutaneous segment of intraperitoneal cannula or catheter
49440 Insertion of gastrostomy tube, percutaneous, 1085 1525 2457 989 27.48 under fluoroscopic guidance including contrast injection(s), image documentation and report
49441 Insertion of duodenostomy or jejunostomy tube, 1228 1726 2781 1120 31.11 percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report
49442 Insertion of cecostomy or other colonic tube, 2103 2956 4763 931 25.85 percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report
49446 Conversion of gastrostomy tube to gastro- 1045 1469 2366 953 26.47 jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report
49450 Replacement of gastrostomy or cecostomy (or 748 1051 1693 682 18.94 other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report
49451 Replacement of duodenostomy or jejunostomy 816 1148 1849 744 20.68 tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report
49452 Replacement of gastro-jejunostomy tube, 1010 1420 2288 921 25.59 percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report
49460 Mechanical removal of obstructive material 1459 2051 3305 755 20.98 from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including contrast injection(s), if performed, image documentation and report
49465 Contrast injection(s) for radiological evaluation 184 259 417 168 4.66 of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including image documentation and report
49491 Repair, initial inguinal hernia, preterm infant 2501 3516 5664 827 22.96 (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks
CPT copyright 2017 American Medical Association. 337 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
postconception age, with or without hydrocelectomy; reducible
49492 Repair, initial inguinal hernia, preterm infant 2253 3167 5102 997 27.69 (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or strangulated
49495 Repair, initial inguinal hernia, full term infant 1505 2115 3407 427 11.86 younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; reducible
49496 Repair, initial inguinal hernia, full term infant 1446 2032 3274 640 17.77 younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; incarcerated or strangulated
49500 Repair initial inguinal hernia, age 6 months to 1478 2078 3347 429 11.91 younger than 5 years, with or without hydrocelectomy; reducible
49501 Repair initial inguinal hernia, age 6 months to 1425 2003 3226 630 17.51 younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated
49505 Repair initial inguinal hernia, age 5 years or 1483 2084 3358 541 15.03 older; reducible
49507 Repair initial inguinal hernia, age 5 years or 1737 2442 3934 610 16.94 older; incarcerated or strangulated
49520 Repair recurrent inguinal hernia, any age; 1713 2408 3880 657 18.26 reducible
49521 Repair recurrent inguinal hernia, any age; 1943 2732 4401 746 20.71 incarcerated or strangulated
49525 Repair inguinal hernia, sliding, any age 1614 2269 3655 595 16.54
49540 Repair lumbar hernia 1580 2221 3578 699 19.42
49550 Repair initial femoral hernia, any age; reducible 1496 2103 3388 599 16.64
49553 Repair initial femoral hernia, any age; 1656 2328 3751 657 18.26 incarcerated or strangulated
49555 Repair recurrent femoral hernia; reducible 1408 1979 3187 623 17.30
49557 Repair recurrent femoral hernia; incarcerated or 1702 2393 3854 753 20.92 strangulated
338 CPT copyright 2017 American Medical Association. SURGERY – DIGESTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
49560 Repair initial incisional or ventral hernia; 1893 2661 4288 768 21.33 reducible
49561 Repair initial incisional or ventral hernia; 2342 3293 5304 968 26.89 incarcerated or strangulated
49565 Repair recurrent incisional or ventral hernia; 1965 2762 4450 799 22.20 reducible
49566 Repair recurrent incisional or ventral hernia; 2391 3362 5416 977 27.13 incarcerated or strangulated
49568 Implantation of mesh or other prosthesis for 707 993 1601 279 7.76 open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (list separately in addition to code for the incisional or ventral hernia repair)
49570 Repair epigastric hernia (eg, preperitoneal fat); 1192 1676 2700 435 12.07 reducible (separate procedure)
49572 Repair epigastric hernia (eg, preperitoneal fat); 1443 2028 3267 536 14.89 incarcerated or strangulated
49580 Repair umbilical hernia, younger than age 5 1259 1770 2852 346 9.61 years; reducible
49582 Repair umbilical hernia, younger than age 5 1135 1595 2570 502 13.95 years; incarcerated or strangulated
49585 Repair umbilical hernia, age 5 years or older; 1254 1763 2840 463 12.86 reducible
49587 Repair umbilical hernia, age 5 years or older; 1372 1929 3108 495 13.74 incarcerated or strangulated
49590 Repair spigelian hernia 1505 2115 3408 595 16.54
49600 Repair of small omphalocele, with primary 1719 2417 3893 761 21.13 closure
49605 Repair of large omphalocele or gastroschisis; 13902 19542 31483 5135 142.63 with or without prosthesis
49606 Repair of large omphalocele or gastroschisis; 3664 5150 8297 1181 32.81 with removal of prosthesis, final reduction and closure, in operating room
49610 Repair of omphalocele (gross type operation); 1617 2274 3663 716 19.88 first stage
49611 Repair of omphalocele (gross type operation); 1425 2004 3228 631 17.52 second stage
49650 Laparoscopy, surgical; repair initial inguinal 1310 1842 2968 446 12.39 hernia
CPT copyright 2017 American Medical Association. 339 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
49651 Laparoscopy, surgical; repair recurrent inguinal 1561 2194 3535 578 16.06 hernia
49652 Laparoscopy, surgical, repair, ventral, 1920 2699 4348 774 21.51 umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible
49653 Laparoscopy, surgical, repair, ventral, 2331 3277 5279 966 26.82 umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated
49654 Laparoscopy, surgical, repair, incisional hernia 2141 3010 4849 881 24.46 (includes mesh insertion, when performed); reducible
49655 Laparoscopy, surgical, repair, incisional hernia 2590 3640 5864 1075 29.85 (includes mesh insertion, when performed); incarcerated or strangulated
49656 Laparoscopy, surgical, repair, recurrent 2237 3145 5066 955 26.54 incisional hernia (includes mesh insertion, when performed); reducible
49657 Laparoscopy, surgical, repair, recurrent 3200 4498 7247 1374 38.18 incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated
49659 Unlisted laparoscopy procedure, hernioplasty, 0 0 0 0 0.00 herniorrhaphy, herniotomy
49900 Suture, secondary, of abdominal wall for 2006 2820 4543 849 23.57 evisceration or dehiscence
49904 Omental flap, extra-abdominal (eg, for 4660 6551 10553 1476 41.01 reconstruction of sternal and chest wall defects)
49905 Omental flap, intra-abdominal (list separately in 1145 1609 2592 369 10.25 addition to code for primary procedure)
49906 Free omental flap with microvascular 4838 6801 10956 0 0.00 anastomosis
49999 Unlisted procedure, abdomen, peritoneum and 0 0 0 0 0.00 omentum
340 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
URINARY SYSTEM KIDNEY
50010 Renal exploration, not necessitating other 1855 2811 4852 763 21.20 specific procedures
50020 Drainage of perirenal or renal abscess, open 2548 3862 6667 1056 29.33
50040 Nephrostomy, nephrotomy with drainage 3505 5312 9169 964 26.78
50045 Nephrotomy, with exploration 2411 3655 6309 972 27.01
50060 Nephrolithotomy; removal of calculus 2863 4340 7492 1190 33.05
50065 Nephrolithotomy; secondary surgical operation 3027 4588 7920 1262 35.06 for calculus
50070 Nephrolithotomy; complicated by congenital 3010 4561 7874 1237 34.37 kidney abnormality
50075 Nephrolithotomy; removal of large staghorn 3650 5532 9550 1521 42.25 calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)
50080 Percutaneous nephrostolithotomy or 2652 4019 6938 907 25.20 pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm
50081 Percutaneous nephrostolithotomy or 3569 5409 9337 1332 37.01 pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; over 2 cm
50100 Transection or repositioning of aberrant renal 2672 4049 6990 1125 31.24 vessels (separate procedure)
50120 Pyelotomy; with exploration 2377 3603 6220 990 27.51
50125 Pyelotomy; with drainage, pyelostomy 2585 3917 6762 1025 28.47
50130 Pyelotomy; with removal of calculus 2586 3919 6765 1078 29.94 (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)
50135 Pyelotomy; complicated (eg, secondary 2852 4323 7462 1171 32.53 operation, congenital kidney abnormality)
50200 Renal biopsy; percutaneous, by trocar or needle 573 868 1499 550 15.28
50205 Renal biopsy; by surgical exposure of kidney 2498 3786 6535 786 21.84
50220 Nephrectomy, including partial ureterectomy, 2994 4537 7832 1093 30.36 any open approach including rib resection;
CPT copyright 2017 American Medical Association. 341 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50225 Nephrectomy, including partial ureterectomy, 3017 4572 7893 1253 34.80 any open approach including rib resection; complicated because of previous surgery on same kidney
50230 Nephrectomy, including partial ureterectomy, 3597 5452 9411 1337 37.15 any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy
50234 Nephrectomy with total ureterectomy and 3691 5594 9657 1358 37.71 bladder cuff; through same incision
50236 Nephrectomy with total ureterectomy and 3676 5572 9618 1533 42.58 bladder cuff; through separate incision
50240 Nephrectomy, partial 3988 6044 10433 1382 38.38
50250 Ablation, open, 1 or more renal mass lesion(s), 3047 4618 7973 1269 35.26 cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed
50280 Excision or unroofing of cyst(s) of kidney 2390 3622 6252 995 27.64
50290 Excision of perinephric cyst 2249 3409 5885 938 26.05
50300 Donor nephrectomy (including cold 0 0 0 0 0.00 preservation); from cadaver donor, unilateral or bilateral
50320 Donor nephrectomy (including cold 3658 5544 9570 1566 43.50 preservation); open, from living donor
50323 Backbench standard preparation of cadaver 1214 1840 3176 0 0.00 donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary
50325 Backbench standard preparation of living donor 1205 1826 3152 0 0.00 renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary
50327 Backbench reconstruction of cadaver or living 665 1008 1740 226 6.29 donor renal allograft prior to transplantation; venous anastomosis, each
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50328 Backbench reconstruction of cadaver or living 750 1137 1963 199 5.52 donor renal allograft prior to transplantation; arterial anastomosis, each
50329 Backbench reconstruction of cadaver or living 450 683 1178 188 5.21 donor renal allograft prior to transplantation; ureteral anastomosis, each
50340 Recipient nephrectomy (separate procedure) 2359 3575 6172 986 27.40
50360 Renal allotransplantation, implantation of graft; 8027 12166 21002 2519 69.98 without recipient nephrectomy
50365 Renal allotransplantation, implantation of graft; 7139 10820 18678 2978 82.71 with recipient nephrectomy
50370 Removal of transplanted renal allograft 3442 5216 9004 1256 34.88
50380 Renal autotransplantation, reimplantation of 5010 7593 13108 2084 57.90 kidney
50382 Removal (via snare/capture) and replacement of 1321 2002 3456 1139 31.63 internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation
50384 Removal (via snare/capture) of internally 1886 2859 4935 894 24.84 dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation
50385 Removal (via snare/capture) and replacement of 2298 3483 6012 1114 30.95 internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation
50386 Removal (via snare/capture) of internally 1553 2354 4063 719 19.97 dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation
50387 Removal and replacement of externally 640 970 1675 502 13.94 accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation
50389 Removal of nephrostomy tube, requiring 438 664 1146 305 8.47 fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)
50390 Aspiration and/or injection of renal cyst or 371 562 971 100 2.78 pelvis by needle, percutaneous
CPT copyright 2017 American Medical Association. 343 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50391 Instillation(s) of therapeutic agent into renal 303 459 793 126 3.50 pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent)
50395 Introduction of guide into renal pelvis and/or 635 962 1661 186 5.16 ureter with dilation to establish nephrostomy tract, percutaneous
50396 Manometric studies through nephrostomy or 297 450 777 122 3.39 pyelostomy tube, or indwelling ureteral catheter
50400 Pyeloplasty (Foley y-pyeloplasty), plastic 3327 5043 8705 1210 33.60 operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple
50405 Pyeloplasty (Foley y-pyeloplasty), plastic 4816 7300 12601 1457 40.46 operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)
50430 Injection procedure for antegrade 685 1038 1792 470 13.05 nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access
50431 Injection procedure for antegrade 240 364 628 167 4.64 nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access
50432 Placement of nephrostomy catheter, 810 1228 2120 791 21.96 percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation
50433 Placement of nephroureteral catheter, 1186 1797 3102 1081 30.03 percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access
344 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50434 Convert nephrostomy catheter to nephroureteral 2229 3379 5832 847 23.52 catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract
50435 Exchange nephrostomy catheter, percutaneous, 530 803 1386 483 13.42 including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation
50500 Nephrorrhaphy, suture of kidney wound or 3194 4840 8356 1341 37.24 injury
50520 Closure of nephrocutaneous or pyelocutaneous 2840 4304 7430 1206 33.50 fistula
50525 Closure of nephrovisceral fistula (eg, 3856 5844 10089 1531 42.54 renocolic), including visceral repair; abdominal approach
50526 Closure of nephrovisceral fistula (eg, 3834 5811 10032 1642 45.60 renocolic), including visceral repair; thoracic approach
50540 Symphysiotomy for horseshoe kidney with or 2886 4374 7551 1198 33.28 without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation)
50541 Laparoscopy, surgical; ablation of renal cysts 2098 3180 5490 959 26.64
50542 Laparoscopy, surgical; ablation of renal mass 2520 3819 6593 1216 33.79 lesion(s), including intraoperative ultrasound guidance and monitoring, when performed
50543 Laparoscopy, surgical; partial nephrectomy 3929 5955 10280 1553 43.13
50544 Laparoscopy, surgical; pyeloplasty 3471 5260 9081 1300 36.12
50545 Laparoscopy, surgical; radical nephrectomy 3597 5452 9411 1399 38.85 (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)
50546 Laparoscopy, surgical; nephrectomy, including 3303 5006 8642 1256 34.88 partial ureterectomy
50547 Laparoscopy, surgical; donor nephrectomy 5092 7718 13323 1678 46.60 (including cold preservation), from living donor
CPT copyright 2017 American Medical Association. 345 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50548 Laparoscopy, surgical; nephrectomy with total 3721 5639 9735 1406 39.05 ureterectomy
50549 Unlisted laparoscopy procedure, renal 0 0 0 0 0.00
50551 Renal endoscopy through established 897 1360 2348 376 10.44 nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
50553 Renal endoscopy through established 953 1444 2493 403 11.19 nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter
50555 Renal endoscopy through established 1024 1553 2680 431 11.96 nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
50557 Renal endoscopy through established 1046 1586 2737 438 12.16 nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy
50561 Renal endoscopy through established 1778 2695 4652 496 13.78 nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus
50562 Renal endoscopy through established 1457 2209 3813 608 16.88 nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor
50570 Renal endoscopy through nephrotomy or 1234 1871 3230 514 14.28 pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
50572 Renal endoscopy through nephrotomy or 1335 2024 3494 556 15.45 pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter
50574 Renal endoscopy through nephrotomy or 1420 2152 3715 591 16.43 pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
346 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50575 Renal endoscopy through nephrotomy or 1794 2718 4693 747 20.74 pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent)
50576 Renal endoscopy through nephrotomy or 1419 2151 3713 590 16.39 pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy
50580 Renal endoscopy through nephrotomy or 1529 2317 4000 635 17.65 pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus
50590 Lithotripsy, extracorporeal shock wave 2038 3089 5333 749 20.81
50592 Ablation, 1 or more renal tumor(s), 3727 5648 9750 3398 94.40 percutaneous, unilateral, radiofrequency
50593 Ablation, renal tumor(s), unilateral, 5078 7696 13286 4631 128.63 percutaneous, cryotherapy
URETER
50600 Ureterotomy with exploration or drainage 2788 3623 5705 980 27.21 (separate procedure)
50605 Ureterotomy for insertion of indwelling stent, 2866 3724 5865 1030 28.62 all types
50606 Endoluminal biopsy of ureter and/or renal 2024 2630 4142 717 19.93 pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)
50610 Ureterolithotomy; upper one-third of ureter 2807 3648 5745 986 27.40
50620 Ureterolithotomy; middle one-third of ureter 2686 3491 5498 944 26.22
50630 Ureterolithotomy; lower one-third of ureter 2652 3447 5428 932 25.89
50650 Ureterectomy, with bladder cuff (separate 2949 3832 6035 1081 30.04 procedure)
50660 Ureterectomy, total, ectopic ureter, combination 3397 4415 6953 1194 33.16 abdominal, vaginal and/or perineal approach
CPT copyright 2017 American Medical Association. 347 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50684 Injection procedure for ureterography or 176 229 361 111 3.07 ureteropyelography through ureterostomy or indwelling ureteral catheter
50686 Manometric studies through ureterostomy or 427 555 874 150 4.17 indwelling ureteral catheter
50688 Change of ureterostomy tube or externally 253 329 518 82 2.28 accessible ureteral stent via ileal conduit
50690 Injection procedure for visualization of ileal 252 327 516 103 2.85 conduit and/or ureteropyelography, exclusive of radiologic service
50693 Placement of ureteral stent, percutaneous, 1109 1441 2270 1011 28.09 including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract
50694 Placement of ureteral stent, percutaneous, 2787 3622 5704 1110 30.83 including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter
50695 Placement of ureteral stent, percutaneous, 3398 4417 6955 1363 37.86 including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter
50700 Ureteroplasty, plastic operation on ureter (eg, 2748 3571 5623 966 26.82 stricture)
50705 Ureteral embolization or occlusion, including 5625 7311 11513 1977 54.91 imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)
50706 Balloon dilation, ureteral stricture, including 1828 2375 3741 1011 28.08 imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)
50715 Ureterolysis, with or without repositioning of 3689 4794 7550 1271 35.30 ureter for retroperitoneal fibrosis
348 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50722 Ureterolysis for ovarian vein syndrome 5004 6503 10241 1052 29.21
50725 Ureterolysis for retrocaval ureter, with 3274 4255 6701 1151 31.96 reanastomosis of upper urinary tract or vena cava
50727 Revision of urinary-cutaneous anastomosis (any 1510 1962 3091 531 14.74 type urostomy);
50728 Revision of urinary-cutaneous anastomosis (any 2075 2696 4246 729 20.25 type urostomy); with repair of fascial defect and hernia
50740 Ureteropyelostomy, anastomosis of ureter and 3630 4717 7429 1275 35.43 renal pelvis
50750 Ureterocalycostomy, anastomosis of ureter to 3427 4454 7014 1204 33.45 renal calyx
50760 Ureteroureterostomy 3483 4526 7128 1173 32.58
50770 Transureteroureterostomy, anastomosis of 3427 4454 7014 1204 33.45 ureter to contralateral ureter
50780 Ureteroneocystostomy; anastomosis of single 3494 4541 7152 1156 32.11 ureter to bladder
50782 Ureteroneocystostomy; anastomosis of 3887 5051 7954 1122 31.17 duplicated ureter to bladder
50783 Ureteroneocystostomy; with extensive ureteral 3767 4895 7709 1177 32.70 tailoring
50785 Ureteroneocystostomy; with vesico-psoas hitch 3436 4466 7033 1266 35.16 or bladder flap
50800 Ureteroenterostomy, direct anastomosis of 2746 3568 5619 965 26.80 ureter to intestine
50810 Ureterosigmoidostomy, with creation of 4145 5387 8483 1457 40.46 sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis
50815 Ureterocolon conduit, including intestine 3631 4718 7431 1276 35.44 anastomosis
50820 Ureteroileal conduit (ileal bladder), including 3695 4802 7562 1371 38.08 intestine anastomosis (brickier operation)
50825 Continent diversion, including intestine 4899 6367 10027 1722 47.82 anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty)
CPT copyright 2017 American Medical Association. 349 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50830 Urinary undiversion (eg, taking down of 5353 6957 10955 1881 52.25 ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)
50840 Replacement of all or part of ureter by intestine 3650 4744 7471 1283 35.63 segment, including intestine anastomosis
50845 Cutaneous appendico-vesicostomy 4748 6171 9718 1304 36.21
50860 Ureterostomy, transplantation of ureter to skin 2806 3647 5743 986 27.39
50900 Ureterorrhaphy, suture of ureter (separate 2507 3258 5131 881 24.47 procedure)
50920 Closure of ureterocutaneous fistula 2618 3402 5357 920 25.55
50930 Closure of ureterovisceral fistula (including 3273 4254 6699 1150 31.95 visceral repair)
50940 Deligation of ureter 2635 3424 5393 926 25.72
50945 Laparoscopy, surgical; ureterolithotomy 2891 3757 5917 1016 28.22
50947 Laparoscopy, surgical; ureteroneocystostomy 4001 5199 8188 1446 40.16 with cystoscopy and ureteral stent placement
50948 Laparoscopy, surgical; ureteroneocystostomy 3788 4922 7752 1331 36.97 without cystoscopy and ureteral stent placement
50949 Unlisted laparoscopy procedure, ureter 0 0 0 0 0.00
50951 Ureteral endoscopy through established 1116 1450 2283 392 10.89 ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
50953 Ureteral endoscopy through established 1188 1544 2432 418 11.60 ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter
50955 Ureteral endoscopy through established 1263 1642 2585 444 12.33 ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
50957 Ureteral endoscopy through established 1275 1658 2610 448 12.45 ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy
350 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
50961 Ureteral endoscopy through established 1150 1495 2355 404 11.23 ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus
50970 Ureteral endoscopy through ureterotomy, with 1103 1434 2258 388 10.77 or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
50972 Ureteral endoscopy through ureterotomy, with 1066 1386 2183 375 10.41 or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter
50974 Ureteral endoscopy through ureterotomy, with 1408 1829 2881 495 13.74 or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
50976 Ureteral endoscopy through ureterotomy, with 1387 1803 2839 487 13.54 or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy
50980 Ureteral endoscopy through ureterotomy, with 1061 1379 2172 373 10.36 or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus
BLADDER
51020 Cystotomy or cystostomy; with fulguration 1396 1856 2461 490 13.60 and/or insertion of radioactive material
51030 Cystotomy or cystostomy; with cryosurgical 1400 1861 2468 491 13.64 destruction of intravesical lesion
51040 Cystostomy, cystotomy with drainage 874 1162 1541 302 8.39
51045 Cystotomy, with insertion of ureteral catheter or 1200 1596 2117 510 14.16 stent (separate procedure)
51050 Cystolithotomy, cystotomy with removal of 1454 1933 2564 493 13.70 calculus, without vesical neck resection
51060 Transvesical ureterolithotomy 1728 2298 3047 606 16.84
51065 Cystotomy, with calculus basket extraction 1721 2288 3035 604 16.77 and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus
CPT copyright 2017 American Medical Association. 351 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
51080 Drainage of perivesical or prevesical space 1216 1617 2144 427 11.85 abscess
51100 Aspiration of bladder; by needle 182 242 320 64 1.77
51101 Aspiration of bladder; by trocar or intracatheter 364 484 642 128 3.55
51102 Aspiration of bladder; with insertion of 584 777 1030 234 6.51 suprapubic catheter
51500 Excision of urachal cyst or sinus, with or 1872 2489 3301 665 18.46 without umbilical hernia repair
51520 Cystotomy; for simple excision of vesical neck 1767 2350 3116 620 17.22 (separate procedure)
51525 Cystotomy; for excision of bladder 2486 3305 4383 896 24.88 diverticulum, single or multiple (separate procedure)
51530 Cystotomy; for excision of bladder tumor 2321 3087 4093 814 22.62
51535 Cystotomy for excision, incision, or repair of 2163 2877 3815 814 22.61 ureterocele
51550 Cystectomy, partial; simple 2567 3414 4527 1006 27.95
51555 Cystectomy, partial; complicated (eg, 3367 4477 5938 1320 36.68 postradiation, previous surgery, difficult location)
51565 Cystectomy, partial, with reimplantation of 3837 5102 6766 1346 37.39 ureter(s) into bladder (ureteroneocystostomy)
51570 Cystectomy, complete; (separate procedure) 4390 5837 7742 1540 42.78
51575 Cystectomy, complete; with bilateral pelvic 5421 7209 9560 1902 52.83 lymphadenectomy, including external iliac, hypogastric, and obturator nodes
51580 Cystectomy, complete, with 5641 7501 9947 1979 54.97 ureterosigmoidostomy or ureterocutaneous transplantations;
51585 Cystectomy, complete, with 6281 8352 11077 2204 61.21 ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
51590 Cystectomy, complete, with ureteroileal conduit 5569 7406 9821 2020 56.12 or sigmoid bladder, including intestine anastomosis;
352 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
51595 Cystectomy, complete, with ureteroileal conduit 6492 8632 11448 2285 63.46 or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
51596 Cystectomy, complete, with continent 8173 10868 14413 2456 68.23 diversion, any open technique, using any segment of small and/or large intestine to construct neobladder
51597 Pelvic exenteration, complete, for vesical, 7067 9397 12462 2398 66.60 prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof
51600 Injection procedure for cystography or voiding 373 495 657 189 5.26 urethrocystography
51605 Injection procedure and placement of chain for 154 205 272 40 1.12 contrast and/or chain urethrocystography
51610 Injection procedure for retrograde 325 432 573 110 3.06 urethrocystography
51700 Bladder irrigation, simple, lavage and/or 201 267 354 76 2.11 instillation
51701 Insertion of non-indwelling bladder catheter 150 200 265 49 1.35 (eg, straight catheterization for residual urine)
51702 Insertion of temporary indwelling bladder 195 259 343 66 1.83 catheter; simple (eg, Foley)
51703 Insertion of temporary indwelling bladder 299 398 527 130 3.62 catheter; complicated (eg, altered anatomy, fractured catheter/balloon)
51705 Change of cystostomy tube; simple 245 326 432 94 2.62
51710 Change of cystostomy tube; complicated 340 452 600 133 3.70
51715 Endoscopic injection of implant material into 822 1093 1450 302 8.38 the submucosal tissues of the urethra and/or bladder neck
51720 Bladder instillation of anticarcinogenic agent 294 391 519 87 2.41 (including retention time)
51725 Simple cystometrogram (cgm) (eg, spinal 517 735 1104 193 5.37 manometer)
51725-26 212 301 452 79 2.20
CPT copyright 2017 American Medical Association. 353 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
51725-TC 0 0 0 114 3.17
51726 Complex cystometrogram (ie, calibrated 548 779 1170 273 7.59 electronic equipment);
51726-26 178 253 379 89 2.46
51726-TC 0 0 0 185 5.13
51727 Complex cystometrogram (ie, calibrated 457 650 976 321 8.93 electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique
51727-26 157 223 335 111 3.07
51727-TC 0 0 0 211 5.86
51728 Complex cystometrogram (ie, calibrated 749 1066 1600 328 9.10 electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique
51728-26 249 354 531 109 3.02
51728-TC 0 0 0 219 6.08
51729 Complex cystometrogram (ie, calibrated 751 1068 1604 352 9.77 electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique
51729-26 280 398 598 131 3.64
51729-TC 0 0 0 221 6.13
51736 Simple uroflowmetry (UFR) (eg, stop-watch 107 153 229 16 0.44 flow rate, mechanical uroflowmeter)
51736-26 59 83 125 9 0.24
51736-TC 0 0 0 7 0.20
51741 Complex uroflowmetry (eg, calibrated 189 269 404 16 0.45 electronic equipment)
51741-26 101 144 216 9 0.24
51741-TC 0 0 0 8 0.21
51784 Electromyography studies (EMG) of anal or 509 724 1087 71 1.98 urethral sphincter, other than needle, any technique
51784-26 278 395 593 39 1.08
354 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
51784-TC 0 0 0 32 0.90
51785 Needle electromyography studies (EMG) of 1312 1867 2803 283 7.86 anal or urethral sphincter, any technique
51785-26 436 620 931 94 2.61
51785-TC 0 0 0 189 5.25
51792 Stimulus evoked response (eg, measurement of 507 721 1082 219 6.09 bulbocavernosus reflex latency time)
51792-26 132 188 283 57 1.59
51792-TC 0 0 0 162 4.50
51797 Voiding pressure studies, intra-abdominal (ie, 412 586 880 117 3.24 rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)
51797-26 148 210 315 42 1.16
51797-TC 0 0 0 75 2.08
51798 Measurement of post-voiding residual urine 59 84 126 16 0.45 and/or bladder capacity by ultrasound, non- imaging
51800 Cystoplasty or cystourethroplasty, plastic 3475 4780 6753 1085 30.15 operation on bladder and/or vesical neck (anterior y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical neck
51820 Cystourethroplasty with unilateral or bilateral 3170 4360 6159 1130 31.40 ureteroneocystostomy
51840 Anterior vesicourethropexy, or urethropexy (eg, 1614 2220 3136 682 18.95 marshall-Marchetti-Krantz, Burch); simple
51841 Anterior vesicourethropexy, or urethropexy (eg, 2110 2901 4099 797 22.14 marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair)
51845 Abdomino-vaginal vesical neck suspension, 1573 2164 3057 609 16.91 with or without endoscopic control (eg, Stamey, Raz, modified Pereyra)
51860 Cystorrhaphy, suture of bladder wound, injury 1915 2634 3722 777 21.58 or rupture; simple
51865 Cystorrhaphy, suture of bladder wound, injury 2417 3325 4697 933 25.91 or rupture; complicated
51880 Closure of cystostomy (separate procedure) 1290 1775 2507 487 13.52
CPT copyright 2017 American Medical Association. 355 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
51900 Closure of vesicovaginal fistula, abdominal 2263 3112 4397 860 23.90 approach
51920 Closure of vesicouterine fistula; 2111 2904 4103 797 22.13
51925 Closure of vesicouterine fistula; with 2782 3826 5406 1045 29.04 hysterectomy
51940 Closure, exstrophy of bladder 4469 6146 8683 1713 47.59
51960 Enterocystoplasty, including intestinal 5228 7190 10158 1446 40.17 anastomosis
51980 Cutaneous vesicostomy 2434 3347 4729 744 20.68
51990 Laparoscopy, surgical; urethral suspension for 1794 2467 3485 782 21.71 stress incontinence
51992 Laparoscopy, surgical; sling operation for stress 2563 3525 4980 868 24.12 incontinence (eg, fascia or synthetic)
51999 Unlisted laparoscopy procedure, bladder 0 0 0 0 0.00
52000 Cystourethroscopy (separate procedure) 504 700 993 170 4.73
52001 Cystourethroscopy with irrigation and 809 1124 1593 387 10.74 evacuation of multiple obstructing clots
52005 Cystourethroscopy, with ureteral 700 973 1378 276 7.67 catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
52007 Cystourethroscopy, with ureteral 1102 1531 2170 460 12.79 catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis
52010 Cystourethroscopy, with ejaculatory duct 1075 1494 2117 382 10.60 catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service
52204 Cystourethroscopy, with biopsy(s) 1013 1407 1994 383 10.64
52214 Cystourethroscopy, with fulguration (including 1727 2399 3401 688 19.12 cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands
52224 Cystourethroscopy, with fulguration (including 1978 2748 3895 719 19.97 cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm) lesion(s) with or without biopsy
356 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
52234 Cystourethroscopy, with fulguration (including 865 1202 1703 257 7.15 cryosurgery or laser surgery) and/or resection of; small bladder tumor(s) (0.5 up to 2.0 cm)
52235 Cystourethroscopy, with fulguration (including 1024 1422 2016 302 8.38 cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)
52240 Cystourethroscopy, with fulguration (including 1518 2109 2989 410 11.38 cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)
52250 Cystourethroscopy with insertion of radioactive 706 981 1390 251 6.96 substance, with or without biopsy or fulguration
52260 Cystourethroscopy, with dilation of bladder for 585 813 1152 220 6.11 interstitial cystitis; general or conduction (spinal) anesthesia
52265 Cystourethroscopy, with dilation of bladder for 755 1049 1487 377 10.48 interstitial cystitis; local anesthesia
52270 Cystourethroscopy, with internal urethrotomy; 716 994 1410 370 10.27 female
52275 Cystourethroscopy, with internal urethrotomy; 985 1368 1938 498 13.84 male
52276 Cystourethroscopy with direct vision internal 908 1261 1787 276 7.68 urethrotomy
52277 Cystourethroscopy, with resection of external 953 1323 1876 338 9.39 sphincter (sphincterotomy)
52281 Cystourethroscopy, with calibration and/or 751 1043 1478 283 7.86 dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female
52282 Cystourethroscopy, with insertion of permanent 1085 1507 2136 352 9.78 urethral stent
52283 Cystourethroscopy, with steroid injection into 574 797 1130 288 7.99 stricture
52285 Cystourethroscopy for treatment of the female 680 945 1340 290 8.05 urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or trigone
52287 Cystourethroscopy, with injection(s) for 854 1186 1681 323 8.97 chemodenervation of the bladder
CPT copyright 2017 American Medical Association. 357 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
52290 Cystourethroscopy; with ureteral meatotomy, 681 946 1341 256 7.10 unilateral or bilateral
52300 Cystourethroscopy; with resection or 928 1289 1827 293 8.15 fulguration of orthotopic ureterocele(s), unilateral or bilateral
52301 Cystourethroscopy; with resection or 855 1188 1684 303 8.43 fulguration of ectopic ureterocele(s), unilateral or bilateral
52305 Cystourethroscopy; with incision or resection of 820 1139 1614 291 8.08 orifice of bladder diverticulum, single or multiple
52310 Cystourethroscopy, with removal of foreign 700 972 1378 253 7.03 body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple
52315 Cystourethroscopy, with removal of foreign 1224 1701 2410 429 11.93 body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated
52317 Litholapaxy: crushing or fragmentation of 1876 2606 3694 835 23.20 calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)
52318 Litholapaxy: crushing or fragmentation of 1536 2133 3024 495 13.75 calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm)
52320 Cystourethroscopy (including ureteral 899 1248 1770 258 7.17 catheterization); with removal of ureteral calculus
52325 Cystourethroscopy (including ureteral 800 1111 1575 336 9.32 catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)
52327 Cystourethroscopy (including ureteral 1399 1943 2754 274 7.62 catheterization); with subureteric injection of implant material
52330 Cystourethroscopy (including ureteral 1248 1733 2457 513 14.26 catheterization); with manipulation, without removal of ureteral calculus
52332 Cystourethroscopy, with insertion of indwelling 1057 1469 2082 508 14.11 ureteral stent (eg, gibbons or double-j type)
52334 Cystourethroscopy with insertion of ureteral 674 936 1327 268 7.44 guide wire through kidney to establish a percutaneous nephrostomy, retrograde
358 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
52341 Cystourethroscopy; with treatment of ureteral 899 1249 1770 297 8.25 stricture (eg, balloon dilation, laser, electrocautery, and incision)
52342 Cystourethroscopy; with treatment of 828 1151 1631 323 8.97 ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)
52343 Cystourethroscopy; with treatment of intra-renal 1015 1409 1997 360 10.00 stricture (eg, balloon dilation, laser, electrocautery, and incision)
52344 Cystourethroscopy with ureteroscopy; with 1036 1439 2039 387 10.74 treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)
52345 Cystourethroscopy with ureteroscopy; with 1226 1703 2415 412 11.45 treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)
52346 Cystourethroscopy with ureteroscopy; with 1297 1802 2555 467 12.97 treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)
52351 Cystourethroscopy, with ureteroscopy and/or 944 1312 1859 317 8.80 pyeloscopy; diagnostic
52352 Cystourethroscopy, with ureteroscopy and/or 1075 1493 2116 371 10.30 pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)
52353 Cystourethroscopy, with ureteroscopy and/or 1310 1820 2580 410 11.38 pyeloscopy; with lithotripsy (ureteral catheterization is included)
52354 Cystourethroscopy, with ureteroscopy and/or 1259 1749 2479 436 12.12 pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion
52355 Cystourethroscopy, with ureteroscopy and/or 1478 2053 2910 489 13.58 pyeloscopy; with resection of ureteral or renal pelvic tumor
52356 Cystourethroscopy, with ureteroscopy and/or 1275 1771 2511 435 12.08 pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, gibbons or double-j type)
52400 Cystourethroscopy with incision, fulguration, or 1560 2166 3071 499 13.86 resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds
CPT copyright 2017 American Medical Association. 359 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
52402 Cystourethroscopy with transurethral resection 786 1092 1548 279 7.75 or incision of ejaculatory ducts
52441 Cystourethroscopy, with insertion of permanent 2400 3334 4726 1288 35.77 adjustable transprostatic implant; single implant
52442 Cystourethroscopy, with insertion of permanent 2000 2778 3938 986 27.40 adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (list separately in addition to code for primary procedure)
52450 Transurethral incision of prostate 1288 1789 2536 490 13.62
52500 Transurethral resection of bladder neck 1479 2054 2912 509 14.14 (separate procedure)
52601 Transurethral electrosurgical resection of 2194 3048 4320 761 21.15 prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)
52630 Transurethral resection; residual or regrowth of 1263 1755 2487 418 11.60 obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)
52640 Transurethral resection; of postoperative 951 1321 1872 329 9.15 bladder neck contracture
52647 Laser coagulation of prostate, including control 3622 5031 7131 1849 51.36 of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included if performed)
52648 Laser vaporization of prostate, including control 4101 5696 8074 1902 52.84 of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)
52649 Laser enucleation of the prostate with 2470 3431 4864 859 23.86 morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)
52700 Transurethral drainage of prostatic abscess 1297 1801 2553 460 12.78
360 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
URETHRA
53000 Urethrotomy or urethrostomy, external 393 524 687 155 4.30 (separate procedure); pendulous urethra
53010 Urethrotomy or urethrostomy, external 781 1040 1364 307 8.54 (separate procedure); perineal urethra, external
53020 Meatotomy, cutting of meatus (separate 245 326 428 102 2.82 procedure); except infant
53025 Meatotomy, cutting of meatus (separate 188 251 328 72 1.99 procedure); infant
53040 Drainage of deep periurethral abscess 1041 1386 1818 410 11.38
53060 Drainage of Skene's gland abscess or cyst 479 638 837 189 5.24
53080 Drainage of perineal urinary extravasation; 1114 1484 1946 438 12.18 uncomplicated (separate procedure)
53085 Drainage of perineal urinary extravasation; 1728 2302 3018 677 18.81 complicated
53200 Biopsy of urethra 492 655 858 163 4.54
53210 Urethrectomy, total, including cystostomy; 2042 2719 3566 804 22.32 female
53215 Urethrectomy, total, including cystostomy; male 2460 3276 4296 968 26.89
53220 Excision or fulguration of carcinoma of urethra 1200 1599 2096 471 13.09
53230 Excision of urethral diverticulum (separate 1635 2178 2855 631 17.53 procedure); female
53235 Excision of urethral diverticulum (separate 1679 2236 2931 661 18.35 procedure); male
53240 Marsupialization of urethral diverticulum, male 1127 1501 1968 444 12.32 or female
53250 Excision of bulbourethral gland (Cowper's 1072 1428 1872 413 11.47 gland)
53260 Excision or fulguration; urethral polyp(s), distal 502 669 877 209 5.81 urethra
53265 Excision or fulguration; urethral caruncle 562 748 981 227 6.30
53270 Excision or fulguration; Skene's glands 587 781 1024 215 5.96
53275 Excision or fulguration; urethral prolapse 696 927 1216 274 7.61
53400 Urethroplasty; first stage, for fistula, 2126 2831 3712 834 23.18 diverticulum, or stricture (eg, Johannsen type)
CPT copyright 2017 American Medical Association. 361 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
53405 Urethroplasty; second stage (formation of 2317 3085 4045 912 25.32 urethra), including urinary diversion
53410 Urethroplasty, 1-stage reconstruction of male 3047 4057 5320 1021 28.35 anterior urethra
53415 Urethroplasty, transpubic or perineal, 1-stage, 3501 4662 6112 1181 32.80 for reconstruction or repair of prostatic or membranous urethra
53420 Urethroplasty, 2-stage reconstruction or repair 2231 2972 3896 878 24.39 of prostatic or membranous urethra; first stage
53425 Urethroplasty, 2-stage reconstruction or repair 2483 3307 4336 977 27.14 of prostatic or membranous urethra; second stage
53430 Urethroplasty, reconstruction of female urethra 2507 3338 4377 1010 28.06
53431 Urethroplasty with tubularization of posterior 3062 4078 5347 1205 33.47 urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure)
53440 Sling operation for correction of male urinary 2170 2890 3789 786 21.83 incontinence (eg, fascia or synthetic)
53442 Removal or revision of sling for male urinary 2077 2766 3626 817 22.70 incontinence (eg, fascia or synthetic)
53444 Insertion of tandem cuff (dual cuff) 2103 2801 3673 828 22.99
53445 Insertion of inflatable urethral/bladder neck 2500 3329 4366 786 21.84 sphincter, including placement of pump, reservoir, and cuff
53446 Removal of inflatable urethral/bladder neck 1620 2158 2829 670 18.61 sphincter, including pump, reservoir, and cuff
53447 Removal and replacement of inflatable 2182 2905 3809 844 23.44 urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session
53448 Removal and replacement of inflatable 3396 4523 5930 1336 37.12 urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of infected tissue
53449 Repair of inflatable urethral/bladder neck 1621 2159 2831 638 17.72 sphincter, including pump, reservoir, and cuff
53450 Urethromeatoplasty, with mucosal advancement 1330 1772 2323 427 11.85
362 CPT copyright 2017 American Medical Association. SURGERY – URINARY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
53460 Urethromeatoplasty, with partial excision of 1321 1759 2306 478 13.29 distal urethral segment (Richardson type procedure)
53500 Urethrolysis, transvaginal, secondary, open, 1788 2381 3122 778 21.62 including cystourethroscopy (eg, postsurgical obstruction, scarring)
53502 Urethrorrhaphy, suture of urethral wound or 1289 1717 2251 507 14.09 injury, female
53505 Urethrorrhaphy, suture of urethral wound or 1288 1715 2249 507 14.08 injury; penile
53510 Urethrorrhaphy, suture of urethral wound or 1675 2231 2925 659 18.31 injury; perineal
53515 Urethrorrhaphy, suture of urethral wound or 2110 2810 3684 830 23.06 injury; prostatomembranous
53520 Closure of urethrostomy or urethrocutaneous 1476 1965 2577 581 16.13 fistula, male (separate procedure)
53600 Dilation of urethral stricture by passage of 226 301 394 86 2.39 sound or urethral dilator, male; initial
53601 Dilation of urethral stricture by passage of 197 262 344 84 2.34 sound or urethral dilator, male; subsequent
53605 Dilation of urethral stricture or vesical neck by 218 290 380 68 1.88 passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia
53620 Dilation of urethral stricture by passage of 290 386 506 121 3.35 filiform and follower, male; initial
53621 Dilation of urethral stricture by passage of 257 342 449 113 3.15 filiform and follower, male; subsequent
53660 Dilation of female urethra including suppository 180 240 314 73 2.03 and/or instillation; initial
53661 Dilation of female urethra including suppository 173 231 303 72 1.99 and/or instillation; subsequent
53665 Dilation of female urethra, general or 135 180 236 40 1.12 conduction (spinal) anesthesia
53850 Transurethral destruction of prostate tissue; by 6001 7992 10479 2151 59.74 microwave thermotherapy
53852 Transurethral destruction of prostate tissue; by 5201 6925 9081 1985 55.14 radiofrequency thermotherapy
53855 Insertion of a temporary prostatic urethral stent, 1602 2134 2798 808 22.45 including urethral measurement
CPT copyright 2017 American Medical Association. 363 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
53860 Transurethral radiofrequency micro-remodeling 4144 5518 7235 1630 45.29 of the female bladder neck and proximal urethra for stress urinary incontinence
53899 Unlisted procedure, urinary system 0 0 0 0 0.00
364 CPT copyright 2017 American Medical Association. SURGERY – MALE GENITAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
MALE GENITAL SYSTEM PENIS
54000 Slitting of prepuce, dorsal or lateral (separate 408 568 693 155 4.30 procedure); newborn
54001 Slitting of prepuce, dorsal or lateral (separate 480 668 815 192 5.34 procedure); except newborn
54015 Incision and drainage of penis, deep 795 1107 1351 320 8.90
54050 Destruction of lesion(s), penis (eg, condyloma, 250 349 425 138 3.83 papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical
54055 Destruction of lesion(s), penis (eg, condyloma, 339 472 576 124 3.44 papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation
54056 Destruction of lesion(s), penis (eg, condyloma, 276 384 469 147 4.09 papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery
54057 Destruction of lesion(s), penis (eg, condyloma, 369 514 628 144 4.00 papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery
54060 Destruction of lesion(s), penis (eg, condyloma, 482 672 820 187 5.20 papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision
54065 Destruction of lesion(s), penis (eg, condyloma, 474 660 805 227 6.30 papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
54100 Biopsy of penis; (separate procedure) 360 501 611 206 5.71
54105 Biopsy of penis; deep structures 743 1034 1262 275 7.65
54110 Excision of penile plaque (Peyronie disease); 1716 2390 2916 652 18.10
54111 Excision of penile plaque (Peyronie disease); 2201 3064 3740 836 23.21 with graft to 5 cm in length
54112 Excision of penile plaque (Peyronie disease); 2577 3587 4378 978 27.17 with graft greater than 5 cm in length
54115 Removal foreign body from deep penile tissue 1242 1730 2111 472 13.10 (eg, plastic implant)
54120 Amputation of penis; partial 1652 2300 2807 660 18.34
54125 Amputation of penis; complete 2235 3112 3798 849 23.57
CPT copyright 2017 American Medical Association. 365 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
54130 Amputation of penis, radical; with bilateral 3280 4567 5573 1245 34.59 inguinofemoral lymphadenectomy
54135 Amputation of penis, radical; in continuity with 4157 5788 7064 1578 43.84 bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes
54150 Circumcision, using clamp or other device with 436 607 741 161 4.48 regional dorsal penile or ring block
54160 Circumcision, surgical excision other than clamp, 438 609 744 228 6.34 device, or dorsal slit; neonate (28 days of age or less)
54161 Circumcision, surgical excision other than clamp, 664 925 1129 205 5.70 device, or dorsal slit; older than 28 days of age
54162 Lysis or excision of penile post-circumcision 678 944 1152 268 7.44 adhesions
54163 Repair incomplete circumcision 719 1000 1221 228 6.34
54164 Frenulotomy of penis 631 879 1073 202 5.61
54200 Injection procedure for Peyronie disease; 265 369 450 112 3.12
54205 Injection procedure for Peyronie disease; with 1463 2037 2486 555 15.43 surgical exposure of plaque
54220 Irrigation of corpora cavernosa for priapism 615 857 1045 213 5.93
54230 Injection procedure for corpora cavernosography 267 372 454 102 2.82
54231 Dynamic cavernosometry, including 387 539 657 147 4.08 intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)
54235 Injection of corpora cavernosa with 211 294 359 95 2.63 pharmacologic agent(s) (eg, papaverine, phentolamine)
54240 Penile plethysmography 339 472 576 109 3.04
54240-26 223 310 379 72 2.00
54240-TC 0 0 0 37 1.04
54250 Nocturnal penile tumescence and/or rigidity test 419 583 712 126 3.49
54250-26 381 530 647 114 3.17
54250-TC 0 0 0 12 0.32
54300 Plastic operation of penis for straightening of 2252 3135 3826 670 18.62 chordee (eg, hypospadias), with or without mobilization of urethra
366 CPT copyright 2017 American Medical Association. SURGERY – MALE GENITAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
54304 Plastic operation on penis for correction of 2812 3914 4777 783 21.76 chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps
54308 Urethroplasty for second stage hypospadias repair 1967 2738 3342 747 20.74 (including urinary diversion); less than 3 cm
54312 Urethroplasty for second stage hypospadias repair 2288 3186 3888 854 23.72 (including urinary diversion); greater than 3 cm
54316 Urethroplasty for second stage hypospadias repair 2790 3884 4740 1042 28.94 (including urinary diversion) with free skin graft obtained from site other than genitalia
54318 Urethroplasty for third stage hypospadias repair 1955 2722 3322 742 20.62 to release penis from scrotum (eg, third stage Cecil repair)
54322 1-stage distal hypospadias repair (with or without 2594 3612 4408 815 22.63 chordee or circumcision); with simple meatal advancement (eg, MAGPI, v-flap)
54324 1-stage distal hypospadias repair (with or without 3330 4636 5657 1011 28.07 chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)
54326 1-stage distal hypospadias repair (with or without 3361 4679 5710 987 27.41 chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra
54328 1-stage distal hypospadias repair (with or without 3776 5258 6416 980 27.23 chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap
54332 1-stage proximal penile or penoscrotal 3670 5110 6236 1059 29.41 hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap
54336 1-stage perineal hypospadias repair requiring 3271 4554 5557 1242 34.49 extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap
54340 Repair of hypospadias complications (ie, fistula, 1934 2693 3287 595 16.53 stricture, diverticula); by closure, incision, or excision, simple
54344 Repair of hypospadias complications (ie, fistula, 3100 4316 5268 989 27.47 stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft
CPT copyright 2017 American Medical Association. 367 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
54348 Repair of hypospadias complications (ie, fistula, 2789 3883 4739 1059 29.41 stricture, diverticula); requiring extensive dissection and urethroplasty with flap, patch or tubed graft (includes urinary diversion)
54352 Repair of hypospadias cripple requiring extensive 3893 5420 6614 1478 41.05 dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts
54360 Plastic operation on penis to correct angulation 2447 3406 4157 752 20.89
54380 Plastic operation on penis for epispadias distal to 2197 3059 3733 834 23.17 external sphincter;
54385 Plastic operation on penis for epispadias distal to 2596 3615 4411 968 26.90 external sphincter; with incontinence
54390 Plastic operation on penis for epispadias distal to 3410 4748 5794 1295 35.96 external sphincter; with exstrophy of bladder
54400 Insertion of penile prosthesis; non-inflatable 1790 2492 3041 553 15.35 (semi-rigid)
54401 Insertion of penile prosthesis; inflatable (self- 1803 2510 3063 684 19.01 contained)
54405 Insertion of multi-component, inflatable penile 2948 4104 5008 843 23.43 prosthesis, including placement of pump, cylinders, and reservoir
54406 Removal of all components of a multi- 1933 2690 3283 763 21.19 component, inflatable penile prosthesis without replacement of prosthesis
54408 Repair of component(s) of a multi-component, 2046 2848 3475 824 22.90 inflatable penile prosthesis
54410 Removal and replacement of all component(s) of 2862 3984 4862 897 24.91 a multi-component, inflatable penile prosthesis at the same operative session
54411 Removal and replacement of all components of a 2819 3925 4790 1070 29.73 multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
54415 Removal of non-inflatable (semi-rigid) or 1453 2023 2468 552 15.32 inflatable (self-contained) penile prosthesis, without replacement of prosthesis
368 CPT copyright 2017 American Medical Association. SURGERY – MALE GENITAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
54416 Removal and replacement of non-inflatable 1953 2718 3318 741 20.59 (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session
54417 Removal and replacement of non-inflatable 2471 3441 4199 938 26.06 (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
54420 Corpora cavernosa-saphenous vein shunt 1938 2699 3293 736 20.44 (priapism operation), unilateral or bilateral
54430 Corpora cavernosa-corpus spongiosum shunt 1761 2452 2992 669 18.57 (priapism operation), unilateral or bilateral
54435 Corpora cavernosa-glans penis fistulization (eg, 1147 1596 1948 435 12.09 biopsy needle, winter procedure, rongeur, or punch) for priapism
54437 Repair of traumatic corporeal tear(s) 1853 2580 3148 703 19.54
54438 Replantation, penis, complete amputation 3677 5119 6247 1396 38.77 including urethral repair
54440 Plastic operation of penis for injury 2218 3087 3768 0 0.00
54450 Foreskin manipulation including lysis of preputial 153 213 260 73 2.04 adhesions and stretching
TESTIS
54500 Biopsy of testis, needle (separate procedure) 185 255 356 78 2.17
54505 Biopsy of testis, incisional (separate procedure) 734 1011 1410 219 6.08
54512 Excision of extraparenchymal lesion of testis 1612 2220 3095 564 15.67
54520 Orchiectomy, simple (including subcapsular), 1030 1418 1978 341 9.47 with or without testicular prosthesis, scrotal or inguinal approach
54522 Orchiectomy, partial 1461 2012 2805 616 17.12
54530 Orchiectomy, radical, for tumor; inguinal 1486 2046 2854 527 14.65 approach
54535 Orchiectomy, radical, for tumor; with abdominal 1842 2536 3536 777 21.58 exploration
54550 Exploration for undescended testis (inguinal or 1513 2083 2904 513 14.26 scrotal area)
54560 Exploration for undescended testis with 1723 2373 3309 717 19.91 abdominal exploration
CPT copyright 2017 American Medical Association. 369 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
54600 Reduction of torsion of testis, surgical, with or 1333 1835 2559 474 13.16 without fixation of contralateral testis
54620 Fixation of contralateral testis (separate 968 1333 1859 313 8.69 procedure)
54640 Orchiopexy, inguinal approach, with or without 1745 2403 3351 500 13.88 hernia repair
54650 Orchiopexy, abdominal approach, for intra- 2150 2960 4128 743 20.64 abdominal testis (eg, fowler-Stephens)
54660 Insertion of testicular prosthesis (separate 1072 1475 2057 373 10.36 procedure)
54670 Suture or repair of testicular injury 1004 1382 1927 423 11.76
54680 Transplantation of testis(es) to thigh (because of 1947 2682 3739 822 22.82 scrotal destruction)
54690 Laparoscopy, surgical; orchiectomy 1628 2242 3126 687 19.08
54692 Laparoscopy, surgical; orchiopexy for intra- 2742 3775 5264 792 22.01 abdominal testis
54699 Unlisted laparoscopy procedure, testis 0 0 0 0 0.00
EPIDIDYMIS
54700 Incision and drainage of epididymis, testis and/or 576 793 1106 223 6.19 scrotal space (eg, abscess or hematoma)
54800 Biopsy of epididymis, needle 320 440 614 132 3.66
54830 Excision of local lesion of epididymis 1012 1394 1943 389 10.81
54840 Excision of spermatocele, with or without 961 1324 1846 336 9.32 epididymectomy
54860 Epididymectomy; unilateral 1085 1494 2083 438 12.16
54861 Epididymectomy; bilateral 1401 1930 2691 591 16.42
54865 Exploration of epididymis, with or without 888 1223 1706 375 10.41 biopsy
54900 Epididymovasostomy, anastomosis of epididymis 2008 2765 3856 836 23.21 to vas deferens; unilateral
54901 Epididymovasostomy, anastomosis of epididymis 2613 3598 5017 1102 30.62 to vas deferens; bilateral
TUNICA VAGINALIS
55000 Puncture aspiration of hydrocele, tunica 296 407 568 123 3.41 vaginalis, with or without injection of medication
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55040 Excision of hydrocele; unilateral 1040 1432 1996 353 9.80
55041 Excision of hydrocele; bilateral 1512 2082 2903 532 14.78
55060 Repair of tunica vaginalis hydrocele (bottle type) 1160 1597 2227 397 11.04
SCROTUM
55100 Drainage of scrotal wall abscess 564 777 1083 224 6.23
55110 Scrotal exploration 1010 1390 1939 405 11.24
55120 Removal of foreign body in scrotum 822 1132 1579 369 10.26
55150 Resection of scrotum 1297 1786 2490 513 14.24
55175 Scrotoplasty; simple 1097 1510 2106 379 10.53
55180 Scrotoplasty; complicated 2202 3032 4227 715 19.86
VAS DEFERENS
55200 Vasotomy, cannulization with or without incision 1076 1482 2066 454 12.61 of vas, unilateral or bilateral (separate procedure)
55250 Vasectomy, unilateral or bilateral (separate 1000 1377 1920 400 11.12 procedure), including postoperative semen examination(s)
55300 Vasotomy for vasograms, seminal vesiculograms, 463 638 890 195 5.43 or epididymograms, unilateral or bilateral
55400 Vasovasostomy, vasovasorrhaphy 2820 3883 5415 520 14.45
SPERMATIC CORD
55500 Excision of hydrocele of spermatic cord, 1150 1584 2208 412 11.45 unilateral (separate procedure)
55520 Excision of lesion of spermatic cord (separate 1086 1496 2086 471 13.09 procedure)
55530 Excision of varicocele or ligation of spermatic 1143 1574 2195 367 10.20 veins for varicocele; (separate procedure)
55535 Excision of varicocele or ligation of spermatic 1480 2038 2842 449 12.48 veins for varicocele; abdominal approach
55540 Excision of varicocele or ligation of spermatic 1363 1877 2617 575 15.97 veins for varicocele; with hernia repair
55550 Laparoscopy, surgical, with ligation of spermatic 1378 1898 2646 447 12.43 veins for varicocele
55559 Unlisted laparoscopy procedure, spermatic cord 0 0 0 0 0.00
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
55600 Vesiculotomy; 1044 1437 2004 440 12.23
SEMINAL VESICLES
55605 Vesiculotomy; complicated 1309 1802 2513 544 15.11
55650 Vesiculectomy, any approach 1775 2444 3408 749 20.80
55680 Excision of müllerian duct cyst 873 1202 1676 361 10.04
PROSTATE
55700 Biopsy, prostate; needle or punch, single or 545 750 1046 257 7.14 multiple, any approach
55705 Biopsy, prostate; incisional, any approach 658 906 1263 278 7.71
55706 Biopsies, prostate, needle, transperineal, 1022 1407 1962 388 10.79 stereotactic template guided saturation sampling, including imaging guidance
55720 Prostatotomy, external drainage of prostatic 1120 1542 2150 472 13.12 abscess, any approach; simple
55725 Prostatotomy, external drainage of prostatic 1569 2160 3012 619 17.20 abscess, any approach; complicated
55801 Prostatectomy, perineal, subtotal (including 3390 4396 6203 1142 31.71 control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy)
55810 Prostatectomy, perineal radical; 4064 5269 7435 1368 38.01
55812 Prostatectomy, perineal radical; with lymph node 5035 6529 9213 1680 46.66 biopsy(s) (limited pelvic lymphadenectomy)
55815 Prostatectomy, perineal radical; with bilateral 5465 7087 9999 1840 51.12 pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes
55821 Prostatectomy (including control of postoperative 2443 3168 4470 912 25.32 bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages
55831 Prostatectomy (including control of postoperative 2681 3477 4906 986 27.39 bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal
55840 Prostatectomy, retropubic radical, with or without 3599 4667 6585 1223 33.98 nerve sparing;
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
55842 Prostatectomy, retropubic radical, with or without 4017 5209 7349 1224 33.99 nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)
55845 Prostatectomy, retropubic radical, with or without 4401 5707 8052 1423 39.54 nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
55860 Exposure of prostate, any approach, for insertion 2712 3517 4962 913 25.37 of radioactive substance;
55862 Exposure of prostate, any approach, for insertion 3413 4426 6244 1145 31.80 of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy)
55865 Exposure of prostate, any approach, for insertion 4135 5362 7566 1392 38.68 of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes
55866 Laparoscopy, surgical prostatectomy, retropubic 4818 6248 8816 1507 41.87 radical, including nerve sparing, includes robotic assistance, when performed
55870 Electroejaculation 542 703 992 183 5.07
55873 Cryosurgical ablation of the prostate (includes 8038 10424 14707 7330 203.62 ultrasonic guidance and monitoring)
55874 Transperineal placement of biodegradable 11277 14623 20632 3797 105.48 material, peri-prostatic, single or multiple injection(s), including image guidance, when performed
55875 Transperineal placement of needles or catheters 2087 2707 3819 797 22.14 into prostate for interstitial radioelement application, with or without cystoscopy
55876 Placement of interstitial device(s) for radiation 394 511 721 142 3.94 therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple
55899 Unlisted procedure, male genital system 1872 2427 3424 0 0.00
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
374 CPT copyright 2017 American Medical Association. SURGERY – REPRODUCTIVE SYSTEM AND INTERSEX SURGERY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
REPRODUCTIVE SYSTEM PROCEDURES 55920 Placement of needles or catheters into pelvic 1366 1772 2500 467 12.97 organs and/or genitalia (except prostate) for subsequent interstitial radioelement application INTERSEX SURGERY 55970 Intersex surgery; male to female 0 0 0 0 0.00
55980 Intersex surgery; female to male 0 0 0 0 0.00
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
376 CPT copyright 2017 American Medical Association. SURGERY – FEMALE GENITAL SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
FEMALE GENITAL SYSTEM VULVA, PERINEUM AND INTROITUS
56405 Incision and drainage of vulva or perineal 345 450 674 112 3.10 abscess
56420 Incision and drainage of Bartholin's gland 364 475 711 125 3.47 abscess
56440 Marsupialization of Bartholin's gland cyst 580 757 1132 186 5.16
56441 Lysis of labial adhesions 347 453 678 148 4.12
56442 Hymenotomy, simple incision 152 198 296 49 1.36
56501 Destruction of lesion(s), vulva; simple (eg, laser 292 381 570 135 3.75 surgery, electrosurgery, cryosurgery, chemosurgery)
56515 Destruction of lesion(s), vulva; extensive (eg, 550 718 1074 232 6.45 laser surgery, electrosurgery, cryosurgery, chemosurgery)
56605 Biopsy of vulva or perineum (separate 218 285 426 84 2.33 procedure); 1 lesion
56606 Biopsy of vulva or perineum (separate 114 149 222 39 1.08 procedure); each separate additional lesion (list separately in addition to code for primary procedure)
56620 Vulvectomy simple; partial 1548 2019 3022 539 14.96
56625 Vulvectomy simple; complete 2006 2618 3917 652 18.12
56630 Vulvectomy, radical, partial; 2939 3834 5738 965 26.80
56631 Vulvectomy, radical, partial; with unilateral 3138 4095 6128 1233 34.24 inguinofemoral lymphadenectomy
56632 Vulvectomy, radical, partial; with bilateral 3653 4766 7132 1435 39.85 inguinofemoral lymphadenectomy
56633 Vulvectomy, radical, complete; 3202 4177 6251 1257 34.93
56634 Vulvectomy, radical, complete; with unilateral 3470 4528 6776 1363 37.86 inguinofemoral lymphadenectomy
56637 Vulvectomy, radical, complete; with bilateral 4061 5298 7928 1595 44.30 inguinofemoral lymphadenectomy
56640 Vulvectomy, radical, complete, with 4062 5300 7932 1596 44.32 inguinofemoral, iliac, and pelvic lymphadenectomy
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
56700 Partial hymenectomy or revision of hymenal 527 688 1029 190 5.27 ring
56740 Excision of Bartholin's gland or cyst 805 1051 1572 307 8.53
56800 Plastic repair of introitus 765 998 1494 246 6.82
56805 Clitoroplasty for intersex state 3182 4151 6212 1160 32.21
56810 Perineoplasty, repair of perineum, 753 983 1471 265 7.37 nonobstetrical (separate procedure)
56820 Colposcopy of the vulva; 328 428 641 115 3.20
56821 Colposcopy of the vulva; with biopsy(s) 361 471 705 151 4.20
VAGINA
57000 Colpotomy; with exploration 489 637 954 192 5.33
57010 Colpotomy; with drainage of pelvic abscess 1120 1461 2187 440 12.22
57020 Colpocentesis (separate procedure) 300 391 586 94 2.62
57022 Incision and drainage of vaginal hematoma; 452 590 883 170 4.73 obstetrical/postpartum
57023 Incision and drainage of vaginal hematoma; 709 925 1385 315 8.74 non-obstetrical (eg, post-trauma, spontaneous bleeding)
57061 Destruction of vaginal lesion(s); simple (eg, 270 352 527 117 3.24 laser surgery, electrosurgery, cryosurgery, chemosurgery)
57065 Destruction of vaginal lesion(s); extensive (eg, 575 750 1123 200 5.55 laser surgery, electrosurgery, cryosurgery, chemosurgery)
57100 Biopsy of vaginal mucosa; simple (separate 233 304 455 91 2.54 procedure)
57105 Biopsy of vaginal mucosa; extensive, requiring 378 493 737 140 3.88 suture (including cysts)
57106 Vaginectomy, partial removal of vaginal wall; 1284 1676 2508 508 14.12
57107 Vaginectomy, partial removal of vaginal wall; 3800 4958 7420 1493 41.46 with removal of paravaginal tissue (radical vaginectomy)
57109 Vaginectomy, partial removal of vaginal wall; 4645 6061 9070 1824 50.68 with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
lymphadenectomy and para-aortic lymph node sampling (biopsy)
57110 Vaginectomy, complete removal of vaginal 2020 2636 3945 908 25.23 wall;
57111 Vaginectomy, complete removal of vaginal 4645 6061 9070 1824 50.68 wall; with removal of paravaginal tissue (radical vaginectomy)
57112 Vaginectomy, complete removal of vaginal 4974 6490 9713 1954 54.27 wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy)
57120 Colpocleisis (le fort type) 1240 1618 2421 518 14.38
57130 Excision of vaginal septum 559 729 1091 180 5.00
57135 Excision of vaginal cyst or tumor 529 690 1033 197 5.46
57150 Irrigation of vagina and/or application of 126 164 245 46 1.28 medicament for treatment of bacterial, parasitic, or fungoid disease
57155 Insertion of uterine tandem and/or vaginal 1217 1588 2377 378 10.49 ovoids for clinical brachytherapy
57156 Insertion of a vaginal radiation afterloading 480 626 937 206 5.71 apparatus for clinical brachytherapy
57160 Fitting and insertion of pessary or other 161 211 315 77 2.15 intravaginal support device
57170 Diaphragm or cervical cap fitting with 154 201 301 62 1.71 instructions
57180 Introduction of any hemostatic agent or pack for 350 457 684 143 3.98 spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure)
57200 Colporrhaphy, suture of injury of vagina 787 1027 1537 309 8.59 (nonobstetrical)
57210 Colpoperineorrhaphy, suture of injury of vagina 1058 1380 2066 375 10.42 and/or perineum (nonobstetrical)
57220 Plastic operation on urethral sphincter, vaginal 748 975 1460 325 9.02 approach (eg, Kelly urethral plication)
57230 Plastic repair of urethrocele 823 1074 1607 400 11.12
57240 Anterior colporrhaphy, repair of cystocele with 1509 1969 2947 604 16.77 or without repair of urethrocele, including cystourethroscopy, when performed
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
57250 Posterior colporrhaphy, repair of rectocele with 1414 1845 2762 606 16.84 or without perineorrhaphy
57260 Combined anteroposterior colporrhaphy, 1980 2584 3867 777 21.58 including cystourethroscopy, when performed;
57265 Combined anteroposterior colporrhaphy, 2176 2840 4249 873 24.24 including cystourethroscopy, when performed; with enterocele repair
57267 Insertion of mesh or other prosthesis for repair 689 898 1344 262 7.29 of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list separately in addition to code for primary procedure)
57268 Repair of enterocele, vaginal approach (separate 1400 1827 2734 494 13.71 procedure)
57270 Repair of enterocele, abdominal approach 1755 2290 3426 822 22.82 (separate procedure)
57280 Colpopexy, abdominal approach 2430 3171 4745 974 27.06
57282 Colpopexy, vaginal; extra-peritoneal approach 1450 1891 2830 511 14.19 (sacrospinous, iliococcygeus)
57283 Colpopexy, vaginal; intra-peritoneal approach 1683 2196 3287 701 19.46 (uterosacral, levator myorrhaphy)
57284 Paravaginal defect repair (including repair of 2251 2936 4394 833 23.14 cystocele, if performed); open abdominal approach
57285 Paravaginal defect repair (including repair of 1477 1927 2883 687 19.08 cystocele, if performed); vaginal approach
57287 Removal or revision of sling for stress 1752 2286 3421 699 19.43 incontinence (eg, fascia or synthetic)
57288 Sling operation for stress incontinence (eg, 2040 2662 3984 734 20.40 fascia or synthetic)
57289 Pereyra procedure, including anterior 1967 2566 3841 773 21.46 colporrhaphy
57291 Construction of artificial vagina; without graft 1367 1783 2668 537 14.91
57292 Construction of artificial vagina; with graft 2106 2748 4113 827 22.98
57295 Revision (including removal) of prosthetic 1189 1551 2322 488 13.55 vaginal graft; vaginal approach
57296 Revision (including removal) of prosthetic 2443 3187 4770 959 26.65 vaginal graft; open abdominal approach
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
57300 Closure of rectovaginal fistula; vaginal or 1608 2098 3140 579 16.07 transanal approach
57305 Closure of rectovaginal fistula; abdominal 2455 3203 4793 964 26.78 approach
57307 Closure of rectovaginal fistula; abdominal 2692 3512 5256 1057 29.37 approach, with concomitant colostomy
57308 Closure of rectovaginal fistula; transperineal 1741 2271 3399 684 18.99 approach, with perineal body reconstruction, with or without levator plication
57310 Closure of urethrovaginal fistula; 1225 1598 2391 481 13.36
57311 Closure of urethrovaginal fistula; with 1392 1817 2719 547 15.19 bulbocavernosus transplant
57320 Closure of vesicovaginal fistula; vaginal 1399 1825 2731 549 15.26 approach
57330 Closure of vesicovaginal fistula; transvesical 1964 2563 3835 771 21.43 and vaginal approach
57335 Vaginoplasty for intersex state 3137 4093 6125 1171 32.53
57400 Dilation of vagina under anesthesia (other than 408 532 796 136 3.78 local)
57410 Pelvic examination under anesthesia (other than 280 365 547 111 3.07 local)
57415 Removal of impacted vaginal foreign body 379 495 741 164 4.56 (separate procedure) under anesthesia (other than local)
57420 Colposcopy of the entire vagina, with cervix if 310 404 605 121 3.36 present;
57421 Colposcopy of the entire vagina, with cervix if 398 519 776 161 4.48 present; with biopsy(s) of vagina/cervix
57423 Paravaginal defect repair (including repair of 2061 2689 4025 931 25.85 cystocele, if performed), laparoscopic approach
57425 Laparoscopy, surgical, colpopexy (suspension 2308 3012 4507 990 27.50 of vaginal apex)
57426 Revision (including removal) of prosthetic 2466 3217 4815 856 23.77 vaginal graft, laparoscopic approach
CERVIX UTERI
57452 Colposcopy of the cervix including 280 365 547 111 3.09 upper/adjacent vagina;
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
57454 Colposcopy of the cervix including 400 522 781 155 4.31 upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage
57455 Colposcopy of the cervix including 343 447 669 145 4.04 upper/adjacent vagina; with biopsy(s) of the cervix
57456 Colposcopy of the cervix including 342 446 668 137 3.81 upper/adjacent vagina; with endocervical curettage
57460 Colposcopy of the cervix including 771 1006 1506 287 7.97 upper/adjacent vagina; with loop electrode biopsy(s) of the cervix
57461 Colposcopy of the cervix including 879 1146 1716 325 9.02 upper/adjacent vagina; with loop electrode conization of the cervix
57500 Biopsy of cervix, single or multiple, or local 307 411 583 130 3.61 excision of lesion, with or without fulguration (separate procedure)
57505 Endocervical curettage (not done as part of a 259 347 492 105 2.91 dilation and curettage)
57510 Cautery of cervix; electro or thermal 304 407 577 134 3.73
57511 Cautery of cervix; cryocautery, initial or repeat 334 447 634 148 4.12
57513 Cautery of cervix; laser ablation 750 1006 1426 150 4.16
57520 Conization of cervix, with or without 939 1259 1785 315 8.75 fulguration, with or without dilation and curettage, with or without repair; cold knife or laser
57522 Conization of cervix, with or without 825 1106 1569 269 7.47 fulguration, with or without dilation and curettage, with or without repair; loop electrode excision
57530 Trachelectomy (cervicectomy), amputation of 955 1281 1816 354 9.82 cervix (separate procedure)
57531 Radical trachelectomy, with bilateral total 5118 6861 9731 1714 47.62 pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s)
57540 Excision of cervical stump, abdominal 2324 3116 4420 789 21.91 approach;
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
57545 Excision of cervical stump, abdominal 2306 3092 4385 832 23.12 approach; with pelvic floor repair
57550 Excision of cervical stump, vaginal approach; 1144 1534 2176 413 11.47
57555 Excision of cervical stump, vaginal approach; 1687 2261 3207 609 16.91 with anterior and/or posterior repair
57556 Excision of cervical stump, vaginal approach; 1596 2140 3035 576 16.00 with repair of enterocele
57558 Dilation and curettage of cervical stump 350 469 666 126 3.51
57700 Cerclage of uterine cervix, nonobstetrical 846 1134 1608 315 8.75
57720 Trachelorrhaphy, plastic repair of uterine 785 1053 1493 311 8.65 cervix, vaginal approach
57800 Dilation of cervical canal, instrumental 185 248 352 61 1.70 (separate procedure)
CORPUS UTERI
58100 Endometrial sampling (biopsy) with or without 266 357 506 111 3.08 endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)
58110 Endometrial sampling (biopsy) performed in 136 182 258 49 1.37 conjunction with colposcopy (list separately in addition to code for primary procedure)
58120 Dilation and curettage, diagnostic and/or 801 1074 1524 264 7.34 therapeutic (nonobstetrical)
58140 Myomectomy, excision of fibroid tumor(s) of 2651 3553 5040 935 25.97 uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach
58145 Myomectomy, excision of fibroid tumor(s) of 2501 3352 4755 561 15.58 uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach
58146 Myomectomy, excision of fibroid tumor(s) of 3392 4547 6449 1167 32.42 uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach
58150 Total abdominal hysterectomy (corpus and 2820 3781 5362 1042 28.95 cervix), with or without removal of tube(s), with or without removal of ovary(s);
58152 Total abdominal hysterectomy (corpus and 3095 4149 5885 1274 35.40 cervix), with or without removal of tube(s),
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
with or without removal of ovary(s); with colpo-urethrocystopexy (eg, marshall- Marchetti-Krantz, Burch)
58180 Supracervical abdominal hysterectomy (subtotal 2805 3760 5333 983 27.31 hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)
58200 Total abdominal hysterectomy, including partial 3994 5354 7594 1423 39.54 vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)
58210 Radical abdominal hysterectomy, with bilateral 5865 7863 11153 1917 53.26 total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)
58240 Pelvic exenteration for gynecologic 8358 11205 15893 3016 83.79 malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof
58260 Vaginal hysterectomy, for uterus 250 g or less; 2242 3005 4262 839 23.31
58262 Vaginal hysterectomy, for uterus 250 g or less; 2500 3352 4755 935 25.97 with removal of tube(s), and/or ovary(s)
58263 Vaginal hysterectomy, for uterus 250 g or less; 2638 3536 5015 1004 27.90 with removal of tube(s), and/or ovary(s), with repair of enterocele
58267 Vaginal hysterectomy, for uterus 250 g or less; 3189 4276 6065 1067 29.64 with colpo-urethrocystopexy (marshall- Marchetti-Krantz type, Pereyra type) with or without endoscopic control
58270 Vaginal hysterectomy, for uterus 250 g or less; 2732 3662 5194 896 24.89 with repair of enterocele
58275 Vaginal hysterectomy, with total or partial 2773 3718 5273 1001 27.80 vaginectomy;
58280 Vaginal hysterectomy, with total or partial 2949 3953 5607 1064 29.56 vaginectomy; with repair of enterocele
58285 Vaginal hysterectomy, radical (Schauta type 4131 5538 7855 1491 41.41 operation)
384 CPT copyright 2017 American Medical Association. SURGERY – FEMALE REPRODUCTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
58290 Vaginal hysterectomy, for uterus greater than 2819 3779 5360 1166 32.38 250 g;
58291 Vaginal hysterectomy, for uterus greater than 3213 4308 6110 1265 35.14 250 g; with removal of tube(s) and/or ovary(s)
58292 Vaginal hysterectomy, for uterus greater than 3684 4939 7005 1329 36.93 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele
58293 Vaginal hysterectomy, for uterus greater than 3831 5135 7284 1382 38.40 250 g; with colpo-urethrocystopexy (marshall- Marchetti-Krantz type, Pereyra type) with or without endoscopic control
58294 Vaginal hysterectomy, for uterus greater than 3414 4576 6491 1232 34.22 250 g; with repair of enterocele
58300 Insertion of intrauterine device (iud) 226 303 430 75 2.09
58301 Removal of intrauterine device (iud) 217 291 413 97 2.70
58321 Artificial insemination; intra-cervical 250 335 475 78 2.17
58322 Artificial insemination; intra-uterine 228 305 433 88 2.44
58323 Sperm washing for artificial insemination 150 201 285 16 0.44
58340 Catheterization and introduction of saline or 452 606 860 122 3.40 contrast material for saline infusion sonohysterography (sis) or hysterosalpingography
58345 Transcervical introduction of fallopian tube 1062 1424 2019 282 7.84 catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography
58346 Insertion of Heyman capsules for clinical 1287 1725 2447 464 12.90 brachytherapy
58350 Chromotubation of oviduct, including materials 263 353 500 99 2.74
58353 Endometrial ablation, thermal, without 2235 2996 4249 1023 28.41 hysteroscopic guidance
58356 Endometrial cryoablation with ultrasonic 5009 6715 9524 1905 52.93 guidance, including endometrial curettage, when performed
58400 Uterine suspension, with or without shortening 1291 1731 2455 450 12.49 of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure)
58410 Uterine suspension, with or without shortening 2255 3024 4289 814 22.61 of round ligaments, with or without shortening
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
of sacrouterine ligaments; with presacral sympathectomy
58520 Hysterorrhaphy, repair of ruptured uterus 2307 3093 4387 797 22.13 (nonobstetrical)
58540 Hysteroplasty, repair of uterine anomaly 2547 3414 4842 919 25.53 (Strassman type)
58541 Laparoscopy, surgical, supracervical 2400 3218 4564 729 20.24 hysterectomy, for uterus 250 g or less;
58542 Laparoscopy, surgical, supracervical 2480 3325 4716 831 23.09 hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
58543 Laparoscopy, surgical, supracervical 2865 3840 5447 841 23.37 hysterectomy, for uterus greater than 250 g;
58544 Laparoscopy, surgical, supracervical 3073 4120 5843 915 25.43 hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
58545 Laparoscopy, surgical, myomectomy, excision; 2711 3635 5156 921 25.57 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas
58546 Laparoscopy, surgical, myomectomy, excision; 3714 4979 7062 1139 31.63 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g
58548 Laparoscopy, surgical, with radical 5383 7217 10236 1970 54.73 hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed
58550 Laparoscopy, surgical, with vaginal 2512 3367 4776 896 24.89 hysterectomy, for uterus 250 g or less;
58552 Laparoscopy, surgical, with vaginal 2659 3565 5056 1008 28.00 hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
58553 Laparoscopy, surgical, with vaginal 3005 4029 5714 1145 31.81 hysterectomy, for uterus greater than 250 g;\
58554 Laparoscopy, surgical, with vaginal 3430 4598 6521 1354 37.62 hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
58555 Hysteroscopy, diagnostic (separate procedure) 880 1180 1674 274 7.60
58558 Hysteroscopy, surgical; with sampling (biopsy) 1521 2039 2892 1387 38.52 of endometrium and/or polypectomy, with or without d & c
386 CPT copyright 2017 American Medical Association. SURGERY – FEMALE REPRODUCTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
58559 Hysteroscopy, surgical; with lysis of 2008 2692 3819 297 8.26 intrauterine adhesions (any method)
58560 Hysteroscopy, surgical; with division or 1875 2514 3566 324 9.00 resection of intrauterine septum (any method)
58561 Hysteroscopy, surgical; with removal of 1841 2468 3500 371 10.30 leiomyomata
58562 Hysteroscopy, surgical; with removal of 1012 1357 1924 346 9.62 impacted foreign body
58563 Hysteroscopy, surgical; with endometrial 3385 4538 6436 1618 44.95 ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
58565 Hysteroscopy, surgical; with bilateral fallopian 4048 5427 7697 1896 52.68 tube cannulation to induce occlusion by placement of permanent implants
58570 Laparoscopy, surgical, with total hysterectomy, 2527 3388 4805 797 22.13 for uterus 250 g or less;
58571 Laparoscopy, surgical, with total hysterectomy, 2640 3539 5019 920 25.56 for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
58572 Laparoscopy, surgical, with total hysterectomy, 3009 4034 5722 1048 29.11 for uterus greater than 250 g;
58573 Laparoscopy, surgical, with total hysterectomy, 3384 4536 6434 1249 34.70 for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
58575 Laparoscopy, surgical, total hysterectomy for 5349 7170 10171 1930 53.62 resection of malignancy (tumor debulking), with omentectomy including salpingo- oophorectomy, unilateral or bilateral, when performed
58578 Unlisted laparoscopy procedure, uterus 2001 2682 3804 0 0.00
58579 Unlisted hysteroscopy procedure, uterus 0 0 0 0 0.00
OVIDUCT/OVARY
58600 Ligation or transection of fallopian tube(s), 1152 1633 2478 369 10.25 abdominal or vaginal approach, unilateral or bilateral
58605 Ligation or transection of fallopian tube(s), 974 1382 2096 334 9.27 abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)
CPT copyright 2017 American Medical Association. 387 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
58611 Ligation or transection of fallopian tube(s) 430 610 925 78 2.18 when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (list separately in addition to code for primary procedure)
58615 Occlusion of fallopian tube(s) by device (eg, 716 1016 1541 247 6.86 band, clip, Falope ring) vaginal or suprapubic approach
58660 Laparoscopy, surgical; with lysis of adhesions 1909 2708 4107 687 19.09 (salpingolysis, ovariolysis) (separate procedure)
58661 Laparoscopy, surgical; with removal of adnexal 1941 2753 4176 664 18.45 structures (partial or total oophorectomy and/or salpingectomy)
58662 Laparoscopy, surgical; with fulguration or 2008 2849 4321 725 20.15 excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
58670 Laparoscopy, surgical; with fulguration of 1196 1697 2574 370 10.28 oviducts (with or without transection)
58671 Laparoscopy, surgical; with occlusion of 1137 1614 2447 369 10.26 oviducts by device (eg, band, clip, or Falope ring)
58672 Laparoscopy, surgical; with fimbrioplasty 4358 6182 9377 744 20.67
58673 Laparoscopy, surgical; with salpingostomy 2522 3577 5425 809 22.47 (salpingoneostomy)
58674 Laparoscopy, surgical, ablation of uterine 2362 3351 5083 827 22.97 fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency
58679 Unlisted laparoscopy procedure, oviduct, ovary 2386 3384 5133 0 0.00
58700 Salpingectomy, complete or partial, unilateral 1950 2766 4196 797 22.13 or bilateral (separate procedure)
58720 Salpingo-oophorectomy, complete or partial, 2016 2860 4338 756 21.01 unilateral or bilateral (separate procedure)
58740 Lysis of adhesions (salpingolysis, ovariolysis) 2110 2993 4540 909 25.24
58750 Tubotubal anastomosis 2724 3864 5862 912 25.33
58752 Tubouterine implantation 2598 3685 5589 909 25.26
58760 Fimbrioplasty 2341 3320 5036 819 22.76
58770 Salpingostomy (salpingoneostomy) 2464 3495 5302 863 23.96
388 CPT copyright 2017 American Medical Association. SURGERY – FEMALE REPRODUCTIVE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
OVARY
58800 Drainage of ovarian cyst(s), unilateral or 730 1036 1571 323 8.97 bilateral (separate procedure); vaginal approach
58805 Drainage of ovarian cyst(s), unilateral or 1017 1442 2187 410 11.38 bilateral (separate procedure); abdominal approach
58820 Drainage of ovarian abscess; vaginal approach, 922 1308 1984 316 8.78 open
58822 Drainage of ovarian abscess; abdominal 2024 2871 4355 708 19.68 approach
58825 Transposition, ovary(s) 2003 2841 4309 703 19.54
58900 Biopsy of ovary, unilateral or bilateral (separate 1197 1698 2576 419 11.64 procedure)
58920 Wedge resection or bisection of ovary, 2139 3034 4602 709 19.69 unilateral or bilateral
58925 Ovarian cystectomy, unilateral or bilateral 2000 2838 4304 764 21.22
58940 Oophorectomy, partial or total, unilateral or 1575 2234 3388 541 15.03 bilateral;
58943 Oophorectomy, partial or total, unilateral or 3557 5045 7653 1217 33.80 bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy
58950 Resection (initial) of ovarian, tubal or primary 3404 4829 7324 1174 32.60 peritoneal malignancy with bilateral salpingo- oophorectomy and omentectomy;
58951 Resection (initial) of ovarian, tubal or primary 4710 6681 10134 1509 41.93 peritoneal malignancy with bilateral salpingo- oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy
58952 Resection (initial) of ovarian, tubal or primary 5009 7105 10777 1705 47.37 peritoneal malignancy with bilateral salpingo- oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)
CPT copyright 2017 American Medical Association. 389 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
58953 Bilateral salpingo-oophorectomy with 5749 8155 12370 2114 58.72 omentectomy, total abdominal hysterectomy and radical dissection for debulking;
58954 Bilateral salpingo-oophorectomy with 6397 9074 13763 2299 63.86 omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy
58956 Bilateral salpingo-oophorectomy with total 4206 5966 9050 1434 39.84 omentectomy, total abdominal hysterectomy for malignancy
58957 Resection (tumor debulking) of recurrent 4365 6192 9392 1649 45.80 ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed;
58958 Resection (tumor debulking) of recurrent 5014 7112 10788 1721 47.80 ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; with pelvic lymphadenectomy and limited para- aortic lymphadenectomy
58960 Laparotomy, for staging or restaging of ovarian, 2903 4118 6246 1009 28.04 tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy
IN VITRO FERTILIZATION
58970 Follicle puncture for oocyte retrieval, any 2000 2838 4304 226 6.27 method
58974 Embryo transfer, intrauterine 1063 1508 2288 0 0.00
58976 Gamete, zygote, or embryo intrafallopian 716 1015 1540 251 6.96 transfer, any method
OTHER PROCEDURES
58999 Unlisted procedure, female genital system 759 1077 1633 0 0.00 (nonobstetrical)
390 CPT copyright 2017 American Medical Association. SURGERY – MATERNITY CARE AND DELIVERY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
MATERNITY CARE AND DELIVERY ANTEPARTUM AND FETAL INVASIVE SERVICES
59000 Amniocentesis; diagnostic 461 616 891 130 3.61
59001 Amniocentesis; therapeutic amniotic fluid 677 905 1309 186 5.18 reduction (includes ultrasound guidance)
59012 Cordocentesis (intrauterine), any method 724 969 1401 210 5.84
59015 Chorionic villus sampling, any method 597 798 1154 162 4.49
59020 Fetal contraction stress test 313 419 605 73 2.02
59020-26 166 222 321 39 1.07
59020-TC 0 0 0 34 0.95
59025 Fetal non-stress test 134 180 260 50 1.38
59025-26 84 112 162 31 0.86
59025-TC 0 0 0 19 0.52
59030 Fetal scalp blood sampling 277 370 535 117 3.26
59050 Fetal monitoring during labor by consulting 200 267 386 53 1.47 physician (ie, non-attending physician) with written report; supervision and interpretation
59051 Fetal monitoring during labor by consulting 129 173 250 44 1.22 physician (ie, non-attending physician) with written report; interpretation only
59070 Transabdominal amnioinfusion, including 1040 1390 2011 419 11.64 ultrasound guidance
59072 Fetal umbilical cord occlusion, including 1285 1718 2485 544 15.12 ultrasound guidance
59074 Fetal fluid drainage (eg, vesicocentesis, 1420 1899 2746 404 11.23 thoracocentesis, paracentesis), including ultrasound guidance
59076 Fetal shunt placement, including ultrasound 1285 1718 2485 544 15.12 guidance
59100 Hysterotomy, abdominal (eg, for hydatidiform 2037 2725 3941 863 23.98 mole, abortion)
59120 Surgical treatment of ectopic pregnancy; tubal 2209 2955 4273 822 22.83 or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach
CPT copyright 2017 American Medical Association. 391 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
59121 Surgical treatment of ectopic pregnancy; tubal 1942 2598 3757 823 22.86 or ovarian, without salpingectomy and/or oophorectomy
59130 Surgical treatment of ectopic pregnancy; 2269 3034 4388 961 26.70 abdominal pregnancy
59135 Surgical treatment of ectopic pregnancy; 2241 2998 4335 950 26.38 interstitial, uterine pregnancy requiring total hysterectomy
59136 Surgical treatment of ectopic pregnancy; 2147 2872 4153 910 25.27 interstitial, uterine pregnancy with partial resection of uterus
59140 Surgical treatment of ectopic pregnancy; 978 1308 1892 414 11.51 cervical, with evacuation
59150 Laparoscopic treatment of ectopic pregnancy; 2099 2808 4060 797 22.14 without salpingectomy and/or oophorectomy
59151 Laparoscopic treatment of ectopic pregnancy; 2190 2929 4235 773 21.47 with salpingectomy and/or oophorectomy
59160 Curettage, postpartum 634 848 1226 211 5.87
59200 Insertion of cervical dilator (eg, laminaria, 208 279 403 75 2.07 prostaglandin) (separate procedure)
59300 Episiotomy or vaginal repair, by other than 476 637 921 200 5.56 attending
59320 Cerclage of cervix, during pregnancy; vaginal 794 1062 1536 158 4.40
59325 Cerclage of cervix, during pregnancy; 595 796 1150 252 7.00 abdominal
59350 Hysterorrhaphy of ruptured uterus 690 923 1334 292 8.12
VAGINAL DELIVERY, ANTEPARTUM AND POSTPARTUM CARE
59400 Routine obstetric care including antepartum 4330 5791 8374 2157 59.92 care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care
59409 Vaginal delivery only (with or without 2179 2915 4215 844 23.44 episiotomy and/or forceps);
59410 Vaginal delivery only (with or without 2503 3348 4841 1078 29.94 episiotomy and/or forceps); including postpartum care
59412 External cephalic version, with or without 348 466 674 107 2.98 tocolysis
59414 Delivery of placenta (separate procedure) 295 395 571 95 2.65
392 CPT copyright 2017 American Medical Association. SURGERY – MATERNITY CARE AND DELIVERY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
59425 Antepartum care only; 4-6 visits 797 1066 1541 469 13.02
59426 Antepartum care only; 7 or more visits 1800 2407 3481 838 23.27
59430 Postpartum care only (separate procedure) 318 425 614 190 5.27
CESAREAN DELIVERY
59510 Routine obstetric care including antepartum 4805 6427 9293 2393 66.46 care, cesarean delivery, and postpartum care
59514 Cesarean delivery only; 2530 3385 4894 950 26.39
59515 Cesarean delivery only; including postpartum 3044 4072 5888 1309 36.37 care
59525 Subtotal or total hysterectomy after cesarean 1520 2034 2941 504 14.01 delivery (list separately in addition to code for primary procedure)
DELIVERY AFTER PREVIOUS CESAREAN DELIVERY
59610 Routine obstetric care including antepartum 4764 6372 9214 2271 63.08 care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery
59612 Vaginal delivery only, after previous cesarean 2659 3556 5142 951 26.41 delivery (with or without episiotomy and/or forceps);
59614 Vaginal delivery only, after previous cesarean 2955 3952 5715 1182 32.84 delivery (with or without episiotomy and/or forceps); including postpartum care
59618 Routine obstetric care including antepartum 5195 6948 10047 2423 67.32 care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery
59620 Cesarean delivery only, following attempted 2928 3917 5664 985 27.35 vaginal delivery after previous cesarean delivery;
59622 Cesarean delivery only, following attempted 3335 4460 6450 1342 37.29 vaginal delivery after previous cesarean delivery; including postpartum care
ABORTION
59812 Treatment of incomplete abortion, any 864 1155 1671 328 9.11 trimester, completed surgically
59820 Treatment of missed abortion, completed 1010 1351 1954 392 10.89 surgically; first trimester
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
59821 Treatment of missed abortion, completed 1090 1458 2109 395 10.98 surgically; second trimester
59830 Treatment of septic abortion, completed 1065 1424 2059 451 12.53 surgically
59840 Induced abortion, by dilation and curettage 725 970 1403 225 6.24
59841 Induced abortion, by dilation and evacuation 1059 1416 2048 395 10.98
59850 Induced abortion, by 1 or more intra-amniotic 927 1240 1793 393 10.91 injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;
59851 Induced abortion, by 1 or more intra-amniotic 972 1300 1880 412 11.44 injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation
59852 Induced abortion, by 1 or more intra-amniotic 1236 1654 2391 524 14.55 injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra- amniotic injection)
59855 Induced abortion, by 1 or more vaginal 1234 1650 2386 429 11.93 suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;
59856 Induced abortion, by 1 or more vaginal 2127 2845 4114 505 14.02 suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation
59857 Induced abortion, by 1 or more vaginal 1269 1697 2454 537 14.93 suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)
OTHER PROCEDURES
59866 Multifetal pregnancy reduction(s) (MPR) 1269 1697 2454 225 6.25
59870 Uterine evacuation and curettage for 1217 1628 2354 487 13.54 hydatidiform mole
394 CPT copyright 2017 American Medical Association. SURGERY – MATERNITY CARE AND DELIVERY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
59871 Removal of cerclage suture under anesthesia 429 574 830 139 3.85 (other than local)
59897 Unlisted fetal invasive procedure, including 3186 4261 6161 0 0.00 ultrasound guidance, when performed
59898 Unlisted laparoscopy procedure, maternity care 0 0 0 0 0.00 and delivery
59899 Unlisted procedure, maternity care and delivery 576 770 1113 0 0.00
CPT copyright 2017 American Medical Association. 395 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
396 CPT copyright 2017 American Medical Association. SURGERY – ENDOCRINE SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
ENDOCRINE SYSTEM THYROID GLAND
60000 Incision and drainage of thyroglossal duct cyst, 491 648 979 173 4.81 infected
60100 Biopsy thyroid, percutaneous core needle 282 372 562 116 3.22
60200 Excision of cyst or adenoma of thyroid, or 1663 2197 3319 679 18.87 transection of isthmus
60210 Partial thyroid lobectomy, unilateral; with or 2005 2649 4002 729 20.26 without isthmusectomy
60212 Partial thyroid lobectomy, unilateral; with 3031 4005 6049 1070 29.71 contralateral subtotal lobectomy, including isthmusectomy
60220 Total thyroid lobectomy, unilateral; with or 2150 2841 4291 726 20.18 without isthmusectomy
60225 Total thyroid lobectomy, unilateral; with 2547 3366 5084 959 26.64 contralateral subtotal lobectomy, including isthmusectomy
60240 Thyroidectomy, total or complete 2815 3720 5618 948 26.33
60252 Thyroidectomy, total or subtotal for 3988 5269 7958 1363 37.85 malignancy; with limited neck dissection
60254 Thyroidectomy, total or subtotal for 4641 6132 9262 1719 47.75 malignancy; with radical neck dissection
60260 Thyroidectomy, removal of all remaining 3001 3965 5989 1126 31.29 thyroid tissue following previous removal of a portion of thyroid
60270 Thyroidectomy, including substernal thyroid; 4005 5292 7994 1413 39.26 sternal split or transthoracic approach
60271 Thyroidectomy, including substernal thyroid; 3120 4122 6227 1090 30.27 cervical approach
60280 Excision of thyroglossal duct cyst or sinus; 1557 2057 3107 451 12.54
60281 Excision of thyroglossal duct cyst or sinus; 1697 2242 3386 599 16.63 recurrent
60300 Aspiration and/or injection, thyroid cyst 325 429 649 121 3.36
PARATHYROID, THYMUS, ADRENAL GLANDS, PANCREAS AND CAROTID BODY
60500 Parathyroidectomy or exploration of 2827 3736 5642 998 27.73 parathyroid(s);
CPT copyright 2017 American Medical Association. 397 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
60502 Parathyroidectomy or exploration of 3520 4651 7026 1334 37.05 parathyroid(s); re-exploration
60505 Parathyroidectomy or exploration of 4056 5360 8095 1431 39.76 parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach
60512 Parathyroid autotransplantation (list separately 743 982 1483 252 7.01 in addition to code for primary procedure)
60520 Thymectomy, partial or total; transcervical 3385 4473 6756 1087 30.20 approach (separate procedure)
60521 Thymectomy, partial or total; sternal split or 3473 4589 6931 1164 32.34 transthoracic approach, without radical mediastinal dissection (separate procedure)
60522 Thymectomy, partial or total; sternal split or 4019 5311 8022 1418 39.40 transthoracic approach, with radical mediastinal dissection (separate procedure)
60540 Adrenalectomy, partial or complete, or 3155 4169 6297 1105 30.69 exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);
60545 Adrenalectomy, partial or complete, or 3585 4737 7155 1265 35.14 exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor
60600 Excision of carotid body tumor; without 4064 5370 8112 1434 39.84 excision of carotid artery
60605 Excision of carotid body tumor; with excision 5495 7261 10968 1738 48.28 of carotid artery
60650 Laparoscopy, surgical, with adrenalectomy, 3597 4753 7179 1242 34.49 partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal
60659 Unlisted laparoscopy procedure, endocrine 0 0 0 0 0.00 system
60699 Unlisted procedure, endocrine system 0 0 0 0 0.00
398 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
NERVOUS SYSTEM SKULL, MENINGES, AND BRAIN
61000 Subdural tap through fontanelle, or suture, 449 716 1031 120 3.34 infant, unilateral or bilateral; initial
61001 Subdural tap through fontanelle, or suture, 366 584 841 114 3.17 infant, unilateral or bilateral; subsequent taps
61020 Ventricular puncture through previous burr 568 906 1304 103 2.87 hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection
61026 Ventricular puncture through previous burr 399 637 917 109 3.04 hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment
61050 Cisternal or lateral cervical (C1-C2) puncture; 297 474 683 90 2.49 without injection (separate procedure)
61055 Cisternal or lateral cervical (C1-C2) puncture; 410 654 942 129 3.58 with injection of medication or other substance for diagnosis or treatment
61070 Puncture of shunt tubing or reservoir for 311 496 714 59 1.65 aspiration or injection procedure
61105 Twist drill hole for subdural or ventricular 1821 2906 4183 488 13.55 puncture
61107 Twist drill hole(s) for subdural, intracerebral, or 1372 2189 3152 332 9.21 ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device
61108 Twist drill hole(s) for subdural, intracerebral, or 3070 4897 7050 942 26.16 ventricular puncture; for evacuation and/or drainage of subdural hematoma
61120 Burr hole(s) for ventricular puncture (including 2940 4690 6752 787 21.87 injection of gas, contrast media, dye, or radioactive material)
61140 Burr hole(s) or trephine; with biopsy of brain or 4019 6411 9230 1328 36.89 intracranial lesion
61150 Burr hole(s) or trephine; with drainage of brain 5345 8526 12275 1431 39.76 abscess or cyst
61151 Burr hole(s) or trephine; with subsequent 3918 6251 8999 1049 29.15 tapping (aspiration) of intracranial abscess or cyst
CPT copyright 2017 American Medical Association. 399 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61154 Burr hole(s) with evacuation and/or drainage of 4040 6445 9278 1335 37.09 hematoma, extradural or subdural
61156 Burr hole(s); with aspiration of hematoma or 4916 7842 11290 1317 36.57 cyst, intracerebral
61210 Burr hole(s); for implanting ventricular catheter, 1640 2617 3767 391 10.86 reservoir, eeg electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure)
61215 Insertion of subcutaneous reservoir, pump or 1739 2774 3994 532 14.79 continuous infusion system for connection to ventricular catheter
61250 Burr hole(s) or trephine, supratentorial, 3416 5449 7845 915 25.41 exploratory, not followed by other surgery
61253 Burr hole(s) or trephine, infratentorial, 3549 5661 8151 1049 29.15 unilateral or bilateral
61304 Craniectomy or craniotomy, exploratory; 5632 7896 13166 1722 47.82 supratentorial
61305 Craniectomy or craniotomy, exploratory; 6716 9415 15700 2123 58.96 infratentorial (posterior fossa)
61312 Craniectomy or craniotomy for evacuation of 6507 9123 15212 2187 60.74 hematoma, supratentorial; extradural or subdural
61313 Craniectomy or craniotomy for evacuation of 6597 9249 15422 2084 57.90 hematoma, supratentorial; intracerebral
61314 Craniectomy or craniotomy for evacuation of 5729 8031 13392 1923 53.43 hematoma, infratentorial; extradural or subdural
61315 Craniectomy or craniotomy for evacuation of 6621 9282 15478 2174 60.39 hematoma, infratentorial; intracerebellar
61316 Incision and subcutaneous placement of cranial 310 435 726 94 2.60 bone graft (list separately in addition to code for primary procedure)
61320 Craniectomy or craniotomy, drainage of 6297 8828 14721 1999 55.54 intracranial abscess; supratentorial
61321 Craniectomy or craniotomy, drainage of 7117 9977 16637 2249 62.48 intracranial abscess; infratentorial
61322 Craniectomy or craniotomy, decompressive, 7289 10218 17039 2497 69.36 with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy
400 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61323 Craniectomy or craniotomy, decompressive, 7439 10429 17391 2527 70.20 with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy
61330 Decompression of orbit only, transcranial 6000 8412 14028 1896 52.68 approach
61332 Exploration of orbit (transcranial approach); 6312 8849 14755 2097 58.25 with biopsy
61333 Exploration of orbit (transcranial approach); 6681 9367 15619 2143 59.52 with removal of lesion
61340 Subtemporal cranial decompression 4832 6774 11296 1527 42.42 (pseudotumor cerebri, slit ventricle syndrome)
61343 Craniectomy, suboccipital with cervical 8296 11631 19394 2308 64.10 laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation)
61345 Other cranial decompression, posterior fossa 6819 9561 15942 2155 59.87
61450 Craniectomy, subtemporal, for section, 6430 9014 15031 2032 56.45 compression, or decompression of sensory root of gasserian ganglion
61458 Craniectomy, suboccipital; for exploration or 6713 9411 15693 2114 58.71 decompression of cranial nerves
61460 Craniectomy, suboccipital; for section of 1 or 7034 9861 16443 2223 61.75 more cranial nerves
61480 Craniectomy, suboccipital; for mesencephalic 6489 9098 15170 2051 56.97 tractotomy or pedunculotomy
61500 Craniectomy; with excision of tumor or other 4813 6747 11251 1378 38.28 bone lesion of skull
61501 Craniectomy; for osteomyelitis 3760 5271 8790 1188 33.01
61510 Craniectomy, trephination, bone flap 7041 9872 16461 2296 63.77 craniotomy; for excision of brain tumor, supratentorial, except meningioma
61512 Craniectomy, trephination, bone flap 8274 11600 19344 2677 74.37 craniotomy; for excision of meningioma, supratentorial
61514 Craniectomy, trephination, bone flap 6279 8803 14678 1998 55.50 craniotomy; for excision of brain abscess, supratentorial
CPT copyright 2017 American Medical Association. 401 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61516 Craniectomy, trephination, bone flap 6114 8571 14293 1959 54.42 craniotomy; for excision or fenestration of cyst, supratentorial
61517 Implantation of brain intracavitary 295 414 690 93 2.59 chemotherapy agent (list separately in addition to code for primary procedure)
