University Physicians Group: Prices of Provider Services

CPT Unit Base Service Procedure Modifier Code Price Price Type 00100 PR ANESTH, SALIVARY GLAND W/BX 1.00 5.00 00102 PR ANESTH, CLEFT LIP 1.00 6.00 Anesthesia REPAIR 00103 PR ANESTH, 1.00 5.00 Anesthesia BLEPHAROPLASTY 00104 ANESTH, ELECTROSHOCK/ 1.00 4.00 Anesthesia ECT 00120 ANESTH, 1.00 5.00 Anesthesia 00124 ANESTH, EAR EXAM 1.00 4.00 Anesthesia 00126 PR ANESTH, TYMPANOTOMY 1.00 4.00 Anesthesia 00140 PR ANESTH, PROCEDURES ON EYE 1.00 5.00 Anesthesia 00142 ANESTH, LENS SURGERY 1.00 4.00 Anesthesia 00144 PR ANESTH, CORNEAL TRANSPLANT 1.00 6.00 Anesthesia 00145 ANESTH, VITREORETINAL 1.00 6.00 Anesthesia SURG 00147 PR ANESTH, IRIDECTOMY 1.00 4.00 Anesthesia 00148 ANESTH,EYE EXAM 1.00 4.00 Anesthesia 00160 PR ANESTH,NOSE,SINUS SURGERY 1.00 5.00 Anesthesia 00162 PR ANESTH,NOSE,RADICAL SINUS 1.00 7.00 Anesthesia SURGERY 00164 PR ANESTH,BIOPSY OF NOSE 1.00 4.00 Anesthesia 00170 PR ANESTH,PROCEDURE ON MOUTH 1.00 5.00 Anesthesia 00172 PR ANESTH,CLEFT PALATE REPAIR 1.00 6.00 Anesthesia 00174 PR ANESTH,EXCIS RETROPHARYNG 1.00 6.00 Anesthesia TUMOR 00176 PR ANESTH,PHARYNX SURG RADICAL 1.00 7.00 Anesthesia 00190 PR ANESTH,FACIAL BONE SURGERY 1.00 5.00 Anesthesia 00192 PR ANESTH,RADICAL FACIAL BONE 1.00 7.00 Anesthesia SURGERY 00210 PR ANESTH,OPEN HEAD SURGERY 1.00 11.00 Anesthesia 00211 PR ANESTH, INTRACRANIAL 1.00 10.00 Anesthesia EVACUATION 00212 PR ANESTH,SKULL SURG SUBDUR TAP 1.00 5.00 Anesthesia 00214 PR ANESTH,SKULL SURG BURR HOLE 1.00 9.00 Anesthesia 00215 PR ANESTH, CRANIOPLASTY 1.00 9.00 Anesthesia 00216 PR ANESTH,HEAD VESSEL SURGERY 1.00 15.00 Anesthesia 00218 PR ANESTH,SPECIAL HEAD SURGERY 1.00 13.00 Anesthesia 00220 PR ANESTH,INTRACRAN PROC; CSF 1.00 10.00 Anesthesia SHUNT PROC 00222 PR ANESTH,INTRACRAN NERVE 1.00 6.00 Anesthesia COAGULATN 00300 PR ANESTH,SKIN SURG HEAD/NECK 1.00 5.00 Anesthesia 00320 PR ANESTH,NECK ORG PROC; NOS, 1.00 6.00 Anesthesia AGE 1 YR/OLD 00322 PR ANESTH,NEEDLE BX THYROID 1.00 3.00 Anesthesia 00326 PR ANESTH,LARYNX/TRACH PROC; 1.00 7.00 Anesthesia CHILDREN <1 YR 00350 PR ANESTH,NECK VESSEL SURGERY 1.00 10.00 Anesthesia NOS 00352 PR ANESTH,NECK VESSEL SURG SIMPL 1.00 5.00 Anesthesia LIGAT 00400 PR ANESTH,SKIN SURG THORAX/EXTR 1.00 3.00 Anesthesia 00402 PR ANESTH,SURG BREAST 1.00 5.00 Anesthesia RECONSTRUCTIVE 00404 PR ANESTH,SURG BREAST RAD 1.00 5.00 Anesthesia MASTEC 00406 PR ANESTH,SURG BREAST RAD MAST W 1.00 13.00 Anesthesia NODE 00410 PR ANESTH,CORRECT HEART RHYTHM 1.00 4.00 Anesthesia 0042T CEREBRAL PERFUS ANALYSIS, CT 200.0 W/CONTRAST 0 00450 PR ANESTH,SURG CLAVICLE/SCAPULA 1.00 5.00 Anesthesia 00454 PR ANESTH,CLAVICLE BIOPSY 1.00 3.00 Anesthesia 00470 PR ANESTH,PARTIAL RIB RESECTN 1.00 6.00 Anesthesia 00472 PR ANESTH,CHEST WALL REPAIR 1.00 10.00 Anesthesia 00474 PR ANESTH,CHEST WALL REPAIR 1.00 13.00 Anesthesia EXTENSIVE 00500 PR ANESTH,ESOPHAGEAL SURGERY 1.00 15.00 Anesthesia 00520 PR ANESTH,CHEST PROC CLOSED,NOS 1.00 6.00 Anesthesia 00522 PR ANESTH,CHEST PLEURAL BIOPSY 1.00 4.00 Anesthesia 00524 PR ANESTH,CHEST DRAINAGE 1.00 4.00 Anesthesia 00528 PR 1.00 8.00 Anesthesia ANESTH,MEDIASTINOSCOPY 00529 PR ANESTH, CHEST PARTITION VIEW 1.00 11.00 Anesthesia 00530 PR ANESTH,PACEMAKER INSERTION 1.00 4.00 Anesthesia 00532 PR ANESTH,CENTRL VASCULAR 1.00 4.00 Anesthesia ACCESS 00534 PR ANESTH,CARDIOVERTER/DEFIB 1.00 7.00 Anesthesia 00537 PR ANESTH,CARD ELECTROPHYS PROC 1.00 7.00 Anesthesia 00539 PR ANESTH,TRACHEOBRONCHIAL 1.00 18.00 Anesthesia RECONSTRUCT 00540 PR ANESTH,CHEST 1.00 12.00 Anesthesia SURGERY,THORACOTOMY 00541 PR ANESTH,THORACOTOMY PROC, W/1 1.00 15.00 Anesthesia LUNG VENT 00542 PR ANESTH,CHEST DECORTICATION 1.00 15.00 Anesthesia 00546 PR ANESTH,LUNG 1.00 15.00 Anesthesia RESEC,THORACOPLASTY 00548 PR ANESTH,TRACH,BRONCHI 1.00 17.00 Anesthesia INTRATHOR SURG 0054T BONE SURGERY USING COMPUTER 640.0 ASSIST, FLURO GUIDED 0 00550 PR ANESTH,STERNAL DEBRIDEMENT 1.00 10.00 Anesthesia 00560 PR ANESTH,OPEN HEART; W/O PUMP 1.00 15.00 Anesthesia OXYEGENATOR 00561 PR ANESTH, HEART SURG < AGE 1 1.00 25.00 Anesthesia 00562 PR ANESTH,OPEN HEART 1.00 20.00 Anesthesia SURGERY+PUMP 00563 PR ANESTH,OPEN 1.00 25.00 Anesthesia HEART,PUMP+HYPOTHERM 00566 PR ANESTH,DIRECT CABG W/O PUMP 1.00 25.00 Anesthesia OXYGENATOR 00567 PR ANESTH, DIRECT CABG W PUMP 1.00 18.00 Anesthesia OXYGENATOR 00580 PR ANESTH,HEART/LUNG TRANSPLANT 1.00 20.00 Anesthesia 00600 PR ANESTH,CERV SPINE,CORD 1.00 10.00 Anesthesia SURGERY 00604 PR ANESTH,CERV SPINE, SITTING 1.00 13.00 Anesthesia POSITION 00620 PR ANESTH,THOR SPINE,CORD 1.00 10.00 Anesthesia SURGERY 00630 PR ANESTH,LUMBAR SPINE,CORD 1.00 8.00 Anesthesia SURGERY 00632 PR ANESTH,LUMBAR SYMPATHECTOMY 1.00 7.00 Anesthesia 00635 PR ANESTH,LUMBAR PUNCTURE 1.00 4.00 Anesthesia 00640 PR ANESTH,CLOSED MANIPULATION, 1.00 3.00 Anesthesia SPINE C/T/L 00670 PR ANESTH,EXTENSIVE SPINE,CORD 1.00 13.00 Anesthesia PROCED 00700 PR ANESTH,ABD WALL,UPER 1.00 4.00 Anesthesia ANTER,SURG 00702 PR ANESTH,FOR LIVER 1.00 4.00 Anesthesia BIOPSY 0071T U/S LEIOMYOMATA ABLATE <200 CC 2500. 00 00730 PR ANESTH,ABD WALL,UPPER 1.00 5.00 Anesthesia POST,SURG 00731 PR ANESTHESIA UPPER GI 1.00 5.00 Anesthesia ENDOSCOPIC PX NOS 00732 PR ANESTHESIA UPPER GI 1.00 6.00 Anesthesia ENDOSCOPIC PX ERCP 00740 PR ANESTH,UGI ENDOSCOPY 1.00 5.00 Anesthesia 00750 PR ANESTH,REPAIR UPPER ABD HERNIA 1.00 4.00 Anesthesia NOS 00752 PR ANESTH,REPAIR UP HERNIA 1.00 6.00 Anesthesia LUMBAR/VENTR 00754 PR ANESTH,REPAIR UP HERNIA 1.00 7.00 Anesthesia OMPHALOCELE 00756 PR ANESTH,REPAIR UP HERNIA 1.00 7.00 Anesthesia DIAPHRAGM 0075T PR TCAT PLMT XTRC VRT 26 2136. CRTD STENT RS&I PRQ 1ST 00 VSL 00770 PR ANESTH,MAJOR ABD BLOOD VESSEL 1.00 15.00 Anesthesia REPAIR 00790 PR ANESTH,SURG UPPER ABDOMEN 1.00 7.00 Anesthesia 00792 PR ANESTH,PARTIAL LIVER REMOVAL 1.00 13.00 Anesthesia 00794 PR ANESTH,PANCREAS REMOVAL 1.00 8.00 Anesthesia 00796 PR ANESTH,FOR LIVER TRANSPLANT 1.00 30.00 Anesthesia 00797 PR ANESTH,GASTRIC RESTRICT, 1.00 11.00 Anesthesia MORBID OBESITY 00800 PR ANESTH,ABD WALL,LOWER 1.00 4.00 Anesthesia ANT,SURG 00802 PR ANESTH,FAT LAYER REMOVAL 1.00 5.00 Anesthesia 00810 PR ANESTH,INTESTINE,SCOPE,LOW 1.00 5.00 Anesthesia 00811 PR ANESTHESIA LOWER INTST 1.00 4.00 Anesthesia ENDOSCOPIC PX NOS 00812 PR ANESTHESIA LOWER INTST 1.00 3.00 Anesthesia ENDOSCOPIC PX SCR COLSC 00813 PR ANESTHESIA COMBINED 1.00 5.00 Anesthesia UPPER&LOWER GI ENDOSCOPIC PX 00820 PR ANESTH,ABD WALL,LOWER 1.00 5.00 Anesthesia POST,SURG 00830 PR ANESTH,REPAIR LO ABD HERNIA 1.00 4.00 Anesthesia NOS 00832 PR ANESTH,REPAIR LO HERNIA 1.00 6.00 Anesthesia VENTR/INCIS 00834 PR ANESTH,REPAIR LO ABD HERNIA 1.00 5.00 Anesthesia NOS, < 1 YR 00836 PR ANESTH,REP LO ABD HERN NOS, 1.00 6.00 Anesthesia PREM <50 WKS 00840 PR ANESTH,SURG LOWER ABDOMEN 1.00 6.00 Anesthesia 00842 PR ANESTH,AMNIOCENTESIS 1.00 4.00 Anesthesia 00844 PR ANESTH,ABD-PERINEAL RESECTION 1.00 7.00 Anesthesia 00846 PR ANESTH,RADICAL 1.00 8.00 Anesthesia 00848 PR ANESTH, 1.00 8.00 Anesthesia 00851 PR ANESTH,TUBAL 1.00 6.00 Anesthesia LIGATION/TRANSECTION 00860 PR ANESTH,SURG LOW 1.00 6.00 Anesthesia ABD,EXTRAPERINTONEAL 00862 PR ANESTH,KIDNEY,PROX URETER 1.00 7.00 Anesthesia SURG 00864 PR ANESTH,REMOVAL OF BLADDER 1.00 8.00 Anesthesia 00865 PR ANESTH,REMOVAL OF PROSTATE 1.00 7.00 Anesthesia 00866 PR ANESTH,REMOVAL OF ADRENAL 1.00 10.00 Anesthesia 00868 PR ANESTH,KIDNEY TRANSPLANT 1.00 10.00 Anesthesia 00870 PR ANESTH,BLADDER STONE SURG 1.00 5.00 Anesthesia 00872 PR ANESTH,KID STONE 1.00 7.00 Anesthesia DESTRUCT+WATER BATH 00873 PR ANESTH,KID STONE DESTRUCT 1.00 5.00 Anesthesia 00880 PR ANESTH,MAJOR LOW ABD VESSEL 1.00 15.00 Anesthesia SURG 00882 PR ANESTH,INFER VENA CAVAL 1.00 10.00 Anesthesia LIGATION 00902 PR ANESTH,ANORECTAL SURGERY 1.00 5.00 Anesthesia 00904 PR ANESTH,RADICAL PERINEAL 1.00 7.00 Anesthesia SURGERY 00906 PR ANESTH,REMOVAL OF 1.00 4.00 Anesthesia 00908 PR ANESTH,PERINEAL REMV OF 1.00 6.00 Anesthesia PROSTATE 00910 PR ANESTH,TRANSURETHRAL 1.00 3.00 Anesthesia SURG,NOS 00912 PR ANESTH,XURETHRAL BLADDER 1.00 5.00 Anesthesia TUMOR SURG 00914 PR ANESTH,XURETHRAL REMOVAL OF 1.00 5.00 Anesthesia PROSTATE 00916 PR ANESTH,POST XURETHRAL 1.00 5.00 Anesthesia BLEEDING CONTR 00918 PR ANESTH,STONE RMVOVAL 1.00 5.00 Anesthesia 00920 PR ANESTH,MALE GENITALIA SURGERY 1.00 3.00 Anesthesia 00921 PR ANESTH,VASECTOMY, UNILAT/BILAT 1.00 3.00 Anesthesia 00922 PR ANESTH,SPERM DUCT SURGERY 1.00 6.00 Anesthesia 00924 PR ANESTH,TESTIS EXPLORATION 1.00 4.00 Anesthesia 00926 PR ANESTH,RADICAL REMV 1.00 4.00 Anesthesia TESTIS,INGUINAL 00928 PR ANESTH,RADICAL REMV 1.00 6.00 Anesthesia TESTIS,ABDOMINAL 00930 PR ANESTH,TESTIS SUSPENSION 1.00 4.00 Anesthesia 00932 PR ANESTH, OF PENIS 1.00 4.00 Anesthesia 00934 PR ANESTH,PENIS,NODES REMOVAL 1.00 6.00 Anesthesia 00936 PR ANESTH,PENIS,COMBO NODES 1.00 8.00 Anesthesia REMOVAL 00938 PR ANESTH,INSERT PENIS 1.00 4.00 Anesthesia 00940 PR ANESTH,VAGINAL PROCEDURES 1.00 3.00 Anesthesia 00942 PR 1.00 4.00 Anesthesia ANESTH,COLPOT,VAGINECT,COLPORR, URETH PRO 00944 PR ANESTH,VAGINAL HYSTERECTOMY 1.00 6.00 Anesthesia 00948 PR ANESTH,REPAIR OF 1.00 4.00 Anesthesia 00950 PR ANESTH,VAGINAL ENDOSCOPY 1.00 5.00 Anesthesia 00952 PR ANESTH,/VAG BX 1.00 4.00 Anesthesia 01112 PR ANESTH,BONE MARROW ASP/BX 1.00 5.00 Anesthesia ILIAC CRST 01120 PR ANESTH,BONY SURGERY 1.00 6.00 Anesthesia 01130 PR ANESTH,BODY CAST PROCEDURE 1.00 3.00 Anesthesia 01140 PR ANESTH,AMPUTATION AT PELVIS 1.00 15.00 Anesthesia 01150 PR ANESTH,RADICAL PELVIC TUMOR 1.00 10.00 Anesthesia SURGERY 01160 PR ANESTH,,SACROILIAC CLOSED 1.00 4.00 Anesthesia PROC 01170 PR ANESTH,PUBIS,SACROILIAC OPEN 1.00 8.00 Anesthesia PROC 01173 PR ANESTH, FX REPAIR, 1.00 12.00 Anesthesia PELVIS 01180 PR ANESTH,PELV NERV REMOVAL 1.00 3.00 Anesthesia EXTRAPELV 01190 PR ANESTH,PELV NERV REMOVAL 1.00 4.00 Anesthesia INTRAPELV 01200 PR ANESTH,HIP JOINT PROCEDURE 1.00 4.00 Anesthesia 01202 PR ANESTH,ARTHROSCOPY OF HIP 1.00 4.00 Anesthesia 01210 PR ANESTH,HIP JOINT SURGERY 1.00 6.00 Anesthesia 01212 PR ANESTH,HIP DISARTICULATION 1.00 10.00 Anesthesia 01214 PR ANESTH,TOTAL HIP ARTHROPLASTY 1.00 8.00 Anesthesia 01215 PR ANESTH,REVISE TOTAL HIP 1.00 10.00 Anesthesia ARTHROPLASTY 01220 PR ANESTH,CLOSED PROC UPPER 2/3 1.00 4.00 Anesthesia 01230 PR ANESTH,OPEN PROC UPPER 2/3 1.00 6.00 Anesthesia FEMUR 01232 PR ANESTH,AMPUTATION OF FEMUR 1.00 5.00 Anesthesia 01234 PR ANESTH,RADICAL FEMUR SURG 1.00 8.00 Anesthesia 01250 PR ANESTH,UPPER LEG SURGERY 1.00 4.00 Anesthesia 01260 PR ANESTH,UPPER LEG VEINS SURG 1.00 3.00 Anesthesia 0126T CAROTID INT-MEDIA THICKNESS EVAL 55.00 FOR ATHERSCLER 01270 PR ANESTH,THIGH ARTERIES SURG 1.00 8.00 Anesthesia 01272 PR ANESTH,FEMORAL ARTERY 1.00 4.00 Anesthesia LIGATION 01274 PR ANESTH,FEMORAL EMBOLECTOMY 1.00 6.00 Anesthesia 01320 PR ANESTH,KNEE AREA SURGERY 1.00 4.00 Anesthesia 01340 PR ANESTH,LOWER 1/3 FEMUR,CLOSED 1.00 4.00 Anesthesia PROC 01360 PR ANESTH,LOWER 1/3 FEMUR,OPEN 1.00 5.00 Anesthesia PROC 01380 PR ANESTH,KNEE JOINT,CLOSED 1.00 3.00 Anesthesia PROCEDURE 01382 PR ANESTH,DX ARTHROSCOPIC PROC 1.00 3.00 Anesthesia KNEE JOINT 01390 PR ANESTH,UPPER LEG,CLOSED 1.00 3.00 Anesthesia PROCEDURE 01392 PR ANESTH,UPPER LEG,OPEN 1.00 4.00 Anesthesia PROCEDURE 01400 PR ANESTH,KNEE JOINT; NOS 1.00 4.00 Anesthesia 01402 PR ANESTH,TOTAL KNEE 1.00 7.00 Anesthesia ARTHROPLASTY 01404 PR ANESTH,AMPUTATION AT KNEE 1.00 5.00 Anesthesia 01420 PR ANESTH,KNEE JOINT CASTING 1.00 3.00 Anesthesia 01430 PR ANESTH,KNEE VEINS SURGERY 1.00 3.00 Anesthesia 01432 PR ANESTH,KNEE AV FISTULA VESSEL 1.00 6.00 Anesthesia SURG 01440 PR ANESTH,KNEE ARTERIES SURG 1.00 8.00 Anesthesia 01442 PR ANESTH,POPLIT 1.00 8.00 Anesthesia THROMBOENDARTECTOMY 01444 PR ANESTH,POPLIT ARTERY EXCISION 1.00 8.00 Anesthesia 01462 PR ANESTH,LOWER LEG,CLOSED 1.00 3.00 Anesthesia PROCEDURE 01464 PR ANESTH,ARTHROSCOP PROC,ANKLE 1.00 3.00 Anesthesia &/OR FOOT 01470 PR ANESTH,LOWER LEG,OPEN 1.00 3.00 Anesthesia SURGERY 01472 PR ANESTH,ACHILLES SURG 1.00 5.00 Anesthesia 01474 PR ANESTH,GASTROCNEMIUS 1.00 5.00 Anesthesia SURGERY 01480 PR ANESTH,LOWER LEG BONE SURG 1.00 3.00 Anesthesia 01482 PR ANESTH,RADICAL LEG RESECTION 1.00 4.00 Anesthesia 01484 PR ANESTH,LOWER LEG BONE 1.00 4.00 Anesthesia REVISION 01486 PR ANESTH,ANKLE REPLACEMENT 1.00 7.00 Anesthesia 01490 PR ANESTH,LOWER LEG CASTING 1.00 3.00 Anesthesia 01500 PR ANESTH,LOWER LEG ARTERIES 1.00 8.00 Anesthesia SURG 01502 PR ANESTH,LOWER LEG 1.00 6.00 Anesthesia EMBOLECTOMY 01520 PR ANESTH,LOWER LEG VEIN 1.00 3.00 Anesthesia SURG,NOS 01522 PR ANESTH,LOWER LEG VEIN 1.00 5.00 Anesthesia THROMBECTOMY 0159T COMPUTER AIDED BREAST 26 314.0 MRI 0 01610 PR ANESTH,SURGERY OF SHOULDER 1.00 5.00 Anesthesia 01620 PR ANESTH,SHOULDER,CLOSED 1.00 4.00 Anesthesia PROCEDURE 01622 PR ANESTH,DX ARTHROSC 1.00 4.00 Anesthesia PROC,SHOULDER JOINT 01630 PR ANESTH,SHOULDER JOINT,NOS 1.00 5.00 Anesthesia 01634 PR ANESTH,SHOULDER JOINT AMPUT 1.00 9.00 Anesthesia 01636 PR ANESTH,FOREQUARTER AMPUT 1.00 15.00 Anesthesia 01638 PR ANESTH,SHOULDER REPLACEMENT 1.00 10.00 Anesthesia 01650 PR ANESTH,SHOULDER ARTERY 1.00 6.00 Anesthesia SURG,NOS 01652 PR ANESTH,AXILLARY-BRACHIAL 1.00 10.00 Anesthesia ANEURYSM 01654 PR ANESTH,SHLDR VESSEL 1.00 8.00 Anesthesia SURG,BYPASS GRFT 01656 PR ANESTH,AXILL-FEM BYPASS GRFT 1.00 10.00 Anesthesia SURG 01670 PR ANESTH,SHOULDER VEIN SURG 1.00 4.00 Anesthesia 01680 PR ANESTH,SHOULDER CASTING 1.00 3.00 Anesthesia 01682 PR ANESTH,SHOULDER SPICA 1.00 4.00 Anesthesia 01710 PR ANESTH,ELBOW AREA SURGERY 1.00 3.00 Anesthesia 01712 PR ANESTH,UPPERARM TENDON SURG 1.00 5.00 Anesthesia 01714 PR ANESTH,UPPERARM TENDON 1.00 5.00 Anesthesia REVISN SURG 01716 PR ANESTH,BICEPS TENDON REPAIR 1.00 5.00 Anesthesia 01730 PR ANESTH,ARM/ELBOW 1.00 3.00 Anesthesia BONES,CLOSED PROC 01732 PR ANESTH,DX ARTHROSCOPIC PROC 1.00 3.00 Anesthesia ELBOW JOINT 01740 PR ANESTH,ELBOW,NOS 1.00 4.00 Anesthesia 01742 PR ANESTH,HUMERUS SURGERY 1.00 5.00 Anesthesia 01744 PR ANESTH,HUMERUS 1.00 5.00 Anesthesia REPAIR 01756 PR ANESTH,RADICAL HUMERUS SURG 1.00 6.00 Anesthesia 01758 PR ANESTH,HUMERAL LESION SURG 1.00 5.00 Anesthesia 01760 PR ANESTH,ELBOW REPLACEMENT 1.00 7.00 Anesthesia 01770 PR ANESTH,UPPERARM ARTERY SURG 1.00 6.00 Anesthesia 01772 PR ANESTH,UPPERARM EMBOLECTOMY 1.00 6.00 Anesthesia 01780 PR ANESTH,UPPER ARM VEIN SURG 1.00 3.00 Anesthesia 01782 PR ANESTH,UPPER ARM VEIN REPAIR 1.00 4.00 Anesthesia 01810 PR ANESTH,LOWER ARM SURGERY 1.00 3.00 Anesthesia 01820 PR ANESTH,FOREARM BONES,CLOSED 1.00 3.00 Anesthesia PROC 01829 PR ANESTH,DX ARTHROSCOPIC PROC 1.00 3.00 Anesthesia WRIST 01830 PR ANESTH,DISTAL RADIUS/ULNA 1.00 3.00 Anesthesia WRIST/HAND,NOS 01832 PR ANESTH,WRIST REPLACEMENT 1.00 6.00 Anesthesia 01840 PR ANESTH,LOWER ARM ARTERY SURG 1.00 6.00 Anesthesia 01842 PR ANESTH,LOWER ARM 1.00 6.00 Anesthesia EMBOLECTOMY 01844 PR ANESTH,LOWER ARM,VASC SHUNT 1.00 6.00 Anesthesia SURG 0184T PR RECTAL TUMOR EXCISION, 2315. TRANSANAL ENDOSCOPIC 00 MICROSURGICAL, FULL THICK 01850 PR ANESTH,LOWER ARM VEIN SURG 1.00 3.00 Anesthesia 01852 PR ANESTH,LOWER ARM VEIN REPAIR 1.00 4.00 Anesthesia 01860 PR ANESTH,LOWER ARM CASTING 1.00 3.00 Anesthesia 01916 PR ANESTH,DX 1.00 5.00 Anesthesia ARTERIOGRAPHY/VENOGRAPHY 0191T PR ANT SEGMENT INSERTION 2100. DRAINAGE W/O RESERVOIR INT 00 01920 PR ANESTH,CARDIAC CATH W/CORON 1.00 7.00 Anesthesia ART & VENT 01922 PR ANESTH,CAT/MRI SCAN,RADIATN 1.00 7.00 Anesthesia THERAPY 01924 PR ANESTH,INTER RAD,ARTERIAL 1.00 5.00 Anesthesia SYS,NOS 01925 ANESTH,INTER RAD, ARTERIAL, 1.00 7.00 Anesthesia CAROTID/CORONARY 01926 ANESTH,INTER RAD,ARTERIAL, 1.00 8.00 Anesthesia INTRACRA/INTRACAR/AORT 01930 PR ANESTH,INTER RAD,VENOUS/LYMPH 1.00 5.00 Anesthesia SYS,NOS 01931 ANESTH,INTER 1.00 7.00 Anesthesia RAD,VENOUS/LYMPH,INTRAHEPAT/POR TAL CIRC 01932 ANESTH,INTER 1.00 6.00 Anesthesia RAD,VENOUS/LYMPH,INTRATHORACIC/J UGULAR 01933 ANESTH,INTER 1.00 7.00 Anesthesia RAD,VENOUS/LYMPH,INTRACRANIAL 01935 PR ANESTH,PERC IMAGE GUIDE SPINAL 1.00 5.00 Anesthesia PROC, DIAG 01936 PR ANESTH,PERC IMAGE GUIDE SPINAL 1.00 5.00 Anesthesia PROC, THER 01951 PR ANESTH,BURN TX, <4% 1.00 3.00 Anesthesia TBSA 01952 PR ANESTH,BURN TX, 4-9% TBSA 1.00 5.00 Anesthesia 01958 PR ANESTH, ANTEPARTUM MANIPUL 1.00 5.00 Anesthesia 01960 PR ANESTH,VAGINAL DELIVERY ONLY 1.00 5.00 Anesthesia 01961 PR ANESTH,CESAREAN DELIVERY ONLY 1.00 7.00 Anesthesia 01962 PR ANESTH,URG HYSTERECTOMY FOL 1.00 8.00 Anesthesia DELIVERY 01963 PR ANESTH,CESAREAN HYST W/O 1.00 8.00 Anesthesia LABOR ANAL/ANES 01965 PR ANESTH, INCOMP/MISSED AB PROC 1.00 4.00 Anesthesia 01966 PR ANESTH, INDUCED AB PROCEDURE 1.00 4.00 Anesthesia 01967 ANESTH, NEURAXIAL LABOR, PLAN VAG 2500. DEL 00 01968 ANESTH,CES DEL AFTER NEURAXIAL 1.00 2.00 Anesthesia ANESTH 01969 PR ANESTH,CES HYST FOL NEURAXIAL 1.00 5.00 Anesthesia ANAL/ANES 01990 PR PHYS SUPPORT,BRAIN-DEAD 1.00 7.00 Anesthesia ORGAN DONOR 01991 PR ANES DX/THER NRV BLK/NJX 1.00 3.00 Anesthesia OTH/THN PRONE POS 01992 PR ANES DX/THER NERVE 1.00 5.00 Anesthesia BLOCK/INJECTION PRONE POS 01996 PR DAILY MGMT,EPIDUR/SUBARACH 285.0 CONT DRUG ADM 0 01999 PR UNLISTED ANESTH PROCEDURE 1.00 0 Anesthesia 0232T PR INJECT PLATELET RICH PLASMA 187.0 W/IMG HARVEST/PREPARATOIN 0 0234T PR TRANSLUMINAL PERIPHERAL 2012. ATHERECTOMY, RENAL ARTERY 00 0237T PR TRANSLUMINAL PERIPHERAL 1868. ATHERECTOMY, BRACHIOCEPHAL AND 00 BRANCHES, EACH 0238T PR TRANSLUMINAL PERIPHERAL 1877. ATHERECTOMY, ILIAC ARTERY, EACH 00 0253T PR INSERT ANT SGM DRAINAGE DEV 2153. W/O RESERVR INT APPR 00 0254T PR EVASC RPR ILAC ART BIFUR 3412. ENDGRFT CATHJ RS&I UNI 00 0281T PR PERC TRANSCTH CLOSR LT ATRIAL 3574. APPNDGE IMPLNT S&I 00 0296T PR EXT ECG > 48HR TO 21 DAY RCRD 269.0 W/CONECT INTL RCRD 0 0298T PR EXT ECG > 48HR TO 21 DAY REVIEW 133.0 AND INTERPRETATN 0 0346T PR ULTRASOUND ELASTOGRAPHY 276.0 0 0375T PR TOTAL DISC ARTHRP ANT APPR 8709. W/DISCECTOMY CRV 3+ 00 0376T PR ANT SEGMENT INSERT DRAIN W/O 2568. RESERVOIR EA ADDL 00 0379T PR VISUAL FIELD ASSESSMENT TECH 109.0 SUPPORT W/INSTRUCT 0 0387T PR TRANSCATH INSERT OR REPLACE 1124. LEADLESS PM VENTR 00 0389T PR PROG DEVICE EVAL IN PERSON 115.0 LEADLESS PM SYSTEM 0 0389T PR PROG DEVICE EVAL IN 26 115.0 PERSON LEADLESS PM 0 SYSTEM 0391T PR INTERROG DEVICE EVAL IN PERSON 87.00 LEADLESS PM SYST 0397T PR ERCP WITH OPTICAL 1002. ENDOMICROSCOPY ADD ON 00 0398T PR MRGFUS STEREOTACTIC ABLATION 15604 LESION INTRACRANIAL 0399T PR MYOCARDIAL STRAIN IMAGING 513.0 QUAN ASSMT 0 0399T PR MYOCARDIAL STRAIN 26 513.0 IMAGING QUAN ASSMT 0 0438T PR TPRNL PLMT BIODEGRADABLE 764.0 MATRL PERIPROSTATIC 0 0442T PR ABLTJ PERC CRYOABLTJ IMG GDN 450 NRV PLEX/TRNCL NRV 0449T PR INSJ AQUEOUS DRAIN DEV W/O EO 2033. RSVR INITIAL DEV 00 0466T PR INSRT CH WALL RESPIR ELTRD/RA & 1235. CONJ PULSE GEN 00 0474T PR CYPASS GLAUCOMA IMPLANT 2100. 00 0482T PR ABSOLUTE QUAN 26 179.0 MYOCARD BLD FLO PET 0 STRESS & REST 0483T PR TMVI W/PROSTHETIC VALVE 5681. PERCUTANEOUS APPROACH 00 0484T PR TMVI W/PROSTHETIC VALVE 8059. TRANSTHORACIC EXPOSURE 00 0494T PR PREP & CANNULJ CDVR DON LNG 812.0 ORGN PRFUJ SYS 0 0495T PR INIT & MNTR CDVR DON LNG ORGN 7000. PRFUJ SYS 1ST 2 HR 00 0496T PR MNTR CDVR DON LNG ORGN PRFUJ 3500. SYS EA ADDL HR 00 0497T PR XTRNL PT ACT ECG W/O ATTN MNTR 24.00 IN-OFFICE CONN 0498T PR XTRNL PT ACT ECG W/O ATTN MNTR 65.00 R&I PR 30 DAYS 0499T PR CYSTO W/DIL & URTL RX DEL F/URTL 967.0 STRIX/STENOSIS 0 0504T PR COR FFR CTA DATA REVIEW 443 W/INTERPJ & FINAL REPORT 0507T PR NEAR INFRARED DUAL 26 16.00 IMG MEIBOMIAN GLND UNI/BI I&R 0514T PR INTRAOPERATIVE VISUAL AXIS ID 184.0 USING PT FIXATION 0 0537T PR CAR-T THERAPY HRVG BLD DRV T 220 LMPHCYT PR DAY 10004 PR FINE NEEDLE ASPIRATION BX W/O 135.0 IMG GDN EA ADDL 0 10005 PR FINE NEEDLE ASPIRATION BX W/US 324.0 GDN 1ST LESION 0 10006 PR FINE NEEDLE ASPIRATION BX W/US 155.0 GDN EA ADDL 0 10007 PR FINE NEEDLE ASPIRATION BX 729.0 W/FLUOR GDN 1ST LESION 0 10008 PR FINE NEEDLE ASPIRATION BX 411.0 W/FLUOR GDN EA ADDL 0 10009 PR FINE NEEDLE ASPIRATION BX W/CT 1193. GDN 1ST LESION 00 10010 PR FINE NEEDLE ASPIRATION BX W/CT 719.0 GDN EA ADDL 0 10011 PR FINE NEEDLE ASPIRATION BX W/MR 1193. GDN 1ST LESION 00 10012 PR FINE NEEDLE ASPIRATION BX W/MR 719.0 GDN EA ADDL 0 10021 PR FINE NEEDLE ASP;W/O IMAGING 308.0 GUIDANCE 0 10022 PR FINE NEEDLE ASP;W/IMAGING 328.0 GUIDANCE 0 10030 PR IMAGE-GUIDED CATHETER FLUID 1938. COLLECTION DRAINAGE 00 10035 PR PERQ SFT TISS LOC DEVICE PLMT 1359. 1ST LES W/GDNCE 00 10040 PR ACNE SURGERY OF SKIN ABSCESS 253.0 0 10060 PR DRAIN SKIN ABSCESS SIMPLE 286.0 0 10061 PR DRAIN SKIN ABSCESS COMPLIC 507.0 0 10080 PR DRAIN PILONIDAL CYST SIMPL 452.0 0 10081 PR DRAIN PILONIDAL CYST COMPLIC 665.0 0 10120 PR REMOVE FOREIGN BODY SIMPLE 364.0 0 10121 PR REMOVE FOREIGN BODY COMPLIC 687.0 0 10140 PR DRAINAGE OF HEMATOMA/FLUID 410.0 0 10160 PR PUNCTURE DRAINAGE OF LESION 326.0 0 10180 PR COMPLEX DRAINAGE, WOUND 617.0 0 11000 PR DEBRIDEMENT, INFECTED SKIN, UP 131.0 TO 10% BSA 0 11004 PR DEBRIDE NECROTIC SKIN/ TISSUE, 1433. GENIT & PERINM 00 11005 PR DEBRIDE NECROTIC SKIN/ TISSUE, 1940. ABD WALL 00 11006 PR DEBRIDE NECROT SKIN/ TISS, 1739. GENIT,PERI, ADB WALL 00 11008 REMOVE MESH FROM ABD WALL FOR 683.0 0 11010 PR DEBRIDE ASSOC OPEN FX/DISLOC 1412. SKIN/SUBQ 00 11011 PR DEBRIDE ASSOC OPEN FX/DISLOC 1676. SKIN/MUSCLE 00 11012 PR DEBRIDE ASSOC OPEN FX/DISLO 2446. SKIN/MUS/BONE 00 11042 PR DEBRIDEMENT, SKIN, SUB-Q 395.0 TISSUE,=<20 SQ CM 0 11043 PR DEBRIDEMENT, SKIN, SUB-Q 575.0 TISSUE,MUSCLE,=<20 SQ CM 0 11044 PR DEBRIDEMENT, SKIN, SUB-Q 981.0 TISSUE,MUSCLE,BONE,=<20 SQ CM 0 11045 PR DEBRIDEMENT, SKIN, SUB-Q 102.0 TISSUE,EACH ADD 20 SQ CM 0 11046 PR DEBRIDEMENT, SKIN, SUB-Q 183.0 TISSUE,MUSCLE,EACH ADD 20 SQ CM 0 11047 PR DEBRIDEMENT, SKIN, SUB-Q 313.0 TISSUE,MUSCLE,BONE,EACH ADD 20 SQ 0 CM 11055 PR TRIM HYPERKERATOTIC SKIN 119.0 LESION, ONE 0 11056 TRIM BENIGN HYPERKERATOTIC SKIN 141.0 LESION,2-4 0 11057 TRIM BENIGN HYPERKERATOTIC SKIN 167.0 LESION,>4 0 11100 PR BIOPSY OF SKIN LESION 239.0 0 11101 PR BIOPSY, EACH ADDED LESION 74.00 11102 PR TANGENTIAL BIOPSY SKIN SINGLE 253.0 LESION 0 11103 PR TANGENTIAL BIOPSY SKIN EA 137.0 SEP/ADDITIONAL LESION 0 11104 PR PUNCH BIOPSY SKIN SINGLE LESION 318.0 0 11105 PR PUNCH BIOPSY SKIN EA 156.0 SEP/ADDITIONAL LESION 0 11106 PR INCISIONAL BIOPSY SKIN SINGLE 384.0 LESION 0 11107 PR INCISIONAL BIOPSY SKIN EA 184.0 SEP/ADDITIONAL LESION 0 11200 PR REMOVAL OF SKIN TAGS, UP TO 15 226.0 0 11201 PR REMOVAL OF SKIN TAGS, EACH ADD 56.00 10 11300 PR SHAV SKIN LES <5MM 225.0 TRUNK,ARM,LEG 0 11301 PR SHAV SKIN LES 6-10MM 276.0 TRUNK,ARM,LEG 0 11302 PR SHAV SKIN LES 11-20MM 326.0 TRUNK,ARM,LEG 0 11303 PR SHAV SKIN LES >21MM 358.0 TRUNK,ARM,LEG 0 11305 PR SHAV SKIN LES <5MM REMAINDR 226.0 BODY 0 11306 PR SHAV SKIN LES 6-10MM REMAINDR 279.0 BODY 0 11307 PR SHAV SKIN LES 11-20MM REMAINDR 330.0 BODY 0 11308 PR SHAV SKIN LES >21MM REMAINDR 350.0 BODY 0 11310 PR SHAV SKIN LES <5MM FACE,FACIAL 262.0 0 11311 PR SHAV SKIN LES 6-10MM FACE,FACIAL 255.0 0 11312 PR SHAV SKIN LES 11-20MM 398.0 FACE,FACIAL 0 11313 PR SHAV SKIN LES >21MM FACE,FACIAL 443.0 0 11400 PR EXC SKIN BENIG <5MM 285.0 TRUNK,ARM,LEG 0 11401 PR EXC SKIN BENIG 0.6-1CM 342.0 TRUNK,ARM,LEG 0 11402 PR EXC SKIN BENIG 1.1-2CM 380.0 TRUNK,ARM,LEG 0 11403 PR EXC SKIN BENIG 2.1-3CM 475.0 TRUNK,ARM,LEG 0 11404 PR EXC SKIN BENIG 3.1-4CM 528.0 TRUNK,ARM,LEG 0 11406 PR EXC SKIN BENIG >4CM 764.0 TRUNK,ARM,LEG 0 11420 PR EXC SKIN BENIG <5MM REMAINDR 307.0 BODY 0 11421 PR EXC SKIN BENIG 0.6-1CM REMAINDR 361.0 BODY 0 11422 PR EXC SKIN BENIG 1.1-2CM REMAINDR 401.0 BODY 0 11423 PR EXC SKIN BENIG 2.1-3CM REMAINDR 462.0 BODY 0 11424 PR EXC SKIN BENIG 3.1-4CM REMAINDR 530.0 BODY 0 11426 PR EXC SKIN BENIG >4CM REMAINDR 682.0 BODY 0 11440 PR EXC SKIN BENIG <5MM FACE,FACIAL 334.0 0 11441 PR EXC SKIN BENIG 0.6-1CM 395.0 FACE,FACIAL 0 11442 PR EXC SKIN BENIG 1.1-2CM 455.0 FACE,FACIAL 0 11443 PR EXC SKIN BENIG 2.1-3CM 543.0 FACE,FACIAL 0 11444 PR EXC SKIN BENIG 3.1-4CM 1086. FACE,FACIAL 00 11446 PR EXC SKIN BENIG >4CM FACE,FACIAL 807.0 0 11450 PR EXC SWEAT GLAND LESN 810.0 AXILL,SIMPL 0 11451 PR EXC SWEAT GLAND LESN 989.0 AXILL,COMPLX 0 11462 PR EXC SWEAT GLAND LESN 900.0 INGUIN,SIMPL 0 11463 PR EXC SWEAT GLAND LESN 1192. INGUIN,COMPLX 00 11470 PR EXC SWEAT GLAND LESN 985.0 PERINEAL,SIMPL 0 11471 PR EXC SWEAT GLAND LESN 1302 PERINEAL,COMPLX 1158F PR ADVANCE CARE PLANNING DISCUSS 0.00 DOCUMENTED IN MEDICAL RECORD 11600 PR EXC SKIN MALIG <5MM 466.0 TRUNK,ARM,LEG 0 11601 PR EXC SKIN MALIG 0.6-1CM 523.0 TRUNK,ARM,LEG 0 11602 PR EXC SKIN MALIG 1.1-2CM 568.0 TRUNK,ARM,LEG 0 11603 PR EXC SKIN MALIG 2.1-3CM 645.0 TRUNK,ARM,LEG 0 11604 PR EXC SKIN MALIG 3.1-4CM 718.0 TRUNK,ARM,LEG 0 11606 PR EXC SKIN MALIG >4CM 1095. TRUNK,ARM,LEG 00 11620 PR EXC SKIN MALIG <5MM REMAINDR 360.0 BODY 0 11621 PR EXC SKIN MALIG 0.6-1CM REMAINDR 527.0 BODY 0 11622 PR EXC SKIN MALIG 1.1-2CM REMAINDR 587.0 BODY 0 11623 PR EXC SKIN MALIG 2.1-3CM REMAINDR 735.0 BODY 0 11624 PR EXC SKIN MALIG 3.1-4CM REMAINDR 829.0 BODY 0 11626 PR EXC SKIN MALIG >4CM REMAINDR 982.0 BODY 0 11640 PR EXC SKIN MALIG <5MM FACE,FACIAL 485.0 0 11641 PR EXC SKIN MALIG 0.6-1CM 545.0 FACE,FACIAL 0 11642 PR EXC SKIN MALIG 1.1-2CM 621.0 FACE,FACIAL 0 11643 PR EXC SKIN MALIG 2.1-3CM 681.0 FACE,FACIAL 0 11644 PR EXC SKIN MALIG 3.1-4CM 1189. FACE,FACIAL 00 11646 PR EXC SKIN MALIG >4CM FACE,FACIAL 1225. 00 11719 PR TRIM NAIL(S) 52.00 11720 PR DEBRIDEMENT OF NAIL(S), 1-5 75.00 11721 PR DEBRIDEMENT OF NAILS, 6 OR 103.0 MORE 0 11730 PR REMOVAL OF NAIL PLATE 240.0 0 11732 PR REMOVE ADDITIONAL NAIL PLATE 89.00 11740 PR DRAIN BLOOD FROM UNDER NAIL 123.0 0 11750 PR REMOVAL OF NAIL BED 529.0 0 11752 PR REMOVE NAIL BED/FINGER TIP 680.0 0 11755 PR BIOPSY, NAIL UNIT (SEP PROC) 309.0 0 11760 PR RECONSTRUC OF NAIL 539.0 BED 0 11762 PR RECONSTRUC OF NAIL BED W 684.0 GRAFT 0 11765 PR EXCISION OF NAIL FOLD, TOE 405.0 0 11770 PR REMV PILONIDAL LESION SIMPLE 694.0 0 11771 PR REMV PILONIDAL LESION EXTENS 1112. 00 11772 PR REMV PILONIDAL LESION COMPLIC 1738. 00 11900 INJECTION INTO SKIN LESIONS, UP TO 7 139.0 0 11901 INJECTION INTO SKIN LESIONS, 8 OR 174.0 MORE 0 11920 PR CORRECT SKIN COLR DEFCT <6SQ 495.0 CM 0 11950 PR FILL CONTOUR DEFCT 195.0 <1CC 0 11951 PR FILL CONTOUR DEFCT 1.1-5CC 251.0 0 11952 PR FILL CONTOUR DEFCT 5.1-10CC 330.0 0 11954 PR FILL CONTOUR DEFCT >10CC 605.0 0 11960 PR INSERT TISSUE EXPANDER(S) 2415. 00 11970 PR REPLACE TISSUE EXPANDER 2680. 00 11971 PR REMOVE TISSUE EXPANDER(S) 1029. 00 11976 PR REMOVAL OF CONTRACEPTIVE 341.0 CAPSUL 0 11980 PR 244.0 IMPLANT,HORMONE,SUBCUTANEOUS 0 11981 PR INSERTION DRUG IMPLANT DEVICE 329.0 0 11982 PR REMOVAL DRUG IMPLANT DEVICE 371.0 0 11983 PR REMOVAL W/ REINSERT DRUG 519.0 IMPLANT DEVICE 0 12001 PR REPR SUPERF WND BODY <2.5CM 282.0 0 12002 PR REPR SUP NPTERF WND BODY 2.6- 300.0 7.5 0 12004 PR REPR SUPERF WND BODY 7.6-12.5 351.0 0 12005 PR REPR SUPERF WND BODY 12.6-20 538.0 0 12006 PR REPR SUPERF WND BODY 20.1-30 537.0 0 12011 PR REPR SUPERF WND FACE <2.5CM 298.0 0 12013 PR REPR SUPERF WND FACE 2.6-5 327.0 0 12014 PR REPR SUPERF WND FACE 5.1-7.5 387.0 0 12015 PR REPR SUPERF WND FACE 7.6-12.5 598.0 0 12016 PR REPR SUPERF WND FACE 12.6-20 709.0 0 12018 PR REPR SUPERF WND FACE >30CM 470.0 0 12020 PR CLOSURE SUPERF WND DEHIS 704.0 SIMPLE 0 12021 PR CLOSURE SUPERF WND DEHIS W 327.0 PACKING 0 12031 PR LAYR CLOS WND TRUNK,ARM,LEG 547.0 <2.5 CM 0 12032 PR LAYR CLOS WND TRUNK,ARM,LEG 698.0 2.6-7.5 CM 0 12034 PR LAYR CLOS WND TRUNK,ARM,LEG 714.0 7.6-12.5 CM 0 12035 PR LAYR CLOS WND TRUNK,ARM,LEG 807.0 12.6-20 CM 0 12036 PR LAYR CLOS WND TRUNK,ARM,LEG 906.0 20.1-30 CM 0 12037 PR LAYR CLOS WND 1018. TRUNK,ARM,LEG >30 CM 00 12041 PR LAYR CLOS WND REST BODY <2.5 576.0 CM 0 12042 PR LAYR CLOS WND REST BODY 2.6-7.5 660.0 CM 0 12044 PR LAYR CLOS WND REST BODY 7.6- 599.0 12.5 CM 0 12045 PR LAYR CLOS WND REST BODY 12.6-20 763.0 CM 0 12046 PR LAYR CLOS WND REST BODY 20.1-30 1189. CM 00 12047 PR LAYR CLOS WND REST BODY >30 CM 1375. 00 12051 PR LAYR CLOS WND FACE,FACIAL <2.5 625.0 CM 0 12052 PR LAYR CLOS WND FACE,FACIAL 2.5-5 673.0 CM 0 12053 PR LAYR CLOS WND FACE,FACIAL 5.1- 779.0 7.5 CM 0 12054 PR LAYR CLOS WND FACE,FACIAL 7.6- 873.0 12.5 CM 0 12055 PR LAYR CLOS WND FACE,FACIAL 12.6- 1805. 20 CM 00 12056 PR LAYR CLOS WND FACE,FACIAL 20.1- 1325. 30 CM 00 12057 PR LAYR CLOS WND FACE,FACIAL >30 1506 CM 13100 PR REPR CMPL WND TRUNK 1.1-2.5CM 671.0 0 13101 PR REPR CMPL WND TRUNK 2.6-7.5CM 993.0 0 13102 PR REP,SKIN,TRUNK,CMPLX,+5CM/< 400.0 0 13120 PR REPR CMPL WND SCALP,EXTR 1.1- 697.0 2.5 0 13121 PR REPR CMPL WND SCALP,EXTR 2.6- 1006. 7.5 00 13122 PR REP,SKIN,SCALP/EXTREM+5CM/< 600.0 0 13131 PR REPR CMPL WND HEAD,FAC,HAND 967.0 1.1-2.5 0 13132 PR REPR CMPL WND HEAD,FAC,HAND 1315. 2.6-7.5 00 13133 PR REP,FACE,GENITAL,HAND,FT+5CM/< 800.0 0 13151 PR REPR CMPL WND LID,NOS,EAR 1.1- 963.0 2.5 0 13152 PR REPR CMPL WND LID,NOS,EAR 2.5- 1271. 7.5 00 13153 PR REP,EYELID,NOSE,EAR,LIP+5CM 636.0 0 13160 PR SECD CLOS SURG WND 2169. EXTEN/COMPLIC 00 14000 PR ADJ TISS XFER TRUNK <10SQCM 1311. 00 14001 PR ADJ TISS XFER TRUNK 10.1-30 1710. 00 14020 PR ADJ TISS XFER SCALP,EXTREM 1516. <10SQCM 00 14021 PR ADJ TISS XFER SCALP,EXTREM 10.1- 2190. 30 00 14040 PR ADJ TISS XFER HEAD,FAC,HAND 2855. <10SQCM 00 14041 PR ADJ TISS XFER HEAD,FAC,HAND 2748. 10.1-30 00 14060 PR ADJ TISS XFER LID,NOS,EAR 1992. <10SQCM 00 14061 PR ADJ TISS XFER LID,NOS,EAR 10.1-30 3326. 00 14301 PR ADJ TISS XFER ANY AREA,30.1-60 3749. SQCM 00 14302 PR ADJ TISS XFER ANY AREA,EA ADD 854.0 30.0 SQCM 0 14350 PR FILLET FINGR/TOE FLAP W PREP 2220. 00 15002 PR WOUND PREP, PED, TRK/ARM/LG 950.0 1ST 100 CM 0 15003 PR WOUND PREP, PED, TRK/ARM/LG 425.0 ADDL 100 CM 0 15004 PR WND PREP PED, 1050. FACE/NCK/HND/FT/GEN 00 15005 PR WND PREP,PED, 500.0 FACE/NCK/HND/FT/GEN ADD 100 CM 0 15040 PR SKIN GRAFT, HARVEST CULTURED 632.0 TISSUE 0 15050 PR SKIN PINCH GRAFT PROCEDURE 1052. <2CM 00 15100 PR SPLIT GRFT TRUNK,ARM,LEG 2045. <100SQCM 00 15101 PR SPLIT GRFT,TRUNK,ARM,LEG EA 508.0 100SQCM 0 15120 PR SPLIT GRFT,HEAD,FAC,HAND,FEET 2500. <100SQCM 00 15121 PR SPLIT GRFT,HEAD,FAC,HAND,FEET 730.0 EA 100SQCM 0 15200 PR FULL THICK GRFT TRUNK <20 SQCM 1650. 00 15201 PR FULL THICK GRFT TRUNK ADD 20 363.0 SQCM 0 15220 PR FULL THICK GRFT SCALP,ARM,LEG 1760. <20SQC 00 15221 PR FULL THICK GRFT SCALP,ARM ADD 450.0 20 SQCM 0 15240 PR FULL THICK GRFT HEAD,FAC,HAND 2270. <20SQC 00 15241 PR FULL THICK GRFT HEAD,FAC,HA ADD 715.0 20SQ 0 15260 PR FULL THICK GRFT NOS,EAR,LID 2463. <20SQCM 00 15261 PR FULL THICK GRFT NOS,EAR,LID ADD 1180. 20SQ 00 15271 PR APP SKN SUB GRFT T/A/L 350.0 AREA/<100SCM /<1ST 25 SCM 0 15272 PR APP SKN SUB GRFT T/A/L 68.00 AREA/<100SCM EA ADL 25SCM 15273 PR APP SKN SUB GRFT T/A/L 1001. AREA/>100SCM 1ST 100SCM 00 15274 PR APP SKN SUB GRFT T/A/L 237.0 AREA/>100SCM ADL 100SCM 0 15275 PR SUB GRFT F/S/N/H/F/G/M/D /<100SCM 377.0 /<1ST 25 SCM 0 15276 PR SUB GRFT F/S/N/H/F/G/M/D /<100SCM 85.00 EA ADL 25SCM 15277 PR SUB GRFT F/S/N/H/F/G/M/D />100SCM 821.0 1ST 100SCM 0 15278 PR SUB GRFT F/S/N/H/F/G/M/D />100SCM 215.0 ADL 100SCM 0 15570 PR FORM SKIN PEDICLE FLAP TRUNK 3230. 00 15572 PR FORM SKIN PEDICLE FLAP 3100. SCALP,ARM,LEG 00 15574 PR FORM SKIN PEDICLE FLAP 1950. FACE,GEN,HAND 00 15576 PR FORM SKIN PEDICLE FLAP 2205. LID,EAR,NOSE 00 15600 PR DELAY/SECTN FLAP 895.0 TRUNK 0 15610 PR DELAY/SECTN FLAP SCALP,ARM,LEG 894.0 0 15620 PR DELAY/SECTN FLAP 990.0 FACE,GENIT,HAND,FT 0 15630 PR DELAY/SECTN FLAP LID,NOS,EAR,LIP 1050. 00 15650 PR TRANSFER SKIN PEDICLE FLAP 1270. 00 15730 PR MIDFACE FLAP W/PRESERVATION 5573. OF VASCULAR PEDICLES 00 15731 PR FOREHEAD FLAP W/VASC PEDICLE 3966. 00 15732 PR MUSCLE-SKIN FLAP,HEAD/NECK 4529. 00 15733 PR MUSC MYOQ/FSCQ FLAP 3801. HEAD&NECK W/NAMED VASC PEDCL 00 15734 PR MUSCLE-SKIN 5667. FLAP,TRUNK 00 15736 PR MUSCLE-SKIN FLAP,ARM 4609. 00 15738 PR MUSCLE-SKIN FLAP,LEG 4812. 00 15740 PR FLAP ISLAND PEDICLE ANATOMIC 3519. NAMED AXIAL ARTERY 00 15750 PR NEUROVASCULAR PEDICLE GRAFT 3255. 00 15756 PR FREE MUSC-SKIN FLAP 8527. W/MICROVASC ANAST 00 15757 PR FREE SKIN FLAP W MICROVASC 8329. ANAST 00 15760 PR COMPOSITE SKIN GRAFT 2378. 00 15770 PR DERMA-FAT- 2145. GRAFT 00 15777 PR IMPLNT BIO IMPLNT FOR SOFT 531.0 TISSUE REINFORCEMENT 0 15780 PR DERMABRAS RX SKIN TOTAL FACE 2100. 00 15781 PR DERMABRAS RX SKIN SGMENT FACE 1349. 00 15782 PR DERMABRAS RX SKIN REGIONAL 1548 15786 PR ABRASION SINGLE LESION 616.0 0 15787 PR ABRASION, EACH ADDN 4 OR LESS 124.0 0 15788 PR CHEM PEEL, FACE, 803.0 EPIDERM 0 15789 PR CHEM PEEL, FACE, 1400. DERMAL 00 15819 PR , NECK 3185. 00 15820 PR REVISION OF LOWER 1130. EYELID 00 15821 PR REV LOWER EYELID EXTEN FAT PAD 1617. 00 15822 PR REVISION OF UPPER 1119. EYELID 00 15823 PR REV UPPER EYELID W EXCESS SKIN 1560. 00 15824 PR REMOVAL OF FOREHEAD WRINKLES 2647. 00 15825 PR REMOV NECK WRINKLES W PLTSY 4402. TIGHT 00 15828 PR REML OF CHEEK,CHIN,NECK 5045. WRINKLES 00 15829 PR REMOVAL OF SKIN WRINKLES 8777. 00 15830 PR EXCISE EXCESS SKIN 3550. TISSUE,ABDOMEN 00 15832 PR EXCISE EXCESS SKIN TISSUE,THIGH 2700. 00 15833 PR EXCISE EXCESS SKIN TISSUE,LEG 3030. 00 15834 PR EXCISE EXCESS SKIN TISSUE,HIP 3146. 00 15835 PR EXCISE EXCESS SKIN 3237. TISSUE,BUTTOCK 00 15836 PR EXCISE EXCESS SKIN TISSUE,ARM 1560. 00 15839 PR EXCISE EXCESS SKIN 1738. TISSUE,OTHER 00 15840 PR GRAFT FACE N PALSY,FREE FASCIA 3564. 00 15841 PR GRAFT FACE N PALSY,FREE 5000. MUSCLE 00 15845 PR GRAFT FACE N PALSY,REGN MUSC 3565. XFER 00 15847 PR EXCISE EXCESS SKIN 1250. TISSUE,ABDOMEN, ADD-ON 00 15850 PR REM SUTURES W ANESTH SAME 222.0 SURGEON 0 15851 PR REM SUTURES W ANESTH OTHR 895.0 SURGEON 0 15852 PR DRESSING CHANGE,NOT FOR BURN 119.0 0 15860 PR IV INJ TO TEST BLOOD FLOW IN 450.0 FLAP/GRAFT 0 15876 PR SUCT ASSIS LIPECTOMY,HEAD/NECK 1406. 00 15877 PR SUCT ASSIS LIPECTOMY,TRUNK 1150. 00 15878 PR SUCT ASSIS LIPECTOMY,UP EXTREM 920.0 0 15879 PR SUCT ASSIS LIPECTOMY,LOW 1933. EXTREM 00 15920 PR EXC COCCYX/ULCER W SUTURE 1537. 00 15931 PR EXC SACR PRESS ULC W PRI 1687. SUTURE 00 15933 PR EXC SACR PRESS ULC BONE & 2486. SUTURE 00 15934 PR EXC SACR PRESS ULC W FLAP CLOS 3374 15935 PR EXC SACR PRESS ULC BONE & FLAP 2910. CLO 00 15936 PR EXC SACR PRESS ULC W MUSC 2797. FLAP CLO 00 15937 PR EXC SACR PRESS ULC BONE/W 3668. MUSC FLAP 00 15940 PR EXC ISCH PRES ULC W PRIM CLOS 1721. 00 15946 PR EXC ISCH PRES ULC BONE MYOCUT 6622. FLAP 00 15950 PR EXC TROC PRES ULC W PRIM CLOS 1251. 00 15956 PR EXC TROC PRES ULC W MYOCUT 4067. FLAP 00 15958 PR EXC TROC PRES ULC BONE MYOCUT 3596. FLAP 00 16020 PR DRESS/DEBRID SMALL BURN NO 198.0 ANES 0 16025 PR DRESS/DEBRID MED BURN NO 370.0 ANESTH 0 16030 PR DRESS/DEBRID LARGE BURN NO 466.0 ANESTH 0 16035 PR ESCHAROTOMY 895.0 0 16036 PR INCISION OF BURN SCAB, EACH 207.0 ADDNTL 0 17000 PR DESTRUC PREMALIGNANT, FIRST 187.0 LESION 0 17003 PR DESTRUC PREMALIGNANT,2-14 24.00 LESIONS 17004 PR DESTRUC PREMALIGNANT,15+ 402.0 LESIONS 0 17106 PR DESTRUC CUT/VASC <10SQ CM 889 17107 PR DESTRUC CUT/VASC 10-50 SQ CM 1130 17108 PR DESTRUC CUT/VASC >50 SQ CM 1666 17110 PR DESTRUCTION BENIGN LESIONS UP 257.0 TO 14 0 17111 DESTRUCTION BENIGN LESIONS 15 OR 304.0 MORE 0 17250 PR CHEMICAL CAUTERIZATION OF 175.0 GRANULATION TISSUE 0 17260 PR DESTR MALIG TRUNK,EXTREM <0.6 215.0 CM 0 17261 PR DESTR MALIG TRUNK,EXTREM 0.6-1 331.0 CM 0 17262 PR DESTR MALIG TRUNK,EXTREM 1.1-2 401.0 CM 0 17263 PR DESTR MALIG TRUNK,EXTREM 2.1-3 437.0 CM 0 17264 PR DESTR MALIG TRUNK,EXTREM 3.1-4 469.0 CM 0 17266 PR DESTR MALIG TRUNK,EXTREM >4.0 530.0 CM 0 17270 PR DESTR MALIG SCAL,NCK,HAND <0.6 346.0 CM 0 17271 PR DESTR MALIG SCAL,NCK,HAND 0.6-1 375.0 CM 0 17272 PR DESTR MALIG SCAL,NCK,HAND 1.1-2 426.0 CM 0 17273 PR DESTR MALIG SCAL,NCK,HAND 2.1-3 516.0 CM 0 17274 PR DESTR MALIG SCAL,NCK,HAND 3.1-4 617.0 CM 0 17276 PR DESTR MALIG SCAL,NCK,HAND >4 647.0 CM 0 17280 PR DESTR MALIG FACE,NOSE,LIP <0.6 350.0 CM 0 17281 PR DESTR MALIG FACE,NOSE,LIP 0.6-1 407.0 CM 0 17282 PR DESTR MALIG FACE,NOSE,LIP 1.1-2 466.0 CM 0 17283 PR DESTR MALIG FACE,NOSE,LIP 2.1-3 614.0 CM 0 17284 PR DESTR MALIG FACE,NOSE,LIP 3.1-4 702.0 CM 0 17286 PR DESTR MALIG FACE,NOSE,LIP >4CM 899.0 0 17311 PR MOHS, 1 STAGE, 2416. HEAD/NECK/HAND/FEET/GENTIAL 00 17312 PR MOHS, ADDL STAGE, 963.0 HEAD/NECK/HAND/FEET/GENTIAL 0 17313 PR MOHS, 1 STAGE, TRUNK/ARM/LEG 1531. 00 17314 PR MOHS, ADDL STAGE, 924.0 TRUNK/ARM/LEG 0 17315 PR MOHS SURG, ADDL BLOCK 198.0 0 17340 PR CRYOTHERAPY ACNE 130.0 0 17380 PR HAIR REMOV ELECTROLYSIS EA 30 190.0 MIN 0 19000 PR PUNC/ASPIR BREAST 250.0 CYST 0 19001 PR PUCT/ASPIR BREAST CYST,EACH 77.00 ADDN 19020 PR EXPLO/DRAIN BREAST ABSCESS 927.0 0 19030 PR INJECT 382.0 DUCTOGRAM/GALACTOGRAM 0 19081 PR BX BREAST W DEVICE 1ST LESION 1664. STEREOTACTIC GUIDE 00 19082 PR BX BREAST W DEVICE ADDL LESION 1349. STEREOTACT GUIDE 00 19083 PR BX BREAST W DEVICE 1ST LESION 1654. ULTRASOUND GUIDE 00 19084 PR BX BREAST W DEVICE ADDL LESION 1331. ULTRASOUND GUIDE 00 19085 PR BX BREAST W DEVICE 1ST LESION 2505. MAGNETIC RES GUIDE 00 19086 PR BX BREAST W DEVICE ADDL LESION 2005. MAGNET RES GUIDE 00 19100 PR BIOPSY OF BREAST, NEEDLE CORE 344.0 0 19101 PR BIOPSY OF BREAST, INCISIONAL 861.0 0 19110 PR NIPPLE EXPLORATION 1153. 00 19112 PR EXCISE BREAST DUCT FISTULA 880.0 0 19120 PR REMOVAL OF BREAST LESION 1239. 00 19125 PR EXCISE BREAST LES W XRAY 1373. MARKER 00 19126 PR EXCISE BREAST LES XRAY MARK 367.0 ADDNL 0 19260 PR EXCIS CHEST WALL TUMOR/RIBS 3164. 00 19271 PR EXCIS CHEST WALL TUM W RECON 3906. 00 19272 PR EXTENSIVE CHEST WALL SURGERY 3807. 00 19281 PR PERQ DEVICE PLACEMT BREAST 603.0 LOC 1ST LES W GUIDNCE 0 19282 PR PERQ DEVICE PLACEMT BREAST 420.0 LOC EA LES W GUIDNCE 0 19283 PR PERQ BREAST LOC DEVICE 685.0 PLACEMT 1ST STRTCTC GUID 0 19285 PR PERQ BREAST LOC DEVICE 1157. PLACEMT 1ST LESIO US IMAG 00 19286 PR PERQ BREAST LOC DEVICE 971.0 PLACEMT EACH LES US IMAGE 0 19287 PR PERQ BREAST LOC DEVICE 2138. PLACEMT 1ST LESIO MR GUID 00 19288 PR PERQ BREAST LOC DEVICE 1752. PLACEMT ADD LESIO MR GUID 00 19294 PR PREP TUMOR CAVITY IORT 425.0 W/PARTIAL MASTECTOMY 0 19296 PR PLACE POSTOP BREAST CATH FOR 9315. RAD 00 19297 PR PLACE INTRAOP BREAST CATH FOR 244.0 RAD 0 19300 PR MASTECTOMY FOR GYNECOMASTIA 1400. 00 19301 PR MASTECTOMY, PARTIAL 2306. 00 19302 PR MASTECTOMY,PARTIAL, WITH 2182. AXILLARY LYMPHADENECTOMY 00 19303 PR MASTECTOMY, SIMPLE, COMPLETE 3574. 00 19304 PR MASTECTOMY, SUBCUTANEOUS 1456. 00 19305 PR MASTECTOMY, RADICAL 3996. 00 19307 PR MASTECTOMY, MODIFIED RADICAL 4231. 00 19316 PR SUSPENSION OF BREAST 2474. 00 19318 PR REDUCTION OF LARGE BREAST 3681. 00 19325 PR ENLARGE BREAST WITH IMPLANT 1627. 00 19328 PR REMOVAL OF BREAST IMPLANT 1254. 00 19330 PR REMOVAL OF IMPLANT MATERIAL 1605. 00 19340 PR INSERT BREAST PROS IMMED 3563. AFTER EXCIS 00 19342 PR DELAY BREAST PROS AFTER 3274. BREAST SURG 00 19350 PR NIPPLE/AREOLA RECONSTRUCTION 2152. 00 19357 PR BREAST RECONSTRUC W TISS 5689. EXPANDR 00 19361 PR BREAST RECONSTRUC W FREE 6255. FLAP, W/O IMPLANT 00 19364 PR BREAST RECONSTRUC W FREE 10447.00 FLAP 19366 PR BREAST RECONSTRUC W OTHR 5727. TECHNIQ 00 19367 PR BREAST RECONSTRUCT W TRAM 1 6617. PEDICL 00 19368 PR BREAST RECONSTRUCT W TRAM 8963. UVASC ANAS 00 19370 PR SURGERY OF BREAST CAPSULE 1739. 00 19371 PR REMOVAL OF BREAST CAPSULE 2782. 00 19380 PR REVISE BREAST RECONSTRUCTION 2745. 00 20005 PR I&D ABSCESS 1216. SUBFASCIAL 00 20100 PR EXPLORE WOUND,NECK 1817. 00 20101 PR EXPLORE WOUND,CHEST 858.0 0 20102 PR EXPLORE 1007. WOUND,ABDOMEN/FLANK/BACK 00 20103 PR EXPLORE WOUND,EXTREMITY 1465. 00 20150 PR EXCISION OF EPIPHYSEAL BAR 2753. 00 20200 PR 520.0 0 20205 PR DEEP MUSCLE BIOPSY 644.0 0 20206 PR NEEDLE BIOPSY,MUSCLE 635.0 0 20220 PR BONE BIOPSY,TROCAR/NEEDLE 476.0 SUPERF 0 20225 PR BONE BIOPSY,TROCAR/NEEDLE 2089. DEEP 00 20240 PR BIOPSY BONE OPEN SUPERFICIAL 770.0 0 20245 PR BIOPSY BONE OPEN DEEP 1389. 00 20250 PR OPEN BONE BIOP VERT DORSAL 1255. 00 20251 PR OPEN BONE BIOP VERT LUMB/CERV 1075. 00 20500 PR INJECT SINUS TRACT THERAPEUTIC 260.0 0 20501 PR INJECT SINUS TRACT FOR DX W 312.0 XRAY 0 20520 PR REMOVAL OF FOREIGN BODY 533.0 0 20525 PR REMOVAL OF FOREIGN BODY 1167. DEEP/COMPLIC 00 20526 PR INJECT CARPAL TUNNEL 247.0 0 20527 PR INJECTION ENZYME PALMAR 186.0 FASCIAL CORD 0 20550 PR INJECT TENDON SHEATH/LIGAMENT 190.0 0 20551 PR INJECT TENDON ORIGIN/INSERT 187.0 0 20552 PR INJECT TRIGGER POINT, 1 OR 2 200.0 0 20553 PR INJECT TRIGGER POINTS, > 3 231.0 0 20600 PR ARTHROCENTESIS ASPIR&/INJ 121.0 SMALL JT/BURSA W/O US 0 20604 PR ARTHROCNT ASPIR&/INJ SMALL 179.0 JT/BURSAW/US REC RPRT 0 20605 PR ARTHROCENTESIS ASPIR&/INJ 141.0 INTERM JT/BURS W/O US 0 20605 PR ARTHROCENTESIS 26 474.0 ASPIR&/INJ INTERM JT/BURS 0 W/O US 20606 PR ARTHROCENTESIS ASPIR&/INJ 196.0 INTERM JT/BURS W/US 0 20610 PR ARTHROCENTESIS ASPIR&/INJ 226.0 MAJOR JT/BURSA W/O US 0 20611 PR ARTHROCENTESIS ASPIR&/INJ 229.0 MAJOR JT/BURSA W/US 0 20612 PR ASPIRAT/INJECTION GANGLION 184.0 CYST(S) 0 20615 PR ASPIR/INJEC BONE CYST 607.0 0 20650 PR INSERT AND REMOVE BONE PIN 613.0 0 20660 PR APPLY/REMOVE CRANIAL FIX DEV 875 20661 PR APPLY/REMOVE HALO CRANIAL 1274. 00 20664 PR APPLY HALO 6/> PINS THIN SKULL 3106. OSTEOLOGY 00 20670 PR REMOVAL SUPERFICIAL IMPLANT 986.0 0 20680 PR REMOVAL DEEP IMPLANT 1987. 00 20690 PR APPLY BONE UNIPLANE,EXT FIX DEV 1507. 00 20692 PR APPLY BONE MULTIPLAN,EXT FIX 2786. DEV 00 20693 PR ADJUST EXTERN BONE FIX DEV W 1517. ANESTH 00 20694 PR REMOVE EXTERN BONE FIX DEV W 1432. ANESTH 00 20696 PR COMP ASSIST MULTIPLANE EXT 4285. FIXATION, INITIAL 00 20816 PR DIGIT MCP, 10610.00 COMPLETE 20822 PR REPLANTATION DIGIT DISTAL, 9144. COMPLT 00 20824 PR REPLANTATION THUMB MCP, 7949. COMPLETE 00 20827 PR REPLANTATION THUMB 7474. DISTAL,COMPLETE 00 20900 PR REMV BONE FOR GRAFT MINOR 1204. 00 20902 PR REMV BONE FOR GRAFT MAJOR 1917. 00 20910 PR REMV CARTILAGE FOR GRAFT 1145. COSTOCH 00 20912 PR REMV CARTILAGE FOR GRAFT 1208. NASAL 00 20922 PR REMV FASCIA FOR GRAFT INCIS 1490. 00 20924 PR REMV TENDON FOR 1642. GRAFT 00 20926 PR REMV TISSUE FOR GRAFT OTHR 1050. 00 20930 PR ALLOGRAFT FOR SPINE SURGERY 624.0 ONLY MORSELIZED 0 20931 PR ALLOGRAFT FOR SPINE SURGERY 573.0 ONLY STRUCTURAL 0 20932 PR OSTEOARTICULAR ALLOGRAFT 2591. W/ARTICULAR SURF & BONE 00 20933 PR HEMICORTICAL INTERCALARY 2377. ALLOGRAFT PARTIAL 00 20934 PR INTERCALARY ALLOGRAFT 2590. COMPLETE 00 20936 AUTOGRAFT SPINE SURGERY LOCAL 414.0 FROM SAME INCISION 0 20937 AUTOGRAFT SPINE SURGERY 858.0 MORSELIZED SEP INCISION 0 20938 AUTOGRAFT SPINE SURGERY 956.0 BICORT/TRICORT SEP INCISION 0 20939 PR BONE MARROW ASPIRATION BONE 350.0 GRFG SPI SURG ONLY 0 20950 PR RECORD FLUID PRESSURE,MUSCLE 669.0 0 20955 PR MICROVASCULAR FIBULA GRAFT 10198 20956 PR MICROVASCULAR ILIAC CREST 10821.00 GRAFT 20962 PR MICROVASCULAR BONE 9530. GRAFT,OTHER 00 20969 PR BONE-SKIN GRAFT, 11239.00 MICROVASCULAR 20975 PR ELECT BONE STIM 425.0 INVASIVE 0 20982 PR ABLATION BONE TUMOR RF PERQ 9739. W/IMG GDN WHEN DONE 00 20983 PR ABLATJ BONE TUMOR CRYO PERQ 1007 W/IMG GDN WHEN PRFMD 20985 PR CPTR-ASST SURGICAL NAVIGATION 640.0 IMAGE-LESS 0 21011 PR EXCISION TUMOR SOFT TISS 853.0 FACE/SCALP SUBQ < 2CM 0 21012 PR EXCISION TUMOR SOFT TISS 832.0 FACE/SCALP SUBQ 2+CM 0 21013 PR EXC TUMOR SOFT TISS 1273. FACE&SCALP SUBFASCIAL < 2CM 00 21014 PR EXC TUMOR SOFT TISS 1277. FACE&SCALP SUBFASCIAL 2+CM 00 21015 PR RAD RESECTION TUMOR SOFT TISS 1793. FACE/SCALP < 2CM 00 21016 PR RAD RESECTION TUMOR SOFT TISS 3623. FACE/SCALP 2 CM/> 00 21025 PR EXCISION OF BONE, LOWER JAW 2965. 00 21026 PR EXCISION OF FACIAL BONE(S) 1571. 00 21029 PR CONTOUR OF FACE BONE LESION 1955. 00 21030 PR EXCISION,BENIGN 1320. TUMOR,MAXILLA/ZYGOMA 00 21031 PR EXCISION,TORUS MANDIBULARIS 1001. 00 21034 PR EXCISION,MALIG TUMOR, 4033. MAXILLA/ZYGOMA 00 21040 PR EXCISION,BENIGN 1044. TUMOR, 00 21044 PR REMV MALIG JAW BONE LESION 2669. 00 21045 PR REMV MALIG JAW BONE RADICAL 3708. 00 21046 PR EXCISION,BEN 3897. TUMOR,MANDIBLE,INTRA-ORAL 00 21047 PR EXCISION,BEN 5368. TUMOR,MANDIBLE,EXTRA-ORAL 00 21048 PR EXCISION,BEN 4018. TUMOR,MAXILLA,INTRA-ORAL 00 21049 PR EXCISION,BEN 4299. TUMOR,MAXILLA,EXTRA-ORAL 00 21070 PR REMV CORONOID 1547. PROCESS 00 21079 PR PREP FACE/ORAL PROST TEMP 3412. OBTURATOR 00 21080 PR PREP FACE/ORAL PROST FINL 5000. OBTURATOR 00 21085 PR PREP FACE/ORAL PROST ORAL 2024 SPLINT 21086 PR PREP FACE/ORAL PROST 1800 AURICULAR 21089 PR PREP FACE/ORAL PROST UNLISTED 1700. 00 21110 PR INTERDENTAL FIXATION 2044. 00 21141 PR RECONST FACE,LEFORT I,1 PIECE 4854. 00 21142 PR RECONST FACE,LEFORT I,2 PIECES 5866. 00 21145 PR RECONST FACE,LEFORT I,1 6510. PIECE+GRFT 00 21147 PR RECONST FACE,LEFORT 6849. I,3+PIECES+GRFT 00 21172 PR RECONST 8433. ORBIT/FOREHEAD 00 21175 PR RECONST ORBIT/FOREHEAD 8575. BIFRONTAL 00 21179 PR RECONST ENTIRE 5551. FOREHEAD+GRAFT 00 21180 PR RECONST ENTIRE 6935. FOREHEAD+AUTOGRFT 00 21181 PR CONTOUR CRANIAL BONE LESION 2632. 00 21188 PR RECONST MIDFACE 6643. 00 21193 PR RECONST MANDIBLE,C/L 5360. OSTEOTOMY 00 21194 PR RECONST MANDIBLE,C/L 6026. OSTEO+GRFT 00 21196 PR RECONST MANDIBLE,SAG 6790. SPLIT+FIXATN 00 21198 PR OSTEOTOMY, MANDIBLE 4172. 00 21199 PR RECONST MANDIBLE,GLOSSAL 3605. ADVANCEMT 00 21206 PR RECONST MAXILLA,SEGMENTAL 4345. 00 21208 PR AUGMENT FACIAL BONES 4884. 00 21209 PR REDUCTION OF FACIAL BONES 2289 21210 PR NASAL,MAXILLA,MALAR BONE 7917. GRAFT 00 21230 PR RIB CARTILAGE GRAFT TO FACE 1737. 00 21235 PR EAR CARTILAGE GRAFT TO FACE 1575. 00 21240 PR ARTHROPLASTY TMJ 4003. 00 21247 PR RECONSTR MANDIB CONDYLE 6681 21248 PR RECONSTR JAW,PART-ENDO IMPLNT 3957. 00 21267 PR REPOSITN ORBITS,EXTRACRAN 6456. 00 21270 PR AUGMENTATION CHEEK BONE 3035. 00 21280 PR REVISION OF EYELID,MEDIAL 1440. 00 21282 PR REVISION OF EYELID,LATERAL 2415. 00 21310 PR CLOSED RX NOSE FRACTURE 325.0 0 21315 PR CLOSED RX NOSE FRACTURE 560.0 0 21320 PR CLOSED RX NOSE FX W 601.0 STABILIZATN 0 21325 PR OPEN RX NOSE 1207. FRACTURE 00 21330 PR OPEN RX NOSE FX COMPLICATED 1785. 00 21335 PR OPEN RX NOSE FX+OPEN FIX 1846. SEPTUM 00 21336 PR OPEN RX NASAL SEPTAL FRACTURE 1633. 00 21337 PR CLOSED RX NASAL SEPTAL 992.0 FRACTURE 0 21338 PR REPAIR NASOETHMOID FRACTURE 2431. 00 21339 PR REPAIR NASOETHMOID FX+EXTERN 2291. FIXATN 00 21340 PR REPAIR NASOETHMOID COMPLEX 2858. FRACTURE 00 21343 PR OPEN RX DEPRES FRONTAL SINUS 4631. FRAC 00 21344 PR OPEN RX COMPLIC FRONT SINUS 4847. FRACT 00 21345 PR CLOSED RX NOSE/JAW FRAC+WIRES 1999. 00 21346 PR OPEN RX NOSE/JAW FRACT+WIRES 2244. 00 21347 PR OPEN RX NOSE/JAW FRACT/COMPLX 3809. 00 21348 PR OPEN RX NOSE/JAW FRACT+GRAFT 4895. 00 21356 PR OPEN RX DEPRESS ZYGOMA FRAC 1318. 00 21360 PR OPEN RX DEPRESS MALAR FRAC 1908. 00 21365 PR OPEN RX COMPLX CHEEK BONE 2746. FRAC 00 21385 PR REPAIR EYE 1945. BLOWOUT,TRANSANTRAL 00 21386 PR REPAIR EYE 1763. BLOWOUT,PERIORBITAL 00 21387 PR REPAIR EYE BLOWOUT,COMBINED 2664. 00 21390 PR REPAIR EYE 2798. BLOWOUT,PERIORB+IMPLNT 00 21401 PR CLOSED RX FX ORBIT W 1316. MANIPULATN 00 21406 PR OPEN RX FX ORBIT 1449. 00 21407 PR OPEN RX FX ORBIT W IMPLANT 1641. 00 21408 PR OPEN RX FX ORBIT W GRAFT 3229 21422 PR OPEN RX LEFORTE I 1815. 00 21423 PR OPEN RX LEFORTE I,COMPLICATED 3801. 00 21432 PR OPEN RX LEFORTE III+FIXATN 2876. 00 21433 PR OPEN RX LEFORTE III,COMPLICATED 5814. 00 21435 PR OPEN RX LEFORTE 5163. III,COMPL+FIXATN 00 21451 PR CLOSED RX MANDIBLE 2086. FX+MANIPULATN 00 21452 PR PERCUT RX MANDIBLE FX EXT 1523. FIXATN 00 21453 PR CLOSED RX MANDIBLE FX+DENTAL 2262. FIX 00 21454 PR OPEN RX MANDIBLE FX+EXTERN FIX 1468. 00 21461 PR OPEN RX MANDIBLE FX 3787. 00 21462 PR OPEN RX MANDIBLE FX+DENTAL FIX 3452. 00 21470 PR OPEN RX MANDIBLE CONDYLE 3679. FX,COMPL 00 21480 PR REDUCE TEMPOROMANDIBL DISLOC 250.0 0 21485 PR REDUCE TEMPOROMANDIBL 2114 DISLOC,COMP 21501 PR I&D DEEP ABSC/HEMATOMA 932.0 NECK/CHEST 0 21550 PR BIOPSY SOFT TISSUE NECK/CHEST 525.0 0 21552 PR EXC TUMOR SOFT TISSUE NECK/ANT 1030. THORAX SUBQ 3+CM 00 21554 PR EXC TUMOR SOFT TISSUE NECK/ANT 1653. THORAX SUBFASCIAL 5+CM 00 21555 PR EXC TUMOR SOFT TISSUE NECK/ANT 1056. THORAX SUBQ <3CM 00 21556 PR EXC TUMOR SOFT TISSUE NECK/ANT 1340. THORAX SUBFASCIAL <5CM 00 21557 PR RAD RESECT TUMOR SOFT TISS 1831. NECK/ANT THORAX <5CM 00 21558 PR RAD RESECT TUMOR SOFT TISS 3102. NECK/ANT THORAX 5CM/> 00 21600 PR PARTIAL REMOVAL OF RIB 1314. 