Chenango Memorial Hospital HCPCS MODIFIER REV SHORT DESCRIPTION CHARGE SELFPAY AVERAGE AVERAGE AVERAGE COMMERCIAL MEDICARE MEDICAID 0001A Adm Sarscov2 30Mcg/0.3Ml 1St $6,606 $4,294 $4,968 $15 0001F Heart Failure Composite 0001U Rbc Dna Hea 35 Ag 11 Bld Grp $1,474 $958 $1,476 $739 0002A Adm Sarscov2 30Mcg/0.3Ml 2Nd $1,405 $913 $1,067 $24 0002M Liver Dis 10 Assays W/Ash $2,637 $1,714 $2,022 $517 0002U Onc Clrct 3 Ur Metab Alg Plp $413 $268 $312 $26 0003A Fee Covid-19 Vac 1 Booster $419 $272 $343 0003M Liver Dis 10 Assays W/Nash $913 $593 $728 $517 0003U Onc Ovar 5 Prtn Ser Alg Scor $1,824 $1,186 $1,449 $976 0004A Fee Covid-19 Vac 1 Res $2,392 $1,555 $1,960 0004M Scoliosis Dna Alys $5,112 $3,323 $3,880 $81 0005F Osteoarthritis Composite 0005U Onco Prst8 3 Gene Ur Alg 0006M Onc Hep Gene Risk Classifier 0006U Detc Ia Meds 120+ Analytes 0007M Onc Gastro 51 Gene Nomogram 0007U Rx Test Prsmv Ur W/Def Conf 0008U Hpylori Detcj Abx Rstnc Dna 0009U Onc Brst Ca Erbb2 Amp/Nonamp 00100 Anesth Salivary Gland $17 $11 $14 00102 Anesth Repair Of Cleft Lip 00103 Anesth Blepharoplasty 00104 Anesth Electroshock $508 $331 $417 $100 0010U Nfct Ds Strn Typ Whl Gen Seq 0011A Adm Sarscov2 100Mcg/0.5Ml1St 0011M Onc Prst8 Ca Mrna 12 Gen Alg 0011U Rx Mntr Lc-Ms/Ms Oral Fluid 00120 Anesth Ear Surgery $21 $14 $17 00124 Anesth Ear Exam $142 $92 $116 $78 00126 Anesth Tympanotomy $653 $425 $535 $73 0012A Adm Sarscov2 100Mcg/0.5Ml2Nd 0012F Cap Bacterial Assess 0012M Onc Mrna 5 Gen Rsk Urthl Ca 0012U Germln Do Gene Reargmt Detcj 0013A Fee Covid-19 Vac 2 Booster 0013M Onc Mrna 5 Gen Recr Urthl Ca 0013U Onc Sld Org Neo Gene Reargmt 00140 Anesth Procedures On Eye $800 $520 $655 $35 00142 Anesth Lens Surgery $47 $31 $39 00144 Anesth Corneal Transplant $60 $39 $49 00145 Anesth Vitreoretinal Surg 00147 Anesth Iridectomy 00148 Anesth Eye Exam 0014A Fee Covid-19 Vac 2 Res 0014F Comp Preop Assess Cat Surg 0014M Liver Ds Alys 3 Bmrk Srm Alg 0014U Hem Hmtlmf Neo Gene Reargmt 0015F Melan Follow-Up Complete 0015M Adrnl Cortcl Tum Bchm Asy 25 00160 Anesth Nose/Sinus Surgery $1,327 $863 $1,087 $160 00162 Anesth Nose/Sinus Surgery 00164 Anesth Biopsy Of Nose 0016M Onc Bladder Mrna 209 Gen Alg 0016U Onc Hmtlmf Neo Rna Bcr/Abl1 00170 Anesth Procedure On Mouth $1,112 $723 $911 $117 00172 Anesth Cleft Palate Repair $900 $585 $737 $117 00174 Anesth Pharyngeal Surgery 00176 Anesth Pharyngeal Surgery 0017M Onc Dlbcl Mrna 20 Genes Alg 0017U Onc Hmtlmf Neo Jak2 Mut Dna 0018U Onc Thyr 10 Microrna Seq Alg 00190 Anesth Face/Skull Bone Surg $1,350 $878 $1,106 $175 00192 Anesth Facial Bone Surgery 0019U Onc Rna Tiss Predict Alg 00210 Anesth Cranial Surg Nos $182 $118 $149 00211 Anesth Cran Surg Hemotoma $5,032 $3,271 $4,118 00212 Anesth Skull Drainage $894 $581 $732 00214 Anesth Skull Drainage $4,227 $2,748 $3,459 00215 Anesth Skull Repair/Fract 00216 Anesth Head Vessel Surgery 00218 Anesth Special Head Surgery $4,599 $2,989 $3,768 0021A Fee Covid-19 Vac 3 Dose 1 0021U Onc Prst8 Detcj 8 Autoantb 00220 Anesth Intrcrn Nerve $541 $352 $443 00222 Anesth Head Nerve Surgery $1,134 $737 $929 0022A Fee Covid-19 Vac 3 Dose 2 0022U Trgt Gen Seq Dna&Rna 23 Gene 0023A Fee Covid-19 Vac 3 Booster 0023U Onc Aml Dna Detcj/Nondetcj 0024A Fee Covid-19 Vac 3 Res 0024U Glyca Nuc Mr Spectrsc Quan 0025U Tenofovir Liq Chrom Ur Quan 0026U Onc Thyr Dna&Mrna 112 Genes 0027U Jak2 Gene Trgt Seq Alys 0029U Rx Metab Advrs Trgt Seq Alys 00300 Anesth Head/Neck/Ptrunk $1,055 $685 $864 $107 0030U Rx Metab Warf Trgt Seq Alys 0031A Fee Covid-19 Vac 4 Dose 1 0031U Cyp1A2 Gene 00320 Anesth Neck Organ 1Yr/> $1,417 $921 $1,161 $168 00322 Anesth Biopsy Of Thyroid 00326 Anesth Larynx/Trach < 1 Yr 0032A Fee Covid-19 Vac 4 Dose 2 0032U Comt Gene 0033A Fee Covid-19 Vac 4 Booster 0033U Htr2A Htr2C Genes 0034A Fee Covid-19 Vac 4 Res 0034U 301 Tpmt Nudt15 Genes $1,169 $760 $1,117 $479 00350 Anesth Neck Vessel Surgery 00352 Anesth Neck Vessel Surgery 0035U 301 Neuro Csf Prion Prtn Qual $1,420 $923 $1,112 $556 0036U Xome Tum & Nml Spec Seq Alys 0037U 301 Trgt Gen Seq Dna 324 Genes $12,250 $7,963 $10,992 $3,594 0038U Vitamin D Srm Microsamp Quan 0039U Dna Antb 2Strand Hi Avidity 00400 Anesth Skin Ext/Per/Atrunk $831 $540 $681 $96 00402 Anesth Surgery Of Breast $2,022 $1,314 $1,657 $287 00404 Anesth Surgery Of Breast 00406 Anesth Surgery Of Breast 0040U Bcr/Abl1 Gene Major Bp Quan 00410 Anesth Correct Heart Rhythm 0041A Fee Covid-19 Vac 5 Dose 1 0041U B Brgdrferi Antb 5 Prtn Igm 0042A Fee Covid-19 Vac 5 Dose 2 0042T 350 Ct Perfusion W/Contrast Cbf $1,879 $1,221 $1,539 0042U B Brgdrferi Antb 12 Prtn Igg 0043A Fee Covid-19 Vac 5 Booster 0043U Tbrf B Grp Antb 4 Prtn Igm 0044A Fee Covid-19 Vac 5 Res 0044U Tbrf B Grp Antb 4 Prtn Igg 00450 Anesth Surgery Of Shoulder $1,600 $1,040 $1,311 $91 00454 Anesth Collar Bone Biopsy 0045U Onc Brst Dux Carc Is 12 Gene 0046U Flt3 Gene Itd Variants Quan 00470 Anesth Removal Of