61518 Craniectomy for excision of brain tumor, 8722 12229 20391 2893 80.36 infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull
61519 Craniectomy for excision of brain tumor, 9542 13377 22306 3084 85.68 infratentorial or posterior fossa; meningioma
61520 Craniectomy for excision of brain tumor, 11888 16667 27792 3918 108.84 infratentorial or posterior fossa; cerebellopontine angle tumor
61521 Craniectomy for excision of brain tumor, 10714 15021 25046 3355 93.19 infratentorial or posterior fossa; midline tumor at base of skull
61522 Craniectomy, infratentorial or posterior fossa; 7309 10247 17087 2310 64.17 for excision of brain abscess
61524 Craniectomy, infratentorial or posterior fossa; 6958 9755 16267 2199 61.09 for excision or fenestration of cyst
61526 Craniectomy, bone flap craniotomy, 11800 16544 27587 3730 103.60 transtemporal (mastoid) for excision of cerebellopontine angle tumor;
61530 Craniectomy, bone flap craniotomy, 10262 14386 23989 3243 90.09 transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy
61531 Subdural implantation of strip electrodes 4079 5718 9535 1289 35.81 through 1 or more burr or trephine hole(s) for long-term seizure monitoring
61533 Craniotomy with elevation of bone flap; for 5593 7841 13074 1604 44.55 subdural implantation of an electrode array, for long-term seizure monitoring
61534 Craniotomy with elevation of bone flap; for 5497 7707 12851 1737 48.26 excision of epileptogenic focus without electrocorticography during surgery
61535 Craniotomy with elevation of bone flap; for 3338 4681 7805 1055 29.31 removal of epidural or subdural electrode array,without excision of cerebral tissue (separate procedure)
402 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61536 Craniotomy with elevation of bone flap; for 8614 12077 20139 2723 75.63 excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)
61537 Craniotomy with elevation of bone flap; for 8206 11504 19183 2593 72.04 lobectomy, temporal lobe, without electrocorticography during surgery
61538 Craniotomy with elevation of bone flap; for 8915 12499 20842 2818 78.27 lobectomy, temporal lobe, with electrocorticography during surgery
61539 Craniotomy with elevation of bone flap; for 7888 11059 18440 2493 69.25 lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery
61540 Craniotomy with elevation of bone flap; for 7294 10227 17053 2305 64.04 lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery
61541 Craniotomy with elevation of bone flap; for 7180 10067 16786 2269 63.04 transection of corpus callosum
61543 Craniotomy with elevation of bone flap; for 7259 10177 16970 2294 63.73 partial or subtotal (functional) hemispherectomy
61544 Craniotomy with elevation of bone flap; for 6360 8917 14869 2010 55.84 excision or coagulation of choroid plexus
61545 Craniotomy with elevation of bone flap; for 10610 14875 24804 3353 93.15 excision of craniopharyngioma
61546 Craniotomy for hypophysectomy or excision of 7710 10809 18024 2437 67.69 pituitary tumor, intracranial approach
61548 Hypophysectomy or excision of pituitary tumor, 6326 8869 14790 1649 45.80 transnasal or transseptal approach, nonstereotactic
61550 Craniectomy for craniosynostosis; single cranial 3955 5544 9245 1250 34.72 suture
61552 Craniectomy for craniosynostosis; multiple 4291 6015 10030 1562 43.40 cranial sutures
61556 Craniotomy for craniosynostosis; frontal or 5694 7983 13311 1800 49.99 parietal bone flap
61557 Craniotomy for craniosynostosis; bifrontal bone 5613 7870 13122 1774 49.28 flap
CPT copyright 2017 American Medical Association. 403 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61558 Extensive craniectomy for multiple cranial 6275 8797 14669 1983 55.09 suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts
61559 Extensive craniectomy for multiple cranial 7832 10980 18309 2524 70.10 suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)
61563 Excision, intra and extracranial, benign tumor 6618 9278 15471 2092 58.10 of cranial bone (eg, fibrous dysplasia); without optic nerve decompression
61564 Excision, intra and extracranial, benign tumor 8039 11271 18794 2541 70.58 of cranial bone (eg, fibrous dysplasia); with optic nerve decompression
61566 Craniotomy with elevation of bone flap; for 7512 10532 17561 2374 65.95 selective amygdalohippocampectomy
61567 Craniotomy with elevation of bone flap; for 8554 11993 19998 2704 75.10 multiple subpial transections, with electrocorticography during surgery
61570 Craniectomy or craniotomy; with excision of 6241 8749 14589 1972 54.79 foreign body from brain
61571 Craniectomy or craniotomy; with treatment of 6646 9318 15537 2101 58.35 penetrating wound of brain
61575 Transoral approach to skull base, brain stem or 8368 11732 19564 2645 73.47 upper spinal cord for biopsy, decompression or excision of lesion;
61576 Transoral approach to skull base, brain stem or 12612 17682 29484 4404 122.33 upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy)
61580 Craniofacial approach to anterior cranial fossa; 8550 11987 19987 2528 70.23 extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration
61581 Craniofacial approach to anterior cranial fossa; 8530 11959 19942 2696 74.89 extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy
61582 Craniofacial approach to anterior cranial fossa; 9992 14008 23358 3158 87.72 extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa
404 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61583 Craniofacial approach to anterior cranial fossa; 10460 14665 24453 3003 83.41 intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa
61584 Orbitocranial approach to anterior cranial fossa, 11604 16268 27126 2981 82.80 extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration
61585 Orbitocranial approach to anterior cranial fossa, 10690 14987 24990 3379 93.85 extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration
61586 Bicoronal, transzygomatic and/or LeFort i 8027 11253 18765 2537 70.47 osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft
61590 Infratemporal pre-auricular approach to middle 9134 12805 21352 3156 87.67 cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parotidectomy, craniotomy, decompression and/or mobilization of the facial nerve and/or petrous carotid artery
61591 Infratemporal post-auricular approach to middle 8389 11761 19612 3180 88.33 cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resection of sigmoid sinus, with or without decompression and/or mobilization of contents of auditory canal or petrous carotid artery
61592 Orbitocranial zygomatic approach to middle 13306 18655 31107 3301 91.70 cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural elevation of temporal lobe
61595 Transtemporal approach to posterior cranial 7167 10048 16755 2413 67.03 fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization
61596 Transcochlear approach to posterior cranial 7907 11086 18485 2499 69.42 fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid artery
CPT copyright 2017 American Medical Association. 405 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61597 Transcondylar (far lateral) approach to posterior 9880 13851 23097 3123 86.74 cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompression of vertebral artery, with or without mobilization
61598 Transpetrosal approach to posterior cranial 9437 13230 22061 2983 82.85 fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus
61600 Resection or excision of neoplastic, vascular or 6797 9529 15889 2202 61.17 infectious lesion of base of anterior cranial fossa; extradural
61601 Resection or excision of neoplastic, vascular or 9806 13748 22924 2499 69.41 infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft
61605 Resection or excision of neoplastic, vascular or 6527 9151 15259 2216 61.57 infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural
61606 Resection or excision of neoplastic, vascular or 9706 13607 22690 3068 85.21 infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft
61607 Resection or excision of neoplastic, vascular or 9519 13345 22253 3008 83.57 infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural
61608 Resection or excision of neoplastic, vascular or 13437 18839 31413 3395 94.32 infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft
61610 Transection or ligation, carotid artery in 6146 8616 14367 1995 55.41 cavernous sinus, with repair by anastomosis or graft (list separately in addition to code for primary procedure)
61611 Transection or ligation, carotid artery in petrous 1438 2016 3362 499 13.87 canal; without repair (list separately in addition to code for primary procedure)
61612 Transection or ligation, carotid artery in petrous 4597 6446 10748 1874 52.06 canal; with repair by anastomosis or graft (list separately in addition to code for primary procedure)
406 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61613 Obliteration of carotid aneurysm, arteriovenous 10922 15313 25534 3452 95.89 malformation, or carotid-cavernous fistula by dissection within cavernous sinus
61615 Resection or excision of neoplastic, vascular or 9159 12841 21411 2942 81.71 infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural
61616 Resection or excision of neoplastic, vascular or 14642 20527 34229 3469 96.37 infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, with or without graft
61618 Secondary repair of dura for cerebrospinal fluid 5465 7661 12775 1350 37.51 leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)
61619 Secondary repair of dura for cerebrospinal fluid 4599 6448 10752 1495 41.52 leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis muscle)
61623 Endovascular temporary balloon arterial 2347 3384 5815 605 16.80 occlusion, head or neck (extracranial/ intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiography required for balloon occlusion and to exclude vascular injury post occlusion
61624 Transcatheter permanent occlusion or 3850 5551 9538 1209 33.58 embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord)
61626 Transcatheter permanent occlusion or 3069 4425 7604 907 25.19 embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; non- central nervous system, head or neck (extracranial, brachiocephalic branch)
CPT copyright 2017 American Medical Association. 407 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61630 Balloon angioplasty, intracranial (eg, 4180 6026 10355 1433 39.81 atherosclerotic stenosis), percutaneous
61635 Transcatheter placement of intravascular 4246 6122 10519 1527 42.42 stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed
61640 Balloon dilatation of intracranial vasospasm, 2321 3347 5751 504 14.01 percutaneous; initial vessel
61641 Balloon dilatation of intracranial vasospasm, 675 973 1672 177 4.92 percutaneous; each additional vessel in same vascular family (list separately in addition to code for primary procedure)
61642 Balloon dilatation of intracranial vasospasm, 1351 1947 3346 354 9.84 percutaneous; each additional vessel in different vascular family (list separately in addition to code for primary procedure)
61645 Percutaneous arterial transluminal mechanical 2491 3592 6172 865 24.04 thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s)
61650 Endovascular intracranial prolonged 1731 2496 4289 564 15.66 administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory
61651 Endovascular intracranial prolonged 756 1090 1873 239 6.65 administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (list separately in addition to code for primary procedure)
61680 Surgery of intracranial arteriovenous 9170 13221 22717 2357 65.48 malformation; supratentorial, simple
61682 Surgery of intracranial arteriovenous 15808 22791 39161 4365 121.24 malformation; supratentorial, complex
61684 Surgery of intracranial arteriovenous 10400 14995 25765 2999 83.31 malformation; infratentorial, simple
61686 Surgery of intracranial arteriovenous 16170 23314 40059 4663 129.53 malformation; infratentorial, complex
408 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61690 Surgery of intracranial arteriovenous 8006 11543 19833 2309 64.13 malformation; dural, simple
61692 Surgery of intracranial arteriovenous 13344 19239 33058 3848 106.89 malformation; dural, complex
61697 Surgery of complex intracranial aneurysm, 13101 18889 32455 4410 122.50 intracranial approach; carotid circulation
61698 Surgery of complex intracranial aneurysm, 16580 23904 41074 4781 132.81 intracranial approach; vertebrobasilar circulation
61700 Surgery of simple intracranial aneurysm, 11152 16079 27628 3575 99.32 intracranial approach; carotid circulation
61702 Surgery of simple intracranial aneurysm, 14635 21100 36255 4220 117.23 intracranial approach; vertebrobasilar circulation
61703 Surgery of intracranial aneurysm, cervical 4975 7173 12324 1435 39.85 approach by application of occluding clamp to cervical carotid artery ((No Suggestions) type)
61705 Surgery of aneurysm, vascular malformation or 9529 13739 23606 2748 76.33 carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery
61708 Surgery of aneurysm, vascular malformation or 9321 13438 23090 2688 74.66 carotid-cavernous fistula; by intracranial electrothrombosis
61710 Surgery of aneurysm, vascular malformation or 7842 11307 19428 2261 62.82 carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter
61711 Anastomosis, arterial, extracranial-intracranial 10331 14895 25593 2745 76.26 (eg, middle cerebral/cortical) arteries
61720 Creation of lesion by stereotactic method, 4652 6706 11523 1341 37.26 including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus
61735 Creation of lesion by stereotactic method, 5820 8391 14418 1678 46.62 including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus
61750 Stereotactic biopsy, aspiration, or excision, 5004 7215 12397 1488 41.34 including burr hole(s), for intracranial lesion;
CPT copyright 2017 American Medical Association. 409 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61751 Stereotactic biopsy, aspiration, or excision, 5510 7943 13649 1454 40.39 including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance
61760 Stereotactic implantation of depth electrodes 7004 10098 17351 1664 46.23 into the cerebrum for long-term seizure monitoring
61770 Stereotactic localization, including burr hole(s), 5950 8578 14740 1716 47.66 with insertion of catheter(s) or probe(s) for placement of radiation source
61781 Stereotactic computer-assisted (navigational) 932 1343 2308 250 6.95 procedure; cranial, intradural (list separately in addition to code for primary procedure)
61782 Stereotactic computer-assisted (navigational) 624 900 1547 180 5.01 procedure; cranial, extradural (list separately in addition to code for primary procedure)
61783 Stereotactic computer-assisted (navigational) 825 1189 2043 245 6.81 procedure; spinal (list separately in addition to code for primary procedure)
61790 Creation of lesion by stereotactic method, 3687 5315 9133 926 25.71 percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion
61791 Creation of lesion by stereotactic method, 4116 5934 10197 1187 32.97 percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract
61796 Stereotactic radiosurgery (particle beam, 3981 5740 9863 1069 29.69 gamma ray, or linear accelerator); 1 simple cranial lesion
61797 Stereotactic radiosurgery (particle beam, 960 1384 2378 235 6.52 gamma ray, or linear accelerator); each additional cranial lesion, simple (list separately in addition to code for primary procedure)
61798 Stereotactic radiosurgery (particle beam, 5555 8009 13761 1456 40.45 gamma ray, or linear accelerator); 1 complex cranial lesion
61799 Stereotactic radiosurgery (particle beam, 1186 1710 2939 323 8.96 gamma ray, or linear accelerator); each additional cranial lesion, complex (list separately in addition to code for primary procedure)
410 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61800 Application of stereotactic headframe for 607 875 1503 163 4.53 stereotactic radiosurgery (list separately in addition to code for primary procedure)
61850 Twist drill or burr hole(s) for implantation of 3594 5182 8904 1036 28.79 neurostimulator electrodes, cortical
61860 Craniectomy or craniotomy for implantation of 5731 8263 14198 1653 45.91 neurostimulator electrodes, cerebral, cortical
61863 Twist drill, burr hole, craniotomy, or 5766 8313 14284 1580 43.89 craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array
61864 Twist drill, burr hole, craniotomy, or 1295 1867 3209 301 8.37 craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional array (list separately in addition to primary procedure)
61867 Twist drill, burr hole, craniotomy, or 6343 9145 15713 2401 66.69 craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array
61868 Twist drill, burr hole, craniotomy, or 2052 2958 5083 530 14.73 craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; each additional array (list separately in addition to primary procedure)
61870 Craniectomy for implantation of 4247 6123 10520 1249 34.70 neurostimulator electrodes, cerebellar, cortical
61880 Revision or removal of intracranial 1718 2476 4255 596 16.55 neurostimulator electrodes
61885 Insertion or replacement of cranial 1668 2404 4131 538 14.94 neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array
CPT copyright 2017 American Medical Association. 411 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
61886 Insertion or replacement of cranial 2811 4053 6963 885 24.58 neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays
61888 Revision or removal of cranial neurostimulator 1353 1951 3352 417 11.58 pulse generator or receiver
62000 Elevation of depressed skull fracture; simple, 3769 5434 9337 1087 30.19 extradural
62005 Elevation of depressed skull fracture; 4653 6708 11526 1342 37.27 compound or comminuted, extradural
62010 Elevation of depressed skull fracture; with 5426 7823 13442 1618 44.94 repair of dura and/or debridement of brain
62100 Craniotomy for repair of dural/cerebrospinal 5605 8081 13886 1659 46.08 fluid leak, including surgery for rhinorrhea/otorrhea
62115 Reduction of craniomegalic skull (eg, treated 5337 7695 13222 1764 49.01 hydrocephalus); not requiring bone grafts or cranioplasty
62117 Reduction of craniomegalic skull (eg, treated 7191 10367 17814 2074 57.60 hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts)
62120 Repair of encephalocele, skull vault, including 6759 9746 16745 2240 62.23 cranioplasty
62121 Craniotomy for repair of encephalocele, skull 6173 8901 15293 1780 49.45 base
62140 Cranioplasty for skull defect; up to 5 cm 3690 5321 9142 1075 29.86 diameter
62141 Cranioplasty for skull defect; larger than 5 cm 4230 6099 10479 1191 33.08 diameter
62142 Removal of bone flap or prosthetic plate of 2961 4269 7335 930 25.82 skull
62143 Replacement of bone flap or prosthetic plate of 3553 5123 8802 1090 30.29 skull
62145 Cranioplasty for skull defect with reparative 5505 7937 13638 1481 41.15 brain surgery
62146 Cranioplasty with autograft (includes obtaining 4494 6480 11134 1296 36.00 bone grafts); up to 5 cm diameter
412 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
62147 Cranioplasty with autograft (includes obtaining 5841 8422 14470 1541 42.80 bone grafts); larger than 5 cm diameter
62148 Incision and retrieval of subcutaneous cranial 483 696 1196 135 3.74 bone graft for cranioplasty (list separately in addition to code for primary procedure)
62160 Neuroendoscopy, intracranial, for placement or 623 899 1544 202 5.61 replacement of ventricular catheter and attachment to shunt system or external drainage (list separately in addition to code for primary procedure)
62161 Neuroendoscopy, intracranial; with dissection 5671 8176 14049 1601 44.46 of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter)
62162 Neuroendoscopy, intracranial; with fenestration 6922 9980 17149 1996 55.45 or excision of colloid cyst, including placement of external ventricular catheter for drainage
62163 Neuroendoscopy, intracranial; with retrieval of 4478 6456 11093 1291 35.87 foreign body
62164 Neuroendoscopy, intracranial; with excision of 7650 11030 18952 2206 61.28 brain tumor, including placement of external ventricular catheter for drainage
62165 Neuroendoscopy, intracranial; with excision of 5764 8310 14279 1601 44.46 pituitary tumor, transnasal or trans-sphenoidal approach
62180 Ventriculocisternostomy (Torkildsen type 5862 8452 14523 1691 46.96 operation)
62190 Creation of shunt; subarachnoid/subdural-atrial, 3019 4353 7480 974 27.06 -jugular, -auricular
62192 Creation of shunt; subarachnoid/subdural- 3563 5137 8826 1027 28.54 peritoneal, -pleural, other terminus
62194 Replacement or irrigation, 1774 2558 4395 512 14.21 subarachnoid/subdural catheter
62200 Ventriculocisternostomy, third ventricle; 5042 7270 12491 1454 40.39
62201 Ventriculocisternostomy, third ventricle; 4847 6988 12007 1267 35.20 stereotactic, neuroendoscopic method
62220 Creation of shunt; ventriculo-atrial, -jugular, - 3684 5312 9126 1062 29.51 auricular
62223 Creation of shunt; ventriculo-peritoneal, - 3806 5487 9427 1094 30.39 pleural, other terminus
CPT copyright 2017 American Medical Association. 413 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
62225 Replacement or irrigation, ventricular catheter 1977 2850 4897 547 15.19
62230 Replacement or revision of cerebrospinal fluid 3030 4369 7507 882 24.51 shunt, obstructed valve, or distal catheter in shunt system
62252 Reprogramming of programmable cerebrospinal 301 434 745 87 2.43 shunt
62252-26 167 241 414 49 1.35
62252-TC 0 0 0 39 1.08
62256 Removal of complete cerebrospinal fluid shunt 1977 2850 4897 628 17.45 system; without replacement
62258 Removal of complete cerebrospinal fluid shunt 4124 5945 10216 1172 32.55 system; with replacement by similar or other shunt at same operation
SPINE AND SPINAL CORD
62263 Percutaneous lysis of epidural adhesions using 1112 1782 3085 612 17.01 solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days
62264 Percutaneous lysis of epidural adhesions using 1501 2405 4165 430 11.95 solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day
62267 Percutaneous aspiration within the nucleus 551 883 1529 255 7.07 pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes
62268 Percutaneous aspiration, spinal cord cyst or 865 1386 2400 268 7.44 syrinx
62269 Biopsy of spinal cord, percutaneous needle 884 1416 2452 271 7.54
62270 Spinal puncture, lumbar, diagnostic 402 644 1115 162 4.51
62272 Spinal puncture, therapeutic, for drainage of 458 734 1271 208 5.78 cerebrospinal fluid (by needle or catheter)
62273 Injection, epidural, of blood or clot patch 680 1090 1887 178 4.95
62280 Injection/infusion of neurolytic substance (eg, 1050 1682 2912 321 8.93 alcohol, phenol, iced saline solutions), with or
414 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
without other therapeutic substance; subarachnoid
62281 Injection/infusion of neurolytic substance (eg, 714 1144 1982 245 6.81 alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic
62282 Injection/infusion of neurolytic substance (eg, 520 833 1442 297 8.25 alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal)
62284 Injection procedure for myelography and/or 450 721 1248 195 5.41 computed tomography, lumbar
62287 Decompression procedure, percutaneous, of 2892 4634 8024 595 16.54 nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar
62290 Injection procedure for discography, each level; 878 1407 2437 334 9.28 lumbar
62291 Injection procedure for discography, each level; 753 1207 2090 332 9.22 cervical or thoracic
62292 Injection procedure for chemonucleolysis, 1935 3100 5368 594 16.51 including discography, intervertebral disc, single or multiple levels, lumbar
62294 Injection procedure, arterial, for occlusion of 3261 5225 9048 1002 27.83 arteriovenous malformation, spinal
62302 Myelography via lumbar injection, including 523 838 1451 249 6.91 radiological supervision and interpretation; cervical
62303 Myelography via lumbar injection, including 613 983 1702 255 7.07 radiological supervision and interpretation; thoracic
62304 Myelography via lumbar injection, including 513 822 1424 246 6.82 radiological supervision and interpretation; lumbosacral
62305 Myelography via lumbar injection, including 522 836 1447 267 7.42 radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)
CPT copyright 2017 American Medical Association. 415 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
62320 Injection(s), of diagnostic or therapeutic 639 1024 1773 170 4.73 substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance
62321 Injection(s), of diagnostic or therapeutic 800 1282 2220 254 7.05 substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or ct)
62322 Injection(s), of diagnostic or therapeutic 768 1231 2131 160 4.44 substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance
62323 Injection(s), of diagnostic or therapeutic 750 1202 2081 251 6.96 substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or ct)
62324 Injection(s), including indwelling catheter 745 1194 2067 149 4.14 placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance
62325 Injection(s), including indwelling catheter 828 1327 2298 226 6.27 placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or ct)
62326 Injection(s), including indwelling catheter 640 1025 1776 157 4.36 placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
416 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance
62327 Injection(s), including indwelling catheter 735 1178 2039 230 6.39 placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or ct)
62350 Implantation, revision or repositioning of 1653 2648 4586 414 11.51 tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy
62351 Implantation, revision or repositioning of 4303 6895 11939 895 24.86 tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy
62355 Removal of previously implanted intrathecal or 975 1562 2704 278 7.73 epidural catheter
62360 Implantation or replacement of device for 1359 2177 3769 324 8.99 intrathecal or epidural drug infusion; subcutaneous reservoir
62361 Implantation or replacement of device for 1460 2340 4051 449 12.46 intrathecal or epidural drug infusion; nonprogrammable pump
62362 Implantation or replacement of device for 1496 2396 4150 399 11.07 intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming
62365 Removal of subcutaneous reservoir or pump, 1192 1910 3308 308 8.55 previously implanted for intrathecal or epidural infusion
62367 Electronic analysis of programmable, implanted 152 243 421 44 1.21 pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming or refill
62368 Electronic analysis of programmable, implanted 178 285 493 59 1.63 pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm
CPT copyright 2017 American Medical Association. 417 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
status, drug prescription status); with reprogramming
62369 Electronic analysis of programmable, implanted 282 452 782 123 3.41 pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill
62370 Electronic analysis of programmable, implanted 351 562 973 130 3.60 pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring skill of a physician or other qualified health care professional)
62380 Endoscopic decompression of spinal cord, nerve 7502 12019 20812 0 0.00 root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar
63001 Laminectomy with exploration and/or 3929 6295 10900 1299 36.08 decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical
63003 Laminectomy with exploration and/or 3751 6009 10406 1302 36.16 decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic
63005 Laminectomy with exploration and/or 3958 6341 10980 1238 34.38 decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis
63011 Laminectomy with exploration and/or 3158 5060 8762 1139 31.65 decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral
63012 Laminectomy with removal of abnormal facets 3069 4917 8514 1247 34.64 and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (gill type procedure)
63015 Laminectomy with exploration and/or 4867 7798 13504 1554 43.16 decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or
418 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical
63016 Laminectomy with exploration and/or 4801 7692 13319 1603 44.52 decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic
63017 Laminectomy with exploration and/or 4636 7428 12862 1317 36.57 decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar
63020 Laminotomy (hemilaminectomy), with 4442 7117 12324 1212 33.67 decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical
63030 Laminotomy (hemilaminectomy), with 3658 5861 10148 1015 28.19 decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar
63035 Laminotomy (hemilaminectomy), with 846 1356 2348 201 5.58 decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or lumbar (list separately in addition to code for primary procedure)
63040 Laminotomy (hemilaminectomy), with 4460 7146 12375 1464 40.67 decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical
63042 Laminotomy (hemilaminectomy), with 4435 7106 12304 1356 37.66 decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar
63043 Laminotomy (hemilaminectomy), with 1379 2210 3826 0 0.00 decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional cervical interspace (list separately in addition to code for primary procedure)
CPT copyright 2017 American Medical Association. 419 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
63044 Laminotomy (hemilaminectomy), with 1391 2229 3859 0 0.00 decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional lumbar interspace (list separately in addition to code for primary procedure)
63045 Laminectomy, facetectomy and foraminotomy 5143 8239 14268 1346 37.38 (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical
63046 Laminectomy, facetectomy and foraminotomy 4432 7100 12295 1281 35.58 (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic
63047 Laminectomy, facetectomy and foraminotomy 4138 6630 11481 1152 32.00 (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar
63048 Laminectomy, facetectomy and foraminotomy 911 1459 2527 222 6.18 (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (list separately in addition to code for primary procedure)
63050 Laminoplasty, cervical, with decompression of 5393 8641 14963 1657 46.02 the spinal cord, 2 or more vertebral segments;
63051 Laminoplasty, cervical, with decompression of 5693 9121 15793 1787 49.64 the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)
63055 Transpedicular approach with decompression of 6902 11057 19147 1705 47.35 spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic
63056 Transpedicular approach with decompression of 5854 9380 16242 1556 43.23 spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral
420 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
extraforaminal approach) (eg, far lateral herniated intervertebral disc)
63057 Transpedicular approach with decompression of 2448 3922 6791 337 9.35 spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (list separately in addition to code for primary procedure)
63064 Costovertebral approach with decompression of 5686 9110 15774 1866 51.83 spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment
63066 Costovertebral approach with decompression of 716 1147 1987 220 6.11 spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (list separately in addition to code for primary procedure)
63075 Discectomy, anterior, with decompression of 5040 8075 13983 1413 39.26 spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace
63076 Discectomy, anterior, with decompression of 1688 2705 4684 260 7.21 spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (list separately in addition to code for primary procedure)
63077 Discectomy, anterior, with decompression of 4616 7396 12808 1558 43.27 spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace
63078 Discectomy, anterior, with decompression of 720 1153 1996 221 6.14 spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (list separately in addition to code for primary procedure)
63081 Vertebral corpectomy (vertebral body 5538 8874 15366 1841 51.13 resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment
63082 Vertebral corpectomy (vertebral body 1050 1682 2913 280 7.79 resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (list separately in addition to code for primary procedure)
63085 Vertebral corpectomy (vertebral body 6104 9780 16935 2000 55.57 resection), partial or complete, transthoracic
CPT copyright 2017 American Medical Association. 421 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment
63086 Vertebral corpectomy (vertebral body 742 1189 2060 201 5.57 resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (list separately in addition to code for primary procedure)
63087 Vertebral corpectomy (vertebral body 6927 11098 19218 2529 70.25 resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment
63088 Vertebral corpectomy (vertebral body 1045 1674 2899 260 7.21 resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (list separately in addition to code for primary procedure)
63090 Vertebral corpectomy (vertebral body 5781 9262 16038 2052 56.99 resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment
63091 Vertebral corpectomy (vertebral body 903 1447 2506 187 5.19 resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional segment (list separately in addition to code for primary procedure)
63101 Vertebral corpectomy (vertebral body 7941 12723 22032 2434 67.61 resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment
63102 Vertebral corpectomy (vertebral body 6086 9750 16883 2372 65.90 resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment
63103 Vertebral corpectomy (vertebral body 931 1492 2583 309 8.59 resection), partial or complete, lateral
422 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment (list separately in addition to code for primary procedure)
63170 Laminectomy with myelotomy (eg, Bischof or 5473 8769 15184 1681 46.70 DREZ type), cervical, thoracic, or thoracolumbar
63172 Laminectomy with drainage of intramedullary 4852 7773 13461 1490 41.40 cyst/syrinx; to subarachnoid space
63173 Laminectomy with drainage of intramedullary 5933 9506 16462 1823 50.63 cyst/syrinx; to peritoneal or pleural space
63180 Laminectomy and section of dentate ligaments, 5108 8185 14173 1569 43.59 with or without dural graft, cervical; 1 or 2 segments
63182 Laminectomy and section of dentate ligaments, 5609 8986 15561 1723 47.86 with or without dural graft, cervical; more than 2 segments
63185 Laminectomy with rhizotomy; 1 or 2 segments 2834 4541 7863 1185 32.92
63190 Laminectomy with rhizotomy; more than 2 4235 6786 11750 1301 36.14 segments
63191 Laminectomy with section of spinal accessory 4736 7587 13139 1455 40.41 nerve
63194 Laminectomy with cordotomy, with section of 1 5406 8661 14997 1687 46.85 spinothalamic tract, 1 stage; cervical
63195 Laminectomy with cordotomy, with section of 1 4888 7832 13561 1624 45.12 spinothalamic tract, 1 stage; thoracic
63196 Laminectomy with cordotomy, with section of 5434 8706 15075 1882 52.28 both spinothalamic tracts, 1 stage; cervical
63197 Laminectomy with cordotomy, with section of 5506 8822 15276 1807 50.20 both spinothalamic tracts, 1 stage; thoracic
63198 Laminectomy with cordotomy with section of 6402 10257 17762 2209 61.37 both spinothalamic tracts, 2 stages within 14 days; cervical
63199 Laminectomy with cordotomy with section of 6718 10763 18637 2315 64.30 both spinothalamic tracts, 2 stages within 14 days; thoracic
63200 Laminectomy, with release of tethered spinal 5185 8308 14386 1610 44.72 cord, lumbar
CPT copyright 2017 American Medical Association. 423 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
63250 Laminectomy for excision or occlusion of 9847 18431 35631 3130 86.94 arteriovenous malformation of spinal cord; cervical
63251 Laminectomy for excision or occlusion of 10061 18831 36405 3198 88.83 arteriovenous malformation of spinal cord; thoracic
63252 Laminectomy for excision or occlusion of 10060 18829 36401 3197 88.82 arteriovenous malformation of spinal cord; thoracolumbar
63265 Laminectomy for excision or evacuation of 5200 9734 18818 1753 48.69 intraspinal lesion other than neoplasm, extradural; cervical
63266 Laminectomy for excision or evacuation of 5511 10316 19942 1804 50.10 intraspinal lesion other than neoplasm, extradural; thoracic
63267 Laminectomy for excision or evacuation of 4286 8023 15511 1433 39.80 intraspinal lesion other than neoplasm, extradural; lumbar
63268 Laminectomy for excision or evacuation of 4784 8955 17311 1521 42.24 intraspinal lesion other than neoplasm, extradural; sacral
63270 Laminectomy for excision of intraspinal lesion 6902 12919 24975 2194 60.94 other than neoplasm, intradural; cervical
63271 Laminectomy for excision of intraspinal lesion 6577 12310 23798 2170 60.29 other than neoplasm, intradural; thoracic
63272 Laminectomy for excision of intraspinal lesion 5894 11032 21327 1990 55.27 other than neoplasm, intradural; lumbar
63273 Laminectomy for excision of intraspinal lesion 6196 11598 22422 1970 54.71 other than neoplasm, intradural; sacral
63275 Laminectomy for biopsy/excision of intraspinal 6385 11952 23106 1889 52.48 neoplasm; extradural, cervical
63276 Laminectomy for biopsy/excision of intraspinal 6358 11901 23008 1872 52.00 neoplasm; extradural, thoracic
63277 Laminectomy for biopsy/excision of intraspinal 5262 9849 19041 1628 45.21 neoplasm; extradural, lumbar
63278 Laminectomy for biopsy/excision of intraspinal 5278 9879 19098 1678 46.60 neoplasm; extradural, sacral
63280 Laminectomy for biopsy/excision of intraspinal 7493 14025 27113 2220 61.67 neoplasm; intradural, extramedullary, cervical
424 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
63281 Laminectomy for biopsy/excision of intraspinal 6919 12950 25035 2198 61.07 neoplasm; intradural, extramedullary, thoracic
63282 Laminectomy for biopsy/excision of intraspinal 6937 12984 25101 2067 57.42 neoplasm; intradural, extramedullary, lumbar
63283 Laminectomy for biopsy/excision of intraspinal 6312 11814 22840 2006 55.73 neoplasm; intradural, sacral
63285 Laminectomy for biopsy/excision of intraspinal 8685 16256 31426 2760 76.68 neoplasm; intradural, intramedullary, cervical
63286 Laminectomy for biopsy/excision of intraspinal 8578 16056 31041 2727 75.74 neoplasm; intradural, intramedullary, thoracic
63287 Laminectomy for biopsy/excision of intraspinal 9110 17053 32967 2896 80.44 neoplasm; intradural, intramedullary, thoracolumbar
63290 Laminectomy for biopsy/excision of intraspinal 9263 17339 33520 2944 81.79 neoplasm; combined extradural-intradural lesion, any level
63295 Osteoplastic reconstruction of dorsal spinal 1350 2527 4885 354 9.83 elements, following primary intraspinal procedure (list separately in addition to code for primary procedure)
63300 Vertebral corpectomy (vertebral body 6107 11431 22099 1921 53.35 resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical
63301 Vertebral corpectomy (vertebral body 7328 13716 26516 2329 64.70 resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach
63302 Vertebral corpectomy (vertebral body 7236 13544 26184 2300 63.89 resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach
63303 Vertebral corpectomy (vertebral body 7689 14392 27823 2444 67.89 resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach
63304 Vertebral corpectomy (vertebral body 7806 14611 28246 2481 68.92 resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical
CPT copyright 2017 American Medical Association. 425 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
63305 Vertebral corpectomy (vertebral body 8306 15548 30057 2640 73.34 resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach
63306 Vertebral corpectomy (vertebral body 7563 14157 27368 2594 72.07 resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach
63307 Vertebral corpectomy (vertebral body 7931 14845 28699 2541 70.59 resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach
63308 Vertebral corpectomy (vertebral body 1200 2246 4342 338 9.39 resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (list separately in addition to codes for single segment)
63600 Creation of lesion of spinal cord by stereotactic 2345 4389 8484 1095 30.41 method, percutaneous, any modality (including stimulation and/or recording)
63610 Stereotactic stimulation of spinal cord, 2125 3977 7688 618 17.17 percutaneous, separate procedure not followed by other surgery
63615 Stereotactic biopsy, aspiration, or excision of 4112 7698 14881 1307 36.31 lesion, spinal cord
63620 Stereotactic radiosurgery (particle beam, 4392 8221 15893 1181 32.81 gamma ray, or linear accelerator); 1 spinal lesion
63621 Stereotactic radiosurgery (particle beam, 849 1590 3074 270 7.50 gamma ray, or linear accelerator); each additional spinal lesion (list separately in addition to code for primary procedure)
63650 Percutaneous implantation of neurostimulator 3946 7386 14279 1353 37.59 electrode array, epidural
63655 Laminectomy for implantation of 2608 4882 9437 867 24.07 neurostimulator electrodes, plate/paddle, epidural
63661 Removal of spinal neurostimulator electrode 1803 3375 6524 602 16.73 percutaneous array(s), including fluoroscopy, when performed
63662 Removal of spinal neurostimulator electrode 2250 4212 8143 876 24.33 plate/paddle(s) placed via laminotomy or
426 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
laminectomy, including fluoroscopy, when performed
63663 Revision including replacement, when 3030 5672 10965 810 22.49 performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
63664 Revision including replacement, when 2348 4395 8496 912 25.33 performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed
63685 Insertion or replacement of spinal 1500 2808 5428 377 10.47 neurostimulator pulse generator or receiver, direct or inductive coupling
63688 Revision or removal of implanted spinal 1600 2995 5790 387 10.76 neurostimulator pulse generator or receiver
63700 Repair of meningocele; less than 5 cm diameter 4462 8352 16147 1370 38.05
63702 Repair of meningocele; larger than 5 cm 4646 8696 16811 1500 41.68 diameter
63704 Repair of myelomeningocele; less than 5 cm 5292 9905 19148 1739 48.31 diameter
63706 Repair of myelomeningocele; larger than 5 cm 6092 11403 22045 1936 53.79 diameter
63707 Repair of dural/cerebrospinal fluid leak, not 3021 5654 10930 965 26.81 requiring laminectomy
63709 Repair of dural/cerebrospinal fluid leak or 3260 6103 11798 1150 31.94 pseudomeningocele, with laminectomy
63710 Dural graft, spinal 4014 7513 14525 1131 31.43
63740 Creation of shunt, lumbar, subarachnoid- 3224 6035 11668 1025 28.47 peritoneal, -pleural, or other; including laminectomy
63741 Creation of shunt, lumbar, subarachnoid- 2112 3954 7643 711 19.74 peritoneal, -pleural, or other; percutaneous, not requiring laminectomy
63744 Replacement, irrigation or revision of 2327 4355 8420 689 19.13 lumbosubarachnoid shunt
63746 Removal of entire lumbosubarachnoid shunt 1987 3718 7188 631 17.54 system without replacement
CPT copyright 2017 American Medical Association. 427 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
EXTRACRANIAL NERVES, PERIPHERAL NERVES AND AUTONOMIC NERVOUS SYSTEM
64400 Injection, anesthetic agent; trigeminal nerve, 320 554 1024 135 3.74 any division or branch
64402 Injection, anesthetic agent; facial nerve 268 465 858 145 4.02
64405 Injection, anesthetic agent; greater occipital 259 448 829 105 2.93 nerve
64408 Injection, anesthetic agent; vagus nerve 468 810 1497 119 3.31
64410 Injection, anesthetic agent; phrenic nerve 608 1054 1947 158 4.40
64413 Injection, anesthetic agent; cervical plexus 502 870 1607 131 3.63
64415 Injection, anesthetic agent; brachial plexus, 827 1433 2648 121 3.37 single
64416 Injection, anesthetic agent; brachial plexus, 1391 2410 4452 82 2.27 continuous infusion by catheter (including catheter placement)
64417 Injection, anesthetic agent; axillary nerve 720 1247 2305 133 3.69
64418 Injection, anesthetic agent; suprascapular nerve 341 591 1092 120 3.34
64420 Injection, anesthetic agent; intercostal nerve, 283 490 904 114 3.18 single
64421 Injection, anesthetic agent; intercostal nerves, 600 1039 1920 155 4.30 multiple, regional block
64425 Injection, anesthetic agent; ilioinguinal, 435 753 1392 138 3.82 iliohypogastric nerves
64430 Injection, anesthetic agent; pudendal nerve 451 781 1443 141 3.91
64435 Injection, anesthetic agent; paracervical 286 496 917 140 3.89 (uterine) nerve
64445 Injection, anesthetic agent; sciatic nerve, single 563 974 1800 141 3.91
64446 Injection, anesthetic agent; sciatic nerve, 1284 2224 4109 82 2.27 continuous infusion by catheter (including catheter placement)
64447 Injection, anesthetic agent; femoral nerve, 736 1275 2356 125 3.46 single
64448 Injection, anesthetic agent; femoral nerve, 1139 1973 3646 74 2.05 continuous infusion by catheter (including catheter placement)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64449 Injection, anesthetic agent; lumbar plexus, 900 1559 2881 87 2.43 posterior approach, continuous infusion by catheter (including catheter placement)
64450 Injection, anesthetic agent; other peripheral 244 423 782 82 2.28 nerve or branch
64455 Injection(s), anesthetic agent and/or steroid, 125 217 400 49 1.36 plantar common digital nerve(s) (eg, Morton's neuroma)
64461 Paravertebral block (PVB) (paraspinous block), 725 1255 2319 152 4.22 thoracic; single injection site (includes imaging guidance, when performed)
64462 Paravertebral block (PVB) (paraspinous block), 408 707 1305 84 2.32 thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (list separately in addition to code for primary procedure)
64463 Paravertebral block (PVB) (paraspinous block), 993 1719 3177 162 4.51 thoracic; continuous infusion by catheter (includes imaging guidance, when performed)
64479 Injection(s), anesthetic agent and/or steroid, 1000 1732 3201 240 6.68 transforaminal epidural, with imaging guidance (fluoroscopy or ct); cervical or thoracic, single level
64480 Injection(s), anesthetic agent and/or steroid, 482 835 1543 116 3.22 transforaminal epidural, with imaging guidance (fluoroscopy or ct); cervical or thoracic, each additional level (list separately in addition to code for primary procedure)
64483 Injection(s), anesthetic agent and/or steroid, 932 1615 2983 223 6.20 transforaminal epidural, with imaging guidance (fluoroscopy or ct); lumbar or sacral, single level
64484 Injection(s), anesthetic agent and/or steroid, 484 838 1548 94 2.62 transforaminal epidural, with imaging guidance (fluoroscopy or ct); lumbar or sacral, each additional level (list separately in addition to code for primary procedure)
64486 Transversus abdominis plane (tap) block 608 1053 1946 120 3.33 (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)
64487 Transversus abdominis plane (tap) block 796 1379 2548 137 3.80 (abdominal plane block, rectus sheath block)
CPT copyright 2017 American Medical Association. 429 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
unilateral; by continuous infusion(s) (includes imaging guidance, when performed)
64488 Transversus abdominis plane (tap) block 1070 1854 3425 138 3.83 (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed)
64489 Transversus abdominis plane (tap) block 800 1386 2560 187 5.19 (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed)
64490 Injection(s), diagnostic or therapeutic agent, 835 1446 2671 194 5.38 paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; single level
64491 Injection(s), diagnostic or therapeutic agent, 417 723 1336 95 2.65 paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; second level (list separately in addition to code for primary procedure)
64492 Injection(s), diagnostic or therapeutic agent, 400 693 1280 96 2.67 paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; third and any additional level(s) (list separately in addition to code for primary procedure)
64493 Injection(s), diagnostic or therapeutic agent, 860 1489 2752 176 4.88 paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; single level
64494 Injection(s), diagnostic or therapeutic agent, 403 698 1290 88 2.45 paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; second level (list separately in addition to code for primary procedure)
64495 Injection(s), diagnostic or therapeutic agent, 361 626 1156 88 2.45 paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)
430 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64505 Injection, anesthetic agent; sphenopalatine 189 327 604 112 3.12 ganglion
64508 Injection, anesthetic agent; carotid sinus 231 400 739 51 1.41 (separate procedure)
64510 Injection, anesthetic agent; stellate ganglion 533 924 1707 130 3.62 (cervical sympathetic)
64517 Injection, anesthetic agent; superior hypogastric 791 1370 2532 195 5.41 plexus
64520 Injection, anesthetic agent; lumbar or thoracic 624 1081 1996 192 5.33 (paravertebral sympathetic)
64530 Injection, anesthetic agent; celiac plexus, with 810 1402 2591 193 5.36 or without radiologic monitoring
64550 Application of surface (transcutaneous) 45 78 145 18 0.51 neurostimulator (eg, tens unit)
64553 Percutaneous implantation of neurostimulator 1269 2198 4060 1157 32.14 electrode array; cranial nerve
64555 Percutaneous implantation of neurostimulator 1356 2349 4339 1237 34.35 electrode array; peripheral nerve (excludes sacral nerve)
64561 Percutaneous implantation of neurostimulator 3936 6817 12594 853 23.69 electrode array; sacral nerve (transforaminal placement) including image guidance, if performed
64566 Posterior tibial neurostimulation, percutaneous 301 521 962 132 3.68 needle electrode, single treatment, includes programming
64568 Incision for implantation of cranial nerve (eg, 1887 3269 6039 667 18.52 vagus nerve) neurostimulator electrode array and pulse generator
64569 Revision or replacement of cranial nerve (eg, 2916 5050 9331 804 22.34 vagus nerve) neurostimulator electrode array, including connection to existing pulse generator
64570 Removal of cranial nerve (eg, vagus nerve) 3008 5210 9625 773 21.48 neurostimulator electrode array and pulse generator
64575 Incision for implantation of neurostimulator 4388 7600 14041 334 9.28 electrode array; peripheral nerve (excludes sacral nerve)
64580 Incision for implantation of neurostimulator 1245 2156 3983 317 8.81 electrode array; neuromuscular
CPT copyright 2017 American Medical Association. 431 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64581 Incision for implantation of neurostimulator 2000 3465 6401 690 19.18 electrode array; sacral nerve (transforaminal placement)
64585 Revision or removal of peripheral 810 1403 2592 252 7.00 neurostimulator electrode array
64590 Insertion or replacement of peripheral or gastric 682 1181 2181 274 7.62 neurostimulator pulse generator or receiver, direct or inductive coupling
64595 Revision or removal of peripheral or gastric 736 1275 2356 253 7.03 neurostimulator pulse generator or receiver
64600 Destruction by neurolytic agent, trigeminal 834 1371 2462 417 11.57 nerve; supraorbital, infraorbital, mental, or inferior alveolar branch
64605 Destruction by neurolytic agent, trigeminal 1975 3248 5831 559 15.53 nerve; second and third division branches at foramen ovale
64610 Destruction by neurolytic agent, trigeminal 2224 3656 6565 763 21.19 nerve; second and third division branches at foramen ovale under radiologic monitoring
64611 Chemodenervation of parotid and 300 493 886 124 3.45 submandibular salivary glands, bilateral
64612 Chemodenervation of muscle(s); muscle(s) 360 591 1062 137 3.81 innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)
64615 Chemodenervation of muscle(s); muscle(s) 385 633 1137 152 4.21 innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)
64616 Chemodenervation of muscle(s); neck 341 561 1007 135 3.74 muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)
64617 Chemodenervation of muscle(s); larynx, 500 822 1476 165 4.58 unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed
64620 Destruction by neurolytic agent, intercostal 778 1279 2297 210 5.84 nerve
64630 Destruction by neurolytic agent; pudendal nerve 462 759 1362 236 6.56
64632 Destruction by neurolytic agent; plantar 200 329 590 88 2.44 common digital nerve
432 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64633 Destruction by neurolytic agent, paravertebral 1331 2188 3929 429 11.92 facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, single facet joint
64634 Destruction by neurolytic agent, paravertebral 620 1020 1831 193 5.36 facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, each additional facet joint (list separately in addition to code for primary procedure)
64635 Destruction by neurolytic agent, paravertebral 1333 2191 3935 424 11.79 facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, single facet joint
64636 Destruction by neurolytic agent, paravertebral 599 984 1768 175 4.87 facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, each additional facet joint (list separately in addition to code for primary procedure)
64640 Destruction by neurolytic agent; other 624 1026 1842 136 3.77 peripheral nerve or branch
64642 Chemodenervation of one extremity; 1-4 363 597 1072 148 4.12 muscle(s)
64643 Chemodenervation of one extremity; each 251 412 741 95 2.65 additional extremity, 1-4 muscle(s) (list separately in addition to code for primary procedure)
64644 Chemodenervation of one extremity; 5 or more 408 670 1203 170 4.71 muscles
64645 Chemodenervation of one extremity; each 321 529 949 118 3.27 additional extremity, 5 or more muscles (list separately in addition to code for primary procedure)
64646 Chemodenervation of trunk muscle(s); 1-5 414 681 1222 155 4.30 muscle(s)
64647 Chemodenervation of trunk muscle(s); 6 or 493 811 1456 184 5.11 more muscles
64650 Chemodenervation of eccrine glands; both 250 412 739 80 2.23 axillae
64653 Chemodenervation of eccrine glands; other 276 454 814 99 2.74 area(s) (eg, scalp, face, neck), per day
64680 Destruction by neurolytic agent, with or without 825 1357 2436 310 8.61 radiologic monitoring; celiac plexus
CPT copyright 2017 American Medical Association. 433 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64681 Destruction by neurolytic agent, with or without 561 922 1656 532 14.79 radiologic monitoring; superior hypogastric plexus
64702 Neuroplasty; digital, 1 or both, same digit 1565 2573 4620 518 14.39
64704 Neuroplasty; nerve of hand or foot 1016 1671 3001 330 9.17
64708 Neuroplasty, major peripheral nerve, arm or leg, 1825 3001 5389 517 14.35 open; other than specified
64712 Neuroplasty, major peripheral nerve, arm or leg, 1860 3058 5490 599 16.63 open; sciatic nerve
64713 Neuroplasty, major peripheral nerve, arm or leg, 3205 5269 9461 797 22.13 open; brachial plexus
64714 Neuroplasty, major peripheral nerve, arm or leg, 1826 3002 5391 737 20.46 open; lumbar plexus
64716 Neuroplasty and/or transposition; cranial nerve 2575 4233 7601 546 15.18 (specify)
64718 Neuroplasty and/or transposition; ulnar nerve at 2056 3381 6071 613 17.04 elbow
64719 Neuroplasty and/or transposition; ulnar nerve at 1495 2458 4413 414 11.51 wrist
64721 Neuroplasty and/or transposition; median nerve 1683 2767 4968 444 12.34 at carpal tunnel
64722 Decompression; unspecified nerve(s) (specify) 1124 1848 3319 371 10.30
64726 Decompression; plantar digital nerve 800 1315 2362 280 7.79
64727 Internal neurolysis, requiring use of operating 740 1217 2185 192 5.33 microscope (list separately in addition to code for neuroplasty) (neuroplasty includes external neurolysis)
64732 Transection or avulsion of; supraorbital nerve 1295 1971 3487 462 12.82
64734 Transection or avulsion of; infraorbital nerve 1533 2333 4129 523 14.52
64736 Transection or avulsion of; mental nerve 1176 1790 3167 401 11.14
64738 Transection or avulsion of; inferior alveolar 1408 2144 3793 480 13.34 nerve by osteotomy
64740 Transection or avulsion of; lingual nerve 1497 2279 4032 510 14.18
64742 Transection or avulsion of; facial nerve, 1493 2272 4021 509 14.14 differential or complete
434 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64744 Transection or avulsion of; greater occipital 1517 2309 4086 517 14.37 nerve
64746 Transection or avulsion of; phrenic nerve 1308 1991 3523 446 12.39
64755 Transection or avulsion of; vagus nerves limited 2808 4275 7563 958 26.60 to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)
64760 Transection or avulsion of; vagus nerve 1568 2386 4222 535 14.85 (vagotomy), abdominal
64763 Transection or avulsion of obturator nerve, 1552 2362 4180 529 14.70 extrapelvic, with or without adductor tenotomy
64766 Transection or avulsion of obturator nerve, 1912 2910 5149 652 18.11 intrapelvic, with or without adductor tenotomy
64771 Transection or avulsion of other cranial nerve, 1804 2746 4859 615 17.09 extradural
64772 Transection or avulsion of other spinal nerve, 1872 2850 5043 586 16.27 extradural
64774 Excision of neuroma; cutaneous nerve, 910 1386 2452 427 11.85 surgically identifiable
64776 Excision of neuroma; digital nerve, 1 or both, 1216 1852 3276 405 11.24 same digit
64778 Excision of neuroma; digital nerve, each 490 746 1321 191 5.31 additional digit (list separately in addition to code for primary procedure)
64782 Excision of neuroma; hand or foot, except 1206 1835 3247 472 13.11 digital nerve
64783 Excision of neuroma; hand or foot, each 656 999 1767 229 6.35 additional nerve, except same digit (list separately in addition to code for primary procedure)
64784 Excision of neuroma; major peripheral nerve, 1907 2903 5137 753 20.92 except sciatic
64786 Excision of neuroma; sciatic nerve 3200 4872 8620 1041 28.92
64787 Implantation of nerve end into bone or muscle 777 1183 2092 251 6.98 (list separately in addition to neuroma excision)
64788 Excision of neurofibroma or neurolemmoma; 1290 1964 3475 410 11.38 cutaneous nerve
CPT copyright 2017 American Medical Association. 435 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64790 Excision of neurofibroma or neurolemmoma; 2475 3769 6668 873 24.25 major peripheral nerve
64792 Excision of neurofibroma or neurolemmoma; 3675 5594 9898 1253 34.81 extensive (including malignant type)
64795 Biopsy of nerve 617 939 1662 203 5.64
64802 Sympathectomy, cervical 2222 3383 5986 873 24.25
64804 Sympathectomy, cervicothoracic 3101 4721 8353 1246 34.60
64809 Sympathectomy, thoracolumbar 3133 4770 8440 1145 31.81
64818 Sympathectomy, lumbar 1919 2922 5169 654 18.18
64820 Sympathectomy; digital arteries, each digit 2096 3190 5645 738 20.50
64821 Sympathectomy; radial artery 2107 3208 5675 719 19.96
64822 Sympathectomy; ulnar artery 2107 3208 5675 719 19.96
64823 Sympathectomy; superficial palmar arch 2399 3653 6463 818 22.73
64831 Suture of digital nerve, hand or foot; 1 nerve 2162 3291 5822 712 19.77
64832 Suture of digital nerve, hand or foot; each 1130 1720 3044 352 9.78 additional digital nerve (list separately in addition to code for primary procedure)
64834 Suture of 1 nerve; hand or foot, common 2289 3485 6166 768 21.32 sensory nerve
64835 Suture of 1 nerve; median motor thenar 2483 3780 6688 847 23.52
64836 Suture of 1 nerve; ulnar motor 2270 3455 6114 847 23.52
64837 Suture of each additional nerve, hand or foot 1131 1722 3046 385 10.70 (list separately in addition to code for primary procedure)
64840 Suture of posterior tibial nerve 2932 4464 7899 1000 27.78
64856 Suture of major peripheral nerve, arm or leg, 3171 4827 8540 1052 29.23 except sciatic; including transposition
64857 Suture of major peripheral nerve, arm or leg, 3179 4839 8562 1100 30.55 except sciatic; without transposition
64858 Suture of sciatic nerve 3595 5474 9684 1226 34.06
64859 Suture of each additional major peripheral nerve 1120 1705 3016 262 7.27 (list separately in addition to code for primary procedure)
64861 Suture of; brachial plexus 4322 6581 11643 1597 44.37
436 CPT copyright 2017 American Medical Association. SURGERY – NERVOUS SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64862 Suture of; lumbar plexus 4211 6411 11342 1436 39.89
64864 Suture of facial nerve; extracranial 3327 5066 8963 905 25.13
64865 Suture of facial nerve; infratemporal, with or 3312 5043 8922 1130 31.38 without grafting
64866 Anastomosis; facial-spinal accessory 3915 5961 10546 1335 37.09
64868 Anastomosis; facial-hypoglossal 3048 4641 8211 1034 28.73
64872 Suture of nerve; requiring secondary or delayed 358 545 964 122 3.39 suture (list separately in addition to code for primary neurorrhaphy)
64874 Suture of nerve; requiring extensive 538 820 1450 184 5.10 mobilization, or transposition of nerve (list separately in addition to code for nerve suture)
64876 Suture of nerve; requiring shortening of bone of 609 927 1641 208 5.77 extremity (list separately in addition to code for nerve suture)
64885 Nerve graft (includes obtaining graft), head or 3402 5180 9164 1160 32.23 neck; up to 4 cm in length
64886 Nerve graft (includes obtaining graft), head or 3903 5941 10512 1331 36.97 neck; more than 4 cm length
64890 Nerve graft (includes obtaining graft), single 3342 5088 9002 1125 31.25 strand, hand or foot; up to 4 cm length
64891 Nerve graft (includes obtaining graft), single 3509 5342 9451 1197 33.24 strand, hand or foot; more than 4 cm length
64892 Nerve graft (includes obtaining graft), single 3207 4882 8638 1094 30.38 strand, arm or leg; up to 4 cm length
64893 Nerve graft (includes obtaining graft), single 3423 5212 9221 1167 32.43 strand, arm or leg; more than 4 cm length
64895 Nerve graft (includes obtaining graft), multiple 4059 6179 10933 1384 38.45 strands (cable), hand or foot; up to 4 cm length
64896 Nerve graft (includes obtaining graft), multiple 4378 6664 11791 1493 41.47 strands (cable), hand or foot; more than 4 cm length
64897 Nerve graft (includes obtaining graft), multiple 3876 5901 10441 1322 36.72 strands (cable), arm or leg; up to 4 cm length
64898 Nerve graft (includes obtaining graft), multiple 4391 6685 11828 1433 39.81 strands (cable), arm or leg; more than 4 cm length
CPT copyright 2017 American Medical Association. 437 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
64901 Nerve graft, each additional nerve; single strand 1841 2803 4959 628 17.44 (list separately in addition to code for primary procedure)
64902 Nerve graft, each additional nerve; multiple 2131 3245 5741 727 20.19 strands (cable) (list separately in addition to code for primary procedure)
64905 Nerve pedicle transfer; first stage 3714 5654 10004 1055 29.30
64907 Nerve pedicle transfer; second stage 3981 6060 10722 1358 37.71
64910 Nerve repair; with synthetic conduit or vein 2222 3383 5986 831 23.09 allograft (eg, nerve tube), each nerve
64911 Nerve repair; with autogenous vein graft 3127 4760 8422 1066 29.62 (includes harvest of vein graft), each nerve
64912 Nerve repair; with nerve allograft, each nerve, 2363 3598 6366 806 22.39 first strand (cable)
64913 Nerve repair; with nerve allograft, each 479 730 1291 163 4.54 additional strand (list separately in addition to code for primary procedure)
64999 Unlisted procedure, nervous system 0 0 0 0 0.00
438 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
EYE AND OCULAR ADNEXA EYEBALL
65091 Evisceration of ocular contents; without implant 1689 2408 3096 651 18.09
65093 Evisceration of ocular contents; with implant 1934 2757 3545 644 17.89
65101 Enucleation of eye; without implant 1962 2798 3598 757 21.02
65103 Enucleation of eye; with implant, muscles not 1974 2814 3619 790 21.94 attached to implant
65105 Enucleation of eye; with implant, muscles 2469 3520 4526 870 24.18 attached to implant
65110 Exenteration of orbit (does not include skin 3246 4629 5951 1252 34.77 graft), removal of orbital contents; only
65112 Exenteration of orbit (does not include skin 3765 5369 6903 1452 40.33 graft), removal of orbital contents; with therapeutic removal of bone
65114 Exenteration of orbit (does not include skin 3948 5630 7239 1522 42.29 graft), removal of orbital contents; with muscle or myocutaneous flap
65125 Modification of ocular implant with placement 1220 1740 2237 471 13.07 or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure)
65130 Insertion of ocular implant secondary; after 1947 2776 3569 751 20.85 evisceration, in scleral shell
65135 Insertion of ocular implant secondary; after 1975 2815 3620 761 21.15 enucleation, muscles not attached to implant
65140 Insertion of ocular implant secondary; after 2146 3060 3935 828 22.99 enucleation, muscles attached to implant
65150 Reinsertion of ocular implant; with or without 1537 2191 2817 593 16.46 conjunctival graft
65155 Reinsertion of ocular implant; with use of 2249 3207 4123 867 24.09 foreign material for reinforcement and/or attachment of muscles to implant
65175 Removal of ocular implant 1747 2491 3203 674 18.71
65205 Removal of foreign body, external eye; 150 214 275 58 1.62 conjunctival superficial
65210 Removal of foreign body, external eye; 152 216 278 71 1.97 conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating
CPT copyright 2017 American Medical Association. 439 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
65220 Removal of foreign body, external eye; corneal, 224 319 411 61 1.69 without slit lamp
65222 Removal of foreign body, external eye; corneal, 176 251 323 69 1.93 with slit lamp
65235 Removal of foreign body, intraocular; from 1600 2282 2934 729 20.24 anterior chamber of eye or lens
65260 Removal of foreign body, intraocular; from 2555 3643 4685 985 27.37 posterior segment, magnetic extraction, anterior or posterior route
65265 Removal of foreign body, intraocular; from 2845 4057 5217 1106 30.71 posterior segment, nonmagnetic extraction
65270 Repair of laceration; conjunctiva, with or 714 1018 1309 275 7.65 without nonperforating laceration sclera, direct closure
65272 Repair of laceration; conjunctiva, by 1340 1910 2456 517 14.35 mobilization and rearrange, without hospitalization
65273 Repair of laceration; conjunctiva, by 1013 1444 1857 391 10.85 mobilization and rearrange, with hospitalization
65275 Repair of laceration; cornea, nonperforating, 1541 2198 2826 594 16.51 with or without removal foreign body
65280 Repair of laceration; cornea and/or sclera, 1733 2471 3178 689 19.15 perforating, not involving uveal tissue
65285 Repair of laceration; cornea and/or sclera, 2509 3578 4600 1138 31.60 perforating, with reposition or resection of uveal tissue
65286 Repair of laceration; application of tissue glue, 1321 1883 2421 724 20.12 wounds of cornea and/or sclera
65290 Repair of wound, extraocular muscle, tendon 1306 1862 2395 504 13.99 and/or Tenon's capsule
ANTERIOR SEGMENT
65400 Excision of lesion, cornea (keratectomy, 1325 1886 2760 698 19.40 lamellar, partial), except pterygium
65410 Biopsy of cornea 451 643 940 148 4.11
65420 Excision or transposition of pterygium; without 1016 1447 2116 531 14.76 graft
65426 Excision or transposition of pterygium; with 1505 2144 3136 670 18.62 graft
440 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
65430 Scraping of cornea, diagnostic, for smear and/or 335 478 699 119 3.30 culture
65435 Removal of corneal epithelium; with or without 160 228 333 84 2.32 chemocauterization (abrasion, curettage)
65436 Removal of corneal epithelium; with 768 1094 1601 399 11.07 application of chelating agent (eg, EDTA)
65450 Destruction of lesion of cornea by cryotherapy, 927 1320 1932 335 9.31 photocoagulation or thermocauterization
65600 Multiple punctures of anterior cornea (eg, for 680 968 1417 405 11.25 corneal erosion, tattoo)
65710 Keratoplasty (corneal transplant); anterior 3143 4476 6548 1134 31.49 lamellar
65730 Keratoplasty (corneal transplant); penetrating 3667 5222 7640 1259 34.97 (except in aphakia or pseudophakia)
65750 Keratoplasty (corneal transplant); penetrating 3611 5142 7522 1265 35.13 (in aphakia)
65755 Keratoplasty (corneal transplant); penetrating 3492 4973 7276 1259 34.96 (in pseudophakia)
65756 Keratoplasty (corneal transplant); endothelial 3398 4839 7079 1215 33.75
65757 Backbench preparation of corneal endothelial 700 997 1459 0 0.00 allograft prior to transplantation (list separately in addition to code for primary procedure)
65760 Keratomileusis 1900 2705 3958 0 0.00
65765 Keratophakia 0 0 0 0 0.00
65767 Epikeratoplasty 0 0 0 0 0.00
65770 Keratoprosthesis 4319 6150 8998 1437 39.92
65771 Radial keratotomy 0 0 0 0 0.00
65772 Corneal relaxing incision for correction of 1008 1435 2100 464 12.88 surgically induced astigmatism
65775 Corneal wedge resection for correction of 1726 2458 3596 566 15.72 surgically induced astigmatism
65778 Placement of amniotic membrane on the ocular 2250 3205 4689 1448 40.21 surface; without sutures
65779 Placement of amniotic membrane on the ocular 2218 3159 4622 1241 34.46 surface; single layer, sutured
CPT copyright 2017 American Medical Association. 441 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
65780 Ocular surface reconstruction; amniotic 2016 2871 4200 684 19.00 membrane transplantation, multiple layers
65781 Ocular surface reconstruction; limbal stem cell 4174 5944 8696 1368 38.01 allograft (eg, cadaveric or living donor)
65782 Ocular surface reconstruction; limbal 2316 3298 4825 1181 32.80 conjunctival autograft (includes obtaining graft)
65785 Implantation of intrastromal corneal ring 7646 10888 15930 2573 71.47 segments
65800 Paracentesis of anterior chamber of eye 310 441 645 123 3.42 (separate procedure); with removal of aqueous
65810 Paracentesis of anterior chamber of eye 1089 1550 2268 478 13.27 (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection
65815 Paracentesis of anterior chamber of eye 1300 1852 2709 656 18.23 (separate procedure); with removal of blood, with or without irrigation and/or air injection
65820 Goniotomy 2003 2852 4173 769 21.35
65850 Trabeculotomy ab externo 1838 2618 3830 861 23.92
65855 Trabeculoplasty by laser surgery 960 1367 2000 252 7.00
65860 Severing adhesions of anterior segment, laser 1160 1652 2417 318 8.83 technique (separate procedure)
65865 Severing adhesions of anterior segment of eye, 1237 1762 2577 485 13.48 incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae
65870 Severing adhesions of anterior segment of eye, 1293 1841 2693 606 16.84 incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae
65875 Severing adhesions of anterior segment of eye, 1360 1937 2834 647 17.97 incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae
65880 Severing adhesions of anterior segment of eye, 2077 2957 4326 681 18.91 incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions
65900 Removal of epithelial downgrowth, anterior 3015 4294 6282 989 27.46 chamber of eye
442 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
65920 Removal of implanted material, anterior 2001 2849 4168 809 22.46 segment of eye
65930 Removal of blood clot, anterior segment of eye 1589 2263 3311 654 18.16
66020 Injection, anterior chamber of eye (separate 433 617 902 192 5.34 procedure); air or liquid
66030 Injection, anterior chamber of eye (separate 348 496 725 172 4.77 procedure); medication
66130 Excision of lesion, sclera 1551 2200 3530 715 19.87
66150 Fistulization of sclera for glaucoma; 2544 3609 5790 900 24.99 trephination with iridectomy
66155 Fistulization of sclera for glaucoma; 2542 3606 5785 899 24.97 thermocauterization with iridectomy
66160 Fistulization of sclera for glaucoma; 2866 4065 6522 1013 28.15 sclerectomy with punch or scissors, with iridectomy
66170 Fistulization of sclera for glaucoma; 2493 3536 5673 1122 31.18 trabeculectomy ab externo in absence of previous surgery
66172 Fistulization of sclera for glaucoma; 2970 4212 6758 1223 33.96 trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents)
66174 Transluminal dilation of aqueous outflow canal; 3365 4772 7657 972 27.01 without retention of device or stent
66175 Transluminal dilation of aqueous outflow canal; 3343 4741 7606 1018 28.28 with retention of device or stent
66179 Aqueous shunt to extraocular equatorial plate 2599 3687 5915 1106 30.72 reservoir, external approach; without graft
66180 Aqueous shunt to extraocular equatorial plate 3083 4373 7016 1167 32.41 reservoir, external approach; with graft
66183 Insertion of anterior segment aqueous drainage 2652 3761 6034 1057 29.36 device, without extraocular reservoir, external approach
66184 Revision of aqueous shunt to extraocular 2600 3687 5916 806 22.38 equatorial plate reservoir; without graft
66185 Revision of aqueous shunt to extraocular 2125 3014 4836 867 24.07 equatorial plate reservoir; with graft
66220 Repair of scleral staphyloma; without graft 2168 3075 4933 766 21.29
CPT copyright 2017 American Medical Association. 443 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
66225 Repair of scleral staphyloma; with graft 2704 3836 6154 956 26.56
66250 Revision or repair of operative wound of 1507 2137 3429 770 21.38 anterior segment, any type, early or late, major or minor procedure
66500 Iridotomy by stab incision (separate procedure); 1026 1456 2336 363 10.08 except transfixion
66505 Iridotomy by stab incision (separate procedure); 1126 1597 2563 398 11.06 with transfixion as for iris bombe
66600 Iridectomy, with corneoscleral or corneal 2417 3428 5500 855 23.74 section; for removal of lesion
66605 Iridectomy, with corneoscleral or corneal 3064 4345 6972 1083 30.09 section; with cyclectomy
66625 Iridectomy, with corneoscleral or corneal 1059 1503 2411 441 12.24 section; peripheral for glaucoma (separate procedure)
66630 Iridectomy, with corneoscleral or corneal 1653 2344 3760 584 16.23 section; sector for glaucoma (separate procedure)
66635 Iridectomy, with corneoscleral or corneal 1669 2367 3798 590 16.39 section; optical (separate procedure)
66680 Repair of iris, ciliary body (as for iridodialysis) 1556 2207 3541 531 14.75
66682 Suture of iris, ciliary body (separate procedure) 1650 2341 3755 655 18.19 with retrieval of suture through small incision (eg, McCannel suture)
66700 Ciliary body destruction; diathermy 1311 1860 2984 464 12.88
66710 Ciliary body destruction; 1252 1776 2850 454 12.60 cyclophotocoagulation, transscleral
66711 Ciliary body destruction; 1542 2186 3508 660 18.33 cyclophotocoagulation, endoscopic
66720 Ciliary body destruction; cryotherapy 1066 1512 2425 473 13.15
66740 Ciliary body destruction; cyclodialysis 2027 2875 4613 450 12.51
66761 Iridotomy/iridectomy by laser surgery (eg, for 961 1364 2188 305 8.48 glaucoma) (per session)
66762 Iridoplasty by photocoagulation (1 or more 1036 1469 2357 489 13.58 sessions) (eg, for improvement of vision, for widening of anterior chamber angle)
444 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
66770 Destruction of cyst or lesion iris or ciliary body 1535 2178 3494 543 15.08 (nonexcisional procedure)
66820 Discission of secondary membranous cataract 912 1259 2303 405 11.26 (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or wheeler knife)
66821 Discission of secondary membranous cataract 800 1104 2020 338 9.40 (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages)
66825 Repositioning of intraocular lens prosthesis, 1857 2563 4688 779 21.65 requiring an incision (separate procedure)
66830 Removal of secondary membranous cataract 1898 2619 4792 730 20.29 (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy)
66840 Removal of lens material; aspiration technique, 1733 2391 4375 715 19.86 1 or more stages
66850 Removal of lens material; phacofragmentation 2095 2891 5290 814 22.60 technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration
66852 Removal of lens material; pars plana approach, 2795 3857 7057 867 24.07 with or without vitrectomy
66920 Removal of lens material; intracapsular 2662 3674 6721 774 21.49
66930 Removal of lens material; intracapsular, for 3024 4173 7634 879 24.41 dislocated lens
66940 Removal of lens material; extracapsular (other 2201 3037 5555 803 22.30 than 66840, 66850, 66852)
66982 Extracapsular cataract removal with insertion of 2701 3727 6817 815 22.65 intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage
66983 Intracapsular cataract extraction with insertion 2631 3631 6642 765 21.24 of intraocular lens prosthesis (1 stage procedure)
CPT copyright 2017 American Medical Association. 445 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
66984 Extracapsular cataract removal with insertion of 2478 3420 6256 656 18.23 intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification)
66985 Insertion of intraocular lens prosthesis 2173 2998 5485 791 21.96 (secondary implant), not associated with concurrent cataract removal
66986 Exchange of intraocular lens 2353 3247 5940 932 25.90
66990 Use of ophthalmic endoscope (list separately in 318 439 804 93 2.57 addition to code for primary procedure)
66999 Unlisted procedure, anterior segment of eye 0 0 0 0 0.00
POSTERIOR SEGMENT
67005 Removal of vitreous, anterior approach (open 1808 2485 3300 485 13.47 sky technique or limbal incision); partial removal
67010 Removal of vitreous, anterior approach (open 2035 2796 3714 557 15.47 sky technique or limbal incision); subtotal removal with mechanical vitrectomy
67015 Aspiration or release of vitreous, subretinal or 1431 1967 2612 595 16.54 choroidal fluid, pars plana approach (posterior sclerotomy)
67025 Injection of vitreous substitute, pars plana or 1406 1933 2567 746 20.73 limbal approach (fluid-gas exchange), with or without aspiration (separate procedure)
67027 Implantation of intravitreal drug delivery 2675 3675 4881 874 24.29 system (eg, ganciclovir implant), includes concomitant removal of vitreous
67028 Intravitreal injection of a pharmacologic agent 451 619 822 104 2.90 (separate procedure)
67030 Discission of vitreous strands (without 2238 3075 4084 547 15.19 removal), pars plana approach
67031 Severing of vitreous strands, vitreous face 850 1168 1552 400 11.11 adhesions, sheets, membranes or opacities, laser surgery (1 or more stages)
67036 Vitrectomy, mechanical, pars plana approach; 3095 4253 5649 925 25.69
67039 Vitrectomy, mechanical, pars plana approach; 3571 4907 6517 990 27.51 with focal endolaser photocoagulation
67040 Vitrectomy, mechanical, pars plana approach; 3622 4978 6611 1070 29.73 with endolaser panretinal photocoagulation
446 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
67041 Vitrectomy, mechanical, pars plana approach; 3548 4876 6476 1183 32.85 with removal of preretinal cellular membrane (eg, macular pucker)
67042 Vitrectomy, mechanical, pars plana approach; 3854 5296 7034 1183 32.85 with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil)
67043 Vitrectomy, mechanical, pars plana approach; 3804 5227 6942 1250 34.71 with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and laser photocoagulation
67101 Repair of retinal detachment, including drainage 1671 2296 3049 337 9.36 of subretinal fluid when performed; cryotherapy
67105 Repair of retinal detachment, including drainage 1706 2344 3113 305 8.46 of subretinal fluid when performed; photocoagulation
67107 Repair of retinal detachment; scleral buckling 3075 4225 5612 1162 32.27 (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid
67108 Repair of retinal detachment; with vitrectomy, 4149 5701 7571 1232 34.22 any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique
67110 Repair of retinal detachment; by injection of air 2173 2986 3966 900 24.99 or other gas (eg, pneumatic retinopexy)
67113 Repair of complex retinal detachment (eg, 4493 6174 8200 1375 38.19 proliferative vitreoretinopathy, stage c-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens
67115 Release of encircling material (posterior 2100 2885 3832 513 14.25 segment)
CPT copyright 2017 American Medical Association. 447 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
67120 Removal of implanted material, posterior 1673 2298 3053 674 18.71 segment; extraocular
67121 Removal of implanted material, posterior 2136 2935 3898 932 25.89 segment; intraocular
67141 Prophylaxis of retinal detachment (eg, retinal 1223 1681 2232 539 14.96 break, lattice degeneration) without drainage, 1 or more sessions; cryotherapy, diathermy
67145 Prophylaxis of retinal detachment (eg, retinal 1275 1752 2327 542 15.06 break, lattice degeneration) without drainage, 1 or more sessions; photocoagulation (laser or xenon arc)
67208 Destruction of localized lesion of retina (eg, 1800 2474 3286 615 17.08 macular edema, tumors), 1 or more sessions; cryotherapy, diathermy
67210 Destruction of localized lesion of retina (eg, 1356 1864 2475 532 14.77 macular edema, tumors), 1 or more sessions; photocoagulation
67218 Destruction of localized lesion of retina (eg, 3811 5237 6955 1419 39.41 macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source)
67220 Destruction of localized lesion of choroid (eg, 1605 2206 2929 548 15.23 choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions
67221 Destruction of localized lesion of choroid (eg, 818 1125 1494 294 8.17 choroidal neovascularization); photodynamic therapy (includes intravenous infusion)
67225 Destruction of localized lesion of choroid (eg, 315 433 576 31 0.85 choroidal neovascularization); photodynamic therapy, second eye, at single session (list separately in addition to code for primary eye treatment)
67227 Destruction of extensive or progressive 1314 1805 2397 299 8.31 retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy
67228 Treatment of extensive or progressive 2000 2749 3650 351 9.75 retinopathy (eg, diabetic retinopathy), photocoagulation
67229 Treatment of extensive or progressive 2055 2825 3751 1196 33.23 retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg,
448 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
retinopathy of prematurity), photocoagulation or cryotherapy
67250 Scleral reinforcement (separate procedure); 3278 4505 5983 801 22.25 without graft
67255 Scleral reinforcement (separate procedure); with 1830 2515 3341 702 19.49 graft
67299 Unlisted procedure, posterior segment 0 0 0 0 0.00
OCULAR ADNEXA
67311 Strabismus surgery, recession or resection 2000 2854 4776 613 17.03 procedure; 1 horizontal muscle
67312 Strabismus surgery, recession or resection 2228 3179 5321 730 20.27 procedure; 2 horizontal muscles
67314 Strabismus surgery, recession or resection 2100 2996 5014 690 19.16 procedure; 1 vertical muscle (excluding superior oblique)
67316 Strabismus surgery, recession or resection 2279 3251 5440 823 22.86 procedure; 2 or more vertical muscles (excluding superior oblique)
67318 Strabismus surgery, any procedure, superior 2261 3226 5398 725 20.13 oblique muscle
67320 Transposition procedure (eg, for paretic 1804 2574 4308 332 9.21 extraocular muscle), any extraocular muscle (specify) (list separately in addition to code for primary procedure)
67331 Strabismus surgery on patient with previous eye 1252 1787 2990 314 8.73 surgery or injury that did not involve the extraocular muscles (list separately in addition to code for primary procedure)
67332 Strabismus surgery on patient with scarring of 1709 2438 4081 341 9.47 extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (list separately in addition to code for primary procedure)
67334 Strabismus surgery by posterior fixation suture 1644 2346 3926 310 8.61 technique, with or without muscle recession (list separately in addition to code for primary procedure)
67335 Placement of adjustable suture(s) during 704 1004 1680 152 4.23 strabismus surgery, including postoperative
CPT copyright 2017 American Medical Association. 449 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
adjustment(s) of suture(s) (list separately in addition to code for specific strabismus surgery)
67340 Strabismus surgery involving exploration and/or 1850 2639 4417 369 10.24 repair of detached extraocular muscle(s) (list separately in addition to code for primary procedure)
67343 Release of extensive scar tissue without 1945 2775 4644 669 18.57 detaching extraocular muscle (separate procedure)
67345 Chemodenervation of extraocular muscle 557 795 1331 251 6.98
67346 Biopsy of extraocular muscle 570 813 1361 199 5.54
67399 Unlisted procedure, extraocular muscle 0 0 0 0 0.00
67400 Orbitotomy without bone flap (frontal or 3393 4840 8100 954 26.50 transconjunctival approach); for exploration, with or without biopsy
67405 Orbitotomy without bone flap (frontal or 2188 3122 5224 811 22.52 transconjunctival approach); with drainage only
67412 Orbitotomy without bone flap (frontal or 2501 3568 5970 873 24.26 transconjunctival approach); with removal of lesion
67413 Orbitotomy without bone flap (frontal or 2606 3717 6221 877 24.35 transconjunctival approach); with removal of foreign body
67414 Orbitotomy without bone flap (frontal or 3083 4399 7361 1358 37.73 transconjunctival approach); with removal of bone for decompression
67415 Fine needle aspiration of orbital contents 308 439 735 108 2.99
67420 Orbitotomy with bone flap or window, lateral 4001 5708 9553 1658 46.05 approach (eg, Kroenlein); with removal of lesion
67430 Orbitotomy with bone flap or window, lateral 3656 5215 8728 1279 35.52 approach (eg, Kroenlein); with removal of foreign body
67440 Orbitotomy with bone flap or window, lateral 3536 5045 8443 1237 34.36 approach (eg, Kroenlein); with drainage
67445 Orbitotomy with bone flap or window, lateral 4550 6491 10863 1436 39.90 approach (eg, Kroenlein); with removal of bone for decompression
450 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
67450 Orbitotomy with bone flap or window, lateral 3677 5246 8780 1286 35.73 approach (eg, Kroenlein); for exploration, with or without biopsy
67500 Retrobulbar injection; medication (separate 300 428 716 82 2.27 procedure, does not include supply of medication)
67505 Retrobulbar injection; alcohol 256 365 611 90 2.49
67515 Injection of medication or other substance into 188 268 449 99 2.76 Tenon's capsule
67550 Orbital implant (implant outside muscle cone); 2717 3876 6487 989 27.48 insertion
67560 Orbital implant (implant outside muscle cone); 2761 3939 6591 1014 28.18 removal or revision
67570 Optic nerve decompression (eg, incision or 4497 6415 10736 1193 33.13 fenestration of optic nerve sheath)
67599 Unlisted procedure, orbit 0 0 0 0 0.00
67700 Blepharotomy, drainage of abscess, eyelid 450 609 919 276 7.68
67710 Severing of tarsorrhaphy 467 632 954 230 6.40
67715 Canthotomy (separate procedure) 500 676 1021 247 6.87
67800 Excision of chalazion; single 255 345 521 131 3.64
67801 Excision of chalazion; multiple, same lid 383 518 783 167 4.64
67805 Excision of chalazion; multiple, different lids 445 602 909 208 5.77
67808 Excision of chalazion; under general anesthesia 856 1158 1749 378 10.51 and/or requiring hospitalization, single or multiple
67810 Incisional biopsy of eyelid skin including lid 330 446 674 176 4.89 margin
67820 Correction of trichiasis; epilation, by forceps 119 161 243 41 1.15 only
67825 Correction of trichiasis; epilation by other than 293 396 598 132 3.66 forceps (eg, by electrosurgery, cryotherapy, laser surgery)
67830 Correction of trichiasis; incision of lid margin 784 1060 1601 274 7.62
67835 Correction of trichiasis; incision of lid margin, 1148 1552 2343 450 12.51 with free mucous membrane graft
CPT copyright 2017 American Medical Association. 451 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
67840 Excision of lesion of eyelid (except chalazion) 525 710 1072 283 7.87 without closure or with simple direct closure
67850 Destruction of lesion of lid margin (up to 1 cm) 524 708 1070 220 6.12
67875 Temporary closure of eyelids by suture (eg, 643 869 1312 177 4.93 frost suture)
67880 Construction of intermarginal adhesions, 1067 1443 2179 471 13.08 median tarsorrhaphy, or canthorrhaphy;
67882 Construction of intermarginal adhesions, 1317 1781 2690 580 16.11 median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate
67900 Repair of brow ptosis (supraciliary, mid- 2009 2717 4103 657 18.24 forehead or coronal approach)
67901 Repair of blepharoptosis; frontalis muscle 2125 2874 4340 776 21.56 technique with suture or other material (eg, banked fascia)
67902 Repair of blepharoptosis; frontalis muscle 2401 3246 4902 742 20.61 technique with autologous fascial sling (includes obtaining fascia)
67903 Repair of blepharoptosis; (tarso) levator 2050 2772 4186 609 16.92 resection or advancement, internal approach
67904 Repair of blepharoptosis; (tarso) levator 2110 2852 4308 752 20.89 resection or advancement, external approach
67906 Repair of blepharoptosis; superior rectus 1329 1797 2714 522 14.49 technique with fascial sling (includes obtaining fascia)
67908 Repair of blepharoptosis; conjunctivo-tarso- 2032 2747 4148 507 14.08 Muller's muscle-levator resection (eg, Fasanella-Servat type)
67909 Reduction of overcorrection of ptosis 1405 1899 2868 551 15.31
67911 Correction of lid retraction 2200 2975 4493 577 16.03
67912 Correction of lagophthalmos, with implantation 2049 2770 4184 900 24.99 of upper eyelid lid load (eg, gold weight)
67914 Repair of ectropion; suture 1113 1505 2273 482 13.39
67915 Repair of ectropion; thermocauterization 768 1038 1568 301 8.37
67916 Repair of ectropion; excision tarsal wedge 1651 2232 3371 608 16.88
67917 Repair of ectropion; extensive (eg, tarsal strip 1889 2554 3857 619 17.20 operations)
452 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
67921 Repair of entropion; suture 980 1325 2001 473 13.14
67922 Repair of entropion; thermocauterization 761 1028 1553 298 8.29
67923 Repair of entropion; excision tarsal wedge 1548 2093 3160 607 16.87
67924 Repair of entropion; extensive (eg, tarsal strip 1745 2360 3564 648 18.00 or capsulopalpebral fascia repairs operation)
67930 Suture of recent wound, eyelid, involving lid 792 1071 1618 374 10.40 margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness
67935 Suture of recent wound, eyelid, involving lid 1400 1893 2859 610 16.94 margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness
67938 Removal of embedded foreign body, eyelid 445 601 908 251 6.98
67950 Canthoplasty (reconstruction of canthus) 1673 2262 3416 588 16.33
67961 Excision and repair of eyelid, involving lid 1800 2434 3676 591 16.41 margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrange; up to one-fourth of lid margin
67966 Excision and repair of eyelid, involving lid 2000 2705 4085 788 21.90 margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrange; over one-fourth of lid margin
67971 Reconstruction of eyelid, full thickness by 2227 3011 4547 743 20.63 transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage
67973 Reconstruction of eyelid, full thickness by 2601 3516 5310 955 26.54 transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage
67974 Reconstruction of eyelid, full thickness by 2835 3832 5788 953 26.47 transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage
67975 Reconstruction of eyelid, full thickness by 1520 2055 3104 703 19.52 transfer of tarsoconjunctival flap from opposing eyelid; second stage
67999 Unlisted procedure, eyelids 0 0 0 0 0.00
CONJUNCTIVA
68020 Incision of conjunctiva, drainage of cyst 300 391 546 124 3.44
CPT copyright 2017 American Medical Association. 453 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
68040 Expression of conjunctival follicles (eg, for 200 261 364 64 1.78 trachoma)
68100 Biopsy of conjunctiva 413 538 751 176 4.88
68110 Excision of lesion, conjunctiva; up to 1 cm 490 638 891 232 6.45
68115 Excision of lesion, conjunctiva; over 1 cm 662 863 1204 320 8.90
68130 Excision of lesion, conjunctiva; with adjacent 1200 1563 2182 553 15.37 sclera
68135 Destruction of lesion, conjunctiva 440 573 800 162 4.49
68200 Subconjunctival injection 154 201 280 42 1.18
68320 Conjunctivoplasty; with conjunctival graft or 1579 2056 2870 744 20.67 extensive rearrange
68325 Conjunctivoplasty; with buccal mucous 1438 1873 2615 675 18.76 membrane graft (includes obtaining graft)
68326 Conjunctivoplasty, reconstruction cul-de-sac; 2835 3692 5154 663 18.42 with conjunctival graft or extensive rearrange
68328 Conjunctivoplasty, reconstruction cul-de-sac; 1549 2018 2817 728 20.21 with buccal mucous membrane graft (includes obtaining graft)
68330 Repair of symblepharon; conjunctivoplasty, 1822 2373 3312 621 17.25 without graft
68335 Repair of symblepharon; with free graft 1418 1848 2579 666 18.50 conjunctiva or buccal mucous membrane (includes obtaining graft)
68340 Repair of symblepharon; division of 1434 1868 2607 560 15.55 symblepharon, with or without insertion of conformer or contact lens
68360 Conjunctival flap; bridge or partial (separate 1161 1512 2110 545 15.14 procedure)
68362 Conjunctival flap; total (such as Gunderson thin 1849 2409 3362 674 18.72 flap or purse string flap)
68371 Harvesting conjunctival allograft, living donor 902 1175 1641 424 11.77
68399 Unlisted procedure, conjunctiva 0 0 0 0 0.00
68400 Incision, drainage of lacrimal gland 623 811 1132 292 8.12
68420 Incision, drainage of lacrimal sac 552 719 1004 330 9.18 (dacryocystotomy or dacryocystostomy)
68440 Snip incision of lacrimal punctum 354 461 644 105 2.91
454 CPT copyright 2017 American Medical Association. SURGERY – EYE AND OCULAR ADNEXA
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
68500 Excision of lacrimal gland (dacryoadenectomy), 2131 2776 3875 1001 27.80 except for tumor; total
68505 Excision of lacrimal gland (dacryoadenectomy), 2121 2762 3855 996 27.66 except for tumor; partial
68510 Biopsy of lacrimal gland 974 1268 1770 457 12.70
68520 Excision of lacrimal sac (dacryocystectomy) 1502 1956 2731 705 19.59
68525 Biopsy of lacrimal sac 738 961 1341 271 7.53
68530 Removal of foreign body or dacryolith, lacrimal 988 1287 1797 439 12.19 passages
68540 Excision of lacrimal gland tumor; frontal 2029 2643 3690 953 26.47 approach
68550 Excision of lacrimal gland tumor; involving 2488 3241 4523 1168 32.45 osteotomy
68700 Plastic repair of canaliculi 1582 2061 2877 620 17.23
68705 Correction of everted punctum, cautery 508 662 923 244 6.77
68720 Dacryocystorhinostomy (fistulization of 2236 2913 4066 777 21.57 lacrimal sac to nasal cavity)
68745 Conjunctivorhinostomy (fistulization of 1661 2164 3021 780 21.67 conjunctiva to nasal cavity); without tube
68750 Conjunctivorhinostomy (fistulization of 2405 3133 4373 807 22.42 conjunctiva to nasal cavity); with insertion of tube or stent
68760 Closure of the lacrimal punctum; by 397 518 723 207 5.76 thermocauterization, ligation, or laser surgery
68761 Closure of the lacrimal punctum; by plug, each 275 358 500 152 4.23
68770 Closure of lacrimal fistula (separate procedure) 1375 1792 2501 646 17.94
68801 Dilation of lacrimal punctum, with or without 234 305 425 91 2.52 irrigation
68810 Probing of nasolacrimal duct, with or without 423 551 769 159 4.41 irrigation;
68811 Probing of nasolacrimal duct, with or without 552 719 1004 140 3.89 irrigation; requiring general anesthesia
68815 Probing of nasolacrimal duct, with or without 1172 1527 2131 408 11.33 irrigation; with insertion of tube or stent
CPT copyright 2017 American Medical Association. 455 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
68816 Probing of nasolacrimal duct, with or without 1559 2031 2835 665 18.47 irrigation; with transluminal balloon catheter dilation
68840 Probing of lacrimal canaliculi, with or without 325 423 591 132 3.66 irrigation
68850 Injection of contrast medium for 224 291 406 64 1.78 dacryocystography
68899 Unlisted procedure, lacrimal system 0 0 0 0 0.00
456 CPT copyright 2017 American Medical Association. SURGERY – AUDITORY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
AUDITORY SYSTEM EXTERNAL EAR
69000 Drainage external ear, abscess or hematoma; 372 484 651 191 5.30 simple
69005 Drainage external ear, abscess or hematoma; 545 708 953 217 6.03 complicated
69020 Drainage external auditory canal, abscess 399 519 699 234 6.51
69090 Ear piercing 50 65 88 0 0.00
69100 Biopsy external ear 163 212 285 103 2.87
69105 Biopsy external auditory canal 337 439 591 141 3.93
69110 Excision external ear; partial, simple repair 941 1223 1646 468 12.99
69120 Excision external ear; complete amputation 878 1141 1537 413 11.48
69140 Excision exostosis(es), external auditory canal 2500 3250 4376 890 24.73
69145 Excision soft tissue lesion, external auditory 842 1095 1473 400 11.11 canal
69150 Radical excision external auditory canal lesion; 2261 2939 3957 1064 29.56 without neck dissection
69155 Radical excision external auditory canal lesion; 3592 4669 6286 1691 46.96 with neck dissection
69200 Removal foreign body from external auditory 254 331 445 84 2.33 canal; without general anesthesia
69205 Removal foreign body from external auditory 312 405 545 103 2.85 canal; with general anesthesia
69209 Removal impacted cerumen using 36 47 63 14 0.40 irrigation/lavage, unilateral
69210 Removal impacted cerumen requiring 100 130 175 50 1.38 instrumentation, unilateral
69220 Debridement, mastoidectomy cavity, simple 261 339 456 84 2.32 (eg, routine cleaning)
69222 Debridement, mastoidectomy cavity, complex 449 584 786 221 6.13 (eg, with anesthesia or more than routine cleaning)
69300 Otoplasty, protruding ear, with or without size 1941 2523 3396 642 17.82 reduction
CPT copyright 2017 American Medical Association. 457 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
69310 Reconstruction of external auditory canal 2943 3826 5151 1107 30.74 (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure)
69320 Reconstruction external auditory canal for 4902 6372 8578 1552 43.10 congenital atresia, single stage
69399 Unlisted procedure, external ear 0 0 0 0 0.00
MIDDLE EAR
69420 Myringotomy including aspiration and/or 394 653 1312 194 5.39 eustachian tube inflation
69421 Myringotomy including aspiration and/or 452 749 1505 151 4.20 eustachian tube inflation requiring general anesthesia
69424 Ventilating tube removal requiring general 307 508 1021 130 3.60 anesthesia
69433 Tympanostomy (requiring insertion of 440 729 1465 205 5.69 ventilating tube), local or topical anesthesia
69436 Tympanostomy (requiring insertion of 664 1101 2213 163 4.52 ventilating tube), general anesthesia
69440 Middle ear exploration through postauricular or 2050 3398 6829 698 19.40 ear canal incision
69450 Tympanolysis, transcanal 1582 2622 5268 555 15.41
69501 Transmastoid antrotomy (simple 2584 4282 8605 744 20.66 mastoidectomy)
69502 Mastoidectomy; complete 2660 4408 8858 988 27.45
69505 Mastoidectomy; modified radical 4134 6852 13768 1221 33.93
69511 Mastoidectomy; radical 4347 7205 14477 1251 34.76
69530 Petrous apicectomy including radical 5833 9667 19425 1679 46.64 mastoidectomy
69535 Resection temporal bone, external approach 9555 15836 31820 2750 76.40
69540 Excision aural polyp 450 746 1499 211 5.86
69550 Excision aural glomus tumor; transcanal 3671 6083 12224 1057 29.35
69552 Excision aural glomus tumor; transmastoid 5543 9186 18459 1596 44.32
69554 Excision aural glomus tumor; extended 8911 14768 29676 2565 71.25 (extratemporal)
458 CPT copyright 2017 American Medical Association. SURGERY – AUDITORY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
69601 Revision mastoidectomy; resulting in complete 3692 6119 12295 1063 29.52 mastoidectomy
69602 Revision mastoidectomy; resulting in modified 3839 6363 12787 1105 30.70 radical mastoidectomy
69603 Revision mastoidectomy; resulting in radical 4446 7369 14807 1280 35.55 mastoidectomy
69604 Revision mastoidectomy; resulting in 3926 6506 13074 1130 31.39 tympanoplasty
69605 Revision mastoidectomy; with apicectomy 5766 9557 19204 1584 44.01
69610 Tympanic membrane repair, with or without 869 1441 2895 390 10.83 site preparation of perforation for closure, with or without patch
69620 Myringoplasty (surgery confined to drumhead 1905 3157 6343 701 19.47 and donor area)
69631 Tympanoplasty without mastoidectomy 3000 4973 9993 898 24.94 (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction
69632 Tympanoplasty without mastoidectomy 3650 6050 12157 1094 30.39 (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration)
69633 Tympanoplasty without mastoidectomy 3551 5886 11827 1061 29.48 (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])
69635 Tympanoplasty with antrotomy or 3304 5476 11003 1258 34.94 mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction
69636 Tympanoplasty with antrotomy or 4023 6668 13400 1401 38.93 mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction
69637 Tympanoplasty with antrotomy or 3823 6337 12733 1414 39.29 mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or
CPT copyright 2017 American Medical Association. 459 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])
69641 Tympanoplasty with mastoidectomy (including 3814 6321 12701 1058 29.38 canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction
69642 Tympanoplasty with mastoidectomy (including 4391 7277 14623 1358 37.71 canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction
69643 Tympanoplasty with mastoidectomy (including 3939 6529 13120 1243 34.54 canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction
69644 Tympanoplasty with mastoidectomy (including 4390 7276 14621 1502 41.71 canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction
69645 Tympanoplasty with mastoidectomy (including 4657 7718 15510 1472 40.90 canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction
69646 Tympanoplasty with mastoidectomy (including 5359 8881 17846 1571 43.64 canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction
69650 Stapes mobilization 2363 3916 7869 816 22.68
69660 Stapedectomy or stapedotomy with 3107 5150 10348 942 26.17 reestablishment of ossicular continuity, with or without use of foreign material;
69661 Stapedectomy or stapedotomy with 3801 6300 12659 1228 34.11 reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out
69662 Revision of stapedectomy or stapedotomy 3826 6341 12741 1178 32.73
69666 Repair oval window fistula 2456 4070 8179 825 22.91
69667 Repair round window fistula 2395 3970 7978 826 22.94
69670 Mastoid obliteration (separate procedure) 3349 5551 11154 964 26.78
460 CPT copyright 2017 American Medical Association. SURGERY – AUDITORY SYSTEM
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
69676 Tympanic neurectomy 2931 4858 9763 844 23.44
69700 Closure postauricular fistula, mastoid (separate 2419 4009 8055 696 19.34 procedure)
69710 Implantation or replacement of electromagnetic 0 0 0 0 0.00 bone conduction hearing device in temporal bone
69711 Removal or repair of electromagnetic bone 3042 5041 10129 876 24.32 conduction hearing device in temporal bone
69714 Implantation, osseointegrated implant, 3198 5300 10649 1097 30.46 temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy
69715 Implantation, osseointegrated implant, 4753 7878 15829 1352 37.55 temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; with mastoidectomy
69717 Replacement (including removal of existing 3991 6614 13290 1149 31.91 device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy
69718 Replacement (including removal of existing 4746 7866 15806 1366 37.95 device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; with mastoidectomy
69720 Decompression facial nerve, intratemporal; 4312 7147 14361 1241 34.48 lateral to geniculate ganglion
69725 Decompression facial nerve, intratemporal; 6650 11021 22145 1914 53.17 including medial to geniculate ganglion
69740 Suture facial nerve, intratemporal, with or 4126 6838 13740 1188 32.99 without graft or decompression; lateral to geniculate ganglion
69745 Suture facial nerve, intratemporal, with or 4388 7273 14615 1263 35.09 without graft or decompression; including medial to geniculate ganglion
69799 Unlisted procedure, middle ear 0 0 0 0 0.00
INNER EAR
69801 Labyrinthotomy, with perfusion of 1227 2034 4087 198 5.51 vestibuloactive drug(s), transcanal
CPT copyright 2017 American Medical Association. 461 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
69805 Endolymphatic sac operation; without shunt 3727 6177 12412 1073 29.80
69806 Endolymphatic sac operation; with shunt 3508 5814 11683 960 26.67
69905 Labyrinthectomy; transcanal 3238 5366 10783 932 25.89
69910 Labyrinthectomy; with mastoidectomy 3594 5957 11970 1035 28.74
69915 Vestibular nerve section, translabyrinthine 5468 9063 18211 1567 43.53 approach
69930 Cochlear device implantation, with or without 4548 7538 15147 1246 34.61 mastoidectomy
69949 Unlisted procedure, inner ear 0 0 0 0 0.00
TEMPORAL BONE, MIDDLE FOSSA APPROACH
69950 Vestibular nerve section, transcranial approach 6309 10457 21012 1816 50.45
69955 Total facial nerve decompression and/or repair 7001 11603 23316 2015 55.98 (may include graft)
69960 Decompression internal auditory canal 6813 11292 22691 1961 54.48
69970 Removal of tumor, temporal bone 7583 12567 25252 2183 60.63
69979 Unlisted procedure, temporal bone, middle 0 0 0 0 0.00 fossa approach
69990 Microsurgical techniques, requiring use of 904 1498 3010 231 6.42 operating microscope (list separately in addition to code for primary procedure)
