Procedure Procedure Unit Charge in Procedure Description Code Modifier Dollars
10021 PR FINE NEEDLE ASP;W/O IMAGING GUIDANCE 247.00
10022 PR FINE NEEDLE ASP;W/IMAGING GUIDANCE 494.00
10040 PR ACNE SURGERY OF SKIN ABSCESS 203.00
10060 PR DRAIN SKIN ABSCESS SIMPLE 240.00
10061 PR DRAIN SKIN ABSCESS COMPLIC 328.00
10080 PR DRAIN PILONIDAL CYST SIMPL 261.00
10081 PR DRAIN PILONIDAL CYST COMPLIC 1248.00
10120 PR REMOVE FOREIGN BODY SIMPLE 360.00
10121 PR REMOVE FOREIGN BODY COMPLIC 616.00
10140 PR DRAINAGE OF HEMATOMA/FLUID 1343.00
10160 PR PUNCTURE DRAINAGE OF LESION 240.00
10180 PR COMPLEX DRAINAGE, WOUND 505.00
11000 PR DEBRIDEMENT, INFECTED SKIN, UP TO 10% BSA 321.00
11004 PR DEBRIDE NECR SKIN/TISS,SUBQ/MUSC/FASC,GENIT& 1378.00
11005 PR DEBRIDE NECROTIC SKIN/ TISSUE, ABD WALL 1757.00
11006 PR DEBR NEC SKIN/TISS,GEN/PERI/ADB WALL W/WO C 1592.00
11008 PR REMOVE MESH FROM ABD WALL FOR INFECTION 617.00
11010 PR DEBRIDE ASSOC OPEN FX/DISLOC SKIN/SUBQ 1118.00
11011 PR DEBRIDE ASSOC OPEN FX/DISLOC SKIN/MUSCLE 1217.00
11012 PR DEBRIDE ASSOC OPEN FX/DISLO SKIN/MUS/BONE 1632.00
11040 PR DEBRIDEMENT, SKIN, PARTIAL THICKNESS 91.00
11041 PR DEBRIDEMENT, SKIN, FULL THICKNESS 343.00 11042 PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM 322.00
11043 PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,=<20 SQ CM 451.00
11044 PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,BONE,=<20 SQ CM 679.00
11045 PR PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,EACH ADD 20 SQ CM 96.00
11046 PR PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,EACH ADD 20 SQ CM 168.00
11047 PR PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,BONE,EACH ADD 20 SQ CM 281.00
11055 PR TRIM HYPERKERATOTIC SKIN LESION, ONE 145.00
11056 PR TRIM BENIGN HYPERKERATOTIC SKIN LESION,2-4 168.00
11057 PR TRIM BENIGN HYPERKERATOTIC SKIN LESION,>4 189.00
11100 PR BIOPSY OF SKIN LESION 223.00
11101 PR BIOPSY, EACH ADDED LESION 110.00
11200 PR REMOVAL OF SKIN TAGS, UP TO 15 165.00
11201 PR REMOVAL OF SKIN TAGS, EACH ADD 10 121.00
11300 PR SHAV SKIN LES <5MM TRUNK,ARM,LEG 136.00
11301 PR SHAV SKIN LES 6-10MM TRUNK,ARM,LEG 173.00
11302 PR SHAV SKIN LES 11-20MM TRUNK,ARM,LEG 204.00
11303 PR SHAV SKIN LES >21MM TRUNK,ARM,LEG 242.00
11305 PR SHAV SKIN LES <5MM REMAINDR BODY 134.00
11306 PR SHAV SKIN LES 6-10MM REMAINDR BODY 187.00
11307 PR SHAV SKIN LES 11-20MM REMAINDR BODY 228.00
11308 PR SHAV SKIN LES >21MM REMAINDR BODY 264.00
11310 PR SHAV SKIN LES <5MM FACE,FACIAL 167.00
11311 PR SHAV SKIN LES 6-10MM FACE,FACIAL 204.00 11312 PR SHAV SKIN LES 11-20MM FACE,FACIAL 230.00
11313 PR SHAV SKIN LES >21MM FACE,FACIAL 361.00
11400 PR EXC SKIN BENIG <5MM TRUNK,ARM,LEG 498.00
11401 PR EXC SKIN BENIG 0.6-1CM TRUNK,ARM,LEG 525.00
11402 PR EXC SKIN BENIG 1.1-2CM TRUNK,ARM,LEG 536.00
11403 PR EXC SKIN BENIG 2.1-3CM TRUNK,ARM,LEG 927.00
11404 PR EXC SKIN BENIG 3.1-4CM TRUNK,ARM,LEG 1748.00
11406 PR EXC SKIN BENIG >4CM TRUNK,ARM,LEG 1836.00
11420 PR EXC SKIN BENIG <5MM REMAINDR BODY 856.00
11421 PR EXC SKIN BENIG 0.6-1CM REMAINDR BODY 888.00
11422 PR EXC SKIN BENIG 1.1-2CM REMAINDR BODY 915.00
11423 PR EXC SKIN BENIG 2.1-3CM REMAINDR BODY 1744.00
11424 PR EXC SKIN BENIG 3.1-4CM REMAINDR BODY 1768.00
11426 PR EXC SKIN BENIG >4CM REMAINDR BODY 632.00
11440 PR EXC SKIN BENIG <5MM FACE,FACIAL 525.00
11441 PR EXC SKIN BENIG 0.6-1CM FACE,FACIAL 556.00
11442 PR EXC SKIN BENIG 1.1-2CM FACE,FACIAL 927.00
11443 PR EXC SKIN BENIG 2.1-3CM FACE,FACIAL 964.00
11444 PR EXC SKIN BENIG 3.1-4CM FACE,FACIAL 1057.00
11446 PR EXC SKIN BENIG >4CM FACE,FACIAL 940.00
11450 PR EXC SWEAT GLAND LESN AXILL,SIMPL 907.00
11451 PR EXC SWEAT GLAND LESN AXILL,COMPLX 1176.00
11462 PR EXC SWEAT GLAND LESN INGUIN,SIMPL 880.00 11470 PR EXC SWEAT GLAND LESN PERINEAL,SIMPL 1012
11471 PR EXC SWEAT GLAND LESN PERINEAL,COMPLX 1233.00
11600 PR EXC SKIN MALIG <5MM TRUNK,ARM,LEG 896.00
11601 PR EXC SKIN MALIG 0.6-1CM TRUNK,ARM,LEG 575.00
11602 PR EXC SKIN MALIG 1.1-2CM TRUNK,ARM,LEG 592.00
11603 PR EXC SKIN MALIG 2.1-3CM TRUNK,ARM,LEG 981.00
11604 PR EXC SKIN MALIG 3.1-4CM TRUNK,ARM,LEG 1041.00
11606 PR EXC SKIN MALIG >4CM TRUNK,ARM,LEG 1917.00
11620 PR EXC SKIN MALIG <5MM REMAINDR BODY 898.00
11621 PR EXC SKIN MALIG 0.6-1CM REMAINDR BODY 633.00
11622 PR EXC SKIN MALIG 1.1-2CM REMAINDR BODY 957.00
11623 PR EXC SKIN MALIG 2.1-3CM REMAINDR BODY 1805.00
11624 PR EXC SKIN MALIG 3.1-4CM REMAINDR BODY 1897.00
11626 PR EXC SKIN MALIG >4CM REMAINDR BODY 934.00
11640 PR EXC SKIN MALIG <5MM FACE,FACIAL 605.00
11641 PR EXC SKIN MALIG 0.6-1CM FACE,FACIAL 585.00
11642 PR EXC SKIN MALIG 1.1-2CM FACE,FACIAL 616.00
11643 PR EXC SKIN MALIG 2.1-3CM FACE,FACIAL 742.00
11644 PR EXC SKIN MALIG 3.1-4CM FACE,FACIAL 936.00
11646 PR EXC SKIN MALIG >4CM FACE,FACIAL 1187.00
11719 PR TRIM NAIL(S) 55.00
11720 PR DEBRIDEMENT OF NAIL(S), 1-5 56.00
11721 PR DEBRIDEMENT OF NAILS, 6 OR MORE 110.00 11730 PR REMOVAL OF NAIL PLATE 191.00
11732 PR REMOVE ADDITIONAL NAIL PLATE 68.00
11740 PR DRAIN BLOOD FROM UNDER NAIL 95.00
11750 PR REMOVAL OF NAIL BED 603.00
11752 PR REMOVE NAIL BED/FINGER TIP 782.00
11755 PR BIOPSY, NAIL UNIT (SEP PROC) 328.00
11760 PR RECONSTRUC OF NAIL BED 263.00
11765 PR EXCISION OF NAIL FOLD, TOE 203.00
11770 PR REMV PILONIDAL LESION SIMPLE 453.00
11771 PR REMV PILONIDAL LESION EXTENS 1320.00
11772 PR REMV PILONIDAL LESION COMPLIC 1602.00
11900 PR INJECTION INTO SKIN LESIONS, UP TO 7 156.00
11901 PR INJECTION INTO SKIN LESIONS, 8 OR MORE 182.00
11952 PR FILL CONTOUR DEFCT 5.1-10CC 301.00
11975 PR INSERT CONTRACEPTIVE CAPSUL 383.00
11976 PR REMOVAL OF CONTRACEPTIVE CAPSUL 514.00
11977 PR REMOVAL/REINSERT CONTRA CAP 709.00
11980 PR IMPLANT,HORMONE,SUBCUTANEOUS 246.00
11981 PR INSERTION DRUG IMPLANT DEVICE 383.00
11982 PR REMOVAL DRUG IMPLANT DEVICE 448.00
11983 PR REMOVAL W/ REINSERT DRUG IMPLANT DEVICE 762.00
12001 PR REPR SUPERF WND BODY <2.5CM 333.00
12002 PR REPR SUP NPTERF WND BODY 2.6-7.5 361.00 12004 PR REPR SUPERF WND BODY 7.6-12.5 418.00
12005 PR REPR SUPERF WND BODY 12.6-20 517.00
12006 PR REPR SUPERF WND BODY 20.1-30 486.00
12011 PR REPR SUPERF WND FACE <2.5CM 358.00
12013 PR REPR SUPERF WND FACE 2.6-5 396.00
12014 PR REPR SUPERF WND FACE 5.1-7.5 418.00
12015 PR REPR SUPERF WND FACE 7.6-12.5 416.00
12020 PR CLOSURE SUPERF WND DEHIS SIMPLE 546.00
12021 PR CLOSURE SUPERF WND DEHIS W PACKING 459.00
12031 PR LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM 473.00
12032 PR LAYR CLOS WND TRUNK,ARM,LEG 2.6-7.5 CM 522.00
12034 PR LAYR CLOS WND TRUNK,ARM,LEG 7.6-12.5 CM 552.00
12035 PR LAYR CLOS WND TRUNK,ARM,LEG 12.6-20 CM 612.00
12036 PR LAYR CLOS WND TRUNK,ARM,LEG 20.1-30 CM 689.00
12037 PR LAYR CLOS WND TRUNK,ARM,LEG >30 CM 1168.00
12041 PR LAYR CLOS WND REST BODY <2.5 CM 339.00
12042 PR LAYR CLOS WND REST BODY 2.6-7.5 CM 421.00
12044 PR LAYR CLOS WND REST BODY 7.6-12.5 CM 807.00
12045 PR LAYR CLOS WND REST BODY 12.6-20 CM 973.00
12046 PR LAYR CLOS WND REST BODY 20.1-30 CM 1147.00
12051 PR LAYR CLOS WND FACE,FACIAL <2.5 CM 541.00
12052 PR LAYR CLOS WND FACE,FACIAL 2.5-5 CM 579.00
12053 PR LAYR CLOS WND FACE,FACIAL 5.1-7.5 CM 793.00 13100 PR REPR CMPL WND TRUNK 1.1-2.5CM 732.00
13101 PR REPR CMPL WND TRUNK 2.6-7.5CM 650.00
13102 PR REP,SKIN,TRUNK,CMPLX,+5CM/< 296.00
13120 PR REPR CMPL WND SCALP,EXTR 1.1-2.5 858.00
13121 PR REPR CMPL WND SCALP,EXTR 2.6-7.5 1039.00
13122 PR REP,SKIN,SCALP/EXTREM+5CM/< 276.00
13131 PR REPR CMPL WND HEAD,FAC,HAND 1.1-2.5 786.00
13132 PR REPR CMPL WND HEAD,FAC,HAND 2.6-7.5 1357.00
13133 PR REP,FACE,GENITAL,HAND,FT+5CM/< 390.00
13150 REPR CMPL WND LID,NOS,EAR <1CM 833.00
13151 PR REPR CMPL WND LID,NOS,EAR 1.1-2.5 950.00
13152 PR REPR CMPL WND LID,NOS,EAR 2.5-7.5 1169.00
13153 PR REP,EYELID,NOSE,EAR,LIP+5CM 429.00
13160 PR SECD CLOS SURG WND EXTEN/COMPLIC 1639.00
14020 PR ADJ TISS XFER SCALP,EXTREM <10SQCM 2193.00
14021 PR ADJ TISS XFER SCALP,EXTREM 10.1-30 2081.00
14040 PR ADJ TISS XFER HEAD,FAC,HAND <10SQCM 1797.00
