2017 National Physician Fee Schedule Relative Value File January Release CPT codes and descriptions only are copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.

Dental codes (D codes) are copyright 2016/16 American Dental Association. All Rights Reserved.

RELEASED 11/14/2016

NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 10021 Fna w/o image 3.47 70.00 $242.90 10022 Fna w/image 4.00 70.00 $280.00 1003F Level of activity assess 0.00 70.00 $0.00 10030 Guide cathet fluid drainage 19.80 70.00 $1,386.00 10035 Perq dev soft tiss 1st imag 15.25 70.00 $1,067.50 10036 Perq dev soft tiss add imag 13.19 70.00 $923.30 1004F Clin symp vol ovrld assess 0.00 70.00 $0.00 10040 Acne surgery 2.89 70.00 $202.30 1005F Asthma symptoms evaluate 0.00 70.00 $0.00 1006F Osteoarthritis assess 0.00 70.00 $0.00 10060 Drainage of skin abscess 3.33 70.00 $233.10 10061 Drainage of skin abscess 5.86 70.00 $410.20 1007F Anti-inflm/anlgsc otc assess 0.00 70.00 $0.00 1008F Gi/renal risk assess 0.00 70.00 $0.00 10080 Drainage of pilonidal cyst 5.08 70.00 $355.60 10081 Drainage of pilonidal cyst 7.63 70.00 $534.10 1010F Severity angina by actvty 0.00 70.00 $0.00 1011F Angina present 0.00 70.00 $0.00 1012F Angina absent 0.00 70.00 $0.00 10120 Remove foreign body 4.32 70.00 $302.40 10121 Remove foreign body 7.77 70.00 $543.90 10140 Drainage of hematoma/fluid 4.63 70.00 $324.10 1015F Copd symptoms assess 0.00 70.00 $0.00 10160 Puncture drainage of lesion 3.68 70.00 $257.60 1018F Assess dyspnea not present 0.00 70.00 $0.00 10180 Complex drainage wound 7.00 70.00 $490.00 1019F Assess dyspnea present 0.00 70.00 $0.00 1022F Pneumo imm status assess 0.00 70.00 $0.00 1026F Co-morbid condition assess 0.00 70.00 $0.00 1030F Influenza imm status assess 0.00 70.00 $0.00 1031F Smoking & 2nd hand assessed 0.00 70.00 $0.00 1032F Smoker/exposed 2nd hnd smoke 0.00 70.00 $0.00 1033F Tobacco nonsmoker nor 2ndhnd 0.00 70.00 $0.00 1034F Current tobacco smoker 0.00 70.00 $0.00 1035F Smokeless tobacco user 0.00 70.00 $0.00 1036F Tobacco non-user 0.00 70.00 $0.00 1038F Persistent asthma 0.00 70.00 $0.00 1039F Intermittent asthma 0.00 70.00 $0.00 1040F Dsm-5 info mdd docd 0.00 70.00 $0.00 1050F History of mole changes 0.00 70.00 $0.00 1052F Type location activityassess 0.00 70.00 $0.00 1055F Visual funct status assess 0.00 70.00 $0.00 1060F Doc perm/cont/parox atr fib 0.00 70.00 $0.00 1061F Doc lack perm+cont+parox fib 0.00 70.00 $0.00 1065F Ischm stroke symp lt3 hrsb/4 0.00 70.00 $0.00 1066F Ischm stroke symp ge3 hrsb/4 0.00 70.00 $0.00 1070F Alarm symp assessed-absent 0.00 70.00 $0.00 1071F Alarm symp assessed-1+ prsnt 0.00 70.00 $0.00 1090F Pres/absn urine incon assess 0.00 70.00 $0.00 1091F Urine incon characterized 0.00 70.00 $0.00 1100F Ptfalls assess-docd ge2>/yr 0.00 70.00 $0.00 11000 Debride infected skin 1.54 70.00 $107.80 11001 Debride infected skin add-on 0.61 70.00 $42.70 11004 Debride genitalia & perineum 16.76 70.00 $1,173.20 11005 Debride abdom wall 22.67 70.00 $1,586.90 11006 Debride genit/per/abdom wall 20.41 70.00 $1,428.70 11008 Remove mesh from abd wall 7.97 70.00 $557.90 1101F Pt falls assess-docd le1/yr 0.00 70.00 $0.00 11010 Debride skin at fx site 14.37 70.00 $1,005.90 11011 Debride skin musc at fx site 15.27 70.00 $1,068.90 11012 Deb skin bone at fx site 20.23 70.00 $1,416.10 11042 Deb subq tissue 20 sq cm/< 3.30 70.00 $231.00 11043 Deb musc/fascia 20 sq cm/< 6.48 70.00 $453.60 11044 Deb bone 20 sq cm/< 8.94 70.00 $625.80 11045 Deb subq tissue add-on 1.16 70.00 $81.20 11046 Deb musc/fascia add-on 2.09 70.00 $146.30 11047 Deb bone add-on 3.55 70.00 $248.50 11055 Trim skin lesion 1.35 70.00 $94.50 11056 Trim skin lesions 2 to 4 1.65 70.00 $115.50 11057 Trim skin lesions over 4 1.85 70.00 $129.50 1110F Pt lft inpt fac w/in 60 days 0.00 70.00 $0.00 11100 Biopsy skin lesion 2.93 70.00 $205.10 11101 Biopsy skin add-on 0.93 70.00 $65.10 1111F Dschrg med/current med merge 0.00 70.00 $0.00 1116F Auric/peri pain assessed 0.00 70.00 $0.00 1118F Gerd symps assessed 12 month 0.00 70.00 $0.00 1119F Init eval for condition 0.00 70.00 $0.00 11200 Removal of skin tags 2.0 cm 4.45 70.00 $311.50 11305 Shave skin lesion 0.5 cm/< 2.81 70.00 $196.70 11306 Shave skin lesion 0.6-1.0 cm 3.48 70.00 $243.60 11307 Shave skin lesion 1.1-2.0 cm 4.09 70.00 $286.30 11308 Shave skin lesion >2.0 cm 4.29 70.00 $300.30 11310 Shave skin lesion 0.5 cm/< 3.24 70.00 $226.80 11311 Shave skin lesion 0.6-1.0 cm 3.15 70.00 $220.50 11312 Shave skin lesion 1.1-2.0 cm 4.57 70.00 $319.90 11313 Shave skin lesion >2.0 cm 5.30 70.00 $371.00 1134F Epsd bk pain for 6 wks/< 0.00 70.00 $0.00 1135F Epsd bk pain for >6 wks 0.00 70.00 $0.00 1136F Epsd bk pain for 12 wks/< 0.00 70.00 $0.00 1137F Epsd bk pain for >12 wks 0.00 70.00 $0.00 11400 Exc tr-ext b9+marg 0.5 cm< 3.52 70.00 $246.40 11401 Exc tr-ext b9+marg 0.6-1 cm 4.23 70.00 $296.10 11402 Exc tr-ext b9+marg 1.1-2 cm 4.71 70.00 $329.70 11403 Exc tr-ext b9+marg 2.1-3cm/< 5.45 70.00 $381.50 11404 Exc tr-ext b9+marg 3.1-4 cm 6.19 70.00 $433.30 11406 Exc tr-ext b9+marg >4.0 cm 8.92 70.00 $624.40 11420 Exc h-f-nk-sp b9+marg 0.5/< 3.47 70.00 $242.90 11421 Exc h-f-nk-sp b9+marg 0.6-1 4.44 70.00 $310.80 11422 Exc h-f-nk-sp b9+marg 1.1-2 4.98 70.00 $348.60 11423 Exc h-f-nk-sp b9+marg 2.1-3 5.72 70.00 $400.40 11424 Exc h-f-nk-sp b9+marg 3.1-4 6.64 70.00 $464.80 11426 Exc h-f-nk-sp b9+marg >4 cm 9.49 70.00 $664.30 11440 Exc face-mm b9+marg 0.5 cm/< 3.81 70.00 $266.70 11441 Exc face-mm b9+marg 0.6-1 cm 4.76 70.00 $333.20 11442 Exc face-mm b9+marg 1.1-2 cm 5.33 70.00 $373.10 11443 Exc face-mm b9+marg 2.1-3 cm 6.36 70.00 $445.20 11444 Exc face-mm b9+marg 3.1-4 cm 8.00 70.00 $560.00 11446 Exc face-mm b9+marg >4 cm 11.11 70.00 $777.70 11450 Removal sweat gland lesion 10.84 70.00 $758.80 11451 Removal sweat gland lesion 13.81 70.00 $966.70 11462 Removal sweat gland lesion 10.59 70.00 $741.30 11463 Removal sweat gland lesion 13.99 70.00 $979.30 11470 Removal sweat gland lesion 11.70 70.00 $819.00 11471 Removal sweat gland lesion 14.51 70.00 $1,015.70 1150F Doc pt rsk death w/in 1yr 0.00 70.00 $0.00 1151F Doc no pt rsk death w/in 1yr 0.00 70.00 $0.00 1152F Doc advncd dis comfort 1st 0.00 70.00 $0.00 1153F Doc advncd dis cmfrt not 1st 0.00 70.00 $0.00 1157F Advnc care plan in rcrd 0.00 70.00 $0.00 1158F Advnc care plan tlk docd 0.00 70.00 $0.00 1159F Med list docd in rcrd 0.00 70.00 $0.00 1160F Rvw meds by rx/dr in rcrd 0.00 70.00 $0.00 11600 Exc tr-ext mal+marg 0.5 cm/< 5.46 70.00 $382.20 11601 Exc tr-ext mal+marg 0.6-1 cm 6.50 70.00 $455.00 11602 Exc tr-ext mal+marg 1.1-2 cm 7.05 70.00 $493.50 11603 Exc tr-ext mal+marg 2.1-3 cm 8.06 70.00 $564.20 11604 Exc tr-ext mal+marg 3.1-4 cm 8.96 70.00 $627.20 11606 Exc tr-ext mal+marg >4 cm 12.82 70.00 $897.40 11620 Exc h-f-nk-sp mal+marg 0.5/< 5.51 70.00 $385.70 11621 Exc s/n/h/f/g mal+mrg 0.6-1 6.54 70.00 $457.80 11622 Exc s/n/h/f/g mal+mrg 1.1-2 7.29 70.00 $510.30 11623 Exc s/n/h/f/g mal+mrg 2.1-3 8.55 70.00 $598.50 11624 Exc s/n/h/f/g mal+mrg 3.1-4 9.65 70.00 $675.50 11626 Exc s/n/h/f/g mal+mrg >4 cm 11.61 70.00 $812.70 11640 Exc f/e/e/n/l mal+mrg 0.5cm< 5.69 70.00 $398.30 11641 Exc f/e/e/n/l mal+mrg 0.6-1 6.76 70.00 $473.20 11642 Exc f/e/e/n/l mal+mrg 1.1-2 7.72 70.00 $540.40 11643 Exc f/e/e/n/l mal+mrg 2.1-3 9.10 70.00 $637.00 11644 Exc f/e/e/n/l mal+mrg 3.1-4 11.21 70.00 $784.70 11646 Exc f/e/e/n/l mal+mrg >4 cm 14.66 70.00 $1,026.20 1170F Fxnl status assessed 0.00 70.00 $0.00 11719 Trim nail(s) any number 0.40 70.00 $28.00 11720 Debride nail 1-5 0.91 70.00 $63.70 11721 Debride nail 6 or more 1.27 70.00 $88.90 11730 Removal of nail plate 2.97 70.00 $207.90 11732 Remove nail plate add-on 0.90 70.00 $63.00 11740 Drain blood from under nail 1.40 70.00 $98.00 1175F Function stat assessed rvwd 0.00 70.00 $0.00 11750 Removal of nail bed 4.34 70.00 $303.80 11755 Biopsy nail unit 3.77 70.00 $263.90 11760 Repair of nail bed 5.35 70.00 $374.50 11762 Reconstruction of nail bed 7.90 70.00 $553.00 11765 Excision of nail fold toe 4.74 70.00 $331.80 11770 Remove pilonidal cyst simple 7.87 70.00 $550.90 11771 Remove pilonidal cyst exten 16.30 70.00 $1,141.00 11772 Remove pilonidal cyst compl 19.75 70.00 $1,382.50 1180F Thromboemb risk assessed 0.00 70.00 $0.00 1181F Neuropsychia sympts assessed 0.00 70.00 $0.00 1182F Neuropsychi sympt 1+present 0.00 70.00 $0.00 1183F Neuropsychiatric symp absent 0.00 70.00 $0.00 11900 Inject skin lesions 7 1.99 70.00 $139.30 11920 Correct skin color 6.0 cm/< 4.83 70.00 $338.10 11921 Correct skn color 6.1-20.0cm 5.61 70.00 $392.70 11922 Correct skin color ea 20.0cm 1.74 70.00 $121.80 11950 Tx contour defects 1 cc/< 2.21 70.00 $154.70 11951 Tx contour defects 1.1-5.0cc 2.84 70.00 $198.80 11952 Tx contour defects 5.1-10cc 3.54 70.00 $247.80 11954 Tx contour defects >10.0 cc 4.49 70.00 $314.30 11960 Insert tissue expander(s) 27.26 70.00 $1,908.20 11970 Replace tissue expander 17.50 70.00 $1,225.00 11971 Remove tissue expander(s) 13.33 70.00 $933.10 11976 Remove contraceptive capsule 4.05 70.00 $283.50 11980 Implant hormone pellet(s) 2.67 70.00 $186.90 11981 Insert drug implant device 4.01 70.00 $280.70 11982 Remove drug implant device 4.55 70.00 $318.50 11983 Remove/insert drug implant 6.42 70.00 $449.40 1200F Seizure type& frequ docd 0.00 70.00 $0.00 12001 Rpr s/n/ax/gen/trnk 2.5cm/< 2.54 70.00 $177.80 12002 Rpr s/n/ax/gen/trnk2.6-7.5cm 3.08 70.00 $215.60 12004 Rpr s/n/ax/gen/trk7.6-12.5cm 3.62 70.00 $253.40 12005 Rpr s/n/a/gen/trk12.6-20.0cm 4.57 70.00 $319.90 12006 Rpr s/n/a/gen/trk20.1-30.0cm 5.40 70.00 $378.00 12007 Rpr s/n/ax/gen/trnk >30.0 cm 6.21 70.00 $434.70 12011 Rpr f/e/e/n/l/m 2.5 cm/< 3.10 70.00 $217.00 12013 Rpr f/e/e/n/l/m 2.6-5.0 cm 3.23 70.00 $226.10 12014 Rpr f/e/e/n/l/m 5.1-7.5 cm 3.78 70.00 $264.60 12015 Rpr f/e/e/n/l/m 7.6-12.5 cm 4.58 70.00 $320.60 12016 Rpr fe/e/en/l/m 12.6-20.0 cm 5.79 70.00 $405.30 12017 Rpr fe/e/en/l/m 20.1-30.0 cm 4.48 70.00 $313.60 12018 Rpr f/e/e/n/l/m >30.0 cm 5.07 70.00 $354.90 12020 Closure of split wound 7.96 70.00 $557.20 12021 Closure of split wound 4.61 70.00 $322.70 12031 Intmd rpr s/a/t/ext 2.5 cm/< 6.74 70.00 $471.80 12032 Intmd rpr s/a/t/ext 2.6-7.5 8.61 70.00 $602.70 12034 Intmd rpr s/tr/ext 7.6-12.5 8.86 70.00 $620.20 12035 Intmd rpr s/a/t/ext 12.6-20 10.81 70.00 $756.70 12036 Intmd rpr s/a/t/ext 20.1-30 11.96 70.00 $837.20 12037 Intmd rpr s/tr/ext >30.0 cm 13.68 70.00 $957.60 12041 Intmd rpr n-hf/genit 2.5cm/< 6.73 70.00 $471.10 12042 Intmd rpr n-hf/genit2.6-7.5 8.21 70.00 $574.70 12044 Intmd rpr n-hf/genit7.6-12.5 10.19 70.00 $713.30 12045 Intmd rpr n-hf/genit12.6-20 11.37 70.00 $795.90 12046 Intmd rpr n-hf/genit20.1-30 13.50 70.00 $945.00 12047 Intmd rpr n-hf/genit >30.0cm 15.57 70.00 $1,089.90 1205F Epi etiol synd rvwd and docd 0.00 70.00 $0.00 12051 Intmd rpr face/mm 2.5 cm/< 7.32 70.00 $512.40 12052 Intmd rpr face/mm 2.6-5.0 cm 8.35 70.00 $584.50 12053 Intmd rpr face/mm 5.1-7.5 cm 9.80 70.00 $686.00 12054 Intmd rpr face/mm 7.6-12.5cm 10.22 70.00 $715.40 12055 Intmd rpr face/mm 12.6-20 cm 13.24 70.00 $926.80 12056 Intmd rpr face/mm 20.1-30.0 13.92 70.00 $974.40 12057 Intmd rpr face/mm >30.0 cm 15.43 70.00 $1,080.10 1220F Pt screened for depression 0.00 70.00 $0.00 13100 Cmplx rpr trunk 1.1-2.5 cm 9.50 70.00 $665.00 13101 Cmplx rpr trunk 2.6-7.5 cm 11.24 70.00 $786.80 13102 Cmplx rpr trunk addl 5cm/< 3.45 70.00 $241.50 13120 Cmplx rpr s/a/l 1.1-2.5 cm 9.94 70.00 $695.80 13121 Cmplx rpr s/a/l 2.6-7.5 cm 12.13 70.00 $849.10 13122 Cmplx rpr s/a/l addl 5 cm/> 3.79 70.00 $265.30 13131 Cmplx rpr f/c/c/m/n/ax/g/h/f 10.95 70.00 $766.50 13132 Cmplx rpr f/c/c/m/n/ax/g/h/f 13.53 70.00 $947.10 13133 Cmplx rpr f/c/c/m/n/ax/g/h/f 5.09 70.00 $356.30 13151 Cmplx rpr e/n/e/l 1.1-2.5 cm 12.00 70.00 $840.00 13152 Cmplx rpr e/n/e/l 2.6-7.5 cm 14.40 70.00 $1,008.00 13153 Cmplx rpr e/n/e/l addl 5cm/< 5.53 70.00 $387.10 13160 Late closure of wound 23.08 70.00 $1,615.60 1400F Prkns diag rviewed 0.00 70.00 $0.00 14000 Tis trnfr trunk 10 sq cm/< 17.70 70.00 $1,239.00 14001 Tis trnfr trunk 10.1-30sqcm 22.85 70.00 $1,599.50 14020 Tis trnfr s/a/l 10 sq cm/< 19.82 70.00 $1,387.40 14021 Tis trnfr s/a/l 10.1-30 sqcm 24.81 70.00 $1,736.70 14040 Tis trnfr f/c/c/m/n/a/g/h/f 21.69 70.00 $1,518.30 14041 Tis trnfr f/c/c/m/n/a/g/h/f 26.89 70.00 $1,882.30 14060 Tis trnfr e/n/e/l 10 sq cm/< 22.13 70.00 $1,549.10 14061 Tis trnfr e/n/e/l10.1-30sqcm 28.93 70.00 $2,025.10 14301 Tis trnfr any 30.1-60 sq cm 30.71 70.00 $2,149.70 14302 Tis trnfr addl 30 sq cm/< 6.40 70.00 $448.00 14350 Filleted finger/toe flap 19.72 70.00 $1,380.40 1450F Symptoms improved/consist 0.00 70.00 $0.00 1451F Sympt show clin import drop 0.00 70.00 $0.00 1460F Qual card diag prior 12 mons 0.00 70.00 $0.00 1461F No qual card diag prior12mon 0.00 70.00 $0.00 1490F Dem severity classified mild 0.00 70.00 $0.00 1491F Dem severity classified mod 0.00 70.00 $0.00 1493F Dem severity class severe 0.00 70.00 $0.00 1494F Cognit assessed and reviewed 0.00 70.00 $0.00 1500F Symptom+sign symm polyneuro 0.00 70.00 $0.00 15002 Wound prep trk/arm/leg 9.88 70.00 $691.60 15003 Wound prep addl 100 cm 2.15 70.00 $150.50 15004 Wound prep f/n/hf/g 11.39 70.00 $797.30 15005 Wnd prep f/n/hf/g addl cm 3.56 70.00 $249.20 1501F Not initial eval for cond 0.00 70.00 $0.00 1502F Pt queried pain fxn w/ instr 0.00 70.00 $0.00 1503F Pt queried symp resp insuff 0.00 70.00 $0.00 1504F Pt has resp insufficiency 0.00 70.00 $0.00 15040 Harvest cultured skin graft 7.22 70.00 $505.40 1505F Pt has no resp insufficiency 0.00 70.00 $0.00 15050 Skin pinch graft 15.94 70.00 $1,115.80 15100 Skin splt grft trnk/arm/leg 24.45 70.00 $1,711.50 15101 Skin splt grft t/a/l add-on 5.29 70.00 $370.30 15110 Epidrm autogrft trnk/arm/leg 22.68 70.00 $1,587.60 15111 Epidrm autogrft t/a/l add-on 3.31 70.00 $231.70 15115 Epidrm a-grft face/nck/hf/g 22.87 70.00 $1,600.90 15116 Epidrm a-grft f/n/hf/g addl 4.68 70.00 $327.60 15120 Skn splt a-grft fac/nck/hf/g 24.23 70.00 $1,696.10 15121 Skn splt a-grft f/n/hf/g add 5.94 70.00 $415.80 15130 Derm autograft trnk/arm/leg 19.01 70.00 $1,330.70 15131 Derm autograft t/a/l add-on 2.58 70.00 $180.60 15135 Derm autograft face/nck/hf/g 23.94 70.00 $1,675.80 15136 Derm autograft f/n/hf/g add 2.48 70.00 $173.60 15150 Cult skin grft t/arm/leg 19.54 70.00 $1,367.80 15151 Cult skin grft t/a/l addl 3.46 70.00 $242.20 15152 Cult skin graft t/a/l +% 4.23 70.00 $296.10 15155 Cult skin graft f/n/hf/g 20.49 70.00 $1,434.30 15156 Cult skin grft f/n/hfg add 4.68 70.00 $327.60 15157 Cult epiderm grft f/n/hfg +% 5.27 70.00 $368.90 15200 Skin full graft trunk 23.68 70.00 $1,657.60 15201 Skin full graft trunk add-on 4.16 70.00 $291.20 15220 Skin full graft sclp/arm/leg 21.96 70.00 $1,537.20 15221 Skin full graft add-on 3.88 70.00 $271.60 15240 Skin full grft face/genit/hf 26.60 70.00 $1,862.00 15241 Skin full graft add-on 5.25 70.00 $367.50 15260 Skin full graft een & lips 28.87 70.00 $2,020.90 15261 Skin full graft add-on 6.12 70.00 $428.40 15271 Skin sub graft trnk/arm/leg 3.98 70.00 $278.60 15272 Skin sub graft t/a/l add-on 0.77 70.00 $53.90 15273 Skin sub grft t/arm/lg child 8.54 70.00 $597.80 15274 Skn sub grft t/a/l child add 2.04 70.00 $142.80 15275 Skin sub graft face/nk/hf/g 4.23 70.00 $296.10 15276 Skin sub graft f/n/hf/g addl 0.99 70.00 $69.30 15277 Skn sub grft f/n/hf/g child 9.31 70.00 $651.70 15278 Skn sub grft f/n/hf/g ch add 2.44 70.00 $170.80 15570 Skin pedicle flap trunk 26.04 70.00 $1,822.80 15572 Skin pedicle flap arms/legs 25.37 70.00 $1,775.90 15574 Pedcle fh/ch/ch/m/n/ax/g/h/f 25.99 70.00 $1,819.30 15576 Pedicle e/n/e/l/ntroral 22.97 70.00 $1,607.90 15600 Delay flap trunk 9.14 70.00 $639.80 15610 Delay flap arms/legs 10.12 70.00 $708.40 15620 Delay flap f/c/c/n/ax/g/h/f 12.42 70.00 $869.40 15630 Delay flap eye/nos/ear/lip 13.05 70.00 $913.50 15650 Transfer skin pedicle flap 14.38 70.00 $1,006.60 15731 Forehead flap w/vasc pedicle 32.10 70.00 $2,247.00 15732 Muscle-skin graft head/neck 36.59 70.00 $2,561.30 15734 Muscle-skin graft trunk 42.95 70.00 $3,006.50 15736 Muscle-skin graft arm 37.69 70.00 $2,638.30 15738 Muscle-skin graft leg 40.00 70.00 $2,800.00 15740 Island pedicle flap graft 29.03 70.00 $2,032.10 15750 Neurovascular pedicle flap 26.37 70.00 $1,845.90 15756 Free myo/skin flap microvasc 66.81 70.00 $4,676.70 15757 Free skin flap microvasc 65.88 70.00 $4,611.60 15758 Free fascial flap microvasc 66.07 70.00 $4,624.90 15760 Composite skin graft 24.31 70.00 $1,701.70 15770 Derma-fat-fascia graft 19.19 70.00 $1,343.30 15775 Hair trnspl 1-15 punch grfts 8.56 70.00 $599.20 15776 Hair trnspl >15 punch grafts 13.86 70.00 $970.20 15777 Acellular derm matrix implt 6.23 70.00 $436.10 15780 Dermabrasion total face 24.52 70.00 $1,716.40 15781 Dermabrasion segmental face 15.78 70.00 $1,104.60 15782 Dermabrasion other than face 18.12 70.00 $1,268.40 15783 Dermabrasion suprfl any site 13.58 70.00 $950.60 15786 Abrasion lesion single 6.96 70.00 $487.20 15787 Abrasion lesions add-on 1.40 70.00 $98.00 15788 Chemical peel face epiderm 13.03 70.00 $912.10 15789 Chemical peel face dermal 15.84 70.00 $1,108.80 15792 Chemical peel nonfacial 12.39 70.00 $867.30 15793 Chemical peel nonfacial 14.06 70.00 $984.20 15819 Plastic surgery neck 22.75 70.00 $1,592.50 15820 Revision of lower eyelid 16.61 70.00 $1,162.70 15821 Revision of lower eyelid 17.21 70.00 $1,204.70 15822 Revision of upper eyelid 12.64 70.00 $884.80 15823 Revision of upper eyelid 17.21 70.00 $1,204.70 15824 Removal of forehead wrinkles 0.00 70.00 $0.00 15825 Removal of neck wrinkles 0.00 70.00 $0.00 15826 Removal of brow wrinkles 0.00 70.00 $0.00 15828 Removal of face wrinkles 0.00 70.00 $0.00 15829 Removal of skin wrinkles 0.00 70.00 $0.00 15830 Exc skin abd 33.77 70.00 $2,363.90 15832 Excise excessive skin thigh 26.28 70.00 $1,839.60 15833 Excise excessive skin leg 24.54 70.00 $1,717.80 15834 Excise excessive skin hip 25.49 70.00 $1,784.30 15835 Excise excessive skin buttck 26.24 70.00 $1,836.80 15836 Excise excessive skin arm 22.62 70.00 $1,583.40 15837 Excise excess skin arm/hand 24.37 70.00 $1,705.90 15838 Excise excess skin fat pad 16.30 70.00 $1,141.00 15839 Excise excess skin & tissue 25.15 70.00 $1,760.50 15840 Nerve palsy fascial graft 28.84 70.00 $2,018.80 15841 Nerve palsy muscle graft 45.72 70.00 $3,200.40 15842 Nerve palsy microsurg graft 70.13 70.00 $4,909.10 15845 Skin and muscle repair face 28.59 70.00 $2,001.30 15847 Exc skin abd add-on 0.00 70.00 $0.00 15850 Remove sutures same surgeon 2.51 70.00 $175.70 15851 Remove sutures diff surgeon 2.80 70.00 $196.00 15852 Dressing change not for burn 1.35 70.00 $94.50 15860 Test for blood flow in graft 3.17 70.00 $221.90 15876 Suction lipectomy head&neck 0.00 70.00 $0.00 15877 Suction lipectomy trunk 0.00 70.00 $0.00 15878 Suction lipectomy upr extrem 0.00 70.00 $0.00 15879 Suction lipectomy lwr extrem 0.00 70.00 $0.00 15920 Removal of tail bone ulcer 17.81 70.00 $1,246.70 15922 Removal of tail bone ulcer 22.44 70.00 $1,570.80 15931 Remove sacrum pressure sore 19.75 70.00 $1,382.50 15933 Remove sacrum pressure sore 24.26 70.00 $1,698.20 15934 Remove sacrum pressure sore 26.78 70.00 $1,874.60 15935 Remove sacrum pressure sore 31.69 70.00 $2,218.30 15936 Remove sacrum pressure sore 25.58 70.00 $1,790.60 15937 Remove sacrum pressure sore 29.63 70.00 $2,074.10 15940 Remove hip pressure sore 20.09 70.00 $1,406.30 15941 Remove hip pressure sore 25.77 70.00 $1,803.90 15944 Remove hip pressure sore 25.53 70.00 $1,787.10 15945 Remove hip pressure sore 28.20 70.00 $1,974.00 15946 Remove hip pressure sore 47.00 70.00 $3,290.00 15950 Remove thigh pressure sore 16.98 70.00 $1,188.60 15951 Remove thigh pressure sore 24.92 70.00 $1,744.40 15952 Remove thigh pressure sore 25.78 70.00 $1,804.60 15953 Remove thigh pressure sore 28.57 70.00 $1,999.90 15956 Remove thigh pressure sore 33.00 70.00 $2,310.00 15958 Remove thigh pressure sore 33.67 70.00 $2,356.90 15999 Removal of pressure sore 0.00 70.00 $0.00 16000 Initial treatment of burn(s) 1.96 70.00 $137.20 16020 Dress/debrid p-thick burn s 2.32 70.00 $162.40 16025 Dress/debrid p-thick burn m 4.19 70.00 $293.30 16030 Dress/debrid p-thick burn l 5.28 70.00 $369.60 16035 Incision of burn scab initi 5.60 70.00 $392.00 16036 Escharotomy addl incision 2.35 70.00 $164.50 17000 Destruct premalg lesion 1.89 70.00 $132.30 17003 Destruct premalg les 2-14 0.16 70.00 $11.20 17004 Destroy premal lesions 15/> 4.26 70.00 $298.20 17106 Destruction of skin lesions 9.75 70.00 $682.50 17107 Destruction of skin lesions 12.31 70.00 $861.70 17108 Destruction of skin lesions 18.32 70.00 $1,282.40 17110 Destruct b9 lesion 1-14 3.14 70.00 $219.80 17111 Destruct lesion 15 or more 3.73 70.00 $261.10 17250 Chemical cautery tissue 2.24 70.00 $156.80 17260 Destruction of skin lesions 2.69 70.00 $188.30 17261 Destruction of skin lesions 4.06 70.00 $284.20 17262 Destruction of skin lesions 4.96 70.00 $347.20 17263 Destruction of skin lesions 5.42 70.00 $379.40 17264 Destruction of skin lesions 5.79 70.00 $405.30 17266 Destruction of skin lesions 6.60 70.00 $462.00 17270 Destruction of skin lesions 4.27 70.00 $298.90 17271 Destruction of skin lesions 4.63 70.00 $324.10 17272 Destruction of skin lesions 5.28 70.00 $369.60 17273 Destruction of skin lesions 5.90 70.00 $413.00 17274 Destruction of skin lesions 6.98 70.00 $488.60 17276 Destruction of skin lesions 8.06 70.00 $564.20 17280 Destruction of skin lesions 4.00 70.00 $280.00 17281 Destruction of skin lesions 5.05 70.00 $353.50 17282 Destruction of skin lesions 5.80 70.00 $406.00 17283 Destruction of skin lesions 6.95 70.00 $486.50 17284 Destruction of skin lesions 7.94 70.00 $555.80 17286 Destruction of skin lesions 10.18 70.00 $712.60 17311 Mohs 1 stage h/n/hf/g 18.79 70.00 $1,315.30 17312 Mohs addl stage 11.04 70.00 $772.80 17313 Mohs 1 stage t/a/l 17.56 70.00 $1,229.20 17314 Mohs addl stage t/a/l 10.59 70.00 $741.30 17315 Mohs surg addl block 2.28 70.00 $159.60 17340 Cryotherapy of skin 1.47 70.00 $102.90 17360 Skin peel therapy 3.65 70.00 $255.50 17380 Hair removal by electrolysis 0.00 70.00 $0.00 17999 Skin tissue procedure 0.00 70.00 $0.00 19000 Drainage of breast lesion 3.20 70.00 $224.00 19001 Drain breast lesion add-on 0.77 70.00 $53.90 19020 Incision of breast lesion 13.44 70.00 $940.80 19030 Injection for breast x-ray 4.69 70.00 $328.30 19081 Bx breast 1st lesion strtctc 19.64 70.00 $1,374.80 19082 Bx breast add lesion strtctc 16.21 70.00 $1,134.70 19083 Bx breast 1st lesion us imag 19.05 70.00 $1,333.50 19084 Bx breast add lesion us imag 15.58 70.00 $1,090.60 19085 Bx breast 1st lesion mr imag 28.94 70.00 $2,025.80 19086 Bx breast add lesion mr imag 23.15 70.00 $1,620.50 19100 Bx breast percut w/o image 4.28 70.00 $299.60 19101 Biopsy of breast open 9.70 70.00 $679.00 19105 Cryosurg ablate fa each 66.54 70.00 $4,657.80 19110 Nipple exploration 13.81 70.00 $966.70 19112 Excise breast duct fistula 13.08 70.00 $915.60 19120 Removal of breast lesion 14.09 70.00 $986.30 19125 Excision breast lesion 15.62 70.00 $1,093.40 19126 Excision addl breast lesion 4.68 70.00 $327.60 19260 Removal of chest wall lesion 34.62 70.00 $2,423.40 19271 Revision of chest wall 46.78 70.00 $3,274.60 19272 Extensive chest wall surgery 51.20 70.00 $3,584.00 19281 Perq device breast 1st imag 6.82 70.00 $477.40 19282 Perq device breast ea imag 4.73 70.00 $331.10 19283 Perq dev breast 1st strtctc 7.70 70.00 $539.00 19284 Perq dev breast add strtctc 5.79 70.00 $405.30 19285 Perq dev breast 1st us imag 14.67 70.00 $1,026.90 19286 Perq dev breast add us imag 12.79 70.00 $895.30 19287 Perq dev breast 1st mr guide 24.55 70.00 $1,718.50 19288 Perq dev breast add mr guide 19.75 70.00 $1,382.50 19296 Place po breast cath for rad 111.95 70.00 $7,836.50 19297 Place breast cath for rad 2.75 70.00 $192.50 19298 Place breast rad tube/caths 27.82 70.00 $1,947.40 19300 Removal of breast tissue 14.92 70.00 $1,044.40 19301 Partial mastectomy 18.77 70.00 $1,313.90 19302 P-mastectomy w/ln removal 25.90 70.00 $1,813.00 19303 Mast simple complete 29.09 70.00 $2,036.30 19304 Mast subq 16.57 70.00 $1,159.90 19305 Mast radical 32.52 70.00 $2,276.40 19306 Mast rad urban type 34.14 70.00 $2,389.80 19307 Mast mod rad 34.44 70.00 $2,410.80 19316 Suspension of breast 22.16 70.00 $1,551.20 19318 Reduction of large breast 31.73 70.00 $2,221.10 19324 Enlarge breast 14.20 70.00 $994.00 19325 Enlarge breast with implant 18.45 70.00 $1,291.50 19328 Removal of breast implant 14.22 70.00 $995.40 19330 Removal of implant material 18.21 70.00 $1,274.70 19340 Immediate breast prosthesis 28.87 70.00 $2,020.90 19342 Delayed breast prosthesis 26.52 70.00 $1,856.40 19350 Breast reconstruction 23.53 70.00 $1,647.10 19355 Correct inverted nipple(s) 19.93 70.00 $1,395.10 19357 Breast reconstruction 43.27 70.00 $3,028.90 19361 Breast reconstr w/lat flap 45.39 70.00 $3,177.30 19364 Breast reconstruction 79.46 70.00 $5,562.20 19366 Breast reconstruction 40.65 70.00 $2,845.50 19367 Breast reconstruction 51.52 70.00 $3,606.40 19368 Breast reconstruction 63.50 70.00 $4,445.00 19369 Breast reconstruction 58.42 70.00 $4,089.40 19370 Surgery of breast capsule 19.72 70.00 $1,380.40 19371 Removal of breast capsule 22.54 70.00 $1,577.80 19380 Revise breast reconstruction 22.24 70.00 $1,556.80 19396 Design custom breast implant 8.32 70.00 $582.40 19499 Breast surgery procedure 0.00 70.00 $0.00 2000F Blood pressure measure 0.00 70.00 $0.00 20005 I&d abscess subfascial 8.88 70.00 $621.60 2001F Weight record 0.00 70.00 $0.00 2002F Clin sign vol ovrld assess 0.00 70.00 $0.00 2004F Initial exam involved joints 0.00 70.00 $0.00 2010F Vital signs recorded 0.00 70.00 $0.00 20100 Explore wound neck 17.51 70.00 $1,225.70 20101 Explore wound chest 12.70 70.00 $889.00 20102 Explore wound abdomen 13.85 70.00 $969.50 20103 Explore wound extremity 16.60 70.00 $1,162.00 2014F Mental status assess 0.00 70.00 $0.00 2015F Asthma impairment assessed 0.00 70.00 $0.00 20150 Excise epiphyseal bar 27.19 70.00 $1,903.30 2016F Asthma risk assessed 0.00 70.00 $0.00 2018F Hydration status assess 0.00 70.00 $0.00 2019F Dilated macul exam done 0.00 70.00 $0.00 2020F Dilated fundus eval done 0.00 70.00 $0.00 20200 Muscle biopsy 5.90 70.00 $413.00 20205 Deep muscle biopsy 8.24 70.00 $576.80 20206 Needle biopsy muscle 6.68 70.00 $467.60 2021F Dilat macular exam done 0.00 70.00 $0.00 2022F Dil retina exam interp rev 0.00 70.00 $0.00 20220 Bone biopsy trocar/needle 4.77 70.00 $333.90 20225 Bone biopsy trocar/needle 14.81 70.00 $1,036.70 2024F 7 field photo interp doc rev 0.00 70.00 $0.00 20240 Bone biopsy open superficial 4.41 70.00 $308.70 20245 Bone biopsy open deep 10.21 70.00 $714.70 20250 Open bone biopsy 11.20 70.00 $784.00 20251 Open bone biopsy 12.26 70.00 $858.20 2026F Eye image valid to dx rev 0.00 70.00 $0.00 2027F Optic nerve head eval done 0.00 70.00 $0.00 2028F Foot exam performed 0.00 70.00 $0.00 2029F Complete phys skin exam done 0.00 70.00 $0.00 2030F H2o stat docd normal 0.00 70.00 $0.00 2031F H2o stat docd dehydrated 0.00 70.00 $0.00 2035F Tymp memb motion examd 0.00 70.00 $0.00 2040F Bk pn xm on init visit date 0.00 70.00 $0.00 2044F Doc mntl tst b/4 bk trxmnt 0.00 70.00 $0.00 2050F Wound char size etc docd 0.00 70.00 $0.00 20500 Injection of sinus tract 2.93 70.00 $205.10 20501 Inject sinus tract for x-ray 3.35 70.00 $234.50 20520 Removal of foreign body 5.80 70.00 $406.00 20525 Removal of foreign body 13.61 70.00 $952.70 20526 Ther injection carp tunnel 2.20 70.00 $154.00 20527 Inj dupuytren cord w/enzyme 2.40 70.00 $168.00 20550 Inj tendon sheath/ligament 1.50 70.00 $105.00 20551 Inj tendon origin/insertion 1.72 70.00 $120.40 20552 Inj trigger point 1/2 muscl 1.57 70.00 $109.90 20553 Inject trigger points 3/> 1.81 70.00 $126.70 20555 Place ndl musc/tis for rt 9.40 70.00 $658.00 2060F Pt talk eval hlthwkr re mdd 0.00 70.00 $0.00 20600 Drain/inj joint/bursa w/o us 1.36 70.00 $95.20 20604 Drain/inj joint/bursa w/us 2.06 70.00 $144.20 20605 Drain/inj joint/bursa w/o us 1.43 70.00 $100.10 20606 Drain/inj joint/bursa w/us 2.28 70.00 $159.60 20610 Drain/inj joint/bursa w/o us 1.72 70.00 $120.40 20611 Drain/inj joint/bursa w/us 2.59 70.00 $181.30 20612 Aspirate/inj ganglion cyst 1.72 70.00 $120.40 20615 Treatment of bone cyst 6.87 70.00 $480.90 20650 Insert and remove bone pin 5.95 70.00 $416.50 20660 Apply rem fixation device 7.14 70.00 $499.80 20661 Application of head brace 14.55 70.00 $1,018.50 20662 Application of pelvis brace 12.47 70.00 $872.90 20663 Application of thigh brace 13.02 70.00 $911.40 20664 Application of halo 25.34 70.00 $1,773.80 20665 Removal of fixation device 3.02 70.00 $211.40 20670 Removal of support implant 10.78 70.00 $754.60 20680 Removal of support implant 17.62 70.00 $1,233.40 20690 Apply bone fixation device 17.12 70.00 $1,198.40 20692 Apply bone fixation device 32.19 70.00 $2,253.30 20693 Adjust bone fixation device 12.75 70.00 $892.50 20694 Remove bone fixation device 12.12 70.00 $848.40 20696 Comp multiplane ext fixation 34.77 70.00 $2,433.90 20697 Comp ext fixate strut change 59.73 70.00 $4,181.10 20802 Replantation arm complete 79.74 70.00 $5,581.80 20805 Replant forearm complete 90.14 70.00 $6,309.80 20808 Replantation hand complete 115.33 70.00 $8,073.10 20816 Replantation digit complete 60.77 70.00 $4,253.90 20822 Replantation digit complete 51.65 70.00 $3,615.50 20824 Replantation thumb complete 56.32 70.00 $3,942.40 20827 Replantation thumb complete 52.96 70.00 $3,707.20 20838 Replantation foot complete 77.70 70.00 $5,439.00 20900 Removal of bone for graft 11.86 70.00 $830.20 20902 Removal of bone for graft 8.24 70.00 $576.80 20910 Remove cartilage for graft 12.98 70.00 $908.60 20912 Remove cartilage for graft 13.68 70.00 $957.60 20920 Removal of fascia for graft 11.32 70.00 $792.40 20922 Removal of fascia for graft 16.88 70.00 $1,181.60 20924 Removal of tendon for graft 14.57 70.00 $1,019.90 20926 Removal of tissue for graft 12.15 70.00 $850.50 20930 Sp bone algrft morsel add-on 0.00 70.00 $0.00 20931 Sp bone algrft struct add-on 3.29 70.00 $230.30 20936 Sp bone agrft local add-on 0.00 70.00 $0.00 20937 Sp bone agrft morsel add-on 4.90 70.00 $343.00 20938 Sp bone agrft struct add-on 5.42 70.00 $379.40 20950 Fluid pressure muscle 7.15 70.00 $500.50 20955 Fibula bone graft microvasc 72.24 70.00 $5,056.80 20956 Iliac bone graft microvasc 76.71 70.00 $5,369.70 20957 Mt bone graft microvasc 65.50 70.00 $4,585.00 20962 Other bone graft microvasc 62.02 70.00 $4,341.40 20969 Bone/skin graft microvasc 79.63 70.00 $5,574.10 20970 Bone/skin graft iliac crest 83.05 70.00 $5,813.50 20972 Bone/skin graft metatarsal 69.59 70.00 $4,871.30 20973 Bone/skin graft great toe 71.36 70.00 $4,995.20 20974 Electrical bone stimulation 2.20 70.00 $154.00 20975 Electrical bone stimulation 5.16 70.00 $361.20 20979 Us bone stimulation 1.48 70.00 $103.60 20982 Ablate bone tumor(s) perq 48.38 70.00 $3,386.60 20983 Ablate bone tumor(s) perq 178.44 70.00 $12,490.80 20985 Cptr-asst dir ms px 4.26 70.00 $298.20 20999 Musculoskeletal surgery 0.00 70.00 $0.00 21010 Incision of jaw joint 21.78 70.00 $1,524.60 21011 Exc face les sc <2 cm 9.93 70.00 $695.10 21012 Exc face les sbq 2 cm/> 9.75 70.00 $682.50 21013 Exc face tum deep < 2 cm 14.82 70.00 $1,037.40 21014 Exc face tum deep 2 cm/> 15.00 70.00 $1,050.00 21015 Resect face/scalp tum < 2 cm 20.35 70.00 $1,424.50 21016 Resect face/scalp tum 2 cm/> 29.38 70.00 $2,056.60 21025 Excision of bone lower jaw 25.67 70.00 $1,796.90 21026 Excision of facial bone(s) 17.80 70.00 $1,246.00 21029 Contour of face bone lesion 22.10 70.00 $1,547.00 21030 Excise max/zygoma b9 tumor 14.96 70.00 $1,047.20 21031 Remove exostosis mandible 11.40 70.00 $798.00 21032 Remove exostosis maxilla 11.53 70.00 $807.10 21034 Excise max/zygoma mal tumor 37.88 70.00 $2,651.60 21040 Excise mandible lesion 15.06 70.00 $1,054.20 21044 Removal of jaw bone lesion 25.24 70.00 $1,766.80 21045 Extensive jaw surgery 35.34 70.00 $2,473.80 21046 Remove mandible cyst complex 32.36 70.00 $2,265.20 21047 Excise lwr jaw cyst w/repair 38.04 70.00 $2,662.80 21048 Remove maxilla cyst complex 33.20 70.00 $2,324.00 21049 Excis uppr jaw cyst w/repair 34.78 70.00 $2,434.60 21050 Removal of jaw joint 24.02 70.00 $1,681.40 21060 Remove jaw joint cartilage 23.13 70.00 $1,619.10 21070 Remove coronoid process 17.51 70.00 $1,225.70 21073 Mnpj of tmj w/anesth 11.45 70.00 $801.50 21076 Prepare face/oral prosthesis 28.68 70.00 $2,007.60 21077 Prepare face/oral prosthesis 72.43 70.00 $5,070.10 21079 Prepare face/oral prosthesis 48.80 70.00 $3,416.00 21080 Prepare face/oral prosthesis 54.81 70.00 $3,836.70 21081 Prepare face/oral prosthesis 50.55 70.00 $3,538.50 21082 Prepare face/oral prosthesis 47.66 70.00 $3,336.20 21083 Prepare face/oral prosthesis 45.48 70.00 $3,183.60 21084 Prepare face/oral prosthesis 52.14 70.00 $3,649.80 21085 Prepare face/oral prosthesis 21.87 70.00 $1,530.90 21086 Prepare face/oral prosthesis 53.82 70.00 $3,767.40 21087 Prepare face/oral prosthesis 53.54 70.00 $3,747.80 21088 Prepare face/oral prosthesis 0.00 70.00 $0.00 21089 Prepare face/oral prosthesis 0.00 70.00 $0.00 21100 Maxillofacial fixation 23.90 70.00 $1,673.00 21110 Interdental fixation 23.15 70.00 $1,620.50 21116 Injection jaw joint x-ray 4.19 70.00 $293.30 21120 Reconstruction of chin 17.21 70.00 $1,204.70 21121 Reconstruction of chin 23.19 70.00 $1,623.30 21122 Reconstruction of chin 19.00 70.00 $1,330.00 21123 Reconstruction of chin 26.07 70.00 $1,824.90 21125 Augmentation lower jaw bone 91.51 70.00 $6,405.70 21127 Augmentation lower jaw bone 125.23 70.00 $8,766.10 21137 Reduction of forehead 20.00 70.00 $1,400.00 21138 Reduction of forehead 26.49 70.00 $1,854.30 21139 Reduction of forehead 31.21 70.00 $2,184.70 21141 Lefort i-1 piece w/o graft 39.24 70.00 $2,746.80 21142 Lefort i-2 piece w/o graft 41.59 70.00 $2,911.30 21143 Lefort i-3/> piece w/o graft 42.32 70.00 $2,962.40 21145 Lefort i-1 piece w/ graft 46.24 70.00 $3,236.80 21146 Lefort i-2 piece w/ graft 48.17 70.00 $3,371.90 21147 Lefort i-3/> piece w/ graft 48.53 70.00 $3,397.10 21150 Lefort ii anterior intrusion 50.14 70.00 $3,509.80 21151 Lefort ii w/bone grafts 58.12 70.00 $4,068.40 21154 Lefort iii w/o lefort i 54.35 70.00 $3,804.50 21155 Lefort iii w/ lefort i 60.31 70.00 $4,221.70 21159 Lefort iii w/fhdw/o lefort i 75.73 70.00 $5,301.10 21160 Lefort iii w/fhd w/ lefort i 78.49 70.00 $5,494.30 21172 Reconstruct orbit/forehead 59.50 70.00 $4,165.00 21175 Reconstruct orbit/forehead 60.89 70.00 $4,262.30 21179 Reconstruct entire forehead 39.33 70.00 $2,753.10 21180 Reconstruct entire forehead 45.86 70.00 $3,210.20 21181 Contour cranial bone lesion 21.32 70.00 $1,492.40 21182 Reconstruct cranial bone 57.06 70.00 $3,994.20 21183 Reconstruct cranial bone 64.31 70.00 $4,501.70 21184 Reconstruct cranial bone 78.72 70.00 $5,510.40 21188 Reconstruction of midface 47.07 70.00 $3,294.90 21193 Reconst lwr jaw w/o graft 34.03 70.00 $2,382.10 21194 Reconst lwr jaw w/graft 42.73 70.00 $2,991.10 21195 Reconst lwr jaw w/o fixation 38.05 70.00 $2,663.50 21196 Reconst lwr jaw w/fixation 42.93 70.00 $3,005.10 21198 Reconstr lwr jaw segment 33.77 70.00 $2,363.90 21199 Reconstr lwr jaw w/advance 29.17 70.00 $2,041.90 21206 Reconstruct upper jaw bone 35.18 70.00 $2,462.60 21208 Augmentation of facial bones 52.89 70.00 $3,702.30 21209 Reduction of facial bones 23.36 70.00 $1,635.20 21210 Face bone graft 65.20 70.00 $4,564.00 21215 Lower jaw bone graft 114.90 70.00 $8,043.00 21230 Rib cartilage graft 21.46 70.00 $1,502.20 21235 Ear cartilage graft 20.74 70.00 $1,451.80 21240 Reconstruction of jaw joint 32.43 70.00 $2,270.10 21242 Reconstruction of jaw joint 29.84 70.00 $2,088.80 21243 Reconstruction of jaw joint 49.52 70.00 $3,466.40 21244 Reconstruction of lower jaw 30.70 70.00 $2,149.00 21245 Reconstruction of jaw 31.63 70.00 $2,214.10 21246 Reconstruction of jaw 25.53 70.00 $1,787.10 21247 Reconstruct lower jaw bone 44.24 70.00 $3,096.80 21248 Reconstruction of jaw 32.04 70.00 $2,242.80 21249 Reconstruction of jaw 43.67 70.00 $3,056.90 21255 Reconstruct lower jaw bone 39.97 70.00 $2,797.90 21256 Reconstruction of orbit 34.64 70.00 $2,424.80 21260 Revise eye sockets 35.98 70.00 $2,518.60 21261 Revise eye sockets 60.82 70.00 $4,257.40 21263 Revise eye sockets 56.17 70.00 $3,931.90 21267 Revise eye sockets 45.60 70.00 $3,192.00 21268 Revise eye sockets 50.19 70.00 $3,513.30 21270 Augmentation cheek bone 27.75 70.00 $1,942.50 21275 Revision orbitofacial bones 24.15 70.00 $1,690.50 21280 Revision of eyelid 16.26 70.00 $1,138.20 21282 Revision of eyelid 10.87 70.00 $760.90 21295 Revision of jaw muscle/bone 5.33 70.00 $373.10 21296 Revision of jaw muscle/bone 12.75 70.00 $892.50 21299 Cranio/maxillofacial surgery 0.00 70.00 $0.00 21310 Closed tx nose fx w/o manj 3.77 70.00 $263.90 21315 Closed tx nose fx w/o stablj 7.86 70.00 $550.20 21320 Closed tx nose fx w/ stablj 7.29 70.00 $510.30 21325 Open tx nose fx uncomplicatd 13.57 70.00 $949.90 21330 Open tx nose fx w/skele fixj 16.41 70.00 $1,148.70 21335 Open tx nose & septal fx 20.74 70.00 $1,451.80 21336 Open tx septal fx w/wo stabj 18.49 70.00 $1,294.30 21337 Closed tx septal&nose fx 11.54 70.00 $807.80 21338 Open nasoethmoid fx w/o fixj 21.59 70.00 $1,511.30 21339 Open nasoethmoid fx w/ fixj 24.33 70.00 $1,703.10 21340 Perq tx nasoethmoid fx 23.02 70.00 $1,611.40 21343 Open tx dprsd front sinus fx 34.98 70.00 $2,448.60 21344 Open tx compl front sinus fx 40.03 70.00 $2,802.10 21345 Closed tx nose/jaw fx 23.08 70.00 $1,615.60 21346 Opn tx nasomax fx w/fixj 26.02 70.00 $1,821.40 21347 Opn tx nasomax fx multple 32.75 70.00 $2,292.50 21348 Opn tx nasomax fx w/graft 34.62 70.00 $2,423.40 21355 Perq tx malar fracture 12.88 70.00 $901.60 21356 Opn tx dprsd zygomatic arch 14.37 70.00 $1,005.90 21360 Opn tx dprsd malar fracture 15.53 70.00 $1,087.10 21365 Opn tx complx malar fx 32.06 70.00 $2,244.20 21366 Opn tx complx malar w/grft 32.60 70.00 $2,282.00 21385 Opn tx orbit fx transantral 19.46 70.00 $1,362.20 21386 Opn tx orbit fx periorbital 19.99 70.00 $1,399.30 21387 Opn tx orbit fx combined 20.35 70.00 $1,424.50 21390 Opn tx orbit periorbtl implt 22.85 70.00 $1,599.50 21395 Opn tx orbit periorbt w/grft 29.13 70.00 $2,039.10 21400 Closed tx orbit w/o manipulj 5.50 70.00 $385.00 21401 Closed tx orbit w/manipulj 13.91 70.00 $973.70 21406 Opn tx orbit fx w/o implant 16.43 70.00 $1,150.10 21407 Opn tx orbit fx w/implant 18.57 70.00 $1,299.90 21408 Opn tx orbit fx w/bone grft 25.70 70.00 $1,799.00 21421 Treat mouth roof fracture 24.29 70.00 $1,700.30 21422 Treat mouth roof fracture 19.50 70.00 $1,365.00 21423 Treat mouth roof fracture 22.75 70.00 $1,592.50 21431 Treat craniofacial fracture 21.12 70.00 $1,478.40 21432 Treat craniofacial fracture 19.59 70.00 $1,371.30 21433 Treat craniofacial fracture 50.13 70.00 $3,509.10 21435 Treat craniofacial fracture 36.60 70.00 $2,562.00 21436 Treat craniofacial fracture 54.74 70.00 $3,831.80 21440 Treat dental ridge fracture 16.63 70.00 $1,164.10 21445 Treat dental ridge fracture 22.09 70.00 $1,546.30 21450 Treat lower jaw fracture 17.76 70.00 $1,243.20 21451 Treat lower jaw fracture 23.62 70.00 $1,653.40 21452 Treat lower jaw fracture 16.38 70.00 $1,146.60 21453 Treat lower jaw fracture 26.24 70.00 $1,836.80 21454 Treat lower jaw fracture 16.64 70.00 $1,164.80 21461 Treat lower jaw fracture 61.33 70.00 $4,293.10 21462 Treat lower jaw fracture 65.21 70.00 $4,564.70 21465 Treat lower jaw fracture 27.13 70.00 $1,899.10 21470 Treat lower jaw fracture 34.84 70.00 $2,438.80 21480 Reset dislocated jaw 2.81 70.00 $196.70 21485 Reset dislocated jaw 20.08 70.00 $1,405.60 21490 Repair dislocated jaw 26.48 70.00 $1,853.60 21497 Interdental wiring 21.28 70.00 $1,489.60 21499 Head surgery procedure 0.00 70.00 $0.00 21501 Drain neck/chest lesion 12.91 70.00 $903.70 21502 Drain chest lesion 14.61 70.00 $1,022.70 21510 Drainage of bone lesion 12.86 70.00 $900.20 21550 Biopsy of neck/chest 7.49 70.00 $524.30 21552 Exc neck les sc 3 cm/> 12.85 70.00 $899.50 21554 Exc neck tum deep 5 cm/> 21.07 70.00 $1,474.90 21555 Exc neck les sc < 3 cm 11.85 70.00 $829.50 21556 Exc neck tum deep < 5 cm 15.22 70.00 $1,065.40 21557 Resect neck thorax tumor<5cm 27.63 70.00 $1,934.10 21558 Resect neck tumor 5 cm/> 38.80 70.00 $2,716.00 21600 Partial removal of rib 15.99 70.00 $1,119.30 21610 Partial removal of rib 34.17 70.00 $2,391.90 21615 Removal of rib 17.99 70.00 $1,259.30 21616 Removal of rib and nerves 21.76 70.00 $1,523.20 21620 Partial removal of sternum 14.52 70.00 $1,016.40 21627 Sternal debridement 15.54 70.00 $1,087.80 21630 Extensive sternum surgery 35.01 70.00 $2,450.70 21632 Extensive sternum surgery 34.49 70.00 $2,414.30 21685 Hyoid myotomy & suspension 28.59 70.00 $2,001.30 21700 Revision of neck muscle 10.66 70.00 $746.20 21705 Revision of neck muscle/rib 15.93 70.00 $1,115.10 21720 Revision of neck muscle 14.27 70.00 $998.90 21725 Revision of neck muscle 15.53 70.00 $1,087.10 21740 Reconstruction of sternum 29.70 70.00 $2,079.00 21742 Repair stern/nuss w/o scope 0.00 70.00 $0.00 21743 Repair sternum/nuss w/scope 0.00 70.00 $0.00 21750 Repair of sternum separation 19.74 70.00 $1,381.80 21811 Optx of rib fx w/fixj scope 17.58 70.00 $1,230.60 21812 Treatment of rib fracture 21.09 70.00 $1,476.30 21813 Treatment of rib fracture 27.77 70.00 $1,943.90 21820 Treat sternum fracture 4.00 70.00 $280.00 21825 Treat sternum fracture 15.54 70.00 $1,087.80 21899 Neck/chest surgery procedure 0.00 70.00 $0.00 21920 Biopsy soft tissue of back 7.34 70.00 $513.80 21925 Biopsy soft tissue of back 12.85 70.00 $899.50 21930 Exc back les sc < 3 cm 13.52 70.00 $946.40 21931 Exc back les sc 3 cm/> 13.55 70.00 $948.50 21932 Exc back tum deep < 5 cm 19.09 70.00 $1,336.30 21933 Exc back tum deep 5 cm/> 21.29 70.00 $1,490.30 21935 Resect back tum < 5 cm 29.71 70.00 $2,079.70 21936 Resect back tum 5 cm/> 40.81 70.00 $2,856.70 22010 I&d p-spine c/t/cerv-thor 27.56 70.00 $1,929.20 22015 I&d abscess p-spine l/s/ls 27.14 70.00 $1,899.80 22100 Remove part of neck vertebra 26.63 70.00 $1,864.10 22101 Remove part thorax vertebra 24.59 70.00 $1,721.30 22102 Remove part lumbar vertebra 22.54 70.00 $1,577.80 22103 Remove extra spine segment 4.08 70.00 $285.60 22110 Remove part of neck vertebra 30.25 70.00 $2,117.50 22112 Remove part thorax vertebra 31.93 70.00 $2,235.10 22114 Remove part lumbar vertebra 28.57 70.00 $1,999.90 22116 Remove extra spine segment 4.12 70.00 $288.40 22206 Incis spine 3 column thorac 71.17 70.00 $4,981.90 22207 Incis spine 3 column lumbar 69.79 70.00 $4,885.30 22208 Incis spine 3 column adl seg 17.01 70.00 $1,190.70 22210 Incis 1 vertebral seg cerv 51.91 70.00 $3,633.70 22212 Incis 1 vertebral seg thorac 43.06 70.00 $3,014.20 22214 Incis 1 vertebral seg lumbar 43.17 70.00 $3,021.90 22216 Incis addl spine segment 10.62 70.00 $743.40 22220 Incis w/discectomy cervical 46.38 70.00 $3,246.60 22222 Incis w/discectomy thoracic 43.45 70.00 $3,041.50 22224 Incis w/discectomy lumbar 45.86 70.00 $3,210.20 22226 Revise extra spine segment 10.57 70.00 $739.90 22310 Closed tx vert fx w/o manj 8.82 70.00 $617.40 22315 Closed tx vert fx w/manj 25.39 70.00 $1,777.30 22318 Treat odontoid fx w/o graft 47.79 70.00 $3,345.30 22319 Treat odontoid fx w/graft 53.30 70.00 $3,731.00 22325 Treat spine fracture 41.75 70.00 $2,922.50 22326 Treat neck spine fracture 43.34 70.00 $3,033.80 22327 Treat thorax spine fracture 43.59 70.00 $3,051.30 22328 Treat each add spine fx 8.27 70.00 $578.90 22505 Manipulation of spine 3.82 70.00 $267.40 22510 Perq cervicothoracic inject 47.77 70.00 $3,343.90 22511 Perq lumbosacral injection 47.33 70.00 $3,313.10 22512 Vertebroplasty addl inject 27.18 70.00 $1,902.60 22513 Perq vertebral augmentation 203.68 70.00 $14,257.60 22514 Perq vertebral augmentation 202.50 70.00 $14,175.00 22515 Perq vertebral augmentation 123.57 70.00 $8,649.90 22526 Idet single level 65.60 70.00 $4,592.00 22527 Idet 1 or more levels 55.39 70.00 $3,877.30 22532 Lat thorax spine fusion 51.61 70.00 $3,612.70 22533 Lat lumbar spine fusion 48.13 70.00 $3,369.10 22534 Lat thor/lumb addl seg 10.54 70.00 $737.80 22548 Neck spine fusion 56.89 70.00 $3,982.30 22551 Neck spine fuse&remov bel c2 49.87 70.00 $3,490.90 22552 Addl neck spine fusion 11.68 70.00 $817.60 22554 Neck spine fusion 36.48 70.00 $2,553.60 22556 Thorax spine fusion 48.52 70.00 $3,396.40 22558 Lumbar spine fusion 44.64 70.00 $3,124.80 22585 Additional spinal fusion 9.61 70.00 $672.70 22586 Prescrl fuse w/ instr l5-s1 55.46 70.00 $3,882.20 22590 Spine & skull spinal fusion 46.03 70.00 $3,222.10 22595 Neck spinal fusion 43.91 70.00 $3,073.70 22600 Neck spine fusion 37.51 70.00 $2,625.70 22610 Thorax spine fusion 36.70 70.00 $2,569.00 22612 Lumbar spine fusion 46.14 70.00 $3,229.80 22614 Spine fusion extra segment 11.47 70.00 $802.90 22630 Lumbar spine fusion 45.76 70.00 $3,203.20 22632 Spine fusion extra segment 9.43 70.00 $660.10 22633 Lumbar spine fusion combined 53.96 70.00 $3,777.20 22634 Spine fusion extra segment 14.55 70.00 $1,018.50 22800 Post fusion vert seg 70.55 70.00 $4,938.50 22808 Ant fusion 2-3 vert seg 53.74 70.00 $3,761.80 22810 Ant fusion 4-7 vert seg 59.55 70.00 $4,168.50 22812 Ant fusion 8/> vert seg 63.62 70.00 $4,453.40 22818 Kyphectomy 1-2 segments 63.59 70.00 $4,451.30 22819 Kyphectomy 3 or more 79.42 70.00 $5,559.40 22830 Exploration of spinal fusion 23.59 70.00 $1,651.30 22840 Insert spine fixation device 22.26 70.00 $1,558.20 22841 Insert spine fixation device 0.00 70.00 $0.00 22842 Insert spine fixation device 22.35 70.00 $1,564.50 22843 Insert spine fixation device 23.91 70.00 $1,673.70 22844 Insert spine fixation device 28.85 70.00 $2,019.50 22845 Insert spine fixation device 21.42 70.00 $1,499.40 22846 Insert spine fixation device 22.24 70.00 $1,556.80 22847 Insert spine fixation device 24.33 70.00 $1,703.10 22848 Insert pelv fixation device 10.52 70.00 $736.40 22849 Reinsert spinal fixation 37.75 70.00 $2,642.50 22850 Remove spine fixation device 20.98 70.00 $1,468.60 22852 Remove spine fixation device 20.08 70.00 $1,405.60 22853 Insj biomechanical device 7.64 70.00 $534.80 22854 Insj biomechanical device 9.89 70.00 $692.30 22855 Remove spine fixation device 32.19 70.00 $2,253.30 22856 Cerv artific diskectomy 47.62 70.00 $3,333.40 22857 Lumbar artif diskectomy 51.43 70.00 $3,600.10 22858 Second level cer diskectomy 14.63 70.00 $1,024.10 22859 Insj biomechanical device 9.89 70.00 $692.30 22861 Revise cerv artific disc 57.01 70.00 $3,990.70 22862 Revise lumbar artif disc 61.76 70.00 $4,323.20 22864 Remove cerv artif disc 60.37 70.00 $4,225.90 22865 Remove lumb artif disc 59.03 70.00 $4,132.10 22867 Insj stablj dev w/dcmprn 28.55 70.00 $1,998.50 22868 Insj stablj dev w/dcmprn 7.14 70.00 $499.80 22869 Insj stablj dev w/o dcmprn 15.70 70.00 $1,099.00 22870 Insj stablj dev w/o dcmprn 4.16 70.00 $291.20 22899 Spine surgery procedure 0.00 70.00 $0.00 22900 Exc abdl tum deep < 5 cm 16.27 70.00 $1,138.90 22901 Exc abdl tum deep 5 cm/> 19.23 70.00 $1,346.10 22902 Exc abd les sc < 3 cm 12.53 70.00 $877.10 22903 Exc abd les sc 3 cm/> 12.65 70.00 $885.50 22904 Radical resect abd tumor<5cm 30.34 70.00 $2,123.80 22905 Rad resect abd tumor 5 cm/> 38.47 70.00 $2,692.90 22999 Abdomen surgery procedure 0.00 70.00 $0.00 23000 Removal of calcium deposits 16.56 70.00 $1,159.20 23020 Release shoulder joint 19.80 70.00 $1,386.00 23030 Drain shoulder lesion 12.63 70.00 $884.10 23031 Drain shoulder bursa 12.13 70.00 $849.10 23035 Drain shoulder bone lesion 19.52 70.00 $1,366.40 23040 Exploratory shoulder surgery 20.60 70.00 $1,442.00 23044 Exploratory shoulder surgery 16.30 70.00 $1,141.00 23065 Biopsy shoulder tissues 6.21 70.00 $434.70 23066 Biopsy shoulder tissues 15.92 70.00 $1,114.40 23071 Exc shoulder les sc 3 cm/> 12.08 70.00 $845.60 23073 Exc shoulder tum deep 5 cm/> 20.01 70.00 $1,400.70 23075 Exc shoulder les sc < 3 cm 13.39 70.00 $937.30 23076 Exc shoulder tum deep < 5 cm 15.52 70.00 $1,086.40 23077 Resect shoulder tumor < 5 cm 32.98 70.00 $2,308.60 23078 Resect shoulder tumor 5 cm/> 41.41 70.00 $2,898.70 23100 Biopsy of shoulder joint 14.32 70.00 $1,002.40 23101 Shoulder joint surgery 12.82 70.00 $897.40 23105 Remove shoulder joint lining 18.27 70.00 $1,278.90 23106 Incision of collarbone joint 13.80 70.00 $966.00 23107 Explore treat shoulder joint 18.99 70.00 $1,329.30 23120 Partial removal collar bone 16.76 70.00 $1,173.20 23125 Removal of collar bone 19.95 70.00 $1,396.50 23130 Remove shoulder bone part 17.49 70.00 $1,224.30 23140 Removal of bone lesion 15.47 70.00 $1,082.90 23145 Removal of bone lesion 19.71 70.00 $1,379.70 23146 Removal of bone lesion 17.67 70.00 $1,236.90 23150 Removal of humerus lesion 18.90 70.00 $1,323.00 23155 Removal of humerus lesion 22.69 70.00 $1,588.30 23156 Removal of humerus lesion 19.22 70.00 $1,345.40 23170 Remove collar bone lesion 16.09 70.00 $1,126.30 23172 Remove shoulder blade lesion 15.91 70.00 $1,113.70 23174 Remove humerus lesion 21.79 70.00 $1,525.30 23180 Remove collar bone lesion 19.00 70.00 $1,330.00 23182 Remove shoulder blade lesion 18.88 70.00 $1,321.60 23184 Remove humerus lesion 21.04 70.00 $1,472.80 23190 Partial removal of scapula 16.40 70.00 $1,148.00 23195 Removal of head of humerus 21.70 70.00 $1,519.00 23200 Resect clavicle tumor 43.54 70.00 $3,047.80 23210 Resect scapula tumor 50.95 70.00 $3,566.50 23220 Resect prox humerus tumor 56.16 70.00 $3,931.20 23330 Remove shoulder foreign body 7.05 70.00 $493.50 23333 Remove shoulder fb deep 12.95 70.00 $906.50 23334 Shoulder prosthesis removal 31.00 70.00 $2,170.00 23335 Shoulder prosthesis removal 36.90 70.00 $2,583.00 23350 Injection for shoulder x-ray 3.70 70.00 $259.00 23395 Muscle transfer shoulder/arm 36.88 70.00 $2,581.60 23397 Muscle transfers 32.88 70.00 $2,301.60 23400 Fixation of shoulder blade 27.14 70.00 $1,899.80 23405 Incision of tendon & muscle 17.88 70.00 $1,251.60 23406 Incise tendon(s) & muscle(s) 22.11 70.00 $1,547.70 23410 Repair rotator cuff acute 23.62 70.00 $1,653.40 23412 Repair rotator cuff chronic 24.48 70.00 $1,713.60 23415 Release of shoulder ligament 20.03 70.00 $1,402.10 23420 Repair of shoulder 27.86 70.00 $1,950.20 23430 Repair biceps tendon 21.41 70.00 $1,498.70 23440 Remove/transplant tendon 21.68 70.00 $1,517.60 23450 Repair shoulder capsule 27.32 70.00 $1,912.40 23455 Repair shoulder capsule 28.63 70.00 $2,004.10 23460 Repair shoulder capsule 31.29 70.00 $2,190.30 23462 Repair shoulder capsule 30.39 70.00 $2,127.30 23465 Repair shoulder capsule 31.98 70.00 $2,238.60 23466 Repair shoulder capsule 32.19 70.00 $2,253.30 23470 Reconstruct shoulder joint 34.60 70.00 $2,422.00 23472 Reconstruct shoulder joint 41.98 70.00 $2,938.60 23473 Revis reconst shoulder joint 46.88 70.00 $3,281.60 23474 Revis reconst shoulder joint 50.64 70.00 $3,544.80 23480 Revision of collar bone 23.57 70.00 $1,649.90 23485 Revision of collar bone 27.40 70.00 $1,918.00 23490 Reinforce clavicle 24.13 70.00 $1,689.10 23491 Reinforce shoulder bones 29.09 70.00 $2,036.30 23500 Treat clavicle fracture 6.21 70.00 $434.70 23505 Treat clavicle fracture 9.98 70.00 $698.60 23515 Treat clavicle fracture 20.69 70.00 $1,448.30 23520 Treat clavicle dislocation 6.51 70.00 $455.70 23525 Treat clavicle dislocation 10.61 70.00 $742.70 23530 Treat clavicle dislocation 16.37 70.00 $1,145.90 23532 Treat clavicle dislocation 17.79 70.00 $1,245.30 23540 Treat clavicle dislocation 6.37 70.00 $445.90 23545 Treat clavicle dislocation 9.57 70.00 $669.90 23550 Treat clavicle dislocation 16.07 70.00 $1,124.90 23552 Treat clavicle dislocation 18.80 70.00 $1,316.00 23570 Treat shoulder blade fx 6.60 70.00 $462.00 23575 Treat shoulder blade fx 11.35 70.00 $794.50 23585 Treat scapula fracture 28.19 70.00 $1,973.30 23600 Treat humerus fracture 9.28 70.00 $649.60 23605 Treat humerus fracture 13.19 70.00 $923.30 23615 Treat humerus fracture 25.42 70.00 $1,779.40 23616 Treat humerus fracture 35.76 70.00 $2,503.20 23620 Treat humerus fracture 7.65 70.00 $535.50 23625 Treat humerus fracture 10.75 70.00 $752.50 23630 Treat humerus fracture 22.40 70.00 $1,568.00 23650 Treat shoulder dislocation 8.92 70.00 $624.40 23655 Treat shoulder dislocation 11.47 70.00 $802.90 23660 Treat shoulder dislocation 16.68 70.00 $1,167.60 23665 Treat dislocation/fracture 12.12 70.00 $848.40 23670 Treat dislocation/fracture 25.16 70.00 $1,761.20 23675 Treat dislocation/fracture 15.65 70.00 $1,095.50 23680 Treat dislocation/fracture 26.62 70.00 $1,863.40 23700 Fixation of shoulder 5.63 70.00 $394.10 23800 Fusion of shoulder joint 29.25 70.00 $2,047.50 23802 Fusion of shoulder joint 36.81 70.00 $2,576.70 23900 Amputation of arm & girdle 40.02 70.00 $2,801.40 23920 Amputation at shoulder joint 31.75 70.00 $2,222.50 23921 Amputation follow-up surgery 13.35 70.00 $934.50 23929 Shoulder surgery procedure 0.00 70.00 $0.00 23930 Drainage of arm lesion 10.12 70.00 $708.40 23931 Drainage of arm bursa 8.17 70.00 $571.90 23935 Drain arm/elbow bone lesion 14.51 70.00 $1,015.70 24000 Exploratory elbow surgery 13.70 70.00 $959.00 24006 Release elbow joint 20.43 70.00 $1,430.10 24065 Biopsy arm/elbow soft tissue 7.31 70.00 $511.70 24066 Biopsy arm/elbow soft tissue 17.83 70.00 $1,248.10 24071 Exc arm/elbow les sc 3 cm/> 11.68 70.00 $817.60 24073 Ex arm/elbow tum deep 5 cm/> 19.95 70.00 $1,396.50 24075 Exc arm/elbow les sc < 3 cm 14.00 70.00 $980.00 24076 Ex arm/elbow tum deep < 5 cm 15.61 70.00 $1,092.70 24077 Resect arm/elbow tum < 5 cm 29.87 70.00 $2,090.90 24079 Resect arm/elbow tum 5 cm/> 38.33 70.00 $2,683.10 24100 Biopsy elbow joint lining 11.87 70.00 $830.90 24101 Explore/treat elbow joint 14.27 70.00 $998.90 24102 Remove elbow joint lining 17.68 70.00 $1,237.60 24105 Removal of elbow bursa 10.02 70.00 $701.40 24110 Remove humerus lesion 16.71 70.00 $1,169.70 24115 Remove/graft bone lesion 20.83 70.00 $1,458.10 24116 Remove/graft bone lesion 24.81 70.00 $1,736.70 24120 Remove elbow lesion 15.16 70.00 $1,061.20 24125 Remove/graft bone lesion 17.62 70.00 $1,233.40 24126 Remove/graft bone lesion 18.46 70.00 $1,292.20 24130 Removal of head of radius 14.55 70.00 $1,018.50 24134 Removal of arm bone lesion 21.48 70.00 $1,503.60 24136 Remove radius bone lesion 17.05 70.00 $1,193.50 24138 Remove elbow bone lesion 19.33 70.00 $1,353.10 24140 Partial removal of arm bone 20.19 70.00 $1,413.30 24145 Partial removal of radius 16.78 70.00 $1,174.60 24147 Partial removal of elbow 17.86 70.00 $1,250.20 24149 Radical resection of elbow 33.77 70.00 $2,363.90 24150 Resect distal humerus tumor 44.93 70.00 $3,145.10 24152 Resect radius tumor 38.53 70.00 $2,697.10 24155 Removal of elbow joint 24.56 70.00 $1,719.20 24160 Remove elbow joint implant 36.47 70.00 $2,552.90 24164 Remove radius head implant 20.99 70.00 $1,469.30 24200 Removal of arm foreign body 5.89 70.00 $412.30 24201 Removal of arm foreign body 15.63 70.00 $1,094.10 24220 Injection for elbow x-ray 4.51 70.00 $315.70 24300 Manipulate elbow w/anesth 11.88 70.00 $831.60 24301 Muscle/tendon transfer 21.53 70.00 $1,507.10 24305 Arm tendon lengthening 16.53 70.00 $1,157.10 24310 Revision of arm tendon 13.42 70.00 $939.40 24320 Repair of arm tendon 21.95 70.00 $1,536.50 24330 Revision of arm muscles 20.57 70.00 $1,439.90 24331 Revision of arm muscles 22.31 70.00 $1,561.70 24332 Tenolysis triceps 17.58 70.00 $1,230.60 24340 Repair of biceps tendon 17.58 70.00 $1,230.60 24341 Repair arm tendon/muscle 21.41 70.00 $1,498.70 24342 Repair of ruptured tendon 22.27 70.00 $1,558.90 24343 Repr elbow lat ligmnt w/tiss 20.29 70.00 $1,420.30 24344 Reconstruct elbow lat ligmnt 31.37 70.00 $2,195.90 24345 Repr elbw med ligmnt w/tissu 20.19 70.00 $1,413.30 24346 Reconstruct elbow med ligmnt 31.58 70.00 $2,210.60 24357 Repair elbow perc 12.08 70.00 $845.60 24358 Repair elbow w/deb open 14.97 70.00 $1,047.90 24359 Repair elbow deb/attch open 18.92 70.00 $1,324.40 24360 Reconstruct elbow joint 25.87 70.00 $1,810.90 24361 Reconstruct elbow joint 28.84 70.00 $2,018.80 24362 Reconstruct elbow joint 30.51 70.00 $2,135.70 24363 Replace elbow joint 41.96 70.00 $2,937.20 24365 Reconstruct head of radius 18.33 70.00 $1,283.10 24366 Reconstruct head of radius 19.54 70.00 $1,367.80 24370 Revise reconst elbow joint 44.71 70.00 $3,129.70 24371 Revise reconst elbow joint 51.43 70.00 $3,600.10 24400 Revision of humerus 23.52 70.00 $1,646.40 24410 Revision of humerus 30.44 70.00 $2,130.80 24420 Revision of humerus 28.33 70.00 $1,983.10 24430 Repair of humerus 30.43 70.00 $2,130.10 24435 Repair humerus with graft 30.95 70.00 $2,166.50 24470 Revision of elbow joint 19.27 70.00 $1,348.90 24495 Decompression of forearm 15.30 70.00 $1,071.00 24498 Reinforce humerus 24.84 70.00 $1,738.80 24500 Treat humerus fracture 10.19 70.00 $713.30 24505 Treat humerus fracture 14.21 70.00 $994.70 24515 Treat humerus fracture 25.19 70.00 $1,763.30 24516 Treat humerus fracture 24.71 70.00 $1,729.70 24530 Treat humerus fracture 10.82 70.00 $757.40 24535 Treat humerus fracture 17.51 70.00 $1,225.70 24538 Treat humerus fracture 21.39 70.00 $1,497.30 24545 Treat humerus fracture 26.72 70.00 $1,870.40 24546 Treat humerus fracture 29.90 70.00 $2,093.00 24560 Treat humerus fracture 9.11 70.00 $637.70 24565 Treat humerus fracture 15.14 70.00 $1,059.80 24566 Treat humerus fracture 20.60 70.00 $1,442.00 24575 Treat humerus fracture 21.07 70.00 $1,474.90 24576 Treat humerus fracture 9.66 70.00 $676.20 24577 Treat humerus fracture 15.52 70.00 $1,086.40 24579 Treat humerus fracture 24.00 70.00 $1,680.00 24582 Treat humerus fracture 23.21 70.00 $1,624.70 24586 Treat elbow fracture 31.13 70.00 $2,179.10 24587 Treat elbow fracture 31.18 70.00 $2,182.60 24600 Treat elbow dislocation 10.35 70.00 $724.50 24605 Treat elbow dislocation 13.42 70.00 $939.40 24615 Treat elbow dislocation 20.45 70.00 $1,431.50 24620 Treat elbow fracture 15.70 70.00 $1,099.00 24635 Treat elbow fracture 19.31 70.00 $1,351.70 24640 Treat elbow dislocation 3.33 70.00 $233.10 24650 Treat radius fracture 7.43 70.00 $520.10 24655 Treat radius fracture 12.40 70.00 $868.00 24665 Treat radius fracture 18.72 70.00 $1,310.40 24666 Treat radius fracture 21.05 70.00 $1,473.50 24670 Treat ulnar fracture 8.26 70.00 $578.20 24675 Treat ulnar fracture 12.86 70.00 $900.20 24685 Treat ulnar fracture 18.75 70.00 $1,312.50 24800 Fusion of elbow joint 23.85 70.00 $1,669.50 24802 Fusion/graft of elbow joint 28.35 70.00 $1,984.50 24900 Amputation of upper arm 21.00 70.00 $1,470.00 24920 Amputation of upper arm 20.70 70.00 $1,449.00 24925 Amputation follow-up surgery 14.91 70.00 $1,043.70 24930 Amputation follow-up surgery 21.83 70.00 $1,528.10 24931 Amputate upper arm & implant 23.04 70.00 $1,612.80 24935 Revision of amputation 27.94 70.00 $1,955.80 24940 Revision of upper arm 0.00 70.00 $0.00 24999 Upper arm/elbow surgery 0.00 70.00 $0.00 25000 Incision of tendon sheath 9.61 70.00 $672.70 25001 Incise flexor carpi radialis 9.82 70.00 $687.40 25020 Decompress forearm 1 space 16.42 70.00 $1,149.40 25023 Decompress forearm 1 space 31.51 70.00 $2,205.70 25024 Decompress forearm 2 spaces 22.26 70.00 $1,558.20 25025 Decompress forearm 2 spaces 35.22 70.00 $2,465.40 25028 Drainage of forearm lesion 14.97 70.00 $1,047.90 25031 Drainage of forearm bursa 10.39 70.00 $727.30 25035 Treat forearm bone lesion 16.70 70.00 $1,169.00 25040 Explore/treat wrist joint 16.12 70.00 $1,128.40 25065 Biopsy forearm soft tissues 7.22 70.00 $505.40 25066 Biopsy forearm soft tissues 10.30 70.00 $721.00 25071 Exc forearm les sc 3 cm/> 12.24 70.00 $856.80 25073 Exc forearm tum deep 3 cm/> 15.33 70.00 $1,073.10 25075 Exc forearm les sc < 3 cm 13.61 70.00 $952.70 25076 Exc forearm tum deep < 3 cm 14.86 70.00 $1,040.20 25077 Resect forearm/wrist tum<3cm 25.61 70.00 $1,792.70 25078 Resect forarm/wrist tum 3cm> 33.59 70.00 $2,351.30 25085 Incision of wrist capsule 12.83 70.00 $898.10 25100 Biopsy of wrist joint 9.65 70.00 $675.50 25101 Explore/treat wrist joint 11.55 70.00 $808.50 25105 Remove wrist joint lining 13.80 70.00 $966.00 25107 Remove wrist joint cartilage 17.65 70.00 $1,235.50 25109 Excise tendon forearm/wrist 15.42 70.00 $1,079.40 25110 Remove wrist tendon lesion 9.77 70.00 $683.90 25111 Remove wrist tendon lesion 9.16 70.00 $641.20 25112 Reremove wrist tendon lesion 11.07 70.00 $774.90 25115 Remove wrist/forearm lesion 21.77 70.00 $1,523.90 25116 Remove wrist/forearm lesion 17.19 70.00 $1,203.30 25118 Excise wrist tendon sheath 10.91 70.00 $763.70 25119 Partial removal of ulna 14.13 70.00 $989.10 25120 Removal of forearm lesion 14.24 70.00 $996.80 25125 Remove/graft forearm lesion 16.88 70.00 $1,181.60 25126 Remove/graft forearm lesion 16.89 70.00 $1,182.30 25130 Removal of wrist lesion 12.75 70.00 $892.50 25135 Remove & graft wrist lesion 16.00 70.00 $1,120.00 25136 Remove & graft wrist lesion 13.89 70.00 $972.30 25145 Remove forearm bone lesion 14.83 70.00 $1,038.10 25150 Partial removal of ulna 16.18 70.00 $1,132.60 25151 Partial removal of radius 16.70 70.00 $1,169.00 25170 Resect radius/ulnar tumor 42.62 70.00 $2,983.40 25210 Removal of wrist bone 13.95 70.00 $976.50 25215 Removal of wrist bones 17.71 70.00 $1,239.70 25230 Partial removal of radius 12.38 70.00 $866.60 25240 Partial removal of ulna 12.25 70.00 $857.50 25246 Injection for wrist x-ray 4.59 70.00 $321.30 25248 Remove forearm foreign body 11.79 70.00 $825.30 25250 Removal of wrist prosthesis 15.20 70.00 $1,064.00 25251 Removal of wrist prosthesis 20.64 70.00 $1,444.80 25259 Manipulate wrist w/anesthes 11.86 70.00 $830.20 25260 Repair forearm tendon/muscle 18.03 70.00 $1,262.10 25263 Repair forearm tendon/muscle 17.88 70.00 $1,251.60 25265 Repair forearm tendon/muscle 21.47 70.00 $1,502.90 25270 Repair forearm tendon/muscle 14.02 70.00 $981.40 25272 Repair forearm tendon/muscle 15.84 70.00 $1,108.80 25274 Repair forearm tendon/muscle 18.97 70.00 $1,327.90 25275 Repair forearm tendon sheath 19.21 70.00 $1,344.70 25280 Revise wrist/forearm tendon 16.14 70.00 $1,129.80 25290 Incise wrist/forearm tendon 12.49 70.00 $874.30 25295 Release wrist/forearm tendon 15.02 70.00 $1,051.40 25300 Fusion of tendons at wrist 19.50 70.00 $1,365.00 25301 Fusion of tendons at wrist 18.44 70.00 $1,290.80 25310 Transplant forearm tendon 17.75 70.00 $1,242.50 25312 Transplant forearm tendon 20.58 70.00 $1,440.60 25315 Revise palsy hand tendon(s) 22.15 70.00 $1,550.50 25316 Revise palsy hand tendon(s) 26.17 70.00 $1,831.90 25320 Repair/revise wrist joint 28.30 70.00 $1,981.00 25332 Revise wrist joint 24.16 70.00 $1,691.20 25335 Realignment of hand 27.13 70.00 $1,899.10 25337 Reconstruct ulna/radioulnar 25.57 70.00 $1,789.90 25350 Revision of radius 19.31 70.00 $1,351.70 25355 Revision of radius 21.86 70.00 $1,530.20 25360 Revision of ulna 18.73 70.00 $1,311.10 25365 Revise radius & ulna 26.31 70.00 $1,841.70 25370 Revise radius or ulna 28.94 70.00 $2,025.80 25375 Revise radius & ulna 27.41 70.00 $1,918.70 25390 Shorten radius or ulna 22.11 70.00 $1,547.70 25391 Lengthen radius or ulna 28.64 70.00 $2,004.80 25392 Shorten radius & ulna 29.34 70.00 $2,053.80 25393 Lengthen radius & ulna 32.25 70.00 $2,257.50 25394 Repair carpal bone shorten 22.50 70.00 $1,575.00 25400 Repair radius or ulna 23.06 70.00 $1,614.20 25405 Repair/graft radius or ulna 29.80 70.00 $2,086.00 25415 Repair radius & ulna 27.82 70.00 $1,947.40 25420 Repair/graft radius & ulna 33.43 70.00 $2,340.10 25425 Repair/graft radius or ulna 27.69 70.00 $1,938.30 25426 Repair/graft radius & ulna 31.45 70.00 $2,201.50 25430 Vasc graft into carpal bone 21.01 70.00 $1,470.70 25431 Repair nonunion carpal bone 22.61 70.00 $1,582.70 25440 Repair/graft wrist bone 22.08 70.00 $1,545.60 25441 Reconstruct wrist joint 26.86 70.00 $1,880.20 25442 Reconstruct wrist joint 23.13 70.00 $1,619.10 25443 Reconstruct wrist joint 22.25 70.00 $1,557.50 25444 Reconstruct wrist joint 23.49 70.00 $1,644.30 25445 Reconstruct wrist joint 20.73 70.00 $1,451.10 25446 Wrist replacement 33.73 70.00 $2,361.10 25447 Repair wrist joints 23.77 70.00 $1,663.90 25449 Remove wrist joint implant 29.68 70.00 $2,077.60 25450 Revision of wrist joint 14.85 70.00 $1,039.50 25455 Revision of wrist joint 20.83 70.00 $1,458.10 25490 Reinforce radius 20.65 70.00 $1,445.50 25491 Reinforce ulna 21.25 70.00 $1,487.50 25492 Reinforce radius and ulna 26.00 70.00 $1,820.00 25500 Treat fracture of radius 7.77 70.00 $543.90 25505 Treat fracture of radius 14.23 70.00 $996.10 25515 Treat fracture of radius 19.18 70.00 $1,342.60 25520 Treat fracture of radius 16.11 70.00 $1,127.70 25525 Treat fracture of radius 22.53 70.00 $1,577.10 25526 Treat fracture of radius 27.33 70.00 $1,913.10 25530 Treat fracture of ulna 7.44 70.00 $520.80 25535 Treat fracture of ulna 13.90 70.00 $973.00 25545 Treat fracture of ulna 17.87 70.00 $1,250.90 25560 Treat fracture radius & ulna 7.89 70.00 $552.30 25565 Treat fracture radius & ulna 14.73 70.00 $1,031.10 25574 Treat fracture radius & ulna 19.34 70.00 $1,353.80 25575 Treat fracture radius/ulna 25.88 70.00 $1,811.60 25600 Treat fracture radius/ulna 9.32 70.00 $652.40 25605 Treat fracture radius/ulna 15.48 70.00 $1,083.60 25606 Treat fx distal radial 19.00 70.00 $1,330.00 25607 Treat fx rad extra-articul 21.08 70.00 $1,475.60 25608 Treat fx rad intra-articul 23.65 70.00 $1,655.50 25609 Treat fx radial 3+ frag 30.08 70.00 $2,105.60 25622 Treat wrist bone fracture 8.65 70.00 $605.50 25624 Treat wrist bone fracture 13.57 70.00 $949.90 25628 Treat wrist bone fracture 20.68 70.00 $1,447.60 25630 Treat wrist bone fracture 8.68 70.00 $607.60 25635 Treat wrist bone fracture 11.96 70.00 $837.20 25645 Treat wrist bone fracture 16.17 70.00 $1,131.90 25650 Treat wrist bone fracture 9.07 70.00 $634.90 25651 Pin ulnar styloid fracture 13.82 70.00 $967.40 25652 Treat fracture ulnar styloid 17.88 70.00 $1,251.60 25660 Treat wrist dislocation 11.73 70.00 $821.10 25670 Treat wrist dislocation 17.37 70.00 $1,215.90 25671 Pin radioulnar dislocation 15.19 70.00 $1,063.30 25675 Treat wrist dislocation 12.29 70.00 $860.30 25676 Treat wrist dislocation 18.01 70.00 $1,260.70 25680 Treat wrist fracture 13.70 70.00 $959.00 25685 Treat wrist fracture 21.05 70.00 $1,473.50 25690 Treat wrist dislocation 13.50 70.00 $945.00 25695 Treat wrist dislocation 18.16 70.00 $1,271.20 25800 Fusion of wrist joint 21.01 70.00 $1,470.70 25805 Fusion/graft of wrist joint 24.28 70.00 $1,699.60 25810 Fusion/graft of wrist joint 24.93 70.00 $1,745.10 25820 Fusion of hand bones 17.61 70.00 $1,232.70 25825 Fuse hand bones with graft 21.72 70.00 $1,520.40 25830 Fusion radioulnar jnt/ulna 27.01 70.00 $1,890.70 25900 Amputation of forearm 20.33 70.00 $1,423.10 25905 Amputation of forearm 20.16 70.00 $1,411.20 25907 Amputation follow-up surgery 17.47 70.00 $1,222.90 25909 Amputation follow-up surgery 19.59 70.00 $1,371.30 25915 Amputation of forearm 29.16 70.00 $2,041.20 25920 Amputate hand at wrist 19.97 70.00 $1,397.90 25922 Amputate hand at wrist 14.60 70.00 $1,022.00 25924 Amputation follow-up surgery 19.08 70.00 $1,335.60 25927 Amputation of hand 23.07 70.00 $1,614.90 25929 Amputation follow-up surgery 16.38 70.00 $1,146.60 25931 Amputation follow-up surgery 20.75 70.00 $1,452.50 25999 Forearm or wrist surgery 0.00 70.00 $0.00 26010 Drainage of finger abscess 7.51 70.00 $525.70 26011 Drainage of finger abscess 11.07 70.00 $774.90 26020 Drain hand tendon sheath 12.39 70.00 $867.30 26025 Drainage of palm bursa 12.08 70.00 $845.60 26030 Drainage of palm bursas 14.11 70.00 $987.70 26034 Treat hand bone lesion 15.44 70.00 $1,080.80 26035 Decompress fingers/hand 24.58 70.00 $1,720.60 26037 Decompress fingers/hand 16.21 70.00 $1,134.70 26040 Release palm contracture 8.91 70.00 $623.70 26045 Release palm contracture 13.40 70.00 $938.00 26055 Incise finger tendon sheath 15.85 70.00 $1,109.50 26060 Incision of finger tendon 7.44 70.00 $520.80 26070 Explore/treat hand joint 9.02 70.00 $631.40 26075 Explore/treat finger joint 9.52 70.00 $666.40 26080 Explore/treat finger joint 11.15 70.00 $780.50 26100 Biopsy hand joint lining 9.27 70.00 $648.90 26105 Biopsy finger joint lining 9.54 70.00 $667.80 26110 Biopsy finger joint lining 9.20 70.00 $644.00 26111 Exc hand les sc 1.5 cm/> 11.98 70.00 $838.60 26113 Exc hand tum deep 1.5 cm/> 15.74 70.00 $1,101.80 26115 Exc hand les sc < 1.5 cm 14.34 70.00 $1,003.80 26116 Exc hand tum deep < 1.5 cm 15.10 70.00 $1,057.00 26117 Rad resect hand tumor < 3 cm 21.44 70.00 $1,500.80 26118 Rad resect hand tumor 3 cm/> 30.32 70.00 $2,122.40 26121 Release palm contracture 17.11 70.00 $1,197.70 26123 Release palm contracture 23.93 70.00 $1,675.10 26125 Release palm contracture 7.92 70.00 $554.40 26130 Remove wrist joint lining 13.23 70.00 $926.10 26135 Revise finger joint each 15.74 70.00 $1,101.80 26140 Revise finger joint each 14.43 70.00 $1,010.10 26145 Tendon excision palm/finger 14.68 70.00 $1,027.60 26160 Remove tendon sheath lesion 16.30 70.00 $1,141.00 26170 Removal of palm tendon each 11.61 70.00 $812.70 26180 Removal of finger tendon 12.66 70.00 $886.20 26185 Remove finger bone 15.56 70.00 $1,089.20 26200 Remove hand bone lesion 12.85 70.00 $899.50 26205 Remove/graft bone lesion 17.09 70.00 $1,196.30 26210 Removal of finger lesion 12.65 70.00 $885.50 26215 Remove/graft finger lesion 16.01 70.00 $1,120.70 26230 Partial removal of hand bone 14.30 70.00 $1,001.00 26235 Partial removal finger bone 14.09 70.00 $986.30 26236 Partial removal finger bone 12.61 70.00 $882.70 26250 Extensive hand surgery 31.01 70.00 $2,170.70 26260 Resect prox finger tumor 23.10 70.00 $1,617.00 26262 Resect distal finger tumor 18.05 70.00 $1,263.50 26320 Removal of implant from hand 9.91 70.00 $693.70 26340 Manipulate finger w/anesth 9.51 70.00 $665.70 26341 Manipulat palm cord post inj 2.81 70.00 $196.70 26350 Repair finger/hand tendon 20.07 70.00 $1,404.90 26352 Repair/graft hand tendon 22.59 70.00 $1,581.30 26356 Repair finger/hand tendon 22.72 70.00 $1,590.40 26357 Repair finger/hand tendon 25.42 70.00 $1,779.40 26358 Repair/graft hand tendon 27.98 70.00 $1,958.60 26370 Repair finger/hand tendon 21.38 70.00 $1,496.60 26372 Repair/graft hand tendon 24.32 70.00 $1,702.40 26373 Repair finger/hand tendon 23.54 70.00 $1,647.80 26390 Revise hand/finger tendon 23.67 70.00 $1,656.90 26392 Repair/graft hand tendon 27.45 70.00 $1,921.50 26410 Repair hand tendon 15.91 70.00 $1,113.70 26412 Repair/graft hand tendon 19.52 70.00 $1,366.40 26415 Excision hand/finger tendon 19.21 70.00 $1,344.70 26416 Graft hand or finger tendon 24.46 70.00 $1,712.20 26418 Repair finger tendon 16.26 70.00 $1,138.20 26420 Repair/graft finger tendon 19.91 70.00 $1,393.70 26426 Repair finger/hand tendon 14.34 70.00 $1,003.80 26428 Repair/graft finger tendon 20.88 70.00 $1,461.60 26432 Repair finger tendon 14.04 70.00 $982.80 26433 Repair finger tendon 14.91 70.00 $1,043.70 26434 Repair/graft finger tendon 18.23 70.00 $1,276.10 26437 Realignment of tendons 17.55 70.00 $1,228.50 26440 Release palm/finger tendon 17.43 70.00 $1,220.10 26442 Release palm & finger tendon 27.28 70.00 $1,909.60 26445 Release hand/finger tendon 16.22 70.00 $1,135.40 26449 Release forearm/hand tendon 19.89 70.00 $1,392.30 26450 Incision of palm tendon 11.43 70.00 $800.10 26455 Incision of finger tendon 11.36 70.00 $795.20 26460 Incise hand/finger tendon 11.10 70.00 $777.00 26471 Fusion of finger tendons 17.33 70.00 $1,213.10 26474 Fusion of finger tendons 16.92 70.00 $1,184.40 26476 Tendon lengthening 16.28 70.00 $1,139.60 26477 Tendon shortening 16.41 70.00 $1,148.70 26478 Lengthening of hand tendon 17.46 70.00 $1,222.20 26479 Shortening of hand tendon 17.31 70.00 $1,211.70 26480 Transplant hand tendon 21.18 70.00 $1,482.60 26483 Transplant/graft hand tendon 23.72 70.00 $1,660.40 26485 Transplant palm tendon 22.74 70.00 $1,591.80 26489 Transplant/graft palm tendon 26.35 70.00 $1,844.50 26490 Revise thumb tendon 22.53 70.00 $1,577.10 26492 Tendon transfer with graft 25.00 70.00 $1,750.00 26494 Hand tendon/muscle transfer 22.07 70.00 $1,544.90 26496 Revise thumb