462 CPT copyright 2017 American Medical Association.
RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
DIAGNOSTIC RADIOLOGY (DIAGNOSTIC IMAGING)
70010 Myelography, posterior fossa, radiological 192 240 341 62 1.73 supervision and interpretation
70015 Cisternography, positive contrast, radiological 444 556 791 147 4.09 supervision and interpretation
70015-26 0 0 0 61 1.70
70015-TC 0 0 0 86 2.39
70030 Radiologic examination, eye, for detection of 94 117 167 28 0.79 foreign body
70030-26 35 44 62 9 0.24
70030-TC 0 0 0 20 0.55
70100 Radiologic examination, mandible; partial, less 90 112 160 33 0.93 than 4 views
70100-26 36 45 64 9 0.26
70100-TC 0 0 0 24 0.67
70110 Radiologic examination, mandible; complete, 124 156 221 39 1.07 minimum of 4 views
70110-26 46 58 82 13 0.36
70110-TC 0 0 0 26 0.71
70120 Radiologic examination, mastoids; less than 3 90 113 161 34 0.94 views per side
70120-26 29 37 53 9 0.26
70120-TC 0 0 0 24 0.68
70130 Radiologic examination, mastoids; complete, 155 194 276 55 1.53 minimum of 3 views per side
70130-26 51 64 91 18 0.49
70130-TC 0 0 0 37 1.04
70134 Radiologic examination, internal auditory 150 188 268 51 1.41 meati, complete
70134-26 0 0 0 18 0.49
CPT copyright 2017 American Medical Association. 463 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
70134-TC 0 0 0 33 0.92
70140 Radiologic examination, facial bones; less than 111 139 198 30 0.84 3 views
70140-26 40 50 71 11 0.30
70140-TC 0 0 0 19 0.54
70150 Radiologic examination, facial bones; 130 163 232 42 1.17 complete, minimum of 3 views
70150-26 48 60 85 14 0.38
70150-TC 0 0 0 28 0.79
70160 Radiologic examination, nasal bones, complete, 93 116 165 33 0.93 minimum of 3 views
70160-26 33 42 59 9 0.25
70160-TC 0 0 0 24 0.68
70170 Dacryocystography, nasolacrimal duct, 46 57 82 0 0.00 radiological supervision and interpretation
70170-26 0 0 0 15 0.43
70170-TC 0 0 0 0 0.00
70190 Radiologic examination; optic foramina 85 106 151 36 1.01
70190-26 33 42 59 12 0.32
70190-TC 0 0 0 25 0.69
70200 Radiologic examination; orbits, complete, 136 171 243 43 1.20 minimum of 4 views
70200-26 54 68 96 15 0.41
70200-TC 0 0 0 28 0.79
70210 Radiologic examination, sinuses, paranasal, 70 88 124 30 0.84 less than 3 views
70210-26 30 38 54 9 0.25
70210-TC 0 0 0 21 0.59
70220 Radiologic examination, sinuses, paranasal, 109 136 194 38 1.06 complete, minimum of 3 views
70220-26 46 57 82 13 0.36
70220-TC 0 0 0 25 0.70
464 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
70240 Radiologic examination, sella turcica 93 116 165 31 0.87
70240-26 0 0 0 10 0.28
70240-TC 0 0 0 21 0.59
70250 Radiologic examination, skull; less than 4 104 130 185 37 1.03 views
70250-26 43 54 76 13 0.36
70250-TC 0 0 0 24 0.67
70260 Radiologic examination, skull; complete, 160 200 285 46 1.29 minimum of 4 views
70260-26 64 80 114 18 0.50
70260-TC 0 0 0 28 0.79
70300 Radiologic examination, teeth; single view 37 46 65 15 0.42
70300-26 25 31 45 6 0.17
70300-TC 0 0 0 9 0.25
70310 Radiologic examination, teeth; partial 104 130 185 38 1.05 examination, less than full mouth
70310-26 18 22 32 8 0.23
70310-TC 0 0 0 30 0.82
70320 Radiologic examination, teeth; complete, full 298 374 531 54 1.49 mouth
70320-26 38 48 68 13 0.35
70320-TC 0 0 0 41 1.14
70328 Radiologic examination, temporomandibular 98 123 174 31 0.86 joint, open and closed mouth; unilateral
70328-26 37 46 65 9 0.26
70328-TC 0 0 0 22 0.60
70330 Radiologic examination, temporomandibular 149 187 265 48 1.33 joint, open and closed mouth; bilateral
70330-26 46 58 82 13 0.35
70330-TC 0 0 0 35 0.98
70332 Temporomandibular joint arthrography, 241 303 430 72 2.00 radiological supervision and interpretation
CPT copyright 2017 American Medical Association. 465 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
70332-26 143 179 255 28 0.77
70332-TC 0 0 0 44 1.23
70336 Magnetic resonance (eg, proton) imaging, 1474 1847 2625 320 8.90 temporomandibular joint(s)
70336-26 267 335 476 75 2.09
70336-TC 0 0 0 245 6.81
70350 Cephalogram, orthodontic 124 156 221 20 0.55
70350-26 45 56 80 10 0.28
70350-TC 0 0 0 10 0.27
70355 Orthopantogram (eg, panoramic x-ray) 124 156 221 21 0.59
70355-26 42 53 75 12 0.32
70355-TC 0 0 0 10 0.27
70360 Radiologic examination; neck, soft tissue 94 118 168 29 0.80
70360-26 33 42 59 9 0.24
70360-TC 0 0 0 20 0.56
70370 Radiologic examination; pharynx or larynx, 147 184 261 73 2.03 including fluoroscopy and/or magnification technique
70370-26 74 93 133 16 0.45
70370-TC 0 0 0 57 1.58
70371 Complex dynamic pharyngeal and speech 265 333 473 91 2.52 evaluation by cine or video recording
70371-26 97 122 173 43 1.19
70371-TC 0 0 0 48 1.33
70380 Radiologic examination, salivary gland for 102 128 182 33 0.91 calculus
70380-26 0 0 0 9 0.24
70380-TC 0 0 0 24 0.67
70390 Sialography, radiological supervision and 283 355 505 96 2.66 interpretation
70390-26 0 0 0 19 0.54
70390-TC 0 0 0 76 2.12
466 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
70450 Computed tomography, head or brain; without 643 787 1026 118 3.28 contrast material
70450-26 166 203 265 44 1.21
70450-TC 0 0 0 75 2.07
70460 Computed tomography, head or brain; with 676 828 1079 166 4.62 contrast material(s)
70460-26 206 252 329 58 1.62
70460-TC 0 0 0 108 3.00
70470 Computed tomography, head or brain; without 907 1110 1447 195 5.42 contrast material, followed by contrast material(s) and further sections
70470-26 231 283 369 65 1.81
70470-TC 0 0 0 130 3.61
70480 Computed tomography, orbit, sella, or posterior 765 936 1221 184 5.12 fossa or outer, middle, or inner ear; without contrast material
70480-26 223 273 356 66 1.82
70480-TC 0 0 0 119 3.30
70481 Computed tomography, orbit, sella, or posterior 913 1117 1457 281 7.80 fossa or outer, middle, or inner ear; with contrast material(s)
70481-26 245 300 392 71 1.97
70481-TC 0 0 0 210 5.83
70482 Computed tomography, orbit, sella, or posterior 1128 1381 1801 306 8.50 fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections
70482-26 254 311 406 74 2.06
70482-TC 0 0 0 232 6.44
70486 Computed tomography, maxillofacial area; 715 876 1142 142 3.94 without contrast material
70486-26 205 251 327 44 1.22
70486-TC 0 0 0 98 2.72
CPT copyright 2017 American Medical Association. 467 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
70487 Computed tomography, maxillofacial area; 853 1044 1362 171 4.74 with contrast material(s)
70487-26 226 276 360 58 1.60
70487-TC 0 0 0 113 3.14
70488 Computed tomography, maxillofacial area; 1029 1260 1643 208 5.78 without contrast material, followed by contrast material(s) and further sections
70488-26 253 310 405 65 1.81
70488-TC 0 0 0 143 3.97
70490 Computed tomography, soft tissue neck; 747 914 1192 171 4.76 without contrast material
70490-26 225 275 359 66 1.83
70490-TC 0 0 0 105 2.93
70491 Computed tomography, soft tissue neck; with 856 1048 1366 207 5.75 contrast material(s)
70491-26 241 295 384 71 1.97
70491-TC 0 0 0 136 3.78
70492 Computed tomography, soft tissue neck; 1110 1358 1771 249 6.93 without contrast material followed by contrast material(s) and further sections
70492-26 277 340 443 83 2.31
70492-TC 0 0 0 166 4.62
70496 Computed tomographic angiography, head, 1309 1602 2089 298 8.29 with contrast material(s), including noncontrast images, if performed, and image postprocessing
70496-26 290 355 462 90 2.49
70496-TC 0 0 0 209 5.80
70498 Computed tomographic angiography, neck, 1290 1579 2059 298 8.27 with contrast material(s), including noncontrast images, if performed, and image postprocessing
70498-26 287 351 458 90 2.49
70498-TC 0 0 0 208 5.78
70540 Magnetic resonance (eg, proton) imaging, orbit, 1529 1872 2441 276 7.68 face, and/or neck; without contrast material(s)
468 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
70540-26 289 353 461 69 1.92
70540-TC 0 0 0 207 5.76
70542 Magnetic resonance (eg, proton) imaging, orbit, 1559 1908 2488 328 9.11 face, and/or neck; with contrast material(s)
70542-26 311 381 497 83 2.31
70542-TC 0 0 0 245 6.80
70543 Magnetic resonance (eg, proton) imaging, orbit, 2517 3081 4017 412 11.44 face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences
70543-26 413 505 659 109 3.04
70543-TC 0 0 0 302 8.40
70544 Magnetic resonance angiography, head; 1489 1822 2376 307 8.52 without contrast material(s)
70544-26 226 277 361 62 1.71
70544-TC 0 0 0 245 6.81
70545 Magnetic resonance angiography, head; with 1484 1816 2368 314 8.73 contrast material(s)
70545-26 287 351 457 62 1.71
70545-TC 0 0 0 253 7.02
70546 Magnetic resonance angiography, head; 2286 2797 3648 493 13.70 without contrast material(s), followed by contrast material(s) and further sequences
70546-26 334 409 534 76 2.10
70546-TC 0 0 0 418 11.60
70547 Magnetic resonance angiography, neck; 1459 1786 2329 307 8.53 without contrast material(s)
70547-26 236 289 377 62 1.72
70547-TC 0 0 0 245 6.81
70548 Magnetic resonance angiography, neck; with 1488 1821 2374 330 9.16 contrast material(s)
70548-26 231 283 369 77 2.14
70548-TC 0 0 0 253 7.02
CPT copyright 2017 American Medical Association. 469 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
70549 Magnetic resonance angiography, neck; 2227 2725 3554 513 14.24 without contrast material(s), followed by contrast material(s) and further sequences
70549-26 323 395 515 92 2.56
70549-TC 0 0 0 420 11.68
70551 Magnetic resonance (eg, proton) imaging, brain 1426 1745 2275 236 6.55 (including brain stem); without contrast material
70551-26 279 341 445 76 2.12
70551-TC 0 0 0 159 4.43
70552 Magnetic resonance (eg, proton) imaging, brain 1606 1966 2564 327 9.08 (including brain stem); with contrast material(s)
70552-26 337 413 538 91 2.54
70552-TC 0 0 0 235 6.54
70553 Magnetic resonance (eg, proton) imaging, brain 2505 3066 3998 386 10.71 (including brain stem); without contrast material, followed by contrast material(s) and further sequences
70553-26 453 554 722 117 3.25
70553-TC 0 0 0 269 7.46
70554 Magnetic resonance imaging, brain, functional 1398 1711 2232 459 12.74 mori; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist admin
70554-26 385 471 615 108 3.01
70554-TC 0 0 0 350 9.73
70555 Magnetic resonance imaging, brain, functional 411 503 656 0 0.00 mori; requiring physician or psychologist administration of entire neurofunctional testing
70555-26 411 503 656 128 3.56
70555-TC 0 0 0 0 0.00
70557 Magnetic resonance (eg, proton) imaging, brain 673 823 1074 0 0.00 (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material
470 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
70557-26 0 0 0 161 4.46
70557-TC 0 0 0 0 0.00
70558 Magnetic resonance (eg, proton) imaging, brain 734 898 1171 0 0.00 (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)
70558-26 0 0 0 177 4.91
70558-TC 0 0 0 0 0.00
70559 Magnetic resonance (eg, proton) imaging, brain 714 875 1140 0 0.00 (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences
70559-26 714 875 1140 167 4.63
70559-TC 0 0 0 0 0.00
71045 Radiologic examination, chest; single view 91 108 150 20 0.56
71045-26 0 0 0 9 0.26
71045-TC 0 0 0 11 0.30
71046 Radiologic examination, chest; 2 views 140 166 231 31 0.86
71046-26 0 0 0 11 0.31
71046-TC 0 0 0 20 0.55
71047 Radiologic examination, chest; 3 views 179 212 295 40 1.10
71047-26 0 0 0 14 0.40
71047-TC 0 0 0 25 0.70
71048 Radiologic examination, chest; 4 or more views 192 227 316 42 1.18
71048-26 0 0 0 17 0.46
71048-TC 0 0 0 26 0.72
71100 Radiologic examination, ribs, unilateral; 2 110 130 181 34 0.94 views
71100-26 45 53 74 12 0.32
71100-TC 0 0 0 22 0.62
CPT copyright 2017 American Medical Association. 471 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
71101 Radiologic examination, ribs, unilateral; 123 146 204 39 1.08 including posteroanterior chest, minimum of 3 views
71101-26 50 59 83 14 0.39
71101-TC 0 0 0 25 0.69
71110 Radiologic examination, ribs, bilateral; 3 views 128 151 210 41 1.13
71110-26 50 60 83 15 0.42
71110-TC 0 0 0 26 0.71
71111 Radiologic examination, ribs, bilateral; 155 183 255 48 1.33 including posteroanterior chest, minimum of 4 views
71111-26 61 72 101 17 0.47
71111-TC 0 0 0 31 0.86
71120 Radiologic examination; sternum, minimum of 100 119 165 30 0.84 2 views
71120-26 37 44 61 10 0.29
71120-TC 0 0 0 20 0.55
71130 Radiologic examination; sternoclavicular joint 114 135 188 37 1.02 or joints, minimum of 3 views
71130-26 40 48 66 12 0.32
71130-TC 0 0 0 25 0.70
71250 Computed tomography, thorax; without 797 943 1314 166 4.61 contrast material
71250-26 205 242 337 60 1.66
71250-TC 0 0 0 106 2.95
71260 Computed tomography, thorax; with contrast 968 1146 1597 200 5.56 material(s)
71260-26 231 273 381 64 1.77
71260-TC 0 0 0 136 3.79
71270 Computed tomography, thorax; without 1242 1469 2047 240 6.66 contrast material, followed by contrast material(s) and further sections
71270-26 271 320 446 71 1.97
472 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
71270-TC 0 0 0 169 4.69
71275 Computed tomographic angiography, chest 1256 1487 2070 306 8.49 (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing
71275-26 318 376 524 93 2.59
71275-TC 0 0 0 212 5.90
71550 Magnetic resonance (eg, proton) imaging, chest 1613 1910 2660 320 8.89 (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)
71550-26 282 333 464 75 2.08
71550-TC 0 0 0 245 6.81
71551 Magnetic resonance (eg, proton) imaging, chest 1656 1960 2731 466 12.95 (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)
71551-26 354 419 583 89 2.46
71551-TC 0 0 0 378 10.49
71552 Magnetic resonance (eg, proton) imaging, chest 2592 3067 4272 572 15.89 (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences
71552-26 435 515 717 116 3.21
71552-TC 0 0 0 456 12.68
71555 Magnetic resonance angiography, chest 1964 2324 3237 408 11.32 (excluding myocardium), with or without contrast material(s)
71555-26 337 399 556 92 2.55
71555-TC 0 0 0 316 8.77
72020 Radiologic examination, spine, single view, 68 85 115 23 0.63 specify level
72020-26 30 38 52 8 0.22
72020-TC 0 0 0 15 0.41
72040 Radiologic examination, spine, cervical; 2 or 3 89 112 151 34 0.94 views
72040-26 36 46 62 12 0.32
CPT copyright 2017 American Medical Association. 473 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
72040-TC 0 0 0 22 0.62
72050 Radiologic examination, spine, cervical; 4 or 5 162 204 275 46 1.28 views
72050-26 59 74 100 16 0.45
72050-TC 0 0 0 30 0.83
72052 Radiologic examination, spine, cervical; 6 or 209 263 355 57 1.58 more views
72052-26 65 81 110 19 0.52
72052-TC 0 0 0 38 1.06
72070 Radiologic examination, spine; thoracic, 2 92 115 156 35 0.96 views
72070-26 37 47 63 12 0.32
72070-TC 0 0 0 23 0.64
72072 Radiologic examination, spine; thoracic, 3 122 153 207 35 0.98 views
72072-26 41 52 70 11 0.31
72072-TC 0 0 0 24 0.67
72074 Radiologic examination, spine; thoracic, 148 186 252 40 1.10 minimum of 4 views
72074-26 44 55 74 11 0.31
72074-TC 0 0 0 28 0.79
72080 Radiologic examination, spine; thoracolumbar 116 146 197 34 0.95 junction, minimum of 2 views
72080-26 44 56 75 12 0.32
72080-TC 0 0 0 23 0.63
72081 Radiologic examination, spine, entire thoracic 120 150 203 39 1.09 and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view
72081-26 47 59 79 14 0.38
72081-TC 0 0 0 26 0.71
72082 Radiologic examination, spine, entire thoracic 156 196 265 63 1.76 and lumbar, including skull, cervical and
474 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
sacralspine if performed (eg, scoliosis evaluation); 2 or 3 views
72082-26 50 63 85 17 0.46
72082-TC 0 0 0 47 1.30
72083 Radiologic examination, spine, entire thoracic 201 253 342 76 2.12 and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views
72083-26 61 77 104 19 0.52
72083-TC 0 0 0 58 1.60
72084 Radiologic examination, spine, entire thoracic 193 242 328 89 2.47 and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views
72084-26 64 80 108 22 0.61
72084-TC 0 0 0 67 1.86
72100 Radiologic examination, spine, lumbosacral; 2 109 138 186 36 0.99 or 3 views
72100-26 43 54 73 12 0.32
72100-TC 0 0 0 24 0.67
72110 Radiologic examination, spine, lumbosacral; 170 214 289 50 1.38 minimum of 4 views
72110-26 60 75 102 16 0.45
72110-TC 0 0 0 33 0.93
72114 Radiologic examination, spine, lumbosacral; 211 265 359 63 1.74 complete, including bending views, minimum of 6 views
72114-26 49 61 83 17 0.47
72114-TC 0 0 0 46 1.27
72120 Radiologic examination, spine, lumbosacral; 132 165 223 41 1.15 bending views only, 2 or 3 views
72120-26 44 55 74 12 0.32
72120-TC 0 0 0 30 0.83
72125 Computed tomography, cervical spine; without 784 972 1274 174 4.82 contrast material
CPT copyright 2017 American Medical Association. 475 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
72125-26 193 240 314 55 1.52
72125-TC 0 0 0 119 3.30
72126 Computed tomography, cervical spine; with 989 1225 1607 232 6.45 contrast material
72126-26 218 270 354 63 1.74
72126-TC 0 0 0 170 4.71
72127 Computed tomography, cervical spine; without 1202 1489 1953 275 7.64 contrast material, followed by contrast material(s) and further sections
72127-26 234 290 380 65 1.80
72127-TC 0 0 0 210 5.84
72128 Computed tomography, thoracic spine; without 777 963 1264 170 4.73 contrast material
72128-26 190 236 309 51 1.43
72128-TC 0 0 0 119 3.30
72129 Computed tomography, thoracic spine; with 812 1006 1320 233 6.48 contrast material
72129-26 212 263 345 63 1.74
72129-TC 0 0 0 171 4.74
72130 Computed tomography, thoracic spine; without 1152 1427 1871 277 7.69 contrast material, followed by contrast material(s) and further sections
72130-26 210 261 342 65 1.81
72130-TC 0 0 0 212 5.88
72131 Computed tomography, lumbar spine; without 788 977 1281 170 4.73 contrast material
72131-26 192 238 312 51 1.43
72131-TC 0 0 0 119 3.30
72132 Computed tomography, lumbar spine; with 996 1235 1619 232 6.45 contrast material
72132-26 213 264 347 63 1.74
72132-TC 0 0 0 170 4.71
476 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
72133 Computed tomography, lumbar spine; without 1231 1526 2001 274 7.62 contrast material, followed by contrast material(s) and further sections
72133-26 224 277 363 65 1.81
72133-TC 0 0 0 209 5.81
72141 Magnetic resonance (eg, proton) imaging, 1467 1818 2385 229 6.37 spinal canal and contents, cervical; without contrast material
72141-26 287 356 466 76 2.12
72141-TC 0 0 0 153 4.25
72142 Magnetic resonance (eg, proton) imaging, 1701 2108 2765 333 9.25 spinal canal and contents, cervical; with contrast material(s)
72142-26 346 429 562 92 2.55
72142-TC 0 0 0 241 6.70
72146 Magnetic resonance (eg, proton) imaging, 1496 1854 2431 230 6.38 spinal canal and contents, thoracic; without contrast material
72146-26 282 350 459 76 2.12
72146-TC 0 0 0 153 4.26
72147 Magnetic resonance (eg, proton) imaging, 1622 2011 2637 330 9.18 spinal canal and contents, thoracic; with contrast material(s)
72147-26 353 437 573 91 2.54
72147-TC 0 0 0 239 6.64
72148 Magnetic resonance (eg, proton) imaging, 1506 1866 2448 229 6.37 spinal canal and contents, lumbar; without contrast material
72148-26 272 337 441 76 2.12
72148-TC 0 0 0 153 4.25
72149 Magnetic resonance (eg, proton) imaging, 1611 1996 2618 329 9.13 spinal canal and contents, lumbar; with contrast material(s)
72149-26 337 417 547 92 2.55
72149-TC 0 0 0 237 6.58
CPT copyright 2017 American Medical Association. 477 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
72156 Magnetic resonance (eg, proton) imaging, 2255 2795 3666 388 10.77 spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical
72156-26 405 502 658 117 3.25
72156-TC 0 0 0 271 7.52
72157 Magnetic resonance (eg, proton) imaging, 2225 2757 3616 388 10.79 spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic
72157-26 410 508 666 117 3.25
72157-TC 0 0 0 271 7.54
72158 Magnetic resonance (eg, proton) imaging, 2436 3019 3959 387 10.75 spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar
72158-26 425 527 691 117 3.26
72158-TC 0 0 0 270 7.49
72159 Magnetic resonance angiography, spinal canal 2041 2529 3317 345 9.57 and contents, with or without contrast material(s)
72159-26 327 406 532 92 2.55
72159-TC 0 0 0 253 7.02
72170 Radiologic examination, pelvis; 1 or 2 views 140 173 227 32 0.90
72170-26 45 56 73 9 0.25
72170-TC 0 0 0 23 0.65
72190 Radiologic examination, pelvis; complete, 125 155 203 39 1.07 minimum of 3 views
72190-26 42 51 68 11 0.31
72190-TC 0 0 0 27 0.76
72191 Computed tomographic angiography, pelvis, 1217 1508 1978 311 8.65 with contrast material(s), including noncontrast images, if performed, and image postprocessing
72191-26 263 326 428 92 2.56
72191-TC 0 0 0 219 6.09
478 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
72192 Computed tomography, pelvis; without contrast 727 901 1181 149 4.13 material
72192-26 181 224 294 56 1.55
72192-TC 0 0 0 93 2.58
72193 Computed tomography, pelvis; with contrast 844 1045 1371 230 6.39 material(s)
72193-26 202 250 328 60 1.66
72193-TC 0 0 0 170 4.73
72194 Computed tomography, pelvis; without contrast 1093 1354 1776 265 7.36 material, followed by contrast material(s) and further sections
72194-26 223 277 363 63 1.74
72194-TC 0 0 0 202 5.62
72195 Magnetic resonance (eg, proton) imaging, 1486 1841 2415 320 8.89 pelvis; without contrast material(s)
72195-26 256 317 415 75 2.08
72195-TC 0 0 0 245 6.81
72196 Magnetic resonance (eg, proton) imaging, 1486 1841 2415 355 9.85 pelvis; with contrast material(s)
72196-26 296 366 480 89 2.47
72196-TC 0 0 0 266 7.38
72197 Magnetic resonance (eg, proton) imaging, 2421 3000 3934 435 12.07 pelvis; without contrast material(s), followed by contrast material(s) and further sequences
72197-26 410 508 666 113 3.13
72197-TC 0 0 0 322 8.94
72198 Magnetic resonance angiography, pelvis, with 1928 2390 3134 409 11.35 or without contrast material(s)
72198-26 307 380 498 91 2.53
72198-TC 0 0 0 318 8.82
72200 Radiologic examination, sacroiliac joints; less 96 120 157 29 0.80 than 3 views
72200-26 36 45 58 9 0.25
CPT copyright 2017 American Medical Association. 479 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
72200-TC 0 0 0 20 0.55
72202 Radiologic examination, sacroiliac joints; 3 or 107 132 174 33 0.93 more views
72202-26 34 42 55 10 0.27
72202-TC 0 0 0 24 0.66
72220 Radiologic examination, sacrum and coccyx, 90 111 146 29 0.80 minimum of 2 views
72220-26 33 40 53 9 0.25
72220-TC 0 0 0 20 0.55
72240 Myelography, cervical, radiological supervision 392 485 636 100 2.77 and interpretation
72240-26 165 205 269 46 1.29
72240-TC 0 0 0 53 1.48
72255 Myelography, thoracic, radiological 301 372 488 100 2.78 supervision and interpretation
72255-26 185 230 301 48 1.32
72255-TC 0 0 0 53 1.46
72265 Myelography, lumbosacral, radiological 399 494 648 94 2.60 supervision and interpretation
72265-26 229 284 372 42 1.17
72265-TC 0 0 0 51 1.43
72270 Myelography, 2 or more regions (eg, 599 742 973 130 3.62 lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation
72270-26 286 354 464 69 1.92
72270-TC 0 0 0 61 1.70
72275 Epidurography, radiological supervision and 351 435 570 118 3.27 interpretation
72275-26 206 256 335 40 1.11
72275-TC 0 0 0 78 2.16
72285 Discography, cervical or thoracic, radiological 610 756 991 114 3.17 supervision and interpretation
480 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
72285-26 267 331 435 61 1.70
72285-TC 0 0 0 53 1.47
72295 Discography, lumbar, radiological supervision 654 811 1064 99 2.75 and interpretation
72295-26 189 234 307 44 1.23
72295-TC 0 0 0 55 1.52
73000 Radiologic examination; clavicle, complete 89 112 153 28 0.79
73000-26 31 39 54 9 0.24
73000-TC 0 0 0 20 0.55
73010 Radiologic examination; scapula, complete 94 119 162 31 0.86
73010-26 33 41 56 9 0.26
73010-TC 0 0 0 22 0.60
73020 Radiologic examination, shoulder; 1 view 75 94 128 23 0.65
73020-26 30 38 52 8 0.23
73020-TC 0 0 0 15 0.42
73030 Radiologic examination, shoulder; complete, 98 123 169 30 0.83 minimum of 2 views
73030-26 36 46 62 10 0.27
73030-TC 0 0 0 20 0.56
73040 Radiologic examination, shoulder, 320 402 550 103 2.86 arthrography, radiological supervision and interpretation
73040-26 94 119 162 28 0.78
73040-TC 0 0 0 75 2.08
73050 Radiologic examination; acromioclavicular 107 134 184 36 1.01 joints, bilateral, with or without weighted distraction
73050-26 36 45 62 11 0.30
73050-TC 0 0 0 26 0.71
73060 Radiologic examination; humerus, minimum of 87 110 150 30 0.82 2 views
73060-26 31 39 54 9 0.24
CPT copyright 2017 American Medical Association. 481 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
73060-TC 0 0 0 21 0.58
73070 Radiologic examination, elbow; 2 views 87 110 150 28 0.77
73070-26 31 38 52 8 0.23
73070-TC 0 0 0 19 0.54
73080 Radiologic examination, elbow; complete, 101 127 174 32 0.89 minimum of 3 views
73080-26 34 43 59 9 0.25
73080-TC 0 0 0 23 0.64
73085 Radiologic examination, elbow, arthrography, 317 399 546 98 2.71 radiological supervision and interpretation
73085-26 105 131 180 30 0.82
73085-TC 0 0 0 68 1.89
73090 Radiologic examination; forearm, 2 views 83 104 143 26 0.73
73090-26 30 37 51 9 0.24
73090-TC 0 0 0 18 0.49
73092 Radiologic examination; upper extremity, 85 107 146 28 0.77 infant, minimum of 2 views
73092-26 29 36 49 8 0.23
73092-TC 0 0 0 19 0.54
73100 Radiologic examination, wrist; 2 views 83 104 142 32 0.89
73100-26 30 37 51 9 0.25
73100-TC 0 0 0 23 0.64
73110 Radiologic examination, wrist; complete, 103 130 178 36 0.99 minimum of 3 views
73110-26 34 43 59 9 0.25
73110-TC 0 0 0 27 0.74
73115 Radiologic examination, wrist, arthrography, 293 369 505 109 3.02 radiological supervision and interpretation
73115-26 91 114 157 29 0.81
73115-TC 0 0 0 80 2.21
73120 Radiologic examination, hand; 2 views 77 97 133 29 0.80
482 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
73120-26 29 36 49 9 0.24
73120-TC 0 0 0 20 0.56
73130 Radiologic examination, hand; minimum of 3 96 120 164 32 0.90 views
73130-26 33 42 57 9 0.25
73130-TC 0 0 0 23 0.65
73140 Radiologic examination, finger(s), minimum of 81 102 139 33 0.91 2 views
73140-26 25 31 42 7 0.20
73140-TC 0 0 0 26 0.71
73200 Computed tomography, upper extremity; 728 915 1252 170 4.73 without contrast material
73200-26 177 222 304 51 1.43
73200-TC 0 0 0 119 3.30
73201 Computed tomography, upper extremity; with 854 1073 1468 227 6.30 contrast material(s)
73201-26 189 238 325 60 1.66
73201-TC 0 0 0 167 4.64
73202 Computed tomography, upper extremity; 1081 1359 1860 283 7.86 without contrast material, followed by contrast material(s) and further sections
73202-26 219 275 376 63 1.74
73202-TC 0 0 0 220 6.12
73206 Computed tomographic angiography, upper 1199 1507 2062 334 9.28 extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing
73206-26 279 350 479 92 2.55
73206-TC 0 0 0 242 6.73
73218 Magnetic resonance (eg, proton) imaging, 1371 1723 2358 315 8.75 upper extremity, other than joint; without contrast material(s)
73218-26 233 293 400 69 1.93
73218-TC 0 0 0 246 6.82
CPT copyright 2017 American Medical Association. 483 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
73219 Magnetic resonance (eg, proton) imaging, 1527 1920 2627 411 11.42 upper extremity, other than joint; with contrast material(s)
73219-26 282 355 485 83 2.31
73219-TC 0 0 0 328 9.11
73220 Magnetic resonance (eg, proton) imaging, 2261 2843 3889 510 14.16 upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences
73220-26 370 465 636 110 3.06
73220-TC 0 0 0 400 11.10
73221 Magnetic resonance (eg, proton) imaging, any 1441 1811 2478 242 6.73 joint of upper extremity; without contrast material(s)
73221-26 247 311 425 70 1.94
73221-TC 0 0 0 172 4.79
73222 Magnetic resonance (eg, proton) imaging, any 1691 2126 2908 387 10.75 joint of upper extremity; with contrast material(s)
73222-26 283 355 486 84 2.32
73222-TC 0 0 0 303 8.43
73223 Magnetic resonance (eg, proton) imaging, any 2227 2800 3831 480 13.33 joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences
73223-26 355 446 610 110 3.06
73223-TC 0 0 0 370 10.27
73225 Magnetic resonance angiography, upper 1443 1815 2483 341 9.46 extremity, with or without contrast material(s)
73225-26 305 383 524 88 2.44
73225-TC 0 0 0 253 7.02
73501 Radiologic examination, hip, unilateral, with 78 98 134 31 0.85 pelvis when performed; 1 view
73501-26 30 37 51 10 0.27
484 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
73501-TC 0 0 0 21 0.58
73502 Radiologic examination, hip, unilateral, with 111 140 191 42 1.17 pelvis when performed; 2-3 views
73502-26 38 48 65 12 0.32
73502-TC 0 0 0 31 0.85
73503 Radiologic examination, hip, unilateral, with 136 171 235 53 1.46 pelvis when performed; minimum of 4 views
73503-26 47 59 80 15 0.41
73503-TC 0 0 0 38 1.05
73521 Radiologic examination, hips, bilateral, with 106 134 183 38 1.06 pelvis when performed; 2 views
73521-26 38 47 65 12 0.32
73521-TC 0 0 0 27 0.74
73522 Radiologic examination, hips, bilateral, with 139 175 240 50 1.38 pelvis when performed; 3-4 views
73522-26 50 63 87 15 0.43
73522-TC 0 0 0 34 0.95
73523 Radiologic examination, hips, bilateral, with 169 213 292 58 1.60 pelvis when performed; minimum of 5 views
73523-26 55 69 95 17 0.46
73523-TC 0 0 0 41 1.14
73525 Radiologic examination, hip, arthrography, 305 384 526 105 2.92 radiological supervision and interpretation
73525-26 99 125 171 30 0.83
73525-TC 0 0 0 75 2.09
73551 Radiologic examination, femur; 1 view 72 90 123 28 0.79
73551-26 27 35 47 9 0.24
73551-TC 0 0 0 20 0.55
73552 Radiologic examination, femur; minimum 2 87 109 149 33 0.93 views
73552-26 30 38 52 10 0.27
73552-TC 0 0 0 24 0.66
CPT copyright 2017 American Medical Association. 485 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
73560 Radiologic examination, knee; 1 or 2 views 92 116 159 32 0.88
73560-26 34 43 59 9 0.24
73560-TC 0 0 0 23 0.64
73562 Radiologic examination, knee; 3 views 104 131 180 36 1.01
73562-26 35 44 61 10 0.27
73562-TC 0 0 0 27 0.74
73564 Radiologic examination, knee; complete, 4 or 120 152 207 40 1.12 more views
73564-26 42 53 72 12 0.32
73564-TC 0 0 0 29 0.80
73565 Radiologic examination, knee; both knees, 90 113 155 36 1.01 standing, anteroposterior
73565-26 32 41 56 9 0.25
73565-TC 0 0 0 27 0.76
73580 Radiologic examination, knee, arthrography, 206 259 355 119 3.31 radiological supervision and interpretation
73580-26 87 110 150 30 0.82
73580-TC 0 0 0 90 2.49
73590 Radiologic examination; tibia and fibula, 2 83 105 143 29 0.81 views
73590-26 30 37 51 9 0.24
73590-TC 0 0 0 21 0.57
73592 Radiologic examination; lower extremity, 83 104 143 28 0.77 infant, minimum of 2 views
73592-26 28 35 48 8 0.23
73592-TC 0 0 0 19 0.54
73600 Radiologic examination, ankle; 2 views 82 103 141 30 0.84
73600-26 31 39 54 9 0.24
73600-TC 0 0 0 22 0.60
73610 Radiologic examination, ankle; complete, 95 120 165 32 0.89 minimum of 3 views
73610-26 33 41 57 9 0.25
486 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
73610-TC 0 0 0 23 0.64
73615 Radiologic examination, ankle, arthrography, 222 280 383 109 3.02 radiological supervision and interpretation
73615-26 101 128 175 30 0.82
73615-TC 0 0 0 79 2.20
73620 Radiologic examination, foot; 2 views 63 79 108 27 0.74
73620-26 25 32 43 8 0.22
73620-TC 0 0 0 19 0.52
73630 Radiologic examination, foot; complete, 93 118 161 30 0.83 minimum of 3 views
73630-26 34 42 58 9 0.24
73630-TC 0 0 0 21 0.59
73650 Radiologic examination; calcaneus, minimum 72 91 125 28 0.77 of 2 views
73650-26 26 33 46 8 0.23
73650-TC 0 0 0 19 0.54
73660 Radiologic examination; toe(s), minimum of 2 72 91 125 29 0.80 views
73660-26 23 29 40 7 0.19
73660-TC 0 0 0 22 0.61
73700 Computed tomography, lower extremity; 719 897 1125 170 4.73 without contrast material
73700-26 179 224 280 51 1.43
73700-TC 0 0 0 119 3.30
73701 Computed tomography, lower extremity; with 825 1029 1291 230 6.39 contrast material(s)
73701-26 199 248 311 60 1.66
73701-TC 0 0 0 170 4.73
73702 Computed tomography, lower extremity; 1079 1346 1688 279 7.76 without contrast material, followed by contrast material(s) and further sections
73702-26 216 269 338 62 1.73
CPT copyright 2017 American Medical Association. 487 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
73702-TC 0 0 0 217 6.03
73706 Computed tomographic angiography, lower 1157 1443 1810 350 9.71 extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing
73706-26 282 351 441 97 2.69
73706-TC 0 0 0 253 7.02
73718 Magnetic resonance (eg, proton) imaging, 1440 1796 2253 313 8.70 lower extremity other than joint; without contrast material(s)
73718-26 234 292 366 69 1.93
73718-TC 0 0 0 244 6.77
73719 Magnetic resonance (eg, proton) imaging, 1544 1926 2416 336 9.33 lower extremity other than joint; with contrast material(s)
73719-26 264 329 413 83 2.31
73719-TC 0 0 0 253 7.02
73720 Magnetic resonance (eg, proton) imaging, 2189 2730 3424 434 12.05 lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences
73720-26 342 427 536 110 3.05
73720-TC 0 0 0 324 9.00
73721 Magnetic resonance (eg, proton) imaging, any 1460 1821 2284 242 6.73 joint of lower extremity; without contrast material
73721-26 247 308 387 70 1.94
73721-TC 0 0 0 172 4.79
73722 Magnetic resonance (eg, proton) imaging, any 1754 2187 2744 390 10.82 joint of lower extremity; with contrast material(s)
73722-26 293 365 458 84 2.32
73722-TC 0 0 0 306 8.50
73723 Magnetic resonance (eg, proton) imaging, any 2303 2872 3603 479 13.31 joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences
488 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
73723-26 367 458 574 110 3.05
73723-TC 0 0 0 369 10.26
73725 Magnetic resonance angiography, lower 1667 2080 2609 409 11.36 extremity, with or without contrast material(s)
73725-26 332 414 520 92 2.56
73725-TC 0 0 0 317 8.80
74018 Radiologic examination, abdomen; 1 view 114 146 205 28 0.77
74018-26 0 0 0 9 0.26
74018-TC 0 0 0 18 0.51
74019 Radiologic examination, abdomen; 2 views 139 179 250 34 0.94
74019-26 0 0 0 12 0.33
74019-TC 0 0 0 22 0.61
74021 Radiologic examination, abdomen; 3 or more 162 209 293 40 1.10 views
74021-26 0 0 0 14 0.39
74021-TC 0 0 0 26 0.71
74022 Radiologic examination, abdomen; complete 136 175 245 45 1.26 acute abdomen series, including supine, erect, and/or decubitus views, single view chest
74022-26 59 75 106 17 0.46
74022-TC 0 0 0 29 0.80
74150 Computed tomography, abdomen; without 792 1020 1430 153 4.24 contrast material
74150-26 222 286 401 61 1.70
74150-TC 0 0 0 91 2.54
74160 Computed tomography, abdomen; with contrast 990 1275 1788 235 6.53 material(s)
74160-26 234 302 423 65 1.81
74160-TC 0 0 0 170 4.72
74170 Computed tomography, abdomen; without 1173 1510 2118 267 7.43 contrast material, followed by contrast material(s) and further sections
CPT copyright 2017 American Medical Association. 489 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
74170-26 258 333 467 72 2.00
74170-TC 0 0 0 195 5.43
74174 Computed tomographic angiography, abdomen 1613 2077 2913 364 10.12 and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing
74174-26 374 481 675 112 3.10
74174-TC 0 0 0 253 7.02
74175 Computed tomographic angiography, abdomen, 1228 1582 2218 313 8.69 with contrast material(s), including noncontrast images, if performed, and image postprocessing
74175-26 313 404 566 93 2.57
74175-TC 0 0 0 220 6.12
74176 Computed tomography, abdomen and pelvis; 878 1131 1586 204 5.68 without contrast material
74176-26 322 415 581 89 2.48
74176-TC 0 0 0 115 3.20
74177 Computed tomography, abdomen and pelvis; 1303 1678 2353 318 8.82 with contrast material(s)
74177-26 341 439 615 94 2.60
74177-TC 0 0 0 224 6.22
74178 Computed tomography, abdomen and pelvis; 1425 1835 2574 355 9.87 without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions
74178-26 400 516 723 103 2.85
74178-TC 0 0 0 253 7.02
74181 Magnetic resonance (eg, proton) imaging, 1438 1852 2597 288 8.00 abdomen; without contrast material(s)
74181-26 282 363 509 75 2.08
74181-TC 0 0 0 213 5.92
74182 Magnetic resonance (eg, proton) imaging, 1645 2118 2970 391 10.85 abdomen; with contrast material(s)
74182-26 315 406 570 89 2.47
490 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
74182-TC 0 0 0 302 8.38
74183 Magnetic resonance (eg, proton) imaging, 2402 3093 4337 436 12.10 abdomen; without contrast material(s), followed by with contrast material(s) and further sequences
74183-26 413 532 745 113 3.13
74183-TC 0 0 0 323 8.97
74185 Magnetic resonance angiography, abdomen, 1673 2155 3022 411 11.42 with or without contrast material(s)
74185-26 329 424 594 91 2.54
74185-TC 0 0 0 320 8.88
74190 Peritoneogram (eg, after injection of air or 202 261 365 0 0.00 contrast), radiological supervision and interpretation
74190-26 72 92 130 24 0.67
74190-TC 0 0 0 0 0.00
74210 Radiologic examination; pharynx and/or 149 189 261 79 2.20 cervical esophagus
74210-26 74 94 130 18 0.51
74210-TC 0 0 0 61 1.69
74220 Radiologic examination; esophagus 243 309 426 90 2.50
74220-26 82 104 143 24 0.66
74220-TC 0 0 0 66 1.84
74230 Swallowing function, with 254 322 445 131 3.65 cineradiography/videoradiography
74230-26 97 123 170 27 0.76
74230-TC 0 0 0 104 2.89
74235 Removal of foreign body(s), esophageal, with 153 194 268 0 0.00 use of balloon catheter, radiological supervision and interpretation
74235-26 0 0 0 63 1.76
74235-TC 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 491 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
74240 Radiologic examination, gastrointestinal tract, 285 363 500 115 3.19 upper; with or without delayed images, without kub
74240-26 122 156 214 36 0.99
74240-TC 0 0 0 79 2.20
74241 Radiologic examination, gastrointestinal tract, 368 467 644 119 3.31 upper; with or without delayed images, with kub
74241-26 128 163 224 35 0.98
74241-TC 0 0 0 84 2.33
74245 Radiologic examination, gastrointestinal tract, 468 595 820 174 4.83 upper; with small intestine, includes multiple serial images
74245-26 161 205 283 47 1.30
74245-TC 0 0 0 127 3.53
74246 Radiological examination, gastrointestinal tract, 320 407 561 129 3.57 upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed images, without kub
74246-26 92 117 162 35 0.98
74246-TC 0 0 0 93 2.59
74247 Radiological examination, gastrointestinal tract, 330 419 578 144 3.99 upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed images, with kub
74247-26 95 121 167 35 0.98
74247-TC 0 0 0 108 3.01
74249 Radiological examination, gastrointestinal tract, 489 621 856 186 5.18 upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with small intestine follow-through
74249-26 160 203 280 47 1.30
74249-TC 0 0 0 140 3.88
74250 Radiologic examination, small intestine, 267 340 468 105 2.92 includes multiple serial images;
492 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
74250-26 86 109 150 24 0.67
74250-TC 0 0 0 81 2.25
74251 Radiologic examination, small intestine, 598 761 1049 426 11.83 includes multiple serial images; via enteroclysis tube
74251-26 198 252 348 35 0.98
74251-TC 0 0 0 391 10.85
74260 Duodenography, hypotonic 854 1086 1497 354 9.83
74260-26 0 0 0 26 0.72
74260-TC 0 0 0 328 9.11
74261 Computed tomographic (ct) colonography, 1156 1470 2027 242 6.72 diagnostic, including image postprocessing; without contrast material
74261-26 368 468 646 123 3.42
74261-TC 0 0 0 119 3.30
74262 Computed tomographic (ct) colonography, 1119 1423 1962 381 10.58 diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed
74262-26 418 531 733 128 3.56
74262-TC 0 0 0 253 7.02
74263 Computed tomographic (ct) colonography, 1347 1712 2361 777 21.57 screening, including image postprocessing
74263-26 391 497 685 116 3.23
74263-TC 0 0 0 660 18.34
74270 Radiologic examination, colon; contrast (eg, 396 504 695 153 4.24 barium) enema, with or without kub
74270-26 124 158 218 35 0.98
74270-TC 0 0 0 117 3.26
74280 Radiologic examination, colon; air contrast 486 617 851 217 6.02 with specific high density barium, with or without glucagon
74280-26 169 214 295 51 1.41
CPT copyright 2017 American Medical Association. 493 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
74280-TC 0 0 0 166 4.61
74283 Therapeutic enema, contrast or air, for 481 611 843 214 5.94 reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)
74283-26 319 406 559 105 2.93
74283-TC 0 0 0 108 3.01
74290 Cholecystography, oral contrast 171 218 300 71 1.97
74290-26 0 0 0 17 0.46
74290-TC 0 0 0 54 1.51
74300 Cholangiography and/or pancreatography; 225 285 394 0 0.00 intraoperative, radiological supervision and interpretation
74300-26 68 87 120 19 0.52
74300-TC 0 0 0 0 0.00
74301 Cholangiography and/or pancreatography; 44 56 77 0 0.00 additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)
74301-26 0 0 0 11 0.30
74301-TC 0 0 0 0 0.00
74328 Endoscopic catheterization of the biliary ductal 436 554 764 0 0.00 system, radiological supervision and interpretation
74328-26 128 163 224 36 1.01
74328-TC 0 0 0 0 0.00
74329 Endoscopic catheterization of the pancreatic 292 371 511 0 0.00 ductal system, radiological supervision and interpretation
74329-26 122 156 215 37 1.02
74329-TC 0 0 0 0 0.00
74330 Combined endoscopic catheterization of the 272 346 477 0 0.00 biliary and pancreatic ductal systems, radiological supervision and interpretation
74330-26 164 209 288 47 1.30
74330-TC 0 0 0 0 0.00
494 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
74340 Introduction of long gastrointestinal tube (eg, 104 132 182 0 0.00 miller-Abbott), including multiple fluoroscopies and images, radiological supervision and interpretation
74340-26 88 112 154 28 0.77
74340-TC 0 0 0 0 0.00
74355 Percutaneous placement of enteroclysis tube, 132 168 232 0 0.00 radiological supervision and interpretation
74355-26 0 0 0 40 1.12
74355-TC 0 0 0 0 0.00
74360 Intraluminal dilation of strictures and/or 280 356 491 0 0.00 obstructions (eg, esophagus), radiological supervision and interpretation
74360-26 119 152 209 29 0.80
74360-TC 0 0 0 0 0.00
74363 Percutaneous transhepatic dilation of biliary 163 207 286 0 0.00 duct stricture with or without placement of stent, radiological supervision and interpretation
74363-26 163 207 286 44 1.21
74363-TC 0 0 0 0 0.00
74400 Urography (pyelography), intravenous, with or 298 480 1139 112 3.10 without kub, with or without tomography
74400-26 90 145 344 25 0.70
74400-TC 0 0 0 86 2.40
74410 Urography, infusion, drip technique and/or 259 417 989 113 3.14 bolus technique;
74410-26 84 134 319 25 0.70
74410-TC 0 0 0 88 2.44
74415 Urography, infusion, drip technique and/or 310 499 1183 139 3.85 bolus technique; with nephrotomography
74415-26 49 79 186 25 0.70
74415-TC 0 0 0 113 3.15
74420 Urography, retrograde, with or without kub 404 650 1543 0 0.00
CPT copyright 2017 American Medical Association. 495 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
74420-26 66 106 252 18 0.50
74420-TC 0 0 0 0 0.00
74425 Urography, antegrade (pyelostogram, 223 359 851 0 0.00 nephrostogram, loopogram), radiological supervision and interpretation
74425-26 68 109 260 18 0.50
74425-TC 0 0 0 0 0.00
74430 Cystography, minimum of 3 views, radiological 163 263 623 39 1.08 supervision and interpretation
74430-26 60 96 228 17 0.46
74430-TC 0 0 0 22 0.62
74440 Vasography, vesiculography, or 261 419 995 82 2.27 epididymography, radiological supervision and interpretation
74440-26 0 0 0 19 0.52
74440-TC 0 0 0 63 1.75
74445 Corpora cavernosography, radiological 183 294 697 0 0.00 supervision and interpretation
74445-26 0 0 0 57 1.59
74445-TC 0 0 0 0 0.00
74450 Urethrocystography, retrograde, radiological 283 455 1080 0 0.00 supervision and interpretation
74450-26 61 98 233 17 0.47
74450-TC 0 0 0 0 0.00
74455 Urethrocystography, voiding, radiological 279 449 1066 84 2.33 supervision and interpretation
74455-26 69 111 262 17 0.47
74455-TC 0 0 0 67 1.86
74470 Radiologic examination, renal cyst study, 86 139 329 0 0.00 translumbar, contrast visualization, radiological supervision and interpretation
74470-26 0 0 0 27 0.75
74470-TC 0 0 0 0 0.00
496 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
74485 Dilation of nephrostomy, ureters, or urethra, 331 533 1264 94 2.62 radiological supervision and interpretation
74485-26 94 151 357 27 0.74
74485-TC 0 0 0 68 1.88
74710 Pelvimetry, with or without placental 118 190 451 37 1.03 localization
74710-26 0 0 0 18 0.49
74710-TC 0 0 0 19 0.54
74712 Magnetic resonance (eg, proton) imaging, fetal, 1625 2614 6202 273 7.58 including placental and maternal pelvic imaging when performed; single or first gestation
74712-26 595 957 2271 154 4.28
74712-TC 0 0 0 119 3.30
74713 Magnetic resonance (eg, proton) imaging, fetal, 775 1247 2959 243 6.75 including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)
74713-26 0 0 0 95 2.65
74713-TC 0 0 0 148 4.10
74740 Hysterosalpingography, radiological 219 353 837 76 2.11 supervision and interpretation
74740-26 90 145 344 19 0.54
74740-TC 0 0 0 57 1.57
74742 Transcervical catheterization of fallopian tube, 406 654 1552 0 0.00 radiological supervision and interpretation
74742-26 406 654 1552 32 0.88
74742-TC 0 0 0 0 0.00
74775 Perineogram (eg, vaginogram, for sex 102 164 390 0 0.00 determination or extent of anomalies)
74775-26 0 0 0 32 0.89
74775-TC 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 497 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75557 Cardiac magnetic resonance imaging for 1417 1935 3158 336 9.33 morphology and function without contrast material;
75557-26 437 597 974 118 3.29
75557-TC 0 0 0 217 6.04
75559 Cardiac magnetic resonance imaging for 1506 2057 3357 392 10.88 morphology and function without contrast material; with stress imaging
75559-26 486 663 1083 146 4.06
75559-TC 0 0 0 246 6.82
75561 Cardiac magnetic resonance imaging for 2214 3024 4935 442 12.29 morphology and function without contrast material(s), followed by contrast material(s) and further sequences;
75561-26 407 556 907 131 3.63
75561-TC 0 0 0 312 8.66
75563 Cardiac magnetic resonance imaging for 3140 4289 7001 526 14.62 morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging
75563-26 482 658 1074 150 4.17
75563-TC 0 0 0 376 10.45
75565 Cardiac magnetic resonance imaging for 354 484 790 56 1.55 velocity flow mapping (list separately in addition to code for primary procedure)
75565-26 43 59 97 13 0.35
75565-TC 0 0 0 43 1.20
75571 Computed tomography, heart, without contrast 211 289 471 92 2.55 material, with quantitative evaluation of coronary calcium
75571-26 96 132 215 30 0.82
75571-TC 0 0 0 62 1.73
75572 Computed tomography, heart, with contrast 841 1149 1875 291 8.08 material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)
498 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75572-26 246 337 550 89 2.47
75572-TC 0 0 0 202 5.61
75573 Computed tomography, heart, with contrast 1232 1683 2746 382 10.60 material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of lv cardiac function, rv structure and function and evaluation of venous structures, if performed)
75573-26 376 514 839 129 3.58
75573-TC 0 0 0 253 7.02
75574 Computed tomographic angiography, heart, 1148 1568 2559 374 10.38 coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)
75574-26 357 488 797 121 3.36
75574-TC 0 0 0 253 7.02
75600 Aortography, thoracic, without serialography, 386 528 862 204 5.67 radiological supervision and interpretation
75600-26 212 290 473 25 0.69
75600-TC 0 0 0 179 4.98
75605 Aortography, thoracic, by serialography, 385 526 859 140 3.90 radiological supervision and interpretation
75605-26 177 242 395 57 1.58
75605-TC 0 0 0 84 2.32
75625 Aortography, abdominal, by serialography, 673 920 1501 140 3.88 radiological supervision and interpretation
75625-26 166 227 370 57 1.59
75625-TC 0 0 0 82 2.29
75630 Aortography, abdominal plus bilateral 730 997 1627 174 4.82 iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation
75630-26 243 333 543 90 2.50
CPT copyright 2017 American Medical Association. 499 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75630-TC 0 0 0 84 2.32
75635 Computed tomographic angiography, 1317 1799 2936 374 10.39 abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing
75635-26 381 520 849 121 3.37
75635-TC 0 0 0 253 7.02
75705 Angiography, spinal, selective, radiological 760 1038 1694 258 7.17 supervision and interpretation
75705-26 376 513 838 118 3.28
75705-TC 0 0 0 140 3.89
75710 Angiography, extremity, unilateral, radiological 682 932 1521 175 4.87 supervision and interpretation
75710-26 166 227 370 88 2.45
75710-TC 0 0 0 87 2.42
75716 Angiography, extremity, bilateral, radiological 913 1247 2036 199 5.53 supervision and interpretation
75716-26 190 260 425 99 2.74
75716-TC 0 0 0 100 2.79
75726 Angiography, visceral, selective or 549 750 1224 152 4.22 supraselective (with or without flush aortogram), radiological supervision and interpretation
75726-26 191 261 426 57 1.57
75726-TC 0 0 0 95 2.65
75731 Angiography, adrenal, unilateral, selective, 639 873 1425 175 4.87 radiological supervision and interpretation
75731-26 0 0 0 59 1.63
75731-TC 0 0 0 117 3.24
75733 Angiography, adrenal, bilateral, selective, 687 938 1531 188 5.23 radiological supervision and interpretation
75733-26 0 0 0 65 1.81
75733-TC 0 0 0 123 3.42
500 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75736 Angiography, pelvic, selective or 541 739 1206 163 4.52 supraselective, radiological supervision and interpretation
75736-26 202 276 450 56 1.56
75736-TC 0 0 0 107 2.96
75741 Angiography, pulmonary, unilateral, selective, 542 741 1209 153 4.24 radiological supervision and interpretation
75741-26 241 329 537 64 1.79
75741-TC 0 0 0 88 2.45
75743 Angiography, pulmonary, bilateral, selective, 609 832 1358 172 4.77 radiological supervision and interpretation
75743-26 266 363 592 82 2.29
75743-TC 0 0 0 89 2.48
75746 Angiography, pulmonary, by nonselective 490 670 1093 154 4.29 catheter or venous injection, radiological supervision and interpretation
75746-26 213 291 474 57 1.58
75746-TC 0 0 0 98 2.71
75756 Angiography, internal mammary, radiological 823 1124 1835 176 4.88 supervision and interpretation
75756-26 177 241 394 58 1.62
75756-TC 0 0 0 117 3.26
75774 Angiography, selective, each additional vessel 398 543 887 88 2.45 studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)
75774-26 67 91 149 18 0.49
75774-TC 0 0 0 71 1.96
75801 Lymphangiography, extremity only, unilateral, 166 240 385 0 0.00 radiological supervision and interpretation
75801-26 0 0 0 46 1.27
75801-TC 0 0 0 0 0.00
75803 Lymphangiography, extremity only, bilateral, 201 289 464 0 0.00 radiological supervision and interpretation
CPT copyright 2017 American Medical Association. 501 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75803-26 0 0 0 62 1.71
75803-TC 0 0 0 0 0.00
75805 Lymphangiography, pelvic/abdominal, 183 264 424 0 0.00 unilateral, radiological supervision and interpretation
75805-26 0 0 0 40 1.12
75805-TC 0 0 0 0 0.00
75807 Lymphangiography, pelvic/abdominal, 189 272 437 0 0.00 bilateral, radiological supervision and interpretation
75807-26 0 0 0 58 1.61
75807-TC 0 0 0 0 0.00
75809 Shuntogram for investigation of previously 304 438 702 101 2.80 placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation
75809-26 112 161 258 24 0.68
75809-TC 0 0 0 76 2.12
75810 Splenoportography, radiological supervision 359 518 830 0 0.00 and interpretation
75810-26 0 0 0 56 1.55
75810-TC 0 0 0 0 0.00
75820 Venography, extremity, unilateral, radiological 332 478 767 118 3.27 supervision and interpretation
75820-26 112 162 259 36 0.99
75820-TC 0 0 0 82 2.28
75822 Venography, extremity, bilateral, radiological 362 522 836 138 3.84 supervision and interpretation
75822-26 171 247 395 53 1.48
75822-TC 0 0 0 85 2.36
75825 Venography, caval, inferior, with 543 783 1256 137 3.81 serialography, radiological supervision and interpretation
75825-26 200 288 463 57 1.59
502 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75825-TC 0 0 0 80 2.22
75827 Venography, caval, superior, with 680 981 1573 141 3.93 serialography, radiological supervision and interpretation
75827-26 213 307 492 58 1.60
75827-TC 0 0 0 84 2.33
75831 Venography, renal, unilateral, selective, 330 476 763 143 3.97 radiological supervision and interpretation
75831-26 190 274 440 57 1.57
75831-TC 0 0 0 86 2.40
75833 Venography, renal, bilateral, selective, 612 882 1414 169 4.70 radiological supervision and interpretation
75833-26 258 372 596 75 2.07
75833-TC 0 0 0 95 2.63
75840 Venography, adrenal, unilateral, selective, 493 710 1139 151 4.20 radiological supervision and interpretation
75840-26 0 0 0 59 1.63
75840-TC 0 0 0 93 2.57
75842 Venography, adrenal, bilateral, selective, 590 851 1364 181 5.03 radiological supervision and interpretation
75842-26 0 0 0 77 2.13
75842-TC 0 0 0 104 2.90
75860 Venography, venous sinus (eg, petrosal and 510 736 1180 147 4.08 inferior sagittal) or jugular, catheter, radiological supervision and interpretation
75860-26 173 250 400 57 1.59
75860-TC 0 0 0 90 2.49
75870 Venography, superior sagittal sinus, 728 1049 1682 151 4.20 radiological supervision and interpretation
75870-26 282 407 653 59 1.63
75870-TC 0 0 0 93 2.57
75872 Venography, epidural, radiological supervision 664 957 1535 151 4.20 and interpretation
CPT copyright 2017 American Medical Association. 503 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75872-26 0 0 0 59 1.63
75872-TC 0 0 0 93 2.57
75880 Venography, orbital, radiological supervision 456 658 1055 128 3.56 and interpretation
75880-26 0 0 0 36 1.00
75880-TC 0 0 0 92 2.56
75885 Percutaneous transhepatic portography with 595 858 1376 159 4.43 hemodynamic evaluation, radiological supervision and interpretation
75885-26 261 376 603 70 1.94
75885-TC 0 0 0 90 2.49
75887 Percutaneous transhepatic portography without 565 814 1306 160 4.44 hemodynamic evaluation, radiological supervision and interpretation
75887-26 247 356 571 70 1.94
75887-TC 0 0 0 90 2.50
75889 Hepatic venography, wedged or free, with 1385 1997 3202 146 4.06 hemodynamic evaluation, radiological supervision and interpretation
75889-26 202 292 467 56 1.55
75889-TC 0 0 0 90 2.51
75891 Hepatic venography, wedged or free, without 577 832 1335 147 4.09 hemodynamic evaluation, radiological supervision and interpretation
75891-26 222 320 512 57 1.57
75891-TC 0 0 0 91 2.52
75893 Venous sampling through catheter, with or 147 212 339 122 3.40 without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation
75893-26 101 145 232 28 0.77
75893-TC 0 0 0 95 2.63
75894 Transcatheter therapy, embolization, any 240 324 636 0 0.00 method, radiological supervision and interpretation
504 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75894-26 240 324 636 74 2.05
75894-TC 0 0 0 0 0.00
75898 Angiography through existing catheter for 459 619 1214 0 0.00 follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis
75898-26 289 390 765 92 2.56
75898-TC 0 0 0 0 0.00
75901 Mechanical removal of pericatheter obstructive 479 647 1268 183 5.07 material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation
75901-26 94 127 249 24 0.67
75901-TC 0 0 0 158 4.40
75902 Mechanical removal of intraluminal 220 297 583 73 2.04 (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation
75902-26 62 83 163 19 0.54
75902-TC 0 0 0 54 1.50
75956 Endovascular repair of descending thoracic 1044 1409 2761 0 0.00 aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological supervision and interpretation
75956-26 1044 1409 2761 355 9.87
75956-TC 0 0 0 0 0.00
75957 Endovascular repair of descending thoracic 893 1205 2362 0 0.00 aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological supervision and interpretation
CPT copyright 2017 American Medical Association. 505 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
75957-26 893 1205 2362 305 8.46
75957-TC 0 0 0 0 0.00
75958 Placement of proximal extension prosthesis for 554 747 1465 0 0.00 endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption), radiological supervision and interpretation
75958-26 554 747 1465 203 5.63
75958-TC 0 0 0 0 0.00
75959 Placement of distal extension prosthesis(s) 557 752 1474 0 0.00 (delayed) after endovascular repair of descending thoracic aorta, as needed, to level of celiac origin, radiological supervision and interpretation
75959-26 0 0 0 178 4.94
75959-TC 0 0 0 0 0.00
75970 Transcatheter biopsy, radiological supervision 1578 2130 4175 0 0.00 and interpretation
75970-26 159 214 420 41 1.13
75970-TC 0 0 0 0 0.00
75984 Change of percutaneous tube or drainage 325 438 859 108 3.00 catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation
75984-26 135 182 357 36 0.99
75984-TC 0 0 0 72 2.01
75989 Radiological guidance (ie, fluoroscopy, 307 415 813 124 3.44 ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation
75989-26 207 280 549 60 1.66
75989-TC 0 0 0 64 1.78
76000 Fluoroscopy (separate procedure), up to 1 hour 216 317 518 49 1.35 physician or other qualified health care professional time
76000-26 89 130 212 9 0.25
506 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76000-TC 0 0 0 40 1.10
76001 Fluoroscopy, physician or other qualified health 329 483 789 0 0.00 care professional time more than 1 hour, assisting a nonradiologic physician or other qualified health care professional (eg, nephrostolithotomy, ERCP, bronchoscopy, transbronchial biopsy)
76001-26 183 268 438 38 1.05
76001-TC 0 0 0 0 0.00
76010 Radiologic examination from nose to rectum 108 158 259 27 0.74 for foreign body, single view, child
76010-26 34 50 82 9 0.26
76010-TC 0 0 0 17 0.48
76080 Radiologic examination, abscess, fistula or 141 207 338 56 1.55 sinus tract study, radiological supervision and interpretation
76080-26 94 138 226 27 0.74
76080-TC 0 0 0 29 0.81
76098 Radiological examination, surgical specimen 102 150 245 17 0.48
76098-26 32 47 77 8 0.23
76098-TC 0 0 0 9 0.25
76100 Radiologic examination, single plane body 186 273 446 93 2.59 section (eg, tomography), other than with urography
76100-26 61 90 147 32 0.90
76100-TC 0 0 0 61 1.69
76101 Radiologic examination, complex motion (ie, 531 779 1274 108 3.01 hypercycloidal) body section (eg, mastoid polytomography), other than with urography; unilateral
76101-26 0 0 0 29 0.81
76101-TC 0 0 0 79 2.20
76102 Radiologic examination, complex motion (ie, 415 609 996 174 4.82 hypercycloidal) body section (eg, mastoid polytomography), other than with urography; bilateral
CPT copyright 2017 American Medical Association. 507 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76102-26 92 135 221 36 0.99
76102-TC 0 0 0 138 3.83
76120 Cineradiography/videoradiography, except 166 244 398 94 2.62 where specifically included
76120-26 83 122 199 18 0.51
76120-TC 0 0 0 76 2.11
76125 Cineradiography/videoradiography to 81 120 196 0 0.00 complement routine examination (list separately in addition to code for primary procedure)
76125-26 43 63 103 14 0.40
76125-TC 0 0 0 0 0.00
76140 Consultation on x-ray examination made 87 128 209 0 0.00 elsewhere, written report
76376 3d rendering with interpretation and reporting 300 440 719 24 0.66 of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation
76376-26 43 64 104 10 0.28
76376-TC 0 0 0 14 0.38
76377 3d rendering with interpretation and reporting 322 473 773 72 2.01 of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation
76377-26 118 174 284 41 1.13
76377-TC 0 0 0 32 0.88
76380 Computed tomography, limited or localized 446 655 1071 148 4.11 follow-up study
76380-26 171 251 410 50 1.39
76380-TC 0 0 0 98 2.72
76390 Magnetic resonance spectroscopy 1791 2629 4298 458 12.72
76390-26 308 452 739 72 1.99
508 CPT copyright 2017 American Medical Association. DIAGNOSTIC RADIOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76390-TC 0 0 0 386 10.73
76496 Unlisted fluoroscopic procedure (eg, 0 0 0 0 0.00 diagnostic, interventional)
76496-26 0 0 0 0 0.00
76496-TC 0 0 0 0 0.00
76497 Unlisted computed tomography procedure (eg, 0 0 0 0 0.00 diagnostic, interventional)
76497-26 0 0 0 0 0.00
76497-TC 0 0 0 0 0.00
76498 Unlisted magnetic resonance procedure (eg, 0 0 0 0 0.00 diagnostic, interventional)
76498-26 0 0 0 0 0.00
76498-TC 0 0 0 0 0.00
76499 Unlisted diagnostic radiographic procedure 0 0 0 0 0.00
76499-26 0 0 0 0 0.00
76499-TC 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 509 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
510 CPT copyright 2017 American Medical Association. DIAGNOSTIC ULTRASOUND
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
DIAGNOSTIC ULTRASOUND 76506 Echoencephalography, real time with image 314 422 613 120 3.34 documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated
76506-26 124 167 243 33 0.91
76506-TC 0 0 0 87 2.43
76510 Ophthalmic ultrasound, diagnostic; b-scan and 369 497 722 140 3.89 quantitative a-scan performed during the same patient encounter
76510-26 187 252 366 73 2.04
76510-TC 0 0 0 67 1.85
76511 Ophthalmic ultrasound, diagnostic; quantitative 174 234 340 84 2.33 a-scan only
76511-26 151 203 295 44 1.22
76511-TC 0 0 0 40 1.11
76512 Ophthalmic ultrasound, diagnostic; b-scan (with 201 271 393 77 2.13 or without superimposed non-quantitative a- scan)
76512-26 146 196 285 44 1.22
76512-TC 0 0 0 33 0.91
76513 Ophthalmic ultrasound, diagnostic; anterior 178 240 348 98 2.72 segment ultrasound, immersion (water bath) b- scan or high resolution biomicroscopy
76513-26 113 153 222 37 1.02
76513-TC 0 0 0 61 1.70
76514 Ophthalmic ultrasound, diagnostic; corneal 41 55 80 16 0.44 pachymetry, unilateral or bilateral (determination of corneal thickness)
76514-26 27 36 52 10 0.28
76514-TC 0 0 0 6 0.16
76516 Ophthalmic biometry by ultrasound echography, 181 244 354 65 1.80 a-scan;
CPT copyright 2017 American Medical Association. 511 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76516-26 146 197 286 26 0.71
76516-TC 0 0 0 39 1.09
76519 Ophthalmic biometry by ultrasound echography, 181 244 354 76 2.11 a-scan; with intraocular lens power calculation
76519-26 107 144 209 32 0.89
76519-TC 0 0 0 44 1.22
76529 Ophthalmic ultrasonic foreign body localization 205 276 401 82 2.28
76529-26 0 0 0 34 0.94
76529-TC 0 0 0 48 1.34
76536 Ultrasound, soft tissues of head and neck (eg, 286 385 559 120 3.32 thyroid, parathyroid, parotid), real time with image documentation
76536-26 102 137 200 29 0.80
76536-TC 0 0 0 91 2.52
76604 Ultrasound, chest (includes mediastinum), real 264 329 430 91 2.54 time with image documentation
76604-26 105 131 171 28 0.77
76604-TC 0 0 0 64 1.77
76641 Ultrasound, breast, unilateral, real time with 261 326 426 110 3.06 image documentation, including axilla when performed; complete
76641-26 110 137 179 37 1.04
76641-TC 0 0 0 73 2.02
76642 Ultrasound, breast, unilateral, real time with 272 339 443 90 2.51 image documentation, including axilla when performed; limited
76642-26 113 141 184 35 0.97
76642-TC 0 0 0 55 1.54
76700 Ultrasound, abdominal, real time with image 366 456 596 126 3.49 documentation; complete
76700-26 143 179 234 41 1.15
76700-TC 0 0 0 84 2.34
512 CPT copyright 2017 American Medical Association. DIAGNOSTIC ULTRASOUND
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76705 Ultrasound, abdominal, real time with image 277 346 452 94 2.61 documentation; limited (eg, single organ, quadrant, follow-up)
76705-26 107 133 175 30 0.84
76705-TC 0 0 0 64 1.77
76706 Ultrasound, abdominal aorta, real time with 296 369 482 97 2.69 image documentation, screening study for abdominal aortic aneurysm (aaa)
76706-26 107 134 175 28 0.79
76706-TC 0 0 0 68 1.90
76770 Ultrasound, retroperitoneal (eg, renal, aorta, 332 414 541 116 3.23 nodes), real time with image documentation; complete
76770-26 131 164 214 38 1.05
76770-TC 0 0 0 78 2.18
76775 Ultrasound, retroperitoneal (eg, renal, aorta, 260 324 424 59 1.65 nodes), real time with image documentation; limited
76775-26 105 131 171 30 0.82
76775-TC 0 0 0 30 0.83
76776 Ultrasound, transplanted kidney, real time and 389 485 634 161 4.47 duplex Doppler with image documentation
76776-26 121 151 198 39 1.08
76776-TC 0 0 0 122 3.39
76800 Ultrasound, spinal canal and contents 576 780 1164 149 4.15
76800-26 202 273 408 61 1.70
76800-TC 0 0 0 88 2.45
76801 Ultrasound, pregnant uterus, real time with 362 490 731 127 3.52 image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation
76801-26 161 218 325 51 1.42
76801-TC 0 0 0 76 2.10
CPT copyright 2017 American Medical Association. 513 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76802 Ultrasound, pregnant uterus, real time with 211 286 427 67 1.85 image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)
76802-26 120 162 242 44 1.21
76802-TC 0 0 0 23 0.64
76805 Ultrasound, pregnant uterus, real time with 354 479 715 146 4.06 image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation
76805-26 149 203 302 52 1.44
76805-TC 0 0 0 94 2.62
76810 Ultrasound, pregnant uterus, real time with 316 429 640 96 2.66 image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)
76810-26 169 229 342 51 1.43
76810-TC 0 0 0 44 1.23
76811 Ultrasound, pregnant uterus, real time with 603 817 1219 188 5.22 image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation
76811-26 297 402 600 100 2.79
76811-TC 0 0 0 87 2.43
76812 Ultrasound, pregnant uterus, real time with 539 730 1089 210 5.83 image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)
76812-26 259 352 524 94 2.62
76812-TC 0 0 0 116 3.21
76813 Ultrasound, pregnant uterus, real time with 357 483 721 125 3.48 image documentation, first trimester fetal nuchal
514 CPT copyright 2017 American Medical Association. DIAGNOSTIC ULTRASOUND
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
translucency measurement, transabdominal or transvaginal approach; single or first gestation
76813-26 182 247 368 62 1.73
76813-TC 0 0 0 63 1.75
76814 Ultrasound, pregnant uterus, real time with 262 355 530 83 2.31 image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)
76814-26 156 211 314 53 1.47
76814-TC 0 0 0 30 0.84
76815 Ultrasound, pregnant uterus, real time with 266 360 537 87 2.41 image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses
76815-26 122 165 246 33 0.93
76815-TC 0 0 0 53 1.48
76816 Ultrasound, pregnant uterus, real time with 288 391 583 119 3.30 image documentation, follow-up (eg, re- evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetus
76816-26 129 174 260 45 1.25
76816-TC 0 0 0 74 2.05
76817 Ultrasound, pregnant uterus, real time with 311 422 629 100 2.77 image documentation, transvaginal
76817-26 136 184 274 39 1.08
76817-TC 0 0 0 61 1.69
76818 Fetal biophysical profile; with non-stress testing 367 497 742 127 3.52
76818-26 171 231 345 56 1.55
76818-TC 0 0 0 71 1.97
76819 Fetal biophysical profile; without non-stress 298 403 601 92 2.56 testing
CPT copyright 2017 American Medical Association. 515 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76819-26 134 181 270 40 1.12
76819-TC 0 0 0 52 1.44
76820 Doppler velocimetry, fetal; umbilical artery 204 277 412 49 1.37
76820-26 89 121 180 26 0.73
76820-TC 0 0 0 23 0.64
76821 Doppler velocimetry, fetal; middle cerebral 323 438 653 96 2.66 artery
76821-26 161 219 326 37 1.03
76821-TC 0 0 0 59 1.63
76825 Echocardiography, fetal, cardiovascular system, 673 911 1359 285 7.93 real time with image documentation (2d), with or without m-mode recording;
76825-26 286 387 578 86 2.39
76825-TC 0 0 0 199 5.54
76826 Echocardiography, fetal, cardiovascular system, 363 492 733 168 4.68 real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study
76826-26 173 235 351 42 1.18
76826-TC 0 0 0 126 3.50
76827 Doppler echocardiography, fetal, pulsed wave 320 434 648 77 2.15 and/or continuous wave with spectral display; complete
76827-26 131 178 265 30 0.82
76827-TC 0 0 0 48 1.33
76828 Doppler echocardiography, fetal, pulsed wave 164 222 331 55 1.52 and/or continuous wave with spectral display; follow-up or repeat study
76828-26 101 137 204 29 0.81
76828-TC 0 0 0 26 0.71
76830 Ultrasound, transvaginal 300 406 606 125 3.48
76830-26 118 160 238 36 0.99
76830-TC 0 0 0 90 2.49
516 CPT copyright 2017 American Medical Association. DIAGNOSTIC ULTRASOUND
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76831 Saline infusion sonohysterography (sis), 288 391 583 123 3.41 including color flow Doppler, when performed
76831-26 128 174 259 38 1.05
76831-TC 0 0 0 85 2.36
76856 Ultrasound, pelvic (nonobstetric), real time with 330 447 667 113 3.14 image documentation; complete
76856-26 127 172 257 35 0.98
76856-TC 0 0 0 78 2.16
76857 Ultrasound, pelvic (nonobstetric), real time with 210 284 424 50 1.38 image documentation; limited or follow-up (eg, for follicles)
76857-26 75 102 152 26 0.71
76857-TC 0 0 0 24 0.67
76870 Ultrasound, scrotum and contents 328 440 653 69 1.93
76870-26 126 169 251 33 0.91
76870-TC 0 0 0 37 1.02
76872 Ultrasound, transrectal; 303 406 602 99 2.75
76872-26 161 216 321 35 0.96
76872-TC 0 0 0 64 1.79
76873 Ultrasound, transrectal; prostate volume study 460 617 915 177 4.93 for brachytherapy treatment planning (separate procedure)
76873-26 313 419 622 80 2.22
76873-TC 0 0 0 98 2.71
76881 Ultrasound, complete joint (ie, joint space and 274 367 544 104 2.89 peri-articular soft tissue structures) real-time with image documentation
76881-26 92 123 182 32 0.90
76881-TC 0 0 0 72 1.99
76882 Ultrasound, limited, joint or other nonvascular 102 136 202 59 1.64 extremity structure(s) (eg, joint space, peri- articular tendon[s], muscle[s], nerve[s], other soft tissue structure[s], or soft tissue mass[es]), real-time with image documentation
CPT copyright 2017 American Medical Association. 517 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76882-26 69 92 136 25 0.70
76882-TC 0 0 0 34 0.94
76885 Ultrasound, infant hips, real time with imaging 384 515 764 148 4.12 documentation; dynamic (requiring physician or other qualified health care professional manipulation)
76885-26 134 180 267 38 1.06
76885-TC 0 0 0 110 3.06
76886 Ultrasound, infant hips, real time with imaging 340 456 675 108 3.01 documentation; limited, static (not requiring physician or other qualified health care professional manipulation)
76886-26 129 173 257 32 0.89
76886-TC 0 0 0 76 2.12
76930 Ultrasonic guidance for pericardiocentesis, 164 218 327 0 0.00 imaging supervision and interpretation
76930-26 94 126 188 34 0.94
76930-TC 0 0 0 0 0.00
76932 Ultrasonic guidance for endomyocardial biopsy, 148 196 295 0 0.00 imaging supervision and interpretation
76932-26 148 196 295 33 0.93
76932-TC 0 0 0 0 0.00
76936 Ultrasound guided compression repair of arterial 508 675 1013 279 7.74 pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)
76936-26 338 449 674 100 2.78
76936-TC 0 0 0 179 4.96
76937 Ultrasound guidance for vascular access 114 151 227 32 0.89 requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary procedure)
76937-26 59 78 117 15 0.41
518 CPT copyright 2017 American Medical Association. DIAGNOSTIC ULTRASOUND
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76937-TC 0 0 0 17 0.48
76940 Ultrasound guidance for, and monitoring of, 331 440 660 0 0.00 parenchymal tissue ablation
76940-26 331 440 660 106 2.94
76940-TC 0 0 0 0 0.00
76941 Ultrasonic guidance for intrauterine fetal 252 334 502 0 0.00 transfusion or cordocentesis, imaging supervision and interpretation
76941-26 252 334 502 70 1.94
76941-TC 0 0 0 0 0.00
76942 Ultrasonic guidance for needle placement (eg, 331 440 660 61 1.70 biopsy, aspiration, injection, localization device), imaging supervision and interpretation
76942-26 142 188 283 33 0.92
76942-TC 0 0 0 28 0.78
76945 Ultrasonic guidance for chorionic villus 398 529 794 0 0.00 sampling, imaging supervision and interpretation
76945-26 128 170 256 35 0.97
76945-TC 0 0 0 0 0.00
76946 Ultrasonic guidance for amniocentesis, imaging 225 300 450 33 0.93 supervision and interpretation
76946-26 106 141 211 20 0.56
76946-TC 0 0 0 13 0.37
76948 Ultrasonic guidance for aspiration of ova, 270 359 538 73 2.03 imaging supervision and interpretation
76948-26 177 235 353 36 0.99
76948-TC 0 0 0 37 1.04
76965 Ultrasonic guidance for interstitial radioelement 537 714 1072 94 2.61 application
76965-26 264 351 527 69 1.92
76965-TC 0 0 0 25 0.69
76970 Ultrasound study follow-up (specify) 200 265 398 94 2.62
76970-26 118 157 235 19 0.54
CPT copyright 2017 American Medical Association. 519 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
76970-TC 0 0 0 75 2.08
76975 Gastrointestinal endoscopic ultrasound, 204 272 408 0 0.00 supervision and interpretation
76975-26 0 0 0 44 1.21
76975-TC 0 0 0 0 0.00
76977 Ultrasound bone density measurement and 39 52 78 8 0.21 interpretation, peripheral site(s), any method
76977-26 7 10 15 3 0.08
76977-TC 0 0 0 5 0.13
76998 Ultrasonic guidance, intraoperative 303 402 604 0 0.00
76998-26 162 216 324 65 1.81
76998-TC 0 0 0 0 0.00
76999 Unlisted ultrasound procedure (eg, diagnostic, 0 0 0 0 0.00 interventional)
76999-26 0 0 0 0 0.00
76999-TC 0 0 0 0 0.00
520 CPT copyright 2017 American Medical Association. RADIOLOGIC GUIDANCE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
RADIOLOGIC GUIDANCE
77001 Fluoroscopic guidance for central venous access 259 344 516 86 2.38 device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position) (list separately in addition to code for primary procedure)
77001-26 66 88 132 19 0.53
77001-TC 0 0 0 67 1.85
77002 Fluoroscopic guidance for needle placement (eg, 210 279 418 96 2.67 biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)
77002-26 91 120 181 29 0.80
77002-TC 0 0 0 67 1.87
77003 Fluoroscopic guidance and localization of needle 230 306 460 96 2.67 or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)
77003-26 112 148 222 31 0.85
77003-TC 0 0 0 66 1.82
77011 Computed tomography guidance for stereotactic 960 1276 1915 231 6.41 localization
77011-26 148 197 295 64 1.78
77011-TC 0 0 0 167 4.63
77012 Computed tomography guidance for needle 742 986 1480 127 3.53 placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation
77012-26 204 272 408 59 1.63
77012-TC 0 0 0 68 1.90
77013 Computed tomography guidance for, and 645 857 1287 0 0.00 monitoring of, parenchymal tissue ablation
CPT copyright 2017 American Medical Association. 521 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77013-26 645 857 1287 197 5.48
77013-TC 0 0 0 0 0.00
77014 Computed tomography guidance for placement 497 661 992 122 3.40 of radiation therapy fields
77014-26 146 194 291 45 1.26
77014-TC 0 0 0 77 2.14
77021 Magnetic resonance guidance for needle 977 1299 1950 398 11.06 placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation
77021-26 231 307 461 75 2.09
77021-TC 0 0 0 323 8.97
77022 Magnetic resonance guidance for, and 646 858 1288 0 0.00 monitoring of, parenchymal tissue ablation
77022-26 0 0 0 221 6.15
77022-TC 0 0 0 0 0.00
522 CPT copyright 2017 American Medical Association. BREAST MAMMOGRAPHY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
BREAST MAMMOGRAPHY
77053 Mammary ductogram or galactogram, single 284 378 567 59 1.65 duct, radiological supervision and interpretation
77053-26 57 76 114 18 0.51
77053-TC 0 0 0 41 1.14
77054 Mammary ductogram or galactogram, multiple 229 304 456 78 2.16 ducts, radiological supervision and interpretation
77054-26 0 0 0 23 0.65
77054-TC 0 0 0 54 1.51
77058 Magnetic resonance imaging, breast, without 2124 2823 4237 540 15.00 and/or with contrast material(s); unilateral
77058-26 300 399 598 84 2.32
77058-TC 0 0 0 456 12.68
77059 Magnetic resonance imaging, breast, without 2337 3106 4662 540 15.00 and/or with contrast material(s); bilateral
77059-26 284 378 567 84 2.32
77059-TC 0 0 0 456 12.68
77061 Digital breast tomosynthesis; unilateral 122 162 244 0 0.00
77061-26 82 109 164 0 0.00
77061-TC 0 0 0 0 0.00
77062 Digital breast tomosynthesis; bilateral 146 194 292 0 0.00
77062-26 87 115 173 0 0.00
77062-TC 0 0 0 0 0.00
77063 Screening digital breast tomosynthesis, bilateral 146 193 290 56 1.56 (list separately in addition to code for primary procedure)
77063-26 92 122 183 31 0.85
77063-TC 0 0 0 26 0.71
77065 Diagnostic mammography, including computer- 360 479 719 136 3.79 aided detection (cad) when performed; unilateral
77065-26 115 153 230 40 1.12
77065-TC 0 0 0 96 2.67
CPT copyright 2017 American Medical Association. 523 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77066 Diagnostic mammography, including computer- 395 525 788 173 4.80 aided detection (cad) when performed; bilateral
77066-26 142 188 282 50 1.39
77066-TC 0 0 0 123 3.41
77067 Screening mammography, bilateral (2-view 365 485 727 140 3.88 study of each breast), including computer-aided detection (cad) when performed
77067-26 110 147 220 38 1.06
77067-TC 0 0 0 102 2.82
524 CPT copyright 2017 American Medical Association. BONE JOINT STUDIES
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
BONE/JOINT STUDIES
77071 Manual application of stress performed by 115 153 230 49 1.37 physician or other qualified health care professional for joint radiography, including contralateral joint if indicated
77072 Bone age studies 92 122 183 23 0.65
77072-26 29 39 59 10 0.27
77072-TC 0 0 0 14 0.38
77073 Bone length studies (orthoroentgenogram, 130 172 258 37 1.02 scanogram)
77073-26 49 65 98 15 0.41
77073-TC 0 0 0 22 0.61
77074 Radiologic examination, osseous survey; 188 250 375 66 1.82 limited (eg, for metastases)
77074-26 87 116 175 23 0.65
77074-TC 0 0 0 42 1.17
77075 Radiologic examination, osseous survey; 286 381 571 89 2.47 complete (axial and appendicular skeleton)
77075-26 95 126 189 28 0.77
77075-TC 0 0 0 61 1.70
77076 Radiologic examination, osseous survey, infant 240 319 479 98 2.71
77076-26 100 133 199 36 1.00
77076-TC 0 0 0 62 1.71
77077 Joint survey, single view, 2 or more joints 110 147 220 38 1.05 (specify)
77077-26 47 62 94 17 0.46
77077-TC 0 0 0 21 0.59
77078 Computed tomography, bone mineral density 339 451 677 117 3.26 study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)
77078-26 48 64 96 13 0.35
77078-TC 0 0 0 105 2.91
CPT copyright 2017 American Medical Association. 525 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77080 Dual-energy x-ray absorptiometry (DXA), bone 241 320 481 43 1.19 density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)
77080-26 43 58 87 10 0.29
77080-TC 0 0 0 32 0.90
77081 Dual-energy x-ray absorptiometry (DXA), bone 100 133 200 29 0.80 density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)
77081-26 40 53 79 11 0.31
77081-TC 0 0 0 18 0.49
77084 Magnetic resonance (eg, proton) imaging, bone 1400 1860 2792 397 11.03 marrow blood supply
77084-26 174 231 347 82 2.29
77084-TC 0 0 0 315 8.74
77085 Dual-energy x-ray absorptiometry (DXA), bone 172 229 343 58 1.61 density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment
77085-26 51 67 101 15 0.43
77085-TC 0 0 0 42 1.18
77086 Vertebral fracture assessment via dual-energy x- 88 118 176 37 1.03 ray absorptiometry (DXA)
77086-26 28 38 57 9 0.25
77086-TC 0 0 0 28 0.78
526 CPT copyright 2017 American Medical Association. RADIATION ONCOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
RADIATION ONCOLOGY
77261 Therapeutic radiology treatment planning; 236 341 490 73 2.03 simple
77262 Therapeutic radiology treatment planning; 355 511 735 110 3.06 intermediate
77263 Therapeutic radiology treatment planning; 572 824 1185 171 4.74 complex
77280 Therapeutic radiology simulation-aided field 676 975 1402 287 7.98 setting; simple
77280-26 128 184 264 37 1.04
77280-TC 0 0 0 250 6.94
77285 Therapeutic radiology simulation-aided field 771 1112 1599 469 13.03 setting; intermediate
77285-26 174 250 360 57 1.59
77285-TC 0 0 0 412 11.44
77290 Therapeutic radiology simulation-aided field 1331 1919 2759 539 14.96 setting; complex
77290-26 271 391 562 84 2.32
77290-TC 0 0 0 455 12.64
77293 Respiratory motion management simulation (list 1391 2005 2883 485 13.47 separately in addition to code for primary procedure)
77293-26 335 482 694 107 2.96
77293-TC 0 0 0 378 10.51
77295 3-dimensional radiotherapy plan, including 3033 4371 6286 509 14.14 dose-volume histograms
77295-26 743 1071 1540 229 6.35
77295-TC 0 0 0 280 7.79
77299 Unlisted procedure, therapeutic radiology 0 0 0 0 0.00 clinical treatment planning
77299-26 0 0 0 0 0.00
77299-TC 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 527 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77300 Basic radiation dosimetry calculation, central 328 400 546 69 1.91 axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non- ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician
77300-26 131 160 218 33 0.92
77300-TC 0 0 0 36 0.99
77301 Intensity modulated radiotherapy plan, 6268 7653 10433 2033 56.48 including dose-volume histograms for target and critical structure partial tolerance specifications
77301-26 1306 1594 2173 425 11.81
77301-TC 0 0 0 1608 44.67
77306 Teletherapy isodose plan; simple (1 or 2 551 673 917 155 4.31 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)
77306-26 223 272 371 75 2.08
77306-TC 0 0 0 80 2.23
77307 Teletherapy isodose plan; complex (multiple 933 1139 1553 299 8.31 treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)
77307-26 427 521 710 154 4.28
77307-TC 0 0 0 145 4.03
77316 Brachytherapy isodose plan; simple 694 847 1155 195 5.43 (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)
77316-26 223 273 372 75 2.08
77316-TC 0 0 0 121 3.35
77317 Brachytherapy isodose plan; intermediate 908 1109 1512 255 7.08 (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)
77317-26 298 364 497 97 2.70
528 CPT copyright 2017 American Medical Association. RADIATION ONCOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77317-TC 0 0 0 158 4.38
77318 Brachytherapy isodose plan; complex 1043 1273 1736 368 10.23 (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)
77318-26 396 483 659 154 4.28
77318-TC 0 0 0 214 5.95
77321 Special teletherapy port plan, particles, 601 734 1000 96 2.68 hemibody, total body
77321-26 162 198 270 51 1.41
77321-TC 0 0 0 46 1.27
77331 Special dosimetry (eg, TLD, microdosimetry) 227 277 378 66 1.84 (specify), only when prescribed by the treating physician
77331-26 139 170 232 46 1.29
77331-TC 0 0 0 20 0.55
77332 Treatment devices, design and construction; 268 327 446 60 1.68 simple (simple block, simple bolus)
77332-26 87 106 144 24 0.68
77332-TC 0 0 0 36 1.00
77333 Treatment devices, design and construction; 299 365 497 100 2.79 intermediate (multiple blocks, stents, bite blocks, special bolus)
77333-26 138 169 230 40 1.11
77333-TC 0 0 0 60 1.68
77334 Treatment devices, design and construction; 581 709 967 133 3.69 complex (irregular blocks, special shields, compensators, wedges, molds or casts)
77334-26 211 257 351 62 1.71
77334-TC 0 0 0 71 1.98
77336 Continuing medical physics consultation, 294 359 490 83 2.30 including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy
CPT copyright 2017 American Medical Association. 529 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77338 Multi-leaf collimator (mlc) device(s) for 1606 1961 2673 527 14.65 intensity modulated radiation therapy (IMRT), design and construction per IMRT plan
77338-26 686 837 1142 229 6.35
77338-TC 0 0 0 299 8.30
77370 Special medical radiation physics consultation 376 459 626 127 3.54
77371 Radiation treatment delivery, stereotactic 9280 11331 15448 0 0.00 radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source cobalt 60 based
77372 Radiation treatment delivery, stereotactic 3988 4869 6638 1119 31.07 radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based
77373 Stereotactic body radiation therapy, treatment 4997 6101 8318 1423 39.52 delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
77385 Intensity modulated radiation treatment delivery 1714 2092 2853 0 0.00 (IMRT), includes guidance and tracking, when performed; simple
77386 Intensity modulated radiation treatment delivery 2553 3117 4249 0 0.00 (IMRT), includes guidance and tracking, when performed; complex
77387 Guidance for localization of target volume for 354 432 589 0 0.00 delivery of radiation treatment delivery, includes intra-fraction tracking, when performed
77399 Unlisted procedure, medical radiation physics, 0 0 0 0 0.00 dosimetry and treatment devices, and special services
77399-26 0 0 0 0 0.00
77399-TC 0 0 0 0 0.00
77401 Radiation treatment delivery, superficial and/or 39 52 63 26 0.71 ortho voltage, per day
77402 Radiation treatment delivery, >=1 mev; simple 400 541 650 0 0.00
77407 Radiation treatment delivery, >=1 mev; 388 524 630 0 0.00 intermediate
77412 Radiation treatment delivery, >=1 mev; 549 742 892 0 0.00 complex
530 CPT copyright 2017 American Medical Association. RADIATION ONCOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77417 Therapeutic radiology port image(s) 87 118 141 12 0.32
77423 High energy neutron radiation treatment 0 0 0 0 0.00 delivery, 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)
77424 Intraoperative radiation treatment delivery, x- 0 0 0 0 0.00 ray, single treatment session
77425 Intraoperative radiation treatment delivery, 0 0 0 0 0.00 electrons, single treatment session
77427 Radiation treatment management, 5 treatments 642 977 1100 191 5.31
77431 Radiation therapy management with complete 311 472 532 105 2.92 course of therapy consisting of 1 or 2 fractions only
77432 Stereotactic radiation treatment management of 1412 2146 2416 430 11.95 cranial lesion(s) (complete course of treatment consisting of 1 session)
77435 Stereotactic body radiation therapy, treatment 2110 3207 3612 649 18.02 management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions
77469 Intraoperative radiation treatment management 1053 1601 1803 328 9.11
77470 Special treatment procedure (eg, total body 1372 2086 2349 140 3.89 irradiation, hemibody radiation, per oral or endocavitary irradiation)
77470-26 355 540 608 108 3.00
77470-TC 0 0 0 32 0.89
77499 Unlisted procedure, therapeutic radiology 0 0 0 0 0.00 treatment management
77499-26 0 0 0 0 0.00
77499-TC 0 0 0 0 0.00
77520 Proton treatment delivery; simple, without 3044 4627 5211 0 0.00 compensation
77522 Proton treatment delivery; simple, with 5802 8820 9933 0 0.00 compensation
77523 Proton treatment delivery; intermediate 5991 9107 10256 0 0.00
77525 Proton treatment delivery; complex 7274 11057 12452 0 0.00
CPT copyright 2017 American Medical Association. 531 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77600 Hyperthermia, externally generated; superficial 461 701 790 442 12.29 (ie, heating to a depth of 4 cm or less)
77600-26 289 439 495 72 2.01
77600-TC 0 0 0 370 10.28
77605 Hyperthermia, externally generated; deep (ie, 2543 3866 4354 780 21.67 heating to depths greater than 4 cm)
77605-26 1169 1777 2001 104 2.90
77605-TC 0 0 0 676 18.77
77610 Hyperthermia generated by interstitial probe(s); 2854 4339 4886 784 21.79 5 or fewer interstitial applicators
77610-26 0 0 0 68 1.88
77610-TC 0 0 0 717 19.91
77615 Hyperthermia generated by interstitial probe(s); 3584 5449 6136 1069 29.70 more than 5 interstitial applicators