14041 PR ADJ TISS XFER HEAD,FAC,HAND 10.1-30 2256.00
14060 PR ADJ TISS XFER LID,NOS,EAR <10SQCM 1821.00
14061 PR ADJ TISS XFER LID,NOS,EAR 10.1-30 2390.00
14301 PR ADJ TISS XFER ANY AREA,30.1-60 SQCM 2587.00
14302 PR ADJ TISS XFER ANY AREA,EA ADD 30.0 SQCM 528.00
15002 PR WOUND PREP, PED, TRK/ARM/LG 1ST 100 CM 780.00 15004 PR WND PREP PED, FACE/NCK/HND/FT/GEN 972.00
15100 PR SPLIT GRFT TRUNK,ARM,LEG <100SQCM 2037.00
15101 PR SPLIT GRFT,TRUNK,ARM,LEG EA 100SQCM 447.00
15110 PR EPIDRM AUTOGRFT TRNK/ARM/LEG 1929.00
15115 PR EPIDRM A-GRFT FACE/NCK/HF/G 2066.00
15120 PR SPLIT GRFT,HEAD,FAC,HAND,FEET <100SQCM 2201.00
15121 PR SPLIT GRFT,HEAD,FAC,HAND,FEET EA 100SQCM 315.00
15220 PR FULL THICK GRFT SCALP,ARM,LEG <20SQC 1842.00
15240 PR FULL THICK GRFT HEAD,FAC,HAND <20SQC 2165.00
15241 PR FULL THICK GRFT HEAD,FAC,HA ADD 20SQ 451.00
15260 PR FULL THICK GRFT NOS,EAR,LID <20SQCM 2350.00
15261 PR FULL THICK GRFT NOS,EAR,LID ADD 20SQ 519.00
15271 PR APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM 343.00
15272 PR APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM 65.00
15275 PR SUB GRFT F/S/N/H/F/G/M/D /<100SCM /<1ST 25 SCM 366.00
15276 PR SUB GRFT F/S/N/H/F/G/M/D /<100SCM EA ADL 25SCM 83.00
15630 PR DELAY/SECTN FLAP LID,NOS,EAR,LIP 1122.00
15731 PR FOREHEAD FLAP W/VASC PEDICLE 2720.00
15732 PR MUSCLE-SKIN FLAP,HEAD/NECK 3118.00
15732 PR MUSCLE-SKIN FLAP,HEAD/NECK 50M 4677.00
15733 PR MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL 2541.00
15734 PR MUSCLE-SKIN FLAP,TRUNK 80M 713.00
15734 PR MUSCLE-SKIN FLAP,TRUNK 3563.00 15760 PR COMPOSITE SKIN GRAFT 1983.00
15780 PR DERMABRAS RX SKIN TOTAL FACE 2248.00
15781 PR DERMABRAS RX SKIN SGMENT FACE 1279.00
15823 PR REV UPPER EYELID W EXCESS SKIN 1416.00
15823 PR REV UPPER EYELID W EXCESS SKIN 50M 2125.00
15830 PR EXCISE EXCESS SKIN TISSUE,ABDOMEN 80M 560.00
15830 PR EXCISE EXCESS SKIN TISSUE,ABDOMEN 2792.00
15839 PR EXCISE EXCESS SKIN TISSUE,OTHER 1987.00
15852 PR DRESSING CHANGE,NOT FOR BURN 108.00
15944 PR EXC ISCH PRES ULC W FLAP CLOS 2151.00
16000 PR INITIAL RX BURN(S) 1ST DEGREE 152.00
16020 PR DRESS/DEBRID SMALL BURN NO ANES 199.00
16025 PR DRESS/DEBRID MED BURN NO ANESTH 328.00
16035 PR ESCHAROTOMY 572.00
17000 PR DESTRUC PREMALIGNANT, FIRST LESION 146.00
17003 PR DESTRUC PREMALIGNANT,2-14 LESIONS 42.00
17004 PR DESTRUC PREMALIGNANT,15+ LESIONS 481.00
17106 PR DESTRUC CUT/VASC <10SQ CM 320.00
17107 PR DESTRUC CUT/VASC 10-50 SQ CM 512.00
17108 PR DESTRUC CUT/VASC >50 SQ CM 679.00
17110 PR DESTRUCTION BENIGN LESIONS UP TO 14 165.00
17111 PR DESTRUCTION BENIGN LESIONS 15 OR MORE 238.00
17250 PR CHEMICAL CAUTERIZATION OF GRANULATION TISSUE 204.00 17260 PR DESTR MALIG TRUNK,EXTREM <0.6 CM 226.00
17261 PR DESTR MALIG TRUNK,EXTREM 0.6-1 CM 252.00
17262 PR DESTR MALIG TRUNK,EXTREM 1.1-2 CM 280.00
17263 PR DESTR MALIG TRUNK,EXTREM 2.1-3 CM 375.00
17270 PR DESTR MALIG SCAL,NCK,HAND <0.6 CM 261.00
17271 PR DESTR MALIG SCAL,NCK,HAND 0.6-1 CM 286.00
17272 PR DESTR MALIG SCAL,NCK,HAND 1.1-2 CM 307.00
17273 PR DESTR MALIG SCAL,NCK,HAND 2.1-3 CM 498.00
17280 PR DESTR MALIG FACE,NOSE,LIP <0.6 CM 272.00
17281 PR DESTR MALIG FACE,NOSE,LIP 0.6-1 CM 398.00
17282 PR DESTR MALIG FACE,NOSE,LIP 1.1-2 CM 418.00
17283 PR DESTR MALIG FACE,NOSE,LIP 2.1-3 CM 530.00
17286 PR DESTR MALIG FACE,NOSE,LIP >4CM 864.00
17340 PR CRYOTHERAPY ACNE 155.00
17999 PR SKIN MUC MEMBRANE SUBQ TISSUE PROC UNLISTED 321.00
19000 PR PUNC/ASPIR BREAST CYST 471.00
19001 PR PUCT/ASPIR BREAST CYST,EACH ADDN 174.00
19020 PR EXPLO/DRAIN BREAST ABSCESS 1049.00
19081 PR BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE 1656.00
19083 PR BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE 1648.00
19084 PR BX BREAST W DEVICE ADDL LESION ULTRASOUND GUIDE 1339.00
19100 PR BIOPSY OF BREAST, NEEDLE CORE 550.00
19101 PR BIOPSY OF BREAST, INCISIONAL 2591.00 19102 BX OF BREAST, NEEDLE CORE, IMAGE GUIDE 512.00
19103 BX OF BREAST,VACUUM ASST,IMAGE GUIDE 1331.00
19110 PR NIPPLE EXPLORATION 1268.00
19120 PR REMOVAL OF BREAST LESION 1127.00
19125 PR EXCISE BREAST LES W XRAY MARKER 1247.00
19126 PR EXCISE BREAST LES XRAY MARK ADDNL 361.00
19295 BX OF BREAST,PLC METAL CLIP W/IMAGING 228.00
19300 PR MASTECTOMY FOR GYNECOMASTIA 1215.00
19301 PR MASTECTOMY, PARTIAL 1459.00
19302 PR MASTECTOMY,PARTIAL, WITH AXILLARY LYMPHADENECTOMY 2017.00
19303 PR MASTECTOMY, SIMPLE, COMPLETE 80M 440.00
19303 PR MASTECTOMY, SIMPLE, COMPLETE 2197.00
19303 PR MASTECTOMY, SIMPLE, COMPLETE 50M 3295.00
19304 PR MASTECTOMY, SUBCUTANEOUS 1306.00
19304 PR MASTECTOMY, SUBCUTANEOUS 50M 1959.00
19307 PR MASTECTOMY, MODIFIED RADICAL 80M 526.00
19307 PR MASTECTOMY, MODIFIED RADICAL 2624.00
19316 PR SUSPENSION OF BREAST 1808.00
19318 PR REDUCTION OF LARGE BREAST 80M 521.00
19318 PR REDUCTION OF LARGE BREAST 2603.00
19328 PR REMOVAL OF BREAST IMPLANT 1192.00
19328 PR REMOVAL OF BREAST IMPLANT 50M 1787.00
19330 PR REMOVAL OF IMPLANT MATERIAL 1530.00 19371 PR REMOVAL OF BREAST CAPSULE 1892.00
20005 PR I&D SOFT TISSUE ABSCESS SUBFASCIAL 709.00
20100 PR EXPLORE WOUND,NECK 80M 276.00
20100 PR EXPLORE WOUND,NECK 1376.00
20101 PR EXPLORE WOUND,CHEST 1137.00
20102 PR EXPLORE WOUND,ABDOMEN/FLANK/BACK 1134.00
20103 PR EXPLORE WOUND,EXTREMITY 1390.00
20205 PR DEEP MUSCLE BIOPSY 627.00
20206 PR NEEDLE BIOPSY,MUSCLE 927.00
20220 PR BONE BIOPSY,TROCAR/NEEDLE SUPERF 418.00
20225 PR BONE BIOPSY,TROCAR/NEEDLE DEEP 260.00
20240 PR BONE BIOPSY,EXCISIONAL SUPERF 524.00
20245 PR BONE BIOPSY,EXCISIONAL DEEP 1443.00
20500 PR INJECT SINUS TRACT THERAPUTIC 202.00
20520 PR REMOVAL OF FOREIGN BODY 478.00
20525 PR REMOVAL OF FOREIGN BODY DEEP/COMPLIC 1161.00
20526 PR INJECT CARPAL TUNNEL 305.00
20526 PR INJECT CARPAL TUNNEL 50M 457.00
20527 PR INJ DUPUYTREN CORD W/ENZYME 308.00
20550 PR INJECT TENDON SHEATH/LIGAMENT 288.00
20550 PR INJECT TENDON SHEATH/LIGAMENT 50M 432.00
20551 PR INJECT TENDON ORIGIN/INSERT 289.00
20551 PR INJECT TENDON ORIGIN/INSERT 50M 433.00 20552 PR INJECT TRIGGER POINT, 1 OR 2 284.00
20553 PR INJECT TRIGGER POINTS, > 3 289.00
20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US 286.00
20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US 50M 429.00
20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US 288.00
20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US 50M 432.00
20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US 297.00
20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US 50M 446.00
20612 PR ASPIRAT/INJECTION GANGLION CYST(S) 289.00
20650 PR INSERT AND REMOVE BONE PIN 358.00
20665 PR REMOVE TONG/HALO APPL BY OTHR DR 250.00
20670 PR REMOVAL SUPERFICIAL IMPLANT 1795.00
20680 PR REMOVAL DEEP IMPLANT 80M 284.00
20680 PR REMOVAL DEEP IMPLANT 1414.00
20690 PR APPLY BONE UNIPLANE,EXT FIX DEV 1339.00
20692 PR APPLY BONE MULTIPLAN,EXT FIX DEV 2696.00
20693 PR ADJUST EXTERN BONE FIX DEV W ANESTH 1074.00
20694 PR REMOVE EXTERN BONE FIX DEV W ANESTH 1007.00
20822 PR REPLANTATION DIGIT DISTAL, COMPLT 4324.00
20827 PR REPLANTATION THUMB DISTAL,COMPLETE 4516.00
20900 PR BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL 1052.00
20902 PR BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE 751.00
20910 PR CATRILAGE GRAFT; COSTOCHONDRAL 1110.00 20912 PR CATRILAGE GRAFT; NASAL SEPTUM 1134.00
20920 PR FASCIA LATA GRAFT; BY STRIPPER 950.00
20926 PR TISSUE GRAFTS, OTHER 975.00
20931 PR ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL 80M 52.00
20931 PR ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL 252.00
20937 PR AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION 80M 79.00
20937 PR AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION 383.00
20938 PR AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INCISION 411.00
20950 PR RECORD FLUID PRESSURE,MUSCLE 218.00
20974 PR ELECT BONE STIM NONINVASIVE 189.00
20975 PR ELECT BONE STIM INVASIVE 402.00
20979 PR US BONE STIMULATION 128.00
20985 PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS 350.00
