CMH PHYSICIAN PRACTICE PRICING EFFECTIVE FEBRUARY 1, 2018
SERVICE DESCRIPTION PRICE 1 lung with ventilation; PRO $1,600.00 12 LEAD EKG $0.01 1ST HOSP CARE PR D 30 MIN $201.13 1ST HOSP CARE PR D 50 MIN $271.90 1ST HOSP CARE PR D 70 MIN $402.72 1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB $258.16 1ST HOSP/BIRTHING CENTER NB ADMIT&DSCHG SM DATE $294.25 1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/< $2,592.55 1ST INPT CONSLTJ 110 MIN $475.01 1ST INPT CONSLTJ 20 MIN $114.73 1ST INPT CONSLTJ 40 MIN $176.70 1ST INPT CONSLTJ 55 MIN $269.62 1ST INPT CONSLTJ 80 MIN $388.96 1ST NF CARE PR D E/M HI SEVERITY $320.35 1ST NF CARE PR D E/M LW SEVERITY $237.44 1ST NF CARE PR D E/M MOD SEVERITY $251.01 1ST OBS CARE PR D HIGH SEVERITY $369.28 1ST OBS CARE PR D LOW SEVERITY $198.80 1ST OBS CARE PR D MODERATE SEVERITY $269.53 1ST PREVENTIVE MEDICINE NEW PATIENT < 1YR $274.17 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 12-17 YR $294.88 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 1-4 YRS $271.93 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 18-39YRS $338.17 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 40-64YRS $379.14 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 5-11 YRS $290.27 1ST PREVENTIVE MEDICINE NEW PATIENT AGE 65YRS&> $76.69 2 OR MORE FALLS WITH INJURY $0.01 7 FIELD PHOTO INTERP DOC REV $0.01 76856 U/S PELVIC COMPL/OFC; PRO $319.25 ABD PARACENTESIS WO IMAGING $219.25 ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC $740.82 ABDOM PARACENTESE WO/IMAGING GUIDANCE $465.49 ABDOMEN ULTRASOUND LTD $215.32 Abdominoperineal resection; PRO $800.00 ABLATION & RCNSTJ ATRIA LMTD $3,868.03 ABLTJ SOF TISS INF TURBS UNI/BI SUPFC $539.42 ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL $800.04 Access to CVC; PRO $500.00 ACETABULOPLASTY $3,708.81 ACETABULOPLASTY RESECTION FEMORAL HEAD $3,130.04 ACNE SURGERY $270.19 ACUP 1/> NDLS W/ELEC STIMJ 1ST 15 MIN $40.10 ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ $37.88 ACUP 1/> NDLS W/O ELEC STIMJ 1ST 15 MIN $40.10 ACUP 1/> NDLS W/O ELEC STIMJ EA 15 MIN $27.85 ADENOIDECTOMY PRIM AGE 12/> $663.20 ADENOIDECTOMY PRIM UNDER AGE 12 $613.63 ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 CM/< $1,464.90 ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES $1,305.01 ADMN&INTERPJ HLTH RISK ASSMT INSTRUMENT $35.65 Adrenalectomy; PRO $1,100.00 ADRENALIN 1 ML $8.00 ADRENALIN, EPINEPHRINE $5.00 ADVNC CARE PLAN IN RCRD $0.01 ADVNC CARE PLAN TLK DOCD $0.01 ADVNCD CARE PLAN 30 MINS $206.10 ADVNCD CARE PLAN ADDTL 30 MINS $204.65 AFO; PREFAB W/FITTING+AD $133.02 AIR CAST $315.59 ALBUTEROL UNIT 1MG $5.00 ALGINATE OR OTHER FIBER GELLING DRESSING $22.32 All procedures nerve, muscle, tendon, knee; PRO $500.00 All procedures nerve, muscle, tendon, upper leg; PRO $500.00 All procedures veins includes exploration; PRO $400.00 ALLERGEN IMMUN OTHER SERUM $23.97 ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED $535.60 ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL $306.95 ALUMINUM CRUTCHES $74.28 Amniocentesis Anes; PRO $500.00 AMNIOCNTS DX $362.67 AMNISURE/ROM POINT OF CARETEST $40.00 AMNT PAIN NOTED NONE PRSNT $0.01 AMNT PAIN NOTED PAIN PRSNT $0.01 AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV $1,955.09 AMP F/TH 1/2 JT/PHALANX 1 W/NEURECT LOCAL FLAP $1,864.29 AMP F/TH 1/2 JT/PHALANX 1 W/NEURECT W/DIR CLSR $1,860.26 AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST $2,496.84 AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION $1,946.49 AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REVJ $1,653.98 AMP MTCRPL W/FNGR/THMB 1 +-INTEROSS TR $2,018.04 AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION $1,408.07 AMPUTATION ARM THRU HUMERUS W/PRIMARY CLOSURE $1,997.76 AMPUTATION FOOT MIDTARSAL $1,560.01 AMPUTATION FOOT TRANSMETARSAL $2,172.56 AMPUTATION FOREARM THROUGH RADIUS & ULNA $2,015.45 AMPUTATION LEG THROUGH TIBIA&FIBULA $2,714.26 AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR $1,778.00 AMPUTATION METATARSAL W/TOE SINGLE $1,277.87 AMPUTATION THIGH THROUGH FEMUR ANY LEVEL $2,372.98 AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION $2,132.81 AMPUTATION TOE INTERPHALANGEAL JOINT $1,124.55 AMPUTATION TOE METATARSOPHALANGEAL JOINT $1,199.88 Amputation; PRO $600.00 ANALYZE PACEMAKER SYSTEM; PRO $645.02 ANES Gastrocnemius recession $600.00 ANGIOGRAPHY EXT BIL $191.36 ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I $52.53 ANGRPH XTR UNI RS&I $167.32 ANKLE DISARTICULATION $1,868.31 ANKLE FOOT ORTHOSIS AFO $689.67 ANKLE FOOT ORTHOTIC $146.32 ANNUAL DEPRESSION SCR 15 MIN; PRO $52.18 ANNUAL WELLNESS VISIT INITIAL $499.65 ANNUAL WELLNESS VISIT SUBSEQ $335.27 Anorectal procedure; PRO $600.00 ANOSC DX +-COLLJ SPEC BR/WA SPX $243.29 ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX $318.00 ANT COLPORRHAPHY RPR CSTOCELE +-RPR URETHROCELE $1,953.82 ANTB HIV-1 $20.00 ANTEPARTUM C DLVR&POSTPARTUM FA V AP C DLVER $5,558.86 ANTEPARTUM CARE ONLY 4-6 VSTS $1,274.26 ANTEPARTUM CARE ONLY 7+ VSTS $2,288.04 ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS $2,119.82 ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS $3,605.00 ANTERIOR TIBIAL TUBERCLEPLASTY $2,240.63 ANTI RHEUM DRUGTHXPYRXD GVN $0.01 ANTIGEN,RAPID GROUP A STREP $39.00 AORTOGRAPY ABDL SRLOGRAPY RS&I $165.83 APLIGRAF,PER SQUARE CM $81.69 APPENDEC INDICATED PURPOSE OTH MAJOR PX X SPX $246.51 APPENDEC RPTD APPENDIX ABSC/PRITONITIS $2,493.56 APPENDECTOMY INCIDENTAL TO PROCEDURE $1,885.51 APPL CLUBFOOT CAST MOLDING/MNPJ LONG/SHORT LEG $352.65 APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS $768.36 APPL SURF TC NSTIM $46.80 APPLICATION CAST ELBOW FINGER SHORT ARM $251.32 APPLICATION CAST HAND&LOWER FOREARM GAUNTLET $227.23 APPLICATION CAST SHOULDER HAND LONG ARM $279.72 APPLICATION CYLINDER CAST THIGH ANKLE $290.15 APPLICATION FINGER SPLINT STATIC $97.72 APPLICATION FINGER SPLINT STATIC ER PHY $65.05 APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE $1,116.68 APPLICATION LONG ARM SPLINT SHOULDER HAND $248.17 APPLICATION LONG LEG CAST THIGH-TOE $386.18 APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE $373.11 APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES $226.92 APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM $2,656.14 Application of lower leg cast removal or repair; PRO $400.00 APPLICATION SHORT ARM SPLINT DYNAMIC $223.51 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC $182.53 APPLICATION SHORT LEG CAST BELOW KNEE-TOE $231.41 APPLICATION SHORT LEG SPLINT CALF FOOT $203.27 APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM $1,417.63 APPLY FEET, DIG, TO 100 SQCM; 1ST 25 SQ CM $419.99 APPLY SHORT LEG CAST $222.02 APPROPRIATE EMPIRIC ANTIBIOTIC PRESCRIBED $0.01 ARANESP/MCG NON ESRD $14.40 Arteries of knee and popliteal area; PRO $900.00 ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT $1,985.00 Arteriovenous fistula; PRO $700.00 ARTHO KNEE OSTEOCHOND ALLOGRAFT $3,695.30 Arthoscopic ankle and/or foot; PRO $400.00 Arthoscopic elbow procedures; PRO $400.00 ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2 $4,998.89 ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC $1,545.00 ARTHRD ANT MIN DISCECT INTERBODY CERV BELW C2 $3,672.98 ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT $2,269.18 ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH $2,036.13 ARTHRD CARP/MTCRPL JT THMB +-INT FIXJ $2,067.08 ARTHRD IPHAL JT +-INT FIXJ $1,626.63 ARTHRD IPHAL JT +-INT FIXJ EA IPHAL JT $297.27 ARTHRD IPHAL JT +-INT FIXJ W/AGRFT $2,010.24 ARTHRD IPHAL JT +-INT FIXJ W/AGRFT EA JT $624.59 ARTHRD MIDTARSL/TARS MLT/TRANSVRS $2,157.08 ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT $2,303.44 ARTHRD MTCARPHLNGL JT +-INT FIXJ $1,938.96 ARTHRD MTCARPHLNGL JT +-INT FIXJ W/AGRFT $2,202.09 ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFORM $1,957.99 ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK $1,892.39 ARTHRD WRST COMPL W/O B1 GRF $2,084.54 ARTHRD WRST W/ILIAC/OTH AGRFT $2,427.61 ARTHRD WRST W/SLIDING GRF $2,274.97 ARTHRO ANKLE EXCISION OF OSTEOCHON DEFECT $1,960.29 ARTHRO KNEE MEN REPAIR MED AND LATERAL $2,436.13 ARTHROCENTESIS ASPIR&/INJECTION INTERM JT/BURSA $141.78 ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA $174.07 ARTHROCENTESIS ASPIR&/INJECTION SMALL JT/BURSA $135.01 ARTHRODESIS ANKLE OPEN $2,937.80 ARTHRODESIS ANTERIOR INTERBODY EA ADDL NTRSPC $968.43 ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT $1,389.54 ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT $2,395.75 ARTHRODESIS KNEE ANY TECHNIQUE $4,087.53 ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR $1,029.11 ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR $4,774.51 ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT $2,076.24 ARTHRODESIS PANTALAR $3,469.18 ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL $1,142.02 ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR $4,498.47 ARTHRODESIS SACROILIAC JOINT $1,821.22 ARTHRODESIS SACROILIAC JOINT W/OBTAINING GRAFT $3,253.88 ARTHRODESIS SUBTALAR $2,283.15 ARTHRODESIS TRIPLE $2,236.78 ARTHRODESIS WRIST LIMITED W/AUTOGRAFT $2,122.42 ARTHRODESIS WRIST LIMITED W/O BONE GRAFT $1,665.58 ARTHROPLASTY ANKLE $1,725.24 ARTHROPLASTY ELBOW W/MEMBRANE $2,507.62 ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE $2,362.69 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER $4,269.22 ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY $3,525.83 ARTHROPLASTY INTERPHALANGEAL JOINT EACH $1,201.36 ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA $2,056.58 ARTHROPLASTY KNEE HINGE PROSTHESIS $3,428.25 ARTHROPLASTY PATELLA W/O PROSTHESIS $1,835.17 ARTHROPLASTY PATELLA W/PROSTHESIS $2,340.35 ARTHROPLASTY RADIAL HEAD $1,781.57 ARTHROPLASTY RADIAL HEAD W/IMPLANT $1,897.69 Arthroscopic procedure hip joint; PRO $500.00 Arthroscopic shoulder procedure; PRO $500.00 ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE $1,661.51 ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL $1,417.28 ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB $1,160.10 ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY $1,927.08 ARTHROSCOPY KNEE DIAGNOSTIC +-SYNOVIAL BX SPX $1,388.44 ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE $1,464.31 ARTHROSCOPY KNEE LATERAL RELEASE $1,252.35 ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY $1,574.65 ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS $1,927.95 ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX $1,452.18 ARTHROSCOPY KNEE W/LYSIS ADHESIONS+-MNPJ SPX $1,720.56 ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL $2,103.76 ARTHROSCOPY SHOULDER BICEPS TENODESIS $2,649.27 ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY $1,947.85 ARTHROSCOPY SHOULDER DX +-SYNOVIAL BIOPSY SPX $1,127.90 ARTHROSCOPY SHOULDER LYSIS&RESCJ ADHESION +-MNPJ $1,378.21 ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR $3,092.17 ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE $1,815.70 ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED $1,662.97 ARTHROSCOPY SHOULDER SURG SYNOVECTOMY COMPLETE $1,662.25 ARTHROSCOPY SHOULDER SURG SYNOVECTOMY PARTIAL $1,568.48 ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY $3,098.20 ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB $1,716.44 ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION $3,114.80 ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE $1,617.15 ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL $1,395.70 ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB $1,908.91 ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH $762.28 ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH $944.09 ARTHROTOMY ELBOW W/SYNOVECTOMY $1,721.86 ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY $1,126.37 ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB $2,012.97 ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY $2,845.61 ARTHROTOMY HIP W/DRAINAGE $2,744.06 ARTHROTOMY W/MENISCUS REPAIR KNEE $1,864.74 ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY $1,626.98 ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR $1,934.41 ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT $4,086.59 ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCMT $3,928.86 ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS $2,429.99 ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT CMPRTS $3,966.53 ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT $3,237.67 ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT $1,634.36 ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS $3,279.80 ARTHRP WRST +-INTERPOS +-XTRNL/INT FIXJ $2,400.13 ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR $1,916.11 ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ $2,962.03 ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ $3,418.65 ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG $1,925.85 ARTHRS KNE DRLG OSTEO DISS GRFG $1,803.43 ARTHRS KNE DRLG OSTEO DISS LES $1,525.32 ARTHRS KNE DRLG OSTEO DISS LES INT FIXJ $1,787.18 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG $1,578.51 ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX $1,942.49 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG $1,823.72 ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING $1,687.89 ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JT DBRDMT $1,513.97 ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB $1,607.79 ARTHRT ANKLE W/JT EXPL +-BX +-RMVL LOOSE/FB $1,226.96 ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX $1,982.62 ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB $3,556.13 ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT $892.54 ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA $1,141.50 ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA $968.06 ARTHRT KNE W/EXPL DRG/RMVL FB $2,139.10 ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB $3,549.32 ARTHRT PST CAPSULAR RLS ANKLE +-ACHLL TDN LNGTH $1,552.13 ARTHRT W/EXC SEMILUNAR CRTLG KNE MEDIAL&LAT $1,566.16 ARTHRT W/EXC SEMILUNAR CRTLG KNE MEDIAL/LAT $1,787.22 ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT $969.36 ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT $1,067.08 ARTHRT W/SYNVCT KNE ANT&PST W/POP AREA $2,162.02 ARTHRT WRST JT W/JT EXPL +-BX +-RMVL LOOSE/FB $1,142.50 ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN $295.37 ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ $154.40 ARTL PNXR W/DRAWAL BLD DX $86.55 ARVEN ANAST OPN F/ARM VEIN TRPOS $2,185.20 ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS $2,189.71 ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS $2,071.89 AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT $9,300.55 ASCENDING AORTA GRF W/CARD BYP & VALVE SSP $9,480.68 ASPIRATION&/INJECTION GANGLION CYST ANY LOCATION $170.96 ASPIRATION&INJECTION TREATMENT BONE CYST $595.86 ATRIA ABLATE & RCNSTJ W OTHER PROCEDURE LIMITED $1,720.21 ATRIA ABLATE &RCNSTJ W OTHER PX EXTENSIVE W BYP $2,490.42 ATT/R ANY AREA DEFECT 30.1-60SQCM $3,019.54 ATT/R ANY AREA DEFECT EA ADDL 30SQCM OR PART $645.00 ATT/REARGMT E/N/E/L DFCT 10 CM/< $2,179.79 ATT/REARGMT EYELID/NOSE/EAR/LIP 10.1-30.0 CM $2,847.83 ATT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0CM $2,657.46 ATT/REARRANGEMENT F/C/C/M/N/AX/G/H/F 10 CM/< $2,135.52 ATT/REARRANGEMENT SCALP/ARM/LEG 10 CM/< $1,867.92 ATT/REARRANGEMENT SCALP/ARM/LEG 10.1-30.0 CM $2,453.18 ATT/REARRANGEMENT TRUNK 10.1-30.0CM $2,134.62 ATTN AT DELIVERY& 1ST STABILIZATION OF NEWBORN $207.49 AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC $509.24 AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION $255.11 AVULSION NAIL PLATE PARTIAL/COMPLETE SMPL EA $100.40 AVULSION NAIL PLATE-ONE $233.74 AX LMPHADEC COMPL $2,567.42 AX LMPHADEC SUPFC $1,925.08 Axillary femoral bypass graft; PRO $1,100.00 Axillary-brachial aneurysm; PRO $1,100.00 BENADRYL,25-50MG $5.00 BETAMETHACETATE ACETATE $65.18 BINOC MIC $84.00 BIOPSY BONE OPEN SUPERFICIAL $633.45 BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL $471.14 BIOPSY BREAST NEEDLE CORE W/IMAGING GUIDANCE $592.00 BIOPSY BREAST OPEN INCISIONAL $952.79 BIOPSY CERVIX 1/MLT OR EXCISION OF LESION $357.00 BIOPSY INTRANASAL $385.92 BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE $272.95 BIOPSY MUSCLE DEEP $776.65 BIOPSY MUSCLE PERCUTANEOUS NEEDLE $660.04 BIOPSY MUSCLE SUPERFICIAL $483.30 BIOPSY NAIL UNIT SPX $363.76 Biopsy of clavicle; PRO $400.00 BIOPSY SKIN-EACH ADL ONE LESION $93.73 BIOPSY SKIN-ONE LESION $294.54 BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP $1,011.20 BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL $596.36 BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP $1,361.59 BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL $472.77 BIOPSY SOFT TISSUE NECK/THORAX $618.55 BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL $510.15 BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP $1,122.94 BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL $636.95 BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP $1,464.65 BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL $720.32 Biopsy soft tissue; PRO $500.00 BLADDER PRESSURE MEASUREMENT DURING FILLING $951.64 BLDR INSTLJ ANTICARCINOGENIC AGT $307.00 BLDR IRRIGATION SMPL LVG&/INSTLJ $239.99 BLEPHAROPLASTY UPPER EYELID $1,254.15 BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN $1,716.36 BLEPHAROTOMY DRG ABSC EYELID $757.76 BLOOD COUNT OTHER THAN SPL $32.00 Body cast application; PRO $400.00 BODY MASS INDEX DOCD $0.01 BONE GRAFT ANY DONOR AREA MAJOR/LARGE $839.45 BONE GRAFT ANY DONOR AREA MINOR/SMALL $1,172.00 Bone marrow aspiration; PRO $600.00 