Rib 00472 Anesth Chest Wall Repair 00474 Anesth Surgery Of Rib 0047U Onc Prst8 Mrna 17 Gene Alg 0048U Onc Sld Org Neo Dna 468 Gene 0049U Npm1 Gene Analysis Quan 00500 Anesth Esophageal Surgery 0050U Trgt Gen Seq Dna 194 Genes 0051A Fee Covid-19 Vac 6 Dose 1 0051U Rx Mntr Lc-Ms/Ms Ur 31 Pnl 00520 Anesth Chest Procedure 00522 Anesth Chest Lining Biopsy 00524 Anesth Chest Drainage 00528 Anes Mediascpy & Dx Thorscpy 00529 Anes Medscpy&Thorscpy 1 Lung 0052A Fee Covid-19 Vac 6 Dose 2 0052U Lpoprtn Bld W/5 Maj Classes 00530 Anesth Pacemaker Insertion 00532 Anesth Vascular Access $900 $585 $737 $73 00534 Anesth Cardioverter/Defib $1,550 $1,008 $1,270 $173 00537 Anesth Cardiac Electrophys $2,333 $1,517 $1,912 $248 00539 Anesth Trach-Bronch Reconst 0053A Fee Covid-19 Vac 6 Booster 0053U Onc Prst8 Ca Fish Alys 4 Gen 00540 Anesth Chest Surgery 00541 Anesth One Lung Ventilation 00542 Anesthesia Removal Pleura 00546 Anesth Lung Chest Wall Surg 00548 Anesth Trachea Bronchi Surg 0054A Fee Covid-19 Vac 6 Res 0054T Bone Srgry Cmptr Fluor Image 0054U Rx Mntr 14+ Drugs & Sbsts 00550 Anesth Sternal Debridement 0055T Bone Srgry Cmptr Ct/Mri Imag 0055U Card Hrt Trnspl 96 Dna Seq 00560 Anesth Heart Surg W/O Pump 00561 Anesth Heart Surg <1 Yr 00562 Anesth Hrt Surg W/Pmp Age 1+ 00563 Anesth Heart Surg W/Arrest 00566 Anesth Cabg W/O Pump 00567 Anesth Cabg W/Pump 0056U Hem Aml Dna Gene Reargmt 00580 Anesth Heart/Lung Transplnt 0058T Cryopreservation Ovary Tiss 0058U Onc Merkel Cll Carc Srm Quan 0059U Onc Merkel Cll Carc Srm +/- 00600 Anesth Spine Cord Surgery $1,800 $1,170 $1,475 $233 00604 Anesth Sitting Procedure 0060U Twn Zyg Gen Seq Alys Chrms2 0061A Fee Covid-19 Vac 7 Dose 1 0061U Tc Meas 5 Bmrk Sfdi M-S Alys 00620 Anesth Spine Cord Surgery 00625 Anes Spine Tranthor W/O Vent 00626 Anes Spine Transthor W/Vent 0062A Fee Covid-19 Vac 7 Dose 2 0062U Ai Sle Igg&Igm Alys 80 Bmrk 00630 Anesth Spine Cord Surgery $1,589 $1,033 $1,302 $156 00632 Anesth Removal Of Nerves 00635 Anesth Lumbar Puncture 0063A Fee Covid-19 Vac 7 Booster 0063U Neuro Autism 32 Amines Alg 00640 Anesth Spine Manipulation 0064A Fee Covid-19 Vac 7 Res 0064U Antb Tp Total&Rpr Ia Qual 0065U Syfls Tst Nontreponemal Antb 0066U Pamg-1 Ia Cervico-Vag Fluid 00670 Anesth Spine Cord Surgery $2,125 $1,381 $1,741 $233 0067U Onc Brst Imhchem Prfl 4 Bmrk 0068U Candida Species Pnl Amp Prb 0069U Onc Clrct Microrna Mir-31-3P 00700 Anesth Abdominal Wall Surg $800 $520 $655 $18 00702 Anesth For Liver Biopsy 0070U 301 Cyp2D6 Gen Com&Slct Rar Vrnt $834 $542 $973 $695 0071A Fee Covid-19 Vac 8 Dose 1 0071T Us Leiomyomata Ablate <200 0071U 301 Cyp2D6 Full Gene Sequence $1,930 $1,255 $1,604 $309 0072A Fee Covid-19 Vac 8 Dose 2 0072T Us Leiomyomata Ablate >200 0072U 301 Cyp2D6 Gen Cyp2D6-2D7 Hybrid $2,619 $1,702 $2,198 $463 00730 Anesth Abdominal Wall Surg 00731 Anes Upr Gi Ndsc Px Nos $784 $509 $642 $94 00732 Anes Upr Gi Ndsc Px Ercp 0073A Fee Covid-19 Vac 8 Booster 0073U 301 Cyp2D6 Gen Cyp2D7-2D6 Hybrid $2,895 $1,882 $2,405 $463 0074A Fee Covid-19 Vac 8 Res 0074U 301 Cyp2D6 Nonduplicated Gene $3,308 $2,150 $2,715 $463 00750 Anesth Repair Of Hernia $1,000 $650 $819 $105 00752 Anesth Repair Of Hernia $1,267 $823 $1,038 $119 00754 Anesth Repair Of Hernia 00756 Anesth Repair Of Hernia 0075T Perq Stent/Chest Vert Art 0075T 26 Perq Stent/Chest Vert Art 0075T TC Perq Stent/Chest Vert Art 0075U 301 Cyp2D6 5' Gene Dup/Mlt $3,584 $2,330 $2,922 $463 0076T S&I Stent/Chest Vert Art 0076T 26 S&I Stent/Chest Vert Art 0076T TC S&I Stent/Chest Vert Art 0076U 301 Cyp2D6 3' Gene Dup/Mlt $3,859 $2,508 $3,129 $463 00770 Anesth Blood Vessel Repair 0077U Ig Paraprotein Qual Bld/Ur 0078U Pain Mgt Opi Use Gnotyp Pnl 00790 Anesth Surg Upper Abdomen $1,401 $910 $1,147 $160 00792 Anesth Hemorr/Excise Liver 00794 Anesth Pancreas Removal 00796 Anesth For Liver Transplant 00797 Anesth Surgery For Obesity 0079U Cmprtv Dna Alys Mlt Snps 00800 Anesth Abdominal Wall Surg $700 $455 $573 $91 00802 Anesth Fat Layer Removal $2,533 $1,647 $2,075 $342 0080U Onc Lng 5 Clin Rsk Factr Alg 00811 Anes Lwr Intst Ndsc Nos $775 $504 $635 $103 00812 Anes Lwr Intst Scr Colsc $550 $358 $451 $71 00813 Anes Upr Lwr Gi Ndsc Px $918 $597 $752 $88 0081A Fee Covid-19 Vac 9 Dose 1 00820 Anesth Abdominal Wall Surg 0082A Fee Covid-19 Vac 9 Dose 2 0082U Rx Test Def 90+ Rx/Sbsts Ur 00830 Anesth Repair Of Hernia $971 $631 $796 $99 00832 Anesth Repair Of Hernia $1,100 $715 $901 $50 00834 Anesth Hernia Repair < 1 Yr 00836 Anesth Hernia Repair Preemie 0083A Fee Covid-19 Vac 9 Booster 0083U Onc Rspse Chemo Cntrst Tomog 00840 Anesth Surg Lower Abdomen $1,198 $779 $982 $147 00842 Anesth Amniocentesis 00844 Anesth Pelvis Surgery 00846 Anesth Hysterectomy 00848 Anesth Pelvic Organ Surg 0084A Fee Covid-19 Vac 9 Res 0084U Rbc Dna Gnotyp 10 Bld Groups 00851 Anesth Tubal Ligation $1,027 $668 $841 $119 0085T Breath Test Heart Reject 00860 Anesth Surgery