21011 PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM 1153.00
21012 PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM 799.00
21013 PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM 1263.00
21014 PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM 1235.00
21016 PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/> 2443.00
21025 PR EXCISION OF BONE, LOWER JAW 2164.00
21026 PR EXCISION OF FACIAL BONE(S) 1474.00
21029 PR CONTOUR OF FACE BONE LESION 1841.00
21032 PR EXCISION,MAXILLARY TORUS PALATINUS 949.00
21049 PR EXCISION,BEN TUMOR,MAXILLA,EXTRA-ORAL 2904.00 21073 PR MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA 903.00
21194 PR RECONST MANDIBLE,C/L OSTEO+GRFT 3294.00
21235 PR EAR CARTILAGE GRAFT TO FACE 1722.00
21315 PR CLOSED RX NOSE FRACTURE 644.00
21320 PR CLOSED RX NOSE FX W STABILIZATN 608.00
21335 PR OPEN RX NOSE FX+OPEN FIX SEPTUM 1767.00
21337 PR CLOSED RX NASAL SEPTAL FRACTURE 992.00
21343 PR OPEN RX DEPRES FRONTAL SINUS FRAC 2941.00
21347 PR OPEN RX NOSE/JAW FRACT/COMPLX 2426.00
21356 PR OPEN RX DEPRESS ZYGOMA FRAC 1242.00
21365 PR OPEN RX COMPLX CHEEK BONE FRAC 2574.00
21386 PR REPAIR EYE BLOWOUT,PERIORBITAL 1682.00
21390 PR REPAIR EYE BLOWOUT,PERIORB+IMPLNT 1833.00
21407 PR OPEN RX FX ORBIT W IMPLANT 1560.00
21445 PR OPEN RX DENTAL RIDGE FX 1924.00
21453 PR CLOSED RX MANDIBLE FX+DENTAL FIX 2085.00
21461 PR OPEN RX MANDIBLE FX 3299.00
21462 PR OPEN RX MANDIBLE FX+DENTAL FIX 2413.00
21470 PR OPEN RX MANDIBLE CONDYLE FX,COMPL 2926.00
21480 PR REDUCE TEMPOROMANDIBL DISLOC 275.00
21501 PR I&D DEEP ABSC/HEMATOMA NECK/CHEST 1085.00
21550 PR BIOPSY SOFT TISSUE NECK/CHEST 583
21552 PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM 1036.00 21554 PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL 5+CM 1692.00
21555 PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM 956.00
21556 PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL <5CM 1223.00
21557 PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM 2265.00
21558 PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/> 3188.00
21685 PR HYOID MYOTOMY & SUSPENSION 2434.00
21811 PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS 80M 290.00
21811 PR OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS 1444.00
21920 PR BIOPSY SOFT TISSUE BACK,SUPERF 479.00
21925 PR BIOPSY SOFT TISSUE BACK,DEEP 1089.00
21930 PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM 1151.00
21931 PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM 1087.00
21932 PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM 1524.00
21933 PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM 1704.00
22015 PR I&D, POST SPINE, LUMB/SACR/LUMBOSAC 2125.00
22305 PR CLOSED TREAT SPINE PROCESS FX 467.00
22513 PR PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION 1568.00
22524 PR PERC VERTEB AUGMENT/ KYPHOPLAST, LUMBAR 1244.00
22551 PR PR ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2 80M 968.00
22551 PR PR ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2 4839.00
22552 PR PR ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2 E 80M 225.00
22552 PR PR ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2 EACH ADDL 1124.00
22554 PR CERV SPINE FUSN,ANTER,BELOW C2 80M 568.00 22554 PR CERV SPINE FUSN,ANTER,BELOW C2 2836.00
22558 PR LUMBAR SPINE FUSION,ANTER APPRCH 80M 703.00
22558 PR LUMBAR SPINE FUSION,ANTER APPRCH 3512.00
22585 PR SPINAL FUSION,ANT,EA ADNL LEVEL 80M 152.00
22585 PR SPINAL FUSION,ANT,EA ADNL LEVEL 758.00
22600 PR CERV FUSN,BELOW C2,POST TECH 3039.00
22610 PR ARTHRODESIS POSTERIOR/POSTEROLATERAL THORACIC 2983.00
22612 PR ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR 80M 716.00
22612 PR ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR 3578.00
22614 PR SPINE FUSN,POST TECH,EA ADDNL SGMT 80M 178.00
22614 PR SPINE FUSN,POST TECH,EA ADDNL SGMT 886.00
22830 PR EXPLORATION OF SPINAL FUSION 1878.00
22840 PR POSTERIOR NON-SEGMENTAL INSTRUMENTATION 80M 345.00
22840 PR POSTERIOR NON-SEGMENTAL INSTRUMENTATION 1722.00
22842 PR POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG 80M 346.00
22842 PR POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG 1729.00
22845 PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS 80M 354.00
22845 PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS 1767.00
22846 PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS 80M 343.00
22846 PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS 1714.00
22849 PR REINSERT SPINAL FIXATION 3045.00
22850 PR REMOVE SPINE FIX DEV,HARRINGTON 1468.00
22852 PR REMOVE SPINE FIX DEV,POST SGMTAL 1547.00 22855 PR REMOVE SPINE FIX DEV,ANTERIOR 2490.00
22900 PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM 1309.00
22901 PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM 1551.00
22902 PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM 1039.00
22903 PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM 1017.00
22905 PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/> 3119.00
23000 PR REMOVAL SUBDELTOID CALCAREOUS DEP,OPEN 1422.00
23030 PR INCIS/DRAIN SHLDR ABSC/HEMA,DEEP 1042.00
23040 PR DEEP INCIS SHLDR BONE CORTEX 1665.00
23066 PR BIOPSY SHLDR SOFT TISSUES,SUPERFIC 1365.00
23071 PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM 1087.00
23073 PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM 1609.00
23075 PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM 920.00
23076 PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM 1228.00
23120 PR PARTIAL REMOVAL, CLAVICLE 1359.00
23130 PR PARTIAL REMOVAL/REPAIR,ACROMION 1438.00
23150 PR EXCIS/CURET BENIGN TUMR PROX HUMERUS 1552.00
23156 PR EXCIS BENIG TUMR PROX HUMER,AUTOGRFT 1564.00
23180 PR PART EXCIS CLAVICLE 1581.00
23195 PR REMOVAL OF HEAD OF HUMERUS 80M 362.00
23195 PR REMOVAL OF HEAD OF HUMERUS 1807.00
23330 PR REMOVE SUBCUT SHOULDER FOREIGN BODY 591.00
23405 PR INCISE TENDON/MUSCLE,SHLDR,SINGLE 1457.00 23410 PR REPAIR ROTATOR CUFF,ACUTE 80M 342.00
23410 PR REPAIR ROTATOR CUFF,ACUTE 1707.00
23412 PR REPAIR ROTATOR CUFF,CHRONIC 80M 437.00
23412 PR REPAIR ROTATOR CUFF,CHRONIC 2182.00
23420 PR REPAIR COMPL ROTATOR CUFF AVULSN,CHR 2244.00
23430 PR REPAIR BICEPS LONG TENDON 80M 339.00
23430 PR REPAIR BICEPS LONG TENDON 1689.00
23440 PR REMV/TRANSPLANT LONG BICEPS TENDON 1750.00
23462 PR REPAIR SHLDR CAPSU,ANT,CORACOID XFER 2541.00
23466 PR REPAIR SHLDR CAPSU FOR INSTABILITY 2666.00
23470 PR RECONSTRUCT PROX HUMERAL IMPLANT 80M 552.00
23470 PR RECONSTRUCT PROX HUMERAL IMPLANT 2759.00
23472 PR RECONSTR TOTAL SHOULDER IMPLANT 80M 684.00
23472 PR RECONSTR TOTAL SHOULDER IMPLANT 3413.00
23473 PR REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT 3773.00
23474 PR REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT 80M 847.00
23474 PR REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT 4233.00
23480 PR OSTEOTOMY CLAVICLE 1957.00
23500 PR CLOSED RX CLAVICLE FRACTURE 522.00
23505 PR CLOSED RX CLAVICLE FX,MANIPULATN 812.00
23515 PR OPEN TREATMENT CLAVICULAR FRACTURE INTERNAL FX 80M 330.00
23515 PR OPEN TREATMENT CLAVICULAR FRACTURE INTERNAL FX 1639.00
23550 PR OPEN RX A-C JT DISLOC 1320.00 23552 PR OPEN RX A-C JT DISLOC,FASCIAL GRFT 1497.00
23570 PR CLOSED RX SCAPULA FX 564.00
23585 PR OPEN RX SCAPULA FRACTURE 2261.00
23600 PR CLOSED RX PROX HUMERUS FRACTURE 793.00
23605 PR CLOSED RX PROX HUMERUS FX,MANIP 1113.00
23615 PR OPEN TREATMENT PROX HUMERAL FRACTURE 80M 403.00
23615 PR OPEN TREATMENT PROX HUMERAL FRACTURE 2008.00
23616 PR OPEN PROX HUMERAL FRACTURE PROSHETIC REPLACEMENT 80M 577.00
23616 PR OPEN PROX HUMERAL FRACTURE PROSHETIC REPLACEMENT 2881.00
23620 PR CLOSED RX GR TUBEROSITY HUM FX 659.00
23625 PR CLOSED RX GR TUBER HUM FX,MANIP 912.00
23630 PR OPEN TX GREATER HUERAL TUEROSITY FRACTURE INTERNAL 1352.00
23650 PR CLOSED RX SHLDR DISLOCATION 718.00
23655 PR CLOSED RX SHLDR DISLOC,ANESTHESIA 886.00