BONIVA 1MG $221.73 Bony pelvis procedures; PRO $700.00 BOTULINUM TOXIN TYPE A PER UNIT $12.38 BP < 80 DIASTOLIC $0.01 BP 80-89 DIASTOLIC $0.01 BP GREATER-EQUAL 90 DIASTOLIC $0.01 BREAST BIOPSY VACUUM ASSISTED/ROTATING DEVICE $1,485.00 BREATHING CAPACITY TEST (PFT) $100.37 BRIEF EMOTIONAL/BEHAV ASSESSMENT $13.80 BRNCHSC BRNCL/ENDOBRNCL BX 1+ SITS $941.13 BRNCHSC BRUSHING/PROTECTED BRUSHINGS $765.33 BRNCHSC INCL FLUOR GID DX W/CELL WASHG SPX $431.57 BRNCHSC NDL BX TRACHEA MAIN STEM&/BRONCHUSI $567.74 BRNCHSC W/BRNCL ALVEOLAR LAVAGE $436.72 BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC $622.85 BRNCHSC W/EXCISION TUMOR $733.22 BRNCHSC W/PLACEMENT TRACHEAL STENT $664.00 BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL $512.06 BRNCHSC W/REMOVAL FOREIGN BODY $788.57 BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE 1ST $728.38 BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE SBSQ $646.96 BRNCHSC W/TRACHEAL/BRNCL DILAT/CLSD RDCTJ FX $576.26 BRNCHSC W/TRANSBRNCL LUNG BX 1 LOBE $981.17 BRNCHSC W/TRANSBRNCL LUNG BX EA LOBE $177.47 BRNCHSC W/TRANSBRNCL NDL ASPIR BX EA LOBE $219.16 BURN DEB PRTL THICKNESS-5-10% $414.63 BURN DEBRIDE PRTL THICKNESS < 5% $230.52 Burn excision 4%; PRO $400.00 Burr holes; PRO $1,000.00 BX ABDL/RPR MASS PRQ NDL $461.98 BX ANRCT WALL ANAL APPR $877.85 BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX $405.86 BX HYPOPHARYNX $488.00 BX LVR NDL DONE PURPOSE TM OTH MAJOR PX $305.57 BX LVR WEDGE $2,345.10 BX NASOPHARYNX SURV UNKNOWN PRIM LES $584.82 BX NASOPHARYNX VISIBLE LES SMPL $541.64 BX OROPHARYNX $442.12 BX PALATE UVULA $363.56 BX THYR PRQ CORE NDL $321.00 BX TONGUE PST ONE-3RD $445.64 BX VAG MUCOSA SMPL SPX $251.02 BX VESTIBULE MOUTH $493.59 BX VULVA/PR SPX 1 LES $231.29 BX VULVA/PR SPX EA SEP ADDL LES $106.91 BX XTRNL EAR $281.75 BX/EXC LYMPH NODE NDL SUPFC $357.00 BX/EXC LYMPH NODE OPN DP AX NODE $1,035.74 BX/EXC LYMPH NODE OPN DP CRV NODE $1,474.53 BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD $1,111.04 BX/EXC LYMPH NODE OPN INT MAM NODE $1,561.08 BX/EXC LYMPH NODE OPN SUPFC $885.42 BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL $5,011.08 BYP OTH/THN VEIN AORTOBIFEM $5,153.65 BYP OTH/THN VEIN AX-FEM-FEM $4,113.82 BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL $3,804.47 BYP OTH/THN VEIN FEM-FEM $3,256.90 BYP OTH/THN VEIN FEMPOP $3,253.78 BYP OTH/THN VEIN ILIOFEM $3,521.48 BYP OTH/THN VEIN ILIOILIAC $3,165.48 BYP W/VEIN FEMPOP $4,197.99 BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL $3,987.05 BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL $5,147.22 Bypass graft; PRO $900.00 C DLVR ONLY $2,687.27 C DLVR ONLY FA V AP C DLVER $2,777.91 C DLVR ONLY FA V AP C DLVER W/POSTPARTUM CARE $3,414.23 C DLVR ONLY W/POSTPARTUM CARE $3,693.88 C ENDARTERCOMY OPN ANY METH $679.80 C.DIPHTHERIAE CULTURE $62.00 CAB W/ARTL GRF 1 ARTL GRF $5,504.66 CAB W/ARTL GRF 2 C ARTL GRFS $6,485.70 CAB W/ARTL GRF 3 C ARTL GRFS $7,224.84 CAB W/ARTL GRF 4/> C ARTL GRFS $7,292.45 CAM-WALKER NONPNEUMATIC $181.83 CANALITH REPOSITIONING PROCEDURE $122.54 CAPILLARY STICK $12.00 CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC $2,617.68 CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS $2,328.40 CAPSUL MTTARPHLNGL JT +-TENORRHAPHY EA JT SPX $1,348.61 CAPSULAR CONTRACTURE RELEASE $1,927.59 CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON $2,645.05 CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR $2,841.78 CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK $3,039.84 CAPSULORRHAPHY GLENOHUMERAL JT PST +-BONE BLK $3,053.96 CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS $3,062.14 Cardiac catherization; PRO $800.00 Cardiac elecrophysiologic; PRO $800.00 CARDIO STRESS TEST; TRACING ONLY $111.74 CARDIOPULM RESUSCITATION $880.75 CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP $4,718.41 CARDIOVASCULAR STRESS TEST, INTERP AND REPORT (H) $43.88 CARDIOVASCULAR STRESS TEST; SUPERVISON W/O INTERP $65.82 CARDIOVERSION ELECTIVE ARRHYT XTRNL $595.34 Carotid and coronary; PRO $800.00 CARPECTOMY 1 BONE $1,388.38 CARPECTOMY ALL BONES PROXIMAL ROW $1,726.76 CARTILAGE GRAFT COSTOCHONDRAL $1,310.46 CASING SUPPLY SHORT ARM FIBERGLASS $20.26 Cast application for forearm, wrist and hand; PRO $400.00 Cast application removal or repair involving knee; PRO $400.00 CAST SUP LNG LEG PED PLASTER $17.59 CAST SUPPLIES $80.34 CASTING SUPPLY FIBERGLASS LONG LEG $93.82 CASTING SYNTHETIC $50.65 CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I; PRO $917.30 CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I; PRO $1,034.17 CATHETER PLACEMENT MAIN RENAL ARTERY BILATERAL $1,084.08 CATHJ&INTRO SALINE NFS SHG/HSG $334.57 CBC WITH DIFFERENTIAL $132.00 CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN $528.59 CC E/M CRITICALLY ILL/INJURED EA 30 MIN $236.15 CEFAZOLIN SODIUM 500 MG $5.00 CEFTRIAXONE 250MG $5.00 CERCLAGE CERVIX PREGNANCY VAG $447.02 Cerebrospinal fluid shunting procedures; PRO $1,100.00 CERV/VAG CANCER SCREEN $113.52 Cervical cerclage; PRO $500.00 Cervical spine; PRO $1,100.00 Cesarean delivery following neuraxial analgesia; PRO $300.00 Cesarean delivery only; PRO $800.00 Cesarean hysterectomy following neuraxial analgesia; PRO $600.00 Cesarean hysterectomy; PRO $900.00 CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE $138.50 CHECKOUT ORTHOTIC/PROSTHETIC USE $106.09 CHEMICAL CAUTERIZATION $224.90 CHEMODNRVTJ ECCRINE GLNDS BTH AX $224.54 CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO $183.34 CHNG CSTOST TUBE SMPL $261.62 CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL $225.74 CHOLECSTC $2,557.96 CHOLECSTC CHOLANGRPH $3,211.10 CHRONIC CARE MANAGEMENT SERVICES $114.75 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK $439.72 CLAVICULECTOMY PARTIAL $1,699.57 Closed chest procedures; PRO $700.00 Closed procedure lower femur; PRO $500.00 Closed procedure pubis or si joint; PRO $500.00 Closed procedures hip joint; PRO $500.00 Closed procedures knee; PRO $400.00 Closed procedures on humeral head, shoulder joints; PRO $500.00 Closed procedures on humerus and wlbow; PRO $400.00 Closed procedures on lower leg, ankle and/or foot; PRO $400.00 Closed procedures on radius, ulna, wrist and hand; PRO $400.00 Closed procedures upper ends of tibia, fibula and patella; P $400.00 Closed procedures upper femur; PRO $500.00 CLOSED TREATMENT COCCYGEAL FRACTURE $509.99 CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION $366.10 CLOSED TREATMENT NASAL FRACTURE W/STABILIZATION $706.47 CLOSED TREATMENT OF LUNATE DISLOCATION $1,384.16 CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MNPJ $756.76 CLOSED TREATMENT SESAMOID FRACTURE $330.16 CLOSED TREATMENT ULNAR STYLOID FRACTURE $902.76 CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA $869.79 CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MNPJ $1,324.14 CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MNPJ $941.82 CLOSED TX CALCANEAL FRACTURE W/MANIPULATION $1,105.32 CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION $703.44 CLOSED TX CARPAL SCAPHOID FRACTURE W/MNPJ $1,155.29 CLOSED TX CARPAL SCAPHOID FRACTURE W/O MNPJ $855.85 CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MNPJ $1,034.88 CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION $1,471.42 CLOSED TX KNEE DISLOCATION W/ANESTHESIA $1,485.43 CLOSED TX KNEE DISLOCATION W/O ANESTHESIA $1,430.70 CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION $1,666.94 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION $620.09 CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MNPJ $1,538.78 CLOSED TX NASAL FRACTURE W/O STABILIZATION $763.75 CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA $1,348.10 CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA $1,056.10 CLOSED TX PATELLAR FRACTURE W/O MANIPULATION $909.30 CLOSED TX PELVIC RIGHT FX $298.48 CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION $1,197.72 CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION $735.44 CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION $1,418.72 CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION $728.69 CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MNPJ $1,455.00 CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MNPJ $780.51 CLOSED TX RIB FRACTURE UNCOMPLICATED EACH $283.00 CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION $653.24 CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION $928.97 CLOSED TX TALUS FRACTURE W/ MANIPULATION $899.45 CLOSED TX TALUS FRACTURE W/O MANIPULATION $669.95 CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES $771.36 CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES $515.30 CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ $287.03 CLOSED TX ULNAR FRACTURE PROXIMAL END W MNPJ $1,208.25 CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MNPJ $819.94 CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION $1,378.63 CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION $737.19 CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION $638.21 CLSD TX CLAVICULAR FRACTURE W/MANIPULATION $835.08 CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION $612.43 CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION $528.67 CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION $1,002.79 CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES $1,171.16 CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES $882.46 CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION $626.92 CLSR ENTEROENTERIC/ENTEROCOLIC FSTL $3,492.67 CLSR ENTEROVES FSTL W/O INTSTINAL/BLDR RESCJ $3,289.16 CLSR LAC VESTIBULE MOUTH > 2.5 CM/CPLX $813.76 CLSR LAC VESTIBULE MOUTH 2.5 CM/< $637.74 CLSR NTRSTM LG/SM RESCJ&ANAST OTH/THN CLRCT $2,998.26 CLSR NTRSTM LG/SM RESCJ&CLRCT ANAST $4,721.06 CLSR RECTOVAG FSTL ABDL APPR $2,542.81 CLSR VESICOVAG FSTL VAG APPR $1,520.12 CLST/SKN LVL CECOSTOMY $3,378.49 CLTX ACETABULUM HIP/SOCKT FX MNPJ +-SKEL TRACJ $2,870.56 CLTX ACETABULUM HIP/SOCKT FX W/O MNPJ $1,504.31 CLTX ANKLE DISLC REQ ANES +-PRQ SKEL FIXJ $1,185.59 CLTX ARTICULAR FX INVG MTCARPHLNGL/IPHAL JT W/ $1,010.58 CLTX ARTICULAR FX INVG MTCARPHLNGL/IPHAL JT W/O $612.89 CLTX CARP/MTCRPL DISLC THMB MNPJ EA JT REQ ANES $1,175.50 CLTX CARP/MTCRPL DISLC THMB MNPJ EA W/O ANES $957.25 CLTX CARP/MTCRPL DISLC THMB W/MNPJ $1,016.42 CLTX CARP/MTCRPL FX DISLC THMB W/MNPJ $1,128.71 CLTX CARPL B1 FX W/MNPJ EA B1 $1,353.42 CLTX CARPL B1 FX W/O MNPJ EA B1 $862.04 CLTX DSTL FEM EPIPHYSL SEP W/MNPJ +-SKN/SKEL $1,671.46 CLTX DSTL FEM EPIPHYSL SEP W/O MNPJ $1,416.53 CLTX DSTL FIBULAR FX LAT MALLS W/MNPJ $1,191.14 CLTX DSTL FIBULAR FX LAT MALLS W/O MNPJ $886.00 CLTX DSTL PHLNGL FX FNGR/THMB W/MNPJ EA $887.56 CLTX DSTL PHLNGL FX FNGR/THMB W/O MNPJ EA $517.39 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ $881.92 CLTX DSTL RDL FX/EPIPHYSL SEP +-W/MNPJ $1,530.00 CLTX DSTL XTNSR TDN INSJ +-PRQ PINNING $2,237.05 CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MNPJ $1,490.14 CLTX FEM FX PROX END NCK W/MNPJ +-SKEL TRACJ $2,112.88 CLTX FEM FX PROX END NCK W/O MNPJ $1,346.72 CLTX FEM SHFT FX W/MNPJ +-SKN/SKEL TRACJ $2,234.07 CLTX FX GRT TOE PHLX/PHLG W/MNPJ $504.12 CLTX FX GRT TOE PHLX/PHLG W/O MNPJ $397.68 CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MNPJ $438.62 CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MNPJ $351.33 CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ $1,535.44 CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MNPJ $885.69 CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ $757.09 CLTX GRTER TRCHNTRIC FX W/O MNPJ $1,124.80 CLTX HIP DISLC TRAUMTC REQ ANES $2,165.62 CLTX HIP DISLC TRAUMTC W/O ANES $534.57 CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MNPJ $913.50 CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MNPJ $1,289.32 CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MNPJ $903.08 CLTX HUMERAL SHFT FX W/MANIPULATION +-SKEL TRACJ $1,452.70 CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MNPJ $1,343.78 CLTX INTERCONDYLAR SPI&/TUBRST FX KNE +-MNPJ $1,321.70 CLTX IPHAL JT DISLC 1 W/MNPJ REQ ANES $1,099.38 CLTX IPHAL JT DISLC 1 W/MNPJ W/O ANES $774.00 CLTX IPHAL JT DISLC REQ ANES $376.10 CLTX IPHAL JT DISLC W/O ANES $340.30 CLTX MEDIAL MALLS FX W/MNPJ +-SKN/SKEL TRACJ $1,344.50 CLTX MEDIAL MALLS FX W/O MNPJ $940.87 CLTX METAR FX W/MNPJ $684.28 CLTX METATARSOPHLNGL JT DISLC REQ ANES $472.54 CLTX METATARSOPHLNGL JT DISLC W/O ANES $371.20 CLTX MTCARPHLNGL DISLC 1 W/MNPJ REQ ANES $1,124.03 CLTX MTCARPHLNGL DISLC 1 W/MNPJ W/O ANES $906.77 CLTX MTCRPL FX 1 W/MNPJ EA B1 $906.51 CLTX MTCRPL FX 1 W/O MNPJ EA B1 $789.52 CLTX MTCRPL FX W/MNPJ W/XTRNL FIXJ EA B1 $3,269.38 CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/O MNPJ $1,326.18 CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MNPJ EA $951.81 CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MNPJ EA $556.27 CLTX POST HIP ARTHRP DISLC REQ ANES $1,700.31 CLTX POST HIP ARTHRP DISLC W/O ANES $1,167.52 CLTX PROX FIBULA/SHFT FX W/MNPJ $1,024.00 CLTX PROX FIBULA/SHFT FX W/O MNPJ $862.44 CLTX PROX HUMRL FX W/MANIPULATION +-SKEL TRACJ $1,311.38 CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION $913.19 CLTX RDCRPL/INTERCARPL DISLC 1+ B1S W/MNPJ $1,125.50 CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MNPJ $379.67 CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT $1,503.00 CLTX SCAPULAR FX W/MANIPULATION +-SKEL TRACTION $949.96 CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MNPJ $1,201.62 CLTX SHOULDER DISLC W/SURG/ANTMCL NCK FX W/MNPJ $1,557.62 CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MNPJ $1,719.85 CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX+-MNPJ $1,072.97 CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MNPJ $2,353.96 CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MNPJ $1,428.22 CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES $580.31 CLTX TIBL FX PROX +-MNPJ W/SKEL TRACJ $1,455.65 CLTX TIBL FX PROX W/O MNPJ $849.74 CLTX TIBL SHFT FX W/MNPJ +-SKEL TRACJ $1,523.89 CLTX TIBL SHFT FX W/O MNPJ $976.15 CLTX TRIMAL ANKLE FX W/MNPJ $1,371.51 CLTX TRIMAL ANKLE FX W/O MNPJ $903.43 CLTX VRT BDY FX W/O MNPJ REQ&W/CSTING/BRACING $897.27 CMBN ANTEROPOST COLPORRHAPHY $2,119.31 CMBN ANTEROPOST COLPORRHAPHY W/NTRCL RPR $2,637.69 COLCT PRTL W/ANAST $3,943.74 COLCT PRTL W/END CLST&CLSR DSTL SGM $4,895.43 COLCT PRTL W/RESCJ W/CLST/ILEOST&MUCOFSTL $4,252.37 COLCT PRTL W/RMVL TERMINAL ILE W/ILEOCLST $3,653.00 COLCT PRTL W/SKN LVL CECOSTOMY/CLST $4,361.69 COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS $5,500.51 COLLECT OF PAP SMEAR $60.56 COLONOSCOPY W/ABLATION $1,213.83 COLONOSCOPY W/BAND LIGATION $792.92 COLONOSCOPY W/RESECTION $849.46 COLORECTAL CANCER SCREENING $552.13 COLORECTAL SCREENING NOT HIGH RISK $553.56 COLOTOMY EXPL BX/FB RMVL $2,369.50 COLPOCLEISIS LE FORT TYP $1,481.84 COLPOPEXY ABDL APPR $2,777.91 COLPOPEXY VAG INTRA-PRTL APPR $2,004.72 COLPOPEXY VAG XTR-PRTL APPR $1,456.88 COLPORRHAPHY SUTR INJ VAG $876.04 COLPOSCOPY CERVIX BX CERVIX&ENDOCRV CURTG $443.71 COLPOSCOPY CERVIX UPR/ADJ VAG $306.98 COLPOSCOPY CERVIX VAG BX CERVIX $402.00 COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX $894.18 COLPOSCOPY CERVIX VAG ENDOCRV CURTG $378.60 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX $789.61 COLPOSCOPY ENTIRE VAG W/CERVIX BX $443.81 COLPOSCOPY ENTIRE VAG W/CERVIX IF PRESENT $332.00 COLPOSCOPY VULVA $307.61 COLPOSCOPY VULVA W/BX $382.48 COLPOTOMY W/DRG PEL ABSC $1,262.00 Colpotomy, vaginectomy,; PRO $500.00 COLSC FLX PROX SPLENIC FLXR ABLTJ LES $1,191.00 COLSC FLX PROX SPLENIC FLXR RMVL LES CAUT $662.05 COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ $740.48 COLSC FLX PROX SPLENIC FLXR SBMCSL NJX $584.12 COMFORT NIGHT SPLINT $192.43 COMPAZINE $24.40 COMPL RPR ANOM VEN RETURN $4,938.65 Complete amputation of the penis; PRO $500.00 COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE $880.30 COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES $897.41 COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE $961.88 COMPUTER-ASSISTED SURG NAVIGATIONAL PROC $410.77 CONIZATION CERVIX +-D&C RPR ELTRD EXC $739.53 CONIZATION CERVIX +-D&C RPR KNIFE/LASER $888.58 CONSULT BEFORE SCREEN COLONOSCOPY $312.28 CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX $611.14 CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE $287.08 CONV PREVIOUS HIP TOT HIP ARTHRP +-AGRFT/ALGRFT $4,911.44 CORACOACROMIAL LIGAMENT RELEASE +-ACROMIOPLASTY $1,942.50 Corneal Transplant; PRO $700.00 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 1 VEIN $552.13 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 2 VEIN $1,250.80 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 3 VEIN $1,652.88 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 4 VEIN $1,980.70 CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 5 VEIN $2,089.18 CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT $5,687.60 CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS $6,260.86 CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS $7,124.73 CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS $7,118.70 CORRECTION HAMMERTOE $1,457.38 CORRJ HALLUX VALGUS +-SESMDC 2 OSTEOT $2,063.45 CORRJ HALLUX VALGUS +-SESMDC LAPIDUS-TYP PX $2,487.75 CORRJ HALLUX VALGUS +-SESMDC PHALANX OSTEOT $1,735.92 CORRJ HALLUX VALGUS +-SESMDC RESCJ JT W/IMPLT $2,349.05 CORRJ HALLUX VALGUS +-SESMDC W/METAR OSTEOT $2,182.12 CORRJ HALUX RIGDUS W/IMPLT $1,243.74 CORTROSYN, 0.25 MG $107.15 CPLX UROFLOMETRY $45.32 Cranioplasty, elevation of skull fracture; PRO $1,000.00 Craniotomy, craniectomy, evac hematoma; PRO $1,100.00 CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF $1,993.05 CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO $484.10 CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM $1,662.85 CRV LMPHADEC COMPL $3,239.70 CRV LMPHADEC MODF RAD NCK DSJ $3,511.13 CSTORR SUTR BLDR WND INJ/RPT SMPL $2,189.33 CTRL NASPHRYNGL HEMRRG 1/2 COMP REQ HOSPIZATION $1,317.00 CTRL NASPHRYNGL HEMRRG 1/2 SMPL W/PST NSL PACKS $1,156.15 CTRL NASPHRYNGL HEMRRG 1/2 W/SEC SURG IVNTJ $1,475.37 CTRL NSL HEMRRG PST PST NSL PACKS&/CAUT 1ST $705.31 CTRL NSL HEMRRG PST PST NSL PACKS&/CAUT SBSQ $818.90 CTRL OROPHARYNGEAL HEMRRG 1/2 COMP REQ HOSPITJ $1,023.80 CTRL OROPHARYNGEAL HEMRRG 1/2 SMPL $505.17 CTRL OROPHARYNGEAL HEMRRG 1/2 W/SEC SURG IVNTJ $1,479.40 Culdoscopy; PRO $600.00 CURR MED/ROUTE DOC BY ELIG PROF $0.01 CURTG POSTPARTUM $574.30 CUSTOM AFO(PLASTIC) $1,322.48 CYSTO BLADDER DILAT INTRSTL CYSTITIS LOCAL $1,031.73 CYSTO W INJECTION CHEMODENERVATION OF BLAD $856.19 Cystolithotomy; PRO $600.00 CYSTOSCOPY $589.16 CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT $969.32 CYSTOURETHROSCOPY WITH BIOPSY $1,047.25 D&C DX&/THER $725.10 DBRDMT FX&/DISLC SUBQ T/M/F BONE $2,006.73 DBRDMT MSTDC CAVITY CPLX $564.94 DBRDMT MSTDC CAVITY SMPL $347.68 DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL $2,303.03 DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR $1,708.91 DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL $2,011.94 DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC $1,528.73 DBRDMT W/RMVL FM FX&/DISLC SKN&SUBQ TISS $1,326.38 DBRDMT X10SV ECZMT/INFCT SKN EA 10% BDY SURF $60.62 DBRDMT X10SV ECZMT/INFCT SKN UP 10% BDY SURF $146.21 DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DBRDMT $1,843.04 DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT $3,097.38 DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT $1,684.24 DCMPRN FASCT LEG ANT&/LAT CMPRTS ONLY $1,220.31 DCMPRN FASCT LEG ANT&/LAT&PST CMPRT $1,464.60 DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUSC&/NRV $2,253.92 DCMPRN FASCT LEG PST CMPRT ONLY $1,294.30 DCMPRN FASCT THI&/KNE 1 CMPRT $1,450.36 DCMPRN FASCT THI&/KNE MLT CMPRTS $1,595.33 DCMPRN FASCT THI&/KNE MLT DBRDMT NV MUSC&/NRV $1,674.71 DEBRIDE NAIL 1-5 $86.55 DEBRIDE NAIL 6 OR MORE $128.75 DEBRIDEMENT OPEN WOUND 20 SQ CM< $205.86 DEBRIDEMENT OPEN WOUND ADDL 20 SQ CM $72.66 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< $315.81 DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL $1,620.88 DECOMPRESSION FINGERS&/HAND INJECTION INJURY $4,164.21 DECOMPRESSIVE FASCIOTOMY HAND $1,637.93 Decortication; PRO $1,600.00 DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F $1,276.59 DELIVERY/BIRTHING ROOM RESUSCITATION $424.16 DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IPPB $213.81 DENOSUMAB 1 MG $35.00 DEPO MEDROL,5ML,80MG $97.08 DEPO PROVERA 1 MG $1.00 DEPO-MEDROL,5ML,20MG $61.48 DEPO-PROVERA 1MG $1.00 DEPO-TESTOSTERONE 200 MG $20.00 DEPRO-MEDROL,5ML,40MG $64.82 DESTROY C/TH FACET INT ADDL $168.20 DESTROY CERV/THOR FACET JNT $553.95 DESTROY L/S FACET JNT ADDL $147.09 DESTROY LUMB/SAC FACET JNT $543.89 DESTRUCTION BENIGN LESIONS 15/> $369.27 DESTRUCTION BENIGN LESIONS UP TO 14 $300.60 DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM $387.16 DESTRUCTION PREMALIGNANT LESION 1ST $155.70 DESTRUCTION PREMALIGNANT LESION 2-14 EA $16.08 DEVELOPMENTAL TSTG LMTD W/I&R $57.84 DEXAMETHASONE 1 MG $5.00 DEXAMETHASONE 1MG $5.00 DIABETIC SHOE FITTING $111.43 Diagnositic knee arthroscopies; PRO $400.00 Diagnostic arteriography and venography; PRO $600.00 Diagnostic arthroscopic wrist; PRO $400.00 Diagnostic or therapeutic nerve block; PRO $400.00 DIAMOX UP TO 500MG $36.26 DIGITAL RECTAL PROSTATE CANCER SCREENING $45.92 DIL RETINA EXAM INTERP REV $0.01 DILAT CRV CANAL INSTRUMENTAL SPX $147.08 DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ 1ST $199.73 DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ $195.81 DIPH,PERTUS,TET,POLIO/PF 0.5 ML VIAL $99.44 DIPH,PERTUSS(ACELL)TET VAC/PF 0.5 SYR $71.07 DIPHT PERTUSS TETANUS VAC 0.5 ML SYR $65.56 DIPHTHERIA TETANUS TOXOID PERTUSSIS VACCINE IM $71.00 DIR RPR ARYSM&GRF INSJ ABDL AORTA $5,234.27 DIR RPR ARYSM&GRF INSJ AX-BRACH ART $2,998.14 DIR RPR ARYSM&GRF INSJ AX-BRACH ART 3 $3,573.13 DIR RPR ARYSM&GRF INSJ COMMON FEM ART $3,315.87 DIR RPR ARYSM&GRF INSJ POP ART $3,614.05 DIR/PATCH CLSR SINUS VENOSUS +-ANOM PULM VEN DRG $4,170.08 Direct coronary artery bypass grafting; PRO $2,600.00 Disarticulation of knee; PRO $600.00 DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB $1,062.37 DLVR PLACENTA SPX $269.32 DOM/R-HOME E/M EST PT LW MOD SEVERITY $182.64 DOM/R-HOME E/M EST PT MOD HI SEVERITY $259.28 DOM/R-HOME E/M EST PT SELF-LMTD/MINOR $116.19 DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM $370.36 DOM/R-HOME E/M NEW PT HI SEVERITY $357.41 DOM/R-HOME E/M NEW PT MOD HI SEVERITY $268.45 DOM/R-HOME E/M NEW PT MOD SEVERITY $155.43 DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM $508.13 DOM/R-HOME LW SEVERITY $146.41 DPHRM/CRV CAP FITG W/INSTRUCTIONS $171.33 DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM $639.16 DRAINAGE FINGER ABSCESS COMPLICATED $1,095.78 DRAINAGE FINGER ABSCESS SIMPLE $744.22 DRAINAGE OF NOSE LESION $298.22 DRAINAGE OF PALMAR BURSA MULTIPLE BURSA $3,593.79 DRAINAGE OF PALMAR BURSA SINGLE BURSA $1,200.70 DRAINAGE OF SKIN ABS COMPL. $484.21 DRAINAGE OF SKIN ABS-SINGLE $312.29 DRAINAGE TENDON SHEATH DIGIT&/PALM EACH $1,270.87 DRESSING CHANGE UNDER ANESTHESIA $138.02 DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS $766.13 DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL $555.59 DRG PRTL ABSC/LOCLZD PRITONITIS OPN $3,823.85 DRG RPR ABSC OPN $2,639.68 DRG SCROTAL WALL ABSC $611.97 DRG SUBDIPHRG/SUBPHRENIC ABSC OPN $2,400.35 DRG XTRNL AUD CANAL ABSC $597.69 DRG XTRNL EAR ABSC/HMTMA COMP $597.20 DRG XTRNL EAR ABSC/HMTMA SMPL $515.31 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE $471.37 DSCHRG MED CURRENT MED MERGE $0.01 DSJ DP JUG NODE $1,244.29 DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS $3,420.97 DSTRJ LES ANUS SMPL CHEM $681.93 DSTRJ LES ANUS SMPL ELTRDSICCATION $600.98 DSTRJ LES ANUS SMPL SURG EXC $731.04 DSTRJ LES VULVA SMPL $368.06 DSTRJ LES VULVA X10SV $636.28 DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE $243.39 DSTRJ NULYT OTH PRPH NRV/BRANCH $386.88 DSTRJ VAG LES SMPL $319.00 DTAP-HEPB-IPV VACCINE INTRAMUSCU $104.90 DTAP-HIB-IPV VACCINE IM $130.04 DTP-HIB VACCINE INTRAMUSCULAR $46.35 DUONEB $6.18 DUP-SCAN OF HEMODIALYSIS ACCESS $376.03 DX BONE MARROW BX AND ASPIR $415.43 E/M PT INVG ANNUAL NF ASSMT $184.61 each additional 9%; PRO $200.00 ECHO TRANSESOPHAGEAL $52.87 ECHO TTHRC R-T 2D -+M-MODE COMPLETE REST&STRS (pro) $168.28 ECHOCARDIOGRAM ADULT PROFESSIONAL $150.62 EKG $49.86 EKG - TRACING ONLY $25.11 EKG GLOBAL $356.16 EKG INTERP ONLY $24.88 EKG TRACING FOR IPPE; PRO $23.27 ELBOW ORTHOTIC, W/O JOINTS, SOFT $301.37 Electrical conversion of arrythymias; PRO $500.00 Electrocoagulation of intracranial nerve; PRO $700.00 Electroconvulsive therapy; PRO $500.00 ELIGIBLE PROF ATTESTS THE PT IS NOT ELIG M; PRO $0.01 EMBLC/THRMBC +-CATH RDL/UR ART ARM INC $1,796.45 EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART $1,799.27 EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART $2,761.08 EMBLC/THRMBC FEMPOP A-ILIAC ART $3,085.23 EMBLC/THRMBC POP-TIBIO-PRONEAL ART LEG INC $2,858.27 EMBLC/THRMBC RNL CELIAC MESENTERY A-ILIAC ART $3,772.12 Embolectomy; PRO $700.00 EMER DEPT HI SEVERITY&URGENT EVAL $356.83 EMER DEPT HIGH SEVERITY&THREAT FUNCJ $539.27 EMER DEPT LOW TO MODERATE SEVERITY $127.36 EMER DEPT MODERATE SEVERITY $192.32 EMER DEPT SELF LIMITED/MINOR $64.90 EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL $551.05 EMPLOYER PHYSICAL $100.00 ENDO SHEATH $37.11 ENDOCRV CURTG X DONE AS PART DILAT&CURTG $286.47 ENDOMETRIAL BX +-ENDOCRV BX W/O DILAT SPX $306.66 ENDOSCOPIC PLANTAR FASCIOTOMY $1,463.78 ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN $1,037.21 ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS $832.20 ENTEROLSS FRING INTSTINAL ADHESION SPX $3,214.98 ENTERONTRSTM ANAST INT +-CUTAN NTRSTM SPX $3,861.92 ENTERORRHAPHY 1 PRF8J $3,388.76 ENTERORRHAPHY MLT PRF8J $3,873.39 ENTRC RESCJ SM INT 1 RESCJ&ANAST $3,598.21 ENTRC RESCJ SM INT EA RESCJ&ANAST $713.15 EPIGLOTTIDECTOMY $2,194.26 EPISIOTOMY/VAG RPR OTH/THN ATTENDING PHYS $544.00 EPO 1,000 UNITS NON $65.56 ERCP W/PLACEMENT OF STENT $1,329.65 ERCP W/RMVL ST1/CALCULI BILIARY&/PNCRTC DUXS $1,162.82 ERTAPENEM SODIUM 500 $163.43 ESOPHAGOSCOPY RIG TRNSO BIOPSY $469.68 ESOPHAGOSCOPY RIGID TRNSO DX $424.00 Esophagus procedures; PRO $1,600.00 Esophagus, thyroid, neck age 1 year or older; PRO $700.00 ESPHGSC RGD/FLX DX +-COLLJ SPEC BR/WA SPX $252.35 ETHMOIDECTOMY EXTRANASAL TOTAL $2,127.22 ETONOGESTREL IMPLANT $1,264.28 EUFLEXXA