00 21610 PR 5956. COSTOTRANSVERSECTOMY 00 21615 PR REMOVAL 1ST/CERVICAL 1975. RIB 00 21620 PR PARTIAL REMOVAL OF STERNUM 1355. 00 21627 PR STERNAL DEBRIDEMENT 1739. 00 21630 PR RADICAL RESECTN STERNUM 4372. 00 21685 PR HYOID & SUSPENSION 3482. 00 21700 PR DIVIDE SCALENUS 1370. ANTICUS 00 21705 PR DIVIDE SCALENUS+RESECT CERV 1346. RIB 00 21720 PR DIVIDE STERNOMASTOID OPEN 1866. 00 21740 PR RECONST PECTUS 3728. EXCAV/CARIN,OPEN 00 21743 PR RECONST PECTUS EXCAV/CARIN W/ 6413. THORACOS 00 21750 PR CLOSE MED STERNOTOMY SEP, 2641. W/WO DEBRIDE 00 21811 PR OPEN TX RIB FX W/FIXJ 2131. THORACOSCOPIC VIS 1-3 RIBS 00 21812 PR OPEN TX RIB FX W/FIXJ 2595. THORACOSCOPIC VIS 4-6 RIBS 00 21820 PR CLOSED RX STERNUM FRACTURE 361.0 0 21825 PR OPEN RX STERNUM FRACTURE 1594. 00 21925 PR BIOPSY SOFT TISSUE BACK,DEEP 1436. 00 21930 PR EXCISION TUMOR SOFT TISSUE 2195. BACK/FLANK SUBQ <3CM 00 21931 PR EXCISION TUMOR SOFT TISSUE 1235. BACK/FLANK SUBQ 3+CM 00 21932 PR EXC TUMOR SOFT TISS BACK/FLANK 1515. SUBFASCIAL <5CM 00 21933 PR EXC TUMOR SOFT TISS BACK/FLANK 2541. SUBFASCIAL 5+CM 00 21935 PR RAD RESECTION TUMOR SOFT 3967. TISSUE BACK/FLANK <5CM 00 21936 PR RAD RESECTION TUMOR SOFT 4037. TISSUE BACK/FLANK 5CM/> 00 22010 PR I&D, POST SPINE, CERV/THOR/CERV- 3138. THOR 00 22015 PR I&D, POST SPINE, 3110. LUMB/SACR/LUMBOSAC 00 22100 PR REMV PART POST CERV VERT,1 LVL 4644. 00 22101 PR REMV PART POST THOR VERT,1 LVL 4311. 00 22102 PR REMV PART POST LUMB VERT,1 LVL 2916 22103 PR REMV PART POST VERT,EA ADDN 715.0 SGMT 0 22110 PR REMV PART CERV VERT BODY,1 LVL 5293. 00 22116 PR REMV PART VERT BODY,EA ADDN 360.0 SGMT 0 22206 PR OSTEOTOMY SPINE POSTERIOR 3 12452.00 COLUMN THORACIC 22207 PR OSTEOTOMY SPINE POSTERIOR 3 12221.00 COLUMN LUMBAR 22208 PR OSTEOTOMY SPINE POSTERIOR 3 2976. COLUMN EA ADDL SGM 00 22210 PR OSTEOTOMY CERV SP,POST,1 LVL 9079. 00 22212 PR OSTEOTOMY THOR SP,POST,1 LVL 7548. 00 22214 PR OSTEOTOMY LUMB SP,POST,1 LVL 7567. 00 22216 PR OSTEOTOMY,POST,EA ADDN SGMT 1859. 00 22220 PR OSTEOTOMY CERV SP,ANT,REMV 8124. DISC 00 22222 PR OSTEOTOMY THOR SP,ANT,REMV 5136. DISC 00 22224 PR OSTEOTOMY LUMB SP,ANT,REMV 8048. DISC 00 22226 PR OSTEOTOMY,DISCECT,ANT,EA 1850. ADDNL SGMT 00 22305 PR CLOSED TREAT SPINE PROCESS FX 684.0 0 22310 PR CLOSED TREAT VERT BODY FRACT 979.0 0 22315 PR CLOSED TREAT VERT BODY 3123. FX,MANIPULATN 00 22318 PR ODONTOID FX,W/O GRAFT,OPEN 8325. 00 22319 PR ODONTOID,FX,GRAFTING,OPEN 9273. 00 22325 PR OPEN POST RX LUMB VERT FX,1 LVL 7305. 00 22326 PR OPEN POST RX CERV VERT FX,1 LVL 7569. 00 22327 PR OPEN POST RX THOR VERT FX,1 LVL 7622. 00 22328 PR OPEN POST REPAIR EA ADDN VERT 1443. FX 00 22510 PR PERQ VERTEBROPLASTY UNI/BI INJX 4312. CERVICOTHORACIC 00 22511 PR PERQ VERTEBROPLASTY UNI/BI 4271. INJECTION LUMBOSACRAL 00 22512 PR VERTEBROPLASTY EACH ADDL 2388. CERVICOTHOR/LUMBOSACRAL 00 22513 PR PERQ VERT AGMNTJ CAVITY CRTJ 25280.00 UNI/BI CANNULATION 22514 PR PERQ VERT AGMNTJ CAVITY CRTJ 1733. UNI/BI CANNULJ LMBR 00 22515 PR PERQ VERT AGMNTJ CAVITY CRTJ 15233.00 UNI/BI CANNULJ EACH 22532 PR LAT THORAX SPINE 9029. FUSION 00 22533 PR LAT LUMBAR SPINE 8445. FUSION 00 22534 PR LAT THOR/LUMB, ADDL 1844. SEG 00 22551 PR ARTHRODESIS ANT INTERBODY INC 8709. DISCECTOMY, CERVICAL BELOW C2 00 22552 PR ARTHRODESIS ANT INTERBODY INC 2038. DISCECTOMY, CERVICAL BELOW C2 00 EACH ADDL 22554 PR CERV SPINE FUSN,ANTER,BELOW C2 6380. 00 22556 PR THORAX SPINE FUSION,ANTER 8489. APPRCH 00 22558 PR LUMBAR SPINE FUSION,ANTER 7825. APPRCH 00 22585 PR SPINAL FUSION,ANT,EA ADNL LEVEL 1681. 00 22586 PR ARTHRODESIS PRESACRAL 7759. INTRBDY W/INSTRUMENT L5/S1 00 22590 PR CRANIOCERV FUSN,POST 8030. TECHNIQUE 00 22595 PR CERV C1-2 FUSN,POSTER TECH 7662. 00 22600 PR CERV FUSN,BELOW C2,POST TECH 6554. 00 22610 PR ARTHRODESIS 6420. POSTERIOR/POSTEROLATERAL 00 THORACIC 22612 PR ARTHRODESIS 8082. POSTERIOR/POSTEROLATERAL 00 LUMBAR 22614 PR SPINE FUSN,POST TECH,EA ADDNL 2003. SGMT 00 22630 PR LUMBAR SPINE FUSN,POST INTRBDY 7990. 00 22632 PR LUMB SP FUSN,POST INTERBDY,EA 1644. ADDNL 00 22633 PR ARTHDSIS 9438. POST/POSTEROLATRL/POSTINTERBODY 00 LUMBAR 22634 PR ARTHDSIS 2541. POST/POSTERLATRL/POSTINTRBDYADL 00 SPC/SEG 22800 PR SPINE FUSN,POSTER,UP TO 6 6874. SGMTS 00 22802 PR SPINE FUSION,POSTER,7-12 SGMTS 10698.00 22804 PR SPINE FUSION,POSTER,13+ SGMTS 12367.00 22808 PR SPINE FUSION,ANTER,3 SGMTS 9402. 00 22810 PR SPINE FUSION,ANTER,4-7 SGMTS 10425.00 22830 PR EXPLORATION OF SPINAL FUSION 4133. 00 22840 POSTERIOR NON-SEGMENTAL 3890. INSTRUMENTATION 00 22842 POSTERIOR SEGMENTAL 3905. INSTRUMENTATION 3-6 VRT SEG 00 22843 POSTERIOR SEGMENTAL 4178. INSTRUMENTATION 7-12 VRT SEG 00 22844 POSTERIOR SEGMENTAL 5050. INSTRUMENTATION 13/> VRT SEG 00 22845 ANTERIOR INSTRUMENTATION 2-3 3738. VERTEBRAL SEGMENTS 00 22846 ANTERIOR INSTRUMENTATION 4-7 3881. VERTEBRAL SEGMENTS 00 22847 ANTERIOR INSTRUMENTATION 8/> 2868. VERTEBRAL SEGMENTS 00 22848 PELVIC FIXATION OTHER THAN SACRUM 1842. 00 22849 PR REINSERT SPINAL 6609. FIXATION 00 22850 PR REMOVE SPINE FIX 3675. DEV,HARRINGTON 00 22851 PR APPLICATION INTERVERTEBRAL 2125. BIOMECHANICAL DEVICE 00 22852 PR REMOVE SPINE FIX DEV,POST 3519. SGMTAL 00 22853 PR INSJ BIOMCHN DEV 686.0 INTERVERTEBRAL DSC SPC W/ARTHRD 0 22854 PR INSJ BIOMCHN DEV VRT 888.0 CORPECTOMY DEFECT W/ARTHRD 0 22855 PR REMOVE SPINE FIX DEV,ANTERIOR 5630. 00 22856 PR TOT DISC ARTHRP ART DISC ANT 4906. APPRO 1 NTRSPC CRV 00 22858 PR TOT DISC ARTHRP ANT APPR DISC 1567. 2ND LEVEL CERVICAL 00 22859 PR INSJ BIOMCHN DEV NTRVRT DISC 888.0 SPACE W/O ARTHRD 0 22867 PR INSJ STABLJ DEV W/DCMPRN 3587. LUMBAR SINGLE LEVEL 00 22868 PR INSJ STABLJ DEV W/DCMPRN 641.0 LUMBAR SECOND LEVEL 0 22869 PR INSJ STABLJ DEV W/O DCMPRN 1409. LUMBAR SINGLE LEVEL 00 22870 PR INSJ STABLJ DEV W/O DCMPRN 374.0 LUMBAR SECOND LEVEL 0 22900 PR EXC TUMOR SOFT TISSUE ABDL 1091. WALL SUBFASCIAL <5CM 00 22901 PR EXC TUMOR SOFT TISSUE ABDL 2364. WALL SUBFASCIAL 5+CM 00 22902 PR EXC TUMOR SOFT TISSUE 1074. ABDOMINAL WALL SUBQ <3CM 00 22903 PR EXC TUMOR SOFT TISSUE 1083. ABDOMINAL WALL SUBQ 3+CM 00 22904 PR RAD RESECTION TUMOR SOFT 3731. TISSUE ABDL WALL <5CM 00 22905 PR RAD RESECTION TUMOR SOFT 5405. TISSUE ABDL WALL 5 CM/> 00 23030 PR INCIS/DRAIN SHLDR 1114. ABSC/HEMA,DEEP 00 23031 PR DRAIN INFECT SHOULDER BURSA 1070. 00 23040 PR DEEP INCIS SHLDR BONE CORTEX 2554. 00 23044 PR EXPLOR/REMV INFECT GLENO-HUM 1639. JT 00 23065 PR EXPLOR INFECT A-C/S-C 654.0 JT 0 23066 PR BIOPSY SHLDR SOFT 1404. TISSUES,SUPERFIC 00 23071 PR EXCISION TUMOR SOFT TISSUE 1055. SHOULDER SUBQ 3+CM 00 23073 PR EXC TUMOR SOFT TISSUE 2440. SHOULDER SUBFASCIAL 5+CM 00 23075 PR EXCISION TUMOR SOFT TISSUE 1172. SHOULDER SUBQ <3CM 00 23076 PR EXC TUMOR SOFT TISS SHOULDER 1457. SUBFASC <5CM 00 23077 PR RAD RESECTION TUMOR SOFT 3877. TISSUE SHOULDER <5CM 00 23078 PR RAD RESECTION TUMOR SOFT 3761. TISSUE SHOULDER 5 CM/> 00 23120 PR PARTIAL REMOVAL, CLAVICLE 1807. 00 23125 PR TOTAL REMOVAL OF CLAVICLE 1756. 00 23130 PR PARTIAL 1946. REMOVAL/REPAIR,ACROMION 00 23140 PR EXCIS/CURET BENIGN TUMR 1361. CLAV/SCAPULA 00 23150 PR EXCIS/CURET BENIGN TUMR PROX 2058. HUMERUS 00 23170 PR SEQUESTRECTOMY, CLAVICLE 1997. 00 23180 PR PART EXCIS CLAVICLE 2343. 00 23195 PR REMOVAL OF HEAD OF HUMERUS 2692. 00 23220 PR RAD RESECT PROX HUMERUS FOR 7000 TUMOR 23330 PR REMOVE SUBCUT SHOULDER 651.0 FOREIGN BODY 0 23333 PR REMOVAL SHOULDER FOREIGN 1186. BODY DEEP SUBFASCIAL/IM 00 23334 PR PROSTHESIS REMOVAL 3736. HUMERAL/GLENOID COMPONENT 00 23335 PR PROSTHESIS REMOVAL HUMERAL 4545. AND GLENOID COMPONENT 00 23350 PR INJ PROC SHOULDER 794.0 ARTHROGRAPHY/CT/MRI 0 23395 PR MUSCLE 4545. TRANSFER,SHOULDER/ARM,SINGLE 00 23397 PR MUSCLE 4050. TRANSFER,SHLDR/ARM,MULTIPLE 00 23400 PR FIXATION OF SHOULDER BLADE 3345. 00 23405 PR INCISE 1575. TENDON/MUSCLE,SHLDR,SINGLE 00 23410 PR REPAIR ROTATOR CUFF,ACUTE 2923. 00 23412 PR REPAIR ROTATOR CUFF,CHRONIC 3109. 00 23420 PR REPAIR COMPL ROTATOR CUFF 3433. AVULSN,CHR 00 23430 PR REPAIR BICEPS LONG TENDON 2417. 00 23450 PR REPAIR SHOULDER 3374 CAPSULE,ANTERIOR 23455 PR REPAIR SHOULDER 3340. CAPSULE,BANKART 00 23460 PR REPAIR SHLDR CAPSUL,ANT,BONE 3585. BLOCK 00 23462 PR REPAIR SHLDR 3503. CAPSU,ANT,CORACOID XFER 00 23465 PR REPAIR SHLDR CAPSU,POST,RECUR 3941. DISLOC 00 23466 PR REPAIR SHLDR CAPSU FOR 3992 INSTABILITY 23470 PR RECONSTRUCT PROX HUMERAL 3929. IMPLANT 00 23472 PR RECONSTR TOTAL SHOULDER 5781. IMPLANT 00 23473 PR REVIS SHOULDER ARTHRPLSTY 6601. HUMERAL/GLENOID COMPNT 00 23474 PR REVIS SHOULDER ARTHRPLSTY 6840. HUMERAL&GLENOID COMPNT 00 23485 PR OSTEOTOMY CLAVICLE W BONE 3124. GRAFT 00 23491 PR REINFORCE PROX HUMERUS/HEAD 3618. 00 23500 PR CLOSED RX CLAVICLE FRACTURE 548.0 0 23505 PR CLOSED RX CLAVICLE 1177. FX,MANIPULATN 00 23515 OPEN TREATMENT CLAVICULAR 1854. FRACTURE INTERNAL FX 00 23525 PR CLOSED RX STERN-CLAV 1153. DISLOC,MANIP 00 23530 PR OPEN RX STERN-CLAV DISLOC 1828. 00 23532 PR OPEN RX STERN-CLAV DISLOC,FASC 2223. GRFT 00 23540 PR CLOSED RX A-C JT DISLOC 562.0 0 23545 PR CLOSED RX A-C JT 1010. DISLOC,MANIPULATN 00 23550 PR OPEN RX A-C JT DISLOC 2099. 00 23552 PR OPEN RX A-C JT DISLOC,FASCIAL 2318. GRFT 00 23570 PR CLOSED RX SCAPULA FX 766.0 0 23585 PR OPEN RX SCAPULA FRACTURE 2227. 00 23600 PR CLOSED RX PROX HUMERUS 1119. FRACTURE 00 23605 PR CLOSED RX PROX HUMERUS 1501. FX,MANIP 00 23615 OPEN TREATMENT PROX HUMERAL 2398. FRACTURE 00 23616 OPEN PROX HUMERAL FRACTURE 4421. PROSHETIC REPLACEMENT 00 23620 PR CLOSED RX GR TUBEROSITY HUM 979.0 FX 0 23630 PR OPEN RX GR TUBEROSITY FX 1855. 00 23650 PR CLOSED RX SHLDR DISLOCATION 775.0 0 23655 PR CLOSED RX SHLDR 987.0 DISLOC,ANESTHESIA 0 23660 PR OPEN RX ACUTE SHLDR DISLOC 1909. 00 23665 PR CLOSED RX SHLDR DISLOC,GR TUB 1496. FX 00 23670 PR OPEN RX SHLDR DISLOC,GR TUB FX 3100. 00 23675 PR CLOSED RX SHLDR DISLOC,PROX 1787. HUM FX 00 23700 PR MANIPULATN SHLDR JT W 641.0 ANESTHESIA 0 23800 PR FUSION SHOULDER JOINT 3298. 00 23920 PR AMPUTATION AT SHOULDER JOINT 4035 23930 PR INCIS/DRAIN ARM,DEEP 892.0 ABSC/HEMATOMA 0 23931 PR INCIS/DRAIN ARM/ELBOW INFECT 1010. BURSA 00 23935 PR INCIS DEEP ARM/ELBOW BONE 1796. LESION 00 24000 PR EXPLORE/DRAIN ELBOW FOR 1482. INFECT 00 24006 PR ARTHROTOMY/CAPULE RELEASE 2266. ELBOW JT 00 24065 PR BX ARM/ELBOW SOFT 646.0 TISSUE,SUPERFICIAL 0 24066 PR BX ARM/ELBOW SOFT TISSUE,DEEP 1571. 00 24071 PR EXC TUMOR SOFT TISSUE UPPER 1070. ARM/ELBOW SUBQ 3+CM 00 24073 PR EXC TUMOR SOFT TISS UPPER 4488. ARM/ELBW SUBFASC 5+CM 00 24075 PR EXC TUMOR SOFT TISS UPPER 1234. ARM/ELBOW SUBQ <3CM 00 24076 PR EXC TUMOR SOFT TISS UPR 1374. ARM/ELBOW SUBFASC <5CM 00 24077 PR RAD RESECT TUMOR SOFT TISS 3239. UPPER ARM/ELBOW <5CM 00 24079 PR RAD RESECT TUMOR SOFT TISS 4968. UPPER ARM/ELBOW 5CM/> 00 24101 PR EXPLORE ELBOW JOINT 1750. 00 24102 PR EXPLOR ELBOW JT/REMOV 2290. SYNOVIUM 00 24105 PR REMOVAL OF ELBOW 1046. BURSA 00 24110 PR EXCIS/CURET BENIGN HUMERUS 1909. LESN 00 24116 PR EXCIS BENIGN HUMERUS 3073. LESN,ALLOGRFT 00 24120 PR EXCIS/CURET BENIGN ELBOW LESN 1663. 00 24130 PR REMOVAL OF HEAD OF RADIUS 1619. 00 24138 PR SEQUESTRECTOMY,OLECRANNON 1716. PROCESS 00 24140 PR PARTIAL REMOVAL HUMERUS 2467. 00 24147 PR PARTIAL REMOVAL OLECRANNON 2132. PROCESS 00 24149 PR RADICAL RESECT ELBOW, CONTRAC 3414. RELEAS 00 24160 PR PROSTHESIS REMOVAL HUMERAL 1943. AND ULNAR COMPONENTS 00 24164 PR PROSTHESIS REMOVAL RADIAL 2585. HEAD 00 24200 PR REMOVAL ARM/ELBOW 518.0 F.B.,SUPERFICIAL 0 24201 PR REMOVAL ARM/ELBOW F.B.,DEEP 1928. 00 24220 PR INJECTION FOR ELBOW 719.0 ARTHROGRAM 0 24300 PR MANIPULATE ELBOW W/ANESTH 1048. 00 24301 PR MUSC/TENDON 2655. XFER,ARM/ELBOW,SINGLE 00 24305 PR ARM/ELBOW TENDON 1875. LENGTHEN,SINGLE,EA 00 24310 PR ,ELBOW- 1545. SHLDR,SINGL,EACH 00 24320 PR TENOPLASTY,ELB-SHLDR,MUSC 2782. XFER,SINGL 00 24332 PR TENOLYSIS, TRICEPS 1845. 00 24340 PR REPAIR OF BICEPS TENDON AT 1969. ELBOW 00 24341 PR MUSC/TENDON REPAIR EACH; 2163. ARM/ELBOW 00 24342 PR REINSERT BI/TRICEPS 2549. TENDON,DISTAL 00 24343 PR REPR ELBOW LAT LIGMNT W/TISS 2336. 00 24344 PR RECONSTRUCT ELBOW LAT LIGMNT 3865. W/GRAFT 00 24345 PR REPR ELBW MED LIGMNT W/TISS 1779. 00 24346 PR RECONSTRUCT ELBOW MED LIGMNT 3890. W/GRAFT 00 24357 PR TENOTOMY ELBOW 1083. LATERAL/MEDIAL PERCUTANEOUS 00 24358 PR TENOTOMY ELBOW 1575. LATERAL/MEDIAL DEBRIDE OPEN 00 24359 PR TENOTOMY ELBOW 1934. LATERAL/MEDIAL DEBRIDE REPAIR 00 24360 PR ARTHROPLASTY,ELBOW,W 3187. MEMBRANE 00 24363 PR ARTHROPLASTY,ELBOW,TOTAL 4994. PROSTH REPL 00 24366 PR RECONSTRUCT RADIAL HEAD W 2212. IMPLANT 00 24370 PR REVIS ELBOW ARTHRPLSTY 6297. HUMERAL/ULNA COMPNT 00 24371 PR REVIS ELBOW ARTHRPLSTY 7339. HUMERAL&ULNA COMPNT 00 24400 PR OSTEOTOMY HUMERUS 2666. 00 24430 PR REPAIR NON/MALUNION HUMERUS 3020. 00 24435 PR REPAIR NON/MALUNION 3203. HUMERUS,GRAFT 00 24495 PR DECOMPRESS FOREARM,BRACH 2248. ART EXPLOR 00 24498 PR REINFORCE HUMERUS 3103 24500 PR CLOSED RX MID HUMERUS 1116. FRACTURE 00 24505 PR CLOSED RX MID HUMERUS 1630. FX,MANIPULATN 00 24515 PR OPEN FIXATN MID HUMERUS 2804. FRACTURE 00 24516 PR OPEN ROD FIXATN HUMERAL SHAFT 2776. FX 00 24530 PR CLOSED RX HUMERAL 1157. SUPRACONDYLAR FX 00 24535 PR CLOSED RX HUM SUPRACONDYLR 2007. FX,MANIPU 00 24538 PR PERCUT FIX HUM SUPRACONDYLAR 2403. FX 00 24545 OPEN TX HUMERAL SUPRACONDYLAR 2522. FRACTURE W/O XTN 00 24546 OPEN TX HUMERAL SUPRACONDYLAR 3620. FRACTURE W XTN 00 24560 PR CLOSED RX HUMER EPICONDYLR FX 804.0 0 24565 PR CLOSED RX HUMER EPICONDYLR 1336. FX,MANIP 00 24566 PR PERCUT FIXATN HUMERAL 2539. EPICONDYLAR FX 00 24575 OPEN TX HUMERAL EPICONDYLAR 2531. FRACTURE 00 24576 PR CLOSED RX HUMER CONDYLR FX 1012. 00 24577 PR CLOSED RX HUMER CONDYLR 1752. FX,MANIP 00 24579 OPEN TX HUMERAL CONDYLAR 2734. FRACTURE 00 24582 PR PERCUT FIXATN HUMERAL 2323. CONDYLAR FX 00 24586 PR OPEN RX PERIARTIC FX/DISLOC 3837. ELBOW 00 24587 PR OPEN RX PERIARTIC FX 3840. ELBOW,IMPLNT 00 24600 PR CLOSED RX ELBOW DISLOCATION 1276. 00 24605 PR CLOSED RX ELBOW 1412. DISLOCATN,ANESTHESIA 00 24615 PR OPEN RX ELBOW DISLOCATION 2289. 00 24620 PR CLOSED RX MONTEGGIA FX/DISLOC 1737. ELBOW 00 24635 OPEN TX MONTEGGIA FRACTURE 3620. DISLOCATION ELBOW 00 24640 PR CLOSED RX RADIAL HEAD 345.0 DISLOC,CHILD 0 24650 PR CLOSED RX RADIAL HEAD/NECK FX 865.0 0 24655 PR CLOSED RX RADIAL HEAD/NECK 1452. FX,MANIP 00 24665 OPEN TX RADIAL HEAD/NECK 2076. FRACTURE 00 24666 OPEN TX RADIAL HEAD/NECK 2393. FRACTURE PROSTHETIC 00 24670 CLOSED TX ULNAR FRACTURE PROX 905.0 END W/O MANIPULATE 0 24675 CLOSED TX ULNAR FRACTURE PROX 1134. END W MANIPULATION 00 24685 OPEN TX ULNAR FRACTURE PROX END 2175. 00 24800 PR FUSION OF ELBOW JOINT 2958 24802 PR FUSION/GRAFT OF ELBOW JOINT 3595 24900 PR AMPUTATN ARM,THRU 2635. HUMERUS,PRIM CLOS 00 24920 PR AMPUTATN ARM,THRU 2551. HUMERUS,CIRCULAR 00 24925 PR AMPUTATN ARM,THRU 1773. HUMER,SECOND CLOS 00 25000 PR INCIS TENDON SHEATH,RADIAL 1331. STYLOID 00 25001 PR INCIS FLEXOR TENDON 897 SHEATH,WRIST 25020 PR DECOMP FOREARM,1 COMPART,W/O 2056. DEBRIDE 00 25024 PR DECOMP FOREARM,2 COMPART,W/O 2268. DEBRIDE 00 25028 PR INCIS/DRAIN FOREARM DEEP 1777. ABSCESS 00 25040 PR EXPLORE/TREAT WRIST JOINT 1919. 00 25065 PR BIOPSY FOREARM SOFT 1922 TISSUES,SUPERFIC 25066 PR BIOPSY FOREARM SOFT 1468. TISSUES,DEEP 00 25071 PR EXC TUMOR SOFT TISS FOREARM 1077. AND/WRIST SUBQ 3+CM 00 25073 PR EXC TUMOR SFT TISS 1307. FOREARM&//WRIST SUBFASC 3+CM 00 25075 PR EXC TUMOR SOFT TISSUE FOREARM 1167. &/WRIST SUBQ <3CM 00 25076 PR EXC TUMOR SOFT TISS 1267. FOREARM&/WRIST SUBFASC <3CM 00 25077 PR RAD RESECT TUMOR SOFT TISS 2272. FOREARM&/WRIST <3 CM 00 25078 PR RAD RESCJ TUM SOFT TISSUE 2918. FOREARM&/WRIST 3 CM/> 00 25085 PR INCISION OF WRIST CAPSULE 1583. 00 25101 PR EXPLORE/TREAT WRIST JOINT 1425. 00 25105 PR EXPLOR WRIST JT/REMV SYNOVIUM 1224. 00 25107 PR REPAIR TRIANGULAR CART,WRIST 1940. JT 00 25109 PR EXCISE TENDON FOREARM/ WRIST 1915. 00 25110 PR EXCIS TENDON SHEATH 861.0 LESN,WRIST/FORE 0 25111 PR EXCIS PRIMARY GANGLION WRIST 1130. 00 25112 PR EXCIS RECURRENT GANGLION 1303. WRIST 00 25115 PR RAD EXCIS WRIST 3016. SYNOV/TENDON,FLEXOR 00 25116 PR RAD EXCIS WRIST 2664. SYNOV/TENDON,EXTEN 00 25118 PR EXCIS SYNOV WRIST,EXTENS 1421. TENDON 00 25119 PR EXCIS SYNOV WRIST,PART REMV 1268. ULNA 00 25120 PR EXCIS/CURET BENIG BONE LES 2390. RAD/ULNA 00 25130 PR EXCIS BENIGN LESN CARPALS 1591. 00 25136 PR EXCIS BENIGN LESN 1287 CARPALS,ALLOGRFT 25145 PR 1909. SEQUESTRECTOMY,FOREARM/WRIST 00 25150 PR PART REMOVAL 2019. BONE,ULNA 00 25151 PR PART REMOVAL BONE,RADIUS 2647. 00 25210 PR REMOVAL OF CARPAL 1685. BONE 00 25215 PR REMOVAL OF PROX ROW CARPAL 2227. BONES 00 25230 PR REMOVAL OF RADIAL STYLOID 1528. 00 25240 PR EXCIS DISTAL 1602. ULNA,PART/COMPLETE 00 25246 PR INJECTION FOR WRIST 958.0 ARTHROGRAM 0 25248 PR REMOVE FOREARM/WRIST FOREIGN 1372. BODY 00 25259 PR MANIPULATE WRIST W/ANESTHES 1479. 00 25260 PR REPR FOREARM 1987. TEND/MUSC,FLEX,PRIM,EA 00 25263 PR REPR FOREARM 1983. TEND/MUSC,FLEX,SECON,EA 00 25265 PR REPR FOREARM 2646. TEND/FLEX,SECOND,GRFT 00 25270 PR REPR FOREARM 1689. TEND/MUSC,EXTEN,PRIM,EA 00 25272 PR REPR FOREARM 1396. TEND/MUSC,EXTEN,SECOND 00 25274 PR REPR FOREARM 2341. TEND/EXT,SECOND,GRAFT,EA 00 25275 PR REPR FOREARM EXT TEND 2122. SHEATH,GRAFT 00 25280 PR REVISE WRIST/FOREARM TENDON 1423. 00 25290 PR INCISE WRIST/FOREARM TENDON 1541. 00 25295 PR RELEASE WRIST/FOREARM TENDON 2472. 00 25301 PR FUSION WRIST,FINGR 2189. EXTENSORS 00 25310 PR TRANSPLANT FOREARM/WRIST 2796. TENDON 00 25312 PR XPLANT FOREARM TENDON,W 1825. TENDON GRFT 00 25316 PR REVISE PALSY HAND TENDON(S),W 3254. XFER 00 25320 PR REVISE WRIST JOINT,CARPAL 2892. INSTABIL 00 25332 PR ARTHROPLASTY WRIST JT 2724. 00 25335 PR REALIGNMENT OF WRIST ON ULNA 3346. 00 25337 PR RECONSTRUCT ULNA/RADIOULNAR 2795. 00 25360 PR OSTEOTOMY ULNA 2109. 00 25365 PR OSTEOTOMY 3258. RADIUS/ULNA 00 25375 PR OSTEOTOMY+ROD,RADIUS AND 3394. ULNA 00 25390 PR OSTEOPLASTY,RADIUS OR 3302. ULNA,SHORTEN 00 25400 PR REPAIR NONUNION RADIUS OR 3451. ULNA 00 25405 PR REPAIR NONUNION RADIUS OR 4198. ULNAW/GRAFT 00 25415 PR REPAIR NONUNION RADIUS AND 3446. ULNA 00 25420 PR REPAIR NONUNION RADIUS AND 4119. ULNA W/GRAFT 00 25430 PR INSERT VASC PEDICLE,CARPAL 2588. BONE (HARII) 00 25440 PR REPAIR NONUNION SCAPHOID 2636. CARPAL BONE 00 25447 PR REPAIR INTERCARP/CARP- 2932. METACARP JT 00 25449 PR REMOVE WRIST JOINT IMPLANT 3661. 00 25450 PR EPIPHYSEAL ARREST DIST RAD OR 2192. ULNA 00 25500 PR CLOSED RX RADIAL SHAFT FX 834.0 0 25505 PR CLOSED RX RADIAL SHAFT 1624. FX,MANIPULATN 00 25515 OPEN TREATMENT RADIAL SHAFT 2218. FRACTURE 00 25520 PR CLOSED RX RADIAL SHAFT FX 1802. W/DISLOCATION 00 25525 OPEN RDL SHAFT FX CLOSED RAD/ULN 2777. JT DISLOCATE 00 25526 OPEN RDL SHAFT FX OPEN RAD/ULN JT 3369. DISLOCATE 00 25530 PR CLOSED RX ULNA SHAFT 804.0 FX 0 25535 PR CLOSED RX ULNA SHAFT 1568. FX,MANIPULATN 00 25545 OPEN TREATMENT OF ULNAR SHAFT 2204. FRACTURE 00 25560 PR CLOSED RX RAD/ULNA SHAFT FX 838.0 0 25565 PR CLOSED RX RAD/ULNA SHAFT 1701. FX,MANIP 00 25574 OPEN TX RADIAL & ULNAR SHAFT FX FIX 2354. RADIUS OR ULNA 00 25575 OPEN TX RADIAL & ULNAR SHAFT FX FIX 2639. RADIUS AND ULNA 00 25600 PR CLOSED RX DIST RAD/ULNA FX 921.0 0 25605 PR CLOSED RX DIST RAD/ULNA 1812. FX,MANIPUL 00 25606 PR PERCUT SKELETAL FIX, DISTAL 2112. RADIUS FX 00 25607 PR OPEN RX DISTAL RADIUS FX, EXTRA- 2599. ARTICULAR 00 25608 PR OPEN RX DISTAL RADIUS FX, INTRA- 2915. ARTICULAR, 2 FRAG 00 25609 PR OPEN RX DISTAL RADIUS FX, INTRA- 3708. ARTICULAR, 3+ FRAG 00 25622 PR CLOSED RX NAVICULAR 939.0 FX 0 25628 OPEN TX CARPAL SCAPHOID 2550. NAVICULAR FRACTURE 00 25630 PR CLOSED RX CARPAL FX 766.0 0 25645 PR OPEN RX CARPAL BONE FX,EACH 1425. BONE 00 25650 PR CLOSED RX ULNA STYLOID FX 1023. 00 25651 PR PERCUT SKELETAL FIX,ULNAR 1422. STYLOID FX 00 25660 PR CLOSED TREAT WRIST 1449. DISLOCATION 00 25670 PR OPEN REPAIR WRIST DISLOCATION 2142. 00 25671 PR PERCUT SKELETAL FIX,DIST 1350. RADIOULN DISLOC 00 25675 PR CLOSED RX RADIO-ULNA 1454. DISLOCATION 00 25676 PR OPEN RX RADIO-ULNA DISLOCATION 2221. 00 25680 PR CLOSED RX NAVIC/LUNATE 1209. FX/DISLOC 00 25685 PR OPEN RX NAVIC-PERILUNATE 1965. FX/DISLOC 00 25690 PR CLOSED RX LUNATE DISLOCATION 1190. 00 25695 PR OPEN REPAIR LUNATE DISLOCATION 1599. 00 25800 PR FUSION OF WRIST JOINT 2501. 00 25805 PR FUSION/SLIDING GRAFT WRIST 2856. JOINT 00 25810 PR FUSION/GRAFT WRIST 3076. JOINT 00 25820 PR FUSION INTERCARPAL 2290. 00 25825 PR FUSION/GRAFT INTERCARPAL 3105. 00 25830 PR FUSION RADIOULNAR JNT/ULNA 3333. RESEC 00 25900 PR AMPUTATION FOREARM 1790. 00 25920 PR AMPUTATE THRU WRIST 1828 25927 PR AMPUTATION TRANSMETACARPAL 2725. 00 26010 PR DRAIN FINGER ABSCESS,SIMPLE 649.0 0 26011 PR DRAIN FINGER 978.0 ABSCESS,COMPLICATED 0 26020 PR DRAIN HAND TENDON SHEATH 1342. 00 26025 PR DRAINAGE PALM BURSA,SINGLE 1499. 00 26030 PR DRAINAGE PALM 1253. BURSA,MULTIP/COMPLX 00 26034 PR INCIS DEEP FINGR/HAND BONE LESN 1360. 00 26035 PR DECOMPRESS 2595. FINGERS/HAND,INJECT INJ 00 26040 PR RELEASE PALM 786.0 CONTRACT,PERCUTANEOUS 0 26045 PR RELEASE PALM 1079. CONTRACT,OPEN,PARTIAL 00 26055 PR INCISE FINGER TENDON SHEATH 2165. 00 26075 PR EXPLORE & TREAT METACARPO- 1047. PHAL JT 00 26080 PR EXPLORE/TREAT 983.0 INTERPHALANGEAL JT,EA 0 26105 PR BIOPSY SYNOVIUM MC-P 1200. JT 00 26110 PR BIOPSY SYNOVIUM I-P JT 1136. 00 26111 PR EX TUM/VASC MALF SFT TISS 1022. HAND/FNGR SUBQ 1.5+CM 00 26113 PR EX TUM/VASC MAL SFT TIS 1341. HAND/FNGR SUBFSC 1.5+CM 00 26115 PR EXC TUM/VASC MAL SFT TISS 1562. HAND/FNGR SUBQ <1.5CM 00 26116 PR EXC TUM/VAS MAL SFT TIS 1506. HAND/FNGR SUBFASC<1.5CM 00 26118 PR RAD RESCJ TUM SOFT TISSUE 3738. HAND/FINGER 3 CM/> 00 26121 PR PALMAR FASCIECTOMY 2268. 00 26123 PR PART PALMAR FASCIEC,OPEN 1 2617. DIGIT 00 26125 PR PART PALMAR FASCIEC,OPEN 952.0 ADDNL DIGIT 0 26130 PR EXCIS JT 1660. LINING,CARPOMETACARPAL JT 00 26135 PR EXCIS JT LINING,MC-P JT,EACH 1942. DIGIT 00 26140 PR EXCIS JT LINING,PROX I-P JT,EACH 1700. 00 26145 PR RAD EXCIS JT LINING,FLEXOR,EACH 1624. 00 26160 PR EXCIS TENDON SHEATH LESION, 2001. HAND/FINGER 00 26170 PR EXCIS PALM TENDON FLEXOR, EACH 1034. 00 26180 PR EXCIS FINGER TENDON FLEXOR, 1563. EACH 00 26200 PR EXCIS BENIGN BONE 1133. LESN,METACARPAL 00 26210 PR EXCIS BENIGN BONE LESN,PHALANX 1384. 00 26230 PR PART REMV BONE,METACARPAL 1615. 00 26235 PR PART REMV BONE,PROX/MID 1579. PHALANX 00 26236 PR PART REMV BONE,DISTAL PHALANX 1390. 00 26260 PR RAD RESEC PROX/MID PHALANX 2142. 00 26320 PR REMOVAL OF IMPLANT FROM 1223. HAND/FINGR 00 26340 PR MANIPULATE FINGER JT W/ 934.0 ANESTH,EACH 0 26341 PR MANIPLATN PALAR FASCIAL CRD 244.0 POST INJ SINGLE CORD 0 26350 PR REPAIR FLEXOR TENDON,HAND,W/O 1950. GRAFT,EA 00 26352 PR REPAIR FLEXOR TENDON,HAND,W/ 1994. GRAFT,EA 00 26356 PR REPAIR FLEX TENDON,ZONE 2,HAND 2464. 00 26357 PR REPAIR FLEX TENDON,ZONE 3133. 2,SECON,HAND,EA 00 26358 PR REPAIR FLEX TEND,ZONE 2240. 2,SEC,HAND,W/GRFT 00 26370 PR REPAIR PROFUNDUS 2135. TENDON,PRIMARY 00 26372 PR REPAIR PROFUNDUS 2159. TENDON,SECONDARY/GRFT 00 26390 PR EXCIS FLEX TEND HAND,IMPL 2999. ROD,DELAY GRFT 00 26392 PR REMOV ROD & INSERT FLEX TEND 3386. HAND GRFT 00 26410 PR REPAIR EXTEN TENDON,DORSUM 1539. HAND,EA 00 26412 PR REPAIR EXTEN TENDON,DORSUM 2408. HAND,GRFT 00 26415 PR EXCIS EXT TEND HAND,IMPL 2385. ROD,DELAY GRFT 00 26418 PR REPAIR EXTEN TENDON,DORSUM 2184. FINGR,EA 00 26420 PR REPAIR EXTEN TENDON,DORSUM 2702. FINGR,GRFT 00 26426 PR REPAIR EXT TEND,CENT SLIP,SEC 1804. 00 26432 PR REPAIR EXTEN TENDON,DISTAL 1876. INSERT,CLOSE 00 26433 PR REPAIR EXTEN TENDON,DISTAL 1330. INSERT,OPEN 00 26437 PR REALIGNMENT OF TENDONS,HAND 2291. 00 26440 PR TENOLYSIS, FLEX 1711. TENDON,PALM/FINGER,EA 00 26442 PR TENOLYSIS FLEX TENDON,PALM & 3181. FINGER,EA 00 26445 PR TENOLYSIS EXT 2316. TENDON,HAND/FINGER,EA 00 26449 PR RELEASE FOREARM/HAND EXTEN 1759. TENDON 00 26450 PR TENOTOMY PALM 1447. FLEX,SINGLE,OPEN,EACH 00 26455 PR TENOTOMY FINGR 1434. FLEX,SINGLE,OPEN,EACH 00 26460 PR TENOTOMY HAND 1386. EXTEN,SINGLE,OPEN,EACH 00 26471 PR FUSION FINGER TENDONS,PIP JT 2141. STABIL 00 26474 PR FUSION FINGER TENDONS,DIP JT 1555 STABIL 26478 PR TENDON 1651. LENGTHENING,FLEX,HAND/FINGR 00 26479 PR TENDON 2201. SHORTENING,FLEX,HAND/FINGR 00 26480 PR TRANSPLANT HAND 2867. TENDON 00 26483 PR TRANSPLANT/GRAFT HAND TENDON 2960. 00 26485 PR TRANSPLANT PALM 2006. TENDON 00 26489 PR TRANSPLANT/GRAFT PALM TENDON 2352. 00 26490 PR REVISE THUMB TENDON 2778. 00 26492 PR THUMB ,GRAFT 2202. 00 26496 PR REVISE THUMB TENDON,OTHR 3020. 00 26497 PR FINGER TENDON TRANSFER,4-5 2159. FINGRS 00 26500 PR HAND TENDON PULLEY 1631. RECONSTRUCTION 00 26502 PR HAND TENDON PULLEY 1765. RECONST,GRAFT 00 26508 PR RELEASE THUMB CONTRACTURE 1661. 00 26516 PR FUSION MC-P 2439. JOINT,SINGLE 00 26520 PR RELEASE MC-P JT CONTRACTURE 1781. 00 26525 PR RELEASE I-P JT CONTRACTURE 2559. 00 26530 PR ARTHROPLASTY MC-P JT,SINGLE 1835. 00 26531 PR ARTHROPLASTY MC-P JT,IMPLANT 1976. 00 26535 PR ARTHROPLASTY I-P JT 1430. 00 26536 PR ARTHROPLASTY I-P JT,IMPLANT 1890. 00 26540 PR FIX COLLAT LIG,MC-P JT,I-P JT 1880. 00 26541 PR FIX COLLAT LIG,MC-P JT,GRAFT 2077. 00 26542 PR FIX COLLAT LIG,MC-P JT,LOCAL TISS 2478. 00 26545 PR FIX COLAT LIG,I-P JT,GRAFT,EACH 2538. 00 26546 PR FIX NONUNION 3125. METACARPAL/PHALANX 00 26548 PR FIX FINGER,VOLAR PLATE,I-P JT 1968. 00 26550 PR POLLICIZATION OF DIGIT 6578. 00 26560 PR REPAIR OF WEB FINGER,EACH 2075. 00 26561 PR REPAIR OF WEB FINGER,GRAFT 3095. 00 26562 PR REPAIR OF WEB FINGER,COMPLEX 5291. 00 26565 PR CORRECT METACARPAL DEFORM 1685. 00 26567 PR CORRECT FINGER DEFORMITY 1765. 00 26587 PR RECONST POLYDACT DIGIT,SOFT 3039. TIS & BONE 00 26591 PR REPAIR MUSCLES OF 1096. HAND 00 26593 PR RELEASE MUSCLES OF HAND 1536. 00 26596 PR EXCISION CONSTRICT FINGR TISSUE 1920. 00 26600 PR CLOSED RX METACARPAL FX 778.0 0 26605 PR CLOSED RX METACARPAL FX,MANIP 701.0 0 26607 PR CLOSED RX METACARP 1629. FX,W/MANIP,W/EXT FIX 00 26608 PR CLOSED RX METACARPAL 1320. FX,PERCUT 00 26615 OPEN TX METACARPAL FRACTURE 1433. SINGLE EA BONE 00 26641 PR TREAT THUMB DISLOC,MANIPULATN 941.0 0 26645 PR TREAT THUMB FX/DISLOC,MANIP 912.0 0 26650 PRQ SKEL FIXATION CARP/MTCRPL FX 1345. DISLOCATE THUMB 00 26665 OPEN TX CARPOMETACARPAL 1938. FRACTURE DISLOCATE THUMB 00 26670 PR CLOSED RX, CARPOMETACAR 851.0 DISLOC,NON-THUMB 0 26676 PR PERCUT FIX CARPOMETACAR 1258. DISLOC,NON-THUMB 00 26685 OPEN TX CARPOMETACARPAL 1760. DISLOCATE NOT THUMB 00 26686 PR OPEN RX C-MC DISLOC,COMPLEX 2104. 00 26700 PR CLOSED RX MC-P DISLOC 1081. 00 26705 PR CLOSED RX MC-P DISLOC,ANESTH 1451. 00 26706 PR PERCUT RX MC-P DISLOC 1086. 00 26715 OPEN TREATMENT 1250. METACARPOPHALANGEAL 00 DISLOCATION 1 26720 PR CLOSE RX PROX/MID FING SHFT FX 711.0 0 26725 PR CLOSE RX PROX/MID FING SHFT 1219. FX,MANIP 00 26727 PR PERCUT RX PROX/MID FING SHFT FX 1140. 00 26735 OPEN TX PHALANGEAL SHAFT 1460. FRACTURE PROX/MIDDLE EA 00 26740 PR CLOSE RX FINGR ARTICULAR FX 711.0 0 26742 PR CLOSE RX FINGR ARTICULAR 839.0 FX,MANIP 0 26746 OPEN TX ARTICULAR FRACTURE MCP/IP 1698. JOINT EA 00 26750 PR CLOSE RX DIST FINGR FX 624.0 0 26755 PR CLOSE RX DIST FINGR 709.0 FX,MANIPULATN 0 26756 PR PERCUT RX DIST FINGR 1030. FX 00 26765 OPEN TX DISTAL PHALANGEAL 970.0 FRACTURE EACH 0 26770 PR CLOSED RX IP JT DISLOCATION 683.0 0 26775 PR CLOSED RX IP JT 1238. DISLOCATION,ANESTH 00 26776 PR PERCUT RX IP JT DISLOCATION 1114. 00 26785 OPEN TX INTERPHALANGEAL JOINT 1185. DISLOCATION 1 00 26841 PR FUSION 1ST CARPOMETACARPAL JT 1916. 00 26850 PR FUSION MC-P JT 2525. 00 26852 PR FUSION MC-P JT,GRAFT 2819. 00 26860 PR FUSION FINGER JOINT 2079. 00 26861 PR FUSION FINGER JOINT,EACH ADDNL 692.0 0 26862 PR FUSION/GRAFT FINGER JT 2529. 00 26910 PR AMPUTATE METACARPAL+FINGER 1795. 00 26951 PR AMPUTATION FINGER/THUMB 1949. 00 26952 PR AMPUTATION 1686. FINGER/THUMB+FLAPS 00 26990 PR INCIS/DRAIN PELVIS/HIP,DEEP 1990. ABSCESS 00 26992 PR INCIS/DRAIN PELVIS/HIP,OPEN BONE 3179. 00 27000 PR INCIS HIP 1444. ADDUCTOR,SUBCUT,CLOSED 00 27001 PR INCIS HIP ADDUCTOR,SUBCUT,OPEN 1741. 00 27003 PR INCIS HIP ADDUC,OPEN,OBTUR 1840. NEUREC 00 27005 PR INCIS ILIOPSOAS,OPEN 2340. 00 27006 PR INCIS HIP ADDUCTORS,OPEN 2599. 00 27025 PR INCIS OF HIP/THIGH 3276. FASCIA 00 27030 PR DRAINAGE OF HIP JOINT 3036. 00 27035 PR DENERVATION OF HIP 3000. JOINT 00 27036 PR RELEASE HIP FLEXION 3584. CONTRACTURE 00 27040 PR BX SOFT 1214. TISSUES,PELV/HIP,SUPERFICL 00 27041 PR BX SOFT TISSUES,PELV/HIP,DEEP 1683. 00 27043 PR EXCISION TUMOR SOFT TISSUE 1191. PELVIS&HIP SUBQ 3+CM 00 27045 PR EXC TUMOR SOFT TISSUE PELVIS & 2640. HIP SUBFASC 5+CM 00 27047 PR EXC TUMOR SOFT TISSUE PELVIS & 1533. HIP SUBQ <3CM 00 27048 PR EXC TUMOR SOFT TISSUE PELVIS & 1547. HIP SUBFASC <5CM 00 27049 PR RAD RESECT TUMOR SOFT TISSUE 3469. PELVIS & HIP <5 CM 00 27050 PR OPEN BIOPSY SACROILIAC JOINT 1163. 00 27052 PR OPEN BIOPSY OF HIP 2063. JOINT 00 27059 PR RAD RESECTION TUMOR SOFT TISS 4264. PELVIS&HIP 5 CM/> 00 27060 PR REMOVAL OF ISCHIAL BURSA 1183 27062 PR REMOVE TROCH 1151. BURSA/CALCIFICATN 00 27066 PR EXCISISON BONE CYST BENIGN 2880. TUMOR,PELVIS/HIP,DEEP 00 27071 PR PARTIAL EXCISION DEEP PELVIS 3265. 00 27075 PR RAD RESEC UNILAT ILEUM 8193. 00 27076 PR RAD RESEC + 8981. 00 27078 PR RAD RESEC ISCHIAL TUBER+GR 7407. TROCH 00 27080 PR REMOVAL OF COCCYX 1307. 00 27086 PR REMOVE PELV/HIP 754.0 F.B.,SUBCUTANEOUS 0 27090 PR REMOVAL OF HIP PROSTHESIS 2647. 00 27091 PR REMOVAL OF HIP 5547. PROSTHESIS,COMPLEX 00 27093 PR INJECTION HIP ARTHROGRAM 1222. 00 27095 PR INJECTION HIP 1524. ARTHROGRAM,ANESTH 00 27096 PR INJECT SI JOINT 505.0 ARTHRGRPHY&/ANES/STEROID 0 W/IMAGE 27120 PR RECONSTRUC HIP 4594. SOCKET 00 27122 PR RECONSTRUC HIP SOCKET,RESEC 3470. FEM HEAD 00 27125 PR PARTIAL HIP 3378. REPLACEMENT 00 27130 PR TOTAL HIP 5757. ARTHROPLASTY 00 27132 PR CONV PREV HIP SURG TO TOT HIP 6818. ARTHROPLAS 00 27134 PR REVISE TOTAL HIP REPLACEMENT 7424. 00 27137 PR REVISE ACETABULAR PART OF 5909. TOTAL HIP 00 27138 PR REVISE FEM PART OFTOTAL HIP 5909. 00 27146 PR OSTEOTOMY OF 4552. 00 27147 PR OSTEOTOMY HIP BONE,OPEN REDN 6003. HIP 00 27156 PR OSTEOTOMY HIP/FEMUR,OPEN 6956 REDN HIP 27158 PR OSTEOTOMY PELVIS BILAT 5724. 00 27161 PR OSTEOTOMY OF NECK OF FEMUR 4309. 00 27165 PR OSTEOTOMY/FIX INTER/SUBTROCH 4874. FEMUR 00 27170 PR BONE GRAFT FEMUR 3670. HEAD/NECK/RIDGE 00 27176 PR CLOSED RX SLIP FEM 3030. EPIPHYSIS,PINS 00 27177 PR OPEN RX SLIP EPIPHYSIS 3475. 00 27187 PR REINFORCE HIP BONES 3333. 00 27193 PR CLOSED RX PELVIC RING 1662. FX/SUBLUX 00 27194 PR CLOSED RX PELV RING 2445. FX/SUBLUX,MANIP 00 27197 PR CLSD TX PELVIC RING FX W/O 301.0 MANIPULATION 0 27198 PR CLSD TX PELVIC RING FX 767.0 W/MANIPULATION W/ANES 0 27215 PR OPEN FIX ILIAC FX,INTERN FIXATN 2334. 00 27216 PR PERCUT FIX POST PELV RING FX 3357. 00 27217 PR OPEN INTERN FIX ANTER PELV RING 3252. FX 00 27218 PR OPEN INTERN FIX POST PELV RING 4894. FX 00 27220 PR CLOSED RX ACETABULAR FX 1891. 00 27222 PR CLOSED RX ACETABULAR 3019. FX,MANIPULATN 00 27226 PR OPEN INTERN FIX ACETABULAR 3094. WALL FX 00 27227 PR OPEN INTERN FIX ACETABULAR FX 5962. 00 27228 PR OPEN INTERN FIX COMPLEX 6879. ACETABUL FX 00 27230 PR CLOSED RX PROX/NECK FEMUR FX 1692. 00 27235 PR PERCUT FIX PROX/NECK FEMUR FX 3250. 00 27236 PR FEMORAL FX, OPEN TX 3562. 00 27238 PR CLOSED RX INTER/SUBTROCH 1210 FEMUR FX 27240 PR CLOSED RX INTER/SUBTROCH 3431 FX,MANIP 27244 PR TREAT INTER/SUBTROCH 3651. FX,W/PLATE/SCREW 00 27245 PR OPEN FIX INTER/SUBTROCH 5226. FX,IMPLNT 00 27246 PR CLOSED RX GR TROCHANTERIC FX 1365. 00 27248 OPEN TREATMENT GREATER 2491. TROCHANTERIC FRACTURE 00 27250 PR CLOSED RX TRAUMATIC HIP 1172. DISLOCATN 00 27252 PR CLOSED RX TRAUMA HIP 2378. DISLOC,ANESTH 00 27253 PR OPEN RX TRAUMATIC HIP 3345. DISLOCATN 00 27256 PR CLOSED RX SPONTANEOUS HIP 1077. DISLOC 00 27257 PR CLOSED RX SPONT HIP 1211. DISLOC,ANESTH 00 27258 PR OPEN RX SPONTANEOUS HIP 3962. DISLOC 00 27259 PR OPEN RX SPONT HIP DISLOC,FEM 6341. SHORT 00 27265 PR CLOSED RX POST HIP ARTHRPLAS 1298. DISLOC 00 27266 PR CLOSED RX POST HIP FIX 1835. DISLOC,ANESTH 00 27267 PR CLOSED TX FEMORAL FRACTURE 1258. PROX HEAD W/O MANIP 00 27269 PR OPEN TX FEMORAL FRACTURE 4437. PROXIMAL END HEAD 00 27275 PR MANIPULATION HIP JOINT W 651.0 ANESTHESIA 0 27279 PR ARTHRODESIS SACROILIAC JOINT 1409. PERCUTANEOUS 00 27280 PR ARTHRODESIS SACROILIAC JOINT 3179. W/OBTAINING GRAFT 00 27282 PR FUSION OF PUBIC BONES 2585. 00 27290 PR HINDQUARTER 5809. AMPUTATION 00 27295 PR DISARTICULATION OF HIP 4517. 00 27301 PR INCIS/DRAIN THIGH/KNEE 1815. ABSCESS,DEEP 00 27303 PR INCIS DEEP BONE 1619. LESN,FEMUR/KNEE 00 27305 PR ,ILIOTIBIAL,OPEN 1697. 00 27306 PR INCIS THIGH 1244. TENDON,ADDUC/HAMST,SINGL 00 27307 PR INCIS THIGH 1500. TENDON,ADDUC/HAMST,MULTI 00 27310 PR EXPLOR/DRAIN KNEE,INFECTN 2245. 00 27323 PR BX THIGH/KNEE SOFT 682.0 TISSUES,SUPERF 0 27324 PR BX THIGH/KNEE SOFT 1223. TISSUES,DEEP 00 27327 PR EXCISION TUMOR SOFT TISSUE 1168. THIGH/KNEE SUBQ <3CM 00 27328 PR EXC TUMOR SOFT TISSUE 1572. THIGH/KNEE SUBFASC <5CM 00 27329 PR RAD RESECT TUMOR SOFT TISSUE 3680. THIGH/KNEE <5CM 00 27331 PR ARTHROTOMY/EXPLORE/TREAT 1199. KNEE JOINT 00 27334 PR RMV KNEE SYNOVIUM,ANT/POST 2144. 00 27335 PR REMV SYNOVIUM KNEE,ANTER & 2714. POST 00 27337 PR EXCISON TUMOR SOFT TISSUE 976.0 THIGH/KNEE SUBQ 3+CM 0 27339 PR EXC TUMOR SOFT TISSUE 1757. THIGH/KNEE SUBFASC 5+CM 00 27340 PR REMOVAL PREPATELLA BURSA 1150. 00 27345 PR REMOVAL SYNOVIAL CYST,KNEE 1211. 00 27347 PR REMOVE KNEE CYST/GANGLION 2045. 00 27350 PR PART/FULL REMOVAL OF KNEECAP 2046. 00 27355 PR REMV BENIGN FEMUR LESION 2132. 00 27356 PR REMV BENIGN FEMUR 2314. LESN/ALLOGRAFT 00 27358 PR REMV BENIGN FEMUR LESN/INTERN 987.0 FIX 0 27360 PR PART REMV FEMUR/PROX TIB/FIB 2710. 00 27364 PR RAD RESECTION TUMOR SOFT TIS 3530. THIGH/KNEE 5 CM/> 00 27365 PR RAD RESEC TUMOR,FEMUR OR 7410 KNEE 27369 PR NJX PX CNTRST KNE ARTHG 513.0 CNTRST ENHNCD CT/MRI KNE 0 27370 PR INJECTION KNEE ARTHROGRAPHY 1098. 00 27372 PR REMV FOREIGN 1450. BODY,KNEE/THIGH,DEEP 00 27380 PR FIX INFRAPATELLA 1909. TENDON,PRIMARY 00 27381 PR FIX PATELLA TENDN,SECONDARY 2581. 00 27385 PR FIX QUAD/HAMSTR MUSC 2036. RUPT,PRIMARY 00 27386 PR FIX QUAD/HAMSTR MUSC 2951. RUPT,SECOND 00 27390 PR TENOTOMY,HAMSTR,KNEE- 1596. THIGH,SINGL 00 27391 PR TENOTOMY,UNI HAMSTR,KNEE- 1837. THIGH,MULTI 00 27392 PR TENOTOMY,BI HAMSTR,KNEE- 2252. THIGH,MULTI 00 27393 PR LENGTHEN HAMSTR 1628. TENDON,SINGLE 00 27394 PR LENGTHEN HAMSTR 2102. TENDON,MULTI,ONE LEG 00 27395 PR LENGTHEN HAMSTR 2820. TENDON,MULTI,2 LEGS 00 27400 PR TENDON/MUSC XFER,HAMSTR- 1729. FEMUR 00 27403 PR ARTHROTOMY,OPEN REPAIR 2424. MENISCUS 00 27405 PR REPAIR COLLAT 2379. LIGAMT/CAPSULE,KNEE 00 27407 PR REPAIR CRUCIATE LIGAMENT,KNEE 2823. 00 27412 PR AUTOCHONDROCYTE IMPLANT 6139. KNEE 00 27415 PR OSTEOCHONDRAL KNEE 4699. ALLOGRAFT 00 27416 PR OSTEOCHONDRAL KNEE 2888. AUTOGRAFT 00 27418 PR REPAIR ANTER TIBIAL TUBERCLE 3182. 00 27420 PR REVISION OF UNSTABLE PATELLA 2515. 00 27422 PR FIX UNSTABLE PATELLA,EXTEN 2606. REALIGN 00 27425 PR LATERAL RETINACULAR RELEASE 2273. OPEN 00 27427 PR LIGMT REVISION,KNEE,EXTRA-ARTIC 3636. 00 27428 PR LIGMT REVISION,KNEE,INTRA-ARTIC 3983. 00 27429 PR LIGMT REVISN,KNEE,INTRA/EXTRA- 4242. ART 00 27430 PR REVISION QUADRICEPS 2354. 00 27435 PR POST CAPSULAR RELEASE,KNEE 2855. 00 27438 PR ARTHROPLASTY PATELLA WITH 2631. IMPLANT 00 27445 PR PLASTY KNEE,CONSTRAINED 4467. PROSTHESIS 00 27446 PR PLASTY KNEE,MED OR LAT 3738. COMPARTMT 00 27447 PR TOTAL KNEE ARTHROPLASTY 5696. 00 27448 PR OSTEOTOMY FEMUR 2632. SHAFT/SUPRACONDY 00 27450 PR OSTEOTOMY FEMUR SHAFT,W 3289. FIXATN 00 27454 PR OSTEOTOMIES FEMUR 4033. SHAFT+INTRA ROD 00 27455 PR OSTEOTOMY PROX TIB,1 1643. COMPARTMT 00 27500 PR CLOSED RX FEMUR SHAFT FX 1700. 00 27502 PR CLOSED RX FEMUR SHAFT 2500. FX+MANIP 00 27503 PR CLOSED RX CONDYLAR FX+MANIP 2855. 00 27506 PR OPEN RX FEMUR FX+INTRAMED 4032. ROD 00 27507 PR OPEN RX FEMUR FX+PLATE/SCREW 3203. 00 27509 PR PERCUT FIX DISTAL 2270. FEMUR 00 27510 PR CLOSED RX FEMUR,DISTAL+MANIP 2178. 00 27511 OPEN TX FEMORAL SUPRACONDYLAR 3314. FRACTURE W/O EXTENSION 00 27513 OPEN TX FEMORAL SUPRACONDYLAR 4247. FRACTURE W EXTENSION 00 27514 OPEN TX FEMORAL FRACTURE DISTAL 4092. MED/LAT CONDYLE 00 27520 PR CLOSED RX PATELLA FX 1047. 00 27524 PR OPEN RX PATELLA FX 2423. 00 27530 PR CLOSED RX TIBIAL PLATEAU FX 1258. 00 27532 PR CLOSED RX TIB PLAT FX+MANIP 1999. 00 27535 OPEN TX TIBIAL FRACTURE PROXIMAL 2874. UNICONDYLAR 00 27536 PR OPEN RX BILAT TIB PLAT 3637. FX 00 27538 PR CLOSED RX TIB TUBER FX 1559. 00 27540 OPEN TX INTERCONDYLAR 3023. SPINE/TUBRST FRACTURE KNEE 00 27550 PR CLOSED RX KNEE DISLOCATN 1253. 00 27552 PR CLOSED RX KNEE DISLOC+ANESTH 1966. 00 27556 OPEN TX KNEE DISLOCATION W/O 3141 LIGAMENTOUS REPAIR 27560 PR CLOSED RX KNEECAP DISLOCATN 892.0 0 27570 PR MANIPULATN KNEE JT+ANESTHESIA 515.0 0 27580 PR FUSION OF KNEE 4566. 00 27590 PR AMPUTATE THIGH,THRU FEMUR 3131. 00 27592 PR AMPUTATE THIGH,OPEN CIRCULAR 2440 27594 PR AMPUTATE THIGH,SECONDRY 1449. CLOSUR 00 27596 PR AMPUTATE THIGH,RE-AMPUTATN 2374. 00 27598 PR AMPUTATE LOWER LEG AT KNEE 2547 27600 PR DECOMPRESS ANT/LAT LEG 1378. CMPART 00 27601 PR DECOMPRESS POST LEG 1130. COMPARTMT 00 27602 PR DECOMPRESS ANT/LAT+POST LEG 1406. CMPART 00 27603 PR DRAIN LOWER LEG DEEP 1856. ABSC/HEMATOMA 00 27605 PR INCIS ACHILLES TENDON+LOCAL 1487. ANESTH 00 27606 PR INCIS ACHILLES TENDON+GEN 1818. ANESTH 00 27607 PR DRAIN LEG/ANKLE BONE FOR 1939. INFECT 00 27610 PR EXPLORE/TREAT ANKLE JOINT 2053. 00 27612 PR EXPLORE/RELEASE POST CAP 1793. ANKLE JT 00 27613 PR BX LOW LEG SOFT 645.0 TISSUE,SUPERFICIAL 0 27614 PR BX LOW LEG SOFT TISSUE,DEEP 1868. 00 27615 PR RAD RESECTION TUMOR SOFT 3716. TISSUE LEG/ANKLE <5CM 00 27616 PR RAD RESECTION TUMOR SOFT 3052. TISSUE LEG/ANKLE 5 CM/> 00 27618 PR EXC TUMOR SOFT TISSUE 1826. LEG/ANKLE SUBQ <3CM 00 27619 PR EXC TUMOR SOFT TISSUE 1660. LEG/ANKLE SUBFASCIAL <3CM 00 27620 PR EXPLOR ANKLE JOINT 1152. 00 27625 PR EXPLOR ANKLE JT+SYNOVECTOMY 2056. 00 27626 PR EXPLOR ANKLE 1574. JT+TENOSYNOVECTOMY 00 27630 PR EXCIS LESN TENDON SHEALTH 1779. LEG/ANKLE 00 27632 PR EXC TUMOR SOFT TISSUE 1422. LEG/ANKLE SUBQ 3+CM 00 27634 PR EXC TUMOR SOFT TISSUE 2335. LEG/ANKLE SUBFASC 5+CM 00 27635 PR EXCIS BENIGN 1945. LESN,TIB/FIB 00 27637 PR EXCIS BENIGN 2698. LESN,TIB/FIB+AUTOGRFT 00 27638 PR EXCIS BENIGN 2533. LESN,TIB/FIB+ALLOGRFT 00 27640 PR PARTIAL REMOVAL OF 2940. TIBIA 00 27641 PR PARTIAL REMOVAL OF FIBULA 2393. 00 27645 PR RAD RESEC TUMOR,TIBIA 3531. 00 27648 PR INJECTION FOR ANKLE 863.0 ARTHROGRAM 0 27650 PR REPAIR ACHILLES TENDON,PRIMARY 2301. 00 27654 PR REPAIR ACHILLES 2314. TENDON,SECONDARY 00 27656 PR REPAIR LEG FASCIA 1565. DEFECT 00 27658 PR REPAIR FLEX LEG TENDON,PRIM,EA 1833. 00 27659 PR REPAIR FLEX LEG 2356. TENDON,SECOND,EA 00 27664 PR REPAIR EXTEN LEG 918.0 TENDN,PRIM,EACH 0 27665 PR REPAIR EXTEN LEG 2123. TENDN,SECOND,EA 00 27675 PR REPAIR PERONEAL TENDONS 1733. 00 27676 PR REPAIR PERONEAL TENDONS,FIB 2027. OSTEOTMY 00 27680 PR RELEASE TIB/FIB/ANKLE FLEX 1453. TENDON,EA 00 27681 PR RELEASE TIB/FIB/ANKL FLEX 1948. TENDON,MUL 00 27685 PR LENGTH/SHORT LEG/ANKL 1920. TENDON,SINGLE 00 27686 PR LENGTH/SHORT LEG/ANKL 2604. TENDON,MULTI 00 27687 PR GASTROCNEMIUS RECESSION 1554. 00 27690 PR XFER SINGLE SUPERFICI LOW LEG 2032. TENDON 00 27691 PR XFER SINGLE DEEP LOW LEG 2653. TENDON 00 27695 PR REPAIR 1 COLLAT ANKLE 1652. LIGMNT,PRIMARY 00 27696 PR REPAIR BOTH COLLAT ANKL 1964. LIGMT,PRIMRY 00 27698 PR REPAIR COLLAT ANKLE 3175. LIGMNT,SECONDARY 00 27700 PR ARTHROPLASTY ANKLE JOINT 1547. 00 27702 PR TOTAL ANKLE REPLACEMENT 3541. 00 27703 PR SECONDARY 3622. RECONSTRUCTION,ANKLE JOINT 00 27704 PR REMOVAL OF ANKLE IMPLANT 1469. 00 27705 PR OSTEOTOMY TIBIA 2486. 00 27707 PR OSTEOTOMY FIBULA 1235. 00 27709 PR OSTEOTOMY TIBIA & 2424. FIBULA 00 27712 PR OSTEOTOMIES TIB/FIB+INTRAMED 3946. ROD 00 27715 PR LENGTHENING 3727. TIBIA/FIBULA 00 27720 RPR NON/MALUNION TIBIA 3100. 00 27722 RPR NON/MALUNION TIBIA+SLIDING 3175. GRAFT 00 27724 RPR NON/MALUNION TIBIA+AUTOGRAFT 4080. 00 27726 PR RPR FIBULA NONUNION/MALUNION 2748. W INT FIXATION 00 27730 PR ARREST,EPIPHYSEAL,OPEN,DISTAL 3206. TIBIA 00 27732 PR STOP GROWTH DISTAL FIBULA 1316. EPIPHYSIS 00 27734 PR STOP GROWTH DISTAL TIB/FIB 1967. EPIPHYSES 00 27745 PR REINFORCE TIBIA 2678. 00 27750 PR CLOSED RX TIBIA SHAFT 1112. FX 00 27752 PR CLOSED RX TIBIA SHAFT 1737. FX,MANIPULATN 00 27756 PR PERCUT RX TIBIA SHAFT 2063. FX 00 27758 PR OPEN RX TIBIA SHAFT FX,SCREWS 2779. 00 27759 PR TREAT TIBIAL SHAFT FX, INTRAMED 3225. IMPLANT 00 27760 PR CLOSED RX MED MALLEOLUS FX 1071. 00 27762 PR CLOSED RX MED MALLEOLUS 1619. FX,MANIP 00 27766 OPEN TREATMENT MEDIAL MALLEOLUS 2069. FRACTURE 00 27767 PR CLOSED TREATMENT PST 773.0 MALLEOLUS FRACTURE W/O MANIP 0 27768 PR CLOSED TREATMENT PST 1290. MALLEOLUS FRACTURE W MANIP 00 27769 PR OPEN TREATMENT POSTERIOR 2057. MALLEOLUS FRACTURE 00 27780 PR CLOSED RX PROX/SHAFT FIBULA FX 978.0 0 27781 PR CLOSED RX PROX/SHAFT FIB 1401. FX,MANIP 00 27784 OPEN TREATMENT PROXIMAL 1802. FIBULA/SHAFT FRACTURE 00 27786 PR CLOSED RX DIST FIBULA 1027. FX 00 27788 PR CLOSED RX DIST FIBULA FX,MANIP 1425. 00 27792 OPEN TX DISTAL FIBULAR FRACTURE 1937. LAT MALLEOLUS 00 27808 CLOSED TX BIMALLEOLAR ANKLE 1099. FRACTURE W/O MANIP 00 27810 CLOSED TX BIMALLEOLAR ANKLE 1582. FRACTURE W MANIP 00 27814 OPEN TREATMENT BIMALLEOLAR 2569. ANKLE FRACTURE 00 27816 PR CLOSED RX TRIMALLEOLAR FX 808.0 0 27818 PR CLOSED RX TRIMALLEOLAR 1646. FX,MANIP 00 27822 OPEN TX TRIMALLEOLAR ANKLE FX W/O 2848. FIX PST LIP 00 27823 OPEN TX TRIMALLEOLAR ANKLE FX W 3246. FIX PST LIP 00 27824 PR CLOSED RX WEIGHT BEAR DIST 1093. TIBIA 00 27825 PR CLOSED RX WEIGHT BEAR DIST 1885. TIB,MANIP 00 27826 OPEN TREATMENT FRACTURE DISTAL 2424. TIBIA FIBULA 00 27827 OPEN TREATMENT FRACTURE DISTAL 3560. TIBIA ONLY 00 27828 OPEN TREATMENT FRACTURE DISTAL 4010. TIBIA & FIBULA 00 27829 OPEN TX DISTAL TIBIOFIBULAR JOINT 1612. DISRUPTION 00 27830 PR CLOSED RX PROX TIB/FIB DISLOC 947.0 0 27832 OPEN TX PROX TIBFIB JOINT 2608. DISLOCATE EXC PROX FIB 00 27840 PR CLOSED RX ANKLE DISLOCATN 1115. 00 27842 PR CLOSED RX ANKLE 1498. DISLOCATN,ANESTH 00 27846 PR OPEN RX ANKLE 2364. DISLOCATN 00 27848 PR OPEN RX ANKLE 2784. DISLOCATN+FIXATN 00 27860 PR MANIPULATION ANKLE JT W 579.0 ANESTHESIA 0 27870 PR 3269. ARTHRODESIS,ANKLE,OPEN 00 27880 PR AMPUTATION LOW LEG THRU TIB/FIB 2578. 00 27882 PR AMPUTATION LOW LEG,CIRCULAR 2104. 00 27884 PR AMPUTATION LOW LEG,SECOND 1489. CLOSURE 00 27886 PR RE-AMPUTATION LOWER LEG 2149. 00 27889 PR ANKLE DISARTICULATION 2316 27892 PR DECOMPRESS FASCIOTOMY 1971. LEG,ANT/LAT 00 27894 PR DECOMPRESS LEG,ANT/LAT & POST 3041. 00 28001 PR INCIS/DRAINAGE BURSA OF FOOT 1002 28002 PR DEEP DISSEC FOOT INFEC,1 BURSA 1536. 00 28003 PR DEEP DISSEC FOOT 2127. INFEC,MULTIPLE 00 28008 PR INCISION OF FOOT/TOE FASCIA 1099. 00 28010 PR INCISION SUBCUT TOE TENDON 1083. 00 28011 PR INCISION SUBCUT TOE TENDON,>1 821.0 0 28020 PR EXPLOR TARSAL/TARSOMETATAR JT 1377. 00 28022 PR EXPLOR METATARSO-PHALANG JT 1409. 00 28035 PR TARSAL TUNNEL RELEASE 1515. 00 28039 PR EXCISION TUMOR SOFT TISSUE 1185. FOOT/TOE SUBQ 1.5+CM 00 28041 PR EXC TUMOR SOFT TISSUE 1087. FOOT/TOE SUBFASC 1.5+CM 00 28043 PR EXCISION TUMOR SOFT TISSUE 991.0 FOOT/TOE SUBQ <1.5CM 0 28045 PR EXC TUMOR SOFT TISSUE 1785. FOOT/TOE SUBFASC <1.5CM 00 28046 PR RAD RESECTION TUMOR SOFT 2579. TISSUE FOOT/TOE <3CM 00 28060 PR PART EXCIS PLANTAR FASCIA 1524. 00 28080 PR EXCIS INTERDIGITAL NEUROMA,EA 1236. 00 28086 PR SYNOVECTOMY FLEX TENDN 1948. SHEATH,FOOT 00 28090 PR EXCIS TENDN/CAPSULE LESN,FOOT 1362. 00 28092 PR EXCIS TENDN/CAPSULE LESN,TOES 1290. 00 28100 PR REMV TALUS/HEEL BENIGN BONE 2167. LESN 00 28103 PR REMV TALUS/HEEL BENIGN 1955. LESN,ALLOGRFT 00 28104 PR REMV TARSAL/METATARSAL BENIGN 1888. BONE LESN 00 28107 PR REMV OTHR FOOT BENIGN 1854. LESN,ALLOGRFT 00 28108 PR REMV TOE BENIGN BONE LESN 1254. 00 28110 PR PART EXCIS 5TH METATARSAL HEAD 1659. 00 28111 PR FULL EXCIS 1ST METATARSAL HEAD 1262. 00 28112 PR FULL EXCIS 2,3 OR 4TH METATAR 1457. HEAD 00 28113 PR FULL EXCIS 5TH METATARSAL HEAD 1514. 00 28116 PR EXCIS TARSAL COALITION 1982. 00 28118 PR REMOVAL OF HEEL BONE 1719. 00 28119 PR REMOVAL OF HEEL SPUR 1345. 00 28120 PR PART REMV TALUS OR CALCANEUS 1826. 00 28122 PR PART REMV OTHR 2001. TARSAL/METATARSAL 00 28124 PR PART REMV PHALANX OF TOE 1428. 00 28130 PR REMOVAL OF TALUS 1634. 00 28140 PR REMOVAL OF 1986. METATARSAL 00 28153 PR RESEC HEAD OF PHALANX,TOE 1181. 00 28160 PR RESEC TOE AT I-P JT,SINGLE,EA 1228. 00 28190 PR REMV FOOT FOREIGN 738.0 BODY,SUBCUTANEOUS 0 28192 PR REMV FOOT FOREIGN BODY,DEEP 1151. 00 28200 PR REPAIR FLEX FOOT TENDON,EA 1379. 00 28208 PR REPAIR EXTEN LEG 1321. TENDON,PRIM,EA 00 28220 PR RELEASE FLEX FOOT 1326. TENDON,SINGLE 00 28222 PR RELEASE FLEX FOOT 1834. TENDON,MULTIPLE 00 28225 PR RELEASE EXTEN FOOT 1057. TENDON,SINGLE 00 28230 PR INCISION FLEX FOOT TENDON(S) 1292. 00 28232 PR INCISION FLEX TOE 1177. TENDON 00 28234 PR INCISION EXTEN FOOT/TOE TENDON 1191. 00 28238 PR RECONST POST TIB TEND,EXCIS 2397. ACC TAR NAV 00 28240 PR RELEASE OF BIG TOE TENDN 1653. 00 28250 PR DIVISN PLANTAR FASCIA/MUSCLE 1642. 00 28260 PR CAPSULOTOMY MIDFOOT JT,MED 2000. RELEASE 00 28261 PR CAPSULOTOMY MIDFOOT,TENDN 3580. LENGTH 00 28262 PR CAPSULOTOMY 4011. MIDFOOT,EXTENSIVE 00 28264 PR CAPSULOTOMY 2518. MIDTARSAL 00 28270 PR CAPSULOTOMY MT-P JT,FOOT,EACH 1402. 00 28272 PR CAPSULOTOMY I-P JT,FOOT,EA 1170. 00 28285 PR REPAIR OF HAMMERTOE,ONE 1384. 00 28288 PR PART REMV BONE METATARSAL 1494. HEAD,EA 00 28289 PR HALLUX RIGIDUS W/CHEILECTOMY 2101. 1ST MP JT W/O IMPLT 00 28291 PR HALLUX RIGIDUS W/CHEILECTOMY 2610. 1ST MP JT W/IMPLT 00 28292 PR CORRJ HALLUX VALGUS W/SESMDC 1959. W/RESCJ PROX PHAL 00 28295 PR CORRJ HALLUX VALGUS W/SESMDC 2432. W/PROX METAR OSTEOT 00 28296 PR CORRJ HALLUX VALGUS W/SESMDC 2305. W/DIST METAR OSTEOT 00 28297 PR CORRJ HALLUX VALGUS W/SESMDC 2427. W/1METAR MEDIAL CNF 00 28298 PR CORRJ HALLUX VALGUS W/SESMDC 2028. W/PROX PHLNX OSTEOT 00 28299 PR CORRJ HALLUX VALGUS W/SESMDC 2554. W/2 OSTEOT 00 28300 PR OSTEOTOMY HEEL BONE 2963. 00 28302 PR OSTEOTOMY TALUS 2952. 00 28304 PR OSTEOTOMY MIDTARSAL BONES 2282. 00 28306 PR OSTEOTOMY 1ST 1715. METATARSAL,BASE/SHAFT 00 28308 PR OSTEOTOMY METATARSAL (NOT 1497. 1ST) 00 28309 PR OSTEOTOMY 3204. METATARSALS,MULTIPLE 00 28310 PR OSTEOTOMY PROX PHALANX,1ST 1965. TOE 00 28312 PR OSTEOTOMY,ANY PHALANX,ANY 1303. TOE 00 28313 PR RECONSTRUC TOE DEFORM,SOFT 1500. TISSUE 00 28315 PR REMOV SESAMOID BONE,1ST TOE 1404. 00 28320 PR REPAIR NON/MALUNION TARSAL 2135. BONE(S) 00 28322 PR REPAIR NON/MALUNION 2430. METATARSAL 00 28344 PR REPAIR EXTRA TOE(S) 1990. 00 28345 PR REPAIR WEBBED TOE(S) 1430. 00 28400 PR CLOSED RX HEEL FX 832.0 0 28405 PR CLOSED RX HEEL FX,MANIPULATN 1325. 00 28406 PR PERCUT RX HEEL FX 1731. 00 28415 OPEN TREATMENT CALCANEAL 3898. FRACTURE 00 28420 OPEN TREATMENT CALCANEAL 4515. FRACTURE W BONE GRAFT 00 28430 PR CLOSED RX TALUS FX 796.0 0 28435 PR CLOSED RX TALUS FX,MANIPULATN 1034. 00 28436 PR PERCUT RX TALUS FX 1145. 00 28445 OPEN TREATMENT TALUS FRACTURE 3500. 00 28446 PR OPEN OSTEOCHONDRAL 3556. AUTOGRAFT TALUS 00 28450 PR CLOSED RX TARSAL FX,EACH 769.0 0 28455 PR CLOSED RX TARSAL FX,MANIP,EACH 728.0 0 28456 PR PERCUT RX TARSAL FX,EACH 796.0 0 28465 OPEN TX TARSAL FRACTURE XCP 1770. TALUS &CALCANEUS EA 00 28470 PR CLOSED RX METATARSAL FX 757.0 0 28475 PR CLOSED RX METATARSAL FX,MANIP 920.0 0 28476 PR PERCUT RX METATARSAL FX 1091. 00 28485 OPEN TREATMENT METATARSAL 1493. FRACTURE EACH 00 28490 PR CLOSED RX BIG TOE FRACTURE 425.0 0 28495 PR CLOSED RX BIG TOE FX,MANIP 530.0 0 28496 PR PERCUT BIG TOE FX 1593. 00 28505 OPEN TX FRACTURE GREAT 1730. TOE/PHALANX/PHALANGES 00 28510 PR CLOSED RX TOE FX 397.0 0 28515 PR CLOSED RX TOE FX,MANIPULATN 414.0 0 28525 OPEN TX FRACTURE 1612. PHALANX/PHALANGES NOT GREAT TOE 00 28540 PR CLOSED RX TARSAL DISLOCATION 639.0 0 28545 PR CLOSED RX TARSAL 699.0 DISLOC,ANESTH 0 28546 PR PERCUT RX TARSAL DISLOCATION 1427. 