tendon 24.24 70.00 $1,696.80 26497 Finger tendon transfer 24.52 70.00 $1,716.40 26498 Finger tendon transfer 32.17 70.00 $2,251.90 26499 Revision of finger 23.18 70.00 $1,622.60 26500 Hand tendon reconstruction 17.60 70.00 $1,232.00 26502 Hand tendon reconstruction 20.03 70.00 $1,402.10 26508 Release thumb contracture 17.77 70.00 $1,243.90 26510 Thumb tendon transfer 16.76 70.00 $1,173.20 26516 Fusion of knuckle joint 19.75 70.00 $1,382.50 26517 Fusion of knuckle joints 22.09 70.00 $1,546.30 26518 Fusion of knuckle joints 23.30 70.00 $1,631.00 26520 Release knuckle contracture 18.32 70.00 $1,282.40 26525 Release finger contracture 18.33 70.00 $1,283.10 26530 Revise knuckle joint 15.40 70.00 $1,078.00 26531 Revise knuckle with implant 17.87 70.00 $1,250.90 26535 Revise finger joint 12.09 70.00 $846.30 26536 Revise/implant finger joint 19.95 70.00 $1,396.50 26540 Repair hand joint 18.53 70.00 $1,297.10 26541 Repair hand joint with graft 22.62 70.00 $1,583.40 26542 Repair hand joint with graft 19.13 70.00 $1,339.10 26545 Reconstruct finger joint 19.90 70.00 $1,393.00 26546 Repair nonunion hand 28.13 70.00 $1,969.10 26548 Reconstruct finger joint 21.39 70.00 $1,497.30 26550 Construct thumb replacement 46.60 70.00 $3,262.00 26551 Great toe-hand transfer 95.76 70.00 $6,703.20 26553 Single transfer toe-hand 80.96 70.00 $5,667.20 26554 Double transfer toe-hand 94.79 70.00 $6,635.30 26555 Positional change of finger 36.45 70.00 $2,551.50 26556 Toe joint transfer 97.65 70.00 $6,835.50 26560 Repair of web finger 16.39 70.00 $1,147.30 26561 Repair of web finger 26.34 70.00 $1,843.80 26562 Repair of web finger 37.84 70.00 $2,648.80 26565 Correct metacarpal flaw 19.10 70.00 $1,337.00 26567 Correct finger deformity 19.14 70.00 $1,339.80 26568 Lengthen metacarpal/finger 25.41 70.00 $1,778.70 26580 Repair hand deformity 42.52 70.00 $2,976.40 26587 Reconstruct extra finger 28.78 70.00 $2,014.60 26590 Repair finger deformity 37.38 70.00 $2,616.60 26591 Repair muscles of hand 12.24 70.00 $856.80 26593 Release muscles of hand 16.92 70.00 $1,184.40 26596 Excision constricting tissue 21.43 70.00 $1,500.10 26600 Treat metacarpal fracture 8.35 70.00 $584.50 26605 Treat metacarpal fracture 9.12 70.00 $638.40 26607 Treat metacarpal fracture 13.00 70.00 $910.00 26608 Treat metacarpal fracture 13.60 70.00 $952.00 26615 Treat metacarpal fracture 16.49 70.00 $1,154.30 26641 Treat thumb dislocation 10.66 70.00 $746.20 26645 Treat thumb fracture 12.15 70.00 $850.50 26650 Treat thumb fracture 13.63 70.00 $954.10 26665 Treat thumb fracture 17.97 70.00 $1,257.90 26670 Treat hand dislocation 9.64 70.00 $674.80 26675 Treat hand dislocation 12.84 70.00 $898.80 26676 Pin hand dislocation 14.27 70.00 $998.90 26685 Treat hand dislocation 16.48 70.00 $1,153.60 26686 Treat hand dislocation 17.88 70.00 $1,251.60 26700 Treat knuckle dislocation 9.18 70.00 $642.60 26705 Treat knuckle dislocation 11.75 70.00 $822.50 26706 Pin knuckle dislocation 12.57 70.00 $879.90 26715 Treat knuckle dislocation 16.38 70.00 $1,146.60 26720 Treat finger fracture each 5.62 70.00 $393.40 26725 Treat finger fracture each 9.55 70.00 $668.50 26727 Treat finger fracture each 13.41 70.00 $938.70 26735 Treat finger fracture each 17.08 70.00 $1,195.60 26740 Treat finger fracture each 6.54 70.00 $457.80 26742 Treat finger fracture each 10.50 70.00 $735.00 26746 Treat finger fracture each 21.28 70.00 $1,489.60 26750 Treat finger fracture each 5.21 70.00 $364.70 26755 Treat finger fracture each 8.90 70.00 $623.00 26756 Pin finger fracture each 11.90 70.00 $833.00 26765 Treat finger fracture each 14.32 70.00 $1,002.40 26770 Treat finger dislocation 7.80 70.00 $546.00 26775 Treat finger dislocation 10.87 70.00 $760.90 26776 Pin finger dislocation 12.64 70.00 $884.80 26785 Treat finger dislocation 15.67 70.00 $1,096.90 26820 Thumb fusion with graft 21.68 70.00 $1,517.60 26841 Fusion of thumb 20.46 70.00 $1,432.20 26842 Thumb fusion with graft 22.12 70.00 $1,548.40 26843 Fusion of hand joint 20.79 70.00 $1,455.30 26844 Fusion/graft of hand joint 23.19 70.00 $1,623.30 26850 Fusion of knuckle 19.50 70.00 $1,365.00 26852 Fusion of knuckle with graft 22.46 70.00 $1,572.20 26860 Fusion of finger joint 15.90 70.00 $1,113.00 26861 Fusion of finger jnt add-on 2.99 70.00 $209.30 26862 Fusion/graft of finger joint 20.48 70.00 $1,433.60 26863 Fuse/graft added joint 6.68 70.00 $467.60 26910 Amputate metacarpal bone 20.37 70.00 $1,425.90 26951 Amputation of finger/thumb 18.40 70.00 $1,288.00 26952 Amputation of finger/thumb 18.17 70.00 $1,271.90 26989 Hand/finger surgery 0.00 70.00 $0.00 26990 Drainage of pelvis lesion 17.98 70.00 $1,258.60 26991 Drainage of pelvis bursa 20.18 70.00 $1,412.60 26992 Drainage of bone lesion 27.56 70.00 $1,929.20 27000 Incision of hip tendon 11.68 70.00 $817.60 27001 Incision of hip tendon 15.55 70.00 $1,088.50 27003 Incision of hip tendon 16.76 70.00 $1,173.20 27005 Incision of hip tendon 20.79 70.00 $1,455.30 27006 Incision of hip tendons 21.09 70.00 $1,476.30 27025 Incision of hip/thigh fascia 26.22 70.00 $1,835.40 27027 Buttock fasciotomy 25.50 70.00 $1,785.00 27030 Drainage of hip joint 26.93 70.00 $1,885.10 27033 Exploration of hip joint 27.99 70.00 $1,959.30 27035 Denervation of hip joint 30.54 70.00 $2,137.80 27036 Excision of hip joint/muscle 29.09 70.00 $2,036.30 27040 Biopsy of soft tissues 9.82 70.00 $687.40 27041 Biopsy of soft tissues 19.91 70.00 $1,393.70 27043 Exc hip pelvis les sc 3 cm/> 13.56 70.00 $949.20 27045 Exc hip/pelv tum deep 5 cm/> 21.56 70.00 $1,509.20 27047 Exc hip/pelvis les sc < 3 cm 13.35 70.00 $934.50 27048 Exc hip/pelv tum deep < 5 cm 17.60 70.00 $1,232.00 27049 Resect hip/pelv tum < 5 cm 38.38 70.00 $2,686.60 27050 Biopsy of sacroiliac joint 11.08 70.00 $775.60 27052 Biopsy of hip joint 16.65 70.00 $1,165.50 27054 Removal of hip joint lining 19.65 70.00 $1,375.50 27057 Buttock fasciotomy w/dbrdmt 29.11 70.00 $2,037.70 27059 Resect hip/pelv tum 5 cm/> 52.32 70.00 $3,662.40 27060 Removal of ischial bursa 13.28 70.00 $929.60 27062 Remove femur lesion/bursa 13.07 70.00 $914.90 27065 Remove hip bone les super 14.82 70.00 $1,037.40 27066 Remove hip bone les deep 23.37 70.00 $1,635.90 27067 Remove/graft hip bone lesion 29.45 70.00 $2,061.50 27070 Part remove hip bone super 24.49 70.00 $1,714.30 27071 Part removal hip bone deep 26.31 70.00 $1,841.70 27075 Resect hip tumor 60.25 70.00 $4,217.50 27076 Resect hip tum incl acetabul 72.94 70.00 $5,105.80 27077 Resect hip tum w/innom bone 81.37 70.00 $5,695.90 27078 Rsect hip tum incl femur 59.46 70.00 $4,162.20 27080 Removal of tail bone 14.69 70.00 $1,028.30 27086 Remove hip foreign body 7.91 70.00 $553.70 27087 Remove hip foreign body 17.75 70.00 $1,242.50 27090 Removal of hip prosthesis 23.84 70.00 $1,668.80 27091 Removal of hip prosthesis 46.04 70.00 $3,222.80 27093 Injection for hip x-ray 5.32 70.00 $372.40 27095 Injection for hip x-ray 6.91 70.00 $483.70 27096 Inject sacroiliac joint 4.52 70.00 $316.40 27097 Revision of hip tendon 19.45 70.00 $1,361.50 27098 Transfer tendon to pelvis 18.35 70.00 $1,284.50 27100 Transfer of abdominal muscle 23.49 70.00 $1,644.30 27105 Transfer of spinal muscle 24.93 70.00 $1,745.10 27110 Transfer of iliopsoas muscle 27.89 70.00 $1,952.30 27111 Transfer of iliopsoas muscle 25.95 70.00 $1,816.50 27120 Reconstruction of hip socket 37.29 70.00 $2,610.30 27122 Reconstruction of hip socket 31.70 70.00 $2,219.00 27125 Partial hip replacement 32.67 70.00 $2,286.90 27130 Total hip arthroplasty 39.11 70.00 $2,737.70 27132 Total hip arthroplasty 48.32 70.00 $3,382.40 27134 Revise hip joint replacement 55.33 70.00 $3,873.10 27137 Revise hip joint replacement 42.51 70.00 $2,975.70 27138 Revise hip joint replacement 44.16 70.00 $3,091.20 27140 Transplant femur ridge 25.67 70.00 $1,796.90 27146 Incision of hip bone 36.70 70.00 $2,569.00 27147 Revision of hip bone 42.11 70.00 $2,947.70 27151 Incision of hip bones 45.95 70.00 $3,216.50 27156 Revision of hip bones 48.87 70.00 $3,420.90 27158 Revision of pelvis 40.46 70.00 $2,832.20 27161 Incision of neck of femur 34.97 70.00 $2,447.90 27165 Incision/fixation of femur 39.56 70.00 $2,769.20 27170 Repair/graft femur head/neck 33.89 70.00 $2,372.30 27175 Treat slipped epiphysis 18.86 70.00 $1,320.20 27176 Treat slipped epiphysis 26.44 70.00 $1,850.80 27177 Treat slipped epiphysis 32.11 70.00 $2,247.70 27178 Treat slipped epiphysis 23.09 70.00 $1,616.30 27179 Revise head/neck of femur 27.47 70.00 $1,922.90 27181 Treat slipped epiphysis 36.84 70.00 $2,578.80 27185 Revision of femur epiphysis 20.64 70.00 $1,444.80 27187 Reinforce hip bones 28.54 70.00 $1,997.80 27197 Clsd tx pelvic ring fx 3.35 70.00 $234.50 27198 Clsd tx pelvic ring fx 8.54 70.00 $597.80 27200 Treat tail bone fracture 5.17 70.00 $361.90 27202 Treat tail bone fracture 15.93 70.00 $1,115.10 27215 Treat pelvic fracture(s) 17.94 70.00 $1,255.80 27216 Treat pelvic ring fracture 26.60 70.00 $1,862.00 27217 Treat pelvic ring fracture 24.96 70.00 $1,747.20 27218 Treat pelvic ring fracture 34.50 70.00 $2,415.00 27220 Treat hip socket fracture 15.19 70.00 $1,063.30 27222 Treat hip socket fracture 28.04 70.00 $1,962.80 27226 Treat hip wall fracture 30.45 70.00 $2,131.50 27227 Treat hip fracture(s) 47.93 70.00 $3,355.10 27228 Treat hip fracture(s) 54.47 70.00 $3,812.90 27230 Treat thigh fracture 13.60 70.00 $952.00 27232 Treat thigh fracture 21.53 70.00 $1,507.10 27235 Treat thigh fracture 26.19 70.00 $1,833.30 27236 Treat thigh fracture 34.48 70.00 $2,413.60 27238 Treat thigh fracture 13.19 70.00 $923.30 27240 Treat thigh fracture 27.56 70.00 $1,929.20 27244 Treat thigh fracture 35.49 70.00 $2,484.30 27245 Treat thigh fracture 35.49 70.00 $2,484.30 27246 Treat thigh fracture 11.01 70.00 $770.70 27248 Treat thigh fracture 21.37 70.00 $1,495.90 27250 Treat hip dislocation 5.19 70.00 $363.30 27252 Treat hip dislocation 21.78 70.00 $1,524.60 27253 Treat hip dislocation 27.12 70.00 $1,898.40 27254 Treat hip dislocation 36.53 70.00 $2,557.10 27256 Treat hip dislocation 8.53 70.00 $597.10 27257 Treat hip dislocation 9.82 70.00 $687.40 27258 Treat hip dislocation 31.96 70.00 $2,237.20 27259 Treat hip dislocation 44.83 70.00 $3,138.10 27265 Treat hip dislocation 11.38 70.00 $796.60 27266 Treat hip dislocation 16.68 70.00 $1,167.60 27267 Cltx thigh fx 12.40 70.00 $868.00 27268 Cltx thigh fx w/mnpj 15.22 70.00 $1,065.40 27269 Optx thigh fx 35.85 70.00 $2,509.50 27275 Manipulation of hip joint 5.22 70.00 $365.40 27279 Arthrodesis sacroiliac joint 19.93 70.00 $1,395.10 27280 Fusion of sacroiliac joint 39.39 70.00 $2,757.30 27282 Fusion of pubic bones 23.40 70.00 $1,638.00 27284 Fusion of hip joint 42.70 70.00 $2,989.00 27286 Fusion of hip joint 46.81 70.00 $3,276.70 27290 Amputation of leg at hip 46.40 70.00 $3,248.00 27295 Amputation of leg at hip 36.49 70.00 $2,554.30 27299 Pelvis/hip joint surgery 0.00 70.00 $0.00 27301 Drain thigh/knee lesion 19.19 70.00 $1,343.30 27303 Drainage of bone lesion 18.39 70.00 $1,287.30 27305 Incise thigh tendon & fascia 13.76 70.00 $963.20 27306 Incision of thigh tendon 10.08 70.00 $705.60 27307 Incision of thigh tendons 12.22 70.00 $855.40 27310 Exploration of knee joint 20.99 70.00 $1,469.30 27323 Biopsy thigh soft tissues 7.73 70.00 $541.10 27324 Biopsy thigh soft tissues 11.42 70.00 $799.40 27325 Neurectomy hamstring 14.68 70.00 $1,027.60 27326 Neurectomy popliteal 14.31 70.00 $1,001.70 27327 Exc thigh/knee les sc < 3 cm 13.10 70.00 $917.00 27328 Exc thigh/knee tum deep <5cm 17.88 70.00 $1,251.60 27329 Resect thigh/knee tum < 5 cm 29.97 70.00 $2,097.90 27330 Biopsy knee joint lining 11.80 70.00 $826.00 27331 Explore/treat knee joint 13.61 70.00 $952.70 27332 Removal of knee cartilage 18.41 70.00 $1,288.70 27333 Removal of knee cartilage 16.82 70.00 $1,177.40 27334 Remove knee joint lining 19.62 70.00 $1,373.40 27335 Remove knee joint lining 21.89 70.00 $1,532.30 27337 Exc thigh/knee les sc 3 cm/> 12.03 70.00 $842.10 27339 Exc thigh/knee tum dep 5cm/> 21.71 70.00 $1,519.70 27340 Removal of kneecap bursa 10.64 70.00 $744.80 27345 Removal of knee cyst 13.75 70.00 $962.50 27347 Remove knee cyst 15.16 70.00 $1,061.20 27350 Removal of kneecap 18.68 70.00 $1,307.60 27355 Remove femur lesion 17.30 70.00 $1,211.00 27356 Remove femur lesion/graft 21.10 70.00 $1,477.00 27357 Remove femur lesion/graft 23.38 70.00 $1,636.60 27358 Remove femur lesion/fixation 8.08 70.00 $565.60 27360 Partial removal leg bone(s) 24.40 70.00 $1,708.00 27364 Resect thigh/knee tum 5 cm/> 45.02 70.00 $3,151.40 27365 Resect femur/knee tumor 59.55 70.00 $4,168.50 27370 Injection for knee x-ray 4.37 70.00 $305.90 27372 Removal of foreign body 17.20 70.00 $1,204.00 27380 Repair of kneecap tendon 17.00 70.00 $1,190.00 27381 Repair/graft kneecap tendon 22.92 70.00 $1,604.40 27385 Repair of thigh muscle 16.45 70.00 $1,151.50 27386 Repair/graft of thigh muscle 23.76 70.00 $1,663.20 27390 Incision of thigh tendon 12.65 70.00 $885.50 27391 Incision of thigh tendons 16.41 70.00 $1,148.70 27392 Incision of thigh tendons 20.10 70.00 $1,407.00 27393 Lengthening of thigh tendon 14.62 70.00 $1,023.40 27394 Lengthening of thigh tendons 18.25 70.00 $1,277.50 27395 Lengthening of thigh tendons 25.27 70.00 $1,768.90 27396 Transplant of thigh tendon 17.58 70.00 $1,230.60 27397 Transplants of thigh tendons 26.01 70.00 $1,820.70 27400 Revise thigh muscles/tendons 19.65 70.00 $1,375.50 27403 Repair of knee cartilage 18.36 70.00 $1,285.20 27405 Repair of knee ligament 19.35 70.00 $1,354.50 27407 Repair of knee ligament 22.25 70.00 $1,557.50 27409 Repair of knee ligaments 27.78 70.00 $1,944.60 27412 Autochondrocyte implant knee 47.69 70.00 $3,338.30 27415 Osteochondral knee allograft 39.62 70.00 $2,773.40 27416 Osteochondral knee autograft 28.25 70.00 $1,977.50 27418 Repair degenerated kneecap 23.68 70.00 $1,657.60 27420 Revision of unstable kneecap 21.33 70.00 $1,493.10 27422 Revision of unstable kneecap 21.33 70.00 $1,493.10 27424 Revision/removal of kneecap 21.51 70.00 $1,505.70 27425 Lat retinacular release open 12.83 70.00 $898.10 27427 Reconstruction knee 20.42 70.00 $1,429.40 27428 Reconstruction knee 31.96 70.00 $2,237.20 27429 Reconstruction knee 35.72 70.00 $2,500.40 27430 Revision of thigh muscles 21.22 70.00 $1,485.40 27435 Incision of knee joint 23.16 70.00 $1,621.20 27437 Revise kneecap 19.01 70.00 $1,330.70 27438 Revise kneecap with implant 24.14 70.00 $1,689.80 27440 Revision of knee joint 22.87 70.00 $1,600.90 27441 Revision of knee joint 23.73 70.00 $1,661.10 27442 Revision of knee joint 25.01 70.00 $1,750.70 27443 Revision of knee joint 23.39 70.00 $1,637.30 27445 Revision of knee joint 36.11 70.00 $2,527.70 27446 Revision of knee joint 33.42 70.00 $2,339.40 27447 Total knee arthroplasty 39.09 70.00 $2,736.30 27448 Incision of thigh 22.13 70.00 $1,549.10 27450 Incision of thigh 29.16 70.00 $2,041.20 27454 Realignment of thigh bone 37.41 70.00 $2,618.70 27455 Realignment of knee 27.07 70.00 $1,894.90 27457 Realignment of knee 27.21 70.00 $1,904.70 27465 Shortening of thigh bone 35.52 70.00 $2,486.40 27466 Lengthening of thigh bone 33.82 70.00 $2,367.40 27468 Shorten/lengthen thighs 38.74 70.00 $2,711.80 27470 Repair of thigh 33.85 70.00 $2,369.50 27472 Repair/graft of thigh 36.37 70.00 $2,545.90 27475 Surgery to stop leg growth 19.01 70.00 $1,330.70 27477 Surgery to stop leg growth 21.08 70.00 $1,475.60 27479 Surgery to stop leg growth 26.51 70.00 $1,855.70 27485 Surgery to stop leg growth 19.15 70.00 $1,340.50 27486 Revise/replace knee joint 40.56 70.00 $2,839.20 27487 Revise/replace knee joint 50.73 70.00 $3,551.10 27488 Removal of knee prosthesis 34.58 70.00 $2,420.60 27495 Reinforce thigh 32.41 70.00 $2,268.70 27496 Decompression of thigh/knee 15.41 70.00 $1,078.70 27497 Decompression of thigh/knee 16.59 70.00 $1,161.30 27498 Decompression of thigh/knee 18.67 70.00 $1,306.90 27499 Decompression of thigh/knee 19.85 70.00 $1,389.50 27500 Treatment of thigh fracture 14.84 70.00 $1,038.80 27501 Treatment of thigh fracture 14.43 70.00 $1,010.10 27502 Treatment of thigh fracture 21.84 70.00 $1,528.80 27503 Treatment of thigh fracture 22.98 70.00 $1,608.60 27506 Treatment of thigh fracture 38.55 70.00 $2,698.50 27507 Treatment of thigh fracture 28.02 70.00 $1,961.40 27508 Treatment of thigh fracture 15.00 70.00 $1,050.00 27509 Treatment of thigh fracture 18.41 70.00 $1,288.70 27510 Treatment of thigh fracture 19.59 70.00 $1,371.30 27511 Treatment of thigh fracture 28.74 70.00 $2,011.80 27513 Treatment of thigh fracture 35.77 70.00 $2,503.90 27514 Treatment of thigh fracture 27.86 70.00 $1,950.20 27516 Treat thigh fx growth plate 14.48 70.00 $1,013.60 27517 Treat thigh fx growth plate 18.39 70.00 $1,287.30 27519 Treat thigh fx growth plate 25.71 70.00 $1,799.70 27520 Treat kneecap fracture 9.19 70.00 $643.30 27524 Treat kneecap fracture 21.61 70.00 $1,512.70 27530 Treat knee fracture 8.59 70.00 $601.30 27532 Treat knee fracture 17.60 70.00 $1,232.00 27535 Treat knee fracture 25.85 70.00 $1,809.50 27536 Treat knee fracture 34.26 70.00 $2,398.20 27538 Treat knee fracture(s) 13.59 70.00 $951.30 27540 Treat knee fracture 23.33 70.00 $1,633.10 27550 Treat knee dislocation 14.48 70.00 $1,013.60 27552 Treat knee dislocation 17.98 70.00 $1,258.60 27556 Treat knee dislocation 24.86 70.00 $1,740.20 27557 Treat knee dislocation 29.44 70.00 $2,060.80 27558 Treat knee dislocation 34.50 70.00 $2,415.00 27560 Treat kneecap dislocation 10.24 70.00 $716.80 27562 Treat kneecap dislocation 13.60 70.00 $952.00 27566 Treat kneecap dislocation 25.58 70.00 $1,790.60 27570 Fixation of knee joint 4.33 70.00 $303.10 27580 Fusion of knee 41.38 70.00 $2,896.60 27590 Amputate leg at thigh 23.21 70.00 $1,624.70 27591 Amputate leg at thigh 27.82 70.00 $1,947.40 27592 Amputate leg at thigh 19.78 70.00 $1,384.60 27594 Amputation follow-up surgery 14.58 70.00 $1,020.60 27596 Amputation follow-up surgery 20.90 70.00 $1,463.00 27598 Amputate lower leg at knee 20.72 70.00 $1,450.40 27599 Leg surgery procedure 0.00 70.00 $0.00 27600 Decompression of lower leg 11.74 70.00 $821.80 27601 Decompression of lower leg 12.84 70.00 $898.80 27602 Decompression of lower leg 14.11 70.00 $987.70 27603 Drain lower leg lesion 15.10 70.00 $1,057.00 27604 Drain lower leg bursa 14.01 70.00 $980.70 27605 Incision of achilles tendon 9.79 70.00 $685.30 27606 Incision of achilles tendon 8.10 70.00 $567.00 27607 Treat lower leg bone lesion 17.47 70.00 $1,222.90 27610 Explore/treat ankle joint 18.66 70.00 $1,306.20 27612 Exploration of ankle joint 16.17 70.00 $1,131.90 27613 Biopsy lower leg soft tissue 7.21 70.00 $504.70 27614 Biopsy lower leg soft tissue 16.58 70.00 $1,160.60 27615 Resect leg/ankle tum < 5 cm 29.48 70.00 $2,063.60 27616 Resect leg/ankle tum 5 cm/> 36.61 70.00 $2,562.70 27618 Exc leg/ankle tum < 3 cm 12.88 70.00 $901.60 27619 Exc leg/ankle tum deep <5 cm 13.44 70.00 $940.80 27620 Explore/treat ankle joint 13.05 70.00 $913.50 27625 Remove ankle joint lining 16.64 70.00 $1,164.80 27626 Remove ankle joint lining 17.38 70.00 $1,216.60 27630 Removal of tendon lesion 15.99 70.00 $1,119.30 27632 Exc leg/ankle les sc 3 cm/> 11.89 70.00 $832.30 27634 Exc leg/ankle tum dep 5 cm/> 19.73 70.00 $1,381.10 27635 Remove lower leg bone lesion 16.81 70.00 $1,176.70 27637 Remove/graft leg bone lesion 21.90 70.00 $1,533.00 27638 Remove/graft leg bone lesion 21.91 70.00 $1,533.70 27640 Partial removal of tibia 23.99 70.00 $1,679.30 27641 Partial removal of fibula 19.19 70.00 $1,343.30 27645 Resect tibia tumor 51.20 70.00 $3,584.00 27646 Resect fibula tumor 42.81 70.00 $2,996.70 27647 Resect talus/calcaneus tum 29.51 70.00 $2,065.70 27648 Injection for ankle x-ray 4.71 70.00 $329.70 27650 Repair achilles tendon 18.90 70.00 $1,323.00 27652 Repair/graft achilles tendon 19.67 70.00 $1,376.90 27654 Repair of achilles tendon 20.34 70.00 $1,423.80 27656 Repair leg fascia defect 17.74 70.00 $1,241.80 27658 Repair of leg tendon each 10.70 70.00 $749.00 27659 Repair of leg tendon each 13.73 70.00 $961.10 27664 Repair of leg tendon each 10.40 70.00 $728.00 27665 Repair of leg tendon each 11.78 70.00 $824.60 27675 Repair lower leg tendons 14.07 70.00 $984.90 27676 Repair lower leg tendons 17.43 70.00 $1,220.10 27680 Release of lower leg tendon 12.33 70.00 $863.10 27681 Release of lower leg tendons 15.70 70.00 $1,099.00 27685 Revision of lower leg tendon 19.02 70.00 $1,331.40 27686 Revise lower leg tendons 16.06 70.00 $1,124.20 27687 Revision of calf tendon 13.03 70.00 $912.10 27690 Revise lower leg tendon 18.19 70.00 $1,273.30 27691 Revise lower leg tendon 21.49 70.00 $1,504.30 27692 Revise additional leg tendon 3.03 70.00 $212.10 27695 Repair of ankle ligament 13.70 70.00 $959.00 27696 Repair of ankle ligaments 15.87 70.00 $1,110.90 27698 Repair of ankle ligament 18.41 70.00 $1,288.70 27700 Revision of ankle joint 17.50 70.00 $1,225.00 27702 Reconstruct ankle joint 27.73 70.00 $1,941.10 27703 Reconstruction ankle joint 31.92 70.00 $2,234.40 27704 Removal of ankle implant 16.51 70.00 $1,155.70 27705 Incision of tibia 21.79 70.00 $1,525.30 27707 Incision of fibula 11.47 70.00 $802.90 27709 Incision of tibia & fibula 33.75 70.00 $2,362.50 27712 Realignment of lower leg 31.87 70.00 $2,230.90 27715 Revision of lower leg 30.26 70.00 $2,118.20 27720 Repair of tibia 25.15 70.00 $1,760.50 27722 Repair/graft of tibia 25.63 70.00 $1,794.10 27724 Repair/graft of tibia 36.43 70.00 $2,550.10 27725 Repair of lower leg 34.32 70.00 $2,402.40 27726 Repair fibula nonunion 27.72 70.00 $1,940.40 27727 Repair of lower leg 25.69 70.00 $1,798.30 27730 Repair of tibia epiphysis 15.91 70.00 $1,113.70 27732 Repair of fibula epiphysis 10.64 70.00 $744.80 27734 Repair lower leg epiphyses 18.85 70.00 $1,319.50 27740 Repair of leg epiphyses 19.93 70.00 $1,395.10 27742 Repair of leg epiphyses 21.69 70.00 $1,518.30 27745 Reinforce tibia 21.73 70.00 $1,521.10 27750 Treatment of tibia fracture 9.87 70.00 $690.90 27752 Treatment of tibia fracture 15.32 70.00 $1,072.40 27756 Treatment of tibia fracture 16.55 70.00 $1,158.50 27758 Treatment of tibia fracture 25.63 70.00 $1,794.10 27759 Treatment of tibia fracture 28.75 70.00 $2,012.50 27760 Cltx medial ankle fx 9.47 70.00 $662.90 27762 Cltx med ankle fx w/mnpj 13.41 70.00 $938.70 27766 Optx medial ankle fx 17.48 70.00 $1,223.60 27767 Cltx post ankle fx 7.98 70.00 $558.60 27768 Cltx post ankle fx w/mnpj 12.54 70.00 $877.80 27769 Optx post ankle fx 20.77 70.00 $1,453.90 27780 Treatment of fibula fracture 8.71 70.00 $609.70 27781 Treatment of fibula fracture 12.16 70.00 $851.20 27784 Treatment of fibula fracture 20.54 70.00 $1,437.80 27786 Treatment of ankle fracture 8.99 70.00 $629.30 27788 Treatment of ankle fracture 11.99 70.00 $839.30 27792 Treatment of ankle fracture 18.74 70.00 $1,311.80 27808 Treatment of ankle fracture 9.51 70.00 $665.70 27810 Treatment of ankle fracture 13.28 70.00 $929.60 27814 Treatment of ankle fracture 22.17 70.00 $1,551.90 27816 Treatment of ankle fracture 9.16 70.00 $641.20 27818 Treatment of ankle fracture 13.78 70.00 $964.60 27822 Treatment of ankle fracture 24.67 70.00 $1,726.90 27823 Treatment of ankle fracture 27.98 70.00 $1,958.60 27824 Treat lower leg fracture 8.94 70.00 $625.80 27825 Treat lower leg fracture 15.55 70.00 $1,088.50 27826 Treat lower leg fracture 24.43 70.00 $1,710.10 27827 Treat lower leg fracture 31.61 70.00 $2,212.70 27828 Treat lower leg fracture 37.81 70.00 $2,646.70 27829 Treat lower leg joint 19.98 70.00 $1,398.60 27830 Treat lower leg dislocation 10.74 70.00 $751.80 27831 Treat lower leg dislocation 10.82 70.00 $757.40 27832 Treat lower leg dislocation 21.75 70.00 $1,522.50 27840 Treat ankle dislocation 10.49 70.00 $734.30 27842 Treat ankle dislocation 14.13 70.00 $989.10 27846 Treat ankle dislocation 20.93 70.00 $1,465.10 27848 Treat ankle dislocation 23.18 70.00 $1,622.60 27860 Fixation of ankle joint 4.96 70.00 $347.20 27870 Fusion of ankle joint open 29.64 70.00 $2,074.80 27871 Fusion of tibiofibular joint 19.67 70.00 $1,376.90 27880 Amputation of lower leg 26.60 70.00 $1,862.00 27881 Amputation of lower leg 25.09 70.00 $1,756.30 27882 Amputation of lower leg 17.40 70.00 $1,218.00 27884 Amputation follow-up surgery 16.66 70.00 $1,166.20 27886 Amputation follow-up surgery 19.04 70.00 $1,332.80 27888 Amputation of foot at ankle 19.87 70.00 $1,390.90 27889 Amputation of foot at ankle 18.78 70.00 $1,314.60 27892 Decompression of leg 15.99 70.00 $1,119.30 27893 Decompression of leg 17.41 70.00 $1,218.70 27894 Decompression of leg 24.70 70.00 $1,729.00 27899 Leg/ankle surgery procedure 0.00 70.00 $0.00 28001 Drainage of bursa of foot 7.96 70.00 $557.20 28002 Treatment of foot infection 12.70 70.00 $889.00 28003 Treatment of foot infection 20.19 70.00 $1,413.30 28005 Treat foot bone lesion 16.59 70.00 $1,161.30 28008 Incision of foot fascia 12.49 70.00 $874.30 28010 Incision of toe tendon 6.66 70.00 $466.20 28011 Incision of toe tendons 9.22 70.00 $645.40 28020 Exploration of foot joint 15.58 70.00 $1,090.60 28022 Exploration of foot joint 14.01 70.00 $980.70 28024 Exploration of toe joint 13.25 70.00 $927.50 28035 Decompression of tibia nerve 15.22 70.00 $1,065.40 28039 Exc foot/toe tum sc 1.5 cm/> 14.64 70.00 $1,024.80 28041 Exc foot/toe tum dep 1.5cm/> 13.16 70.00 $921.20 28043 Exc foot/toe tum sc < 1.5 cm 11.58 70.00 $810.60 28045 Exc foot/toe tum deep <1.5cm 14.34 70.00 $1,003.80 28046 Resect foot/toe tumor < 3 cm 20.98 70.00 $1,468.60 28047 Resect foot/toe tumor 3 cm/> 30.67 70.00 $2,146.90 28050 Biopsy of foot joint lining 13.71 70.00 $959.70 28052 Biopsy of foot joint lining 12.80 70.00 $896.00 28054 Biopsy of toe joint lining 11.11 70.00 $777.70 28055 Neurectomy foot 10.85 70.00 $759.50 28060 Partial removal foot fascia 14.93 70.00 $1,045.10 28062 Removal of foot fascia 16.95 70.00 $1,186.50 28070 Removal of foot joint lining 15.51 70.00 $1,085.70 28072 Removal of foot joint lining 14.71 70.00 $1,029.70 28080 Removal of foot lesion 15.18 70.00 $1,062.60 28086 Excise foot tendon sheath 15.75 70.00 $1,102.50 28088 Excise foot tendon sheath 12.89 70.00 $902.30 28090 Removal of foot lesion 13.58 70.00 $950.60 28092 Removal of toe lesions 12.26 70.00 $858.20 28100 Removal of ankle/heel lesion 17.51 70.00 $1,225.70 28102 Remove/graft foot lesion 17.40 70.00 $1,218.00 28103 Remove/graft foot lesion 11.42 70.00 $799.40 28104 Removal of foot lesion 15.25 70.00 $1,067.50 28106 Remove/graft foot lesion 12.34 70.00 $863.80 28107 Remove/graft foot lesion 14.94 70.00 $1,045.80 28108 Removal of toe lesions 12.71 70.00 $889.70 28110 Part removal of metatarsal 13.39 70.00 $937.30 28111 Part removal of metatarsal 14.24 70.00 $996.80 28112 Part removal of metatarsal 14.14 70.00 $989.80 28113 Part removal of metatarsal 17.08 70.00 $1,195.60 28114 Removal of metatarsal heads 31.02 70.00 $2,171.40 28116 Revision of foot 21.93 70.00 $1,535.10 28118 Removal of heel bone 17.08 70.00 $1,195.60 28119 Removal of heel spur 15.17 70.00 $1,061.90 28120 Part removal of ankle/heel 19.50 70.00 $1,365.00 28122 Partial removal of foot bone 17.30 70.00 $1,211.00 28124 Partial removal of toe 13.79 70.00 $965.30 28126 Partial removal of toe 11.44 70.00 $800.80 28130 Removal of ankle bone 18.50 70.00 $1,295.00 28140 Removal of metatarsal 17.20 70.00 $1,204.00 28150 Removal of toe 12.32 70.00 $862.40 28153 Partial removal of toe 11.87 70.00 $830.90 28160 Partial removal of toe 12.13 70.00 $849.10 28171 Resect tarsal tumor 24.41 70.00 $1,708.70 28173 Resect metatarsal tumor 21.87 70.00 $1,530.90 28175 Resect phalanx of toe tumor 14.10 70.00 $987.00 28190 Removal of foot foreign body 7.42 70.00 $519.40 28192 Removal of foot foreign body 13.54 70.00 $947.80 28193 Removal of foot foreign body 15.35 70.00 $1,074.50 28200 Repair of foot tendon 14.19 70.00 $993.30 28202 Repair/graft of foot tendon 17.14 70.00 $1,199.80 28208 Repair of foot tendon 13.78 70.00 $964.60 28210 Repair/graft of foot tendon 16.85 70.00 $1,179.50 28220 Release of foot tendon 13.06 70.00 $914.20 28222 Release of foot tendons 14.66 70.00 $1,026.20 28225 Release of foot tendon 11.94 70.00 $835.80 28226 Release of foot tendons 14.16 70.00 $991.20 28230 Incision of foot tendon(s) 12.59 70.00 $881.30 28232 Incision of toe tendon 11.20 70.00 $784.00 28234 Incision of foot tendon 11.80 70.00 $826.00 28238 Revision of foot tendon 19.35 70.00 $1,354.50 28240 Release of big toe 13.06 70.00 $914.20 28250 Revision of foot fascia 16.69 70.00 $1,168.30 28260 Release of midfoot joint 20.01 70.00 $1,400.70 28261 Revision of foot tendon 28.91 70.00 $2,023.70 28262 Revision of foot and ankle 42.37 70.00 $2,965.90 28264 Release of midfoot joint 25.25 70.00 $1,767.50 28270 Release of foot contracture 14.23 70.00 $996.10 28272 Release of toe joint each 11.40 70.00 $798.00 28280 Fusion of toes 14.92 70.00 $1,044.40 28285 Repair of hammertoe 15.46 70.00 $1,082.20 28286 Repair of hammertoe 13.02 70.00 $911.40 28288 Partial removal of foot bone 17.44 70.00 $1,220.80 28289 Corrj halux rigdus w/o implt 21.58 70.00 $1,510.60 28291 Corrj halux rigdus w/implt 21.14 70.00 $1,479.80 28292 Correction hallux valgus 21.58 70.00 $1,510.60 28295 Correction hallux valgus 27.10 70.00 $1,897.00 28296 Correction hallux valgus 26.33 70.00 $1,843.10 28297 Correction hallux valgus 30.25 70.00 $2,117.50 28298 Correction hallux valgus 24.55 70.00 $1,718.50 28299 Correction hallux valgus 28.93 70.00 $2,025.10 28300 Incision of heel bone 18.73 70.00 $1,311.10 28302 Incision of ankle bone 20.59 70.00 $1,441.30 28304 Incision of midfoot bones 23.90 70.00 $1,673.00 28305 Incise/graft midfoot bones 19.18 70.00 $1,342.60 28306 Incision of metatarsal 17.76 70.00 $1,243.20 28307 Incision of metatarsal 19.26 70.00 $1,348.20 28308 Incision of metatarsal 16.39 70.00 $1,147.30 28309 Incision of metatarsals 25.92 70.00 $1,814.40 28310 Revision of big toe 15.84 70.00 $1,108.80 28312 Revision of toe 14.70 70.00 $1,029.00 28313 Repair deformity of toe 15.22 70.00 $1,065.40 28315 Removal of sesamoid bone 13.95 70.00 $976.50 28320 Repair of foot bones 17.61 70.00 $1,232.70 28322 Repair of metatarsals 22.70 70.00 $1,589.00 28340 Resect enlarged toe tissue 16.72 70.00 $1,170.40 28341 Resect enlarged toe 19.40 70.00 $1,358.00 28344 Repair extra toe(s) 16.11 70.00 $1,127.70 28345 Repair webbed toe(s) 15.34 70.00 $1,073.80 28360 Reconstruct cleft foot 26.52 70.00 $1,856.40 28400 Treatment of heel fracture 7.10 70.00 $497.00 28405 Treatment of heel fracture 11.24 70.00 $786.80 28406 Treatment of heel fracture 14.93 70.00 $1,045.10 28415 Treat heel fracture 32.31 70.00 $2,261.70 28420 Treat/graft heel fracture 36.61 70.00 $2,562.70 28430 Treatment of ankle fracture 6.75 70.00 $472.50 28435 Treatment of ankle fracture 9.20 70.00 $644.00 28436 Treatment of ankle fracture 12.77 70.00 $893.90 28445 Treat ankle fracture 30.60 70.00 $2,142.00 28446 Osteochondral talus autogrft 34.73 70.00 $2,431.10 28450 Treat midfoot fracture each 6.17 70.00 $431.90 28455 Treat midfoot fracture each 8.23 70.00 $576.10 28456 Treat midfoot fracture 9.02 70.00 $631.40 28465 Treat midfoot fracture each 18.06 70.00 $1,264.20 28470 Treat metatarsal fracture 6.25 70.00 $437.50 28475 Treat metatarsal fracture 7.31 70.00 $511.70 28476 Treat metatarsal fracture 10.10 70.00 $707.00 28485 Treat metatarsal fracture 15.56 70.00 $1,089.20 28490 Treat big toe fracture 4.16 70.00 $291.20 28495 Treat big toe fracture 5.10 70.00 $357.00 28496 Treat big toe fracture 12.88 70.00 $901.60 28505 Treat big toe fracture 19.30 70.00 $1,351.00 28510 Treatment of toe fracture 3.54 70.00 $247.80 28515 Treatment of toe fracture 4.63 70.00 $324.10 28525 Treat toe fracture 16.27 70.00 $1,138.90 28530 Treat sesamoid bone fracture 3.30 70.00 $231.00 28531 Treat sesamoid bone fracture 9.90 70.00 $693.00 28540 Treat foot dislocation 5.52 70.00 $386.40 28545 Treat foot dislocation 8.47 70.00 $592.90 28546 Treat foot dislocation 16.17 70.00 $1,131.90 28555 Repair foot dislocation 25.32 70.00 $1,772.40 28570 Treat foot dislocation 5.16 70.00 $361.20 28575 Treat foot dislocation 10.15 70.00 $710.50 28576 Treat foot dislocation 11.33 70.00 $793.10 28585 Repair foot dislocation 24.90 70.00 $1,743.00 28600 Treat foot dislocation 6.34 70.00 $443.80 28605 Treat foot dislocation 9.37 70.00 $655.90 28606 Treat foot dislocation 11.38 70.00 $796.60 28615 Repair foot dislocation 23.12 70.00 $1,618.40 28630 Treat toe dislocation 4.56 70.00 $319.20 28635 Treat toe dislocation 5.05 70.00 $353.50 28636 Treat toe dislocation 10.06 70.00 $704.20 28645 Repair toe dislocation 18.94 70.00 $1,325.80 28660 Treat toe dislocation 3.35 70.00 $234.50 28665 Treat toe dislocation 4.46 70.00 $312.20 28666 Treat toe dislocation 5.33 70.00 $373.10 28675 Repair of toe dislocation 16.86 70.00 $1,180.20 28705 Fusion of foot bones 35.91 70.00 $2,513.70 28715 Fusion of foot bones 27.02 70.00 $1,891.40 28725 Fusion of foot bones 22.39 70.00 $1,567.30 28730 Fusion of foot bones 21.08 70.00 $1,475.60 28735 Fusion of foot bones 22.55 70.00 $1,578.50 28737 Revision of foot bones 20.05 70.00 $1,403.50 28740 Fusion of foot bones 24.41 70.00 $1,708.70 28750 Fusion of big toe joint 23.39 70.00 $1,637.30 28755 Fusion of big toe joint 14.68 70.00 $1,027.60 28760 Fusion of big toe joint 22.94 70.00 $1,605.80 28800 Amputation of midfoot 15.58 70.00 $1,090.60 28805 Amputation thru metatarsal 21.12 70.00 $1,478.40 28810 Amputation toe & metatarsal 12.45 70.00 $871.50 28820 Amputation of toe 16.28 70.00 $1,139.60 28825 Partial amputation of toe 15.56 70.00 $1,089.20 28890 Hi enrgy eswt plantar fascia 9.34 70.00 $653.80 28899 Foot/toes surgery procedure 0.00 70.00 $0.00 29000 Application of body cast 8.59 70.00 $601.30 29010 Application of body cast 6.25 70.00 $437.50 29015 Application of body cast 7.62 70.00 $533.40 29035 Application of body cast 7.31 70.00 $511.70 29040 Application of body cast 6.45 70.00 $451.50 29044 Application of body cast 7.14 70.00 $499.80 29046 Application of body cast 7.47 70.00 $522.90 29049 Application of figure eight 2.10 70.00 $147.00 29055 Application of shoulder cast 6.28 70.00 $439.60 29058 Application of shoulder cast 3.51 70.00 $245.70 29065 Application of long arm cast 2.74 70.00 $191.80 29075 Application of forearm cast 2.48 70.00 $173.60 29085 Apply hand/wrist cast 2.73 70.00 $191.10 29086 Apply finger cast 2.17 70.00 $151.90 29105 Apply long arm splint 2.51 70.00 $175.70 29125 Apply forearm splint 1.84 70.00 $128.80 29126 Apply forearm splint 2.16 70.00 $151.20 29130 Application of finger splint 1.17 70.00 $81.90 29131 Application of finger splint 1.45 70.00 $101.50 29200 Strapping of chest 0.85 70.00 $59.50 29240 Strapping of shoulder 0.81 70.00 $56.70 29260 Strapping of elbow or wrist 0.82 70.00 $57.40 29280 Strapping of hand or finger 0.82 70.00 $57.40 29305 Application of hip cast 7.01 70.00 $490.70 29325 Application of hip casts 7.80 70.00 $546.00 29345 Application of long leg cast 3.90 70.00 $273.00 29355 Application of long leg cast 4.03 70.00 $282.10 29358 Apply long leg cast brace 4.59 70.00 $321.30 29365 Application of long leg cast 3.51 70.00 $245.70 29405 Apply short leg cast 2.34 70.00 $163.80 29425 Apply short leg cast 2.24 70.00 $156.80 29435 Apply short leg cast 3.36 70.00 $235.20 29440 Addition of walker to cast 1.25 70.00 $87.50 29445 Apply rigid leg cast 3.84 70.00 $268.80 29450 Application of leg cast 4.14 70.00 $289.80 29505 Application long leg splint 2.39 70.00 $167.30 29515 Application lower leg splint 2.06 70.00 $144.20 29520 Strapping of hip 0.89 70.00 $62.30 29530 Strapping of knee 0.81 70.00 $56.70 29540 Strapping of ankle and/or ft 0.74 70.00 $51.80 29550 Strapping of toes 0.54 70.00 $37.80 29580 Application of paste boot 1.49 70.00 $104.30 29581 Apply multlay comprs lwr leg 1.77 70.00 $123.90 29582 Apply multlay comprs upr leg 2.00 70.00 $140.00 29583 Apply multlay comprs upr arm 1.25 70.00 $87.50 29584 Appl multlay comprs arm/hand 2.00 70.00 $140.00 29700 Removal/revision of cast 1.80 70.00 $126.00 29705 Removal/revision of cast 1.91 70.00 $133.70 29710 Removal/revision of cast 3.48 70.00 $243.60 29720 Repair of body cast 2.43 70.00 $170.10 29730 Windowing of cast 1.84 70.00 $128.80 29740 Wedging of cast 2.85 70.00 $199.50 29750 Wedging of clubfoot cast 2.59 70.00 $181.30 29799 Casting/strapping procedure 0.00 70.00 $0.00 29800 Jaw arthroscopy/surgery 15.17 70.00 $1,061.90 29804 Jaw arthroscopy/surgery 18.56 70.00 $1,299.20 29805 Shoulder arthroscopy dx 13.56 70.00 $949.20 29806 Shoulder arthroscopy/surgery 30.58 70.00 $2,140.60 29807 Shoulder arthroscopy/surgery 29.82 70.00 $2,087.40 29819 Shoulder arthroscopy/surgery 16.84 70.00 $1,178.80 29820 Shoulder arthroscopy/surgery 15.35 70.00 $1,074.50 29821 Shoulder arthroscopy/surgery 16.77 70.00 $1,173.90 29822 Shoulder arthroscopy/surgery 16.29 70.00 $1,140.30 29823 Shoulder arthroscopy/surgery 17.77 70.00 $1,243.90 29824 Shoulder arthroscopy/surgery 19.15 70.00 $1,340.50 29825 Shoulder arthroscopy/surgery 16.58 70.00 $1,160.60 29826 Shoulder arthroscopy/surgery 5.10 70.00 $357.00 29827 Arthroscop rotator cuff repr 30.36 70.00 $2,125.20 29828 Arthroscopy biceps tenodesis 26.20 70.00 $1,834.00 29830 Elbow arthroscopy 13.12 70.00 $918.40 29834 Elbow arthroscopy/surgery 13.99 70.00 $979.30 29835 Elbow arthroscopy/surgery 14.39 70.00 $1,007.30 29836 Elbow arthroscopy/surgery 16.42 70.00 $1,149.40 29837 Elbow arthroscopy/surgery 15.01 70.00 $1,050.70 29838 Elbow arthroscopy/surgery 16.88 70.00 $1,181.60 29840 Wrist arthroscopy 12.93 70.00 $905.10 29843 Wrist arthroscopy/surgery 13.92 70.00 $974.40 29844 Wrist arthroscopy/surgery 14.23 70.00 $996.10 29845 Wrist arthroscopy/surgery 16.53 70.00 $1,157.10 29846 Wrist arthroscopy/surgery 14.93 70.00 $1,045.10 29847 Wrist arthroscopy/surgery 15.57 70.00 $1,089.90 29848 Wrist endoscopy/surgery 14.68 70.00 $1,027.60 29850 Knee arthroscopy/surgery 17.44 70.00 $1,220.80 29851 Knee arthroscopy/surgery 25.97 70.00 $1,817.90 29855 Tibial arthroscopy/surgery 22.50 70.00 $1,575.00 29856 Tibial arthroscopy/surgery 28.57 70.00 $1,999.90 29860 Hip arthroscopy dx 18.99 70.00 $1,329.30 29861 Hip arthro w/fb removal 20.74 70.00 $1,451.80 29862 Hip arthr0 w/debridement 23.18 70.00 $1,622.60 29863 Hip arthr0 w/synovectomy 23.17 70.00 $1,621.90 29866 Autgrft implnt knee w/scope 29.85 70.00 $2,089.50 29867 Allgrft implnt knee w/scope 36.90 70.00 $2,583.00 29868 Meniscal trnspl knee w/scpe 47.51 70.00 $3,325.70 29870 Knee arthroscopy dx 16.67 70.00 $1,166.90 29871 Knee arthroscopy/drainage 14.80 70.00 $1,036.00 29873 Knee arthroscopy/surgery 15.03 70.00 $1,052.10 29874 Knee arthroscopy/surgery 15.45 70.00 $1,081.50 29875 Knee arthroscopy/surgery 14.23 70.00 $996.10 29876 Knee arthroscopy/surgery 18.92 70.00 $1,324.40 29877 Knee arthroscopy/surgery 17.87 70.00 $1,250.90 29879 Knee arthroscopy/surgery 19.05 70.00 $1,333.50 29880 Knee arthroscopy/surgery 16.17 70.00 $1,131.90 29881 Knee arthroscopy/surgery 15.56 70.00 $1,089.20 29882 Knee arthroscopy/surgery 20.19 70.00 $1,413.30 29883 Knee arthroscopy/surgery 24.32 70.00 $1,702.40 29884 Knee arthroscopy/surgery 17.65 70.00 $1,235.50 29885 Knee arthroscopy/surgery 21.50 70.00 $1,505.00 29886 Knee arthroscopy/surgery 18.27 70.00 $1,278.90 29887 Knee arthroscopy/surgery 21.27 70.00 $1,488.90 29888 Knee arthroscopy/surgery 28.38 70.00 $1,986.60 29889 Knee arthroscopy/surgery 35.21 70.00 $2,464.70 29891 Ankle arthroscopy/surgery 19.32 70.00 $1,352.40 29892 Ankle arthroscopy/surgery 18.62 70.00 $1,303.40 29893 Scope plantar fasciotomy 17.62 70.00 $1,233.40 29894 Ankle arthroscopy/surgery 14.29 70.00 $1,000.30 29895 Ankle arthroscopy/surgery 13.72 70.00 $960.40 29897 Ankle arthroscopy/surgery 14.47 70.00 $1,012.90 29898 Ankle arthroscopy/surgery 16.22 70.00 $1,135.40 29899 Ankle arthroscopy/surgery 29.90 70.00 $2,093.00 29900 Mcp joint arthroscopy dx 12.07 70.00 $844.90 29901 Mcp joint arthroscopy surg 15.13 70.00 $1,059.10 29902 Mcp joint arthroscopy surg 13.96 70.00 $977.20 29904 Subtalar arthro w/fb rmvl 18.06 70.00 $1,264.20 29905 Subtalar arthro w/exc 19.55 70.00 $1,368.50 29906 Subtalar arthro w/deb 19.90 70.00 $1,393.00 29907 Subtalar arthro w/fusion 25.21 70.00 $1,764.70 29914 Hip arthro w/femoroplasty 28.59 70.00 $2,001.30 29915 Hip arthro acetabuloplasty 29.12 70.00 $2,038.40 29916 Hip arthro w/labral repair 29.15 70.00 $2,040.50 29999 Arthroscopy of joint 0.00 70.00 $0.00 30000 Drainage of nose lesion 6.48 70.00 $453.60 30020 Drainage of nose lesion 6.57 70.00 $459.90 3006F Cxr doc rev 0.00 70.00 $0.00 3008F Body mass index docd 0.00 70.00 $0.00 30100 Intranasal biopsy 3.98 70.00 $278.60 3011F Lipid panel doc rev 0.00 70.00 $0.00 30110 Removal of nose polyp(s) 6.51 70.00 $455.70 30115 Removal of nose polyp(s) 12.23 70.00 $856.10 30117 Removal of intranasal lesion 24.73 70.00 $1,731.10 30118 Removal of intranasal lesion 21.84 70.00 $1,528.80 30120 Revision of nose 14.84 70.00 $1,038.80 30124 Removal of nose lesion 8.10 70.00 $567.00 30125 Removal of nose lesion 17.19 70.00 $1,203.30 30130 Excise inferior turbinate 10.79 70.00 $755.30 3014F Screen mammo doc rev 0.00 70.00 $0.00 30140 Resect inferior turbinate 12.46 70.00 $872.20 3015F Cerv cancer screen docd 0.00 70.00 $0.00 30150 Partial removal of nose 21.82 70.00 $1,527.40 3016F Pt scrnd unhlthy oh use 0.00 70.00 $0.00 30160 Removal of nose 21.91 70.00 $1,533.70 3017F Colorectal ca screen doc rev 0.00 70.00 $0.00 3018F Pre-prxd rsk et al docd 0.00 70.00 $0.00 3019F Lvef assess planpost dschrge 0.00 70.00 $0.00 3020F Lvf assess 0.00 70.00 $0.00 30200 Injection treatment of nose 3.19 70.00 $223.30 3021F Lvef mod/sever deprs syst 0.00 70.00 $0.00 30210 Nasal sinus therapy 4.23 70.00 $296.10 3022F Lvef >/=40% systolic 0.00 70.00 $0.00 30220 Insert nasal septal button 8.55 70.00 $598.50 3023F Spirom doc rev 0.00 70.00 $0.00 3025F Spirom fev/fvc <70% w/copd 0.00 70.00 $0.00 3027F Spirom fev/fvc>/=70%/w/ocopd 0.00 70.00 $0.00 3028F O2 saturation doc rev 0.00 70.00 $0.00 30300 Remove nasal foreign body 5.04 70.00 $352.80 30310 Remove nasal foreign body 5.85 70.00 $409.50 30320 Remove nasal foreign body 12.80 70.00 $896.00 3035F O2 saturation88%/pao>55 hg 0.00 70.00 $0.00 3038F Pulm fx w/in 12 mon b/4 surg 0.00 70.00 $0.00 3040F Fev <40% predicted value 0.00 70.00 $0.00 30400 Reconstruction of nose 28.63 70.00 $2,004.10 30410 Reconstruction of nose 33.35 70.00 $2,334.50 3042F Fev >/=40% predicted value 0.00 70.00 $0.00 30420 Reconstruction of nose 38.86 70.00 $2,720.20 30430 Revision of nose 24.26 70.00 $1,698.20 30435 Revision of nose 35.69 70.00 $2,498.30 3044F Hg a1c level lt 7.0% 0.00 70.00 $0.00 3045F Hg a1c level 7.0-9.0% 0.00 70.00 $0.00 30450 Revision of nose 42.33 70.00 $2,963.10 3046F Hemoglobin a1c level >9.0% 0.00 70.00 $0.00 30460 Revision of nose 23.19 70.00 $1,623.30 30462 Revision of nose 40.05 70.00 $2,803.50 30465 Repair nasal stenosis 27.81 70.00 $1,946.70 3048F Ldl-c <100 mg/dl 0.00 70.00 $0.00 3049F Ldl-c 100-129 mg/dl 0.00 70.00 $0.00 3050F Ldl-c >/= 130 mg/dl 0.00 70.00 $0.00 30520 Repair of nasal septum 17.65 70.00 $1,235.50 30540 Repair nasal defect 19.62 70.00 $1,373.40 30545 Repair nasal defect 25.18 70.00 $1,762.60 3055F Lvef less than/equal to 35% 0.00 70.00 $0.00 3056F Lvef greater than 35% 0.00 70.00 $0.00 30560 Release of nasal adhesions 7.57 70.00 $529.90 30580 Repair upper jaw fistula 18.65 70.00 $1,305.50 3060F Pos microalbuminuria rev 0.00 70.00 $0.00 30600 Repair mouth/nose fistula 16.17 70.00 $1,131.90 3061F Neg microalbuminuria rev 0.00 70.00 $0.00 3062F Pos macroalbuminuria rev 0.00 70.00 $0.00 30620 Intranasal reconstruction 17.70 70.00 $1,239.00 30630 Repair nasal septum defect 17.63 70.00 $1,234.10 3066F Nephropathy doc tx 0.00 70.00 $0.00 3072F Low risk for retinopathy 0.00 70.00 $0.00 3073F Pre-surg eye measures docd 0.00 70.00 $0.00 3074F Syst bp lt 130 mm hg 0.00 70.00 $0.00 3075F Syst bp ge 130 - 139mm hg 0.00 70.00 $0.00 3077F Syst bp >/= 140 mm hg 0.00 70.00 $0.00 3078F Diast bp <80 mm hg 0.00 70.00 $0.00 3079F Diast bp 80-89 mm hg 0.00 70.00 $0.00 3080F Diast bp >/= 90 mm hg 0.00 70.00 $0.00 30801 Ablate inf turbinate superf 6.47 70.00 $452.90 30802 Ablate inf turbinate submuc 8.21 70.00 $574.70 3082F Kt/v <1.2 0.00 70.00 $0.00 3083F Kt/v =/> 1.2 & <1.7 0.00 70.00 $0.00 3084F Kt/v >/= 1.7 0.00 70.00 $0.00 3085F Suicide risk assessed 0.00 70.00 $0.00 3088F Mdd mild 0.00 70.00 $0.00 3089F Mdd moderate 0.00 70.00 $0.00 3090F Mdd severe w/o psych 0.00 70.00 $0.00 30901 Control of nosebleed 2.70 70.00 $189.00 30903 Control of nosebleed 6.26 70.00 $438.20 30905 Control of nosebleed 7.69 70.00 $538.30 30906 Repeat control of nosebleed 9.84 70.00 $688.80 3091F Mdd severe w/psych 0.00 70.00 $0.00 30915 Ligation nasal sinus artery 16.31 70.00 $1,141.70 3092F Mdd in remission 0.00 70.00 $0.00 30920 Ligation upper jaw artery 23.74 70.00 $1,661.80 3093F Doc new diag 1st/addl mdd 0.00 70.00 $0.00 30930 Ther fx nasal inf turbinate 3.49 70.00 $244.30 3095F Central dexa results docd 0.00 70.00 $0.00 3096F Central dexa ordered 0.00 70.00 $0.00 30999 Nasal surgery procedure 0.00 70.00 $0.00 3100F Image test ref carot diam 0.00 70.00 $0.00 31000 Irrigation maxillary sinus 5.21 70.00 $364.70 31002 Irrigation sphenoid sinus 5.40 70.00 $378.00 31020 Exploration maxillary sinus 13.75 70.00 $962.50 31030 Exploration maxillary sinus 19.58 70.00 $1,370.60 31032 Explore sinus remove polyps 16.30 70.00 $1,141.00 31040 Exploration behind upper jaw 21.65 70.00 $1,515.50 31050 Exploration sphenoid sinus 13.71 70.00 $959.70 31051 Sphenoid sinus surgery 18.29 70.00 $1,280.30 31070 Exploration of frontal sinus 12.42 70.00 $869.40 31075 Exploration of frontal sinus 22.27 70.00 $1,558.90 31080 Removal of frontal sinus 29.65 70.00 $2,075.50 31081 Removal of frontal sinus 42.52 70.00 $2,976.40 31084 Removal of frontal sinus 33.73 70.00 $2,361.10 31085 Removal of frontal sinus 45.38 70.00 $3,176.60 31086 Removal of frontal sinus 32.18 70.00 $2,252.60 31087 Removal of frontal sinus 30.95 70.00 $2,166.50 31090 Exploration of sinuses 29.04 70.00 $2,032.80 3110F Pres/absn hmrhg/lesion docd 0.00 70.00 $0.00 3111F Ct/mri brain done w/in 24hrs 0.00 70.00 $0.00 3112F Ct/mri brain done 24 hrs 0.00 70.00 $0.00 3115F Quant results activity &symp 0.00 70.00 $0.00 3117F Hf assessment tool completed 0.00 70.00 $0.00 3118F Ny heart assoc class docd 0.00 70.00 $0.00 3119F No eval activity clin symp 0.00 70.00 $0.00 3120F 12-lead ecg performed 0.00 70.00 $0.00 31200 Removal of ethmoid sinus 16.24 70.00 $1,136.80 31201 Removal of ethmoid sinus 20.98 70.00 $1,468.60 31205 Removal of ethmoid sinus 25.55 70.00 $1,788.50 31225 Removal of upper jaw 53.43 70.00 $3,740.10 31230 Removal of upper jaw 58.81 70.00 $4,116.70 31231 Nasal endoscopy dx 5.92 70.00 $414.40 31233 Nasal/sinus endoscopy dx 7.42 70.00 $519.40 31235 Nasal/sinus endoscopy dx 8.47 70.00 $592.90 31237 Nasal/sinus endoscopy surg 7.32 70.00 $512.40 31238 Nasal/sinus endoscopy surg 7.31 70.00 $511.70 31239 Nasal/sinus endoscopy surg 17.58 70.00 $1,230.60 31240 Nasal/sinus endoscopy surg 4.60 70.00 $322.00 31254 Revision of ethmoid sinus 7.82 70.00 $547.40 31255 Removal of ethmoid sinus 11.45 70.00 $801.50 31256 Exploration maxillary sinus 5.66 70.00 $396.20 3126F Esoph bx rprt w/dyspl info 0.00 70.00 $0.00 31267 Endoscopy maxillary sinus 9.08 70.00 $635.60 31276 Sinus endoscopy surgical 14.44 70.00 $1,010.80 31287 Nasal/sinus endoscopy surg 6.64 70.00 $464.80 31288 Nasal/sinus endoscopy surg 7.70 70.00 $539.00 31290 Nasal/sinus endoscopy surg 33.04 70.00 $2,312.80 31291 Nasal/sinus endoscopy surg 35.26 70.00 $2,468.20 31292 Nasal/sinus endoscopy surg 28.56 70.00 $1,999.20 31293 Nasal/sinus endoscopy surg 31.03 70.00 $2,172.10 31294 Nasal/sinus endoscopy surg 35.90 70.00 $2,513.00 31295 Sinus endo w/balloon dil 57.31 70.00 $4,011.70 31296 Sinus endo w/balloon dil 58.46 70.00 $4,092.20 31297 Sinus endo w/balloon dil 57.40 70.00 $4,018.00 31299 Sinus surgery procedure 0.00 70.00 $0.00 3130F Upper gi endoscopy performed 0.00 70.00 $0.00 31300 Removal of larynx lesion 37.31 70.00 $2,611.70 3132F Doc ref upper gi endoscopy 0.00 70.00 $0.00 31320 Diagnostic incision larynx 16.07 70.00 $1,124.90 31360 Removal of larynx 60.43 70.00 $4,230.10 31365 Removal of larynx 74.53 70.00 $5,217.10 31367 Partial removal of larynx 63.86 70.00 $4,470.20 31368 Partial removal of larynx 71.08 70.00 $4,975.60 31370 Partial removal of larynx 60.13 70.00 $4,209.10 31375 Partial removal of larynx 57.01 70.00 $3,990.70 31380 Partial removal of larynx 56.24 70.00 $3,936.80 31382 Partial removal of larynx 61.87 70.00 $4,330.90 31390 Removal of larynx & pharynx 83.10 70.00 $5,817.00 31395 Reconstruct larynx & pharynx 87.85 70.00 $6,149.50 3140F Upper gi endo shows barrtts 0.00 70.00 $0.00 31400 Revision of larynx 28.15 70.00 $1,970.50 3141F Upper gi endo not barrtts 0.00 70.00 $0.00 3142F Barium swallow test ordered 0.00 70.00 $0.00 31420 Removal of epiglottis 23.74 70.00 $1,661.80 3150F Forceps esoph biopsy done 0.00 70.00 $0.00 31500 Insert emergency airway 4.07 70.00 $284.90 31502 Change of windpipe airway 1.01 70.00 $70.70 31505 Diagnostic laryngoscopy 2.34 70.00 $163.80 31510 Laryngoscopy with biopsy 6.03 70.00 $422.10 31511 Remove foreign body larynx 6.02 70.00 $421.40 31512 Removal of larynx lesion 5.87 70.00 $410.90 31513 Injection into vocal cord 3.80 70.00 $266.00 31515 Laryngoscopy for aspiration 5.17 70.00 $361.90 31520 Dx laryngoscopy newborn 4.51 70.00 $315.70 31525 Dx laryngoscopy excl nb 7.20 70.00 $504.00 31526 Dx laryngoscopy w/oper scope 4.53 70.00 $317.10 31527 Laryngoscopy for treatment 5.61 70.00 $392.70 31528 Laryngoscopy and dilation 4.17 70.00 $291.90 31529 Laryngoscopy and dilation 4.66 70.00 $326.20 31530 Laryngoscopy w/fb removal 5.71 70.00 $399.70 31531 Laryngoscopy w/fb & op scope 6.11 70.00 $427.70 31535 Laryngoscopy w/biopsy 5.46 70.00 $382.20 31536 Laryngoscopy w/bx & op scope 6.08 70.00 $425.60 31540 Laryngoscopy w/exc of tumor 6.98 70.00 $488.60 31541 Larynscop w/tumr exc + scope 7.61 70.00 $532.70 31545 Remove vc lesion w/scope 10.45 70.00 $731.50 31546 Remove vc lesion scope/graft 15.88 70.00 $1,111.60 3155F Cytogen test marrow b/4 tx 0.00 70.00 $0.00 31551 Laryngoplasty laryngeal sten 40.74 70.00 $2,851.80 31552 Laryngoplasty laryngeal sten 41.19 70.00 $2,883.30 31553 Laryngoplasty laryngeal sten 44.91 70.00 $3,143.70 31554 Laryngoplasty laryngeal sten 47.29 70.00 $3,310.30 31560 Laryngoscop w/arytenoidectom 9.03 70.00 $632.10 31561 Larynscop remve cart + scop 9.89 70.00 $692.30 31570 Laryngoscope w/vc inj 9.64 70.00 $674.80 31571 Laryngoscop w/vc inj + scope 7.21 70.00 $504.70 31572 Largsc w/laser dstrj les 14.15 70.00 $990.50 31573 Largsc w/ther injection 7.53 70.00 $527.10 31574 Largsc w/njx augmentation 29.16 70.00 $2,041.20 31575 Diagnostic laryngoscopy 3.23 70.00 $226.10 31576 Laryngoscopy with biopsy 7.53 70.00 $527.10 31577 Largsc w/rmvl foreign bdy(s) 7.80 70.00 $546.00 31578 Largsc w/removal lesion 8.57 70.00 $599.90 31579 Laryngoscopy telescopic 5.04 70.00 $352.80 31580 Laryngoplasty laryngeal web 35.73 70.00 $2,501.10 31584 Laryngoplasty fx rdctj fixj 39.65 70.00 $2,775.50 31587 Laryngoplasty cricoid split 33.28 70.00 $2,329.60 31590 Reinnervate larynx 24.95 70.00 $1,746.50 31591 Laryngoplasty medialization 29.85 70.00 $2,089.50 31592 Cricotracheal resection 48.30 70.00 $3,381.00 31595 Larynx nerve surgery 21.66 70.00 $1,516.20 31599 Larynx surgery procedure 0.00 70.00 $0.00 3160F Doc fe+ stores b/4 epo thx 0.00 70.00 $0.00 31600 Incision of windpipe 11.46 70.00 $802.20 31601 Incision of windpipe 6.10 70.00 $427.00 31603 Incision of windpipe 6.44 70.00 $450.80 31605 Incision of windpipe 5.32 70.00 $372.40 31610 Incision of windpipe 20.39 70.00 $1,427.30 31611 Surgery/speech prosthesis 15.32 70.00 $1,072.40 31612 Puncture/clear windpipe 2.37 70.00 $165.90 31613 Repair windpipe opening 12.96 70.00 $907.20 31614 Repair windpipe opening 21.53 70.00 $1,507.10 31615 Visualization of windpipe 4.79 70.00 $335.30 31622 Dx bronchoscope/wash 6.86 70.00 $480.20 31623 Dx bronchoscope/brush 7.70 70.00 $539.00 31624 Dx bronchoscope/lavage 7.20 70.00 $504.00 31625 Bronchoscopy w/biopsy(s) 9.43 70.00 $660.10 31626 Bronchoscopy w/markers 23.92 70.00 $1,674.40 31627 Navigational bronchoscopy 39.65 70.00 $2,775.50 31628 Bronchoscopy/lung bx each 10.00 70.00 $700.00 31629 Bronchoscopy/needle bx each 12.36 70.00 $865.20 31630 Bronchoscopy dilate/fx repr 5.78 70.00 $404.60 31631 Bronchoscopy dilate w/stent 6.63 70.00 $464.10 31632 Bronchoscopy/lung bx addl 1.84 70.00 $128.80 31633 Bronchoscopy/needle bx addl 2.29 70.00 $160.30 31634 Bronch w/balloon occlusion 50.88 70.00 $3,561.60 31635 Bronchoscopy w/fb removal 7.96 70.00 $557.20 31636 Bronchoscopy bronch stents 6.37 70.00 $445.90 31637 Bronchoscopy stent add-on 2.14 70.00 $149.80 31638 Bronchoscopy revise stent 7.26 70.00 $508.20 31640 Bronchoscopy w/tumor excise 7.30 70.00 $511.00 31641 Bronchoscopy treat blockage 7.45 70.00 $521.50 31643 Diag bronchoscope/catheter 5.12 70.00 $358.40 31645 Bronchoscopy clear airways 7.25 70.00 $507.50 31646 Bronchoscopy reclear airway 6.53 70.00 $457.10 31647 Bronchial valve init insert 6.10 70.00 $427.00 31648 Bronchial valve remov init 5.57 70.00 $389.90 31649 Bronchial valve remov addl 2.01 70.00 $140.70 31651 Bronchial valve addl insert 2.15 70.00 $150.50 31652 Bronch ebus samplng 1/2 node 23.48 70.00 $1,643.60 31653 Bronch ebus samplng 3/> node 24.85 70.00 $1,739.50 31654 Bronch ebus ivntj perph les 3.59 70.00 $251.30 31660 Bronch thermoplsty 1 lobe 5.66 70.00 $396.20 31661 Bronch thermoplsty 2/> lobes 5.97 70.00 $417.90 3170F Flow cyto done b/4 tx 0.00 70.00 $0.00 31717 Bronchial brush biopsy 7.39 70.00 $517.30 31720 Clearance of airways 1.50 70.00 $105.00 31725 Clearance of airways 2.25 70.00 $157.50 31730 Intro windpipe wire/tube 35.07 70.00 $2,454.90 31750 Repair of windpipe 40.15 70.00 $2,810.50 31755 Repair of windpipe 50.82 70.00 $3,557.40 31760 Repair of windpipe 40.24 70.00 $2,816.80 31766 Reconstruction of windpipe 51.61 70.00 $3,612.70 31770 Repair/graft of bronchus 38.64 70.00 $2,704.80 31775 Reconstruct bronchus 36.94 70.00 $2,585.80 31780 Reconstruct windpipe 33.89 70.00 $2,372.30 31781 Reconstruct windpipe 40.20 70.00 $2,814.00 31785 Remove windpipe lesion 31.08 70.00 $2,175.60 31786 Remove windpipe lesion 43.17 70.00 $3,021.90 31800 Repair of windpipe injury 21.00 70.00 $1,470.00 31805 Repair of windpipe injury 23.66 70.00 $1,656.20 31820 Closure of windpipe lesion 12.33 70.00 $863.10 31825 Repair of windpipe defect 17.08 70.00 $1,195.60 31830 Revise windpipe scar 12.58 70.00 $880.60 31899 Airways surgical procedure 0.00 70.00 $0.00 3200F Barium swallow test not req 0.00 70.00 $0.00 32035 Thoracostomy w/rib resection 20.92 70.00 $1,464.40 32036 Thoracostomy w/flap drainage 22.34 70.00 $1,563.80 32096 Open wedge/bx lung infiltr 23.33 70.00 $1,633.10 32097 Open wedge/bx lung nodule 23.27 70.00 $1,628.90 32098 Open biopsy of lung pleura 22.07 70.00 $1,544.90 3210F Grp a strep test performed 0.00 70.00 $0.00 32100 Exploration of chest 23.47 70.00 $1,642.90 32110 Explore/repair chest 42.35 70.00 $2,964.50 32120 Re-exploration of chest 25.22 70.00 $1,765.40 32124 Explore chest free adhesions 26.82 70.00 $1,877.40 32140 Removal of lung lesion(s) 28.53 70.00 $1,997.10 32141 Remove/treat lung lesions 44.12 70.00 $3,088.40 3215F Pt immunity to hep a docd 0.00 70.00 $0.00 32150 Removal of lung lesion(s) 29.08 70.00 $2,035.60 32151 Remove lung foreign body 29.00 70.00 $2,030.00 3216F Pt immunity to hep b docd 0.00 70.00 $0.00 32160 Open chest heart massage 22.87 70.00 $1,600.90 3218F Rna tstng hep c docd done 0.00 70.00 $0.00 3220F Hep c quant rna tstng docd 0.00 70.00 $0.00 32200 Drain open lung lesion 32.65 70.00 $2,285.50 32215 Treat chest lining 23.05 70.00 $1,613.50 32220 Release of lung 45.80 70.00 $3,206.00 32225 Partial release of lung 28.73 70.00 $2,011.10 3230F Note hring tst w/in 6 mon 0.00 70.00 $0.00 32310 Removal of chest lining 26.44 70.00 $1,850.80 32320 Free/remove chest lining 46.22 70.00 $3,235.40 32400 Needle biopsy chest lining 4.30 70.00 $301.00 32405 Percut bx lung/mediastinum 11.03 70.00 $772.10 32440 Remove lung pneumonectomy 45.28 70.00 $3,169.60 32442 Sleeve pneumonectomy 89.11 70.00 $6,237.70 32445 Removal of lung extrapleural 102.75 70.00 $7,192.50 32480 Partial removal of lung 42.79 70.00 $2,995.30 32482 Bilobectomy 45.78 70.00 $3,204.60 32484 Segmentectomy 41.56 70.00 $2,909.20 32486 Sleeve lobectomy 68.12 70.00 $4,768.40 32488 Completion pneumonectomy 69.57 70.00 $4,869.90 32491 Lung volume reduction 42.62 70.00 $2,983.40 3250F Nonprim loc anat bx site tum 0.00 70.00 $0.00 32501 Repair bronchus add-on 7.10 70.00 $497.00 32503 Resect apical lung tumor 52.33 70.00 $3,663.10 32504 Resect apical lung tum/chest 60.12 70.00 $4,208.40 32505 Wedge resect of lung initial 26.95 70.00 $1,886.50 32506 Wedge resect of lung add-on 4.54 70.00 $317.80 32507 Wedge resect of lung diag 4.54 70.00 $317.80 32540 Removal of lung lesion 50.23 70.00 $3,516.10 32550 Insert pleural cath 20.22 70.00 $1,415.40 32551 Insertion of chest tube 4.56 70.00 $319.20 32552 Remove lung catheter 5.28 70.00 $369.60 32553 Ins mark thor for rt perq 14.84 70.00 $1,038.80 32554 Aspirate pleura w/o imaging 5.74 70.00 $401.80 32555 Aspirate pleura w/ imaging 8.24 70.00 $576.80 32556 Insert cath pleura w/o image 15.71 70.00 $1,099.70 32557 Insert cath pleura w/ image 14.52 70.00 $1,016.40 32560 Treat pleurodesis w/agent 6.93 70.00 $485.10 32561 Lyse chest fibrin init day 2.64 70.00 $184.80 32562 Lyse chest fibrin subq day 2.37 70.00 $165.90 3260F Pt cat/pn cat/hist grd docd 0.00 70.00 $0.00 32601 Thoracoscopy diagnostic 8.94 70.00 $625.80 32604 Thoracoscopy wbx sac 14.01 70.00 $980.70 32606 Thoracoscopy w/bx med space 13.41 70.00 $938.70 32607 Thoracoscopy w/bx infiltrate 8.94 70.00 $625.80 32608 Thoracoscopy w/bx nodule 10.97 70.00 $767.90 32609 Thoracoscopy w/bx pleura 7.50 70.00 $525.00 3265F Rna tstng hepc vir ord/docd 0.00 70.00 $0.00 32650 Thoracoscopy w/pleurodesis 19.24 70.00 $1,346.80 32651 Thoracoscopy remove cortex 31.70 70.00 $2,219.00 32652 Thoracoscopy rem totl cortex 48.11 70.00 $3,367.70 32653 Thoracoscopy remov fb/fibrin 30.64 70.00 $2,144.80 32654 Thoracoscopy contrl bleeding 34.26 70.00 $2,398.20 32655 Thoracoscopy resect bullae 27.66 70.00 $1,936.20 32656 Thoracoscopy w/pleurectomy 23.17 70.00 $1,621.90 32658 Thoracoscopy w/sac fb remove 20.64 70.00 $1,444.80 32659 Thoracoscopy w/sac drainage 21.16 70.00 $1,481.20 3266F Hepc gn tstng docd b/4txmnt 0.00 70.00 $0.00 32661 Thoracoscopy w/pericard exc 23.13 70.00 $1,619.10 32662 Thoracoscopy w/mediast exc 25.82 70.00 $1,807.40 32663 Thoracoscopy w/lobectomy 40.56 70.00 $2,839.20 32664 Thoracoscopy w/ th nrv exc 24.44 70.00 $1,710.80 32665 Thoracoscop w/esoph musc exc 35.74 70.00 $2,501.80 32666 Thoracoscopy w/wedge resect 25.20 70.00 $1,764.00 32667 Thoracoscopy w/w resect addl 4.56 70.00 $319.20 32668 Thoracoscopy w/w resect diag 4.56 70.00 $319.20 32669 Thoracoscopy remove segment 38.96 70.00 $2,727.20 3267F Path rprt w/ pt pn cat et al 0.00 70.00 $0.00 32670 Thoracoscopy bilobectomy 46.42 70.00 $3,249.40 32671 Thoracoscopy pneumonectomy 51.47 70.00 $3,602.90 32672 Thoracoscopy for lvrs 44.13 70.00 $3,089.10 32673 Thoracoscopy w/thymus resect 35.22 70.00 $2,465.40 32674 Thoracoscopy lymph node exc 6.27 70.00 $438.90 3268F Psa/t/glsc docd b/4 txmnt 0.00 70.00 $0.00 3269F Bone scn b/4 txmnt/aftr dx 0.00 70.00 $0.00 3270F No bone scn b/4 txmnt/aftrdx 0.00 70.00 $0.00 32701 Thorax stereo rad targetw/tx 6.21 70.00 $434.70 3271F Low risk prostate cancer 0.00 70.00 $0.00 3272F Med risk prostate cancer 0.00 70.00 $0.00 3273F High risk prostate cancer 0.00 70.00 $0.00 3274F Prost cncr rsk not lw/md/hgh 0.00 70.00 $0.00 3278F Serum lvls ca/ipth/lpd ord 0.00 70.00 $0.00 3279F Hgb lvl >/= 13 g/dl 0.00 70.00 $0.00 3280F Hgb lvl 11-12.9 g/dl 0.00 70.00 $0.00 32800 Repair lung hernia 27.36 70.00 $1,915.20 3281F Hgb lvl <11 g/dl 0.00 70.00 $0.00 32810 Close chest after drainage 25.83 70.00 $1,808.10 32815 Close bronchial fistula 80.81 70.00 $5,656.70 32820 Reconstruct injured chest 40.71 70.00 $2,849.70 3284F Iop down >15% of pre-svc lvl 0.00 70.00 $0.00 3285F Iop down <15% of pre-svc lvl 0.00 70.00 $0.00 32850 Donor pneumonectomy 0.00 70.00 $0.00 32851 Lung transplant single 95.63 70.00 $6,694.10 32852 Lung transplant with bypass 104.47 70.00 $7,312.90 32853 Lung transplant double 133.36 70.00 $9,335.20 32854 Lung transplant with bypass 141.58 70.00 $9,910.60 32855 Prepare donor lung single 0.00 70.00 $0.00 32856 Prepare donor lung double 0.00 70.00 $0.00 3288F Fall risk assessment docd 0.00 70.00 $0.00 3290F Pt=d(rh)- and unsensitized 0.00 70.00 $0.00 32900 Removal of rib(s) 40.73 70.00 $2,851.10 32905 Revise & repair chest wall 38.91 70.00 $2,723.70 32906 Revise & repair chest wall 47.96 70.00 $3,357.20 3291F Pt=d(rh)+ or sensitized 0.00 70.00 $0.00 3292F Hiv tstng asked/docd/revwd 0.00 70.00 $0.00 3293F Abo rh blood typing docd 0.00 70.00 $0.00 3294F Grp b strep screening docd 0.00 70.00 $0.00 32940 Revision of lung 35.84 70.00 $2,508.80 32960 Therapeutic pneumothorax 3.66 70.00 $256.20 32997 Total lung lavage 9.88 70.00 $691.60 32998 Perq rf ablate tx pul tumor 54.95 70.00 $3,846.50 32999 Chest surgery procedure 0.00 70.00 $0.00 3300F Ajcc stage docd b/4 thxpy 0.00 70.00 $0.00 3301F Cancer stage docd metast 0.00 70.00 $0.00 33010 Drainage of heart sac 3.11 70.00 $217.70 33011 Repeat drainage of heart sac 3.14 70.00 $219.80 33015 Incision of heart sac 14.82 70.00 $1,037.40 33020 Incision of heart sac 25.49 70.00 $1,784.30 33025 Incision of heart sac 23.12 70.00 $1,618.40 33030 Partial removal of heart sac 58.10 70.00 $4,067.00 33031 Partial removal of heart sac 71.67 70.00 $5,016.90 33050 Resect heart sac lesion 28.91 70.00 $2,023.70 33120 Removal of heart lesion 60.90 70.00 $4,263.00 33130 Removal of heart lesion 40.05 70.00 $2,803.50 33140 Heart revascularize (tmr) 45.78 70.00 $3,204.60 33141 Heart tmr w/other procedure 3.83 70.00 $268.10 3315F Er+ or pr+ breast cancer 0.00 70.00 $0.00 3316F Er- or pr- breast cancer 0.00 70.00 $0.00 3317F Path rpt malig cancer docd 0.00 70.00 $0.00 3318F Path rpt malig cancer docd 0.00 70.00 $0.00 3319F X-ray/ct/ultrsnd et al ord 0.00 70.00 $0.00 3320F No xray/ct/ et al ordd 0.00 70.00 $0.00 33202 Insert epicard eltrd open 22.49 70.00 $1,574.30 33203 Insert epicard eltrd endo 23.34 70.00 $1,633.80 33206 Insert heart pm atrial 13.08 70.00 $915.60 33207 Insert heart pm ventricular 13.95 70.00 $976.50 33208 Insrt heart pm atrial & vent 15.14 70.00 $1,059.80 3321F Ajcc cncr 0/ia melan docd 0.00 70.00 $0.00 33210 Insert electrd/pm cath sngl 4.81 70.00 $336.70 33211 Insert card electrodes dual 4.92 70.00 $344.40 33212 Insert pulse gen sngl lead 9.28 70.00 $649.60 33213 Insert pulse gen dual leads 9.71 70.00 $679.70 33214 Upgrade of pacemaker system 13.85 70.00 $969.50 33215 Reposition pacing-defib lead 9.01 70.00 $630.70 33216 Insert 1 electrode pm-defib 10.73 70.00 $751.10 33217 Insert 2 electrode pm-defib 10.52 70.00 $736.40 33218 Repair lead pace-defib one 11.28 70.00 $789.60 3322F Melanomaajcc stage 0 or ia 0.00 70.00 $0.00 33220 Repair lead pace-defib dual 11.29 70.00 $790.30 33221 Insert pulse gen mult leads 10.46 70.00 $732.20 33222 Relocation pocket pacemaker 9.74 70.00 $681.80 33223 Relocate pocket for defib 11.82 70.00 $827.40 33224 Insert pacing lead & connect 15.02 70.00 $1,051.40 33225 L ventric pacing lead add-on 13.69 70.00 $958.30 33226 Reposition l ventric lead 14.45 70.00 $1,011.50 33227 Remove&replace pm gen singl 9.79 70.00 $685.30 33228 Remv&replc pm gen dual lead 10.24 70.00 $716.80 33229 Remv&replc pm gen mult leads 10.85 70.00 $759.50 3323F Clin node stgng docdb/4 surg 0.00 70.00 $0.00 33230 Insrt pulse gen w/dual leads 11.10 70.00 $777.00 33231 Insrt pulse gen w/mult leads 11.67 70.00 $816.90 33233 Removal of pm generator 6.65 70.00 $465.50 33234 Removal of pacemaker system 14.07 70.00 $984.90 33235 Removal pacemaker electrode 18.49 70.00 $1,294.30 33236 Remove electrode/thoracotomy 22.71 70.00 $1,589.70 33237 Remove electrode/thoracotomy 24.26 70.00 $1,698.20 33238 Remove electrode/thoracotomy 27.04 70.00 $1,892.80 3324F Mri ct scan ord rvwd rqstd 0.00 70.00 $0.00 33240 Insrt pulse gen w/singl lead 10.59 70.00 $741.30 33241 Remove pulse generator 6.23 70.00 $436.10 33243 Remove eltrd/thoracotomy 39.70 70.00 $2,779.00 33244 Remove elctrd transvenously 24.96 70.00 $1,747.20 33249 Insj/rplcmt defib w/lead(s) 26.61 70.00 $1,862.70 3325F Preop asses 4 cataract surg 0.00 70.00 $0.00 33250 Ablate heart dysrhythm focus 42.14 70.00 $2,949.80 33251 Ablate heart dysrhythm focus 47.11 70.00 $3,297.70 33254 Ablate atria lmtd 39.59 70.00 $2,771.30 33255 Ablate atria w/o bypass ext 47.68 70.00 $3,337.60 33256 Ablate atria w/bypass exten 56.39 70.00 $3,947.30 33257 Ablate atria lmtd add-on 16.87 70.00 $1,180.90 33258 Ablate atria x10sv add-on 18.96 70.00 $1,327.20 33259 Ablate atria w/bypass add-on 24.48 70.00 $1,713.60 33261 Ablate heart dysrhythm focus 47.10 70.00 $3,297.00 33262 Rmvl& replc pulse gen 1 lead 10.81 70.00 $756.70 33263 Rmvl & rplcmt dfb gen 2 lead 11.26 70.00 $788.20 33264 Rmvl & rplcmt dfb gen mlt ld 11.74 70.00 $821.80 33265 Ablate atria lmtd endo 39.38 70.00 $2,756.60 33266 Ablate atria x10sv endo 53.57 70.00 $3,749.90 33270 Ins/rep subq defibrillator 17.13 70.00 $1,199.10 33271 Insj subq impltbl dfb elctrd 14.33 70.00 $1,003.10 33272 Rmvl of subq defibrillator 10.12 70.00 $708.40 33273 Repos prev impltbl subq dfb 11.82 70.00 $827.40 3328F Prfrmnc docd 2 wks b/4 surg 0.00 70.00 $0.00 33282 Implant pat-active ht record 6.53 70.00 $457.10 33284 Remove pat-active ht record 5.74 70.00 $401.80 3330F Imaging study ordered (bkp) 0.00 70.00 $0.00 33300 Repair of heart wound 71.12 70.00 $4,978.40 33305 Repair of heart wound 119.06 70.00 $8,334.20 3331F Bk imaging tst not ordered 0.00 70.00 $0.00 33310 Exploratory heart surgery 34.22 70.00 $2,395.40 33315 Exploratory heart surgery 55.50 70.00 $3,885.00 33320 Repair major blood vessel(s) 30.81 70.00 $2,156.70 33321 Repair major vessel 34.52 70.00 $2,416.40 33322 Repair major blood vessel(s) 40.26 70.00 $2,818.20 33330 Insert major vessel graft 41.46 70.00 $2,902.20 33335 Insert major vessel graft 54.43 70.00 $3,810.10 33340 Perq clsr tcat l atr apndge 23.22 70.00 $1,625.40 33361 Replace aortic valve perq 39.59 70.00 $2,771.30 33362 Replace aortic valve open 43.20 70.00 $3,024.00 33363 Replace aortic valve open 45.48 70.00 $3,183.60 33364 Replace aortic valve open 47.16 70.00 $3,301.20 33365 Replace aortic valve open 51.88 70.00 $3,631.60 33366 Trcath replace aortic valve 56.11 70.00 $3,927.70 33367 Replace aortic valve w/byp 18.20 70.00 $1,274.00 33368 Replace aortic valve w/byp 21.73 70.00 $1,521.10 33369 Replace aortic valve w/byp 28.74 70.00 $2,011.80 33390 Valvuloplasty aortic valve 55.37 70.00 $3,875.90 33391 Valvuloplasty aortic valve 65.61 70.00 $4,592.70 3340F Mammo assess inc xray docd 0.00 70.00 $0.00 33404 Prepare heart-aorta conduit 50.92 70.00 $3,564.40 33405 Replacement aortic valve opn 65.85 70.00 $4,609.50 33406 Replacement aortic valve opn 83.54 70.00 $5,847.80 3341F Mammo assess negative docd 0.00 70.00 $0.00 33410 Replacement aortic valve opn 73.82 70.00 $5,167.40 33411 Replacement of aortic valve 97.43 70.00 $6,820.10 33412 Replacement of aortic valve 92.11 70.00 $6,447.70 33413 Replacement of aortic valve 94.28 70.00 $6,599.60 33414 Repair of aortic valve 62.71 70.00 $4,389.70 33415 Revision subvalvular tissue 59.03 70.00 $4,132.10 33416 Revise ventricle muscle 58.92 70.00 $4,124.40 33417 Repair of aortic valve 48.58 70.00 $3,400.60 33418 Repair tcat mitral valve 52.42 70.00 $3,669.40 33419 Repair tcat mitral valve 12.39 70.00 $867.30 3342F Mammo assess bengn docd 0.00 70.00 $0.00 33420 Revision of mitral valve 42.40 70.00 $2,968.00 33422 Revision of mitral valve 48.49 70.00 $3,394.30 33425 Repair of mitral valve 79.27 70.00 $5,548.90 33426 Repair of mitral valve 69.13 70.00 $4,839.10 33427 Repair of mitral valve 70.99 70.00 $4,969.30 3343F Mammo probably bengn docd 0.00 70.00 $0.00 33430 Replacement of mitral valve 81.20 70.00 $5,684.00 3344F Mammo assess susp docd 0.00 70.00 $0.00 3345F Mammo assess hghlymalig doc 0.00 70.00 $0.00 33460 Revision of tricuspid valve 70.48 70.00 $4,933.60 33463 Valvuloplasty tricuspid 89.71 70.00 $6,279.70 33464 Valvuloplasty tricuspid 70.88 70.00 $4,961.60 33465 Replace tricuspid valve 80.08 70.00 $5,605.60 33468 Revision of tricuspid valve 71.49 70.00 $5,004.30 33470 Revision of pulmonary valve 37.71 70.00 $2,639.70 33471 Valvotomy pulmonary valve 40.30 70.00 $2,821.00 33474 Revision of pulmonary valve 63.49 70.00 $4,444.30 33475 Replacement pulmonary valve 67.67 70.00 $4,736.90 33476 Revision of heart chamber 44.32 70.00 $3,102.40 33477 Implant tcat pulm vlv perq 38.02 70.00 $2,661.40 33478 Revision of heart chamber 45.80 70.00 $3,206.00 33496 Repair prosth valve clot 48.57 70.00 $3,399.90 3350F Mammo bx proven malig docd 0.00 70.00 $0.00 33500 Repair heart vessel fistula 45.37 70.00 $3,175.90 33501 Repair heart vessel fistula 32.31 70.00 $2,261.70 33502 Coronary artery correction 37.16 70.00 $2,601.20 33503 Coronary artery graft 38.61 70.00 $2,702.70 33504 Coronary artery graft 42.69 70.00 $2,988.30 33505 Repair artery w/tunnel 60.19 70.00 $4,213.30 33506 Repair artery translocation 59.92 70.00 $4,194.40 33507 Repair art intramural 50.27 70.00 $3,518.90 33508 Endoscopic vein harvest 0.47 70.00 $32.90 3351F Neg scrn dep symp by deptool 0.00 70.00 $0.00 33510 Cabg vein single 56.07 70.00 $3,924.90 33511 Cabg vein two 61.63 70.00 $4,314.10 33512 Cabg vein three 70.05 70.00 $4,903.50 33513 Cabg vein four 72.11 70.00 $5,047.70 33514 Cabg vein five 76.15 70.00 $5,330.50 33516 Cabg vein six or more 79.73 70.00 $5,581.10 33517 Cabg artery-vein single 5.45 70.00 $381.50 33518 Cabg artery-vein two 11.97 70.00 $837.90 33519 Cabg artery-vein three 15.83 70.00 $1,108.10 3352F No sig dep symp by dep tool 0.00 70.00 $0.00 33521 Cabg artery-vein four 18.99 70.00 $1,329.30 33522 Cabg artery-vein five 21.31 70.00 $1,491.70 33523 Cabg art-vein six or more 24.15 70.00 $1,690.50 3353F Mild-mod dep symp by deptool 0.00 70.00 $0.00 33530 Coronary artery bypass/reop 15.29 70.00 $1,070.30 33533 Cabg arterial single 54.22 70.00 $3,795.40 33534 Cabg arterial two 63.80 70.00 $4,466.00 33535 Cabg arterial three 71.22 70.00 $4,985.40 33536 Cabg arterial four or more 76.77 70.00 $5,373.90 3354F Clin sig dep sym by dep tool 0.00 70.00 $0.00 33542 Removal of heart lesion 76.18 70.00 $5,332.60 33545 Repair of heart damage 89.92 70.00 $6,294.40 33548 Restore/remodel ventricle 86.10 70.00 $6,027.00 33572 Open coronary endarterectomy 6.69 70.00 $468.30 33600 Closure of valve 50.06 70.00 $3,504.20 33602 Closure of valve 48.59 70.00 $3,401.30 33606 Anastomosis/artery-aorta 51.80 70.00 $3,626.00 33608 Repair anomaly w/conduit 52.44 70.00 $3,670.80 33610 Repair by enlargement 51.73 70.00 $3,621.10 33611 Repair double ventricle 56.93 70.00 $3,985.10 33612 Repair double ventricle 58.45 70.00 $4,091.50 33615 Repair modified fontan 58.20 70.00 $4,074.00 33617 Repair single ventricle 63.06 70.00 $4,414.20 33619 Repair single ventricle 79.46 70.00 $5,562.20 33620 Apply r&l pulm art bands 48.15 70.00 $3,370.50 33621 Transthor cath for stent 27.12 70.00 $1,898.40 33622 Redo compl cardiac anomaly 106.14 70.00 $7,429.80 33641 Repair heart septum defect 47.82 70.00 $3,347.40 33645 Revision of heart veins 50.47 70.00 $3,532.90 33647 Repair heart septum defects 53.02 70.00 $3,711.40 33660 Repair of heart defects 51.23 70.00 $3,586.10 33665 Repair of heart defects 57.33 70.00 $4,013.10 33670 Repair of heart chambers 57.59 70.00 $4,031.30 33675 Close mult vsd 57.54 70.00 $4,027.80 33676 Close mult vsd w/resection 62.32 70.00 $4,362.40 33677 Cl mult vsd w/rem pul band 64.75 70.00 $4,532.50 33681 Repair heart septum defect 53.58 70.00 $3,750.60 33684 Repair