PER DOSE $474.41 EVACUATION SUBUNGUAL HEMATOMA $141.53 EVASC PLMT ILIAC ART OCCLUSION DEV $576.98 EVASC RPR AAA AORTO-UNIILIAC/AORTO-UNIFEM PROSTH $3,564.60 EVASC RPR AAA W/MDLR BFRC PROSTH 1 LIMB $3,729.24 EVASC RPR AAA W/UNIBDY BFRC PROSTH $3,725.44 EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH $5,212.02 EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN $4,608.92 EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM $1,609.63 EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM $1,210.32 EXC AURAL POLYP $574.99 EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M > 4.0CM $919.22 EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.5CM/< $380.42 EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM $451.48 EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM $502.94 EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM $627.15 EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM $788.26 EXC B9 LES MRGN XCP SK TG S/N/H/F/G > 4.0CM $783.17 EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.5 CM/< $331.01 EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM $422.24 EXC B9 LES MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM $470.19 EXC B9 LES MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM $652.23 EXC B9 LES MRGN XCP SK TG T/A/L > 4.0 CM $876.01 EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/< $333.35 EXC B9 LES MRGN XCP SK TG T/A/L 0.6-1.0 CM $400.03 EXC B9 LES MRGN XCP SK TG T/A/L 1.1-2.0 CM $445.64 EXC B9 LES MRGN XCP SK TG T/A/L 2.1-3.0 CM $512.30 EXC B9 LES MRGN XCP SK TG T/A/L 3.1-4.0 CM $580.14 EXC BARTHOLIN'S GLAND OR CYST $875.09 EXC BRANCHIAL CL CST CONFINED SKN&SUBQ TISS $933.08 EXC BRANCHIAL CL CST EXTG BELW SUBQ TISS&/PHRNX $1,657.98 EXC BRST LES PREOP PLMT RAD MARKER OPN 1 LES $1,285.27 EXC CRV STUMP ABDL APPR $2,179.60 EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ $2,390.92 EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ $1,212.21 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LES $1,159.31 EXC DEBRIDE-BONE 20 SQCM OR LESS $886.29 EXC DEBRIDE-MUSCLE 20 SQCM OR LESS $640.51 EXC DEBRIDE-MUSCLE>20 SQ CM $172.57 EXC DEBRIDE-SUBQ>20 SQ CM $106.43 EXC EXOSTOSIS XTRNL AUD CANAL $2,423.58 EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F $1,957.25 EXC FRENUM LABIAL/BUCCAL $765.67 EXC INFCT GRF XTR $1,689.30 EXC LES FLOOR MOUTH $932.37 EXC LES MUCOSA&SBMCSL VESTIBULE MOUTH W/O RPR $576.64 EXC LES MUCOSA&SBMCSL VESTIBULE SMPL RPR $793.02 EXC LES PALATE UVULA W/LOCAL FLAP CLSR $1,115.99 EXC LES PALATE UVULA W/O CLSR $619.92 EXC LES PALATE UVULA W/SMPL PRIM CLSR $661.60 EXC LES SPRMATIC CORD SPX $1,102.78 EXC LES TDN SHTH/JT CAPSL HAND/FNGR $1,608.65 EXC LES TONGUE W/CLSR ANT 2-3RD $925.18 EXC LES TONGUE W/CLSR PST ONE-3RD $887.88 EXC LES TONGUE W/O CLSR $510.53 EXC LES/TUM XCP LISTED ABOVE DENTALVLR $611.11 EXC LES/TUM XCP LISTED ABOVE DENTALVLR SMPL RPR $763.82 EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT $1,127.50 EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA $1,210.15 EXC MUCOSA VESTIBULE MOUTH AS DON GRF $786.14 EXC NAIL MATRIX PRM RMVL W/AMP TUFT DSTL PHALANX $732.14 EXC NEUROMA HAND/FOOT XCP DGTAL NRV $2,545.54 EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NRV $3,137.14 EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NRV $3,524.35 EXC PRTD TUM/PRTD GLND TOT EN BLOC RMVL $2,201.28 EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ $4,008.26 EXC RCT PROCIDENTIA W/ANAST ABDL&PRNL APPR $3,622.38 EXC RCT TUM NOT INCL MUSCULARIS PROPRIA $1,761.84 EXC SOFT TISS LES XTRNL AUD CANAL $1,090.66 EXC SUBMNDBLR SUBMAX GLND $1,223.82 EXC THROMBOSED HEMORRHOID XTRNL $498.27 EXC THYROGLOSSAL DUX CST/SINUS $1,306.32 EXC THYROGLOSSAL DUX CST/SINUS RECRT $1,683.68 EXC TONSIL TAGS $500.61 EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM $1,547.07 EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM $1,423.01 EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM $3,660.47 EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM $3,830.05 EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM $2,640.90 EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM $3,363.91 EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM $3,391.91 EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM $1,325.21 EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM $2,026.85 EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM $3,403.44 EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM $1,340.77 EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM $1,943.43 EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM $1,233.07 EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM $1,282.16 EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM $1,357.96 EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM $1,294.80 EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM $3,712.47 EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM $3,234.37 EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM $1,300.02 EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM $1,167.96 EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM $3,016.86 EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM $2,145.48 EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM $1,315.00 EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM $3,736.28 EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM $3,576.09 EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM $2,104.20 EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM $3,093.80 EXC VAG CST/TUM $555.63 EXC VAG SEPTUM $511.91 EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA $2,045.99 EXC XTRNL EAR COMPL AMP $965.31 EXC XTRNL EAR PRTL SMPL RPR $1,082.55 EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT $1,707.06 EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT $1,643.65 EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN $1,479.74 EXC/CURTG CST/B9 TUM PHALANGES FOOT $1,089.04 EXC/CURTG CST/B9 TUM TARSAL/METAR $1,306.52 EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT $1,349.19 EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT $1,651.33 EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM $4,299.64 EXC/DSTRJ LES PHARYNX ANY METH $650.42 EXC/DSTRJ LNGL TONSIL ANY METH SPX $1,453.07 EXC/FULGURATION URTL CARUNCLE $619.80 EXC/FULGURATION URTL POLYP DSTL URT $477.85 EXCHNG PREV PLACED IV CATH THROMBOLYTIC THER $880.00 EXCISION BENIGN 2.1-3.0 CM $540.37 Excision Burn between 4-9%; PRO $600.00 EXCISION DISTAL ULNA PARTIAL/COMPLETE $1,216.80 EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY $925.42 EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT $1,130.05 EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR $1,017.60 EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE $1,035.13 EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH $1,443.34 EXCISION LESION MENISCUS/CAPSULE KNEE $1,254.84 EXCISION LESION TENDON SHEATH FOREARM&/WRIST $969.09 EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANKLE $1,326.59 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/< $516.99 EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM $614.07 EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM $665.53 EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM $756.76 EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM $840.98 EXCISION MALIGNANT LES F/E/E/N/L/M 0.6-1.0 CM $664.82 EXCISION MALIGNANT LES F/E/E/N/L/M 1.1-2.0 CM $759.08 EXCISION MALIGNANT LES F/E/E/N/L/M 2.1-3.0 CM $896.43 EXCISION MALIGNANT LES F/E/E/N/L/M 3.1-4.0 CM $1,108.05 EXCISION MALIGNANT LESION F/E/E/N/L/M > 4.0 CM $1,452.59 EXCISION MALIGNANT LESION F/E/E/N/L/M 0.5 CM/< $540.37 EXCISION MALIGNANT LESION S/N/H/F/G > 4.0 CM $1,086.60 EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/< $524.00 EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM $617.57 EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM $687.75 EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM $803.56 EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM $949.08 EXCISION MALIGNANT LESION TRUNK/ARM/LEG >4.0 CM $1,197.72 EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS $766.54 EXCISION NASAL POLYP EXTENSIVE $1,171.99 EXCISION NASAL POLYP SIMPLE $637.46 Excision of cyst or tumor fo humerus; PRO $600.00 EXCISION OF NAIL-PART OR COMPL $503.97 Excision of retropharyngeal tumor; PRO $700.00 EXCISION OLECRANON BURSA $1,022.16 EXCISION PILONIDAL CYST/SINUS COMPLICATED $1,848.04 EXCISION PILONIDAL CYST/SINUS EXTENSIVE $1,601.34 EXCISION PILONIDAL CYST/SINUS SIMPLE $766.71 EXCISION PREPATELLAR BURSA $1,084.22 EXCISION RADIAL HEAD $1,306.50 EXCISION SYNOVIAL CYST POPLITEAL SPACE $1,398.18 EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH $2,266.46 EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM $938.06 EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM $2,027.37 EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM $1,322.55 EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM $2,739.99 EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM $1,098.30 EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM $982.68 EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3+ CM $1,213.97 EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM $3,232.66 EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM $1,262.05 EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM $2,625.65 EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM $1,281.46 EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA $1,718.19 EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES $1,269.96 EXCISION/CURETTAGE CYST/TUMOR FEMUR $1,755.12 EXCISION/CURETTAGE CYST/TUMOR METACARPAL $1,319.04 EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER $1,295.99 EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA $1,413.48 EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS $1,670.26 EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS $1,429.44 EXCISION/DESTRUCTION INTRANASAL LESION INT APPR $2,408.95 EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS 5 CM $3,417.49 EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM $3,120.62 EXPL LAPT EXPL CELIOTOMY +-BX SPX $1,847.55 EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK $1,325.21 EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD $3,526.45 EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR $2,053.36 EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST $1,176.34 EXPLORATION PENETRATING WOUND SPX CHEST $1,082.60 EXPLORATION PENETRATING WOUND SPX EXTREMITY $1,567.33 EXPLORATION PENETRATING WOUND SPX NECK $1,784.65 Extensive spine procedures; PRO $1,400.00 External cephalic verson procedure; PRO $600.00 External, middle and inner ear; PRO $600.00 Extraperitonela procedures lower inclds urinary tract; PRO $700.00 EYE IMAGE VALID TO DX REV $0.01 Eye procedure; PRO $600.00 Eyelid reconstructive; PRO $600.00 FACET INJECTION LEVEL 2 $206.61 FACET INJECTION LEVEL 3 $207.43 FACET INJECTIONS LEVEL 1 $408.25 Facial bones and skull; PRO $600.00 FALL CARE PLAN; PRO $0.01 FALL RISK ASSESSMENT $0.01 FAM PSYCTX W/O PT PRESENT $533.88 FAMILY PSYCHOTHERAPY $315.00 FASCIECTOMY PLANTAR FASCIA PARTIAL SPX $1,416.45 FASCIOTOMY HIP/THIGH ANY TYPE $2,583.51 FASCIOTOMY ILIOTIBIAL OPEN $1,361.66 FASCIOTOMY PALMAR OPEN PARTIAL $1,369.77 FASCIOTOMY PALMAR PERCUTANEOUS $1,970.09 FASCIOTOMY PLANTAR FASCIA RADICAL SPX $1,732.25 FASCT PRTL PLMR 1 DGT PROX IPHAL JT +-TISS $2,420.68 FASCT PRTL PLMR 1 DGT PROX IPHAL JT +-Z-PLASTY $811.45 Femoral artery embolectomy; PRO $700.00 Femoral artery ligation; PRO $500.00 FERN TEST $27.32 FIBERGLASS GAUNTLET CAST $32.36 FIMBRIOPLASTY $1,940.67 FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE $365.70 FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE $407.88 FINGER SPLINT $50.47 FITG&INSJ PESSARY/OTH INTRAVAG SUPPORT DEV $214.62 FITTING CUSTOM PREP AND SUPPLY SHOE MOLDED CAST $259.85 FLAP ISLAND PEDICLE $2,879.71 FLEXOR ORIGIN SLIDE FOREARM &/WRIST $2,096.02 FLU IMMUNO ADMIND RCVD $0.01 FLU VAC NO PRSV 4 VAL 6-35 MNTHS $22.00 FLU VAC QUADRIV SPL VIRUS $20.00 FLU VAC QUADRIVALENT LIV $20.00 FLU VAC TV (18 YR+)RCM/PF $41.00 FLU VACCINE ADMINISTRATION $24.00 FLU VACCINE PRESERV FREE 6-35MTHS $20.00 FLU VIRUS VAC $17.82 FLU VIRUS VAC, SPLIT VIRU $25.33 FLU VIRUS, SPLIT VIRUS, 3 $14.63 FLUOR GID & LOCLZJ NDL/CATH SPI DX/THER NJX $82.87 FLUOR GID CTR VAD PLMT RPLCMT/RMVL $208.54 FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT; PRO $242.76 FOOT ARCH SUPPORT $84.57 FOOT HEEL STABILIZER PREFAB $73.69 FOOT INSERT FORMED TO PATIENT FOOT $254.62 FOOT INSERT REMOVABLE PLASTAZOTE OR EQUAL $233.81 FOOT, ARCH SUPPORT, PREMOLDED $87.79 FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC $293.04 FRMJ DIR/TUBED PEDCL +-TR FT/CH/CH/M/N/AX/G/H/F $2,161.89 FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/< $2,497.20 FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 CM/< $2,712.41 FTL NON-STRS TST $258.05 FXNL STATUS ASSESSED $0.01 GARDASIL $239.60 GARDASIL 9 HPV $286.16 Gastric restrictive procedure; PRO $1,200.00 GASTRIC TUBE PLMT W/ASPIR & LAVAGE $64.73 GASTROCNEMIUS RECESSION $1,114.45 GASTROJEJUNOSTOMY W/O VAGOTOMY $3,216.03 GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ $3,258.14 GASTROSTOMY OPN W/CONSTJ GSTR TUBE $2,497.85 GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX $2,052.31 GENTAMICIN,UP TO 80MG $5.00 GLUC MNTR CONT REC FROM NTRSTL TISS FLU I&R $128.42 GLUCOSE 1 HR POST GLUCOLA $67.00 GLUCOSE ACCUCHEK $23.00 GLUCOSE;BLOOD,REAGENT STRIP $23.00 GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR $1,869.11 GRF THIERSCH RCT INCONT&/PROLAPSE $1,507.68 GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY $4,878.00 GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ $5,480.61 GSTRT W/EXPL/FB RMVL $1,870.56 GSTRT W/SUTR RPR PRE-ESOPG/GSTR LAC $4,226.89 HAEMOPHILUS B VAC VIAL $52.72 HAEMPH B-MENIN/PF 7.5 MCG/0.5 ML VIAL $52.72 HALAPERIDOL DEC PER 50 MG $45.90 HALLUS VALGUS NIGHT DYNAMIC SPLINT $49.58 HALLUX RGDUS CORRJ W/CHEILC $2,194.01 HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB $41.00 HANDLING CONVEY/ANY OTH SVC INVG DEV FIT BY PHYS $34.54 Heart procedures without pump oxygenator; PRO $1,600.00 Heart Transplant; PRO $2,100.00 HEEL PAD AND DEPRESSION FOR SPUR $136.32 HEEL PAD, REMOVABLE SPUR $12.02 HEMIARTHROPLASTY HIP PARTIAL $3,326.67 HEMIPHALANGC/IPHAL JT EXC TOE $795.16 HEMOGLOBIN $32.00 HEMOGLOBIN A1C $90.00 HEMOPHILUS INFLUENZA B VACCINE PRP-D BOOSTER IM $51.50 HEMOPHILUS INFLUENZA B VACCINE PRP-OMP 3 DOSE IM $52.72 HEMORRHOIDECTOMY INT & XTRNL 2+ COLUMN/GROUP $1,392.99 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS $539.31 HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP $1,425.28 HEMORRHOIDECTOMY XTRNL 2+ COLUMN/GROUP $1,248.01 HEP B (PF) VAC VFC 5 MCG INJ $63.65 HEPARIN 1000UNIT/ML 10 ML $5.00 HEPATITIS A & B VACCINE/PF 1 ML VIAL $143.15 HEPATITIS A VACCINE PEDIATRIC 3 DOSE SCHEDULE IM $59.01 HEPATITIS A VIRUS VAC ADULT 1440 UNI S $101.33 HEPATITIS A VIRUS VAC PED 720 UNIT/0.5 Ml SYR $59.01 HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML 5 ML VIAL $168.28 HEPATITIS B VACCINE ADOLESCENT 2 DOSE IM $33.95 HEPATITIS B VACCINE ADULT DOSAGE INTRAMUSCULAR $105.03 HEPATITIS B VACCINE DIALYSIS DOSAGE 4 IM $172.65 HEPB-HIB VACCINE $90.69 Hernia repair upper abdomen; PRO $500.00 Hernia repairs; PRO $600.00 HIB VACCINE $54.59 Hip disarticulation; PRO $1,100.00 HISTRELIN, IMPLANT 50MG $4,455.78 HIV ANTIGEN W/HIV ANTIBODIES $86.99 HIV-1ANTIBODY CONE WESTERNBLOT $60.00 HOLTER MONITOR ECG RECORDING ONLY (93225) $80.79 HOME VST EST PT LOW TO MOD SEVERITY $162.76 HOME VST EST PT MOD TO HI SEVERITY $300.19 HOME VST EST PT SELF LIMITED/MINOR $154.92 HOME VST NEW PT LOW SEVERITY $129.72 HOME VST NEW PT MOD SEVERITY $153.42 HOSP DSCHRG D MGMT > 30 MIN $212.91 HOSP DSCHRG D MGMT 30 MIN/< $144.60 HRHC NTRNL LIG OTH THAN RBBR BAND 1 COL/GRP $724.34 HRHC NTRNL LIG OTH THAN RBBR BAND 2+ COL/GRP $762.46 HTROPHL ANTIBODIES SCR $108.00 HYALGAN PER DOSE $265.40 HYALURONAN OR SYNVISC 1 M $72.13 HYALURONIDASE UP TO 150 UNITS $64.50 HYDROXYPROGESTERONE 10 MG $52.68 HYPPHSEC/EXC PITUITARY TUM TRANSNSL/SEPTAL $4,634.35 Hysteroscopy; PRO $500.00 HYSTSC BX ENDOMETRIUM&/POLYPC +-D&C $777.23 HYSTSC DX SPX $537.00 HYSTSC ENDOMETRIAL ABLTJ $995.85 HYSTSC OCCLUSION PLMT PRM $5,223.69 HYSTSC RMVL IMPACTED FB $945.19 I & D HEMATOMA/SEROMA $437.44 I&D ABSC PRITONSILLAR $528.67 I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL $1,277.27 I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR $1,982.90 I&D APPENDICEAL ABSC OPN $1,856.67 I&D BELW FSCA FOOT 1 BURSAL SPACE $1,264.98 I&D BELW FSCA FOOT MLT AREAS $1,703.69 I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX $1,068.76 I&D DP ABSC BURSA/HMTMA THI/KNE REGION $1,893.51 I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE $629.33 I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA $3,667.57 I&D INTRAMURAL IM/ABSC TRANSANAL ANES $1,030.23 I&D ISCHIORCT&/PRIRCT ABSC SPX $1,433.99 I&D OF BARTHOLIN'S GLAND ABSC $341.14 I&D PELVIS/HIP JT AREA DP ABSC/HMTMA $3,890.58 I&D PRIANAL ABSC SUPFC $556.75 I&D SHOULDER DEEP ABSCESS/HEMATOMA $1,247.90 I&D SOFT TISSUE ABSCESS SUBFASC $877.85 I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA $955.60 I&D VAG HMTMA NON-OBAL $903.31 I&D VULVA/PRNL ABSC $308.00 ICD DEVICE PROG EVAL 1 SNGL; PRO $184.22 ILEOST/JEJUNOSTOMY NON-TUBE $3,075.71 ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI $1,429.72 IM/SUBCUTANEOUS INJECTION $62.28 IMADM INTRANSL/ORAL EA VAC $16.00 IMADM PRQ ID SUBQ/IM