Fee Item C O D E Fee Sch Ed U Le a M O U N T a N Aesth Esia in Ten Sity

44 43 42 41 40 39 34 31 30 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 Fee Item Code $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

25.41 21.04 28.00 52.73 39.75 77.43 34.96 39.21 21.74 36.38 54.65 24.51 46.93 23.32 25.14 13.20 19.84 12.45 Fee Schedule Amount

4.45 3.40 2.59 8.42 8.42 7.56 8.42

0 0 0 0 0 0 0 0 0 0 5 0 7 0 0 0 0 0 0 0 0 0 0 0 0 Anaesthesia Intensity level * * * * * * * * * * * * * * * * * * * * * * * * * Referral Flag Spec1 Spec2 Spec3 Spec4 Spec5 * * * * * * * * * * * * * * * * * * * * * * * * * Time Dependency INJECTION, INTRA-ARTICULAR INJECTION, INTRA-ARTICULAR INJECTION, INTRA-ARTERIAL MINI TRAY FEE ANTICOAGULATION THERAPY MILEAGE ULTRASOUND, TREATMENT GAVAGE STOMACH METHADONE TREATMENT ONLY INJECTION SUBCUTANEOUS SMALLPOX-VACCINATION SKIN TESTS-DIAGNOSTIC HYPERBARIC CHAMBER-OUTSIDE CHAMBER HYPERBARIC CHAMBER-OUTSIDE CHAMBER HYPERBARIC CHAMBER-IN CHAMBER HYPERBARIC CHAMBER-IN CHAMBER VEIN DISSECTIONFORI.V. THERAPY BLOOD TRANSFUSIONWITHVEINDISSECTION SERUM TRANSFUSION BLOOD TRANSFUSIONINHOSPITAL BLOOD TRANSFUSIONADMINISTEREDOUTSIDEHOSPITAL VENESECTION FORPOLYCYTHAEMIAORPHLEBOTOMY BLOOD TRANSFUSION,AUTOLOGOUSASCITICINFUSION INSERTION OFCENTRALVENOUSPRESSURECATHETER INJECTION, INTRATHECAL

Fee Item Description * * * * * * * * * * * * * * * * * * * * * * * * * Service Clarification Flag * * * * * * * * * * * * * * * * * * * * * * * * * Restriction Flag ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** ** BCMA Status Flag 45 $ 15.67 0 * * MANIPULATION THERAPY * * ** 46 $ 24.79 0 * * HYPERBARIC CHAMBER - ADDITIONAL CHARGE PER HOUR * * ** 50 $ 105.18 0 * * EYE BANK SERVICES * * ** 51 $ 368.41 0 * * CORNEAL TISSUE PROCESSING * * ** 62 $ 62.03 0 * * ADOPTION-EXAMINATION * * ** 64 $ 27.90 0 * * ADOPTION-SUBSEQUENT EXAM * * ** 65 $ 61.41 0 * * MENTAL ILL-HEALTH-INVESTIGATION * * ** 66 $ 27.60 0 * * MENTAL ILL-HEALTH-DOCUMENTATION * * ** 67 $ 27.52 0 * * MENTAL ILL-HEALTH - VOLUNTARY COMMITTAL * * ** 80 $ 8.89 0 * * MINOR TRAY * * ** 81 $ 88.02 0 * * EMERGENCY BEDSIDE CARE * * ** 82 $ 52.79 0 * * CRITICAL CARE MONITORING * * ** 83 $ 88.02 0 * * CRISIS INTERVENTION * * ** 84 $ 185.00 0 * * ACCOMPANYING PATIENTS * * ** 90 $ 26.68 0 * * MAJOR TRAY * * ** 94 $ 55.59 0 * 6 * YAG LASER TRAY SERVICE FEE * * ** 100 $ 27.90 0 * * VISIT IN OFFICE (AGE 2 - 59) * * ** 101 $ 62.03 0 * * COMPLETE EXAMINATION IN OFFICE (AGE 2-59) * * ** 103 $ 64.56 0 * * VISIT, HOME * * ** 104 $ 32.28 0 * * EXTRA PATIENTS SEEN DURING SAME HOUSE CALL * * ** 105 $ 51.25 0 * * ON CALL, ON SITE HOSPITAL VISIT - NIGHT * * ** 108 $ 31.31 0 * * VISIT, HOSPITAL * * ** 109 $ 74.23 0 * * FIRST HOSPITAL VISIT * * ** 110 $ 62.03 0 * * CONSULTATION (IN OR OUT OF OFFICE): AGE 2-59 * * ** 111 $ 104.09 0 * * VISIT, EMERGENCY HOME * * ** 112 $ 81.47 0 * * VISIT, EMERGENCY * * ** 113 $ 36.44 0 * * ON CALL, ON SITE HOSPITAL VISIT - EVENING * * ** 114 $ 21.74 0 * * VISIT NURSING HOME ONE OR MULTIPLE PATIENTS * * ** 115 $ 64.56 0 * * VISIT NURSING HOME ONE PATIENT SPECIAL DAY CALL * * ** 116 $ 136.37 0 * 0 * CONSULTATION, SPECIAL IN-HOSPITAL * * ** 117 $ 8.79 0 * * ECG INTERPRETATION ONLY G.P. * * ** 118 $ 80.23 0 * * CAESAREAN SECTION-ATTENDANCE * * ** 119 $ 61.41 0 * * NEWBORN CARE, ROUTINE, IN HOSPITAL * * ** 120 $ 48.57 0 * * INDIVIDUAL COUNSELLING IN OFFICE (AGE 2-59) * * ** 121 $ 79.40 0 * * GROUP COUNSELLING-FIRST FULL HOUR * * ** 122 $ 39.75 0 * * GROUP COUNSELLING-2ND HOUR/PER HALF OR MAJOR PART * * ** 123 $ 36.44 0 * * ON CALL, ON SITE HOSPITAL VISIT - SAT, SUN OR HOLS * * ** 127 $ 31.31 0 * * HOSPITAL VISIT FOR TERMINAL CARE * * ** 128 $ 26.51 0 * * SUPPORTIVE CARE * * ** 129 $ 67.19 0 * * WCB EMERGENCY CALL OUT * * ** 130 $ 22.27 0 * 30 * CHIROPRACTOR'S SERVICES - INITIAL OFFICE VISIT * * ** 133 $ 27.05 0 * 30 * CHIROPRACTOR'S SERVICE - HOME OR INSTITUTIONAL * * ** 136 $ 34.85 0 * 30 * CHIRO EMERG VISIT, NIGHT SUNDAY OR STAT. * * ** 137 $ 17.35 0 * 30 * CHIROPRACTOR'S SERVICE - SUBSEQUENT OFFICE * * ** 138 $ 23.00 0 * 30 * CHIROPRACTIC SERVICE * * ** 145 $ 23.00 0 * 31 * NATUROPATHY SERVICE * * ** 152 $ 36.87 0 * 38 * PODIATRISTS' SERVICE - SURGICAL CONSULTATION * * ** 155 $ 27.11 0 * 38 * PODIATRY NON REFERRED PRE-OPERATIVE ASSESSMENT * * ** 171 $ 36.87 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 172 $ 36.87 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 173 $ 49.02 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 174 $ 73.41 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 175 $ 61.18 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 176 $ 98.04 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 179 $ 98.04 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 180 $ 122.15 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 183 $ 98.04 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 186 $ 29.55 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 187 $ 85.96 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 188 $ 130.00 0 * 38 * NAILS - PERMANENT PARTIAL MATRIXECTOMY * * ** 189 $ 23.00 0 * 38 * PODIATRY SERVICE * * ** 190 $ 27.60 0 * 0 2 5 6 7 * ELECTROSURG./CRYOTHERAPY FOR REMOVAL OF WARTS ETC. * * ** 193 $ 24.70 0 * * NON-CVT CERT. SURGICAL ASSIST @ OPEN HEART SURGERY * * ** 194 $ 65.21 0 * * SURGICAL ASSIST LESS THAN $105.00 * * ** 195 $ 115.58 0 * * SURGICAL ASSIST.$105.00 TO 314.00 INCLUSIVE * * ** 196 $ 162.97 0 * * SURGICAL ASSIST $314.01 TO 523.00 INCLUSIVE * * ** 197 $ 213.40 0 * * SURGICAL ASSISTANCE - OPERATIONS OVER $523.00 * * ** 198 $ 24.41 0 * * SURGICAL ASSIST TIME AFTER 3 HRS - PER 15 MINS * * ** 204 $ 20.87 0 * 1 * DIRECTIVE CARE BY CONSULTANTS * * ** 205 $ 82.99 0 * 1 * VISIT, EMERGENCY, DERMATOLOGY * * ** 206 $ 125.64 0 * 1 * EXAMINATION SYSTEMIC DISEASES DERMATOLOGICAL * * ** 207 $ 21.89 0 * 1 * VISIT, OFFICE, DERMATOLOGY * * ** 208 $ 20.87 0 * 1 * VISIT, HOSPITAL, DERMATOLOGY * * ** 209 $ 41.58 0 * 1 * VISIT, HOME DERMATOLOGY * * ** 210 $ 52.95 0 * 1 * CONSULTATION, DERMATOLOGY * * ** 214 $ 36.15 0 * 1 * CONSULTATION, DERMATOLOGY - REPEAT/LIMITED * * ** 217 $ 10.29 0 * 1 * SKIN DISORDERS/LESIONS - SPECIAL THERAPY * * ** 218 $ 57.28 0 * * CURETTAGE AND ELECTROSURGERY OF SKIN CARCINOMA * * ** 219 $ 28.62 0 * * CURETTAGE SKIN CARCINOMA, ADDITIONAL LESION * * ** 222 $ 19.94 0 * * PSORALEN ULTRA VIOLET A TREATMENT - WHOLE BODY * * ** 223 $ 19.94 0 * * PSORALEN ULTRA VIOLET A TREATMENT - PARTIAL BODY * * ** 224 $ 19.94 0 * * ULTRA VIOLET B TREATMENT, WHOLE OR PARTIAL BODY * * ** 225 $ 341.56 0 * 1 * MOH'S TECHNIQUE-INITIAL CUT * * ** 226 $ 295.85 0 * 1 * MOH'S TECHNIQUE-ADDITIONAL CUTS * * ** 227 $ 318.49 0 * 1 * MOH'S TECHNIQUE-TECHNICAL COMPONENT * * ** 228 $ 27.88 0 * * PHOTO EPILATION OF FACIAL HAIR - PER 1/4 HR * * ** 235 $ 66.61 3 * * PULSED LASER- FACE/NECK: < 50CM2 * * ** 236 $ 99.91 3 * * PULSED LASER - FACE/NECK > 50CM2 OR EYE SHIELDS * * ** 237 $ 37.21 0 * * ADDITIONAL FEE FOR PULSED LASER - UNDER GA * * ** 240 $ 11.94 0 * 38 * BIOPSY SKIN - PODIATRY * * ** 242 $ 36.87 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 244 $ 207.77 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 245 $ 183.78 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 246 $ 133.05 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 247 $ 49.02 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 248 $ 18.38 0 * 38 * PODIATRISTS' SERVICE - SURGICAL SERVICE-PROCEDURES * * ** 251 $ 107.77 0 * 38 * PODIATRISTS' SERVICE - SPECIAL SURGICAL-PROCEDURES * * ** 252 $ 85.96 0 * 38 * PODIATRISTS' SERVICE - SPECIAL SURGICAL-PROCEDURES * * ** 253 $ 85.96 0 * 38 * SPECIAL SURGICAL AND OTHER PROCEDURES - * * ** 254 $ 85.96 0 * 38 * PODIATRISTS' SERVICE - REPAIR OF DEFORMITIES OF * * ** 255 $ 122.15 0 * 38 * PODIATRISTS' SERVICE - REPAIR OF DEFORMITIES OF * * ** 256 $ 183.78 0 * 38 * PODIATRISTS' SERVICE - REPAIR OF DEFORMITIES OF * * ** 257 $ 218.14 0 * 38 * PODIATRISTS' SERVICE - HALLUX VALGUS - SIMPLE * * ** 258 $ 244.86 0 * 38 * PODIATRISTS' SERVICE - HALLUX VALGUS - OSTEOTOMY * * ** 259 $ 124.88 0 * 38 * PODIATRISTS' SERVICE - HALLUX VALGUS -EXCISION OF * * ** 260 $ 85.96 0 * 38 * PODIATRISTS' SERVICE - HALLUX VALGUS - EXCISION * * ** 261 $ 92.71 0 * 38 * PODIATRISTS' SERVICE - HALLUX VALGUS - * * ** 262 $ 61.18 0 * 38 * PODIATRISTS' SERVICE - HALLUX VALGUS - EXOSTOSIS * * ** 269 $ 239.94 0 * 38 * PODIATRISTS' SERVICE - SURGICAL & OTHER PROCEDURES * * ** 270 $ 36.43 0 * 34 * OSTEOPATHY-FOR AN INITIAL OFFICE VISIT (AGE 0-69) * * ** 271 $ 28.60 0 * 34 * OSTEOPATHY - SUBSEQUENT OFFICE VISIT, MANIPULATION * * ** 272 $ 79.25 0 * 34 * OSTEOPATHIC CONSULTATION, IN OR OUT OF OFFICE * * ** 273 $ 43.58 0 * 34 * OSTEO-INITIAL OFFICE VISIT PATIENT AGE 70+ * * ** 274 $ 35.74 0 * 34 * OSTEO-SUBSEQUENT OFFICE VISIT PATIENT AGE 70+ * * ** 275 $ 95.15 0 * 34 * OSTEOPATHIC CONSULTATION (IN OR OUT) 70+ * * ** 276 $ 49.78 0 * 34 * PROLONGED VISIT/OR COUNSELING COMPLEX CASE 0-69 * * ** 277 $ 62.24 0 * 34 * PROLONGED VISIT AND/OR COUNSELING COMPLEX CASE 70+ * * ** 301 $ 217.85 0 * 24 * GERIATRIC ASSESSMENT * * ** 302 $ 59.62 0 * 24 * GERIATRIC REASSESSMENT * * ** 305 $ 93.00 0 * 15 * VISIT, EMERGENCY, INT. MED. * * ** 306 $ 38.19 0 * 15 * DIRECTIVE CARE, INTERNAL MEDICINE * * ** 307 $ 39.89 0 * 15 * VISIT, OFFICE, INT. MED. * * ** 308 $ 23.51 0 * 15 * VISIT, HOSPITAL, INT. MED. * * ** 309 $ 41.97 0 * 15 * VISIT, HOME, INT. MED. * * ** 310 $ 137.05 0 * 15 * CONSULTATION, INT. MED. * * ** 312 $ 65.80 0 * 15 * CONSULTATION, LIMITED, INT. MED. * * ** 313 $ 91.75 0 * 15 * GROUP COUNSELLING, INT. MED. * * ** 314 $ 44.80 0 * 15 * INTERNAL MEDICINE PROLONGED VISIT FOR COUNSELLING * * ** 315 $ 45.85 0 * 15 * GROUP COUNSELLING, INT. MED. * * ** 316 $ 24.05 0 * 15 * ECG AND INTERPRETATION OFFICE (INT. MED.) * * ** 317 $ 33.45 0 * 15 * ECG AND INTERPRETATION HOME (INT. MED) * * ** 318 $ 8.42 0 * 15 19 * ECG, INTERPRETATION ONLY, INT. MED. * * ** 319 $ 55.46 2 * * CENTRAL CATHETER INSERTION - TPN * * ** 322 $ 45.64 0 * 15 * CARDIOANGIOGRAM INTERNIST PART * * ** 323 $ 341.49 0 * * DIALYSIS PERITONEAL * * ** 325 $ 79.10 2 * * CARDIOVERSION * * ** 326 $ 45.36 0 * * PACEMAKER TESTING - SINGLE CHAMBER * * ** 328 $ 68.02 0 * * PACEMAKER TESTING - DUAL CHAMBER * * ** 330 $ 156.97 4 * * PACEMAKER TEMPORARY- EXTERNAL * * ** 331 $ 105.08 4 * * CHEST DRAINAGE - CLOSED * * ** 332 $ 79.10 4 * 15 19 * PACEMAKER, INTERNIST STANDBY * * ** 333 $ 258.25 4 * 8 15 19 * PACEMAKER, INTERNIST GENERATOR * * ** 334 $ 73.06 0 * 15 * GRADED EXERCISE TEST * * ** 335 $ 43.34 0 * 15 * GRADED EXERCISE TEST - PROFESSIONAL FEE * * ** 336 $ 29.72 0 * * GRADED EXERCISE TEST - TECHNICAL FEE * * ** 337 $ 282.31 0 * 15 * TRANSFUSION, REPLACEMENT HEPATIC FAILURE * * ** 338 $ 112.59 0 * 14 15 * PLASMAPHERESIS -THERAPEUTIC * * ** 343 $ 4.56 0 * * CARDIAC SCREENING * * ** 344 $ 2.28 0 * * CARDIAC SCREENING- PROFESSIONAL FEE * * ** 345 $ 2.28 0 * * CARDIAC SCREENING-TECHNICAL FEE * * ** 347 $ 64.86 0 * 14 15 19 * SCANNING OF 24 HR. E.C.G.-PROFESSIONAL FEE * * ** 348 $ 24.33 0 * * SCANNING OF 24 HR. E.C.G.- TECHNICAL FEE * * ** 349 $ 53.12 0 * * SCANNING OF 24 HR. E.C.G. - LEVEL 1 * * ** 350 $ 456.44 0 * * DIALYSIS ACUTE RENAL, HEMODIALYSIS * * ** 351 $ 171.53 0 * * DIALYSIS BLOOD, REPEAT * * ** 352 $ 115.39 0 * * DIALYSIS VEIN DISSECTION * * ** 353 $ 22.68 0 * * PACEMAKER TESTING - SINGLE CHAMBER * * ** 354 $ 45.36 0 * * PACEMAKER TESTING - DUAL CHAMBER * * ** 355 $ 341.49 0 * * DIALYSIS ACUTE RENAL FAILURE, PERITONEAL * * ** 356 $ 44.86 0 * * PERITONEAL DIALYSIS SUBSEQUENT * * ** 357 $ 86.33 3 * 15 16 19 * TRANS-ESOPHAGEAL ECHOCARDIOGRAPHY * * ** 358 $ 44.86 0 * * DIALYSIS CHRONIC RENAL (HEMODIALYSIS) * * ** 359 $ 44.86 0 * * DIALYSIS PERITONEAL * * ** 361 $ 54.23 0 * * DIALYSIS HOME SUPERVISION * * ** 362 $ 35.52 0 * * EVENT/UNMONITORED LOOP RECORDERS(FIRST STRIP) * * ** 363 $ 39.83 0 * 14 15 * SCANNING OF 24-HR. E.C.G. - LEVEL 2 * * ** 364 $ 26.63 0 * 14 15 * SCANNING OF 24-HR. E.C.G. - LEVEL 3 * * ** 365 $ 13.31 0 * 14 15 * SCANNING OF 24-HR. E.C.G. - LEVEL 4 * * ** 366 $ 761.24 4 * 15 19 * INTRACARDIAC ELECTROPHYSIOLOGICAL MAPPING * * ** 368 $ 113.80 4 * 15 19 * OESOPHAGEAL OR INTRA-ATRIAL ELECTROPHYSIOLOGICAL * * ** 369 $ 17.76 0 * * EVENT/UNMONITORED LOOP RECORDERS EACH ADDITIONAL * * ** 370 $ 55.76 3 * * OESOPHAGEAL DILATION - FIRST * * ** 371 $ 33.67 3 * * OESOPHAGEAL DILATION - REPEAT * * ** 373 $ 229.07 2 * * COLONOSCOPY - BIOPSY * * ** 374 $ 342.47 2 * * COLONOSCOPY - REMOVAL OF POLYP * * ** 381 $ 146.10 0 * * CANCER CHEMOTHERAPY, HIGH INTENSITY * * ** 382 $ 85.69 0 * * CANCER CHEMOTHERAPY-MAJOR * * ** 383 $ 48.97 0 * * CANCER CHEMOTHERAPY, LIMITED * * ** 385 $ 930.31 4 * 15 19 * CATHETER ABLATION - AV NODE * * ** 386 $ 1,422.82 4 * 15 19 * CATHETER ABLATION OF SVT * * ** 387 $ 1,532.27 4 * 15 19 * CATHETER ABLATION OF VT * * ** 388 $ 328.34 4 * 15 19 * REPEAT DIAGNOSTIC EP STUDY * * ** 389 $ 136.81 0 * 15 19 * CATHETER ABLATION - ASSISTANT'S FEE (PER HOUR) * * ** 390 $ 1,015.65 0 * 15 * CARE OF RENAL TRANSPLANT PATIENT * * ** 391 $ 141.42 0 * 15 16 19 * ECHOCARDIOGRAM - 2-D/ M-MODE * * ** 392 $ 42.68 0 * * EVENT/UNMONITORED LOOP RECORDER-TECH FEE * * ** 393 $ 159.28 3 * * PERCUTANEOUS ENDOSCOPICALLY PLACED FEEDING TUBE * * ** 394 $ 109.56 0 * * PEG PROCEDURE ASSISTANTS FEE * * ** 405 $ 79.14 0 * 2 * VISIT, EMERGENCY, NEUROLOGY * * ** 406 $ 36.61 0 * 2 * DIRECTIVE CARE, NEUROLOGY * * ** 407 $ 36.60 0 * 2 * VISIT, OFFICE, NEUROLOGY * * ** 408 $ 36.61 0 * 2 * VISIT, HOSPITAL, NEUROLOGY * * ** 409 $ 39.63 0 * 2 * VISIT, HOME, NEUROLOGY * * ** 410 $ 145.47 0 * 2 * CONSULTATION, NEUROLOGY * * ** 411 $ 73.21 0 * 2 * CONSULTATION, LIMITED, NEUROLOGY * * ** 413 $ 76.30 0 * * ELECTROENCEPHALOGRAM - TECHNICAL FEE * * ** 415 $ 112.67 0 * 2 * ELECTROENCEPHALOGRAM AND INTERPRETATION * * ** 416 $ 33.35 0 * 2 * ELECTROENCEPHALOGRAM INTERPRETATION NEUROLOGIST * * ** 417 $ 223.90 0 * 2 * ELECTROCORTICOGRAPHY * * ** 418 $ 21.95 0 * 2 6 * ACTIVATING AGENT BY ELECTRO ENCEPHALOGRAPHIC * * ** 419 $ 395.18 0 * 2 * ELECTROCLINICAL DETAILED INTERPRETATION OF SEIZURE * * ** 420 $ 203.49 0 * 2 * SHORT STUDY OF ELECTROCLINICAL INTERP. OF SEIZURES * * ** 421 $ 482.49 0 * 2 * ELECTROCORTICOGRAPHY IN AWAKE CRANIOTOMY * * ** 424 $ 114.83 0 * 2 6 7 * BOTULINUM TOXIN INJECTIONS * * ** 426 $ 149.39 0 * 2 * ELECTROENCEPHALOGRAM - SLEEP ONLY * * ** 427 $ 39.53 0 * 2 * ELECTROENCEPHALOGRAM - SLEEP ONLY - INTERPRETATION * * ** 428 $ 112.50 0 * 2 * ELECTROENCEPHALOGRAM - SLEEP ONLY - TECHNICAL FEE * * ** 505 $ 89.20 0 * 14 * VISIT, EMERGENCY, PAEDIATRICS * * ** 506 $ 38.23 0 * 14 * DIRECTIVE CARE, PAEDIATRICS * * ** 507 $ 48.86 0 * 14 * VISIT, OFFICE, PAEDIATRICS * * ** 508 $ 38.64 0 * 14 * VISIT, HOSPITAL, PAEDIATRICS * * ** 509 $ 56.61 0 * 14 * VISIT, HOME, PAEDIATRICS * * ** 510 $ 158.25 0 * 14 * CONSULTATION, PAEDIATRICS * * ** 511 $ 320.65 0 * 14 * CONSULTATION FOR COMPLEX CONDITION - CHILD * * ** 512 $ 76.75 0 * 14 * CONSULTATION, LIMITED, PAEDIATRICS * * ** 513 $ 93.08 0 * 14 * GROUP COUNSELLING- PAEDIATRICS * * ** 514 $ 59.36 0 * 14 * VISIT, PROLONGED, PAEDIATRICS COUNSELLING * * ** 515 $ 46.53 0 * 14 * GROUP COUNSELLING - PAEDIATRICS * * ** 523 $ 340.44 0 * * EXCHANGE TRANSFUSION - PROCEDURAL FEE * * ** 525 $ 71.04 0 * * INSERTION OF INTRA-ARTERIAL INFUSION LINE, INFANTS * * ** 526 $ 42.49 0 * * INSERTION OF INTRAVENOUS INFUSION LINE, UNDER 5 * * ** 527 $ 25.93 0 * 14 * ECG AND INTERPRETATION OFFICE (PAED.) * * ** 528 $ 36.05 0 * 14 * ECG AND INTERPRETATION HOME (PAED.) * * ** 529 $ 9.07 0 * 14 * ECG, INTERPRETATION ONLY, (PAED.) * * ** 530 $ 32.03 0 * 14 * GRADED EXERCISE TEST, PAED. - TECHNICAL FEE * * ** 531 $ 78.73 0 * 14 * GRADED EXERCISE TEST, PAED. - TOTAL FEE * * ** 532 $ 42.49 0 * 14 * ECG AND INTERPRETATION CHILDREN (UNDER 2 YEARS) * * ** 533 $ 9.97 0 * 14 * ECG - PROFESSIONAL FEE (UNDER 2 YEARS) * * ** 534 $ 32.52 0 * * ECG - TECHNICAL FEE (UNDER 2 YEARS) * * ** 535 $ 46.70 0 * 14 * GRADED EXERCISE TEST - PROFESSIONAL FEE * * ** 537 $ 117.81 0 * 14 * RECTAL MANOMETRY * * ** 538 $ 176.18 0 * 8 12 14 15 * ESOPHAGEAL MANOMETRY * * ** 539 $ 78.95 0 * 8 12 14 15 * RECTAL SUCTION BIOPSY * * ** 540 $ 182.27 0 * 8 12 14 15 * 24 HOUR INTRA-ESOPHAGEAL PH STUDY IN CHILDREN * * ** 545 $ 39.75 0 * 14 * PEDIATRIC CASE CONFERENCE * * ** 605 $ 123.60 0 * 3 * VISIT, EMERGENCY, PSYCHIATRY * * ** 607 $ 39.75 0 * 3 * VISIT, OFFICE, PSYCHIATRY * * ** 608 $ 46.62 0 * 3 * VISIT, HOSPITAL, PSYCHIATRY * * ** 609 $ 61.88 0 * 3 * VISIT, HOME, PSYCHIATRY * * ** 610 $ 185.95 0 * 3 * CONSULTATION, PSYCHIATRY * * ** 613 $ 256.46 0 * 3 * GERIATRIC CONSULTATION (AGE 75 YEARS OR OLDER) * * ** 614 $ 128.21 0 * 3 * REPEAT GERIATRIC CONSULTATION * * ** 615 $ 204.54 0 * 3 * HOSPITAL/INSTITUTION INPATIENT OR HOME VISIT * * ** 622 $ 320.65 0 * 3 * EMOTIONALLY DISTURBED CHILD - CONSULTATION * * ** 623 $ 320.65 0 * 3 * EMOTIONALLY DISTURBED FAMILY - CONSULTATION * * ** 624 $ 72.99 0 * 3 * EVALUATION INTERVIEW WITH FAMILY MEMBER * * ** 625 $ 93.91 0 * 3 * REPEAT CONSULTATION - PSYCHIATRY * * ** 626 $ 160.33 0 * 3 * EMOTIONALLY DISTURBED CHILD - REPEAT CONSULTATION * * ** 627 $ 160.33 0 * 3 * EMOTIONALLY DISTURBED FAMILY - REPEAT CONSULTATION * * ** 630 $ 79.46 0 * 3 * PSYCHOTHERAPY INDIV. (OFF.,OUT-PATIENT) PER 1/2 HR * * ** 631 $ 110.74 0 * 3 * PSYCHOTHERAPY INDIV. (OFF.,OUT-PATIENT) PER 3/4 HR * * ** 632 $ 141.81 0 * 3 * PSYCHOTHERAPY INDIV. (OFF.,OUT-PATIENT) PER HOUR * * ** 633 $ 84.68 0 * 3 * PSYCHOTHERAPY FAMILY PER 1/2 HR * * ** 635 $ 118.01 0 * 3 * PSYCHOTHERAPY FAMILY PER 3/4 HR * * ** 636 $ 151.19 0 * 3 * PSYCHOTHERAPY FAMILY PER HOUR * * ** 641 $ 70.66 0 * * ELECTROCONVULSIVE THERAPY * * ** 645 $ 39.75 0 * 3 * PATIENT MANGMNT CONFER. - 3RD PARTIES, PER 1/4 HR * * ** 650 $ 93.26 0 * 3 * PSYCHOTHERAPY INDIV.(HOSP OR INSTITUT) PER 1/2 HR * * ** 651 $ 129.98 0 * 3 * PSYCHOTHERAPY INDIV.(HOSP OR INSTITUT) PER 3/4 HR * * ** 652 $ 166.56 0 * 3 * PSYCHOTHERAPY INDIV.(HOSP OR INSTITUT) PER 1 HR * * ** 663 $ 27.09 0 * 3 * GROUP PSYCHOTHERAPY - THREE PATIENTS - PER PATIENT * * ** 664 $ 21.90 0 * 3 * GROUP PSYCHOTHERAPY - FOUR PATIENTS - PER PATIENT * * ** 665 $ 18.80 0 * 3 * GROUP PSYCHOTHERAPY - FIVE PATIENTS - PER PATIENT * * ** 666 $ 16.74 0 * 3 * GROUP PSYCHOTHERAPY - SIX PATIENTS - PER PATIENT * * ** 667 $ 15.26 0 * 3 * GROUP PSYCHOTHERAPY - SEVEN PATIENTS - PER PATIENT * * ** 668 $ 14.16 0 * 3 * GROUP PSYCHOTHERAPY - EIGHT PATIENTS - PER PATIENT * * ** 669 $ 13.29 0 * 3 * GROUP PSYCHOTHERAPY - NINE PATIENTS - PER PATIENT * * ** 670 $ 12.59 0 * 3 * GROUP PSYCHOTHERAPY - TEN PATIENTS - PER PATIENT * * ** 700 $ 77.71 4 * * BRONCHOSCOPY OR BRONCHOFIBROSCOPY * * ** 701 $ 36.63 5 * * DIRECT LARYNGOSCOPY * * ** 702 $ 124.46 4 * * BRONCHOSCOPY WITH BIOPSY * * ** 703 $ 124.74 2 * * CULDOSCOPY OR OPEN COLPOTOMY * * ** 704 $ 93.50 2 * * CYSTOSCOPY TO INCLUDE DILATION & PANENDOSCOPY * * ** 705 $ 98.33 2 * * CYSTOSCOPY WITH CATHETERIZATION OF URETERS * * ** 706 $ 104.85 3 * * OESOPHAGOSCOPY WITH BIOPSY * * ** 707 $ 86.33 3 * * OESOPHAGOGASTRODUODENOSCOPY * * ** 708 $ 84.45 3 * * GASTROSCOPY * * ** 709 $ 72.61 3 * * OESOPHAGOSCOPY * * ** 710 $ 154.52 4 * * MEDIASTINOSCOPY OR ANTERIOR MEDIASTINOTOMY * * ** 711 $ 26.40 3 * * GASTRIC BIOPSY * * ** 715 $ 35.32 2 * * SIGMOIDOSCOPY WITH BIOPSY * * ** 716 $ 58.47 2 * * SIGMOIDOSCOPY; FLEXIBLE; DIAGNOSTIC * * ** 717 $ 73.25 5 * * MICRO-LARYNGOSCOPY * * ** 718 $ 75.33 2 * * SIGMOIDOSCOPY, FLEXIBLE AND WITH BIOPSY * * ** 719 $ 136.87 7 * * THORACOSCOPY * * ** 721 $ 39.37 2 * * MYELOGRAM DIAGNOSTIC * * ** 722 $ 68.44 0 * * ARTERIOGRAPHY, OPERATIVE * * ** 723 $ 39.37 2 * * SIALOGRAM OR GALACTOGRAMS INJECTION * * ** 724 $ 34.89 2 * * AIR INSUFFLATION - PRESACRAL * * ** 727 $ 64.26 2 * * SALPINGOGRAM DIAGNOSTIC * * ** 728 $ 11.43 2 * * ORTHODIAGRAM DIAGNOSTIC * * ** 729 $ 10.90 0 * * CHEST FLUOROSCOPY BY INTERNIST OR PEADIATRICIAN * * ** 730 $ 24.46 4 * * CATHETERIZATION OF BRONCHI FOR BRONCHOGRAM * * ** 731 $ 75.33 3 * * DUODENAL BIOPSY * * ** 732 $ 17.56 2 * * CYSTO-URETHROGRAM, VOIDING * * ** 733 $ 56.20 2 * 0 1 2 5 6 * INTRA-OSSEOUS VENOGRAM * * ** 734 $ 116.61 0 * * LYMPHANGIOGRAPHY OR LYMPHOGRAPHY - SURGICAL * * ** 735 $ 24.78 0 * * LARYNGOGRAM * * ** 736 $ 65.45 4 * * BRONCHIAL BRUSHING - EXTRA TO BRONCHOSCOPY * * ** 738 $ 183.46 4 * * BILIARY CALCULI - REMOVAL BY BURHENNE TECHNIQUE * * ** 739 $ 79.83 2 * * PERCUTANEOUS LUNG OR MEDIASTINAL BIOPSY * * ** 740 $ 78.77 2 * * LIVER BIOPSY * * ** 741 $ 78.77 2 * * SPLENIC BIOPSY * * ** 742 $ 79.83 2 * * RENAL BIOPSY * * ** 743 $ 84.04 2 * * BREAST LESION, NON-PALPABLE LOCALIZING * * ** 744 $ 46.02 2 * * THYROID BIOPSY * * ** 745 $ 12.08 2 * * PERIPHERAL OR SUBCUTANEOUS LYMPH NODE BIOPSY * * ** 746 $ 86.81 4 * * REDUCTION OF INTUSSUSCEPTION USING HYDROSTATIC * * ** 747 $ 19.38 2 * * PROSTATE BIOPSY * * ** 748 $ 36.09 0 * * BONE BIOPSY, UNDER LOCAL/REGIONAL ANAESTHETIC * * ** 749 $ 46.02 2 * * PARIETAL PLEURAL INCLUDING THORACENTESIS * * ** 750 $ 25.14 2 * 0 1 2 5 6 * LUMBAR PUNCTURE * * ** 751 $ 43.58 3 * * PERICARDIAL PUNCTURE * * ** 752 $ 34.21 2 * * CISTERNAL PUNCTURE * * ** 753 $ 35.32 2 * * MARROW ASPIRATION * * ** 754 $ 23.32 2 * * TAP SUBDURAL - INFANT * * ** 755 $ 6.25 2 * * ARTERY PUNCTURE * * ** 757 $ 11.42 2 * * ASPIRATION OTHER JOINTS * * ** 759 $ 21.67 2 * * PARACENTESIS (THORACIC)OR TRANSTRACHIAL ASPIRATION * * ** 760 $ 23.04 2 * * PARACENTESIS ABDOMINAL * * ** 761 $ 13.92 2 * * BURSA OR CYST - PUNCTURE PROCEDURE * * ** 762 $ 1.03 0 * * SCRATCH TEST, PER ANTIGEN * * ** 763 $ 2.25 0 * * SCRATCH TEST - CHILDREN UNDER 5 YEARS * * ** 764 $ 2.08 0 * * INTRACUTANEOUS TEST, PER TEST * * ** 765 $ 33.37 0 * * ANNUAL MAXIMUM (SCRATCH OR INTRACUTANEOUS TESTS) * * ** 767 $ 1.28 0 * * PATCH TESTING, PER TEST (ANNUAL MAX - 45) * * ** 768 $ 4.93 0 * * PHOTOPATCH TEST, PER TEST * * ** 769 $ 49.33 0 * * PHOTOPATCH TEST, ANNUAL MAXIMUM * * ** 770 $ 25.08 2 * * PELVIC EXAMINATION UNDER GA * * ** 771 $ 19.69 3 * * RETINAL EXAMINATION UNDER ANAESTHESIA * * ** 774 $ 81.08 0 * * SECRETIN PANCREOZYMIN STIMULATION TEST * * ** 775 $ 30.79 0 * * HYDROTUBATION * * ** 776 $ 30.79 0 * * FETAL SCALP SAMPLING * * ** 780 $ 12.89 0 * * DIAGNOSTIC SCHIRMER TEST * * ** 782 $ 23.92 2 * * NEEDLE ASPIRATION OF POUCH OF DOUGLAS * * ** 783 $ 30.79 0 * * HUHNERS TEST * * ** 784 $ 12.01 2 * * CERVICAL PUNCH BIOPSY * * ** 785 $ 30.79 2 * * ENDOMETRIAL BIOPSY * * ** 786 $ 44.73 2 * * PELVIC EXAM WITH ASPIRATION POUCH OF DOUGLAS * * ** 787 $ 65.97 2 * * AMNIOCENTESIS, TRANSABDOMINAL * * ** 788 $ 68.05 0 * * OESOPHAGEAL, MOTILITY TEST - TECHNICAL FEE * * ** 789 $ 84.08 2 * * PERITONEAL LAVAGE * * ** 790 $ 11.45 0 * 0 5 * FOETAL HEART MONITORING - INTERPRETATION ONLY * * ** 792 $ 11.17 2 * * CYSTO-URETEROGRAM - TECHNICAL FEE * * ** 793 $ 5.58 0 * * CYSTO-URETEROGRAM - PROFESSIONAL FEE * * ** 794 $ 91.57 2 * * CHORIONIC VILLUS SAMPLING * * ** 797 $ 125.59 0 * * OESOPHAGEAL, MOTILITY TEST * * ** 798 $ 57.54 0 * * OESOPHAGEAL, MOTILITY TEST - PROFESSIONAL FEE * * ** 799 $ 155.07 2 * * TRANSURETHRAL URETERORENOSCOPY TO INCLUDE C&P * * ** 800 $ 275.00 2 * * TRANSURETHRAL URETERORENOSCOPY WITH X-RAY CONTROL * * ** 801 $ 21.67 0 * * INTRA-ARTERIAL CANNULATION * * ** 802 $ 38.77 2 * * URETHROGRAM * * ** 803 $ 48.71 0 * * LOOPOGRAM * * ** 804 $ 50.38 0 * * BERNSTEIN ACID PERFUSION TESTS * * ** 805 $ 45.58 0 * * TUTTLES PH PROBE * * ** 806 $ 70.64 0 * * BERNSTEIN ACID + TUTTLES PH TESTS * * ** 807 $ 89.18 2 * * DIAGNOSTIC HYSTEROSCOPY * * ** 808 $ 136.48 2 * * DIAGNOSTIC HYSTEROSCOPY WITH BIOPSY(S) * * ** 809 $ 210.93 3 * * RETROGRADE PANCREATOGRAPHY * * ** 810 $ 162.26 4 * * CATHETERIZATION RIGHT HEART * * ** 811 $ 45.58 2 * * JOINT INJECTION, ASPIRATION OR ARTHOGRAM * * ** 812 $ 54.45 4 * * ANGIOCARDIOGRAM SELECTIVE * * ** 813 $ 77.62 4 * * ERGONOVINE TESTING, CORONARY ARTERY SPASM * * ** 814 $ 54.45 4 * * DYE DILUTION STUDIES * * ** 815 $ 43.97 4 * * LAPAROSCOPIC BIOPSIES/LYSIS OF ADHESIONS * * ** 816 $ 28.40 2 * * HYDROGEN ION STUDY * * ** 817 $ 12.21 0 * * OESOPHAGEAL PH STUDY - TECHNICAL FEE * * ** 818 $ 40.04 0 * * OESOPHAGEAL PH STUDY - PROFESSIONAL FEE * * ** 819 $ 89.18 2 * * DIAGNOSTIC VAGINOSCOPY UNDER GA * * ** 820 $ 25.19 0 * * BERNSTEIN ACID PERFUSION TEST - PROFESSIONAL FEE * * ** 821 $ 25.19 0 * * BERNSTEIN ACID PERFUSION TESTS - TECHNICAL FEE * * ** 822 $ 22.79 0 * * TUTTLES PH PROBE - PROFESSIONAL FEE * * ** 823 $ 22.79 0 * * TUTTLES PH PROBE - TECHNICAL FEE * * ** 824 $ 35.32 0 * * TUTTLES PH + BERNSTEIN ACID TESTS-PROFESSIONAL FEE * * ** 825 $ 35.32 0 * * TUTTLES PH + BERNSTEIN ACID TESTS - TECHNICAL FEE * * ** 826 $ 74.81 2 * * BIOPSY OF PANCREAS - PERCUTANEOUS * * ** 827 $ 129.78 4 * * RETROGRADE LEFT HEART CATHETERIZATION - EXTRA * * ** 830 $ 174.88 4 * * TRANS-SEPTAL LEFT HEART CATHETERIZATION * * ** 835 $ 70.47 0 * * LEFT VENTRIC. AND FEM. ARTERY PUNCTURES-SPECIALIST * * ** 836 $ 75.75 4 * * LEFT VENTRIC. AND FEM. ARTERY PUNCTURES-SURGEON * * ** 839 $ 353.16 4 * * DIRECT INTRA-CORONARY STREPTOKINASE THROMBOLYSIS * * ** 840 $ 369.39 4 * * PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY * * ** 841 $ 194.74 4 * * DIRECT ANGIOGRAPHY CORONARY * * ** 842 $ 185.37 0 * * PERCUT. TRANSLUM. COR. ANGIOPL. - ADDITIONAL SITE * * ** 843 $ 89.91 2 * * SELECTIVE ARTERIOGRAPHY OF ABDOMINAL BRANCH * * ** 844 $ 49.44 3 * * BIOPSY OF SALIVARY GLAND, FINE OR CORE NEEDLE * * ** 845 $ 54.45 0 * * CARDIOLOGY ASSIST FOR FIRST HOUR OR FRACTION * * ** 846 $ 10.90 0 * * CARDIOLOGY ASSIST- AFTER ONE HOUR, FOR EACH 15 MIN * * ** 847 $ 145.77 2 * * SELECTIVE ARTERIOGRAPHY OF THORACIC AORTIC BRANCH * * ** 853 $ 21.61 2 * * VENACAVOGRAM - SUPERIOR * * ** 854 $ 103.53 2 * * VENACAVOGRAM - INFERIOR * * ** 855 $ 80.40 2 * * SELECTIVE CATHETERIZATION, VENA CAVA OR ILIAC -1ST * * ** 856 $ 53.47 2 * * SELECTIVE CATH. OF VENA CAVA OR ILIAC - OTHERS * * ** 857 $ 101.09 2 * * CHOLANGIOGRAM PERCUTANEOUS TRANSHEPATIC * * ** 859 $ 91.90 2 * * SPLENOPORTOGRAM - BY WHATEVER MEANS * * ** 866 $ 77.53 2 * * DYNAMIC CAVERNOSOMETRY AND CAVERNOSOGRAPHY * * ** 868 $ 246.39 2 * 16 * GASTROSTOMY/GASTROJEJUNOSTOMY - PERCUTANEOUS * * ** 869 $ 57.54 2 * * MANOMETRY - ANAL - ADULT * * ** 871 $ 54.45 0 * * PULSE TRACING - INTRAVASCULAR * * ** 874 $ 19.38 0 * * URETHRAL PROFILOMETRY (WATER OR GAS) * * ** 875 $ 31.02 0 * * UROFLOWIMETRY * * ** 876 $ 108.55 0 * * VIDEO URO-DYNAMICS (FULL STUDY) * * ** 877 $ 31.02 0 * * NOCTURNAL PENILE TUMESCENCE MONITORING * * ** 878 $ 46.52 0 * * CYSTOMETRY/PELVIC FLOOR EMG * * ** 880 $ 58.64 0 * * PORTAL PRESSURES - HEPATIC VEIN WEDGE PRESSURE * * ** 881 $ 46.93 2 * * PORTAL PRESSURES - PERCUTANEOUS, SPLENIC * * ** 882 $ 20.93 0 * * PORTAL PRESSURES - SPLENOPORTOGRAM * * ** 885 $ 41.87 2 * * DIGITAL ANGIOGRAPHY - PERIPHERAL INJECTION * * ** 886 $ 82.82 2 * * DIGITAL ANGIOGRAPHY - CENTRAL INJECTION * * ** 888 $ 251.48 3 * * VENTRICULOGRAM, WITH NO VENTRICULAR ACCESS DEVICE * * ** 889 $ 125.75 3 * * VENTRICULOGRAM THROUGH PREVIOUS VENTRICULAR ACCESS * * ** 890 $ 103.53 2 * * AORTOGRAM ABDOMINAL * * ** 891 $ 153.83 3 * * ARTERIOGRAM - CAROTID PERCUTANEOUS; BILATERAL * * ** 892 $ 102.30 3 * * ARTERIOGRAM - CAROTID PERCUTANEOUS, UNILATERAL * * ** 893 $ 79.20 2 * * ARTERIOGRAM - FEMORAL OR AXILLARY * * ** 894 $ 172.47 3 * * ARTERIOGRAM - CEREBRAL * * ** 896 $ 125.67 3 * * ARTERIOGRAPHY PULMONARY * * ** 897 $ 148.82 2 * * AORTOGRAM THORACIC * * ** 898 $ 251.39 7 * * BALLOON SEPTOSTOMY * * ** 900 $ 117.75 0 * * ELECTRODIAGNOSIS, EXTENSIVE EXAMINATION (SCHED. A) * * ** 901 $ 78.75 0 * * ELECTRODIAGNOSIS, LIMITED EXAMINATION (SCHED. B) * * ** 902 $ 39.25 0 * * ELECTRODIAGNOSIS, SHORT EXAMINATION (SCHED C) * * ** 905 $ 6.19 0 * * FACIAL PALSY, NERVE CONDUCTION * * ** 906 $ 43.09 0 * * NERVE CONDUCTION, FACIAL PALSY, MAXIMUM * * ** 907 $ 32.13 3 * * ENDOSCOPIC EXAM OF NOSE AND NASOPHARYNX * * ** 908 $ 51.40 3 * * ENDOSCOPIC EXAM AND BIOPSY OF SINUS * * ** 909 $ 37.96 3 * 7 * FLEXIBLE FIBEROPTIC NASOPHARYNGOLARYNGOSCOPY * * ** 910 $ 27.36 0 * * OVERNIGHT HOME OXIMETRY - PROFESSIONAL FEE * * ** 911 $ 15.32 0 * * OVERNIGHT HOME OXIMETRY - TECHNICAL FEE * * ** 914 $ 42.56 0 * * INSERTION OF SPHENOIDAL ELECTRODES, EEG RECORDING * * ** 915 $ 95.62 2 * * SODIUM AMYTAL, INTRA-CAROTID INJECTION * * ** 919 $ 6.22 0 * * IMPEDANCE PLETHYSMOGRAPHY - PROFESSIONAL FEE * * ** 920 $ 31.19 0 * * IMPEDANCE PLETHYSMOGRAPHY - TECHNICAL FEE * * ** 921 $ 360.90 3 * * VARICOCELE +/OR UTERINE ARTERY EMBOLIZATION UNILAT * * ** 922 $ 51.72 0 * * ELECTOR DIAGNOSTIC COMPONENT OF DECAMETHONIUM TEST * * ** 923 $ 19.90 0 * * TECHNICAL FEE FOR ELECTRODIAGNOSTIC TESTING * * ** 925 $ 501.79 3 * * VARICOCELE AND/OR UTERINE ARTERY EMBOLIZATION * * ** 926 $ 144.27 2 * * SEIZURE ACTIVATION WITH AGENT - INSERT. ELECTRODES * * ** 927 $ 33.67 0 * * DECAMETHONIUM TEST - DIAGNOSTIC * * ** 928 $ 12.52 0 * * SIMPLE SCREENING SPIROMETRY WITHOUT BRONCHODILATOR * * ** 929 $ 18.54 0 * * SPIROMETRY-BEFORE AND AFTER BRONCHODILATORS * * ** 930 $ 5.44 0 * * PEAK EXPIRATORY FLOW RATE * * ** 931 $ 13.90 0 * * LUNG VOLUMES - PROFESSIONAL FEE * * ** 932 $ 13.90 0 * * LUNG VOLUMES - TECHNICAL FEE * * ** 933 $ 10.90 0 * * SPIROMETRY, FORCED EXPIRATORY, W/O BRONCH. - PROF * * ** 934 $ 10.90 0 * * SPIROMETRY, FORCED EXPIRATORY, W/O BRONCH - TECH * * ** 935 $ 12.52 0 * * SPIROMETRY,FORCED EXPIRATORY,BEFORE AND AFTER-PROF * * ** 936 $ 13.90 0 * * SPIROMETRY,FORCED EXPIRATORY,BEFORE AND AFTER-TECH * * ** 937 $ 10.90 0 * * FLOW VOLUME LOGS, W/O BRONCHODILATORS - PROF FEE * * ** 938 $ 17.85 0 * * FLOW VOLUME LOOPS - W/O BRONCHODILATORS - TECH FEE * * ** 940 $ 13.90 0 * * FLOW VOLUME LOGS - BEFORE AND AFTER BRONCH - PROF * * ** 941 $ 26.40 0 * * SPIROMETRY-FLOW VOLUME LOOPS-BEFORE & AFTER BRONCH * * ** 942 $ 14.82 0 * * DIFFUSION STUDIES - CARBON MONOXIDE/PROFESSIONAL * * ** 943 $ 12.62 0 * * DIFFUSION STUDIES WITH CARBON MONOXIDE - TECHNICAL * * ** 944 $ 284.56 0 * 15 19 * TILT TABLE TESTING - TOTAL FEE * * ** 945 $ 41.24 0 * * PULMONARY FUNCTION STUDIES - DETAILED/PROFESSIONAL * * ** 946 $ 39.51 0 * * PULMONARY FUNCTION STUDIES - DETAILED - TECHNICAL * * ** 947 $ 175.12 0 * 15 19 * TILT TABLE TESTING - PROFESSIONAL FEE * * ** 948 $ 109.45 0 * 15 19 * TILT TABLE TESTING - TECHNICAL FEE * * ** 950 $ 21.67 0 * * PROGRESSIVE EXERCISE TEST - PROFESSIONAL FEE * * ** 951 $ 31.97 0 * * PROGRESSIVE EXERCISE TEST - TECHNICAL FEE * * ** 952 $ 26.45 0 * * VENTILATION AT REST/EXERCISE WITH BLOOD GAS -PROF * * ** 953 $ 42.74 0 * * VENTILATION AT REST/EXERCISE WITH BLOOD GAS - TECH * * ** 954 $ 45.09 0 * * EXERCISE IN A STEADY STATE - PROFESSIONAL FEE * * ** 955 $ 45.09 0 * * EXERCISE IN A STEADY STATE - TECHNICAL FEE * * ** 956 $ 53.68 0 * * EXERCISE IN A STEADY STATE, AA GRADIENTS - PROF * * ** 957 $ 53.68 0 * * EXERCISE IN A STEADY STATE, AA GRADIENTS - TECH * * ** 958 $ 21.67 0 * * EXERCISE INDUCED ASTHMA - PROFESSIONAL FEE * * ** 959 $ 31.97 0 * * EXERCISE INDUCED ASTHMA - TECHNICAL FEE * * ** 960 $ 4.62 0 * * EAR OXIMETRY - PROFESSIONAL FEE * * ** 961 $ 15.64 0 * * EAR OXIMETRY - TECHNICAL FEE * * ** 962 $ 3.13 0 * * EXPIRED GAS ANALYSIS - PROFESSIONAL FEE * * ** 963 $ 15.64 0 * * EXPIRED GAS ANALYSIS - TECHNICAL FEE * * ** 964 $ 13.21 0 * * PLETHSYSOMOGRAPHY AND AIRWAY RESISTANCE - PROF * * ** 965 $ 26.40 0 * * PLETHSYSOMOGRAPHY AND AIRWAY RESISTANCE - TECH * * ** 966 $ 45.09 0 * * LUNG COMPLIANCE WITH PRESSURE VOLUME - PROF * * ** 967 $ 35.71 0 * * LUNG COMPLIANCE WITH PRESSURE VOLUME - TECH * * ** 968 $ 35.71 0 * * INHALATION CHALLENGE - PROFESSIONAL FEE * * ** 969 $ 35.71 0 * * INHALATION CHALLENGE - TECHNICAL FEE * * ** 970 $ 10.90 0 * * PRECIPITIN TESTS - PROFESSIONAL FEE * * ** 971 $ 26.40 0 * * PRECIPITIN TESTS - TECHNICAL FEE * * ** 972 $ 17.85 0 * * CO2/O2 RESPONSIVENESS OF RESP. CENTRES - PROF * * ** 973 $ 10.90 0 * * CO2/O2 RESPONSIVENESS OF RESP. CENTRES - TECH * * ** 974 $ 12.02 0 * * INSPIRATORY & EXPIRATORY MUSCLE STRENGTH - PROF * * ** 975 $ 12.48 0 * * INSPIRATORY & EXPIRATORY MUSCLE STRENGTH - TECH * * ** 976 $ 98.20 3 * * RADIOLOGICAL OESOPHAGEAL DILATATION * * ** 977 $ 94.58 2 * * ANTEGRADE PYELOGRAM * * ** 978 $ 268.13 2 * * PERCUTANEOUS NEPHROSTOMY, PROCEDURAL FEE * * ** 979 $ 357.43 2 * * PERCUTANEOUS NEPHROSTOMY, WITH DILATATION * * ** 980 $ 378.78 3 * * TRANSHEPATIC BILIARY DRAINAGE, RADIOLOGICAL * * ** 981 $ 378.78 3 * * EMBOLIZATION, THERAPEUTIC RADIOLOGICAL * * ** 982 $ 361.07 2 * * ANGIOPLASTY, PERCUTANEOUS TRANSLUMINAL * * ** 983 $ 246.61 2 * * PERCUTANEOUS ABDOMINAL ABSCESS DRAINAGE * * ** 984 $ 112.97 2 * * EXCHANGE OF PREVIOUSLY INSERTED CATH. OR DILATOR * * ** 985 $ 47.48 0 * * BRAINSTEM AUDITORY EVOKED RESPONSE * * ** 986 $ 36.17 0 * * SOMATOSENSORY EVOKED RESPONSE - UPPER EXTREMITY * * ** 987 $ 62.55 0 * * SOMATOSENSORY EVOKED RESPONSE - UPPER AND LOWER * * ** 988 $ 70.50 0 * * VISUAL EVOKED RESPONSE * * ** 989 $ 121.67 4 * * EXTRA-CORPOREAL SHOCK WAVE LITHOTRIPSY * * ** 994 $ 148.79 4 * * EXTRA-CORP. SHOCK WAVE BILIARY LITHOTRIPSY * * ** 995 $ 1,868.30 3 * * EMBOLIZATION OF BRAIN AND SPINAL CORD AVM'S * * ** 997 $ 1,168.24 3 * * DETACHABLE BALLOON EMBOLIZATION * * ** 998 $ 1,440.79 3 * * EMBOLIZATION OF HEAD, NECK AND SPINAL VASCULAR * * ** 1005 $ 33.19 0 * * ANAESTHESIA FOR MRI OR CT SCAN - PER 15 MINUTES * * ** 1007 $ 72.76 0 * * CATHETER INSERTION INTRAPLEURAL FOR PAIN MGMT * * ** 1011 $ 18.98 0 * * PATIENT CONTROLLED ANALGESIA (PCA)-FIRST DAY * * ** 1012 $ 18.98 0 * * PATIENT CONTROLLED ANALGESIA-SUPERVISION * * ** 1013 $ 56.77 0 * 18 * PAIN MANAGEMENT-CONSULTATION, FOR POST OP PAIN * * ** 1015 $ 85.17 0 * 18 * CONSULTATION , ANAESTHESIA: * * ** 1016 $ 175.70 0 * 18 * CONSULTATION, MGMT OF COMPLICATED CHRONIC PAIN * * ** 1019 $ 37.80 0 * * INTERPLEURAL INDWELLING CATHETER REPEAT INJECTIONS * * ** 1021 $ 22.72 0 * * INTRAPLEURAL INFUSION- SUPERVISION * * ** 1022 $ 117.99 0 * * NERVE PLEXUS * * ** 1025 $ 109.12 0 * * EPIDURAL CATHETER INSERTION-LUMBAR OR CAUDAL * * ** 1026 $ 141.86 0 * * EPIDURAL CATHETER INSERTION-THORACIC PAIN MGMT * * ** 1032 $ 139.36 0 * * SUBARACHNOID (SPINAL) BLOCK SUBDURAL (SPINAL) * * ** 1034 $ 185.82 0 * * SUBARACHNOID (SPINAL) BLOCK DIFFERENTIAL SPINAL * * ** 1035 $ 221.59 0 * * GASSERIAN GANGLION * * ** 1036 $ 198.59 0 * * EPIDURAL BLOCKS: THORACIC * * ** 1037 $ 229.15 0 * * EPIDURAL BLOCKS: CERVICAL * * ** 1040 $ 102.69 0 * * SYMPATHETIC NERVE STELLATE GANGLION - BLOCK * * ** 1042 $ 168.83 0 * * PARAVERTEBRAL (LUMBAR SYMPATHETIC) NERVE BLOCK * * ** 1044 $ 235.00 0 * * SYMPATHETIC NERVE (COELIAC PLEXUS) BLOCK * * ** 1050 $ 37.80 0 * * EPIDURAL INDWELLING CATHETER REPEAT INJECTION - 4 * * ** 1059 $ 26.62 0 * * PRONE POSITION * * ** 1065 $ 35.46 0 * * PATIENTS < ONE YEAR - ANAESTHETIC MODIFIER * * ** 1070 $ 53.23 0 * * HYPOTENSION - CONTROLLED IN NEUROSURGICAL ANAESTH * * ** 1071 $ 47.28 0 * * EPIDURAL CATHETER-THORACIC INSERTION DURING GA * * ** 1072 $ 36.37 0 * * EPIDURAL CATHETER-LUMBAR INSERTION DURING GA * * ** 1073 $ 22.72 0 * * EPIDURAL INFUSION - SUPERVISION * * ** 1074 $ 63.17 0 * * CATHETER INSERTION-AXILLARY FOR PAIN MGMT * * ** 1075 $ 37.80 0 * * AXILLARY INDWELLING CATHETER - REPEAT INJECTION * * ** 1076 $ 22.72 0 * * AXILLARY INDWELLING CATHETER - SUPERVISION * * ** 1077 $ 48.44 0 * * PULMONARY ARTERY CATHETERIZATION * * ** 1080 $ 523.50 0 * * CARDIAC/EMERGENCY/CHRONIC/> 8HRS-ADDITIONAL 10% * * ** 1082 $ 21.12 0 * * CATHETER AXILLARY-INSERTION DURING GA * * ** 1084 $ 24.31 0 * * CATHETER INSERTION-INTRAPLEURAL, DURING GA * * ** 1088 $ 50.75 0 * * RESUSCITATION BY ANAESTHETIST - PER 15 MINS. * * ** 1090 $ 50.75 0 * * NEONATAL RESUSCITATION BY ANAESTHETIST-PER 15 MIN * * ** 1091 $ 115.34 0 * * INTUBATION REQUESTED BY ATTENDING PHYSICIAN * * ** 1093 $ 35.50 0 * * SPINAL CORD MONITORING-INTERP OF SSEP DURING GA * * ** 1094 $ 145.50 0 * * CATHETER PLACEMENT-PULMONARY ARTERY NOT ASSOC W AN * * ** 1095 $ 30.00 0 * * CATHETER PLACEMENT-INTRA-ARTERIAL- ISOLATED PROC * * ** 1096 $ 29.66 0 * * RETROBULBAR/PERIBULBAR BLOCK WITH ANAESTHETIC * * ** 1102 $ 113.92 0 * * CATHETER INSERTION - EPIDURAL - DURING LABOUR. * * ** 1103 $ 37.80 0 * * REPEAT INJECTION-EPIDURAL CATHETER DURING LABOUR * * ** 1104 $ 22.72 0 * * EPIDURAL INFUSIONS DURING LABOUR - SUPERVISION * * ** 1105 $ 2.00 0 * * ANESTHESIA FOR CATARACT SURGERY-PER 1 MIN * * ** 1106 $ 30.00 0 * * ELECTROCONVULSIVE THERAPY (ECT) - ANAESTHESIA * * ** 1107 $ 49.42 0 * 18 * OFFICE VISIT - ANAESTHESIA * * ** 1108 $ 41.19 0 * 18 * HOSPITAL VISIT - ANAESTHESIA * * ** 1110 $ 31.59 0 * * DENTAL PROCEDURES - ANAESTHESIA-PER 15 MIN * * ** 1111 $ 44.36 0 * * ACUTE UPPER AIRWAY OBSTRUCTION - EMERGENCY ANAES. * * ** 1112 $ 28.39 0 * * ATTENDANCE FOR ANAES. OR NEONATAL RESUSCITATION * * ** 1115 $ 56.77 0 * 18 * CONSULTATION -REPEAT/ LIMITED- ANAESTHESIA * * ** 1116 $ 87.83 0 * 18 * CONSULTATION-REPEAT OR LTD -DIAGNOSTIC/PAIN MGMT * * ** 1124 $ 55.89 0 * * PERIPHERAL NERVE BLOCK - SINGLE * * ** 1125 $ 84.46 0 * * PERIPHERAL NERVE BLOCK - MULTIPLE * * ** 1135 $ 130.94 0 * * EPIDURAL BLOCK: LUMBAR * * ** 1138 $ 130.94 0 * * EPIDURAL BLOCK: CAUDAL * * ** 1140 $ 159.49 0 * * NERVE ROOT/ FACET BLOCK: CERVICAL SINGLE * * ** 1141 $ 212.65 0 * * NERVE ROOT/FACET BLOCK: CERVICAL MULTIPLE * * ** 1142 $ 146.06 0 * * NERVE ROOT/FACET BLOCK: THORACIC SINGLE * * ** 1143 $ 194.75 0 * * NERVE ROOT/FACET BLOCK: THORACIC MULTIPLE * * ** 1144 $ 132.65 0 * * NERVE ROOT/FACET BLOCK: LUMBAR SINGLE * * ** 1145 $ 176.88 0 * * NERVE ROOT/FACET BLOCK: LUMBAR MULTIPLE * * ** 1146 $ 307.29 0 * * CRYOSECTION/NEUROLYSIS: MAJOR PLEXUS/NERVE ROOT * * ** 1147 $ 145.33 0 * * CRYOSECTION/NEUROLYSIS: SINGLE PERIPHERAL NERVE * * ** 1148 $ 194.75 0 * * CRYOSECTION/NEUROLYSIS:MULTIPLE PERIPHERAL NERVES * * ** 1149 $ 345.79 0 * * EPIDURAL OR SUBARACHNOID NEUROLYSIS * * ** 1150 $ 345.79 0 * * GASSERIAN GANGLION NEUROLYSIS * * ** 1151 $ 26.62 0 * 18 * PRE-ANAESTHETIC EVALUATION - STANDARD * * ** 1156 $ 52.92 0 * * TRIGGER POINT INJECTION: - SINGLE * * ** 1157 $ 66.35 0 * * TRIGGER POINT INJECTIONS: - MULTIPLE * * ** 1158 $ 109.12 0 * * TRIGGER POINT INJECTIONS: - EPIDURAL BLOOD PATCH * * ** 1159 $ 52.92 0 * * IV INJCTN FOR DIAGNSS/THERPTC MANG OF PAIN - LOCAL * * ** 1160 $ 105.84 0 * * IV INJCT FOR DIAGNS/THERP MANG OF PAIN - GUANETHID * * ** 1164 $ 17.74 0 * * PATIENTS 70-79 YEARS OF AGE - ANAESTHESIA * * ** 1165 $ 24.96 0 * * PATIENTS 80 YEARS OF AGE AND OVER-ANAESTHESIA * * ** 1166 $ 53.23 0 * * SITTING POSITION - ANAESTHESIA * * ** 1168 $ 70.93 0 * * NEONATES-ANAESTHESIA:< 42 GEST WKS AND/OR 4000 GR * * ** 1172 $ 30.00 2 * * ANAES. INTENSITY/COMPLEXITY LEVEL 2 - PER 15 MINS * * ** 1173 $ 31.59 3 * * ANAES. INTENSITY/COMPLEXITY LEVEL 3 - PER 15 MINS * * ** 1174 $ 33.19 4 * * ANAES. INTENSITY/COMPLEXITY LEVEL 4 - PER 15 MINS * * ** 1175 $ 34.78 5 * * ANAES. INTENSITY/COMPLEXITY LEVEL 5 - PER 15 MINS * * ** 1176 $ 36.37 6 * * ANAES. INTENSITY/COMPLEXITY LEVEL 6 - PER 15 MINS * * ** 1177 $ 37.96 7 * * ANAES. INTENSITY/COMPLEXITY LEVEL 7 - PER 15 MINS * * ** 1178 $ 39.55 8 * * ANAES. INTENSITY/COMPLEXITY LEVEL 8 - PER 15 MINS * * ** 1179 $ 41.16 9 * * ANAES. INTENSITY/COMPLEXITY LEVEL 9 - PER 15 MINS * * ** 1180 $ 42.76 10 * * ANAES. INTENSITY/COMPLEXITY LEVEL 10 - PER 15 MINS * * ** 1181 $ 44.36 11 * * ANAES. INTENSITY/COMPLEXITY LEVEL 11 - PER 15 MINS * * ** 1186 $ 39.92 0 * * MAJOR PERIPHERAL NERVE BLOCK - SINGLE * * ** 1187 $ 60.33 0 * * MAJOR PERIPHERAL NERVE BLOCK - MULTIPLE * * ** 1192 $ 53.23 0 * * AWAKE INTUBATION, ANY MEANS, FOR DIFFICULT AIRWAY * * ** 1200 $ 47.84 0 * * CALL-OUT CHARGE - EVENING * * ** 1201 $ 67.19 0 * * CALL-OUT CHARGE - NIGHT * * ** 1202 $ 47.84 0 * * CALL-OUT CHARGE/SATURDAY, SUNDAY, OR STAT HOLIDAY * * ** 1205 $ 39.95 0 * * SURCHARGE - NONOPERATIVE - EVENING * * ** 1206 $ 60.14 0 * * SURCHARGE - NONOPERATIVE - NIGHT * * ** 1207 $ 43.98 0 * * SURCHARGE - NONOPERATIVE/WEEKEND AND STAT/HOLIDAY * * ** 1210 $ 296.86 0 * * SURCHARGE - OPERATIVE - EVENING * * ** 1211 $ 416.88 0 * * SURCHARGE - OPERATIVE - NIGHT * * ** 1212 $ 296.86 0 * * SURCHARGE - OPERATIVE - WEEKEND AND STAT HOLIDAY * * ** 1215 $ 39.95 0 * * ANESTHESIA SURCHARGE - NONOPERATIVE - EVENING * * ** 1216 $ 60.14 0 * * ANESTHESIA SURCHARGE - NONOPERATIVE - NIGHT * * ** 1217 $ 43.98 0 * * ANESTHESIA SURCHARGE - NONOPERATIVE -WEEKEND, STAT * * ** 1305 $ 36.87 0 * 38 * PODIATRY HOSPITAL CONSULTATION * * ** 1308 $ 14.66 0 * 38 * POST-PODIATRIC SURGERY VISIT * * ** 1411 $ 307.19 0 * * CRITICAL CARE (ICU) - 1ST DAY * * ** 1412 $ 267.84 0 * * VENTILATORY SUPPORT (ICU) - 1ST DAY * * ** 1413 $ 508.90 0 * * COMPREHENSIVE CARE (ICU) - 1ST DAY * * ** 1421 $ 154.11 0 * * CRITICAL CARE (ICU) - 2ND TO 7TH DAY (INCL.) * * ** 1422 $ 133.92 0 * * VENTILATORY SUPPORT (ICU) - 2ND TO 7TH DAY (INCL.) * * ** 1423 $ 229.22 0 * * COMPREHENSIVE CARE (ICU) - 2ND TO 7TH DAY (INCL.) * * ** 1431 $ 77.01 0 * * CRITICAL CARE (ICU) - 8TH TO 30TH DAY * * ** 