00 28555 OPEN TREATMENT TARSAL BONE 2306. DISLOCATION 00 28570 PR CLOSED RX TALOTARSAL DISLOC 546.0 0 28576 PR PERCUT RX TALOTARSAL 1836. DISLOCATION 00 28585 OPEN TREATMENT TALOTARSAL JOINT 2137. DISLOCATION 00 28600 PR CLOSED RX TAR-METATAR 671.0 DISLOCATION 0 28605 PR CLOSED RX TAR-METATAR 843.0 DISLOC,ANESTH 0 28606 PR PERCUT RX TAR-METATAR FOOT 2661. DISLOC 00 28615 OPEN TREATMENT TARSOMETATARSAL 2085. JOINT DISLOCATION 00 28630 PR CLOSED RX MT-PHAL TOE 387.0 DISLOCATION 0 28635 PR CLOSED RX MT-PHAL TOE 453.0 DISLOC,ANESTH 0 28636 PR PERCUT RX MT-PHAL TOE 1242. DISLOCATION 00 28645 OPEN TX METATARSOPHALANGEAL 2346. JOINT DISLOCATION 00 28660 PR CLOSED RX I-P JT,TOE DISLOCATION 290.0 0 28665 PR CLOSED RX I-P JT,TOE 474.0 DISLOC,ANESTH 0 28666 PR PERCUT RX I-P JT,TOE DISLOC 478.0 0 28705 PR FUSION FOOT BONES,PANTALAR 5070. 00 28715 PR FUSION FOOT BONES,TRIPLE 3060. 00 28725 PR FUSION FOOT BONES,SUBTALAR 2672. 00 28730 PR FUSION FOOT 2571. BONES,MIDTARSAL,MULTI 00 28735 PR FUSION FOOT 2508. BONES,MIDTARSAL,OSTEOTMY 00 28737 PR FUSION W/TEND ADV,MIDTAR NAV- 2217. CUNEIFORM 00 28740 PR FUSION FOOT BONE,MIDTARSAL,1 JT 2564. 00 28750 PR FUSION BIG TOE,MT-P JT 2630. 00 28755 PR FUSION BIG TOE,I-P JOINT 1512. 00 28760 PR FUSION BIG TOE,I-P JT+TENDN XFER 2089. 00 28800 PR AMPUTATION FOOT,MIDTARSAL- 1574. CHOPART 00 28805 PR AMPUTATION 1901. FOOT,TRANSMETATARSAL 00 28810 PR AMPUTATION 1281. METATARSAL+TOE,SINGLE 00 28820 PR AMPUTATION TOE,MT-P JT 1388. 00 28825 PR AMPUTATION TOE,I-P JT 1475. 00 29010 PR APPLY BODY CAST,RISSER JACKET 697.0 0 29035 PR APPLY BODY CAST,SHLDR-HIP 1728 29065 PR APPLY LONG ARM CAST 278.0 0 29075 PR APPLY FOREARM CAST 257.0 0 29085 PR APPLY HAND/WRIST CAST 274.0 0 29105 PR APPLY LONG ARM SPLINT 218.0 0 29125 PR APPLY FOREARM SPLINT,STATIC 161.0 0 29126 PR APPLY FOREARM SPLINT,DYNAMIC 193.0 0 29130 PR APPLY FINGER SPLINT,STATIC 103.0 0 29131 PR APPLY FINGER SPLINT,DYNAMIC 165.0 0 29200 PR STRAPPING OF CHEST 127.0 0 29240 PR STRAPPING OF 137.0 SHOULDER 0 29260 PR STRAPPING OF ELBOW OR WRIST 124.0 0 29280 PR STRAPPING OF HAND OR FINGER 122.0 0 29305 PR APPLY OF HIP CAST,ONE LEG 650 29325 PR APPLY OF HIP CASTS,TWO LEGS 743.0 0 29345 PR APPLY LONG LEG CAST 407.0 0 29355 PR APPLY LONG LEG CAST,WALKER 356.0 0 29365 PR APPLY LONG LEG CAST,CYLINDER 438.0 0 29405 PR APPLY SHORT LEG CAST 266.0 0 29425 PR APPLY SHORT LEG CAST,WALKER 289.0 0 29450 PR APPLY OF CLUBFOOT 461.0 CAST 0 29505 PR APPLY LONG LEG SPLINT 207.0 0 29515 PR APPLY LOWER LEG SPLINT 179.0 0 29520 PR STRAPPING OF HIP 179.0 0 29530 PR STRAPPING OF KNEE 126.0 0 29540 PR STRAPPING; ANKLE &/OR FOOT 96.00 29550 PR STRAPPING OF TOES 94.00 29580 PR APPLY OF PASTE BOOT 122.0 0 29581 PR APPL MLTLAYR COMPRES LEG 157.0 BELOW KNEE W/ANKLE FOOT 0 29582 PR APPL MLTLAYR COMPRES THGH LEG 178.0 ANKLE FT WHEN DONE 0 29805 PR SHLDR ARTHROSCOP,DIAGNOSTIC 1533. 00 29806 PR SHLDR 3387. ARTHROSCOP,SURG,CAPSULORRHAPH 00 Y 29807 PR SHLDR 3301. ARTHROSCOP,SURG,REPAIR,SLAP 00 LESION 29819 PR SHLDR 1902. ARTHROSCOP,SURG,W/REMOVAL,LOOS 00 E/FB 29820 PR SHLDR ARTHROSCOP,PART 1903. SYNOVECT 00 29822 PR SHLDR ARTHROSCOP,PART 1862. DEBRIDE 00 29823 PR SHLDR ARTHROSCOP,EXTEN 2034. DEBRIDE 00 29824 PR SHLDR ARTHROSCOP,SURG,DIS 2074. CLAVICULECTOMY 00 29825 PR SHLDR ARTHROSCOP,LYSE 1920. ADHESNS 00 29826 PR SHOULDER SCOPE BONE SHAVING 2190. 00 29827 PR SHLDR 3551. ARTHROSCOP,SURG,W/ROTAT CUFF 00 REPR 29828 PR ARTHROSCOPY SHOULDER 2731. SURGICAL BICEPS TENODESIS 00 29834 PR ELBOW ARTHROSCOP,REMV LOOSE 1891. BODY 00 29835 PR ELBOW ARTHROSCOP,PART 2072. SYNOVECT 00 29836 PR ELBOW ARTHROSCOP,FULL 1483 SYNOVECT 29837 PR ELBOW ARTHROSCOP,PART 1891. DEBRIDE 00 29838 PR ELBOW ARTHROSCOP,EXTEN 2409. DEBRIDE 00 29840 PR WRIST ARTHROSCOP,DIAGNOSTIC 1424. 00 29844 PR WRIST ARTHROSCOP,PART 1813. SYNOVECT 00 29845 PR WRIST ARTHROSCOP,FULL 2072. SYNOVECT 00 29846 PR WRIST ARTHROSCOP,EXCIS TRIANG 1943. CART 00 29847 PR WRIST ARTHROSCOP,INTERN 1919. FIXATN 00 29848 PR WRIST ARTHROSCOP,RELEASE 1444. XVERS LIG 00 29850 PR KNEE SCOPE/SURG/INTERCOND FX 2149. AID 00 29851 PR KNEE SCOPE/SURG/INCOND FX 3048. AID+FIXAT 00 29855 PR TIBIAL SCOPE/SURG/FX 2733. AID,UNICONDYLR 00 29860 PR HIP ARTHROSCOPY, DX 1701. 00 29861 PR HIP SCOPE/REMOV LOOSE/FOREIGN 2190. BODY 00 29862 PR HIP SCOPE/REMV 2440. BODY,PLASTY/RESECTN 00 29863 PR HIP SCOPE/REMV 2434. BODY,SYNOVECTOMY 00 29866 PR KNEE SCOPE, AUTOGRAFT IMPANT 5449. 00 29867 PR KNEE SCOPE, ALLOGRAFT IMPANT 3972. 00 29868 PR KNEE SCOPE, MENISC TRANSPLANT 6481. 00 29870 PR KNEE SCOPE,DIAGNOSTIC 1307. 00 29871 PR KNEE 1636. SCOPE,CLEAN/DRAIN 00 29873 PR KNEE SCOPE, W/LATERAL RELEASE 1646. 00 29874 PR KNEE SCOPE,REMV LOOSE BODY 1824. 00 29875 PR KNEE SCOPE,PART SYNOVECT 1800. 00 29876 PR KNEE SCOPE,FULL SYNOVECT 2148. 00 29877 PR KNEE SCOPE,SHAVE ARTICULAR 1920. CART 00 29879 PR KNEE SCOPE,ABRASN 2208. ARTHROPLASTY 00 29880 PR ARTHRS KNEE W/MENISCECTOMY 2640. MED&LAT W/SHAVING 00 29881 PR ARTHRS KNE SURG 2184. W/MENISCECTOMY MED/LAT W/SHVG 00 29882 PR KNEE SCOPE,MED OR LAT MENIS 2364. REPAIR 00 29883 PR KNEE SCOPE,MED+LAT MENIS 3072. REPAIR 00 29884 PR KNEE SCOPE,LYSIS OF ADHESNS 1847. 00 29885 PR KNEE SCOPE,DRILL OSTE 2650. DISSEC+GRFT 00 29886 PR KNEE SCOPE,DRILL OSTEIT DISSEC 1626. 00 29887 PR KNEE SCOPE,DRILL OSTE DISS+INT 2681. FIX 00 29888 PR KNEE SCOPE,AID ANT CRUCIATE 3908. REPAIR 00 29889 PR KNEE SCOPE,AID POST CRUC 3864. REPAIR 00 29891 PR ANKLE SCOPE,EXCIS OSTEOCHON 2424. DEFCT 00 29894 PR ANKLE SCOPE,REMVL LOOSE BODY 1766. 00 29895 PR ANKLE SCOPE,PART SYNOVECTOMY 1848. 00 29897 PR ANKLE SCOPE,PART DEBRIDEMENT 1732. 00 29898 PR ANKLE SCOPE,EXTENS 2424. DEBRIDEMNT 00 29899 PR ANKLE SCOPE,W/ANKLE 3685. ARTHRODESIS 00 29904 PR ARTHROSCOPY SUBTALAR JOINT 2225. REMOVE LOOSE/FOREIGN BODY 00 29905 PR ARTHROSCOPY SUBTALAR JOINT 1984. WITH SYNOVECTOMY 00 29906 PR ARTHROSCOPY SUBTALAR JOINT 2478. WITH DEBRIDEMENT 00 29907 PR ARTHROSCOPY SUBTALAR JOINT 3106. SUBTALAR ARTHRODESIS 00 29914 PR ARTHROSCOPY HIP 4023. W/FEMOROPLASTY 00 29915 PR ARTHROSCOPY HIP 4023. W/ACETABULOPLASTY 00 29916 PR ARTHROSCOPY HIP W/LABRAL 3520. REPAIR 00 30020 PR DRAIN ABSCESS/HEMATOMA,NASAL 614 SEPTUM 30100 PR INTRANASAL BIOPSY 288.0 0 30110 PR EXCISION NOSE POLYP(S),SIMPLE 467.0 0 30117 PR EXCIS/DEST INTRANAS LESION; INT 2185. APP 00 30118 PR EXCIS/DEST INTRANAS LESION; EXT 2957. APP 00 30120 PR EXCISION SKIN OF NOSE 2000. 00 30125 PR EXCIS NASAL DERMOID,COMPLX 1520. 00 30130 PR EXCISION TURBINATE 947.0 0 30140 PR EXCISION TURBINATE,SUBMUCOUS 1101. 00 30150 PR PARTIAL EXCISION OF 1746. NOSE 00 30160 PR EXCISION OF NOSE 2979. 00 3028F OXYGEN SATURATION RESULTS 0.00 DOCUMENTED/REVIEWED 30300 PR REMOVE NASAL FOREIGN BODY 575.0 0 30310 PR REMV NASAL FOR BODY,GEN 543 ANESTH 30400 PR RECONSTR NOSE 2800. 00 30410 PR RECONSTR 3180. NOSE,COMPLETE+EXTERNAL 00 30420 PR RECONSTR NOSE+MAJ SEPTAL 3449. REPAIR 00 30430 PR REVIS NOSE,SECONDARY,MINOR 2026. 00 30435 PR REVIS 3744. NOSE,SECONDARY,INTERMEDIATE 00 30450 PR REVIS NOSE,SECONDARY,MAJOR 4873. 00 30460 PR REVIS NOSE/CLEFT LIP/TIP 2445. 00 30462 PR REVIS NOSE/CLEFT LIP/TIP,SEPTUM 6329. 00 30465 PR REPAIR NASAL CAVITY STENOSIS 2500. 00 30520 PR REPAIR OF NASAL 2106. SEPTUM 00 30540 PR REPAIR CHOANAL 1824. ATRESIA,INTRANASAL 00 30560 PR RELEASE OF NASAL ADHESIONS 565.0 0 30580 PR REPAIR ORO-MAXILLARY FISTULA 1140. 00 30600 PR REPAIR ORO-NASAL FISTULA 1785. 00 30620 PR INTRANASAL RECONSTRUCTION 1971. 00 30630 PR REPAIR NASAL SEPTUM PERFORATN 1386. 00 30802 PR CAUTER TURBINATE 764 MUCOSA,INTRAMURAL 30901 PR CTRL NOSEBLEED,ANTER,SIMPLE 239.0 0 30903 PR CTRL NOSEBLEED,ANTER,COMPLEX 407.0 0 30905 PR CTRL NOSEBLEED,POST,W/PACKS 510.0 &/OR CAUT 0 30906 PR REPEAT CONTROL OF NOSEBLEED 584.0 0 30920 PR LIGATE INTERN MAXILL ARTERY 2898. 00 30930 PR THERAPEUTIC FRACTURE INFER 244.0 TURBINATE 0 31000 PR IRRIGATION MAXILLARY SINUS 376.0 0 3100F PR CAROTID IMG STUDY MEAS DISTAL 0.00 INT CAROTID DIAM DOCUMENTED 31020 PR EXPLOR MAXILL SINUS,INTRANASAL 1036. 00 31030 PR EXPLOR MAXILL SINUS,RADICAL 1741. 00 31032 PR EXPLOR MAXILL SINUS,RMV POLYPS 1945. 00 31040 PR EXPLOR PTERYGOMAXILL FOSSA 3039. 00 31051 PR EXPLOR SPHENOID SINUS+RMV 1490. POLYPS 00 31070 PR EXPLOR FRONT 1561. SINUS,EXTERN,SIMPLE 00 31075 PR EXPLOR FRONT 1967. SINUS,TRANSORBIT,UNI 00 31081 PR OBLITER FRONT SINUS,CORON 3965 INCIS 31085 PR OBLITER FRONT 4557. SINUS+FLAP,CORON INCI 00 31201 PR REMOV ETHMOID 1854. SINUS,INTRANASAL,TOTL 00 31205 PR REMOV ETHMOID 2266. SINUS,EXTRANASAL,TOTL 00 31225 PR REMV UPPER JAW-MAXILLECTOMY 3435. 00 31230 PR REMV UPPER JAW+ORBIT 8248. EXENTERATN 00 31231 PR NASAL ENDOSCOPY,DX 528.0 0 31233 PR NASAL/MAXILL SINUS 1331. ENDOSCOPY,DX 00 31235 PR NASAL/SPHENOID SINUS 665.0 ENDOSCOPY,DX 0 31237 PR NASAL SCOPE,BX/RMV 1280. POLYP/DEBRID 00 31238 PR NASAL/SINUS SCOPY,W/CONTROL 866.0 NASAL HEM 0 31239 PR NASAL/SINUS SCOPY,SURG TEAR 1457. DUCT 00 31240 PR NASAL/SINUS SCOPY,RMV CONCHA 525.0 BULL 0 31241 PR NASAL/SINUS NDSC W/LIG 1155. SPHENOPALATINE ARTERY 00 31253 PR NASAL/SINUS NDSC TOT W/FRNT 1294. SINS EXPL TISS RMVL 00 31254 PR NASAL/SINUS NDSC W/PARTIAL 1204. ETHMOIDECTOMY 00 31255 PR NASAL/SINUS NDSC W/TOTAL 2344. ETHOIDECTOMY 00 31256 PR NASAL SCOPY,OPEN MAXILL SINUS 926.0 0 31257 PR NASAL/SINUS NDSC TOTAL WITH 1152. SPHENOIDOTOMY 00 31259 PR NASAL/SINUS NDSC TOT 1221. W/SPHENDT W/SPHEN TISS RMVL 00 31267 PR NASAL SCOPY,RMV TISS MAXILL 1737. SINUS 00 31276 PR NASAL/SINUS NDSC W/RMVL TISS 3500. FROM FRONTAL SINUS 00 31287 PR NASAL SCOPY,SPHENOIDOTOMY 1379. 00 31288 PR NASAL SCOPY,REMV TISS 1379. SPHENOID 00 31290 PR NASAL SCOPY,REPAIR CSF 3717. LEAK,ETHMOID 00 31291 PR NASAL SCOPY,REPR CSF 3885. LEAK,SPHENOID 00 31292 PR NASAL SCOPY,MED/INF ORBIT 4200. DECOMPRES 00 31293 PR NASAL SCOPY,MED+INF ORBIT 3782. DECOMPRES 00 31295 PR NASAL/SINUS ENDOSCOPY,W/DILAT 5065. MAXILLARY SINUS OSTIUM 00 31296 PR NASAL/SINUS ENDOSCOPY,W/DILAT 5166. FRONTAL SINUS OSTIUM 00 31297 PR NASAL/SINUS ENDOSCOPY,W/DILAT 5073. SPHENOID SINUS OSTIUM 00 31298 PR NASAL/SINUS NDSC W/FRONTAL & 9883. SPHEN SINS DILATION 00 31299 PR SINUS SURGERY PROC UNLISTED 450.0 0 31300 PR REMOVAL OF LARYNX LESION 3092. 00 31360 PR REMOVAL OF LARYNX 3645. 00 31365 PR REMOVAL OF LARYNX+RAD TOTL 5375. NECK 00 31367 PR PART SUPRAGLOT REMV LARYNX 9023. 00 31390 PR REMV LARYNX & PHARYNX 11598.00 31395 PR REMV LARYNX+PHARYNX W 5672. RECONSTRUC 00 31400 PR REVISION ARYTENOIDS 3460. 00 31500 PR INSERT EMERGENCY ENDOTRACH 396.0 AIRWAY 0 31502 PR TRACH TUBE CHANGE 84.00 31505 PR LARYNGOSCOPY,INDIRECT,DX 207.0 0 31510 PR LARYNGOSCOPY,INDIRECT WITH 533.0 BIOPSY 0 31515 PR LARYNGOSCOPY,DIRECT FOR 929.0 ASPIRATION 0 31520 PR 778.0 LARYNGOSCOPY,DIRECT,DIAGNOS,NE 0 WBRN 31525 PR 734.0 LARYNGOSCOPY,DIRECT,DIAGNOSTIC 0 31526 PR LARYNGOSCOPY,DIRECT,DX,OP 361.0 MICROSCOP 0 31527 PR LARYNGOSCOPY,DIRECT,INSRT 734.0 OBTURATOR 0 31528 PR LARYNGOSCOPY DIRECT,W/DILAT, 460.0 INITIAL 0 31529 PR LARYNGOSCOPY DIRECT,W/DILAT, 763.0 SUBSEQUENT 0 31530 PR LARYNGOSCOPY,DIRCT,OP,F.B. 763.0 REMVL 0 31535 PR LARYNGOSCOPY,DIRCT,OP,BIOPSY 763.0 0 31536 PR LARYNGOSCOPY,DIRCT,OP 878.0 SCOPE,BIOPSY 0 31540 PR LARYNGOSCOPY,DIRCT,OP,EXC 923.0 TUMOR 0 31541 PR LARYNGOSCOPY,DIRCT,OP 1439. SCOP,EXC TUMR 00 31545 PR LARYNGOSCOPY,DIR,OP,EXC 923.0 TUMR,LCL FLAP 0 31551 PR LARYNGOPLASTY LARYNGEAL STEN 5849. W/O STENT < 12 YRS 00 31552 PR LARYNGOPLASTY LARYNGEAL STEN 5174. W/O STENT 12 YRS > 00 31553 PR LARYNGOPLASTY LARYNGEAL STEN 6448. W/STENT < 12 YRS 00 31554 PR LARYNGOPLASTY LARYNGEAL STEN 6789. W/STENT 12 YRS > 00 31560 PR LARYNGOSCOPY,DIRCT,OP,REMV 2128. ARYTENOD 00 31561 PR LARYNGOSCOPY,DIRCT,OP 1520. SCOP,REMV ARY 00 31570 PR LARYNGOSCOPY,DIRCT,INJ VOCAL 929.0 CORD 0 31571 PR LARYNGOSCOPY,DIRECT,SCOPE,INJ 869.0 CORDS 0 31572 PR LARYNGOSCOPY FLEXIBLE ABLATJ 1250. DESTJ LESION(S) UNI 00 31573 PR LARYNGOSCOPY FLEXIBLE 665.0 THERAPEUTIC INJECTION UNI 0 31574 PR LARYNGOSCOPY FLEXIBLE 2577. W/INJECTION AGMNTJ UNI 00 31575 PR LARYNGOSCOPY FLEXIBLE 260.0 DIAGNOSTIC 0 31576 PR LARYNGOSCOPY FLEXIBLE 495.0 W/BIOPSY(IES) 0 31577 PR LARYNGOSCOPY FLX RMVL 540.0 FOREIGN BODY(S) 0 31579 PR LARYNGOSCOPY FLX/RGD 498.0 TELESCOPIC W/STROBOSCOPY 0 31580 PR LARYNGOPLASTY LARYN WEB 4417. W/KEEL STENT INSERTION 00 31582 PR REVISION LARYNX,STENOSIS W 3844. GRFT 00 31584 PR LARYNGOPLASTY W/OPEN 3844. REDUCTION FRACTURE W/TRACHS 00 31587 PR LARYNGOPLASTY CRICOID SPLIT 3844. W/O GRAFT PLACEMENT 00 31588 PR REVISION OF LARYNX, UNSPECIFIED 3844. 00 31590 PR REINNERVATE LARYNX W PEDICLE 2415. 00 31591 PR LARYNGOPLASTY MEDIALIZATION 3672. UNLIATERAL 00 31592 PR CRICOTRACHEAL RESECTION 6934. 00 31600 PR TRACHEOSTOMY, 985.0 PLANNED 0 31601 TRACHEOSTOMY, <2 Y/O 797.0 0 31603 PR TRACHEOSTOMY,EMERG,XTRACH 911.0 0 31610 PR 1543. TRACHEOSTOMY,FENESTRATN+FLAPS 00 31611 PR CREATE T-E FISTULA+SPEECH 1158. PROSTHESIS 00 31613 PR TRACH REVISION,SIMPLE 957.0 0 31614 PR TRACH 1594. REVISION,COMPLEX 00 31615 PR TRACHEOBRNCHSC THRU EST 395.0 TRACHS INC 0 31622 PR BRNCHSC INCL FLUOR GDNCE DX 733.0 W/CELL WASHG SPX 0 31623 PR BRNCHSC BRUSHING/PROTECTED 853.0 BRUSHINGS 0 31624 PR BRNCHSC W/BRNCL ALVEOLAR 769.0 LAVAGE 0 31625 PR BRONCHOSCOPY 826.0 BRONCHIAL/ENDOBRNCL BX 1+ SITES 0 31627 PR BRONCHOSCOPY W/CPTR-ASST 4814. IMAGE-GUIDED NAVIGATION 00 31628 PR BRONCHOSCOPY 968.0 W/TRANSBRONCHIAL LUNG BX 1 LOBE 0 31629 PR BRONCHOSCOPY NEEDLE BX 1386. TRACHEA MAIN STEM&/BRON 00 31630 PR BRONCHOSCOPY,TRACH/BRONCH 735.0 DILATN 0 31631 PR BRONCHOSCOPY,TRACH DIL+STENT 589.0 0 31632 PR BRONCHOSCOPY 175.0 W/TRANSBRONCHIAL LUNG BX EACH 0 LOBE 31633 PR BRONCHOSCOPY W/TRANSBRONCL 214.0 NDL ASPIR BX EA LOBE 0 31634 PR BRONCHOSCOPY BALLOON 4687. OCCLUSION 00 31635 PR BRONCHOSCOPY W/REMOVAL 830.0 FOREIGN BODY 0 31636 PR BRONCHOSCOPY, BRONCH STENTS 565.0 0 31637 PR BRONCHOSCOPY, STENT ADD-ON 199 31638 PR BRONCHOSCOPY, REVISE STENT 671 31640 PR BRONCHOSCOPY,EXCIS LESN 946.0 0 31641 PR BRONCHOSCOPY,RX STENOSIS 946.0 0 31645 PR BRONCHOSCOPY W/THER ASPIR 717.0 TRACHBRNCL TREE 1ST 0 31646 PR BRONCHOSCOPY W/THER ASPIR 708.0 TRACHBRNCL TREE SBSQ 0 31647 PR BRNCHSC OCCLUSION&INSERT 540.0 BRONCH VALVE INIT LOBE 0 31648 PR BRNCHSC REMOVAL BRONCHIAL 548.0 VALVE INITIAL 0 31649 PR BRNCHSC REMOVAL BRONCHIAL 179.0 VALVE EA ADDL 0 31651 PR BRNCHSC OCCLUSION&INSERT 191.0 BRONCH VALVE ADDL LOBE 0 31652 PR BRNCHSC EBUS GUIDED SAMPL 1/2 2301. NODE STATION/STRUX 00 31653 PR BRNCHSC EBUS GUIDED SAMPL 3/> 2445. NODE STATION/STRUX 00 31654 PR BRNSCHSC TNDSC EBUS DX/TX 351.0 INTERVENTION PERPH LES 0 31660 PR BRONCHOSCOPIC THERMOPLASTY 526.0 ONE LOBE 0 31661 PR BRONCHOSCOPIC THERMOPLASTY 555.0 2/> LOBES 0 31720 PR CATHETER ASPIRATN,NASOTRACH 132.0 0 31730 PR INTRO WINDPIPE 3098. WIRE/TUBE 00 31750 PR REVISN 4960. TRACHEA,CERVICAL 00 31760 PR REVISN TRACHEA,INTRATHROACIC 5645. 00 31780 PR EXCIS TRACH STEN/RECONST,CERV 3343. 00 31785 PR EXCIS TRACH LESN,CERVICAL 3398. 00 31800 PR REPAIR TRACH 1529. WOUND/INJ,CERVICAL 00 31820 PR SURG CLOSURE TRACH/FISTULA 923.0 0 31825 PR SURG CLOSURE TRACH/FIST,PLAST 1602. REPR 00 31830 PR REVISE TRACHEOSTOMY SCAR 1338. 00 32035 PR THORACOSTOMY,RIB 1558. RESECT,EMPYEMA 00 32036 PR THORACOSTOMY,OPEN 1689. DRAIN/EMPYEMA 00 32096 PR THORACTOMY W/DX BX LUNG 2865. INFILTRATE UNILATERAL 00 32098 PR THORACOTOMY W/BIOPSY OF 1907. PLEURA 00 32100 PR THORACOTOMY WITH EXPLORATION 3279. 00 32110 PR THORCOM CTRL TRAUMTC 5229. HEMRRG&/RPR LNG TEAR 00 32120 PR THORACOTOMY POSTOPERATIVE 3099. COMPLICATIONS 00 32141 PR THORACOTOMY W/RESECTION 3368. BULLAE 00 32151 PR THORCOM W/RMVL IPUL 2232. FB 00 32160 PR THORACOTOMY W/CARDIAC 1702. MASSAGE 00 32200 PR PNEUMONOSTOMY,OPEN DRAIN 4060. ABSC/CYST 00 32220 PR 5507. DECORTICATION,PULMONARY,TOTAL 00 32225 PR 3099. DECORTICATION,PULMONARY,PARTIAL 00 32310 PR REMOVAL PARIETAL PLEURA 2986. 00 32320 PR DECORTICATE/REMV PARIETAL 5478. PLEURA 00 32400 PR NEEDLE BIOPSY PLEURA 342.0 0 32405 PR BIOPSY LUNG/MEDIASTINUM 1095. PERCUTANEOUS NEEDLE 00 32440 PR REMOVAL OF LUNG 5524. PNEUMONECTOMY 00 32480 PR RMVL LUNG OTHER THAN 5325. PNEUMONECTOMY 1 LOBE LOBECT 00 32482 PR RMVL LUNG OTHER THAN 5518. PNEUMONECT 2 LOBES BILOBEC 00 32484 PR RMVL LUNG OTHER THAN 4691. PNEUMONECT 1 SEGMENTECTOMY 00 32486 PR RMVL LUNG XCP TOT 9583. PNEUMONECTOMY SLEEVE 00 LOBECTOMY 32488 PR RMVL LUNG OTHER/THAN PNUMEC 9775. COMPLETION PNUMEC 00 32491 PR RMVL LUNG OTH/THN PNUMEC 5300. RESXN-PLCTJ EMPHY LUNG 00 32501 PR REPAIR BRONCHUS (ADD-ON) 583.0 0 32503 PR RESECT APICAL LUNG TUMOR 7327 32504 PR RESECT APICAL LUNG TUM/ CHEST 8348. WALL RECONST 00 32505 PR THORACOTOMY W/THERAPEUTIC 2342. WEDGE RESEXN INITIAL 00 32506 PR THORACOTOMY W/THERAP WEDGE 394.0 RESEXN ADDL IPSILATRL 0 32507 PR THORACOTOMY W/DX WEDGE 394.0 RESEXN &ANTOM LUNG RESEXN 0 32540 PR EXTRAPLEURAL REMV EMPYEMA 7031. 00 32550 PR INSERTION INDWELLING TUNNELED 1515. PLEURAL CATHETER 00 32551 PR TUBE THORACOSTOMY INCLUDES 501.0 WATER SEAL 0 32552 PR REMOVAL OF INDWELLING 466.0 TUNNELED PLEURAL CATHETER WITH 0 CUFF 32554 PR THORACENTESIS NEEDLE/CATH 1384. PLEURA W/O IMAGING 00 32555 PR THORACENTESIS NEEDLE/CATH 1404. PLEURA W/IMAGING 00 32556 PR PERQ DRAINAGE PLEURA INSERT 1459. CATH W/O IMAGING 00 32557 PR PERQ DRAINAGE PLEURA INSERT 2706. CATH W/IMAGING 00 32560 PR CHEMICAL PLEURODESIS FOR 612.0 PERSISTENT PNEUMOTHORAX 0 32561 PR INSTILL VIA CHEST TUBE AGENT 242.0 FOR FIBRINOLYSIS, 1ST DAY 0 32562 PR INSTILL VIA CHEST TUBE AGENT 210.0 FOR FIBRINOLYSIS, SUBSEQUENT 0 32601 PR THORSC DX 810.0 LUNGS/PERICAR/MED/PLEURAL SPACE 0 W/O BX 32606 PR THORACOSCOPY,DX MEDIAST W BX 1176. 00 32607 PR THORACOSCOPY W/DX BX OF LUNG 785.0 INFILTRATE UNILATRL 0 32608 PR THORACOSCOPY W/DX BX OF LUNG 953.0 NODULES UNILATRL 0 32609 PR THORACOSCOPY WITH BIOPSYIES 659.0 OF PLEURA 0 32650 PR THORACOSCOPY SURG 2227. W/PLEURODESIS 00 32651 PR THORACOSCOPY SURG PART PULM 2584. DECORT 00 32652 PR THORACOSCOPY SURG TOT PULM 3688. DECORT 00 32653 PR THORACOSCOPY SURG REMOV FB 2549. INTRAPLEU 00 32654 PR THORACOSCOPY SURG CTRL 2584. TRAUMA BLEED 00 32655 PR THORACOSCOPY W/RESECTION 2612. BULLAE W/WO PLEURAL PX 00 32656 PR THORACOSCOPY SURG PART 2850. PLEURECTOMY 00 32658 PR THORACOSCOPY SURG EXC 2549 FB/CLOT PERICA 32661 PR THORACOSCOPY SURG EXC 2847. PERICARD MASS 00 32662 PR THORACOSCOPY SURG EXC 3240. MEDIAST MASS 00 32663 PR THORACOSCOPY W/LOBECTOMY 5036. SINGLE LOBE 00 32664 PR THORACOSCOPY SURG THOR 2812. SYMPATHECT 00 32665 PR THORACOSCOPY SURG 5027. ESOPHAGOMYOTOMY 00 32666 PR THORACOSCOPY W/THERA WEDGE 2189. RESEXN INITIAL UNILAT 00 32667 PR THORACOSCOPY W/THERA WEDGE 394.0 RESEXN ADDL IPSILATRL 0 32668 PR THORACOSCOPY W/DX WEDGE 396.0 RESEXN ANATO LUNG RESEXN 0 32669 PR THORACOSCOPY 3369. W/SEGMENTECTOMY 00 32672 PR THORACOSCOPY W/RESEXN-PLICAJ 3819. EMPHYSEMA LUNG UNIL 00 32673 PR THORACOSCOPY RESEXN THYMUS 3018. UNI/BILATERAL 00 32674 PR THORCOSCPY W/MEDIASTINL 540.0 ®IONL LYMPHADENECTOMY 0 32800 PR REPAIR LUNG HERNIA 3363. 00 32810 PR CLOSE CHEST AFTER DRAINAGE 3216 32815 PR CLOSE BRONCHIAL 11491 FISTULA 32850 PR DONOR 2311. PNEUMONECTOMY 00 32851 PR LUNG 8740. TRANSPLANT,SINGLE 00 32852 PR LUNG TRANSPLANT,SINGL W CP 9428. BYPASS 00 32853 PR LUNG 10500.00 TRANSPLANT,DOUBLE 32854 PR LUNG TRANSPLANT,DBL W CP 11200.00 BYPASS 32855 PR TRANSPLANT,PREP DONOR LUNG, 13596.00 SINGLE 32856 PR TRANSPLANT,PREP DONOR LUNG, 14892.00 DOUBLE 32900 PR REMOVAL OF RIB(S) 3478. 00 32994 PR ABLATION THER 1+ PULM TUMORS 15761.00 PERQ CRYOABLATION 32998 PR ABLATION THER 1+ PULM TUMORS 6630. PERQ RADIOFREQUENCY 00 32999 PR CHEST SURGERY PROCEDURE 450.0 UNLISTED 0 33010 PR PERICARDIOCENTESIS INITIAL 350.0 0 33015 PR INCIS HEART SAC TUBE 1258. 00 33020 PR INCIS HEART SAC REMV CLOT/FB 2661. 00 33025 PR INCIS HEART SAC WINDW FOR 2580. DRAIN 00 33030 PR REMOV HEART SAC NO CP BYPASS 4010. 00 33031 PR REMOV HEART SAC W CP BYPASS 5232. 00 33050 PR RESECTION PERICARDIAL 3176. CYST/TUMOR 00 33120 PR REMOVAL HEART LESION INTERN 5996. 00 33130 PR REMOVAL HEART LESION EXTERN 5618. 00 33202 PR INSERT EPICARDIAL ELECTRODE, 3025. OPEN 00 33206 PR INS NEW/RPLCMT PRM PACEMAKR 1728. W/TRANS ELTRD ATRIAL 00 33207 PR INS NEW/RPLC PRM PACEMAKER 1230. W/TRANSV ELTRD VENTR 00 33208 PR INS NEW/RPLCMT PRM PM 1328. W/TRANSV ELTRD ATRIAL&VENT 00 33210 PR INSJ/RPLCMT TEMP TRANSVNS 650.0 1CHMBR ELTRD/PM CATH 0 33211 PR INSJ/RPLCMT TEMP TRANSVNS 472.0 2CHMBR PACG ELTRDS SPX 0 33212 PR INS PM PLS GEN W/EXIST SINGLE 918.0 LEAD 0 33213 PR INS PACEMAKER PULSE GEN ONLY 1005. W/EXIST DUAL LEADS 00 33214 PR UPG PACEMAKER SYS CONVERT 1216. 1CHMBR SYS 2CHMBR SYS 00 33215 PR RPSG PREV IMPLTED PM/DFB R 773.0 ATR/R VENTR ELECTRODE 0 33216 PR INSJ 1 TRANSVNS ELTRD PERM 1012. PACEMAKER/IMPLTBL DFB 00 33217 PR INSJ 2 TRANSVNS ELTRD PERM 950.0 PACEMAKER/IMPLTBL DFB 0 33218 PR RPR 1 TRANSVNS ELTRD PRM 993.0 PM/PACING IMPLNTBL DFB 0 33220 PR RPR 2 TRANSVNS ELECTRODES 995.0 PRM PM/IMPLANTABLE DFB 0 33221 PR INS PACEMAKER PULSE GEN ONLY 925.0 W/EXIST MULT LEADS 0 33222 PR RELOCATION OF SKIN POCKET FOR 921.0 PACEMAKER 0 33223 PR RELOCATE SKIN POCKET 1041. IMPLANTABLE DEFIBRILLATOR 00 33224 PR INSJ ELTRD CAR VEN SYS ATTCH 1285. PREV PM/DFB PLS GEN 00 33225 PR INSJ ELTRD CAR VEN SYS TM INSJ 1158. DFB/PM PLS GEN 00 33226 PR RPSG PREV IMPLTED CAR VEN SYS 1237. L VENTR ELTRD 00 33227 PR REMVL PERM PM PLSE GEN W/REPL 816.0 PLSE GEN SNGL LEAD 0 33228 PR REMVL PERM PM PLS GEN W/REPL 852.0 PLSE GEN 2 LEAD SYS 0 33229 PR REMVL PERM PM PLS GEN W/REPL 886.0 PLSE GEN MULT LEAD 0 33230 PR INSJ IMPLNTBL DEFIB PULSE GEN 984.0 W/EXIST DUAL LEADS 0 33233 PR REMOVAL PERMANENT PACEMAKER 678.0 PULSE GENERATOR ONLY 0 33234 PR RMVL TRANSVNS PM ELTRD 1 LEAD 1263. SYS ATR/VENTR 00 33235 PR RMVL TRANSVNS PM ELTRD DUAL 2253. LEAD SYS 00 33237 PR REMV EPICARD SYST TWO 2999. LD/THORACOTMY 00 33241 PR REMOVAL IMPLANTABLE DEFIB 572.0 PULSE GENERATOR ONLY 0 33243 PR RMVL 1/DUAL CHAMBER DEFIB 4969. ELECTRODE BY THORACOM 00 33244 PR RMVL1/DUAL CHMBR IMPLTBL DFB 3032. ELTRD TRANSVNS XTRJ 00 33249 PR INSJ/RPLCMT PERM DFB 3222. W/TRNSVNS LDS 1/DUAL CHMBR 00 33255 PR ABLATE/ RECONSTUCT ATRIA, 6685. EXTENS, W/O BYPASS 00 33256 PR ABLATE/ RECONSTUCT ATRIA, 7914. EXTENS, W/ BYPASS 00 33257 PR ABLATE/ RECONSTUCT ATRIA, W 1367. OTHER PROCED LIMITED 00 33259 PR ABLATE/ RECONSTUCT ATRIA, W 2000. OTHER PROCED EXTENS W/ BYPASS 00 33261 PR ABLAT VENTR DYSRHYTHM FOCUS 3647. 00 33262 PR RMVL IMPLTBL DFB PLSE GEN 886.0 W/REPL PLSE GEN 1 LEAD 0 33263 PR RMVL IMPLTBL DFB PLSE GEN 922.0 W/RPLCMT PLSE GEN 2 LD 0 33264 PR RMVL IMPLTBL DFB PLS GEN 956.0 W/RPLCMT PLS GEN MLT LD 0 33265 PR ENDO ABLATE/ RECONSTUCT ATRIA, 5543. LIMITED 00 33270 PR INS/RPLCMNT PERM SUBQ IMPLTBL 1581. DFB W/SUBQ ELTRD 00 33271 PR INSJ OF SUBQ IMPLANTABLE 1258. DEFIBRILLATOR ELECTRODE 00 33272 PR RMVL OF SUBQ IMPLANTABLE 1058. DEFIBRILLATOR ELECTRODE 00 33273 PR REPOS PREVIOUSLY IMPLANTED 1039. SUBQ IMPLANTABLE DFB 00 33274 PR TCAT INSJ/RPL PERM LEADLESS 1281. PACEMAKER RV W/IMG 00 33275 PR TCAT REMOVAL PERM LEADLESS 1361. PACEMAKER R VENTR 00 33282 PR IMPLANTATION PT-ACTIVATED 2000. CARDIAC EVENT RECORDER 00 33284 PR RMVL IMPLANTABLE PT-ACTIVATED 593.0 CAR EVENT RECORDER 0 33285 PR INSERTION SUBQ CARDIAC RHYTHM 2000 MONITOR W/PRGRMG 33286 PR REMOVAL SUBCUTANEOUS 343.0 CARDIAC RHYTHM MONITOR 0 33289 PR TCAT IMPL WRLS P-ART PRS SNR L-T 857.0 HEMODYN MNTR 0 33300 PR REPAIR HEART WOUND 9990. 00 33315 PR EXPLOR HEART SURG WND W CP 7725. BYPASS 00 33322 PR REPR AO/GRT VESSEL W CP 5009. BYPASS 00 33340 PR PERQ CLSR TCAT L ATR APNDGE 2917. W/ENDOCARDIAL IMPLNT 00 33361 PR REPLACE AORTIC VALVE PERQ 5554. FEMORAL ARTRY APPROACH 00 33362 PR REPLACE AORTIC VALVE 6060. OPENFEMORAL ARTERY APPROACH 00 33363 PR REPLACE AORTIC VALVE OPEN 6381. AXILLRY ARTRY APPROACH 00 33364 PR REPLACE AORTIC VALVE OPEN ILIAC 6615. ARTERY APPROACH 00 33365 PR REPLACE AORTIC VALVE OPEN 7277. TRANSAORTIC APPROACH 00 33366 PR TRANSCATHETER TRANSAPICAL 7870. REPLACEMT AORTIC VALVE 00 33367 PR REPLACE AORTIC VALVE W/BYP PRQ 2234. ART/VENOUS APPRCH 00 33368 PR REPLACE AORTIC VALVE W/BYP 2666. OPEN ART/VENOUS APRCH 00 33369 PR REPLACE AORTA VALVE W/BYP 3526. CNTRL ART/VENOUS APRCH 00 33390 PR VALVULOPLASTY AORTIC VALVE 7949. OPEN CARD BYP SIMPLE 00 33391 PR VALVULOPLASTY AORTIC VALVE 9419. OPEN CARD BYP COMPLEX 00 33400 PR REPR AORT VALV W CP BYPASS 6424. 00 33403 PR REPR AORT VALV XVENT DIL W/CP 5678. BYPAS 00 33405 PR RPLCMT PROST AORTIC VALVE 7770. OPEN XCP HOMOGRF/STENT 00 3340F PR MAMMO ASSESS CAT OF 0.00 INCOMPLETE NEED ADD IMAGE DOCUMENTED 33411 PR REPLACE AORT VALV W ANNULUS 8035. ENLRGEMENT 00 33412 PR REPLAC AO VALV XVENT AO ANNUL 12952.00 ENLG 33413 PR REPL AORT VALVE,TRANSLOC 9386. AUTOL PULM VALV 00 33414 PR REPAIR LV OUTFLOW OBSTR PATCH 8794. ENLG 00 33415 PR REVIS SUBVALV TIS SVAS 6385. 00 33416 PR REVIS VENT MUSC FOR 6942. IHSS 00 33417 PR AORTOPLAS FOR SUPRAVALV STEN 4598. 00 33418 PR TCAT MITRAL VALVE REPAIR INITIAL 6371. PROSTHESIS 00 33419 PR TCAT MITRAL VALVE REPAIR ADDL 1344. PROSTHESIS 00 3341F PR MAMMO ASSESS CAT OF NEGATIVE 0.00 DOCUMENTED 33425 PR MITRALPLASTY W CP BYPASS 6087. 00 33426 PR MITRALPLASTY W PROSTHETIC 7329. RING 00 33427 PR MITRALPLASTY W RADICAL 9826. RECONSTR 00 3342F PR MAMMO ASSESS CAT OF BENIGN 0.00 DOCUMENTED 33430 PR REPLACEMENT OF MITRAL VALVE 11247.00 33440 PR RPLCMT AORTIC VALVE BY TLCJ 14142.00 AUTOL PULM VALVE 33463 PR VALVULOPLAS TRICUS NO RING 6898. INSERT 00 33464 PR VALVULOPLAS TRICUS W RING 6348. INSERT 00 33465 PR REPLACE TRICUSPID W CP BYPASS 6164. 00 33471 PR PULM VALVOTOMY VIA PULM ART 4265. 00 33474 PR PULM VALVOTOMY W CP BYPASS 8904. 00 33475 PR REPLACEMENT, PULMONARY VALVE 5805. 00 33476 PR RV RESEC INFUND STEN 5850. 00 33477 PR TCAT PULMONARY VALVE 5383. IMPLANTATION PRQ APPROACH 00 33478 PR RV OUTFLOW TRACT AUGMENTATN 6225. 00 33502 PR REPR ANOMAL CORON ART PA 3100. ORIGIN BY LIGATN 00 33506 PR REPR ANOMAL COR ART PA ORIGIN 8213 TRANSLOCATION 33507 PR REPR INTRAMURAL COR ART 7054. TRANSLOC/ UNROOF 00 33508 PR ENDOSCOPY W/VIDEO-ASST VEIN 350.0 HARVEST,CABG 0 33510 PR CABG, VEIN, SINGLE 6571. 00 33511 PR CABG, VEIN, TWO 6827. 00 33512 PR CABG, VEIN, THREE 7188. 00 33517 PR CABG, ARTERY-VEIN, SINGLE 426.0 0 33518 PR CABG, ARTERY-VEIN, TWO 931.0 0 33519 PR CABG, ARTERY-VEIN, 1236. THREE 00 33521 PR CABG, ARTERY-VEIN, 2331. FOUR 00 33530 CABG, REOPERATE >1 MON ORIG 1189. 00 33533 PR CABG, ARTERIAL, SINGLE 7511. 00 33534 PR CABG, ARTERIAL, TWO 7249. 00 33535 PR CABG, ARTERIAL, THREE 7675. 00 33542 PR MYOCARD RESECTN 6848. 00 33548 PR RESTORE/REMODEL VENTRICLE 12083.00 33572 PR OPEN CORONARY 585.0 ENDARTERECTOMY 0 33600 PR CLOSURE OF AV VALVE 7029. 00 33606 PR ANAST PULM ARTERY TO AORTA 7231. 00 33610 PR REPAIR BY SURG 7260. ENLARGEMENT,VSD 00 33615 PR REPR (SIMPLE FONTAN) 6510. 00 33617 PR REPR BY MODIFIED 8682. FONTAN 00 33619 PR REPR HYPOPLAS LT 10622.00 HEART 33620 PR APPLICATION RIGHT & LEFT 6752. PULMONARY ARTERY BANDS 00 33641 PR REPR ASD W BYPASS 4943. 00 33645 PR REPR/CLOS SINUS VENOSUS 5804. 00 33647 PR REPR ASD & VSD 6844. 00 33660 PR REPR ASD OSTIUM 6949. PREMUM 00 33665 PR REPR INTERMED AV CANAL DEFECT 6860. 00 33670 PR REPR COMPL AV CANAL DEFECT 7463. 00 33675 PR CLOSE MULTIPLE VSD 8072. 00 33677 PR CLOSE MULTIPLE VSD, REMOVE PA 7982. BAND 00 33681 PR CLOSE SINGLE VSD 7521 33684 PR CLOSE SINGLE VSD, WITH 6907. RESECTION 00 33690 PR BANDING PULM ARTERY 4290. 00 33692 PR REPR TET FALLOT WO PULM 7141. ARTRES 00 33694 PR REPR TET FALLOT X-ANNULAR PTCH 7778. 00 33697 PR REPR TET FALLOT W PULM ATRESIA 8253. 00 33710 PR REPR VALSALVA FISTULA & VSD 8400. 00 33720 PR REPR VALSALVA 6337. ANEURYSM 00 33724 PR REPAIR PULMONARY VENOUS 6301. ANOMALY 00 33726 PR REPAIR PULMONARY VENOUS 8324. STENOSIS 00 33730 PR REPRAIR ANOMAL PULMONARY 7656. VENOUS RETURN 00 33732 PR REPR COR TRIAT/SUPRAVALV MITR 5420. RING 00 33735 PR ATR SEPTEC/SEPTOSTOMY CLOSED 4295. 00 33737 PR ATR SEPTEC/SEPTOSTMY OPN 4340. INFLW OCCL 00 33750 PR SHUNT SUBCL TO PULM 5075. ART 00 33764 PR SHUNT CENTRAL W PROSTH GRAFT 5112. 00 33766 PR SHUNT SVC TO PA, ONE LUNG 4070. 00 33767 PR SHUNT SVC TO PA, BOTH LUNGS 5875. 00 33768 PR ANAST SECONDARY SVC TO PA 1136. 00 33778 PR REPR XPOSTN GRT VES,AO-PUL ART 9007. RECON 00 33780 PR REPR XPTN GR VES,AP ART W CLOS 9520. VSD 00 33786 PR REPAIR TRUNCUS ARTERIOSUS 9313. 00 33788 PR REIMPLNT ANOMAL PULM ART 5110. 00 33800 PR AORTIC SUSPENSN FOR TRACH 2705. DECOMPRE 00 33802 PR DIVISN ABERRANT VESSEL 3881. 00 33814 PR OBLIT AO-PUL SEPTAL DFCT W CP 6181. BYPAS 00 33820 PR REPR PDA BY LIGATN 3582. 00 33822 REPR PDA BY DIVISION <18 4016. Y/O 00 33840 PR EXCISN COARCT AORTA DRCT 5086. ANAST 00 33845 PR EXCISN COARCT AORTA W GRAFT 5504. 00 33852 PR REPR HYPOPLASTIC AORTIC ARCH 3818. 00 33853 PR REPR HYPOPLASTIC ARCH W CP 7512. BYPASS 00 33860 PR ASCEND AORTA GRAFT INCL VAVLE 12960.00 SUSPENSION 33863 PR ASCEND AORTA GRAFT W ROOT 9772. REPLACMENT.VALVE CONDUIT/CORON 00 RECONSTRUCT 33864 PR ASCEND AORTA GRAFT W VALVE 7322. SPARING ANNULUS REMODEL 00 33866 PR AORTIC HEMIARCH GRAFT W/ISOL & 3766. CTRL ARCH VESSELS 00 33870 PR TRANSV AORTIC ARCH GRAFT W 9620. BYPASS 00 33875 PR THORACIC AORTA GRAFT 7447. 00 33877 PR REPR THORACOABDOM AA W 9543. GRAFT 00 33880 PR ENDOVASC TAA REPR INCL SUBCL 4180. 00 33881 PR ENDOVASC TAA REPR W/O SUBCL 6329. 00 33883 PR INSERT ENDOVASC PROSTH, TAA 2599. 00 33884 PR ENDOVASC PROSTH, TAA, EA ADD 950.0 0 33886 PR ENDOVASC DIST EXTENS TAA 3400. PROSTH, DELAYED 00 33889 PR SUBCLAV TRANSPOS W/ ENDOVAS 1880. TAA REPAIR 00 33891 PR CAR-CAR BYPASS GRFT W/ 2412. ENDOVAS TAA REPAIR 00 33910 PR REMOVE PUL ART EMBOLI W CP 10752.00 BYPASS 33916 PR PULM ENDARTERECTOMY 17458 33917 PR REPAIR PULMONARY ART STEN 5981. 00 33920 PR REPAIR PULM ART 7224. ATRESIA,CONDUIT 00 33922 PR TRANSECT PULMONARY ARTERY 4375. 00 33924 PR REMV SYS-PULM SHUNT W CONG 689.0 HRT 0 33926 PR REPAIR PUL ART UNIFOCAL ARBOR 10466.00 W/ CP BYPASS 33927 PR IMPLTJ TOTAL RPLCMT HEART SYS 10629.00 W/RCP CARDIECTOMY 33930 PR REMOVAL OF DONOR HEART/LUNG 5251. 00 33933 PR TRANSPLANT,PREP DONOR 8373. HEART/LUNG 00 33940 PR REMOVAL OF DONOR 5251. HEART 00 33944 PR TRANSPLANT,PREP DONOR HEART 5796. 00 33945 PR TRANSPLANTATION OF HEART 10786.00 33946 PR ECMO/ECLS INITIATION VENO- 796.0 VENOUS 0 33947 PR ECMO/ECLS INITIATION VENO- 869.0 ARTERIAL 0 33948 PR ECMO/ECLS DAILY MANAGEMENT 612.0 EACH DAY VENO-VENOUS 0 33949 PR ECMO/ECLS DAILY MANAGEMENT EA 597.0 DAY VENO-ARTERIAL 0 33951 PR ECMO/ECLS INSJ OF PRPH CANNULA 1001. BIRTH-5 YRS PERQ 00 33952 PR ECMO/ECLS INSJ OF PRPH CANNULA 976.0 6 YRS&OLDER PERQ 0 33953 PR ECMO/ECLS INSJ OF PRPH CANNULA 1115. BIRTH-5 YRS OPEN 00 33954 PR ECMO/ECLS INSJ OF PRPH CANNULA 1087. 6 YRS&OLDER OPEN 00 33955 PR ECMO/ECLS INSJ OF CENTRAL 3150. CANNULA BIRTH-5 YRS 00 33956 PR ECMO/ECLS INSJ OF CENTRAL 2977. CANNULA 6 YRS & OLDER 00 33957 PR ECMO/ECLS REPOS PERIPH 712.0 CANNULA PERQ BIRTH-5 YRS 0 33958 PR ECMO/ECLS REPOS PERPH 695.0 CANNULA PRQ 6 YRS & OLDER 0 33959 PR ECMO/ECLS REPOS PERPH 830.0 CANNULA OPEN BIRTH-5 YRS 0 33962 PR ECMO/ECLS REPOS PERPH 791.0 CANNULA OPEN 6 YRS & OLDER 0 33963 PR ECMO/ECLS REPOS CENTRAL 1388. PERPH CANNULA BIRTH-5YRS 00 33964 PR ECMO/ECLS ECLS REPOS CENTRAL 1406. CNULA 6YRS & OLDER 00 33965 PR ECMO/ECLS RMVL OF PERPH 704.0 CANNULA PERQ BIRTH-5 YRS 0 33966 PR ECMO/ECLS RMVL OF PRPH 786.0 CANNULA PRQ 6 YRS & OLDER 0 33967 PR INSERT INTRA-AORTIC BALLOON 850.0 ASST DEVICE 0 33968 PR RMV AORTIC BALLOON DEVICE 81.00 33969 PR ECMO/ECLS RMVL OF PERPH 845.0 CANNULA OPEN BIRTH-5 YRS 0 33970 PR INSRT AORT BALLOON ASSIST FEM 1166. ART 00 33971 PR REMV AORTIC BALLOON ASSIST FEM 2534 ART 33973 PR INSRT AORTIC BALLOON THRU ASC 1286. AORT 00 33974 PR REMV AORTIC BALLOON FROM ASC 3184. AORT 00 33975 PR INSERT VENT ASST DEVICE,SINGLE 4034. VENTRICLE 00 33976 PR INSERT VENT ASST 4576. DEVICE,BIVENTRICULAR 00 33977 PR REMOVE VENT ASST DEVICE,SINGLE 3869. VENTRICLE 00 33978 PR REMOVE VENT ASST 4911. DEVICE,BIVENTRICULAR 00 33979 PR INSERT VENT ASST 6668. DEV,IMPLANT,SINGLE VENT 00 33980 PR REMOVE VENT ASST 8150. DEV,IMPLANT,SINGLE VENT 00 33981 PR REPLACE EXTRACORP VENT ASST 3016 DEV,SINGLE/BIVENT, 1/EACH PUMP 33982 PR REPLACE VENT ASST DEV, IMPLANT 7399. INTRACORP, SINGLE VENT, W/O 00 BYPASS 33983 PR REPLACE VENT ASST DEV, IMPLANT 8460. INTRACORP, SINGLE VENT, W/ BYPASS 00 33984 PR ECMO/ECLS RMVL PRPH CANNULA 827.0 OPEN 6 YRS & OLDER 0 33985 PR ECMO/ECLS REMOVAL OF CENTRAL 1566. CANNULA BIRTH-5 YRS 00 33986 PR ECMO/ECLS RMVL OF CENTRAL 2074. CANNULA 6 YRS & OLDER 00 33987 PR ARTERY EXPOS/GRAFT ARTERY 624.0 PERFUSION ECMO/ECLS 0 33988 PR INSERT LEFT HEART VENT BY 2637. THORACIC INC ECMO/ECLS 00 33989 PR RMVL LEFT HEART VENT BY 1248. THORACIC INCIS ECMO/ECLS 00 33990 PR INSJ PERQ VAD W/IMAGING ARTERY 1047. ACCESS ONLY 00 33991 PR INSJ PERQ VAD TRNSPTAL W/IMAGE 2136. ART&VENOUS ACCESS 00 33992 PR REMOVAL PERCUTANEOUS VAD 513.0 DIFFERENT SESSION 0 33993 PR REPOSITION VAD W/IMAGING 448.0 DIFFERENT SESSION 0 33999 PR CARDIAC SURG PROCEDURE UNLIST 2000. 00 34101 PR REMV ART CLOT AXILL-BRACH,ARM 1416. INCIS 00 34111 PR REMV ART CLOT ARM,ARM INCIS 1415. 00 34151 PR REMV ART CLOT VISC,ABD INCIS 5168. 00 34201 PR REMV ART CLOT ILIAC-POP,LEG 2354. INCIS 00 34203 PR REMV ART CLOT LOW LEG,LEG INCIS 3079. 00 34471 PR REMV VEIN CLOT SUBCLAV,NECK 2978. INCIS 00 34490 PR REMV VEIN CLOT AXILL-SUBCL,ARM 2185. INCIS 00 34502 PR RECONSTRUCT, VENA 6326. CAVA 00 34701 PR EVASC RPR DPLMNT AORTO-AORTIC 5143. NDGFT 00 34702 PR EVASC RPR DPLMNT AORTO-AORTIC 7682. NDGFT RPT 00 34703 PR EVASC RPR DPLMNT AORTO-UN- 5795. ILIAC NDGFT 00 34704 PR EVASC RPR DPLMNT AORTO-UN- 9639. ILIAC NDGFT RPT 00 34705 PR EVASC RPR DPLMNT AORTO-BI-ILIAC 6384. NDGFT 00 34706 PR EVASC RPR DPLMNT AORTO-BI-ILIAC 9608. NDGFT RPT 00 34707 PR EVASC RPR DPLMNT ILIO-ILIAC 4796. NDGFT 00 34708 PR EVASC RPR DPLMNT ILIO-ILIAC 7718. NDGFT RPT 00 34709 PR PLACEMENT XTN PROSTH FOR 844.0 ENDOVASCULAR RPR 0 34710 PR DLYD PLACEMENT XTN PROSTH FOR 2929. EVASC RPR 1ST VSL 00 34711 PR DLYD PLACEMENT XTN PROSTH FOR 780.0 EVASC RPR EA ADDL 0 34712 PR TRANSCATHETER DLVR ENHNCD 2503. FIXATION DEVICES RS&I 00 34713 PR PERQ ACCESS & CLOSURE FEM ART 337.0 FOR DELIVERY NDGFT 0 34714 PR OPN FEM ART EXPOS W/CNDT CRTJ 707.0 DLVR EVASC PROSTH 0 34715 PR OPN AX/SUBCLA ART EXPOS DLVR 790.0 EVASC PROSTH UNI 0 34716 PR OPN AXILLARY/SUBCLAVIAN ART 980.0 EXPOS W/CNDT CRTJ 0 34800 PR AAA REPAIR,AORTO-AORTIC TUBE 3789. PROSTH 00 34802 PR AAA REPAIR,MODULR BIFURCATED 4789. PROSTH 00 34803 PR AAA REPAIR,MODULR BIFUR 4884. PROSTH,2-DOCK 00 34805 PR ENDOVASC ABDO REPAIR W/PROS 2752. 00 34808 PR AAA REPAIR,ILIAC ARTERY OCCLSN 500.0 DEVICE 0 34812 PR OPN FEM ART EXPOS DLVR EVASC 830.0 PROSTH UNI 0 34813 PR AAA REPAIR, FEMORAL-FEMORAL 580.0 GRAFT 0 34820 PR OPN ILIAC ART EXPOS PROSTH/ILIAC 1200. OCCLS EVASC UNI 00 34825 PR AAA REPR,1ST VESSEL,EXTENSION 1628. PROSTH 00 34826 PR AAA REPR,ADD VESSEL,EXTENSION 500.0 PROSTH 0 34830 PR AAA+TRAUMA REPR,OPEN,TUBE 4281. PROSTH 00 34833 PR OPN ILIAC ART EXPOS CRTJ 1455. PROSTH EST CARD BYP 00 34834 PR OPN BRACHIAL ARTERY EXPOS 1166. DLVR EVASC PROSTH UNI 00 34839 PR PLNNING PT SPEC FENEST 1035. VISCERAL AORTIC GRAFT 00 34842 PR ENDOVASC VISCER AORTA REPAIR 5096. FENEST 2 ENDOGRAFT 00 34843 PR ENDOVASC VISCER AORTA REPAIR 5852. FENEST 3 ENDOGRAFT 00 34845 PR VISCER AND INFRARENAL ABDOM 6885 AORTA 1 PROSTHESIS 34846 PR VISCER AND INFRARENAL ABDOM 4565. AORTA 2 PROSTHESIS 00 34847 PR VISCER AND INFRARENAL ABDOM 5412. AORTA 3 PROSTHESIS 00 34900 PR ENDOVASCULAR REPAIR ILIAC 3224. ARTERY W ILIO-ILIAC PROSTHESIS 00 35011 PR REPR DFCT ART AXILLO-BRACH 3258. 00 35045 PR REPR ANEURYSM/GRFT 3446. INS,RADIAL/ULNAR 00 35081 PR REPR ANEURYSM/GRFT 5899. INS,ABDOMINAL AORTA 00 35082 PR REPR ART RUPTURE, ABD AORTA 8983. 00 35091 PR REPR ANEURYSM/GRFT INS,ABD 7346. AORT W/VISCER 00 35102 PR REPR ANEURYSM/GRFT INS,ABD 7748. AORT W/ILIAC 00 35103 PR REPR ART RUPTURE,AORTOILIAC 9213 35121 PR REPR ANEUR/GRFT 6769. INS,HEP/CEL/REN/MESENTER 00 35131 PR REPR ANEURYSM/GRFT INS,ILIAC 5713. 00 35132 PR REPR ART RUPTURE,ILIAC 3982. 00 35141 PR REPR ANEURYSM/GRFT 3667. INS,COMMON FEMORAL 00 35142 PR REPR ART RUPTURE,FEMORAL 5406 35151 PR REPR ANEURYSM/GRFT 4737. INS,POPLITEAL 00 35184 PR REPR CONG AV FIST,EXTREM 3448. 00 35190 PR REPR ACQ AV 2411. FIST,EXTREM 00 35201 PR REPR BL VES 2968. DIRECT,NECK 00 35206 PR REPR BL VES DIRECT,UP EXTREM 2653. 00 35207 PR REPR BL VES DIRECT,HAND/FINGR 3750. 00 35211 PR REPR BL VES DIRECT,CHEST W 3137. BYPASS 00 35216 PR REPR BL VES 5220. DIRECT,CHEST 00 35221 PR REPR BL VES DIRECT,ABD 5056. 00 35226 PR REPR BL VES DIRECT,LOW EXTREM 2972. 00 35231 PR REPR BL VES VEIN GRFT,NECK 5084. 00 35236 PR REPR BL VES VEIN GRFT,UP 4650. EXTREM 00 35241 PR REPR BL VES VEIN GRFT,CHEST/W 3281. BYPAS 00 35246 PR REPR BL VES VEIN GRFT,CHEST 6420 35251 PR REPR BL VES VEIN GRFT,ABD 7136 35256 PR REPR BL VES VEIN GRFT,LOW 3664. EXTREM 00 35261 PR REPR BL VES 3239. GRAFT,NECK 00 35266 PR REPR BL VES GRAFT,UP EXTREM 3102 35271 PR REPR BL VES GRAFT,CHEST W 3129. BYPASS 00 35276 PR REPR BL VES 5596. GRAFT,CHEST 00 35281 PR REPR BL VES GRAFT,ABDOMEN 5763. 00 35286 PR REPR BL VES GRAFT,LOW EXTREM 3189. 00 35301 PR THROMBOENDARTECTMY 3510. NECK,NECK INCIS 00 35302 PR THROMBOENDARTECTMY 4546. SUPERFICIAL FEM ARTERY 00 35303 PR THROMBOENDARTECTMY 5292. POPLITEAL ARTERY 00 35305 PR THROMBOENDARTECTMY TIBIAL/ 5063. PERON ARTERY, INITIAL 00 35306 PR THROMBOENDARTECTMY TIBIAL/ 1244 PERON ARTERY, ADD 35321 PR THROMBOENDARTECTMY AXILLARY- 2926. BRACH 00 35331 PR THROMBOENDARTECTMY ABD 5486. AORTA 00 35341 PR THROMBOENDARTECTMY VISCERAL 5284. 00 35351 PR THROMBOENDARTECTMY ILIAC 5260. 00 35355 PR THROMBOENDARTECTMY 3706. ILIOFEMORAL 00 35371 PR THROMBOENDARTECTMY FEMORAL 2744. COMMON 00 35372 PR THROMBOENDARTECTMY FEMORAL 3312. DEEP 00 35390 PR REOPER, CAROTID ENDARTEC>1 398.0 MON 0 35400 PR ANGIOSCOPY DURING RX 391.0 INTERVENTN 0 35460 PR BALLN ANGIOPLASTY OPEN,VENOUS 794.0 0 35471 PR BALLN ANGIOPLASTY 12695.00 PERC,VISCERAL 35472 PR BALLN ANGIOPLASTY PERC,AORTIC 5072. 00 35475 PR BALLN ANGIOPLASTY 5657. PERC,BRACHIOCEPH 00 35476 PR BALLN ANGIOPLASTY,PERC VENOUS 4321. 00 35500 PR HARVEST VEIN FOR 806.0 BYPASS 0 35501 PR VEIN BYPASS GRAFT,CAROTID, 3615. COMMON-INT CAR ART 00 35506 PR VEIN BYPASS GRAFT,CAROT-SUBCL/ 3624. SUBCL-CAROTD 00 35510 PR ARTERY BYPASS GRAFT 5025. 00 35516 PR VEIN BYPASS GRAFT,SUBCL-AXILL 2889. 00 35522 PR ARTERY BYPASS GRAFT 4959 35523 PR VEIN BYPASS GRAFT, BRACHIAL 5227. ULNAR OR RADIAL 00 35525 PR ARTERY BYPASS GRAFT 4556. 00 35531 PR VEIN BYPASS GRAFT,AORTO-MESEN 8348. 00 35537 PR VEIN BYPASS 8726. GRAFT,AORTOILIOFEMORAL 00 35556 PR VEIN BYPASS GRAFT,FEM-POP 4608. 00 35566 PR VEIN BYPASS GRAFT,FEM-TIBIAL 5731. 00 35571 PR VEIN BYPASS GRAFT,TIB-PERONEAL 5283. 00 35600 HARVEST UPPER EXTREMITY ART 1 620.0 SEGMENT FOR CABG 0 35601 PR BYPASS GRAFT OTHR,CAROTID-INT 3367. CAROTID 00 35606 PR BYPASS GRAFT OTHR,CAROT- 3270. SUBCL 00 35621 PR BYPASS GRAFT OTHR,AXILL-FEM 3689. 00 35626 PR BYPASS GRAFT 5739. OTHR,AORTOSUBCLAVIAN/AORTOINNO 00 MINATE/AORTOCAROTID 35631 PR BYPASS GRAFT OTHR,AORTO- 6982. MESENTER 00 35632 PR BYPASS GRAFT OTHR,ILIO-CELIAC 6493. 00 35633 PR BYPASS GRAFT OTHR,ILIO- 5797. MESENTERIC 00 35637 PR BYPASS GRAFT OTHR,AORTOILIAC 4140. 00 35638 PR BYPASS GRAFT OTHR,AORTOBI- 6288. ILIAC 00 35646 PR BYPASS GRAFT 6550. OTHR,AORTOBIFEMORAL 00 35647 PR BYPASS GRAFT 3820. OTHR,AORTOFEMORAL 00 35654 PR BYPASS GRAFT OTHR,AXILL-FEM- 5201. FEM 00 35656 PR BYPASS GRAFT OTHR,FEM-POP 3609. 00 35661 PR BYPASS GRAFT OTHR,FEM-FEM 3481. 00 35663 PR BYPASS GRAFT OTHR,ILIOILIAC 5147. 00 35665 PR BYPASS GRAFT OTHR,ILIOFEMORAL 4409. 00 35666 PR BYPASS GRAFT OTHR,FEM-TIBIAL 4992. 00 35671 PR BYPASS GRAFT OTHR,POP- 4581. PERONEAL 00 35681 PR BYPASS GRAFT 207.0 COMPOSITE/PROS+VEIN 0 35682 PR BYPASS GRAFT COMPOS/2 VEINS/2 868.0 LOCATN 0 35685 PR BYPASS GRAFT VEIN 509.0 PATCH/CUFF,SYNTHETIC 0 35693 PR ART TRANSPOSITN,VERT-SUBCL 2858. 00 35697 PR REIMPLANT ARTERY EACH 391.0 0 35700 PR REOPERATION, BYPASS GRAFT 384.0 0 35701 PR EXPLORATION, CAROTID ARTERY 1529 35721 PR EXPLORATION, FEMORAL ARTERY 1119. 00 35741 PR EXPLORATION POPLITEAL ARTERY 1316. 00 35761 PR EXPLORATION OF ARTERY/VEIN 895.0 0 35800 PR EXPLOR POSTOP 1824. BLEED,INFEC,CLOT-NECK 00 35820 PR EXPLOR POSTOP 6564. BLEED,INFEC,CLOT-CHST 00 35840 PR EXPLOR POSTOP 4867. BLEED,INFEC,CLOT-ABD 00 35860 PR EXPLOR POSTOP 2321. BLEED,INFEC,CLOT-EXTR 00 35875 PR REMOVAL OF CLOT IN GRAFT 2107. 00 35876 PR REMOVAL OF CLOT IN GRAFT 3337. 00 35879 PR REVISE GRAFT/VEIN PATCH ANGIO 3321. 00 35881 PR REVISE GRAFT/SEG VEIN INTERPOS 3215. 00 35883 PR REVISE FEMORAL GRAFT, NON- 5133. AUTOGENOUS GRAFT 00 35884 PR REVISE FEMORAL GRAFT, 5091. AUTOGENOUS GRAFT 00 35901 PR EXCISION, INFEC GRAFT, NECK 1240. 00 35903 PR EXCISION, INFEC GRAFT, 1594. EXTREMITY 00 35905 PR EXCISION, INFEC GRAFT, THORAX 6868 35907 PR EXCISION, INFEC GRAFT, ABDOMEN 7238. 00 36000 PR PLACE NEEDLE IN VEIN 65.00 36002 PR INJECTION RX EXTREMITY 416.0 PSEUDOANEURYSM 0 36005 PR INJECTION 780.0 PROC,EXTREMITY,VENOGRAPHY 0 36010 PR INTRO CATHETER 1958. SUPERIOR/INFERIOR VENA CAVA 00 36011 PR PLACE CATH IN VEIN,SELECT 2569. 00 36012 PR PLACE CATH IN VEIN,SUBSELECT 2016. 00 36013 PR PLACE CATH IN RT HRT,MAIN PULM 2004. ART 00 36014 PR PLACE CATH IN LT/RT PULM ART 2019. 00 36015 PR PLACE CATH IN SUBSEGMT PULM 2287. ART 00 36120 PR PLACE CATH BRACHIAL 1120. ART 00 36140 PR INTRO OF NEEDLE OR 1265. INTRACATHETER UPR/LXTR ARTERY 00 36147 PR PLACE NEEDLE/CATH A-V DIALYSIS 1813. SHUNT,1ST ACCESS W/ RAD EVAL 00 36148 PR PLACE NEEDLE/CATH A-V DIALYSIS 657.0 SHUNT,ADDL ACCESS FOR THERAPY 0 36160 PR PLACE CATH AORTA VIA 1389. TRANSLUMBAR 00 36200 PR INTRODUCTION CATHETER AORTA 1672. 00 36215 PR PLACE CATH SELECTIVE ART,NECK 2786. 00 36216 PR PLACE CATH SUBSELECT ART,NECK 3016. 00 36217 PR PLACE CATH SUBSUBSELECT 5259. ART,NECK 00 36218 PR PLACE CATH ADDN SUBSELEC 512.0 ART,NECK 0 36221 PR NONSLCTV CATH THOR AORTA 540.0 ANGIO INTR/XTRCRANL ART 0 36222 PR SLCTV CATH CAROTID/INNOM ART 3526. ANGIO XTRCRANL ART 00 36223 PR SLCTV CATH CAROTID/INNOM ART 3843. ANGIO INTRCRANL ART 00 36224 PR SLCTV CATH INTRNL CAROTID ART 4177. ANGIO INTRCRNL ART 00 36225 PR SLCTV CATH SUBCLAVIAN ART 3813. ANGIO VERTEBRAL ARTERY 00 36226 PR SLCTV CATH VERTEBRAL ART 4261. ANGIO VERTEBRAL ARTERY 00 36227 PR SLCTV CATH XTRNL CAROTID ANGIO 613.0 XTRNL CAROTD CIRC 0 36228 PR SLCTV CATH INTRCRNL BRNCH 2934. ANGIO INTRL CAROT/VERT 00 36245 PR SLCTV CATHJ EA 1ST ORD ABDL 3197. PEL/LXTR ART BRNCH 00 36246 PR SLCTV CATHJ 2ND ORDER ABDL 3074. PEL/LXTR ART BRNCH 00 36247 PR SLCTV CATHJ 3RD+ ORD SLCTV 4866. ABDL PEL/LXTR BRNCH 00 36248 PR SLCTV CATHJ EA 2ND+ ORD ABDL 431.0 PEL/LXTR ART BRNCH 0 36251 PR SLCTV CATH 1STORD W/WO ART 3573. PUNCT/FLUORO/S&I UN 00 36252 PR SLCTV CATH 1STORD W/WO ART 3919. PUNCT/FLUOR/S&I BIL 00 36253 PR SUPSLCTV CATH 2ND+ORD 5467. RENAL&ACCESSORY ARTERY/S&I 00 36254 PR SUPSLCTV CATH 2ND+ORD 5563. RENAL&ACCESSORY ARTERY/S&I 00 36406 PR VNPNXR <3 YEARS PHYS/QHP SKILL 64.00 OTHER VEIN 36410 PR VNPNXR 3 YEARS/> PHYS/QHP SKILL 41.00 36415 PR COLLECTION VENOUS 8.00 BLOOD,VENIPUNCTURE 36416 PR COLLECTION CAPILLARY BLOOD 11.00 SPECIMEN 36430 PR BLOOD TRANSFUSION SERVICE 89.00 36456 PR PRTL EXCHANGE TRANSFUSE 278.0 BLOOD/PLSM/CRYST NEWBORN 0 36460 PR TRANSFUSION FETAL,INTRAUTER 1400. 00 36465 PR NJX NONCMPND SCLEROSANT 4060. SINGLE INCMPTNT VEIN 00 36466 PR NJX NONCMPND SCLEROSANT 4242. MULTIPLE INCMPTNT VEINS 00 36468 PR INJECTIONS SCLEROSANT FOR 137.0 SPIDER VEINS LIM/TRNK 0 36470 PR INJECTION SCLEROSANT SINGLE 373.0 INCMPTNT VEIN 0 36471 PR INJECTION SCLEROSANT MULTIPLE 436.0 INCMPTNT VEINS 0 36473 PR ENDOVEN ABLTJ INCMPTNT VEIN 450.0 MCHNCHEM 1ST VEIN 0 36474 PR ENDOVEN ABLTJ INCMPTNT VEIN 226.0 MCHNCHEM SBSQ VEINS 0 36475 PR ENDOVENOUS RF, 1ST 4147. VEIN 00 36478 PR ENDOVENOUS LASER, 1ST VEIN 3282. 00 36479 PR ENDOVEN ABLTJ INCMPTNT VEIN 958.0 XTR LASER 2ND+ VEINS 0 36481 PR PRQ PORTAL VEIN 4963. CATHETERIZATION ANY METHOD 00 36482 PR ENDOVEN ABLTI THER CHEM 5158 ADHESIVE 1ST VEIN 36483 PR ENDOVEN ABLTI THER CHEM 368.0 ADHESIVE SBSQ VEIN 0 36500 PR VENOUS SELECT SAMPLING W CATH 424.0 0 36510 PR CATH, VEIN UMBILICAL NEWBORN 232.0 0 36511 PR THER APHERESIS,WHITE BLOOD 232.0 CELLS 0 36512 PR THER APHERESIS,RED BLOOD 227.0 CELLS 0 36513 PR THER APHERESIS,PLATELETS 248.0 0 36514 PR THER APHERESIS,PLASMA 2027. PHERESIS 00 36522 PR PHOTOPHERESIS 6263. 00 36555 PR INSJ NON-TUNNELED CENTRAL 711.0 VENOUS CATH AGE < 5 Y 0 36556 PR INSERT NON-TUNNEL CV CATH 664.0 0 36557 PR INSERT TUNNELED CVC W/O SUBQ 2201. PORT/PMP AGE <5 YR 00 36558 PR INSJ TUNNELED CVC W/O SUBQ 2170. PORT/PMP AGE 5 YR/> 00 36560 PR INSJ TUNNELED CTR VAD W/SUBQ 3168. PORT UNDER 5 YR 00 36561 PR INSJ TUNNELED CTR VAD W/SUBQ 3010. PORT AGE 5 YR/> 00 36565 PR INSJ TUN VAD REQ 2 CATH 2 SITS 2379 W/O SUBQ PORT/PMP 36566 PR INSJ TUN VAD REQ 2 CATH 2 SITS 8520. W/SUBQ PORT 00 36568 PR INSERTION PICC W/O IMG GDN < 5 798.0 YR 0 36569 PR INSERT TUNNELED CV 751.0 CATH 0 36571 PR INSJ PRPH CTR VAD W/SUBQ PORT 3251. AGE 5 YR/> 00 36572 PR INSERTION PICC W/RS&I < 5 YR 1073. 00 36573 PR INSERTION PICC W/RS&I 5 YR/> 1010. 00 36575 PR REPAIR TUNNELED CV 386.0 CATH 0 36578 PR RPLCMT CATH CTR VAD SUBQ 1278. PORT/PMP 00 36580 PR REPLACE NON-TUNNELED CENTRAL 672.0 LINE, W/O PORT/PUMP 0 36581 PR RPLCMT COMPL TUN CVC W/O SUBQ 1940. PORT/PMP 00 36582 PR RPLCMT COMPL TUN CTR VAD 2686. W/SUBQ PORT 00 36584 PR REPLACE COMPLETE PICC W/O 663.0 PORT/PUMP, SAME ACCESS 0 36585 PR RPLCMT COMPL PRPH CTR VAD 2767. W/SUBQ PORT 00 36589 PR REMOVAL TUNNELED CV CATH 397.0 0 36590 PR RMVL TUN CTR VAD W/SUBQ 745.0 PORT/PMP CTR/PRPH INSJ 0 36593 PR DECLOT BY THROMBOLYTIC AGENT 67.00 IMPLANT DEVICE/CATH 36595 PR MECH REMOV TUNNELED CV CATH 1701. 00 36596 PR MECH REMOV TUNNELED CV CATH 368.0 0 36597 PR REPOSITION VENOUS CATHETER 395.0 0 36598 PR CONTRAST INJ CENT VEN CATH, INC 292.0 FLOURO 0 36600 PR WITHDRAWAL OF ARTERIAL BLOOD 78.00 36620 PR INSERT 270.0 CATH,ART,PERCUT,SHORTTERM 0 36625 PR INSERT 244.0 CATH,ART,CUTDOWN,SHORTTERM 0 36680 PR INSERT NEEDLE,INTRAOSSEOUS 188.0 INFUSN 0 36800 PR INSERT CANNULA,VEIN- 405.0 VEIN 0 36818 PR AV ANAST,UP ARM CEPHALIC VEIN 1647. TRANSPOSIT 00 36819 PR AV ANAST,UP ARM BASILIC VEIN 2648. TRANSPOSIT 00 36820 PR AV ANAST,FOREARM VEIN 2636. TRANSPOSITION 00 36821 PR ANASTOMOSIS,AV,ANY 1539. SITE 00 36825 PR CREAT AV FISTULA,AUTOGENOUS 1810. GRAFT 00 36830 PR CREAT AV FISTULA,NON- 2343. AUTOGENOUS GRAFT 00 36831 PR THROMBECTOMY,AV FISTULA 2219. DIALYS GRFT 00 36832 PR REVISE AV FISTULA,W/O 2071. THROMBECTOMY 00 36833 PR AV FIST REVISE GRFT,W 2322. THROMBECTOMY 00 36838 PR DIST REVAS LIGATION, HEMO 4708. 