23660 PR OPEN RX ACUTE SHLDR DISLOC 1010.00
23665 PR CLOSED RX SHLDR DISLOC,GR TUB FX 1023.00
23675 PR CLOSED RX SHLDR DISLOC,PROX HUM FX 1313.00
23700 PR MANIPULATN SHLDR JT W ANESTHESIA 443.00
23930 PR INCIS/DRAIN ARM,DEEP ABSC/HEMATOMA 819.00
23931 PR INCIS/DRAIN ARM/ELBOW INFECT BURSA 705.00
23935 PR INCIS DEEP ARM/ELBOW BONE LESION 1202.00
24000 PR EXPLORE/DRAIN ELBOW FOR INFECT 1152.00
24006 PR ARTHROTOMY/CAPULE RELEASE ELBOW JT 1709.00 24065 PR BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL 619.00
24066 PR BX ARM/ELBOW SOFT TISSUE,DEEP 1531.00
24071 PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM 950.00
24073 PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM 80M 322.00
24073 PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM 1606.00
24075 PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM 975.00
24076 PR EXC TUMOR SOFT TISS UARM/ELBOW SUBFASC <5CM 1246.00
24077 PR RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM 2472.00
24101 PR EXPLORE ELBOW JOINT 1137.00
24105 PR REMOVAL OF ELBOW BURSA 787.00
24115 PR EXCIS BENIGN HUMERUS LESN,AUTOGRFT 1770
24147 PR PARTIAL REMOVAL OLECRANNON PROCESS 1454.00
24149 PR RADICAL RESECT ELBOW, CONTRAC RELEAS 2824.00
24200 PR REMOVAL ARM/ELBOW F.B.,SUPERFICIAL 508.00
24201 PR REMOVAL ARM/ELBOW F.B.,DEEP 1376.00
24332 PR TENOLYSIS, TRICEPS 1458.00
24340 PR REPAIR OF BICEPS TENDON AT ELBOW 1425.00
24341 PR MUSC/TENDON REPAIR EACH; ARM/ELBOW 1734.00
24342 PR REINSERT BI/TRICEPS TENDON,DISTAL 1775.00
24343 PR REPR ELBOW LAT LIGMNT W/TISS 1666.00
24344 PR RECONSTRUCT ELBOW LAT LIGMNT W/GRAFT 2546.00
24358 PR TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE OPEN 1193.00
24359 PR TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE REPAIR 1493.00 24363 PR ARTHROPLASTY,ELBOW,TOTAL PROSTH REPL 3488.00
24366 PR RECONSTRUCT RADIAL HEAD W IMPLANT 1579.00
24400 PR OSTEOTOMY HUMERUS 1901.00
24430 PR REPAIR NON/MALUNION HUMERUS 2467.00
24435 PR REPAIR NON/MALUNION HUMERUS,GRAFT 2493.00
24500 PR CLOSED RX MID HUMERUS FRACTURE 869.00
24505 PR CLOSED RX MID HUMERUS FX,MANIPULATN 1128.00
24515 PR OPEN FIXATN MID HUMERUS FRACTURE 80M 400.00
24515 PR OPEN FIXATN MID HUMERUS FRACTURE 1994.00
24516 PR OPEN ROD FIXATN HUMERAL SHAFT FX 2009.00
24530 PR CLOSED RX HUMERAL SUPRACONDYLAR FX 928.00
24535 PR CLOSED RX HUM SUPRACONDYLR FX,MANIPU 1433.00
24538 PR PERCUT FIX HUM SUPRACONDYLAR FX 1693.00
24545 PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN 2103.00
24546 PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W XTN 2407.00
24560 PR CLOSED RX HUMER EPICONDYLR FX 780.00
24565 PR CLOSED RX HUMER EPICONDYLR FX,MANIP 1277.00
24575 PR OPEN TX HUMERAL EPICONDYLAR FRACTURE 1703.00
24579 PR OPEN TX HUMERAL CONDYLAR FRACTURE 1961.00
24586 PR OPEN RX PERIARTIC FX/DISLOC ELBOW 2575.00
24587 PR OPEN RX PERIARTIC FX ELBOW,IMPLNT 2583.00
24600 PR CLOSED RX ELBOW DISLOCATION 847.00
24605 PR CLOSED RX ELBOW DISLOCATN,ANESTHESIA 1119.00 24615 PR OPEN RX ELBOW DISLOCATION 1225.00
24620 PR CLOSED RX MONTEGGIA FX/DISLOC ELBOW 1312.00
24635 PR OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW 2417.00
24640 PR CLOSED RX RADIAL HEAD DISLOC,CHILD 321.00
24650 PR CLOSED RX RADIAL HEAD/NECK FX 739.00
24655 PR CLOSED RX RADIAL HEAD/NECK FX,MANIP 1054.00
24665 PR OPEN TX RADIAL HEAD/NECK FRACTURE 1348.00
24666 PR OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC 1668.00
24670 PR CLOSED TX ULNAR FRACTURE PROX END W/O MANIPULATE 629.00
24685 PR OPEN TX ULNAR FRACTURE PROX END 80M 297.00
24685 PR OPEN TX ULNAR FRACTURE PROX END 1483.00
24999 PR UPPER ARM/ELBOW SURG UNLISTED 2132.00
25000 PR INCIS TENDON SHEATH,RADIAL STYLOID 810.00
25020 PR DECOMP FOREARM,1 COMPART,W/O DEBRIDE 1397.00
25028 PR INCIS/DRAIN FOREARM DEEP ABSCESS 1233.00
25031 PR INCIS/DRAIN FOREARM INFECTED BURSA 827.00
25040 PR EXPLORE/TREAT WRIST JOINT 1316.00
25065 PR BIOPSY FOREARM SOFT TISSUES,SUPERFIC 1150.00
25071 PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM 1113.00
25073 PR EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM 1250.00
25075 PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM 1163.00
25076 PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM 1217.00
25107 PR REPAIR TRIANGULAR CART,WRIST JT 1472.00 25109 PR EXCISE TENDON FOREARM/ WRIST 1246.00
25110 PR EXCIS TENDON SHEATH LESN,WRIST/FORE 811.00
25111 PR EXCIS PRIMARY GANGLION WRIST 731.00
25112 PR EXCIS RECURRENT GANGLION WRIST 881.00
25118 PR EXCIS SYNOV WRIST,EXTENS TENDON 920.00
25130 PR EXCIS BENIGN LESN CARPALS 1034.00
25151 PR PART REMOVAL BONE,RADIUS 1397.00
25215 PR REMOVAL OF PROX ROW CARPAL BONES 1450.00
25240 PR EXCIS DISTAL ULNA,PART/COMPLETE 1040.00
25248 PR REMOVE FOREARM/WRIST FOREIGN BODY 979.00
25260 PR REPR FOREARM TEND/MUSC,FLEX,PRIM,EA 1512.00
25270 PR REPR FOREARM TEND/MUSC,EXTEN,PRIM,EA 1198.00
25272 PR REPR FOREARM TEND/MUSC,EXTEN,SECOND 1334.00
25274 PR REPR FOREARM TEND/EXT,SECOND,GRAFT,EA 1597.00
25295 PR RELEASE WRIST/FOREARM TENDON 1671.00
25310 PR TRANSPLANT FOREARM/WRIST TENDON 1482.00
25312 PR XPLANT FOREARM TENDON,W TENDON GRFT 1725.00
25337 PR RECONSTRUCT ULNA/RADIOULNAR 2079.00
25350 PR OSTEOTOMY RADIUS,DISTAL THIRD 1605.00
25390 PR OSTEOPLASTY,RADIUS OR ULNA,SHORTEN 1838.00
25400 PR REPAIR NONUNION RADIUS OR ULNA 1907.00
25405 PR REPAIR NONUNION RADIUS OR ULNAW/GRAFT 2411.00
25440 PR REPAIR NONUNION SCAPHOID CARPAL BONE 1799.00 25441 PR RECONSTRUCT DIST RADIUS W PROSTH 2242.00
25447 PR REPAIR INTERCARP/CARP-METACARP JT 80M 377.00
25447 PR REPAIR INTERCARP/CARP-METACARP JT 1880.00
25505 PR CLOSED RX RADIAL SHAFT FX,MANIPULATN 1130.00
25515 PR OPEN TREATMENT RADIAL SHAFT FRACTURE 1551.00
25520 PR CLOSED RX RADIAL SHAFT FX W/DISLOCATION 1352.00
25525 PR OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE 1826.00
25535 PR CLOSED RX ULNA SHAFT FX,MANIPULATN 1144.00
25545 PR OPEN TREATMENT OF ULNAR SHAFT FRACTURE 1419.00
25560 PR CLOSED RX RAD/ULNA SHAFT FX 564.00
25565 PR CLOSED RX RAD/ULNA SHAFT FX,MANIP 1179.00
25574 PR OPEN TX RADIAL & ULNAR SHAFT FX FIX RADIUS OR ULNA 1618.00
25575 PR OPEN TX RADIAL & ULNAR SHAFT FX FIX RADIUS AND ULNA 2080.00
25600 PR CLOSED RX DIST RAD/ULNA FX 524.00
25605 PR CLOSED RX DIST RAD/ULNA FX,MANIPUL 1402.00
25605 PR CLOSED RX DIST RAD/ULNA FX,MANIPUL 50M 2103.00
25606 PR PERCUT SKELETAL FIX, DISTAL RADIUS FX 1543.00
25607 PR OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR 80M 341.00
25607 PR OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR 1700.00
25608 PR OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG 1860.00
25609 PR OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG 80M 474.00
25609 PR OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG 2367.00
25622 PR CLOSED RX NAVICULAR FX 624.00 25624 PR CLOSED RX NAVICULAR FX,MANIPULATN 1151.00
25628 PR OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE 1674.00
25645 PR OPEN RX CARPAL BONE FX,EACH BONE 1338.00
25652 PR OPEN RX ULNAR STYLOID FX 1501.00
25670 PR OPEN REPAIR WRIST DISLOCATION 1418.00
25675 PR CLOSED RX RADIO-ULNA DISLOCATION 1070.00
25676 PR OPEN RX RADIO-ULNA DISLOCATION 1483.00
25680 PR CLOSED RX NAVIC/LUNATE FX/DISLOC 1137.00
25685 PR OPEN RX NAVIC-PERILUNATE FX/DISLOC 1752.00
25690 PR CLOSED RX LUNATE DISLOCATION 1137.00
25695 PR OPEN REPAIR LUNATE DISLOCATION 1482.00
25810 PR FUSION/GRAFT WRIST JOINT 80M 418.00
25810 PR FUSION/GRAFT WRIST JOINT 2087.00
25820 PR FUSION INTERCARPAL 1468.00
25825 PR FUSION/GRAFT INTERCARPAL 1771.00
25929 PR AMPUTATION FOLLOW-UP SURGERY 2302.00
26010 PR DRAIN FINGER ABSCESS,SIMPLE 597.00
26011 PR DRAIN FINGER ABSCESS,COMPLICATED 981.00
26020 PR DRAIN HAND TENDON SHEATH 1053.00
26025 PR DRAINAGE PALM BURSA,SINGLE 1006.00
26030 PR DRAINAGE PALM BURSA,MULTIP/COMPLX 1164.00
26034 PR INCIS DEEP FINGR/HAND BONE LESN 1296.00
26035 PR DECOMPRESS FINGERS/HAND,INJECT INJ 2049.00 26040 PR RELEASE PALM CONTRACT,PERCUTANEOUS 2233.00
26045 PR RELEASE PALM CONTRACT,OPEN,PARTIAL 1061.00
26055 PR INCISE FINGER TENDON SHEATH 1318.00
26070 PR EXPLORE & TREAT CARPOMETACARP JT 752.00
26075 PR EXPLORE & TREAT METACARPO-PHAL JT 761.00
26080 PR EXPLORE/TREAT INTERPHALANGEAL JT,EA 912.00
26105 PR BIOPSY SYNOVIUM MC-P JT 759.00
26110 PR BIOPSY SYNOVIUM I-P JT 781.00
26111 PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM 984.00
26113 PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM 1290.00
26115 PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM 1265.00
26116 PR EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM 1227.00
26117 PR RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM 1792.00
26118 PR RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/> 2526.00
26121 PR PALMAR FASCIECTOMY 1362.00
26123 PR PART PALMAR FASCIEC,OPEN 1 DIGIT 1893.00
26125 PR PART PALMAR FASCIEC,OPEN ADDNL DIGIT 635.00
26140 PR EXCIS JT LINING,PROX I-P JT,EACH 1193.00
26145 PR RAD EXCIS JT LINING,FLEXOR,EACH 1207.00
26160 PR EXCIS TENDON SHEATH LESION, HAND/FINGER 1432.00
26210 PR EXCIS BENIGN BONE LESN,PHALANX 1033.00
26215 PR EXCIS/GRFT BENIGN LESN,PHALANX 1356.00
26230 PR PART REMV BONE,METACARPAL 1164.00 26235 PR PART REMV BONE,PROX/MID PHALANX 1151.00
26236 PR PART REMV BONE,DISTAL PHALANX 1030.00
26340 PR MANIPULATE FINGER JT W/ ANESTH,EACH 1212.00
26341 PR MANIPULAT PALM CORD POST INJ 554.00
26350 PR REPAIR FLEXOR TENDON,HAND,W/O GRAFT,EA 1724.00
26356 PR REPAIR FLEX TENDON,ZONE 2,HAND 2271.00
26357 PR REPAIR FLEX TENDON,ZONE 2,SECON,HAND,EA 1989.00
26370 PR REPAIR PROFUNDUS TENDON,PRIMARY 1801.00
26410 PR REPAIR EXTEN TENDON,DORSUM HAND,EA 1309.00
26418 PR REPAIR EXTEN TENDON,DORSUM FINGR,EA 1333.00
26426 PR REPAIR EXT TEND,CENT SLIP,SEC 1212.00
26432 PR REPAIR EXTEN TENDON,DISTAL INSERT,CLOSE 1204.00
26433 PR REPAIR EXTEN TENDON,DISTAL INSERT,OPEN 1285.00
26437 PR REALIGNMENT OF TENDONS,HAND 1468.00
26445 PR TENOLYSIS EXT TENDON,HAND/FINGER,EA 1396.00
26480 PR TRANSPLANT HAND TENDON 1786.00
26525 PR RELEASE I-P JT CONTRACTURE 1554.00
26530 PR ARTHROPLASTY MC-P JT,SINGLE 1110.00
26540 PR FIX COLLAT LIG,MC-P JT,I-P JT 1154.00
26541 PR FIX COLLAT LIG,MC-P JT,GRAFT 80M 376.00
26541 PR FIX COLLAT LIG,MC-P JT,GRAFT 1876.00
26546 PR FIX NONUNION METACARPAL/PHALANX 2326.00
26548 PR FIX FINGER,VOLAR PLATE,I-P JT 1820.00 26560 PR REPAIR OF WEB FINGER,EACH 1338.00
26565 PR CORRECT METACARPAL DEFORM 1413.00
26591 PR REPAIR MUSCLES OF HAND 1055.00
26600 PR CLOSED RX METACARPAL FX 711.00
26605 PR CLOSED RX METACARPAL FX,MANIP 723.00
26608 PR CLOSED RX METACARPAL FX,PERCUT 1087.00
26615 PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE 1291.00
26641 PR TREAT THUMB DISLOC,MANIPULATN 887.00
26650 PR PRQ SKEL FIXATION CARP/MTCRPL FX DISLOCATE THUMB 1089.00
26665 PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB 1650.00
26670 PR CLOSED RX, CARPOMETACAR DISLOC,NON-THUMB 796.00
26676 PR PERCUT FIX CARPOMETACAR DISLOC,NON-THUMB 1174.00
26685 PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB 723.00
26700 PR CLOSED RX MC-P DISLOC 779.00
26720 PR CLOSE RX PROX/MID FING SHFT FX 483.00
26725 PR CLOSE RX PROX/MID FING SHFT FX,MANIP 763.00
26727 PR PERCUT RX PROX/MID FING SHFT FX 1100.00
26735 PR OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA 1339.00
26740 PR CLOSE RX FINGR ARTICULAR FX 561.00
26742 PR CLOSE RX FINGR ARTICULAR FX,MANIP 827.00
26746 PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA 1712.00
26750 PR CLOSE RX DIST FINGR FX 452.00
26755 PR CLOSE RX DIST FINGR FX,MANIPULATN 1149.00 26756 PR PERCUT RX DIST FINGR FX 1005.00
26765 PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH 1195.00
26770 PR CLOSED RX IP JT DISLOCATION 636.00
26775 PR CLOSED RX IP JT DISLOCATION,ANESTH 930.00
26776 PR PERCUT RX IP JT DISLOCATION 1008.00
26785 PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION 1 1260.00
26850 PR FUSION MC-P JT 1629.00
26860 PR FUSION FINGER JOINT 1299.00
26862 PR FUSION/GRAFT FINGER JT 1716.00
26910 PR AMPUTATE METACARPAL+FINGER 1695.00
26951 PR AMPUTATION FINGER/THUMB 1473.00
26952 PR AMPUTATION FINGER/THUMB+FLAPS 1524.00
26990 PR INCIS/DRAIN PELVIS/HIP,DEEP ABSCESS 1448.00
26991 PR INCIS/DRAIN PELVIS/HIP,INFECT BURSA 1709.00
26992 PR INCIS/DRAIN PELVIS/HIP,OPEN BONE 2305.00
27000 PR INCIS HIP ADDUCTOR,SUBCUT,CLOSED 1006.00
27025 PR INCIS OF HIP/THIGH FASCIA 2199.00
27030 PR DRAINAGE OF HIP JOINT 80M 432.00
27030 PR DRAINAGE OF HIP JOINT 2154.00
27033 PR EXPLORATION OF HIP JOINT 2322.00
27036 PR RELEASE HIP FLEXION CONTRACTURE 2356.00
27041 PR BX SOFT TISSUES,PELV/HIP,DEEP 1567.00
27043 PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM 1088.00 27045 PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM 1780.00
27047 PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM 1133.00
27048 PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM 1421.00
27059 PR RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5 CM/> 4335.00
27062 PR REMOVE TROCH BURSA/CALCIFICATN 1080.00
27071 PR PARTIAL EXCISION DEEP PELVIS 2121.00
27080 PR REMOVAL OF COCCYX 1144.00
27087 PR REMOVE PELV/HIP F.B.,DEEP 1466
27090 PR REMOVAL OF HIP PROSTHESIS 1968.00
27091 PR REMOVAL OF HIP PROSTHESIS,COMPLEX 3678.00
27093 PR INJECTION HIP ARTHROGRAM 475.00
27122 PR RECONSTRUC HIP SOCKET,RESEC FEM HEAD 2610.00
27125 PR PARTIAL HIP REPLACEMENT 2576.00
27130 PR TOTAL HIP ARTHROPLASTY 80M 659.00
27130 PR TOTAL HIP ARTHROPLASTY 3287.00
27132 PR CONV PREV HIP SURG TO TOT HIP ARTHROPLAS 80M 778.00
27132 PR CONV PREV HIP SURG TO TOT HIP ARTHROPLAS 3884.00
27134 PR REVISE TOTAL HIP REPLACEMENT 80M 1101.00
27134 PR REVISE TOTAL HIP REPLACEMENT 4400.00
27137 PR REVISE ACETABULAR PART OF TOTAL HIP 80M 676.00
27137 PR REVISE ACETABULAR PART OF TOTAL HIP 3375.00
27138 PR REVISE FEM PART OFTOTAL HIP 80M 710.00
27138 PR REVISE FEM PART OFTOTAL HIP 3545.00 27170 PR BONE GRAFT FEMUR HEAD/NECK/RIDGE 80M 562.00
27170 PR BONE GRAFT FEMUR HEAD/NECK/RIDGE 2805.00
27176 PR CLOSED RX SLIP FEM EPIPHYSIS,PINS 2161.00
27187 PR REINFORCE HIP BONES 2314.00
27193 PR CLOSED RX PELVIC RING FX/SUBLUX 1155.00
27222 PR CLOSED RX ACETABULAR FX,MANIPULATN 2362.00
27230 PR CLOSED RX PROX/NECK FEMUR FX 1146.00
27235 PR PERCUT FIX PROX/NECK FEMUR FX 2076.00
27236 PR FEMORAL FX, OPEN TX 80M 545.00
27236 PR FEMORAL FX, OPEN TX 2722.00
27244 PR TREAT INTER/SUBTROCH FX,W/PLATE/SCREW 2799.00
27245 PR OPEN FIX INTER/SUBTROCH FX,IMPLNT 2832.00
27246 PR CLOSED RX GR TROCHANTERIC FX 928.00
27248 PR OPEN TREATMENT GREATER TROCHANTERIC FRACTURE 1731.00
27250 PR CLOSED RX TRAUMATIC HIP DISLOCATN 437.00
27252 PR CLOSED RX TRAUMA HIP DISLOC,ANESTH 1715.00
27253 PR OPEN RX TRAUMATIC HIP DISLOCATN 80M 449.00
27253 PR OPEN RX TRAUMATIC HIP DISLOCATN 2239.00
27256 PR CLOSED RX SPONTANEOUS HIP DISLOC 661.00
27257 PR CLOSED RX SPONT HIP DISLOC,ANESTH 871.00
27265 PR CLOSED RX POST HIP ARTHRPLAS DISLOC 890.00
27266 PR CLOSED RX POST HIP FIX DISLOC,ANESTH 1320.00
27268 PR CLOSED TX FEMORAL FRACTURE PROX HEAD W MANIP 1303.00 27269 PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD 2995.00
27299 PR PELVIS/HIP JOINT SURG PROC UNLISTED 2195.00
27301 PR INCIS/DRAIN THIGH/KNEE ABSCESS,DEEP 1581.00
27310 PR EXPLOR/DRAIN KNEE,INFECTN 1690.00
27323 PR BX THIGH/KNEE SOFT TISSUES,SUPERF 663.00
27324 PR BX THIGH/KNEE SOFT TISSUES,DEEP 905.00
27327 PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM 900.00
27328 PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM 1454.00
27331 PR ARTHROTOMY/EXPLORE/TREAT KNEE JOINT 1079.00
27335 PR REMV SYNOVIUM KNEE,ANTER & POST 1791.00
27337 PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM 974.00
27339 PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM 80M 269.00
27339 PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM 1343.00
27340 PR REMOVAL PREPATELLA BURSA 899.00
27345 PR REMOVAL SYNOVIAL CYST,KNEE 1121.00
27347 PR REMOVE KNEE CYST/GANGLION 1191.00
27355 PR REMV BENIGN FEMUR LESION 1436.00