Of Abdomen $1,718 $1,117 $1,408 $198 00862 Anesth Kidney/Ureter Surg $2,200 $1,430 $1,802 $55 00864 Anesth Removal Of Bladder 00865 Anesth Removal Of Prostate 00866 Anesth Removal Of Adrenal 00868 Anesth Kidney Transplant 0086U Nfct Ds Bact&Fng Org Id 6+ 00870 Anesth Bladder Stone Surg 00872 Anesth Kidney Stone Destruct $1,350 $878 $1,106 $181 00873 Anesth Kidney Stone Destruct $1,100 $715 $901 $143 0087U Crd Hrt Trnspl Mrna 1283 Gen 00880 Anesth Abdomen Vessel Surg 00882 Anesth Major Vein Ligation 0088U Trnsplj Kdn Algrft Rej 1494 0089U Onc Mlnma Prame & Linc00518 00902 Anesth Anorectal Surgery $810 $526 $663 $98 00904 Anesth Perineal Surgery 00906 Anesth Removal Of Vulva 00908 Anesth Removal Of Prostate 0090U Onc Cutan Mlnma Mrna 23 Gene 00910 Anesth Bladder Surgery $703 $457 $576 $79 00912 Anesth Bladder Tumor Surg $440 $286 $360 $124 00914 Anesth Removal Of Prostate $1,000 $650 $819 $130 00916 Anesth Bleeding Control 00918 Anesth Stone Removal $567 $368 $464 $103 0091A Fee Covid-19 Vac 10 Dose 1 0091U Onc Clrct Scr Whl Bld Alg 00920 Anesth Genitalia Surgery $1,033 $672 $847 $126 00921 Anesth Vasectomy $600 $390 $492 $58 00922 Anesth Sperm Duct Surgery $1,200 $780 $983 $156 00924 Anesth Testis Exploration 00926 Anesth Removal Of Testis 00928 Anesth Removal Of Testis 0092A Fee Covid-19 Vac 10 Dose 2 0092U Onc Lng 3 Prtn Bmrk Plsm Alg 00930 Anesth Testis Suspension 00932 Anesth Amputation Of Penis 00934 Anesth Penis Nodes Removal 00936 Anesth Penis Nodes Removal 00938 Anesth Insert Penis Device 0093A Fee Covid-19 Vac 10 Booster 0093U Rx Mntr 65 Com Drugs Urine 00940 Anesth Vaginal Procedures $636 $413 $521 $69 00942 Anesth Surg On Vag/Urethral 00944 Anesth Vaginal Hysterectomy $1,479 $961 $1,211 $144 00948 Anesth Repair Of Cervix $800 $520 $655 $117 0094A Fee Covid-19 Vac 10 Res 0094U Genome Rapid Sequence Alys 00950 Anesth Vaginal Endoscopy 00952 Anesth Hysteroscope/Graph $718 $467 $588 $81 0095T Rmvl Artific Disc Addl Crvcl 0095U Inflm Ee Elisa Alys Alg 0096U Hpv Hi Risk Types Male Urine 0097U Gi Pathogen 22 Targets $1,215 $790 $995 $275 0098T Rev Artific Disc Addl 0098U Respir Pathogen 14 Targets 0099U Respir Pathogen 20 Targets 0100T Prosth Retina Receive&Gen 0100U 300 Respir Pathogen 21 Targets $1,319 $857 $1,081 0101A Fee Covid-19 Vac 11 Dose 1 0101T Extracorp Shockwv Tx Hi Enrg 0101U Hered Colon Ca Do 15 Genes 0102A Fee Covid-19 Vac 11 Dose 2 0102T Extracorp Shockwv Tx Anesth 0102U Hered Brst Ca Rltd Do 17 Gen 0103A Fee Covid-19 Vac 11 Booster 0103U Hered Ova Ca Pnl 24 Genes 0104A Fee Covid-19 Vac 11 Res 0105U Neph Ckd Mult Eclia Tum Nec 0106T Touch Quant Sensory Test 0106U Gstr Emptg 7 Timed Brth Spec 0107T Vibrate Quant Sensory Test 0107U C Diff Tox Ag Detcj Ia Stool 0108T Cool Quant Sensory Test 0108U Gi Barrett Esoph 9 Prtn Bmrk 0109T Heat Quant Sensory Test 0109U Id Aspergillus Dna 4 Species 0110T Nos Quant Sensory Test 0110U Rx Mntr 1+Oral Onc Rx&Sbsts 01112 Anesth Bone Aspirate/Bx 0111T Rbc Membranes Fatty Acids 0111U Onc Colon Ca Kras&Nras Alys 01120 Anesth Pelvis Surgery 0112U Iadi 16S&18S Rrna Genes 01130 Anesth Body Cast Procedure 0113U Onc Prst8 Pca3&Tmprss2-Erg 01140 Anesth Amputation At Pelvis 0114U Gi Barretts Esoph Vim&Ccna1 01150 Anesth Pelvic Tumor Surgery 0115U Respir Iadna 18 Viral&2 Bact 01160 Anesth Pelvis Procedure 0116U Rx Mntr Nzm Ia 35+Oral Flu 01170 Anesth Pelvis Surgery 01173 Anesth Fx Repair Pelvis 0117U Pain Mgmt 11 Endogenous Anal 0118U Trnsplj Don-Drv Cll-Fr Dna 0119U Crd Ceramides Liq Chrom Plsm 01200 Anesth Hip Joint Procedure 01202 Anesth Arthroscopy Of Hip $1,700 $1,105 $1,393 $125 0120U Onc B Cll Lymphm Mrna 58 Gen 01210 Anesth Hip Joint Surgery $1,200 $780 $983 $156 01212 Anesth Hip Disarticulation 01214 Anesth Hip Arthroplasty $1,540 $1,001 $1,262 $200 01215 Anesth Revise Hip Repair 0121U Sc Dis Vcam-1 Whole Blood 01220 Anesth Procedure On Femur 0122U Sc Dis P-Selectin Whl Blood 01230 Anesth Surgery Of Femur $1,300 $845 $1,065 $168 01232 Anesth Amputation Of Femur 01234 Anesth Radical Femur Surg 0123U Mchnl Fragility Rbc Prflg 0124U Ftl Cgen Abnor 3 Analytes 01250 Anesth Upper Leg Surgery $960 $624 $787 $127 0125U Ftl Cgen Abnor Prnt Comp 5 01260 Anesth Upper Leg Veins Surg $1,000 $650 $819 $130 0126T Chd Risk Imt Study 0126U Ftl Cgen Abnor Prnt Comp 5 Y 01270 Anesth Thigh Arteries Surg 01272 Anesth Femoral Artery Surg 01274 Anesth Femoral Embolectomy 0127U Ob Pe 3 Analytes 0128U Ob Pe 3 Analytes Y Chrmsm 0129U Hered Brst Ca Rltd Do Panel 0130U Hered Colon Ca Do Mrna Pnl 0131U Hered Brst Ca Rltd Do Pnl 13 01320 Anesth Knee Area Surgery 0132U Hered Ova Ca Rltd Do Pnl 17 0133U Hered Prst8 Ca Rltd Do 11 01340 Anesth Knee Area Procedure 0134U Hered Pan Ca Mrna Pnl 18 Gen 0135U Hered Gyn Ca Mrna Pnl 12 Gen 01360 Anesth Knee Area Surgery 0136U Atm Mrna Seq Alys 0137U Palb2 Mrna Seq Alys 01380 Anesth Knee Joint Procedure 01382 Anesth Dx Knee Arthroscopy 