00 36870 PR THROMBECTOMY,ARTERIOVENOUS 4878. FISTULA 00 36901 PR INTRO CATH DIALYSIS CIRCUIT DX 1429. ANGRPH FLUOR S&I 00 36902 PR INTRO CATH DIALYSIS CIRCUIT 563.0 W/TRLUML BALO ANGIOP 0 36903 PR INTRO CATH DIALYSIS CIRCUIT 770.0 W/TCAT PLMT IV STENT 0 36904 PR PERQ THRMBC/NFS DIALYSIS 887.0 CIRCUIT IMG DX ANGRPH 0 36905 PR PERQ THRMBC/NFS DIAL CIRCUIT 1113. TRLUML BALO ANGIOP 00 36906 PR PERQ THRMBC/NFS DIAL CIRCUIT 1299. TCAT PLMT IV STENT 00 36907 PR TRLUML BALO ANGIOP CTR 324.0 DIALYSIS SEG W/IMG S&I 0 36908 PR STENT PLMT CENTRAL DIAYLSIS 486.0 SEG PFRMD DIAL CIR 0 36909 PR DIALYIS CIRCUIT VASC EMBOLI 462.0 OCCLS EVASC IMG S&I 0 37140 PR VENOUS 4929. ANASTOMOSIS,OPEN,PORTOCAVAL 00 37182 PR INSERT TRANSVEN INTRAHEP 3350. PORTOSYS SHUNT 00 37183 PR REVJ TRANSVNS INTRAHEPATIC 965.0 PORTOSYSTEMIC SHUNT 0 37184 PR PRIM PRQ TRLUML MCHNL THRMBC 6625. N-COR N-ICRA 1ST 00 37185 PR PRIM PRQ TRLUML MCHNL THRMBC 2166. N-COR N-ICRA SBSQ 00 37186 PR SEC PRQ TRLUML THRMBC N- 4003. CORONARY N-INTRACRANIAL 00 37187 PR PRQ TRANSLUMINAL MECHANICAL 6443. THROMBECTOMY VEIN 00 37188 PR PRQ TRLUML MCHNL THRMBC VEIN 5558. REPEAT TX 00 37191 PR INS INTRVAS VC FILTR W/WO VAS 6509. ACS VSL SELXN RS&I 00 37192 PR REPSNG INTRVAS VC FILTR W/WO 3917. ACS VSL SELXN RS&I 00 37193 PR RTRVL INTRVAS VC FILTR W/WO ACS 4160. VSL SELXN RS&I 00 37197 PR PRQ TRANSCATHETER RTRVL 3777. INTRVAS FB WITH IMAGING 00 37200 PR TRANSCATHETER BIOPSY 533.0 0 37211 PR THROMBOLYSIS ARTERIAL INFUSION 976.0 ICRA RS&I INIT TX 0 37212 PR THROMBOLYSIS VENOUS INFUSION 862.0 W/IMAGING INIT TX 0 37213 PR THROMBOLYSIS ART/VENOUS INFSN 602.0 W/IMAGE SUBSQ TX 0 37214 PR CESSATION THROMBOLYTIC THER 354.0 W/CATHETER REMOVAL 0 37215 PR TCAT IV STENT CRV CRTD ART 3586. EMBOLIC PROTECJ 00 37216 PR TCAT IV STENT CRV CRTD ART W/O 3333. EMBOLIC PROTECJ 00 37217 PR TCATH STENT PLACEMT 2679. RETROGRAD CAROTID/INNOMINATE 00 37218 PR TCATH STENT PLACEMT 3034. ANTEGRADE CAROTID/INNOMINATE 00 37220 PR REVASCULARIZATION ILIAC ARTERY 1052. ANGIOP 1ST VSL 00 37221 PR REVSC OPN/PRQ ILIAC ART W/STNT 1285. PLMT & ANGIOPLSTY 00 37222 PR REVASCULARIZATION ILIAC ART 2225. ANGIOP EA IPSI VSL 00 37223 PR REVSC OPN/PRQ ILIAC ART W/STNT 543.0 & ANGIOP IPSILATL 0 37224 PR REVSC OPN/PRG FEM/POP 1165. W/ANGIOPLASTY UNI 00 37225 PR REVSC OPN/PRQ FEM/POP 1570. W/ATHRC/ANGIOP SM VSL 00 37226 PR REVSC OPN/PRQ FEM/POP 1824. W/STNT/ANGIOP SM VSL 00 37227 PR REVSC OPN/PRQ FEM/POP 2646. W/STNT/ATHRC/ANGIOP SM VSL 00 37228 PR REVSC OPN/PRQ TIB/PERO 1420. W/ANGIOPLASTY UNI 00 37229 PR REVSC OPN/PRQ TIB/PERO 2568. W/ATHRC/ANGIOP SM VSL 00 37230 PR REVSC OPN/PRQ TIB/PERO 2497. W/STNT/ANGIOP SM VSL 00 37231 PR REVSC OPN/PRQ TIB/PERO 1955. W/STNT/ATHR/ANGIOP SM VSL 00 37232 PR REVSC OPN/PRQ TIB/PERO 2967. W/ANGIOPLASTY UNI EA VSL 00 37233 PR REVSC OPN/PRQ TIB/PERO 3702. W/ATHRC/ANGIOP UNI EA VSL 00 37234 PR REVSC OPN/PRQ TIB/PERO 714.0 W/STNT/ANGIOP UNI EA VSL 0 37236 PR OPEN/PERQ PLACEMENT 1795. INTRAVASCULAR STENT INITIAL 00 37237 PR OPEN/PERQ PLACEMENT 546.0 INTRAVASCULAR STENT EA ADDL 0 37238 PR OPEN/PERQ PLACEMENT 819.0 INTRAVASCULAR STENT SAME 1ST 0 37239 PR OPEN/PERQ PLACEMENT 381.0 INTRAVASC STENT SAME EA ADDL 0 37241 PR VASCULAR EMBOLIZATION OR 1789. OCCLUSION VENOUS RS&I 00 37242 PR VASCULAR EMBOLIZATION OR 1773. OCCLUSION ARTERIAL RS&I 00 37243 PR VASCULAR EMBOLIZE/OCCLUDE 2382. ORGAN TUMOR INFARCT 00 37244 PR VASCULAR EMBOLIZATION OR 2778. OCCLUSION HEMORRHAGE 00 37246 PR TRLML BALO ANGIOP OPEN/PERQ 924.0 IMG S&I 1ST ART 0 37247 PR TRLML BALO ANGIOP OPEN/PERQ 458.0 IMG S&I EA ADDL ART 0 37248 PR TRLML BALO ANGIOP OPEN/PERQ 795.0 W/IMG S&I 1ST VEIN 0 37249 PR TRLML BALO ANGIOP OPEN/PERQ 390.0 W/IMG S&I ADDL VEIN 0 37252 PR INTRAVASCULAR US 3554. NONCORONARY RS&I INTIAL VESSEL 00 37253 PR INTRAVASCULAR US 530.0 NONCORONARY RS&I ADDL VESSEL 0 37607 PR LIGATN ANGIOACCESS AV FISTULA 903.0 0 37609 PR TEMPORAL ARTERY LIGATN OR BX 779.0 0 37617 PR LIGATN OF ABDOMEN ARTERY 4619. 00 37618 PR LIGATN OF EXTREMITY ARTERY 979.0 0 37619 PR INS INTRVAS VC FILTR W/WO VAS 4021. ACS VSL SELXN RS&I 00 37700 PR LIGATN LONG SAPHENOUS VEIN AT 673 SEPH-FEM JUNC 37765 PR PHLEB VEINS - EXTREM - TO 20 1645 37766 PR PHLEB VEINS - EXTREM 1500. 20+ 00 37785 PR REVISE SECONDARY VARICOSITY 913.0 0 38100 PR REMOVAL SPLEEN, TOTAL 2713. 00 38101 PR REMOVAL SPLEEN, 2867. PARTIAL 00 38102 PR REMOVAL SPLEEN, TOTAL W OTHR 602.0 PROC 0 38115 PR REPAIR OF RUPTURED SPLEEN 3220. 00 38120 PR LAP,SPLENECTOMY 3155. 00 38200 PR INJECTION FOR SPLEEN X-RAY 327.0 0 38205 PR PROG CELL 197.0 HARVEST,TRANSPLANT,ALLOGENIC 0 38206 PR PROG CELL 198.0 HARVEST,TRANSPLANT,AUTOLOGOUS 0 38220 PR DIAGNOSTIC BONE MARROW 422.0 ASPIRATIONS 0 38221 PR DIAGNOSTIC BONE MARROW 421.0 BIOPSIES 0 38222 PR DIAGNOSTIC BONE MARROW 436.0 BIOPSIES & ASPIRATIONS 0 38230 PR BONE MARROW HARVEST 1500. TRANSPLANTATION ALLOGENEIC 00 38232 PR BONE MARROW HARVEST 500.0 TRANSPLANTATION AUTOLOGOUS 0 38240 PR TRNSPLJ ALLOGENEIC 500.0 HEMATOPOIETIC CELLS PER DONOR 0 38241 PR TRNSPLJ AUTOLOGOUS 500.0 HEMATOPOIETIC CELLS PER DONOR 0 38242 PR ALLOGENEIC LYMPHOCYTE 304.0 INFUSIONS 0 38243 PR TRNSPLJ HEMATOPOIETIC CELL 304.0 BOOST 0 38300 PR DRAINAGE LYMPH NODE,SIMPLE 800.0 0 38305 PR DRAINAGE LYMPH NODE,EXTENSIVE 988.0 0 38308 PR INCISION OF LYMPH CHANNELS 1136. 00 38380 PR LIGATN THOR DUCT,CERV 1224. APPROACH 00 38381 PR LIGATN THOR DUCT,THOR 2921. APPROACH 00 38500 PR BIOPSY/EXCISION, LYMPH NODE(S) 835.0 0 38505 PR NEEDLE BIOPSY, LYMPH NODE(S) 285.0 0 38510 PR BX/REMV,LYMPH NODE,DEEP CERV 1310. 00 38520 PR BX/REMV,LYMPH NODE,DEEP 1179. CERV/SCAL 00 38525 PR BX/REMV,LYMPH NODE,DEEP AXILL 1113. 00 38530 PR BX/REMV,LYMPH NODE,INTERN 1423. MAMM 00 38531 PR OPEN BIOPSY/EXCISION 1136. INGUINOFEMORAL NODES 00 38562 PR REMOVAL, PELVIC LYMPH 2225. NODES,STAGING 00 38570 PR LAP,LYMPH NODE BX 1335 38571 PR LAP,PELVIC LYMPHADENECTOMY 2580. 00 38572 PR LAP,PELVIC LYMPHADENECTOMY/BX 3225. 00 38573 PR LAPS W/BI TOT PEL LMPHADEC & 4232. OMNTC LYMPH BX 00 38700 PR REMOVAL NODES, 2685. NECK,SUPRAHYOID 00 38720 PR REMOVAL NODES, NECK,CERV 2841. CMPLT 00 38724 PR REMOVAL NODES, NECK,CERV MOD 5802. RAD 00 38740 PR REMOVE ARMPIT LYMPH NODES 2014. SUPERFIC 00 38745 PR REMOVE ARMPITS LYMPH NODES 2714. COMPLT 00 38746 PR REMOVE THOR LYMPH NODES RAD 658.0 REGNL 0 38747 PR REMOVE ABD LYMPH NODES RAD 754.0 REGNL 0 38760 PR REMOVE GROIN LYMPH NODES 2560. SUPERF 00 38765 PR REMOVE GROIN LYMPH NODES 3983. 00 38770 PR REMOVE PELVIS LYMPH NODES 2600. 00 38780 PR REMOVE ABD LYMPH NODES 3977. EXTENSIVE 00 38790 PR INJECTION FOR LYMPHATIC XRAY 776.0 0 38792 PR INJ RADIOACTIVE TRACER FOR ID 102.0 OF SENTINEL NODE 0 38794 PR ACCESS THORACIC LYMPH DUCT 768.0 0 38900 PR INTRAOPERATIVE SENTINEL LYMPH 328.0 NODE ID W DYE INJECTION 0 39000 PR MEDIASTINOSCOPY, CERV 1239. APPROACH 00 39010 PR MEDIASTINOSCOPY, CHST 2456. APPROACH 00 39200 PR RESECTION OF MEDIASTINAL CYST 3120. 00 39220 PR RESECTION MEDIASTINAL TUMOR 3435. 00 39401 PR MEDIASTINOSCOPY INCLUDES 802.0 MEDIASTINAL MASS BIOPSY 0 39402 PR MEDIASTINOSCOPY WITH LYMPH 1063. NODE BIOPSY/IES 00 39501 PR REPAIR DIAPHRAGM LACERATION 2693. 00 39503 PR REPAIR DIAPHR HERNIA,NEONATE 18769.00 39540 PR REPAIR DIAPHR HERNIA TRAUMA 2715. ACUTE 00 39541 PR REPAIR DIAPHR HERNIA TRAUMA 2873. CHR 00 39545 PR REVISION OF DIAPHRAGM 3191 39560 PR RESECT DIAPHRAM,SIMPLE REPAIR 2517. 00 39561 PR RESECT DIAPHRAM,COMPLX REP 4432. 00 40490 PR BIOPSY OF LIP 299.0 0 40500 PR LIP SHAVE 1280. 00 40510 PR PARTIAL EXCIS LIP,WEDGE PRIM 1520. CLOS 00 40520 PR PARTIAL EXCIS LIP,V-EXC PRIM 1251. CLOS 00 40525 PR FULL THICK EXCIS LIP,RECON W 1410. FLAP 00 40527 PR FULL THICK EXCIS LIP,FIX W XFLAP 3570. 00 40530 PR PARTIAL REMOVAL OF LIP,>1/4 1180. 00 40650 PR REPAIR LIP,FULL THICK,VERMILION 1111. 00 40652 PR REPAIR LIP,<1/2 VERT HEIGHT 1246. 00 40654 PR REPAIR LIP,>1/2 VERT HEIGHT 2128. 00 40700 PR REPAIR CLEFT LIP/NASAL,UNILAT 2897. 00 40701 PR REPR CLEFT LIP,BILAT,1 STAGE 4285. 00 40702 PR REPR CLEFT LIP,BILAT,1OF2 STAGE 3225. 00 40720 PR REPR CLEFT LIP/NASAL,SECONDARY 3561. 00 40761 PR REPR CLEFT LIP/NASAL,XLIP PED 3890. GRFT 00 40800 PR DRAIN MOUTH 413.0 ABSC/CYST/HEMATOMA,SIMPL 0 40801 PR DRAIN MOUTH 806.0 ABSC/CYST/HEMAT,COMPLX 0 40806 PR INCISION OF LIP FOLD 325.0 0 40808 PR BIOPSY OF MOUTH 476.0 LESION 0 40810 PR EXCIS MOUTH MUCOSA/SUB,NO 415.0 REPAIR 0 40812 PR EXCIS MOUTH MUCOSA/SUB,SIMPL 527.0 REPAIR 0 40814 PR EXCIS MOUTH 1902. MUCOSA/SUB,COMPLX REPR 00 40816 PR EXCIS MOUTH COMPLEX,EXC THRU 1031. MUSCLE 00 40819 PR EXCISE LIP OR CHEEK 691.0 FOLD 0 40820 PR DESTRUC MOUTH LESION/SCAR 696.0 0 40830 PR REPAIR MOUTH LACERATION,<2.5CM 686.0 0 40831 PR REPAIR MOUTH LACERATION,>2.5CM 714.0 0 40840 PR RECONSTRUC MOUTH ANTERIOR 1709. 00 41005 PR I&D MOUTH/TONG 588.0 INTRA,SUBLING,SUPERF 0 41007 PR I&D MOUTH/TONG 977.0 INTRA,SUBMENTAL 0 41008 PR I&D MOUTH/TONG 979.0 INTRA,SUBMANDIBULAR 0 41010 PR INCISION OF TONGUE 512.0 FOLD 0 41015 PR I&D MOUTH/TONG EXTRA,SUBLING 1171. 00 41017 PR I&D MOUTH/TONG 1144. EXTRA,SUBMANDIBUL 00 41100 PR BIOPSY TONGUE,ANTER 383.0 2/3 0 41105 PR BIOPSY TONGUE,POSTER 1/3 352.0 0 41108 PR BIOPSY OF FLOOR OF MOUTH 302.0 0 41110 PR EXCIS TONGUE LESN 434.0 0 41112 PR EXCIS TONGUE LESN,ANT 2/3+CLOS 686.0 0 41113 PR EXCIS TONGUE LESN,POST 1/3 949.0 0 41115 PR EXCIS TONGUE FOLD 628.0 0 41116 PR EXCIS FLOOR MOUTH LESION 836.0 0 41120 PR PART REMOVAL TONGUE,<1/2 3212. 00 41130 PR PART REMOVAL TONGUE, 1/2 4769. 00 41135 PR PART EXC TONGUE,UNILAT RAD 7415. NECK 00 41140 PR REMOVAL OF TONGUE 9029. 00 41145 PR EXCIS TONGUE,UNILAT RAD NECK 9540. 00 41150 PR EXCIS 7569. TONGUE,MOUTH,JAW 00 41153 PR EXCIS TONGUE,MOUTH,NECK 4344. 00 41155 PR EXCIS TONGUE,MOUTH,JAW,RAD 5536. NECK 00 41250 PR REPAIR TONGUE LACER,<2.6CM 675.0 0 41252 PR REPAIR TONGUE 708.0 LACER,2.6CM+/COMPLX 0 41500 PR FIXATION OF TONGUE,MECHANICAL 1153. 00 41800 PR DRAINAGE OF GUM 682.0 LESION 0 41820 PR EXCISION, GUM, EACH QUADRANT 680 41822 PR EXCIS FIBROUS TUBER,DENTOALV 800.0 0 41823 PR EXCIS OSSEOUS TUBER,DENTOALV 833.0 0 41825 PR EXCIS DENTOALVEOLAR LESION 569 41827 PR EXCIS DENTOALV LESN,COMPLX 2007. REP 00 41828 PR EXCISION OF GUM LESION 790.0 0 41830 PR REMOVAL OF GUM TISSUE 800.0 0 41870 PR GUM GRAFT 775.0 0 41874 PR REPAIR TOOTH SOCKET 980.0 0 42000 PR DRAINAGE ABSCESS PALATE/UVULA 496.0 0 42100 PR BIOPSY PALATE/UVULA 315.0 0 42104 PR EXCIS 469.0 LESN,PALATE/UVULA 0 42106 PR EXCIS LESN,PALATE/UVULA-SIMPL 699.0 CLOS 0 42120 PR REMOVE PALATE/LESION 2925. 00 42140 PR EXCISION OF UVULA 518.0 0 42145 PR PALATOPHAYNGOPLASTY 2128. 00 42160 PR DESTRUC LESN PALATE/UVULA 600.0 0 42182 PR REPAIR PALATE LACER 2+CM OR 826.0 COMPLX 0 42200 PR RECONST CLEFT 3003. PALATE,SOFT/HARD 00 42205 PR RECONST CLEFT PALATE,CLOS 3570. ALVE RDG 00 42210 PR RECONST CLEFT PALATE,BONE 4020. GRFT 00 42215 PR RECONST CLEFT PALATE,MAJOR 1854. REVIS 00 42220 PR RECONST CLEFT 1350. PALATE,LENGTHENING 00 42225 PR RECONST CLEFT PALATE,ATTACH 3050. PHAR 00 42226 PR LENGTHENING PALATE+PHARY FLAP 3142. 00 42235 PR REPAIR ANTER PALATE W VOMER 1840. FLAP 00 42281 PR INSERTION, PALATE PROSTHESIS 428.0 0 42300 PR DRAIN ABSCESS PAROTID,SIMPLE 441.0 0 42305 PR DRAIN ABSCESS PAROTID,COMPLIC 1114. 00 42330 PR REMOVAL SALIVARY 492.0 STONE,UNCOMPLIC 0 42335 PR REMOVAL SUBMAND 714.0 STONE,COMPLICATED 0 42400 PR BIOPSY SALIVARY GLAND,NEEDLE 269.0 0 42405 PR BIOPSY SALIVARY 687.0 GLAND,INCISIONAL 0 42408 PR EXCISION SUBLING SALIVARY CYST 963.0 0 42409 PR DRAINAGE SUBLING SALIVARY CYST 847.0 0 42410 PR EXC PAROTD LESN,LATER LOBE 1985. 00 42415 PR EXC PAROTD,LAT LOBE,DISSECT 4226. 5TH NERV 00 42420 PR EXC PAROTD,TOTAL,DISSECT 5TH 3528. NERV 00 42425 PR EXC PAROTD,TOTAL,SACRIFICE 5TH 2556. NERV 00 42426 PR EXC PAROTD,TOTAL,UNILAT RAD 4851. NECK 00 42440 PR EXCISION SUBMAXILLARY GLAND 1473. 00 42450 PR EXCISION SUBLINGUAL GLAND 1216. 00 42500 PR REPAIR SALIVARY DUCT SIMPLE 1103. 00 42600 PR CLOSURE OF SALIVARY FISTULA 1277 42650 PR DILATION OF SALIVARY DUCT 285.0 0 42700 PR INC/DRAIN PERITONSIL ABSCESS 478.0 0 42720 PR INC/DRAIN RETROPHARYNG 1153. ABSCESS,ORAL 00 42725 PR INC/DRAIN RETROPHARYNG 2476. ABSCESS,EXT 00 42800 PR BIOPSY OROPHARYNX 397.0 0 42804 PR BIOPSY NASOPHARYNX,SIMPLE 495.0 0 42808 PR EXCISE PHARYNX LESION 687.0 0 42809 PR REMOVE PHARYNX FOREIGN BODY 911.0 0 42810 PR EXCISION BRACH CLFT 804.0 CYST,SUPERFICIAL 0 42815 PR EXCISION BRANC CLFT CYST,DEEP 1474. 00 42820 REMOVE TONSILS/ADENOIDS,<12 Y/O 776 42821 PR REMOVE TONSILS/ADENOIDS,12+ 744.0 Y/O 0 42825 REMOVAL OF TONSILS,<12 645.0 Y/O 0 42826 PR REMOVAL OF TONSILS,12+ Y/O 744.0 0 42830 REMOVAL ADENOIDS,PRIMARY,<12 Y/O 528.0 0 42831 PR REMOVAL ADENOIDS,PRIMARY,12+ 490.0 Y/O 0 42835 REMOVAL ADENOIDS,SECOND,<12 Y/O 423.0 0 42836 PR REMOVAL ADENOIDS,SECOND,12+ 537.0 Y/O 0 42842 PR RAD RESEC 3605. TONSIL/PILLARS 00 42844 PR RAD RESEC TONSIL/PILLARS,CLOS 5010. LOCAL 00 42845 PR RAD RESEC TONSIL/PILLARS,CLOS 4316. FLAP 00 42870 PR EXCISION OF LINGUAL TONSIL 1256. 00 42890 PR PARTIAL REMOVAL OF PHARYNX 2776. 00 42894 PR RESEC PHARYN WALL,CLOS 5774. MYOCUT FLAP 00 42950 PR RECONSTRUCTION OF THROAT 2080. 00 42953 PR REPAIR THROAT, ESOPHAGUS 2229. 00 42960 PR CONTROL THROAT BLEED,SIMPLE 401.0 0 42961 PR CONTROL THROAT BLEED,COMPL IN 1076. HOSP 00 42962 PR CONTROL THROAT BLEED,SURG 1203. INTERVENTN 00 42972 PR CNTRL NASOPHARYNG 1318. BLEED,SURGERY 00 42999 PR THROAT SURGERY PROCEDURE 3784. UNLISTED 00 43030 PR CRICOPHAYNGEAL MYOTOMY 1763. 00 43101 PR EXCIS ESOPHAGUS LESN,THOR 3215. APPROACH 00 43107 PR REMOVAL ESOPHAGUS,NO 8521. THORACOTOMY 00 43112 PR TOTAL ESOPHAGECTOMY 9258. W/THORCOM W/WO PYLORPLASTY 00 43117 PR PART REMOV ESOPHAGUS,LOWER 9157. 2/3 00 43123 PR PART RMV ESOPH,THORACOABD 15000.00 APP,W/COL INT 43124 PR REMOVAL OF ESOPHAGUS,NO 15528.00 RECONSTRUC 43130 PR REMOV ESOPHAG DIVERTIC,CERV 2674. APPRCH 00 43135 PR REMOV ESOPHAG DIVERTIC,THOR 6040. APPRCH 00 43180 PR ESOPHAGOSCP RIG TRANSORAL 1321. HYPOPHARYNX CRV ESOPH 00 43191 PR ESOPHAGOSCOPY RIGID 890.0 TRANSORAL DIAGNOSTIC BRUSH 0 43192 PR ESOPHAGOSCOPY RIGID 435.0 TRANSORAL INJ SUBMUCOSAL 0 43193 PR ESOPHAGOSCOPY RIGID 441.0 TRANSORAL WITH BIOPSY 0 43194 PR ESOPHAGOSCOPY RIG TRANSORAL 495.0 REMOVAL FOREIGN BODY 0 43197 PR ESOPHAGOSCOPY FLEXIBLE 475.0 TRANSNASAL DIAGNOSTIC 0 43200 PR ESOPHAGOSCOPY FLEXIBLE 697.0 TRANSORAL DIAGNOSTIC 0 43201 PR ESOPHAGOSCOPY FLEXIBLE 722.0 TRANSORAL W SUBMUCOUS INJ 0 43202 PR ESOPHAGOSCOPY FLEXIBLE 849.0 TRANSORAL WITH BIOPSY 0 43205 PR ESPHGOSCOPY FLEX W/BAND 760.0 LIGATION ESOPHGL VARICES 0 43206 PR ESOPHAGOSCOPY TRANSORAL 713.0 W/OPTICAL ENDOMICROSCOPY 0 43212 PR ESOPHAGOSCOPY TRANSORAL 485.0 STENT PLACEMENT 0 43213 PR ESOPHAGOSCOPY RETROGRADE 2919. DILATE BALLOON/OTHER 00 43214 PR ESOPHAGOSCOPY DILATE 499.0 ESOPHAGUS BALLOON 30 MM 0 43215 PR ESOPHAGOSCOPY FLEXIBLE 403.0 REMOVAL FOREIGN BODY 0 43216 PR ESPHAGOSCOPY FLEX LESION 1080 REMOVAL HOT BX FORCEPS 43217 PR ESOPHAGOSCOPY FLEXIB LESION 1125. REMOVAL TUMOR SNARE 00 43220 PR ESOPHAGOSCOPY FLEX BALLOON 470.0 DILAT <30 MM DIAM 0 43226 PR ESOPHAGOSCOPY FLEXIBLE GUIDE 926.0 WIRE DILATION 0 43229 PR ESOPHAGOSCOPY FLEX 1761. TRANSORAL LESION ABLATION 00 43231 PR ESOPHAGOSCOPY FLEXIBLE 675.0 TRANSORAL ULTRASOUND EXAM 0 43232 PR ESOPHAGOSCOPY 647.0 INTRA/TRANSMURAL NEEDLE 0 ASPIRAT/BX 43233 PR EGD ESOPHAGUS BALLOON 600.0 DILATION 30 MM OR LARGER 0 43235 PR 725.0 ESOPHAGOGASTRODUODENOSCOPY 0 TRANSORAL DIAGNOSTIC 43236 PR 969.0 ESOPHAGOGASTRODUODENOSCOPY 0 SUBMUCOSAL INJECTION 43237 PR 582.0 ESOPHAGOGASTRODUODENOSCOPY 0 US SCOPE W/ADJ STRXRS 43238 PR EGD INTRMURAL US NEEDLE 725.0 ASPIRATE/BIOPSY ESOPHAGS 0 43239 PR EGD TRANSORAL BIOPSY 856.0 SINGLE/MULTIPLE 0 43240 PR EGD TRANSORAL TRANSMURAL 995.0 DRAINAGE PSEUDOCYST 0 43241 PR EGD INTRALUMINAL 565.0 TUBE/CATHETER INSERTION 0 43242 PR EGD INTRMURAL NEEDLE 1045. ASPIR/BIOP ALTERED ANATOMY 00 43243 PR EGD INJECTION SCLEROSIS 970.0 ESOPHGL/GASTRIC VARICES 0 43244 PR EGD BAND LIGATION 920.0 ESOPHGEAL/GASTRIC VARICES 0 43245 PR EGD DILATION GASTRIC/DUODENAL 729.0 STRICTURE 0 43246 PR EGD PERCUTANEOUS PLACEMENT 729.0 GASTROSTOMY TUBE 0 43247 PR EGD FLEXIBLE FOREIGN BODY 725.0 REMOVAL 0 43248 PR EGD INSERT GUIDE WIRE DILATOR 680.0 PASSAGE ESOPHAGUS 0 43249 PR EGD BALLOON DILATION 429.0 ESOPHAGUS <30 MM DIAM 0 43250 PR EGD FLEX REMOVAL LESION(S) BY 465.0 HOT BIOPSY FORCEPS 0 43251 PR EGD REMOVAL TUMOR 795.0 POLYP/OTHER LESION SNARE TECH 0 43252 PR EGD FLEX TRANSORAL W/OPTICAL 900.0 ENDOMICROSCOPY 0 43253 PR EGD US GUIDED TRANSMURAL 683.0 INJXN/FIDUCIAL MARKER 0 43254 PR EGD TRANSORAL ENDOSCOPIC 709.0 MUCOSAL RESECTION 0 43255 PR EGD TRANSORAL CONTROL 925.0 BLEEDING ANY METHOD 0 43259 PR EDG US EXAM SURGICAL ALTER 825.0 STOM DUODENUM/JEJUNUM 0 43260 PR ERCP DX COLLECTION SPECIMEN 1050. BRUSHING/WASHING 00 43261 PR ERCP W/BIOPSY SINGLE/MULTIPLE 1150. 00 43262 PR ERCP 1440. W/SPHINCTEROTOMY/PAPILLOTOMY 00 43264 PR ERCP REMOVE CALCULI/DEBRIS 1650. BILIARY/PANCREAS DUCT 00 43265 PR ERCP DESTRUCTION/LITHOTRIPSY 1550. CALCULI ANY METHOD 00 43266 PR EGD ENDOSCOPIC STENT 587.0 PLACEMENT W/WIRE& DILATION 0 43270 PR EGD ABLATE TUMOR POLYP/LESION 1802. W/DILATION& WIRE 00 43273 PR ENDOSCOPIC PAPILLA 316.0 CANNULATION BILE/PANCREATIC 0 43274 PR ERCP STENT PLACEMENT 1922. BILIARY/PANCREATIC DUCT 00 43275 PR ERCP REMOVE FOREIGN 1002. BODY/STENT BILIARY/PANC DUCT 00 43276 PR ERCP BILIARY/PANC DUCT STENT 1264. EXCHANGE W/DIL&WIRE 00 43277 PR ERCP BALLOON DILATE 1008. BILIARY/PANC DUCT/AMPULLA EA 00 43278 PR ERCP TUMOR/POLYP/LESION 1146. ABLATION W/DILATION&WIRE 00 43279 PR LAP, ESOPHAGOMYOTOMY W 3195. FUNDOPLASTY 00 43280 PR LAP,ESOPHAGOGAST 3289. FUNDOPLASTY 00 43281 PR LAP, REPAIR PARAESOPHAGEAL 6199. HERNIA, INCL FUNDOPLASTY W/O MESH 00 43282 PR LAP, REPAIR PARAESOPHAGEAL 4605. HERNIA, INCL FUNDOPLASTY W/ MESH 00 43283 PR LAP ESOPHAGEAL LENGTHENING 403.0 0 43284 PR LAPS ESOPHGL SPHNCTR AGMNTJ 1686. PLMT DEV CRRPL 00 43285 PR REMOVAL ESOPHAGEAL SPHINCTER 1706. AGMNTJ DEVICE 00 43286 PR ESOPHAGECTOMY TOTAL NEAR 13109.00 TOTAL W/LAPS MOBLJ 43287 PR ESOPHAGECTOMY DISTAL 2/3 14972.00 W/LAPAROSCOPIC MOBLJ 43288 PR ESOPHAGECTOMY TOTAL NEAR 15622.00 TOTAL W/THRSC MOBLJ 43300 PR ESOPHAGOPLASTY,CERV APPRCH 2735. 00 43305 PR REPAIR TRACHEOESOPHAGEAL 2728. FISTULA 00 43310 PR ESOPHAGOPLASTY,THORACIC 6055. APPRCH 00 43312 PR REPAIR TRACHEOESOPHAGEAL 6563. FISTULA 00 43314 PR ESOPHAGOPLASTY CON 10954.00 DEF,W/REPAIR TE FIST 43325 PR ESOPHAGOGASTRIC 2832. FUNDOPLASTY+PATCH 00 43327 PR ESOPHAGOGASTRIC FUNDOPLASTY 2028. PARTIAL OR COMPLETE; LAPAROTOMY 00 43328 PR ESOPHAGOGASTRIC FUNDOPLASTY 4016. PARTIAL OR COMPLETE; 00 THORACOTOMY 43330 PR ESOPHAGOMYOTOMY,ABD APPRCH 3757. 00 43331 PR ESOPHAGOMYOTOMY,THORACIC 5475. APPRCH 00 43332 PR REPAIR PARAESOPHAGEAL HIATAL 2903. HERNIA,LAPAROTOMY, WO MESH 00 43333 PR REPAIR PARAESOPHAGEAL HIATAL 3153. HERNIA,LAPAROTOMY, W MESH 00 43334 PR REPAIR PARAESOPHAGEAL HIATAL 3185. HERNIA,THORACOTOMY, WO MESH 00 43335 PR REPAIR PARAESOPHAGEAL HIATAL 5471. HERNIA,THORACOTOMY, W MESH 00 43336 PR REPAIR PARAESOPHAGEAL HIATAL 6142. HERNIA,THORACOABDOMINAL, WO 00 MESH 43338 PR ESOPHAGUS 334.0 LENGTHENING 0 43351 PR SURG OPENING,ESOPHAGUS,THOR 2877. APPRCH 00 43352 PR SURG OPENING,ESOPHAGUS,CERV 3813. APPRCH 00 43360 PR GI REPAIR PREV ESOPH RMVL 9248 43361 PR GI RECON,PRIOR 11004.00 ESOPHAGECT,W/COLON INTERP 43400 PR LIGATE ESOPHAGUS VARICES 6219. 00 43410 PR SUTURE ESOPHAGUS WOUND,CERV 1801. APPRCH 00 43415 PR SUTURE ESOPHAGUS WOUND,THOR 10547.00 APPRCH 43420 PR REPAIR ESOPHAGUS 3006. OPENING,CERV APPRCH 00 43450 PR DILATE ESOPHAGUS 361.0 0 43453 PR DILATION ESOPHAGUS GUIDE WIRE 738.0 0 43500 PR SURGICAL OPENING OF STOMACH 2798. 00 43520 PR INCISION OF PYLORIC MUSCLE 2477 43605 PR BIOPSY OF STOMACH,BY 2952. LAPAROTOMY 00 43610 PR EXCIS STOMACH 3537 ULCER,LESN;LOCAL 43611 PR EXCIS STOAMCH MALIG 3307. 00 43621 PR REMOVAL STOMACH,ROUX-EN-Y 9355 43622 PR REMOVAL STOMACH,FORM INTEST 9450. POUCH 00 43631 PR REMV 5698 STOMACH,PART,DISTAL,GASTRODUOD 43632 PR REMV 4724. STOMACH,PART,DISTAL,GASTROJEJUN 00 43633 PR REMV 7818. STOMACH,PART,DISTAL,ROUX-EN-Y 00 43640 PR 3162. VAGOTOMY/PYLOROPLASTY,SELECT 00 43641 PR VAGOTOMY/PYLOROPLASTY,HI 4299. SELECT 00 43644 PR LAP GASTRIC BYPASS/ROUX-EN-Y 6948. 00 43653 PR LAP,GASTROSTOMY,W/O TUBE 1455. CONSTR 00 43752 PR PLACEMENT NG/OG TUBE BY 93.00 PHYSICIAN 43753 PR GASTRIC INTUBATION/ASPIRATION, 56.00 THERAPEUTIC 43756 PR DUODENAL 510.0 INTUBATION/ASPIRATION, DIAGNOSTIC, 0 1 SPECIMEN 43757 PR DUODENAL 781.0 INTUBATION/ASPIRATION, DIAGNOSTIC, 0 MULTIPLE SPECIMEN 43760 CHANGE GASTROSTOMY TUBE 1137. PERCUTANEOUS W/O GUIDE 00 43761 PR REPOSITION GASTRIC FEEDING 278.0 TUBE THRU DUODENUM 0 43762 PR PERQ REPLACEMENT GTUBE NOT 569.0 REQ REVJ GSTRST TRC 0 43763 PR PERQ REPLACEMENT GTUBE REQ 845.0 REVJ GSTRST TRC 0 43770 LAP, PLACE ADJUST GAST RESTRICT 4042 DEVICE 43771 LAP, REVISE ADJUST GAST RESTRICT 2332. DEVICE 00 43772 LAP, REMOVE ADJUST GAST RESTRICT 2566. DEVICE 00 43774 LAP, REMOVE ADJUST GAST RESTRICT 2360. DEVICE/PORT 00 43775 PR LAP, GAST RESTRICT PROC, 4422. LONGITUDINAL GASTRECTOMY 00 43800 PR RECONSTRUCTION OF PYLORUS 3349 43820 PR GASTROJEJUNOSTOMY 3412. 00 43830 PR GASTROSTOMY,OPEN,W/O TUBE 2520 CNSTR 43831 PR PLACE GASTROSTOMY 1517. TUBE,NEONATE 00 43840 PR REPAIR PERF DUOD/GAST ULC- 5550. WND/INJ 00 43846 PR GASTRIC BYPASS,OBESE<150CM 6608. ROUX-EN-Y 00 43848 REVISION GASTROPLASTY,OBESITY, 7859. NON-GAST RESTRICT DEVICE 00 43860 PR REVISE,GASTROJEJUN ANAST,W/O 6727 VAGOTOMY 43870 PR CLOSURE OF 1475. GASTROSTOMY,SURGICAL 00 43880 PR CLOSURE GASTROCOLIC FISTULA 5184. 00 43886 PR REVISE GASTRIC PORT, OPEN 930 43887 PR REMOVE GASTRIC PORT, OPEN 837 44005 PR FREEING BOWEL 3015. ADHESION,ENTEROLYSIS 00 44010 PR DUODENOTOMY FOR EXPLOR,BX,FB 3078. REMOV 00 44015 PR INSERT TUBE-BOWEL,ENTERAL 442.0 ALIMENT 0 44020 PR ENTEROTOMY,NON- 3476. DUOD,EXPLOR/BX/FB REMOVAL 00 44021 PR ENTEROTOMY DECOMPRESS SMALL 2046. BOWEL 00 44025 PR INCIS COLON FOR EXPLOR,BX,FB 3466. REM 00 44050 PR REDUCE VOLVULUS,INTUSS,INTERN 3365 HERNIA 44055 PR CORRECT MALROTATION OF BOWEL 4552. 00 44110 PR EXCIS BOWEL LESION(S),SINGLE 2248. ENTEROTOMY 00 44111 PR EXCIS BOWEL LESION(S),MULT 2740. ENTEROTOMIES 00 44120 PR RESECT SMALL INTEST,SINGL 4563. RESEC/ANAS 00 44121 PR RESECT SMALL INTEST,EACH ADDNL 558.0 0 44125 PR RESECT SMALL INTEST W 3241. ENTEROSTOMY 00 44126 PR RESECT SM INTEST,CONG 10077.00 ATRESIA,W/O TAPER 44127 PR RESECT SM INTEST,CONG 8766. ATRESIA,W/TAPER 00 44130 PR BOWEL TO BOWEL ANASTOMOSIS 4907. 00 44139 PR MOBILIZE SPLENIC FLEX 302.0 0 44140 PR PART REMOVAL COLON W 4421. ANASTOMOSIS 00 44141 PR PART REMOVAL COLON W 3829. COLOSTOMY 00 44143 PR PART REMOVAL COLON W END 4980. COLOSTOMY 00 44144 PR PART REMOVAL COLON W 4595. OSTOMY/MUCOFIST 00 44145 PR PART REMOVAL COLON W 5512. COLOPROCTOSTOMY 00 44146 PR PART REMOVAL COLON W 5960. COLOPROC,COLOST 00 44147 PR PART REMOVAL 7936. COLON,ABD/TRANSANAL APP 00 44150 PR REMOVAL COLON/ILEOSTOMY 5302. 00 44155 PR REMOVAL 6072. COLON/PROCTECTOMY/ILEOSTOMY 00 44157 PR REMOVAL COLON/PROCTEC/ 8964. ILEOANAL ANAST 00 44158 PR REMOVAL 7429. COLON/PROCTEC/ILEOANAL ANAST 00 POUCH 44160 PR REMVL COLON & TERM ILEUM 3436. W/ILEOCOLOSTOMY 00 44180 PR LAP, SURG ENTEROLYSIS 1925. 00 44186 PR LAP, SURG JEJUNOSTOMY 1456. 00 44187 PR LAP, SURG ILEO/JEJUNO-STOMY 3544. 00 44188 PR LAP, SURG COLOSTOMY 2948. 00 44202 PR LAP,SURG,ENTERECTOMY,RESECT 4612. & ANAST 00 44203 PR LAP,SURG,EA ADDL RESECT & 550.0 ANAST 0 44204 PR LAP,SURG,COLECTOMY, PARTIAL, 5228. W/ANAST 00 44205 PR LAP,SURG,COLECTOMY,W/REMVL 4635. TERM ILEUM 00 44206 PR LAP,SURG,COLECTOMY,W/END 5606. COLOST & CLOSUR 00 44207 PR LAP,SURG,COLECTOMY,W/ANAST 7447. 00 44208 PR 6647. LAP,SURG,COLECTOMY,W/ANAST,W/CO 00 LOSTOMY 44210 PR LAP,SURG,COLECTOMY,TOTAL,W/O 5876. PROCTECTOMY 00 44211 PR 8930. LAP,SURG,COLECTOMY,TOTAL,W/PROC 00 TECTOMY 44212 PR 6826. LAP,SURG,COLECT,TOT,W/PROCTECT, 00 W/ILEOST 44213 PR LAP, SURG MOBIL SPLENIC FL DUR 414.0 PTL COLECTOMY 0 44227 PR LAP, SURG CLOSE ENTEROSTOMY 6808. RESECT ANAST 00 44300 PLACEMENT 2271. ENTEROSTOMY/CECOSTOMY TUBE 00 OPEN 44310 PR 2924. ILEOSTOMY/JEJUNOSTOMY,NONTUBE 00 44312 PR REVISION OF ILEOSTOMY,SIMPLE 1513. 00 44314 PR REVISION OF 2781. ILEOSTOMY,COMPLICATED 00 44320 PR COLOSTOMY 3263. 00 44322 PR COLOSTOMY,W/MULTIPLE BIOPSIES 3581. 00 44340 PR REVISION OF COLOSTOMY,SIMPLE 1272. 00 44345 PR REVISION OF 2875. COLOSTOMY,COMPLICATED 00 44346 PR REVIS COLOSTOMY,REPR 3140. PARACOLO HERNIA 00 44360 PR ENDOSCOPY UPPER SMALL 590.0 INTESTINE 0 44361 PR ENDOSCOPY UPPER SMALL 660.0 INTESTINE W/BIOPSY 0 44363 PR ENTEROSCOPY > 2ND PRTN W/RMVL 531 FOREIGN BODY 44364 PR ENTEROSCOPY > 2ND PRTN W/RMVL 550.0 LESION SNARE 0 44366 PR ENTEROSCOPY > 2ND PRTN 960.0 W/CONTROL BLEEDING 0 44369 PR ENTEROSCOPY > 2ND PRTN ABLTJ 1030. LESION 00 44372 PR ENTEROSCOPY > 2ND PRTN W/PLMT 975.0 PRQ TUBE 0 44373 PR ENTEROSCOPY > 2ND PRTN CONV 800.0 GSTRST TUBE 0 44376 PR ENTEROSC >2ND PRTN W/ILEUM 850.0 W/WO COLLJ SPEC SPX 0 44377 PR ENTEROSC >2ND PRTN W/ILEUM 793.0 W/BX SINGLE/MULTIPLE 0 44378 PR ENTEROSCOPY > 2ND PRTN ILEUM 1018. CONTROL BLEEDING 00 44379 PR ENTEROSCOPY > 2ND PRTN 1080. W/ILEUM W/STENT PLMT 00 44380 PR ILEOSCOPY THRU STOMA DX 536.0 W/COLLJ SPEC WHEN PRFMD 0 44381 PR ILEOSCOPY STOMA W/BALLOON 464.0 DILATION 0 44382 PR ILEOSCOPY STOMA W/BX 776.0 SINGLE/MULTIPLE 0 44384 PR ILEOSCOPY STOMA W/PLMT OF 587.0 ENDOSCOPIC STENT 0 44385 PR NDSC EVAL INTSTINAL POUCH DX 667.0 W/COLLJ SPEC SPX 0 44386 PR NDSC EVAL INTSTINAL POUCH W/BX 849.0 SINGLE/MULTIPLE 0 44388 PR COLONOSCOPY STOMA DX 858.0 INCLUDING COLLJ SPEC SPX 0 44389 PR COLONOSCOPY STOMA W/BIOPSY 971.0 SINGLE/MULTIPLE 0 44390 PR COLONOSCOPY STOMA W/RMVL 1114. FOREIGN BODY 00 44391 PR COLONOSCOPY STOMA CONTROL 1862. BLEEDING 00 44392 PR COLONOSCOPY STOMA RMVL LES 1058. BY HOT BIOPSY FORCEPS 00 44394 PR COLONOSCOPY STOMA W/RMVL 1074. TUM POLYP/OTH LES SNARE 00 44401 PR COLONOSCOPY STOMA ABLATION 1156. LESION 00 44403 PR COLONOSCOPY STOMA 788.0 W/ENDOSCOPIC MUCOSAL RESCJ 0 44404 PR COLONOSCOPY STOMA 1000. W/SUBMUCOSAL INJECTION 00 44405 PR COLONOSCOPY STOMA W/BALLOON 1491. DILATION 00 44406 PR COLONOSCOPY STOMA 612.0 W/ENDOSCOPIC ULTRASOUND EXAM 0 44500 PR INTRODUCTION LONG GI TUBE 58.00 SEPARATE PROCEDURE 44602 PR SUTURE SM INTEST,SINGLE PERF 5746. 00 44603 PR SUTURE SM INTEST,MULTPL PERF 3366. 00 44604 PR SUTURE LRG INTEST 2930. 00 44605 PR SUTURE LRG INTEST W COLOSTOMY 5361 44615 PR INTESTINAL STRICTUROPLASTY 2940. 00 44620 PR CLOSE ENTEROSTOMY 2275. 00 44625 PR CLOSE 2774. ENTEROSTOMY,RESEC+ANAST 00 44626 PR CLOSE 5251. ENTEROSTOMY,RESEC+COLOREC 00 ANAS 44640 PR REPAIR BOWEL-SKIN FISTULA 5768 44650 PR REPAIR BOWEL-BOWEL FISTULA 4868. 00 44661 PR REPR BOW-BLAD 5057. FIST,W/INTEST/BLAD RESECT 00 44680 PR INTESTINAL PLICATION 3794 44700 PR EXCLUSION,SMALL BOWEL FROM 3634. PELVIS 00 44701 PR INTRAOPERATIVE COLONIC LAVAGE 382.0 0 44705 PR PREPARE FECAL MICROBIOTA FOR 310.0 INSTILLATION 0 44800 PR EXCISION MECKEL,OMPHALOMES 2158. DUCT 00 44820 PR EXCISION OF MESENTERY LESION 1752. 00 44850 PR SUTURE OF MESENTERY 2044. 00 44950 PR APPENDECTOMY 1340. 00 44955 PR APPENDECTOMY,W OTHR PROC 300.0 0 44960 PR APPENDECTOMY,RUPT 2300. APPENDX+ABSCESS 00 44970 PR LAP,APPENDECTOMY 1526. 00 45000 PR DRAINAGE OF PELVIC ABSCESS 1172 45005 PR I&D RECTAL SUBMUCOSAL ABSCESS 577.0 0 45020 PR DRAINAGE OF DEEP RECTAL 1156. ABSCESS 00 45100 PR BIOPSY OF RECTUM 761.0 0 45110 PR PROCTECTOMY,AP 7586 RESECT+OSTOMY 45112 PR PROCTECTOMY,AP RESEC,PULL- 3984. THRU 00 45113 PR PROCTECTOMY,PART,ILEAL RESERV 7793. 00 45119 PR PROCTECTOMY,A-P PULLTHRU 4095. W/RESERVOIR 00 45120 PR PROCTECTOMY,COMPLT,PULL- 6502. THRU,ANAST 00 45121 PR 5676. PROCTECTOMY,COMPL,COLECTOMY,BX 00 'S 45123 PR PROCTECTOMY,PART,NO 3032. ANAST,PERINEAL 00 45126 PR PELVIC EXENTERATION 9764. 00 45130 PR EXCIS RECTAL PROLAPSE,PERINEAL 2992. 00 45136 PR EXCIS,ILEOANAL RESERVOIR 7591 W/ILEOSTOMY 45160 PR EXCIS RECTAL LESION 2095. 00 45171 PR EXCIS RECTAL TUMOR, TRANSANAL, 1501. PARTIAL THICKNESS 00 45172 PR EXCIS RECTAL TUMOR, TRANSANAL, 2886. FULL THICKNESS 00 45300 PR 231.0 PROCTOSIGMOIDOSCOPY,RIGID,DIAGN 0 OS 45305 PR PROCTOSGMDSC RIGID W/BX 443.0 SINGLE/MULTIPLE 0 45307 PR PROCTOSGMDSC RIGID W/RMVL 593.0 FOREIGN BODY 0 45309 PR PROCTOSGMDSC RIGID RMVL 1 564.0 LESION SNARE TQ 0 45317 PR PROCTOSGMDSC RIGID CONTROL 596.0 BLEEDING 0 45330 PR SIGMOIDOSCOPY FLX DX W/COLLJ 419.0 SPEC BR/WA IF PFRMD 0 45331 PR SIGMOIDOSCOPY,BIOPSY 643.0 0 45332 PR SIGMOIDOSCOPY FLX W/RMVL 755.0 FOREIGN BODY 0 45333 PR SIGMOIDOSCOPY FLX W/RMVL 877.0 TUMOR BY HOT BX FORCEPS 0 45334 PR SIGMOIDOSCOPY FLX CONTROL 550.0 BLEEDING 0 45335 PR SGMDSC FLX DIRED SBMCSL NJX 616.0 ANY SBST 0 45337 PR SGMDSC FLX W/DCMPRN W/PLMT 490.0 DCMPRN TUBE 0 45338 PR SGMDSC FLX RMVL TUM POLYP/OTH 788.0 LES SNARE TQ 0 45340 PR SIGMOIDOSCOPY FLX TNDSC BALO 1108. DILAT 00 45341 PR SIGMOIDOSCOPY FLX NDSC US XM 585.0 0 45342 PR SIGMOIDOSCOPY FLX TNDSC US GID 675.0 NDL ASPIR/BX 0 45346 PR SIGMOIDOSCOPY FLX ABLATION 443.0 TUMOR POLYP/OTH LES 0 45347 PR SIGMOIDOSCOPY FLX PLACEMENT 443.0 OF ENDOSCOPIC STENT 0 45349 PR SGMDSC FLX WITH ENDOSCOPIC 443.0 MUCOSAL RESECTION 0 45378 PR COLONOSCOPY FLX DX W/COLLJ 961.0 SPEC WHEN PFRMD 0 45379 PR COLONOSCOPY FLX W/REMOVAL OF 1226. FOREIGN BODY(S) 00 45380 PR COLONOSCOPY W/BIOPSY 1520 SINGLE/MULTIPLE 45381 PR COLSC FLX WITH DIRECTED 1119. SUBMUCOSAL NJX ANY SBST 00 45382 PR COLSC FLEXIBLE W/CONTROL 1926. BLEEDING ANY METHOD 00 45384 PR COLSC FLX W/REMOVAL LESION BY 1136. HOT BX FORCEPS 00 45385 PR COLSC FLX W/RMVL OF TUMOR 1294. POLYP LESION SNARE TQ 00 45386 PR COLSC FLEXIBLE 1743. W/TRANSENDOSCOPIC BALLOON DILAT 00 45388 PR COLONOSCOPY FLX ABLATION 443.0 TUMOR POLYP/OTHER LES 0 45389 PR COLONOSCOPY FLX WITH 837.0 ENDOSCOPIC STENT PLACEMENT 0 45390 PR COLONOSCOPY FLX W/ENDOSCOPIC 864.0 MUCOSAL RESECTION 0 45391 PR COLSC FLX W/NDSC US XM RCTM ET 730.0 AL LMTD&ADJ STRUX 0 45392 PR COLSC FLX W/US GUID NDL 875.0 ASPIR/BX W/US RCTM ET AL 0 45393 PR COLONOSCOPY FLEXIBLE WITH 1071. DECOMPRESSION 00 45395 PR LAP, SURG PROCTECTOMY W 4898. COLOSTOMY 00 45397 PR LAP, SURG PROCTECTOMY W J- 8800. POUCH 00 45398 PR COLONOSCOPY FLEXIBLE WITH 1785. BAND LIGATION(S) 00 45400 PR LAP, SURG PROCTOPEXY 4027. 00 45500 PR REPAIR OF RECTUM,STENOSIS 1067. 00 45505 PR REPAIR OF RECTUM,PROLAPSE 1506. MUCOSA 00 45540 PR FIX RECTAL PROLAPSE,ABD 3908. APPRCH 00 45550 PR REPAIR RECTUM; REMOVE SIGMOID 4847. 00 45560 PR REPAIR OF RECTOCELE 2454 45562 PR EXPLOR/REPAIR RECTUM 2327. 00 45563 PR EXPLOR/REPAIR 5038. RECTUM,INJ,COLOSTOMY 00 45800 PR CLOSE RECTUM-BLADDER FISTULA 5089. 00 45905 PR DILATION ANAL SPHINCTER W 1203. ANESTH 00 45910 FL DILATION FOR RECTAL STRICTURE 1629. 00 45915 PR REMV RECTAL OBSTR:FECES/F.B. W 693.0 ANEST 0 45990 PR SURG DIAGNOSTIC EXAM, 275.0 ANORECTAL 0 46020 PR PLACEMENT,SETON 698.0 0 46030 PR REMOVAL OF RECTAL MARKER 351.0 0 46040 PR I&D PERIRECTAL ABSCESS 1028. 00 46045 PR I&D RECTAL WALL ABSCESS W 1149 ANESTH 46050 PR I&D PERIANAL 499.0 ABSCESS,SUPERFICIAL 0 46060 PR I&D RECTAL ABSCESS + 1209. FISTULECTOMY 00 46080 PR ANAL SPHINCTEROTOMY 547.0 0 46083 PR INCISE EXTERNAL HEMORRHOID 413.0 0 46200 PR REMOVAL OF ANAL 816.0 FISSURE 0 46220 PR EXCISION SINGLE EXTERNAL 390.0 PAPILLA OR TAG ANUS 0 46221 PR HEMORRHOIDECTOMY INTERNAL 511.0 RUBBER BAND LIGATIONS 0 46230 PR EXCISION MULTIPLE EXTERNAL 610.0 PAPILLAE/TAGS ANUS 0 46250 PR HEMORRHOIDECTOMY,EXTERNAL, 1167. 2+ COLUMNS/GROUPS 00 46255 PR HEMORRHOIDECTOMY,INT/EXT,1 1277. COLUMN/GROUP 00 46260 PR HEMORRHOIDECTOMY,INT/EXT, 2+ 1095. COLUMNS/GROUPS 00 46270 PR REMOVAL ANAL 1281. FISTULA,SUBCUTANEOUS 00 46275 PR REMOVAL ANAL 1359. FISTULA,INTERSPNINCTERIC 00 46280 PR REMOVAL ANAL 1200. FISTULA,TRANS/SUPRA/EXTRAPHINCT, 00 +/-SETON 46285 PR REMOVAL ANAL FISTULA,SECOND 1351. STAGE 00 46288 PR REPAIR ANAL FISTULA,RECT ADV 1398. FLAP 00 46320 PR EXCISION THROMBOSED 485.0 HEMORRHOID, EXTERNAL 0 46505 PR CHEMODENERVATION ANAL 700.0 SPHINCTER 0 46600 PR ANOSCOPY DX W/COLLJ SPEC 217.0 BR/WA SPX WHEN PRFRMD 0 46601 PR ANOSCOPY DX W/HRA &CHEM 346.0 AGNTS ENHANCEMENT 0 46604 PR ANOSCOPY,W/DILATION 1561. 00 46606 PR ANOSCOPY AND BIOPSY 569.0 0 46607 PR ANOSCOPY DX W/HRA &CHEM 486.0 AGNTS ENHANCEMENT W/BX 0 46611 PR ANOSCOPY,REMOVE LESN,SNARE 409.0 0 46614 PR ANOSCOPY,W/CONTROL,BLEEDING 331.0 0 46615 PR ANOSCOPY,ABLATE 367.0 LESION 0 46700 PR REPAIR ANAL STRICTURE,ADULT 1731 46705 PR REPAIR ANAL STRICTURE,INFANT 1406 46715 PR REPR LO IMPERF ANUS W FISTULA 1051. 00 46716 PR REPR LO IMPERF ANUS W 2884. TRANSPOSTN 00 46730 PR REPR HI IMPERF ANUS 7436. 00 46740 PR REPR HI IMPERF ANUS,W FISTULA 6221. 00 46742 PR REPR HI IMPERF 10134 ANUS,FIST,COMBINED 46750 PR REPAIR OF ANAL SPHINCTER,ADULT 2691 46900 PR DESTRUCT,ANAL 607.0 LESN(S),SIMPLE,CHEM 0 46910 PR ELECTRODESSICATN,ANAL LESN(S) 647.0 0 46916 PR CRYOSURGERY, ANAL LESION(S) 580.0 0 46917 PR LASER SURGERY, ANAL LESION(S) 1115. 00 46922 PR SURG EXCISION OF ANAL LESION(S) 509.0 0 46924 PR DESTRUCTION,ANAL 1342. LESION(S),EXTENSIVE 00 46945 PR HEMORRHOIDECTOMY, INT, 687.0 LIGATION NOT RUBBER BAND, SINGLE 0 46946 PR HEMORRHOIDECTOMY, INT, 791.0 LIGATION NOT RUBBER BAND, 2+ 0 47000 PR BIOPSY LIVER NEEDLE 884.0 PERCUTANEOUS 0 47000 PR BIOPSY LIVER NEEDLE 26 537.0 PERCUTANEOUS 0 47001 PR NEEDLE BIOPSY LIVER,W OTHR 295.0 PROC 0 47010 PR DRAINAGE OF LIVER LESION, OPEN 3237. 00 47015 PR INJECT/ASPIRATE LIVER 4155. CYST/ABSCESS 00 47100 PR WEDGE BIOPSY OF LIVER 3041 47120 PR RESEC LIVER,PART LOBECTOMY 9148. 00 47122 PR RESEC LIVER,TRISEGMENTECTOMY 11481.00 47125 PR RESEC LIVER,TOTAL LT LOBECTOMY 6750. 00 47130 PR RESEC LIVER,TOTAL RT 11138.00 LOBECTOMY 47133 PR REMOVAL OF DONOR 5566. LIVER 00 47135 PR TRANSPLANT 19900.00 LIVER,ALLOTRANSPLANT 47141 PR PARTIAL REMOVAL, DONOR LIVER, 17584 LEFT LOBE 47142 PR PARTIAL REMOVAL, DONOR LIVER, 14000.00 RIGHT LOBE 47143 PR TRANSPLANT,PREP DONOR LIVER, 13092.00 WHOLE 47144 PR TRANSPLANT,PREP DONOR LIVER, 12523.00 3-SEGMENT 47145 PR TRANSPLANT,PREP DONOR LIVER, 11730.00 LOBE SPLIT 47146 PR TRANSPLANT,PREP DONOR 702.0 LIVER/VENOUS 0 47147 PR TRANSPLANT,PREP DONOR 819.0 LIVER/ARTERIAL 0 47300 PR MARSUPIALIZE LIVER 4029. CYST/ABSCESS 00 47350 PR REPAIR BLEED LIVER/SUTURE 3671. WOUND 00 47360 PR REPR BLEED LIVER/COMPLX 5750. SUTURE WND 00 47361 PR EXPLOR LIVER WOUND,EXTENSIV 9752. DEBRIDE 00 47362 PR RE-EXPLORE LIVER WOUND,REMV 3576. PACKING 00 47370 PR LAP,ABLAT 1+ LIVER 5145 TUMOR(S),RADIOFREQ 47380 PR ABLAT,OPEN,1+ LIVER 4912. TUMOR(S),RADIOFREQ 00 47382 PR ABLTJ 1/> LVR TUM PRQ 2613. RF 00 47383 PR ABLATION 1/> LIVER TUMOR PERQ 18361.00 CRYOABLATION 47400 PR INCISION OF LIVER 8649. DUCT/EXPLOR,DRAIN 00 47420 PR INCIS BILE DUCT/EXPL,DRAIN,REMV 3733. CALC 00 47490 PR 1184. CHOLECYSTOSTOMY,PERCUTANEOUS, 00 COMPLETE 47525 PR CHANGE PERCUT BILE DUCT 1812. CATHETER 00 47531 PR NJX CHOLANGIO PRQ W/IMG GID 946.0 RS&I EXISTING ACCESS 0 47532 PR NJX CHOLANGIO PRQ W/IMG GID 2014. RS&I NEW ACCESS 00 47533 PR PRQ PLMT BILIARY DRG CATH W/IMG 3394. GID RS&I EXTERNL 00 47534 PR PRQ PLMT BILIARY DRG CATH W/IMG 4183. GID RS&I INT-EXT 00 47535 PR CONV EXT BIL DRG CATH TO INT- 2805. EXT BIL DRG CATH 00 47536 PR EXCHANGE BILIARY DRG CATHETER 2070. PRQ W/IMG GID RS&I 00 47537 PR REMOVAL BILIARY DRG CATHETER 1024. REQ FLUOR GID RS&I 00 47538 PR PLMT BILE DUCT STENT PRQ 3500. EXISTING ACCESS 00 47540 PR PLMT BILE DUCT STENT PRQ NEW 4400. ACCESS W/SEP CATH 00 47542 PR BALLOON DILAT BILIARY 1312. DUCT/AMPULLA PRQ EACH DUCT 00 47543 PR ENDOLUMINAL BX BILIARY TREE 3374. PRQ ANY METH 1/MLT 00 47544 PR REMOVAL BILIARY DUCT &/GLBLDR 2061. CALCULI PERQ RS&I 00 47550 PR BILE DUCT 377.0 ENDOSCOPY,INTRAOPERATIVE 0 47552 PR BILIARY ENDO PRQ T-TUBE DX 775.0 W/COLLECT SPEC BRUSH 0 47555 PR BILIARY ENDOSCOPY PERCUT,DIL 882.0 STRICT 0 47562 PR LAP,CHOLECYSTECTOMY 2083. 00 47563 PR LAP,CHOLECYSTECTOMY/GRAPH 2310. 00 47564 PR LAP,CHOLECYSTECTOMY/EXPLORE 2540. 00 47600 PR REMOVAL GALLBLADDER 2601. 00 47605 PR REMV GALLBLADDER W 2791. CHOLANGIOGRAM 00 47610 PR REMV GALLBLADDER,EXPLOR 3525. COMMON DUCT 00 47612 PR REMV GB,W 5153. CHOLEDOCHOENTEROSTOMY 00 47701 PR BILE DUCT REVISION 7085. 00 47711 PR EXCIS BILE DUCT 5001. TUMOR,EXTRAHEPATIC 00 47712 PR EXCIS BILE DUCT 6456. TUMOR,INTRAHEPATIC 00 47715 PR EXCISION CHOLEDOCHAL CYST 3541. 00 47720 PR CHOLECYSTOENTEROSTOMY 4124. 00 47760 PR ANAST EXTRAHEP DUCT TO GI 5552. TRACT 00 47765 PR ANAST INTRAHEP DUCT TO GI 12413.00 TRACT 47780 PR ANAST,ROUX-EN-Y,EXTRAHEP TO GI 5684. TRCT 00 47785 PR ANAST,ROUX-EN-Y,INTRAHEP TO GI 7914. TRCT 00 47800 PR RECONSTR EXTRAHEP 6413. DUCTS,PLASTIC 00 47999 PR BILE TRACT SURG PROC, UNLISTED 615.0 0 48020 PR REMOVAL OF PANCREATIC STONE 2439. 00 48100 PR BIOPSY,PANCREAS,OPEN 2444. 00 48102 PR NEEDLE BIOPSY OF PANCREAS 1147. 00 48105 PR RESECT/DEBRIDE ACUTE NECROT 9512. PANCREAS 00 48120 PR EXCISION OF PANCREAS LESION 3938. 00 48140 PR PART REMV PANCREAS,DISTAL 4928. SUBTOTAL 00 48145 PR PART REMV PANC,DIST+ANAST 22550.00 PANC-JEJU 48150 PR PART REMV PANC,PROX+REMV 10227.00 DUOD+ANAST 48153 PR PART REMV PANC,PROX+PART 10236.00 DUOD+ANAST 48154 PR PART REMV PANC,PROX+PART 7467. REMV DUOD 00 48155 PR REMOVAL OF PANCREAS, TOTAL 5669. 00 48160 PR 12860 PANCREATECTOMY,W/AUTOLOGOUS TRANSPLANT 48500 PR 4029 MARSUPIALIZATION,CYST,PANCREAS 48510 PR EXTERN DRAIN PANC 3924. PSEUDOCYST,OPEN 00 48520 PR ANAST PANC CYST-BOWEL,DIRECT 3902. 00 48545 PR PANCREATORRHAPHY,INJURY 5464. 00 48548 PR ANAST PANCREAS-JEJUNUM/SIDE- 6781. SIDE 00 48550 PR DONOR 5251. PANCREATECTOMY 00 48551 PR TRANSPLANT,PREP DONOR 9655. PANCREAS 00 48554 PR TRANSPLANT ALLOGRAFT 6838. PANCREAS 00 48556 PR REMOVAL ALLOGRAFT PANCREAS 4555. 00 49000 PR EXPLORATORY OF ABDOMEN 2287. 00 49002 PR REOPEN RECENT ABD 2551. EXPLORATORY 00 49010 PR EXPLORATORY RETROPERITONEAL 2471. 00 49020 PR DRAIN ABD ABSCESS 4978. OPEN 00 49040 PR DRAIN SUBDIAPH/SUBPHR 3554. ABSCESS,OPEN 00 49060 PR DRAIN RETROPERITONEAL 3216. ABSCESS,OPEN 00 49062 PR DRAIN LYMPH-PERITONEAL 2363. CAVITY,OPEN 00 49082 PR ABDOM PARACENTESIS DX/THER 400.0 W/O IMAGING GUIDANCE 0 49083 PR ABDOM PARACENTESIS DX/THER W 754.0 IMAGING GUIDANCE 0 49084 PR PERITONEAL LAVAGE W/WO 279.0 IMAGING GUIDANCE 0 49180 PR PERCUT BIOPSY, ABDOMINAL MASS 412.0 0 49185 PR SCLEROTHERAPY FLUID 2692 COLLECTION PRQ W/IMG GID 49203 PR EXCISION/DESTRUCTION OPEN 4891. ABDOMINAL TUMORS 5 CM 00 49204 PR EXCISION/DESTRUCTION OPEN 6261. ABDOMINAL TUMORS 5.1-10.0 CM 00 49205 PR EXCISION/DESTRUCTION OPEN 7039. ABDOMINAL TUMORS >10.0 CM 00 49215 PR EXCISE PRESACRAL/SACRAL 7067. TUMOR 00 49250 PR EXCISION OF UMBILICUS 1232. 00 49255 PR REMOVAL OF OMENTUM 2848 49320 PR LAP,DIAGNOSTIC 744.0 ABDOMEN 0 49321 PR LAP,DX SURGICAL ABD W/BIOPSY 1015. 00 49322 PR LAP,ABDOMEN,ASPIRATE CYST 1400. 00 49323 PR LAP,ABDOMEN,DRAIN LYMPHOCELE 2276. 00 49324 PR LAP INSERTION TUNNELED 912.0 INTRAPERITONEAL CATHETER 0 49325 PR LAP REVISE INTRAPERITONEAL 992.0 CATHETER 0 49326 PR LAP OMENTOPEXY ADD- 412.0 ON 0 49400 PR AIR/CONTRAST INJECT INTO 426.0 ABDOMEN 0 49402 PR REMOVE PERITONEAL FOREIGN 2838. BODY 00 49405 PR IMAGE-GUIDE FLUID COLLXN 2173. DRAINAGE CATH VISC PERQ 00 49406 PR IMG-GUIDE FLUID COLLXN DRAINAG 497.0 CATH PERITON PERQ 0 49407 PR IMAGE FLUID COLLXN DRAINAG 1836. CATH TRANSREC/VAGINAL 00 49418 PR INSJ INTRAPERITONEAL CATHETER 3707. W/IMG GUID 00 49419 PR INSERTION TUNNEL 957.0 INTRAPERITONEAL CATH W SUBQ PORT 0 49421 PR INSERTION TUNNEL 877.0 INTRAPERITONEAL CATH DIAL OPEN 0 49422 PR REMOVAL TUNNELED 960.0 INTRAPERITONEAL CATHETER 0 49423 PR DRAINAGE CATHETER EXCHANGE 1349. 00 49424 PR CONTRAST INJ,ABSCESS/CYST VIA 380.0 CATH TUBE 0 49425 PR INSERT ABDOMEN-VENOUS SHUNT 2594 49429 PR REMOVAL OF ABD-VENOUS SHUNT 1220 49435 PR INSERT SUBQ EXTENSION 310.0 INTRAPERITONEAL CATH 0 49440 PR INSERT GASTROSTOMY TUBE 2041. PERCUTANEOUS 00 49441 PR INSERT 2416. DUODENOSTOMY/JEJUNOSTOMY TUBE 00 PERQ 49442 PR INSERT CECOSTOMY/OTHER 2440. COLONIC TUBE PERCUTANEOUS 00 49446 PR CONVERT GASTROSTOMY-GASTRO- 2131. JEJUNOSTOMY TUBE PERQ 00 49450 PR REPLACE 1401. GASTROSTOMY/CECOSTOMY TUBE 00 PERCUTANEOUS 49451 PR REPLACE 1487. DUODENOSTOMY/JEJUNOSTOMY TUBE 00 PERCUTANEOUS 49452 PR REPLACEMENT GASTRO- 2257. JEJUNOSTOMY TUBE PERCUTANEOUS 00 49460 PR OBSTRUCTIVE MATERIAL REMOVAL 1482. FROM GI TUBE 00 49465 PR CONTRAST INJECTION 312.0 PERCUTANEOUOS RADIOLOGIC EVAL GI 0 TUBE 49491 REPAIR ING HERNIA,PRETERM 2146. INFANT,REDUC 00 49495 REPAIR ING HERNIA,FULL/PRETERM 1046. INF,REDUC 00 49496 REPAIR ING HERNIA,<6MO,STRANG 1577. 00 49500 REPAIR ING HERNIA,6MO-5YR,REDUC 1181. 00 49501 PR REPAIR ING HERNIA,6MO- 1489. 5YR,STRANG 00 49505 PR REPAIR ING 1320. HERNIA,5+Y/O,REDUCIBL 00 49507 PR REPAIR ING HERNIA,5+Y/O,STRANG 2090. 00 49520 PR REPAIR RECURR INGUIN 1371. HERN,REDUCIBL 00 49521 PR REPAIR RECURR INGUIN 2269. HERN,STRANG 00 49525 PR REPAIR SLIDING INGUINAL HERNIA 1340. 00 49550 PR REPAIR FEMORAL 1348. HERNIA,REDUCIBLE 00 49553 PR REPAIR FEMORAL HERNIA,STRANG 1623 49560 PR REPAIR INCISIONAL 2249. HERNIA,REDUCIBLE 00 49561 PR REPAIR INCISIONAL HERNIA,STRANG 2673. 00 49565 PR REPAIR RECURR INCIS 2268. HERNIA,REDUC 00 49566 PR REPAIR RECURR INCIS 2701. HERNIA,STRANG 00 49568 PR IMPLANT MESH HERNIA 626.0 REPAIR/DEBRIDEMENT CLOSURE 0 49570 PR REPAIR EPIGASTRIC HERNIA,REDUC 1050. 00 49572 PR REPAIR EPIGASTRIC 1054. HERNIA,STRANG 00 49580 REPAIR UMBILICAL HERN,<5Y/O,REDUC 832.0 0 49585 REPAIR UMBILICAL HERN,5+Y/O,REDUC 1173. 00 49587 REPAIR UMBILICAL 1077. HERN,5+Y/O,STRANG 00 49590 PR REPAIR SPIEGELIAN 1225. HERNIA 00 49600 PR REPAIR SMALL OMPHALOCELE 2607. 00 49605 PR REPAIR LARGE OMPHALOCELE 10497.00 49606 PR REPAIR LARGE 3593. OMPHALOCELE,FINAL 00 49610 PR REPAIR OMPHALOCELE,FIRST 2453. STAGE 00 49650 PR LAP,INGUINAL HERNIA REPR,INITIAL 1048. 00 49651 PR LAP,INGUINAL HERNIA REPR,RECUR 1364. 00 49652 PR LAP, VENTRAL HERNIA 3349. REPAIR,REDUCIBLE 00 49653 PR LAP, VENTRAL HERNIA 3773. REPAIR,INCARCERATED 00 49654 PR LAP, INCISIONAL HERNIA 3349. REPAIR,REDUCIBLE 00 49655 PR LAP, INCISIONAL HERNIA 3773. REPAIR,INCARCERATED 00 49656 PR LAP, RECURRENT INCISIONAL 3555. HERNIA REPAIR,REDUCIBLE 00 49657 PR LAP, RECURRENT INCISIONAL 3368. HERNIA REPAIR,INCARCERATED 00 49900 PR SUTURE ABD WALL-DEHIS/EVISCER 2896. 00 49904 PR OMENTAL FLAP,EXTRA-ABDOMINAL 5790. 00 49905 PR OMENTAL FLAP,INTRA-ABDOMINAL 942 49906 PR FREE OMENTAL FLAP,MICROVASC 4247. ANAST 00 50060 PR REMOVAL OF KIDNEY STONE 3439. 00 50080 PR PERCUT REMV KID STONE,UP TO 2 3486. CM 00 50081 PR PERCUT REMV KID STONE,2+ CM 5317. 00 50200 PR RENAL BIOPSY PRQ 1496. TROCAR/NEEDLE 00 50205 PR BIOPSY OF KIDNEY,OPEN EXPOS 2242. 00 50220 PR REMV KIDNEY,W/RIB RESECTION 3282. 00 50225 PR REMV KIDNEY,COMPLICATED 4861. 00 50230 PR REMV KIDNEY,RADICAL 5283. 00 50234 PR REMV KIDNEY/URETER,SAME INCIS 5272. 00 50236 PR REMV KIDNEY/URETER,SEPAR INCIS 6017. 00 50240 PR PARTIAL REMOVAL OF KIDNEY 5404. 00 50280 PR EXCIS/UNROOF RENAL 3428. CYST 00 50300 PR RMV,DONOR KIDNEY,CADAVER 2359. 00 50320 PR 4760. RMV,KIDNEY,DONOR,LIVING 00 50323 PR TRANSPLANT,PREP CADAVER 10839.00 RENAL GRAFT 50325 PR TRANSPLANT,PREP LIVING RENAL 11614.00 GRAFT 50327 PR TRANSPLANT,PREP RENAL 468.0 GRAFT/VENOUS 0 50328 PR TRANSPLANT,PREP RENAL 410.1 GRAFT/ARTERIAL 8 50329 PR TRANSPLANT,PREP RENAL 460.0 GRAFT/URETERAL 0 50340 PR REMOVAL OF RECIPIENT KIDNEY 2709. 00 50360 PR TRANSPLANTATION OF KIDNEY 7189. 00 50365 PR TRANSPLANT KIDNEY+RECIP 11669.00 NEPHREC 50370 PR REMOVE TRANSPLANTED KIDNEY 2963. 00 50380 PR REIMPLANTATION OF KIDNEY 7809. 00 50382 PR RMVL & RPLCMT INTLY DWELLING 2952. URETERAL STENT PRQ 00 50384 PR REMOVAL INDWELLING URETERAL 2306. STENT PRQ 00 50385 PR REMOVE & REPLACE INDWELL 2984 URETERAL STENT TRURTHRL 50387 PR RMVL & RPLCMT XTRNL 1664. ACCESSIBLE NEPHROURTRL CATH 00 50389 PR REMOVE RENAL TUBE W/FLUORO 748.0 0 50390 PR PERCUT DRAIN/INJECT RENAL CYST 229.0 0 50395 PR PERCUT DILATN RENAL TRACT 430.0 0 50396 PR MEASURE KIDNEY PRESSURE THRU 301.0 TUBE 0 50400 PR REVISION RENAL PELVIS,SIMPLE 3621. 00 50405 PR REVISION RENAL 5764. PELVIS,COMPLICATED 00 50430 PR NJX PX ANTEGRDE NFROSGRM 1323. &/URTRGRM NEW ACCESS 00 50431 PR NJX PX ANTEGRDE NFROSGRM 411.0 &/URTRGRM EXSTNG ACESS 0 50432 PR PLMT NEPHROSTOMY CATH PRQ 2144. NEW ACCESS RS&I 00 50433 PR PLMT NEPHROURETERAL CATH PRQ 2886. NEW ACCESS RS&I 00 50434 PR CONVERT NEPHROSTOMY CATH TO 2285. NEPHROURTRL CATH PRQ 00 50435 PR EXCHANGE NEPHROSTOMY 1199. CATHETER PRQ W/IMG GID RS&I 00 50436 PR PERQ DILATION XST TRC 394.0 ENDOUROLOGIC PX W/IMG 0 50437 PR PERQ DILATION XST TRC NEW 657.0 ACCESS RENAL COLTJ SYS 0 50500 PR REPAIR OF KIDNEY 5249. WOUND 00 50520 PR CLOSE KIDNEY-SKIN FISTULA 3689. 00 50541 PR LAP,ABLATION OF RENAL CYSTS 3246. 00 50543 PR LAP,PARTIAL NEPHRECTOMY 4926. 00 50544 PR LAP,PYELOPLASTY 5037. 00 50545 PR LAP, RADICAL NEPHRECTOMY 5418. 00 50546 PR NEPHRECTOMY 4392. 00 50547 PR LAP,DONOR KIDNEY REMOV,LIVING 5331. 00 50548 PR NEPHRECTOMY, W/PART. 5155. URETECTOMY 00 50551 PR RENAL ENDOSCOPY 884.0 0 50553 PR RENAL ENDOSCOPY,CATH URETER 1065. 00 50555 PR RENAL 1060. ENDOSCOPY,BIOPSY 00 50557 PR RENAL ENDOSCOPY,TREATMENT 1069. 00 50561 PR RENAL ENDOSCOPY,REMV 3344. FB/STONE 00 50562 PR RENAL 1808. SCOPE,W/RESECTION,TUMOR 00 50574 PR RENAL SCOPE,BIOPSY 901.0 0 50575 PR RENAL SCOPE,ENDOPYELOTOMY 3509. 00 50580 PR RENAL SCOPE,REMV FB/STONE 2196 50590 PR FRAGMENT KIDNEY STONE/ ESWL 3250. 00 50592 PR ABLTJ 1/> RENAL TUMOR PRQ UNI 1200. RADIOFREQUENCY 00 50593 PR ABLATION RENAL TUMOR 1600. UNILATERAL PERQ CRYOTHERAPY 00 50605 PR URETEROTOMY TO INSERT STENT 3299. 00 50650 PR REMOVAL URETER,BLADDER CUFF 3726. 00 50660 PR REMOVAL URETER,TOTAL,ECTOPIC 4701. 00 50684 PR INJECT INDWELL CATH,URETER X- 468.0 RAY 0 50686 PR MEASURE URETER PRESS,INDWELL 391.0 CATH 0 50688 PR CHANGE OF URETEROSTOMY TUBE 238.0 VIA ILEAL CONDUIT 0 50690 PR INJECT RETROGRADE/CONDUIT X- 404.0 RAY 0 50693 PR PLMT URTRL STENT PRQ PRE- 2686. EXISTING NFROS TRACT 00 50694 PR PLMT URTRL STNT PRQ NEW ACESS 2958. W/O SEP NFROS CATH 00 50695 PR PLMT URTRL STENT PRQ NEW 3580. ACCESS W/SEP NFROS CATH 00 50706 PR BALLOON DILAT URETERAL 1942. STRICTURE W/IMG GID RS&I 00 50715 PR RELEASE URETER,RETROPER 3508. FIBROSIS 00 50727 PR REVISE URINARY-CUTAN ANAST 2500. 00 50728 PR REVISE URINARY-CUTAN 1683. ANAST+REPAIR 00 50740 PR ANASTOMOSE URETER/RENAL 3527. PELVIS 00 50760 PR ANASTOMSIS OF URETER 3623. 00 50780 PR REIMPLANT URETER,SINGLE 3500. URETER 00 50782 PR REIMPLANT URETER,DUPLICATED 4238. URETER 00 50783 PR REIMPLANT URETER,EXTENSIVE 4636. TAILORING 00 50785 PR REIMPLANT URETER,VESICOPSOAS 4907. HITCH 00 50815 PR URETEROCOLON 5014. CONDUIT,W/BOWEL ANASTOMOSIS 00 50820 PR URETEROILEAL CONDUIT,W/BOWEL 5351. ANASTOMOSIS 00 50825 PR CONTINENT DIVERSION,W/BOWEL 7150. ANASTOMOSIS 00 50830 PR URINARY UN-DIVERSION 7436. 00 50845 PR APPENDICO- 4830. VESICOSTOMY 00 50860 PR TRANSPLANT URETER TO SKIN 3478. 00 50930 PR CLOSURE URETER/BOWEL FISTULA 4443. 00 50947 PR LAP,REIMPLANT URETER 5555. W/CYSTO,STENT 00 50948 PR LAP,REIMPLANT URETER W/O 5241. CYSTO,STENT 00 50957 PR URETER ENDOSCOPY,FULGUR/INCIS 1104. 00 50970 PR URETER ENDOSCOPY 985 51020 PR INCISE/FULGUR LESN BLADDER 1238 51040 PR INCISE/DRAIN BLADDER 1507. 00 51050 PR OPEN BLADDER,REMV CALCULUS 2003. 00 51065 PR CYSTOTOMY,EXTRACT &/OR FRAG 1486. URETER CALC 00 51080 PR DRAIN PERI-BLADDER ABSCESS 1050. 00 51101 PR ASPIRATION BLADDER 311.0 TROCAR/INTRACATHETER 0 51102 PR ASPIRATION BLADDER INSERT 706.0 SUPRAPUBIC CATHETER 0 51500 PR REMOVAL URACHAL CYST 2048. 00 51525 PR CYSTOTOMY,EXCIS BLADDER TIC 3074. 00 51530 PR CYSTOTOMY,EXCIS BLADDER 2806. TUMOR 00 51550 PR PART REMV BLADDER,SIMPLE 2820. 00 51555 PR PART REMV 5181. BLADDER,COMPLICATED 00 51565 PR PART REMV BLADDER,REIMPLNT 5317. URETER 00 51575 PR REMV BLADDER/NODES 7218. 00 51590 PR CYSTECTOMY,ILEAL 7700. CONDUIT/SIGMOID BLADDER 00 51595 PR REMV BLADDER/NODES,ILEAL 8907. CONDUIT 00 51596 PR CYSTECTOMY,W/CONTINENT 9456. DIVERSION 00 51597 PR PELVIC EXENTERATION 9196. 00 51600 PR INJECTION FOR BLADDER X-RAY 493.0 0 51610 PR INJECT FOR RETROGRADE 408.0 URETHOCYSTO 0 51700 PR IRRIGATION OF BLADDER 216.0 0 51701 PR INSERT,NON-INDWELLING BLADDER 155.0 CATHETER 0 51702 PR INSERT,TEMP INDWELLING BLAD 204.0 CATH,SIMPLE 0 51703 PR INSERT,TEMP INDWELLING BLAD 353.0 CATH,COMP 0 51705 PR CHANGE OF BLADDER TUBE,SIMPLE 284.0 0 51710 PR CHANGE OF BLADDER 404.0 TUBE,COMPLICATED 0 51715 PR ENDOSCOPIC INJECTION/IMPLANT 1029. 00 51720 PR INSTILL ANTICANCER AGENT IN 285.0 BLADDER 0 51725 PR SIMPLE 26 197.0 CYSTOMETROGRAM 0 51726 PR COMPLEX 26 250.0 CYSTOMETROGRAM 0 51728 PR COMPLEX 26 690.0 CYSTOMETROGRAM VOIDING 0 PRESSURE STUDIES 51729 PR COMPLEX 26 305.0 CYSTOMETROGRAM W/VOID 0 PRESS&URETHRAL PROFILE 51741 PR ELECTRO- 26 165.0 UROFLOWMETRY, FIRST 0 51784 PR ANAL/URINARY MUSCLE 26 200.0 STUDY 0 51785 PR ANAL/URINARY MUSCLE 26 225.0 STUDY,NEEDLE 0 51797 PR VOIDING PRESS STUDY 26 233.0 INTRA-ABDOMINAL VOID 0 51798 PR MEAS,POST-VOID RES,US,NON- 42.00 IMAGING 51798 PR MEAS,POST-VOID 26 48.00 RES,US,NON-IMAGING 51800 PR REVISION OF BLADDER/URETHRA 3740. 00 51820 PR REVISE 3895 BLAADER/URETHRA+URETER 51860 PR REPAIR BLADDER 2661. WOUND/INJ,SIMPLE 00 51865 PR REPAIR BLADDER 2958. WOUND/INJ,COMPLIC 00 51880 PR CLOSE CYSTOSTOMY 1348. 00 51900 PR CLOSE BLADDER/ 2997. FISTULA,ABDOM 00 51960 PR ENTEROCYSTOPLASTY,W/BOWEL 6378. ANASTOMOSIS 00 51980 PR CONSTRUCT BLADDER OPENING- 3403. CUTANEOUS 00 52000 PR CYSTOURETHROSCOPY 550.0 0 52001 PR CYSTOURETHROSCOPY W/IRRIG & 933.0 EVAC CLOTS 0 52005 PR CYSTOURETHROSCOPY,URETER 738.0 CATHETER 0 52007 PR CYSTOURETHROSCOPY,URETERAL 1117. BIOPSY 00 52204 PR CYSTOURETHROSCOPY,BIOPSIES 1251. 