1432 $ 89.28 0 * * VENTILATORY SUPPORT (ICU) - 8TH TO 30TH DAY * * ** 1433 $ 114.38 0 * * COMPREHENSIVE CARE (ICU) - 8TH TO 30TH DAY * * ** 1441 $ 25.67 0 * * CRITICAL CARE (ICU) - 31ST DAY ONWARD * * ** 1442 $ 33.48 0 * * VENTILATORY SUPPORT (ICU) - 31ST DAY ONWARD * * ** 1443 $ 58.59 0 * * COMPREHENSIVE CARE (ICU) - 31ST DAY ONWARD * * ** 1511 $ 472.68 0 * * NEONATAL ICU - LEVEL A - DAY 1 * * ** 1512 $ 346.65 0 * * NEONATAL ICU - LEVEL B - DAY 1 * * ** 1513 $ 299.36 0 * * NEONATAL ICU - LEVEL C - DAY 1 * * ** 1521 $ 189.06 0 * * NEONATAL ICU - LEVEL A - DAY 2 - 10 * * ** 1522 $ 126.05 0 * * NEONATAL ICU - LEVEL B - DAY 2 - 10 * * ** 1523 $ 92.52 0 * * NEONATAL ICU - LEVEL C - DAY 2 - 10 * * ** 1531 $ 126.05 0 * * NEONATAL ICU - LEVEL A - DAY 11 ONWARD * * ** 1532 $ 93.66 0 * * NEONATAL ICU - LEVEL B - DAY 11 ONWARD * * ** 1533 $ 47.27 0 * * NEONATAL ICU - LEVEL C - DAY 11 ONWARD * * ** 1705 $ 96.40 0 * 20 * VISIT, EMERGENCY, PHYSICAL MEDICINE * * ** 1706 $ 63.17 0 * 20 * DIRECTIVE CARE - PHYSICAL MEDICINE * * ** 1707 $ 76.91 0 * 20 * VISIT, OFFICE, PHYSICAL MEDICINE * * ** 1708 $ 40.95 0 * 20 * VISIT, HOSPITAL, PHYSICAL MEDICINE * * ** 1709 $ 62.01 0 * 20 * VISIT, HOME, PHYSICAL MEDICINE * * ** 1710 $ 184.30 0 * 20 * CONSULTATION, PHYSICAL MEDICINE * * ** 1712 $ 80.33 0 * 20 * CONSULTATION, LIMITED, PHYSICAL MEDICINE * * ** 1713 $ 130.25 0 * 20 * GROUP COUNSELLING, PHYSICAL MED & REHAB - 1ST HR * * ** 1714 $ 72.30 0 * 20 * PHYSICAL MEDICINE, PROLONGED VISIT FOR COUNSELLING * * ** 1715 $ 65.09 0 * 20 * GROUP COUNSELLING - PHYSICAL MEDICINE * * ** 1721 $ 81.89 0 * 20 * REHABILITATION, FAMILY CONFERENCE * * ** 1728 $ 19.26 0 * 20 * BIOFEEDBACK * * ** 1730 $ 30.79 0 * 20 * GRADED EXERCISE TEST - TECHNICAL * * ** 1731 $ 44.91 0 * 20 * GRADED EXERCISE TEST - PROFESSIONAL * * ** 1732 $ 75.69 0 * 20 * GRADED EXERCISE TEST - TOTAL * * ** 1810 $ 127.77 0 * 28 * EMERGENCY MEDICINE CONSULTATION * * ** 1811 $ 29.52 0 * * LEVEL I EMERGENCY CARE - DAY * * ** 1812 $ 50.60 0 * * LEVEL II EMERGENCY CARE - DAY * * ** 1813 $ 67.27 0 * * LEVEL III EMERGENCY CARE - DAY * * ** 1821 $ 37.11 0 * * LEVEL I EMERGENCY CARE - EVENING * * ** 1822 $ 63.22 0 * * LEVEL II EMERGENCY CARE - EVENING * * ** 1823 $ 83.65 0 * * LEVEL III EMERGENCY CARE - EVENING * * ** 1831 $ 56.79 0 * * LEVEL I EMERGENCY CARE - NIGHT * * ** 1832 $ 94.96 0 * * LEVEL II EMERGENCY CARE - NIGHT * * ** 1833 $ 133.95 0 * * LEVEL III EMERGENCY CARE - NIGHT * * ** 1841 $ 37.11 0 * * LEVEL I EMERGENCY CARE - SAT, SUN, OR STAT HOL * * ** 1842 $ 63.22 0 * * LEVEL II EMERGENCY CARE - SAT, SUN OR STAT HOL * * ** 1843 $ 83.65 0 * * LEVEL III EMERGENCY CARE - SAT, SUN OR STAT HOL * * ** 1850 $ 103.56 2 * * CLAVICLE FRACTURE: CLOSED - ADULT * * ** 1851 $ 89.59 0 * * FIBULA FRACTURE, SHAFT OR MALLEOLUS - NO REDUCTION * * ** 1860 $ 67.63 3 * * TMJ DISLOCATION - CLOSED REDUCTION * * ** 1861 $ 64.78 2 * * PATELLA DISLOCATION - CLOSED * * ** 1862 $ 48.58 2 * * TOE DISLOCATION - CLOSED * * ** 2000 $ 10.43 0 * * ORTHOPTIC SERVICES/EYE EXERCISES FOR CO-ORDINATION * * ** 2005 $ 88.10 0 * 6 * EMERGENCY VISIT - OPHTHALMOLOGY * * ** 2007 $ 27.58 0 * 6 * OFFICE VISIT - OPHTHALMOLOGY * * ** 2008 $ 21.72 0 * 6 * HOSPITAL VISIT - OPHTHALMOLOGY * * ** 2009 $ 45.46 0 * 6 * HOME VISIT - OPHTHALMOLOGY * * ** 2010 $ 71.37 0 * 6 * CONSULTATION - OPHTHALMOLOGY * * ** 2011 $ 47.89 0 * 6 * LIMITED CONSULTATION - OPHTHALMOLOGY * * ** 2012 $ 119.20 0 * 6 * SPECIAL CONSULTATION - OPHTHALMOLOGY * * ** 2014 $ 47.01 0 * 6 * ORTHOPTIC EVALUATION * * ** 2015 $ 48.90 0 * 6 * EYE EXAMINATION (REFRACTION, OPTHALMOSCOPY ETC...) * * ** 2017 $ 26.62 0 * 6 * OCULO-MOTOR FUNCTION TEST * * ** 2018 $ 24.64 0 * 6 * BIOMICROSCOPY * * ** 2019 $ 24.64 0 * 6 * TONOMETRY * * ** 2020 $ 28.06 0 * 6 * OPHTHALMODYNAMOMETRY * * ** 2025 $ 104.90 0 * 6 * FLUORESCEIN ANGIOGRAPHY OF RETINA WITH INTERPRET. * * ** 2026 $ 26.38 0 * 6 * FLUORESCEIN ANGIOGRAPHY OF RETINA - PROF FEE * * ** 2027 $ 78.52 0 * 6 * FLUORESCEIN ANGIOGRAPHY OF RETINA - TECH FEE * * ** 2028 $ 48.54 0 * 6 * EXAMINATION FOR LOW VISUAL AID * * ** 2030 $ 79.18 0 * 6 * ELECTRO-RETINOGRAM * * ** 2031 $ 26.39 0 * 6 * ELECTRO -RETINOGRAM - PROFESSIONAL FEE * * ** 2032 $ 52.79 0 * 6 * ELECTRO- RETINOGRAM - TECHNICAL FEE * * ** 2034 $ 20.99 0 * 6 * DARK ADAPTATION, PER EYE * * ** 2035 $ 40.25 0 * 6 * COLOR VISION ASSESSMENT * * ** 2036 $ 26.39 0 * 6 * COLOUR VISION ASSESSMENT (PROFESSIONAL) * * ** 2037 $ 13.86 0 * 6 * COLOUR VISION ASSESSMENT (TECHNICAL) * * ** 2038 $ 15.33 0 * 6 * KERATOMETRY * * ** 2039 $ 13.14 0 * 6 * FUNDUS PHOTOGRAPHY * * ** 2040 $ 130.49 3 * 6 * RETINOSCOPY UNDER GA * * ** 2041 $ 30.71 0 * 6 * VISUAL FIELD EXAMINATION (LIMITED) * * ** 2042 $ 44.82 0 * 6 * QUANTITATIVE PERIMETRY EXAMINATION * * ** 2043 $ 59.65 0 * 6 * COMPREHENSIVE QUANTITATIVE PERIMETRY EXAMINATION * * ** 2044 $ 74.86 0 * 6 * ELECTRO-OCULOGRAM * * ** 2045 $ 26.39 0 * 6 * ELECTRO-OCULOGRAM - PROFESSIONAL FEE * * ** 2047 $ 61.35 0 * 6 * DACRYOCYSTOGRAM * * ** 2048 $ 13.19 0 * 6 * EXOPHTHALMOMETRY * * ** 2049 $ 30.71 0 * 6 * POTENTIOMETRY * * ** 2058 $ 261.00 0 * * CONTACT LENS BANDAGE - APHAKIA - UNILATERAL * * ** 2061 $ 42.99 0 * 6 * RETINAL NERVE FIBRE LAYER PHOTOGRAPHY * * ** 2062 $ 12.28 0 * 6 * RETINAL NERVE FIBRE LAYER PHOTO -PROF * * ** 2063 $ 30.71 0 * 6 * RETINAL NERVE FIBRE LAYER PHOTO -TECH * * ** 2064 $ 38.46 0 * 6 * NEURORETINAL RIM ASSESSMENT * * ** 2065 $ 12.28 0 * 6 * NEURORETINAL RIM ASSESSMENT - PROF * * ** 2066 $ 26.36 0 * 6 * NEURORETINAL RIM ASSESSMENT - TECH * * ** 2067 $ 63.92 0 * 6 * MANUAL RETINAL NERVE FIBRE LAYER PHOTOGRAPHY * * ** 2068 $ 12.28 0 * 6 * RET NERVE FIBRE AND NEURO-RETINAL ASSESS. - PROF * * ** 2069 $ 51.64 0 * 6 * RET NERVE FIBRE AND NEURO-RETINAL ASSESS. - TECH * * ** 2072 $ 31.87 4 * 6 * LASER INTERFEROMETRY * * ** 2073 $ 134.03 0 * 2 6 * BOTULINUM TOXIN INJECTION FOR BLEPHAROSPASM * * ** 2075 $ 73.24 0 * 2 6 * BOTULINUM TOXIN INJECTION FOR ENTROPION * * ** 2076 $ 203.98 0 * 2 6 * BOTULINUM TOXIN INJECTION FOR STRABISMUS * * ** 2090 $ 131.85 4 * * INTRAVITREAL INJECTION OF ANTIBIOTICS * * ** 2091 $ 131.65 4 * * ANTERIOR CHAMBER PARACENTESIS * * ** 2092 $ 211.04 4 * * INTRAVITREAL BIOPSY * * ** 2100 $ 461.42 3 * * MUELLERECTOMY - GRADED * * ** 2101 $ 1,730.36 7 * * ORBITOTOMY - POSTERIOR, MICRODISSECTION * * ** 2103 $ 86.86 3 * * EYE LID REPAIR - MINOR * * ** 2104 $ 865.18 3 * * EYE LID RECONSTRUCTION - MAJOR * * ** 2105 $ 1,441.97 3 * * EYE LID RECONSTRUCTION - 2-STAGE * * ** 2106 $ 571.35 3 * * TRICHIASIS - MICRO REPAIR * * ** 2107 $ 288.39 3 * * EYE LID MARGIN REPAIR - LAYERED CLOSURE * * ** 2108 $ 20.35 0 * * BETA RADIATION * * ** 2109 $ 21.92 0 * * SUBCONJUNCTIVAL INJECTION * * ** 2110 $ 792.21 5 * * RADIOACTIVE PLAQUE * * ** 2111 $ 1,097.92 6 * * LACRIMAL GLAND MICRO-DISSECTION * * ** 2112 $ 1,038.22 4 * * DACRYOCYSTECTOMY (COMPLEX) * * ** 2116 $ 514.61 4 * * PANRETINAL PHOTOCOAGULATION - > 700 BURNS MAX. * * ** 2118 $ 47.02 3 * * TWO OR THREE SNIP PROCEDURE * * ** 2119 $ 34.61 3 * * DACRYOCYSTOSTOMY (LA) * * ** 2120 $ 25.05 3 * * PUNCTUM DILATION AND SYRINGING SAC * * ** 2122 $ 25.05 3 * * LACRIMAL DUCT PROBING (LA) * * ** 2123 $ 202.21 3 * * INSERTION OF QUICKERT TUBE * * ** 2126 $ 549.38 3 * * DACRYOCYSTORHINOSTOMY * * ** 2127 $ 403.74 3 * * REPAIR OF CANALICULI * * ** 2129 $ 346.07 3 * * INSERTION OF LESTER JONES TUBE * * ** 2132 $ 89.18 2 * * RETROBULBAR INJECTION * * ** 2133 $ 432.92 4 * * ENUCLEATION OR EVISCERATION * * ** 2134 $ 634.46 4 * * ORBIT - ENUCLEATION WITH COMPLICATED IMPLANT * * ** 2135 $ 824.07 4 * * ORBIT - EXENTERATION OF * * ** 2144 $ 133.00 3 * * ASPIRATION NEEDLE BIOPSY OF ORBIT UNDER SCAN * * ** 2145 $ 1,372.76 7 * * ORBITAL EXENTERATION * * ** 2146 $ 21.92 3 * * TRICHIASIS - EPILATION (FORCEPS) * * ** 2147 $ 63.15 3 * * TRICHIASIS - ELECTRIC * * ** 2148 $ 115.36 3 * * CRYOTHERAPY OF EYE LIDS * * ** 2149 $ 21.92 0 * * MEIBOMIAN GLAND EVACUATION * * ** 2150 $ 55.27 3 * * CHALAZION REMOVAL * * ** 2152 $ 114.67 3 * * TARSORRHAPHY * * ** 2153 $ 55.27 3 * * ECTROPION/ENTROPIAN - ZIEGLER OR SIMPLE PROCEDURE * * ** 2154 $ 328.53 3 * * ECTROPION/ENTROPIAN - COMPLICATED * * ** 2155 $ 288.39 3 * * PTOSIS REPAIR (SYNTHETIC SLING) * * ** 2156 $ 86.86 3 * * EXCISION OF TUMOUR OF EYELID MARGIN OR CONJUNCTIVA * * ** 2157 $ 37.58 3 * * EYELID TUMOUR - BENIGN - EXCISION * * ** 2158 $ 259.90 3 * * FASANELLA-SERVAT PROCEDURE * * ** 2159 $ 536.76 3 * * PTOSIS REPAIR (AUTOLOGOUS SLING) * * ** 2160 $ 527.42 3 * * PTOSIS REPAIR (LEVATOR RESECTION) * * ** 2161 $ 366.99 3 * * STRABISMUS (1 OR 2 MUSCLES) * * ** 2162 $ 519.11 3 * * STRABISMUS (3 OR MORE MUSCLES) * * ** 2163 $ 576.78 4 * * STRABISMUS (COMPLICATED RE-OPERATION) * * ** 2166 $ 461.42 3 * * LID ELEVATION & SCLERAL GRAFT * * ** 2167 $ 31.21 3 * * CAUTERY OR CRYOTHERAPY OF CORNEAL ULCER * * ** 2168 $ 938.34 4 * * KERATOPLASTY - COMPLICATED RE-OPERATION * * ** 2169 $ 687.82 4 * * SUTURE OF CORNEA/SCLERA (COMPLICATED) * * ** 2171 $ 124.50 3 * * PTERYGIUM OR LIMBUS TUMOUR EXCISION * * ** 2172 $ 288.39 3 * * GUNDERSON-TYPE FLAP * * ** 2173 $ 731.78 3 * * KERATOPLASTY - LAMELLAR * * ** 2174 $ 304.00 4 * * SUTURE OF CORNEA/SCLERA (SIMPLE) * * ** 2175 $ 835.06 4 * * KERATOPLASTY - PENETRATING * * ** 2176 $ 128.93 4 * * SCLEROTOMY - POSTERIOR - ISOLATED PROCEDURE * * ** 2177 $ 338.61 4 * * GLAUCOMA - PERIPHERAL IRIDECTOMY(ISOLATED PROCED.) * * ** 2178 $ 488.95 4 * * GLAUCOMA - FILTERING PROCEDURE, NON-MICROSCOPIC * * ** 2180 $ 444.47 4 * * GLAUCOMA - GONIOTOMY * * ** 2181 $ 506.89 4 * * INTRAOCULAR FOREIGN BODY - MAGNETIC EXTRACTION * * ** 2182 $ 613.11 4 * * INTRAOCULAR FOREIGN BODY/(ISOLATED PROCEDURE) * * ** 2183 $ 221.52 4 * * GLAUCOMA - GONIOTOMY REPEAT WITHIN 3 MONTHS * * ** 2184 $ 328.53 4 * * GLAUCOMA - CYCLODIALYSIS * * ** 2187 $ 576.78 4 * * GLAUCOMA - FILTERING PROCEDURE, MICROSCOPIC * * ** 2188 $ 422.52 0 * * CATARACT LINEAR EXTRACTION, CONGENITAL, TRAUMATIC * * ** 2189 $ 618.84 4 * * IRIDOCYCLECTOMY VIA SCLERAL FLAP DISSECTION * * ** 2190 $ 111.21 0 * * INTRAOCULAR LENS IMPLANT - PRIMARY * * ** 2192 $ 472.46 0 * * INTRAOCULAR LENS IMPLANT - SECONDARY * * ** 2194 $ 792.21 5 * * BUCKLING PROCEDURE * * ** 2195 $ 222.62 5 * * CRYOPEXY OR DIATHERMY FOR RETINAL TEAR OR OTHER * * ** 2196 $ 221.52 0 * * INTRAOCULAR LENS IMPLANT - REPOSITIONING * * ** 2197 $ 508.73 4 * * EVACUATION OF HYPHEMA * * ** 2198 $ 342.82 4 * * ANTERIOR VITRECTOMY * * ** 2199 $ 893.30 5 * * POSTERIOR VITRECTOMY WITH 2 OR 3 PORT DEVICE * * ** 2206 $ 79.19 2 * * REMOVAL OF EAR CANAL OSTEOMA * * ** 2209 $ 462.90 3 * * REMOVAL OF OBSTRUCTING EXOSTOSIS OF EAR CANAL * * ** 2210 $ 42.63 2 * * PARACENTESIS OF THE EAR DRUM (OPERATION ONLY) * * ** 2221 $ 25.89 2 * * MICROSCOPIC DEBRIDEMENT OR ... REMOVAL-EAR-L/A * * ** 2223 $ 60.90 2 * * MICROSCOPIC DEBRIDEMENT OR ... REMOVAL-EAR G/A * * ** 2224 $ 209.00 4 * * SEMICIRCULAR CANAL OCCLUS-TRANSCANAL LABRINTHOTOMY * * ** 2231 $ 506.75 3 * * STENOSIS-SOFT TISSUE-EXTERNAL EAR,MICROSURGICAL * * ** 2233 $ 1,076.87 4 * * FACIAL NERVE DECOMPRESSION-TRANSMASTOID,..SEGMENTS * * ** 2234 $ 560.37 4 * * FACIAL NERVE DECOMPRESSION - TRANSMASTOID/VERTICAL * * ** 2239 $ 341.07 3 * * TYMPANOTOMY-WITH OSSICULAR CHAIN RECONSTRUCTION * * ** 2241 $ 548.17 4 * * LABYRINTHECTOMY-DRILL OUT OF PETROUS BONE * * ** 2242 $ 760.14 3 * * ATRESIA-SOFT TISSUE-EXTERNAL EAR CANAL,MICROSURGIC * * ** 2243 $ 1,011.07 3 * * REPAIR ATRESIA EXTERNAL EAR CANAL, COMPLETE, BONY * * ** 2244 $ 584.72 3 * * REPAIR STENOSIS EXTERNAL EAR CANAL, BONY * * ** 2245 $ 633.44 3 * * STENOSIS-SOFT TISSUE-EXTERNAL EAR CANAL,MICROSURGI * * ** 2246 $ 633.44 3 * * STAPES-RECONSTRUCTION WITH LASER * * ** 2247 $ 584.72 3 * * MASTOIDECTOMY - PARTIAL, CANAL WALL UP (CORTICAL) * * ** 2248 $ 743.07 4 * * RADICAL MASTOIDECTOMY * * ** 2249 $ 584.72 3 * * STAPES - RECONSTRUCTION * * ** 2250 $ 341.07 3 * * STAPES - MOBILIZATION OF * * ** 2251 $ 182.72 3 * * MYRINGOPLASTY REPAIR OF DRUM WITHOUT EXPLORATION * * ** 2252 $ 426.36 3 * * TYMPANOPLASTY-WITHOUT OSSICULAR CHAIN RECONSTRUCT * * ** 2253 $ 986.72 3 * * TYMPANOMASTOIDECTOMY - COMPLETE, CANAL WALL DOWN * * ** 2254 $ 79.19 2 * * MYRINGOTOMY WITH INSERTION OF AERATING TUBE * * ** 2255 $ 225.37 2 * * EXPLORATORY TYMPANOTOMY * * ** 2256 $ 828.34 6 * * ENDOLYMPHATIC SHUNT (ANY PROCEDURE) * * ** 2259 $ 645.63 3 * * GLOMUS EXCISION - BY TYMPANOTOMY * * ** 2260 $ 836.63 6 * * GLOMUS EXCISION, EXTENSIVE DISSECTION IS REQUIRED * * ** 2261 $ 371.54 3 * * EXPLORATORY TYMPANOTOMY WITH CHEMICAL CONTROL * * ** 2262 $ 1,848.77 8 * * TRANSLABYRINTHINE APPROACH FOR NEUROSURGICAL * * ** 2263 $ 316.71 3 * * TRANS-TYMPANIC POLYNEURECTOMY * * ** 2264 $ 645.63 3 * * TYMPANOPLASTY- WITH OSSICULAR CHAIN RECONSTRUCTION * * ** 2265 $ 584.72 3 * * TYPANOMASTOIEDECTOMY - PARTIAL, CANAL WALL DOWN * * ** 2266 $ 42.63 2 * * MYRINGOPLASTY - PAPER PATCH OR SYNTHETIC * * ** 2267 $ 304.53 3 * * CONCHAL CARTILAGE GRAFT * * ** 2268 $ 925.81 4 * * INTRA-COCHLEAR IMPLANT * * ** 2269 $ 448.49 4 * * IMPLANTABLE BONE CONDUCTOR * * ** 2270 $ 760.14 4 * * SEMICIRCULAR CANAL OCCLUSION- TRANSMASTOID * * ** 2271 $ 1,900.33 5 * 7 * FACIAL NEUROMA-TRANSMASTOID MICROSURGICAL REMOVAL * * ** 2272 $ 1,140.20 5 * * TUMOR - MIDDLE EAR/MASTOID - MICROSURGICAL REMOVAL * * ** 2273 $ 1,076.87 5 * * TYMPANOMASTOIDECTOMY-COMPLETE, MICROSURGICAL * * ** 2274 $ 121.82 2 * * MYRINGOTOMY W INSERTION AERATING TUBE-BILATERAL * * ** 2275 $ 1,008.55 6 * * GLOSSECTOMY - SUBTOTAL * * ** 2276 $ 645.63 3 * * TYMPANOPLASTY-LATERAL GRAFT,HOMOGRAFT TYMPANIC MEM * * ** 2279 $ 1,839.45 6 * * RESECTION-BASE OF TONGUE &/OR TONSIL/SOFT PALATE * * ** 2280 $ 2,303.45 8 * * CRANIO-FACIAL RESECTION -OTOLARYNGEAL COMPONENT * * ** 2281 $ 1,198.59 6 * * CONSERVATIVE RADICAL NECK DISSECTION * * ** 2282 $ 1,839.45 7 * * TONGUE/MANDIBLE - COMPOSITE RESECTION AND ... * * ** 2298 $ 146.17 3 * * CRYOSURGICAL TREATMENT OF TURBINATES - UNILATERAL * * ** 2299 $ 182.72 3 * * CRYOSURGICAL TREATMENT OF TURBINATES - BILATERAL * * ** 2301 $ 60.90 3 * * REMOVAL OF FOREIGN BODY FROM NOSE - COMPLICATED * * ** 2303 $ 36.54 3 * * CAUTERIZATION OF SEPTUM - ELECTRIC * * ** 2304 $ 91.35 3 * * TURBINECTOMY - UNILATERAL * * ** 2305 $ 133.99 3 * * TURBINECTOMY - BILATERAL * * ** 2306 $ 158.35 3 * * SUBMUCOUS RESECTION OF SEPTUM * * ** 2307 $ 109.63 3 * * NASO-ANTRAL WINDOW - SINGLE * * ** 2308 $ 170.54 3 * * NASO-ANTRAL WINDOW - DOUBLE * * ** 2309 $ 304.53 3 * * RADICAL ANTROSTOMY * * ** 2310 $ 438.54 4 * * RADICAL ANTROSTOMY WITH CLOSURE OF ALVEOLAR FISTUL * * ** 2315 $ 560.37 4 * * EXTERNAL RADICAL FRONTO - ETHMOIDECTOMY * * ** 2317 $ 48.72 3 * * ELECTROCOAGULATION OF TURBINATES - ONE SIDE * * ** 2318 $ 73.08 3 * * ELECTROCOAGULATION OF TURBINATES - BOTH SIDES * * ** 2319 $ 243.63 3 * * TREPHINING FRONTAL SINUS * * ** 2321 $ 255.83 3 * * SINUS SPHENOIDOTOMY (INTRANASAL) * * ** 2322 $ 97.46 3 * * REMOVAL OF NASAL POLYPI- UNILATERAL * * ** 2323 $ 158.35 3 * * REMOVAL OF NASAL POLYPI- BILATERAL * * ** 2324 $ 32.06 3 * * ANTRAL LAVAGE - UNILATERAL * * ** 2325 $ 48.09 3 * * ANTRAL LAVAGE - BILATERAL * * ** 2326 $ 462.90 3 * * CHOANAL ATRESIA; DEFINITIVE REPAIR OF - UNILATERAL * * ** 2327 $ 645.63 4 * * CHOANAL ATRESIA ; DEFINITIVE REPAIR OF - BILATERAL * * ** 2328 $ 158.35 3 * * CHOANAL ATRESIA; PERFORATION OF - UNILATERAL * * ** 2329 $ 219.26 4 * * CHOANAL ATRESIA PERFORATION OF - BILATERAL * * ** 2330 $ 158.35 3 * * SUBMUCOUS TURBINECTOMY - UNILATERAL * * ** 2331 $ 243.63 3 * * SUBMUCOUS TURBINECTOMY - BILATERAL * * ** 2332 $ 560.37 3 * * LATERAL RHINOTOMY AND EXCISION OF TUMOUR - BENIGN * * ** 2333 $ 596.90 3 * * LAT RHINOTOMY/MEDIAL MAXILLECTOMY FOR EXIS TUMOUR * * ** 2334 $ 462.90 3 * * TRANSANTRAL ETHMOIDECTOMY * * ** 2335 $ 487.27 6 * * TRANSANTRAL LIGATION, INTERNAL MAXILLARY ARTERY * * ** 2336 $ 126.69 4 * * STENOSIS - CHOANAL - LASER REVISION * * ** 2337 $ 304.53 6 * * LIGATION OF ANTERIOR AND POSTERIOR ETHMOID ARTERIE * * ** 2338 $ 706.52 6 * * REMOVAL OF ANGIOFIBROMA - NASAL PHARYNX * * ** 2339 $ 246.19 3 * * PALATAL FENESTRATION * * ** 2341 $ 60.90 3 * * NASAL PACKING - POSTERIOR (OPERATION ONLY) * * ** 2342 $ 767.44 5 * * MAXILLECTOMY WITH EXENTERATION OF ETHMOID * * ** 2343 $ 365.45 3 * * SEPTAL RECONSTRUCTION * * ** 2345 $ 109.63 3 * * DRAINAGE OF ABSCESS OR HAEMATOMA OF SEPTUM * * ** 2346 $ 95.01 3 * * NASAL PACKING-POSTERIOR/WITH ANAESTHETIC * * ** 2347 $ 889.28 4 * * OSTEOPLASTIC FRONTAL FLAP OPERATION - EXTERNAL * * ** 2348 $ 341.07 3 * * ORAL NASAL FISTULA - OPERATIVE CLOSURE * * ** 2349 $ 487.27 3 * * NASAL SEPTAL PERFORATION - OPERATIVE CLOSURE * * ** 2351 $ 341.07 3 * * NASAL REFRACTURE REQUIRING LATERAL OSTEOTOMIES * * ** 2352 $ 401.99 3 * * RECONSTRUCTION OF NASAL TIP, ALA AND COLUMELLA * * ** 2353 $ 538.43 3 * * NASAL TIP, ALA AND COLUMELLA/EXTERNAL RECONSTRUCT * * ** 2354 $ 584.72 3 * * RHINOPLASTY/COMPLETE - WITH SMR TO INCLUDE NASAL * * ** 2355 $ 741.14 3 * * RHINOPLASTY/SMR, COMPLETE - WITHOUT SKIN GRAFTING * * ** 2357 $ 384.55 0 * * SINUS SURGERY- FUNCTIONAL - ENDOSCOPIC - <14 YEARS * * ** 2358 $ 443.41 3 * * SINUSOTOMY - FRONTAL - ENDOSCOPIC - REVISION * * ** 2359 $ 506.75 3 * * SPHENO-ETHMOIDOTOMY/INTRANASAL/ENDOSCOPIC/REVISION * * ** 2360 $ 341.07 3 * * ETHMOIDOTOMY-INTRANASAL-POSTERIOR-UNILATERAL * * ** 2361 $ 523.82 3 * * ETHMOIDOTOMY-INTRANASAL-POSTERIOR-BILATERAL * * ** 2362 $ 182.72 3 * * ETHMOIDOTOMY -INTRANASAL - ANTERIOR - UNILATERAL * * ** 2363 $ 304.53 3 * * ETHMOIDOTOMY-INTRANASAL-ANTERIOR- BILATERAL * * ** 2364 $ 60.90 3 * * NASAL FRACTURE - SIMPLE REDUCTION * * ** 2365 $ 121.82 3 * * NASAL FRACTURE - REDUCTION AND SPLINTING * * ** 2399 $ 109.63 3 * * CRYOTHERAPY OF TONSILS AND ORAL LESIONS * * ** 2403 $ 246.07 4 * * TONSILLECTOMY - UNDER LA * * ** 2406 $ 231.44 6 * * RETROPHARYNGEAL ABSCESS, WITH LATERAL PHARYNGOTOMY * * ** 2407 $ 280.19 5 * * TRACHEOTOMY * * ** 2408 $ 182.72 5 * * REMOVAL OF TUMOR FROM LARYNX OR TRACHEA * * ** 2409 $ 401.99 5 * * UVULO-PALATO-PHARYNGOPLASTY FOR OBSTRUCTIVE * * ** 2410 $ 487.27 5 * * THYROTOMY * * ** 2411 $ 1,260.31 6 * * LARYNGECTOMY, TOTAL * * ** 2412 $ 121.82 5 * * BIOPSY OF LARYNX AND/OR CAUTERIZATION * * ** 2413 $ 158.35 6 * * OPERATIVE CONTROL OF POST-TONSILLECTOMY HAEMORRHAG * * ** 2414 $ 1,376.52 8 * * LARYNGO TRACHEAL STENOSIS- REPAIR, INCLUDES .. * * ** 2418 $ 791.80 8 * * FRACTURED LARYNX -REPAIR - EXTERNAL APPROACH * * ** 2419 $ 146.17 5 * * LARYNGOSCOPY-DIRECT OR INDIRECT-WITH F B REMOVAL * * ** 2420 $ 79.19 5 * * DILATION OF TRACHEA * * ** 2421 $ 36.54 5 * * DILATION OF TRACHEA - REPEAT WITHIN ONE MONTH * * ** 2422 $ 363.41 6 * * BRONCHO OR MICROLARYNGOSCOPY W F B REMOVAL- <3 YRS * * ** 2423 $ 425.34 5 * * MICROLARYNGOSCOPY W REMOVAL MALIGNANCY OR ..LESION * * ** 2424 $ 341.07 5 * * TRACHEOESOPHAGEAL PUNCTURE AND INSERTION OF VOICE * * ** 2425 $ 609.09 5 * * ARYTENOIDECTOMY * * ** 2428 $ 170.54 5 * * MICRO-LARYNGOSCOPY W BIOPSY OF LARYNX AND/OR CAUT * * ** 2429 $ 194.91 5 * * MICRO-LARYNGOSCOPY & REMOVAL OF TUMOR FROM LARYNX * * ** 2430 $ 425.34 6 * * MICRO-SURGERY W CO2 LASER FOR REMOVAL OF-1ST PROC * * ** 2431 $ 1,382.27 6 * * HEMILARYNGECTOMY * * ** 2432 $ 1,504.21 6 * * SUPRAGLOTTIC LARYNGECTOMY * * ** 2433 $ 304.53 5 * * VOCAL CORD IMPLANT - INJECTION * * ** 2434 $ 609.09 5 * * VOCAL CORD IMPLANT - EXTERNAL APPROACH * * ** 2435 $ 425.34 6 * * MICROSURGERY W C02 LASER FOR ..-SUBSEQUENT PROC * * ** 2437 $ 584.72 8 * 7 * TRANSPHENOIDAL REMOVAL OF PITUITARY TUMOR OR * * ** 2438 $ 401.99 5 * * TRANS-ORAL CRICOPHARYNGEAL MYOTOMY * * ** 2440 $ 323.07 4 * * SUBMANDIBULAR SALIVARY DUCTS - MICRO-TRANSPOSITION * * ** 2441 $ 285.05 11 * 7 * STANDBY FEE- ENT * * ** 2442 $ 122.99 4 * * ADENOIDECTOMY - ADULT OR CHILD OVER 14 YEARS * * ** 2443 $ 151.07 4 * * ADENOIDECTOMY - 14 YEARS AND UNDER * * ** 2444 $ 122.99 6 * * INCISION OF PERITONSILLAR ABSCESS-GENERAL ANAESTHE * * ** 2445 $ 182.72 4 * * TONSILLECTOMY - OVER 14 YEARS OF AGE * * ** 2446 $ 170.54 4 * * TONSILLECTOMY -14 YEARS AND UNDER(INCLUDES NEONATE * * ** 2447 $ 48.72 4 * * INCISION OF PERITONSILLAR ABSCESS-LOCAL ANAESTHETI * * ** 2448 $ 121.82 4 * * RETROPHARYNGEAL ABSCESS - DRAINAGE,LOCAL ANAESTHE * * ** 2449 $ 182.72 4 * * OESOPHAGOSCOPY-RIGID FOR REMOVAL OF FOREIGN BODY * * ** 2450 $ 243.63 6 * * BRONCHO OR MICROLARYNGOSCOPY W REMOVAL F BODY * * ** 2451 $ 401.99 4 * * CONGENITAL CYST/FISTULA - EXCISION, NECK * * ** 2452 $ 60.90 3 * * SIALOLITHOTOMY - SIMPLE IN DUCT * * ** 2453 $ 182.72 3 * * SIALOLITHOTOMY - COMPLICATED IN GLAND * * ** 2454 $ 182.72 3 * * ALVEOLECTOMY * * ** 2455 $ 304.53 4 * * EXCISION OF SUBMANDIBULAR GLAND * * ** 2456 $ 401.99 4 * * FISTULA - SALIVARY -PLASTIC TO STENSON'S DUCT * * ** 2457 $ 79.19 3 * * TONGUE TIE, G.A. * * ** 2458 $ 158.35 3 * * TONGUE - LOCAL EXCISION/GA * * ** 2459 $ 523.82 4 * * EXCISION CYSTIC HYGROMA * * ** 2470 $ 1,008.61 6 * * RADICAL NECK DISSECTION * * ** 2471 $ 804.01 4 * * SUBTOTAL PAROTIDECTOMY W FACIAL NERVE DISSECTION * * ** 2472 $ 925.81 4 * * TOTAL PAROTIDECTOMY .. FOR MALIGNANCY OR DEEP LOBE * * ** 2473 $ 1,512.91 6 * * LARYNGO-PHARYNGO-OESOPHAGECTOMY - PRIMARY EXCISION * * ** 2474 $ 1,008.58 5 * * TRANSORAL MAXILLECTOMY WITH SKIN GRAFT * * ** 2476 $ 609.09 5 * * RE-ESTABLISHMENT IN NECK * * ** 2477 $ 462.90 5 * * SUPRAHYOID DISSECTION - CONTRALATERAL * * ** 2478 $ 353.27 6 * * GLOSSECTOMY - PARTIAL FOR CARCINOMA * * ** 2479 $ 1,260.66 6 * * TRANSPALATAL ETHMOIDECTOMY/MAXILLECTOMY/SPHENOIDE * * ** 2480 $ 1,260.66 7 * * MANDIBLE/ FLOOR OF MOUTH-RESECTION FOR MALIGNANCY * * ** 2505 $ 85.47 0 * 7 * EMERGENCY VISIT - OTOLARYNGOLOGY * * ** 2507 $ 25.95 0 * 7 * SUBSEQUENT OFFICE VISIT - OTOLARYNGOLOGY * * ** 2508 $ 21.36 0 * 7 * SUBSEQUENT HOSPITAL VISIT - OTOLARYNGOLOGY * * ** 2509 $ 42.80 0 * 7 * SUBSEQUENT HOME VISIT - OTOLARYNGOLOGY * * ** 2510 $ 66.14 0 * 7 * CONSULTATION - OTOLARYNGOLOGY * * ** 2511 $ 81.77 0 * 7 * CONSULTATION: WITH PURE TONE AUDIOGRAM * * ** 2512 $ 145.47 0 * 7 * CONSULTATION, SPECIAL FOR DIZZINESS * * ** 2513 $ 95.23 0 * 7 * MALIGNANCY MANAGEMENT-CONSULTATION * * ** 2514 $ 39.58 0 * 7 * REPEAT OR LIMITED CONSULTATION - OTOLARYNGOLOGY * * ** 2515 $ 126.99 0 * 7 * ALLERGY CONSULTATION - OTOLARYNGOLOGY * * ** 2520 $ 15.01 0 * * AUDIOGRAM - PURE TONE (AC AND BC) * * ** 2521 $ 16.37 0 * * AUDIOGRAM - SPEECH (SRT, PB, MCL) * * ** 2525 $ 8.78 0 * 7 * IMPEDANCE TEST * * ** 2526 $ 10.80 0 * 7 * COLD CALORICS TEST * * ** 2527 $ 23.41 0 * 7 * BITHERMAL TEST * * ** 2528 $ 46.20 0 * 7 * ELECTRONYSTAGMOGRAPHY - E.N.G. * * ** 2529 $ 10.99 0 * 7 * FUNCTIONAL TESTS - LOMBARD * * ** 2530 $ 23.41 0 * 7 * FUNCTIONAL TESTS - STENGER * * ** 2531 $ 17.29 0 * 7 * IMPEDANCE TEST,INCLUDING CONTRALATERAL REFLEX * * ** 2532 $ 6.06 0 * 7 * PI-PB TEST * * ** 2533 $ 23.41 0 * 7 * AUDIOMETRY - PLAY * * ** 2534 $ 23.41 0 * 7 * AUDIOMETRY - FREE FIELD * * ** 2535 $ 113.55 3 * * MAXILLARY SINUS ENDOSCOPY VIA CANINE FOSSA * * ** 2536 $ 45.87 0 * 7 * AUDIOMETRY - BRAINSTEM EVOKED RESPONSE * * ** 2538 $ 71.42 0 * 7 * LARYNGOSTROBOSCOPY * * ** 2539 $ 66.28 0 * 7 * AUDIOMETRY-BRAINSTEM E R WITH ELECTROCOCHLEOGRAPHY * * ** 2540 $ 61.04 3 * * FLEXIBLE NASOPHARYNGOSCOPY WITH VIDEO FLUOROSCOPY * * ** 2541 $ 49.96 0 * 7 * ELECTROCOCHLEOGRAPHY * * ** 2542 $ 31.23 0 * 7 * AUTOACOUSTIC EMISSIONS - MEASUREMENT OF * * ** 2600 $ 2,303.45 8 * * TEMPORAL BONE RESECTION - COMPLETE, ENT FEE * * ** 2601 $ 1,151.71 8 * * TEMPORAL BONE RESECTION - SUBTOTAL AND LATERAL * * ** 2610 $ 1,376.51 8 * * MIDDLE CRANIAL FOSSA APPROACH WITHOUT PETROSECTOMY * * ** 2612 $ 1,842.68 8 * * MIDDLE CRANIAL FOSSA APPROACH - PETROSECTOMY * * ** 2613 $ 2,303.22 8 * * MIDDLE CRANIAL FOSSA APPROACH-PETROSECTOMY-> 8HRS * * ** 2614 $ 1,151.58 8 * * RETROLABYRINTHINE APPROACH - NEUROSURGICAL ACCESS * * ** 2618 $ 921.67 8 * * CSF LEAK REPAIR * * ** 2622 $ 1,842.68 8 * * INFRA-TEMPORAL FOSSA APPROACH TO SKULL BASE * * ** 2623 $ 2,303.22 8 * * INFRA-TEMPORAL FOSSA APPROACH TO SKULL BASE >8 HRS * * ** 2892 $ 40.33 0 * 39 * EXAMINATION FOR LOW VISION AID * * ** 2893 $ 31.78 0 * 39 * COMPUTER-ASSISTED QUANTITATIVE VISUAL FIELDS * * ** 2894 $ 213.95 0 * 39 * CONTACT LENSES FITTING FOR KERATOCONUS - * * ** 2895 $ 322.72 0 * 39 * CONTACT LENSES FITTING FOR KERATOCONUS - BILATERAL * * ** 2897 $ 10.40 0 * 39 * REPEAT TONOMETRY * * ** 2898 $ 21.64 0 * 39 * RE-EXAMINATION OR MINOR EXAMINATION * * ** 2899 $ 44.83 0 * 39 * FULL OPTOMETRIC DIAGNOSTIC EXAMINATION OF THE EYES * * ** 3005 $ 110.76 0 * 9 * VISIT, EMERGENCY, NEUROSURGERY * * ** 3007 $ 42.34 0 * 9 * VISIT, OFFICE, NEUROSURGERY * * ** 3008 $ 26.54 0 * 9 * VISIT, HOSPITAL, NEUROSURGERY * * ** 3009 $ 53.76 0 * 9 * VISIT, HOME, NEUROSURGERY * * ** 3010 $ 149.13 0 * 9 * CONSULTATION, NEUROSURGERY * * ** 3011 $ 70.90 0 * 9 * CONSULTATION, LIMITED, NEUROSURGERY * * ** 3030 $ 824.54 6 * * VENTRICULOSCOPY * * ** 3031 $ 1,265.01 6 * * VENTRICULOSCOPY, THIRD VENTRICULOSTOMY * * ** 3032 $ 1,265.01 6 * * VENTRICULOSCOPY/ENDOSCOPY BIOPSY /INTRAVENTRICULAR * * ** 3033 $ 1,265.01 6 * * VENTRICULOSCOPIC RETRIEVAL OF FOREIGN BODY * * ** 3034 $ 1,265.01 6 * * VENTRICULOSCOPY/FENESTRATION OF CYST OR SEPTUM * * ** 3035 $ 2,527.32 6 * * VENTRICULOSCOPIC RESECTION /INTRAVENTRICULAR TUMOR * * ** 3036 $ 1,054.17 6 * * VENTRICULAR SHUNT WITH VENTRICULOSCOPIC GUIDANCE * * ** 3045 $ 951.39 3 * * BRACHIAL PLEXUS EXPLORATION FOR NEUROLYSIS * * ** 3046 $ 237.21 3 * * BRACHIAL PLEXUS SURGERY - POST TRAUMATIC DELAYED * * ** 3047 $ 209.31 0 * * BRACHIAL PLEXUS /INTRAOPERATIVE DIAGNOSTIC MONITOR * * ** 3048 $ 190.28 0 * * BRACHIAL PLEXUS EXPLORATION - NERVE GRAFT * * ** 3049 $ 443.99 0 * * NEUROTIZATION IN BRACHIAL PLEXUS SURGERY * * ** 3053 $ 672.39 8 * * CRANIOTOMY * * ** 3055 $ 2,227.43 8 * * CRANIOTOMY - MICROSURGICAL-RESECTION-EPILEPSY-GA * * ** 3056 $ 2,752.77 8 * * CRANIOTOMY - RESECTION - EPILEPSY/AWAKE * * ** 3057 $ 1,607.89 8 * * CRANIOTOMY - CORTICAL RESECTION -EPILEPSY * * ** 3058 $ 2,192.58 8 * * HEMISPHERECTOMY * * ** 3059 $ 2,543.00 8 * * CRANIOTOMY AND MICROSURGICAL HEMISPHEROTOMY * * ** 3065 $ 1,607.89 7 * * CRANIAL FACIAL RESECTION -NEUROSURGICAL * * ** 3066 $ 189.44 0 * * CRANIOTOMY-MICROSURGICAL RESECTION-EXTRA-AXIAL * * ** 3094 $ 2,890.72 8 * * ANTERIOR DECOMPRESSING CRANIOVERTEBRAL JUNCTION * * ** 3095 $ 1,355.18 8 * * POSTERIOR DECOMPRESSION OF CHIARI MALFORMATION * * ** 3096 $ 1,609.82 8 * * POSTERIOR DECOMPRESSION OF CHIARI MALFORMATION * * ** 3097 $ 1,863.38 8 * * POSTERIOR DECOMPRESSION OF CHIARI MALFORMATION * * ** 3100 $ 40.09 0 * * INTRA-OPERATIVE ULTRASOUND DURING NEUROSURGERY * * ** 3101 $ 221.58 3 * * AVULSION SUPRA OR INTRA-ORBITAL NERVE * * ** 3102 $ 1,172.76 8 * * DECOMPRESSION GASSERIAN GANGLION * * ** 3103 $ 1,017.97 3 * * PREGANGLIONIC RHIZOTOMY 5TH NERVE * * ** 3104 $ 1,004.60 3 * * PERCUTANEOUS RHIZOTOMY 5TH NERVE * * ** 3106 $ 1,688.90 8 * * POSTERIOR FOSSA EXPLORATION W/ RHIZOTOMY 5TH NERVE * * ** 3108 $ 715.92 4 * * RHIZOTOMY, FACET * * ** 3110 $ 139.55 6 * * ELEVATION OF DEPRESSED SKULL FRACTURE IN INFANT * * ** 3111 $ 715.92 5 * * SKULL FRACTURE DEPRESSED SIMPLE * * ** 3112 $ 931.82 6 * * SKULL FRACTURE DEPRESSED COMPOUND * * ** 3113 $ 1,464.47 8 * * CEREBRAL LACERATION WITH SKULL FRACTURE * * ** 3114 $ 2,853.42 8 * * CRANIOTOMY * * ** 3115 $ 808.48 6 * * EXPLORATION SUBDURAL SPACE * * ** 3116 $ 1,540.42 8 * * ABSCESS INTRA-CRANIAL * * ** 3118 $ 1,581.12 8 * * CRANIOTOMY REPAIR CFS LEAK * * ** 3119 $ 1,811.04 8 * * CRANIOTOMY, MICROVASCULAR DECOMPRESSION * * ** 3120 $ 1,321.38 9 * * CRANIOTOMY, FACIAL * * ** 3121 $ 931.82 7 * * CRANIOPLASTY * * ** 3122 $ 1,040.96 7 * * CRANIECTOMY FOR OSTEOMYELITIS OR SKULL TUMOR * * ** 3123 $ 1,464.47 7 * * CRANIECTOMY OSTEOMYELITIS OR TUMOR W/CRANIOPLASTY * * ** 3124 $ 1,012.97 7 * * LINEAR CRANIECTOMY OR CRANIOTOMY * * ** 3125 $ 1,876.46 8 * * BILATERAL CRANIECTOMIES FOR EXPANSION / SYNOSTOSIS * * ** 3126 $ 639.69 6 * * RE-OPENING OR REMOVAL OF BONE FLAP * * ** 3127 $ 248.62 7 * * LINEAR CRANIECTOMY OR CRANIOTOMY ADDIT. SUTURES * * ** 3128 $ 891.04 7 * * CEREBRAL NEEDLING VIA TREPHINE * * ** 3129 $ 1,524.40 8 * * CRANIOTOMY FOR TUMOR * * ** 3130 $ 3,993.60 8 * * CRANIOTOMY EXTRA-AXIAL MICROSURGICAL * * ** 3131 $ 1,983.52 8 * 7 9 * HYPOPHYSECTOMY * * ** 3132 $ 1,437.80 8 * 9 * HYPOPHYSECTOMY * * ** 3133 $ 2,853.42 8 * * CRANIOTOMY * * ** 3135 $ 3,466.55 9 * * CRANIOTOMY OR LAMINECTOMY * * ** 3136 $ 2,388.87 9 * * CRANIOTOMY FOR INTRACRANIAL ANEURYSM OR ANGIOMA * * ** 3137 $ 1,172.66 8 * * LATERAL CANTHAL, UNILATERAL * * ** 3138 $ 1,172.66 7 * * STEREOTAXIC INTRACRANIAL PROCEDURE * * ** 3139 $ 453.10 3 * * IMPLANTATION OF STIMULATOR * * ** 3140 $ 1,427.44 7 * * INTRA-CRANIAL STIMULATING ELECTRODES * * ** 3141 $ 1,836.13 9 * * CEREBRAL ARTERIAL ANASTOMOSIS * * ** 3142 $ 550.84 5 * * SILVERSTONE CLAMP * * ** 3143 $ 1,255.70 8 * * LATERAL CANTHAL - BILATERAL * * ** 3144 $ 1,959.66 8 * * CORPUS CALLOSUM - SECTION OF * * ** 3145 $ 1,119.22 7 * * CRANIOPLASTY USING AUTOLOGOUS BONE GRAFT * * ** 3146 $ 1,711.92 8 * * MORCELLATION OF SKULL * * ** 3147 $ 2,038.03 8 * * CRANIAL RECONSTRUCTION FOR COMPLEX DEFORMITY * * ** 3148 $ 280.34 0 * * FOREHEAD RECONSTRUCTION/EXTRA LINEAR CRANIECTOMY * * ** 3150 $ 1,231.82 5 * * LAMINECTOMY FOR SELECTIVE POSTERIOR RHIZOTOMY * * ** 3151 $ 775.93 5 * * STEREOTAXIC SURGERY * * ** 3152 $ 918.07 5 * * MYELOTOMY, BISCHOFF`S * * ** 3153 $ 1,381.55 6 * * LAMINECTOMY WITH DREZ LESION FOR PAIN * * ** 3155 $ 930.59 6 * * LAMINECTOMY FOR HAEMATOMA, TUMOR OR VASULAR MALFOR * * ** 3156 $ 722.59 6 * * LAMINECTOMY FOR CERVICAL DISC - ONE LEVEL * * ** 3157 $ 792.88 6 * * LAMINECTOMY FOR CERVICAL DISC - MULTIPLE LEVELS * * ** 3158 $ 600.99 5 * * LAMINECTOMY FOR LUMBAR DISC - ONE LEVEL * * ** 3159 $ 655.18 5 * * LAMINECTOMY FOR LUMBAR DISC - MULTIPLE LEVELS * * ** 3160 $ 1,333.45 5 * * LAMINECTOMY, TETHERED SPINAL CORD OR CONGENITAL * * ** 3161 $ 697.94 5 * * LAMINECTOMY FOR LOCALIZED SPINAL STENOSIS * * ** 3162 $ 1,087.39 5 * * LAMINECTOMY FOR GENERALIZED SPINAL STENOSIS * * ** 3163 $ 792.88 6 * * DISCECTOMY, ANTERIOR CERVICAL - ONE LEVEL * * ** 3164 $ 1,010.40 6 * * DISCECTOMY, ANTERIOR CERVICAL - MULTIPLE LEVELS * * ** 3165 $ 290.41 6 * * INTRA-CRANIAL PRESSURE MONITORING DEVICE * * ** 3166 $ 845.51 8 * * THORACIC DISC, REMOVAL * * ** 3167 $ 123.85 4 * * SKULL TONGS - INSERTION * * ** 3168 $ 1,785.32 7 * * LAMINECTOMY FOR INTRADURAL SPINAL CORD * * ** 3169 $ 673.51 7 * * SPINE FRACTURE WITHOUT CORD INJURY * * ** 3170 $ 636.72 0 * * SPINE - OPEN REDUCTION AND FUSION TEAM OPERATION * * ** 3172 $ 919.01 7 * * SPINE - OPEN REDUCTION AND FUSION WITH CORD INJURY * * ** 3173 $ 636.72 0 * * SPINE - OPEN REDUCTION AND FUSION TEAM OPERATION * * ** 3174 $ 1,215.92 8 * * THORACIC DISC, REMOVAL - TEAM PROCEDURE * * ** 3175 $ 982.11 6 * * REPAIR OF MENINGOCOELE/ENCEPHALOCOELE * * ** 3176 $ 965.09 4 * * CORDOTOMY PERCUTANEOUS * * ** 3177 $ 775.93 5 * * CORDOTOMY * * ** 3178 $ 914.46 5 * * RHIZOTOMY * * ** 3179 $ 461.43 8 * * THORACIC OR GENERAL SURGEON * * ** 3180 $ 1,281.55 6 * * LAMINECTOMY FOR CERVICAL CORD, MULTIPLE LEVEL * * ** 3181 $ 991.83 6 * * SHUNT PROCEDURE FOR VENTRICULAR OBSTRUCTION * * ** 3182 $ 991.83 6 * * REVISION-SHUNT/VENTRICULAR OBSTRUCTION * * ** 3183 $ 1,720.73 6 * * MENINGOMYELOCELE - MICROSURGICAL REPAIR * * ** 3184 $ 991.83 5 * * HYDROCEPHALUS SHUNT * * ** 3185 $ 1,264.78 8 * * POSTERO-LATERAL MICROSURGICAL THORACIC DISCECTOMY * * ** 3188 $ 283.87 6 * * VENTRICULOSTOMY INSERTION OF EXTERNAL VENTRICULAR * * ** 3189 $ 431.29 0 * * STEREOTACTIC LOCALIZATION DURING NEUROSURGERY * * ** 3196 $ 276.06 2 * * PERIPHERAL NERVE - MOBILIZATION AND TRANSPOSITION * * ** 3198 $ 218.14 2 * * NEURECTOMY OF MAJOR PERIPHERAL NERVE * * ** 3200 $ 564.17 3 * * PERIPHERAL NERVE SUTURE SECONDARY & TRANSPOSITION * * ** 3201 $ 429.30 3 * * PERIPHERAL NERVE SUTURE SECONDARY * * ** 3204 $ 668.64 4 * * HYPOGLOSSAL FACIAL ANASTOMOSIS * * ** 3205 $ 423.49 3 * * NERVE GRAFT * * ** 3207 $ 799.49 3 * * MICROSURGICAL REMOVAL OF NEOPLASM/MAJOR PERIPHERAL * * ** 3211 $ 54.72 2 * * MUSCLE BIOPSY * * ** 3215 $ 45.72 2 * * SPINAL SUBARACHNOID - INSERTION OF * * ** 3216 $ 35.51 2 * * PUNCTURE OF VENTRICULAR SHUNT FOR CSF ASPIRATION * * ** 3217 $ 126.87 2 * * PERCUTANEOUS VENTRICULAR PUNCTURE * * ** 3218 $ 453.10 3 * * SPINAL SUBARACHNOID INFUSION PUMP FOR SPINAL * * ** 3219 $ 384.00 3 * * SPINAL SUBARACHNOID DEVICE-RESERVOIR - INSERTION * * ** 3220 $ 614.40 3 * * SPINAL SUBARACHNOID CATHETER ACCESS DEVICE * * ** 3221 $ 521.11 4 * * IMPLANTATION OF VAGAL NERVE STIMULATOR-INCLUDING * * ** 3222 $ 5,235.00 9 * * CRANIOTOMY LASTING MORE THAN 12 HOURS * * ** 3223 $ 217.22 3 * * REPLACEMENT OF STIMULATOR COMPONENT OF VAGAL NERVE * * ** 3224 $ 1,848.77 8 * * TUMOR - CEREBELLAR PONTINE ANGLE - MICROSURGICAL * * ** 3225 $ 383.98 4 * * REMOVAL OF VAGAL NERVE STIMULATOR AND ELECTRODES * * ** 3227 $ 46.78 0 * 9 * NEUROSURGICAL INTERPRETATION & REPORT OF XRAY FILM * * ** 3230 $ 3,486.49 0 * * REPEAT NEUROSURGERY * * ** 3231 $ 587.42 5 * * REPAIR OF SPINAL CSF LEAK OR PSEUDOMENINGOCOELE * * ** 3232 $ 719.09 0 * * CRANIAL NERVE WITH GRAFT/MICROSURGICAL ANASTOMOSIS * * ** 3233 $ 440.53 0 * * CRANIAL NERVE WITHOUT GRAFT - MICROSURGICAL * * ** 3235 $ 230.95 0 * * CORTICAL LOCALIZATION SSEP OR STIMULATION UNDER GA * * ** 3236 $ 1,077.85 8 * * SUBDURAL STRIP ELECTRODES - UNILATERAL - INSERTION * * ** 3237 $ 461.94 6 * * SUBDURAL STRIP ELECTRODES - UNILATERAL - REMOVAL * * ** 3238 $ 461.94 0 * * CORTICAL OR DEEP BRAIN LOCALIZATION WITH SSEP * * ** 3239 $ 1,437.00 7 * * CRANIOTOMY / INSERTION OF SUBDURAL GRID ELECTRODES * * ** 3240 $ 458.81 6 * * VENTRICULAR ACCESS DEVICE - INSERTION OF * * ** 3241 $ 774.00 6 * * RE-OPENING OF CRANIOTOMY REMOVAL SUBDURAL GRID * * ** 3250 $ 3,067.00 0 * * MICROELECTRODE RECORDING (MER) * * ** 3301 $ 275.97 5 * * LAMINOTOMY * * ** 3302 $ 156.68 2 * * PERCUTANEOUS FLUOROSCOPY/SPINAL STIMULATOR * * ** 3303 $ 353.45 3 * * IMPLANTATION - PULSE GENERATOR/RECEIVER * * ** 3304 $ 496.99 3 * * IMPLANT COMPLETE/PERCUTANEOUS ELECTRODE * * ** 3305 $ 555.46 5 * * IMPLANT COMPLETE/LAMINOTOMY ELECTRODE * * ** 3306 $ 353.45 3 * * SPINAL/CRANIAL STIMULATOR - REVISION * * ** 3307 $ 233.88 3 * * SPINAL/BRAIN STIMULATOR - REMOVAL * * ** 3310 $ 130.03 0 * 9 * VIDEO CONSULT - NEUROSURGICAL * * ** 3311 $ 39.75 0 * 9 * FOLLOW-UP ASSESSMENT VIA VIDEO CONFERENCING * * ** 3312 $ 64.32 0 * 9 * REPEAT/ OR LIMITED VIDEO CONSULT - NEUROSURGICAL * * ** 3313 $ 74.90 0 * * VIDEO CONFERENCING - ASSISTANTS FEE * * ** 3320 $ 410.71 6 * * SKULL TUMOR REMOVAL * * ** 3333 $ - 0 * * NO CHARGE REFERRAL * * ** 3713 $ 200.00 0 * 41 * LASER SURGERY - UNDER GENERAL ANAESTHESIA - SINGLE * * ** 3714 $ 300.00 0 * 41 * LASER SURGERY - UNDER GENERAL ANAESTHESIA/MULTIPLE * * ** 3719 $ 125.00 0 * 41 * LASER SURGERY - UNDER LOCAL - SINGLE < OR = 1 CM * * ** 3720 $ 200.00 0 * 41 * LASER SURGERY - UNDER LOCAL - SINGLE > 1 CM * * ** 3721 $ 300.00 0 * 41 * LASER SURGERY - UNDER LOCAL ANAESTHESIA - MULTIPLE * * ** 3770 $ 222.42 0 * 41 * DIAGNOSTIC EXAMINATION/CONSULTATION/STOMATOGNATHIC * * ** 3771 $ 111.32 0 * 41 * BIOPSY, INCISION, SOFT TISSUE * * ** 3772 $ 160.50 0 * 41 * BIOPSY, INCISION, HARD TISSUE * * ** 3773 $ 218.48 0 * 41 * BIOPSY, EXCISION, SOFT TISSUE < OR = 1 CM * * ** 3774 $ 423.83 0 * 41 * BIOPSY, EXCISION, SOFT TISSUE GREATER THAN 1 CM * * ** 3775 $ 214.94 0 * 41 * BIOPSY, EXCISION, HARD TISSUE LESS THAN 1 CM * * ** 3776 $ 33.50 0 * 41 * ANAESTHETIC & ANALGESIC PROCEDURES: REGIONAL NERVE * * ** 3777 $ 111.65 0 * 41 * ANAESTHETIC/ANALGESIC PROCEDURES/DIVISIONAL NERVE * * ** 3778 $ 39.08 0 * 41 * ANAESTHETIC & ANALGESIC PROCEDURES: TRIGGER POINT * * ** 3779 $ 72.58 0 * 41 * ANAESTHETIC & ANALGESIC PROCED: VAPOCOOLANT SPRAY * * ** 3782 $ 35.30 0 * 41 * ANAESTHETIC & ANALGESIC PROCEDURES: INTRALESIONAL * * ** 3783 $ 27.90 0 * 41 * SALIVARY GLAND PROCEDURES: MEASUREMENT OF SALIVARY * * ** 3784 $ 50.25 0 * 41 * SALIVARY GLAND PROCEDURES: SALIVARY GLAND DUCT * * ** 3785 $ 51.92 0 * 41 * SALIVARY GLAND PROCEDURES: HOSPITAL VISIT, FOLLOW- * * ** 3788 $ 119.37 0 * 41 * OROFACIAL PAIN/TEMPOROMANDIBULAR DISORDERS/CLOSED * * ** 3789 $ 145.15 0 * 41 * OROFACIAL PAIN/TEMPOROMANDIBULAR DISORDERS/CLOSED * * ** 3790 $ 119.37 0 * 41 * OROFACIAL PAIN & TEMPOROMANDIBULAR DISORDERS: TM J * * ** 3791 $ 145.16 0 * 41 * OROFACIAL PAIN & TEMPOROMANDIBULAR DISORDERS: TM J * * ** 3792 $ 119.90 0 * 41 * OROFACIAL PAIN & TEMPOROMANDIBULAR DISORDERS: ARTH * * ** 3793 $ 119.37 0 * 41 * OROFACIAL PAIN & TEMPOROMANDIBULAR DISORDERS: ARTH * * ** 3794 $ 70.27 0 * 41 * INCISION AND DRAINAGE OF ABSCESS: INTRAORAL (SUPER * * ** 3795 $ 200.00 0 * 41 * INCISION AND DRAINAGE OF ABSCESS: INTRAORAL (DEEP) * * ** 3796 $ 55.64 0 * 41 * COUNSELLING: REHAB CONFERENCE WITH PATIENT * * ** 3803 $ 49.50 0 * 37 42 * PANORAMIC RADIOGRAPHS PRE-TREATMENT POST-TREATMENT * * ** 3804 $ 32.34 0 * 37 42 * CEPHALOMETRIC RADIOGRAPHS PRE-TREATMENT POST-TREAT * * ** 3805 $ 53.57 0 * 37 42 * CEPHALOMETRIC RADIOGRAPHS PRE-TREATMENT POST-TREAT * * ** 3806 $ 21.23 0 * 37 42 * CEPHALOMETRIC RADIOGRAPHS PRE-TREATMENT POST-TREAT * * ** 3807 $ 60.00 0 * 37 42 * CEPHALOMETRIC TRACING/INTERPRETATION PRE-TREATMENT * * ** 3809 $ 44.44 0 * 37 42 * TMJ RADIOGRAPHS, TOMOGRAPHY, SINGLE VIEW * * ** 3810 $ 55.66 0 * 37 42 * TMJ RADIOGRAPHS, TOMOGRAPHY, TWO VIEWS * * ** 3811 $ 32.34 0 * 37 42 * TMJ RADIOGRAPHS, RADIOGRAPHS, TMJ ONE FILM * * ** 3812 $ 53.57 0 * 37 42 * TMJ RADIOGRAPHS, RADIOGRAPHS, TMJ, TWO FILMS * * ** 3813 $ 74.58 0 * 37 42 * TMJ RADIOGRAPHS, RADIOGRAPHS, TMJ, THREE FILMS * * ** 3814 $ 98.01 0 * 37 42 * TMJ RADIOGRAPHS, RADIOGRAPHS, TMJ, FOUR FILMS * * ** 3815 $ 12.96 0 * 37 42 * PHOTOGRAPHS, FIRST PHOTOGRAPH * * ** 3816 $ 4.30 0 * 37 42 * PHOTOGRAPHS, EACH ADDITIONAL * * ** 3817 $ 54.78 0 * 37 42 * DIAGNOSTIC MODELS, UPPER AND LOWER * * ** 3818 $ 30.00 0 * 37 42 * DUPLICATE MODELS, UPPER AND LOWER * * ** 3819 $ 65.12 0 * 37 42 * CASTS, DIAGNOSTIC, MOUNTED, ONE OR MORE SETS MAYBE * * ** 3820 $ 237.71 0 * 37 42 * CASTS, DIAGNOSTIC, MOUNTED USING FACEBOW AND OCCLU * * ** 3821 $ 60.00 0 * 37 42 * DIAGNOSTIC (GNATHOLOGICAL WAX-UP) MODEL SURGERY ON * * ** 3822 $ 120.00 0 * 37 42 * DIAGNOSTIC (GHATHOLOGICAL WAX-UP) MODEL SURGERY TW * * ** 3823 $ 180.00 0 * 37 42 * DIAGNOSTIC (GNATHOLOGICAL WAX-UP) MODEL SURGERY TH * * ** 3824 $ 250.00 0 * 37 42 * APPLIANCES, REMOVABLE, RETENTION (SPLINT) MAXILLAR * * ** 3825 $ 250.00 0 * 37 42 * APPLIANCES, REMOVABLE, RETENTION (SPLINT) MANDIBUL * * ** 3826 $ 50.00 0 * 37 42 * APPLIANCES/REMOVABLE/RETENTION(SPLINT) - PALATAL * * ** 3830 $ 21.23 0 * 37 42 * TMJ RADIOGRAPHS - EACH ADDITIONAL FILM OVER FOUR * * ** 3831 $ 12.65 0 * 37 42 * PERIAPICAL - SINGLE FILM * * ** 3832 $ 17.38 0 * 37 42 * PERIAPICAL - TWO FILMS * * ** 3833 $ 22.11 0 * 37 42 * PERIAPICAL - THREE FILMS * * ** 3834 $ 26.84 0 * 37 42 * PERIAPICAL - FOUR FILMS * * ** 3835 $ 31.57 0 * 37 42 * PERIAPICAL - FIVE FILMS * * ** 3836 $ 36.30 0 * 37 42 * PERIAPICAL - SIX FILMS * * ** 3841 $ 16.50 0 * 37 42 * OCCLUSAL - SINGLE FILM * * ** 3842 $ 24.42 0 * 37 42 * OCCLUSAL - TWO FILMS * * ** 3844 $ 5.83 0 * 37 42 * RADIOGRAPHS/DUPLICATIONS - SINGLE FILM * * ** 3845 $ 11.44 0 * 37 42 * RADIOGRAPHS/DUPLICATIONS - TWO FILMS * * ** 3846 $ 17.27 0 * 37 42 * RADIOGRAPHS/DUPLICATIONS - THREE FILMS * * ** 3847 $ 3.30 0 * 37 42 * RADIOGRAPHS/DUPLICATIONS - EACH ADDITIONAL * * ** 3952 $ 75.00 0 * 42 * SEVERE CONGENITAL CRANIO-FACIAL ANOMALIES-INITIAL * * ** 3953 $ 240.01 0 * 42 * SEVERE CONGENITAL CRANIO-FACIAL /DIAGNOSTIC PHASE * * ** 3954 $ 175.00 0 * 42 * SEVERE CONGENITAL CRANIAL-FACIAL ANOMALIES - CASE * * ** 3955 $ 2,290.00 0 * 42 * DECIDUOUS - SIMPLE - MALOCCLUSION REQ. THE USE OF * * ** 3956 $ 2,290.00 0 * 42 * DECIDUOUS - COMPLEX-MALOCCLUSION REQ. 2 OR MORE * * ** 3957 $ 2,290.00 0 * 42 * SEVERE - MALOCCLUSION REQ. 2 OR MORE REMOVABLE * * ** 3958 $ 2,290.00 0 * 42 * MIXED DENTITION - SIMPLE - MALOCCLUSION REQ.USE OF * * ** 3959 $ 2,290.00 0 * 42 * MIXED DENTITION - COMPLEX- MALOCCLUSION REQ. 2 OR * * ** 3960 $ 2,290.00 0 * 42 * MIXED DENTITION - SEVERE-MALOCCLUSION REQ. 2 OR * * ** 3961 $ 2,290.00 0 * 42 * PERMANENT DENTITION - SIMPLE - MALOCCLUSION REQ A * * ** 3962 $ 2,290.00 0 * 42 * PERMANENT DENTITION - COMPLEX-MALOCCLUSION * * ** 3963 $ 2,290.00 0 * 42 * PERMANENT DENTITION-SEVERE-MALOCCLUSION REQ. A * * ** 3964 $ 75.00 0 * 42 * NEWBORN-INITIAL EXAMINATION & EXPL. RE: NATURE OF * * ** 3965 $ 1,045.47 0 * 42 * ORTHO CARE OF NEWBORN < 2YRS. BONE-MOVING * * ** 3966 $ 30.00 0 * 42 * OBSERVATION & ADJUSTMENTS -(OBSERVATION TO BE * * ** 3967 $ 45.01 0 * 42 * OBSERVATION & ADJUSTMENTS - SERIAL EXTRACTION * * ** 3968 $ 33.99 0 * 42 * OBSERVATION & ADJUSTMENTS - REMOVABLE APPLIANCE * * ** 3969 $ 31.56 0 * 42 * OBSERVATION & ADJUSTMENTS - FIXED APPLIANCE - TO * * ** 3970 $ 75.00 0 * 42 * INITIAL EXAM.