27360 PR PART REMV FEMUR/PROX TIB/FIB 2035.00
27365 PR RAD RESEC TUMOR,FEMUR OR KNEE 4902.00
27372 PR REMV FOREIGN BODY,KNEE/THIGH,DEEP 1483.00
27380 PR FIX INFRAPATELLA TENDON,PRIMARY 1383.00
27381 PR FIX PATELLA TENDN,SECONDARY 80M 384.00
27381 PR FIX PATELLA TENDN,SECONDARY 1916.00 27385 PR FIX QUAD/HAMSTR MUSC RUPT,PRIMARY 80M 271.00
27385 PR FIX QUAD/HAMSTR MUSC RUPT,PRIMARY 1350.00
27386 PR FIX QUAD/HAMSTR MUSC RUPT,SECOND 1979.00
27396 PR TRANSPLANT OF THIGH TENDON 1482.00
27403 PR ARTHROTOMY,OPEN REPAIR MENISCUS 1525.00
27405 PR REPAIR COLLAT LIGAMT/CAPSULE,KNEE 80M 329.00
27405 PR REPAIR COLLAT LIGAMT/CAPSULE,KNEE 1637.00
27415 PR OSTEOCHONDRAL KNEE ALLOGRAFT 3318.00
27418 PR REPAIR ANTER TIBIAL TUBERCLE 1927.00
27420 PR REVISION OF UNSTABLE PATELLA 80M 341.00
27420 PR REVISION OF UNSTABLE PATELLA 1703.00
27422 PR FIX UNSTABLE PATELLA,EXTEN REALIGN 1722.00
27427 PR LIGMT REVISION,KNEE,EXTRA-ARTIC 80M 344.00
27427 PR LIGMT REVISION,KNEE,EXTRA-ARTIC 1716.00
27428 PR LIGMT REVISION,KNEE,INTRA-ARTIC 2678.00
27438 PR ARTHROPLASTY PATELLA WITH IMPLANT 80M 305.00
27438 PR ARTHROPLASTY PATELLA WITH IMPLANT 1521.00
27446 PR PLASTY KNEE,MED OR LAT COMPARTMT 80M 506.00
27446 PR PLASTY KNEE,MED OR LAT COMPARTMT 2527.00
27447 PR TOTAL KNEE ARTHROPLASTY 80M 705.00
27447 PR TOTAL KNEE ARTHROPLASTY 50M,80M 1057.00
27447 PR TOTAL KNEE ARTHROPLASTY 3514.00
27447 PR TOTAL KNEE ARTHROPLASTY 50M 5270.00 27454 PR OSTEOTOMIES FEMUR SHAFT+INTRA ROD 3080.00
27470 PR FIX NON/MALUNION FEMUR BELOW NECK 2836.00
27472 PR FIX NON/MALUNION FEMUR,W GRAFT 2941.00
27486 PR REVISE KNEE JOINT REPLACE,1 PART 80M 650.00
27486 PR REVISE KNEE JOINT REPLACE,1 PART 3248.00
27487 PR REVISE KNEE JOINT REPLACE,ALL PARTS 80M 806.00
27487 PR REVISE KNEE JOINT REPLACE,ALL PARTS 4027.00
27488 PR REMOVAL OF KNEE PROSTHESIS 2800.00
27496 PR DECOMPRESS THIGH/KNEE,1 COMPARTMT 1314.00
27500 PR CLOSED RX FEMUR SHAFT FX 1202.00
27502 PR CLOSED RX FEMUR SHAFT FX+MANIP 1829.00
27503 PR CLOSED RX CONDYLAR FX+MANIP 1850.00
27506 PR OPEN RX FEMUR FX+INTRAMED ROD 3048.00
27507 PR OPEN RX FEMUR FX+PLATE/SCREW 2248.00
27509 PR PERCUT FIX DISTAL FEMUR 1554.00
27511 PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O EXTENSION 80M 461.00
27511 PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O EXTENSION 2303.00
27513 PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W EXTENSION 2104.00
27514 PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE 2256.00
27520 PR CLOSED RX PATELLA FX 780.00
27524 PR OPEN RX PATELLA FX 1714.00
27530 PR CLOSED RX TIBIAL PLATEAU FX 742.00
27532 PR CLOSED RX TIB PLAT FX+MANIP 1490.00 27535 PR OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR 2079.00
27536 PR OPEN RX BILAT TIB PLAT FX 2714.00
27540 PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE 1866.00
27550 PR CLOSED RX KNEE DISLOCATN 80M 290.00
27550 PR CLOSED RX KNEE DISLOCATN 1155.00
27552 PR CLOSED RX KNEE DISLOC+ANESTH 1478.00
27557 PR OPEN TX KNEE DISLOCATION W LIGAMENTOUS REPAIR 2480.00
27560 PR CLOSED RX KNEECAP DISLOCATN 867.00
27570 PR MANIPULATN KNEE JT+ANESTHESIA 351.00
27590 PR AMPUTATE THIGH,THRU FEMUR 1885.00
27592 PR AMPUTATE THIGH,OPEN CIRCULAR 80M 324.00
27592 PR AMPUTATE THIGH,OPEN CIRCULAR 1620.00
27594 PR AMPUTATE THIGH,SECONDRY CLOSUR 1196.00
27596 PR AMPUTATE THIGH,RE-AMPUTATN 1705.00
27598 PR AMPUTATE LOWER LEG AT KNEE 1705.00
27602 PR DECOMPRESS ANT/LAT+POST LEG CMPART 1163.00
27603 PR DRAIN LOWER LEG DEEP ABSC/HEMATOMA 1232.00
27607 PR DRAIN LEG/ANKLE BONE FOR INFECT 1430.00
27610 PR EXPLORE/TREAT ANKLE JOINT 1525.00
27618 PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM 1058.00
27619 PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <3CM 1033.00
27630 PR EXCIS LESN TENDON SHEALTH LEG/ANKLE 1388.00
27635 PR EXCIS BENIGN LESN,TIB/FIB 1390.00 27640 PR PARTIAL REMOVAL OF TIBIA 1953.00
27641 PR PARTIAL REMOVAL OF FIBULA 1559.00
27650 PR REPAIR ACHILLES TENDON,PRIMARY 1538.00
27654 PR REPAIR ACHILLES TENDON,SECONDARY 1669.00
27658 PR REPAIR FLEX LEG TENDON,PRIM,EA 872.00
27659 PR REPAIR FLEX LEG TENDON,SECOND,EA 1151.00
27664 PR REPAIR EXTEN LEG TENDN,PRIM,EACH 854.00
27665 PR REPAIR EXTEN LEG TENDN,SECOND,EA 993.00
27675 PR REPAIR PERONEAL TENDONS 1148.00
27680 PR RELEASE TIB/FIB/ANKLE FLEX TENDON,EA 995.00
27685 PR LENGTH/SHORT LEG/ANKL TENDON,SINGLE 1563.00
27687 PR GASTROCNEMIUS RECESSION 1104.00
27690 PR XFER SINGLE SUPERFICI LOW LEG TENDON 1481.00
27691 PR XFER SINGLE DEEP LOW LEG TENDON 1752.00
27695 PR REPAIR 1 COLLAT ANKLE LIGMNT,PRIMARY 1132.00
27696 PR REPAIR BOTH COLLAT ANKL LIGMT,PRIMRY 1349.00
27698 PR REPAIR COLLAT ANKLE LIGMNT,SECONDARY 1538.00
27702 PR TOTAL ANKLE REPLACEMENT 80M 463.00
27702 PR TOTAL ANKLE REPLACEMENT 2315.00
27707 PR OSTEOTOMY FIBULA 969.00
27724 PR REPAIR NON/MALUNION TIBIA W ILIAC OR AUTOGRAFT 3030.00
27726 PR REPAIR FIBULA NONUNION/MALUNION W INT FIXATION 2218.00
27750 PR CLOSED RX TIBIA SHAFT FX 835.00 27752 PR CLOSED RX TIBIA SHAFT FX,MANIPULATN 1258.00
27756 PR PERCUT RX TIBIA SHAFT FX 80M 269.00
27756 PR PERCUT RX TIBIA SHAFT FX 1340.00
27758 PR OPEN RX TIBIA SHAFT FX,SCREWS 2030.00
27759 PR TREAT TIBIAL SHAFT FX, INTRAMED IMPLANT 80M 457.00
27759 PR TREAT TIBIAL SHAFT FX, INTRAMED IMPLANT 2282.00
27760 PR CLOSED RX MED MALLEOLUS FX 1205.00
27762 PR CLOSED RX MED MALLEOLUS FX,MANIP 1128.00
27766 PR OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE 1395.00
27769 PR OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE 1680.00
27784 PR OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE 1686.00
27786 PR CLOSED RX DIST FIBULA FX 778.00
27792 PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS 1621.00
27808 PR CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANIP 817.00
27810 PR CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MANIP 1070.00
27814 PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE 1769.00
27814 PR OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE 50M 2653.00
27818 PR CLOSED RX TRIMALLEOLAR FX,MANIP 1166.00
27822 PR OPEN TX TRIMALLEOLAR ANKLE FX W/O FIX PST LIP 1939.00
27823 PR OPEN TX TRIMALLEOLAR ANKLE FX W FIX PST LIP 2200.00
27825 PR CLOSED RX WEIGHT BEAR DIST TIB,MANIP 1315.00
27827 PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY 80M 505.00
27827 PR OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY 2521.00 27828 PR OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA 2969.00
27829 PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION 80M 311.00
27829 PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION 1550.00
27840 PR CLOSED RX ANKLE DISLOCATN 892.00
27842 PR CLOSED RX ANKLE DISLOCATN,ANESTH 1175.00
27846 PR OPEN RX ANKLE DISLOCATN 1764.00
27848 PR OPEN RX ANKLE DISLOCATN+FIXATN 1893.00
27870 PR ARTHRODESIS,ANKLE,OPEN 2469.00
27880 PR AMPUTATION LOW LEG THRU TIB/FIB 2123.00
27882 PR AMPUTATION LOW LEG,CIRCULAR 1426.00
27884 PR AMPUTATION LOW LEG,SECOND CLOSURE 1354.00
27886 PR RE-AMPUTATION LOWER LEG 1555.00
27892 PR DECOMPRESS FASCIOTOMY LEG,ANT/LAT 1343.00
28001 PR INCIS/DRAINAGE BURSA OF FOOT 683.00
28002 PR DEEP DISSEC FOOT INFEC,1 BURSA 1078.00
28003 PR DEEP DISSEC FOOT INFEC,MULTIPLE 1557.00
28005 PR DEEP INCIS FOOT BONE INFECTN 1386.00
28010 PR INCISION SUBCUT TOE TENDON 553.00
28020 PR EXPLOR TARSAL/TARSOMETATAR JT 1362.00
28022 PR EXPLOR METATARSO-PHALANG JT 1147.00
28024 PR EXPLOR INTERPHALANGEAL JT 1152.00
28035 PR TARSAL TUNNEL RELEASE 1264.00
28039 PR EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM 1156.00 28041 PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM 1105.00
28043 PR EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM 936.00
28045 PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM 1233.00
28047 PR RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/> 2444.00
28054 PR BX SYNOVIUM INTERPHALANG JT 945.00
28055 PR NEURECTOMY, INTRINSIC MUSCULATURE FOOT 890.00
28060 PR PART EXCIS PLANTAR FASCIA 1178.00