00 52214 PR 3067. CYSTOURETHROSCOPY,FULGURATN 00 52224 PR CYSTOURETHROSCOPY,FULGUR 2903. <.5CM LESN 00 52234 PR CYSTOURETHROSCOPY,FULGUR .5- 998.0 2CM LESN 0 52235 PR CYSTOURETHROSCOPY,FULGUR 2- 845.0 5CM LESN 0 52240 PR 2263. CYSTOURETHROSCOPY,FULGUR >5CM 00 LESN 52260 PR CYSTOSCOPY,DIL BLADDER,GEN 630.0 ANESTH 0 52265 PR CYSTOSCOPY,DIL BLADDER,LOCAL 1207. ANESTH 00 52270 PR CYSTOSCOPY,INTERN 897.0 URETHROTOMY,FEMALE 0 52275 PR CYSTOSCOPY,INTERN 1528. URETHROTOMY,MALE 00 52276 PR CYSTOSCOPY,DIR VIS INT 1140. URETHROTOMY 00 52281 PR CYSTOSCOPY,DIL URETHRAL 802.0 STRICTURE 0 52287 PR CYSTOURETHROSCOPY INJ 755.0 CHEMODENERVATION BLADDER 0 52290 PR CYSTOSCOPY,URETERAL 625.0 MEATOTOMY 0 52300 PR CYSTOSCOPY,RESECT ORTHO 1340. URETEROCELE 00 52301 PR CYSTOSCOPY,RESECT ECTOPIC 725.0 URETEROCEL 0 52310 PR CYSTOSCOPY,REMV 706.0 CALCULUS,SIMPLE 0 52315 PR CYSTOSCOPY,REMV 1114. CALCULUS,COMPLIC 00 52317 PR REMOVE BLADDER STONE,<2.5CM 2655. 00 52318 PR REMOVE BLADDER STONE,>2.5CM 2186. 00 52320 PR CYSTOSCOPY,REMV URETERAL 636.0 STONE 0 52327 PR CYSTOSCOPY,INJECT IMPLNT 672.0 MATERIAL 0 52330 PR 1246. CYSTOSCOPY,MANIPULATN 00 52332 PR CYSTOSCOPY,INSERT URETERAL 1231. STENT 00 52334 PR CYSTOSCOPY,GUIDE,PERCUT 641.0 NEPHROS 0 52341 PR CYSTOSCOPY,TX URETERAL 752 STRICTURE 52342 PR CYSTOSCOPY,TX URETEROPELVC 798.0 STRICTURE 0 52343 PR CYSTOSCOPY,TX INTRARENAL 911 STRICTURE 52344 PR CYSTO/URETEROSCOPY,TX URETER 963.0 STRICT 0 52345 PR CYSTO/URETEROSCOPY,TX 1015. URET/PELV STRICT 00 52346 PR CYSTO/URETEROSCOPY,TX 1159. INTRARENAL STRICT 00 52351 PR CYSTO/URETERO/PYELOSCOPY, DX 794.0 0 52352 PR CYSTO/URETERO/PYELOSCOPY, 933.0 CALCULUS TX 0 52353 PR CYSTO/URETERO/PYELOSCOPY 3545. W/LITHOTRIPSY 00 52354 PR CYSTO/URETERO/PYELOSC,BX &/OR 2130. FULG LESN 00 52355 PR 2500. CYSTO/URETERO/PYELOSCOPY,W/RES 00 ECT TUMOR 52356 PR CYSTO/URETERO W/LITHOTRIPSY 1040. &INDWELL STENT INSRT 00 52400 PR CYSTOSCOPY,RESEC CONGEN 1199. MUCOSAL FOLDS 00 52402 PR CYSTOSCOPY,RESEC 677.0 EJACULATORY DUCT 0 52441 PR CYSTO INSERTION 590.0 TRANSPROSTATIC IMPLANT SINGLE 0 52442 PR CYSTO INSERTION 197.0 TRANSPROSTATIC IMPLANT EA ADDL 0 52450 PR TRANSURETHRAL INCISION OF 2420. PROSTATE 00 52500 PR TRANSURETHRAL RESEC BLADDER 1863. NECK 00 52601 PR TRANSURETHRAL ELEC-SURG 3113. PROSTATECTOM 00 52630 PR REMV RESID OBSTRUC 2916. PROSTATE,>1 YR 00 52640 PR RELIEVE POSTOP BLADDER 1646. CONTRACTURE 00 52648 PR LASER VAPORIZATION SURGERY 8787. PROSTATE, COMPLETE 00 52649 PR LASER ENUCLEATION PROSTATE W 2903. MORCELLATION 00 52700 PR DRAINAGE OF PROSTATE ABSCESS 1136. 00 53000 PR INCISION OF URETHRA 381.0 0 53010 PR INCISION OF URETHRA,PERINEAL 1730. 00 53020 PR INCISION OF URETHRAL MEATUS 361.0 0 53025 PR INCISION OF URETHRAL 387.0 MEATUS,INFANT 0 53040 PR DRAINAGE DEEP URETHRAL 1191. ABSCESS 00 53200 PR BIOPSY OF URETHRA 403.0 0 53215 PR REMOVAL OF URETHRA,MALE 2782. 00 53230 PR EXCIS URETHRAL TIC,FEMALE 2167. 00 53240 PR MARSUP URETHRAL TIC 1085. 00 53260 PR EXCIS URETHRAL 511.0 POLYP(S) 0 53275 PR EXCIS URETHRAL PROLAPSE 673.0 0 53400 PR REVISE URETHRA, 1ST STAGE 2329. 00 53405 PR REVISE URETHRA, 2ND STAGE 3713. 00 53410 PR RECONSTRUC ANT MALE URETHRA 2865. 00 53415 PR RECONSTRUC PROSTATIC URETHRA 4037. 00 53420 PR RECONSTRUC PROS URETHRA,1ST 3781. STAGE 00 53425 PR RECONSTRUC PROS URETHRA,2ND 3352. STAGE 00 53430 PR RECONSTRUC FEMALE URETHRA 2823. 00 53431 PR 4745. URETHROPLASTY,W/TUBULARIZATION 00 53440 PR SLING 2708. OPERATION,CORRECTION,MALE 00 INCONT 53445 PR INSERT,INFLATABLE SPHINCTER 5477. 00 53446 PR REMOVAL,INFLATABLE SPHINCTER 2027. 00 53447 PR REMOVAL & REPLACE,INFLATABLE 2611. SPHINCTER 00 53450 PR URETHRAL MEATAL REVISION 984.0 0 53460 PR URETHROPLASTY,EXCIS DIST 1153. URETHRA 00 53502 PR REPAIR URETHRA INJURY,FEMALE 1250. 00 53505 PR REPAIR URETHRA INJURY,PENILE 1241. 00 53520 PR CLOSE 1643. URETHROSTOMY/FISTULA,MALE 00 53600 PR DIL URETHRA STRIC,MALE,INITIAL 210.0 0 53601 PR DIL URETHRA STRIC,MALE,SUBSEQ 208.0 0 53660 PR DIL URETHRA,FEMALE,INITIAL 181.0 0 53661 PR DIL URETHRA,FEMALE,SUBSEQUENT 180.0 0 53665 PR DIL URETHRA,GEN/SPINAL ANESTH 100.0 0 53854 PR TRURL DSTRJ PRST8 TISS RF WV 4690. THERMOTHERAPY 00 54001 PR SLITTING OF PREPUCE 475.0 0 54050 PR DESTR PENIS 335.0 LESN,SIMPL,CHEMICAL 0 54056 PR DESTR PENIS 327.0 LESN,SIMPL,CRYOSURG 0 54057 PR DESTR PENIS LESN,SIMPL,LASER 532.0 SURG 0 54060 PR DESTR PENIS LESN,SIMPL,SURG 450.0 EXCIS 0 54065 PR DESTR PENIS LESN,EXTENSIVE 502.0 0 54100 PR BX,PENIS (SEPARATE PROCEDURE) 442.0 0 54110 PR EXCIS PENILE PLAQUE 2555. 00 54111 PR EXCIS PENILE PLAQUE,GRAFT <5CM 3328. 00 54115 PR REMV FOR.BODY DEEP PENILE TISS 1129. 00 54120 PR REMOVAL PENIS,PARTIAL 2012. 00 54125 PR REMOVAL PENIS,TOTAL 2913. 00 54150 PR CIRCUMCISION,CLAMP,NEWBORN W/ 400.0 ANESTH 0 54160 PR CIRCUMCISION,OTHER,<28 D/O 577.0 0 54161 PR CIRCUMCISION,OTHER,28+ D/O 677.0 0 54162 PR LYSIS/EXCIS,PENILE POSTCIRCUM 670.0 ADHESIONS 0 54163 PR REPAIR,INCOMPLETE 629.0 CIRCUMCISION 0 54164 PR FRENULOTOMY,PENIS 498.0 0 54200 PR INJECT PROC PENILE PLAQUE 267.0 0 54220 PR IRRIGAT CORPUS CAVERN,PRIAPISM 1065. 00 54230 PR INJECT CORPORA CAVERN XRAY 507.0 0 54235 PR INJECT CORPORA CAVERN,PHARM 210.0 AGNT 0 54300 PR STRAIGHTEN PENIS 2237. 00 54304 PR HYPOSPADIUS REPAIR,1ST STAGE 2695. 00 54308 PR HYPOSPADIUS REPAIR,2ND 3993. STAGE,<3CM 00 54312 PR HYPOSPADIUS REPAIR,2ND 4662. STAGE,>3CM 00 54322 PR HYPOSPAD REPAIR,1 STAGE,DISTAL 2436. 00 54324 PR HYPOSPAD REPAIR,1 3142. STAGE,DIST,PLASTY 00 54326 PR HYPOSPAD REPAIR,1 4411. STAGE,DIST,PLASTY 00 54328 PR HYPOSPAD REPR,1 3872. STAGE,DIST,EXTENSV 00 54332 PR HYPOSPAD REPR,1 3872. STAGE,PROX,EXTENSV 00 54336 PR HYPOSPAD REPR,1 4900 STAGE,PERINEAL,EXTEN 54340 PR REPAIR HYPOSPAD 1635. COMPLIC,SIMPLE 00 54344 PR REPAIR HYPOSPAD 3279. COMPLIC,MOBILIZ 00 54360 PR PENIS PLASTIC SURG,CORRECT 2536. ANGULATN 00 54380 PR REPAIR 2895. PENIS,EPISPADIUS 00 54400 PR INSERT SEMI-RIGID PENILE 1397 PROSTHESIS 54405 PR INSERT,INFLATABLE PENILE 3708. PROSTHESIS 00 54406 PR REMVL,INFLAT PENILE PROSTH W/O 2614. REPLACMT 00 54408 PR REPAIR,INFLATABLE PENILE 2828. PROSTHESIS 00 54410 PR REPLACE,INFLATABLE PENILE 2602. PROSTHESIS 00 54415 PR REMOVAL,PENILE PROSTHESIS W/O 1551. REPLACMT 00 54416 PR REPLACE,PENILE PROSTHESIS 2555. 00 54430 PR CORPORA CAVER-SPONGIOSA 2616. SHUNT 00 54435 PR CORPORA-GLANS FISTULIZATN 1072. 00 54437 PR REPAIR OF TRAUMATIC CORPOREAL 2431 TEAR(S) 54440 PR REPAIR PENIS POST 2411. INJURY 00 54450 PR PREPUTIAL STRETCHING 250.0 0 54505 PR BIOPSY OF TESTIS,INCISIONAL 734.0 0 54512 PR EXCIS TESTIS EXTRAPARENCHYMAL 1271. LESION 00 54520 PR REMOVAL TESTIS,SIMPLE 1186. 00 54530 PR REMOVAL 1796. TESTIS,RADICAL 00 54550 PR EXPLORE UNDESC 1628. TESTIS,INGUIN/SCROTAL 00 54560 PR EXPLORE UNDESC 2470. TESTIS,ABDOMINAL 00 54600 PR REDUCE TESTIS TORSION 1559. 00 54620 PR FIXATN OF TESTIS OPP TORSN 1134. 00 54640 PR ORCHIOPEXY,INGUNIAL APPROACH 1519. 00 54660 PR INSERT TESTICULAR PROSTHESIS 919.0 0 54670 PR REPAIR TESTIS INJURY 1047. 00 54680 PR RELOCATION OF 2778. TESTIS(ES) 00 54692 PR LAP,ORCHIOPEXY 2779. 00 54700 PR INCIS/DRAIN 576.0 SCROTUM/TESTIS,EPIDIDYM 0 54830 PR EXCIS EPIDIDYMIS LOCAL LESION 1157. 00 54840 PR EXCIS SPERMATOCELE 2133. 00 54900 PR ANAST EPIDIDYMIS-VAS 2892 DEFERENS,UNILAT 55000 PR DRAINAGE OF HYDROCELE,TUNICA 303.0 0 55040 PR REMOVAL OF 1163. HYDROCELE,TUNICA,UNILAT 00 55041 PR REMOVAL OF 2048. HYDROCELE,TUNICA,BILAT 00 55060 PR REPAIR OF HYDROCELE,TUNICA 1375. 00 55100 PR DRAINAGE SCROTAL WALL 541.0 ABSCESS 0 55110 PR EXPLORE SCROTUM 1235. 00 55120 PR REMOVAL OF SCROTAL FOR.BODY 941 55150 PR REMOVAL OF SCROTUM 1361. 00 55175 PR REVISION OF SCROTUM,SIMPLE 1467. 00 55180 PR REVISION OF 2000. SCROTUM,COMPLICATED 00 55250 PR REMOVAL OF SPERM DUCT(S) 1237. 00 55400 PR REPAIR OF SPERM DUCT 5200. 00 55450 PR LIGATION OF SPERM DUCT 178.0 0 55500 PR REMV HYDROCELE,SPERM 1223. CORD,UNILAT 00 55520 PR REMOVAL OF SPERM CORD LESION 1149. 00 55530 PR EXCISE VARICOCELE 1573. 00 55550 PR LAP,LIGATION SPERMATIC VEINS 1066. 00 55680 PR EXCISE MULLERIAN DUCT CYST 927.0 0 55700 PR BIOPSY OF 625.0 PROSTATE,NEEDLE/PUNCH 0 55705 PR BIOPSY OF PROSTATE,INCISIONAL 944.0 0 55706 PR BIOPSY OF 944.0 PROSTATE,NEEDLE,TRANSPERINEAL 0 55810 PR REMV 5421. PROSTATE,PERINEAL,RADICAL 00 55821 PR REMV 3127. PROSTATE,SUPRAPUBIC,SUBTOTAL 00 55840 PR REMV 5432. PROSTATE,RETROPUB,RADICAL 00 55842 PR REMV 4818. PROSTATE,RETROPUB,RAD,LTD NODES 00 55845 PR REMV 6883. PROSTATE,RETROPUB,RAD,TOT NODES 00 55866 PR 6807. LAP,PROSTATECTOMY,RADICAL,W/NER 00 VE SPARE,INCL ROBOTIC 55873 PR CRYOSURG ABLATION OF 2730. PROSTATE 00 55874 PR TRANSPERINEAL PLMT 9491. BIODEGRADABLE MATRL 1/MLT NJX 00 55875 PR PERCUT/NEEDLE 2690. INSERT,PROSTATE,RADIOISOT 00 55875 PR PERCUT/NEEDLE 26 2690. INSERT,PROSTATE,RADIOISO 00 T 55876 PR PLACE RADIOTHER 552.0 DEVICE/MARKER, PROSTATE 0 55920 PR PLACEMENT NEEDLE PELVIC ORGAN 1065. RADIOELEMENT APPL 00 56405 PR I&D OF VULVA/PERINEUM ABSCESS 275.0 0 56420 PR I&D BARTHOLIN GLAND ABSCESS 305.0 0 56440 PR MARSUP BARTHOLIN GLAND CYST 450.0 0 56441 PR LYSIS OF LABIAL 366.0 LESION(S) 0 56442 PR HYMENOTOMY, SIMPLE INCISION 121.0 0 56501 PR 350.0 DESTRUCTION,LESION(S),VULVA,SIMPL 0 E 56515 PR 525.0 DESTRUCTION,LESION(S),VULVA;EXTEN 0 SIVE 56605 PR BIOPSY VULVA/PERINEUM,ONE LESN 225.0 0 56606 PR BX,VULVA/PERINEUM,ADDL LESION 130.0 0 56620 PR PART SIMPLE REMV 1200. VULVA 00 56625 PR COMPLETE SIMPLE REMV VULVA 1600. 00 56630 PR VULVA RESECT,RADICAL,PARTIAL 2625. 00 56631 PR VULVA RESECT,RAD,PART,UNI 3400. NODES 00 56632 PR VULVA RESECT,RAD,PART,BILAT 4625. NODES 00 56633 PR VULVA 3425. RESECT,RAD,TOTAL 00 56634 PR VULVA RESECT,RAD,TOTAL,UNI 5300. NODES 00 56700 PR PARTIAL REMOVAL OF 550.0 0 56740 PR EXCIS BARTHOLIN GLAND/CYST 800.0 0 56800 PR REPAIR OF VAGINA 615.0 0 56805 PR REPAIR CLITORIS 4000. 00 56810 PR REPAIR OF PERINEUM,NON 900.0 OBSTETRICAL 0 56820 PR ,VULVA 265.0 0 56821 PR COLPOSCOPY,VULVA,W/BIOPSY(S) 345.0 0 57020 PR DRAINAGE OF PELVIC 250.0 FLUID 0 57022 PR I&D VAGINAL 400.0 HEMATOMA,OBSTET/POSTPART 0 57061 PR DESTRUCT,VAGINAL 275.0 LESION(S),SIMPLE 0 57065 PR DESTRUCT,VAGINAL 500.0 LESION(S),EXTENSIVE 0 57100 PR BIOPSY OF 200.0 VAGINA,SIMPLE 0 57105 PR BIOPSY OF VAGINA,EXTENSIVE 350.0 0 57106 PR REMOVE VAGINA WALL, PARTIAL 1250. 00 57110 PR COMPLETE REMOVAL OF VAGINA 3300. WALL 00 57120 PR CLOSURE OF VAGINA 1900. 00 57130 PR EXCIS VAGINAL SEPTUM 450.0 0 57135 PR EXCIS VAGINAL CYST/TUMOR 478.0 0 57155 PR INSERTION UTERINE 1638. TANDEM&/VAGINAL OVOIDS 00 57156 PR INSERT VAGINAL RADIATION DEVICE 586.0 0 57160 PR FIT/INSERT INTRAVAG SUPPORT 190.0 DEVICE 0 57170 PR FITTING OF 221.0 DIAPHRAGM/CAP 0 57180 PR TREAT VAGINAL BLEEDING 375.0 0 57200 PR REPAIR OF VAGINA 754.0 0 57210 PR REPAIR 957 VAGINA/PERINEUM 57220 PR REVISION OF URETHRA SPHINCTER 1200. 00 57240 PR ANTERIOR COLPORRAPHY RPR 1675. CYSTOCELE W/CYSTO 00 57250 PR POST 1600. COLPORRHAPHY,RECTUM/VAGINA 00 57260 PR CMBND ANTERPOST COLPORRAPHY 2100. W/CYSTO 00 57265 PR CMBND ANTERPOST COLPORRAPHY 3006. W/CYSTO W/NTRCL RPR 00 57267 PR INSERT MESH/PELVIC FLR ADDON 670 57280 PR SUSPENSION OF VAGINA,ABD 2900. APPRCH 00 57282 PR REPR VAGINAL 2900. PROLAPSE,SACROSP LIG 00 57283 PR REPR VAGINAL 2775. PROLAPSE,UTEROSACRAL 00 57285 PR PARAVAGINAL DEFECT REPAIR 2366. VAGINAL APPROACH 00 57287 PR REMV/REVS SLING FOR STRES 1800. INCONTINENCE 00 57288 PR SLING OPER STRES INCONTINENCE 2825. 00 57291 PR CONSTRUCTION ARTIFIC VAGINA 3639. 00 57292 PR CONSTRUCT ARTIFIC VAGINA W 2850. GRAFT 00 57295 PR REVISION VAGINAL GRAFT, VAG 2900. APPROACH 00 57300 PR REPAIR RECTO-VAG FISTULA 1421. 00 57307 PR REPR REC-VAG 3715. FIST,ABD+COLOSTOMY 00 57310 PR CLOSE URETHROVAGINAL FISTULA 1184. 00 57311 PR CLOSE URETHROVAGINAL 1346 FIST+XPLANT 57320 PR CLOSE BLAD-VAG FISTULA,VAG 2471. APPRCH 00 57400 PR DILATION OF VAGINA W ANESTH 350.0 0 57410 PR W ANESTH 375.0 0 57415 PR REMOVAL VAGINAL FOR.BODY W 375.0 ANESTH 0 57420 PR COLPOSCOPY,ENTIRE VAGINA 300.0 0 57421 PR COLPOSCOPY,ENTIRE 400.0 VAGINA,W/BIOPSY(S) 0 57425 PR LAPAROSCOPY, SURG, COLPOPEXY 3050. 00 57452 PR COLPOSCOPY,CERVIX W/ADJ 270.0 VAGINA 0 57454 PR COLPOSC,CERVIX W/ADJ VAG,W/BX 370.0 & CURRETAG 0 57455 PR COLPOSCOPY,CERVIX W/ADJ 330.0 VAGINA,W/BX 0 57456 PR COLPOSCOPY,CERVIX W/ADJ 315.0 VAGINA, CURETTAG 0 57460 PR COLPOSCOPY,CERVIX W/ADJ 710.0 VAG,W/LOOP BX 0 57461 PR COLPOSCOPY,CERVIX W/ADJ 900.0 VAG,W/LOOP CONIZ 0 57500 PR BIOPSY CERVIX, 1 OR MORE, OR 320.0 EXCISION OF LESION 0 57505 PR ENDOCERVICAL CURETTAGE 240.0 0 57510 PR 330.0 CAUTERIZATION,CERVIX,ELECTRO/THE 0 RMAL 57511 PR CRYOCAUTERY OF 350.0 CERVIX 0 57513 PR LASER SURGERY OF 370.0 CERVIX 0 57520 PR CONIZATION CERVIX,KNIFE/LASER 825.0 0 57522 PR CONIZATION CERVIX,LOOP ELECTRD 655.0 0 57540 PR REMV CERV STUMP,ABD APPRCH 2717. 00 57555 PR REMV CERV STUMP,VAG,ANT/POST 1520. FIX 00 57558 PR D&C OF CERVIX STUMP 320.0 0 57700 PR REVISION OF CERVIX,NON 650.0 OBSTETRICAL 0 57720 PR PLASTIC REPR CERVIX,VAG APPRCH 770.0 0 57800 PR DILATION OF CERVICAL CANAL 150.0 0 58100 PR BIOPSY OF 275.0 LINING 0 58110 PR ENDOMET BIOPSY DONE 122.0 W/COLPOSCOPY 0 58120 PR DILATION/CURETTAGE,DIAGNOSTIC 625.0 0 58140 PR MYOMECTOMY 1-4,W/TOT 2975. 250GMS/<,ABD APPRCH 00 58145 PR EXCIS UTERINE FIBROID,VAG 1400. APPRCH 00 58146 PR MYOMECTOMY 5/>,TOT>250 2900. GMS,ABD APPRCH 00 58150 PR TOTAL ABDOM HYSTERECTOMY 3100. 00 58180 PR SUPRACERV ABD HYSTERECTOMY 3100. 00 58200 PR TOTAL ABD HYSTEREC+LTD NODES 4925. 00 58210 PR RADICAL ABD HYSTEREC+PELV 7500. NODES 00 58240 PR PELVIC EXENTERATN,GYN 8700. MALIGNANCY 00 58260 PR VAGINAL HYSTERECTOMY,UTERUS 2675. 250 GMS/< 00 58262 PR VAG HYST,RMV TUBE/OVARY 3025. 00 58263 PR VAG HYST,RMV TUBE/,FIX 3275. ENTEROCE 00 58267 PR VAG HYST,REV VAG/URETHRA 3475. 00 58275 PR VAG HYST, 3400 W/ 58290 PR VAG HYST,UTERUS >250 GMS 3850. 00 58291 PR VAG HYST,UTERUS >250 GMS,REM 5000 TUBE/OVARY 58300 PR INSERT INTRAUTERINE DEVICE 210.0 0 58301 PR REMOVE INTRAUTERINE DEVICE 243.0 0 58322 PR ARTIF INSEMINATION,INTRA- 211.0 UTERINE 0 58340 PR CATH/INJECT 620.0 HYSTEROSALPINGOGRAM 0 58345 PR REOPEN FALLOPIAN 700.0 TUBE,TRANSCERV CATH 0 58350 PR REOPEN FALLOPIAN 240.0 TUBE,CHROMOTUBATION 0 58353 PR , THERMAL 2520. 00 58542 PR LAP, SUPRACERVIAL 2920. HYSTERECTOMY W/ TUBE&OV, <250G 00 58545 PR LAP,MYOMECTOMY 1-4,TOT WT 250 2975. GMS 00 58546 PR LAP,MYOMECTOMY 5/>,TOTAL 2950. WT >250 GMS 00 58548 PR LAP, RADICAL HYST W/ TUBE&OV, 6410. NODE BX 00 58550 PR LAP,VAG HYST,UTERUS 250GMS/< 3100. 00 58552 PR LAP,VAG HYST,UTERUS 3250. 250GMS/<,SALP-OOPH 00 58554 PR LAP,VAG 5025. HYST,UTERUS >250GMS,SALP-OOPH 00 58555 PR HYSTEROSCOPY,DX,SEP PROC 1000. 00 58558 PR HYSTEROSCOPY,W/ENDO BX 1300. 00 58559 PR HYSTEROSCOPY,LYSIS ADHESIONS 850.0 0 58560 PR HYSTEROSCOPY,RESECT SEPTUM 1000. 00 58561 PR HYSTEROSCOPY,RMV MYOMA 2300. 00 58562 PR HYSTEROSCOPY,RMV FB 1000. 00 58563 PR HYSTEROSCOPY,W/ENDOMETRIAL 5643. ABLATION 00 58565 PR HYSTEROSCOPY, STERILIZE W 5150. IMPLANTS 00 58570 PR LAPAROSCOPY W TOT HYSTERECT 2825. UTERUS 250 GRAM OR LESS 00 58571 PR LAPAROSCOPY W TOT 3100. HYSTERECTUTERUS <=250 GRAM W 00 TUBE/OVARY 58572 PR LAPAROSCOPY TOTAL 3600. HYSTERECTOMY UTERUS > 250 GRAM 00 58573 PR LAPAROSCOPY TOT 3400. HYSTERECTOMY UTERUS >250 GRAM W 00 TUBE/OVARY 58575 PR LAPS TOT HYSTERECTOMY RESJ 2789. MALIGNANCY W/OMNTC 00 58605 PR LIGATE FALLOPIAN 1225. TUBE,POSTPARTUM 00 58611 PR LIGATION, W/C- 600.0 SECTION 0 58660 PR LAP,LYSIS OF ADHESIONS 2000. 00 58661 PR LAP,RMV ADNEXAL STRUCTURE 1900. 00 58662 PR LAP,FULGURATE/EXCISE LESIONS 2200. 00 58670 PR LAP,TUBAL CAUTERY 909.0 0 58671 PR LAP,TUBAL BLOCK BY DEVICE 1225. 00 58674 PR LAPS ABLTJ UTERINE FIBROIDS 2918. W/INTRAOP US GDN 00 58700 PR REMOVAL OF FALLOPIAN TUBE 1700. 00 58720 PR REMOVAL OF OVARY/TUBE(S) 1900. 00 58740 PR LYSIS ADNEXAL 3110. ADHESIONS 00 58800 PR DRAIN OVARIAN CYST(S),VAG 774.0 APPRCH 0 58805 PR DRAIN OVARIAN CYST(S),ABD 888.0 APPRCH 0 58825 PR TRANSPOSITION, 2423. OVARY(S) 00 58900 PR BIOPSY OF OVARY(S) 908.0 0 58925 PR REMOVAL OF OVARIAN CYST(S) 2325. 00 58940 PR REMOVAL OF OVARY(S) 1098. 00 58943 PR OOPHORECTORMY FOR MALIG, 4100. W/BX 00 58950 PR RESEC OVAR MALIG+BILAT 3450. OVAR+OMENTUM 00 58951 PR RESEC OVAR MALIG+TAH+PELV 5125. NODES 00 58952 PR OOPH W/RADIC DISSECT FOR 5725. DEBULKING 00 58953 PR BIL SALP-OOPH 7250. W/OMENTECT,TAH,RAD DISSECT 00 58954 PR BIL SAL-OOPH 7900. W/OMENTECT,TAH,RAD DIS,LYMP 00 58956 PR BSO, OMENTECTOMY 4975. W/TAH 00 58957 PR RESECT RECURRENT GYN MALIG 6450. 00 59000 PR AMNIOCENTESIS,DIAGNOSTIC 295.0 0 59001 PR AMNIOCENTESIS,THER AMNIOTIC 460.0 FLUID REDUCT 0 59012 PR FETAL CORD PUNCTURE,PRENATAL 850.0 0 59015 PR CHORION VILLUS BIOPSY 400.0 0 59025 PR FETAL NON-STRESS TEST 119.0 0 59025 PR FETAL NON-STRESS TEST 26 100.0 0 59051 PR FETAL MONITOR/INTERPRET ONLY 110.0 0 59120 PR TREAT ECTOPIC PREG,RMV 1800. TUBE/OVARY 00 59150 PR RX ECTOP PREG BY LAPAROSCOPE 2000. 00 59151 PR RX ECTOP PREG BY SCOPE,RMV 2100. TUBE/OVRY 00 59160 PR D&C AFTER DELIVERY 625.0 0 59200 PR INSERT CERVICAL 210.0 DILATOR 0 59300 PR EPISIOTOMY/VAG RPR OTH/THN 485.0 ATTENDING 0 59320 PR REVISION CERVIX W PREG,VAG 850.0 APPRCH 0 59325 PR REVISION CERVIX W PREG,ABD 900.0 APPRCH 0 59400 PR FULL ROUT OBSTE CARE,VAGINAL 4900. DELIV 00 59409 PR OBSTETRICAL CARE,VAG DELIV 2400. ONLY 00 59410 PR OBSTE CARE,VAG 2800. DELIV+POSTPARTUM 00 59412 PR ANTEPARTUM HEAD MANIPULATION 600.0 0 59414 PR DELIVER PLACENTA 600.0 0 59425 PR ANTEPARTUM CARE ONLY, 4-6 1150. VISITS 00 59426 PR ANTEPARTUM CARE ONLY, >7 VISITS 2400. 00 59430 PR CARE AFTER DELIVERY ONLY 475.0 0 59510 PR FULL ROUT OBSTE CARE,CESAREAN 5400. DELIV 00 59514 PR CESAREAN DELIVERY 3250. ONLY 00 59515 PR CESAREAN 3100. DELIVERY+POSTPARTUM CARE 00 59525 PR REMOVE UTERUS AFTER CESAREAN 1150. 00 59610 PR ROUT OB CARE,VAG DELIV,PREV C- 4900. SEC 00 59612 PR VAG DELIV ONLY,PREV C-SECTN 3225. 00 59614 PR VAG DELIV+POSTPARTUM 2900. CARE,PREV C-SEC 00 59618 PR ROUT OB CARE,C-SEC,PREV C-SEC 5200. 00 59620 PR C-SEC ONLY,PREV C-SEC 3350. 00 59622 PR C-SEC+POSTPARTUM CARE,PREV C- 3200. SEC 00 59812 PR SURG RX INCOMPLETE ABORTN 800.0 0 59820 PR SURG RX MISSED ABORTN,1ST TRI 900.0 0 59821 PR SURG RX MISSED ABORTN,2ND TRI 970.0 0 59830 PR SURG RX SEPTIC ABORTN 1104. 00 59840 PR INDUCED ABORTN BY D&C 750.0 0 59841 PR INDUCED ABORTN BY DIL/EVAC 800.0 0 59855 PR INDUCED AB BY VAG SUPPOS 875.0 0 59870 PR EVACUATE MOLE OF UTERUS 2000. 00 59871 PR REMOVE CERCLAGE SUTURE 342.0 0 60100 PR BIOPSY OF THYROID,PERCUT 259.0 0 60200 PR REMOVE BENIGN THYROID LESION 2342. 00 60210 PR PARTIAL EXCISION THYROID,UNILAT 2222. 00 60220 PR THYROID LOBECTOMY,UNILAT 2414. 00 60225 PR THYR LOBECTOMY+PART REMOV 2755. CONTRA 00 60240 PR THYROIDECTOMY 3224. 00 60252 PR THYROIDECTOMY,MALIG,LTD NECK 4670. SURG 00 60254 PR THYROIDECTOMY W RAD NECK 5859. SURGERY 00 60260 PR THYROIDECTOMY POST PREV THYR 3881. SURG 00 60270 PR 3385. THYROIDECTOMY,SUBSTERNAL,TRANS 00 THOR APP 60271 PR 4700. THYROIDECTOMY=SUBSTERNAL,TRANS 00 CERV 60280 PR EXCIS THYROID DUCT CYST/SINUS 1529. 00 60300 PR ASPIRATION AND/OR INJECTION 187.0 THYROID CYST 0 60500 PR EXPLORE PARATHYROID GLANDS 3096. 00 60502 PR RE-EXPLORE PARATHYROIDS 4417. 00 60505 PR EXPLORE 5706 PARATHYROID+MEDIASTINUM 60512 PR AUTOTRANSPLANT, PARATHYROID 688.0 0 60520 PR THYMECTOMY,TRANSCERVICAL 3436. 00 60521 PR THYMECTOMY,TRANSTHORACIC 3963. 00 60522 PR THYMECTOMY,RADICAL MEDIAST 5347. DISSSEC 00 60540 PR EXCISE ADRENAL GLAND 3172. 00 60545 PR EXCISE ADRENAL+ADJ RETROPER 3758. TUMOR 00 60600 PR EXCISE CAROTID BODY LESION 5647. 00 60605 PR EXCISE CAROTID BODY+CAROTID 3374. ARTERY 00 60650 PR LAP,ADRENALECTOMY 3635. 00 61020 PR VENTRICULAR PUCTURE 325.0 0 61070 PR BRAIN SHUNT TUBE/RESERV 300.0 INJECTN 0 61107 PR TWIST HOLE SKULL,IMPLANT 2117. CATH/DEVICE 00 61140 PR BURR HOLE FOR BIOPSY 6503. 00 61150 PR BURR HOLE FOR DRAINAGE 7081. ABSC/CYST 00 61154 PR BURR HOLE EVAC SUBDUR/EXTRA 6351. HEMATOMA 00 61210 PR BURR HOLE IMPLANT CATH/DEVICE 2419. 00 61304 PR OPEN SKULL SUPRATENT EXPLORE 9084. 00 61312 PR OPEN SKULL EVAC SUB/EXTRADUR 10053.00 BLOOD 61313 PR OPEN SKULL EVAC INTRACEREBR 10176.00 BLOOD 61314 PR OPEN SKULL EVAC SUB/EXTRADUR 9622. BLOOD 00 61315 PR OPEN SKULL EVAC INTRACEREBR 11135.00 BLOOD 61320 PR OPEN SKULL DRAIN SUPRATENT 10095.00 ABSC 61322 PR OPEN 10963.00 SKULL,DECOMPRES,W/DURAPLASTY 61323 PR OPEN 11205.00 SKULL,DECOMP,W/LOBECTOMY 61330 PR DECOMPRESS 4366. ORBIT,TRANSCRANIAL 00 61340 PR SUBTEMPORAL CRANIAL 7509. DECOMPRESSION 00 61343 PR SUBOCCIPT DECOMP MEDULLA/SP 12283.00 CRD 61345 PR CRANIAL DECOMPRESSN POST 10718.00 FOSSA 61458 PR CRANIECT EXPL/DECOM CRANIAL 11122.00 NER 61460 PR CRANIECT SECTN 1+ CRAN NERVES 11389.00 61500 PR CRANIECT EXCIS SKULL BONE LESN 7491. 00 61510 PR EXCIS SUPRATENT BRAIN TUMOR 11543.00 61512 PR EXCIS SUPRATENT MENINGIOMA 13933.00 61516 PR EXCIS SUPRATENT BRAIN CYST 11448.00 61518 PR EXCIS INFRATENT BRAIN TUMOR 14904.00 61519 PR EXCIS INFRATENT MENINGIOMA 16293.00 61520 PR EXCIS INFRATENT CP ANGLE TUMOR 21041.00 61521 PR EXCIS INFRATENT MIDLINE TUMOR 17519.00 61524 PR EXCIS INFRATENT BRAIN CYST 11355.00 61526 PR EXCIS TRANSTEMP CP ANGLE 19784.00 TUMOR 61531 PR SUBDUR IMPLNT ELECTR,BURR 6039. HOLE 00 61533 SUBDUR IMPLNT ELECTR, CRAN BONE 7980. FLAP 00 61534 PR EXCIS EPILEPTOGENIC FOCUS 7707. 00 61535 PR REMOVE BRAIN ELECTRODES 4538. 00 61537 PR REMOVAL OF BRAIN 11168.00 TISSUE 61540 PR REMOVAL OF BRAIN 13458.00 TISSUE 61541 PR TRANSECT CORPUS CALLOSUM 7241. 00 61545 PR EXCISION CRANIOPHARYNGIOMA 19586.00 61546 PR EXCIS PITUITARY,INTRACRANIAL 12530.00 61548 PR EXCIS 9020. PITUITARY,TRANSNASAL/SEPTAL 00 61550 PR CRANIECTOMY SYNSOTOSIS,SINGLE 7275. SUT 00 61557 PR OPEN FLAP 8762. SYNOSTOSIS,BIFRONTAL 00 61559 PR EXTEN CRANIEC W RECONTOUR 8449. SYNOSTOSIS 00 61566 PR REMOVAL OF BRAIN 13823.00 TISSUE 61581 PR CRANIOFACIAL 13333.00 APPROACH,EXTRADURAL+ 61583 PR CRANIOFACIAL 14302.00 APPROACH,INTRADURAL 61584 PR ORBITOCRANIAL APPROACH/SKULL 13610.00 61586 PR BICOR,XZYGOMA APPROACH ANT 9223. CRAN FOSS 00 61590 PR INFRATEMPORAL 12552 APPROACH/PREAURICULAR 61591 PR INFRATEMPORAL 16642.00 APPROACH/POSTAURICULAR 61592 PR ORBITOCRANIAL 15518.00 APPROACH/ZYGOMATIC 61595 PR TRANSTEMPORAL 6044. APPROACH/SKULL 00 61600 PR RESECT BASE ANT CRAN 10103.00 FOSSA/EXTRADURL 61601 PR RESECT BASE ANT CRAN 11002.00 FOSSA/INTRADURL 61605 PR RESECT INFRATEMP 5365. FOSSA/EXTRADURL 00 61606 PR RESECT INFRATEMP 17964.00 FOSSA/INTRADURL 61608 PR RESECT PARASELLAR 16454.00 FOSSA/INTRADURL 61616 PR EXCIS BASE POST CRAN 11400.00 FOSSA/INTRADURL 61618 PR SEC REPR,CSF LEAK/CRANIAL 3408. FOSSA 00 61619 PR REPAIR DURA POSTOP SK BASE- 5742. PEDICLE 00 61623 PR ENDOVASC TEMP BALLOON 1477. OCCLUS,HEAD/NCK 00 61624 PR PERM 4680. OCCLUSION/EMBOLIZATION,PERCUT,CN 00 S 61626 PR PERCUT CATH OCCLUSN NON CNS 2744. LESN 00 61630 PR INTRACRANIAL BALLOON 2624. ANGIOPLASTY 00 61635 PR INTRACRANIAL BALLOON 5200. ANGIOPLSTY W/STENT 00 61640 PR BALLOON DILATION INTRACRANIAL 2383. VASOSPASM, INIT 00 61645 PR PERQ ART TRLUML M-THROMBEC 2831. &/NFS INTRACRANIAL 00 61650 PR EVASC INTRACRANIAL PROLNG 1385. ADMN RX AGENT ART 1ST 00 61651 PR EVASC INTRACRANIAL PROLNG 590.0 ADMN RX AGENT ART ADDL 0 61680 PR BRAIN AVM 12672.00 SURG,SUPRATENT,SIMPLE 61682 PR BRAIN AVM 23372.00 SURG,SUPRATENT,COMPLX 61686 PR BRAIN AVM 24497.00 SURG,INFRATENT,COMPLX 61690 PR BRAIN AVM SURG,DURAL,SIMPLE 13484.00 61692 PR BRAIN AVM SURG,DURAL,COMPLX 19670.00 61697 PR COMPLEX ANEURYSM 19317.00 SURG/CAROTID CIRC 61698 PR COMPLX ANEURYSM SURG/VERT- 27954.00 BASILAR CIRC 61700 PR ANEURYSM, INTRACRAN, SIMPLE 13923.00 SURG 61711 PR INTRA-EXTRACRANIAL ART 10655.00 ANASTOM 61720 PR CREATE LESN GLOBUS/THAL 7148. STEREO 00 61735 PR CREATE LESN SUBCORTICAL 9771. STEREO 00 61750 PR STEREOTACTIC BRAIN 7258. BX,ASPIR,EXC 00 61751 PR STEREO 7410. BX/ASPIR/EXCIS,INTRACRANIAL LESN 00 61760 STEREO IMPLANT BRAIN ELECTRODES, 8741. SEIZURE MONITOR 00 61781 PR STEREOTACTIC COMP ASSIST 1365. PROC,CRANIAL,INTRADURAL 00 61782 PR STEREOTACTIC COMP ASSIST 753.0 PROC,CRANIAL,EXTRADURAL 0 61783 PR STEREOTACTIC COMP ASSIST 1365. PROC,SPINAL 00 61791 PR STEREO TREAT TRIGEMINAL TRACT 4513. 00 61796 PR STEREOTACTIC RADIOSURGERY, 6600. CRANIAL,SIMPLE,SINGLE 00 61797 PR STEREOTACTIC RADIOSURGERY, 6600. CRANIAL,SIMPLE,EA ADD 00 61798 PR STEREOTACTIC RADIOSURGERY, 9900. CRANIAL,COMPLEX,SINGLE 00 61799 PR STEREOTACTIC RADIOSURGERY, 9900. CRANIAL,COMPLEX,EA ADD 00 61800 PR APPLY STEREOTACTIC HEADFRAME 2000. FOR RADIOSURGERY 00 61863 PR IMPLANT NEUROELECTRODE 6229. 00 61864 PR IMPLANT NEUROELECTRDE, ADD'L 1733. 00 61867 PR IMPLANT NEUROELECTRODE 9357. 00 61868 PR IMPLANT NEUROELECTRDE, ADDL 3077. 00 61880 PR REVISE/REMOVE INTRACRAN 2754. NEUROELEC 00 61885 PR IMP STIM,CRANIAL,SUBQ,1 ARRAY 2472. 00 61886 PR IMP STIM,CRANIAL,SUBQ,>1 ARRAY 3170. 00 62000 PR FIX SIMPL DEPRESS SKULL FX 3534. 00 62010 PR FIX DEPRESS SKULL FX,REPR DURA 8104. 00 62100 PR CRANIOTOMY,REPAIR,DURAL/CSF 4001. LEAK 00 62120 PR REPAIR ENCEPHALOCELE,VAULT 8744. 00 62121 PR REPAIR ENCEPHALOCELE,BASE 6936. 00 62140 PR REPAIR SKULL DEFECT,UP TO 5CM 5629. 00 62141 PR REPAIR SKULL DEFECT,>5CM 6350. 00 62142 PR REMOVE SKULL 4629. PLATE/FLAP 00 62143 PR REPLACE SKULL PLATE/FLAP 5285. 00 62146 PR REPAIR SKULL W GRAFT,UP TO 5CM 5772. 00 62147 PR REPAIR SKULL W GRAFT,>5CM 6000. 00 62160 PR NEUROENDOSCOP,PLACE/REPLACE 979.0 VENTCATH 0 62161 PR NEUROENDOSCOP,DISS 7271. ADHESION/FENESTRATION 00 62162 PR 8968. NEUROENDOSCOP,W/FENESTRAT/EXCI 00 S COLLOID 62163 PR NEUROENDOSCOP,W/RETRIEVAL, 7547. FB 00 62164 PR NEUROENDOSCOP,W/EXCISE BRAIN 12728.00 TUMOR 62165 PR NEUROENDOSCOP,EXC,PIT 6243. TUM,TRANSNAS/SPHEN 00 62192 PR CREATE SHUNT:SUBARCH/DUR- 5272. PLEURAL 00 62200 PR VENTRICULO-CISTERNOSTOMY,3RD 4835. VENT 00 62201 PR VENTRICULO-CISTERNOSTOMY,3RD 4843. VENT,STEREO 00 62220 PR CREATE SHUNT:VENTRIC-ATRIAL 6214. 00 62223 PR CREATE SHUNT:VENTRIC- 5508. PERITONEAL 00 62225 PR REPLACE/IRRIGATE VENTRIC CATH 2331. 00 62230 PR REPLACEMENT/REVISION,CSF 4350. SHUNT 00 62252 PR 26 263.0 REPROGRAMMING,PROGRAM 0 MABLE CSF SHUNT 62256 PR REMOVAL,COMPLETE CSF 2940. SHUNT,W/O REPLACE 00 62258 PR REMOVE & REPLACE CSF SHUNT 6003. 00 62267 PR PERCUT ASPIRATION VERTEBRAL 570.0 DISC 0 62270 PR SPINAL 373.0 PUNCTURE,LUMBAR,DIAGNOSTIC 0 62272 PR SPINAL PUNCTURE,THERAPEUTIC 588.0 DRAINAGE 0 62273 PR INJ,LUMB EPIDUR,BLOOD/CLOT 409.0 PATCH 0 62281 PR INJECT 610.0 NEUROLYTIC,EPIDUR,CERV/THOR 0 62282 PR 741.0 INJ,NEUROLYTIC,EPID/LUMB/CAUDAL 0 62284 PR INJECTION PROCEDURE 552.0 MYELOGRAPHY/CT LUMBAR 0 62287 PR DCMPRN PERQ NUCLEUS 1459. PULPOSUS 1/> LEVELS LUMBAR 00 62290 PR INJECT DISCOGRAM,LUMBAR,EA 829.0 LEVEL 0 62292 PR INJECT CHEMONUCLEOLYSIS 2941. 00 62294 PR INJECT SPINAL ARTERY,OCCLUDE 4844. AVM 00 62302 PR MYELOGRAPHY VIA LUMBAR 606.0 INJECTION RS&I CERVICAL 0 62303 PR MYELOGRAPHY VIA LUMBAR 630.0 INJECTION RS&I THORACIC 0 62304 PR MYELOGRAPHY VIA LUMBAR INJECT 597.0 RS&I LUMBOSACRAL 0 62305 PR MYELOGRAPHY VIA LUMBAR 652.0 INJECTION RS&I 2+ REGIONS 0 62310 PR NJX DX/THER SBST 725.0 EPIDURAL/SUBRACH CERV/THORACIC 0 62311 PR NJX DX/THER SBST 614.0 EPIDURAL/SUBARACH LUMBAR/SACRAL 0 62318 PR INJ/INFUS,CERV/THORAC,W/CATH 738.0 0 62319 PR NJX INFUS/BOLUS DX/SBST 563.0 EDRL/SUBARACH LUM/SACRAL 0 62320 PR NJX DX/THER SBST INTRLMNR 427.0 CRV/THRC W/O IMG GDN 0 62321 PR NJX DX/THER SBST INTRLMNR 634.0 CRV/THRC W/IMG GDN 0 62322 PR NJX DX/THER SBST INTRLMNR 398.0 LMBR/SAC W/O IMG GDN 0 62323 PR NJX DX/THER SBST INTRLMNR 622.0 LMBR/SAC W/IMG GDN 0 62324 PR NJX DX/THER SBST INTRLMNR 373.0 CRV/THRC W/O IMG GDN 0 62325 PR NJX DX/THER SBST INTRLMNR 562.0 CRV/THRC W/IMG GDN 0 62326 PR NJX DX/THER SBST INTRLMNR 392.0 LMBR/SAC W/O IMG GDN 0 62327 PR NJX DX/THER SBST INTRLMNR 573.0 LMBR/SAC W/IMG GDN 0 62350 PR IMP SPINAL CANAL CATH 2460. 00 62355 PR REMOVE SPINAL CANAL CATHETER 893.0 0 62362 INSERT/ REPLACE INFUSN 2600. PUMP,PROGRAMMABLE 00 62365 PR REMOVE INFUSN DEVICE/PUMP 2023. 00 62367 PR ELECT ANLYS IMPLT ITHCL/EDRL 89.00 PMP W/O REPRG/REFIL 62368 PR ANALYZE INFUSN 165.0 PUMP+REPROGRAM 0 62370 PR ELEC ANLYS IMPLT ITHCL/EDRL PMP 445.0 W/REPR PHYS/QHP 0 63001 LAM W/O FACETEC FORAMOT/DSKC 1/2 6317. VRT SEG, CERVICAL 00 63003 LAM W/O FACETEC FORAMOT/DSKC 1/2 6312. VRT SEG, THORACIC 00 63005 LAM W/O FACETEC FORAMOT/DSKC 1/2 6014. VRT SEG, LUMBAR 00 63011 LAM W/O FACETEC FORAMOT/DSKC 1/2 5559. VRT SEG, SACRAL 00 63012 PR 6060. LAMINECTOMY,FACETECTOMY,LUMBAR 00 63015 PR LAMINECTOMY,>2 SGMT,CERVICAL 7547. 00 63016 PR LAMINECTOMY,>2 SGMT,THORACIC 7766. 00 63017 PR LAMINECTOMY,>2 SGMT,LUMBAR 6396. 00 63020 PR LAMNOTMY INCL W/DCMPRSN NRV 5909. ROOT 1 INTRSPC CERVC 00 63030 PR LAMNOTMY INCL W/DCMPRSN NRV 4933. ROOT 1 INTRSPC LUMBR 00 63035 PR LAMNOTMY W/DCMPRSN NRV EACH 980.0 ADDL CRVCL/LMBR 0 63040 PR LAMINOTOMY 7093. 00 63042 PR REDO EXCIS LUMBAR 6595. DISC 00 63043 PR REDO EXCIS CERV DISC, ADDN 990.0 CERV INTERSPC 0 63044 PR REDO EXCIS CERV DISC, ADDN 990.0 LUMB INTERSPC 0 63045 LAMINEC/FACETECT/FORAMIN,CERVICA 6558. L 1 SEG 00 63046 LAMINEC/FACETECT/FORAMIN,THORACI 6220. C 1 SEG 00 63047 LAMINEC/FACETECT/FORAMIN,LUMBAR 5608. 1 SEG 00 63048 PR LAMINEC/FACETECT/FORAMIN,EACH 1081. ADDNL 00 63050 PR C- LAMINOPLASTY, 2 OR MORE 5090. 00 63051 PR C-LAMINOPLASTY W/GRAFT/PLATE, 2 8708. OR MORE 00 63055 PR XPEDICUL DECOMPRESS THROACIC 8296. CORD 00 63056 PR DECOMPRESS SPINAL CORD,1 SEG 6043. 00 63064 PR COSTOVERT DECOMPRESS 9029. THORACIC CORD 00 63066 PR COSTOVERT DECOMP THOR 1056. CORD,EACH ADDN 00 63075 PR DISK 6893. SURG,ANTER,CERVICAL,SINGLE LVL 00 63076 PR DISK SURG,ANTER,CERV,EA ADDNL 1267. LVL 00 63077 PR DISK SURG,THORAX,SINGLE LEVEL 7595. 00 63081 PR REMV VERT BODY,CERV,ONE SGMT 8946. 00 63082 PR REMV VERT BODY,CERV,EACH 8946. ADDNL SGMT 00 63085 PR REMV VERT BODY,THOR,ONE SGMT 9753. 00 63086 PR REMV VERT BODY,THOR,EACH 975.0 ADDNL SGMT 0 63087 PR REMV VERT BODY,LO 12284.00 THOR/LUMB,ONE 63088 PR REMV VERT BODY,LO 1330. THOR/LUMB,EA ADDNL 00 63090 PR REMV VERT 9969. BODY,LOWER,RETROPER,ONE 00 63091 PR REMV VERT 909.0 BODY,LOWR,RETROPER,EA ADDN 0 63101 PR REMOVAL OF VERTEBRAL BODY 11789.00 63102 PR REMOVAL OF VERTEBRAL BODY 11577.00 63103 PR REMOVE VERTEBRAL BODY ADD-ON 2497. 00 63170 PR INCISE SPINAL CORD TRACT(S) 8155. 00 63172 PR DRAIN 7188. INTRAMEDULLARY->SUBARACH 00 63173 PR DRAIN 8712. INTRAMEDULLARY->PERITONEAL 00 63185 PR INCISE SP 5815. COLUMN/NERVES,ONE/TWO LVL 00 63190 PR INCISE SP COLUMN/NERVES,>2 LVL 6522. 00 63191 PR INCISE SPINAL ACCESS NERVE 6465. 00 63194 PR INCIS 1 SPINOTHAL,CERV,1 STAGE 7131. 00 63195 PR INCIS 1 SPINOTHAL,THOR,1 STAGE 6489. 00 63200 PR RELEASE TETHERED SPINAL 7828. CORD,LUMBR 00 63250 PR EXCIS/OCCLUD CORD 15227.00 AVM,CERVICAL 63251 PR EXCIS/OCCLUD CORD 15424.00 AVM,THORACIC 63252 PR EXCIS/OCCLUD CORD 15479.00 AVM,THORCOLUMBAR 63265 PR EXCIS INTRASP 8500. LESN,XDURAL,CERVICAL 00 63266 PR EXCIS INTRASP 8760. LESN,XDURAL,THORACIC 00 63267 PR EXCIS INTRASP 6969. LESN,XDURAL,LUMBAR 00 63268 PR EXCIS INTRASP 7120. LESN,XDURAL,SACRAL 00 63270 PR EXCIS INTRASP 10599.00 LESN,INTRADUR,CERV 63271 PR EXCIS INTRASP 10516.00 LESN,INTRADUR,THOR 63272 PR EXCIS INTRASP 9619. LESN,INTRADUR,LUMB 00 63275 PR BX/EXCIS SPINAL 9161. TUMOR,XDURAL,CERV 00 63276 PR BX/EXCIS SPINAL 9111. TUMOR,XDURAL,THOR 00 63277 PR BX/EXCIS SPINAL 7898. TUMOR,XDURAL,LUMB 00 63278 PR BX/EXCIS SPINAL 8050. TUMOR,XDURAL,SACR 00 63280 PR BX/EXCIS SPIN 10755.00 TUM,INDUR,XMED,CERV 63281 PR BX/EXCIS SPIN 10672.00 TUM,INDUR,XMED,THOR 63282 PR BX/EXCIS SPIN 10040.00 TUM,INDUR,XMED,LUMB 63283 PR BX/EXCIS SPIN 9629. TUM,INDUR,XMED,SACR 00 63285 PR BX/EXCIS SPIN 13414.00 TUM,INDUR,INMED,CERV 63286 PR BX/EXCIS SPIN 13089.00 TUM,INDUR,INMED,THOR 63287 PR BX/EXCIS SPIN 14075.00 TUM,INDUR,INMED,THLUM 63290 PR BX/EXCIS SPIN TUM,COMBINED,ANY 11399.00 LVL 63300 PR REMV VERT,EXDUR,CERV TUMOR 9344. 00 63301 PR REMV VERT,EXUDR,XTHOR,THOR 10591.00 TUMOR 63302 PR REMV VERT,EXDUR,THORLUM,THOR 10979.00 TUMOR 63303 PR REMV VERT,EXDUR,LUMB/SACR 11484.00 TUMOR 63305 PR REMV VERT,INDURAL,XTHOR,THOR 10280.00 TUMOR 63307 PR REMV VERT,INDURAL,LUMB/SACR 11110.00 TUMOR 63308 PR REMV VERT,EACH ADDNL SEGMENT 1650. 00 63600 PR CREATE SP CORD LESN,STEREOTAC 4568. 00 63650 PR PERCUT IMPLNT 3294. NEUROELECT,EPIDURAL 00 63655 PR SURG IMPLNT 4210. NEUROELECT,EPIDURAL 00 63661 PR REMOVE SPINAL NEUROSTIM 2921. ELECTRODE PERC ARRAY, INCL 00 FLUORO 63662 PR REMOVE SPINAL NEUROSTIM 4252. ELECTRODE PLATE/PADDLE, INCL 00 FLUORO 63663 PR REVISION SPINAL NEUROSTIM 2500. ELECTRODE PERC ARRAY, INCL 00 FLUORO 63664 PR REVISION SPINAL NEUROSTIM 4390. ELECTRODE PLATE/PADDLE, INCL 00 FLUORO 63685 PR IMPLANT NEUROSTIM/RECEIVER 1853. 00 63688 PR REVISE/REMOVE 1883. NEUROSTIM/RECEIVER 00 63704 PR REPR MYELOMENIGOCELE,<5CM DIA 7451. 00 63706 PR REPR MYELOMENIGOCELE,5+CM DIA 8888. 00 63707 PR REPR,DURAL/CSF LEAK,NOT REQ 4682. LAMINECTOMY 00 63709 PR REPR,DURAL/CSF 5600. LEAK,W/LAMINECTOMY 00 63710 PR DURAL GRAFT REPAIR,SPINE 5506. DEFECT 00 63740 PR INSTALL SPINAL 4759. SHUNT,LAMINECTOMY 00 63741 PR INSTALL SPINAL SHUNT,PERCUT 3438. 00 63744 PR REVISION OF SPINAL 3364. SHUNT 00 63746 PR REMOVAL OF SPINAL 3066. SHUNT 00 64400 PR INJECT NERV BLCK,TRIGEMINAL 308.0 0 64402 PR INJECT NERV BLCK,FACIAL NERV 318.0 0 64405 PR INJECT NERV BLCK,GREAT OCCIPTL 285.0 0 64408 PR INJECT NERV BLCK, 294 64413 PR INJECT NERV BLCK,CERV PLEXUS 320.0 0 64415 PR INJ,ANES AGENT,BRACHIAL 401.0 PLEXUS,SINGLE 0 64416 PR INJ,ANES AGENT,BRACHIAL 420.0 PLEXUS,CONT INF 0 64417 PR INJECT NERV BLCK,AXILLARY NERV 366.0 0 64418 PR INJECT NERV BLCK,SUPRASCAP N. 365.0 0 64420 PR INJECT NERV 418.0 BLCK,INTERCOSTAL,ONE 0 64421 PR INJECT NERV 634.0 BLCK,INTERCOST,MULTPL 0 64425 PR INJECT NERV 395.0 BLCK,ILIOINGU/ILIOHYP 0 64430 PR INJECT NERV BLCK,PUDENDAL 413.0 0 64445 PR INJ,ANES AGENT,SCIATIC 400.0 NERVE,SINGLE 0 64446 PR INJ,ANES AGENT,SCIATIC 420.0 NERVE,CONT INF 0 64447 PR INJ,ANES AGENT,FEMORAL 365.0 NERVE,SINGLE 0 64448 PR INJ,ANES AGENT,FEMORAL 400.0 NERVE,CONT INF 0 64449 PR N BLOCK INJ, LUMBAR PLEXUS 216.0 0 64450 PR INJECT NERV BLCK,OTHR PERIPH 310.0 NERV 0 64455 PR INJECT PLANTAR COMMON DIGITAL 121.0 NERVE 0 64461 PR PVB THORACIC SINGLE INJECTION 375 SITE W/IMG GID 64462 PR PVB THORACIC SECOND & ADDL INJ 212 SITE W/IMG GID 64463 PR PVB THORACIC CONT CATHETER 407 INFUSION W/IMG GID 64479 PR INJECT ANES/STEROID FORAMEN 589.0 CERV/THORACIC W IMG GUIDE ,1 LEVEL 0 64480 PR INJECT ANES/STEROID FORAMEN 286.0 CERV/THORACIC W IMG GUIDE ,EA ADD 0 LEVEL 64483 PR INJECT ANES/STEROID FORAMEN 547.0 LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL 0 64484 PR INJECT ANES/STEROID FORAMEN 220.0 LUMBAR/SACRAL W IMG GUIDE ,EA ADD 0 LEVEL 64486 PR TAP BLOCK UNILATERAL BY 308.0 INJECTION(S) 0 64488 PR TAP BLOCK BILATERAL BY 379.0 INJECTION(S) 0 64490 PR INJ DX/THER AGNT PARAVERT 732.0 FACET JOINT, CERV/THORAC, 1ST 0 LEVEL 64491 PR INJ DX/THER AGNT PARAVERT 298.0 FACET JOINT, CERV/THORAC, 2ND 0 LEVEL 64492 PR INJ DX/THER AGNT PARAVERT 298.0 FACET JOINT, CERV/THORAC, ADD 0 LEVEL 64493 PR INJ DX/THER AGNT PARAVERT 668.0 FACET JOINT, LUMBAR/SAC, 1ST LEVEL 0 64494 PR INJ DX/THER AGNT PARAVERT 264.0 FACET JOINT, LUMBAR/SAC, 2ND LEVEL 0 64495 PR INJ DX/THER AGNT PARAVERT 217.0 FACET JOINT, LUMBAR/SAC, ADD LEVEL 0 64505 PR INJECT NERV BLCK,SPHENOPALAT 295.0 GANGLN 0 64510 PR INJECT NERV BLCK,STELLATE 397.0 GANGLION 0 64520 PR INJECT NERV BLCK,PARAVERT 581.0 SYMPATH 0 64530 PR INJECT NERV BLCK,CELIAC PLEXUS 592.0 0 64550 PR APPLICATION OF SURFACE 40.00 NEUROSTIMULATOR 64555 PR PRQ IMPLTJ NEUROSTIMULATOR 3047. ELTRD PERIPHERAL NRV 00 64561 PR PRQ IMPLTJ NEUROSTIM ELTRD 2101. SACRAL NRVE W/IMAGING 00 64566 PR POST TIBIAL 418.0 NEUROSTIMULATION,PERC NEEDLE 0 ELECTRODE 64568 PR INCISION IMPLANT CRANIAL NERVE 1650. STIM ELECTRODE/PULSE GEN 00 64569 PR REVISE/REPLACE CRANIAL NERVE 4713. STIM ELECTRODE/CONNECT PULSE 00 GEN 64570 PR REMOVE IMPLANT CRANIAL NERVE 1665. STIM ELECTRODE/PULSE GEN 00 64575 PR INC IMPLTJ PERIPH NERVE 1622. NEUROSTIMULATOR ELTRD 00 64581 PR INC IMPLTJ NEUROSTIMULATOR 1800. ELTRD SACRAL NERVE 00 64585 PR REVJ/RMVL PERIPHERAL 617.0 NEUROSTIMULATOR ELECTRODE 0 64590 PR IMPLANT GASTRIC 800.0 NEUROSTIM/RECEIVER 0 64595 PR REVISE/REMOVE GASTRIC 619.0 NEUROSTIM/RECEIVER 0 64600 PR INJECT TRIGEM NERV,1ST BRANCH 986.0 0 64610 PR INJECT 5TH N.-2,3 DIV,F.OVALE,XRAY 2836. 00 64611 PR CHEMODENERVATION 295.0 PAROTID/SUBMANDIBULAR SALIVARY 0 GLANDS,BILATERAL 64612 PR CHEMODNRVTJ MUSC MUSC 350.0 INNERVATED FACIAL NRV UNIL 0 64615 PR CHEMODERVATE 435.0 FACIAL/TRIGEM/CERV MUSC MIGRAINE 0 64616 PR CHEMODENERVATION MUSCLE 344.0 NECK UNILAT FOR DYSTONIA 0 64617 PR CHEMODENERVATION MUSCLE 515 LARYNX UNILAT W/EMG 64630 PR DESTRUCT BY NEURO AGENT; 677.0 PUDENDAL 0 64633 PR DSTR NROLYTC AGNT PARVERTEB 1329. FCT SNGL CRVCL/THORA 00 64634 PR DSTR NROLYTC AGNT PARVERTEB 609.0 FCT ADDL CRVCL/THORA 0 64635 PR DSTR NROLYTC AGNT PARVERTEB 1306. FCT SNGL LMBR/SACRAL 00 64636 PR DSTR NROLYTC AGNT PARVERTEB 548.0 FCT ADDL LMBR/SACRAL 0 64640 PR INJECT RX OTHER PERIPH NERVE 646.0 0 64642 PR CHEMODENERVATION ONE 371.0 EXTREMITY 1-4 MUSCLE 0 64643 PR CHEMODENERVATION 1 EXTREMITY 275.0 EA ADDL 1-4 MUSCLE 0 64644 PR CHEMODENERVATION 1 EXTREMITY 410.0 5 OR MORE MUSCLES 0 64645 PR CHEMODENERVATION 1 EXTREMITY 313.0 EA ADDL 5/< MUSCLES 0 64646 PR CHEMODENERVATION OF TRUNK 405.0 MUSCLE 1-5 MUSCLES 0 64647 PR CHEMODENERVATION OF TRUNK 6 475.0 OR MORE MUSCLES 0 64650 PR CHEMODENERV ECCRINE GLANDS 286.0 BOTH AXILLAE 0 64653 PR CHEMODENERV ECCRINE GLANDS, 356.0 NON-AXILLARY 0 64680 PR INJECT RX CELIAC PLEXUS NERVE 950.0 0 64681 PR INJECTION TREATMENT OF NERVE 1312. 00 64702 PR REVISE/REPAIR FINGER/TOE NERVE 1265. 00 64704 PR REVISE/REPAIR HAND/FOOT NERVE 1430. 00 64708 PR NEUROPLASTY OTHER ARM/LEG 2521. NERVE,OPEN 00 64712 PR NEUROPLASTY SCIATIC 2940. NERVE,OPEN 00 64713 PR NEUROPLASTY BRACHIAL 3889. PLEXUS,OPEN 00 64714 PR NEUROPLASTY LUMBAR 2517. PLEXUS,OPEN 00 64716 PR REVISION OF CRANIAL NERVE 1351. 00 64718 PR REVISE ULNAR NERVE AT ELBOW 2990. 00 64719 PR REVISE ULNAR NERVE AT WRIST 2022. 00 64721 PR REVISE MEDIAN N/CARPAL TUNNEL 1467. SURG 00 64722 PR RELIEVE PRESSURE ON NERVE(S) 919.0 0 64726 PR RELEASE FOOT/TOE 932.0 NERVE 0 64727 PR INTERN NERVE REVIS,OPER 940.0 MICROSCOPE 0 64734 PR TRANSECT INFRAORBITAL NERV 2090. 00 64744 PR TRANSECT GREAT OCCIPITAL NERV 1725. 00 64763 PR TRANSECT 1613. OBTURATR,XTRAPELV,HIP/LEG 00 64771 PR TRANSECT OTHER CRAN 3043. N,EXTRADURAL 00 64772 PR TRANSECT OTHR SPINAL 2854. N,XTRADURAL 00 64774 PR EXCISE CUTANEOUS NEUROMA 2098. 00 64776 PR EXCISE DIGITAL NEUROMA 1172. 00 64782 PR EXCISE HAND/FOOT NEUROMA 1075. 00 64783 PR EXCISE HAND/FOOT 790.0 NEUROMA,EACH ADDNL 0 64784 PR EXCISE MAJOR PERIPHERAL 3697. NEUROMA 00 64786 PR EXCISE SCIATIC NERVE NEUROMA 5494. 00 64787 PR IMPLANT NERVE END TO 1078. BONE/MUSC 00 64788 PR EXCISE CUTANEOUS 2019. NEUROFIBROMA 00 64790 PR EXCISE MAJOR PERIPH 4284. NEUROFIBROMA 00 64792 PR EXCISE NEUROFIBROMA EXTENSIVE 5507. 00 64795 PR BIOPSY OF NERVE 983.0 0 64804 PR 4267. SYMPATHECTOMY,CERVICOTHORACIC 00 64820 PR SYMPATHECTOMY,DIGITAL 2680. ARTERIES, EA 00 64821 PR SYMPATHECTOMY,RADIAL ARTERY 2450. 00 64822 PR SYMPATHECTOMY,ULNAR ARTERY 1750. 00 64831 PR REPAIR OF DIGIT NERVE 1599. 00 64832 PR REPAIR EACH ADDNL DIGIT NERVE 843.0 0 64834 SUTURE 1 NERVE HAND/FOOT COMMON 2349. SENSORY NERVE 00 64835 SUTURE 1 NERVE MEDIAN MOTOR 2535. THENAR 00 64836 SUTURE 1 NERVE ULNAR MOTOR 2927. 00 64837 PR REPAIR EACH ADDNL HAND/FOOT 1075. NERVE 00 64856 PR REPAIR/TRANSPOS MAJ PERIPH 3071. NERVE 00 64857 PR REPAIR MAJOR PERIPHERAL NERVE 3290. 00 64858 PR REPAIR SCIATIC NERVE 4210. 00 64859 PR REPAIR ADDNL MAJ PERIPH NERVE 642.0 0 64864 PR REPR FACIAL 2853. NERVE,EXTRACRANIAL 00 64866 PR ANAST FACIAL-SPINAL ACCESS 4577 64868 PR ANAST FACIAL-HYPOGLOSSAL 3513. NERVE 00 64872 PR REPR NERVE,SECONDARY/DELAY 418.0 0 64874 PR REPR/TRANSPOSE 425.0 NERVE,SECONDARY 0 64885 PR NERVE 3478. GRAFT,HEAD/NECK,ONE,=<4CM 00 64886 PR NERVE 4691. GRAFT,HEAD/NECK,ONE,>4CM 00 64890 PR NERVE 3427. GRAFT,HAND/FOOT,ONE,=<4CM 00 64893 PR NERVE GRAFT,ARM/LEG,ONE,>4CM 4008. 00 64896 PR NERV GRFT,HAND/FOOT,MULT,>4CM 5857. 00 64898 PR NERV GRFT,ARM/LEG,MULT,>4CM 5990. 00 64902 PR EA ADDNL NERVE GRAFT,MULTPL 2326. STRANDS 00 64905 PR NERVE PEDICLE XFER,FIRST STAGE 3547. 00 64910 PR NERVE REPAIR W/ALLOGRAFT OR 2906. SYNTH 00 64912 PR NERVE REPAIR W/NERVE 2821. ALLOGRAFT FIRST STRAND 00 64913 PR NERVE REPAIR W/NERVE 572.0 ALLOGRAFT EA ADDL STRAND 0 65101 PR REMOVAL OF EYE 1878. 00 65103 PR REMOVE EYE W IMPLANT 1948. 00 65105 PR REMOVE EYE W MUSC TO IMPLANT 2167. 00 65110 PR REMOVAL OF ORBITAL CONTENTS 4321. 00 65205 PR REMV F.B.,EYE,SUPERF CONJUNC 142.0 0 65210 PR REMV F.B.,EYE,EMBED CONJUNC 173.0 0 65220 PR REMV F.B.,EYE,CORNEA,NO SLIT 229.0 0 65222 PR REMV F.B.,EYE,CORNEA,SLIT LAMP 170.0 0 65235 PR REMOVAL,FB,INTRAOCULAR,ANT 1782. CHAMBER/LENS 00 65260 PR REMV F.B.,EYE,POST 3401. SGMT,MAGNETIC 00 65265 PR REMV F.B.,EYE,POST 3817. SGMT,NONMAGNETIC 00 65270 PR REPAIR CONJUNC LACERATN 665.0 0 65275 PR REPAIR CORNEA 1445. LAC,NONPERFORATING 00 65280 PR REPAIR CORNEA LAC,PERF,NO 1732. UVEAL 00 65285 PR REPAIR CORNEA LAC,PERF,RESEC 2960. UVEAL 00 65286 PR REPAIR CORNEA LAC,APPLY GLUE 1755. 00 65400 PR EXCIS CORNEA LESN 1703. 00 65410 PR BIOPSY OF CORNEA 358.0 0 65426 PR EXCIS PTERYGIUM,W 1624. GRAFT 00 65430 PR CORNEAL SMEAR 290.0 0 65435 PR CURETTE/TREAT CORNEA 203.0 0 65436 PR CURETTE/TREAT CORNEA,APPLY 986.0 CHELATE 0 65450 PR DESTR CORNEAL 813.0 LESN,CRYO,PHOTO,THERM 0 65600 PR MULT PUNC ANTER 987.0 CORNEA 0 65730 PR CORNEAL 3681. TRANSPLANT,PENETRATING 00 65750 PR CORNEAL 3681. TRANSPLANT,PENETRAT,APHAKIA 00 65755 PR CORNEAL 3681. TRANSPLANT,PEN,PSEUDOAPHAK 00 65756 PR CORNEAL 3400. TRANSPLANT,ENDOTHELIAL 00 65770 PR REVISE CORNEA WITH IMPLANT 4100. 00 65778 PR PLACE AMNIOTIC MEMBRA OCULAR 3431. SURFACE W/O SUTURES 00 65779 PR PLACE AMNIOTIC MEMBRANE 600.0 OCULAR SURFACE SUTURED 0 65780 PR OCULAR SURF RECONST, AMNIOTIC 2500. TRANSPLANT, MULTIPLE LAYERS 00 65800 PR PARACENTSIS ANT CHAMB EYE 301.0 ASPIR AQUEOUS SPX 0 65815 PR DRAIN ANT CHMBR,REMV BLOOD 1605. 00 65820 PR RELIEVE INNER EYE PRESSURE 1878. 00 65850 PR INCISION OF EYE 2400. 00 65855 PR TRABECULOPLASTY BY LASER 854.0 SURGERY 0 65860 PR INCISE INNER EYE ADHESNS,LASER 814.0 0 65865 PR INCISE INNER EYE ADHESNS,INCISN 1181. 00 65875 PR INCISE POST SYNECHIAE,EYE 1595. 00 65920 PR REMVL,IMPLANT MATERIAL,ANT 1980. SEGMENT,EYE 00 66020 PR INJECTION,ANT 500.0 CHAMBER,EYE,AIR/LIQUID 0 66030 PR INJECT ANTER CHMBR 412.0 EYE,MEDICATN 0 66170 PR GLAUCOMA SURG,TRABECU AB 3400. EXTERNO 00 66172 PR GLAUCOMA SURG,TRAB AB 4100. EXT,PREV SCAR 00 66180 PR AQUEOUS SHUNT EXTRAOC EQUAT 3400. PLATE RSVR W/GRAFT 00 66183 PR INSERT ANTER DRAINAGE DEV W/O 3588. EXTRAOC RESERVOIR 00 66184 PR REVJ SHUNT EXTRAOCULAR 1987. RESERVOIR W/O GRAFT 00 66185 PR REVJ AQUEOUS SHUNT 2400. EXTRAOCULAR RESERVOIR W/GRAFT 00 66250 PR REVIS/REPAIR OP WOUND ANTER 1895. SGMT 00 66605 PR REMV IRIS,CYCLECTOMY 3739. 00 66625 PR REMV IRIS,PERIPH FOR GLAUCOMA 1400. 00 66682 PR SUTURE IRIS/CILIARY 1601. BODY 00 66710 PR DESTRUC,CILIARY 1097. BODY,CYCLOPHOTOCOAG 00 66711 PR DESTRUC,CILIARY 1603. BODY,CYCLOPHOTO,ENDOSCO 00 66761 PR IRIDOTOMY/IRIDECTOMY BY LASER, 900.0 PER SESSION 0 66762 PR IRIDOPLASTY BY PHOTOCOAG 1183. 00 66821 PR DISCISSION,2ND CATARACT,LASER 828.0 0 66825 PR REPOSITION INTRAOCULAR LENS W 1904. INCIS 00 66840 PR REMV LENS MATERIAL,ASPIRATN 1759. 00 66850 PR REMV LENS 2300. MATERIAL,PHACOFRAGMT 00 66852 PR REMV LENS MATERIAL,PARS 2500. PLANAR APPRC 00 66982 PR REMV CATARACT EXTRACAP,INSERT 2800. LENS,COMP 00 66984 PR REMV CATARACT EXTRACAP,INSERT 2100. LENS 00 66985 PR INSERT LENS PROSTHESIS ONLY 2200. 00 66986 PR EXCHANGE LENS PROSTHESIS 2500. 00 66990 PR OPHTHALMIC ENDOSCOPE USE 250.0 0 67005 PR PART REMV VITREOUS,ANT APPRCH 1181. 00 67010 PR SUBTOT REMV VITREOUS,MECH 1369. VIRECTOMY 00 67015 PR RELEAS 1460. VITREOUS,SUBRET/CHOROID FLUID 00 67025 PR REPLACE EYE FLUID 1842. 00 67028 PR INJECT INTRAVITREAL 400.0 PHARMCOLOGIC 0 67036 PR 3200. VITRECTOMY,MECHANICAL 00 67039 PR VITRECTOMY,FOCAL LASER RX 3400. RETINA 00 67040 PR VITRECTOMY,PANRETINAL LASER 3700. RX 00 67041 PR VITRECTOMY PARS PLANA REMOVE 3800. PRERETINAL MEMBRANE 00 67042 PR VITRECTOMY PARS PLANA REMOVE 4032. INT MEMB RETINA 00 67043 PR VITRECTOMY PARS PLANA REMOVE 4300. SUBRETINAL MEMBRANE 00 67101 PR RPR RETINAL DTCHMNT DRG 2100. SUBRETINAL FLUID CRTX 00 67105 PR RPR RETINAL DTCHMNT DRG 1802. SUBRETINAL FLUID PC 00 67107 PR REPAIR RETINAL DETACHMENT 3600. SCLERAL BUCKLING 00 67108 PR RPR RETINAL DTCHMNT 6412. W/VITRECTOMY ANY METH 00 67110 PR REPAIR DETACD RETINA,INJECT 2400. AIR/GAS 00 67113 PR RPR COMPLEX RETINA DETACH 4800. VITRECT &MEMBRANE PEEL 00 67115 PR RELEASE ENCIRCL MATERIAL,POST 610.0 SGMT 0 67120 PR REMV POST EYE IMPLNT 1800. MATER,EXTRAOCUL 00 67121 PR REMV POST EYE IMPLNT 2600. MATER,INTRAOCUL 00 67141 PR PROPHYLAXIS RETINA 1331. DETACH,CRYO/DIATH 00 67145 PR PROPHYLAXIS RETINA 1500. DETACH,PHOTOCOAG 00 67208 PR DESTRUC RETINAL 1500. LESN,CRYOTHERAPY 00 67210 PR DESTRUC RETINAL 1293. LESN,PHOTOCOAG 00 67218 PR DESTRUC RETINAL LESN,RADN 3600. IMPLNT 00 67220 PR DEST,CHOROID 1700. LESION,PHOTOCOAG 00 67221 PR DEST,CHOROID 820.0 LESN,PHOTODYNAMIC THERAPY 0 67228 PR TREATMENT EXTENSIVE 2700. RETINOPATHY PHOTOCOAGULATION 00 67229 PR TX EXTENSIVE RETINOPATHY, 3268. PRETERM INFANT 00 67255 PR REINFORCE SCLERA EYE W GRAFT 2400. 00 67311 PR STABISMUS SURG,ONE HORIZ 1600. MUSCLE 00 67312 PR STABISMUS SURG,TWO HORIZ 1900. MUSCLE 00 67314 PR STABISMUS SURG,ONE VERT 1800. MUSCLE 00 67316 PR STABISMUS SURG,2+ VERT MUSCLE 2200. 00 67318 PR STRABISMUS SURG,SUPER-OBLIQ 1787. MUSC 00 67320 PR TRANSPOSITION ANY EXTRAOCUL 830.0 MUSC 0 67331 PR STRABISM SURG,PREV EYE 800.0 SURG,NOT MUSC 0 67332 PR STRABISMUS SURG,SCAR 920.0 EXTRAOCUL MUSC 0 67334 PR STRABISMUS SURG,POST FIXATN 756.0 SUTURE 0 67335 PR STRABISMUS SURG,PLACE ADJUST 430.0 SUTURE 0 67345 PR DESTROY NERVE OF EYE MUSCLE 700.0 0 67400 PR EXPLORE EYE SOCKET 2700. 00 67405 PR EXPLORE EYE SOCKET,DRAINAGE 2100. 00 67412 PR EXPLORE EYE SOCKET,REMV LESN 2600. 00 67413 PR EXPLORE EYE SOCKET,REMV F.B. 2400. 00 67414 PR EXPLORE EYE 3600. SOCKET,DECOMPRESS 00 67415 PR NEEDLE ASPIR ORBITAL CONTENTS 420.0 0 67420 PR LAT EXPLOR EYE SOCK,REMV LESN 4300. 00 67445 PR LAT EXPLOR EYE 4931. SOCK,DECOMPRESS 00 67500 PR RETROBULBAR INJECT,MEDICATN 197.0 0 67515 PR INJ,THER AGENT INTO TENON'S 260.0 CAPSULE 0 67550 PR INSERT EYE SOCKET IMPLANT 3414. 00 67560 PR REVISE EYE SOCKET IMPLANT 3501. 00 67710 PR INCISION OF EYELID 555.0 0 67715 PR INCISION OF EYELID FOLD 610.0 0 67800 PR EXCIS CHALAZION,SINGLE 330.0 0 67801 PR EXCIS CHALAZION,MULT,SAME LID 422.0 0 67805 PR EXCIS CHALAZION,MULT,BOTH LIDS 527.0 0 67808 PR EXCIS CHALAZION,GEN ANESTHESIA 970.0 0 67810 PR INCISIONAL BIOPSY EYELID SKIN & 430.0 LID MARGIN 0 67820 PR REVISE EYELASHES,FORCEPS 125.0 0 67825 PR REVISE EYELASHES 340.0 0 67840 PR REMOVE EYELID LESN (NOT 720.0 CHALAZION) 0 67850 PR DESTRUC EYELID LESN, <1 CM 543.0 0 67875 PR TEMP CLOSURE EYELID BY SUTURE 440.0 0 67880 PR REVISION OF EYELID 990.0 0 67882 PR REVISION EYELID,XPOSITN TARSAL 1490. PLATE 00 67900 PR REPAIR BROW PTOSIS 1619. 00 67901 PR FIX LID PTOSIS,FRONTALIS 1914. MUSC,SUT 00 67902 PR FIX LID PTOSIS,FRONT MUSC,FAS 1829. SLNG 00 67903 PR FIX LID PTOSIS,LEVATR 1580. RESEC,INTERN 00 67904 PR FIX LID PTOSIS,LEVATR 1900. RESEC,EXTERN 00 67911 PR CORRECT LID RETRACTN 1520. 00 67912 PR CORRECTION EYELID W/ IMPLANT 2190. 00 67914 PR FIX ECTROPION,SUTURE 1167. 00 67917 PR FIX ECTROPION,ENTENSV LID 1560. REPAIR 00 67921 PR FIX ENTROPION,SUTURE 1143. 00 67923 PR FIX ENTROPION,EXCIS TARSAL 1479. WEDGE 00 67924 PR FIX ENTROPION,EXTENSV LID 1600. REPAIR 00 67930 PR SUTURE EYELID WOUND,PARTIAL 940.0 THICK 0 67935 PR SUTURE EYELID WOUND,FULL THICK 1540. 00 67938 PR REMOVE EYELID FOREIGN 530.0 BODY,EMBEDDED 0 67950 PR CANTHOPLASTY 1434. 00 67961 PR REVISION OF EYELID,< 1/4 LID 1500. MARGIN 00 67966 PR REVISION OF EYELID,> 1/4 LID 1980. MARGIN 00 67971 PR RECONSTRUC EYELID,<2/3,ONE 2548. STAGE 00 67973 PR RECONSTRUC EYELID,TOT LOWER,1 2703. STAGE 00 67974 PR RECONSTRUC EYELID,TOT UPPER,1 3271. STAGE 00 67975 PR RECONSTRUC EYELID,SECOND 1780. STAGE 00 68100 PR BIOPSY OF CONJUNCTIVA 440.0 0 68110 PR EXCIS CONJUNC LESN,=<1 CM 580.0 0 68115 PR EXCIS CONJUNC LESN,>1 CM 780.0 0 68135 PR DESTRUC CONJUNC LESN 420.0 0 68200 PR SUBCONJUNCTIVAL 105.0 INJECTN 0 68320 PR REVISE CONJUNC,CONJUNC GRFT 1812. 