77615-26 0 0 0 98 2.71
77615-TC 0 0 0 972 26.99
77620 Hyperthermia generated by intracavitary 1626 2471 2783 485 13.47 probe(s)
77620-26 0 0 0 89 2.46
77620-TC 0 0 0 396 11.01
77750 Infusion or instillation of radioelement solution 1111 1202 1863 384 10.68 (includes 3-month follow-up care)
77750-26 813 880 1364 266 7.39
77750-TC 0 0 0 118 3.29
77761 Intracavitary radiation source application; 1387 1500 2325 405 11.25 simple
77761-26 0 0 0 205 5.70
77761-TC 0 0 0 200 5.55
77762 Intracavitary radiation source application; 1838 1988 3081 537 14.91 intermediate
77762-26 0 0 0 307 8.53
77762-TC 0 0 0 230 6.38
532 CPT copyright 2017 American Medical Association. RADIATION ONCOLOGY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77763 Intracavitary radiation source application; 2629 2843 4407 768 21.33 complex
77763-26 0 0 0 464 12.89
77763-TC 0 0 0 304 8.44
77767 Remote afterloading high dose rate radionuclide 857 927 1437 234 6.49 skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel
77767-26 180 195 302 56 1.55
77767-TC 0 0 0 178 4.94
77768 Remote afterloading high dose rate radionuclide 394 426 660 367 10.19 skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions
77768-26 228 246 382 75 2.08
77768-TC 0 0 0 292 8.11
77770 Remote afterloading high dose rate radionuclide 1297 1403 2175 334 9.29 interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel
77770-26 378 408 633 104 2.88
77770-TC 0 0 0 231 6.41
77771 Remote afterloading high dose rate radionuclide 2416 2614 4051 622 17.27 interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels
77771-26 699 757 1173 203 5.63
77771-TC 0 0 0 419 11.64
77772 Remote afterloading high dose rate radionuclide 3751 4057 6288 949 26.35 interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels
77772-26 843 912 1413 287 7.97
77772-TC 0 0 0 662 18.38
77778 Interstitial radiation source application, 2722 2944 4563 850 23.62 complex, includes supervision, handling, loading of radiation source, when performed
CPT copyright 2017 American Medical Association. 533 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
77778-26 1883 2036 3156 466 12.94
77778-TC 0 0 0 384 10.68
77789 Surface application of low dose rate 125 136 210 125 3.47 radionuclide source
77789-26 61 66 103 61 1.70
77789-TC 0 0 0 64 1.77
77790 Supervision, handling, loading of radiation 232 251 389 15 0.43 source
77799 Unlisted procedure, clinical brachytherapy 0 0 0 0 0.00
77799-26 0 0 0 0 0.00
77799-TC 0 0 0 0 0.00
534 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
NUCLEAR MEDICINE
78012 Thyroid uptake, single or multiple quantitative 209 266 363 85 2.37 measurement(s) (including stimulation, suppression, or discharge, when performed)
78012-26 35 45 61 10 0.27
78012-TC 0 0 0 76 2.10
78013 Thyroid imaging (including vascular flow, when 458 582 794 203 5.63 performed);
78013-26 55 70 96 19 0.52
78013-TC 0 0 0 184 5.11
78014 Thyroid imaging (including vascular flow, when 555 706 963 255 7.08 performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)
78014-26 83 106 145 25 0.70
78014-TC 0 0 0 230 6.38
78015 Thyroid carcinoma metastases imaging; limited 456 579 791 235 6.53 area (eg, neck and chest only)
78015-26 121 154 210 34 0.94
78015-TC 0 0 0 201 5.59
78016 Thyroid carcinoma metastases imaging; with 684 869 1186 297 8.26 additional studies (eg, urinary recovery)
78016-26 0 0 0 35 0.97
78016-TC 0 0 0 262 7.29
78018 Thyroid carcinoma metastases imaging; whole 714 908 1240 330 9.17 body
78018-26 164 209 285 42 1.17
78018-TC 0 0 0 288 8.00
78020 Thyroid carcinoma metastases uptake (list 202 256 350 88 2.45 separately in addition to code for primary procedure)
78020-26 99 126 172 28 0.79
CPT copyright 2017 American Medical Association. 535 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78020-TC 0 0 0 60 1.66
78070 Parathyroid planar imaging (including 496 631 861 317 8.80 subtraction, when performed);
78070-26 137 174 237 40 1.11
78070-TC 0 0 0 277 7.69
78071 Parathyroid planar imaging (including 980 1247 1702 377 10.48 subtraction, when performed); with tomographic (SPECT)
78071-26 193 245 334 60 1.67
78071-TC 0 0 0 317 8.81
78072 Parathyroid planar imaging (including 1816 2309 3151 437 12.14 subtraction, when performed); with tomographic (SPECT), and concurrently acquired computed tomography (ct) for anatomical localization
78072-26 268 341 465 79 2.19
78072-TC 0 0 0 358 9.95
78075 Adrenal imaging, cortex and/or medulla 1098 1396 1906 478 13.27
78075-26 0 0 0 38 1.06
78075-TC 0 0 0 440 12.21
78099 Unlisted endocrine procedure, diagnostic 0 0 0 0 0.00 nuclear medicine
78099-26 0 0 0 0 0.00
78099-TC 0 0 0 0 0.00
78102 Bone marrow imaging; limited area 287 378 566 179 4.96
78102-26 103 136 204 27 0.75
78102-TC 0 0 0 152 4.21
78103 Bone marrow imaging; multiple areas 532 699 1048 228 6.34
78103-26 0 0 0 36 1.00
78103-TC 0 0 0 192 5.34
78104 Bone marrow imaging; whole body 914 1201 1800 261 7.24
78104-26 139 182 274 40 1.10
536 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78104-TC 0 0 0 221 6.14
78110 Plasma volume, radiopharmaceutical volume- 220 289 433 85 2.37 dilution technique (separate procedure); single sampling
78110-26 0 0 0 8 0.23
78110-TC 0 0 0 77 2.14
78111 Plasma volume, radiopharmaceutical volume- 209 275 412 82 2.27 dilution technique (separate procedure); multiple samplings
78111-26 0 0 0 10 0.27
78111-TC 0 0 0 72 2.00
78120 Red cell volume determination (separate 206 271 406 80 2.23 procedure); single sampling
78120-26 0 0 0 10 0.28
78120-TC 0 0 0 70 1.95
78121 Red cell volume determination (separate 229 301 451 89 2.48 procedure); multiple samplings
78121-26 0 0 0 14 0.38
78121-TC 0 0 0 76 2.10
78122 Whole blood volume determination, including 373 491 735 100 2.79 separate measurement of plasma volume and red cell volume (radiopharmaceutical volume- dilution technique)
78122-26 80 105 158 22 0.60
78122-TC 0 0 0 79 2.19
78130 Red cell survival study; 368 484 725 143 3.98
78130-26 0 0 0 26 0.72
78130-TC 0 0 0 117 3.26
78135 Red cell survival study; differential organ/tissue 776 1020 1529 301 8.37 kinetics (eg, splenic and/or hepatic sequestration)
78135-26 0 0 0 27 0.76
78135-TC 0 0 0 274 7.61
CPT copyright 2017 American Medical Association. 537 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78140 Labeled red cell sequestration, differential 304 400 599 118 3.29 organ/tissue (eg, splenic and/or hepatic)
78140-26 0 0 0 26 0.72
78140-TC 0 0 0 93 2.57
78185 Spleen imaging only, with or without vascular 465 611 916 181 5.02 flow
78185-26 0 0 0 17 0.48
78185-TC 0 0 0 163 4.54
78191 Platelet survival study 368 484 725 143 3.98
78191-26 0 0 0 26 0.72
78191-TC 0 0 0 117 3.26
78195 Lymphatics and lymph nodes imaging 877 1152 1727 376 10.44
78195-26 206 270 405 60 1.67
78195-TC 0 0 0 316 8.77
78199 Unlisted hematopoietic, reticuloendothelial and 0 0 0 0 0.00 lymphatic procedure, diagnostic nuclear medicine
78199-26 0 0 0 0 0.00
78199-TC 0 0 0 0 0.00
78201 Liver imaging; static only 721 898 1190 200 5.55
78201-26 78 97 129 22 0.60
78201-TC 0 0 0 178 4.95
78202 Liver imaging; with vascular flow 849 1058 1402 211 5.85
78202-26 47 58 77 24 0.67
78202-TC 0 0 0 186 5.18
78205 Liver imaging (SPECT); 546 680 901 222 6.18
78205-26 127 158 210 34 0.95
78205-TC 0 0 0 188 5.23
78206 Liver imaging (SPECT); with vascular flow 596 742 984 363 10.09
78206-26 243 303 402 48 1.33
78206-TC 0 0 0 315 8.76
538 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78215 Liver and spleen imaging; static only 456 568 753 205 5.70
78215-26 111 139 184 25 0.69
78215-TC 0 0 0 180 5.01
78216 Liver and spleen imaging; with vascular flow 553 689 914 133 3.70
78216-26 117 146 194 28 0.78
78216-TC 0 0 0 105 2.92
78226 Hepatobiliary system imaging, including 764 952 1263 350 9.71 gallbladder when present;
78226-26 124 154 204 37 1.04
78226-TC 0 0 0 312 8.67
78227 Hepatobiliary system imaging, including 973 1212 1607 474 13.16 gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed
78227-26 146 182 241 46 1.27
78227-TC 0 0 0 428 11.89
78230 Salivary gland imaging; 390 486 645 184 5.10
78230-26 0 0 0 23 0.65
78230-TC 0 0 0 160 4.45
78231 Salivary gland imaging; with serial images 277 345 458 111 3.07
78231-26 0 0 0 22 0.62
78231-TC 0 0 0 88 2.45
78232 Salivary gland function study 224 279 370 105 2.93
78232-26 0 0 0 20 0.56
78232-TC 0 0 0 85 2.37
78258 Esophageal motility 627 781 1035 237 6.59
78258-26 195 243 322 37 1.04
78258-TC 0 0 0 200 5.55
78261 Gastric mucosa imaging 530 660 875 213 5.91
78261-26 0 0 0 30 0.82
78261-TC 0 0 0 183 5.09
CPT copyright 2017 American Medical Association. 539 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78262 Gastroesophageal reflux study 697 868 1151 255 7.07
78262-26 407 507 673 34 0.94
78262-TC 0 0 0 221 6.13
78264 Gastric emptying imaging study (eg, solid, 683 850 1128 355 9.85 liquid, or both);
78264-26 140 175 232 40 1.10
78264-TC 0 0 0 315 8.75
78265 Gastric emptying imaging study (eg, solid, 1265 1575 2089 421 11.69 liquid, or both); with small bowel transit
78265-26 167 209 277 49 1.37
78265-TC 0 0 0 372 10.32
78266 Gastric emptying imaging study (eg, solid, 1066 1328 1761 501 13.93 liquid, or both); with small bowel and colon transit, multiple days
78266-26 0 0 0 55 1.52
78266-TC 0 0 0 447 12.41
78267 Urea breath test, c-14 (isotopic); acquisition for 50 62 82 0 0.00 analysis
78268 Urea breath test, c-14 (isotopic); analysis 180 224 297 0 0.00
78270 Vitamin B-12 absorption study (eg, schilling 230 286 379 108 3.00 test); without intrinsic factor
78270-26 0 0 0 11 0.30
78270-TC 0 0 0 97 2.70
78271 Vitamin B-12 absorption study (eg, schilling 193 241 319 77 2.13 test); with intrinsic factor
78271-26 0 0 0 9 0.24
78271-TC 0 0 0 68 1.89
78272 Vitamin B-12 absorption studies combined, 269 336 445 84 2.34 with and without intrinsic factor
78272-26 0 0 0 12 0.33
78272-TC 0 0 0 72 2.01
78278 Acute gastrointestinal blood loss imaging 600 748 991 368 10.23
540 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78278-26 179 222 295 50 1.39
78278-TC 0 0 0 318 8.84
78282 Gastrointestinal protein loss 44 54 72 0 0.00
78282-26 0 0 0 19 0.54
78282-TC 0 0 0 0 0.00
78290 Intestine imaging (eg, ectopic gastric mucosa, 544 678 899 350 9.71 Meckel's localization, volvulus)
78290-26 117 146 193 34 0.95
78290-TC 0 0 0 315 8.76
78291 Peritoneal-venous shunt patency test (eg, for 575 716 949 270 7.51 LeVeen, Denver shunt)
78291-26 0 0 0 44 1.21
78291-TC 0 0 0 227 6.30
78299 Unlisted gastrointestinal procedure, diagnostic 0 0 0 0 0.00 nuclear medicine
78299-26 0 0 0 0 0.00
78299-TC 0 0 0 0 0.00
78300 Bone and/or joint imaging; limited area 376 457 593 244 6.77
78300-26 112 136 177 32 0.89
78300-TC 0 0 0 212 5.88
78305 Bone and/or joint imaging; multiple areas 511 620 804 297 8.25
78305-26 143 174 226 42 1.17
78305-TC 0 0 0 255 7.08
78306 Bone and/or joint imaging; whole body 624 757 983 320 8.90
78306-26 158 192 249 44 1.21
78306-TC 0 0 0 277 7.69
78315 Bone and/or joint imaging; 3 phase study 738 895 1162 365 10.15
78315-26 178 216 280 51 1.42
78315-TC 0 0 0 314 8.73
78320 Bone and/or joint imaging; tomographic 834 1012 1314 241 6.69 (SPECT)
CPT copyright 2017 American Medical Association. 541 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78320-26 199 241 313 51 1.43
78320-TC 0 0 0 189 5.26
78350 Bone density (bone mineral content) study, 1 or 78 94 122 34 0.95 more sites; single photon absorptiometry
78350-26 0 0 0 12 0.32
78350-TC 0 0 0 23 0.63
78351 Bone density (bone mineral content) study, 1 or 63 77 100 16 0.44 more sites; dual photon absorptiometry, 1 or more sites
78399 Unlisted musculoskeletal procedure, diagnostic 0 0 0 0 0.00 nuclear medicine
78399-26 0 0 0 0 0.00
78399-TC 0 0 0 0 0.00
78414 Determination of central c-v hemodynamics 88 119 171 0 0.00 (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations
78414-26 0 0 0 23 0.63
78414-TC 0 0 0 0 0.00
78428 Cardiac shunt detection 440 596 858 192 5.34
78428-26 0 0 0 39 1.07
78428-TC 0 0 0 154 4.27
78445 Non-cardiac vascular flow imaging (ie, 638 864 1243 197 5.47 angiography, venography)
78445-26 82 111 159 25 0.70
78445-TC 0 0 0 172 4.77
78451 Myocardial perfusion imaging, tomographic 782 1060 1524 359 9.98 (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)
78451-26 205 278 399 69 1.91
78451-TC 0 0 0 291 8.07
542 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78452 Myocardial perfusion imaging, tomographic 1211 1640 2359 500 13.90 (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection
78452-26 251 339 488 81 2.25
78452-TC 0 0 0 419 11.65
78453 Myocardial perfusion imaging, planar 420 568 817 321 8.91 (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)
78453-26 174 235 339 50 1.40
78453-TC 0 0 0 270 7.51
78454 Myocardial perfusion imaging, planar 570 773 1111 461 12.81 (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection
78454-26 218 295 424 68 1.89
78454-TC 0 0 0 393 10.92
78456 Acute venous thrombosis imaging, peptide 748 1014 1458 327 9.08
78456-26 0 0 0 50 1.38
78456-TC 0 0 0 277 7.70
78457 Venous thrombosis imaging, venogram; 463 627 902 202 5.62 unilateral
78457-26 0 0 0 39 1.07
78457-TC 0 0 0 164 4.55
78458 Venous thrombosis imaging, venogram; 493 668 960 215 5.98 bilateral
78458-26 0 0 0 46 1.28
78458-TC 0 0 0 169 4.70
CPT copyright 2017 American Medical Association. 543 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78459 Myocardial imaging, positron emission 946 1282 1844 0 0.00 tomography (pet), metabolic evaluation
78459-26 946 1282 1844 72 2.01
78459-TC 0 0 0 0 0.00
78466 Myocardial imaging, infarct avid, planar; 473 640 921 208 5.78 qualitative or quantitative
78466-26 82 111 159 36 1.00
78466-TC 0 0 0 172 4.78
78468 Myocardial imaging, infarct avid, planar; with 329 446 641 203 5.64 ejection fraction by first pass technique
78468-26 164 222 319 40 1.10
78468-TC 0 0 0 163 4.54
78469 Myocardial imaging, infarct avid, planar; 756 1024 1473 242 6.71 tomographic SPECT with or without quantification
78469-26 188 254 366 46 1.28
78469-TC 0 0 0 195 5.43
78472 Cardiac blood pool imaging, gated equilibrium; 625 847 1218 242 6.71 planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing
78472-26 161 218 314 49 1.37
78472-TC 0 0 0 192 5.34
78473 Cardiac blood pool imaging, gated equilibrium; 817 1106 1592 305 8.46 multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification
78473-26 222 300 432 73 2.02
78473-TC 0 0 0 232 6.44
78481 Cardiac blood pool imaging (planar), first pass 260 353 507 184 5.12 technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification
78481-26 138 187 269 49 1.36
544 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78481-TC 0 0 0 135 3.76
78483 Cardiac blood pool imaging (planar), first pass 634 859 1236 254 7.06 technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification
78483-26 0 0 0 73 2.02
78483-TC 0 0 0 181 5.04
78491 Myocardial imaging, positron emission 315 426 614 0 0.00 tomography (pet), perfusion; single study at rest or stress
78491-26 315 426 614 73 2.02
78491-TC 0 0 0 0 0.00
78492 Myocardial imaging, positron emission 2672 3618 5205 0 0.00 tomography (pet), perfusion; multiple studies at rest and/or stress
78492-26 192 260 374 92 2.55
78492-TC 0 0 0 0 0.00
78494 Cardiac blood pool imaging, gated equilibrium, 520 704 1012 237 6.59 SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing
78494-26 227 307 441 59 1.65
78494-TC 0 0 0 178 4.94
78496 Cardiac blood pool imaging, gated equilibrium, 328 444 638 46 1.27 single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)
78496-26 80 108 155 25 0.69
78496-TC 0 0 0 21 0.58
78499 Unlisted cardiovascular procedure, diagnostic 0 0 0 0 0.00 nuclear medicine
78499-26 0 0 0 0 0.00
78499-TC 0 0 0 0 0.00
78579 Pulmonary ventilation imaging (eg, aerosol or 694 940 1352 197 5.48 gas)
CPT copyright 2017 American Medical Association. 545 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78579-26 86 117 168 24 0.68
78579-TC 0 0 0 173 4.80
78580 Pulmonary perfusion imaging (eg, particulate) 439 595 855 252 7.00
78580-26 125 169 243 37 1.04
78580-TC 0 0 0 215 5.96
78582 Pulmonary ventilation (eg, aerosol or gas) and 812 1100 1583 353 9.80 perfusion imaging
78582-26 165 223 321 54 1.50
78582-TC 0 0 0 299 8.30
78597 Quantitative differential pulmonary perfusion, 445 603 867 214 5.95 including imaging when performed
78597-26 118 160 231 36 1.01
78597-TC 0 0 0 178 4.94
78598 Quantitative differential pulmonary perfusion 857 1161 1670 322 8.94 and ventilation (eg, aerosol or gas), including imaging when performed
78598-26 133 180 259 42 1.17
78598-TC 0 0 0 280 7.77
78599 Unlisted respiratory procedure, diagnostic 0 0 0 0 0.00 nuclear medicine
78599-26 0 0 0 0 0.00
78599-TC 0 0 0 0 0.00
78600 Brain imaging, less than 4 static views; 477 622 782 195 5.41
78600-26 0 0 0 23 0.63
78600-TC 0 0 0 172 4.78
78601 Brain imaging, less than 4 static views; with 481 627 788 226 6.29 vascular flow
78601-26 246 320 403 26 0.71
78601-TC 0 0 0 201 5.58
78605 Brain imaging, minimum 4 static views; 514 670 843 210 5.83
78605-26 0 0 0 27 0.76
78605-TC 0 0 0 183 5.07
546 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78606 Brain imaging, minimum 4 static views; with 775 1010 1270 348 9.66 vascular flow
78606-26 116 152 191 32 0.89
78606-TC 0 0 0 316 8.77
78607 Brain imaging, tomographic (SPECT) 937 1222 1537 370 10.27
78607-26 200 261 328 60 1.68
78607-TC 0 0 0 309 8.59
78608 Brain imaging, positron emission tomography 3698 4822 6066 0 0.00 (pet); metabolic evaluation
78608-26 312 407 511 73 2.04
78608-TC 0 0 0 0 0.00
78609 Brain imaging, positron emission tomography 592 772 971 76 2.12 (pet); perfusion evaluation
78609-26 0 0 0 76 2.12
78609-TC 0 0 0 0 0.00
78610 Brain imaging, vascular flow only 679 885 1114 185 5.13
78610-26 57 74 93 15 0.43
78610-TC 0 0 0 169 4.70
78630 Cerebrospinal fluid flow, imaging (not 718 937 1178 357 9.93 including introduction of material); cisternography
78630-26 135 176 221 35 0.96
78630-TC 0 0 0 323 8.97
78635 Cerebrospinal fluid flow, imaging (not 876 1143 1437 358 9.94 including introduction of material); ventriculography
78635-26 0 0 0 32 0.88
78635-TC 0 0 0 326 9.06
78645 Cerebrospinal fluid flow, imaging (not 602 785 987 343 9.54 including introduction of material); shunt evaluation
78645-26 114 148 186 28 0.79
78645-TC 0 0 0 315 8.75
CPT copyright 2017 American Medical Association. 547 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78647 Cerebrospinal fluid flow, imaging (not 908 1184 1490 371 10.30 including introduction of material); tomographic (SPECT)
78647-26 0 0 0 46 1.29
78647-TC 0 0 0 324 9.01
78650 Cerebrospinal fluid leakage detection and 786 1024 1288 288 7.99 localization
78650-26 0 0 0 26 0.72
78650-TC 0 0 0 262 7.27
78660 Radiopharmaceutical dacryocystography 466 607 764 190 5.28
78660-26 0 0 0 27 0.74
78660-TC 0 0 0 163 4.54
78699 Unlisted nervous system procedure, diagnostic 0 0 0 0 0.00 nuclear medicine
78699-26 0 0 0 0 0.00
78699-TC 0 0 0 0 0.00
78700 Kidney imaging morphology; 446 554 748 182 5.05
78700-26 95 117 159 23 0.63
78700-TC 0 0 0 159 4.42
78701 Kidney imaging morphology; with vascular 633 785 1060 226 6.29 flow
78701-26 93 115 156 24 0.68
78701-TC 0 0 0 202 5.61
78707 Kidney imaging morphology; with vascular 630 781 1055 245 6.81 flow and function, single study without pharmacological intervention
78707-26 162 201 271 48 1.32
78707-TC 0 0 0 198 5.49
78708 Kidney imaging morphology; with vascular 688 853 1153 185 5.13 flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)
78708-26 207 256 346 60 1.68
548 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78708-TC 0 0 0 124 3.45
78709 Kidney imaging morphology; with vascular 1026 1272 1719 387 10.74 flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)
78709-26 238 296 399 70 1.94
78709-TC 0 0 0 317 8.80
78710 Kidney imaging morphology; tomographic 1020 1265 1709 213 5.91 (SPECT)
78710-26 147 182 246 31 0.85
78710-TC 0 0 0 182 5.06
78725 Kidney function study, non-imaging 499 619 836 113 3.13 radioisotopic study
78725-26 99 122 165 19 0.52
78725-TC 0 0 0 94 2.61
78730 Urinary bladder residual study (list separately in 282 350 472 82 2.29 addition to code for primary procedure)
78730-26 0 0 0 8 0.23
78730-TC 0 0 0 74 2.06
78740 Ureteral reflux study (radiopharmaceutical 720 893 1206 230 6.39 voiding cystogram)
78740-26 113 140 190 28 0.78
78740-TC 0 0 0 202 5.61
78761 Testicular imaging with vascular flow 759 942 1272 222 6.17
78761-26 0 0 0 36 1.01
78761-TC 0 0 0 186 5.16
78799 Unlisted genitourinary procedure, diagnostic 0 0 0 0 0.00 nuclear medicine
78799-26 0 0 0 0 0.00
78799-TC 0 0 0 0 0.00
78800 Radiopharmaceutical localization of tumor or 443 561 685 203 5.65 distribution of radiopharmaceutical agent(s); limited area
CPT copyright 2017 American Medical Association. 549 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78800-26 111 141 172 35 0.96
78800-TC 0 0 0 169 4.69
78801 Radiopharmaceutical localization of tumor or 355 449 548 274 7.61 distribution of radiopharmaceutical agent(s); multiple areas
78801-26 143 181 222 40 1.12
78801-TC 0 0 0 234 6.49
78802 Radiopharmaceutical localization of tumor or 3898 4928 6021 342 9.49 distribution of radiopharmaceutical agent(s); whole body, single day imaging
78802-26 166 209 256 42 1.18
78802-TC 0 0 0 299 8.31
78803 Radiopharmaceutical localization of tumor or 932 1179 1440 361 10.04 distribution of radiopharmaceutical agent(s); tomographic (SPECT)
78803-26 190 241 294 53 1.47
78803-TC 0 0 0 309 8.57
78804 Radiopharmaceutical localization of tumor or 1411 1784 2180 599 16.65 distribution of radiopharmaceutical agent(s); whole body, requiring 2 or more days imaging
78804-26 177 224 274 53 1.48
78804-TC 0 0 0 546 15.17
78805 Radiopharmaceutical localization of 424 537 656 193 5.36 inflammatory process; limited area
78805-26 128 162 198 37 1.02
78805-TC 0 0 0 156 4.34
78806 Radiopharmaceutical localization of 870 1100 1344 352 9.79 inflammatory process; whole body
78806-26 160 202 247 43 1.19
78806-TC 0 0 0 310 8.60
78807 Radiopharmaceutical localization of 933 1179 1441 362 10.06 inflammatory process; tomographic (SPECT)
78807-26 193 244 298 53 1.48
550 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78807-TC 0 0 0 309 8.58
78808 Injection procedure for radiopharmaceutical 122 155 189 40 1.12 localization by non-imaging probe study, intravenous (eg, parathyroid adenoma)
78811 Positron emission tomography (pet) imaging; 3468 4386 5358 0 0.00 limited area (eg, chest, head/neck)
78811-26 3468 4386 5358 78 2.17
78811-TC 0 0 0 0 0.00
78812 Positron emission tomography (pet) imaging; 3917 4953 6051 0 0.00 skull base to mid-thigh
78812-26 365 461 563 95 2.65
78812-TC 0 0 0 0 0.00
78813 Positron emission tomography (pet) imaging; 639 808 987 0 0.00 whole body
78813-26 0 0 0 99 2.74
78813-TC 0 0 0 0 0.00
78814 Positron emission tomography (pet) with 4043 5113 6247 0 0.00 concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)
78814-26 398 503 615 110 3.05
78814-TC 0 0 0 0 0.00
78815 Positron emission tomography (pet) with 4405 5571 6806 0 0.00 concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh
78815-26 401 507 620 122 3.38
78815-TC 0 0 0 0 0.00
78816 Positron emission tomography (pet) with 4131 5224 6382 0 0.00 concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body
78816-26 383 484 592 123 3.42
78816-TC 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 551 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
78999 Unlisted miscellaneous procedure, diagnostic 0 0 0 0 0.00 nuclear medicine
78999-26 0 0 0 0 0.00
78999-TC 0 0 0 0 0.00
79005 Radiopharmaceutical therapy, by oral admin 513 655 843 140 3.90
79005-26 307 391 504 90 2.50
79005-TC 0 0 0 50 1.40
79101 Radiopharmaceutical therapy, by intravenous 544 694 894 148 4.12 admin
79101-26 328 419 539 99 2.74
79101-TC 0 0 0 50 1.38
79200 Radiopharmaceutical therapy, by intracavitary 304 387 499 137 3.81 admin
79200-26 0 0 0 85 2.36
79200-TC 0 0 0 52 1.45
79300 Radiopharmaceutical therapy, by interstitial 182 232 299 0 0.00 radioactive colloid admin
79300-26 0 0 0 82 2.28
79300-TC 0 0 0 0 0.00
79403 Radiopharmaceutical therapy, radiolabeled 438 558 719 198 5.49 monoclonal antibody by intravenous infusion
79403-26 0 0 0 112 3.12
79403-TC 0 0 0 85 2.37
79440 Radiopharmaceutical therapy, by intra-articular 320 407 525 127 3.53 admin
79440-26 0 0 0 85 2.36
79440-TC 0 0 0 42 1.17
79445 Radiopharmaceutical therapy, by intra-arterial 407 519 669 0 0.00 particulate admin
79445-26 407 519 669 117 3.26
79445-TC 0 0 0 0 0.00
552 CPT copyright 2017 American Medical Association. NUCLEAR MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
79999 Radiopharmaceutical therapy, unlisted 0 0 0 0 0.00 procedure
79999-26 0 0 0 0 0.00
79999-TC 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 553 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
554 CPT copyright 2017 American Medical Association.
PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
ORGAN OR DISEASE ORIENTED PANELS
80047 Basic metabolic panel (calcium, ionized) this 45 64 92 0 0.00 panel must include the following: calcium, ionized (82330) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)
80048 Basic metabolic panel (calcium, total) this panel 37 53 77 0 0.00 must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)
80050 General health panel this panel must include the 172 247 354 0 0.00 following: comprehensive metabolic panel (80053) blood count, complete (CBC), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (CBC), automated (85027) and appropriate manual differential wbc count (85007 or 85009) thyroid stimulating hormone (TSH) (84443)
80051 Electrolyte panel this panel must include the 32 46 66 0 0.00 following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)
80053 Comprehensive metabolic panel this panel must 51 73 105 0 0.00 include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium (84295) transferase, alanine amino (alt) (SGPT) (84460) transferase, aspartate amino (ast) (SGOT) (84450) urea nitrogen (bun) (84520)
80055 Obstetric panel this panel must include the 254 364 522 0 0.00 following: blood count, complete (CBC), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (CBC), automated (85027) and appropriate manual differential wbc count
CPT copyright 2017 American Medical Association. 555 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
(85007 or 85009) hepatitis b surface antigen (HBsAg) (87340) antibody, rubella (86762) syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, art) (86592) antibody screen, rbc, each serum technique (86850) blood typing, ABO (86900) and blood typing, rh (d) (86901)
80061 Lipid panel this panel must include the 72 104 149 0 0.00 following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) triglycerides (84478)
80069 Renal function panel this panel must include the 41 59 84 0 0.00 following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)
80074 Acute hepatitis panel this panel must include the 345 496 711 0 0.00 following: hepatitis a antibody (HAAb), IgM antibody (86709) hepatitis b core antibody (HBcAB), IgM antibody (86705) hepatitis b surface antigen (HBsAg) (87340) hepatitis c antibody (86803)
80076 Hepatic function panel this panel must include 40 58 83 0 0.00 the following: albumin (82040) bilirubin, total (82247) bilirubin, direct (82248) phosphatase, alkaline (84075) protein, total (84155) transferase, alanine amino (alt) (SGPT) (84460) transferase, aspartate amino (ast) (SGOT) (84450)
80081 Obstetric panel (includes hiv testing) this panel 440 632 907 0 0.00 must include the following: blood count, complete (CBC), and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (CBC), automated (85027) and appropriate manual differential wbc count (85007 or 85009) hepatitis b surface antigen (HBsAg) (87340) hiv-1 antigen(s), with hiv-1 and hiv-2 antibodies, single result (87389) antibody, rubella (86762) syphilis test, non- treponemal antibody; qualitative (eg, VDRL, RPR, art) (86592) antibody screen, rbc, each serum technique (86850) blood typing, ABO (86900) and blood typing, rh (d) (86901)
556 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
THERAPEUTIC DRUG ASSAYS
80150 Amikacin 86 124 177 0 0.00
80155 Caffeine 41 59 84 0 0.00
80156 Carbamazepine; total 81 116 167 0 0.00
80157 Carbamazepine; free 73 104 150 0 0.00
80158 Cyclosporine 175 252 361 0 0.00
80159 Clozapine 92 132 189 0 0.00
80162 Digoxin; total 72 104 149 0 0.00
80163 Digoxin; free 62 89 128 0 0.00
80164 Valproic acid (dipropylacetic acid); total 78 112 161 0 0.00
80165 Valproic acid (dipropylacetic acid); free 115 165 236 0 0.00
80168 Ethosuximide 121 174 249 0 0.00
80169 Everolimus 100 143 206 0 0.00
80170 Gentamicin 75 107 154 0 0.00
80171 Gabapentin, whole blood, serum, or plasma 87 125 179 0 0.00
80173 Haloperidol 81 116 166 0 0.00
80175 Lamotrigine 123 176 253 0 0.00
80176 Lidocaine 32 46 66 0 0.00
80177 Levetiracetam 88 126 181 0 0.00
80178 Lithium 61 88 127 0 0.00
80180 Mycophenolate (mycophenolic acid) 150 215 308 0 0.00
80183 Oxcarbazepine 115 165 237 0 0.00
80184 Phenobarbital 73 104 150 0 0.00
80185 Phenytoin; total 76 110 157 0 0.00
80186 Phenytoin; free 92 132 189 0 0.00
80188 Primidone 47 67 96 0 0.00
80190 Procainamide; 79 113 162 0 0.00
80192 Procainamide; with metabolites (eg, n-acetyl 79 113 162 0 0.00 procainamide)
CPT copyright 2017 American Medical Association. 557 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
80194 Quinidine 88 126 181 0 0.00
80195 Sirolimus 137 197 283 0 0.00
80197 Tacrolimus 165 237 340 0 0.00
80198 Theophylline 62 90 128 0 0.00
80199 Tiagabine 71 103 147 0 0.00
80200 Tobramycin 107 153 220 0 0.00
80201 Topiramate 71 101 146 0 0.00
80202 Vancomycin 121 173 248 0 0.00
80203 Zonisamide 139 199 286 0 0.00
80299 Quantitation of therapeutic drug, not elsewhere 58 84 120 0 0.00 specified
DRUG ASSAY
80305 Drug test(s), presumptive, any number of drug 42 60 86 0 0.00 classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service
80306 Drug test(s), presumptive, any number of drug 72 104 149 0 0.00 classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service
80307 Drug test(s), presumptive, any number of drug 245 351 504 0 0.00 classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, emit, fpia, ia, kims, RIA]), chromatography (eg, gc, HPLC), and mass spectrometry either with or without chromatography, (eg, dart, desi, gc-ms, gc- ms/ms, lc-ms, lc-ms/ms, ldtd, MALDI, TOF) includes sample validation when performed, per date of service
80320 Alcohols 50 72 104 0 0.00
80321 Alcohol biomarkers; 1 or 2 77 110 158 0 0.00
80322 Alcohol biomarkers; 3 or more 63 91 130 0 0.00
558 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
80323 Alkaloids, not otherwise specified 64 91 131 0 0.00
80324 Amphetamines; 1 or 2 61 88 126 0 0.00
80325 Amphetamines; 3 or 4 127 183 263 0 0.00
80326 Amphetamines; 5 or more 25 37 53 0 0.00
80327 Anabolic steroids; 1 or 2 210 301 432 0 0.00
80328 Anabolic steroids; 3 or more 0 0 0 0 0.00
80329 Analgesics, non-opioid; 1 or 2 56 81 116 0 0.00
80330 Analgesics, non-opioid; 3-5 78 112 161 0 0.00
80331 Analgesics, non-opioid; 6 or more 10 14 20 0 0.00
80332 Antidepressants, serotonergic class; 1 or 2 58 83 120 0 0.00
80333 Antidepressants, serotonergic class; 3-5 61 88 126 0 0.00
80334 Antidepressants, serotonergic class; 6 or more 44 63 90 0 0.00
80335 Antidepressants, tricyclic and other cyclicals; 1 56 81 116 0 0.00 or 2
80336 Antidepressants, tricyclic and other cyclicals; 3- 118 170 244 0 0.00 5
80337 Antidepressants, tricyclic and other cyclicals; 6 102 147 211 0 0.00 or more
80338 Antidepressants, not otherwise specified 56 81 116 0 0.00
80339 Antiepileptics, not otherwise specified; 1-3 69 100 143 0 0.00
80340 Antiepileptics, not otherwise specified; 4-6 122 176 252 0 0.00
80341 Antiepileptics, not otherwise specified; 7 or 10 15 21 0 0.00 more
80342 Antipsychotics, not otherwise specified; 1-3 66 95 136 0 0.00
80343 Antipsychotics, not otherwise specified; 4-6 189 272 390 0 0.00
80344 Antipsychotics, not otherwise specified; 7 or 64 92 132 0 0.00 more
80345 Barbiturates 61 88 126 0 0.00
80346 Benzodiazepines; 1-12 67 96 137 0 0.00
80347 Benzodiazepines; 13 or more 102 147 211 0 0.00
80348 Buprenorphine 68 98 140 0 0.00
CPT copyright 2017 American Medical Association. 559 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
80349 Cannabinoids, natural 65 93 134 0 0.00
80350 Cannabinoids, synthetic; 1-3 53 76 109 0 0.00
80351 Cannabinoids, synthetic; 4-6 126 180 259 0 0.00
80352 Cannabinoids, synthetic; 7 or more 77 111 159 0 0.00
80353 Cocaine 56 81 116 0 0.00
80354 Fentanyl 68 97 139 0 0.00
80355 Gabapentin, non-blood 61 88 127 0 0.00
80356 Heroin metabolite 68 98 140 0 0.00
80357 Ketamine and norketamine 59 84 121 0 0.00
80358 Methadone 59 85 122 0 0.00
80359 Methylenedioxyamphetamines (MDA, meda, 58 83 119 0 0.00 mama)
80360 Methylphenidate 61 88 126 0 0.00
80361 Opiates, 1 or more 71 103 147 0 0.00
80362 Opioids and opiate analogs; 1 or 2 86 124 178 0 0.00
80363 Opioids and opiate analogs; 3 or 4 72 104 148 0 0.00
80364 Opioids and opiate analogs; 5 or more 63 90 129 0 0.00
80365 Oxycodone 68 97 140 0 0.00
80366 Pregabalin 61 88 126 0 0.00
80367 Propoxyphene 56 81 116 0 0.00
80368 Sedative hypnotics (non-benzodiazepines) 63 90 129 0 0.00
80369 Skeletal muscle relaxants; 1 or 2 86 123 177 0 0.00
80370 Skeletal muscle relaxants; 3 or more 64 92 131 0 0.00
80371 Stimulants, synthetic 62 89 128 0 0.00
80372 Tapentadol 64 91 131 0 0.00
80373 Tramadol 64 91 131 0 0.00
80374 Stereoisomer (enantiomer) analysis, single drug 63 90 129 0 0.00 class
80375 Drug(s) or substance(s), definitive, qualitative or 64 92 132 0 0.00 quantitative, not otherwise specified; 1-3
560 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
80376 Drug(s) or substance(s), definitive, qualitative or 92 133 190 0 0.00 quantitative, not otherwise specified; 4-6
80377 Drug(s) or substance(s), definitive, qualitative or 103 148 213 0 0.00 quantitative, not otherwise specified; 7 or more
EVOCATIVE/SUPPRESSION TESTING
80400 ACTH stimulation panel; for adrenal 103 148 213 0 0.00 insufficiency this panel must include the following: cortisol (82533 x 2)
80402 ACTH stimulation panel; for 21 hydroxylase 0 0 0 0 0.00 deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2)
80406 ACTH stimulation panel; for 3 beta- 0 0 0 0 0.00 hydroxydehydrogenase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2)
80408 Aldosterone suppression evaluation panel (eg, 0 0 0 0 0.00 saline infusion) this panel must include the following: aldosterone (82088 x 2) renin (84244 x 2)
80410 Calcitonin stimulation panel (eg, calcium, 0 0 0 0 0.00 pentagastrin) this panel must include the following: calcitonin (82308 x 3)
80412 Corticotropic releasing hormone (CRH) 0 0 0 0 0.00 stimulation panel this panel must include the following: cortisol (82533 x 6) adrenocorticotropic hormone (act) (82024 x 6)
80414 Chorionic gonadotropin stimulation panel; 181 259 372 0 0.00 testosterone response this panel must include the following: testosterone (84403 x 2 on 3 pooled blood samples)
80415 Chorionic gonadotropin stimulation panel; 159 228 327 0 0.00 estradiol response this panel must include the following: estradiol (82670 x 2 on 3 pooled blood samples)
80416 Renal vein renin stimulation panel (eg, captopril) 0 0 0 0 0.00 this panel must include the following: renin (84244 x 6)
80417 Peripheral vein renin stimulation panel (eg, 0 0 0 0 0.00 captopril) this panel must include the following: renin (84244 x 2)
CPT copyright 2017 American Medical Association. 561 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
80418 Combined rapid anterior pituitary evaluation 804 1155 1657 0 0.00 panel this panel must include the following: adrenocorticotropic hormone (act) (82024 x 4) luteinizing hormone (LH) (83002 x 4) follicle stimulating hormone (FSH) (83001 x 4) prolactin (84146 x 4) human growth hormone (HGH) (83003 x 4) cortisol (82533 x 4) thyroid stimulating hormone (TSH) (84443 x 4)
80420 Dexamethasone suppression panel, 48 hour this 0 0 0 0 0.00 panel must include the following: free cortisol, urine (82530 x 2) cortisol (82533 x 2) volume measurement for timed collection (81050 x 2)
80422 Glucagon tolerance panel; for insulinoma this 168 242 347 0 0.00 panel must include the following: glucose (82947 x 3) insulin (83525 x 3)
80424 Glucagon tolerance panel; for 256 367 527 0 0.00 pheochromocytoma this panel must include the following: catecholamines, fractionated (82384 x 2)
80426 Gonadotropin releasing hormone stimulation 0 0 0 0 0.00 panel this panel must include the following: follicle stimulating hormone (FSH) (83001 x 4) luteinizing hormone (LH) (83002 x 4)
80428 Growth hormone stimulation panel (eg, arginine 233 335 480 0 0.00 infusion, l-dopa admin) this panel must include the following: human growth hormone (HGH) (83003 x 4)
80430 Growth hormone suppression panel (glucose 0 0 0 0 0.00 admin) this panel must include the following: glucose (82947 x 3) human growth hormone (HGH) (83003 x 4)
80432 Insulin-induced c-peptide suppression panel this 0 0 0 0 0.00 panel must include the following: insulin (83525) c-peptide (84681 x 5) glucose (82947 x 5)
80434 Insulin tolerance panel; for act insufficiency this 0 0 0 0 0.00 panel must include the following: cortisol (82533 x 5) glucose (82947 x 5)
80435 Insulin tolerance panel; for growth hormone 0 0 0 0 0.00 deficiency this panel must include the following: glucose (82947 x 5) human growth hormone (HGH) (83003 x 5)
80436 Metyrapone panel this panel must include the 0 0 0 0 0.00 following: cortisol (82533 x 2) 11 deoxycortisol (82634 x 2)
562 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
80438 Thyrotropin releasing hormone (try) stimulation 0 0 0 0 0.00 panel; 1 hour this panel must include the following: thyroid stimulating hormone (TSH) (84443 x 3)
80439 Thyrotropin releasing hormone (try) stimulation 0 0 0 0 0.00 panel; 2 hour this panel must include the following: thyroid stimulating hormone (TSH) (84443 x 4)
CONSULTATIONS (CLINICAL PATHOLOGY)
80500 Clinical pathology consultation; limited, without 98 105 182 24 0.66 review of patient's history and medical records
80502 Clinical pathology consultation; comprehensive, 167 178 309 76 2.10 for a complex diagnostic problem, with review of patient's history and medical records
URINALYSIS
81000 Urinalysis, by dip stick or tablet reagent for 16 23 31 0 0.00 bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy
81001 Urinalysis, by dip stick or tablet reagent for 26 38 51 0 0.00 bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy
81002 Urinalysis, by dip stick or tablet reagent for 14 20 27 0 0.00 bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy
81003 Urinalysis, by dip stick or tablet reagent for 15 22 29 0 0.00 bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy
81005 Urinalysis; qualitative or semiquantitative, 10 15 20 0 0.00 except immunoassays
81007 Urinalysis; bacteriuria screen, except by culture 26 37 50 0 0.00 or dipstick
81015 Urinalysis; microscopic only 21 31 41 0 0.00
81020 Urinalysis; 2 or 3 glass test 29 43 58 0 0.00
CPT copyright 2017 American Medical Association. 563 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81025 Urine pregnancy test, by visual color comparison 25 37 50 0 0.00 methods
81050 Volume measurement for timed collection, each 15 22 30 0 0.00
81099 Unlisted urinalysis procedure 0 0 0 0 0.00
MOLECULAR PATHOLOGY
81105 Human platelet antigen 1 genotyping (hpa-1), 0 0 0 0 0.00 itgb3 (integrin, beta 3 [platelet glycoprotein IIIA], antigen cd61 [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [nait], post- transfusion purpura), gene analysis, common variant, hpa-1a/b (l33p)
81106 Human platelet antigen 2 genotyping (hpa-2), 0 0 0 0 0.00 gp1ba (glycoprotein ib [platelet], alpha polypeptide [GPIba]) (eg, neonatal alloimmune thrombocytopenia [nait], post-transfusion purpura), gene analysis, common variant, hpa- 2a/b (t145m)
81107 Human platelet antigen 3 genotyping (hpa-3), 0 0 0 0 0.00 itga2b (integrin, alpha 2b [platelet glycoprotein IIB of IIB/IIIA complex], antigen cd41 [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [nait], post-transfusion purpura), gene analysis, common variant, hpa-3a/b (i843s)
81108 Human platelet antigen 4 genotyping (hpa-4), 0 0 0 0 0.00 itgb3 (integrin, beta 3 [platelet glycoprotein IIIA], antigen cd61 [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [nait], post- transfusion purpura), gene analysis, common variant, hpa-4a/b (r143q)
81109 Human platelet antigen 5 genotyping (hpa-5), 0 0 0 0 0.00 itga2 (integrin, alpha 2 [cd49b, alpha 2 subunit of vla-2 receptor] [GPIa]) (eg, neonatal alloimmune thrombocytopenia [nait], post- transfusion purpura), gene analysis, common variant (eg, hpa-5a/b (k505e))
81110 Human platelet antigen 6 genotyping (hpa-6w), 0 0 0 0 0.00 itgb3 (integrin, beta 3 [platelet glycoprotein IIIA, antigen cd61] [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [nait], post-transfusion purpura), gene analysis, common variant, hpa- 6a/b (r489q)
81111 Human platelet antigen 9 genotyping (hpa-9w), 0 0 0 0 0.00 itga2b (integrin, alpha 2b [platelet glycoprotein IIB of IIB/IIIA complex, antigen cd41] [GPIIb]) (eg, neonatal alloimmune thrombocytopenia
564 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
[nait], post-transfusion purpura), gene analysis, common variant, hpa-9a/b (v837m)
81112 Human platelet antigen 15 genotyping (hpa-15), 0 0 0 0 0.00 cd109 (cd109 molecule) (eg, neonatal alloimmune thrombocytopenia [nait], post- transfusion purpura), gene analysis, common variant, hpa-15a/b (s682y)
81120 Idh1 (isocitrate dehydrogenase 1 [NADP+], 0 0 0 0 0.00 soluble) (eg, glioma), common variants (eg, r132h, r132c)
81121 Idh2 (isocitrate dehydrogenase 2 [NADP+], 0 0 0 0 0.00 mitochondrial) (eg, glioma), common variants (eg, r140w, r172m)
81161 DMD (dystrophin) (eg, Duchenne/Becker 251 362 528 0 0.00 muscular dystrophy) deletion analysis, and duplication analysis, if performed
81162 Brca1, brca2 (breast cancer 1 and 2) (eg, 3561 5144 7496 0 0.00 hereditary breast and ovarian cancer) gene analysis; full sequence analysis and full duplication/deletion analysis
81170 Abl1 (ABL proto-oncogene 1, non-receptor 409 591 861 0 0.00 tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain
81175 Asxl1 (additional sex combs like 1, 0 0 0 0 0.00 transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; full gene sequence
81176 Asxl1 (additional sex combs like 1, 0 0 0 0 0.00 transcriptional regulator) (eg, myelodysplastic syndrome, myeloproliferative neoplasms, chronic myelomonocytic leukemia), gene analysis; targeted sequence analysis (eg, exon 12)
81200 ASPA (aspartoacylase) (eg, Canavan disease) 143 206 300 0 0.00 gene analysis, common variants (eg, e285a, y231x)
81201 APC (adenomatous polyposis coli) (eg, familial 563 813 1184 0 0.00 adenomatosis polyposis [FAP], attenuated FAP) gene analysis; full gene sequence
81202 APC (adenomatous polyposis coli) (eg, familial 406 586 855 0 0.00 adenomatosis polyposis [FAP], attenuated FAP) gene analysis; known familial variants
CPT copyright 2017 American Medical Association. 565 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81203 APC (adenomatous polyposis coli) (eg, familial 604 873 1272 0 0.00 adenomatosis polyposis [FAP], attenuated FAP) gene analysis; duplication/deletion variants
81205 BCKDHB (branched-chain keto acid 336 486 708 0 0.00 dehydrogenase e1, beta polypeptide) (eg, maple syrup urine disease) gene analysis, common variants (eg, r183p, g278s, e422x)
81206 BCR/abl1 (t(9;22)) (eg, chronic myelogenous 282 407 593 0 0.00 leukemia) translocation analysis; major breakpoint, qualitative or quantitative
81207 BCR/abl1 (t(9;22)) (eg, chronic myelogenous 252 363 529 0 0.00 leukemia) translocation analysis; minor breakpoint, qualitative or quantitative
81208 BCR/abl1 (t(9;22)) (eg, chronic myelogenous 351 508 740 0 0.00 leukemia) translocation analysis; other breakpoint, qualitative or quantitative
81209 BLM (bloom syndrome, RecQ helicase-like) (eg, 141 203 296 0 0.00 bloom syndrome) gene analysis, 2281del6ins7 variant
81210 BRAF (b-raf proto-oncogene, serine/threonine 226 327 477 0 0.00 kinase) (eg, colon cancer, melanoma), gene analysis, v600 variant(s)
81211 Brca1, brca2 (breast cancer 1 and 2) (eg, 3355 4848 7064 0 0.00 hereditary breast and ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants in brca1 (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510bp, exon 8-9 del 7.1kb)
81212 Brca1, brca2 (breast cancer 1 and 2) (eg, 595 860 1253 0 0.00 hereditary breast and ovarian cancer) gene analysis; 185delag, 5385insc, 6174delt variants
81213 Brca1, brca2 (breast cancer 1 and 2) (eg, 705 1019 1485 0 0.00 hereditary breast and ovarian cancer) gene analysis; uncommon duplication/deletion variants
81214 Brca1 (breast cancer 1) (eg, hereditary breast and 3603 5205 7585 0 0.00 ovarian cancer) gene analysis; full sequence analysis and common duplication/deletion variants (ie, exon 13 del 3.835kb, exon 13 dup 6kb, exon 14-20 del 26kb, exon 22 del 510bp, exon 8-9 del 7.1kb)
566 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81215 Brca1 (breast cancer 1) (eg, hereditary breast and 486 702 1023 0 0.00 ovarian cancer) gene analysis; known familial variant
81216 Brca2 (breast cancer 2) (eg, hereditary breast and 2002 2892 4215 0 0.00 ovarian cancer) gene analysis; full sequence analysis
81217 Brca2 (breast cancer 2) (eg, hereditary breast and 490 707 1031 0 0.00 ovarian cancer) gene analysis; known familial variant
81218 Cebpa (ccaat/enhancer binding protein [c/ebp], 661 955 1392 0 0.00 alpha) (eg, acute myeloid leukemia), gene analysis, full gene sequence
81219 Calr (calreticulin) (eg, myeloproliferative 402 581 846 0 0.00 disorders), gene analysis, common variants in exon 9
81220 CFTR (cystic fibrosis transmembrane 1112 1607 2342 0 0.00 conductance regulator) (eg, cystic fibrosis) gene analysis; common variants (eg, ACMG/ACOG guidelines)
81221 CFTR (cystic fibrosis transmembrane 0 0 0 0 0.00 conductance regulator) (eg, cystic fibrosis) gene analysis; known familial variants
81222 CFTR (cystic fibrosis transmembrane 466 674 982 0 0.00 conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants
81223 CFTR (cystic fibrosis transmembrane 506 732 1066 0 0.00 conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence
81224 CFTR (cystic fibrosis transmembrane 1008 1456 2121 0 0.00 conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-t analysis (eg, male infertility)
81225 Cyp2C19 (cytochrome p450, family 2, 686 991 1444 0 0.00 subfamily c, polypeptide 19) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *8, *17)
81226 Cyp2d6 (cytochrome p450, family 2, subfamily 1194 1725 2514 0 0.00 d, polypeptide 6) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1xn, *2xn, *4xn)
CPT copyright 2017 American Medical Association. 567 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81227 Cyp2c9 (cytochrome p450, family 2, subfamily 465 672 979 0 0.00 c, polypeptide 9) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *5, *6)
81228 Cytogenomic constitutional (genome-wide) 3009 4347 6335 0 0.00 microarray analysis; interrogation of genomic regions for copy number variants (eg, bacterial artificial chromosome [BAC] or oligo-based comparative genomic hybridization [CGH] microarray analysis)
81229 Cytogenomic constitutional (genome-wide) 3089 4463 6503 0 0.00 microarray analysis; interrogation of genomic regions for copy number and single nucleotide polymorphism (snp) variants for chromosomal abnormalities
81230 Cyp3a4 (cytochrome p450 family 3 subfamily a 0 0 0 0 0.00 member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2, *22)
81231 Cyp3a5 (cytochrome p450 family 3 subfamily a 0 0 0 0 0.00 member 5) (eg, drug metabolism), gene analysis, common variants (eg, *2, *3, *4, *5, *6, *7)
81232 Dpyd (dihydropyrimidine dehydrogenase) (eg, 0 0 0 0 0.00 5-fluorouracil/5-fu and capecitabine drug metabolism), gene analysis, common variant(s) (eg, *2a, *4, *5, *6)
81235 EGFR (epidermal growth factor receptor) (eg, 471 680 991 0 0.00 non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, l858r, t790m, g719a, g719s, l861q)
81238 F9 (coagulation factor ix) (eg, hemophilia b), 0 0 0 0 0.00 full gene sequence
81240 F2 (prothrombin, coagulation factor ii) (eg, 169 244 355 0 0.00 hereditary hypercoagulability) gene analysis, 20210g>a variant
81241 F5 (coagulation factor v) (eg, hereditary 211 304 443 0 0.00 hypercoagulability) gene analysis, Leiden variant
81242 FANCC (Fanconi anemia, complementation 142 205 299 0 0.00 group c) (eg, Fanconi anemia, type c) gene analysis, common variant (eg, ivs4+4a>t)
81243 Fmr1 (fragile x mental retardation 1) (eg, fragile 502 726 1057 0 0.00 x mental retardation) gene analysis; evaluation to detect abnormal (eg, expanded) alleles
568 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81244 Fmr1 (fragile x mental retardation 1) (eg, fragile 501 724 1056 0 0.00 x mental retardation) gene analysis; characterization of alleles (eg, expanded size and methylation status)
81245 Flt3 (fms-related tyrosine kinase 3) (eg, acute 182 263 383 0 0.00 myeloid leukemia), gene analysis; internal tandem duplication (ITD) variants (ie, exons 14, 15)
81246 Flt3 (fms-related tyrosine kinase 3) (eg, acute 263 380 554 0 0.00 myeloid leukemia), gene analysis; tyrosine kinase domain (tkd) variants (eg, d835, i836)
81247 G6pd (glucose-6-phosphate dehydrogenase) (eg, 0 0 0 0 0.00 hemolytic anemia, jaundice), gene analysis; common variant(s) (eg, a, a-)
81248 G6pd (glucose-6-phosphate dehydrogenase) (eg, 0 0 0 0 0.00 hemolytic anemia, jaundice), gene analysis; known familial variant(s)
81249 G6pd (glucose-6-phosphate dehydrogenase) (eg, 0 0 0 0 0.00 hemolytic anemia, jaundice), gene analysis; full gene sequence
81250 G6pc (glucose-6-phosphatase, catalytic subunit) 240 347 505 0 0.00 (eg, glycogen storage disease, type 1a, von Gierke disease) gene analysis, common variants (eg, r83c, q347x)
81251 GBA (glucosidase, beta, acid) (eg, Gaucher 216 313 456 0 0.00 disease) gene analysis, common variants (eg, n370s, 84gg, l444p, ivs2+1g>a)
81252 Gjb2 (gap junction protein, beta 2, 26kda, 153 221 322 0 0.00 connexin 26) (eg, nonsyndromic hearing loss) gene analysis; full gene sequence
81253 Gjb2 (gap junction protein, beta 2, 26kda, 0 0 0 0 0.00 connexin 26) (eg, nonsyndromic hearing loss) gene analysis; known familial variants
81254 Gjb6 (gap junction protein, beta 6, 30kda, 0 0 0 0 0.00 connexin 30) (eg, nonsyndromic hearing loss) gene analysis, common variants (eg, 309kb [del(gjb6-d13s1830)] and 232kb [del(gjb6- d13s1854)])
81255 HEXA (hexosaminidase a [alpha polypeptide]) 207 299 436 0 0.00 (eg, Tay-Sachs disease) gene analysis, common variants (eg, 1278instatc, 1421+1g>c, g269s)
CPT copyright 2017 American Medical Association. 569 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81256 HFE (hemochromatosis) (eg, hereditary 469 678 988 0 0.00 hemochromatosis) gene analysis, common variants (eg, C282y, h63d)
81257 Hba1/hba2 (alpha globin 1 and alpha globin 2) 207 299 435 0 0.00 (eg, alpha thalassemia, HB Bart hydrops fetalis syndrome, hbh disease), gene analysis; common deletions or variant (eg, southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, constant spring)
81258 Hba1/hba2 (alpha globin 1 and alpha globin 2) 0 0 0 0 0.00 (eg, alpha thalassemia, HB Bart hydrops fetalis syndrome, hbh disease), gene analysis; known familial variant
81259 Hba1/hba2 (alpha globin 1 and alpha globin 2) 0 0 0 0 0.00 (eg, alpha thalassemia, HB Bart hydrops fetalis syndrome, hbh disease), gene analysis; full gene sequence
81260 IKBKAP (inhibitor of kappa light polypeptide 142 205 299 0 0.00 gene enhancer in b-cells, kinase complex- associated protein) (eg, familial dysautonomia) gene analysis, common variants (eg, 2507+6t>c, r696p)
81261 IGH@ (immunoglobulin heavy chain locus) (eg, 401 580 845 0 0.00 leukemias and lymphomas, b-cell), gene rearrange analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction)
81262 IGH@ (immunoglobulin heavy chain locus) (eg, 229 331 482 0 0.00 leukemias and lymphomas, b-cell), gene rearrange analysis to detect abnormal clonal population(s); direct probe methodology (eg, southern blot)
81263 IGH@ (immunoglobulin heavy chain locus) (eg, 515 745 1085 0 0.00 leukemia and lymphoma, b-cell), variable region somatic mutation analysis
81264 IGK@ (immunoglobulin kappa light chain 358 517 754 0 0.00 locus) (eg, leukemia and lymphoma, b-cell), gene rearrange analysis, evaluation to detect abnormal clonal population(s)
81265 Comparative analysis using short tandem repeat 517 746 1088 0 0.00 (str) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient germline [eg, buccal swab or other germline tissue sample] and donor testing, twin
570 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
zygosity testing, or maternal cell contamination of fetal cells)
81266 Comparative analysis using short tandem repeat 942 1361 1983 0 0.00 (str) markers; each additional specimen (eg, additional cord blood donor, additional fetal samples from different cultures, or additional zygosity in multiple birth pregnancies) (list separately in addition to code for primary procedure)
81267 Chimerism (engraftment) analysis, post 814 1176 1714 0 0.00 transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection
81268 Chimerism (engraftment) analysis, post 755 1090 1589 0 0.00 transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; with cell selection (eg, cd3, cd33), each cell type
81269 Hba1/hba2 (alpha globin 1 and alpha globin 2) 0 0 0 0 0.00 (eg, alpha thalassemia, HB Bart hydrops fetalis syndrome, hbh disease), gene analysis; duplication/deletion variants
81270 Jak2 (janus kinase 2) (eg, myeloproliferative 324 468 682 0 0.00 disorder) gene analysis, p.val617phe (v617f) variant
81272 Kit (v-kit hardy-Zuckerman 4 feline sarcoma 1533 2214 3227 0 0.00 viral oncogene homolog) (eg, gastrointestinal stromal tumor [gist], acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons 8, 11, 13, 17, 18)
81273 Kit (v-kit hardy-Zuckerman 4 feline sarcoma 441 638 929 0 0.00 viral oncogene homolog) (eg, mastocytosis), gene analysis, d816 variant(s)
81275 KRAS (Kirsten rat sarcoma viral oncogene 301 435 634 0 0.00 homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13)
81276 KRAS (Kirsten rat sarcoma viral oncogene 437 632 921 0 0.00 homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146)
81283 Ifnl3 (interferon, lambda 3) (eg, drug response), 0 0 0 0 0.00 gene analysis, rs12979860 variant
CPT copyright 2017 American Medical Association. 571 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81287 Mgmt (o-6-methylguanine-dna 469 678 988 0 0.00 methyltransferase) (eg, glioblastoma multiforme), methylation analysis
81288 Mlh1 (MutL homolog 1, colon cancer, 415 600 875 0 0.00 nonpolyposis type 2) (eg, hereditary non- polyposis colorectal cancer, lynch syndrome) gene analysis; promoter methylation analysis
81290 Mcoln1 (mucolipin 1) (eg, mucolipidosis, type 150 217 317 0 0.00 iv) gene analysis, common variants (eg, ivs3- 2a>g, del6.4kb)
81291 MTHFR (5,10-methylenetetrahydrofolate 259 374 546 0 0.00 reductase) (eg, hereditary hypercoagulability) gene analysis, common variants (eg, 677t, 1298c)
81292 Mlh1 (MutL homolog 1, colon cancer, 931 1345 1961 0 0.00 nonpolyposis type 2) (eg, hereditary non- polyposis colorectal cancer, lynch syndrome) gene analysis; full sequence analysis
81293 Mlh1 (MutL homolog 1, colon cancer, 391 565 823 0 0.00 nonpolyposis type 2) (eg, hereditary non- polyposis colorectal cancer, lynch syndrome) gene analysis; known familial variants
81294 Mlh1 (MutL homolog 1, colon cancer, 502 726 1057 0 0.00 nonpolyposis type 2) (eg, hereditary non- polyposis colorectal cancer, lynch syndrome) gene analysis; duplication/deletion variants
81295 Msh2 (mutS homolog 2, colon cancer, 618 893 1301 0 0.00 nonpolyposis type 1) (eg, hereditary non- polyposis colorectal cancer, lynch syndrome) gene analysis; full sequence analysis
81296 Msh2 (mutS homolog 2, colon cancer, 477 689 1005 0 0.00 nonpolyposis type 1) (eg, hereditary non- polyposis colorectal cancer, lynch syndrome) gene analysis; known familial variants
81297 Msh2 (mutS homolog 2, colon cancer, 0 0 0 0 0.00 nonpolyposis type 1) (eg, hereditary non- polyposis colorectal cancer, lynch syndrome) gene analysis; duplication/deletion variants
81298 Msh6 (mutS homolog 6 [e. coli]) (eg, hereditary 492 711 1036 0 0.00 non-polyposis colorectal cancer, lynch syndrome) gene analysis; full sequence analysis
81299 Msh6 (mutS homolog 6 [e. coli]) (eg, hereditary 476 688 1003 0 0.00 non-polyposis colorectal cancer, lynch
572 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
syndrome) gene analysis; known familial variants
81300 Msh6 (mutS homolog 6 [e. coli]) (eg, hereditary 0 0 0 0 0.00 non-polyposis colorectal cancer, lynch syndrome) gene analysis; duplication/deletion variants
81301 Microsatellite instability analysis (eg, hereditary 1189 1717 2502 0 0.00 non-polyposis colorectal cancer, lynch syndrome) of markers for mismatch repair deficiency (eg, bat25, bat26), includes comparison of neoplastic and normal tissue, if performed
81302 Mecp2 (methyl CpG binding protein 2) (eg, Rett 808 1167 1701 0 0.00 syndrome) gene analysis; full sequence analysis
81303 Mecp2 (methyl CpG binding protein 2) (eg, Rett 0 0 0 0 0.00 syndrome) gene analysis; known familial variant
81304 Mecp2 (methyl CpG binding protein 2) (eg, Rett 825 1191 1736 0 0.00 syndrome) gene analysis; duplication/deletion variants
81310 Npm1 (nucleophosmin) (eg, acute myeloid 254 367 534 0 0.00 leukemia) gene analysis, exon 12 variants
81311 NRAS (neuroblastoma ras viral [v-ras] oncogene 648 936 1363 0 0.00 homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61)
81313 Pca3/klk3 (prostate cancer antigen 3 [non- 572 826 1204 0 0.00 protein coding]/kallikrein-related peptidase 3 [prostate specific antigen]) ratio (eg, prostate cancer)
81314 PDGFRA (platelet-derived growth factor 1539 2223 3240 0 0.00 receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor [gist]), gene analysis, targeted sequence analysis (eg, exons 12, 18)
81315 PML/RAR-alpha, (t(15;17)), (promyelocytic 287 415 604 0 0.00 leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quantitative
81316 PML/RAR-alpha, (t(15;17)), (promyelocytic 1660 2398 3495 0 0.00 leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative or quantitative
CPT copyright 2017 American Medical Association. 573 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81317 Pms2 (postmeiotic segregation increased 2 [s. 917 1325 1930 0 0.00 cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; full sequence analysis
81318 Pms2 (postmeiotic segregation increased 2 [s. 331 478 697 0 0.00 cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; known familial variants
81319 Pms2 (postmeiotic segregation increased 2 [s. 282 407 593 0 0.00 cerevisiae]) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) gene analysis; duplication/deletion variants
81321 PTEN (phosphatase and tensin homolog) (eg, 867 1252 1825 0 0.00 Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; full sequence analysis
81322 PTEN (phosphatase and tensin homolog) (eg, 101 146 213 0 0.00 Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; known familial variant
81323 PTEN (phosphatase and tensin homolog) (eg, 627 906 1320 0 0.00 Cowden syndrome, PTEN hamartoma tumor syndrome) gene analysis; duplication/deletion variant
81324 Pmp22 (peripheral myelin protein 22) (eg, 1043 1507 2196 0 0.00 Charcot-Marie-tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; duplication/deletion analysis
81325 Pmp22 (peripheral myelin protein 22) (eg, 1031 1490 2171 0 0.00 Charcot-Marie-tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; full sequence analysis
81326 Pmp22 (peripheral myelin protein 22) (eg, 0 0 0 0 0.00 Charcot-Marie-tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; known familial variant
81327 Sept9 (septin9) (eg, colorectal cancer) 411 593 864 0 0.00 methylation analysis
81328 Slco1b1 (solute carrier organic anion transporter 0 0 0 0 0.00 family, member 1b1) (eg, adverse drug reaction), gene analysis, common variant(s) (eg, *5)
81330 Smpd1(sphingomyelin phosphodiesterase 1, acid 143 207 302 0 0.00 lysosomal) (eg, Niemann-pick disease, type a) gene analysis, common variants (eg, r496l, l302p, fsp330)
574 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81331 SNRPN/ube3a (small nuclear ribonucleoprotein 518 749 1091 0 0.00 polypeptide n and ubiquitin protein ligase e3a) (eg, Prader-Willi syndrome and/or Angelman syndrome), methylation analysis
81332 Serpina1 (serpin peptidase inhibitor, clade a, 101 145 212 0 0.00 alpha-1 antiproteinase, antitrypsin, member 1) (eg, alpha-1-antitrypsin deficiency), gene analysis, common variants (eg, *s and *z)
81334 Runx1 (runt related transcription factor 1) (eg, 0 0 0 0 0.00 acute myeloid leukemia, familial platelet disorder with associated myeloid malignancy), gene analysis, targeted sequence analysis (eg, exons 3-8)
81335 TPMT (thiopurine s-methyltransferase) (eg, drug 0 0 0 0 0.00 metabolism), gene analysis, common variants (eg, *2, *3)
81340 TRB@ (t cell antigen receptor, beta) (eg, 688 994 1449 0 0.00 leukemia and lymphoma), gene rearrange analysis to detect abnormal clonal population(s); using amplification methodology (eg, polymerase chain reaction)
81341 TRB@ (t cell antigen receptor, beta) (eg, 260 376 548 0 0.00 leukemia and lymphoma), gene rearrange analysis to detect abnormal clonal population(s); using direct probe methodology (eg, southern blot)
81342 TRG@ (t cell antigen receptor, gamma) (eg, 403 582 848 0 0.00 leukemia and lymphoma), gene rearrange analysis, evaluation to detect abnormal clonal population(s)
81346 Tyms (thymidylate synthetase) (eg, 5- 0 0 0 0 0.00 fluorouracil/5-fu drug metabolism), gene analysis, common variant(s) (eg, tandem repeat variant)
81350 Ugt1a1 (UDP glucuronosyltransferase 1 family, 301 435 634 0 0.00 polypeptide a1) (eg, irinotecan metabolism), gene analysis, common variants (eg, *28, *36, *37)
81355 VkorC1 (vitamin k epoxide reductase complex, 278 402 586 0 0.00 subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639g>a, c.173+1000c>t)
81361 HBB (hemoglobin, subunit beta) (eg, sickle cell 0 0 0 0 0.00 anemia, beta thalassemia, hemoglobinopathy); common variant(s) (eg, HBs, HBc, HBe)
CPT copyright 2017 American Medical Association. 575 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81362 HBB (hemoglobin, subunit beta) (eg, sickle cell 0 0 0 0 0.00 anemia, beta thalassemia, hemoglobinopathy); known familial variant(s)
81363 HBB (hemoglobin, subunit beta) (eg, sickle cell 0 0 0 0 0.00 anemia, beta thalassemia, hemoglobinopathy); duplication/deletion variant(s)
81364 HBB (hemoglobin, subunit beta) (eg, sickle cell 0 0 0 0 0.00 anemia, beta thalassemia, hemoglobinopathy); full gene sequence
81370 HLA class i and ii typing, low resolution (eg, 1579 2281 3324 0 0.00 antigen equivalents); HLA-a, -b, -c, -drb1/3/4/5, and -dqb1
81371 HLA class i and ii typing, low resolution (eg, 1264 1826 2660 0 0.00 antigen equivalents); HLA-a, -b, and -drb1 (eg, verification typing)
81372 HLA class i typing, low resolution (eg, antigen 639 924 1346 0 0.00 equivalents); complete (ie, HLA-a, -b, and -c)
81373 HLA class i typing, low resolution (eg, antigen 456 659 961 0 0.00 equivalents); one locus (eg, HLA-a, -b, or -c), each
81374 HLA class i typing, low resolution (eg, antigen 213 307 448 0 0.00 equivalents); one antigen equivalent (eg, b*27), each
81375 HLA class ii typing, low resolution (eg, antigen 602 870 1267 0 0.00 equivalents); hla-drb1/3/4/5 and -dqb1
81376 HLA class ii typing, low resolution (eg, antigen 229 331 482 0 0.00 equivalents); one locus (eg, hla-drb1, -drb3/4/5, - dqb1, -dqa1, -dpb1, or -dpa1), each
81377 HLA class ii typing, low resolution (eg, antigen 376 543 792 0 0.00 equivalents); one antigen equivalent, each
81378 HLA class i and ii typing, high resolution (ie, 1814 2621 3820 0 0.00 alleles or allele groups), HLA-a, -b, -c, and -drb1
81379 HLA class i typing, high resolution (ie, alleles or 1761 2544 3707 0 0.00 allele groups); complete (ie, HLA-a, -b, and -c)
81380 HLA class i typing, high resolution (ie, alleles or 456 659 960 0 0.00 allele groups); one locus (eg, HLA-a, -b, or -c), each
81381 HLA class i typing, high resolution (ie, alleles or 585 845 1231 0 0.00 allele groups); one allele or allele group (eg, b*57:01p), each
576 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81382 HLA class ii typing, high resolution (ie, alleles 330 477 694 0 0.00 or allele groups); one locus (eg, hla-drb1, - drb3/4/5, -dqb1, -dqa1, -dpb1, or -dpa1), each
81383 HLA class ii typing, high resolution (ie, alleles 324 467 681 0 0.00 or allele groups); one allele or allele group (eg, hla-dqb1*06:02p), each
81400 Molecular pathology procedure, Level 1 377 544 793 0 0.00 (eg, identification of single germline variant [eg, SNP] by techniques such as restriction enzyme digestion or melt curve analysis) ACADM (acyl-CoA dehydrogenase, C-4 to C-12 straight chain, MCAD) (eg, medium chain acyl dehydrogenase deficiency), K304E variant ACE (angiotensin converting enzyme) (eg, hereditary blood pressure regulation), insertion/deletion variant AGTR1 (angiotensin II receptor, type 1) (eg, essential hypertension), 1166A>C variant BCKDHA (branched chain keto acid dehydrogenase E1, alpha polypeptide) (eg, maple syrup urine disease, type 1A), Y438N variant CCR5 (chemokine C-C motif receptor 5) (eg, HIV resistance), 32-bp deletion mutation/794 825del32 deletion CLRN1 (clarin 1) (eg, Usher syndrome, type 3), N48K variant F2 (coagulation factor 2) (eg, hereditary hypercoagulability), 1199G>A variant F5 (coagulation factor V) (eg, hereditary hypercoagulability), HR2 variant F7 (coagulation factor VII [serum prothrombin conversion accelerator]) (eg, hereditary hypercoagulability), R353Q variant F13B (coagulation factor XIII, B polypeptide) (eg, hereditary hypercoagulability), V34L variant FGB (fibrinogen beta chain) (eg, hereditary ischemic heart disease), - 455G>A variant FGFR1 (fibroblast growth factor receptor 1) (eg, Pfeiffer syndrome type 1, craniosynostosis), P252R variant FGFR3 (fibroblast growth factor receptor 3) (eg, Muenke syndrome), P250R variant FKTN (fukutin) (eg, Fukuyama congenital muscular dystrophy), retrotransposon insertion variant GNE (glucosamine [UDP- N-acetyl]-2-epimerase/N- acetylmannosamine kinase) (eg, inclusion
CPT copyright 2017 American Medical Association. 577 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
body myopathy 2 [IBM2], Nonaka myopathy), M712T variant IVD (isovaleryl- CoA dehydrogenase) (eg, isovaleric acidemia), A282V variant LCT (lactase- phlorizin hydrolase) (eg, lactose intolerance), 13910 C>T variant NEB (nebulin) (eg, nemaline myopathy 2), exon 55 deletion variant PCDH15 (protocadherin-related 15) (eg, Usher syndrome type 1F), R245X variant SERPINE1 (serpine peptidase inhibitor clade E, member 1, plasminogen activator inhibitor -1, PAI-1) (eg, thrombophilia), 4G variant SHOC2 (soc-2 suppressor of clear homolog) (eg, Noonan-like syndrome with loose anagen hair), S2G variant SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy), exon 7 deletion SRY (sex determining region Y) (eg, 46,XX testicular disorder of sex development, gonadal dysgenesis), gene analysis TOR1A (torsin family 1, member A [torsin A]) (eg, early-onset primary dystonia [DYT1]), 907_909delGAG (904_906delGAG) variant. 81401 Molecular pathology procedure, Level 2 345 498 726 0 0.00 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant [typically using nonsequencing target variant analysis], or detection of a dynamic mutation disorder/triplet repeat) ABCC8 (ATP- binding cassette, sub-family C [CFTR/MRP], member 8) (eg, familial hyperinsulinism), common variants (eg, c.3898-9G>A [c.3992-9G>A], F1388del) ABL1 (ABL proto-oncogene 1, non- receptor tyrosine kinase) (eg, acquired imatinib resistance), T315I variant ACADM (acyl-CoA dehydrogenase, C-4 to C-12 straight chain, MCAD) (eg, medium chain acyl dehydrogenase deficiency), commons variants (eg, K304E, Y42H) ADRB2 (adrenergic beta-2 receptor surface) (eg, drug metabolism), common variants (eg, G16R, Q27E) AFF2 (AF4/FMR2 family, member 2 [FMR2]) (eg, fragile X mental retardation 2 [FRAXE]), evaluation to detect abnormal
578 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
(eg, expanded) alleles APOB (apolipoprotein B) (eg, familial hypercholesterolemia type B), common variants (eg, R3500Q, R3500W) APOE (apolipoprotein E) (eg, hyperlipoproteinemia type III, cardiovascular disease, Alzheimer disease), common variants (eg, *2, *3, *4) AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation), characterization of alleles (eg, expanded size or methylation status) ATN1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy), evaluation to detect abnormal (eg, expanded) alleles ATXN1 (ataxin 1) (eg, spinocerebellar ataxia), evaluation to detect abnormal (eg, expanded) alleles ATXN2 (ataxin 2) (eg, spinocerebellar ataxia), evaluation to detect abnormal (eg, expanded) alleles ATXN3 (ataxin 3) (eg, spinocerebellar ataxia, Machado-Joseph disease), evaluation to detect abnormal (eg, expanded) alleles ATXN7 (ataxin 7) (eg, spinocerebellar ataxia), evaluation to detect abnormal (eg, expanded) alleles ATXN8OS (ATXN8 opposite strand [non-protein coding]) (eg, spinocerebellar ataxia), evaluation to detect abnormal (eg, expanded) alleles ATXN10 (ataxin 10) (eg, spinocerebellar ataxia), evaluation to detect abnormal (eg, expanded) alleles CACNA1A (calcium channel, voltage-dependent, P/Q type, alpha 1A subunit) (eg, spinocerebellar ataxia), evaluation to detect abnormal (eg, expanded) alleles CBFB/MYH11 (inv(16)) (eg, acute myeloid leukemia), qualitative, and quantitative, if performed CBS (cystathionine-beta-synthase) (eg, homocystinuria, cystathionine beta-synthase deficiency), common variants (eg, I278T, G307S) CCND1/IGH (BCL1/IgH, t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative, and quantitative, if performed CFH/ARMS2 (complement factor H/age-related maculopathy susceptibility 2) (eg, macular degeneration), common variants (eg,
CPT copyright 2017 American Medical Association. 579 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
Y402H [CFH], A69S [ARMS2]) CNBP (CCHC-type zinc finger, nucleic acid binding protein) (eg, myotonic dystrophy type 2), evaluation to detect abnormal (eg, expanded) alleles CSTB (cystatin B [stefin B]) (eg, Unverricht-Lundborg disease), evaluation to detect abnormal (eg, expanded) alleles DEK/NUP214 (t(6;9)) (eg, acute myeloid leukemia), translocation analysis, qualitative, and quantitative, if performed DMPK (dystrophia myotonica- protein kinase) (eg, myotonic dystrophy, type 1), evaluation to detect abnormal (eg, expanded) alleles E2A/PBX1 (t(1;19)) (eg, acute lymphocytic leukemia), translocation analysis, qualitative, and quantitative, if performed EML4/ALK (inv(2)) (eg, non- small cell lung cancer), translocation or inversion analysis ETV6/NTRK3 (t(12;15)) (eg, congenital/infantile fibrosarcoma), translocation analysis, qualitative, and quantitative, if performed ETV6/RUNX1 (t(12;21)) (eg, acute lymphocytic leukemia), translocation analysis, qualitative, and quantitative, if performed EWSR1/ATF1 (t(12;22)) (eg, clear cell sarcoma), translocation analysis, qualitative, and quantitative, if performed EWSR1/ERG (t(21;22)) (eg, Ewing sarcoma/peripheral neuroectodermal tumor), translocation analysis, qualitative, and quantitative, if performed EWSR1/FLI1 (t(11;22)) (eg, Ewing sarcoma/peripheral neuroectodermal tumor), translocation analysis, qualitative, and quantitative, if performed EWSR1/WT1 (t(11;22)) (eg, desmoplastic small round cell tumor), translocation analysis, qualitative, and quantitative, if performed F11 (coagulation factor XI) (eg, coagulation disorder), common variants (eg, E117X [Type II], F283L [Type III], IVS14del14, and IVS14+1G>A [Type I]) FGFR3 (fibroblast growth factor receptor 3) (eg, achondroplasia, hypochondroplasia), common variants (eg, 1138G>A, 1138G>C, 1620C>A, 1620C>G) FIP1L1/PDGFRA (del[4q12]) (eg, imatinib-sensitive chronic
580 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
eosinophilic leukemia), qualitative, and quantitative, if performed FLG (filaggrin) (eg, ichthyosis vulgaris), common variants (eg, R501X, 2282del4, R2447X, S3247X, 3702delG) FOXO1/PAX3 (t(2;13)) (eg, alveolar rhabdomyosarcoma), translocation analysis, qualitative, and quantitative, if performed FOXO1/PAX7 (t(1;13)) (eg, alveolar rhabdomyosarcoma), translocation analysis, qualitative, and quantitative, if performed FUS/DDIT3 (t(12;16)) (eg, myxoid liposarcoma), translocation analysis, qualitative, and quantitative, if performed FXN (frataxin) (eg, Friedreich ataxia), evaluation to detect abnormal (expanded) alleles GALC (galactosylceramidase) (eg, Krabbe disease), common variants (eg, c.857G>A, 30-kb deletion) GALT (galactose-1- phosphate uridylyltransferase) (eg, galactosemia), common variants (eg, Q188R, S135L, K285N, T138M, L195P, Y209C, IVS2-2A>G, P171S, del5kb, N314D, L218L/N314D) H19 (imprinted maternally expressed transcript [non-protein coding]) (eg, Beckwith-Wiedemann syndrome), methylation analysis HTT (huntingtin) (eg, Huntington disease), evaluation to detect abnormal (eg, expanded) alleles IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma), translocation analysis; single breakpoint (eg, major breakpoint region [MBR] or minor cluster region [mcr]), qualitative or quantitative (When both MBR and mcr breakpoints are performed, use 81402) KCNQ1OT1 (KCNQ1 overlapping transcript 1 [non- protein coding]) (eg, Beckwith-Wiedemann syndrome), methylation analysis LINC00518 (long intergenic non-protein coding RNA 518) (eg, melanoma), expression analysis LRRK2 (leucine-rich repeat kinase 2) (eg, Parkinson disease), common variants (eg, R1441G, G2019S, I2020T) MED12 (mediator complex subunit 12) (eg, FG syndrome type 1, Lujan syndrome), common variants (eg, R961W, N1007S) MEG3/DLK1 (maternally
CPT copyright 2017 American Medical Association. 581 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
expressed 3 [non-protein coding]/delta-like 1 homolog [Drosophila]) (eg, intrauterine growth retardation), methylation analysis MLL/AFF1 (t(4;11)) (eg, acute lymphoblastic leukemia), translocation analysis, qualitative, and quantitative, if performed MLL/MLLT3 (t(9;11)) (eg, acute myeloid leukemia), translocation analysis, qualitative, and quantitative, if performed MT-ATP6 (mitochondrially encoded ATP synthase 6) (eg, neuropathy with ataxia and retinitis pigmentosa [NARP], Leigh syndrome), common variants (eg, m.8993T>G, m.8993T>C) MT-ND4, MT-ND6 (mitochondrially encoded NADH dehydrogenase 4, mitochondrially encoded NADH dehydrogenase 6) (eg, Leber hereditary optic neuropathy [LHON]), common variants (eg, m.11778G>A, m.3460G>A, m.14484T>C) MT-ND5 (mitochondrially encoded tRNA leucine 1 [UUA/G], mitochondrially encoded NADH dehydrogenase 5) (eg, mitochondrial encephalopathy with lactic acidosis and stroke-like episodes [MELAS]), common variants (eg, m.3243A>G, m.3271T>C, m.3252A>G, m.13513G>A) MT-RNR1 (mitochondrially encoded 12S RNA) (eg, nonsyndromic hearing loss), common variants (eg, m.1555A>G, m.1494C>T) MT-TK (mitochondrially encoded tRNA lysine) (eg, myoclonic epilepsy with ragged-red fibers [MERRF]), common variants (eg, m.8344A>G, m.8356T>C) MT-TL1 (mitochondrially encoded tRNA leucine 1 [UUA/G]) (eg, diabetes and hearing loss), common variants (eg, m.3243A>G, m.14709 T>C) MT-TL1 MT- TS1, MT-RNR1 (mitochondrially encoded tRNA serine 1 [UCN], mitochondrially encoded 12S RNA) (eg, nonsyndromic sensorineural deafness [including aminoglycoside-induced nonsyndromic deafness]), common variants (eg, m.7445A>G, m.1555A>G) MUTYH (mutY homolog [E. coli]) (eg, MYH-associated polyposis), common variants (eg, Y165C,
582 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
G382D) NOD2 (nucleotide-binding oligomerization domain containing 2) (eg, Crohn's disease, Blau syndrome), common variants (eg, SNP 8, SNP 12, SNP 13) NPM1/ALK (t(2;5)) (eg, anaplastic large cell lymphoma), translocation analysis PABPN1 (poly[A] binding protein, nuclear 1) (eg, oculopharyngeal muscular dystrophy), evaluation to detect abnormal (eg, expanded) alleles PAX8/PPARG (t(2;3) (q13;p25)) (eg, follicular thyroid carcinoma), translocation analysis PPP2R2B (protein phosphatase 2, regulatory subunit B, beta) (eg, spinocerebellar ataxia), evaluation to detect abnormal (eg, expanded) alleles PRSS1 (protease, serine, 1 [trypsin 1]) (eg, hereditary pancreatitis), common variants (eg, N29I, A16V, R122H) PRAME (preferentially expressed antigen in melanoma) (eg, melanoma), expression analysis PYGM (phosphorylase, glycogen, muscle) (eg, glycogen storage disease type V, McArdle disease), common variants (eg, R50X, G205S) RUNX1/RUNX1T1 (t(8;21)) (eg, acute myeloid leukemia) translocation analysis, qualitative, and quantitative, if performed SMN1/SMN2 (survival of motor neuron 1, telomeric/survival of motor neuron 2, centromeric) (eg, spinal muscular atrophy), dosage analysis (eg, carrier testing) (For duplication/deletion analysis of SMN1/SMN2, use 81401) SS18/SSX1 (t(X;18)) (eg, synovial sarcoma), translocation analysis, qualitative, and quantitative, if performed SS18/SSX2 (t(X;18)) (eg, synovial sarcoma), translocation analysis, qualitative, and quantitative, if performed TBP (TATA box binding protein) (eg, spinocerebellar ataxia), evaluation to detect abnormal (eg, expanded) alleles VWF (von Willebrand factor) (eg, von Willebrand disease type 2N), common variants (eg, T791M, R816W, R854Q). 81402 Molecular pathology procedure, Level 3 429 620 904 0 0.00 (eg, >10 SNPs, 2-10 methylated variants, or
CPT copyright 2017 American Medical Association. 583 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
2-10 somatic variants [typically using non- sequencing target variant analysis], immunoglobulin and T-cell receptor gene rearrangements, duplication/deletion variants of 1 exon, loss of heterozygosity [LOH], uniparental disomy [UPD]) Chromosome 1p-/19q- (eg, glial tumors), deletion analysis Chromosome 18q- (eg, D18S55, D18S58, D18S61, D18S64, and D18S69) (eg, colon cancer), allelic imbalance assessment (ie, loss of heterozygosity) COL1A1/PDGFB (t(17;22)) (eg, dermatofibrosarcoma protuberans), translocation analysis, multiple breakpoints, qualitative, and quantitative, if performed CYP21A2 (cytochrome P450, family 21, subfamily A, polypeptide 2) (eg, congenital adrenal hyperplasia, 21-hydroxylase deficiency), common variants (eg, IVS2-13G, P30L, I172N, exon 6 mutation cluster [I235N, V236E, M238K], V281L, L307FfsX6, Q318X, R356W, P453S, G110VfsX21, 30- kb deletion variant) ESR1/PGR (receptor 1/progesterone receptor) ratio (eg, breast cancer) IGH@/BCL2 (t(14;18)) (eg, follicular lymphoma), translocation analysis; major breakpoint region (MBR) and minor cluster region (mcr) breakpoints, qualitative or quantitative MEFV (Mediterranean fever) (eg, familial Mediterranean fever), common variants (eg, E148Q, P369S, F479L, M680I, I692del, M694V, M694I, K695R, V726A, A744S, R761H) MPL (myeloproliferative leukemia virus oncogene, thrombopoietin receptor, TPOR) (eg, myeloproliferative disorder), common variants (eg, W515A, W515K, W515L, W515R) TRD@ (T cell antigen receptor, delta) (eg, leukemia and lymphoma), gene rearrangement analysis, evaluation to detect abnormal clonal population Uniparental disomy (UPD) (eg, Russell-Silver syndrome, Prader- Willi/Angelman syndrome), short tandem repeat (STR) analysis. 81403 Molecular pathology procedure, Level 4 486 703 1024 0 0.00 (eg, analysis of single exon by DNA
584 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or duplication/deletion variants of 2-5 exons) ANG (angiogenin, ribonuclease, RNase A family, 5) (eg, amyotrophic lateral sclerosis), full gene sequence ARX (aristaless-related homeobox) (eg, X-linked lissencephaly with ambiguous genitalia, X- linked mental retardation), duplication/deletion analysis CEL (carboxyl ester lipase [bile salt-stimulated lipase]) (eg, maturity-onset diabetes of the young [MODY]), targeted sequence analysis of exon 11 (eg, c.1785delC, c.1686delT) CTNNB1 (catenin [cadherin-associated protein], beta 1, 88kDa) (eg, desmoid tumors), targeted sequence analysis (eg, exon 3) DAZ/SRY (deleted in azoospermia and sex determining region Y) (eg, male infertility), common deletions (eg, AZFa, AZFb, AZFc, AZFd) DNMT3A (DNA [cytosine-5-]-methyltransferase 3 alpha) (eg, acute myeloid leukemia), targeted sequence analysis (eg, exon 23) EPCAM (epithelial cell adhesion molecule) (eg, Lynch syndrome), duplication/deletion analysis F8 (coagulation factor VIII) (eg, hemophilia A), inversion analysis, intron 1 and intron 22A F12 (coagulation factor XII [Hageman factor]) (eg, angioedema, hereditary, type III; factor XII deficiency), targeted sequence analysis of exon 9 FGFR3 (fibroblast growth factor receptor 3) (eg, isolated craniosynostosis), targeted sequence analysis (eg, exon 7) (For targeted sequence analysis of multiple FGFR3 exons, use 81404) GJB1 (gap junction protein, beta 1) (eg, Charcot-Marie-Tooth X-linked), full gene sequence GNAQ (guanine nucleotide-binding protein G[q] subunit alpha) (eg, uveal melanoma), common variants (eg, R183, Q209) Human erythrocyte antigen gene analyses (eg, SLC14A1 [Kidd blood group], BCAM [Lutheran blood group], ICAM4 [Landsteiner-Wiener blood group], SLC4A1 [Diego blood group], AQP1
CPT copyright 2017 American Medical Association. 585 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
[Colton blood group], ERMAP [Scianna blood group], RHCE [Rh blood group, CcEe antigens], KEL [Kell blood group], DARC [Duffy blood group], GYPA, GYPB, GYPE [MNS blood group], ART4 [Dombrock blood group]) (eg, sickle-cell disease, thalassemia, hemolytic transfusion reactions, hemolytic disease of the fetus or newborn), common variants HRAS (v-Ha- ras Harvey rat sarcoma viral oncogene homolog) (eg, Costello syndrome), exon 2 sequence JAK2 (Janus kinase 2) (eg, myeloproliferative disorder), exon 12 sequence and exon 13 sequence, if performed KCNC3 (potassium voltage- gated channel, Shaw-related subfamily, member 3) (eg, spinocerebellar ataxia), targeted sequence analysis (eg, exon 2) KCNJ2 (potassium inwardly-rectifying channel, subfamily J, member 2) (eg, Andersen-Tawil syndrome), full gene sequence KCNJ11 (potassium inwardly- rectifying channel, subfamily J, member 11) (eg, familial hyperinsulinism), full gene sequence Killer cell immunoglobulin-like receptor (KIR) gene family (eg, hematopoietic stem cell transplantation), genotyping of KIR family genes Known familial variant not otherwise specified, for gene listed in Tier 1 or Tier 2, or identified during a genomic sequencing procedure, DNA sequence analysis, each variant exon (For a known familial variant that is considered a common variant, use specific common variant Tier 1 or Tier 2 code) MC4R (melanocortin 4 receptor) (eg, obesity), full gene sequence MICA (MHC class I polypeptide-related sequence A) (eg, solid organ transplantation), common variants (eg, *001, *002) MPL (myeloproliferative leukemia virus oncogene, thrombopoietin receptor, TPOR) (eg, myeloproliferative disorder), exon 10 sequence MT-RNR1 (mitochondrially encoded 12S RNA) (eg, nonsyndromic hearing loss), full gene sequence MT-TS1 (mitochondrially encoded tRNA serine 1) (eg, nonsyndromic hearing loss), full gene
586 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
sequence NDP (Norrie disease [pseudoglioma]) (eg, Norrie disease), duplication/deletion analysis NHLRC1 (NHL repeat containing 1) (eg, progressive myoclonus epilepsy), full gene sequence PHOX2B (paired-like homeobox 2b) (eg, congenital central hypoventilation syndrome), duplication/deletion analysis PLN (phospholamban) (eg, dilated cardiomyopathy, hypertrophic cardiomyopathy), full gene sequence RHD (Rh blood group, D antigen) (eg, hemolytic disease of the fetus and newborn, Rh maternal/fetal compatibility), deletion analysis (eg, exons 4, 5, and 7, pseudogene) RHD (Rh blood group, D antigen) (eg, hemolytic disease of the fetus and newborn, Rh maternal/fetal compatibility), deletion analysis (eg, exons 4, 5, and 7, pseudogene), performed on cell-free fetal DNA in maternal blood (For human erythrocyte gene analysis of RHD, use a separate unit of 81403) SH2D1A (SH2 domain containing 1A) (eg, X-linked lymphoproliferative syndrome), duplication/deletion analysis SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy), known familial sequence variant(s) TWIST1 (twist homolog 1 [Drosophila]) (eg, Saethre- Chotzen syndrome), duplication/deletion analysis UBA1 (ubiquitin-like modifier activating enzyme 1) (eg, spinal muscular atrophy, X-linked), targeted sequence analysis (eg, exon 15) VHL (von Hippel- Lindau tumor suppressor) (eg, von Hippel- Lindau familial cancer syndrome), deletion/duplication analysis VWF (von Willebrand factor) (eg, von Willebrand disease types 2A, 2B, 2M), targeted sequence analysis (eg, exon 28). 81404 Molecular pathology procedure, Level 5 300 433 631 0 0.00 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation disorder/triplet repeat by Southern blot analysis) ACADS (acyl-CoA
CPT copyright 2017 American Medical Association. 587 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