heart septum defect 55.11 70.00 $3,857.70 33688 Repair heart septum defect 58.12 70.00 $4,068.40 33690 Reinforce pulmonary artery 34.93 70.00 $2,445.10 33692 Repair of heart defects 60.39 70.00 $4,227.30 33694 Repair of heart defects 56.93 70.00 $3,985.10 33697 Repair of heart defects 59.97 70.00 $4,197.90 3370F Ajcc brst cncr stage 0 docd 0.00 70.00 $0.00 33702 Repair of heart defects 45.04 70.00 $3,152.80 33710 Repair of heart defects 59.86 70.00 $4,190.20 3372F Ajcc brst cncr stage 1 docd 0.00 70.00 $0.00 33720 Repair of heart defect 45.07 70.00 $3,154.90 33722 Repair of heart defect 47.39 70.00 $3,317.30 33724 Repair venous anomaly 44.89 70.00 $3,142.30 33726 Repair pul venous stenosis 59.33 70.00 $4,153.10 33730 Repair heart-vein defect(s) 58.46 70.00 $4,092.20 33732 Repair heart-vein defect 48.01 70.00 $3,360.70 33735 Revision of heart chamber 37.73 70.00 $2,641.10 33736 Revision of heart chamber 40.96 70.00 $2,867.20 33737 Revision of heart chamber 37.79 70.00 $2,645.30 3374F Ajcc brst cncr stage 1 docd 0.00 70.00 $0.00 33750 Major vessel shunt 38.55 70.00 $2,698.50 33755 Major vessel shunt 40.02 70.00 $2,801.40 3376F Ajcc brstcncr stage 2 docd 0.00 70.00 $0.00 33762 Major vessel shunt 39.16 70.00 $2,741.20 33764 Major vessel shunt & graft 38.34 70.00 $2,683.80 33766 Major vessel shunt 40.74 70.00 $2,851.80 33767 Major vessel shunt 41.46 70.00 $2,902.20 33768 Cavopulmonary shunting 12.96 70.00 $907.20 33770 Repair great vessels defect 65.32 70.00 $4,572.40 33771 Repair great vessels defect 67.36 70.00 $4,715.20 33774 Repair great vessels defect 52.43 70.00 $3,670.10 33775 Repair great vessels defect 56.74 70.00 $3,971.80 33776 Repair great vessels defect 59.95 70.00 $4,196.50 33777 Repair great vessels defect 55.15 70.00 $3,860.50 33778 Repair great vessels defect 68.51 70.00 $4,795.70 33779 Repair great vessels defect 71.85 70.00 $5,029.50 3378F Ajcc brstcncr stage 3 docd 0.00 70.00 $0.00 33780 Repair great vessels defect 73.13 70.00 $5,119.10 33781 Repair great vessels defect 71.52 70.00 $5,006.40 33782 Nikaidoh proc 94.24 70.00 $6,596.80 33783 Nikaidoh proc w/ostia implt 101.83 70.00 $7,128.10 33786 Repair arterial trunk 70.15 70.00 $4,910.50 33788 Revision of pulmonary artery 46.97 70.00 $3,287.90 3380F Ajcc brstcncr stage 4 docd 0.00 70.00 $0.00 33800 Aortic suspension 28.78 70.00 $2,014.60 33802 Repair vessel defect 31.56 70.00 $2,209.20 33803 Repair vessel defect 33.51 70.00 $2,345.70 33813 Repair septal defect 37.71 70.00 $2,639.70 33814 Repair septal defect 44.37 70.00 $3,105.90 3382F Ajcc cln cncr stage 0 docd 0.00 70.00 $0.00 33820 Revise major vessel 28.23 70.00 $1,976.10 33822 Revise major vessel 31.13 70.00 $2,179.10 33824 Revise major vessel 34.34 70.00 $2,403.80 3384F Ajcc cln cncr stage 1 docd 0.00 70.00 $0.00 33840 Remove aorta constriction 37.67 70.00 $2,636.90 33845 Remove aorta constriction 38.84 70.00 $2,718.80 33851 Remove aorta constriction 38.72 70.00 $2,710.40 33852 Repair septal defect 40.75 70.00 $2,852.50 33853 Repair septal defect 53.41 70.00 $3,738.70 3386F Ajcc cln cncr stage 2 docd 0.00 70.00 $0.00 33860 Ascending aortic graft 93.29 70.00 $6,530.30 33863 Ascending aortic graft 91.53 70.00 $6,407.10 33864 Ascending aortic graft 93.79 70.00 $6,565.30 33870 Transverse aortic arch graft 73.38 70.00 $5,136.60 33875 Thoracic aortic graft 79.62 70.00 $5,573.40 33877 Thoracoabdominal graft 105.77 70.00 $7,403.90 3388F Ajcc cln cncr stage 3 docd 0.00 70.00 $0.00 33880 Endovasc taa repr incl subcl 52.50 70.00 $3,675.00 33881 Endovasc taa repr w/o subcl 45.10 70.00 $3,157.00 33883 Insert endovasc prosth taa 32.73 70.00 $2,291.10 33884 Endovasc prosth taa add-on 12.05 70.00 $843.50 33886 Endovasc prosth delayed 28.17 70.00 $1,971.90 33889 Artery transpose/endovas taa 23.02 70.00 $1,611.40 33891 Car-car bp grft/endovas taa 28.61 70.00 $2,002.70 3390F Ajcc cln cncr stage 4 docd 0.00 70.00 $0.00 33910 Remove lung artery emboli 76.55 70.00 $5,358.50 33915 Remove lung artery emboli 36.92 70.00 $2,584.40 33916 Surgery of great vessel 122.03 70.00 $8,542.10 33917 Repair pulmonary artery 42.45 70.00 $2,971.50 33920 Repair pulmonary atresia 55.58 70.00 $3,890.60 33922 Transect pulmonary artery 40.46 70.00 $2,832.20 33924 Remove pulmonary shunt 8.35 70.00 $584.50 33925 Rpr pul art unifocal w/o cpb 50.12 70.00 $3,508.40 33926 Repr pul art unifocal w/cpb 74.61 70.00 $5,222.70 33930 Removal of donor heart/lung 0.00 70.00 $0.00 33933 Prepare donor heart/lung 0.00 70.00 $0.00 33935 Transplantation heart/lung 144.43 70.00 $10,110.10 3394F Quant her2 ihc eval brst cx 0.00 70.00 $0.00 33940 Removal of donor heart 0.00 70.00 $0.00 33944 Prepare donor heart 0.00 70.00 $0.00 33945 Transplantation of heart 141.21 70.00 $9,884.70 33946 Ecmo/ecls initiation venous 8.97 70.00 $627.90 33947 Ecmo/ecls initiation artery 9.96 70.00 $697.20 33948 Ecmo/ecls daily mgmt-venous 6.94 70.00 $485.80 33949 Ecmo/ecls daily mgmt artery 6.80 70.00 $476.00 3395F Quant nonher2 ihc brst cx 0.00 70.00 $0.00 33951 Ecmo/ecls insj prph cannula 12.46 70.00 $872.20 33952 Ecmo/ecls insj prph cannula 12.46 70.00 $872.20 33953 Ecmo/ecls insj prph cannula 13.92 70.00 $974.40 33954 Ecmo/ecls insj prph cannula 13.92 70.00 $974.40 33955 Ecmo/ecls insj ctr cannula 24.38 70.00 $1,706.60 33956 Ecmo/ecls insj ctr cannula 24.28 70.00 $1,699.60 33957 Ecmo/ecls repos perph cnula 5.43 70.00 $380.10 33958 Ecmo/ecls repos perph cnula 5.30 70.00 $371.00 33959 Ecmo/ecls repos perph cnula 6.88 70.00 $481.60 33962 Ecmo/ecls repos perph cnula 6.88 70.00 $481.60 33963 Ecmo/ecls repos perph cnula 13.76 70.00 $963.20 33964 Ecmo/ecls repos perph cnula 14.07 70.00 $984.90 33965 Ecmo/ecls rmvl perph cannula 5.43 70.00 $380.10 33966 Ecmo/ecls rmvl prph cannula 6.91 70.00 $483.70 33967 Insert i-aort percut device 7.56 70.00 $529.20 33968 Remove aortic assist device 0.98 70.00 $68.60 33969 Ecmo/ecls rmvl perph cannula 8.04 70.00 $562.80 33970 Aortic circulation assist 10.34 70.00 $723.80 33971 Aortic circulation assist 20.62 70.00 $1,443.40 33973 Insert balloon device 15.00 70.00 $1,050.00 33974 Remove intra-aortic balloon 25.94 70.00 $1,815.80 33975 Implant ventricular device 38.14 70.00 $2,669.80 33976 Implant ventricular device 46.49 70.00 $3,254.30 33977 Remove ventricular device 32.81 70.00 $2,296.70 33978 Remove ventricular device 38.86 70.00 $2,720.20 33979 Insert intracorporeal device 56.87 70.00 $3,980.90 33980 Remove intracorporeal device 51.96 70.00 $3,637.20 33981 Replace vad pump ext 24.15 70.00 $1,690.50 33982 Replace vad intra w/o bp 57.08 70.00 $3,995.60 33983 Replace vad intra w/bp 67.49 70.00 $4,724.30 33984 Ecmo/ecls rmvl prph cannula 8.35 70.00 $584.50 33985 Ecmo/ecls rmvl ctr cannula 15.06 70.00 $1,054.20 33986 Ecmo/ecls rmvl ctr cannula 15.23 70.00 $1,066.10 33987 Artery expos/graft artery 6.12 70.00 $428.40 33988 Insertion of left heart vent 22.85 70.00 $1,599.50 33989 Removal of left heart vent 14.47 70.00 $1,012.90 33990 Insert vad artery access 12.41 70.00 $868.70 33991 Insert vad art&vein access 18.17 70.00 $1,271.90 33992 Remove vad different session 5.84 70.00 $408.80 33993 Reposition vad diff session 5.10 70.00 $357.00 33999 Cardiac surgery procedure 0.00 70.00 $0.00 34001 Removal of artery clot 28.34 70.00 $1,983.80 34051 Removal of artery clot 25.98 70.00 $1,818.60 34101 Removal of artery clot 17.55 70.00 $1,228.50 34111 Removal of arm artery clot 17.54 70.00 $1,227.80 34151 Removal of artery clot 41.07 70.00 $2,874.90 34201 Removal of artery clot 30.20 70.00 $2,114.00 34203 Removal of leg artery clot 27.96 70.00 $1,957.20 34401 Removal of vein clot 42.65 70.00 $2,985.50 34421 Removal of vein clot 21.23 70.00 $1,486.10 34451 Removal of vein clot 47.70 70.00 $3,339.00 34471 Removal of vein clot 31.87 70.00 $2,230.90 34490 Removal of vein clot 17.80 70.00 $1,246.00 3450F Dyspnea scrnd no-mild dysp 0.00 70.00 $0.00 34501 Repair valve femoral vein 26.25 70.00 $1,837.50 34502 Reconstruct vena cava 44.89 70.00 $3,142.30 3451F Dyspnea scrnd mod-high dysp 0.00 70.00 $0.00 34510 Transposition of vein valve 34.87 70.00 $2,440.90 3452F Dyspnea not screened 0.00 70.00 $0.00 34520 Cross-over vein graft 30.80 70.00 $2,156.00 34530 Leg vein fusion 27.82 70.00 $1,947.40 3455F Tb scrng done-interpd 6mon 0.00 70.00 $0.00 3470F Ra disease activity low 0.00 70.00 $0.00 3471F Ra disease activity mod 0.00 70.00 $0.00 3472F Ra disease activity high 0.00 70.00 $0.00 3475F Disease progn ra poor docd 0.00 70.00 $0.00 3476F Disease progn ra good docd 0.00 70.00 $0.00 34800 Endovas aaa repr w/sm tube 33.07 70.00 $2,314.90 34802 Endovas aaa repr w/2-p part 36.51 70.00 $2,555.70 34803 Endovas aaa repr w/3-p part 37.86 70.00 $2,650.20 34804 Endovas aaa repr w/1-p part 36.57 70.00 $2,559.90 34805 Endovas aaa repr w/long tube 34.93 70.00 $2,445.10 34806 Aneurysm press sensor add-on 2.92 70.00 $204.40 34808 Endovas iliac a device addon 6.08 70.00 $425.60 34812 Xpose for endoprosth femorl 9.88 70.00 $691.60 34813 Femoral endovas graft add-on 6.92 70.00 $484.40 34820 Xpose for endoprosth iliac 14.33 70.00 $1,003.10 34825 Endovasc extend prosth init 20.37 70.00 $1,425.90 34826 Endovasc exten prosth addl 6.02 70.00 $421.40 34830 Open aortic tube prosth repr 52.72 70.00 $3,690.40 34831 Open aortoiliac prosth repr 55.79 70.00 $3,905.30 34832 Open aortofemor prosth repr 55.40 70.00 $3,878.00 34833 Xpose for endoprosth iliac 17.81 70.00 $1,246.70 34834 Xpose endoprosth brachial 7.97 70.00 $557.90 34839 Plnning pt spec fenest graft 0.00 70.00 $0.00 34841 Endovasc visc aorta 1 graft 0.00 70.00 $0.00 34842 Endovasc visc aorta 2 graft 0.00 70.00 $0.00 34843 Endovasc visc aorta 3 graft 0.00 70.00 $0.00 34844 Endovasc visc aorta 4 graft 0.00 70.00 $0.00 34845 Visc & infraren abd 1 prosth 0.00 70.00 $0.00 34846 Visc & infraren abd 2 prosth 0.00 70.00 $0.00 34847 Visc & infraren abd 3 prosth 0.00 70.00 $0.00 34848 Visc & infraren abd 4+ prost 0.00 70.00 $0.00 3490F History aids-defining cond 0.00 70.00 $0.00 34900 Endovasc iliac repr w/graft 26.15 70.00 $1,830.50 3491F Hiv unsure baby of hiv+moms 0.00 70.00 $0.00 3492F History cd4+ cell count <350 0.00 70.00 $0.00 3493F No hist cd4+ cell count <350 0.00 70.00 $0.00 3494F Cd4+cell count <200cells/mm3 0.00 70.00 $0.00 3495F Cd4+cell cnt 200-499 cells 0.00 70.00 $0.00 3496F Cd4+ cell count + 500 cells 0.00 70.00 $0.00 3497F Cd4+ cell percentage <15% 0.00 70.00 $0.00 3498F Cd4+ cell =15% (hiv) 0.00 70.00 $0.00 3500F Cd4+cell cnt/% docd as done 0.00 70.00 $0.00 35001 Repair defect of artery 32.67 70.00 $2,286.90 35002 Repair artery rupture neck 33.53 70.00 $2,347.10 35005 Repair defect of artery 32.91 70.00 $2,303.70 35011 Repair defect of artery 29.47 70.00 $2,062.90 35013 Repair artery rupture arm 36.71 70.00 $2,569.70 3502F Hiv rna vrl ld segmt 11.98 70.00 $838.60 35685 Bypass graft patency/patch 5.83 70.00 $408.10 35686 Bypass graft/av fist patency 4.70 70.00 $329.00 35691 Art trnsposj vertbrl carotid 27.54 70.00 $1,927.80 35693 Art trnsposj subclavian 24.48 70.00 $1,713.60 35694 Art trnsposj subclav carotid 28.97 70.00 $2,027.90 35695 Art trnsposj carotid subclav 30.56 70.00 $2,139.20 35697 Reimplant artery each 4.33 70.00 $303.10 3570F Rprt bone scint xref w xray 0.00 70.00 $0.00 35700 Reoperation bypass graft 4.48 70.00 $313.60 35701 Exploration carotid artery 16.47 70.00 $1,152.90 3572F Pt consid poss risk fx 0.00 70.00 $0.00 35721 Exploration femoral artery 13.40 70.00 $938.00 3573F Pt not consid poss risk fx 0.00 70.00 $0.00 35741 Exploration popliteal artery 14.98 70.00 $1,048.60 35761 Exploration of artery/vein 11.39 70.00 $797.30 35800 Explore neck vessels 20.85 70.00 $1,459.50 35820 Explore chest vessels 58.49 70.00 $4,094.30 35840 Explore abdominal vessels 34.67 70.00 $2,426.90 35860 Explore limb vessels 24.57 70.00 $1,719.90 35870 Repair vessel graft defect 36.48 70.00 $2,553.60 35875 Removal of clot in graft 17.46 70.00 $1,222.20 35876 Removal of clot in graft 27.78 70.00 $1,944.60 35879 Revise graft w/vein 27.05 70.00 $1,893.50 35881 Revise graft w/vein 29.92 70.00 $2,094.40 35883 Revise graft w/nonauto graft 35.45 70.00 $2,481.50 35884 Revise graft w/vein 36.31 70.00 $2,541.70 35901 Excision graft neck 14.49 70.00 $1,014.30 35903 Excision graft extremity 16.49 70.00 $1,154.30 35905 Excision graft thorax 51.88 70.00 $3,631.60 35907 Excision graft abdomen 56.08 70.00 $3,925.60 36000 Place needle in vein 0.73 70.00 $51.10 36002 Pseudoaneurysm injection trt 4.60 70.00 $322.00 36005 Injection ext venography 9.15 70.00 $640.50 36010 Place catheter in vein 13.71 70.00 $959.70 36011 Place catheter in vein 23.46 70.00 $1,642.20 36012 Place catheter in vein 24.18 70.00 $1,692.60 36013 Place catheter in artery 21.82 70.00 $1,527.40 36014 Place catheter in artery 22.62 70.00 $1,583.40 36015 Place catheter in artery 24.42 70.00 $1,709.40 36100 Establish access to artery 13.57 70.00 $949.90 36120 Establish access to artery 11.91 70.00 $833.70 36140 Establish access to artery 11.99 70.00 $839.30 36160 Establish access to aorta 13.93 70.00 $975.10 36200 Place catheter in aorta 15.93 70.00 $1,115.10 36215 Place catheter in artery 31.84 70.00 $2,228.80 36216 Place catheter in artery 32.92 70.00 $2,304.40 36217 Place catheter in artery 53.88 70.00 $3,771.60 36218 Place catheter in artery 5.27 70.00 $368.90 36221 Place cath thoracic aorta 29.21 70.00 $2,044.70 36222 Place cath carotid/inom art 34.15 70.00 $2,390.50 36223 Place cath carotid/inom art 41.90 70.00 $2,933.00 36224 Place cath carotd art 53.36 70.00 $3,735.20 36225 Place cath subclavian art 40.31 70.00 $2,821.70 36226 Place cath vertebral art 50.60 70.00 $3,542.00 36227 Place cath xtrnl carotid 7.20 70.00 $504.00 36228 Place cath intracranial art 36.24 70.00 $2,536.80 36245 Ins cath abd/l-ext art 1st 36.90 70.00 $2,583.00 36246 Ins cath abd/l-ext art 2nd 23.34 70.00 $1,633.80 36247 Ins cath abd/l-ext art 3rd 42.45 70.00 $2,971.50 36248 Ins cath abd/l-ext art addl 4.33 70.00 $303.10 36251 Ins cath ren art 1st unilat 38.92 70.00 $2,724.40 36252 Ins cath ren art 1st bilat 42.16 70.00 $2,951.20 36253 Ins cath ren art 2nd+ unilat 62.45 70.00 $4,371.50 36254 Ins cath ren art 2nd+ bilat 60.66 70.00 $4,246.20 36260 Insertion of infusion pump 18.49 70.00 $1,294.30 36261 Revision of infusion pump 9.39 70.00 $657.30 36262 Removal of infusion pump 8.66 70.00 $606.20 36299 Vessel injection procedure 0.00 70.00 $0.00 36400 Bl draw < 3 yrs fem/jugular 0.77 70.00 $53.90 36405 Bl draw <3 yrs scalp vein 0.73 70.00 $51.10 36406 Bl draw <3 yrs other vein 0.53 70.00 $37.10 36410 Non-routine bl draw 3/> yrs 0.48 70.00 $33.60 36415 Routine venipuncture 0.00 70.00 $0.00 36416 Capillary blood draw 0.00 70.00 $0.00 36420 Vein access cutdown < 1 yr 1.56 70.00 $109.20 36425 Vein access cutdown > 1 yr 1.16 70.00 $81.20 36430 Blood transfusion service 0.99 70.00 $69.30 36440 Bl push transfuse 2 yr/< 1.57 70.00 $109.90 36450 Bl exchange/transfuse nb 5.40 70.00 $378.00 36455 Bl exchange/transfuse non-nb 3.71 70.00 $259.70 36456 Prtl exchange transfuse nb 3.09 70.00 $216.30 36460 Transfusion service fetal 9.95 70.00 $696.50 36468 Injection(s) spider veins 0.00 70.00 $0.00 36470 Injection therapy of vein 4.19 70.00 $293.30 36471 Injection therapy of veins 4.97 70.00 $347.90 36473 Endovenous mchnchem 1st vein 42.42 70.00 $2,969.40 36474 Endovenous mchnchem add-on 7.77 70.00 $543.90 36475 Endovenous rf 1st vein 43.07 70.00 $3,014.90 36476 Endovenous rf vein add-on 8.39 70.00 $587.30 36478 Endovenous laser 1st vein 34.10 70.00 $2,387.00 36479 Endovenous laser vein addon 8.81 70.00 $616.70 36481 Insertion of catheter vein 55.61 70.00 $3,892.70 3650F Eeg ordered rvwd reqstd 0.00 70.00 $0.00 36500 Insertion of catheter vein 5.30 70.00 $371.00 36510 Insertion of catheter vein 2.47 70.00 $172.90 36511 Apheresis wbc 2.69 70.00 $188.30 36512 Apheresis rbc 2.72 70.00 $190.40 36513 Apheresis platelets 2.80 70.00 $196.00 36514 Apheresis plasma 15.34 70.00 $1,073.80 36515 Apheresis adsorp/reinfuse 59.02 70.00 $4,131.40 36516 Apheresis selective 59.57 70.00 $4,169.90 36522 Photopheresis 40.27 70.00 $2,818.90 36555 Insert non-tunnel cv cath 5.83 70.00 $408.10 36556 Insert non-tunnel cv cath 6.64 70.00 $464.80 36557 Insert tunneled cv cath 26.11 70.00 $1,827.70 36558 Insert tunneled cv cath 20.35 70.00 $1,424.50 36560 Insert tunneled cv cath 28.56 70.00 $1,999.20 36561 Insert tunneled cv cath 30.93 70.00 $2,165.10 36563 Insert tunneled cv cath 34.95 70.00 $2,446.50 36565 Insert tunneled cv cath 25.19 70.00 $1,763.30 36566 Insert tunneled cv cath 153.47 70.00 $10,742.90 36568 Insert picc cath 7.03 70.00 $492.10 36569 Insert picc cath 7.10 70.00 $497.00 36570 Insert picvad cath 35.08 70.00 $2,455.60 36571 Insert picvad cath 34.49 70.00 $2,414.30 36575 Repair tunneled cv cath 4.71 70.00 $329.70 36576 Repair tunneled cv cath 8.96 70.00 $627.20 36578 Replace tunneled cv cath 12.75 70.00 $892.50 36580 Replace cvad cath 6.07 70.00 $424.90 36581 Replace tunneled cv cath 19.99 70.00 $1,399.30 36582 Replace tunneled cv cath 28.64 70.00 $2,004.80 36583 Replace tunneled cv cath 35.45 70.00 $2,481.50 36584 Replace picc cath 5.81 70.00 $406.70 36585 Replace picvad cath 30.55 70.00 $2,138.50 36589 Removal tunneled cv cath 4.69 70.00 $328.30 36590 Removal tunneled cv cath 6.35 70.00 $444.50 36591 Draw blood off venous device 0.67 70.00 $46.90 36592 Collect blood from picc 0.75 70.00 $52.50 36593 Declot vascular device 0.89 70.00 $62.30 36595 Mech remov tunneled cv cath 16.62 70.00 $1,163.40 36596 Mech remov tunneled cv cath 3.74 70.00 $261.80 36597 Reposition venous catheter 3.61 70.00 $252.70 36598 Inj w/fluor eval cv device 3.15 70.00 $220.50 36600 Withdrawal of arterial blood 0.89 70.00 $62.30 36620 Insertion catheter artery 1.47 70.00 $102.90 36625 Insertion catheter artery 3.02 70.00 $211.40 36640 Insertion catheter artery 3.31 70.00 $231.70 36660 Insertion catheter artery 2.13 70.00 $149.10 36680 Insert needle bone cavity 1.69 70.00 $118.30 36800 Insertion of cannula 3.57 70.00 $249.90 36810 Insertion of cannula 6.26 70.00 $438.20 36815 Insertion of cannula 4.00 70.00 $280.00 36818 Av fuse uppr arm cephalic 20.32 70.00 $1,422.40 36819 Av fuse uppr arm basilic 21.46 70.00 $1,502.20 36820 Av fusion/forearm vein 21.44 70.00 $1,500.80 36821 Av fusion direct any site 19.45 70.00 $1,361.50 36823 Insertion of cannula(s) 40.24 70.00 $2,816.80 36825 Artery-vein autograft 23.40 70.00 $1,638.00 36830 Artery-vein nonautograft 19.56 70.00 $1,369.20 36831 Open thrombect av fistula 18.07 70.00 $1,264.90 36832 Av fistula revision open 22.17 70.00 $1,551.90 36833 Av fistula revision 23.79 70.00 $1,665.30 36835 Artery to vein shunt 14.30 70.00 $1,001.00 36838 Dist revas ligation hemo 33.56 70.00 $2,349.20 36860 External cannula declotting 5.95 70.00 $416.50 36861 Cannula declotting 3.91 70.00 $273.70 36901 Intro cath dialysis circuit 16.18 70.00 $1,132.60 36902 Intro cath dialysis circuit 34.41 70.00 $2,408.70 36903 Intro cath dialysis circuit 157.80 70.00 $11,046.00 36904 Thrmbc/nfs dialysis circuit 50.17 70.00 $3,511.90 36905 Thrmbc/nfs dialysis circuit 64.20 70.00 $4,494.00 36906 Thrmbc/nfs dialysis circuit 191.35 70.00 $13,394.50 36907 Balo angiop ctr dialysis seg 20.59 70.00 $1,441.30 36908 Stent plmt ctr dialysis seg 75.84 70.00 $5,308.80 36909 Dialysis circuit embolj 55.32 70.00 $3,872.40 3700F Psych disorders assessed 0.00 70.00 $0.00 37140 Revision of circulation 67.14 70.00 $4,699.80 37145 Revision of circulation 62.39 70.00 $4,367.30 37160 Revision of circulation 64.10 70.00 $4,487.00 37180 Revision of circulation 61.68 70.00 $4,317.60 37181 Splice spleen/kidney veins 62.42 70.00 $4,369.40 37182 Insert hepatic shunt (tips) 24.09 70.00 $1,686.30 37183 Remove hepatic shunt (tips) 164.63 70.00 $11,524.10 37184 Prim art m-thrmbc 1st vsl 62.97 70.00 $4,407.90 37185 Prim art m-thrmbc sbsq vsl 20.00 70.00 $1,400.00 37186 Sec art thrombectomy add-on 37.87 70.00 $2,650.90 37187 Venous mech thrombectomy 55.84 70.00 $3,908.80 37188 Venous m-thrombectomy add-on 47.66 70.00 $3,336.20 37191 Ins endovas vena cava filtr 72.69 70.00 $5,088.30 37192 Redo endovas vena cava filtr 45.36 70.00 $3,175.20 37193 Rem endovas vena cava filter 43.33 70.00 $3,033.10 37195 Thrombolytic therapy stroke 0.00 70.00 $0.00 37197 Remove intrvas foreign body 40.86 70.00 $2,860.20 3720F Cognit impairment assessed 0.00 70.00 $0.00 37200 Transcatheter biopsy 6.37 70.00 $445.90 37211 Thrombolytic art therapy 11.26 70.00 $788.20 37212 Thrombolytic venous therapy 9.82 70.00 $687.40 37213 Thromblytic art/ven therapy 6.83 70.00 $478.10 37214 Cessj therapy cath removal 3.59 70.00 $251.30 37215 Transcath stent cca w/eps 29.09 70.00 $2,036.30 37216 Transcath stent cca w/o eps 0.00 70.00 $0.00 37217 Stent placemt retro carotid 32.12 70.00 $2,248.40 37218 Stent placemt ante carotid 23.80 70.00 $1,666.00 37220 Iliac revasc 86.76 70.00 $6,073.20 37221 Iliac revasc w/stent 128.65 70.00 $9,005.50 37222 Iliac revasc add-on 24.35 70.00 $1,704.50 37223 Iliac revasc w/stent add-on 72.18 70.00 $5,052.60 37224 Fem/popl revas w/tla 105.23 70.00 $7,366.10 37225 Fem/popl revas w/ather 308.26 70.00 $21,578.20 37226 Fem/popl revasc w/stent 252.59 70.00 $17,681.30 37227 Fem/popl revasc stnt & ather 417.59 70.00 $29,231.30 37228 Tib/per revasc w/tla 150.71 70.00 $10,549.70 37229 Tib/per revasc w/ather 303.88 70.00 $21,271.60 37230 Tib/per revasc w/stent 232.18 70.00 $16,252.60 37231 Tib/per revasc stent & ather 375.96 70.00 $26,317.20 37232 Tib/per revasc add-on 33.63 70.00 $2,354.10 37233 Tibper revasc w/ather add-on 40.65 70.00 $2,845.50 37234 Revsc opn/prq tib/pero stent 110.02 70.00 $7,701.40 37235 Tib/per revasc stnt & ather 118.20 70.00 $8,274.00 37236 Open/perq place stent 1st 111.94 70.00 $7,835.80 37237 Open/perq place stent ea add 68.39 70.00 $4,787.30 37238 Open/perq place stent same 116.75 70.00 $8,172.50 37239 Open/perq place stent ea add 56.71 70.00 $3,969.70 37241 Vasc embolize/occlude venous 134.24 70.00 $9,396.80 37242 Vasc embolize/occlude artery 210.49 70.00 $14,734.30 37243 Vasc embolize/occlude organ 273.53 70.00 $19,147.10 37244 Vasc embolize/occlude bleed 190.77 70.00 $13,353.90 37246 Trluml balo angiop 1st art 60.60 70.00 $4,242.00 37247 Trluml balo angiop addl art 24.52 70.00 $1,716.40 37248 Trluml balo angiop 1st vein 41.98 70.00 $2,938.60 37249 Trluml balo angiop addl vein 17.99 70.00 $1,259.30 3725F Screen depression performed 0.00 70.00 $0.00 37252 Intrvasc us noncoronary 1st 39.05 70.00 $2,733.50 37253 Intrvasc us noncoronary addl 5.88 70.00 $411.60 3750F Ptnotrcvngsteroid>/=10mg/day 0.00 70.00 $0.00 37500 Endoscopy ligate perf veins 18.87 70.00 $1,320.90 37501 Vascular endoscopy procedure 0.00 70.00 $0.00 3751F Electrodiag polyneuro 6 mn 0.00 70.00 $0.00 3752F No electrodiag polyneuro 6mn 0.00 70.00 $0.00 3753F Pt has symp&signs neuropathy 0.00 70.00 $0.00 3754F Screening tests dm done 0.00 70.00 $0.00 3755F Cog&behav imprmnt scrng done 0.00 70.00 $0.00 3756F Pt w/pseudobulb affect/als 0.00 70.00 $0.00 37565 Ligation of neck vein 21.35 70.00 $1,494.50 3757F Pt w/o pseudobulbaffect/als 0.00 70.00 $0.00 3758F Pt ref pulm fx test/peakflow 0.00 70.00 $0.00 3759F Pt scrn dysphag/wt loss/nutr 0.00 70.00 $0.00 3760F Pt w/ dysphag/wt loss/nutr 0.00 70.00 $0.00 37600 Ligation of neck artery 20.65 70.00 $1,445.50 37605 Ligation of neck artery 23.00 70.00 $1,610.00 37606 Ligation of neck artery 15.08 70.00 $1,055.60 37607 Ligation of a-v fistula 10.96 70.00 $767.20 37609 Temporal artery procedure 8.84 70.00 $618.80 3761F Pt w/o dysphag/wt loss/nutr 0.00 70.00 $0.00 37615 Ligation of neck artery 14.72 70.00 $1,030.40 37616 Ligation of chest artery 31.99 70.00 $2,239.30 37617 Ligation of abdomen artery 38.98 70.00 $2,728.60 37618 Ligation of extremity artery 11.14 70.00 $779.80 37619 Ligation of inf vena cava 47.98 70.00 $3,358.60 3762F Patient is dysarthric 0.00 70.00 $0.00 3763F Patient is not dysarthric 0.00 70.00 $0.00 37650 Revision of major vein 13.50 70.00 $945.00 37660 Revision of major vein 37.76 70.00 $2,643.20 37700 Revise leg vein 7.23 70.00 $506.10 37718 Ligate/strip short leg vein 12.64 70.00 $884.80 37722 Ligate/strip long leg vein 13.90 70.00 $973.00 37735 Removal of leg veins/lesion 17.04 70.00 $1,192.80 3775F Adenoma detected screening 0.00 70.00 $0.00 3776F Adenoma not detect screening 0.00 70.00 $0.00 37760 Ligate leg veins radical 17.90 70.00 $1,253.00 37761 Ligate leg veins open 16.01 70.00 $1,120.70 37765 Stab phleb veins xtr 10-20 18.68 70.00 $1,307.60 37766 Phleb veins - extrem 20+ 22.18 70.00 $1,552.60 37780 Revision of leg vein 7.31 70.00 $511.70 37785 Ligate/divide/excise vein 10.20 70.00 $714.00 37788 Revascularization penis 36.51 70.00 $2,555.70 37790 Penile venous occlusion 14.08 70.00 $985.60 37799 Vascular surgery procedure 0.00 70.00 $0.00 38100 Removal of spleen total 33.42 70.00 $2,339.40 38101 Removal of spleen partial 33.46 70.00 $2,342.20 38102 Removal of spleen total 7.62 70.00 $533.40 38115 Repair of ruptured spleen 36.77 70.00 $2,573.90 38120 Laparoscopy splenectomy 30.47 70.00 $2,132.90 38129 Laparoscope proc spleen 0.00 70.00 $0.00 38200 Injection for spleen x-ray 3.92 70.00 $274.40 38204 Bl donor search management 3.04 70.00 $212.80 38205 Harvest allogeneic stem cell 2.40 70.00 $168.00 38206 Harvest auto stem cells 2.40 70.00 $168.00 38207 Cryopreserve stem cells 1.35 70.00 $94.50 38208 Thaw preserved stem cells 0.86 70.00 $60.20 38209 Wash harvest stem cells 0.36 70.00 $25.20 38210 T-cell depletion of harvest 2.38 70.00 $166.60 38211 Tumor cell deplete of harvst 2.16 70.00 $151.20 38212 Rbc depletion of harvest 1.43 70.00 $100.10 38213 Platelet deplete of harvest 0.36 70.00 $25.20 38214 Volume deplete of harvest 1.23 70.00 $86.10 38215 Harvest stem cell concentrte 1.43 70.00 $100.10 38220 Bone marrow aspiration 4.77 70.00 $333.90 38221 Bone marrow biopsy 4.77 70.00 $333.90 38230 Bone marrow harvest allogen 5.73 70.00 $401.10 38232 Bone marrow harvest autolog 5.65 70.00 $395.50 38240 Transplt allo hct/donor 6.46 70.00 $452.20 38241 Transplt autol hct/donor 4.83 70.00 $338.10 38242 Transplt allo lymphocytes 3.42 70.00 $239.40 38243 Transplj hematopoietic boost 3.42 70.00 $239.40 38300 Drainage lymph node lesion 7.74 70.00 $541.80 38305 Drainage lymph node lesion 13.22 70.00 $925.40 38308 Incision of lymph channels 12.89 70.00 $902.30 38380 Thoracic duct procedure 16.15 70.00 $1,130.50 38381 Thoracic duct procedure 23.28 70.00 $1,629.60 38382 Thoracic duct procedure 19.42 70.00 $1,359.40 38500 Biopsy/removal lymph nodes 9.49 70.00 $664.30 38505 Needle biopsy lymph nodes 3.59 70.00 $251.30 38510 Biopsy/removal lymph nodes 14.87 70.00 $1,040.90 38520 Biopsy/removal lymph nodes 13.38 70.00 $936.60 38525 Biopsy/removal lymph nodes 12.62 70.00 $883.40 38530 Biopsy/removal lymph nodes 15.99 70.00 $1,119.30 38542 Explore deep node(s) neck 14.94 70.00 $1,045.80 38550 Removal neck/armpit lesion 14.57 70.00 $1,019.90 38555 Removal neck/armpit lesion 29.34 70.00 $2,053.80 38562 Removal pelvic lymph nodes 20.37 70.00 $1,425.90 38564 Removal abdomen lymph nodes 20.25 70.00 $1,417.50 38570 Laparoscopy lymph node biop 14.58 70.00 $1,020.60 38571 Laparoscopy lymphadenectomy 19.34 70.00 $1,353.80 38572 Laparoscopy lymphadenectomy 27.17 70.00 $1,901.90 38589 Laparoscope proc lymphatic 0.00 70.00 $0.00 38700 Removal of lymph nodes neck 23.19 70.00 $1,623.30 38720 Removal of lymph nodes neck 38.71 70.00 $2,709.70 38724 Removal of lymph nodes neck 41.83 70.00 $2,928.10 38740 Remove armpit lymph nodes 20.07 70.00 $1,404.90 38745 Remove armpit lymph nodes 25.36 70.00 $1,775.20 38746 Remove thoracic lymph nodes 6.25 70.00 $437.50 38747 Remove abdominal lymph nodes 7.75 70.00 $542.50 38760 Remove groin lymph nodes 24.38 70.00 $1,706.60 38765 Remove groin lymph nodes 37.47 70.00 $2,622.90 38770 Remove pelvis lymph nodes 23.38 70.00 $1,636.60 38780 Remove abdomen lymph nodes 29.69 70.00 $2,078.30 38790 Inject for lymphatic x-ray 2.40 70.00 $168.00 38792 Ra tracer id of sentinl node 1.15 70.00 $80.50 38794 Access thoracic lymph duct 8.66 70.00 $606.20 38900 Io map of sent lymph node 4.01 70.00 $280.70 38999 Blood/lymph system procedure 0.00 70.00 $0.00 39000 Exploration of chest 14.35 70.00 $1,004.50 39010 Exploration of chest 22.80 70.00 $1,596.00 39200 Resect mediastinal cyst 25.25 70.00 $1,767.50 39220 Resect mediastinal tumor 32.86 70.00 $2,300.20 39401 Mediastinoscpy w/medstnl bx 9.02 70.00 $631.40 39402 Mediastinoscpy w/lmph nod bx 11.78 70.00 $824.60 39499 Chest procedure 0.00 70.00 $0.00 39501 Repair diaphragm laceration 24.56 70.00 $1,719.20 39503 Repair of diaphragm hernia 172.06 70.00 $12,044.20 39540 Repair of diaphragm hernia 25.15 70.00 $1,760.50 39541 Repair of diaphragm hernia 27.33 70.00 $1,913.10 39545 Revision of diaphragm 25.66 70.00 $1,796.20 39560 Resect diaphragm simple 23.11 70.00 $1,617.70 39561 Resect diaphragm complex 35.98 70.00 $2,518.60 39599 Diaphragm surgery procedure 0.00 70.00 $0.00 4000F Tobacco use txmnt counseling 0.00 70.00 $0.00 4001F Tobacco use txmnt pharmacol 0.00 70.00 $0.00 4003F Pt ed write/oral pts w/ hf 0.00 70.00 $0.00 4004F Pt tobacco screen rcvd tlk 0.00 70.00 $0.00 4005F Pharm thx for op rxd 0.00 70.00 $0.00 4008F Beta-blocker therapy rxd/tkn 0.00 70.00 $0.00 4010F Ace/arb therapy rxd/taken 0.00 70.00 $0.00 4011F Oral antiplatelet therapy rx 0.00 70.00 $0.00 4012F Warfarin therapy rx 0.00 70.00 $0.00 4013F Statin therapy/currently tkn 0.00 70.00 $0.00 4014F Written discharge instr prvd 0.00 70.00 $0.00 4015F Persist asthma medicine ctrl 0.00 70.00 $0.00 4016F Anti-inflm/anlgsc agent rx 0.00 70.00 $0.00 4017F Gi prophylaxis for nsaid rx 0.00 70.00 $0.00 4018F Therapy exercise joint rx 0.00 70.00 $0.00 4019F Doc recpt counsl vit d/calc+ 0.00 70.00 $0.00 4025F Inhaled bronchodilator rx 0.00 70.00 $0.00 4030F Oxygen therapy rx 0.00 70.00 $0.00 4033F Pulmonary rehab rec 0.00 70.00 $0.00 4035F Influenza imm rec 0.00 70.00 $0.00 4037F Influenza imm order/admin 0.00 70.00 $0.00 4040F Pneumoc vac/admin/rcvd 0.00 70.00 $0.00 4041F Doc order cefazolin/cefurox 0.00 70.00 $0.00 4042F Doc antibio not given 0.00 70.00 $0.00 4043F Doc order given stop antibio 0.00 70.00 $0.00 4044F Doc order given vte prophylx 0.00 70.00 $0.00 4045F Empiric antibiotic rx 0.00 70.00 $0.00 4046F Doc antibio given b/4 surg 0.00 70.00 $0.00 4047F Doc antibio given b/4 surg 0.00 70.00 $0.00 4048F Doc antibio given b/4 surg 0.00 70.00 $0.00 4049F Doc order given stop antibio 0.00 70.00 $0.00 40490 Biopsy of lip 3.69 70.00 $258.30 4050F Ht care plan doc 0.00 70.00 $0.00 40500 Partial excision of lip 14.52 70.00 $1,016.40 4051F Referred for an av fistula 0.00 70.00 $0.00 40510 Partial excision of lip 13.90 70.00 $973.00 4052F Hemodialysis via av fistula 0.00 70.00 $0.00 40520 Partial excision of lip 14.05 70.00 $983.50 40525 Reconstruct lip with flap 15.93 70.00 $1,115.10 40527 Reconstruct lip with flap 18.01 70.00 $1,260.70 4053F Hemodialysis via av graft 0.00 70.00 $0.00 40530 Partial removal of lip 15.41 70.00 $1,078.70 4054F Hemodialysis via catheter 0.00 70.00 $0.00 4055F Pt rcvng periton dialysis 0.00 70.00 $0.00 4056F Approp oral rehyd recommd 0.00 70.00 $0.00 4058F Ped gastro ed given caregvr 0.00 70.00 $0.00 4060F Psych svcs provided 0.00 70.00 $0.00 4062F Pt referral psych docd 0.00 70.00 $0.00 4063F Antidepres rxthxpy not rxd 0.00 70.00 $0.00 4064F Antidepressant rx 0.00 70.00 $0.00 4065F Antipsychotic rx 0.00 70.00 $0.00 40650 Repair lip 12.58 70.00 $880.60 40652 Repair lip 14.11 70.00 $987.70 40654 Repair lip 16.43 70.00 $1,150.10 4066F Ect provided 0.00 70.00 $0.00 4067F Pt referral for ect docd 0.00 70.00 $0.00 4069F Vte prophylaxis rcvd 0.00 70.00 $0.00 4070F Dvt prophylx recvd day 2 0.00 70.00 $0.00 40700 Repair cleft lip/nasal 29.20 70.00 $2,044.00 40701 Repair cleft lip/nasal 34.60 70.00 $2,422.00 40702 Repair cleft lip/nasal 26.08 70.00 $1,825.60 40720 Repair cleft lip/nasal 28.84 70.00 $2,018.80 4073F Oral antiplat thx rx dischrg 0.00 70.00 $0.00 4075F Anticoag thx rx at dischrg 0.00 70.00 $0.00 40761 Repair cleft lip/nasal 28.05 70.00 $1,963.50 4077F Doc t-pa admin considered 0.00 70.00 $0.00 4079F Doc rehab svcs considered 0.00 70.00 $0.00 40799 Lip surgery procedure 0.00 70.00 $0.00 40800 Drainage of mouth lesion 6.16 70.00 $431.20 40801 Drainage of mouth lesion 9.13 70.00 $639.10 40804 Removal foreign body mouth 5.31 70.00 $371.70 40805 Removal foreign body mouth 9.33 70.00 $653.10 40806 Incision of lip fold 3.02 70.00 $211.40 40808 Biopsy of mouth lesion 5.39 70.00 $377.30 40810 Excision of mouth lesion 5.97 70.00 $417.90 40812 Excise/repair mouth lesion 8.38 70.00 $586.60 40814 Excise/repair mouth lesion 11.21 70.00 $784.70 40816 Excision of mouth lesion 11.68 70.00 $817.60 40818 Excise oral mucosa for graft 10.44 70.00 $730.80 40819 Excise lip or cheek fold 9.18 70.00 $642.60 40820 Treatment of mouth lesion 7.69 70.00 $538.30 40830 Repair mouth laceration 7.76 70.00 $543.20 40831 Repair mouth laceration 9.78 70.00 $684.60 4084F Aspirin recvd w/in 24 hrs 0.00 70.00 $0.00 40840 Reconstruction of mouth 23.37 70.00 $1,635.90 40842 Reconstruction of mouth 23.64 70.00 $1,654.80 40843 Reconstruction of mouth 31.38 70.00 $2,196.60 40844 Reconstruction of mouth 37.25 70.00 $2,607.50 40845 Reconstruction of mouth 42.14 70.00 $2,949.80 4086F Aspirin/clopidogrel rxd 0.00 70.00 $0.00 40899 Mouth surgery procedure 0.00 70.00 $0.00 4090F Pt rcvng epo thxpy 0.00 70.00 $0.00 4095F Pt not rcvng epo thxpy 0.00 70.00 $0.00 4100F Biphos thxpy vein ord/recvd 0.00 70.00 $0.00 41000 Drainage of mouth lesion 4.69 70.00 $328.30 41005 Drainage of mouth lesion 6.55 70.00 $458.50 41006 Drainage of mouth lesion 11.22 70.00 $785.40 41007 Drainage of mouth lesion 11.06 70.00 $774.20 41008 Drainage of mouth lesion 11.05 70.00 $773.50 41009 Drainage of mouth lesion 11.73 70.00 $821.10 41010 Incision of tongue fold 5.77 70.00 $403.90 41015 Drainage of mouth lesion 13.21 70.00 $924.70 41016 Drainage of mouth lesion 12.82 70.00 $897.40 41017 Drainage of mouth lesion 12.98 70.00 $908.60 41018 Drainage of mouth lesion 14.72 70.00 $1,030.40 41019 Place needles h&n for rt 13.64 70.00 $954.80 4110F Int mam art used for cabg 0.00 70.00 $0.00 41100 Biopsy of tongue 4.85 70.00 $339.50 41105 Biopsy of tongue 4.94 70.00 $345.80 41108 Biopsy of floor of mouth 4.28 70.00 $299.60 41110 Excision of tongue lesion 6.12 70.00 $428.40 41112 Excision of tongue lesion 9.71 70.00 $679.70 41113 Excision of tongue lesion 10.63 70.00 $744.10 41114 Excision of tongue lesion 18.49 70.00 $1,294.30 41115 Excision of tongue fold 7.10 70.00 $497.00 41116 Excision of mouth lesion 9.59 70.00 $671.30 41120 Partial removal of tongue 31.35 70.00 $2,194.50 41130 Partial removal of tongue 38.58 70.00 $2,700.60 41135 Tongue and neck surgery 63.45 70.00 $4,441.50 41140 Removal of tongue 63.93 70.00 $4,475.10 41145 Tongue removal neck surgery 80.82 70.00 $5,657.40 4115F Beta blckr admin w/in 24 hrs 0.00 70.00 $0.00 41150 Tongue mouth jaw surgery 64.24 70.00 $4,496.80 41153 Tongue mouth neck surgery 69.85 70.00 $4,889.50 41155 Tongue jaw & neck surgery 88.01 70.00 $6,160.70 4120F Antibiot rxd/given 0.00 70.00 $0.00 4124F Antibiot not rxd/given 0.00 70.00 $0.00 41250 Repair tongue laceration 7.71 70.00 $539.70 41251 Repair tongue laceration 8.28 70.00 $579.60 41252 Repair tongue laceration 9.16 70.00 $641.20 4130F Topical prep rx aoe 0.00 70.00 $0.00 4131F Syst antimicrobial thx rx 0.00 70.00 $0.00 4132F No syst antimicrobial thx rx 0.00 70.00 $0.00 4133F Antihist/decong rx/recom 0.00 70.00 $0.00 4134F No antihist/decong rx/recom 0.00 70.00 $0.00 4135F Systemic corticosteroids rx 0.00 70.00 $0.00 4136F Syst corticosteroids not rx 0.00 70.00 $0.00 4140F Inhaled corticosteroids rxd 0.00 70.00 $0.00 4142F Corticoster sparng thrpy rxd 0.00 70.00 $0.00 4144F Alt long-term cntrl med rxd 0.00 70.00 $0.00 4145F 2+ anti-hyprtnsv agents tkn 0.00 70.00 $0.00 4148F Hep a vac injxn admin/recvd 0.00 70.00 $0.00 4149F Hep b vac injxn admin/recvd 0.00 70.00 $0.00 4150F Pt recvng antivir txmnt hepc 0.00 70.00 $0.00 41500 Fixation of tongue 13.06 70.00 $914.20 4151F Pt not recvng antiv hep c 0.00 70.00 $0.00 41510 Tongue to lip surgery 12.33 70.00 $863.10 41512 Tongue suspension 19.17 70.00 $1,341.90 41520 Reconstruction tongue fold 10.22 70.00 $715.40 4153F Combo pegintf/rib rx 0.00 70.00 $0.00 41530 Tongue base vol reduction 28.11 70.00 $1,967.70 4155F Hep a vac series prev recvd 0.00 70.00 $0.00 4157F Hep b vac series prev recvd 0.00 70.00 $0.00 4158F Pt edu re alcoh drnkng done 0.00 70.00 $0.00 4159F Contrcp talk b/4 antiv txmnt 0.00 70.00 $0.00 41599 Tongue and mouth surgery 0.00 70.00 $0.00 4163F Pt couns 4 txmnt opt prost 0.00 70.00 $0.00 4164F Adjv hrmnl thxpy rxd 0.00 70.00 $0.00 4165F 3d-crt/imrt received 0.00 70.00 $0.00 4167F Hd bed tilted 1st day vent 0.00 70.00 $0.00 4168F Pt care icu&vent w/in 24hrs 0.00 70.00 $0.00 4169F No pt care icu/vent in 24hrs 0.00 70.00 $0.00 4171F Pt rcvng esa thxpy 0.00 70.00 $0.00 4172F Pt not rcvng esa thxpy 0.00 70.00 $0.00 4174F Couns potent glauc impct 0.00 70.00 $0.00 4175F Vis 20/40/> w/in 90 days 0.00 70.00 $0.00 4176F Talk re uv light pt/crgvr 0.00 70.00 $0.00 4177F Talk pt/crgvr re areds prev 0.00 70.00 $0.00 4178F Antid glbln rcvd w/in 26wks 0.00 70.00 $0.00 4179F Tamoxifen/ai prescribed 0.00 70.00 $0.00 4180F Adjv thxpyrxd/rcvd colon ca 0.00 70.00 $0.00 41800 Drainage of gum lesion 7.98 70.00 $558.60 41805 Removal foreign body gum 7.15 70.00 $500.50 41806 Removal foreign body jawbone 10.27 70.00 $718.90 4181F Conformal radn thxpy rcvd 0.00 70.00 $0.00 4182F No conformal radn thxpy 0.00 70.00 $0.00 41820 Excision gum each quadrant 0.00 70.00 $0.00 41821 Excision of gum flap 0.00 70.00 $0.00 41822 Excision of gum lesion 9.12 70.00 $638.40 41823 Excision of gum lesion 13.32 70.00 $932.40 41825 Excision of gum lesion 6.15 70.00 $430.50 41826 Excision of gum lesion 9.18 70.00 $642.60 41827 Excision of gum lesion 12.85 70.00 $899.50 41828 Excision of gum lesion 8.95 70.00 $626.50 41830 Removal of gum tissue 11.44 70.00 $800.80 4185F Continuous ppi or h2ra rcvd 0.00 70.00 $0.00 41850 Treatment of gum lesion 0.00 70.00 $0.00 4186F No cont ppi or h2ra rcvd 0.00 70.00 $0.00 4187F Anti rheum drugthxpyrxd/gvn 0.00 70.00 $0.00 41870 Gum graft 0.00 70.00 $0.00 41872 Repair gum 10.93 70.00 $765.10 41874 Repair tooth socket 11.04 70.00 $772.80 4188F Approp ace/arb tstng done 0.00 70.00 $0.00 4189F Approp digoxin tstng done 0.00 70.00 $0.00 41899 Dental surgery procedure 0.00 70.00 $0.00 4190F Approp diuretic tstng done 0.00 70.00 $0.00 4191F Approp anticonvuls tstng 0.00 70.00 $0.00 4192F Pt not rcvng glucoco thxpy 0.00 70.00 $0.00 4193F Pt rcvng<10mg daily predniso 0.00 70.00 $0.00 4194F Pt rcvng10mg daily predniso 0.00 70.00 $0.00 4195F Pt rcvng anti-rheum thxpy ra 0.00 70.00 $0.00 4196F Ptnot rcvng anti-rhm thxpyra 0.00 70.00 $0.00 4200F External beam to prost only 0.00 70.00 $0.00 42000 Drainage mouth roof lesion 4.61 70.00 $322.70 4201F Extrnl beam other than prost 0.00 70.00 $0.00 4210F Ace/arb thxpy for mos/> 0.00 70.00 $0.00 42100 Biopsy roof of mouth 4.34 70.00 $303.80 42104 Excision lesion mouth roof 6.23 70.00 $436.10 42106 Excision lesion mouth roof 7.95 70.00 $556.50 42107 Excision lesion mouth roof 13.36 70.00 $935.20 42120 Remove palate/lesion 29.50 70.00 $2,065.00 42140 Excision of uvula 7.26 70.00 $508.20 42145 Repair palate pharynx/uvula 20.32 70.00 $1,422.40 42160 Treatment mouth roof lesion 6.70 70.00 $469.00 42180 Repair palate 7.01 70.00 $490.70 42182 Repair palate 9.22 70.00 $645.40 4220F Digoxin thxpy for 6 mos/> 0.00 70.00 $0.00 42200 Reconstruct cleft palate 24.65 70.00 $1,725.50 42205 Reconstruct cleft palate 26.36 70.00 $1,845.20 4221F Diuretic thxpy for 6 mos/> 0.00 70.00 $0.00 42210 Reconstruct cleft palate 30.07 70.00 $2,104.90 42215 Reconstruct cleft palate 20.96 70.00 $1,467.20 42220 Reconstruct cleft palate 15.28 70.00 $1,069.60 42225 Reconstruct cleft palate 25.22 70.00 $1,765.40 42226 Lengthening of palate 26.19 70.00 $1,833.30 42227 Lengthening of palate 24.67 70.00 $1,726.90 42235 Repair palate 21.08 70.00 $1,475.60 42260 Repair nose to lip fistula 24.24 70.00 $1,696.80 42280 Preparation palate mold 4.74 70.00 $331.80 42281 Insertion palate prosthesis 5.89 70.00 $412.30 42299 Palate/uvula surgery 0.00 70.00 $0.00 4230F Anticonv thxpy for 6 mos/> 0.00 70.00 $0.00 42300 Drainage of salivary gland 6.01 70.00 $420.70 42305 Drainage of salivary gland 12.49 70.00 $874.30 42310 Drainage of salivary gland 4.63 70.00 $324.10 42320 Drainage of salivary gland 7.13 70.00 $499.10 42330 Removal of salivary stone 6.68 70.00 $467.60 42335 Removal of salivary stone 10.76 70.00 $753.20 42340 Removal of salivary stone 13.40 70.00 $938.00 4240F Instr xrcz back pain 12 wks 0.00 70.00 $0.00 42400 Biopsy of salivary gland 3.02 70.00 $211.40 42405 Biopsy of salivary gland 8.59 70.00 $601.30 42408 Excision of salivary cyst 13.06 70.00 $914.20 42409 Drainage of salivary cyst 9.58 70.00 $670.60 42410 Excise parotid gland/lesion 17.93 70.00 $1,255.10 42415 Excise parotid gland/lesion 30.45 70.00 $2,131.50 4242F Sprvsd xrcz back pn >12 wks 0.00 70.00 $0.00 42420 Excise parotid gland/lesion 34.17 70.00 $2,391.90 42425 Excise parotid gland/lesion 24.10 70.00 $1,687.00 42426 Excise parotid gland/lesion 38.94 70.00 $2,725.80 42440 Excise submaxillary gland 11.87 70.00 $830.90 4245F Pt instr nrml lifest 0.00 70.00 $0.00 42450 Excise sublingual gland 13.03 70.00 $912.10 4248F Pt instr no bd rest 4 days/> 0.00 70.00 $0.00 4250F Wrmng 4 surg normothermia 0.00 70.00 $0.00 42500 Repair salivary duct 12.49 70.00 $874.30 42505 Repair salivary duct 15.97 70.00 $1,117.90 42507 Parotid duct diversion 14.49 70.00 $1,014.30 42509 Parotid duct diversion 24.35 70.00 $1,704.50 42510 Parotid duct diversion 18.63 70.00 $1,304.10 4255F Anesth 60 min/> as docd 0.00 70.00 $0.00 42550 Injection for salivary x-ray 3.87 70.00 $270.90 4256F Anesthe <60 min as docd 0.00 70.00 $0.00 4260F Wound srfc culturetech used 0.00 70.00 $0.00 42600 Closure of salivary fistula 13.55 70.00 $948.50 4261F Tech other than surfc cultr 0.00 70.00 $0.00 4265F Wet-dry dressings rx recmd 0.00 70.00 $0.00 42650 Dilation of salivary duct 2.40 70.00 $168.00 4266F No wet-dry drssings rx recmd 0.00 70.00 $0.00 42660 Dilation of salivary duct 3.70 70.00 $259.00 42665 Ligation of salivary duct 9.08 70.00 $635.60 4267F Comprssion thxpy prescribed 0.00 70.00 $0.00 4268F Pt ed re comp thxpy rcvd 0.00 70.00 $0.00 4269F Appropos mthd offloading rxd 0.00 70.00 $0.00 42699 Salivary surgery procedure 0.00 70.00 $0.00 4270F Pt rcvng anti r-viral thxpy 0.00 70.00 $0.00 42700 Drainage of tonsil abscess 5.44 70.00 $380.80 4271F Pt rcvng anti r-viral thxpy 0.00 70.00 $0.00 42720 Drainage of throat abscess 13.05 70.00 $913.50 42725 Drainage of throat abscess 23.70 70.00 $1,659.00 4274F Flu immuno admind rcvd 0.00 70.00 $0.00 4276F Potent antivir thxpy rxd 0.00 70.00 $0.00 4279F Pcp prophylaxis rxd 0.00 70.00 $0.00 4280F Pcp prophylax rxd 3mon low % 0.00 70.00 $0.00 42800 Biopsy of throat 4.55 70.00 $318.50 42804 Biopsy of upper nose/throat 5.60 70.00 $392.00 42806 Biopsy of upper nose/throat 6.29 70.00 $440.30 42808 Excise pharynx lesion 6.52 70.00 $456.40 42809 Remove pharynx foreign body 5.76 70.00 $403.20 42810 Excision of neck cyst 11.11 70.00 $777.70 42815 Excision of neck cyst 16.12 70.00 $1,128.40 42820 Remove tonsils and adenoids 8.32 70.00 $582.40 42821 Remove tonsils and adenoids 8.68 70.00 $607.60 42825 Removal of tonsils 7.55 70.00 $528.50 42826 Removal of tonsils 7.25 70.00 $507.50 42830 Removal of adenoids 5.97 70.00 $417.90 42831 Removal of adenoids 6.45 70.00 $451.50 42835 Removal of adenoids 5.24 70.00 $366.80 42836 Removal of adenoids 6.94 70.00 $485.80 42842 Extensive surgery of throat 29.46 70.00 $2,062.20 42844 Extensive surgery of throat 40.53 70.00 $2,837.10 42845 Extensive surgery of throat 65.08 70.00 $4,555.60 42860 Excision of tonsil tags 5.42 70.00 $379.40 42870 Excision of lingual tonsil 17.31 70.00 $1,211.70 42890 Partial removal of pharynx 41.78 70.00 $2,924.60 42892 Revision of pharyngeal walls 55.15 70.00 $3,860.50 42894 Revision of pharyngeal walls 69.28 70.00 $4,849.60 4290F Pt scrned for inj drug use 0.00 70.00 $0.00 42900 Repair throat wound 9.76 70.00 $683.20 4293F Pt scrnd hgh-risk sex behav 0.00 70.00 $0.00 42950 Reconstruction of throat 23.77 70.00 $1,663.90 42953 Repair throat esophagus 28.55 70.00 $1,998.50 42955 Surgical opening of throat 22.14 70.00 $1,549.80 42960 Control throat bleeding 4.91 70.00 $343.70 42961 Control throat bleeding 12.18 70.00 $852.60 42962 Control throat bleeding 15.00 70.00 $1,050.00 42970 Control nose/throat bleeding 11.80 70.00 $826.00 42971 Control nose/throat bleeding 13.28 70.00 $929.60 42972 Control nose/throat bleeding 14.74 70.00 $1,031.80 42999 Throat surgery procedure 0.00 70.00 $0.00 4300F Pt rcvng warf thxpy 0.00 70.00 $0.00 4301F Pt not rcvng warf thxpy 0.00 70.00 $0.00 43020 Incision of esophagus 15.47 70.00 $1,082.90 43030 Throat muscle surgery 14.94 70.00 $1,045.80 43045 Incision of esophagus 37.70 70.00 $2,639.00 4305F Pt ed re ft care inspct rcvd 0.00 70.00 $0.00 4306F Pt tlk psych & rx opd addic 0.00 70.00 $0.00 43100 Excision of esophagus lesion 17.93 70.00 $1,255.10 43101 Excision of esophagus lesion 30.89 70.00 $2,162.30 43107 Removal of esophagus 74.17 70.00 $5,191.90 43108 Removal of esophagus 135.36 70.00 $9,475.20 43112 Removal of esophagus 78.36 70.00 $5,485.20 43113 Removal of esophagus 126.63 70.00 $8,864.10 43116 Partial removal of esophagus 152.24 70.00 $10,656.80 43117 Partial removal of esophagus 71.61 70.00 $5,012.70 43118 Partial removal of esophagus 109.93 70.00 $7,695.10 43121 Partial removal of esophagus 82.84 70.00 $5,798.80 43122 Partial removal of esophagus 74.34 70.00 $5,203.80 43123 Partial removal of esophagus 136.57 70.00 $9,559.90 43124 Removal of esophagus 111.53 70.00 $7,807.10 43130 Removal of esophagus pouch 22.66 70.00 $1,586.20 43135 Removal of esophagus pouch 43.02 70.00 $3,011.40 43180 Esophagoscopy rigid trnso 15.84 70.00 $1,108.80 43191 Esophagoscopy rigid trnso dx 4.47 70.00 $312.90 43192 Esophagoscp rig trnso inject 4.92 70.00 $344.40 43193 Esophagoscp rig trnso biopsy 4.91 70.00 $343.70 43194 Esophagoscp rig trnso rem fb 5.61 70.00 $392.70 43195 Esophagoscopy rigid balloon 5.36 70.00 $375.20 43196 Esophagoscp guide wire dilat 5.72 70.00 $400.40 43197 Esophagoscopy flex dx brush 5.37 70.00 $375.90 43198 Esophagosc flex trnsn biopsy 5.95 70.00 $416.50 4320F Pt talk psychsoc&rx oh dpnd 0.00 70.00 $0.00 43200 Esophagoscopy flexible brush 6.15 70.00 $430.50 43201 Esoph scope w/submucous inj 6.28 70.00 $439.60 43202 Esophagoscopy flex biopsy 8.72 70.00 $610.40 43204 Esoph scope w/sclerosis inj 3.99 70.00 $279.30 43205 Esophagus endoscopy/ligation 4.15 70.00 $290.50 43206 Esoph optical endomicroscopy 7.56 70.00 $529.20 43210 Egd esophagogastrc fndoplsty 12.63 70.00 $884.10 43211 Esophagoscop mucosal resect 6.93 70.00 $485.10 43212 Esophagoscop stent placement 5.58 70.00 $390.60 43213 Esophagoscopy retro balloon 32.66 70.00 $2,286.20 43214 Esophagosc dilate balloon 30 5.65 70.00 $395.50 43215 Esophagoscopy flex remove fb 10.23 70.00 $716.10 43216 Esophagoscopy lesion removal 10.12 70.00 $708.40 43217 Esophagoscopy snare les remv 10.79 70.00 $755.30 4322F Crgvr prov w/ ed addl rsrcs 0.00 70.00 $0.00 43220 Esophagoscopy balloon <30mm 30.40 70.00 $2,128.00 43226 Esoph endoscopy dilation 9.02 70.00 $631.40 43227 Esophagoscopy control bleed 17.82 70.00 $1,247.40 43229 Esophagoscopy lesion ablate 18.33 70.00 $1,283.10 43231 Esophagoscop ultrasound exam 9.52 70.00 $666.40 43232 Esophagoscopy w/us needle bx 11.43 70.00 $800.10 43233 Egd balloon dil esoph30 mm/> 6.69 70.00 $468.30 43235 Egd diagnostic brush wash 7.28 70.00 $509.60 43236 Uppr gi scope w/submuc inj 9.34 70.00 $653.80 43237 Endoscopic us exam esoph 5.75 70.00 $402.50 43238 Egd us fine needle bx/aspir 6.85 70.00 $479.50 43239 Egd biopsy single/multiple 9.73 70.00 $681.10 4324F Pt queried prkns complic 0.00 70.00 $0.00 43240 Egd w/transmural drain cyst 11.55 70.00 $808.50 43241 Egd tube/cath insertion 4.19 70.00 $293.30 43242 Egd us fine needle bx/aspir 7.73 70.00 $541.10 43243 Egd injection varices 6.97 70.00 $487.90 43244 Egd varices ligation 7.22 70.00 $505.40 43245 Egd dilate stricture 15.67 70.00 $1,096.90 43246 Egd place gastrostomy tube 5.88 70.00 $411.60 43247 Egd remove foreign body 9.94 70.00 $695.80 43248 Egd guide wire insertion 9.95 70.00 $696.50 43249 Esoph egd dilation <30 mm 28.82 70.00 $2,017.40 4325F Med txmnt options rvwd w/pt 0.00 70.00 $0.00 43250 Egd cautery tumor polyp 11.28 70.00 $789.60 43251 Egd remove lesion snare 12.50 70.00 $875.00 43252 Egd optical endomicroscopy 8.58 70.00 $600.60 43253 Egd us transmural injxn/mark 7.73 70.00 $541.10 43254 Egd endo mucosal resection 7.96 70.00 $557.20 43255 Egd control bleeding any 18.86 70.00 $1,320.20 43257 Egd w/thrml txmnt gerd 6.83 70.00 $478.10 43259 Egd us exam duodenum/jejunum 6.65 70.00 $465.50 4326F Pt asked re symp auto dysfxn 0.00 70.00 $0.00 43260 Ercp w/specimen collection 9.48 70.00 $663.60 43261 Endo cholangiopancreatograph 9.96 70.00 $697.20 43262 Endo cholangiopancreatograph 10.51 70.00 $735.70 43263 Ercp sphincter pressure meas 10.53 70.00 $737.10 43264 Ercp remove duct calculi 10.71 70.00 $749.70 43265 Ercp lithotripsy calculi 12.75 70.00 $892.50 43266 Egd endoscopic stent place 6.42 70.00 $449.40 43270 Egd lesion ablation 18.92 70.00 $1,324.40 43273 Endoscopic pancreatoscopy 3.52 70.00 $246.40 43274 Ercp duct stent placement 13.62 70.00 $953.40 43275 Ercp remove forgn body duct 11.08 70.00 $775.60 43276 Ercp stent exchange w/dilate 14.18 70.00 $992.60 43277 Ercp ea duct/ampulla dilate 11.14 70.00 $779.80 43278 Ercp lesion ablate w/dilate 12.74 70.00 $891.80 43279 Lap myotomy heller 37.43 70.00 $2,620.10 4328F Pt asked re sleep disturb 0.00 70.00 $0.00 43280 Laparoscopy fundoplasty 31.33 70.00 $2,193.10 43281 Lap paraesophag hern repair 44.78 70.00 $3,134.60 43282 Lap paraesoph her rpr w/mesh 50.37 70.00 $3,525.90 43283 Lap esoph lengthening 4.61 70.00 $322.70 43284 Laps esophgl sphnctr agmntj 18.79 70.00 $1,315.30 43285 Rmvl esophgl sphnctr dev 19.01 70.00 $1,330.70 43289 Laparoscope proc esoph 0.00 70.00 $0.00 4330F Cnslng epi spec sfty issues 0.00 70.00 $0.00 43300 Repair of esophagus 17.86 70.00 $1,250.20 43305 Repair esophagus and fistula 31.49 70.00 $2,204.30 43310 Repair of esophagus 42.79 70.00 $2,995.30 43312 Repair esophagus and fistula 46.71 70.00 $3,269.70 43313 Esophagoplasty congenital 78.59 70.00 $5,501.30 43314 Tracheo-esophagoplasty cong 86.44 70.00 $6,050.80 43320 Fuse esophagus & stomach 40.19 70.00 $2,813.30 43325 Revise esophagus & stomach 38.73 70.00 $2,711.10 43327 Esoph fundoplasty lap 23.76 70.00 $1,663.20 43328 Esoph fundoplasty thor 32.71 70.00 $2,289.70 43330 Esophagomyotomy abdominal 38.71 70.00 $2,709.70 43331 Esophagomyotomy thoracic 38.82 70.00 $2,717.40 43332 Transab esoph hiat hern rpr 33.66 70.00 $2,356.20 43333 Transab esoph hiat hern rpr 36.74 70.00 $2,571.80 43334 Transthor diaphrag hern rpr 36.31 70.00 $2,541.70 43335 Transthor diaphrag hern rpr 38.95 70.00 $2,726.50 43336 Thorabd diaphr hern repair 43.75 70.00 $3,062.50 43337 Thorabd diaphr hern repair 47.16 70.00 $3,301.20 43338 Esoph lengthening 3.38 70.00 $236.60 43340 Fuse esophagus & intestine 39.67 70.00 $2,776.90 43341 Fuse esophagus & intestine 40.74 70.00 $2,851.80 43351 Surgical opening esophagus 39.98 70.00 $2,798.60 43352 Surgical opening esophagus 31.05 70.00 $2,173.50 43360 Gastrointestinal repair 68.53 70.00 $4,797.10 43361 Gastrointestinal repair 74.84 70.00 $5,238.80 4340F Cnslng chldbrng women epi 0.00 70.00 $0.00 43400 Ligate esophagus veins 43.15 70.00 $3,020.50 43401 Esophagus surgery for veins 42.75 70.00 $2,992.50 43405 Ligate/staple esophagus 44.35 70.00 $3,104.50 43410 Repair esophagus wound 30.47 70.00 $2,132.90 43415 Repair esophagus wound 74.58 70.00 $5,220.60 43420 Repair esophagus opening 29.38 70.00 $2,056.60 43425 Repair esophagus opening 42.28 70.00 $2,959.60 43450 Dilate esophagus 1/mult pass 4.46 70.00 $312.20 43453 Dilate esophagus 25.77 70.00 $1,803.90 43460 Pressure treatment esophagus 6.26 70.00 $438.20 43496 Free jejunum flap microvasc 0.00 70.00 $0.00 43499 Esophagus surgery procedure 0.00 70.00 $0.00 4350F Cnslng provided symp mngmnt 0.00 70.00 $0.00 43500 Surgical opening of stomach 22.76 70.00 $1,593.20 43501 Surgical repair of stomach 39.01 70.00 $2,730.70 43502 Surgical repair of stomach 43.61 70.00 $3,052.70 43510 Surgical opening of stomach 26.80 70.00 $1,876.00 43520 Incision of pyloric muscle 19.89 70.00 $1,392.30 43605 Biopsy of stomach 24.34 70.00 $1,703.80 43610 Excision of stomach lesion 28.38 70.00 $1,986.60 43611 Excision of stomach lesion 35.42 70.00 $2,479.40 43620 Removal of stomach 57.05 70.00 $3,993.50 43621 Removal of stomach 65.80 70.00 $4,606.00 43622 Removal of stomach 66.52 70.00 $4,656.40 43631 Removal of stomach partial 42.03 70.00 $2,942.10 43632 Removal of stomach partial 58.92 70.00 $4,124.40 43633 Removal of stomach partial 55.72 70.00 $3,900.40 43634 Removal of stomach partial 61.46 70.00 $4,302.20 43635 Removal of stomach partial 3.28 70.00 $229.60 43640 Vagotomy & pylorus repair 34.15 70.00 $2,390.50 43641 Vagotomy & pylorus repair 34.57 70.00 $2,419.90 43644 Lap gastric bypass/roux-en-y 50.23 70.00 $3,516.10 43645 Lap gastr bypass incl smll i 53.52 70.00 $3,746.40 43647 Lap impl electrode antrum 0.00 70.00 $0.00 43648 Lap revise/remv eltrd antrum 0.00 70.00 $0.00 43651 Laparoscopy vagus nerve 18.89 70.00 $1,322.30 43652 Laparoscopy vagus nerve 22.15 70.00 $1,550.50 43653 Laparoscopy gastrostomy 16.57 70.00 $1,159.90 43659 Laparoscope proc stom 0.00 70.00 $0.00 43752 Nasal/orogastric w/tube plmt 1.18 70.00 $82.60 43753 Tx gastro intub w/asp 0.63 70.00 $44.10 43754 Dx gastr intub w/asp spec 3.48 70.00 $243.60 43755 Dx gastr intub w/asp specs 3.92 70.00 $274.40 43756 Dx duod intub w/asp spec 5.74 70.00 $401.80 43757 Dx duod intub w/asp specs 8.26 70.00 $578.20 43760 Change gastrostomy tube 13.90 70.00 $973.00 43761 Reposition gastrostomy tube 3.36 70.00 $235.20 43770 Lap place gastr adj device 32.43 70.00 $2,270.10 43771 Lap revise gastr adj device 36.83 70.00 $2,578.10 43772 Lap rmvl gastr adj device 27.43 70.00 $1,920.10 43773 Lap replace gastr adj device 36.91 70.00 $2,583.70 43774 Lap rmvl gastr adj all parts 27.77 70.00 $1,943.90 43775 Lap sleeve gastrectomy 31.97 70.00 $2,237.90 43800 Reconstruction of pylorus 26.94 70.00 $1,885.80 43810 Fusion of stomach and bowel 29.39 70.00 $2,057.30 43820 Fusion of stomach and bowel 38.87 70.00 $2,720.90 43825 Fusion of stomach and bowel 37.45 70.00 $2,621.50 43830 Place gastrostomy tube 20.22 70.00 $1,415.40 43831 Place gastrostomy tube 16.27 70.00 $1,138.90 43832 Place gastrostomy tube 30.03 70.00 $2,102.10 43840 Repair of stomach lesion 39.37 70.00 $2,755.90 43842 V-band gastroplasty 34.46 70.00 $2,412.20 43843 Gastroplasty w/o v-band 36.81 70.00 $2,576.70 43845 Gastroplasty duodenal switch 56.86 70.00 $3,980.20 43846 Gastric bypass for obesity 46.91 70.00 $3,283.70 43847 Gastric bypass incl small i 51.44 70.00 $3,600.80 43848 Revision gastroplasty 55.74 70.00 $3,901.80 43850 Revise stomach-bowel fusion 46.78 70.00 $3,274.60 43855 Revise stomach-bowel fusion 48.40 70.00 $3,388.00 43860 Revise stomach-bowel fusion 47.40 70.00 $3,318.00 43865 Revise stomach-bowel fusion 49.09 70.00 $3,436.30 43870 Repair stomach opening 20.58 70.00 $1,440.60 43880 Repair stomach-bowel fistula 46.35 70.00 $3,244.50 43881 Impl/redo electrd antrum 0.00 70.00 $0.00 43882 Revise/remove electrd antrum 0.00 70.00 $0.00 43886 Revise gastric port open 10.46 70.00 $732.20 43887 Remove gastric port open 9.43 70.00 $660.10 43888 Change gastric port open 13.24 70.00 $926.80 43999 Stomach surgery procedure 0.00 70.00 $0.00 4400F Rehab thxpy options w/pt 0.00 70.00 $0.00 44005 Freeing of bowel adhesion 31.73 70.00 $2,221.10 44010 Incision of small bowel 25.01 70.00 $1,750.70 44015 Insert needle cath bowel 4.14 70.00 $289.80 44020 Explore small intestine 28.19 70.00 $1,973.30 44021 Decompress small bowel 28.21 70.00 $1,974.70 44025 Incision of large bowel 28.48 70.00 $1,993.60 44050 Reduce bowel obstruction 27.07 70.00 $1,894.90 44055 Correct malrotation of bowel 43.21 70.00 $3,024.70 44100 Biopsy of bowel 3.17 70.00 $221.90 44110 Excise intestine lesion(s) 24.68 70.00 $1,727.60 44111 Excision of bowel lesion(s) 28.43 70.00 $1,990.10 44120 Removal of small intestine 35.46 70.00 $2,482.20 44121 Removal of small intestine 7.04 70.00 $492.80 44125 Removal of small intestine 34.22 70.00 $2,395.40 44126 Enterectomy w/o taper cong 70.60 70.00 $4,942.00 44127 Enterectomy w/taper cong 80.23 70.00 $5,616.10 44128 Enterectomy cong add-on 7.12 70.00 $498.40 44130 Bowel to bowel fusion 38.06 70.00 $2,664.20 44132 Enterectomy cadaver donor 0.00 70.00 $0.00 44133 Enterectomy live donor 0.00 70.00 $0.00 44135 Intestine transplnt cadaver 0.00 70.00 $0.00 44136 Intestine transplant live 0.00 70.00 $0.00 44137 Remove intestinal allograft 0.00 70.00 $0.00 44139 Mobilization of colon 3.53 70.00 $247.10 44140 Partial removal of colon 38.88 70.00 $2,721.60 44141 Partial removal of colon 52.94 70.00 $3,705.80 44143 Partial removal of colon 48.27 70.00 $3,378.90 44144 Partial removal of colon 51.30 70.00 $3,591.00 44145 Partial removal of colon 48.09 70.00 $3,366.30 44146 Partial removal of colon 61.53 70.00 $4,307.10 44147 Partial removal of colon 56.34 70.00 $3,943.80 44150 Removal of colon 54.19 70.00 $3,793.30 44151 Removal of colon/ileostomy 61.87 70.00 $4,330.90 44155 Removal of colon/ileostomy 60.44 70.00 $4,230.80 44156 Removal of colon/ileostomy 65.74 70.00 $4,601.80 44157 Colectomy w/ileoanal anast 62.58 70.00 $4,380.60 44158 Colectomy w/neo-rectum pouch 64.77 70.00 $4,533.90 44160 Removal of colon 35.99 70.00 $2,519.30 44180 Lap enterolysis 26.63 70.00 $1,864.10 44186 Lap jejunostomy 18.86 70.00 $1,320.20 44187 Lap ileo/jejuno-stomy 32.02 70.00 $2,241.40 44188 Lap colostomy 35.50 70.00 $2,485.00 44202 Lap enterectomy 40.17 70.00 $2,811.90 44203 Lap resect s/intestine addl 7.01 70.00 $490.70 44204 Laparo partial colectomy 44.62 70.00 $3,123.40 44205 Lap colectomy part w/ileum 38.81 70.00 $2,716.70 44206 Lap part colectomy w/stoma 50.80 70.00 $3,556.00 44207 L colectomy/coloproctostomy 52.81 70.00 $3,696.70 44208 L colectomy/coloproctostomy 57.65 70.00 $4,035.50 44210 Laparo total proctocolectomy 51.66 70.00 $3,616.20 44211 Lap colectomy w/proctectomy 63.41 70.00 $4,438.70 44212 Laparo total proctocolectomy 59.39 70.00 $4,157.30 44213 Lap mobil splenic fl add-on 5.48 70.00 $383.60 44227 Lap close enterostomy 48.35 70.00 $3,384.50 44238 Laparoscope proc intestine 0.00 70.00 $0.00 44300 Open bowel to skin 24.37 70.00 $1,705.90 44310 Ileostomy/jejunostomy 30.26 70.00 $2,118.20 44312 Revision of ileostomy 17.09 70.00 $1,196.30 44314 Revision of ileostomy 29.07 70.00 $2,034.90 44316 Devise bowel pouch 41.10 70.00 $2,877.00 44320 Colostomy 34.82 70.00 $2,437.40 44322 Colostomy with biopsies 28.81 70.00 $2,016.70 44340 Revision of colostomy 18.04 70.00 $1,262.80 44345 Revision of colostomy 30.48 70.00 $2,133.60 44346 Revision of colostomy 34.29 70.00 $2,400.30 44360 Small bowel endoscopy 4.23 70.00 $296.10 44361 Small bowel endoscopy/biopsy 4.67 70.00 $326.90 44363 Small bowel endoscopy 5.64 70.00 $394.80 44364 Small bowel endoscopy 6.01 70.00 $420.70 44365 Small bowel endoscopy 5.30 70.00 $371.00 44366 Small bowel endoscopy 7.06 70.00 $494.20 44369 Small bowel endoscopy 7.24 70.00 $506.80 44370 Small bowel endoscopy/stent 7.84 70.00 $548.80 44372 Small bowel endoscopy 7.07 70.00 $494.90 44373 Small bowel endoscopy 5.65 70.00 $395.50 44376 Small bowel endoscopy 8.36 70.00 $585.20 44377 Small bowel endoscopy/biopsy 8.81 70.00 $616.70 44378 Small bowel endoscopy 11.32 70.00 $792.40 44379 S bowel endoscope w/stent 12.06 70.00 $844.20 44380 Small bowel endoscopy br/wa 4.77 70.00 $333.90 44381 Small bowel endoscopy br/wa 26.53 70.00 $1,857.10 44382 Small bowel endoscopy 7.43 70.00 $520.10 44384 Small bowel endoscopy 4.48 70.00 $313.60 44385 Endoscopy of bowel pouch 5.42 70.00 $379.40 44386 Endoscopy bowel pouch/biop 8.10 70.00 $567.00 44388 Colonoscopy thru stoma spx 8.21 70.00 $574.70 44388 53 Colonoscopy thru stoma spx 4.08 70.00 $285.60 44389 Colonoscopy with biopsy 10.76 70.00 $753.20 44390 Colonoscopy for foreign body 10.65 70.00 $745.50 44391 Colonoscopy for bleeding 19.66 70.00 $1,376.20 44392 Colonoscopy & polypectomy 9.96 70.00 $697.20 44394 Colonoscopy w/snare 11.49 70.00 $804.30 44401 Colonoscopy with ablation 90.09 70.00 $6,306.30 44402 Colonoscopy w/stent plcmt 7.65 70.00 $535.50 44403 Colonoscopy w/resection 8.92 70.00 $624.40 44404 Colonoscopy w/injection 10.23 70.00 $716.10 44405 Colonoscopy w/dilation 15.30 70.00 $1,071.00 44406 Colonoscopy w/ultrasound 6.75 70.00 $472.50 44407 Colonoscopy w/ndl aspir/bx 8.09 70.00 $566.30 44408 Colonoscopy w/decompression 6.81 70.00 $476.70 4450F Self-care ed provided to pt 0.00 70.00 $0.00 44500 Intro gastrointestinal tube 0.56 70.00 $39.20 44602 Suture small intestine 40.94 70.00 $2,865.80 44603 Suture small intestine 47.02 70.00 $3,291.40 44604 Suture large intestine 30.68 70.00 $2,147.60 44605 Repair of bowel lesion 37.78 70.00 $2,644.60 44615 Intestinal stricturoplasty 31.12 70.00 $2,178.40 44620 Repair bowel opening 25.16 70.00 $1,761.20 44625 Repair bowel opening 29.48 70.00 $2,063.60 44626 Repair bowel opening 46.50 70.00 $3,255.00 44640 Repair bowel-skin fistula 40.67 70.00 $2,846.90 44650 Repair bowel fistula 41.95 70.00 $2,936.50 44660 Repair bowel-bladder fistula 38.77 70.00 $2,713.90 44661 Repair bowel-bladder fistula 44.97 70.00 $3,147.90 44680 Surgical revision intestine 30.93 70.00 $2,165.10 4470F Icd counseling provided 0.00 70.00 $0.00 44700 Suspend bowel w/prosthesis 29.49 70.00 $2,064.30 44701 Intraop colon lavage add-on 4.89 70.00 $342.30 44705 Prepare fecal microbiota 0.00 70.00 $0.00 44715 Prepare donor intestine 0.00 70.00 $0.00 44720 Prep donor intestine/venous 8.82 70.00 $617.40 44721 Prep donor intestine/artery 11.18 70.00 $782.60 44799 Unlisted px small intestine 0.00 70.00 $0.00 4480F Pt rcvng ace/arb b-blockertx 0.00 70.00 $0.00 44800 Excision of bowel pouch 22.15 70.00 $1,550.50 4481F Pt rcvng ace/arb blker >3mos 0.00 70.00 $0.00 44820 Excision of mesentery lesion 24.22 70.00 $1,695.40 44850 Repair of mesentery 21.71 70.00 $1,519.70 44899 Bowel surgery procedure 0.00 70.00 $0.00 44900 Drain appendix abscess open 22.21 70.00 $1,554.70 44950 Appendectomy 18.59 70.00 $1,301.30 44955 Appendectomy add-on 2.44 70.00 $170.80 44960 Appendectomy 25.32 70.00 $1,772.40 44970 Laparoscopy appendectomy 17.38 70.00 $1,216.60 44979 Laparoscope proc app 0.00 70.00 $0.00 4500F Ref to outpt card rehab prog 0.00 70.00 $0.00 45000 Drainage of pelvic abscess 12.23 70.00 $856.10 45005 Drainage of rectal abscess 7.86 70.00 $550.20 45020 Drainage of rectal abscess 16.55 70.00 $1,158.50 4510F Prev cardrehab qualcardevent 0.00 70.00 $0.00 45100 Biopsy of rectum 8.64 70.00 $604.80 45108 Removal of anorectal lesion 10.53 70.00 $737.10 45110 Removal of rectum 53.53 70.00 $3,747.10 45111 Partial removal of rectum 31.48 70.00 $2,203.60 45112 Removal of rectum 54.43 70.00 $3,810.10 45113 Partial proctectomy 56.02 70.00 $3,921.40 45114 Partial removal of rectum 52.34 70.00 $3,663.80 45116 Partial removal of rectum 46.89 70.00 $3,282.30 45119 Remove rectum w/reservoir 56.43 70.00 $3,950.10 45120 Removal of rectum 45.99 70.00 $3,219.30 45121 Removal of rectum and colon 48.12 70.00 $3,368.40 45123 Partial proctectomy 32.45 70.00 $2,271.50 45126 Pelvic exenteration 80.90 70.00 $5,663.00 45130 Excision of rectal prolapse 31.55 70.00 $2,208.50 45135 Excision of rectal prolapse 39.59 70.00 $2,771.30 45136 Excise ileoanal reservior 55.36 70.00 $3,875.20 45150 Excision of rectal stricture 10.42 70.00 $729.40 45160 Excision of rectal lesion 29.56 70.00 $2,069.20 45171 Exc rect tum transanal part 17.36 70.00 $1,215.20 45172 Exc rect tum transanal full 23.40 70.00 $1,638.00 45190 Destruction rectal tumor 20.10 70.00 $1,407.00 4525F Neuropsychia interven order 0.00 70.00 $0.00 4526F Neuropsychia interven rcvd 0.00 70.00 $0.00 45300 Proctosigmoidoscopy dx 3.51 70.00 $245.70 45303 Proctosigmoidoscopy dilate 25.61 70.00 $1,792.70 45305 Proctosigmoidoscopy w/bx 4.06 70.00 $284.20 45307 Proctosigmoidoscopy fb 4.74 70.00 $331.80 45308 Proctosigmoidoscopy removal 4.55 70.00 $318.50 45309 Proctosigmoidoscopy removal 4.74 70.00 $331.80 45315 Proctosigmoidoscopy removal 5.15 70.00 $360.50 45317 Proctosigmoidoscopy bleed 5.20 70.00 $364.00 45320 Proctosigmoidoscopy ablate 5.05 70.00 $353.50 45321 Proctosigmoidoscopy volvul 2.95 70.00 $206.50 45327 Proctosigmoidoscopy w/stent 3.30 70.00 $231.00 45330 Diagnostic sigmoidoscopy 4.74 70.00 $331.80 45331 Sigmoidoscopy and biopsy 7.27 70.00 $508.90 45332 Sigmoidoscopy w/fb removal 7.13 70.00 $499.10 45333 Sigmoidoscopy & polypectomy 8.33 70.00 $583.10 45334 Sigmoidoscopy for bleeding 15.62 70.00 $1,093.40 45335 Sigmoidoscopy w/submuc inj 6.63 70.00 $464.10 45337 Sigmoidoscopy & decompress 3.39 70.00 $237.30 45338 Sigmoidoscopy w/tumr remove 7.63 70.00 $534.10 45340 Sig w/tndsc balloon dilation 12.23 70.00 $856.10 45341 Sigmoidoscopy w/ultrasound 3.64 70.00 $254.80 45342 Sigmoidoscopy w/us guide bx 4.99 70.00 $349.30 45346 Sigmoidoscopy w/ablation 86.54 70.00 $6,057.80 45347 Sigmoidoscopy w/plcmt stent 4.54 70.00 $317.80 45349 Sigmoidoscopy w/resection 5.83 70.00 $408.10 45350 Sgmdsc w/band ligation 14.87 70.00 $1,040.90 45378 Diagnostic colonoscopy 8.99 70.00 $629.30 45378 53 Diagnostic colonoscopy 4.51 70.00 $315.70 45379 Colonoscopy w/fb removal 11.60 70.00 $812.00 45380 Colonoscopy and biopsy 11.50 70.00 $805.00 45381 Colonoscopy submucous njx 10.99 70.00 $769.30 45382 Colonoscopy w/control bleed 20.45 70.00 $1,431.50 45384 Colonoscopy w/lesion removal 12.76 70.00 $893.20 45385 Colonoscopy w/lesion removal 12.09 70.00 $846.30 45386 Colonoscopy w/balloon dilat 16.60 70.00 $1,162.00 45388 Colonoscopy w/ablation 90.96 70.00 $6,367.20 45389 Colonoscopy w/stent plcmt 8.53 70.00 $597.10 45390 Colonoscopy w/resection 9.77 70.00 $683.90 45391 Colonoscopy w/endoscope us 7.58 70.00 $530.60 45392 Colonoscopy w/endoscopic fnb 8.94 70.00 $625.80 45393 Colonoscopy w/decompression 7.43 70.00 $520.10 45395 Lap removal of rectum 57.33 70.00 $4,013.10 45397 Lap remove rectum w/pouch 62.43 70.00 $4,370.10 45398 Colonoscopy w/band ligation 19.09 70.00 $1,336.30 45399 Unlisted procedure colon 0.00 70.00 $0.00 4540F Disease modif pharmacothxpy 0.00 70.00 $0.00 45400 Laparoscopic proc 33.04 70.00 $2,312.80 45402 Lap proctopexy w/sig resect 44.06 70.00 $3,084.20 4541F Pt offered tx for pseudobulb 0.00 70.00 $0.00 45499 Laparoscope proc rectum 0.00 70.00 $0.00 4550F Noninvas resp support talk 0.00 70.00 $0.00 45500 Repair of rectum 15.08 70.00 $1,055.60 45505 Repair of rectum 17.10 70.00 $1,197.00 4551F Nutritional support offered 0.00 70.00 $0.00 4552F Pt ref for speech lang path 0.00 70.00 $0.00 45520 Treatment of rectal prolapse 4.42 70.00 $309.40 4553F Pt asst re end life issues 0.00 70.00 $0.00 4554F Pt recvd inhal anesthetic 0.00 70.00 $0.00 45540 Correct rectal prolapse 30.63 70.00 $2,144.10 45541 Correct rectal prolapse 27.31 70.00 $1,911.70 4555F Pt recvd no inhal anesthic 0.00 70.00 $0.00 45550 Repair rectum/remove sigmoid 42.37 70.00 $2,965.90 4556F Pt w/3+ post-op nausea&vom 0.00 70.00 $0.00 45560 Repair of rectocele 19.86 70.00 $1,390.20 45562 Exploration/repair of rectum 32.53 70.00 $2,277.10 45563 Exploration/repair of rectum 47.52 70.00 $3,326.40 4557F Pt w/o 3+ post-opnausea&vom 0.00 70.00 $0.00 4558F Pt recvd 2 rx anti-emet agt 0.00 70.00 $0.00 4559F 1 bodytemp >=35.5cw/in 30min 0.00 70.00 $0.00 4560F Anesth w/o gen/neurax anesth 0.00 70.00 $0.00 4561F Pt w/ coronary artery stent 0.00 70.00 $0.00 4562F Pt w/o coronary artery stent 0.00 70.00 $0.00 4563F Pt recvd aspirin w/in 24 hrs 0.00 70.00 $0.00 45800 Repair rect/bladder fistula 34.86 70.00 $2,440.20 45805 Repair fistula w/colostomy 41.50 70.00 $2,905.00 45820 Repair rectourethral fistula 32.67 70.00 $2,286.90 45825 Repair fistula w/colostomy 41.45 70.00 $2,901.50 45900 Reduction of rectal prolapse 5.85 70.00 $409.50 45905 Dilation of anal sphincter 4.87 70.00 $340.90 45910 Dilation of rectal narrowing 5.59 70.00 $391.30 45915 Remove rectal obstruction 9.48 70.00 $663.60 45990 Surg dx exam anorectal 3.12 70.00 $218.40 45999 Rectum surgery procedure 0.00 70.00 $0.00 46020 Placement of seton 7.92 70.00 $554.40 46030 Removal of rectal marker 3.98 70.00 $278.60 46040 Incision of rectal abscess 15.33 70.00 $1,073.10 46045 Incision of rectal abscess 12.54 70.00 $877.80 46050 Incision of anal abscess 5.75 70.00 $402.50 46060 Incision of rectal abscess 13.73 70.00 $961.10 46070 Incision of anal septum 6.53 70.00 $457.10 46080 Incision of anal sphincter 7.10 70.00 $497.00 46083 Incise external hemorrhoid 5.04 70.00 $352.80 46200 Removal of anal fissure 12.76 70.00 $893.20 46220 Excise anal ext tag/papilla 5.88 70.00 $411.60 46221 Ligation of hemorrhoid(s) 7.66 70.00 $536.20 46230 Removal of anal tags 7.81 70.00 $546.70 46250 Remove ext hem groups 2+ 13.24 70.00 $926.80 46255 Remove int/ext hem 1 group 14.49 70.00 $1,014.30 46257 Remove in/ex hem grp & fiss 12.13 70.00 $849.10 46258 Remove in/ex hem grp w/fistu 13.37 70.00 $935.90 46260 Remove in/ex hem groups 2+ 13.71 70.00 $959.70 46261 Remove in/ex hem grps & fiss 15.06 70.00 $1,054.20 46262 Remove in/ex hem grps w/fist 15.96 70.00 $1,117.20 46270 Remove anal fist subq 14.54 70.00 $1,017.80 46275 Remove anal fist inter 15.41 70.00 $1,078.70 46280 Remove anal fist complex 13.52 70.00 $946.40 46285 Remove anal fist 2 stage 15.32 70.00 $1,072.40 46288 Repair anal fistula 15.87 70.00 $1,110.90 46320 Removal of hemorrhoid clot 5.25 70.00 $367.50 46500 Injection into hemorrhoid(s) 5.36 70.00 $375.20 46505 Chemodenervation anal musc 8.16 70.00 $571.20 46600 Diagnostic anoscopy spx 2.52 70.00 $176.40 46601 Diagnostic anoscopy 3.89 70.00 $272.30 46604 Anoscopy and dilation 17.66 70.00 $1,236.20 46606 Anoscopy and biopsy 6.44 70.00 $450.80 46607 Diagnostic anoscopy & biopsy 5.49 70.00 $384.30 46608 Anoscopy remove for body 6.68 70.00 $467.60 46610 Anoscopy remove lesion 6.49 70.00 $454.30 46611 Anoscopy 5.03 70.00 $352.10 46612 Anoscopy remove lesions 7.10 70.00 $497.00 46614 Anoscopy control bleeding 3.66 70.00 $256.20 46615 Anoscopy 4.09 70.00 $286.30 46700 Repair of anal stricture 18.88 70.00 $1,321.60 46705 Repair of anal stricture 14.43 70.00 $1,010.10 46706 Repr of anal fistula w/glue 5.04 70.00 $352.80 46707 Repair anorectal fist w/plug 13.59 70.00 $951.30 46710 Repr per/vag pouch sngl proc 30.12 70.00 $2,108.40 46712 Repr per/vag pouch dbl proc 61.17 70.00 $4,281.90 46715 Rep perf anoper fistu 15.63 70.00 $1,094.10 46716 Rep perf anoper/vestib fistu 31.98 70.00 $2,238.60 46730 Construction of absent anus 52.62 70.00 $3,683.40 46735 Construction of absent anus 60.95 70.00 $4,266.50 46740 Construction of absent anus 58.73 70.00 $4,111.10 46742 Repair of imperforated anus 78.69 70.00 $5,508.30 46744 Repair of cloacal anomaly 102.12 70.00 $7,148.40 46746 Repair of cloacal anomaly 103.63 70.00 $7,254.10 46748 Repair of cloacal anomaly 114.67 70.00 $8,026.90 46750 Repair of anal sphincter 21.77 70.00 $1,523.90 46751 Repair of anal sphincter 17.19 70.00 $1,203.30 46753 Reconstruction of anus 16.68 70.00 $1,167.60 46754 Removal of suture from anus 8.43 70.00 $590.10 46760 Repair of anal sphincter 31.96 70.00 $2,237.20 46761 Repair of anal sphincter 26.65 70.00 $1,865.50 46762 Implant artificial sphincter 26.38 70.00 $1,846.60 46900 Destruction anal lesion(s) 6.91 70.00 $483.70 46910 Destruction anal lesion(s) 7.32 70.00 $512.40 46916 Cryosurgery anal lesion(s) 6.57 70.00 $459.90 46917 Laser surgery anal lesions 12.96 70.00 $907.20 46922 Excision of anal lesion(s) 7.62 70.00 $533.40 46924 Destruction anal lesion(s) 15.19 70.00 $1,063.30 46930 Destroy internal hemorrhoids 5.87 70.00 $410.90 46940 Treatment of anal fissure 6.53 70.00 $457.10 46942 Treatment of anal fissure 6.17 70.00 $431.90 46945 Remove by ligat int hem grp 8.83 70.00 $618.10 46946 Remove by ligat int hem grps 8.96 70.00 $627.20 46947 Hemorrhoidopexy by stapling 11.02 70.00 $771.40 46999 Anus surgery procedure 0.00 70.00 $0.00 47000 Needle biopsy of liver 8.70 70.00 $609.00 47001 Needle biopsy liver add-on 3.03 70.00 $212.10 47010 Open drainage liver lesion 34.92 70.00 $2,444.40 47015 Inject/aspirate liver cyst 33.65 70.00 $2,355.50 47100 Wedge biopsy of liver 24.42 70.00 $1,709.40 47120 Partial removal of liver 67.53 70.00 $4,727.10 47122 Extensive removal of liver 99.41 70.00 $6,958.70 47125 Partial removal of liver 89.12 70.00 $6,238.40 47130 Partial removal of liver 95.75 70.00 $6,702.50 47133 Removal of donor liver 0.00 70.00 $0.00 47135 Transplantation of liver 155.54 70.00 $10,887.80 47140 Partial removal donor liver 96.88 70.00 $6,781.60 47141 Partial removal donor liver 123.72 70.00 $8,660.40 47142 Partial removal donor liver 135.77 70.00 $9,503.90 47143 Prep donor liver whole 0.00 70.00 $0.00 47144 Prep donor liver 3-segment 0.00 70.00 $0.00 47145 Prep donor liver lobe split 0.00 70.00 $0.00 47146 Prep donor liver/venous 9.59 70.00 $671.30 47147 Prep donor liver/arterial 11.13 70.00 $779.10 47300 Surgery for liver lesion 32.79 70.00 $2,295.30 47350 Repair liver wound 39.63 70.00 $2,774.10 47360 Repair liver wound 53.66 70.00 $3,756.20 47361 Repair liver wound 87.96 70.00 $6,157.20 47362 Repair liver wound 42.03 70.00 $2,942.10 47370 Laparo ablate liver tumor rf 36.15 70.00 $2,530.50 47371 Laparo ablate liver cryosurg 35.96 70.00 $2,517.20 47379 Laparoscope procedure liver 0.00 70.00 $0.00 47380 Open ablate liver tumor rf 41.72 70.00 $2,920.40 47381 Open ablate liver tumor cryo 40.02 70.00 $2,801.40 47382 Percut ablate liver rf 137.16 70.00 $9,601.20 47383 Perq abltj lvr cryoablation 192.77 70.00 $13,493.90 47399 Liver surgery procedure 0.00 70.00 $0.00 47400 Incision of liver duct 61.83 70.00 $4,328.10 47420 Incision of bile duct 38.82 70.00 $2,717.40 47425 Incision of bile duct 37.82 70.00 $2,647.40 47460 Incise bile duct sphincter 36.43 70.00 $2,550.10 47480 Incision of gallbladder 25.36 70.00 $1,775.20 47490 Incision of gallbladder 9.57 70.00 $669.90 47531 Injection for cholangiogram 8.88 70.00 $621.60 47532 Injection for cholangiogram 22.77 70.00 $1,593.90 47533 Plmt biliary drainage cath 35.12 70.00 $2,458.40 47534 Plmt biliary drainage cath 41.82 70.00 $2,927.40 47535 Conversion ext bil drg cath 28.85 70.00 $2,019.50 47536 Exchange biliary drg cath 19.58 70.00 $1,370.60 47537 Removal biliary drg cath 10.40 70.00 $728.00 47538 Perq plmt bile duct stent 122.37 70.00 $8,565.90 47539 Perq plmt bile duct stent 135.43 70.00 $9,480.10 47540 Perq plmt bile duct stent 138.81 70.00 $9,716.70 47541 Plmt access bil tree sm bwl 33.30 70.00 $2,331.00 47542 Dilate biliary duct/ampulla 13.10 70.00 $917.00 47543 Endoluminal bx biliary tree 16.37 70.00 $1,145.90 47544 Removal duct glbldr calculi 30.86 70.00 $2,160.20 47550 Bile duct endoscopy add-on 4.81 70.00 $336.70 47552 Biliary endo perq dx w/speci 8.99 70.00 $629.30 47553 Biliary endoscopy thru skin 8.93 70.00 $625.10 47554 Biliary endoscopy thru skin 13.76 70.00 $963.20 47555 Biliary endoscopy thru skin 10.60 70.00 $742.00 47556 Biliary endoscopy thru skin 12.09 70.00 $846.30 47562 Laparoscopic cholecystectomy 19.03 70.00 $1,332.10 47563 Laparo cholecystectomy/graph 20.67 70.00 $1,446.90 47564 Laparo cholecystectomy/explr 32.22 70.00 $2,255.40 47570 Laparo cholecystoenterostomy 22.48 70.00 $1,573.60 47579 Laparoscope proc biliary 0.00 70.00 $0.00 47600 Removal of gallbladder 30.90 70.00 $2,163.00 47605 Removal of gallbladder 32.53 70.00 $2,277.10 47610 Removal of gallbladder 36.34 70.00 $2,543.80 47612 Removal of gallbladder 36.71 70.00 $2,569.70 47620 Removal of gallbladder 39.69 70.00 $2,778.30 47700 Exploration of bile ducts 30.09 70.00 $2,106.30 47701 Bile duct revision 49.47 70.00 $3,462.90 47711 Excision of bile duct tumor 45.09 70.00 $3,156.30 47712 Excision of bile duct tumor 57.79 70.00 $4,045.30 47715 Excision of bile duct cyst 38.39 70.00 $2,687.30 47720 Fuse gallbladder & bowel 33.06 70.00 $2,314.20 47721 Fuse upper gi structures 39.12 70.00 $2,738.40 47740 Fuse gallbladder & bowel 37.86 70.00 $2,650.20 47741 Fuse gallbladder & bowel 42.03 70.00 $2,942.10 47760 Fuse bile ducts and bowel 65.31 70.00 $4,571.70 47765 Fuse liver ducts & bowel 88.13 70.00 $6,169.10 47780 Fuse bile ducts and bowel 71.71 70.00 $5,019.70 47785 Fuse bile ducts and bowel 94.01 70.00 $6,580.70 47800 Reconstruction of bile ducts 45.68 70.00 $3,197.60 47801 Placement bile duct support 29.01 70.00 $2,030.70 47802 Fuse liver duct & intestine 44.14 70.00 $3,089.80 47900 Suture bile duct injury 39.74 70.00 $2,781.80 47999 Bile tract surgery procedure 0.00 70.00 $0.00 48000 Drainage of abdomen 54.07 70.00 $3,784.90 48001 Placement of drain pancreas 67.05 70.00 $4,693.50 48020 Removal of pancreatic stone 33.62 70.00 $2,353.40 48100 Biopsy of pancreas open 25.76 70.00 $1,803.20 48102 Needle biopsy pancreas 15.17 70.00 $1,061.90 48105 Resect/debride pancreas 82.58 70.00 $5,780.60 48120 Removal of pancreas lesion 32.06 70.00 $2,244.20 48140 Partial removal of pancreas 45.31 70.00 $3,171.70 48145 Partial removal of pancreas 47.03 70.00 $3,292.10 48146 Pancreatectomy 54.26 70.00 $3,798.20 48148 Removal of pancreatic duct 36.01 70.00 $2,520.70 48150 Partial removal of pancreas 90.29 70.00 $6,320.30 48152 Pancreatectomy 83.66 70.00 $5,856.20 48153 Pancreatectomy 89.77 70.00 $6,283.90 48154 Pancreatectomy 83.62 70.00 $5,853.40 48155 Removal of pancreas 52.65 70.00 $3,685.50 48160 Pancreas removal/transplant 0.00 70.00 $0.00 48400 Injection intraop add-on 3.10 70.00 $217.00 48500 Surgery of pancreatic cyst 32.75 70.00 $2,292.50 48510 Drain pancreatic pseudocyst 31.55 70.00 $2,208.50 48520 Fuse pancreas cyst and bowel 31.63 70.00 $2,214.10 48540 Fuse pancreas cyst and bowel 37.99 70.00 $2,659.30 48545 Pancreatorrhaphy 38.95 70.00 $2,726.50 48547 Duodenal exclusion 51.71 70.00 $3,619.70 48548 Fuse pancreas and bowel 48.02 70.00 $3,361.40 48550 Donor pancreatectomy 0.00 70.00 $0.00 48551 Prep donor pancreas 0.00 70.00 $0.00 48552 Prep donor pancreas/venous 6.81 70.00 $476.70 48554 Transpl allograft pancreas 73.86 70.00 $5,170.20 48556 Removal allograft pancreas 36.69 70.00 $2,568.30 48999 Pancreas surgery procedure 0.00 70.00 $0.00 49000 Exploration of abdomen 22.29 70.00 $1,560.30 49002 Reopening of abdomen 30.28 70.00 $2,119.60 49010 Exploration behind abdomen 27.06 70.00 $1,894.20 49020 Drainage abdom abscess open 46.09 70.00 $3,226.30 49040 Drain open abdom abscess 28.92 70.00 $2,024.40 49060 Drain open retroperi abscess 31.80 70.00 $2,226.00 49062 Drain to peritoneal cavity 21.40 70.00 $1,498.00 49082 Abd paracentesis 5.48 70.00 $383.60 49083 Abd paracentesis w/imaging 8.36 70.00 $585.20 49084 Peritoneal lavage 3.15 70.00 $220.50 49180 Biopsy abdominal mass 4.64 70.00 $324.80 49185 Sclerotx fluid collection 27.78 70.00 $1,944.60 49203 Exc abd tum 5 cm or less 34.69 70.00 $2,428.30 49204 Exc abd tum over 5 cm 44.42 70.00 $3,109.40 49205 Exc abd tum over 10 cm 51.01 70.00 $3,570.70 49215 Excise sacral spine tumor 64.33 70.00 $4,503.10 49220 Multiple surgery abdomen 28.14 70.00 $1,969.80 49250 Excision of umbilicus 17.02 70.00 $1,191.40 49255 Removal of omentum 22.89 70.00 $1,602.30 49320 Diag laparo separate proc 9.41 70.00 $658.70 49321 Laparoscopy biopsy 9.97 70.00 $697.90 49322 Laparoscopy aspiration 10.67 70.00 $746.90 49323 Laparo drain lymphocele 18.41 70.00 $1,288.70 49324 Lap insert tunnel ip cath 11.26 70.00 $788.20 49325 Lap revision perm ip cath 12.01 70.00 $840.70 49326 Lap w/omentopexy add-on 5.49 70.00 $384.30 49327 Lap ins device for rt 3.80 70.00 $266.00 49329 Laparo proc abdm/per/oment 0.00 70.00 $0.00 49400 Air injection into abdomen 3.85 70.00 $269.50 49402 Remove foreign body adbomen 24.77 70.00 $1,733.90 49405 Image cath fluid colxn visc 22.91 70.00 $1,603.70 49406 Image cath fluid peri/retro 22.92 70.00 $1,604.40 49407 Image cath fluid trns/vgnl 18.61 70.00 $1,302.70 49411 Ins mark abd/pel for rt perq 13.70 70.00 $959.00 49412 Ins device for rt guide open 2.39 70.00 $167.30 49418 Insert tun ip cath perc 38.70 70.00 $2,709.00 49419 Insert tun ip cath w/port 12.86 70.00 $900.20 49421 Ins tun ip cath for dial opn 6.67 70.00 $466.90 49422 Remove tunneled ip cath 11.00 70.00 $770.00 49423 Exchange drainage catheter 15.51 70.00 $1,085.70 49424 Assess cyst contrast inject 4.14 70.00 $289.80 49425 Insert abdomen-venous drain 20.85 70.00 $1,459.50 49426 Revise abdomen-venous shunt 17.67 70.00 $1,236.90 49427 Injection abdominal shunt 1.33 70.00 $93.10 49428 Ligation of shunt 13.29 70.00 $930.30 49429 Removal of shunt 13.31 70.00 $931.70 49435 Insert subq exten to ip cath 3.47 70.00 $242.90 49436 Embedded ip cath exit-site 5.39 70.00 $377.30 49440 Place gastrostomy tube perc 27.52 70.00 $1,926.40 49441 Place duod/jej tube perc 31.06 70.00 $2,174.20 49442 Place cecostomy tube perc 25.84 70.00 $1,808.80 49446 Change g-tube to g-j perc 26.44 70.00 $1,850.80 49450 Replace g/c tube perc 18.89 70.00 $1,322.30 49451 Replace duod/jej tube perc 20.64 70.00 $1,444.80 49452 Replace g-j tube perc 25.52 70.00 $1,786.40 49460 Fix g/colon tube w/device 20.89 70.00 $1,462.30 49465 Fluoro exam of g/colon tube 4.66 70.00 $326.20 49491 Rpr hern preemie reduc 22.65 70.00 $1,585.50 49492 Rpr ing hern premie blocked 27.70 70.00 $1,939.00 49495 Rpr ing hernia baby reduc 10.93 70.00 $765.10 49496 Rpr ing hernia baby blocked 15.67 70.00 $1,096.90 49500 Rpr ing hernia init reduce 11.38 70.00 $796.60 49501 Rpr ing hernia init blocked 17.51 70.00 $1,225.70 49505 Prp i/hern init reduc >5 yr 15.04 70.00 $1,052.80 49507 Prp i/hern init block >5 yr 16.91 70.00 $1,183.70 49520 Rerepair ing hernia reduce 18.27 70.00 $1,278.90 49521 Rerepair ing hernia blocked 20.72 70.00 $1,450.40 49525 Repair ing hernia sliding 16.56 70.00 $1,159.20 49540 Repair lumbar hernia 19.47 70.00 $1,362.90 49550 Rpr rem hernia init reduce 16.63 70.00 $1,164.10 49553 Rpr fem hernia init blocked 18.23 70.00 $1,276.10 49555 Rerepair fem hernia reduce 17.28 70.00 $1,209.60 49557 Rerepair fem hernia blocked 20.95 70.00 $1,466.50 49560 Rpr ventral hern init reduc 21.34 70.00 $1,493.80 49561 Rpr ventral hern init block 26.91 70.00 $1,883.70 49565 Rerepair ventrl hern reduce 22.22 70.00 $1,555.40 49566 Rerepair ventrl hern block 27.15 70.00 $1,900.50 49568 Hernia repair w/mesh 7.76 70.00 $543.20 49570 Rpr epigastric hern reduce 12.03 70.00 $842.10 49572 Rpr epigastric hern blocked 14.91 70.00 $1,043.70 49580 Rpr umbil hern reduc < 5 yr 9.46 70.00 $662.20 49582 Rpr umbil hern block < 5 yr 13.34 70.00 $933.80 49585 Rpr umbil hern reduc > 5 yr 12.85 70.00 $899.50 49587 Rpr umbil hern block > 5 yr 13.72 70.00 $960.40 49590 Repair spigelian hernia 16.55 70.00 $1,158.50 49600 Repair umbilical lesion 19.02 70.00 $1,331.40 49605 Repair umbilical lesion 143.40 70.00 $10,038.00 49606 Repair umbilical lesion 32.84 70.00 $2,298.80 49610 Repair umbilical lesion 18.83 70.00 $1,318.10 49611 Repair umbilical lesion 16.19 70.00 $1,133.30 49650 Lap ing hernia repair init 12.37 70.00 $865.90 49651 Lap ing hernia repair recur 16.08 70.00 $1,125.60 49652 Lap vent/abd hernia repair 21.51 70.00 $1,505.70 49653 Lap vent/abd hern proc comp 26.84 70.00 $1,878.80 49654 Lap inc hernia repair 24.47 70.00 $1,712.90 49655 Lap inc hern repair comp 29.86 70.00 $2,090.20 49656 Lap inc hernia repair recur 26.55 70.00 $1,858.50 49657 Lap inc hern recur comp 38.24 70.00 $2,676.80 49659 Laparo proc hernia repair 0.00 70.00 $0.00 49900 Repair of abdominal wall 23.55 70.00 $1,648.50 49904 Omental flap extra-abdom 41.08 70.00 $2,875.60 49905 Omental flap intra-abdom 10.26 70.00 $718.20 49906 Free omental flap microvasc 0.00 70.00 $0.00 49999 Abdomen surgery procedure 0.00 70.00 $0.00 50010 Exploration of kidney 21.37 70.00 $1,495.90 50020 Renal abscess open drain 29.32 70.00 $2,052.40 50040 Drainage of kidney 26.75 70.00 $1,872.50 50045 Exploration of kidney 27.15 70.00 $1,900.50 5005F Pt counsld on exam for moles 0.00 70.00 $0.00 50060 Removal of kidney stone 32.97 70.00 $2,307.90 50065 Incision of kidney 34.94 70.00 $2,445.80 50070 Incision of kidney 35.80 70.00 $2,506.00 50075 Removal of kidney stone 42.17 70.00 $2,951.90 50080 Removal of kidney stone 25.12 70.00 $1,758.40 50081 Removal of kidney stone 36.88 70.00 $2,581.60 5010F Macul result phy/qhp mng dm 0.00 70.00 $0.00 50100 Revise kidney blood vessels 31.78 70.00 $2,224.60 50120 Exploration of kidney 27.85 70.00 $1,949.50 50125 Explore and drain kidney 29.67 70.00 $2,076.90 50130 Removal of kidney stone 29.82 70.00 $2,087.40 50135 Exploration of kidney 32.41 70.00 $2,268.70 5015F Doc fx & test/txmnt for op 0.00 70.00 $0.00 5020F Txmnts 2 phys/qhp by 1 mon 0.00 70.00 $0.00 50200 Renal biopsy perq 15.21 70.00 $1,064.70 50205 Renal biopsy open 21.80 70.00 $1,526.00 50220 Remove kidney open 30.24 70.00 $2,116.80 50225 Removal kidney open complex 34.71 70.00 $2,429.70 50230 Removal kidney open radical 37.06 70.00 $2,594.20 50234 Removal of kidney & ureter 37.61 70.00 $2,632.70 50236 Removal of kidney & ureter 42.40 70.00 $2,968.00 50240 Partial removal of kidney 38.24 70.00 $2,676.80 50250 Cryoablate renal mass open 34.95 70.00 $2,446.50 50280 Removal of kidney lesion 27.70 70.00 $1,939.00 50290 Removal of kidney lesion 25.95 70.00 $1,816.50 50300 Remove cadaver donor kidney 0.00 70.00 $0.00 50320 Remove kidney living donor 43.46 70.00 $3,042.20 50323 Prep cadaver renal allograft 0.00 70.00 $0.00 50325 Prep donor renal graft 0.00 70.00 $0.00 50327 Prep renal graft/venous 6.30 70.00 $441.00 50328 Prep renal graft/arterial 5.52 70.00 $386.40 50329 Prep renal graft/ureteral 5.21 70.00 $364.70 50340 Removal of kidney 27.34 70.00 $1,913.80 50360 Transplantation of kidney 70.00 70.00 $4,900.00 50365 Transplantation of kidney 82.66 70.00 $5,786.20 50370 Remove transplanted kidney 34.76 70.00 $2,433.20 50380 Reimplantation of kidney 55.57 70.00 $3,889.90 50382 Change ureter stent percut 31.51 70.00 $2,205.70 50384 Remove ureter stent percut 24.73 70.00 $1,731.10 50385 Change stent via transureth 30.68 70.00 $2,147.60 50386 Remove stent via transureth 19.56 70.00 $1,369.20 50387 Change nephroureteral cath 13.92 70.00 $974.40 50389 Remove renal tube w/fluoro 8.44 70.00 $590.80 50390 Drainage of kidney lesion 2.79 70.00 $195.30 50391 Instll rx agnt into rnal tub 3.49 70.00 $244.30 50395 Create passage to kidney 5.16 70.00 $361.20 50396 Measure kidney pressure 3.39 70.00 $237.30 50400 Revision of kidney/ureter 33.48 70.00 $2,343.60 50405 Revision of kidney/ureter 40.41 70.00 $2,828.70 50430 Njx px nfrosgrm &/urtrgrm 12.97 70.00 $907.90 50431 Njx px nfrosgrm &/urtrgrm 4.63 70.00 $324.10 50432 Plmt nephrostomy catheter 21.93 70.00 $1,535.10 50433 Plmt nephroureteral catheter 30.00 70.00 $2,100.00 50434 Convert nephrostomy catheter 23.55 70.00 $1,648.50 50435 Exchange nephrostomy cath 13.39 70.00 $937.30 5050F Plan 2 main dr by 1 month 0.00 70.00 $0.00 50500 Repair of kidney wound 33.48 70.00 $2,343.60 50520 Close kidney-skin fistula 29.77 70.00 $2,083.90 50525 Close nephrovisceral fistula 45.87 70.00 $3,210.90 50526 Close nephrovisceral fistula 42.78 70.00 $2,994.60 50540 Revision of horseshoe kidney 32.93 70.00 $2,305.10 50541 Laparo ablate renal cyst 26.55 70.00 $1,858.50 50542 Laparo ablate renal mass 33.69 70.00 $2,358.30 50543 Laparo partial nephrectomy 42.99 70.00 $3,009.30 50544 Laparoscopy pyeloplasty 36.03 70.00 $2,522.10 50545 Laparo radical nephrectomy 38.74 70.00 $2,711.80 50546 Laparoscopic nephrectomy 34.77 70.00 $2,433.90 50547 Laparo removal donor kidney 46.55 70.00 $3,258.50 50548 Laparo remove w/ureter 38.96 70.00 $2,727.20 50549 Laparoscope proc renal 0.00 70.00 $0.00 50551 Kidney endoscopy 10.36 70.00 $725.20 50553 Kidney endoscopy 11.04 70.00 $772.80 50555 Kidney endoscopy & biopsy 11.86 70.00 $830.20 50557 Kidney endoscopy & treatment 12.08 70.00 $845.60 50561 Kidney endoscopy & treatment 13.67 70.00 $956.90 50562 Renal scope w/tumor resect 16.81 70.00 $1,176.70 50570 Kidney endoscopy 14.29 70.00 $1,000.30 50572 Kidney endoscopy 15.41 70.00 $1,078.70 50574 Kidney endoscopy & biopsy 16.38 70.00 $1,146.60 50575 Kidney endoscopy 20.71 70.00 $1,449.70 50576 Kidney endoscopy & treatment 16.34 70.00 $1,143.80 50580 Kidney endoscopy & treatment 17.61 70.00 $1,232.70 50590 Fragmenting of kidney stone 20.65 70.00 $1,445.50 50592 Perc rf ablate renal tumor 35.00 70.00 $2,450.00 50593 Perc cryo ablate renal tum 128.35 70.00 $8,984.50 5060F Fndngs mammo 2pt w/in 3 days 0.00 70.00 $0.00 50600 Exploration of ureter 27.22 70.00 $1,905.40 50605 Insert ureteral support 28.50 70.00 $1,995.00 50606 Endoluminal bx urtr rnl plvs 19.98 70.00 $1,398.60 50610 Removal of ureter stone 27.97 70.00 $1,957.90 5062F Mammo result com to pt 5 day 0.00 70.00 $0.00 50620 Removal of ureter stone 26.07 70.00 $1,824.90 50630 Removal of ureter stone 25.93 70.00 $1,815.10 50650 Removal of ureter 29.92 70.00 $2,094.40 50660 Removal of ureter 33.48 70.00 $2,343.60 50684 Injection for ureter x-ray 3.03 70.00 $212.10 50686 Measure ureter pressure 4.19 70.00 $293.30 50688 Change of ureter tube/stent 2.29 70.00 $160.30 50690 Injection for ureter x-ray 2.82 70.00 $197.40 50693 Plmt ureteral stent prq 28.03 70.00 $1,962.10 50694 Plmt ureteral stent prq 30.77 70.00 $2,153.90 50695 Plmt ureteral stent prq 37.78 70.00 $2,644.60 50700 Revision of ureter 26.68 70.00 $1,867.60 50705 Ureteral embolization/occl 54.94 70.00 $3,845.80 50706 Balloon dilate urtrl strix 28.33 70.00 $1,983.10 50715 Release of ureter 35.32 70.00 $2,472.40 50722 Release of ureter 30.33 70.00 $2,123.10 50725 Release/revise ureter 32.56 70.00 $2,279.20 50727 Revise ureter 14.69 70.00 $1,028.30 50728 Revise ureter 20.16 70.00 $1,411.20 50740 Fusion of ureter & kidney 35.10 70.00 $2,457.00 50750 Fusion of ureter & kidney 33.15 70.00 $2,320.50 50760 Fusion of ureters 32.52 70.00 $2,276.40 50770 Splicing of ureters 33.94 70.00 $2,375.80 50780 Reimplant ureter in bladder 32.01 70.00 $2,240.70 50782 Reimplant ureter in bladder 34.49 70.00 $2,414.30 50783 Reimplant ureter in bladder 32.73 70.00 $2,291.10 50785 Reimplant ureter in bladder 35.05 70.00 $2,453.50 50800 Implant ureter in bowel 26.67 70.00 $1,866.90 50810 Fusion of ureter & bowel 39.52 70.00 $2,766.40 50815 Urine shunt to intestine 35.42 70.00 $2,479.40 50820 Construct bowel bladder 38.00 70.00 $2,660.00 50825 Construct bowel bladder 47.94 70.00 $3,355.80 50830 Revise urine flow 52.57 70.00 $3,679.90 50840 Replace ureter by bowel 35.57 70.00 $2,489.90 50845 Appendico-vesicostomy 36.12 70.00 $2,528.40 50860 Transplant ureter to skin 27.52 70.00 $1,926.40 50900 Repair of ureter 24.81 70.00 $1,736.70 50920 Closure ureter/skin fistula 26.45 70.00 $1,851.50 50930 Closure ureter/bowel fistula 31.85 70.00 $2,229.50 50940 Release of ureter 25.50 70.00 $1,785.00 50945 Laparoscopy ureterolithotomy 28.23 70.00 $1,976.10 50947 Laparo new ureter/bladder 40.12 70.00 $2,808.40 50948 Laparo new ureter/bladder 36.90 70.00 $2,583.00 50949 Laparoscope proc ureter 0.00 70.00 $0.00 50951 Endoscopy of ureter 10.82 70.00 $757.40 50953 Endoscopy of ureter 11.43 70.00 $800.10 50955 Ureter endoscopy & biopsy 12.24 70.00 $856.80 50957 Ureter endoscopy & treatment 12.36 70.00 $865.20 50961 Ureter endoscopy & treatment 11.14 70.00 $779.80 50970 Ureter endoscopy 10.73 70.00 $751.10 50972 Ureter endoscopy & catheter 10.37 70.00 $725.90 50974 Ureter endoscopy & biopsy 13.70 70.00 $959.00 50976 Ureter endoscopy & treatment 13.51 70.00 $945.70 50980 Ureter endoscopy & treatment 10.31 70.00 $721.70 5100F Rsk fx ref w/n 24 hrs xray 0.00 70.00 $0.00 51020 Incise & treat bladder 13.54 70.00 $947.80 51030 Incise & treat bladder 13.57 70.00 $949.90 51040 Incise & drain bladder 8.35 70.00 $584.50 51045 Incise bladder/drain ureter 14.10 70.00 $987.00 51050 Removal of bladder stone 13.62 70.00 $953.40 51060 Removal of ureter stone 16.71 70.00 $1,169.70 51065 Remove ureter calculus 16.71 70.00 $1,169.70 51080 Drainage of bladder abscess 11.84 70.00 $828.80 51100 Drain bladder by needle 1.76 70.00 $123.20 51101 Drain bladder by trocar/cath 3.52 70.00 $246.40 51102 Drain bl w/cath insertion 6.48 70.00 $453.60 51500 Removal of bladder cyst 18.43 70.00 $1,290.10 51520 Removal of bladder lesion 17.20 70.00 $1,204.00 51525 Removal of bladder lesion 24.82 70.00 $1,737.40 51530 Removal of bladder lesion 23.02 70.00 $1,611.40 51535 Repair of ureter lesion 22.55 70.00 $1,578.50 51550 Partial removal of bladder 27.88 70.00 $1,951.60 51555 Partial removal of bladder 36.63 70.00 $2,564.10 51565 Revise bladder & ureter(s) 37.58 70.00 $2,630.60 51570 Removal of bladder 42.74 70.00 $2,991.80 51575 Removal of bladder & nodes 52.66 70.00 $3,686.20 51580 Remove bladder/revise tract 55.59 70.00 $3,891.30 51585 Removal of bladder & nodes 61.15 70.00 $4,280.50 51590 Remove bladder/revise tract 55.90 70.00 $3,913.00 51595 Remove bladder/revise tract 63.26 70.00 $4,428.20 51596 Remove bladder/create pouch 68.04 70.00 $4,762.80 51597 Removal of pelvic structures 66.25 70.00 $4,637.50 51600 Injection for bladder x-ray 5.22 70.00 $365.40 51605 Preparation for bladder xray 1.11 70.00 $77.70 51610 Injection for bladder x-ray 3.04 70.00 $212.80 51700 Irrigation of bladder 2.07 70.00 $144.90 51701 Insert bladder catheter 1.35 70.00 $94.50 51702 Insert temp bladder cath 1.79 70.00 $125.30 51703 Insert bladder cath complex 3.56 70.00 $249.20 51705 Change of bladder tube 2.59 70.00 $181.30 51710 Change of bladder tube 3.67 70.00 $256.90 51715 Endoscopic injection/implant 8.31 70.00 $581.70 51720 Treatment of bladder lesion 2.51 70.00 $175.70 51725 Simple cystometrogram 5.32 70.00 $372.40 51725 TC Simple cystometrogram 3.12 70.00 $218.40 51725 26 Simple cystometrogram 2.20 70.00 $154.00 51726 Complex cystometrogram 7.49 70.00 $524.30 51726 TC Complex cystometrogram 5.03 70.00 $352.10 51726 26 Complex cystometrogram 2.46 70.00 $172.20 51727 Cystometrogram w/up 8.85 70.00 $619.50 51727 TC Cystometrogram w/up 5.76 70.00 $403.20 51727 26 Cystometrogram w/up 3.09 70.00 $216.30 51728 Cystometrogram w/vp 8.95 70.00 $626.50 51728 TC Cystometrogram w/vp 5.93 70.00 $415.10 51728 26 Cystometrogram w/vp 3.02 70.00 $211.40 51729 Cystometrogram w/vp&up 9.67 70.00 $676.90 51729 TC Cystometrogram w/vp&up 6.02 70.00 $421.40 51729 26 Cystometrogram w/vp&up 3.65 70.00 $255.50 51736 Urine flow measurement 0.44 70.00 $30.80 51736 TC Urine flow measurement 0.20 70.00 $14.00 51736 26 Urine flow measurement 0.24 70.00 $16.80 51741 Electro-uroflowmetry first 0.45 70.00 $31.50 51741 TC Electro-uroflowmetry first 0.21 70.00 $14.70 51741 26 Electro-uroflowmetry first 0.24 70.00 $16.80 51784 Anal/urinary muscle study 1.97 70.00 $137.90 51784 TC Anal/urinary muscle study 0.89 70.00 $62.30 51784 26 Anal/urinary muscle study 1.08 70.00 $75.60 51785 Anal/urinary muscle study 7.52 70.00 $526.40 51785 TC Anal/urinary muscle study 4.95 70.00 $346.50 51785 26 Anal/urinary muscle study 2.57 70.00 $179.90 51792 Urinary reflex study 6.01 70.00 $420.70 51792 TC Urinary reflex study 4.42 70.00 $309.40 51792 26 Urinary reflex study 1.59 70.00 $111.30 51797 Intraabdominal pressure test 3.18 70.00 $222.60 51797 TC Intraabdominal pressure test 2.02 70.00 $141.40 51797 26 Intraabdominal pressure test 1.16 70.00 $81.20 51798 Us urine capacity measure 0.55 70.00 $38.50 51800 Revision of bladder/urethra 30.21 70.00 $2,114.70 51820 Revision of urinary tract 33.93 70.00 $2,375.10 51840 Attach bladder/urethra 18.93 70.00 $1,325.10 51841 Attach bladder/urethra 22.58 70.00 $1,580.60 51845 Repair bladder neck 16.84 70.00 $1,178.80 51860 Repair of bladder wound 21.54 70.00 $1,507.80 51865 Repair of bladder wound 25.87 70.00 $1,810.90 51880 Repair of bladder opening 13.50 70.00 $945.00 51900 Repair bladder/vagina lesion 24.22 70.00 $1,695.40 51920 Close bladder-uterus fistula 22.60 70.00 $1,582.00 51925 Hysterectomy/bladder repair 29.78 70.00 $2,084.60 51940 Correction of bladder defect 47.83 70.00 $3,348.10 51960 Revision of bladder & bowel 40.05 70.00 $2,803.50 51980 Construct bladder opening 20.60 70.00 $1,442.00 51990 Laparo urethral suspension 21.69 70.00 $1,518.30 51992 Laparo sling operation 24.23 70.00 $1,696.10 51999 Laparoscope proc bla 0.00 70.00 $0.00 5200F Eval appros surg thxpy epi 0.00 70.00 $0.00 52000 Cystoscopy 4.68 70.00 $327.60 52001 Cystoscopy removal of clots 10.66 70.00 $746.20 52005 Cystoscopy & ureter catheter 7.58 70.00 $530.60 52007 Cystoscopy and biopsy 12.63 70.00 $884.10 52010 Cystoscopy & duct catheter 10.47 70.00 $732.90 52204 Cystoscopy w/biopsy(s) 10.50 70.00 $735.00 52214 Cystoscopy and treatment 18.77 70.00 $1,313.90 52224 Cystoscopy and treatment 19.66 70.00 $1,376.20 52234 Cystoscopy and treatment 7.13 70.00 $499.10 52235 Cystoscopy and treatment 8.36 70.00 $585.20 52240 Cystoscopy and treatment 11.35 70.00 $794.50 52250 Cystoscopy and radiotracer 6.93 70.00 $485.10 52260 Cystoscopy and treatment 6.09 70.00 $426.30 52265 Cystoscopy and treatment 10.40 70.00 $728.00 52270 Cystoscopy & revise urethra 10.14 70.00 $709.80 52275 Cystoscopy & revise urethra 13.68 70.00 $957.60 52276 Cystoscopy and treatment 7.67 70.00 $536.90 52277 Cystoscopy and treatment 9.36 70.00 $655.20 52281 Cystoscopy and treatment 7.78 70.00 $544.60 52282 Cystoscopy implant stent 9.75 70.00 $682.50 52283 Cystoscopy and treatment 7.93 70.00 $555.10 52285 Cystoscopy and treatment 8.00 70.00 $560.00 52287 Cystoscopy chemodenervation 8.88 70.00 $621.60 52290 Cystoscopy and treatment 7.06 70.00 $494.20 52300 Cystoscopy and treatment 8.12 70.00 $568.40 52301 Cystoscopy and treatment 8.40 70.00 $588.00 52305 Cystoscopy and treatment 8.08 70.00 $565.60 52310 Cystoscopy and treatment 6.95 70.00 $486.50 52315 Cystoscopy and treatment 11.80 70.00 $826.00 52317 Remove bladder stone 22.90 70.00 $1,603.00 52318 Remove bladder stone 13.71 70.00 $959.70 52320 Cystoscopy and treatment 7.15 70.00 $500.50 52325 Cystoscopy stone removal 9.30 70.00 $651.00 52327 Cystoscopy inject material 7.59 70.00 $531.30 52330 Cystoscopy and treatment 14.09 70.00 $986.30 52332 Cystoscopy and treatment 13.92 70.00 $974.40 52334 Create passage to kidney 7.40 70.00 $518.00 52341 Cysto w/ureter stricture tx 8.23 70.00 $576.10 52342 Cysto w/up stricture tx 8.96 70.00 $627.20 52343 Cysto w/renal stricture tx 9.96 70.00 $697.20 52344 Cysto/uretero stricture tx 10.70 70.00 $749.00 52345 Cysto/uretero w/up stricture 11.42 70.00 $799.40 52346 Cystouretero w/renal strict 12.92 70.00 $904.40 52351 Cystouretero & or pyeloscope 8.77 70.00 $613.90 52352 Cystouretero w/stone remove 10.25 70.00 $717.50 52353 Cystouretero w/lithotripsy 11.35 70.00 $794.50 52354 Cystouretero w/biopsy 12.08 70.00 $845.60 52355 Cystouretero w/excise tumor 13.54 70.00 $947.80 52356 Cysto/uretero w/lithotripsy 12.04 70.00 $842.80 52400 Cystouretero w/congen repr 13.82 70.00 $967.40 52402 Cystourethro cut ejacul duct 7.73 70.00 $541.10 52441 Cystourethro w/implant 35.22 70.00 $2,465.40 52442 Cystourethro w/addl implant 26.95 70.00 $1,886.50 52450 Incision of prostate 13.56 70.00 $949.20 5250F Asthma discharge plan presnt 0.00 70.00 $0.00 52500 Revision of bladder neck 14.08 70.00 $985.60 52601 Prostatectomy (turp) 24.43 70.00 $1,710.10 52630 Remove prostate regrowth 11.55 70.00 $808.50 52640 Relieve bladder contracture 9.09 70.00 $636.30 52647 Laser surgery of prostate 50.69 70.00 $3,548.30 52648 Laser surgery of prostate 52.16 70.00 $3,651.20 52649 Prostate laser enucleation 23.77 70.00 $1,663.90 52700 Drainage of prostate abscess 12.76 70.00 $893.20 53000 Incision of urethra 4.26 70.00 $298.20 53010 Incision of urethra 8.50 70.00 $595.00 53020 Incision of urethra 2.81 70.00 $196.70 53025 Incision of urethra 2.07 70.00 $144.90 53040 Drainage of urethra abscess 11.33 70.00 $793.10 53060 Drainage of urethra abscess 5.27 70.00 $368.90 53080 Drainage of urinary leakage 12.12 70.00 $848.40 53085 Drainage of urinary leakage 19.02 70.00 $1,331.40 53200 Biopsy of urethra 4.49 70.00 $314.30 53210 Removal of urethra 22.47 70.00 $1,572.90 53215 Removal of urethra 26.83 70.00 $1,878.10 53220 Treatment of urethra lesion 13.21 70.00 $924.70 53230 Removal of urethra lesion 17.49 70.00 $1,224.30 53235 Removal of urethra lesion 18.31 70.00 $1,281.70 53240 Surgery for urethra pouch 12.26 70.00 $858.20 53250 Removal of urethra gland 11.80 70.00 $826.00 53260 Treatment of urethra lesion 5.77 70.00 $403.90 53265 Treatment of urethra lesion 6.25 70.00 $437.50 53270 Removal of urethra gland 5.92 70.00 $414.40 53275 Repair of urethra defect 7.60 70.00 $532.00 53400 Revise urethra stage 1 23.11 70.00 $1,617.70 53405 Revise urethra stage 2 25.38 70.00 $1,776.60 53410 Reconstruction of urethra 28.24 70.00 $1,976.80 53415 Reconstruction of urethra 32.65 70.00 $2,285.50 53420 Reconstruct urethra stage 1 24.30 70.00 $1,701.00 53425 Reconstruct urethra stage 2 27.06 70.00 $1,894.20 53430 Reconstruction of urethra 27.92 70.00 $1,954.40 53431 Reconstruct urethra/bladder 33.34 70.00 $2,333.80 53440 Male sling procedure 21.74 70.00 $1,521.80 53442 Remove/revise male sling 22.59 70.00 $1,581.30 53444 Insert tandem cuff 22.89 70.00 $1,602.30 53445 Insert uro/ves nck sphincter 21.74 70.00 $1,521.80 53446 Remove uro sphincter 18.53 70.00 $1,297.10 53447 Remove/replace ur sphincter 23.34 70.00 $1,633.80 53448 Remov/replc ur sphinctr comp 37.03 70.00 $2,592.10 53449 Repair uro sphincter 17.65 70.00 $1,235.50 53450 Revision of urethra 11.79 70.00 $825.30 53460 Revision of urethra 13.22 70.00 $925.40 53500 Urethrlys transvag w/ scope 21.60 70.00 $1,512.00 53502 Repair of urethra injury 14.04 70.00 $982.80 53505 Repair of urethra injury 14.02 70.00 $981.40 53510 Repair of urethra injury 18.22 70.00 $1,275.40 53515 Repair of urethra injury 22.81 70.00 $1,596.70 53520 Repair of urethra defect 16.05 70.00 $1,123.50 53600 Dilate urethra stricture 2.38 70.00 $166.60 53601 Dilate urethra stricture 2.32 70.00 $162.40 53605 Dilate urethra stricture 1.87 70.00 $130.90 53620 Dilate urethra stricture 3.33 70.00 $233.10 53621 Dilate urethra stricture 3.12 70.00 $218.40 53660 Dilation of urethra 2.01 70.00 $140.70 53661 Dilation of urethra 1.98 70.00 $138.60 53665 Dilation of urethra 1.12 70.00 $78.40 53850 Prostatic microwave thermotx 58.95 70.00 $4,126.50 53852 Prostatic rf thermotx 54.39 70.00 $3,807.30 53855 Insert prost urethral stent 22.09 70.00 $1,546.30 53860 Transurethral rf treatment 44.52 70.00 $3,116.40 53899 Urology surgery procedure 0.00 70.00 $0.00 54000 Slitting of prepuce 4.23 70.00 $296.10 54001 Slitting of prepuce 5.28 70.00 $369.60 54015 Drain penis lesion 8.89 70.00 $622.30 54050 Destruction penis lesion(s) 3.79 70.00 $265.30 54055 Destruction penis lesion(s) 3.39 70.00 $237.30 54056 Cryosurgery penis lesion(s) 4.05 70.00 $283.50 54057 Laser surg penis lesion(s) 3.89 70.00 $272.30 54060 Excision of penis lesion(s) 5.13 70.00 $359.10 54065 Destruction penis lesion(s) 6.25 70.00 $437.50 54100 Biopsy of penis 5.66 70.00 $396.20 54105 Biopsy of penis 7.57 70.00 $529.90 54110 Treatment of penis lesion 18.07 70.00 $1,264.90 54111 Treat penis lesion graft 23.31 70.00 $1,631.70 54112 Treat penis lesion graft 27.09 70.00 $1,896.30 54115 Treatment of penis lesion 13.09 70.00 $916.30 54120 Partial removal of penis 18.25 70.00 $1,277.50 54125 Removal of penis 23.52 70.00 $1,646.40 54130 Remove penis & nodes 34.48 70.00 $2,413.60 54135 Remove penis & nodes 43.70 70.00 $3,059.00 54150 Circumcision w/regionl block 4.42 70.00 $309.40 54160 Circumcision neonate 6.28 70.00 $439.60 54161 Circum 28 days or older 5.68 70.00 $397.60 54162 Lysis penil circumic lesion 7.35 70.00 $514.50 54163 Repair of circumcision 6.31 70.00 $441.70 54164 Frenulotomy of penis 5.59 70.00 $391.30 54200 Treatment of penis lesion 3.06 70.00 $214.20 54205 Treatment of penis lesion 15.36 70.00 $1,075.20 54220 Treatment of penis lesion 5.85 70.00 $409.50 54230 Prepare penis study 2.77 70.00 $193.90 54231 Dynamic cavernosometry 4.02 70.00 $281.40 54235 Penile injection 2.59 70.00 $181.30 54240 Penis study 2.98 70.00 $208.60 54240 TC Penis study 0.99 70.00 $69.30 54240 26 Penis study 1.99 70.00 $139.30 54250 Penis study 3.48 70.00 $243.60 54250 TC Penis study 0.31 70.00 $21.70 54250 26 Penis study 3.17 70.00 $221.90 54300 Revision of penis 18.56 70.00 $1,299.20 54304 Revision of penis 21.61 70.00 $1,512.70 54308 Reconstruction of urethra 20.65 70.00 $1,445.50 54312 Reconstruction of urethra 24.72 70.00 $1,730.40 54316 Reconstruction of urethra 30.14 70.00 $2,109.80 54318 Reconstruction of urethra 20.53 70.00 $1,437.10 54322 Reconstruction of urethra 22.32 70.00 $1,562.40 54324 Reconstruction of urethra 27.94 70.00 $1,955.80 54326 Reconstruction of urethra 27.32 70.00 $1,912.40 54328 Revise penis/urethra 27.64 70.00 $1,934.80 54332 Revise penis/urethra 30.59 70.00 $2,141.30 54336 Revise penis/urethra 34.36 70.00 $2,405.20 54340 Secondary urethral surgery 16.34 70.00 $1,143.80 54344 Secondary urethral surgery 27.39 70.00 $1,917.30 54348 Secondary urethral surgery 29.30 70.00 $2,051.00 54352 Reconstruct urethra/penis 40.94 70.00 $2,865.80 54360 Penis plastic surgery 20.82 70.00 $1,457.40 54380 Repair penis 23.09 70.00 $1,616.30 54385 Repair penis 28.05 70.00 $1,963.50 54390 Repair penis and bladder 35.85 70.00 $2,509.50 54400 Insert semi-rigid prosthesis 15.28 70.00 $1,069.60 54401 Insert self-contd prosthesis 18.90 70.00 $1,323.00 54405 Insert multi-comp penis pros 23.35 70.00 $1,634.50 54406 Remove muti-comp penis pros 21.10 70.00 $1,477.00 54408 Repair multi-comp penis pros 22.83 70.00 $1,598.10 54410 Remove/replace penis prosth 24.82 70.00 $1,737.40 54411 Remov/replc penis pros comp 29.64 70.00 $2,074.80 54415 Remove self-contd penis pros 15.26 70.00 $1,068.20 54416 Remv/repl penis contain pros 20.51 70.00 $1,435.70 54417 Remv/replc penis pros compl 25.96 70.00 $1,817.20 54420 Revision of penis 20.32 70.00 $1,422.40 54430 Revision of penis 18.46 70.00 $1,292.20 54435 Revision of penis 12.04 70.00 $842.80 54437 Repair corporeal tear 19.58 70.00 $1,370.60 54438 Replantation of penis 38.92 70.00 $2,724.40 54440 Repair of penis 0.00 70.00 $0.00 54450 Preputial stretching 2.01 70.00 $140.70 54500 Biopsy of testis 2.16 70.00 $151.20 54505 Biopsy of testis 6.06 70.00 $424.20 54512 Excise lesion testis 15.60 70.00 $1,092.00 54520 Removal of testis 9.42 70.00 $659.40 54522 Orchiectomy partial 17.09 70.00 $1,196.30 54530 Removal of testis 14.58 70.00 $1,020.60 54535 Extensive testis surgery 21.71 70.00 $1,519.70 54550 Exploration for testis 14.32 70.00 $1,002.40 54560 Exploration for testis 20.75 70.00 $1,452.50 54600 Reduce testis torsion 13.14 70.00 $919.80 54620 Suspension of testis 8.66 70.00 $606.20 54640 Suspension of testis 13.80 70.00 $966.00 54650 Orchiopexy (fowler-stephens) 20.98 70.00 $1,468.60 54660 Revision of testis 10.50 70.00 $735.00 54670 Repair testis injury 11.83 70.00 $828.10 54680 Relocation of testis(es) 23.19 70.00 $1,623.30 54690 Laparoscopy orchiectomy 19.08 70.00 $1,335.60 54692 Laparoscopy orchiopexy 23.09 70.00 $1,616.30 54699 Laparoscope proc testis 0.00 70.00 $0.00 54700 Drainage of scrotum 6.17 70.00 $431.90 54800 Biopsy of epididymis 3.85 70.00 $269.50 54830 Remove epididymis lesion 10.76 70.00 $753.20 54840 Remove epididymis lesion 9.27 70.00 $648.90 54860 Removal of epididymis 12.09 70.00 $846.30 54861 Removal of epididymis 16.33 70.00 $1,143.10 54865 Explore epididymis 10.36 70.00 $725.20 54900 Fusion of spermatic ducts 24.18 70.00 $1,692.60 54901 Fusion of spermatic ducts 30.50 70.00 $2,135.00 55000 Drainage of hydrocele 3.35 70.00 $234.50 55040 Removal of hydrocele 9.76 70.00 $683.20 55041 Removal of hydroceles 14.73 70.00 $1,031.10 55060 Repair of hydrocele 10.99 70.00 $769.30 55100 Drainage of scrotum abscess 6.16 70.00 $431.20 55110 Explore scrotum 11.20 70.00 $784.00 55120 Removal of scrotum lesion 10.39 70.00 $727.30 55150 Removal of scrotum 14.20 70.00 $994.00 55175 Revision of scrotum 10.51 70.00 $735.70 55180 Revision of scrotum 19.86 70.00 $1,390.20 55200 Incision of sperm duct 12.38 70.00 $866.60 55250 Removal of sperm duct(s) 11.02 70.00 $771.40 55300 Prepare sperm duct x-ray 5.43 70.00 $380.10 55400 Repair of sperm duct 14.39 70.00 $1,007.30 55450 Ligation of sperm duct 10.49 70.00 $734.30 55500 Removal of hydrocele 11.42 70.00 $799.40 55520 Removal of sperm cord lesion 13.08 70.00 $915.60 55530 Revise spermatic cord veins 10.15 70.00 $710.50 55535 Revise spermatic cord veins 12.42 70.00 $869.40 55540 Revise hernia & sperm veins 15.94 70.00 $1,115.80 55550 Laparo ligate spermatic vein 12.37 70.00 $865.90 55559 Laparo proc spermatic cord 0.00 70.00 $0.00 55600 Incise sperm duct pouch 12.17 70.00 $851.90 55605 Incise sperm duct pouch 15.76 70.00 $1,103.20 55650 Remove sperm duct pouch 20.76 70.00 $1,453.20 55680 Remove sperm pouch lesion 10.51 70.00 $735.70 55700 Biopsy of prostate 7.06 70.00 $494.20 55705 Biopsy of prostate 7.69 70.00 $538.30 55706 Prostate saturation sampling 10.75 70.00 $752.50 55720 Drainage of prostate abscess 13.05 70.00 $913.50 55725 Drainage of prostate abscess 18.89 70.00 $1,322.30 55801 Removal of prostate 31.69 70.00 $2,218.30 55810 Extensive prostate surgery 37.87 70.00 $2,650.90 55812 Extensive prostate surgery 47.80 70.00 $3,346.00 55815 Extensive prostate surgery 51.16 70.00 $3,581.20 55821 Removal of prostate 25.24 70.00 $1,766.80 55831 Removal of prostate 27.30 70.00 $1,911.00 55840 Extensive prostate surgery 33.87 70.00 $2,370.90 55842 Extensive prostate surgery 33.86 70.00 $2,370.20 55845 Extensive prostate surgery 39.41 70.00 $2,758.70 55860 Surgical exposure prostate 25.29 70.00 $1,770.30 55862 Extensive prostate surgery 32.40 70.00 $2,268.00 55865 Extensive prostate surgery 38.55 70.00 $2,698.50 55866 Laparo radical prostatectomy 41.74 70.00 $2,921.80 55870 Electroejaculation 5.04 70.00 $352.80 55873 Cryoablate prostate 200.52 70.00 $14,036.40 55875 Transperi needle place pros 22.03 70.00 $1,542.10 55876 Place rt device/marker pros 3.88 70.00 $271.60 55899 Genital surgery procedure 0.00 70.00 $0.00 55920 Place needles pelvic for rt 12.92 70.00 $904.40 55970 Sex transformation m to f 0.00 70.00 $0.00 55980 Sex transformation f to m 0.00 70.00 $0.00 56405 I & d of vulva/perineum 3.11 70.00 $217.70 56420 Drainage of gland abscess 3.44 70.00 $240.80 56440 Surgery for vulva lesion 5.19 70.00 $363.30 56441 Lysis of labial lesion(s) 4.09 70.00 $286.30 56442 Hymenotomy 1.36 70.00 $95.20 56501 Destroy vulva lesions sim 3.72 70.00 $260.40 56515 Destroy vulva lesion/s compl 6.45 70.00 $451.50 56605 Biopsy of vulva/perineum 2.34 70.00 $163.80 56606 Biopsy of vulva/perineum 1.08 70.00 $75.60 56620 Partial removal of vulva 14.92 70.00 $1,044.40 56625 Complete removal of vulva 18.15 70.00 $1,270.50 56630 Extensive vulva surgery 26.76 70.00 $1,873.20 56631 Extensive vulva surgery 34.09 70.00 $2,386.30 56632 Extensive vulva surgery 39.76 70.00 $2,783.20 56633 Extensive vulva surgery 34.93 70.00 $2,445.10 56634 Extensive vulva surgery 37.43 70.00 $2,620.10 56637 Extensive vulva surgery 43.66 70.00 $3,056.20 56640 Extensive vulva surgery 43.95 70.00 $3,076.50 56700 Partial removal of hymen 5.34 70.00 $373.80 56740 Remove vagina gland lesion 8.58 70.00 $600.60 56800 Repair of vagina 6.86 70.00 $480.20 56805 Repair clitoris 36.16 70.00 $2,531.20 56810 Repair of perineum 7.41 70.00 $518.70 56820 Exam of vulva w/scope 3.20 70.00 $224.00 56821 Exam/biopsy of vulva w/scope 4.21 70.00 $294.70 57000 Exploration of vagina 5.25 70.00 $367.50 57010 Drainage of pelvic abscess 12.36 70.00 $865.20 57020 Drainage of pelvic fluid 2.63 70.00 $184.10 57022 I & d vaginal hematoma pp 4.89 70.00 $342.30 57023 I & d vag hematoma non-ob 8.80 70.00 $616.00 57061 Destroy vag lesions simple 3.22 70.00 $225.40 57065 Destroy vag lesions complex 5.56 70.00 $389.20 57100 Biopsy of vagina 2.55 70.00 $178.50 57105 Biopsy of vagina 3.88 70.00 $271.60 57106 Remove vagina wall partial 14.13 70.00 $989.10 57107 Remove vagina tissue part 41.72 70.00 $2,920.40 57109 Vaginectomy partial w/nodes 50.60 70.00 $3,542.00 57110 Remove vagina wall complete 25.40 70.00 $1,778.00 57111 Remove vagina tissue compl 46.23 70.00 $3,236.10 57112 Vaginectomy w/nodes compl 51.79 70.00 $3,625.30 57120 Closure of vagina 14.46 70.00 $1,012.20 57130 Remove vagina lesion 5.02 70.00 $351.40 57135 Remove vagina lesion 5.46 70.00 $382.20 57150 Treat vagina infection 1.28 70.00 $89.60 57155 Insert uteri tandem/ovoids 10.38 70.00 $726.60 57156 Ins vag brachytx device 5.65 70.00 $395.50 57160 Insert pessary/other device 2.17 70.00 $151.90 57170 Fitting of diaphragm/cap 1.73 70.00 $121.10 57180 Treat vaginal bleeding 3.98 70.00 $278.60 57200 Repair of vagina 8.62 70.00 $603.40 57210 Repair vagina/perineum 10.43 70.00 $730.10 57220 Revision of urethra 9.09 70.00 $636.30 57230 Repair of urethral lesion 11.22 70.00 $785.40 57240 Repair bladder & vagina 19.11 70.00 $1,337.70 57250 Repair rectum & vagina 19.22 70.00 $1,345.40 57260 Repair of vagina 23.67 70.00 $1,656.90 57265 Extensive repair of vagina 25.94 70.00 $1,815.80 57267 Insert mesh/pelvic flr addon 7.31 70.00 $511.70 57268 Repair of bowel bulge 13.77 70.00 $963.90 57270 Repair of bowel pouch 22.83 70.00 $1,598.10 57280 Suspension of vagina 27.17 70.00 $1,901.90 57282 Colpopexy extraperitoneal 14.24 70.00 $996.80 57283 Colpopexy intraperitoneal 19.59 70.00 $1,371.30 57284 Repair paravag defect open 23.22 70.00 $1,625.40 57285 Repair paravag defect vag 19.15 70.00 $1,340.50 57287 Revise/remove sling repair 19.44 70.00 $1,360.80 57288 Repair bladder defect 20.43 70.00 $1,430.10 57289 Repair bladder & vagina 21.04 70.00 $1,472.80 57291 Construction of vagina 15.01 70.00 $1,050.70 57292 Construct vagina with graft 23.26 70.00 $1,628.20 57295 Revise vag graft via vagina 13.59 70.00 $951.30 57296 Revise vag graft open abd 26.67 70.00 $1,866.90 57300 Repair rectum-vagina fistula 16.09 70.00 $1,126.30 57305 Repair rectum-vagina fistula 26.86 70.00 $1,880.20 57307 Fistula repair & colostomy 30.23 70.00 $2,116.10 57308 Fistula repair transperine 18.15 70.00 $1,270.50 57310 Repair urethrovaginal lesion 13.30 70.00 $931.00 57311 Repair urethrovaginal lesion 15.09 70.00 $1,056.30 57320 Repair bladder-vagina lesion 15.25 70.00 $1,067.50 57330 Repair bladder-vagina lesion 21.59 70.00 $1,511.30 57335 Repair vagina 35.65 70.00 $2,495.50 57400 Dilation of vagina 3.85 70.00 $269.50 57410 Pelvic examination 3.08 70.00 $215.60 57415 Remove vaginal foreign body 4.56 70.00 $319.20 57420 Exam of vagina w/scope 3.36 70.00 $235.20 57421 Exam/biopsy of vag w/scope 4.48 70.00 $313.60 57423 Repair paravag defect lap 25.94 70.00 $1,815.80 57425 Laparoscopy surg colpopexy 27.63 70.00 $1,934.10 57426 Revise prosth vag graft lap 23.97 70.00 $1,677.90 57452 Exam of cervix w/scope 3.10 70.00 $217.00 57454 Bx/curett of cervix w/scope 4.34 70.00 $303.80 57455 Biopsy of cervix w/scope 4.05 70.00 $283.50 57456 Endocerv curettage w/scope 3.82 70.00 $267.40 57460 Bx of cervix w/scope leep 8.00 70.00 $560.00 57461 Conz of cervix w/scope leep 9.06 70.00 $634.20 57500 Biopsy of cervix 3.62 70.00 $253.40 57505 Endocervical curettage 2.90 70.00 $203.00 57510 Cauterization of cervix 3.72 70.00 $260.40 57511 Cryocautery of cervix 4.11 70.00 $287.70 57513 Laser surgery of cervix 4.12 70.00 $288.40 57520 Conization of cervix 8.75 70.00 $612.50 57522 Conization of cervix 7.48 70.00 $523.60 57530 Removal of cervix 9.90 70.00 $693.00 57531 Removal of cervix radical 52.95 70.00 $3,706.50 57540 Removal of residual cervix 24.05 70.00 $1,683.50 57545 Remove cervix/repair pelvis 23.78 70.00 $1,664.60 57550 Removal of residual cervix 11.52 70.00 $806.40 57555 Remove cervix/repair vagina 17.12 70.00 $1,198.40 57556 Remove cervix repair bowel 16.06 70.00 $1,124.20 57558 D&c of cervical stump 3.52 70.00 $246.40 57700 Revision of cervix 8.91 70.00 $623.70 57720 Revision of cervix 8.74 70.00 $611.80 57800 Dilation of cervical canal 1.72 70.00 $120.40 58100 Biopsy of uterus lining 3.10 70.00 $217.00 58110 Bx done w/colposcopy add-on 1.36 70.00 $95.20 58120 Dilation and curettage 7.34 70.00 $513.80 58140 Myomectomy abdom method 26.16 70.00 $1,831.20 58145 Myomectomy vag method 15.60 70.00 $1,092.00 58146 Myomectomy abdom complex 32.79 70.00 $2,295.30 58150 Total hysterectomy 29.01 70.00 $2,030.70 58152 Total hysterectomy 35.54 70.00 $2,487.80 58180 Partial hysterectomy 27.43 70.00 $1,920.10 58200 Extensive hysterectomy 39.45 70.00 $2,761.50 58210 Extensive hysterectomy 53.20 70.00 $3,724.00 58240 Removal of pelvis contents 83.76 70.00 $5,863.20 58260 Vaginal hysterectomy 23.46 70.00 $1,642.20 58262 Vag hyst including t/o 26.18 70.00 $1,832.60 58263 Vag hyst w/t/o & vag repair 28.09 70.00 $1,966.30 58267 Vag hyst w/urinary repair 29.79 70.00 $2,085.30 58270 Vag hyst w/enterocele repair 25.05 70.00 $1,753.50 58275 Hysterectomy/revise vagina 27.96 70.00 $1,957.20 58280 Hysterectomy/revise vagina 29.80 70.00 $2,086.00 58285 Extensive hysterectomy 41.04 70.00 $2,872.80 58290 Vag hyst complex 32.68 70.00 $2,287.60 58291 Vag hyst incl t/o complex 35.25 70.00 $2,467.50 58292 Vag hyst t/o & repair compl 37.17 70.00 $2,601.90 58293 Vag hyst w/uro repair compl 38.69 70.00 $2,708.30 58294 Vag hyst w/enterocele compl 34.49 70.00 $2,414.30 58300 Insert intrauterine device 2.06 70.00 $144.20 58301 Remove intrauterine device 2.69 70.00 $188.30 58321 Artificial insemination 2.18 70.00 $152.60 58322 Artificial insemination 2.43 70.00 $170.10 58323 Sperm washing 0.43 70.00 $30.10 58340 Catheter for hysterography 3.38 70.00 $236.60 58345 Reopen fallopian tube 7.89 70.00 $552.30 58346 Insert heyman uteri capsule 13.00 70.00 $910.00 58350 Reopen fallopian tube 2.74 70.00 $191.80 58353 Endometr ablate thermal 28.41 70.00 $1,988.70 58356 Endometrial cryoablation 53.20 70.00 $3,724.00 58400 Suspension of uterus 12.52 70.00 $876.40 58410 Suspension of uterus 22.93 70.00 $1,605.10 58520 Repair of ruptured uterus 23.87 70.00 $1,670.90 58540 Revision of uterus 25.58 70.00 $1,790.60 58541 Lsh uterus 250 g or less 20.37 70.00 $1,425.90 58542 Lsh w/t/o ut 250 g or less 23.27 70.00 $1,628.90 58543 Lsh uterus above 250 g 23.49 70.00 $1,644.30 58544 Lsh w/t/o uterus above 250 g 25.63 70.00 $1,794.10 58545 Laparoscopic myomectomy 25.72 70.00 $1,800.40 58546 Laparo-myomectomy complex 31.86 70.00 $2,230.20 58548 Lap radical hyst 54.80 70.00 $3,836.00 58550 Laparo-asst vag hysterectomy 25.05 70.00 $1,753.50 58552 Laparo-vag hyst incl t/o 28.11 70.00 $1,967.70 58553 Laparo-vag hyst complex 32.33 70.00 $2,263.10 58554 Laparo-vag hyst w/t/o compl 37.78 70.00 $2,644.60 58555 Hysteroscopy dx sep proc 7.60 70.00 $532.00 58558 Hysteroscopy biopsy 38.51 70.00 $2,695.70 58559 Hysteroscopy lysis 8.28 70.00 $579.60 58560 Hysteroscopy resect septum 9.07 70.00 $634.90 58561 Hysteroscopy remove myoma 12.52 70.00 $876.40 58562 Hysteroscopy remove fb 9.64 70.00 $674.80 58563 Hysteroscopy ablation 44.97 70.00 $3,147.90 58565 Hysteroscopy sterilization 53.16 70.00 $3,721.20 58570 Tlh uterus 250 g or less 22.18 70.00 $1,552.60 58571 Tlh w/t/o 250 g or less 25.64 70.00 $1,794.80 58572 Tlh uterus over 250 g 29.07 70.00 $2,034.90 58573 Tlh w/t/o uterus over 250 g 34.76 70.00 $2,433.20 58578 Laparo proc uterus 0.00 70.00 $0.00 58579 Hysteroscope procedure 0.00 70.00 $0.00 58600 Division of fallopian tube 10.30 70.00 $721.00 58605 Division of fallopian tube 9.33 70.00 $653.10 58611 Ligate oviduct(s) add-on 2.19 70.00 $153.30 58615 Occlude fallopian tube(s) 7.07 70.00 $494.90 58660 Laparoscopy lysis 19.18 70.00 $1,342.60 58661 Laparoscopy remove adnexa 18.52 70.00 $1,296.40 58662 Laparoscopy excise lesions 20.23 70.00 $1,416.10 58670 Laparoscopy tubal cautery 10.35 70.00 $724.50 58671 Laparoscopy tubal block 10.32 70.00 $722.40 58672 Laparoscopy fimbrioplasty 20.82 70.00 $1,457.40 58673 Laparoscopy salpingostomy 22.66 70.00 $1,586.20 58674 Laps abltj uterine fibroids 23.23 70.00 $1,626.10 58679 Laparo proc oviduct-ovary 0.00 70.00 $0.00 58700 Removal of fallopian tube 22.22 70.00 $1,555.40 58720 Removal of ovary/tube(s) 21.08 70.00 $1,475.60 58740 Adhesiolysis tube ovary 25.20 70.00 $1,764.00 58750 Repair oviduct 27.45 70.00 $1,921.50 58752 Revise ovarian tube(s) 25.80 70.00 $1,806.00 58760 Fimbrioplasty 22.93 70.00 $1,605.10 58770 Create new tubal opening 24.82 70.00 $1,737.40 58800 Drainage of ovarian cyst(s) 8.98 70.00 $628.60 58805 Drainage of ovarian cyst(s) 11.51 70.00 $805.70 58820 Drain ovary abscess open 9.29 70.00 $650.30 58822 Drain ovary abscess percut 19.82 70.00 $1,387.40 58825 Transposition ovary(s) 21.58 70.00 $1,510.60 58900 Biopsy of ovary(s) 11.74 70.00 $821.80 58920 Partial removal of ovary(s) 21.55 70.00 $1,508.50 58925 Removal of ovarian cyst(s) 21.30 70.00 $1,491.00 58940 Removal of ovary(s) 15.04 70.00 $1,052.80 58943 Removal of ovary(s) 33.72 70.00 $2,360.40 58950 Resect ovarian malignancy 32.51 70.00 $2,275.70 58951 Resect ovarian malignancy 41.90 70.00 $2,933.00 58952 Resect ovarian malignancy 47.42 70.00 $3,319.40 58953 Tah rad dissect for debulk 58.67 70.00 $4,106.90 58954 Tah rad debulk/lymph remove 63.74 70.00 $4,461.80 58956 Bso omentectomy w/tah 39.83 70.00 $2,788.10 58957 Resect recurrent gyn mal 45.80 70.00 $3,206.00 58958 Resect recur gyn mal w/lym 50.52 70.00 $3,536.40 58960 Exploration of abdomen 27.87 70.00 $1,950.90 58970 Retrieval of oocyte 6.32 70.00 $442.40 58974 Transfer of embryo 0.00 70.00 $0.00 58976 Transfer of embryo 7.18 70.00 $502.60 58999 Genital surgery procedure 0.00 70.00 $0.00 59000 Amniocentesis diagnostic 3.60 70.00 $252.00 59001 Amniocentesis therapeutic 5.21 70.00 $364.70 59012 Fetal cord puncture prenatal 5.89 70.00 $412.30 59015 Chorion biopsy 4.49 70.00 $314.30 59020 Fetal contract stress test 2.03 70.00 $142.10 59020 TC Fetal contract stress test 0.96 70.00 $67.20 59020 26 Fetal contract stress test 1.07 70.00 $74.90 59025 Fetal non-stress test 1.38 70.00 $96.60 59025 TC Fetal non-stress test 0.52 70.00 $36.40 59025 26 Fetal non-stress test 0.86 70.00 $60.20 59030 Fetal scalp blood sample 2.89 70.00 $202.30 59050 Fetal monitor w/report 1.39 70.00 $97.30 59051 Fetal monitor/interpret only 1.23 70.00 $86.10 59070 Transabdom amnioinfus w/us 11.51 70.00 $805.70 59072 Umbilical cord occlud w/us 13.51 70.00 $945.70 59074 Fetal fluid drainage w/us 11.08 70.00 $775.60 59076 Fetal shunt placement w/us 13.51 70.00 $945.70 59100 Remove uterus lesion 22.63 70.00 $1,584.10 59120 Treat ectopic pregnancy 22.85 70.00 $1,599.50 59121 Treat ectopic pregnancy 22.92 70.00 $1,604.40 59130 Treat ectopic pregnancy 26.88 70.00 $1,881.60 59135 Treat ectopic pregnancy 23.90 70.00 $1,673.00 59136 Treat ectopic pregnancy 25.45 70.00 $1,781.50 59140 Treat ectopic pregnancy 10.69 70.00 $748.30 59150 Treat ectopic pregnancy 22.18 70.00 $1,552.60 59151 Treat ectopic pregnancy 21.62 70.00 $1,513.40 59160 D & c after delivery 5.85 70.00 $409.50 59200 Insert cervical dilator 2.06 70.00 $144.20 59300 Episiotomy or vaginal repair 5.53 70.00 $387.10 59320 Revision of cervix 4.43 70.00 $310.10 59325 Revision of cervix 7.04 70.00 $492.80 59350 Repair of uterus 7.98 70.00 $558.60 59400 Obstetrical care 60.28 70.00 $4,219.60 59409 Obstetrical care 23.58 70.00 $1,650.60 59410 Obstetrical care 30.10 70.00 $2,107.00 59412 Antepartum manipulation 2.99 70.00 $209.30 59414 Deliver placenta 2.67 70.00 $186.90 59425 Antepartum care only 13.08 70.00 $915.60 59426 Antepartum care only 23.42 70.00 $1,639.40 59430 Care after delivery 5.31 70.00 $371.70 59510 Cesarean delivery 66.91 70.00 $4,683.70 59514 Cesarean delivery only 26.58 70.00 $1,860.60 59515 Cesarean delivery 36.59 70.00 $2,561.30 59525 Remove uterus after cesarean 14.10 70.00 $987.00 59610 Vbac delivery 63.45 70.00 $4,441.50 59612 Vbac delivery only 26.61 70.00 $1,862.70 59614 Vbac care after delivery 33.09 70.00 $2,316.30 59618 Attempted vbac delivery 67.81 70.00 $4,746.70 59620 Attempted vbac delivery only 27.16 70.00 $1,901.20 59622 Attempted vbac after care 37.27 70.00 $2,608.90 59812 Treatment of miscarriage 9.17 70.00 $641.90 59820 Care of miscarriage 10.91 70.00 $763.70 59821 Treatment of miscarriage 11.00 70.00 $770.00 59830 Treat uterus infection 12.62 70.00 $883.40 59840 Abortion 6.24 70.00 $436.80 59841 Abortion 11.04 70.00 $772.80 59850 Abortion 10.99 70.00 $769.30 59851 Abortion 11.52 70.00 $806.40 59852 Abortion 14.48 70.00 $1,013.60 59855 Abortion 12.01 70.00 $840.70 59856 Abortion 14.12 70.00 $988.40 59857 Abortion 14.88 70.00 $1,041.60 59866 Abortion (mpr) 6.22 70.00 $435.40 59870 Evacuate mole of uterus 13.62 70.00 $953.40 59871 Remove cerclage suture 3.89 70.00 $272.30 59897 Fetal invas px w/us 0.00 70.00 $0.00 59898 Laparo proc ob care/deliver 0.00 70.00 $0.00 59899 Maternity care procedure 0.00 70.00 $0.00 60000 Drain thyroid/tongue cyst 4.54 70.00 $317.80 6005F Care level rationale doc 0.00 70.00 $0.00 6010F Dysphag test done b/4 eating 0.00 70.00 $0.00 60100 Biopsy of thyroid 3.22 70.00 $225.40 6015F Dysphag test done b/4 eating 0.00 70.00 $0.00 6020F Npo (nothing-mouth) ordered 0.00 70.00 $0.00 60200 Remove thyroid lesion 19.00 70.00 $1,330.00 60210 Partial thyroid excision 20.37 70.00 $1,425.90 60212 Partial thyroid excision 29.07 70.00 $2,034.90 60220 Partial removal of thyroid 20.32 70.00 $1,422.40 60225 Partial removal of thyroid 26.80 70.00 $1,876.00 60240 Removal of thyroid 26.48 70.00 $1,853.60 60252 Removal of thyroid 38.08 70.00 $2,665.60 60254 Extensive thyroid surgery 48.05 70.00 $3,363.50 60260 Repeat thyroid surgery 31.49 70.00 $2,204.30 60270 Removal of thyroid 39.50 70.00 $2,765.00 60271 Removal of thyroid 30.48 70.00 $2,133.60 60280 Remove thyroid duct lesion 12.69 70.00 $888.30 60281 Remove thyroid duct lesion 16.96 70.00 $1,187.20 6030F Max sterile barriers follwd 0.00 70.00 $0.00 60300 Aspir/inj thyroid cyst 3.36 70.00 $235.20 6040F Appro rad ds dvcs techs docd 0.00 70.00 $0.00 6045F Radxps in end rprt4fluro pxd 0.00 70.00 $0.00 60500 Explore parathyroid glands 27.83 70.00 $1,948.10 60502 Re-explore parathyroids 37.14 70.00 $2,599.80 60505 Explore parathyroid glands 39.93 70.00 $2,795.10 60512 Autotransplant parathyroid 7.03 70.00 $492.10 60520 Removal of thymus gland 30.14 70.00 $2,109.80 60521 Removal of thymus gland 32.45 70.00 $2,271.50 60522 Removal of thymus gland 39.43 70.00 $2,760.10 60540 Explore adrenal gland 30.78 70.00 $2,154.60 60545 Explore adrenal gland 35.22 70.00 $2,465.40 60600 Remove carotid body lesion 40.19 70.00 $2,813.30 60605 Remove carotid body lesion 55.93 70.00 $3,915.10 60650 Laparoscopy adrenalectomy 34.52 70.00 $2,416.40 60659 Laparo proc endocrine 0.00 70.00 $0.00 60699 Endocrine surgery procedure 0.00 70.00 $0.00 6070F Pt asked/cnsld aed effects 0.00 70.00 $0.00 6080F Pt/caregiver queried falls 0.00 70.00 $0.00 6090F Pt/caregiver counsel safety 0.00 70.00 $0.00 6100F Verify pt site pxd docd 0.00 70.00 $0.00 61000 Remove cranial cavity fluid 3.28 70.00 $229.60 61001 Remove cranial cavity fluid 2.42 70.00 $169.40 6101F Safety counseling dementia 0.00 70.00 $0.00 6102F Safety counseling dem order 0.00 70.00 $0.00 61020 Remove brain cavity fluid 2.94 70.00 $205.80 61026 Injection into brain canal 3.02 70.00 $211.40 61050 Remove brain canal fluid 2.48 70.00 $173.60 61055 Injection into brain canal 3.52 70.00 $246.40 61070 Brain canal shunt procedure 1.66 70.00 $116.20 6110F Counsel prov driving risks 0.00 70.00 $0.00 61105 Twist drill hole 12.92 70.00 $904.40 61107 Drill skull for implantation 9.27 70.00 $648.90 61108 Drill skull for drainage 26.47 70.00 $1,852.90 61120 Burr hole for puncture 21.84 70.00 $1,528.80 61140 Pierce skull for biopsy 36.96 70.00 $2,587.20 61150 Pierce skull for drainage 39.76 70.00 $2,783.20 61151 Pierce skull for drainage 29.26 70.00 $2,048.20 61154 Pierce skull & remove clot 37.21 70.00 $2,604.70 61156 Pierce skull for drainage 36.58 70.00 $2,560.60 61210 Pierce skull implant device 10.91 70.00 $763.70 61215 Insert brain-fluid device 14.86 70.00 $1,040.20 61250 Pierce skull & explore 24.22 70.00 $1,695.40 61253 Pierce skull & explore 23.46 70.00 $1,642.20 61304 Open skull for exploration 47.97 70.00 $3,357.90 61305 Open skull for exploration 59.25 70.00 $4,147.50 61312 Open skull for drainage 61.05 70.00 $4,273.50 61313 Open skull for drainage 58.17 70.00 $4,071.90 61314 Open skull for drainage 53.62 70.00 $3,753.40 61315 Open skull for drainage 60.77 70.00 $4,253.90 61316 Implt cran bone flap to abdo 2.62 70.00 $183.40 61320 Open skull for drainage 55.76 70.00 $3,903.20 61321 Open skull for drainage 62.06 70.00 $4,344.20 61322 Decompressive craniotomy 69.85 70.00 $4,889.50 61323 Decompressive lobectomy 70.75 70.00 $4,952.50 61330 Decompress eye socket 51.54 70.00 $3,607.80 61332 Explore/biopsy eye socket 49.37 70.00 $3,455.90 61333 Explore orbit/remove lesion 52.26 70.00 $3,658.20 61340 Subtemporal decompression 42.60 70.00 $2,982.00 61343 Incise skull (press relief) 64.40 70.00 $4,508.00 61345 Relieve cranial pressure 59.72 70.00 $4,180.40 61450 Incise skull for surgery 56.72 70.00 $3,970.40 61458 Incise skull for brain wound 58.99 70.00 $4,129.30 61460 Incise skull for surgery 60.46 70.00 $4,232.20 61480 Incise skull for surgery 57.23 70.00 $4,006.10 6150F Pt notrcvng1st antitnf txmnt 0.00 70.00 $0.00 61500 Removal of skull lesion 38.44 70.00 $2,690.80 61501 Remove infected skull bone 33.39 70.00 $2,337.30 61510 Removal of brain lesion 64.04 70.00 $4,482.80 61512 Remove brain lining lesion 74.79 70.00 $5,235.30 61514 Removal of brain abscess 55.79 70.00 $3,905.30 61516 Removal of brain lesion 54.48 70.00 $3,813.60 61517 Implt brain chemotx add-on 2.58 70.00 $180.60 61518 Removal of brain lesion 80.88 70.00 $5,661.60 61519 Remove brain lining lesion 86.34 70.00 $6,043.80 61520 Removal of brain lesion 110.40 70.00 $7,728.00 61521 Removal of brain lesion 93.32 70.00 $6,532.40 61522 Removal of brain abscess 64.50 70.00 $4,515.00 61524 Removal of brain lesion 61.17 70.00 $4,281.90 61526 Removal of brain lesion 107.79 70.00 $7,545.30 61530 Removal of brain lesion 89.94 70.00 $6,295.80 61531 Implant brain electrodes 35.25 70.00 $2,467.50 61533 Implant brain electrodes 44.41 70.00 $3,108.70 61534 Removal of brain lesion 48.47 70.00 $3,392.90 61535 Remove brain electrodes 28.84 70.00 $2,018.80 61536 Removal of brain lesion 75.19 70.00 $5,263.30 61537 Removal of brain tissue 72.76 70.00 $5,093.20 61538 Removal of brain tissue 78.43 70.00 $5,490.10 61539 Removal of brain tissue 69.65 70.00 $4,875.50 61540 Removal of brain tissue 63.47 70.00 $4,442.90 61541 Incision of brain tissue 63.38 70.00 $4,436.60 61543 Removal of brain tissue 61.36 70.00 $4,295.20 61544 Remove & treat brain lesion 56.10 70.00 $3,927.00 61545 Excision of brain tumor 93.98 70.00 $6,578.60 61546 Removal of pituitary gland 67.71 70.00 $4,739.70 61548 Removal of pituitary gland 46.04 70.00 $3,222.80 61550 Release of skull seams 34.84 70.00 $2,438.80 61552 Release of skull seams 33.56 70.00 $2,349.20 61556 Incise skull/sutures 45.36 70.00 $3,175.20 61557 Incise skull/sutures 49.51 70.00 $3,465.70 61558 Excision of skull/sutures 55.33 70.00 $3,873.10 61559 Excision of skull/sutures 66.98 70.00 $4,688.60 61563 Excision of skull tumor 57.91 70.00 $4,053.70 61564 Excision of skull tumor 66.98 70.00 $4,688.60 61566 Removal of brain tissue 66.30 70.00 $4,641.00 61567 Incision of brain tissue 69.43 70.00 $4,860.10 61570 Remove foreign body brain 53.98 70.00 $3,778.60 61571 Incise skull for brain wound 58.63 70.00 $4,104.10 61575 Skull base/brainstem surgery 72.99 70.00 $5,109.30 61576 Skull base/brainstem surgery 98.65 70.00 $6,905.50 61580 Craniofacial approach skull 71.43 70.00 $5,000.10 61581 Craniofacial approach skull 76.40 70.00 $5,348.00 61582 Craniofacial approach skull 87.66 70.00 $6,136.20 61583 Craniofacial approach skull 84.41 70.00 $5,908.70 61584 Orbitocranial approach/skull 82.88 70.00 $5,801.60 61585 Orbitocranial approach/skull 92.51 70.00 $6,475.70 61586 Resect nasopharynx skull 69.17 70.00 $4,841.90 61590 Infratemporal approach/skull 87.96 70.00 $6,157.20 61591 Infratemporal approach/skull 89.13 70.00 $6,239.10 61592 Orbitocranial approach/skull 92.67 70.00 $6,486.90 61595 Transtemporal approach/skull 67.91 70.00 $4,753.70 61596 Transcochlear approach/skull 70.40 70.00 $4,928.00 61597 Transcondylar approach/skull 83.25 70.00 $5,827.50 61598 Transpetrosal approach/skull 81.68 70.00 $5,717.60 61600 Resect/excise cranial lesion 61.42 70.00 $4,299.40 61601 Resect/excise cranial lesion 69.80 70.00 $4,886.00 61605 Resect/excise cranial lesion 62.44 70.00 $4,370.80 61606 Resect/excise cranial lesion 86.23 70.00 $6,036.10 61607 Resect/excise cranial lesion 78.24 70.00 $5,476.80 61608 Resect/excise cranial lesion 94.98 70.00 $6,648.60 61610 Transect artery sinus 48.07 70.00 $3,364.90 61611 Transect artery sinus 11.25 70.00 $787.50 61612 Transect artery sinus 34.66 70.00 $2,426.20 61613 Remove aneurysm sinus 94.10 70.00 $6,587.00 61615 Resect/excise lesion skull 71.64 70.00 $5,014.80 61616 Resect/excise lesion skull 97.00 70.00 $6,790.00 61618 Repair dura 37.73 70.00 $2,641.10 61619 Repair dura 41.69 70.00 $2,918.30 61623 Endovasc tempory vessel occl 16.62 70.00 $1,163.40 61624 Transcath occlusion cns 33.43 70.00 $2,340.10 61626 Transcath occlusion non-cns 25.03 70.00 $1,752.10 61630 Intracranial angioplasty 39.17 70.00 $2,741.90 61635 Intracran angioplsty w/stent 41.79 70.00 $2,925.30 61640 Dilate ic vasospasm init 14.01 70.00 $980.70 61641 Dilate ic vasospasm add-on 4.92 70.00 $344.40 61642 Dilate ic vasospasm add-on 9.84 70.00 $688.80 61645 Perq art m-thrombect &/nfs 22.77 70.00 $1,593.90 61650 Evasc prlng admn rx agnt 1st 15.57 70.00 $1,089.90 61651 Evasc prlng admn rx agnt add 6.62 70.00 $463.40 61680 Intracranial vessel surgery 66.33 70.00 $4,643.10 61682 Intracranial vessel surgery 122.40 70.00 $8,568.00 61684 Intracranial vessel surgery 83.95 70.00 $5,876.50 61686 Intracranial vessel surgery 132.75 70.00 $9,292.50 61690 Intracranial vessel surgery 63.94 70.00 $4,475.80 61692 Intracranial vessel surgery 107.65 70.00 $7,535.50 61697 Brain aneurysm repr complx 123.91 70.00 $8,673.70 61698 Brain aneurysm repr complx 136.58 70.00 $9,560.60 61700 Brain aneurysm repr simple 100.11 70.00 $7,007.70 61702 Inner skull vessel surgery 117.93 70.00 $8,255.10 61703 Clamp neck artery 36.02 70.00 $2,521.40 61705 Revise circulation to head 76.83 70.00 $5,378.10 61708 Revise circulation to head 67.91 70.00 $4,753.70 61710 Revise circulation to head 62.58 70.00 $4,380.60 61711 Fusion of skull arteries 76.62 70.00 $5,363.40 61720 Incise skull/brain surgery 37.40 70.00 $2,618.00 61735 Incise skull/brain surgery 46.84 70.00 $3,278.80 61750 Incise skull/brain biopsy 41.32 70.00 $2,892.40 61751 Brain biopsy w/ct/mr guide 40.52 70.00 $2,836.40 61760 Implant brain electrodes 46.38 70.00 $3,246.60 61770 Incise skull for treatment 47.87 70.00 $3,350.90 61781 Scan proc cranial intra 6.96 70.00 $487.20 61782 Scan proc cranial extra 5.07 70.00 $354.90 61783 Scan proc spinal 6.83 70.00 $478.10 61790 Treat trigeminal nerve 25.77 70.00 $1,803.90 61791 Treat trigeminal tract 32.07 70.00 $2,244.90 61796 Srs cranial lesion simple 29.83 70.00 $2,088.10 61797 Srs cran les simple addl 6.52 70.00 $456.40 61798 Srs cranial lesion complex 40.61 70.00 $2,842.70 61799 Srs cran les complex addl 9.02 70.00 $631.40 61800 Apply srs headframe add-on 4.55 70.00 $318.50 61850 Implant neuroelectrodes 28.89 70.00 $2,022.30 61860 Implant neuroelectrodes 45.51 70.00 $3,185.70 61863 Implant neuroelectrode 44.10 70.00 $3,087.00 61864 Implant neuroelectrde addl 8.41 70.00 $588.70 61867 Implant neuroelectrode 67.00 70.00 $4,690.00 61868 Implant neuroelectrde addl 14.77 70.00 $1,033.90 61870 Implant neuroelectrodes 30.10 70.00 $2,107.00 61880 Revise/remove neuroelectrode 16.59 70.00 $1,161.30 61885 Insrt/redo neurostim 1 array 14.99 70.00 $1,049.30 61886 Implant neurostim arrays 24.63 70.00 $1,724.10 61888 Revise/remove neuroreceiver 11.58 70.00 $810.60 62000 Treat skull fracture 28.02 70.00 $1,961.40 62005 Treat skull fracture 36.92 70.00 $2,584.40 62010 Treatment of head injury 44.87 70.00 $3,140.90 62100 Repair brain fluid leakage 46.32 70.00 $3,242.40 62115 Reduction of skull defect 37.83 70.00 $2,648.10 62117 Reduction of skull defect 57.87 70.00 $4,050.90 62120 Repair skull cavity lesion 47.91 70.00 $3,353.70 62121 Incise skull repair 46.19 70.00 $3,233.30 62140 Repair of skull defect 30.22 70.00 $2,115.40 62141 Repair of skull defect 33.37 70.00 $2,335.90 62142 Remove skull plate/flap 25.95 70.00 $1,816.50 62143 Replace skull plate/flap 30.50 70.00 $2,135.00 62145 Repair of skull & brain 41.47 70.00 $2,902.90 62146 Repair of skull with graft 35.08 70.00 $2,455.60 62147 Repair of skull with graft 41.65 70.00 $2,915.50 62148 Retr bone flap to fix skull 3.74 70.00 $261.80 62160 Neuroendoscopy add-on 5.63 70.00 $394.10 62161 Dissect brain w/scope 44.45 70.00 $3,111.50 62162 Remove colloid cyst w/scope 55.44 70.00 $3,880.80 62163 Zneuroendoscopy w/fb removal 36.02 70.00 $2,521.40 62164 Remove brain tumor w/scope 60.98 70.00 $4,268.60 62165 Remove pituit tumor w/scope 44.88 70.00 $3,141.60 62180 Establish brain cavity shunt 47.16 70.00 $3,301.20 62190 Establish brain cavity shunt 20.92 70.00 $1,464.40 62192 Establish brain cavity shunt 28.63 70.00 $2,004.10 62194 Replace/irrigate catheter 12.91 70.00 $903.70 62200 Establish brain cavity shunt 39.68 70.00 $2,777.60 62201 Brain cavity shunt w/scope 35.28 70.00 $2,469.60 62220 Establish brain cavity shunt 30.24 70.00 $2,116.80 62223 Establish brain cavity shunt 30.54 70.00 $2,137.80 62225 Replace/irrigate catheter 14.77 70.00 $1,033.90 62230 Replace/revise brain shunt 24.60 70.00 $1,722.00 62252 Csf shunt reprogram 2.46 70.00 $172.20 62252 TC Csf shunt reprogram 1.09 70.00 $76.30 62252 26 Csf shunt reprogram 1.37 70.00 $95.90 62256 Remove brain cavity shunt 17.51 70.00 $1,225.70 62258 Replace brain cavity shunt 32.75 70.00 $2,292.50 62263 Epidural lysis mult sessions 17.18 70.00 $1,202.60 62264 Epidural lysis on single day 11.90 70.00 $833.00 62267 Interdiscal perq aspir dx 7.09 70.00 $496.30 62268 Drain spinal cord cyst 7.47 70.00 $522.90 62269 Needle biopsy spinal cord 7.72 70.00 $540.40 62270 Spinal fluid tap diagnostic 4.51 70.00 $315.70 62272 Drain cerebro spinal fluid 5.74 70.00 $401.80 62273 Inject epidural patch 4.90 70.00 $343.00 62280 Treat spinal cord lesion 8.57 70.00 $599.90 62281 Treat spinal cord lesion 6.87 70.00 $480.90 62282 Treat spinal canal lesion 8.43 70.00 $590.10 62284 Injection for myelogram 5.32 70.00 $372.40 62287 Percutaneous diskectomy 16.50 70.00 $1,155.00 62290 Inject for spine disk x-ray 9.36 70.00 $655.20 62291 Inject for spine disk x-ray 9.41 70.00 $658.70 62292 Injection into disk lesion 16.60 70.00 $1,162.00 62294 Injection into spinal artery 27.85 70.00 $1,949.50 62302 Myelography lumbar injection 6.90 70.00 $483.00 62303 Myelography lumbar injection 7.11 70.00 $497.70 62304 Myelography lumbar injection 6.81 70.00 $476.70 62305 Myelography lumbar injection 7.41 70.00 $518.70 62320 Njx interlaminar crv/thrc 4.75 70.00 $332.50 62321 Njx interlaminar crv/thrc 7.06 70.00 $494.20 62322 Njx interlaminar lmbr/sac 4.43 70.00 $310.10 62323 Njx interlaminar lmbr/sac 6.93 70.00 $485.10 62324 Njx interlaminar crv/thrc 4.15 70.00 $290.50 62325 Njx interlaminar crv/thrc 6.26 70.00 $438.20 62326 Njx interlaminar lmbr/sac 4.36 70.00 $305.20 62327 Njx interlaminar lmbr/sac 6.38 70.00 $446.60 62350 Implant spinal canal cath 11.52 70.00 $806.40 62351 Implant spinal canal cath 24.94 70.00 $1,745.80 62355 Remove spinal canal catheter 7.72 70.00 $540.40 62360 Insert spine infusion device 8.92 70.00 $624.40 62361 Implant spine infusion pump 12.26 70.00 $858.20 62362 Implant spine infusion pump 11.11 70.00 $777.70 62365 Remove spine infusion device 8.60 70.00 $602.00 62367 Analyze spine infus pump 1.17 70.00 $81.90 62368 Analyze sp inf pump w/reprog 1.60 70.00 $112.00 62369 Anal sp inf pmp w/reprg&fill 3.36 70.00 $235.20 62370 Anl sp inf pmp w/mdreprg&fil 3.55 70.00 $248.50 62380 Ndsc dcmprn 1 ntrspc lumbar 0.00 70.00 $0.00 63001 Remove spine lamina 1/2 crvl 36.23 70.00 $2,536.10 63003 Remove spine lamina 1/2 thrc 36.18 70.00 $2,532.60 63005 Remove spine lamina 1/2 lmbr 34.45 70.00 $2,411.50 63011 Remove spine lamina 1/2 scrl 31.72 70.00 $2,220.40 63012 Remove lamina/facets lumbar 34.69 70.00 $2,428.30 63015 Remove spine lamina >2 crvcl 43.30 70.00 $3,031.00 63016 Remove spine lamina >2 thrc 44.52 70.00 $3,116.40 63017 Remove spine lamina >2 lmbr 36.67 70.00 $2,566.90 63020 Neck spine disk surgery 33.81 70.00 $2,366.70 63030 Low back disk surgery 28.20 70.00 $1,974.00 63035 Spinal disk surgery add-on 5.61 70.00 $392.70 63040 Laminotomy single cervical 40.58 70.00 $2,840.60 63042 Laminotomy single lumbar 37.67 70.00 $2,636.90 63043 Laminotomy addl cervical 0.00 70.00 $0.00 63044 Laminotomy addl lumbar 0.00 70.00 $0.00 63045 Remove spine lamina 1 crvl 37.58 70.00 $2,630.60 63046 Remove spine lamina 1 thrc 35.58 70.00 $2,490.60 63047 Remove spine lamina 1 lmbr 32.06 70.00 $2,244.20 63048 Remove spinal lamina add-on 6.19 70.00 $433.30 63050 Cervical laminoplsty 2/> seg 43.79 70.00 $3,065.30 63051 C-laminoplasty w/graft/plate 49.79 70.00 $3,485.30 63055 Decompress spinal cord thrc 47.59 70.00 $3,331.30 63056 Decompress spinal cord lmbr 43.21 70.00 $3,024.70 63057 Decompress spine cord add-on 9.37 70.00 $655.90 63064 Decompress spinal cord thrc 51.75 70.00 $3,622.50 63066 Decompress spine cord add-on 6.08 70.00 $425.60 63075 Neck spine disk surgery 39.44 70.00 $2,760.80 63076 Neck spine disk surgery 7.26 70.00 $508.20 63077 Spine disk surgery thorax 43.40 70.00 $3,038.00 63078 Spine disk surgery thorax 5.67 70.00 $396.90 63081 Remove vert body dcmprn crvl 51.19 70.00 $3,583.30 63082 Remove vertebral body add-on 7.80 70.00 $546.00 63085 Remove vert body dcmprn thrc 55.80 70.00 $3,906.00 63086 Remove vertebral body add-on 5.58 70.00 $390.60 63087 Remov vertbr dcmprn thrclmbr 70.26 70.00 $4,918.20 63088 Remove vertebral body add-on 7.61 70.00 $532.70 63090 Remove vert body dcmprn lmbr 56.83 70.00 $3,978.10 63091 Remove vertebral body add-on 5.18 70.00 $362.60 63101 Remove vert body dcmprn thrc 67.55 70.00 $4,728.50 63102 Remove vert body dcmprn lmbr 66.20 70.00 $4,634.00 63103 Remove vertebral body add-on 8.57 70.00 $599.90 63170 Incise spinal cord tract(s) 46.91 70.00 $3,283.70 63172 Drainage of spinal cyst 41.31 70.00 $2,891.70 63173 Drainage of spinal cyst 50.06 70.00 $3,504.20 63180 Revise spinal cord ligaments 39.04 70.00 $2,732.80 63182 Revise spinal cord ligaments 48.06 70.00 $3,364.20 63185 Incise spine nrv half segmnt 33.21 70.00 $2,324.70 63190 Incise spine nrv >2 segmnts 37.22 70.00 $2,605.40 63191 Incise spine accessory nerve 36.85 70.00 $2,579.50 63194 Incise spine & cord cervical 40.63 70.00 $2,844.10 63195 Incise spine & cord thoracic 36.74 70.00 $2,571.80 63196 Incise spine&cord 2 trx crvl 40.84 70.00 $2,858.80 63197 Incise spine&cord 2 trx thrc 40.91 70.00 $2,863.70 63198 Incise spin&cord 2 stgs crvl 48.12 70.00 $3,368.40 63199 Incise spin&cord 2 stgs thrc 50.49 70.00 $3,534.30 63200 Release spinal cord lumbar 44.99 70.00 $3,149.30 63250 Revise spinal cord vsls crvl 87.67 70.00 $6,136.90 63251 Revise spinal cord vsls thrc 88.74 70.00 $6,211.80 63252 Revise spine cord vsl thrlmb 89.06 70.00 $6,234.20 63265 Excise intraspinl lesion crv 48.79 70.00 $3,415.30 63266 Excise intrspinl lesion thrc 50.28 70.00 $3,519.60 63267 Excise intrspinl lesion lmbr 39.92 70.00 $2,794.40 63268 Excise intrspinl lesion scrl 40.77 70.00 $2,853.90 63270 Excise intrspinl lesion crvl 60.97 70.00 $4,267.90 63271 Excise intrspinl lesion thrc 60.42 70.00 $4,229.40 