-WILL INCLUDE CLINICAL EXAM.AND EXP. * * ** 3971 $ 240.01 0 * 42 * DIAGNOSTIC PHASE-DIAGNOSTIC MODELS,FACIALS, * * ** 3972 $ 175.00 0 * 42 * CASE ANALYSIS & CONSLT.INCLUDES TREATMENT PLANNING * * ** 3973 $ 2,176.48 0 * 42 * SIMPLE - MALOCCLUSIONS REQ. UNCOMPLICATED * * ** 3974 $ 815.00 0 * 42 * COMPLEX - MALOCCLUSIONS REQ. ONE COMPLEXED FIXED * * ** 3975 $ 1,000.00 0 * 42 * SEVERE - MALOCCLUSIONS THAT REQ. ONE OR MORE * * ** 3978 $ 75.00 0 * 42 * FULL ALIGNMENT & RETENTION.- INITIAL EXAM. * * ** 3979 $ 240.01 0 * 42 * FULL ALIGNMENT AND RETENTION - DIAGNOSTIC PHASE - * * ** 3980 $ 175.00 0 * 42 * FULL ALIGNMENT AND RETENTION - CASE ANALYSIS AND * * ** 3981 $ 1,400.00 0 * 42 * CLASS 1 MALOCCLUSIONS-SIMPLE - REQUIRING BANDING * * ** 3982 $ 1,475.00 0 * 42 * CLASS 1 MALOCCLUSIONS-COMPLEX-FULL BANDING OF BOTH * * ** 3983 $ 1,550.00 0 * 42 * CLASS 1 MALOCCLUSIONS - SEVERE- REQUIRING FULL * * ** 3984 $ 1,550.00 0 * 42 * CLASS 11 MALOCCLUSIONS-SIMPLE REQUIRING BANDING IN * * ** 3985 $ 1,625.00 0 * 42 * CLASS 11 MALOCCLUSIONS - COMPLEX-REQUIRING FULL * * ** 3986 $ 1,700.00 0 * 42 * CLASS 11 MALOCCLUSIONS-SEVERE - FULL BANDING OF * * ** 3987 $ 1,550.00 0 * 42 * CLASS 111 MALOCCLUSIONS - SIMPLE - BANDING IN BOTH * * ** 3988 $ 1,625.00 0 * 42 * CLASS 111 MALOCCLUSIONS - COMPLEX - FULL BANDING * * ** 3989 $ 1,700.00 0 * 42 * CLASS 111 MALOCCLUSIONS - SEVERE - REQUIRING FULL * * ** 4000 $ 262.95 4 * * COMPLICATED DELIVERY * * ** 4001 $ 153.90 4 * * LAPAROSCOPY * * ** 4003 $ 263.82 5 * * OOPHORECTOMY/SALPINGECTOMY * * ** 4005 $ 96.74 0 * 5 * VISIT, EMERGENCY, OB&G * * ** 4007 $ 27.90 0 * 5 * VISIT, OFFICE, OB&G * * ** 4008 $ 19.80 0 * 5 * VISIT, HOSPITAL, OB&G * * ** 4009 $ 44.80 0 * 5 * VISIT, HOME, OB&G * * ** 4010 $ 101.13 0 * 5 * CONSULTATION, OB&G * * ** 4011 $ 659.56 6 * * CA OVARY/ FALLOPIAN TUBES * * ** 4012 $ 50.60 0 * 5 * CONSULTATION, LIMITED, 0B&G * * ** 4014 $ 329.78 4 * * MIDCAVITY FORCEPS - DELIVERY * * ** 4017 $ 390.49 4 * * MIDCAVITY ROTATION - SURGICAL DELIVERY * * ** 4018 $ 390.49 4 * * BREECH VAGINAL BIRTH * * ** 4022 $ 164.89 3 * * SPHINCTER REPAIR - EXTERNAL * * ** 4023 $ 164.89 3 * * CERVICAL /VAGINAL LACERATIONS * * ** 4024 $ 197.85 3 * * 4TH DEGREE LACERATION - REPAIR * * ** 4025 $ 483.69 6 * * C-SECTION - HIGH RISK * * ** 4026 $ 164.89 3 * * RETAINED PLACENTA - MANUAL REMOVAL * * ** 4029 $ 263.82 5 * * OMENTECTOMY/REMOVAL OF SOFT-TISSUE MASS * * ** 4032 $ 65.97 2 * * BIOPSY - VULVA (GREATER THAN OR EQUAL TO 2CM) * * ** 4033 $ 263.82 4 * * VAGINECTOMY-PARTIAL * * ** 4034 $ 50.57 4 * * SALPINGOLYSIS VIA LAPAROSCOPY - UNILATERAL * * ** 4035 $ 101.13 4 * * SALPINGOLYSIS VIA LAPAROSCOPE - BILATERAL * * ** 4036 $ 109.94 4 * * SALPINGOSTOMY VIA LAPAROSCOPY - UNILATERAL * * ** 4037 $ 219.85 4 * * SALPINGOSTOMY VIA LAPAROSCOPY - BILATERAL * * ** 4038 $ 170.49 0 * 5 * REPEAT INTRAPARTUM ASSESS BY CONSULTANT AT REQUEST * * ** 4039 $ 516.41 0 * 5 * MANAGEMENT OF COMPLICATED LABOUR BY OBSTETRICIAN * * ** 4040 $ 43.97 4 * * CAUTERY OF ENDOMETRIOSIS * * ** 4041 $ 109.93 5 * * OOPHORECTOMY AND/OR SALPINGECTOMY-UNILATERAL * * ** 4042 $ 219.85 5 * * OOPHORECTOMY AND/OR SALPINGECTOMY-BILATERAL * * ** 4043 $ 175.89 5 * * OVARIAN CYSTECTOMY - UNILATERAL * * ** 4044 $ 329.79 5 * * OVARIAN CYSTECTOMY-BILATERAL * * ** 4045 $ 109.93 4 * * VENTRAL SUSPENSION OF UTERUS * * ** 4046 $ 153.91 4 * * PRESACRAL NEURECTOMY * * ** 4047 $ 241.83 6 * * EXCISION OF EXTENSIVE PERITONEAL ENDOMETRIOSIS * * ** 4048 $ 329.79 6 * * REMOVAL OF COMPLICATED PELVIC DISEASE * * ** 4049 $ 94.02 0 * * EXTERNAL CEPHALIC VERSION * * ** 4050 $ 373.70 5 * * CAESAREAN SECTION - ELECTIVE * * ** 4052 $ 417.70 6 * * CAESAREAN SECTION - EMERGENCY * * ** 4092 $ 123.13 0 * * MULTIPLE NATURAL BIRTHS - EACH ADDITIONAL CHILD * * ** 4093 $ 61.57 0 * * CAESAREAN SECTION MULTIPLE BIRTHS, EACH ADDITIONAL * * ** 4106 $ 571.62 8 * * CAESAREAN HYSTERECTOMY * * ** 4107 $ 101.13 5 * * SUPERVISION OF LABOUR AND VAGINAL DELIVERY * * ** 4110 $ 153.90 2 * * THERAPEUTIC ABORTION (VAGINAL) 14 - 18 WEEKS * * ** 4111 $ 109.94 2 * * THERAPEUTIC ABORTION (VAGINAL) LESS THAN 14 WEEKS * * ** 4114 $ 215.45 3 * * THERAPEUTIC ABORTION BY D&E, 18 WKS AND OVER * * ** 4116 $ 135.48 3 * * CURETTAGE FOR POST-PARTUM HAEMORRHAGE (> 20 WEEKS) * * ** 4118 $ 30.35 0 * * INDUC. OR STIM. OF LABOUR BY OXYTOCIN - 1ST HOUR * * ** 4119 $ 20.21 0 * * INDUC. OR STIM. OF LABOUR BY OXYTOCIN - SUBS. HRS * * ** 4201 $ 329.78 5 * * OVARIAN CYSTECTOMY * * ** 4202 $ 483.69 4 * * VAGINAL HYSTERECTOMY * * ** 4203 $ 329.78 5 * * MYOMECTOMY * * ** 4204 $ 263.82 5 * * HYSTEROTOMY - ABDOMINAL WITH/WITHOUT STERILIZATION * * ** 4206 $ 175.87 4 * * SUSPENSION OF UTERUS * * ** 4208 $ 328.69 5 * * ECTOPIC PREGNANCY * * ** 4212 $ 439.70 6 * * PELVIC LYMPHADENECTOMY * * ** 4216 $ 307.80 5 * * NEURECTOMY PRESACRAL * * ** 4217 $ 263.82 6 * * HEMORRHAGE - POST OP (INTRA-ABDOMINAL MANAGEMENT) * * ** 4218 $ 725.51 6 * * HYSTERECTOMY - RADICAL * * ** 4219 $ 439.70 6 * * PARA-AORTIC LYMPHADENECTOMY * * ** 4220 $ 193.45 5 * * PARA-AORTIC LYMPHADENECTOMY - PARTIAL * * ** 4221 $ 143.82 2 * * HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-SIMPLE * * ** 4222 $ 241.43 2 * * HYSTEROSCOPIC DIV OF INTRAUTERINE ADHESIONS-COMP * * ** 4223 $ 335.33 2 * * RESECTION OF MYOMA * * ** 4224 $ 335.33 2 * * ENDOMETRIAL ABLATION * * ** 4225 $ 241.43 2 * * HYSTEROSCOPIC DIVISION OF UTERINE SEPTUM * * ** 4227 $ 278.65 2 * * CYSTOCOELE/URETHROCOELE REPAIR * * ** 4228 $ 483.69 5 * * HYSTERECTOMY - TOTAL * * ** 4229 $ 483.69 6 * * REMOVAL OF COMPLICATED PELVIC DISEASE * * ** 4230 $ 219.85 4 * * STERILIZATION - ABDOMINAL-OPEN * * ** 4232 $ 63.91 0 * * OOPHORECTOMY/OVARIAN CYSTECTOMY AND/OR ADNEXECTOMY * * ** 4233 $ 127.81 0 * * OOPHORECTOMY/OVARIAN CYSTECTOMY AND/OR ADNEXECTOMY * * ** 4300 $ 30.79 2 * * HYMEN INCISION * * ** 4301 $ 87.95 2 * * BARTHOLINS CYST/ABSCESS MARSUPIALIZATION * * ** 4303 $ 131.92 2 * * HYDROCELE CANAL OF NUCK EXCISION * * ** 4304 $ 43.97 2 * * URETHRAL CARUNCLE - CAUTERY OR EXCISION IN HOSP * * ** 4305 $ 26.37 0 * * VENEREAL WARTS, CAUTERY OR EXCISION * * ** 4306 $ 87.95 2 * * VENEREAL WARTS UNDER G.A., HOSPITAL * * ** 4307 $ 285.82 3 * * VULVECTOMY - SIMPLE * * ** 4309 $ 96.74 2 * * LABIUM VARICOCELE * * ** 4311 $ 96.74 2 * * VULVAR ATRESIA OR ENLARGEMENT OF VAGINAL INTROITUS * * ** 4312 $ 87.95 2 * * LABIA MINORA RESECTION * * ** 4316 $ 175.87 2 * * VULVOVAGINOPLASTY * * ** 4317 $ 12.01 2 * * BIOPSY - VULVA - < 2 CM * * ** 4318 $ 625.94 3 * * VULVECTOMY - RADICAL * * ** 4320 $ 273.14 4 * * LYMPHADENECTOMY - INGUINAL/FEMORAL - UNILATERAL * * ** 4322 $ 455.21 4 * * LYMPHADENECTOMY - INGUINAL/FEMORAL - BILATERAL * * ** 4401 $ 395.73 3 * * FISTULA RECTO-VAGINAL REPAIR * * ** 4402 $ 109.94 2 * * ABSCESS PELVIC COLPOTOMY DRAINAGE * * ** 4404 $ 26.37 2 * * CYST VAGINAL INCLUSION * * ** 4405 $ 114.32 2 * * CYST VAGINAL OTHER THAN INCLUSION * * ** 4406 $ 87.95 2 * * SEPTUM VAGINAL REMOVAL * * ** 4408 $ 395.73 4 * * VAULT PROLAPSE (VAGINAL APPROACH) * * ** 4410 $ 114.32 5 * * POST-OP HAEMORRHAGE, VAGINAL MANAGEMENT W/ GA * * ** 4411 $ 395.73 4 * * VAGINECTOMY - TOTAL * * ** 4421 $ 278.65 2 * * RECTOCELE REPAIR * * ** 4422 $ 340.03 2 * * ENTEROCELE REPAIR * * ** 4424 $ 435.87 3 * * COMPLETE REPAIR OF PROLAPSE * * ** 4427 $ 242.85 2 * * LEFORTS OPERATION * * ** 4429 $ 290.22 2 * * PERINEAL LACERATION REPAIR OF OLD 3RD DEGREE * * ** 4432 $ 96.52 2 * * VAGINAL PLASTIC PROCEDURE -REPEAT * * ** 4500 $ 87.95 2 * * CERVIX DILATION AND CURETTAGE * * ** 4502 $ 87.95 2 * * CERVIX, REPAIR OF * * ** 4503 $ 52.77 2 * * CRYOSURGERY - CERVIX * * ** 4508 $ 48.38 2 * * BIOPSY CERVIX, UNDER G.A. * * ** 4509 $ 12.01 2 * * POLYPECTOMY - CERVICAL * * ** 4510 $ 87.95 2 * * BIOPSY CERVIX WITH D&C * * ** 4512 $ 109.94 4 * * MYOMECTOMY VAGINAL * * ** 4515 $ 43.97 2 * * CERVICAL LIGATURE, REMOVAL OF UNDER ANAESTHETIC * * ** 4516 $ 219.85 2 * * CERVICAL INCOMPETENCE - EMERGENCY REPAIR * * ** 4517 $ 175.87 2 * * CERVICAL INCOMPETENCE - ELECTIVE REPAIR * * ** 4530 $ 43.97 2 * * CAUTERIZATION CERVIX, G.A. * * ** 4531 $ 87.95 2 * * CAUTERIZATION OF CERVIX TO INCLUDE D&C IF DONE * * ** 4533 $ 26.37 0 * * CAUTERIZATION CERVIX, ELECTRIC, IN OFFICE * * ** 4536 $ 193.45 2 * * CONE BIOPSY CERVIX (INCLUDES D&C) * * ** 4545 $ 21.98 0 * * ARTIFICIAL INSEMINATION - OPERATION ONLY * * ** 4551 $ 193.45 3 * * CERVICAL STUMP REMOVAL * * ** 4602 $ 329.78 5 * * SALPINGOLYSIS - UNILATERAL/BILATERAL * * ** 4605 $ 435.87 5 * * VAULT PROLAPSE * * ** 4616 $ 455.11 5 * * MICRO SALPINGOSTOMY -UNILATERAL * * ** 4617 $ 591.63 5 * * MICRO SALPINGOSTOMY - BILATERAL * * ** 4620 $ 112.69 2 * * CERVICAL NEOPLASIA * * ** 4621 $ 112.69 2 * * VAGINAL NEOPLASIA WITH OR WITHOUT G.A. * * ** 4622 $ 112.69 2 * * VULVAR CONDYLOMATA * * ** 4623 $ 169.02 2 * * EXTENSIVE VULVAR AND/OR VAGINAL CONDYL. UNDER G.A. * * ** 4624 $ 281.71 2 * * VULVAR INTRAEPITHELIAL LESION DIFFUSE W/ PERIANAL * * ** 4625 $ 225.38 2 * * VULVAR INTRAEPITHELIAL LESION/DIFFUSE MULTIFOCAL * * ** 4626 $ 659.56 5 * * TUBO-CORNUAL ANASTOMOSIS - UNILATERAL (MICRO) * * ** 4627 $ 857.42 5 * * TUBO-CORNUAL ANASTOMOSIS - BILATERAL (MICRO) * * ** 4628 $ 351.77 5 * * REMOVAL OF EXTRAPELVIC SOFT TISSUE MASS > 10 CM * * ** 4660 $ 65.97 4 * * TUBAL INTERRUPTION (STERILIZATION ) * * ** 4662 $ 65.97 4 * * LAPAROSCOPY - REMOVAL OF FOREIGN BODY * * ** 4664 $ 251.81 4 * * ECTOPIC PREGNANCY - REMOVAL VIA SCOPE. * * ** 4680 $ 99.95 0 * 5 16 * GUIDED AMNIOCENTESIS * * ** 4699 $ 5.48 0 * * FERN TEST * * ** 5982 $ 425.62 1 * * WCB ARTHROSCOPIC ACROMIOPLASTY * * ** 6005 $ 85.31 0 * 11 * VISIT, EMERGENCY, PLASTIC SURGERY * * ** 6007 $ 21.45 0 * 11 * VISIT, OFFICE, PLASTIC SURGERY * * ** 6008 $ 18.28 0 * 11 * VISIT, HOSPITAL, PLASTIC SURGERY * * ** 6009 $ 42.74 0 * 11 * VISIT, HOME, PLASTIC SURGERY * * ** 6010 $ 63.54 0 * 11 * CONSULTATION, PLASTIC SURGERY * * ** 6012 $ 35.58 0 * 11 * CONSULTATION, LIMITED OR REPEAT, PLASTIC SURGERY * * ** 6015 $ 8.35 2 * * REMOVAL OF EXTENSIVE SCARS PER CM OVER 5 CM * * ** 6016 $ 104.01 2 * * REMOVAL OF TUMOR OR SCAR UNDER GA, UP TO 5 CM * * ** 6017 $ 222.09 2 * * REMOVAL OF TUMOUR; 5 CM TO 10 CM * * ** 6018 $ 339.15 2 * * REMOVAL OF TUMOR - MORE THAN 10 CM * * ** 6019 $ 115.79 2 * * SKIN GRAFTS - SINGLE OR MULTIPLE FLAPS < 2CM * * ** 6020 $ 230.38 2 * * SKIN GRAFTS - SINGLE * * ** 6021 $ 288.85 2 * * SKIN GRAFTS/SINGLE WITH FREE SKIN GRAFT SECONDARY * * ** 6022 $ 461.46 2 * * SKIN GRAFTS - MULTIPLE * * ** 6023 $ 519.00 2 * * SKIN GRAFTS - MULTIPLE WITH FREE SKIN GRAFT * * ** 6024 $ 288.85 3 * * SKIN GRAFT; EYEBROW/EYELID, LIP, EAR, NOSE SINGLE * * ** 6025 $ 461.46 3 * * SKIN GRAFT; EYEBROW/EYELID/LIP/EAR/NOSE; TWO STAGE * * ** 6026 $ 346.38 2 * * SKIN GRAFT; ARTERIAL ISLAND FLAP * * ** 6027 $ 115.79 3 * * SKIN GRAFT; REPAIR OF TORN (SPLIT) EARLOBE (SIMPLE * * ** 6028 $ 49.58 2 * * ABSCESS - WEB SPACE OPERATION ONLY * * ** 6029 $ 66.41 2 * * ABSCESS - WEB SPACE UNDER GENERAL ANAESTHETIC * * ** 6030 $ 461.46 2 * * SKIN GRAFTS; FLAPS FROM A DISTANCE, UPPER * * ** 6031 $ 578.88 2 * * SKIN GRAFTS; FLAPS FROM A DISTANCE - FREE GRAFT * * ** 6032 $ 695.13 2 * * SKIN GRAFTS; FLAPS FROM A DISTANCE, LOWER * * ** 6033 $ 346.38 4 * * SKIN GRAFTS - INDIRECT TUBES, JUMPS - MAJOR STAGE * * ** 6034 $ 230.38 3 * * SKIN GRAFTS - INDIRECT TUBES, JUMPS - MINOR STAGE * * ** 6035 $ 70.10 3 * * SKIN GRAFTS INDIRECT; TUBES/JUMPS, DELAYING TUBES * * ** 6036 $ 346.38 3 * * SKIN GRAFTS; INDIRECT, TUBES/JUMPS, MINOR + GRAFT * * ** 6040 $ 288.85 2 * * FINGER, PHALANX MULTIPLE SKIN GRAFT FREE * * ** 6041 $ 346.38 2 * * FULL THICKNESS FREE SKIN GRAFTS; EYELID/NOSE/LIP * * ** 6042 $ 66.41 2 * * ABSCESS - MID PALMER/THENAR/DORSAL * * ** 6043 $ 93.24 2 * * SKIN GRAFT - FINGER TIP - FULL THICKNESS * * ** 6044 $ 288.85 2 * * SKIN GRAFTS - FULL THICKNESS - FREE - SOLE OR PALM * * ** 6045 $ 115.79 2 * * FREE SKIN GRAFT; FULL THICKNESS - TOE PULP GRAFT * * ** 6046 $ 58.48 2 * * SPLIT THICKNESS FREE SKIN GRAFT; < 6.5 SQ. CM. * * ** 6047 $ 115.79 2 * * SKIN GRAFTS - SPLIT THICKNESS - FREE - 65 SQ. CM * * ** 6048 $ 230.38 2 * * SKIN GRAFTS - SPLIT THICKNESS - FREE - 650 SQ. CM * * ** 6049 $ 4.38 3 * * SPLIT THICKNESS FREE SKIN GRAFTS; EACH 6.5 > 650 * * ** 6050 $ 346.38 2 * * SKIN GRAFTS - REGIONS OF MAJOR JOINTS AND HANDS * * ** 6051 $ 93.24 2 * * SKIN GRAFTS - FUNCTIONAL AREAS - FINGER TIP * * ** 6052 $ 230.38 3 * * SKIN GRAFTS - HEAD AND NECK - 65 SQ. CM OR LESS * * ** 6053 $ 346.38 3 * * SKIN GRAFT; FUNCTIONAL AREAS: HEAD & NECK > 65 CM * * ** 6054 $ 809.02 3 * * SKIN GRAFTS - HEAD AND NECK - IN EXCESS OF 195 SQ * * ** 6055 $ 393.37 3 * * SKIN GRAFTS - CAVITY GRAFTING - EYE SOCKET * * ** 6056 $ 578.88 3 * * SKIN GRAFTS/CAVITY GRAFTING/EYE SOCKET WITH MUCOSA * * ** 6057 $ 346.38 3 * * SKIN GRAFTS - CAVITY GRAFTING - NOSE * * ** 6058 $ 461.46 2 * * SKIN GRAFTS; FUNCTIONAL AREAS; MAJOR JOINTS, LATE * * ** 6060 $ 461.46 3 * * SKIN GRAFTS - CAVITY GRAFTING - MOUTH * * ** 6061 $ 230.38 3 * * SKIN GRAFTS/CAVITY GRAFTING - LINING PEDICLE FLAPS * * ** 6062 $ 346.38 4 * * BONE CAVITY GRAFTING IN LARGE BONE OVER 7.5 CM * * ** 6063 $ 104.01 2 * * REMOVAL OF FOREIGN BODY REQUIRING GA * * ** 6064 $ 173.08 2 * * BONE CAVITY IN SMALL BONE - CAVITY GRAFTING * * ** 6065 $ 230.38 3 * * BONE CAVITY IN LARGE BONE - CAVITY GRAFTING * * ** 6066 $ 420.35 4 * * CAVITY GRAFTING; ABSENCE OF VAGINA - CONGENITAL * * ** 6069 $ 57.55 2 * * EXCISION OF TUMOR OR SMALL SCAR - FACE * * ** 6070 $ 58.48 2 * * SKIN GRAFT FOLLOWING REMOVAL OF TUMOR; < 6.5 SQ CM * * ** 6071 $ 115.79 2 * * SKIN GRAFT FOLLOWING REMOVAL OF TUMOR; < 65 SQ CM * * ** 6072 $ 230.38 2 * * SKIN GRAFT FOLLOWING REMOVAL OF TUMOR; < 650 SQ CM * * ** 6073 $ 2.92 3 * * SKIN GRAFT FOLLOWING REMOVAL OF TUMOR/EACH 6.5>650 * * ** 6075 $ 230.38 3 * * LIPS AND EYELID WOUNDS COMPLICATED * * ** 6076 $ 230.38 3 * * NOSE AND EAR WOUNDS COMPLICATED * * ** 6077 $ 230.38 3 * * COMPLICATED LACERATION OF THE SCALP CHEEK AND NECK * * ** 6078 $ 23.14 4 * * MINOR BURNS; DRESSING (IN HOSP CARE ONLY) * * ** 6079 $ 34.88 5 * * SURGICAL DEBRIDEMENT; MINOR BURNS, EACH 5% OF BODY * * ** 6080 $ 17.43 5 * * BURNS; SUBSEQUENT SURG DEBRIDEMENT; EACH 5% BODY * * ** 6081 $ 115.79 5 * * BURNS SURGICAL EXCISION - FIRST 5% OF BODY SURFACE * * ** 6082 $ 58.48 5 * * BURNS SURGICAL EXCISION/EACH ADDITIONAL 5% OF BODY * * ** 6083 $ 58.48 0 * * BURNS, SEVERE, GENERAL CARE - FIRST HOUR * * ** 6084 $ 34.88 0 * * BURNS, SEVERE, GENERAL CARE - SUBSEQUENT HOURS * * ** 6085 $ 361.66 3 * * TISSUE EXPANSION - MAJOR AREAS * * ** 6086 $ 241.30 2 * * TISSUE EXPANSION - MINOR AREAS * * ** 6087 $ 53.93 2 * * INCISION SUBPERIOSTEAL ABSCESS * * ** 6109 $ 180.76 3 * * RHINOPLASTY - REMOVAL OF HUMP * * ** 6110 $ 636.42 3 * * FACIAL PARALYSIS - DYNAMIC SLINGS * * ** 6111 $ 519.00 3 * * FACIAL PARALYSIS STATIC SLINGS * * ** 6112 $ 58.48 3 * * ABRASIVE SURGERY <1/4 OF FACE * * ** 6113 $ 173.08 3 * * ABRASIVE SURGERY 1/4 TO 1/2 OF FACE * * ** 6114 $ 346.38 3 * * ABRASIVE SURGERY - FULL FACE * * ** 6115 $ 695.13 3 * * RHINOPLASTY - FOREHEAD, 2 OPERATIONS * * ** 6116 $ 288.85 3 * * RHINOPLASTY - COMPOSITE GRAFT * * ** 6117 $ 230.38 3 * * RHINOPHYMA * * ** 6118 $ 461.46 3 * * RHINOPLASTY; BONE GRAFT TO NOSE - AUTOLOGOUS * * ** 6119 $ 346.38 3 * * RHINOPLASTY; BONE GRAFT NOSE, NON-AUTOLOGOUS * * ** 6120 $ 636.42 3 * * FACIAL PARALYSIS COMPOSITE REPAIR * * ** 6123 $ 235.52 3 * * NASAL FRACTURE-COMMINUTED-WIRE PLATE FIXATION * * ** 6124 $ 346.38 3 * * NASAL FRACTURE - WIRE PLATE FIXATION - OPEN REDUCT * * ** 6125 $ 137.94 3 * * EYELIDS - BLEPHAROPLASTY - SIMPLE * * ** 6126 $ 243.01 3 * * BLEPHAROPLASTY - COMPLICATED * * ** 6127 $ 685.13 3 * * LYMPHOEDEMA - ENTIRE LEG * * ** 6128 $ 1,024.28 3 * * LYMPHOEDEMA - LOWER LIMB * * ** 6129 $ 925.27 3 * * MUSCLE TRANSPLANT AND FACE LIFT * * ** 6130 $ 115.79 3 * * AURICLE - ACCESSORY * * ** 6131 $ 230.38 3 * * OTOPLASTY - OUTSTANDING EARS * * ** 6132 $ 230.38 3 * * MICROTIA - PARTIAL * * ** 6133 $ 692.78 3 * * MICROTIA - TOTAL MAJOR * * ** 6134 $ 230.38 3 * * MICROTIA - TOTAL MINOR * * ** 6135 $ 138.91 3 * * PREAURICULAR SINUS - SIMPLE * * ** 6136 $ 578.88 4 * * ABBE OPERATION * * ** 6137 $ 461.46 4 * * MOUTH ROTATION FLAP TO LIP * * ** 6138 $ 809.02 4 * * CLEFT LIP - BILATERAL * * ** 6139 $ 405.09 4 * * CLEFT LIP - UNILATERAL * * ** 6140 $ 81.66 3 * * WEDGE RESECTION - LIP VERMILION * * ** 6141 $ 173.08 3 * * WEDGE RESECTION OF LIP SULCUS * * ** 6142 $ 405.09 6 * * PHARYNGOPLASTY, PHARYNGEAL FLAP * * ** 6143 $ 578.88 6 * * PHARYNGEAL FLAP PUSH BACK * * ** 6144 $ 578.88 4 * * CLEFT LIP, BILATERAL * * ** 6145 $ 405.09 6 * * CLEFT PALATE * * ** 6146 $ 232.51 3 * * LIP SHAVE - VERMILLIONECTOMY * * ** 6147 $ 461.46 4 * * PALATAL CLEFT - BONE GRAFT * * ** 6148 $ 346.38 3 * * EYEBROW, DIRECT FLAP - FIRST STAGE * * ** 6149 $ 173.08 3 * * EYEBROW, DIRECT FLAP - SECOND STAGE * * ** 6150 $ 461.46 4 * * MAMMOPLASTY * * ** 6151 $ 519.00 4 * * ULCER DECUBITUS PLASTIC SURGERY * * ** 6153 $ 461.46 4 * * BONE GRAFT ORBIT, AUTOLOGOUS * * ** 6154 $ 346.38 4 * * BONE GRAFT ORBIT, NON-AUTOLOGOUS IMPLANT * * ** 6156 $ 173.08 2 * * NEUROMA TRANSPLANT * * ** 6157 $ 332.29 2 * * NIPPLE-AREOLAR RECONSTRUCTION * * ** 6159 $ 1,000.00 5 * * TRAM FLAP RECONSTRUCTION OF MASTECTOMY DEFECT * * ** 6163 $ 173.08 6 * * DIRECT ADVANCEMENT - ASSISTANT FEE * * ** 6164 $ 288.85 3 * * BREAST REPLACEMENT - UNILATERAL * * ** 6165 $ 461.46 3 * * BREAST REPLACEMENT - BILATERAL * * ** 6166 $ 318.21 4 * * EXCISION OF AXILLARY SWEAT GLAND FOR HYPERHYDROSIS * * ** 6167 $ 346.38 4 * * THOMPSON PROCEDURE LYMPHOEDEMA - FOREARM * * ** 6168 $ 230.38 4 * * THOMPSON PROCEDURE LYMPHOEDEMA - UPPER EXTREMITY * * ** 6169 $ 578.88 4 * * THOMPSON PROCEDURE LYMPHOEDEMA - LOWER EXTREMITY * * ** 6170 $ 578.88 4 * * THOMPSON PROCEDURE LYMPHOEDEMA - LOWER EXTREMITY * * ** 6171 $ 230.38 2 * * SYNDACTYLY LOCAL FLAP - FIRST CLEFT * * ** 6172 $ 346.38 2 * * SYNDACTYLY WITH SKIN GRAFT - FIRST CLEFT * * ** 6173 $ 288.85 2 * * FINGER, DIRECT FLAP * * ** 6175 $ 809.02 4 * * POLLICIZATION * * ** 6176 $ 536.28 5 * * DIGITAL TRANSPLANT * * ** 6177 $ 578.88 3 * * NEUROVASCULAR PEDICLE * * ** 6178 $ 339.15 2 * * BREAST IMPLANT - EXCISION/PATHOLOGIC CAPSULE * * ** 6179 $ 104.01 2 * * BREAST IMPLANT - EXCISION ONLY * * ** 6180 $ 230.38 3 * * PREAURICULAR SINUS - COMPLICATED * * ** 6181 $ 230.38 3 * * LIP ADHESION FOR CLEFT PALATE * * ** 6182 $ 178.39 2 * * GANGLIA OF TENDON SHEATH OR JOINT * * ** 6183 $ 297.08 2 * * FLEXOR - REPAIR * * ** 6184 $ 184.00 2 * * EXTENSOR - REPAIR * * ** 6185 $ 536.62 2 * * TENDON GRAFT * * ** 6186 $ 177.88 2 * * TENOPLASTY - ONE TENDON * * ** 6187 $ 297.08 2 * * TENOPLASTY - TWO OR MORE TENDONS * * ** 6188 $ 297.08 2 * * TENOLYSIS * * ** 6189 $ 119.41 2 * * TENOLYSIS - EACH ADDITIONAL * * ** 6193 $ 358.13 2 * * PALMAR FASCIECTOMY - EXTENSIVE * * ** 6194 $ 477.91 2 * * PALMAR FASCIECTOMY - WITH SKIN GRAFTING * * ** 6195 $ 358.13 3 * * SILASTIC ROD * * ** 6196 $ 59.71 3 * * SILASTIC PULLEY * * ** 6197 $ 119.41 2 * * TENOSYNOVITIS, ACUTE * * ** 6198 $ 119.41 2 * * TENOSYNOVITIS - ULNA OR RADIAL BURSA * * ** 6200 $ 112.25 3 * * TATTOOING SURGERY FACIAL AREA - < 1/4 OF FACE * * ** 6201 $ 230.38 3 * * TATTOOING SURGERY FACIAL AREA - 1/4 TO 1/2 FACE * * ** 6202 $ 346.38 4 * * TATTOOING SURGERY FACIAL AREA - FULL FACE * * ** 6203 $ 439.16 2 * * TENDON TRANSFER HAND AND WRIST * * ** 6204 $ 131.73 2 * * TENDON TRANSFER HAND AND WRIST - EACH ADDITIONAL * * ** 6205 $ 58.48 2 * * TATTOOING SURGERY NON-FACIAL AREA - < 6.5 SQ. CM * * ** 6206 $ 115.79 2 * * TATTOOING SURGERY NON-FACIAL AREA - < 65 SQ. CM * * ** 6207 $ 230.38 2 * * TATTOOING SURGERY NON-FACIAL AREA - < 650 SQ. CM * * ** 6210 $ 238.83 2 * * MICRONEURAL SURGERY; NEUROLYSIS - EXTERNAL * * ** 6211 $ 358.13 2 * * MICRONEURAL SURGERY; NEUROLYSIS - INTRANEURAL * * ** 6212 $ 266.90 2 * * MICROFASCICULAR NEURORRAPHY - DIGITAL OR PALMAR * * ** 6213 $ 535.43 2 * * MICROFASCICULAR NEURORRAPHY - MAJOR NERVE * * ** 6214 $ 383.96 2 * * INTRAFASCICULAR NERVE GRAFT - DIGITAL OR PALMAR * * ** 6215 $ 1,153.07 4 * * INTRAFASCICULAR NERVE GRAFT - MAJOR NERVE * * ** 6216 $ 535.43 6 * * MICROVASCULAR SURGERY - ARTERY OR VEIN * * ** 6217 $ 2,303.79 4 * * MICROREIMPLANTATION - DIGIT OR EXTREMITY * * ** 6218 $ 147.43 2 * * AMPUTATION - TRANSMETACARPAL * * ** 6219 $ 118.64 2 * * AMPUTATION - FINGER * * ** 6220 $ 2,303.79 5 * * MICROVASCULAR SURGICAL FREE FLAP * * ** 6221 $ 195.81 2 * * BONE GRAFT - METACARPAL, PHALANX * * ** 6222 $ 89.85 2 * * FINGER FRACTURE - PHALANX * * ** 6223 $ 89.85 2 * * FRACTURE - METACARPAL * * ** 6224 $ 147.43 2 * * FRACTURE - DISTAL PHALANGES, FIRST * * ** 6225 $ 89.85 2 * * FRACTURE - DISTAL PHALANGES, EACH ADDITIONAL * * ** 6226 $ 236.17 2 * * FRACTURE, OTHER THAN DISTAL PHALANGES - FIRST * * ** 6227 $ 125.53 2 * * FRACTURE; OTHER THAN DISTAL PHALANGES, ADDITIONAL * * ** 6228 $ 247.13 2 * * ARTHROPLASTY OF METACARPOPHALANGEAL/INTERPHALANGEA * * ** 6229 $ 228.28 2 * * ARTHRODESIS OF METACARPOPHALANGEAL/INTERPHALANGEAL * * ** 6231 $ 752.77 3 * * HAND JOINTS - RHEUMATOID - RECONSTRUCTION * * ** 6232 $ 141.66 2 * * PROSTHESIS - FINGER JOINT - FIRST JOINT * * ** 6233 $ 83.51 2 * * PROSTHESIS - FINGER JOINT - SUBSEQUENT JOINTS * * ** 6234 $ 282.42 2 * * SYNOVECTOMY - RHEUMATOID DISEASE * * ** 6235 $ 187.81 2 * * INTRINSIC RELEASE - JOINTS * * ** 6236 $ 40.58 2 * * METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT * * ** 6237 $ 120.59 2 * * METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT * * ** 6238 $ 196.76 2 * * REPAIR OF COMPLICATED FINGERTIP INJURY * * ** 6240 $ 292.38 6 * * INTERDENTAL AND INTERMAXILLARY WIRING * * ** 6241 $ 352.26 6 * * GUNNING SPLINTS IMPRESSION * * ** 6242 $ 352.26 6 * * MANDIBLE -OPEN REDUCTION - UNILATERAL * * ** 6243 $ 547.18 6 * * MANDIBLE -OPEN REDUCTION - BILATERAL * * ** 6244 $ 425.06 6 * * MANDIBLE -OPEN REDUCTION AND WIRING - UNILATERAL * * ** 6245 $ 587.10 6 * * MANDIBLE -OPEN REDUCTION AND WIRING - BILATERAL * * ** 6246 $ 81.66 4 * * REMOVAL OF SUTURES, INTRA-ORAL SPLINTS, UNDER GA * * ** 6250 $ 587.10 6 * * FACE, FRACTURE LE FORTE - HORIZONTAL * * ** 6251 $ 587.10 6 * * FACE, FRACTURE LE FORTE - PYRAMIDAL * * ** 6252 $ 587.10 6 * * FACE, FRACTURE LE FORTE/CRANIO-FACIAL DYSJUNCTION * * ** 6253 $ 587.10 6 * * WIRE SUSPENSION, CRANIOMAXILLARY * * ** 6255 $ 169.09 2 * * PERIPHERAL NERVE SUTURE: MINOR * * ** 6256 $ 164.79 2 * * NERVE REPAIR - PALMAR * * ** 6257 $ 327.31 3 * * PERIPHERAL NERVE SUTURE: MAJOR * * ** 6258 $ 223.21 2 * * PERIPHERAL NERVE/NEUROLYSIS - EXPLORATION * * ** 6259 $ 328.88 2 * * MICROSURGICAL REMOVAL NEOPLASM, DIGITAL/PALMAR * * ** 6260 $ 115.79 3 * * MAXILLARY FRACTURE ZYGOMATIC - TEMPORAL ELEVATION * * ** 6261 $ 469.68 4 * * MAXILLARY FRACTURE ZYGOMATIC - OPEN REDUCTION AND * * ** 6262 $ 115.79 4 * * MAXILLARY FRACTURE ZYGOMATIC - REDUCTION * * ** 6265 $ 115.79 3 * * MAXILLARY FRACTURE ZYGOMATIC - ARCH - TEMPORAL * * ** 6266 $ 292.38 4 * * ZYGOMATIC ARCH/OPEN REDUCTION/INTEROSSEOUS WIRING * * ** 6270 $ 410.96 4 * * ORBITAL FLOOR FRACTURE * * ** 6271 $ 82.90 3 * * ALVEOLAR FRACTURE - ONE TOOTH EXTRACTION * * ** 6272 $ 23.14 3 * * ALVEOLAR FRACTURE - ADDITIONAL TEETH * * ** 6273 $ 234.02 3 * * FRACTURE-ALVEOLUS; ARCH BAR FIXATION * * ** 6280 $ 234.02 3 * * TEMPORO-MANDIBULAR JOINT; MENISCECTOMY * * ** 6281 $ 352.26 3 * * TEMPORO-MANDIBULAR JOINT; CONDYLECTOMY * * ** 6282 $ 410.96 3 * * TEMPORO-MANDIBULAR ARTHROPLASTY * * ** 6291 $ 344.24 4 * * MANDIBULAR RESECTION; TUMOURS; ENUCLEATION * * ** 6292 $ 519.00 4 * * MANDIBULAR RESECTION; TUMOURS; WITH BONE GRAFT * * ** 6293 $ 468.51 4 * * BONE GRAFT JAW, AUTOLOGOUS * * ** 6294 $ 352.26 4 * * BONE GRAFT JAW, NON-AUTOLOGOUS * * ** 6300 $ 797.28 6 * * OSTEOTOMIES, MAXILLO-FACIAL; LE FORT 1, HORIZONTAL * * ** 6301 $ 1,137.80 6 * * OSTEOTOMIES, MAXILLO-FACIAL LE FORT II - PYRAMIDAL * * ** 6302 $ 2,283.82 8 * * MAXILLO-FACIAL OSTEOTOMY; LE FORT III INTRACRANIAL * * ** 6303 $ 1,822.35 7 * * MAXILLO-FACIAL OSTEOTOMY; LE FORT III EXTRACRANIAL * * ** 6304 $ 797.28 6 * * OSTEOTOMIES, MAXILLO-FACIAL - MALAR MAXILLIARY * * ** 6305 $ 455.60 6 * * OSTEOTOMIES, MANDIBULAR MAXILLO-FACIAL/UNILATERAL * * ** 6306 $ 683.40 6 * * OSTEOTOMIES, MANDIBULAR MAXILLO-FACIAL - BILATERAL * * ** 6307 $ 569.49 6 * * OSTEOTOMIES, PRE-MAXILLARY SET BACK * * ** 6308 $ 587.10 6 * * MANDIBULAR OSTEOTOMY/INTERNAL FIXATION/UNILATERAL * * ** 6309 $ 874.77 6 * * MANDIBULAR OSTEOTOMY - INTERNAL FIXATION/BILATERAL * * ** 6310 $ 2,243.91 8 * * OSTEOTOMY - ORBITAL ADVANCEMENT - UNILATERAL * * ** 6311 $ 3,365.26 8 * * OSTEOTOMY - ORBITAL ADVANCEMENT * * ** 6312 $ 2,243.91 8 * * OSTEOTOMY - INTRACRANIAL CORRECTION HYPERTELORISM * * ** 6313 $ 2,243.91 8 * * OSTEOTOMY - ORBITAL EXPANSION * * ** 6314 $ 445.03 3 * * OSTEOTOMY - CANTHOPEXY * * ** 7005 $ 88.44 0 * 8 * EMERGENCY VISIT - GENERAL SURGERY * * ** 7006 $ 25.91 0 * 8 * DIRECTIVE CARE - GENERAL SURGERY * * ** 7007 $ 22.24 0 * 8 * SUBSEQUENT OFFICE VISIT - GENERAL SURGERY * * ** 7008 $ 18.94 0 * 8 * SUBSEQUENT HOSPITAL VISIT - GENERAL SURGERY * * ** 7009 $ 44.27 0 * 8 * SUBSEQUENT HOME VISIT- GENERAL SURGERY * * ** 7010 $ 94.77 0 * 8 * CONSULTATION- GENERAL SURGERY * * ** 7012 $ 51.74 0 * 8 * REPEAT OR LIMITED CONSULTATION- GENERAL SURGERY * * ** 7025 $ 72.53 2 * * TEMPORAL ARTERY BIOPSY * * ** 7027 $ 116.89 2 * * ABSCESS - DEEP - GENERAL ANAESTHETIC * * ** 7028 $ 67.38 2 * * SURAL NERVE - BIOPSY OF * * ** 7041 $ 38.31 2 * * ABDOMEN ASPIRATION/CHEST * * ** 7043 $ 795.78 0 * * REPEAT SURGERY - GENERAL SURGERY * * ** 7045 $ 36.02 2 * * ANTERIOR CLOSED SPACE ABSCESS - OP ONLY * * ** 7053 $ 126.29 2 * * EXC OF NAIL BED, COMPLETE, W/SHORTENING OF PHALANX * * ** 7055 $ 125.68 2 * * GANGLIA - WRIST * * ** 7059 $ 52.61 2 * * ABSCESS - DEEP - LOCAL/REGIONAL ANESTHESIA * * ** 7061 $ 74.55 2 * * WOUND INFECTION - POST-OP/GA * * ** 7072 $ 111.77 2 * * HYDRADENITIS SUPPURATIVA EXCISION - AXILLARY * * ** 7073 $ 123.10 3 * * TENOTOMY CONGENITAL TORTICOLLIS * * ** 7074 $ 236.13 3 * * TENOTOMY RESECTION OF TENDON * * ** 7075 $ 111.77 2 * * HYDRADENITIS SUPPURATIVA EXCISION - INGUINAL * * ** 7076 $ 111.77 2 * * HYDRADENITIS SUPPURATIVA EXCISION - PERIANAL * * ** 7082 $ 111.77 2 * * HYDRADENITIS SUPPURATIVA EXCISION - PERINEAL * * ** 7108 $ 234.48 2 * * STRIPPING LONG SAPHENOUS * * ** 7109 $ 135.18 2 * * STRIPPING SHORT SAPHENOUS * * ** 7110 $ 101.05 2 * * LIGATIONS AND STRIPPINGS - 3 TO 5 INCISIONS * * ** 7111 $ 175.55 2 * * LIGATIONS AND STRIPPINGS - 6 OR MORE INCISIONS * * ** 7112 $ 183.10 2 * * LIGATION OF 2 OR MORE PERFORATORS * * ** 7116 $ 479.06 3 * * MULTIPLE LIGATIONS, STRIPPINGS, PERFORATORS * * ** 7134 $ 357.28 6 * * PERITONEAL VENOUS SHUNT FOR ASCITES * * ** 7139 $ 125.68 2 * * BROVIAC CATHETER - INSERTION OF * * ** 7140 $ 246.24 4 * * CATHETER INSERTION - BROVIAC TYPE, <3 MO OR <3 KG * * ** 7141 $ 35.08 2 * * CATHETER REMOVAL - BROVIAC TYPE * * ** 7142 $ 231.08 2 * * VENOUS ACCESS PORT - IMPLANTABLE - INSERTION * * ** 7143 $ 268.87 2 * * VENOUS ACCESS PORT - IMPLANTABLE/REVISION/REMOVAL * * ** 7145 $ 37.23 2 * * INTRA OSSEOUS - ACCESS * * ** 7146 $ 336.66 2 * * INFERIOR VENA CAVA FILTER - INSERTION * * ** 7360 $ 590.00 6 * * SPLENECTOMY * * ** 7361 $ 246.24 4 * * TB GLANDS - RADICAL REMOVAL * * ** 7363 $ 491.27 5 * * RADICAL FEMORAL, INGUINAL AND ILIAC DISSECTION * * ** 7365 $ 859.40 5 * * LIMB PERFUSION - ISOLATED * * ** 7366 $ 714.33 6 * * LAPAROTOMY AND STAGING OF LYMPHOMA * * ** 7368 $ 590.00 6 * * LAPAROSCOPIC SPLENECTOMY * * ** 7402 $ 397.39 6 * * HEPATOTAMY - ABSCESS/CYST - SINGLE * * ** 7403 $ 598.52 6 * * HEPATOTAMY - MULTIPLE, INCLUDING MARSUPIALIZATION * * ** 7404 $ 491.27 7 * * LIVER MASS - SUBSEGMENTAL EXCISION * * ** 7405 $ 923.99 8 * * HEPATECTOMY - SEGMENTAL RESECTION - ONE OR MORE * * ** 7406 $ 1,084.84 8 * * HEPATECTOMY - TWO OR MORE SEGMENTS * * ** 7407 $ 1,197.06 8 * * HEPATECTOMY - TOTAL LEFT LOBECTOMY * * ** 7408 $ 1,197.06 8 * * HEPATECTOMY - TOTAL RIGHT LOBECTOMY * * ** 7409 $ 1,309.27 8 * * HEPATECTOMY - EXTENDED LEFT LOBECTOMY * * ** 7410 $ 1,346.69 8 * * HEPATECTOMY - CAUDATE LOBECTOMY * * ** 7411 $ 1,500.99 8 * * HEPATECTOMY - EXTENDED RIGHT LOBECTOMY * * ** 7412 $ 502.90 8 * * HEPATORRHAPHY - SIMPLE * * ** 7413 $ 590.00 8 * * HEPATORRHAPHY - WITH PACKING * * ** 7430 $ 94.12 3 * * PERITONEAL LAVAGE (CATHETER) - DIAGNOSTIC * * ** 7431 $ 736.27 8 * * DIAPHRAGMATIC INJURY - REPAIR * * ** 7432 $ 415.90 5 * * LAPAROTOMY FOR TRAUMA * * ** 7433 $ 590.00 7 * * LAPAROTOMY AND REMOVAL OF INJURED SPLEEN * * ** 7434 $ 683.53 7 * * SPLENIC REPAIR, ANY METHOD * * ** 7435 $ 524.18 7 * * LACERATIONS TO STOMACH - REPAIR * * ** 7436 $ 590.00 7 * * DUODENUM/PANCREAS - EXPLORATION AND MOBILIZATION * * ** 7437 $ 785.02 7 * * DUODENUM - REPAIR OF LACERATION TO * * ** 7438 $ 982.51 7 * * DUODENAL INJURY - RESECTION AND DEBRIDEMENT * * ** 7440 $ 923.99 8 * * LIVER - RESECTIONAL DEBRIDEMENT * * ** 7441 $ 869.14 8 * * HEPATIC ARTERY LIGATION * * ** 7442 $ 1,179.98 9 * * HEPATIC LOBECTOMY FOR TRAUMA * * ** 7443 $ 785.02 8 * * DISTAL PANCREAS - RESECTION FOR TRAUMA * * ** 7444 $ 1,572.50 9 * * WHIPPLE PROCEDURE FOR TRAUMA * * ** 7445 $ 524.18 7 * * BOWEL - SMALL - REPAIR OF LACERATIONS * * ** 7446 $ 590.00 7 * * BOWEL - SMALL - RESECTION OF INJURED * * ** 7447 $ 524.18 6 * * MESENTERIC INJURY - REPAIR OF * * ** 7448 $ 988.74 7 * * COLONIC INJURY +/- COLOSTOMY - REPAIR * * ** 7449 $ 988.74 7 * * RESECTION OF COLONIC INJURY * * ** 7450 $ 618.76 7 * * COLONIC INJURY- EXTERIORIZATION * * ** 7451 $ 261.48 8 * * THORACIC EXTENSION OF ABDOMINAL INCISION(EXTRA) * * ** 7452 $ 988.74 7 * * EXTRA-PERITONEAL RECTUM +/- COLOSTOMY - REPAIR * * ** 7455 $ 1,030.67 6 * * EMERGENCY RESECTION OF OBSTRUCTED COLON * * ** 7460 $ 224.43 2 * * SIGMOIDOSCOPY - DECOMPRESSION - VOLVULUS * * ** 7461 $ 110.43 2 * * SIGMOIDOSCOPY - REMOVAL OF FOREIGN BODY * * ** 7462 $ 147.22 2 * * SIGMOIDOSCOPY - CONTROL BLEEDING * * ** 7463 $ 123.70 2 * * SIGMOIDOSCOPY - DECOMPRESSION VOLVULUS, ANY METHOD * * ** 7464 $ 257.78 2 * * SIGMOIDOSCOPY - POLYP REMOVAL * * ** 7465 $ 174.33 2 * * SIGMOIDOSCOPY - ABLATION OF TUMOR/OTHER LESION * * ** 7466 $ 462.64 2 * * ANAL STRICTURE - CHILD * * ** 7470 $ 155.30 2 * * NIPPLE EXPLORATION * * ** 7471 $ 312.06 3 * * MASTECTOMY - SIMPLE FOR BENIGN DISEASE * * ** 7472 $ 433.96 3 * * MASTECTOMY - TOTAL FOR MALIGNANCY * * ** 7473 $ 217.23 3 * * MASTECTOMY - PARTIAL FOR MALIGNANCY * * ** 7474 $ 433.96 3 * * AXILLARY DISSECTION (LEVEL II) - COMPLETE * * ** 7475 $ 217.23 3 * * AXILLARY DISSECTION - PARTIAL * * ** 7479 $ 433.96 3 * * SENTINEL LYMPH NODE BIOPSY * * ** 7497 $ 202.11 2 * * BIOPSY OR SEGMENTAL RESECTION OF NON-PALPABLE BREA * * ** 7498 $ 518.63 3 * * MASTECTOMY - SUBCUTANEOUS (FEMALE ONLY) * * ** 7500 $ 368.14 5 * * RESECTION OF MANDIBLE * * ** 7515 $ 74.55 3 * * ABSCESS - PARTOID/SUBMAXILLARY/SUBLINGUAL * * ** 7516 $ 111.77 3 * * EXCISION OR MARSUPIALIZATION OF SALIVARY CYST * * ** 7517 $ 409.16 3 * * ERCP - PAPILLOTOMY/SPHINCTEROTOMY * * ** 7518 $ 485.13 3 * * ERCP - STONE EXTRACTION * * ** 7519 $ 397.45 3 * * ERCP - BILIARY STENTING * * ** 7522 $ 123.10 3 * * LOCAL EXCISION OF PAROTID TUMOR * * ** 7526 $ 25.59 3 * * SALIVARY DUCT - DILATION * * ** 7528 $ 60.56 5 * * PLACEMENT GASTROESOPHAGEAL VENOUS COMPRESSION BALL * * ** 7536 $ 674.10 7 * * DIRECT LIGATION OF OESOPHAGEAL VARICES * * ** 7546 $ 188.92 3 * * OESOPHAGOGASTRODUODENOSCOPY - WITH INJECTION * * ** 7552 $ 584.50 9 * * AORTOPEXY FOR TRACHEOMALACIA * * ** 7554 $ 397.45 3 * * ERCP - BALLOON DILATATION * * ** 7556 $ 508.52 3 * * ERCP - STONE EXTRACTION REQUIRING LITHOTRIPSY * * ** 7560 $ 94.71 3 * * NASO-BILIARY DRAINAGE TUBE - INSERTION * * ** 7561 $ 157.85 5 * * CHOLEDOCHAL STENT - PLACEMENT * * ** 7562 $ 157.85 3 * * DUODENAL BILIARY STENT - REPLACEMENT * * ** 7563 $ 121.11 3 * * THERMAL COAGULATION - HEATER PROBE AND LASER * * ** 7565 $ 849.03 5 * * TAKEDOWN PELVIC POUCH TO INCLUDE ILEOSTOMY * * ** 7566 $ 767.92 6 * * RECTAL MUCOSECTOMY, ILEOANAL ANASTOMOSIS * * ** 7567 $ 1,590.59 6 * * PROCTECTOMY WITH RECTAL MUCOSECTOMY * * ** 7569 $ 1,117.76 6 * * COLECTOMY AND HEMIPROCTECTOMY * * ** 7570 $ 824.47 6 * * COLO-COLOSTOMY OR ENTERO-COLOSTOMY * * ** 7571 $ 1,052.66 6 * * PENA POSTERIOR SAGITTAL ANAL PROCTOPLASTY * * ** 7574 $ 229.90 5 * * GASTRIC POLYPECTOMY * * ** 7578 $ 582.68 5 * * VAGOTOMY - HIGHLY SELECTIVE * * ** 7580 $ 662.56 5 * * RECTAL TUMOR EXCISION BY POSTERIOR PARASACRAL * * ** 7588 $ 484.41 5 * * COLOSTOMY OR ILEOSTOMY - LOOP - END * * ** 7589 $ 1,352.62 7 * * TOTAL PROCTOCOLECTOMY SYNCHRONOUS ABDOMINAL PORTIO * * ** 7590 $ 386.91 7 * * TOTAL PROCTOCOLECTOMY SYNCHRONOUS PERINEAL PORTION * * ** 7593 $ 310.39 0 * * PENA POSTERIOR SAGITTAL ANOPROCTOPLASTY 2ND SURGEO * * ** 7596 $ 74.81 2 * * HERNIA; INCISIONAL; REPAIR FOLLOWING LAPAROTOMY * * ** 7597 $ 347.40 6 * * HAEMORRHAGE; INTRA-ABDOMINAL MANAGEMENT - POST OPE * * ** 7600 $ 316.93 5 * * LAPAROTOMY TO INCLUDE BIOPSY - EXPLORATORY * * ** 7601 $ 397.39 5 * * INTRA-ABDOMINAL ABSCESS EXCLUDING INTRAHEPATIC * * ** 7602 $ 24.87 0 * * PNEUMOPERITONEUM - THERAPEUTIC * * ** 7603 $ 246.24 5 * * ABDOMINAL WOUND EVISCERATION - RESUTURE * * ** 7610 $ 187.03 4 * * HERNIA, EPIGASTRIC * * ** 7614 $ 368.14 7 * * OMPHALOCELE OR GASTROSCHESIS - TEMPORARY REPAIR * * ** 7615 $ 561.12 7 * * OMPHALOCELE OR GASTROSCHESIS - PERMANENT REPAIR * * ** 7623 $ 919.12 7 * * GASTRECTOMY REVISION AFTER PREVIOUS GASTRECTOMY * * ** 7624 $ 919.12 7 * * GASTRECTOMY EMERGENCY FOR CONTINUED HAEMORRHAGE * * ** 7626 $ 368.14 5 * * PYLOROPLASTY * * ** 7627 $ 397.39 5 * * GASTROJEJUNOSTOMY * * ** 7628 $ 582.68 5 * * GASTROJEJUNOSTOMY OR PYLOROPLASTY * * ** 7630 $ 307.19 5 * * GASTROSTOMY - OPEN * * ** 7632 $ 418.50 6 * * GASTROTOMY, OPEN * * ** 7633 $ 1,043.44 5 * * CLOSURE OF GASTROJEJUNOCOLIC FISTULA * * ** 7634 $ 500.51 5 * * ENTEROTOMY OR COLOTOMY (SINGLE); FOR EXPLORATION * * ** 7635 $ 657.12 5 * * MULTIPLE COLOTOMY WITH OPERATIVE SIGMOIDOSCOPY * * ** 7636 $ 552.22 5 * * SMALL INTESTINE RESECTION - WITH ANASTOMOSIS * * ** 7640 $ 1,157.64 6 * * COLECTOMY, TOTAL, ABDOMINAL, WITHOUT PROCTECTOMY, * * ** 7641 $ 1,690.22 7 * * PROCTOCOLECTOMY TOTAL WITH PERINEAL EXCISION * * ** 7643 $ 500.51 5 * * ENTEROENTEROSTOMY * * ** 7645 $ 420.45 5 * * COLOSTOMY OR ILEOSTOMY - LOOP * * ** 7646 $ 386.91 4 * * CLOSURE OF LOOP ENTEROSTOMY, LARGE/SMALL INTESTINE * * ** 7647 $ 578.81 5 * * CLOSURE OF LOOP ENTEROSTOMY WITH RESECTION * * ** 7648 $ 230.62 4 * * REVISION OF COLOSTOMY, ILEOSTOMY - SIMPLE INCISION * * ** 7649 $ 431.09 5 * * REVISION OF COLOSTOMY, ILEOSTOMY - RADICAL * * ** 7650 $ 459.55 5 * * INTESTINAL OBSTRUCTION; RESECTION OF BANDS * * ** 7651 $ 540.43 5 * * VOLVULUS REDUCTION, INTUSSUSCEPTION BY LAPAROTOMY * * ** 7652 $ 604.40 7 * * MORBID OBESITY - ILEOJEJUNAL BYPASS - SURGERY * * ** 7653 $ 674.10 6 * * ATRESIA; SMALL BOWEL; EXCISION OR BYPASS * * ** 7654 $ 521.73 5 * * INTESTINAL OBSTRUCTION, PLICATION/INSERTION - TUBE * * ** 7655 $ 337.33 4 * * EXCISION OF MECKEL'S DIVERTICULUM * * ** 7658 $ 618.76 5 * * EXTERIORIZATION OF BOWEL * * ** 7660 $ 230.46 2 * * PELVIC ABSCESS - TRANSRECTAL DRAINAGE * * ** 7662 $ 1,384.71 7 * * ABDOMINO-PERINEAL RESECTION (SINGLE SURGEON) * * ** 7663 $ 1,156.01 7 * * ABDOMINO-PERINEAL RESECTION (SYNCHRONOUS ABDOMINAL * * ** 7664 $ 386.91 7 * * ABDOMINO-PERINEAL RESECTION (SYNCHRONOUS PERINEAL * * ** 7665 $ 155.05 2 * * ANORECTAL WALL, BIOPSY - ANAL APPROACH * * ** 7666 $ 160.76 2 * * FISTULA-IN-ANO; SECOND STAGE; DIVISION - SPHINCTER * * ** 7672 $ 717.55 5 * * COMPLETE RECTAL PROLAPSE * * ** 7675 $ 155.05 2 * * FISTULA-IN-ANO - SUBCUTANEOUS OR SUBMUCOUS * * ** 7676 $ 346.83 2 * * FISTULA-IN-ANO - SUBMUSCULAR * * ** 7677 $ 463.67 2 * * FISTULA-IN-ANO - MULTIPLE OR HORSESHOE * * ** 7678 $ 93.90 2 * * INCISION AND DRAINAGE PERIANAL ABSCESS,SUPERFICIAL * * ** 7679 $ 136.79 2 * * INCISION/DRAIN ABSCESS - ISCHIORECTAL, INTRAMURAL * * ** 7683 $ 275.28 2 * * HEMORRHOIDECTOMY * * ** 7685 $ 253.92 2 * * PILONIDAL CYSTS OR SINUS - EXCISION OR MARSUPIALI * * ** 7687 $ 93.90 2 * * ANAL FISSURE, EXCISION * * ** 7689 $ 93.81 2 * * ANAL DILATION UNDER GENERAL ANAESTHETIC * * ** 7690 $ 618.76 4 * * ANOPLASTY FOR IMPERFORATE ANUS * * ** 7691 $ 45.52 2 * * ANUS IMPERFORATE SIMPLE INCISION * * ** 7692 $ 927.34 7 * * REPAIR MAJOR ANO-RECTAL ANOMALIES, SACRAL APPROACH * * ** 7697 $ 1,082.42 6 * * SACROCOCCYGEAL TERATOMA- EXCISION * * ** 7698 $ 386.42 5 * * CHOLECYSTOSTOMY - OPEN * * ** 7699 $ 485.16 5 * * CHOLECYSTECTOMY - OPEN * * ** 7700 $ 2,208.53 6 * * CLOACAL ANOMALIES; PRIMARY SURGEON, TOTAL CORRECT * * ** 7702 $ 404.91 0 * * CLOACAL ANOMALY - TOTAL CORRECTION SECOND SURGEON * * ** 7703 $ 759.85 6 * * CHOLEDOCHODUODENOSTOMY * * ** 7705 $ 841.69 6 * * CHOLEDOCHOJEJUNOSTOMY/ANASTOMOSIS OF EXTRA-HEPATIC * * ** 7706 $ 598.76 6 * * CHOLECYSTOENTEROSTOMY - DIRECT (LOOP) * * ** 7707 $ 485.16 5 * * CHOLECYSTECTOMY - LAPAROSCOPIC * * ** 7710 $ 61.49 0 * * PANCREATOGRAM W/ OR W/O SPHINCTEROTOMY - EXTRA * * ** 7711 $ 552.22 5 * * PANCREATIC PSEUDOCYST INTERNAL DRAINAGE * * ** 7714 $ 859.40 6 * * PANCREATICOJEJUNOSTOMY; SIDE-TO-SIDE ANASTOMOSIS * * ** 7725 $ 747.11 5 * * MAXILLECTOMY * * ** 7726 $ 962.63 5 * * MAXILLECTOMY WITH EXENTERATION OF ORBIT AND SKIN G * * ** 7732 $ 674.10 5 * * PANCREATIC PSEUDOCYST - DRAINAGE, TRANSDUODENAL * * ** 7733 $ 701.40 5 * * ANASTOMOSIS OF PANCREATIC PSEUDOCYST, ROUX-EN-Y- * * ** 7740 $ 175.35 4 * * BIOPSY OF THYROID - OPEN * * ** 7741 $ 307.19 4 * * THYROIDECTOMY; SUBTOTAL UNILATERAL (LOCAL EXCISION * * ** 7743 $ 758.21 4 * * THYROIDECTOMY - TOTAL OR COMPLETE * * ** 7744 $ 673.33 4 * * PARATHYROIDECTOMY - SUBTOTAL PARATHYROIDECTOMY * * ** 7745 $ 614.89 4 * * PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROIDS * * ** 7749 $ 498.49 5 * * PARTIAL MAXILLECTOMY FOR MALIGNANCY - FENESTRATION * * ** 7756 $ 397.39 5 * * PANCREATIC PSEUDOCYST - OPEN * * ** 7758 $ 397.39 5 * * PANCREATIC PSEUDOCYST - LAPAROSCOPIC * * ** 7760 $ 856.00 7 * * IMPLANTATION OF KIDNEY GRAFT -UROLOGIST * * ** 7762 $ 246.24 7 * * TRANSPLANTATION FROM CADAVER WITH NECESSARY KIDNEY * * ** 7763 $ 491.27 7 * * TRANSPLANTATION - FROM LIVING DONOR * * ** 7764 $ 59.96 0 * * CHOLANGIOGRAPHY; OPERATIVE * * ** 7768 $ 249.85 3 * * EXCISION TUBERCULOUS LYMPH NODES NECK * * ** 7769 $ 604.62 5 * * DUODENOTOMY AND SPHINCTEROPLASTY * * ** 7771 $ 373.54 5 * * PICKING OPERATION; METASTATIC NECK NODES * * ** 7776 $ 701.40 5 * * REPAIR OF CHOLECYSTENTERIC FISTULA * * ** 7780 $ 121.90 0 * * BILIARY ENDOSCOPY - INTRAOPERATIVE * * ** 7781 $ 74.81 2 * * BILIARY ENDOSCOPY - PERCUTANEOUS * * ** 7782 $ 121.90 2 * * BILIARY ENDOSCOPY -STONE REMOVAL * * ** 7783 $ 121.90 2 * * BILIARY ENDOSCOPY; WITH DILATION OF DUCT STRICTURE * * ** 7789 $ 292.25 3 * * LESION - TONGUE * * ** 7790 $ 111.77 3 * * LESION - BENIGN - FLOOR OF MOUTH * * ** 7796 $ 498.49 5 * * EXCISION NEUROGENIC NEOPLASM NECK * * ** 7805 $ 92.75 0 * 12 * VISIT, EMERGENCY, CARDIO-THORACIC * * ** 7807 $ 27.03 0 * 12 * VISIT, OFFICE, CARDIO-THORACIC * * ** 7808 $ 23.07 0 * 12 * VISIT, HOSPITAL, CARDIO-THORACIC * * ** 7809 $ 46.47 0 * 12 * VISIT, HOME, CARDIO-THORACIC * * ** 7810 $ 135.47 0 * 12 * CONSULTATION, CARDIO-THORACIC * * ** 7812 $ 60.97 0 * 12 * CONSULTATION, LIMITED OR REPEAT, CARDIO-THORACIC * * ** 7820 $ 881.97 9 * * COARCTATION OF AORTA * * ** 7821 $ 1,583.75 10 * * ANEURYSM THORACIC * * ** 7822 $ 1,710.27 11 * * ANEURYSM RUPTURED THORACIC * * ** 7824 $ 1,486.59 10 * * RESECTING ANEURYSM OF THE VENTRICLE * * ** 7825 $ 255.78 10 * * RESECTING ANEURYSM WITH OTHER PROCEDURE * * ** 7826 $ 2,243.30 10 * * RESECTION OF AORTIC ARCH ANEURYSM * * ** 7827 $ 1,583.75 10 * * AORTIC DISSECTION REPAIR (THORACIC) * * ** 7828 $ 1,583.75 10 * * AORTIC INJURY REPAIR (THORACIC) * * ** 7829 $ 881.97 10 * * REPAIR OF TRAUMATIC INJURY, INTRATHORACIC VESSELS * * ** 7830 $ 770.78 9 * * PULMONARY ARTERY - BANDING * * ** 7831 $ 770.78 9 * * PERICARDIOTOMY * * ** 7832 $ 770.78 9 * * PERICARDECTOMY * * ** 7833 $ 559.87 9 * * CARDIOTOMY * * ** 7834 $ 770.78 9 * * PATENT DUCTUS ARTERIOSUS * * ** 7835 $ 770.78 9 * * BLALOCK OR POTT'S PROCEDURE 4 TETRALOGY OF FALLOT * * ** 7836 $ 770.78 9 * * BLALOCK-HANLON PROCEDURE * * ** 7837 $ 770.78 9 * * MITRAL COMMISSUROTOMY (CLOSED) * * ** 7838 $ 770.78 9 * * PULMONARY VALVULOTOMY (CLOSED) * * ** 7839 $ 770.78 9 * * AORTIC VALVULOTOMY * * ** 7841 $ 677.47 8 * * INTRAMYOCARDIAL PACEMAKER (ATRIAL A-V SEQUENTIAL) * * ** 7842 $ 559.87 8 * * IMPLANTATION OF INTRAMYOCARDIAL PACEMAKER (VENT.) * * ** 7843 $ 388.00 4 * * IMPLANTATION OF ENDOCARDIAL PACEMAKER (VENTRIC.) * * ** 7844 $ 234.44 4 * * IMPLANTATION/REPLACEMENT PULSE GENERATOR * * ** 7845 $ 237.12 4 * * REPAIR, REPLACEMENT, ADJUSTMENT OF ELECTRODE * * ** 7846 $ 392.41 11 * * CARDIAC MASSAGE FOR CARDIAC ARREST * * ** 7847 $ 507.46 4 * * ENDOCARDIAL PACEMAKER (ATRIAL A-V SEQUENTIAL) * * ** 7851 $ 443.55 8 * * PHRENIC NERVE STIMULATION * * ** 7852 $ 881.97 9 * * GORE-TEX MODIFIED AORTO-PULMONARY SHUNT * * ** 7853 $ 1,331.92 9 * * MITRAL VALVE: COMMISSUROTOMY * * ** 7854 $ 1,331.92 