0138U Brca1 Brca2 Mrna Seq Alys 01390 Anesth Knee Area Procedure $600 $390 $492 $78 01392 Anesth Knee Area Surgery $1,200 $780 $983 $156 0139U Neuro Austm Meas 6 C Metablt 01400 Anesth Knee Joint Surgery $1,182 $768 $968 $113 01402 Anesth Knee Arthroplasty $1,513 $984 $1,240 $163 01404 Anesth Amputation At Knee 0140U Nfct Ds Fungi Dna 15 Trgt 0141U Nfct Ds Bact&Fng Gram Pos 01420 Anesth Knee Joint Casting 0142U Nfct Ds Bact&Fng Gram Neg 01430 Anesth Knee Veins Surgery 01432 Anesth Knee Vessel Surg 0143U Drug Assay 120+ Rx/Metablt 01440 Anesth Knee Arteries Surg 01442 Anesth Knee Artery Surg 01444 Anesth Knee Artery Repair 0144U Drug Assay 160+ Rx/Metablt 0145U Drug Assay 65+ Rx/Metablt 01462 Anesth Lower Leg Procedure $600 $390 $492 $78 01464 Anesth Ankle/Ft Arthroscopy $875 $569 $717 $57 0146U Drug Assay 80+ Rx/Metablt 01470 Anesth Lower Leg Surgery $950 $618 $778 $97 01472 Anesth Achilles Tendon Surg $1,300 $845 $1,065 $128 01474 Anesth Lower Leg Surgery $800 $520 $655 $50 0147U Drug Assay 85+ Rx/Metablt 01480 Anesth Lower Leg Bone Surg $1,088 $707 $891 $129 01482 Anesth Radical Leg Surgery 01484 Anesth Lower Leg Revision 01486 Anesth Ankle Replacement 0148U Drug Assay 100+ Rx/Metablt 01490 Anesth Lower Leg Casting 0149U Drug Assay 60+ Rx/Metablt 01500 Anesth Leg Arteries Surg 01502 Anesth Lwr Leg Embolectomy 0150U Drug Assay 120+ Rx/Metablt 0151U Nfct Bct/Vir Resp Nfctj 33 01520 Anesth Lower Leg Vein Surg $700 $455 $573 $18 01522 Anesth Lower Leg Vein Surg 0152U Nfct Ds Dna Untrgt Ngnrj Seq 0153U Onc Breast Mrna 101 Genes 0154U Fgfr3 Gene Analysis 0155U Pik3Ca Gene Analysis 0156U Copy Number Sequence Alys 0157U Apc Mrna Seq Alys 0158U Mlh1 Mrna Seq Alys 0159U Msh2 Mrna Seq Alys 0160U Msh6 Mrna Seq Alys 01610 Anesth Surgery Of Shoulder $1,400 $910 $1,147 $143 0161U Pms2 Mrna Seq Alys 01620 Anesth Shoulder Procedure $600 $390 $492 $78 01622 Anes Dx Shoulder Arthroscopy 0162U Hered Colon Ca Trgt Mrna Pnl 01630 Anesth Surgery Of Shoulder $1,325 $861 $1,085 $179 01634 Anesth Shoulder Joint Amput 01636 Anesth Forequarter Amput 01638 Anesth Shoulder Replacement 0163T Lumb Artif Diskectomy Addl 0163U Onc Clrct Scr 3 Prtn Alg 0164T Remove Lumb Artif Disc Addl 0164U Gi Ibs Ia Anti-Cdtb&Vinculin 01650 Anesth Shoulder Artery Surg 01652 Anesth Shoulder Vessel Surg 01654 Anesth Shoulder Vessel Surg 01656 Anesth Arm-Leg Vessel Surg 0165T Revise Lumb Artif Disc Addl 0165U Peanut Allg Asmt Epi 0166U Liver Ds 10 Biochem Asy Srm 01670 Anesth Shoulder Vein Surg 0167U Chornc Gonadotropin Hcg Ia 01680 Anesth Shoulder Casting 0168U Ftl Aneuploidy Dna Seq Alys 0169U Nudt15&Tpmt Gene Com Vrnt 0170U Neuro Asd Rna Next Gen Seq 01710 Anesth Elbow Area Surgery $933 $607 $765 $118 01712 Anesth Uppr Arm Tendon Surg 01714 Anesth Uppr Arm Tendon Surg 01716 Anesth Biceps Tendon Repair 0171U Trgt Gen Seq Alys Pnl Dna 23 0172U Onc Sld Tum Alys Brca1 Brca2 01730 Anesth Uppr Arm Procedure 01732 Anesth Dx Elbow Arthroscopy 0173U Psyc Gen Alys Panel 14 Genes 01740 Anesth Upper Arm Surgery 01742 Anesth Humerus Surgery 01744 Anesth Humerus Repair 0174T Cad Cxr With Interp 0174U Onc Solid Tumor 30 Prtn Trgt 01756 Anesth Radical Humerus Surg 01758 Anesth Humeral Lesion Surg 0175T Cad Cxr Remote 0175U Psyc Gen Alys Panel 15 Genes 01760 Anesth Elbow Replacement 0176U Cdtb&Vinculin Igg Antb Ia 01770 Anesth Uppr Arm Artery Surg 01772 Anesth Uppr Arm Embolectomy 0177U Onc Brst Ca Dna Pik3Ca 11 01780 Anesth Upper Arm Vein Surg 01782 Anesth Uppr Arm Vein Repair 0178U Peanut Allg Asmt Epi Clin Rx 0179U Onc Nonsm Cll Lng Ca Alys 23 0180U Abo Gnotyp Abo 7 Exons 01810 Anesth Lower Arm Surgery $695 $451 $569 $85 0181U Co Gnotyp Aqp1 Exon 1 01820 Anesth Lower Arm Procedure $567 $368 $464 $70 01829 Anesth Dx Wrist Arthroscopy 0182U Crom Gnotyp Cd55 Exons 1-10 01830 Anesth Lower Arm Surgery $885 $575 $725 $125 01832 Anesth Wrist Replacement 0183U Di Gnotyp Slc4A1 Exon 19 01840 Anesth Lwr Arm Artery Surg 01842 Anesth Lwr Arm Embolectomy 01844 Anesth Vascular Shunt Surg 0184T Exc Rectal Tumor Endoscopic 0184U Do Gnotyp Art4 Exon 2 01850 Anesth Lower Arm Vein Surg 01852 Anesth Lwr Arm Vein Repair 0185U Fut1 Gnotyp Fut1 Exon 4 01860 Anesth Lower Arm Casting 0186U Fut2 Gnotyp Fut2 Exon 2 0187U Fy Gnotyp Ackr1 Exons 1-2 0188U Ge Gnotyp Gypc Exons 1-4 0189U Gypa Gnotyp Ntrns 1 5 Exon 2 0190U Gypb Gnotyp Ntrns 1 5 Seux 3 01916 Anesth Dx Arteriography $950 $618 $778 $77 0191T Insert Ant Segment Drain Int 0191U In Gnotyp Cd44 Exons 2 3 6 01920 Anesth Catheterize Heart 01922 Anesth Cat Or Mri Scan 01924 Anes Ther Interven Rad Artrl $1,000 $650 $819 $60 01925 Anes Ther Interven Rad Card 01926 Anes Tx Interv Rad Hrt/Cran 0192U Jk Gnotyp Slc14A1 Exon 9 01930 Anes Ther Interven Rad Vein $988 $642 $809 $113 01931 Anes Ther Interven Rad Tips 01932 Anes Tx Interv Rad Th Vein 01933 Anes Tx Interv Rad Cran Vein 01935 Anesth Perc Img Dx Sp Proc $800 $520 $655 $104 