00 68326 PR REVISE CONJUNC,FIX CUL-DE- 1627. SAC+GRFT 00 68328 PR REVISE CONJUNC,FIX CUL-DE- 1830. SAC=BUCCAL 00 68335 PR REPAIR SYMBLEPHARON+FREE 1670. GRFT 00 68340 PR DIVISION OF SYMBLEPHARON 1380. 00 68362 PR CONJUNC FLAP,TOTAL 1700. 00 68440 PR INCISE TEAR DUCT 280.0 OPENING 0 68510 PR BIOPSY OF TEAR GLAND 1113. 00 68700 PR REPAIR TEAR DUCTS 1600. 00 68720 PR CREATE TEAR SAC-NASAL FISTULA 2040. 00 68750 PR CREATE CONJUNC-NASAL 2786. FISTULA+STENT 00 68760 PR CLOSE TEAR DUCT OPENING 525.0 0 68761 PR CLOSE TEAR DUCT OPENING BY 380.0 PLUG,EA 0 68801 PR DILATION NASOLACRIMAL DUCT 310.0 0 68810 PR PROBE NASOLACRIMAL DUCT 620.0 0 68811 PR PROBE NASOLAC DUCT W GEN 517.0 ANESTH 0 68815 PR PROBE NASOLAC DUCT,INSERT 1060. TUBE/STENT 00 68840 PR EXPLORE LACRIMAL CANALICULI 340.0 0 68850 PR INJECTION FOR TEAR SAC X-RAY 155.0 0 69000 PR DRAIN EXT EAR 417.0 ABSC/BLOOD,SIMPLE 0 69005 PR DRAIN EXT EAR 455.0 ABSC/BLOOD,COMPLIC 0 69020 PR DRAIN EXT AUD CANAL ABSCESS 584.0 0 69090 PR PIERCE 68.00 69100 PR BIOPSY OF EXTERNAL 233.0 EAR 0 69105 PR BIOPSY OF EXT AUDITORY CANAL 299.0 0 69110 PR REMOVAL EXTERNAL EAR,PARTIAL 963.0 0 69120 PR REMOVAL EXTERNAL EAR,TOTAL 882.0 0 69140 PR REMV EXT CANAL EXOSTOSIS 1900. 00 69145 PR REMV EXT CANAL SOFT TISSUE 699.0 LESN 0 69150 PR RAD EXCIS EXT CANAL 3702. LESN 00 69155 PR RAD EXCIS EXT CANAL LESN+NECK 4500. DISSEC 00 69200 PR REMV EXT CANAL FOREIGN BODY 273.0 0 69205 PR REMV EXT CANAL F.B.,GEN ANESTH 359.0 0 69209 PR REMOVAL IMPACTED CERUMEN 33.00 IRRIGATION/LVG UNILAT 69210 PR REMOVAL IMPACTED CERUMEN 113.0 INSTRUMENTATION UNILAT 0 69220 PR DEBRIDE MASTOID CAVITY,SIMPLE 287.0 0 69222 PR DEBRIDE MASTOID 468.0 CAVITY,COMPLEX 0 69300 PR OTOPLASTY PROTRUDING EAR 1216. W/WO SIZE RDCTJ 00 69310 PR RECONSTRUCTION,EXT AUDITORY 3338. CANAL 00 69320 PR REBUILD EXT AUD CANAL,CONG 7500 ANOMALY 69420 PR INCISION EARDRUM,ASPIR 400.0 0 69421 PR INCISION EARDRUM,ASPIR,GEN 420.0 ANESTH 0 69424 PR VENT TUBE REMVL REQ GEN 271.0 ANESTHESIA 0 69433 PR CREATE EARDRUM OPENING,LOCAL 507.0 ANESTH 0 69436 PR CREATE EARDRUM OPENING,GEN 519.0 ANESTH 0 69440 PR EXPLORATION OF 2358. 00 69501 PR MASTOIDECTOMY,SIMPLE 1920. 00 69502 PR MASTOIDECTOMY,COMPLETE 3450. 00 69505 PR MASTOIDECTOMY,MOD RADICAL 3161. 00 69511 PR 3161. MASTOIDECTOMY,RADICAL 00 69535 PR RESECT ,EXTERN 9487. APPRCH 00 69540 PR REMV AURAL POLYP 1423. 00 69550 PR REMV AURAL GLOMUS 3640. TUMOR,TRANSCANAL 00 69552 PR REMV AURAL GLOMUS 4468. TUMOR,TRANSMASTOID 00 69601 PR MASTOIDECT REVISN W COMPLETE 3698. REMVAL 00 69602 PR MASTOID REVISN ->MOD RAD 3861. MASTOIDECT 00 69603 PR MASTOID REVISN ->RAD 4408. MASTOIDECTOMY 00 69604 PR MASTOID REVISN 3943 ->TYMPANOPLASTY 69610 PR REPAIR TYMPANIC MEMBRANE 936.0 0 69620 PR MYRINGOPLASTY 1770. 00 69631 PR 5000. 00 69632 PR TYMPANOPLASTY,REBUILD OSSICUL 3079. CHAIN 00 69633 PR TYMPANOPLASTY,REBLD OSSIC 6500. CHAIN+PROS 00 69635 PR 3109. TYMPANOPLAS/ANTROTOMY 00 69636 PR TYMPANOPLAS/ANTROT,REBLD 4875. OSSIC CHAIN 00 69637 PR TYMPANOPLAS/ANTROT,REBLD 3152. OSSIC+PROST 00 69641 PR TYMPANOPLAS/MASTOIDECTOMY 3500. 00 69642 PR TYMPANOPLAS/MASTOIDEC,REBLD 3858. OSSICLES 00 69643 PR TYMPANOPLAS/MASTOIDEC,INTACT 3858. WALL 00 69644 PR TYMPANOPLAS/MASTOID,INTCT 3914. WALL,REBLD 00 69645 PR 3840. TYMPANOPLAS/MASTOIDEC,RADICAL/C 00 OMPLE 69646 PR 7575. TYMPANOPLAS/MASTOIDEC,RAD,REBLD 00 OSSI 69650 PR STAPES MOBILIZATION 2063. 00 69660 PR 2932. 00 69661 PR STAPEDECTOMY,FOOTPLATE DRILL 3258. OUT 00 69662 PR REVISE 4056. STAPEDECTOMY/STAPEDOTOMY 00 69666 PR REPAIR OVAL WINDOW FISTULA 2688. 00 69667 PR REPAIR ROUND WINDOW FISTULA 2688. 00 69670 PR MASTOID OBLITERATION 3320. 00 69710 PR IMPLANT/REPLACE HEAR AID,TEMP 2655. BONE 00 69711 PR REMOVE/REPAIR HEAR AID,TEMP 3015. BONE 00 69714 PR IMPLNT,TEMPORAL BONE,W/EXTRN 3308. STIM 00 69717 PR REPLCE IMPLNT,TEMPORAL 3527. BONE,W/EXTRN STIM 00 69718 PR REPLCE IMPLNT,TEMPORAL 4750. BONE,REMV MASTOID 00 69720 PR RELEASE ,LAT TO 4300. GANGLION 00 69740 PR REPAIR FACIAL NERVE,LAT TO 3407. GANGLION 00 69801 PR LABYRINTHOTOMY W PERFUSION 1602. VESTIBULOACTIVE 00 DRUGS,TRANSCRANIAL 69805 PR ENDOLYMPH SAC OPERATN,NO 3263. SHUNT 00 69806 PR ENDOLYMPH SAC OP W SHUNT 3263. 00 69905 PR EXCIS LABYRINTH,TRANSCANAL 3903. 00 69930 PR IMPLANT COCHLEAR 4468. DEVICE 00 69960 PR DECOMPRESS INTERN AUDITORY 7714. CANAL 00 69990 PR MICROSURG TECHNIQUES,REQ 1117. OPER MICROSCOPE 00 70015 PR CISTERNOGRAPHY,POS 26 206.0 CONTRAST 0 70030 PR X-RAY EYE FOR FOREIGN 26 30.00 BODY 70100 CHG X-RAY JAW <4 VW 84.00 70100 CHG X-RAY JAW <4 VW 26 31.00 70110 CHG X-RAY JAW 4+ VW 96.00 70110 CHG X-RAY JAW 4+ VW 26 43.00 70120 CHG X-RAY MASTOIDS <3 VW 26 31.00 70140 CHG X-RAY FACIAL BONES <3 VW 75.00 70140 CHG X-RAY FACIAL BONES <3 26 34.00 VW 70150 CHG X-RAY FACIAL BONES 3+ VW 104.0 0 70150 CHG X-RAY FACIAL BONES 3+ 26 45.00 VW 70160 PR X-RAY NASAL BONES 82.00 70160 PR X-RAY NASAL BONES 26 30.00 70190 PR X-RAY OPTIC FORAMEN 26 36.00 70200 CHG X-RAY ORBITS 106.0 0 70200 CHG X-RAY ORBITS 26 48.00 70200 CHG X-RAY ORBITS TC 73.00 70210 CHG X-RAY SINUSES <3 VW 26 30.00 70210 CHG X-RAY SINUSES <3 VW TC 57 70220 CHG X-RAY SINUSES 3+ VW 94.00 70220 CHG X-RAY SINUSES 3+ VW 26 43.00 70250 CHG X-RAY SKULL <4 VW 91.00 70250 CHG X-RAY SKULL <4 VW 26 41.00 7025F PR PT INFO IN REMIND SYSTEM W/ 0.00 TARGET DATE FOR NEXT MAMMO 70260 CHG X-RAY SKULL 4+ VW 115.0 0 70260 CHG X-RAY SKULL 4+ VW 26 58.00 70300 PR X-RAY TEETH SINGLE 20.00 70300 PR X-RAY TEETH SINGLE 26 20.00 70310 PR X-RAY TEETH PARTIAL 25.00 70328 PR X-RAY TMJ UNILAT 78.00 70328 PR X-RAY TMJ UNILAT 26 24.00 70330 PR X-RAY TMJ BILAT 118.0 0 70330 PR X-RAY TMJ BILAT 26 32.00 70332 PR X-RAY TMJ ARTHROGRAM 26 184.0 0 70336 PR MRI, TMJ 26 257.0 0 70355 PR ORTHOPANTOGRAM 53.00 70355 PR ORTHOPANTOGRAM 26 35.00 70360 PR X-RAY NECK SOFT TISSUE 61.00 70360 PR X-RAY NECK SOFT TISSUE 26 30.00 70371 PR SPEECH EVALUATION, COMPLEX 247 70450 PR CT SCAN,HEAD/BRAIN,W/O 26 148.0 CONTRAST MATL 0 70460 PR CT SCAN HEAD CONTRAST 26 197.0 0 70470 PR CT SCAN HEAD COMBO 26 221.0 0 70480 PR CT 26 222.0 SCAN,ORBIT/SELLA/POST 0 FOSSA/EAR,W/O 70481 PR CT SCAN SKULL 26 239.0 CONTRAST 0 70482 PR CT SCAN SKULL COMBO 26 251.0 0 70486 PR CT SCAN,MAXILLOFACIAL 26 221.0 AREA,W/O CONTRAST 0 70487 PR CT SCAN, FACE/JAW 26 227.0 CONTRAST 0 70488 PR CT SCANS FACE/JAW 26 246.0 COMBO 0 70490 PR CT SCAN,SOFT TISSUE 26 222.0 NECK,W/O CONTRAST 0 70491 PR CT NECK TISSUE 26 239.0 CONTRAST 0 70492 PR CT NECK TISSUE COMBO 26 251.0 0 70496 PR CT ANGIO,HEAD 26 314.0 COMBO,INCL IMAGE 0 PROCESS 70498 PR CT ANGIO,NECK 26 314.0 COMBO,INCL IMAGE 0 PROCESS 70540 PR MRI, FACE, NECK 26 233.0 0 70542 PR MRI, FACE, NECK 26 280.0 W/CONTRAST 0 70543 PR MRI, FACE, NECK, COMBO 26 371.0 0 70544 PR MR ANGIO, HEAD 26 208.0 0 70545 PR MR ANGIO, HEAD 26 208.0 W/CONTRAST 0 70546 PR MR ANGIO, HEAD, COMBO 26 312.0 0 70547 PR MR ANGIO, NECK 26 208.0 0 70548 PR MR ANGIO, NECK 26 208.0 W/CONTRAST 0 70549 PR MR ANGIO, NECK, COMBO 26 312.0 0 70551 PR MRI BRAIN 26 257.0 0 70552 PR MRI BRAIN CONTRAST 26 311.0 0 70553 PR MRI BRAIN COMBO 26 409.0 0 70554 PR FUNCTIONAL MRI BRAIN 26 239.0 BY TECH 0 70555 PR FUNCTIONAL MRI BRAIN 26 414.0 BY PHYS/PSYCH 0 70557 PR MRI BRAIN W/O DYE 26 433.0 0 70558 PR MRI BRAIN W/ DYE 26 400.0 0 70559 PR MRI BRAIN W/O & W/ DYE 26 404.0 0 71010 PR CHEST X-RAY 1 VW 57.00 71010 PR CHEST X-RAY 1 VW 26 31.00 71020 CHG CHEST X-RAY 2 VW 77.00 71020 CHG CHEST X-RAY 2 VW 26 39.00 71021 CHG CHEST X-RAY W APICAL 26 46.00 LORD 71022 CHG CHEST X-RAY W 26 54.00 OBLIQUES 71023 CHG CHEST X-RAY W FLUORO 26 67.00 71030 CHG CHEST X-RAY 4 VW 26 51.00 71035 PR CHEST X-RAY SPEC VIEWS 86.00 71035 PR CHEST X-RAY SPEC VIEWS 26 31.00 71045 CHG RADIOLOGIC EXAM CHEST SINGLE 51.00 VIEW 71045 CHG RADIOLOGIC EXAM 26 24.00 CHEST SINGLE VIEW 71045 CHG RADIOLOGIC EXAM TC 27.00 CHEST SINGLE VIEW 71046 CHG RADIOLOGIC EXAM CHEST 2 78.00 VIEWS 71046 CHG RADIOLOGIC EXAM 26 28.00 CHEST 2 VIEWS 71047 CHG RADIOLOGIC EXAM CHEST 3 99.00 VIEWS 71047 CHG RADIOLOGIC EXAM 26 36.00 CHEST 3 VIEWS 71048 CHG RADIOLOGIC EXAM CHEST 4+ 107.0 VIEWS 0 71048 CHG RADIOLOGIC EXAM 26 42.00 CHEST 4+ VIEWS 71100 CHG X-RAY RIBS 2 VW UNILAT 74.00 71100 CHG X-RAY RIBS 2 VW UNILAT 26 39.00 71100 CHG X-RAY RIBS 2 VW UNILAT TC 55.00 71101 CHG X-RAY RIBS, CHEST 3+ 89.00 VW 71101 CHG X-RAY RIBS, CHEST 3+ 26 46.00 VW 71101 CHG X-RAY RIBS, CHEST 3+ TC 65.00 VW 71110 CHG X-RAY RIBS 3 VW BILAT 26 46.00 71110 CHG X-RAY RIBS 3 VW BILAT TC 67.00 71111 CHG X-RAY RIBS, CHEST 4+ 128.0 VW 0 71111 CHG X-RAY RIBS, CHEST 4+ 26 55.00 VW 71111 CHG X-RAY RIBS, CHEST 4+ TC 91.00 VW 71120 CHG X-RAY STERNUM 2+ VW 76.00 71120 CHG X-RAY STERNUM 2+ VW 26 35.00 71120 CHG X-RAY STERNUM 2+ VW TC 53.00 71130 CHG X-RAY STERNO- 26 39.00 CLAVICLUAR JT 71130 CHG X-RAY STERNO- TC 64.00 CLAVICLUAR JT 71250 PR CT SCAN,THORAX,W/O 26 202.0 CONTRAST 0 71260 PR CAT SCAN OF CHEST 26 214.0 CONTRAST 0 71270 PR CAT SCAN OF CHEST 26 239.0 COMBO 0 71275 PR CT ANGIO, CHEST (NON- 26 343.0 CORON), COMBO, INCL IMG 0 PROC 71550 PR MRI, CHEST 26 251.0 0 71551 PR MRI, CHEST, W/CONTRAST 26 298.0 0 71552 PR MRI, CHEST, COMBO 26 381.0 0 71555 PR MR ANGIO CHEST (MRA) 26 315.0 0 72020 PR X-RAY SPINE ONE VIEW 67.00 72020 PR X-RAY SPINE ONE VIEW 26 26.00 72020 PR X-RAY SPINE ONE VIEW TC 38.00 72040 CHG RADEX SPINE CERVICAL 2 OR 3 92.00 VIEWS 72040 CHG RADEX SPINE CERVICAL 26 39.00 2 OR 3 VIEWS 72040 CHG RADEX SPINE CERVICAL TC 59.00 2 OR 3 VIEWS 72050 CHG RADEX SPINE CERVICAL 4 OR 5 120.0 VIEWS 0 72050 CHG RADEX SPINE CERVICAL 26 54.00 4 OR 5 VIEWS 72050 CHG RADEX SPINE CERVICAL TC 80.00 4 OR 5 VIEWS 72052 CHG RADEX SPINE CERVICAL 6 OR 150.0 MORE VIEWS 0 72052 CHG RADEX SPINE CERVICAL 26 64.00 6 OR MORE VIEWS 72052 CHG RADEX SPINE CERVICAL TC 107.0 6 OR MORE VIEWS 0 72070 CHG X-RAY THORACIC SPINE 2 VW 79.00 72070 CHG X-RAY THORACIC SPINE 26 39.00 2 VW 72070 CHG X-RAY THORACIC SPINE TC 57.00 2 VW 72072 CHG X-RAY THORACIC SPINE+SWIM 3 87.00 VW 72072 CHG X-RAY THORACIC 26 39.00 SPINE+SWIM 3 VW 72072 CHG X-RAY THORACIC TC 65.00 SPINE+SWIM 3 VW 72074 CHG X-RAY THORACIC SPINE 4 VW 107.0 0 72074 CHG X-RAY THORACIC SPINE 26 39.00 4 VW 72074 CHG X-RAY THORACIC SPINE TC 82.00 4 VW 72080 CHG RADEX SPINE THORACOLUMBAR 88.00 JUNCTION MIN 2 VIEWS 72080 CHG RADEX SPINE 26 39.00 THORACOLUMBAR JUNCTION MIN 2 VIEWS 72080 CHG RADEX SPINE TC 60.00 THORACOLUMBAR JUNCTION MIN 2 VIEWS 72081 CHG RADEX ENTIR THRC LMBR CRV 98.00 SAC SPI W/SKULL 1 VW 72081 CHG RADEX ENTIR THRC 26 34.00 LMBR CRV SAC SPI W/SKULL 1 VW 72081 CHG RADEX ENTIR THRC TC 63.00 LMBR CRV SAC SPI W/SKULL 1 VW 72082 CHG RADEX ENTIR THRC LMBR CRV 156.0 SAC SPI W/SKULL 2/3 VW 0 72082 CHG RADEX ENTIR THRC 26 42.00 LMBR CRV SAC SPI W/SKULL 2/3 VW 72082 CHG RADEX ENTIR THRC TC 116.0 LMBR CRV SAC SPI W/SKULL 0 2/3 VW 72083 CHG RADEX ENTIR THRC LMBR CRV 169.0 SAC SPI W/SKULL 4/5 VW 0 72083 CHG RADEX ENTIR THRC 26 45.00 LMBR CRV SAC SPI W/SKULL 4/5 VW 72083 CHG RADEX ENTIR THRC TC 142.0 LMBR CRV SAC SPI W/SKULL 0 4/5 VW 72084 CHG RADEX ENTIR THRC LMBR CRV 201.0 SAC SPI W/SKULL 6/> VW 0 72084 CHG RADEX ENTIR THRC 26 52.00 LMBR CRV SAC SPI W/SKULL 6/> VW 72084 CHG RADEX ENTIR THRC TC 165.0 LMBR CRV SAC SPI W/SKULL 0 6/> VW 72100 CHG X-RAY LUMBAR SPINE 2/3 VW 87.00 72100 CHG X-RAY LUMBAR SPINE 26 39.00 2/3 VW 72100 CHG X-RAY LUMBAR SPINE TC 60.00 2/3 VW 72110 CHG X-RAY LUMBAR SPINE 4 VW 120.0 0 72110 CHG X-RAY LUMBAR SPINE 4 26 54.00 VW 72110 CHG X-RAY LUMBAR SPINE 4 TC 83.00 VW 72114 PR RADEX SPINE LUMBSCRL 26 64.00 COMPL W/BENDING VIEWS MIN 6 72114 PR RADEX SPINE LUMBSCRL TC 115.0 COMPL W/BENDING VIEWS 0 MIN 6 72120 PR RADEX SPINE LUMBOSACRAL ONLY 102.0 BENDING 2/3 VIEWS 0 72120 PR RADEX SPINE 26 29.00 LUMBOSACRAL ONLY BENDING 2/3 VIEWS 72120 PR RADEX SPINE TC 74.00 LUMBOSACRAL ONLY BENDING 2/3 VIEWS 72125 PR CT SCAN,CERVICAL 26 202.0 SPINE,W/O CONTRAST 0 72126 PR CT SCAN CERV SPINE 26 211.0 CONTRAST 0 72127 PR CT SCAN CERV SP COMBO 26 148.0 0 72128 PR CT SCAN,THORACIC 26 135.0 SPINE,W/O CONTRAST 0 72129 PR CT SCAN DORSAL SP 26 142.0 CONTRAST 0 72130 PR CT SCAN DORSAL SP 26 148.0 COMBO 0 72131 PR CT SCAN,LUMBAR 26 135.0 SPINE,W/O CONTRAST 0 72132 PR CT SCAN LUMBAR SP 26 142.0 CONTRAST 0 72133 PR CT SCAN LUMBAR SP 26 148.0 COMBO 0 72141 PR MRI, CERV SPINE 26 186.0 0 72142 PR MRI, CERV SPINE 26 225.0 CONTRAST 0 72146 PR MRI, DORSAL SPINE 26 186.0 0 72147 PR MRI, DORSAL SPINE 26 224.0 CONTRAST 0 72148 PR MRI, LUMBAR SPINE 26 173.0 0 72149 PR MRI, LUMBAR SPINE 26 208.0 CONTRAST 0 72156 PR MRI, CERV SPINE COMBO 26 298.0 0 72157 PR MRI, DORSAL SPINE 26 298.0 COMBO 0 72158 PR MRI, LUMBAR SPINE 26 274.0 COMBO 0 72159 PR MR ANGIO SPINE (MRA) 26 215.0 0 72170 CHG X-RAY PELVIS 1/2 VW 68.00 72170 CHG X-RAY PELVIS 1/2 VW 26 21.00 72170 CHG X-RAY PELVIS 1/2 VW TC 58.00 72190 CHG X-RAY PELVIS 3+ VW 101.0 0 72190 CHG X-RAY PELVIS 3+ VW 26 25.00 72191 PR CT ANGIO, PELVIS, 26 211.0 COMBO, INCL IMAGE PROC 0 72192 PR CT SCAN,PELVIS,W/O 26 127.0 CONTRAST 0 72193 PR CT SCAN OF PELVIS 26 135.0 CONTRAST 0 72194 PR CT SCAN OF PELVIS 26 142.0 COMBO 0 72195 PR MRI, PELVIS, W/O 26 170.0 CONTRAST 0 72196 PR MRI, PELVIS W/CONTRAST 26 202.0 0 72197 PR MRI, PELVIS, COMBO 26 262.0 0 72198 PR MR ANGIO PELVIS(MRA) 26 209.0 0 72200 CHG X-RAY SACROILIAC JTS <3 VW 71.00 72200 CHG X-RAY SACROILIAC JTS 26 23.00 <3 VW 72202 CHG X-RAY SACROILIAC JTS 3+ VW 84.00 72202 CHG X-RAY SACROILIAC JTS 26 22.00 3+ VW 72220 CHG X-RAY SACRUM/COCCYX 2+ VW 70.00 72220 CHG X-RAY SACRUM/COCCYX 26 21.00 2+ VW 72220 CHG X-RAY SACRUM/COCCYX TC 50.00 2+ VW 72240 PR MYELOGRAPHY CERV 26 105.0 SPINE 0 72275 PR 26 100.0 EPIDUROGRAPHY,SUPERV/IN 0 TERPRET 72285 PR X- 26 151.0 RAY,C/T,DISC,SUPERV/INTER 0 PRET 73000 PR X-RAY CLAVICLE 69.00 73000 PR X-RAY CLAVICLE 26 19.00 73000 PR X-RAY CLAVICLE TC 51.00 73010 PR X-RAY SCAPULA 78.00 73010 PR X-RAY SCAPULA 26 21.00 73010 PR X-RAY SCAPULA TC 55.00 73020 CHG X-RAY SHOULDER 1 VW 57.00 73020 CHG X-RAY SHOULDER 1 VW 26 18.00 73020 CHG X-RAY SHOULDER 1 VW TC 40.00 73030 CHG X-RAY SHOULDER 2+ VW 72.00 73030 CHG X-RAY SHOULDER 2+ VW 26 22.00 73030 CHG X-RAY SHOULDER 2+ VW TC 51.00 73040 PR ARTHROGRAM OF 26 64.00 SHOULDER 73050 PR X-RAY AC JTS 98.00 73050 PR X-RAY AC JTS 26 24.00 73050 PR X-RAY AC JTS TC 70.00 73060 CHG X-RAY HUMERUS 68.00 73060 CHG X-RAY HUMERUS 26 21.00 73060 CHG X-RAY HUMERUS TC 52.00 73070 CHG X-RAY ELBOW 2 VW 68.00 73070 CHG X-RAY ELBOW 2 VW 26 18.00 73080 CHG X-RAY ELBOW 3+ VW 79.00 73080 CHG X-RAY ELBOW 3+ VW 26 21.00 73080 CHG X-RAY ELBOW 3+ VW TC 61.00 73085 PR ARTHROGRAM OF ELBOW 26 64.00 73090 CHG X-RAY FOREARM 2 VW 68.00 73090 CHG X-RAY FOREARM 2 VW 26 19.00 73090 CHG X-RAY FOREARM 2 VW TC 48.00 73092 CHG X-RAY ARM, INFANT 79.00 73092 CHG X-RAY ARM, INFANT 26 19.00 73092 CHG X-RAY ARM, INFANT TC 50.00 73100 CHG X-RAY WRIST 2 VW 75.00 73100 CHG X-RAY WRIST 2 VW 26 19.00 73110 CHG X-RAY WRIST 3+ VW 88.00 73110 CHG X-RAY WRIST 3+ VW 26 21.00 73115 PR ARTHROGRAM OF WRIST 26 64.00 73120 CHG X-RAY HAND 2 VW 65.00 73120 CHG X-RAY HAND 2 VW 26 19.00 73130 CHG X-RAY HAND 3+ VW 77.00 73130 CHG X-RAY HAND 3+ VW 26 21.00 73140 CHG X-RAY EXAM OF 82.00 FINGER(S) 73140 CHG X-RAY EXAM OF 26 16.00 FINGER(S) 73140 CHG X-RAY EXAM OF TC 64.00 FINGER(S) 73200 PR CT SCAN,UPPER 26 127.0 EXTREMITY,W/O CONTRAST 0 73201 PR CT SCAN OF ARM 26 135.0 CONTRAST 0 73202 PR CT SCAN OF ARM COMBO 26 142.0 0 73206 PR CT ANGIO,UPPER 26 211.0 EXTREM,COMBO 0 73218 PR MRI, UPPER EXTREM 26 157.0 0 73219 PR MRI, UPPER EXTREM 26 189.0 W/CONTRAST 0 73220 PR MRI UPPER EXTR, 26 250.0 W/CONTRAST 0 73221 PR MRI, JOINT UPPER 26 157.0 EXTREM 0 73222 PR MRI, JOINT UPPER 26 189.0 EXTREM W/CONTRAST 0 73223 PR MRI, JOINT UPPER 26 250.0 EXTREM COMBO 0 73225 PR MR ANGIO UPPER EXTREM 26 207.0 0 73501 CHG RADEX HIP UNILATERAL WITH 76.00 PELVIS 1 VIEW 73501 CHG RADEX HIP UNILATERAL 26 25.00 WITH PELVIS 1 VIEW 73501 CHG RADEX HIP UNILATERAL TC 52.00 WITH PELVIS 1 VIEW 73502 CHG RADEX HIP UNILATERAL WITH 104.0 PELVIS 2-3 VIEWS 0 73502 CHG RADEX HIP UNILATERAL 26 29.00 WITH PELVIS 2-3 VIEWS 73502 CHG RADEX HIP UNILATERAL TC 76.00 WITH PELVIS 2-3 VIEWS 73503 CHG RADEX HIP UNILATERAL WITH 130.0 PELVIS MINIMUM 4 VIEWS 0 73503 CHG RADEX HIP UNILATERAL 26 37.00 WITH PELVIS MINIMUM 4 VIEWS 73521 CHG RADEX HIPS BILATERAL WITH 101.0 PELVIS 2 VIEWS 0 73521 CHG RADEX HIPS BILATERAL 26 30.00 WITH PELVIS 2 VIEWS 73521 CHG RADEX HIPS BILATERAL TC 70.00 WITH PELVIS 2 VIEWS 73522 CHG RADEX HIPS BILATERAL WITH 123.0 PELVIS 3-4 VIEWS 0 73522 CHG RADEX HIPS BILATERAL 26 39.00 WITH PELVIS 3-4 VIEWS 73522 CHG RADEX HIPS BILATERAL TC 85.00 WITH PELVIS 3-4 VIEWS 73523 CHG RADEX HIPS BILATERAL WITH 143.0 PELVIS MINIMUM 5 VIEWS 0 73523 CHG RADEX HIPS BILATERAL 26 42.00 WITH PELVIS MINIMUM 5 VIEWS 73523 CHG RADEX HIPS BILATERAL TC 102.0 WITH PELVIS MINIMUM 5 0 VIEWS 73525 PR ARTHROGRAM OF HIP 26 65.00 73551 CHG RADIOLOGIC EXAMINATION FEMUR 70.00 1 VIEW 73551 CHG RADIOLOGIC 26 22.00 EXAMINATION FEMUR 1 VIEW 73551 CHG RADIOLOGIC TC 49.00 EXAMINATION FEMUR 1 VIEW 73552 CHG RADIOLOGIC EXAMINATION FEMUR 82.00 MINIMUM 2 VIEWS 73552 CHG RADIOLOGIC 26 25.00 EXAMINATION FEMUR MINIMUM 2 VIEWS 73552 CHG RADIOLOGIC TC 59.00 EXAMINATION FEMUR MINIMUM 2 VIEWS 73560 CHG X-RAY KNEE 1 OR 2 VIEW 73.00 73560 CHG X-RAY KNEE 1 OR 2 VIEW 26 21.00 73560 CHG X-RAY KNEE 1 OR 2 VIEW TC 57.00 73562 CHG X-RAY KNEE 3 VIEW 88.00 73562 CHG X-RAY KNEE 3 VIEW 26 22.00 73562 CHG X-RAY KNEE 3 VIEW TC 67.00 73564 CHG X-RAY KNEE 4+ VIEW 106.0 0 73564 CHG X-RAY KNEE 4+ VIEW 26 26.00 73564 CHG X-RAY KNEE 4+ VIEW TC 77.00 73565 PR X-RAY KNEE BILAT STANDING 84.00 73565 PR X-RAY KNEE BILAT 26 21.00 STANDING 73580 PR ARTHROGRAM OF KNEE 26 64.00 JOINT 73590 CHG X-RAY TIB + FIB, 2VW 72.00 73590 CHG X-RAY TIB + FIB, 2VW 26 21.00 73590 CHG X-RAY TIB + FIB, 2VW TC 51.00 73592 CHG X-RAY LEG, INFANT 69.00 73592 CHG X-RAY LEG, INFANT 26 19.00 73592 CHG X-RAY LEG, INFANT TC 50.00 73600 CHG X-RAY ANKLE 2 VW 68.00 73600 CHG X-RAY ANKLE 2 VW 26 19.00 73600 CHG X-RAY ANKLE 2 VW TC 54.00 73610 CHG X-RAY ANKLE 3+ VW 81.00 73610 CHG X-RAY ANKLE 3+ VW 26 21.00 73610 CHG X-RAY ANKLE 3+ VW TC 61.00 73620 CHG X-RAY FOOT 2 VW 67.00 73620 CHG X-RAY FOOT 2 VW 26 19.00 73620 CHG X-RAY FOOT 2 VW TC 48.00 73630 CHG X-RAY FOOT 3+ VW 77.00 73630 CHG X-RAY FOOT 3+ VW 26 21.00 73630 CHG X-RAY FOOT 3+ VW TC 50.00 73650 CHG X-RAY HEEL 69.00 73650 CHG X-RAY HEEL 26 19.00 73660 CHG X-RAY TOE(S) 68.00 73660 CHG X-RAY TOE(S) 26 16.00 73660 CHG X-RAY TOE(S) TC 58.00 73700 PR CT SCAN,LOWER 26 127.0 EXTREMITY,W/O CONTRAST 0 73701 PR CT SCAN OF LEG 26 135.0 CONTRAST 0 73702 PR CT SCAN OF LEG COMBO 26 142.0 0 73706 PR CT ANGIO,LOWER 26 222.0 EXTREM,COMBO,IMAGE PRC 0 73718 PR MRI, LOWER EXTREM 26 157.0 0 73719 PR MRI, LOWER EXTREM 26 188.0 W/CONTRAST 0 73720 PR MRI, LOWER EXTR, W/O 26 249.0 CONTRAST F/U BY CONTRAST 0 73721 PR MRI LOWER EXTREM JT, 26 157.0 W/O CONTRAST 0 73722 PR MRI, JOINT OF LEG 26 189.0 W/CONTRAST 0 73723 PR MRI, JOINT OF LEG. 26 250.0 COMBO 0 73725 PR MR ANGIO LOWER 26 212.0 EXTREM (MRA) 0 74000 PR X-RAY ABDOMEN 1 VW 60.00 74000 PR X-RAY ABDOMEN 1 VW 26 22.00 74010 PR X-RAY ABDOMEN 1+ VW 26 28.00 74018 CHG RADIOLOGIC EXAM ABDOMEN 1 70.00 VIEW 74018 CHG RADIOLOGIC EXAM 26 24.00 ABDOMEN 1 VIEW 74018 CHG RADIOLOGIC EXAM TC 46.00 ABDOMEN 1 VIEW 74019 CHG RADIOLOGIC EXAM ABDOMEN 2 85.00 VIEWS 74019 CHG RADIOLOGIC EXAM 26 30.00 ABDOMEN 2 VIEWS 74019 CHG RADIOLOGIC EXAM TC 55.00 ABDOMEN 2 VIEWS 74020 PR X-RAY ABDOMEN 2 VW 90.00 74020 PR X-RAY ABDOMEN 2 VW 26 32.00 74021 CHG RADIOLOGIC EXAM ABDOMEN 3+ 99.00 VIEWS 74021 CHG RADIOLOGIC EXAM 26 36.00 ABDOMEN 3+ VIEWS 74021 CHG RADIOLOGIC EXAM TC 63.00 ABDOMEN 3+ VIEWS 74022 PR X-RAY ABDOMEN,COMP ACUTE 117.0 SERIES 0 74022 PR X-RAY ABDOMEN,COMP 26 37.00 ACUTE SERIES 74022 PR X-RAY ABDOMEN,COMP TC 81.00 ACUTE SERIES 74150 PR CT SCAN,ABDOMEN,W/O 26 138.0 CONTRAST 0 74160 PR CT SCAN OF ABDOMEN 26 148.0 CONTRAST 0 74170 PR CT SCAN OF ABDOMEN 26 163.0 COMBO 0 74174 PR CT ANGIO ABD&PLVIS 26 260.0 CNTRST MTRL W/WO CNTRST 0 IMGES 74175 PR CT ANGIO, ABD, 26 221.0 COMBO,INCL IMAGE PROC 0 74176 CHG CT SCAN,ABDOMENT 26 208.0 AND PELVIS,W/O CONTRAST 0 74177 PR CT SCAN,ABDOMEN AND 26 218.0 PELVIS,W CONTRAST 0 74178 CHG CT SCAN,ABDOMENT 26 241.0 AND PELVIS,COMBO 0 74181 PR MRI, ABDOMEN (MRI) 26 169.0 0 74182 PR MRI, ABDOMEN 26 202.0 W/CONTRAST 0 74183 PR MRI, ABDOMEN, COMBO 26 262.0 0 74185 PR MR ANGIO ABDOMEN 26 209.0 (MRA) 0 74190 PR X-RAY PERITONEUM 26 57.00 74210 PR CONTRAST XRAY 26 43.00 THROAT/CERV ESOPHA 74220 PR ESOPHAGRAM 26 54.00 74230 PR SWALLOWING FCN,W/CINE 26 62.00 &/OR VIDEO 74240 CHG RADEX GI TRACT UPPER 26 80.00 W/WO DELAYED IMAGES W/O KUB 74241 CHG RADEX GI TRACT UPPER 26 80.00 W/WO DELAYED IMAGES W/KUB 74245 CHG RADEX GI TRACT UPR 26 106.0 W/SM INT W/MULT SERIAL 0 IMAGES 74246 CHG RADEX UPPER GI W/WO 26 80.00 GLUCAGON/DELAY IMGES W/O KUB 74247 CHG RADEX UPPER GI W/WO 26 80.00 GLUCAGON/DELAY IMAGES W/KUB 74249 CHG X-RAY,UPPER GI TRACT 26 106.0 W/CONT,SMALL INTEST 0 74250 CHG RADEX SMALL 26 55.00 INTESTINE W/MULTIPLE SERIAL IMAGES 74261 CHG CT COLONOGRAPHY INC 26 267.0 IMAGE PROCESS, 0 DIAGNOSTIC, W/O CONTRAST 74262 CHG CT COLONOGRAPHY INC 26 293.0 IMAGE PROCESS, 0 DIAGNOSTIC, W/ CONTRAST 74263 CHG CT COLONOGRAPHY INC 26 279.0 IMAGE PROCESS, SCREENING 0 74270 CHG X-RAY COLON 26 80.00 CONTRAST 74280 PR X-RAY COLON AIR 26 115.0 CONTRAST 0 74283 PR X-RAY B.E. REDUCTN 26 235.0 INTUSS 0 74300 PR X-RAY OPER 26 43.00 CHOLANGIOGRAM 74328 PR X-RAY FOR BILE DUCT 26 82.00 ENDOSCOPY 74329 PR X-RAY FOR PANCREAS 26 82.00 ENDOSCOPY 74330 PR X-RAY BILE/PANCREAS 26 105.0 ENDOSCOPY 0 74340 CHG INTRO LONG GI TUBE 26 64.00 W/MULT FLUORO & IMAGES RS&I 74360 PR X-RAY GUIDE, GI DILATION 26 66.00 74363 PR PERCUT TRANSHEPAT 26 102.0 DILAT,BILE DUCT STRICT 0 74400 PR X-RAY IV PYELOGRAM 276.0 (IVP) 0 74400 PR X-RAY IV PYELOGRAM 26 63.00 (IVP) 74420 PR X-RAY RETROGRADE 26 46.00 PYELOGRAM 74425 PR X-RAY ANTEGRADE 26 43.00 PYELOGRAM TUBE 74430 X-RAY CYSTOGRAM, MIN 3 26 38.00 VIEW 74445 PR X-RAY PENIS 26 137.0 0 74450 PR X-RAY 26 43.00 URETHROCYSTOGRAM 74455 PR X-RAY 26 40.00 URETHROCYSTOGRAM+VOIDI NG 74485 PR X-RAY GUIDE, GU 26 64.00 DILATION 74712 CHG FETAL MRI W/PLACNTL 26 384.0 MATRNL PLVC IMG SING/1ST 0 GES 74740 PR X-RAY 26 45.00 HYSTEROSALPINGOGRAM 75557 CHG CARDIAC MRI 26 302 MORPHOLOGY & FUNCTION W/O CONTRAST 75559 CHG CARDIAC MRI W/O 26 374 CONTRAST W STRESS IMAGING 75561 CHG CARDIAC MRI W/W/O 26 335 CONTRAST & FURTHER SEQ 75563 CHG CARDIAC MRI W/W/O 26 383 CONTRAST W STRESS 75565 CHG CARDIAC MRI FOR 26 33 VELOCITY FLOW MAPPING 75571 CHG CT HEART W/O 26 74 CONTRAST QUANT EVAL CORONARY CALCIUM 75572 CHG CT HEART CONTRAST 26 227 EVAL CARDIAC STRUCT/MORPH 75573 CHG CT HEART CONTRAST 26 330 EVAL CARDIAC STRUCT/MORPH, CONGEN HEART DISEASE 75574 PR CT ANGIO HRT CORNRY 26 310 ART/BYPASS GRFTS CONTRST 3D POST 75600 PR ANGIO AORTOGRAM 26 65.00 THORACIC 75605 PR ANGIO AORTOGRAM THOR 26 196.0 SERIAL 0 75625 PR ANGIO AORTOGRAM ABD 26 146.0 SERIAL 0 75630 PR ANGIO AORTOBIFEMORAL 26 216.0 W CATH 0 75635 PR CT ANGIO 26 281.0 AORTOBIFEMORAL, COMBO 0 75658 PR ANGIO RETRO BRACHIAL 26 159.0 ANGIO 0 75705 PR ANGIO SPINAL SELECTV 26 289.0 0 75710 PR ANGIO EXTREMITY UNILAT 26 147.0 0 75716 PR ANGIO EXTERMITY BILAT 26 167.0 0 75726 PR ANGIO VISCERAL 26 134.0 SELECTV/SUBSELEC 0 75731 PR ANGIO ADRENAL UNILAT 26 135.0 SELECT 0 75736 PR ANGIO PELVIS 26 135.0 0 75741 PR ANGIO PULMON UNILAT 26 154.0 SELECT 0 75743 PR ANGIO PULMON BILAT 26 193.0 SELECT 0 75756 PR ANGIO INTERN MAMMARY 26 203.0 0 75774 PR ANGIO EA ADDNL 26 43.00 SELECTV VESSEL 75791 CHG ANGIO AV SHUNT 26 201.0 COMPLETE EVAL 0 75801 PR LYMPHANGIO EXTREM 26 97.00 UNILAT 75803 PR LYMPHANGIO EXTREM 26 154.0 BILAT 0 75805 PR LYMPHANGIO ABD/PELV 26 96.00 UNILAT 75807 PR LYMPHANGIO ABD/PELV 26 136.0 BILAT 0 75809 PR NONVASCULAR 26 100.0 SHUNTOGRAM 0 75810 PR VENOGRAM 26 146.0 SPLENOPORTOGRAM 0 75820 PR VENOGRAM EXTREM 26 83.00 UNILAT 75822 PR VENOGRAM EXTREM 26 132.0 BILAT 0 75825 PR VENOGRAM INFER VENA 26 134.0 CAVA 0 75827 PR VENOGRAM SUPER VENA 26 133.0 CAVA 0 75831 PR VENOGRAM RENAL 26 133.0 UNILAT 0 75833 PR VENOGRAM RENAL BILAT 26 175.0 0 75840 PR VENOGRAM ADRENAL 26 137.0 UNILAT 0 75860 PR VENOGRAM 26 138.0 SINUS/JUGULAR 0 75870 PR VENOGRAM SUPER SAG 26 136.0 SINUS 0 75885 PR PERCUT XHEPATIC 26 168.0 PORTO+DYNAMIC 0 75887 PR PERCUT XHEPATIC 26 169.0 PORTOGRAM 0 75889 PR VENOGRAM HEPATIC W 26 133.0 HEMODYNAMICS 0 75891 PR VENOGRAM HEPATIC 377.0 0 75891 PR VENOGRAM HEPATIC 26 142.0 0 75893 PR VENOUS SAMPLING BY 26 64.00 CATHETER 75894 PR TRANSCATHETER RX 26 172.0 EMBOLIZATN 0 75898 CHG ANGRPH CATH F-UP STD 26 218.0 TCAT OTHER THAN 0 THROMBYLSIS 75901 PR REMOVE,OBST MATL,CVA 26 58.00 DEV VIA SEP VEN ACC 75902 PR REMOVE,OBST MATL,CVA 26 46.00 DEVICE VIA LUMEN 75952 PR ENDOVASC REPAIR AAA 26 560.0 0 75953 PR PLACEMNT,PROX/DIST 26 162.0 EXT PROS, INFRARENAL 0 75954 CHG REPAIR,ILIAC 26 260.0 ANRYSM/PSEUDO/AV 0 MALF/TRAUMA W/ ENDOPROSTHESIS 75956 PR ENDOVASC REPAIR THOR AORTA 855.0 INCL SUBCLAVIAN 0 75956 PR ENDOVASC REPAIR THOR 26 855.0 AORTA INCL SUBCLAVIAN 0 75957 PR ENDOVASC REPAIR THOR 26 733.0 AORTA EXCL SUBCLAVIAN 0 75958 PR PROXIMAL EXTENS 26 488.0 DURNG ENDOVASC REPR 0 THOR AORTA 75959 PR DELAYED PROX EXTENS 26 450.0 ENDOVASC REPR THOR 0 AORTA 75962 PR TRANSLUMINAL BALLOON 26 65.00 ANGIOP PERIPHERAL ART RSI 75966 PR BALLOON ANGIOPLASTY 26 159.0 VISCERAL 0 75968 PR BALLOON ANGIO ADDNL 26 44.00 VISCERAL 75970 PR VASCULAR BIOPSY 26 99.00 75978 PR BALLOON ANGIO VENOUS 26 64.00 75984 CHANGE PERCUT 26 84.00 TUBE/DRAIN CATH W CONTRAST MONIT 75989 PR RAD GUIDED,PERCUT 26 138.0 DRAINAGE,W/CATH PLACE 0 76000 CHG FLUOROSCOPY UP TO 1 26 121.0 HOUR PHYSICIAN/QHP TIME 0 76001 CHG FLUOROSCOPY SPX >1 26 80.00 HOUR PHYS/QHP TIME 76010 PR X-RAY NOSE-RECTUM 26 22.00 CHILD F.B. 76080 PR X-RAY 26 64.00 FISTULA,ABSCESS,SINUS TRACT 76098 PR X-RAY EXAM, BREAST 26 19.00 SPECIMEN 76120 PR 26 47.00 CINE/VIDEORADIOLOGY,EXC WHERE SPEC INCL 76140 PR X-RAY CONSULTATION 115.0 0 76376 CHG 3D RENDERING W/INTERP & 162.0 POSTPROCESS SUPERVISION 0 76376 CHG 3D RENDERING 26 25.00 W/INTERP & POSTPROCESS SUPERVISION 76377 CHG 3D RENDERING 212.0 W/INTERP&POSTPROC DIFF WORK 0 STATION 76377 CHG 3D RENDERING 26 96.00 W/INTERP&POSTPROC DIFF WORK STATION 76380 PR CT 26 114.0 SCAN,LIMITED/LOCALIZED F/U 0 STUDY 76390 PR MRI SPECTROSCOPY 26 162.0 0 76391 CHG MAGNETIC RESONANCE 601.0 ELASTOGRAPHY 0 76391 CHG MAGNETIC RESONANCE 26 143.0 ELASTOGRAPHY 0 76496 CHG UNLISTED 26 205.0 FLUOROSCOPIC PROCEDURE 0 76497 PR UNLISTED CT PROCEDURE 26 150.0 0 76498 PR UNLISTED MR 26 308.0 PROCEDURE 0 76499 CHG UNLISTED DX 26 100.0 RADIOGRAPHIC PROCEDURE 0 76506 US, HEAD, REAL TIME 26 78.00 76511 US, EYE A-SCAN 26 135.0 0 76512 US, EYE B-SCAN 26 135.0 0 76513 US, EYE,ANTERIOR 26 91.00 76514 US, EYE, FOR CORNEAL 26 25.00 THICKNESS 76516 US, EYE BIOMETRY 197.0 0 76516 US, EYE BIOMETRY 26 78.00 76519 US, EYE BIOMETRY W LENS CALC 212.0 0 76519 US, EYE BIOMETRY W LENS 26 80.00 CALC 76536 US, HEAD/NECK TISSUES,REAL TIME 302.0 0 76536 US, HEAD/NECK 26 64.00 TISSUES,REAL TIME 76604 US, CHEST,REAL TIME 26 63.00 76641 CHG US BREAST UNI REAL 26 91.00 TIME WITH IMAGE COMPLETE 76642 CHG US BREAST UNI REAL 26 85.00 TIME WITH IMAGE LIMITED 76700 US, ABDOM,B-SCAN &/OR 26 95.00 REAL TIME,COMPLETE 76705 US ABDOMEN LIMITED 270.0 0 76705 US ABDOMEN LIMITED 26 69.00 76706 CHG US ABDOMINAL AORTA REAL TIME 239.0 SCREEN STUDY AAA 0 76706 CHG US ABDOMINAL AORTA 26 71.00 REAL TIME SCREEN STUDY AAA 76770 PR US,RETROPERIT,REAL 321.0 TIME,COMPLETE 0 76770 PR US,RETROPERIT,REAL 26 87.00 TIME,COMPLETE 76775 US, RETROPERITNL ABD, LTD 259.0 0 76775 US, RETROPERITNL ABD, LTD 26 88.00 76776 PR US,TRANSPLANTED 26 87.00 KIDNEY, REAL TIME/ DOPPLER 76800 US, SPINAL CANAL & 26 151.0 CONTENTS 0 76801 US, OB < 14 WKS, SINGLE FETUS 310.0 0 76801 US, OB < 14 WKS, SINGLE 26 123.0 FETUS 0 76802 US, OB < 14 WKS, ADD'L 163.0 FETUS 0 76802 US, OB < 14 WKS, ADD'L 26 95.00 FETUS 76805 US, OB >/= 14 WKS, SNGL 358.0 FETUS 0 76805 US, OB >/= 14 WKS, SNGL 26 130.0 FETUS 0 76810 US, OB >/= 14 WKS, ADDL 26 145.0 FETUS 0 76811 PR US,PREG UTER,FET & MAT,+ DETL 464.0 FET EXM 0 76811 PR US,PREG UTER,FET & 26 225.0 MAT,+ DETL FET EXM 0 76812 PR US,PREG UTER,FET & 26 210.0 MAT,+ DETL FET,ADDL 0 76813 PR US,PREG UTER,NUCHAL MEAS, 1ST 303.0 TRIMEST, SINGLETON 0 76813 PR US,PREG UTER,NUCHAL 26 135.0 MEAS, 1ST TRIMEST, 0 SINGLETON 76814 PR US,PREG UTER,NUCHAL MEAS, 1ST 202.0 TRI,ADDL GEST 0 76814 PR US,PREG UTER,NUCHAL 26 115.0 MEAS, 1ST TRI,ADDL GEST 0 76815 CHG US,PREGNANT UTERUS,LIMITED, 219.0 1/> FETUSES 0 76815 CHG US,PREGNANT 26 90.00 UTERUS,LIMITED, 1/> FETUSES 76816 PR US,PREGNANT 288.0 UTERUS,F/U,TRANSABD APP 0 76816 PR US,PREGNANT 26 103.0 UTERUS,F/U,TRANSABD APP 0 76817 PR US,PREGNANT 247.0 UTERUS,TRANSVAGINAL 0 76817 PR US,PREGNANT 26 95.00 UTERUS,TRANSVAGINAL 76818 PR FETAL BIOPHYSICAL PROFILE 305.0 0 76818 PR FETAL BIOPHYSICAL 26 160.0 PROFILE 0 76819 PR FETAL BIOPHYS PROF,W/O NST 222.0 0 76819 PR FETAL BIOPHYS PROF,W/O 26 94.00 NST 76820 CHG US DOPPLER FETAL UMBILICAL 118.0 ARTERY 0 76820 CHG US DOPPLER FETAL 26 59.00 UMBILICAL ARTERY 76821 CHG US DOPPLER FETAL MID 26 240.0 CEREBRAL ARTERY 0 76825 ECHOCARDIOGRAPHY 691.0 FETAL,2D,COMPLT 0 76825 ECHOCARDIOGRAPHY 26 210.0 FETAL,2D,COMPLT 0 76826 ECHOCARDIOGRAPHY 410.0 FETAL,2D,F/U,REPT 0 76826 ECHOCARDIOGRAPHY 26 107.0 FETAL,2D,F/U,REPT 0 76827 FETAL ECHOCARDIOGRAPHY 191.0 DOPPLER,COMP 0 76827 FETAL ECHOCARDIOGRAPHY 26 86.00 DOPPLER,COMP 76828 FETAL ECHO DOPPLER F/U 134.0 0 76828 FETAL ECHO DOPPLER F/U 26 75.00 76830 PR ECHOGRAPHY,TRANSVAGINAL 305.0 0 76830 PR 26 80.00 ECHOGRAPHY,TRANSVAGINA L 76831 PR SONO EXAM, 26 160.0 HYSTEROSONOGRAPHY 0 76856 PR US,PELVIC (NONOBSTETRIC),REAL 300.0 TIME,COMPLETE 0 76856 PR US,PELVIC 26 81.00 (NONOBSTETRIC),REAL TIME,COMPLETE 76857 PR US,PELVIC 26 64.00 (NONOBSTETRIC),REAL TIME,LIMITED 76870 PR ECHO,SCROTUM & 26 82.00 CONTENTS 76872 PR ECHO,TRANSRECTAL 240.0 0 76872 PR ECHO,TRANSRECTAL 26 121.0 0 76873 PR ECHO,TRANSRECTAL,PROSTATE 195.0 VOL 0 76873 PR 26 195.0 ECHO,TRANSRECTAL,PROSTA 0 TE VOL 76881 CHG US COMPL JOINT R-T 26 71.00 W/IMAGE DOCUMENTATION 76882 CHG US LMTD JOINT/OTH NONVASC 91.00 XTR STRUX R-T W/IMG 76882 CHG US LMTD JOINT/OTH 26 63.00 NONVASC XTR STRUX R-T W/IMG 76885 CHG US INFT HIPS R-T IMG 26 86.00 DYNAMIC REQ PHYS/QHP MANJ 76886 CHG US INFT HIPS R-T IMG 26 72.00 LMTD STATIC PHYS/QHP MANJ 76930 PR SONO GUIDE PERICARD 26 84.00 TAP 76932 PR SONO GUIDE HEART 26 93.00 BIOPSY 76936 PR US GUID,COMP 26 244.0 REPAIR,PSEUDO-ANEUR/AV 0 FIST 76937 PR US GUIDE, VASCULAR ACCESS 85.00 76937 PR US GUIDE, VASCULAR 26 37.00 ACCESS 76940 PR US GUIDE, TISSUE 26 265.0 ABLATION 0 76941 PR SONO GUIDE INTRAUTER 26 163.0 XFUSN 0 76942 PR SONO GUIDE NEEDLE BIOPSY 487.0 0 76942 PR SONO GUIDE NEEDLE 26 100.0 BIOPSY 0 76945 PR SONO GUIDE CHOR VILL 26 81.00 SAMPLING 76946 PR SONO GUIDE 26 60.00 AMNIOCENTESIS 76965 PR SONO GUIDE RADIOELEMT 26 169.0 APPLIC 0 76975 PR GI ENDOSCOPIC ULTRASOUND 559.0 0 76975 PR GI ENDOSCOPIC 26 108.0 ULTRASOUND 0 76978 CHG ULTRASOUND TRGT DYNAMIC 828.0 MICROBUBBLE 1ST LESION 0 76978 CHG ULTRASOUND TRGT 26 208.0 DYNAMIC MICROBUBBLE 1ST 0 LESION 76979 CHG ULTRASOUND TRGT DYNAMIC 562.0 MICROBUBBLE EA ADDL LES 0 76979 CHG ULTRASOUND TRGT 26 110.0 DYNAMIC MICROBUBBLE EA 0 ADDL LES 76981 CHG ULTRASOUND ELASTOGRAPHY 274.0 PARENCHYMA 0 76981 CHG ULTRASOUND 26 77.00 ELASTOGRAPHY PARENCHYMA 76982 CHG ULTRASOUND ELASTOGRAPHY 246.0 FIRST TARGET LESION 0 76982 CHG ULTRASOUND 26 77.00 ELASTOGRAPHY FIRST TARGET LESION 76983 CHG ULTRASOUND ELASTOGRAPHY EA 151.0 ADDL TAGET LESION 0 76983 CHG ULTRASOUND 26 65.00 ELASTOGRAPHY EA ADDL TAGET LESION 76998 PR ULTRASONIC GUIDANCE, 26 152.0 INTRAOPERATIVE 0 76999 PR UNLISTED ULTRASOUND 26 3500. PROCEDURE 00 77001 PR FLUOROGUIDE CNTRL 26 45.00 VEN ACCESS,PLACE,REPLACE,RE MOVE 77002 CHG FLUOROSCOPIC GUIDANCE 239.0 NEEDLE PLACEMENT ADD ON 0 77002 CHG FLUOROSCOPIC 26 71.00 GUIDANCE NEEDLE PLACEMENT ADD ON 77003 CHG FLUOR NEEDLE/CATH 145.0 SPINE/PARASPINAL DX/THER ADDON 0 77003 CHG FLUOR NEEDLE/CATH 26 67.00 SPINE/PARASPINAL DX/THER ADDON 77011 PR CT GUIDANCE 26 155.0 STEREOTACTIC 0 LOCALIZATION 77012 PR CT GUIDANCE NEEDLE 26 135.0 PLACEMENT 0 77013 PR CT GUIDANCE TISSUE 26 467.0 ABLATION 0 77014 PR CT GUIDANCE 26 152.0 PLACEMENT RAD THERAPY 0 FIELDS 77021 PR MRI GUIDANCE NEEDLE 26 177.0 PLACEMENT 0 77022 PR MRI GUIDANCE TISSUE 26 547.0 ABLATION 0 77046 CHG MRI BREAST WITHOUT CONTRAST 633.0 MATERIAL UNILATERAL 0 77046 CHG MRI BREAST WITHOUT 26 186.0 CONTRAST MATERIAL 0 UNILATERAL 77047 CHG MRI BREAST WITHOUT CONTRAST 650.0 MATERIAL BILATERAL 0 77047 CHG MRI BREAST WITHOUT 26 206.0 CONTRAST MATERIAL 0 BILATERAL 77048 CHG MRI BREAST W/OUT&WITH 1005. CONTRAST W/CAD UNILATERAL 00 77048 CHG MRI BREAST 26 269.0 W/OUT&WITH CONTRAST 0 W/CAD UNILATERAL 77049 CHG MRI BREAST WITHOUT&WITH 1027. CONTRAST W/CAD BILATERAL 00 77049 CHG MRI BREAST 26 294.0 WITHOUT&WITH CONTRAST 0 W/CAD BILATERAL 77051 CHG COMPUTER-AIDED 26 8.00 DETECTION DX MAMMOGRAPHY 77052 CHG COMPUTER-AIDED 26 8.00 DETECTION SCREENING MAMMOGRAPHY 77053 PR MAMMARY DUCTOGRAM, 26 43.00 SINGLE 77055 PR MAMMOGRAPHY; 26 66.00 UNILATERAL 77056 PR MAMMOGRAPHY; 26 101.0 BILATERAL 0 77057 CHG SCREENING 26 81.00 MAMMOGRAPHY BILATERAL 77058 PR MRI BREAST, W/WO 26 189.0 CONTRAST, SINGLE 0 77059 PR MRI BREAST, W/WO 26 189.0 CONTRAST, BILATERAL 0 77061 CHG DIGITAL BREAST 26 107.0 TOMOSYNTHESIS 0 UNILATERAL 77062 CHG DIGITAL BREAST TOMOSYNTHESIS 423.0 BILATERAL 0 77062 CHG DIGITAL BREAST 26 123.0 TOMOSYNTHESIS BILATERAL 0 77063 CHG SCREENING DIGITAL 26 76.00 BREAST TOMOSYNTHESIS BI 77065 CHG DIAGNOSTIC 26 100.0 MAMMOGRAPHY COMPUTER- 0 AIDED DETCJ UNI 77066 CHG DIAGNOSTIC 26 109.0 MAMMOGRAPHY COMPUTER- 0 AIDED DETCJ BI 77067 CHG SCREENING 26 108.0 MAMMOGRAPHY BI 2-VIEW 0 BREAST INC CAD 77072 PR X-RAYS FOR BONE AGE 58.00 77072 PR X-RAYS FOR BONE AGE 26 22.00 77073 PR X-RAYS, BONE LENGTH 26 32.00 STUDIES 77074 PR X-RAYS, BONE SURVEY, 26 53.00 LIMITED 77075 PR X-RAYS, BONE SURVEY 26 64.00 COMPLETE 77076 PR X-RAYS, BONE SURVEY, 26 81.00 INFANT 77077 PR JOINT SURVEY, SINGLE VIEW 97.00 77077 PR JOINT SURVEY, SINGLE 26 41.00 VIEW 77078 PR CT BONE DENS STUDY, 1+ 26 29.00 SITE,AXIAL 77080 PR DEXA,BONE DENSITY,AXIAL 309.0 SKELETON 0 77080 PR DEXA,BONE 26 26.00 DENSITY,AXIAL SKELETON 77081 PR DEXA,BONE DENSITY,APPENDICULR 77.00 SKELTN 77081 PR DEXA,BONE 26 27.00 DENSITY,APPENDICULR SKELTN 77261 CHG RADIATION THERAPY PLAN SIMPLE 290.0 0 77262 CHG RADIATION THERAPY PLAN 286.0 INTERM 0 77263 CHG RADIATION THERAPY PLAN 648.0 COMPLEX 0 77280 CHG SET RADN THERAPY 26 190.0 FIELD SIMPLE 0 77290 CHG SET RADN THERAPY 26 315.0 FIELD COMPLEX 0 77293 CHG RESPIRATORY MOTION 26 257.0 MANAGEMENT SIMULATION 0 77295 CHG 3-D RADIOTHERAPY 26 919.0 PLAN DOSE-VOLUME 0 HISTOGRAMS 77300 CHG RADIATION 26 128.0 THERAPY,DOSIMETRY PLAN 0 77301 CHG INTEN MOD RADIOTHER 26 1613. PLAN W/DOSE VOL HIST 00 77306 CHG TELETHX ISODOSE PLN 26 177.0 SMPL W/DOSIMETRY 0 CALCULATION 77307 CHG TELETHX ISODOSE PLN 26 366.0 CPLX W/BASIC DOSIMETRY 0 77316 CHG BRACHYTX ISODOSE 26 177.0 PLN SMPL W/DOSIMETRY CAL 0 77317 CHG BRACHYTX ISODOSE 26 233.0 PLN INTERMED W/DOSIMETRY 0 CAL 77318 CHG BRACHYTX ISODOSE 26 367.0 PLN CPLX W/DOSIMETRY CAL 0 77321 CHG TELETHER ISO-PORT 26 191.0 PLAN 0 77331 CHG SPECIAL RADIATION 26 175.0 DOSIMETRY 0 77332 CHG RADN TREATMENT 26 109.0 AID(S) SIMPLE 0 77333 CHG RADN TREATMENT 26 169.0 AID(S) INTERM 0 77334 CHG RADN TREATMENT 26 250.0 AID(S) COMPLX 0 77338 CHG MLC IMRT DESIGN & 26 870.0 CONSTRUCTION PER IMRT 0 PLAN 77387 CHG GUIDANCE FOR LOC OF TARGET 187.0 VOL RADIAJ TX DLVR 0 77387 CHG GUIDANCE FOR LOC OF 26 60.00 TARGET VOL RADIAJ TX DLVR 77401 CHG RADIATION TX DELIVERY 51.00 SUPERFICIAL&/ORTHO VOLTA 77427 CHG RADIATION,MANGEMENT,5 TX'S 668.0 0 77431 CHG RADIATION THERAPY 379.0 MANAGEMENT 0 77432 CHG STEREOTACTIC RADIATION TX 2640. MANAGEMENT CRANIAL LESION 00 77435 CHG RADN RX DELIV,BODY, 2444. MANAGEMENT, PER COURSE 00 77470 PR SPECIAL TREATMENT 26 422.0 PROCEDURE 0 77767 CHG HDR RDNCL SKN SURF 26 138.0 BRACHYTX LES 2CM&2CHAN/MLT LES 77770 CHG HDR RDNCL 26 255.0 NTRSTL/INTRCAV BRACHYTX 0 1 CHANNEL 77771 CHG HDR RDNCL 26 497.0 NTRSTL/INTRCAV BRACHYTX 0 2-12 CHANNEL 77772 CHG HDR RDNCL 26 705.0 NTRSTL/INTRCAV 0 BRACHYTX >12 CHANNELS 77778 CHG INTERSTITIAL RADIATION 26 2253. SOURCE APPLIC COMPLEX 00 77789 CHG SURFACE APPLIC LOW 26 228.0 DOSE RATE RADIONUCLIDE 0 SOURCE 77799 PR RADIUM/RADIOISOTOPE 26 800.0 THERAPY UNLIST 0 78012 CHG THYROID UPTAKE 26 23.00 SINGLE/MULTIPLE QUANT MEASUREMENT 78013 CHG THYROID IMAGING WITH 26 44.00 VASCULAR FLOW 78014 CHG THYROID UPTAKE 26 59.00 W/BLOOD FLOW SNGLE/MULT QUAN MEAS 78015 PR THYROID MET IMAGING 26 79.00 LTD 78018 PR THYROID MET IMAGING 26 101.0 BODY 0 78020 PR THYROID MET UPTAKE 26 78.00 78070 CHG PARATHYROID PLANAR 26 97.00 IMAGING 78071 CHG PARATHYROID PLANAR 26 139.0 IMAGING W/WO 0 SUBTRACTION 78072 CHG PARATHYROID IMAGING 26 193.0 W/TOMOGRAPHIC SPECT & 0 CT 78102 PR BONE MARROW IMAGING, 26 64.00 LTD 78103 PR BONE MARROW IMAGING, 26 92.00 MULT 78195 PR LYMPHATICS & LYMPH 26 141.0 GLANDS IMAGING 0 78201 PR LIVER IMAGING 26 54.00 78202 PR LIVER IMAGING WITH 26 59.00 FLOW 78205 PR LIVER IMAGING (SPECT) 26 83.00 78206 PR LIVER IMAGE (3-D) 26 113.0 W/FLOW 0 78215 PR LIVER AND SPLEEN 26 58.00 IMAGING 78226 PR HEPATOBILIARY SYST 26 87.00 IMAGING INCLUDING GALLBLADDER 78227 PR HEPATOBIL SYST IMAG 26 105.0 INC GB W/PHARMA 0 INTERVENJ 78264 CHG GASTRIC EMPTYING 26 91.00 IMAGING STUDY 78278 PR ACUTE GI BLOOD LOSS 26 116.0 IMAGING 0 78290 PR BOWEL IMAGING 26 80.00 78300 PR BONE IMAGING, LIMITED 26 73.00 AREA 78305 PR BONE IMAGING, MULTIPLE 26 104.0 AREAS 0 78306 PR BONE IMAGING, WHOLE 26 101.0 BODY 0 78315 CHG BONE IMAGING, 3 PHASE 26 119.0 0 78320 PR BONE IMAGING (SPECT) 26 122.0 0 78350 CHG BONE MINERAL, SINGLE PHOTON 83.00 78350 CHG BONE MINERAL, SINGLE 26 28.00 PHOTON 78451 MYOCARDIAL 26 162.0 SPECT,SINGLE,REST OR 0 STRESS,EF,WALL MOTION 78452 MYOCARDIAL SPECT 26 192.0 MULTIPLE 0 STUDIES,REST,STRESS,BLOO D POOL IMAGING GTD 78459 PR HEART MUSCLE IMAGING 26 194.0 (PET) 0 78469 PR HEART INFARCT IMAGE 26 115.0 SPECT 0 78472 CARDIAC BLOOD POOL 26 117.0 IMAGING, PLANAR,SINGLE 0 78491 PR HEART IMAGE (PET) 26 184.0 SINGLE 0 78492 PR HEART IMAGE (PET) 26 229.0 MULTIPLE 0 78579 PR PULMONARY VENTILATION 26 61.00 IMAGING 78580 PR PULMONARY PERFUSION 26 87.00 IMAGING PARTICULATE 78582 PR PULMONARY VENTILATION 26 124.0 & PERFUSION IMAGING 0 78597 PR QUANT DIFFERENTIAL 26 86.00 PULM PERFUSION W/WO IMAGING 78598 PR QUANT DIFF PULM 26 97.00 PRFUSION & VENTLAJ W/WO IMAGING 78606 BRAIN IMAGING MIN 4 STATIC 26 75.00 VIEWS W VASCULAR FLOW 78607 BRAIN IMAGING 26 145.0 TOMOGRAPHIC SPECT 0 78608 PR BRAIN IMAGING PET 26 175.0 METABOLIC 0 78609 PR BRAIN IMAGING PET 26 252.0 PERFUSION 0 78645 PR CSF SHUNT EVALUATION 26 66.00 78707 PR RENAL IMAGING, MORPH 26 112.0 W/ FLOW/FUNC 0 78708 PR RENAL IMAGING, MORPH 26 141.0 W/ FLOW/FUNC, PHARM, 0 SINGLE 78709 PR RENAL IMAGING, MORPH 26 164.0 W/ FLOW/FUNC, PHARM, 0 MULTI 78740 PR URETERAL REFLUX STUDY 566.0 0 78740 PR URETERAL REFLUX STUDY 26 70.00 78800 PR TUMOR IMAGING, LIMITED 26 77.00 AREA 78801 PR TUMOR IMAGING, MULT 26 94.00 AREAS 78802 PR TUMOR IMAGING, WHOLE 26 101.0 BODY 0 78803 PR TUMOR IMAGING SPECT 26 128.0 0 78804 CHG TUMOR IMAGING, 26 125.0 WHOLE BODY, 2 OR MORE 0 DAYS 78805 PR ABSCESS IMAGING, LTD 26 86.00 AREA 78806 PR ABSCESS IMAGING, 26 101.0 WHOLE BODY 0 78807 PR NUCLEAR 26 129.0 LOCALIZATION/ABSCESS 0 78814 PET IMAGING CT FOR 26 259.0 ATTENUATION LIMITED AREA 0 78815 PET IMAGING CT 26 286.0 ATTENUATION SKULL BASE 0 MID-THIGH 78816 PET IMAGING FOR CT 26 294.0 ATTENUATION WHOLE BODY 0 79005 CHG NUC THERAPY 26 210.0 INTRACAVITARY 0 RADIOCOLLOID 79101 CHG NUC THERAPY INTRA- 26 231.0 ARTERIAL 0 79403 PR NUCLEAR THERAPY, 26 272.0 MONOCLONAL AB 0 79445 PR NUCLEAR THERAPY, 26 302 INTRA-ARTERIAL 80048 CHG BASIC METABOLIC PANEL 29.00 CALCIUM TOTAL 80053 CHG METABOLIC 36.00 PANEL,COMPREHENSIVE 80061 CHG LIPID PANEL 44.00 80360 CHG DRUG SCREENING 60.00 METHYLPHENIDATE 80364 CHG DRUG SCREENING OPIOIDS & 58 OPIATE ANALOGS 5/MORE 80500 CHG LAB PATHOLOGY CONSULT-LTD 100.0 0 80500 CHG LAB PATHOLOGY 26 100.0 CONSULT-LTD 0 81000 CHG URINALYSIS, NONAUTO, W/SCOPE 19.00 81001 CHG URINALYSIS, AUTO, W/SCOPE 11.00 81002 CHG URINALYSIS NONAUTO W/O SCOPE 14.00 81003 CHG URINALYSIS, AUTO, W/O SCOPE 8.00 81025 CHG URINE PREGNANCY 21.00 TEST 81120 CHG IDH1 COMMON 100.0 VARIANTS 0 81121 CHG IDH2 COMMON 100.0 VARIANTS 0 81163 CHG BRCA1 BRCA2 GENE ANALYSIS 100.0 FULL SEQUENCE ANALYSIS 0 81164 CHG BRCA1 BRCA2 GENE ANALYSIS 100.0 FULL DUP/DEL ANALYSIS 0 81165 CHG BRCA1 GENE ANALYSIS FULL 100.0 SEQUENCE ANALYSIS 0 81166 CHG BRCA1 GENE ANALYSIS FULL 100.0 DUP/DEL ANALYSIS 0 81167 CHG BRCA2 GENE ANALYSIS FULL 100.0 DUP/DEL ANALYSIS 0 81171 CHG AFF2 GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81172 CHG AFF2 GENE ANALYSIS 100.0 CHARACTERIZATION OF ALLELES 0 81173 CHG AR GENE ANALYSIS FULL GENE 100.0 SEQUENCE 0 81174 CHG AR GENE ANALYSIS KNOWN 100.0 FAMILIAL VARIANT 0 81177 CHG ATN1 GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81178 CHG ATXN1 GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81179 CHG ATXN2 GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81180 CHG ATXN3 GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81181 CHG ATXN7 GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81182 CHG ATXN8OS GENE ANALYSIS EVAL 100.0 DETECT ABNOR ALLELES 0 81183 CHG ATXN10 GENE ANALYSIS EVAL 100.0 DETC ABNORMAL ALLELES 0 81184 CHG CACNA1A GENE ANALYSIS EVAL 100.0 DETECT ABNOR ALLELES 0 81185 CHG CACNA1A GENE ANALYSIS FULL 100.0 GENE SEQUENCE 0 81186 CHG CACNA1A GENE ANALYSIS KNOWN 100.0 FAMILIAL VARIANT 0 81187 CHG CNBP GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81188 CHG CSTB GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81189 CHG CSTB GENE ANALYSIS FULL GENE 100.0 SEQUENCE 0 81190 CHG CSTB GENE ANALYSIS KNOWN 100.0 FAMILIAL VARIANTS 0 81204 CHG AR GENE ANALYSIS 100.0 CHARACTERIZATION OF ALLELES 0 81206 PR BCR/ABL1 MAJOR BREAKPNT 100.0 QUALITATIVE/QUANTITATIVE 0 81210 CHG BRAF GENE ANALYSIS V600 100.0 VARIANT(S) 0 81215 PR BRCA1 GENE ANALYSIS KNOWN 939.0 FAMILIAL VARIANT 0 81229 PR CYTOGENOM CONST MICROARRAY 100.0 COPY NUMBER&SNP VAR 0 81233 CHG BTK GENE ANALYSIS COMMON 100.0 VARIANTS 0 81234 CHG DMPK GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81235 CHG EGFR GENE ANALYSIS COMMON 348.0 VARIANTS 0 81235 CHG EGFR GENE ANALYSIS 26 100.0 COMMON VARIANTS 0 81236 CHG EZH2 GENE ANALYSIS FULL GENE 100.0 SEQUENCE 0 81237 CHG EZH2 GENE ANALYSIS COMMON 100.0 VARIANTS 0 81239 CHG DMPK GENE ANALYSIS 100.0 CHARACTERIZATION OF ALLELES 0 81240 PR F2 GENE ANALYSIS 20210G >A 100.0 VARIANT 0 81241 PR F5 COAGULATION FACTOR V ANAL 100.0 LEIDEN VARIANT 0 81243 PR FMR1 ANALYSIS EVAL TO DETECT 100.0 ABNORMAL ALLELES 0 81244 PR FMR1 GENE ANALYSIS 100.0 CHARACTERIZATION OF ALLELES 0 81256 PR HFE HEMOCHROMATOSIS GENE 100.0 ANAL COMMON VARIANTS 0 81260 PR IKBKAP GENE ANALYSIS COMMON 138 VARIANTS 81261 PR IGH@ REARRANGE ABNORMAL 100.0 CLONAL POP AMPLIFIED 0 81265 PR COMPARATIVE ANAL STR MARKERS 100.0 PATIENT&COMP SPEC 0 81267 PR CHIMERISM W/COMP TO BASELINE 100.0 W/O CELL SELECTION 0 81270 PR JAK2 GENE ANALYSIS P.VAL617PHE 100.0 VARIANT 0 81271 CHG HTT GENE ANALYSIS DETECT 100.0 ABNORMAL ALLELES 0 81274 CHG HTT GENE ANALYSIS 100.0 CHARACTERIZATION ALLELES 0 81275 CHG KRAS GENE ANALYSIS VARIANTS 100.0 IN EXON 2 0 81276 CHG KRAS GENE ANALYSIS ADDITIONAL 468 VARIANT(S) 81284 CHG FXN GENE ANALYSIS EVAL 100.0 DETECT ABNORMAL ALLELES 0 81285 CHG FXN GENE ANALYSIS 100.0 CHARACTERIZATION ALLELES 0 81286 CHG FXN GENE ANALYSIS FULL GENE 100.0 SEQUENCE 0 81287 CHG MGMT METHYLATION ANALYSIS 100.0 0 81288 CHG MLH1 GENE ANALYSIS 26 100.0 PROMOTER METHYLATION 0 ANALYSIS 81289 CHG FXN GENE ANALYSIS KNOWN 100.0 FAMILIAL VARIANTS 0 81301 PR MICROSATELLITE INSTAB ANAL 100.0 MISMATCH REPAIR DEF 0 81305 CHG MYD88 GENE ANALYSIS P.LEU265 100.0 (L265P) VARIANT 0 81306 CHG NUDT15 GENE ANALYSIS COMMON 100.0 VARIANTS 0 81310 PR NPM1 NUCLEOPHOSMIN GENE ANAL 597 EXON 12 VARIANTS 81311 CHG NRAS GENE ANALYSIS VARIANTS 716 IN EXON 2&3 81312 CHG PABPN1 GENE ANALYSIS EVAL 100.0 DETC ABNORMAL ALLELES 0 81320 CHG PLCG2 GENE ANALYSIS COMMON 100.0 VARIANTS 0 81329 CHG SMN1 GENE ANALYSIS 100.0 DOSAGE/DELET ALYS W/SMN2 ALYS 0 81333 CHG TGFBI GENE ANALYSIS COMMON 100.0 VARIANTS 0 81336 CHG SMN1 GENE ANALYSIS FULL GENE 100.0 SEQUENCE 0 81337 CHG SMN1 GENE ANALYSIS KNOWN 100.0 FAMILIAL SEQ VARIANTS 0 81340 PR TRB@ REARRANGEMENT ANAL 100.0 AMPLIFICATION METHOD 0 81342 PR TRG@ GENE REARRANGEMENT 100.0 ANALYSIS 0 81343 CHG PPP2R2B GENE ANALYSIS EVAL 100.0 DETC ABNORMAL ALLELES 0 81344 CHG TBP GENE ANALYSIS EVAL DETECT 100.0 ABNORMAL ALLELES 0 81345 CHG TERT GENE ANALYSIS TARGETED 100.0 SEQUENCE ANALYSIS 0 81403 CHG MOLECULAR PATHOLOGY 100.0 PROCEDURE LEVEL 4 0 81404 CHG MOLECULAR 26 115.0 PATHOLOGY PROCEDURE 0 LEVEL 5 81406 CHG MOLECULAR PATHOLOGY 100.0 PROCEDURE LEVEL 7 0 81443 CHG GENETIC TESTING FOR SEVERE 1645. INHERITED CONDITIONS 00 81445 CHG GEN SEQ ANALYS SOLID ORGAN 1495. NEOPLASM 5-50 GENE 00 81445 CHG GEN SEQ ANALYS SOLID 26 200.0 ORGAN NEOPLASM 5-50 GENE 0 81450 CHG GEN SEQ ANALYS 1899 HEMATOLYMPHOID NEO 5-50 GENE 81455 CHG GEN SEQ ANALYS SOL 1645. ORG/HEMTOLMPHOID NEO 51/> GEN 00 81455 CHG GEN SEQ ANALYS SOL 26 200.0 ORG/HEMTOLMPHOID NEO 0 51/> GEN 81479 CHG UNLISTED MOLELCULAR 100.0 PATHOLOGY PROCEDURE 0 82270 BLOOD OCCULT,BY 11.00 PEROXID,FECES,SINGLE, COLORECTAL SCREEN 82272 BLOOD OCCULT,BY PEROXID, FECES, 1- 11.00 3 SIMULT, NON CA SCREEN 82656 PR PANCREATIC ELASTASE, FECAL, 40.00 QUAL/SEMI-QUANT 82710 CHG FATS/LIPIDS, FECES, 48.00 QUANTITATIVE 82962 CHG GLUCOSE BLOOD TEST 9.00 83020 CHG HEMOGLOBIN 26 60.00 ELECTROPHORESIS 83036 PR GLYCOSYLATED HEMOGLOBIN TEST 32.00 83655 ASSAY OF LEAD 40.00 83986 CHG PH BODY FLUID NOS 10.00 83993 CHG ASSAY FOR CALPROTECTIN FECAL 67.00 84145 CHG ASSAY OF PROCALCITONIN 92.00 84165 CHG PROTEIN E-PHORESIS, 26 47.00 SERUM 84166 PR PROTEIN E-PHORESIS/URINE/CSF 61.00 84403 ASSAY OF TOTAL TESTOSTERONE 85.00 85013 CHG 8.00 MICROHEMATOCRIT,SPUN 85014 CHG HEMATOCRIT 8.00 85018 CHG HEMOGLOBIN 8.00 85025 CHG COMPLETE CBC & AUTO DIFF WBC 26.00 85060 PR BLOOD SMEAR INTERPRETATION 62.00 85097 PR BONE MARROW, SMEAR 231.0 INTERPRETATION 0 85097 PR BONE MARROW, SMEAR 26 214.0 INTERPRETATION 0 85390 CHG FIBRINOLYSINS SCREEN 26 60.00 85576 CHG BLOOD PLATELET 26 62.00 AGGREGATION 85610 CHG PROTHROMBIN TIME 13.00 86077 CHG PHYS BLD BANK SERV,DIFF XMTCH 143.0 0 86078 CHG PHYS BLD BANK SERV,XFUSN RX 143.0 0 86308 CHG HETEROPHILE 17.00 ANTIBODIES,SCREEN 86325 CHG IMMUNOELECTROPHOR,OTHER 74.00 FLUIDS W/CONC 86325 CHG 26 64.00 IMMUNOELECTROPHOR,OTHE R FLUIDS W/CONC 86580 CHG TB INTRADERMAL TEST 19.00 86788 PR WEST NILE VIRUS AB, IGM 56.00 87210 CHG SMEAR,STAIN,WET MNT,INTERP 14.00 87220 CHG TISSUE EXAM BY KOH 10.00 87662 CHG IADNA DNA/RNA ZIKA VIRUS 159.0 AMPLIFIED PROBE TQ 0 87804 CHG DETECT AGENT,IMMUN,DIR 39.00 OBS,INFLUENZA 87807 PR DETECT AGENT,IMMUN,DIR OBS, 41.00 RSV 87880 CHG STREP A ASSAY 39.00 W/OPTIC 88020 CHG AUTOPSY COMPL,W/O 1696. CNS 00 88025 CHG AUTOPSY COMPL,W 2355. BRAIN 00 88028 CHG AUTOPSY COMPL,INFANT W BRAIN 2355. 