63272 Excise intrspinl lesion lmbr 55.20 70.00 $3,864.00 63273 Excise intrspinl lesion scrl 53.65 70.00 $3,755.50 63275 Bx/exc xdrl spine lesn crvl 52.60 70.00 $3,682.00 63276 Bx/exc xdrl spine lesn thrc 52.31 70.00 $3,661.70 63277 Bx/exc xdrl spine lesn lmbr 45.25 70.00 $3,167.50 63278 Bx/exc xdrl spine lesn scrl 46.28 70.00 $3,239.60 63280 Bx/exc idrl spine lesn crvl 61.81 70.00 $4,326.70 63281 Bx/exc idrl spine lesn thrc 61.34 70.00 $4,293.80 63282 Bx/exc idrl spine lesn lmbr 57.68 70.00 $4,037.60 63283 Bx/exc idrl spine lesn scrl 55.34 70.00 $3,873.80 63285 Bx/exc idrl imed lesn cervl 77.21 70.00 $5,404.70 63286 Bx/exc idrl imed lesn thrc 75.22 70.00 $5,265.40 63287 Bx/exc idrl imed lesn thrlmb 81.02 70.00 $5,671.40 63290 Bx/exc xdrl/idrl lsn any lvl 81.98 70.00 $5,738.60 63295 Repair laminectomy defect 9.82 70.00 $687.40 63300 Remove vert xdrl body crvcl 53.59 70.00 $3,751.30 63301 Remove vert xdrl body thrc 60.67 70.00 $4,246.90 63302 Remove vert xdrl body thrlmb 63.13 70.00 $4,419.10 63303 Remov vert xdrl bdy lmbr/sac 66.02 70.00 $4,621.40 63304 Remove vert idrl body crvcl 67.99 70.00 $4,759.30 63305 Remove vert idrl body thrc 70.45 70.00 $4,931.50 63306 Remov vert idrl bdy thrclmbr 60.43 70.00 $4,230.10 63307 Remov vert idrl bdy lmbr/sac 63.37 70.00 $4,435.90 63308 Remove vertebral body add-on 9.47 70.00 $662.90 63600 Remove spinal cord lesion 25.78 70.00 $1,804.60 63610 Stimulation of spinal cord 12.99 70.00 $909.30 63615 Remove lesion of spinal cord 36.45 70.00 $2,551.50 63620 Srs spinal lesion 32.88 70.00 $2,301.60 63621 Srs spinal lesion addl 7.41 70.00 $518.70 63650 Implant neuroelectrodes 37.24 70.00 $2,606.80 63655 Implant neuroelectrodes 24.09 70.00 $1,686.30 63661 Remove spine eltrd perq aray 16.54 70.00 $1,157.80 63662 Remove spine eltrd plate 24.33 70.00 $1,703.10 63663 Revise spine eltrd perq aray 22.31 70.00 $1,561.70 63664 Revise spine eltrd plate 25.12 70.00 $1,758.40 63685 Insrt/redo spine n generator 10.54 70.00 $737.80 63688 Revise/remove neuroreceiver 10.71 70.00 $749.70 63700 Repair of spinal herniation 33.40 70.00 $2,338.00 63702 Repair of spinal herniation 37.12 70.00 $2,598.40 63704 Repair of spinal herniation 42.28 70.00 $2,959.60 63706 Repair of spinal herniation 50.77 70.00 $3,553.90 63707 Repair spinal fluid leakage 26.77 70.00 $1,873.90 63709 Repair spinal fluid leakage 32.02 70.00 $2,241.40 63710 Graft repair of spine defect 31.47 70.00 $2,202.90 63740 Install spinal shunt 27.28 70.00 $1,909.60 63741 Install spinal shunt 19.69 70.00 $1,378.30 63744 Revision of spinal shunt 19.27 70.00 $1,348.90 63746 Removal of spinal shunt 17.60 70.00 $1,232.00 64400 N block inj trigeminal 3.63 70.00 $254.10 64402 N block inj facial 3.81 70.00 $266.70 64405 N block inj occipital 2.86 70.00 $200.20 64408 N block inj vagus 3.38 70.00 $236.60 64410 N block inj phrenic 3.85 70.00 $269.50 64413 N block inj cervical plexus 3.62 70.00 $253.40 64415 N block inj brachial plexus 3.32 70.00 $232.40 64416 N block cont infuse b plex 2.26 70.00 $158.20 64417 N block inj axillary 3.63 70.00 $254.10 64418 N block inj suprascapular 4.12 70.00 $288.40 64420 N block inj intercost sng 3.15 70.00 $220.50 64421 N block inj intercost mlt 4.25 70.00 $297.50 64425 N block inj ilio-ing/hypogi 3.74 70.00 $261.80 64430 N block inj pudendal 3.90 70.00 $273.00 64435 N block inj paracervical 3.84 70.00 $268.80 64445 N block inj sciatic sng 3.84 70.00 $268.80 64446 N blk inj sciatic cont inf 2.26 70.00 $158.20 64447 N block inj fem single 3.38 70.00 $236.60 64448 N block inj fem cont inf 2.04 70.00 $142.80 64449 N block inj lumbar plexus 2.40 70.00 $168.00 64450 N block other peripheral 2.27 70.00 $158.90 64455 N block inj plantar digit 1.36 70.00 $95.20 64461 Pvb thoracic single inj site 4.21 70.00 $294.70 64462 Pvb thoracic 2nd+ inj site 2.39 70.00 $167.30 64463 Pvb thoracic cont infusion 4.72 70.00 $330.40 64479 Inj foramen epidural c/t 6.65 70.00 $465.50 64480 Inj foramen epidural add-on 3.19 70.00 $223.30 64483 Inj foramen epidural l/s 6.17 70.00 $431.90 64484 Inj foramen epidural add-on 2.48 70.00 $173.60 64486 Tap block unil by injection 3.45 70.00 $241.50 64487 Tap block uni by infusion 3.82 70.00 $267.40 64488 Tap block bi injection 3.96 70.00 $277.20 64489 Tap block bi by infusion 5.06 70.00 $354.20 64490 Inj paravert f jnt c/t 1 lev 5.35 70.00 $374.50 64491 Inj paravert f jnt c/t 2 lev 2.65 70.00 $185.50 64492 Inj paravert f jnt c/t 3 lev 2.66 70.00 $186.20 64493 Inj paravert f jnt l/s 1 lev 4.85 70.00 $339.50 64494 Inj paravert f jnt l/s 2 lev 2.44 70.00 $170.80 64495 Inj paravert f jnt l/s 3 lev 2.45 70.00 $171.50 64505 N block spenopalatine gangl 3.01 70.00 $210.70 64508 N block carotid sinus s/p 1.71 70.00 $119.70 64510 N block stellate ganglion 3.59 70.00 $251.30 64517 N block inj hypogas plxs 5.27 70.00 $368.90 64520 N block lumbar/thoracic 5.25 70.00 $367.50 64530 N block inj celiac pelus 5.35 70.00 $374.50 64550 Apply neurostimulator 0.45 70.00 $31.50 64553 Implant neuroelectrodes 5.77 70.00 $403.90 64555 Implant neuroelectrodes 5.99 70.00 $419.30 64561 Implant neuroelectrodes 23.42 70.00 $1,639.40 64565 Implant neuroelectrodes 5.50 70.00 $385.00 64566 Neuroeltrd stim post tibial 3.61 70.00 $252.70 64568 Inc for vagus n elect impl 18.87 70.00 $1,320.90 64569 Revise/repl vagus n eltrd 22.72 70.00 $1,590.40 64570 Remove vagus n eltrd 19.03 70.00 $1,332.10 64575 Implant neuroelectrodes 9.22 70.00 $645.40 64580 Implant neuroelectrodes 8.69 70.00 $608.30 64581 Implant neuroelectrodes 19.14 70.00 $1,339.80 64585 Revise/remove neuroelectrode 6.98 70.00 $488.60 64590 Insrt/redo pn/gastr stimul 7.56 70.00 $529.20 64595 Revise/rmv pn/gastr stimul 7.00 70.00 $490.00 64600 Injection treatment of nerve 11.18 70.00 $782.60 64605 Injection treatment of nerve 17.33 70.00 $1,213.10 64610 Injection treatment of nerve 21.34 70.00 $1,493.80 64611 Chemodenerv saliv glands 3.37 70.00 $235.90 64612 Destroy nerve face muscle 3.73 70.00 $261.10 64615 Chemodenerv musc migraine 4.16 70.00 $291.20 64616 Chemodenerv musc neck dyston 3.65 70.00 $255.50 64617 Chemodener muscle larynx emg 5.12 70.00 $358.40 64620 Injection treatment of nerve 5.80 70.00 $406.00 64630 Injection treatment of nerve 6.58 70.00 $460.60 64632 N block inj common digit 2.43 70.00 $170.10 64633 Destroy cerv/thor facet jnt 11.87 70.00 $830.90 64634 Destroy c/th facet jnt addl 5.32 70.00 $372.40 64635 Destroy lumb/sac facet jnt 11.74 70.00 $821.80 64636 Destroy l/s facet jnt addl 4.84 70.00 $338.80 64640 Injection treatment of nerve 3.75 70.00 $262.50 64642 Chemodenerv 1 extremity 1-4 4.06 70.00 $284.20 64643 Chemodenerv 1 extrem 1-4 ea 2.65 70.00 $185.50 64644 Chemodenerv 1 extrem 5/> mus 4.67 70.00 $326.90 64645 Chemodenerv 1 extrem 5/> ea 3.28 70.00 $229.60 64646 Chemodenerv trunk musc 1-5 4.26 70.00 $298.20 64647 Chemodenerv trunk musc 6/> 5.08 70.00 $355.60 64650 Chemodenerv eccrine glands 2.21 70.00 $154.70 64653 Chemodenerv eccrine glands 2.69 70.00 $188.30 64680 Injection treatment of nerve 8.69 70.00 $608.30 64681 Injection treatment of nerve 14.92 70.00 $1,044.40 64702 Revise finger/toe nerve 14.34 70.00 $1,003.80 64704 Revise hand/foot nerve 9.16 70.00 $641.20 64708 Revise arm/leg nerve 14.31 70.00 $1,001.70 64712 Revision of sciatic nerve 16.70 70.00 $1,169.00 64713 Revision of arm nerve(s) 22.12 70.00 $1,548.40 64714 Revise low back nerve(s) 20.40 70.00 $1,428.00 64716 Revision of cranial nerve 15.31 70.00 $1,071.70 64718 Revise ulnar nerve at elbow 16.98 70.00 $1,188.60 64719 Revise ulnar nerve at wrist 11.48 70.00 $803.60 64721 Carpal tunnel surgery 12.30 70.00 $861.00 64722 Relieve pressure on nerve(s) 10.43 70.00 $730.10 64726 Release foot/toe nerve 7.83 70.00 $548.10 64727 Internal nerve revision 5.35 70.00 $374.50 64732 Incision of brow nerve 10.80 70.00 $756.00 64734 Incision of cheek nerve 14.56 70.00 $1,019.20 64736 Incision of chin nerve 11.17 70.00 $781.90 64738 Incision of jaw nerve 13.23 70.00 $926.10 64740 Incision of tongue nerve 12.98 70.00 $908.60 64742 Incision of facial nerve 13.06 70.00 $914.20 64744 Incise nerve back of head 14.19 70.00 $993.30 64746 Incise diaphragm nerve 12.23 70.00 $856.10 64755 Incision of stomach nerves 25.28 70.00 $1,769.60 64760 Incision of vagus nerve 14.29 70.00 $1,000.30 64763 Incise hip/thigh nerve 13.80 70.00 $966.00 64766 Incise hip/thigh nerve 16.21 70.00 $1,134.70 64771 Sever cranial nerve 17.27 70.00 $1,208.90 64772 Incision of spinal nerve 16.22 70.00 $1,135.40 64774 Remove skin nerve lesion 11.91 70.00 $833.70 64776 Remove digit nerve lesion 11.15 70.00 $780.50 64778 Digit nerve surgery add-on 4.09 70.00 $286.30 64782 Remove limb nerve lesion 13.07 70.00 $914.90 64783 Limb nerve surgery add-on 6.41 70.00 $448.70 64784 Remove nerve lesion 20.98 70.00 $1,468.60 64786 Remove sciatic nerve lesion 31.24 70.00 $2,186.80 64787 Implant nerve end 7.03 70.00 $492.10 64788 Remove skin nerve lesion 11.47 70.00 $802.90 64790 Removal of nerve lesion 24.43 70.00 $1,710.10 64792 Removal of nerve lesion 31.25 70.00 $2,187.50 64795 Biopsy of nerve 5.61 70.00 $392.70 64802 Sympathectomy cervical 18.54 70.00 $1,297.80 64804 Remove sympathetic nerves 25.87 70.00 $1,810.90 64809 Remove sympathetic nerves 26.14 70.00 $1,829.80 64818 Remove sympathetic nerves 16.44 70.00 $1,150.80 64820 Sympathectomy digital artery 20.38 70.00 $1,426.60 64821 Remove sympathetic nerves 19.84 70.00 $1,388.80 64822 Remove sympathetic nerves 19.83 70.00 $1,388.10 64823 Sympathectomy supfc palmar 22.68 70.00 $1,587.60 64831 Repair of digit nerve 19.73 70.00 $1,381.10 64832 Repair nerve add-on 9.78 70.00 $684.60 64834 Repair of hand or foot nerve 21.46 70.00 $1,502.20 64835 Repair of hand or foot nerve 23.20 70.00 $1,624.00 64836 Repair of hand or foot nerve 23.72 70.00 $1,660.40 64837 Repair nerve add-on 11.04 70.00 $772.80 64840 Repair of leg nerve 28.05 70.00 $1,963.50 64856 Repair/transpose nerve 29.19 70.00 $2,043.30 64857 Repair arm/leg nerve 30.42 70.00 $2,129.40 64858 Repair sciatic nerve 33.79 70.00 $2,365.30 64859 Nerve surgery 7.27 70.00 $508.90 64861 Repair of arm nerves 36.06 70.00 $2,524.20 64862 Repair of low back nerves 40.19 70.00 $2,813.30 64864 Repair of facial nerve 25.35 70.00 $1,774.50 64865 Repair of facial nerve 32.12 70.00 $2,248.40 64866 Fusion of facial/other nerve 32.94 70.00 $2,305.80 64868 Fusion of facial/other nerve 29.76 70.00 $2,083.20 64872 Subsequent repair of nerve 3.39 70.00 $237.30 64874 Repair & revise nerve add-on 4.76 70.00 $333.20 64876 Repair nerve/shorten bone 5.12 70.00 $358.40 64885 Nerve graft head/neck 4 cm 37.48 70.00 $2,623.60 64890 Nerve graft hand/foot 4 cm 33.28 70.00 $2,329.60 64892 Nerve graft arm/leg <4 cm 30.11 70.00 $2,107.70 64893 Nerve graft arm/leg >4 cm 32.84 70.00 $2,298.80 64895 Nerve graft hand/foot 4 cm 41.51 70.00 $2,905.70 64897 Nerve graft arm/leg 4 cm 42.87 70.00 $3,000.90 64901 Nerve graft add-on 16.10 70.00 $1,127.00 64902 Nerve graft add-on 18.84 70.00 $1,318.80 64905 Nerve pedicle transfer 29.81 70.00 $2,086.70 64907 Nerve pedicle transfer 38.34 70.00 $2,683.80 64910 Nerve repair w/allograft 23.65 70.00 $1,655.50 64911 Neurorraphy w/vein autograft 29.28 70.00 $2,049.60 64999 Nervous system surgery 0.00 70.00 $0.00 65091 Revise eye 18.00 70.00 $1,260.00 65093 Revise eye with implant 17.78 70.00 $1,244.60 65101 Removal of eye 20.90 70.00 $1,463.00 65103 Remove eye/insert implant 21.80 70.00 $1,526.00 65105 Remove eye/attach implant 24.02 70.00 $1,681.40 65110 Removal of eye 34.69 70.00 $2,428.30 65112 Remove eye/revise socket 40.28 70.00 $2,819.60 65114 Remove eye/revise socket 41.95 70.00 $2,936.50 65125 Revise ocular implant 12.77 70.00 $893.90 65130 Insert ocular implant 20.69 70.00 $1,448.30 65135 Insert ocular implant 21.01 70.00 $1,470.70 65140 Attach ocular implant 22.83 70.00 $1,598.10 65150 Revise ocular implant 16.37 70.00 $1,145.90 65155 Reinsert ocular implant 23.91 70.00 $1,673.70 65175 Removal of ocular implant 18.61 70.00 $1,302.70 65205 Remove foreign body from eye 1.59 70.00 $111.30 65210 Remove foreign body from eye 1.94 70.00 $135.80 65220 Remove foreign body from eye 1.65 70.00 $115.50 65222 Remove foreign body from eye 1.89 70.00 $132.30 65235 Remove foreign body from eye 20.11 70.00 $1,407.70 65260 Remove foreign body from eye 27.22 70.00 $1,905.40 65265 Remove foreign body from eye 30.64 70.00 $2,144.80 65270 Repair of eye wound 7.50 70.00 $525.00 65272 Repair of eye wound 14.20 70.00 $994.00 65273 Repair of eye wound 10.81 70.00 $756.70 65275 Repair of eye wound 16.34 70.00 $1,143.80 65280 Repair of eye wound 19.04 70.00 $1,332.80 65285 Repair of eye wound 31.43 70.00 $2,200.10 65286 Repair of eye wound 19.90 70.00 $1,393.00 65290 Repair of eye socket wound 13.95 70.00 $976.50 65400 Removal of eye lesion 19.23 70.00 $1,346.10 65410 Biopsy of cornea 4.04 70.00 $282.80 65420 Removal of eye lesion 14.59 70.00 $1,021.30 65426 Removal of eye lesion 18.43 70.00 $1,290.10 65430 Corneal smear 3.23 70.00 $226.10 65435 Curette/treat cornea 2.26 70.00 $158.20 65436 Curette/treat cornea 10.97 70.00 $767.90 65450 Treatment of corneal lesion 9.20 70.00 $644.00 65600 Revision of cornea 11.16 70.00 $781.20 65710 Corneal transplant 31.33 70.00 $2,193.10 65730 Corneal transplant 34.78 70.00 $2,434.60 65750 Corneal transplant 34.97 70.00 $2,447.90 65755 Corneal transplant 34.79 70.00 $2,435.30 65756 Corneal trnspl endothelial 33.59 70.00 $2,351.30 65757 Prep corneal endo allograft 0.00 70.00 $0.00 65760 Revision of cornea 0.00 70.00 $0.00 65765 Revision of cornea 0.00 70.00 $0.00 65767 Corneal tissue transplant 0.00 70.00 $0.00 65770 Revise cornea with implant 39.74 70.00 $2,781.80 65771 Radial keratotomy 0.00 70.00 $0.00 65772 Correction of astigmatism 12.77 70.00 $893.90 65775 Correction of astigmatism 15.62 70.00 $1,093.40 65778 Cover eye w/membrane 40.13 70.00 $2,809.10 65779 Cover eye w/membrane suture 33.97 70.00 $2,377.90 65780 Ocular reconst transplant 18.89 70.00 $1,322.30 65781 Ocular reconst transplant 37.80 70.00 $2,646.00 65782 Ocular reconst transplant 32.62 70.00 $2,283.40 65785 Impltj ntrstrml crnl rng seg 59.79 70.00 $4,185.30 65800 Drainage of eye 3.37 70.00 $235.90 65810 Drainage of eye 13.19 70.00 $923.30 65815 Drainage of eye 18.02 70.00 $1,261.40 65820 Relieve inner eye pressure 21.19 70.00 $1,483.30 65850 Incision of eye 23.79 70.00 $1,665.30 65855 Trabeculoplasty laser surg 6.92 70.00 $484.40 65860 Incise inner eye adhesions 8.73 70.00 $611.10 65865 Incise inner eye adhesions 13.40 70.00 $938.00 65870 Incise inner eye adhesions 16.75 70.00 $1,172.50 65875 Incise inner eye adhesions 17.86 70.00 $1,250.20 65880 Incise inner eye adhesions 18.80 70.00 $1,316.00 65900 Remove eye lesion 27.30 70.00 $1,911.00 65920 Remove implant of eye 22.33 70.00 $1,563.10 65930 Remove blood clot from eye 18.06 70.00 $1,264.20 66020 Injection treatment of eye 5.27 70.00 $368.90 66030 Injection treatment of eye 4.69 70.00 $328.30 66130 Remove eye lesion 19.70 70.00 $1,379.00 66150 Glaucoma surgery 24.83 70.00 $1,738.10 66155 Glaucoma surgery 24.81 70.00 $1,736.70 66160 Glaucoma surgery 27.98 70.00 $1,958.60 66170 Glaucoma surgery 31.01 70.00 $2,170.70 66172 Incision of eye 33.74 70.00 $2,361.80 66174 Translum dil eye canal 26.87 70.00 $1,880.90 66175 Trnslum dil eye canal w/stnt 28.14 70.00 $1,969.80 66179 Aqueous shunt eye w/o graft 30.54 70.00 $2,137.80 66180 Aqueous shunt eye w/graft 32.23 70.00 $2,256.10 66183 Insert ant drainage device 29.18 70.00 $2,042.60 66184 Revision of aqueous shunt 22.24 70.00 $1,556.80 66185 Revise aqueous shunt eye 23.92 70.00 $1,674.40 66220 Repair eye lesion 20.12 70.00 $1,408.40 66225 Repair/graft eye lesion 26.42 70.00 $1,849.40 66250 Follow-up surgery of eye 21.17 70.00 $1,481.90 66500 Incision of iris 10.03 70.00 $702.10 66505 Incision of iris 11.06 70.00 $774.20 66600 Remove iris and lesion 23.58 70.00 $1,650.60 66605 Removal of iris 29.94 70.00 $2,095.80 66625 Removal of iris 12.16 70.00 $851.20 66630 Removal of iris 16.14 70.00 $1,129.80 66635 Removal of iris 16.28 70.00 $1,139.60 66680 Repair iris & ciliary body 14.68 70.00 $1,027.60 66682 Repair iris & ciliary body 18.06 70.00 $1,264.20 66700 Destruction ciliary body 12.74 70.00 $891.80 66710 Ciliary transsleral therapy 12.44 70.00 $870.80 66711 Ciliary endoscopic ablation 18.22 70.00 $1,275.40 66720 Destruction ciliary body 13.02 70.00 $911.40 66740 Destruction ciliary body 12.36 70.00 $865.20 66761 Revision of iris 8.37 70.00 $585.90 66762 Revision of iris 13.44 70.00 $940.80 66770 Removal of inner eye lesion 14.94 70.00 $1,045.80 66820 Incision secondary cataract 11.16 70.00 $781.20 66821 After cataract laser surgery 9.33 70.00 $653.10 66825 Reposition intraocular lens 21.52 70.00 $1,506.40 66830 Removal of lens lesion 20.22 70.00 $1,415.40 66840 Removal of lens material 19.74 70.00 $1,381.80 66850 Removal of lens material 22.47 70.00 $1,572.90 66852 Removal of lens material 23.93 70.00 $1,675.10 66920 Extraction of lens 21.38 70.00 $1,496.60 66930 Extraction of lens 24.24 70.00 $1,696.80 66940 Extraction of lens 22.17 70.00 $1,551.90 66982 Cataract surgery complex 22.54 70.00 $1,577.80 66983 Cataract surg w/iol 1 stage 21.02 70.00 $1,471.40 66984 Cataract surg w/iol 1 stage 18.14 70.00 $1,269.80 66985 Insert lens prosthesis 21.82 70.00 $1,527.40 66986 Exchange lens prosthesis 25.76 70.00 $1,803.20 66990 Ophthalmic endoscope add-on 2.57 70.00 $179.90 66999 Eye surgery procedure 0.00 70.00 $0.00 67005 Partial removal of eye fluid 13.39 70.00 $937.30 67010 Partial removal of eye fluid 15.38 70.00 $1,076.60 67015 Release of eye fluid 16.44 70.00 $1,150.80 67025 Replace eye fluid 20.54 70.00 $1,437.80 67027 Implant eye drug system 24.16 70.00 $1,691.20 67028 Injection eye drug 2.89 70.00 $202.30 67030 Incise inner eye strands 15.08 70.00 $1,055.60 67031 Laser surgery eye strands 11.00 70.00 $770.00 67036 Removal of inner eye fluid 25.54 70.00 $1,787.80 67039 Laser treatment of retina 27.37 70.00 $1,915.90 67040 Laser treatment of retina 29.59 70.00 $2,071.30 67041 Vit for macular pucker 32.66 70.00 $2,286.20 67042 Vit for macular hole 32.69 70.00 $2,288.30 67043 Vit for membrane dissect 34.52 70.00 $2,416.40 67101 Repair detached retina crtx 9.28 70.00 $649.60 67105 Repair detached retina pc 8.40 70.00 $588.00 67107 Repair detached retina 32.12 70.00 $2,248.40 67108 Repair detached retina 34.06 70.00 $2,384.20 67110 Repair detached retina 24.82 70.00 $1,737.40 67113 Repair retinal detach cplx 38.01 70.00 $2,660.70 67115 Release encircling material 14.17 70.00 $991.90 67120 Remove eye implant material 18.60 70.00 $1,302.00 67121 Remove eye implant material 25.75 70.00 $1,802.50 67141 Treatment of retina 14.82 70.00 $1,037.40 67145 Treatment of retina 14.91 70.00 $1,043.70 67208 Treatment of retinal lesion 16.98 70.00 $1,188.60 67210 Treatment of retinal lesion 14.68 70.00 $1,027.60 67218 Treatment of retinal lesion 39.25 70.00 $2,747.50 67220 Treatment of choroid lesion 15.12 70.00 $1,058.40 67221 Ocular photodynamic ther 8.12 70.00 $568.40 67225 Eye photodynamic ther add-on 0.84 70.00 $58.80 67227 Dstrj extensive retinopathy 8.21 70.00 $574.70 67228 Treatment x10sv retinopathy 9.65 70.00 $675.50 67229 Tr retinal les preterm inf 33.06 70.00 $2,314.20 67250 Reinforce eye wall 22.11 70.00 $1,547.70 67255 Reinforce/graft eye wall 19.37 70.00 $1,355.90 67299 Eye surgery procedure 0.00 70.00 $0.00 67311 Revise eye muscle 16.94 70.00 $1,185.80 67312 Revise two eye muscles 20.17 70.00 $1,411.90 67314 Revise eye muscle 19.06 70.00 $1,334.20 67316 Revise two eye muscles 22.72 70.00 $1,590.40 67318 Revise eye muscle(s) 20.00 70.00 $1,400.00 67320 Revise eye muscle(s) add-on 9.17 70.00 $641.90 67331 Eye surgery follow-up add-on 8.71 70.00 $609.70 67332 Rerevise eye muscles add-on 9.45 70.00 $661.50 67334 Revise eye muscle w/suture 8.58 70.00 $600.60 67335 Eye suture during surgery 4.23 70.00 $296.10 67340 Revise eye muscle add-on 10.20 70.00 $714.00 67343 Release eye tissue 18.54 70.00 $1,297.80 67345 Destroy nerve of eye muscle 6.87 70.00 $480.90 67346 Biopsy eye muscle 5.51 70.00 $385.70 67399 Unlisted px extraocular musc 0.00 70.00 $0.00 67400 Explore/biopsy eye socket 26.33 70.00 $1,843.10 67405 Explore/drain eye socket 22.43 70.00 $1,570.10 67412 Explore/treat eye socket 24.09 70.00 $1,686.30 67413 Explore/treat eye socket 24.19 70.00 $1,693.30 67414 Explr/decompress eye socket 37.60 70.00 $2,632.00 67415 Aspiration orbital contents 2.99 70.00 $209.30 67420 Explore/treat eye socket 45.88 70.00 $3,211.60 67430 Explore/treat eye socket 35.02 70.00 $2,451.40 67440 Explore/drain eye socket 34.14 70.00 $2,389.80 67445 Explr/decompress eye socket 39.74 70.00 $2,781.80 67450 Explore/biopsy eye socket 35.40 70.00 $2,478.00 67500 Inject/treat eye socket 2.22 70.00 $155.40 67505 Inject/treat eye socket 2.51 70.00 $175.70 67515 Inject/treat eye socket 2.75 70.00 $192.50 67550 Insert eye socket implant 27.31 70.00 $1,911.70 67560 Revise eye socket implant 27.98 70.00 $1,958.60 67570 Decompress optic nerve 33.06 70.00 $2,314.20 67599 Orbit surgery procedure 0.00 70.00 $0.00 67700 Drainage of eyelid abscess 7.56 70.00 $529.20 67710 Incision of eyelid 6.29 70.00 $440.30 67715 Incision of eyelid fold 6.75 70.00 $472.50 67800 Remove eyelid lesion 3.58 70.00 $250.60 67801 Remove eyelid lesions 4.58 70.00 $320.60 67805 Remove eyelid lesions 5.69 70.00 $398.30 67808 Remove eyelid lesion(s) 10.44 70.00 $730.80 67810 Biopsy eyelid & lid margin 4.87 70.00 $340.90 67820 Revise eyelashes 1.42 70.00 $99.40 67825 Revise eyelashes 3.63 70.00 $254.10 67830 Revise eyelashes 7.49 70.00 $524.30 67835 Revise eyelashes 12.45 70.00 $871.50 67840 Remove eyelid lesion 7.76 70.00 $543.20 67850 Treat eyelid lesion 6.08 70.00 $425.60 67875 Closure of eyelid by suture 4.84 70.00 $338.80 67880 Revision of eyelid 12.95 70.00 $906.50 67882 Revision of eyelid 15.94 70.00 $1,115.80 67900 Repair brow defect 18.11 70.00 $1,267.70 67901 Repair eyelid defect 21.39 70.00 $1,497.30 67902 Repair eyelid defect 20.51 70.00 $1,435.70 67903 Repair eyelid defect 16.78 70.00 $1,174.60 67904 Repair eyelid defect 20.71 70.00 $1,449.70 67906 Repair eyelid defect 14.42 70.00 $1,009.40 67908 Repair eyelid defect 13.94 70.00 $975.80 67909 Revise eyelid defect 15.16 70.00 $1,061.20 67911 Revise eyelid defect 15.96 70.00 $1,117.20 67912 Correction eyelid w/implant 24.85 70.00 $1,739.50 67914 Repair eyelid defect 13.26 70.00 $928.20 67915 Repair eyelid defect 8.24 70.00 $576.80 67916 Repair eyelid defect 16.73 70.00 $1,171.10 67917 Repair eyelid defect 17.03 70.00 $1,192.10 67921 Repair eyelid defect 12.98 70.00 $908.60 67922 Repair eyelid defect 8.17 70.00 $571.90 67923 Repair eyelid defect 16.70 70.00 $1,169.00 67924 Repair eyelid defect 17.80 70.00 $1,246.00 67930 Repair eyelid wound 10.30 70.00 $721.00 67935 Repair eyelid wound 16.81 70.00 $1,176.70 67938 Remove eyelid foreign body 6.87 70.00 $480.90 67950 Revision of eyelid 16.19 70.00 $1,133.30 67961 Revision of eyelid 16.24 70.00 $1,136.80 67966 Revision of eyelid 21.73 70.00 $1,521.10 67971 Reconstruction of eyelid 20.53 70.00 $1,437.10 67973 Reconstruction of eyelid 26.42 70.00 $1,849.40 67974 Reconstruction of eyelid 26.35 70.00 $1,844.50 67975 Reconstruction of eyelid 19.42 70.00 $1,359.40 67999 Revision of eyelid 0.00 70.00 $0.00 68020 Incise/drain eyelid lining 3.38 70.00 $236.60 68040 Treatment of eyelid lesions 1.75 70.00 $122.50 68100 Biopsy of eyelid lining 4.79 70.00 $335.30 68110 Remove eyelid lining lesion 6.36 70.00 $445.20 68115 Remove eyelid lining lesion 8.78 70.00 $614.60 68130 Remove eyelid lining lesion 15.21 70.00 $1,064.70 68135 Remove eyelid lining lesion 4.43 70.00 $310.10 68200 Treat eyelid by injection 1.17 70.00 $81.90 68320 Revise/graft eyelid lining 20.46 70.00 $1,432.20 68325 Revise/graft eyelid lining 18.68 70.00 $1,307.60 68326 Revise/graft eyelid lining 18.32 70.00 $1,282.40 68328 Revise/graft eyelid lining 20.11 70.00 $1,407.70 68330 Revise eyelid lining 17.07 70.00 $1,194.90 68335 Revise/graft eyelid lining 18.39 70.00 $1,287.30 68340 Separate eyelid adhesions 15.38 70.00 $1,076.60 68360 Revise eyelid lining 15.03 70.00 $1,052.10 68362 Revise eyelid lining 18.62 70.00 $1,303.40 68371 Harvest eye tissue alograft 11.71 70.00 $819.70 68399 Eyelid lining surgery 0.00 70.00 $0.00 68400 Incise/drain tear gland 8.00 70.00 $560.00 68420 Incise/drain tear sac 9.05 70.00 $633.50 68440 Incise tear duct opening 2.88 70.00 $201.60 68500 Removal of tear gland 27.74 70.00 $1,941.80 68505 Partial removal tear gland 27.48 70.00 $1,923.60 68510 Biopsy of tear gland 12.56 70.00 $879.20 68520 Removal of tear sac 19.47 70.00 $1,362.90 68525 Biopsy of tear sac 7.52 70.00 $526.40 68530 Clearance of tear duct 12.06 70.00 $844.20 68540 Remove tear gland lesion 26.34 70.00 $1,843.80 68550 Remove tear gland lesion 31.56 70.00 $2,209.20 68700 Repair tear ducts 17.13 70.00 $1,199.10 68705 Revise tear duct opening 6.68 70.00 $467.60 68720 Create tear sac drain 21.46 70.00 $1,502.20 68745 Create tear duct drain 21.54 70.00 $1,507.80 68750 Create tear duct drain 22.30 70.00 $1,561.00 68760 Close tear duct opening 5.68 70.00 $397.60 68761 Close tear duct opening 4.17 70.00 $291.90 68770 Close tear system fistula 17.86 70.00 $1,250.20 68801 Dilate tear duct opening 2.50 70.00 $175.00 68810 Probe nasolacrimal duct 4.45 70.00 $311.50 68811 Probe nasolacrimal duct 3.87 70.00 $270.90 68815 Probe nasolacrimal duct 11.21 70.00 $784.70 68816 Probe nl duct w/balloon 18.20 70.00 $1,274.00 68840 Explore/irrigate tear ducts 3.61 70.00 $252.70 68850 Injection for tear sac x-ray 1.75 70.00 $122.50 68899 Tear duct system surgery 0.00 70.00 $0.00 69000 Drain external ear lesion 5.32 70.00 $372.40 69005 Drain external ear lesion 6.10 70.00 $427.00 69020 Drain outer ear canal lesion 6.58 70.00 $460.60 69090 Pierce earlobes 0.00 70.00 $0.00 69100 Biopsy of external ear 2.86 70.00 $200.20 69105 Biopsy of external ear canal 3.97 70.00 $277.90 69110 Remove external ear partial 13.04 70.00 $912.80 69120 Removal of external ear 11.60 70.00 $812.00 69140 Remove ear canal lesion(s) 24.99 70.00 $1,749.30 69145 Remove ear canal lesion(s) 11.24 70.00 $786.80 69150 Extensive ear canal surgery 29.96 70.00 $2,097.20 69155 Extensive ear/neck surgery 47.72 70.00 $3,340.40 69200 Clear outer ear canal 2.35 70.00 $164.50 69205 Clear outer ear canal 2.90 70.00 $203.00 69209 Remove impacted ear wax uni 0.36 70.00 $25.20 69210 Remove impacted ear wax uni 1.39 70.00 $97.30 69220 Clean out mastoid cavity 2.56 70.00 $179.20 69222 Clean out mastoid cavity 6.22 70.00 $435.40 69300 Revise external ear 16.88 70.00 $1,181.60 69310 Rebuild outer ear canal 31.16 70.00 $2,181.20 69320 Rebuild outer ear canal 43.54 70.00 $3,047.80 69399 Outer ear surgery procedure 0.00 70.00 $0.00 69420 Incision of eardrum 5.42 70.00 $379.40 69421 Incision of eardrum 4.25 70.00 $297.50 69424 Remove ventilating tube 3.61 70.00 $252.70 69433 Create eardrum opening 5.74 70.00 $401.80 69436 Create eardrum opening 4.58 70.00 $320.60 69440 Exploration of middle ear 19.67 70.00 $1,376.90 69450 Eardrum revision 15.56 70.00 $1,089.20 69501 Mastoidectomy 20.97 70.00 $1,467.90 69502 Mastoidectomy 27.92 70.00 $1,954.40 69505 Remove mastoid structures 34.39 70.00 $2,407.30 69511 Extensive mastoid surgery 35.26 70.00 $2,468.20 69530 Extensive mastoid surgery 47.77 70.00 $3,343.90 69535 Remove part of temporal bone 77.15 70.00 $5,400.50 69540 Remove ear lesion 5.92 70.00 $414.40 69550 Remove ear lesion 29.73 70.00 $2,081.10 69552 Remove ear lesion 44.58 70.00 $3,120.60 69554 Remove ear lesion 72.16 70.00 $5,051.20 69601 Mastoid surgery revision 29.91 70.00 $2,093.70 69602 Mastoid surgery revision 31.24 70.00 $2,186.80 69603 Mastoid surgery revision 36.22 70.00 $2,535.40 69604 Mastoid surgery revision 31.80 70.00 $2,226.00 69605 Mastoid surgery revision 47.97 70.00 $3,357.90 69610 Repair of eardrum 10.93 70.00 $765.10 69620 Repair of eardrum 19.70 70.00 $1,379.00 69631 Repair eardrum structures 25.26 70.00 $1,768.20 69632 Rebuild eardrum structures 30.81 70.00 $2,156.70 69633 Rebuild eardrum structures 29.86 70.00 $2,090.20 69635 Repair eardrum structures 35.34 70.00 $2,473.80 69636 Rebuild eardrum structures 39.43 70.00 $2,760.10 69637 Rebuild eardrum structures 40.04 70.00 $2,802.80 69641 Revise middle ear & mastoid 29.77 70.00 $2,083.90 69642 Revise middle ear & mastoid 38.19 70.00 $2,673.30 69643 Revise middle ear & mastoid 34.99 70.00 $2,449.30 69644 Revise middle ear & mastoid 42.25 70.00 $2,957.50 69645 Revise middle ear & mastoid 41.53 70.00 $2,907.10 69646 Revise middle ear & mastoid 44.11 70.00 $3,087.70 69650 Release middle ear bone 23.08 70.00 $1,615.60 69660 Revise middle ear bone 26.50 70.00 $1,855.00 69661 Revise middle ear bone 34.48 70.00 $2,413.60 69662 Revise middle ear bone 33.23 70.00 $2,326.10 69666 Repair middle ear structures 23.23 70.00 $1,626.10 69667 Repair middle ear structures 23.23 70.00 $1,626.10 69670 Remove mastoid air cells 27.16 70.00 $1,901.20 69676 Remove middle ear nerve 23.74 70.00 $1,661.80 69700 Close mastoid fistula 19.84 70.00 $1,388.80 69710 Implant/replace hearing aid 0.00 70.00 $0.00 69711 Remove/repair hearing aid 24.64 70.00 $1,724.80 69714 Implant temple bone w/stimul 30.85 70.00 $2,159.50 69715 Temple bne implnt w/stimulat 39.54 70.00 $2,767.80 69717 Temple bone implant revision 32.44 70.00 $2,270.80 69718 Revise temple bone implant 38.43 70.00 $2,690.10 69720 Release facial nerve 34.85 70.00 $2,439.50 69725 Release facial nerve 53.85 70.00 $3,769.50 69740 Repair facial nerve 34.21 70.00 $2,394.70 69745 Repair facial nerve 33.56 70.00 $2,349.20 69799 Middle ear surgery procedure 0.00 70.00 $0.00 69801 Incise inner ear 5.56 70.00 $389.20 69805 Explore inner ear 30.17 70.00 $2,111.90 69806 Explore inner ear 27.05 70.00 $1,893.50 69820 Establish inner ear window 23.92 70.00 $1,674.40 69840 Revise inner ear window 25.86 70.00 $1,810.20 69905 Remove inner ear 26.22 70.00 $1,835.40 69910 Remove inner ear & mastoid 29.30 70.00 $2,051.00 69915 Incise inner ear nerve 45.49 70.00 $3,184.30 69930 Implant cochlear device 35.05 70.00 $2,453.50 69949 Inner ear surgery procedure 0.00 70.00 $0.00 69950 Incise inner ear nerve 52.07 70.00 $3,644.90 69955 Release facial nerve 56.50 70.00 $3,955.00 69960 Release inner ear canal 55.17 70.00 $3,861.90 69970 Remove inner ear lesion 61.40 70.00 $4,298.00 69979 Temporal bone surgery 0.00 70.00 $0.00 69990 Microsurgery add-on 6.43 70.00 $450.10 70010 Contrast x-ray of brain 1.90 70.00 $133.00 70015 Contrast x-ray of brain 4.40 70.00 $308.00 70015 TC Contrast x-ray of brain 2.61 70.00 $182.70 70015 26 Contrast x-ray of brain 1.79 70.00 $125.30 70030 X-ray eye for foreign body 0.78 70.00 $54.60 70030 TC X-ray eye for foreign body 0.54 70.00 $37.80 70030 26 X-ray eye for foreign body 0.24 70.00 $16.80 7010F Pt info into recall system 0.00 70.00 $0.00 70100 X-ray exam of jaw <4views 0.93 70.00 $65.10 70100 TC X-ray exam of jaw <4views 0.67 70.00 $46.90 70100 26 X-ray exam of jaw <4views 0.26 70.00 $18.20 70110 X-ray exam of jaw 4/> views 1.07 70.00 $74.90 70110 TC X-ray exam of jaw 4/> views 0.71 70.00 $49.70 70110 26 X-ray exam of jaw 4/> views 0.36 70.00 $25.20 70120 X-ray exam of mastoids 0.95 70.00 $66.50 70120 TC X-ray exam of mastoids 0.69 70.00 $48.30 70120 26 X-ray exam of mastoids 0.26 70.00 $18.20 70130 X-ray exam of mastoids 1.54 70.00 $107.80 70130 TC X-ray exam of mastoids 1.05 70.00 $73.50 70130 26 X-ray exam of mastoids 0.49 70.00 $34.30 70134 X-ray exam of middle ear 1.46 70.00 $102.20 70134 TC X-ray exam of middle ear 0.96 70.00 $67.20 70134 26 X-ray exam of middle ear 0.50 70.00 $35.00 70140 X-ray exam of facial bones 0.84 70.00 $58.80 70140 TC X-ray exam of facial bones 0.54 70.00 $37.80 70140 26 X-ray exam of facial bones 0.30 70.00 $21.00 70150 X-ray exam of facial bones 1.17 70.00 $81.90 70150 TC X-ray exam of facial bones 0.79 70.00 $55.30 70150 26 X-ray exam of facial bones 0.38 70.00 $26.60 70160 X-ray exam of nasal bones 0.92 70.00 $64.40 70160 TC X-ray exam of nasal bones 0.67 70.00 $46.90 70160 26 X-ray exam of nasal bones 0.25 70.00 $17.50 70170 X-ray exam of tear duct 0.00 70.00 $0.00 70170 TC X-ray exam of tear duct 0.00 70.00 $0.00 70170 26 X-ray exam of tear duct 0.43 70.00 $30.10 70190 X-ray exam of eye sockets 1.00 70.00 $70.00 70190 TC X-ray exam of eye sockets 0.68 70.00 $47.60 70190 26 X-ray exam of eye sockets 0.32 70.00 $22.40 7020F Mammo assess cat in dbase 0.00 70.00 $0.00 70200 X-ray exam of eye sockets 1.19 70.00 $83.30 70200 TC X-ray exam of eye sockets 0.79 70.00 $55.30 70200 26 X-ray exam of eye sockets 0.40 70.00 $28.00 70210 X-ray exam of sinuses 0.84 70.00 $58.80 70210 TC X-ray exam of sinuses 0.59 70.00 $41.30 70210 26 X-ray exam of sinuses 0.25 70.00 $17.50 70220 X-ray exam of sinuses 1.06 70.00 $74.20 70220 TC X-ray exam of sinuses 0.70 70.00 $49.00 70220 26 X-ray exam of sinuses 0.36 70.00 $25.20 70240 X-ray exam pituitary saddle 0.85 70.00 $59.50 70240 TC X-ray exam pituitary saddle 0.57 70.00 $39.90 70240 26 X-ray exam pituitary saddle 0.28 70.00 $19.60 7025F Pt infosys alarm 4 nxt mammo 0.00 70.00 $0.00 70250 X-ray exam of skull 1.02 70.00 $71.40 70250 TC X-ray exam of skull 0.66 70.00 $46.20 70250 26 X-ray exam of skull 0.36 70.00 $25.20 70260 X-ray exam of skull 1.29 70.00 $90.30 70260 TC X-ray exam of skull 0.79 70.00 $55.30 70260 26 X-ray exam of skull 0.50 70.00 $35.00 70300 X-ray exam of teeth 0.42 70.00 $29.40 70300 TC X-ray exam of teeth 0.25 70.00 $17.50 70300 26 X-ray exam of teeth 0.17 70.00 $11.90 70310 X-ray exam of teeth 1.02 70.00 $71.40 70310 TC X-ray exam of teeth 0.79 70.00 $55.30 70310 26 X-ray exam of teeth 0.23 70.00 $16.10 70320 Full mouth x-ray of teeth 1.50 70.00 $105.00 70320 TC Full mouth x-ray of teeth 1.15 70.00 $80.50 70320 26 Full mouth x-ray of teeth 0.35 70.00 $24.50 70328 X-ray exam of jaw joint 0.86 70.00 $60.20 70328 TC X-ray exam of jaw joint 0.60 70.00 $42.00 70328 26 X-ray exam of jaw joint 0.26 70.00 $18.20 70330 X-ray exam of jaw joints 1.36 70.00 $95.20 70330 TC X-ray exam of jaw joints 1.00 70.00 $70.00 70330 26 X-ray exam of jaw joints 0.36 70.00 $25.20 70332 X-ray exam of jaw joint 2.26 70.00 $158.20 70332 TC X-ray exam of jaw joint 1.38 70.00 $96.60 70332 26 X-ray exam of jaw joint 0.88 70.00 $61.60 70336 Magnetic image jaw joint 9.08 70.00 $635.60 70336 TC Magnetic image jaw joint 6.98 70.00 $488.60 70336 26 Magnetic image jaw joint 2.10 70.00 $147.00 70350 X-ray head for orthodontia 0.56 70.00 $39.20 70350 TC X-ray head for orthodontia 0.27 70.00 $18.90 70350 26 X-ray head for orthodontia 0.29 70.00 $20.30 70355 Panoramic x-ray of jaws 0.59 70.00 $41.30 70355 TC Panoramic x-ray of jaws 0.27 70.00 $18.90 70355 26 Panoramic x-ray of jaws 0.32 70.00 $22.40 70360 X-ray exam of neck 0.79 70.00 $55.30 70360 TC X-ray exam of neck 0.55 70.00 $38.50 70360 26 X-ray exam of neck 0.24 70.00 $16.80 70370 Throat x-ray & fluoroscopy 2.17 70.00 $151.90 70370 TC Throat x-ray & fluoroscopy 1.71 70.00 $119.70 70370 26 Throat x-ray & fluoroscopy 0.46 70.00 $32.20 70371 Speech evaluation complex 2.54 70.00 $177.80 70371 TC Speech evaluation complex 1.35 70.00 $94.50 70371 26 Speech evaluation complex 1.19 70.00 $83.30 70380 X-ray exam of salivary gland 1.01 70.00 $70.70 70380 TC X-ray exam of salivary gland 0.75 70.00 $52.50 70380 26 X-ray exam of salivary gland 0.26 70.00 $18.20 70390 X-ray exam of salivary duct 2.64 70.00 $184.80 70390 TC X-ray exam of salivary duct 2.10 70.00 $147.00 70390 26 X-ray exam of salivary duct 0.54 70.00 $37.80 70450 Ct head/brain w/o dye 3.28 70.00 $229.60 70450 TC Ct head/brain w/o dye 2.06 70.00 $144.20 70450 26 Ct head/brain w/o dye 1.22 70.00 $85.40 70460 Ct head/brain w/dye 4.58 70.00 $320.60 70460 TC Ct head/brain w/dye 2.97 70.00 $207.90 70460 26 Ct head/brain w/dye 1.61 70.00 $112.70 70470 Ct head/brain w/o & w/dye 5.42 70.00 $379.40 70470 TC Ct head/brain w/o & w/dye 3.60 70.00 $252.00 70470 26 Ct head/brain w/o & w/dye 1.82 70.00 $127.40 70480 Ct orbit/ear/fossa w/o dye 6.58 70.00 $460.60 70480 TC Ct orbit/ear/fossa w/o dye 4.75 70.00 $332.50 70480 26 Ct orbit/ear/fossa w/o dye 1.83 70.00 $128.10 70481 Ct orbit/ear/fossa w/dye 7.78 70.00 $544.60 70481 TC Ct orbit/ear/fossa w/dye 5.81 70.00 $406.70 70481 26 Ct orbit/ear/fossa w/dye 1.97 70.00 $137.90 70482 Ct orbit/ear/fossa w/o&w/dye 8.49 70.00 $594.30 70482 TC Ct orbit/ear/fossa w/o&w/dye 6.43 70.00 $450.10 70482 26 Ct orbit/ear/fossa w/o&w/dye 2.06 70.00 $144.20 70486 Ct maxillofacial w/o dye 3.93 70.00 $275.10 70486 TC Ct maxillofacial w/o dye 2.71 70.00 $189.70 70486 26 Ct maxillofacial w/o dye 1.22 70.00 $85.40 70487 Ct maxillofacial w/dye 4.73 70.00 $331.10 70487 TC Ct maxillofacial w/dye 3.12 70.00 $218.40 70487 26 Ct maxillofacial w/dye 1.61 70.00 $112.70 70488 Ct maxillofacial w/o & w/dye 5.77 70.00 $403.90 70488 TC Ct maxillofacial w/o & w/dye 3.96 70.00 $277.20 70488 26 Ct maxillofacial w/o & w/dye 1.81 70.00 $126.70 70490 Ct soft tissue neck w/o dye 5.45 70.00 $381.50 70490 TC Ct soft tissue neck w/o dye 3.62 70.00 $253.40 70490 26 Ct soft tissue neck w/o dye 1.83 70.00 $128.10 70491 Ct soft tissue neck w/dye 6.65 70.00 $465.50 70491 TC Ct soft tissue neck w/dye 4.67 70.00 $326.90 70491 26 Ct soft tissue neck w/dye 1.98 70.00 $138.60 70492 Ct sft tsue nck w/o & w/dye 7.84 70.00 $548.80 70492 TC Ct sft tsue nck w/o & w/dye 5.77 70.00 $403.90 70492 26 Ct sft tsue nck w/o & w/dye 2.07 70.00 $144.90 70496 Ct angiography head 8.28 70.00 $579.60 70496 TC Ct angiography head 5.78 70.00 $404.60 70496 26 Ct angiography head 2.50 70.00 $175.00 70498 Ct angiography neck 8.26 70.00 $578.20 70498 TC Ct angiography neck 5.76 70.00 $403.20 70498 26 Ct angiography neck 2.50 70.00 $175.00 70540 Mri orbit/face/neck w/o dye 8.53 70.00 $597.10 70540 TC Mri orbit/face/neck w/o dye 6.61 70.00 $462.70 70540 26 Mri orbit/face/neck w/o dye 1.92 70.00 $134.40 70542 Mri orbit/face/neck w/dye 9.58 70.00 $670.60 70542 TC Mri orbit/face/neck w/dye 7.26 70.00 $508.20 70542 26 Mri orbit/face/neck w/dye 2.32 70.00 $162.40 70543 Mri orbt/fac/nck w/o &w/dye 11.76 70.00 $823.20 70543 TC Mri orbt/fac/nck w/o &w/dye 8.70 70.00 $609.00 70543 26 Mri orbt/fac/nck w/o &w/dye 3.06 70.00 $214.20 70544 Mr angiography head w/o dye 11.07 70.00 $774.90 70544 TC Mr angiography head w/o dye 9.35 70.00 $654.50 70544 26 Mr angiography head w/o dye 1.72 70.00 $120.40 70545 Mr angiography head w/dye 10.96 70.00 $767.20 70545 TC Mr angiography head w/dye 9.25 70.00 $647.50 70545 26 Mr angiography head w/dye 1.71 70.00 $119.70 70546 Mr angiograph head w/o&w/dye 16.89 70.00 $1,182.30 70546 TC Mr angiograph head w/o&w/dye 14.32 70.00 $1,002.40 70546 26 Mr angiograph head w/o&w/dye 2.57 70.00 $179.90 70547 Mr angiography neck w/o dye 11.12 70.00 $778.40 70547 TC Mr angiography neck w/o dye 9.40 70.00 $658.00 70547 26 Mr angiography neck w/o dye 1.72 70.00 $120.40 70548 Mr angiography neck w/dye 11.66 70.00 $816.20 70548 TC Mr angiography neck w/dye 9.94 70.00 $695.80 70548 26 Mr angiography neck w/dye 1.72 70.00 $120.40 70549 Mr angiograph neck w/o&w/dye 16.99 70.00 $1,189.30 70549 TC Mr angiograph neck w/o&w/dye 14.42 70.00 $1,009.40 70549 26 Mr angiograph neck w/o&w/dye 2.57 70.00 $179.90 70551 Mri brain stem w/o dye 6.52 70.00 $456.40 70551 TC Mri brain stem w/o dye 4.41 70.00 $308.70 70551 26 Mri brain stem w/o dye 2.11 70.00 $147.70 70552 Mri brain stem w/dye 9.04 70.00 $632.80 70552 TC Mri brain stem w/dye 6.49 70.00 $454.30 70552 26 Mri brain stem w/dye 2.55 70.00 $178.50 70553 Mri brain stem w/o & w/dye 10.66 70.00 $746.20 70553 TC Mri brain stem w/o & w/dye 7.39 70.00 $517.30 70553 26 Mri brain stem w/o & w/dye 3.27 70.00 $228.90 70554 Fmri brain by tech 12.69 70.00 $888.30 70554 TC Fmri brain by tech 9.66 70.00 $676.20 70554 26 Fmri brain by tech 3.03 70.00 $212.10 70555 Fmri brain by phys/psych 0.00 70.00 $0.00 70555 TC Fmri brain by phys/psych 0.00 70.00 $0.00 70555 26 Fmri brain by phys/psych 3.57 70.00 $249.90 70557 Mri brain w/o dye 0.00 70.00 $0.00 70557 TC Mri brain w/o dye 0.00 70.00 $0.00 70557 26 Mri brain w/o dye 4.19 70.00 $293.30 70558 Mri brain w/dye 0.00 70.00 $0.00 70558 TC Mri brain w/dye 0.00 70.00 $0.00 70558 26 Mri brain w/dye 4.57 70.00 $319.90 70559 Mri brain w/o & w/dye 0.00 70.00 $0.00 70559 TC Mri brain w/o & w/dye 0.00 70.00 $0.00 70559 26 Mri brain w/o & w/dye 4.63 70.00 $324.10 71010 Chest x-ray 1 view frontal 0.64 70.00 $44.80 71010 TC Chest x-ray 1 view frontal 0.38 70.00 $26.60 71010 26 Chest x-ray 1 view frontal 0.26 70.00 $18.20 71015 Chest x-ray stereo frontal 0.78 70.00 $54.60 71015 TC Chest x-ray stereo frontal 0.47 70.00 $32.90 71015 26 Chest x-ray stereo frontal 0.31 70.00 $21.70 71020 Chest x-ray 2vw frontal&latl 0.79 70.00 $55.30 71020 TC Chest x-ray 2vw frontal&latl 0.48 70.00 $33.60 71020 26 Chest x-ray 2vw frontal&latl 0.31 70.00 $21.70 71021 Chest x-ray frnt lat lordotc 0.96 70.00 $67.20 71021 TC Chest x-ray frnt lat lordotc 0.57 70.00 $39.90 71021 26 Chest x-ray frnt lat lordotc 0.39 70.00 $27.30 71022 Chest x-ray frnt lat oblique 1.17 70.00 $81.90 71022 TC Chest x-ray frnt lat oblique 0.70 70.00 $49.00 71022 26 Chest x-ray frnt lat oblique 0.47 70.00 $32.90 71023 Chest x-ray and fluoroscopy 1.79 70.00 $125.30 71023 TC Chest x-ray and fluoroscopy 1.25 70.00 $87.50 71023 26 Chest x-ray and fluoroscopy 0.54 70.00 $37.80 71030 Chest x-ray 4/> views 1.18 70.00 $82.60 71030 TC Chest x-ray 4/> views 0.73 70.00 $51.10 71030 26 Chest x-ray 4/> views 0.45 70.00 $31.50 71034 Chest x-ray&fluoro 4/> views 2.33 70.00 $163.10 71034 TC Chest x-ray&fluoro 4/> views 1.67 70.00 $116.90 71034 26 Chest x-ray&fluoro 4/> views 0.66 70.00 $46.20 71035 Chest x-ray special views 0.92 70.00 $64.40 71035 TC Chest x-ray special views 0.66 70.00 $46.20 71035 26 Chest x-ray special views 0.26 70.00 $18.20 71100 X-ray exam ribs uni 2 views 0.93 70.00 $65.10 71100 TC X-ray exam ribs uni 2 views 0.61 70.00 $42.70 71100 26 X-ray exam ribs uni 2 views 0.32 70.00 $22.40 71101 X-ray exam unilat ribs/chest 1.03 70.00 $72.10 71101 TC X-ray exam unilat ribs/chest 0.64 70.00 $44.80 71101 26 X-ray exam unilat ribs/chest 0.39 70.00 $27.30 71110 X-ray exam ribs bil 3 views 1.06 70.00 $74.20 71110 TC X-ray exam ribs bil 3 views 0.67 70.00 $46.90 71110 26 X-ray exam ribs bil 3 views 0.39 70.00 $27.30 71111 X-ray exam ribs/chest4/> vws 1.36 70.00 $95.20 71111 TC X-ray exam ribs/chest4/> vws 0.89 70.00 $62.30 71111 26 X-ray exam ribs/chest4/> vws 0.47 70.00 $32.90 71120 X-ray exam breastbone 2/>vws 0.83 70.00 $58.10 71120 TC X-ray exam breastbone 2/>vws 0.54 70.00 $37.80 71120 26 X-ray exam breastbone 2/>vws 0.29 70.00 $20.30 71130 X-ray strenoclavic jt 3/>vws 1.01 70.00 $70.70 71130 TC X-ray strenoclavic jt 3/>vws 0.69 70.00 $48.30 71130 26 X-ray strenoclavic jt 3/>vws 0.32 70.00 $22.40 71250 Ct thorax w/o dye 5.10 70.00 $357.00 71250 TC Ct thorax w/o dye 3.64 70.00 $254.80 71250 26 Ct thorax w/o dye 1.46 70.00 $102.20 71260 Ct thorax w/dye 6.48 70.00 $453.60 71260 TC Ct thorax w/dye 4.70 70.00 $329.00 71260 26 Ct thorax w/dye 1.78 70.00 $124.60 71270 Ct thorax w/o & w/dye 7.76 70.00 $543.20 71270 TC Ct thorax w/o & w/dye 5.79 70.00 $405.30 71270 26 Ct thorax w/o & w/dye 1.97 70.00 $137.90 71275 Ct angiography chest 8.48 70.00 $593.60 71275 TC Ct angiography chest 5.88 70.00 $411.60 71275 26 Ct angiography chest 2.60 70.00 $182.00 71550 Mri chest w/o dye 11.72 70.00 $820.40 71550 TC Mri chest w/o dye 9.64 70.00 $674.80 71550 26 Mri chest w/o dye 2.08 70.00 $145.60 71551 Mri chest w/dye 13.03 70.00 $912.10 71551 TC Mri chest w/dye 10.56 70.00 $739.20 71551 26 Mri chest w/dye 2.47 70.00 $172.90 71552 Mri chest w/o & w/dye 16.36 70.00 $1,145.20 71552 TC Mri chest w/o & w/dye 13.13 70.00 $919.10 71552 26 Mri chest w/o & w/dye 3.23 70.00 $226.10 71555 Mri angio chest w or w/o dye 11.24 70.00 $786.80 71555 TC Mri angio chest w or w/o dye 8.69 70.00 $608.30 71555 26 Mri angio chest w or w/o dye 2.55 70.00 $178.50 72020 X-ray exam of spine 1 view 0.62 70.00 $43.40 72020 TC X-ray exam of spine 1 view 0.40 70.00 $28.00 72020 26 X-ray exam of spine 1 view 0.22 70.00 $15.40 72040 X-ray exam neck spine 2-3 vw 0.93 70.00 $65.10 72040 TC X-ray exam neck spine 2-3 vw 0.61 70.00 $42.70 72040 26 X-ray exam neck spine 2-3 vw 0.32 70.00 $22.40 72050 X-ray exam neck spine 4/5vws 1.28 70.00 $89.60 72050 TC X-ray exam neck spine 4/5vws 0.83 70.00 $58.10 72050 26 X-ray exam neck spine 4/5vws 0.45 70.00 $31.50 72052 X-ray exam neck spine 6/>vws 1.58 70.00 $110.60 72052 TC X-ray exam neck spine 6/>vws 1.06 70.00 $74.20 72052 26 X-ray exam neck spine 6/>vws 0.52 70.00 $36.40 72070 X-ray exam thorac spine 2vws 0.96 70.00 $67.20 72070 TC X-ray exam thorac spine 2vws 0.64 70.00 $44.80 72070 26 X-ray exam thorac spine 2vws 0.32 70.00 $22.40 72072 X-ray exam thorac spine 3vws 0.97 70.00 $67.90 72072 TC X-ray exam thorac spine 3vws 0.66 70.00 $46.20 72072 26 X-ray exam thorac spine 3vws 0.31 70.00 $21.70 72074 X-ray exam thorac spine4/>vw 1.10 70.00 $77.00 72074 TC X-ray exam thorac spine4/>vw 0.79 70.00 $55.30 72074 26 X-ray exam thorac spine4/>vw 0.31 70.00 $21.70 72080 X-ray exam thoracolmb 2/> vw 0.86 70.00 $60.20 72080 TC X-ray exam trunk spine 2 vws 0.55 70.00 $38.50 72080 26 X-ray exam trunk spine 2 vws 0.31 70.00 $21.70 72081 X-ray exam entire spi 1 vw 1.10 70.00 $77.00 72081 TC X-ray exam entire spi 1 vw 0.72 70.00 $50.40 72081 26 X-ray exam entire spi 1 vw 0.38 70.00 $26.60 72082 X-ray exam entire spi 2/3 vw 1.76 70.00 $123.20 72082 TC X-ray exam entire spi 2/3 vw 1.30 70.00 $91.00 72082 26 X-ray exam entire spi 2/3 vw 0.46 70.00 $32.20 72083 X-ray exam entire spi 4/5 vw 1.91 70.00 $133.70 72083 TC X-ray exam entire spi 4/5 vw 1.41 70.00 $98.70 72083 26 X-ray exam entire spi 4/5 vw 0.50 70.00 $35.00 72084 X-ray exam entire spi 6/> vw 2.27 70.00 $158.90 72084 TC X-ray exam entire spi 6/> vw 1.69 70.00 $118.30 72084 26 X-ray exam entire spi 6/> vw 0.58 70.00 $40.60 72100 X-ray exam l-s spine 2/3 vws 0.99 70.00 $69.30 72100 TC X-ray exam l-s spine 2/3 vws 0.67 70.00 $46.90 72100 26 X-ray exam l-s spine 2/3 vws 0.32 70.00 $22.40 72110 X-ray exam l-2 spine 4/>vws 1.38 70.00 $96.60 72110 TC X-ray exam l-2 spine 4/>vws 0.93 70.00 $65.10 72110 26 X-ray exam l-2 spine 4/>vws 0.45 70.00 $31.50 72114 X-ray exam l-s spine bending 1.75 70.00 $122.50 72114 TC X-ray exam l-s spine bending 1.28 70.00 $89.60 72114 26 X-ray exam l-s spine bending 0.47 70.00 $32.90 72120 X-ray bend only l-s spine 1.14 70.00 $79.80 72120 TC X-ray bend only l-s spine 0.82 70.00 $57.40 72120 26 X-ray bend only l-s spine 0.32 70.00 $22.40 72125 Ct neck spine w/o dye 5.22 70.00 $365.40 72125 TC Ct neck spine w/o dye 3.69 70.00 $258.30 72125 26 Ct neck spine w/o dye 1.53 70.00 $107.10 72126 Ct neck spine w/dye 6.45 70.00 $451.50 72126 TC Ct neck spine w/dye 4.71 70.00 $329.70 72126 26 Ct neck spine w/dye 1.74 70.00 $121.80 72127 Ct neck spine w/o & w/dye 7.62 70.00 $533.40 72127 TC Ct neck spine w/o & w/dye 5.81 70.00 $406.70 72127 26 Ct neck spine w/o & w/dye 1.81 70.00 $126.70 72128 Ct chest spine w/o dye 5.10 70.00 $357.00 72128 TC Ct chest spine w/o dye 3.67 70.00 $256.90 72128 26 Ct chest spine w/o dye 1.43 70.00 $100.10 72129 Ct chest spine w/dye 6.48 70.00 $453.60 72129 TC Ct chest spine w/dye 4.73 70.00 $331.10 72129 26 Ct chest spine w/dye 1.75 70.00 $122.50 72130 Ct chest spine w/o & w/dye 7.65 70.00 $535.50 72130 TC Ct chest spine w/o & w/dye 5.84 70.00 $408.80 72130 26 Ct chest spine w/o & w/dye 1.81 70.00 $126.70 72131 Ct lumbar spine w/o dye 5.08 70.00 $355.60 72131 TC Ct lumbar spine w/o dye 3.65 70.00 $255.50 72131 26 Ct lumbar spine w/o dye 1.43 70.00 $100.10 72132 Ct lumbar spine w/dye 6.44 70.00 $450.80 72132 TC Ct lumbar spine w/dye 4.70 70.00 $329.00 72132 26 Ct lumbar spine w/dye 1.74 70.00 $121.80 72133 Ct lumbar spine w/o & w/dye 7.61 70.00 $532.70 72133 TC Ct lumbar spine w/o & w/dye 5.80 70.00 $406.00 72133 26 Ct lumbar spine w/o & w/dye 1.81 70.00 $126.70 72141 Mri neck spine w/o dye 6.34 70.00 $443.80 72141 TC Mri neck spine w/o dye 4.22 70.00 $295.40 72141 26 Mri neck spine w/o dye 2.12 70.00 $148.40 72142 Mri neck spine w/dye 9.18 70.00 $642.60 72142 TC Mri neck spine w/dye 6.63 70.00 $464.10 72142 26 Mri neck spine w/dye 2.55 70.00 $178.50 72146 Mri chest spine w/o dye 6.35 70.00 $444.50 72146 TC Mri chest spine w/o dye 4.23 70.00 $296.10 72146 26 Mri chest spine w/o dye 2.12 70.00 $148.40 72147 Mri chest spine w/dye 9.12 70.00 $638.40 72147 TC Mri chest spine w/dye 6.57 70.00 $459.90 72147 26 Mri chest spine w/dye 2.55 70.00 $178.50 72148 Mri lumbar spine w/o dye 6.32 70.00 $442.40 72148 TC Mri lumbar spine w/o dye 4.19 70.00 $293.30 72148 26 Mri lumbar spine w/o dye 2.13 70.00 $149.10 72149 Mri lumbar spine w/dye 9.08 70.00 $635.60 72149 TC Mri lumbar spine w/dye 6.52 70.00 $456.40 72149 26 Mri lumbar spine w/dye 2.56 70.00 $179.20 72156 Mri neck spine w/o & w/dye 10.73 70.00 $751.10 72156 TC Mri neck spine w/o & w/dye 7.46 70.00 $522.20 72156 26 Mri neck spine w/o & w/dye 3.27 70.00 $228.90 72157 Mri chest spine w/o & w/dye 10.75 70.00 $752.50 72157 TC Mri chest spine w/o & w/dye 7.48 70.00 $523.60 72157 26 Mri chest spine w/o & w/dye 3.27 70.00 $228.90 72158 Mri lumbar spine w/o & w/dye 10.69 70.00 $748.30 72158 TC Mri lumbar spine w/o & w/dye 7.41 70.00 $518.70 72158 26 Mri lumbar spine w/o & w/dye 3.28 70.00 $229.60 72159 Mr angio spine w/o&w/dye 11.75 70.00 $822.50 72159 TC Mr angio spine w/o&w/dye 9.17 70.00 $641.90 72159 26 Mr angio spine w/o&w/dye 2.58 70.00 $180.60 72170 X-ray exam of pelvis 0.90 70.00 $63.00 72170 TC X-ray exam of pelvis 0.65 70.00 $45.50 72170 26 X-ray exam of pelvis 0.25 70.00 $17.50 72190 X-ray exam of pelvis 1.07 70.00 $74.90 72190 TC X-ray exam of pelvis 0.76 70.00 $53.20 72190 26 X-ray exam of pelvis 0.31 70.00 $21.70 72191 Ct angiograph pelv w/o&w/dye 8.64 70.00 $604.80 72191 TC Ct angiograph pelv w/o&w/dye 6.06 70.00 $424.20 72191 26 Ct angiograph pelv w/o&w/dye 2.58 70.00 $180.60 72192 Ct pelvis w/o dye 4.13 70.00 $289.10 72192 TC Ct pelvis w/o dye 2.57 70.00 $179.90 72192 26 Ct pelvis w/o dye 1.56 70.00 $109.20 72193 Ct pelvis w/dye 6.38 70.00 $446.60 72193 TC Ct pelvis w/dye 4.72 70.00 $330.40 72193 26 Ct pelvis w/dye 1.66 70.00 $116.20 72194 Ct pelvis w/o & w/dye 7.34 70.00 $513.80 72194 TC Ct pelvis w/o & w/dye 5.60 70.00 $392.00 72194 26 Ct pelvis w/o & w/dye 1.74 70.00 $121.80 72195 Mri pelvis w/o dye 10.59 70.00 $741.30 72195 TC Mri pelvis w/o dye 8.50 70.00 $595.00 72195 26 Mri pelvis w/o dye 2.09 70.00 $146.30 72196 Mri pelvis w/dye 11.59 70.00 $811.30 72196 TC Mri pelvis w/dye 9.11 70.00 $637.70 72196 26 Mri pelvis w/dye 2.48 70.00 $173.60 72197 Mri pelvis w/o & w/dye 14.27 70.00 $998.90 72197 TC Mri pelvis w/o & w/dye 11.04 70.00 $772.80 72197 26 Mri pelvis w/o & w/dye 3.23 70.00 $226.10 72198 Mr angio pelvis w/o & w/dye 11.33 70.00 $793.10 72198 TC Mr angio pelvis w/o & w/dye 8.78 70.00 $614.60 72198 26 Mr angio pelvis w/o & w/dye 2.55 70.00 $178.50 72200 X-ray exam si joints 0.80 70.00 $56.00 72200 TC X-ray exam si joints 0.55 70.00 $38.50 72200 26 X-ray exam si joints 0.25 70.00 $17.50 72202 X-ray exam si joints 3/> vws 0.93 70.00 $65.10 72202 TC X-ray exam si joints 3/> vws 0.66 70.00 $46.20 72202 26 X-ray exam si joints 3/> vws 0.27 70.00 $18.90 72220 X-ray exam sacrum tailbone 0.79 70.00 $55.30 72220 TC X-ray exam sacrum tailbone 0.54 70.00 $37.80 72220 26 X-ray exam sacrum tailbone 0.25 70.00 $17.50 72240 Myelography neck spine 2.78 70.00 $194.60 72240 TC Myelography neck spine 1.49 70.00 $104.30 72240 26 Myelography neck spine 1.29 70.00 $90.30 72255 Myelography thoracic spine 2.79 70.00 $195.30 72255 TC Myelography thoracic spine 1.46 70.00 $102.20 72255 26 Myelography thoracic spine 1.33 70.00 $93.10 72265 Myelography l-s spine 2.61 70.00 $182.70 72265 TC Myelography l-s spine 1.43 70.00 $100.10 72265 26 Myelography l-s spine 1.18 70.00 $82.60 72270 Myelogphy 2/> spine regions 3.60 70.00 $252.00 72270 TC Myelogphy 2/> spine regions 1.69 70.00 $118.30 72270 26 Myelogphy 2/> spine regions 1.91 70.00 $133.70 72275 Epidurography 3.26 70.00 $228.20 72275 TC Epidurography 2.15 70.00 $150.50 72275 26 Epidurography 1.11 70.00 $77.70 72285 Discography cerv/thor spine 3.19 70.00 $223.30 72285 TC Discography cerv/thor spine 1.47 70.00 $102.90 72285 26 Discography cerv/thor spine 1.72 70.00 $120.40 72295 X-ray of lower spine disk 2.76 70.00 $193.20 72295 TC X-ray of lower spine disk 1.53 70.00 $107.10 72295 26 X-ray of lower spine disk 1.23 70.00 $86.10 73000 X-ray exam of collar bone 0.78 70.00 $54.60 73000 TC X-ray exam of collar bone 0.54 70.00 $37.80 73000 26 X-ray exam of collar bone 0.24 70.00 $16.80 73010 X-ray exam of shoulder blade 0.85 70.00 $59.50 73010 TC X-ray exam of shoulder blade 0.59 70.00 $41.30 73010 26 X-ray exam of shoulder blade 0.26 70.00 $18.20 73020 X-ray exam of shoulder 0.65 70.00 $45.50 73020 TC X-ray exam of shoulder 0.42 70.00 $29.40 73020 26 X-ray exam of shoulder 0.23 70.00 $16.10 73030 X-ray exam of shoulder 0.82 70.00 $57.40 73030 TC X-ray exam of shoulder 0.55 70.00 $38.50 73030 26 X-ray exam of shoulder 0.27 70.00 $18.90 73040 Contrast x-ray of shoulder 2.82 70.00 $197.40 73040 TC Contrast x-ray of shoulder 2.04 70.00 $142.80 73040 26 Contrast x-ray of shoulder 0.78 70.00 $54.60 73050 X-ray exam of shoulders 1.00 70.00 $70.00 73050 TC X-ray exam of shoulders 0.70 70.00 $49.00 73050 26 X-ray exam of shoulders 0.30 70.00 $21.00 73060 X-ray exam of humerus 0.82 70.00 $57.40 73060 TC X-ray exam of humerus 0.58 70.00 $40.60 73060 26 X-ray exam of humerus 0.24 70.00 $16.80 73070 X-ray exam of elbow 0.77 70.00 $53.90 73070 TC X-ray exam of elbow 0.54 70.00 $37.80 73070 26 X-ray exam of elbow 0.23 70.00 $16.10 73080 X-ray exam of elbow 0.88 70.00 $61.60 73080 TC X-ray exam of elbow 0.63 70.00 $44.10 73080 26 X-ray exam of elbow 0.25 70.00 $17.50 73085 Contrast x-ray of elbow 2.70 70.00 $189.00 73085 TC Contrast x-ray of elbow 1.88 70.00 $131.60 73085 26 Contrast x-ray of elbow 0.82 70.00 $57.40 73090 X-ray exam of forearm 0.73 70.00 $51.10 73090 TC X-ray exam of forearm 0.49 70.00 $34.30 73090 26 X-ray exam of forearm 0.24 70.00 $16.80 73092 X-ray exam of arm infant 0.78 70.00 $54.60 73092 TC X-ray exam of arm infant 0.55 70.00 $38.50 73092 26 X-ray exam of arm infant 0.23 70.00 $16.10 73100 X-ray exam of wrist 0.82 70.00 $57.40 73100 TC X-ray exam of wrist 0.58 70.00 $40.60 73100 26 X-ray exam of wrist 0.24 70.00 $16.80 73110 X-ray exam of wrist 1.00 70.00 $70.00 73110 TC X-ray exam of wrist 0.75 70.00 $52.50 73110 26 X-ray exam of wrist 0.25 70.00 $17.50 73115 Contrast x-ray of wrist 3.00 70.00 $210.00 73115 TC Contrast x-ray of wrist 2.19 70.00 $153.30 73115 26 Contrast x-ray of wrist 0.81 70.00 $56.70 73120 X-ray exam of hand 0.74 70.00 $51.80 73120 TC X-ray exam of hand 0.50 70.00 $35.00 73120 26 X-ray exam of hand 0.24 70.00 $16.80 73130 X-ray exam of hand 0.87 70.00 $60.90 73130 TC X-ray exam of hand 0.62 70.00 $43.40 73130 26 X-ray exam of hand 0.25 70.00 $17.50 73140 X-ray exam of finger(s) 0.89 70.00 $62.30 73140 TC X-ray exam of finger(s) 0.69 70.00 $48.30 73140 26 X-ray exam of finger(s) 0.20 70.00 $14.00 73200 Ct upper extremity w/o dye 5.07 70.00 $354.90 73200 TC Ct upper extremity w/o dye 3.64 70.00 $254.80 73200 26 Ct upper extremity w/o dye 1.43 70.00 $100.10 73201 Ct upper extremity w/dye 6.28 70.00 $439.60 73201 TC Ct upper extremity w/dye 4.62 70.00 $323.40 73201 26 Ct upper extremity w/dye 1.66 70.00 $116.20 73202 Ct uppr extremity w/o&w/dye 7.82 70.00 $547.40 73202 TC Ct uppr extremity w/o&w/dye 6.08 70.00 $425.60 73202 26 Ct uppr extremity w/o&w/dye 1.74 70.00 $121.80 73206 Ct angio upr extrm w/o&w/dye 9.27 70.00 $648.90 73206 TC Ct angio upr extrm w/o&w/dye 6.71 70.00 $469.70 73206 26 Ct angio upr extrm w/o&w/dye 2.56 70.00 $179.20 73218 Mri upper extremity w/o dye 10.31 70.00 $721.70 73218 TC Mri upper extremity w/o dye 8.37 70.00 $585.90 73218 26 Mri upper extremity w/o dye 1.94 70.00 $135.80 73219 Mri upper extremity w/dye 11.34 70.00 $793.80 73219 TC Mri upper extremity w/dye 9.02 70.00 $631.40 73219 26 Mri upper extremity w/dye 2.32 70.00 $162.40 73220 Mri uppr extremity w/o&w/dye 14.11 70.00 $987.70 73220 TC Mri uppr extremity w/o&w/dye 11.04 70.00 $772.80 73220 26 Mri uppr extremity w/o&w/dye 3.07 70.00 $214.90 73221 Mri joint upr extrem w/o dye 6.70 70.00 $469.00 73221 TC Mri joint upr extrem w/o dye 4.75 70.00 $332.50 73221 26 Mri joint upr extrem w/o dye 1.95 70.00 $136.50 73222 Mri joint upr extrem w/dye 10.67 70.00 $746.90 73222 TC Mri joint upr extrem w/dye 8.35 70.00 $584.50 73222 26 Mri joint upr extrem w/dye 2.32 70.00 $162.40 73223 Mri joint upr extr w/o&w/dye 13.27 70.00 $928.90 73223 TC Mri joint upr extr w/o&w/dye 10.19 70.00 $713.30 73223 26 Mri joint upr extr w/o&w/dye 3.08 70.00 $215.60 73225 Mr angio upr extr w/o&w/dye 11.54 70.00 $807.80 73225 TC Mr angio upr extr w/o&w/dye 9.09 70.00 $636.30 73225 26 Mr angio upr extr w/o&w/dye 2.45 70.00 $171.50 73501 X-ray exam hip uni 1 view 0.84 70.00 $58.80 73501 TC X-ray exam hip uni 1 view 0.57 70.00 $39.90 73501 26 X-ray exam hip uni 1 view 0.27 70.00 $18.90 73502 X-ray exam hip uni 2-3 views 1.17 70.00 $81.90 73502 TC X-ray exam hip uni 2-3 views 0.85 70.00 $59.50 73502 26 X-ray exam hip uni 2-3 views 0.32 70.00 $22.40 73503 X-ray exam hip uni 4/> views 1.46 70.00 $102.20 73503 TC X-ray exam hip uni 4/> views 1.05 70.00 $73.50 73503 26 X-ray exam hip uni 4/> views 0.41 70.00 $28.70 73521 X-ray exam hips bi 2 views 1.12 70.00 $78.40 73521 TC X-ray exam hips bi 2 views 0.79 70.00 $55.30 73521 26 X-ray exam hips bi 2 views 0.33 70.00 $23.10 73522 X-ray exam hips bi 3-4 views 1.38 70.00 $96.60 73522 TC X-ray exam hips bi 3-4 views 0.95 70.00 $66.50 73522 26 X-ray exam hips bi 3-4 views 0.43 70.00 $30.10 73523 X-ray exam hips bi 5/> views 1.60 70.00 $112.00 73523 TC X-ray exam hips bi 5/> views 1.14 70.00 $79.80 73523 26 X-ray exam hips bi 5/> views 0.46 70.00 $32.20 73525 Contrast x-ray of hip 2.87 70.00 $200.90 73525 TC Contrast x-ray of hip 2.05 70.00 $143.50 73525 26 Contrast x-ray of hip 0.82 70.00 $57.40 73551 X-ray exam of femur 1 0.79 70.00 $55.30 73551 TC X-ray exam of femur 1 0.55 70.00 $38.50 73551 26 X-ray exam of femur 1 0.24 70.00 $16.80 73552 X-ray exam of femur 2/> 0.92 70.00 $64.40 73552 TC X-ray exam of femur 2/> 0.65 70.00 $45.50 73552 26 X-ray exam of femur 2/> 0.27 70.00 $18.90 73560 X-ray exam of knee 1 or 2 0.87 70.00 $60.90 73560 TC X-ray exam of knee 1 or 2 0.63 70.00 $44.10 73560 26 X-ray exam of knee 1 or 2 0.24 70.00 $16.80 73562 X-ray exam of knee 3 1.01 70.00 $70.70 73562 TC X-ray exam of knee 3 0.74 70.00 $51.80 73562 26 X-ray exam of knee 3 0.27 70.00 $18.90 73564 X-ray exam knee 4 or more 1.12 70.00 $78.40 73564 TC X-ray exam knee 4 or more 0.80 70.00 $56.00 73564 26 X-ray exam knee 4 or more 0.32 70.00 $22.40 73565 X-ray exam of knees 1.01 70.00 $70.70 73565 TC X-ray exam of knees 0.76 70.00 $53.20 73565 26 X-ray exam of knees 0.25 70.00 $17.50 73580 Contrast x-ray of knee joint 3.21 70.00 $224.70 73580 TC Contrast x-ray of knee joint 2.41 70.00 $168.70 73580 26 Contrast x-ray of knee joint 0.80 70.00 $56.00 73590 X-ray exam of lower leg 0.81 70.00 $56.70 73590 TC X-ray exam of lower leg 0.57 70.00 $39.90 73590 26 X-ray exam of lower leg 0.24 70.00 $16.80 73592 X-ray exam of leg infant 0.78 70.00 $54.60 73592 TC X-ray exam of leg infant 0.55 70.00 $38.50 73592 26 X-ray exam of leg infant 0.23 70.00 $16.10 73600 X-ray exam of ankle 0.84 70.00 $58.80 73600 TC X-ray exam of ankle 0.60 70.00 $42.00 73600 26 X-ray exam of ankle 0.24 70.00 $16.80 73610 X-ray exam of ankle 0.89 70.00 $62.30 73610 TC X-ray exam of ankle 0.64 70.00 $44.80 73610 26 X-ray exam of ankle 0.25 70.00 $17.50 73615 Contrast x-ray of ankle 2.97 70.00 $207.90 73615 TC Contrast x-ray of ankle 2.16 70.00 $151.20 73615 26 Contrast x-ray of ankle 0.81 70.00 $56.70 73620 X-ray exam of foot 0.73 70.00 $51.10 73620 TC X-ray exam of foot 0.51 70.00 $35.70 73620 26 X-ray exam of foot 0.22 70.00 $15.40 73630 X-ray exam of foot 0.82 70.00 $57.40 73630 TC X-ray exam of foot 0.58 70.00 $40.60 73630 26 X-ray exam of foot 0.24 70.00 $16.80 73650 X-ray exam of heel 0.76 70.00 $53.20 73650 TC X-ray exam of heel 0.53 70.00 $37.10 73650 26 X-ray exam of heel 0.23 70.00 $16.10 73660 X-ray exam of toe(s) 0.79 70.00 $55.30 73660 TC X-ray exam of toe(s) 0.60 70.00 $42.00 73660 26 X-ray exam of toe(s) 0.19 70.00 $13.30 73700 Ct lower extremity w/o dye 5.08 70.00 $355.60 73700 TC Ct lower extremity w/o dye 3.65 70.00 $255.50 73700 26 Ct lower extremity w/o dye 1.43 70.00 $100.10 73701 Ct lower extremity w/dye 6.38 70.00 $446.60 73701 TC Ct lower extremity w/dye 4.72 70.00 $330.40 73701 26 Ct lower extremity w/dye 1.66 70.00 $116.20 73702 Ct lwr extremity w/o&w/dye 7.73 70.00 $541.10 73702 TC Ct lwr extremity w/o&w/dye 5.99 70.00 $419.30 73702 26 Ct lwr extremity w/o&w/dye 1.74 70.00 $121.80 73706 Ct angio lwr extr w/o&w/dye 10.04 70.00 $702.80 73706 TC Ct angio lwr extr w/o&w/dye 7.34 70.00 $513.80 73706 26 Ct angio lwr extr w/o&w/dye 2.70 70.00 $189.00 73718 Mri lower extremity w/o dye 10.29 70.00 $720.30 73718 TC Mri lower extremity w/o dye 8.36 70.00 $585.20 73718 26 Mri lower extremity w/o dye 1.93 70.00 $135.10 73719 Mri lower extremity w/dye 11.43 70.00 $800.10 73719 TC Mri lower extremity w/dye 9.11 70.00 $637.70 73719 26 Mri lower extremity w/dye 2.32 70.00 $162.40 73720 Mri lwr extremity w/o&w/dye 14.18 70.00 $992.60 73720 TC Mri lwr extremity w/o&w/dye 11.11 70.00 $777.70 73720 26 Mri lwr extremity w/o&w/dye 3.07 70.00 $214.90 73721 Mri jnt of lwr extre w/o dye 6.69 70.00 $468.30 73721 TC Mri jnt of lwr extre w/o dye 4.75 70.00 $332.50 73721 26 Mri jnt of lwr extre w/o dye 1.94 70.00 $135.80 73722 Mri joint of lwr extr w/dye 10.76 70.00 $753.20 73722 TC Mri joint of lwr extr w/dye 8.44 70.00 $590.80 73722 26 Mri joint of lwr extr w/dye 2.32 70.00 $162.40 73723 Mri joint lwr extr w/o&w/dye 13.28 70.00 $929.60 73723 TC Mri joint lwr extr w/o&w/dye 10.21 70.00 $714.70 73723 26 Mri joint lwr extr w/o&w/dye 3.07 70.00 $214.90 73725 Mr ang lwr ext w or w/o dye 11.33 70.00 $793.10 73725 TC Mr ang lwr ext w or w/o dye 8.76 70.00 $613.20 73725 26 Mr ang lwr ext w or w/o dye 2.57 70.00 $179.90 74000 X-ray exam of abdomen 0.67 70.00 $46.90 74000 TC X-ray exam of abdomen 0.41 70.00 $28.70 74000 26 X-ray exam of abdomen 0.26 70.00 $18.20 74010 X-ray exam of abdomen 0.99 70.00 $69.30 74010 TC X-ray exam of abdomen 0.66 70.00 $46.20 74010 26 X-ray exam of abdomen 0.33 70.00 $23.10 74020 X-ray exam of abdomen 1.06 70.00 $74.20 74020 TC X-ray exam of abdomen 0.67 70.00 $46.90 74020 26 X-ray exam of abdomen 0.39 70.00 $27.30 74022 X-ray exam series abdomen 1.26 70.00 $88.20 74022 TC X-ray exam series abdomen 0.80 70.00 $56.00 74022 26 X-ray exam series abdomen 0.46 70.00 $32.20 74150 Ct abdomen w/o dye 4.23 70.00 $296.10 74150 TC Ct abdomen w/o dye 2.53 70.00 $177.10 74150 26 Ct abdomen w/o dye 1.70 70.00 $119.00 74160 Ct abdomen w/dye 6.52 70.00 $456.40 74160 TC Ct abdomen w/dye 4.70 70.00 $329.00 74160 26 Ct abdomen w/dye 1.82 70.00 $127.40 74170 Ct abdomen w/o & w/dye 7.41 70.00 $518.70 74170 TC Ct abdomen w/o & w/dye 5.41 70.00 $378.70 74170 26 Ct abdomen w/o & w/dye 2.00 70.00 $140.00 74174 Ct angio abd&pelv w/o&w/dye 10.98 70.00 $768.60 74174 TC Ct angio abd&pelv w/o&w/dye 7.85 70.00 $549.50 74174 26 Ct angio abd&pelv w/o&w/dye 3.13 70.00 $219.10 74175 Ct angio abdom w/o & w/dye 8.67 70.00 $606.90 74175 TC Ct angio abdom w/o & w/dye 6.09 70.00 $426.30 74175 26 Ct angio abdom w/o & w/dye 2.58 70.00 $180.60 74176 Ct abd & pelvis w/o contrast 5.68 70.00 $397.60 74176 TC Ct abd & pelvis w/o contrast 3.19 70.00 $223.30 74176 26 Ct abd & pelvis w/o contrast 2.49 70.00 $174.30 74177 Ct abd & pelv w/contrast 8.79 70.00 $615.30 74177 TC Ct abd & pelv w/contrast 6.19 70.00 $433.30 74177 26 Ct abd & pelv w/contrast 2.60 70.00 $182.00 74178 Ct abd & pelv 1/> regns 9.98 70.00 $698.60 74178 TC Ct abd & pelv 1/> regns 7.11 70.00 $497.70 74178 26 Ct abd & pelv 1/> regns 2.87 70.00 $200.90 74181 Mri abdomen w/o dye 9.39 70.00 $657.30 74181 TC Mri abdomen w/o dye 7.31 70.00 $511.70 74181 26 Mri abdomen w/o dye 2.08 70.00 $145.60 74182 Mri abdomen w/dye 12.83 70.00 $898.10 74182 TC Mri abdomen w/dye 10.35 70.00 $724.50 74182 26 Mri abdomen w/dye 2.48 70.00 $173.60 74183 Mri abdomen w/o & w/dye 14.30 70.00 $1,001.00 74183 TC Mri abdomen w/o & w/dye 11.07 70.00 $774.90 74183 26 Mri abdomen w/o & w/dye 3.23 70.00 $226.10 74185 Mri angio abdom w orw/o dye 11.38 70.00 $796.60 74185 TC Mri angio abdom w orw/o dye 8.83 70.00 $618.10 74185 26 Mri angio abdom w orw/o dye 2.55 70.00 $178.50 74190 X-ray exam of peritoneum 0.00 70.00 $0.00 74190 TC X-ray exam of peritoneum 0.00 70.00 $0.00 74190 26 X-ray exam of peritoneum 0.67 70.00 $46.90 74210 Contrst x-ray exam of throat 2.19 70.00 $153.30 74210 TC Contrst x-ray exam of throat 1.67 70.00 $116.90 74210 26 Contrst x-ray exam of throat 0.52 70.00 $36.40 74220 Contrast x-ray esophagus 2.49 70.00 $174.30 74220 TC Contrast x-ray esophagus 1.83 70.00 $128.10 74220 26 Contrast x-ray esophagus 0.66 70.00 $46.20 74230 Cine/vid x-ray throat/esoph 3.61 70.00 $252.70 74230 TC Cine/vid x-ray throat/esoph 2.85 70.00 $199.50 74230 26 Cine/vid x-ray throat/esoph 0.76 70.00 $53.20 74235 Remove esophagus obstruction 0.00 70.00 $0.00 74235 TC Remove esophagus obstruction 0.00 70.00 $0.00 74235 26 Remove esophagus obstruction 1.76 70.00 $123.20 74240 X-ray upper gi delay w/o kub 3.18 70.00 $222.60 74240 TC X-ray upper gi delay w/o kub 2.19 70.00 $153.30 74240 26 X-ray upper gi delay w/o kub 0.99 70.00 $69.30 74241 X-ray upper gi delay w/kub 3.32 70.00 $232.40 74241 TC X-rayupper gi delay w/kub 2.33 70.00 $163.10 74241 26 X-rayupper gi delay w/kub 0.99 70.00 $69.30 74245 X-ray upper gi&small intest 4.83 70.00 $338.10 74245 TC X-ray upper gi&small intest 3.53 70.00 $247.10 74245 26 X-ray upper gi&small intest 1.30 70.00 $91.00 74246 Contrst x-ray uppr gi tract 3.58 70.00 $250.60 74246 TC Contrst x-ray uppr gi tract 2.59 70.00 $181.30 74246 26 Contrst x-ray uppr gi tract 0.99 70.00 $69.30 74247 Contrst x-ray uppr gi tract 3.99 70.00 $279.30 74247 TC Contrst x-ray uppr gi tract 3.00 70.00 $210.00 74247 26 Contrst x-ray uppr gi tract 0.99 70.00 $69.30 74249 Contrst x-ray uppr gi tract 5.18 70.00 $362.60 74249 TC Contrst x-ray uppr gi tract 3.88 70.00 $271.60 74249 26 Contrst x-ray uppr gi tract 1.30 70.00 $91.00 74250 X-ray exam of small bowel 2.93 70.00 $205.10 74250 TC X-ray exam of small bowel 2.25 70.00 $157.50 74250 26 X-ray exam of small bowel 0.68 70.00 $47.60 74251 X-ray exam of small bowel 11.83 70.00 $828.10 74251 TC X-ray exam of small bowel 10.84 70.00 $758.80 74251 26 X-ray exam of small bowel 0.99 70.00 $69.30 74260 X-ray exam of small bowel 9.66 70.00 $676.20 74260 TC X-ray exam of small bowel 8.94 70.00 $625.80 74260 26 X-ray exam of small bowel 0.72 70.00 $50.40 74261 Ct colonography dx 13.73 70.00 $961.10 74261 TC Ct colonography dx 10.29 70.00 $720.30 74261 26 Ct colonography dx 3.44 70.00 $240.80 74262 Ct colonography dx w/dye 15.39 70.00 $1,077.30 74262 TC Ct colonography dx w/dye 11.81 70.00 $826.70 74262 26 Ct colonography dx w/dye 3.58 70.00 $250.60 74263 Ct colonography screening 21.27 70.00 $1,488.90 74263 TC Ct colonography screening 18.04 70.00 $1,262.80 74263 26 Ct colonography screening 3.23 70.00 $226.10 74270 Contrast x-ray exam of colon 4.23 70.00 $296.10 74270 TC Contrast x-ray exam of colon 3.24 70.00 $226.80 74270 26 Contrast x-ray exam of colon 0.99 70.00 $69.30 74280 Contrast x-ray exam of colon 6.02 70.00 $421.40 74280 TC Contrast x-ray exam of colon 4.60 70.00 $322.00 74280 26 Contrast x-ray exam of colon 1.42 70.00 $99.40 74283 Contrast x-ray exam of colon 5.90 70.00 $413.00 74283 TC Contrast x-ray exam of colon 2.96 70.00 $207.20 74283 26 Contrast x-ray exam of colon 2.94 70.00 $205.80 74290 Contrast x-ray gallbladder 1.98 70.00 $138.60 74290 TC Contrast x-ray gallbladder 1.52 70.00 $106.40 74290 26 Contrast x-ray gallbladder 0.46 70.00 $32.20 74300 X-ray bile ducts/pancreas 0.00 70.00 $0.00 74300 TC X-ray bile ducts/pancreas 0.00 70.00 $0.00 74300 26 X-ray bile ducts/pancreas 0.52 70.00 $36.40 74301 X-rays at surgery add-on 0.00 70.00 $0.00 74301 TC X-rays at surgery add-on 0.00 70.00 $0.00 74301 26 X-rays at surgery add-on 0.30 70.00 $21.00 74328 X-ray bile duct endoscopy 0.00 70.00 $0.00 74328 TC X-ray bile duct endoscopy 0.00 70.00 $0.00 74328 26 X-ray bile duct endoscopy 1.02 70.00 $71.40 74329 X-ray for pancreas endoscopy 0.00 70.00 $0.00 74329 TC X-ray for pancreas endoscopy 0.00 70.00 $0.00 74329 26 X-ray for pancreas endoscopy 1.02 70.00 $71.40 74330 X-ray bile/panc endoscopy 0.00 70.00 $0.00 74330 TC X-ray bile/panc endoscopy 0.00 70.00 $0.00 74330 26 X-ray bile/panc endoscopy 1.30 70.00 $91.00 74340 X-ray guide for gi tube 0.00 70.00 $0.00 74340 TC X-ray guide for gi tube 0.00 70.00 $0.00 74340 26 X-ray guide for gi tube 0.77 70.00 $53.90 74355 X-ray guide intestinal tube 0.00 70.00 $0.00 74355 TC X-ray guide intestinal tube 0.00 70.00 $0.00 74355 26 X-ray guide intestinal tube 1.09 70.00 $76.30 74360 X-ray guide gi dilation 0.00 70.00 $0.00 74360 TC X-ray guide gi dilation 0.00 70.00 $0.00 74360 26 X-ray guide gi dilation 0.80 70.00 $56.00 74363 X-ray bile duct dilation 0.00 70.00 $0.00 74363 TC X-ray bile duct dilation 0.00 70.00 $0.00 74363 26 X-ray bile duct dilation 1.22 70.00 $85.40 74400 Contrst x-ray urinary tract 3.11 70.00 $217.70 74400 TC Contrst x-ray urinary tract 2.41 70.00 $168.70 74400 26 Contrst x-ray urinary tract 0.70 70.00 $49.00 74410 Contrst x-ray urinary tract 3.07 70.00 $214.90 74410 TC Contrst x-ray urinary tract 2.37 70.00 $165.90 74410 26 Contrst x-ray urinary tract 0.70 70.00 $49.00 74415 Contrst x-ray urinary tract 3.85 70.00 $269.50 74415 TC Contrst x-ray urinary tract 3.15 70.00 $220.50 74415 26 Contrst x-ray urinary tract 0.70 70.00 $49.00 74420 Contrst x-ray urinary tract 0.00 70.00 $0.00 74420 TC Contrst x-ray urinary tract 0.00 70.00 $0.00 74420 26 Contrst x-ray urinary tract 0.50 70.00 $35.00 74425 Contrst x-ray urinary tract 0.00 70.00 $0.00 74425 TC Contrst x-ray urinary tract 0.00 70.00 $0.00 74425 26 Contrst x-ray urinary tract 0.50 70.00 $35.00 74430 Contrast x-ray bladder 1.07 70.00 $74.90 74430 TC Contrast x-ray bladder 0.61 70.00 $42.70 74430 26 Contrast x-ray bladder 0.46 70.00 $32.20 74440 X-ray male genital tract 2.29 70.00 $160.30 74440 TC X-ray male genital tract 1.76 70.00 $123.20 74440 26 X-ray male genital tract 0.53 70.00 $37.10 74445 X-ray exam of penis 0.00 70.00 $0.00 74445 TC X-ray exam of penis 0.00 70.00 $0.00 74445 26 X-ray exam of penis 1.54 70.00 $107.80 74450 X-ray urethra/bladder 0.00 70.00 $0.00 74450 TC X-ray urethra/bladder 0.00 70.00 $0.00 74450 26 X-ray urethra/bladder 0.47 70.00 $32.90 74455 X-ray urethra/bladder 2.31 70.00 $161.70 74455 TC X-ray urethra/bladder 1.84 70.00 $128.80 74455 26 X-ray urethra/bladder 0.47 70.00 $32.90 74470 X-ray exam of kidney lesion 0.00 70.00 $0.00 74470 TC X-ray exam of kidney lesion 0.00 70.00 $0.00 74470 26 X-ray exam of kidney lesion 0.75 70.00 $52.50 74485 X-ray guide gu dilation 2.59 70.00 $181.30 74485 TC X-ray guide gu dilation 1.85 70.00 $129.50 74485 26 X-ray guide gu dilation 0.74 70.00 $51.80 74710 X-ray measurement of pelvis 1.04 70.00 $72.80 74710 TC X-ray measurement of pelvis 0.55 70.00 $38.50 74710 26 X-ray measurement of pelvis 0.49 70.00 $34.30 74712 Mri fetal sngl/1st gestation 13.59 70.00 $951.30 74712 TC Mri fetal sngl/1st gestation 9.29 70.00 $650.30 74712 26 Mri fetal sngl/1st gestation 4.30 70.00 $301.00 74713 Mri fetal ea addl gestation 6.58 70.00 $460.60 74713 TC Mri fetal ea addl gestation 3.93 70.00 $275.10 74713 26 Mri fetal ea addl gestation 2.65 70.00 $185.50 74740 X-ray female genital tract 2.11 70.00 $147.70 74740 TC X-ray female genital tract 1.57 70.00 $109.90 74740 26 X-ray female genital tract 0.54 