01936 Anesth Perc Img Tx Sp Proc $876 $570 $718 $109 0193U Jr Gnotyp Abcg2 Exons 2-26 0194U Kel Gnotyp Kel Exon 8 01951 Anesth Burn Less 4 Percent 01952 Anesth Burn 4-9 Percent 01953 Anesth Burn Each 9 Percent 01958 Anesth Antepartum Manipul 0195U Klf1 Targeted Sequencing 01960 Anesth Vaginal Delivery 01961 Anesth Cs Delivery $1,050 $683 $860 $249 01962 Anesth Emer Hysterectomy 01963 Anesth Cs Hysterectomy 01965 Anesth Inc/Missed Ab Proc $683 $444 $560 $82 01966 Anesth Induced Ab Procedure 01967 Anesth/Analg Vag Delivery $4,750 $3,088 $3,892 $337 01968 Anes/Analg Cs Deliver Add-On 01969 Anesth/Analg Cs Hyst Add-On 0196U Lu Gnotyp Bcam Exon 3 0197U Lw Gnotyp Icam4 Exon 1 0198T Ocular Blood Flow Measure 0198U Rhd&Rhce Gntyp Rhd1-10&Rhce5 01990 Support For Organ Donor $2,600 $1,690 $2,130 $145 01991 Anesth Nerve Block/Inj 01992 Anesth N Block/Inj Prone $700 $455 $573 $56 01996 Hosp Manage Cont Drug Admin 01999 Unlisted Anesth Procedure 0199U Sc Gnotyp Ermap Exons 4 12 0200T Perq Sacral Augmt Unilat Inj 0200U Xk Gnotyp Xk Exons 1-3 0201T Perq Sacral Augmt Bilat Inj 0201U Yt Gnotyp Ache Exon 2 0202T Post Vert Arthrplst 1 Lumbar 0202U Nfct Ds 22 Trgt Sars-Cov-2 0203U Ai Ibd Mrna Xprsn Prfl 17 0204U Onc Thyr Mrna Xprsn Alys 593 0205U Oph Amd Alys 3 Gene Variants 0206U Neuro Alzheimer Cell Aggregj 0207T Clear Eyelid Gland W/Heat 0207U Neuro Alzheimer Quan Imaging 0208T Audiometry Air Only 0208U Onc Mtc Mrna Xprsn Alys 108 0209T Audiometry Air & Bone 0209U Cytog Const Alys Interrog 0210T Speech Audiometry Threshold 0210U Syphilis Tst Antb Ia Quan 0211T Speech Audiom Thresh & Recog 0211U Onc Pan-Tum Dna&Rna Gnrj Seq 0212T Compre Audiometry Evaluation 0212U Rare Ds Gen Dna Alys Proband 0213T Njx Paravert W/Us Cer/Thor 0213U Rare Ds Gen Dna Alys Ea Comp 0214T Njx Paravert W/Us Cer/Thor 0214U Rare Ds Xom Dna Alys Proband 0215T Njx Paravert W/Us Cer/Thor 0215U Rare Ds Xom Dna Alys Ea Comp 0216T Njx Paravert W/Us Lumb/Sac 0216U Neuro Inh Ataxia Dna 12 Com 0217T Njx Paravert W/Us Lumb/Sac 0217U Neuro Inh Ataxia Dna 51 Gene 0218T Njx Paravert W/Us Lumb/Sac 0218U Neuro Musc Dys Dmd Seq Alys 0219T Plmt Post Facet Implt Cerv 0219U Nfct Agt Hiv Gnrj Seq Alys 0220T Plmt Post Facet Implt Thor 0220U Onc Brst Ca Ai Assmt 12 Feat 0221T Plmt Post Facet Implt Lumb 0221U Abo Gnotyp Next Gnrj Seq Abo 0222T Plmt Post Facet Implt Addl 0222U Rhd&Rhce Gntyp Next Gnrj Seq 0223U Nfct Ds 22 Trgt Sars-Cov-2 0224U Antibody Sars-Cov-2 Titer(S) 0225U Nfct Ds Dna&Rna 21 Sarscov2 0226U Svnt Sarscov2 Elisa Plsm Srm 0227U Rx Asy Prsmv 30+Rx/Metablt 0228T Njx Tfrml Eprl W/Us Cer/Thor 0228U Onc Prst8 Ma Molec Prfl Alg 0229T Njx Tfrml Eprl W/Us Cer/Thor 0229U Bcat1 Promoter Mthyltn Alys 0230T Njx Tfrml Eprl W/Us Lumb/Sac 0230U Ar Full Sequence Analysis 0231T Njx Tfrml Eprl W/Us Lumb/Sac 0231U Cacna1A Full Gene Analysis 0232T Njx Platelet Plasma 0232U Cstb Full Gene Analysis 0233U Fxn Gene Analysis 0234T Trluml Perip Athrc Renal Art 0234U Mecp2 Full Gene Analysis 0235T Trluml Perip Athrc Visceral 0235U Pten Full Gene Analysis 0236T Trluml Perip Athrc Abd Aorta 0236U Smn1&Smn2 Full Gene Analysis 0237T Trluml Perip Athrc Brchiocph 0237U Car Ion Chnlpthy Gen Seq Pnl 0238T Trluml Perip Athrc Iliac Art 0238U Onc Lnch Syn Gen Dna Seq Aly 0239U Trgt Gen Seq Alys Pnl 311+ 0240U Nfct Ds Vir Resp Rna 3 Trgt 0241U Nfct Ds Vir Resp Rna 4 Trgt 0253T Insert Aqueous Drain Device 0263T Im B1 Mrw Cel Ther Cmpl 0264T Im B1 Mrw Cel Ther Xcl Hrvst 0265T Im B1 Mrw Cel Ther Hrvst Onl 0266T Implt/Rpl Crtd Sns Dev Total 0267T Implt/Rpl Crtd Sns Dev Lead 0268T Implt/Rpl Crtd Sns Dev Gen 0269T Rev/Remvl Crtd Sns Dev Total 0270T Rev/Remvl Crtd Sns Dev Lead 0271T Rev/Remvl Crtd Sns Dev Gen 0272T Interrogate Crtd Sns Dev 0273T Interrogate Crtd Sns W/Pgrmg 0274T Perq Lamot/Lam Crv/Thrc 0275T Perq Lamot/Lam Lumbar 0278T Tempr 0290T Laser Inc For Pkp/Lkp Recip 0295T Ext Ecg Complete 0296T 731 Ext Ecg Recording $610 $397 $500 0297T Ext Ecg Scan W/Report 0298T 731 Ext Ecg Review And Interp $129 $84 $106 0308T Insj Ocular Telescope Prosth 0312T Laps Impltj Nstim Vagus 0313T Laps Rmvl Nstim Array Vagus 0314T Laps Rmvl Vgl Arry&Pls Gen 0315T Rmvl Vagus Nerve Pls Gen 0316T Replc Vagus Nerve Pls Gen 0317T Elec Alys Vagus Nrv Pls Gen 0329T Mntr Io Press 24Hrs/> Uni/Bi 0330T Tear Film Img Uni/Bi W/I&R 0331T Heart Symp Image Plnr 0332T Heart Symp Image Plnr Spect 0333T Visual Ep Scr Acuity Auto 0335T Insj Sinus Tarsi Implant 0338T Trnscth Renal Symp Denrv Unl 0339T Trnscth Renal Symp Denrv Bil 0342T Thxp Apheresis W/Hdl Delip 0345T Transcath Mtral Vlve Repair 0347T Ins Bone Device For Rsa 0348T Rsa Spine Exam 0349T Rsa Upper Extr Exam 0350T Rsa Lower Extr Exam 0351T Intraop Oct Brst/Node Spec 0352T Oct Brst/Node I&R Per Spec 0353T Intraop Oct Breast Cavity 0354T Oct Breast Surg Cavity I&R 0355T Gi Tract Capsule Endoscopy 0356T Insrt Drug Device For Iop 0358T Bia Whole Body 0362T