9 * * MITRAL VALVE PLICATION * * ** 7855 $ 1,486.59 9 * * MITRAL VALVE: REPLACEMENT * * ** 7856 $ 1,486.59 9 * * MITRAL VALVE: COMPLETE REPAIR * * ** 7857 $ 1,331.92 9 * * AORTIC VALVE: COMMISSUROTOMY * * ** 7858 $ 1,331.92 9 * * AORTIC VALVE: PLICATION * * ** 7859 $ 1,486.59 9 * * AORTIC VALVE: REPLACEMENT * * ** 7860 $ 2,529.23 10 * * AORTIC ROOT RECONSTRUCTION * * ** 7861 $ 1,331.92 9 * * TRICUSPID VALVE: COMMISSUROTOMY * * ** 7862 $ 1,486.59 9 * * TRICUSPID VALVE: REPLACEMENT * * ** 7863 $ 1,331.92 9 * * TRICUSPID VALVE: ANNULOPLASTY * * ** 7864 $ 2,243.30 10 * * MULTIPLE VALVE REPLACEMENT - 2 VALVES * * ** 7865 $ 2,593.53 10 * * MULTIPLE VALVE REPLACEMENT - 3 VALUES * * ** 7866 $ 2,064.33 10 * * MULTIPLE VALVE REPLACEMENT - VALVED EXTERNAL CONDU * * ** 7867 $ 1,331.92 9 * * ATRIAL SEPTUM DEFECT: SECUNDUM - SUTURE * * ** 7868 $ 1,331.92 9 * * ATRIAL SEPTUM DEFECT: SECUNDUM - PATCH * * ** 7869 $ 1,486.59 9 * * ATRIAL SEPTUM DEFECT: PRIMUM * * ** 7870 $ 1,331.92 9 * * ATRIAL SEPTUM DEFECT: MULTIPLE * * ** 7871 $ 1,331.92 10 * * ATRIAL SEPTUM DEFECT - PLUS PULMONARY STENOSIS * * ** 7872 $ 1,486.59 10 * * ATRIAL SEPTUM DEFECT: MULTIPLE + PART. PULM. DRAIN * * ** 7874 $ 1,430.35 9 * * VENTRICULAR SEPTAL DEFECT: SIMPLE * * ** 7875 $ 1,430.35 9 * * VENTRICULAR SEPTAL DEFECT: MULTIPLE * * ** 7876 $ 1,430.35 9 * * VENTRICULAR SEPTAL DEFECT PLUS PATENT DUCTUS * * ** 7877 $ 1,430.35 10 * * VENTRICULAR SEPTAL DEFECT + PULMONARY HYPERTENSION * * ** 7878 $ 1,430.35 10 * * VENTRICULAR SEPTAL DEFECT + CORRECTED TRANSPOSITIO * * ** 7879 $ 1,430.35 10 * * VENTRICULAR SEPTAL DEFECT + AORTIC REGURGITATION * * ** 7881 $ 1,331.92 9 * * SUBAORTIC STENOSIS- FIBROUS RING * * ** 7882 $ 1,486.59 9 * * SUBAORTIC STENOSIS - MUSCULAR HYPERTROPHY * * ** 7884 $ 1,331.92 9 * * PULMONARY VALVE: VALVULOTOMY * * ** 7885 $ 1,486.59 9 * * PULMONARY VALVE: INFUNDIBULECTOMY * * ** 7886 $ 1,486.59 9 * * PULMONARY VALVE: PATCH * * ** 7887 $ 1,486.59 9 * * PULMONARY VALVE: ARTERIOPLASTY WITH BYPASS * * ** 7889 $ 1,486.59 10 * * PULMONARY VALVE: TETRALOGY OF FALLOT * * ** 7890 $ 1,710.27 10 * * PULM. VALVE: TETRALOGY OF FALLOT + OUTFLOW PATCH * * ** 7893 $ 1,710.27 10 * * PULM. VALVE: TETRA. OF FALLOT W/ PREV. ANAST. SHUN * * ** 7898 $ 1,849.61 10 * * PULMONARY VALVE: TRANSPOSITION * * ** 7899 $ 1,849.61 10 * * ANOMALOUS PULMONARY DRAINAGE, TOTAL * * ** 7900 $ 1,486.59 10 * * AORTICOPULMONARY WINDOW * * ** 7901 $ 1,486.59 10 * * PULMONARY VALVE: RUPTURED SINUS OF VALSALVA * * ** 7902 $ 2,243.30 10 * * PULMONARY VALVE: ATRIOVENTRICULAR COMMUNIS * * ** 7905 $ 1,486.59 9 * * PULMONARY VALVE: INTRACARDIAC TUMOURS * * ** 7906 $ 1,331.92 11 * * PULMONARY EMBOLECTOMY WITH BYPASS * * ** 7908 $ 1,331.92 9 * * CORONARY ARTERY BYPASS GRAFT - ONE ARTERY * * ** 7909 $ 253.10 0 * * CORONARY ARTERY BYPASS GRAFT - EACH ADDIT. ARTERY * * ** 7910 $ 1,704.42 9 * * SUPRAVENTRICULAR ARRHYTHMIA SURGERY * * ** 7911 $ 2,069.66 9 * * VENTRICULAR ARRHYTHMIA SURGERY * * ** 7912 $ 357.90 0 * * ENDOCARDIAL MAPPING * * ** 7913 $ 1,331.92 9 * * PERICARDIECTOMY WITH BYPASS * * ** 7914 $ 279.56 0 * * RECURRENT OPEN HEART SURGERY AFTER 21 DAYS - EXTRA * * ** 7915 $ 258.34 0 * 8 12 * 1ST ASSIST AT OPEN HEART SURGERY: <= $1027.00 * * ** 7916 $ 151.09 0 * 8 12 * 2ND & 3RD ASSISTS AT OPEN HEART SURG: <= $1027.00 * * ** 7917 $ 370.69 0 * 8 12 * 1ST ASSIST AT OPEN HEART SURGERY: > $1027.00 * * ** 7918 $ 231.86 0 * 8 12 * 2ND & 3RD ASSISTS AT OPEN HEART SURG: > $1027.00 * * ** 7920 $ 20.28 0 * 8 12 * ASSIST AT OPEN HEART SURG: > 4 HRS, PER 15 MINS * * ** 7924 $ 35.79 4 * * DECOMPRESSION TRAUMATIC PNEUMOTHORAX * * ** 7925 $ 24.91 4 * * ARTIFICIAL PNEUMOTHORAX * * ** 7949 $ 426.11 7 * * LASER THERAPY:INTRA-TRACHEAL/INTRA-BRONCHIAL TUMOR * * ** 7952 $ 90.12 0 * * ELECTRONIC MONITORING OF PACING AND PACEMAKER FUNC * * ** 7953 $ 507.46 4 * * DOUBLE LEAD ENDOCARDIAL PACEMAKER * * ** 7960 $ 630.17 0 * * INTRA-AORTIC BALLOON INSERTION, REMOVAL & CARE * * ** 8005 $ 90.00 0 * 13 * VISIT, EMERGENCY, UROLOGY * * ** 8007 $ 28.00 0 * 13 * VISIT, OFFICE, UROLOGY * * ** 8008 $ 22.00 0 * 13 * VISIT, HOSPITAL, UROLOGY * * ** 8009 $ 45.00 0 * 13 * VISIT, HOME, UROLOGY * * ** 8010 $ 85.00 0 * 13 * CONSULTATION, UROLOGY * * ** 8012 $ 45.00 0 * 13 * CONSULTATION, REPEAT OR LIMITED, UROLOGY * * ** 8100 $ 193.84 5 * * PERINEPHRIC ABSCESS - DRAINAGE * * ** 8104 $ 426.43 5 * * NEPHRECTOMY - PARTIAL * * ** 8105 $ 387.66 5 * * NEPHRECTOMY * * ** 8106 $ 387.66 5 * * NEPHRECTOMY - ECTOPIC KIDNEY * * ** 8108 $ 620.25 8 * * NEPHRECTOMY - THORACO-ABDOMINAL * * ** 8109 $ 581.50 6 * * NEPHRECTOMY - RADICAL WITH GLAND DISSECTION * * ** 8110 $ 659.02 6 * * NEPHRO-URETERECTOMY TO INCLUDE BLADDER CUFF * * ** 8112 $ 310.13 5 * * RENAL BIOPSY-OPEN (AS AN INDEPENDENT PROCEDURE) * * ** 8113 $ 426.43 5 * * SYMPHYSIOTOMY AND NEPHROPEXY OR NEPHRECTOMY IN HOR * * ** 8114 $ 426.43 5 * * PYELOPLASTY INCLUDES NEPHROPEXY & MGMT OF ABERRANT * * ** 8116 $ 465.20 6 * * RUPTURED OR LACERATED KIDNEY-REPAIR OR REMOVAL * * ** 8117 $ 465.20 5 * * NEPHROLITHOTOMY AND/OR PYELOLITHOTOMY * * ** 8118 $ 465.20 5 * * NEPHROLITHOTOMY OR PYELOLITHOTOMY W X-RAY CONTROL * * ** 8119 $ 542.73 6 * * NEPHROLITHOTOMY OR PYELOLITHOTOMY W RENAL COOLING * * ** 8123 $ 213.21 4 * * EXTRA-CORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) * * ** 8146 $ 325.00 3 * * URETEROSCOPY BASKET MANIPULATION URETERAL CALCULUS * * ** 8147 $ 387.66 5 * * URETEROTOMY,URETERAL LITHOTOMY,UPPER & LOWER * * ** 8148 $ 503.96 5 * * URETRO-VESICAL REANASTOMOSIS - BILATERAL * * ** 8151 $ 387.66 5 * * URETEROTOMY OR REMOVAL OF STUMP * * ** 8152 $ 387.66 5 * * URETRO-VESICAL REANASTOMOSIS - UNILATERAL * * ** 8153 $ 77.53 5 * * URETERAL TAILORING-UNILATERAL,EXTRA TO 08152,08148 * * ** 8154 $ 108.55 5 * * URETERAL TAILORING-BILATERAL,EXTRA TO 08148 * * ** 8155 $ 125.00 3 * * URETERAL STENT-INTERNAL-INSERTION,INCLUDES C&P & * * ** 8156 $ 387.66 5 * * URETERO-URETEROSTOMY * * ** 8157 $ 271.36 5 * * URETERO-CUTANEOUS-ANASTOMOSIS, UNILATERAL * * ** 8158 $ 387.66 5 * * URETERO-SIGMOID ANASTOMOSIS, BILATERAL * * ** 8159 $ 348.89 5 * * URETEROLYSIS * * ** 8160 $ 465.20 5 * * URETER RECONSTRUCTION LOWER SEGMNT BY BLADDER FLAP * * ** 8161 $ 213.21 3 * * TRANSURETHRAL MANIPULATION OF URETERAL CALCULUS WI * * ** 8163 $ 426.43 5 * * URETERO-VESICAL ANASTOMOSIS IF URETEROCELE OR URET * * ** 8168 $ 348.89 4 * * NEPHROSCOPY & STONE REMOVAL-INCLUDES LITHOPAXY * * ** 8170 $ 387.66 5 * * PREPARATION OF INTESTINAL SEGMENT AND RE-ANASTOMOS * * ** 8173 $ 775.32 7 * * RADICAL CYSTECTOMY WITH PELVIC LYMPHADENECTOMY * * ** 8174 $ 775.32 6 * * PREP OF INTEST. SEG. REANASTOMOSIS & URETERAL TRAN * * ** 8175 $ 1,046.68 6 * * CYSTECTOMY AND URETERAL TRANSPLANTATION(SAME SURGE * * ** 8176 $ 1,162.98 7 * * RADICAL CYSTECTOMY AND URETERAL TRANSPLANTATION (S * * ** 8177 $ 1,434.34 6 * * CYSTECTOMY AND ILEAL LOOP DIVERSION (INCLUDES..) * * ** 8178 $ 1,550.64 7 * * RADICAL CYSTECTOMY & ILEAL LOOP URINARY DIVERSION * * ** 8181 $ 503.96 5 * * BLADDER AUGMENTATION WITH BOWEL SEGMENT * * ** 8182 $ 1,162.98 6 * * CONTINENT URINARY DIVERSION * * ** 8183 $ 1,744.48 7 * * CYSTECTOMY- RADICAL & CONTINENT URINARY DIVERSION * * ** 8184 $ 503.96 6 * * CYSTECTOMY-ISOLATED PROCEDURE W OR WO URETHRECTOMY * * ** 8200 $ 155.07 2 * * BLADDER FULGURATION WITH CYSTOSCOPY * * ** 8201 $ 193.84 2 * * CYSTOSTOMY-ISOLATED PROCEDURE * * ** 8202 $ 46.52 2 * * CYSTOSTOMY BY TROCHAR-ISOLATED PROCEDURE * * ** 8203 $ 232.59 2 * * CYSTOLITHOTOMY * * ** 8204 $ 426.43 5 * * CYSTECTOMY - PARTIAL FOR TUMOR OR DIVERTICULUM * * ** 8207 $ 387.66 5 * * RUPTURED BLADDER REPAIR * * ** 8232 $ 174.45 2 * * COLLAGEN INJECTIONS - PERIURETHRAL * * ** 8250 $ 310.13 3 * * TRANSURETHRAL RESECTION BLADDER, URETHRAL TUMOR * * ** 8251 $ 155.07 3 * * TRANSURETHRAL RESECTION BLADDER NECK,FEMALE * * ** 8253 $ 310.13 4 * * VY VESICAL NECK PLASTY * * ** 8254 $ 232.59 2 * * LITHOLAPAXY AND REMOVAL OF FRAGMENTS * * ** 8255 $ 465.20 5 * * FISTULA CLOSURE-SUPRAPUBIC,VESICO-(VAGINAL,RECTAL * * ** 8256 $ 232.59 3 * * TRANSURETHRAL RESECTION EXTERNAL URINARY SPHINCTER * * ** 8257 $ 232.59 3 * * TRANSURETHRAL REMOVAL OF FOREIGN BODY (NOT STENTS) * * ** 8259 $ 542.73 3 * * STRICTURE URETHRA-1ST STAGE PLASTIC W PEDICLE GRFT * * ** 8260 $ 155.07 2 * * URETHROTOMY, EXTERNAL OR INTERNAL * * ** 8261 $ 155.07 2 * * URETHROSTOMY * * ** 8262 $ 19.38 2 * * MEATOTOMY AND PLASTIC REPAIR * * ** 8263 $ 232.59 3 * * URETHRECTOMY, TOTAL * * ** 8264 $ 19.38 0 * * STRICTURE OF URETHRA - OFFICE DILATION * * ** 8265 $ 38.77 2 * * STRICTURE OF URETHRA - DILATION IN HOSPITAL * * ** 8266 $ 232.59 3 * * STRICTURE OF URETHRA - FIRST STAGE PLASTIC REPAIR * * ** 8267 $ 232.59 3 * * STRICTURE OF URETHRA - SECOND STAGE PLASTIC REPAIR * * ** 8268 $ 271.36 2 * * URETHRAL DIVERTICULECTOMY, MALE OR FEMALE * * ** 8269 $ 193.84 2 * * URETHRAL VALVES-TUR,POSTERIOR * * ** 8272 $ 174.45 2 * * URETHRA FISTULA (PENILE EXCISION) * * ** 8274 $ 232.59 2 * * HYPOSPADIAS-1ST STAGE CHORDEE,EXCLUDES URETHROSTOM * * ** 8275 $ 348.89 2 * * HYPOSPADIAS-SECOND STAGE (PENILE) EXCLUDES URETHRO * * ** 8276 $ 426.43 2 * * HYPOSPADIAS-PENOSCROTAL,EXCLUDES URETHROSTOMY * * ** 8277 $ 465.20 2 * * HYPOSPADIAS-EPISPADIAS PLASTIC REPAIR,EXCLUDES URE * * ** 8278 $ 310.13 3 * * SUPRAPUBIC CYSTOSTOMY & PRIMARY REPAIR OF URETHRA * * ** 8282 $ 116.30 2 * * EXCISION PROLAPSE-URETHRA OR CARUNCLE -INCLUDES.. * * ** 8283 $ 325.64 4 * * URINARY INCONTINENCE-RETROPUBIC OPERATION * * ** 8296 $ 503.96 3 * * PENILE PROSTH. INSERTION AFTER TRAUMATIC OR SURG * * ** 8297 $ 387.66 2 * * DEEP DISSECTION OF INTERCRURAL REGION W LIGATION * * ** 8299 $ 348.89 2 * * RADICAL AMPUTATION OF PENIS * * ** 8300 $ 348.89 2 * * PRIAPISM: SAPHENO-CAVERNOUS SHUNT * * ** 8301 $ 38.77 2 * * DORSAL SLIT, ISOLATED PROCEDURE * * ** 8305 $ 193.84 2 * * SIMPLE AMPUTATION OF PENIS * * ** 8306 $ 232.59 2 * * CLITORAL RECESSION * * ** 8307 $ 387.66 2 * * PEYRONIES PLAQUE, EXCISION-WITH REPLACEMENT GRAFT * * ** 8308 $ 542.73 4 * * FEMORAL AND INGUINAL GLANDS,EXCISION-UNILATERAL * * ** 8309 $ 814.09 4 * * FEMORAL AND INGUINAL GLANDS,EXCISION-BILATERAL W O * * ** 8311 $ 465.20 5 * * PROSTATECTOMY, RETROPUBIC, SUPRAPUBIC, PERINEAL, T * * ** 8312 $ 100.79 2 * * CIRCUMCISION-EXCLUDES CLAMP OR BELL TECHNIQUE * * ** 8314 $ 659.02 7 * * PROSTATECTOMY-RADICAL PERINEAL RETROPUBIC PROSTATE * * ** 8317 $ 310.13 4 * * ANTI-INCONTINENCE, PROCEDURE (KAUFMAN) * * ** 8318 $ 775.32 7 * * PROSTATECTOMY, RADICAL, TO INCLUDE LYMPHADENECTOMY * * ** 8319 $ 222.89 2 * * BALLOON DILATION OF PROSTATE-INCLUDES CYSTOSCOPY * * ** 8322 $ 310.13 2 * * ORCHIDOPEXY - ONE OR TWO STAGES * * ** 8323 $ 116.30 2 * * EXPLORATION SCROTAL CONTENTS - UNILATERAL * * ** 8324 $ 232.59 2 * * EXPLORE UNDESCENDED TESTICLE, WITHOUT ORCHIDOPEXY * * ** 8325 $ 213.21 2 * * TESTIS-REDUCE TORSION & REPAIR SPERMATIC CORD-BILA * * ** 8326 $ 251.98 2 * * TESTICLE - RUPTURED -REPAIR * * ** 8327 $ 77.53 2 * * TESTIS-BIOPSY * * ** 8328 $ 348.89 2 * * TESTIS - RECURRENT UNDESCENDED * * ** 8329 $ 93.04 2 * * ORCHIDECTOMY - SIMPLE * * ** 8330 $ 186.07 2 * * ORCHIDECTOMY - INGUINAL APPROACH * * ** 8340 $ 116.30 2 * * EPIDIDYMIS-ABSCESS,INCISION,COMPLETE CARE * * ** 8341 $ 155.07 2 * * SPERMATOCELE OR HYDROCELE - EXCISION * * ** 8342 $ 193.84 2 * * EPIDIDYMECTOMY - UNILATERAL * * ** 8343 $ 310.13 2 * * EPIDIDYMOVASOSTOMY OR RE-ANASTOMOSIS OF VAS,UNILAT * * ** 8344 $ 116.30 2 * * VAS CANNULATION, UNILATERAL OR BILATERAL * * ** 8345 $ 98.91 2 * * VASECTOMY, BILATERAL * * ** 8346 $ 174.45 2 * * VARICOCELE RESECTION * * ** 8347 $ 310.13 2 * * AVULSION PENILE SKIN AND SCROTUM - REPAIR * * ** 8349 $ 775.32 4 * * RETROPERITONEAL LYMPHADENECTOMY FOR CA OF TESTIS * * ** 8350 $ 465.20 4 * * URETHRO-VESICAL NECK PLASTY FOR CONGENITAL INCONTI * * ** 8353 $ 581.50 5 * * PLASTIC REPAIR OF EXOTROPHY & OF BLADDER WITH SKIN * * ** 8354 $ 1,085.45 4 * * LYMPHADENECTOMY-RETROPERITONEAL, POST CHEMOTHERAPY * * ** 8363 $ 174.45 3 * * PENILE PROSTHESIS-REVISION, INCLUDES REMOVAL,CORRE * * ** 8399 $ 46.52 0 * 13 16 * PENILE BLOOD FLOW-DOPPLER EVALUATION * * ** 8500 $ 47.56 0 * 16 * SKULL X-RAY ROUTINE * * ** 8501 $ 31.44 0 * 16 * SKULL X-RAY SPECIAL STUDIES * * ** 8503 $ 31.44 0 * 16 * SINUSES PARA-NASAL X-RAY DIAGNOSTIC * * ** 8504 $ 31.44 0 * 16 * FACIAL BONES X-RAY * * ** 8505 $ 31.44 0 * 16 * NASAL BONES - X-RAY * * ** 8506 $ 47.56 0 * 16 * MASTOIDS X-RAY * * ** 8507 $ 31.44 0 * 16 * MANDIBLE X-RAY * * ** 8508 $ 31.44 0 * 16 * MANDIBLE TEMPORO MANDIBULAR JOINT X-RAY * * ** 8509 $ 31.44 0 * 16 * SALIVARY GLAND AREA X-RAY * * ** 8510 $ 47.07 0 * 16 * SIALOGRAPHY * * ** 8511 $ 31.44 0 * 16 * EYE X-RAY FOR FOREIGN BODY * * ** 8512 $ 47.07 0 * 16 * EYE X-RAY LOCALIZATION PROCEDURE * * ** 8513 $ 31.11 0 * 16 * DACRYOCYSTOGRAM X-RAY * * ** 8514 $ 20.40 0 * 16 * NASOPHARYNX AND/OR NECK, SOFT TISSUE * * ** 8515 $ 47.08 0 * 16 * LARYNGOGRAM (EXCLUDING PROCEDURAL FEE) * * ** 8516 $ 4.66 0 * 16 * TEETH X-RAY - BITING OR ROUTINE DENTAL-SINGLE FILM * * ** 8517 $ 64.95 0 * 16 * TEETH X-RAY - FULL SERIES * * ** 8518 $ 21.63 0 * 16 * PRE-MRI VIEW(S) OF ORBITS TO RULE OUT METALLIC FB * * ** 8520 $ 31.44 0 * 16 * SHOULDER GIRDLE * * ** 8521 $ 31.44 0 * 16 * HUMERUS X-RAY * * ** 8522 $ 31.44 0 * 16 * ELBOW X-RAY * * ** 8523 $ 31.44 0 * 16 * FOREARM X-RAY * * ** 8524 $ 31.44 0 * 16 * WRIST X-RAY * * ** 8525 $ 31.44 0 * 16 * HAND ANY PART X-RAY * * ** 8526 $ 15.85 0 * 16 * UPPER EXTREMITY, REQUESTED ADD. X-RAY * * ** 8530 $ 31.44 0 * 16 * HIP X-RAY * * ** 8531 $ 31.44 0 * 16 * FEMUR X-RAY * * ** 8532 $ 31.44 0 * 16 * KNEE X-RAY * * ** 8533 $ 31.44 0 * 16 * FIBULA AND TIBIA X-RAY * * ** 8534 $ 31.44 0 * 16 * ANKLE X-RAY * * ** 8535 $ 31.44 0 * 16 * FOOT X-RAY * * ** 8536 $ 37.03 0 * 16 * LEG LENGTH X-RAY * * ** 8537 $ 15.85 0 * 16 * LOWER EXTREMITY, REQUESTED ADD. X-RAY * * ** 8540 $ 37.64 0 * 16 * SPINE AND PELVIS X-RAY - CERVICAL * * ** 8541 $ 31.44 0 * 16 * SPINE AND PELVIS X-RAY - THORACIC * * ** 8542 $ 47.56 0 * 16 * SPINE AND PELVIS X-RAY - LUMBAR * * ** 8543 $ 31.44 0 * 16 * SPINE AND PELVIS X-RAY - SACRUM AND COCCYX * * ** 8544 $ 31.44 0 * 16 * PELVIS X-RAY * * ** 8545 $ 31.44 0 * 16 * SACRO-ILIAC JOINT X-RAY * * ** 8546 $ 41.14 0 * 16 * SCOLIOSIS FILM * * ** 8547 $ 37.64 0 * 16 * PELVIS X-RAY AND ADDITIONAL VIEWS * * ** 8548 $ 93.14 0 * 16 * MYELOGRAM AND/OR POSTERIOR FOSSA POSITIVE CONTRAST * * ** 8549 $ 29.62 0 * 16 * SPINE, X-RAY REQUESTED ADDITIONAL * * ** 8550 $ 31.21 0 * 16 * CHEST X-RAYS - THORACIC VISCERA * * ** 8551 $ 31.21 0 * 16 * CHEST X-RAYS - THORACIC INLET * * ** 8552 $ 15.85 0 * 16 * CHEST X-RAYS - THORACIC INLET -ADDITIONAL VIEWS * * ** 8553 $ 15.97 0 * 16 * CHEST FLUOROSCOPY * * ** 8554 $ 31.44 0 * 16 * CHEST X-RAYS - RIBS ONE SIDE * * ** 8555 $ 47.56 0 * 16 * CHEST X-RAYS - RIBS BOTH SIDES * * ** 8556 $ 31.44 0 * 16 * CHEST X-RAYS - STERNUM OR STERNO * * ** 8557 $ 47.56 0 * 16 * CHEST X-RAYS - STERNUM AND STERNO * * ** 8558 $ 85.77 0 * 16 * BRONCHOGRAM X-RAY ONE SIDE * * ** 8559 $ 117.02 0 * 16 * BRONCHOGRAM X-RAY BOTH SIDES * * ** 8570 $ 31.44 0 * 16 * ABDOMEN X-RAY * * ** 8571 $ 47.56 0 * 16 * ABDOMINAL MULTIPLE X-RAY * * ** 8572 $ 53.63 0 * 16 * OESOPHAGUS ONLY -X-RAY * * ** 8573 $ 76.60 0 * 16 * OESOPHAGUS, STOMACH AND DUODENUM -X-RAY * * ** 8574 $ 76.60 0 * 16 * SMALL BOWEL * * ** 8575 $ 38.31 0 * 16 * VIDEO FLUROSCOPY - 50 % TO BE ADDED * * ** 8576 $ 86.32 0 * 16 * COLON OR DOUBLE CONTRAST AIR STUDIES * * ** 8577 $ 76.60 0 * 16 * HYPOTONIC DUODENOGRAPHY * * ** 8578 $ 46.83 0 * 16 * PANCREATOGRAPHY * * ** 8579 $ 33.70 0 * 16 * GLUCAGON ASSISTED CONTRAST STUDY * * ** 8580 $ 46.83 0 * 16 * CHOLECYSTOGRAM ORAL X-RAY * * ** 8581 $ 68.00 0 * 16 * CHOLANGIOGRAM INTRAVENOUS X-RAY * * ** 8582 $ 51.10 0 * 16 * CHOLANGIOGRAM OPERATIVE X-RAY * * ** 8583 $ 55.13 0 * 16 * CHOLANGIOGRAM, DIRECT POST-OPERATIVE * * ** 8584 $ 57.60 0 * 16 * BILIARY CALCULI, REMOVAL, RADIOLOGICAL * * ** 8590 $ 31.44 0 * 16 * KUB X-RAY * * ** 8591 $ 70.83 0 * 16 * PYELOGRAM X-RAY INTRAVENOUS * * ** 8593 $ 47.07 0 * 16 * PYELOGRAM X-RAY RETROGRADE OR ANTEGRADE * * ** 8594 $ 93.14 0 * 16 * INTRAVENOUS PYELOGRAM / VOIDING CYSTOURETHROGRAM * * ** 8595 $ 47.07 0 * 16 * CYSTOGRAM OR RETROGRADEURETHROGRAM * * ** 8596 $ 76.60 0 * 16 * HYSTERO-SALPINGOGRAM X-RAY * * ** 8597 $ 64.95 0 * 16 * PELVIMETRY X-RAY * * ** 8599 $ 77.83 0 * 16 * VOIDING CYSTOURETHROGRAM X-RAY * * ** 8601 $ 59.19 0 * 16 * X-RAY SINUS/FISTULA WITH CONTRAST MEDIA/INJECTION * * ** 8602 $ 44.84 0 * 16 * BODY SECTION RADIOGRAPHY * * ** 8603 $ 32.95 0 * 16 * BONE SURVEY - AGE * * ** 8604 $ 31.44 0 * 16 * BONE SURVEY - 1ST ANATOMICAL AREA * * ** 8605 $ 15.85 0 * 16 * BONE SURVEY - ADDITIONAL ANATOMICAL AREA * * ** 8606 $ 33.84 0 * 16 * ARTHROGRAM X-RAY - SHOULDER * * ** 8607 $ 31.11 0 * 16 * ARTHROGRAM X-RAY - HIP * * ** 8608 $ 66.77 0 * 16 * ARTHROGRAM X-RAY - KNEE * * ** 8609 $ 31.11 0 * 16 * ARTHROGRAM X-RAY - ANKLE * * ** 8610 $ 70.11 0 * 16 * MAMMOGRAPHY - UNILATERAL * * ** 8611 $ 89.33 0 * 16 * MAMMOGRAPHY - BILATERAL * * ** 8614 $ 62.49 0 * 16 * LYMPHANGIOGRAM * * ** 8615 $ 120.71 0 * 16 * ANGIOGRAPHY CEREBRAL X-RAY - UNILATERAL * * ** 8616 $ 207.08 0 * 16 * ANGIOGRAPHY CEREBRAL X-RAY - BILATERAL * * ** 8617 $ 62.49 0 * 16 * ANGIOGRAPHY PERIPHERAL - UNILATERAL * * ** 8618 $ 93.14 0 * 16 * ANGIOGRAPHY PERIPHERAL - BILATERAL * * ** 8619 $ 71.72 0 * 16 * VENOGRAPHY, ORBITAL * * ** 8620 $ 160.50 0 * 16 * AORTOGRAPHY (AORTOGRAPHY PLUS PERIPHERAL ANGIOGRAP * * ** 8624 $ 62.49 0 * 16 * ANGIOGRAM, THORACIC OR ABDOMINAL , SINGLE FILM * * ** 8625 $ 15.57 0 * 16 * ANGIOGRAM, THORACIC OR ABDOMINAL, SELECTIVE * * ** 8626 $ 122.62 0 * 16 * ANGIOGRAM, THORACIC OR ABDOMINAL, MULT NON-SELECT * * ** 8627 $ 120.71 0 * 16 * ANGIOGRAM, THORACIC OR ABDOMINAL, MULT SELECTIVE * * ** 8628 $ 15.12 0 * 16 * INTERPRETATION OF A SUBMITTED FILM * * ** 8629 $ 36.39 0 * 16 * FLUOROSCOPY WITH CLINICAL PROCEDURES * * ** 8630 $ 283.55 0 * 16 * PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY * * ** 8631 $ 31.11 0 * 16 * ARTHOGRAM - WRIST (EXCLUDING INJECTION OF CONTRAST * * ** 8632 $ 100.56 0 * 16 * RADIOLOGY ASSISTANT FEE - FIRST HOUR OR FRACTION * * ** 8633 $ 25.15 0 * 16 * RADIOLOGY ASSISTANT FEE - EACH 15 MIN AFTER 1 HOUR * * ** 8637 $ 31.11 0 * 16 * ARTHOGRAM - ELBOW (EXCLUDING INJECTION OF CONTRAST * * ** 8638 $ 99.90 0 * 15 16 19 * ECHOCARDIOGRAM - REAL TIME * * ** 8641 $ 90.06 0 * 6 16 * OPHTHALMIC B-SCAN * * ** 8642 $ 61.23 0 * 16 * B SCAN SOFT TISSUES OF NECK * * ** 8644 $ 98.01 0 * 15 16 19 * GUIDED PERICARDIOCENTESIS * * ** 8645 $ 77.17 0 * 16 * THORAX - B SCAN * * ** 8646 $ 89.49 0 * 16 * GUIDED THORACENTESIS * * ** 8648 $ 98.04 0 * 16 * ABDOMINAL B-SCAN * * ** 8649 $ 77.17 0 * 16 * RENAL B SCAN * * ** 8650 $ 94.41 0 * 16 * GUIDANCE FOR BIOPSY OR CYST PUNCTURE * * ** 8651 $ 98.01 0 * 5 16 * OBS. - B-SCAN - 14 WKS. OR MORE * * ** 8652 $ 49.24 0 * 5 16 * B SCAN I.U.D. LOCALIZATION * * ** 8653 $ 98.01 0 * 5 16 * PELVIC B SCAN - NON-OBSTETRICAL * * ** 8655 $ 73.54 0 * 5 16 * OBS. B-SCAN - LESS THAN 14 WKS. * * ** 8657 $ 98.54 0 * 5 16 * CHORIONIC VILLUS SAMPLING FOR ULTRASONIC GUIDANCE * * ** 8658 $ 53.07 0 * * EXTREMITY B SCAN * * ** 8659 $ 93.72 0 * 16 * B SCAN BRAIN * * ** 8660 $ 109.11 0 * 16 47 * ABDOMINAL DUPLEX- NATIVE/ TRANSPLANT LIVER/KIDNEY * * ** 8662 $ 229.94 0 * 15 16 19 * EXERCISE ECHOCARDIOGRAPHY * * ** 8664 $ 54.32 0 * 16 47 * DOPPLER RESTING ARTERIAL ASSESSMENT * * ** 8665 $ 96.33 0 * 16 47 * TREADMILL STRESS; WITH MONITORING PHYSICIAN * * ** 8666 $ 65.15 0 * 16 47 * TREADMILL STRESS WITHOUT MONITORING PHYSICIAN * * ** 8667 $ 40.41 0 * 16 47 * HYPEREMIA * * ** 8668 $ 65.15 0 * 16 47 * VASOSPASTIC ASSESSMENT * * ** 8669 $ 39.69 0 * 16 47 * SYMPATHETIC TONE RESPONSE * * ** 8670 $ 39.93 0 * 16 47 * PERIPHERAL VENOUS - DEEP VENOUS SYSTEM * * ** 8676 $ 108.96 0 * 8 12 16 * CAROTID IMAGING - DUPLEX SCANNING OF NECK VESSELS * * ** 8677 $ 39.93 0 * 8 12 16 * PERIORBITAL ASSESSMENTS * * ** 8678 $ 54.67 0 * 8 12 16 * SUBCLAVIAN OR VERTEBRAL ASSESSMENT * * ** 8679 $ 45.83 0 * 8 12 15 16 19 * DOPPLER ECHOCARDIOGRAPHY * * ** 8684 $ 98.01 0 * 13 16 * PROSTATE SCAN USING RECTAL PROBE * * ** 8688 $ 61.64 0 * 16 33 * BONE DENSITY - SINGLE AREA * * ** 8689 $ 42.18 0 * 16 33 * BONE DENSITY - SECOND AREA * * ** 8690 $ 43.89 0 * 16 * TOMOGRAPHY-HEAD SCAN WITHOUT CONTRAST * * ** 8691 $ 61.23 0 * 16 * TOMOGRAPHY - HEAD SCAN WITH CONTRAST * * ** 8692 $ 79.07 0 * 16 * TOMOGRAPHY-HEAD SCAN DOUBLE SCAN OR 2 PLANES * * ** 8693 $ 87.60 0 * 16 * TOMOGRAPHY-BODY SCAN ONE REGION WITHOUT CONTRAST * * ** 8694 $ 96.83 0 * 16 * TOMOGRAPHY-BODY SCAN ONE REGION WITH CONTRAST * * ** 8695 $ 132.37 0 * 16 * TOMOGRAPHY - BODY SCAN DOUBLE SCAN OR TWO REGIONS * * ** 8696 $ 111.01 0 * 16 33 * BONE DENSITY - WHOLE BODY * * ** 8710 $ 51.95 0 * 16 * CONSULT MALIGNANT HAEMOPOIETIC/REPRODUCTIVE/ETC. * * ** 8711 $ 39.11 0 * 16 * RADIOLOGY CONSULT FOR MALIGNANT LESION - W/ BIOPSY * * ** 8712 $ 26.11 0 * 16 * RADIOLOGY CONSULT FOR MALIGNANT LESION OF SKIN * * ** 8786 $ 41.89 0 * * NONMALIGNANT DISEASE - FIRST TREATMENT * * ** 8787 $ 21.08 0 * * NONMALIGNANT DISEASE - SUBSEQUENT TREATMENT * * ** 9802 $ 185.14 0 * * OESOPHAGEAL MOTILITY - ORALLY ADMIN RADIOISOTOPE * * ** 9804 $ 302.08 0 * * G.I. BLEEDING-RED CELL LABEL * * ** 9805 $ 104.14 0 * * CARBON-14 GLYCINECHOLATE BREATH ANALYSIS * * ** 9806 $ 371.62 0 * * PARATHYROID IMAGING * * ** 9807 $ 448.81 0 * * M.I.B.G. IMAGING * * ** 9808 $ 224.11 0 * * GASTRIC EMPTYING (SOLID) * * ** 9809 $ 175.48 0 * * RADIONUCLIDE VENOGRAM ALONE * * ** 9813 $ 157.80 0 * * CNS SHUNT * * ** 9814 $ 132.90 0 * * LACRIMAL DUCT SCAN * * ** 9816 $ 267.99 0 * * LYMPHOSCINTIGRAPHY * * ** 9817 $ 235.77 0 * * RECEPTOR IMAGING-ISOLATED PROCEDURE * * ** 9818 $ 163.22 0 * * SALIVARY GLAND STUDY * * ** 9819 $ 232.08 0 * * SECHAT * * ** 9820 $ 40.83 0 * * THYROID UPTAKE, SINGLE DETERMINATION * * ** 9821 $ 61.78 0 * * THYROID UPTAKE, DOUBLE DETERMINATION * * ** 9823 $ 168.32 0 * * THYROID SCAN (IODINE-123) * * ** 9824 $ 153.91 0 * * TESTICULAR IMAGING * * ** 9825 $ 67.30 0 * * THYROID SCAN (PERECHNETATE) * * ** 9826 $ 1,265.13 0 * * TUMOR IMAGING WITH METABOLIC/BIOLOGICAL AGENT * * ** 9828 $ 167.76 0 * * VOIDING CYSTOGRAPHY * * ** 9829 $ 395.93 0 * * ADRENAL IMAGING * * ** 9832 $ 147.50 0 * * BLOOD POOL JOINT SCAN * * ** 9833 $ 153.67 0 * * BONE MARROW SCAN * * ** 9834 $ 208.88 0 * * BONE SCAN * * ** 9835 $ 32.09 0 * * PLASMA VOLUME * * ** 9836 $ 106.62 0 * * RED CELL MASS DETERMINATION * * ** 9837 $ 143.21 0 * * RED CELL MASS AND PLASMA VOLUME * * ** 9838 $ 254.16 0 * * GALLIUM SCAN * * ** 9839 $ 92.17 0 * * GALLIUM SCAN-EACH REPEAT/NO ADD RADIONUCLIDE * * ** 9840 $ 135.96 0 * * RADIOIRON, CLEARANCE * * ** 9841 $ 132.37 0 * * RADIOIRON, TURNOVER * * ** 9842 $ 135.76 0 * * RADIOIRON, RED CELL UTILIZATION * * ** 9843 $ 263.97 0 * * RADIOIRON, CLEARANCE, TURNOVER, RED CELL * * ** 9844 $ 207.26 0 * * RED CELL SURVIVAL STUDY * * ** 9848 $ 114.40 0 * * G.F.R. (IN-VITRO) * * ** 9849 $ 271.31 0 * * PLATELET SURVIVAL * * ** 9850 $ 146.14 0 * * LIVER SCAN, STATIC * * ** 9851 $ 204.15 0 * * LIVER AND SPLEEN SCAN, STATIC * * ** 9852 $ 65.37 0 * * VITAMIN B12 ABSORPTION/BLOOD RADIO DETERMINATION * * ** 9853 $ 306.47 0 * * MECKEL'S LOCALIZATION (ECTOPIC GASTRIC MUCOSA) * * ** 9854 $ 374.11 0 * * THALLIUM MYOCARDIAL SCAN * * ** 9855 $ 210.93 0 * * VENTILATION LUNG SCAN * * ** 9856 $ 120.26 0 * * VITAMIN B12 ABSORPTION WITHOUT INTRINSIC FACTOR * * ** 9857 $ 144.42 0 * * VITAMIN B12 ABSORPTION STUDY WITH INTRINSIC FACTOR * * ** 9858 $ 135.76 0 * * GASTROINTESTINAL PROTEIN LOSS STUDY * * ** 9859 $ 106.23 0 * * GASTROINTESTINAL BLOOD LOSS STUDY * * ** 9860 $ 81.82 0 * * VITAMIN B12 ABSORPTION STUDY, TWO RADIONUCLIDES * * ** 9863 $ 236.52 0 * * RADIONUCLIDE CARDIAC VENTRICULOGRAPHY * * ** 9864 $ 135.76 0 * * CARDIAC SCAN, STATIC * * ** 9865 $ 107.86 0 * * PERFUSION STUDY, DONE ALONE * * ** 9866 $ 40.98 0 * * PERFUSION STUDY, ADDITION TO MAJOR SCAN * * ** 9867 $ 184.92 0 * * BRAIN SCAN, STATIC * * ** 9868 $ 203.94 0 * * LUNG SCAN, STATIC * * ** 9869 $ 263.58 0 * * PANCREAS SCAN, STATIC * * ** 9870 $ 164.92 0 * * OCULAR TUMOR LOCALIZATION * * ** 9871 $ 239.95 0 * * BRAIN SCAN-REGIONAL CEREBRAL BLOOD FLOW * * ** 9873 $ 135.76 0 * * SPLEEN SCAN, STATIC * * ** 9876 $ 67.07 0 * * TRANSFER OF RADIONUCLIDE FROM CSF TO BLOOD * * ** 9877 $ 632.57 0 * * REPEAT OF MAJOR SCAN,NO ADDITIONAL RADIONUCLIDE * * ** 9878 $ 242.86 0 * * LIVER CLEARANCE OF HIDA (BILIARY SCAN) * * ** 9879 $ 254.03 0 * * GASTRIC EMPTYING - LIQUID * * ** 9880 $ 205.41 0 * * HYPERTHYROIDISM OR CARDIAC DISEASE, IODINE THERAPY * * ** 9881 $ 205.41 0 * * POLYCYTHAEMIA VERA WITH P32 * * ** 9882 $ 457.73 0 * * THYROID CANCER-CHARGE PER COURSE OF TREATMENT * * ** 9883 $ 414.88 0 * * PROSTATE CANCER-CHARGE PER COURSE OF TREATMENT * * ** 9884 $ 269.74 0 * * METASTATIC CARCINOMA OF BONE, TREATMENT * * ** 9885 $ 403.91 0 * * ASCITES AND/OR PLEURAL EFFUSION, MALIGNANT * * ** 9886 $ 306.88 0 * * CISTERNOGRAPHY * * ** 9890 $ 446.94 0 * * JOINT INJECTION WITH ISOTOPE-THERAPEUTIC * * ** 9895 $ 224.11 0 * * GASTRO-OESOPHAGEAL REFLUX * * ** 9896 $ 29.76 0 * * LUMBAR ADMINISTRATION OF RADIONUCLIDE * * ** 9897 $ 25.53 0 * * CORONARY ADMIN OF RADIO PARTICLES - TRANSCATHETER * * ** 9898 $ 175.74 0 * * CORONARY PERFUSION WITH RADIO PARTICLES * * ** 9902 $ 15.65 0 * 32 * SUBSEQUENT VISIT - SHORT EVALUATION AND EITHER * * ** 9903 $ 4.10 0 * 32 * FIRST ADDITIONAL AREA. PHYSICAL THERAPY. * * ** 9904 $ 23.85 0 * 32 * INITIAL VISIT - INCL. EVALUATION & TREATMENT - * * ** 9908 $ 28.70 0 * 32 * HOME VISIT - REQUIRES THERAPIST TO TRAVEL TO HOME * * ** 9910 $ 23.85 0 * 32 * INITIAL VISIT - NURSING HOME - PHYSICAL THERAPY * * ** 9911 $ 15.65 0 * 32 * SUBSEQUENT VISIT AT NURSING HOME-THERAPY RENDERED * * ** 9912 $ 23.60 0 * 32 * PROLONGED VISIT AT NURSING HOME, THERAPY RENDERED * * ** 9913 $ 4.10 0 * 32 * MULTIPLE AREA TREATMENT - SECOND ADDITIONAL AREA * * ** 9914 $ 4.10 0 * 32 * MULTIPLE AREA TREATMENT - THIRD ADDITIONAL AREA. * * ** 9933 $ 23.60 0 * 32 * PROLONGED VISIT - ASSESSMENT,TREATMENT,INSTRUCTION * * ** 9934 $ 23.60 0 * 32 * PROLONGED VISIT - ASSESSMENT,TREATMENT,INSTRUCTION * * ** 9935 $ 35.90 0 * 32 * PROLONGED VISIT - CNS, ASSESSMENT,TREATMENT OF CNS * * ** 9938 $ 23.00 0 * 32 * PHYSIOTHERAPY SERVICE * * ** 9948 $ 23.00 0 * 43 * MASSAGE THERAPY SERVICE * * ** 10010 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-DTAP-P * * ** 10011 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-DTAP-P-HIB * * ** 10012 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS - TD * * ** 10013 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-TDP * * ** 10014 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-TDAP * * ** 10015 $ 3.00 0 * * IMMUNIZATION - PATIENT < 19 YRS - FLU (INFLUENZA) * * ** 10016 $ 3.00 0 * * IMMUNIZATION - PATIENT < 19 YRS - HA (HEPATITIS A) * * ** 10017 $ 3.00 0 * * IMMUNIZATION-PATIENT <19 YRS-HB(HEPATITIS B) * * ** 10018 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-HIB * * ** 10019 $ 3.00 0 * * IMMUNIZATION - PATIENT < 19 YRS-IPV * * ** 10020 $ 3.00 0 * * IMMUNIZATION-PATIENT <19 YRS-MEN-C-C(MENINGOCOCCAL * * ** 10021 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-MEN-P-ACYW135(MENING * * ** 10022 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-MMR(MEASLES,MUMPS, * * ** 10023 $ 3.00 0 * * IMMUNIZATION-PATIENT <19 YRS-PNEU-C-7(PNEUMOCOCCAL * * ** 10024 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-PNEU-P-23 * * ** 10025 $ 3.00 0 * * IMMUNIZATION-PATIENT < 19 YRS-RAB (RABIES) * * ** 10026 $ 3.00 0 * * IMMUNIZATION - PATIENT < 19 YRS - VAR (VARICELLA) * * ** 10707 $ 183.15 4 * * FLEXIBLE OESOPHAGOSCOPY FOR REMOVAL OF MATERIAL * * ** 10708 $ 250.00 0 * 15 * VIDEO CAPSULE ENDOSCOPY USING M2A CAPSULE * * ** 10714 $ 31.33 2 * * PROCTOSIGMOIDOSCOPY, RIGID - DIAGNOSTIC * * ** 10730 $ 219.78 4 * * COLONOSCOPY - FLEXIBLE - SINGLE/MULTIPLE * * ** 10731 $ 211.98 2 * * COLONOSCOPY - FLEXIBLE - DIAGNOSTIC * * ** 10732 $ 249.01 2 * * COLONOSCOPY - REMOVAL OF FOREIGN BODY * * ** 10733 $ 278.24 2 * * COLONOSCOPY - CONTROL BLEEDING * * ** 10735 $ 150.00 0 * * ENDOSCOPY-RECTAL USING (RADIAL/LINEAR) ULTRASOUND * * ** 10740 $ 250.00 0 * * ENDOSCOPY - UPPER GI USING RADIAL ULTRASOUND * * ** 10741 $ 250.00 0 * * ENDOSCOPY - UPPER GI USING LINEAR ULTRASOUND * * ** 10742 $ 50.00 0 * * ENDOSCOPY-UPPER GI,RAD/LIN ULTRASND,WITH BIOPSY * * ** 10743 $ 150.00 0 * * ENDOSCOPY-UPPER GI,RAD/LIN ULTRASND,WITH INJECTION * * ** 10744 $ 200.00 0 * * ENDOSCOPY-UPPER GI,RAD/LIN ULTRASND,WITH DRAINAGE * * ** 10900 $ 850.00 0 * 16 * ABDOMINAL AORTIC ANEURYSM * * ** 10901 $ 525.00 2 * 16 * PERCUTANEOUS IMAGE-GUIDED CATHETER DIRECTED THROMB * * ** 10902 $ 100.00 2 * 16 * PERIPHERALLY INSERTED IMAGE-GUIDED CENTRAL VENOUS * * ** 10903 $ 525.00 2 * 16 * PERCUTANEOUS HEMODIALYSIS GRAFT THROMBOLYSIS * * ** 10904 $ 525.00 3 * 16 * PERCUTANEOUS TRANSCATHETER ARTERIAL CHEMO-EMBOLIZ * * ** 10905 $ 1,168.24 5 * 16 * CEREBRAL INTRA-ARTERIAL THROMBOLYSIS * * ** 10906 $ 325.00 4 * 16 * IMAGE-GUIDED PERCUTANEOUS VERTEBROPLASTY-1ST LEVEL * * ** 10907 $ 75.00 4 * 16 * IMAGE-GUIDE PERCUTANEOUS VERTEBROPLASTY-EACH ADD. * * ** 10908 $ 432.00 3 * 16 * PERCUTANEOUS IMAGE-GUID TUMOUR ABLATION-1ST LESION * * ** 10909 $ 350.00 3 * 16 * PERCUTANEOUS INTRAVASCULAR/INTRACORPOREAL MEDICAL * * ** 10911 $ 350.00 2 * 16 * SELECTIVE SALPINGOGRAPHY/FALLOPIAN TUBE RECANALIZA * * ** 10912 $ 350.00 2 * 16 * TRANSJUGULAR LIVER/RENAL BIOPSY * * ** 11200 $ 290.85 2 * * ARTHROSCOPY- SHOULDER JOINT * * ** 11215 $ 181.78 2 * * ARTHROTOMY - SHOULDER JOINT/BURSA * * ** 11230 $ 181.78 2 * * BIOPSY - NEEDLE - SHOULDER JOINT/GA * * ** 11232 $ 236.30 2 * * ARTHROSCOPY - BIOPSY- SHOULDER * * ** 11245 $ 236.30 2 * * BIOPSY - SHOULDER JOINT - OPEN * * ** 11300 $ 261.32 2 * * ARTHROSCOPY - ELBOW JOINT * * ** 11302 $ 22.72 2 * * ASPIRATION - BURSA/TENDON SHEATH - DIAGNOSTIC * * ** 11315 $ 181.78 2 * * ARTHROTOMY - ELBOW JOINT * * ** 11330 $ 181.78 2 * * BIOPSY - NEEDLE - ELBOW JOINT/GA * * ** 11332 $ 288.58 2 * * ARTHROSCOPY/BIOPSY- ELBOW JOINT * * ** 11345 $ 236.30 2 * * BIOPSY - OPEN - ELBOW JOINT * * ** 11400 $ 181.78 2 * * ARTHROSCOPY - WRIST JOINT * * ** 11402 $ 22.72 2 * * ASPIRATION - BURSA/SYNOVIAL SHEATH, ETC. * * ** 11415 $ 181.78 2 * * ARTHROTOMY - WRIST JOINT * * ** 11416 $ 181.78 2 * * ARTHROTOMY - MP/PIP/DIP JOINTS * * ** 11430 $ 181.78 2 * * BIOPSY - NEEDLE - WRIST JOINT/GA * * ** 11432 $ 181.78 2 * * ARTHROSCOPY/BIOPSY - WRIST /HAND JOINT(S) * * ** 11445 $ 236.30 2 * * BIOPSY - OPEN - HAND/WRIST * * ** 11500 $ 504.44 3 * * ARTHROSCOPY - HIP JOINT * * ** 11501 $ 22.72 2 * * ASPIRATION - HIP JOINT * * ** 11502 $ 11.36 2 * * ASPIRATION - HIP -BURSA/TENDON SHEATH, ETC. * * ** 11515 $ 290.85 3 * * ARTHROTOMY - HIP JOINT * * ** 11530 $ 181.78 2 * * BIOPSY - NEEDLE- HIP/GA * * ** 11532 $ 504.44 3 * * ARTHROSCOPY/BIOPSY - HIP * * ** 11545 $ 236.30 3 * * ARTHROTOMY/BIOPSY - HIP * * ** 11546 $ 236.30 2 * * BIOPSY - HIP - SOFT TISSUE/BONE * * ** 11600 $ 209.04 2 * * ARTHROSCOPY - KNEE JOINT * * ** 11602 $ 22.72 2 * * ASPIRATION - KNEE JOINT - BURSA/TENDON SHEATH, E * * ** 11615 $ 236.30 3 * * ARTHROTOMY - KNEE JOINT * * ** 11630 $ 181.78 2 * * BIOPSY - NEEDLE - KNEE JOINT/GA * * ** 11632 $ 209.04 2 * * ARTHROSCOPY/BIOPSY - KNEE JOINT * * ** 11645 $ 236.30 2 * * BIOPSY - OPEN - KNEE JOINT * * ** 11700 $ 181.78 2 * * ARTHROSCOPY - ANKLE /SUBTALAR JOINT * * ** 11702 $ 22.72 2 * * ASPIRATION - ANKLE JOINT - BURSA/TENDON SHEATH, ET * * ** 11715 $ 181.78 2 * * ANKLE JOINT - INCISION -DIAGNOSTIC * * ** 11716 $ 181.78 2 * * SUBTALAR JOINT - INCISION - DIAGNOSTIC * * ** 11717 $ 181.78 2 * * MIDTARSAL JOINT - INCISION - DIAGNOSTIC * * ** 11718 $ 181.78 2 * * TARSO-METATAR/METATAR-PHALANG/INTERPHALANG JOINTS * * ** 11730 $ 181.78 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT - NEEDLE BIOPSY W/ GA * * ** 11745 $ 236.30 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT - OPEN BIOPSY W/ GA * * ** 11830 $ 209.04 2 * * BIOPSY - NEEDLE - THORACIC SPINE/GA * * ** 11831 $ 181.78 2 * * BIOPSY - NEEDLE - LUMBAR SPINE/GA * * ** 11845 $ 236.30 3 * * BIOPSY - SPINE - OPEN * * ** 11915 $ 164.17 0 * * STANDARD POLYSOMNOGRAPHY - PROFESSIONAL FEE * * ** 11916 $ 379.57 0 * * STANDARD POLYSOMNOGRAPHY - TECHNICAL FEE * * ** 11917 $ 246.26 0 * * TWO-NIGHT POLYSOMNOGRAPHY - PROFESSIONAL FEE * * ** 11918 $ 759.13 0 * * TWO-NIGHT POLYSOMNOGRAPHY - TECHNICAL FEE * * ** 11919 $ 82.09 0 * * MULTIPLE SLEEPLATENCY TEST (MSLT) PROFESSIONAL FEE * * ** 11920 $ 189.78 0 * * MULTIPLE SLEEPLATENCY TEST (MSLT) - TECHNICAL FEE * * ** 12100 $ 30.69 0 * * VISIT IN OFFICE (AGE 0-1) * * ** 12101 $ 68.24 0 * * COMPLETE EXAMINATION IN OFFICE (AGE 0-1) * * ** 12110 $ 68.24 0 * * CONSULTATION (IN OR OUT OF OFFICE):(AGE 0-1) * * ** 12120 $ 53.43 0 * * INDIVIDUAL COUNSELLING IN OFFICE (AGE 0 - 1) * * ** 12148 $ 31.31 0 * * SUB-ACUTE HOSPITAL VISIT * * ** 12200 $ 30.69 0 * * VISIT - OUT OF OFFICE (AGE 0 - 1) * * ** 12201 $ 68.24 0 * * COMPLETE EXAMINATION - OUT OF OFFICE (AGE 0-1) * * ** 12220 $ 53.43 0 * * INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 0 - 1) * * ** 13000 $ 13.95 0 * * TELEPHONE ADVICE IN FIRST NATIONS COMMUNITIES * * ** 13005 $ 13.95 0 * * TELEPHONE ADVICE ABOUT A PATIENT IN COMMUNITY CARE * * ** 13015 $ 50.00 0 * * HIV/AIDS PRIMARY CARE MGMT - PER 1/2 HR OR * * ** 13020 $ 27.90 0 * * TELEHEALTH GENERAL PRACTITIONER ASSISTANT * * ** 13052 $ 32.36 0 * * ANAES. EVALUATION - NON-CERTIFIED ANAESTHETIST * * ** 13108 $ 62.62 0 * * HOSPITAL VISIT - FIRST ROUTINE VISIT OF THE DAY * * ** 13114 $ 43.48 0 * * LONG-TERM CARE INSTITUTION VISIT -FIRST VISIT * * ** 13127 $ 62.62 0 * * HOSPITAL VISIT FOR TERMINAL CARE-FIRST VISIT * * ** 13128 $ 53.02 0 * * SUPPORTIVE CARE-FIRST IN-HOPSITAL VISIT OF THE DAY * * ** 13135 $ 167.40 0 * 0 * ANNUAL COMPLEX CARE BLOCK FEE (AGE 2-59) * * ** 13136 $ 192.48 0 * 0 * ANNUAL COMPLEX CARE BLOCK FEE (AGE 60-69) * * ** 13137 $ 209.22 0 * 0 * ANNUAL COMPLEX CARE BLOCK FEE (AGE 70-79) * * ** 13138 $ 217.62 0 * 0 * ANNUAL COMPLEX CARE BLOCK FEE (AGE 80+) * * ** 13148 $ 62.62 0 * * SUB-ACUTE HOSPITAL VISIT - 1ST VISIT OF DAY * * ** 13200 $ 27.90 0 * * VISIT - OUT OF OFFICE (AGE 2-59) * * ** 13201 $ 62.03 0 * * COMPLETE EXAMINATION - OUT OF OFFICE (AGE 2-59) * * ** 13220 $ 48.57 0 * * INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 2-59) * * ** 13600 $ 40.33 2 * * BIOPSY - MUCOSA/SKIN * * ** 13601 $ 40.33 2 * * BIOPSY - FACE * * ** 13605 $ 34.54 2 * * ABSCESS - SUPERFICIAL * * ** 13610 $ 27.67 0 * * MINOR LACERATION OR FOREIGN BODY - NO ANAESTHESIA * * ** 13611 $ 51.53 2 * * MINOR LACERATION/FOREIGN BODY REQUIRING ANAES. * * ** 13612 $ 10.33 2 * * EXTENSIVE LACERATION GREATER THAN 5CM * * ** 13620 $ 51.53 2 * * EXCISION TUMOR OF SKIN/SCAR UP TO 5CM * * ** 13621 $ 12.84 0 * * EXCISION ADDITIONAL TUMOR OF SKIN/SCAR UP TO 5CM * * ** 13622 $ 56.93 2 * * LOCALIZED CARCINOMA OF SKIN PROVEN HISTOPATH. * * ** 13630 $ 27.60 2 * * PARONYCHIA * * ** 13631 $ 27.60 2 * * NAIL REMOVAL - SIMPLE * * ** 13632 $ 55.84 2 * * NAIL REMOVAL WITH DESTRUCTION OF NAIL BED * * ** 13633 $ 49.27 2 * * WEDGE EXCISION OF ONE NAIL * * ** 13650 $ 40.49 2 * * ENUCLEATION OR EXCISION OF EXT THROMBOTIC HAEMORRH * * ** 13660 $ 40.99 2 * * METATARSAL BONE - CLOSED REDUCTION * * ** 14004 $ 258.33 0 * 0 * FULL SERVICE GP-OBSTET DELIVERY BONUS-W DELIVERY * * ** 14008 $ 48.32 0 * 0 * FULL SERVICE GP-BONUS WITH POST NATAL CARE * * ** 14009 $ 215.17 0 * 0 * FULL SERVICE GP-OBSTET DELIVERY BONUS-W C SECTION * * ** 14015 $ 40.00 0 * 0 * GENERAL PRACTICE FACILITY PATIENT CONFERENCE * * ** 14016 $ 40.00 0 * 0 * GENERAL PRACTICE COMMUNITY PATIENT CONFERENCE FEE * * ** 14030 $ 100.00 0 * 0 * MAJOR COMPLEX CARE PLAN * * ** 14031 $ 75.00 0 * 0 * MINOR COMPLEX CARE PLAN * * ** 14032 $ 35.00 0 * 0 * COMPLEX CARE FOLLOW UP * * ** 14033 $ 315.00 0 * 0 * ANNUAL COMPLEX CARE PRACTICE FEE * * ** 14034 $ 100.00 0 * 0 * PREVENTION FEE-CARDIOVASCULAR RISK ASSESSMENT * * ** 14050 $ 125.00 0 * 0 * INCENTIVE FOR FULL SERVICE GP - ANNUAL CHRONIC * * ** 14051 $ 125.00 0 * 0 * INCENTIVE FOR FULL SERVICE GP-ANNUAL CHRONIC CARE * * ** 14052 $ 50.00 0 * 0 * INCENTIVE FOR FULL SERVICE GP-ANNUAL CHRONIC CARE * * ** 14090 $ 74.44 0 * * PRENATAL VISIT- COMPLETE EXAMINATION * * ** 14091 $ 27.90 0 * * PRENATAL VISIT - SUBSEQUENT EXAMINATION * * ** 14094 $ 27.90 0 * * POST-NATAL OFFICE VISIT * * ** 14104 $ 516.65 0 * * DELIVERY AND POST-NATAL CARE * * ** 14108 $ 96.63 0 * * POST-NATAL CARE AFTER ELECTIVE C-SECTION * * ** 14109 $ 430.34 0 * * DELIVERY - ATTENDANCE - EMERG C/S * * ** 14199 $ 75.03 0 * * MNGMNT OF PRLNGD 2ND STG LABOUR - PER 30 MINS * * ** 14540 $ 33.51 2 * * INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE * * ** 14545 $ 100.24 0 * * MEDICAL ABORTION * * ** 14560 $ 27.90 0 * * ROUTINE PELVIC EXAM INCLUDING PAP * * ** 15000 $ 1.45 0 * * HAEMOGLOBIN - OTHER METHODS * * ** 15100 $ 3.33 0 * * GLUCOSE - SEMIQUANTITATIVE * * ** 15110 $ 4.41 0 * * OCCULT BLOOD - FECES * * ** 15120 $ 9.85 0 * * PREGNANCY TEST, IMMUNOLOGIC, URINE * * ** 15130 $ 1.96 0 * * URINALYSIS - SCREENING * * ** 15131 $ 4.00 0 * * URINALYSIS - MICRO EXAM OF CENTRIFUGED DEPOSIT * * ** 15132 $ 6.50 0 * * CANDIDA CULTURE * * ** 15133 $ 6.97 0 * * EXAMINATION OF EOSINOPHILS/SECRETIONS/EXCRETIONS * * ** 15134 $ 5.76 0 * * PINWORM OVA-EXAMINATION * * ** 15136 $ 8.23 0 * * FUNGUS, DIRECT EXAMINATION, KOH PREPARATION * * ** 15137 $ 3.07 0 * * HAEMOGLOBIN - CYANMETHAEMOGLOBIN * * ** 15138 $ 2.46 0 * * SEDIMENTATION RATE * * ** 15139 $ 14.40 0 * * SPERM, SEMINAL EXAMINATION FOR PRESENCE OR ABSENCE * * ** 15140 $ 7.25 0 * * STAINED SMEAR * * ** 15141 $ 5.49 0 * * TRICHOMONAS AND / OR CANDIDA, DIRECT EXAMINATION * * ** 15142 $ 5.37 0 * * URINALYSIS-COMPLETE DIAGNOSTIC, SEMI-QUANT & MICRO * * ** 15143 $ 6.31 0 * * WHITE CELL COUNT ONLY * * ** 16100 $ 32.08 0 * * VISIT IN OFFICE (AGE 60-69) * * ** 16101 $ 71.34 0 * * COMPLETE EXAMINATION IN OFFICE (AGE 60-69) * * ** 16110 $ 71.34 0 * * CONSULTATION(IN OR OUT OF OFFICE):(AGE 60-69) * * ** 16120 $ 55.86 0 * * INDIVIDUAL COUNSELLING IN OFFICE (AGE 60 - 69) * * ** 16200 $ 32.08 0 * * VISIT - OUT OF OFFICE (AGE 60-69) * * ** 16201 $ 71.34 0 * * COMPLETE EXAMINATION - OUT OF OFFICE (AGE 60-69) * * ** 16220 $ 55.86 0 * * INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 60-69) * * ** 17100 $ 34.87 0 * * VISIT IN OFFICE (AGE 70-79) * * ** 17101 $ 77.54 0 * * COMPLETE EXAMINATION IN OFFICE (AGE 70-79) * * ** 17110 $ 77.54 0 * * CONSULTATION(IN OR OUT OF OFFICE):(AGE 70-79) * * ** 17120 $ 60.72 0 * * INDIVIDUAL COUNSELLING IN OFFICE (AGE 70-79) * * ** 17200 $ 34.87 0 * * VISIT - OUT OF OFFICE (AGE 70-79) * * ** 17201 $ 77.54 0 * * COMPLETE EXAMINATION - OUT OF OFFICE (AGE 70-79) * * ** 17220 $ 60.72 0 * * INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 70-79) * * ** 18100 $ 36.27 0 * * VISIT IN OFFICE (AGE 80+) * * ** 18101 $ 80.64 0 * * COMPLETE EXAMINATION IN OFFICE (AGE 80+) * * ** 18110 $ 80.64 0 * * CONSULTATION (IN OR OUT OF OFFICE):(AGE 80+) * * ** 18120 $ 63.15 0 * * INDIVIDUAL COUNSELLING IN OFFICE (AGE 80+) * * ** 18200 $ 36.27 0 * * VISIT - OUT OF OFFICE (AGE 80+) * * ** 18201 $ 80.64 0 * * COMPLETE EXAMINATION - OUT OF OFFICE (AGE 80+) * * ** 18220 $ 63.15 0 * * INDIVIDUAL COUNSELLING - OUT OF OFFICE (AGE 80 +) * * ** 19130 $ 30.38 0 * 30 * WCB CHIRO INITIAL VISIT * * ** 19131 $ 28.21 0 * 30 * WCB CHIRO SUBSEQUENT VISIT (2 - 12). * * ** 19132 $ 46.00 0 * 30 * WCB CHIRO PRE-ARRANGED PHONE CONSULT-UP TO 15 MIN * * ** 19133 $ 40.53 0 * 30 * WCB CHIRO HOME VISIT. * * ** 19134 $ 32.12 0 * 30 * WCB CHIRO FORM FEE (8C) * * ** 19135 $ 25.28 0 * 30 * WCB CHIRO FORM FEE (11C). * * ** 19138 $ 59.86 0 * 30 * WCB CHIRO SPINAL SERIES - MIN 2 VIEWS * * ** 19139 $ 23.19 0 * 30 * WCB CHIRO SPINAL SERIES - RECHECK. * * ** 19140 $ 26.70 0 * 30 * WCB CHIRO PERIPHERAL JOINTS - ALL VIEWS * * ** 19141 $ 42.98 0 * 30 * WCB CHIRO WRITTEN REPORT * * ** 19142 $ 22.34 0 * 30 * WCB CHIRO PHOTOCOPIES OF PATIENT RECORD (FIRST 5) * * ** 19143 $ 1.06 0 * 30 * WCB CHIRO PHOTOCOPIES OF PATIENT'S RECORD (ADDTNL * * ** 19144 $ 209.59 0 * 30 * WCB CHIRO COMPREHENSIVE REPORT REQUESTED BY BOARD * * ** 19145 $ - 0 * 30 * WCB CHIRO FIRST REPORT(EFORM 8C)NO CHARGE * * ** 19146 $ - 0 * 30 * WCB CHIRO PROGRESS REPORT(EFORM 11C) NO CHG * * ** 19150 $ 26.82 0 * 43 * WCB MASSAGE THERAPY - INITIAL TREATMENT * * ** 19151 $ 24.00 0 * 43 * WCB MASSAGE THERAPY - SUBSEQUENT VISIT * * ** 19155 $ 15.84 0 * 43 * WCB MASSAGE THERAPY - HOME/INSTITUTIONAL VISIT * * ** 19156 $ 22.36 0 * 43 * WCB MASSAGE THERAPY - HISTORY & NOTES FIRST 5 PGS * * ** 19157 $ 1.15 0 * 43 * WCB MASSAGE THERAPY - HISTORY & NOTES ADDTNL PGS * * ** 19158 $ 25.00 0 * 43 * WCB MASSAGE THERAPY - TELEPHONE CONSULTN WITH WCB * * ** 19159 $ 25.87 0 * 43 * WCB MASSAGE THERAPY DISCHARGE/REASSESSMENT/RTW * * ** 19163 $ 