dehydrogenase, C-2 to C-3 short chain) (eg, short chain acyl-CoA dehydrogenase deficiency), targeted sequence analysis (eg, exons 5 and 6) AFF2 (AF4/FMR2 family, member 2 [FMR2]) (eg, fragile X mental retardation 2 [FRAXE]), characterization of alleles (eg, expanded size and methylation status) AQP2 (aquaporin 2 [collecting duct]) (eg, nephrogenic diabetes insipidus), full gene sequence ARX (aristaless related homeobox) (eg, X-linked lissencephaly with ambiguous genitalia, X-linked mental retardation), full gene sequence AVPR2 (arginine vasopressin receptor 2) (eg, nephrogenic diabetes insipidus), full gene sequence BBS10 (Bardet-Biedl syndrome 10) (eg, Bardet-Biedl syndrome), full gene sequence BTD (biotinidase) (eg, biotinidase deficiency), full gene sequence C10orf2 (chromosome 10 open reading frame 2) (eg, mitochondrial DNA depletion syndrome), full gene sequence CAV3 (caveolin 3) (eg, CAV3-related distal myopathy, limb-girdle muscular dystrophy type 1C), full gene sequence CD40LG (CD40 ligand) (eg, X- linked hyper IgM syndrome), full gene sequence CDKN2A (cyclin-dependent kinase inhibitor 2A) (eg, CDKN2A-related cutaneous malignant melanoma, familial atypical mole-malignant melanoma syndrome), full gene sequence CLRN1 (clarin 1) (eg, Usher syndrome, type 3), full gene sequence COX6B1 (cytochrome c oxidase subunit VIb polypeptide 1) (eg, mitochondrial respiratory chain complex IV deficiency), full gene sequence CPT2 (carnitine palmitoyltransferase 2) (eg, carnitine palmitoyltransferase II deficiency), full gene sequence CRX (cone- rod homeobox) (eg, cone-rod dystrophy 2, Leber congenital amaurosis), full gene sequence CSTB (cystatin B [stefin B]) (eg, Unverricht-Lundborg disease), full gene sequence CYP1B1 (cytochrome P450, family 1, subfamily B, polypeptide 1) (eg, primary congenital glaucoma), full gene sequence DMPK (dystrophia myotonica- protein kinase) (eg, myotonic dystrophy
588 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
type 1), characterization of abnormal (eg, expanded) alleles EGR2 (early growth response 2) (eg, Charcot-Marie-Tooth), full gene sequence EMD (emerin) (eg, Emery- Dreifuss muscular dystrophy), duplication/deletion analysis EPM2A (epilepsy, progressive myoclonus type 2A, Lafora disease [laforin]) (eg, progressive myoclonus epilepsy), full gene sequence FGF23 (fibroblast growth factor 23) (eg, hypophosphatemic rickets), full gene sequence FGFR2 (fibroblast growth factor receptor 2) (eg, craniosynostosis, Apert syndrome, Crouzon syndrome), targeted sequence analysis (eg, exons 8, 10) FGFR3 (fibroblast growth factor receptor 3) (eg, achondroplasia, hypochondroplasia), targeted sequence analysis (eg, exons 8, 11, 12, 13) FHL1 (four and a half LIM domains 1) (eg, Emery-Dreifuss muscular dystrophy), full gene sequence FKRP (fukutin related protein) (eg, congenital muscular dystrophy type 1C [MDC1C], limb-girdle muscular dystrophy [LGMD] type 2I), full gene sequence FOXG1 (forkhead box G1) (eg, Rett syndrome), full gene sequence FSHMD1A (facioscapulohumeral muscular dystrophy 1A) (eg, facioscapulohumeral muscular dystrophy), evaluation to detect abnormal (eg, deleted) alleles FSHMD1A (facioscapulohumeral muscular dystrophy 1A) (eg, facioscapulohumeral muscular dystrophy), characterization of haplotype(s) (ie, chromosome 4A and 4B haplotypes) FXN (frataxin) (eg, Friedreich ataxia), full gene sequence GH1 (growth hormone 1) (eg, growth hormone deficiency), full gene sequence GP1BB (glycoprotein Ib [platelet], beta polypeptide) (eg, Bernard- Soulier syndrome type B), full gene sequence (For common deletion variants of alpha globin 1 and alpha globin 2 genes, use 81257) HNF1B (HNF1 homeobox B) (eg, maturity-onset diabetes of the young [MODY]), duplication/deletion analysis HRAS (v-Ha-ras Harvey rat sarcoma viral oncogene homolog) (eg, Costello
CPT copyright 2017 American Medical Association. 589 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
syndrome), full gene sequence HSD3B2 (hydroxy-delta-5-steroid dehydrogenase, 3 beta- and steroid delta-isomerase 2) (eg, 3- beta-hydroxysteroid dehydrogenase type II deficiency), full gene sequence HSD11B2 (hydroxysteroid [11-beta] dehydrogenase 2) (eg, mineralocorticoid excess syndrome), full gene sequence HSPB1 (heat shock 27kDa protein 1) (eg, Charcot-Marie-Tooth disease), full gene sequence INS (insulin) (eg, diabetes mellitus), full gene sequence KCNJ1 (potassium inwardly-rectifying channel, subfamily J, member 1) (eg, Bartter syndrome), full gene sequence KCNJ10 (potassium inwardly-rectifying channel, subfamily J, member 10) (eg, SeSAME syndrome, EAST syndrome, sensorineural hearing loss), full gene sequence LITAF (lipopolysaccharide- induced TNF factor) (eg, Charcot-Marie- Tooth), full gene sequence MEFV (Mediterranean fever) (eg, familial Mediterranean fever), full gene sequence MEN1 (multiple endocrine neoplasia I) (eg, multiple endocrine neoplasia type 1, Wermer syndrome), duplication/deletion analysis MMACHC (methylmalonic aciduria [cobalamin deficiency] cblC type, with homocystinuria) (eg, methylmalonic acidemia and homocystinuria), full gene sequence MPV17 (MpV17 mitochondrial inner membrane protein) (eg, mitochondrial DNA depletion syndrome), duplication/deletion analysis NDP (Norrie disease [pseudoglioma]) (eg, Norrie disease), full gene sequence NDUFA1 (NADH dehydrogenase [ubiquinone] 1 alpha subcomplex, 1, 7.5kDa) (eg, Leigh syndrome, mitochondrial complex I deficiency), full gene sequence NDUFAF2 (NADH dehydrogenase [ubiquinone] 1 alpha subcomplex, assembly factor 2) (eg, Leigh syndrome, mitochondrial complex I deficiency), full gene sequence NDUFS4 (NADH dehydrogenase [ubiquinone] Fe-S protein 4, 18kDa [NADH-coenzyme Q reductase]) (eg, Leigh syndrome, mitochondrial complex I deficiency), full
590 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
gene sequence NIPA1 (non-imprinted in Prader-Willi/Angelman syndrome 1) (eg, spastic paraplegia), full gene sequence NLGN4X (neuroligin 4, X-linked) (eg, autism spectrum disorders), duplication/deletion analysis NPC2 (Niemann-Pick disease, type C2 [epididymal secretory protein E1]) (eg, Niemann-Pick disease type C2), full gene sequence NR0B1 (nuclear receptor subfamily 0, group B, member 1) (eg, congenital adrenal hypoplasia), full gene sequence PDX1 (pancreatic and duodenal homeobox 1) (eg, maturity-onset diabetes of the young [MODY]), full gene sequence PHOX2B (paired-like homeobox 2b) (eg, congenital central hypoventilation syndrome), full gene sequence PIK3CA (phosphatidylinositol-4,5-bisphosphate 3- kinase, catalytic subunit alpha) (eg, colorectal cancer), targeted sequence analysis (eg, exons 9 and 20) PLP1 (proteolipid protein 1) (eg, Pelizaeus- Merzbacher disease, spastic paraplegia), duplication/deletion analysis PQBP1 (polyglutamine binding protein 1) (eg, Renpenning syndrome), duplication/deletion analysis PRNP (prion protein) (eg, genetic prion disease), full gene sequence PROP1 (PROP paired-like homeobox 1) (eg, combined pituitary hormone deficiency), full gene sequence PRPH2 (peripherin 2 [retinal degeneration, slow]) (eg, retinitis pigmentosa), full gene sequence PRSS1 (protease, serine, 1 [trypsin 1]) (eg, hereditary pancreatitis), full gene sequence RAF1 (v-raf-1 murine leukemia viral oncogene homolog 1) (eg, LEOPARD syndrome), targeted sequence analysis (eg, exons 7, 12, 14, 17) RET (ret proto-oncogene) (eg, multiple endocrine neoplasia, type 2B and familial medullary thyroid carcinoma), common variants (eg, M918T, 2647_2648delinsTT, A883F) RHO (rhodopsin) (eg, retinitis pigmentosa), full gene sequence RP1 (retinitis pigmentosa 1) (eg, retinitis pigmentosa), full gene sequence SCN1B (sodium channel, voltage-
CPT copyright 2017 American Medical Association. 591 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
gated, type I, beta) (eg, Brugada syndrome), full gene sequence SCO2 (SCO cytochrome oxidase deficient homolog 2 [SCO1L]) (eg, mitochondrial respiratory chain complex IV deficiency), full gene sequence SDHC (succinate dehydrogenase complex, subunit C, integral membrane protein, 15kDa) (eg, hereditary paraganglioma- pheochromocytoma syndrome), duplication/deletion analysis SDHD (succinate dehydrogenase complex, subunit D, integral membrane protein) (eg, hereditary paraganglioma), full gene sequence SGCG (sarcoglycan, gamma [35kDa dystrophin-associated glycoprotein]) (eg, limb-girdle muscular dystrophy), duplication/deletion analysis SH2D1A (SH2 domain containing 1A) (eg, X-linked lymphoproliferative syndrome), full gene sequence SLC16A2 (solute carrier family 16, member 2 [thyroid hormone transporter]) (eg, specific thyroid hormone cell transporter deficiency, Allan-Herndon- Dudley syndrome), duplication/deletion analysis SLC25A20 (solute carrier family 25 [carnitine/acylcarnitine translocase], member 20) (eg, carnitine-acylcarnitine translocase deficiency), duplication/deletion analysis SLC25A4 (solute carrier family 25 [mitochondrial carrier; adenine nucleotide translocator], member 4) (eg, progressive external ophthalmoplegia), full gene sequence SOD1 (superoxide dismutase 1, soluble) (eg, amyotrophic lateral sclerosis), full gene sequence SPINK1 (serine peptidase inhibitor, Kazal type 1) (eg, hereditary pancreatitis), full gene sequence STK11 (serine/threonine kinase 11) (eg, Peutz-Jeghers syndrome), duplication/deletion analysis TACO1 (translational activator of mitochondrial encoded cytochrome c oxidase I) (eg, mitochondrial respiratory chain complex IV deficiency), full gene sequence THAP1 (THAP domain containing, apoptosis associated protein 1) (eg, torsion dystonia), full gene sequence TOR1A (torsin family 1, member A [torsin A]) (eg, torsion
592 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
dystonia), full gene sequence TP53 (tumor protein 53) (eg, tumor samples), targeted sequence analysis of 2-5 exons TTPA (tocopherol [alpha] transfer protein) (eg, ataxia), full gene sequence TTR (transthyretin) (eg, familial transthyretin amyloidosis), full gene sequence TWIST1 (twist homolog 1 [Drosophila]) (eg, Saethre-Chotzen syndrome), full gene sequence TYR (tyrosinase [oculocutaneous albinism IA]) (eg, oculocutaneous albinism IA), full gene sequence USH1G (Usher syndrome 1G [autosomal recessive]) (eg, Usher syndrome, type 1), full gene sequence VHL (von Hippel-Lindau tumor suppressor) (eg, von Hippel-Lindau familial cancer syndrome), full gene sequence VWF (von Willebrand factor) (eg, von Willebrand disease type 1C), targeted sequence analysis (eg, exons 26, 27, 37) ZEB2 (zinc finger E-box binding homeobox 2) (eg, Mowat-Wilson syndrome), duplication/deletion analysis ZNF41 (zinc finger protein 41) (eg, X-linked mental retardation 89), full gene sequence. 81405 Molecular pathology procedure, Level 6 306 442 643 0 0.00 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array analysis) ABCD1 (ATP-binding cassette, sub-family D [ALD], member 1) (eg, adrenoleukodystrophy), full gene sequence ACADS (acyl-CoA dehydrogenase, C-2 to C-3 short chain) (eg, short chain acyl-CoA dehydrogenase deficiency), full gene sequence ACTA2 (actin, alpha 2, smooth muscle, aorta) (eg, thoracic aortic aneurysms and aortic dissections), full gene sequence ACTC1 (actin, alpha, cardiac muscle 1) (eg, familial hypertrophic cardiomyopathy), full gene sequence ANKRD1 (ankyrin repeat domain 1) (eg, dilated cardiomyopathy), full gene sequence APTX (aprataxin) (eg, ataxia with oculomotor apraxia 1), full gene sequence AR (androgen receptor) (eg, androgen insensitivity syndrome), full gene sequence
CPT copyright 2017 American Medical Association. 593 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
ARSA (arylsulfatase A) (eg, arylsulfatase A deficiency), full gene sequence BCKDHA (branched chain keto acid dehydrogenase E1, alpha polypeptide) (eg, maple syrup urine disease, type 1A), full gene sequence BCS1L (BCS1-like [S. cerevisiae]) (eg, Leigh syndrome, mitochondrial complex III deficiency, GRACILE syndrome), full gene sequence BMPR2 (bone morphogenetic protein receptor, type II [serine/threonine kinase]) (eg, heritable pulmonary arterial hypertension), duplication/deletion analysis CASQ2 (calsequestrin 2 [cardiac muscle]) (eg, catecholaminergic polymorphic ventricular tachycardia), full gene sequence CASR (calcium-sensing receptor) (eg, hypocalcemia), full gene sequence CDKL5 (cyclin-dependent kinase-like 5) (eg, early infantile epileptic encephalopathy), duplication/deletion analysis CHRNA4 (cholinergic receptor, nicotinic, alpha 4) (eg, nocturnal frontal lobe epilepsy), full gene sequence CHRNB2 (cholinergic receptor, nicotinic, beta 2 [neuronal]) (eg, nocturnal frontal lobe epilepsy), full gene sequence COX10 (COX10 homolog, cytochrome c oxidase assembly protein) (eg, mitochondrial respiratory chain complex IV deficiency), full gene sequence COX15 (COX15 homolog, cytochrome c oxidase assembly protein) (eg, mitochondrial respiratory chain complex IV deficiency), full gene sequence CPOX (coproporphyrinogen oxidase) (eg, hereditary coproporphyria), full gene sequence CTRC (chymotrypsin C) (eg, hereditary pancreatitis), full gene sequence CYP11B1 (cytochrome P450, family 11, subfamily B, polypeptide 1) (eg, congenital adrenal hyperplasia), full gene sequence CYP17A1 (cytochrome P450, family 17, subfamily A, polypeptide 1) (eg, congenital adrenal hyperplasia), full gene sequence CYP21A2 (cytochrome P450, family 21, subfamily A, polypeptide2) (eg, steroid 21- hydroxylase isoform, congenital adrenal hyperplasia), full gene sequence Cytogenomic constitutional targeted
594 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
microarray analysis of chromosome 22q13 by interrogation of genomic regions for copy number and single nucleotide polymorphism (SNP) variants for chromosomal abnormalities (When performing genome-wide cytogenomic constitutional microarray analysis, see 81228, 81229) (Do not report analyte- specific molecular pathology procedures separately when the specific analytes are included as part of the microarray analysis of chromosome 22q13) (Do not report 88271 when performing cytogenomic microarray analysis) DBT (dihydrolipoamide branched chain transacylase E2) (eg, maple syrup urine disease, type 2), duplication/deletion analysis DCX (doublecortin) (eg, X-linked lissencephaly), full gene sequence DES (desmin) (eg, myofibrillar myopathy), full gene sequence DFNB59 (deafness, autosomal recessive 59) (eg, autosomal recessive nonsyndromic hearing impairment), full gene sequence DGUOK (deoxyguanosine kinase) (eg, hepatocerebral mitochondrial DNA depletion syndrome), full gene sequence DHCR7 (7-dehydrocholesterol reductase) (eg, Smith-Lemli-Opitz syndrome), full gene sequence EIF2B2 (eukaryotic translation initiation factor 2B, subunit 2 beta, 39kDa) (eg, leukoencephalopathy with vanishing white matter), full gene sequence EMD (emerin) (eg, Emery-Dreifuss muscular dystrophy), full gene sequence ENG (endoglin) (eg, hereditary hemorrhagic telangiectasia, type 1), duplication/deletion analysis EYA1 (eyes absent homolog 1 [Drosophila]) (eg, branchio-oto-renal [BOR] spectrum disorders), duplication/deletion analysis FGFR1 (fibroblast growth factor receptor 1) (eg, Kallmann syndrome 2), full gene sequence FH (fumarate hydratase) (eg, fumarate hydratase deficiency, hereditary leiomyomatosis with renal cell cancer), full gene sequence FKTN (fukutin) (eg, limb- girdle muscular dystrophy [LGMD] type
CPT copyright 2017 American Medical Association. 595 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
2M or 2L), full gene sequence FTSJ1 (FtsJ RNA methyltransferase homolog 1 [E. coli]) (eg, X-linked mental retardation 9), duplication/deletion analysis GABRG2 (gamma-aminobutyric acid [GABA] A receptor, gamma 2) (eg, generalized epilepsy with febrile seizures), full gene sequence GCH1 (GTP cyclohydrolase 1) (eg, autosomal dominant dopa-responsive dystonia), full gene sequence GDAP1 (ganglioside-induced differentiation- associated protein 1) (eg, Charcot-Marie- Tooth disease), full gene sequence GFAP (glial fibrillary acidic protein) (eg, Alexander disease), full gene sequence GHR (growth hormone receptor) (eg, Laron syndrome), full gene sequence GHRHR (growth hormone releasing hormone receptor) (eg, growth hormone deficiency), full gene sequence GLA (galactosidase, alpha) (eg, Fabry disease), full gene sequence HNF1A (HNF1 homeobox A) (eg, maturity-onset diabetes of the young [MODY]), full gene sequence HNF1B (HNF1 homeobox B) (eg, maturity-onset diabetes of the young [MODY]), full gene sequence HTRA1 (HtrA serine peptidase 1) (eg, macular degeneration), full gene sequence IDS (iduronate 2-sulfatase) (eg, mucopolysacchridosis, type II), full gene sequence IL2RG (interleukin 2 receptor, gamma) (eg, X-linked severe combined immunodeficiency), full gene sequence ISPD (isoprenoid synthase domain containing) (eg, muscle-eye-brain disease, Walker-Warburg syndrome), full gene sequence KRAS (Kirsten rat sarcoma viral oncogene homolog) (eg, Noonan syndrome), full gene sequence LAMP2 (lysosomal-associated membrane protein 2) (eg, Danon disease), full gene sequence LDLR (low density lipoprotein receptor) (eg, familial hypercholesterolemia), duplication/deletion analysis MEN1 (multiple endocrine neoplasia I) (eg, multiple endocrine neoplasia type 1, Wermer syndrome), full gene sequence MMAA (methylmalonic aciduria
596 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
[cobalamine deficiency] type A) (eg, MMAA-related methylmalonic acidemia), full gene sequence MMAB (methylmalonic aciduria [cobalamine deficiency] type B) (eg, MMAA-related methylmalonic acidemia), full gene sequence MPI (mannose phosphate isomerase) (eg, congenital disorder of glycosylation 1b), full gene sequence MPV17 (MpV17 mitochondrial inner membrane protein) (eg, mitochondrial DNA depletion syndrome), full gene sequence MPZ (myelin protein zero) (eg, Charcot-Marie-Tooth), full gene sequence MTM1 (myotubularin 1) (eg, X- linked centronuclear myopathy), duplication/deletion analysis MYL2 (myosin, light chain 2, regulatory, cardiac, slow) (eg, familial hypertrophic cardiomyopathy), full gene sequence MYL3 (myosin, light chain 3, alkali, ventricular, skeletal, slow) (eg, familial hypertrophic cardiomyopathy), full gene sequence MYOT (myotilin) (eg, limb-girdle muscular dystrophy), full gene sequence NDUFS7 (NADH dehydrogenase [ubiquinone] Fe-S protein 7, 20kDa [NADH-coenzyme Q reductase]) (eg, Leigh syndrome, mitochondrial complex I deficiency), full gene sequence NDUFS8 (NADH dehydrogenase [ubiquinone] Fe-S protein 8, 23kDa [NADH-coenzyme Q reductase]) (eg, Leigh syndrome, mitochondrial complex I deficiency), full gene sequence NDUFV1 (NADH dehydrogenase [ubiquinone] flavoprotein 1, 51kDa) (eg, Leigh syndrome, mitochondrial complex I deficiency), full gene sequence NEFL (neurofilament, light polypeptide) (eg, Charcot-Marie-Tooth), full gene sequence NF2 (neurofibromin 2 [merlin]) (eg, neurofibromatosis, type 2), duplication/deletion analysis NLGN3 (neuroligin 3) (eg, autism spectrum disorders), full gene sequence NLGN4X (neuroligin 4, X-linked) (eg, autism spectrum disorders), full gene sequence NPHP1 (nephronophthisis 1 [juvenile]) (eg, Joubert syndrome), deletion analysis, and
CPT copyright 2017 American Medical Association. 597 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
duplication analysis, if performed NPHS2 (nephrosis 2, idiopathic, steroid-resistant [podocin]) (eg, steroid-resistant nephrotic syndrome), full gene sequence NSD1 (nuclear receptor binding SET domain protein 1) (eg, Sotos syndrome), duplication/deletion analysis OTC (ornithine carbamoyltransferase) (eg, ornithine transcarbamylase deficiency), full gene sequence PAFAH1B1 (platelet- activating factor acetylhydrolase 1b, regulatory subunit 1 [45kDa]) (eg, lissencephaly, Miller-Dieker syndrome), duplication/deletion analysis PARK2 (Parkinson protein 2, E3 ubiquitin protein ligase [parkin]) (eg, Parkinson disease), duplication/deletion analysis PCCA (propionyl CoA carboxylase, alpha polypeptide) (eg, propionic acidemia, type 1), duplication/deletion analysis PCDH19 (protocadherin 19) (eg, epileptic encephalopathy), full gene sequence PDHA1 (pyruvate dehydrogenase [lipoamide] alpha 1) (eg, lactic acidosis), duplication/deletion analysis PDHB (pyruvate dehydrogenase [lipoamide] beta) (eg, lactic acidosis), full gene sequence PINK1 (PTEN induced putative kinase 1) (eg, Parkinson disease), full gene sequence PKLR (pyruvate kinase, liver and RBC) (eg, pyruvate kinase deficiency), full gene sequence PLP1 (proteolipid protein 1) (eg, Pelizaeus-Merzbacher disease, spastic paraplegia), full gene sequence POU1F1 (POU class 1 homeobox 1) (eg, combined pituitary hormone deficiency), full gene sequence PRX (periaxin) (eg, Charcot- Marie-Tooth disease), full gene sequence PQBP1 (polyglutamine binding protein 1) (eg, Renpenning syndrome), full gene sequence PSEN1 (presenilin 1) (eg, Alzheimer disease), full gene sequence RAB7A (RAB7A, member RAS oncogene family) (eg, Charcot-Marie-Tooth disease), full gene sequence RAI1 (retinoic acid induced 1) (eg, Smith-Magenis syndrome), full gene sequence REEP1 (receptor accessory protein 1) (eg, spastic
598 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
paraplegia), full gene sequence RET (ret proto-oncogene) (eg, multiple endocrine neoplasia, type 2A and familial medullary thyroid carcinoma), targeted sequence analysis (eg, exons 10, 11, 13-16) RPS19 (ribosomal protein S19) (eg, Diamond- Blackfan anemia), full gene sequence RRM2B (ribonucleotide reductase M2 B [TP53 inducible]) (eg, mitochondrial DNA depletion), full gene sequence SCO1 (SCO cytochrome oxidase deficient homolog 1) (eg, mitochondrial respiratory chain complex IV deficiency), full gene sequence SDHB (succinate dehydrogenase complex, subunit B, iron sulfur) (eg, hereditary paraganglioma), full gene sequence SDHC (succinate dehydrogenase complex, subunit C, integral membrane protein, 15kDa) (eg, hereditary paraganglioma- pheochromocytoma syndrome), full gene sequence SGCA (sarcoglycan, alpha [50kDa dystrophin-associated glycoprotein]) (eg, limb-girdle muscular dystrophy), full gene sequence SGCB (sarcoglycan, beta [43kDa dystrophin- associated glycoprotein]) (eg, limb-girdle muscular dystrophy), full gene sequence SGCD (sarcoglycan, delta [35kDa dystrophin-associated glycoprotein]) (eg, limb-girdle muscular dystrophy), full gene sequence SGCE (sarcoglycan, epsilon) (eg, myoclonic dystonia), duplication/deletion analysis SGCG (sarcoglycan, gamma [35kDa dystrophin-associated glycoprotein]) (eg, limb-girdle muscular dystrophy), full gene sequence SHOC2 (soc-2 suppressor of clear homolog) (eg, Noonan-like syndrome with loose anagen hair), full gene sequence SHOX (short stature homeobox) (eg, Langer mesomelic dysplasia), full gene sequence SIL1 (SIL1 homolog, endoplasmic reticulum chaperone [S. cerevisiae]) (eg, ataxia), full gene sequence SLC2A1 (solute carrier family 2 [facilitated glucose transporter], member 1) (eg, glucose transporter type 1 [GLUT 1] deficiency syndrome), full gene sequence SLC16A2 (solute carrier family 16,
CPT copyright 2017 American Medical Association. 599 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
member 2 [thyroid hormone transporter]) (eg, specific thyroid hormone cell transporter deficiency, Allan-Herndon- Dudley syndrome), full gene sequence SLC22A5 (solute carrier family 22 [organic cation/carnitine transporter], member 5) (eg, systemic primary carnitine deficiency), full gene sequence SLC25A20 (solute carrier family 25 [carnitine/acylcarnitine translocase], member 20) (eg, carnitine- acylcarnitine translocase deficiency), full gene sequence SMAD4 (SMAD family member 4) (eg, hemorrhagic telangiectasia syndrome, juvenile polyposis), duplication/deletion analysis SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy), full gene sequence SPAST (spastin) (eg, spastic paraplegia), duplication/deletion analysis SPG7 (spastic paraplegia 7 [pure and complicated autosomal recessive]) (eg, spastic paraplegia), duplication/deletion analysis SPRED1 (sprouty-related, EVH1 domain containing 1) (eg, Legius syndrome), full gene sequence STAT3 (signal transducer and activator of transcription 3 [acute-phase response factor]) (eg, autosomal dominant hyper-IgE syndrome), targeted sequence analysis (eg, exons 12, 13, 14, 16, 17, 20, 21) STK11 (serine/threonine kinase 11) (eg, Peutz- Jeghers syndrome), full gene sequence SURF1 (surfeit 1) (eg, mitochondrial respiratory chain complex IV deficiency), full gene sequence TARDBP (TAR DNA binding protein) (eg, amyotrophic lateral sclerosis), full gene sequence TBX5 (T-box 5) (eg, Holt-Oram syndrome), full gene sequence TCF4 (transcription factor 4) (eg, Pitt-Hopkins syndrome), duplication/deletion analysis TGFBR1 (transforming growth factor, beta receptor 1) (eg, Marfan syndrome), full gene sequence TGFBR2 (transforming growth factor, beta receptor 2) (eg, Marfan syndrome), full gene sequence THRB (thyroid hormone receptor, beta) (eg, thyroid hormone resistance, thyroid
600 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
hormone beta receptor deficiency), full gene sequence or targeted sequence analysis of >5 exons TK2 (thymidine kinase 2, mitochondrial) (eg, mitochondrial DNA depletion syndrome), full gene sequence TNNC1 (troponin C type 1 [slow]) (eg, hypertrophic cardiomyopathy or dilated cardiomyopathy), full gene sequence TNNI3 (troponin I, type 3 [cardiac]) (eg, familial hypertrophic cardiomyopathy), full gene sequence TP53 (tumor protein 53) (eg, Li-Fraumeni syndrome, tumor samples), full gene sequence or targeted sequence analysis of >5 exons TPM1 (tropomyosin 1 [alpha]) (eg, familial hypertrophic cardiomyopathy), full gene sequence TSC1 (tuberous sclerosis 1) (eg, tuberous sclerosis), duplication/deletion analysis TYMP (thymidine phosphorylase) (eg, mitochondrial DNA depletion syndrome), full gene sequence VWF (von Willebrand factor) (eg, von Willebrand disease type 2N), targeted sequence analysis (eg, exons 18-20, 23-25) WT1 (Wilms tumor 1) (eg, Denys-Drash syndrome, familial Wilms tumor), full gene sequence ZEB2 (zinc finger E-box binding homeobox 2) (eg, Mowat-Wilson syndrome), full gene sequence. 81406 Molecular pathology procedure, Level 7 307 443 646 0 0.00 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons, cytogenomic array analysis for neoplasia) ACADVL (acyl-CoA dehydrogenase, very long chain) (eg, very long chain acyl-coenzyme A dehydrogenase deficiency), full gene sequence ACTN4 (actinin, alpha 4) (eg, focal segmental glomerulosclerosis), full gene sequence AFG3L2 (AFG3 ATPase family gene 3-like 2 [S. cerevisiae]) (eg, spinocerebellar ataxia), full gene sequence AIRE (autoimmune regulator) (eg, autoimmune polyendocrinopathy syndrome type 1), full gene sequence ALDH7A1 (aldehyde dehydrogenase 7 family, member A1) (eg, pyridoxine-dependent epilepsy), full gene
CPT copyright 2017 American Medical Association. 601 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
sequence ANO5 (anoctamin 5) (eg, limb- girdle muscular dystrophy), full gene sequence ANOS1 (anosmin-1) (eg, Kallmann syndrome 1), full gene sequence APP (amyloid beta [A4] precursor protein) (eg, Alzheimer disease), full gene sequence ASS1 (argininosuccinate synthase 1) (eg, citrullinemia type I), full gene sequence ATL1 (atlastin GTPase 1) (eg, spastic paraplegia), full gene sequence ATP1A2 (ATPase, Na+/K+ transporting, alpha 2 polypeptide) (eg, familial hemiplegic migraine), full gene sequence ATP7B (ATPase, Cu++ transporting, beta polypeptide) (eg, Wilson disease), full gene sequence BBS1 (Bardet-Biedl syndrome 1) (eg, Bardet-Biedl syndrome), full gene sequence BBS2 (Bardet-Biedl syndrome 2) (eg, Bardet-Biedl syndrome), full gene sequence BCKDHB (branched-chain keto acid dehydrogenase E1, beta polypeptide) (eg, maple syrup urine disease, type 1B), full gene sequence BEST1 (bestrophin 1) (eg, vitelliform macular dystrophy), full gene sequence BMPR2 (bone morphogenetic protein receptor, type II [serine/threonine kinase]) (eg, heritable pulmonary arterial hypertension), full gene sequence BRAF (B-Raf proto-oncogene, serine/threonine kinase) (eg, Noonan syndrome), full gene sequence BSCL2 (Berardinelli-Seip congenital lipodystrophy 2 [seipin]) (eg, Berardinelli-Seip congenital lipodystrophy), full gene sequence BTK (Bruton agammaglobulinemia tyrosine kinase) (eg, X-linked agammaglobulinemia), full gene sequence CACNB2 (calcium channel, voltage- dependent, beta 2 subunit) (eg, Brugada syndrome), full gene sequence CAPN3 (calpain 3) (eg, limb-girdle muscular dystrophy [LGMD] type 2A, calpainopathy), full gene sequence CBS (cystathionine-beta-synthase) (eg, homocystinuria, cystathionine beta-synthase deficiency), full gene sequence CDH1 (cadherin 1, type 1, E-cadherin [epithelial]) (eg, hereditary diffuse gastric cancer), full
602 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
gene sequence CDKL5 (cyclin-dependent kinase-like 5) (eg, early infantile epileptic encephalopathy), full gene sequence CLCN1 (chloride channel 1, skeletal muscle) (eg, myotonia congenita), full gene sequence CLCNKB (chloride channel, voltage-sensitive Kb) (eg, Bartter syndrome 3 and 4b), full gene sequence CNTNAP2 (contactin-associated protein-like 2) (eg, Pitt-Hopkins-like syndrome 1), full gene sequence COL6A2 (collagen, type VI, alpha 2) (eg, collagen type VI-related disorders), duplication/deletion analysis CPT1A (carnitine palmitoyltransferase 1A [liver]) (eg, carnitine palmitoyltransferase 1A [CPT1A] deficiency), full gene sequence CRB1 (crumbs homolog 1 [Drosophila]) (eg, Leber congenital amaurosis), full gene sequence CREBBP (CREB binding protein) (eg, Rubinstein- Taybi syndrome), duplication/deletion analysis Cytogenomic microarray analysis, neoplasia (eg, interrogation of copy number, and loss-of-heterozygosity via single nucleotide polymorphism [SNP]- based comparative genomic hybridization [CGH] microarray analysis) (Do not report analyte-specific molecular pathology procedures separately when the specific analytes are included as part of the cytogenomic microarray analysis for neoplasia) (Do not report 88271 when performing cytogenomic microarray analysis) DBT (dihydrolipoamide branched chain transacylase E2) (eg, maple syrup urine disease, type 2), full gene sequence DLAT (dihydrolipoamide S- acetyltransferase) (eg, pyruvate dehydrogenase E2 deficiency), full gene sequence DLD (dihydrolipoamide dehydrogenase) (eg, maple syrup urine disease, type III), full gene sequence DSC2 (desmocollin) (eg, arrhythmogenic right ventricular dysplasia/cardiomyopathy 11), full gene sequence DSG2 (desmoglein 2) (eg, arrhythmogenic right ventricular dysplasia/cardiomyopathy 10), full gene sequence DSP (desmoplakin) (eg,
CPT copyright 2017 American Medical Association. 603 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
arrhythmogenic right ventricular dysplasia/cardiomyopathy 8), full gene sequence EFHC1 (EF-hand domain [C- terminal] containing 1) (eg, juvenile myoclonic epilepsy), full gene sequence EIF2B3 (eukaryotic translation initiation factor 2B, subunit 3 gamma, 58kDa) (eg, leukoencephalopathy with vanishing white matter), full gene sequence EIF2B4 (eukaryotic translation initiation factor 2B, subunit 4 delta, 67kDa) (eg, leukoencephalopathy with vanishing white matter), full gene sequence EIF2B5 (eukaryotic translation initiation factor 2B, subunit 5 epsilon, 82kDa) (eg, childhood ataxia with central nervous system hypomyelination/vanishing white matter), full gene sequence ENG (endoglin) (eg, hereditary hemorrhagic telangiectasia, type 1), full gene sequence EYA1 (eyes absent homolog 1 [Drosophila]) (eg, branchio-oto- renal [BOR] spectrum disorders), full gene sequence F8 (coagulation factor VIII) (eg, hemophilia A), duplication/deletion analysis FAH (fumarylacetoacetate hydrolase [fumarylacetoacetase]) (eg, tyrosinemia, type 1), full gene sequence FASTKD2 (FAST kinase domains 2) (eg, mitochondrial respiratory chain complex IV deficiency), full gene sequence FIG4 (FIG4 homolog, SAC1 lipid phosphatase domain containing [S. cerevisiae]) (eg, Charcot- Marie-Tooth disease), full gene sequence FTSJ1 (FtsJ RNA methyltransferase homolog 1 [E. coli]) (eg, X-linked mental retardation 9), full gene sequence FUS (fused in sarcoma) (eg, amyotrophic lateral sclerosis), full gene sequence GAA (glucosidase, alpha; acid) (eg, glycogen storage disease type II [Pompe disease]), full gene sequence GALC (galactosylceramidase) (eg, Krabbe disease), full gene sequence GALT (galactose-1-phosphate uridylyltransferase) (eg, galactosemia), full gene sequence GARS (glycyl-tRNA synthetase) (eg, Charcot-Marie-Tooth disease), full gene sequence GCDH (glutaryl-CoA
604 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
dehydrogenase) (eg, glutaricacidemia type 1), full gene sequence GCK (glucokinase [hexokinase 4]) (eg, maturity-onset diabetes of the young [MODY]), full gene sequence GLUD1 (glutamate dehydrogenase 1) (eg, familial hyperinsulinism), full gene sequence GNE (glucosamine [UDP-N- acetyl]-2-epimerase/N-acetylmannosamine kinase) (eg, inclusion body myopathy 2 [IBM2], Nonaka myopathy), full gene sequence GRN (granulin) (eg, frontotemporal dementia), full gene sequence HADHA (hydroxyacyl-CoA dehydrogenase/3-ketoacyl-CoA thiolase/enoyl-CoA hydratase [trifunctional protein] alpha subunit) (eg, long chain acyl- coenzyme A dehydrogenase deficiency), full gene sequence HADHB (hydroxyacyl- CoA dehydrogenase/3-ketoacyl-CoA thiolase/enoyl-CoA hydratase [trifunctional protein], beta subunit) (eg, trifunctional protein deficiency), full gene sequence HEXA (hexosaminidase A, alpha polypeptide) (eg, Tay-Sachs disease), full gene sequence HLCS (HLCS holocarboxylase synthetase) (eg, holocarboxylase synthetase deficiency), full gene sequence HMBS (hydroxymethylbilane synthase) (eg, acute intermittent porphyria), full gene sequence HNF4A (hepatocyte nuclear factor 4, alpha) (eg, maturity-onset diabetes of the young [MODY]), full gene sequence IDUA (iduronidase, alpha-L-) (eg, mucopolysaccharidosis type I), full gene sequence INF2 (inverted formin, FH2 and WH2 domain containing) (eg, focal segmental glomerulosclerosis), full gene sequence IVD (isovaleryl-CoA dehydrogenase) (eg, isovaleric acidemia), full gene sequence JAG1 (jagged 1) (eg, Alagille syndrome), duplication/deletion analysis JUP (junction plakoglobin) (eg, arrhythmogenic right ventricular dysplasia/cardiomyopathy 11), full gene sequence KCNH2 (potassium voltage-gated channel, subfamily H [eag-related], member 2) (eg, short QT syndrome, long QT
CPT copyright 2017 American Medical Association. 605 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
syndrome), full gene sequence KCNQ1 (potassium voltage-gated channel, KQT- like subfamily, member 1) (eg, short QT syndrome, long QT syndrome), full gene sequence KCNQ2 (potassium voltage-gated channel, KQT-like subfamily, member 2) (eg, epileptic encephalopathy), full gene sequence LDB3 (LIM domain binding 3) (eg, familial dilated cardiomyopathy, myofibrillar myopathy), full gene sequence LDLR (low density lipoprotein receptor) (eg, familial hypercholesterolemia), full gene sequence LEPR (leptin receptor) (eg, obesity with hypogonadism), full gene sequence LHCGR (luteinizing hormone/choriogonadotropin receptor) (eg, precocious male puberty), full gene sequence LMNA (lamin A/C) (eg, Emery- Dreifuss muscular dystrophy [EDMD1, 2 and 3] limb-girdle muscular dystrophy [LGMD] type 1B, dilated cardiomyopathy [CMD1A], familial partial lipodystrophy [FPLD2]), full gene sequence LRP5 (low density lipoprotein receptor-related protein 5) (eg, osteopetrosis), full gene sequence MAP2K1 (mitogen-activated protein kinase 1) (eg, cardiofaciocutaneous syndrome), full gene sequence MAP2K2 (mitogen- activated protein kinase 2) (eg, cardiofaciocutaneous syndrome), full gene sequence MAPT (microtubule-associated protein tau) (eg, frontotemporal dementia), full gene sequence MCCC1 (methylcrotonoyl-CoA carboxylase 1 [alpha]) (eg, 3-methylcrotonyl-CoA carboxylase deficiency), full gene sequence MCCC2 (methylcrotonoyl-CoA carboxylase 2 [beta]) (eg, 3-methylcrotonyl carboxylase deficiency), full gene sequence MFN2 (mitofusin 2) (eg, Charcot-Marie- Tooth disease), full gene sequence MTM1 (myotubularin 1) (eg, X-linked centronuclear myopathy), full gene sequence MUT (methylmalonyl CoA mutase) (eg, methylmalonic acidemia), full gene sequence MUTYH (mutY homolog [E. coli]) (eg, MYH-associated polyposis), full gene sequence NDUFS1 (NADH
606 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
dehydrogenase [ubiquinone] Fe-S protein 1, 75kDa [NADH-coenzyme Q reductase]) (eg, Leigh syndrome, mitochondrial complex I deficiency), full gene sequence NF2 (neurofibromin 2 [merlin]) (eg, neurofibromatosis, type 2), full gene sequence NOTCH3 (notch 3) (eg, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy [CADASIL]), targeted sequence analysis (eg, exons 1-23) NPC1 (Niemann-Pick disease, type C1) (eg, Niemann-Pick disease), full gene sequence NPHP1 (nephronophthisis 1 [juvenile]) (eg, Joubert syndrome), full gene sequence NSD1 (nuclear receptor binding SET domain protein 1) (eg, Sotos syndrome), full gene sequence OPA1 (optic atrophy 1) (eg, optic atrophy), duplication/deletion analysis OPTN (optineurin) (eg, amyotrophic lateral sclerosis), full gene sequence PAFAH1B1 (platelet-activating factor acetylhydrolase 1b, regulatory subunit 1 [45kDa]) (eg, lissencephaly, Miller-Dieker syndrome), full gene sequence PAH (phenylalanine hydroxylase) (eg, phenylketonuria), full gene sequence PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer), full gene sequence PARK2 (Parkinson protein 2, E3 ubiquitin protein ligase [parkin]) (eg, Parkinson disease), full gene sequence PAX2 (paired box 2) (eg, renal coloboma syndrome), full gene sequence PC (pyruvate carboxylase) (eg, pyruvate carboxylase deficiency), full gene sequence PCCA (propionyl CoA carboxylase, alpha polypeptide) (eg, propionic acidemia, type 1), full gene sequence PCCB (propionyl CoA carboxylase, beta polypeptide) (eg, propionic acidemia), full gene sequence PCDH15 (protocadherin-related 15) (eg, Usher syndrome type 1F), duplication/deletion analysis PCSK9 (proprotein convertase subtilisin/kexin type 9) (eg, familial hypercholesterolemia), full gene sequence PDHA1 (pyruvate dehydrogenase [lipoamide] alpha 1) (eg,
CPT copyright 2017 American Medical Association. 607 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
lactic acidosis), full gene sequence PDHX (pyruvate dehydrogenase complex, component X) (eg, lactic acidosis), full gene sequence PHEX (phosphate-regulating endopeptidase homolog, X-linked) (eg, hypophosphatemic rickets), full gene sequence PKD2 (polycystic kidney disease 2 [autosomal dominant]) (eg, polycystic kidney disease), full gene sequence PKP2 (plakophilin 2) (eg, arrhythmogenic right ventricular dysplasia/cardiomyopathy 9), full gene sequence PNKD (paroxysmal nonkinesigenic dyskinesia) (eg, paroxysmal nonkinesigenic dyskinesia), full gene sequence POLG (polymerase [DNA directed], gamma) (eg, Alpers-Huttenlocher syndrome, autosomal dominant progressive external ophthalmoplegia), full gene sequence POMGNT1 (protein O-linked mannose beta1,2-N acetylglucosaminyltransferase) (eg, muscle- eye-brain disease, Walker-Warburg syndrome), full gene sequence POMT1 (protein-O-mannosyltransferase 1) (eg, limb-girdle muscular dystrophy [LGMD] type 2K, Walker-Warburg syndrome), full gene sequence POMT2 (protein-O- mannosyltransferase 2) (eg, limb-girdle muscular dystrophy [LGMD] type 2N, Walker-Warburg syndrome), full gene sequence PPOX (protoporphyrinogen oxidase) (eg, variegate porphyria), full gene sequence PRKAG2 (protein kinase, AMP- activated, gamma 2 non-catalytic subunit) (eg, familial hypertrophic cardiomyopathy with Wolff-Parkinson-White syndrome, lethal congenital glycogen storage disease of heart), full gene sequence PRKCG (protein kinase C, gamma) (eg, spinocerebellar ataxia), full gene sequence PSEN2 (presenilin 2 [Alzheimer disease 4]) (eg, Alzheimer disease), full gene sequence PTPN11 (protein tyrosine phosphatase, non-receptor type 11) (eg, Noonan syndrome, LEOPARD syndrome), full gene sequence PYGM (phosphorylase, glycogen, muscle) (eg, glycogen storage disease type V, McArdle disease), full gene sequence
608 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
RAF1 (v-raf-1 murine leukemia viral oncogene homolog 1) (eg, LEOPARD syndrome), full gene sequence RET (ret proto-oncogene) (eg, Hirschsprung disease), full gene sequence RPE65 (retinal pigment epithelium-specific protein 65kDa) (eg, retinitis pigmentosa, Leber congenital amaurosis), full gene sequence RYR1 (ryanodine receptor 1, skeletal) (eg, malignant hyperthermia), targeted sequence analysis of exons with functionally- confirmed mutations SCN4A (sodium channel, voltage-gated, type IV, alpha subunit) (eg, hyperkalemic periodic paralysis), full gene sequence SCNN1A (sodium channel, nonvoltage-gated 1 alpha) (eg, pseudohypoaldosteronism), full gene sequence SCNN1B (sodium channel, nonvoltage-gated 1, beta) (eg, Liddle syndrome, pseudohypoaldosteronism), full gene sequence SCNN1G (sodium channel, nonvoltage-gated 1, gamma) (eg, Liddle syndrome, pseudohypoaldosteronism), full gene sequence SDHA (succinate dehydrogenase complex, subunit A, flavoprotein [Fp]) (eg, Leigh syndrome, mitochondrial complex II deficiency), full gene sequence SETX (senataxin) (eg, ataxia), full gene sequence SGCE (sarcoglycan, epsilon) (eg, myoclonic dystonia), full gene sequence SH3TC2 (SH3 domain and tetratricopeptide repeats 2) (eg, Charcot-Marie-Tooth disease), full gene sequence SLC9A6 (solute carrier family 9 [sodium/hydrogen exchanger], member 6) (eg, Christianson syndrome), full gene sequence SLC26A4 (solute carrier family 26, member 4) (eg, Pendred syndrome), full gene sequence SLC37A4 (solute carrier family 37 [glucose-6- phosphate transporter], member 4) (eg, glycogen storage disease type Ib), full gene sequence SMAD4 (SMAD family member 4) (eg, hemorrhagic telangiectasia syndrome, juvenile polyposis), full gene sequence SOS1 (son of sevenless homolog 1) (eg, Noonan syndrome, gingival fibromatosis), full gene sequence SPAST
CPT copyright 2017 American Medical Association. 609 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
(spastin) (eg, spastic paraplegia), full gene sequence SPG7 (spastic paraplegia 7 [pure and complicated autosomal recessive]) (eg, spastic paraplegia), full gene sequence STXBP1 (syntaxin-binding protein 1) (eg, epileptic encephalopathy), full gene sequence TAZ (tafazzin) (eg, methylglutaconic aciduria type 2, Barth syndrome), full gene sequence TCF4 (transcription factor 4) (eg, Pitt-Hopkins syndrome), full gene sequence TH (tyrosine hydroxylase) (eg, Segawa syndrome), full gene sequence TMEM43 (transmembrane protein 43) (eg, arrhythmogenic right ventricular cardiomyopathy), full gene sequence TNNT2 (troponin T, type 2 [cardiac]) (eg, familial hypertrophic cardiomyopathy), full gene sequence TRPC6 (transient receptor potential cation channel, subfamily C, member 6) (eg, focal segmental glomerulosclerosis), full gene sequence TSC1 (tuberous sclerosis 1) (eg, tuberous sclerosis), full gene sequence TSC2 (tuberous sclerosis 2) (eg, tuberous sclerosis), duplication/deletion analysis UBE3A (ubiquitin protein ligase E3A) (eg, Angelman syndrome), full gene sequence UMOD (uromodulin) (eg, glomerulocystic kidney disease with hyperuricemia and isosthenuria), full gene sequence VWF (von Willebrand factor) (von Willebrand disease type 2A), extended targeted sequence analysis (eg, exons 11-16, 24-26, 51, 52) WAS (Wiskott-Aldrich syndrome [eczema- thrombocytopenia]) (eg, Wiskott-Aldrich syndrome), full gene sequence. 81407 Molecular pathology procedure, Level 8 849 1226 1787 0 0.00 (eg, analysis of 26-50 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of >50 exons, sequence analysis of multiple genes on one platform) ABCC8 (ATP-binding cassette, sub-family C [CFTR/MRP], member 8) (eg, familial hyperinsulinism), full gene sequence AGL (amylo-alpha-1, 6- glucosidase, 4-alpha-glucanotransferase) (eg, glycogen storage disease type III), full gene sequence AHI1 (Abelson helper
610 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
integration site 1) (eg, Joubert syndrome), full gene sequence ASPM (asp [abnormal spindle] homolog, microcephaly associated [Drosophila]) (eg, primary microcephaly), full gene sequence CACNA1A (calcium channel, voltage-dependent, P/Q type, alpha 1A subunit) (eg, familial hemiplegic migraine), full gene sequence CHD7 (chromodomain helicase DNA binding protein 7) (eg, CHARGE syndrome), full gene sequence COL4A4 (collagen, type IV, alpha 4) (eg, Alport syndrome), full gene sequence COL4A5 (collagen, type IV, alpha 5) (eg, Alport syndrome), duplication/deletion analysis COL6A1 (collagen, type VI, alpha 1) (eg, collagen type VI-related disorders), full gene sequence COL6A2 (collagen, type VI, alpha 2) (eg, collagen type VI-related disorders), full gene sequence COL6A3 (collagen, type VI, alpha 3) (eg, collagen type VI-related disorders), full gene sequence CREBBP (CREB binding protein) (eg, Rubinstein-Taybi syndrome), full gene sequence F8 (coagulation factor VIII) (eg, hemophilia A), full gene sequence JAG1 (jagged 1) (eg, Alagille syndrome), full gene sequence KDM5C (lysine [K]-specific demethylase 5C) (eg, X-linked mental retardation), full gene sequence KIAA0196 (KIAA0196) (eg, spastic paraplegia), full gene sequence L1CAM (L1 cell adhesion molecule) (eg, MASA syndrome, X-linked hydrocephaly), full gene sequence LAMB2 (laminin, beta 2 [laminin S]) (eg, Pierson syndrome), full gene sequence MYBPC3 (myosin binding protein C, cardiac) (eg, familial hypertrophic cardiomyopathy), full gene sequence MYH6 (myosin, heavy chain 6, cardiac muscle, alpha) (eg, familial dilated cardiomyopathy), full gene sequence MYH7 (myosin, heavy chain 7, cardiac muscle, beta) (eg, familial hypertrophic cardiomyopathy, Liang distal myopathy), full gene sequence MYO7A (myosin VIIA) (eg, Usher syndrome, type 1), full gene sequence NOTCH1 (notch 1) (eg, aortic valve disease), full gene sequence NPHS1
CPT copyright 2017 American Medical Association. 611 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
(nephrosis 1, congenital, Finnish type [nephrin]) (eg, congenital Finnish nephrosis), full gene sequence OPA1 (optic atrophy 1) (eg, optic atrophy), full gene sequence PCDH15 (protocadherin-related 15) (eg, Usher syndrome, type 1), full gene sequence PKD1 (polycystic kidney disease 1 [autosomal dominant]) (eg, polycystic kidney disease), full gene sequence PLCE1 (phospholipase C, epsilon 1) (eg, nephrotic syndrome type 3), full gene sequence SCN1A (sodium channel, voltage-gated, type 1, alpha subunit) (eg, generalized epilepsy with febrile seizures), full gene sequence SCN5A (sodium channel, voltage- gated, type V, alpha subunit) (eg, familial dilated cardiomyopathy), full gene sequence SLC12A1 (solute carrier family 12 [sodium/potassium/chloride transporters], member 1) (eg, Bartter syndrome), full gene sequence SLC12A3 (solute carrier family 12 [sodium/chloride transporters], member 3) (eg, Gitelman syndrome), full gene sequence SPG11 (spastic paraplegia 11 [autosomal recessive]) (eg, spastic paraplegia), full gene sequence SPTBN2 (spectrin, beta, non-erythrocytic 2) (eg, spinocerebellar ataxia), full gene sequence TMEM67 (transmembrane protein 67) (eg, Joubert syndrome), full gene sequence TSC2 (tuberous sclerosis 2) (eg, tuberous sclerosis), full gene sequence USH1C (Usher syndrome 1C [autosomal recessive, severe]) (eg, Usher syndrome, type 1), full gene sequence VPS13B (vacuolar protein sorting 13 homolog B [yeast]) (eg, Cohen syndrome), duplication/deletion analysis WDR62 (WD repeat domain 62) (eg, primary autosomal recessive microcephaly), full gene sequence. 81408 Molecular pathology procedure, Level 9 967 1398 2037 0 0.00 (eg, analysis of >50 exons in a single gene by DNA sequence analysis) ABCA4 (ATP- binding cassette, sub-family A [ABC1], member 4) (eg, Stargardt disease, age- related macular degeneration), full gene sequence ATM (ataxia telangiectasia mutated) (eg, ataxia telangiectasia), full
612 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
gene sequence CDH23 (cadherin-related 23) (eg, Usher syndrome, type 1), full gene sequence CEP290 (centrosomal protein 290kDa) (eg, Joubert syndrome), full gene sequence COL1A1 (collagen, type I, alpha 1) (eg, osteogenesis imperfecta, type I), full gene sequence COL1A2 (collagen, type I, alpha 2) (eg, osteogenesis imperfecta, type I), full gene sequence COL4A1 (collagen, type IV, alpha 1) (eg, brain small-vessel disease with hemorrhage), full gene sequence COL4A3 (collagen, type IV, alpha 3 [Goodpasture antigen]) (eg, Alport syndrome), full gene sequence COL4A5 (collagen, type IV, alpha 5) (eg, Alport syndrome), full gene sequence DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy), full gene sequence DYSF (dysferlin, limb girdle muscular dystrophy 2B [autosomal recessive]) (eg, limb-girdle muscular dystrophy), full gene sequence FBN1 (fibrillin 1) (eg, Marfan syndrome), full gene sequence ITPR1 (inositol 1,4,5-trisphosphate receptor, type 1) (eg, spinocerebellar ataxia), full gene sequence LAMA2 (laminin, alpha 2) (eg, congenital muscular dystrophy), full gene sequence LRRK2 (leucine-rich repeat kinase 2) (eg, Parkinson disease), full gene sequence MYH11 (myosin, heavy chain 11, smooth muscle) (eg, thoracic aortic aneurysms and aortic dissections), full gene sequence NEB (nebulin) (eg, nemaline myopathy 2), full gene sequence NF1 (neurofibromin 1) (eg, neurofibromatosis, type 1), full gene sequence PKHD1 (polycystic kidney and hepatic disease 1) (eg, autosomal recessive polycystic kidney disease), full gene sequence RYR1 (ryanodine receptor 1, skeletal) (eg, malignant hyperthermia), full gene sequence RYR2 (ryanodine receptor 2 [cardiac]) (eg, catecholaminergic polymorphic ventricular tachycardia, arrhythmogenic right ventricular dysplasia), full gene sequence or targeted sequence analysis of > 50 exons USH2A (Usher syndrome 2A [autosomal recessive, mild])
CPT copyright 2017 American Medical Association. 613 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
(eg, Usher syndrome, type 2), full gene sequence VPS13B (vacuolar protein sorting 13 homolog B [yeast]) (eg, Cohen syndrome), full gene sequence VWF (von Willebrand factor) (eg, von Willebrand disease types 1 and 3), full gene sequence. GENOMIC SEQUENCING PROCEDURES AND OTHER MOLECULAR MULTIANALYTE ASSAYS
81410 Aortic dysfunction or dilation (eg, Marfan 6690 9665 14085 0 0.00 syndrome, loeys Dietz syndrome, Ehler Danlos syndrome type iv, arterial tortuosity syndrome); genomic sequence analysis panel, must include sequencing of at least 9 genes, including fbn1, tgfbr1, tgfbr2, col3a1, myh11, acta2, slC2a10, smad3, and mylk
81411 Aortic dysfunction or dilation (eg, Marfan 3240 4681 6821 0 0.00 syndrome, loeys Dietz syndrome, Ehler Danlos syndrome type iv, arterial tortuosity syndrome); duplication/deletion analysis panel, must include analyses for tgfbr1, tgfbr2, myh11, and col3a1
81412 Ashkenazi Jewish associated disorders (eg, 3511 5071 7390 0 0.00 bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group c, Gaucher disease, Tay-Sachs disease), genomic sequence analysis panel, must include sequencing of at least 9 genes, including ASPA, BLM, CFTR, FANCC, gba, HEXA, IKBKAP, mcoln1, and smpd1
81413 Cardiac ion channelopathies (eg, Brugada 3071 4436 6465 0 0.00 syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing of at least 10 genes, including ank2, casq2, cav3, kcne1, kcne2, kcnh2, kcnj2, kcnq1, ryr2, and scn5a
81414 Cardiac ion channelopathies (eg, Brugada 2207 3188 4646 0 0.00 syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include analysis of at least 2 genes, including kcnh2 and kcnq1
81415 Exome (eg, unexplained constitutional or 15045 21735 31673 0 0.00 heritable disorder or syndrome); sequence analysis
81416 Exome (eg, unexplained constitutional or 10031 14491 21117 0 0.00 heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents,
614 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
siblings) (list separately in addition to code for primary procedure)
81417 Exome (eg, unexplained constitutional or 0 0 0 0 0.00 heritable disorder or syndrome); re-evaluation of previously obtained exome sequence (eg, updated knowledge or unrelated condition/syndrome)
81420 Fetal chromosomal aneuploidy (eg, trisomy 21, 3018 4360 6354 0 0.00 monosomy x) genomic sequence analysis panel, circulating cell-free fetal dan in maternal blood, must include analysis of chromosomes 13, 18, and 21
81422 Fetal chromosomal microdeletion(s) genomic 1311 1893 2759 0 0.00 sequence analysis (eg, DiGeorge syndrome, cri- du-chat syndrome), circulating cell-free fetal dan in maternal blood
81425 Genome (eg, unexplained constitutional or 0 0 0 0 0.00 heritable disorder or syndrome); sequence analysis
81426 Genome (eg, unexplained constitutional or 0 0 0 0 0.00 heritable disorder or syndrome); sequence analysis, each comparator genome (eg, parents, siblings) (list separately in addition to code for primary procedure)
81427 Genome (eg, unexplained constitutional or 0 0 0 0 0.00 heritable disorder or syndrome); re-evaluation of previously obtained genome sequence (eg, updated knowledge or unrelated condition/syndrome)
81430 Hearing loss (eg, nonsyndromic hearing loss, 0 0 0 0 0.00 usher syndrome, Pendred syndrome); genomic sequence analysis panel, must include sequencing of at least 60 genes, including cdh23, clrn1, gjb2, gpr98, mtrnr1, myo7a, myo15a, pcdh15, otof, slC26a4, tmC1, tmprss3, ush1c, ush1g, ush2a, and wfs1
81431 Hearing loss (eg, nonsyndromic hearing loss, 0 0 0 0 0.00 usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for strc and dfnb1 deletions in gjb2 and gjb6 genes
81432 Hereditary breast cancer-related disorders (eg, 2650 3829 5579 0 0.00 hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer); genomic sequence analysis panel, must include sequencing of at least 10 genes, always including
CPT copyright 2017 American Medical Association. 615 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
brca1, brca2, cdh1, mlh1, msh2, msh6, palb2, PTEN, stk11, and tp53
81433 Hereditary breast cancer-related disorders (eg, 1663 2402 3500 0 0.00 hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer); duplication/deletion analysis panel, must include analyses for brca1, brca2, mlh1, msh2, and stk11
81434 Hereditary retinal disorders (eg, retinitis 2305 3329 4852 0 0.00 pigmentosa, Leber congenital amaurosis, cone- rod dystrophy), genomic sequence analysis panel, must include sequencing of at least 15 genes, including abca4, cnga1, crb1, eys, pde6a, pde6b, prpf31, prph2, rdh12, rho, rp1, rp2, rpe65, rpgr, and ush2a
81435 Hereditary colon cancer disorders (eg, lynch 2004 2895 4219 0 0.00 syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis); genomic sequence analysis panel, must include sequencing of at least 10 genes, including APC, bmpr1a, cdh1, mlh1, msh2, msh6, mutyh, PTEN, smad4, and stk11
81436 Hereditary colon cancer disorders (eg, lynch 2022 2920 4256 0 0.00 syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis); duplication/deletion analysis panel, must include analysis of at least 5 genes, including mlh1, msh2, epcam, smad4, and stk11
81437 Hereditary neuroendocrine tumor disorders (eg, 4215 6089 8873 0 0.00 medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma); genomic sequence analysis panel, must include sequencing of at least 6 genes, including max, SDHB, sdhc, SDHD, tmem127, and VHL
81438 Hereditary neuroendocrine tumor disorders (eg, 1663 2402 3500 0 0.00 medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or paraganglioma); duplication/deletion analysis panel, must include analyses for SDHB, sdhc, SDHD, and VHL
81439 Hereditary cardiomyopathy (eg, hypertrophic 3071 4436 6465 0 0.00 cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at least 5 cardiomyopathy-related genes (eg, dsg2, mybpC3, myh7, pkp2, ttn)
616 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81440 Nuclear encoded mitochondrial genes (eg, 0 0 0 0 0.00 neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 genes, including bcs1l, C10orf2, coq2, cox10, dguok, mpv17, opa1, pdss2, polg, polg2, rrm2b, sco1, sco2, slC25a4, sucla2, suclg1, taz, tk2, and tymp
81442 Noonan spectrum disorders (eg, Noonan 2305 3329 4852 0 0.00 syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, leopard syndrome, Noonan- like syndrome), genomic sequence analysis panel, must include sequencing of at least 12 genes, including BRAF, cbl, hras, KRAS, map2k1, map2k2, NRAS, ptpn11, raf1, rit1, shoC2, and sos1
81445 Targeted genomic sequence analysis panel, solid 2061 2978 4340 0 0.00 organ neoplasm, dan analysis, and rna analysis when performed, 5-50 genes (eg, ALK, BRAF, cdkn2a, EGFR, erbb2, kit, KRAS, NRAS, met, PDGFRA, PDGF-b, PGR, pik3ca, PTEN, ret), interrogation for sequence variants and copy number variants or rearranges, if performed
81448 Hereditary peripheral neuropathies (eg, Charcot- 0 0 0 0 0.00 Marie-tooth, spastic paraplegia), genomic sequence analysis panel, must include sequencing of at least 5 peripheral neuropathy- related genes (eg, bscl2, gjb1, mfn2, MPZ, reep1, spast, spg11, sptlC1)
81450 Targeted genomic sequence analysis panel, 5015 7245 10558 0 0.00 hematolymphoid neoplasm or disorder, dan analysis, and rna analysis when performed, 5-50 genes (eg, BRAF, cebpa, dnmt3a, ezh2, flt3, idh1, idh2, jak2, KRAS, kit, MLL, NRAS, npm1, notch1), interrogation for sequence variants, and copy number variants or rearranges, or isoform expression or mrna expression levels, if performed
81455 Targeted genomic sequence analysis panel, solid 5817 8404 12247 0 0.00 organ or hematolymphoid neoplasm, dan analysis, and rna analysis when performed, 51 or greater genes (eg, ALK, BRAF, cdkn2a, cebpa, dnmt3a, EGFR, erbb2, ezh2, flt3, idh1, idh2, jak2, kit, KRAS, MLL, npm1, NRAS, met, notch1, PDGFRA, PDGF-b, PGR, pik3ca, PTEN, ret), interrogation for sequence variants and copy number variants or rearranges, if performed
CPT copyright 2017 American Medical Association. 617 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81460 Whole mitochondrial genome (eg, Leigh 2030 2932 4273 0 0.00 syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes [melas], myoclonic epilepsy with ragged-red fibers [merff], neuropathy, ataxia, and retinitis pigmentosa [NARP], Leber hereditary optic neuropathy [lhon]), genomic sequence, must include sequence analysis of entire mitochondrial genome with heteroplasmy detection
81465 Whole mitochondrial genome large deletion 0 0 0 0 0.00 analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed
81470 X-linked intellectual disability (xlid) (eg, 0 0 0 0 0.00 syndromic and non-syndromic xlid); genomic sequence analysis panel, must include sequencing of at least 60 genes, including arx, atrx, cdkl5, fgd1, fmr1, huwe1, il1rapl, kdm5c, l1cam, mecp2, med12, mid1, ocrl, rps6ka3, and slC16a2
81471 X-linked intellectual disability (xlid) (eg, 0 0 0 0 0.00 syndromic and non-syndromic xlid); duplication/deletion gene analysis, must include analysis of at least 60 genes, including arx, atrx, cdkl5, fgd1, fmr1, huwe1, il1rapl, kdm5c, l1cam, mecp2, med12, mid1, ocrl, rps6ka3, and slC16a2
81479 Unlisted molecular pathology procedure 0 0 0 0 0.00
MULTIANALYTE ASSAYS WITH ALGORITHMIC ANALYSIS
81490 Autoimmune (rheumatoid arthritis), analysis of 1008 1456 2121 0 0.00 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score
81493 Coronary artery disease, mrna, gene expression 1264 1825 2660 0 0.00 profiling by real-time rt-PCR of 23 genes, utilizing whole peripheral blood, algorithm reported as a risk score
81500 Oncology (ovarian), biochemical assays of two 549 793 1156 0 0.00 proteins (ca-125 and he4), utilizing serum, with menopausal status, algorithm reported as a risk score
81503 Oncology (ovarian), biochemical assays of five 1517 2192 3194 0 0.00 proteins (ca-125, apolipoprotein a1, beta-2 microglobulin, transferrin, and pre-albumin),
618 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
utilizing serum, algorithm reported as a risk score
81504 Oncology (tissue of origin), microarray gene 0 0 0 0 0.00 expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores
81506 Endocrinology (type 2 diabetes), biochemical 0 0 0 0 0.00 assays of seven analytes (glucose, hba1c, insulin, hs-crp, adiponectin, ferritin, interleukin 2- receptor alpha), utilizing serum or plasma, algorithm reporting a risk score
81507 Fetal aneuploidy (trisomy 21, 18, and 13) dan 2503 3616 5269 0 0.00 sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy
81508 Fetal congenital abnormalities, biochemical 222 321 468 0 0.00 assays of two proteins (PAPP-a, hcg [any form]), utilizing maternal serum, algorithm reported as a risk score
81509 Fetal congenital abnormalities, biochemical 1511 2183 3182 0 0.00 assays of three proteins (PAPP-a, hcg [any form], dia), utilizing maternal serum, algorithm reported as a risk score
81510 Fetal congenital abnormalities, biochemical 0 0 0 0 0.00 assays of three analytes (afp, ue3, hcg [any form]), utilizing maternal serum, algorithm reported as a risk score
81511 Fetal congenital abnormalities, biochemical 492 711 1037 0 0.00 assays of four analytes (afp, ue3, hcg [any form], dia) utilizing maternal serum, algorithm reported as a risk score (may include additional results from previous biochemical testing)
81512 Fetal congenital abnormalities, biochemical 0 0 0 0 0.00 assays of five analytes (afp, ue3, total hcg, hyperglycosylated hcg, dia) utilizing maternal serum, algorithm reported as a risk score
81519 Oncology (breast), mrna, gene expression 4653 6722 9795 0 0.00 profiling by real-time rt-PCR of 21 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score
81520 Oncology (breast), mrna gene expression 0 0 0 0 0.00 profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin- fixed paraffin-embedded tissue, algorithm reported as a recurrence risk score
CPT copyright 2017 American Medical Association. 619 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
81521 Oncology (breast), mrna, microarray gene 0 0 0 0 0.00 expression profiling of 70 content genes and 465 housekeeping genes, utilizing fresh frozen or formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk of distant metastasis
81525 Oncology (colon), mrna, gene expression 4434 6405 9334 0 0.00 profiling by real-time rt-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin- fixed paraffin-embedded tissue, algorithm reported as a recurrence score
81528 Oncology (colorectal) screening, quantitative 651 941 1371 0 0.00 real-time target and signal amplification of 10 dan markers (KRAS mutations, promoter methylation of ndrg4 and bmp3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result
81535 Oncology (gynecologic), live tumor cell culture 1558 2251 3280 0 0.00 and chemotherapeutic response by dapi stain and morphology, predictive algorithm reported as a drug response score; first single drug or drug combination
81536 Oncology (gynecologic), live tumor cell culture 621 897 1307 0 0.00 and chemotherapeutic response by dapi stain and morphology, predictive algorithm reported as a drug response score; each additional single drug or drug combination (list separately in addition to code for primary procedure)
81538 Oncology (lung), mass spectrometric 8-protein 3491 5043 7349 0 0.00 signature, including amyloid a, utilizing serum, prognostic and predictive algorithm reported as good versus poor overall survival
81539 Oncology (high-grade prostate cancer), 1833 2648 3858 0 0.00 biochemical assay of four proteins (total PSA, free PSA, intact PSA, and human kallikrein-2 [hk2]), utilizing plasma or serum, prognostic algorithm reported as a probability score
81540 Oncology (tumor of unknown origin), mrna, 7523 10869 15838 0 0.00 gene expression profiling by real-time rt-PCR of 92 genes (87 content and 5 housekeeping) to classify tumor into main cancer type and subtype, utilizing formalin-fixed paraffin- embedded tissue, algorithm reported as a probability of a predicted main cancer type and subtype
81541 Oncology (prostate), mrna gene expression 0 0 0 0 0.00 profiling by real-time rt-PCR of 46 genes (31
620 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease-specific mortality risk score
81545 Oncology (thyroid), gene expression analysis of 6445 9311 13569 0 0.00 142 genes, utilizing fine needle aspirate, algorithm reported as a categorical result (eg, benign or suspicious)
81551 Oncology (prostate), promoter methylation 0 0 0 0 0.00 profiling by real-time PCR of 3 genes (gstp1, APC, rassf1), utilizing formalin-fixed paraffin- embedded tissue, algorithm reported as a likelihood of prostate cancer detection on repeat biopsy
81595 Cardiology (heart transplant), mrna, gene 3626 5238 7632 0 0.00 expression profiling by real-time quantitative PCR of 20 genes (11 content and 9 housekeeping), utilizing subfraction of peripheral blood, algorithm reported as a rejection risk score
81599 Unlisted multianalyte assay with algorithmic 0 0 0 0 0.00 analysis
CHEMISTRY
82009 Ketone body(s) (eg, acetone, acetoacetic acid, 20 29 42 0 0.00 beta-hydroxybutyrate); qualitative
82010 Ketone body(s) (eg, acetone, acetoacetic acid, 55 80 116 0 0.00 beta-hydroxybutyrate); quantitative
82013 Acetylcholinesterase 79 115 167 0 0.00
82016 Acylcarnitines; qualitative, each specimen 38 54 79 0 0.00
82017 Acylcarnitines; quantitative, each specimen 25 36 52 0 0.00
82024 Adrenocorticotropic hormone (act) 163 235 343 0 0.00
82030 Adenosine, 5-monophosphate, cyclic (cyclic 54 77 113 0 0.00 amp)
82040 Albumin; serum, plasma or whole blood 20 29 43 0 0.00
82042 Albumin; other source, quantitative, each 20 29 42 0 0.00 specimen
82043 Albumin; urine (eg, microalbumin), quantitative 65 94 137 0 0.00
82044 Albumin; urine (eg, microalbumin), 17 25 37 0 0.00 semiquantitative (eg, reagent strip assay)
CPT copyright 2017 American Medical Association. 621 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
82045 Albumin; ischemia modified 120 173 252 0 0.00
82075 Alcohol (ethanol), breath 30 44 64 0 0.00
82085 Aldolase 77 111 162 0 0.00
82088 Aldosterone 171 247 360 0 0.00
82103 Alpha-1-antitrypsin; total 91 132 192 0 0.00
82104 Alpha-1-antitrypsin; phenotype 96 138 202 0 0.00
82105 Alpha-fetoprotein (afp); serum 83 120 175 0 0.00
82106 Alpha-fetoprotein (afp); amniotic fluid 78 113 164 0 0.00
82107 Alpha-fetoprotein (afp); afp-l3 fraction isoform 201 290 423 0 0.00 and total afp (including ratio)
82108 Aluminum 154 222 324 0 0.00
82120 Amines, vaginal fluid, qualitative 13 18 26 0 0.00
82127 Amino acids; single, qualitative, each specimen 51 74 108 0 0.00
82128 Amino acids; multiple, qualitative, each 70 101 148 0 0.00 specimen
82131 Amino acids; single, quantitative, each specimen 59 85 124 0 0.00
82135 Aminolevulinic acid, delta (ala) 110 159 231 0 0.00
82136 Amino acids, 2 to 5 amino acids, quantitative, 135 195 285 0 0.00 each specimen
82139 Amino acids, 6 or more amino acids, 44 64 93 0 0.00 quantitative, each specimen
82140 Ammonia 82 118 172 0 0.00
82143 Amniotic fluid scan (spectrophotometric) 41 59 86 0 0.00
82150 Amylase 37 53 78 0 0.00
82154 Androstanediol glucuronide 219 317 461 0 0.00
82157 Androstenedione 132 191 279 0 0.00
82160 Androsterone 77 111 162 0 0.00
82163 Angiotensin ii 123 178 259 0 0.00
82164 Angiotensin i - converting enzyme (ace) 104 150 218 0 0.00
82172 Apolipoprotein, each 72 103 151 0 0.00
82175 Arsenic 108 157 228 0 0.00
622 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
82180 Ascorbic acid (vitamin c), blood 48 70 102 0 0.00
82190 Atomic absorption spectroscopy, each analyte 52 75 109 0 0.00
82232 Beta-2 microglobulin 101 146 212 0 0.00
82239 Bile acids; total 86 124 181 0 0.00
82240 Bile acids; cholylglycine 47 68 99 0 0.00
82247 Bilirubin; total 22 32 47 0 0.00
82248 Bilirubin; direct 14 21 30 0 0.00
82252 Bilirubin; feces, qualitative 20 29 43 0 0.00
82261 Biotinidase, each specimen 25 36 52 0 0.00
82270 Blood, occult, by peroxidase activity (eg, 15 22 32 0 0.00 guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)
82271 Blood, occult, by peroxidase activity (eg, 12 17 25 0 0.00 guaiac), qualitative; other sources
82272 Blood, occult, by peroxidase activity (eg, 16 23 33 0 0.00 guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening
82274 Blood, occult, by fecal hemoglobin 51 73 106 0 0.00 determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations
82286 Bradykinin 36 52 76 0 0.00
82300 Cadmium 67 96 140 0 0.00
82306 Vitamin d; 25 hydroxy, includes fraction(s), if 196 283 412 0 0.00 performed
82308 Calcitonin 152 220 320 0 0.00
82310 Calcium; total 27 39 57 0 0.00
82330 Calcium; ionized 58 84 122 0 0.00
82331 Calcium; after calcium infusion test 27 39 57 0 0.00
82340 Calcium; urine quantitative, timed specimen 28 41 59 0 0.00
82355 Calculus; qualitative analysis 41 59 86 0 0.00
CPT copyright 2017 American Medical Association. 623 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
82360 Calculus; quantitative analysis, chemical 71 102 148 0 0.00
82365 Calculus; infrared spectroscopy 72 104 151 0 0.00
82370 Calculus; x-ray diffraction 132 191 279 0 0.00
82373 Carbohydrate deficient transferrin 166 240 349 0 0.00
82374 Carbon dioxide (bicarbonate) 26 38 55 0 0.00
82375 Carboxyhemoglobin; quantitative 64 92 134 0 0.00
82376 Carboxyhemoglobin; qualitative 13 18 26 0 0.00
82378 Carcinoembryonic antigen (CEA) 101 146 212 0 0.00
82379 Carnitine (total and free), quantitative, each 26 37 54 0 0.00 specimen
82380 Carotene 68 98 143 0 0.00
82382 Catecholamines; total urine 148 214 311 0 0.00
82383 Catecholamines; blood 132 190 277 0 0.00
82384 Catecholamines; fractionated 184 265 386 0 0.00
82387 Cathepsin-d 91 131 192 0 0.00
82390 Ceruloplasmin 77 111 161 0 0.00
82397 Chemiluminescent assay 54 78 114 0 0.00
82415 Chloramphenicol 85 123 179 0 0.00
82435 Chloride; blood 18 25 37 0 0.00
82436 Chloride; urine 20 29 42 0 0.00
82438 Chloride; other source 58 83 121 0 0.00
82441 Chlorinated hydrocarbons, screen 76 109 160 0 0.00
82465 Cholesterol, serum or whole blood, total 21 30 44 0 0.00
82480 Cholinesterase; serum 60 86 126 0 0.00
82482 Cholinesterase; rbc 58 84 123 0 0.00
82485 Chondroitin b sulfate, quantitative 108 157 228 0 0.00
82495 Chromium 85 122 178 0 0.00
82507 Citrate 80 116 169 0 0.00
82523 Collagen cross links, any method 132 191 279 0 0.00
624 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
82525 Copper 71 102 148 0 0.00
82528 Corticosterone 157 226 330 0 0.00
82530 Cortisol; free 66 95 139 0 0.00
82533 Cortisol; total 110 159 231 0 0.00
82540 Creatine 21 30 44 0 0.00
82542 Column chromatography, includes mass 85 123 180 0 0.00 spectrometry, if performed (eg, HPLC, lc, lc/ms, lc/ms-ms, gc, gc/ms-ms, gc/ms, HPLC/ms), non- drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen
82550 Creatine kinase (ck), (CPK); total 32 46 66 0 0.00
82552 Creatine kinase (ck), (CPK); isoenzymes 52 76 110 0 0.00
82553 Creatine kinase (ck), (CPK); mb fraction only 56 81 118 0 0.00
82554 Creatine kinase (ck), (CPK); isoforms 62 90 131 0 0.00
82565 Creatinine; blood 21 31 45 0 0.00
82570 Creatinine; other source 26 38 56 0 0.00
82575 Creatinine; clearance 48 69 100 0 0.00
82585 Cryofibrinogen 72 104 151 0 0.00
82595 Cryoglobulin, qualitative or semi-quantitative 53 77 112 0 0.00 (eg, cryocrit)
82600 Cyanide 99 143 208 0 0.00
82607 Cyanocobalamin (vitamin b-12); 90 130 190 0 0.00
82608 Cyanocobalamin (vitamin b-12); unsaturated 81 117 171 0 0.00 binding capacity
82610 Cystatin c 65 94 138 0 0.00
82615 Cystine and homocystine, urine, qualitative 39 57 83 0 0.00
82626 Dehydroepiandrosterone (DHEA) 157 201 267 0 0.00
82627 Dehydroepiandrosterone-sulfate (DHEA-s) 127 163 216 0 0.00
82633 Desoxycorticosterone, 11- 169 216 287 0 0.00
82634 Deoxycortisol, 11- 92 118 157 0 0.00
82638 Dibucaine number 73 93 124 0 0.00
CPT copyright 2017 American Medical Association. 625 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
82652 Vitamin d; 1, 25 dihydroxy, includes fraction(s), 217 278 370 0 0.00 if performed
82656 Elastase, pancreatic (el-1), fecal, qualitative or 79 101 135 0 0.00 semi-quantitative
82657 Enzyme activity in blood cells, cultured cells, or 80 102 135 0 0.00 tissue, not elsewhere specified; nonradioactive substrate, each specimen
82658 Enzyme activity in blood cells, cultured cells, or 108 138 183 0 0.00 tissue, not elsewhere specified; radioactive substrate, each specimen
82664 Electrophoretic technique, not elsewhere 150 191 254 0 0.00 specified
82668 Erythropoietin 143 183 243 0 0.00
82670 Estradiol 130 166 221 0 0.00
82671 Estrogens; fractionated 120 153 203 0 0.00
82672 Estrogens; total 161 206 273 0 0.00
82677 Estriol 98 126 167 0 0.00
82679 Estrone 115 148 196 0 0.00
82693 Ethylene glycol 36 46 61 0 0.00
82696 Etiocholanolone 74 95 126 0 0.00
82705 Fat or lipids, feces; qualitative 89 114 152 0 0.00
82710 Fat or lipids, feces; quantitative 134 172 228 0 0.00
82715 Fat differential, feces, quantitative 61 78 104 0 0.00
82725 Fatty acids, nonesterified 55 70 93 0 0.00
82726 Very long chain fatty acids 53 68 91 0 0.00
82728 Ferritin 82 104 139 0 0.00
82731 Fetal fibronectin, cervicovaginal secretions, 348 445 591 0 0.00 semi-quantitative
82735 Fluoride 28 36 48 0 0.00
82746 Folic acid; serum 92 118 157 0 0.00
82747 Folic acid; rbc 58 74 99 0 0.00
82757 Fructose, semen 78 99 132 0 0.00
626 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
82759 Galactokinase, rbc 128 164 218 0 0.00
82760 Galactose 33 42 56 0 0.00
82775 Galactose-1-phosphate uridyl transferase; 31 40 53 0 0.00 quantitative
82776 Galactose-1-phosphate uridyl transferase; screen 22 28 37 0 0.00
82777 Galectin-3 61 78 104 0 0.00
82784 Gammaglobulin (immunoglobulin); IgA, IgD, 57 73 97 0 0.00 igg, IgM, each
82785 Gammaglobulin (immunoglobulin); IgE 89 114 151 0 0.00
82787 Gammaglobulin (immunoglobulin); 76 97 130 0 0.00 immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each
82800 Gases, blood, ph only 25 32 43 0 0.00
82803 Gases, blood, any combination of ph, pco2, po2, 69 88 117 0 0.00 co2, hco3 (including calculated o2 saturation);
82805 Gases, blood, any combination of ph, pco2, po2, 93 118 157 0 0.00 co2, hco3 (including calculated o2 saturation); with o2 saturation, by direct measurement, except pulse oximetry
82810 Gases, blood, o2 saturation only, by direct 34 43 57 0 0.00 measurement, except pulse oximetry
82820 Hemoglobin-oxygen affinity (po2 for 50% 26 33 44 0 0.00 hemoglobin saturation with oxygen)
82930 Gastric acid analysis, includes ph if performed, 21 26 35 0 0.00 each specimen
82938 Gastrin after secretin stimulation 105 135 179 0 0.00
82941 Gastrin 76 98 130 0 0.00
82943 Glucagon 133 170 225 0 0.00
82945 Glucose, body fluid, other than blood 56 72 95 0 0.00
82946 Glucagon tolerance test 27 34 45 0 0.00
82947 Glucose; quantitative, blood (except reagent 21 26 35 0 0.00 strip)
82948 Glucose; blood, reagent strip 15 20 26 0 0.00
82950 Glucose; post glucose dose (includes glucose) 31 40 53 0 0.00
CPT copyright 2017 American Medical Association. 627 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
82951 Glucose; tolerance test (gtt), 3 specimens 65 83 111 0 0.00 (includes glucose)
82952 Glucose; tolerance test, each additional beyond 3 21 27 36 0 0.00 specimens (list separately in addition to code for primary procedure)
82955 Glucose-6-phosphate dehydrogenase (g6pd); 86 110 146 0 0.00 quantitative
82960 Glucose-6-phosphate dehydrogenase (g6pd); 10 13 17 0 0.00 screen
82962 Glucose, blood by glucose monitoring device(s) 14 18 24 0 0.00 cleared by the fad specifically for home use
82963 Glucosidase, beta 128 164 218 0 0.00
82965 Glutamate dehydrogenase 81 103 137 0 0.00
82977 Glutamyltransferase, gamma (GGT) 26 33 44 0 0.00
82978 Glutathione 43 55 74 0 0.00
82979 Glutathione reductase, rbc 60 77 103 0 0.00
82985 Glycated protein 69 88 117 0 0.00
83001 Gonadotropin; follicle stimulating hormone 108 138 184 0 0.00 (FSH)
83002 Gonadotropin; luteinizing hormone (LH) 102 131 174 0 0.00
83003 Growth hormone, human (HGH) (somatotropin) 102 131 174 0 0.00
83006 Growth stimulation expressed gene 2 (st2, 313 400 532 0 0.00 interleukin 1 receptor like-1)
83009 Helicobacter pylori, blood test analysis for 102 131 174 0 0.00 urease activity, non-radioactive isotope (eg, c- 13)
83010 Haptoglobin; quantitative 82 105 140 0 0.00
83012 Haptoglobin; phenotypes 102 131 174 0 0.00
83013 Helicobacter pylori; breath test analysis for 230 294 391 0 0.00 urease activity, non-radioactive isotope (eg, c- 13)
83014 Helicobacter pylori; drug admin 34 43 57 0 0.00
83015 Heavy metal (eg, arsenic, barium, beryllium, 55 71 94 0 0.00 bismuth, antimony, mercury); qualitative, any number of analytes
628 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
83018 Heavy metal (eg, arsenic, barium, beryllium, 143 183 243 0 0.00 bismuth, antimony, mercury); quantitative, each, not elsewhere specified
83020 Hemoglobin fractionation and quantitation; 112 143 191 0 0.00 electrophoresis (eg, a2, s, c, and/or f)
83020-26 38 49 65 19 0.52
83021 Hemoglobin fractionation and quantitation; 135 173 230 0 0.00 chromatography (eg, a2, s, c, and/or f)
83026 Hemoglobin; by copper sulfate method, non- 4 6 7 0 0.00 automated
83030 Hemoglobin; f (fetal), chemical 52 67 89 0 0.00
83033 Hemoglobin; f (fetal), qualitative 30 38 51 0 0.00
83036 Hemoglobin; glycosylated (a1c) 66 84 112 0 0.00
83037 Hemoglobin; glycosylated (a1c) by device 32 41 54 0 0.00 cleared by fad for home use
83045 Hemoglobin; methemoglobin, qualitative 15 19 26 0 0.00
83050 Hemoglobin; methemoglobin, quantitative 35 44 59 0 0.00
83051 Hemoglobin; plasma 21 27 36 0 0.00
83060 Hemoglobin; sulfhemoglobin, quantitative 41 52 69 0 0.00
83065 Hemoglobin; thermolabile 41 52 70 0 0.00
83068 Hemoglobin; unstable, screen 33 42 56 0 0.00
83069 Hemoglobin; urine 31 40 53 0 0.00
83070 Hemosiderin, qualitative 44 57 75 0 0.00
83080 B-hexosaminidase, each assay 73 94 125 0 0.00
83088 Histamine 185 237 315 0 0.00
83090 Homocysteine 124 158 210 0 0.00
83150 Homovanillic acid (HVA) 57 73 97 0 0.00
83491 Hydroxycorticosteroids, 17- (17-ohcs) 55 70 93 0 0.00
83497 Hydroxyindolacetic acid, 5-(HIAA) 38 48 64 0 0.00
83498 Hydroxyprogesterone, 17-d 42 54 71 0 0.00
83500 Hydroxyproline; free 135 173 229 0 0.00
83505 Hydroxyproline; total 145 185 246 0 0.00
CPT copyright 2017 American Medical Association. 629 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
83516 Immunoassay for analyte other than infectious 89 130 179 0 0.00 agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method
83518 Immunoassay for analyte other than infectious 21 30 42 0 0.00 agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)
83519 Immunoassay for analyte other than infectious 147 215 297 0 0.00 agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA)
83520 Immunoassay for analyte other than infectious 163 237 328 0 0.00 agent antibody or infectious agent antigen; quantitative, not otherwise specified
83525 Insulin; total 74 107 149 0 0.00
83527 Insulin; free 93 135 187 0 0.00
83528 Intrinsic factor 75 110 152 0 0.00
83540 Iron 31 45 63 0 0.00
83550 Iron binding capacity 43 63 87 0 0.00
83570 Isocitric dehydrogenase (IDH) 42 61 85 0 0.00
83582 Ketogenic steroids, fractionation 67 98 136 0 0.00
83586 Ketosteroids, 17- (17-ks); total 71 104 144 0 0.00
83593 Ketosteroids, 17- (17-ks); fractionation 82 119 165 0 0.00
83605 Lactate (lactic acid) 43 63 87 0 0.00
83615 Lactate dehydrogenase (ld), (LDH); 29 43 59 0 0.00
83625 Lactate dehydrogenase (ld), (LDH); isoenzymes, 78 114 158 0 0.00 separation and quantitation
83630 Lactoferrin, fecal; qualitative 74 108 150 0 0.00
83631 Lactoferrin, fecal; quantitative 44 64 89 0 0.00
83632 Lactogen, human placental (hPL) human 96 140 194 0 0.00 chorionic somatomammotropin
83633 Lactose, urine, qualitative 26 38 53 0 0.00
83655 Lead 45 65 90 0 0.00
83661 Fetal lung maturity assessment; lecithin 104 152 211 0 0.00 sphingomyelin (l/s) ratio
630 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
83662 Fetal lung maturity assessment; foam stability 90 131 181 0 0.00 test
83663 Fetal lung maturity assessment; fluorescence 90 131 181 0 0.00 polarization
83664 Fetal lung maturity assessment; lamellar body 90 131 181 0 0.00 density
83670 Leucine aminopeptidase (lap) 43 63 88 0 0.00
83690 Lipase 43 62 86 0 0.00
83695 Lipoprotein (a) 77 113 156 0 0.00
83698 Lipoprotein-associated phospholipase a2 (lp- 157 230 318 0 0.00 pla2)
83700 Lipoprotein, blood; electrophoretic separation 293 427 591 0 0.00 and quantitation
83701 Lipoprotein, blood; high resolution fractionation 177 258 357 0 0.00 and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation)
83704 Lipoprotein, blood; quantitation of lipoprotein 146 213 295 0 0.00 particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed
83718 Lipoprotein, direct measurement; high density 35 51 70 0 0.00 cholesterol (HDL cholesterol)
83719 Lipoprotein, direct measurement; VLDL 26 38 53 0 0.00 cholesterol
83721 Lipoprotein, direct measurement; LDL 42 62 85 0 0.00 cholesterol
83727 Luteinizing releasing factor (LRH) 300 438 606 0 0.00
83735 Magnesium 33 48 67 0 0.00
83775 Malate dehydrogenase 35 51 71 0 0.00
83785 Manganese 73 106 147 0 0.00
83789 Mass spectrometry and tandem mass 74 108 150 0 0.00 spectrometry (eg, ms, ms/ms, MALDI, ms-TOF, qtof), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen
83825 Mercury, quantitative 129 188 260 0 0.00
CPT copyright 2017 American Medical Association. 631 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
83835 Metanephrines 158 230 318 0 0.00
83857 Methemalbumin 51 74 103 0 0.00
83861 Microfluidic analysis utilizing an integrated 45 66 92 0 0.00 collection and analysis device, tear osmolarity
83864 Mucopolysaccharides, acid, quantitative 111 162 224 0 0.00
83872 Mucin, synovial fluid (ropes test) 42 61 84 0 0.00
83873 Myelin basic protein, cerebrospinal fluid 132 193 266 0 0.00
83874 Myoglobin 80 117 162 0 0.00
83876 Myeloperoxidase (MPO) 159 231 320 0 0.00
83880 Natriuretic peptide 157 230 318 0 0.00
83883 Nephelometry, each analyte not elsewhere 101 148 204 0 0.00 specified
83885 Nickel 38 56 78 0 0.00
83915 Nucleotidase 5'- 54 75 112 0 0.00
83916 Oligoclonal immune (oligoclonal bands) 144 202 302 0 0.00
83918 Organic acids; total, quantitative, each specimen 69 96 143 0 0.00
83919 Organic acids; qualitative, each specimen 254 356 531 0 0.00
83921 Organic acid, single, quantitative 49 69 103 0 0.00
83930 Osmolality; blood 65 91 136 0 0.00
83935 Osmolality; urine 65 91 135 0 0.00
83937 Osteocalcin (bone g1a protein) 188 263 393 0 0.00
83945 Oxalate 53 74 110 0 0.00
83950 Oncoprotein; her-2/neu 252 354 527 0 0.00
83951 Oncoprotein; des-gamma-carboxy-prothrombin 372 522 779 0 0.00 (DCP)
83970 Parathormone (parathyroid hormone) 187 262 390 0 0.00
83986 Ph; body fluid, not otherwise specified 14 20 30 0 0.00
83987 Ph; exhaled breath condensate 72 101 151 0 0.00
83992 Phencyclidine (pcpt) 52 73 109 0 0.00
83993 Calprotectin, fecal 90 126 188 0 0.00
632 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
84030 Phenylalanine (PKU), blood 21 29 44 0 0.00
84035 Phenylketones, qualitative 123 172 256 0 0.00
84060 Phosphatase, acid; total 30 43 64 0 0.00
84066 Phosphatase, acid; prostatic 37 52 77 0 0.00
84075 Phosphatase, alkaline; 20 28 42 0 0.00
84078 Phosphatase, alkaline; heat stable (total not 26 37 55 0 0.00 included)
84080 Phosphatase, alkaline; isoenzymes 75 105 157 0 0.00
84081 Phosphatidylglycerol 75 105 157 0 0.00
84085 Phosphogluconate, 6-, dehydrogenase, rbc 31 43 64 0 0.00
84087 Phosphohexose isomerase 47 66 98 0 0.00
84100 Phosphorus inorganic (phosphate); 21 29 43 0 0.00
84105 Phosphorus inorganic (phosphate); urine 22 30 45 0 0.00
84106 Porphobilinogen, urine; qualitative 20 27 41 0 0.00
84110 Porphobilinogen, urine; quantitative 79 110 165 0 0.00
84112 Evaluation of cervicovaginal fluid for specific 204 286 426 0 0.00 amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [pamg-1], placental protein 12 [pp12], alpha-fetoprotein), qualitative, each specimen
84119 Porphyrins, urine; qualitative 39 55 82 0 0.00
84120 Porphyrins, urine; quantitation and fractionation 124 174 259 0 0.00
84126 Porphyrins, feces, quantitative 158 221 330 0 0.00
84132 Potassium; serum, plasma or whole blood 21 30 44 0 0.00
84133 Potassium; urine 18 25 37 0 0.00
84134 Prealbumin 68 95 142 0 0.00
84135 Pregnanediol 60 84 125 0 0.00
84138 Pregnanetriol 59 83 124 0 0.00
84140 Pregnenolone 107 150 224 0 0.00
84143 17-hydroxypregnenolone 168 236 352 0 0.00
84144 Progesterone 97 137 204 0 0.00
CPT copyright 2017 American Medical Association. 633 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
84145 Procalcitonin (pct) 94 132 197 0 0.00
84146 Prolactin 137 192 286 0 0.00
84150 Prostaglandin, each 132 186 277 0 0.00
84152 Prostate specific antigen (PSA); complexed 62 87 130 0 0.00 (direct measurement)
84153 Prostate specific antigen (PSA); total 96 135 201 0 0.00
84154 Prostate specific antigen (PSA); free 86 121 180 0 0.00
84155 Protein, total, except by refractometry; serum, 20 28 42 0 0.00 plasma or whole blood
84156 Protein, total, except by refractometry; urine 38 53 79 0 0.00
84157 Protein, total, except by refractometry; other 41 57 86 0 0.00 source (eg, synovial fluid, cerebrospinal fluid)
84160 Protein, total, by refractometry, any source 18 26 38 0 0.00
84163 Pregnancy-associated plasma protein-a (PAPP-a) 82 114 171 0 0.00
84165 Protein; electrophoretic fractionation and 67 94 140 0 0.00 quantitation, serum
84165-26 37 52 77 19 0.52
84166 Protein; electrophoretic fractionation and 109 152 227 0 0.00 quantitation, other fluids with concentration (eg, urine, csf)
84166-26 47 65 97 19 0.52
84181 Protein; western blot, with interpretation and 39 54 81 0 0.00 report, blood or other body fluid
84181-26 39 54 81 19 0.52
84182 Protein; western blot, with interpretation and 254 356 531 0 0.00 report, blood or other body fluid, immunological probe for band identification, each
84182-26 77 109 162 19 0.52
84202 Protoporphyrin, rbc; quantitative 67 93 139 0 0.00
84203 Protoporphyrin, rbc; screen 26 37 55 0 0.00
84206 Proinsulin 83 117 174 0 0.00
84207 Pyridoxal phosphate (vitamin b-6) 115 162 241 0 0.00
84210 Pyruvate 32 45 66 0 0.00
634 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
84220 Pyruvate kinase 198 278 415 0 0.00
84228 Quinine 86 121 180 0 0.00
84233 Receptor assay; estrogen 98 138 206 0 0.00
84234 Receptor assay; progesterone 91 128 191 0 0.00
84235 Receptor assay; endocrine, other than estrogen 188 263 392 0 0.00 or progesterone (specify hormone)
84238 Receptor assay; non-endocrine (specify receptor) 155 218 325 0 0.00
84244 Renin 127 178 266 0 0.00
84252 Riboflavin (vitamin b-2) 67 93 139 0 0.00