00 88029 CHG AUTOPSY COMPL,NEWBORN W 1884. BRAIN 00 88037 CHG LTD AUTOPSY,SINGLE ORGAN 866.0 0 88099 CHG NECROPSY (AUTOPSY) UNLISTED 330.0 0 88104 CHG CYTOPATH 26 75.00 FLUIDS,SMEAR,INTERP 88108 CHG CYTOPATH 26 84.00 FLUIDS,CONCENTRATN,INTER P 88112 CHG CYTOPATH, CELL 26 161.0 ENHANCE TECH 0 88141 CHG CYTOPATH CERV/VAG INTERPRET 82.00 88142 CHG CYTOPATH CERV/VAG THIN LAYER 70.00 88143 CHG CYTOPATH CERV/VAG THIN LAYER 70.00 REDO 88160 CHG CYTOPATH,OTHR 26 79.00 SOURC,SCREEN,INTERP 88172 CHG EVALUATION OF FNA 26 134.0 SMEAR TO DETERMINE 0 ADEQUACY, FIRST EVAL 88173 CHG INTERPRETATION OF 26 250.0 FNA SMEAR 0 88174 CHG CYTOPATH,CERV/VAG,AUTO THIN 74.00 LAYER,INTERP 88177 CHG EVALUATION OF FNA 26 58.00 SMEAR TO DETERMINE ADEQUACY, EA ADD EVAL 88187 PR FLOWCYTOMETRY/READ, 2-8 175.0 MARKERS 0 88188 PR FLOWCYTOMETRY/READ, 9-15 220.0 MARKERS 0 88189 PR FLOWCYTOMETRY/READ, 16 & > 278.0 MARKERS 0 88237 CHG TISSUE CULTURE, BONE MARROW 434.0 0 88261 CHG CHROMOSOME ANAL:5 CELLS,1 607.0 KARYOTYPE 0 88263 CHG CHROMOSOME ANAL:45 493.0 CELLS,MOSAICISM 0 88271 CHG CYTOGENETICS, DNA PROBE 74.00 88291 CHG CYTO/MOLECULAR REPORT 84.00 88300 CHG SURG 26 39.00 PATH,GROSS,LEVEL I 88302 CHG SURG PATH,LEVEL II 26 60.00 88304 CHG SURG PATH,LEVEL III 26 94.00 88305 CHG SURG PATH,LEVEL IV 26 178.0 0 88307 CHG SURG PATH,LEVEL V 325.0 0 88307 CHG SURG PATH,LEVEL V 26 314.0 0 88309 CHG SURG PATH,LEVEL VI 26 462.0 0 88311 CHG DECALCIFY TISSUE 26 34.00 88312 PR SPECIAL STAIN GROUP 1 60.00 MICROORGANISMS I&R 88312 PR SPECIAL STAIN GROUP 1 26 67.00 MICROORGANISMS I&R 88313 PR SPCL STN 2 I&R EXCPT 70.00 MICROORG/ENZYME/IMCYT&IMHIS 88313 PR SPCL STN 2 I&R EXCPT 26 65.00 MICROORG/ENZYME/IMCYT&I MHIS 88314 PR SPECIAL STAIN I&R 26 158.0 HISTOCHEMICAL W/FROZEN 0 TISSUE 88319 PR SPECIAL STAIN I&R 26 86.00 GROUP III ENZYME CONSITUENTS 88321 CHG MICROSLIDE CONSULT 368.0 0 88323 CHG MICROSLIDE CONSULT W SLIDE 368.0 PREP 0 88323 CHG MICROSLIDE CONSULT 26 197.0 W SLIDE PREP 0 88325 CHG COMPREHENSIVE REVIEW OF 400.0 DATA 0 88329 CHG PATH CONSULT IN GC 136.0 SURGERY 0 88331 PR PATH CONSULT IN 26 204.0 SURG,W FRZ SEC 0 88332 CHG PATH CONSULT IN 26 135.0 SURG,W ADDN FRZ SEC 0 88333 PR INTRAOPERATIVE CYTO 26 164.0 PATH CONSULT, INITIAL SITE 0 88334 CHG INTRAOPERATIVE CYTO 26 101.0 PATH CONSULT, ADD SITES 0 88334 CHG INTRAOPERATIVE CYTO GC 101.0 PATH CONSULT, ADD SITES 0 88341 CHG IMHISTOCHEM/CYTCHM EA ADDL 228.0 ANTIBODY SLIDE 0 88341 CHG IMHISTOCHEM/CYTCHM 26 74.00 EA ADDL ANTIBODY SLIDE 88342 CHG IMHISTOCHEM/CYTCHM INIT 268.0 ANTIBODY STAIN PROCEDURE 0 88342 CHG IMHISTOCHEM/CYTCHM 26 93.00 INIT ANTIBODY STAIN PROCEDURE 88346 CHG IMMUNOFLUORESCENCE 26 101.0 PER SPEC 1ST SINGL ANTB 0 STAIN 88348 CHG ELECTRON 26 468.0 MICROSCOPY,DIAGNOSTIC 0 88350 CHG IMMUNOFLUORESCENCE 26 75.00 PER SPEC ADD SINGL ANTB STAIN 88360 CHG M/PHMTRC ALYS TUMOR 26 134.0 IMHCHEM EA ANTIBODY 0 MANUAL 88361 CHG M/PHMTRC ALYS TUMOR 26 142 IMHCHEM EA ANTBDY CMPTR ASST 88363 CHG EXAM & SELECT ARCHIVE TISSUE 55.00 MOLECULAR ANALYSIS 88364 CHG IN SITU HYBRIDIZATION 26 91.00 EA ADDL PROBE STAIN 88365 CHG IN SITU HYBRIDIZATION 1ST 440.0 PROBE STAIN 0 88365 CHG IN SITU HYBRIDIZATION 26 144.0 1ST PROBE STAIN 0 88366 CHG IN SITU HYBRIDIZATION 26 162.0 EA MULTIPLEX PROBE STAIN 0 88367 CHG M/PHMTRC ALYS ISH CPTR-ASST 604.0 TECH 1ST PROBE STAIN 0 88367 CHG M/PHMTRC ALYS ISH 26 160.0 CPTR-ASST TECH 1ST PROBE 0 STAIN 88368 CHG M/PHMTRC ALYS IN SITU 149.0 HYBRIDIZATION EA PROBE MNL 0 88368 CHG M/PHMTRC ALYS IN SITU 26 160.0 HYBRIDIZATION EA PROBE 0 MNL 88369 CHG M/PHMTRC ALYS ISH 26 84.00 QUANT/SEMIQ MNL PER SPEC EACH 88377 CHG M/PHMTRC ALYS ISH 166.0 QUANT/SEMIQ MNL EACH MULTIPRB 0 88377 CHG M/PHMTRC ALYS ISH 26 166.0 QUANT/SEMIQ MNL EACH 0 MULTIPRB 88720 CHG BILIRUBIN TOTAL 18.00 TRANSCUTANEOUS 89060 CHG EXAM,SYNOVIAL FLUID 26 47.00 CRYSTALS 90389 PR TETANUS IG, IM 776.0 0 90460 PR IM ADM THRU 18YR ANY RTE 21.00 1ST/ONLY COMPT VAC/TOX 90461 PR IM ADM THRU 18YR ANY RTE ADDL 21.00 VAC/TOX COMPT 90471 PR IMMUNIZ ADMIN,1 SINGLE/COMB 21.00 VAC/TOXOID 90472 PR IMMUNIZ,ADMIN,EACH 21.00 ADDL 90473 PR IMMUNIZ ADMIN,INTRANASAL/ORAL,1 21.00 VAC/TOX 90474 PR IMMUNIZ 21.00 ADMIN,INTRANASAL/ORAL,EACH ADDL 90620 PR MENB-4C RECOMBNT PROT & 675.0 OUTER MEMB VESIC VACC IM 0 90630 PR INFLUENZA VACC IIV4 SPLIT VIRUS 49.00 PRSRV FREE ID 90632 PR HEPA VACCINE ADULT DOSE FOR 134.0 INTRAMUSCULAR USE 0 90633 PR HEPA VACCINE 2 DOSE SCHEDULE 63.00 PED/ADOLESC IM USE 90636 PR HEPA/HEPB VACCINE ADULT IM 200.0 0 90647 PR HIB PRP-OMP VACCINE 3 DOSE 55.00 SCHEDULE IM USE 90648 PR HIB PRP-T VACCINE 4 DOSE 61.00 SCHEDULE IM USE 90649 PR 4VHPV VACCINE 3 DOSE SCHEDULE 336.0 FOR IM USE 0 90650 PR 2VHPV VACCINE 3 DOSE SCHEDULE 164.0 FOR IM USE 0 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM 346.0 USE 0 90655 PR IIV3 VACC PRESRV FREE 0.25 ML 51.00 DOSAGE IM USE 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 35.00 ML DOSAGE IM USE 90657 PR IIV3 VACCINE SPLIT VIRUS 0.25 ML 11.00 DOSAGE IM USE 90658 PR IIV3 VACCINE SPLIT VIRUS 0.5 ML 41.00 DOSAGE IM USE 90660 PR LAIV3 VACCINE LIVE FOR 55.00 INTRANASAL USE 90662 PR IIV VACCINE PRESERV FREE 50.00 INCREASED AG COUNT IM 90670 PR PCV13 VACCINE FOR 334.0 INTRAMUSCULAR USE 0 90672 PR LAIV4 VACCINE FOR INTRANASAL 56.00 USE 90673 PR RIV3 VACCINE PRESERVATIVE FREE 79.00 FOR IM USE 90675 PR RABIES VACCINE, IM 636.0 0 90680 PR RV5 VACCINE 3 DOSE SCHEDULE 182.0 LIVE FOR ORAL USE 0 90681 PR RV1 VACCINE 2 DOSE SCHEDULE 230.0 LIVE FOR ORAL USE 0 90682 PR RIV4 VACC RECOMBINANT DNA 50.00 PRSRV ANTIBIO FREE IM 90685 PR IIV4 VACC PRSRV FREE 0.25 ML DOS 52.00 FOR IM USE 90686 PR IIV4 VACC PRESRV FREE 0.5 ML DOS 20.00 FOR IM USE 90691 PR TYPHOID VACCINE, IM 186.0 0 90696 PR DTAP-IPV VACCINE CHILD 4-6 YRS 104.0 FOR IM USE 0 90698 PR DTAP-IPV/HIB VACCINE FOR 178.0 INTRAMUSCULAR USE 0 90700 DTAP IMMUNIZATION, IM, <7 60.00 YO 90702 PR DT VACCINE YOUNGER THAN 7 YRS 80.00 FOR IM USE 90707 PR MMR VIRUS IMMUNIZATION, SUBCUT 132.0 0 90710 PR COMBINED 378.0 VACCINE,MMR+VARICELLA,SUB-Q 0 90713 PR POLIOMYELITIS 63.00 IMMUNIZATN,INACTV,SUB-Q 90714 PR TD VACCINE PRSRV FREE 7 YRS OR 55.00 OLDER FOR IM USE 90715 PR TDAP VACCINE IM 91.00 90716 PR VAR VACCINE LIVE FOR 226.0 SUBCUTANEOUS USE 0 90717 PR YELLOW FEVER 295.0 IMMUNIZATN,LIVE,SUB-Q 0 90723 PR DTAP-HEPB-IPV VACCINE 153.0 INTRAMUSCULAR 0 90732 PR PPSV23 VACCINE 2 YRS OR OLDER 166.0 FOR SUBQ/IM USE 0 90733 PR MPSV4 VACCINE GROUPS ACYW-135 129.0 SUBQ USE 0 90734 PR MCV4/MENACWY CONJ VACC GRPS 126.0 ACYW-135 IM USE 0 90736 PR ZOSTER VACCINE HZV LIVE FOR 414.0 SUBCUTANEOUS USE 0 90738 CHG JAPANESE ENCEPH VACC, 487.0 INACTIVATED, IM 0 90744 PR HEPB VACCINE PED/ADOLESC 3 47.00 DOSE SCHEDULE IM 90746 PR HEPB VACCINE ADULT 3 DOSE 114.0 SCHEDULE FOR IM USE 0 90750 PR HZV ZOSTER VACC RECOMBINANT 175.0 ADJUVANTED IM NJX 0 90785 PR PSYCHOTHERAPY COMPLEX 40.00 INTERACTIVE 90791 PR PSYCHIATRIC DIAGNOSTIC 399.0 EVALUATION 0 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL 361.0 W/MEDICAL SERVICES 0 90832 PR PSYCHOTHERAPY W/PATIENT 30 166.0 MINUTES 0 90833 PR PSYCHOTHERAPY W/PATIENT 166.0 W/E&M SRVCS 30 MIN 0 90834 PR PSYCHOTHERAPY W/PATIENT 45 214.0 MINUTES 0 90836 PR PSYCHOTHERAPY W/PATIENT 214.0 W/E&M SRVCS 45 MIN 0 90837 PR PSYCHOTHERAPY W/PATIENT 60 315.0 MINUTES 0 90838 PR PSYCHOTHERAPY W/PATIENT 315.0 W/E&M SRVCS 60 MIN 0 90839 PR PSYCHOTHERAPY FOR CRISIS 343.0 INITIAL 60 MINUTES 0 90840 PR PSYCHOTHERAPY FOR CRISIS EACH 183.0 ADDL 30 MINUTES 0 90846 PR FAMILY PSYCHOTHERAPY W/O 256.0 PATIENT PRESENT 50 MINS 0 90847 PR FAMILY PSYCHOTHERAPY 286.0 W/PATIENT PRESENT 50 MINS 0 90849 PR MULTIP FAMILY-GROUP 88.00 PSYCHOTHERAPY 90853 PR GROUP PSYCHOTHERAPY 85.00 90867 PR REPET TMS TX INITIAL W/MAP/MOTR 852.0 THRESHLD/DEL&MNG 0 90868 PR THERAP REPETITIVE TMS TX 463.0 SUBSEQ DELIVERY & MNGT 0 90869 PR REPET TMS TX SUBSEQ MOTR 1053. THRESHLD W/DELIV & MNGT 00 90870 PR ELECTROCONVULSIVE THERAPY,1 410.0 SEIZ 0 90887 PR CONSULTATION WITH FAMILY 216.0 0 90899 PR PSYCHIATRIC SERVICE/THERAPY 400.0 0 90901 PR BIOFEEDBACK TRAINING,ANY 101 MODALITY 90911 PR BIOFEEDBACK PERI/URO/RECTAL 230.0 0 90935 PR HEMODIALYSIS PROCEDURE W/ 225.0 PHYS/QHP EVALUATION 0 90937 PR HEMODIALYSIS, REPEATED EVAL. 375.0 0 90945 PR DIALYSIS OTHER/THAN 210.0 HEMODIALYSIS 1 PHYS/QHP EVAL 0 90947 PR DIALYSIS OTH/THN HEMODIALY 350.0 REPEAT PHYS/QHP EVALS 0 90953 PR ESRD RELATED SVC MONTHLY <2 1216. YR OLD 1 VISIT 00 90956 PR ESRD RELATED SVC MONTHLY 2-11 798.0 YR OLD 1 VISIT 0 90957 PR ESRD RELATED SVC MONTHLY 12-19 2184. YR OLD 4/> VISITS 00 90958 PR ESRD RELATED SVC MONTHLY 12-19 1058. YR OLD 2/3 VISITS 00 90959 PR ESRD RELATED SVC MONTHLY 12-19 711.0 YR OLD 1 VISIT 0 90960 PR ESRD RELATED SVC MONTHLY 20&/> 700.0 YR OLD 4/> VISITS 0 90961 PR ESRD RELATED SVC MONTHLY 575.0 20/>YR OLD 2/3 VISITS 0 90962 PR ESRD RELATED SVC MONTHLY 430.0 20&/>YR OLD 1 VISIT 0 90963 PR ESRD SERVICES, HOME DIALYSIS, 1904. PER MONTH, < 2 YR OLD 00 90964 PR ESRD SERVICES, HOME DIALYSIS, 1189. PER MONTH, 2-11 YR OLD 00 90965 PR ESRD SERVICES, HOME DIALYSIS, 1132. PER MONTH, 12-19 YR OLD 00 90966 PR ESRD SERVICES, HOME DIALYSIS, 572.0 PER MONTH, 20+ YR OLD 0 90967 PR ESRD SERVICES, PER DAY, < 2 YR 48.00 OLD 90968 PR ESRD SERVICES, PER DAY, 2-11 YR 39.00 OLD 90969 PR ESRD SERVICES, PER DAY, 12-19 YR 38.00 OLD 90970 PR ESRD SERVICES, PER DAY,20+ YR 20.00 OLD 90989 PR DIALYSIS TRAINING/COMPLETE 767.0 0 91010 PR ESOPHAGEAL MOTILITY 26 300.0 STUDY W/INTERP&RPT 0 91034 PR GERD TST W/ NASAL PH 26 128.0 ELECTROD 0 91035 PR GERD TST W/ MUCOS PH 26 208.0 ELECTROD 0 91038 PR GERD TST W/ MUCOS 26 145.0 IMPEDE ELECTROD,>1HR 0 91065 PR BREATH 26 60.00 HYDROGEN/METHANE TEST 91110 PR GI IMAG INTRALUMINAL 2350. ESOPHAGUS-ILEUM W/I&R 00 91110 PR GI IMAG INTRALUMINAL 26 540.0 ESOPHAGUS-ILEUM W/I&R 0 91112 PR GI TRANSIT & PRES MEAS 26 280.0 WIRELESS CAPSULE 0 W/INTERP 91122 PR ANAL PRESSURE RECORD 26 300.0 0 91200 PR LIVER ELASTOGRAPHY 26 38.00 W/O IMAG W/I&R 92002 PR EYE EXAM, NEW PATIENT,INTERMED 185.0 0 92004 PR EYE EXAM, NEW 325.0 PATIENT,COMPREHESV 0 92012 PR EYE EXAM ESTABLISHED 185.0 PT 0 92012 PR EYE EXAM ESTABLISHED 26 185.0 PT 0 92014 PR EYE EXAM, EST 265.0 PATIENT,COMPREHESV 0 92015 PR REFRACTION 30.00 92018 PR NEW EYE EXAM & TREATMENT 367.0 0 92019 PR EYE EXAM & TREATMENT 184.0 0 92020 PR SPECIAL EYE EVAL,GONIOSCOPY 68.00 92020 PR SPECIAL EYE 26 68.00 EVAL,GONIOSCOPY 92025 PR CORNEAL TOPOGRAPHY 26 51.00 92060 PR SPECIAL EYE 26 98.00 EVAL,SENSORIMOTOR 92071 PR FIT CONTACT LENS TX OCULAR 95.00 SURFACE DISEASE 92072 PR FITTING CONTACT LENS FOR MNGT 341.0 OF KERATOCONUS 0 92081 PR VISUAL FIELD 26 42.00 EXAM,LIMITED 92082 PR VISUAL FIELD EXAM,INTERMED 122.0 0 92082 PR VISUAL FIELD 26 57.00 EXAM,INTERMED 92083 PR VISUAL FIELD 26 71.00 EXAM,EXTENDED 92100 PR SERIAL TONOMETRY EXAM(S) 199.0 0 92132 PR COMPUTERIZED 26 50.00 OPHTHALMIC IMAGING ANTERIOR SEGMENT 92133 PR COMPUTERIZED 26 71.00 OPHTHALMIC IMAGING OPTIC NERVE 92134 PR COMPUTERIZED OPHTHALMIC 261.0 IMAGING RETINA 0 92134 PR COMPUTERIZED 26 74.00 OPHTHALMIC IMAGING RETINA 92136 PR OPHTHAL BIOMETRY,INTRAOC LENS 225.0 POW CALC 0 92136 PR OPHTHAL 26 79.00 BIOMETRY,INTRAOC LENS POW CALC 92225 PR SPECIAL EYE EXAM, 70.00 INITIAL 92226 PR SPECIAL EYE EXAM, SUBSEQUENT 70.00 92230 PR FLUORESCEIN 145.0 ANGIOSCOPY 0 92235 PR FLUORESCEIN ANGRPH 26 116.0 W/MULTIFRAME I&R UNI/BI 0 92240 PR INDOCYANINE-GREEN 26 161.0 ANGRPH W/MULTIFRAME I&R 0 UNI/BI 92242 PR FLUORESCEIN ICG ANGRPH 575.0 W/MULTIFRAME I&R UNI/BI 0 92242 PR FLUORESCEIN ICG 26 141.0 ANGRPH W/MULTIFRAME I&R 0 UNI/BI 92250 PR FUNDAL PHOTOGRAPHY 26 61.00 92265 PR EYE MUSCLE EVALUATION 214.0 0 92265 PR EYE MUSCLE EVALUATION 26 118.0 0 92273 PR FULL FIELD 341.0 ELECTRORETINOGRAPHY W/I&R 0 92273 PR FULL FIELD 26 96.00 ELECTRORETINOGRAPHY W/I&R 92274 PR MULTIFOCAL 231.0 ELECTRORETINOGRAPHY W/I&R 0 92274 PR MULTIFOCAL 26 85.00 ELECTRORETINOGRAPHY W/I&R 92274 PR MULTIFOCAL TC 146.0 ELECTRORETINOGRAPHY 0 W/I&R 92275 PR ELECTRORETINOGRAPHY 26 148.0 0 92283 PR COLOR VISION 26 24.00 EXAMINATION 92285 PR EYE PHOTOGRAPHY 26 16.00 92286 PR ANT SGM IMAGING 26 56.00 W/MICROSCOPY ENDOTHELIAL ANALY 92310 PR CONTACT LENS FITTING,BILAT 75.00 92311 PR CONTACT LENS FIT,APHAKIA UNILAT 252.0 0 92312 PR CONTACT LENS FIT,APHAKIA BILAT 290.0 0 92313 PR CONTACT LENS 243.0 FIT,CORNEOSCLERAL LENS 0 92502 PR EAR AND THROAT EXAMINATION 221.0 0 92504 PR EAR MICROSCOPY EXAMINATION 71.00 92507 PR SPEECH/HEARING 205 THERAPY 92511 PR NASOPHARYNGOSCOPY 361.0 0 92516 PR FACIAL NERVE FUNCTION TEST 175.0 0 92521 PR EVALUATION OF SPEECH FLUENCY 288 (STUTTER CLUTTER) 92522 PR EVALUATION OF SPEECH SOUND 240 PRODUCTION ARTICULATE 92523 PR EVAL SPEECH SOUND PRODUCT 502 LANGUAGE COMPREHENSION 92524 PR BEHAVIORAL & QUALIT ANALYSIS 233 VOICE AND RESONANCE 92526 PR ORAL FUNCTION THERAPY 224 92532 PR POSITIONAL NYSTAGMUS 61.00 92537 PR CALORIC VESTIBULAR TEST W/REC 388.0 BI BITHERMAL 0 92537 PR CALORIC VESTIBULAR 26 128.0 TEST W/REC BI BITHERMAL 0 92538 PR CALORIC VESTIBULAR TEST W/REC 194.0 BI MONOTHERMAL 0 92538 PR CALORIC VESTIBULAR 26 64.00 TEST W/REC BI MONOTHERMAL 92540 PR VESTIBULAR EVAL NYSTAG 320.0 FOVL&PERPH STIM OSCIL TRACKING 0 92540 PR VESTIBULAR EVAL 26 320.0 NYSTAG FOVL&PERPH STIM 0 OSCIL TRACKING 92541 PR SPONTANEOUS NYSTAGMUS TEST 134.0 0 92541 PR SPONTANEOUS 26 48.00 NYSTAGMUS TEST 92542 PR POSITIONAL NYSTAGMUS TEST 139.0 0 92542 PR POSITIONAL NYSTAGMUS 26 64.00 TEST 92544 PR OPTOKINETIC NYSTAGMUS TEST 111.0 0 92544 PR OPTOKINETIC 26 38.00 NYSTAGMUS TEST 92545 PR OSCILLATING TRACKING TEST 102.0 0 92545 PR OSCILLATING TRACKING 26 30.00 TEST 92546 PR SINUSOIDAL ROTATIONAL TEST 197.0 0 92546 PR SINUSOIDAL ROTATIONAL 26 119.0 TEST 0 92548 PR COMPUTERIZED DYNAMIC 250.0 POSTUROGRAPHY 0 92548 PR COMPUTERIZED DYNAMIC 26 66.00 POSTUROGRAPHY 92550 PR TYMPANOMETRY AND REFLEX 85.00 THRESHOLD MEASUREMENTS 92551 PR PURE TONE HEARING TEST, AIR 31.00 92552 PR PURE TONE AUDIOMETRY, AIR 78.00 92553 PR AUDIOMETRY, AIR & BONE 93.00 92555 PR SPEECH THRESHOLD AUDIOMETRY 58.00 92556 PR SPEECH AUDIOMETRY, COMPLETE 95.00 92557 PR COMPREHENSIVE HEARING TEST 115.0 0 92565 PR STENGER TEST, PURE 35.00 TONE 92567 PR TYMPANOMETRY 49.00 92568 PR ACOUSTIC REFLEX 47.00 TESTING 92575 PR SENSORINEURAL ACUITY TEST 178.0 0 92577 PR STENGER TEST, SPEECH 46.00 92579 PR VISUAL AUDIOMETRY 107.0 (VRA) 0 92582 PR CONDITIONING PLAY AUDIOMETRY 167.0 0 92583 PR SELECT PICTURE AUDIOMETRY 200.0 0 92584 PR 190.0 ELECTROCOCHLEOGRAPHY 0 92585 PR AUDITORY EVOKED POTENTIAL 294.0 0 92585 PR AUDITORY EVOKED 26 294.0 POTENTIAL 0 92586 PR AUDITORY EVOKED POTENTIAL, 339.0 LIMITED 0 92587 PR DISTORT PRODUCT EVOKED 115.0 OTOACOUSTIC EMISNS LIMITD 0 92587 PR DISTORT PRODUCT 26 65.00 EVOKED OTOACOUSTIC EMISNS LIMITD 92588 PR DISTRT PROD EVOKD OTOACOUSTIC 163.0 EMSNS COMP/DX EVAL 0 92588 PR DISTRT PROD EVOKD 26 95.00 OTOACOUSTIC EMSNS COMP/DX EVAL 92601 DX ANAL COCHLEAR IMP,PT <7 403.0 YRS,W/PROG 0 92602 DX ANAL COCHLEAR IMP,PT <7 257.0 YRS,REPROG 0 92603 PR DX ANAL COCHLEAR IMP,PT >7 343.0 YRS,W/PROG 0 92604 PR DX ANAL COCHLEAR IMP,PT >7 204.0 YRS,REPROG 0 92607 PR EVAL,SPEECH-GEN AUG/ALT COMM 330.0 DEV,1ST HR 0 92608 PR EVAL,SPEECH-GEN AUG/ALT COMM 133.0 DEV,ADDL 30 0 92610 PR EVAL,ORAL & PHARYNGEAL 222 SWALLOW FUNCTION 92612 PR FLEXIBLE ENDOSCOPIC EVAL 484 SWALLOW C/V REC 92613 PR FLEXIBLE ENDOSCOPIC EVAL 145.0 SWALLOW C/V REC I&R 0 92620 PR AUDITORY FUNCTION, 60 MIN 239.0 0 92621 PR EVAL CENTRAL AUDITORY FUNCJ 57.00 W/REPRT EA 15 MIN 92625 PR TINNITUS ASSESSMENT 165.0 0 92626 PR EVAL AUDITORY REHAB STATUS, 230.0 1ST HOUR 0 92627 PR EVAL AUDITORY REHAB STATUS, EA 70.00 ADD 15 MIN 92920 PR PRQ TRLUML CORONARY 1814. ANGIOPLASTY ONE ART/BRANCH 00 92921 PR PRQ TRLUML CORONARY 493.0 ANGIOPLASTY ADDL BRANCH 0 92924 PR PRQ TRLUML CORONARY 2156. ANGIO/ATHERECT ONE ART/BRNCH 00 92928 PR PRQ TRLUML CORONARY STENT 2013. W/ANGIO ONE ART/BRNCH 00 92929 PR PRQ TRLUML CORONARY STENT 775.0 W/ANGIO ADDL ART/BRNCH 0 92929 PR PRQ TRLUML CORONARY 26 548.0 STENT W/ANGIO ADDL 0 ART/BRNCH 92933 PR PRQ TRLUML CORONRY 2253. STENT/ATH/ANGIO ONE ART/BRNCH 00 92934 PR PRQ TRLUML CORONARY 705.0 STENT/ATH/ANGIO ADDL BRANCH 0 92937 PR PRQ TRLUML CORONARY BYP GRFT 2012. REVASC ONE VESSEL 00 92941 PR PRQ TRLUML CORONRY TOT 2695. OCCLUS REVASC MI ONE VSL 00 92943 PR PRQ TRLUML CORONRY CHRONIC 2257. OCCLUS REVASC ONE VSL 00 92944 PR PRQ TRLUML CORONRY CHRNIC 906.0 OCCLUS REVASC ADDL VSL 0 92950 PR HEART/LUNG RESUSCITATION (CPR) 687.0 0 92960 PR CARDIOVERSION ELECTIVE 672.0 ARRHYTHMIA EXTERNAL 0 92961 PR CARDIOVERSION ELECTIVE 980.0 ARRHYTHMIA INTERNAL SPX 0 92970 PR CARDIOASSIST, INTERNAL 439.0 0 92978 PR ENDOLUMINAL 26 243.0 CORONARY IVUS OCT I&R 0 INITIAL VESSEL 92979 PR ENDOLUMINAL 26 188.0 CORONARY IVUS OCT I&R 0 ADDL VESSEL 92986 PR PRQ BALLOON VALVULOPLASTY 5512. AORTIC VALVE 00 92987 PR PRQ BALLOON VALVULOPLASTY 5689. MITRAL VALVE 00 92990 PR PERCUT PULMONARY 3755. VALVULOPLASTY 00 92992 PR ATRIAL 4000. SEPTOSTOMY,XVENOUS,BALLOON 00 92993 PR ATRIAL 4500. SEPTOSTOMY,XVENOUS,BLADE 00 92997 PR PUL ART BALLOON 3200. REPAIR,PERC,1ST VESL 00 92998 PR PUL ART BALLOON 1600. REPAIR,PERC,ADDN VES 00 93000 PR ELECTROCARDIOGRAM, COMPLETE 52.00 93005 PR ELECTROCARDIOGRAM, TRACING 34.00 93010 PR ELECTROCARDIOGRAM REPORT 30.00 93010 PR ELECTROCARDIOGRAM 76 30.00 REPORT 93015 PR CV STRS TST XERS&/OR RX CONT 227.0 ECG W/SI&R 0 93016 PR CV STRS TST XERS&/OR RX CONT 125.0 ECG W/O I&R 0 93017 CARDIAC STRESS TEST 136.0 0 93018 PR CARDIAC STRESS TST,INTERP/REPT 120.0 ONLY 0 93040 PR RHYTHM ECG WITH 31.00 REPORT 93041 PR RHYTHM ECG, TRACING 14.00 93042 PR RHYTHM ECG, REPORT 25.00 93224 PR XTRNL ECG & 48 HR RECORD SCAN 228.0 STOR W/R&I 0 93225 PR EXT ECG RECORD CONTIN 48 HR, 92.00 RECORD 93226 PR EXT ECG RECORD CONTIN 48 HR, 97.00 SCAN ANALYSIS W REPORT 93227 PR XTRNL ECG CONTINUOUS RHYTHM 78.00 W/I&R UP TO 48 HRS 93228 PR XTRNL MOBILE CV TELEMETRY 64.00 W/I&REPORT 30 DAYS 93260 PR PRGRMG DEV EVAL 26 112.0 IMPLANTABLE SUBQ LEAD 0 DFB SYSTEM 93261 PR INTERROGATION EVAL F2F 26 107.0 IMPLANT SUBQ LEAD DEFIB 0 93264 PR REMOTE MNTR WIRELESS P-ART 130.0 PRS SNR UP TO 30 D 0 93270 PR EXT ECG,PT DEMAND EVENT, SYMPT 27.00 MEMORY LOOP, RECORD 93271 PR EXT ECG,PT DEMAND EVENT, SYMPT 454.0 MEMORY LOOP, TRANSMIT 0 93272 PR XTRNL PT ACTIVTD ECG DWNLD 65.00 W/R&I 50.00 HR REVIEW 93792 PR PT/CAREGIVER TRAINJ FOR 138.0 INITIATION HOME INR MNTR 0 93793 PR ANTICOAGULANT MGMT FOR PT 31.00 TAKING WARFARIN 93880 PR DUPLEX SCAN 26 102.0 EXTRACRANIAL,BILAT 0 93882 PR DUPLEX SCAN 26 54.00 EXTRACRANIAL,LIMITED 93886 PR TRANSCRAN DOPPLER 26 115.0 INTRACRAN ART 0 93922 PR NON-INVAS PHYSIOLOGIC 26 31.00 STD EXTREMITY ART 1-2 LEVEL 93923 PR NON-INVASIVE 26 56.00 PHYSIOLOGIC STUDY EXTREMITY 3 LEVELS 93924 PR NON-INVASIVE LOWER 26 73.00 EXTREM ART STRESS/REST, COMPLETE,BILATERAL 93925 PR DUPLEX LO EXTREM ART 26 100.0 BILAT 0 93926 PR DUPLEX LO EXTREM ART 26 62.00 UNILAT/LTD 93930 PR DUPLEX UP EXTREM ART 26 101.0 BILAT 0 93931 PR DUPLEX UP EXTREM ART 26 62.00 UNILAT/LTD 93970 PR DUPLEX EXTREM VENOUS,BILAT 498.0 0 93970 PR DUPLEX EXTREM 26 81.00 VENOUS,BILAT 93971 PR DUPLEX EXTREM VENOUS,UNI OR 306.0 LTD 0 93971 PR DUPLEX EXTREM 26 53.00 VENOUS,UNI OR LTD 93975 PR DUPLEX ABD/PEL VASC 26 215.0 STUDY,COMPLETE 0 93976 PR DUPLEX ABD/PEL VASC 501.0 STUDY,LIMITD 0 93976 PR DUPLEX ABD/PEL VASC 26 141.0 STUDY,LIMITD 0 93978 PR DUPLEX LARGE 26 100.0 VESSEL(S),COMPLETE 0 93979 PR DUPLEX LARGE 26 55.00 VESSEL(S),LIMITED 93980 PR PENILE VASCULAR 26 210.0 STUDY,COMPLETE 0 93990 PR DUPLEX HEMODIALYSIS 26 31.00 ACCESS 94010 PR BREATHING CAPACITY 86.00 TEST 94010 PR BREATHING CAPACITY 26 31.00 TEST 94060 PR EVAL OF BRONCHOSPASM 152.0 0 94060 PR EVAL OF BRONCHOSPASM 26 48.00 94070 PR EVAL OF 26 71.00 BRONCHOSPASM,PROLONGE D 94150 PR VITAL CAPACITY TEST 56.00 94150 PR VITAL CAPACITY TEST 26 56.00 94200 PR LUNG FUNCTION TEST (MBC/MVV) 65.00 94375 PR RESPIRATORY FLOW 26 41.00 VOLUME LOOP 94452 PR HIGH ALTITUDE SIMULATJ 26 37.00 TEST W/PHYS INTERP&REPORT 94453 PR HIGH ALTITUDE SIMULATJ 26 48.00 W/PHYS I&R W/O2 TITRATION 94617 PR EXERCISE TEST FOR 243.0 BRONCHOSPASM 0 94617 PR EXERCISE TEST FOR 26 86.00 BRONCHOSPASM 94618 PR PULMONARY STRESS TESTING 88.00 94618 PR PULMONARY STRESS 26 59.00 TESTING 94620 PR PULMONARY STRESS 136.0 TESTING,SIMPLE 0 94620 PR PULMONARY STRESS 26 100.0 TESTING,SIMPLE 0 94621 PR CARDIOPULMONARY 26 170.0 EXERCISE TESTING 0 94640 PR PRESSURIZED/NONPRESSURIZED 46.00 INHALATION TREATMENT 94640 PR 26 46.00 PRESSURIZED/NONPRESSURI ZED INHALATION TREATMENT 94645 PR CONTINUOUS INHALATION TX, EACH 37.00 ADD HR 94664 PR DEMO &/OR EVAL,PT USE,AEROSOL 40.00 DEVICE 94690 PR EXHALED AIR ANALYSIS 129.0 0 94690 PR EXHALED AIR ANALYSIS 26 10.00 94726 PR PLETHYSMOGRAPHY 26 31.00 LUNG VOLUMES W/WO AIRWAY RESIST 94727 PR GAS DILUT/WASHOUT 26 31.00 LUNG VOL W/WO DISTRIB VENT&VOL 94728 PR AIRWAY RESISTANCE BY IMPULSE 108.0 OSCILLOMETRY 0 94729 PR DIFFUSING CAPACITY 26 21.00 94750 PR PULMONARY COMPLIANCE 26 30.00 STUDY 94760 PR NONINVASV OXYGEN SATUR;SINGLE 8.00 94761 PR NONINVASV OXYGEN 13.00 SATUR,MULTIPLE 94780 PR CAR SEAT/BED TESTING W/INTERP & 125.0 REPORT 60 MIN 0 94781 PR CAR SEAT/BED TESTNG W/INTERP & 49.00 REPORT +30MIN 95004 PR PERCUTANEOUS TESTS 16.00 W/ALLERGENIC EXTRACTS 95017 PR ALLG TSTG PERQ & IC VENOMS 227.0 IMMED REACT W/ I&R 0 95018 PR ALLG TEST PERQ & IC DRUG/BIOL 54.00 IMMED REACT W/ I&R 95024 PR INTRACUTANEOUS TESTS 19.00 W/ALLERGENIC EXTRACTS 95028 PR ALLERGY SKIN TESTS 31.00 95044 PR ALLERGY PATCH TESTS 17.00 95070 PR BRONCHIAL ALLERGY TESTS,DRUGS 77.00 95076 PR INGESTION CHALLENGE TEST 288.0 INITIAL 120 MINUTES 0 95079 PR INGESTION CHALLENGE TEST EACH 203.0 ADDL 60 MINUTES 0 95115 PR IMMUNOTHERAPY, ONE INJECTION 26.00 95117 PR IMMUNOTHERAPY, 2+ INJECTIONS 32.00 95145 PR PROFES SVC,IMMUNOTHERAPY,1 50.00 INSECT VENOM 95165 PR PROFES 39.00 SVC,IMMUNOTHER,SINGLE/MULT AGS 95180 PR RAPID DESENSITIZATION 347.0 PROC,EACH HOUR 0 95249 PR CONT GLUC MONITORING PATIENT 141.0 PROVIDED EQUIPTMENT 0 95251 PR CONTINUOUS GLUCOSE 104.0 MONITORING ANALYSIS I&R 0 95782 PR POLYSOM <6 YRS SLEEP 26 315.0 STAGE 4/> ADDL PARAM 0 ATTND 95783 PR POLYSOM <6 YRS SLEEP 26 344.0 W/CPAP/BILVL VENT 4/> 0 PARAM 95800 PR SLEEP STUDY, 26 144.0 UNATTENDED, RECORD 0 HEART RATE/O2 SAT/RESP ANAL/SLEEP TIME 95801 PR SLEEP STUDY, 26 127.0 UNATTENDED, RECORD 0 HEART RATE/O2 SAT/RESP ANALYSIS 95803 PR ACTIGRAPHY TESTING, 3- 26 111.0 14 DAY 0 95805 PR MULTIPLE SLEEP 26 216.0 LATENCY TEST 0 95806 PR SLEEP STUDY, 26 177.0 UNATTENDED, SIMUL 0 RECORD HR/O2 SAT/RESP FLOW/RESP EFF 95808 PR POLYSOM ANY AGE SLEEP 26 290.0 STAGE 1-3 ADDL PARAM 0 ATTND 95810 PR POLYSOM 6/>YRS SLEEP 26 424.0 4/> ADDL PARAM ATTND 0 95811 PR POLYSOM 6/>YRS SLEEP 26 473.0 W/CPAP 4/> ADDL PARAM 0 ATTND 95812 PR EEG,EXTENDED 26 146.0 MONITORING,41-60 MINUTES 0 95813 PR EEG >1 HR 26 232.0 0 95816 PR EEG,W/AWAKE & DROWSY 26 207.0 RECORD 0 95819 PR EEG,W/AWAKE & ASLEEP 26 207.0 RECORD 0 95822 PR EEG,COMA/SLEEP 26 150.0 RECORD ONLY 0 95824 PR EEG EVAL CEREBRAL 26 101.0 DEATH 0 95827 PR EEG,ALL NIGHT RECORD 26 125.0 0 95829 PR SURGERY ELECTROCORTICOGRAM 4787. 00 95829 PR SURGERY 26 750.0 ELECTROCORTICOGRAM 0 95836 PR ECOG IMPLANTED BRAIN NPGT 283.0 W/REC I&R <30 DAYS 0 95860 PR EMG, NEEDLE, ONE LIMB 26 175.0 0 95861 PR EMG, NEEDLE, TWO LIMBS 26 235.0 0 95863 PR EMG, NEEDLE, 3 LIMBS 26 280.0 0 95865 PR EMG, NEEDLE, LARYNX 368.0 0 95866 PR EMG, NEEDLE, HEMIDIAPHRAGM 341.0 0 95866 PR EMG, NEEDLE, 26 171.0 HEMIDIAPHRAGM 0 95867 PR EMG,NEEDLE,CRANIAL 26 108.0 NERVE SUPP MUS,UNILAT 0 95869 PR EMG,NEEDLE,THOR PARASPIN 237.0 MUS,EXC T1/T12 0 95869 PR EMG,NEEDLE,THOR 26 51.00 PARASPIN MUS,EXC T1/T12 95870 PR EMG,1 26 70.00 EXTREM,NONPARASPINAL 95872 PR EMG, NEEDLE, ONE FIBER 26 363.3 3 95873 PR ELECTRIC STIM GUIDANCE 26 49.00 FOR CHEMODENERVATION 95874 PR NEEDLE EMG GUIDANCE 26 65.00 FOR CHEMODENERVATION 95885 PR NEEDLE EMG EA 26 137.0 EXTREMITY W/PARASPINL 0 AREA LIMITED 95886 PR NEEDLE EMG EA 26 214.0 EXTREMTY W/PARASPINL 0 AREA COMPLETE 95887 PR NEEDLE EMG 26 191.0 NONEXTREMTY MSCLES 0 W/NERVE CONDUCTION 95907 PR MOTOR &/SENS 1-2 NRV 26 205.0 CNDJ PRECONF ELTRODE 0 LIMB 95908 PR MOTOR &/SENS 3-4 NRV 26 258.0 CNDJ PRECONF ELTRODE 0 LIMB 95909 PR MOTOR &/SENS 5-6 NRV 26 308.0 CNDJ PRECONF ELTRODE 0 LIMB 95910 PR MOTOR &/SENS 7-8 NRV 26 412.0 CNDJ PRECONF ELTRODE 0 LIMB 95911 PR MOTOR &/SENS 9-10 NRV 26 513.0 CNDJ PRECONF ELTRODE 0 LIMB 95912 PR MOTOR &/SENS 11-12 NRV 26 617.0 CNDJ PRECONF ELTRODE 0 LIMB 95913 PR MOTOR &/SENS 13/> NRV 26 730.0 CNDJ PRECONF ELTRODE 0 LIMB 95925 PR SOMATOSENSORY 26 80.00 TEST,UPPER LIMBS 95926 PR SOMATOSENSORY 26 80.00 TEST,LOWER LIMBS 95930 PR VISUAL EP TESTING CNS 26 48.00 EXCEPT GLAUCOMA W/I&R 95933 PR BLINK REFLEX TEST 26 80.00 95937 PR NEUROMUSCULAR 26 115.0 JUNCTION TEST 0 95938 PR SHORT-LATENCY 26 721.0 SOMATOSENS EP STD UPR & 0 LOW LIMBS 95950 PR AMBULATORY EEG 26 205.0 MONITORING 0 95951 PR EEG MONITORING/VIDEORECORD 790.0 0 95951 PR EEG 26 939.0 MONITORING/VIDEORECORD 0 95953 PR EEG 26 399.0 MONITORING/COMPUTER, EA 0 24 HOURS, UNATTENDED 95955 PR EEG DURING SURGERY 26 137.0 0 95956 PR EEG MONITORING/COMPUTER, EA 24 4073. HOURS, ATTENDED BY TECH/NURSE 00 95956 PR EEG 26 616.0 MONITORING/COMPUTER, EA 0 24 HOURS, ATTENDED BY TECH/NURSE 95958 PR EEG 26 600.0 MONITORING/FUNCTION TEST 0 95961 PR FUNCJAL CORT&SUBCORT MAPG 768.0 PHYS/QHP ATTND INIT HR 0 95961 PR FUNCJAL CORT&SUBCORT 26 425.0 MAPG PHYS/QHP ATTND INIT 0 HR 95962 PR FUNCJAL CORT&SUBCORT MAPG 659.0 PHYS/QHP ATTND ADDL HR 0 95962 PR FUNCJAL CORT&SUBCORT 26 446.0 MAPG PHYS/QHP ATTND 0 ADDL HR 95970 PR ELEC ALYS NSTIM PLS GEN 171.0 BRN/SC/PERPH W/O REPRGRM 0 95971 PR ELEC ALYS IMPLT NPGT SMPL SP/PN 129.0 NPGT PRGRMG 0 95972 PR ELEC ALYS IMPLT NPGT CPLX SP/PN 300.0 PRGRMG 0 95974 PR ELEC ALYS NSTIM PLS GEN CPLX 519.0 CRNL NRV 1ST HR 0 95975 PR ELEC ALYS NSTIM PLS GEN CPLX 283.0 CRNL NRV EA 30 MIN 0 95976 PR ELEC ALYS IMPLT SMPL CN NPGT 105.0 PRGRMG 0 95977 PR ELEC ALYS IMPLT CPLX CN NPGT 139.0 PRGRMG 0 95978 PR ANALYZE NEUROSTIM BRAIN, FIRST 514.0 1H 0 95979 PR ANALYZ NEUROSTIM BRAIN, EACH 240.0 ADD 30 MIN 0 95983 PR ELEC ALYS IMPLT BRN NPGT 132.0 PRGRMG 1ST 15 MIN 0 95984 PR ELEC ALYS IMPLT BRN NPGT 115.0 PRGRMG EA ADDL 15 MIN 0 95990 PR REFILL&MAINTENANCE PUMP DRUG 226.0 DLVR SPINAL/BRAIN 0 95991 PR RFL&MAIN IMPLT PMP/RSVR DLVR 280.0 SPI/BRN PHY/QHP 0 95992 PR CANALITH REPOSITIONING 122.0 PROCEDURE, PER DAY 0 96002 PR DYN SURF EMG,WALKING/FUNC 56.00 ACT,1-12 MUS 96101 PR PSYCHOLOGIC TESTING BY 300.0 PSYCH/PHYS 0 96103 PR PSYCHOLOGIC TESTING ADMIN BY 158.0 COMPUTER 0 96110 PR DEVELOPMENTAL SCREEN 30.00 W/SCORING & DOC STD INSTRM 96111 PR DEVELOPMENTAL TESTING 320.0 W/INTERP & REPORT 0 96112 PR DEVELOPMENTAL TST ADMIN 346.0 PHYS/QHP 1ST HOUR 0 96113 PR DEVELOPMENTAL TST ADMIN 155.0 PHYS/QHP EA ADDL 30 MIN 0 96116 PR NEUROBEHAVIORAL STATUS EXAM 250.0 BY PSYCH/PHYS 0 96118 PR NEUROPSYCH TESTING BY 300.0 PSYCH/PHYS 0 96119 PR NEUROPSYCH TESTING BY 201.0 TECHNICIAN 0 96121 PR NEUROBEHAVIORAL STATUS XM 210.0 PHYS/QHP EA ADDL HOUR 0 96127 PR BEHAV ASSMT W/SCORE & 12.00 DOCD/STAND INSTRUMENT 96130 PR PSYCHOLOGICAL TST EVAL SVC 298.0 PHYS/QHP FIRST HOUR 0 96131 PR PSYCHOLOGICAL TST EVAL SVC 227.0 PHYS/QHP EA ADDL HOUR 0 96132 PR NEUROPSYCHOLOGICAL TST EVAL 335.0 PHYS/QHP 1ST HOUR 0 96133 PR NEUROPSYCHOLOGICAL TST EVAL 255.0 PHYS/QHP EA ADDL HR 0 96136 PR PSYL/NRPSYCL TST PHYS/QHP 2+ 120.0 TST 1ST 30 MIN 0 96137 PR PSYCL/NRPSYCL TST PHYS/QHP 2+ 111.0 TST EA ADDL 30 MIN 0 96138 PR PSYCL/NRPSYCL TST TECH 2+ TST 98.00 1ST 30 MIN 96139 PR PSYCL/NRPSYCL TST TECH 2+ TST 98.00 EA ADDL 30 MIN 96146 PR PSYCL/NRPSYCL TST ELEC 6.00 PLATFORM AUTO RESULT 96150 PR HEAL & BEHAV ASSESS,EA 15 64.00 MIN,INIT 96151 PR HEAL & BEHAV ASSESS,EA 15 63.00 MIN,RE-ASSESS 96152 PR HEAL & BEHAV INTERVENT,EA 15 60.00 MIN,INDIV 96154 PR HEAL & BEHAV INTERV,EA 15 59.00 MIN,FAM W/PT 96155 PR HEAL & BEHAV INTERV,EA 15 59.00 MIN,FAM W/O PT 96160 PR PT-FOCUSED HLTH RISK ASSMT 12.00 SCORE DOC STND INSTRM 96161 PR CAREGIVER HLTH RISK ASSMT 30.00 SCORE DOC STND INSTRM 96360 PR IV INFUSION, HYDRATION, 31-60 MIN 130.0 0 96361 PR IV INFUSION, HYDRATION, EA ADD 110.0 HOUR 0 96365 PR IV INFUSION, 159.0 THERAP/PROPH/DIAGNOST,INITIAL,1ST 0 HOUR 96366 PR IV INFUSION, 53.00 THERAP/PROPH/DIAGNOST,INITIAL,EA ADD HOUR 96367 PR IV INFUSION THER PROPH ADDL 88.00 SEQUENTIAL TO 1 HR 96368 PR IV INFUSION, 51.00 THERAP/PROPH/DIAGNOST,CONCURRE NT INFUSION 96372 PR 56.00 INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT 96373 PR 48.00 INJECTION,THERAP/PROPH/DIAGNOST, INTRA-ARTERIAL 96374 PR 119.0 INJECTION,THERAP/PROPH/DIAGNOST, 0 IV PUSH, INITIAL DRUG 96375 PR 55.00 INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG 96401 PR CHEMOTHER,NON-HORMONE ANTI- 156.0 NEOPL, SUB-Q/IM 0 96402 PR CHEMOTHER HORMON ANTINEOPL 106.0 SUB-Q/IM 0 96405 PR INTRALESIONAL CHEMO ADMIN,<8 417.0 LESN 0 96409 PR CHEMOTHER, IV PUSH, SNGL DRUG 298.0 0 96411 PR CHEMOTHER, IV PUSH,EA ADD 183.0 DRUG 0 96413 PR CHEMOTHER, IV INFUSION, 1 HR 485.0 0 96415 PR CHEMOTHER, IV INFUSION, EA HR 149.0 0 96417 PR CHEMOTHER, IV INFUSE, EACH 218.0 SEQU INFUS 0 96450 PR CHEMOTHER,CNS,W/LUMBAR 1291. PUNCTURE 00 96542 PR CHEMOTHER 770.0 INJECT,SUBARACH/INTRAVENT 0 96573 PR PDT DSTR PRMLG LES SKN 484.0 ILLUM/ACTIVJ BY PHYS/QHP 0 96574 PR DEBRIDEMENT PRMLG 623.0 HYPERKERATOTIC LES W/PDT 0 97010 PR HOT OR COLD PACKS THERAPY 16 97012 PR MECHANICAL TRACTION THERAPY 39 97014 PR ELECTRIC STIMULATION THERAPY 39 97016 PR VASOPNEUMATIC DEVICE THERAPY 46 97018 PR PARAFFIN BATH THERAPY 27 97022 PR WHIRLPOOL THERAPY 56 97032 PR ELECTRICAL STIMULATION 46.00 97034 PR CONTRAST BATH 44 THERAPY 97035 PR ULTRASOUND THERAPY 35 97039 PR PHYSICAL THERAPY TREATMENT 32 97110 PR THERAPEUTIC EXERCISES 78 97112 PR NEUROMUSC REEDUCAT,1+ AREAS, 89 EA 15 MIN 97116 PR GAIT TRAINING THERAPY 77 97140 PR MANUAL THER TECH,1+REGIONS,EA 72 15 MIN 97150 PR GROUP THERAPEUTIC 47 PROCEDURES 97161 PR PHYSICAL THERAPY EVALUATION 215 LOW COMPLEX 20 MINS 97162 PR PHYSICAL THERAPY EVALUATION 215 MOD COMPLEX 30 MINS 97163 PR PHYSICAL THERAPY EVALUATION 215 HIGH COMPLEX 45 MINS 97164 PR PHYSICAL THERAPY RE-EVAL EST 146 PLAN CARE 20 MINS 97165 PR OCCUPATIONAL THERAPY EVAL 231 LOW COMPLEX 30 MINS 97166 PR OCCUPATIONAL THERAPY EVAL 231 MOD COMPLEX 45 MINS 97167 PR OCCUPATIONAL THERAPY EVAL 231 HIGH COMPLEX 60 MINS 97168 PR OCCUPATIONAL THER RE-EVAL EST 158 PLAN CARE 30 MINS 97530 PR THERAPEUT ACTVITY DIRECT PT 101 CONTACT EACH 15 MIN 97533 PR SENSORY INTEGRATIVE 108 TECHNIQUES EACH 15 MINUTES 97535 PR SELF-CARE/HOME MGMT TRAINING 87 EACH 15 MINUTES 97545 PR WORK HARDENING/CONDN,0-2 HR 394 97597 PR DEBRIDEMENT OPEN WOUND 20 SQ 189.0 CM< 0 97598 PR DEBRIDEMENT OPEN WOUND EA 63.00 ADDL 20 SQ CM 97602 PR RMVL DEVITAL TISS N-SLCTV 137.0 DBRDMT W/O ANES 1 SESS 0 97605 PR NEGATIVE PRESSURE WOUND 100.0 THERAPY DME 50 SQ CM 0 97607 PR NEG PRESSURE WOUND THERAPY 446.0 NON DME 50 SQ CM 0 97750 PR PHYSICAL PERFORMANCE TEST 83.00 97760 PR ORTHOTICS MGMT & TRAINJ INITIAL 121 ENCTR EA 15 MINS 97761 PR PROSTHETICS TRAINING INITIAL 104 ENCTR EA 15 MINS 97763 PR ORTHOTICS/PROSTH MGMT 128 &/TRAINJ SBSQ ENCTR 15 MIN 97802 PR MED NUTR THER, 1ST, INDIV, EA 15 88.00 MIN 97803 PR MED NUTR THER, SUBSQ, INDIV, EA 76.00 15 MIN 97804 PR MED NUTR THER, GROUP, EA 30 MIN 40.00 97810 PR ACUPUNCT W/O ELEC STIMUL 15 MIN 136.0 0 97813 PR ACUPUNCT W/ ELEC STIMUL 15 MIN 136.0 0 98925 PR OSTEOPATHIC MANIP,1-2 BODY 80 REGN 98926 PR OSTEOPATHIC MANIP,3-4 BODY 115 REGN 98927 PR OSTEOPATHIC MANIP,5-6 BODY 151.0 REGN 0 98928 PR OSTEOPATHIC MANIP,7-8 BODY 183 REGN 98929 PR OSTEOPATHIC MANIP,9-10 BODY 219.0 REGN 0 98961 PR SELF-MGMT EDUC/TRAIN, 2-4 PT, EA 46.00 30 MIN 98968 PR NONPHYSICIAN TELEPHONE 150.0 ASSESSMENT 21-30 MIN 0 99000 PR HANDLG&/OR CONVEY OF SPEC FOR 16 TR OFFICE TO LAB 99024 PR POST-OP FOLLOW-UP 0.00 VISIT 99050 PR MEDICAL SERVICES AFTER HRS 47.00 99053 PR MEDICAL SERVICES 10PM-8AM, 24 55.00 HR FAC 99058 PR EMERGENCY CARE DISRUPTING 144.0 OFFICE 0 99070 PR SUPPLIES&MATERIALS 50.00 ABOVE/BEYOND PROV BY PHYS/QHP 99080 PR SPECIAL REPORTS OR FORMS 49.00 99100 SPECIAL ANESTHESIA 132.0 SERVICE 0 99140 PR EMERGENCY ANESTHESIA 263.0 0 99143 PR MODERATE SEDATJ SAME 148.0 PHYS/QHP <5 YRS INIT 30 MIN 0 99144 PR MODERATE SEDATJ SAME 135.0 PHYS/QHP 5/>YRS INIT 30 MIN 0 99144 PR MODERATE SEDATJ SAME 26 135.0 PHYS/QHP 5/>YRS INIT 30 MIN 0 99145 PR MODERATE SEDATJ SAME 63.00 PHYS/QHP EACH ADDL 15 MIN 99145 PR MODERATE SEDATJ SAME 26 63.00 PHYS/QHP EACH ADDL 15 MIN 99148 PR MOD SEDATJ DIFF PHYS/QHP <5 YRS 137.0 INIT 30 MIN 0 99149 PR MODERATE SEDATJ DIFF PHYS/QHP 128.0 5/>YRS INIT 30 MIN 0 99150 PR MODERATE SEDATJ DIFF PHYS/QHP 70.00 EA ADDL 15 MIN 99151 PR MOD SED SAME PHYS/QHP INITIAL 196.0 15 MINS <5 YRS 0 99152 PR MOD SED SAME PHYS/QHP INITIAL 131.0 15 MINS 5/> YRS 0 99153 PR MOD SED SAME PHYS/QHP EACH 28.00 ADDL 15 MINS 99155 PR MOD SED OTHER PHYS/QHP INITIAL 236.0 15 MINS <5 YRS 0 99156 PR MOD SED OTHER PHYS/QHP INITIAL 193.0 15 MINS 5/> YRS 0 99157 PR MOD SED OTHER PHYS/QHP EACH 147.0 ADDL 15 MINS 0 99173 PR VISUAL SCREENING TEST, BILAT 72.00 99174 PR INSTRUMENT BASED OCULAR SCR 67.00 BI W/RMT ANAL & RPT 99184 PR INITIAT SELECTIVE HEAD/BODY 565.0 HYPOTHERMIA NEONATE 0 99188 PR APPLICATION TOPICAL FLUORIDE 49.00 VARNISH BY PHS/QHP 99201 PR OFFICE OUTPATIENT NEW 10 106.0 MINUTES 0 99202 PR OFFICE OUTPATIENT NEW 20 181.0 MINUTES 0 99203 PR OFFICE OUTPATIENT NEW 30 262.0 MINUTES 0 99204 PR OFFICE OUTPATIENT NEW 45 396.0 MINUTES 0 99205 PR OFFICE OUTPATIENT NEW 60 494.0 MINUTES 0 99211 PR OFFICE OUTPATIENT VISIT 5 49.00 MINUTES 99212 PR OFFICE OUTPATIENT VISIT 10 105.0 MINUTES 0 99213 PR OFFICE OUTPATIENT VISIT 15 177.0 MINUTES 0 99214 PR OFFICE OUTPATIENT VISIT 25 258.0 MINUTES 0 99215 PR OFFICE OUTPATIENT VISIT 40 345.0 MINUTES 0 99217 PR OBSERVATION CARE DISCHARGE 184.0 MANAGEMENT 0 99218 PR INITIAL OBSERVATION CARE/DAY 30 252.0 MINUTES 0 99219 PR INITIAL OBSERVATION CARE/DAY 50 342.0 MINUTES 0 99220 PR INITIAL OBSERVATION CARE/DAY 70 468.0 MINUTES 0 99221 PR INITIAL HOSPITAL CARE/DAY 30 255.0 MINUTES 0 99222 PR INITIAL HOSPITAL CARE/DAY 50 344.0 MINUTES 0 99223 PR INITIAL HOSPITAL CARE/DAY 70 510.0 MINUTES 0 99224 PR SBSQ OBSERVATION CARE/DAY 15 101.0 MINUTES 0 99225 PR SBSQ OBSERVATION CARE/DAY 25 184.0 MINUTES 0 99226 PR SBSQ OBSERVATION CARE/DAY 35 264.0 MINUTES 0 99231 PR SBSQ HOSPITAL CARE/DAY 15 99.00 MINUTES 99232 PR SBSQ HOSPITAL CARE/DAY 25 183.0 MINUTES 0 99233 PR SBSQ HOSPITAL CARE/DAY 35 262.0 MINUTES 0 99234 PR OBSERVATION/INPATIENT HOSPITAL 335.0 CARE 40 MINUTES 0 99235 PR OBSERVATION/INPATIENT HOSPITAL 435.0 CARE 50 MINUTES 0 99236 PR OBSERVATION/INPATIENT HOSPITAL 549.0 CARE 55 MINUTES 0 99238 PR HOSPITAL DISCHARGE DAY,<30 MIN 184.0 0 99239 PR HOSPITAL DISCHARGE DAY,>30 MIN 271.0 0 99241 PR OFFICE CONSULTATION NEW/ESTAB 117.0 PATIENT 15 MIN 0 99242 PR OFFICE CONSULTATION NEW/ESTAB 219.0 PATIENT 30 MIN 0 99243 PR OFFICE CONSULTATION NEW/ESTAB 300.0 PATIENT 40 MIN 0 99244 PR OFFICE CONSULTATION NEW/ESTAB 444.0 PATIENT 60 MIN 0 99245 PR OFFICE CONSULTATION NEW/ESTAB 696.0 PATIENT 80 MIN 0 99251 PR INITL INPATIENT CONSULT 123.0 NEW/ESTAB PT 20 MIN 0 99252 PR INITL INPATIENT CONSULT 188.0 NEW/ESTAB PT 40 MIN 0 99253 PR INITL INPATIENT CONSULT 289.0 NEW/ESTAB PT 55 MIN 0 99254 PR INITL INPATIENT CONSULT 420.0 NEW/ESTAB PT 80 MIN 0 99255 PR INITIAL INPATIENT CONSULT 505.0 NEW/ESTAB PT 110 MIN 0 99281 PR EMERGENCY DEPARTMENT VISIT 60.00 LIMITED/MINOR PROB 99282 PR EMERGENCY DEPARTMENT VISIT 104.0 LOW/MODER SEVERITY 0 99283 PR EMERGENCY DEPARTMENT VISIT 156.0 MODERATE SEVERITY 0 99284 PR EMERGENCY DEPARTMENT VISIT 295.0 HIGH/URGENT SEVERITY 0 99285 PR EMERGENCY DEPT VISIT HIGH 435.0 SEVERITY&THREAT FUNCJ 0 99288 PR PHYS/QHP DIRECTION EMERGENCY 297.0 MEDICAL SYSTEMS 0 99291 PR CRITICAL CARE, E/M 30-74 MINUTES 1060 99292 PR CRITICAL CARE, ADDL 30 MIN 308.0 0 99304 PR INITIAL NURSING FACILITY 230.0 CARE/DAY 25 MINUTES 0 99305 PR INITIAL NURSING FACILITY 328.0 CARE/DAY 35 MINUTES 0 99306 PR INITIAL NURSING FACILITY 420.0 CARE/DAY 45 MINUTES 0 99307 PR SBSQ NURSING FACILITY CARE/DAY 112.0 E/M STABLE 10 MIN 0 99308 PR SBSQ NURSING FACIL CARE/DAY 174.0 MINOR COMPLJ 15 MIN 0 99308 PR SBSQ NURSING FACIL 26 173.0 CARE/DAY MINOR COMPLJ 15 0 MIN 99309 PR SBSQ NURSING FACIL CARE/DAY 230.0 NEW PROBLEM 25 MIN 0 99310 PR SBSQ NURS FACIL CARE/DAY 342.0 UNSTABL/NEW PROB 35 MIN 0 99315 PR NURSING FAC DISCHRGE DAY,1-30 184.0 MIN 0 99316 PR NURSING FAC DISCHRGE DAY,MORE 267.0 30 MIN 0 99318 PR E/M ANNUAL NURSING FACILITY 242.0 ASSESS STABLE 30 MIN 0 99324 PR DOMICIL/REST HOME NEW PT VISIT 139.0 LOW SEVER 20 MIN 0 99325 PR DOMICIL/REST HOME NEW PT VISIT 202.0 MOD SEVER 30 MIN 0 99326 PR DOMICIL/REST HOME NEW PT HI- 350.0 MOD SEVER 45 MINUTES 0 99327 PR DOMICIL/REST HOME NEW PT VISIT 468.0 HI SEVER 60 MIN 0 99328 PR DOM/R-HOME E/M NEW PT SIGNIF 548.0 NEW PROB 75 MINUTES 0 99334 PR DOM/R-HOME E/M EST PT SELF- 151.0 LMTD/MINOR 15 MINUTES 0 99335 PR DOM/R-HOME E/M EST PT LW MOD 238.0 SEVERITY 25 MINUTES 0 99336 PR DOM/R-HOME E/M EST PT MOD HI 340.0 SEVERITY 40 MINUTES 0 99337 PR DOM/R-HOME E/M EST PT SIGNIF 486.0 NEW PROB 60 MINUTES 0 99339 PR DOMICIL/REST-HOME CARE 195.0 SUPERVISION, <30 MIN 0 99340 PR DOMICIL/REST-HOME CARE 273.0 SUPERVISION, =>30 MIN 0 99341 PR HOME VISIT NEW PATIENT LOW 138.0 SEVERITY 20 MINUTES 0 99342 PR HOME VISIT NEW PATIENT MOD 200.0 SEVERITY 30 MINUTES 0 99343 PR HOME VST NEW PATIENT MOD-HI 328.0 SEVERITY 45 MINUTES 0 99344 PR HOME VISIT NEW PATIENT HI 459.0 SEVERITY 60 MINUTES 0 99345 PR HOME VISIT NEW PT 558.0 UNSTABL/SIGNIF NEW PROB 75 MIN 0 99347 PR HOME VISIT EST PT SELF 139.0 LIMITED/MINOR 15 MINUTES 0 99348 PR HOME VISIT EST PT LOW-MOD 212.0 SEVERITY 25 MINUTES 0 99349 PR HOME VISIT EST PT MOD-HI 324.0 SEVERITY 40 MINUTES 0 99350 PR HOME VST EST PT UNSTABLE/SIGNIF 450.0 NEW PROB 60 MINS 0 99354 PR PROLNG E&M/PSYCTX SVC OFFICE 328.0 O/P DIR CON 1ST HR 0 99355 PR PROLNG E&M/PSYCTX SVC OFFICE 248.0 O/P DIR CON ADDL 30 0 99356 PR PROLONGED SERVICE I/P REQ 232.0 UNIT/FLOOR TIME 1ST HR 0 99357 PR PROLONGED SVC I/P REQ 233.0 UNIT/FLOOR TIME EA 30 MIN 0 99358 PR PROLNG E/M SVC BEFORE&/AFTER 294.0 DIR PT CARE 1ST HR 0 99359 PR PROLNG E/M BEFORE&/AFTER DIR 147.0 CARE EA 30 MIN 0 99360 PR PHYS STANDBY SVC PROLNG PHYS 202.0 ATTN EA 30 MINUTES 0 99363 PR ANTICOAG MGMT, INITIAL 90 DAYS 318.0 0 99364 PR ANTICOAG MGMT, EACH SUBSEQ 90 109.0 DAYS 0 99366 PR TEAM CONFERENCE FACE-TO-FACE 108.0 NONPHYSICIAN 0 99367 PR TEAM CONFERENCE NON-FACE-TO- 143.0 FACE PHYSICIAN 0 99368 PR TEAM CONFERENCE NON-FACE-TO- 93.00 FACE NONPHYSICIAN 99374 PR SUPVJ PT HOME HEALTH AGENCY 176.0 MO 15-29 MINUTES 0 99375 PR SUPERVISION PT HOME HEALTH 263.0 AGENCY MONTH 30 MIN/> 0 99377 PR SUPERVISION HOSPICE 176.0 PATIENT/MONTH 15-29 MIN 0 99378 PR SUPERVISION HOSPICE 278.0 PATIENT/MONTH 30 MINUTES/> 0 99379 PR SUPERVISION NURS FACILITY 176.0 PATIENT MO 15-29 MIN 0 99380 PR SUPERVISION NURS FACILITY 263.0 PATIENT MONTH 30 MIN/> 0 99381 PR PREVENTIVE VISIT,NEW,INFANT < 1 275.0 YR 0 99382 PR PREVENTIVE VISIT,NEW,AGE 1-4 287.0 0 99383 PR PREVENTIVE VISIT,NEW,AGE5-11 300.0 0 99384 PR PREVENTIVE VISIT,NEW,12-17 339.0 0 99385 PR PREVENTIVE VISIT,NEW,18-39 327.0 0 99386 PR PREVENTIVE VISIT,NEW,40-64 380.0 0 99387 PR PREVENTIVE VISIT,NEW,65 & OVER 412.0 0 99391 PR PREVENTIVE VISIT,EST, INFANT < 1 248.0 YR 0 99392 PR PREVENTIVE VISIT,EST,AGE 1-4 264.0 0 99393 PR PREVENTIVE VISIT,EST,AGE5-11 264.0 0 99394 PR PREVENTIVE VISIT,EST,12- 289.0 17 0 99395 PR PREVENTIVE VISIT,EST,18- 295.0 39 0 99396 PR PREVENTIVE VISIT,EST,40- 315.0 64 0 99397 PR PREVENTIVE VISIT,EST,65 & OVER 339.0 0 99401 PR PREVENT COUNSEL,INDIV,15 MIN 91.00 99402 PR PREVENT COUNSEL,INDIV,30 MIN 155.0 0 99403 PR PREVENT COUNSEL,INDIV,45 MIN 216.0 0 99404 PR PREVENT COUNSEL,INDIV,60 MIN 279.0 0 99406 PR TOBACCO USE CESSATION 37.00 INTERMEDIATE 3-10 MINUTES 99407 PR TOBACCO USE CESSATION 71.00 INTENSIVE >10 MINUTES 99408 PR ALCOHOL/SUBSTANCE SCREEN & 89.00 INTERVEN 15-30 MIN 99409 PR ALCOHOL/SUBSTANCE SCREEN & 173.0 INTERVEN >30 MIN 0 99411 PR PREVENT COUNSEL,GROUP,30 MIN 41.00 99412 PR PREVENT COUNSEL,GROUP,60 MIN 54.00 99415 PR PROLNG CLINCL STAFF SVC DURING 25.00 O/P E/M 1ST HR 99416 PR PROLNG CLINCL STAFF SVC DURING 20.00 O/P E/M EA 30 MIN 99441 PR PHYS/QHP TELEPHONE EVALUATION 36.00 5-10 MIN 99442 PR PHYS/QHP TELEPHONE EVALUATION 68.00 11-20 MIN 99443 PR PHYS/QHP TELEPHONE EVALUATION 100.0 21-30 MIN 0 99444 PR PHYS/QHP ONLINE EVALUATION & 84.00 MANAGEMENT SERVICE 99446 PR INTERPROF PHONE/INTERNET 30.00 ASSESS/MANAGE 5-10 99450 PR LIFE/DISABILITY EVALUATION 334.0 0 99451 PR NTRPROF PHONE/NTRNET/EHR 94.00 ASSMT&MGMT 5/> MIN 99452 PR NTRPROF PHONE/NTRNET/EHR 94.00 REFERRAL SVC 30 MIN 99453 PR REM MNTR PHYSIOL PARAM 1ST SET 49.00 UP PT EDUCAJ EQP 99454 PR REM MNTR PHYSIOL PARAM 1ST 161.0 DEV SUPPLY EA 30 D 0 99455 PR DISABILITY EXAM/TREATING DR 459.0 0 99456 PR DISABILITY EXAM/OTHER 528.0 DR 0 99457 PR REMOTE PHYSIOLOGIC 129.0 MONITORING 20 MIN+ PER MONTH 0 99460 PR INITIAL NORMAL NEWBORN CARE, 252.0 HOSPITAL OR BIRTH CENTER 0 99461 PR INITIAL NORMAL NEWBORN CARE, 245.0 EXCEPT HOSPITAL OR BIRTH CENTER 0 99462 PR SUBSEQUENT HOSPITAL CARE, 112.0 NORMAL NEWBORN 0 99463 PR INITIAL NORMAL NEWBORN CARE, 301.0 SAME DAY DISCHARGE 0 99464 PR ATTN AT DELIVERY 1ST 194.0 STABILIZATION OF NEWBORN 0 99465 PR DELIVERY/BIRTHING ROOM 384.0 RESUSCITATION 0 99466 PR CRITICAL CARE INTERFACILITY 639.0 TRANSPORT 30-74 MIN 0 99467 PR CRITICAL CARE INTERFACILITY 309.0 TRANSPORT EA 30 MIN 0 99468 PR INITIAL HOSP NEONATE 28 DAY OR 3676. LESS, CRITICALLY ILL 00 99469 PR SUBSEQUENT HOSP NEONATE 28 1553. DAY OR LESS, CRITICALLY ILL 00 99471 PR INITIAL PED CRITICAL CARE 29 DAY 3050. THRU 24 MO 00 99472 PR SUBSEQUENT PED CRITICAL CARE 1035. 29 DAY THRU 24 MO 00 99475 PR INITIAL PED CRITICAL CARE 2 YR 2027. THRU 5 YR 00 99476 PR SUBSEQUENT PED CRITICAL CARE 2 868.0 YR THRU 5 YR 0 99477 PR INITIAL HOSP NEONATE 28 DAY OR 897.0 LESS, NOT CRITICALLY ILL 0 99478 PR SUBSEQUENT INTENSIVE CARE 353.0 INFANT < 1500 GRAMS 0 99479 PR SUBSEQUENT INTENSIVE CARE 314.0 INFANT 1500-2500 GRAMS 0 99480 PR SUBSEQUENT INTENSIVE CARE 303.0 INFANT 2501-5000 GRAMS 0 99483 PR ASSMT & CARE PLANNING PT 597.0 W/COGNITIVE IMPAIRMENT 0 99484 PR CARE MGMT SERVICES BEHAVIORAL 120.0 HLTH COND 20 MINS 0 99485 PR SUPERVISION INTERFACILITY 193.0 TRANSPORT INIT 30 MIN 0 99486 PR SUPERVISION INTERFACILITY 168.0 TRANSPORT ADDL 30 MIN 0 99487 PR CMPLX CHRON CARE MGMT W/O PT 205.0 VST 1ST HR PER MO 0 99489 PR CMPLX CHRON CARE MGMT EA 115.6 ADDL 30 MIN PER MONTH 7 99490 PR CHRON CARE MANAGEMENT SRVC 106.0 20 MIN PER MONTH 0 99491 PR CHRONIC CARE MGMT SVC AT 210.0 LEAST 30 MIN PER MONTH 0 99492 PR 1ST PSYCHIATRIC COLLAB CARE 404.0 MGMT 1ST 70 MINS 0 99493 PR SBSQ PSYCHIATRIC COLLAB CARE 323.0 MGMT 1ST 60 MINS 0 99494 PR 1ST/SBSQ PSYCH COLLAB CARE 167.0 MGMT EA ADDL 30 MINS 0 99495 PR TRANSITIONAL CARE MANAGE 496.0 SERVICE 14 DAY DISCHRGE 0 99496 PR TRANSITIONAL CARE MANAGE 584.0 SERVICE 7 DAY DISCHARGE 0 99497 PR ADVANCE CARE PLANNING FIRST 30 213.0 MINS 0 99498 PR ADVANCE CARE PLANNING EA ADDL 188.0 30 MINS 0 99499 PR UNLISTED E/M SERVICE 0.00 99502 HOME VISIT,NEWBORN 121.0 CARE,ASSESSMENT 0 A4351 PR STRAIGHT TIP URINE CATHETER 5.00 A4353 PR INTERMITTENT URINARY CATH 17.00 A4358 PR URINARY LEG OR ABDOMEN BAG 16.00 A4450 PR NON-WATERPROOF TAPE 1 A4495 PR THIGH LENGTH SURG STOCKING 22.00 A4500 PR BELOW KNEE SURGICAL STOCKING 20.00 A4550 PR SURGICAL TRAYS 55.00 A4556 PR ELECTRODES, PAIR 35 A4562 PR PESSARY, NON RUBBER,ANY TYPE 139.0 0 A4565 PR SLINGS 14.00 A4570 PR SPLINT 32 A4595 PR TENS SUPPL 2 LEAD PER MONTH 39.00 A4615 CANNULA NASAL 2.00 A4617 MOUTH PIECE 9.00 A4627 PR SPACER BAG/RESERVOIR 28.00 A5500 PR DIAB SHOE FOR DENSITY INSERT 89.00 A5501 PR DIABETIC CUSTOM MOLDED SHOE 268.0 0 A5503 PR DIABETIC SHOE W/ROLLER/ROCKR 44.00 A5504 PR DIABETIC SHOE WITH WEDGE 44.00 A5506 PR DIABETIC SHOE W/OFF SET HEEL 46 A5507 PR MODIFICATION DIABETIC SHOE 80.00 A5512 PR MULTI DEN INSERT DIRECT FORM 55.00 A5513 PR MULTI DEN INSERT CUSTOM MOLD 139.0 0 A6025 PR SILICONE GEL SHEET, 44 EACH A6453 PR SELF-ADHER BAND W 2 <3/YD A6504 PR CMPRSBURNGARMENT GLOVE- 315.0 WRIST 0 A6505 PR CMPRSBURNGARMENT GLOVE- 367 ELBOW A6506 PR CMPRSBURNGRMNT GLOVE-AXILLA 383 A6507 PR CMPRS BURNGARMENT FOOT-KNEE 108 A6530 PR COMPRESSION STOCKING BK18-30 38.00 A6531 PR COMPRESSION STOCKING BK30-40 61.00 A6533 PR GC STOCKING THIGHLNGTH 18-30 51.00 A6534 PR GC STOCKING THIGHLNGTH 30-40 133.0 0 A6536 PR GC STOCKING FULL LNGTH 18-30 57.00 A6537 PR GC STOCKING FULL LNGTH 30-40 65.00 A6539 PR GC STOCKING WAISTLNGTH 18-30 134.0 0 A6540 PR GC STOCKING WAISTLNGTH 30-40 185.0 0 A6541 PR GC STOCKING WAISTLNGTH 40-50 260 A6549 PR G COMPRESSION 272.0 STOCKING 0 A7003 PR NEBULIZER ADMINISTRATION SET 5.00 A7015 PR AEROSOL MASK USED W NEBULIZE 4.00 A8000 PR SOFT PROTECT HELMET PREFAB 209.0 0 A8001 PR HARD PROTECT HELMET PREFAB 209.0 0 A8002 PR SOFT PROTECT HELMET CUSTOM 329.0 0 A8003 PR HARD PROTECT HELMET CUSTOM 2492. 00 A9270 PR NON-COVERED ITEM OR SERVICE 25.00 A9279 PR MONITORING FEATURE/DEVICENOC 250.0 0 D0120 PR PERIODIC ORAL EVALUATION 55.00 D0140 PR LIMIT ORAL EVAL PROBLM FOCUS 75.00 D0145 PR ORAL EVALUATION, PT < 3YRS 60.00 D0150 PR COMPREHENSVE ORAL EVALUATION 90.00 D0160 PR EXTENSV ORAL EVAL PROB FOCUS 75.00 D0170 PR RE-EVAL,EST PT,PROBLEM FOCUS 75.00 D0171 PR RE-EVAL POST-OP VISIT 0.00 D0180 PR COMP PERIODONTAL EVALUATION 100.0 0 D0210 PR INTRAOR COMPLETE FILM SERIES 140.0 0 D0220 PR INTRAORAL PERIAPICAL FIRST F 32.00 D0230 PR INTRAORAL PERIAPICAL EA ADD 26.00 D0240 PR INTRAORAL OCCLUSAL 48.00 FILM D0250 PR EXTRAORAL FIRST FILM 50.00 D0251 EXTRA-ORAL POSTERIOR DENTAL 75.00 RADIOGRAPHIC IMAGE D0270 PR DENTAL BITEWING SINGLE FILM 32.00 D0272 PR DENTAL BITEWINGS TWO FILMS 50.00 D0273 PR BITEWINGS - THREE FILMS 50.00 D0274 PR DENTAL BITEWINGS FOUR FILMS 70.00 D0277 PR VERT BITEWINGS-SEV TO EIGHT 100.0 0 D0330 PR DENTAL PANORAMIC FILM 125.0 0 D0340 PR DENTAL CEPHALOMETRIC FILM 140.0 0 D0350 PR ORAL/FACIAL PHOTO IMAGES 70.00 D0351 PR 3D PHOTOGRAPHIC IMAGE 0.00 D0363 PR CONE BEAM, THREE DIMENSIONAL 300.0 0 D0364 CONE BEAM CT CAPT & 400.0 INTERP 0 D0365 CONE BEAM CT INTERPRETE MAN 400.0 0 D0366 CONE BEAM CT INTERPRETE MAX 400.0 0 D0367 CONE BEAM CT INTERP BOTH JAW 400.0 0 D0368 CONE BEAM CT INTERPRETE TMJ 400.0 0 D0380 PR CONE BEAM CT CAPTURE LIMITED 300.0 0 D0381 PR CONE BEAM CT CAPT MANDIBLE 300.0 0 D0382 PR CONE BEAM CT CAPT MAXILLA 300.0 0 D0383 PR CONE BEAM CT BOTH 300.0 JAWS 0 D0384 PR CONE BEAM CT CAPTURE TMJ 300.0 0 D0391 PR INTERPRETE DIAGNOSTIC IMAGE 250.0 0 D0460 PR PULP VITALITY TEST 65.00 D0470 PR DIAGNOSTIC CASTS 90.00 D1110 PR DENTAL PROPHYLAXIS ADULT 95.00 D1120 PR DENTAL PROPHYLAXIS CHILD 75.00 D1206 PR TOPICAL FLUORIDE VARNISH 45.00 D1208 TOPICAL APPLICATION FLOURIDE 45.00 D1310 PR NUTRI COUNSEL-CONTROL CARIES 28.00 D1320 PR TOBACCO COUNSELING 0.00 D1330 PR ORAL HYGIENE INSTRUCTION 0.00 D1351 PR DENTAL SEALANT PER TOOTH 60.00 D1352 PREV RESIN REST, PERM TOOTH 75.00 D1353 PR SEALANT REPAIR PER TOOTH 60.00 D1354 INTERIM CARIES ARRESTING 50.00 MEDICAMENT APPLICATION - PER TOOTH D1510 PR SPACE MAINTAINER FXD UNILAT 300.0 0 D1515 PR FIXED BILAT SPACE MAINTAINER 400.0 0 D1516 SPACE MAINTAINER-FIXED- 350 BILATERAL,MAXILLARY D1517 SPACE MAINTAINER-FIXED-BILATERAL- 350 MANDIBULAR D1520 PR REMOVE UNILAT SPACE MAINTAIN 300.0 0 D1525 PR REMOVE BILAT SPACE MAINTAIN 400.0 0 D1550 PR RECEMENT SPACE MAINTAINER 70.00 D1555 PR REMOVE FIX SPACE MAINTAINER 75.00 D1575 PR DIST SPACE MAINT, FIXED UNIL 300.0 0 D2140 PR AMALGAM ONE SURFACE 150.0 PERMANEN 0 D2150 PR AMALGAM TWO SURFACES 200.0 PERMANE 0 D2160 PR AMALGAM THREE SURFACES 250.0 PERMA 0 D2161 PR AMALGAM 4 OR > SURFACES PERM 300.0 0 D2330 PR RESIN ONE SURFACE-ANTERIOR 180.0 0 D2331 PR RESIN TWO SURFACES-ANTERIOR 220.0 0 D2332 PR RESIN THREE SURFACES-ANTERIO 290.0 0 D2335 PR RESIN 4/> SURF OR W INCIS AN 350.0 0 D2390 PR ANT RESIN-BASED CMPST CROWN 500.0 0 D2391 PR POST 1 SRFC RESINBASED CMPST 200.0 0 D2392 PR POST 2 SRFC RESINBASED CMPST 260.0 0 D2393 PR POST 3 SRFC RESINBASED CMPST 320.0 0 D2394 PR POST >=4SRFC RESINBASE CMPST 380.0 0 D2520 PR DENTAL INLAY METALLIC 2 SURF 1000. 00 D2530 PR DENTAL INLAY METL 3/MORE SUR 1100. 00 D2542 PR DENTAL ONLAY METALLIC 2 SURF 1000. 00 D2543 PR DENTAL ONLAY METALLIC 3 SURF 1100. 00 D2620 PR INLAY PORCELAIN/CERAMIC 2 SU 1050. 00 D2642 PR DENTAL ONLAY PORCELIN 2 SURF 1100. 00 D2643 PR DENTAL ONLAY PORCELIN 3 SURF 1160. 00 D2644 PR DENTAL ONLAY PORC 4/MORE SUR 1200. 00 D2651 PR INLAY COMPOSITE/RESIN TWO SU 950.0 0 D2652 PR DENTAL INLAY RESIN 3/MRE SUR 1000. 00 D2662 PR DENTAL ONLAY RESIN 2 SURFACE 1100. 00 D2663 PR DENTAL ONLAY RESIN 3 SURFACE 1150. 00 D2664 PR DENTAL ONLAY RESIN 4/MRE SUR 1000. 00 D2740 PR CROWN PORCELAIN/CERAMIC SUBS 1200. 