26.10 0 * 32 * WCB PHYSIO SUBSEQUENT HOME VISIT * * ** 19165 $ 26.10 0 * 32 * WCB PHYSIO SUB CENTRAL NERVOUS DISORDER VISIT * * ** 19167 $ 36.16 0 * 32 * WCB PHYSIO REQUESTED REPORT * * ** 19171 $ 26.10 0 * 32 * WCB PHYSIO CLINICAL RECORD/CHART NOTES,1ST 5 PAGES * * ** 19172 $ 1.22 0 * 32 * WCB PHYSIO COPY OF REPORT EACH PAGE OVER 5 PAGES * * ** 19173 $ 36.16 0 * 32 * WCB PHYSIO REPORT FOR HOME VISIT * * ** 19175 $ 36.16 0 * 32 * WCB PHYSIO REPORT FOR CNS DISORDER * * ** 19176 $ - 0 * 32 * WCB PHYSIO PLAN/REPORT 'NO CHARGE' RESUBMIT * * ** 19177 $ 26.52 0 * 32 * WCB PHYSIO TELEPHONE CONSULT INITIATED BY WCB * * ** 19178 $ 57.10 0 * 32 * WCB PHYSIO INT STD TRT VISIT FORM REC'D IN 72 HRS * * ** 19179 $ 51.79 0 * 32 * WCB PHYSIO INT STD TRT VISIT, FORM REC'D > 72 HRS * * ** 19181 $ 46.49 0 * 32 * WCB PHYSIO INITIAL VIST EXCEPTION TO STD TREATMENT * * ** 19182 $ 26.10 0 * 32 * WCB PHYSIO INITIAL HOME VISIT * * ** 19183 $ 26.10 0 * 32 * WCB PHYSIO INITIAL CNS DISORDER VISIT * * ** 19184 $ 34.52 0 * 32 * WCB PHYSIO SUBSEQUENT VISIT EXCEPTION TO STD TRTMT * * ** 19185 $ 36.16 0 * 32 * WCB PHYSIO STANDARD TREATMENT REPORT * * ** 19186 $ 31.16 0 * 32 * WCB PHYSIO STANDARD TREATMENT LATE REPORT * * ** 19187 $ 31.16 0 * 32 * WCB PHYSIO EXCEPTIONS TO STD TREATMENT LATE REPORT * * ** 19188 $ 31.16 0 * 32 * WCB PHYSIO LATE REQUESTED REPORT * * ** 19189 $ 31.16 0 * 32 * WCB PHYSIO LATE REPORT FOR HOME VISIT * * ** 19190 $ 27.00 0 * 43 * WCB MASSAGE THERAPY WRITTEN REPORT WCB REQUEST * * ** 19191 $ 15.84 0 * 43 * WCB MASSAGE THERAPY HOME INSTITUTION VISIT TRAVEL * * ** 19192 $ 18.00 0 * 43 * WCB MASSAGE VISIT, EXTENUATING CIRCUMSTANCES * * ** 19197 $ 31.16 0 * 32 * WCB PHYSIO LATE REPORT FOR CNS DISORDER * * ** 19198 $ 26.10 0 * 32 * WCB PHYSIO HOME VISIT TRAVEL * * ** 19199 $ 26.10 0 * 32 * WCB PHYSIO HYDROTHERAPY - SMALL GROUP * * ** 19200 $ 360.00 0 * 32 * WCB PHYSIO MEDICAL - LEGAL REPORT * * ** 19201 $ 34.52 0 * 32 * WCB PHYSIO HYDROTHERAPY - LARGE GROUP * * ** 19202 $ 34.52 0 * 32 * WCB PHYSIO SUBSEQUENT VISIT STD TREATMENT * * ** 19203 $ 36.16 0 * 32 * WCB PHYSIO EXCEPTION TO STANDARD TREATMENT REPORT * * ** 19204 $ 26.52 0 * 32 * WCB PHYSIO TELEPHONE CONSULT FOR RTW * * ** 19205 $ 57.10 0 * 32 * WCB PHYSIO INITIAL VISIT FOR PENDING CLAIM * * ** 19333 $ - 0 * * WCB NO CHARGE LINK FEE ITEM TO TELEPLAN E-FORM * * ** 19334 $ - 0 * * WCB ADDITIONAL NO CHARGE LINK FEE ITEM TO EFORMS * * ** 19335 $ - 0 * * WCB E-FORM NO CHARGE FEE USED TO TRANSMIT 4TH NOTE * * ** 19337 $ - 0 * 30 32 * WCB SUPPLEMENTARY BENEFIT PRACTITIONER LINK FEE * * ** 19338 $ - 0 * 30 32 * WCB SUPPLEMENTARY BENEFIT PRACTITIONERS 2ND LINK * * ** 19339 $ - 0 * 30 32 * WCB SUPPLEMENTARY BENEFIT PRACTITIONER 3RD LINK * * ** 19500 $ 552.00 0 * 6 8 9 10 11 * WCB -EXPEDITED SURGICAL PROCEDURE-LEVEL 1 * * ** 19501 $ 800.00 0 * 6 8 9 10 11 * WCB -EXPEDITED SURGICAL PROCEDURE-LEVEL 2 * * ** 19502 $ 1,010.00 0 * 6 8 9 10 11 * WCB - EXPEDITED SURGICAL PROCEDURE-LEVEL 3 * * ** 19503 $ 1,224.00 0 * 6 8 9 10 11 * WCB - EXPEDITED SURGICAL PROCEDURE-LEVEL 4 * * ** 19504 $ 1,449.00 0 * 6 8 9 10 11 * WCB - EXPEDITED SURGICAL PROCEDURE-LEVEL 5 * * ** 19505 $ 2,150.00 0 * 6 8 9 10 11 * WCB - EXPEDITED SURGICAL PROCEDURE-LEVEL 6 * * ** 19506 $ 3,300.00 0 * 6 8 9 10 11 * WCB - EXPEDITED SURGICAL PROCEDURE-LEVEL 7 * * ** 19507 $ 68.25 0 * 0 18 * WCB - EXPEDITED ANAESTHESIA SERVICES * * ** 19508 $ 68.00 0 * * WCB TELEPHONE CONSULT BETWEEN WCB & PHY * * ** 19509 $ 135.00 0 * 0 * WCB - COMPLEX SPINAL CORD INJURY INITIAL VISIT * * ** 19510 $ 75.00 0 * 0 * WCB - COMPLEX SPINAL CORD INJURY OFFICE * * ** 19511 $ 155.00 0 * 0 * WCB - COMPLEX SPINAL CORD INJURY HOME VISIT * * ** 19512 $ 1,081.41 0 * 6 7 8 9 10 * WCB - SURCHARGE - OPERATIVE EVENING * * ** 19513 $ 1,733.82 0 * 6 7 8 9 10 * WCB - SURCHARGE - OPERATIVE - NIGHT * * ** 19514 $ 1,081.41 0 * 6 7 8 9 10 * WCB - SURCHARGE - OPERATIVE SAT SUN HOLS * * ** 19701 $ 169.00 0 * * WCB BURN/SOFT TISSUE INJURY * * ** 19702 $ 110.00 0 * * WCB OUT PATIENT VISIT FACILITY FEE * * ** 19717 $ 46.00 0 * 30 * WCB CHIRO TELEPHONE CONSULT WTH EMPLOYER-TO 15 MIN * * ** 19718 $ 265.00 0 * 30 * WCB CHIRO JOBSITE VISIT/ASSESSMENT (INCLUDES * * ** 19719 $ 210.00 0 * 30 * WCB CHIRO JOBSITE VISIT/ASSESSMENT (INCLUDES * * ** 19741 $ 110.00 0 * * WCB HOSP - ACUTE CARE PER DIEM WARD RATE * * ** 19742 $ 200.00 0 * * WCB HOSP - MEDICAL IMAGING 2ND OPINION - EXPEDITED * * ** 19743 $ 169.00 0 * * WCB HOSP - NERVE/EPIDURAL BLOCK * * ** 19744 $ 200.00 0 * * WCB HOSP - MEDICAL MISCELLANEOUS - TAKE AWAY ITEMS * * ** 19745 $ 169.00 0 * * WCB HOSP - DRESSING CHANGES - BOOKED OUTPATIENT * * ** 19746 $ 169.00 0 * * WCB HOSP - STERILE ENVIRONMENT - BOOKED OUTPATIENT * * ** 19747 $ 169.00 0 * * WCB HOSP - CAST CLINIC - BOOKED OUTPATIENT VISIT * * ** 19748 $ 500.00 0 * * WCB HOSP - CUSTOM BRACES/SPLINTS * * ** 19749 $ 500.00 0 * * WCB HOSP - COMPRESSION GARMENTS * * ** 19786 $ 354.00 0 * * WCB HOSP - HAEMODIALYSIS * * ** 19787 $ 754.00 0 * * WCB HOSP - CANCER CHEMOTHERAPY VISIT + TREATMENT * * ** 19788 $ 500.00 0 * * WCB HOSP - ORTHOTICS * * ** 19789 $ 1,500.00 0 * * WCB HOSP - PROSTHETICS * * ** 19790 $ 40.00 0 * * WCB HOSP - REFERRED IN LABORATORY SPECIMENS * * ** 19791 $ 266.00 0 * * WCB HOSP - RADIOACTIVE THERAPY SERVICES * * ** 19792 $ 635.00 0 * * WCB HOSP - HYPERBARIC OXYGEN THERAPY * * ** 19793 $ 759.00 0 * * WCB HOSP - MEDICAL RESONANCE IMAGING (MRI) * * ** 19794 $ 759.00 0 * * WCB HOSP - MEDICAL RESONANCE ANGIOGRAM (MRA) * * ** 19795 $ 332.00 0 * * WCB HOSP - COMPUTERIZED TOMOGRAPHY (CT) * * ** 19890 $ 45.00 0 * * WCB HOME CHRONIC WOUND CARE INITIAL ASSESSMENT * * ** 19891 $ 42.50 0 * * WCB COMMUNITY CHRONIC WOUND CARE TREATMENT * * ** 19892 $ 153.00 0 * * WCB CHRONIC WOUND CARE - CLINIC VISIT * * ** 19893 $ 42.50 0 * * WCB HOME IV THERAPY VISIT * * ** 19894 $ 153.00 0 * * WCB IV THERAPY CLINIC VISIT * * ** 19900 $ 31.24 0 * * WCB FIRST REPORT OF INJURY (FORM 8) RECD WN 3 DAYS * * ** 19901 $ 20.00 0 * * WCB FIRST REPORT OF INJURY(FORM 8 RECD WN 4-6 DAYS * * ** 19902 $ 29.12 0 * * WCB PROGRESS REPORT(FORM 11) RECD WITHIN 3 WORKING * * ** 19903 $ 14.00 0 * * WCB PROGRESS REPORT(FORM 11) RECD WITHIN 4-6 DAYS * * ** 19904 $ 40.00 0 * * WCB BOARD REQUEST FOR A COPY OF AN EXISTING REPORT * * ** 19905 $ 25.00 0 * * WCB BOARD REQUEST FOR A COPY OF EXISTING REPORT * * ** 19906 $ 1.20 0 * * WCB ADDITIONAL CHARGE PER PAGE FOR OVER 20 PAGES * * ** 19907 $ 255.00 0 * * WCB FACTUAL WRITTEN SUMMARY OF A REASONED MEDICAL * * ** 19908 $ 27.00 0 * * WCB NON-EXPEDITED SPECIALIST CONSULTATION REPORT * * ** 19909 $ 75.00 0 * 0 * WCB STANDARDIZED ASSESSMENT FORM RECD WITHIN 15 DA * * ** 19910 $ 70.00 0 * 0 * WCB STANDARDIZED ASSESSMENT FORM RECD AFTER 15 * * ** 19911 $ 317.87 0 * 2 8 9 10 11 * WCB INITIAL EXPEDITED COMPREHENSIVE CONSULTATION * * ** 19912 $ 156.00 0 * 2 8 9 10 11 * WCB REPEAT CONSULT WITHIN 2 - 4 MONTHS OF 19911 * * ** 19913 $ 317.87 0 * 3 * WCB INITIAL EXPEDITED COMPREHENSIVE CONSULTATION * * ** 19914 $ 156.00 0 * 3 * WCB REPEAT CONSULT WITHIN 2 - 4 MONTHS OF 19913 * * ** 19915 $ 317.87 0 * 6 7 13 * WCB INITIAL EXPEDITED COMPREHENSIVE CONSULTATION * * ** 19916 $ 156.00 0 * 6 7 13 * WCB REPEAT CONSULT WITHIN 2 - 4 MONTHS OF 19915 * * ** 19917 $ 317.87 0 * 1 * WCB INITIAL EXPEDITED COMPREHENSIVE CONSULTATION * * ** 19918 $ 156.00 0 * 1 * WCB REPEAT CONSULT WITHIN 2 - 4 MONTHS OF 19917 * * ** 19919 $ 56.00 0 * * WCB OFFICE CONSULTATION WITH WCB OFFICER * * ** 19921 $ 169.00 0 * * WCB HOSPITAL EMERGENCY PER DIEM RATE * * ** 19922 $ 250.00 0 * * WCB TRAY SERVICE * * ** 19923 $ 33.28 0 * * WCB FIRST REPORT OF INJURY(FORM 8 HOSPITAL)W/N 5 D * * ** 19924 $ 33.28 0 * * WCB FIRST REPORT OF INJURY(FORM 8 HOSPITAL)W/N 6-7 * * ** 19925 $ 26.86 0 * * WCB PROGRESS REPORT(FORM 11 HOSPITAL) W/N 5 WORKIN * * ** 19926 $ 26.86 0 * * WCB PROGRESS REPORT(FORM 11 HOSPITAL)W/N 6-7 WORKI * * ** 19927 $ 50.00 0 * * WCB FIRST REPORT OF INJURY (FORM 8) REQ'D LATER * * ** 19929 $ 130.00 0 * * WCB EXCESSIVELY PROLONGED OR COMPLEX CASE-REPORT * * ** 19930 $ 50.00 0 * * WCB PRE-ARRANGED TELEPHONE CONSULT - UP TO 15 MIN * * ** 19931 $ 75.00 0 * * WCB POST OPERATIVE CONSULT + FORM 11 REC'D W/I 5 * * ** 19932 $ 815.00 0 * * WCB MEDICAL-LEGAL REPORT - FACTUAL SUMMARY * * ** 19933 $ 1,361.00 0 * * WCB MEDICAL-LEGAL OPINION - EXPERT OPINION * * ** 19934 $ 317.87 0 * 18 * WCB INITIAL EXPEDITED CONSULT & REPORT FROM ANAES * * ** 19935 $ 156.00 0 * 18 * WCB REPEAT CONSULT WITHIN 2-4 MONTHS - ANAESTHETI * * ** 19936 $ 50.00 0 * * WCB CANCELLATION FEE * * ** 19937 $ 42.84 0 * * WCB TELEPLAN E-FORM 8 REC'D WITHIN 3 WORKING DAYS * * ** 19938 $ 31.20 0 * * WCB TELEPLAN E-FORM REC'D WITHIN 4-6 WORKING DAYS * * ** 19939 $ 50.00 0 * * WCB TELEPLAN E-FORM 8 REC'D WITHIN 10 DAYS OF FAX * * ** 19940 $ 38.00 0 * * WCB TELEPLAN E-FORM 11 REC'D WITHIN 3 WORKING DAYS * * ** 19941 $ 17.00 0 * * WCB TELEPLAN E-FORM 11 REC'D WN 4-6 WORKING DAYS * * ** 19942 $ 295.00 0 * * WCB JOB SITE MEETING * * ** 19943 $ - 0 * * WCB E-FORM 8 RESUBMISSION, NO CHARGE * * ** 19944 $ - 0 * * WCB E-FORM 11 SUBMISSION * * ** 19950 $ 260.00 0 * * WCB RETURN TO WORK - CONSULTATION * * ** 19953 $ 120.00 0 * * WCB REQ'D COPY OF AN EXISTING REPORT OR CHART NOTE * * ** 19954 $ 169.00 0 * * WCB HOSP - IV THERAPY * * ** 19957 $ 681.00 0 * * WCB HOSP - DAY CARE SURGERY * * ** 19958 $ 150.00 0 * * WCB HOSP - FIBERGLASS CAST * * ** 19960 $ 218.00 0 * * WCB HOSP - PER DIEM EXTENDED LTC * * ** 19961 $ 2,220.00 0 * * WCB HOSP - ACUTE CARE PER DIEM * * ** 19976 $ 15.00 0 * * WCB RETURN TO WORK REQUEST * * ** 20207 $ 21.89 0 * 1 * TELEHEALTH SUBSEQUENT OFFICE VISIT - DERMATOLOGY * * ** 20208 $ 20.87 0 * 1 * TELEHEALTH SUBSEQUENT HOSPITAL VISIT - DERMATOLOGY * * ** 20210 $ 52.95 0 * 1 * TELEHEALTH CONSULTATION, DERMATOLOGY * * ** 20214 $ 36.15 0 * 1 * TELEHEALTH REPEAT CONSULTATION, DERMATOLOGY * * ** 22007 $ 27.58 0 * 6 * TELEHEALTH SUBSEQUENT OFFICE VISIT - OPHTHALMOLOGY * * ** 22008 $ 21.72 0 * 6 * TELEHEALTH SUBSEQNT HOSPITAL VISIT - OPHTHALMOLOGY * * ** 22010 $ 71.37 0 * 6 * TELEHEALTH CONSULTATION - OPHTHALMOLOGY * * ** 22011 $ 47.89 0 * 6 * TELEHEALTH REPEAT OR LMTD CONSULT - OPHTHALMOLOGY * * ** 22023 $ 33.91 0 * * 10 OR 24 HOUR TENSION CURVE - DIURNAL * * ** 22046 $ 10.99 2 * 6 * POSTERIOR SEGMENT CONTACT LENS EXAM * * ** 22047 $ 12.27 2 * 6 * ANTERIOR SEGMENT GONIOSCOPY * * ** 22056 $ 78.29 0 * * CONTACT LENS BANDAGE - UNILATERAL * * ** 22059 $ 261.00 0 * * CONTACT LENS - KERATOCONUS - UNILATERAL * * ** 22067 $ 63.92 0 * 6 * COMPUTERIZED RETINAL NERVE FIBRE LAYER PHOTOGRAPHY * * ** 22068 $ 12.28 0 * 6 * PROFESSIONAL FEE -COMPUTERIZED RETINAL NERVE FIBRE * * ** 22069 $ 51.64 0 * 6 * TECHNICAL FEE - COMPUTERIZED RETINAL NERVE FIBRE * * ** 22070 $ 955.92 5 * * MOLTENO IMPLANT (INCLUDES PHASE 1 AND PHASE 2) * * ** 22113 $ 115.36 4 * * LASER IRIDOTOMY * * ** 22114 $ 125.92 4 * * LASER TRABECULOPLASTY PER EYE * * ** 22115 $ 104.39 4 * * CAPSULOTOMY - YAG LASER, PER EYE * * ** 22116 $ 125.92 4 * * RETINAL PHOTOCOAGULATION - LEFT * * ** 22117 $ 125.92 4 * * RETINAL PHOTOCOAGULATION - RIGHT * * ** 22118 $ 32.56 0 * * POST-LASER FOLLOW-UP * * ** 22121 $ 173.04 3 * * DUCT PROBING UNDER GA - UNILATERAL OR BILATERAL * * ** 22125 $ 274.39 0 * 6 * PHOTODYNAMIC THRPY FOR AGE-RLTD WET MACULAR DEGENE * * ** 22136 $ 288.39 4 * * BIOPSY OR EXCISION OF ANTERIOR ORBITAL TUMOUR * * ** 22138 $ 1,153.58 6 * * POSTERIOR ORBITOTOMY * * ** 22140 $ 922.85 6 * * ORBITAL EXPLORATION (POSTERIOR ROUTE) * * ** 22141 $ 519.11 6 * * ORBITAL DECOMPRESSION - (1 WALL) * * ** 22142 $ 801.68 6 * * ORBITAL DECOMPRESSION - (2 WALL) * * ** 22143 $ 1,153.58 6 * * ORBITAL DECOMPRESSION - (3 WALL) * * ** 22165 $ 749.82 4 * * STRABISMUS (5 OR MORE MUSCLES) * * ** 22166 $ 173.04 0 * * ADJUSTABLE SUTURE FEE - EXTRA TO STRABISMUS * * ** 22167 $ 135.72 0 * 6 * PRISM ADAPTATION AND/OR AMBLYOPIA THERAPY * * ** 22169 $ 21.72 4 * * POST-KERATOPLASTY SUTURE REMOVAL AT SLIT LAMP * * ** 22171 $ 412.04 4 * * PTERYGIUM EXCISION WITH MUCOUS MEMBRANE GRAFT * * ** 22172 $ 494.45 4 * * PTERYGIUM EXCISION - COMPLICATED * * ** 22185 $ 304.00 4 * * GLAUCOMA - CYCLOABLATIVE PROCEDURES * * ** 22187 $ 824.07 4 * * GLAUCOMA - COMPLICATED TRABECULECTOMY * * ** 22191 $ 204.25 0 * * CATARACT - CAPSULOTOMY (NEEDLING OR DISCISSION) * * ** 22195 $ 170.30 5 * * BUCKLE MATERIAL OR SPONGE - REMOVAL * * ** 22196 $ 380.18 5 * * PNEUMATIC RETINOPEXY WITH AIR/GAS - ISOLATED PROC. * * ** 22197 $ 97.78 5 * * ADDITIONAL GAS/AIR INJECTION - POST-OP * * ** 22198 $ 962.52 5 * * REPAIR SCLERAL LACERATION(ISOLATED PROCEDURE) * * ** 22199 $ 65.93 5 * * FLUID/GAS EXCHANGE AND SILICONE INJECTION IF REQ. * * ** 22200 $ 203.28 5 * * PAN RETINAL ENDOLASER: > 200 BURNS * * ** 22201 $ 54.93 5 * * SCLERAL BUCKLE DONE WITH POSTERIOR VITRECTOMY * * ** 22202 $ 54.93 5 * * INTRA OCULAR LENS REMOVAL/LENSECTOMY * * ** 22203 $ 219.75 5 * * INTRA OCULAR FOREIGN BODY - REMOVAL * * ** 22399 $ 63.11 0 * 6 16 * OPHTHALMIC A-SCAN TO DETERMINE AXIAL LENGTH * * ** 25100 $ 426.33 6 * * LASER PHOTOCOAGULATION OF HHT LESIONS NASAL CAVITY * * ** 25300 $ 1,000.00 6 * 7 * ENDOSCOP RESEC INTRANASAL/SINUS TUMOR-UP TO 7 HRS * * ** 25301 $ 250.00 0 * 7 * ENDOSCOP RESEC INTRANASAL/SINUS TUMOR-ADD AFTER 7 * * ** 25305 $ 400.00 6 * 7 * ENDOSCOPIC LIGATION - SPHENOPALATINE ARTERY * * ** 25310 $ 932.82 8 * 7 * ENDOSCOP TRANS-NASAL REPAIR CSF LEAK FRM ANT SKULL * * ** 25315 $ 222.00 3 * 7 * PRIMARY FRONTAL SINUSOTOMY * * ** 27000 $ 70.56 0 * 40 * EMERGENCY CONSULTATION IN A HOSPITAL * * ** 27005 $ 70.56 0 * 40 * NON-EMERGENT CONSULTATION * * ** 27008 $ 15.52 0 * 40 * HOSPITAL VISIT FOR MEDICAL MGMT OF ORAL DISEASE * * ** 27013 $ 43.03 0 * 40 * CALL-OUT CHARGES - EVENING * * ** 27014 $ 60.44 0 * 40 * CALL-OUT CHARGES - NIGHT * * ** 27015 $ 43.03 0 * 40 * CALL-OUT CHARGES - SAT/SUN OR STATUTORY HOLIDAYS * * ** 27023 $ 296.86 0 * 40 * CONTINUING CARE OPERATIVE SURCHARGES - EVENING * * ** 27024 $ 416.88 0 * 40 * CONTINUING CARE OPERATIVE SURCHARGES - NIGHT * * ** 27025 $ 296.86 0 * 40 * CONT CARE OPERATIVE SURCHARGES - SAT/SUN OR STATS * * ** 27030 $ 54.64 0 * 40 * ERUPTED TEETH - FIRST TOOTH PER QUADRANT * * ** 27031 $ 36.01 0 * 40 * ERUPTED TEETH - EACH ADDITIONAL TOOTH * * ** 27033 $ 106.80 0 * 40 * ERUPTED TEETH - SURGICAL REMOVAL WITH FLAP * * ** 27034 $ 75.72 0 * 40 * ERUPTED TEETH - EACH ADDITIONAL SURGICAL REMOVAL * * ** 27040 $ 106.80 0 * 40 * IMPACTED TEETH - SOFT TISSUE * * ** 27041 $ 70.48 0 * 40 * IMPACTED - TEETH - EACH ADDITIONAL "SOFT TISSUE" * * ** 27045 $ 123.10 0 * 40 * IMPACTED TEETH - PARTIAL BONY * * ** 27046 $ 58.21 0 * 40 * IMPACTED TEETH - EACH ADDITIONAL "PART BONY" * * ** 27050 $ 172.07 0 * 40 * IMPACTED TEETH - FULL BONY * * ** 27051 $ 86.23 0 * 40 * IMPACTED TEETH - EACH ADDITIONAL "FULL BONY" * * ** 27054 $ 183.46 0 * 40 * IMPACTED TEETH - FULL BONY OF EXTREME DIFFICULTY * * ** 27055 $ 127.01 0 * 40 * IMPACTED TEETH - EACH ADD 'FULL BONY OF EXTREME' * * ** 27058 $ 101.75 0 * 40 * IMPACTED TEETH - REMOVAL OF A TOOTH FOLLICLE * * ** 27059 $ 81.34 0 * 40 * IMPACTED TEETH - EACH ADDITIONAL TOOTH FOLLICLE * * ** 27060 $ 65.42 0 * 40 * RESIDUAL ROOTS - SOFT TISSUE FIRST PER QUADRANT * * ** 27061 $ 28.95 0 * 40 * RESIDUAL ROOTS - EACH ADDITIONAL SOFT TISSUE * * ** 27063 $ 123.17 0 * 40 * RESIDUAL ROOTS - BONE COVERAGE FIRST PER QUADRANT * * ** 27064 $ 46.01 0 * 40 * RESIDUAL ROOTS - EACH ADDITIONAL "BONE COVERAGE" * * ** 27070 $ 211.68 0 * 40 * TOOTH TRANSPLANTATION * * ** 27071 $ 105.84 0 * 40 * TOOTH TRANSPLANTATION - EACH ADDITIONAL * * ** 27073 $ 149.69 0 * 40 * SURGICAL UPRIGHTING/REPOSITIONING * * ** 27074 $ 74.91 0 * 40 * SURGICAL UPRIGHTING - EACH ADDITIONAL PER QUADRANT * * ** 27076 $ 180.00 0 * 40 * SURGICAL UPRIGHTING/REPOSITIONING/UNCOVERING * * ** 27077 $ 90.00 0 * 40 * SURGICAL UPRIGHTING/REPOS/UNCOVER - EACH ADDITION * * ** 27080 $ 198.85 0 * 40 * APICOECTOMY - ANTERIOR * * ** 27082 $ 246.97 0 * 40 * APICOECTOMY - BICUSPIDS AND BUCCAL ROOTS * * ** 27084 $ 236.03 0 * 40 * APICOECTOMY - PALATAL ROOTS OF MAXILLARY MOLARS * * ** 27086 $ 23.57 0 * 40 * APICOECTOMY - PER ROOT END FILL, ADD * * ** 27088 $ 87.94 0 * 40 * APICOECTOMY - HEMISECTION * * ** 27090 $ 175.88 0 * 40 * ROOT AMPUTATIONS - ONE ROOT PER TOOTH * * ** 27092 $ 211.04 0 * 40 * ROOT AMPUTATIONS - TWO ROOTS PER TOOTH * * ** 27100 $ 71.32 0 * 40 * ALVEOLOPLASTY - PER EDENTULOUS SEXTANT * * ** 27102 $ 53.63 0 * 40 * ALVEOLOPLASTY - CONJUNCTION WITH MULTIPLE EXTRACTS * * ** 27105 $ 148.18 0 * 40 * ALVEOLOPLASTY - TUBEROSITY REDUCTION BONE REMOVAL * * ** 27107 $ 116.58 0 * 40 * REMOVAL OF TORUS/EXOSTOSIS - PER QUADRANT * * ** 27108 $ 183.87 0 * 40 * REMOVAL OF TORUS/EXOSTOSIS - PALATAL TORUS * * ** 27120 $ 65.42 0 * 40 * UNCOMPLICATED EXCISION OF HYPERPLASTIC TISSUE * * ** 27122 $ 30.57 0 * 40 * OPERCULECTOMY * * ** 27124 $ 70.84 0 * 40 * GINGIVOPLASTY - PER SEXTANT * * ** 27128 $ 147.70 0 * 40 * FRENECTOMY * * ** 27129 $ 73.86 0 * 40 * FRENECTOMY - SECOND AT SAME SURGERY * * ** 27131 $ 270.65 0 * 40 * VESTIBULOPLASTY - EACH SEXTANT * * ** 27132 $ 52.92 0 * 40 * VESTIBULOPLASTY - MUCOUS MEMBRANE GRAFT * * ** 27160 $ 438.48 0 * 40 * SUBPERIOSTEAL IMPLANTS - FIRST SESSION * * ** 27161 $ 287.10 0 * 40 * SUBPERIOSTEAL IMPLANTS - SECOND SESSION * * ** 27165 $ 141.12 0 * 40 * INTRAOSSEOUS IMPLANTS - PLACEMENT OF FIRST UNIT * * ** 27166 $ 88.20 0 * 40 * INTRAOSSEOUS IMPLANTS - EACH ADDITIONAL PLACED * * ** 27168 $ 71.84 0 * 40 * INTRAOSSEOUS IMPLANTS - EXPOSURE OF FIRST UNIT * * ** 27169 $ 35.92 0 * 40 * INTRAOSSEOUS IMPLANTS - EACH ADDITIONAL EXPOSED * * ** 27172 $ 423.36 0 * 40 * REMOVAL OF IMPLANTS - SUBPERIOSTEAL/MANDIBULAR * * ** 27174 $ 70.56 0 * 40 * REMOVAL OF IMPLANTS - INTRAOSSEOUS, FIRST UNIT * * ** 27175 $ 35.28 0 * 40 * REMOVAL OF IMPLANTS - INTRAOSSEOUS/ADDITIONAL UNIT * * ** 27180 $ 78.55 0 * 40 * INCISIONAL BIOPSIES - SOFT TISSUE * * ** 27182 $ 141.12 0 * 40 * INCISIONAL BIOPSIES - HARD TISSUE * * ** 27220 $ 159.66 0 * 40 * PRIMARY CLOSURE - LESION BASE < OR = 1 CM * * ** 27221 $ 79.83 0 * 40 * PRIMARY CLOSURE - ADDITIONAL LESION < OR = 1CM * * ** 27225 $ 314.64 0 * 40 * PRIMARY CLOSURE - LESION BASE > 1CM * * ** 27226 $ 157.32 0 * 40 * PRIMARY CLOSURE - EACH ADDITIONAL LESION > 1CM * * ** 27240 $ 127.72 0 * 40 * SURFACE OSSEOUS LESIONS - LESION BASE < OR = 1CM * * ** 27241 $ 63.86 0 * 40 * SURFACE OSSEOUS LESIONS - ADDITIONAL < OR = 1CM * * ** 27245 $ 241.60 0 * 40 * SURFACE OSSEOUS LESIONS - LESION BASE > 1 CM * * ** 27246 $ 120.80 0 * 40 * SURFACE OSSEOUS LESIONS - ADDITIONAL LESION > 1CM * * ** 27250 $ 159.66 0 * 40 * INTRAOSSEOUS LESIONS - < OR = 1 CM IN DIAMETER * * ** 27252 $ 314.64 0 * 40 * INTRAOSSEOUS LESIONS - 1 CM TO 5 CM * * ** 27260 $ 157.32 0 * 40 * INTRAOSSEOUS LESIONS - ADDITIONAL LESION SAME JAW * * ** 27265 $ 235.98 0 * 40 * INTRAOSSEOUS LESIONS - ADDITIONAL LESION 2ND JAW * * ** 27350 $ 38.73 0 * 40 * VESTIBULAR OR SUBPERIOSTEAL ABSCESS * * ** 27355 $ 60.00 0 * 40 * INTRAORAL SUPERFICIAL * * ** 27365 $ 88.77 0 * 40 * EXTRAORAL SUPERFICIAL * * ** 27375 $ 181.02 0 * 40 * SEQUESTRECTOMY FOR OSTEOMYELITIS * * ** 27400 $ 226.13 0 * 40 * IMPLANTATION AND SPLINTING OF AN AVULSED TOOTH * * ** 27402 $ 352.00 0 * 40 * REDUCTION OF ALVEOLAR FRACTURE * * ** 27405 $ 85.96 0 * 40 * SINGLE LAYER SUTURE OF LACERATION * * ** 27440 $ 312.86 0 * 40 * CLOSED REDUCTIONS - CLOSED REDUCTION OF MAXILLA * * ** 27470 $ 354.72 0 * 40 * CLOSED REDUCTIONS - CLOSED REDUCTION OF MANDIBLE * * ** 27475 $ 460.00 0 * 40 * SIMPLE FRACTURE OF MANDIBLE * * ** 27500 $ 88.20 0 * 40 * REDUCTION OF DISLOCATION * * ** 27502 $ 88.20 0 * 40 * MANIPULATION UNDER ANAESTHESIA * * ** 27692 $ 67.29 0 * 40 * REMOVAL OF FOREIGN BODY FROM SOFT TISSUE * * ** 27695 $ 211.68 0 * 40 * REMOVAL OF FOREIGN BODY FROM BONE * * ** 27711 $ 67.03 0 * 40 * IMMEDIATE RECOVERY OF A TOOTH OR FOREIGN BODY * * ** 27712 $ 211.68 0 * 40 * SECONDARY RECOVERY OF A TOOTH OR FOREIGN BODY * * ** 27720 $ 146.31 0 * 40 * CLOSURE OF AN ORAL ANTRAL FISTULA * * ** 27740 $ 28.49 0 * 40 * DILATION OF SALIVARY DUCT * * ** 27742 $ 88.20 0 * 40 * SIALODOCHOPLASTY * * ** 27747 $ 88.20 0 * 40 * SUBMANDIBULAR * * ** 27770 $ 31.75 0 * 40 * POST OPERATIVE COMPLICATIONS * * ** 27801 $ 352.80 0 * 40 * G.P. SURGICAL ASSISTANT * * ** 27802 $ 17.64 0 * 40 * AFTER THREE HOURS CONTINUOUS SURGICAL ASSISTANCE * * ** 30005 $ 84.97 0 * 45 * EMERGENCY VISIT - CLINICAL IMMUNOLOGY AND ALLERGY * * ** 30006 $ 34.89 0 * 45 * CLINICAL IMMUNOLOGY & ALLEGY - DIRECTIVE CARE * * ** 30007 $ 36.45 0 * 45 * CLINICAL IMMUNOLOGY AND ALLEGY - OFFICE VISIT * * ** 30008 $ 21.48 0 * 45 * CLINICAL IMMUNOLOGY AND ALLERGY - HOSPITAL VISIT * * ** 30010 $ 138.81 0 * 45 * CLINICAL IMMUNOLOGY AND ALLERGY CONSULTATION * * ** 30011 $ 158.25 0 * 45 * PAEDIATRIC CLINICAL IMMUNOLOGY AND ALLERGY CONSULT * * ** 30012 $ 60.12 0 * 45 * REPEAT OR LTD CLINICAL IMMUNOLOGY AND ALLERGY CONS * * ** 30015 $ 7.07 0 * * EOSINOPHILS - SECRETION SMEAR * * ** 31005 $ 87.41 0 * 44 * RHEUMATOLOGY - EMERGENCY VISIT, SPECIALLY CALLED * * ** 31006 $ 40.00 0 * 44 * RHEUMATOLOGY - DIRECTIVE CARE * * ** 31007 $ 60.09 0 * 44 * RHEUMATOLOGY - SUBSEQUENT OFFICE VISIT * * ** 31008 $ 29.10 0 * 44 * RHEUMATOLOGY - SUBSEQUENT HOSPITAL VISIT * * ** 31010 $ 144.34 0 * 44 * RHEUMATOLOGY - CONSULTATION * * ** 31012 $ 97.00 0 * 44 * RHEUMATOLOGY - REPEAT OR LIMITED CONSULTATION * * ** 31014 $ 48.11 0 * 44 * RHEUMATOLOGY - PROLONGED VISIT FOR COUNSELLING * * ** 31106 $ 40.00 0 * 44 * TELEHEALTH DIRECTIVE CARE - RHEUMATOLOGY * * ** 31107 $ 44.99 0 * 44 * TELEHEALTH SUBSEQUENT OFFICE VISIT - RHEUMATOLOGY * * ** 31108 $ 29.10 0 * 44 * TELEHEALTH SUBSEQUENT HOSPITAL VISIT -RHEUMATOLOGY * * ** 31110 $ 144.34 0 * 44 * TELEHEALTH CONSULTATION - RHEUMATOLOGY * * ** 31112 $ 72.62 0 * 44 * TELEHEALTH REPEAT OR LIMITED CONSULT- RHEUMATOLOGY * * ** 32005 $ 93.00 0 * 49 * VISIT, EMERGENCY, RESPIROLOGY * * ** 32006 $ 38.19 0 * 49 * DIRECTIVE CARE, RESPIROLOGY * * ** 32007 $ 39.89 0 * 49 * VISIT, OFFICE, RESPIROLOGY * * ** 32008 $ 23.51 0 * 49 * VISIT, HOSPITAL, RESPIROLOGY * * ** 32010 $ 137.05 0 * 49 * CONSULTATION, RESPIROLOGY * * ** 32012 $ 65.80 0 * 49 * CONSULTATION, LIMITED, RESPIROLOGY * * ** 32014 $ 44.80 0 * 49 * PROLONGED VISIT FOR COUNSELLING, RESPIROLOGY * * ** 35000 $ 88.20 0 * 37 * EMERGENCY CONSULTATION - IN HOSPITAL * * ** 35005 $ 88.20 0 * 37 * NON-EMERGENT CONSULTATION - INITIAL * * ** 35008 $ 19.40 0 * 37 * HOSPITAL VISITS - MEDICAL MANAGEMENT * * ** 35013 $ 43.03 0 * 37 41 * CALL-OUT CHARGES - EVENING * * ** 35014 $ 60.44 0 * 37 41 * CALL-OUT CHARGES - NIGHT * * ** 35015 $ 43.03 0 * 37 41 * CALL-OUT CHARGES - SAT, SUN OR STATUTORY HOLIDAY * * ** 35023 $ 296.86 0 * 37 41 * CONTINUING CARE OPERATIVE SURCHARGES - EVENING * * ** 35024 $ 416.88 0 * 37 41 * CONTINUING CARE OPERATIVE SURCHARGES - NIGHT * * ** 35025 $ 296.86 0 * 37 41 * CONT CARE OPERATIVE SURCHARGES - SAT, SUN, OR STAT * * ** 35030 $ 68.30 0 * 37 * ERUPTED TEETH - FIRST TOOTH PER QUADRANT * * ** 35031 $ 45.02 0 * 37 * ERUPTED TEETH - EACH ADDITIONAL TOOTH PER QUADRANT * * ** 35033 $ 133.50 0 * 37 * ERUPTED TEETH - SURGICAL REMOVAL WITH FLAP * * ** 35034 $ 88.09 0 * 37 * ERUPTED TEETH - EACH ADDITIONAL SURGICAL REMOVAL * * ** 35040 $ 133.50 0 * 37 * IMPACTED TEETH - SOFT TISSUE * * ** 35041 $ 88.09 0 * 37 * IMPACTED TEETH - EACH ADDITIONAL 'SOFT TISSUE' * * ** 35045 $ 153.87 0 * 37 * IMPACTED TEETH - PARTIAL BONY * * ** 35046 $ 72.77 0 * 37 * IMPACTED TEETH - EACH ADDITIONAL 'PART BONY' * * ** 35050 $ 215.09 0 * 37 * IMPACTED TEETH - FULL BONY * * ** 35051 $ 107.79 0 * 37 * IMPACTED TEETH - EACH ADDITIONAL 'FULL BONY' * * ** 35054 $ 229.32 0 * 37 * IMPACTED TEETH - FULL BONY IMPACTION EXTREME * * ** 35055 $ 158.76 0 * 37 * IMPACTED TEETH - EACH ADDITIONAL FULL BONY EXTREME * * ** 35058 $ 127.19 0 * 37 * IMPACTED TEETH - REMOVAL OF A TOOTH FOLLICLE * * ** 35059 $ 101.68 0 * 37 * IMPACTED TEETH - EACH ADDITIONAL TOOTH FOLLICLE * * ** 35060 $ 73.25 0 * 37 * RESIDUAL ROOTS - SOFT TISSUE COVERAGE * * ** 35061 $ 36.19 0 * 37 * RESIDUAL ROOTS - EACH ADDITIONAL 'SOFT TISSUE' * * ** 35063 $ 133.69 0 * 37 * RESIDUAL ROOTS - BONE COVERAGE FIRST PER QUADRANT * * ** 35064 $ 57.51 0 * 37 * RESIDUAL ROOTS - EACH ADDITIONAL 'BONE COVERAGE' * * ** 35070 $ 264.60 0 * 37 * TOOTH TRANSPLANTATION * * ** 35071 $ 132.30 0 * 37 * TOOTH TRANSPLANTATION - EACH ADDITIONAL QUADRANT * * ** 35073 $ 187.11 0 * 37 * SURGICAL UPRIGHTING/REPOS/UNCOVERING OF A TOOTH * * ** 35074 $ 93.64 0 * 37 * SURGICAL UPRIGHTING/REPOS/ - EACH ADDITIONAL * * ** 35076 $ 225.00 0 * 37 * SURGICAL UPRIGHTING - PLACEMENT OF TRACTION DEVICE * * ** 35077 $ 112.50 0 * 37 * SURGICAL UPRIGHTING - TRACTION DEVICE - EACH ADD * * ** 35080 $ 248.57 0 * 37 * APICOECTOMY - ANTERIOR * * ** 35082 $ 308.72 0 * 37 * APICOECTOMY - BICUSPIDS AND BUCCAL ROOTS * * ** 35084 $ 295.04 0 * 37 * APICOECTOMY - PALATAL ROOTS OF MAXILLARY MOLARS * * ** 35086 $ 29.46 0 * 37 * APICOECTOMY - PER ROOT END FILL, ADD * * ** 35088 $ 109.92 0 * 37 * APICOECTOMY - HEMISECTION * * ** 35090 $ 219.85 0 * 37 * ROOT AMPUTATIONS - ONE ROOT PER TOOTH * * ** 35092 $ 263.80 0 * 37 * ROOT AMPUTATIONS - TWO ROOTS PER TOOTH * * ** 35100 $ 81.40 0 * 37 * ALVEOLOPLASTY - PER EDENTULOUS SEXTANT * * ** 35102 $ 67.04 0 * 37 * ALVEOLOPLASTY - IN CONJUNCTION MULTIPLE EXTRACTION * * ** 35105 $ 185.23 0 * 37 * ALVEOLOPLASTY - TUBEROSITY REDUCTION BONE REMOVAL * * ** 35107 $ 145.72 0 * 37 * REMOVAL OF TORUS/EXOSTOSIS - PER QUADRANT * * ** 35108 $ 229.84 0 * 37 * REMOVAL OF TORUS/EXOSTOSIS - PALATAL TORUS * * ** 35120 $ 70.63 0 * 37 * UNCOMPLICATED EXCISION OF HYPERPLASTIC TISSUE * * ** 35122 $ 34.35 0 * 37 * OPERCULECTOMY * * ** 35124 $ 88.55 0 * 37 * GINGIVOPLASTY, PER SEXTANT * * ** 35126 $ 175.88 0 * 37 * SURGICAL TREATMENT / PALATAL PAPILLARY HYPERPLASIA * * ** 35128 $ 184.63 0 * 37 * FRENECTOMY * * ** 35129 $ 92.32 0 * 37 * FRENECTOMY - SECOND AT SAME SURGERY * * ** 35131 $ 270.65 0 * 37 * VESTIBULOPLASTY - EACH SEXTANT * * ** 35132 $ 66.15 0 * 37 * VESTIBULOPLASTY - MUCOUS MEMBRANE OR SKIN GRAFT * * ** 35134 $ 238.71 0 * 37 * VESTIBULOPLASTY - DETACHMENT OF MYLOHYOID MUSCLE * * ** 35140 $ 396.90 0 * 37 * PREPROSTHETIC AUGMENTATION WITH BONE OR ALLOPLAST * * ** 35142 $ 396.90 0 * 37 * PREPROSTHETIC MAXILLARY ANTRUM/NASAL FLOOR * * ** 35143 $ 198.45 0 * 37 * PREPROSTHETIC MAXILLARY ANTRUM AUGMENTATION * * ** 35145 $ 39.69 0 * 37 * PLACEMENT OF ALLOPLASTIC MEMBRANE/BARRIER * * ** 35149 $ 39.69 0 * 37 * REMOVAL BARRIER/MEMBRANE PER SEXTANT * * ** 35150 $ 429.88 0 * 37 * PREPROSTHETIC AUG BY OSTEOTOMY/WITHOUT BONE GRAFT * * ** 35151 $ 264.60 0 * 37 * PREPROSTHETIC AUG BY OSTEOTOMY - EACH ADDITIONAL * * ** 35153 $ 463.05 0 * 37 * PREPROSTHETIC AUG BY OSTEOTOMY - WITH BONE GRAFT * * ** 35154 $ 286.65 0 * 37 * PREPROSTHETIC AUG BY OSTEOTOMY/EACH ADD/BONE GRAFT * * ** 35160 $ 548.10 0 * 37 * SUBPERIOSTEAL IMPLANTS - PER ARCH PER SURGICAL * * ** 35161 $ 358.87 0 * 37 * SUBPERIOSTEAL IMPLANTS - PER ARCH SECOND SURGICAL * * ** 35165 $ 176.40 0 * 37 * INTRAOSSEOUS IMPLANTS - PLACEMENT OF FIRST UNIT * * ** 35166 $ 110.25 0 * 37 * INTRAOSSEOUS IMPLANTS/EACH ADDITIONAL UNIT PLACED * * ** 35168 $ 89.81 0 * 37 * INTRAOSSEOUS IMPLANTS - EXPOSURE OF FIRST UNIT * * ** 35169 $ 44.90 0 * 37 * INTRAOSSEOUS IMPLANTS/EACH ADDITIONAL UNIT EXPOSED * * ** 35172 $ 529.20 0 * 37 * REMOVAL OF IMPLANTS - SUBPERIOSTEAL * * ** 35174 $ 88.20 0 * 37 * REMOVAL OF IMPLANTS - INTRAOSSEOUS, FIRST UNIT * * ** 35175 $ 44.10 0 * 37 * REMOVAL OF IMPLANTS - INTRAOSSEOUS/EACH ADDITIONAL * * ** 35180 $ 98.18 0 * 37 * INCISIONAL BIOPSIES - SOFT TISSUE * * ** 35182 $ 176.40 0 * 37 * INCISIONAL BIOPSIES - HARD TISSUE (BONE/CARTILAGE) * * ** 35184 $ 242.55 0 * 37 * LIP SURGERY - VERMILIONECTOMY * * ** 35186 $ 242.55 0 * 37 * LIP SURGERY - CHEILOPLASTY * * ** 35188 $ 89.08 0 * 37 * LIP SURGERY - WEDGE RESECTION VERMILION BORDER * * ** 35190 $ 220.50 0 * 37 * LIP SURGERY - WEDGE RESECTION DEPTH OF THE SULCUS * * ** 35200 $ 132.30 0 * 37 * PRIMARY CLOSURE - LESION BASED < OR = 2 CM * * ** 35201 $ 264.60 0 * 37 * PRIMARY CLOSURE - LESION BASED > 2 CM * * ** 35205 $ 190.32 0 * 37 * COMPLICATED CLOSURE - FREE SKIN GRAFT - PLACEMENT * * ** 35206 $ 95.21 0 * 37 * COMPLICATED CLOSURE - EACH ADDITIONAL GRAFT * * ** 35210 $ 372.00 0 * 37 * COMPLICATED CLOSURE - ARTERIAL ISLAND FLAP * * ** 35211 $ 186.06 0 * 37 * COMPLICATED CLOSURE - EACH ADDITIONAL PEDICLE FLAP * * ** 35215 $ 185.51 0 * 37 * COMPLICATED CLOSURE - LOCAL TISSUE SHIFTS * * ** 35220 $ 199.57 0 * 37 * PRIMARY CLOSURE - LESION BASE < OR = 1 CM * * ** 35221 $ 99.79 0 * 37 * PRIMARY CLOSURE/EACH ADDITIONAL LESION < OR = 1 CM * * ** 35225 $ 393.30 0 * 37 * PRIMARY CLOSURE - LESION BASE > 1 CM * * ** 35226 $ 196.65 0 * 37 * PRIMARY CLOSURE - EACH ADDITIONAL LESION > 1 CM * * ** 35230 $ 51.90 0 * 37 * COMPLICATED CLOSURE - SOFT TISSUE GRAFT PLACEMENT * * ** 35231 $ 103.79 0 * 37 * COMPLICATED CLOSURE - ISLAND AND ROTATION FLAPS * * ** 35240 $ 159.65 0 * 37 * SURFACE OSSEOUS LESIONS - LESION BASE < OR = 1 CM * * ** 35241 $ 79.83 0 * 37 * SURFACE OSSEOUS LESIONS - EACH ADD BASE < OR = 1CM * * ** 35245 $ 302.00 0 * 37 * SURFACE OSSEOUS LESIONS - LESION BASE > 1 CM * * ** 35246 $ 151.00 0 * 37 * SURFACE OSSEOUS LESIONS - EACH ADD LESION > 1 CM * * ** 35250 $ 199.57 0 * 37 * INTRAOSSEOUS LESIONS - < OR = 1 CM IN DIAMETER * * ** 35252 $ 393.30 0 * 37 * INTRAOSSEOUS LESIONS - 1 CM TO 5 CM * * ** 35255 $ 441.00 0 * 37 * INTRAOSSEOUS LESIONS - > 5 CM * * ** 35260 $ 220.50 0 * 37 * INTRAOSSEOUS LESIONS - EACH ADDITIONAL SAME JAW * * ** 35265 $ 330.75 0 * 37 * INTRAOSSEOUS LESIONS/EACH ADDITIONAL ALTERNATE JAW * * ** 35270 $ 396.90 0 * 37 * INTRAOSSEOUS LESIONS - < OR = 2 CM DIAMETER * * ** 35272 $ 573.30 0 * 37 * INTRAOSSEOUS LESIONS - > 2 CM * * ** 35280 $ 793.80 0 * 37 * DISCONTINUITY DEFECT - UNILATERAL RESECTION * * ** 35282 $ 1,234.80 0 * 37 * DISCONTINUITY DEFECT - BILATERAL RESECTION * * ** 35290 $ 873.18 0 * 37 * SECONDARY REPAIR DISCONTINUITY DEFECT/UNILATERAL * * ** 35292 $ 1,323.00 0 * 37 * SECONDARY REPAIR DISCONTINUITY DEFECT/BILATERAL * * ** 35295 $ 2,116.80 0 * 37 * SECONDARY DISCONTINUITY DEFECT/MICROVASCULAR * * ** 35300 $ 516.22 0 * 37 * PRIMARY REPAIR CLEFT LIP - UNILATERAL REPAIR * * ** 35302 $ 741.18 0 * 37 * PRIMARY REPAIR CLEFT LIP - BILATERAL REPAIR * * ** 35305 $ 495.28 0 * 37 * PRIMARY REPAIR CLEFT PALATE - SURGICAL REPAIR * * ** 35310 $ 500.00 0 * 37 * SECONDARY REPAIR CLEFT LIP - SOFT TISSUE * * ** 35311 $ 250.00 0 * 37 * SECONDARY REPAIR CLEFT LIP/EACH ADDITIONAL FISTULA * * ** 35315 $ 330.75 0 * 37 * SECONDARY REPAIR CLEFT LIP - PHARYNGOPLASTY * * ** 35320 $ 485.10 0 * 37 * SECONDARY REPAIR CLEFT LIP - PUSH-BACK OF PALATE * * ** 35330 $ 600.00 0 * 37 * SECONDARY REPAIR OF CLEFT PALATE - UNILATERAL * * ** 35332 $ 800.00 0 * 37 * SECONDARY REPAIR OF CLEFT PALATE - BILATERAL * * ** 35350 $ 48.41 0 * 37 * SOFT TISSUE INCISION & DRAINAGE - VESTIBULAR * * ** 35355 $ 75.00 0 * 37 * SOFT TISSUE INCISION/INTRAORAL SUPERFICIAL * * ** 35360 $ 230.00 0 * 37 * SOFT TISSUE INCISION/INTRAORAL DEEP * * ** 35365 $ 110.96 0 * 37 * SOFT TISSUE INCISION/DRAIN/EXTRAORAL SUPERFICIAL * * ** 35370 $ 400.00 0 * 37 * SOFT TISSUE INCISION & DRAINAGE - EXTRAORAL DEEP * * ** 35375 $ 226.27 0 * 37 * SOFT TISSUE INCISION & DRAINAGE - SEQUESTRECTOMY * * ** 35380 $ 550.00 0 * 37 * SOFT TISSUE/INCIS/DRAIN/-SEQUESTRECTOMY EXTENSIVE * * ** 35400 $ 282.66 0 * 37 * DENTOALVEOLAR TRAUMA - IMPLANTATION & SPLINTING * * ** 35402 $ 440.00 0 * 37 * DENTOALVEOLAR TRAUMA - REDUCTION OF ALVEOLAR * * ** 35405 $ 107.45 0 * 37 * SOFT TISSUE INJURIES - SIMPLE/SINGLE LAYER SUTURE * * ** 35410 $ 244.31 0 * 37 * COMPLICATED - CLOSED WITH A FREE GRAFT * * ** 35412 $ 210.00 0 * 37 * FOREHEAD/SCALP/NECK - < OR = 5 CM LACERATION * * ** 35413 $ 273.42 0 * 37 * FOREHEAD/SCALP/NECK - > 5 CM LACERATION * * ** 35415 $ 210.33 0 * 37 * NOSE/EAR/CHEEK/CHIN - < OR = 5 CM LACERATION * * ** 35416 $ 273.43 0 * 37 * NOSE/EAR/CHEEK/CHIN - > 5 CM LACERATION * * ** 35420 $ 273.43 0 * 37 * EYELID/LIP - COMPLICATED REPAIR * * ** 35430 $ 529.20 0 * 37 * FRONTAL/ORBITAL - FRONTAL SINUS FRACTURES * * ** 35432 $ 793.80 0 * 37 * FRONTAL/ORBITAL - NASO-ORBITAL-ETHMOID - OPEN * * ** 35433 $ 352.80 0 * 37 * FRONTAL/ORBITAL - NASO-ORBITAL-ETHMOID - CLOSED * * ** 35435 $ 308.70 0 * 37 * FRONTAL/ORBITAL - ISOLATED FRACTURES * * ** 35436 $ 485.10 0 * 37 * FRONTAL/ORBITAL - FLOOR OF ORBIT FRACTURES * * ** 35440 $ 391.08 0 * 37 * CLOSED REDUCTIONS - OF MAXILLA WITH ARCH BARS * * ** 35442 $ 529.20 0 * 37 * CLOSED REDUCTIONS/OF MAXILLA USING GUNNING SPLINTS * * ** 35444 $ 200.00 0 * 37 * CLOSED REDUCTIONS - ZYGOMATIC COMPLEX BY TEMPORAL * * ** 35451 $ 727.65 0 * 37 * OPEN REDUCTIONS - LE FORT I * * ** 35452 $ 811.44 0 * 37 * OPEN REDUCTIONS - LE FORT II * * ** 35453 $ 970.20 0 * 37 * OPEN REDUCTIONS - LE FORT III * * ** 35455 $ 687.77 0 * 37 * OPEN REDUCTIONS - CRANIOPLASTY - UNILATERAL * * ** 35456 $ 1,031.66 0 * 37 * OPEN REDUCTIONS - CRANIOPLASTY - BILATERAL * * ** 35457 $ 441.00 0 * 37 * OPEN REDUCTIONS - ZYGOMATIC ARCH * * ** 35459 $ 600.00 0 * 37 * OPEN REDUCTIONS - ZYGOMATICO - ORBITAL COMPLEX * * ** 35460 $ 60.00 0 * 37 * NASAL FRACTURES - SIMPLE REDUCTION * * ** 35462 $ 120.00 0 * 37 * NASAL FRACTURES - REDUCTION AND SPLINTING * * ** 35464 $ 250.00 0 * 37 * NASAL FRACTURES - COMMINUTED NASAL FRACTURES * * ** 35470 $ 443.40 0 * 37 * MANDIBULAR FRACTURES - CLOSED REDUCTION/ARCH BARS * * ** 35472 $ 600.00 0 * 37 * MANDIBULAR FRACTURES/CLOSED REDUCT/USING GUNNING * * ** 35475 $ 575.00 0 * 37 * OPEN REDUCTIONS - SUBCONDYLAR FRACTURE * * ** 35477 $ 575.00 0 * 37 * OPEN REDUCTIONS - ANGLE/BODY FRACTURE * * ** 35479 $ 490.00 0 * 37 * OPEN REDUCTIONS - SYMPHYSEAL/PARASYMPHYSEAL * * ** 35480 $ 575.00 0 * 37 * OPEN REDUCTIONS/EXTRAORAL - SUBCONDYLAR * * ** 35482 $ 575.00 0 * 37 * OPEN REDUCTIONS/EXTRAORAL - ANGLE/BODY * * ** 35484 $ 490.00 0 * 37 * OPEN REDUCTIONS/EXTRAORAL - SYMPHYSEAL/PARASYMPH * * ** 35491 $ 220.50 0 * 37 * PERICRANIAL/PERIAURICULAR FLAPS - UNILATERAL, ADD * * ** 35492 $ 308.70 0 * 37 * PERICRANIAL/PERIAURICULAR FLAPS - BILATERAL, ADD * * ** 35500 $ 110.25 0 * 37 * TEMPOROMANDIBULAR JOINT - REDUCTION OF DISLOCATION * * ** 35502 $ 110.25 0 * 37 * TEMPOROMANDIBULAR JOINT - MANIPULATION * * ** 35504 $ 110.25 0 * 37 * TEMPOROMANDIBULAR JOINT - ARTHROCENTESIS * * ** 35506 $ 154.35 0 * 37 * TEMPOROMANDIBULAR JOINT/THERAPEUTIC ARTHROCENTESIS * * ** 35510 $ 705.60 0 * 37 * OPEN JOINT PROCEDURES - ARTHROTOMY * * ** 35511 $ 79.38 0 * 37 * OPEN JOINT PROCEDURES - CONDYLOPLASTY, ADD * * ** 35512 $ 79.38 0 * 37 * OPEN JOINT PROCEDURES - EMINOPLASTY, ADD * * ** 35513 $ 79.38 0 * 37 * OPEN JOINT PROCEDURES - MENISCOPLASTY * * ** 35514 $ 90.00 0 * 37 * OPEN JOINT PROCEDURES - MUSCLE FLAP AND/OR DERMAL * * ** 35515 $ 90.00 0 * 37 * OPEN JOINT PROCEDURES - ALLOPLASTIC FOSSA * * ** 35516 $ 220.50 0 * 37 * OPEN JOINT PROCEDURES - RAMUS/CONDYLAR * * ** 35520 $ 1,323.00 0 * 37 * OPEN JOINT PROCEDURES - TOTAL JOINT REPLACEMENT * * ** 35525 $ 855.52 0 * 37 * GAP ARTHROPLASTY FOR ANKLYLOSIS * * ** 35526 $ 154.35 0 * 37 * SIGNIFICANT SURGICAL SOFT TISSUE/MUSCLE RELEASE * * ** 35527 $ 154.35 0 * 37 * CORONOIDECTOMY, ADD * * ** 35530 $ 330.75 0 * 37 * REOPERATION OF TEMPOROMANDIBULAR JOINT * * ** 35532 $ 171.99 0 * 37 * ARTHOROSCOPY - DIAGNOSTIC ARTHROSCOPY - MANIPULATE * * ** 35534 $ 348.39 0 * 37 * ARTHROSCOPY/DIAGNOSTIC ARTHROSCOPY/PORT TECHNIQUE * * ** 35536 $ 83.79 0 * 37 * ARTHROSCOPY IN CONJUNCTION WITH OPEN ARTHROTOMY * * ** 35538 $ 463.05 0 * 37 * ARTHROSCOPIC SURGERY THROUGH MORE THAN ONE PORT * * ** 35550 $ 171.99 0 * 37 * INTERDENTAL CORTICOTOMY/OSTECTOMY - FIRST TOOTH * * ** 35551 $ 83.79 0 * 37 * INTERDENTAL CORTICOTOMY/OSTECTOMY - SECOND TEETH * * ** 35560 $ 550.00 0 * 37 * SEGMENTAL OSTEOTOMIES - PER SEGMENT * * ** 35562 $ 1,019.06 0 * 37 * SEGMENTAL OSTEOTOMIES - TOTAL ALVEOLAR OSTEOTOMY * * ** 35570 $ 340.00 0 * 37 * MANDIBULAR SYMPHYSEAL SURGERY - BY OSTEOPLASTY * * ** 35572 $ 600.00 0 * 37 * MANDIBULAR SYMPHYSEAL SURGERY/OSTECTOMY/OSTEOTOMY * * ** 35574 $ 575.00 0 * 37 * MANDIBULAR SYMPHYSEAL SURGERY - AUGMENTATION GRAFT * * ** 35576 $ 325.00 0 * 37 * MANDIBULAR SYMPHYSEAL SURGERY/ALLOPLASTIC MATERIAL * * ** 35580 $ 850.00 0 * 37 * MANDIBULAR OSTEOTOMIES - UNILATERAL - INTRAORAL * * ** 35581 $ 900.00 0 * 37 * MANDIBULAR OSTEOTOMIES - UNILATERAL - EXTRAORAL * * ** 35583 $ 1,375.00 0 * 37 * MANDIBULAR OSTEOTOMIES - BILATERAL - INTRAORAL * * ** 35584 $ 1,450.00 0 * 37 * MANDIBULAR OSTEOTOMIES - BILATERAL - EXTRAORAL * * ** 35586 $ 850.00 0 * 37 * BODY OSTEOTOMIES - UNILATERAL * * ** 35587 $ 1,375.00 0 * 37 * BODY OSTEOTOMIES - BILATERAL * * ** 35589 $ 650.00 0 * 37 * BODY OSTEOTOMIES - INFERIOR OSTEOTOMY/OSTECTOMY * * ** 35591 $ 850.00 0 * 37 * OSTEOTOMY OF ZYGOMATIC COMPLEX - UNILATERAL * * ** 35592 $ 1,400.00 0 * 37 * OSTEOTOMY OF ZYGOMATIC COMPLEX - BILATERAL * * ** 35595 $ 500.00 0 * 37 * OSTEOTOMY OF ZYGOMATIC COMPLEX - POST TRAUMATIC * * ** 35600 $ 1,400.00 0 * 37 * MAXILLARY OSTEOTOMIES - LE FORT I * * ** 35601 $ 160.00 0 * 37 * MAXILLARY OSTEOTOMIES - FIRST ADDITIONAL SEGMENT * * ** 35602 $ 80.00 0 * 37 * MAXILLARY OSTEOTOMIES - EACH ADDITIONAL ALVEOLAR * * ** 35605 $ 1,700.00 0 * 37 * MAXILLARY OSTEOTOMIES - LE FORT II * * ** 35607 $ 2,400.00 0 * 37 * MAXILLARY OSTEOTOMIES - LE FORT III, EXTRACRANIAL * * ** 35608 $ 3,000.00 0 * 37 * MAXILLARY OSTEOTOMIES - LE FORT III - INTRACRANIAL * * ** 35610 $ 2,400.00 0 * 37 * ORBITAL RIM OSTEOTOMIES - UNILATERAL * * ** 35611 $ 3,000.00 0 * 37 * ORBITAL RIM OSTEOTOMIES - BILATERAL * * ** 35620 $ 740.00 0 * 37 * REDUCTION OF MASSETERIC - UNILATERAL - INTRAORAL * * ** 35621 $ 900.00 0 * 37 * REDUCTION OF MASSETERIC - UNILATERAL - EXTRAORAL * * ** 35624 $ 1,140.00 0 * 37 * REDUCTION OF MASSETERIC - BILATERAL - INTRAORAL * * ** 35625 $ 1,300.00 0 * 37 * REDUCTION OF MASSETERIC - BILATERAL - EXTRAORAL * * ** 35630 $ 300.00 0 * 37 * WHEN RIGID FIXATION IS USED FOR OSTEOTOMIES * * ** 35632 $ 1,358.76 0 * 37 * REOPERATION OF A DENTOFACIAL DEFORMITY * * ** 35634 $ 600.00 0 * 37 * DISTRACTION OSTEOGENESIS * * ** 35636 $ 275.00 0 * 37 * PLACEMENT OF ARCH BARS OR OTHER TOOTH FIXATION * * ** 35638 $ 350.00 0 * 37 * PLACEMENT OF GUNNING TYPE SPLINTS * * ** 35640 $ 97.00 0 * 37 * CHEILOPLASTY (V/Y, DOUBLE V/Y CLOSURE) * * ** 35642 $ 100.00 0 * 37 * REMOVAL OF SPLINTS, SUSPENSION LIGATURES * * ** 35643 $ 176.40 0 * 37 * REMOVAL OF INTRAOSSEOUS WIRES/PINS * * ** 35645 $ 360.00 0 * 37 * REMOVAL OF INTERNAL FIXATION DEVICES * * ** 35647 $ 50.00 0 * 37 * REMOVAL OF SPLINTS, SUSPENS. LIGATURES - OTHER JAW * * ** 35650 $ 65.00 0 * 37 * TURBINECTOMIES - MAXILLARY OSTEOTOMY - UNILATERAL * * ** 35651 $ 85.00 0 * 37 * TURBINECTOMIES - MAXILLARY OSTEOTOMY - BILATERAL * * ** 35656 $ 185.22 0 * 37 * CLOSURE ORONASAL FISTULA - TRANSPOSITIONAL FLAP * * ** 35657 $ 330.86 0 * 37 * CLOSURE ORONASAL FISTULA - ARTERIAL PEDICLE FLAP * * ** 35659 $ 371.58 0 * 37 * CLOSURE ORONASAL FISTULA - TONGUE FLAP CLOSURE * * ** 35670 $ 240.00 0 * 37 * HARD/SOFT TISSUE GRAFTS - BONE/ALLOPLAST GRAFTING * * ** 35675 $ 132.30 0 * 37 * HARD/SOFT TISSUE GRAFTS - SOFT TISSUE GRAFTING * * ** 35680 $ 35.28 0 * 37 * HARVESTING OF HARD TISSUE GRAFTS - LOCAL SITES * * ** 35683 $ 105.00 0 * 37 * HARVESTING HARD/SOFT TISSUE GRAFTS - LOCAL SITE * * ** 35685 $ 300.00 0 * 37 * HARVESTING HARD/SOFT TISSUE GRAFTS - DISTANT SITE * * ** 35690 $ 299.90 0 * 37 * REMOVAL OF FOREIGN BODIES - WITHIN DEEP TISSUE * * ** 35692 $ 84.12 0 * 37 * REMOVAL FOREIGN BODIES - SUPERFICIALLY LOCATED * * ** 35695 $ 264.60 0 * 37 * REMOVAL OF FOREIGN BODY FROM BONE - SURGICAL * * ** 35701 $ 192.31 0 * 37 * PRIMARY NERVE REPAIR * * ** 35702 $ 431.14 0 * 37 * SECONDARY NERVE REPAIR * * ** 35704 $ 980.00 0 * 37 * NERVE REPAIR WITH GRAFT * * ** 35706 $ 262.99 0 * 37 * DECOMPRESSION/TRANSPOSITION OF MANDIBULAR NERVE * * ** 35711 $ 83.79 0 * 37 * ANTRAL SURGERY - IMMEDIATE RECOVERY OF A TOOTH * * ** 35712 $ 264.60 0 * 37 * ANTRAL SURGERY - SECONDARY RECOVERY OF A TOOTH * * ** 35715 $ 308.70 0 * 37 * ANTRAL SURGERY - RADICAL ANTROSTOMY/CALDWELL LUC * * ** 35717 $ 100.16 0 * 37 * ANTRAL SURGERY - NASAL ANTROSTOMY * * ** 35720 $ 182.88 0 * 37 * CLOSURE OF AN ORAL ANTRAL FISTULA - IMMEDIATE * * ** 35722 $ 194.04 0 * 37 * CLOSURE ORAL ANTRAL FISTULA - SECONDARY CLOSURE * * ** 35723 $ 220.50 0 * 37 * CLOSURE ORAL ANTRAL FISTULA/SECONDARY - GOLD FOIL * * ** 35724 $ 357.12 0 * 37 * CLOSURE ORAL ANTRAL FISTULA/SECONDARY/PALATAL FLAP * * ** 35726 $ 30.00 0 * 37 * ANTRAL LAVAGE - UNILATERAL (SEPARATE PROCEDURE) * * ** 35727 $ 55.00 0 * 37 * ANTRAL LAVAGE - BILATERAL (SEPARATE PROCEDURE) * * ** 35729 $ 95.00 0 * 37 * DIAGNOSTIC SINUS ENDOSCOPY, WITH OR WITHOUT BIOPSY * * ** 35730 $ 250.00 0 * 37 * SINUS ENDOSCOPIC SURGICAL PROCEDURE * * ** 35740 $ 35.61 0 * 37 * SALIVARY GLANDS - DILATION OF SALIVARY DUCT * * ** 