28062 PR RAD EXCIS PLANTAR FASCIA 1446.00
28070 PR SYNOVECTOMY TARS/TARSOMETA JT,EA 1331.00
28080 PR EXCIS INTERDIGITAL NEUROMA,EA 1176.00
28090 PR EXCIS TENDN/CAPSULE LESN,FOOT 863.00
28092 PR EXCIS TENDN/CAPSULE LESN,TOES 1059.00
28100 PR REMV TALUS/HEEL BENIGN BONE LESN 1423.00
28106 PR REMV OTHR FOOT BENIGN LESN,AUTOGRFT 1086.00
28107 PR REMV OTHR FOOT BENIGN LESN,ALLOGRFT 1393.00
28112 PR FULL EXCIS 2,3 OR 4TH METATAR HEAD 1222.00
28113 PR FULL EXCIS 5TH METATARSAL HEAD 1473.00
28116 PR EXCIS TARSAL COALITION 1563.00
28119 PR REMOVAL OF HEEL SPUR 1196.00
28120 PR PART REMV TALUS OR CALCANEUS 1590.00
28122 PR PART REMV OTHR TARSAL/METATARSAL 1508.00
28124 PR PART REMV PHALANX OF TOE 1180.00
28126 PR RESEC ONE TOE PHALANGEAL BASE,EA 947.00 28153 PR RESEC HEAD OF PHALANX,TOE 2483.00
28160 PR RESEC TOE AT I-P JT,SINGLE,EA 1047.00
28190 PR REMV FOOT FOREIGN BODY,SUBCUTANEOUS 955.00
28192 PR REMV FOOT FOREIGN BODY,DEEP 1130.00
28193 PR REMV FOOT FOREIGN BODY,COMPLEX 1280.00
28200 PR REPAIR FLEX FOOT TENDON,EA 1146.00
28208 PR REPAIR EXTEN LEG TENDON,PRIM,EA 1063.00
28225 PR RELEASE EXTEN FOOT TENDON,SINGLE 974.00
28232 PR INCISION FLEX TOE TENDON 965.00
28234 PR INCISION EXTEN FOOT/TOE TENDON 1028.00
28238 PR RECONST POST TIB TEND,EXCIS ACC TAR NAV 1676.00
28240 PR RELEASE OF BIG TOE TENDN 1156.00
28250 PR DIVISN PLANTAR FASCIA/MUSCLE 1352.00
28260 PR CAPSULOTOMY MIDFOOT JT,MED RELEASE 1653.00
28270 PR CAPSULOTOMY MT-P JT,FOOT,EACH 1121.00
28272 PR CAPSULOTOMY I-P JT,FOOT,EA 941.00
28280 PR FUSION OF TOES 1287.00
28285 PR REPAIR OF HAMMERTOE,ONE 1079.00
28288 PR PART REMV BONE METATARSAL HEAD,EA 1506.00
28289 PR REPAIR HALLUX RIGIDUS 1747.00
28290 PR CORRECT BUNION,SIMPLE 1465.00
28292 PR CORRECT BUNION,KELLER/MCBRIDE/MAYO 1945.00
28295 PR CORRJ HALLUX VALGUS W/SESMDC W/PROX METAR OSTEOT 2370.00 28296 PR CORRECT BUNION,METATARSAL OSTEOTOMY 1654.00
28297 PR CORRECT BUNION,LAPIDUS TYPE 1947.00
28298 PR CORRECT BUNION,PHALANX OSTEOTOMY 2146.00
28299 PR CORRECT BUNION,DOUBLE OSTEOTOMY 3128.00
28300 PR OSTEOTOMY HEEL BONE 1536.00
28304 PR OSTEOTOMY MIDTARSAL BONES 1987.00
28305 PR OSTEOTOMY MIDTARSAL,AUTOGRAFT 1604.00
28306 PR OSTEOTOMY 1ST METATARSAL,BASE/SHAFT 1527.00
28308 PR OSTEOTOMY METATARSAL (NOT 1ST) 1413.00
28313 PR RECONSTRUC TOE DEFORM,SOFT TISSUE 1240.00
28315 PR REMOV SESAMOID BONE,1ST TOE 1186.00
28320 PR REPAIR NON/MALUNION TARSAL BONE(S) 1449.00
28322 PR REPAIR NON/MALUNION METATARSAL 1938.00
28400 PR CLOSED RX HEEL FX 591.00
28405 PR CLOSED RX HEEL FX,MANIPULATN 904.00
28415 PR OPEN TREATMENT CALCANEAL FRACTURE 80M 517.00
28415 PR OPEN TREATMENT CALCANEAL FRACTURE 2584.00
28435 PR CLOSED RX TALUS FX,MANIPULATN 787.00
28436 PR PERCUT RX TALUS FX 1045.00
28445 PR OPEN TREATMENT TALUS FRACTURE 2486.00
28446 PR OPEN OSTEOCHONDRAL AUTOGRAFT TALUS 2934.00
28450 PR CLOSED RX TARSAL FX,EACH 534.00
28465 PR OPEN TX TARSAL FRACTURE XCP TALUS &CALCANEUS EA 1147.00 28470 PR CLOSED RX METATARSAL FX 534.00
28475 PR CLOSED RX METATARSAL FX,MANIP 632.00
28476 PR PERCUT RX METATARSAL FX 866.00
28485 PR OPEN TREATMENT METATARSAL FRACTURE EACH 1228.00
28490 PR CLOSED RX BIG TOE FRACTURE 364.00
28496 PR PERCUT BIG TOE FX 1114.00
28505 PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES 1642.00
28515 PR CLOSED RX TOE FX,MANIPULATN 352.00
28525 PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE 1405.00
28540 PR CLOSED RX TARSAL DISLOCATION 464.00
28545 PR CLOSED RX TARSAL DISLOC,ANESTH 717.00
28555 PR OPEN TREATMENT TARSAL BONE DISLOCATION 2001.00
28575 PR CLOSED RX TALOTARSAL DISLOC,ANESTH 891.00
28585 PR OPEN TREATMENT TALOTARSAL JOINT DISLOCATION 2098.00
28606 PR PERCUT RX TAR-METATAR FOOT DISLOC 961.00
28615 PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION 80M 376.00
28615 PR OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION 1876.00
28635 PR CLOSED RX MT-PHAL TOE DISLOC,ANESTH 432.00
28645 PR OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION 1630.00
28660 PR CLOSED RX I-P JT,TOE DISLOCATION 271.00
28665 PR CLOSED RX I-P JT,TOE DISLOC,ANESTH 382.00
28715 PR FUSION FOOT BONES,TRIPLE 2186.00
28725 PR FUSION FOOT BONES,SUBTALAR 1836.00 28730 PR FUSION FOOT BONES,MIDTARSAL,MULTI 1739.00
28740 PR FUSION FOOT BONE,MIDTARSAL,1 JT 1966.00
28750 PR FUSION BIG TOE,MT-P JT 1970.00
28750 PR FUSION BIG TOE,MT-P JT 50M 2956.00
28755 PR FUSION BIG TOE,I-P JOINT 1270.00
28760 PR FUSION BIG TOE,I-P JT+TENDN XFER 1869.00
28805 PR AMPUTATION FOOT,TRANSMETATARSAL 1739.00
28810 PR AMPUTATION METATARSAL+TOE,SINGLE 1019.00
28820 PR AMPUTATION TOE,MT-P JT 1366.00
28825 PR AMPUTATION TOE,I-P JT 1317.00
28899 PR FOOT/TOES SURG PROC UNLISTED 1672.00
29065 PR APPLY LONG ARM CAST 314.00
29075 PR APPLY FOREARM CAST 308.00
29085 PR APPLY HAND/WRIST CAST 242.00
29105 PR APPLY LONG ARM SPLINT 218.00
29125 PR APPLY FOREARM SPLINT,STATIC 167.00
29126 PR APPLY FOREARM SPLINT,DYNAMIC 192.00
29130 PR APPLY FINGER SPLINT,STATIC 136.00
29260 PR STRAPPING OF ELBOW OR WRIST 206.00
29280 PR STRAPPING OF HAND OR FINGER 203.00
29305 PR APPLY OF HIP CAST,ONE LEG 656.00
29325 PR APPLY OF HIP CASTS,TWO LEGS 701.00
29345 PR APPLY LONG LEG CAST 377.00 29355 PR APPLY LONG LEG CAST,WALKER 357.00
29358 PR APPLY LONG LEG CAST BRACE 531.00
29365 PR APPLY LONG LEG CAST,CYLINDER 495.00
29405 PR APPLY SHORT LEG CAST 313.00
29425 PR APPLY SHORT LEG CAST,WALKER 363.00
29435 PR APPLY PATELLA TENDON BEARING CAST 490.00
29445 PR APPLY RIGID LEG CAST 544.00
29450 PR APPLY OF CLUBFOOT CAST 413.00
29505 PR APPLY LONG LEG SPLINT 255.00
29515 PR APPLY LOWER LEG SPLINT 177.00
29530 PR STRAPPING OF KNEE 206.00
29540 PR STRAPPING; ANKLE &/OR FOOT 177.00
29550 PR STRAPPING OF TOES 159.00
29580 PR APPLY OF PASTE BOOT 172.00
29581 PR APPLY MULTLAY COMPRS LWR LEG 155.00
29700 PR REMV/REVISN BOOT/BODY CAST 225.00
29705 PR REMV/REVISN FULL ARM/LEG CAST 254.00
29720 PR REPAIR OF BODY CAST 247.00
29730 PR WINDOWING OF CAST 250.00
29740 PR WEDGING OF CAST 294.00
29799 PR CAST/STRAP PROC UNLISTED 75.00
29805 PR SHLDR ARTHROSCOP,DIAGNOSTIC 1076.00
29806 PR SHLDR ARTHROSCOP,SURG,CAPSULORRHAPHY 2422.00 29807 PR SHLDR ARTHROSCOP,SURG,REPAIR,SLAP LESION 2365.00
29819 PR SHLDR ARTHROSCOP,SURG,W/REMOVAL,LOOSE/FB 1340.00
29820 PR SHLDR ARTHROSCOP,PART SYNOVECT 1234.00
29821 PR SHOULDER ARTHROSCOPY/SURGERY 1350.00
29822 PR SHLDR ARTHROSCOP,PART DEBRIDE 80M 264.00
29822 PR SHLDR ARTHROSCOP,PART DEBRIDE 1313.00
29823 PR SHLDR ARTHROSCOP,EXTEN DEBRIDE 80M 287.00
29823 PR SHLDR ARTHROSCOP,EXTEN DEBRIDE 1432.00
29823 PR SHLDR ARTHROSCOP,EXTEN DEBRIDE 50M 2148.00
29824 PR SHLDR ARTHROSCOP,SURG,DIS CLAVICULECTOMY 80M 309.00
29824 PR SHLDR ARTHROSCOP,SURG,DIS CLAVICULECTOMY 1539.00
29825 PR SHLDR ARTHROSCOP,LYSE ADHESNS 1337.00
29826 PR SHOULDER SCOPE BONE SHAVING 80M 306.00
29826 PR SHOULDER SCOPE BONE SHAVING 1523.00
29827 PR SHLDR ARTHROSCOP,SURG,W/ROTAT CUFF REPR 80M 494.00
29827 PR SHLDR ARTHROSCOP,SURG,W/ROTAT CUFF REPR 2464.00
29828 PR ARTHROSCOPY SHOULDER SURGICAL BICEPS TENODESIS 2090.00
29830 PR ELBOW ARTHROSCOP,DIAGNOSTIC 1037.00
29834 PR ELBOW ARTHROSCOP,REMV LOOSE BODY 80M 226.00
29834 PR ELBOW ARTHROSCOP,REMV LOOSE BODY 1125.00
29835 PR ELBOW ARTHROSCOP,PART SYNOVECT 1207.00
29836 PR ELBOW ARTHROSCOP,FULL SYNOVECT 1356.00
29837 PR ELBOW ARTHROSCOP,PART DEBRIDE 1210.00 29838 PR ELBOW ARTHROSCOP,EXTEN DEBRIDE 80M 271.00
29838 PR ELBOW ARTHROSCOP,EXTEN DEBRIDE 1353.00
29840 PR WRIST ARTHROSCOP,DIAGNOSTIC 1030.00
29843 PR WRIST ARTHROSCOP,CLEAN/DRAIN 1102.00
29846 PR WRIST ARTHROSCOP,EXCIS TRIANG CART 1195.00
29847 PR WRIST ARTHROSCOP,INTERN FIXATN 1240.00
29850 PR KNEE SCOPE/SURG/INTERCOND FX AID 1363.00
29851 PR KNEE SCOPE/SURG/INCOND FX AID+FIXAT 2126.00
29855 PR TIBIAL SCOPE/SURG/FX AID,UNICONDYLR 80M 360.00
29855 PR TIBIAL SCOPE/SURG/FX AID,UNICONDYLR 1794.00
29860 PR HIP ARTHROSCOPY, DX 80M 317.00
29860 PR HIP ARTHROSCOPY, DX 1583.00
29861 PR HIP SCOPE/REMOV LOOSE/FOREIGN BODY 80M 347.00