70.00 $37.80 74742 X-ray fallopian tube 0.00 70.00 $0.00 74742 TC X-ray fallopian tube 0.00 70.00 $0.00 74742 26 X-ray fallopian tube 0.87 70.00 $60.90 74775 X-ray exam of perineum 0.00 70.00 $0.00 74775 TC X-ray exam of perineum 0.00 70.00 $0.00 74775 26 X-ray exam of perineum 0.89 70.00 $62.30 75557 Cardiac mri for morph 9.04 70.00 $632.80 75557 TC Cardiac mri for morph 5.74 70.00 $401.80 75557 26 Cardiac mri for morph 3.30 70.00 $231.00 75559 Cardiac mri w/stress img 12.35 70.00 $864.50 75559 TC Cardiac mri w/stress img 8.28 70.00 $579.60 75559 26 Cardiac mri w/stress img 4.07 70.00 $284.90 75561 Cardiac mri for morph w/dye 12.00 70.00 $840.00 75561 TC Cardiac mri for morph w/dye 8.35 70.00 $584.50 75561 26 Cardiac mri for morph w/dye 3.65 70.00 $255.50 75563 Card mri w/stress img & dye 14.30 70.00 $1,001.00 75563 TC Card mri w/stress img & dye 10.12 70.00 $708.40 75563 26 Card mri w/stress img & dye 4.18 70.00 $292.60 75565 Card mri veloc flow mapping 1.55 70.00 $108.50 75565 TC Card mri veloc flow mapping 1.20 70.00 $84.00 75565 26 Card mri veloc flow mapping 0.35 70.00 $24.50 75571 Ct hrt w/o dye w/ca test 2.85 70.00 $199.50 75571 TC Ct hrt w/o dye w/ca test 2.03 70.00 $142.10 75571 26 Ct hrt w/o dye w/ca test 0.82 70.00 $57.40 75572 Ct hrt w/3d image 8.01 70.00 $560.70 75572 TC Ct hrt w/3d image 5.54 70.00 $387.80 75572 26 Ct hrt w/3d image 2.47 70.00 $172.90 75573 Ct hrt w/3d image congen 11.03 70.00 $772.10 75573 TC Ct hrt w/3d image congen 7.43 70.00 $520.10 75573 26 Ct hrt w/3d image congen 3.60 70.00 $252.00 75574 Ct angio hrt w/3d image 11.89 70.00 $832.30 75574 TC Ct angio hrt w/3d image 8.51 70.00 $595.70 75574 26 Ct angio hrt w/3d image 3.38 70.00 $236.60 75600 Contrast exam thoracic aorta 5.58 70.00 $390.60 75600 TC Contrast exam thoracic aorta 4.89 70.00 $342.30 75600 26 Contrast exam thoracic aorta 0.69 70.00 $48.30 75605 Contrast exam thoracic aorta 3.90 70.00 $273.00 75605 TC Contrast exam thoracic aorta 2.31 70.00 $161.70 75605 26 Contrast exam thoracic aorta 1.59 70.00 $111.30 75625 Contrast exam abdominl aorta 3.88 70.00 $271.60 75625 TC Contrast exam abdominl aorta 2.29 70.00 $160.30 75625 26 Contrast exam abdominl aorta 1.59 70.00 $111.30 75630 X-ray aorta leg arteries 4.81 70.00 $336.70 75630 TC X-ray aorta leg arteries 2.31 70.00 $161.70 75630 26 X-ray aorta leg arteries 2.50 70.00 $175.00 75635 Ct angio abdominal arteries 10.78 70.00 $754.60 75635 TC Ct angio abdominal arteries 7.38 70.00 $516.60 75635 26 Ct angio abdominal arteries 3.40 70.00 $238.00 75658 Artery x-rays arm 4.76 70.00 $333.20 75658 TC Artery x-rays arm 2.93 70.00 $205.10 75658 26 Artery x-rays arm 1.83 70.00 $128.10 75705 Artery x-rays spine 6.99 70.00 $489.30 75705 TC Artery x-rays spine 3.72 70.00 $260.40 75705 26 Artery x-rays spine 3.27 70.00 $228.90 75710 Artery x-rays arm/leg 4.58 70.00 $320.60 75710 TC Artery x-rays arm/leg 2.98 70.00 $208.60 75710 26 Artery x-rays arm/leg 1.60 70.00 $112.00 75716 Artery x-rays arms/legs 5.27 70.00 $368.90 75716 TC Artery x-rays arms/legs 3.45 70.00 $241.50 75716 26 Artery x-rays arms/legs 1.82 70.00 $127.40 75726 Artery x-rays abdomen 4.22 70.00 $295.40 75726 TC Artery x-rays abdomen 2.64 70.00 $184.80 75726 26 Artery x-rays abdomen 1.58 70.00 $110.60 75731 Artery x-rays adrenal gland 4.85 70.00 $339.50 75731 TC Artery x-rays adrenal gland 3.22 70.00 $225.40 75731 26 Artery x-rays adrenal gland 1.63 70.00 $114.10 75733 Artery x-rays adrenals 5.25 70.00 $367.50 75733 TC Artery x-rays adrenals 3.44 70.00 $240.80 75733 26 Artery x-rays adrenals 1.81 70.00 $126.70 75736 Artery x-rays pelvis 4.52 70.00 $316.40 75736 TC Artery x-rays pelvis 2.95 70.00 $206.50 75736 26 Artery x-rays pelvis 1.57 70.00 $109.90 75741 Artery x-rays lung 4.26 70.00 $298.20 75741 TC Artery x-rays lung 2.45 70.00 $171.50 75741 26 Artery x-rays lung 1.81 70.00 $126.70 75743 Artery x-rays lungs 4.77 70.00 $333.90 75743 TC Artery x-rays lungs 2.48 70.00 $173.60 75743 26 Artery x-rays lungs 2.29 70.00 $160.30 75746 Artery x-rays lung 4.33 70.00 $303.10 75746 TC Artery x-rays lung 2.73 70.00 $191.10 75746 26 Artery x-rays lung 1.60 70.00 $112.00 75756 Artery x-rays chest 4.80 70.00 $336.00 75756 TC Artery x-rays chest 3.18 70.00 $222.60 75756 26 Artery x-rays chest 1.62 70.00 $113.40 75774 Artery x-ray each vessel 2.44 70.00 $170.80 75774 TC Artery x-ray each vessel 1.94 70.00 $135.80 75774 26 Artery x-ray each vessel 0.50 70.00 $35.00 75801 Lymph vessel x-ray arm/leg 0.00 70.00 $0.00 75801 TC Lymph vessel x-ray arm/leg 0.00 70.00 $0.00 75801 26 Lymph vessel x-ray arm/leg 1.27 70.00 $88.90 75803 Lymph vessel x-ray arms/legs 0.00 70.00 $0.00 75803 TC Lymph vessel x-ray arms/legs 0.00 70.00 $0.00 75803 26 Lymph vessel x-ray arms/legs 1.73 70.00 $121.10 75805 Lymph vessel x-ray trunk 0.00 70.00 $0.00 75805 TC Lymph vessel x-ray trunk 0.00 70.00 $0.00 75805 26 Lymph vessel x-ray trunk 1.16 70.00 $81.20 75807 Lymph vessel x-ray trunk 0.00 70.00 $0.00 75807 TC Lymph vessel x-ray trunk 0.00 70.00 $0.00 75807 26 Lymph vessel x-ray trunk 1.68 70.00 $117.60 75809 Nonvascular shunt x-ray 2.79 70.00 $195.30 75809 TC Nonvascular shunt x-ray 2.11 70.00 $147.70 75809 26 Nonvascular shunt x-ray 0.68 70.00 $47.60 75810 Vein x-ray spleen/liver 0.00 70.00 $0.00 75810 TC Vein x-ray spleen/liver 0.00 70.00 $0.00 75810 26 Vein x-ray spleen/liver 1.64 70.00 $114.80 75820 Vein x-ray arm/leg 3.26 70.00 $228.20 75820 TC Vein x-ray arm/leg 2.27 70.00 $158.90 75820 26 Vein x-ray arm/leg 0.99 70.00 $69.30 75822 Vein x-ray arms/legs 3.87 70.00 $270.90 75822 TC Vein x-ray arms/legs 2.38 70.00 $166.60 75822 26 Vein x-ray arms/legs 1.49 70.00 $104.30 75825 Vein x-ray trunk 3.83 70.00 $268.10 75825 TC Vein x-ray trunk 2.23 70.00 $156.10 75825 26 Vein x-ray trunk 1.60 70.00 $112.00 75827 Vein x-ray chest 3.91 70.00 $273.70 75827 TC Vein x-ray chest 2.31 70.00 $161.70 75827 26 Vein x-ray chest 1.60 70.00 $112.00 75831 Vein x-ray kidney 3.96 70.00 $277.20 75831 TC Vein x-ray kidney 2.39 70.00 $167.30 75831 26 Vein x-ray kidney 1.57 70.00 $109.90 75833 Vein x-ray kidneys 4.66 70.00 $326.20 75833 TC Vein x-ray kidneys 2.60 70.00 $182.00 75833 26 Vein x-ray kidneys 2.06 70.00 $144.20 75840 Vein x-ray adrenal gland 4.22 70.00 $295.40 75840 TC Vein x-ray adrenal gland 2.58 70.00 $180.60 75840 26 Vein x-ray adrenal gland 1.64 70.00 $114.80 75842 Vein x-ray adrenal glands 5.07 70.00 $354.90 75842 TC Vein x-ray adrenal glands 2.99 70.00 $209.30 75842 26 Vein x-ray adrenal glands 2.08 70.00 $145.60 75860 Vein x-ray neck 4.06 70.00 $284.20 75860 TC Vein x-ray neck 2.47 70.00 $172.90 75860 26 Vein x-ray neck 1.59 70.00 $111.30 75870 Vein x-ray skull 4.22 70.00 $295.40 75870 TC Vein x-ray skull 2.58 70.00 $180.60 75870 26 Vein x-ray skull 1.64 70.00 $114.80 75872 Vein x-ray skull epidural 4.39 70.00 $307.30 75872 TC Vein x-ray skull epidural 2.77 70.00 $193.90 75872 26 Vein x-ray skull epidural 1.62 70.00 $113.40 75880 Vein x-ray eye socket 4.15 70.00 $290.50 75880 TC Vein x-ray eye socket 3.13 70.00 $219.10 75880 26 Vein x-ray eye socket 1.02 70.00 $71.40 75885 Vein x-ray liver w/hemodynam 4.42 70.00 $309.40 75885 TC Vein x-ray liver w/hemodynam 2.48 70.00 $173.60 75885 26 Vein x-ray liver w/hemodynam 1.94 70.00 $135.80 75887 Vein x-ray liver w/o hemodyn 4.47 70.00 $312.90 75887 TC Vein x-ray liver w/o hemodyn 2.51 70.00 $175.70 75887 26 Vein x-ray liver w/o hemodyn 1.96 70.00 $137.20 75889 Vein x-ray liver w/hemodynam 4.06 70.00 $284.20 75889 TC Vein x-ray liver w/hemodynam 2.50 70.00 $175.00 75889 26 Vein x-ray liver w/hemodynam 1.56 70.00 $109.20 75891 Vein x-ray liver 4.11 70.00 $287.70 75891 TC Vein x-ray liver 2.52 70.00 $176.40 75891 26 Vein x-ray liver 1.59 70.00 $111.30 75893 Venous sampling by catheter 3.36 70.00 $235.20 75893 TC Venous sampling by catheter 2.59 70.00 $181.30 75893 26 Venous sampling by catheter 0.77 70.00 $53.90 75894 X-rays transcath therapy 0.00 70.00 $0.00 75894 TC X-rays transcath therapy 0.00 70.00 $0.00 75894 26 X-rays transcath therapy 1.94 70.00 $135.80 75898 Follow-up angiography 0.00 70.00 $0.00 75898 TC Follow-up angiography 0.00 70.00 $0.00 75898 26 Follow-up angiography 2.46 70.00 $172.20 75901 Remove cva device obstruct 5.00 70.00 $350.00 75901 TC Remove cva device obstruct 4.33 70.00 $303.10 75901 26 Remove cva device obstruct 0.67 70.00 $46.90 75902 Remove cva lumen obstruct 2.04 70.00 $142.80 75902 TC Remove cva lumen obstruct 1.50 70.00 $105.00 75902 26 Remove cva lumen obstruct 0.54 70.00 $37.80 75952 Endovasc repair abdom aorta 0.00 70.00 $0.00 75952 TC Endovasc repair abdom aorta 0.00 70.00 $0.00 75952 26 Endovasc repair abdom aorta 6.36 70.00 $445.20 75953 Abdom aneurysm endovas rpr 0.00 70.00 $0.00 75953 TC Abdom aneurysm endovas rpr 0.00 70.00 $0.00 75953 26 Abdom aneurysm endovas rpr 1.93 70.00 $135.10 75954 Iliac aneurysm endovas rpr 0.00 70.00 $0.00 75954 TC Iliac aneurysm endovas rpr 0.00 70.00 $0.00 75954 26 Iliac aneurysm endovas rpr 3.23 70.00 $226.10 75956 Xray endovasc thor ao repr 0.00 70.00 $0.00 75956 TC Xray endovasc thor ao repr 0.00 70.00 $0.00 75956 26 Xray endovasc thor ao repr 9.91 70.00 $693.70 75957 Xray endovasc thor ao repr 0.00 70.00 $0.00 75957 TC Xray endovasc thor ao repr 0.00 70.00 $0.00 75957 26 Xray endovasc thor ao repr 8.51 70.00 $595.70 75958 Xray place prox ext thor ao 0.00 70.00 $0.00 75958 TC Xray place prox ext thor ao 0.00 70.00 $0.00 75958 26 Xray place prox ext thor ao 5.67 70.00 $396.90 75959 Xray place dist ext thor ao 0.00 70.00 $0.00 75959 TC Xray place dist ext thor ao 0.00 70.00 $0.00 75959 26 Xray place dist ext thor ao 4.84 70.00 $338.80 75970 Vascular biopsy 0.00 70.00 $0.00 75970 TC Vascular biopsy 0.00 70.00 $0.00 75970 26 Vascular biopsy 1.14 70.00 $79.80 75984 Xray control catheter change 2.99 70.00 $209.30 75984 TC Xray control catheter change 2.00 70.00 $140.00 75984 26 Xray control catheter change 0.99 70.00 $69.30 75989 Abscess drainage under x-ray 3.42 70.00 $239.40 75989 TC Abscess drainage under x-ray 1.76 70.00 $123.20 75989 26 Abscess drainage under x-ray 1.66 70.00 $116.20 76000 Fluoroscope examination 1.34 70.00 $93.80 76000 TC Fluoroscope examination 1.09 70.00 $76.30 76000 26 Fluoroscope examination 0.25 70.00 $17.50 76001 Fluoroscope exam extensive 0.00 70.00 $0.00 76001 TC Fluoroscope exam extensive 0.00 70.00 $0.00 76001 26 Fluoroscope exam extensive 1.04 70.00 $72.80 76010 X-ray nose to rectum 0.74 70.00 $51.80 76010 TC X-ray nose to rectum 0.48 70.00 $33.60 76010 26 X-ray nose to rectum 0.26 70.00 $18.20 76080 X-ray exam of fistula 1.56 70.00 $109.20 76080 TC X-ray exam of fistula 0.81 70.00 $56.70 76080 26 X-ray exam of fistula 0.75 70.00 $52.50 76098 X-ray exam breast specimen 0.47 70.00 $32.90 76098 TC X-ray exam breast specimen 0.24 70.00 $16.80 76098 26 X-ray exam breast specimen 0.23 70.00 $16.10 76100 X-ray exam of body section 2.59 70.00 $181.30 76100 TC X-ray exam of body section 1.69 70.00 $118.30 76100 26 X-ray exam of body section 0.90 70.00 $63.00 76101 Complex body section x-ray 3.72 70.00 $260.40 76101 TC Complex body section x-ray 2.72 70.00 $190.40 76101 26 Complex body section x-ray 1.00 70.00 $70.00 76102 Complex body section x-rays 4.85 70.00 $339.50 76102 TC Complex body section x-rays 3.90 70.00 $273.00 76102 26 Complex body section x-rays 0.95 70.00 $66.50 76120 Cine/video x-rays 2.39 70.00 $167.30 76120 TC Cine/video x-rays 1.84 70.00 $128.80 76120 26 Cine/video x-rays 0.55 70.00 $38.50 76125 Cine/video x-rays add-on 0.00 70.00 $0.00 76125 TC Cine/video x-rays add-on 0.00 70.00 $0.00 76125 26 Cine/video x-rays add-on 0.41 70.00 $28.70 76140 X-ray consultation 0.00 70.00 $0.00 76376 3d render w/intrp postproces 0.66 70.00 $46.20 76376 TC 3d render w/intrp postproces 0.38 70.00 $26.60 76376 26 3d render w/intrp postproces 0.28 70.00 $19.60 76377 3d render w/intrp postproces 2.02 70.00 $141.40 76377 TC 3d render w/intrp postproces 0.88 70.00 $61.60 76377 26 3d render w/intrp postproces 1.14 70.00 $79.80 76380 Cat scan follow-up study 4.12 70.00 $288.40 76380 TC Cat scan follow-up study 2.72 70.00 $190.40 76380 26 Cat scan follow-up study 1.40 70.00 $98.00 76390 Mr spectroscopy 12.54 70.00 $877.80 76390 TC Mr spectroscopy 10.56 70.00 $739.20 76390 26 Mr spectroscopy 1.98 70.00 $138.60 76496 Fluoroscopic procedure 0.00 70.00 $0.00 76496 TC Fluoroscopic procedure 0.00 70.00 $0.00 76496 26 Fluoroscopic procedure 0.00 70.00 $0.00 76497 Ct procedure 0.00 70.00 $0.00 76497 TC Ct procedure 0.00 70.00 $0.00 76497 26 Ct procedure 0.00 70.00 $0.00 76498 Mri procedure 0.00 70.00 $0.00 76498 TC Mri procedure 0.00 70.00 $0.00 76498 26 Mri procedure 0.00 70.00 $0.00 76499 Radiographic procedure 0.00 70.00 $0.00 76499 TC Radiographic procedure 0.00 70.00 $0.00 76499 26 Radiographic procedure 0.00 70.00 $0.00 76506 Echo exam of head 3.36 70.00 $235.20 76506 TC Echo exam of head 2.44 70.00 $170.80 76506 26 Echo exam of head 0.92 70.00 $64.40 76510 Ophth us b & quant a 4.80 70.00 $336.00 76510 TC Ophth us b & quant a 2.28 70.00 $159.60 76510 26 Ophth us b & quant a 2.52 70.00 $176.40 76511 Ophth us quant a only 2.88 70.00 $201.60 76511 TC Ophth us quant a only 1.37 70.00 $95.90 76511 26 Ophth us quant a only 1.51 70.00 $105.70 76512 Ophth us b w/non-quant a 2.62 70.00 $183.40 76512 TC Ophth us b w/non-quant a 1.12 70.00 $78.40 76512 26 Ophth us b w/non-quant a 1.50 70.00 $105.00 76513 Echo exam of eye water bath 2.69 70.00 $188.30 76513 TC Echo exam of eye water bath 1.68 70.00 $117.60 76513 26 Echo exam of eye water bath 1.01 70.00 $70.70 76514 Echo exam of eye thickness 0.43 70.00 $30.10 76514 TC Echo exam of eye thickness 0.15 70.00 $10.50 76514 26 Echo exam of eye thickness 0.28 70.00 $19.60 76516 Echo exam of eye 2.22 70.00 $155.40 76516 TC Echo exam of eye 1.34 70.00 $93.80 76516 26 Echo exam of eye 0.88 70.00 $61.60 76519 Echo exam of eye 2.39 70.00 $167.30 76519 TC Echo exam of eye 1.50 70.00 $105.00 76519 26 Echo exam of eye 0.89 70.00 $62.30 76529 Echo exam of eye 2.23 70.00 $156.10 76529 TC Echo exam of eye 1.32 70.00 $92.40 76529 26 Echo exam of eye 0.91 70.00 $63.70 76536 Us exam of head and neck 3.31 70.00 $231.70 76536 TC Us exam of head and neck 2.51 70.00 $175.70 76536 26 Us exam of head and neck 0.80 70.00 $56.00 76604 Us exam chest 2.51 70.00 $175.70 76604 TC Us exam chest 1.74 70.00 $121.80 76604 26 Us exam chest 0.77 70.00 $53.90 76641 Ultrasound breast complete 3.05 70.00 $213.50 76641 TC Ultrasound breast complete 2.01 70.00 $140.70 76641 26 Ultrasound breast complete 1.04 70.00 $72.80 76642 Ultrasound breast limited 2.51 70.00 $175.70 76642 TC Ultrasound breast limited 1.54 70.00 $107.80 76642 26 Ultrasound breast limited 0.97 70.00 $67.90 76700 Us exam abdom complete 3.48 70.00 $243.60 76700 TC Us exam abdom complete 2.33 70.00 $163.10 76700 26 Us exam abdom complete 1.15 70.00 $80.50 76705 Echo exam of abdomen 2.60 70.00 $182.00 76705 TC Echo exam of abdomen 1.76 70.00 $123.20 76705 26 Echo exam of abdomen 0.84 70.00 $58.80 76706 Us abdl aorta screen aaa 2.66 70.00 $186.20 76706 TC Us abdl aorta screen aaa 1.87 70.00 $130.90 76706 26 Us abdl aorta screen aaa 0.79 70.00 $55.30 76770 Us exam abdo back wall comp 3.22 70.00 $225.40 76770 TC Us exam abdo back wall comp 2.17 70.00 $151.90 76770 26 Us exam abdo back wall comp 1.05 70.00 $73.50 76775 Us exam abdo back wall lim 1.66 70.00 $116.20 76775 TC Us exam abdo back wall lim 0.84 70.00 $58.80 76775 26 Us exam abdo back wall lim 0.82 70.00 $57.40 76776 Us exam k transpl w/doppler 4.46 70.00 $312.20 76776 TC Us exam k transpl w/doppler 3.38 70.00 $236.60 76776 26 Us exam k transpl w/doppler 1.08 70.00 $75.60 76800 Us exam spinal canal 4.06 70.00 $284.20 76800 TC Us exam spinal canal 2.35 70.00 $164.50 76800 26 Us exam spinal canal 1.71 70.00 $119.70 76801 Ob us < 14 wks single fetus 3.52 70.00 $246.40 76801 TC Ob us < 14 wks single fetus 2.09 70.00 $146.30 76801 26 Ob us < 14 wks single fetus 1.43 70.00 $100.10 76802 Ob us < 14 wks addl fetus 1.84 70.00 $128.80 76802 TC Ob us < 14 wks addl fetus 0.63 70.00 $44.10 76802 26 Ob us < 14 wks addl fetus 1.21 70.00 $84.70 76805 Ob us >/= 14 wks sngl fetus 4.06 70.00 $284.20 76805 TC Ob us >/= 14 wks sngl fetus 2.62 70.00 $183.40 76805 26 Ob us >/= 14 wks sngl fetus 1.44 70.00 $100.80 76810 Ob us >/= 14 wks addl fetus 2.66 70.00 $186.20 76810 TC Ob us >/= 14 wks addl fetus 1.23 70.00 $86.10 76810 26 Ob us >/= 14 wks addl fetus 1.43 70.00 $100.10 76811 Ob us detailed sngl fetus 5.24 70.00 $366.80 76811 TC Ob us detailed sngl fetus 2.43 70.00 $170.10 76811 26 Ob us detailed sngl fetus 2.81 70.00 $196.70 76812 Ob us detailed addl fetus 5.87 70.00 $410.90 76812 TC Ob us detailed addl fetus 3.22 70.00 $225.40 76812 26 Ob us detailed addl fetus 2.65 70.00 $185.50 76813 Ob us nuchal meas 1 gest 3.49 70.00 $244.30 76813 TC Ob us nuchal meas 1 gest 1.74 70.00 $121.80 76813 26 Ob us nuchal meas 1 gest 1.75 70.00 $122.50 76814 Ob us nuchal meas add-on 2.32 70.00 $162.40 76814 TC Ob us nuchal meas add-on 0.85 70.00 $59.50 76814 26 Ob us nuchal meas add-on 1.47 70.00 $102.90 76815 Ob us limited fetus(s) 2.42 70.00 $169.40 76815 TC Ob us limited fetus(s) 1.48 70.00 $103.60 76815 26 Ob us limited fetus(s) 0.94 70.00 $65.80 76816 Ob us follow-up per fetus 3.31 70.00 $231.70 76816 TC Ob us follow-up per fetus 2.05 70.00 $143.50 76816 26 Ob us follow-up per fetus 1.26 70.00 $88.20 76817 Transvaginal us obstetric 2.78 70.00 $194.60 76817 TC Transvaginal us obstetric 1.69 70.00 $118.30 76817 26 Transvaginal us obstetric 1.09 70.00 $76.30 76818 Fetal biophys profile w/nst 3.53 70.00 $247.10 76818 TC Fetal biophys profile w/nst 1.97 70.00 $137.90 76818 26 Fetal biophys profile w/nst 1.56 70.00 $109.20 76819 Fetal biophys profil w/o nst 2.58 70.00 $180.60 76819 TC Fetal biophys profil w/o nst 1.45 70.00 $101.50 76819 26 Fetal biophys profil w/o nst 1.13 70.00 $79.10 76820 Umbilical artery echo 1.38 70.00 $96.60 76820 TC Umbilical artery echo 0.64 70.00 $44.80 76820 26 Umbilical artery echo 0.74 70.00 $51.80 76821 Middle cerebral artery echo 2.66 70.00 $186.20 76821 TC Middle cerebral artery echo 1.62 70.00 $113.40 76821 26 Middle cerebral artery echo 1.04 70.00 $72.80 76825 Echo exam of fetal heart 7.93 70.00 $555.10 76825 TC Echo exam of fetal heart 5.53 70.00 $387.10 76825 26 Echo exam of fetal heart 2.40 70.00 $168.00 76826 Echo exam of fetal heart 4.66 70.00 $326.20 76826 TC Echo exam of fetal heart 3.48 70.00 $243.60 76826 26 Echo exam of fetal heart 1.18 70.00 $82.60 76827 Echo exam of fetal heart 2.16 70.00 $151.20 76827 TC Echo exam of fetal heart 1.33 70.00 $93.10 76827 26 Echo exam of fetal heart 0.83 70.00 $58.10 76828 Echo exam of fetal heart 1.54 70.00 $107.80 76828 TC Echo exam of fetal heart 0.72 70.00 $50.40 76828 26 Echo exam of fetal heart 0.82 70.00 $57.40 76830 Transvaginal us non-ob 3.48 70.00 $243.60 76830 TC Transvaginal us non-ob 2.49 70.00 $174.30 76830 26 Transvaginal us non-ob 0.99 70.00 $69.30 76831 Echo exam uterus 3.41 70.00 $238.70 76831 TC Echo exam uterus 2.36 70.00 $165.20 76831 26 Echo exam uterus 1.05 70.00 $73.50 76856 Us exam pelvic complete 3.14 70.00 $219.80 76856 TC Us exam pelvic complete 2.15 70.00 $150.50 76856 26 Us exam pelvic complete 0.99 70.00 $69.30 76857 Us exam pelvic limited 1.37 70.00 $95.90 76857 TC Us exam pelvic limited 0.66 70.00 $46.20 76857 26 Us exam pelvic limited 0.71 70.00 $49.70 76870 Us exam scrotum 1.94 70.00 $135.80 76870 TC Us exam scrotum 1.02 70.00 $71.40 76870 26 Us exam scrotum 0.92 70.00 $64.40 76872 Us transrectal 2.70 70.00 $189.00 76872 TC Us transrectal 1.75 70.00 $122.50 76872 26 Us transrectal 0.95 70.00 $66.50 76873 Echograp trans r pros study 4.86 70.00 $340.20 76873 TC Echograp trans r pros study 2.64 70.00 $184.80 76873 26 Echograp trans r pros study 2.22 70.00 $155.40 76881 Us xtr non-vasc complete 3.36 70.00 $235.20 76881 TC Us xtr non-vasc complete 2.46 70.00 $172.20 76881 26 Us xtr non-vasc complete 0.90 70.00 $63.00 76882 Us xtr non-vasc lmtd 1.02 70.00 $71.40 76882 TC Us xtr non-vasc lmtd 0.32 70.00 $22.40 76882 26 Us xtr non-vasc lmtd 0.70 70.00 $49.00 76885 Us exam infant hips dynamic 4.17 70.00 $291.90 76885 TC Us exam infant hips dynamic 3.11 70.00 $217.70 76885 26 Us exam infant hips dynamic 1.06 70.00 $74.20 76886 Us exam infant hips static 3.10 70.00 $217.00 76886 TC Us exam infant hips static 2.25 70.00 $157.50 76886 26 Us exam infant hips static 0.85 70.00 $59.50 76930 Echo guide cardiocentesis 0.00 70.00 $0.00 76930 TC Echo guide cardiocentesis 0.00 70.00 $0.00 76930 26 Echo guide cardiocentesis 0.94 70.00 $65.80 76932 Echo guide for heart biopsy 0.00 70.00 $0.00 76932 TC Echo guide for heart biopsy 0.00 70.00 $0.00 76932 26 Echo guide for heart biopsy 0.93 70.00 $65.10 76936 Echo guide for artery repair 7.74 70.00 $541.80 76936 TC Echo guide for artery repair 4.95 70.00 $346.50 76936 26 Echo guide for artery repair 2.79 70.00 $195.30 76937 Us guide vascular access 0.89 70.00 $62.30 76937 TC Us guide vascular access 0.48 70.00 $33.60 76937 26 Us guide vascular access 0.41 70.00 $28.70 76940 Us guide tissue ablation 0.00 70.00 $0.00 76940 TC Us guide tissue ablation 0.00 70.00 $0.00 76940 26 Us guide tissue ablation 2.95 70.00 $206.50 76941 Echo guide for transfusion 0.00 70.00 $0.00 76941 TC Echo guide for transfusion 0.00 70.00 $0.00 76941 26 Echo guide for transfusion 1.84 70.00 $128.80 76942 Echo guide for biopsy 1.71 70.00 $119.70 76942 TC Echo guide for biopsy 0.79 70.00 $55.30 76942 26 Echo guide for biopsy 0.92 70.00 $64.40 76945 Echo guide villus sampling 0.00 70.00 $0.00 76945 TC Echo guide villus sampling 0.00 70.00 $0.00 76945 26 Echo guide villus sampling 1.00 70.00 $70.00 76946 Echo guide for amniocentesis 0.93 70.00 $65.10 76946 TC Echo guide for amniocentesis 0.37 70.00 $25.90 76946 26 Echo guide for amniocentesis 0.56 70.00 $39.20 76948 Echo guide ova aspiration 2.03 70.00 $142.10 76948 TC Echo guide ova aspiration 1.07 70.00 $74.90 76948 26 Echo guide ova aspiration 0.96 70.00 $67.20 76965 Echo guidance radiotherapy 2.58 70.00 $180.60 76965 TC Echo guidance radiotherapy 0.68 70.00 $47.60 76965 26 Echo guidance radiotherapy 1.90 70.00 $133.00 76970 Ultrasound exam follow-up 2.62 70.00 $183.40 76970 TC Ultrasound exam follow-up 2.07 70.00 $144.90 76970 26 Ultrasound exam follow-up 0.55 70.00 $38.50 76975 Gi endoscopic ultrasound 0.00 70.00 $0.00 76975 TC Gi endoscopic ultrasound 0.00 70.00 $0.00 76975 26 Gi endoscopic ultrasound 1.20 70.00 $84.00 76977 Us bone density measure 0.21 70.00 $14.70 76977 TC Us bone density measure 0.13 70.00 $9.10 76977 26 Us bone density measure 0.08 70.00 $5.60 76998 Us guide intraop 0.00 70.00 $0.00 76998 TC Us guide intraop 0.00 70.00 $0.00 76998 26 Us guide intraop 1.81 70.00 $126.70 76999 Echo examination procedure 0.00 70.00 $0.00 76999 TC Echo examination procedure 0.00 70.00 $0.00 76999 26 Echo examination procedure 0.00 70.00 $0.00 77001 Fluoroguide for vein device 2.38 70.00 $166.60 77001 TC Fluoroguide for vein device 1.84 70.00 $128.80 77001 26 Fluoroguide for vein device 0.54 70.00 $37.80 77002 Needle localization by xray 2.63 70.00 $184.10 77002 TC Needle localization by xray 1.83 70.00 $128.10 77002 26 Needle localization by xray 0.80 70.00 $56.00 77003 Fluoroguide for spine inject 2.66 70.00 $186.20 77003 TC Fluoroguide for spine inject 1.81 70.00 $126.70 77003 26 Fluoroguide for spine inject 0.85 70.00 $59.50 77011 Ct scan for localization 6.33 70.00 $443.10 77011 TC Ct scan for localization 4.54 70.00 $317.80 77011 26 Ct scan for localization 1.79 70.00 $125.30 77012 Ct scan for needle biopsy 3.51 70.00 $245.70 77012 TC Ct scan for needle biopsy 1.88 70.00 $131.60 77012 26 Ct scan for needle biopsy 1.63 70.00 $114.10 77013 Ct guide for tissue ablation 0.00 70.00 $0.00 77013 TC Ct guide for tissue ablation 0.00 70.00 $0.00 77013 26 Ct guide for tissue ablation 5.54 70.00 $387.80 77014 Ct scan for therapy guide 3.35 70.00 $234.50 77014 TC Ct scan for therapy guide 2.10 70.00 $147.00 77014 26 Ct scan for therapy guide 1.25 70.00 $87.50 77021 Mr guidance for needle place 11.30 70.00 $791.00 77021 TC Mr guidance for needle place 9.18 70.00 $642.60 77021 26 Mr guidance for needle place 2.12 70.00 $148.40 77022 Mri for tissue ablation 0.00 70.00 $0.00 77022 TC Mri for tissue ablation 0.00 70.00 $0.00 77022 26 Mri for tissue ablation 6.07 70.00 $424.90 77053 X-ray of mammary duct 1.66 70.00 $116.20 77053 TC X-ray of mammary duct 1.14 70.00 $79.80 77053 26 X-ray of mammary duct 0.52 70.00 $36.40 77054 X-ray of mammary ducts 2.19 70.00 $153.30 77054 TC X-ray of mammary ducts 1.54 70.00 $107.80 77054 26 X-ray of mammary ducts 0.65 70.00 $45.50 77058 Mri one breast 15.29 70.00 $1,070.30 77058 TC Mri one breast 12.96 70.00 $907.20 77058 26 Mri one breast 2.33 70.00 $163.10 77059 Mri both breasts 15.19 70.00 $1,063.30 77059 TC Mri both breasts 12.86 70.00 $900.20 77059 26 Mri both breasts 2.33 70.00 $163.10 77061 Breast tomosynthesis uni 0.00 70.00 $0.00 77061 TC Breast tomosynthesis uni 0.00 70.00 $0.00 77061 26 Breast tomosynthesis uni 0.00 70.00 $0.00 77062 Breast tomosynthesis bi 0.00 70.00 $0.00 77062 TC Breast tomosynthesis bi 0.00 70.00 $0.00 77062 26 Breast tomosynthesis bi 0.00 70.00 $0.00 77063 Breast tomosynthesis bi 1.57 70.00 $109.90 77063 TC Breast tomosynthesis bi 0.71 70.00 $49.70 77063 26 Breast tomosynthesis bi 0.86 70.00 $60.20 77065 Dx mammo incl cad uni 3.76 70.00 $263.20 77065 TC Dx mammo incl cad uni 2.65 70.00 $185.50 77065 26 Dx mammo incl cad uni 1.11 70.00 $77.70 77066 Dx mammo incl cad bi 4.77 70.00 $333.90 77066 TC Dx mammo incl cad bi 3.39 70.00 $237.30 77066 26 Dx mammo incl cad bi 1.38 70.00 $96.60 77067 Scr mammo bi incl cad 3.85 70.00 $269.50 77067 TC Scr mammo bi incl cad 2.80 70.00 $196.00 77067 26 Scr mammo bi incl cad 1.05 70.00 $73.50 77071 X-ray stress view 1.37 70.00 $95.90 77072 X-rays for bone age 0.65 70.00 $45.50 77072 TC X-rays for bone age 0.38 70.00 $26.60 77072 26 X-rays for bone age 0.27 70.00 $18.90 77073 X-rays bone length studies 1.01 70.00 $70.70 77073 TC X-rays bone length studies 0.60 70.00 $42.00 77073 26 X-rays bone length studies 0.41 70.00 $28.70 77074 X-rays bone survey limited 1.82 70.00 $127.40 77074 TC X-rays bone survey limited 1.17 70.00 $81.90 77074 26 X-rays bone survey limited 0.65 70.00 $45.50 77075 X-rays bone survey complete 2.46 70.00 $172.20 77075 TC X-rays bone survey complete 1.69 70.00 $118.30 77075 26 X-rays bone survey complete 0.77 70.00 $53.90 77076 X-rays bone survey infant 2.73 70.00 $191.10 77076 TC X-rays bone survey infant 1.73 70.00 $121.10 77076 26 X-rays bone survey infant 1.00 70.00 $70.00 77077 Joint survey single view 1.05 70.00 $73.50 77077 TC Joint survey single view 0.59 70.00 $41.30 77077 26 Joint survey single view 0.46 70.00 $32.20 77078 Ct bone density axial 3.23 70.00 $226.10 77078 TC Ct bone density axial 2.88 70.00 $201.60 77078 26 Ct bone density axial 0.35 70.00 $24.50 77080 Dxa bone density axial 1.16 70.00 $81.20 77080 TC Dxa bone density axial 0.87 70.00 $60.90 77080 26 Dxa bone density axial 0.29 70.00 $20.30 77081 Dxa bone density/peripheral 0.79 70.00 $55.30 77081 TC Dxa bone density/peripheral 0.48 70.00 $33.60 77081 26 Dxa bone density/peripheral 0.31 70.00 $21.70 77084 Magnetic image bone marrow 11.02 70.00 $771.40 77084 TC Magnetic image bone marrow 8.72 70.00 $610.40 77084 26 Magnetic image bone marrow 2.30 70.00 $161.00 77085 Dxa bone density study 1.58 70.00 $110.60 77085 TC Dxa bone density study 1.14 70.00 $79.80 77085 26 Dxa bone density study 0.44 70.00 $30.80 77086 Fracture assessment via dxa 1.00 70.00 $70.00 77086 TC Fracture assessment via dxa 0.75 70.00 $52.50 77086 26 Fracture assessment via dxa 0.25 70.00 $17.50 77261 Radiation therapy planning 2.16 70.00 $151.20 77262 Radiation therapy planning 3.21 70.00 $224.70 77263 Radiation therapy planning 4.71 70.00 $329.70 77280 Set radiation therapy field 7.77 70.00 $543.90 77280 TC Set radiation therapy field 6.74 70.00 $471.80 77280 26 Set radiation therapy field 1.03 70.00 $72.10 77285 Set radiation therapy field 12.38 70.00 $866.60 77285 TC Set radiation therapy field 10.83 70.00 $758.10 77285 26 Set radiation therapy field 1.55 70.00 $108.50 77290 Set radiation therapy field 14.64 70.00 $1,024.80 77290 TC Set radiation therapy field 12.34 70.00 $863.80 77290 26 Set radiation therapy field 2.30 70.00 $161.00 77293 Respirator motion mgmt simul 13.23 70.00 $926.10 77293 TC Respirator motion mgmt simul 10.28 70.00 $719.60 77293 26 Respirator motion mgmt simul 2.95 70.00 $206.50 77295 3-d radiotherapy plan 13.92 70.00 $974.40 77295 TC 3-d radiotherapy plan 7.63 70.00 $534.10 77295 26 3-d radiotherapy plan 6.29 70.00 $440.30 77299 Radiation therapy planning 0.00 70.00 $0.00 77299 TC Radiation therapy planning 0.00 70.00 $0.00 77299 26 Radiation therapy planning 0.00 70.00 $0.00 77300 Radiation therapy dose plan 1.89 70.00 $132.30 77300 TC Radiation therapy dose plan 0.97 70.00 $67.90 77300 26 Radiation therapy dose plan 0.92 70.00 $64.40 77301 Radiotherapy dose plan imrt 55.44 70.00 $3,880.80 77301 TC Radiotherapy dose plan imrt 43.71 70.00 $3,059.70 77301 26 Radiotherapy dose plan imrt 11.73 70.00 $821.10 77306 Telethx isodose plan simple 4.24 70.00 $296.80 77306 TC Telethx isodose plan simple 2.18 70.00 $152.60 77306 26 Telethx isodose plan simple 2.06 70.00 $144.20 77307 Telethx isodose plan cplx 8.20 70.00 $574.00 77307 TC Telethx isodose plan cplx 3.94 70.00 $275.80 77307 26 Telethx isodose plan cplx 4.26 70.00 $298.20 77316 Brachytx isodose plan simple 5.35 70.00 $374.50 77316 TC Brachytx isodose plan simple 3.29 70.00 $230.30 77316 26 Brachytx isodose plan simple 2.06 70.00 $144.20 77317 Brachytx isodose intermed 6.97 70.00 $487.90 77317 TC Brachytx isodose intermed 4.28 70.00 $299.60 77317 26 Brachytx isodose intermed 2.69 70.00 $188.30 77318 Brachytx isodose complex 10.07 70.00 $704.90 77318 TC Brachytx isodose complex 5.81 70.00 $406.70 77318 26 Brachytx isodose complex 4.26 70.00 $298.20 77321 Special teletx port plan 2.64 70.00 $184.80 77321 TC Special teletx port plan 1.24 70.00 $86.80 77321 26 Special teletx port plan 1.40 70.00 $98.00 77331 Special radiation dosimetry 1.82 70.00 $127.40 77331 TC Special radiation dosimetry 0.54 70.00 $37.80 77331 26 Special radiation dosimetry 1.28 70.00 $89.60 77332 Radiation treatment aid(s) 1.91 70.00 $133.70 77332 TC Radiation treatment aid(s) 1.24 70.00 $86.80 77332 26 Radiation treatment aid(s) 0.67 70.00 $46.90 77333 Radiation treatment aid(s) 2.74 70.00 $191.80 77333 TC Radiation treatment aid(s) 1.64 70.00 $114.80 77333 26 Radiation treatment aid(s) 1.10 70.00 $77.00 77334 Radiation treatment aid(s) 3.71 70.00 $259.70 77334 TC Radiation treatment aid(s) 2.02 70.00 $141.40 77334 26 Radiation treatment aid(s) 1.69 70.00 $118.30 77336 Radiation physics consult 2.25 70.00 $157.50 77338 Design mlc device for imrt 14.40 70.00 $1,008.00 77338 TC Design mlc device for imrt 8.11 70.00 $567.70 77338 26 Design mlc device for imrt 6.29 70.00 $440.30 77370 Radiation physics consult 3.46 70.00 $242.20 77371 Srs multisource 0.00 70.00 $0.00 77372 Srs linear based 30.45 70.00 $2,131.50 77373 Sbrt delivery 38.65 70.00 $2,705.50 77385 Ntsty modul rad tx dlvr smpl 0.00 70.00 $0.00 77386 Ntsty modul rad tx dlvr cplx 0.00 70.00 $0.00 77387 Guidance for radiaj tx dlvr 0.00 70.00 $0.00 77399 External radiation dosimetry 0.00 70.00 $0.00 77399 TC External radiation dosimetry 0.00 70.00 $0.00 77399 26 External radiation dosimetry 0.00 70.00 $0.00 77401 Radiation treatment delivery 0.70 70.00 $49.00 77402 Radiation treatment delivery 0.00 70.00 $0.00 77407 Radiation treatment delivery 0.00 70.00 $0.00 77412 Radiation treatment delivery 0.00 70.00 $0.00 77417 Radiology port images(s) 0.31 70.00 $21.70 77422 Neutron beam tx simple 0.00 70.00 $0.00 77423 Neutron beam tx complex 0.00 70.00 $0.00 77424 Io rad tx delivery by x-ray 0.00 70.00 $0.00 77425 Io rad tx deliver by elctrns 0.00 70.00 $0.00 77427 Radiation tx management x5 5.27 70.00 $368.90 77431 Radiation therapy management 2.90 70.00 $203.00 77432 Stereotactic radiation trmt 11.87 70.00 $830.90 77435 Sbrt management 17.89 70.00 $1,252.30 77469 Io radiation tx management 9.12 70.00 $638.40 77470 Special radiation treatment 4.09 70.00 $286.30 77470 TC Special radiation treatment 1.10 70.00 $77.00 77470 26 Special radiation treatment 2.99 70.00 $209.30 77499 Radiation therapy management 0.00 70.00 $0.00 77499 TC Radiation therapy management 0.00 70.00 $0.00 77499 26 Radiation therapy management 0.00 70.00 $0.00 77520 Proton trmt simple w/o comp 0.00 70.00 $0.00 77522 Proton trmt simple w/comp 0.00 70.00 $0.00 77523 Proton trmt intermediate 0.00 70.00 $0.00 77525 Proton treatment complex 0.00 70.00 $0.00 77600 Hyperthermia treatment 11.75 70.00 $822.50 77600 TC Hyperthermia treatment 9.77 70.00 $683.90 77600 26 Hyperthermia treatment 1.98 70.00 $138.60 77605 Hyperthermia treatment 22.09 70.00 $1,546.30 77605 TC Hyperthermia treatment 19.20 70.00 $1,344.00 77605 26 Hyperthermia treatment 2.89 70.00 $202.30 77610 Hyperthermia treatment 24.38 70.00 $1,706.60 77610 TC Hyperthermia treatment 22.42 70.00 $1,569.40 77610 26 Hyperthermia treatment 1.96 70.00 $137.20 77615 Hyperthermia treatment 29.05 70.00 $2,033.50 77615 TC Hyperthermia treatment 26.35 70.00 $1,844.50 77615 26 Hyperthermia treatment 2.70 70.00 $189.00 77620 Hyperthermia treatment 13.11 70.00 $917.70 77620 TC Hyperthermia treatment 10.65 70.00 $745.50 77620 26 Hyperthermia treatment 2.46 70.00 $172.20 77750 Infuse radioactive materials 10.56 70.00 $739.20 77750 TC Infuse radioactive materials 3.22 70.00 $225.40 77750 26 Infuse radioactive materials 7.34 70.00 $513.80 77761 Apply intrcav radiat simple 11.10 70.00 $777.00 77761 TC Apply intrcav radiat simple 5.49 70.00 $384.30 77761 26 Apply intrcav radiat simple 5.61 70.00 $392.70 77762 Apply intrcav radiat interm 14.81 70.00 $1,036.70 77762 TC Apply intrcav radiat interm 6.35 70.00 $444.50 77762 26 Apply intrcav radiat interm 8.46 70.00 $592.20 77763 Apply intrcav radiat compl 20.87 70.00 $1,460.90 77763 TC Apply intrcav radiat compl 8.15 70.00 $570.50 77763 26 Apply intrcav radiat compl 12.72 70.00 $890.40 77767 Hdr rdncl skn surf brachytx 6.38 70.00 $446.60 77767 TC Hdr rdncl skn surf brachytx 4.83 70.00 $338.10 77767 26 Hdr rdncl skn surf brachytx 1.55 70.00 $108.50 77768 Hdr rdncl skn surf brachytx 10.01 70.00 $700.70 77768 TC Hdr rdncl skn surf brachytx 7.95 70.00 $556.50 77768 26 Hdr rdncl skn surf brachytx 2.06 70.00 $144.20 77770 Hdr rdncl ntrstl/icav brchtx 9.10 70.00 $637.00 77770 TC Hdr rdncl ntrstl/icav brchtx 6.24 70.00 $436.80 77770 26 Hdr rdncl ntrstl/icav brchtx 2.86 70.00 $200.20 77771 Hdr rdncl ntrstl/icav brchtx 16.95 70.00 $1,186.50 77771 TC Hdr rdncl ntrstl/icav brchtx 11.37 70.00 $795.90 77771 26 Hdr rdncl ntrstl/icav brchtx 5.58 70.00 $390.60 77772 Hdr rdncl ntrstl/icav brchtx 25.90 70.00 $1,813.00 77772 TC Hdr rdncl ntrstl/icav brchtx 17.99 70.00 $1,259.30 77772 26 Hdr rdncl ntrstl/icav brchtx 7.91 70.00 $553.70 77778 Apply interstit radiat compl 23.31 70.00 $1,631.70 77778 TC Apply interstit radiat compl 10.45 70.00 $731.50 77778 26 Apply interstit radiat compl 12.86 70.00 $900.20 77789 Apply surf ldr radionuclide 3.37 70.00 $235.90 77789 TC Apply surface radiation 1.69 70.00 $118.30 77789 26 Apply surface radiation 1.68 70.00 $117.60 77790 Radiation handling 0.42 70.00 $29.40 77799 Radium/radioisotope therapy 0.00 70.00 $0.00 77799 TC Radium/radioisotope therapy 0.00 70.00 $0.00 77799 26 Radium/radioisotope therapy 0.00 70.00 $0.00 78012 Thyroid uptake measurement 2.35 70.00 $164.50 78012 TC Thyroid uptake measurement 2.08 70.00 $145.60 78012 26 Thyroid uptake measurement 0.27 70.00 $18.90 78013 Thyroid imaging w/blood flow 5.59 70.00 $391.30 78013 TC Thyroid imaging w/blood flow 5.07 70.00 $354.90 78013 26 Thyroid imaging w/blood flow 0.52 70.00 $36.40 78014 Thyroid imaging w/blood flow 7.07 70.00 $494.90 78014 TC Thyroid imaging w/blood flow 6.36 70.00 $445.20 78014 26 Thyroid imaging w/blood flow 0.71 70.00 $49.70 78015 Thyroid met imaging 6.49 70.00 $454.30 78015 TC Thyroid met imaging 5.55 70.00 $388.50 78015 26 Thyroid met imaging 0.94 70.00 $65.80 78016 Thyroid met imaging/studies 8.31 70.00 $581.70 78016 TC Thyroid met imaging/studies 7.33 70.00 $513.10 78016 26 Thyroid met imaging/studies 0.98 70.00 $68.60 78018 Thyroid met imaging body 9.16 70.00 $641.20 78018 TC Thyroid met imaging body 7.98 70.00 $558.60 78018 26 Thyroid met imaging body 1.18 70.00 $82.60 78020 Thyroid met uptake 2.43 70.00 $170.10 78020 TC Thyroid met uptake 1.64 70.00 $114.80 78020 26 Thyroid met uptake 0.79 70.00 $55.30 78070 Parathyroid planar imaging 8.78 70.00 $614.60 78070 TC Parathyroid planar imaging 7.66 70.00 $536.20 78070 26 Parathyroid planar imaging 1.12 70.00 $78.40 78071 Parathyrd planar w/wo subtrj 10.45 70.00 $731.50 78071 TC Parathyrd planar w/wo subtrj 8.78 70.00 $614.60 78071 26 Parathyrd planar w/wo subtrj 1.67 70.00 $116.90 78072 Parathyrd planar w/spect&ct 12.05 70.00 $843.50 78072 TC Parathyrd planar w/spect&ct 9.87 70.00 $690.90 78072 26 Parathyrd planar w/spect&ct 2.18 70.00 $152.60 78075 Adrenal cortex & medulla img 12.99 70.00 $909.30 78075 TC Adrenal cortex & medulla img 11.94 70.00 $835.80 78075 26 Adrenal cortex & medulla img 1.05 70.00 $73.50 78099 Endocrine nuclear procedure 0.00 70.00 $0.00 78099 TC Endocrine nuclear procedure 0.00 70.00 $0.00 78099 26 Endocrine nuclear procedure 0.00 70.00 $0.00 78102 Bone marrow imaging ltd 4.98 70.00 $348.60 78102 TC Bone marrow imaging ltd 4.22 70.00 $295.40 78102 26 Bone marrow imaging ltd 0.76 70.00 $53.20 78103 Bone marrow imaging mult 6.42 70.00 $449.40 78103 TC Bone marrow imaging mult 5.41 70.00 $378.70 78103 26 Bone marrow imaging mult 1.01 70.00 $70.70 78104 Bone marrow imaging body 7.17 70.00 $501.90 78104 TC Bone marrow imaging body 6.08 70.00 $425.60 78104 26 Bone marrow imaging body 1.09 70.00 $76.30 78110 Plasma volume single 2.92 70.00 $204.40 78110 TC Plasma volume single 2.64 70.00 $184.80 78110 26 Plasma volume single 0.28 70.00 $19.60 78111 Plasma volume multiple 2.78 70.00 $194.60 78111 TC Plasma volume multiple 2.47 70.00 $172.90 78111 26 Plasma volume multiple 0.31 70.00 $21.70 78120 Red cell mass single 2.74 70.00 $191.80 78120 TC Red cell mass single 2.41 70.00 $168.70 78120 26 Red cell mass single 0.33 70.00 $23.10 78121 Red cell mass multiple 3.04 70.00 $212.80 78121 TC Red cell mass multiple 2.59 70.00 $181.30 78121 26 Red cell mass multiple 0.45 70.00 $31.50 78122 Blood volume 2.81 70.00 $196.70 78122 TC Blood volume 2.21 70.00 $154.70 78122 26 Blood volume 0.60 70.00 $42.00 78130 Red cell survival study 4.89 70.00 $342.30 78130 TC Red cell survival study 4.03 70.00 $282.10 78130 26 Red cell survival study 0.86 70.00 $60.20 78135 Red cell survival kinetics 10.31 70.00 $721.70 78135 TC Red cell survival kinetics 9.39 70.00 $657.30 78135 26 Red cell survival kinetics 0.92 70.00 $64.40 78140 Red cell sequestration 4.04 70.00 $282.80 78140 TC Red cell sequestration 3.17 70.00 $221.90 78140 26 Red cell sequestration 0.87 70.00 $60.90 78185 Spleen imaging 6.18 70.00 $432.60 78185 TC Spleen imaging 5.61 70.00 $392.70 78185 26 Spleen imaging 0.57 70.00 $39.90 78190 Platelet survival kinetics 11.50 70.00 $805.00 78190 TC Platelet survival kinetics 9.96 70.00 $697.20 78190 26 Platelet survival kinetics 1.54 70.00 $107.80 78191 Platelet survival 4.89 70.00 $342.30 78191 TC Platelet survival 4.03 70.00 $282.10 78191 26 Platelet survival 0.86 70.00 $60.20 78195 Lymph system imaging 10.42 70.00 $729.40 78195 TC Lymph system imaging 8.74 70.00 $611.80 78195 26 Lymph system imaging 1.68 70.00 $117.60 78199 Blood/lymph nuclear exam 0.00 70.00 $0.00 78199 TC Blood/lymph nuclear exam 0.00 70.00 $0.00 78199 26 Blood/lymph nuclear exam 0.00 70.00 $0.00 78201 Liver imaging 5.52 70.00 $386.40 78201 TC Liver imaging 4.92 70.00 $344.40 78201 26 Liver imaging 0.60 70.00 $42.00 78202 Liver imaging with flow 5.85 70.00 $409.50 78202 TC Liver imaging with flow 5.18 70.00 $362.60 78202 26 Liver imaging with flow 0.67 70.00 $46.90 78205 Liver imaging (3d) 6.17 70.00 $431.90 78205 TC Liver imaging (3d) 5.21 70.00 $364.70 78205 26 Liver imaging (3d) 0.96 70.00 $67.20 78206 Liver image (3d) with flow 10.01 70.00 $700.70 78206 TC Liver image (3d) with flow 8.68 70.00 $607.60 78206 26 Liver image (3d) with flow 1.33 70.00 $93.10 78215 Liver and spleen imaging 5.68 70.00 $397.60 78215 TC Liver and spleen imaging 4.99 70.00 $349.30 78215 26 Liver and spleen imaging 0.69 70.00 $48.30 78216 Liver & spleen image/flow 3.70 70.00 $259.00 78216 TC Liver & spleen image/flow 2.92 70.00 $204.40 78216 26 Liver & spleen image/flow 0.78 70.00 $54.60 78226 Hepatobiliary system imaging 9.68 70.00 $677.60 78226 TC Hepatobiliary system imaging 8.64 70.00 $604.80 78226 26 Hepatobiliary system imaging 1.04 70.00 $72.80 78227 Hepatobil syst image w/drug 13.13 70.00 $919.10 78227 TC Hepatobil syst image w/drug 11.86 70.00 $830.20 78227 26 Hepatobil syst image w/drug 1.27 70.00 $88.90 78230 Salivary gland imaging 5.11 70.00 $357.70 78230 TC Salivary gland imaging 4.46 70.00 $312.20 78230 26 Salivary gland imaging 0.65 70.00 $45.50 78231 Serial salivary imaging 3.76 70.00 $263.20 78231 TC Serial salivary imaging 3.02 70.00 $211.40 78231 26 Serial salivary imaging 0.74 70.00 $51.80 78232 Salivary gland function exam 2.92 70.00 $204.40 78232 TC Salivary gland function exam 2.36 70.00 $165.20 78232 26 Salivary gland function exam 0.56 70.00 $39.20 78258 Esophageal motility study 6.58 70.00 $460.60 78258 TC Esophageal motility study 5.53 70.00 $387.10 78258 26 Esophageal motility study 1.05 70.00 $73.50 78261 Gastric mucosa imaging 7.18 70.00 $502.60 78261 TC Gastric mucosa imaging 6.22 70.00 $435.40 78261 26 Gastric mucosa imaging 0.96 70.00 $67.20 78262 Gastroesophageal reflux exam 7.09 70.00 $496.30 78262 TC Gastroesophageal reflux exam 6.15 70.00 $430.50 78262 26 Gastroesophageal reflux exam 0.94 70.00 $65.80 78264 Gastric emptying imag study 9.84 70.00 $688.80 78264 TC Gastric emptying study 8.73 70.00 $611.10 78264 26 Gastric emptying study 1.11 70.00 $77.70 78265 Gastric emptying imag study 11.67 70.00 $816.90 78265 TC Gastric emptying imag study 10.29 70.00 $720.30 78265 26 Gastric emptying imag study 1.38 70.00 $96.60 78266 Gastric emptying imag study 13.83 70.00 $968.10 78266 TC Gastric emptying imag study 12.31 70.00 $861.70 78266 26 Gastric emptying imag study 1.52 70.00 $106.40 78267 Breath tst attain/anal c-14 0.00 70.00 $0.00 78268 Breath test analysis c-14 0.00 70.00 $0.00 78270 Vit b-12 absorption exam 2.96 70.00 $207.20 78270 TC Vit b-12 absorption exam 2.66 70.00 $186.20 78270 26 Vit b-12 absorption exam 0.30 70.00 $21.00 78271 Vit b-12 absrp exam int fac 2.62 70.00 $183.40 78271 TC Vit b-12 absrp exam int fac 2.33 70.00 $163.10 78271 26 Vit b-12 absrp exam int fac 0.29 70.00 $20.30 78272 Vit b-12 absorp combined 2.86 70.00 $200.20 78272 TC Vit b-12 absorp combined 2.48 70.00 $173.60 78272 26 Vit b-12 absorp combined 0.38 70.00 $26.60 78278 Acute gi blood loss imaging 10.19 70.00 $713.30 78278 TC Acute gi blood loss imaging 8.80 70.00 $616.00 78278 26 Acute gi blood loss imaging 1.39 70.00 $97.30 78282 Gi protein loss exam 0.00 70.00 $0.00 78282 TC Gi protein loss exam 0.00 70.00 $0.00 78282 26 Gi protein loss exam 0.54 70.00 $37.80 78290 Meckels divert exam 9.71 70.00 $679.70 78290 TC Meckels divert exam 8.75 70.00 $612.50 78290 26 Meckels divert exam 0.96 70.00 $67.20 78291 Leveen/shunt patency exam 7.48 70.00 $523.60 78291 TC Leveen/shunt patency exam 6.26 70.00 $438.20 78291 26 Leveen/shunt patency exam 1.22 70.00 $85.40 78299 Gi nuclear procedure 0.00 70.00 $0.00 78299 TC Gi nuclear procedure 0.00 70.00 $0.00 78299 26 Gi nuclear procedure 0.00 70.00 $0.00 78300 Bone imaging limited area 5.30 70.00 $371.00 78300 TC Bone imaging limited area 4.41 70.00 $308.70 78300 26 Bone imaging limited area 0.89 70.00 $62.30 78305 Bone imaging multiple areas 6.78 70.00 $474.60 78305 TC Bone imaging multiple areas 5.60 70.00 $392.00 78305 26 Bone imaging multiple areas 1.18 70.00 $82.60 78306 Bone imaging whole body 7.35 70.00 $514.50 78306 TC Bone imaging whole body 6.15 70.00 $430.50 78306 26 Bone imaging whole body 1.20 70.00 $84.00 78315 Bone imaging 3 phase 10.12 70.00 $708.40 78315 TC Bone imaging 3 phase 8.69 70.00 $608.30 78315 26 Bone imaging 3 phase 1.43 70.00 $100.10 78320 Bone imaging (3d) 6.67 70.00 $466.90 78320 TC Bone imaging (3d) 5.23 70.00 $366.10 78320 26 Bone imaging (3d) 1.44 70.00 $100.80 78350 Bone mineral single photon 0.93 70.00 $65.10 78350 TC Bone mineral single photon 0.62 70.00 $43.40 78350 26 Bone mineral single photon 0.31 70.00 $21.70 78351 Bone mineral dual photon 0.44 70.00 $30.80 78399 Musculoskeletal nuclear exam 0.00 70.00 $0.00 78399 TC Musculoskeletal nuclear exam 0.00 70.00 $0.00 78399 26 Musculoskeletal nuclear exam 0.00 70.00 $0.00 78414 Non-imaging heart function 0.00 70.00 $0.00 78414 TC Non-imaging heart function 0.00 70.00 $0.00 78414 26 Non-imaging heart function 0.63 70.00 $44.10 78428 Cardiac shunt imaging 5.29 70.00 $370.30 78428 TC Cardiac shunt imaging 4.22 70.00 $295.40 78428 26 Cardiac shunt imaging 1.07 70.00 $74.90 78445 Vascular flow imaging 5.31 70.00 $371.70 78445 TC Vascular flow imaging 4.62 70.00 $323.40 78445 26 Vascular flow imaging 0.69 70.00 $48.30 78451 Ht muscle image spect sing 9.92 70.00 $694.40 78451 TC Ht muscle image spect sing 8.01 70.00 $560.70 78451 26 Ht muscle image spect sing 1.91 70.00 $133.70 78452 Ht muscle image spect mult 13.78 70.00 $964.60 78452 TC Ht muscle image spect mult 11.54 70.00 $807.80 78452 26 Ht muscle image spect mult 2.24 70.00 $156.80 78453 Ht muscle image planar sing 8.87 70.00 $620.90 78453 TC Ht muscle image planar sing 7.46 70.00 $522.20 78453 26 Ht muscle image planar sing 1.41 70.00 $98.70 78454 Ht musc image planar mult 12.76 70.00 $893.20 78454 TC Ht musc image planar mult 10.86 70.00 $760.20 78454 26 Ht musc image planar mult 1.90 70.00 $133.00 78456 Acute venous thrombus image 9.34 70.00 $653.80 78456 TC Acute venous thrombus image 7.95 70.00 $556.50 78456 26 Acute venous thrombus image 1.39 70.00 $97.30 78457 Venous thrombosis imaging 5.13 70.00 $359.10 78457 TC Venous thrombosis imaging 4.07 70.00 $284.90 78457 26 Venous thrombosis imaging 1.06 70.00 $74.20 78458 Ven thrombosis images bilat 5.98 70.00 $418.60 78458 TC Ven thrombosis images bilat 4.69 70.00 $328.30 78458 26 Ven thrombosis images bilat 1.29 70.00 $90.30 78459 Heart muscle imaging (pet) 0.00 70.00 $0.00 78459 TC Heart muscle imaging (pet) 0.00 70.00 $0.00 78459 26 Heart muscle imaging (pet) 2.01 70.00 $140.70 78466 Heart infarct image 5.71 70.00 $399.70 78466 TC Heart infarct image 4.71 70.00 $329.70 78466 26 Heart infarct image 1.00 70.00 $70.00 78468 Heart infarct image (ef) 5.67 70.00 $396.90 78468 TC Heart infarct image (ef) 4.56 70.00 $319.20 78468 26 Heart infarct image (ef) 1.11 70.00 $77.70 78469 Heart infarct image (3d) 6.63 70.00 $464.10 78469 TC Heart infarct image (3d) 5.35 70.00 $374.50 78469 26 Heart infarct image (3d) 1.28 70.00 $89.60 78472 Gated heart planar single 6.68 70.00 $467.60 78472 TC Gated heart planar single 5.31 70.00 $371.70 78472 26 Gated heart planar single 1.37 70.00 $95.90 78473 Gated heart multiple 8.42 70.00 $589.40 78473 TC Gated heart multiple 6.40 70.00 $448.00 78473 26 Gated heart multiple 2.02 70.00 $141.40 78481 Heart first pass single 5.09 70.00 $356.30 78481 TC Heart first pass single 3.73 70.00 $261.10 78481 26 Heart first pass single 1.36 70.00 $95.20 78483 Heart first pass multiple 7.06 70.00 $494.20 78483 TC Heart first pass multiple 5.03 70.00 $352.10 78483 26 Heart first pass multiple 2.03 70.00 $142.10 78491 Heart image (pet) single 0.00 70.00 $0.00 78491 TC Heart image (pet) single 0.00 70.00 $0.00 78491 26 Heart image (pet) single 2.03 70.00 $142.10 78492 Heart image (pet) multiple 0.00 70.00 $0.00 78492 TC Heart image (pet) multiple 0.00 70.00 $0.00 78492 26 Heart image (pet) multiple 2.55 70.00 $178.50 78494 Heart image spect 6.54 70.00 $457.80 78494 TC Heart image spect 4.89 70.00 $342.30 78494 26 Heart image spect 1.65 70.00 $115.50 78496 Heart first pass add-on 1.27 70.00 $88.90 78496 TC Heart first pass add-on 0.58 70.00 $40.60 78496 26 Heart first pass add-on 0.69 70.00 $48.30 78499 Cardiovascular nuclear exam 0.00 70.00 $0.00 78499 TC Cardiovascular nuclear exam 0.00 70.00 $0.00 78499 26 Cardiovascular nuclear exam 0.00 70.00 $0.00 78579 Lung ventilation imaging 5.44 70.00 $380.80 78579 TC Lung ventilation imaging 4.76 70.00 $333.20 78579 26 Lung ventilation imaging 0.68 70.00 $47.60 78580 Lung perfusion imaging 6.99 70.00 $489.30 78580 TC Lung perfusion imaging 5.95 70.00 $416.50 78580 26 Lung perfusion imaging 1.04 70.00 $72.80 78582 Lung ventilat&perfus imaging 9.79 70.00 $685.30 78582 TC Lung ventilat&perfus imaging 8.28 70.00 $579.60 78582 26 Lung ventilat&perfus imaging 1.51 70.00 $105.70 78597 Lung perfusion differential 5.90 70.00 $413.00 78597 TC Lung perfusion differential 4.89 70.00 $342.30 78597 26 Lung perfusion differential 1.01 70.00 $70.70 78598 Lung perf&ventilat diferentl 8.95 70.00 $626.50 78598 TC Lung perf&ventilat diferentl 7.77 70.00 $543.90 78598 26 Lung perf&ventilat diferentl 1.18 70.00 $82.60 78599 Respiratory nuclear exam 0.00 70.00 $0.00 78599 TC Respiratory nuclear exam 0.00 70.00 $0.00 78599 26 Respiratory nuclear exam 0.00 70.00 $0.00 78600 Brain image < 4 views 5.42 70.00 $379.40 78600 TC Brain image < 4 views 4.78 70.00 $334.60 78600 26 Brain image < 4 views 0.64 70.00 $44.80 78601 Brain image w/flow < 4 views 6.28 70.00 $439.60 78601 TC Brain image w/flow < 4 views 5.57 70.00 $389.90 78601 26 Brain image w/flow < 4 views 0.71 70.00 $49.70 78605 Brain image 4+ views 5.86 70.00 $410.20 78605 TC Brain image 4+ views 5.10 70.00 $357.00 78605 26 Brain image 4+ views 0.76 70.00 $53.20 78606 Brain image w/flow 4 + views 9.65 70.00 $675.50 78606 TC Brain image w/flow 4 + views 8.76 70.00 $613.20 78606 26 Brain image w/flow 4 + views 0.89 70.00 $62.30 78607 Brain imaging (3d) 10.28 70.00 $719.60 78607 TC Brain imaging (3d) 8.59 70.00 $601.30 78607 26 Brain imaging (3d) 1.69 70.00 $118.30 78608 Brain imaging (pet) 0.00 70.00 $0.00 78608 TC Brain imaging (pet) 0.00 70.00 $0.00 78608 26 Brain imaging (pet) 2.04 70.00 $142.80 78609 Brain imaging (pet) 2.12 70.00 $148.40 78609 TC Brain imaging (pet) 0.00 70.00 $0.00 78609 26 Brain imaging (pet) 2.12 70.00 $148.40 78610 Brain flow imaging only 5.12 70.00 $358.40 78610 TC Brain flow imaging only 4.69 70.00 $328.30 78610 26 Brain flow imaging only 0.43 70.00 $30.10 78630 Cerebrospinal fluid scan 9.91 70.00 $693.70 78630 TC Cerebrospinal fluid scan 8.95 70.00 $626.50 78630 26 Cerebrospinal fluid scan 0.96 70.00 $67.20 78635 Csf ventriculography 10.01 70.00 $700.70 78635 TC Csf ventriculography 9.12 70.00 $638.40 78635 26 Csf ventriculography 0.89 70.00 $62.30 78645 Csf shunt evaluation 9.49 70.00 $664.30 78645 TC Csf shunt evaluation 8.70 70.00 $609.00 78645 26 Csf shunt evaluation 0.79 70.00 $55.30 78647 Cerebrospinal fluid scan 10.36 70.00 $725.20 78647 TC Cerebrospinal fluid scan 9.06 70.00 $634.20 78647 26 Cerebrospinal fluid scan 1.30 70.00 $91.00 78650 Csf leakage imaging 9.69 70.00 $678.30 78650 TC Csf leakage imaging 8.84 70.00 $618.80 78650 26 Csf leakage imaging 0.85 70.00 $59.50 78660 Nuclear exam of tear flow 5.25 70.00 $367.50 78660 TC Nuclear exam of tear flow 4.50 70.00 $315.00 78660 26 Nuclear exam of tear flow 0.75 70.00 $52.50 78699 Nervous system nuclear exam 0.00 70.00 $0.00 78699 TC Nervous system nuclear exam 0.00 70.00 $0.00 78699 26 Nervous system nuclear exam 0.00 70.00 $0.00 78700 Kidney imaging morphol 5.01 70.00 $350.70 78700 TC Kidney imaging morphol 4.38 70.00 $306.60 78700 26 Kidney imaging morphol 0.63 70.00 $44.10 78701 Kidney imaging with flow 6.18 70.00 $432.60 78701 TC Kidney imaging with flow 5.51 70.00 $385.70 78701 26 Kidney imaging with flow 0.67 70.00 $46.90 78707 K flow/funct image w/o drug 6.80 70.00 $476.00 78707 TC K flow/funct image w/o drug 5.47 70.00 $382.90 78707 26 K flow/funct image w/o drug 1.33 70.00 $93.10 78708 K flow/funct image w/drug 5.13 70.00 $359.10 78708 TC K flow/funct image w/drug 3.44 70.00 $240.80 78708 26 K flow/funct image w/drug 1.69 70.00 $118.30 78709 K flow/funct image multiple 10.66 70.00 $746.20 78709 TC K flow/funct image multiple 8.71 70.00 $609.70 78709 26 K flow/funct image multiple 1.95 70.00 $136.50 78710 Kidney imaging (3d) 5.87 70.00 $410.90 78710 TC Kidney imaging (3d) 5.00 70.00 $350.00 78710 26 Kidney imaging (3d) 0.87 70.00 $60.90 78725 Kidney function study 3.11 70.00 $217.70 78725 TC Kidney function study 2.59 70.00 $181.30 78725 26 Kidney function study 0.52 70.00 $36.40 78730 Urinary bladder retention 2.06 70.00 $144.20 78730 TC Urinary bladder retention 1.85 70.00 $129.50 78730 26 Urinary bladder retention 0.21 70.00 $14.70 78740 Ureteral reflux study 6.40 70.00 $448.00 78740 TC Ureteral reflux study 5.62 70.00 $393.40 78740 26 Ureteral reflux study 0.78 70.00 $54.60 78761 Testicular imaging w/flow 6.24 70.00 $436.80 78761 TC Testicular imaging w/flow 5.22 70.00 $365.40 78761 26 Testicular imaging w/flow 1.02 70.00 $71.40 78799 Genitourinary nuclear exam 0.00 70.00 $0.00 78799 TC Genitourinary nuclear exam 0.00 70.00 $0.00 78799 26 Genitourinary nuclear exam 0.00 70.00 $0.00 78800 Tumor imaging limited area 5.63 70.00 $394.10 78800 TC Tumor imaging limited area 4.67 70.00 $326.90 78800 26 Tumor imaging limited area 0.96 70.00 $67.20 78801 Tumor imaging mult areas 7.68 70.00 $537.60 78801 TC Tumor imaging mult areas 6.54 70.00 $457.80 78801 26 Tumor imaging mult areas 1.14 70.00 $79.80 78802 Tumor imaging whole body 9.47 70.00 $662.90 78802 TC Tumor imaging whole body 8.28 70.00 $579.60 78802 26 Tumor imaging whole body 1.19 70.00 $83.30 78803 Tumor imaging (3d) 9.99 70.00 $699.30 78803 TC Tumor imaging (3d) 8.51 70.00 $595.70 78803 26 Tumor imaging (3d) 1.48 70.00 $103.60 78804 Tumor imaging whole body 16.56 70.00 $1,159.20 78804 TC Tumor imaging whole body 15.08 70.00 $1,055.60 78804 26 Tumor imaging whole body 1.48 70.00 $103.60 78805 Abscess imaging ltd area 5.35 70.00 $374.50 78805 TC Abscess imaging ltd area 4.33 70.00 $303.10 78805 26 Abscess imaging ltd area 1.02 70.00 $71.40 78806 Abscess imaging whole body 9.75 70.00 $682.50 78806 TC Abscess imaging whole body 8.56 70.00 $599.20 78806 26 Abscess imaging whole body 1.19 70.00 $83.30 78807 Nuclear localization/abscess 10.01 70.00 $700.70 78807 TC Nuclear localization/abscess 8.53 70.00 $597.10 78807 26 Nuclear localization/abscess 1.48 70.00 $103.60 78808 Iv inj ra drug dx study 1.28 70.00 $89.60 78811 Pet image ltd area 0.00 70.00 $0.00 78811 TC Pet image ltd area 0.00 70.00 $0.00 78811 26 Pet image ltd area 2.19 70.00 $153.30 78812 Pet image skull-thigh 0.00 70.00 $0.00 78812 TC Pet image skull-thigh 0.00 70.00 $0.00 78812 26 Pet image skull-thigh 2.67 70.00 $186.90 78813 Pet image full body 0.00 70.00 $0.00 78813 TC Pet image full body 0.00 70.00 $0.00 78813 26 Pet image full body 2.78 70.00 $194.60 78814 Pet image w/ct lmtd 0.00 70.00 $0.00 78814 TC Pet image w/ct lmtd 0.00 70.00 $0.00 78814 26 Pet image w/ct lmtd 3.09 70.00 $216.30 78815 Pet image w/ct skull-thigh 0.00 70.00 $0.00 78815 TC Pet image w/ct skull-thigh 0.00 70.00 $0.00 78815 26 Pet image w/ct skull-thigh 3.40 70.00 $238.00 78816 Pet image w/ct full body 0.00 70.00 $0.00 78816 TC Pet image w/ct full body 0.00 70.00 $0.00 78816 26 Pet image w/ct full body 3.44 70.00 $240.80 78999 Nuclear diagnostic exam 0.00 70.00 $0.00 78999 TC Nuclear diagnostic exam 0.00 70.00 $0.00 78999 26 Nuclear diagnostic exam 0.00 70.00 $0.00 79005 Nuclear rx oral admin 3.90 70.00 $273.00 79005 TC Nuclear rx oral admin 1.40 70.00 $98.00 79005 26 Nuclear rx oral admin 2.50 70.00 $175.00 79101 Nuclear rx iv admin 4.09 70.00 $286.30 79101 TC Nuclear rx iv admin 1.36 70.00 $95.20 79101 26 Nuclear rx iv admin 2.73 70.00 $191.10 79200 Nuclear rx intracav admin 3.99 70.00 $279.30 79200 TC Nuclear rx intracav admin 1.55 70.00 $108.50 79200 26 Nuclear rx intracav admin 2.44 70.00 $170.80 79300 Nuclr rx interstit colloid 0.00 70.00 $0.00 79300 TC Nuclr rx interstit colloid 0.00 70.00 $0.00 79300 26 Nuclr rx interstit colloid 2.29 70.00 $160.30 79403 Hematopoietic nuclear tx 5.47 70.00 $382.90 79403 TC Hematopoietic nuclear tx 2.34 70.00 $163.80 79403 26 Hematopoietic nuclear tx 3.13 70.00 $219.10 79440 Nuclear rx intra-articular 4.21 70.00 $294.70 79440 TC Nuclear rx intra-articular 1.44 70.00 $100.80 79440 26 Nuclear rx intra-articular 2.77 70.00 $193.90 79445 Nuclear rx intra-arterial 0.00 70.00 $0.00 79445 TC Nuclear rx intra-arterial 0.00 70.00 $0.00 79445 26 Nuclear rx intra-arterial 3.28 70.00 $229.60 79999 Nuclear medicine therapy 0.00 70.00 $0.00 79999 TC Nuclear medicine therapy 0.00 70.00 $0.00 79999 26 Nuclear medicine therapy 0.00 70.00 $0.00 80047 Metabolic panel ionized ca 0.00 58.28 $0.00 80048 Metabolic panel total ca 0.00 58.28 $0.00 80050 General health panel 0.00 58.28 $0.00 80051 Electrolyte panel 0.00 58.28 $0.00 80053 Comprehen metabolic panel 0.00 58.28 $0.00 80055 Obstetric panel 0.00 58.28 $0.00 80061 Lipid panel 0.00 58.28 $0.00 80069 Renal function panel 0.00 58.28 $0.00 80074 Acute hepatitis panel 0.00 58.28 $0.00 80076 Hepatic function panel 0.00 58.28 $0.00 80081 Obstetric panel 0.00 58.28 $0.00 80150 Assay of amikacin 0.00 58.28 $0.00 80155 Drug assay caffeine 0.00 58.28 $0.00 80156 Assay carbamazepine total 0.00 58.28 $0.00 80157 Assay carbamazepine free 0.00 58.28 $0.00 80158 Drug assay cyclosporine 0.00 58.28 $0.00 80159 Drug assay clozapine 0.00 58.28 $0.00 80162 Assay of digoxin total 0.00 58.28 $0.00 80163 Assay of digoxin free 0.00 58.28 $0.00 80164 Assay dipropylacetic acd tot 0.00 58.28 $0.00 80165 Dipropylacetic acid free 0.00 58.28 $0.00 80168 Assay of ethosuximide 0.00 58.28 $0.00 80169 Drug assay everolimus 0.00 58.28 $0.00 80170 Assay of gentamicin 0.00 58.28 $0.00 80171 Drug screen quant gabapentin 0.00 58.28 $0.00 80173 Assay of haloperidol 0.00 58.28 $0.00 80175 Drug screen quan lamotrigine 0.00 58.28 $0.00 80176 Assay of lidocaine 0.00 58.28 $0.00 80177 Drug scrn quan levetiracetam 0.00 58.28 $0.00 80178 Assay of lithium 0.00 58.28 $0.00 80180 Drug scrn quan mycophenolate 0.00 58.28 $0.00 80183 Drug scrn quant oxcarbazepin 0.00 58.28 $0.00 80184 Assay of phenobarbital 0.00 58.28 $0.00 80185 Assay of phenytoin total 0.00 58.28 $0.00 80186 Assay of phenytoin free 0.00 58.28 $0.00 80188 Assay of primidone 0.00 58.28 $0.00 80190 Assay of procainamide 0.00 58.28 $0.00 80192 Assay of procainamide 0.00 58.28 $0.00 80194 Assay of quinidine 0.00 58.28 $0.00 80195 Assay of sirolimus 0.00 58.28 $0.00 80197 Assay of tacrolimus 0.00 58.28 $0.00 80198 Assay of theophylline 0.00 58.28 $0.00 80199 Drug screen quant tiagabine 0.00 58.28 $0.00 80200 Assay of tobramycin 0.00 58.28 $0.00 80201 Assay of topiramate 0.00 58.28 $0.00 80202 Assay of vancomycin 0.00 58.28 $0.00 80203 Drug screen quant zonisamide 0.00 58.28 $0.00 80299 Quantitative assay drug 0.00 58.28 $0.00 80305 Drug test prsmv dir opt obs 0.00 58.28 $0.00 80306 Drug test prsmv instrmnt 0.00 58.28 $0.00 80307 Drug test prsmv chem anlyzr 0.00 58.28 $0.00 80320 Drug screen quantalcohols 0.00 58.28 $0.00 80321 Alcohols biomarkers 1or 2 0.00 58.28 $0.00 80322 Alcohols biomarkers 3/more 0.00 58.28 $0.00 80323 Alkaloids nos 0.00 58.28 $0.00 80324 Drug screen amphetamines 1/2 0.00 58.28 $0.00 80325 Amphetamines 3or 4 0.00 58.28 $0.00 80326 Amphetamines 5 or more 0.00 58.28 $0.00 80327 Anabolic steroid 1 or 2 0.00 58.28 $0.00 80328 Anabolic steroid 3 or more 0.00 58.28 $0.00 80329 Analgesics non-opioid 1 or 2 0.00 58.28 $0.00 80330 Analgesics non-opioid 3-5 0.00 58.28 $0.00 80331 Analgesics non-opioid 6/more 0.00 58.28 $0.00 80332 Antidepressants class 1 or 2 0.00 58.28 $0.00 80333 Antidepressants class 3-5 0.00 58.28 $0.00 80334 Antidepressants class 6/more 0.00 58.28 $0.00 80335 Antidepressant tricyclic 1/2 0.00 58.28 $0.00 80336 Antidepressant tricyclic 3-5 0.00 58.28 $0.00 80337 Tricyclic & cyclicals 6/more 0.00 58.28 $0.00 80338 Antidepressant not specified 0.00 58.28 $0.00 80339 Antiepileptics nos 1-3 0.00 58.28 $0.00 80340 Antiepileptics nos 4-6 0.00 58.28 $0.00 80341 Antiepileptics nos 7/more 0.00 58.28 $0.00 80342 Antipsychotics nos 1-3 0.00 58.28 $0.00 80343 Antipsychotics nos 4-6 0.00 58.28 $0.00 80344 Antipsychotics nos 7/more 0.00 58.28 $0.00 80345 Drug screening barbiturates 0.00 58.28 $0.00 80346 Benzodiazepines1-12 0.00 58.28 $0.00 80347 Benzodiazepines 13 or more 0.00 58.28 $0.00 80348 Drug screening buprenorphine 0.00 58.28 $0.00 80349 Cannabinoids natural 0.00 58.28 $0.00 80350 Cannabinoids synthetic 1-3 0.00 58.28 $0.00 80351 Cannabinoids synthetic 4-6 0.00 58.28 $0.00 80352 Cannabinoid synthetic 7/more 0.00 58.28 $0.00 80353 Drug screening cocaine 0.00 58.28 $0.00 80354 Drug screening fentanyl 0.00 58.28 $0.00 80355 Gabapentin non-blood 0.00 58.28 $0.00 80356 Heroin metabolite 0.00 58.28 $0.00 80357 Ketamine and norketamine 0.00 58.28 $0.00 80358 Drug screening methadone 0.00 58.28 $0.00 80359 Methylenedioxyamphetamines 0.00 58.28 $0.00 80360 Methylphenidate 0.00 58.28 $0.00 80361 Opiates 1 or more 0.00 58.28 $0.00 80362 Opioids & opiate analogs 1/2 0.00 58.28 $0.00 80363 Opioids & opiate analogs 3/4 0.00 58.28 $0.00 80364 Opioid &opiate analog 5/more 0.00 58.28 $0.00 80365 Drug screening oxycodone 0.00 58.28 $0.00 80366 Drug screening pregabalin 0.00 58.28 $0.00 80367 Drug screening propoxyphene 0.00 58.28 $0.00 80368 Sedative hypnotics 0.00 58.28 $0.00 80369 Skeletal muscle relaxant 1/2 0.00 58.28 $0.00 80370 Skel musc relaxant 3 or more 0.00 58.28 $0.00 80371 Stimulants synthetic 0.00 58.28 $0.00 80372 Drug screening tapentadol 0.00 58.28 $0.00 80373 Drug screening tramadol 0.00 58.28 $0.00 80374 Stereoisomer analysis 0.00 58.28 $0.00 80375 Drug/substance nos 1-3 0.00 58.28 $0.00 80376 Drug/substance nos 4-6 0.00 58.28 $0.00 80377 Drug/substance nos 7/more 0.00 58.28 $0.00 80400 Acth stimulation panel 0.00 58.28 $0.00 80402 Acth stimulation panel 0.00 58.28 $0.00 80406 Acth stimulation panel 0.00 58.28 $0.00 80408 Aldosterone suppression eval 0.00 58.28 $0.00 80410 Calcitonin stimul panel 0.00 58.28 $0.00 80412 Crh stimulation panel 0.00 58.28 $0.00 80414 Testosterone response 0.00 58.28 $0.00 80415 Estradiol response panel 0.00 58.28 $0.00 80416 Renin stimulation panel 0.00 58.28 $0.00 80417 Renin stimulation panel 0.00 58.28 $0.00 80418 Pituitary evaluation panel 0.00 58.28 $0.00 80420 Dexamethasone panel 0.00 58.28 $0.00 80422 Glucagon tolerance panel 0.00 58.28 $0.00 80424 Glucagon tolerance panel 0.00 58.28 $0.00 80426 Gonadotropin hormone panel 0.00 58.28 $0.00 80428 Growth hormone panel 0.00 58.28 $0.00 80430 Growth hormone panel 0.00 58.28 $0.00 80432 Insulin suppression panel 0.00 58.28 $0.00 80434 Insulin tolerance panel 0.00 58.28 $0.00 80435 Insulin tolerance panel 0.00 58.28 $0.00 80436 Metyrapone panel 0.00 58.28 $0.00 80438 Trh stimulation panel 0.00 58.28 $0.00 80439 Trh stimulation panel 0.00 58.28 $0.00 80500 Lab pathology consultation 0.66 58.28 $38.46 80502 Lab pathology consultation 2.09 58.28 $121.81 81000 Urinalysis nonauto w/scope 0.00 58.28 $0.00 81001 Urinalysis auto w/scope 0.00 58.28 $0.00 81002 Urinalysis nonauto w/o scope 0.00 58.28 $0.00 81003 Urinalysis auto w/o scope 0.00 58.28 $0.00 81005 Urinalysis 0.00 58.28 $0.00 81007 Urine screen for bacteria 0.00 58.28 $0.00 81015 Microscopic exam of urine 0.00 58.28 $0.00 81020 Urinalysis glass test 0.00 58.28 $0.00 81025 Urine pregnancy test 0.00 58.28 $0.00 81050 Urinalysis volume measure 0.00 58.28 $0.00 81099 Urinalysis test procedure 0.00 58.28 $0.00 81161 Dmd dup/delet analysis 0.00 58.28 $0.00 81162 Brca1&2 seq & full dup/del 0.00 58.28 $0.00 81170 Abl1 gene 0.00 58.28 $0.00 81200 Aspa gene 0.00 58.28 $0.00 81201 Apc gene full sequence 0.00 58.28 $0.00 81202 Apc gene known fam variants 0.00 58.28 $0.00 81203 Apc gene dup/delet variants 0.00 58.28 $0.00 81205 Bckdhb gene 0.00 58.28 $0.00 81206 Bcr/abl1 gene major bp 0.00 58.28 $0.00 81207 Bcr/abl1 gene minor bp 0.00 58.28 $0.00 81208 Bcr/abl1 gene other bp 0.00 58.28 $0.00 81209 Blm gene 0.00 58.28 $0.00 81210 Braf gene 0.00 58.28 $0.00 81211 Brca1&2 seq & com dup/del 0.00 58.28 $0.00 81212 Brca1&2 185&5385&6174 var 0.00 58.28 $0.00 81213 Brca1&2 uncom dup/del var 0.00 58.28 $0.00 81214 Brca1 full seq & com dup/del 0.00 58.28 $0.00 81215 Brca1 gene known fam variant 0.00 58.28 $0.00 81216 Brca2 gene full sequence 0.00 58.28 $0.00 81217 Brca2 gene known fam variant 0.00 58.28 $0.00 81218 Cebpa gene full sequence 0.00 58.28 $0.00 81219 Calr gene com variants 0.00 58.28 $0.00 81220 Cftr gene com variants 0.00 58.28 $0.00 81221 Cftr gene known fam variants 0.00 58.28 $0.00 81222 Cftr gene dup/delet variants 0.00 58.28 $0.00 81223 Cftr gene full sequence 0.00 58.28 $0.00 81224 Cftr gene intron poly t 0.00 58.28 $0.00 81225 Cyp2c19 gene com variants 0.00 58.28 $0.00 81226 Cyp2d6 gene com variants 0.00 58.28 $0.00 81227 Cyp2c9 gene com variants 0.00 58.28 $0.00 81228 Cytogen micrarray copy nmbr 0.00 58.28 $0.00 81229 Cytogen m array copy no&snp 0.00 58.28 $0.00 81235 Egfr gene com variants 0.00 58.28 $0.00 81240 F2 gene 0.00 58.28 $0.00 81241 F5 gene 0.00 58.28 $0.00 81242 Fancc gene 0.00 58.28 $0.00 81243 Fmr1 gene detection 0.00 58.28 $0.00 81244 Fmr1 gene characterization 0.00 58.28 $0.00 81245 Flt3 gene 0.00 58.28 $0.00 81246 Flt3 gene analysis 0.00 58.28 $0.00 81250 G6pc gene 0.00 58.28 $0.00 81251 Gba gene 0.00 58.28 $0.00 81252 Gjb2 gene full sequence 0.00 58.28 $0.00 81253 Gjb2 gene known fam variants 0.00 58.28 $0.00 81254 Gjb6 gene com variants 0.00 58.28 $0.00 81255 Hexa gene 0.00 58.28 $0.00 81256 Hfe gene 0.00 58.28 $0.00 81257 Hba1/hba2 gene 0.00 58.28 $0.00 81260 Ikbkap gene 0.00 58.28 $0.00 81261 Igh gene rearrange amp meth 0.00 58.28 $0.00 81262 Igh gene rearrang dir probe 0.00 58.28 $0.00 81263 Igh vari regional mutation 0.00 58.28 $0.00 81264 Igk rearrangeabn clonal pop 0.00 58.28 $0.00 81265 Str markers specimen anal 0.00 58.28 $0.00 81266 Str markers spec anal addl 0.00 58.28 $0.00 81267 Chimerism anal no cell selec 0.00 58.28 $0.00 81268 Chimerism anal w/cell select 0.00 58.28 $0.00 81270 Jak2 gene 0.00 58.28 $0.00 81272 Kit gene targeted seq analys 0.00 58.28 $0.00 81273 Kit gene analys d816 variant 0.00 58.28 $0.00 81275 Kras gene variants exon 2 0.00 58.28 $0.00 81276 Kras gene addl variants 0.00 58.28 $0.00 81287 Mgmt gene methylation anal 0.00 58.28 $0.00 81288 Mlh1 gene 0.00 58.28 $0.00 81290 Mcoln1 gene 0.00 58.28 $0.00 81291 Mthfr gene 0.00 58.28 $0.00 81292 Mlh1 gene full seq 0.00 58.28 $0.00 81293 Mlh1 gene known variants 0.00 58.28 $0.00 81294 Mlh1 gene dup/delete variant 0.00 58.28 $0.00 81295 Msh2 gene full seq 0.00 58.28 $0.00 81296 Msh2 gene known variants 0.00 58.28 $0.00 81297 Msh2 gene dup/delete variant 0.00 58.28 $0.00 81298 Msh6 gene full seq 0.00 58.28 $0.00 81299 Msh6 gene known variants 0.00 58.28 $0.00 81300 Msh6 gene dup/delete variant 0.00 58.28 $0.00 81301 Microsatellite instability 0.00 58.28 $0.00 81302 Mecp2 gene full seq 0.00 58.28 $0.00 81303 Mecp2 gene known variant 0.00 58.28 $0.00 81304 Mecp2 gene dup/delet variant 0.00 58.28 $0.00 81310 Npm1 gene 0.00 58.28 $0.00 81311 Nras gene variants exon 2&3 0.00 58.28 $0.00 81313 Pca3/klk3 antigen 0.00 58.28 $0.00 81314 Pdgfra gene 0.00 58.28 $0.00 81315 Pml/raralpha com breakpoints 0.00 58.28 $0.00 81316 Pml/raralpha 1 breakpoint 0.00 58.28 $0.00 81317 Pms2 gene full seq analysis 0.00 58.28 $0.00 81318 Pms2 known familial variants 0.00 58.28 $0.00 81319 Pms2 gene dup/delet variants 0.00 58.28 $0.00 81321 Pten gene full sequence 0.00 58.28 $0.00 81322 Pten gene known fam variant 0.00 58.28 $0.00 81323 Pten gene dup/delet variant 0.00 58.28 $0.00 81324 Pmp22 gene dup/delet 0.00 58.28 $0.00 81325 Pmp22 gene full sequence 0.00 58.28 $0.00 81326 Pmp22 gene known fam variant 0.00 58.28 $0.00 81327 Sept9 methylation analysis 0.00 58.28 $0.00 81330 Smpd1 gene common variants 0.00 58.28 $0.00 81331 Snrpn/ube3a gene 0.00 58.28 $0.00 81332 Serpina1 gene 0.00 58.28 $0.00 81340 Trb@ gene rearrange amplify 0.00 58.28 $0.00 81341 Trb@ gene rearrange dirprobe 0.00 58.28 $0.00 81342 Trg gene rearrangement anal 0.00 58.28 $0.00 81350 Ugt1a1 gene 0.00 58.28 $0.00 81355 Vkorc1 gene 0.00 58.28 $0.00 81370 Hla i & ii typing lr 0.00 58.28 $0.00 81371 Hla i & ii type verify lr 0.00 58.28 $0.00 81372 Hla i typing complete lr 0.00 58.28 $0.00 81373 Hla i typing 1 locus lr 0.00 58.28 $0.00 81374 Hla i typing 1 antigen lr 0.00 58.28 $0.00 81375 Hla ii typing ag equiv lr 0.00 58.28 $0.00 81376 Hla ii typing 1 locus lr 0.00 58.28 $0.00 81377 Hla ii type 1 ag equiv lr 0.00 58.28 $0.00 81378 Hla i & ii typing hr 0.00 58.28 $0.00 81379 Hla i typing complete hr 0.00 58.28 $0.00 81380 Hla i typing 1 locus hr 0.00 58.28 $0.00 81381 Hla i typing 1 allele hr 0.00 58.28 $0.00 81382 Hla ii typing 1 loc hr 0.00 58.28 $0.00 81383 Hla ii typing 1 allele hr 0.00 58.28 $0.00 81400 Mopath procedure level 1 0.00 58.28 $0.00 81401 Mopath procedure level 2 0.00 58.28 $0.00 81402 Mopath procedure level 3 0.00 58.28 $0.00 81403 Mopath procedure level 4 0.00 58.28 $0.00 81404 Mopath procedure level 5 0.00 58.28 $0.00 81405 Mopath procedure level 6 0.00 58.28 $0.00 81406 Mopath procedure level 7 0.00 58.28 $0.00 81407 Mopath procedure level 8 0.00 58.28 $0.00 81408 Mopath procedure level 9 0.00 58.28 $0.00 81410 Aortic dysfunction/dilation 0.00 58.28 $0.00 81411 Aortic dysfunction/dilation 0.00 58.28 $0.00 81412 Ashkenazi jewish assoc dis 0.00 58.28 $0.00 81413 Car ion chnnlpath inc 10 gns 0.00 58.28 $0.00 81414 Car ion chnnlpath inc 2 gns 0.00 58.28 $0.00 81415 Exome sequence analysis 0.00 58.28 $0.00 81416 Exome sequence analysis 0.00 58.28 $0.00 81417 Exome re-evaluation 0.00 58.28 $0.00 81420 Fetal chrmoml aneuploidy 0.00 58.28 $0.00 81422 Fetal chrmoml microdeltj 0.00 58.28 $0.00 81425 Genome sequence analysis 0.00 58.28 $0.00 81426 Genome sequence analysis 0.00 58.28 $0.00 81427 Genome re-evaluation 0.00 58.28 $0.00 81430 Hearing loss sequence analys 0.00 58.28 $0.00 81431 Hearing loss dup/del analys 0.00 58.28 $0.00 81432 Hrdtry brst ca-rlatd dsordrs 0.00 58.28 $0.00 81433 Hrdtry brst ca-rlatd dsordrs 0.00 58.28 $0.00 81434 Hereditary retinal disorders 0.00 58.28 $0.00 81435 Hereditary colon ca dsordrs 0.00 58.28 $0.00 81436 Hereditary colon ca dsordrs 0.00 58.28 $0.00 81437 Heredtry nurondcrn tum dsrdr 0.00 58.28 $0.00 81438 Heredtry nurondcrn tum dsrdr 0.00 58.28 $0.00 81439 Inherited cardmypthy 5 gns 0.00 58.28 $0.00 81440 Mitochondrial gene 0.00 58.28 $0.00 81442 Noonan spectrum disorders 0.00 58.28 $0.00 81445 Targeted genomic seq analys 0.00 58.28 $0.00 81450 Targeted genomic seq analys 0.00 58.28 $0.00 81455 Targeted genomic seq analys 0.00 58.28 $0.00 81460 Whole mitochondrial genome 0.00 58.28 $0.00 81465 Whole mitochondrial genome 0.00 58.28 $0.00 81470 X-linked intellectual dblt 0.00 58.28 $0.00 81471 X-linked intellectual dblt 0.00 58.28 $0.00 81479 Unlisted molecular pathology 0.00 58.28 $0.00 81490 Autoimmune rheumatoid arthr 0.00 58.28 $0.00 81493 Cor artery disease mrna 0.00 58.28 $0.00 81500 Onco (ovar) two proteins 0.00 58.28 $0.00 81503 Onco (ovar) five proteins 0.00 58.28 $0.00 81504 Oncology tissue of origin 0.00 58.28 $0.00 81506 Endo assay seven anal 0.00 58.28 $0.00 81507 Fetal aneuploidy trisom risk 0.00 58.28 $0.00 81508 Ftl cgen abnor two proteins 0.00 58.28 $0.00 81509 Ftl cgen abnor 3 proteins 0.00 58.28 $0.00 81510 Ftl cgen abnor three anal 0.00 58.28 $0.00 81511 Ftl cgen abnor four anal 0.00 58.28 $0.00 81512 Ftl cgen abnor five anal 0.00 58.28 $0.00 81519 Oncology breast mrna 0.00 58.28 $0.00 81525 Oncology colon mrna 0.00 58.28 $0.00 81528 Oncology colorectal scr 0.00 58.28 $0.00 81535 Oncology gynecologic 0.00 