35742 $ 110.25 0 * 37 * SALIVARY GLANDS - SIALODOCHOPLASTY * * ** 35744 $ 402.36 0 * 37 * SALIVARY GLANDS - REPAIR OF SALIVARY FISTULA * * ** 35747 $ 110.25 0 * 37 * INTRADUCTAL SIALOLITHOTOMY - SUBMANDIBULAR * * ** 35749 $ 225.00 0 * 37 * INTRADUCTAL SIALOLITHOTOMY - PAROTID * * ** 35752 $ 242.55 0 * 37 * INTRAGLANDULAR SIALOLITHOTOMY * * ** 35754 $ 275.69 0 * 37 * EXCISION OF SUBLINGUAL GLAND, INTRAORALLY * * ** 35756 $ 352.80 0 * 37 * EXCISION OF SUBMANDIBULAR GLAND * * ** 35758 $ 78.57 0 * 37 * EXCISION RANULA/SUPERFICIAL * * ** 35760 $ 352.80 0 * 37 * EXCISION RANULA/PLUNGING * * ** 35762 $ 750.00 0 * 37 * REMOVAL BENIGN PAROTID TUMOUR * * ** 35770 $ 39.69 0 * 37 * TREATMENT OF A DENTOALVEOLAR COMPLICATION * * ** 35800 $ 460.00 0 * 37 41 42 * SURGICAL ASST/CERTIFIED SURGICAL ASST OVER $550.00 * * ** 35801 $ 352.80 0 * 37 41 42 * SURGICAL ASSISTANT * * ** 35802 $ 22.05 0 * 37 41 42 * SURGICAL ASSISTANT - AFTER THREE HOURS CONTINUOUS * * ** 36010 $ 236.64 0 * 80 * MIDWIFE PHASE 1 (1ST TRIMESTER) - TOTAL CARE * * ** 36014 $ 94.66 0 * 80 * MIDWIFE PHASE 1 (1ST TRIMESTER)-TRANS TO OTHR 40% * * ** 36016 $ 141.99 0 * 80 * MIDWIFE PHASE 1 (1ST TRIMESTER)-TRANS FRM OTHR 60% * * ** 36020 $ 236.64 0 * 80 * MIDWIFE PHASE 2 (2ND TRIMESTER) - TOTAL CARE * * ** 36021 $ 236.64 0 * 80 * MIDWIFE PHASE 1 (1ST TRIMEST) 1ST VISIT IS IN PH 2 * * ** 36024 $ 94.66 0 * 80 * MIDWIFE PHASE 2 (2ND TRIMESTER)-TRANS TO OTHR 40% * * ** 36026 $ 141.99 0 * 80 * MIDWIFE PHASE 2 (2ND TRIMESTER)-TRANS FRM OTHR 60% * * ** 36030 $ 473.39 0 * 80 * MIDWIFE PHASE 3 (3RD TRIMESTER) - TOTAL CARE * * ** 36034 $ 189.36 0 * 80 * MIDWIFE PHASE 3 (3ND TRIMESTER)-TRANS TO OTHR 40% * * ** 36036 $ 284.03 0 * 80 * MIDWIFE PHASE 3 (3ND TRIMESTER)-TRANS FRM OTHR 60% * * ** 36040 $ 946.62 0 * 80 * MIDWIFE PHASE 4 (L & D) - FIRST CONTACT PRIOR 34 W * * ** 36044 $ 473.32 0 * 80 * MIDWIFE PHASE 4 (L & D) - FIRST CONTACT AFTER 34 W * * ** 36050 $ 946.62 0 * 80 * MIDWIFE PHASE 5 (POST PARTUM CARE) - TOTAL CARE * * ** 36054 $ 378.65 0 * 80 * MIDWIFE PHASE 5 (POST PART CARE) -TRNSFR FRM OTHER * * ** 36056 $ 567.97 0 * 80 * MIDWIFE PHASE 5 (POST PART CARE) - TRNSFR TO OTHER * * ** 36061 $ 2,839.92 0 * 80 * MIDWIFE SUPERVISION OF UP TO 5 BIRTHS OR 4 FULL CS * * ** 36062 $ 5,679.83 0 * 80 * MIDWIFE SUPERVISION OF 5 FULL COURSES OF CARE * * ** 36063 $ 8,519.75 0 * 80 * MIDWIFE SUPERVISION OF 6 - 10 FULL COURSES OF CARE * * ** 36064 $ 11,359.66 0 * 80 * MIDWIFE SUPERVISION OF 11-15 FULL COURSES OF CARE * * ** 36065 $ 14,199.58 0 * 80 * MIDWIFE SUPERVISION OF 16-30 FULL COURSES OF CARE * * ** 36210 $ - 0 * 87 * NP - INJECTION, INTRAMUSCULAR * * ** 36211 $ - 0 * 87 * NP - INJECTION, INTRAVENOUS * * ** 36212 $ - 0 * 87 * NP - INJECTION, VENEPUNCTURE * * ** 36213 $ - 0 * 87 * NP - INJECTION, INTRA-ARTERIAL * * ** 36214 $ - 0 * 87 * NP - IMMUNIZATION-PATIENT <19 YRS-DTAPP-P * * ** 36215 $ - 0 * 87 * NP - IMMUNIZATION-PATIENT <19 YRS - DTAP-P-HIB * * ** 36216 $ - 0 * 87 * NP-IMMUNIZATION-PATIENT <19 YRS-TD(TETANUS,DIPTH * * ** 36217 $ - 0 * 87 * NP - IMMUNIZATION,PATIENT <19 YRS-TDP * * ** 36218 $ - 0 * 87 * NP - IMMUNIZATION - PATIENT <19 YRS - TDAP * * ** 36219 $ - 0 * 87 * NP - IMMUNIZATION - PATIENT <19 YRS, FLU(INFLUENZA * * ** 36220 $ - 0 * 87 * NP - IMMUNIZATION -PATIENT <19 YRS-HA(HEPATITIS A) * * ** 36221 $ - 0 * 87 * NP - IMMUNIZATION- PATIENT <19YRS - HB(HEPATITIS B * * ** 36222 $ - 0 * 87 * NP - IMMUNIZATION-PATIENT <19 YRS-HIB (HAEMOPHILUS * * ** 36223 $ - 0 * 87 * NP - IMMUNIZATION-PATIENT <19YRS(POLIO INACTIVATED * * ** 36224 $ - 0 * 87 * NP - IMMUNIZATION-PATIENT <19YRS MEN-C-C * * ** 36225 $ - 0 * 87 * NP - IMMUNIZATION-PATIENT <19YRS-MEN-P-ACYW135 * * ** 36226 $ - 0 * 87 * NP - IMMUNIZATION-PATIENT <19YRS MMR * * ** 36227 $ - 0 * 87 * NP - IMMUNIZATION - PATIENT <19YRS - PNEU-C-7 * * ** 36228 $ - 0 * 87 * NP - IMMUNIZATION PATIENT < 19YRS PNEU-C-23 * * ** 36229 $ - 0 * 87 * NP - IMMUNIZATION PATIENT <19YRS - RAB (RABIES) * * ** 36230 $ - 0 * 87 * NP - SKIN TESTS, DIAGNOSTIC * * ** 36231 $ - 0 * 87 * NP - IMMUNIZATION - PATIENT <19YRS-VAR (VARICELLA) * * ** 36234 $ - 0 * 87 * NP - SUBCUTANEOUS INJECTION (IE IMMUNIZATION) * * ** 36243 $ - 0 * 87 * NP - ANTICOAGULATION THERAPY * * ** 36245 $ - 0 * 87 * NP - MANIPULATION THERAPY * * ** 36246 $ - 0 * 87 * NP - PEAKFLOW READINGS * * ** 36247 $ - 0 * 87 * NP - OXIMETER READINGS * * ** 36249 $ - 0 * 87 * NP - ECG, INTERPRETATION ONLY * * ** 36250 $ - 0 * 87 * NP - CALL-OUT CHARGE, EVENING * * ** 36251 $ - 0 * 87 * NP - CALL-OUT CHARGE, NIGHT * * ** 36252 $ - 0 * 87 * NP - CALL-OUT CHARGE, SAT, SUN, OR STAT HOLIDAY * * ** 36255 $ - 0 * 87 * NP - NEWBORN CARE, ROUTINE, IN HOSPITAL * * ** 36262 $ - 0 * 87 * NP - ADOPTION EXAMINATION * * ** 36265 $ - 0 * 87 * NP - MENTAL ILL-HEALTH INVESTIGATION * * ** 36266 $ - 0 * 87 * NP - MENTAL ILL-HEALTH DOCUMENTATION * * ** 36270 $ - 0 * 87 * NP - CRISIS INTERVENTION, PER HALF HOUR * * ** 36274 $ - 0 * 87 * NP - ACCOMPANYING PATIENT(S) TO A DISTANT HOSPITAL * * ** 36275 $ - 0 * 87 * NP - ENVIRONMENTAL ASSESSMENT, PATIENTS RESIDENCE * * ** 36276 $ - 0 * 87 * NP - BODY COMPOSITION ASSESSMENT * * ** 36280 $ - 0 * 87 * NP - PHONE CONTACT WITH PROFESSIONAL CARE PROVIDER * * ** 36281 $ - 0 * 87 * NP - TELEPHONE CONTACT, NEW PROBLEM * * ** 36283 $ - 0 * 87 * NP - PRESCRIPTION, INITIAL ORDER BY TELEPHONE * * ** 36285 $ - 0 * 87 * NP - TELEPHONE CONTACT WITH PATIENT FAMILY/FRIEND * * ** 36290 $ - 0 * 87 * NP - CASE REVIEW, DURING OFFICE HOURS * * ** 36291 $ - 0 * 87 * NP - REVIEW, AFTER OFFICE HOURS * * ** 36292 $ - 0 * 87 * NP - SYRINGING EAR * * ** 36293 $ - 0 * 87 * NP - SUTURE REMOVAL * * ** 36294 $ - 0 * 87 * NP - DRESSING CHANGE * * ** 36300 $ - 0 * 87 * NP - VISIT IN OFFICE (AGE 0-1) * * ** 36301 $ - 0 * 87 * NP - VISIT IN OFFICE (AGE 2 - 59) * * ** 36302 $ - 0 * 87 * NP - VISIT IN OFFICE (AGE 60 - 69) * * ** 36303 $ - 0 * 87 * NP - VISIT IN OFFICE (AGE 70 - 79) * * ** 36304 $ - 0 * 87 * NP - VISIT IN OFFICE (AGE 80+) * * ** 36305 $ - 0 * 87 * NP - VISIT OUT OF OFFICE (AGE 0 - 1) * * ** 36306 $ - 0 * 87 * NP - VISIT OUT OF OFFICE (AGE 2 - 59) * * ** 36307 $ - 0 * 87 * NP - VISIT OUT OF OFFICE (AGE 60 - 69) * * ** 36308 $ - 0 * 87 * NP - VISIT OUT OF OFFICE (AGE 70 - 79) * * ** 36309 $ - 0 * 87 * NP - VISIT OUT OF OFFICE (AGE 80+) * * ** 36310 $ - 0 * 87 * NP - COMPLETE EXAMINATION IN OFFICE (AGE 0-1) * * ** 36311 $ - 0 * 87 * NP - COMPLETE EXAMINATION IN OFFICE (AGE 2 - 59) * * ** 36312 $ - 0 * 87 * NP - COMPLETE EXAMINATION IN OFFICE (AGE 60 - 69) * * ** 36313 $ - 0 * 87 * NP - COMPLETE EXAMINATION IN OFFICE (AGE 70 - 79) * * ** 36314 $ - 0 * 87 * NP - COMPLETE EXAMINATION IN OFFICE (AGE 80+) * * ** 36315 $ - 0 * 87 * NP - COMPLETE EXAMINATION OUT OF OFFICE (AGE 0-1) * * ** 36316 $ - 0 * 87 * NP - COMPLETE EXAMINATION OUT OF OFFICE (AGE 2-59) * * ** 36317 $ - 0 * 87 * NP -COMPLETE EXAMINATION OUT OF OFFICE (AGE 60-69) * * ** 36318 $ - 0 * 87 * NP -COMPLETE EXAMINATION OUT OF OFFICE (AGE 70-79) * * ** 36319 $ - 0 * 87 * NP - COMPLETE EXAMINATION OUT OF OFFICE (AGE 80+) * * ** 36320 $ - 0 * 87 * NP - CONSULTATION, IN OR OUT OF OFFICE (AGE 0 - 1) * * ** 36321 $ - 0 * 87 * NP - CONSULTATION, IN OR OUT OF OFFICE (AGE 2-59) * * ** 36322 $ - 0 * 87 * NP - CONSULTATION, IN OR OUT OF OFFICE (AGE 60-69) * * ** 36323 $ - 0 * 87 * NP - CONSULTATION, IN OR OUT OF OFFICE (AGE 70-79) * * ** 36324 $ - 0 * 87 * NP - CONSULTATION, IN OR OUT OF OFFICE (AGE 80+) * * ** 36330 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING IN OFFICE (AGE 0 - 1) * * ** 36331 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING IN OFFICE (AGE 2 - 59) * * ** 36332 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING IN OFFICE (AGE 60-69) * * ** 36333 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING IN OFFICE (AGE 70-79) * * ** 36334 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING IN OFFICE (AGE 80+) * * ** 36335 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING OUT OF OFF (AGE 0 - 1) * * ** 36336 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING OUT OF OFF (AGE 2-59) * * ** 36337 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING OUT OF OFF (AGE 60-69) * * ** 36338 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING OUT OF OFF (AGE 70-79) * * ** 36339 $ - 0 * 87 * NP - INDIVIDUAL COUNSELLING OUT OF OFF (AGE 80+) * * ** 36340 $ - 0 * 87 * NP - GROUP COUNSELLING, FIRST FULL HOUR * * ** 36342 $ - 0 * 87 * NP - GROUP COUNSELLING, 2ND HR/PER 1/2 HR OR MAJOR * * ** 36343 $ - 0 * 87 * NP - VISIT, HOME * * ** 36344 $ - 0 * 87 * NP - EXTRA PATIENTS SEEN DURING SAME HOUSE CALL * * ** 36345 $ - 0 * 87 * NP - VISIT, ROUTINE HOSPITAL * * ** 36346 $ - 0 * 87 * NP - HOSPITAL VISIT FOR TERMINAL CARE * * ** 36347 $ - 0 * 87 * NP - VISIT, EMERGENCY (BETWEEN 0800 AND 1800 HRS) * * ** 36348 $ - 0 * 87 * NP - SUPPORTIVE CARE HOSPITAL VISIT * * ** 36350 $ - 0 * 87 * NP - ON-CALL, ON-SITE HOSPITAL VISIT, EVENING * * ** 36351 $ - 0 * 87 * NP - ON-CALL, ON-SITE HOSPITAL VISIT - NIGHT * * ** 36352 $ - 0 * 87 * NP -ON-CALL,ON-SITE HOSPITAL VISIT-SAT, SUN OR HOL * * ** 36355 $ - 0 * 87 * NP - VISIT, NURSING HOME, ONE OR MULTIPLE PATIENTS * * ** 36356 $ - 0 * 87 * NP - VISIT, NURSING HOME, ONE PATIENT SPECIAL CALL * * ** 36360 $ - 0 * 87 * NP - PRENATAL VISIT, COMPLETE EXAMINATION * * ** 36361 $ - 0 * 87 * NP - PRENATAL VISIT, SUBSEQUENT EXAMINATION * * ** 36362 $ - 0 * 87 * NP - MANAGEMENT OF LABOUR & DELIVERY IN INSTITUTIO * * ** 36363 $ - 0 * 87 * NP - POST-NATAL OFFICE VISIT * * ** 36364 $ - 0 * 87 * NP - POST-NATAL CARE AFTER ELECTIVE C-SECTION * * ** 36365 $ - 2 * 87 * NP - INSERTION INTRAUTERINE CONTRACEPTIVE DEVICE * * ** 36366 $ - 0 * 87 * NP - ROUTINE PELVIC EXAMINATION INCLUDING PAP * * ** 36370 $ - 0 * 87 * NP - HIV/AIDS PRIMARY CARE MGMT, PER 1/2 HR OR MAJ * * ** 36372 $ - 0 * 87 * NP - CASE CONFERENCE * * ** 36374 $ - 0 * 87 * NP - FORMAL CASE MANAGEMENT * * ** 36375 $ - 0 * 87 * NP - INFORMAL CASE MANAGEMENT * * ** 36377 $ - 0 * 87 * NP - FAMILY CONFERENCE, DURING OFFICE HOURS * * ** 36378 $ - 0 * 87 * NP - FAMILY CONFERENCE, AFTER OFFICE HOURS * * ** 36380 $ - 0 * 87 * NP - EDUCATION, RELATED TO A SPECIFIC DIAGNOSIS * * ** 36381 $ - 0 * 87 * NP - EDUCATION, HEALTH PROMOTION/DISEASE PREVENTIO * * ** 36382 $ - 0 * 87 * NP - EDUCATION, FAMILY PLANNING * * ** 36383 $ - 0 * 87 * NP - EDUCATION, SMOKING * * ** 36384 $ - 0 * 87 * NP - EDUCATION, SUBSTANCE ABUSE * * ** 36385 $ - 0 * 87 * NP - EDUCATION, HEALTH RISK (NEC) * * ** 36386 $ - 0 * 87 * NP - EDUCATION, PARENTING * * ** 36387 $ - 0 * 87 * NP - EDUCATION, HOME ENVIRONMENT * * ** 36388 $ - 0 * 87 * NP - EDUCATION, ENVIRONMENTAL ISSUES * * ** 36389 $ - 0 * 87 * NP - EDUCATION, OCCUPATIONAL HEALTH AND SAFETY * * ** 36390 $ - 0 * 87 * NP - EDUCATION, NUTRITION * * ** 36411 $ - 2 * 87 * NP - ABSCESS, SUPERFICIAL * * ** 36412 $ - 0 * 87 * NP - MINOR LACERATION OR FOREIGN BODY, NO ANAESTHE * * ** 36413 $ - 2 * 87 * NP - MINOR LACERATION/FOREIGN BODY, REQUIRING ANAE * * ** 36415 $ - 0 * 87 * NP - CRYOTHERAPY * * ** 36500 $ - 0 * 87 * NP - GLUCOSE, SEMIQUANTITATIVE * * ** 36501 $ - 0 * 87 * NP - PREGNANCY TEST, IMMUNOLOGIC, URINE * * ** 36503 $ - 0 * 87 * NP - CANDIDA CULTURE * * ** 36504 $ - 0 * 87 * NP - EXAMINATION FOR PINWORM OVA * * ** 36505 $ - 0 * 87 * NP - FERN TEST * * ** 36506 $ - 0 * 87 * NP - FUNGUS, DIRECT EXAMINATION, KOH PREPARATION * * ** 36507 $ - 0 * 87 * NP - HAEMOGLOBIN, CYANMETHAEMOGLOBIN METHOD, AND/O * * ** 36508 $ - 0 * 87 * NP - HAEMOGLOBIN, OTHER METHODS * * ** 36509 $ - 0 * 87 * NP - OCCULT BLOOD, FAECES * * ** 36511 $ - 0 * 87 * NP - SECRETION SMEAR FOR EOSINOPHILS * * ** 36512 $ - 0 * 87 * NP - SEDIMENTATION RATE * * ** 36513 $ - 0 * 87 * NP - SPERM, SEMINAL EXAM. FOR PRESENCE OR ABSENCE * * ** 36514 $ - 0 * 87 * NP - STAINED SMEAR * * ** 36515 $ - 0 * 87 * NP -TRICHOMONAS AND/OR CANDIDA, DIRECT EXAMINATION * * ** 36516 $ - 0 * 87 * NP - URINALYSIS, CHEMICAL OR ANY PART OF (SCREENIN * * ** 36517 $ - 0 * 87 * NP - URINALYSIS, MICRO EXAM OF CENTRIFUGED DEPOSIT * * ** 36518 $ - 0 * 87 * NP - URINALYSIS, COMPLETE DIAG, SEMI-QUANT & MICRO * * ** 36519 $ - 0 * 87 * NP - WHITE CELL COUNT ONLY (SEE HEMATOLOGY PROTOCO * * ** 36520 $ - 0 * 87 * NP - EXAMINATION FOR EOSINOPHILS IN SECRET, EXCRET * * ** 39966 $ 2,500.00 0 * 42 * ORTHODONTIC CARE OF NEWBORN - UNILATERAL * * ** 39967 $ 3,000.00 0 * 42 * ORTHODONTIC CARE OF NEWBORN - BILATERAL * * ** 39976 $ 909.49 0 * 42 * PALATAL FISTULA OBTURATOR * * ** 39977 $ 38.46 0 * 42 * CONTINUING CARE OF PALATAL FISTULA OBTURATOR * * ** 39978 $ 603.13 0 * 42 * REMAKE OF A PALATAL FISTULA OBTURATOR * * ** 39979 $ 5,995.00 0 * 42 * SPEECH OBTURATOR * * ** 39980 $ 76.92 0 * 42 * SIMPLE CONTINUING CARE OF SPEECH OBTURATOR * * ** 39981 $ 384.60 0 * 42 * COMPLEX CONTINUING CARE OF SPEECH OBTURATOR * * ** 39982 $ 3,995.00 0 * 42 * SPEECH OBTURATOR REMAKE * * ** 39983 $ 4,545.00 0 * 42 * SPEECH LIFT * * ** 39984 $ 57.69 0 * 42 * CONTINUING CARE OF SPEECH LIFT * * ** 39985 $ 3,030.00 0 * 42 * SPEECH LIFT REMAKE * * ** 50506 $ 38.23 0 * 14 * TELEHEALTH DIRECTIVE CARE - PAEDIATRICS * * ** 50507 $ 48.86 0 * 14 * TELEHEALTH SUBSEQUENT OFFICE VISIT - PAEDIATRICS * * ** 50508 $ 38.64 0 * 14 * TELEHEALTH SUBSEQUENT HOSPITAL VISIT - PAEDIATRICS * * ** 50510 $ 158.25 0 * 14 * TELEHEALTH CONSULTATION, PAEDIATRICS * * ** 50511 $ 320.65 0 * 14 * TELEHEALTH CONSULTATION, PAEDIATRICS * * ** 50512 $ 76.75 0 * 14 * TELEHEALTH REPEAT OR LIMITED CONSULT, PAEDIATRICS * * ** 50514 $ 59.36 0 * 14 * TELEHEALTH PROLONGED VISIT FOR COUNSELLING PAEDIAT * * ** 51007 $ 32.68 0 * 10 * OFFICE VISIT - ORTHOPAEDICS * * ** 51008 $ 18.18 0 * 10 * HOSPITAL VISIT - ORTHOPAEDICS * * ** 51010 $ 92.60 0 * 10 * CONSULTATION - ORTHOPAEDICS * * ** 51012 $ 45.44 0 * 10 * CONSULTATION - REPEAT/LIMITED - ORTHOPAEDICS * * ** 51015 $ 156.78 0 * 10 * CONSULTATION - SPECIAL - ORTHOPAEDICS * * ** 51016 $ 22.72 2 * * CAST: SHORT ARM * * ** 51017 $ 22.72 2 * * CAST - LONG ARM * * ** 51018 $ 85.00 2 * * CAST - SHOULDER SPICA * * ** 51019 $ 22.72 2 * * CAST - BELOW KNEE * * ** 51020 $ 22.72 2 * * CAST - LONG LEG CYLINDER * * ** 51021 $ 22.72 2 * * CAST - LONG LEG * * ** 51022 $ 85.00 2 * * CAST - HIP SPICA - CHILD * * ** 51023 $ 85.00 2 * * CAST - HIP SPICA - ADULT * * ** 51024 $ 85.00 2 * * CAST - BODY * * ** 51025 $ 45.44 2 * * CAST - CAST BRACE * * ** 51030 $ 27.27 0 * 10 * REPORT/INTERPRETATION OF FILMS - ORTHOPAEDICS * * ** 51035 $ 90.89 2 * * SKELETAL TRACTION - APPLICATION * * ** 51036 $ 90.89 2 * * COMPARTMENT PRESSURE MONITORING - EXTRA * * ** 51037 $ 90.89 2 * * HARVESTING OF ILIAC CREST GRAFT - EXTRA * * ** 51038 $ 99.97 2 * * HARVESTING OF SKIN GRAFT - EXTRA * * ** 51039 $ 22.72 0 * * ASPIRATION - BURSA * * ** 51040 $ 22.72 0 * * ASPIRATION - JOINT * * ** 51051 $ 581.68 5 * * MALIGNANT SUBFASCIAL SOFT TISSUE TUMOUR -SIMPLE * * ** 51052 $ 1,245.17 6 * * MALIGNANT SUBFASCIAL SOFT TISSUE TUMOUR - COMPLEX * * ** 51053 $ 1,054.32 6 * * MALIGNANT BONE TUMOUR - LIMB * * ** 51054 $ 1,063.40 6 * * SKELETAL DEFECT - RECONSTRUCTION * * ** 51055 $ 1,054.32 6 * * MALIGNANT GIRDLE TUMOUR - SCAPULA * * ** 51056 $ 1,581.47 6 * * MALIGNANT GIRDLE TUMOUR - PELVIS/SACRUM * * ** 51057 $ 1,063.40 6 * * SHOULDER/PELVIS/SACRUM - RECONSTRUCTION * * ** 51058 $ 2,117.71 6 * * MALIGNANT TUMOR/ROTATION PLASTY - RESECTION * * ** 51065 $ 1,063.40 3 * * ILIZAROV INSTRUMENTATION, SIMPLE * * ** 51066 $ 1,458.76 4 * * ILIZAROV INSTRUMENTATION; COMPLEX, MULTIPLE * * ** 51067 $ 209.04 3 * * ILIZAROV INSTRUMENTATION EXTENSION/REVISION -FRAME * * ** 52210 $ 181.78 2 * * INCISION/DRAINAGE - BURSA -GA * * ** 52215 $ 181.78 2 * * ABSCESS - INCISION/DRAINAGE - GA * * ** 52220 $ 236.30 2 * * HEMATOMA - INCISION/DRAINAGE - GA * * ** 52225 $ 181.78 2 * * ARTHROTOMY - SHOULDER JOINT - I AND D * * ** 52250 $ 370.37 2 * * SOFT TISSUE RELEASE - MUSCLE, TENDON * * ** 52255 $ 527.15 2 * * SHOULDER CONTRACTURE - MAJOR * * ** 52305 $ 236.30 2 * * EXCISION - ENDOSCOPIC - REMOVAL OF LOOSE BODY * * ** 52306 $ 236.30 2 * * EXCISION - ENDOSCOPIC - WITH/WITHOUT LOOSE BODY. * * ** 52307 $ 340.84 2 * * PINNING - OSTEOCHONDRAL FRAGMENT * * ** 52310 $ 340.84 2 * * DEBRIDEMENT, SYNOVECTOMY - TOTAL OR SUBTOTAL * * ** 52315 $ 340.84 2 * * SHOULDER ABRASION * * ** 52320 $ 236.30 2 * * LABRUM TEAR- EXCISION * * ** 52325 $ 554.42 2 * * STABILIZATION PROCEDURE * * ** 52330 $ 340.84 2 * * ACROMIOPLASTY - ENDOSCOPIC * * ** 52355 $ 209.04 2 * * EXCISION OF BURSA - SUBACROMIAL - OPEN * * ** 52356 $ 340.84 2 * * ACROMIONECTOMY, ACROMIOPLASTY * * ** 52357 $ 209.04 2 * * CLAVICLE EXCISION - OPEN * * ** 52360 $ 395.37 2 * * ARTHROTOMY - SHOULDER. * * ** 52365 $ 395.37 2 * * SUBFASCIAL SOFT TISSUE TUMOUR - BENIGN * * ** 52370 $ 395.37 2 * * BONE TUMOUR - BENIGN * * ** 52380 $ 181.78 2 * * OSTEOMYELITIS - ACUTE, DECOMPRESSION * * ** 52385 $ 313.57 3 * * OSTEOMYELITIS - DEBRIDEMENT WITH/WITHOUT RECONSTR * * ** 52405 $ 11.36 0 * * INJECTION OF JOINT - SHOULDER/CLAVICLE/HUMERUS * * ** 52410 $ 11.36 0 * * INJECTION - BURSA,TENDON SHEATH- SHOULDER/CLAVICLE * * ** 52415 $ 236.30 2 * * INT FIXATION DEVICE(S) - REMOVAL - GA * * ** 52420 $ 68.17 2 * * INT FIXATION DEVICE(S), REMOVAL - WITHOUT GA * * ** 52505 $ 422.64 3 * * ROTATOR CUFF REPAIR - SIMPLE * * ** 52506 $ 699.84 4 * * ROTATOR CUFF RECONSTRUCTION - COMPLEX * * ** 52515 $ 263.58 2 * * STABILIZATION - ACROMIOCLAVICULAR JOINT - ACUTE * * ** 52516 $ 395.37 2 * * STABILIZATION - ACROMIOCLAVICULAR JOINT - CHRONIC * * ** 52525 $ 554.42 3 * * SHOULDER INSTABILITY - INFERIOR CAPSULAR SHIFT * * ** 52526 $ 613.50 3 * * SHOULDER INSTABILITY -BANKART * * ** 52535 $ 447.62 3 * * SHOULDER INSTABILITY-ANTERIOR REPAIRS * * ** 52540 $ 699.84 3 * * SHOULDER INSTABILITY - POSTERIOR-GLENOID OSTEOTOMY * * ** 52541 $ 581.68 3 * * SHOULDER INSTABILITY - POSTERIOR - SOFT TISSUE * * ** 52545 $ 699.84 3 * * STABILIZATION - SHOULDER INSTABILITY -REVISION, * * ** 52550 $ 422.64 3 * * TENDON REPAIR, PROXIMAL BICEPS, PECTORALIS MAJOR * * ** 52555 $ 499.90 3 * * SHOULDER/CLAVICLE/HUMERUS TENDON TRANSFER * * ** 52601 $ 699.84 3 * * PROXIMAL HUMERUS - REPAIR/REVISION * * ** 52602 $ 395.37 2 * * CLAVICLE - REPAIR/REVISION * * ** 52603 $ 604.41 4 * * HEMI-ARTHROPLASTY - SHOULDER * * ** 52604 $ 781.65 5 * * SHOULDER PROSTHESIS - TOTAL * * ** 52605 $ 449.90 3 * * SHOULDER PROSTHESIS - REMOVAL * * ** 52606 $ 781.65 5 * * SHOULDER ARTHROPLASTY/HEMIARTHROPLASTY- TOTAL -REV * * ** 52607 $ 1,140.65 5 * * SHOULDER ARTHROPLASTY - TOTAL - REVISION * * ** 52651 $ 236.30 2 * * BONE GRAFTING - PROXIMAL HUMERUS * * ** 52652 $ 145.42 2 * * BONE GRAFTING - CLAVICLE * * ** 52705 $ 343.11 2 * * ORIF - CLAVICLE/ACROMION/CORACOID * * ** 52708 $ 90.89 2 * * CLAVICLE/ACROMION/CORACOID - PRIMARY WOUND CARE * * ** 52709 $ 181.78 2 * * CLAVICLE/ACROMION/CORACOID - SECONDARY WOUND MANAG * * ** 52715 $ 899.81 3 * * SCAPULA - FRACTURE/DISLOCATION - ORIF * * ** 52718 $ 90.89 2 * * SCAPULA - OPEN INJURY, PRIMARY WOUND CARE * * ** 52719 $ 181.78 2 * * SCAPULA - OPEN INJURY, SECONDARY WOUND MANAGEMENT * * ** 52721 $ 90.89 2 * * GLENOHUMERAL - CLOSED REDUCTION WITHOUT GA * * ** 52722 $ 236.30 2 * * GLENOHUMERAL - CLOSED REDUCTION WITH GA * * ** 52725 $ 395.37 2 * * GLENOHUMERAL - OPEN REDUCTION * * ** 52728 $ 90.89 2 * * GLENOHUMERAL - PRIMARY WOUND CARE * * ** 52729 $ 181.78 2 * * GLENOHUMERAL - SECONDARY WOUND MANAGEMENT * * ** 52731 $ 181.78 2 * * PROXIMAL HUMERUS - CLOSED REDUCTION WITH GA * * ** 52732 $ 181.78 2 * * PROXIMAL HUMERUS-CLOSED RED. WITH GA TRACTION/PIN * * ** 52735 $ 527.15 2 * * PROXIMAL HUMERUS - ORIF - TWO PART * * ** 52736 $ 581.68 2 * * PROXIMAL HUMERUS - ORIF - THREE OR MORE PARTS * * ** 52737 $ 781.65 3 * * PROXIMAL HUMERUS- HEMIPROSTHESIS/WIRING-FRACTURE * * ** 52738 $ 90.89 2 * * PROXIMAL HUMERUS - OPEN INJURY-PRIMARY WOUND CARE * * ** 52739 $ 181.78 2 * * PROXIMAL HUMERUS - OPEN INJURY -SECONDARY WOUND * * ** 52741 $ 236.30 2 * * HUMERUS - SHAFT -CLOSED REDUCTION WITH GA * * ** 52742 $ 345.39 2 * * HUMERUS - SHAFT-CLOSED REDUCTION-EXTERNAL FIXATION * * ** 52745 $ 554.42 2 * * HUMERUS- SHAFT - ORIF/INTRAMEDULLARY NAILING * * ** 52748 $ 90.89 2 * * HUMERUS - SHAFT - OPEN INJURY PRIMARY WOUND CARE * * ** 52749 $ 181.78 2 * * HUMERUS - SHAFT-OPEN SECONDARY WOUND MANAGEMENT * * ** 52800 $ 90.89 2 * * MANIPULATION UNDER GA - SHOULDER JOINT * * ** 52810 $ 927.07 4 * * ARTHRODESIS - SHOULDER JOINT * * ** 52811 $ 727.12 4 * * ARTHRODESIS - SCAPULA-THORACIC JOINT * * ** 52980 $ 754.38 4 * * AMPUTATION - SHOULDER DISARTICULATION * * ** 52981 $ 899.81 5 * * AMPUTATION - FOREQUARTER * * ** 52982 $ 527.15 3 * * AMPUTATION - HUMERAL SHAFT * * ** 52998 $ 90.89 3 * * AMPUTATION - PRIMARY WOUND CARE - OPEN INJURY * * ** 52999 $ 181.78 3 * * AMPUTATION - SECONDARY WOUND MANAGEMENT - OPEN * * ** 53210 $ 181.78 2 * * ELBOW, PROXIMAL RADIUS/ULNA - I & D * * ** 53215 $ 181.78 2 * * ELBOW, PROXIMAL RADIUS- ABSCESS I&D UNDER GA * * ** 53220 $ 236.30 2 * * ELBOW, PROXIMAL RADIUS/ULNA - HEMATOMA UNDER GA * * ** 53225 $ 181.78 2 * * ELBOW JOINT ARTHROTOMY I AND D * * ** 53250 $ 236.30 2 * * ELBOW,PROXIMAL RADIUS/ULNA- DECOMPRESSION/NEUROLY * * ** 53255 $ 395.37 2 * * ELBOW, INCISION-DECOMPRESSION,NEUROLYSIS * * ** 53260 $ 209.04 2 * * ELBOW, FASCIOTOMY, COMPARTMENT SYNDROME * * ** 53269 $ 181.78 2 * * ELBOW, INCISION - FASCIOTOMY, SECONDARY WOUND * * ** 53305 $ 288.58 2 * * ELBOW, EXCISION -REMOVAL LOOSE BODY * * ** 53310 $ 554.42 2 * * ELBOW, EXCISION - DEBRIDEMENT, SYNOVECTOMY-TOTAL * * ** 53355 $ 209.04 2 * * ELBOW, EXCISION -THERAPEUTIC - BURSA/GANGLION * * ** 53360 $ 395.37 2 * * ELBOW ARTHROTOMY - OPEN SYNOVECTOMY * * ** 53365 $ 263.58 2 * * ELBOW EXCISION BENIGN SOFT TISSUE TUMOR,SUBFACIAL * * ** 53370 $ 263.58 2 * * ELBOW - BONE TUMOUR, BENIGN * * ** 53380 $ 181.78 2 * * BONE TUMOUR - ELBOW - OSTEOMYELITIS, ACUTE * * ** 53385 $ 313.57 2 * * BONE TUMOUR - ELBOW - OSTEOMYELITIS-DEBRIDEMENT * * ** 53386 $ 236.30 2 * * RADIAL HEAD RESECTION - ELBOW * * ** 53405 $ 11.36 0 * * INJECTION OF JOINT - ELBOW * * ** 53410 $ 11.36 0 * * INJECTION OF BURSA/TENDON SHEATH - ELBOW * * ** 53415 $ 209.04 2 * * INT FIXATION DEVICE(S)-ELBOW-REMOVAL WITH GA * * ** 53420 $ 68.17 2 * * INT FIXATION DEVICE(S)-ELBOW-REMOVAL/WITHOUT GA * * ** 53505 $ 658.93 2 * * ELBOW INSTABILITY- CHRONIC * * ** 53510 $ 554.42 2 * * RECURRENT DISLOCATION - RADIAL HEAD - ELBOW * * ** 53515 $ 343.11 2 * * TRICEPS TENDON - ACUTE - ELBOW * * ** 53516 $ 395.37 2 * * TRICEPS TENDON, FASCIAL RECONSTRUCTION - ELBOW * * ** 53520 $ 263.58 2 * * BICEPS TENDON, LONGHEAD, TENODESIS - ELBOW * * ** 53521 $ 554.42 2 * * BICEPS TENDON, DISTAL INSERTION - ELBOW * * ** 53530 $ 699.84 2 * * TENDON TRANSFER - MAJOR - ELBOW * * ** 53531 $ 422.64 2 * * TENDON TRANSFER- MINOR - ELBOW * * ** 53540 $ 209.04 2 * * EPICONDYLITIS - FASCIAL STRIPPING - ELBOW * * ** 53601 $ 527.15 2 * * HUMERAL SHAFT - REPAIR - ELBOW * * ** 53602 $ 699.84 2 * * DISTAL HUMERUS - REPAIR - ELBOW * * ** 53603 $ 579.40 2 * * RADIUS SHAFT -REPAIR - ELBOW * * ** 53604 $ 422.64 2 * * ULNA SHAFT - REPAIR - ELBOW * * ** 53605 $ 699.84 2 * * RADIUS AND ULNA SHAFTS - REPAIR/REVISION - ELBOW * * ** 53606 $ 263.58 2 * * EPIPHYSIODESIS - REPAIR/REVISION - ELBOW * * ** 53607 $ 436.26 2 * * PHYSEAL BAR EXCISION/HARVEST - ELBOW * * ** 53641 $ 899.81 3 * * ARTHROPLASTY - ELBOW - INTERPOSITION/DISTRACTION * * ** 53642 $ 727.12 3 * * ARTHROPLASTY- TOTAL ELBOW * * ** 53643 $ 1,113.39 3 * * ARTHROPLASTY- TOTAL ELBOW - REVISION * * ** 53651 $ 236.30 2 * * BONE GRAFTING: HUMERUS - ELBOW * * ** 53652 $ 236.30 2 * * BONE GRAFTING - RADIUS AND/OR ULNA - ELBOW * * ** 53653 $ 145.42 2 * * BONE GRAFTING - OLECRANON - ELBOW * * ** 53701 $ 236.30 2 * * HUMERAL EPICONDYLE - FRACTURE/DISLOCATION/GA * * ** 53702 $ 263.58 2 * * HUMERAL EPICONDYLE - CLOSED REDUCTION * * ** 53705 $ 263.58 2 * * HUMERAL EPICONDYLE - ORIF * * ** 53708 $ 90.89 2 * * HUMERAL EPICONDYLE - PRIMARY WOUND CARE * * ** 53709 $ 181.78 2 * * HUMERAL EPICONDYLE - SECONDARY WOUND * * ** 53711 $ 181.78 2 * * DISTAL HUMERUS: CLOSED REDUCTION * * ** 53712 $ 343.11 2 * * DISTAL HUMERUS - CLOSED REDUCTION * * ** 53715 $ 395.37 2 * * DISTAL HUMERUS - ORIF * * ** 53718 $ 90.89 2 * * DISTAL HUMERUS - PRIMARY WOUND CARE * * ** 53719 $ 181.78 2 * * DISTAL HUMERUS - SECONDARY WOUND MANAGEMENT * * ** 53721 $ 181.78 2 * * DISTAL HUMERUS: INTRA-ARTICULAR - CLOSED RED W/ GA * * ** 53722 $ 345.39 2 * * DISTAL HUMERUS-CLOSED REDUCTION EXTERNAL FIXATION * * ** 53725 $ 395.37 2 * * DISTAL HUMERUS - ORIF - UNICONDYLAR * * ** 53726 $ 845.27 2 * * DISTAL HUMERUS - ORIF - BICONDYLAR * * ** 53727 $ 90.89 2 * * DISTAL HUMERUS - PRIMARY WOUND CARE * * ** 53728 $ 181.78 2 * * DISTAL HUMERUS - SECONDARY WOUND MANAGEMENT * * ** 53735 $ 290.85 2 * * OLECRANON - FRACTURE/DISLOCATION - ORIF * * ** 53738 $ 90.89 2 * * OLECRANON - PRIMARY WOUND CARE * * ** 53739 $ 181.78 2 * * OLECRANON - SECONDARY WOUND MANAGEMENT * * ** 53741 $ 236.30 2 * * RADIAL HEAD/NECK - FRACTURE/DISLOCATION - CLOSED * * ** 53742 $ 263.58 2 * * RADIAL HEAD/NECK - CLOSED REDUCTION PERCUTANEOUS * * ** 53745 $ 395.37 2 * * RADIAL HEAD/NECK - ORIF * * ** 53748 $ 90.89 2 * * RADIAL HEAD/NECK - PRIMARY WOUND CARE * * ** 53749 $ 181.78 2 * * RADIAL HEAD/NECK - SECONDARY WOUND MANAGEMENT * * ** 53751 $ 145.42 2 * * ELBOW JOINT - DISLOCATION - CLOSED REDUCTION * * ** 53752 $ 236.30 2 * * ELBOW JOINT - DISLOCATION - CLOSED REDUCTION/GA * * ** 53755 $ 290.85 2 * * ELBOW JOINT - DISLOCATION - OPEN REDUCTION * * ** 53761 $ 90.89 2 * * RADIUS/ULNA SHAFT - FRACTURE/DISLOCATION - CLOSED * * ** 53762 $ 290.85 2 * * RADIUS/ULNA SHAFT- FRACTURE/DISLOCATION- CLOSED/GA * * ** 53765 $ 527.15 2 * * RADIUS/ULNA SHAFT - ORIF * * ** 53768 $ 90.89 2 * * RADIUS/ULNA SHAFT - OPEN INJURY-PRIMARY WOUND CARE * * ** 53769 $ 181.78 2 * * RADIUS/ULNA SHAFT-SECONDARY WOUND MGMT-OPEN INJURY * * ** 53771 $ 263.58 2 * * RADIUS OR ULNA SHAFT/MONTEGGIA-CLOSED REDUCTION/GA * * ** 53772 $ 263.58 2 * * RADIUS OR ULNA SHAFT/MONTEGGIA - CLOSED REDUCTION * * ** 53775 $ 370.37 2 * * RADIUS OR ULNA SHAFT/MONTEGGIA - ORIF * * ** 53778 $ 90.89 2 * * RADIUS OR ULNA SHAFT/MONTEGGIA - PRIMARY WOUND * * ** 53779 $ 181.78 2 * * RADIUS OR ULNA SHAFT/MONTEGGIA - SECONDARY WOUND * * ** 53800 $ 90.89 2 * * MANIPULATION - UNDER GA - ELBOW JOINT * * ** 53810 $ 699.84 3 * * ARTHRODESIS - ELBOW JOINT * * ** 53980 $ 395.37 3 * * AMPUTATION - ELBOW * * ** 53981 $ 395.37 3 * * AMPUTATION - FOREARM * * ** 53998 $ 90.89 3 * * AMPUTATION - FOREARM - PRIMARY WOUND CARE * * ** 53999 $ 181.78 3 * * AMPUTATION - FOREARM - SECONDARY WOUND MANAGEMENT * * ** 54305 $ 236.30 2 * * REMOVAL OF LOOSE BODY - HAND/WRIST * * ** 54310 $ 315.84 2 * * DEBRIDEMENT/ SYNOVECTOMY- HAND/WRIST - TOTAL * * ** 54315 $ 315.84 2 * * TRIANGULAR FIBRO CARTILAGE COMPLEX (TFCC) * * ** 54350 $ 209.04 2 * * FOREIGN BODY REMOVAL - HAND/WRIST/GA * * ** 54351 $ 315.84 2 * * EXCISION - OPEN - MENISCUS/RADIOCARPAL * * ** 54372 $ 315.84 2 * * BONE TUMOR - BENIGN - CARPALS/DISTAL RADIUS * * ** 54380 $ 181.78 2 * * OSTEOMYELITIS, ACUTE - CARPALS, DISTAL/RADIUS * * ** 54385 $ 313.57 2 * * OSTEOMYELITIS/DEBRIDEMENT - CARPALS/DISTAL RADIUS * * ** 54386 $ 209.04 2 * * STYLOID - RADIAL/ULNAR - EXCISION * * ** 54387 $ 527.15 2 * * CARPECTOMY - PROXIMAL ROW * * ** 54405 $ 22.72 0 * * INJECTION - THERAPEUTIC - HAND/WRIST JOINT * * ** 54410 $ 22.72 0 * * INJECTION - THERAPEUTIC - BURSA/TENDON SHEATH * * ** 54415 $ 209.04 2 * * INT FIXATION DEVICE(S) AND/WRIST- REMOVAL/GA * * ** 54420 $ 45.44 2 * * INT FIXATION DEVICE(S) - HAND/WRIST -REMOVAL * * ** 54505 $ 581.68 2 * * CARPAL INSTABILITY - ACUTE * * ** 54510 $ 640.77 2 * * CARPAL INSTABILITY: CHRONIC * * ** 54515 $ 474.89 2 * * DISTAL RADIO-ULNAR INSTABILITY - CHRONIC * * ** 54601 $ 640.77 2 * * OSTEOTOMY - DISTAL RADIUS * * ** 54602 $ 318.12 2 * * OSTEOTOMY - DISTAL ULNA * * ** 54603 $ 527.15 2 * * CARPAL BONE (SCAPHOID) - REPAIR/REVISION * * ** 54604 $ 395.37 2 * * OSTEOTOMY - EPIPHYSIODESIS/EPIPHYSIOPLASTY/RADIUS/ * * ** 54631 $ 236.30 2 * * ARTHROPLASTY - ULNA - DISTAL EXCISION * * ** 54632 $ 699.84 2 * * JOINT REPLACEMENT - TOTAL WRIST * * ** 54633 $ 527.15 2 * * ARTHROPLASTY- SILASTIC WRIST * * ** 54634 $ 263.58 2 * * WRIST PROSTHESIS - REMOVAL * * ** 54635 $ 927.07 3 * * ARTHROPLASTY - TOTAL WRIST - REVISION * * ** 54651 $ 236.30 2 * * BONE GRAFTING - DISTAL RADIUS/ULNA * * ** 54652 $ 118.15 2 * * BONE GRAFTING - METACARPAL/PHALANX * * ** 54701 $ 245.40 2 * * RADIUS - FRACTURE/DISLOCATION-CLOSED REDUCTION * * ** 54702 $ 290.85 2 * * RADIUS - CLOSED REDUCTION/GA * * ** 54703 $ 318.12 2 * * RADIUS - EXTERNAL/PERCUTANEOUS FIXATION. * * ** 54705 $ 504.44 2 * * RADIUS - ORIF * * ** 54708 $ 45.44 2 * * RADIUS - PRIMARY WOUND CARE * * ** 54709 $ 90.89 2 * * RADIUS - SECONDARY WOUND MANAGEMENT * * ** 54715 $ 422.64 2 * * CARPAL BONE FRACTURE(SCAPHOID) - OPEN REDUCTION * * ** 54721 $ 245.40 2 * * CARPUS-DISLOCATION-W/WO FRACTURE-CLOSED REDUCTION * * ** 54722 $ 290.85 2 * * CARPUS - CLOSED REDUCTION/PERCUTANEOUS FIXATION * * ** 54725 $ 581.68 2 * * CARPUS - ORIF * * ** 54728 $ 45.44 2 * * CARPUS - PRIMARY WOUND CARE * * ** 54729 $ 90.89 2 * * CARPUS - SECONDARY WOUND MANAGEMENT * * ** 54800 $ 90.89 2 * * MANIPULATION - HAND/WRIST JOINT UNDER GA * * ** 54810 $ 640.77 2 * * ARTHRODESIS - WRIST - LIMITED OR TOTAL * * ** 55210 $ 181.78 2 * * PELVIS/HIP/FEMUR- INCISION/DRAINAGE/GA * * ** 55215 $ 181.78 2 * * ABSCESS - PELVIS/HIP/FEMUR -INCISION/DRAINAGE/GA * * ** 55220 $ 290.85 2 * * HEMATOMA - PELVIS/HIP/FEMUR - DRAINAGE UNDER GA * * ** 55225 $ 313.57 3 * * ARTHROTOMY - HIP JOINT - I AND D * * ** 55255 $ 263.58 2 * * SOFT TISSUE RELEASE - HIP- PERCUTANEOUS * * ** 55270 $ 290.85 2 * * MINOR RELEASE - HIP - ONE TENDON * * ** 55275 $ 395.37 3 * * MAJOR RELEASE - TWO OR MORE - HIP * * ** 55305 $ 368.09 3 * * LOOSE BODY - HIP - REMOVAL * * ** 55310 $ 581.68 3 * * DEBRIDEMENT/SYNOVECTOMY - HIP - TOTAL * * ** 55355 $ 209.04 2 * * EXCISION - OPEN - HIP - BURSA/TROCHANTERIC * * ** 55360 $ 554.42 3 * * ARTHROTOMY - HIP - OPEN SYNOVECTOMY - TOTAL * * ** 55365 $ 395.37 3 * * SOFT TISSUE TUMOUR - BENIGN -HIP - SUBFASCIAL * * ** 55370 $ 422.64 3 * * BONE TUMOUR, BENIGN - HIP * * ** 55380 $ 181.78 3 * * OSTEOMYELITIS, ACUTE - HIP - DECOMPRESSION * * ** 55385 $ 313.57 3 * * OSTEOMYELITIS, DEBRIDEMENT - HIP * * ** 55405 $ 11.36 0 * * INJECTION OF JOINT - HIP * * ** 55410 $ 11.36 0 * * INJECTION OF BURSA/TENDON SHEATH - HIP * * ** 55415 $ 236.30 3 * * INT FIXATION DEVICE(S) - REMOVAL - HIP/GA * * ** 55420 $ 68.17 3 * * INT FIXATION DEVICE(S) - REMOVAL - HIP/WITHOUT G * * ** 55505 $ 636.23 3 * * SOFT TISSUE REPAIR - HIP INSTABILITY * * ** 55510 $ 640.77 3 * * TENDON-MUSCLE TRANSFER - HIP * * ** 55515 $ 318.12 3 * * TENDON AVULSION REPAIR - HIP * * ** 55601 $ 727.12 6 * * OSTEOTOMY - PELVIS - ADULT * * ** 55602 $ 581.68 6 * * OSTEOTOMY - PELVIS - PAEDIATRIC * * ** 55603 $ 727.12 4 * * OSTEOTOMY - PROXIMAL FEMUR - ADULT * * ** 55604 $ 527.15 4 * * OSTEOTOMY - PROXIMAL FEMUR - PAEDIATRIC * * ** 55605 $ 754.38 4 * * OSTEOTOMY - FEMORAL SHAFT - ADULT * * ** 55606 $ 422.64 4 * * OSTEOTOMY - FEMORAL SHAFT - PAEDIATRIC * * ** 55607 $ 867.99 6 * * OSTEOTOMY - MULTIPLE FOR OSTEOGENESIS IMPERFECTA * * ** 55631 $ 1,326.98 4 * * PELVIS: NON-UNION OR MALUNION * * ** 55632 $ 1,799.60 4 * * NONUNION OR MALUNION - ACETABULUM * * ** 55633 $ 872.54 4 * * NONUNION OR MALUNION - PROXIMAL FEMUR * * ** 55634 $ 754.38 4 * * NONUNION OR MALUNION - SHAFT FEMUR * * ** 55635 $ 872.54 4 * * NONUNION OR MALUNION - FEMORAL LENGTHENING, OPEN * * ** 55636 $ 872.54 4 * * NONUNION OR MALUNION - FEMORAL SHORTENING, CLOSED * * ** 55651 $ 263.58 4 * * BONE GRAFTING - FEMUR * * ** 55652 $ 318.12 4 * * BONE GRAFTING - EPIPHYSIODESIS * * ** 55661 $ 477.17 5 * * ARTHROPLASTY - RESECTION - HIP * * ** 55662 $ 504.44 5 * * HEMI-ARTHROPLASTY - HIP * * ** 55663 $ 781.65 5 * * TOTAL HIP PROSTHESIS * * ** 55671 $ 781.65 5 * * REVISION TOTAL HIP ARTHROPLASTY: COMPONENTS * * ** 55672 $ 422.64 5 * * TOTAL HIP ARTHROPLASTY- EXCHG OF MODULAR COMPONENT * * ** 55673 $ 963.42 6 * * REVISION - FEMUR OR ACETABULUM * * ** 55674 $ 1,272.44 6 * * REVISION - FEMUR AND ACETABULUM,INCLUDES PROSTALAC * * ** 55675 $ 1,590.56 6 * * PROXIMAL FEMORAL REPLACEMENT * * ** 55701 $ 90.89 3 * * FRACTURE-PELVIS-CLOSED REDUCTION-SKELETAL TRACTION * * ** 55702 $ 481.72 4 * * PELVIS - CLOSED REDUCTION - EXTERNAL FIXATION * * ** 55705 $ 1,063.40 5 * * PELVIS - EXTERNAL FIXATION/ORIF * * ** 55706 $ 745.28 5 * * PELVIS -ORIF- ANTERIOR OR POSTERIOR * * ** 55707 $ 1,140.65 5 * * PELVIS -ORIF - ANTERIOR AND POSTERIOR * * ** 55711 $ 90.89 2 * * HIP - DISLOCATION - TRAUMATIC * * ** 55712 $ 181.78 2 * * REDUCTION - HIP/GA * * ** 55715 $ 477.17 4 * * REDUCTION - HIP - OPEN * * ** 55718 $ 90.89 2 * * HIP - PRIMARY WOUND CARE * * ** 55719 $ 181.78 2 * * HIP - SECONDARY WOUND MANAGEMENT * * ** 55721 $ 263.58 2 * * DISLOCATION- CONGENITAL- HIP- CLOSED REDUCTION/GA * * ** 55725 $ 695.30 2 * * DISLOCATION - CONGENITAL - OPEN REDUCTION -HIP * * ** 55726 $ 1,020.22 4 * * HIP DISLOC.OPEN REDUCTION FEM OR PELVIC OSTEOTOMY * * ** 55727 $ 1,283.81 4 * * HIP DISLOC. OPEN REDUCTION FEM & PELVIC OSTEOTOMY * * ** 55731 $ 90.89 2 * * HIP - FRACTURE/DISLOCATION - REDUCTION * * ** 55732 $ 181.78 2 * * HIP - REDUCTION/GA * * ** 55735 $ 477.17 4 * * HIP - OPEN REDUCTION * * ** 55736 $ 927.07 5 * * HIP - ORIF * * ** 55738 $ 90.89 2 * * HIP - PRIMARY WOUND CARE * * ** 55739 $ 181.78 2 * * HIP - SECONDARY WOUND MANAGEMENT * * ** 55741 $ 181.78 2 * * ACETABULUM - FRACTURE- CLOSED REDUCTION * * ** 55745 $ 1,272.44 5 * * ACETABULUM - ORIF - ONE APPROACH * * ** 55746 $ 1,799.60 6 * * ACETABULUM - TWO/EXTENSILE APPROACH * * ** 55751 $ 504.44 5 * * FEMORAL NECK/SUBCAPITAL -FRACTURE-CLOSED REDUCTION * * ** 55755 $ 808.91 5 * * FEMORAL NECK/SUBCAPITAL - ORIF * * ** 55758 $ 90.89 2 * * FEMORAL NECK/SUBCAPITAL - PRIMARY WOUND CARE * * ** 55759 $ 181.78 2 * * FRAC. FEMORAL NECK OR SUBCAPITAL: OPEN -SEC. WOUND * * ** 55760 $ 474.89 5 * * FEMORAL NECK/SUBCAPITAL - SCFE INSITU FIXATION * * ** 55761 $ 636.23 5 * * HIP - INTERTROCHANTERIC - REDUCTION * * ** 55768 $ 90.89 2 * * HIP FRACTURE INTERTROCHANTERIC PRIMARY WOUND CARE * * ** 55769 $ 181.78 2 * * HIP-INTERTROCHANTERIC - SECONDARY WOUND MANAGEMENT * * ** 55771 $ 867.99 5 * * HIP: SUBTROCHANTERIC - INTERNAL FIXATION * * ** 55778 $ 90.89 2 * * SUBTROCHANTERIC - PRIMARY WOUND CARE * * ** 55779 $ 181.78 2 * * SUBTROCHANTERIC - SECONDARY WOUND MANAGEMENT * * ** 55780 $ 118.15 2 * * FEMUR/SHAFT - CAST/TRACTION - CLOSED REDUCTION * * ** 55781 $ 209.04 2 * * FEMUR/SHAFT - CLOSED REDUCTION/GA * * ** 55782 $ 345.39 4 * * FEMUR/SHAFT - EXTERNAL SKELETAL FIXATION * * ** 55783 $ 754.38 5 * * FEMUR/SHAFT - CLOSED REDUCTION, IM NAIL * * ** 55785 $ 754.38 5 * * FEMUR/SHAFT - ORIF * * ** 55788 $ 90.89 2 * * FEMUR/SHAFT - PRIMARY WOUND CARE * * ** 55789 $ 181.78 2 * * FEMUR/SHAFT - SECONDARY WOUND MANAGEMENT * * ** 55800 $ 90.89 2 * * MANIPULATION - HIP JOINT UNDER GA * * ** 55810 $ 1,195.19 6 * * ARTHRODESIS - HIP JOINT * * ** 55980 $ 2,381.28 6 * * AMPUTATION - HEMICORPECTOMY * * ** 55981 $ 1,326.98 6 * * AMPUTATION - HEMIPELVECTOMY * * ** 55982 $ 1,008.87 6 * * AMPUTATION - HIP DISARTICULATION * * ** 55983 $ 636.23 4 * * AMPUTATION - ABOVE KNEE * * ** 55984 $ 636.23 4 * * AMPUTATION - KNEE DISARTICULATION * * ** 55998 $ 90.89 4 * * AMPUTATION - PRIMARY WOUND CARE - ABOVE KNEE * * ** 55999 $ 181.78 4 * * AMPUTATION - SECONDARY WOUND MANAGEMENT-ABOVE KNEE * * ** 56210 $ 181.78 2 * * FEMUR, KNEE JOINT/TIBIA/FIBULA - I & D/GA * * ** 56215 $ 181.78 2 * * FEMUR/KNEE JOINT/TIBIA/FIBULA - ABSCESS I & D/GA * * ** 56220 $ 290.85 2 * * HEMATOMA - FEMUR/KNEE JOINT/TIBIA/FIBULA * * ** 56225 $ 181.78 3 * * ARTHROTOMY - KNEE JOINT * * ** 56250 $ 209.04 2 * * DECOMPRESSION - KNEE JOINT * * ** 56260 $ 209.04 3 * * FASCIOTOMY, COMPARTMENT SYNDROME - KNEE JOINT * * ** 56269 $ 181.78 2 * * KNEE JOINT - SECONDARY WOUND CLOSURE * * ** 56270 $ 336.30 2 * * SOFT TISSUE RELEASE - KNEE - MINOR * * ** 56275 $ 474.89 3 * * SOFT TISSUE RELEASE - KNEE - MAJOR * * ** 56280 $ 749.83 3 * * KNEE LIBERATION/MAJOR RELEASE * * ** 56285 $ 608.95 3 * * QUADRICEPS PLASTY - KNEE * * ** 56290 $ 236.30 2 * * RETINACULAR RELEASE - LATERAL/MEDIAL KNEE - OPEN * * ** 56305 $ 236.30 2 * * REMOVAL OF LOOSE BODY - KNEE * * ** 56306 $ 315.84 2 * * KNEE - PINNING/DRILLING OSTEOCHONDRAL FRAGMENT * * ** 56310 $ 449.90 2 * * SYNOVECTOMY KNEE, TOTAL * * ** 56315 $ 209.04 2 * * RESECTION 'PLICA' * * ** 56320 $ 236.30 2 * * MENISECTOMY - KNEE * * ** 56325 $ 343.11 2 * * MENISCAL REPAIR * * ** 56330 $ 236.30 2 * * ABRASION/DEBRIDEMENT - KNEE * * ** 56335 $ 236.30 2 * * LATERAL/MEDIAL RELEASE - ENDOSCOPIC KNEE * * ** 56353 $ 209.04 2 * * GANGLION/CYST - KNEE * * ** 56354 $ 290.85 2 * * POPLITEAL CYST - KNEE * * ** 56355 $ 209.04 2 * * OPEN EXCISION - KNEE - BURSA/PREPATELLAR * * ** 56356 $ 236.30 3 * * ARTHROTOMY - REMOVAL OF LOOSE BODY - KNEE * * ** 56357 $ 343.11 3 * * ARTHROTOMY KNEE - PINNING/DRILLING * * ** 56360 $ 452.17 3 * * SYNOVECTOMY - KNEE, TOTAL * * ** 56361 $ 236.30 3 * * MENISECTOMY - KNEE * * ** 56362 $ 343.11 3 * * MENISCAL REPAIR - KNEE * * ** 56365 $ 318.12 3 * * SOFT TISSUE TUMOUR - BENIGN - KNEE * * ** 56370 $ 263.58 3 * * BONE TUMOUR - BENIGN - KNEE * * ** 56380 $ 181.78 3 * * OSTEOMYELITIS ACUTE - KNEE - DECOMPRESSION * * ** 56385 $ 209.04 3 * * OSTEOMYELITIS/DEBRIDEMENT - KNEE. * * ** 56390 $ 318.12 3 * * PATELLECTOMY * * ** 56405 $ 22.72 0 * * INJECTION OF JOINT - KNEE * * ** 56410 $ 22.72 0 * * INJECTION - BURSA/TENDON SHEATH - KNEE * * ** 56415 $ 236.30 2 * * KNEE - REMOVAL OF INT FIXATION DEVICE(S)/GA * * ** 56420 $ 68.17 2 * * KNEE - REMOVAL OF INTERNAL FIXATION DEVICE(S) * * ** 56505 $ 527.15 3 * * KNEE LIGAMENT INSTABILITY - ONE REPAIR * * ** 56510 $ 727.12 3 * * KNEE LIGAMENT INSTABILITY - POSTERIOR CRUCIATE * * ** 56515 $ 606.68 3 * * KNEE LIGAMENT INSTABILITY - TWO LIGAMENTS * * ** 56520 $ 813.46 3 * * KNEE LIGAMENT INSTABILITY - THREE LIGAMENTS * * ** 56525 $ 699.84 3 * * REVISION OF KNEE LIGAMENT RECONSTRUCTION * * ** 56528 $ 90.89 2 * * KNEE LIGAMENT - OPEN INJURY - PRIMARY WOUND CARE * * ** 56529 $ 181.78 2 * * KNEE LIGAMENT - OPEN INJURY - SECONDARY WOUND CARE * * ** 56530 $ 422.64 3 * * RECUR. SUBLUX./DISLOC. PATELLA-EXTENSOR REALIGNMEN * * ** 56531 $ 236.30 2 * * RECURR. SUBLUX./DISLOC. PATELLA-LATERAL RELEASE * * ** 56540 $ 336.30 2 * * RECURR. SUBLUX./DISLOC. QUAD. TENDON RUPTURE,ACUTE * * ** 56541 $ 477.17 2 * * RECURR. SUBLUX./DISLOC. QUAD. TENDON RUPT.-CHRONIC * * ** 56545 $ 318.12 2 * * TENDON TRANSFER, TRANSPLANT - PATELLA * * ** 56601 $ 781.65 3 * * OSTEOTOMY DISTAL FEMUR - NON-UNION/MALUNION * * ** 56602 $ 554.42 3 * * OSTEOTOMY PROXIMAL TIBIA - NON-UNION/MALUNION * * ** 56603 $ 727.12 3 * * OSTEOTOMY TIBIA/SHAFT/FIBULA - NON-UNION/MALUNION * * ** 56604 $ 263.58 3 * * OSTEOTOMY FIBULA -NON-UNION/MALUNION * * ** 56651 $ 263.58 3 * * FEMUR - BONE GRAFTING * * ** 56652 $ 263.58 3 * * BONE GRAFTING - TIBIA * * ** 56653 $ 290.85 3 * * BONE GRAFTING - EPIPHYSIODESIS * * ** 56654 $ 495.35 3 * * BONE GRAFTING - PHYSEAL BAR EXCISION * * ** 56661 $ 663.48 4 * * ARTHROPLASTY - KNEE JOINT * * ** 56662 $ 781.65 4 * * TOTAL KNEE REPLACEMENT * * ** 56663 $ 477.17 4 * * TOTAL KNEE, REMOVAL PROSTHESIS, INCLUDES PROSTALAC * * ** 56664 $ 1,074.75 4 * * REVISION - TOTAL KNEE * * ** 56665 $ 395.37 3 * * REVISION - PATELLAR COMPONENT * * ** 56701 $ 118.15 2 * * FRAC./DISLOC. FEMUR (SUPRACOND) -CLOSED W/O GA * * ** 56702 $ 209.04 2 * * FRAC./DISLOC. FEMUR (SUPRACOND) - CLOSED W/ GA * * ** 56703 $ 345.39 2 * * FRAC./DISLOC. FEMUR (SUPRACOND)-CLOSED, EXTERN FIX * * ** 56704 $ 754.38 5 * * FRAC./DISLOC. FEMUR (SUPRACOND)- CLOSED W/ IM NAIL * * ** 56705 $ 754.38 4 * * FRAC./DISLOC. FEMUR (SUPRACONDYLAR) - ORIF * * ** 56708 $ 90.89 2 * * FRAC./DISLOC. FEMUR (SUPRACOND)- PRIM. WOUND CARE * * ** 56709 $ 181.78 2 * * FRAC./DISLOC. FEMUR (SUPRACOND)- SEC. WOUND CARE * * ** 56711 $ 90.89 2 * * FRAC./DISLOC. FEMUR COND./INTRACOND-CLOSED W/O GA * * ** 56712 $ 181.78 2 * * FRAC./DISLOC. FEMUR COND./INTRACOND.