Bhv Id Suprt Assmt Ea 15 Min 0373T Adapt Bhv Tx Ea 15 Min 0376T Insert Ant Segment Drain Int 0378T Visual Field Assmnt Rev/Rprt 0379T Vis Field Assmnt Tech Suppt 0381T Ext H Rate Epi Sz 14 Days 0382T Ext H Rate Sz 14 Day Ri Only 0383T Ext H Rate Sz Up To 30 Days 0384T Ex H Rate Sz 30 Day Ri Only 0385T Ex H Rate For Sz Ovr 30 Day 0386T Ex H Rate Sz 30+ Day Ri Only 0394T Hdr Elctrnc Skn Surf Brchytx 0395T Hdr Elctr Ntrst/Ntrcv Brchtx 0396T Intraop Kinetic Balnce Sensr 0397T Ercp W/Optical Endomicroscpy 0398T Mrgfus Strtctc Les Abltj 0400T Mltispectrl Digital Les Alys 0401T Mltispectrl Digital Les Alys 0402T Colgn Cross-Link Crn Med Sep 0403T Diabetes Prev Standard Curr 0404T Trnscrv Uterin Fibroid Abltj 0405T Ovrsght Xtrcorp Liv Asst Pat 0408T Insj/Rplc Cardiac Modulj Sys 0409T Insj/Rplc Car Modulj Pls Gn 0410T Insj/Rplc Car Modulj Atr Elt 0411T Insj/Rplc Car Modulj Vnt Elt 0412T Rmvl Cardiac Modulj Pls Gen 0413T Rmvl Car Modulj Tranvns Elt 0414T Rmvl & Rpl Car Modulj Pls Gn 0415T Repos Car Modulj Tranvns Elt 0416T Reloc Skin Pocket Pls Gen 0417T Prgrmg Eval Cardiac Modulj 0418T Interro Eval Cardiac Modulj 0419T Dstrj Neurofibroma Xtnsv 0420T Dstrj Neurofibroma Xtnsv 0421T Waterjet Prostate Abltj Cmpl 0422T Tactile Breast Img Uni/Bi 0423T Assay Secretory Type Ii Pla2 0424T Insj/Rplc Nstim Apnea Compl 0425T Insj/Rplc Nstim Apnea Sen Ld 0426T Insj/Rplc Nstim Apnea Stm Ld 0427T Insj/Rplc Nstim Apnea Pls Gn 0428T Rmvl Nstim Apnea Pls Gen 0429T Rmvl Nstim Apnea Sen Ld 0430T Rmvl Nstim Apnea Stimj Ld 0431T Rmvl/Rplc Nstim Apnea Pls Gn 0432T Repos Nstim Apnea Stimj Ld 0433T Repos Nstim Apnea Sensing Ld 0434T Interro Eval Npgs Apnea 0435T Prgrmg Eval Npgs Apnea 1 Ses 0436T Prgrmg Eval Npgs Apnea Study 0437T Impltj Synth Rnfcmt Abdl Wal 0439T Myocrd Contrast Prfuj Echo 0440T Abltj Perc Uxtr/Perph Nrv 0441T Abltj Perc Lxtr/Perph Nrv 0442T Abltj Perc Plex/Trncl Nrv 0443T R-T Spctrl Alys Prst8 Tiss 0444T 1St Plmt Drug Elut Oc Ins 0445T Sbsqt Plmt Drug Elut Oc Ins 0446T Insj Impltbl Glucose Sensor 0447T Rmvl Impltbl Glucose Sensor 0448T Remvl Insj Impltbl Gluc Sens 0449T Insj Aqueous Drain Dev 1St 0450T Insj Aqueous Drain Dev Each 0451T Insj/Rplcmt Aortic Ventr Sys 0452T Insj/Rplcmt Dev Vasc Seal 0453T Insj/Rplcmt Mech-Elec Ntrfce 0454T Insj/Rplcmt Subq Electrode 0455T Remvl Aortic Ventr Cmpl Sys 0456T Remvl Aortic Dev Vasc Seal 0457T Remvl Mech-Elec Skin Ntrfce 0458T Remvl Subq Electrode 0459T Relocaj Rplcmt Aortic Ventr 0460T Repos Aortic Ventr Dev Eltrd 0461T Repos Aortic Contrpulsj Dev 0462T Prgrmg Eval Aortic Ventr Sys 0463T Interrog Aortic Ventr Sys 0464T Visual Ep Test For Glaucoma 0465T Supchrdl Njx Rx W/O Supply 0466T Insj Ch Wal Respir Eltrd/Ra 0467T Revj/Rplmnt Ch Respir Eltrd 0468T Rmvl Ch Wal Respir Eltrd/Ra 0469T Rta Polarize Scan Oc Scr Bi 0470T Oct Skn Img Acquisj I&R 1St 0470T 26 Oct Skn Img Acquisj I&R 1St 0470T TC Oct Skn Img Acquisj I&R 1St 0471T Oct Skn Img Acquisj I&R Addl 0471T 26 Oct Skn Img Acquisj I&R Addl 0471T TC Oct Skn Img Acquisj I&R Addl 0472T Prgrmg Io Rta Eltrd Ra 0473T Reprgrmg Io Rta Eltrd Ra 0474T Insj Aqueous Drg Dev Io Rsvr 0475T Rec Ftl Car Sgl 3 Ch I&R 0476T Rec Ftl Car Sgl Elec Tr Data 0477T Rec Ftl Car Sgl Xrtj Alys 0478T Rec Ftl Car 3 Ch Rev I&R 0479T Fxjl Abl Lsr 1St 100 Sq Cm 0480T Fxjl Abl Lsr Ea Addl 100Sqcm 0481T Njx Autol Wbc Concentrate 0483T Tmvi Percutaneous Approach 0484T Tmvi Transthoracic Exposure 0485T Oct Mid Ear I&R Unilateral 0485T 26 Oct Mid Ear I&R Unilateral 0485T TC Oct Mid Ear I&R Unilateral 0486T Oct Mid Ear I&R Bilateral 0486T 26 Oct Mid Ear I&R Bilateral 0486T TC Oct Mid Ear I&R Bilateral 0487T Trvg Biomchn Mapg W/Reprt 0488T Diabetes Prev Online/Elec 0489T Regn Cell Tx Scldr Hands 0490T Regn Cell Tx Scldr H Mlt Inj 0491T Abl Lsr Opn Wnd 1St 20 Sqcm 0492T Abl Lsr Opn Wnd Addl 20 Sqcm 0493T Near Ifr Spectrsc Of Wounds 0494T Prep & Cannulj Cdvr Don Lung 0495T Mntr Cdvr Don Lng 1St 2 Hrs 0496T Mntr Cdvr Don Lng Ea Addl Hr 0497T Xtrnl Pt Act Ecg In-Off Conn 0498T Xtrnl Pt Act Ecg R&I Pr 30 D 0499T Cysto F/Urtl Strix/Stenosis 0500F 510 Initial Prenatal Care Visit $0 $0 $14 0500T Hpv 5+ Hi Risk Hpv Types 0501F Prenatal Flow Sheet 0501T Cor Ffr Derived Cor Cta Data 0502F 510 Subsequent Prenatal Care $0 $0 $17 0502T Cor Ffr Data Prep & Transmis 0503F 510 Postpartum Care Visit $0 $0 $10 0503T Cor Ffr Alys Gnrj Ffr Mdl 0504T Cor Ffr Data Review I&R 0505F Hemodialysis Plan Docd 0505T Ev Fempop Artl Revsc 0506T Mac Pgmt Opt Dns Meas Hfp 0506T 26 Mac Pgmt Opt Dns Meas Hfp 0506T TC Mac Pgmt Opt Dns Meas Hfp 0507F Periton Dialysis Plan Docd 0507T Near Ifr 2Img Mibmn Glnd I&R 0507T 26 Near Ifr 2Img Mibmn Glnd I&R 0507T TC Near Ifr 2Img Mibmn Glnd I&R 0508T Pls Echo Us B1 Dns Meas Tib 0508T 26 Pls Echo Us B1 Dns Meas Tib 0508T TC Pls Echo Us B1 Dns Meas Tib 0509F Urine Incon Plan Docd 0509T Pattern Erg W/I&R 0509T 26 Pattern Erg W/I&R 0509T TC Pattern Erg