84255 Selenium 85 119 160 0 0.00
84260 Serotonin 209 292 392 0 0.00
84270 Sex hormone binding globulin (SHBG) 104 146 196 0 0.00
84275 Sialic acid 80 112 151 0 0.00
84285 Silica 126 176 237 0 0.00
84295 Sodium; serum, plasma or whole blood 25 35 47 0 0.00
84300 Sodium; urine 21 29 40 0 0.00
84302 Sodium; other source 55 77 104 0 0.00
84305 Somatomedin 163 228 306 0 0.00
84307 Somatostatin 126 175 236 0 0.00
84311 Spectrophotometry, analyte not elsewhere 25 35 47 0 0.00 specified
84315 Specific gravity (except urine) 36 51 68 0 0.00
84375 Sugars, chromatographic, tlc or paper 105 147 197 0 0.00 chromatography
84376 Sugars (mono-, di-, and oligosaccharides); single 94 132 177 0 0.00 qualitative, each specimen
84377 Sugars (mono-, di-, and oligosaccharides); 46 65 87 0 0.00 multiple qualitative, each specimen
84378 Sugars (mono-, di-, and oligosaccharides); single 42 58 78 0 0.00 quantitative, each specimen
84379 Sugars (mono-, di-, and oligosaccharides); 62 86 116 0 0.00 multiple quantitative, each specimen
CPT copyright 2017 American Medical Association. 635 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
84392 Sulfate, urine 19 27 36 0 0.00
84402 Testosterone; free 141 197 264 0 0.00
84403 Testosterone; total 130 181 243 0 0.00
84410 Testosterone; bioavailable, direct measurement 151 211 283 0 0.00 (eg, differential precipitation)
84425 Thiamine (vitamin b-1) 119 166 223 0 0.00
84430 Thiocyanate 55 76 103 0 0.00
84431 Thromboxane metabolite(s), including 74 103 138 0 0.00 thromboxane if performed, urine
84432 Thyroglobulin 102 142 191 0 0.00
84436 Thyroxine; total 42 58 78 0 0.00
84437 Thyroxine; requiring elution (eg, neonatal) 11 16 21 0 0.00
84439 Thyroxine; free 70 97 131 0 0.00
84442 Thyroxine binding globulin (TBG) 62 86 116 0 0.00
84443 Thyroid stimulating hormone (TSH) 92 129 173 0 0.00
84445 Thyroid stimulating immune globulins (TSI) 316 442 593 0 0.00
84446 Tocopherol alpha (vitamin e) 80 111 150 0 0.00
84449 Transcortin (cortisol binding globulin) 75 105 141 0 0.00
84450 Transferase; aspartate amino (ast) (SGOT) 20 28 38 0 0.00
84460 Transferase; alanine amino (alt) (SGPT) 23 32 43 0 0.00
84466 Transferrin 74 103 139 0 0.00
84478 Triglycerides 31 44 59 0 0.00
84479 Thyroid hormone (t3 or t4) uptake or thyroid 42 58 78 0 0.00 hormone binding ratio (THBR)
84480 Triiodothyronine t3; total (tt-3) 91 127 171 0 0.00
84481 Triiodothyronine t3; free 165 230 309 0 0.00
84482 Triiodothyronine t3; reverse 139 194 261 0 0.00
84484 Troponin, quantitative 131 184 247 0 0.00
84485 Trypsin; duodenal fluid 40 56 76 0 0.00
84488 Trypsin; feces, qualitative 39 55 73 0 0.00
636 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
84490 Trypsin; feces, quantitative, 24-hour collection 16 22 29 0 0.00
84510 Tyrosine 97 136 183 0 0.00
84512 Troponin, qualitative 40 56 76 0 0.00
84520 Urea nitrogen; quantitative 20 28 38 0 0.00
84525 Urea nitrogen; semiquantitative (eg, reagent strip 20 28 38 0 0.00 test)
84540 Urea nitrogen, urine 23 33 44 0 0.00
84545 Urea nitrogen, clearance 27 38 51 0 0.00
84550 Uric acid; blood 25 35 48 0 0.00
84560 Uric acid; other source 20 28 37 0 0.00
84577 Urobilinogen, feces, quantitative 67 94 126 0 0.00
84578 Urobilinogen, urine; qualitative 17 24 33 0 0.00
84580 Urobilinogen, urine; quantitative, timed 38 53 71 0 0.00 specimen
84583 Urobilinogen, urine; semiquantitative 27 38 51 0 0.00
84585 Vanillylmandelic acid (VMA), urine 45 62 84 0 0.00
84586 Vasoactive intestinal peptide (vip) 338 472 634 0 0.00
84588 Vasopressin (antidiuretic hormone, ADH) 284 396 532 0 0.00
84590 Vitamin a 73 102 137 0 0.00
84591 Vitamin, not otherwise specified 55 77 103 0 0.00
84597 Vitamin k 49 68 91 0 0.00
84600 Volatiles (eg, acetic anhydride, diethyl ether) 38 53 71 0 0.00
84620 Xylose absorption test, blood and/or urine 64 89 119 0 0.00
84630 Zinc 59 82 110 0 0.00
84681 C-peptide 97 136 183 0 0.00
84702 Gonadotropin, chorionic (hcg); quantitative 86 120 162 0 0.00
84703 Gonadotropin, chorionic (hcg); qualitative 44 61 82 0 0.00
84704 Gonadotropin, chorionic (hcg); free beta chain 81 113 152 0 0.00
84830 Ovulation tests, by visual color comparison 25 35 47 0 0.00 methods for human luteinizing hormone
CPT copyright 2017 American Medical Association. 637 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
84999 Unlisted chemistry procedure 0 0 0 0 0.00
HEMATOLOGY AND COAGULATION
85002 Bleeding time 47 59 85 0 0.00
85004 Blood count; automated differential wbc count 25 31 45 0 0.00
85007 Blood count; blood smear, microscopic 19 24 34 0 0.00 examination with manual differential wbc count
85008 Blood count; blood smear, microscopic 16 20 28 0 0.00 examination without manual differential wbc count
85009 Blood count; manual differential wbc count, 13 16 23 0 0.00 buffy coat
85013 Blood count; spun microhematocrit 13 16 24 0 0.00
85014 Blood count; hematocrit (HCT) 16 20 29 0 0.00
85018 Blood count; hemoglobin (hgb) 16 20 28 0 0.00
85025 Blood count; complete (CBC), automated (hgb, 35 44 64 0 0.00 HCT, rbc, wbc and platelet count) and automated differential wbc count
85027 Blood count; complete (CBC), automated (hgb, 32 41 59 0 0.00 HCT, rbc, wbc and platelet count)
85032 Blood count; manual cell count (erythrocyte, 12 16 23 0 0.00 leukocyte, or platelet) each
85041 Blood count; red blood cell (rbc), automated 11 14 20 0 0.00
85044 Blood count; reticulocyte, manual 30 38 55 0 0.00
85045 Blood count; reticulocyte, automated 38 47 68 0 0.00
85046 Blood count; reticulocytes, automated, including 27 34 49 0 0.00 1 or more cellular parameters (eg, reticulocyte hemoglobin content [chr], immature reticulocyte fraction [IRF], reticulocyte volume [MRV], rna content), direct measurement
85048 Blood count; leukocyte (wbc), automated 11 14 20 0 0.00
85049 Blood count; platelet, automated 24 31 44 0 0.00
85055 Reticulated platelet assay 83 105 151 0 0.00
85060 Blood smear, peripheral, interpretation by 74 93 134 26 0.71 physician with written report
85097 Bone marrow, smear interpretation 224 282 407 94 2.60
638 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
85130 Chromogenic substrate assay 113 166 237 0 0.00
85170 Clot retraction 19 28 39 0 0.00
85175 Clot lysis time, whole blood dilution 10 15 22 0 0.00
85210 Clotting; factor ii, prothrombin, specific 41 61 87 0 0.00
85220 Clotting; factor v (AcG or proaccelerin), labile 221 326 465 0 0.00 factor
85230 Clotting; factor vii (proconvertin, stable factor) 186 275 392 0 0.00
85240 Clotting; factor viii (AHG), 1-stage 177 261 373 0 0.00
85244 Clotting; factor viii related antigen 200 294 419 0 0.00
85245 Clotting; factor viii, vw factor, ristocetin 184 271 387 0 0.00 cofactor
85246 Clotting; factor viii, vw factor antigen 203 299 427 0 0.00
85247 Clotting; factor viii, von Willebrand factor, 292 430 614 0 0.00 multimetric analysis
85250 Clotting; factor ix (PTC or Christmas) 186 273 390 0 0.00
85260 Clotting; factor x (Stuart-Prower) 223 329 469 0 0.00
85270 Clotting; factor xi (pta) 184 270 385 0 0.00
85280 Clotting; factor xii (Hageman) 186 275 392 0 0.00
85290 Clotting; factor xiii (fibrin stabilizing) 184 271 387 0 0.00
85291 Clotting; factor xiii (fibrin stabilizing), screen 75 111 158 0 0.00 solubility
85292 Clotting; prekallikrein assay (fletcher factor 98 145 206 0 0.00 assay)
85293 Clotting; high molecular weight kininogen assay 98 145 206 0 0.00 (Fitzgerald factor assay)
85300 Clotting inhibitors or anticoagulants; 136 201 286 0 0.00 antithrombin iii, activity
85301 Clotting inhibitors or anticoagulants; 181 267 381 0 0.00 antithrombin iii, antigen assay
85302 Clotting inhibitors or anticoagulants; protein c, 191 281 401 0 0.00 antigen
85303 Clotting inhibitors or anticoagulants; protein c, 186 274 390 0 0.00 activity
CPT copyright 2017 American Medical Association. 639 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
85305 Clotting inhibitors or anticoagulants; protein s, 172 254 362 0 0.00 total
85306 Clotting inhibitors or anticoagulants; protein s, 204 300 428 0 0.00 free
85307 Activated protein c (APC) resistance assay 136 200 285 0 0.00
85335 Factor inhibitor test 202 298 425 0 0.00
85337 Thrombomodulin 54 80 114 0 0.00
85345 Coagulation time; lee and white 19 28 40 0 0.00
85347 Coagulation time; activated 17 25 36 0 0.00
85348 Coagulation time; other methods 18 26 37 0 0.00
85360 Euglobulin lysis 50 73 104 0 0.00
85362 Fibrin(Ogen) degradation (split) products (FDP) 103 151 216 0 0.00 (FSP); agglutination slide, semiquantitative
85366 Fibrin(Ogen) degradation (split) products (FDP) 93 137 195 0 0.00 (FSP); paracoagulation
85370 Fibrin(Ogen) degradation (split) products (FDP) 62 91 130 0 0.00 (FSP); quantitative
85378 Fibrin degradation products, d-dimer; qualitative 59 87 125 0 0.00 or semiquantitative
85379 Fibrin degradation products, d-dimer; 59 88 125 0 0.00 quantitative
85380 Fibrin degradation products, d-dimer; 31 46 65 0 0.00 ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative
85384 Fibrinogen; activity 54 79 113 0 0.00
85385 Fibrinogen; antigen 41 60 86 0 0.00
85390 Fibrinolysins or coagulopathy screen, 204 300 428 0 0.00 interpretation and report
85390-26 74 109 155 19 0.52
85396 Coagulation/fibrinolysis assay, whole blood (eg, 80 117 167 21 0.59 viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day
640 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
85397 Coagulation and fibrinolysis, functional activity, 130 192 273 0 0.00 not otherwise specified (eg, adamts-13), each analyte
85400 Fibrinolytic factors and inhibitors; plasmin 46 68 96 0 0.00
85410 Fibrinolytic factors and inhibitors; alpha-2 72 106 152 0 0.00 antiplasmin
85415 Fibrinolytic factors and inhibitors; plasminogen 168 248 354 0 0.00 activator
85420 Fibrinolytic factors and inhibitors; plasminogen, 176 260 370 0 0.00 except antigenic assay
85421 Fibrinolytic factors and inhibitors; plasminogen, 53 78 111 0 0.00 antigenic assay
85441 Heinz bodies; direct 25 35 47 0 0.00
85445 Heinz bodies; induced, acetyl phenylhydrazine 40 56 76 0 0.00
85460 Hemoglobin or RBCs, fetal, for fetomaternal 104 144 196 0 0.00 hemorrhage; differential lysis (Kleihauer-Betke)
85461 Hemoglobin or RBCs, fetal, for fetomaternal 95 132 180 0 0.00 hemorrhage; rosette
85475 Hemolysin, acid 52 73 99 0 0.00
85520 Heparin assay 75 104 141 0 0.00
85525 Heparin neutralization 165 230 312 0 0.00
85530 Heparin-protamine tolerance test 58 81 110 0 0.00
85536 Iron stain, peripheral blood 54 75 102 0 0.00
85540 Leukocyte alkaline phosphatase with count 49 68 92 0 0.00
85547 Mechanical fragility, rbc 51 71 96 0 0.00
85549 Muramidase 91 127 172 0 0.00
85555 Osmotic fragility, rbc; unincubated 40 55 75 0 0.00
85557 Osmotic fragility, rbc; incubated 79 110 149 0 0.00
85576 Platelet, aggregation (in vitro), each agent 59 83 112 0 0.00
85576-26 15 21 28 19 0.52
85597 Phospholipid neutralization; platelet 118 164 223 0 0.00
85598 Phospholipid neutralization; hexagonal 135 187 254 0 0.00 phospholipid
CPT copyright 2017 American Medical Association. 641 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
85610 Prothrombin time; 22 30 41 0 0.00
85611 Prothrombin time; substitution, plasma fractions, 19 26 36 0 0.00 each
85612 Russell viper venom time (includes venom); 222 310 420 0 0.00 undiluted
85613 Russell viper venom time (includes venom); 81 113 153 0 0.00 diluted
85635 Reptilase test 108 150 204 0 0.00
85651 Sedimentation rate, erythrocyte; non-automated 25 35 47 0 0.00
85652 Sedimentation rate, erythrocyte; automated 34 47 64 0 0.00
85660 Sickling of rbc, reduction 50 70 95 0 0.00
85670 Thrombin time; plasma 53 74 101 0 0.00
85675 Thrombin time; titer 40 56 77 0 0.00
85705 Thromboplastin inhibition, tissue 151 210 285 0 0.00
85730 Thromboplastin time, partial (ptt); plasma or 44 61 83 0 0.00 whole blood
85732 Thromboplastin time, partial (ptt); substitution, 43 60 82 0 0.00 plasma fractions, each
85810 Viscosity 87 121 165 0 0.00
85999 Unlisted hematology and coagulation procedure 0 0 0 0 0.00
IMMUNOLOGY
86000 Agglutinins, febrile (eg, brucella, Francisella, 46 59 84 0 0.00 murine typhus, q fever, rocky mountain spotted fever, scrub typhus), each antigen
86001 Allergen specific igg quantitative or 13 16 23 0 0.00 semiquantitative, each allergen
86003 Allergen specific IgE; quantitative or 28 37 52 0 0.00 semiquantitative, crude allergen extract, each
86005 Allergen specific IgE; qualitative, multiallergen 38 49 70 0 0.00 screen (eg, disk, sponge, card)
86008 Allergen specific IgE; quantitative or 0 0 0 0 0.00 semiquantitative, recombinant or purified component, each
86021 Antibody identification; leukocyte antibodies 141 183 260 0 0.00
642 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86022 Antibody identification; platelet antibodies 170 219 313 0 0.00
86023 Antibody identification; platelet associated 96 124 176 0 0.00 immunoglobulin assay
86038 Antinuclear antibodies (ana); 82 106 150 0 0.00
86039 Antinuclear antibodies (ana); titer 57 73 104 0 0.00
86060 Antistreptolysin 0; titer 55 71 100 0 0.00
86063 Antistreptolysin 0; screen 25 33 47 0 0.00
86077 Blood bank physician services; difficult cross 168 218 310 58 1.60 match and/or evaluation of irregular antibody(s), interpretation and written report
86078 Blood bank physician services; investigation of 160 207 295 58 1.60 transfusion reaction including suspicion of transmissible disease, interpretation and written report
86079 Blood bank physician services; authorization for 175 226 322 57 1.59 deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of rh incompatible units), with written report
86140 C-reactive protein; 48 62 89 0 0.00
86141 C-reactive protein; high sensitivity (hsCRP) 74 96 136 0 0.00
86146 Beta 2 glycoprotein i antibody, each 67 87 124 0 0.00
86147 Cardiolipin (phospholipid) antibody, each iG 82 106 152 0 0.00 class
86148 Anti-phosphatidylserine (phospholipid) antibody 37 47 68 0 0.00
86152 Cell enumeration using immunologic selection 680 880 1254 0 0.00 and identification in fluid specimen (eg, circulating tumor cells in blood);
86153 Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required
86153-26 71 91 130 35 0.98
86155 Chemotaxis assay, specify method 80 104 148 0 0.00
86156 Cold agglutinin; screen 23 30 42 0 0.00
86157 Cold agglutinin; titer 50 65 93 0 0.00
CPT copyright 2017 American Medical Association. 643 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86160 Complement; antigen, each component 86 111 158 0 0.00
86161 Complement; functional activity, each 61 79 113 0 0.00 component
86162 Complement; total hemolytic (ch50) 155 200 285 0 0.00
86171 Complement fixation tests, each antigen 44 57 81 0 0.00
86200 Cyclic citrullinated peptide (CCP), antibody 124 161 229 0 0.00
86215 Deoxyribonuclease, antibody 85 110 157 0 0.00
86225 Deoxyribonucleic acid (dan) antibody; native or 84 108 154 0 0.00 double stranded
86226 Deoxyribonucleic acid (dan) antibody; single 45 59 83 0 0.00 stranded
86235 Extractable nuclear antigen, antibody to, any 83 107 152 0 0.00 method (eg, nRNP, ss-a, ss-b, sm, rRNP, sC170, j01), each antibody
86255 Fluorescent noninfectious agent antibody; 108 139 199 0 0.00 screen, each antibody
86255-26 40 52 74 19 0.52
86256 Fluorescent noninfectious agent antibody; titer, 101 130 186 0 0.00 each antibody
86256-26 40 51 73 19 0.52
86277 Growth hormone, human (HGH), antibody 79 102 145 0 0.00
86280 Hemagglutination inhibition test (hai) 22 29 41 0 0.00
86294 Immunoassay for tumor antigen, qualitative or 50 65 93 0 0.00 semiquantitative (eg, bladder tumor antigen)
86300 Immunoassay for tumor antigen, quantitative; ca 121 157 223 0 0.00 15-3 (27.29)
86301 Immunoassay for tumor antigen, quantitative; ca 131 169 241 0 0.00 19-9
86304 Immunoassay for tumor antigen, quantitative; ca 125 162 231 0 0.00 125
86305 Human epididymis protein 4 (he4) 201 260 370 0 0.00
86308 Heterophile antibodies; screening 26 34 48 0 0.00
86309 Heterophile antibodies; titer 46 59 85 0 0.00
644 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86310 Heterophile antibodies; titers after absorption 37 48 69 0 0.00 with beef cells and guinea pig kidney
86316 Immunoassay for tumor antigen, other antigen, 141 182 259 0 0.00 quantitative (eg, ca 50, 72-4, 549), each
86317 Immunoassay for infectious agent antibody, 40 52 74 0 0.00 quantitative, not otherwise specified
86318 Immunoassay for infectious agent antibody, 37 48 69 0 0.00 qualitative or semiquantitative, single step method (eg, reagent strip)
86320 Immunoelectrophoresis; serum 109 140 200 0 0.00
86320-26 55 72 102 19 0.52
86325 Immunoelectrophoresis; other fluids (eg, urine, 87 113 160 0 0.00 cerebrospinal fluid) with concentration
86325-26 62 81 115 19 0.52
86327 Immunoelectrophoresis; crossed (2-dimensional 114 147 209 0 0.00 assay)
86327-26 0 0 0 21 0.59
86329 Immunodiffusion; not elsewhere specified 66 86 122 0 0.00
86331 Immunodiffusion; gel diffusion, qualitative 36 47 67 0 0.00 (Ouchterlony), each antigen or antibody
86332 Immune complex assay 142 183 261 0 0.00
86334 Immunofixation electrophoresis; serum 147 190 270 0 0.00
86334-26 41 53 76 19 0.52
86335 Immunofixation electrophoresis; other fluids 149 192 274 0 0.00 with concentration (eg, urine, csf)
86335-26 53 68 97 19 0.52
86336 Inhibin a 82 107 152 0 0.00
86337 Insulin antibodies 196 254 362 0 0.00
86340 Intrinsic factor antibodies 135 174 248 0 0.00
86341 Islet cell antibody 93 120 171 0 0.00
86343 Leukocyte histamine release test (LHR) 202 261 371 0 0.00
86344 Leukocyte phagocytosis 40 52 74 0 0.00
CPT copyright 2017 American Medical Association. 645 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86352 Cellular function assay involving stimulation 234 303 432 0 0.00 (eg, mitogen or antigen) and detection of biomarker (eg, atp)
86353 Lymphocyte transformation, mitogen 108 139 198 0 0.00 (phytomitogen) or antigen induced blastogenesis
86355 B cells, total count 89 115 163 0 0.00
86356 Mononuclear cell antigen, quantitative (eg, flow 73 94 134 0 0.00 cytometry), not otherwise specified, each antigen
86357 Natural killer (NK) cells, total count 88 114 163 0 0.00
86359 T cells; total count 90 117 167 0 0.00
86360 T cells; absolute cd4 and cd8 count, including 192 248 353 0 0.00 ratio
86361 T cells; absolute cd4 count 162 210 299 0 0.00
86367 Stem cells (ie, cd34), total count 288 372 531 0 0.00
86376 Microsomal antibodies (eg, thyroid or liver- 108 140 199 0 0.00 kidney), each
86382 Neutralization test, viral 148 191 272 0 0.00
86384 Nitroblue tetrazolium dye test (NTD) 57 74 105 0 0.00
86386 Nuclear matrix protein 22 (nmp22), qualitative 52 67 95 0 0.00
86403 Particle agglutination; screen, each antibody 28 36 52 0 0.00
86406 Particle agglutination; titer, each antibody 98 127 181 0 0.00
86430 Rheumatoid factor; qualitative 41 53 76 0 0.00
86431 Rheumatoid factor; quantitative 45 59 83 0 0.00
86480 Tuberculosis test, cell mediated immunity 233 301 429 0 0.00 antigen response measurement; gamma interferon
86481 Tuberculosis test, cell mediated immunity 298 385 549 0 0.00 antigen response measurement; enumeration of gamma interferon-producing t-cells in cell suspension
86485 Skin test; candida 24 30 43 0 0.00
86486 Skin test; unlisted antigen, each 0 0 0 5 0.14
86490 Skin test; coccidioidomycosis 114 148 210 91 2.54
86510 Skin test; histoplasmosis 22 28 40 6 0.18
646 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86580 Skin test; tuberculosis, intradermal 25 33 46 8 0.23
86590 Streptokinase, antibody 25 33 46 0 0.00
86592 Syphilis test, non-treponemal antibody; 35 46 65 0 0.00 qualitative (eg, VDRL, RPR, art)
86593 Syphilis test, non-treponemal antibody; 34 44 63 0 0.00 quantitative
86602 Antibody; actinomyces 74 100 136 0 0.00
86603 Antibody; adenovirus 94 128 173 0 0.00
86606 Antibody; aspergillus 58 80 108 0 0.00
86609 Antibody; bacterium, not elsewhere specified 23 32 43 0 0.00
86611 Antibody; Bartonella 71 96 131 0 0.00
86612 Antibody; Blastomyces 78 106 144 0 0.00
86615 Antibody; Bordetella 76 103 140 0 0.00
86617 Antibody; Borrelia burgdorferi (lyme disease) 150 204 278 0 0.00 confirmatory test (eg, western blot or immunoblot)
86618 Antibody; Borrelia burgdorferi (lyme disease) 125 170 231 0 0.00
86619 Antibody; Borrelia (relapsing fever) 99 135 183 0 0.00
86622 Antibody; brucella 49 66 90 0 0.00
86625 Antibody; campylobacter 95 130 176 0 0.00
86628 Antibody; candida 76 103 140 0 0.00
86631 Antibody; chlamydia 43 58 79 0 0.00
86632 Antibody; chlamydia, IgM 57 77 104 0 0.00
86635 Antibody; coccidioides 48 65 88 0 0.00
86638 Antibody; Coxiella burnetii (q fever) 17 23 31 0 0.00
86641 Antibody; cryptococcus 66 89 121 0 0.00
86644 Antibody; cytomegalovirus (CMV) 109 148 201 0 0.00
86645 Antibody; cytomegalovirus (CMV), IgM 102 139 189 0 0.00
86648 Antibody; diphtheria 135 183 249 0 0.00
86651 Antibody; encephalitis, California (la Crosse) 78 106 145 0 0.00
86652 Antibody; encephalitis, eastern equine 94 129 175 0 0.00
CPT copyright 2017 American Medical Association. 647 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86653 Antibody; encephalitis, st. Louis 76 104 141 0 0.00
86654 Antibody; encephalitis, western equine 86 117 158 0 0.00
86658 Antibody; enterovirus (eg, coxsackie, echo, 37 50 68 0 0.00 polio)
86663 Antibody; Epstein-Barr (EB) virus, early antigen 97 132 179 0 0.00 (ea)
86664 Antibody; Epstein-Barr (EB) virus, nuclear 83 113 153 0 0.00 antigen (EBNA)
86665 Antibody; Epstein-Barr (EB) virus, viral capsid 91 124 169 0 0.00 (VCA)
86666 Antibody; ehrlichia 83 113 154 0 0.00
86668 Antibody; Francisella tularensis 58 79 107 0 0.00
86671 Antibody; fungus, not elsewhere specified 103 140 190 0 0.00
86674 Antibody; Giardia lamblia 50 68 93 0 0.00
86677 Antibody; helicobacter pylori 68 92 125 0 0.00
86682 Antibody; helminth, not elsewhere specified 126 171 233 0 0.00
86684 Antibody; haemophilus influenza 131 178 242 0 0.00
86687 Antibody; HTLV-i 90 123 167 0 0.00
86688 Antibody; HTLV-ii 155 211 287 0 0.00
86689 Antibody; HTLV or hiv antibody, confirmatory 106 144 196 0 0.00 test (eg, western blot)
86692 Antibody; hepatitis, delta agent 121 165 224 0 0.00
86694 Antibody; herpes simplex, non-specific type test 118 160 218 0 0.00
86695 Antibody; herpes simplex, type 1 96 131 178 0 0.00
86696 Antibody; herpes simplex, type 2 110 150 204 0 0.00
86698 Antibody; histoplasma 72 98 134 0 0.00
86701 Antibody; hiv-1 35 48 65 0 0.00
86702 Antibody; hiv-2 75 102 138 0 0.00
86703 Antibody; hiv-1 and hiv-2, single result 71 96 131 0 0.00
86704 Hepatitis b core antibody (HBcAB); total 81 110 150 0 0.00
86705 Hepatitis b core antibody (HBcAB); IgM 99 135 184 0 0.00 antibody
648 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86706 Hepatitis b surface antibody (HBsAB) 73 99 135 0 0.00
86707 Hepatitis be antibody (HBeAb) 63 85 116 0 0.00
86708 Hepatitis a antibody (HAAb) 87 118 160 0 0.00
86709 Hepatitis a antibody (HAAb), IgM antibody 69 93 127 0 0.00
86710 Antibody; influenza virus 38 52 71 0 0.00
86711 Antibody; jc (john Cunningham) virus 1476 2007 2728 0 0.00
86713 Antibody; legionella 78 107 145 0 0.00
86717 Antibody; leishmania 68 92 125 0 0.00
86720 Antibody; leptospira 141 192 261 0 0.00
86723 Antibody; listeria monocytogenes 73 99 135 0 0.00
86727 Antibody; lymphocytic choriomeningitis 71 97 131 0 0.00
86732 Antibody; mucormycosis 73 99 135 0 0.00
86735 Antibody; mumps 107 146 199 0 0.00
86738 Antibody; mycoplasma 55 75 103 0 0.00
86741 Antibody; neisseria meningitidis 99 135 184 0 0.00
86744 Antibody; nocardia 73 99 135 0 0.00
86747 Antibody; parvovirus 89 121 164 0 0.00
86750 Antibody; plasmodium (malaria) 57 77 104 0 0.00
86753 Antibody; protozoa, not elsewhere specified 71 96 131 0 0.00
86756 Antibody; respiratory syncytial virus 32 43 58 0 0.00
86757 Antibody; rickettsia 78 107 145 0 0.00
86759 Antibody; rotavirus 33 45 61 0 0.00
86762 Antibody; rubella 62 84 114 0 0.00
86765 Antibody; rubeola 113 153 208 0 0.00
86768 Antibody; salmonella 36 49 66 0 0.00
86771 Antibody; shigella 73 99 135 0 0.00
86774 Antibody; tetanus 117 159 216 0 0.00
86777 Antibody; toxoplasma 93 126 171 0 0.00
86778 Antibody; toxoplasma, IgM 89 122 165 0 0.00
CPT copyright 2017 American Medical Association. 649 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86780 Antibody; treponema pallidum 50 69 93 0 0.00
86784 Antibody; trichinella 42 57 78 0 0.00
86787 Antibody; varicella-zoster 83 113 154 0 0.00
86788 Antibody; west Nile virus, IgM 72 97 132 0 0.00
86789 Antibody; west Nile virus 79 107 145 0 0.00
86790 Antibody; virus, not elsewhere specified 137 187 254 0 0.00
86793 Antibody; yersinia 90 123 167 0 0.00
86794 Antibody; Zika virus, IgM 0 0 0 0 0.00
86800 Thyroglobulin antibody 98 134 182 0 0.00
86803 Hepatitis c antibody; 102 139 189 0 0.00
86804 Hepatitis c antibody; confirmatory test (eg, 466 634 861 0 0.00 immunoblot)
86805 Lymphocytotoxicity assay, visual crossmatch; 294 400 544 0 0.00 with titration
86806 Lymphocytotoxicity assay, visual crossmatch; 263 358 486 0 0.00 without titration
86807 Serum screening for cytotoxic percent reactive 202 275 374 0 0.00 antibody (pra); standard method
86808 Serum screening for cytotoxic percent reactive 180 245 333 0 0.00 antibody (pra); quick method
86812 HLA typing; a, b, or c (eg, a10, b7, b27), single 182 247 336 0 0.00 antigen
86813 HLA typing; a, b, or c, multiple antigens 346 470 639 0 0.00
86816 HLA typing; dr/dq, single antigen 243 330 449 0 0.00
86817 HLA typing; dr/dq, multiple antigens 356 484 658 0 0.00
86821 HLA typing; lymphocyte culture, mixed (mlc) 312 424 577 0 0.00
86825 Human leukocyte antigen (HLA) crossmatch, 588 800 1087 0 0.00 non-cytotoxic (eg, using flow cytometry); first serum sample or dilution
86826 Human leukocyte antigen (HLA) crossmatch, 155 211 286 0 0.00 non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)
86828 Antibody to human leukocyte antigens (HLA), 136 184 251 0 0.00
650 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA class i and class ii HLA antigens
86829 Antibody to human leukocyte antigens (HLA), 280 381 518 0 0.00 solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA class i or class ii HLA antigens
86830 Antibody to human leukocyte antigens (HLA), 280 381 518 0 0.00 solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA class i
86831 Antibody to human leukocyte antigens (HLA), 281 382 519 0 0.00 solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA class ii
86832 Antibody to human leukocyte antigens (HLA), 535 728 989 0 0.00 solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), HLA class i
86833 Antibody to human leukocyte antigens (HLA), 521 708 963 0 0.00 solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), HLA class ii
86834 Antibody to human leukocyte antigens (HLA), 1507 2050 2785 0 0.00 solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); semi-quantitative panel (eg, titer), HLA class i
86835 Antibody to human leukocyte antigens (HLA), 1361 1851 2516 0 0.00 solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); semi-quantitative panel (eg, titer), HLA class ii
86849 Unlisted immunology procedure 0 0 0 0 0.00
TRANSFUSION MEDICINE
86850 Antibody screen, rbc, each serum technique 50 73 92 0 0.00
86860 Antibody elution (rbc), each elution 84 123 156 0 0.00
CPT copyright 2017 American Medical Association. 651 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86870 Antibody identification, rbc antibodies, each 122 178 226 0 0.00 panel for each serum technique
86880 Antihuman globulin test (coombs test); direct, 47 69 87 0 0.00 each antiserum
86885 Antihuman globulin test (coombs test); indirect, 23 34 43 0 0.00 qualitative, each reagent red cell
86886 Antihuman globulin test (coombs test); indirect, 74 109 138 0 0.00 each antibody titer
86890 Autologous blood or component, collection 272 398 505 0 0.00 processing and storage; predeposited
86891 Autologous blood or component, collection 90 132 168 0 0.00 processing and storage; intra- or postoperative salvage
86900 Blood typing, serologic; ABO 24 36 45 0 0.00
86901 Blood typing, serologic; rh (d) 27 39 49 0 0.00
86902 Blood typing, serologic; antigen testing of donor 66 97 123 0 0.00 blood using reagent serum, each antigen test
86904 Blood typing, serologic; antigen screening for 29 43 55 0 0.00 compatible unit using patient serum, per unit screened
86905 Blood typing, serologic; rbc antigens, other than 74 109 138 0 0.00 ABO or rh (d), each
86906 Blood typing, serologic; rh phenotyping, 28 41 51 0 0.00 complete
86910 Blood typing, for paternity testing, per 0 0 0 0 0.00 individual; ABO, rh and mn
86911 Blood typing, for paternity testing, per 0 0 0 0 0.00 individual; each additional antigen system
86920 Compatibility test each unit; immediate spin 82 120 153 0 0.00 technique
86921 Compatibility test each unit; incubation 138 202 257 0 0.00 technique
86922 Compatibility test each unit; antiglobulin 95 140 177 0 0.00 technique
86923 Compatibility test each unit; electronic 113 165 209 0 0.00
86927 Fresh frozen plasma, thawing, each unit 21 31 39 0 0.00
652 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
86930 Frozen blood, each unit; freezing (includes 0 0 0 0 0.00 preparation)
86931 Frozen blood, each unit; thawing 0 0 0 0 0.00
86932 Frozen blood, each unit; freezing (includes 0 0 0 0 0.00 preparation) and thawing
86940 Hemolysins and agglutinins; auto, screen, each 68 99 126 0 0.00
86941 Hemolysins and agglutinins; incubated 117 171 217 0 0.00
86945 Irradiation of blood product, each unit 276 405 513 0 0.00
86950 Leukocyte transfusion 0 0 0 0 0.00
86960 Volume reduction of blood or blood product (eg, 58 85 108 0 0.00 red blood cells or platelets), each unit
86965 Pooling of platelets or other blood products 121 178 226 0 0.00
86970 Pretreatment of RBCs for use in rbc antibody 121 178 225 0 0.00 detection, identification, and/or compatibility testing; incubation with chemical agents or drugs, each
86971 Pretreatment of RBCs for use in rbc antibody 0 0 0 0 0.00 detection, identification, and/or compatibility testing; incubation with enzymes, each
86972 Pretreatment of RBCs for use in rbc antibody 0 0 0 0 0.00 detection, identification, and/or compatibility testing; by density gradient separation
86975 Pretreatment of serum for use in rbc antibody 0 0 0 0 0.00 identification; incubation with drugs, each
86976 Pretreatment of serum for use in rbc antibody 0 0 0 0 0.00 identification; by dilution
86977 Pretreatment of serum for use in rbc antibody 0 0 0 0 0.00 identification; incubation with inhibitors, each
86978 Pretreatment of serum for use in rbc antibody 110 161 205 0 0.00 identification; by differential red cell absorption using patient RBCs or RBCs of known phenotype, each absorption
86985 Splitting of blood or blood products, each unit 92 135 171 0 0.00
86999 Unlisted transfusion medicine procedure 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 653 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
MICROBIOLOGY
87003 Animal inoculation, small animal, with 65 82 109 0 0.00 observation and dissection
87015 Concentration (any type), for infectious agents 27 34 45 0 0.00
87040 Culture, bacterial; blood, aerobic, with isolation 90 115 152 0 0.00 and presumptive identification of isolates (includes anaerobic culture, if appropriate)
87045 Culture, bacterial; stool, aerobic, with isolation 43 55 72 0 0.00 and preliminary examination (eg, KIA, LIA), salmonella and shigella species
87046 Culture, bacterial; stool, aerobic, additional 41 53 70 0 0.00 pathogens, isolation and presumptive identification of isolates, each plate
87070 Culture, bacterial; any other source except urine, 48 61 81 0 0.00 blood or stool, aerobic, with isolation and presumptive identification of isolates
87071 Culture, bacterial; quantitative, aerobic with 51 65 86 0 0.00 isolation and presumptive identification of isolates, any source except urine, blood or stool
87073 Culture, bacterial; quantitative, anaerobic with 17 21 28 0 0.00 isolation and presumptive identification of isolates, any source except urine, blood or stool
87075 Culture, bacterial; any source, except blood, 44 56 74 0 0.00 anaerobic with isolation and presumptive identification of isolates
87076 Culture, bacterial; anaerobic isolate, additional 49 62 82 0 0.00 methods required for definitive identification, each isolate
87077 Culture, bacterial; aerobic isolate, additional 30 38 51 0 0.00 methods required for definitive identification, each isolate
87081 Culture, presumptive, pathogenic organisms, 29 37 49 0 0.00 screening only;
87084 Culture, presumptive, pathogenic organisms, 38 48 64 0 0.00 screening only; with colony estimation from density chart
87086 Culture, bacterial; quantitative colony count, 47 60 79 0 0.00 urine
87088 Culture, bacterial; with isolation and 32 40 53 0 0.00 presumptive identification of each isolate, urine
654 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87101 Culture, fungi (mold or yeast) isolation, with 45 58 76 0 0.00 presumptive identification of isolates; skin, hair, or nail
87102 Culture, fungi (mold or yeast) isolation, with 41 52 68 0 0.00 presumptive identification of isolates; other source (except blood)
87103 Culture, fungi (mold or yeast) isolation, with 78 99 131 0 0.00 presumptive identification of isolates; blood
87106 Culture, fungi, definitive identification, each 31 40 52 0 0.00 organism; yeast
87107 Culture, fungi, definitive identification, each 71 90 118 0 0.00 organism; mold
87109 Culture, mycoplasma, any source 91 115 152 0 0.00
87110 Culture, chlamydia, any source 50 64 84 0 0.00
87116 Culture, tubercle or other acid-fast bacilli (eg, tb, 85 109 143 0 0.00 afb, mycobacteria) any source, with isolation and presumptive identification of isolates
87118 Culture, mycobacterial, definitive identification, 65 83 110 0 0.00 each isolate
87140 Culture, typing; immunofluorescent method, 52 66 87 0 0.00 each antiserum
87143 Culture, typing; gas liquid chromatography (glc) 48 61 81 0 0.00 or high pressure liquid chromatography (HPLC) method
87147 Culture, typing; immunologic method, other than 31 40 53 0 0.00 immunofluorescence (eg, agglutination grouping), per antiserum
87149 Culture, typing; identification by nucleic acid 60 77 101 0 0.00 (dan or rna) probe, direct probe technique, per culture or isolate, each organism probed
87150 Culture, typing; identification by nucleic acid 48 62 81 0 0.00 (dan or rna) probe, amplified probe technique, per culture or isolate, each organism probed
87152 Culture, typing; identification by pulse field gel 20 26 34 0 0.00 typing
87153 Culture, typing; identification by nucleic acid 366 465 614 0 0.00 sequencing method, each isolate (eg, sequencing of the 16s rRNA gene)
87158 Culture, typing; other methods 9 12 16 0 0.00
CPT copyright 2017 American Medical Association. 655 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87164 Dark field examination, any source (eg, penile, 42 53 71 0 0.00 vaginal, oral, skin); includes specimen collection
87164-26 42 53 71 19 0.52
87166 Dark field examination, any source (eg, penile, 43 55 73 0 0.00 vaginal, oral, skin); without collection
87168 Macroscopic examination; arthropod 81 103 135 0 0.00
87169 Macroscopic examination; parasite 24 30 40 0 0.00
87172 Pinworm exam (eg, cellophane tape prep) 34 44 58 0 0.00
87176 Homogenization, tissue, for culture 52 66 87 0 0.00
87177 Ova and parasites, direct smears, concentration 40 51 67 0 0.00 and identification
87181 Susceptibility studies, antimicrobial agent; agar 18 23 30 0 0.00 dilution method, per agent (eg, antibiotic gradient strip)
87184 Susceptibility studies, antimicrobial agent; disk 27 34 46 0 0.00 method, per plate (12 or fewer agents)
87185 Susceptibility studies, antimicrobial agent; 32 41 54 0 0.00 enzyme detection (eg, beta lactamase), per enzyme
87186 Susceptibility studies, antimicrobial agent; 38 48 63 0 0.00 microdilution or agar dilution (minimum inhibitory concentration [mic] or breakpoint), each multi-antimicrobial, per plate
87187 Susceptibility studies, antimicrobial agent; 43 54 72 0 0.00 microdilution or agar dilution, minimum lethal concentration (mlc), each plate (list separately in addition to code for primary procedure)
87188 Susceptibility studies, antimicrobial agent; 52 66 87 0 0.00 macrobroth dilution method, each agent
87190 Susceptibility studies, antimicrobial agent; 22 28 37 0 0.00 mycobacteria, proportion method, each agent
87197 Serum bactericidal titer (Schlichter test) 58 73 97 0 0.00
87205 Smear, primary source with interpretation; gram 26 33 44 0 0.00 or Giemsa stain for bacteria, fungi, or cell types
87206 Smear, primary source with interpretation; 46 58 77 0 0.00 fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types
656 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87207 Smear, primary source with interpretation; 52 66 87 0 0.00 special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)
87207-26 11 13 18 19 0.52
87209 Smear, primary source with interpretation; 62 78 103 0 0.00 complex special stain (eg, trichrome, iron hematoxylin) for ova and parasites
87210 Smear, primary source with interpretation; wet 20 26 34 0 0.00 mount for infectious agents (eg, saline, India ink, KOH preps)
87220 Tissue examination by KOH slide of samples 23 30 39 0 0.00 from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)
87230 Toxin or antitoxin assay, tissue culture (eg, 37 47 62 0 0.00 clostridium difficile toxin)
87250 Virus isolation; inoculation of embryonated 95 121 160 0 0.00 eggs, or small animal, includes observation and dissection
87252 Virus isolation; tissue culture inoculation, 128 163 215 0 0.00 observation, and presumptive identification by cytopathic effect
87253 Virus isolation; tissue culture, additional studies 71 90 119 0 0.00 or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate
87254 Virus isolation; centrifuge enhanced (shell vial) 78 99 131 0 0.00 technique, includes identification with immunofluorescence stain, each virus
87255 Virus isolation; including identification by non- 114 145 192 0 0.00 immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)
87260 Infectious agent antigen detection by 36 46 61 0 0.00 immunofluorescent technique; adenovirus
87265 Infectious agent antigen detection by 45 57 75 0 0.00 immunofluorescent technique; Bordetella pertussis/parapertussis
87267 Infectious agent antigen detection by 46 59 77 0 0.00 immunofluorescent technique; enterovirus, direct fluorescent antibody (DFA)
CPT copyright 2017 American Medical Association. 657 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87269 Infectious agent antigen detection by 44 56 74 0 0.00 immunofluorescent technique; Giardia
87270 Infectious agent antigen detection by 26 33 44 0 0.00 immunofluorescent technique; chlamydia trachomatis
87271 Infectious agent antigen detection by 46 59 77 0 0.00 immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (DFA)
87272 Infectious agent antigen detection by 36 45 60 0 0.00 immunofluorescent technique; cryptosporidium
87273 Infectious agent antigen detection by 46 59 78 0 0.00 immunofluorescent technique; herpes simplex virus type 2
87274 Infectious agent antigen detection by 73 93 123 0 0.00 immunofluorescent technique; herpes simplex virus type 1
87275 Infectious agent antigen detection by 31 39 52 0 0.00 immunofluorescent technique; influenza b virus
87276 Infectious agent antigen detection by 31 40 52 0 0.00 immunofluorescent technique; influenza a virus
87278 Infectious agent antigen detection by 100 128 169 0 0.00 immunofluorescent technique; legionella pneumophila
87279 Infectious agent antigen detection by 42 53 71 0 0.00 immunofluorescent technique; parainfluenza virus, each type
87280 Infectious agent antigen detection by 37 47 62 0 0.00 immunofluorescent technique; respiratory syncytial virus
87281 Infectious agent antigen detection by 23 30 39 0 0.00 immunofluorescent technique; pneumocystis carinii
87283 Infectious agent antigen detection by 46 59 77 0 0.00 immunofluorescent technique; rubeola
87285 Infectious agent antigen detection by 46 59 77 0 0.00 immunofluorescent technique; treponema pallidum
87290 Infectious agent antigen detection by 37 47 62 0 0.00 immunofluorescent technique; varicella zoster virus
658 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87299 Infectious agent antigen detection by 42 53 70 0 0.00 immunofluorescent technique; not otherwise specified, each organism
87300 Infectious agent antigen detection by 60 77 101 0 0.00 immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum
87301 Infectious agent antigen detection by 25 32 43 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; adenovirus enteric types 40/41
87305 Infectious agent antigen detection by 67 85 112 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; aspergillus
87320 Infectious agent antigen detection by 38 48 64 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; chlamydia trachomatis
87324 Infectious agent antigen detection by 108 137 181 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; clostridium difficile toxin(s)
87327 Infectious agent antigen detection by 105 134 177 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; cryptococcus neoformans
87328 Infectious agent antigen detection by 31 39 51 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca])
CPT copyright 2017 American Medical Association. 659 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
qualitative or semiquantitative, multiple-step method; cryptosporidium
87329 Infectious agent antigen detection by 35 45 59 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; Giardia
87332 Infectious agent antigen detection by 115 146 193 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; cytomegalovirus
87335 Infectious agent antigen detection by 53 67 89 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; Escherichia coli 0157
87336 Infectious agent antigen detection by 36 45 60 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; entamoeba histolytica dispar group
87337 Infectious agent antigen detection by 41 52 69 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; entamoeba histolytica group
87338 Infectious agent antigen detection by 142 180 238 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; helicobacter pylori, stool
87339 Infectious agent antigen detection by 23 30 39 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA],
660 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; helicobacter pylori
87340 Infectious agent antigen detection by 63 80 105 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; hepatitis b surface antigen (HBsAg)
87341 Infectious agent antigen detection by 55 70 93 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; hepatitis b surface antigen (HBsAg) neutralization
87350 Infectious agent antigen detection by 63 80 105 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; hepatitis be antigen (HBeAg)
87380 Infectious agent antigen detection by 63 80 106 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; hepatitis, delta agent
87385 Infectious agent antigen detection by 143 182 241 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; histoplasma capsulatum
87389 Infectious agent antigen detection by 106 134 177 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; hiv-1 antigen(s), with hiv-1 and hiv-2 antibodies, single result
CPT copyright 2017 American Medical Association. 661 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87390 Infectious agent antigen detection by 83 105 139 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; hiv-1
87391 Infectious agent antigen detection by 27 34 45 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; hiv-2
87400 Infectious agent antigen detection by 34 43 57 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; influenza, a or b, each
87420 Infectious agent antigen detection by 46 59 78 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; respiratory syncytial virus
87425 Infectious agent antigen detection by 99 125 166 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; rotavirus
87427 Infectious agent antigen detection by 68 86 114 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]) qualitative or semiquantitative, multiple-step method; shiga-like toxin
87430 Infectious agent antigen detection by 31 40 53 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca])
662 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
qualitative or semiquantitative, multiple-step method; streptococcus, group a
87449 Infectious agent antigen detection by 55 70 93 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]), qualitative or semiquantitative; multiple-step method, not otherwise specified, each organism
87450 Infectious agent antigen detection by 22 27 36 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]), qualitative or semiquantitative; single step method, not otherwise specified, each organism
87451 Infectious agent antigen detection by 99 126 166 0 0.00 immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [imca]), qualitative or semiquantitative; multiple step method, polyvalent for multiple organisms, each polyvalent antiserum
87471 Infectious agent detection by nucleic acid (dan 381 484 640 0 0.00 or rna); Bartonella henselae and Bartonella quintana, amplified probe technique
87472 Infectious agent detection by nucleic acid (dan 165 209 277 0 0.00 or rna); Bartonella henselae and Bartonella quintana, quantification
87475 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); Borrelia burgdorferi, direct probe technique
87476 Infectious agent detection by nucleic acid (dan 132 167 221 0 0.00 or rna); Borrelia burgdorferi, amplified probe technique
87480 Infectious agent detection by nucleic acid (dan 78 99 130 0 0.00 or rna); candida species, direct probe technique
87481 Infectious agent detection by nucleic acid (dan 108 137 182 0 0.00 or rna); candida species, amplified probe technique
87482 Infectious agent detection by nucleic acid (dan 80 102 134 0 0.00 or rna); candida species, quantification
CPT copyright 2017 American Medical Association. 663 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87483 Infectious agent detection by nucleic acid (dan 864 1098 1451 0 0.00 or rna); central nervous system pathogen (eg, neisseria meningitidis, streptococcus pneumoniae, listeria, haemophilus influenzae, e. coli, streptococcus agalactiae, enterovirus, human parechovirus, herpes simplex virus type 1 and 2, human herpesvirus 6, cytomegalovirus, varicella zoster virus, cryptococcus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets
87485 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); chlamydia pneumoniae, direct probe technique
87486 Infectious agent detection by nucleic acid (dan 53 67 89 0 0.00 or rna); chlamydia pneumoniae, amplified probe technique
87487 Infectious agent detection by nucleic acid (dan 118 149 197 0 0.00 or rna); chlamydia pneumoniae, quantification
87490 Infectious agent detection by nucleic acid (dan 50 64 85 0 0.00 or rna); chlamydia trachomatis, direct probe technique
87491 Infectious agent detection by nucleic acid (dan 124 157 208 0 0.00 or rna); chlamydia trachomatis, amplified probe technique
87492 Infectious agent detection by nucleic acid (dan 57 72 96 0 0.00 or rna); chlamydia trachomatis, quantification
87493 Infectious agent detection by nucleic acid (dan 102 129 171 0 0.00 or rna); clostridium difficile, toxin gene(s), amplified probe technique
87495 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); cytomegalovirus, direct probe technique
87496 Infectious agent detection by nucleic acid (dan 151 192 254 0 0.00 or rna); cytomegalovirus, amplified probe technique
87497 Infectious agent detection by nucleic acid (dan 379 481 636 0 0.00 or rna); cytomegalovirus, quantification
87498 Infectious agent detection by nucleic acid (dan 53 67 89 0 0.00 or rna); enterovirus, amplified probe technique, includes reverse transcription when performed
87500 Infectious agent detection by nucleic acid (dan 50 64 84 0 0.00 or rna); vancomycin resistance (eg, enterococcus species van a, van b), amplified probe technique
664 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87501 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype
87502 Infectious agent detection by nucleic acid (dan 176 223 295 0 0.00 or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub- types
87503 Infectious agent detection by nucleic acid (dan 55 69 92 0 0.00 or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, each additional influenza virus type or sub-type beyond 2 (list separately in addition to code for primary procedure)
87505 Infectious agent detection by nucleic acid (dan 247 314 415 0 0.00 or rna); gastrointestinal pathogen (eg, clostridium difficile, e. coli, salmonella, shigella, norovirus, Giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets
87506 Infectious agent detection by nucleic acid (dan 369 469 620 0 0.00 or rna); gastrointestinal pathogen (eg, clostridium difficile, e. coli, salmonella, shigella, norovirus, Giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 6-11 targets
87507 Infectious agent detection by nucleic acid (dan 774 983 1299 0 0.00 or rna); gastrointestinal pathogen (eg, clostridium difficile, e. coli, salmonella, shigella, norovirus, Giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets
87510 Infectious agent detection by nucleic acid (dan 80 102 134 0 0.00 or rna); Gardnerella vaginalis, direct probe technique
87511 Infectious agent detection by nucleic acid (dan 132 167 221 0 0.00 or rna); Gardnerella vaginalis, amplified probe technique
CPT copyright 2017 American Medical Association. 665 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87512 Infectious agent detection by nucleic acid (dan 110 139 184 0 0.00 or rna); Gardnerella vaginalis, quantification
87516 Infectious agent detection by nucleic acid (dan 306 388 513 0 0.00 or rna); hepatitis b virus, amplified probe technique
87517 Infectious agent detection by nucleic acid (dan 368 468 618 0 0.00 or rna); hepatitis b virus, quantification
87520 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); hepatitis c, direct probe technique
87521 Infectious agent detection by nucleic acid (dan 313 398 526 0 0.00 or rna); hepatitis c, amplified probe technique, includes reverse transcription when performed
87522 Infectious agent detection by nucleic acid (dan 449 570 754 0 0.00 or rna); hepatitis c, quantification, includes reverse transcription when performed
87525 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); hepatitis g, direct probe technique
87526 Infectious agent detection by nucleic acid (dan 135 172 227 0 0.00 or rna); hepatitis g, amplified probe technique
87527 Infectious agent detection by nucleic acid (dan 161 204 270 0 0.00 or rna); hepatitis g, quantification
87528 Infectious agent detection by nucleic acid (dan 76 96 127 0 0.00 or rna); herpes simplex virus, direct probe technique
87529 Infectious agent detection by nucleic acid (dan 151 192 253 0 0.00 or rna); herpes simplex virus, amplified probe technique
87530 Infectious agent detection by nucleic acid (dan 174 221 293 0 0.00 or rna); herpes simplex virus, quantification
87531 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); herpes virus-6, direct probe technique
87532 Infectious agent detection by nucleic acid (dan 131 166 220 0 0.00 or rna); herpes virus-6, amplified probe technique
87533 Infectious agent detection by nucleic acid (dan 329 418 552 0 0.00 or rna); herpes virus-6, quantification
87534 Infectious agent detection by nucleic acid (dan 81 102 135 0 0.00 or rna); hiv-1, direct probe technique
666 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87535 Infectious agent detection by nucleic acid (dan 399 507 670 0 0.00 or rna); hiv-1, amplified probe technique, includes reverse transcription when performed
87536 Infectious agent detection by nucleic acid (dan 395 502 663 0 0.00 or rna); hiv-1, quantification, includes reverse transcription when performed
87537 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); hiv-2, direct probe technique
87538 Infectious agent detection by nucleic acid (dan 211 269 355 0 0.00 or rna); hiv-2, amplified probe technique, includes reverse transcription when performed
87539 Infectious agent detection by nucleic acid (dan 165 209 277 0 0.00 or rna); hiv-2, quantification, includes reverse transcription when performed
87540 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); legionella pneumophila, direct probe technique
87541 Infectious agent detection by nucleic acid (dan 53 67 89 0 0.00 or rna); legionella pneumophila, amplified probe technique
87542 Infectious agent detection by nucleic acid (dan 161 204 270 0 0.00 or rna); legionella pneumophila, quantification
87550 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); mycobacteria species, direct probe technique
87551 Infectious agent detection by nucleic acid (dan 53 67 89 0 0.00 or rna); mycobacteria species, amplified probe technique
87552 Infectious agent detection by nucleic acid (dan 165 209 277 0 0.00 or rna); mycobacteria species, quantification
87555 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); mycobacteria tuberculosis, direct probe technique
87556 Infectious agent detection by nucleic acid (dan 90 114 150 0 0.00 or rna); mycobacteria tuberculosis, amplified probe technique
87557 Infectious agent detection by nucleic acid (dan 165 209 277 0 0.00 or rna); mycobacteria tuberculosis, quantification
CPT copyright 2017 American Medical Association. 667 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87560 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); mycobacteria avium-intracellulare, direct probe technique
87561 Infectious agent detection by nucleic acid (dan 151 191 253 0 0.00 or rna); mycobacteria avium-intracellulare, amplified probe technique
87562 Infectious agent detection by nucleic acid (dan 165 209 277 0 0.00 or rna); mycobacteria avium-intracellulare, quantification
87580 Infectious agent detection by nucleic acid (dan 77 98 130 0 0.00 or rna); mycoplasma pneumoniae, direct probe technique
87581 Infectious agent detection by nucleic acid (dan 53 68 89 0 0.00 or rna); mycoplasma pneumoniae, amplified probe technique
87582 Infectious agent detection by nucleic acid (dan 161 204 270 0 0.00 or rna); mycoplasma pneumoniae, quantification
87590 Infectious agent detection by nucleic acid (dan 40 51 67 0 0.00 or rna); neisseria gonorrhoeae, direct probe technique
87591 Infectious agent detection by nucleic acid (dan 124 157 208 0 0.00 or rna); neisseria gonorrhoeae, amplified probe technique
87592 Infectious agent detection by nucleic acid (dan 62 79 105 0 0.00 or rna); neisseria gonorrhoeae, quantification
87623 Infectious agent detection by nucleic acid (dan 171 217 287 0 0.00 or rna); human papillomavirus (HPV), low-risk types (eg, 6, 11, 42, 43, 44)
87624 Infectious agent detection by nucleic acid (dan 147 186 246 0 0.00 or rna); human papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68)
87625 Infectious agent detection by nucleic acid (dan 137 174 229 0 0.00 or rna); human papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed
87631 Infectious agent detection by nucleic acid (dan 261 332 438 0 0.00 or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets
668 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87632 Infectious agent detection by nucleic acid (dan 319 405 535 0 0.00 or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 6-11 targets
87633 Infectious agent detection by nucleic acid (dan 711 903 1193 0 0.00 or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets
87634 Infectious agent detection by nucleic acid (dan 0 0 0 0 0.00 or rna); respiratory syncytial virus, amplified probe technique
87640 Infectious agent detection by nucleic acid (dan 132 167 221 0 0.00 or rna); staphylococcus aureus, amplified probe technique
87641 Infectious agent detection by nucleic acid (dan 136 173 229 0 0.00 or rna); staphylococcus aureus, methicillin resistant, amplified probe technique
87650 Infectious agent detection by nucleic acid (dan 70 89 118 0 0.00 or rna); streptococcus, group a, direct probe technique
87651 Infectious agent detection by nucleic acid (dan 78 99 130 0 0.00 or rna); streptococcus, group a, amplified probe technique
87652 Infectious agent detection by nucleic acid (dan 102 130 172 0 0.00 or rna); streptococcus, group a, quantification
87653 Infectious agent detection by nucleic acid (dan 131 166 220 0 0.00 or rna); streptococcus, group b, amplified probe technique
87660 Infectious agent detection by nucleic acid (dan 79 100 132 0 0.00 or rna); trichomonas vaginalis, direct probe technique
87661 Infectious agent detection by nucleic acid (dan 132 167 221 0 0.00 or rna); trichomonas vaginalis, amplified probe technique
87662 Infectious agent detection by nucleic acid (dan 0 0 0 0 0.00 or rna); Zika virus, amplified probe technique
CPT copyright 2017 American Medical Association. 669 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87797 Infectious agent detection by nucleic acid (dan 72 92 121 0 0.00 or rna), not otherwise specified; direct probe technique, each organism
87798 Infectious agent detection by nucleic acid (dan 131 166 219 0 0.00 or rna), not otherwise specified; amplified probe technique, each organism
87799 Infectious agent detection by nucleic acid (dan 91 116 153 0 0.00 or rna), not otherwise specified; quantification, each organism
87800 Infectious agent detection by nucleic acid (dan 127 161 212 0 0.00 or rna), multiple organisms; direct probe(s) technique
87801 Infectious agent detection by nucleic acid (dan 209 266 351 0 0.00 or rna), multiple organisms; amplified probe(s) technique
87802 Infectious agent antigen detection by 30 38 51 0 0.00 immunoassay with direct optical observation; streptococcus, group b
87803 Infectious agent antigen detection by 50 63 83 0 0.00 immunoassay with direct optical observation; clostridium difficile toxin a
87804 Infectious agent antigen detection by 35 45 59 0 0.00 immunoassay with direct optical observation; influenza
87806 Infectious agent antigen detection by 58 74 98 0 0.00 immunoassay with direct optical observation; hiv-1 antigen(s), with hiv-1 and hiv-2 antibodies
87807 Infectious agent antigen detection by 36 45 60 0 0.00 immunoassay with direct optical observation; respiratory syncytial virus
87808 Infectious agent antigen detection by 34 43 56 0 0.00 immunoassay with direct optical observation; trichomonas vaginalis
87809 Infectious agent antigen detection by 35 45 59 0 0.00 immunoassay with direct optical observation; adenovirus
87810 Infectious agent antigen detection by 50 64 84 0 0.00 immunoassay with direct optical observation; chlamydia trachomatis
87850 Infectious agent antigen detection by 21 27 35 0 0.00 immunoassay with direct optical observation; neisseria gonorrhoeae
670 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
87880 Infectious agent antigen detection by 35 45 59 0 0.00 immunoassay with direct optical observation; streptococcus, group a
87899 Infectious agent antigen detection by 44 55 73 0 0.00 immunoassay with direct optical observation; not otherwise specified
87900 Infectious agent drug susceptibility phenotype 249 317 419 0 0.00 prediction using regularly updated genotypic bioinformatics
87901 Infectious agent genotype analysis by nucleic 559 710 939 0 0.00 acid (dan or rna); hiv-1, reverse transcriptase and protease regions
87902 Infectious agent genotype analysis by nucleic 681 865 1143 0 0.00 acid (dan or rna); hepatitis c virus
87903 Infectious agent phenotype analysis by nucleic 863 1097 1449 0 0.00 acid (dan or rna) with drug resistance tissue culture analysis, hiv 1; first through 10 drugs tested
87904 Infectious agent phenotype analysis by nucleic 47 60 79 0 0.00 acid (dan or rna) with drug resistance tissue culture analysis, hiv 1; each additional drug tested (list separately in addition to code for primary procedure)
87905 Infectious agent enzymatic activity other than 43 55 72 0 0.00 virus (eg, sialidase activity in vaginal fluid)
87906 Infectious agent genotype analysis by nucleic 283 360 476 0 0.00 acid (dan or rna); hiv-1, other region (eg, integrase, fusion)
87910 Infectious agent genotype analysis by nucleic 991 1259 1663 0 0.00 acid (dan or rna); cytomegalovirus
87912 Infectious agent genotype analysis by nucleic 470 597 789 0 0.00 acid (dan or rna); hepatitis b virus
87999 Unlisted microbiology procedure 0 0 0 0 0.00
ANATOMIC PATHOLOGY
88000 Necropsy (autopsy), gross examination only; 0 0 0 0 0.00 without cns
88005 Necropsy (autopsy), gross examination only; 0 0 0 0 0.00 with brain
88007 Necropsy (autopsy), gross examination only; 0 0 0 0 0.00 with brain and spinal cord
CPT copyright 2017 American Medical Association. 671 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88012 Necropsy (autopsy), gross examination only; 0 0 0 0 0.00 infant with brain
88014 Necropsy (autopsy), gross examination only; 0 0 0 0 0.00 stillborn or newborn with brain
88016 Necropsy (autopsy), gross examination only; 0 0 0 0 0.00 macerated stillborn
88020 Necropsy (autopsy), gross and microscopic; 0 0 0 0 0.00 without cns
88025 Necropsy (autopsy), gross and microscopic; with 0 0 0 0 0.00 brain
88027 Necropsy (autopsy), gross and microscopic; with 0 0 0 0 0.00 brain and spinal cord
88028 Necropsy (autopsy), gross and microscopic; 0 0 0 0 0.00 infant with brain
88029 Necropsy (autopsy), gross and microscopic; 0 0 0 0 0.00 stillborn or newborn with brain
88036 Necropsy (autopsy), limited, gross and/or 0 0 0 0 0.00 microscopic; regional
88037 Necropsy (autopsy), limited, gross and/or 0 0 0 0 0.00 microscopic; single organ
88040 Necropsy (autopsy); forensic examination 0 0 0 0 0.00
88045 Necropsy (autopsy); coroner's call 0 0 0 0 0.00
88099 Unlisted necropsy (autopsy) procedure 0 0 0 0 0.00
CYTOPATHOLOGY
88104 Cytopathology, fluids, washings or brushings, 188 213 255 74 2.06 except cervical or vaginal; smears with interpretation
88104-26 89 101 121 30 0.83
88104-TC 0 0 0 44 1.23
88106 Cytopathology, fluids, washings or brushings, 270 306 366 66 1.83 except cervical or vaginal; simple filter method with interpretation
88106-26 71 81 97 21 0.57
88106-TC 0 0 0 45 1.26
88108 Cytopathology, concentration technique, smears 236 267 320 62 1.73 and interpretation (eg, Saccomanno technique)
672 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88108-26 97 110 132 24 0.66
88108-TC 0 0 0 39 1.07
88112 Cytopathology, selective cellular enhancement 248 281 336 70 1.95 technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal
88112-26 157 177 212 30 0.82
88112-TC 0 0 0 41 1.13
88120 Cytopathology, in situ hybridization (eg, fish), 1630 1845 2210 650 18.05 urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual
88120-26 183 207 248 61 1.69
88120-TC 0 0 0 589 16.36
88121 Cytopathology, in situ hybridization (eg, fish), 1152 1303 1561 542 15.05 urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology
88121-26 280 317 379 52 1.45
88121-TC 0 0 0 490 13.60
88125 Cytopathology, forensic (eg, sperm) 69 78 94 27 0.76
88125-26 0 0 0 15 0.41
88125-TC 0 0 0 13 0.35
88130 Sex chromatin identification; Barr bodies 63 71 85 0 0.00
88140 Sex chromatin identification; peripheral blood 33 38 45 0 0.00 smear, polymorphonuclear drumsticks
88141 Cytopathology, cervical or vaginal (any 71 80 96 33 0.92 reporting system), requiring interpretation by physician
88142 Cytopathology, cervical or vaginal (any 77 87 104 0 0.00 reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision
88143 Cytopathology, cervical or vaginal (any 37 42 51 0 0.00 reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision
CPT copyright 2017 American Medical Association. 673 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88147 Cytopathology smears, cervical or vaginal; 60 68 81 0 0.00 screening by automated system under physician supervision
88148 Cytopathology smears, cervical or vaginal; 80 91 109 0 0.00 screening by automated system with manual rescreening under physician supervision
88150 Cytopathology, slides, cervical or vaginal; 36 41 49 0 0.00 manual screening under physician supervision
88152 Cytopathology, slides, cervical or vaginal; with 44 50 60 0 0.00 manual screening and computer-assisted rescreening under physician supervision
88153 Cytopathology, slides, cervical or vaginal; with 26 29 35 0 0.00 manual screening and rescreening under physician supervision
88155 Cytopathology, slides, cervical or vaginal, 23 26 31 0 0.00 definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (list separately in addition to code[s] for other technical and interpretation services)
88160 Cytopathology, smears, any other source; 100 113 135 74 2.06 screening and interpretation
88160-26 79 90 108 27 0.76
88160-TC 0 0 0 47 1.30
88161 Cytopathology, smears, any other source; 86 97 117 67 1.87 preparation, screening and interpretation
88161-26 64 72 87 26 0.73
88161-TC 0 0 0 41 1.14
88162 Cytopathology, smears, any other source; 119 134 161 99 2.75 extended study involving over 5 slides and/or multiple stains
88162-26 104 118 141 41 1.13
88162-TC 0 0 0 58 1.62
88164 Cytopathology, slides, cervical or vaginal (the 45 51 61 0 0.00 Bethesda system); manual screening under physician supervision
88165 Cytopathology, slides, cervical or vaginal (the 25 28 34 0 0.00 Bethesda system); with manual screening and rescreening under physician supervision
674 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88166 Cytopathology, slides, cervical or vaginal (the 44 50 60 0 0.00 Bethesda system); with manual screening and computer-assisted rescreening under physician supervision
88167 Cytopathology, slides, cervical or vaginal (the 44 50 60 0 0.00 Bethesda system); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision
88172 Cytopathology, evaluation of fine needle 177 201 240 59 1.64 aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site
88172-26 126 142 170 38 1.06
88172-TC 0 0 0 21 0.58
88173 Cytopathology, evaluation of fine needle 346 391 469 158 4.39 aspirate; interpretation and report
88173-26 208 236 282 75 2.08
88173-TC 0 0 0 83 2.31
88174 Cytopathology, cervical or vaginal (any 137 155 185 0 0.00 reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision
88175 Cytopathology, cervical or vaginal (any 94 106 127 0 0.00 reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under physician supervision
88177 Cytopathology, evaluation of fine needle 89 101 121 31 0.87 aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)
88177-26 70 79 95 23 0.65
88177-TC 0 0 0 8 0.22
88182 Flow cytometry, cell cycle or dan analysis 177 200 240 134 3.72
88182-26 107 121 145 41 1.13
88182-TC 0 0 0 93 2.59
CPT copyright 2017 American Medical Association. 675 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88184 Flow cytometry, cell surface, cytoplasmic, or 236 267 320 68 1.89 nuclear marker, technical component only; first marker
88185 Flow cytometry, cell surface, cytoplasmic, or 141 159 191 31 0.85 nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)
88187 Flow cytometry, interpretation; 2 to 8 markers 200 226 271 48 1.34
88188 Flow cytometry, interpretation; 9 to 15 markers 265 300 359 67 1.85
88189 Flow cytometry, interpretation; 16 or more 332 376 450 89 2.47 markers
88199 Unlisted cytopathology procedure 0 0 0 0 0.00
88199-26 0 0 0 0 0.00
88199-TC 0 0 0 0 0.00
CYTOGENETIC STUDIES
88230 Tissue culture for non-neoplastic disorders; 377 427 511 0 0.00 lymphocyte
88233 Tissue culture for non-neoplastic disorders; skin 518 586 702 0 0.00 or other solid tissue biopsy
88235 Tissue culture for non-neoplastic disorders; 402 455 545 0 0.00 amniotic fluid or chorionic villus cells
88237 Tissue culture for neoplastic disorders; bone 476 538 645 0 0.00 marrow, blood cells
88239 Tissue culture for neoplastic disorders; solid 607 687 823 0 0.00 tumor
88240 Cryopreservation, freezing and storage of cells, 74 84 101 0 0.00 each cell line
88241 Thawing and expansion of frozen cells, each 26 29 35 0 0.00 aliquot
88245 Chromosome analysis for breakage syndromes; 619 701 839 0 0.00 baseline sister chromatid exchange (sce), 20-25 cells
88248 Chromosome analysis for breakage syndromes; 720 815 976 0 0.00 baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia, fragile x)
88249 Chromosome analysis for breakage syndromes; 720 815 976 0 0.00 score 100 cells, clastogen stress (eg,
676 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
diepoxybutane, mitomycin c, ionizing radiation, uv radiation)
88261 Chromosome analysis; count 5 cells, 1 520 589 705 0 0.00 karyotype, with banding
88262 Chromosome analysis; count 15-20 cells, 2 522 591 708 0 0.00 karyotypes, with banding
88263 Chromosome analysis; count 45 cells for 625 707 847 0 0.00 mosaicism, 2 karyotypes, with banding
88264 Chromosome analysis; analyze 20-25 cells 522 591 708 0 0.00
88267 Chromosome analysis, amniotic fluid or 556 629 754 0 0.00 chorionic villus, count 15 cells, 1 karyotype, with banding
88269 Chromosome analysis, in situ for amniotic fluid 473 535 641 0 0.00 cells, count cells from 6-12 colonies, 1 karyotype, with banding
88271 Molecular cytogenetics; dan probe, each (eg, 59 67 80 0 0.00 fish)
88272 Molecular cytogenetics; chromosomal in situ 98 111 133 0 0.00 hybridization, analyze 3-5 cells (eg, for derivatives and markers)
88273 Molecular cytogenetics; chromosomal in situ 118 134 160 0 0.00 hybridization, analyze 10-30 cells (eg, for microdeletions)
88274 Molecular cytogenetics; interphase in situ 126 143 171 0 0.00 hybridization, analyze 25-99 cells
88275 Molecular cytogenetics; interphase in situ 204 231 277 0 0.00 hybridization, analyze 100-300 cells
88280 Chromosome analysis; additional karyotypes, 111 125 150 0 0.00 each study
88283 Chromosome analysis; additional specialized 244 276 331 0 0.00 banding technique (eg, nor, c-banding)
88285 Chromosome analysis; additional cells counted, 86 98 117 0 0.00 each study
88289 Chromosome analysis; additional high resolution 116 131 157 0 0.00 study
88291 Cytogenetics and molecular cytogenetics, 87 98 118 34 0.94 interpretation and report
88299 Unlisted cytogenetic study 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 677 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
SURGICAL PATHOLOGY
88300 Level i - surgical pathology, gross examination 67 93 123 17 0.47 only
88300-26 39 55 72 5 0.13
88300-TC 0 0 0 12 0.34
88302 Level ii - surgical pathology, gross and 127 177 234 32 0.88 microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incidental vas deferens, sterilization
88302-26 75 105 139 8 0.21
88302-TC 0 0 0 24 0.67
88304 Level iii - surgical pathology, gross and 167 233 308 42 1.16 microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque Bartholin's gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel tissue cartilage, shavings cholesteatoma colon, colostomy stoma conjunctiva - biopsy/pterygium cornea diverticulum - esophagus/small intestine Dupuytren's contracture tissue femoral head, other than fracture fissure/fistula foreskin, other than newborn gallbladder ganglion cyst hematoma hemorrhoids hydatid of Morgagni intervertebral disc joint, loose body meniscus mucocele, salivary neuroma - Morton's/traumatic pilonidal cyst/sinus polyps, inflammatory - nasal/sinusoidal skin - cyst/tag/debridement soft tissue, debridement soft tissue, lipoma spermatocele tendon/tendon sheath testicular appendage thrombus or embolus tonsil and/or adenoids varicocele vas deferens, other than sterilization vei
88304-26 105 146 193 12 0.34
88304-TC 0 0 0 30 0.82
88305 Level iv - surgical pathology, gross and 218 304 401 70 1.95 microscopic examination abortion - spontaneous/ missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring
678 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
microscopic evaluation of surgical margins breast, reduction mammoplasty bronchus, biopsy cell block, any source cervix, biopsy colon, biopsy duodenum, biopsy endocervix, curettings/biopsy endometrium, curettings/ biopsy esophagus, biopsy extremity, amputation, traumatic fallopian tube, biopsy fallopian tube, ectopic pregnancy femoral head, fracture fingers/toes, amputation, non-traumatic gingiva/oral mucosa, biopsy heart valve joint, resection kidney, biopsy larynx, biopsy leiomyoma(s), uterine myomectomy - without uterus lip, biopsy/wedge resection lung, transbronchial biopsy lymph node, biopsy muscle, biopsy nasal mucosa, biopsy nasopharynx/oropharynx, biopsy nerve, biopsy odontogenic/dental cyst omentum, biopsy ovary with or without tube, non-neoplastic ovary, biop
88305-26 142 198 261 40 1.11
88305-TC 0 0 0 30 0.84
88307 Level v - surgical pathology, gross and 501 699 921 270 7.50 microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partial/simple cervix, conization colon, segmental resection, other than for tumor extremity, amputation, non-traumatic eye, enucleation kidney, partial/total nephrectomy larynx, partial/total resection liver, biopsy - needle/wedge liver, partial resection lung, wedge biopsy lymph nodes, regional resection mediastinum, mass myocardium, biopsy odontogenic tumor ovary with or without tube, neoplastic pancreas, biopsy placenta, third trimester prostate, except radical resection salivary gland sentinel lymph node small intestine, resection, other than for tumor soft tissue mass (except lipoma) - biopsy/simple excision stomach - subtotal/total resection, other than for tumor testis, biopsy thymus, tumo
88307-26 310 432 570 88 2.44
88307-TC 0 0 0 182 5.06
88309 Level vi - surgical pathology, gross and 697 971 1281 410 11.39 microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection
CPT copyright 2017 American Medical Association. 679 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
extremity, disarticulation fetus, with dissection larynx, partial/total resection - with regional lymph nodes lung - total/lobe/segment resection pancreas, total/subtotal resection prostate, radical resection small intestine, resection for tumor soft tissue tumor, extensive resection stomach - subtotal/total resection for tumor testis, tumor tongue/tonsil -resection for tumor urinary bladder, partial/total resection uterus, with or without tubes and ovaries, neoplastic vulva, total/subtotal resection
88309-26 472 658 868 156 4.33
88309-TC 0 0 0 254 7.06
88311 Decalcification procedure (list separately in 65 91 120 23 0.63 addition to code for surgical pathology examination)
88311-26 48 67 88 13 0.37
88311-TC 0 0 0 9 0.26
88312 Special stain including interpretation and report; 320 446 589 99 2.76 group i for microorganisms (eg, acid fast, methenamine silver)
88312-26 143 199 263 28 0.78
88312-TC 0 0 0 71 1.98
88313 Special stain including interpretation and report; 182 253 334 72 2.00 group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry
88313-26 68 95 125 13 0.35
88313-TC 0 0 0 59 1.65
88314 Special stain including interpretation and report; 146 204 269 87 2.42 histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)
88314-26 65 90 119 24 0.66
88314-TC 0 0 0 63 1.76
88319 Special stain including interpretation and report; 322 448 591 90 2.50 group iii, for enzyme constituents
88319-26 94 132 174 28 0.78
680 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88319-TC 0 0 0 62 1.72
88321 Consultation and report on referred slides 292 407 537 105 2.92 prepared elsewhere
88323 Consultation and report on referred material 323 450 594 125 3.47 requiring preparation of slides
88323-26 238 332 438 91 2.54
88323-TC 0 0 0 33 0.93
88325 Consultation, comprehensive, with review of 467 651 858 190 5.27 records and specimens, with report on referred material
88329 Pathology consultation during surgery; 154 215 284 53 1.48
88331 Pathology consultation during surgery; first 310 432 569 100 2.77 tissue block, with frozen section(s), single specimen
88331-26 224 312 411 67 1.85
88331-TC 0 0 0 33 0.92
88332 Pathology consultation during surgery; each 191 266 351 54 1.51 additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)
88332-26 132 185 243 33 0.91
88332-TC 0 0 0 22 0.60
88333 Pathology consultation during surgery; cytologic 286 399 527 92 2.55 examination (eg, touch prep, squash prep), initial site
88333-26 205 286 377 67 1.85
88333-TC 0 0 0 25 0.70
88334 Pathology consultation during surgery; cytologic 148 206 272 57 1.58 examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)
88334-26 124 173 228 41 1.13
88334-TC 0 0 0 16 0.45
88341 Immunohistochemistry or immunocyto- 233 324 428 95 2.63 chemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)
CPT copyright 2017 American Medical Association. 681 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88341-26 101 141 185 30 0.83
88341-TC 0 0 0 65 1.80
88342 Immunohistochemistry or immunocyto- 242 337 445 112 3.10 chemistry, per specimen; initial single antibody stain procedure
88342-26 129 180 238 37 1.04
88342-TC 0 0 0 74 2.06
88344 Immunohistochemistry or immunocyto- 482 672 886 179 4.96 chemistry, per specimen; each multiplex antibody stain procedure
88344-26 145 203 267 41 1.14
88344-TC 0 0 0 138 3.82
88346 Immunofluorescence, per specimen; initial 163 227 300 96 2.66 single antibody stain procedure
88346-26 105 146 193 38 1.05
88346-TC 0 0 0 58 1.61
88348 Electron microscopy, diagnostic 1107 1544 2037 354 9.84
88348-26 323 450 594 80 2.22
88348-TC 0 0 0 274 7.62
88350 Immunofluorescence, per specimen; each 161 225 296 74 2.05 additional single antibody stain procedure (list separately in addition to code for primary procedure)
88350-26 85 118 156 30 0.84
88350-TC 0 0 0 44 1.21
88355 Morphometric analysis; skeletal muscle 417 581 767 134 3.73
88355-26 0 0 0 86 2.38
88355-TC 0 0 0 49 1.35
88356 Morphometric analysis; nerve 503 701 925 225 6.26
88356-26 389 543 716 130 3.60
88356-TC 0 0 0 96 2.66
88358 Morphometric analysis; tumor (eg, dan ploidy) 286 399 527 97 2.69
682 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88358-26 0 0 0 49 1.36
88358-TC 0 0 0 48 1.33
88360 Morphometric analysis, tumor immunohisto- 398 554 731 136 3.79 chemistry (eg, her-2/neu, estrogen receptor/ progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual
88360-26 194 271 357 47 1.30
88360-TC 0 0 0 90 2.49
88361 Morphometric analysis, tumor immunohisto- 376 525 692 148 4.12 chemistry (eg, her-2/neu, estrogen receptor/ progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer- assisted technology
88361-26 188 262 346 50 1.38
88361-TC 0 0 0 99 2.74
88362 Nerve teasing preparations 700 976 1287 213 5.93
88362-26 0 0 0 116 3.22
88362-TC 0 0 0 98 2.71
88363 Examination and selection of retrieved archival 85 118 156 24 0.68 (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis)
88364 In situ hybridization (eg, fish), per specimen; 339 472 623 135 3.75 each additional single probe stain procedure (list separately in addition to code for primary procedure)
88364-26 110 153 202 37 1.02
88364-TC 0 0 0 98 2.73
88365 In situ hybridization (eg, fish), per specimen; 331 461 608 184 5.10 initial single probe stain procedure
88365-26 182 254 334 46 1.29
88365-TC 0 0 0 137 3.81
88366 In situ hybridization (eg, fish), per specimen; 373 519 685 268 7.45 each multiplex probe stain procedure
88366-26 217 303 399 66 1.82
CPT copyright 2017 American Medical Association. 683 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88366-TC 0 0 0 203 5.63
88367 Morphometric analysis, in situ hybridization 622 867 1143 109 3.04 (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure
88367-26 388 540 713 36 1.01
88367-TC 0 0 0 73 2.03
88368 Morphometric analysis, in situ hybridization 701 977 1289 123 3.43 (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure
88368-26 226 315 415 44 1.21
88368-TC 0 0 0 80 2.22
88369 Morphometric analysis, in situ hybridization 398 555 732 112 3.10 (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)
88369-26 77 107 141 34 0.94
88369-TC 0 0 0 78 2.16
88371 Protein analysis of tissue by western blot, with 79 111 146 0 0.00 interpretation and report;
88371-26 0 0 0 19 0.52
88372 Protein analysis of tissue by western blot, with 46 64 85 0 0.00 interpretation and report; immunological probe for band identification, each
88372-26 46 64 85 19 0.52
88373 Morphometric analysis, in situ hybridization 640 892 1176 80 2.23 (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)
88373-26 77 107 141 29 0.80
88373-TC 0 0 0 51 1.43
88374 Morphometric analysis, in situ hybridization 1369 1909 2518 351 9.76 (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure
684 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88374-26 246 343 452 46 1.28
88374-TC 0 0 0 305 8.48
88375 Optical endomicroscopic image(s), interpretation 153 214 282 52 1.45 and report, real-time or referred, each endoscopic session
88377 Morphometric analysis, in situ hybridization 1051 1465 1932 418 11.60 (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure
88377-26 223 312 411 67 1.86
88377-TC 0 0 0 351 9.74
88380 Microdissection (ie, sample preparation of 216 302 398 140 3.89 microscopically identified target); laser capture
88380-26 89 124 164 58 1.60
88380-TC 0 0 0 82 2.29
88381 Microdissection (ie, sample preparation of 636 886 1169 125 3.47 microscopically identified target); manual
88381-26 199 278 367 26 0.73
88381-TC 0 0 0 99 2.74
88387 Macroscopic examination, dissection, and 85 119 157 36 0.99 preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies); each tissue preparation (eg, a single lymph node)
88387-26 50 70 92 30 0.82
88387-TC 0 0 0 6 0.17
88388 Macroscopic examination, dissection, and 104 144 191 35 0.98 preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies); in conjunction with a touch imprint, intraoperative consultation, or frozen section, each tissue preparation (eg, a single lymph node) (list separately in addition to code for primary procedure)
88388-26 0 0 0 25 0.70
88388-TC 0 0 0 10 0.28
88399 Unlisted surgical pathology procedure 0 0 0 0 0.00
88399-26 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 685 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
88399-TC 0 0 0 0 0.00
IN VIVO (EG, TRANSCUTANEOUS LABORATORY PROCEDURES
88720 Bilirubin, total, transcutaneous 22 31 41 0 0.00
88738 Hemoglobin (hgb), quantitative, transcutaneous 21 30 39 0 0.00
88740 Hemoglobin, quantitative, transcutaneous, per 32 44 59 0 0.00 day; carboxyhemoglobin
88741 Hemoglobin, quantitative, transcutaneous, per 20 28 37 0 0.00 day; methemoglobin
88749 Unlisted in vivo (eg, transcutaneous) laboratory 0 0 0 0 0.00 service
OTHER PROCEDURES
89049 Caffeine halothane contracture test (CHCT) for 759 1077 1721 248 6.89 malignant hyperthermia susceptibility, including interpretation and report
89050 Cell count, miscellaneous body fluids (eg, 20 29 46 0 0.00 cerebrospinal fluid, joint fluid), except blood;
89051 Cell count, miscellaneous body fluids (eg, 48 69 110 0 0.00 cerebrospinal fluid, joint fluid), except blood; with differential count
89055 Leukocyte assessment, fecal, qualitative or 55 78 125 0 0.00 semiquantitative
89060 Crystal identification by light microscopy with 56 80 127 0 0.00 or without polarizing lens analysis, tissue or any body fluid (except urine)
89060-26 21 30 47 19 0.52
89125 Fat stain, feces, urine, or respiratory secretions 41 58 93 0 0.00
89160 Meat fibers, feces 18 26 41 0 0.00
89190 Nasal smear for eosinophils 18 25 40 0 0.00
89220 Sputum, obtaining specimen, aerosol induced 51 72 115 17 0.46 technique (separate procedure)
89230 Sweat collection by iontophoresis 55 79 126 4 0.10
89240 Unlisted miscellaneous pathology test 0 0 0 0 0.00
REPRODUCTIVE MEDICINE PROCEDURES
89250 Culture of oocyte(s)/embryo(s), less than 4 days; 1818 2582 4125 0 0.00
686 CPT copyright 2017 American Medical Association. PATHOLOGY AND LABORATORY
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
89251 Culture of oocyte(s)/embryo(s), less than 4 days; 2086 2962 4732 0 0.00 with co-culture of oocyte(s)/embryos
89253 Assisted embryo hatching, microtechniques (any 665 944 1508 0 0.00 method)
89254 Oocyte identification from follicular fluid 728 1034 1652 0 0.00
89255 Preparation of embryo for transfer (any method) 462 656 1048 0 0.00
89257 Sperm identification from aspiration (other than 1018 1446 2310 0 0.00 seminal fluid)
89258 Cryopreservation; embryo(s) 1038 1474 2355 0 0.00
89259 Cryopreservation; sperm 260 369 589 0 0.00
89260 Sperm isolation; simple prep (eg, sperm wash 204 290 463 0 0.00 and swim-up) for insemination or diagnosis with semen analysis
89261 Sperm isolation; complex prep (eg, Percoll 244 347 554 0 0.00 gradient, albumin gradient) for insemination or diagnosis with semen analysis
89264 Sperm identification from testis tissue, fresh or 482 684 1093 0 0.00 cryopreserved
89268 Insemination of oocytes 527 749 1196 0 0.00
89272 Extended culture of oocyte(s)/embryo(s), 4-7 1355 1924 3073 0 0.00 days
89280 Assisted oocyte fertilization, microtechnique; 2046 2905 4640 0 0.00 less than or equal to 10 oocytes
89281 Assisted oocyte fertilization, microtechnique; 2444 3470 5543 0 0.00 greater than 10 oocytes
89290 Biopsy, oocyte polar body or embryo 2046 2905 4640 0 0.00 blastomere, microtechnique (for pre- implantation genetic diagnosis); less than or equal to 5 embryos
89291 Biopsy, oocyte polar body or embryo 2291 3254 5197 0 0.00 blastomere, microtechnique (for pre- implantation genetic diagnosis); greater than 5 embryos
89300 Semen analysis; presence and/or motility of 65 93 148 0 0.00 sperm including Huhner test (post coital)
89310 Semen analysis; motility and count (not 58 83 132 0 0.00 including Huhner test)
CPT copyright 2017 American Medical Association. 687 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
89320 Semen analysis; volume, count, motility, and 153 217 346 0 0.00 differential
89321 Semen analysis; sperm presence and motility of 53 76 121 0 0.00 sperm, if performed
89322 Semen analysis; volume, count, motility, and 173 245 392 0 0.00 differential using strict morphologic criteria (eg, Kruger)
89325 Sperm antibodies 154 219 349 0 0.00
89329 Sperm evaluation; hamster penetration test 86 122 195 0 0.00
89330 Sperm evaluation; cervical mucus penetration 125 177 283 0 0.00 test, with or without spinnbarkeit test
89331 Sperm evaluation, for retrograde ejaculation, 108 153 245 0 0.00 urine (sperm concentration, motility, and morphology, as indicated)