-CLOSED W/ GA * * ** 56713 $ 345.39 2 * * FRAC./DISLOC. FEMUR COND/INTRACOND-CLOSED EX FIX * * ** 56715 $ 754.38 4 * * FRAC/DISLOC FEMUR COND/INTRACOND-ORIF-UNICONDYLAR * * ** 56716 $ 1,086.13 4 * * FRAC/DISLOC FEMUR COND/INTRACOND-ORIF-BICONDYLAR * * ** 56718 $ 90.89 2 * * FRAC/DISLOC FEMUR CON/INTRACOND-OP PRIM WOUND CARE * * ** 56719 $ 181.78 2 * * FRAC/DISLOC FEMUR COND/INTRACOND-OP SEC WOUND CARE * * ** 56725 $ 236.30 2 * * PATELLAR DISLOCATION - OPEN REDUCTION & REPAIR * * ** 56728 $ 90.89 2 * * PATELLAR DISLOCATION - OPEN - PRIMARY WOUND CARE * * ** 56729 $ 181.78 2 * * PATELLAR DISLOCATION - OPEN -SEC. WOUND MANAGEMENT * * ** 56734 $ 318.12 2 * * PATELLECTOMY - PATELLA FRACTURE * * ** 56735 $ 449.90 2 * * PATELLAR FRACTURE - ORIF * * ** 56738 $ 90.89 2 * * PATELLAR FRACTURE - OPEN - PRIMARY WOUND CARE * * ** 56739 $ 181.78 2 * * PATELLAR FRACTURE - OPEN - SEC. WOUND MANAGEMENT * * ** 56741 $ 181.78 2 * * TIBIAL PLATEAU FRACTURE - CLOSED RED. W/ GA * * ** 56742 $ 372.64 2 * * TIBIAL PLATEAU FRACTURE - CLOSED RED, EXTERN FIX * * ** 56745 $ 636.23 3 * * TIBIAL PLATEAU FRACTURE - ORIF - UNICONDYLAR * * ** 56746 $ 899.81 3 * * TIBIAL PLATEAU FRACTURE - ORIF - BICONDYLAR * * ** 56748 $ 90.89 2 * * TIBIAL PLATEAU FRACTURE - OPEN - PRIM. WOUND CARE * * ** 56749 $ 181.78 2 * * TIBIAL PLATEAU FRACTURE - OPEN - SEC. WOUND MANAGE * * ** 56751 $ 90.89 2 * * TIBIAL SHAFT FRACTURE - CLOSED RED. W/O GA * * ** 56752 $ 209.04 2 * * TIBIAL SHAFT FRACTURE - CLOSED RED. W/ GA * * ** 56753 $ 345.39 2 * * TIBIAL SHAFT FRACTURE - CLOSED RED. EXTERN FIX * * ** 56754 $ 668.02 3 * * TIBIAL SHAFT FRACTURE - CLOSED REDUCTION IM NAIL * * ** 56755 $ 554.42 3 * * TIBIAL SHAFT FRACTURES - ORIF * * ** 56758 $ 90.89 2 * * TIBIAL SHAFT FRACTURE - OPEN - PRIM. WOUND CARE * * ** 56759 $ 181.78 2 * * TIBIAL SHAFT FRACTURE - OPEN - SEC. WOUND MANAG. * * ** 56769 $ 181.78 2 * * FIBULAR SHAFT FRACTURE - OPEN - PRIM. WOUND CARE * * ** 56800 $ 90.89 2 * * MANIPULATION - KNEE JOINT W/ GA * * ** 56810 $ 781.65 3 * * ARTHRODESIS - KNEE JOINT * * ** 56980 $ 504.44 3 * * AMPUTATION - BELOW THE KNEE * * ** 56998 $ 90.89 3 * * AMPUTATION: BELOW KNEE - OPEN - PRIM. WOUND CARE * * ** 56999 $ 181.78 3 * * AMPUTATION: BELOW KNEE - OPEN - SEC. WOUND MANA * * ** 57210 $ 181.78 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT: I&D BURSA W/ GA * * ** 57215 $ 181.78 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT - I&D ABSCESS W/ GA * * ** 57220 $ 290.85 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT-HEMATOMA DRAIN. W/ GA * * ** 57225 $ 181.78 2 * * ANKLE/FOOT JOINT - I&D W/ GA * * ** 57250 $ 290.85 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT-DECOMP/NEUROLYS NERVE * * ** 57260 $ 209.04 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT- FACIOTOMY,COMPAR SYN * * ** 57269 $ 181.78 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT-FACIOTOMY,SEC CLOSURE * * ** 57270 $ 263.58 2 * * PLANTAR FASCIA: OPEN RELEASE OR PARTIAL EXCISION * * ** 57275 $ 395.37 2 * * PLANTAR FASCIECTOMY - TOTAL * * ** 57280 $ 209.04 2 * * ACHILLES TENDON LENGTHENING, PERCUTANEOUS * * ** 57285 $ 422.64 2 * * POSTERIOR HINDFOOT RELEASE * * ** 57286 $ 699.84 2 * * POSTEROMEDIAL RELEASE (CLUB FOOT/VERTICAL TALUS) * * ** 57290 $ 263.58 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT -TENDON LENGTH.- OPEN * * ** 57295 $ 263.58 2 * * TIBIAL METAPHYSIS/ANKLE/FOOT - TENOSYNOVECTOMY * * ** 57305 $ 236.30 2 * * REMOVAL OF LOOSE BODY-TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57306 $ 343.11 2 * * PINNING/DRILLING FRAGMENTS: TIBIAL/ANKLE FOOT * * ** 57310 $ 422.64 2 * * SYNOVECTOMY - ANKLE, TOTAL * * ** 57330 $ 236.30 2 * * ABRASION/DEBRIDEMENT- TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57354 $ 209.04 2 * * GANGLION - TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57355 $ 209.04 2 * * EXCISION BURSA - ACHILLES * * ** 57356 $ 209.04 2 * * NEUROMA - TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57360 $ 345.39 2 * * TOTAL SYNOVECTOMY-TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57365 $ 209.04 2 * * BENIGN SOFT TISSUE TUMOUR - TIBIAL/ANKLE/FOOT * * ** 57370 $ 343.11 2 * * BENIGN BONE TUMOUR - TIBIAL/ANKLE/FOOT * * ** 57371 $ 343.11 2 * * TARSAL COALITION - ANKLE/FOOT * * ** 57372 $ 236.30 2 * * SESAMOIDECTOMY - TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57373 $ 236.30 2 * * ACCESSORY NAVICULAR - TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57374 $ 527.15 2 * * TALECTOMY - TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57375 $ 209.04 2 * * EXCISION - NAIL BED - ANKLE/FOOT/GA * * ** 57380 $ 181.78 2 * * OSTEOMYELITIS, ACUTE- TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57385 $ 313.57 2 * * OSTEOMYELITIS,DEBRIDEMENT- TIBIAL/ANKLE/FOOT * * ** 57405 $ 11.36 0 * * INJECTION OF JOINT - TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57410 $ 11.36 0 * * INJECTION OF BURSA - TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57415 $ 209.04 2 * * REM. OF INT. FIX. DEV(S) - ANKLE/FOOT W/ GA * * ** 57420 $ 45.44 2 * * REM. OF INT. FIX. DEV(S) - ANKLE/FOOT W/O GA * * ** 57505 $ 236.30 2 * * ANKLE INSTABILITY: CAPSULE/LIGAMENT REPAIR * * ** 57510 $ 370.37 2 * * ANKLE INSTABILITY - RECONSTRUCTION * * ** 57515 $ 343.11 2 * * TENDO-ACHILLES REPAIR, ACUTE (W/IN 6 WKS POST-INJ) * * ** 57516 $ 527.15 2 * * TENDO-ACHILLES REPAIR, CHRONIC (> 6 WKS POST-INJ) * * ** 57520 $ 343.11 2 * * FLEXOR TENDON REPAIR - ANKLE/FOOT, SINGLE/MULTI * * ** 57525 $ 118.15 2 * * EXTENSOR TENDON REPAIR - ANKLE/FOOT/WITHOUT GA * * ** 57526 $ 236.30 2 * * EXTENSOR TENDON REPAIR - ANKLE/FOOT - SINGLE/GA * * ** 57527 $ 327.20 2 * * EXTENSOR TENDON REPAIR - ANKLE/FOOT - MULTIPLE/GA * * ** 57535 $ 370.37 2 * * REPAIR/RECONSTRUCTION - TENDON SHEATH * * ** 57550 $ 422.64 2 * * TENDON TRANSFER- TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57555 $ 318.12 2 * * JONES PROCEDURE- TIBIAL METAPHYSIS/ANKLE/FOOT * * ** 57601 $ 631.68 2 * * OSTEOTOMY/MALUNION - DISTAL TIBIAL * * ** 57602 $ 422.64 2 * * OSTEOTOMY/MALUNION - MALLEOLUS * * ** 57603 $ 422.64 2 * * CALCANEAL OSTEOTOMY * * ** 57604 $ 581.68 2 * * MIDTARSAL OSTEOTOMY * * ** 57605 $ 343.11 2 * * OSTEOTOMY/MALUNION - METATARSALS * * ** 57606 $ 236.30 2 * * OSTEOTOMY - OPEN - PHALANGES * * ** 57631 $ 527.15 2 * * OSTEOTOMY/NON-UNION - DISTAL TIBIAL * * ** 57632 $ 318.12 2 * * OSTEOTOMY/NON-UNION - MALLEOLUS, LATERAL/MEDIAL * * ** 57633 $ 370.37 2 * * OSTEOTOMY/NON-UNION - TARSALS * * ** 57634 $ 209.04 2 * * OSTEOTOMY/NON-UNION - METATARSALS * * ** 57635 $ 209.04 2 * * OSTEOTOMY/NON-UNION - PHALANGES (FOOT) * * ** 57636 $ 290.85 2 * * OSTEOTOMY/NON-UNION - EPIPHYSIODESIS * * ** 57637 $ 395.37 2 * * OSTEOTOMY/NON-UNION - PHYSEAL BAR EXCISION * * ** 57651 $ 236.30 2 * * BONE GRAFTING - DISTAL TIBIA * * ** 57652 $ 145.42 2 * * BONE GRAFTING - MALLEOLUS, MEDIAL/LATERAL-TARSALS * * ** 57661 $ 781.65 3 * * TOTAL ANKLE PROSTHESIS * * ** 57662 $ 981.60 3 * * TOTAL ANKLE ARTHROPLASTY- REVISION * * ** 57663 $ 181.78 3 * * TOTAL ANKLE ARTHROPLASTY - REMOVAL * * ** 57671 $ 263.58 2 * * EXCISION ARTHROPLASTY GREAT TOE (KELLER'S) * * ** 57672 $ 290.85 2 * * METATARSAL/PHALANGEAL JOINT RESECTION/RECONSTRUCT. * * ** 57673 $ 290.85 2 * * OSTEOTOMY - DISTAL METATARSAL * * ** 57674 $ 422.64 2 * * OSTEOTOMY - PROXIMAL METATARSAL/DISTAL REALIGNMENT * * ** 57675 $ 290.85 2 * * IMPLANT ARTHROPLASTY - METATARSAL PHALANGEAL JOINT * * ** 57676 $ 263.58 2 * * INTERPHALANGEAL JOINT ARTHROPLASTY, SINGLE/MULTI * * ** 57677 $ 370.37 2 * * RECONSTRUCTION - MINOR FOREFOOT (LESSER TOES) * * ** 57678 $ 579.40 2 * * RECONSTRUCTION - MAJOR FOREFOOT * * ** 57701 $ 181.78 2 * * FRAC/DISLOC ANKLE - CLOSED REDUC. W/ GA * * ** 57702 $ 477.17 2 * * FRAC/DISLOC ANKLE - EXTERNAL FIXATION * * ** 57705 $ 872.54 2 * * FRAC/DISLOC ANKLE - ORIF * * ** 57708 $ 90.89 2 * * FRAC/DISLOC ANKLE - OPEN - PRIMARY WOUND CARE * * ** 57709 $ 181.78 2 * * FRAC/DISLOC ANKLE - OPEN - SECOND. WOUND CARE * * ** 57711 $ 90.89 2 * * FRAC/DISLOC ANKLE(MALLEOLAR) - CLOSED RED. W/O GA * * ** 57712 $ 263.58 2 * * FRAC/DISLOC ANKLE(MALLEOLAR) - CLOSED RED. W/ GA * * ** 57713 $ 263.58 2 * * FRAC/DISLOC ANKLE(MALLEOLAR) - CLOSED RED. EX FIX * * ** 57715 $ 343.11 2 * * FRAC/DISLOC ANKLE(MALLEOLAR) - ORIF - ONE * * ** 57716 $ 395.37 2 * * FRAC/DISLOC ANKLE(MALLEOLAR) - ORIF - TWO OR MORE * * ** 57718 $ 90.89 2 * * FRAC/DISLOC ANKLE(MALLEOLAR) - PRIM. WOUND CARE * * ** 57719 $ 181.78 2 * * FRAC/DISLOC ANKLE(MALLEOLAR) - SECOND. WOUND CARE * * ** 57721 $ 90.89 2 * * HINDFOOT/MIDFOOT/LISFRANC DISLOC - CLOSED W/O GA * * ** 57722 $ 181.78 2 * * HINDFOOT/MIDFOOT/LISFRANC DISLOC - CLOSED W/ GA * * ** 57723 $ 290.85 2 * * HINDFOOT/MIDFOOT/LISFRANC DISLOC - CLOSED W/ FIXAT * * ** 57725 $ 422.64 2 * * HINDFOOT/MIDFOOT/LISFRANC DISLOC - OPEN REDUCTION * * ** 57728 $ 90.89 2 * * HINDFOOT/MIDFOOT/LISFRANC DISLOC - PRIM.WOUND CARE * * ** 57729 $ 181.78 2 * * HINDFOOT/MIDFOOT/LISFRANC DISLOC - SEC.WOUND CARE * * ** 57732 $ 181.78 2 * * OS CALCIS FRACTURE - CLOSED REDUCTION W/ GA * * ** 57733 $ 290.85 2 * * OS CALCIS FRACTURE - CLOSED REDUCTION W/ FIXATION * * ** 57735 $ 608.95 2 * * OS CALCIS FRACTURE - ORIF * * ** 57738 $ 90.89 2 * * OS CALCIS FRACTURE - OPEN - PRIM. WOUND CARE * * ** 57739 $ 181.78 2 * * OS CALCIS FRACTURE - OPEN - SEC. WOUND CARE * * ** 57741 $ 90.89 2 * * TALUS FRACTURE - CLOSED REDUCTION W/O GA * * ** 57742 $ 181.78 2 * * TALUS FRACTURE - CLOSED REDUCTION W/ GA * * ** 57743 $ 318.12 2 * * TALUS FRACTURE - CLOSED REDUCTION, FIXATION * * ** 57745 $ 474.89 2 * * TALUS FRACTURE - ORIF * * ** 57748 $ 90.89 2 * * TALUS FRACTURE - OPEN - PRIM. WOUND CARE * * ** 57749 $ 181.78 2 * * TALUS FRACTURE - OPEN - SEC. WOUND CARE * * ** 57751 $ 90.89 2 * * TARSAL FRACTURE - CLOSED REDUCTION W/O GA * * ** 57752 $ 181.78 2 * * TARSAL FRACTURE - CLOSED REDUCTION W/ GA * * ** 57753 $ 290.85 2 * * TARSAL FRACTURE - CLOSED REDUCTION, FIXATION * * ** 57755 $ 318.12 2 * * TARSAL FRACTURE - ORIF * * ** 57758 $ 90.89 2 * * TARSAL FRACTURE - OPEN - PRIM. WOUND CARE * * ** 57759 $ 181.78 2 * * TARSAL FRACTURE - OPEN - SEC. WOUND CARE * * ** 57761 $ 263.58 2 * * METATARSAL FRACTURE - CLOSED REDUCTION, FIXATION * * ** 57765 $ 290.85 2 * * METATARSAL FRACTURE - ORIF - ONE * * ** 57766 $ 343.11 2 * * METATARSAL FRACTURE - ORIF - TWO OR MORE * * ** 57768 $ 90.89 2 * * METATARSAL FRACTURE - OPEN - PRIMARY WOUND CARE * * ** 57769 $ 181.78 2 * * METATARSAL FRACTURE - OPEN - SECONDARY WOUND CARE * * ** 57771 $ 90.89 2 * * METATARSO-PHALANGEAL DISLOC.- CLOSED RED. W/O GA * * ** 57772 $ 181.78 2 * * METATARSO-PHALANGEAL DISLOC. - CLOSED RED. W/ GA * * ** 57773 $ 209.04 2 * * METATARSO-PHALANGEAL DISLOC. - CLOSED RED, FIX * * ** 57775 $ 290.85 2 * * METATARSO-PHALANGEAL DISLOC. - ORIF * * ** 57778 $ 90.89 2 * * METATARSO-PHALANGEAL DISLOC. - OPEN - PRIM. WOUND * * ** 57779 $ 181.78 2 * * METATARSO-PHALANGEAL DISLOC. - OPEN - SEC. WOUND * * ** 57781 $ 263.58 2 * * PHALANGEAL FRACTURE - CLOSED REDUCTION, FIXATION * * ** 57785 $ 290.85 2 * * PHALANGEAL FRACTURE - ORIF * * ** 57788 $ 45.44 2 * * PHALANGEAL FRACTURE - OPEN - PRIM. WOUND CARE * * ** 57789 $ 90.89 2 * * PHALANGEAL FRACTURE - OPEN - SEC. WOUND CARE * * ** 57791 $ 45.44 2 * * INTERPHALANGEAL DISLOC. - CLOSED RED. W/O GA * * ** 57792 $ 181.78 2 * * INTERPHALANGEAL DISLOC. - CLOSED RED. W/ GA * * ** 57793 $ 263.58 2 * * INTERPHALANGEAL DISLOC. - CLOSED RED. FIXATION * * ** 57795 $ 290.85 2 * * INTERPHALANGEAL DISLOC. - OPEN RED. W/WO FIXATION * * ** 57798 $ 45.44 2 * * INTERPHALANGEAL DISLOC. - OPEN - PRIM.WOUND CARE * * ** 57799 $ 90.89 2 * * INTERPHALANGEAL DISLOC. - OPEN - SEC.WOUND CARE * * ** 57800 $ 90.89 2 * * MANIPULATION - ANKLE/FOOT W/ GA * * ** 57810 $ 581.68 2 * * ARTHRODESIS - TIBIOCALCANEAL * * ** 57811 $ 817.99 2 * * ARTHRODESIS - PANTALAR * * ** 57812 $ 699.84 3 * * ARTHRODESIS - ANKLE JOINT * * ** 57813 $ 581.68 2 * * ARTHRODESIS - SUBTALAR JOINT/TRIPLE * * ** 57814 $ 527.15 2 * * ARTHRODESIS - MIDTARSAL JOINT * * ** 57815 $ 640.77 2 * * ARTHRODESIS - TARSO-METATARSAL JOINTS * * ** 57816 $ 343.11 2 * * ARTHRODESIS - METATARSOPHALANGEAL * * ** 57817 $ 263.58 2 * * ARTHRODESIS - INTERPHANGEAL, SINGLE OR MULTIPLE * * ** 57980 $ 518.05 2 * * AMPUTATION - SYME * * ** 57981 $ 477.17 2 * * AMPUTATION - MIDTARSAL * * ** 57982 $ 395.37 2 * * AMPUTATION - TRANSMETATARSAL * * ** 57983 $ 345.39 2 * * AMPUTATION - SINGLE METATARSAL/RAY RESECTION * * ** 57984 $ 181.78 2 * * AMPUTATION - TOE * * ** 57998 $ 45.44 2 * * AMPUTATION - OPEN INJURY, PRIMARY WOUND CARE * * ** 57999 $ 90.89 2 * * AMPUTATION - OPEN INJURY, SECONDARY WOUND CARE * * ** 58205 $ 90.89 2 * * INJECTION/ASPIRATION - FACET JOINT * * ** 58210 $ 90.89 2 * * DISCOGRAM * * ** 58250 $ 181.78 4 * * ABSCESS/HEMATOMA - EXTRASPINAL/GA * * ** 58305 $ 263.58 3 * * DISCECTOMY * * ** 58370 $ 608.95 6 * * DISCECTOMY - CERVICAL, SINGLE LEVEL * * ** 58375 $ 786.20 6 * * DISCECTOMY - CERVICAL - >2 LEVELS * * ** 58376 $ 1,404.22 8 * * DISCECTOMY - THORACOLUMBAR * * ** 58385 $ 1,590.56 6 * * VERTEBRAL BODY RESECTION - CERVICAL * * ** 58386 $ 1,854.12 8 * * VERTEBRAL BODY RESECTION - THORACOLUMBAR * * ** 58410 $ 499.90 5 * * SPINAL INSTRUMENTATION - REMOVAL * * ** 58605 $ 527.15 6 * * STABILIZATION - POSTERIOR - CERVICAL * * ** 58610 $ 1,058.85 6 * * STABILIZATION - SEGMENTAL - CERVICAL * * ** 58615 $ 477.17 5 * * STABILIZATION THORACOLUMBAR/WITHOUT INSTRUMENTATIO * * ** 58620 $ 754.38 7 * * STABILIZATION THORACOLUMBAR/SIMPLE INSTRUMENTATION * * ** 58625 $ 1,217.91 7 * * STABILIZATION - THORACOLUMBAR/SEGMENTAL INSTRUMENT * * ** 58630 $ 1,536.02 7 * * STABILIZATION THORACOLUMBAR, FUSION/DECOMPRESSION * * ** 58635 $ 1,799.60 7 * * THORACOLUMBAR FUSION/DECOMPRESSION/MULTIPLE LEVELS * * ** 58640 $ 490.80 6 * * STABILIZATION - ANTERIOR: CERVICAL * * ** 58645 $ 963.42 6 * * STABILIZATION - CERVICAL - PLATES/DISCECTOMY * * ** 58650 $ 1,722.34 6 * * STABILIZATION - CERVICAL - PLATES/VERTEBRECTOMY * * ** 58655 $ 927.07 8 * * STABILIZATION - ANTERIOR - THORACOLUMBAR * * ** 58660 $ 1,985.91 8 * * STABILIZATION; ANTERIOR, THORACOLUMBAR/INSTRUMENT * * ** 58670 $ 1,404.22 8 * * DEFORMITY CORRECTION - THORACOLUMBAR * * ** 58675 $ 1,667.81 8 * * DEFORMITY CORRECTION - THORACOLUMBAR/ANTERIOR INST * * ** 58680 $ 2,381.28 6 * * DEFORMITY CORRECTION - CERVICAL * * ** 58685 $ 2,381.28 7 * * OSTEOTOMY - THORACOLUMBAR- POSTERIOR * * ** 58690 $ 1,722.34 7 * * DEFORMITY; INSTRUMENTATION/FUSION/POSTERIOR, ADULT * * ** 58695 $ 1,404.22 7 * * DEFORMITY; INSTRUMENTATION/FUSION/POSTERIOR, CHILD * * ** 58710 $ 181.78 4 * * APPLICATION OF HALO - C-SPINE FRACTURE/DISLOCATION * * ** 58715 $ 981.60 7 * * CERVICAL SPINE - ORIF * * ** 58725 $ 1,272.44 7 * * FRACTURE/DISLOCATION, THORACOLUMBAR SPINE/FIXATION * * ** 58726 $ 1,536.02 7 * * THORACOLUMBAR SPINE; ORIF/FIXATION + DECOMPRESSION * * ** 60607 $ 39.75 0 * 3 * TELEHEALTH SUBSEQUENT OFFICE VISIT PSYCHIATRY * * ** 60608 $ 46.62 0 * 3 * TELEHEALTH HOSPITAL IN-PATIENT VISIT - PSYCHIATRY * * ** 60610 $ 185.95 0 * 3 * TELEHEALTH CONSULTATION PSYCHIATRY * * ** 60613 $ 256.46 0 * 3 * TELEHEALTH GERIATRIC CONSULT PSYCHIATRY 75 YRS OR * * ** 60614 $ 128.21 0 * 3 * TELEHEALTH REPEAT/LIMITED GERIATRIC CONSULT PSYCH * * ** 60622 $ 320.65 0 * 3 * TELEHEALTH CONSULT EMOTIONALLY DISTURBED CHILD PSY * * ** 60624 $ 72.99 0 * 3 * TELEHEALTH EVAL INTERVIEW WITH FAMILY MEMBER, 1/2 * * ** 60625 $ 93.91 0 * 3 * TELEHEALTH REPEAT OR LIMITED CONSULT PSYCHIATRY * * ** 60626 $ 160.33 0 * 3 * TELEHEALTH REPEAT OR LIMITED CONSULT EMOTIONALLY * * ** 60630 $ 79.46 0 * 3 * INDIVIDUAL TELEHEALTH PSYCHIATRIC TREATMENT, 1/2 H * * ** 60631 $ 110.74 0 * 3 * INDIVIDUAL TELEHEALTH PSYCHIATRIC TREATMENT, 3/4 H * * ** 60632 $ 141.81 0 * 3 * INDIVIDUAL TELEHEALTH PSYCHIATRIC TREATMENT, 1 HR * * ** 60633 $ 84.68 0 * 3 * FAMILY/CONJOINT TELEHEALTH THERAPY - PER 1/2 HR * * ** 60635 $ 118.01 0 * 3 * FAMILY/CONJOINT TELEHEALTH THERAPY - PER 3/4 HR * * ** 60636 $ 151.19 0 * 3 * FAMILY/CONJOINT TELEHEALTH THERAPY - PER 1 HR * * ** 60645 $ 39.75 0 * 3 * TELEHEALTH PATIENT MANGEMENT CONFERENCE PSYCHIATRY * * ** 61057 $ 448.08 0 * * NIPPLE AREOLAR RECONSTRUCTION AND TATTOOING * * ** 61152 $ 292.68 4 * * ABDOMINAL PANNICULECTOMY, SECONDARY TO INTERTRIGO * * ** 61156 $ 373.39 5 * * MYOCUTANEOUS FLAP OR FASCIA CUTANEOUS FLAP * * ** 61157 $ 560.08 5 * * MYOCUTANEOUS FLAP OR FASCIA CUTANEOUS FLAP * * ** 61158 $ 746.48 5 * * MYOCUTANEOUS FLAP OR FASCIA CUTANEOUS FLAP * * ** 61166 $ 313.79 3 * * MASTOPEXY, BALANCING UNILATERAL(ISOLATED PROCEDURE * * ** 61167 $ 235.34 3 * * MASTOPEXY BALANCING WITH CONTRALATERAL BREAST SURG * * ** 61222 $ 191.35 2 * * CRIF PHALANGEAL OR METACARPAL FRACTURE (MID/PRXML) * * ** 61223 $ 261.00 2 * * ORIF PHALANGEAL OR METACARPAL FRACTURE (MID/PRXML) * * ** 61224 $ 40.10 2 * * OPEN (COMPOUND) HAND FRACTURES PRIMARY WOUND MGMT * * ** 61225 $ 80.10 2 * * OPEN (COMPOUND)HAND FRACTURES-SECONDARY WOUND MGMT * * ** 66007 $ 21.45 0 * 11 * TELEHEALTH SUBSEQUENT OFFICE VISIT PLASTIC SURGERY * * ** 66008 $ 18.28 0 * 11 * TELEHEALTH SUBSEQUENT HOSPITAL VISIT -PLASTIC SURG * * ** 66010 $ 64.73 0 * 11 * TELEHEALTH MAJOR CONSULTATION, PLASTIC SURGERY * * ** 66012 $ 35.58 0 * 11 * TELEHEALTH REPEAT OR LIMITED CONSULT PLASTIC SURG * * ** 70019 $ 234.90 0 * * CERTIFIED SURGICAL ASSIST * * ** 70020 $ 24.54 0 * * CERTIFIED SURGICAL ASSIST - TIME FROM 1-3 HOURS * * ** 70023 $ 122.49 3 * * EXC BIOPSY OF LYMPH GLAND FOR SUSP MALIG - NECK * * ** 70024 $ 217.23 2 * * EXC BIOPSY OF LYMPH GLANDS FOR SUSP MALIG -AXILLA * * ** 70025 $ 74.55 2 * * EXC BIOPSY OF LYMPH GLANDS FOR SUSP MALIG - GROIN * * ** 70041 $ 40.22 2 * * FINE NEEDLE ASPIRATION SOLID OR CYSTIC LESION * * ** 70042 $ 10.06 2 * * ASPIRATION - FINE NEEDLE - ADDITIONAL CYST/ LESION * * ** 70043 $ 74.55 2 * * MASTOTOMY WITH EXPLORATION OF DRAINAGE OF ABSCESS * * ** 70044 $ 146.12 2 * * MASTOTOMY - GA * * ** 70084 $ 52.61 2 * * ABSCESS - PILONIDAL CYST/SINUS - INCISION/DRAINAGE * * ** 70150 $ 247.58 3 * * LACERATIONS - TONGUE/FLOOR OF MOUTH - COMPLICATED * * ** 70151 $ 393.05 4 * * EXTENSIVE DEBRIDEMENT OF SKIN/SOFT TISSUE/MUSCLE/B * * ** 70152 $ 393.05 3 * * EXTENSIVE DEBRIDEMENT - LIMB * * ** 70469 $ 52.61 2 * * BIOPSY - BREAST - NEEDLE CORE * * ** 70470 $ 105.22 2 * * BIOPSY - BREAST - INCISIONAL * * ** 70471 $ 112.40 2 * * BIOPSY - BREAST - EXCISIONAL * * ** 70472 $ 74.55 2 * 8 16 * BIOPSY - NEEDLE CORE-STEREOTACTIC/ULTRASOUND GUIDE * * ** 70473 $ 105.22 2 * 8 16 * BIOPSY-NEEDLE CORE-STEREOTACTIC/ULTRASOUND GUIDED * * ** 70477 $ 101.06 2 * * BIOPSY BREAST LESION - EACH ADDITIONAL * * ** 70478 $ 204.57 3 * * MASTECTOMY - GYNECOMASTIA * * ** 70479 $ 711.70 3 * * MASTECTOMY - RADICAL * * ** 70500 $ 491.27 5 * * OESOPHAGOTOMY:CERV. APPROACH W/ REM. FOREIGN BODY * * ** 70501 $ 583.55 8 * * OESOPHAGOTOMY:THORA. APPROACH W/ REM. FOREIGN BODY * * ** 70502 $ 429.56 4 * * CRICOPHARYNGEAL MYOTOMY - CERVICAL APPROACH * * ** 70503 $ 433.95 0 * * OESOPHAGECTOMY W/O THORACOTOMY - SECONDARY SURGEON * * ** 70504 $ 433.95 0 * * OESOPHAGECTOMY W/ COLON INTERPOSITION - 2ND SURG * * ** 70505 $ 433.95 0 * * OESOPHAGECTOMY W/ THORACOTOMY - 2ND SURGEON * * ** 70506 $ 433.95 0 * * OESOPHAGECTOMY W/THORACOTOMY&COLON INTER.-2ND SURG * * ** 70509 $ 433.95 0 * * PART. OESOPHAGECTOMY W/COLON INTER. - 2ND SURG * * ** 70511 $ 433.95 0 * * PART.OESOPHAGECTOMY THORACOABDOMINAL - 2ND SURG. * * ** 70530 $ 491.27 6 * * EXCISION OESOPHAGEAL LESION - CERVICAL APPROACH * * ** 70531 $ 711.70 8 * * EXCISION OESOPHAGEAL LESION THORACIC/ABDOMINAL * * ** 70532 $ 711.70 8 * * EXCISION - OESOPHAGEAL LESION - LAPAROSCOPIC/ THO * * ** 70533 $ 1,309.27 8 * * OESOPHAGECTOMY W/O THORACOTOMY - PRIMARY SURGEON * * ** 70534 $ 1,531.39 8 * * OESOPHAGECTOMY W/ COLON INTERPOSITION - PRIM. SURG * * ** 70535 $ 1,496.32 8 * * OESOPHAGECTOMY W/ THORACOTOMY - PRIMARY SURGEON * * ** 70536 $ 1,706.75 8 * * OESOPHAGECTOMY W/THORACOTOMY&COLON INTER.-1ST SURG * * ** 70538 $ 1,496.32 8 * * PARTIAL OESOPHAGECTOMY - DISTAL 2/3 * * ** 70539 $ 1,706.75 8 * * PART. OESOPHAGECTOMY W/COLON INTER. - PRIM. SURG * * ** 70540 $ 1,309.27 8 * * PART. OESOPHAGECTOMY THORACO-ABDOM. OR ABDOMINAL * * ** 70541 $ 1,531.39 8 * * PART. OESOPHAGECTOMY THROACOABDOMINAL - 1ST SURG * * ** 70542 $ 982.51 6 * * OESOPHAGECTOMY,TOTAL OR PARTIAL,W/O RECONSTRUCTION * * ** 70544 $ 598.52 8 * * DIVERTICULECTOMY OF HYPOPHARYNX/OESOPHAGUS-THORACI * * ** 70545 $ 491.27 6 * * DIVERTICULECTOMY OF HYPOPHARYNX/OESOPHAGUS-CERVICA * * ** 70547 $ 188.92 3 * * OESOPHAGOGASTRODUODENOSCOPY - BAND LIGATION * * ** 70549 $ 175.35 3 * * OESOPHAGOGASTRODUODENOSCOPY - TRANSENDOSCOPIC * * ** 70551 $ 99.78 3 * * DILATION OF OESOPHAGUS - BALLOON * * ** 70552 $ 104.96 3 * * DILATION OF OESOPHAGUS - OVERWIRE * * ** 70553 $ 104.96 3 * * DILAT.OF OESOPHAGUS,BALLOON OR DILATOR:FLUOROSCOPE * * ** 70554 $ 99.78 3 * * DILATION OF OESOPHAGUS -WITH BALLOON,FOR ACHALASIA * * ** 70555 $ 99.78 4 * * DILAT. OF OESOPHAGUS,WITH BALLOON OR DILATOR-RETRO * * ** 70601 $ 695.55 6 * * REPAIR PARA-OESOPHAGEAL HIATUS HERNIA * * ** 70602 $ 695.55 6 * * DIAPHRAGMATIC OR OTHER HERNIA - OPEN * * ** 70603 $ 695.55 6 * * DIAPHRAGMATIC OR OTHER HERNIA - LAPAROSCOPIC * * ** 70604 $ 698.47 9 * * CONGENITAL DIAPHRAGMATIC HERNIA * * ** 70605 $ 736.27 8 * * REPAIR DIAPHRAGMATIC HERNIA OR LACERATION - ACUTE * * ** 70606 $ 674.10 8 * * REPAIR DIAPHRAGMATIC HERNIA OR LACERATION -CHRONIC * * ** 70607 $ 615.65 8 * * IMBRICATION OF DIAPHRAGM FOR EVENTRATION * * ** 70620 $ 368.14 5 * * GASTROTOMY * * ** 70621 $ 617.23 6 * * GASTROTOMY WITH SUTURE REPAIR OF BLEEDING ULCER * * ** 70622 $ 642.94 6 * * GASTROTOMY-SUTURE REPAIR OESOPHAGOGASTRIC LACER. * * ** 70624 $ 368.14 5 * * PYLOROMYOTOMY, CUTTING OF PYLORIC MUSCLE * * ** 70625 $ 523.72 6 * * LIMITED/WEDGE EXCISION-ULCER OR BENIGN TUM STOMACH * * ** 70626 $ 598.52 6 * * LIMITED/WEDGE EXCISION MALIGNANT TUMOR-STOMACH * * ** 70627 $ 1,043.44 6 * * GASTRECTOMY - TOTAL * * ** 70628 $ 1,084.84 6 * * GASTRECTOMY - RECONSTRUCTION - ROUX-EN-Y * * ** 70629 $ 1,118.73 6 * * GASTRECTOMY WITH FORMATION OF INTESTINAL POUCH * * ** 70630 $ 897.80 6 * * GASTRECTOMY PARTIAL/DISTAL WITH GASTRODUODENOSTOMY * * ** 70631 $ 897.80 6 * * GASTRECTOMY PARTIAL/DISTAL - GASTROJEJUNOSTOMY * * ** 70632 $ 935.19 6 * * GASTRECTOMY PARTIAL/DISTAL RECONSTRUCTION-ROUX-EN * * ** 70633 $ 1,010.02 6 * * GASTRECTOMY, PARTIAL, DISTAL-INTESTINAL POUCH * * ** 70634 $ 58.45 0 * * VAGOTOMY (EXTRA) * * ** 70635 $ 1,100.74 6 * * GASTRECTOMY - PROXIMAL * * ** 70637 $ 28.05 2 * * TUBE CHANGE - GASTROSTOMY * * ** 70638 $ 95.16 3 * * TUBE REPOSITION - GASTRIC FEEDING * * ** 70641 $ 418.50 6 * * GASTROTOMY - LAPAROSCOPIC * * ** 70642 $ 720.44 7 * * GASTRIC RESTRICTIVE PROCEDURE * * ** 70643 $ 773.63 7 * * GASTRIC RESTRICTIVE PROCEDURE/BYPASS * * ** 70644 $ 851.00 7 * * GASTRIC RESTRICTIVE PROCEDURE/SMALL BOWEL RECONSTR * * ** 70645 $ 771.53 7 * * GASTRIC RESTRICTIVE PROCEDURE - REVISION/ REVERSAL * * ** 70646 $ 368.14 4 * * GASTROSTOMY - CLOSURE - SURGICAL * * ** 70648 $ 246.24 4 * * TUBE OR NEEDLE CATHETER JEJUNOSTOMY * * ** 70649 $ 720.10 5 * * FISTULA - GASTROCOLIC * * ** 70665 $ 368.14 2 * * ANOPLASTY - ADULT * * ** 70666 $ 368.14 2 * * SPHINCTEROPLASTY - ANAL - ADULT * * ** 70668 $ 122.75 2 * * GRAFT - RECTAL INCONTINENCE/PROLAPSE: * * ** 70670 $ 572.82 3 * * SPHINCTEROPLASTY - ANAL - INCONTINENCE * * ** 70671 $ 368.14 2 * * IMBRICATION - LEVATOR MUSCLE * * ** 70672 $ 822.98 4 * * IMPLANTATION - ARTIFICIAL SPHINCTER * * ** 70674 $ 61.49 2 * * DESTRUCTION - ANAL LESION * * ** 70675 $ 23.38 2 * * ANAL SETON - REMOVAL * * ** 70676 $ 317.96 2 * * ABSCESS - ISCHIORECTAL/ INTRAMURAL - INCISION * * ** 70680 $ 123.10 2 * * DESTRUCTION OF ANAL LESION - COMPLICATED * * ** 70683 $ 116.89 2 * * EUA WITH OR WITHOUT SIGMOIDOSCOPY * * ** 70694 $ 485.16 5 * * CHOLEDOCHOTOMY/CHOLEDOCHOSTOMY OPEN * * ** 70695 $ 485.16 5 * * CHOLEDOCHOTOMY/CHOLEDOCHOSTOMY - LAPAROSCOPIC * * ** 70696 $ 847.20 5 * * CHOLEDOCHOTOMY/TRANSDUODENAL SPHINCTEROPLASTY * * ** 70698 $ 386.42 5 * * CHOLECYSTOSTOMY - LAPAROSCOPIC * * ** 70700 $ 594.80 5 * * CHOLECYSTECTOMY; OPEN PRECEDED BY CHOLECYSTECTOMY * * ** 70701 $ 727.74 5 * * CHOLECYSTECTOMY - CBD (LAPAROSCOPIC) * * ** 70702 $ 727.74 5 * * CHOLECYSTECTOMY - CBD (OPEN) * * ** 70703 $ 935.19 5 * * CHOLECYSTECTOMY/CHOLEDOCHODUODENOSTOMY * * ** 70704 $ 958.58 5 * * CHOLECYSTECTOMY WITH CHOLEDOCHOJEJUNOSTOMY * * ** 70705 $ 935.19 5 * * CHOLECYSTECTOMY/TRANSDUODENAL SPHINCTEROTOMY * * ** 70710 $ 403.90 5 * * ATRESIA - BILE DUCTS - CONGENITAL * * ** 70711 $ 1,450.58 6 * * PORTOENTEROSTOMY * * ** 70712 $ 968.86 6 * * TUMOR/STRICTURE - BILE DUCT - LOWER * * ** 70713 $ 1,450.48 6 * * TUMOR/STRICTURE - BILE DUCT - UPPER * * ** 70714 $ 1,567.40 6 * * TUMOR/STRICTURE - BILE DUCT - MULTIPLE ANASTOMOSES * * ** 70715 $ 911.83 5 * * CYST - CHOLEDOCHAL * * ** 70716 $ 1,346.69 5 * * CYST - CHOLEDOCHAL/DUCTOPLASTY * * ** 70717 $ 1,458.92 5 * * CYST; CHOLEDOCHAL - EXCISION, MULTIPLE ANASTOMOSES * * ** 70720 $ 796.79 5 * * CHOLECYSTOENTEROSTOMY/GASTROENTEROSTOMY * * ** 70721 $ 710.75 5 * * CHOLECYSTOENTEROSTOMY/ROUX-EN-Y * * ** 70722 $ 912.75 5 * * CHOLECYSTOENTEROSTOMY/ROUX-EN-Y/GASTROENTEROSTOMY * * ** 70725 $ 993.65 6 * * CHOLEDOCHOJEJUNOSTOMY WITH GASTROJEJUNOSTOMY * * ** 70726 $ 911.83 6 * * CHOLEDOCHOJEJUNOSTOMY/ROUX-EN-Y * * ** 70727 $ 1,110.56 6 * * CHOLEDOCHOJEJUNOSTOMY/ROUX-EN-Y/GASTROJEJUNOSTOMY * * ** 70728 $ 1,122.24 6 * * ANASTOMOSIS - INTRA-HEPATIC DUCTS/GI TRACT * * ** 70730 $ 603.48 5 * * U-TUBE HEPATICO ENTEROSTOMY * * ** 70731 $ 935.19 5 * * EXTRA-HEPATIC BILIARY DUCT: PRIMARY REPAIR * * ** 70740 $ 116.89 3 * * CYST - THYROGLOSSAL - INFECTED * * ** 70742 $ 538.02 4 * * LOBECTOMY - TOTAL THYROID * * ** 70743 $ 666.34 4 * * THYROIDECTOMY; TOTAL; UNILATERAL INC'L ISTHMUS * * ** 70745 $ 646.90 4 * * THYROIDECTOMY - SUBTOTAL - BILATERAL * * ** 70747 $ 635.95 4 * * THYROID TISSUE - REMAINING - REMOVAL * * ** 70748 $ 149.63 0 * * SUBSTERNAL THYROID - STERNAL SPLIT * * ** 71530 $ 486.32 5 * * OESOPHAGOSTOMY - CERVICAL * * ** 71531 $ 736.27 6 * * REPAIR TRACHEO-OESOPHAGAL FISTULA-CERVICAL APPR. * * ** 71532 $ 822.98 8 * * OESOPHAGOPLASTY - W/O TRACHEO-OESOPHAGEAL FISTULA * * ** 71533 $ 952.08 8 * * OESOPHAGOPLASTY - W/ TRACHEO-OESOPHAGEAL FISTULA * * ** 71534 $ 736.27 8 * * DIVISION OF TRACHEO-OESOPHAGEAL FISTULA * * ** 71535 $ 674.10 6 * * OESOPHAGOGASTRIC FUNDOPLASTY - LAPAROSCOPIC * * ** 71536 $ 674.10 6 * * OESOPHAGOGASTRIC FUNDOPLASTY - OPEN * * ** 71537 $ 724.77 8 * * OESOPHAGOGASTRIC FUNDOPLASTY WITH FUNDIC PATCH * * ** 71538 $ 724.77 8 * * OESOPHAGOGASTRIC FUNDOPLASTY - WITH GASTROPLASTY * * ** 71539 $ 615.58 8 * * PLASTIC OPERATION: CARDIOSPASM -THORACIC APPROACH * * ** 71540 $ 615.58 6 * * PLASTIC OPERATION: CARDIOSPASM - LAPAROSCOPIC * * ** 71541 $ 860.38 6 * * CARDIOSPASM - WITH FUNDOPLICATION - OPEN * * ** 71542 $ 860.38 6 * * CARDIOSPASM WITH FUNDOPLICATION - LAPAROSCOPIC * * ** 71543 $ 1,309.27 6 * * GASTROINTESTINAL RECONSTRUCTION - WITH STOMACH * * ** 71544 $ 1,531.39 6 * * GASTROINTESTINAL RECONSTRUCTION - COLON INTERPOSIT * * ** 71546 $ 759.85 6 * * TRANSECTION OF OESOPHAGUS WITH REPAIR * * ** 71547 $ 615.58 6 * * LIGATION/STAPLING - OESOPHAGEAL PERFORATION * * ** 71548 $ 397.39 6 * * OESOPHAGEAL WOUND OR INJURY - CERVICAL APPROACH * * ** 71549 $ 710.75 8 * * OESOPHAGEAL WOUND - TRANSTHORACIC/TRANSABDOMINAL * * ** 71550 $ 493.79 6 * * OESOPHAGOSTOMY/FISTULA CLOSURE-CERVICAL APPROACH * * ** 71551 $ 748.16 8 * * OESOPHAGOSTOMY OR FISTULA CLOSURE - TRANSTHORACIC * * ** 71600 $ 350.70 2 * * HERNIA - INGUINAL - REPAIR - <6 MONTHS * * ** 71601 $ 467.60 2 * * HERNIA - INGUINAL - REPAIR - BILATERAL * * ** 71602 $ 396.29 3 * * HERNIA - INGUINAL - REPAIR - INCARCERATED/STRANGUL * * ** 71603 $ 292.25 2 * * HERNIA - INGUINAL - REPAIR - 6 MONTHS - 12 YEARS * * ** 71604 $ 409.16 2 * * BILATERAL INGUINAL HERNIA - AGE 6 MOS TO 12 YRS * * ** 71605 $ 350.70 3 * * INGUINAL HERNIA - INCARC./STRANG. - 6 MOS TO 12 YR * * ** 71606 $ 318.17 2 * * HERNIA - INGUINAL - REPAIR - REDUCIBLE/OPEN - >12 * * ** 71607 $ 318.17 4 * * REPAIR INGUINAL HERNIA - LAPAROSCOPIC, > 12 YEARS * * ** 71608 $ 368.14 3 * * HERNIA; INGUINAL REPAIR; INCARCERATED/STRANGULATED * * ** 71609 $ 397.70 2 * * HERNIA, REPAIR RECURRENT INGUINAL, OPEN, ANY AGE * * ** 71610 $ 397.70 4 * * HERNIA; REPAIR RECURRENT INGUINAL, LAPAROSCOPIC * * ** 71611 $ 460.17 3 * * HERNIA; REPAIR RECURRENT INGUINAL, INCARCERATED * * ** 71612 $ 477.23 2 * * HERNIA; INGUINAL BILATERAL REPAIR, OPEN, AGE >12 * * ** 71613 $ 477.23 4 * * HERNIA; INGUINAL BILATERAL REPAIR, LAPAROSCOPIC * * ** 71614 $ 397.39 2 * * HERNIA - INITIAL INCISIONAL - REPAIR - REDUCIBLE * * ** 71615 $ 459.55 3 * * HERNIA; INITIAL INCISIONAL REPAIR, INCARCERATED * * ** 71616 $ 459.55 3 * * HERNIA; INITIAL INCISIONAL REPAIR, PROSTHETIC MESH * * ** 71617 $ 496.75 2 * * HERNIA; REPAIR RECURRENT INCISIONAL, REDUCIBLE * * ** 71618 $ 574.44 3 * * HERNIA; REPAIR RECURRENT INCISIONAL, INCARCERATED * * ** 71619 $ 222.11 2 * * HERNIA - UMBILICAL - REPAIR - REDUCIBLE * * ** 71620 $ 280.57 3 * * HERNIA; REPAIR UMBILICAL INCARCERATED/STRANGULATED * * ** 71621 $ 582.15 5 * * HERNIA REPAIR WITH RESECTION OF BOWEL * * ** 71622 $ 701.40 5 * * HERNIA REPAIR, BOWEL RESECTION, SEPARATE INCISION * * ** 71650 $ 429.08 5 * * HERNIA REPAIR - CORRECTION - MALROTATION * * ** 71681 $ 127.64 2 * * SPHINCTEROTOMY WITH/WITHOUT FISSURECTOMY * * ** 71684 $ 55.34 2 * * PAPILLECTOMY - SINGLE - EXTRA * * ** 71686 $ 100.53 2 * * PAPILLECTOMY - MULTIPLE - EXTRA * * ** 71689 $ 82.75 2 * * HEMMORHOID(S); OFFICE PROCEDURE (EG BAND LIGATION) * * ** 71690 $ 82.75 2 * * HEMORRHOID(S); OFFICE PROCEDURE-INFRARED PHOTOCOAG * * ** 71698 $ 150.88 2 * * CHOLECYSTOSTOMY - PERCUTANEOUS * * ** 71700 $ 662.56 2 * * FISTULA-IN-ANO; CLOSURE OF CONGENITAL ANAL FISTULA * * ** 71703 $ 932.80 8 * * ADRENALECTOMY FOR PHEOCHROMOCYTOMA * * ** 71704 $ 736.27 8 * * ADRENALECTOMY - UNILATERAL * * ** 71705 $ 1,010.02 8 * * ADRENALECTOMY - BILATERAL * * ** 71706 $ 747.11 6 * * CAROTID BODY TUMOR - EXCISION * * ** 71707 $ 916.49 8 * * CAROTID BODY TUMOR WITH EXCISION OF CAROTID ARTERY * * ** 71708 $ 397.39 2 * * PANCREATITIS - ACUTE - DRAINAGE * * ** 71709 $ 642.41 8 * * RESECTIONAL DEBRIDEMENT - PANCREAS * * ** 71710 $ 74.81 6 * * BIOPSY - PANCREAS - OPEN * * ** 71712 $ 642.41 6 * * PANCREATIC LESION - EXCISION - LIMITED * * ** 71713 $ 748.16 7 * * PANCREATECTOMY - DISTAL SUBTOTAL * * ** 71714 $ 935.19 7 * * PANCREATECTOMY - WITH SPLENIC PRESERVATION * * ** 71715 $ 935.19 7 * * PANCREATECTOMY - PANCREATICOJEJUNOSTOMY * * ** 71716 $ 981.95 7 * * PANCREATECTOMY -SPLENIC PRESERVATION/PANCREATIC * * ** 71717 $ 1,005.34 7 * * PANCREATECTOMY -DISTAL/NEAR TOTAL * * ** 71718 $ 972.61 6 * * AMPULLA OF VATER - EXCISION * * ** 71719 $ 1,285.90 8 * * PANCREATECTOMY - PROXIMAL/SUBTOTAL * * ** 71720 $ 1,285.90 8 * * PANCREATECTOMY - PYLORIC SPARING * * ** 71721 $ 1,461.24 9 * * PANCREATECTOMY - REGIONAL * * ** 71722 $ 1,344.35 8 * * PANCREATECTOMY - TOTAL * * ** 71746 $ 814.79 4 * * PARATHYROIDECTOMY - RE-EXPLORATION * * ** 71747 $ 876.75 6 * * PARATHYROIDECTOMY - MEDIASTINAL EXPLORATION * * ** 71748 $ 74.81 0 * * PARATHYROID AUTOTRANSPLANTATION * * ** 72620 $ 744.80 5 * * RESECTION OF SMALL INTESTINE-WITH ENTEROSTOMY * * ** 72621 $ 87.68 6 * * MOBILIZATION - SPLENIC FLEXURE * * ** 72622 $ 809.12 6 * * RESECTION - COLON - LIMITED - OPEN * * ** 72623 $ 809.12 6 * * RESECTION - COLON - LIMITED - LAPAROSCOPIC * * ** 72624 $ 849.03 6 * * HEMICOLECTOMY - RIGHT - OPEN * * ** 72625 $ 849.03 6 * * HEMICOLECTOMY - RIGHT - LAPAROSCOPIC * * ** 72626 $ 901.10 6 * * HEMICOLECTOMY - LEFT - OPEN * * ** 72631 $ 901.10 6 * * HEMICOLECTOMY - LEFT - LAPAROSCOPIC * * ** 72632 $ 938.08 6 * * SIGMOID RESECTION - OPEN * * ** 72633 $ 938.08 6 * * SIGMOID RESECTION - LAPAROSCOPIC * * ** 72634 $ 886.36 6 * * SIGMOID RESECTION/END COLOSTOMY * * ** 72635 $ 1,082.42 6 * * ANTERIOR RESECTION - RECTOSIGMOID - CARCINOMA * * ** 72636 $ 1,156.01 7 * * PROCTECTOMY - ABDOMINAL/TRANSANAL * * ** 72637 $ 386.91 7 * * PROCTECTOMY - SYNCHRONOUS PERINEAL * * ** 72640 $ 809.79 6 * * PARTIAL RIGHT COLECTOMY (CAECUM) * * ** 72641 $ 310.14 5 * * CAECOSTOMY/TUBE - DECOMPRESSION * * ** 72644 $ 578.81 5 * * REVISION OF COLOSTOMY, ILEOSTOMY - WITH REPAIR * * ** 72645 $ 919.12 6 * * CONTINENT ILEOSTOMY * * ** 72646 $ 123.10 5 * * COLOSTOMY OR ILEOSTOMY - MULTIPLE BIOPSIES * * ** 72647 $ 467.60 5 * * INTESTINAL STRICTUROPLASTY - SINGLE * * ** 72648 $ 642.94 5 * * INTESTINAL STRICTUROPLASTY - MULTIPLE * * ** 72651 $ 849.03 5 * * RECONSTRUCTION HARTMANN PROCEDURE - OPEN * * ** 72652 $ 849.03 5 * * HARTMAN PROCEDURE - RECONSTRUCTION - LAPAROSCOPIC * * ** 72653 $ 809.79 5 * * FISTULA - ENTEROVESICAL/COLOVESICAL/COLOVAGINAL * * ** 72654 $ 347.47 5 * * FISTULA - CLOSURE/BOWEL RESECTION * * ** 72656 $ 280.37 4 * * APPENDECTOMY - OPEN * * ** 72657 $ 412.01 5 * * APPENDECTOMY - PERFORATED * * ** 72658 $ 280.37 4 * * APPENDECTOMY - LAPAROSCOPIC * * ** 72659 $ 412.01 5 * * APPENDECTOMY - LAPAROSCOPIC - PERFORATED * * ** 72660 $ 397.39 4 * * APPENDICEAL ABSCESS - INCISION/DRAINAGE * * ** 72662 $ 1,325.83 7 * * PROCTECTOMY, COMPLETE - SYNCHRONOUS ABDOMINAL * * ** 72663 $ 386.91 7 * * PROCTECTOMY, COMPLETE - SYNCHRONOUS PERINEAL * * ** 72664 $ 1,690.22 7 * * PROCTECTOMY, COMPLETE - SUBTOTAL/TOTAL COLECTOMY * * ** 72665 $ 515.34 5 * * PROCTECTOMY, PARTIAL - WITHOUT ANASTOMOSIS * * ** 72666 $ 695.52 3 * * RECTAL PROCIDENTIA - EXCISION * * ** 72667 $ 184.04 2 * * DIVISION OF STRICTURE OF RECTUM * * ** 72669 $ 159.01 2 * * EXCISION OF RECTAL TUMOUR, 0 TO 2.5 CM * * ** 72670 $ 213.51 2 * * TUMOR - RECTAL - EXCISION - 2.6 TO 5 CM. * * ** 72671 $ 441.71 2 * * EXCISION OF RECTAL TUMOUR GREATER THAN 5 CM * * ** 72672 $ 159.01 2 * * TUMOR - RECTAL - MALIGNANT - ELECTRODESICCATION * * ** 77005 $ 79.87 0 * 47 * EMERGENCY VISIT - VASCULAR SURGERY * * ** 77006 $ 21.73 0 * 47 * DIRECTIVE CARE - VASCULAR SURGERY * * ** 77007 $ 23.28 0 * 47 * SUBSEQUENT OFFICE VISIT - VASCULAR SURGERY * * ** 77008 $ 19.87 0 * 47 * SUBSEQUENT HOSPITAL VISIT - VASCULAR SURGERY * * ** 77009 $ 40.02 0 * 47 * SUBSEQUENT HOME VISIT - VASCULAR SURGERY * * ** 77010 $ 116.67 0 * 47 * CONSULTATION - VASCULAR SURGERY * * ** 77012 $ 52.51 0 * 47 * REPEAT OR LIMITED CONSULTATION - VASCULAR SURGERY * * ** 77025 $ 269.16 0 * * SYNCHRONOUS COMBINED BYPASS GRAFT - EXTREMITIES * * ** 77030 $ 269.16 0 * * SECOND OPERATOR: SYNCHRONOUS COMBINED BYPASS GRAFT * * ** 77043 $ 697.25 0 * * RE-DISSECTION OF ARTERY/VEIN * * ** 77045 $ 12.06 0 * * VARICOSE VEIN INJECTION * * ** 77050 $ 72.47 2 * * COMPRESSION SCLEROTHERAPY - UNCOMPLICATED * * ** 77055 $ 109.06 2 * * COMPRESSION SCLEROTHERAPY - COMPLICATED * * ** 77060 $ 33.96 2 * * COMPRESSION SCLEROTHERAPY - REPEAT * * ** 77065 $ 200.00 2 * * HIGH LIGATION, LONG SAPHENOUS * * ** 77070 $ 286.25 2 * * FASCIOTOMY - COMPLETE * * ** 77075 $ 269.16 2 * * GROIN - RE-EXPLORATION, AND/OR POPLITEAL FOSSA * * ** 77077 $ 107.85 3 * * ULCER EXCISION AND GRAFTING * * ** 77079 $ 546.85 7 * * VENOUS CROSSOVER GRAFT FOR ILIAC OBSTRUCTION * * ** 77082 $ 133.44 2 * * FEMORAL VEIN - LIGATION * * ** 77084 $ 444.08 5 * * ACUTE VENOUS: LIGATION OF FEMORAL VEIN * * ** 77086 $ 556.46 5 * * THROMBECTOMY/ACUTE ILIO-FEMORAL THROMBOPHLEBITIS * * ** 77090 $ 847.38 8 * * SPLENO-RENAL SHUNT * * ** 77092 $ 847.38 8 * * PORTO-CAVAL SHUNT * * ** 77094 $ 847.38 8 * * MESOCAVAL GRAFT - SYNTHETIC * * ** 77096 $ 902.20 8 * * MESOCAVAL GRAFT - AUTOGENOUS * * ** 77100 $ 1,214.67 0 * * REMOVAL OF SYNTHETIC GRAFT - WITHOUT REPLACEMENT * * ** 77102 $ 607.34 0 * * REMOVAL OF SYNTHETIC GRAFT, REPLACEMENT SAME SITE * * ** 77104 $ 911.00 0 * * REMOVAL OF SYNTHETIC GRAFT - WITH REPLACEMENT * * ** 77110 $ 112.51 4 * * RE-EXPLORATION OF GROIN FOR BLEEDING OR HAEMATOMA * * ** 77112 $ 118.79 4 * * RE-DISSECTION OF GROIN (AFTER 21 DAYS) * * ** 77115 $ 499.18 5 * * THROMBECTOMY WITH OR WITHOUT ANGIOPLASTY * * ** 77120 $ 556.46 5 * * EMBOLECTOMY - TRUNK OR EXTREMITIES * * ** 77125 $ 400.00 5 * * EMBOLECTOMY - ONE SIDE * * ** 77130 $ 816.40 8 * * CAROTID ARTERIES - BYPASS GRAFT (SYNTHETIC) * * ** 77135 $ 698.61 5 * * INOMINATE - NECK OR THORACIC - BYPASS GRAFT * * ** 77140 $ 759.00 5 * * SUBCLAVIAN - NECK OR THORACIC - BYPASS GRAFT * * ** 77145 $ 228.99 5 * * LIGATION OF CAROTID ARTERY - NECK OR THORACIC * * ** 77150 $ 800.00 9 * * AORTA AND/OR ILIAC BYPASS GRAFT - UNILATERAL * * ** 77155 $ 985.00 9 * * AORTA AND/OR ILIAC BYPASS GRAFT - BILATERAL * * ** 77160 $ 776.85 9 * * AORTO-FEMORAL AND ILIO-FEMORAL BYPASS, UNILATERAL * * ** 77165 $ 985.00 9 * * AORTO-ILIAC, AORTO-FEMORAL, ILIO-FEMORAL BYPASS * * ** 77170 $ 444.08 9 * * ARTERIOVENOUS ANEURYSM * * ** 77175 $ 1,056.08 9 * * ABDOMINAL ANEURYSM, WITH GRAFTING * * ** 77177 $ 1,056.08 9 * 47 * ABDOMINAL AORTIC ANEURYSM REPAIR * * ** 77180 $ 111.27 9 * * RESECTION OF ABDOMINAL ANEURYSM * * ** 77185 $ 1,214.67 10 * * RUPTURED ANEURYSM, WITH GRAFTING * * ** 77190 $ 800.00 7 * * SUPERIOR MESENTERIC BYPASS GRAFT (SYNTHETIC) * * ** 77195 $ 800.00 7 * * SUPERIOR MESENTERIC BYPASS GRAFT (AUTOGENOUS VEIN) * * ** 77200 $ 800.00 7 * * RENAL BYPASS GRAFT (SYNTHETIC) * * ** 77205 $ 800.00 7 * * RENAL BYPASS GRAFT (AUTOGENOUS VEIN) * * ** 77210 $ 665.55 7 * * AXILLO-FEMORAL BYPASS GRAFT (SYNTHETIC)/UNILATERAL * * ** 77215 $ 776.85 7 * * AXILLO-FEMORAL BYPASS GRAFT(SYNTHETIC)/BILATERAL * * ** 77220 $ 741.58 7 * * AXILLO-FEMORAL BYPASS GRAFT (AUTOGENOUS VEIN) * * ** 77230 $ 700.00 5 * * FEMORO-FEMORAL CROSSOVER BYPASS GRAFT (SYNTHETIC) * * ** 77235 $ 700.00 5 * * FEMORO-FEMORAL CROSSOVER BYPASS GRAFT/AUTOGENOUS * * ** 77240 $ 444.08 5 * * FEMORAL BYPASS GRAFT (SYNTHETIC) * * ** 77245 $ 609.36 5 * * INFRAINGUINAL POPLITEAL (ENDARTERECTOMY) * * ** 77250 $ 556.39 5 * * INTRAGUINAL - POPLITEAL (SYNTHETIC) * * ** 77255 $ 665.55 5 * * INTRAGUINAL - ANTERIOR, POST TIBIAL OR PERONEAL * * ** 77260 $ 642.42 5 * * BYPASS GRAFT (AUTOGENOUS VEIN) - FEMORAL * * ** 77265 $ 850.33 5 * * BYPASS GRAFT (AUTOGENOUS VEIN) - POPLITEAL * * ** 77270 $ 892.95 5 * * BYPASS GRAFT/ANTERIOR/POSTERIOR TIBIAL OR PERONEAL * * ** 77275 $ 230.46 7 * * VEIN GRAFT - IN SITU * * ** 77280 $ 228.32 7 * * NON-IPSILATERAL LONG SAPHENOUS GRAFT - AUTOGENOUS * * ** 77285 $ 228.32 7 * * SHORT SAPHENOUS GRAFT * * ** 77290 $ 228.32 7 * * SUPERFICIAL FEMORAL VEIN GRAFT(EXTRA) * * ** 77295 $ 228.32 7 * * ARM VEIN GRAFT * * ** 77300 $ 166.38 7 * * A-V FISTULA WITH BYPASS GRAFT IN LIMB SALVAGE * * ** 77310 $ 495.85 5 * * PROFUNDOPLASTY BYPASS GRAFT (SYNTHETIC) * * ** 77315 $ 673.27 5 * * PROFUNDOPLASTY - EXTENDED * * ** 77330 $ 523.42 6 * * REPAIR OF INJURY OF MAJOR VESSEL IN EXTREMITY - SU * * ** 77335 $ 673.27 6 * * REPAIR OF INJURY OF MAJOR VESSEL IN EXTREMITY * * ** 77340 $ 785.66 9 * * REPAIR OF INJURY OF MAJOR VESSEL IN TRUNK - SUTURE * * ** 77345 $ 1,047.91 9 * * REPAIR OF INJURY OF MAJOR VESSEL IN TRUNK - GRAFT * * ** 77350 $ 102.43 0 * * SUPRA RENAL AORTIC CROSS-CLAMP * * ** 77360 $ 300.00 3 * * DECOMPRESSION FASCIOTOMY - SUBCUTANEOUS * * ** 77370 $ 300.00 3 * * RELEASE OF POPLITEAL ENTRAPMENT SYNDROME * * ** 77380 $ 171.24 3 * * PERMANENT PERITONEAL CATHETER - INSERTION * * ** 77385 $ 118.79 3 * * CHRONIC PERITONEAL CATHETER/REMOVAL BY DISSECTION * * ** 77390 $ 67.39 2 * * REMOVAL OF HAEMODIALYSIS SHUNT * * ** 77395 $ 332.78 4 * * CREATION OF INTERNAL ARTERIO-VENOUS FISTU * * ** 77400 $ 444.08 4 * * A-V SHUNT WITH BOVINE GRAFT * * ** 77405 $ 312.94 3 * * THROMBECTOMY OF ARTERIO-VENOUS FISTULA * * ** 77410 $ 35.68 0 * * CANNULA DECLOTTING * * ** 77420 $ 332.78 4 * * LUMBAR SYMPATHECTOMY - UNILATERAL * * ** 77422 $ 450.00 5 * * CERVICAL SYMPATHECTOMY - UNILATERAL * * ** 77424 $ 411.02 7 * * PREGANGLIONIC SYMPATHECTOMY; UPPER DORSAL REGION * * ** 77426 $ 411.02 7 * * LUMBO-DORSAL SYMPATHECTOMY & SPLANCHNIC NEURECTOMY * * ** 77428 $ 111.28 3 * * LUMBAR SYMPATHECTOMY - UNILATERAL (EXTRA) * * ** 77430 $ 222.59 0 * * LUMBAR SYMPATHECTOMY - BILATERAL (EXTRA) * * ** 77440 $ 750.02 7 * * IMPLANTATION OF KIDNEY GRAFT - VASCULAR SURGEON * * ** 78041 $ 1,331.92 9 * 12 * LASER LEAD EXTRACTION - FIRST LEAD * * ** 78042 $ 500.00 9 * 12 * LASER LEAD EXTRACTION - ADDITIONAL LEADS - EXTRA * * ** 78043 $ 50.00 9 * 12 * DEBRIDEMENT CHEST WALL WITH 78041 - EXTRA * * ** 78044 $ 100.00 9 * 12 * WIDE DEBRIDEMENT CHEST WALL WITH 78041-EXTRA * * ** 79005 $ 78.33 0 * 48 * EMERGENCY VISIT - THORACIC SURGERY * * ** 79007 $ 22.83 0 * 48 * SUBSEQUENT OFFICE VISIT - THORACIC SURGERY * * ** 79008 $ 19.48 0 * 48 * SUBSEQUENT HOSPITAL VISIT - THORACIC SURGERY * * ** 79009 $ 39.25 0 * 48 * SUBSEQUENT HOME VISIT - THORACIC SURGERY * * ** 79010 $ 114.41 0 * 48 * CONSULTATION - THORACIC SURGERY * * ** 79012 $ 51.49 0 * 48 * REPEAT OR LIMITED CONSULTATION - THORACIC SURGERY * * ** 79015 $ 1,073.79 8 * * LOBECTOMY * * ** 79020 $ 194.69 9 * * BRONCHOPLASTY (EXTRA TO LOBECTOMY) * * ** 79025 $ 1,166.72 9 * * PNEUMONECTOMY - LUNG * * ** 79030 $ 1,073.79 8 * * SEGMENTAL RESECTION - LUNG * * ** 79035 $ 602.46 8 * * THORACOTOMY - INCLUDING WEDGE RESECTION * * ** 79040 $ 402.66 8 * * DRAINAGE OF ABSCESS LUNG * * ** 79045 $ 609.30 8 * * THORACOTOMY W/WO BIOPSY OR REMOVAL FOREIGN BODY * * ** 79050 $ 939.37 8 * * DECORTICATION OF LUNG * * ** 79055 $ 602.46 8 * * PLEURECTOMY * * ** 79060 $ 809.04 8 * * INTRATHORACIC TUMOR - WITHOUT LUNG INVOLVEMENT * * ** 79065 $ 758.92 10 * * TRACHAEL RESECTION * * ** 79070 $ 374.60 10 * * TRACHEAL RESECTION - WITH LARYNGEAL RELEASE * * ** 79075 $ 374.60 10 * * TRACHEAL RESECTION - WITH HILAR RELEASE * * ** 79080 $ 750.37 10 * * BRONCHOPLEURAL FISTULA CLOSURE * * ** 79085 $ 758.92 9 * * REPAIR OF