NJXS 1 VACC $24.00 IMADM PRQ ID SUBQ/IM NJXS EA VACC $12.00 IMADM THROUGH 18YR ANY ROUTE 1ST VAC $67.75 IMADM THROUGH 18YR ANY ROUTE 1ST VAC/TOXOID $67.75 IMADM THROUGH 18YR ANY ROUTE EA ADDL VAC/TOXOID $34.90 IMAGE GUIDED FLD COLLECTION PERITONEAL $705.00 IMG GID PLMT MTLC LOCLZJ CLIP PRQ BRST BX/ASPIR $254.00 IMITREX,6 MG $239.76 IMMOBILIZER KNEE $200.35 IMMUNE ADMIN ORAL/NASAL $24.00 IMMUNIZATION ADMIN $24.00 IMMUNIZATION ADMIN EACH ADDTL $12.00 IMMUNOTHERAPY 2 OR MORE INJECTIONS $98.96 IMMUNOTHERAPY ONE INJECTION $59.42 IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE $785.89 IMPLANT REMOVAL RADIAL HEAD $1,739.32 IMPLANTABLE LOOP RECORDER SYSTEM $101.22 In sitting position; PRO $1,400.00 INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW $1,201.73 INC DP W/OPNG B1 CORTEX FEMUR/KNE $3,609.34 INC LNGL FRENUM FREXOMY $596.90 INC THROMBOSED HEMORRHOID XTRNL $501.03 INCISION & DRAINAGE PILONIDAL CYST COMPLICATED $753.52 INCISION & DRAINAGE PILONIDAL CYST SIMPLE $502.36 INCISION BONE CORTEX FOOT $3,799.40 INCISION BONE CORTEX HAND/FINGER $1,527.32 INCISION EXTENSOR TENDON SHEATH WRIST $2,281.07 INCISION LEG/ANKLE $3,849.78 INCISION OF TONGUE FOLD $0.00 INCISION&DRAINAGE BURSA FOOT $686.29 INCISION&DRAINAGE COMPLEX PO WOUND INFECTION $659.68 INCISION&DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA $1,495.50 INCISION&DRAINAGE UPPER ARM/ELBOW BURSA $810.81 INCISION&REMOVAL FOREIGN BODY SUBQ TISS COMP $741.56 Incomplete or missed abortion; PRO $500.00 INDIV PSYCTX IA I/P 60 MINUTES $315.53 INDUCED AB 1+ IAM NJXS DLVR FETUS HYSTOT $1,344.92 INDUCED AB 1+ VAG SUPP DLVR FETUS $1,210.77 INDUCED AB DILAT&EVAC $1,080.32 Induced abortion procedure; PRO $500.00 INDWELLING CATHETER $21.82 Inferior vena cava ligation; PRO $1,100.00 INFLUENZA ASSAY W OPTIC $40.46 INFLUENZA HIGH DOSE FLUAD 65 YRS AND OLDER $35.00 INFLUENZA HIGH-DOSE(65YR+)/PF $35.00 INFLUENZA IMM ORDER ADMIN $0.01 INFLUENZA VAC RECOMB/EGG-FREE $41.00 INFLUENZA VACCINE $15.00 INFLUENZA VIRUS VACCINE LIVE INTRAN $15.00 INFLUENZA VIRUS VACCINE SPLIT VIRUS 3 YEARS + IM $15.00 INFLUENZA VIRUS VACCINE SPLIT VIRUS 6-35 MO IM $15.00 INFLUENZA VIRUS VACCINE(PEDS) 1 SYR VIAL $15.00 INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX $2,341.41 INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC $3,089.08 INITIAL OB $0.01 INITIAL PREVENTIVE MEDICARE EXAM $407.33 INITIAL TREATMENT OF BURN(S) $95.01 INITIAL TX 1ST DEGREE BURN LOCAL TX $104.57 INJ BACLOFEN 10 MG $645.00 INJ HYDROMORPHONE UP TO 4 MG $5.25 INJ MORPHINE SULFATE UP TO 10 MG $5.00 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS $170.98 INJECTION CERVICAL OR THORACIC 2ND LEVEL $254.26 INJECTION CERVICAL OR THORACIC 3RD+LEVELS $255.21 INJECTION FOR IDENTIFICATION OF SENTINEL NODE $112.06 INJECTION HIP ARTHROGRAPHY W/ANESTHESIA $666.70 INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA $541.16 INJECTION INTRALESIONAL UP TO & INCL 7 $157.02 INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG $316.16 INJECTION SI JOINT ARTHROGRAPHY&/ANES/STEROID $382.00 INJECTION SINGLE TENDON ORIGIN/INSERTION $171.22 INJECTION SINGLE, W/MED SPINE $236.58 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES $155.49 INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES $179.22 INJECTION THERAPEUTIC CARPAL TUNNEL $217.79 INJECTION TREATMENT OF NOSE $283.19 INSERTION FLOW DIRECTED CATHETER FOR MONITORING $1,754.55 Insertion of penile prosthesis; PRO $500.00 INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN $679.45 INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX $575.47 INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR $748.51 INSJ BIOMECHANICAL DEVICE $662.17 INSJ BIOMECHANICAL DEVICE EACH DEFECT $85.52 INSJ I-AORT BALO ASSIST DEV THRU FEM ART OPN $1,051.83 INSJ INTRAUTERINE DEV $653.18 INSJ MESH/PROSTH PEL FLOOR DFCT EA SIT $750.50 INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT $395.02 INSJ NON-NDWELLG BLDR CATH $156.56 INSJ NON-TUN CTR CVC AGE 5 YR/> $370.25 INSJ NON-TUN CTR CVC UNDER 5 YR $679.10 INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/> $981.33 INSJ PRPH CVC W/O SUBQ PORT/PMP AGE 5 YR/> $273.98 INSJ PRTL-VEN SHUNT $2,045.03 INSJ TEMP NDWELLG BLDR CATH COMP $373.89 INSJ TEMP NDWELLG BLDR CATH SMPL $200.85 INSJ TUN CTR CTR VAD W/SUBQ PORT AGE 5 YR/> $1,075.75 INSJ TUN CTR CTR VAD W/SUBQ PORT UNDER 5 YR $1,046.91 INSJ TUN CTR CVC W/O SUBQ PORT/PMP AGE 5 YR/> $824.00 INSJ TUN CTR CVC W/O SUBQ PORT/PMP UNDER 5 YR $2,449.38 INSJ/RPLCMT PM PLS GEN ONLY 2CHMBR $990.43 INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR&VENTR $1,563.29 INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD VENTR $1,443.09 INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING $1,081.50 INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH $527.81 Integumentary system of extremities; PRO $400.00 Integumentary system; PRO $600.00 INTENS BEHAVE THER CARDIO DX $62.95 INTERFERON ALPHA 2B,1 MIL $45.09 Interpelviabdominal amputation; PRO $1,600.00 INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS $73.33 INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM $107.91 Interthorascoscapular amputation; PRO $1,600.00 Intra hepatic or protal circulation; PRO $800.00 Intracranial procedures; PRO $1,200.00 Intracranial, intracardiac and aorta; PRO $900.00 Intracranial; PRO $800.00 Intraoral procedures; PRO $600.00 Intraperitoneal lower abdomen includes laparoscopy; PRO $700.00 Intrathoracic or juglar; PRO $700.00 Intrathoracic procedures; PRO $1,800.00 INTRO ANY HEMOSTATIC AGT/PACK VAG HEMRRG SPX $339.89 INTRO CATH AORTA $455.26 INTRO CATH SUPRIOR/IVC $364.66 INTRO NDL/CATH AV SHUNT IST ACCESS W/ RAD EVAL $2,228.87 INTRO NDL/INTRACATH RTRGR BRACH ART $298.70 INTRO NDL/INTRACATH XTR ART $314.03 Intrperitoneal procedures; PRO $800.00 INTRVASC US NONCORONARY 1ST $247.07 INTRVASC US NONCORONARY ADDL $197.48 INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE $338.50 IPRATROPIUM EACH MIL $5.00 IPRATROPIUM PER MIL $5.00 Iridectomy; PRO $500.00 IRRIGATION IMPLANTED VAD FOR DRUG DLVR $123.93 IUD $1,211.84 IUD MIRENA $1,326.13 IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL $284.52 IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL $230.53 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR $296.64 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR $375.56 IV US C VSL DX&/THER 1ST VSL $284.52 JOINT INJ/ASP MAJOR JOINT W/US GUIDANCE $218.12 KELLER/MCBRIDE/MAYO PROCEDURE $1,906.69 KENALOG $20.16 KETOROLAC TROM $5.00 KOH SLIDE $69.00 LAM FACETEC&FORAMOT 1 SGM EA CRV THRC/LMBR $624.18 LAM FACETEC&FORAMOT 1 SGM LMBR $2,700.43 LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL $3,811.00 LAMINOTOMY INCL OPEN & NDSC 1 INTERSPACE LUMBAR $2,324.11 LAMOT INCL OPEN&NDSC EA ADDL INTERSPACE CRV/LMBR $556.88 LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED $2,717.79 LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE $2,474.58 LAPS ABD PRTM&OMENTUM DX +-SPEC BR/WA SPX $955.30 LAPS ABLTJ UTERINE FIBROIDS $2,081.90 LAPS CLSR NTRSTM LG/SM INT W/RESCJ&ANAST $4,909.33 LAPS CLST/SKN LVL CECOSTOMY $3,604.41 LAPS COLCT PRTL W/ANAST $4,527.34 LAPS COLCT PRTL W/COLOPXTSTMY LW ANAST $5,369.36 LAPS COLCT PRTL W/END CLST&CLSR DSTL SGM $5,162.48 LAPS COLCT PRTL W/RMVL TERMINAL ILE $3,940.09 LAPS ENTEROLSS FRING INTSTINAL ADHESION SPX $2,697.02 LAPS FULG OVIDUXS $1,059.68 LAPS FULG/EXC OVARY VISCERA/PRTL SURF $2,063.97 LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER $1,144.14 LAPS JEJUNOSTOMY $1,779.46 LAPS LSS ADS SPX $1,961.41 LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLCT $556.20 LAPS MYOMECTOMY EXC 1-4 250 GM/< $2,424.69 LAPS OCCLUSION OVIDUXS DEV $1,058.88 LAPS PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST $5,549.88 LAPS PROCTOPEXY FOR PROLAPSE $2,808.43 LAPS PROCTOPEXY FOR PROLAPSE SIGMOID RESCJ $3,567.29 LAPS REPAIR HERNIA EXCEPT INCAL/INGUN REDUCIBLE $2,179.00 LAPS RMVL ADNEXAL STRUXS $1,892.15 LAPS RPR INCISIONAL HERNIA NCRC8/STRANGULATED $3,021.96 LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH $4,948.73 LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED $3,870.62 LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE $2,692.51 LAPS SUPRACRV HYST >250 G RMVL TUBE/OVARY $2,628.26 LAPS SUPRACRV HYST 250 G/< $2,085.76 LAPS SUPRACRV HYST 250 G/< RMVL TUBE/OVARY $2,384.27 LAPS SURG APPENDEC $1,762.37 LAPS SURG CHOLECSTC $1,925.46 LAPS SURG CHOLECSTC W/CHOLANGRPH $2,092.56 LAPS SURG CHOLECSTC W/EXPL COMMON DUX $2,663.37 LAPS SURG RPR 1ST INGUN HRNA $1,251.05 LAPS SURG RPR LYMPH NODE BX 1/MLT $1,526.40 LAPS SURG RPR RECRT INGUN HRNA $1,625.44 LAPS SURG SPLENC $3,090.42 LAPS SURG W/ASPIR CAVITY/CST 1/MLT $1,081.76 LAPS SURG W/BX 1/MLT $1,012.93 LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY $1,778.54 LAPS TOTAL HYSTERECTOMY 250 G/