W/I&R 0510T Rmvl Sinus Tarsi Implant 0511T Rmvl&Rinsj Sinus Tarsi Implt 0512T Esw Integ Wnd Hlg 1St Wnd 0513F Elev Bp Plan Of Care Docd 0513T Esw Integ Wnd Hlg Ea Addl 0514F Care Plan Hgb Docd Esa Pt 0514T Intraop Vis Axis Id Pt Fixj 0515T Insj Wcs Lv Compl Sys 0516F Anemia Plan Of Care Docd 0516T Insj Wcs Lv Eltrd Only 0517F Glaucoma Plan Of Care Docd 0517T Insj Wcs Lv Pg Compnt 0518F Fall Plan Of Care Docd $0 $0 $0 0518T Rmvl Pg Compnt Wcs 0519F Pland Chemo Docd B/4 Txmnt 0519T Rmvl & Rplcmt Pg Compnt Wcs 0520F Rad Dos Limts B/4 3D Rad 0520T Rmvl&Rplcmt Pg Wcs New Eltrd 0521F Plan Of Care 4 Pain Docd 0521T Interrog Dev Eval Wcs Ip 0521T 26 Interrog Dev Eval Wcs Ip 0521T TC Interrog Dev Eval Wcs Ip 0522T Prgrmg Dev Eval Wcs Ip 0522T 26 Prgrmg Dev Eval Wcs Ip 0522T TC Prgrmg Dev Eval Wcs Ip 0523T Ntrapx C Ffr W/3D Funcjl Map 0524T Ev Cath Dir Chem Abltj W/Img 0525F Initial Visit For Episode 0525T Insj/Rplcmt Compl Iims 0526F Subs Visit For Episode 0526T Insj/Rplcmt Iims Eltrd Only 0527T Insj/Rplcmt Iims Implt Mntr 0528F Rcmnd Flw-Up 10 Yrs Docd 0528T Prgrmg Dev Eval Iims Ip 0528T 26 Prgrmg Dev Eval Iims Ip 0528T TC Prgrmg Dev Eval Iims Ip 0529F Intrvl 3/>Yr Pts Clnscp Docd 0529T Interrog Dev Eval Iims Ip 0529T 26 Interrog Dev Eval Iims Ip 0529T TC Interrog Dev Eval Iims Ip 0530T Removal Complete Iims 0531T Removal Iims Electrode Only 0532T Removal Iims Implt Mntr Only 0533T Cont Rec Mvmt Do 6-10 Days 0533T 26 Cont Rec Mvmt Do 6-10 Days 0533T TC Cont Rec Mvmt Do 6-10 Days 0534T Cont Rec Mvmt Do Setup&Train 0534T 26 Cont Rec Mvmt Do Setup&Train 0534T TC Cont Rec Mvmt Do Setup&Train 0535F Dyspnea Mngmnt Plan Docd 0535T Cont Rec Mvmt Do Reprt Cnfig 0535T 26 Cont Rec Mvmt Do Reprt Cnfig 0535T TC Cont Rec Mvmt Do Reprt Cnfig 0536T Cont Rec Mvmt Do Dl W/I&R 0536T 26 Cont Rec Mvmt Do Dl W/I&R 0536T TC Cont Rec Mvmt Do Dl W/I&R 0537T Bld Drv T Lymphcyt Car-T Cll 0538T Bld Drv T Lymphcyt Prep Trns 0539T Receipt&Prep Car-T Cll Admn 0540F Gluco Mngmnt Plan Docd 0540T Car-T Cll Admn Autologous 0541T Myocardial Imaging Mcg 0542T Myocardial Imaging Mcg I&R 0543T Ta Mv Rpr W/Artif Chord Tend 0544T Tcat Mv Annulus Rcnstj 0545F Follow Up Care Plan Mdd Docd 0545T Tcat Tv Annulus Rcnstj 0546T Rf Spectrsc Ntraop Mrgn Asmt 0547T B1 Matrl Qual Tst Mcrind Tib 0548T Tprnl Balo Cntnc Dev Bi 0549T Tprnl Balo Cntnc Dev Uni 0550F Cytopath Report Nongyn Spcmn 0550T Tprnl Balo Cntnc Dev Rmvl Ea 0551F Cytopath Report Non Routine 0551T Tprnl Balo Cntnc Dev Adjmt 0552T Low-Level Laser Therapy 0553T Perq Tcat Iliac Anast Implt 0554T B1 Str & Fx Rsk Analysis 0555F Symptom Mgmnt Plan Care Docd 0555T B1 Str&Fx Rsk Transmis Data 0556F Plan Care Lipid Control Docd 0556T B1 Str & Fx Rsk Assessment 0557F Plan Caremng Angnl Symptdocd 0557T B1 Str & Fx Rsk I&R 0558T Ct Scan F/Biomchn Ct Alys 0559T Antmc Mdl 3D Print 1St Cmpnt 0560T Antmc Mdl 3D Print Ea Addl 0561T Antmc Guide 3D Print 1St Gd 0562T Antmc Guide 3D Print Ea Addl 0563T Evac Meibomian Glnd Heat Bi 0564T Onc Chemo Rx Cytotox Csc 14 0565T Autol Cell Implt Adps Hrvg 0566T Autol Cell Implt Adps Njx 0567T Perm Flp Tube Occls W/Implt 0568T Intro Mix Saline&Air F/Ssg 0569T Ttvr Perq Appr 1St Prosth 0570T Ttvr Perq Ea Addl Prosth 0571T Insj/Rplcmt Icds Ss Eltrd 0572T Insertion Ss Dfb Electrode 0573T Removal Ss Dfb Electrode 0574T Repos Prev Ss Impl Dfb Eltrd 0575F Hiv Rna Plan Care Docd 0575T Prgrmg Dev Eval Icds Ss Ip 0576T Interrog Dev Eval Icds Ss Ip 0577T Ephys Eval Icds Ss 0578T Rem Interrog Dev Icds Phys 0579T Rem Interrog Dev Icds Tech 0580F Multidisciplinary Care Plan 0580T Rmvl Ss Impl Dfb Pg Only 0581F Pt Trnsfrd From Anesth To Cc 0581T Abltj Mal Brst Tum Perq Crtx 0582F No Trnsfr From Anesth To Cc 0582T Trurl Abltj Mal Prst8 Tiss 0583F Transfer Care Checklist Used 0583T Tmpst Auto Tube Dlvr Sys 0584F No Transfercare Chklist Used 0584T Perq Islet Cell Transplant 0585T Laps Islet Cell Transplant 0586T Open Islet Cell Transplant 0587T Perq Impltj/Rplcmt Isdns Ptn 0588T Revision/Removal Isdns Ptn 0589T Elec Alys Smpl Prgrmg Iins 0590T Elec Alys Cplx Prgrmg Iins 0591T Hlth&Wb Coaching Indiv 1St 0592T Hlth&Wb Coaching Indiv F-Up 0593T Hlth&Wb Coaching Group 0594T Osteot Hum Xtrnl Lngth Dev 0596T Temp Fml Iu Vlv-Pmp 1St Insj 0597T Temp Fml Iu Valve-Pmp Rplcmt 0598T Ncntc R-T Fluor Wnd Img 1St 0599T Ncntc R-T Fluor Wnd Img Ea 0600T Ire Abltj 1+Tum Organ Perq 0601T Ire Abltj 1+Tumors Open 0602T Transdermal Gfr Measurements 0603T Transdermal Gfr Monitoring 0604T Rem Oct Rta Dev Setup&Educaj 0605T Rem Oct Rta Techl Sprt Min 8 0606T Rem Oct Rta Phys/Qhp Ea 30D 0607T Rem Mntr Pulm Flu Mntr Setup 0608T Rem Mntr Pulm Flu Mntr Alys 0609T Mrs Disc Pain Acquisj Data 0610T Mrs Disc Pain Transmis Data 0611T Mrs Disc Pain Alg Alys Data 0612T Mrs Discogenic Pain I&R 0613T Perq Tcat Intratrl Septl Sht 0614T Rmvl&Rplcmt Ss Impl Dfb Pg 0615T Eye Mvmt Alys W/O Calbrj I&R 0616T Insertion Of Iris