58.28 $0.00 81536 Oncology gynecologic 0.00 58.28 $0.00 81538 Oncology lung 0.00 58.28 $0.00 81539 Oncology prostate prob score 0.00 58.28 $0.00 81540 Oncology tum unknown origin 0.00 58.28 $0.00 81545 Oncology thyroid 0.00 58.28 $0.00 81595 Cardiology hrt trnspl mrna 0.00 58.28 $0.00 81599 Unlisted maaa 0.00 58.28 $0.00 82009 Test for acetone/ketones 0.00 58.28 $0.00 82010 Acetone assay 0.00 58.28 $0.00 82013 Acetylcholinesterase assay 0.00 58.28 $0.00 82016 Acylcarnitines qual 0.00 58.28 $0.00 82017 Acylcarnitines quant 0.00 58.28 $0.00 82024 Assay of acth 0.00 58.28 $0.00 82030 Assay of adp & amp 0.00 58.28 $0.00 82040 Assay of serum albumin 0.00 58.28 $0.00 82042 Assay of urine albumin 0.00 58.28 $0.00 82043 Microalbumin quantitative 0.00 58.28 $0.00 82044 Microalbumin semiquant 0.00 58.28 $0.00 82045 Albumin ischemia modified 0.00 58.28 $0.00 82075 Assay of breath ethanol 0.00 58.28 $0.00 82085 Assay of aldolase 0.00 58.28 $0.00 82088 Assay of aldosterone 0.00 58.28 $0.00 82103 Alpha-1-antitrypsin total 0.00 58.28 $0.00 82104 Alpha-1-antitrypsin pheno 0.00 58.28 $0.00 82105 Alpha-fetoprotein serum 0.00 58.28 $0.00 82106 Alpha-fetoprotein amniotic 0.00 58.28 $0.00 82107 Alpha-fetoprotein l3 0.00 58.28 $0.00 82108 Assay of aluminum 0.00 58.28 $0.00 82120 Amines vaginal fluid qual 0.00 58.28 $0.00 82127 Amino acid single qual 0.00 58.28 $0.00 82128 Amino acids mult qual 0.00 58.28 $0.00 82131 Amino acids single quant 0.00 58.28 $0.00 82135 Assay aminolevulinic acid 0.00 58.28 $0.00 82136 Amino acids quant 2-5 0.00 58.28 $0.00 82139 Amino acids quan 6 or more 0.00 58.28 $0.00 82140 Assay of ammonia 0.00 58.28 $0.00 82143 Amniotic fluid scan 0.00 58.28 $0.00 82150 Assay of amylase 0.00 58.28 $0.00 82154 Androstanediol glucuronide 0.00 58.28 $0.00 82157 Assay of androstenedione 0.00 58.28 $0.00 82160 Assay of androsterone 0.00 58.28 $0.00 82163 Assay of angiotensin ii 0.00 58.28 $0.00 82164 Angiotensin i enzyme test 0.00 58.28 $0.00 82172 Assay of apolipoprotein 0.00 58.28 $0.00 82175 Assay of arsenic 0.00 58.28 $0.00 82180 Assay of ascorbic acid 0.00 58.28 $0.00 82190 Atomic absorption 0.00 58.28 $0.00 82232 Assay of beta-2 protein 0.00 58.28 $0.00 82239 Bile acids total 0.00 58.28 $0.00 82240 Bile acids cholylglycine 0.00 58.28 $0.00 82247 Bilirubin total 0.00 58.28 $0.00 82248 Bilirubin direct 0.00 58.28 $0.00 82252 Fecal bilirubin test 0.00 58.28 $0.00 82261 Assay of biotinidase 0.00 58.28 $0.00 82270 Occult blood feces 0.00 58.28 $0.00 82271 Occult blood other sources 0.00 58.28 $0.00 82272 Occult bld feces 1-3 tests 0.00 58.28 $0.00 82274 Assay test for blood fecal 0.00 58.28 $0.00 82286 Assay of bradykinin 0.00 58.28 $0.00 82300 Assay of cadmium 0.00 58.28 $0.00 82306 Vitamin d 25 hydroxy 0.00 58.28 $0.00 82308 Assay of calcitonin 0.00 58.28 $0.00 82310 Assay of calcium 0.00 58.28 $0.00 82330 Assay of calcium 0.00 58.28 $0.00 82331 Calcium infusion test 0.00 58.28 $0.00 82340 Assay of calcium in urine 0.00 58.28 $0.00 82355 Calculus analysis qual 0.00 58.28 $0.00 82360 Calculus assay quant 0.00 58.28 $0.00 82365 Calculus spectroscopy 0.00 58.28 $0.00 82370 X-ray assay calculus 0.00 58.28 $0.00 82373 Assay c-d transfer measure 0.00 58.28 $0.00 82374 Assay blood carbon dioxide 0.00 58.28 $0.00 82375 Assay carboxyhb quant 0.00 58.28 $0.00 82376 Assay carboxyhb qual 0.00 58.28 $0.00 82378 Carcinoembryonic antigen 0.00 58.28 $0.00 82379 Assay of carnitine 0.00 58.28 $0.00 82380 Assay of carotene 0.00 58.28 $0.00 82382 Assay urine catecholamines 0.00 58.28 $0.00 82383 Assay blood catecholamines 0.00 58.28 $0.00 82384 Assay three catecholamines 0.00 58.28 $0.00 82387 Assay of cathepsin-d 0.00 58.28 $0.00 82390 Assay of ceruloplasmin 0.00 58.28 $0.00 82397 Chemiluminescent assay 0.00 58.28 $0.00 82415 Assay of chloramphenicol 0.00 58.28 $0.00 82435 Assay of blood chloride 0.00 58.28 $0.00 82436 Assay of urine chloride 0.00 58.28 $0.00 82438 Assay other fluid chlorides 0.00 58.28 $0.00 82441 Test for chlorohydrocarbons 0.00 58.28 $0.00 82465 Assay bld/serum cholesterol 0.00 58.28 $0.00 82480 Assay serum cholinesterase 0.00 58.28 $0.00 82482 Assay rbc cholinesterase 0.00 58.28 $0.00 82485 Assay chondroitin sulfate 0.00 58.28 $0.00 82495 Assay of chromium 0.00 58.28 $0.00 82507 Assay of citrate 0.00 58.28 $0.00 82523 Collagen crosslinks 0.00 58.28 $0.00 82525 Assay of copper 0.00 58.28 $0.00 82528 Assay of corticosterone 0.00 58.28 $0.00 82530 Cortisol free 0.00 58.28 $0.00 82533 Total cortisol 0.00 58.28 $0.00 82540 Assay of creatine 0.00 58.28 $0.00 82542 Col chromotography qual/quan 0.00 58.28 $0.00 82550 Assay of ck (cpk) 0.00 58.28 $0.00 82552 Assay of cpk in blood 0.00 58.28 $0.00 82553 Creatine mb fraction 0.00 58.28 $0.00 82554 Creatine isoforms 0.00 58.28 $0.00 82565 Assay of creatinine 0.00 58.28 $0.00 82570 Assay of urine creatinine 0.00 58.28 $0.00 82575 Creatinine clearance test 0.00 58.28 $0.00 82585 Assay of cryofibrinogen 0.00 58.28 $0.00 82595 Assay of cryoglobulin 0.00 58.28 $0.00 82600 Assay of cyanide 0.00 58.28 $0.00 82607 Vitamin b-12 0.00 58.28 $0.00 82608 B-12 binding capacity 0.00 58.28 $0.00 82610 Cystatin c 0.00 58.28 $0.00 82615 Test for urine cystines 0.00 58.28 $0.00 82626 Dehydroepiandrosterone 0.00 58.28 $0.00 82627 Dehydroepiandrosterone 0.00 58.28 $0.00 82633 Desoxycorticosterone 0.00 58.28 $0.00 82634 Deoxycortisol 0.00 58.28 $0.00 82638 Assay of dibucaine number 0.00 58.28 $0.00 82652 Vit d 1 25-dihydroxy 0.00 58.28 $0.00 82656 Pancreatic elastase fecal 0.00 58.28 $0.00 82657 Enzyme cell activity 0.00 58.28 $0.00 82658 Enzyme cell activity ra 0.00 58.28 $0.00 82664 Electrophoretic test 0.00 58.28 $0.00 82668 Assay of erythropoietin 0.00 58.28 $0.00 82670 Assay of estradiol 0.00 58.28 $0.00 82671 Assay of estrogens 0.00 58.28 $0.00 82672 Assay of estrogen 0.00 58.28 $0.00 82677 Assay of estriol 0.00 58.28 $0.00 82679 Assay of estrone 0.00 58.28 $0.00 82693 Assay of ethylene glycol 0.00 58.28 $0.00 82696 Assay of etiocholanolone 0.00 58.28 $0.00 82705 Fats/lipids feces qual 0.00 58.28 $0.00 82710 Fats/lipids feces quant 0.00 58.28 $0.00 82715 Assay of fecal fat 0.00 58.28 $0.00 82725 Assay of blood fatty acids 0.00 58.28 $0.00 82726 Long chain fatty acids 0.00 58.28 $0.00 82728 Assay of ferritin 0.00 58.28 $0.00 82731 Assay of fetal fibronectin 0.00 58.28 $0.00 82735 Assay of fluoride 0.00 58.28 $0.00 82746 Assay of folic acid serum 0.00 58.28 $0.00 82747 Assay of folic acid rbc 0.00 58.28 $0.00 82757 Assay of semen fructose 0.00 58.28 $0.00 82759 Assay of rbc galactokinase 0.00 58.28 $0.00 82760 Assay of galactose 0.00 58.28 $0.00 82775 Assay galactose transferase 0.00 58.28 $0.00 82776 Galactose transferase test 0.00 58.28 $0.00 82777 Galectin-3 0.00 58.28 $0.00 82784 Assay iga/igd/igg/igm each 0.00 58.28 $0.00 82785 Assay of ige 0.00 58.28 $0.00 82787 Igg 1 2 3 or 4 each 0.00 58.28 $0.00 82800 Blood ph 0.00 58.28 $0.00 82803 Blood gases any combination 0.00 58.28 $0.00 82805 Blood gases w/o2 saturation 0.00 58.28 $0.00 82810 Blood gases o2 sat only 0.00 58.28 $0.00 82820 Hemoglobin-oxygen affinity 0.00 58.28 $0.00 82930 Gastric analy w/ph ea spec 0.00 58.28 $0.00 82938 Gastrin test 0.00 58.28 $0.00 82941 Assay of gastrin 0.00 58.28 $0.00 82943 Assay of glucagon 0.00 58.28 $0.00 82945 Glucose other fluid 0.00 58.28 $0.00 82946 Glucagon tolerance test 0.00 58.28 $0.00 82947 Assay glucose blood quant 0.00 58.28 $0.00 82948 Reagent strip/blood glucose 0.00 58.28 $0.00 82950 Glucose test 0.00 58.28 $0.00 82951 Glucose tolerance test (gtt) 0.00 58.28 $0.00 82952 Gtt-added samples 0.00 58.28 $0.00 82955 Assay of g6pd enzyme 0.00 58.28 $0.00 82960 Test for g6pd enzyme 0.00 58.28 $0.00 82962 Glucose blood test 0.00 58.28 $0.00 82963 Assay of glucosidase 0.00 58.28 $0.00 82965 Assay of gdh enzyme 0.00 58.28 $0.00 82977 Assay of ggt 0.00 58.28 $0.00 82978 Assay of glutathione 0.00 58.28 $0.00 82979 Assay rbc glutathione 0.00 58.28 $0.00 82985 Assay of glycated protein 0.00 58.28 $0.00 83001 Assay of gonadotropin (fsh) 0.00 58.28 $0.00 83002 Assay of gonadotropin (lh) 0.00 58.28 $0.00 83003 Assay growth hormone (hgh) 0.00 58.28 $0.00 83006 Growth stimulation gene 2 0.00 58.28 $0.00 83009 H pylori (c-13) blood 0.00 58.28 $0.00 83010 Assay of haptoglobin quant 0.00 58.28 $0.00 83012 Assay of haptoglobins 0.00 58.28 $0.00 83013 H pylori (c-13) breath 0.00 58.28 $0.00 83014 H pylori drug admin 0.00 58.28 $0.00 83015 Heavy metal qual any anal 0.00 58.28 $0.00 83018 Heavy metal quant each nes 0.00 58.28 $0.00 83020 Hemoglobin electrophoresis 0.00 58.28 $0.00 83020 26 Hemoglobin electrophoresis 0.52 58.28 $30.31 83021 Hemoglobin chromotography 0.00 58.28 $0.00 83026 Hemoglobin copper sulfate 0.00 58.28 $0.00 83030 Fetal hemoglobin chemical 0.00 58.28 $0.00 83033 Fetal hemoglobin assay qual 0.00 58.28 $0.00 83036 Glycosylated hemoglobin test 0.00 58.28 $0.00 83037 Glycosylated hb home device 0.00 58.28 $0.00 83045 Blood methemoglobin test 0.00 58.28 $0.00 83050 Blood methemoglobin assay 0.00 58.28 $0.00 83051 Assay of plasma hemoglobin 0.00 58.28 $0.00 83060 Blood sulfhemoglobin assay 0.00 58.28 $0.00 83065 Assay of hemoglobin heat 0.00 58.28 $0.00 83068 Hemoglobin stability screen 0.00 58.28 $0.00 83069 Assay of urine hemoglobin 0.00 58.28 $0.00 83070 Assay of hemosiderin qual 0.00 58.28 $0.00 83080 Assay of b hexosaminidase 0.00 58.28 $0.00 83088 Assay of histamine 0.00 58.28 $0.00 83090 Assay of homocystine 0.00 58.28 $0.00 83150 Assay of homovanillic acid 0.00 58.28 $0.00 83491 Assay of corticosteroids 17 0.00 58.28 $0.00 83497 Assay of 5-hiaa 0.00 58.28 $0.00 83498 Assay of progesterone 17-d 0.00 58.28 $0.00 83499 Assay of progesterone 20- 0.00 58.28 $0.00 83500 Assay free hydroxyproline 0.00 58.28 $0.00 83505 Assay total hydroxyproline 0.00 58.28 $0.00 83516 Immunoassay nonantibody 0.00 58.28 $0.00 83518 Immunoassay dipstick 0.00 58.28 $0.00 83519 Ria nonantibody 0.00 58.28 $0.00 83520 Immunoassay quant nos nonab 0.00 58.28 $0.00 83525 Assay of insulin 0.00 58.28 $0.00 83527 Assay of insulin 0.00 58.28 $0.00 83528 Assay of intrinsic factor 0.00 58.28 $0.00 83540 Assay of iron 0.00 58.28 $0.00 83550 Iron binding test 0.00 58.28 $0.00 83570 Assay of idh enzyme 0.00 58.28 $0.00 83582 Assay of ketogenic steroids 0.00 58.28 $0.00 83586 Assay 17- ketosteroids 0.00 58.28 $0.00 83593 Fractionation ketosteroids 0.00 58.28 $0.00 83605 Assay of lactic acid 0.00 58.28 $0.00 83615 Lactate (ld) (ldh) enzyme 0.00 58.28 $0.00 83625 Assay of ldh enzymes 0.00 58.28 $0.00 83630 Lactoferrin fecal (qual) 0.00 58.28 $0.00 83631 Lactoferrin fecal (quant) 0.00 58.28 $0.00 83632 Placental lactogen 0.00 58.28 $0.00 83633 Test urine for lactose 0.00 58.28 $0.00 83655 Assay of lead 0.00 58.28 $0.00 83661 L/s ratio fetal lung 0.00 58.28 $0.00 83662 Foam stability fetal lung 0.00 58.28 $0.00 83663 Fluoro polarize fetal lung 0.00 58.28 $0.00 83664 Lamellar bdy fetal lung 0.00 58.28 $0.00 83670 Assay of lap enzyme 0.00 58.28 $0.00 83690 Assay of lipase 0.00 58.28 $0.00 83695 Assay of lipoprotein(a) 0.00 58.28 $0.00 83698 Assay lipoprotein pla2 0.00 58.28 $0.00 83700 Lipopro bld electrophoretic 0.00 58.28 $0.00 83701 Lipoprotein bld hr fraction 0.00 58.28 $0.00 83704 Lipoprotein bld quan part 0.00 58.28 $0.00 83718 Assay of lipoprotein 0.00 58.28 $0.00 83719 Assay of blood lipoprotein 0.00 58.28 $0.00 83721 Assay of blood lipoprotein 0.00 58.28 $0.00 83727 Assay of lrh hormone 0.00 58.28 $0.00 83735 Assay of magnesium 0.00 58.28 $0.00 83775 Assay malate dehydrogenase 0.00 58.28 $0.00 83785 Assay of manganese 0.00 58.28 $0.00 83789 Mass spectrometry qual/quan 0.00 58.28 $0.00 83825 Assay of mercury 0.00 58.28 $0.00 83835 Assay of metanephrines 0.00 58.28 $0.00 83857 Assay of methemalbumin 0.00 58.28 $0.00 83861 Microfluid analy tears 0.00 58.28 $0.00 83864 Mucopolysaccharides 0.00 58.28 $0.00 83872 Assay synovial fluid mucin 0.00 58.28 $0.00 83873 Assay of csf protein 0.00 58.28 $0.00 83874 Assay of myoglobin 0.00 58.28 $0.00 83876 Assay myeloperoxidase 0.00 58.28 $0.00 83880 Assay of natriuretic peptide 0.00 58.28 $0.00 83883 Assay nephelometry not spec 0.00 58.28 $0.00 83885 Assay of nickel 0.00 58.28 $0.00 83915 Assay of nucleotidase 0.00 58.28 $0.00 83916 Oligoclonal bands 0.00 58.28 $0.00 83918 Organic acids total quant 0.00 58.28 $0.00 83919 Organic acids qual each 0.00 58.28 $0.00 83921 Organic acid single quant 0.00 58.28 $0.00 83930 Assay of blood osmolality 0.00 58.28 $0.00 83935 Assay of urine osmolality 0.00 58.28 $0.00 83937 Assay of osteocalcin 0.00 58.28 $0.00 83945 Assay of oxalate 0.00 58.28 $0.00 83950 Oncoprotein her-2/neu 0.00 58.28 $0.00 83951 Oncoprotein dcp 0.00 58.28 $0.00 83970 Assay of parathormone 0.00 58.28 $0.00 83986 Assay ph body fluid nos 0.00 58.28 $0.00 83987 Exhaled breath condensate 0.00 58.28 $0.00 83992 Assay for phencyclidine 0.00 58.28 $0.00 83993 Assay for calprotectin fecal 0.00 58.28 $0.00 84030 Assay of blood pku 0.00 58.28 $0.00 84035 Assay of phenylketones 0.00 58.28 $0.00 84060 Assay acid phosphatase 0.00 58.28 $0.00 84061 Phosphatase forensic exam 0.00 58.28 $0.00 84066 Assay prostate phosphatase 0.00 58.28 $0.00 84075 Assay alkaline phosphatase 0.00 58.28 $0.00 84078 Assay alkaline phosphatase 0.00 58.28 $0.00 84080 Assay alkaline phosphatases 0.00 58.28 $0.00 84081 Assay phosphatidylglycerol 0.00 58.28 $0.00 84085 Assay of rbc pg6d enzyme 0.00 58.28 $0.00 84087 Assay phosphohexose enzymes 0.00 58.28 $0.00 84100 Assay of phosphorus 0.00 58.28 $0.00 84105 Assay of urine phosphorus 0.00 58.28 $0.00 84106 Test for porphobilinogen 0.00 58.28 $0.00 84110 Assay of porphobilinogen 0.00 58.28 $0.00 84112 Eval amniotic fluid protein 0.00 58.28 $0.00 84119 Test urine for porphyrins 0.00 58.28 $0.00 84120 Assay of urine porphyrins 0.00 58.28 $0.00 84126 Assay of feces porphyrins 0.00 58.28 $0.00 84132 Assay of serum potassium 0.00 58.28 $0.00 84133 Assay of urine potassium 0.00 58.28 $0.00 84134 Assay of prealbumin 0.00 58.28 $0.00 84135 Assay of pregnanediol 0.00 58.28 $0.00 84138 Assay of pregnanetriol 0.00 58.28 $0.00 84140 Assay of pregnenolone 0.00 58.28 $0.00 84143 Assay of 17-hydroxypregneno 0.00 58.28 $0.00 84144 Assay of progesterone 0.00 58.28 $0.00 84145 Procalcitonin (pct) 0.00 58.28 $0.00 84146 Assay of prolactin 0.00 58.28 $0.00 84150 Assay of prostaglandin 0.00 58.28 $0.00 84152 Assay of psa complexed 0.00 58.28 $0.00 84153 Assay of psa total 0.00 58.28 $0.00 84154 Assay of psa free 0.00 58.28 $0.00 84155 Assay of protein serum 0.00 58.28 $0.00 84156 Assay of protein urine 0.00 58.28 $0.00 84157 Assay of protein other 0.00 58.28 $0.00 84160 Assay of protein any source 0.00 58.28 $0.00 84163 Pappa serum 0.00 58.28 $0.00 84165 Protein e-phoresis serum 0.00 58.28 $0.00 84165 26 Protein e-phoresis serum 0.52 58.28 $30.31 84166 Protein e-phoresis/urine/csf 0.00 58.28 $0.00 84166 26 Protein e-phoresis/urine/csf 0.52 58.28 $30.31 84181 Western blot test 0.00 58.28 $0.00 84181 26 Western blot test 0.52 58.28 $30.31 84182 Protein western blot test 0.00 58.28 $0.00 84182 26 Protein western blot test 0.52 58.28 $30.31 84202 Assay rbc protoporphyrin 0.00 58.28 $0.00 84203 Test rbc protoporphyrin 0.00 58.28 $0.00 84206 Assay of proinsulin 0.00 58.28 $0.00 84207 Assay of vitamin b-6 0.00 58.28 $0.00 84210 Assay of pyruvate 0.00 58.28 $0.00 84220 Assay of pyruvate kinase 0.00 58.28 $0.00 84228 Assay of quinine 0.00 58.28 $0.00 84233 Assay of estrogen 0.00 58.28 $0.00 84234 Assay of progesterone 0.00 58.28 $0.00 84235 Assay of endocrine hormone 0.00 58.28 $0.00 84238 Assay nonendocrine receptor 0.00 58.28 $0.00 84244 Assay of renin 0.00 58.28 $0.00 84252 Assay of vitamin b-2 0.00 58.28 $0.00 84255 Assay of selenium 0.00 58.28 $0.00 84260 Assay of serotonin 0.00 58.28 $0.00 84270 Assay of sex hormone globul 0.00 58.28 $0.00 84275 Assay of sialic acid 0.00 58.28 $0.00 84285 Assay of silica 0.00 58.28 $0.00 84295 Assay of serum sodium 0.00 58.28 $0.00 84300 Assay of urine sodium 0.00 58.28 $0.00 84302 Assay of sweat sodium 0.00 58.28 $0.00 84305 Assay of somatomedin 0.00 58.28 $0.00 84307 Assay of somatostatin 0.00 58.28 $0.00 84311 Spectrophotometry 0.00 58.28 $0.00 84315 Body fluid specific gravity 0.00 58.28 $0.00 84375 Chromatogram assay sugars 0.00 58.28 $0.00 84376 Sugars single qual 0.00 58.28 $0.00 84377 Sugars multiple qual 0.00 58.28 $0.00 84378 Sugars single quant 0.00 58.28 $0.00 84379 Sugars multiple quant 0.00 58.28 $0.00 84392 Assay of urine sulfate 0.00 58.28 $0.00 84402 Assay of free testosterone 0.00 58.28 $0.00 84403 Assay of total testosterone 0.00 58.28 $0.00 84410 Testosterone bioavailable 0.00 58.28 $0.00 84425 Assay of vitamin b-1 0.00 58.28 $0.00 84430 Assay of thiocyanate 0.00 58.28 $0.00 84431 Thromboxane urine 0.00 58.28 $0.00 84432 Assay of thyroglobulin 0.00 58.28 $0.00 84436 Assay of total thyroxine 0.00 58.28 $0.00 84437 Assay of neonatal thyroxine 0.00 58.28 $0.00 84439 Assay of free thyroxine 0.00 58.28 $0.00 84442 Assay of thyroid activity 0.00 58.28 $0.00 84443 Assay thyroid stim hormone 0.00 58.28 $0.00 84445 Assay of tsi globulin 0.00 58.28 $0.00 84446 Assay of vitamin e 0.00 58.28 $0.00 84449 Assay of transcortin 0.00 58.28 $0.00 84450 Transferase (ast) (sgot) 0.00 58.28 $0.00 84460 Alanine amino (alt) (sgpt) 0.00 58.28 $0.00 84466 Assay of transferrin 0.00 58.28 $0.00 84478 Assay of triglycerides 0.00 58.28 $0.00 84479 Assay of thyroid (t3 or t4) 0.00 58.28 $0.00 84480 Assay triiodothyronine (t3) 0.00 58.28 $0.00 84481 Free assay (ft-3) 0.00 58.28 $0.00 84482 T3 reverse 0.00 58.28 $0.00 84484 Assay of troponin quant 0.00 58.28 $0.00 84485 Assay duodenal fluid trypsin 0.00 58.28 $0.00 84488 Test feces for trypsin 0.00 58.28 $0.00 84490 Assay of feces for trypsin 0.00 58.28 $0.00 84510 Assay of tyrosine 0.00 58.28 $0.00 84512 Assay of troponin qual 0.00 58.28 $0.00 84520 Assay of urea nitrogen 0.00 58.28 $0.00 84525 Urea nitrogen semi-quant 0.00 58.28 $0.00 84540 Assay of urine/urea-n 0.00 58.28 $0.00 84545 Urea-n clearance test 0.00 58.28 $0.00 84550 Assay of blood/uric acid 0.00 58.28 $0.00 84560 Assay of urine/uric acid 0.00 58.28 $0.00 84577 Assay of feces/urobilinogen 0.00 58.28 $0.00 84578 Test urine urobilinogen 0.00 58.28 $0.00 84580 Assay of urine urobilinogen 0.00 58.28 $0.00 84583 Assay of urine urobilinogen 0.00 58.28 $0.00 84585 Assay of urine vma 0.00 58.28 $0.00 84586 Assay of vip 0.00 58.28 $0.00 84588 Assay of vasopressin 0.00 58.28 $0.00 84590 Assay of vitamin a 0.00 58.28 $0.00 84591 Assay of nos vitamin 0.00 58.28 $0.00 84597 Assay of vitamin k 0.00 58.28 $0.00 84600 Assay of volatiles 0.00 58.28 $0.00 84620 Xylose tolerance test 0.00 58.28 $0.00 84630 Assay of zinc 0.00 58.28 $0.00 84681 Assay of c-peptide 0.00 58.28 $0.00 84702 Chorionic gonadotropin test 0.00 58.28 $0.00 84703 Chorionic gonadotropin assay 0.00 58.28 $0.00 84704 Hcg free betachain test 0.00 58.28 $0.00 84830 Ovulation tests 0.00 58.28 $0.00 84999 Clinical chemistry test 0.00 58.28 $0.00 85002 Bleeding time test 0.00 58.28 $0.00 85004 Automated diff wbc count 0.00 58.28 $0.00 85007 Bl smear w/diff wbc count 0.00 58.28 $0.00 85008 Bl smear w/o diff wbc count 0.00 58.28 $0.00 85009 Manual diff wbc count b-coat 0.00 58.28 $0.00 85013 Spun microhematocrit 0.00 58.28 $0.00 85014 Hematocrit 0.00 58.28 $0.00 85018 Hemoglobin 0.00 58.28 $0.00 85025 Complete cbc w/auto diff wbc 0.00 58.28 $0.00 85027 Complete cbc automated 0.00 58.28 $0.00 85032 Manual cell count each 0.00 58.28 $0.00 85041 Automated rbc count 0.00 58.28 $0.00 85044 Manual reticulocyte count 0.00 58.28 $0.00 85045 Automated reticulocyte count 0.00 58.28 $0.00 85046 Reticyte/hgb concentrate 0.00 58.28 $0.00 85048 Automated leukocyte count 0.00 58.28 $0.00 85049 Automated platelet count 0.00 58.28 $0.00 85055 Reticulated platelet assay 0.00 58.28 $0.00 85060 Blood smear interpretation 0.71 58.28 $41.38 85097 Bone marrow interpretation 2.57 58.28 $149.78 85130 Chromogenic substrate assay 0.00 58.28 $0.00 85170 Blood clot retraction 0.00 58.28 $0.00 85175 Blood clot lysis time 0.00 58.28 $0.00 85210 Clot factor ii prothrom spec 0.00 58.28 $0.00 85220 Blooc clot factor v test 0.00 58.28 $0.00 85230 Clot factor vii proconvertin 0.00 58.28 $0.00 85240 Clot factor viii ahg 1 stage 0.00 58.28 $0.00 85244 Clot factor viii reltd antgn 0.00 58.28 $0.00 85245 Clot factor viii vw ristoctn 0.00 58.28 $0.00 85246 Clot factor viii vw antigen 0.00 58.28 $0.00 85247 Clot factor viii multimetric 0.00 58.28 $0.00 85250 Clot factor ix ptc/chrstmas 0.00 58.28 $0.00 85260 Clot factor x stuart-power 0.00 58.28 $0.00 85270 Clot factor xi pta 0.00 58.28 $0.00 85280 Clot factor xii hageman 0.00 58.28 $0.00 85290 Clot factor xiii fibrin stab 0.00 58.28 $0.00 85291 Clot factor xiii fibrin scrn 0.00 58.28 $0.00 85292 Clot factor fletcher fact 0.00 58.28 $0.00 85293 Clot factor wght kininogen 0.00 58.28 $0.00 85300 Antithrombin iii activity 0.00 58.28 $0.00 85301 Antithrombin iii antigen 0.00 58.28 $0.00 85302 Clot inhibit prot c antigen 0.00 58.28 $0.00 85303 Clot inhibit prot c activity 0.00 58.28 $0.00 85305 Clot inhibit prot s total 0.00 58.28 $0.00 85306 Clot inhibit prot s free 0.00 58.28 $0.00 85307 Assay activated protein c 0.00 58.28 $0.00 85335 Factor inhibitor test 0.00 58.28 $0.00 85337 Thrombomodulin 0.00 58.28 $0.00 85345 Coagulation time lee & white 0.00 58.28 $0.00 85347 Coagulation time activated 0.00 58.28 $0.00 85348 Coagulation time otr method 0.00 58.28 $0.00 85360 Euglobulin lysis 0.00 58.28 $0.00 85362 Fibrin degradation products 0.00 58.28 $0.00 85366 Fibrinogen test 0.00 58.28 $0.00 85370 Fibrinogen test 0.00 58.28 $0.00 85378 Fibrin degrade semiquant 0.00 58.28 $0.00 85379 Fibrin degradation quant 0.00 58.28 $0.00 85380 Fibrin degradj d-dimer 0.00 58.28 $0.00 85384 Fibrinogen activity 0.00 58.28 $0.00 85385 Fibrinogen antigen 0.00 58.28 $0.00 85390 Fibrinolysins screen i&r 0.00 58.28 $0.00 85390 26 Fibrinolysins screen i&r 0.52 58.28 $30.31 85396 Clotting assay whole blood 0.59 58.28 $34.39 85397 Clotting funct activity 0.00 58.28 $0.00 85400 Fibrinolytic plasmin 0.00 58.28 $0.00 85410 Fibrinolytic antiplasmin 0.00 58.28 $0.00 85415 Fibrinolytic plasminogen 0.00 58.28 $0.00 85420 Fibrinolytic plasminogen 0.00 58.28 $0.00 85421 Fibrinolytic plasminogen 0.00 58.28 $0.00 85441 Heinz bodies direct 0.00 58.28 $0.00 85445 Heinz bodies induced 0.00 58.28 $0.00 85460 Hemoglobin fetal 0.00 58.28 $0.00 85461 Hemoglobin fetal 0.00 58.28 $0.00 85475 Hemolysin acid 0.00 58.28 $0.00 85520 Heparin assay 0.00 58.28 $0.00 85525 Heparin neutralization 0.00 58.28 $0.00 85530 Heparin-protamine tolerance 0.00 58.28 $0.00 85536 Iron stain peripheral blood 0.00 58.28 $0.00 85540 Wbc alkaline phosphatase 0.00 58.28 $0.00 85547 Rbc mechanical fragility 0.00 58.28 $0.00 85549 Muramidase 0.00 58.28 $0.00 85555 Rbc osmotic fragility 0.00 58.28 $0.00 85557 Rbc osmotic fragility 0.00 58.28 $0.00 85576 Blood platelet aggregation 0.00 58.28 $0.00 85576 26 Blood platelet aggregation 0.52 58.28 $30.31 85597 Phospholipid pltlt neutraliz 0.00 58.28 $0.00 85598 Hexagnal phosph pltlt neutrl 0.00 58.28 $0.00 85610 Prothrombin time 0.00 58.28 $0.00 85611 Prothrombin test 0.00 58.28 $0.00 85612 Viper venom prothrombin time 0.00 58.28 $0.00 85613 Russell viper venom diluted 0.00 58.28 $0.00 85635 Reptilase test 0.00 58.28 $0.00 85651 Rbc sed rate nonautomated 0.00 58.28 $0.00 85652 Rbc sed rate automated 0.00 58.28 $0.00 85660 Rbc sickle cell test 0.00 58.28 $0.00 85670 Thrombin time plasma 0.00 58.28 $0.00 85675 Thrombin time titer 0.00 58.28 $0.00 85705 Thromboplastin inhibition 0.00 58.28 $0.00 85730 Thromboplastin time partial 0.00 58.28 $0.00 85732 Thromboplastin time partial 0.00 58.28 $0.00 85810 Blood viscosity examination 0.00 58.28 $0.00 85999 Hematology procedure 0.00 58.28 $0.00 86000 Agglutinins febrile antigen 0.00 58.28 $0.00 86001 Allergen specific igg 0.00 58.28 $0.00 86003 Allergen specific ige 0.00 58.28 $0.00 86005 Allergen specific ige 0.00 58.28 $0.00 86021 Wbc antibody identification 0.00 58.28 $0.00 86022 Platelet antibodies 0.00 58.28 $0.00 86023 Immunoglobulin assay 0.00 58.28 $0.00 86038 Antinuclear antibodies 0.00 58.28 $0.00 86039 Antinuclear antibodies (ana) 0.00 58.28 $0.00 86060 Antistreptolysin o titer 0.00 58.28 $0.00 86063 Antistreptolysin o screen 0.00 58.28 $0.00 86077 Phys blood bank serv xmatch 1.60 58.28 $93.25 86078 Phys blood bank serv reactj 1.60 58.28 $93.25 86079 Phys blood bank serv authrj 1.59 58.28 $92.67 86140 C-reactive protein 0.00 58.28 $0.00 86141 C-reactive protein hs 0.00 58.28 $0.00 86146 Beta-2 glycoprotein antibody 0.00 58.28 $0.00 86147 Cardiolipin antibody ea ig 0.00 58.28 $0.00 86148 Anti-phospholipid antibody 0.00 58.28 $0.00 86152 Cell enumeration & id 0.00 58.28 $0.00 86153 26 Cell enumeration phys interp 0.98 58.28 $57.11 86155 Chemotaxis assay 0.00 58.28 $0.00 86156 Cold agglutinin screen 0.00 58.28 $0.00 86157 Cold agglutinin titer 0.00 58.28 $0.00 86160 Complement antigen 0.00 58.28 $0.00 86161 Complement/function activity 0.00 58.28 $0.00 86162 Complement total (ch50) 0.00 58.28 $0.00 86171 Complement fixation each 0.00 58.28 $0.00 86185 Counterimmunoelectrophoresis 0.00 58.28 $0.00 86200 Ccp antibody 0.00 58.28 $0.00 86215 Deoxyribonuclease antibody 0.00 58.28 $0.00 86225 Dna antibody native 0.00 58.28 $0.00 86226 Dna antibody single strand 0.00 58.28 $0.00 86235 Nuclear antigen antibody 0.00 58.28 $0.00 86243 Fc receptor 0.00 58.28 $0.00 86255 Fluorescent antibody screen 0.00 58.28 $0.00 86255 26 Fluorescent antibody screen 0.52 58.28 $30.31 86256 Fluorescent antibody titer 0.00 58.28 $0.00 86256 26 Fluorescent antibody titer 0.52 58.28 $30.31 86277 Growth hormone antibody 0.00 58.28 $0.00 86280 Hemagglutination inhibition 0.00 58.28 $0.00 86294 Immunoassay tumor qual 0.00 58.28 $0.00 86300 Immunoassay tumor ca 15-3 0.00 58.28 $0.00 86301 Immunoassay tumor ca 19-9 0.00 58.28 $0.00 86304 Immunoassay tumor ca 125 0.00 58.28 $0.00 86305 Human epididymis protein 4 0.00 58.28 $0.00 86308 Heterophile antibody screen 0.00 58.28 $0.00 86309 Heterophile antibody titer 0.00 58.28 $0.00 86310 Heterophile antibody absrbj 0.00 58.28 $0.00 86316 Immunoassay tumor other 0.00 58.28 $0.00 86317 Immunoassay infectious agent 0.00 58.28 $0.00 86318 Immunoassay infectious agent 0.00 58.28 $0.00 86320 Serum immunoelectrophoresis 0.00 58.28 $0.00 86320 26 Serum immunoelectrophoresis 0.52 58.28 $30.31 86325 Other immunoelectrophoresis 0.00 58.28 $0.00 86325 26 Other immunoelectrophoresis 0.52 58.28 $30.31 86327 Immunoelectrophoresis assay 0.00 58.28 $0.00 86327 26 Immunoelectrophoresis assay 0.59 58.28 $34.39 86329 Immunodiffusion nes 0.00 58.28 $0.00 86331 Immunodiffusion ouchterlony 0.00 58.28 $0.00 86332 Immune complex assay 0.00 58.28 $0.00 86334 Immunofix e-phoresis serum 0.00 58.28 $0.00 86334 26 Immunofix e-phoresis serum 0.52 58.28 $30.31 86335 Immunfix e-phorsis/urine/csf 0.00 58.28 $0.00 86335 26 Immunfix e-phorsis/urine/csf 0.52 58.28 $30.31 86336 Inhibin a 0.00 58.28 $0.00 86337 Insulin antibodies 0.00 58.28 $0.00 86340 Intrinsic factor antibody 0.00 58.28 $0.00 86341 Islet cell antibody 0.00 58.28 $0.00 86343 Leukocyte histamine release 0.00 58.28 $0.00 86344 Leukocyte phagocytosis 0.00 58.28 $0.00 86352 Cell function assay w/stim 0.00 58.28 $0.00 86353 Lymphocyte transformation 0.00 58.28 $0.00 86355 B cells total count 0.00 58.28 $0.00 86356 Mononuclear cell antigen 0.00 58.28 $0.00 86357 Nk cells total count 0.00 58.28 $0.00 86359 T cells total count 0.00 58.28 $0.00 86360 T cell absolute count/ratio 0.00 58.28 $0.00 86361 T cell absolute count 0.00 58.28 $0.00 86367 Stem cells total count 0.00 58.28 $0.00 86376 Microsomal antibody each 0.00 58.28 $0.00 86378 Migration inhibitory factor 0.00 58.28 $0.00 86382 Neutralization test viral 0.00 58.28 $0.00 86384 Nitroblue tetrazolium dye 0.00 58.28 $0.00 86386 Nuclear matrix protein 22 0.00 58.28 $0.00 86403 Particle agglut antbdy scrn 0.00 58.28 $0.00 86406 Particle agglut antbdy titr 0.00 58.28 $0.00 86430 Rheumatoid factor test qual 0.00 58.28 $0.00 86431 Rheumatoid factor quant 0.00 58.28 $0.00 86480 Tb test cell immun measure 0.00 58.28 $0.00 86481 Tb ag response t-cell susp 0.00 58.28 $0.00 86485 Skin test candida 0.00 58.28 $0.00 86486 Skin test nos antigen 0.14 58.28 $8.16 86490 Coccidioidomycosis skin test 2.06 58.28 $120.06 86510 Histoplasmosis skin test 0.17 58.28 $9.91 86580 Tb intradermal test 0.23 58.28 $13.40 86590 Streptokinase antibody 0.00 58.28 $0.00 86592 Syphilis test non-trep qual 0.00 58.28 $0.00 86593 Syphilis test non-trep quant 0.00 58.28 $0.00 86602 Antinomyces antibody 0.00 58.28 $0.00 86603 Adenovirus antibody 0.00 58.28 $0.00 86606 Aspergillus antibody 0.00 58.28 $0.00 86609 Bacterium antibody 0.00 58.28 $0.00 86611 Bartonella antibody 0.00 58.28 $0.00 86612 Blastomyces antibody 0.00 58.28 $0.00 86615 Bordetella antibody 0.00 58.28 $0.00 86617 Lyme disease antibody 0.00 58.28 $0.00 86618 Lyme disease antibody 0.00 58.28 $0.00 86619 Borrelia antibody 0.00 58.28 $0.00 86622 Brucella antibody 0.00 58.28 $0.00 86625 Campylobacter antibody 0.00 58.28 $0.00 86628 Candida antibody 0.00 58.28 $0.00 86631 Chlamydia antibody 0.00 58.28 $0.00 86632 Chlamydia igm antibody 0.00 58.28 $0.00 86635 Coccidioides antibody 0.00 58.28 $0.00 86638 Q fever antibody 0.00 58.28 $0.00 86641 Cryptococcus antibody 0.00 58.28 $0.00 86644 Cmv antibody 0.00 58.28 $0.00 86645 Cmv antibody igm 0.00 58.28 $0.00 86648 Diphtheria antibody 0.00 58.28 $0.00 86651 Encephalitis californ antbdy 0.00 58.28 $0.00 86652 Encephaltis east eqne anbdy 0.00 58.28 $0.00 86653 Encephaltis st louis antbody 0.00 58.28 $0.00 86654 Encephaltis west eqne antbdy 0.00 58.28 $0.00 86658 Enterovirus antibody 0.00 58.28 $0.00 86663 Epstein-barr antibody 0.00 58.28 $0.00 86664 Epstein-barr nuclear antigen 0.00 58.28 $0.00 86665 Epstein-barr capsid vca 0.00 58.28 $0.00 86666 Ehrlichia antibody 0.00 58.28 $0.00 86668 Francisella tularensis 0.00 58.28 $0.00 86671 Fungus nes antibody 0.00 58.28 $0.00 86674 Giardia lamblia antibody 0.00 58.28 $0.00 86677 Helicobacter pylori antibody 0.00 58.28 $0.00 86682 Helminth antibody 0.00 58.28 $0.00 86684 Hemophilus influenza antibdy 0.00 58.28 $0.00 86687 Htlv-i antibody 0.00 58.28 $0.00 86688 Htlv-ii antibody 0.00 58.28 $0.00 86689 Htlv/hiv confirmj antibody 0.00 58.28 $0.00 86692 Hepatitis delta agent antbdy 0.00 58.28 $0.00 86694 Herpes simplex nes antbdy 0.00 58.28 $0.00 86695 Herpes simplex type 1 test 0.00 58.28 $0.00 86696 Herpes simplex type 2 test 0.00 58.28 $0.00 86698 Histoplasma antibody 0.00 58.28 $0.00 86701 Hiv-1antibody 0.00 58.28 $0.00 86702 Hiv-2 antibody 0.00 58.28 $0.00 86703 Hiv-1/hiv-2 1 result antbdy 0.00 58.28 $0.00 86704 Hep b core antibody total 0.00 58.28 $0.00 86705 Hep b core antibody igm 0.00 58.28 $0.00 86706 Hep b surface antibody 0.00 58.28 $0.00 86707 Hepatitis be antibody 0.00 58.28 $0.00 86708 Hepatitis a antibody 0.00 58.28 $0.00 86709 Hepatitis a igm antibody 0.00 58.28 $0.00 86710 Influenza virus antibody 0.00 58.28 $0.00 86711 John cunningham antibody 0.00 58.28 $0.00 86713 Legionella antibody 0.00 58.28 $0.00 86717 Leishmania antibody 0.00 58.28 $0.00 86720 Leptospira antibody 0.00 58.28 $0.00 86723 Listeria monocytogenes 0.00 58.28 $0.00 86727 Lymph choriomeningitis ab 0.00 58.28 $0.00 86729 Lympho venereum antibody 0.00 58.28 $0.00 86732 Mucormycosis antibody 0.00 58.28 $0.00 86735 Mumps antibody 0.00 58.28 $0.00 86738 Mycoplasma antibody 0.00 58.28 $0.00 86741 Neisseria meningitidis 0.00 58.28 $0.00 86744 Nocardia antibody 0.00 58.28 $0.00 86747 Parvovirus antibody 0.00 58.28 $0.00 86750 Malaria antibody 0.00 58.28 $0.00 86753 Protozoa antibody nos 0.00 58.28 $0.00 86756 Respiratory virus antibody 0.00 58.28 $0.00 86757 Rickettsia antibody 0.00 58.28 $0.00 86759 Rotavirus antibody 0.00 58.28 $0.00 86762 Rubella antibody 0.00 58.28 $0.00 86765 Rubeola antibody 0.00 58.28 $0.00 86768 Salmonella antibody 0.00 58.28 $0.00 86771 Shigella antibody 0.00 58.28 $0.00 86774 Tetanus antibody 0.00 58.28 $0.00 86777 Toxoplasma antibody 0.00 58.28 $0.00 86778 Toxoplasma antibody igm 0.00 58.28 $0.00 86780 Treponema pallidum 0.00 58.28 $0.00 86784 Trichinella antibody 0.00 58.28 $0.00 86787 Varicella-zoster antibody 0.00 58.28 $0.00 86788 West nile virus ab igm 0.00 58.28 $0.00 86789 West nile virus antibody 0.00 58.28 $0.00 86790 Virus antibody nos 0.00 58.28 $0.00 86793 Yersinia antibody 0.00 58.28 $0.00 86800 Thyroglobulin antibody 0.00 58.28 $0.00 86803 Hepatitis c ab test 0.00 58.28 $0.00 86804 Hep c ab test confirm 0.00 58.28 $0.00 86805 Lymphocytotoxicity assay 0.00 58.28 $0.00 86806 Lymphocytotoxicity assay 0.00 58.28 $0.00 86807 Cytotoxic antibody screening 0.00 58.28 $0.00 86808 Cytotoxic antibody screening 0.00 58.28 $0.00 86812 Hla typing a b or c 0.00 58.28 $0.00 86813 Hla typing a b or c 0.00 58.28 $0.00 86816 Hla typing dr/dq 0.00 58.28 $0.00 86817 Hla typing dr/dq 0.00 58.28 $0.00 86821 Lymphocyte culture mixed 0.00 58.28 $0.00 86822 Lymphocyte culture primed 0.00 58.28 $0.00 86825 Hla x-math non-cytotoxic 0.00 58.28 $0.00 86826 Hla x-match noncytotoxc addl 0.00 58.28 $0.00 86828 Hla class i&ii antibody qual 0.00 58.28 $0.00 86829 Hla class i/ii antibody qual 0.00 58.28 $0.00 86830 Hla class i phenotype qual 0.00 58.28 $0.00 86831 Hla class ii phenotype qual 0.00 58.28 $0.00 86832 Hla class i high defin qual 0.00 58.28 $0.00 86833 Hla class ii high defin qual 0.00 58.28 $0.00 86834 Hla class i semiquant panel 0.00 58.28 $0.00 86835 Hla class ii semiquant panel 0.00 58.28 $0.00 86849 Immunology procedure 0.00 58.28 $0.00 86850 Rbc antibody screen 0.00 58.28 $0.00 86860 Rbc antibody elution 0.00 58.28 $0.00 86870 Rbc antibody identification 0.00 58.28 $0.00 86880 Coombs test direct 0.00 58.28 $0.00 86885 Coombs test indirect qual 0.00 58.28 $0.00 86886 Coombs test indirect titer 0.00 58.28 $0.00 86890 Autologous blood process 0.00 58.28 $0.00 86891 Autologous blood op salvage 0.00 58.28 $0.00 86900 Blood typing serologic abo 0.00 58.28 $0.00 86901 Blood typing serologic rh(d) 0.00 58.28 $0.00 86902 Blood type antigen donor ea 0.00 58.28 $0.00 86904 Blood typing patient serum 0.00 58.28 $0.00 86905 Blood typing rbc antigens 0.00 58.28 $0.00 86906 Bld typing serologic rh phnt 0.00 58.28 $0.00 86910 Blood typing paternity test 0.00 58.28 $0.00 86911 Blood typing antigen system 0.00 58.28 $0.00 86920 Compatibility test spin 0.00 58.28 $0.00 86921 Compatibility test incubate 0.00 58.28 $0.00 86922 Compatibility test antiglob 0.00 58.28 $0.00 86923 Compatibility test electric 0.00 58.28 $0.00 86927 Plasma fresh frozen 0.00 58.28 $0.00 86930 Frozen blood prep 0.00 58.28 $0.00 86931 Frozen blood thaw 0.00 58.28 $0.00 86932 Frozen blood freeze/thaw 0.00 58.28 $0.00 86940 Hemolysins/agglutinins auto 0.00 58.28 $0.00 86941 Hemolysins/agglutinins 0.00 58.28 $0.00 86945 Blood product/irradiation 0.00 58.28 $0.00 86950 Leukacyte transfusion 0.00 58.28 $0.00 86960 Vol reduction of blood/prod 0.00 58.28 $0.00 86965 Pooling blood platelets 0.00 58.28 $0.00 86970 Rbc pretx incubatj w/chemicl 0.00 58.28 $0.00 86971 Rbc pretx incubatj w/enzymes 0.00 58.28 $0.00 86972 Rbc pretx incubatj w/density 0.00 58.28 $0.00 86975 Rbc serum pretx incubj drugs 0.00 58.28 $0.00 86976 Rbc serum pretx id dilution 0.00 58.28 $0.00 86977 Rbc serum pretx incubj/inhib 0.00 58.28 $0.00 86978 Rbc pretreatment serum 0.00 58.28 $0.00 86985 Split blood or products 0.00 58.28 $0.00 86999 Transfusion procedure 0.00 58.28 $0.00 87003 Small animal inoculation 0.00 58.28 $0.00 87015 Specimen infect agnt concntj 0.00 58.28 $0.00 87040 Blood culture for bacteria 0.00 58.28 $0.00 87045 Feces culture aerobic bact 0.00 58.28 $0.00 87046 Stool cultr aerobic bact ea 0.00 58.28 $0.00 87070 Culture othr specimn aerobic 0.00 58.28 $0.00 87071 Culture aerobic quant other 0.00 58.28 $0.00 87073 Culture bacteria anaerobic 0.00 58.28 $0.00 87075 Cultr bacteria except blood 0.00 58.28 $0.00 87076 Culture anaerobe ident each 0.00 58.28 $0.00 87077 Culture aerobic identify 0.00 58.28 $0.00 87081 Culture screen only 0.00 58.28 $0.00 87084 Culture of specimen by kit 0.00 58.28 $0.00 87086 Urine culture/colony count 0.00 58.28 $0.00 87088 Urine bacteria culture 0.00 58.28 $0.00 87101 Skin fungi culture 0.00 58.28 $0.00 87102 Fungus isolation culture 0.00 58.28 $0.00 87103 Blood fungus culture 0.00 58.28 $0.00 87106 Fungi identification yeast 0.00 58.28 $0.00 87107 Fungi identification mold 0.00 58.28 $0.00 87109 Mycoplasma 0.00 58.28 $0.00 87110 Chlamydia culture 0.00 58.28 $0.00 87116 Mycobacteria culture 0.00 58.28 $0.00 87118 Mycobacteric identification 0.00 58.28 $0.00 87140 Culture type immunofluoresc 0.00 58.28 $0.00 87143 Culture typing glc/hplc 0.00 58.28 $0.00 87147 Culture type immunologic 0.00 58.28 $0.00 87149 Dna/rna direct probe 0.00 58.28 $0.00 87150 Dna/rna amplified probe 0.00 58.28 $0.00 87152 Culture type pulse field gel 0.00 58.28 $0.00 87153 Dna/rna sequencing 0.00 58.28 $0.00 87158 Culture typing added method 0.00 58.28 $0.00 87164 Dark field examination 0.00 58.28 $0.00 87164 26 Dark field examination 0.52 58.28 $30.31 87166 Dark field examination 0.00 58.28 $0.00 87168 Macroscopic exam arthropod 0.00 58.28 $0.00 87169 Macroscopic exam parasite 0.00 58.28 $0.00 87172 Pinworm exam 0.00 58.28 $0.00 87176 Tissue homogenization cultr 0.00 58.28 $0.00 87177 Ova and parasites smears 0.00 58.28 $0.00 87181 Microbe susceptible diffuse 0.00 58.28 $0.00 87184 Microbe susceptible disk 0.00 58.28 $0.00 87185 Microbe susceptible enzyme 0.00 58.28 $0.00 87186 Microbe susceptible mic 0.00 58.28 $0.00 87187 Microbe susceptible mlc 0.00 58.28 $0.00 87188 Microbe suscept macrobroth 0.00 58.28 $0.00 87190 Microbe suscept mycobacteri 0.00 58.28 $0.00 87197 Bactericidal level serum 0.00 58.28 $0.00 87205 Smear gram stain 0.00 58.28 $0.00 87206 Smear fluorescent/acid stai 0.00 58.28 $0.00 87207 Smear special stain 0.00 58.28 $0.00 87207 26 Smear special stain 0.52 58.28 $30.31 87209 Smear complex stain 0.00 58.28 $0.00 87210 Smear wet mount saline/ink 0.00 58.28 $0.00 87220 Tissue exam for fungi 0.00 58.28 $0.00 87230 Assay toxin or antitoxin 0.00 58.28 $0.00 87250 Virus inoculate eggs/animal 0.00 58.28 $0.00 87252 Virus inoculation tissue 0.00 58.28 $0.00 87253 Virus inoculate tissue addl 0.00 58.28 $0.00 87254 Virus inoculation shell via 0.00 58.28 $0.00 87255 Genet virus isolate hsv 0.00 58.28 $0.00 87260 Adenovirus ag if 0.00 58.28 $0.00 87265 Pertussis ag if 0.00 58.28 $0.00 87267 Enterovirus antibody dfa 0.00 58.28 $0.00 87269 Giardia ag if 0.00 58.28 $0.00 87270 Chlamydia trachomatis ag if 0.00 58.28 $0.00 87271 Cytomegalovirus dfa 0.00 58.28 $0.00 87272 Cryptosporidium ag if 0.00 58.28 $0.00 87273 Herpes simplex 2 ag if 0.00 58.28 $0.00 87274 Herpes simplex 1 ag if 0.00 58.28 $0.00 87275 Influenza b ag if 0.00 58.28 $0.00 87276 Influenza a ag if 0.00 58.28 $0.00 87277 Legionella micdadei ag if 0.00 58.28 $0.00 87278 Legion pneumophilia ag if 0.00 58.28 $0.00 87279 Parainfluenza ag if 0.00 58.28 $0.00 87280 Respiratory syncytial ag if 0.00 58.28 $0.00 87281 Pneumocystis carinii ag if 0.00 58.28 $0.00 87283 Rubeola ag if 0.00 58.28 $0.00 87285 Treponema pallidum ag if 0.00 58.28 $0.00 87290 Varicella zoster ag if 0.00 58.28 $0.00 87299 Antibody detection nos if 0.00 58.28 $0.00 87300 Ag detection polyval if 0.00 58.28 $0.00 87301 Adenovirus ag ia 0.00 58.28 $0.00 87305 Aspergillus ag ia 0.00 58.28 $0.00 87320 Chylmd trach ag ia 0.00 58.28 $0.00 87324 Clostridium ag ia 0.00 58.28 $0.00 87327 Cryptococcus neoform ag ia 0.00 58.28 $0.00 87328 Cryptosporidium ag ia 0.00 58.28 $0.00 87329 Giardia ag ia 0.00 58.28 $0.00 87332 Cytomegalovirus ag ia 0.00 58.28 $0.00 87335 E coli 0157 ag ia 0.00 58.28 $0.00 87336 Entamoeb hist dispr ag ia 0.00 58.28 $0.00 87337 Entamoeb hist group ag ia 0.00 58.28 $0.00 87338 Hpylori stool ia 0.00 58.28 $0.00 87339 H pylori ag ia 0.00 58.28 $0.00 87340 Hepatitis b surface ag ia 0.00 58.28 $0.00 87341 Hepatitis b surface ag ia 0.00 58.28 $0.00 87350 Hepatitis be ag ia 0.00 58.28 $0.00 87380 Hepatitis delta ag ia 0.00 58.28 $0.00 87385 Histoplasma capsul ag ia 0.00 58.28 $0.00 87389 Hiv-1 ag w/hiv-1 & hiv-2 ab 0.00 58.28 $0.00 87390 Hiv-1 ag ia 0.00 58.28 $0.00 87391 Hiv-2 ag ia 0.00 58.28 $0.00 87400 Influenza a/b ag ia 0.00 58.28 $0.00 87420 Resp syncytial ag ia 0.00 58.28 $0.00 87425 Rotavirus ag ia 0.00 58.28 $0.00 87427 Shiga-like toxin ag ia 0.00 58.28 $0.00 87430 Strep a ag ia 0.00 58.28 $0.00 87449 Ag detect nos ia mult 0.00 58.28 $0.00 87450 Ag detect nos ia single 0.00 58.28 $0.00 87451 Ag detect polyval ia mult 0.00 58.28 $0.00 87470 Bartonella dna dir probe 0.00 58.28 $0.00 87471 Bartonella dna amp probe 0.00 58.28 $0.00 87472 Bartonella dna quant 0.00 58.28 $0.00 87475 Lyme dis dna dir probe 0.00 58.28 $0.00 87476 Lyme dis dna amp probe 0.00 58.28 $0.00 87477 Lyme dis dna quant 0.00 58.28 $0.00 87480 Candida dna dir probe 0.00 58.28 $0.00 87481 Candida dna amp probe 0.00 58.28 $0.00 87482 Candida dna quant 0.00 58.28 $0.00 87483 Cns dna amp probe type 12-25 0.00 58.28 $0.00 87485 Chylmd pneum dna dir probe 0.00 58.28 $0.00 87486 Chylmd pneum dna amp probe 0.00 58.28 $0.00 87487 Chylmd pneum dna quant 0.00 58.28 $0.00 87490 Chylmd trach dna dir probe 0.00 58.28 $0.00 87491 Chylmd trach dna amp probe 0.00 58.28 $0.00 87492 Chylmd trach dna quant 0.00 58.28 $0.00 87493 C diff amplified probe 0.00 58.28 $0.00 87495 Cytomeg dna dir probe 0.00 58.28 $0.00 87496 Cytomeg dna amp probe 0.00 58.28 $0.00 87497 Cytomeg dna quant 0.00 58.28 $0.00 87498 Enterovirus probe&revrs trns 0.00 58.28 $0.00 87500 Vanomycin dna amp probe 0.00 58.28 $0.00 87501 Influenza dna amp prob 1+ 0.00 58.28 $0.00 87502 Influenza dna amp probe 0.00 58.28 $0.00 87503 Influenza dna amp prob addl 0.00 58.28 $0.00 87505 Nfct agent detection gi 0.00 58.28 $0.00 87506 Iadna-dna/rna probe tq 6-11 0.00 58.28 $0.00 87507 Iadna-dna/rna probe tq 12-25 0.00 58.28 $0.00 87510 Gardner vag dna dir probe 0.00 58.28 $0.00 87511 Gardner vag dna amp probe 0.00 58.28 $0.00 87512 Gardner vag dna quant 0.00 58.28 $0.00 87515 Hepatitis b dna dir probe 0.00 58.28 $0.00 87516 Hepatitis b dna amp probe 0.00 58.28 $0.00 87517 Hepatitis b dna quant 0.00 58.28 $0.00 87520 Hepatitis c rna dir probe 0.00 58.28 $0.00 87521 Hepatitis c probe&rvrs trnsc 0.00 58.28 $0.00 87522 Hepatitis c revrs trnscrpj 0.00 58.28 $0.00 87525 Hepatitis g dna dir probe 0.00 58.28 $0.00 87526 Hepatitis g dna amp probe 0.00 58.28 $0.00 87527 Hepatitis g dna quant 0.00 58.28 $0.00 87528 Hsv dna dir probe 0.00 58.28 $0.00 87529 Hsv dna amp probe 0.00 58.28 $0.00 87530 Hsv dna quant 0.00 58.28 $0.00 87531 Hhv-6 dna dir probe 0.00 58.28 $0.00 87532 Hhv-6 dna amp probe 0.00 58.28 $0.00 87533 Hhv-6 dna quant 0.00 58.28 $0.00 87534 Hiv-1 dna dir probe 0.00 58.28 $0.00 87535 Hiv-1 probe&reverse trnscrpj 0.00 58.28 $0.00 87536 Hiv-1 quant&revrse trnscrpj 0.00 58.28 $0.00 87537 Hiv-2 dna dir probe 0.00 58.28 $0.00 87538 Hiv-2 probe&revrse trnscripj 0.00 58.28 $0.00 87539 Hiv-2 quant&revrse trnscripj 0.00 58.28 $0.00 87540 Legion pneumo dna dir prob 0.00 58.28 $0.00 87541 Legion pneumo dna amp prob 0.00 58.28 $0.00 87542 Legion pneumo dna quant 0.00 58.28 $0.00 87550 Mycobacteria dna dir probe 0.00 58.28 $0.00 87551 Mycobacteria dna amp probe 0.00 58.28 $0.00 87552 Mycobacteria dna quant 0.00 58.28 $0.00 87555 M.tuberculo dna dir probe 0.00 58.28 $0.00 87556 M.tuberculo dna amp probe 0.00 58.28 $0.00 87557 M.tuberculo dna quant 0.00 58.28 $0.00 87560 M.avium-intra dna dir prob 0.00 58.28 $0.00 87561 M.avium-intra dna amp prob 0.00 58.28 $0.00 87562 M.avium-intra dna quant 0.00 58.28 $0.00 87580 M.pneumon dna dir probe 0.00 58.28 $0.00 87581 M.pneumon dna amp probe 0.00 58.28 $0.00 87582 M.pneumon dna quant 0.00 58.28 $0.00 87590 N.gonorrhoeae dna dir prob 0.00 58.28 $0.00 87591 N.gonorrhoeae dna amp prob 0.00 58.28 $0.00 87592 N.gonorrhoeae dna quant 0.00 58.28 $0.00 87623 Hpv low-risk types 0.00 58.28 $0.00 87624 Hpv high-risk types 0.00 58.28 $0.00 87625 Hpv types 16 & 18 only 0.00 58.28 $0.00 87631 Resp virus 3-5 targets 0.00 58.28 $0.00 87632 Resp virus 6-11 targets 0.00 58.28 $0.00 87633 Resp virus 12-25 targets 0.00 58.28 $0.00 87640 Staph a dna amp probe 0.00 58.28 $0.00 87641 Mr-staph dna amp probe 0.00 58.28 $0.00 87650 Strep a dna dir probe 0.00 58.28 $0.00 87651 Strep a dna amp probe 0.00 58.28 $0.00 87652 Strep a dna quant 0.00 58.28 $0.00 87653 Strep b dna amp probe 0.00 58.28 $0.00 87660 Trichomonas vagin dir probe 0.00 58.28 $0.00 87661 Trichomonas vaginalis amplif 0.00 58.28 $0.00 87797 Detect agent nos dna dir 0.00 58.28 $0.00 87798 Detect agent nos dna amp 0.00 58.28 $0.00 87799 Detect agent nos dna quant 0.00 58.28 $0.00 87800 Detect agnt mult dna direc 0.00 58.28 $0.00 87801 Detect agnt mult dna ampli 0.00 58.28 $0.00 87802 Strep b assay w/optic 0.00 58.28 $0.00 87803 Clostridium toxin a w/optic 0.00 58.28 $0.00 87804 Influenza assay w/optic 0.00 58.28 $0.00 87806 Hiv antigen w/hiv antibodies 0.00 58.28 $0.00 87807 Rsv assay w/optic 0.00 58.28 $0.00 87808 Trichomonas assay w/optic 0.00 58.28 $0.00 87809 Adenovirus assay w/optic 0.00 58.28 $0.00 87810 Chylmd trach assay w/optic 0.00 58.28 $0.00 87850 N. gonorrhoeae assay w/optic 0.00 58.28 $0.00 87880 Strep a assay w/optic 0.00 58.28 $0.00 87899 Agent nos assay w/optic 0.00 58.28 $0.00 87900 Phenotype infect agent drug 0.00 58.28 $0.00 87901 Genotype dna hiv reverse t 0.00 58.28 $0.00 87902 Genotype dna/rna hep c 0.00 58.28 $0.00 87903 Phenotype dna hiv w/culture 0.00 58.28 $0.00 87904 Phenotype dna hiv w/clt add 0.00 58.28 $0.00 87905 Sialidase enzyme assay 0.00 58.28 $0.00 87906 Genotype dna/rna hiv 0.00 58.28 $0.00 87910 Genotype cytomegalovirus 0.00 58.28 $0.00 87912 Genotype dna hepatitis b 0.00 58.28 $0.00 87999 Microbiology procedure 0.00 58.28 $0.00 88000 Autopsy (necropsy) gross 0.00 58.28 $0.00 88005 Autopsy (necropsy) gross 0.00 58.28 $0.00 88007 Autopsy (necropsy) gross 0.00 58.28 $0.00 88012 Autopsy (necropsy) gross 0.00 58.28 $0.00 88014 Autopsy (necropsy) gross 0.00 58.28 $0.00 88016 Autopsy (necropsy) gross 0.00 58.28 $0.00 88020 Autopsy (necropsy) complete 0.00 58.28 $0.00 88025 Autopsy (necropsy) complete 0.00 58.28 $0.00 88027 Autopsy (necropsy) complete 0.00 58.28 $0.00 88028 Autopsy (necropsy) complete 0.00 58.28 $0.00 88029 Autopsy (necropsy) complete 0.00 58.28 $0.00 88036 Limited autopsy 0.00 58.28 $0.00 88037 Limited autopsy 0.00 58.28 $0.00 88040 Forensic autopsy (necropsy) 0.00 58.28 $0.00 88045 Coroners autopsy (necropsy) 0.00 58.28 $0.00 88099 Necropsy (autopsy) procedure 0.00 58.28 $0.00 88104 Cytopath fl nongyn smears 2.10 58.28 $122.39 88104 TC Cytopath fl nongyn smears 1.26 58.28 $73.43 88104 26 Cytopath fl nongyn smears 0.84 58.28 $48.96 88106 Cytopath fl nongyn filter 1.81 58.28 $105.49 88106 TC Cytopath fl nongyn filter 1.24 58.28 $72.27 88106 26 Cytopath fl nongyn filter 0.57 58.28 $33.22 88108 Cytopath concentrate tech 1.77 58.28 $103.16 88108 TC Cytopath concentrate tech 1.11 58.28 $64.69 88108 26 Cytopath concentrate tech 0.66 58.28 $38.46 88112 Cytopath cell enhance tech 1.92 58.28 $111.90 88112 TC Cytopath cell enhance tech 1.11 58.28 $64.69 88112 26 Cytopath cell enhance tech 0.81 58.28 $47.21 88120 Cytp urne 3-5 probes ea spec 17.86 58.28 $1,040.88 88120 TC Cytp urne 3-5 probes ea spec 16.17 58.28 $942.39 88120 26 Cytp urne 3-5 probes ea spec 1.69 58.28 $98.49 88121 Cytp urine 3-5 probes cmptr 15.43 58.28 $899.26 88121 TC Cytp urine 3-5 probes cmptr 13.98 58.28 $814.75 88121 26 Cytp urine 3-5 probes cmptr 1.45 58.28 $84.51 88125 Forensic cytopathology 0.59 58.28 $34.39 88125 TC Forensic cytopathology 0.22 58.28 $12.82 88125 26 Forensic cytopathology 0.37 58.28 $21.56 88130 Sex chromatin identification 0.00 58.28 $0.00 88140 Sex chromatin identification 0.00 58.28 $0.00 88141 Cytopath c/v interpret 0.92 58.28 $53.62 88142 Cytopath c/v thin layer 0.00 58.28 $0.00 88143 Cytopath c/v thin layer redo 0.00 58.28 $0.00 88147 Cytopath c/v automated 0.00 58.28 $0.00 88148 Cytopath c/v auto rescreen 0.00 58.28 $0.00 88150 Cytopath c/v manual 0.00 58.28 $0.00 88152 Cytopath c/v auto redo 0.00 58.28 $0.00 88153 Cytopath c/v redo 0.00 58.28 $0.00 88154 Cytopath c/v select 0.00 58.28 $0.00 88155 Cytopath c/v index add-on 0.00 58.28 $0.00 88160 Cytopath smear other source 2.05 58.28 $119.47 88160 TC Cytopath smear other source 1.29 58.28 $75.18 88160 26 Cytopath smear other source 0.76 58.28 $44.29 88161 Cytopath smear other source 1.85 58.28 $107.82 88161 TC Cytopath smear other source 1.12 58.28 $65.27 88161 26 Cytopath smear other source 0.73 58.28 $42.54 88162 Cytopath smear other source 2.82 58.28 $164.35 88162 TC Cytopath smear other source 1.68 58.28 $97.91 88162 26 Cytopath smear other source 1.14 58.28 $66.44 88164 Cytopath tbs c/v manual 0.00 58.28 $0.00 88165 Cytopath tbs c/v redo 0.00 58.28 $0.00 88166 Cytopath tbs c/v auto redo 0.00 58.28 $0.00 88167 Cytopath tbs c/v select 0.00 58.28 $0.00 88172 Cytp dx eval fna 1st ea site 1.62 58.28 $94.41 88172 TC Cytp dx eval fna 1st ea site 0.56 58.28 $32.64 88172 26 Cytp dx eval fna 1st ea site 1.06 58.28 $61.78 88173 Cytopath eval fna report 4.34 58.28 $252.94 88173 TC Cytopath eval fna report 2.27 58.28 $132.30 88173 26 Cytopath eval fna report 2.07 58.28 $120.64 88174 Cytopath c/v auto in fluid 0.00 58.28 $0.00 88175 Cytopath c/v auto fluid redo 0.00 58.28 $0.00 88177 Cytp fna eval ea addl 0.86 58.28 $50.12 88177 TC Cytp fna eval ea addl 0.21 58.28 $12.24 88177 26 Cytp fna eval ea addl 0.65 58.28 $37.88 88182 Cell marker study 3.38 58.28 $196.99 88182 TC Cell marker study 2.30 58.28 $134.04 88182 26 Cell marker study 1.08 58.28 $62.94 88184 Flowcytometry/ tc 1 marker 1.72 58.28 $100.24 88185 Flowcytometry/tc add-on 1.05 58.28 $61.19 88187 Flowcytometry/read 2-8 1.65 58.28 $96.16 88188 Flowcytometry/read 9-15 2.10 58.28 $122.39 88189 Flowcytometry/read 16 & > 2.58 58.28 $150.36 88199 Cytopathology procedure 0.00 58.28 $0.00 88199 TC Cytopathology procedure 0.00 58.28 $0.00 88199 26 Cytopathology procedure 0.00 58.28 $0.00 88230 Tissue culture lymphocyte 0.00 58.28 $0.00 88233 Tissue culture skin/biopsy 0.00 58.28 $0.00 88235 Tissue culture placenta 0.00 58.28 $0.00 88237 Tissue culture bone marrow 0.00 58.28 $0.00 88239 Tissue culture tumor 0.00 58.28 $0.00 88240 Cell cryopreserve/storage 0.00 58.28 $0.00 88241 Frozen cell preparation 0.00 58.28 $0.00 88245 Chromosome analysis 20-25 0.00 58.28 $0.00 88248 Chromosome analysis 50-100 0.00 58.28 $0.00 88249 Chromosome analysis 100 0.00 58.28 $0.00 88261 Chromosome analysis 5 0.00 58.28 $0.00 88262 Chromosome analysis 15-20 0.00 58.28 $0.00 88263 Chromosome analysis 45 0.00 58.28 $0.00 88264 Chromosome analysis 20-25 0.00 58.28 $0.00 88267 Chromosome analys placenta 0.00 58.28 $0.00 88269 Chromosome analys amniotic 0.00 58.28 $0.00 88271 Cytogenetics dna probe 0.00 58.28 $0.00 88272 Cytogenetics 3-5 0.00 58.28 $0.00 88273 Cytogenetics 10-30 0.00 58.28 $0.00 88274 Cytogenetics 25-99 0.00 58.28 $0.00 88275 Cytogenetics 100-300 0.00 58.28 $0.00 88280 Chromosome karyotype study 0.00 58.28 $0.00 88283 Chromosome banding study 0.00 58.28 $0.00 88285 Chromosome count additional 0.00 58.28 $0.00 88289 Chromosome study additional 0.00 58.28 $0.00 88291 Cyto/molecular report 0.92 58.28 $53.62 88299 Cytogenetic study 0.00 58.28 $0.00 88300 Surgical path gross 0.46 58.28 $26.81 88300 TC Surgical path gross 0.33 58.28 $19.23 88300 26 Surgical path gross 0.13 58.28 $7.58 88302 Tissue exam by pathologist 0.87 58.28 $50.70 88302 TC Tissue exam by pathologist 0.66 58.28 $38.46 88302 26 Tissue exam by pathologist 0.21 58.28 $12.24 88304 Tissue exam by pathologist 1.16 58.28 $67.60 88304 TC Tissue exam by pathologist 0.82 58.28 $47.79 88304 26 Tissue exam by pathologist 0.34 58.28 $19.82 88305 Tissue exam by pathologist 1.94 58.28 $113.06 88305 TC Tissue exam by pathologist 0.83 58.28 $48.37 88305 26 Tissue exam by pathologist 1.11 58.28 $64.69 88307 Tissue exam by pathologist 7.52 58.28 $438.27 88307 TC Tissue exam by pathologist 5.07 58.28 $295.48 88307 26 Tissue exam by pathologist 2.45 58.28 $142.79 88309 Tissue exam by pathologist 11.53 58.28 $671.97 88309 TC Tissue exam by pathologist 7.20 58.28 $419.62 88309 26 Tissue exam by pathologist 4.33 58.28 $252.35 88311 Decalcify tissue 0.63 58.28 $36.72 88311 TC Decalcify tissue 0.26 58.28 $15.15 88311 26 Decalcify tissue 0.37 58.28 $21.56 88312 Special stains group 1 2.78 58.28 $162.02 88312 TC Special stains group 1 1.99 58.28 $115.98 88312 26 Special stains group 1 0.79 58.28 $46.04 88313 Special stains group 2 1.97 58.28 $114.81 88313 TC Special stains group 2 1.62 58.28 $94.41 88313 26 Special stains group 2 0.35 58.28 $20.40 88314 Histochemical stains add-on 2.21 58.28 $128.80 88314 TC Histochemical stains add-on 1.56 58.28 $90.92 88314 26 Histochemical stains add-on 0.65 58.28 $37.88 88319 Enzyme histochemistry 2.51 58.28 $146.28 88319 TC Enzyme histochemistry 1.73 58.28 $100.82 88319 26 Enzyme histochemistry 0.78 58.28 $45.46 88321 Microslide consultation 2.92 58.28 $170.18 88323 Microslide consultation 3.67 58.28 $213.89 88323 TC Microslide consultation 1.15 58.28 $67.02 88323 26 Microslide consultation 2.52 58.28 $146.87 88325 Comprehensive review of data 5.33 58.28 $310.63 88329 Path consult introp 1.48 58.28 $86.25 88331 Path consult intraop 1 bloc 2.75 58.28 $160.27 88331 TC Path consult intraop 1 bloc 0.91 58.28 $53.03 88331 26 Path consult intraop 1 bloc 1.84 58.28 $107.24 88332 Path consult intraop addl 1.49 58.28 $86.84 88332 TC Path consult intraop addl 0.58 58.28 $33.80 88332 26 Path consult intraop addl 0.91 58.28 $53.03 88333 Intraop cyto path consult 1 2.66 58.28 $155.02 88333 TC Intraop cyto path consult 1 0.81 58.28 $47.21 88333 26 Intraop cyto path consult 1 1.85 58.28 $107.82 88334 Intraop cyto path consult 2 1.68 58.28 $97.91 88334 TC Intraop cyto path consult 2 0.55 58.28 $32.05 88334 26 Intraop cyto path consult 2 1.13 58.28 $65.86 88341 Immunohisto antb addl slide 2.57 58.28 $149.78 88341 TC Immunohisto antibody slide 1.74 58.28 $101.41 88341 26 Immunohisto antibody slide 0.83 58.28 $48.37 88342 Immunohisto antb 1st stain 3.02 58.28 $176.01 88342 TC Immunohisto antibody stain 1.98 58.28 $115.39 88342 26 Immunohisto antibody stain 1.04 58.28 $60.61 88344 Immunohisto antibody slide 4.87 58.28 $283.82 88344 TC Immunohisto antibody slide 3.73 58.28 $217.38 88344 26 Immunohisto antibody slide 1.14 58.28 $66.44 88346 Immunofluor antb 1st stain 2.67 58.28 $155.61 88346 TC Immunofluorescent study 1.61 58.28 $93.83 88346 26 Immunofluorescent study 1.06 58.28 $61.78 88348 Electron microscopy 9.79 58.28 $570.56 88348 TC Electron microscopy 7.57 58.28 $441.18 88348 26 Electron microscopy 2.22 58.28 $129.38 88350 Immunofluor antb addl stain 2.07 58.28 $120.64 88350 TC Immunofluor antb addl stain 1.23 58.28 $71.68 88350 26 Immunofluor antb addl stain 0.84 58.28 $48.96 88355 Analysis skeletal muscle 4.03 58.28 $234.87 88355 TC Analysis skeletal muscle 1.67 58.28 $97.33 88355 26 Analysis skeletal muscle 2.36 58.28 $137.54 88356 Analysis nerve 5.91 58.28 $344.43 88356 TC Analysis nerve 2.43 58.28 $141.62 88356 26 Analysis nerve 3.48 58.28 $202.81 88358 Analysis tumor 2.53 58.28 $147.45 88358 TC Analysis tumor 1.20 58.28 $69.94 88358 26 Analysis tumor 1.33 58.28 $77.51 88360 Tumor immunohistochem/manual 3.96 58.28 $230.79 88360 TC Tumor immunohistochem/manual 2.36 58.28 $137.54 88360 26 Tumor immunohistochem/manual 1.60 58.28 $93.25 88361 Tumor immunohistochem/comput 4.37 58.28 $254.68 88361 TC Tumor immunohistochem/comput 2.67 58.28 $155.61 88361 26 Tumor immunohistochem/comput 1.70 58.28 $99.08 88362 Nerve teasing preparations 6.54 58.28 $381.15 88362 TC Nerve teasing preparations 3.35 58.28 $195.24 88362 26 Nerve teasing preparations 3.19 58.28 $185.91 88363 Xm archive tissue molec anal 0.67 58.28 $39.05 88364 Insitu hybridization (fish) 3.71 58.28 $216.22 88364 TC Insitu hybridization (fish) 2.69 58.28 $156.77 88364 26 Insitu hybridization (fish) 1.02 58.28 $59.45 88365 Insitu hybridization (fish) 5.01 58.28 $291.98 88365 TC Insitu hybridization (fish) 3.72 58.28 $216.80 88365 26 Insitu hybridization (fish) 1.29 58.28 $75.18 88366 Insitu hybridization (fish) 7.25 58.28 $422.53 88366 TC Insitu hybridization (fish) 5.44 58.28 $317.04 88366 26 Insitu hybridization (fish) 1.81 58.28 $105.49 88367 Insitu hybridization auto 2.99 58.28 $174.26 88367 TC Insitu hybridization auto 1.98 58.28 $115.39 88367 26 Insitu hybridization auto 1.01 58.28 $58.86 88368 Insitu hybridization manual 3.30 58.28 $192.32 88368 TC Insitu hybridization manual 2.12 58.28 $123.55 88368 26 Insitu hybridization manual 1.18 58.28 $68.77 88369 M/phmtrc alysishquant/semiq 3.02 58.28 $176.01 88369 TC M/phmtrc alysishquant/semiq 2.09 58.28 $121.81 88369 26 M/phmtrc alysishquant/semiq 0.93 58.28 $54.20 88371 Protein western blot tissue 0.00 58.28 $0.00 88371 26 Protein western blot tissue 0.52 58.28 $30.31 88372 Protein analysis w/probe 0.00 58.28 $0.00 88372 26 Protein analysis w/probe 0.52 58.28 $30.31 88373 M/phmtrc alys ishquant/semiq 2.23 58.28 $129.96 88373 TC M/phmtrc alys ishquant/semiq 1.43 58.28 $83.34 88373 26 M/phmtrc alys ishquant/semiq 0.80 58.28 $46.62 88374 M/phmtrc alys ishquant/semiq 9.57 58.28 $557.74 88374 TC M/phmtrc alys ishquant/semiq 8.28 58.28 $482.56 88374 26 M/phmtrc alys ishquant/semiq 1.29 58.28 $75.18 88375 Optical endomicroscpy interp 1.31 58.28 $76.35 88377 M/phmtrc alys ishquant/semiq 11.43 58.28 $666.14 88377 TC M/phmtrc alys ishquant/semiq 9.57 58.28 $557.74 88377 26 M/phmtrc alys ishquant/semiq 1.86 58.28 $108.40 88380 Microdissection laser 3.86 58.28 $224.96 88380 TC Microdissection laser 2.26 58.28 $131.71 88380 26 Microdissection laser 1.60 58.28 $93.25 88381 Microdissection manual 3.43 58.28 $199.90 88381 TC Microdissection manual 2.70 58.28 $157.36 88381 26 Microdissection manual 0.73 58.28 $42.54 88387 Tiss exam molecular study 1.08 58.28 $62.94 88387 TC Tiss exam molecular study 0.21 58.28 $12.24 88387 26 Tiss exam molecular study 0.87 58.28 $50.70 88388 Tiss ex molecul study add-on 0.98 58.28 $57.11 88388 TC Tiss ex molecul study add-on 0.28 58.28 $16.32 88388 26 Tiss ex molecul study add-on 0.70 58.28 $40.80 88399 Surgical pathology procedure 0.00 58.28 $0.00 88399 TC Surgical pathology procedure 0.00 58.28 $0.00 88399 26 Surgical pathology procedure 0.00 58.28 $0.00 88720 Bilirubin total transcut 0.00 58.28 $0.00 88738 Hgb quant transcutaneous 0.00 58.28 $0.00 88740 Transcutaneous carboxyhb 0.00 58.28 $0.00 88741 Transcutaneous methb 0.00 58.28 $0.00 88749 In vivo lab service 0.00 58.28 $0.00 89049 Chct for mal hyperthermia 7.54 58.28 $439.43 89050 Body fluid cell count 0.00 58.28 $0.00 89051 Body fluid cell count 0.00 58.28 $0.00 89055 Leukocyte assessment fecal 0.00 58.28 $0.00 89060 Exam synovial fluid crystals 0.00 58.28 $0.00 89060 26 Exam synovial fluid crystals 0.52 58.28 $30.31 89125 Specimen fat stain 0.00 58.28 $0.00 89160 Exam feces for meat fibers 0.00 58.28 $0.00 89190 Nasal smear for eosinophils 0.00 58.28 $0.00 89220 Sputum specimen collection 0.46 58.28 $26.81 89230 Collect sweat for test 0.12 58.28 $6.99 89240 Pathology lab procedure 0.00 58.28 $0.00 89250 Cultr oocyte/embryo <4 days 0.00 58.28 $0.00 89251 Cultr oocyte/embryo <4 days 0.00 58.28 $0.00 89253 Embryo hatching 0.00 58.28 $0.00 89254 Oocyte identification 0.00 58.28 $0.00 89255 Prepare embryo for transfer 0.00 58.28 $0.00 89257 Sperm identification 0.00 58.28 $0.00 89258 Cryopreservation embryo(s) 0.00 58.28 $0.00 89259 Cryopreservation sperm 0.00 58.28 $0.00 89260 Sperm isolation simple 0.00 58.28 $0.00 89261 Sperm isolation complex 0.00 58.28 $0.00 89264 Identify sperm tissue 0.00 58.28 $0.00 89268 Insemination of oocytes 0.00 58.28 $0.00 89272 Extended culture of oocytes 0.00 58.28 $0.00 89280 Assist oocyte fertilization 0.00 58.28 $0.00 89281 Assist oocyte fertilization 0.00 58.28 $0.00 89290 Biopsy oocyte polar body 0.00 58.28 $0.00 89291 Biopsy oocyte polar body 0.00 58.28 $0.00 89300 Semen analysis w/huhner 0.00 58.28 $0.00 89310 Semen analysis w/count 0.00 58.28 $0.00 89320 Semen anal vol/count/mot 0.00 58.28 $0.00 89321 Semen anal sperm detection 0.00 58.28 $0.00 89322 Semen anal strict criteria 0.00 58.28 $0.00 89325 Sperm antibody test 0.00 58.28 $0.00 89329 Sperm evaluation test 0.00 58.28 $0.00 89330 Evaluation cervical mucus 0.00 58.28 $0.00 89331 Retrograde ejaculation anal 0.00 58.28 $0.00 89335 Cryopreserve testicular tiss 0.00 58.28 $0.00 89337 Cryopreservation oocyte(s) 0.00 58.28 $0.00 89342 Storage/year embryo(s) 0.00 58.28 $0.00 89343 Storage/year sperm/semen 0.00 58.28 $0.00 89344 Storage/year reprod tissue 0.00 58.28 $0.00 89346 Storage/year oocyte(s) 0.00 58.28 $0.00 89352 Thawing cryopresrved embryo 0.00 58.28 $0.00 89353 Thawing cryopresrved sperm 0.00 58.28 $0.00 89354 Thaw cryoprsvrd reprod tiss 0.00 58.28 $0.00 89356 Thawing cryopresrved oocyte 0.00 58.28 $0.00 89398 Unlisted reprod med lab proc 0.00 58.28 $0.00 9001F Aortic aneurysm<5cm diam ct 0.00 44.28 $0.00 9002F Aortic aneurysm 5-5.4cm diam 0.00 44.28 $0.00 9003F Aortic anrysm5.5-5.9cm diam 0.00 44.28 $0.00 9004F Aortic anrysm 6/> cm diam 0.00 44.28 $0.00 9005F Asympt carot/vrtbrbas sten 0.00 44.28 $0.00 9006F Sympt sten-tia/strk<120days 0.00 44.28 $0.00 9007F Other carot sten 120 days/> 0.00 44.28 $0.00 90281 Human ig im 0.00 44.28 $0.00 90283 Human ig iv 0.00 44.28 $0.00 90284 Human ig sc 0.00 44.28 $0.00 90287 Botulinum antitoxin 0.00 44.28 $0.00 90288 Botulism ig iv 0.00 44.28 $0.00 90291 Cmv ig iv 0.00 44.28 $0.00 90296 Diphtheria antitoxin 0.00 44.28 $0.00 90371 Hep b ig im 0.00 44.28 $0.00 90375 Rabies ig im/sc 0.00 44.28 $0.00 90376 Rabies ig heat treated 0.00 44.28 $0.00 90378 Rsv mab im 50mg 0.00 44.28 $0.00 90384 Rh ig full-dose im 0.00 44.28 $0.00 90385 Rh ig minidose im 0.00 44.28 $0.00 90386 Rh ig iv 0.00 44.28 $0.00 90389 Tetanus ig im 0.00 44.28 $0.00 90393 Vaccina ig im 0.00 44.28 $0.00 90396 Varicella-zoster ig im 0.00 44.28 $0.00 90399 Immune globulin 0.00 44.28 $0.00 90460 Im admin 1st/only component 0.72 44.28 $31.88 90461 Im admin each addl component 0.36 44.28 $15.94 90471 Immunization admin 0.72 44.28 $31.88 90472 Immunization admin each add 0.36 44.28 $15.94 90473 Immune admin oral/nasal 0.72 44.28 $31.88 90474 Immune admin oral/nasal addl 0.36 44.28 $15.94 90476 Adenovirus vaccine type 4 0.00 44.28 $0.00 90477 Adenovirus vaccine type 7 0.00 44.28 $0.00 90581 Anthrax vaccine sc or im 0.00 44.28 $0.00 90585 Bcg vaccine percut 0.00 44.28 $0.00 90586 Bcg vaccine intravesical 0.00 44.28 $0.00 90620 Menb rp w/omv vaccine im 0.00 44.28 $0.00 90621 Menb rlp vaccine im 0.00 44.28 $0.00 90625 Cholera vaccine live oral 0.00 44.28 $0.00 90630 Flu vacc iiv4 no preserv id 0.00 44.28 $0.00 90632 Hepa vaccine adult im 0.00 44.28 $0.00 90633 Hepa vacc ped/adol 2 dose im 0.00 44.28 $0.00 90634 Hepa vacc ped/adol 3 dose 0.00 44.28 $0.00 90636 Hep a/hep b vacc adult im 0.00 44.28 $0.00 90644 Hib-mency vacc 6wk-18m0 im 0.00 44.28 $0.00 90647 Hib prp-omp vacc 3 dose im 0.00 44.28 $0.00 90648 Hib prp-t vaccine 4 dose im 0.00 44.28 $0.00 90649 4vhpv vaccine 3 dose im 0.00 44.28 $0.00 90650 2vhpv vaccine 3 dose im 0.00 44.28 $0.00 90651 9vhpv vaccine 3 dose im 0.00 44.28 $0.00 90653 Iiv adjuvant vaccine im 0.00 44.28 $0.00 90654 Flu vacc iiv3 no preserv id 0.00 44.28 $0.00 90655 Iiv3 vacc no prsv 0.25 ml im 0.00 44.28 $0.00 90656 Iiv3 vacc no prsv 0.5 ml im 0.00 44.28 $0.00 90657 Iiv3 vaccine splt 0.25 ml im 0.00 44.28 $0.00 90658 Iiv3 vaccine splt 0.5 ml im 0.00 44.28 $0.00 90660 Laiv3 vaccine intranasal 0.00 44.28 $0.00 90661 Cciiv3 vac no prsv 0.5 ml im 0.00 44.28 $0.00 90662 Iiv no prsv increased ag im 0.00 44.28 $0.00 90664 Laiv vacc pandemic intranasl 0.00 44.28 $0.00 90666 Flu vac pandem prsrv free im 0.00 44.28 $0.00 90667 Iiv vacc pandemic adjuvt im 0.00 44.28 $0.00 90668 Iiv vaccine pandemic im 0.00 44.28 $0.00 90670 Pcv13 vaccine im 0.00 44.28 $0.00 90672 Laiv4 vaccine intranasal 0.00 44.28 $0.00 90673 Riv3 vaccine no preserv im 0.00 44.28 $0.00 90674 Cciiv4 vac no prsv 0.5 ml im 0.00 44.28 $0.00 90675 Rabies vaccine im 0.00 44.28 $0.00 90676 Rabies vaccine id 0.00 44.28 $0.00 90680 Rv5 vacc 3 dose live oral 0.00 44.28 $0.00 90681 Rv1 vacc 2 dose live oral 0.00 44.28 $0.00 90682 Riv4 vacc recombinant dna im 0.00 44.28 $0.00 90685 Iiv4 vacc no prsv 0.25 ml im 0.00 44.28 $0.00 90686 Iiv4 vacc no prsv 0.5 ml im 0.00 44.28 $0.00 90687 Iiv4 vaccine splt 0.25 ml im 0.00 44.28 $0.00 90688 Iiv4 vaccine splt 0.5 ml im 0.00 44.28 $0.00 90690 Typhoid vaccine oral 0.00 44.28 $0.00 90691 Typhoid vaccine im 0.00 44.28 $0.00 90696 Dtap-ipv vaccine 4-6 yrs im 0.00 44.28 $0.00 90697 Dtap-ipv-hib-hepb vaccine im 0.00 44.28 $0.00 90698 Dtap-ipv/hib vaccine im 0.00 44.28 $0.00 90700 Dtap vaccine < 7 yrs im 0.00 44.28 $0.00 90702 Dt vaccine under 7 yrs im 0.00 44.28 $0.00 90707 Mmr vaccine sc 0.00 44.28 $0.00 90710 Mmrv vaccine sc 0.00 44.28 $0.00 90713 Poliovirus ipv sc/im 0.00 44.28 $0.00 90714 Td vacc no presv 7 yrs+ im 0.00 44.28 $0.00 90715 Tdap vaccine 7 yrs/> im 0.00 44.28 $0.00 90716 Var vaccine live subq 0.00 44.28 $0.00 90717 Yellow fever vaccine subq 0.00 44.28 $0.00 90723 Dtap-hep b-ipv vaccine im 0.00 44.28 $0.00 90732 Ppsv23 vacc 2 yrs+ subq/im 0.00 44.28 $0.00 90733 Mpsv4 vaccine subq 0.00 44.28 $0.00 90734 Mcv4 menacwy vaccine im 0.00 44.28 $0.00 90736 Hzv vaccine live subq 0.00 44.28 $0.00 90738 Inactivated je vacc im 0.00 44.28 $0.00 90739 Hepb vacc 2 dose adult im 0.00 44.28 $0.00 90740 Hepb vacc 3 dose immunsup im 0.00 44.28 $0.00 90743 Hepb vacc 2 dose adolesc im 0.00 44.28 $0.00 90744 Hepb vacc 3 dose ped/adol im 0.00 44.28 $0.00 90746 Hepb vaccine 3 dose adult im 0.00 44.28 $0.00 90747 Hepb vacc 4 dose immunsup im 0.00 44.28 $0.00 90748 Hib-hepb vaccine im 0.00 44.28 $0.00 90749 Vaccine toxoid 0.00 44.28 $0.00 90750 Hzv vacc recombinant im njx 0.00 44.28 $0.00 90785 Psytx complex interactive 0.39 44.28 $17.27 90791 Psych diagnostic evaluation 3.68 44.28 $162.95 90792 Psych diag eval w/med srvcs 4.13 44.28 $182.88 90832 Psytx w pt 30 minutes 1.79 44.28 $79.26 90833 Psytx w pt w e/m 30 min 1.86 44.28 $82.36 90834 Psytx w pt 45 minutes 2.38 44.28 $105.39 90836 Psytx w pt w e/m 45 min 2.35 44.28 $104.06 90837 Psytx w pt 60 minutes 3.57 44.28 $158.08 90838 Psytx w pt w e/m 60 min 3.10 44.28 $137.27 90839 Psytx crisis initial 60 min 3.73 44.28 $165.16 90840 Psytx crisis ea addl 30 min 1.78 44.28 $78.82 90845 Psychoanalysis 2.56 44.28 $113.36 90846 Family psytx w/o pt 50 min 2.88 44.28 $127.53 90847 Family psytx w/pt 50 min 2.99 44.28 $132.40 90849 Multiple family group psytx 0.98 44.28 $43.39 90853 Group psychotherapy 0.72 44.28 $31.88 90863 Pharmacologic mgmt w/psytx 0.00 44.28 $0.00 90865 Narcosynthesis 4.71 44.28 $208.56 90867 Tcranial magn stim tx plan 0.00 44.28 $0.00 90868 Tcranial magn stim tx deli 0.00 44.28 $0.00 90869 Tcran magn stim redetemine 0.00 44.28 $0.00 90870 Electroconvulsive therapy 4.98 44.28 $220.51 90875 Psychophysiological therapy 1.74 44.28 $77.05 90876 Psychophysiological therapy 3.05 44.28 $135.05 90880 Hypnotherapy 2.85 44.28 $126.20 90882 Environmental manipulation 0.00 44.28 $0.00 90885 Psy evaluation of records 1.40 44.28 $61.99 90887 Consultation with family 2.49 44.28 $110.26 90889 Preparation of report 0.00 44.28 $0.00 90899 Psychiatric service/therapy 0.00 44.28 $0.00 90901 Biofeedback train any meth 1.04 44.28 $46.05 90911 Biofeedback peri/uro/rectal 2.39 44.28 $105.83 90935 Hemodialysis one evaluation 2.04 44.28 $90.33 90937 Hemodialysis repeated eval 2.94 44.28 $130.18 90940 Hemodialysis access study 0.00 44.28 $0.00 90945 Dialysis one evaluation 2.42 44.28 $107.16 90947 Dialysis repeated eval 3.50 44.28 $154.98 90951 Esrd serv 4 visits p mo <2yr 26.63 44.28 $1,179.18 90952 Esrd serv 2-3 vsts p mo <2yr 0.00 44.28 $0.00 90953 Esrd serv 1 visit p mo <2yrs 0.00 44.28 $0.00 90954 Esrd serv 4 vsts p mo 2-11 23.01 44.28 $1,018.88 90955 Esrd srv 2-3 vsts p mo 2-11 12.93 44.28 $572.54 90956 Esrd srv 1 visit p mo 2-11 8.98 44.28 $397.63 90957 Esrd srv 4 vsts p mo 12-19 18.18 44.28 $805.01 90958 Esrd srv 2-3 vsts p mo 12-19 12.30 44.28 $544.64 90959 Esrd serv 1 vst p mo 12-19 8.36 44.28 $370.18 90960 Esrd srv 4 visits p mo 20+ 8.00 44.28 $354.24 90961 Esrd srv 2-3 vsts p mo 20+ 6.72 44.28 $297.56 90962 Esrd serv 1 visit p mo 20+ 5.18 44.28 $229.37 90963 Esrd home pt serv p mo <2yrs 15.38 44.28 $681.03 90964 Esrd home pt serv p mo 2-11 13.45 44.28 $595.57 90965 Esrd home pt serv p mo 12-19 12.80 44.28 $566.78 90966 Esrd home pt serv p mo 20+ 6.70 44.28 $296.68 90967 Esrd home pt serv p day <2 0.51 44.28 $22.58 90968 Esrd home pt srv p day 2-11 0.44 44.28 $19.48 90969 Esrd home pt srv p day 12-19 0.43 44.28 $19.04 90970 Esrd home pt serv p day 20+ 0.22 44.28 $9.74 90989 Dialysis training complete 0.00 44.28 $0.00 90993 Dialysis training incompl 0.00 44.28 $0.00 90997 Hemoperfusion 2.54 44.28 $112.47 90999 Dialysis procedure 0.00 44.28 $0.00 91010 Esophagus motility study 4.97 44.28 $220.07 91010 TC Esophagus motility study 3.06 44.28 $135.50 91010 26 Esophagus motility study 1.91 44.28 $84.57 91013 Esophgl motil w/stim/perfus 0.66 44.28 $29.22 91013 TC Esophgl motil w/stim/perfus 0.39 44.28 $17.27 91013 26 Esophgl motil w/stim/perfus 0.27 44.28 $11.96 91020 Gastric motility studies 6.58 44.28 $291.36 91020 TC Gastric motility studies 4.45 44.28 $197.05 91020 26 Gastric motility studies 2.13 44.28 $94.32 91022 Duodenal motility study 4.74 44.28 $209.89 91022 TC Duodenal motility study 2.60 44.28 $115.13 91022 26 Duodenal motility study 2.14 44.28 $94.76 91030 Acid perfusion of esophagus 3.79 44.28 $167.82 91030 TC Acid perfusion of esophagus 2.46 44.28 $108.93 91030 26 Acid perfusion of esophagus 1.33 44.28 $58.89 91034 Gastroesophageal reflux test 5.31 44.28 $235.13 91034 TC Gastroesophageal reflux test 3.86 44.28 $170.92 91034 26 Gastroesophageal reflux test 1.45 44.28 $64.21 91035 G-esoph reflx tst w/electrod 13.55 44.28 $599.99 91035 TC G-esoph reflx tst w/electrod 11.16 44.28 $494.16 91035 26 G-esoph reflx tst w/electrod 2.39 44.28 $105.83 91037 Esoph imped function test 4.52 44.28 $200.15 91037 TC Esoph imped function test 3.08 44.28 $136.38 91037 26 Esoph imped function test 1.44 44.28 $63.76 91038 Esoph imped funct test > 1hr 12.65 44.28 $560.14 91038 TC Esoph imped funct test > 1hr 11.01 44.28 $487.52 91038 26 Esoph imped funct test > 1hr 1.64 44.28 $72.62 91040 Esoph balloon distension tst 12.04 44.28 $533.13 91040 TC Esoph balloon distension tst 10.61 44.28 $469.81 91040 26 Esoph balloon distension tst 1.43 44.28 $63.32 91065 Breath hydrogen/methane test 2.11 44.28 $93.43 91065 TC Breath hydrogen/methane test 1.82 44.28 $80.59 91065 26 Breath hydrogen/methane test 0.29 44.28 $12.84 91110 Gi tract capsule endoscopy 26.16 44.28 $1,158.36 91110 TC Gi tract capsule endoscopy 21.79 44.28 $964.86 91110 26 Gi tract capsule endoscopy 4.37 44.28 $193.50 91111 Esophageal capsule endoscopy 21.05 44.28 $932.09 91111 TC Esophageal capsule endoscopy 19.56 44.28 $866.12 91111 26 Esophageal capsule endoscopy 1.49 44.28 $65.98 91112 Gi wireless capsule measure 30.35 44.28 $1,343.90 91112 TC Gi wireless capsule measure 27.23 44.28 $1,205.74 91112 26 Gi wireless capsule measure 3.12 44.28 $138.15 91117 Colon motility 6 hr study 3.99 44.28 $176.68 91120 Rectal sensation test 12.01 44.28 $531.80 91120 TC Rectal sensation test 10.58 44.28 $468.48 91120 26 Rectal sensation test 1.43 44.28 $63.32 91122 Anal pressure record 6.47 44.28 $286.49 91122 TC Anal pressure record 3.88 44.28 $171.81 91122 26 Anal pressure record 2.59 44.28 $114.69 91132 Electrogastrography 4.16 44.28 $184.20 91132 TC Electrogastrography 3.39 44.28 $150.11 91132 26 Electrogastrography 0.77 44.28 $34.10 91133 Electrogastrography w/test 4.85 44.28 $214.76 91133 TC Electrogastrography w/test 3.86 44.28 $170.92 91133 26 Electrogastrography