RUPTURED BRONCHUS * * ** 79095 $ 838.10 8 * * MEDIASTINAL CYST OR TUMOUR * * ** 79100 $ 626.08 8 * * MEDIASTINUM - THYMECTOMY * * ** 79105 $ 391.87 6 * * RIB RESECTION FOR EMPYEMA * * ** 79110 $ 391.87 6 * * CLOSURE OF PLEUROSTOMY RE:LONGTERM CARE OF EMPYEMA * * ** 79115 $ 611.01 8 * * PECTUS EXCAVATUM AND CARINATUM * * ** 79120 $ 611.01 6 * * THORACOPLASTY * * ** 79125 $ 283.92 5 * * CERVICAL RIB RESECTION * * ** 79130 $ 683.78 5 * * TRANS-AXILLARY RESECTION OF FIRST RIB * * ** 79135 $ 799.95 6 * * CHEST WALL TUMOUR WITH RIB RESECTION * * ** 79140 $ 158.03 3 * * SCALENOTOMY - ANTERIOR * * ** 79207 $ 22.83 0 * 48 * TELEHEALTH SUBSEQUENT OFFICE VISIT THORACIC SURG * * ** 79208 $ 19.48 0 * 48 * TELEHEALTH SUBSEQUENT HOSP VISIT THORACIC SURGERY * * ** 79210 $ 114.41 0 * 48 * TELEHEALTH CONSULTATION - THORACIC SURGERY * * ** 79212 $ 51.49 0 * 48 * TELEHEALTH REPEAT OR LIMITED CONSULT - THORACIC * * ** 83000 $ 75.00 0 * 16 * INTERVENTIONAL RADIOLOGY CONSULTATION * * ** 86047 $ 55.74 0 * 16 * BREAST SONOGRAM - UNILATERAL * * ** 86048 $ 27.87 0 * 16 * BREAST SONOGRAM - ADDITIONAL SIDE * * ** 90000 $ 4.63 0 * * VENEPUNCTURE * * ** 90020 $ 15.15 0 * * ABO TYPING * * ** 90025 $ 31.19 0 * * ABO OTHER GROUPS * * ** 90027 $ 39.99 0 * * ACTIVATED PROTEIN C RESISTANCE (APCR * * ** 90030 $ 42.84 0 * * ALPHA 2 ANTIPLASMIN ASSAY * * ** 90035 $ 19.27 0 * * ANTI-DNA * * ** 90036 $ 23.15 0 * * ANTIPHOSPHATIDYLSERINE (LGG) * * ** 90037 $ 17.49 0 * * ANTIPHOSPHATIDYLSERINE (LGM) * * ** 90038 $ 24.28 0 * * ANTI SACCHAROMYCES CEREVISIAE (ASCA) LGA * * ** 90039 $ 19.60 0 * * ANTI SACCHAROMYCES CEREVISIAE (ASCA)LGG * * ** 90040 $ 31.91 0 * * ANTI-THROMBIN III/COAGULATION PROTEINS - BYCHROMOG * * ** 90042 $ 88.67 0 * * ANTI-XA HEPARIN ASSAY * * ** 90045 $ 212.78 0 * * EXAMINATION - BONE MARROW * * ** 90050 $ 54.74 0 * * CIRCULATING ANTICOAGULANT - INCUBATED - 1+ PLASMA * * ** 90055 $ 28.77 0 * * CIRCULATING INHIBITOR SCREEN - UNINCUBATED-SIMPLE * * ** 90060 $ 5.83 0 * * CLOT RETRACTION * * ** 90063 $ 42.86 0 * * COAGULATION FACTOR/CLOTTING ASSAY * * ** 90065 $ 13.64 0 * * COLD AGGLUTININS - QUALITATIVE * * ** 90070 $ 25.81 0 * * COLD AGGLUTININS - QUANTITATIVE * * ** 90072 $ 49.47 0 * * COLLAGEN BINDING ASSAY * * ** 90073 $ 13.19 0 * * DILUTE RUSSELL VIPER VENOM TIME * * ** 90075 $ 9.81 0 * * CELL COUNT - DIFFERENTIAL * * ** 90080 $ 23.41 0 * * ANTIGLOBULIN COOMBS TEST - DIRECT * * ** 90085 $ 14.14 0 * * DONATH-LANDSTEINER * * ** 90090 $ 10.01 0 * * EOSINOPHIL COUNT * * ** 90095 $ 27.81 0 * * ERYTHROPOIETIN (EPO) ASSAY * * ** 90100 $ 90.74 0 * * ESTIMATION- B LYMPHOCYTES * * ** 90105 $ 66.47 0 * * ESTIMATION - LYMPHOCYTE -ROSETTE FORMATION * * ** 90110 $ 15.35 0 * * EUGLOBULIN LYSIS TIME * * ** 90115 $ 51.55 0 * * EXAMINATION - EOSINOPHILS/SECRETIONS/EXCRETIONS * * ** 90120 $ 29.17 0 * * ENA (EXTRACTABLE NUCLEAR ANTIGENS)) * * ** 90123 $ 50.43 0 * * FACTOR II ASSAY - QUANTITATIVE ONLY * * ** 90125 $ 49.62 0 * * FACTOR V * * ** 90127 $ 73.33 0 * * FACTOR V LEIDEN/PGM - 1ST GENE * * ** 90128 $ 46.26 0 * * FACTOR V LEIDEN/PGM - 2ND GENE * * ** 90130 $ 48.26 0 * * FACTOR VII ASSAY * * ** 90135 $ 48.59 0 * * FACTOR VIII C ASSAY * * ** 90140 $ 84.46 0 * * FACTOR VIII:C INHIBITOR ASSAY (BETHESDA TITRE) * * ** 90145 $ 54.72 0 * * FACTOR IX ASSAY * * ** 90150 $ 48.26 0 * * FACTOR XI * * ** 90155 $ 48.26 0 * * FACTOR X ASSAY * * ** 90160 $ 48.26 0 * * FACTOR XII ASSAY * * ** 90165 $ 15.33 0 * * FACTOR XIII SCREEN * * ** 90170 $ 22.17 0 * * FIBRIN/FIBRINOGEN DEGRADATION/INCLUDING D - DIMER * * ** 90175 $ 17.65 0 * * FOETAL HAEMOGLOBIN * * ** 90180 $ 17.93 0 * * FOETAL CELL STAIN * * ** 90185 $ 40.90 0 * * GLUCOSE-6-PHOSPHATE DEHYDROGENASE * * ** 90190 $ 55.61 0 * * GLUCOSE-6-PHOSPHATE DEHYDROGENASE ASSAY * * ** 90200 $ 26.14 0 * * HAM TEST * * ** 90205 $ 10.47 0 * * HAEMATOLOGY PROFILE * * ** 90210 $ 27.41 0 * * HAEMATOLOGY SPECIAL STAINS - ROUTINE * * ** 90215 $ 40.11 0 * * HAEMATOLOGY SPECIAL STAINS - COMPLEX * * ** 90220 $ 13.48 0 * * HAEMOGLOBIN A2 FRACTIONATION * * ** 90225 $ 3.07 0 * * HAEMOGLOBIN-CYANMETHAEMOGLOBIN * * ** 90230 $ 10.32 0 * * HAEMOGLOBIN ONLY * * ** 90235 $ 1.45 0 * * HAEMOGLOBIN - OTHER METHODS * * ** 90240 $ 28.11 0 * * HAEMOGLOBIN ELECTROPHORESIS * * ** 90245 $ 64.63 0 * * HAEMOGLOBIN-H INCLUSION BODIES * * ** 90250 $ 104.32 0 * * HLA - DR PHENOTYPING * * ** 90255 $ 91.97 0 * * HLA-DR TYPING - SOLID ORGAN/BONE MARROW TRANSPLANT * * ** 90260 $ 107.67 0 * * HLA GENOTYPING * * ** 90265 $ 38.69 0 * * HLA - SINGLE ANTIGEN * * ** 90270 $ 78.88 0 * * CIRCULATING LYMPHOCYTOXIC ANTIBODIES * * ** 90275 $ 58.71 0 * * CIRCULATING LYMPHOCYTOXIC ANTIBODIES * * ** 90280 $ 22.71 0 * * IMMUNOFLUORESCENT STAINING - AUTOANTIBODIES * * ** 90285 $ 25.77 0 * * IMMUNOFLUORESCENT STAINING - AUTOANTIBODIES * * ** 90290 $ 212.98 0 * * IMMUNOPHENOTYPING BY FLOW CYTOMETRY- PERIPHERAL * * ** 90295 $ 32.81 0 * * IMMUNOPHENOTYPING/FLOW CYTOMETRY - EACH ADDITIONAL * * ** 90300 $ 14.19 0 * * COOMBS - INDIRECT * * ** 90305 $ 16.30 0 * * SLIDE AGGLUTINATION - INFECTIOUS MONONUCLEOSIS * * ** 90310 $ 25.09 0 * * IVY TEMPLATE - BLEEDING TIME * * ** 90315 $ 8.03 0 * * LATEX TEST (RHEUMATOID FACTOR) * * ** 90320 $ 39.90 0 * * LEUCOCYTE ALKALINE PHOSPHATASE * * ** 90325 $ 100.15 0 * * LYMPHOCYTE STIMULATION TEST * * ** 90330 $ 30.30 0 * * LYMPHOCYTE STIMULATION TEST - EACH ADDITIONAL * * ** 90335 $ 58.93 0 * * MALARIA/OTHER PARASITES * * ** 90340 $ 156.13 0 * * MARROW FILMS -INTERPRETATION * * ** 90345 $ 98.74 0 * * MARROW/PERIPHERAL BLOOD STEM CELLS * * ** 90350 $ 106.25 0 * * MIXED LEUKOCYTE CULTURE - DONOR/RECIPIENT * * ** 90355 $ 121.87 0 * * MIXED LEUKOCYTE CULTURE - EACH ADDITIONAL * * ** 90357 $ 106.25 0 * * NEUTROPHIL OXIDATIVE BURST ASSAY * * ** 90360 $ 28.69 0 * * NITRO BLUE TETRAZOLIUM TEST * * ** 90365 $ 73.46 0 * * OXYGEN DISASSOCIATION CURVE * * ** 90370 $ 6.26 0 * * THROMBOPLASTIN TEST, PARTIAL * * ** 90375 $ 40.77 0 * * PARTIAL THROMBOPLASTIN TIME - SUBSTITUTION TEST * * ** 90377 $ 40.28 0 * * PHOSPHOLIPID NEUTRALIZATION TEST - CONFIRM LUPUS * * ** 90380 $ 15.90 0 * * PLASMA HAEMOGLOBIN * * ** 90385 $ 43.22 0 * * PLASMINOGEN ASSAY * * ** 90390 $ 32.47 0 * * PLATELET ANTIBODIES * * ** 90395 $ 9.56 0 * * PLATELET COUNT ONLY * * ** 90400 $ 4.37 0 * * PLATELET ESTIMATION - FILM * * ** 90405 $ 20.67 0 * * PLATELET FUNCTION AGGREGATION * * ** 90410 $ 15.28 0 * * PREPARATION OF PACKED CELLS, PER UNIT * * ** 90415 $ 15.25 0 * * PLASMA PREPARATION * * ** 90420 $ 48.93 0 * * PROTEIN C ACTIVITY * * ** 90425 $ 52.94 0 * * PROTEIN C ANTIGEN * * ** 90427 $ 36.10 0 * * PROTEIN S ACTIVITY (CLOT BASED) * * ** 90430 $ 40.99 0 * * PROTEIN S FREE ANTIGEN * * ** 90435 $ 38.61 0 * * PROTEIN S TOTAL ANTIGEN * * ** 90440 $ 10.68 0 * * PROTHROMBIN TIME/INR * * ** 90445 $ 71.15 0 * * PYRUVIC KINASE ASSAY * * ** 90450 $ 12.53 0 * * PYRUVIC KINASE TEST * * ** 90455 $ 47.66 0 * * RAJI CELL ASSAY * * ** 90460 $ 6.50 0 * * RBC ANTIBODY DETECTION, ALBUMIN OR ENZYME TUBES * * ** 90465 $ 16.53 0 * * R.B.C. MORPHOLOGY * * ** 90470 $ 30.64 0 * * RED CELL FOLATE * * ** 90475 $ 16.74 0 * * RED CELL FRAGILITY SCREENING TEST * * ** 90480 $ 54.47 0 * * RED CELL FRAGILITY INCUBATED * * ** 90485 $ 38.52 0 * * REPTILASE TIME * * ** 90490 $ 11.00 0 * * RETICULOCYTE COUNT AND/OR HEINZ BODIES * * ** 90495 $ 9.79 0 * * RH (D) TYPING * * ** 90500 $ 38.83 0 * * RH GENOTYPE * * ** 90505 $ 73.07 0 * * RISTOCETIN CO-FACTOR ASSAY * * ** 90510 $ 7.15 0 * * SALINE TUBES (PER TUBE) * * ** 90512 $ 6.97 0 * * SECRETION SMEAR FOR EOSINOPHILS * * ** 90515 $ 10.12 0 * * SEDIMENTATION RATE * * ** 90520 $ 19.47 0 * * SERUM HAPTOGLOBIN * * ** 90525 $ 71.99 0 * * SICKLE CELL IDENTIFICATION * * ** 90530 $ 26.65 0 * * STYPVEN PROTHROMBIN TIME * * ** 90535 $ 10.11 0 * * SUGAR WATER TEST (P.N.H.) * * ** 90540 $ 62.40 0 * * THALASSAEMIA/HAEMOGLOBINOPATHY INVESTIGATION * * ** 90545 $ 7.93 0 * * THROMBIN TIME * * ** 90550 $ 32.25 0 * * DPG ASSAY 2-3 * * ** 90555 $ 101.43 0 * * VON WILLEBRAND FACTOR ANTIGEN * * ** 90560 $ 83.64 0 * * VON WILLEBRAND FACTOR - MULTIMER ANALYSIS * * ** 90565 $ 67.21 0 * * WHITE BLOOD CELLS AGGLUTININS * * ** 90570 $ 9.49 0 * * WHITE CELL COUNT ONLY * * ** 90600 $ 22.74 0 * * ACID FAST ORGANISMS - CULTURE * * ** 90605 $ 11.22 0 * * ANAEROBIC CULTURE INVESTIGATION * * ** 90610 $ 62.57 0 * * SERUM BACTERICIDAL TEST * * ** 90615 $ 11.07 0 * * ANTIBIOTIC SUSCEPTIBILITY TEST - SEMI-QUANTITATIVE * * ** 90620 $ 9.10 0 * * BIOCHEMICAL IDENTIFICATION - MICRO-ORGANISM * * ** 90625 $ 34.39 0 * * BLOOD CULTURE - AEROBIC/ANAEROBIC MEDIA * * ** 90630 $ 15.86 0 * * C. DIFFICILE TOXIN - IMMUNOLOGICAL * * ** 90640 $ 6.50 0 * * CANDIDA CULTURE * * ** 90645 $ 15.86 0 * * CHLAMYDIA ANTIGEN * * ** 90650 $ 40.36 0 * * CHLAMYDIA CULTURE * * ** 90651 $ 24.00 0 * * CHLAMYDIA TRACHOMATIS USING NAT * * ** 90652 $ 22.96 0 * * CHLAMYDIA TRACHOMATIS USING NAT * * ** 90655 $ 17.25 0 * * CLOSTRIDIUM DIFFICILE TOXIN - TISSUE CULTURE * * ** 90660 $ 19.92 0 * * DIPHTHERIA ANTIBODIES * * ** 90665 $ 20.40 0 * * FUNGUS CULTURE * * ** 90670 $ 13.11 0 * * FUNGUS DIRECT EXAMINATION KOH PREPARATION * * ** 90675 $ 14.01 0 * * HEPATITIS BE ANTIGEN * * ** 90685 $ 17.36 0 * * HEPATITIS A - IGM ANTIBODY (ANTI-HAV-IGM) * * ** 90690 $ 10.35 0 * * HEPATITIS B CORE ANTIBODY (ANTI-HBC) * * ** 90700 $ 10.56 0 * * HEPATITIS B SURFACE ANTIBODY (ANTI-HBS) * * ** 90710 $ 15.20 0 * * PROSTATIC SPECIFIC ANTIGEN (PSA) * * ** 90715 $ 15.89 0 * * ROTAVIRUS ANTIGEN * * ** 90720 $ 14.58 0 * * ROUTINE CULTURE * * ** 90725 $ 15.20 0 * * SEROLOGICAL IDENTIFICATION -MICRO-ORGANISM * * ** 90730 $ 11.67 0 * * SMEAR - INCLUSION BODIES * * ** 90736 $ 14.72 0 * * CERVICAL CULTURE * * ** 90737 $ 14.68 0 * * VAGINAL CULTURE * * ** 90738 $ 20.17 0 * * URETHERAL CULTURE * * ** 90739 $ 14.68 0 * * COMBINED VAGINO-ANORECTAL OR VAGINAL CULTURE * * ** 90740 $ 15.93 0 * * STAINED SMEAR * * ** 90741 $ 24.09 0 * * GENITAL CULTURE - OTHER SITE * * ** 90745 $ 16.12 0 * * STOOL CULTURE * * ** 90750 $ 13.76 0 * * BIOCHEMICAL IDENTIFICATION - MICRO-ORGANISM/STOOL * * ** 90755 $ 11.94 0 * * STREPTOCOCCAL ENZYME SLIDE TEST * * ** 90760 $ 12.42 0 * * STREPTOCOCCI - RAPID TEST * * ** 90765 $ 11.05 0 * * ANTI-STREPTOLYSIN * * ** 90770 $ 19.92 0 * * TETANUS ANTIBODIES * * ** 90775 $ 17.33 0 * * THROAT OR NOSE CULTURE * * ** 90780 $ 17.34 0 * * THROAT OR NOSE CULTURE - ADDITIONAL * * ** 90785 $ 11.09 0 * * TRICHOMONAS AND/OR CANDIDA, DIRECT EXAMINATION * * ** 90790 $ 18.65 0 * * URINE COLONY COUNT CULTURE * * ** 90795 $ 41.89 0 * * PINWORM OVA - EXAMINATION * * ** 90800 $ 44.74 0 * * STOOL EXAMINATION - CONCENTRATION METHOD * * ** 90805 $ 40.95 0 * * PARASITE - MACROSCOPIC/MICROSCOPIC EXAM * * ** 90810 $ 44.74 0 * * STOOL EXAMINATION - AMOEBAE * * ** 90815 $ 34.70 0 * * SEROLOGICAL TESTS - 1-3 ANTIGENS * * ** 90820 $ 35.78 0 * * SEROLOGICAL TESTS - > 4 ANTIGENS * * ** 90825 $ 26.19 0 * * SMEAR/SECTION - ELECTRON MICROSCOPY * * ** 90830 $ 44.57 0 * * VIRUS ISOLATION * * ** 91000 $ 14.89 0 * * PRIMARY BASE FEE * * ** 91005 $ 6.70 0 * * SPLIT BASE FEE (COLLECTING FACILITY) * * ** 91010 $ 6.70 0 * * SPLIT BASE FEE (REFERRAL FACILITY) * * ** 91020 $ 97.16 0 * * ACETYLCHOLINE RECEPTOR ANTIBODIES - QUALITATIVE * * ** 91021 $ 159.67 0 * * ACETYLCHOLINE RECEPTOR ANTIBODIES - QUANTITATIVE * * ** 91023 $ 88.29 0 * * ACETYL COA: A-GLUCOSAMINIDE-N-ACETYL TRANSFERASE, * * ** 91025 $ 19.23 0 * * ACID ALPHA-1 GLYCOPROTEIN * * ** 91027 $ 48.29 0 * * ACID LIPASE, WITE BLOOD CELLS * * ** 91030 $ 12.87 0 * * ACID PHOSPHATASE, TOTAL * * ** 91031 $ 12.87 0 * * ACID PHOSPHATASE, FRACTIONS - EACH * * ** 91035 $ 34.45 0 * * ACTH, PLASMA * * ** 91036 $ 42.62 0 * * ACTH STIMULATION TEST * * ** 91037 $ 38.89 0 * * ACYLCARNITINE PROFILING * * ** 91040 $ 1.47 0 * * ALBUMIN, SERUM/PLASMA * * ** 91042 $ 1.00 0 * * ALBUMIN - TRANSUDATE/EXUDATE * * ** 91050 $ 19.82 0 * * ALCOHOL * * ** 91055 $ 13.30 0 * * ALDOLASE * * ** 91060 $ 161.03 0 * * ALDOSTERONE, PLASMA/SERUM * * ** 91061 $ 161.03 0 * * ALDOSTERONE, URINE * * ** 91065 $ 1.39 0 * * ALANINE AMINOTRANSFERASE * * ** 91070 $ 1.49 0 * * ALKALINE PHOSPHATASE * * ** 91075 $ 15.37 0 * * ALLERGEN SPECIFIC IGE ASSAY * * ** 91080 $ 19.13 0 * * ALPHA-1 ANTITRYPSIN * * ** 91090 $ 12.28 0 * * ALPHA FETOGLOBULIN * * ** 91095 $ 23.64 0 * * ALPHA FETOPROTEIN * * ** 91096 $ 48.29 0 * * ALPHA-IDURONIDASE, WHITE BLOOD CELLS * * ** 91097 $ 48.29 0 * * ALPHA-MANNOSIDASE, WHITE BLOOD CELLS * * ** 91100 $ 46.90 0 * * ALUMINUM * * ** 91105 $ 73.88 0 * * AMINO ACID, QUANTITATIVE, CHROMATOGRAPHY * * ** 91110 $ 51.13 0 * * AMINO ACIDS-URINE, CHROMATOGRAPHY * * ** 91115 $ 7.06 0 * * AMMONIA * * ** 91120 $ 51.91 0 * * AMNIOTIC FLUID EXAMINATION/WRITTEN INTERPRETATION * * ** 91125 $ 12.94 0 * * AMYLASE CYST * * ** 91126 $ 5.02 0 * * AMYLASE, SERUM/PLASMA * * ** 91127 $ 12.87 0 * * AMYLASE, TRANSUDATE/EXUDATE * * ** 91128 $ 7.18 0 * * AMYLASE, URINE * * ** 91130 $ 24.96 0 * * PROTEINASE 3 ANTINEUTROPHIL CYTOPLASMIC ANTIBODY * * ** 91135 $ 34.40 0 * * ANDROSTENEDIONE, PLASMA * * ** 91140 $ 17.64 0 * * ANGIOTENSIN CONVERTING ENZYME (ACE)-SERUM ANALYSIS * * ** 91142 $ 107.22 0 * * ANTI-DIURETIC HORMONE (ADH), PLASMA * * ** 91145 $ 46.20 0 * * ANTICARDIOLIPIN AB, IGG * * ** 91146 $ 56.48 0 * * ANTICARDIOLIPIN AB, IGM * * ** 91150 $ 88.94 0 * * ANTI-ENDOMYSIUM ANTIBODIES * * ** 91155 $ 24.53 0 * * ANTIGLOMERULAR BASEMENT MEMBRANE ANTIBODY * * ** 91160 $ 42.66 0 * * ANTIMYELOPEROXIDASE ANTIBODY * * ** 91162 $ 23.05 0 * * ANTI-TISSUE TRANSGLUTAMINASE ANTIBODIES(ANTI-TTG) * * ** 91165 $ 19.23 0 * * APOLIPOPROTEIN A - 1 * * ** 91170 $ 19.23 0 * * APOLIPOPROTEIN B - 100 * * ** 91175 $ 31.63 0 * * APOLIPOPROTEIN E ISOFORMS * * ** 91180 $ 88.46 0 * * APOPROTEIN E GENOTYPING * * ** 91185 $ 41.37 0 * * ARSENIC * * ** 91190 $ 48.40 0 * * ARYL SULFATASE A, FIBROBLASTS * * ** 91191 $ 48.40 0 * * ARYL SULFATASE A, WHITE BLOOD CELLS * * ** 91195 $ 48.40 0 * * ARYL SULFATASE B, FIBROBLASTS * * ** 91196 $ 48.40 0 * * ARYL SULFATASE B, WHITE BLOOD CELLS * * ** 91200 $ 48.40 0 * * ARYL SULFATASE C, FIBROBLASTS * * ** 91201 $ 48.40 0 * * ARYL SULFATASE C, WHITE BLOOD CELLS * * ** 91205 $ 25.22 0 * * ASCORBIC ACID (VITAMIN C) * * ** 91206 $ 7.80 0 * * ASCORBIC ACID (VITAMIN C) - URINE * * ** 91210 $ 1.64 0 * * ASPARTATE AMINOTRANSFERASE * * ** 91215 $ 48.40 0 * * B-GALACTOSIDASE, FIBROBLASTS * * ** 91216 $ 48.40 0 * * B-GALACTOSIDASE, WHITE BLOOD CELLS * * ** 91220 $ 48.40 0 * * B-GLUCOSIDASE, FIBROBLASTS * * ** 91221 $ 48.40 0 * * B-GLUCOSIDASE, WHITE BLOOD CELLS * * ** 91225 $ 11.81 0 * * BARBITURATES - QUALITATIVE * * ** 91226 $ 33.94 0 * * BARBITURATES - QUANTITATIVE * * ** 91227 $ 8.93 0 * * BARBITURATES - QUALITATIVE - GASTRIC * * ** 91228 $ 8.96 0 * * BARBITURATES - QUALITATIVE - URINE * * ** 91230 $ 19.23 0 * * BETA - 2 - MICROGLOBULIN * * ** 91231 $ 48.29 0 * * BETA-GLUCURONIDASE, WHITE BLOOD CELLS * * ** 91232 $ 48.29 0 * * BETA-MANNOSIDASE WHITE BLOOD CELLS * * ** 91235 $ 2.25 0 * * BICARBONATE, SERUM/PLASMA * * ** 91236 $ 1.00 0 * * BICARBONATE, URINE * * ** 91240 $ 2.21 0 * * BILE PIGMENTS AND SALTS, QUALITATIVE, URINE * * ** 91245 $ 1.53 0 * * BILIRUBIN TOTAL, SERUM/PLASMA * * ** 91246 $ 1.00 0 * * BILIRUBIN TOTAL, TRANSUDATE/EXUDATE * * ** 91250 $ 1.50 0 * * BILIRUBIN, DIRECT * * ** 91255 $ 2.29 0 * * BLOOD, QUALITATIVE, GASTRIC * * ** 91260 $ 16.73 0 * * BONE GLA PROTEIN (OSTEOCALCIN) * * ** 91265 $ 15.34 0 * * BROMIDES, QUANTITATIVE * * ** 91270 $ 9.88 0 * * BROMIDES, QUALITATIVE, URINE * * ** 91280 $ 21.80 0 * * C - 1Q ESTERASE INHIBITORS * * ** 91285 $ 9.16 0 * * C - 3 COMPLEMENT * * ** 91290 $ 9.40 0 * * C - 4 COMPLEMENT * * ** 91295 $ 45.21 0 * * C - PEPTIDE * * ** 91300 $ 9.83 0 * * C - REACTIVE PROTEIN * * ** 91305 $ 20.24 0 * * CA 15 - 3 * * ** 91310 $ 21.66 0 * * CA 125 * * ** 91315 $ 19.91 0 * * CA 19 -9 * * ** 91320 $ 48.27 0 * * CALCITONIN * * ** 91325 $ 5.22 0 * * CALCIUM, TIMED URINE COLLECTION * * ** 91326 $ 1.47 0 * * CALCIUM TOTAL, SERUM/PLASMA * * ** 91327 $ 18.58 0 * * CALCIUM, 24 HOURS EXCRETION, FECES * * ** 91328 $ 1.00 0 * * CALCIUM, URINE RANDOM * * ** 91330 $ 26.56 0 * * CALCULUS ANALYSIS, URINE * * ** 91335 $ 14.60 0 * * CARBAMAZEPINE * * ** 91340 $ 16.76 0 * * CARBON MONOXIDE, QUANTITATIVE * * ** 91345 $ 8.49 0 * * CAROTENE * * ** 91350 $ 56.50 0 * * CATECHOLAMINES * * ** 91351 $ 38.89 0 * * CATECHOLAMINES FRACTIONS-SEPARATION/INTERPRETATION * * ** 91352 $ 44.28 0 * * CATECHOLAMINES, TOTAL URINE * * ** 91353 $ 5.14 0 * * CELLS COUNT - EXAMINATION FOR FAECES * * ** 91355 $ 27.42 0 * * CELL COUNT - CSF/OTHER FLUIDS * * ** 91356 $ 11.16 0 * * CELL COUNT - FILM/DIFFERENTIAL * * ** 91360 $ 9.68 0 * * CERULOPLASMIN * * ** 91365 $ 6.78 0 * * CHLORIDE, QUANTITATIVE, CSF/OTHER FLUIDS * * ** 91366 $ 1.41 0 * * CHLORIDE, SERUM/PLASMA * * ** 91367 $ 9.59 0 * * CHLORIDE, TIMED URINE COLLECTION * * ** 91368 $ 3.11 0 * * CHLORIDE, URINE RANDOM * * ** 91369 $ 1.00 0 * * CHLORIDE, WHOLE BLOOD * * ** 91370 $ 73.00 0 * * CHLORIDE - IONTOPHORESIS, SWEAT * * ** 91375 $ 6.57 0 * * CHOLESTEROL, TOTAL * * ** 91380 $ 28.52 0 * * CHOLINESTERASE/DIBUCAINE NUMBER * * ** 91386 $ 34.21 0 * * CHROMATOGRAPHY, KETO ACIDS * * ** 91387 $ 29.58 0 * * CHROMATOGRAPHY, REDUCING SUBSTANCES, URINE * * ** 91388 $ 30.77 0 * * CHROMATOGRAPHY, THIN LAYER (TLC) * * ** 91389 $ 26.11 0 * * CK-MB * * ** 91390 $ 18.48 0 * * COMPLEMENT ASSAY * * ** 91395 $ 41.66 0 * * COMPLEMENT, TOTAL HAEMOLYTIC (CH 100) * * ** 91400 $ 46.90 0 * * COPPER, SERUM * * ** 91401 $ 46.89 0 * * COPPER, TISSUE * * ** 91402 $ 46.90 0 * * COPPER, URINE * * ** 91405 $ 12.66 0 * * CORTISOL * * ** 91410 $ 12.00 0 * * CREATINE, TIMED URINE COLLECTION * * ** 91415 $ 1.79 0 * * CREATINE KINASE * * ** 91420 $ 4.86 0 * * CREATININE, RANDOM URINE * * ** 91421 $ 1.44 0 * * CREATININE, SERUM/PLASMA * * ** 91422 $ 5.54 0 * * CREATININE, TIMED URINE COLLECTION * * ** 91425 $ 16.38 0 * * CRYOFIBRINOGEN * * ** 91430 $ 568.94 0 * * SKIN FIBROBLASTS-CULTURING/BIOCHEMICAL/DNA * * ** 91434 $ 42.14 0 * * CYCLIC AMP, PLASMA/SERUM * * ** 91435 $ 42.82 0 * * CYCLIC A.M.P., URINE * * ** 91440 $ 39.96 0 * * CRYOGLOBULINS * * ** 91445 $ 19.23 0 * * CSF - ALBUMIN * * ** 91450 $ 19.23 0 * * CSF - IMMUNOGLOBULIN G * * ** 91455 $ 22.37 0 * * CYCLOSPORINE * * ** 91460 $ 17.68 0 * * DEHYDROEPIANDROSTERONE, SERUM (DHEA) * * ** 91465 $ 18.09 0 * * DIGOXIN * * ** 91470 $ 58.78 0 * * DISACCHARIDES, INTESTINAL * * ** 91475 $ 58.33 0 * * DOPAMINE, QUANTITATIVE * * ** 91480 $ 43.99 0 * * ACETAZOLAMIDE * * ** 91482 $ 10.93 0 * * ACETAMINOPHEN (QUANTITATIVE) * * ** 91484 $ 43.84 0 * * AMIKACIN * * ** 91486 $ 43.84 0 * * AMIODARONE * * ** 91488 $ 23.21 0 * * AMITRYPTYLINE * * ** 91490 $ 43.84 0 * * AMOXAPINE * * ** 91492 $ 43.84 0 * * CHLORPROMAZINE * * ** 91494 $ 23.51 0 * * CITRATE, URINE * * ** 91496 $ 46.85 0 * * CLOBAZAM * * ** 91498 $ 46.94 0 * * CLOMIPRAMINE * * ** 91500 $ 43.84 0 * * CLONAZEPAM * * ** 91502 $ 26.32 0 * * CLOZAPINE * * ** 91504 $ 23.21 0 * * CYANIDE * * ** 91506 $ 23.21 0 * * DESIPRAMINE * * ** 91508 $ 43.84 0 * * DESMETHYLCLOBAZAM * * ** 91510 $ 43.84 0 * * DIAZEPAM * * ** 91512 $ 43.84 0 * * DISOPYRAMIDE * * ** 91514 $ 43.84 0 * * DOXEPIN * * ** 91516 $ 43.84 0 * * FLUOXETINE * * ** 91518 $ 43.84 0 * * FLUPENTHIXOL * * ** 91520 $ 43.84 0 * * FLUPHENAZINE * * ** 91522 $ 43.84 0 * * FLUVOXAMINE * * ** 91523 $ 23.21 0 * * GABAPENTIN * * ** 91524 $ 25.45 0 * * GENTAMYCIN * * ** 91526 $ 23.20 0 * * HALOPERIDOL * * ** 91528 $ 43.84 0 * * IMIPRAMINE * * ** 91529 $ 23.21 0 * * LAMOTRIGINE * * ** 91530 $ 42.14 0 * * LIDOCAINE * * ** 91532 $ 43.84 0 * * LORAZEPAM * * ** 91534 $ 43.84 0 * * LOXAPINE * * ** 91536 $ 43.84 0 * * MAPROTILINE * * ** 91538 $ 43.84 0 * * METHOTREXATE * * ** 91540 $ 43.84 0 * * METHOTRIMEPRAZINE * * ** 91542 $ 43.84 0 * * METHYLPHENIDATE * * ** 91544 $ 43.84 0 * * N - ACETYL PROCAINAMIDE * * ** 91546 $ 43.84 0 * * NETILMICIN * * ** 91548 $ 43.84 0 * * NITRAZEPAM * * ** 91550 $ 23.21 0 * * NORTRIPTYLINE * * ** 91551 $ 23.21 0 * * OLANZAPINE * * ** 91552 $ 43.84 0 * * PAROXETINE * * ** 91554 $ 43.84 0 * * PERPHENAZINE * * ** 91556 $ 43.84 0 * * PROCAINAMIDE * * ** 91558 $ 43.84 0 * * PROPRANOLOL * * ** 91559 $ 23.21 0 * * QUETIAPINE * * ** 91560 $ 49.32 0 * * SERTRALINE * * ** 91561 $ 24.92 0 * * RISPERIDONE * * ** 91562 $ 45.67 0 * * THIORIDAZINE * * ** 91564 $ 24.94 0 * * TOBRAMYCIN * * ** 91565 $ 23.21 0 * * TOPIRAMATE * * ** 91566 $ 43.84 0 * * TRAZODONE * * ** 91568 $ 43.84 0 * * TRIFLUOPERAZINE * * ** 91570 $ 43.84 0 * * TRIMIPRAMINE * * ** 91572 $ 15.77 0 * * VALPROIC ACID * * ** 91573 $ 14.84 0 * * VANCOMYCIN * * ** 91574 $ 23.21 0 * * ZOPICLONE * * ** 91575 $ 23.21 0 * * ZUCLOPENTHIXOL * * ** 91576 $ 25.14 0 * * VIGABATRIN * * ** 91599 $ 50.96 0 * * DRUG ASSAY - MULTIPLE (2 OR MORE) * * ** 91600 $ 25.00 0 * * ELECTROPHORESIS, PROTEIN, QUALITATIVE * * ** 91601 $ 32.97 0 * * ELECTROPHORESIS, PROTEIN, QUANTITATIVE * * ** 91602 $ 29.75 0 * * ELECTROPHORESIS, C.S.F. * * ** 91603 $ 29.88 0 * * ELECTROPHORESIS, QUALITATIVE, URINE * * ** 91605 $ 66.74 0 * * ERYTHROCYTE GALACTOSE 1 PHOSPHATE TRANSFERASE * * ** 91610 $ 21.39 0 * * ESTRADIOL * * ** 91615 $ 48.67 0 * * ESTROGENS * * ** 91620 $ 17.41 0 * * ETHOSUXIMIDE * * ** 91630 $ 3.68 0 * * FECAL PH * * ** 91631 $ 5.22 0 * * FAT, MICROSCOPIC EXAM-FAECES * * ** 91635 $ 43.96 0 * * FECAL ELASTASE * * ** 91636 $ 88.35 0 * * FAT, BALANCE 3 DAY, FECES * * ** 91640 $ 21.49 0 * * FATTY ACIDS, NONESTERIFIED (FREE), FECES * * ** 91645 $ 9.65 0 * * FERRITIN, SERUM * * ** 91650 $ 27.33 0 * * FIBRINOGEN, QUANTITATIVE, CHEMICAL * * ** 91655 $ 14.28 0 * * FOLIC ACID * * ** 91660 $ 12.53 0 * * FOLLICLE STIMULATING HORMONE (FSH) * * ** 91665 $ 48.40 0 * * GALACTOCEREBROSIDASE, FIBROBLASTS * * ** 91666 $ 48.40 0 * * GALACTOCEREBROSIDASE, WHITE BLOOD CELLS * * ** 91670 $ 16.13 0 * * GALACTOSE, QUALITATIVE, URINE * * ** 91675 $ 3.32 0 * * GASTRIC ACIDITY DETERMINATION, QUANTITATIVE * * ** 91680 $ 17.10 0 * * GASTRIC ANALYSIS, INTUBATION * * ** 91681 $ 0.88 0 * * GASTRIC ANALYSIS, ACID * * ** 91682 $ 84.25 0 * * GASTRIC ANALYSIS, HOLLANDER INSULIN * * ** 91685 $ 60.36 0 * * GASTRIN * * ** 91690 $ 8.05 0 * * GLUCOSE, GESTATIONAL ASSESSMENT * * ** 91700 $ 3.33 0 * * GLUCOSE SEMIQUANTITATIVE * * ** 91705 $ 6.14 0 * * GLUCOSE QUANTITATIVE, CSF * * ** 91706 $ 6.14 0 * * GLUCOSE QUANTITATIVE, JOINT FLUID * * ** 91707 $ 1.38 0 * * GLUCOSE, QUANTITATIVE SERUM/PLASMA * * ** 91708 $ 6.14 0 * * GLUCOSE QUANTITATIVE, TRANSUDATE/EXUDATE * * ** 91709 $ 1.00 0 * * GLUCOSE QUANTITATIVE, URINE * * ** 91710 $ 6.71 0 * * GLUCOSE, TIMED URINE COLLECTION * * ** 91715 $ 10.82 0 * * GLUCOSE TOLERANCE TEST, 2 - 5 HOURS * * ** 91716 $ 37.12 0 * * GLUCOSE TOLERANCE TEST > 6 HOURS * * ** 91717 $ 36.65 0 * * GLUCOSE TOLERANCE TEST, INTRAVENOUS * * ** 91719 $ 15.23 0 * * GLUCOSE - 2 HR, POST-75G * * ** 91720 $ 13.46 0 * * GLUCOSE PHOSPHATE ISOMERASE * * ** 91725 $ 1.58 0 * * GLUTAMYL TRANSPEPTIDASE (GTP) * * ** 91730 $ 41.76 0 * * GLUTATHIONE PEROXIDASE * * ** 91735 $ 41.37 0 * * GOLD * * ** 91740 $ 18.62 0 * * HAPTOGLOBIN * * ** 91745 $ 12.10 0 * * HAEMOGLOBIN, A1C * * ** 91750 $ 2.15 0 * * HEMOGLOBIN, QUALITATIVE, URINE * * ** 91755 $ 9.74 0 * * HEMOSIDERIN, URINE * * ** 91760 $ 34.80 0 * * HELICOBACTER PILORI CARBON 13 UREA BREATH TEST * * ** 91762 $ 88.29 0 * * HEPARAN SULFAMIDASE, WHITE BLOOD CELLS * * ** 91765 $ 9.92 0 * * HEPATITIS B SURFACE ANTIGEN * * ** 91770 $ 48.40 0 * * HEXOSAMINIDASES * * ** 91775 $ 48.40 0 * * HEXOSAMINIDASE, SERUM * * ** 91777 $ 93.55 0 * * HEXOSAMINIDASE WHITE BLOOD CELLS * * ** 91780 $ 7.49 0 * * HDL CHOLESTEROL * * ** 91785 $ 2.15 0 * * HOMOCYSTINE, SCREENING TEST, URINE * * ** 91790 $ 36.81 0 * * HOMOVANILLIC ACID (QUANTITATIVE) URINE * * ** 91795 $ 8.84 0 * * HYDROXYINDOLEACETIC ACID, URINE * * ** 91796 $ 41.72 0 * * HYDROXYINDOLEACETIC ACID, QUANTITATIVE, URINE * * ** 91800 $ 30.70 0 * * IGA ANTI-GLIADIN ANTIBODIES * * ** 91801 $ 19.14 0 * * IGA QUANTITATIVE, SECRETION * * ** 91802 $ 9.37 0 * * IGA QUANTITATIVE, SERUM/PLASMA * * ** 91803 $ 19.13 0 * * IGG QUANTITATIVE SPINAL FLUID * * ** 91805 $ 51.89 0 * * IGF - I (SOMATOMEDIN - C). * * ** 91810 $ 21.80 0 * * IGG1 * * ** 91811 $ 21.80 0 * * IGG2 * * ** 91812 $ 21.80 0 * * IGG3 * * ** 91813 $ 21.80 0 * * IGG4 * * ** 91814 $ 19.23 0 * * IGG BLOCKING ANTIBODY * * ** 91815 $ 42.58 0 * * IMMUNE COMPLEX DETECTION BY C1Q BINDING METHOD * * ** 91820 $ 99.23 0 * * IMMUNOFIXATION, CSF * * ** 91821 $ 99.26 0 * * IMMUNOFIXATION, SERUM/PLASMA * * ** 91822 $ 99.26 0 * * IMMUNOFIXATION, URINE * * ** 91825 $ 19.23 0 * * IMMUNOGLOBULIN D * * ** 91830 $ 19.23 0 * * IMMUNOGLOBULIN + SPECIFIC PROTEIN ASSAYS * * ** 91831 $ 11.81 0 * * IMMUNOGLOBULIN, ADDITIONAL ASSAY * * ** 91835 $ 17.70 0 * * IMMUNOREACTIVE TRYPSIN * * ** 91840 $ 9.48 0 * * IGG - QUANTITATIVE SERUM * * ** 91845 $ 9.58 0 * * IGM - QUANTITATIVE * * ** 91850 $ 7.33 0 * * INCLUSION BODIES, (CYTOMEGALIC) URINE * * ** 91855 $ 26.27 0 * * INSULIN, FIRST SPECIMEN * * ** 91856 $ 18.35 0 * * INSULIN, ADDITIONAL SPECIMEN * * ** 91857 $ 5.92 0 * * INSULIN TOLERANCE TEST, PER SPECIMEN * * ** 91860 $ 13.36 0 * * IONIZED CALCIUM. * * ** 91865 $ 5.56 0 * * IRON, TOTAL AND BINDING CAPACITY, PROTEIN * * ** 91870 $ 24.34 0 * * ISOENZYMES BY ELECTROPHORESIS * * ** 91880 $ 34.77 0 * * KETO ACIDS, CHROMATOGRAPHY - URINE * * ** 91881 $ 10.35 0 * * KETO ACIDS CHROMATOGRAPHY - TOTAL, CHEMICAL - URIN * * ** 91882 $ 5.18 0 * * KETO ACIDS CHROMATOGRAPHY - SCREENING TESTS - URIN * * ** 91885 $ 37.18 0 * * KETOGENIC STEROIDS - URINE * * ** 91890 $ 47.26 0 * * KETOSTEROIDS, TOTAL NEUTRAL - URINE * * ** 91895 $ 7.29 0 * * LACTATE, SERUM/PLASMA * * ** 91896 $ 16.86 0 * * LACTATE, WHOLE BLOOD * * ** 91900 $ 1.00 0 * * LACTATE DEHYDROGENASE, CSF * * ** 91901 $ 1.54 0 * * LACTATE DEHYDROGENASE, SERUM/PLASMA * * ** 91902 $ 1.00 0 * * LACTATE DEHYDROGENASE, TRANSUDATE/EXUDATE * * ** 91905 $ 9.25 0 * * LACTOSE, QUALITATIVE, URINE * * ** 91910 $ 124.58 0 * * LEAD * * ** 91911 $ 38.79 0 * * LEAD, TIMED URINE COLLECTION * * ** 91912 $ 5.86 0 * * LEAD, PORPHYRIN SCREENING TEST, URINE * * ** 91915 $ 218.82 0 * * LECITHIN SPHINGOMYELIN RATIO * * ** 91920 $ 43.54 0 * * LHRH STIMULATION TEST * * ** 91930 $ 8.75 0 * * LIPASE * * ** 91935 $ 27.91 0 * * LIPOPROTEIN(A) * * ** 91936 $ 24.42 0 * * LIPOPROTEIN (A) ISOFORMS * * ** 91940 $ 52.80 0 * * LIPOPROTEIN ELECTROPHORESIS * * ** 91941 $ 24.42 0 * * LIPOPROTEIN, SIZING * * ** 91945 $ 14.25 0 * * LITHIUM, SERUM/PLASMA * * ** 91946 $ 10.58 0 * * LITHIUM, WHOLE BLOOD * * ** 91950 $ 11.84 0 * * LUTEINIZING HORMONE (LH) * * ** 91955 $ 23.70 0 * * MAGNESIUM, FECAL * * ** 91956 $ 27.81 0 * * MAGNESIUM, RED BLOOD CELL * * ** 91957 $ 7.40 0 * * MAGNESIUM, SERUM/PLASMA * * ** 91958 $ 9.59 0 * * MAGNESIUM, URINE * * ** 91959 $ 22.58 0 * * MAGNESIUM, WHOLE BLOOD * * ** 91960 $ 2.22 0 * * MELANIN, QUALITATIVE, URINE * * ** 91965 $ 49.38 0 * * MERCURY * * ** 91970 $ 15.19 0 * * METACHROMATIC GRANULES, URINE * * ** 91975 $ 148.49 0 * * METANEPHRINES, QUANTITATIVE * * ** 91985 $ 7.88 0 * * MICRO ALBUMIN * * ** 91990 $ 4.79 0 * * MICROSCOPIC EXAMINATION OF FECES * * ** 91992 $ 85.32 0 * * MITOCHONDRIAL PREPARATION-MUSCLE * * ** 91995 $ 56.11 0 * * MUCOPOLYSACCHARIDES, URINE * * ** 91997 $ 88.29 0 * * N-ACETYL-GALACTOSAMINE-6-SULFATE SULFATASE, WBC * * ** 92000 $ 18.64 0 * * NITROGEN, 24 HR. EXCRETION - FECES * * ** 92001 $ 6.06 0 * * NITROGEN - 24 HR. EXCRETION - URINE * * ** 92005 $ 6.92 0 * * OCCULT BLOOD-FAECES * * ** 92010 $ 99.32 0 * * ORGANIC ACIDS * * ** 92015 $ 46.95 0 * * OSMOLAR CONCENTRATION, SERUM * * ** 92016 $ 47.10 0 * * OSMOLAR CONCENTRATION, URINE * * ** 92020 $ 55.29 0 * * OXALATE, TIMED URINE COLLECTION * * ** 92025 $ 19.13 0 * * OXYGEN CAPACITY OR CONTENT * * ** 92026 $ 10.43 0 * * OXYGEN, SATURATION (PHOTOMETRIC) * * ** 92030 $ 16.70 0 * * PARATHYROID HORMONE (INTACT) * * ** 92031 $ 23.72 0 * * PARATHYROID HORMONE (MID MOLECULE/CARBOXYL TERMINA * * ** 92035 $ 63.60 0 * * PENTAGASTRIN TEST, GASTRIC * * ** 92040 $ 23.72 0 * * PEPTIDE HORMONES * * ** 92045 $ 34.48 0 * * PH, PC02 AND P02 * * ** 92050 $ 6.81 0 * * PHENOTHIAZINE SCREEN * * ** 92055 $ 3.80 0 * * PHENYLALANINE, SCREENING TEST (GUTHRIE) * * ** 92056 $ 19.37 0 * * PHENYLALANINE, QUANTITATIVE * * ** 92060 $ 16.33 0 * * PHENYTOIN * * ** 92065 $ 2.22 0 * * PHENYLPYRUVIC ACID, QUALITATIVE, URINE * * ** 92070 $ 2.11 0 * * PHOSPHATES, RANDOM URINE * * ** 92071 $ 1.54 0 * * PHOSPHATES, SERUM/PLASMA * * ** 92072 $ 3.76 0 * * PHOSPHATE, TIMED URINE COLLECTION * * ** 92075 $ 13.24 0 * * PIGMENTS, ABNORMAL (SPECTROSCOPIC) * * ** 92080 $ 21.91 0 * * HOMOCYSTEINE - PLASMA * * ** 92085 $ 9.25 0 * * PORPHOBILINOGEN, QUALITATIVE, URINE * * ** 92090 $ 7.27 0 * * PORPHYRINS, QUALITATIVE, URINE * * ** 92091 $ 54.10 0 * * PORPHYRINS, QUANTITATIVE - URINE * * ** 92092 $ 125.03 0 * * PORPHYRINS, QUANTITATIVE - FECES * * ** 92095 $ 20.75 0 * * PORPHYRINS, QUANTITATIVE - BLOOD * * ** 92100 $ 1.31 0 * * POTASSIUM, SERUM/PLASMA * * ** 92101 $ 5.31 0 * * POTASSIUM, TIMED URINE COLLECTION * * ** 92102 $ 2.72 0 * * POTASSIUM, URINE RANDOM * * ** 92103 $ 1.00 0 * * POTASSIUM, WHOLE BLOOD * * ** 92105 $ 19.23 0 * * PRE ALBUMIN * * ** 92108 $ 14.77 0 * * PREGNANCY TEST, IMMUNOLOGIC - URINE * * ** 92110 $ 14.05 0 * * PREGNANCY TEST - SERUM * * ** 92115 $ 42.48 0 * * PREGNANEDIOL, URINE * * ** 92120 $ 50.12 0 * * PREGNANETRIOL, URINE * * ** 92125 $ 17.63 0 * * PRIMIDONE (MYSOLENE) * * ** 92130 $ 14.17 0 * * PROGESTERONE, SERUM/PLASMA * * ** 92131 $ 39.30 0 * * PROGESTERONE, SERUM/PLASMA 17-OH * * ** 92135 $ 12.86 0 * * PROLACTIN * * ** 92145 $ 6.79 0 * * PROTEINS, TOTAL QUANTITATIVE, C.S.F. * * ** 92146 $ 5.68 0 * * PROTEIN, TIMED URINE COLLECTION * * ** 92147 $ 1.00 0 * * PROTEIN TOTAL, JOINT FLUID * * ** 92148 $ 1.52 0 * * PROTEIN TOTAL, SERUM OR PLASMA * * ** 92149 $ 1.00 0 * * PROTEIN TOTAL, TRANSUDATE/EXUDATE * * ** 92150 $ 31.05 0 * * PROTEASE INHIBITOR * * ** 92152 $ 23.24 0 * * DRUG ASSAY (MULTIPLE) - PYRIDINIUM CROSS LINKS * * ** 92155 $ 16.94 0 * * PYRUVATES * * ** 92156 $ 88.29 0 * * PRYRUVATE CARBOXYLASE, FIBROBLASTS * * ** 92157 $ 88.29 0 * * PYRUVATE DEHYDROGENASE, FIBROBLASTS * * ** 92160 $ 15.54 0 * * QUANTITATIVE BETA HCG * * ** 92165 $ 23.72 0 * * QUANTITATIVE HCG (INTACT) * * ** 92170 $ 13.07 0 * * IGE ASSAY, QUANTITATIVE (DUPLICATE) * * ** 92180 $ 25.77 0 * * QUINIDINE * * ** 92185 $ 60.17 0 * * RENIN, SINGLE DETERMINATION * * ** 92190 $ 92.43 0 * * RENIN, TWO OR MORE DETERMINATIONS * * ** 92195 $ 258.67 0 * * RESPIRATORY CHAIN ENZYMES-MUSCLE * * ** 92200 $ 4.93 0 * * SALICYLATES, QUALITATIVE, SERUM * * ** 92201 $ 2.73 0 * * SALICYLATES, QUALITATIVE, GASTRIC * * ** 92202 $ 2.83 0 * * SALICYLATES, QUALITATIVE, URINE * * ** 92203 $ 8.82 0 * * SALICYLATES, QUANTITATIVE, SERUM * * ** 92204 $ 9.21 0 * * SALICYLATES, QUANTITATIVE, URINE * * ** 92205 $ 19.23 0 * * SCC * * ** 92210 $ 435.36 0 * * SECRETIN - PANCREOZYMIN TEST * * ** 92215 $ 46.89 0 * * SELENIUM * * ** 92220 $ 6.89 0 * * SEMINAL FRUCTOSE * * ** 92225 $ 22.08 0 * * SERUM VISCOSITY * * ** 92227 $ 41.00 0 * * SIROLIMUS * * ** 92230 $ 2.60 0 * * SODIUM, RANDOM URINE * * ** 92231 $ 1.31 0 * * SODIUM, SERUM/PLASMA * * ** 92232 $ 4.38 0 * * SODIUM, TIMED URINE COLLECTION * * ** 92233 $ 1.00 0 * * SODIUM, WHOLE BLOOD * * ** 92235 $ 28.63 0 * * SOMATOTROPIN, ONE SPECIMEN * * ** 92236 $ 18.25 0 * * SOMATOTROPIN, ADDITIONAL SPECIMEN * * ** 92240 $ 132.97 0 * * SPECIFIC PROTEIN ANALYSIS/PREPARATIVE ULTRACENTRIF * * ** 92250 $ 48.40 0 * * SPHINGOMYELINASE, FIBROBLASTS * * ** 92251 $ 48.40 0 * * SPHINGOMYELINASE, WHITE BLOOD CELLS * * ** 92255 $ 3.53 0 * * SULFONAMIDES, QUANTITATIVE, URINE * * ** 92260 $ 9.61 0 * * SWEAT TEST (MUCOVISCIDOSIS) CHEMICAL * * ** 92263 $ 22.37 0 * * TACROLIMUS * * ** 92265 $ 39.72 0 * * TESTOSTERONE FREE * * ** 92266 $ 15.08 0 * * TESTOSTERONE TOTAL * * ** 92270 $ 41.37 0 * * THALLIUM * * ** 92275 $ 40.36 0 * * THEOPHYLLINE * * ** 92280 $ 26.30 0 * * THYROGLOBULIN * * ** 92285 $ 19.23 0 * * THYROGLOBULIN ANTIBODIES * * ** 92290 $ 19.23 0 * * THYROID BINDING GLOBULIN * * ** 92305 $ 21.44 0 * * THYROID RECEPTOR AB * * ** 92310 $ 20.43 0 * * TOTAL T3 * * ** 92311 $ 8.91 0 * * T3 - FREE * * ** 92315 $ 13.95 0 * * THYROXINE RATIO, T4 OR TOTAL * * ** 92320 $ 52.67 0 * * THYROID RELEASING HORMONE (TRH) STIMULATION TEST * * ** 92325 $ 9.44 0 * * THYROID STIMULATING HORMONE, TSH * * ** 92330 $ 14.58 0 * * FREE T4 * * ** 92332 $ 19.27 0 * * THYROPEROXIDASE ANTIBODIES * * ** 92335 $ 41.37 0 * * TISSUE IRON * * ** 92340 $ 19.23 0 * * TRANSCOBALAMINE II * * ** 92345 $ 19.02 0 * * TRANSFERRIN * * ** 92346 $ 85.26 0 * * TRANSFERRIN ISOELECTRIC FOCUSING(QUALITIVE) * * ** 92350 $ 6.29 0 * * TRIGLYCERIDES, SERUM/PLASMA * * ** 92351 $ 8.62 0 * * TRIGLYCERIDES, TRANSUDATE/EXUDATE * * ** 92353 $ 63.97 0 * * 13C TRIOLEIN BREATH TEST FOR MALABSORPTION * * ** 92355 $ 14.36 0 * * TROPONIN * * ** 92360 $ 2.11 0 * * TRYPSIN, QUALITATIVE, FECES * * ** 92361 $ 3.72 0 * * TRYPSIN, QUANTITATIVE, FECES * * ** 92362 $ 3.72 0 * * TRYPSIN, QUANTITATIVE, GASTRIC * * ** 92365 $ 1.00 0 * * UREA, AMNIOTIC FLUID * * ** 92366 $ 1.00 0 * * UREA, CSF * * ** 92367 $ 7.07 0 * * UREA, NITROGEN QUANTITATIVE, URINE * * ** 92368 $ 1.49 0 * * UREA, SERUM/PLASMA * * ** 92369 $ 1.67 0 * * UREA, URINE RANDOM * * ** 92370 $ 1.00 0 * * UREA, WHOLE BLOOD * * ** 92375 $ 1.00 0 * * URIC ACID, RANDOM URINE * * ** 92376 $ 1.61 0 * * URIC ACID, SERUM/PLASMA * * ** 92377 $ 1.48 0 * * URIC ACID, SYNOVIAL FLUID * * ** 92378 $ 4.34 0 * * URIC ACID, TIMED URINE COLLECTION * * ** 92382 $ 5.37 0 * * URINALYSIS, SCREENING AND MICROSCOPIC * * ** 92385 $ 1.96 0 * * URINALYSIS - OR ANY PART OF (SCREENING) * * ** 92390 $ 7.08 0 * * URINALYSIS, MACROSCOPIC * * ** 92391 $ 4.00 0 * * URINALYSIS-MICROSCOPIC EXAM OF CENTRIFUGED DEPOSIT * * ** 92395 $ 6.82 0 * * URINALYSIS, MICROSCOPIC * * ** 92396 $ 6.29 0 * * MICROALBUMIN, SEMIQUANTATIVE - BY URINE DIPSTICK * * ** 92400 $ 2.22 0 * * UROBILIN, QUALITATIVE, URINE * * ** 92405 $ 3.85 0 * * UROBILINOGEN, QUALITATIVE, URINE * * ** 92406 $ 12.79 0 * * UROBILINOGEN, TIMED URINE COLLECTION * * ** 92420 $ 36.81 0 * * VANILLYLMANDELIC ACID * * ** 92425 $ 86.38 0 * * VERY LONG CHAIN FATTY ACIDS * * ** 92430 $ 45.10 0 * * VITAMIN A * * ** 92435 $ 51.16 0 * * VITAMIN B1 * * ** 92440 $ 51.16 0 * * VITAMIN B2 * * ** 92445 $ 51.16 0 * * VITAMIN B6 * * ** 92450 $ 13.72 0 * * VITAMIN B12 * * ** 92455 $ 89.02 0 * * VITAMIN D (1,25 DIHYDROXY) * * ** 92460 $ 89.02 0 * * VITAMIN D (25 HYDROXY-CHOLECALCIFEROL) * * ** 92465 $ 50.82 0 * * VITAMIN E * * ** 92467 $ 39.91 0 * * WHITE BLOOD CELL PREPARATION FOR LYSOSOMAL ENZYME * * ** 92470 $ 100.01 0 * * XYLOSE TOLERANCE * * ** 92475 $ 97.66 0 * * ZINC * * ** 92500 $ 10.03 0 * * PRIMARY BASE FEE * * ** 92501 $ 5.01 0 * * SPLIT BASE FEE (COLLECTING FACILITY) * * ** 92502 $ 5.01 0 * * SPLIT BASE FEE (REFERRAL FACILITY0 * * ** 92503 $ 9.10 0 * * AMPHETAMINES * * ** 92504 $ 12.72 0 * * BARBITUATES * * ** 92505 $ 8.01 0 * * BENZODIAZEPINES * * ** 92506 $ 10.42 0 * * TETRAHYDROCANNABINOIDS (THC) * * ** 92507 $ 6.75 0 * * COCAINE/COCAINE METABOLITE * * ** 92508 $ 6.61 0 * * ETHANOL * * ** 92509 $ 3.33 0 * * LSD * * ** 92510 $ 6.49 0 * * METHADONE METABOLITE * * ** 92511 $ 6.81 0 * * OPIATES * * ** 92512 $ 3.34 0 * * PHENOYCLIDINE (PCP) * * ** 92513 $ 3.34 0 * * METHADONE * * ** 92515 $ 43.73 0 * * BLOOD METHADONE * * ** 92520 $ 66.82 0 * * 1-AMPHETAMINE * * ** 92521 $ 66.82 0 * * 1-METAMPHETAMINE * * ** 92522 $ 66.82 0 * * ANILERIDINE * * ** 92523 $ 66.82 0 * * ANTIHISTAMINES * * ** 92524 $ 66.82 0 * * CLONIDINE * * ** 92525 $ 66.82 0 * * FENTANYL * * ** 92526 $ 66.82 0 * * FUROSEMIDE * * ** 92527 $ 66.82 0 * * HYDROCODONE * * ** 92528 $ 66.82 0 * * HYDROMORPHONE * * ** 92529 $ 66.82 0 * * MEPERIDINE * * ** 92530 $ 66.82 0 * * MEPROBAMATE * * ** 92532 $ 66.82 0 * * METHAQUALONE * * ** 92533 $ 66.82 0 * * METHOCARBAMOL * * ** 92534 $ 66.82 0 * * METHYLENEDIOXYAMPHETAMINE * * ** 92535 $ 66.82 0 * * METHYLENEDIOXYMETHAMPHETAMINE * * ** 92536 $ 66.82 0 * * N-ACETYL MORPHINE * * ** 92537 $ 66.82 0 * * NALOXONE * * ** 92538 $ 66.82 0 * * OXYCODONE * * ** 92539 $ 66.82 0 * * OXYMORPHONE * * ** 92540 $ 66.82 0 * * PENTAZOCINE * * ** 92541 $ 66.82 0 * * PHENTERMINE * * ** 92542 $ 66.82 0 * * PHENYLPROPANOLAMINE * * ** 92543 $ 66.82 0 * * PROPOXYPHENE * * ** 92544 $ 66.82 0 * * PSEUDOEPHEDRINE * * ** 92545 $ 64.75 0 * * GC/MS CONFIRMATION OF POSITIVE SCREEN * * ** 92546 $ 113.00 0 * * COMPREHENSIVE DRUG ANALYSIS * * ** 92550 $ 6.64 0 * * URINE, DRUGS OF ABUSE SCREEN - PER ANALYTE * * ** 93010 $ 38.18 0 * * CRYSTAL IDENTIFICATION SYNOVIAL FLUID * * ** 93015 $ 287.37 0 * * CYTOGENETIC ANALYSIS - SHORT TERM BLOOD * * ** 93020 $ 492.46 0 * * CYTOGENETIC ANALYSIS - BONE MARROW * * ** 93025 $ 685.10 0 * * CYTOGENETIC ANALYSIS - CHORIONIC VILLUS * * ** 93030 $ 395.25 0 * * CYTOGENETIC ANALYSIS - CULTURED AMNIOTIC FLUID * * ** 93035 $ 390.51 0 * * CYTOGENETIC ANALYSIS - CULTURED TISSUE * * ** 93040 $ 369.76 0 * * CYTOGENETIC ANALYSIS - FOETAL BLOOD SAMPLE * * ** 93045 $ 910.39 0 * * CYTOGENETIC ANALYSIS * * ** 93050 $ 444.69 0 * * CYTOGENETIC ANALYSIS/IN-SITU HYBRIDIZATION * * ** 93055 $ 29.00 0 * * SPECIAL STAINING (GIEMSA II, DAPI, SCE, NOR) * * ** 93060 $ 28.10 0 * * SPECIAL BANDING (Q-, R-, C-) * * ** 93065 $ 198.04 0 * * AMNIOTIC CELL CULTURE - ANALYSIS ONLY * * ** 93070 $ 171.28 0 * * CHROMOSOMAL BREAKAGE * * ** 93075 $ 109.17 0 * * INVESTIGATION - CHROMOSOMAL MOSAICISM * * ** 93080 $ 118.03 0 * * CHROMOSOME ANALYSIS - HIGH RESOLUTION * * ** 93085 $ 89.84 0 * * FINE NEEDLE ASPIRATE - CYTOLOGIC EXAMINATION * * ** 93090 $ 62.48 0 * * CYTOLOGIC INTERPRETATION OF PRE-SCREENED CYTOLOGY * * ** 93095 $ 81.52 0 * * CYTOLOGIC INTERPRETATION - UNSCREENED CYTOLOGY * * ** 93100 $ 366.45 0 * * ELECTRON MICROSCOPY * * ** 93105 $ 30.64 0 * * HEPATIC GLYCOGEN (TISSUE) * * ** 93110 $ 46.26 0 * * HEPATIC GLUCOSE - 6 PHOSPHATASE * * ** 93115 $ 186.32 0 * * MUSCLE BIOPSY ENZYME STUDIES * * ** 93120 $ 14.27 0 * * ECG TRACING * * ** 93160 $ 78.49 0 * * SEMEN - EXAMINATION - COMPLETE * * ** 93170 $ 25.72 0 * * SEMINAL EXAMINATION * * ** 94005 $ 104.76 0 * 29 * CLINICAL PATHOLOGY, EMERGENCY VISIT * * ** 94006 $ 26.19 0 * 29 * CLINICAL PATHOLOGY, DIRECTIVE CARE * * ** 94007 $ 26.19 0 * 29 * CLINICAL PATHOLOGY, OFFICE VISIT * * ** 94008 $ 26.19 0 * 29 * CLINICAL PATHOLOGY, HOSPITAL VISIT * * ** 94009 $ 52.43 0 * 29 * CLINICAL PATHOLOGY, HOME VISIT * * ** 94010 $ 117.83 0 * 29 * CONSULTATION - MEDICAL MICROBIOLOGY * * ** 94012 $ 65.47 0 * 29 * CONSULT - LIMITED/REPEAT, MEDICAL MICROBIOLOGY * * ** 95000 $ 81.82 0 * * CARDIAC 1ST PASS * * ** 95005 $ 92.59 0 * * CARDIAC SHUNT * * ** 95015 $ 217.41 0 * * IODINE 131 WHOLE BODY SCAN * * ** 95020 $ 217.41 0 * * JOINT SCAN * * ** 95025 $ 357.28 0 * * LIVER CLEARANCE - HIDA /PHARMACEUTICAL * * ** 95030 $ 230.76 0 * * LUNG QUANTIFICATION * * ** 95040 $ 348.23 0 * * RADIONUCLIDE CARDIAC VENTRICULOGRAPHY WITH STRESS * * ** 95045 $ 260.76 0 * * RBC LIVER SCAN * * ** 95053 $ 374.11 0 * * THALLIUM BODY IMAGING * * ** 95055 $ 306.03 0 * * RENAL IMAGING/PHARMACEUTICALS * * ** 95060 $ 277.20 0 * * RENAL IMAGING/ WITHOUT PHARMACEUTICALS * * ** 95062 $ 242.35 0 * * REST MYOCARDIAL PERFUSION * * ** 95063 $ 242.35 0 * * STRESS MYOCARDIAL PERFUSION * * ** 95065 $ 341.89 0 * * WHITE BLOOD CELLS- LABELED/RADIOISOTOPE * * ** 96002 $ - 0 * * PHC- CASE CONFERENCE * * ** 96003 $ - 0 * * PHC - CRISIS COUNSELING * * ** 96004 $ - 0 * * PHC - SHORT-TERM COUNSELING * * ** 96005 $ - 0 * * PHC GROUP COUNSELING/FACILITATION * * ** 96007 $ - 0 * * PHC-PHONE CONTACT WITH PROFESSIONAL CARE PROVIDER * * ** 96008 $ - 0 * * PHC-FORMAL CASE MANAGEMENT * * ** 96009 $ - 0 * * PHC-INFORMAL CASE MANAGEMENT * * ** 96010 $ - 0 * * PHC-CASE REVIEW - DURING OFFICE HOURS * * ** 96011 $ - 0 * * PHC-REVIEW - AFTER OFFICE HOURS * * ** 96012 $ - 0 * * PHC-SYRINGING - EAR * * ** 96013 $ - 0 * * PHC-SUTURE REMOVAL * * ** 96014 $ - 0 * * PHC-DRESSING CHANGE * * ** 96016 $ - 0 * * PHC-TELEPHONE CONTACT - NEW PROBLEM * * ** 96018 $ - 0 * * PHC-COMMUNICABLE DISEASE FOLLOW UP * * ** 96019 $ - 0 * * PHC PRESCRIPTION - INITIAL ORDER BY TELEPHONE * * ** 96020 $ - 0 * * PHC-TELEPHONE CONTACT - FOLLOW UP * * ** 96021 $ - 0 * * PHC-TELEPHONE CALL (PHARMACY) * * ** 96022 $ - 0 * * PHC-FAMILY CONFERENCE - DURING OFFICE HOURS * * ** 96023 $ - 0 * * PHC-FAMILY CONFERENCE - AFTER OFFICE HOURS * * ** 96025 $ - 0 * * PHC-TELEPHONE CONTACT WITH PATIENT FAMILY/FRIEND * * ** 96026 $ - 0 * * PHC-EDUCATION - RELATED TO SPECIFIC DIAGNOSIS * * ** 96027 $ - 0 * * PHC-EDUCATION-HEALTH PROMOTION/DISEASE PREVENT * * ** 96029 $ - 0 * * PHC-EDUCATION - FAMILY PLANNING * * ** 96030 $ - 0 * * PHC-EDUCATION - SMOKING * * ** 96031 $ - 0 * * PHC-EDUCATION - SUBSTANCE ABUSE * * ** 96032 $ - 0 * * PHC-EDUCATION - HEALTH RISK(NEC) * * ** 96034 $ - 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