89335 Cryopreservation, reproductive tissue, testicular 0 0 0 0 0.00
89337 Cryopreservation, mature oocyte(s) 1051 1492 2384 0 0.00
89342 Storage (per year); embryo(s) 255 362 578 0 0.00
89343 Storage (per year); sperm/semen 66 94 151 0 0.00
89344 Storage (per year); reproductive tissue, 0 0 0 0 0.00 testicular/ovarian
89346 Storage (per year); oocyte(s) 51 72 115 0 0.00
89352 Thawing of cryopreserved; embryo(s) 560 795 1270 0 0.00
89353 Thawing of cryopreserved; sperm/semen, each 107 152 243 0 0.00 aliquot
89354 Thawing of cryopreserved; reproductive tissue, 0 0 0 0 0.00 testicular/ovarian
89356 Thawing of cryopreserved; oocytes, each aliquot 560 795 1270 0 0.00
89398 Unlisted reproductive medicine laboratory 0 0 0 0 0.00 procedure
688 CPT copyright 2017 American Medical Association.
MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
IMMUNE GLOBULINS, SERUM OR RECOMBINANT PRODUCTS
90281 Immune globulin (iG), human, for 60 77 99 0 0.00 intramuscular use
90283 Immune globulin (IGIV), human, for 140 179 231 0 0.00 intravenous use
90284 Immune globulin (SCIg), human, for use in 0 0 0 0 0.00 subcutaneous infusions, 100 mg, each
90287 Botulinum antitoxin, equine, any route 0 0 0 0 0.00
90288 Botulism immune globulin, human, for 0 0 0 0 0.00 intravenous use
90291 Cytomegalovirus immune globulin (CMV- 0 0 0 0 0.00 IGIV), human, for intravenous use
90296 Diphtheria antitoxin, equine, any route 0 0 0 0 0.00
90371 Hepatitis b immune globulin (HBIG), human, 168 215 277 0 0.00 for intramuscular use
90375 Rabies immune globulin (rig), human, for 507 647 836 0 0.00 intramuscular and/or subcutaneous use
90376 Rabies immune globulin, heat-treated (rig-ht), 418 533 690 0 0.00 human, for intramuscular and/or subcutaneous use
90378 Respiratory syncytial virus, monoclonal 1763 2250 2909 0 0.00 antibody, recombinant, for intramuscular use, 50 mg, each
90384 Rho(d) immune globulin (RhIg), human, full- 178 227 293 0 0.00 dose, for intramuscular use
90385 Rho(d) immune globulin (RhIg), human, mini- 78 99 128 0 0.00 dose, for intramuscular use
90386 Rho(d) immune globulin (RhIgIV), human, for 0 0 0 0 0.00 intravenous use
90389 Tetanus immune globulin (tig), human, for 51 65 84 0 0.00 intramuscular use
90393 Vaccinia immune globulin, human, for 0 0 0 0 0.00 intramuscular use
90396 Varicella-zoster immune globulin, human, for 46 59 76 0 0.00 intramuscular use
CPT copyright 2017 American Medical Association. 689 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
90399 Unlisted immune globulin 0 0 0 0 0.00
IMMUNIZATION ADMINISTRATION
90460 Immunization administration through 18 years 40 51 66 21 0.58 of age via any route of admin, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered
90461 Immunization administration through 18 years 25 32 42 13 0.36 of age via any route of admin, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)
90471 Immunization administration (includes 37 47 60 21 0.58 percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)
90472 Immunization administration (includes 23 29 38 13 0.36 percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)
90473 Immunization administration by intranasal or 30 39 50 21 0.58 oral route; 1 vaccine (single or combination vaccine/toxoid)
90474 Immunization administration by intranasal or 23 29 38 13 0.36 oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)
VACCINES, TOXOIDS
90476 Adenovirus vaccine, type 4, live, for oral use 10 13 17 0 0.00
90477 Adenovirus vaccine, type 7, live, for oral use 0 0 0 0 0.00
90581 Anthrax vaccine, for subcutaneous or 0 0 0 0 0.00 intramuscular use
90585 Bacillus Calmette-Guerin vaccine (BCG) for 32 41 53 0 0.00 tuberculosis, live, for percutaneous use
90586 Bacillus Calmette-Guerin vaccine (BCG) for 252 321 416 0 0.00 bladder cancer, live, for intravesical use
90587 Dengue vaccine, quadrivalent, live, 3 dose 0 0 0 0 0.00 schedule, for subcutaneous use
690 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
90620 Meningococcal recombinant protein and outer 225 288 372 0 0.00 membrane vesicle vaccine, serogroup b (menb- 4c), 2 dose schedule, for intramuscular use
90621 Meningococcal recombinant lipoprotein 184 234 303 0 0.00 vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use
90625 Cholera vaccine, live, adult dosage, 1 dose 0 0 0 0 0.00 schedule, for oral use
90630 Influenza virus vaccine, quadrivalent (iiv4), 39 50 65 0 0.00 split virus, preservative free, for intradermal use
90632 Hepatitis a vaccine (HepA), adult dosage, for 100 128 166 0 0.00 intramuscular use
90633 Hepatitis a vaccine (HepA), 60 77 100 0 0.00 pediatric/adolescent dosage-2 dose schedule, for intramuscular use
90634 Hepatitis a vaccine (HepA), 55 71 91 0 0.00 pediatric/adolescent dosage-3 dose schedule, for intramuscular use
90636 Hepatitis a and hepatitis b vaccine (HepA- 148 189 244 0 0.00 HepB), adult dosage, for intramuscular use
90644 Meningococcal conjugate vaccine, serogroups 61 78 101 0 0.00 c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use
90647 Haemophilus influenzae type b vaccine (Hib), 47 60 77 0 0.00 prp-omp conjugate, 3 dose schedule, for intramuscular use
90648 Haemophilus influenzae type b vaccine (Hib), 47 60 78 0 0.00 PRP-t conjugate, 4 dose schedule, for intramuscular use
90649 Human papillomavirus vaccine, types 6, 11, 16, 208 265 343 0 0.00 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use
90650 Human papillomavirus vaccine, types 16, 18, 200 255 330 0 0.00 bivalent (2vhpv), 3 dose schedule, for intramuscular use
90651 Human papillomavirus vaccine types 6, 11, 16, 250 319 413 0 0.00 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use
CPT copyright 2017 American Medical Association. 691 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
90653 Influenza vaccine, inactivated (iiv), subunit, 56 72 93 0 0.00 adjuvanted, for intramuscular use
90654 Influenza virus vaccine, trivalent (iiv3), split 32 41 53 0 0.00 virus, preservative-free, for intradermal use
90655 Influenza virus vaccine, trivalent (iiv3), split 30 39 50 0 0.00 virus, preservative free, 0.25 ml dosage, for intramuscular use
90656 Influenza virus vaccine, trivalent (iiv3), split 25 32 42 0 0.00 virus, preservative free, 0.5 ml dosage, for intramuscular use
90657 Influenza virus vaccine, trivalent (iiv3), split 27 34 44 0 0.00 virus, 0.25 ml dosage, for intramuscular use
90658 Influenza virus vaccine, trivalent (iiv3), split 30 38 50 0 0.00 virus, 0.5 ml dosage, for intramuscular use
90660 Influenza virus vaccine, trivalent, live (laiv3), 40 51 66 0 0.00 for intranasal use
90661 Influenza virus vaccine, trivalent (cciiv3), 30 39 50 0 0.00 derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use
90662 Influenza virus vaccine (iiv), split virus, 50 64 83 0 0.00 preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
90664 Influenza virus vaccine, live (laiv), pandemic 0 0 0 0 0.00 formulation, for intranasal use
90666 Influenza virus vaccine (iiv), pandemic 0 0 0 0 0.00 formulation, split virus, preservative free, for intramuscular use
90667 Influenza virus vaccine (iiv), pandemic 25 32 42 0 0.00 formulation, split virus, adjuvanted, for intramuscular use
90668 Influenza virus vaccine (iiv), pandemic 35 45 58 0 0.00 formulation, split virus, for intramuscular use
90670 Pneumococcal conjugate vaccine, 13 valent 216 276 357 0 0.00 (pcv13), for intramuscular use
90672 Influenza virus vaccine, quadrivalent, live 40 51 66 0 0.00 (laiv4), for intranasal use
90673 Influenza virus vaccine, trivalent (riv3), 46 58 75 0 0.00 derived from recombinant dan, hemagglutinin
692 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
(ha) protein only, preservative and antibiotic free, for intramuscular use
90674 Influenza virus vaccine, quadrivalent (cciiv4), 35 45 58 0 0.00 derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use
90675 Rabies vaccine, for intramuscular use 339 433 559 0 0.00
90676 Rabies vaccine, for intradermal use 0 0 0 0 0.00
90680 Rotavirus vaccine, pentavalent (rv5), 3 dose 122 156 201 0 0.00 schedule, live, for oral use
90681 Rotavirus vaccine, human, attenuated (rv1), 2 155 198 256 0 0.00 dose schedule, live, for oral use
90682 Influenza virus vaccine, quadrivalent (riv4), 50 64 83 0 0.00 derived from recombinant dan, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use
90685 Influenza virus vaccine, quadrivalent (iiv4), 35 45 58 0 0.00 split virus, preservative free, 0.25 ml dosage, for intramuscular use
90686 Influenza virus vaccine, quadrivalent (iiv4), 32 41 53 0 0.00 split virus, preservative free, 0.5 ml dosage, for intramuscular use
90687 Influenza virus vaccine, quadrivalent (iiv4), 30 38 50 0 0.00 split virus, 0.25 ml dosage, for intramuscular use
90688 Influenza virus vaccine, quadrivalent (iiv4), 30 38 50 0 0.00 split virus, 0.5 ml dosage, for intramuscular use
90690 Typhoid vaccine, live, oral 70 90 116 0 0.00
90691 Typhoid vaccine, vi capsular polysaccharide 107 137 177 0 0.00 (ViCPs), for intramuscular use
90696 Diphtheria, tetanus toxoids, acellular pertussis 85 108 140 0 0.00 vaccine and inactivated poliovirus vaccine (dtap-IPV), when administered to children 4 through 6 years of age, for intramuscular use
90697 Diphtheria, tetanus toxoids, acellular pertussis 69 88 114 0 0.00 vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-IPV-hib-hepb), for intramuscular use
90698 Diphtheria, tetanus toxoids, acellular pertussis 129 164 212 0 0.00 vaccine, haemophilus influenzae type b, and
CPT copyright 2017 American Medical Association. 693 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
inactivated poliovirus vaccine, (dtap-IPV/Hib), for intramuscular use
90700 Diphtheria, tetanus toxoids, and acellular 50 64 83 0 0.00 pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use
90702 Diphtheria and tetanus toxoids adsorbed (dt) 50 64 83 0 0.00 when administered to individuals younger than 7 years, for intramuscular use
90707 Measles, mumps and rubella virus vaccine 86 110 142 0 0.00 (MMR), live, for subcutaneous use
90710 Measles, mumps, rubella, and varicella vaccine 229 292 377 0 0.00 (MMRV), live, for subcutaneous use
90713 Poliovirus vaccine, inactivated (IPV), for 52 66 85 0 0.00 subcutaneous or intramuscular use
90714 Tetanus and diphtheria toxoids adsorbed (td), 42 54 69 0 0.00 preservative free, when administered to individuals 7 years or older, for intramuscular use
90715 Tetanus, diphtheria toxoids and acellular 70 89 116 0 0.00 pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use
90716 Varicella virus vaccine (var), live, for 144 184 237 0 0.00 subcutaneous use
90717 Yellow fever vaccine, live, for subcutaneous 157 201 259 0 0.00 use
90723 Diphtheria, tetanus toxoids, acellular pertussis 120 153 198 0 0.00 vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-HepB-IPV), for intramuscular use
90732 Pneumococcal polysaccharide vaccine, 23- 105 134 173 0 0.00 valent (ppsv23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use
90733 Meningococcal polysaccharide vaccine, 156 199 258 0 0.00 serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use
90734 Meningococcal conjugate vaccine, serogroups 162 206 267 0 0.00 a, c, y and w-135, quadrivalent (mcv4 or menacwy), for intramuscular use
694 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
90736 Zoster (shingles) vaccine (HZV), live, for 250 319 413 0 0.00 subcutaneous injection
90738 Japanese encephalitis virus vaccine, 313 399 516 0 0.00 inactivated, for intramuscular use
90739 Hepatitis b vaccine (HepB), adult dosage, 2 100 128 166 0 0.00 dose schedule, for intramuscular use
90740 Hepatitis b vaccine (HepB), dialysis or 251 320 414 0 0.00 immunosuppressed patient dosage, 3 dose schedule, for intramuscular use
90743 Hepatitis b vaccine (HepB), adolescent, 2 dose 76 97 125 0 0.00 schedule, for intramuscular use
90744 Hepatitis b vaccine (HepB), 53 68 87 0 0.00 pediatric/adolescent dosage, 3 dose schedule, for intramuscular use
90746 Hepatitis b vaccine (HepB), adult dosage, 3 100 128 166 0 0.00 dose schedule, for intramuscular use
90747 Hepatitis b vaccine (HepB), dialysis or 300 382 494 0 0.00 immunosuppressed patient dosage, 4 dose schedule, for intramuscular use
90748 Hepatitis b and haemophilus influenzae type b 62 79 102 0 0.00 vaccine (hib-hepb), for intramuscular use
90749 Unlisted vaccine/toxoid 0 0 0 0 0.00
90750 Zoster (shingles) vaccine (HZV), recombinant, 0 0 0 0 0.00 subunit, adjuvanted, for intramuscular use
90756 Influenza virus vaccine, quadrivalent (cciiv4), 0 0 0 0 0.00 derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use
PSYCHIATRY
90785 Interactive complexity (list separately in 21 26 33 15 0.41 addition to the code for primary procedure)
90791 Psychiatric diagnostic evaluation 200 254 320 136 3.79
90792 Psychiatric diagnostic evaluation with medical 282 358 451 153 4.24 services
90832 Psychotherapy, 30 minutes with patient 100 127 160 66 1.84
90833 Psychotherapy, 30 minutes with patient when 101 128 162 69 1.92 performed with an evaluation and management service (list separately in addition to the code for primary procedure)
CPT copyright 2017 American Medical Association. 695 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
90834 Psychotherapy, 45 minutes with patient 135 171 216 89 2.46
90836 Psychotherapy, 45 minutes with patient when 152 193 243 87 2.42 performed with an evaluation and management service (list separately in addition to the code for primary procedure)
90837 Psychotherapy, 60 minutes with patient 152 193 243 133 3.69
90838 Psychotherapy, 60 minutes with patient when 186 236 297 115 3.20 performed with an evaluation and management service (list separately in addition to the code for primary procedure)
90839 Psychotherapy for crisis; first 60 minutes 200 254 320 139 3.85
90840 Psychotherapy for crisis; each additional 30 81 103 130 66 1.84 minutes (list separately in addition to code for primary service)
90845 Psychoanalysis 182 247 351 95 2.64
90846 Family psychotherapy (without the patient 130 176 250 107 2.97 present), 50 minutes
90847 Family psychotherapy (conjoint 141 191 271 111 3.09 psychotherapy) (with patient present), 50 minutes
90849 Multiple-family group psychotherapy 100 136 192 37 1.04
90853 Group psychotherapy (other than of a multiple- 55 75 107 27 0.74 family group)
90863 Pharmacologic management, including 100 129 161 27 0.74 prescription and review of medication, when performed with psychotherapy services (list separately in addition to the code for primary procedure)
90865 Narcosynthesis for psychiatric diagnostic and 347 445 557 171 4.74 therapeutic purposes (eg, sodium amobarbital (amytal) interview)
90867 Therapeutic repetitive transcranial magnetic 650 835 1044 0 0.00 stimulation (tms) treatment; initial, including cortical mapping, motor threshold determination, delivery and management
90868 Therapeutic repetitive transcranial magnetic 459 590 737 0 0.00 stimulation (tms) treatment; subsequent delivery and management, per session
90869 Therapeutic repetitive transcranial magnetic 783 1006 1257 0 0.00 stimulation (tms) treatment; subsequent motor
696 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
threshold re-determination with delivery and management
90870 Electroconvulsive therapy (includes necessary 300 386 482 179 4.96 monitoring)
90875 Individual psychophysiological therapy 130 168 209 64 1.77 incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 30 minutes
90876 Individual psychophysiological therapy 145 186 233 111 3.07 incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 45 minutes
90880 Hypnotherapy 201 258 323 105 2.93
90882 Environmental intervention for medical 49 63 79 0 0.00 management purposes on a psychiatric patient’s behalf with agencies, employers, or institutions
90885 Psychiatric evaluation of hospital records, other 74 96 119 51 1.41 psychiatric reports, psychometric and/or projective tests, and other accumulated data for medical diagnostic purposes
90887 Interpretation or explanation of results of 125 160 200 90 2.50 psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient
90889 Preparation of report of patient’s psychiatric 100 129 161 0 0.00 status, history, treatment, or progress (other than for legal or consultative purposes) for other individuals, agencies, or insurance carriers
90899 Unlisted psychiatric service or procedure 0 0 0 0 0.00
BIOFEEDBACK
90901 Biofeedback training by any modality 101 156 245 40 1.12
90911 Biofeedback training, perineal muscles, 169 261 410 89 2.46 anorectal or urethral sphincter, including EMG and/or manometry
CPT copyright 2017 American Medical Association. 697 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
DIALYSIS
90935 Hemodialysis procedure with single evaluation 202 272 348 74 2.06 by a physician or other qualified health care professional
90937 Hemodialysis procedure requiring repeated 302 406 519 106 2.94 evaluation(s) with or without substantial revision of dialysis prescription
90940 Hemodialysis access flow study to determine 0 0 0 0 0.00 blood flow in grafts and arteriovenous fistulae by an indicator method
90945 Dialysis procedure other than hemodialysis (eg, 236 318 407 87 2.42 peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional
90947 Dialysis procedure other than hemodialysis (eg, 368 495 634 126 3.50 peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription
90951 End-stage renal disease (ESRD) related 2230 3000 3842 961 26.69 services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional per month
90952 End-stage renal disease (ESRD) related 1080 1454 1861 0 0.00 services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per month
90953 End-stage renal disease (ESRD) related 791 1064 1363 0 0.00 services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per month
698 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
90954 End-stage renal disease (ESRD) related 2369 3187 4081 828 23.00 services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional per month
90955 End-stage renal disease (ESRD) related 1079 1451 1858 465 12.91 services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per month
90956 End-stage renal disease (ESRD) related 750 1008 1291 323 8.97 services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per month
90957 End-stage renal disease (ESRD) related 1592 2142 2743 655 18.19 services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional per month
90958 End-stage renal disease (ESRD) related 986 1326 1698 444 12.34 services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per month
90959 End-stage renal disease (ESRD) related 835 1124 1439 302 8.38 services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per month
90960 End-stage renal disease (ESRD) related 602 810 1037 288 8.01 services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by
CPT copyright 2017 American Medical Association. 699 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
a physician or other qualified health care professional per month
90961 End-stage renal disease (ESRD) related 495 666 853 243 6.74 services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month
90962 End-stage renal disease (ESRD) related 403 542 695 188 5.21 services monthly, for patients 20 years of age and older; with 1 face-to-face visit by a physician or other qualified health care professional per month
90963 End-stage renal disease (ESRD) related 1682 2263 2898 555 15.43 services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
90964 End-stage renal disease (ESRD) related 1457 1960 2509 485 13.47 services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
90965 End-stage renal disease (ESRD) related 1300 1749 2240 461 12.81 services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents
90966 End-stage renal disease (ESRD) related 512 689 882 242 6.72 services for home dialysis per full month, for patients 20 years of age and older
90967 End-stage renal disease (ESRD) related 67 90 115 18 0.51 services for dialysis less than a full month of service, per day; for patients younger than 2 years of age
90968 End-stage renal disease (ESRD) related 50 67 86 16 0.44 services for dialysis less than a full month of service, per day; for patients 2-11 years of age
90969 End-stage renal disease (ESRD) related 41 56 71 15 0.43 services for dialysis less than a full month of service, per day; for patients 12-19 years of age
700 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
90970 End-stage renal disease (ESRD) related 17 23 30 8 0.22 services for dialysis less than a full month of service, per day; for patients 20 years of age and older
90989 Dialysis training, patient, including helper 762 1025 1312 0 0.00 where applicable, any mode, completed course
90993 Dialysis training, patient, including helper 128 173 221 0 0.00 where applicable, any mode, course not completed, per training session
90997 Hemoperfusion (eg, with activated charcoal or 211 283 363 91 2.52 resin)
90999 Unlisted dialysis procedure, inpatient or 0 0 0 0 0.00 outpatient
GASTROENTEROLOGY
91010 Esophageal motility (manometric study of the 483 643 928 181 5.03 esophagus and/or gastroesophageal junction) study with interpretation and report;
91010-26 257 343 494 69 1.91
91010-TC 0 0 0 112 3.12
91013 Esophageal motility (manometric study of the 72 95 138 26 0.72 esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)
91013-26 0 0 0 10 0.27
91013-TC 0 0 0 16 0.45
91020 Gastric motility (manometric) studies 530 706 1019 241 6.70
91020-26 300 400 577 77 2.14
91020-TC 0 0 0 164 4.56
91022 Duodenal motility (manometric) study 481 641 925 174 4.82
91022-26 0 0 0 77 2.14
91022-TC 0 0 0 96 2.68
91030 Esophagus, acid perfusion (Bernstein) test for 389 519 749 140 3.90 esophagitis
CPT copyright 2017 American Medical Association. 701 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
91030-26 0 0 0 49 1.36
91030-TC 0 0 0 91 2.54
91034 Esophagus, gastroesophageal reflux test; with 552 736 1062 193 5.35 nasal catheter ph electrode(s) placement, recording, analysis and interpretation
91034-26 238 317 458 52 1.45
91034-TC 0 0 0 140 3.90
91035 Esophagus, gastroesophageal reflux test; with 1050 1399 2019 494 13.71 mucosal attached telemetry ph electrode placement, recording, analysis and interpretation
91035-26 231 308 444 86 2.39
91035-TC 0 0 0 408 11.32
91037 Esophageal function test, gastroesophageal 433 577 833 165 4.59 reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;
91037-26 195 260 375 52 1.44
91037-TC 0 0 0 113 3.15
91038 Esophageal function test, gastroesophageal 1006 1341 1935 459 12.76 reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)
91038-26 234 311 449 59 1.64
91038-TC 0 0 0 400 11.12
91040 Esophageal balloon distension study, 1272 1695 2446 459 12.74 diagnostic, with provocation when performed
91040-26 0 0 0 50 1.39
91040-TC 0 0 0 409 11.35
91065 Breath hydrogen or methane test (eg, for 242 323 466 74 2.05 detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)
91065-26 72 95 138 10 0.29
91065-TC 0 0 0 63 1.76
702 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
91110 Gastrointestinal tract imaging, intraluminal (eg, 2019 2691 3884 926 25.73 capsule endoscopy), esophagus through ileum, with interpretation and report
91110-26 610 814 1174 133 3.69
91110-TC 0 0 0 793 22.04
91111 Gastrointestinal tract imaging, intraluminal (eg, 2116 2820 4070 763 21.20 capsule endoscopy), esophagus with interpretation and report
91111-26 0 0 0 54 1.49
91111-TC 0 0 0 710 19.71
91112 Gastrointestinal transit and pressure 2512 3347 4831 1099 30.52 measurement, stomach through colon, wireless capsule, with interpretation and report
91112-26 393 524 756 112 3.11
91112-TC 0 0 0 987 27.41
91117 Colon motility (manometric) study, minimum 6 575 766 1105 143 3.98 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretation and report
91120 Rectal sensation, tone, and compliance test (ie, 830 1106 1597 436 12.10 response to graded balloon distention)
91120-26 177 235 340 51 1.42
91120-TC 0 0 0 384 10.68
91122 Anorectal manometry 635 846 1222 236 6.55
91122-26 347 462 667 93 2.58
91122-TC 0 0 0 143 3.97
91132 Electrogastrography, diagnostic, 427 569 822 154 4.28 transcutaneous;
91132-26 0 0 0 28 0.77
91132-TC 0 0 0 126 3.51
91133 Electrogastrography, diagnostic, 491 654 945 177 4.92 transcutaneous; with provocative testing
91133-26 0 0 0 35 0.98
CPT copyright 2017 American Medical Association. 703 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
91133-TC 0 0 0 142 3.94
91200 Liver elastography, mechanically induced shear 193 257 372 41 1.14 wave (eg, vibration), without imaging, with interpretation and report
91200-26 49 65 94 14 0.40
91200-TC 0 0 0 27 0.74
91299 Unlisted diagnostic gastroenterology procedure 0 0 0 0 0.00
91299-26 0 0 0 0 0.00
91299-TC 0 0 0 0 0.00
OPHTHALMOLOGY
92002 Ophthalmological services: medical 121 153 198 85 2.36 examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient
92004 Ophthalmological services: medical 200 254 328 154 4.27 examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits
92012 Ophthalmological services: medical 125 159 205 89 2.48 examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
92014 Ophthalmological services: medical 166 210 271 129 3.57 examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits
92015 Determination of refractive state 41 55 77 20 0.56
92018 Ophthalmological examination and evaluation, 400 535 752 149 4.13 under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete
92019 Ophthalmological examination and evaluation, 161 215 302 74 2.06 under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited
92020 Gonioscopy (separate procedure) 62 83 116 27 0.76
704 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92025 Computerized corneal topography, unilateral or 88 118 166 39 1.08 bilateral, with interpretation and report
92025-26 60 80 113 21 0.57
92025-TC 0 0 0 18 0.51
92060 Sensorimotor examination with multiple 111 149 209 66 1.84 measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)
92060-26 85 114 160 39 1.09
92060-TC 0 0 0 27 0.75
92065 Orthoptic and/or pleoptic training, with 81 108 152 55 1.53 continuing medical direction and evaluation
92065-26 74 99 140 18 0.51
92065-TC 0 0 0 37 1.02
92071 Fitting of contact lens for treatment of ocular 85 114 161 39 1.07 surface disease
92072 Fitting of contact lens for management of 250 335 470 136 3.77 keratoconus, initial fitting
92081 Visual field examination, unilateral or bilateral, 70 94 132 35 0.98 with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)
92081-26 48 64 90 17 0.47
92081-TC 0 0 0 18 0.51
92082 Visual field examination, unilateral or bilateral, 94 125 176 49 1.37 with interpretation and report; intermediate examination (eg, at least 2 isopters on Goldmann perimeter, or semiquantitative, automated suprathreshold screening program, Humphrey suprathreshold automatic diagnostic test, octopus program 33)
92082-26 68 91 128 22 0.62
92082-TC 0 0 0 27 0.75
92083 Visual field examination, unilateral or bilateral, 133 177 249 66 1.82 with interpretation and report; extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or
CPT copyright 2017 American Medical Association. 705 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, Humphrey visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2)
92083-26 86 116 162 28 0.79
92083-TC 0 0 0 37 1.03
92100 Serial tonometry (separate procedure) with 131 175 246 83 2.30 multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment of acute elevation of intraocular pressure)
92132 Scanning computerized ophthalmic diagnostic 93 124 175 32 0.89 imaging, anterior segment, with interpretation and report, unilateral or bilateral
92132-26 59 79 111 17 0.47
92132-TC 0 0 0 15 0.42
92133 Scanning computerized ophthalmic diagnostic 101 134 189 39 1.07 imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve
92133-26 57 76 107 23 0.64
92133-TC 0 0 0 15 0.43
92134 Scanning computerized ophthalmic diagnostic 100 134 189 42 1.18 imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina
92134-26 53 71 100 27 0.74
92134-TC 0 0 0 16 0.44
92136 Ophthalmic biometry by partial coherence 205 275 386 80 2.23 interferometry with intraocular lens power calculation
92136-26 118 157 221 32 0.89
92136-TC 0 0 0 48 1.34
92145 Corneal hysteresis determination, by air 52 69 97 18 0.50 impulse stimulation, unilateral or bilateral, with interpretation and report
92145-26 30 41 57 10 0.27
92145-TC 0 0 0 8 0.23
706 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92225 Ophthalmoscopy, extended, with retinal 80 103 134 28 0.77 drawing (eg, for retinal detachment, melanoma), with interpretation and report; initial
92226 Ophthalmoscopy, extended, with retinal 76 98 127 26 0.71 drawing (eg, for retinal detachment, melanoma), with interpretation and report; subsequent
92227 Remote imaging for detection of retinal disease 40 51 67 15 0.42 (eg, retinopathy in a patient with diabetes) with analysis and report under physician supervision, unilateral or bilateral
92228 Remote imaging for monitoring and 122 157 204 35 0.96 management of active retinal disease (eg, diabetic retinopathy) with physician review, interpretation and report, unilateral or bilateral
92228-26 84 108 141 21 0.58
92228-TC 0 0 0 14 0.38
92230 Fluorescein angioscopy with interpretation and 149 191 249 59 1.64 report
92235 Fluorescein angiography (includes multiframe 247 317 413 88 2.44 imaging) with interpretation and report, unilateral or bilateral
92235-26 138 177 230 45 1.24
92235-TC 0 0 0 43 1.20
92240 Indocyanine-green angiography (includes 497 639 831 214 5.95 multiframe imaging) with interpretation and report, unilateral or bilateral
92240-26 204 263 342 48 1.33
92240-TC 0 0 0 166 4.62
92242 Fluorescein angiography and indocyanine- 477 614 798 233 6.48 green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral
92242-26 185 238 310 56 1.56
92242-TC 0 0 0 177 4.92
92250 Fundus photography with interpretation and 126 161 210 58 1.62 report
CPT copyright 2017 American Medical Association. 707 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92250-26 76 98 127 22 0.62
92250-TC 0 0 0 36 1.00
92260 Ophthalmodynamometry 40 51 67 19 0.52
92265 Needle oculoelectromyography, 1 or more 237 304 396 90 2.50 extraocular muscles, 1 or both eyes, with interpretation and report
92265-26 0 0 0 48 1.34
92265-TC 0 0 0 42 1.16
92270 Electro-oculography with interpretation and 165 212 276 95 2.64 report
92270-26 116 149 194 42 1.17
92270-TC 0 0 0 53 1.47
92275 Electroretinography with interpretation and 250 322 418 153 4.25 report
92275-26 135 174 226 56 1.55
92275-TC 0 0 0 97 2.70
92283 Color vision examination, extended, eg, 80 103 134 56 1.56 anomaloscope or equivalent
92283-26 42 54 70 9 0.26
92283-TC 0 0 0 47 1.30
92284 Dark adaptation examination with 100 129 167 64 1.78 interpretation and report
92284-26 52 67 87 13 0.36
92284-TC 0 0 0 51 1.42
92285 External ocular photography with interpretation 75 97 125 21 0.59 and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo- photography)
92285-26 36 46 60 3 0.09
92285-TC 0 0 0 18 0.50
92286 Anterior segment imaging with interpretation 200 257 335 39 1.09 and report; with specular microscopy and endothelial cell analysis
708 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92286-26 123 159 206 23 0.63
92286-TC 0 0 0 17 0.46
92287 Anterior segment imaging with interpretation 300 386 502 141 3.93 and report; with fluorescein angiography
92287-26 52 67 87 48 1.33
92287-TC 0 0 0 94 2.60
92310 Prescription of optical and physical 109 147 221 99 2.76 characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia
92311 Prescription of optical and physical 105 141 212 104 2.89 characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, 1 eye
92312 Prescription of optical and physical 132 178 268 121 3.35 characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes
92313 Prescription of optical and physical 225 304 455 99 2.74 characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscleral lens
92314 Prescription of optical and physical 91 122 184 83 2.30 characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia
92315 Prescription of optical and physical 84 113 170 77 2.13 characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, 1 eye
92316 Prescription of optical and physical 105 142 213 96 2.66 characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes
92317 Prescription of optical and physical 88 119 178 80 2.23 characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneoscleral lens
CPT copyright 2017 American Medical Association. 709 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92325 Modification of contact lens (separate 49 66 98 44 1.23 procedure), with medical supervision of adaptation
92326 Replacement of contact lens 70 95 142 37 1.04
92340 Fitting of spectacles, except for aphakia; 40 54 81 36 1.01 monofocal
92341 Fitting of spectacles, except for aphakia; 46 62 93 42 1.16 bifocal
92342 Fitting of spectacles, except for aphakia; 56 76 114 45 1.24 multifocal, other than bifocal
92352 Fitting of spectacle prosthesis for aphakia; 42 57 86 41 1.15 monofocal
92353 Fitting of spectacle prosthesis for aphakia; 49 67 100 48 1.34 multifocal
92354 Fitting of spectacle mounted low vision aid; 151 203 305 14 0.39 single element system
92355 Fitting of spectacle mounted low vision aid; 79 106 159 22 0.60 telescopic or other compound lens system
92358 Prosthesis service for aphakia, temporary 20 27 41 12 0.33 (disposable or loan, including materials)
92370 Repair and refitting spectacles; except for 35 47 70 32 0.88 aphakia
92371 Repair and refitting spectacles; spectacle 24 32 48 12 0.33 prosthesis for aphakia
92499 Unlisted ophthalmological service or procedure 0 0 0 0 0.00
92499-26 0 0 0 0 0.00
92499-TC 0 0 0 0 0.00
SPECIAL OTORHINOLARYNGOLOGIC SERVICES
92502 Otolaryngologic examination under general 270 381 541 99 2.74 anesthesia
92504 Binocular microscopy (separate diagnostic 69 97 138 30 0.83 procedure)
92507 Treatment of speech, language, voice, 90 127 180 80 2.22 communication, and/or auditory processing disorder; individual
710 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92508 Treatment of speech, language, voice, 65 92 131 23 0.65 communication, and/or auditory processing disorder; group, 2 or more individuals
92511 Nasopharyngoscopy with endoscope (separate 325 459 650 111 3.09 procedure)
92512 Nasal function studies (eg, rhinomanometry) 155 219 311 60 1.68
92516 Facial nerve function studies (eg, 236 332 471 70 1.94 electroneuronography)
92520 Laryngeal function studies (ie, aerodynamic 168 237 335 78 2.18 testing and acoustic testing)
92521 Evaluation of speech fluency (eg, stuttering, 200 282 400 116 3.23 cluttering)
92522 Evaluation of speech sound production (eg, 201 283 401 94 2.60 articulation, phonological process, apraxia, dysarthria);
92523 Evaluation of speech sound production (eg, 236 333 472 202 5.60 articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)
92524 Behavioral and qualitative analysis of voice 239 337 477 90 2.49 and resonance
92526 Treatment of swallowing dysfunction and/or 136 191 271 87 2.43 oral function for feeding
92531 Spontaneous nystagmus, including gaze 41 58 82 0 0.00
92532 Positional nystagmus test 59 83 118 0 0.00
92533 Caloric vestibular test, each irrigation 63 89 126 0 0.00 (binaural, bithermal stimulation constitutes 4 tests)
92534 Optokinetic nystagmus test 85 120 170 0 0.00
92537 Caloric vestibular test with recording, bilateral; 102 144 204 41 1.15 bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)
92537-26 63 89 126 32 0.90
92537-TC 0 0 0 9 0.25
92538 Caloric vestibular test with recording, bilateral; 56 79 112 21 0.59 monothermal (ie, one irrigation in each ear for a total of two irrigations)
CPT copyright 2017 American Medical Association. 711 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92538-26 37 52 74 16 0.45
92538-TC 0 0 0 5 0.14
92540 Basic vestibular evaluation, includes 251 369 539 104 2.88 spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording
92540-26 188 277 403 81 2.26
92540-TC 0 0 0 22 0.62
92541 Spontaneous nystagmus test, including gaze 117 172 251 25 0.70 and fixation nystagmus, with recording
92541-26 59 87 126 22 0.60
92541-TC 0 0 0 4 0.10
92542 Positional nystagmus test, minimum of 4 105 155 226 29 0.80 positions, with recording
92542-26 43 64 93 26 0.71
92542-TC 0 0 0 3 0.09
92544 Optokinetic nystagmus test, bidirectional, 151 222 323 17 0.48 foveal or peripheral stimulation, with recording
92544-26 44 65 94 15 0.41
92544-TC 0 0 0 3 0.07
92545 Oscillating tracking test, with recording 158 232 338 16 0.45
92545-26 103 151 220 14 0.38
92545-TC 0 0 0 3 0.07
92546 Sinusoidal vertical axis rotational testing 194 285 415 107 2.96
92546-26 36 52 77 15 0.43
92546-TC 0 0 0 91 2.53
92547 Use of vertical electrodes (list separately in 31 45 66 6 0.17 addition to code for primary procedure)
92548 Computerized dynamic posturography 221 325 474 101 2.80
712 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92548-26 80 117 171 27 0.74
92548-TC 0 0 0 74 2.06
92550 Tympanometry and reflex threshold 68 86 116 22 0.61 measurements
92551 Screening test, pure tone, air only 30 38 51 13 0.35
92552 Pure tone audiometry (threshold); air only 50 64 86 32 0.90
92553 Pure tone audiometry (threshold); air and bone 65 83 112 39 1.08
92555 Speech audiometry threshold; 45 58 77 24 0.68
92556 Speech audiometry threshold; with speech 65 83 111 39 1.08 recognition
92557 Comprehensive audiometry threshold 105 134 180 39 1.07 evaluation and speech recognition (92553 and 92556 combined)
92558 Evoked otoacoustic emissions, screening 75 96 129 10 0.28 (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis
92559 Audiometric testing of groups 109 139 186 0 0.00
92560 Bekesy audiometry; screening 40 51 69 0 0.00
92561 Bekesy audiometry; diagnostic 60 77 103 40 1.11
92562 Loudness balance test, alternate binaural or 55 71 95 48 1.32 monaural
92563 Tone decay test 45 57 77 32 0.88
92564 Short increment sensitivity index (SISI) 99 126 169 27 0.74
92565 Stenger test, pure tone 41 53 71 16 0.44
92567 Tympanometry (impedance testing) 45 57 77 15 0.41
92568 Acoustic reflex testing, threshold 40 51 69 16 0.45
92570 Acoustic immittance testing, includes 73 93 125 33 0.91 tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing
92571 Filtered speech test 40 51 69 28 0.78
92572 Staggered spondaic word test 112 144 193 54 1.50
92575 Sensorineural acuity level test 110 141 189 48 1.34
CPT copyright 2017 American Medical Association. 713 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92576 Synthetic sentence identification test 83 106 142 39 1.07
92577 Stenger test, speech 41 53 71 15 0.41
92579 Visual reinforcement audiometry (VRA) 99 126 169 47 1.30
92582 Conditioning play audiometry 144 184 247 69 1.93
92583 Select picture audiometry 77 99 133 50 1.40
92584 Electrocochleography 212 271 363 76 2.10
92585 Auditory evoked potentials for evoked 300 383 514 138 3.84 response audiometry and/or testing of the central nervous system; comprehensive
92585-26 124 158 212 27 0.76
92585-TC 0 0 0 111 3.08
92586 Auditory evoked potentials for evoked 249 317 426 91 2.53 response audiometry and/or testing of the central nervous system; limited
92587 Distortion product evoked otoacoustic 100 128 171 22 0.61 emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report
92587-26 53 67 90 19 0.52
92587-TC 0 0 0 3 0.09
92588 Distortion product evoked otoacoustic 132 168 225 33 0.93 emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report
92588-26 85 108 146 30 0.82
92588-TC 0 0 0 4 0.11
92590 Hearing aid examination and selection; 99 127 170 0 0.00 monaural
92591 Hearing aid examination and selection; 135 172 231 0 0.00 binaural
92592 Hearing aid check; monaural 50 64 86 0 0.00
92593 Hearing aid check; binaural 65 83 111 0 0.00
92594 Electroacoustic evaluation for hearing aid; 46 59 79 0 0.00 monaural
714 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92595 Electroacoustic evaluation for hearing aid; 62 79 106 0 0.00 binaural
92596 Ear protector attenuation measurements 130 165 222 70 1.94
92597 Evaluation for use and/or fitting of voice 246 314 422 73 2.04 prosthetic device to supplement oral speech
92601 Diagnostic analysis of cochlear implant, patient 300 383 514 168 4.68 younger than 7 years of age; with programming
92602 Diagnostic analysis of cochlear implant, patient 200 255 342 104 2.90 younger than 7 years of age; subsequent reprogramming
92603 Diagnostic analysis of cochlear implant, age 7 294 375 504 156 4.34 years or older; with programming
92604 Diagnostic analysis of cochlear implant, age 7 188 240 322 93 2.57 years or older; subsequent reprogramming
92605 Evaluation for prescription of non-speech- 255 326 438 95 2.64 generating augmentative and alternative communication device, face-to-face with the patient; first hour
92606 Therapeutic service(s) for the use of non- 122 156 210 85 2.35 speech-generating device, including programming and modification
92607 Evaluation for prescription for speech- 200 255 343 134 3.71 generating augmentative and alternative communication device, face-to-face with the patient; first hour
92608 Evaluation for prescription for speech- 90 115 154 54 1.49 generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)
92609 Therapeutic services for the use of speech- 136 173 233 112 3.11 generating device, including programming and modification
92610 Evaluation of oral and pharyngeal swallowing 153 195 262 87 2.43 function
92611 Motion fluoroscopic evaluation of swallowing 258 329 442 89 2.48 function by cine or video recording
92612 Flexible endoscopic evaluation of swallowing 493 629 844 195 5.41 by cine or video recording;
CPT copyright 2017 American Medical Association. 715 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92613 Flexible endoscopic evaluation of swallowing 121 154 207 39 1.08 by cine or video recording; interpretation and report only
92614 Flexible endoscopic evaluation, laryngeal 366 467 627 147 4.09 sensory testing by cine or video recording;
92615 Flexible endoscopic evaluation, laryngeal 81 103 138 34 0.94 sensory testing by cine or video recording; interpretation and report only
92616 Flexible endoscopic evaluation of swallowing 475 606 814 211 5.86 and laryngeal sensory testing by cine or video recording;
92617 Flexible endoscopic evaluation of swallowing 151 192 258 42 1.18 and laryngeal sensory testing by cine or video recording; interpretation and report only
92618 Evaluation for prescription of non-speech- 93 119 159 35 0.96 generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)
92620 Evaluation of central auditory function, with 250 319 428 96 2.68 report; initial 60 minutes
92621 Evaluation of central auditory function, with 51 65 87 23 0.64 report; each additional 15 minutes (list separately in addition to code for primary procedure)
92625 Assessment of tinnitus (includes pitch, 120 153 206 72 1.99 loudness matching, and masking)
92626 Evaluation of auditory rehabilitation status; 180 230 308 92 2.55 first hour
92627 Evaluation of auditory rehabilitation status; 125 160 214 23 0.64 each additional 15 minutes (list separately in addition to code for primary procedure)
92630 Auditory rehabilitation; prelingual hearing loss 201 256 344 0 0.00
92633 Auditory rehabilitation; postlingual hearing 121 154 207 0 0.00 loss
92640 Diagnostic analysis with programming of 315 403 540 117 3.26 auditory brainstem implant, per hour
92700 Unlisted otorhinolaryngological service or 0 0 0 0 0.00 procedure
716 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
CARDIOVASCULAR
92920 Percutaneous transluminal coronary 1339 1878 2753 557 15.47 angioplasty; single major coronary artery or branch
92921 Percutaneous transluminal coronary 744 1044 1530 0 0.00 angioplasty; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)
92924 Percutaneous transluminal coronary 1585 2222 3258 664 18.44 atherectomy, with coronary angioplasty when performed; single major coronary artery or branch
92925 Percutaneous transluminal coronary 0 0 0 0 0.00 atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)
92928 Percutaneous transcatheter placement of 1532 2149 3150 620 17.21 intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
92929 Percutaneous transcatheter placement of 771 1081 1585 0 0.00 intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)
92933 Percutaneous transluminal coronary 1722 2415 3540 694 19.29 atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch
92934 Percutaneous transluminal coronary 680 953 1397 0 0.00 atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)
92937 Percutaneous transluminal revascularization of 1503 2107 3089 619 17.19 or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
92938 Percutaneous transluminal revascularization of 725 1017 1490 0 0.00 or through coronary artery bypass graft
CPT copyright 2017 American Medical Association. 717 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
(internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)
92941 Percutaneous transluminal revascularization of 1690 2370 3474 696 19.33 acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
92943 Percutaneous transluminal revascularization of 1759 2466 3615 696 19.33 chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel
92944 Percutaneous transluminal revascularization of 941 1320 1935 0 0.00 chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)
92950 Cardiopulmonary resuscitation (eg, in cardiac 910 1276 1870 311 8.64 arrest)
92953 Temporary transcutaneous pacing 55 77 113 1 0.03
92960 Cardioversion, elective, electrical conversion of 447 627 919 163 4.53 arrhythmia; external
92961 Cardioversion, elective, electrical conversion of 584 819 1201 261 7.26 arrhythmia; internal (separate procedure)
92970 Cardioassist-method of circulatory assist; 559 784 1150 207 5.74 internal
92971 Cardioassist-method of circulatory assist; 251 352 516 105 2.91 external
92973 Percutaneous transluminal coronary 420 589 864 185 5.15 thrombectomy mechanical (list separately in addition to code for primary procedure)
92974 Transcatheter placement of radiation delivery 493 691 1013 170 4.72 device for subsequent coronary intravascular
718 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
brachytherapy (list separately in addition to code for primary procedure)
92975 Thrombolysis, coronary; by intracoronary 985 1382 2025 395 10.96 infusion, including selective coronary angiography
92977 Thrombolysis, coronary; by intravenous 514 721 1056 59 1.64 infusion
92978 Endoluminal imaging of coronary vessel or 467 655 960 0 0.00 graft using intravascular ultrasound (IVUS) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for primary procedure)
92978-26 280 393 576 100 2.77
92978-TC 0 0 0 0 0.00
92979 Endoluminal imaging of coronary vessel or 302 423 621 0 0.00 graft using intravascular ultrasound (IVUS) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to code for primary procedure)
92979-26 200 281 411 80 2.23
92979-TC 0 0 0 0 0.00
92986 Percutaneous balloon valvuloplasty; aortic 3395 4760 6979 1380 38.33 valve
92987 Percutaneous balloon valvuloplasty; mitral 3854 5404 7922 1423 39.54 valve
92990 Percutaneous balloon valvuloplasty; pulmonary 4666 6543 9592 1137 31.59 valve
92992 Atrial septectomy or septostomy; transvenous 5580 7824 11471 0 0.00 method, balloon (eg, Rashkind type) (includes cardiac catheterization)
92993 Atrial septectomy or septostomy; blade method 3677 5156 7559 0 0.00 (park septostomy) (includes cardiac catheterization)
92997 Percutaneous transluminal pulmonary artery 3256 4565 6693 686 19.05 balloon angioplasty; single vessel
CPT copyright 2017 American Medical Association. 719 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
92998 Percutaneous transluminal pulmonary artery 1734 2431 3564 340 9.45 balloon angioplasty; each additional vessel (list separately in addition to code for primary procedure)
93000 Electrocardiogram, routine ECG with at least 62 86 121 17 0.48 12 leads; with interpretation and report
93005 Electrocardiogram, routine ECG with at least 46 64 90 9 0.24 12 leads; tracing only, without interpretation and report
93010 Electrocardiogram, routine ECG with at least 41 57 81 9 0.24 12 leads; interpretation and report only
93015 Cardiovascular stress test using maximal or 278 385 545 73 2.02 submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report
93016 Cardiovascular stress test using maximal or 69 96 136 23 0.63 submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report
93017 Cardiovascular stress test using maximal or 157 218 308 35 0.97 submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report
93018 Cardiovascular stress test using maximal or 50 70 99 15 0.42 submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only
93024 Ergonovine provocation test 229 317 449 114 3.16
93024-26 151 209 296 58 1.62
93024-TC 0 0 0 55 1.54
93025 Microvolt t-wave alternans for assessment of 652 905 1280 167 4.63 ventricular arrhythmias
93025-26 121 167 237 38 1.05
93025-TC 0 0 0 129 3.58
93040 Rhythm ECG, 1-3 leads; with interpretation 40 56 79 13 0.36 and report
720 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93041 Rhythm ECG, 1-3 leads; tracing only without 74 103 146 6 0.16 interpretation and report
93042 Rhythm ECG, 1-3 leads; interpretation and 47 65 92 7 0.20 report only
93050 Arterial pressure waveform analysis for 42 58 82 17 0.47 assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity artery, non-invasive
93050-26 28 39 55 9 0.24
93050-TC 0 0 0 8 0.23
93224 External electrocardiographic recording up to 314 436 617 93 2.58 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional
93225 External electrocardiographic recording up to 90 125 177 27 0.75 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)
93226 External electrocardiographic recording up to 397 551 780 39 1.07 48 hours by continuous rhythm recording and storage; scanning analysis with report
93227 External electrocardiographic recording up to 80 111 157 27 0.76 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional
93228 External mobile cardiovascular telemetry with 68 95 134 27 0.74 electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional
93229 External mobile cardiovascular telemetry with 5792 8033 11370 743 20.65 electrocardiographic recording, concurrent computerized real time data analysis and
CPT copyright 2017 American Medical Association. 721 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; technical support for connection and patient instructions for use, attended surveillance, analysis and transmission of daily and emergent data reports as prescribed by a physician or other qualified health care professional
93260 Programming device evaluation (in person) 196 272 385 67 1.85 with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead defibrillator system
93260-26 145 201 285 44 1.23
93260-TC 0 0 0 22 0.62
93261 Interrogation device evaluation (in person) with 166 231 327 60 1.68 analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system
93261-26 119 166 235 39 1.07
93261-TC 0 0 0 22 0.61
93268 External patient and, when performed, auto 525 728 1031 210 5.83 activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; includes transmission, review and interpretation by a physician or other qualified health care professional
93270 External patient and, when performed, auto 195 271 384 9 0.26 activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; recording (includes connection, recording, and disconnection)
722 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93271 External patient and, when performed, auto 1817 2519 3566 175 4.85 activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; transmission and analysis
93272 External patient and, when performed, auto 70 97 138 26 0.72 activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional
93278 Signal-averaged electrocardiography 76 105 148 32 0.88 (SAECG), with or without ECG
93278-26 36 49 70 13 0.36
93278-TC 0 0 0 19 0.52
93279 Programming device evaluation (in person) 118 163 231 50 1.40 with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system
93279-26 83 115 162 33 0.92
93279-TC 0 0 0 17 0.48
93280 Programming device evaluation (in person) 140 194 275 59 1.65 with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system
93280-26 99 137 194 39 1.09
93280-TC 0 0 0 20 0.56
93281 Programming device evaluation (in person) 159 220 312 64 1.79 with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system
93281-26 115 159 226 44 1.22
CPT copyright 2017 American Medical Association. 723 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93281-TC 0 0 0 21 0.57
93282 Programming device evaluation (in person) 158 219 309 62 1.73 with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implantable defibrillator system
93282-26 117 162 230 44 1.21
93282-TC 0 0 0 19 0.52
93283 Programming device evaluation (in person) 184 255 361 80 2.21 with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantable defibrillator system
93283-26 141 195 276 59 1.64
93283-TC 0 0 0 21 0.57
93284 Programming device evaluation (in person) 211 292 414 87 2.41 with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous implantable defibrillator system
93284-26 160 221 313 64 1.79
93284-TC 0 0 0 22 0.62
93285 Programming device evaluation (in person) 109 151 214 44 1.21 with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable loop recorder system
93285-26 76 105 149 27 0.75
93285-TC 0 0 0 17 0.46
724 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93286 Peri-procedural device evaluation (in person) 76 105 149 31 0.85 and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system
93286-26 50 69 98 15 0.43
93286-TC 0 0 0 15 0.42
93287 Peri-procedural device evaluation (in person) 90 125 176 39 1.08 and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system
93287-26 71 99 139 24 0.66
93287-TC 0 0 0 15 0.42
93288 Interrogation device evaluation (in person) with 96 134 189 39 1.09 analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system
93288-26 63 88 125 22 0.61
93288-TC 0 0 0 17 0.48
93289 Interrogation device evaluation (in person) with 157 218 309 55 1.54 analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including analysis of heart rhythm derived data elements
93289-26 119 165 234 38 1.06
93289-TC 0 0 0 17 0.48
93290 Interrogation device evaluation (in person) with 73 101 143 37 1.04 analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular monitor system, including analysis of 1 or more recorded
CPT copyright 2017 American Medical Association. 725 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
physiologic cardiovascular data elements from all internal and external sensors
93290-26 50 69 97 22 0.62
93290-TC 0 0 0 15 0.42
93291 Interrogation device evaluation (in person) with 85 118 168 33 0.93 analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable loop recorder system, including heart rhythm derived data analysis
93291-26 58 81 115 19 0.52
93291-TC 0 0 0 15 0.41
93292 Interrogation device evaluation (in person) with 79 109 154 37 1.04 analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system
93292-26 68 94 133 22 0.61
93292-TC 0 0 0 15 0.43
93293 Transtelephonic rhythm strip pacemaker 124 172 244 54 1.51 evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days
93293-26 46 64 91 15 0.43
93293-TC 0 0 0 39 1.08
93294 Interrogation device evaluation(s) (remote), up 86 120 169 31 0.87 to 90 days; single, dual, or multiple lead pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional
93295 Interrogation device evaluation(s) (remote), up 159 221 313 56 1.56 to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional
726 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93296 Interrogation device evaluation(s) (remote), up 75 104 147 27 0.75 to 90 days; single, dual, or multiple lead pacemaker system or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results
93297 Interrogation device evaluation(s), (remote) up 63 87 123 27 0.75 to 30 days; implantable cardiovascular monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other qualified health care professional
93298 Interrogation device evaluation(s), (remote) up 69 96 136 27 0.76 to 30 days; implantable loop recorder system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional
93299 Interrogation device evaluation(s), (remote) up 102 142 201 0 0.00 to 30 days; implantable cardiovascular monitor system or implantable loop recorder system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results
93303 Transthoracic echocardiography for congenital 736 1159 1770 247 6.85 cardiac anomalies; complete
93303-26 244 383 586 65 1.81
93303-TC 0 0 0 181 5.04
93304 Transthoracic echocardiography for congenital 768 1208 1846 164 4.56 cardiac anomalies; follow-up or limited study
93304-26 168 264 404 37 1.04
93304-TC 0 0 0 127 3.52
93306 Echocardiography, transthoracic, real-time with 651 1025 1565 214 5.94 image documentation (2d), includes m-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography
93306-26 200 315 481 75 2.08
93306-TC 0 0 0 139 3.86
93307 Echocardiography, transthoracic, real-time with 455 716 1093 145 4.04 image documentation (2d), includes m-mode
CPT copyright 2017 American Medical Association. 727 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
recording, when performed, complete, without spectral or color Doppler echocardiography
93307-26 148 232 355 46 1.28
93307-TC 0 0 0 99 2.76
93308 Echocardiography, transthoracic, real-time with 306 481 735 108 3.00 image documentation (2d), includes m-mode recording, when performed, follow-up or limited study
93308-26 98 154 235 26 0.73
93308-TC 0 0 0 82 2.27
93312 Echocardiography, transesophageal, real-time 658 1036 1582 253 7.03 with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report
93312-26 356 560 855 112 3.11
93312-TC 0 0 0 141 3.92
93313 Echocardiography, transesophageal, real-time 223 351 537 12 0.33 with image documentation (2d) (with or without m-mode recording); placement of transesophageal probe only
93314 Echocardiography, transesophageal, real-time 365 575 878 244 6.79 with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only
93314-26 238 375 572 94 2.61
93314-TC 0 0 0 150 4.18
93315 Transesophageal echocardiography for 483 761 1162 0 0.00 congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report
93315-26 483 761 1162 132 3.67
93315-TC 0 0 0 0 0.00
93316 Transesophageal echocardiography for 367 578 882 28 0.78 congenital cardiac anomalies; placement of transesophageal probe only
93317 Transesophageal echocardiography for 517 813 1241 0 0.00 congenital cardiac anomalies; image acquisition, interpretation and report only
728 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93317-26 517 813 1241 95 2.65
93317-TC 0 0 0 0 0.00
93318 Echocardiography, transesophageal (tee) for 351 553 845 0 0.00 monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis
93318-26 351 553 845 108 2.99
93318-TC 0 0 0 0 0.00
93320 Doppler echocardiography, pulsed wave and/or 271 427 652 55 1.54 continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete
93320-26 100 157 240 19 0.52
93320-TC 0 0 0 37 1.02
93321 Doppler echocardiography, pulsed wave and/or 176 277 423 28 0.78 continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)
93321-26 41 64 98 8 0.21
93321-TC 0 0 0 21 0.57
93325 Doppler echocardiography color flow velocity 264 415 633 26 0.73 mapping (list separately in addition to codes for echocardiography)
93325-26 47 74 114 3 0.09
93325-TC 0 0 0 23 0.64
93350 Echocardiography, transthoracic, real-time with 538 847 1293 212 5.89 image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;
93350-26 225 353 540 73 2.02
93350-TC 0 0 0 139 3.87
CPT copyright 2017 American Medical Association. 729 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93351 Echocardiography, transthoracic, real-time with 662 1042 1591 239 6.64 image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional
93351-26 245 386 589 87 2.42
93351-TC 0 0 0 152 4.22
93352 Use of echocardiographic contrast agent during 101 160 244 35 0.96 stress echocardiography (list separately in addition to code for primary procedure)
93355 Echocardiography, transesophageal (tee) for 583 918 1401 234 6.49 guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, tavr, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal defect closure) (peri-and intra-procedural), real-time image acquisition and documentation, guidance with quantitative measurements, probe manipulation, interpretation, and report, including diagnostic transesophageal echocardiography and, when performed, administration of ultrasound contrast, Doppler, color flow, and 3d
93451 Right heart catheterization including 2239 3500 5626 745 20.69 measurement(s) of oxygen saturation and cardiac output, when performed
93451-26 458 716 1151 136 3.79
93451-TC 0 0 0 608 16.90
93452 Left heart catheterization including 1022 1597 2567 847 23.53 intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed
93452-26 875 1368 2199 249 6.92
93452-TC 0 0 0 598 16.61
93453 Combined right and left heart catheterization 2078 3249 5222 1101 30.58 including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed
730 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93453-26 1013 1583 2545 333 9.26
93453-TC 0 0 0 768 21.32
93454 Catheter placement in coronary artery(s) for 1990 3111 5000 859 23.87 coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;
93454-26 768 1201 1931 252 6.99
93454-TC 0 0 0 608 16.88
93455 Catheter placement in coronary artery(s) for 1997 3123 5019 1006 27.94 coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography
93455-26 863 1350 2170 294 8.16
93455-TC 0 0 0 712 19.78
93456 Catheter placement in coronary artery(s) for 3098 4844 7787 1088 30.22 coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization
93456-26 940 1470 2363 328 9.10
93456-TC 0 0 0 760 21.12
93457 Catheter placement in coronary artery(s) for 2246 3511 5644 1232 34.22 coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization
93457-26 981 1534 2465 369 10.24
93457-TC 0 0 0 863 23.98
93458 Catheter placement in coronary artery(s) for 4097 6406 10297 1036 28.78 coronary angiography, including intraprocedural injection(s) for coronary
CPT copyright 2017 American Medical Association. 731 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed
93458-26 900 1408 2263 311 8.64
93458-TC 0 0 0 725 20.14
93459 Catheter placement in coronary artery(s) for 4100 6411 10304 1148 31.90 coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography
93459-26 995 1555 2500 353 9.80
93459-TC 0 0 0 796 22.10
93460 Catheter placement in coronary artery(s) for 4933 7713 12397 1237 34.37 coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed
93460-26 1115 1743 2801 395 10.97
93460-TC 0 0 0 842 23.40
93461 Catheter placement in coronary artery(s) for 5917 9251 14869 1416 39.34 coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography
93461-26 1198 1874 3012 436 12.11
93461-TC 0 0 0 980 27.23
93462 Left heart catheterization by transseptal 550 860 1382 220 6.11 puncture through intact septum or by
732 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
transapical puncture (list separately in addition to code for primary procedure)
93463 Pharmacologic agent administration (eg, 279 436 701 101 2.81 inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent admin, when performed (list separately in addition to code for primary procedure)
93464 Physiologic exercise study (eg, bicycle or arm 542 848 1362 261 7.26 ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)
93464-26 298 465 748 90 2.49
93464-TC 0 0 0 172 4.77
93503 Insertion and placement of flow directed 997 1559 2506 108 2.99 catheter (eg, swan-Ganz) for monitoring purposes
93505 Endomyocardial biopsy 2110 3299 5303 719 19.98
93505-26 848 1325 2130 228 6.34
93505-TC 0 0 0 491 13.64
93530 Right heart catheterization, for congenital 1261 1971 3168 0 0.00 cardiac anomalies
93530-26 1261 1971 3168 214 5.95
93530-TC 0 0 0 0 0.00
93531 Combined right heart catheterization and 3046 4762 7654 0 0.00 retrograde left heart catheterization, for congenital cardiac anomalies
93531-26 3046 4762 7654 446 12.38
93531-TC 0 0 0 0 0.00
93532 Combined right heart catheterization and 2937 4592 7381 0 0.00 transseptal left heart catheterization through intact septum with or without retrograde left heart catheterization, for congenital cardiac anomalies
93532-26 2937 4592 7381 537 14.91
93532-TC 0 0 0 0 0.00
CPT copyright 2017 American Medical Association. 733 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93533 Combined right heart catheterization and 2547 3982 6401 0 0.00 transseptal left heart catheterization through existing septal opening, with or without retrograde left heart catheterization, for congenital cardiac anomalies
93533-26 2547 3982 6401 361 10.04
93533-TC 0 0 0 0 0.00
93561 Indicator dilution studies such as dye or 143 224 360 0 0.00 thermodilution, including arterial and/or venous catheterization; with cardiac output measurement (separate procedure)
93561-26 143 224 360 13 0.35
93561-TC 0 0 0 0 0.00
93562 Indicator dilution studies such as dye or 74 116 186 0 0.00 thermodilution, including arterial and/or venous catheterization; subsequent measurement of cardiac output
93562-26 46 72 116 1 0.03
93562-TC 0 0 0 0 0.00
93563 Injection procedure during cardiac 284 444 713 61 1.69 catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (list separately in addition to code for primary procedure)
93564 Injection procedure during cardiac 350 548 880 64 1.78 catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aortocoronary saphenous vein, free radial artery, or free mammary artery graft) to one or more coronary arteries and in situ arterial conduits (eg, internal mammary), whether native or used for bypass to one or more coronary arteries during congenital heart catheterization, when performed (list separately in addition to code for primary procedure)
93565 Injection procedure during cardiac 241 377 606 47 1.31 catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (list separately in addition to code for primary procedure)
734 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93566 Injection procedure during cardiac 363 567 911 166 4.62 catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (list separately in addition to code for primary procedure)
93567 Injection procedure during cardiac 208 326 523 140 3.89 catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (list separately in addition to code for primary procedure)
93568 Injection procedure during cardiac 361 565 908 149 4.13 catheterization including imaging supervision, interpretation, and report; for pulmonary angiography (list separately in addition to code for primary procedure)
93571 Intravascular Doppler velocity and/or pressure 459 718 1155 0 0.00 derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; initial vessel (list separately in addition to code for primary procedure)
93571-26 250 391 628 100 2.77
93571-TC 0 0 0 0 0.00
93572 Intravascular Doppler velocity and/or pressure 206 322 518 0 0.00 derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; each additional vessel (list separately in addition to code for primary procedure)
93572-26 188 294 473 80 2.23
93572-TC 0 0 0 0 0.00
93580 Percutaneous transcatheter closure of 3021 4724 7592 1023 28.42 congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant
93581 Percutaneous transcatheter closure of a 5004 7824 12576 1394 38.72 congenital ventricular septal defect with implant
93582 Percutaneous transcatheter closure of patent 3206 5012 8056 697 19.36 ductus arteriosus
CPT copyright 2017 American Medical Association. 735 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93583 Percutaneous transcatheter septal reduction 2793 4367 7019 778 21.61 therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed
93590 Percutaneous transcatheter closure of 4151 6490 10431 1119 31.07 paravalvular leak; initial occlusion device, mitral valve
93591 Percutaneous transcatheter closure of 3445 5386 8657 929 25.80 paravalvular leak; initial occlusion device, aortic valve
93592 Percutaneous transcatheter closure of 1518 2373 3815 409 11.35 paravalvular leak; each additional occlusion device (list separately in addition to code for primary procedure)
93600 Bundle of his recording 375 494 782 0 0.00
93600-26 309 407 644 125 3.46
93600-TC 0 0 0 0 0.00
93602 Intra-atrial recording 331 437 691 0 0.00
93602-26 331 437 691 121 3.36
93602-TC 0 0 0 0 0.00
93603 Right ventricular recording 499 659 1042 0 0.00
93603-26 375 494 782 121 3.36
93603-TC 0 0 0 0 0.00
93609 Intraventricular and/or intra-atrial mapping of 906 1195 1890 0 0.00 tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)
93609-26 760 1003 1587 291 8.09
93609-TC 0 0 0 0 0.00
93610 Intra-atrial pacing 469 619 979 0 0.00
93610-26 469 619 979 171 4.76
93610-TC 0 0 0 0 0.00
93612 Intraventricular pacing 482 636 1006 0 0.00
93612-26 482 636 1006 170 4.72
736 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93612-TC 0 0 0 0 0.00
93613 Intracardiac electrophysiologic 3-dimensional 967 1276 2018 338 9.38 mapping (list separately in addition to code for primary procedure)
93615 Esophageal recording of atrial electrogram with 119 157 248 0 0.00 or without ventricular electrogram(s);
93615-26 119 157 248 40 1.10
93615-TC 0 0 0 0 0.00
93616 Esophageal recording of atrial electrogram with 171 226 357 0 0.00 or without ventricular electrogram(s); with pacing
93616-26 0 0 0 64 1.77
93616-TC 0 0 0 0 0.00
93618 Induction of arrhythmia by electrical pacing 896 1182 1870 0 0.00
93618-26 896 1182 1870 232 6.44
93618-TC 0 0 0 0 0.00
93619 Comprehensive electrophysiologic evaluation 1383 1825 2886 0 0.00 with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia
93619-26 988 1304 2063 409 11.37
93619-TC 0 0 0 0 0.00
93620 Comprehensive electrophysiologic evaluation 1820 2402 3799 0 0.00 including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording
93620-26 1820 2402 3799 657 18.26
93620-TC 0 0 0 0 0.00
93621 Comprehensive electrophysiologic evaluation 357 470 744 0 0.00 including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)
CPT copyright 2017 American Medical Association. 737 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93621-26 357 470 744 123 3.41
93621-TC 0 0 0 0 0.00
93622 Comprehensive electrophysiologic evaluation 521 687 1087 0 0.00 including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)
93622-26 521 687 1087 180 5.01
93622-TC 0 0 0 0 0.00
93623 Programmed stimulation and pacing after 463 611 967 0 0.00 intravenous drug infusion (list separately in addition to code for primary procedure)
93623-26 463 611 967 166 4.62
93623-TC 0 0 0 0 0.00
93624 Electrophysiologic follow-up study with pacing 700 924 1462 0 0.00 and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia
93624-26 0 0 0 261 7.25
93624-TC 0 0 0 0 0.00
93631 Intra-operative epicardial and endocardial 1112 1467 2321 0 0.00 pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction
93631-26 0 0 0 414 11.51
93631-TC 0 0 0 0 0.00
93640 Electrophysiologic evaluation of single or dual 532 702 1110 0 0.00 chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;
93640-26 505 667 1055 187 5.20
93640-TC 0 0 0 0 0.00
93641 Electrophysiologic evaluation of single or dual 999 1318 2085 0 0.00 chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing
738 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single or dual chamber pacing cardioverter-defibrillator pulse generator
93641-26 850 1122 1774 327 9.09
93641-TC 0 0 0 0 0.00
93642 Electrophysiologic evaluation of single or dual 991 1307 2067 354 9.82 chamber transvenous pacing cardioverter- defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)
93642-26 729 962 1522 269 7.46
93642-TC 0 0 0 85 2.36
93644 Electrophysiologic evaluation of subcutaneous 682 900 1423 209 5.81 implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)
93644-26 0 0 0 154 4.27
93644-TC 0 0 0 55 1.54
93650 Intracardiac catheter ablation of atrioventricular 1534 2024 3201 619 17.20 node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement
93653 Comprehensive electrophysiologic evaluation 2095 2764 4372 876 24.33 including insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia with right atrial pacing and recording, right ventricular pacing and recording (when necessary), and his bundle recording (when necessary) with intracardiac catheter ablation of arrhythmogenic focus; with treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathway, accessory atrioventricular connection, cavo-tricuspid isthmus or other single atrial focus or source of atrial re-entry
CPT copyright 2017 American Medical Association. 739 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93654 Comprehensive electrophysiologic evaluation 2766 3650 5773 1173 32.59 including insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia with right atrial pacing and recording, right ventricular pacing and recording (when necessary), and his bundle recording (when necessary) with intracardiac catheter ablation of arrhythmogenic focus; with treatment of ventricular tachycardia or focus of ventricular ectopy including intracardiac electrophysiologic 3d mapping, when performed, and left ventricular pacing and recording, when performed
93655 Intracardiac catheter ablation of a discrete 1010 1332 2107 446 12.40 mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (list separately in addition to code for primary procedure)
93656 Comprehensive electrophysiologic evaluation 2722 3592 5681 1176 32.68 including transseptal catheterizations, insertion and repositioning of multiple electrode catheters with induction or attempted induction of an arrhythmia including left or right atrial pacing/recording when necessary, right ventricular pacing/recording when necessary, and his bundle recording when necessary with intracardiac catheter ablation of atrial fibrillation by pulmonary vein isolation
93657 Additional linear or focal intracardiac catheter 962 1269 2007 446 12.39 ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (list separately in addition to code for primary procedure)
93660 Evaluation of cardiovascular function with tilt 464 612 968 163 4.54 table evaluation, with continuous ECG monitoring and intermittent bp monitoring, with or without pharmacological intervention
93660-26 269 355 561 96 2.67
93660-TC 0 0 0 67 1.87
93662 Intracardiac echocardiography during 383 506 800 0 0.00 therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)
740 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93662-26 383 506 800 147 4.08
93662-TC 0 0 0 0 0.00
93668 Peripheral arterial disease (pad) rehabilitation, 60 79 125 20 0.55 per session
93701 Bioimpedance-derived physiologic 78 120 214 25 0.69 cardiovascular analysis
93702 Bioimpedance spectroscopy (bis), extracellular 341 525 938 126 3.50 fluid analysis for lymphedema assessment(s)
93724 Electronic analysis of antitachycardia 643 989 1768 278 7.73 pacemaker system (includes electrocardio- graphic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)
93724-26 643 989 1768 249 6.91
93724-TC 0 0 0 30 0.82
93740 Temperature gradient studies 66 101 181 8 0.23
93745 Initial set-up and programming by a physician 209 322 576 0 0.00 or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ECG, transmission of data to data repository, patient instruction in wearing system and patient reporting of problems or events
93745-26 0 0 0 0 0.00
93745-TC 0 0 0 0 0.00
93750 Interrogation of ventricular assist device 142 218 390 57 1.58 (VAD), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming, if performed, and report
93770 Determination of venous pressure 25 39 69 8 0.23
93784 Ambulatory bp monitoring, utilizing a system 176 270 483 55 1.52 such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report
CPT copyright 2017 American Medical Association. 741 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93786 Ambulatory bp monitoring, utilizing a system 101 156 278 30 0.84 such as magnetic tape and/or computer disk, for 24 hours or longer; recording only
93788 Ambulatory bp monitoring, utilizing a system 41 63 113 5 0.15 such as magnetic tape and/or computer disk, for 24 hours or longer; scanning analysis with report
93790 Ambulatory bp monitoring, utilizing a system 58 89 160 19 0.53 such as magnetic tape and/or computer disk, for 24 hours or longer; review with interpretation and report
93792 Patient/caregiver training for initiation of home 145 223 399 55 1.53 international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the INR monitor, obtaining blood sample, instructions for reporting home INR test results, and documentation of patient's/caregiver's ability to perform testing and report results
93793 Anticoagulant management for a patient taking 32 50 89 12 0.34 warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (INR) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed
93797 Physician or other qualified health care 65 100 179 17 0.46 professional services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session)
93798 Physician or other qualified health care 60 92 165 26 0.71 professional services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session)
93799 Unlisted cardiovascular service or procedure 0 0 0 0 0.00
93799-26 0 0 0 0 0.00
93799-TC 0 0 0 0 0.00
NON-INVASIVE VASCULAR DIAGNOSTIC STUDIES
93880 Duplex scan of extracranial arteries; complete 476 625 895 209 5.81 bilateral study
93880-26 117 154 221 41 1.14
742 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93880-TC 0 0 0 168 4.67
93882 Duplex scan of extracranial arteries; unilateral 280 367 526 134 3.72 or limited study
93882-26 58 76 108 26 0.72
93882-TC 0 0 0 108 3.00
93886 Transcranial Doppler study of the intracranial 504 662 948 280 7.78 arteries; complete study
93886-26 136 179 256 48 1.34
93886-TC 0 0 0 232 6.44
93888 Transcranial Doppler study of the intracranial 261 342 490 159 4.42 arteries; limited study
93888-26 112 147 210 27 0.74
93888-TC 0 0 0 132 3.68
93890 Transcranial Doppler study of the intracranial 381 500 716 287 7.96 arteries; vasoreactivity study
93890-26 287 376 539 53 1.46
93890-TC 0 0 0 234 6.50
93892 Transcranial Doppler study of the intracranial 394 517 740 329 9.13 arteries; emboli detection without intravenous microbubble injection
93892-26 238 313 448 62 1.71
93892-TC 0 0 0 267 7.42
93893 Transcranial Doppler study of the intracranial 446 585 839 356 9.90 arteries; emboli detection with intravenous microbubble injection
93893-26 183 240 344 61 1.70
93893-TC 0 0 0 295 8.20
93895 Quantitative carotid intima media thickness and 351 460 659 0 0.00 carotid atheroma evaluation, bilateral
93895-26 0 0 0 0 0.00
93895-TC 0 0 0 0 0.00
93922 Limited bilateral noninvasive physiologic 232 305 437 90 2.51 studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices
CPT copyright 2017 American Medical Association. 743 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
at distal posterior tibial and anterior tibial/ dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1- 2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1-2 levels)
93922-26 43 56 81 13 0.36
93922-TC 0 0 0 77 2.15
93923 Complete bilateral noninvasive physiologic 327 429 615 140 3.89 studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental bp measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at 3 or more levels), or single level study with provocative functional maneuvers (eg, measurements with postural provocative tests, or measurements with reactive hyperemia)
93923-26 82 108 154 23 0.63
93923-TC 0 0 0 117 3.26
93924 Noninvasive physiologic studies of lower 413 542 776 174 4.84 extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at rest with ankle/ brachial indices immediately after and at timed intervals following performance of a standardized protocol on a motorized treadmill plus recording of time of onset of claudication or other symptoms, maximal walking time, and time to recovery) complete bilateral study
93924-26 80 105 151 25 0.70
93924-TC 0 0 0 149 4.14
744 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93925 Duplex scan of lower extremity arteries or 479 629 901 268 7.45 arterial bypass grafts; complete bilateral study
93925-26 108 141 202 41 1.13
93925-TC 0 0 0 228 6.32
93926 Duplex scan of lower extremity arteries or 375 492 705 157 4.36 arterial bypass grafts; unilateral or limited study
93926-26 81 106 151 25 0.69
93926-TC 0 0 0 132 3.67
93930 Duplex scan of upper extremity arteries or 486 638 913 215 5.97 arterial bypass grafts; complete bilateral study
93930-26 122 160 229 41 1.14
93930-TC 0 0 0 174 4.83
93931 Duplex scan of upper extremity arteries or 346 454 650 134 3.71 arterial bypass grafts; unilateral or limited study
93931-26 65 86 123 25 0.70
93931-TC 0 0 0 108 3.01
93970 Duplex scan of extremity veins including 520 683 978 202 5.61 responses to compression and other maneuvers; complete bilateral study
93970-26 128 168 240 35 0.98
93970-TC 0 0 0 167 4.63
93971 Duplex scan of extremity veins including 365 479 687 124 3.44 responses to compression and other maneuvers; unilateral or limited study
93971-26 85 112 160 23 0.64
93971-TC 0 0 0 101 2.80
93975 Duplex scan of arterial inflow and venous 746 978 1401 291 8.08 outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study
93975-26 297 389 558 59 1.65
93975-TC 0 0 0 231 6.43
CPT copyright 2017 American Medical Association. 745 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
93976 Duplex scan of arterial inflow and venous 509 668 957 169 4.70 outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study
93976-26 185 243 348 41 1.13
93976-TC 0 0 0 129 3.57
93978 Duplex scan of aorta, inferior vena cava, iliac 412 541 774 197 5.48 vasculature, or bypass grafts; complete study
93978-26 96 126 181 41 1.13
93978-TC 0 0 0 157 4.35
93979 Duplex scan of aorta, inferior vena cava, iliac 333 437 625 125 3.46 vasculature, or bypass grafts; unilateral or limited study
93979-26 104 136 195 26 0.71
93979-TC 0 0 0 99 2.75
93980 Duplex scan of arterial inflow and venous 486 637 913 129 3.59 outflow of penile vessels; complete study
93980-26 287 377 540 63 1.76
93980-TC 0 0 0 66 1.83
93981 Duplex scan of arterial inflow and venous 196 257 368 79 2.19 outflow of penile vessels; follow-up or limited study
93981-26 81 106 152 22 0.62
93981-TC 0 0 0 57 1.57
93990 Duplex scan of hemodialysis access (including 348 456 654 164 4.55 arterial inflow, body of access and venous outflow)
93990-26 49 64 92 25 0.70
93990-TC 0 0 0 139 3.85
93998 Unlisted noninvasive vascular diagnostic study 0 0 0 0 0.00
PULMONARY
94002 Ventilation assist and management, initiation 314 452 742 95 2.63 of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day
746 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
94003 Ventilation assist and management, initiation 160 231 378 68 1.90 of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, each subsequent day
94004 Ventilation assist and management, initiation 99 142 233 50 1.40 of pressure or volume preset ventilators for assisted or controlled breathing; nursing facility, per day
94005 Home ventilator management care plan 272 392 643 95 2.63 oversight of a patient (patient not present) in home, domiciliary or rest home (eg, assisted living) requiring review of status, review of laboratories and other studies and revision of orders and respiratory care plan (as appropriate), within a calendar month, 30 minutes or more
94010 Spirometry, including graphic record, total and 78 112 184 37 1.02 timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation
94010-26 32 47 77 9 0.24
94010-TC 0 0 0 28 0.78
94011 Measurement of spirometric forced expiratory 270 389 638 89 2.47 flows in an infant or child through 2 years of age
94012 Measurement of spirometric forced expiratory 435 626 1027 145 4.02 flows, before and after bronchodilator, in an infant or child through 2 years of age
94013 Measurement of lung volumes (ie, functional 87 125 205 20 0.55 residual capacity [FRC], forced vital capacity [fvc], and expiratory reserve volume [ERV]) in an infant or child through 2 years of age
94014 Patient-initiated spirometric recording per 30- 100 144 236 58 1.60 day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional
94015 Patient-initiated spirometric recording per 30- 52 75 123 32 0.88 day period of time; recording (includes hook- up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)
CPT copyright 2017 American Medical Association. 747 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
94016 Patient-initiated spirometric recording per 30- 51 73 119 26 0.72 day period of time; review and interpretation only by a physician or other qualified health care professional
94060 Bronchodilation responsiveness, spirometry as 130 187 307 62 1.72 in 94010, pre- and post-bronchodilator admin
94060-26 49 70 116 13 0.37
94060-TC 0 0 0 49 1.35
94070 Bronchospasm provocation evaluation, 188 271 445 62 1.72 multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)
94070-26 89 128 210 30 0.82
94070-TC 0 0 0 32 0.90
94150 Vital capacity, total (separate procedure) 42 60 99 26 0.73
94150-26 26 37 61 4 0.11
94150-TC 0 0 0 22 0.62
94200 Maximum breathing capacity, maximal 40 58 95 28 0.78 voluntary ventilation
94200-26 21 31 50 6 0.16
94200-TC 0 0 0 22 0.62
94250 Expired gas collection, quantitative, single 52 75 123 29 0.80 procedure (separate procedure)
94250-26 34 49 80 6 0.16
94250-TC 0 0 0 23 0.64
94375 Respiratory flow volume loop 80 116 190 41 1.13
94375-26 47 67 111 15 0.42
94375-TC 0 0 0 26 0.71
94400 Breathing response to co2 (co2 response curve) 73 105 173 59 1.64
94400-26 25 36 59 20 0.56
94400-TC 0 0 0 39 1.08
94450 Breathing response to hypoxia (hypoxia 138 198 325 73 2.03 response curve)
748 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
94450-26 86 125 204 21 0.57
94450-TC 0 0 0 53 1.46
94452 High altitude simulation test (hast), with 169 243 399 59 1.64 interpretation and report by a physician or other qualified health care professional;
94452-26 0 0 0 15 0.41
94452-TC 0 0 0 44 1.23
94453 High altitude simulation test (hast), with 234 337 553 82 2.27 interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration
94453-26 0 0 0 19 0.54
94453-TC 0 0 0 62 1.73
94610 Intrapulmonary surfactant administration by a 408 588 965 57 1.59 physician or other qualified health care professional through endotracheal tube
94617 Exercise test for bronchospasm, including pre- 207 299 490 97 2.70 and post-spirometry, electrocardiographic recording(s), and pulse oximetry
94617-26 0 0 0 34 0.95
94617-TC 0 0 0 63 1.75
94618 Pulmonary stress testing (eg, 6-minute walk 74 107 176 35 0.97 test), including measurement of heart rate, oximetry, and oxygen titration, when performed
94618-26 0 0 0 23 0.65
94618-TC 0 0 0 12 0.32
94621 Cardiopulmonary exercise testing, including 368 530 870 168 4.68 measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings
94621-26 220 316 519 71 1.96
94621-TC 0 0 0 98 2.72
94640 Pressurized or nonpressurized inhalation 43 62 102 19 0.53 treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic
CPT copyright 2017 American Medical Association. 749 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device
94642 Aerosol inhalation of pentamidine for 100 144 236 0 0.00 pneumocystis carinii pneumonia treatment or prophylaxis
94644 Continuous inhalation treatment with aerosol 104 150 245 46 1.28 medication for acute airway obstruction; first hour
94645 Continuous inhalation treatment with aerosol 75 108 177 17 0.46 medication for acute airway obstruction; each additional hour (list separately in addition to code for primary procedure)
94660 Continuous positive airway pressure ventilation 134 193 316 66 1.84 (CPAP), initiation and management
94662 Continuous negative pressure ventilation 103 149 245 37 1.03 (CNP), initiation and management
94664 Demonstration and/or evaluation of patient 40 58 95 18 0.49 utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device
94667 Manipulation chest wall, such as cupping, 50 72 119 27 0.76 percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation
94668 Manipulation chest wall, such as cupping, 95 137 224 33 0.91 percussing, and vibration to facilitate lung function; subsequent
94669 Mechanical chest wall oscillation to facilitate 76 110 180 33 0.93 lung function, per session
94680 Oxygen uptake, expired gas analysis; rest and 117 169 277 60 1.66 exercise, direct, simple
94680-26 111 160 263 13 0.36
94680-TC 0 0 0 47 1.30
94681 Oxygen uptake, expired gas analysis; including 190 274 449 58 1.62 CO2 output, percentage oxygen extracted
94681-26 100 144 237 10 0.29
94681-TC 0 0 0 48 1.33
94690 Oxygen uptake, expired gas analysis; rest, 144 207 340 57 1.58 indirect (separate procedure)
750 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
94690-26 15 22 36 4 0.11
94690-TC 0 0 0 53 1.47
94726 Plethysmography for determination of lung 178 256 419 56 1.56 volumes and, when performed, airway resistance
94726-26 54 77 127 13 0.35
94726-TC 0 0 0 44 1.21
94727 Gas dilution or washout for determination of 102 147 242 45 1.25 lung volumes and, when performed, distribution of ventilation and closing volumes
94727-26 38 55 90 13 0.35
94727-TC 0 0 0 32 0.90
94728 Airway resistance by impulse oscillometry 90 129 212 42 1.17
94728-26 55 80 131 13 0.36
94728-TC 0 0 0 29 0.81
94729 Diffusing capacity (eg, carbon monoxide, 120 173 283 56 1.55 membrane) (list separately in addition to code for primary procedure)
94729-26 31 44 72 9 0.26
94729-TC 0 0 0 46 1.29
94750 Pulmonary compliance study (eg, 155 223 367 84 2.34 plethysmography, volume and pressure measurements)
94750-26 31 45 73 11 0.31
94750-TC 0 0 0 73 2.03
94760 Noninvasive ear or pulse oximetry for oxygen 15 22 36 3 0.08 saturation; single determination
94761 Noninvasive ear or pulse oximetry for oxygen 25 37 60 5 0.13 saturation; multiple determinations (eg, during exercise)
94762 Noninvasive ear or pulse oximetry for oxygen 40 58 96 25 0.70 saturation; by continuous overnight monitoring (separate procedure)
94770 Carbon dioxide, expired gas determination by 103 148 242 8 0.21 infrared analyzer
CPT copyright 2017 American Medical Association. 751 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
94772 Circadian respiratory pattern recording 399 575 943 0 0.00 (pediatric pneumogram), 12-24 hour continuous recording, infant
94772-26 254 365 599 0 0.00
94772-TC 0 0 0 0 0.00
94774 Pediatric home apnea monitoring event 899 1295 2124 0 0.00 recording including respiratory rate, pattern and heart rate per 30-day period of time; includes monitor attachment, download of data, review, interpretation, and preparation of a report by a physician or other qualified health care professional
94775 Pediatric home apnea monitoring event 136 196 321 0 0.00 recording including respiratory rate, pattern and heart rate per 30-day period of time; monitor attachment only (includes hook-up, initiation of recording and disconnection)
94776 Pediatric home apnea monitoring event 318 458 752 0 0.00 recording including respiratory rate, pattern and heart rate per 30-day period of time; monitoring, download of information, receipt of transmission(s) and analyses by computer only
94777 Pediatric home apnea monitoring event 243 350 573 0 0.00 recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional
94780 Car seat/bed testing for airway integrity, 178 256 420 53 1.48 neonate, with continual nursing observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes
94781 Car seat/bed testing for airway integrity, 63 91 149 21 0.59 neonate, with continual nursing observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; each additional full 30 minutes (list separately in addition to code for primary procedure)
94799 Unlisted pulmonary service or procedure 0 0 0 0 0.00
94799-26 0 0 0 0 0.00
94799-TC 0 0 0 0 0.00
752 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
ALLERGY AND CLINICAL IMMUNOLOGY
95004 Percutaneous tests (scratch, puncture, prick) 12 15 20 5 0.15 with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
95012 Nitric oxide expired gas determination 36 47 62 21 0.57
95017 Allergy testing, any combination of 25 32 43 8 0.22 percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests
95018 Allergy testing, any combination of 45 58 77 22 0.60 percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests
95024 Intracutaneous (intradermal) tests with 13 17 22 8 0.23 allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
95027 Intracutaneous (intradermal) tests, sequential 15 19 26 5 0.13 and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests
95028 Intracutaneous (intradermal) tests with 17 21 28 13 0.37 allergenic extracts, delayed type reaction, including reading, specify number of tests
95044 Patch or application test(s) (specify number of 15 19 26 6 0.16 tests)
95052 Photo patch test(s) (specify number of tests) 26 33 43 7 0.19
95056 Photo tests 90 115 153 47 1.30
95060 Ophthalmic mucous membrane tests 76 97 129 36 1.00
95065 Direct nasal mucous membrane test 49 63 83 26 0.71
95070 Inhalation bronchial challenge testing (not 124 158 211 32 0.88 including necessary pulmonary function tests); with histamine, methacholine, or similar compounds
CPT copyright 2017 American Medical Association. 753 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95071 Inhalation bronchial challenge testing (not 110 141 187 36 1.00 including necessary pulmonary function tests); with antigens or gases, specify
95076 Ingestion challenge test (sequential and 214 273 364 122 3.39 incremental ingestion of test items, eg, food, drug or other substance); initial 120 minutes of testing
95079 Ingestion challenge test (sequential and 164 209 279 86 2.38 incremental ingestion of test items, eg, food, drug or other substance); each additional 60 minutes of testing (list separately in addition to code for primary procedure)
95115 Professional services for allergen 23 27 33 9 0.25 immunotherapy not including provision of allergenic extracts; single injection
95117 Professional services for allergen 30 36 44 10 0.29 immunotherapy not including provision of allergenic extracts; 2 or more injections
95120 Professional services for allergen 33 39 48 0 0.00 immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single injection
95125 Professional services for allergen 41 47 58 0 0.00 immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 or more injections
95130 Professional services for allergen 43 50 62 0 0.00 immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single stinging insect venom
95131 Professional services for allergen 63 73 90 0 0.00 immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 stinging insect venoms
95132 Professional services for allergen 65 76 94 0 0.00 immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 3 stinging insect venoms
754 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95133 Professional services for allergen 131 153 188 0 0.00 immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 4 stinging insect venoms
95134 Professional services for allergen 184 215 264 0 0.00 immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 5 stinging insect venoms
95144 Professional services for the supervision of 18 21 26 14 0.38 preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials)
95145 Professional services for the supervision of 35 41 50 26 0.73 preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom
95146 Professional services for the supervision of 58 68 84 48 1.34 preparation and provision of antigens for allergen immunotherapy (specify number of doses); 2 single stinging insect venoms
95147 Professional services for the supervision of 65 76 93 51 1.43 preparation and provision of antigens for allergen immunotherapy (specify number of doses); 3 single stinging insect venoms
95148 Professional services for the supervision of 80 93 115 73 2.04 preparation and provision of antigens for allergen immunotherapy (specify number of doses); 4 single stinging insect venoms
95149 Professional services for the supervision of 101 118 145 96 2.68 preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 single stinging insect venoms
95165 Professional services for the supervision of 24 28 34 13 0.37 preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)
95170 Professional services for the supervision of 21 25 30 10 0.28 preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses)
95180 Rapid desensitization procedure, each hour (eg, 251 293 360 139 3.86 insulin, penicillin, equine serum)
CPT copyright 2017 American Medical Association. 755 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95199 Unlisted allergy/clinical immunologic service 0 0 0 0 0.00 or procedure
ENDOCRINOLOGY
95249 Ambulatory continuous glucose monitoring of 132 154 190 56 1.56 interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient- provided equipment, sensor placement, hook- up, calibration of monitor, patient training, and printout of recording
95250 Ambulatory continuous glucose monitoring of 300 350 430 157 4.35 interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook- up, calibration of monitor, patient training, removal of sensor, and printout of recording
95251 Ambulatory continuous glucose monitoring of 89 104 127 37 1.02 interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report
NEUROLOGY AND NEUROMUSCULAR PROCEDURES
95782 Polysomnography; younger than 6 years, sleep 2683 4009 6690 936 25.99 staging with 4 or more additional parameters of sleep, attended by a technologist
95782-26 435 650 1085 129 3.59
95782-TC 0 0 0 806 22.40
95783 Polysomnography; younger than 6 years, sleep 3914 5849 9760 998 27.72 staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist
95783-26 450 672 1121 141 3.91
95783-TC 0 0 0 857 23.81
95800 Sleep study, unattended, simultaneous 502 750 1252 181 5.02 recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time
95800-26 188 281 469 53 1.48
95800-TC 0 0 0 127 3.54
95801 Sleep study, unattended, simultaneous 266 398 664 93 2.57 recording; minimum of heart rate, oxygen
756 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)
95801-26 144 216 360 50 1.40
95801-TC 0 0 0 42 1.17
95803 Actigraphy testing, recording, analysis, 281 420 701 146 4.06 interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
95803-26 142 213 355 45 1.25
95803-TC 0 0 0 101 2.81
95805 Multiple sleep latency or maintenance of 1140 1703 2842 441 12.24 wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
95805-26 197 294 490 60 1.68
95805-TC 0 0 0 380 10.56
95806 Sleep study, unattended, simultaneous 411 615 1025 174 4.82 recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)
95806-26 171 255 426 63 1.74
95806-TC 0 0 0 111 3.08
95807 Sleep study, simultaneous recording of 890 1330 2219 470 13.05 ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
95807-26 245 367 612 64 1.77
95807-TC 0 0 0 406 11.28
95808 Polysomnography; any age, sleep staging with 3183 4757 7938 715 19.86 1-3 additional parameters of sleep, attended by a technologist
95808-26 351 525 876 91 2.52
95808-TC 0 0 0 624 17.34
95810 Polysomnography; age 6 years or older, sleep 1714 2562 4274 639 17.75 staging with 4 or more additional parameters of sleep, attended by a technologist
CPT copyright 2017 American Medical Association. 757 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95810-26 345 515 860 125 3.46
95810-TC 0 0 0 514 14.29
95811 Polysomnography; age 6 years or older, sleep 1825 2727 4551 671 18.64 staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist
95811-26 362 541 902 130 3.60
95811-TC 0 0 0 541 15.04
95812 Electroencephalogram (EEG) extended 752 1124 1876 330 9.16 monitoring; 41-60 minutes
95812-26 177 264 441 59 1.65
95812-TC 0 0 0 270 7.51
95813 Electroencephalogram (EEG) extended 803 1201 2003 414 11.51 monitoring; greater than 1 hour
95813-26 176 264 440 89 2.47
95813-TC 0 0 0 325 9.04
95816 Electroencephalogram (EEG); including 618 924 1542 372 10.33 recording awake and drowsy
95816-26 113 169 283 59 1.65
95816-TC 0 0 0 312 8.68
95819 Electroencephalogram (EEG); including 712 1063 1774 432 12.01 recording awake and asleep
95819-26 157 234 391 59 1.65
95819-TC 0 0 0 373 10.36
95822 Electroencephalogram (EEG); recording in 930 1390 2320 390 10.82 coma or sleep only
95822-26 189 282 470 59 1.65
95822-TC 0 0 0 330 9.17
95824 Electroencephalogram (EEG); cerebral death 125 187 312 0 0.00 evaluation only
95824-26 125 187 312 41 1.13
95824-TC 0 0 0 0 0.00
758 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95827 Electroencephalogram (EEG); all night 1331 1988 3318 640 17.79 recording
95827-26 78 117 195 58 1.61
95827-TC 0 0 0 582 16.18
95829 Electrocorticogram at surgery (separate 3790 5663 9449 1954 54.27 procedure)
95829-26 1221 1824 3043 347 9.63
95829-TC 0 0 0 1607 44.64
95830 Insertion by physician or other qualified health 403 603 1006 239 6.65 care professional of sphenoidal electrodes for electroencephalographic (EEG) recording
95831 Muscle testing, manual (separate procedure) 52 78 130 33 0.93 with report; extremity (excluding hand) or trunk
95832 Muscle testing, manual (separate procedure) 57 85 142 33 0.92 with report; hand, with or without comparison with normal side
95833 Muscle testing, manual (separate procedure) 502 750 1252 42 1.16 with report; total evaluation of body, excluding hands
95834 Muscle testing, manual (separate procedure) 73 109 182 55 1.54 with report; total evaluation of body, including hands
95851 Range of motion measurements and report 48 72 121 21 0.57 (separate procedure); each extremity (excluding hand) or each trunk section (spine)
95852 Range of motion measurements and report 64 96 160 19 0.52 (separate procedure); hand, with or without comparison with normal side
95857 Cholinesterase inhibitor challenge test for 126 188 313 55 1.53 myasthenia gravis
95860 Needle electromyography; 1 extremity with or 231 346 577 126 3.50 without related paraspinal areas
95860-26 167 250 417 53 1.48
95860-TC 0 0 0 73 2.02
95861 Needle electromyography; 2 extremities with 1388 2075 3461 179 4.96 or without related paraspinal areas
95861-26 514 768 1282 85 2.36
CPT copyright 2017 American Medical Association. 759 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95861-TC 0 0 0 94 2.60
95863 Needle electromyography; 3 extremities with 402 601 1004 228 6.33 or without related paraspinal areas
95863-26 264 395 659 103 2.85
95863-TC 0 0 0 125 3.48
95864 Needle electromyography; 4 extremities with 2148 3210 5355 255 7.08 or without related paraspinal areas
95864-26 999 1493 2492 109 3.04
95864-TC 0 0 0 145 4.04
95865 Needle electromyography; larynx 3000 4484 7481 150 4.18
95865-26 512 765 1277 86 2.39
95865-TC 0 0 0 64 1.79
95866 Needle electromyography; hemidiaphragm 309 462 771 138 3.83
95866-26 176 264 440 69 1.92
95866-TC 0 0 0 69 1.91
95867 Needle electromyography; cranial nerve 344 514 858 104 2.89 supplied muscle(s), unilateral
95867-26 226 338 563 44 1.21
95867-TC 0 0 0 60 1.68
95868 Needle electromyography; cranial nerve 1153 1724 2876 139 3.85 supplied muscles, bilateral
95868-26 393 588 981 65 1.80
95868-TC 0 0 0 74 2.05
95869 Needle electromyography; thoracic paraspinal 181 270 450 96 2.66 muscles (excluding T1 or T12)
95869-26 55 81 136 21 0.57
95869-TC 0 0 0 75 2.09
95870 Needle electromyography; limited study of 410 612 1022 97 2.70 muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters
95870-26 202 301 503 21 0.57
760 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95870-TC 0 0 0 77 2.13
95872 Needle electromyography using single fiber 393 587 980 202 5.61 electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied
95872-26 309 462 770 159 4.41
95872-TC 0 0 0 43 1.20
95873 Electrical stimulation for guidance in 153 228 381 75 2.09 conjunction with chemodenervation (list separately in addition to code for primary procedure)
95873-26 81 121 202 21 0.57
95873-TC 0 0 0 55 1.52
95874 Needle electromyography for guidance in 155 231 386 77 2.13 conjunction with chemodenervation (list separately in addition to code for primary procedure)
95874-26 78 117 195 21 0.57
95874-TC 0 0 0 56 1.56
95875 Ischemic limb exercise test with serial 341 510 851 134 3.71 specimen(s) acquisition for muscle(s) metabolite(s)
95875-26 0 0 0 61 1.69
95875-TC 0 0 0 73 2.02
95885 Needle electromyography, each extremity, with 151 226 377 60 1.68 related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)
95885-26 56 83 139 19 0.54
95885-TC 0 0 0 41 1.14
95886 Needle electromyography, each extremity, with 211 315 525 94 2.60 related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for primary procedure)
CPT copyright 2017 American Medical Association. 761 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95886-26 120 179 299 48 1.32
95886-TC 0 0 0 46 1.28
95887 Needle electromyography, non-extremity 181 270 451 83 2.30 (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)
95887-26 42 63 106 39 1.09
95887-TC 0 0 0 44 1.21
95905 Motor and/or sensory nerve conduction, using 129 192 320 74 2.06 preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f- wave study when performed, with interpretation and report
95905-26 77 115 193 3 0.08
95905-TC 0 0 0 71 1.98
95907 Nerve conduction studies; 1-2 studies 219 327 546 100 2.78
95907-26 59 88 147 55 1.53
95907-TC 0 0 0 45 1.25
95908 Nerve conduction studies; 3-4 studies 286 427 713 130 3.60
95908-26 144 215 359 69 1.93
95908-TC 0 0 0 60 1.67
95909 Nerve conduction studies; 5-6 studies 343 513 856 154 4.29
95909-26 192 287 480 83 2.30
95909-TC 0 0 0 72 1.99
95910 Nerve conduction studies; 7-8 studies 452 675 1127 203 5.65
95910-26 267 399 666 111 3.07
95910-TC 0 0 0 93 2.58
95911 Nerve conduction studies; 9-10 studies 568 848 1415 243 6.74
95911-26 321 479 799 138 3.83
95911-TC 0 0 0 105 2.91
95912 Nerve conduction studies; 11-12 studies 635 949 1584 269 7.48
762 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95912-26 385 576 961 164 4.55
95912-TC 0 0 0 105 2.93
95913 Nerve conduction studies; 13 or more studies 725 1084 1808 311 8.63
95913-26 396 591 987 194 5.39
95913-TC 0 0 0 117 3.24
95921 Testing of autonomic nervous system function; 211 315 526 85 2.37 cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio
95921-26 125 186 311 46 1.29
95921-TC 0 0 0 39 1.08
95922 Testing of autonomic nervous system function; 242 362 605 100 2.77 vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat bp and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt
95922-26 58 86 144 50 1.38
95922-TC 0 0 0 50 1.39
95923 Testing of autonomic nervous system function; 384 574 957 133 3.69 sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (QSART), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential
95923-26 131 196 328 47 1.31
95923-TC 0 0 0 86 2.38
95924 Testing of autonomic nervous system function; 304 454 757 154 4.29 combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt
95924-26 194 290 483 91 2.54
95924-TC 0 0 0 63 1.75
95925 Short-latency somatosensory evoked potential 341 510 851 135 3.76 study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs
CPT copyright 2017 American Medical Association. 763 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95925-26 124 185 309 28 0.79
95925-TC 0 0 0 107 2.97
95926 Short-latency somatosensory evoked potential 302 452 754 133 3.69 study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs
95926-26 98 146 244 28 0.78
95926-TC 0 0 0 105 2.91
95927 Short-latency somatosensory evoked potential 251 375 626 139 3.87 study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head
95927-26 61 91 152 28 0.78
95927-TC 0 0 0 111 3.09
95928 Central motor evoked potential study 2373 3546 5916 218 6.05 (transcranial motor stimulation); upper limbs
95928-26 860 1285 2144 82 2.28
95928-TC 0 0 0 136 3.77
95929 Central motor evoked potential study 1271 1899 3169 224 6.22 (transcranial motor stimulation); lower limbs
95929-26 618 924 1541 83 2.30
95929-TC 0 0 0 141 3.92
95930 Visual evoked potential (VEP) checkerboard or 236 353 588 71 1.98 flash testing, central nervous system except glaucoma, with interpretation and report
95930-26 81 121 201 19 0.54
95930-TC 0 0 0 52 1.44
95933 Orbicularis oculi (blink) reflex, by 314 470 784 80 2.22 electrodiagnostic testing
95933-26 127 190 317 32 0.90
95933-TC 0 0 0 48 1.32
95937 Neuromuscular junction testing (repetitive 146 218 363 84 2.33 stimulation, paired stimuli), each nerve, any 1 method
95937-26 42 62 104 35 0.98
764 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95937-TC 0 0 0 49 1.35
95938 Short-latency somatosensory evoked potential 1495 2235 3729 353 9.80 study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs
95938-26 717 1071 1788 48 1.32
95938-TC 0 0 0 305 8.48
95939 Central motor evoked potential study 3474 5192 8663 518 14.40 (transcranial motor stimulation); in upper and lower limbs
95939-26 1229 1836 3064 123 3.42
95939-TC 0 0 0 395 10.98
95940 Continuous intraoperative neurophysiology 238 356 595 33 0.93 monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (list separately in addition to code for primary procedure)
95941 Continuous intraoperative neurophysiology 835 1248 2083 0 0.00 monitoring, from outside the operating room (remote or nearby) or for monitoring of more than one case while in the operating room, per hour (list separately in addition to code for primary procedure)
95943 Simultaneous, independent, quantitative 402 600 1002 0 0.00 measures of both parasympathetic function and sympathetic function, based on time-frequency analysis of heart rate variability concurrent with time-frequency analysis of continuous respiratory activity, with mean heart rate and bp measures, during rest, paced (deep) breathing, valsalva maneuvers, and head-up postural change
95943-26 172 257 429 0 0.00
95943-TC 0 0 0 0 0.00
95950 Monitoring for identification and lateralization 741 1107 1847 350 9.73 of cerebral seizure focus, electroencephalographic (eg, 8 channel eeg) recording and interpretation, each 24 hours
95950-26 219 328 547 82 2.29
95950-TC 0 0 0 268 7.44
CPT copyright 2017 American Medical Association. 765 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95951 Monitoring for localization of cerebral seizure 5055 7554 12605 0 0.00 focus by cable or radio, 16 or more channel telemetry, combined electroencephalographic (EEG) and video recording and interpretation (eg, for presurgical localization), each 24 hours
95951-26 978 1462 2439 329 9.13
95951-TC 0 0 0 0 0.00
95953 Monitoring for localization of cerebral seizure 1052 1572 2623 443 12.30 focus by computerized portable 16 or more channel eeg, electroencephalographic (EEG) recording and interpretation, each 24 hours, unattended
95953-26 386 576 961 168 4.68
95953-TC 0 0 0 274 7.62
95954 Pharmacological or physical activation 788 1178 1966 436 12.12 requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)
95954-26 250 373 622 124 3.44
95954-TC 0 0 0 312 8.68
95955 Electroencephalogram (EEG) during 2572 3844 6414 219 6.09 nonintracranial surgery (eg, carotid surgery)
95955-26 579 866 1444 55 1.54
95955-TC 0 0 0 164 4.55
95956 Monitoring for localization of cerebral seizure 2701 4037 6735 1629 45.24 focus by cable or radio, 16 or more channel telemetry, electroencephalographic (EEG) recording and interpretation, each 24 hours, attended by a technologist or nurse
95956-26 335 501 835 197 5.46
95956-TC 0 0 0 1432 39.78
95957 Digital analysis of electroencephalogram 626 936 1562 294 8.17 (EEG) (eg, for epileptic spike analysis)
95957-26 333 498 830 107 2.97
95957-TC 0 0 0 187 5.20
766 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95958 Wada activation test for hemispheric function, 1431 2138 3567 595 16.52 including electroencephalographic (EEG) monitoring
95958-26 562 840 1401 234 6.49
95958-TC 0 0 0 361 10.03
95961 Functional cortical and subcortical mapping by 681 1018 1699 311 8.65 stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional
95961-26 570 852 1422 166 4.61
95961-TC 0 0 0 145 4.04
95962 Functional cortical and subcortical mapping by 906 1354 2258 269 7.47 stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately in addition to code for primary procedure)
95962-26 600 897 1497 178 4.95
95962-TC 0 0 0 91 2.52
95965 Magnetoencephalography (meg), recording and 1517 2266 3781 0 0.00 analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)
95965-26 1517 2266 3781 435 12.07
95965-TC 0 0 0 0 0.00
95966 Magnetoencephalography (meg), recording and 565 844 1408 0 0.00 analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)
95966-26 0 0 0 221 6.14
95966-TC 0 0 0 0 0.00
95967 Magnetoencephalography (meg), recording and 498 744 1241 0 0.00 analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list
CPT copyright 2017 American Medical Association. 767 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
separately in addition to code for primary procedure)
95967-26 0 0 0 195 5.41
95967-TC 0 0 0 0 0.00
95970 Electronic analysis of implanted 137 204 341 71 1.97 neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple or complex brain, spinal cord, or peripheral (ie, cranial nerve, peripheral nerve, sacral nerve, neuromuscular) neurostimulator pulse generator/transmitter, without reprogramming
95971 Electronic analysis of implanted 142 212 354 52 1.45 neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming
95972 Electronic analysis of implanted 251 376 627 60 1.67 neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming
95974 Electronic analysis of implanted 420 627 1047 213 5.91 neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, with or without nerve interface testing, first hour
768 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95975 Electronic analysis of implanted 301 450 751 114 3.18 neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, each additional 30 minutes after first hour (list separately in addition to code for primary procedure)
95978 Electronic analysis of implanted 514 768 1282 258 7.17 neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, battery status, electrode selectability and polarity, impedance and patient compliance measurements), complex deep brain neurostimulator pulse generator/transmitter, with initial or subsequent programming; first hour
95979 Electronic analysis of implanted 241 361 602 111 3.08 neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, battery status, electrode selectability and polarity, impedance and patient compliance measurements), complex deep brain neurostimulator pulse generator/transmitter, with initial or subsequent programming; each additional 30 minutes after first hour (list separately in addition to code for primary procedure)
95980 Electronic analysis of implanted 122 182 304 48 1.32 neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; intraoperative, with programming
95981 Electronic analysis of implanted 76 113 189 34 0.95 neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/ transmitter; subsequent, without reprogramming
CPT copyright 2017 American Medical Association. 769 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
95982 Electronic analysis of implanted 126 188 313 55 1.53 neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; subsequent, with reprogramming
95990 Refilling and maintenance of implantable pump 191 285 476 95 2.65 or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed;
95991 Refilling and maintenance of implantable pump 248 371 620 122 3.39 or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requiring skill of a physician or other qualified health care professional
95992 Canalith repositioning procedure(s) (eg, Epley 84 126 210 44 1.23 maneuver, Semont maneuver), per day
95999 Unlisted neurological or neuromuscular 0 0 0 0 0.00 diagnostic procedure
96000 Comprehensive computer-based motion 176 263 439 99 2.75 analysis by video-taping and 3d kinematics;
96001 Comprehensive computer-based motion 204 305 509 133 3.69 analysis by video-taping and 3d kinematics; with dynamic plantar pressure measurements during walking
96002 Dynamic surface electromyography, during 58 87 146 23 0.63 walking or other functional activities, 1-12 muscles
96003 Dynamic fine wire electromyography, during 45 67 112 18 0.49 walking or other functional activities, 1 muscle
96004 Review and interpretation by physician or other 301 450 751 118 3.28 qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with written report
770 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
96020 Neurofunctional testing selection and 505 755 1260 0 0.00 administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or other qualified health care professional (ie, psychologist), with review of test results and report
96020-26 505 755 1260 166 4.60
96020-TC 0 0 0 0 0.00
MEDICAL GENETICS AND GENETIC COUNSELING SERVICES
96040 Medical genetics and genetic counseling 151 226 377 48 1.34 services, each 30 minutes face-to-face with patient/family
CENTRAL NERVOUS SYSTEM ASSESSMENTS/TESTS (EG, NEURO-COGNITIVE, MENTAL STATUS, SPEECH TESTING)
96101 Psychological testing (includes 162 242 404 84 2.33 psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI, Rorschach, wais), per hour of the psychologist's or physician's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
96102 Psychological testing (includes 162 242 403 63 1.74 psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI and wais), with qualified health care professional interpretation and report, administered by technician, per hour of technician time, face-to-face
96103 Psychological testing (includes 104 156 260 28 0.78 psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI), administered by a computer, with qualified health care professional interpretation and report
96105 Assessment of aphasia (includes assessment of 253 378 631 111 3.07 expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by Boston diagnostic aphasia examination) with interpretation and report, per hour
96110 Developmental screening (eg, developmental 30 45 75 10 0.29 milestone survey, speech and language delay
CPT copyright 2017 American Medical Association. 771 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
screen), with scoring and documentation, per standardized instrument
96111 Developmental testing, (includes assessment of 268 400 668 138 3.83 motor, language, social, adaptive, and/or cognitive functioning by standardized developmental instruments) with interpretation and report
96116 Neurobehavioral status exam (clinical 198 297 495 95 2.65 assessment of thinking, reasoning and judgment, eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities), per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpreting test results and preparing the report
96118 Neuropsychological testing (eg, Halstead- 219 327 546 99 2.74 Reitan neuropsychological battery, wechsler memory scales and Wisconsin card sorting test), per hour of the psychologist's or physician's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
96119 Neuropsychological testing (eg, Halstead- 191 285 476 81 2.25 Reitan neuropsychological battery, wechsler memory scales and Wisconsin card sorting test), with qualified health care professional interpretation and report, administered by technician, per hour of technician time, face-to- face
96120 Neuropsychological testing (eg, Wisconsin 151 226 377 49 1.35 card sorting test), administered by a computer, with qualified health care professional interpretation and report
96125 Standardized cognitive performance testing 157 235 392 121 3.36 (eg, Ross information processing assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report
96127 Brief emotional/behavioral assessment (eg, 20 30 50 6 0.18 depression inventory, attention- deficit/hyperactivity disorder [Adhd] scale), with scoring and documentation, per standardized instrument
772 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
HEALTH AND BEHAVIOR ASSESSMENT/INTERVENTION
96150 Health and behavior assessment (eg, health- 52 77 129 23 0.63 focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment
96151 Health and behavior assessment (eg, health- 35 53 88 22 0.61 focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; re- assessment
96152 Health and behavior intervention, each 15 35 53 88 21 0.58 minutes, face-to-face; individual
96153 Health and behavior intervention, each 15 13 19 31 5 0.13 minutes, face-to-face; group (2 or more patients)
96154 Health and behavior intervention, each 15 45 68 113 20 0.56 minutes, face-to-face; family (with the patient present)
96155 Health and behavior intervention, each 15 45 68 113 23 0.64 minutes, face-to-face; family (without the patient present)
96160 Administration of patient-focused health risk 30 45 75 4 0.11 assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument
96161 Administration of caregiver-focused health risk 20 30 50 4 0.11 assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument HYDRATION, THERAPEUTIC, PROPHYLACTIC, DIAGNOSTIC INJECTIONS AND INFUSIONS, AND CHEMOTHERAPY AND OTHER HIGHLY COMPLEX DRUG OR HIGHLY COMPLEX BIOLOGIC ADMINISTRATION 96360 Intravenous infusion, hydration; initial, 31 151 207 255 48 1.32 minutes to 1 hour
96361 Intravenous infusion, hydration; each 51 70 86 14 0.39 additional hour (list separately in addition to code for primary procedure)
CPT copyright 2017 American Medical Association. 773 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
96365 Intravenous infusion, for therapy, prophylaxis, 181 249 306 74 2.06 or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, 75 103 127 22 0.62 or diagnosis (specify substance or drug); each
additional hour (list separately in addition to code for primary procedure)
96367 Intravenous infusion, for therapy, prophylaxis, 115 158 194 32 0.89 or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (list separately in addition to code for primary procedure)
96368 Intravenous infusion, for therapy, prophylaxis, 76 105 129 21 0.59 or diagnosis (specify substance or drug); concurrent infusion (list separately in addition to code for primary procedure)
96369 Subcutaneous infusion for therapy or 301 415 510 177 4.91 prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)
96370 Subcutaneous infusion for therapy or 47 65 80 16 0.44 prophylaxis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)
96371 Subcutaneous infusion for therapy or 187 257 316 65 1.80 prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (list separately in addition to code for primary procedure)
96372 Therapeutic, prophylactic, or diagnostic 42 58 71 21 0.58 injection (specify substance or drug); subcutaneous or intramuscular
96373 Therapeutic, prophylactic, or diagnostic 45 62 76 19 0.54 injection (specify substance or drug); intra- arterial
96374 Therapeutic, prophylactic, or diagnostic 125 172 211 47 1.31 injection (specify substance or drug); intravenous push, single or initial substance/drug
96375 Therapeutic, prophylactic, or diagnostic 69 95 117 18 0.51 injection (specify substance or drug); each additional sequential intravenous push of a new
774 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
substance/drug (list separately in addition to code for primary procedure)
96376 Therapeutic, prophylactic, or diagnostic 87 120 147 0 0.00 injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (list separately in addition to code for primary procedure)
96377 Application of on-body injector (includes 73 101 123 21 0.58 cannula insertion) for timed subcutaneous injection
96379 Unlisted therapeutic, prophylactic, or 0 0 0 0 0.00 diagnostic intravenous or intra-arterial injection or infusion
96401 Chemotherapy admin, subcutaneous or 151 208 256 82 2.27 intramuscular; non-hormonal anti-neoplastic
96402 Chemotherapy admin, subcutaneous or 100 138 169 31 0.87 intramuscular; hormonal anti-neoplastic
96405 Chemotherapy admin; intralesional, up to and 199 274 337 82 2.29 including 7 lesions
96406 Chemotherapy admin; intralesional, more than 255 351 431 121 3.36 7 lesions
96409 Chemotherapy admin; intravenous, push 347 478 587 112 3.10 technique, single or initial substance/drug
96411 Chemotherapy admin; intravenous, push 211 290 357 60 1.66 technique, each additional substance/drug (list separately in addition to code for primary procedure)
96413 Chemotherapy admin, intravenous infusion 427 587 721 145 4.02 technique; up to 1 hour, single or initial substance/drug
96415 Chemotherapy admin, intravenous infusion 113 156 192 32 0.88 technique; each additional hour (list separately in addition to code for primary procedure)
96416 Chemotherapy admin, intravenous infusion 422 581 714 147 4.09 technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump
96417 Chemotherapy admin, intravenous infusion 232 319 392 69 1.93 technique; each additional sequential infusion (different substance/drug), up to 1 hour (list
CPT copyright 2017 American Medical Association. 775 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
separately in addition to code for primary procedure)
96420 Chemotherapy admin, intra-arterial; push 351 483 594 108 3.00 technique
96422 Chemotherapy admin, intra-arterial; infusion 409 563 691 189 5.24 technique, up to 1 hour
96423 Chemotherapy admin, intra-arterial; infusion 208 286 352 86 2.38 technique, each additional hour (list separately in addition to code for primary procedure)
96425 Chemotherapy admin, intra-arterial; infusion 489 673 827 197 5.48 technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump
96440 Chemotherapy administration into pleural 2152 2963 3640 804 22.33 cavity, requiring and including thoracentesis
96446 Chemotherapy administration into the 653 899 1104 212 5.89 peritoneal cavity via indwelling port or catheter
96450 Chemotherapy admin, into cns (eg, intrathecal), 690 950 1168 187 5.19 requiring and including spinal puncture
96521 Refilling and maintenance of portable pump 642 884 1086 150 4.17
96522 Refilling and maintenance of implantable pump 261 359 441 122 3.38 or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)
96523 Irrigation of implanted venous access device 75 103 127 28 0.79 for drug delivery systems
96542 Chemotherapy injection, subarachnoid or 402 553 680 136 3.79 intraventricular via subcutaneous reservoir, single or multiple agents
96549 Unlisted chemotherapy procedure 0 0 0 0 0.00
PHOTODYNAMIC THERAPY
96567 Photodynamic therapy by external application 245 337 414 117 3.24 of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day
96570 Photodynamic therapy by endoscopic 143 196 241 53 1.48 application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (list separately in addition to code for
776 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)
96571 Photodynamic therapy by endoscopic 74 101 124 30 0.84 application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)
96573 Photodynamic therapy by external application 518 713 875 193 5.37 of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day
96574 Debridement of premalignant hyperkeratotic 667 918 1128 249 6.92 lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/ activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day
SPECIAL DERMATOLOGICAL PROCEDURES
96900 Actinotherapy (ultraviolet light) 46 62 83 21 0.59
96902 Microscopic examination of hairs plucked or 52 69 93 22 0.61 clipped by the examiner (excluding hair collected by the patient) to determine telogen and anagen counts, or structural hair shaft abnormality
96904 Whole body integumentary photography, for 155 207 277 64 1.77 monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma
96910 Photochemotherapy; tar and ultraviolet b 127 169 226 116 3.21 (Goeckerman treatment) or petrolatum and ultraviolet b
96912 Photochemotherapy; psoralens and ultraviolet a 127 170 227 98 2.71 (PUVA)
96913 Photochemotherapy (Goeckerman and/or 265 353 472 136 3.78 PUVA) for severe photoresponsive dermatoses requiring at least 4-8 hours of care under direct
CPT copyright 2017 American Medical Association. 777 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
supervision of the physician (includes application of medication and dressings)
96920 Laser treatment for inflammatory skin disease 308 411 550 168 4.67 (psoriasis); total area less than 250 sq cm
96921 Laser treatment for inflammatory skin disease 357 476 637 184 5.12 (psoriasis); 250 sq cm to 500 sq cm
96922 Laser treatment for inflammatory skin disease 480 640 856 251 6.97 (psoriasis); over 500 sq cm
96931 Reflectance confocal microscopy (ram) for 327 435 583 172 4.78 cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, first lesion
96932 Reflectance confocal microscopy (ram) for 211 282 377 125 3.47 cellular and sub-cellular imaging of skin; image acquisition only, first lesion
96933 Reflectance confocal microscopy (ram) for 81 108 145 42 1.16 cellular and sub-cellular imaging of skin; interpretation and report only, first lesion
96934 Reflectance confocal microscopy (ram) for 147 196 262 76 2.10 cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, each additional lesion (list separately in addition to code for primary procedure)
96935 Reflectance confocal microscopy (ram) for 69 92 124 36 0.99 cellular and sub-cellular imaging of skin; image acquisition only, each additional lesion (list separately in addition to code for primary procedure)
96936 Reflectance confocal microscopy (ram) for 78 104 139 40 1.11 cellular and sub-cellular imaging of skin; interpretation and report only, each additional lesion (list separately in addition to code for primary procedure)
96999 Unlisted special dermatological service or 0 0 0 0 0.00 procedure
PHYSICAL MEDICINE AND REHABILITATION
97010 Application of a modality to 1 or more areas; 27 36 47 6 0.18 hot or cold packs
97012 Application of a modality to 1 or more areas; 30 40 53 15 0.42 traction, mechanical
778 CPT copyright 2017 American Medical Association. MEDICINE
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
97014 Application of a modality to 1 or more areas; 34 45 60 16 0.44 electrical stimulation (unattended)
97016 Application of a modality to 1 or more areas; 39 52 69 16 0.45 vasopneumatic devices
97018 Application of a modality to 1 or more areas; 35 46 61 9 0.25 paraffin bath
97022 Application of a modality to 1 or more areas; 42 55 74 19 0.54 whirlpool
97024 Application of a modality to 1 or more areas; 29 38 51 7 0.20 diathermy (eg, microwave)
97026 Application of a modality to 1 or more areas; 31 41 54 6 0.18 infrared
97028 Application of a modality to 1 or more areas; 30 40 53 8 0.23 ultraviolet
97032 Application of a modality to 1 or more areas; 35 46 61 16 0.44 electrical stimulation (manual), each 15 minutes
97033 Application of a modality to 1 or more areas; 50 66 88 21 0.59 iontophoresis, each 15 minutes
97034 Application of a modality to 1 or more areas; 35 46 61 15 0.43 contrast baths, each 15 minutes
97035 Application of a modality to 1 or more areas; 33 43 58 14 0.38 ultrasound, each 15 minutes
97036 Application of a modality to 1 or more areas; 41 54 72 36 1.01 Hubbard tank, each 15 minutes
97039 Unlisted modality (specify type and time if 0 0 0 0 0.00 constant attendance)
97110 Therapeutic procedure, 1 or more areas, each 56 70 92 31 0.87 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility
97112 Therapeutic procedure, 1 or more areas, each 58 73 95 36 0.99 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities
97113 Therapeutic procedure, 1 or more areas, each 61 76 100 40 1.11 15 minutes; aquatic therapy with therapeutic exercises
CPT copyright 2017 American Medical Association. 779 MEDICAL FEES 2018
CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
97116 Therapeutic procedure, 1 or more areas, each 50 63 82 31 0.86 15 minutes; gait training (includes stair climbing)
97124 Therapeutic procedure, 1 or more areas, each 35 44 58 31 0.87 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)
97127 Therapeutic interventions that focus on 0 0 0 0 0.00 cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing and sequencing tasks), direct (one-on-one) patient contact
97139 Unlisted therapeutic procedure (specify) 0 0 0 0 0.00
97140 Manual therapy techniques (eg, mobilization/ 55 69 90 28 0.79 manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes
97150 Therapeutic procedure(s), group (2 or more 38 48 62 19 0.52 individuals)
97161 Physical therapy evaluation: low complexity, 150 188 247 86 2.38 requiring these components: a history with no personal factors and/or comorbidities that impact the plan of care; an examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; a clinical presentation with stable and/or uncomplicated characteristics; and clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. typically, 20 minutes are spent face-to-face with the patient and/or family.
97162 Physical therapy evaluation: moderate 150 188 247 86 2.38 complexity, requiring these components: a history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
participation restrictions; an evolving clinical presentation with changing characteristics; and clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. typically, 30minutes are spent face-to-face with the patient and/or family.
97163 Physical therapy evaluation: high complexity, 180 226 296 86 2.38 requiring these components: a history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; a clinical presentation with unstable and unpredictable characteristics; and clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. typically, 45 minutes are spent face-to-face with the patient and/or family.
97164 Re-evaluation of physical therapy established 85 107 140 58 1.61 plan of care, requiring these components: an examination including a review of history and use of standardized tests and measures is required; and revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome typically, 20 minutes are spent face- to-face with the patient and/or family.
97165 Occupational therapy evaluation, low 158 198 260 93 2.57 complexity, requiring these components: an occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; an assessment(s) that identifies 1-3 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and clinical decision making of low complexity, which includes an analysis of the occupational profile, analysis of data from problem-focused assessment(s), and consideration of a limited number of treatment options. patient presents with no comorbidities that affect occupational performance. modification of tasks or
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
assistance (eg, physical or verbal) with assessment(s) is not necessary to enable completion of evaluation component. typically, 30 minutes are spent face-to-face with the patient and/or family.
97166 Occupational therapy evaluation, moderate 160 201 263 93 2.57 complexity, requiring these components: an occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current functional performance; an assessment(s) that identifies 3- 5 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and clinical decision making of moderate analytic complexity, which includes an analysis of the occupational profile, analysis of data from detailed assessment(s), and consideration of several treatment options. patient may present with comorbidities that affect occupational performance. minimal to moderate modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. typically, 45 minutes are spent fac
97167 Occupational therapy evaluation, high 200 251 329 93 2.57 complexity, requiring these components: an occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional performance; an assessment(s) that identifies 5 or more performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and clinical decision making of high analytic complexity, which includes an analysis of the patient profile, analysis of data from comprehensive assessment(s), and consideration of multiple treatment options. patient presents with comorbidities that affect occupational performance. significant modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. typically, 60 minutes are spent face-to-face with
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
97168 Re-evaluation of occupational therapy 100 125 164 63 1.75 established plan of care, requiring these components: an assessment of changes in patient functional or medical status with revised plan of care; an update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals; and a revised plan of care. a formal reevaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required. typically, 30 minutes are spent face-to-face with the patient and/or family.
97169 Athletic training evaluation, low complexity, 75 94 123 0 0.00 requiring these components: a history and physical activity profile with no comorbidities that affect physical activity; an examination of affected body area and other symptomatic or related systems addressing 1-2 elements from any of the following: body structures, physical activity, and/or participation deficiencies; and clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. typically, 15 minutes are spent face-to-face with the patient and/or family.
97170 Athletic training evaluation, moderate 175 219 288 0 0.00 complexity, requiring these components: a medical history and physical activity profile with 1-2 comorbidities that affect physical activity; an examination of affected body area and other symptomatic or related systems addressing a total of 3 or more elements from any of the following: body structures, physical activity, and/or participation deficiencies; and clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. typically, 30 minutes are spent face-to-face with the patient and/or family.
97171 Athletic training evaluation, high complexity, 0 0 0 0 0.00 requiring these components: a medical history and physical activity profile, with 3 or more comorbidities that affect physical activity; a comprehensive examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures, physical
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activity, and/or participation deficiencies; clinical presentation with unstable and unpredictable characteristics; and clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. typically, 45 minutes are spent face- to-face with the patient and/or family.
97172 Re-evaluation of athletic training established 125 157 206 0 0.00 plan of care requiring these components: an assessment of patient's current functional status when there is a documented change; and a revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome with an update in management options, goals, and interventions. typically, 20 minutes are spent face-to-face with the patient and/or family.
97530 Therapeutic activities, direct (one-on-one) 56 70 92 41 1.15 patient contact (use of dynamic activities to improve functional performance), each 15 minutes
97533 Sensory integrative techniques to enhance 52 65 85 35 0.97 sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes
97535 Self-care/home management training (eg, 49 62 81 35 0.98 activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes
97537 Community/work reintegration training (eg, 61 77 101 34 0.94 shopping, transportation, money management, avocational activities and/or work environment/ modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes
97542 Wheelchair management (eg, assessment, 38 48 63 34 0.95 fitting, training), each 15 minutes
97545 Work hardening/conditioning; initial 2 hours 313 393 515 0 0.00
97546 Work hardening/conditioning; each additional 137 171 224 0 0.00 hour (list separately in addition to code for primary procedure)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
97597 Debridement (eg, high pressure waterjet 124 155 203 85 2.37 with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less
97598 Debridement (eg, high pressure waterjet 66 83 109 28 0.79 with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)
97602 Removal of devitalized tissue from wound(s), 75 94 123 0 0.00 non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session
97605 Negative pressure wound therapy (eg, vacuum 92 116 152 45 1.25 assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters
97606 Negative pressure wound therapy (eg, vacuum 117 147 192 53 1.48 assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters
97607 Negative pressure wound therapy, (eg, vacuum 131 164 215 0 0.00 assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s)
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
surface area less than or equal to 50 square centimeters
97608 Negative pressure wound therapy, (eg, vacuum 158 197 259 0 0.00 assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters
97610 Low frequency, non-contact, non-thermal 150 188 247 136 3.79 ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day
97750 Physical performance test or measurement (eg, 62 78 102 39 1.07 musculoskeletal, functional capacity), with written report, each 15 minutes
97755 Assistive technology assessment (eg, to restore, 41 52 68 40 1.11 augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes
97760 Orthotic(s) management and training 65 81 107 48 1.33 (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes
97761 Prosthetic(s) training, upper and/or lower 49 62 81 41 1.15 extremity(ies), initial prosthetic(s) encounter, each 15 minutes
97763 Orthotic(s)/prosthetic(s) management and/or 83 105 137 49 1.37 training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes
97799 Unlisted physical medicine/rehabilitation 0 0 0 0 0.00 service or procedure
MEDICAL NUTRITION THERAPY
97802 Medical nutrition therapy; initial assessment 56 70 92 35 0.98 and intervention, individual, face-to-face with the patient, each 15 minutes
97803 Medical nutrition therapy; re-assessment and 50 63 83 31 0.85 intervention, individual, face-to-face with the patient, each 15 minutes
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
97804 Medical nutrition therapy; group (2 or more 40 51 66 16 0.45 individual(s)), each 30 minutes
ACUPUNCTURE
97810 Acupuncture, 1 or more needles; without 75 94 124 37 1.03 electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient
97811 Acupuncture, 1 or more needles; without 61 77 101 28 0.78 electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (list separately in addition to code for primary procedure)
97813 Acupuncture, 1 or more needles; with electrical 82 103 135 40 1.10 stimulation, initial 15 minutes of personal one- on-one contact with the patient
97814 Acupuncture, 1 or more needles; with electrical 65 81 107 32 0.88 stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (list separately in addition to code for primary procedure)
OSTEOPATHIC MANIPULATIVE TREATMENT
98925 Osteopathic manipulative treatment (OMT); 1- 90 112 147 32 0.90 2 body regions involved
98926 Osteopathic manipulative treatment (OMT); 3- 89 111 146 47 1.30 4 body regions involved
98927 Osteopathic manipulative treatment (OMT); 5- 110 138 181 61 1.70 6 body regions involved
98928 Osteopathic manipulative treatment (OMT); 7- 125 157 206 74 2.06 8 body regions involved
98929 Osteopathic manipulative treatment (OMT); 9- 166 208 273 89 2.46 10 body regions involved
CHIROPRACTIC MANIPULATIVE TREATMENT
98940 Chiropractic manipulative treatment (CMT); 49 61 80 29 0.81 spinal, 1-2 regions
98941 Chiropractic manipulative treatment (CMT); 55 69 91 42 1.16 spinal, 3-4 regions
98942 Chiropractic manipulative treatment (CMT); 65 82 107 54 1.51 spinal, 5 regions
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
98943 Chiropractic manipulative treatment (CMT); 45 56 74 28 0.78 extraspinal, 1 or more regions
EDUCATION AND TRAINING FOR PATIENT SELF-MANAGEMENT
98960 Education and training for patient self- 32 40 53 28 0.79 management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient
98961 Education and training for patient self- 40 50 65 14 0.39 management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients
98962 Education and training for patient self- 11 14 18 10 0.28 management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients
NON-FACE-TO-FACE NON-PHYSICIAN SERVICES
98966 Telephone assessment and management service 24 30 40 14 0.40 provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
98967 Telephone assessment and management service 43 54 71 27 0.76 provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
98968 Telephone assessment and management service 75 94 123 40 1.12 provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion
98969 Online assessment and management service 45 57 74 0 0.00 provided by a qualified nonphysician health care professional to an established patient or guardian, not originating from a related assessment and management service provided within the previous 7 days, using the internet or similar electronic communications network
SPECIAL SERVICES, PROCEDURES AND REPORTS
99000 Handling and/or conveyance of specimen for 17 26 35 0 0.00 transfer from the office to a laboratory
99001 Handling and/or conveyance of specimen for 31 47 64 0 0.00 transfer from the patient in other than an office to a laboratory (distance may be indicated)
99002 Handling, conveyance, and/or any other service 14 21 29 0 0.00 in connection with the implementation of an order involving devices (eg, designing, fitting, packaging, handling, delivery or mailing) when devices such as orthotics, protectives, prosthetics are fabricated by an outside laboratory or shop but which items have been designed, and are to be fitted and adjusted by the attending physician or other qualified health care professional
99024 Postoperative follow-up visit, normally 60 89 122 0 0.00 included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure
99026 Hospital mandated on call service; in-hospital, 0 0 0 0 0.00 each hour
99027 Hospital mandated on call service; out-of- 0 0 0 0 0.00 hospital, each hour
99050 Services provided in the office at times other 50 74 102 0 0.00 than regularly scheduled office hours, or days when the office is normally closed (eg, holidays, Saturday or Sunday), in addition to basic service
99051 Service(s) provided in the office during 45 67 92 0 0.00 regularly scheduled evening, weekend, or
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holiday office hours, in addition to basic service
99053 Service(s) provided between 10:00 pm and 50 74 102 0 0.00 8:00 am at 24-hour facility, in addition to basic service
99056 Service(s) typically provided in the office, 28 41 57 0 0.00 provided out of the office at request of patient, in addition to basic service
99058 Service(s) provided on an emergency basis in 75 111 153 0 0.00 the office, which disrupts other scheduled office services, in addition to basic service
99060 Service(s) provided on an emergency basis, out 111 164 226 0 0.00 of the office, which disrupts other scheduled office services, in addition to basic service
99070 Supplies and materials (except spectacles), 25 37 51 0 0.00 provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)
99071 Educational supplies, such as books, tapes, and 0 0 0 0 0.00 pamphlets, for the patient's education at cost to physician or other qualified health care professional
99075 Medical testimony 132 196 269 0 0.00
99078 Physician or other qualified health care 61 90 124 0 0.00 professional qualified by education, training, licensure/regulation (when applicable) educational services rendered to patients in a group setting (eg, prenatal, obesity, or diabetic instructions)
99080 Special reports such as insurance forms, more 25 37 51 0 0.00 than the information conveyed in the usual medical communications or standard reporting form
99082 Unusual travel (eg, transportation and escort of 60 88 121 0 0.00 patient)
99090 Analysis of clinical data stored in computers 30 44 61 0 0.00 (eg, ECGs, bps, hematologic data)
99091 Collection and interpretation of physiologic 60 89 122 59 1.63 data (eg, ECG, bp, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or
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other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time
QUALIFYING CIRCUMSTANCES FOR ANESTHESIA
99100 Anesthesia for patient of extreme age, younger 125 185 255 0 0.00 than 1 year and older than 70 (list separately in addition to code for primary anesthesia procedure)
99116 Anesthesia complicated by utilization of total 525 778 1071 0 0.00 body hypothermia (list separately in addition to code for primary anesthesia procedure)
99135 Anesthesia complicated by utilization of 678 1005 1382 0 0.00 controlled hypotension (list separately in addition to code for primary anesthesia procedure)
99140 Anesthesia complicated by emergency 220 326 449 0 0.00 conditions (specify) (list separately in addition to code for primary anesthesia procedure)
MODERATE (CONSCIOUS) SEDATION
99151 Moderate sedation services provided by the 168 249 343 79 2.20 same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intraservice time, patient younger than 5 years of age
99152 Moderate sedation services provided by the 100 148 204 53 1.46 same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older
99153 Moderate sedation services provided by the 31 46 63 11 0.31 same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
physiological status; each additional 15 minutes intraservice time (list separately in addition to code for primary service)
99155 Moderate sedation services provided by a 303 449 618 99 2.74 physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger than 5 years of age
99156 Moderate sedation services provided by a 175 259 357 77 2.15 physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 years or older
99157 Moderate sedation services provided by a 144 213 294 59 1.64 physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intraservice time (list separately in addition to code for primary service)
OTHER SERVICES AND PROCEDURES
99170 Anogenital examination, magnified, in 407 570 872 162 4.49 childhood for suspected trauma, including image recording when performed
99172 Visual function screening, automated or semi- 40 56 86 0 0.00 automated bilateral quantitative determination of visual acuity, ocular alignment, color vision by pseudoisochromatic plates, and field of vision (may include all or some screening of the determination[s] for contrast sensitivity, vision under glare)
99173 Screening test of visual acuity, quantitative, 25 35 54 3 0.09 bilateral
99174 Instrument-based ocular screening (eg, 45 63 96 6 0.17 photoscreening, automated-refraction), bilateral; with remote analysis and report
99175 Ipecac or similar administration for individual 62 87 133 26 0.73 emesis and continued observation until stomach adequately emptied of poison
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
99177 Instrument-based ocular screening (eg, 43 61 93 5 0.14 photoscreening, automated-refraction), bilateral; with on-site analysis
99183 Physician or other qualified health care 362 507 775 113 3.14 professional attendance and supervision of hyperbaric oxygen therapy, per session
99184 Initiation of selective head or total body 1329 1861 2847 228 6.32 hypothermia in the critically ill neonate, includes appropriate patient selection by review of clinical, imaging and laboratory data, confirmation of esophageal temperature probe location, evaluation of amplitude eeg, supervision of controlled hypothermia, and assessment of patient tolerance of cooling
99188 Application of topical fluoride varnish by a 36 51 77 13 0.35 physician or other qualified health care professional
99190 Assembly and operation of pump with 779 1091 1668 0 0.00 oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); each hour
99191 Assembly and operation of pump with 583 816 1249 0 0.00 oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 45 minutes
99192 Assembly and operation of pump with 396 555 849 0 0.00 oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 30 minutes
99195 Phlebotomy, therapeutic (separate procedure) 203 285 435 104 2.89
99199 Unlisted special service, procedure or report 0 0 0 0 0.00
HOME HEALTH PROCEDURES/SERVICES
99500 Home visit for prenatal monitoring and 150 181 202 0 0.00 assessment to include fetal heart rate, non- stress test, uterine monitoring, and gestational diabetes monitoring
99501 Home visit for postnatal assessment and 150 181 203 0 0.00 follow-up care
99502 Home visit for newborn care and assessment 150 181 202 0 0.00
99503 Home visit for respiratory therapy care (eg, 85 103 115 0 0.00 bronchodilator, oxygen therapy, respiratory assessment, apnea evaluation)
99504 Home visit for mechanical ventilation care 13 15 17 0 0.00
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CPT DESCRIPTION UCR UCR UCR MFS MFS 50TH 75TH 90TH 2018 RVU
99505 Home visit for stoma care and maintenance 100 121 135 0 0.00 including colostomy and cystostomy
99506 Home visit for intramuscular injections 120 145 162 0 0.00
99507 Home visit for care and maintenance of 95 114 128 0 0.00 catheter(s) (eg, urinary, drainage, and enteral)
99509 Home visit for assistance with activities of 0 0 0 0 0.00 daily living and personal care
99510 Home visit for individual, family, or marriage 0 0 0 0 0.00 counseling
99511 Home visit for fecal impaction management 0 0 0 0 0.00 and enema admin
99512 Home visit for hemodialysis 0 0 0 0 0.00
99600 Unlisted home visit service or procedure 0 0 0 0 0.00
99601 Home infusion/specialty drug admin, per visit 250 301 337 0 0.00 (up to 2 hours);
99602 Home infusion/specialty drug admin, per visit 126 152 171 0 0.00 (up to 2 hours); each additional hour (list separately in addition to code for primary procedure)
MEDICATION THERAPY MANAGEMENT SERVICES
99605 Medication therapy management service(s) 64 77 86 0 0.00 provided by a pharmacist, individual, face-to- face with patient, with assessment and intervention if provided; initial 15 minutes, new patient
99606 Medication therapy management service(s) 56 67 76 0 0.00 provided by a pharmacist, individual, face-to- face with patient, with assessment and intervention if provided; initial 15 minutes, established patient
99607 Medication therapy management service(s) 46 56 62 0 0.00 provided by a pharmacist, individual, face-to- face with patient, with assessment and intervention if provided; each additional 15 minutes (list separately in addition to code for primary service)
794 CPT copyright 2017 American Medical Association.
GEOGRAPHIC ADJUSTMENT
GEOGRAPHIC VARIATION OF identical services provided in different MEDICAL FEES geographic locations.
The percentile fees presented in this book are THE GEOGRAPHIC based on national fee data; however, medical ADJUSTMENT FACTOR (GAF) fees vary substantially by geographic area. In rural areas and smaller towns and cities, In order to help you improve the accuracy of medical fees may be significantly lower than the percentile medical fees in the area where the percentiles presented in this book. you practice, we have included this appendix Likewise, in larger cities, medical fees may be of the Medicare Fee Schedule geographic cost significantly higher than the fees presented. of practice indexes (GPCI) and a weighted There are two primary reasons for the geographic adjustment factor. A geographic geographic variation in medical fees; namely, adjustment factor (GAF) is a multiplier used the cost of running a medical practice and the to determine a more accurate fee for a specific cost of medical malpractice insurance. location of medical practice. This appendix includes a list of geographic adjustment The cost of practice includes rent, employee factors for cities, counties, areas, regions and costs, and other overhead costs, but not states which can be used to "fine tune" the medical malpractice costs. According to the medical fees listed in this book. The cost of practice indexes published in the geographic adjustment factors listed below are Medicare Physicians Fee Schedule, San calculated using data from the 2016 Medicare Francisco has the highest cost of practice Physician's Fee Schedule. index (1.441) and Missouri (other than St. Louis) has the lowest cost of practice index The GAF listed below is a weighted average (0.821). Statistically, the cost of running a of the work, practice expense and malpractice medical practice in San Francisco is almost expense components of the most current 76% higher than running a medical practice in Medicare Fee Schedule. The GAF is used to Missouri based upon the cost of practice calculate the approximate variations of index. geographic location on both the UCR and Medicare fees listed in this publication. The second reason for the geographic variation in medical fees is the cost of medical STATE/LOCALITY NAME malpractice insurance. According to the malpractice expense indexes published in the The geographic region included in the Medicare Fee Schedule, Miami, Florida has geographic adjustment factor. Note that most the highest cost of medical malpractice geographic adjustment factors correspond to insurance expense (3.167) and Nebraska has entire states or specific cities. But others the lowest cost of medical malpractice correspond to specific counties, or terms such insurance expense (0.245). Statistically, as urban, metropolitan, rural, large, small, medical malpractice insurance expense is a northwest, southwest, etc. almost 1300% higher in Detroit than in South Dakota. CARRIER/LOCALITY
These differences in the cost of practice and The Medicare carrier code and locality medical malpractice insurance are reflected in assigned by CMS. The carrier code is included the wide range of fees charged by doctors for so that you can clearly identify the specific
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geographic regions represented by the for each CPT code. Then look up the geographic adjustment factors. geographic adjustment factor for your city, county, area, region or state in this appendix. The location code is included so that you can Finally, multiply the percentile fees times the clearly identify the specific geographic geographic adjustment factor to determine the regions represented by the geographic adjusted fee. adjustment factors. In order to clearly illustrate the process, let's WORK GPCI look at two medical services provided in Arkansas, Queens, NY and Mississippi. We This field defines the Medicare geographic first look up and write down the percentile cost of practice index for the work component fees for each service. Then, looking up these of the procedure or service. locations in this appendix, we find that the GAF for Arkansas is 0.912 the GAF for PE GPCI Queens, NY is 1.160 and the GAF for Mississippi is 0.897 Finally, we multiply the This field defines the Medicare geographic percentile fees times the GAF for each cost of practice index for the practice expense location to determine the adjusted fee. component of the procedure or service.
MP GPCI
This field defines the Medicare geographic cost of practice index for the malpractice expense component of the procedure or service.
WGT GAF
This field is the sum of the weighted averages of the three GPCIs for each locality. The weighting factors are from the CMS report “Review of Alternative GPCI Payment Locality Structures – Final Report,” which weights the physician work GPCI at 52 percent, the practice expense GPCI at 44 percent and the malpractice GPCI four percent. The GAF provides a quick and simple way to determine a more accurate fee for a specific geographic location of a medical practice.
HOW TO USE THE GAF TO ADJUST MEDICAL FEES
To use the geographic adjustment factor, first look up the CPT codes in the book that you want to compare to your doctor's fees or health insurance carrier allowances. Write down the 50th, 75th and 90th percentile fees
796 GEOGRAPHIC ADJUSTMENT
SAMPLE CALCULATION OF ADJUSTED FEES
Sample 1: E & M Service UCR UCR UCR Base Procedure and Locations 50TH 75TH 90TH 99205 Office visit, new patient, about (unadjusted) 373 459 589 60 minutes Arkansas (multiply by 0.912) 340 419 537 Queens, NY (multiply by 1.160) 433 532 683 Mississippi (multiply by 0.897) 335 412 528
Sample 2: Surgical Procedure UCR UCR UCR Base Procedure and Locations 50TH 75TH 90TH 33513 CABG, vein only; four (unadjusted) 6,264 8,678 13,229 coronary venous grafts Arkansas (multiply by 0.912) 5,713 7,914 12,065 Queens, NY (multiply by 1.160) 7,266 10,066 15,346 Mississippi (multiply by 0.897) 5,619 7,784 11,866
As these calculations illustrate, UCR fees in Arkansas are statistically 8.8% lower than the national average, UCR fees in Queens, NY are 16.1% higher than the national percentiles and UCR fees in Mississippi are 10.1% lower than the national percentiles. As previously explained, these variations are mostly due to the cost of practice and cost of medical malpractice insurance.
GEOGRAPHIC ADJUSTMENT FACTORS BY STATE OR LOCALITY
State/Locality Name Carrier Loc Work PE MP WGT GPCI GPCI GPCI GAF Alabama 10102 00 1.000 0.888 0.552 0.933 Alabama 10102 00 0.979 0.890 0.492 0.920 Alaska** 02102 01 1.500 1.117 0.708 1.300 Arizona 03102 00 0.980 0.971 0.834 0.970 Arkansas 07102 13 0.971 0.872 0.576 0.912 Bakersfield, CA 01112 54 1.020 1.074 0.599 1.027 Chico, CA 01112 55 1.020 1.074 0.562 1.025 El Centro, CA 01182 71 1.020 1.074 0.567 1.026 Fresno, CA 01112 56 1.020 1.074 0.562 1.025 Hanford-Corcoran, CA 01112 57 1.020 1.074 0.562 1.025 Los Angeles-Long Beach-Anaheim 01182 18 1.046 1.177 0.694 1.090 (Los Angeles County), CA Los Angeles-Long Beach-Anaheim 01182 26 1.046 1.177 0.694 1.090 (Orange County), CA
CPT copyright 2017 American Medical Association. 797 MEDICAL FEES 2018
State/Locality Name Carrier Loc Work PE MP WGT GPCI GPCI GPCI GAF Madera, CA 01112 58 1.020 1.074 0.562 1.025 Merced, CA 01112 59 1.020 1.074 0.562 1.025 Modesto, CA 01112 60 1.020 1.074 0.562 1.025 Napa, CA 01112 51 1.055 1.256 0.458 1.120 Oxnard-Thousand Oaks-Ventura, CA 01182 17 1.024 1.176 0.673 1.077 Redding, CA 01112 61 1.020 1.074 0.562 1.025 Riverside-San Bernardino-Ontario, CA 01112 62 1.020 1.074 0.689 1.031 Sacramento--Roseville--Arden-Arcade, CA 01112 63 1.025 1.086 0.562 1.033 Salinas, CA 01112 64 1.024 1.092 0.562 1.035 San Diego-Carlsbad, CA 01182 72 1.022 1.102 0.567 1.039 San Francisco-Oakland-Hayward 01112 07 1.075 1.325 0.421 1.159 (Alameda/Contra Costa County), CA San Francisco-Oakland-Hayward 01112 52 1.062 1.279 0.458 1.133 (Marin County), CA San Francisco-Oakland-Hayward 01112 05 1.075 1.325 0.421 1.159 (San Francisco County), CA San Francisco-Oakland-Hayward 01112 06 1.075 1.325 0.421 1.159 (San Mateo County), CA San Jose-Sunnyvale-Santa Clara 01112 65 1.041 1.167 0.562 1.077 (San Benito County), CA San Jose-Sunnyvale-Santa Clara 01112 09 1.083 1.354 0.388 1.174 (Santa Clara County), CA San Luis Obispo-Paso Robles-Arroyo 01182 73 1.020 1.080 0.562 1.028 Grande, CA Santa Cruz-Watsonville, CA 01112 66 1.026 1.132 0.562 1.054 Santa Maria-Santa Barbara, CA 01182 74 1.028 1.108 0.562 1.045 Santa Rosa, CA 01112 67 1.023 1.111 0.562 1.043 Stockton-Lodi, CA 01112 68 1.020 1.074 0.562 1.025 Vallejo-Fairfield, CA 01112 53 1.055 1.256 0.458 1.120 Visalia-Porterville, CA 01112 69 1.020 1.074 0.562 1.025 Yuba City, CA 01112 70 1.020 1.074 0.562 1.025 Rest of CAlifornia, CA 01112 75 1.020 1.074 0.562 1.025 Colorado 04112 01 0.996 1.018 1.042 1.008 Connecticut 13102 00 1.021 1.112 1.255 1.070 DC + MD/VA Suburbs 12202 01 1.045 1.205 1.261 1.124 Delaware 12102 01 1.007 1.019 1.119 1.017 Fort Lauderdale, FL 09102 03 0.983 1.012 1.797 1.028
798 GEOGRAPHIC ADJUSTMENT
State/Locality Name Carrier Loc Work PE MP WGT GPCI GPCI GPCI GAF Miami, FL 09102 04 0.990 1.029 2.566 1.070 Rest of Florida 09102 99 0.975 0.952 1.358 0.980 Atlanta, Ga 10202 01 0.998 0.997 1.088 1.001 Rest of Georgia 10202 99 0.980 0.899 1.073 0.948 Hawaii, Guam 01212 01 1.001 1.146 0.614 1.049 Idaho 02202 00 0.962 0.902 0.512 0.918 Chicago, IL 06102 16 1.008 1.034 1.925 1.056 East St. Louis, IL 06102 12 0.984 0.936 1.785 0.995 Suburban Chicago, IL 06102 15 1.009 1.053 1.565 1.051 Rest of Illinois 06102 99 0.982 0.919 1.208 0.963 Indiana 08102 00 0.969 0.919 0.379 0.923 Iowa 05102 00 0.969 0.907 0.423 0.920 Kansas 05202 00 0.966 0.911 0.615 0.928 Kentucky 15102 00 0.974 0.880 0.819 0.926 New Orleans, LA 07202 01 0.987 0.966 1.273 0.989 Rest of Louisiana 07202 99 0.977 0.887 1.199 0.946 Southern Maine 14112 03 0.980 1.007 0.670 0.979 Rest of Maine 14112 99 0.970 0.922 0.670 0.937 Baltimore/Surrounding Counties, MD 12302 01 1.023 1.095 1.295 1.066 Rest of Maryland 12302 99 1.009 1.033 1.082 1.022 Metropolitan Boston, MA 14212 01 1.033 1.179 1.061 1.098 Rest of Massachusetts 14212 99 1.020 1.067 1.061 1.042 Detroit, MI 08202 01 1.000 0.989 1.691 1.023 Rest of Michigan 08202 99 0.978 0.919 1.018 0.954 Minnesota 06202 00 0.998 1.011 0.362 0.978 Mississippi 07302 00 0.961 0.870 0.370 0.897 Metropolitan Kansas City, MO 05302 02 0.984 0.963 1.073 0.978 Metropolitan St. Louis, MO 05302 01 0.985 0.959 1.053 0.976 Rest of Missouri 05302 99 0.961 0.863 0.993 0.919 Montana*** 03202 01 0.965 1.000 1.631 1.007 Nebraska 05402 00 0.970 0.910 0.318 0.918 Nevada*** 01312 00 1.002 1.017 0.909 1.005 New Hampshire 14312 40 0.991 1.045 1.050 1.017 Northern NJ 12402 01 1.041 1.180 0.938 1.098
CPT copyright 2017 American Medical Association. 799 MEDICAL FEES 2018
State/Locality Name Carrier Loc Work PE MP WGT GPCI GPCI GPCI GAF Rest of New Jersey 12402 99 1.024 1.123 0.938 1.064 New Mexico 04212 05 0.982 0.921 1.247 0.966 Manhattan, NY 13202 01 1.052 1.180 1.615 1.131 NYC Suburbs/Long Island, NY 13202 02 1.041 1.205 2.149 1.157 Poughkeepsie/N NYC Suburbs, NY 13202 03 1.016 1.070 1.313 1.052 Queens, NY 13292 04 1.052 1.200 2.121 1.160 Rest of New York 13282 99 0.987 0.950 0.595 0.955 North CArolina 11502 00 0.975 0.931 0.695 0.944 North Dakota*** 03302 01 0.978 1.000 0.540 0.970 Ohio 15202 00 0.990 0.917 1.005 0.958 Oklahoma 04312 00 0.961 0.891 0.954 0.930 Portland, OR 02302 01 1.010 1.054 0.783 1.020 Rest of Oregon 02302 99 0.991 0.967 0.783 0.972 Metropolitan Philadelphia, PA 12502 01 1.022 1.074 1.379 1.059 Rest of Pennsylvania 12502 99 0.990 0.936 1.033 0.968 Puerto Rico 09202 20 0.998 1.007 0.990 1.002 Rhode Island 14412 01 1.027 1.050 0.999 1.036 South CArolina 11202 01 0.977 0.912 0.553 0.931 South Dakota*** 03402 02 0.961 1.000 0.389 0.955 Tennessee 10302 35 0.976 0.901 0.526 0.925 Austin, TX 04412 31 0.994 1.021 0.747 0.996 Beaumont, TX 04412 20 0.985 0.924 0.839 0.952 Brazoria, TX 04412 9 1.020 0.997 0.839 1.003 Dallas, TX 04412 11 1.012 1.014 0.768 1.003 Fort Worth, TX 04412 28 1.007 0.986 0.747 0.987 Galveston, TX 04412 15 1.020 1.011 0.839 1.009 Houston, TX 04412 18 1.020 1.012 0.936 1.013 Rest of Texas 04412 99 0.990 0.938 0.796 0.959 Utah 03502 09 0.980 0.927 1.165 0.964 Vermont 14512 50 0.979 1.015 0.595 0.979 Virginia 11302 00 0.992 0.986 0.908 0.986 Virgin Islands 09202 50 0.998 1.007 0.990 1.002 Seattle (King County), WA 02402 02 1.027 1.146 0.931 1.076 Rest of Washington 02402 99 0.997 1.011 0.902 0.999
800 GEOGRAPHIC ADJUSTMENT
State/Locality Name Carrier Loc Work PE MP WGT GPCI GPCI GPCI GAF West Virginia 11402 16 0.966 0.857 1.296 0.931 Wisconsin 06302 00 0.983 0.957 0.347 0.946 Wyoming*** 03602 21 0.983 1.000 0.880 0.986
2018 GPCIs reflect the second year of a two year update transition.
* The 1.0 Work GPCI floor required by Section 201 of the MACRA of 2015 expires on December 31, 2017, therefore the Work GPCIs for 2018 do not reflect a 1.0 floor.
** Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.
*** PE GPCI reflects a 1.0 floor for frontier states established by the ACA.
STATE AND COUNTY LISTING
If you are uncertain about your Carrier and Location number, use the following list to quickly find your state, locality and county.
State Location Counties Carrier Loc Alabama Statewide All Counties 10102 00 Alaska Statewide All Counties 02102 01 Arizona Statewide All Counties 03102 00 Arkansas Statewide All Counties 07102 13 California Bakersfield Kern 01112 54
Chico Butte 01112 55
El Centro Imperial 01182 71 Fresno Fresno 01112 56
Hanford-Corcoran Kings 01112 57 Los Angeles-Long Beach- Los Angeles 01182 18 Anaheim Los Angeles-Long Beach- Orange 01182 26
Anaheim
Madera Madera 01112 58 Merced Merced 01112 59
Modesto Stanislaus 01112 60
Napa Napa 01112 51 Oakland/Berkley Alameda and Contra Costa 01112 07
Oxnard-Thousand Oaks- Ventura 01182 17 Ventura Redding Shasta 01112 61
CPT copyright 2017 American Medical Association. 801 MEDICAL FEES 2018
State Location Counties Carrier Loc California Riverside-San Bernardino- San Bernardino, Riverside 01112 62 Ontario Sacramento--Roseville-- Sacramento, Placer, Yolo, 01112 63 Arden-Arcade El Dorado Salinas Monterey 01112 64 San Diego-Carlsbad San Diego 01182 72 San Francisco San Francisco 01112 05 San Francisco-Oakland- Marin 01112 52 Hayward San Jose-Sunnyvale-Santa San Benito 01112 65 Clara San Luis Obispo-Paso San Luis Obispo 01182 73 Robles-Arroyo Grande San Mateo San Mateo 01112 06 Santa Clara Santa Clara 01112 09 Santa Cruz-Watsonville Santa Cruz 01112 66 Santa Maria-Santa Barbara Santa Barbara 01182 74 Santa Rosa Sonoma 01112 67 Stockton-Lodi San Joaquin 01112 68 Vallejo-Fairfield Solano 01112 53 Visalia-Porterville Tulare 01112 69 Yuba City Sutter, Yuba 01112 70 Rest of State* All Other Counties 01112 75 Colorado Statewide All Counties 04112 01 Connecticut Statewide All Counties 13102 00 Delaware Statewide All Counties 12102 01 District of DC + Maryland/ Virginia District of Columbia; 12202 01 Columbia Suburbs Alexandria City, Arlington, Fairfax, Fairfax City, Falls Church City In Virginia; Montgomery and Prince George's In Maryland Florida Fort Lauderdale Broward, Collier, Indian 09102 03 River, Lee, Martin, Palm Beach, and St. Lucie Miami Dade and Monroe 09102 04 Rest of State All Other Counties 09102 99
802 GEOGRAPHIC ADJUSTMENT
State Location Counties Carrier Loc Georgia Atlanta Butts, Cherokee, Clayton, 10202 01 Cobb, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Henry, Newton, Paulding, Rockdale and Walton Rest of State All Other Counties 10202 99 Hawaii/Guam Statewide All Counties 01212 01 Idaho Statewide All Counties 02202 00 Illinois Chicago Cook 06102 16 East St. Louis Bond, Calhoun, Clinton, 06102 12 Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. Clair and Washington Suburban Chicago Dupage, Kane, Lake and 06102 15 Will Rest of State All Other Counties 06102 99 Indiana Statewide All Counties 08102 00 Iowa Statewide All Counties 05102 00 Kansas Statewide* All Counties 05202 00 Kentucky Statewide All Counties 15102 00 Louisiana New Orleans Jefferson, Orleans, 07202 01 Plaquemines and St. Bernard Rest of State All Other Counties 07202 99 Maine Southern Maine Cumberland and York 14112 03
Rest of State All Other Counties 14112 99 Maryland Baltimore/Surrounding Anne Arundel, Baltimore, 12302 01 Counties Baltimore City, Carroll, Harford and Howard Rest of State All Other Counties except 12302 99 Montgomery and Prince George's Massachusetts Metropolitan Boston Middlesex, Norfolk and 14212 01 Suffolk Rest of State All Other Counties 14212 99 Michigan Detroit Macomb, Oakland, 08202 01 Washtenaw and Wayne Rest of State All Other Counties 08202 99 Minnesota Statewide All Counties 06202 00
CPT copyright 2017 American Medical Association. 803 MEDICAL FEES 2018
State Location Counties Carrier Loc Mississippi Statewide All Counties 07302 00 Missouri Metropolitan Kansas City Clay, Jackson and Platte 05302 02
Metropolitan St. Louis Jefferson, St. Charles, St. 05302 01
Louis and St. Louis City
Rest of State* All Other Counties 05302 99 Rest of State* All Other Counties 05302 99 Montana Statewide All Counties 03202 01 Nebraska Statewide All Counties 05402 00 Nevada Statewide All Counties 01312 00 New Hampshire Statewide All Counties 14312 40 New Jersey Northern NJ Bergen, Essex, Hudson, 12402 01 Hunterdon, Middlesex, Morris, Passaic, Somerset, Sussex, Union and Warren Rest of State All Other Counties 12402 99 New Mexico Statewide All Counties 04212 05 New York Manhattan New York 13202 01
NYC Suburbs/Long Island Bronx, Kings, Nassau, 13202 02
Richmond, Rockland,
Suffolk and Westchester
Poughkeepsie/N NYC Columbia, Delaware, 13202 03 Suburbs Dutchess, Greene, Orange, Putnam, Sullivan and Ulster Queens Queens 13292 04 Rest of State All Other Counties 13282 99 North Carolina Statewide All Counties 11502 00 North Dakota Statewide All Counties 03302 01 Ohio Statewide All Counties 15202 00 Oklahoma Statewide All Counties 04312 00 Oregon Portland Clackamas, Multnomah 02302 01 and Washington Rest of State All Other Counties 02302 99 Pennsylvania Metropolitan Philadelphia Bucks, Chester, Delaware, 12502 01 Montgomery and Philadelphia Rest of State All Other Counties 12502 99 Puerto Rico Puerto Rico All County Equivalents 09202 20 Rhode Island Statewide All Counties 14412 01
804 GEOGRAPHIC ADJUSTMENT
State Location Counties Carrier Loc South Carolina Statewide All Counties 11202 01 South Dakota Statewide All Counties 03402 02 Tennessee Statewide All Counties 10302 35 Texas Austin Travis 04412 31
Beaumont Jefferson 04412 20
Brazoria Brazoria 04412 09 Dallas Dallas 04412 11
Fort Worth Tarrant 04412 28 Galveston Galveston 04412 15 Houston Harris 04412 18 Rest of State All Other Counties 04412 99 Utah Statewide All Counties 03502 09 Vermont Statewide All Counties 14512 50 Virgin Islands Virgin Islands All County Equivalents 09202 50 Virginia Statewide All Counties, Except 11302 00 Alexandria City, Arlington, Fairfax, Fairfax City, and Falls Church City Washington Seattle (King County) King 02402 02 Rest of State All Other Counties 02402 99 West Virginia Statewide All Counties 11402 16 Wisconsin Statewide All Counties 06302 00 Wyoming Statewide All Counties 03602 21 * Payment locality is serviced by two carriers.
CPT copyright 2017 American Medical Association. 805 MEDICAL FEES 2018
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