w/test 0.99 44.28 $43.84 91200 Liver elastography 1.09 44.28 $48.27 91200 TC Liver elastography 0.70 44.28 $31.00 91200 26 Liver elastography 0.39 44.28 $17.27 91299 Gastroenterology procedure 0.00 44.28 $0.00 91299 TC Gastroenterology procedure 0.00 44.28 $0.00 91299 26 Gastroenterology procedure 0.00 44.28 $0.00 92002 Eye exam new patient 2.29 44.28 $101.40 92004 Eye exam new patient 4.20 44.28 $185.98 92012 Eye exam establish patient 2.41 44.28 $106.71 92014 Eye exam&tx estab pt 1/>vst 3.49 44.28 $154.54 92015 Determine refractive state 0.56 44.28 $24.80 92018 New eye exam & treatment 4.12 44.28 $182.43 92019 Eye exam & treatment 2.05 44.28 $90.77 92020 Special eye evaluation 0.76 44.28 $33.65 92025 Corneal topography 1.07 44.28 $47.38 92025 TC Corneal topography 0.50 44.28 $22.14 92025 26 Corneal topography 0.57 44.28 $25.24 92060 Special eye evaluation 1.84 44.28 $81.48 92060 TC Special eye evaluation 0.75 44.28 $33.21 92060 26 Special eye evaluation 1.09 44.28 $48.27 92065 Orthoptic/pleoptic training 1.53 44.28 $67.75 92065 TC Orthoptic/pleoptic training 1.02 44.28 $45.17 92065 26 Orthoptic/pleoptic training 0.51 44.28 $22.58 92071 Contact lens fitting for tx 1.07 44.28 $47.38 92072 Fit contac lens for managmnt 3.79 44.28 $167.82 92081 Visual field examination(s) 0.96 44.28 $42.51 92081 TC Visual field examination(s) 0.50 44.28 $22.14 92081 26 Visual field examination(s) 0.46 44.28 $20.37 92082 Visual field examination(s) 1.37 44.28 $60.66 92082 TC Visual field examination(s) 0.75 44.28 $33.21 92082 26 Visual field examination(s) 0.62 44.28 $27.45 92083 Visual field examination(s) 1.82 44.28 $80.59 92083 TC Visual field examination(s) 1.03 44.28 $45.61 92083 26 Visual field examination(s) 0.79 44.28 $34.98 92100 Serial tonometry exam(s) 2.26 44.28 $100.07 92132 Cmptr ophth dx img ant segmt 0.88 44.28 $38.97 92132 TC Cmptr ophth dx img ant segmt 0.41 44.28 $18.15 92132 26 Cmptr ophth dx img ant segmt 0.47 44.28 $20.81 92133 Cmptr ophth img optic nerve 1.06 44.28 $46.94 92133 TC Cmptr ophth img optic nerve 0.42 44.28 $18.60 92133 26 Cmptr ophth img optic nerve 0.64 44.28 $28.34 92134 Cptr ophth dx img post segmt 1.16 44.28 $51.36 92134 TC Cptr ophth dx img post segmt 0.43 44.28 $19.04 92134 26 Cptr ophth dx img post segmt 0.73 44.28 $32.32 92136 Ophthalmic biometry 2.54 44.28 $112.47 92136 TC Ophthalmic biometry 1.65 44.28 $73.06 92136 26 Ophthalmic biometry 0.89 44.28 $39.41 92145 Corneal hysteresis deter 0.51 44.28 $22.58 92145 TC Corneal hysteresis deter 0.23 44.28 $10.18 92145 26 Corneal hysteresis deter 0.28 44.28 $12.40 92225 Special eye exam initial 0.76 44.28 $33.65 92226 Special eye exam subsequent 0.70 44.28 $31.00 92227 Remote dx retinal imaging 0.41 44.28 $18.15 92228 Remote retinal imaging mgmt 0.98 44.28 $43.39 92228 TC Remote retinal imaging mgmt 0.38 44.28 $16.83 92228 26 Remote retinal imaging mgmt 0.60 44.28 $26.57 92230 Eye exam with photos 1.63 44.28 $72.18 92235 Fluorescein angrph uni/bi 2.42 44.28 $107.16 92235 TC Eye exam with photos 1.19 44.28 $52.69 92235 26 Eye exam with photos 1.23 44.28 $54.46 92240 Icg angiography uni/bi 5.87 44.28 $259.92 92240 TC Icg angiography 4.55 44.28 $201.47 92240 26 Icg angiography 1.32 44.28 $58.45 92242 Fluorescein icg angiography 6.40 44.28 $283.39 92242 TC Fluorescein icg angiography 4.83 44.28 $213.87 92242 26 Fluorescein icg angiography 1.57 44.28 $69.52 92250 Eye exam with photos 1.86 44.28 $82.36 92250 TC Eye exam with photos 1.24 44.28 $54.91 92250 26 Eye exam with photos 0.62 44.28 $27.45 92260 Ophthalmoscopy/dynamometry 0.52 44.28 $23.03 92265 Eye muscle evaluation 2.41 44.28 $106.71 92265 TC Eye muscle evaluation 1.09 44.28 $48.27 92265 26 Eye muscle evaluation 1.32 44.28 $58.45 92270 Electro-oculography 2.59 44.28 $114.69 92270 TC Electro-oculography 1.43 44.28 $63.32 92270 26 Electro-oculography 1.16 44.28 $51.36 92275 Electroretinography 4.20 44.28 $185.98 92275 TC Electroretinography 2.66 44.28 $117.78 92275 26 Electroretinography 1.54 44.28 $68.19 92283 Color vision examination 1.58 44.28 $69.96 92283 TC Color vision examination 1.31 44.28 $58.01 92283 26 Color vision examination 0.27 44.28 $11.96 92284 Dark adaptation eye exam 1.77 44.28 $78.38 92284 TC Dark adaptation eye exam 1.41 44.28 $62.43 92284 26 Dark adaptation eye exam 0.36 44.28 $15.94 92285 Eye photography 0.59 44.28 $26.13 92285 TC Eye photography 0.50 44.28 $22.14 92285 26 Eye photography 0.09 44.28 $3.99 92286 Internal eye photography 1.09 44.28 $48.27 92286 TC Internal eye photography 0.46 44.28 $20.37 92286 26 Internal eye photography 0.63 44.28 $27.90 92287 Internal eye photography 3.89 44.28 $172.25 92287 TC Internal eye photography 2.56 44.28 $113.36 92287 26 Internal eye photography 1.33 44.28 $58.89 92310 Contact lens fitting 2.71 44.28 $120.00 92311 Contact lens fitting 2.85 44.28 $126.20 92312 Contact lens fitting 3.32 44.28 $147.01 92313 Contact lens fitting 2.72 44.28 $120.44 92314 Prescription of contact lens 2.25 44.28 $99.63 92315 Rx cntact lens aphakia 1 eye 2.09 44.28 $92.55 92316 Rx cntact lens aphakia 2 eye 2.62 44.28 $116.01 92317 Rx corneoscleral cntact lens 2.14 44.28 $94.76 92325 Modification of contact lens 1.19 44.28 $52.69 92326 Replacement of contact lens 0.99 44.28 $43.84 92340 Fit spectacles monofocal 1.00 44.28 $44.28 92341 Fit spectacles bifocal 1.14 44.28 $50.48 92342 Fit spectacles multifocal 1.23 44.28 $54.46 92352 Fit aphakia spectcl monofocl 1.14 44.28 $50.48 92353 Fit aphakia spectcl multifoc 1.33 44.28 $58.89 92354 Fit spectacles single system 0.38 44.28 $16.83 92355 Fit spectacles compound lens 0.59 44.28 $26.13 92358 Aphakia prosth service temp 0.32 44.28 $14.17 92370 Repair & adjust spectacles 0.87 44.28 $38.52 92371 Repair & adjust spectacles 0.33 44.28 $14.61 92499 Eye service or procedure 0.00 44.28 $0.00 92499 TC Eye service or procedure 0.00 44.28 $0.00 92499 26 Eye service or procedure 0.00 44.28 $0.00 92502 Ear and throat examination 2.74 44.28 $121.33 92504 Ear microscopy examination 0.84 44.28 $37.20 92507 Speech/hearing therapy 2.23 44.28 $98.74 92508 Speech/hearing therapy 0.65 44.28 $28.78 92511 Nasopharyngoscopy 3.12 44.28 $138.15 92512 Nasal function studies 1.71 44.28 $75.72 92516 Facial nerve function test 1.97 44.28 $87.23 92520 Laryngeal function studies 2.15 44.28 $95.20 92521 Evaluation of speech fluency 3.14 44.28 $139.04 92522 Evaluate speech production 2.60 44.28 $115.13 92523 Speech sound lang comprehen 5.55 44.28 $245.75 92524 Behavral qualit analys voice 2.51 44.28 $111.14 92526 Oral function therapy 2.43 44.28 $107.60 92531 Spontaneous nystagmus study 0.00 44.28 $0.00 92532 Positional nystagmus test 0.00 44.28 $0.00 92533 Caloric vestibular test 0.00 44.28 $0.00 92534 Optokinetic nystagmus test 0.00 44.28 $0.00 92537 Caloric vstblr test w/rec 1.14 44.28 $50.48 92537 TC Caloric vstblr test w/rec 0.24 44.28 $10.63 92537 26 Caloric vstblr test w/rec 0.90 44.28 $39.85 92538 Caloric vstblr test w/rec 0.58 44.28 $25.68 92538 TC Caloric vstblr test w/rec 0.13 44.28 $5.76 92538 26 Caloric vstblr test w/rec 0.45 44.28 $19.93 92540 Basic vestibular evaluation 2.89 44.28 $127.97 92540 TC Basic vestibular evaluation 0.63 44.28 $27.90 92540 26 Basic vestibular evaluation 2.26 44.28 $100.07 92541 Spontaneous nystagmus test 0.70 44.28 $31.00 92541 TC Spontaneous nystagmus test 0.10 44.28 $4.43 92541 26 Spontaneous nystagmus test 0.60 44.28 $26.57 92542 Positional nystagmus test 0.79 44.28 $34.98 92542 TC Positional nystagmus test 0.08 44.28 $3.54 92542 26 Positional nystagmus test 0.71 44.28 $31.44 92544 Optokinetic nystagmus test 0.48 44.28 $21.25 92544 TC Optokinetic nystagmus test 0.07 44.28 $3.10 92544 26 Optokinetic nystagmus test 0.41 44.28 $18.15 92545 Oscillating tracking test 0.43 44.28 $19.04 92545 TC Oscillating tracking test 0.06 44.28 $2.66 92545 26 Oscillating tracking test 0.37 44.28 $16.38 92546 Sinusoidal rotational test 2.90 44.28 $128.41 92546 TC Sinusoidal rotational test 2.48 44.28 $109.81 92546 26 Sinusoidal rotational test 0.42 44.28 $18.60 92547 Supplemental electrical test 0.17 44.28 $7.53 92548 Posturography 2.81 44.28 $124.43 92548 TC Posturography 2.07 44.28 $91.66 92548 26 Posturography 0.74 44.28 $32.77 92550 Tympanometry & reflex thresh 0.60 44.28 $26.57 92551 Pure tone hearing test air 0.34 44.28 $15.06 92552 Pure tone audiometry air 0.89 44.28 $39.41 92553 Audiometry air & bone 1.06 44.28 $46.94 92555 Speech threshold audiometry 0.66 44.28 $29.22 92556 Speech audiometry complete 1.07 44.28 $47.38 92557 Comprehensive hearing test 1.07 44.28 $47.38 92558 Evoked auditory test qual 0.00 44.28 $0.00 92559 Group audiometric testing 0.00 44.28 $0.00 92560 Bekesy audiometry screen 0.00 44.28 $0.00 92561 Bekesy audiometry diagnosis 1.09 44.28 $48.27 92562 Loudness balance test 1.31 44.28 $58.01 92563 Tone decay hearing test 0.87 44.28 $38.52 92564 Sisi hearing test 0.77 44.28 $34.10 92565 Stenger test pure tone 0.44 44.28 $19.48 92567 Tympanometry 0.41 44.28 $18.15 92568 Acoustic refl threshold tst 0.45 44.28 $19.93 92570 Acoustic immitance testing 0.91 44.28 $40.29 92571 Filtered speech hearing test 0.77 44.28 $34.10 92572 Staggered spondaic word test 0.89 44.28 $39.41 92575 Sensorineural acuity test 1.65 44.28 $73.06 92576 Synthetic sentence test 1.03 44.28 $45.61 92577 Stenger test speech 0.43 44.28 $19.04 92579 Visual audiometry (vra) 1.29 44.28 $57.12 92582 Conditioning play audiometry 1.89 44.28 $83.69 92583 Select picture audiometry 1.42 44.28 $62.88 92584 Electrocochleography 2.08 44.28 $92.10 92585 Auditor evoke potent compre 3.83 44.28 $169.59 92585 TC Auditor evoke potent compre 3.07 44.28 $135.94 92585 26 Auditor evoke potent compre 0.76 44.28 $33.65 92586 Auditor evoke potent limit 2.44 44.28 $108.04 92587 Evoked auditory test limited 0.61 44.28 $27.01 92587 TC Evoked auditory test limited 0.09 44.28 $3.99 92587 26 Evoked auditory test limited 0.52 44.28 $23.03 92588 Evoked auditory tst complete 0.94 44.28 $41.62 92588 TC Evoked auditory tst complete 0.11 44.28 $4.87 92588 26 Evoked auditory tst complete 0.83 44.28 $36.75 92590 Hearing aid exam one ear 0.00 44.28 $0.00 92591 Hearing aid exam both ears 0.00 44.28 $0.00 92592 Hearing aid check one ear 0.00 44.28 $0.00 92593 Hearing aid check both ears 0.00 44.28 $0.00 92594 Electro hearng aid test one 0.00 44.28 $0.00 92595 Electro hearng aid tst both 0.00 44.28 $0.00 92596 Ear protector evaluation 1.17 44.28 $51.81 92597 Oral speech device eval 2.05 44.28 $90.77 92601 Cochlear implt f/up exam <7 4.19 44.28 $185.53 92602 Reprogram cochlear implt 7/> 2.34 44.28 $103.62 92603 Cochlear implt f/up exam 7/> 4.30 44.28 $190.40 92604 Reprogram cochlear implt 7/> 2.55 44.28 $112.91 92605 Ex for nonspeech device rx 2.64 44.28 $116.90 92606 Non-speech device service 2.35 44.28 $104.06 92607 Ex for speech device rx 1hr 3.61 44.28 $159.85 92608 Ex for speech device rx addl 1.50 44.28 $66.42 92609 Use of speech device service 3.12 44.28 $138.15 92610 Evaluate swallowing function 2.43 44.28 $107.60 92611 Motion fluoroscopy/swallow 2.46 44.28 $108.93 92612 Endoscopy swallow (fees) vid 5.31 44.28 $235.13 92613 Endoscopy swallow (fees) i&r 1.09 44.28 $48.27 92614 Laryngoscopic sensory vid 4.09 44.28 $181.11 92615 Laryngoscopic sensory i&r 0.95 44.28 $42.07 92616 Fees w/laryngeal sense test 5.86 44.28 $259.48 92617 Fees w/laryngeal sense i&r 1.19 44.28 $52.69 92618 Ex for nonspeech dev rx add 0.96 44.28 $42.51 92620 Auditory function 60 min 2.68 44.28 $118.67 92621 Auditory function + 15 min 0.63 44.28 $27.90 92625 Tinnitus assessment 2.00 44.28 $88.56 92626 Eval aud rehab status 2.55 44.28 $112.91 92627 Eval aud status rehab add-on 0.63 44.28 $27.90 92630 Aud rehab pre-ling hear loss 0.00 44.28 $0.00 92633 Aud rehab postling hear loss 0.00 44.28 $0.00 92640 Aud brainstem implt programg 3.16 44.28 $139.92 92700 Ent procedure/service 0.00 44.28 $0.00 92920 Prq cardiac angioplast 1 art 15.49 44.28 $685.90 92921 Prq cardiac angio addl art 0.00 44.28 $0.00 92924 Prq card angio/athrect 1 art 18.49 44.28 $818.74 92925 Prq card angio/athrect addl 0.00 44.28 $0.00 92928 Prq card stent w/angio 1 vsl 17.24 44.28 $763.39 92929 Prq card stent w/angio addl 0.00 44.28 $0.00 92933 Prq card stent/ath/angio 19.34 44.28 $856.38 92934 Prq card stent/ath/angio 0.00 44.28 $0.00 92937 Prq revasc byp graft 1 vsl 17.23 44.28 $762.94 92938 Prq revasc byp graft addl 0.00 44.28 $0.00 92941 Prq card revasc mi 1 vsl 19.38 44.28 $858.15 92943 Prq card revasc chronic 1vsl 19.36 44.28 $857.26 92944 Prq card revasc chronic addl 0.00 44.28 $0.00 92950 Heart/lung resuscitation cpr 8.61 44.28 $381.25 92953 Temporary external pacing 0.03 44.28 $1.33 92960 Cardioversion electric ext 4.49 44.28 $198.82 92961 Cardioversion electric int 7.23 44.28 $320.14 92970 Cardioassist internal 5.36 44.28 $237.34 92971 Cardioassist external 2.93 44.28 $129.74 92973 Prq coronary mech thrombect 5.15 44.28 $228.04 92974 Cath place cardio brachytx 4.72 44.28 $209.00 92975 Dissolve clot heart vessel 10.98 44.28 $486.19 92977 Dissolve clot heart vessel 1.96 44.28 $86.79 92978 Endoluminl ivus oct c 1st 0.00 44.28 $0.00 92978 TC Intravasc us heart add-on 0.00 44.28 $0.00 92978 26 Intravasc us heart add-on 2.78 44.28 $123.10 92979 Endoluminl ivus oct c ea 0.00 44.28 $0.00 92979 TC Intravasc us heart add-on 0.00 44.28 $0.00 92979 26 Intravasc us heart add-on 2.23 44.28 $98.74 92986 Revision of aortic valve 38.38 44.28 $1,699.47 92987 Revision of mitral valve 39.61 44.28 $1,753.93 92990 Revision of pulmonary valve 31.59 44.28 $1,398.81 92992 Revision of heart chamber 0.00 44.28 $0.00 92993 Revision of heart chamber 0.00 44.28 $0.00 92997 Pul art balloon repr percut 18.84 44.28 $834.24 92998 Pul art balloon repr percut 9.31 44.28 $412.25 93000 Electrocardiogram complete 0.48 44.28 $21.25 93005 Electrocardiogram tracing 0.24 44.28 $10.63 93010 Electrocardiogram report 0.24 44.28 $10.63 93015 Cardiovascular stress test 2.16 44.28 $95.64 93016 Cardiovascular stress test 0.63 44.28 $27.90 93017 Cardiovascular stress test 1.11 44.28 $49.15 93018 Cardiovascular stress test 0.42 44.28 $18.60 93024 Cardiac drug stress test 3.16 44.28 $139.92 93024 TC Cardiac drug stress test 1.54 44.28 $68.19 93024 26 Cardiac drug stress test 1.62 44.28 $71.73 93025 Microvolt t-wave assess 4.60 44.28 $203.69 93025 TC Microvolt t-wave assess 3.55 44.28 $157.19 93025 26 Microvolt t-wave assess 1.05 44.28 $46.49 93040 Rhythm ecg with report 0.36 44.28 $15.94 93041 Rhythm ecg tracing 0.16 44.28 $7.08 93042 Rhythm ecg report 0.20 44.28 $8.86 93050 Art pressure waveform analys 0.50 44.28 $22.14 93050 TC Art pressure waveform analys 0.25 44.28 $11.07 93050 26 Art pressure waveform analys 0.25 44.28 $11.07 93224 Ecg monit/reprt up to 48 hrs 2.58 44.28 $114.24 93225 Ecg monit/reprt up to 48 hrs 0.75 44.28 $33.21 93226 Ecg monit/reprt up to 48 hrs 1.07 44.28 $47.38 93227 Ecg monit/reprt up to 48 hrs 0.76 44.28 $33.65 93228 Remote 30 day ecg rev/report 0.74 44.28 $32.77 93229 Remote 30 day ecg tech supp 20.31 44.28 $899.33 93260 Prgrmg dev eval impltbl sys 1.84 44.28 $81.48 93260 TC Prgrmg dev eval impltbl sys 0.60 44.28 $26.57 93260 26 Prgrmg dev eval impltbl sys 1.24 44.28 $54.91 93261 Interrogate subq defib 1.69 44.28 $74.83 93261 TC Interrogate subq defib 0.60 44.28 $26.57 93261 26 Interrogate subq defib 1.09 44.28 $48.27 93268 Ecg record/review 5.76 44.28 $255.05 93270 Remote 30 day ecg rev/report 0.26 44.28 $11.51 93271 Ecg/monitoring and analysis 4.78 44.28 $211.66 93272 Ecg/review interpret only 0.72 44.28 $31.88 93278 Ecg/signal-averaged 0.86 44.28 $38.08 93278 TC Ecg/signal-averaged 0.51 44.28 $22.58 93278 26 Ecg/signal-averaged 0.35 44.28 $15.50 93279 Pm device progr eval sngl 1.42 44.28 $62.88 93279 TC Pm device progr eval sngl 0.50 44.28 $22.14 93279 26 Pm device progr eval sngl 0.92 44.28 $40.74 93280 Pm device progr eval dual 1.65 44.28 $73.06 93280 TC Pm device progr eval dual 0.56 44.28 $24.80 93280 26 Pm device progr eval dual 1.09 44.28 $48.27 93281 Pm device progr eval multi 1.94 44.28 $85.90 93281 TC Pm device progr eval multi 0.66 44.28 $29.22 93281 26 Pm device progr eval multi 1.28 44.28 $56.68 93282 Prgrmg eval implantable dfb 1.79 44.28 $79.26 93282 TC Prgrmg eval implantable dfb 0.58 44.28 $25.68 93282 26 Prgrmg eval implantable dfb 1.21 44.28 $53.58 93283 Prgrmg eval implantable dfb 2.31 44.28 $102.29 93283 TC Prgrmg eval implantable dfb 0.67 44.28 $29.67 93283 26 Prgrmg eval implantable dfb 1.64 44.28 $72.62 93284 Prgrmg eval implantable dfb 2.56 44.28 $113.36 93284 TC Prgrmg eval implantable dfb 0.77 44.28 $34.10 93284 26 Prgrmg eval implantable dfb 1.79 44.28 $79.26 93285 Ilr device eval progr 1.19 44.28 $52.69 93285 TC Ilr device eval progr 0.45 44.28 $19.93 93285 26 Ilr device eval progr 0.74 44.28 $32.77 93286 Peri-px pacemaker device evl 0.77 44.28 $34.10 93286 TC Peri-px pacemaker device evl 0.34 44.28 $15.06 93286 26 Peri-px pacemaker device evl 0.43 44.28 $19.04 93287 Peri-px device eval & prgr 1.04 44.28 $46.05 93287 TC Peri-px device eval & prgr 0.38 44.28 $16.83 93287 26 Peri-px device eval & prgr 0.66 44.28 $29.22 93288 Pm device eval in person 1.06 44.28 $46.94 93288 TC Pm device eval in person 0.45 44.28 $19.93 93288 26 Pm device eval in person 0.61 44.28 $27.01 93289 Interrog device eval heart 1.86 44.28 $82.36 93289 TC Interrog device eval heart 0.56 44.28 $24.80 93289 26 Interrog device eval heart 1.30 44.28 $57.56 93290 Icm device eval 0.89 44.28 $39.41 93290 TC Icm device eval 0.27 44.28 $11.96 93290 26 Icm device eval 0.62 44.28 $27.45 93291 Ilr device interrogate 1.04 44.28 $46.05 93291 TC Ilr device interrogate 0.42 44.28 $18.60 93291 26 Ilr device interrogate 0.62 44.28 $27.45 93292 Wcd device interrogate 0.92 44.28 $40.74 93292 TC Wcd device interrogate 0.31 44.28 $13.73 93292 26 Wcd device interrogate 0.61 44.28 $27.01 93293 Pm phone r-strip device eval 1.52 44.28 $67.31 93293 TC Pm phone r-strip device eval 1.07 44.28 $47.38 93293 26 Pm phone r-strip device eval 0.45 44.28 $19.93 93294 Pm device interrogate remote 0.96 44.28 $42.51 93295 Dev interrog remote 1/2/mlt 1.92 44.28 $85.02 93296 Pm/icd remote tech serv 0.74 44.28 $32.77 93297 Icm device interrogat remote 0.75 44.28 $33.21 93298 Ilr device interrogat remote 0.76 44.28 $33.65 93299 Icm/ilr remote tech serv 0.00 44.28 $0.00 93303 Echo transthoracic 6.69 44.28 $296.23 93303 TC Echo transthoracic 4.88 44.28 $216.09 93303 26 Echo transthoracic 1.81 44.28 $80.15 93304 Echo transthoracic 4.39 44.28 $194.39 93304 TC Echo transthoracic 3.35 44.28 $148.34 93304 26 Echo transthoracic 1.04 44.28 $46.05 93306 Tte w/doppler complete 6.45 44.28 $285.61 93306 TC Tte w/doppler complete 4.64 44.28 $205.46 93306 26 Tte w/doppler complete 1.81 44.28 $80.15 93307 Tte w/o doppler complete 3.67 44.28 $162.51 93307 TC Tte w/o doppler complete 2.39 44.28 $105.83 93307 26 Tte w/o doppler complete 1.28 44.28 $56.68 93308 Tte f-up or lmtd 3.53 44.28 $156.31 93308 TC Tte f-up or lmtd 2.80 44.28 $123.98 93308 26 Tte f-up or lmtd 0.73 44.28 $32.32 93312 Echo transesophageal 6.96 44.28 $308.19 93312 TC Echo transesophageal 3.85 44.28 $170.48 93312 26 Echo transesophageal 3.11 44.28 $137.71 93313 Echo transesophageal 0.33 44.28 $14.61 93314 Echo transesophageal 6.69 44.28 $296.23 93314 TC Echo transesophageal 4.09 44.28 $181.11 93314 26 Echo transesophageal 2.60 44.28 $115.13 93315 Echo transesophageal 0.00 44.28 $0.00 93315 TC Echo transesophageal 0.00 44.28 $0.00 93315 26 Echo transesophageal 3.67 44.28 $162.51 93316 Echo transesophageal 0.77 44.28 $34.10 93317 Echo transesophageal 0.00 44.28 $0.00 93317 TC Echo transesophageal 0.00 44.28 $0.00 93317 26 Echo transesophageal 2.66 44.28 $117.78 93318 Echo transesophageal intraop 0.00 44.28 $0.00 93318 TC Echo transesophageal intraop 0.00 44.28 $0.00 93318 26 Echo transesophageal intraop 2.99 44.28 $132.40 93320 Doppler echo exam heart 1.53 44.28 $67.75 93320 TC Doppler echo exam heart 1.01 44.28 $44.72 93320 26 Doppler echo exam heart 0.52 44.28 $23.03 93321 Doppler echo exam heart 0.77 44.28 $34.10 93321 TC Doppler echo exam heart 0.56 44.28 $24.80 93321 26 Doppler echo exam heart 0.21 44.28 $9.30 93325 Doppler color flow add-on 0.72 44.28 $31.88 93325 TC Doppler color flow add-on 0.63 44.28 $27.90 93325 26 Doppler color flow add-on 0.09 44.28 $3.99 93350 Stress tte only 6.80 44.28 $301.10 93350 TC Stress tte only 4.78 44.28 $211.66 93350 26 Stress tte only 2.02 44.28 $89.45 93351 Stress tte complete 7.66 44.28 $339.18 93351 TC Stress tte complete 5.24 44.28 $232.03 93351 26 Stress tte complete 2.42 44.28 $107.16 93352 Admin ecg contrast agent 0.96 44.28 $42.51 93355 Echo transesophageal (tee) 6.47 44.28 $286.49 93451 Right heart cath 20.53 44.28 $909.07 93451 TC Right heart cath 16.73 44.28 $740.80 93451 26 Right heart cath 3.80 44.28 $168.26 93452 Left hrt cath w/ventrclgrphy 23.37 44.28 $1,034.82 93452 TC Left hrt cath w/ventrclgrphy 16.45 44.28 $728.41 93452 26 Left hrt cath w/ventrclgrphy 6.92 44.28 $306.42 93453 R&l hrt cath w/ventriclgrphy 30.34 44.28 $1,343.46 93453 TC R&l hrt cath w/ventriclgrphy 21.08 44.28 $933.42 93453 26 R&l hrt cath w/ventriclgrphy 9.26 44.28 $410.03 93454 Coronary artery angio s&i 23.72 44.28 $1,050.32 93454 TC Coronary artery angio s&i 16.71 44.28 $739.92 93454 26 Coronary artery angio s&i 7.01 44.28 $310.40 93455 Coronary art/grft angio s&i 27.73 44.28 $1,227.88 93455 TC Coronary art/grft angio s&i 19.57 44.28 $866.56 93455 26 Coronary art/grft angio s&i 8.16 44.28 $361.32 93456 R hrt coronary artery angio 29.99 44.28 $1,327.96 93456 TC R hrt coronary artery angio 20.88 44.28 $924.57 93456 26 R hrt coronary artery angio 9.11 44.28 $403.39 93457 R hrt art/grft angio 33.98 44.28 $1,504.63 93457 TC R hrt art/grft angio 23.72 44.28 $1,050.32 93457 26 R hrt art/grft angio 10.26 44.28 $454.31 93458 L hrt artery/ventricle angio 28.57 44.28 $1,265.08 93458 TC L hrt artery/ventricle angio 19.92 44.28 $882.06 93458 26 L hrt artery/ventricle angio 8.65 44.28 $383.02 93459 L hrt art/grft angio 31.67 44.28 $1,402.35 93459 TC L hrt art/grft angio 21.87 44.28 $968.40 93459 26 L hrt art/grft angio 9.80 44.28 $433.94 93460 R&l hrt art/ventricle angio 34.13 44.28 $1,511.28 93460 TC R&l hrt art/ventricle angio 23.16 44.28 $1,025.52 93460 26 R&l hrt art/ventricle angio 10.97 44.28 $485.75 93461 R&l hrt art/ventricle angio 39.06 44.28 $1,729.58 93461 TC R&l hrt art/ventricle angio 26.93 44.28 $1,192.46 93461 26 R&l hrt art/ventricle angio 12.13 44.28 $537.12 93462 L hrt cath trnsptl puncture 6.09 44.28 $269.67 93463 Drug admin & hemodynmic meas 2.82 44.28 $124.87 93464 Exercise w/hemodynamic meas 7.22 44.28 $319.70 93464 TC Exercise w/hemodynamic meas 4.73 44.28 $209.44 93464 26 Exercise w/hemodynamic meas 2.49 44.28 $110.26 93503 Insert/place heart catheter 3.69 44.28 $163.39 93505 Biopsy of heart lining 19.84 44.28 $878.52 93505 TC Biopsy of heart lining 13.48 44.28 $596.89 93505 26 Biopsy of heart lining 6.36 44.28 $281.62 93530 Rt heart cath congenital 0.00 44.28 $0.00 93530 TC Rt heart cath congenital 0.00 44.28 $0.00 93530 26 Rt heart cath congenital 6.01 44.28 $266.12 93531 R & l heart cath congenital 0.00 44.28 $0.00 93531 TC R & l heart cath congenital 0.00 44.28 $0.00 93531 26 R & l heart cath congenital 12.43 44.28 $550.40 93532 R & l heart cath congenital 0.00 44.28 $0.00 93532 TC R & l heart cath congenital 0.00 44.28 $0.00 93532 26 R & l heart cath congenital 15.48 44.28 $685.45 93533 R & l heart cath congenital 0.00 44.28 $0.00 93533 TC R & l heart cath congenital 0.00 44.28 $0.00 93533 26 R & l heart cath congenital 10.34 44.28 $457.86 93561 Cardiac output measurement 0.00 44.28 $0.00 93561 TC Cardiac output measurement 0.00 44.28 $0.00 93561 26 Cardiac output measurement 0.37 44.28 $16.38 93562 Card output measure subsq 0.00 44.28 $0.00 93562 TC Card output measure subsq 0.00 44.28 $0.00 93562 26 Card output measure subsq 0.03 44.28 $1.33 93563 Inject congenital card cath 1.70 44.28 $75.28 93564 Inject hrt congntl art/grft 1.79 44.28 $79.26 93565 Inject l ventr/atrial angio 1.32 44.28 $58.45 93566 Inject r ventr/atrial angio 4.58 44.28 $202.80 93567 Inject suprvlv aortography 3.87 44.28 $171.36 93568 Inject pulm art hrt cath 4.10 44.28 $181.55 93571 Heart flow reserve measure 0.00 44.28 $0.00 93571 TC Heart flow reserve measure 0.00 44.28 $0.00 93571 26 Heart flow reserve measure 2.78 44.28 $123.10 93572 Heart flow reserve measure 0.00 44.28 $0.00 93572 TC Heart flow reserve measure 0.00 44.28 $0.00 93572 26 Heart flow reserve measure 2.23 44.28 $98.74 93580 Transcath closure of asd 28.47 44.28 $1,260.65 93581 Transcath closure of vsd 39.09 44.28 $1,730.91 93582 Perq transcath closure pda 19.06 44.28 $843.98 93583 Perq transcath septal reduxn 21.60 44.28 $956.45 93590 Perq transcath cls mitral 34.70 44.28 $1,536.52 93591 Perq transcath cls aortic 28.80 44.28 $1,275.26 93592 Perq transcath closure each 12.69 44.28 $561.91 93600 Bundle of his recording 0.00 44.28 $0.00 93600 TC Bundle of his recording 0.00 44.28 $0.00 93600 26 Bundle of his recording 3.45 44.28 $152.77 93602 Intra-atrial recording 0.00 44.28 $0.00 93602 TC Intra-atrial recording 0.00 44.28 $0.00 93602 26 Intra-atrial recording 3.37 44.28 $149.22 93603 Right ventricular recording 0.00 44.28 $0.00 93603 TC Right ventricular recording 0.00 44.28 $0.00 93603 26 Right ventricular recording 3.37 44.28 $149.22 93609 Map tachycardia add-on 0.00 44.28 $0.00 93609 TC Map tachycardia add-on 0.00 44.28 $0.00 93609 26 Map tachycardia add-on 8.08 44.28 $357.78 93610 Intra-atrial pacing 0.00 44.28 $0.00 93610 TC Intra-atrial pacing 0.00 44.28 $0.00 93610 26 Intra-atrial pacing 4.77 44.28 $211.22 93612 Intraventricular pacing 0.00 44.28 $0.00 93612 TC Intraventricular pacing 0.00 44.28 $0.00 93612 26 Intraventricular pacing 4.73 44.28 $209.44 93613 Electrophys map 3d add-on 11.58 44.28 $512.76 93615 Esophageal recording 0.00 44.28 $0.00 93615 TC Esophageal recording 0.00 44.28 $0.00 93615 26 Esophageal recording 1.10 44.28 $48.71 93616 Esophageal recording 0.00 44.28 $0.00 93616 TC Esophageal recording 0.00 44.28 $0.00 93616 26 Esophageal recording 1.52 44.28 $67.31 93618 Heart rhythm pacing 0.00 44.28 $0.00 93618 TC Heart rhythm pacing 0.00 44.28 $0.00 93618 26 Heart rhythm pacing 6.44 44.28 $285.16 93619 Electrophysiology evaluation 0.00 44.28 $0.00 93619 TC Electrophysiology evaluation 0.00 44.28 $0.00 93619 26 Electrophysiology evaluation 11.36 44.28 $503.02 93620 Electrophysiology evaluation 0.00 44.28 $0.00 93620 TC Electrophysiology evaluation 0.00 44.28 $0.00 93620 26 Electrophysiology evaluation 18.27 44.28 $809.00 93621 Electrophysiology evaluation 0.00 44.28 $0.00 93621 TC Electrophysiology evaluation 0.00 44.28 $0.00 93621 26 Electrophysiology evaluation 3.42 44.28 $151.44 93622 Electrophysiology evaluation 0.00 44.28 $0.00 93622 TC Electrophysiology evaluation 0.00 44.28 $0.00 93622 26 Electrophysiology evaluation 5.01 44.28 $221.84 93623 Stimulation pacing heart 0.00 44.28 $0.00 93623 TC Stimulation pacing heart 0.00 44.28 $0.00 93623 26 Stimulation pacing heart 4.64 44.28 $205.46 93624 Electrophysiologic study 0.00 44.28 $0.00 93624 TC Electrophysiologic study 0.00 44.28 $0.00 93624 26 Electrophysiologic study 7.03 44.28 $311.29 93631 Heart pacing mapping 0.00 44.28 $0.00 93631 TC Heart pacing mapping 0.00 44.28 $0.00 93631 26 Heart pacing mapping 11.53 44.28 $510.55 93640 Evaluation heart device 0.00 44.28 $0.00 93640 TC Evaluation heart device 0.00 44.28 $0.00 93640 26 Evaluation heart device 5.21 44.28 $230.70 93641 Electrophysiology evaluation 0.00 44.28 $0.00 93641 TC Electrophysiology evaluation 0.00 44.28 $0.00 93641 26 Electrophysiology evaluation 9.09 44.28 $402.51 93642 Electrophysiology evaluation 9.79 44.28 $433.50 93642 TC Electrophysiology evaluation 2.31 44.28 $102.29 93642 26 Electrophysiology evaluation 7.48 44.28 $331.21 93644 Electrophysiology evaluation 6.18 44.28 $273.65 93644 TC Electrophysiology evaluation 1.64 44.28 $72.62 93644 26 Electrophysiology evaluation 4.54 44.28 $201.03 93650 Ablate heart dysrhythm focus 17.21 44.28 $762.06 93653 Ep & ablate supravent arrhyt 24.35 44.28 $1,078.22 93654 Ep & ablate ventric tachy 32.61 44.28 $1,443.97 93655 Ablate arrhythmia add on 12.41 44.28 $549.51 93656 Tx atrial fib pulm vein isol 32.72 44.28 $1,448.84 93657 Tx l/r atrial fib addl 12.38 44.28 $548.19 93660 Tilt table evaluation 4.48 44.28 $198.37 93660 TC Tilt table evaluation 1.80 44.28 $79.70 93660 26 Tilt table evaluation 2.68 44.28 $118.67 93662 Intracardiac ecg (ice) 0.00 44.28 $0.00 93662 TC Intracardiac ecg (ice) 0.00 44.28 $0.00 93662 26 Intracardiac ecg (ice) 4.09 44.28 $181.11 93668 Peripheral vascular rehab 0.54 44.28 $23.91 93701 Bioimpedance cv analysis 0.69 44.28 $30.55 93702 Bis xtracell fluid analysis 3.49 44.28 $154.54 93724 Analyze pacemaker system 7.69 44.28 $340.51 93724 TC Analyze pacemaker system 0.79 44.28 $34.98 93724 26 Analyze pacemaker system 6.90 44.28 $305.53 93740 Temperature gradient studies 0.23 44.28 $10.18 93745 Set-up cardiovert-defibrill 0.00 44.28 $0.00 93745 TC Set-up cardiovert-defibrill 0.00 44.28 $0.00 93745 26 Set-up cardiovert-defibrill 0.00 44.28 $0.00 93750 Interrogation vad in person 1.58 44.28 $69.96 93770 Measure venous pressure 0.23 44.28 $10.18 93784 Ambulatory bp monitoring 1.52 44.28 $67.31 93786 Ambulatory bp recording 0.84 44.28 $37.20 93788 Ambulatory bp analysis 0.15 44.28 $6.64 93790 Review/report bp recording 0.53 44.28 $23.47 93797 Cardiac rehab 0.46 44.28 $20.37 93798 Cardiac rehab/monitor 0.71 44.28 $31.44 93799 Cardiovascular procedure 0.00 44.28 $0.00 93799 TC Cardiovascular procedure 0.00 44.28 $0.00 93799 26 Cardiovascular procedure 0.00 44.28 $0.00 93880 Extracranial bilat study 5.73 44.28 $253.72 93880 TC Extracranial bilat study 4.59 44.28 $203.25 93880 26 Extracranial bilat study 1.14 44.28 $50.48 93882 Extracranial uni/ltd study 3.65 44.28 $161.62 93882 TC Extracranial uni/ltd study 2.93 44.28 $129.74 93882 26 Extracranial uni/ltd study 0.72 44.28 $31.88 93886 Intracranial complete study 7.81 44.28 $345.83 93886 TC Intracranial complete study 6.47 44.28 $286.49 93886 26 Intracranial complete study 1.34 44.28 $59.34 93888 Intracranial limited study 4.25 44.28 $188.19 93888 TC Intracranial limited study 3.51 44.28 $155.42 93888 26 Intracranial limited study 0.74 44.28 $32.77 93890 Tcd vasoreactivity study 8.05 44.28 $356.45 93890 TC Tcd vasoreactivity study 6.59 44.28 $291.81 93890 26 Tcd vasoreactivity study 1.46 44.28 $64.65 93892 Tcd emboli detect w/o inj 9.31 44.28 $412.25 93892 TC Tcd emboli detect w/o inj 7.60 44.28 $336.53 93892 26 Tcd emboli detect w/o inj 1.71 44.28 $75.72 93893 Tcd emboli detect w/inj 9.80 44.28 $433.94 93893 TC Tcd emboli detect w/inj 8.10 44.28 $358.67 93893 26 Tcd emboli detect w/inj 1.70 44.28 $75.28 93895 Carotid intima atheroma eval 0.00 44.28 $0.00 93895 TC Carotid intima atheroma eval 0.00 44.28 $0.00 93895 26 Carotid intima atheroma eval 0.00 44.28 $0.00 93922 Upr/l xtremity art 2 levels 2.51 44.28 $111.14 93922 TC Upr/l xtremity art 2 levels 2.15 44.28 $95.20 93922 26 Upr/l xtremity art 2 levels 0.36 44.28 $15.94 93923 Upr/lxtr art stdy 3+ lvls 3.90 44.28 $172.69 93923 TC Upr/lxtr art stdy 3+ lvls 3.26 44.28 $144.35 93923 26 Upr/lxtr art stdy 3+ lvls 0.64 44.28 $28.34 93924 Lwr xtr vasc stdy bilat 4.86 44.28 $215.20 93924 TC Lwr xtr vasc stdy bilat 4.15 44.28 $183.76 93924 26 Lwr xtr vasc stdy bilat 0.71 44.28 $31.44 93925 Lower extremity study 7.33 44.28 $324.57 93925 TC Lower extremity study 6.21 44.28 $274.98 93925 26 Lower extremity study 1.12 44.28 $49.59 93926 Lower extremity study 4.30 44.28 $190.40 93926 TC Lower extremity study 3.61 44.28 $159.85 93926 26 Lower extremity study 0.69 44.28 $30.55 93930 Upper extremity study 5.89 44.28 $260.81 93930 TC Upper extremity study 4.75 44.28 $210.33 93930 26 Upper extremity study 1.14 44.28 $50.48 93931 Upper extremity study 3.64 44.28 $161.18 93931 TC Upper extremity study 2.94 44.28 $130.18 93931 26 Upper extremity study 0.70 44.28 $31.00 93970 Extremity study 5.58 44.28 $247.08 93970 TC Extremity study 4.59 44.28 $203.25 93970 26 Extremity study 0.99 44.28 $43.84 93971 Extremity study 3.40 44.28 $150.55 93971 TC Extremity study 2.77 44.28 $122.66 93971 26 Extremity study 0.63 44.28 $27.90 93975 Vascular study 7.98 44.28 $353.35 93975 TC Vascular study 6.33 44.28 $280.29 93975 26 Vascular study 1.65 44.28 $73.06 93976 Vascular study 4.63 44.28 $205.02 93976 TC Vascular study 3.49 44.28 $154.54 93976 26 Vascular study 1.14 44.28 $50.48 93978 Vascular study 5.40 44.28 $239.11 93978 TC Vascular study 4.27 44.28 $189.08 93978 26 Vascular study 1.13 44.28 $50.04 93979 Vascular study 3.39 44.28 $150.11 93979 TC Vascular study 2.68 44.28 $118.67 93979 26 Vascular study 0.71 44.28 $31.44 93980 Penile vascular study 3.44 44.28 $152.32 93980 TC Penile vascular study 1.69 44.28 $74.83 93980 26 Penile vascular study 1.75 44.28 $77.49 93981 Penile vascular study 2.09 44.28 $92.55 93981 TC Penile vascular study 1.46 44.28 $64.65 93981 26 Penile vascular study 0.63 44.28 $27.90 93982 Aneurysm pressure sens study 1.25 44.28 $55.35 93990 Doppler flow testing 4.51 44.28 $199.70 93990 TC Doppler flow testing 3.81 44.28 $168.71 93990 26 Doppler flow testing 0.70 44.28 $31.00 93998 Noninvas vasc dx study proc 0.00 44.28 $0.00 94002 Vent mgmt inpat init day 2.63 44.28 $116.46 94003 Vent mgmt inpat subq day 1.90 44.28 $84.13 94004 Vent mgmt nf per day 1.40 44.28 $61.99 94005 Home vent mgmt supervision 2.63 44.28 $116.46 94010 Breathing capacity test 1.01 44.28 $44.72 94010 TC Breathing capacity test 0.77 44.28 $34.10 94010 26 Breathing capacity test 0.24 44.28 $10.63 94011 Spirometry up to 2 yrs old 2.61 44.28 $115.57 94012 Spirmtry w/brnchdil inf-2 yr 4.20 44.28 $185.98 94013 Meas lung vol thru 2 yrs 0.57 44.28 $25.24 94014 Patient recorded spirometry 1.60 44.28 $70.85 94015 Patient recorded spirometry 0.88 44.28 $38.97 94016 Review patient spirometry 0.72 44.28 $31.88 94060 Evaluation of wheezing 1.72 44.28 $76.16 94060 TC Evaluation of wheezing 1.35 44.28 $59.78 94060 26 Evaluation of wheezing 0.37 44.28 $16.38 94070 Evaluation of wheezing 1.70 44.28 $75.28 94070 TC Evaluation of wheezing 0.88 44.28 $38.97 94070 26 Evaluation of wheezing 0.82 44.28 $36.31 94150 Vital capacity test 0.71 44.28 $31.44 94150 TC Vital capacity test 0.60 44.28 $26.57 94150 26 Vital capacity test 0.11 44.28 $4.87 94200 Lung function test (mbc/mvv) 0.73 44.28 $32.32 94200 TC Lung function test (mbc/mvv) 0.57 44.28 $25.24 94200 26 Lung function test (mbc/mvv) 0.16 44.28 $7.08 94250 Expired gas collection 0.75 44.28 $33.21 94250 TC Expired gas collection 0.59 44.28 $26.13 94250 26 Expired gas collection 0.16 44.28 $7.08 94375 Respiratory flow volume loop 1.12 44.28 $49.59 94375 TC Respiratory flow volume loop 0.70 44.28 $31.00 94375 26 Respiratory flow volume loop 0.42 44.28 $18.60 94400 Co2 breathing response curve 1.61 44.28 $71.29 94400 TC Co2 breathing response curve 1.05 44.28 $46.49 94400 26 Co2 breathing response curve 0.56 44.28 $24.80 94450 Hypoxia response curve 1.96 44.28 $86.79 94450 TC Hypoxia response curve 1.39 44.28 $61.55 94450 26 Hypoxia response curve 0.57 44.28 $25.24 94452 Hast w/report 1.63 44.28 $72.18 94452 TC Hast w/report 1.22 44.28 $54.02 94452 26 Hast w/report 0.41 44.28 $18.15 94453 Hast w/oxygen titrate 2.26 44.28 $100.07 94453 TC Hast w/oxygen titrate 1.72 44.28 $76.16 94453 26 Hast w/oxygen titrate 0.54 44.28 $23.91 94610 Surfactant admin thru tube 1.59 44.28 $70.41 94620 Pulmonary stress test/simple 1.59 44.28 $70.41 94620 TC Pulmonary stress test/simple 0.72 44.28 $31.88 94620 26 Pulmonary stress test/simple 0.87 44.28 $38.52 94621 Pulm stress test/complex 4.60 44.28 $203.69 94621 TC Pulm stress test/complex 2.64 44.28 $116.90 94621 26 Pulm stress test/complex 1.96 44.28 $86.79 94640 Airway inhalation treatment 0.52 44.28 $23.03 94642 Aerosol inhalation treatment 0.00 44.28 $0.00 94644 Cbt 1st hour 1.25 44.28 $55.35 94645 Cbt each addl hour 0.41 44.28 $18.15 94660 Pos airway pressure cpap 1.80 44.28 $79.70 94662 Neg press ventilation cnp 1.00 44.28 $44.28 94664 Evaluate pt use of inhaler 0.49 44.28 $21.70 94667 Chest wall manipulation 0.75 44.28 $33.21 94668 Chest wall manipulation 0.83 44.28 $36.75 94669 Mechanical chest wall oscill 0.93 44.28 $41.18 94680 Exhaled air analysis o2 1.61 44.28 $71.29 94680 TC Exhaled air analysis o2 1.25 44.28 $55.35 94680 26 Exhaled air analysis o2 0.36 44.28 $15.94 94681 Exhaled air analysis o2/co2 1.53 44.28 $67.75 94681 TC Exhaled air analysis o2/co2 1.24 44.28 $54.91 94681 26 Exhaled air analysis o2/co2 0.29 44.28 $12.84 94690 Exhaled air analysis 1.45 44.28 $64.21 94690 TC Exhaled air analysis 1.34 44.28 $59.34 94690 26 Exhaled air analysis 0.11 44.28 $4.87 94726 Pulm funct tst plethysmograp 1.49 44.28 $65.98 94726 TC Pulm funct tst plethysmograp 1.14 44.28 $50.48 94726 26 Pulm funct tst plethysmograp 0.35 44.28 $15.50 94727 Pulm function test by gas 1.19 44.28 $52.69 94727 TC Pulm function test by gas 0.84 44.28 $37.20 94727 26 Pulm function test by gas 0.35 44.28 $15.50 94728 Pulm funct test oscillometry 1.12 44.28 $49.59 94728 TC Pulm funct test oscillometry 0.76 44.28 $33.65 94728 26 Pulm funct test oscillometry 0.36 44.28 $15.94 94729 Co/membane diffuse capacity 1.54 44.28 $68.19 94729 TC Co/membane diffuse capacity 1.28 44.28 $56.68 94729 26 Co/membane diffuse capacity 0.26 44.28 $11.51 94750 Pulmonary compliance study 2.23 44.28 $98.74 94750 TC Pulmonary compliance study 1.92 44.28 $85.02 94750 26 Pulmonary compliance study 0.31 44.28 $13.73 94760 Measure blood oxygen level 0.09 44.28 $3.99 94761 Measure blood oxygen level 0.13 44.28 $5.76 94762 Measure blood oxygen level 0.69 44.28 $30.55 94770 Exhaled carbon dioxide test 0.21 44.28 $9.30 94772 Breath recording infant 0.00 44.28 $0.00 94772 TC Breath recording infant 0.00 44.28 $0.00 94772 26 Breath recording infant 0.00 44.28 $0.00 94774 Ped home apnea rec compl 0.00 44.28 $0.00 94775 Ped home apnea rec hk-up 0.00 44.28 $0.00 94776 Ped home apnea rec downld 0.00 44.28 $0.00 94777 Ped home apnea rec report 0.00 44.28 $0.00 94780 Car seat/bed test 60 min 1.68 44.28 $74.39 94781 Car seat/bed test + 30 min 0.65 44.28 $28.78 94799 Pulmonary service/procedure 0.00 44.28 $0.00 94799 TC Pulmonary service/procedure 0.00 44.28 $0.00 94799 26 Pulmonary service/procedure 0.00 44.28 $0.00 95004 Percut allergy skin tests 0.19 44.28 $8.41 95012 Exhaled nitric oxide meas 0.54 44.28 $23.91 95017 Perq & icut allg test venoms 0.22 44.28 $9.74 95018 Perq&ic allg test drugs/biol 0.58 44.28 $25.68 95024 Icut allergy test drug/bug 0.22 44.28 $9.74 95027 Icut allergy titrate-airborn 0.13 44.28 $5.76 95028 Icut allergy test-delayed 0.38 44.28 $16.83 95044 Allergy patch tests 0.16 44.28 $7.08 95052 Photo patch test 0.19 44.28 $8.41 95056 Photosensitivity tests 1.25 44.28 $55.35 95060 Eye allergy tests 1.00 44.28 $44.28 95065 Nose allergy test 0.71 44.28 $31.44 95070 Bronchial allergy tests 0.87 44.28 $38.52 95071 Bronchial allergy tests 1.03 44.28 $45.61 95076 Ingest challenge ini 120 min 3.28 44.28 $145.24 95079 Ingest challenge addl 60 min 2.34 44.28 $103.62 95115 Immunotherapy one injection 0.25 44.28 $11.07 95117 Immunotherapy injections 0.29 44.28 $12.84 95120 Immunotherapy one injection 0.00 44.28 $0.00 95125 Immunotherapy 2/> injections 0.00 44.28 $0.00 95130 Immntx 1 sting insect 0.00 44.28 $0.00 95131 Immntx 2 sting insects 0.00 44.28 $0.00 95132 Immntx 3 sting insects 0.00 44.28 $0.00 95133 Immntx 4 sting insects 0.00 44.28 $0.00 95134 Immntx 5 sting insects 0.00 44.28 $0.00 95144 Antigen therapy services 0.37 44.28 $16.38 95145 Antigen therapy services 0.71 44.28 $31.44 95146 Antigen therapy services 1.30 44.28 $57.56 95147 Antigen therapy services 1.38 44.28 $61.11 95148 Antigen therapy services 1.95 44.28 $86.35 95149 Antigen therapy services 2.58 44.28 $114.24 95165 Antigen therapy services 0.37 44.28 $16.38 95170 Antigen therapy services 0.27 44.28 $11.96 95180 Rapid desensitization 3.77 44.28 $166.94 95199 Allergy immunology services 0.00 44.28 $0.00 95250 Glucose monitoring cont 4.45 44.28 $197.05 95251 Gluc monitor cont phys i&r 1.24 44.28 $54.91 95782 Polysom <6 yrs 4/> paramtrs 28.85 44.28 $1,277.48 95782 TC Polysom <6 yrs 4/> paramtrs 25.26 44.28 $1,118.51 95782 26 Polysom <6 yrs 4/> paramtrs 3.59 44.28 $158.97 95783 Polysom <6 yrs cpap/bilvl 32.79 44.28 $1,451.94 95783 TC Polysom <6 yrs cpap/bilvl 28.71 44.28 $1,271.28 95783 26 Polysom <6 yrs cpap/bilvl 4.08 44.28 $180.66 95800 Slp stdy unattended 5.04 44.28 $223.17 95800 TC Slp stdy unattended 3.56 44.28 $157.64 95800 26 Slp stdy unattended 1.48 44.28 $65.53 95801 Slp stdy unatnd w/anal 2.57 44.28 $113.80 95801 TC Slp stdy unatnd w/anal 1.17 44.28 $51.81 95801 26 Slp stdy unatnd w/anal 1.40 44.28 $61.99 95803 Actigraphy testing 3.98 44.28 $176.23 95803 TC Actigraphy testing 2.74 44.28 $121.33 95803 26 Actigraphy testing 1.24 44.28 $54.91 95805 Multiple sleep latency test 12.09 44.28 $535.35 95805 TC Multiple sleep latency test 10.41 44.28 $460.95 95805 26 Multiple sleep latency test 1.68 44.28 $74.39 95806 Sleep study unatt&resp efft 4.79 44.28 $212.10 95806 TC Sleep study unatt&resp efft 3.05 44.28 $135.05 95806 26 Sleep study unatt&resp efft 1.74 44.28 $77.05 95807 Sleep study attended 13.14 44.28 $581.84 95807 TC Sleep study attended 11.37 44.28 $503.46 95807 26 Sleep study attended 1.77 44.28 $78.38 95808 Polysom any age 1-3> param 18.08 44.28 $800.58 95808 TC Polysom any age 1-3> param 15.57 44.28 $689.44 95808 26 Polysom any age 1-3> param 2.51 44.28 $111.14 95810 Polysom 6/> yrs 4/> param 17.59 44.28 $778.89 95810 TC Polysom 6/> yrs 4/> param 14.13 44.28 $625.68 95810 26 Polysom 6/> yrs 4/> param 3.46 44.28 $153.21 95811 Polysom 6/>yrs cpap 4/> parm 18.48 44.28 $818.29 95811 TC Polysom 6/>yrs cpap 4/> parm 14.88 44.28 $658.89 95811 26 Polysom 6/>yrs cpap 4/> parm 3.60 44.28 $159.41 95812 Eeg 41-60 minutes 9.15 44.28 $405.16 95812 TC Eeg 41-60 minutes 7.51 44.28 $332.54 95812 26 Eeg 41-60 minutes 1.64 44.28 $72.62 95813 Eeg over 1 hour 11.53 44.28 $510.55 95813 TC Eeg over 1 hour 9.05 44.28 $400.73 95813 26 Eeg over 1 hour 2.48 44.28 $109.81 95816 Eeg awake and drowsy 10.21 44.28 $452.10 95816 TC Eeg awake and drowsy 8.57 44.28 $379.48 95816 26 Eeg awake and drowsy 1.64 44.28 $72.62 95819 Eeg awake and asleep 11.74 44.28 $519.85 95819 TC Eeg awake and asleep 10.09 44.28 $446.79 95819 26 Eeg awake and asleep 1.65 44.28 $73.06 95822 Eeg coma or sleep only 10.60 44.28 $469.37 95822 TC Eeg coma or sleep only 8.95 44.28 $396.31 95822 26 Eeg coma or sleep only 1.65 44.28 $73.06 95824 Eeg cerebral death only 0.00 44.28 $0.00 95824 TC Eeg cerebral death only 0.00 44.28 $0.00 95824 26 Eeg cerebral death only 1.12 44.28 $49.59 95827 Eeg all night recording 18.77 44.28 $831.14 95827 TC Eeg all night recording 17.15 44.28 $759.40 95827 26 Eeg all night recording 1.62 44.28 $71.73 95829 Surgery electrocorticogram 54.13 44.28 $2,396.88 95829 TC Surgery electrocorticogram 44.53 44.28 $1,971.79 95829 26 Surgery electrocorticogram 9.60 44.28 $425.09 95830 Insert electrodes for eeg 6.20 44.28 $274.54 95831 Limb muscle testing manual 0.89 44.28 $39.41 95832 Hand muscle testing manual 0.88 44.28 $38.97 95833 Body muscle testing manual 1.05 44.28 $46.49 95834 Body muscle testing manual 1.48 44.28 $65.53 95851 Range of motion measurements 0.51 44.28 $22.58 95852 Range of motion measurements 0.44 44.28 $19.48 95857 Cholinesterase challenge 1.53 44.28 $67.75 95860 Muscle test one limb 3.46 44.28 $153.21 95860 TC Muscle test one limb 1.99 44.28 $88.12 95860 26 Muscle test one limb 1.47 44.28 $65.09 95861 Muscle test 2 limbs 4.92 44.28 $217.86 95861 TC Muscle test 2 limbs 2.56 44.28 $113.36 95861 26 Muscle test 2 limbs 2.36 44.28 $104.50 95863 Muscle test 3 limbs 6.18 44.28 $273.65 95863 TC Muscle test 3 limbs 3.33 44.28 $147.45 95863 26 Muscle test 3 limbs 2.85 44.28 $126.20 95864 Muscle test 4 limbs 6.95 44.28 $307.75 95864 TC Muscle test 4 limbs 3.89 44.28 $172.25 95864 26 Muscle test 4 limbs 3.06 44.28 $135.50 95865 Muscle test larynx 4.15 44.28 $183.76 95865 TC Muscle test larynx 1.74 44.28 $77.05 95865 26 Muscle test larynx 2.41 44.28 $106.71 95866 Muscle test hemidiaphragm 3.84 44.28 $170.04 95866 TC Muscle test hemidiaphragm 1.91 44.28 $84.57 95866 26 Muscle test hemidiaphragm 1.93 44.28 $85.46 95867 Muscle test cran nerv unilat 2.74 44.28 $121.33 95867 TC Muscle test cran nerv unilat 1.55 44.28 $68.63 95867 26 Muscle test cran nerv unilat 1.19 44.28 $52.69 95868 Muscle test cran nerve bilat 3.81 44.28 $168.71 95868 TC Muscle test cran nerve bilat 2.00 44.28 $88.56 95868 26 Muscle test cran nerve bilat 1.81 44.28 $80.15 95869 Muscle test thor paraspinal 2.59 44.28 $114.69 95869 TC Muscle test thor paraspinal 2.02 44.28 $89.45 95869 26 Muscle test thor paraspinal 0.57 44.28 $25.24 95870 Muscle test nonparaspinal 2.62 44.28 $116.01 95870 TC Muscle test nonparaspinal 2.05 44.28 $90.77 95870 26 Muscle test nonparaspinal 0.57 44.28 $25.24 95872 Muscle test one fiber 5.58 44.28 $247.08 95872 TC Muscle test one fiber 1.19 44.28 $52.69 95872 26 Muscle test one fiber 4.39 44.28 $194.39 95873 Guide nerv destr elec stim 2.07 44.28 $91.66 95873 TC Guide nerv destr elec stim 1.50 44.28 $66.42 95873 26 Guide nerv destr elec stim 0.57 44.28 $25.24 95874 Guide nerv destr needle emg 2.09 44.28 $92.55 95874 TC Guide nerv destr needle emg 1.52 44.28 $67.31 95874 26 Guide nerv destr needle emg 0.57 44.28 $25.24 95875 Limb exercise test 3.32 44.28 $147.01 95875 TC Limb exercise test 1.64 44.28 $72.62 95875 26 Limb exercise test 1.68 44.28 $74.39 95885 Musc tst done w/nerv tst lim 1.66 44.28 $73.50 95885 TC Musc tst done w/nerv tst lim 1.12 44.28 $49.59 95885 26 Musc tst done w/nerv tst lim 0.54 44.28 $23.91 95886 Musc test done w/n test comp 2.58 44.28 $114.24 95886 TC Musc test done w/n test comp 1.26 44.28 $55.79 95886 26 Musc test done w/n test comp 1.32 44.28 $58.45 95887 Musc tst done w/n tst nonext 2.28 44.28 $100.96 95887 TC Musc tst done w/n tst nonext 1.20 44.28 $53.14 95887 26 Musc tst done w/n tst nonext 1.08 44.28 $47.82 95905 Motor &/ sens nrve cndj test 2.02 44.28 $89.45 95905 TC Motor &/ sens nrve cndj test 1.94 44.28 $85.90 95905 26 Motor &/ sens nrve cndj test 0.08 44.28 $3.54 95907 Nvr cndj tst 1-2 studies 2.76 44.28 $122.21 95907 TC Nvr cndj tst 1-2 studies 1.23 44.28 $54.46 95907 26 Nvr cndj tst 1-2 studies 1.53 44.28 $67.75 95908 Nrv cndj tst 3-4 studies 3.55 44.28 $157.19 95908 TC Nrv cndj tst 3-4 studies 1.63 44.28 $72.18 95908 26 Nrv cndj tst 3-4 studies 1.92 44.28 $85.02 95909 Nrv cndj tst 5-6 studies 4.23 44.28 $187.30 95909 TC Nrv cndj tst 5-6 studies 1.93 44.28 $85.46 95909 26 Nrv cndj tst 5-6 studies 2.30 44.28 $101.84 95910 Nrv cndj test 7-8 studies 5.59 44.28 $247.53 95910 TC Nrv cndj test 7-8 studies 2.52 44.28 $111.59 95910 26 Nrv cndj test 7-8 studies 3.07 44.28 $135.94 95911 Nrv cndj test 9-10 studies 6.66 44.28 $294.90 95911 TC Nrv cndj test 9-10 studies 2.83 44.28 $125.31 95911 26 Nrv cndj test 9-10 studies 3.83 44.28 $169.59 95912 Nrv cndj test 11-12 studies 7.35 44.28 $325.46 95912 TC Nrv cndj test 11-12 studies 2.82 44.28 $124.87 95912 26 Nrv cndj test 11-12 studies 4.53 44.28 $200.59 95913 Nrv cndj test 13/> studies 8.44 44.28 $373.72 95913 TC Nrv cndj test 13/> studies 3.08 44.28 $136.38 95913 26 Nrv cndj test 13/> studies 5.36 44.28 $237.34 95921 Autonomic nrv parasym inervj 2.41 44.28 $106.71 95921 TC Autonomic nrv parasym inervj 1.12 44.28 $49.59 95921 26 Autonomic nrv parasym inervj 1.29 44.28 $57.12 95922 Autonomic nrv adrenrg inervj 2.83 44.28 $125.31 95922 TC Autonomic nrv adrenrg inervj 1.45 44.28 $64.21 95922 26 Autonomic nrv adrenrg inervj 1.38 44.28 $61.11 95923 Autonomic nrv syst funj test 3.99 44.28 $176.68 95923 TC Autonomic nrv syst funj test 2.68 44.28 $118.67 95923 26 Autonomic nrv syst funj test 1.31 44.28 $58.01 95924 Ans parasymp & symp w/tilt 4.32 44.28 $191.29 95924 TC Ans parasymp & symp w/tilt 1.76 44.28 $77.93 95924 26 Ans parasymp & symp w/tilt 2.56 44.28 $113.36 95925 Somatosensory testing 3.92 44.28 $173.58 95925 TC Somatosensory testing 3.13 44.28 $138.60 95925 26 Somatosensory testing 0.79 44.28 $34.98 95926 Somatosensory testing 3.80 44.28 $168.26 95926 TC Somatosensory testing 3.02 44.28 $133.73 95926 26 Somatosensory testing 0.78 44.28 $34.54 95927 Somatosensory testing 3.90 44.28 $172.69 95927 TC Somatosensory testing 3.12 44.28 $138.15 95927 26 Somatosensory testing 0.78 44.28 $34.54 95928 C motor evoked uppr limbs 6.04 44.28 $267.45 95928 TC C motor evoked uppr limbs 3.75 44.28 $166.05 95928 26 C motor evoked uppr limbs 2.29 44.28 $101.40 95929 C motor evoked lwr limbs 6.22 44.28 $275.42 95929 TC C motor evoked lwr limbs 3.92 44.28 $173.58 95929 26 C motor evoked lwr limbs 2.30 44.28 $101.84 95930 Visual evoked potential test 3.66 44.28 $162.06 95930 TC Visual evoked potential test 3.13 44.28 $138.60 95930 26 Visual evoked potential test 0.53 44.28 $23.47 95933 Blink reflex test 2.17 44.28 $96.09 95933 TC Blink reflex test 1.27 44.28 $56.24 95933 26 Blink reflex test 0.90 44.28 $39.85 95937 Neuromuscular junction test 2.32 44.28 $102.73 95937 TC Neuromuscular junction test 1.34 44.28 $59.34 95937 26 Neuromuscular junction test 0.98 44.28 $43.39 95938 Somatosensory testing 9.69 44.28 $429.07 95938 TC Somatosensory testing 8.37 44.28 $370.62 95938 26 Somatosensory testing 1.32 44.28 $58.45 95939 C motor evoked upr&lwr limbs 14.28 44.28 $632.32 95939 TC C motor evoked upr&lwr limbs 10.86 44.28 $480.88 95939 26 C motor evoked upr&lwr limbs 3.42 44.28 $151.44 95940 Ionm in operatng room 15 min 0.93 44.28 $41.18 95941 Ionm remote/>1 pt or per hr 0.00 44.28 $0.00 95943 Parasymp&symp hrt rate test 0.00 44.28 $0.00 95943 TC Parasymp&symp hrt rate test 0.00 44.28 $0.00 95943 26 Parasymp&symp hrt rate test 0.00 44.28 $0.00 95950 Ambulatory eeg monitoring 9.43 44.28 $417.56 95950 TC Ambulatory eeg monitoring 7.15 44.28 $316.60 95950 26 Ambulatory eeg monitoring 2.28 44.28 $100.96 95951 Eeg monitoring/videorecord 0.00 44.28 $0.00 95951 TC Eeg monitoring/videorecord 0.00 44.28 $0.00 95951 26 Eeg monitoring/videorecord 9.12 44.28 $403.83 95953 Eeg monitoring/computer 12.00 44.28 $531.36 95953 TC Eeg monitoring/computer 7.32 44.28 $324.13 95953 26 Eeg monitoring/computer 4.68 44.28 $207.23 95954 Eeg monitoring/giving drugs 12.81 44.28 $567.23 95954 TC Eeg monitoring/giving drugs 9.23 44.28 $408.70 95954 26 Eeg monitoring/giving drugs 3.58 44.28 $158.52 95955 Eeg during surgery 6.05 44.28 $267.89 95955 TC Eeg during surgery 4.52 44.28 $200.15 95955 26 Eeg during surgery 1.53 44.28 $67.75 95956 Eeg monitor technol attended 46.07 44.28 $2,039.98 95956 TC Eeg monitor technol attended 40.62 44.28 $1,798.65 95956 26 Eeg monitor technol attended 5.45 44.28 $241.33 95957 Eeg digital analysis 8.64 44.28 $382.58 95957 TC Eeg digital analysis 5.65 44.28 $250.18 95957 26 Eeg digital analysis 2.99 44.28 $132.40 95958 Eeg monitoring/function test 16.43 44.28 $727.52 95958 TC Eeg monitoring/function test 9.98 44.28 $441.91 95958 26 Eeg monitoring/function test 6.45 44.28 $285.61 95961 Electrode stimulation brain 8.68 44.28 $384.35 95961 TC Electrode stimulation brain 4.04 44.28 $178.89 95961 26 Electrode stimulation brain 4.64 44.28 $205.46 95962 Electrode stim brain add-on 7.43 44.28 $329.00 95962 TC Electrode stim brain add-on 2.48 44.28 $109.81 95962 26 Electrode stim brain add-on 4.95 44.28 $219.19 95965 Meg spontaneous 0.00 44.28 $0.00 95965 TC Meg spontaneous 0.00 44.28 $0.00 95965 26 Meg spontaneous 12.01 44.28 $531.80 95966 Meg evoked single 0.00 44.28 $0.00 95966 TC Meg evoked single 0.00 44.28 $0.00 95966 26 Meg evoked single 6.02 44.28 $266.57 95967 Meg evoked each addl 0.00 44.28 $0.00 95967 TC Meg evoked each addl 0.00 44.28 $0.00 95967 26 Meg evoked each addl 5.28 44.28 $233.80 95970 Analyze neurostim no prog 1.93 44.28 $85.46 95971 Analyze neurostim simple 1.43 44.28 $63.32 95972 Analyze neurostim complex 1.65 44.28 $73.06 95974 Cranial neurostim complex 5.90 44.28 $261.25 95975 Cranial neurostim complex 3.17 44.28 $140.37 95978 Analyze neurostim brain/1h 7.08 44.28 $313.50 95979 Analyz neurostim brain addon 3.07 44.28 $135.94 95980 Io anal gast n-stim init 1.32 44.28 $58.45 95981 Io anal gast n-stim subsq 0.91 44.28 $40.29 95982 Io ga n-stim subsq w/reprog 1.50 44.28 $66.42 95990 Spin/brain pump refil & main 2.56 44.28 $113.36 95991 Spin/brain pump refil & main 3.37 44.28 $149.22 95992 Canalith repositioning proc 1.22 44.28 $54.02 95999 Neurological procedure 0.00 44.28 $0.00 96000 Motion analysis video/3d 2.71 44.28 $120.00 96001 Motion test w/ft press meas 3.47 44.28 $153.65 96002 Dynamic surface emg 0.62 44.28 $27.45 96003 Dynamic fine wire emg 0.47 44.28 $20.81 96004 Phys review of motion tests 3.33 44.28 $147.45 96020 Functional brain mapping 0.00 44.28 $0.00 96020 TC Functional brain mapping 0.00 44.28 $0.00 96020 26 Functional brain mapping 4.58 44.28 $202.80 96040 Genetic counseling 30 min 1.33 44.28 $58.89 96101 Psycho testing by psych/phys 2.25 44.28 $99.63 96102 Psycho testing by technician 1.75 44.28 $77.49 96103 Psycho testing admin by comp 0.78 44.28 $34.54 96105 Assessment of aphasia 3.04 44.28 $134.61 96110 Developmental screen w/score 0.27 44.28 $11.96 96111 Developmental test extend 3.71 44.28 $164.28 96116 Neurobehavioral status exam 2.60 44.28 $115.13 96118 Neuropsych tst by psych/phys 2.75 44.28 $121.77 96119 Neuropsych testing by tec 2.24 44.28 $99.19 96120 Neuropsych tst admin w/comp 1.36 44.28 $60.22 96125 Cognitive test by hc pro 3.28 44.28 $145.24 96127 Brief emotional/behav assmt 0.16 44.28 $7.08 96150 Assess hlth/behave init 0.61 44.28 $27.01 96151 Assess hlth/behave subseq 0.59 44.28 $26.13 96152 Intervene hlth/behave indiv 0.56 44.28 $24.80 96153 Intervene hlth/behave group 0.13 44.28 $5.76 96154 Interv hlth/behav fam w/pt 0.55 44.28 $24.35 96155 Interv hlth/behav fam no pt 0.64 44.28 $28.34 96160 Pt-focused hlth risk assmt 0.13 44.28 $5.76 96161 Caregiver health risk assmt 0.13 44.28 $5.76 96360 Hydration iv infusion init 1.63 44.28 $72.18 96361 Hydrate iv infusion add-on 0.43 44.28 $19.04 96365 Ther/proph/diag iv inf init 1.95 44.28 $86.35 96366 Ther/proph/diag iv inf addon 0.53 44.28 $23.47 96367 Tx/proph/dg addl seq iv inf 0.87 44.28 $38.52 96368 Ther/diag concurrent inf 0.58 44.28 $25.68 96369 Sc ther infusion up to 1 hr 5.03 44.28 $222.73 96370 Sc ther infusion addl hr 0.43 44.28 $19.04 96371 Sc ther infusion reset pump 1.93 44.28 $85.46 96372 Ther/proph/diag inj sc/im 0.72 44.28 $31.88 96373 Ther/proph/diag inj ia 0.54 44.28 $23.91 96374 Ther/proph/diag inj iv push 1.62 44.28 $71.73 96375 Tx/pro/dx inj new drug addon 0.63 44.28 $27.90 96376 Tx/pro/dx inj same drug adon 0.00 44.28 $0.00 96377 Applicaton on-body injector 0.00 44.28 $0.00 96379 Ther/prop/diag inj/inf proc 0.00 44.28 $0.00 96401 Chemo anti-neopl sq/im 2.10 44.28 $92.99 96402 Chemo hormon antineopl sq/im 0.92 44.28 $40.74 96405 Chemo intralesional up to 7 2.31 44.28 $102.29 96406 Chemo intralesional over 7 3.38 44.28 $149.67 96409 Chemo iv push sngl drug 3.13 44.28 $138.60 96411 Chemo iv push addl drug 1.76 44.28 $77.93 96413 Chemo iv infusion 1 hr 3.89 44.28 $172.25 96415 Chemo iv infusion addl hr 0.80 44.28 $35.42 96416 Chemo prolong infuse w/pump 3.93 44.28 $174.02 96417 Chemo iv infus each addl seq 1.84 44.28 $81.48 96420 Chemo ia push tecnique 3.00 44.28 $132.84 96422 Chemo ia infusion up to 1 hr 5.22 44.28 $231.14 96423 Chemo ia infuse each addl hr 2.12 44.28 $93.87 96425 Chemotherapy infusion method 5.17 44.28 $228.93 96440 Chemotherapy intracavitary 22.01 44.28 $974.60 96446 Chemotx admn prtl cavity 5.73 44.28 $253.72 96450 Chemotherapy into cns 5.13 44.28 $227.16 96521 Refill/maint portable pump 3.95 44.28 $174.91 96522 Refill/maint pump/resvr syst 3.22 44.28 $142.58 96523 Irrig drug delivery device 0.70 44.28 $31.00 96542 Chemotherapy injection 3.51 44.28 $155.42 96549 Chemotherapy unspecified 0.00 44.28 $0.00 96567 Photodynamic tx skin 3.82 44.28 $169.15 96570 Photodynmc tx 30 min add-on 1.63 44.28 $72.18 96571 Photodynamic tx addl 15 min 0.75 44.28 $33.21 96900 Ultraviolet light therapy 0.59 44.28 $26.13 96902 Trichogram 0.61 44.28 $27.01 96904 Whole body photography 1.77 44.28 $78.38 96910 Photochemotherapy with uv-b 2.01 44.28 $89.00 96912 Photochemotherapy with uv-a 2.58 44.28 $114.24 96913 Photochemotherapy uv-a or b 3.66 44.28 $162.06 96920 Laser tx skin < 250 sq cm 4.41 44.28 $195.27 96921 Laser tx skin 250-500 sq cm 4.86 44.28 $215.20 96922 Laser tx skin >500 sq cm 6.71 44.28 $297.12 96931 Rcm celulr subcelulr img skn 4.51 44.28 $199.70 96932 Rcm celulr subcelulr img skn 2.92 44.28 $129.30 96933 Rcm celulr subcelulr img skn 1.28 44.28 $56.68 96934 Rcm celulr subcelulr img skn 2.32 44.28 $102.73 96935 Rcm celulr subcelulr img skn 0.98 44.28 $43.39 96936 Rcm celulr subcelulr img skn 1.22 44.28 $54.02 96999 Dermatological procedure 0.00 44.28 $0.00 97010 Hot or cold packs therapy 0.17 44.28 $7.53 97012 Mechanical traction therapy 0.46 44.28 $20.37 97014 Electric stimulation therapy 0.45 44.28 $19.93 97016 Vasopneumatic device therapy 0.55 44.28 $24.35 97018 Paraffin bath therapy 0.31 44.28 $13.73 97022 Whirlpool therapy 0.67 44.28 $29.67 97024 Diathermy eg microwave 0.19 44.28 $8.41 97026 Infrared therapy 0.17 44.28 $7.53 97028 Ultraviolet therapy 0.21 44.28 $9.30 97032 Electrical stimulation 0.54 44.28 $23.91 97033 Electric current therapy 0.62 44.28 $27.45 97034 Contrast bath therapy 0.51 44.28 $22.58 97035 Ultrasound therapy 0.36 44.28 $15.94 97036 Hydrotherapy 0.93 44.28 $41.18 97039 Physical therapy treatment 0.00 44.28 $0.00 97110 Therapeutic exercises 0.92 44.28 $40.74 97112 Neuromuscular reeducation 0.96 44.28 $42.51 97113 Aquatic therapy/exercises 1.22 44.28 $54.02 97116 Gait training therapy 0.80 44.28 $35.42 97124 Massage therapy 0.74 44.28 $32.77 97139 Physical medicine procedure 0.00 44.28 $0.00 97140 Manual therapy 1/> regions 0.85 44.28 $37.64 97150 Group therapeutic procedures 0.49 44.28 $21.70 97161 Pt eval low complex 20 min 2.28 44.28 $100.96 97162 Pt eval mod complex 30 min 2.28 44.28 $100.96 97163 Pt eval high complex 45 min 2.28 44.28 $100.96 97164 Pt re-eval est plan care 1.55 44.28 $68.63 97165 Ot eval low complex 30 min 2.21 44.28 $97.86 97166 Ot eval mod complex 45 min 2.21 44.28 $97.86 97167 Ot eval high complex 60 min 2.21 44.28 $97.86 97168 Ot re-eval est plan care 1.46 44.28 $64.65 97169 Athletic trn eval low cmplx 0.00 44.28 $0.00 97170 Athletic trn eval mod cmplx 0.00 44.28 $0.00 97171 Athletic trn eval high cmplx 0.00 44.28 $0.00 97172 Athletic trn re-eval plan cr 0.00 44.28 $0.00 97530 Therapeutic activities 0.99 44.28 $43.84 97532 Cognitive skills development 0.75 44.28 $33.21 97533 Sensory integration 0.83 44.28 $36.75 97535 Self care mngment training 0.99 44.28 $43.84 97537 Community/work reintegration 0.86 44.28 $38.08 97542 Wheelchair mngment training 0.87 44.28 $38.52 97545 Work hardening 0.00 44.28 $0.00 97546 Work hardening add-on 0.00 44.28 $0.00 97597 Rmvl devital tis 20 cm/< 2.13 44.28 $94.32 97598 Rmvl devital tis addl 20cm/< 0.70 44.28 $31.00 97602 Wound(s) care non-selective 0.00 44.28 $0.00 97605 Neg press wound tx 50 cm 1.38 44.28 $61.11 97607 Neg press wnd tx 50 cm 0.00 44.28 $0.00 97610 Low frequency non-thermal us 3.39 44.28 $150.11 97750 Physical performance test 0.93 44.28 $41.18 97755 Assistive technology assess 1.01 44.28 $44.72 97760 Orthotic mgmt and training 1.08 44.28 $47.82 97761 Prosthetic training 0.94 44.28 $41.62 97762 C/o for orthotic/prosth use 1.36 44.28 $60.22 97799 Physical medicine procedure 0.00 44.28 $0.00 97802 Medical nutrition indiv in 0.98 44.28 $43.39 97803 Med nutrition indiv subseq 0.85 44.28 $37.64 97804 Medical nutrition group 0.45 44.28 $19.93 97810 Acupunct w/o stimul 15 min 1.03 44.28 $45.61 97811 Acupunct w/o stimul addl 15m 0.77 44.28 $34.10 97813 Acupunct w/stimul 15 min 1.10 44.28 $48.71 97814 Acupunct w/stimul addl 15m 0.87 44.28 $38.52 98925 Osteopath manj 1-2 regions 0.89 44.28 $39.41 98926 Osteopath manj 3-4 regions 1.29 44.28 $57.12 98927 Osteopath manj 5-6 regions 1.69 44.28 $74.83 98928 Osteopath manj 7-8 regions 2.06 44.28 $91.22 98929 Osteopath manj 9-10 regions 2.46 44.28 $108.93 98940 Chiropract manj 1-2 regions 0.80 44.28 $35.42 98941 Chiropract manj 3-4 regions 1.15 44.28 $50.92 98942 Chiropractic manj 5 regions 1.50 44.28 $66.42 98943 Chiropract manj xtrspinl 1/> 0.77 44.28 $34.10 98960 Self-mgmt educ & train 1 pt 0.79 44.28 $34.98 98961 Self-mgmt educ/train 2-4 pt 0.38 44.28 $16.83 98962 Self-mgmt educ/train 5-8 pt 0.28 44.28 $12.40 98966 Hc pro phone call 5-10 min 0.39 44.28 $17.27 98967 Hc pro phone call 11-20 min 0.76 44.28 $33.65 98968 Hc pro phone call 21-30 min 1.12 44.28 $49.59 98969 Online service by hc pro 0.00 44.28 $0.00 99000 Specimen handling office-lab 0.00 44.28 $0.00 99001 Specimen handling pt-lab 0.00 44.28 $0.00 99002 Device handling phys/qhp 0.00 44.28 $0.00 99024 Postop follow-up visit 0.00 44.28 $0.00 99026 In-hospital on call service 0.00 44.28 $0.00 99027 Out-of-hosp on call service 0.00 44.28 $0.00 99050 Medical services after hrs 0.00 44.28 $0.00 99051 Med serv eve/wkend/holiday 0.00 44.28 $0.00 99053 Med serv 10pm-8am 24 hr fac 0.00 44.28 $0.00 99056 Med service out of office 0.00 44.28 $0.00 99058 Office emergency care 0.00 44.28 $0.00 99060 Out of office emerg med serv 0.00 44.28 $0.00 99070 Special supplies phys/qhp 0.00 44.28 $0.00 99071 Patient education materials 0.00 44.28 $0.00 99075 Medical testimony 0.00 44.28 $0.00 99078 Group health education 0.00 44.28 $0.00 99080 Special reports or forms 0.00 44.28 $0.00 99082 Unusual physician travel 0.00 44.28 $0.00 99090 Computer data analysis 0.00 44.28 $0.00 99091 Collect/review data from pt 1.59 44.28 $70.41 99100 Special anesthesia service 0.00 44.28 $0.00 99116 Anesthesia with hypothermia 0.00 44.28 $0.00 99135 Special anesthesia procedure 0.00 44.28 $0.00 99140 Emergency anesthesia 0.00 44.28 $0.00 99151 Mod sed same phys/qhp <5 yrs 2.18 44.28 $96.53 99152 Mod sed same phys/qhp 5/>yrs 1.45 44.28 $64.21 99153 Mod sed same phys/qhp ea 0.31 44.28 $13.73 99155 Mod sed oth phys/qhp <5 yrs 2.63 44.28 $116.46 99156 Mod sed oth phys/qhp 5/>yrs 2.15 44.28 $95.20 99157 Mod sed other phys/qhp ea 1.63 44.28 $72.18 99170 Anogenital exam child w imag 4.67 44.28 $206.79 99172 Ocular function screen 0.00 44.28 $0.00 99173 Visual acuity screen 0.09 44.28 $3.99 99174 Ocular instrumnt screen bil 0.00 44.28 $0.00 99175 Induction of vomiting 0.45 44.28 $19.93 99177 Ocular instrumnt screen bil 0.00 44.28 $0.00 99183 Hyperbaric oxygen therapy 3.14 44.28 $139.04 99184 Hypothermia ill neonate 6.04 44.28 $267.45 99188 App topical fluoride varnish 0.00 44.28 $0.00 99190 Special pump services 0.00 44.28 $0.00 99191 Special pump services 0.00 44.28 $0.00 99192 Special pump services 0.00 44.28 $0.00 99195 Phlebotomy 2.83 44.28 $125.31 99199 Special service/proc/report 0.00 44.28 $0.00 99201 Office/outpatient visit new 1.24 44.28 $54.91 99202 Office/outpatient visit new 2.11 44.28 $93.43 99203 Office/outpatient visit new 3.05 44.28 $135.05 99204 Office/outpatient visit new 4.63 44.28 $205.02 99205 Office/outpatient visit new 5.83 44.28 $258.15 99211 Office/outpatient visit est 0.57 44.28 $25.24 99212 Office/outpatient visit est 1.23 44.28 $54.46 99213 Office/outpatient visit est 2.06 44.28 $91.22 99214 Office/outpatient visit est 3.03 44.28 $134.17 99215 Office/outpatient visit est 4.08 44.28 $180.66 99217 Observation care discharge 2.06 44.28 $91.22 99218 Initial observation care 2.82 44.28 $124.87 99219 Initial observation care 3.84 44.28 $170.04 99220 Initial observation care 5.25 44.28 $232.47 99221 Initial hospital care 2.87 44.28 $127.08 99222 Initial hospital care 3.87 44.28 $171.36 99223 Initial hospital care 5.73 44.28 $253.72 99224 Subsequent observation care 1.13 44.28 $50.04 99225 Subsequent observation care 2.06 44.28 $91.22 99226 Subsequent observation care 2.97 44.28 $131.51 99231 Subsequent hospital care 1.11 44.28 $49.15 99232 Subsequent hospital care 2.04 44.28 $90.33 99233 Subsequent hospital care 2.95 44.28 $130.63 99234 Observ/hosp same date 3.77 44.28 $166.94 99235 Observ/hosp same date 4.78 44.28 $211.66 99236 Observ/hosp same date 6.16 44.28 $272.76 99238 Hospital discharge day 2.05 44.28 $90.77 99239 Hospital discharge day 3.04 44.28 $134.61 99241 Office consultation 1.34 44.28 $59.34 99242 Office consultation 2.52 44.28 $111.59 99243 Office consultation 3.45 44.28 $152.77 99244 Office consultation 5.16 44.28 $228.48 99245 Office consultation 6.29 44.28 $278.52 99251 Inpatient consultation 1.38 44.28 $61.11 99252 Inpatient consultation 2.11 44.28 $93.43 99253 Inpatient consultation 3.24 44.28 $143.47 99254 Inpatient consultation 4.71 44.28 $208.56 99255 Inpatient consultation 5.68 44.28 $251.51 99281 Emergency dept visit 0.60 44.28 $26.57 99282 Emergency dept visit 1.17 44.28 $51.81 99283 Emergency dept visit 1.75 44.28 $77.49 99284 Emergency dept visit 3.32 44.28 $147.01 99285 Emergency dept visit 4.90 44.28 $216.97 99288 Direct advanced life support 0.00 44.28 $0.00 99291 Critical care first hour 7.75 44.28 $343.17 99292 Critical care addl 30 min 3.47 44.28 $153.65 99304 Nursing facility care init 2.58 44.28 $114.24 99305 Nursing facility care init 3.68 44.28 $162.95 99306 Nursing facility care init 4.71 44.28 $208.56 99307 Nursing fac care subseq 1.26 44.28 $55.79 99308 Nursing fac care subseq 1.95 44.28 $86.35 99309 Nursing fac care subseq 2.58 44.28 $114.24 99310 Nursing fac care subseq 3.84 44.28 $170.04 99315 Nursing fac discharge day 2.07 44.28 $91.66 99316 Nursing fac discharge day 2.99 44.28 $132.40 99318 Annual nursing fac assessmnt 2.72 44.28 $120.44 99324 Domicil/r-home visit new pat 1.56 44.28 $69.08 99325 Domicil/r-home visit new pat 2.27 44.28 $100.52 99326 Domicil/r-home visit new pat 3.94 44.28 $174.46 99327 Domicil/r-home visit new pat 5.25 44.28 $232.47 99328 Domicil/r-home visit new pat 6.15 44.28 $272.32 99334 Domicil/r-home visit est pat 1.70 44.28 $75.28 99335 Domicil/r-home visit est pat 2.68 44.28 $118.67 99336 Domicil/r-home visit est pat 3.81 44.28 $168.71 99337 Domicil/r-home visit est pat 5.45 44.28 $241.33 99339 Domicil/r-home care supervis 2.18 44.28 $96.53 99340 Domicil/r-home care supervis 3.06 44.28 $135.50 99341 Home visit new patient 1.55 44.28 $68.63 99342 Home visit new patient 2.24 44.28 $99.19 99343 Home visit new patient 3.68 44.28 $162.95 99344 Home visit new patient 5.16 44.28 $228.48 99345 Home visit new patient 6.25 44.28 $276.75 99347 Home visit est patient 1.56 44.28 $69.08 99348 Home visit est patient 2.38 44.28 $105.39 99349 Home visit est patient 3.63 44.28 $160.74 99350 Home visit est patient 5.03 44.28 $222.73 99354 Prolong e&m/psyctx serv o/p 3.66 44.28 $162.06 99355 Prolong e&m/psyctx serv o/p 2.76 44.28 $122.21 99356 Prolonged service inpatient 2.60 44.28 $115.13 99357 Prolonged service inpatient 2.60 44.28 $115.13 99358 Prolong service w/o contact 3.16 44.28 $139.92 99359 Prolong serv w/o contact add 1.52 44.28 $67.31 99360 Physician standby services 1.73 44.28 $76.60 99363 Anticoagulant mgmt initial 3.58 44.28 $158.52 99364 Anticoagulant mgmt subseq 1.22 44.28 $54.02 99366 Team conf w/pat by hc prof 1.21 44.28 $53.58 99367 Team conf w/o pat by phys 1.59 44.28 $70.41 99368 Team conf w/o pat by hc pro 1.04 44.28 $46.05 99374 Home health care supervision 1.98 44.28 $87.67 99375 Home health care supervision 2.95 44.28 $130.63 99377 Hospice care supervision 1.98 44.28 $87.67 99378 Hospice care supervision 2.95 44.28 $130.63 99379 Nursing fac care supervision 1.98 44.28 $87.67 99380 Nursing fac care supervision 2.95 44.28 $130.63 99381 Init pm e/m new pat infant 3.11 44.28 $137.71 99382 Init pm e/m new pat 1-4 yrs 3.25 44.28 $143.91 99383 Prev visit new age 5-11 3.39 44.28 $150.11 99384 Prev visit new age 12-17 3.81 44.28 $168.71 99385 Prev visit new age 18-39 3.69 44.28 $163.39 99386 Prev visit new age 40-64 4.29 44.28 $189.96 99387 Init pm e/m new pat 65+ yrs 4.65 44.28 $205.90 99391 Per pm reeval est pat infant 2.79 44.28 $123.54 99392 Prev visit est age 1-4 2.98 44.28 $131.95 99393 Prev visit est age 5-11 2.97 44.28 $131.51 99394 Prev visit est age 12-17 3.26 44.28 $144.35 99395 Prev visit est age 18-39 3.33 44.28 $147.45 99396 Prev visit est age 40-64 3.55 44.28 $157.19 99397 Per pm reeval est pat 65+ yr 3.82 44.28 $169.15 99401 Preventive counseling indiv 1.02 44.28 $45.17 99402 Preventive counseling indiv 1.74 44.28 $77.05 99403 Preventive counseling indiv 2.44 44.28 $108.04 99404 Preventive counseling indiv 3.14 44.28 $139.04 99406 Behav chng smoking 3-10 min 0.41 44.28 $18.15 99407 Behav chng smoking > 10 min 0.79 44.28 $34.98 99408 Audit/dast 15-30 min 0.99 44.28 $43.84 99409 Audit/dast over 30 min 1.93 44.28 $85.46 99411 Preventive counseling group 0.46 44.28 $20.37 99412 Preventive counseling group 0.60 44.28 $26.57 99415 Prolong clincl staff svc 0.25 44.28 $11.07 99416 Prolong clincl staff svc add 0.13 44.28 $5.76 99429 Unlisted preventive service 0.00 44.28 $0.00 99441 Phone e/m phys/qhp 5-10 min 0.39 44.28 $17.27 99442 Phone e/m phys/qhp 11-20 min 0.76 44.28 $33.65 99443 Phone e/m phys/qhp 21-30 min 1.12 44.28 $49.59 99444 Online e/m by phys/qhp 0.00 44.28 $0.00 99446 Interprof phone/online 5-10 0.00 44.28 $0.00 99447 Interprof phone/online 11-20 0.00 44.28 $0.00 99448 Interprof phone/online 21-30 0.00 44.28 $0.00 99449 Interprof phone/online 31/> 0.00 44.28 $0.00 99450 Basic life disability exam 0.00 44.28 $0.00 99455 Work related disability exam 0.00 44.28 $0.00 99456 Disability examination 0.00 44.28 $0.00 99460 Init nb em per day hosp 2.83 44.28 $125.31 99461 Init nb em per day non-fac 2.63 44.28 $116.46 99462 Sbsq nb em per day hosp 1.26 44.28 $55.79 99463 Same day nb discharge 3.38 44.28 $149.67 99464 Attendance at delivery 2.18 44.28 $96.53 99465 Nb resuscitation 4.32 44.28 $191.29 99466 Ped crit care transport 6.89 44.28 $305.09 99467 Ped crit care transport addl 3.46 44.28 $153.21 99468 Neonate crit care initial 28.10 44.28 $1,244.27 99469 Neonate crit care subsq 11.30 44.28 $500.36 99471 Ped critical care initial 24.44 44.28 $1,082.20 99472 Ped critical care subsq 11.66 44.28 $516.30 99475 Ped crit care age 2-5 init 16.31 44.28 $722.21 99476 Ped crit care age 2-5 subsq 9.74 44.28 $431.29 99477 Init day hosp neonate care 10.00 44.28 $442.80 99478 Ic lbw inf < 1500 gm subsq 3.97 44.28 $175.79 99479 Ic lbw inf 1500-2500 g subsq 3.53 44.28 $156.31 99480 Ic inf pbw 2501-5000 g subsq 3.41 44.28 $150.99 99485 Suprv interfacilty transport 2.17 44.28 $96.09 99486 Suprv interfac trnsport addl 1.88 44.28 $83.25 99487 Cmplx chron care w/o pt vsit 2.61 44.28 $115.57 99489 Cmplx chron care addl 30 min 1.31 44.28 $58.01 99490 Chron care mgmt srvc 20 min 1.19 44.28 $52.69 99495 Trans care mgmt 14 day disch 4.61 44.28 $204.13 99496 Trans care mgmt 7 day disch 6.52 44.28 $288.71 99497 Advncd care plan 30 min 2.31 44.28 $102.29 99498 Advncd care plan addl 30 min 2.02 44.28 $89.45 99499 Unlisted e&m service 0.00 44.28 $0.00 99500 Home visit prenatal 0.00 44.28 $0.00 99501 Home visit postnatal 0.00 44.28 $0.00 99502 Home visit nb care 0.00 44.28 $0.00 99503 Home visit resp therapy 0.00 44.28 $0.00 99504 Home visit mech ventilator 0.00 44.28 $0.00 99505 Home visit stoma care 0.00 44.28 $0.00 99506 Home visit im injection 0.00 44.28 $0.00 99507 Home visit cath maintain 0.00 44.28 $0.00 99509 Home visit day life activity 0.00 44.28 $0.00 99510 Home visit sing/m/fam couns 0.00 44.28 $0.00 99511 Home visit fecal/enema mgmt 0.00 44.28 $0.00 99512 Home visit for hemodialysis 0.00 44.28 $0.00 99600 Home visit nos 0.00 44.28 $0.00 99601 Home infusion/visit 2 hrs 0.00 44.28 $0.00 99602 Home infusion each addtl hr 0.00 44.28 $0.00 99605 Mtms by pharm np 15 min 0.00 44.28 $0.00 99606 Mtms by pharm est 15 min 0.00 44.28 $0.00 99607 Mtms by pharm addl 15 min 0.00 44.28 $0.00