Prosthesis 0617T Insj Iris Prosth W/Rmvl&Insj 0618T Insj Iris Prosth Sec Io Lens 0619T Cysto W/Prst8 Commissurotomy 0620T Evasc Ven Artlz Tibl/Prnl Vn 0621T Trabeculostomy Interno Laser 0622T Trabeculostomy Int Lsr W/Scp 0623T Auto Quantification C Plaque 0624T Auto Quan C Plaq Data Prep 0625T Auto Quan C Plaq Cptr Alys 0626T Auto Quan C Plaq I&R 0627T Perq Njx Algc Fluor Lmbr 1St 0628T Perq Njx Algc Fluor Lmbr Ea 0629T Perq Njx Algc Ct Lmbr 1St 0630T Perq Njx Algc Ct Lmbr Ea 0631T Tc Vis Lit Hyperspectral Img 0632T Perq Tcat Us Abltj Nrv P-Art 0633T Ct Breast W/3D Uni C- 0633T 26 Ct Breast W/3D Uni C- 0633T TC Ct Breast W/3D Uni C- 0634T Ct Breast W/3D Uni C+ 0634T 26 Ct Breast W/3D Uni C+ 0634T TC Ct Breast W/3D Uni C+ 0635T Ct Breast W/3D Uni C-/C+ 0635T 26 Ct Breast W/3D Uni C-/C+ 0635T TC Ct Breast W/3D Uni C-/C+ 0636T Ct Breast W/3D Bi C- 0636T 26 Ct Breast W/3D Bi C- 0636T TC Ct Breast W/3D Bi C- 0637T Ct Breast W/3D Bi C+ 0637T 26 Ct Breast W/3D Bi C+ 0637T TC Ct Breast W/3D Bi C+ 0638T Ct Breast W/3D Bi C-/C+ 0638T 26 Ct Breast W/3D Bi C-/C+ 0638T TC Ct Breast W/3D Bi C-/C+ 0639T Wrls Skn Snr Anisotropy Meas 10004 510 Fna Bx W/O Img Gdn Ea Addl $30 $19 $24 10005 450 Fna Bx W/Us Gdn 1St Les $148 $96 $405 $586 $95 10006 510 Fna Bx W/Us Gdn Ea Addl $36 $23 $29 10007 Fna Bx W/Fluor Gdn 1St Les 10008 Fna Bx W/Fluor Gdn Ea Addl 10009 Fna Bx W/Ct Gdn 1St Les 1000F Tobacco Use Assessed 10010 Fna Bx W/Ct Gdn Ea Addl 10011 Fna Bx W/Mr Gdn 1St Les 10012 Fna Bx W/Mr Gdn Ea Addl 10021 510 Fna Bx W/O Img Gdn 1St Les $228 $148 $335 $326 $307 1002F Assess Anginal Symptom/Level 10030 450 Guide Cathet Fluid Drainage $582 $378 $731 $586 10035 Perq Dev Soft Tiss 1St Imag $202 $131 $446 $586 $282 10036 Perq Dev Soft Tiss Add Imag $101 $66 $83 1003F Level Of Activity Assess 10040 983 Acne Surgery $125 $81 $179 $169 $120 1004F Clin Symp Vol Ovrld Assess 1005F Asthma Symptoms Evaluate 10060 450 Drainage Of Skin Abscess $98 $64 $158 $169 10061 450 Drainage Of Skin Abscess $91 $59 $232 $326 1006F Osteoarthritis Assess 1007F Anti-Inflm/Anlgsc Otc Assess 10080 450 Drainage Of Pilonidal Cyst $293 $190 $514 $586 $252 10081 450 Drainage Of Pilonidal Cyst $3,337 $2,169 $2,800 $586 $539 1008F Gi/Renal Risk Assess 1010F Severity Angina By Actvty 1011F Angina Present 10120 450 Remove Foreign Body $190 $123 $306 $326 $189 10121 450 Remove Foreign Body $338 $220 $919 $1,326 $220 1012F Angina Absent 10140 983 Drainage Of Hematoma/Fluid $188 $122 $806 $1,326 $268 1015F Copd Symptoms Assess 10160 450 Puncture Drainage Of Lesion $149 $97 $275 $326 10180 510 Complex Drainage Wound $289 $188 $1,338 $2,234 $701 1018F Assess Dyspnea Not Present 1019F Assess Dyspnea Present 1022F Pneumo Imm Status Assess 1026F Co-Morbid Condition Assess 1030F Influenza Imm Status Assess 1031F Smoking & 2Nd Hand Assessed 1032F Smoker/Exposed 2Nd Hnd Smoke 1033F Tobacco Nonsmoker Nor 2Ndhnd 1034F Current Tobacco Smoker 1035F Smokeless Tobacco User 1036F Tobacco Non-User $0 $0 $0 1038F Persistent Asthma 1039F Intermittent Asthma 1040F Dsm-5 Info Mdd Docd 1050F History Of Mole Changes 1052F Type Location Activityassess 1055F Visual Funct Status Assess 1060F Doc Perm/Cont/Parox Atr Fib 1061F Doc Lack Perm+Cont+Parox Fib 1065F Ischm Stroke Symp Lt3 Hrsb/4 1066F Ischm Stroke Symp Ge3 Hrsb/4 1070F Alarm Symp Assessed-Absent 1071F Alarm Symp Assessed-1+ Prsnt 1090F Pres/Absn Urine Incon Assess 1091F Urine Incon Characterized 11000 983 Debride Infected Skin $88 $57 $314 $494 11001 Debride Infected Skin Add-On 11004 Debride Genitalia & Perineum 11005 Debride Abdom Wall 11006 Debride Genit/Per/Abdom Wall 11008 Remove Mesh From Abd Wall 1100F Ptfalls Assess-Docd Ge2>/Yr 11010 450 Debride Skin At Fx Site $1,185 $770 $1,184 $586 11011 Debride Skin Musc At Fx Site 11012 983 Deb Skin Bone At Fx Site 1101F Pt Falls Assess-Docd Le1/Yr 11042 450 Deb Subq Tissue 20 Sq Cm/< $475 $309 $520 $326 $307 11043 983 Deb Musc/Fascia 20 Sq Cm/< $296 $193 $470 $494 $203 11044 983 Deb Bone 20 Sq Cm/< $409 $266 $973 $1,326 $659 11045 983 Deb Subq Tissue Add-On $51 $33 $42 11046 983 Deb Musc/Fascia Add-On $53 $34 $43 11047 983 Deb Bone Add-On $81 $52 $66 11055 983 Trim Skin Lesion $106 $69 $164 $169 $155 11056 983 Trim Skin Lesions 2 To 4 $120 $78 $175 $169 $169 11057 983 Trim Skin Lesions Over 4 $128 $83 $181 $169 11102 510 Tangntl Bx Skin Single Les $156 $101 $202 $169 11103 510 Tangntl Bx Skin Ea Sep/Addl $80 $52 $66 11104 983 Punch Bx Skin Single Lesion $196 $128 $311 $326 11105 510 Punch Bx Skin Ea Sep/Addl $91 $59 $74 11106 510 Incal Bx Skn Single Les $237 $154 $426 $494 $286 11107 510 Incal Bx Skn Ea Sep/Addl $106 $69 $86 1110F Pt Lft Inpt Fac W/In 60 Days 1111F Dschrg Med/Current Med Merge $0 $0 $0 1116F Auric/Peri Pain Assessed 1118F Gerd Symps Assessed 12 Month 1119F Init Eval For Condition 11200 450 Removal Of Skin Tags
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