00 D2750 PR CROWN PORCELAIN W/ H NOBLE M 1200. 00 D2751 PR CROWN PORCELAIN FUSED BASE M 1200. 00 D2752 PR CROWN PORCELAIN W/ NOBLE MET 1200. 00 D2780 PR CROWN 3/4 CAST HI NOBLE MET 1200. 00 D2781 PR CROWN 3/4 CAST BASE METAL 1200. 00 D2782 PR CROWN 3/4 CAST NOBLE METAL 1200. 00 D2783 PR CROWN 3/4 PORCELAIN/CERAMIC 1200. 00 D2790 PR CROWN FULL CAST HIGH NOBLE M 1200. 00 D2799 PR PROVISIONAL CROWN 350.0 0 D2910 PR RECEMENT INLAY ONLAY OR PART 120.0 0 D2920 PR DENTAL RECEMENT 120.0 CROWN 0 D2921 PR REATTACH TOOTH FRAGMENT 180.0 0 D2929 PREFABRICATED PORCELAIN/CERAMIC 400.0 CROWN, PRIMARY TOOTH 0 D2930 PR PREFAB STNLSS STEEL CRWN PRI 290.0 0 D2931 PR PREFAB STNLSS STEEL CROWN PE 300.0 0 D2940 PR DENTAL SEDATIVE FILLING 120.0 0 D2941 PR INT THERAPEUTIC RESTORATION 100.0 0 D2950 PR CORE BUILD-UP INCL ANY PINS 300.0 0 D2951 PR TOOTH PIN RETENTION 70.00 D2952 PR POST AND CORE CAST + CROWN 500.0 0 D2954 PR PREFAB POST/CORE + CROWN 380.0 0 D2960 PR LAMINATE LABIAL VENEER 700.0 0 D2962 PR LAB LABIAL VENEER PORCELAIN 1200. 00 D2975 PR COPING 200.0 0 D2980 PR CROWN REPAIR 225.0 0 D2999 PR DENTAL UNSPEC RESTORATIVE PR 0.00 D3110 PR PULP CAP DIRECT 95.00 D3120 PR PULP CAP INDIRECT 95.00 D3220 PR THERAPEUTIC 200.0 PULPOTOMY 0 D3221 PR GROSS PULPAL DEBRIDEMENT 250.0 0 D3222 PR PART PULP FOR APEXOGENESIS 200.0 0 D3230 PR PULPAL THERAPY ANTERIOR PRIM 300.0 0 D3240 PR PULPAL THERAPY POSTERIOR PRI 350.0 0 D3310 PR ANTERIOR 800.0 0 D3320 PR ROOT CANAL THERAPY 2 CANALS 900.0 0 D3330 PR ROOT CANAL THERAPY 3 CANALS 1100. 00 D3331 PR NON-SURG TX ROOT CANAL OBS 800.0 0 D3332 PR INCOMPLETE ENDODONTIC TX 500.0 0 D3333 PR INTERNAL ROOT REPAIR 300.0 0 D3346 PR RETREAT ROOT CANAL ANTERIOR 950.0 0 D3347 PR RETREAT ROOT CANAL BICUSPID 1100. 00 D3348 PR RETREAT ROOT CANAL MOLAR 1200. 00 D3351 PR APEXIFICATION/RECALC INITIAL 350.0 0 D3352 PR APEXIFICATION/RECALC INTERIM 300.0 0 D3353 PR APEXIFICATION/RECALC FINAL 800.0 0 D3355 PR PULPAL REGENERATION INITIAL 200.0 0 D3356 PR PULPAL REGENERATION INTERIM 150.0 0 D3410 PR APICOECT/PERIRAD SURG ANTER 800.0 0 D3421 PR ROOT SURGERY BICUSPID 900.0 0 D3425 PR ROOT SURGERY MOLAR 1100. 00 D3426 PR ROOT SURGERY EA ADD ROOT 300.0 0 D3427 PR PERIRADICULAR 550.0 SURGERY 0 D3450 PR ROOT AMPUTATION 500.0 0 D3460 PR ENDODONTIC ENDOSSEOUS IMPLAN 2000. 00 D3470 PR INTENTIONAL REPLANTATION 1000. 00 D4210 PR GINGIVECTOMY/PLASTY PER QUAD 680.0 0 D4212 GINGIVECTOMY/PLASTY REST 247.0 0 D4240 PR GINGIVAL FLAP PROC W/ PLANIN 680.0 0 D4241 PR GNGVL FLAP W ROOTPLAN 1-3 TH 500.0 0 D4245 PR APICALLY POSITIONED 550.0 FLAP 0 D4249 PR CROWN LENGTHEN HARD TISSUE 900.0 0 D4260 PR OSSEOUS SURGERY PER 1100. QUADRANT 00 D4261 PR OSSEOUS SURGL-3TEETHPERQUAD 800.0 0 D4263 PR BONE REPLCE GRAFT FIRST SITE 650.0 0 D4264 PR BONE REPLCE GRAFT EACH ADD 450.0 0 D4265 PR BIO MTRLS TO AID SOFT/OS REG 527.0 0 D4266 PR GUIDED TISS REGEN RESORBLE 800.0 0 D4270 PR PEDICLE SOFT TISSUE GRAFT PR 1000. 00 D4273 PR SUBEPITHELIAL TISSUE GRAFT 1100. 00 D4274 PR DISTAL/PROXIMAL WEDGE PROC 350.0 0 D4277 SOFT TISSUE GRAFT 1ST TOOTH 1000. 00 D4278 SOFT TISSUE GRAFT ADDL TOOTH 500.0 0 D4283 AUTO TISSUE GRAFT ADDL TOOTH 550.0 0 D4320 PR PROVISION SPLNT INTRACORONAL 600.0 0 D4321 PR PROVISIONAL SPLINT EXTRACORO 500.0 0 D4341 PR PERIODONTAL SCALING & ROOT 275.0 0 D4342 PR PERIODONTAL SCALING 1-3TEETH 190.0 0 D4346 SCALING GINGIVAL INFLAMMATION 150 D4355 PR FULL MOUTH 190.0 DEBRIDEMENT 0 D4381 PR LOCALIZED DELIVERY ANTIMICRO 125.0 0 D4910 PR PERIODONTAL MAINT PROCEDURES 160.0 0 D5110 PR DENTURES COMPLETE MAXILLARY 2000. 00 D5120 PR DENTURES COMPLETE MANDIBLE 2000. 00 D5130 PR DENTURES IMMEDIAT MAXILLARY 1300. 00 D5140 PR DENTURES IMMEDIAT MANDIBLE 1300. 00 D5211 MAXILLARY PARTIAL DENTURE-RESIN 1500. BASE (INCLUDING 00 RETENTIVE/CLASPING MATERIALS, RESTS, AND TEETH) D5212 MANDIBULAR PARTIAL DENTURE-RESIN 1500. BASE (INCLUDING 00 RETENTIVE/CLASPING MATERIALS, RESTS AND TEETH) D5213 PR DENTURES MAXILL PART METAL 2000. 00 D5214 PR DENTURES MANDIBL PART METAL 2000. 00 D5221 IMMED MAX PART DENTURE RESIN 1250. 00 D5222 IMMED MAN PART DENTURE RESIN 1250. 00 D5223 IMMED MAX PART DENT 1500. METAL 00 D5224 IMMED MAND PART DENT METAL 1500. 00 D5225 PR MAXILLARY PART DENTURE FLEX 1800. 00 D5226 PR MANDIBULAR PART DENTURE FLEX 1800. 00 D5281 PR REMOVABLE PARTIAL DENTURE 1200. 00 D5282 REMOVABLE UNILATERAL PARTIAL 800 DENTURE-ONE PIECE CAST METAL - MAXILLARY D5283 REMOVABLE UNILATERAL PARTIAL 800 DENTURE-ONE PIECE CAST METAL - MANDIBULAR D5410 PR DENTURES ADJUST CMPLT MAXIL 100.0 0 D5411 PR DENTURES ADJUST CMPLT MAND 100.0 0 D5421 PR DENTURES ADJUST PART MAXILL 100.0 0 D5422 PR DENTURES ADJUST PART MANDBL 100.0 0 D5510 PR DENTUR REPR BROKEN COMPL BAS 230.0 0 D5511 REPAIR BROKEN COMPLETE DENTURE 300.0 BASE, MANDIBULAR 0 D5512 REPAIR BROKEN COMPLETE DENTURE 250.0 BASE, MAXILLARY 0 D5520 PR REPLACE DENTURE TEETH COMPLT 200.0 0 D5610 PR DENTURES REPAIR RESIN BASE 230.0 0 D5611 REPAIR RESIN PARTIAL DENTURE BASE, 300.0 MANDIBULAR 0 D5612 REPAIR RESIN PARTIAL DENTURE BASE, 300.0 MAXILLARY 0 D5621 REPAIR CAST PARTIAL FRAMEWORK, 300.0 MANDIBULAR 0 D5622 REPAIR CAST PARTIAL FRAMEWORK, 300.0 MAXILLARY 0 D5630 REPAIR OR REPLACE BROKEN 300.0 RETENTIVE/CLASPING MATERIALS-PER 0 TOOTH D5640 PR REPLACE PART DENTURE TEETH 200.0 0 D5650 PR ADD TOOTH TO PARTIAL DENTURE 230.0 0 D5660 PR ADD CLASP TO PARTIAL DENTURE 300.0 0 D5710 PR DENTURES REBASE CMPLT MAXIL 600.0 0 D5711 PR DENTURES REBASE CMPLT MAND 600.0 0 D5720 PR DENTURES REBASE PART MAXILL 600.0 0 D5721 PR DENTURES REBASE PART MANDBL 600.0 0 D5730 PR DENTURE RELN CMPLT MAXIL CH 400.0 0 D5731 PR DENTURE RELN CMPLT MAND CHR 400.0 0 D5740 PR DENTURE RELN PART MAXIL CHR 400.0 0 D5741 PR DENTURE RELN PART MAND CHR 400.0 0 D5750 PR DENTURE RELN CMPLT MAX LAB 500.0 0 D5751 PR DENTURE RELN CMPLT MAND LAB 500.0 0 D5760 PR DENTURE RELN PART MAXIL LAB 500.0 0 D5761 PR DENTURE RELN PART MAND LAB 500.0 0 D5810 PR DENTURE INTERM CMPLT MAXILL 1000. 00 D5811 PR DENTURE INTERM CMPLT MANDBL 1000. 00 D5820 PR DENTURE INTERM PART MAXILL 800.0 0 D5821 PR DENTURE INTERM PART MANDBL 800.0 0 D5850 PR DENTURE TISS CONDITN MAXILL 250.0 0 D5851 PR DENTURE TISS CONDTIN MANDBL 250.0 0 D5862 PR PRECISION ATTACHMENT 700.0 0 D5863 OVERDENTURE COMPLETE MAXILLARY 2000. 00 D5864 OVERDENTURE PARTIAL MAXILLARY 2000. 00 D5865 OVERDENTURE COMPLETE 2000. MANDIBULAR 00 D5866 OVERDENTURE PARTIAL MANDIBULAR 2000. 00 D5875 PR PROSTHESIS 800.0 MODIFICATION 0 D5933 PR REFITTING OF 250.0 OBTURATOR 0 D5982 PR SURGICAL STENT 500.0 0 D5983 PR RADIATION APPLICATOR 450.0 0 D5986 PR FLUORIDE APPLICATOR 190.0 0 D5988 PR SURGICAL SPLINT 500.0 0 D6010 PR ODONTICS ENDOSTEAL IMPLANT 2000. 00 D6011 SECOND STAGE IMPLANT SURGERY 0 D6052 SEMI-PRECISION ATTACHMENT 900 ABUTMENT D6056 PR PREFABRICATED 1000. ABUTMENT 00 D6057 PR CUSTOM ABUTMENT 1100. 00 D6058 PR ABUTMENT SUPPORTED CROWN 1400. 00 D6059 PR ABUTMENT SUPPORTED MTL 1400. CROWN 00 D6065 PR IMPLANT SUPPORTED CROWN 1336. 00 D6066 PR IMPLANT SUPPORTED MTL CROWN 1015. 00 D6068 PR ABUTMENT SUPPORTED RETAINER 1125. 00 D6071 PR ABUTMENT SUPPORTED RETAINER 1000. 00 D6076 PR IMPLANT SUPPORTED RETAINER 1100. 00 D6080 PR IMPLANT MAINTENANCE 350 D6090 PR REPAIR IMPLANT 250.0 0 D6091 PR REPL SEMI/PRECISION ATTACH 150.0 0 D6092 PR RECEMENT SUPP CROWN 200.0 0 D6096 REMOVE BROKEN IMPLANT RETAINING 300.0 SCREW 0 D6100 PR REMOVAL OF IMPLANT 1000. 00 D6102 DEBRIDEMENT AND CONTOURING 400 D6104 BONE GRAFT TIME OF 800.0 IMPLANT 0 D6111 IMPLNT/ABUT REMOV DENT MAND 2000. 00 D6118 IMPLANT/ABUT SUPPORTED INTERIM 3500. FIXED DENTURE FOR EDENTULOUS 00 ARCH-MAN D6119 IMPLANT/ABUT SUPPORTED INTERIM 3500. FIXED DENTURE FOR EDENTULOUS 00 ARCH - MAX D6212 PR BRIDGE NOBLE METAL 1100. CAST 00 D6240 PR BRIDGE PORCELAIN HIGH NOBLE 1100. 00 D6242 PR BRIDGE PORCELAIN NOBEL METAL 1100. 00 D6245 PR BRIDGE PORCELAIN/CERAMIC 950.0 0 D6545 PR DENTAL RETAINR CAST METL 800.0 0 D6740 PR CROWN PORCELAIN/CERAMIC 975.0 0 D6750 PR CROWN PORCELAIN HIGH NOBLE 1200. 00 D6752 PR CROWN PORCELAIN NOBLE METAL 1100. 00 D6930 PR DENTAL RECEMENT 200.0 BRIDGE 0 D6980 PR BRIDGE REPAIR 250 D7111 PR EXTRACTION CORONAL REMNANTS 100.0 0 D7140 PR EXTRACTION ERUPTED TOOTH/EXR 180.0 0 D7210 PR REM IMP TOOTH W MUCOPER FLP 300.0 0 D7220 PR IMPACT TOOTH REMOV SOFT TISS 375.0 0 D7230 PR IMPACT TOOTH REMOV PART BONY 450.0 0 D7240 PR IMPACT TOOTH REMOV COMP BONY 600.0 0 D7250 PR TOOTH ROOT REMOVAL 200.0 0 D7260 PR ORAL ANTRAL FISTULA CLOSURE 1300. 00 D7261 PR PRIMARY CLOSURE SINUS PERF 600 D7270 PR TOOTH REIMPLANTATION 700.0 0 D7280 PR EXPOSURE IMPACT TOOTH ORTHOD 400.0 0 D7283 PLACEMENT OF DEVICE TO FACILITATE 300.0 ERUPTION OF IMPACTED TOOTH 0 D7285 PR BIOPSY OF ORAL TISSUE HARD 500.0 0 D7286 PR BIOPSY OF ORAL TISSUE SOFT 400.0 0 D7310 PR ALVEOPLASTY W/ EXTRACTION 350.0 0 D7311 PR ALVEOLOPLASTY W/EXTRACT 1-3 145.0 0 D7320 PR ALVEOPLASTY W/O EXTRACTION 600.0 0 D7321 PR ALVEOLOPLASTY NOT W/EXTRACTS 125.0 0 D7411 PR EXCISION BENIGN LESION>1.25C 470.0 0 D7451 PR REM ODONTOGEN CYST > 1.25 CM 250.0 0 D7465 PR LESION DESTRUCTION 294.0 0 D7471 PR REM EXOSTOSIS ANY SITE 800.0 0 D7472 PR REMOVAL OF TORUS PALATINUS 625.0 0 D7473 PR REMOVE TORUS MANDIBULARIS 625.0 0 D7510 PR I&D ABSC INTRAORAL SOFT TISS 280.0 0 D7530 PR REMOVAL FB SKIN/AREOLAR TISS 408.0 0 D7540 PR REMOVAL OF FB 180.0 REACTION 0 D7550 PR REMOVAL OF SLOUGHED OFF BONE 2000 D7670 PR CLOSD RDUCTN SPLINT ALVEOLUS 2000. 00 D7910 PR DENT SUTUR RECENT WND TO 5CM 400.0 0 D7912 PR SUTURE COMPLICATE WND > 5 CM 600 D7951 PR SINUS AUG W BONE/BONE SUP 1500. 00 D7953 PR BONE REPLACEMENT GRAFT 800.0 0 D7960 PR FRENULECTOMY/FRENULOTOMY 500.0 0 D7970 PR EXCISION HYPERPLASTIC TISSUE 600.0 0 D7971 PR EXCISION PERICORONAL GINGIVA 450.0 0 D8030 PR LIMITED DENTAL TX ADOLESCENT 3500. 00 D8080 PR COMPRE DENTAL TX ADOLESCENT 6500. 00 D8210 PR ORTHODONTIC REM APPLIANCE TX 800.0 0 D8220 PR FIXED APPLIANCE THERAPY HABT 1200. 00 D8660 PR PREORTHODONTIC TX 0 VISIT D8670 PR PERIODIC ORTHODONTC TX VISIT 702.0 0 D8680 PR ORTHODONTIC 190.0 RETENTION 0 D8690 PR ORTHODONTIC 184.0 TREATMENT 0 D8692 PR REPLACEMENT RETAINER 500.0 0 D8693 PR REBOND/CEMENT/REPAIR RETAIN 45.00 D8695 REMOVAL OF FIXED ORTHO 350.0 APPLIANCES FOR REASONS OTHER 0 THAN COMPLETION D9110 PR TX DENTAL PAIN MINOR PROC 150.0 0 D9120 PR FIX PARTIAL DENTURE SECTION 225.0 0 D9230 PR ANALGESIA 100.0 0 D9239 INTRAVENOUS MODERATE 200.0 (CONSCIOUS) SEDATION/ANALGESIA- 0 FIRST 15 MINUTES D9243 IV SEDATION EACH 15M 155.0 0 D9248 PR SEDATION (NON-IV) 300.0 0 D9310 PR DENTAL CONSULTATION 98.00 D9430 PR OFFICE VISIT DURING HOURS 90.00 D9450 PR CASE PRESENTATION TX PLAN 0.00 D9630 PR OTHER DRUGS/MEDICAMENTS 57.00 D9910 PR DENT APPL DESENSITIZING MED 50.00 D9911 PR APPL DESENSITIZING 64.00 RESIN D9940 PR DENTAL OCCLUSAL 500 GUARD D9941 PR FABRICATION ATHLETIC GUARD 250.0 0 D9943 OCCLUSAL GUARD ADJUSTMENT 44.00 D9944 OCCLUSAL GUARD-HARD APPLIANCE, 500 FULL ARCH D9945 OCCLUSAL GUARD-SOFT APPLIANCE, 190 FULL ARCH D9951 PR LIMITED OCCLUSAL ADJUSTMENT 225.0 0 D9970 PR ENAMEL MICROABRASION 35.00 D9971 PR ODONTOPLASTY 1-2 150.0 TEETH 0 D9973 PR EXTRNL BLEACHING PER TOOTH 300.0 0 D9974 PR INTRNL BLEACHING PER TOOTH 350.0 0 D9975 EXTERNAL BLEACHING HOME ARCH 200.0 TOOTH WHITENING FROM OUTSIDE THE 0 TOOTH E0191 PR PROTECTOR HEEL OR ELBOW 145.0 0 E0486 PR ORAL DEVICE/APPLIANCE CUSFAB 1800 E0720 PR TENS TWO LEAD 510.0 0 E0731 PR CONDUCTIVE GARMENT FOR TENS/ 462.0 0 E0860 PR TRACT EQUIP CERVICAL TRACT 69.00 E0945 PR BELT/HARNESS 107 EXTREMITY G0008 PR ADMIN INFLUENZA VIRUS VAC 21.00 G0009 PR ADMIN PNEUMOCOCCAL VACCINE 21.00 G0010 PR ADMIN HEPATITIS B VACCINE 21.00 G0101 PR CA SCREEN;PELVIC/BREAST EXAM 95.00 G0103 PR PSA, TOTAL SCREENING 61.00 G0104 PR CA SCREEN;FLEXI SIGMOIDSCOPE 335.0 0 G0105 PR COLORECTAL SCRN; HI RISK IND 1036. 00 G0108 PR DIAB MANAGE TRN PER INDIV 132.0 0 G0117 PR GLAUCOMA SCRN HGH RISK DIREC 136.0 0 G0120 PR COLON CA SCRN; BARIUM ENEMA 539.0 0 G0120 PR COLON CA SCRN; BARIUM 26 133.0 ENEMA 0 G0121 PR COLON CA SCRN NOT HI RSK IND 961.0 0 G0124 PR SCREEN C/V THIN LAYER BY MD 82.00 G0127 PR TRIM NAIL(S) 45.00 G0168 PR WOUND CLOSURE BY ADHESIVE 257.0 0 G0179 PR MD RECERTIFICATION HHA PT 140.0 0 G0180 PR MD CERTIFICATION HHA PATIENT 150.0 0 G0181 PR HOME HEALTH CARE SUPERVISION 271.0 0 G0182 PR HOSPICE CARE SUPERVISION 273.0 0 G0202 PR SCR MAMMO BI INCL CAD 341.0 0 G0202 PR SCR MAMMO BI INCL CAD 26 81.00 G0204 PR DX MAMMO INCL CAD BI 26 101.0 0 G0206 PR DX MAMMO INCL CAD UNI 26 81.00 G0270 PR MNT SUBS TX FOR CHANGE DX 76.00 G0271 PR GROUP MNT 2 OR MORE 30 MINS 40.00 G0279 PR TOMOSYNTHESIS, MAMMO 26 129.0 SCREEN 0 G0289 PR ARTHRO, LOOSE BODY + CHONDRO 286.0 0 G0296 PR VISIT TO DETERM LDCT 136.0 ELIG 0 G0297 PR LDCT FOR LUNG CA 507.0 SCREEN 0 G0297 PR LDCT FOR LUNG CA 26 129.0 SCREEN 0 G0364 PR BONE MARROW ASPIRATE &BIOPSY 35.00 G0365 PR VESSEL MAPPING HEMO ACCESS 503.0 0 G0365 PR VESSEL MAPPING HEMO 26 31.00 ACCESS G0372 PR MD SERVICE REQUIRED FOR PMD 52.00 G0389 PR ULTRASOUND EXAM AAA 26 68.00 SCREEN G0399 PR HOME SLEEP TEST/TYPE 3 26 147.0 PORTA 0 G0402 PR INITIAL PREVENTIVE EXAM 415.0 0 G0403 PR EKG FOR INITIAL PREVENT EXAM 50.00 G0403 PR EKG FOR INITIAL PREVENT 26 50.00 EXAM G0405 PR EKG INTERPRET & REPORT PREVE 22.00 G0413 PR PELVIC RING FRACTURE UNI/BIL 3357. 00 G0414 PR PELVIC RING FX TREAT INT FIX 3480. 00 G0415 PR OPEN TX POST PELVIC FXCTURE 4894. 00 G0416 PR PROSTATE BIOPSY, ANY 26 462.0 MTHD 0 G0420 PR ED SVC CKD IND PER SESSION 272.0 0 G0425 INPT/ED TELECONSULT30 245.0 0 G0426 INPT/ED TELECONSULT50 350 G0427 INPT/ED TELECONSULT70 521 G0432 PR EIA HIV-1/HIV-2 SCREEN 49.00 G0436 PR TOBACCO-USE COUNSEL 3-10 MIN 35.00 G0437 PR TOBACCO-USE COUNSEL>10MIN 70.00 G0438 PR PPPS, INITIAL VISIT 427.0 0 G0439 PR PPPS, SUBSEQ VISIT 290.0 0 G0442 PR ANNUAL ALCOHOL SCREEN 15 MIN 42.00 G0443 PR BRIEF ALCOHOL MISUSE COUNSEL 65.00 G0444 PR DEPRESSION SCREEN ANNUAL 43.00 G0446 PR INTENS BEHAVE THER CARDIO DX 59.00 G0447 PR BEHAVIOR COUNSEL OBESITY 15M 65.00 G0451 PR DEVLOPMENT TEST INTERPT&REP 26.00 G0452 PR MOLECULAR PATHOLOGY 26 100.0 INTERPR 0 G0455 PR FECAL MICROBIOTA PREP INSTIL 274.0 0 G0500 PR MOD SEDAT ENDO SERVICE >5YRS 149.0 0 G0502 PR INIT PSYCH CARE MANAG, 70MIN 358.0 0 G0503 PR SUBSEQ PSYCH CARE MAN,60MI 316.0 0 G0504 PR INIT/SUB PSYCH CARE ADD 30 M 166.0 0 G0505 PR COG/FUNC ASSESSMENT OUTPT 596.0 0 G0506 PR COMP ASSES CARE PLAN CCM SVC 160.0 0 G0508 PR CRIT CARE TELEHEA CONSULT 60 504.0 0 G0509 PR CRIT CARE TELEHEA CONSULT 50 486.0 0 G6002 PR STEREOSCOPIC X-RAY 26 50.00 GUIDANCE G8600 PR TPA INITI W/IN 3 HRS 0.00 G8601 PR NO ELIG TPA INIT W/IN 3 0.00 HRS G8602 PR NO TPA INIT W/IN 3 HRS 0.00 G9012 PR OTHER SPECIFIED CASE MGMT 243 H0004 PR ALCOHOL AND/OR DRUG SERVICES 24 H0005 PR ALCOHOL AND/OR DRUG SERVICES 8 H0014 PR ALCOHOL AND/OR DRUG SERVICES 140 H2036 PR A/D TX PROGRAM, PER 280.0 DIEM 0 J0171 PR ADRENALIN EPINEPHRINE INJECT 19.00 J0558 PR PENG BENZATHINE/PROCAINE INJ 9.00 J0561 PR PENICILLIN G BENZATHINE INJ 20.00 J0585 PR INJECTION,ONABOTULINUMTOXINA 15.50 J0670 PR INJ MEPIVACAINE HCL/10 10.00 ML J0696 PR CEFTRIAXONE SODIUM INJECTION 20.00 J1020 PR METHYLPREDNISOLONE 20 MG INJ 10.00 J1030 PR METHYLPREDNISOLONE 40 MG INJ 11.00 J1040 PR METHYLPREDNISOLONE 80 MG INJ 26.00 J1050 PR MEDROXYPROGESTERONE 1.00 ACETATE J1071 PR INJ TESTOSTERONE CYPIONATE 1.00 1MG J1100 PR DEXAMETHASONE SODIUM PHOS 2.00 J1439 PR INJ FERRIC CARBOXYMALTOS 1MG 3.00 J1815 PR INSULIN INJECTION 2.00 J1885 PR KETOROLAC TROMETHAMINE INJ 10.00 J2001 PR LIDOCAINE INJECTION 0.00 J2357 PR OMALIZUMAB INJECTION 76.00 J2405 PR ONDANSETRON HCL INJECTION 3.00 J2790 PR RHO D IMMUNE GLOBULIN INJ 184.0 0 J2930 PR METHYLPREDNISOLONE INJECTION 12.00 J3301 PR TRIAMCINOLONE ACETONIDE INJ 5.00 J3420 PR VITAMIN B12 INJECTION 8.00 J7030 PR NORMAL SALINE SOLUTION INFUS 16.00 J7042 PR 5% DEXTROSE/NORMAL SALINE 11.00 J7296 PR KYLEENA, 19.5 MG 1818. 00 J7298 PR MIRENA, 52 MG 1810. 00 J7300 PR INTRAUT COPPER CONTRACEPTIVE 1848. 00 J7301 PR SKYLA, 13.5 MG 1620. 00 J7307 ETONOGESTREL IMPLANT SYSTEM 1670. 00 J7323 EUFLEXXA INJ PER DOSE 381.0 0 J7510 PR PREDNISOLONE ORAL PER 5 MG 1.00 J7613 PR ALBUTEROL NON-COMP UNIT 2.00 J7620 PR ALBUTEROL IPRATROP NON-COMP 3.00 J7644 PR IPRATROPIUM BROMIDE NON-COMP 5.00 J9267 PR PACLITAXEL INJECTION 1.00 J9306 PR INJECTION, PERTUZUMAB, 1 MG 92.00 L0112 PR CRANIAL CERVICAL ORTHOSIS 1531. 00 L0120 PR CERV FLEX N/ADJ FOAM PRE OTS 97.00 L0130 PR FLEX THERMOPLASTIC COLLAR MO 230 L0160 PR CERV SR WIRE OCC/MAN PRE OTS 178.0 0 L0172 PR CERV COL SR FOAM 2PC PRE OTS 159.0 0 L0174 PR CERV SR 2PC THOR EXT PRE OTS 312.0 0 L0180 PR CER POST COL OCC/MAN SUP ADJ 432 L0200 PR CERV COL SUPP ADJ BAR & THOR 586.0 0 L0450 PR TLSO FLEX TRUNK/THOR PRE OTS 174.0 0 L0456 PR TLSO FLEX TRNK SJ-SS PRE CST 1178. 00 L0457 PR TLSO FLEX TRNK SJ-SS PRE OTS 1157. 00 L0464 PR TLSO 4MOD SACRO-SCAP PRE 1760. 00 L0472 PR TLSO RIGID FRAME HYPEREX PRE 459.0 0 L0480 PR TLSO RIGID PLASTIC CUSTOM FA 1394. 00 L0482 PR TLSO RIGID LINED CUSTOM FAB 1876. 00 L0486 PR TLSO RIGIDLINED CUST FAB TWO 2139. 00 L0488 PR TLSO RIGID LINED PRE ONE PIE 1192. 00 L0491 PR TLSO 2 PIECE RIGID SHELL 785.0 0 L0621 PR SIO FLEX PELVIC/SACR PRE OTS 108 L0626 PR LO SAG RIG PNL STAYS PRE CST 92.00 L0627 PR LO SAG RI AN/POS PNL PRE CST 487.0 0 L0628 PR LSO FLEX NO RI STAYS PRE OTS 109.0 0 L0630 PR LSO R POST PNL SJ-T9 PRE CST 192.0 0 L0631 PR LSO SAG R AN/POS PNL PRE CST 1216. 00 L0637 PR LSO SC R ANT/POS PNL PRE CST 1272. 00 L0638 PR LSO SAG-CORONAL PANEL CUSTOM 1348. 00 L0639 PR LSO S/C SHELL/PANEL PREFAB 1272. 00 L0640 PR LSO S/C SHELL/PANEL CUSTOM 1239. 00 L0641 PR LO RIG POS PNL L1-L5 PRE OTS 95 L0710 PR CTLSO A-P-L CONTROL W/ INTER 2369. 00 L0810 PR HALO CERVICAL INTO JCKT VEST 2963. 00 L0859 PR MRI COMPATIBLE SYSTEM 1562. 00 L0861 PR HALO REPL LINER/INTERFACE 255.0 0 L0974 PR TLSO FULL CORSET 176.0 0 L0984 PR PROTECT BODY SOCK EA PRE OTS 77.00 L1000 PR CTLSO MILWAUKE INITIAL MODEL 2008. 00 L1005 PR TENSION BASED SCOLIOSIS ORTH 3588. 00 L1020 PR KYPHOSIS PAD 98.00 L1040 PR LUMBAR OR LUMBAR RIB PAD 94.00 L1050 PR STERNAL PAD 117.0 0 L1060 PR THORACIC PAD 137.0 0 L1110 PR RING FLANGE PLAS/LEATHER MOL 290.0 0 L1210 PR LATERAL THORACIC EXTENSION 297.0 0 L1220 PR ANTERIOR THORACIC EXTENSION 284.0 0 L1270 PR ABDOMINAL PAD 105 L1290 PR LATERAL TROCHANTERIC PAD 93.00 L1300 PR BODY JACKET MOLD TO PATIENT 2089. 00 L1499 PR SPINAL ORTHOSIS NOS 525.0 0 L1620 PR HO FLEX PAVLIK HARNS PRE CST 183.0 0 L1650 PR HO ABDUCTION HIP ADJUSTABLE 256.0 0 L1686 PR HO POST-OP HIP ABDUCTION 1302. 00 L1690 PR COMBINATION BILATERAL HO 2290. 00 L1810 PR KO ELASTIC WITH JOINTS 112.0 0 L1812 PR KO ELASTIC W/JOINTS PRE OTS 112.0 0 L1820 PR KO ELAS W/ CONDYLE PADS & JO 173.0 0 L1830 PR KO IMMOB CANVAS LONG PRE OTS 105.0 0 L1831 PR KNEE ORTH POS LOCKING JOINT 349.0 0 L1832 PR KO ADJ JNT POS R SUP PRE CST 802.0 0 L1833 PR KO ADJ JNT POS R SUP PRE OTS 802.0 0 L1836 PR KO RIGID W/O JOINTS PRE OTS 159.0 0 L1843 PR KO SINGLE UPRIGHT PRE CST 1062. 00 L1844 PR KO W/ADJ JT ROT CNTRL MOLDED 1589. 00 L1845 PR KO DOUBLE UPRIGHT PRE CST 1103. 00 L1846 PR KO W ADJ FLEX/EXT ROTAT MOLD 1352. 00 L1850 PR KO SWEDISH TYPE PRE 345.0 OTS 0 L1851 PR KO SINGLE UPRIGHT PREFAB OTS 1063. 00 L1902 PR AFO ANKLE GAUNTLET PRE OTS 106.0 0 L1904 PR AFO MOLDED ANKLE GAUNTLET 652 L1906 PR AFO MULTILIG ANK SUP PRE OTS 229.0 0 L1907 PR AFO SUPRAMALLEOLAR CUSTOM 666.0 0 L1930 PR AFO PLASTIC 268.0 0 L1932 PR AFO RIG ANT TIB PREFAB TCF/= 1057. 00 L1940 PR AFO MOLDED TO PATIENT PLASTI 561.0 0 L1945 PR AFO MOLDED PLAS RIG ANT TIB 1341. 00 L1950 PR AFO SPIRAL MOLDED TO PT PLAS 889.0 0 L1951 PR AFO SPIRAL PREFABRICATED 994.0 0 L1960 PR AFO POS SOLID ANK PLASTIC MO 671.0 0 L1970 PR AFO PLASTIC MOLDED W/ANKLE J 807.0 0 L1971 PR AFO W/ANKLE JOINT, PREFAB 555.0 0 L1990 PR AFO DOUB SOLID STIRRUP CALF 509.0 0 L2010 PR KAFO SNG SOLID STIRRUP W/O J 1118. 00 L2020 PR KAFO DBL SOLID STIRRUP BAND/ 1407. 00 L2030 PR KAFO DBL SOLID STIRRUP W/O J 1102. 00 L2034 PR KAFO PLA SIN UP W/WO K/A CUS 2171. 00 L2035 PR KAFO PLASTIC PEDIATRIC SIZE 179.0 0 L2036 PR KAFO PLAS DOUB FREE KNEE MOL 2181. 00 L2037 PR KAFO PLAS SING FREE KNEE MOL 2035. 00 L2038 PR KAFO W/O JOINT MULTI-AXIS AN 2067. 00 L2070 PR HKAFO TORSION UNILAT ROT STR 167.0 0 L2106 PR AFO TIB FX CAST PLASTER MOLD 771.0 0 L2108 PR AFO TIB FX CAST MOLDED TO PT 1343. 00 L2112 PR AFO TIBIAL FRACTURE 618.0 SOFT 0 L2114 PR AFO TIB FX SEMI-RIGID 775.0 0 L2116 PR AFO TIBIAL FRACTURE 891.0 RIGID 0 L2128 PR KAFO FEM FX CAST MOLDED TO P 2112. 00 L2180 PR PLAS SHOE INSERT W ANK JOINT 136.0 0 L2182 PR DROP LOCK KNEE 113.0 0 L2200 PR LIMITED ANKLE MOTION EA JNT 54.00 L2210 PR DORSIFLEXION ASSIST EACH JOI 78.00 L2220 PR DORSI & PLANTAR FLEX ASS/RES 93.00 L2230 PR SPLIT FLAT CALIPER STIRR & P 87.00 L2232 PR ROCKER BOTTOM, CONTACT AFO 118.0 0 L2250 PR FOOT PLATE MOLDED STIRRUP AT 437.0 0 L2260 PR REINFORCED SOLID STIRRUP 227.0 0 L2265 PR LONG TONGUE STIRRUP 134.0 0 L2270 PR VARUS/VALGUS STRAP PADDED/LI 63.00 L2275 PR PLASTIC MOD LOW EXT PAD/LINE 148.0 0 L2280 PR MOLDED INNER BOOT 516.0 0 L2300 PR ABDUCTION BAR JOINTED ADJUST 324.0 0 L2320 PR NON-MOLDED LACER 202.0 0 L2330 PR LACER MOLDED TO PATIENT MODE 489.0 0 L2340 PR PRE-TIBIAL SHELL MOLDED TO P 653.0 0 L2350 PR PROSTHETIC TYPE SOCKET MOLDE 1128. 00 L2360 PR EXTENDED STEEL SHANK 51.00 L2380 PR TORSION STRAIGHT KNEE JOINT 132.0 0 L2385 PR STRAIGHT KNEE JOINT HEAVY DU 152.0 0 L2390 PR OFFSET KNEE JOINT EACH 127.0 0 L2395 PR OFFSET KNEE JOINT HEAVY DUTY 177.0 0 L2405 PR KNEE JOINT DROP LOCK EA JNT 103.0 0 L2415 PR KNEE JOINT CAM LOCK EACH JOI 155.0 0 L2425 PR KNEE DISC/DIAL LOCK/ADJ FLEX 170.0 0 L2430 PR KNEE JNT RATCHET LOCK EA JNT 170.0 0 L2510 PR TH/WGHT BEAR QUAD-LAT BRIM M 714.0 0 L2525 PR TH/WGHT BEAR NAR M-L BRIM MO 1452. 00 L2526 PR TH/WGHT BEAR NAR M-L BRIM CU 840.0 0 L2540 PR THIGH/WGHT BEAR LACER MOLDED 414.0 0 L2610 PR HIP CLEVIS/THRUST BEARING LO 305.0 0 L2624 PR HIP ADJ FLEX EXT ABDUCT CONT 376.0 0 L2628 PR METAL FRAME RECIPRO HIP & CA 2064 L2640 PR PELVIC CONTROL BAND & BELT B 381.0 0 L2660 PR THORACIC CONTROL THORACIC BA 183.0 0 L2680 PR THORAC CONT LAT SUPPORT UPRI 197.0 0 L2750 PR PLATING CHROME/NICKEL PR BAR 95.00 L2755 PR CARBON GRAPHITE LAMINATION 155.0 0 L2760 PR EXTENSION PER EXTENSION PER 69.00 L2768 PR ORTHO SIDEBAR DISCONNECT 154.0 0 L2780 PR NON-CORROSIVE FINISH 77.00 L2785 PR DROP LOCK RETAINER EACH 36.00 L2795 PR KNEE CONTROL FULL KNEECAP 98.00 L2800 PR KNEE CAP MEDIAL OR LATERAL P 150.0 0 L2810 PR KNEE CONTROL CONDYLAR PAD 118.0 0 L2820 PR SOFT INTERFACE BELOW KNEE SE 99.00 L2830 PR SOFT INTERFACE ABOVE KNEE SE 107.0 0 L2840 PR TIBIAL LENGTH SOCK FX OR EQU 63.00 L3000 PR FT INSERT UCB BERKELEY SHELL 372.0 0 L3001 PR FOOT INSERT REMOV MOLDED SPE 161 L3002 PR FOOT INSERT PLASTAZOTE OR EQ 203 L3010 PR FOOT LONGITUDINAL ARCH SUPPO 212 L3020 PR FOOT LONGITUD/METATARSAL SUP 235.0 0 L3030 PR FOOT ARCH SUPPORT REMOV PREM 93 L3031 PR FOOT LAMIN/PREPREG COMPOSITE 145.0 0 L3040 PR FT ARCH SUPRT PREMOLD LONGIT 57 L3050 PR FOOT ARCH SUPP PREMOLD METAT 57 L3060 PR FOOT ARCH SUPP LONGITUD/META 87.00 L3090 PR ARCH SUPP ATT TO SHOE LONG/M 42.00 L3100 PR HALLUS-VALGUS NT DYN PRE OTS 52.00 L3150 PR ABDUCT ROTATION BAR W/O SHOE 116.0 0 L3160 PR SHOE STYLED POSITIONING DEV 157.0 0 L3202 PR OXFORD W/ SUPINAT/PRONATOR C 45.00 L3203 PR OXFORD W/ SUPINATOR/PRONATOR 45.00 L3204 PR HIGHTOP W/ SUPP/PRONATOR INF 45.00 L3206 PR HIGHTOP W/ SUPP/PRONATOR CHI 58.00 L3207 PR HIGHTOP W/ SUPP/PRONATOR JUN 63.00 L3216 PR ORTHOPED LADIES SHOES DPTH I 82.50 L3221 PR ORTHOPEDIC MENS SHOES DPTH I 82.50 L3222 PR MENS SHOES HIGHTOP DEPTH INL 85.00 L3224 PR WOMAN'S SHOE OXFORD BRACE 100.0 0 L3225 PR MAN'S SHOE OXFORD BRACE 100.0 0 L3230 PR CUSTOM SHOES DEPTH INLAY 247.5 0 L3250 PR CUSTOM MOLD SHOE REMOV 247.5 PROST 0 L3253 PR SHOE MOLDED PLASTAZOTE CUST 140.0 0 L3257 PR ORTH FOOT ADD CHARGE SPLIT S 192.0 0 L3260 PR AMBULATORY SURGICAL BOOT EAC 40.00 L3300 PR SHO LIFT TAPER TO METATARSAL 62.00 L3310 PR SHOE LIFT ELEV HEEL/SOLE NEO 96.00 L3330 PR LIFTS ELEVATION METAL EXTENS 670.0 0 L3332 PR SHOE LIFTS TAPERED TO ONE-HA 90 L3334 PR SHOE LIFTS ELEVATION HEEL /I 45.00 L3350 PR SHOE HEEL WEDGE 36.00 L3360 PR SHOE SOLE WEDGE OUTSIDE SOLE 42.00 L3370 PR SHOE SOLE WEDGE BETWEEN SOLE 59.00 L3390 PR SHOE OUTFLARE WEDGE 117.0 0 L3400 PR SHOE METATARSAL BAR WEDGE RO 96.00 L3410 PR SHOE METATARSAL BAR BETWEEN 112 L3440 PR HEEL LEATHER REINFORCED 78.00 L3450 PR SHOE HEEL SACH CUSHION TYPE 108.0 0 L3485 PR SHOE HEEL PAD REMOVABLE FOR 45.00 L3530 PR ORTHO SHOE ADD HALF SOLE 38.00 L3540 PR ORTHO SHOE ADD FULL SOLE 60.00 L3550 PR O SHOE ADD STANDARD TOE TAP 11.00 L3600 PR TRANS SHOE CALIP PLATE EXIST 90.00 L3610 PR TRANS SHOE CALIPER PLATE NEW 150.0 0 L3620 PR TRANS SHOE SOLID STIRRUP EXI 130.0 0 L3630 PR TRANS SHOE SOLID STIRRUP NEW 195.0 0 L3649 PR ORTHOPEDIC SHOE MODIFICA NOS 105.0 0 L3650 PR SO 8 ABD RESTRAINT PRE OTS 78 L3660 PR SO 8 AB RSTR CAN/WEB PRE OTS 114.0 0 L3670 PR SO ACRO/CLAV CAN WEB PRE OTS 151.0 0 L3674 PR SO AIRPLANE W/WO JOINT CF 1274. 00 L3675 PR SO VEST CANVAS/WEB PRE OTS 189.0 0 L3710 PR EO ELAS W/METAL JNTS PRE OTS 178 L3740 PR CUFFS ADJ LOCK W/ ACTIVE CON 1024. 00 L3760 PR EO ADJ JT PREFAB CUSTOM FIT 552 L3762 PR EO RIGID W/O JOINTS PRE OTS 116.0 0 L3763 PR EWHO RIGID W/O JNTS CF 774 L3806 WHFO W/JOINT(S) CUSTOM 501 FAB L3807 PR WHFO W/O JOINTS PRE 276 CST L3808 PR WHFO, RIGID W/O JOINTS 413 L3809 PR WHFO W/O JOINTS PRE 276 OTS L3900 PR HINGE EXTENSION/FLEX WRIST/F 1608 L3906 PR WHO W/O JOINTS CF 486 L3908 PR WHO COCK-UP NONMOLDE PRE OTS 149.0 0 L3912 PR HFO FLEXION GLOVE PRE OTS 133 L3913 PR HFO W/O JOINTS CF 299 L3915 PR WHO NONTORSION JNTS PRE CST 573.0 0 L3916 PR WHO NONTORSION JNTS PRE OTS 587 L3919 PR HO W/O JOINTS CF 299 L3923 PR HFO WITHOUT JOINTS PRE CST 107 L3924 PR HFO WITHOUT JOINTS PRE OTS 107 L3925 PR FO PIP DIP JNT/SPRNG PRE OTS 58 L3927 PR FO PIP DIP NO JT SPR PRE OTS 39 L3929 PR HFO NONTORSION JNTS PRE CST 102 L3933 PR FO W/O JOINTS CF 236 L3960 PR SEWHO AIRPLAN DESIG ABDU POS 817.0 0 L3980 PR UP EXT FX ORTHOS HUMERAL NOS 355.0 0 L3982 PR UPPER EXT FX ORTHOSIS RAD/UL 414.0 0 L3984 PR UPPER EXT FX ORTHOSIS WRIST 382.0 0 L4002 PR REPLACE STRAP, ANY ORTHOSIS 12.00 L4100 PR REPL LEATH CUFF KAFO PROX TH 136.0 0 L4110 PR REPL LEATH CUFF KAFO-AFO CAL 102.0 0 L4205 PR ORTHO DVC REPAIR PER 15 MIN 20.00 L4210 PR ORTH DEV REPAIR/REPL MINOR P 12.00 L4350 PR ANKLE CONTROL ORTHO PRE OTS 114.0 0 L4360 PR PNEUMAT WALKING BOOT PRE CST 349.0 0 L4361 PR PNEUMA/VAC WALK BOOT PRE OTS 358 L4370 PR PNEUM FULL LEG SPLNT PRE OTS 231.0 0 L4386 PR NON-PNEUM WALK BOOT PRE CST 188.0 0 L4396 PR STATIC OR DYNAMI AFO PRE CST 199.0 0 L4398 PR FOOT DROP SPLINT PRE OTS 91.00 L4631 PR AFO, WALK BOOT TYPE, CUS FAB 1888. 00 L5000 PR SHO INSERT W ARCH TOE FILLER 674.0 0 L5010 PR MOLD SOCKET ANK HGT W/ TOE F 1270. 00 L5100 PR MOLDED SOCKET SHIN SACH FOOT 2889. 00 L5250 PR HIP CANAD SING AXI CONS FRIC 6271. 00 L5301 PR BK MOLD SOCKET SACH FT ENDO 2775. 00 L5321 PR AK OPEN END SACH 3972. 00 L5341 PR CANADIAN SACH 6000. 00 L5450 PR POSTOP APP NON-WGT BEAR DSG 519.0 0 L5611 PR AK 4 BAR LINK W/FRIC SWING 1947. 00 L5618 PR TEST SOCKET SYMES 382.0 0 L5620 PR TEST SOCKET BELOW 336.0 KNEE 0 L5622 PR TEST SOCKET KNEE DISARTICULA 443.0 0 L5624 PR TEST SOCKET ABOVE 490.0 KNEE 0 L5626 PR TEST SOCKET HIP DISARTICULAT 688.0 0 L5628 PR TEST SOCKET HEMIPELVECTOMY 563.0 0 L5629 PR BELOW KNEE ACRYLIC SOCKET 498.0 0 L5631 PR AK/KNEE DISARTIC ACRYLIC SOC 649.0 0 L5637 PR BELOW KNEE TOTAL CONTACT 411.0 0 L5643 PR HIP FLEX INNER SOCKET EXT FR 1881. 00 L5645 PR BK FLEX INNER SOCKET EXT FRA 964.0 0 L5646 PR BELOW KNEE CUSHION SOCKET 662.0 0 L5647 PR BELOW KNEE SUCTION SOCKET 961.0 0 L5649 PR ISCH CONTAINMT/NARROW M-L SO 2416. 00 L5650 PR TOT CONTACT AK/KNEE DISART S 590.0 0 L5651 PR AK FLEX INNER SOCKET EXT FRA 1451. 00 L5652 PR SUCTION SUSP AK/KNEE DISART 527.0 0 L5654 PR SOCKET INSERT SYMES 401.0 0 L5655 PR SOCKET INSERT BELOW KNEE 339.0 0 L5656 PR SOCKET INSERT KNEE ARTICULAT 413.0 0 L5666 PR BELOW KNEE CUFF SUSPENSION 92.00 L5670 PR BK MOLDED SUPRACONDYLAR SUSP 374.0 0 L5671 PR BK/AK LOCKING 601.0 MECHANISM 0 L5673 PR SOCKET INSERT W LOCK MECH 849.0 0 L5679 PR SOCKET INSERT W/O LOCK MECH 708.0 0 L5681 PR INTL CUSTM CONG/LATYP INSERT 1561. 00 L5683 PR INITIAL CUSTOM SOCKET INSERT 1561. 00 L5685 PR BELOW KNEE SUS/SEAL SLEEVE 152.0 0 L5694 PR AK PELVIC CONTROL BELT PAD/L 190.0 0 L5695 PR AK SLEEVE SUSP NEOPRENE/EQUA 230.0 0 L5698 PR AK/KNEE DISARTIC SILESIAN BA 127.0 0 L5700 PR REPLACE SOCKET BELOW KNEE 3482. 00 L5701 PR REPLACE SOCKET ABOVE KNEE 4319. 00 L5704 PR CUSTOM SHAPE COVER 710.0 BK 0 L5705 PR CUSTOM SHAPE COVER 1302. AK 00 L5781 PR LOWER LIMB PROS VACUUM PUMP 4747. 00 L5782 PR HD LOW LIMB PROS VACUUM PUMP 5005. 00 L5811 PR ENDO KNEE-SHIN MNL LCK ULTRA 761.0 0 L5814 PR ENDO KNEE-SHIN HYDRAL SWG PH 4406. 00 L5828 PR ENDO KNEE-SHIN FLUID SWG/STA 3533. 00 L5845 PR KNEE-SHIN SYS STANCE FLEXION 2127. 00 L5848 PR KNEE-SHIN SYS HYDRAUL STANCE 1276. 00 L5850 PR ENDO AK/HIP KNEE EXTENS ASSI 161.0 0 L5855 PR MECH HIP EXTENSION ASSIST 373.0 0 L5856 PR ELEC KNEE-SHIN SWING/STANCE 28481.00 L5910 PR ENDO BELOW KNEE ALIGNABLE SY 441.0 0 L5920 PR ENDO AK/HIP ALIGNABLE SYSTEM 641.0 0 L5925 PR ABOVE KNEE MANUAL 406.0 LOCK 0 L5930 PR HIGH ACTIVITY KNEE 3445. FRAME 00 L5940 PR ENDO BK ULTRA-LIGHT MATERIAL 606.0 0 L5950 PR ENDO AK ULTRA-LIGHT MATERIAL 1024. 00 L5960 PR ENDO HIP ULTRA-LIGHT MATERIA 1227. 00 L5962 PR BELOW KNEE FLEX COVER SYSTEM 710.0 0 L5968 PR MULTIAXIAL ANKLE W DORSIFLEX 3984. 00 L5970 PR FOOT EXTERNAL KEEL SACH FOOT 265.0 0 L5972 PR FLEXIBLE KEEL FOOT 426.0 0 L5974 PR FOOT SINGLE AXIS ANKLE/FOOT 310.0 0 L5976 PR ENERGY STORING FOOT 677.0 0 L5979 PR MULTI-AXIAL ANKLE/FT PROSTH 2830. 00 L5980 PR FLEX FOOT SYSTEM 3866. 00 L5981 PR FLEX-WALK SYS LOW EXT PROSTH 3873. 00 L5984 PR ENDOSKELETAL AXIAL ROTATION 692.0 0 L5986 PR MULTI-AXIAL ROTATION 770.0 UNIT 0 L5987 PR SHANK FT W VERT LOAD PYLON 8535. 00 L5988 PR VERTICAL SHOCK REDUCING PYLO 2370. 00 L5990 PR USER ADJUSTABLE HEEL HEIGHT 2152. 00 L5999 PR LOWR EXTREMITY PROSTHES NOS 15600.00 L6026 PR PART HAND MYO EXCLU TERM DEV 5111. 00 L6050 PR WRST MLD SCK FLX HNG TRI PAD 2296. 00 L6100 PR ELB MOLD SOCK FLEX HINGE PAD 2326. 00 L6110 PR ELBOW MOLD SOCK SUSPENSION T 2129. 00 L6500 PR ABOVE ELBOW PROSTH TISS SHAP 3217. 00 L6611 PR ADDITIONAL SWITCH, EXT POWER 489.0 0 L6615 PR DISCONNECT LOCKING WRIST UNI 248.0 0 L6616 PR DISCONNECT INSERT LOCKING WR 105.0 0 L6629 PR LAMINATION COLLAR W/ COUPLIN 177.0 0 L6630 PR STAINLESS STEEL ANY WRIST 225.0 0 L6635 PR LIFT ASSIST FOR ELBOW 239.0 0 L6638 PR ELEC LOCK ON MANUAL PW ELBOW 2967. 00 L6655 PR STANDARD CONTROL CABLE EXTRA 91.00 L6660 PR HEAVY DUTY CONTROL CABLE 111.0 0 L6670 PR HOOK TO HAND CABLE ADAPTER 60.00 L6672 PR HARNESS CHEST/SHLDER SADDLE 209 L6675 PR HARNESS FIGURE OF 8 SING CON 145.0 0 L6676 PR HARNESS FIGURE OF 8 DUAL CON 127.0 0 L6680 PR TEST SOCK WRIST DISART/BEL E 280.0 0 L6682 PR TEST SOCK ELBW DISART/ABOVE 314.0 0 L6686 PR SUCTION SOCKET 783.0 0 L6687 PR FRAME TYP SOCKET BEL ELBOW/W 697.0 0 L6688 PR FRAME TYP SOCK ABOVE ELB/DIS 674.0 0 L6693 PR LOCKINGELBOW FOREARM 3368. CNTRBAL 00 L6694 PR ELBOW SOCKET INS USE W/LOCK 849.0 0 L6695 PR ELBOW SOCKET INS USE W/O LCK 708.0 0 L6696 PR CUS ELBO SKT IN FOR CON/ATYP 1561 L6697 PR CUS ELBO SKT IN NOT CON/ATYP 1598 L6698 PR BELOW/ABOVE ELBOW LOCK MECH 459.0 0 L6703 PR TERM DEV, PASSIVE HAND MITT 385.0 0 L6704 PR TERM DEV, SPORT/REC/WORK ATT 637.0 0 L6706 PR TERM DEV MECH HOOK VOL OPEN 422.0 0 L6708 PR TERM DEV MECH HAND VOL OPEN 1011. 00 L6715 PR TERM DEVICE, MULTI ART DIGIT 3746 L6722 PR HOOK/HAND, HVY DTY, VOL CLOS 2406. 00 L6881 PR TERM DEV AUTO GRASP FEATURE 4850. 00 L6882 PR MICROPROCESSOR CONTROL 3679. UPLMB 00 L6890 PR PREFAB GLOVE FOR TERM DEVICE 206.0 0 L6955 PR ABOVE ELBOW MYOELECTRONIC CT 14809.00 L7007 PR ADULT ELECTRIC HAND 4383. 00 L7367 PR REPLACEMNT LITHIUM IONBATTER 444.0 0 L7368 LITHIUM ION BATTERY CHARGER 576.0 0 L7400 PR ADD UE PROST BE/WD, ULTLITE 364.0 0 L7402 PR ADD UE PROST S/D ULTLITE MAT 427.0 0 L7403 PR ADD UE PROST B/E 437.0 ACRYLIC 0 L7404 PR ADD UE PROST A/E 659.0 ACRYLIC 0 L7499 PR UPPER EXTREMITY PROSTHES NOS 2595. 00 L7510 PR PROSTHETIC DEVICE REPAIR REP 62.00 L7520 PR REPAIR PROSTHESIS PER 15 MIN 16.00 L7700 PR PROS SOC INSERT GASKET/SEAL 350.0 0 L8300 PR TRUSS SINGLE W/ STANDARD PAD 102.0 0 L8400 PR SHEATH BELOW KNEE 21.00 L8417 PR PROS SHEATH/SOCK W GEL CUSHN 89.00 L8420 PR PROSTHETIC SOCK MULTI PLY BK 25.00 L8430 PR PROSTHETIC SOCK MULTI PLY AK 27.00 L8435 PR PROS SOCK MULTI PLY UPPER LM 25.00 L8440 PR SHRINKER BELOW KNEE 51.00 L8460 PR SHRINKER ABOVE KNEE 81.00 L8470 PR PROS SOCK SINGLE PLY 8.00 BK L8480 PR PROS SOCK SINGLE PLY 11.00 AK L8681 PR PT PRGRM FOR IMPLT NEUROSTIM 1290. 00 L8689 PR EXTERNAL RECHARG SYS INTERN 2025. 00 M0076 PR PROLOTHERAPY 250.0 0 P3001 PR SCREENING PAP SMEAR BY PHYS 82.00 Q0091 PR OBTAINING SCREEN PAP SMEAR 50.00 Q0111 PR WET MOUNTS/ W PREPARATIONS 14.00 Q0112 PR POTASSIUM HYDROXIDE PREPS 10.00 Q0138 PR FERUMOXYTOL, NON- 1.80 ESRD Q2036 PR FLULAVAL VACC, 3 YRS & >, IM 31.00 Q2038 PR FLUZONE VACC, 3 YRS & >, IM 41.00 Q3014 PR TELEHEALTH FACILITY 43.00 FEE Q4008 PR CAST SUP LONG ARM PED FBRGLS 67.00 Q4010 PR CAST SUP SHT ARM ADULT FBRGL 61.00 Q4012 PR CAST SUP SHT ARM PED FBRGLAS 61.00 Q4022 PR CAST SUP SHT ARM SPLINT FBRG 61.00 S0610 PR ANNUAL GYNECOLOGICAL EXAMINA 107.0 0 S0620 PR ROUTINE OPHTHALMOLOGICAL EXA 90.00 S0621 PR ROUTINE OPHTHALMOLOGICAL EXA 90.00 S0630 PR REMOVAL OF SUTURES 183.0 0 S1040 PR CRANIAL REMOLDING ORTHOSIS 2592. 00 S2083 PR ADJUSTMENT GASTRIC BAND 500.0 0 S8032 PR LOW DOSE CT LUNG 26 200.0 SCREENING 0 S8422 PR CUSTOM GRAD SLEEVE 198.0 MED 0 S8423 PR CUSTOM GRAD SLEEVE HEAVY 401 S8424 PR READY GRADIENT SLEEVE 187.0 0 S8425 PR CUSTOM GRAD GLOVE 326.0 MED 0 S8427 PR READY GRADIENT GLOVE 80.00 S8450 PR SPLINT DIGIT 10.00 S8451 PR SPLINT WRIST OR ANKLE 17.00 S9453 PR SMOKING CESSATION CLASS 31.00 S9470 PR NUTRITIONAL COUNSELING, DIET 51.00 V2520 PR CONTACT LENS HYDROPHILIC 135.0 0 V2627 PR SCLERAL COVER SHELL 3115. 00 V5008 PR HEARING SCREENING 101.0 0 V5010 PR ASSESSMENT FOR HEARING AID 0.00 V5011 PR HEARING AID FITTING/CHECKING 85.00 V5014 PR HEARING AID REPAIR/MODIFYING 125.0 0 V5020 PR CONFORMITY 115 EVALUATION V5160 PR DISPENSING FEE 660.0 BINAURAL 0 V5200 PR CROS HEARING AID DISPENS FEE 330.0 0 V5210 PR IN EAR BICROS HEARING 51.00 AID V5240 PR DISPENSING FEE BICROS 660.0 0 V5241 PR DISPENSING FEE, MONAURAL 330.0 0 V5254 PR HEARING ID, DIGIT, MON, 2900. CIC 00 V5255 PR HEARING AID, DIGIT, MON, ITC 2750. 00 V5256 PR HEARING AID, DIGIT, MON, ITE 2500. 00 V5257 PR HEARING AID, DIGIT, MON, BTE 2600. 00 V5258 PR HEARING AID, DIGIT, BIN, 5800. CIC 00 V5260 PR HEARING AID, DIGIT, BIN, 5000. ITE 00 V5261 PR HEARING AID, DIGIT, BIN, BTE 5200. 00 V5264 PR EAR MOLD/INSERT 75.00 V5265 PR EAR MOLD/INSERT, DISP 5.00 V5266 PR BATTERY FOR HEARING DEVICE 6.00 V5267 PR HEARING AID SUP/ACCESS/DEV 53.00 V5274 PR ALD UNSPECIFIED 150.0 0 V5275 PR EAR IMPRESSION 25.00 01999A DUMMY ANES CODE FOR CRNA/MCR 0 21499A STYLOID PROCESS EXCISION 2965. PROCEDURE 00 22899H POSTERIOR ROD 1800. LENGTHENING 00 24999A DECOMPRESSION FASCIOTOMY, UPPER 2056 ARM 27299B OPEN GLUTEUS MEDIUS/MINIMUS 2036 REPAIR 27299O OPN FEM HIP DISLOC-ACTAB IMPIN 5909. 00 29999A ARTHROSCOPY, HIP, SURGICAL, 2859 ILIOTIBIAL BAND RELEASE/LENGTHENING 29999B ARTHROSCOPY, HIP,SURGICAL, 1267 TROCHANTERIC 29999C ARTHROSCOPY,HIP,SURGICAL,ILIOPSO 2574 AS RELEASE/TENOTOMY 29999D ARTHROSCOPY,HIP,SURGICAL,GLUTEU 2240 S MEDIUS/MINIMUS REPAIR 29999E ARTHROSCOPY,HIP,SURGICAL,LABRAL 3908 RECONSTRUCTION 31299A ENDO ASSIST SKULL BASE SURGERY, 17162 ANTERIOR CRANIAL FOSSA 31299B ENDO ASSIST SKULL BASE SURGERY, 15062 MIDDLE CRANIAL FOSSA 32850A DRY-RUN DONOR PNEUMONECTOMY 2626 32999A INSERT GORE MESH (DURING 670 THORACOTOMY) 33999E MV CLIPS REPAIR OF TRICUSPID VALVE 6371. 00 33999G CARDIOBAND REPAIR OF TRICUSPID 9492. VALVE 00 33999H INSERTION,AXILLARY SUBCLAVIAN 1866 BALLOON PUMP 33999I REMOVAL,AXILLARY SUBCLAVIAN 2534 BALLOON PUMP 33999J INSERT/REMOVE SAME DAY 4400 SUBCLAVIAN BALLOON PUMP 33999K TAVR TRANSCAROTID APPROACH 6800 33999L TAKE DOWN OF VENTRICULAR SEPTAL 7186 DEFECT PATCH 36468A PR INJ SCLERO SOLN VEIN LIMB/TRUNK 300.0 0 36471A PR INJ SCLERO SOLN VEIN MULTI 350.0 0 37799C VENA CAVA RESECTION & REPAIR 5061. 00 37799E RELEASE MED ARCUATE LIGAMENT 1700. 00 37799F ATHERECTOMY OF VEIN 1570. 00 37799G STAB PHLEB OF VAR VEIN, LESS THAN 1108 10 INCISIONS 37799H PHLEB VEINS - EXTREM - LT 10 1108 INCISIONS 37799I CATH/ANGIO OF VESSEL 2225 37799J REMOVAL PORTO SPLENO-RENAL 1220 SHUNT 37799K RELEASE OF INGUINAL LIGAMENT 673 37799L OPEN AAA REPAIR USING BIFURCATED 9298 GRAFT 37799M VEIN BYPASS GRAFT; INTERNAL 3624 JUGULAR TO SUBCLAVIAN 37799N OPEN VENOUS THROMBECTOMY; 5284 RENAL VEIN 38129A LAP UNROOFING OF SPLENIC CYST 1714 38999C BATS CELL INFUSION 304.0 0 38999D LYMPH NODE ABLATION 6630 38999E SCLEROSANT INJ INTO LYMPHANGIOMA 2692 38999F CADAVER LYMPH NODE DISSECTION 1300 39599A VATS DIAPHRAM PLICATION 3191 40000A PR PSYC-UVA NO SHOW CHG 25.00 41899A PR TOOTH EXTRACT PRIOR TO 180.0 RADIATION 0 41899B EXTRACTION,ERUPTED TOOTH OR 180 EXPOSED ROOT 41899C EXTRACTION,ERUPTED TOOTH 300 REQUIRING REMOVAL OF BONE- SECTIONING OF TOOTH 41899D REMOVAL OF IMPACTED TOOTH- 600 (COMPLETELY BONY) 41899E REMOVAL OF RESIDUAL TOOTH ROOTS 200 (CUTTING PROCEDURE) 43289A GASTRIC FUNDUS WEDGE EXCISION OF 3213 MASS 43289B LAP TAKEDOWN OF 5921. FUNDOPLICATION,ESOPHAGUS 00 43659A PARTIAL LAP GASTRECTOMY 4013. 00 43659B LAP PYLOROPLASTY 4019 43659C LAP EXCISION OF GIST 3537 43659D LAP PYLOTOMYOTOMY 2601 43659E LAP GASTROJEJUNOSTOMY 3412 43659F LAP BILLROTH I GASTROJEJUNOSTOMY 6727 W/ PROX DUODENAL RESECTION 43659G LAPAROSCOPIC GASTROSTOMY TUBE 2520 PLACEMENT(OTHER THAN STAMM) 43659H LAPAROSCOPIC TOTAL GASTRECTOMY 11226 W/ROUS-EN-Y ESOPHAGOJEJUNOSTOMY 43659I LAP REDUCTION OF GASTRIC 3365 VOLVULUS W/GASTROPEXY 43999B PARTIAL GASTRECTOMY 5324. ONLY 00 43999C PERORAL ENDOSCOPIC MYOTOMY 2378. 00 43999D ESM DISSECTION STOMACH 2969. 00 43999E POEM 4157. 00 43999F RELOCATION,PORT,LAP ADJ 1023 BAND,BOTH LAP & EXTERNAL APPROACH 43999G ENDOSCOPIC SUTURING FISTULA 2592 CLOSURE 43999H OPEN PARTIAL 4559 GASTRECTOMY 43999I GASTROCUTANEOUS FISTULA TAKE 5768 DOWN. 43999J EMR BANDING STOMACH 4042 44238A LAP REPAIR INTERNAL 2637 HERNIA/VOLVULUS 44799B EXCISION AMPULLARY AND DUODENAL 3100 MASS 44799C CHANGE CECOSTOMY 200 BUTTON 44799D PEXY (STITCHING) OF J 3908 POUCH 44799E EUS GUIDED ANTIGRADE BILIARY ERCP 2466 44799F RETROGRADE SMALL BOWEL 797 ENTEROSCOPY 45399A ESM DISSECTION COLON 2969. 00 45399B UNDERWATER EMR 1218. 00 45399C EXCISION OF POLYPS (2) AT END OF 1342 COLOSTOMY 45999C PEXY OF INTESTINE 3908 45999D ABDOMINAL PERINEAL RESECTION OF 7198 RECTUM 46999A TE RECTAL TUMOR REMOVAL 2648 46999B REPAIR OF ANAL TEAR (NON-PLASTIC) 2153 46999C EXCISION OF INTERNAL HEMORRHOID 483 47379A LAP LIVER CYST 4029. EXCISION/FULGERATION/ABLATION 00 47379B LAPAROSCOPIC PART HEPATECTOMY 8093. 00 47379C LAPAROSCOPIC HEPATIC CYST 4029 FENESTRATION 47379D LAP LIVER BX 3041 47379E LAP HEPATIC TRISECEMYECTOMY 11481 47379F LAP FENESTRATION LIVER 5145 47379G LAP MICROWAVE ABLATION 5145 47399C ETHANOL ABLATION OF HEPATIC 2527. LESION 00 47399D BACKBENCH, OPEN, LIVING DONOR 9800 48999B FREY PROCEDURE W/ROUX-EN-Y 7460. PANCREATICOJEJUNOSTOMY 00 48999C LAP PANCREATECT W/WO SPLENECT 6000. 00 48999E LAPAROSCOPIC ROBOTIC-ASSISTED 12860 PANCREAS TRANSPLANTATION 48999F PANCREATIC ESWL 2000. 00 48999H ENDO PANCREATIC NECROSECTOMY 9750. 00 48999I ROBOTIC ASSISTED LAP PANCREAS 6838. TRANSPLANT 00 48999J LAPAROSCOPIC, BACKBENCH 9655 PANCREAS 48999K DONOR PANCREATECTOMY 5251 48999L LAP ENUCLEATION PANCREAS NE 9512 TUMOR 48999M EUS GUIDED ERCP DIRECT STNT, PAN 4029 49329A LAP REM VENTRICULOPERIT SHUNT 1220 49329B LAP REMOVAL INTRAABDOMIN CYST 4528. 00 49329C LAP PART OMENTECTOMY 1424 49329D LAPAROSCOPIC OMENTUM RESECTION 2848 OF TUMOR 49659A TAPP,FEMORAL NERVE 1948 REPAIR 49659B LAP MORGAGNI HERNIA 6199 REPAIR 49999A FALCIFORM LIGAMENT FLAP 1037 49999B REPAIR SPORTS HERNIA 1320 50549A ROBOTIC ASSISTED LAP KIDNEY 7189. TRANSPLANT 00 50549B LAPAROSCOPIC ROBOTIC-ASSISTED 11669 KIDNEY TRANSPLANTATION 53899B REPLACEMENT OF CONTROL VALVES, 1199 BILATERAL NEPH TUBES 53899C CYSTOSTOMY W/REMOVAL OF FB FROM 2003 BLADDER 60699A THYROID ABLATION 2460. 00 63746A REMOVAL PORTO SPLENO-RENAL 1220 SHUNT 64999E TUMOR TREATMENT,TRANSNASAL OR 6243 TRANSPHENOIDAL ENDO APPROACH 64999F BOTOX INJECTION, PALMS 866 64999G BOTOX INJ, DIGITAL 286 ARTERIES 67999A ENDO REPAIR BROW PTOSIS 2024. W/IMPLANT 00 78999Z CT FUSION FOR 26 135 LOCALIZATION 88036A CHEST CAVITY AND NECK ORGANS 848.0 ONLY 0 88036B ABDOMINAL CAVITY AND PELVIC 848.0 ORGANS ONLY 0 88037A BRAIN ONLY (REMOVED AT UVA) 848.0 0 88037B BRAIN ONLY (WITHOUT REMOVAL) 800.0 0 88037C BRAIN ONLY (DEGENERATIVE WORK-UP 1413. REMOVED AT UVA) 00 88037D BRAIN ONLY (DEGENERATIVE WORK- 1366. UP, PREVIOUSLY REMOVED) 00 88037E BRAIN ONLY (CJD PREVAUTIONS) 0 88037F AUTOPSY, BRAIN ME 0.00 88305C CORE BIOP. PROSTATE 26 178.0 0 88305M DERM TISSUE EXAM 13 26 100.0 0 88321A CONSULT AND SLIDE REVIEW 130.0 0 88321B CHG WINCHESTER 330.0 CYTOLOGY/NEUROPATHOLOGY 0 CONSULT 88321S DERM CONSULT UVA REFRL PATIENT 190.0 0 90899S DRIVING EVALUATIONS 150.0 0 92310A PR NEW CONTACT LENS FIT W 100.0 TRAINING 0 92310B PR NEW CONTACT LENS FIT - TORIC 90.00 LENS 92310C PR NEW CONTACT LENS FIT - 105.0 PRESBYOPIA 0 92310D PR EST CONTACT LENS FIT 75.00 92310E PR DAVIS VISION LENS FIT 60.00 92310F PR CONTACT LENS FIT- IMAGE 130.0 DISPARITY 0 93882A PR DUPLEX EXTRACRANIAL 26 22.00 UNILAT 93922A PR DOPPLER ARTERIAL EXT 26 22.00 93979A PR DUPLEX AORTA/IVC/GRAFT/LTD 22.00 94799A PR CAR SEAT/BED TESTING W/INTERP & 223.0 REPORT 60 MIN >28 DAYS 0 94799B PR CAR SEAT/BED TESTING W/INTERP & 49.00 REPORT +30MIN >28 DAYS 97110A PR INDIVIDUAL YOGA 99.00 97150A PR GROUP YOGA 29.00 99024B PR POST-OP FOLLOW-UP 0.00 VISIT 99211A PR PROSTHETICS/ORTHOTICS FITTING 0.00 99211B PR NURSE VISIT 49.00 99231A PR SUBSEQUENT HOSP CARE,LEVL I, 99.00 CONCURRENT 99231B PR SUBSEQUENT HOSP CARE,LEVL I, 99.00 CONCURRENT 99232A PR SUBSEQUENT HOSP CARE,LEVL II, 183.0 CONCURRENT 0 99232B PR SUBSEQUENT HOSP CARE,LEVL II, 183.0 CONCURRENT 0 99233A PR SUBSEQUENT HOSP CARE,LEVL III, 262.0 CONCURRENT 0 99233B PR SUBSEQUENT HOSP CARE,LEVL III, 262.0 CONCURRENT 0 99234A PR OBSERVATION/INPATIENT HOSPITAL 335.0 CARE 40 MINUTES 0 99235A PR OBSERVATION/INPATIENT HOSPITAL 435.0 CARE 50 MINUTES 0 99236A PR OBSERVATION/INPATIENT HOSPITAL 547.0 CARE 55 MINUTES 0 99238A PR HOSPITAL DISCHARGE DAY,<30 MIN 183.0 0 99239A PR HOSPITAL DISCHARGE DAY,>30 MIN 270.0 0 99291A PR CRITICAL CARE, E/M 30-74 MINUTES 1060 99292A PR CRITICAL CARE, ADDL 30 MIN 308.0 0 99356A PR PROLONGED SERVICE I/P REQ 231.0 UNIT/FLOOR TIME 1ST HR 0 99357A PR PROLONGED SVC I/P REQ 231.0 UNIT/FLOOR TIME EA 30 MIN 0 99446A E-CONSULT REQUEST 0.00 99446B E-CONSULT 5-10 MIN. 0.00 99446C E-CONSULT REQUIRES FACE-TO-FACE 0.00 99446D E-CONSULT DECLINED 0.00 99447A E-CONSULT 11-20 MIN. 0.00 99448A E-CONSULT 21-30 MIN. 0.00 99449A E-CONSULT 31+ MIN. 0.00 99463A PR INITIAL NORMAL NEWBORN CARE, 301.0 SAME DAY DISCHARGE 0 99464A PR ATTN AT DELIVERY 1ST 194.0 STABILIZATION OF NEWBORN 0 99465A PR DELIVERY/BIRTHING ROOM 384.0 RESUSCITATION 0 99499A PR INSUFFICIENT DOCUMENTATION 0.00 99499B PR PRE-OPERATIVE PHYSICAL EXAM 0.00 99499D PR BUS DRIVE/CDL (DOT) PHYSICAL 85.00 99499E PR MRO CALL 85.00 99499G PR SPORTS PHYSICAL 25.00 99499H PR AMBULATORY CARE 0.00 RECONCILIATION 99499I PR WALK OUT/NOT SEEN 0.00 99499J PR NO CHARGE/LAB ONLY 0.00 99499L PR FU WITHIN 90 DAYS OF TREATMENT 0.00 99499N PR CLOSE ENCOUNTER - NO LOS 0.00 99499O PR FU WITHIN 90 DAYS OF TREATMENT 0.00 99499P PR CLOSE ENCOUNTER - NO LOS 0.00 99499R PR OB/GYN SERVICE 0.00 99499S PR OB/GYN SERVICE 0.00 99499U PR PRE-OPERATIVE PHYSICAL EXAM 0.00 99499V LIMITED PHYSICAL W/FORMS 50 99499W PEDS CARDIAC CLEARANCE 75 99499X INTRAOPERATIVE CONSULT 500 99999C PR SUTURE LACERATION 0.00 99999E PR CPT CODE 0.00 UNDETERMINED A4466A KNEE ORTHOTIC, ELASTIC OR SIMILAR 75.00 STRETCHABLE MATERIAL A4466H ABDOMINAL BINDER, ELASTIC 40.00 A4467A KNEE ORTHOTIC, ELASTIC OR SIMILAR 75.00 STRETCHABLE MATERIAL A4467B HINGED KNEE BRACE 103.0 0 A4467C KNEE ORTHOTIC 66.00 A4467D ELBOW SLEEVE 67.00 A4467E PREFABRICATED SHOULDER ORTHOTIC 62.00 A4467F THORACIC,RIB BELT,CUSTOM FIT 47.00 A4467G HEEL PROTECTOR (HEELBO) 69.00 A4467H ABDOMINAL BINDER, ELASTIC 40.00 A6545A GRADIENT COMPRESSION WRAP- 198.0 LOWER LEG 0 A6545B GRADIENT COMPRESSION WRAP- 220.0 UPPER LEG WITH KNEE 0 A6545C GRADIENT COMPRESSION WRAP- 44.00 SINGLE BAND ANKLE FOOT WRAP A6545D GRADIENT COMPRESSION WRAP-HAND 60.00 WRAP A6545E GRADIENT COMPRESSION WRAP-ARM 224.0 WRAP 0 A6549A COMPRESS STOCKING,CUSTOM MADE 759.0 0 A9900A FACE SHIELD 208.0 0 D9940A PR OCCLUSAL GUARD, IN OFFICE 190.0 0 D9999A DENTAL PREPARATION 0.00 L1499F NATL ORTHOSIS.. 550.0 0 L1499Z PECTUS THORACIC BRACE 900.0 0 L2999J PR ADJUST-A-LIFT 11.00 L2999K PR HAMMERTOE SPL PR 15.00 L2999L PR HAPADS PAIR 12.00 L2999M TOE CAP/GUARD 13.00 L2999N PR TOE SEPARATOR PR 4.00 L2999O PR SHIPPING & HANDLING 1.00 L2999Z REMOVABLE HEEL WEDGE 18.00 L3999D SHLD IMMOBIL ELA 37.00 L3999G TENNIS ELBOW AOA 22.00 L3999N SHOULDER IMMOBILIZER 229.0 0 L5999B PR FOOT SHELL FOR PATH FINDER 150.0 0 L5999D PR REPLACE FLEX-FOOT 215.0 SHELL 0 L7499A PR ONE FINGER PROS 416.0 0 L7499C SURELOCK UPPER EXTREMITY CABLE 844.0 LOCK 0 L7499D TOUGHWARE SELF-SUSPENDING 800.0 HUMERAL CUFF 0 L7499R PARTIAL FINGER PROSTHESIS, CUSTON 2508. 00 L8499A PR PROTECTIVE STOCKING 30.00 S0620D PR DAVIS VISION EXAM NEW 51.50 PT S0621D PR DAVIS VISION EXAM RTRN PT 51.50 V2599D PR DAVIS VISION CONTACT LENS 110.5 BENEFIT 0 V5011B FIT/CHECKING OF HA (ALL PLANS) 0.00 V5014B REPAIR/MODIFY HA (ALL 0.00 PLANS) V5014K HA REP (OTICON) ALL WARR 6 MO 220.0 0 V5014L HA REP (OTICON) ALL WARR 12 MO 260.0 0 V5014P HA REP (OTCON) W/AI WARR 12 MO 260.0 0 V5014U HA (WID) BTE&CUST REP WAR 6MO 230.0 0 V5014V HA (WID) BTE&CUST REP WAR 12MO 260.0 0 V5014Y HA WI CUS REM 6MO REM WAR ONL 160.0 0 V5264A MICROMOLD (EACH) 60.00 V5264B ELAN SHELL 40.00 V5267B HEARING AID SUPPLY, WAX GUARDS 53.00 V5267D HEARING AID SUPPLY, DRI-AID KIT 15.00 V5267E HA REMOTE CONTROL/STREAMER 53.00 V5267H HA SUPPLY, TUBING 5.00 V5267I HA SUPPLY, RIC REC. 75.00 (OTICON) V5267K HA SUPPLY, RIC REC. (WIDEX) 100.0 0 V5299A HA FU UNLIM 2YRS PER AID W/PUR 200.0 0 V5299B HA FU UNLIM 5YRS PER AID W/PUR 350.0 0 V5299D HEARING AID DROP-OFF FEE 25.00 V5299E NEUROMONICS PROCESSOR(OASIS) 3590. 00 V5299F AUDIOLOGY, INITIAL TINNITUS VISIT, 150 CASH & CARRY V5299G NEUROMONIC PROCESS (SANCTUARY) 960.0 0 V5299H AUDIOLOGY, F/U TINNITUS VISIT,CASH & 100 CARRY V5299I NEUROMONIC PROCESS F/U PACKAGE. 105.0 0 V5299K HA REPLACEMENT FEE 300.0 0 V5299M HA FU 15 VIST OVR 5YRS PER AID 350.0 0 V5299N HA FU UNLIM 1 YR NON UVA PURCH 200.0 0 V5299O HA FU UNLIM 2 YR NON UVA PURCH 350.0 0 V5299Q HA ADD YR L&D (OTICON) 40.00 V5299R HA ADD YR REP WARR (OTICON) 110.0 0 V5299S HA ADD YR EXT WARR 140.0 (OTICON) 0 V5299 HA (WID) ALL OTHRE 3RD REP WARR 110.0 W 0 V5299X HA (WIDEX) ALL 2ND YEAR 110.0 L&D 0 76499A CONTRAST ENHANC SPECTRAL MAMMO 100.0 U 0 93799Z PR PULM ARTERY PRESS SENS 7300. A IMPLANT 00 99499Z NURSING HOME PE, ESTAB 250.0 A PAT 0 L2999A METATARSAL PAD 6.00 D L2999A HAL-VALG SPLINT 25.00 E L2999A HEEL CUP 30.00 N L2999B ADD PPT TO FO 12.00 F L2999B KNEE SLEEVE 45.00 Y L7499A PREM FUNCT AESTHETIC P. FING 5672. G 00 L7499A BIOMECHANICAL FUNCTION THUMB 21375.00 I L7499A PR TWO FINGER FUNCTION AESTH 8536. L PROS 00 V5014A HA WI BTE&CUS REP WAR GT 5YR 6M 305.0 A 0 V5014A HA REP (PHON) CLAS SVC PLN 6MO 210.0 E 0 V5014A HA REP (PHO) CLAS SVC PLN 12MO 240.0 F 0 V5014A HA REP(PHO) DHC (REM) SPLN 6MO 120.0 G 0 V5014A REPAIR/MODIFICATION OF A HEARING 220.0 I AID 0 V5014A HA REP (PHO) DIG SVC PLN 12 MO 250.0 J 0 V5014A HA REP(PH)WLS CRS/BICRS 12 MO 240.0 R 0 V5014B HA REP(STAR)CIC/CANAL WAR 12MO 250.0 B 0 V5014B HA REP(STAR) CUST DIG 1YR WARR 240.0 F 0 V5299A HA WAR PHO EXT SVC CON DIG YR 180.0 F 0