29861 PR HIP SCOPE/REMOV LOOSE/FOREIGN BODY 1734.00
29862 PR HIP SCOPE/REMV BODY,PLASTY/RESECTN 1952.00
29863 PR HIP SCOPE/REMV BODY,SYNOVECTOMY 80M 391.00
29863 PR HIP SCOPE/REMV BODY,SYNOVECTOMY 1952.00
29866 PR ARTHROSCOPY KNEE; OSTEOCHONDRAL AUTOGRAFT 2390.00
29867 PR KNEE SCOPE, ALLOGRAFT IMPANT 80M 582.00
29867 PR KNEE SCOPE, ALLOGRAFT IMPANT 2904.00
29870 PR KNEE SCOPE,DIAGNOSTIC 1365.00
29871 PR KNEE SCOPE,CLEAN/DRAIN 1171.00
29873 PR KNEE SCOPE, W/LATERAL RELEASE 1192.00 29874 PR KNEE SCOPE,REMV LOOSE BODY 1229.00
29875 PR KNEE SCOPE,PART SYNOVECT 1132.00
29876 PR KNEE SCOPE,FULL SYNOVECT 80M 299.00
29876 PR KNEE SCOPE,FULL SYNOVECT 1495.00
29877 PR KNEE SCOPE,SHAVE ARTICULAR CART 1419.00
29879 PR KNEE SCOPE,ABRASN ARTHROPLASTY 1512.00
29880 PR ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING 1574.00
29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG 1474.00
29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG 50M 2211.00
29882 PR KNEE SCOPE,MED OR LAT MENIS REPAIR 1590.00
29883 PR KNEE SCOPE,MED+LAT MENIS REPAIR 1918.00
29884 PR KNEE SCOPE,LYSIS OF ADHESNS 1413.00
29885 PR KNEE SCOPE,DRILL OSTE DISSEC+GRFT 1710.00
29886 PR KNEE SCOPE,DRILL OSTEIT DISSEC 1446.00
29887 PR KNEE SCOPE,DRILL OSTE DISS+INT FIX 1700.00
29888 PR KNEE SCOPE,AID ANT CRUCIATE REPAIR 80M 452.00
29888 PR KNEE SCOPE,AID ANT CRUCIATE REPAIR 2258.00
29889 PR KNEE SCOPE,AID POST CRUC REPAIR 2780.00
29891 PR ANKLE SCOPE,EXCIS OSTEOCHON DEFCT 1587.00
29892 PR ANKLE SCOPE,AID REPAIR FX,BONE DEFCT 1552.00
29894 PR ANKLE SCOPE,REMVL LOOSE BODY 1183.00
29895 PR ANKLE SCOPE,PART SYNOVECTOMY 1133.00
29897 PR ANKLE SCOPE,PART DEBRIDEMENT 1187.00 29898 PR ANKLE SCOPE,EXTENS DEBRIDEMNT 1319.00
29899 PR ANKLE SCOPE,W/ANKLE ARTHRODESIS 2394.00
29914 PR PR ARTHROSCOPY HIP W/FEMOROPLASTY 80M 480.00
29914 PR PR ARTHROSCOPY HIP W/FEMOROPLASTY 2399.00
29915 PR PR ARTHROSCOPY HIP W/ACETABULOPLASTY 80M 490.00
29915 PR PR ARTHROSCOPY HIP W/ACETABULOPLASTY 2442.00
29916 PR PR ARTHROSCOPY HIP W/LABRAL REPAIR 80M 490.00
29916 PR PR ARTHROSCOPY HIP W/LABRAL REPAIR 2445.00
29999 PR ARTHROSCOPY PROC UNLISTED 2090.00
30000 PR DRAIN ABSCESS/HEMATOMA,NASAL 564.00
30020 PR DRAIN ABSCESS/HEMATOMA,NASAL SEPTUM 547.00
30100 PR INTRANASAL BIOPSY 793.00
30110 PR EXCISION NOSE POLYP(S),SIMPLE 570.00
30117 PR EXCIS/DEST INTRANAS LESION; INT APP 2195.00
30120 PR EXCISION SKIN OF NOSE 1266.00
30124 PR EXCIS NASAL DERMOID,SIMPLE,SUBCUT 643.00
30125 PR EXCIS NASAL DERMOID,COMPLX 1482.00
30130 PR EXCISION TURBINATE 899.00
30130 PR EXCISION TURBINATE 50M 1349.00
30140 PR EXCISION TURBINATE,SUBMUCOUS 1041.00
30140 PR EXCISION TURBINATE,SUBMUCOUS 50M 1562.00
30150 PR PARTIAL EXCISION OF NOSE 2012.00
30200 PR INJECTION TREATMENT OF NOSE 757.00 30220 PR INSERT NASAL SEPTAL PROSTHESIS 946.00
30300 PR REMOVE NASAL FOREIGN BODY 468.00
30310 PR REMV NASAL FOR BODY,GEN ANESTH 510.00
30410 PR RECONSTR NOSE,COMPLETE+EXTERNAL 2831.00
30420 PR RECONSTR NOSE+MAJ SEPTAL REPAIR 3230.00
30430 PR REVIS NOSE,SECONDARY,MINOR 2141.00
30465 PR REPAIR NASAL CAVITY STENOSIS 2306.00
30520 PR REPAIR OF NASAL SEPTUM 1725.00
30560 PR RELEASE OF NASAL ADHESIONS 652.00
30630 PR REPAIR NASAL SEPTUM PERFORATN 1532.00
30801 PR CAUTER TURBINATE MUCOSA,SUPERFICIAL 546.00
30802 PR CAUTER TURBINATE MUCOSA,INTRAMURAL 693.00
30901 PR CTRL NOSEBLEED,ANTER,SIMPLE 248.00
30901 PR CTRL NOSEBLEED,ANTER,SIMPLE 50M 373.00
30903 PR CTRL NOSEBLEED,ANTER,COMPLEX 470.00
30903 PR CTRL NOSEBLEED,ANTER,COMPLEX 50M 705.00
30920 PR LIGATE INTERN MAXILL ARTERY 2003.00
30930 PR FRACTURE THERAPUTIC INFER TURBINATE 299.00
30999 PR NASAL SURG PROC UNLISTED 575.00
31000 PR IRRIGATION MAXILLARY SINUS 464.00
31002 PR IRRIGATION SPHENOID SINUS 499.00
31075 PR EXPLOR FRONT SINUS,TRANSORBIT,UNI 1913.00
31225 PR REMV UPPER JAW-MAXILLECTOMY 4538.00 31231 PR NASAL ENDOSCOPY,DX 462.00
31233 PR NASAL/MAXILL SINUS ENDOSCOPY,DX 659.00
31235 PR NASAL/SPHENOID SINUS ENDOSCOPY,DX 2151.00
31237 PR NASAL SCOPE,BX/RMV POLYP/DEBRID 2173.00
31237 PR NASAL SCOPE,BX/RMV POLYP/DEBRID 50M 3260.00
31238 PR NASAL/SINUS SCOPY,W/CONTROL NASAL HEM 799.00
31240 PR NASAL/SINUS SCOPY,RMV CONCHA BULL 382.00
31254 PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY 808.00
31254 PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY 50M 1213.00
31255 PR NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY 1182.00
31255 PR NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY 50M 1774.00
31256 PR NASAL SCOPY,OPEN MAXILL SINUS 586.00
31256 PR NASAL SCOPY,OPEN MAXILL SINUS 50M 878.00
31267 PR NASAL SCOPY,RMV TISS MAXILL SINUS 939.00
31267 PR NASAL SCOPY,RMV TISS MAXILL SINUS 50M 1408.00
31276 PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS 1491.00
31276 PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS 50M 2236.00
31287 PR NASAL SCOPY,SPHENOIDOTOMY 687.00
31287 PR NASAL SCOPY,SPHENOIDOTOMY 50M 1031.00
31288 PR NASAL SCOPY,REMV TISS SPHENOID 798.00
31288 PR NASAL SCOPY,REMV TISS SPHENOID 50M 1197.00
31291 PR NASAL SCOPY,REPR CSF LEAK,SPHENOID 2875.00
31295 PR PR NASAL/SINUS ENDOSCOPY,W/DILAT MAXILLARY SINUS OSTIUM 404.00 31296 PR PR NASAL/SINUS ENDOSCOPY,W/DILAT FRONTAL SINUS OSTIUM 482.00
31297 PR PR NASAL/SINUS ENDOSCOPY,W/DILAT SPHENOID SINUS OSTIUM 397.00
31299 PR SINUS, ACCESSORY SURG PROC UNLISTED 1182.00
31360 PR REMOVAL OF LARYNX 5027.00
31500 PR INSERT EMERGENCY ENDOTRACH AIRWAY 705.00
31502 PR TRACH TUBE CHANGE 83.00
31515 PR LARYNGOSCOPY, DIRECT FOR ASPIRATION 515.00
31525 PR LARYNGOSCOPY, DIRECT, DIAGNOSTIC 621.00
31526 PR LARYNGOSCOPY, DIRECT, DX, OP MICROSCO 1385.00
31530 PR LARYNGOSCOPY, DIRCT, OP, F.B. REMVL 466.00
31535 PR LARYNGOSCOPY, DIRCT, OP, BIOPSY 564.00
31536 PR LARYNGOSCOPY, DIRCT, OP SCOPE, BIOSPY 505.00
31540 PR LARYNGOSCOPY, DIRCT, OP, EXC TUMOR 573.00
31541 PR LARYNGOSCOPY, DIRCT, OP SCOPE, EXC TUMR 693.00
31545 PR LARYNGOSCOPY, DIR, OP, EXC TUMR, LCL FLA 862.00
31570 PR LARYNGOSCOPY, DIRCT,INJ VOCAL CORD 2227.00
31575 PR LARYNGOSCOPY, FLEX FIBER, DIAGNOSTIC 414.00
31579 PR LARYNGOSCOPY, FLEX /RIGID+ STROBOSCOPE 518.00
31588 PR REVISION OF LARYNX, UNSPECIFIED 2763.00
31599 PR LARYNX SURG PROC UNLISTED 1045.00
31600 PR TRACHEOSTOMY, PLANNED 851.00
31610 PR TRACHEOSTOMY,FENESTRATN+FLAPS 1743.00
31613 PR TRACH REVISION,SIMPLE 1063.00 31614 PR TRACH REVISION,COMPLEX 1825.00
31615 PR SCOPE THRU TRACHEOSTOMY 306.00
31622 PR BRONCHOSCOPY,DIAGNOSTIC 939.00
31623 PR BRONCHOSCOPY,DIAGNOSTIC W BRUSH 820.00
31624 PR BRONCHOSCOPY,DIAGNOSTIC W LAVAGE 771.00
31625 PR BRONCHOSCOPY,BIOPSY 824.00
31628 PR BRONCHOSCOPY,TRANSBRONCH BIOPSY 948.00
31629 PR BRONCHOSCOPY,TRANSBRON ASPIR BX 1463.00
31631 PR BRONCHOSCOPY,TRACH DIL+STENT 550.00
31632 PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE 176.00
31645 PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST 780.00
31646 PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ 717.00
31825 PR SURG CLOSURE TRACH/FIST,PLAST REPR 1463.00
32096 PR THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL 1894.00
32110 PR THORCOM CTRL TRAUMTC HEMRRG&/RLNG TEAR 80M 696.00
32110 PR THORCOM CTRL TRAUMTC HEMRRG&/RLNG TEAR 3479.00
32220 PR DECORTICATION,PULMONARY,TOTAL 80M 752.00
32220 PR DECORTICATION,PULMONARY,TOTAL 3756.00
32225 PR DECORTICATION,PULMONARY,PARTIAL 2341.00
32421 PR THORACENTESIS PUNCTURE PLEURAL CAVITY ASPIRATION 593.00
32440 PR REMOVAL OF LUNG PNEUMONECTOMY 80M 725.00
32440 PR REMOVAL OF LUNG PNEUMONECTOMY 3620.00
32480 PR RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT 80M 685.00 32480 PR RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT 3422.00
32482 PR RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC 80M 734.00
32482 PR RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC 3990.00
32505 PR THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL 80M 444.00
32505 PR THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL 2214.00
32550 PR INSERTION INDWELLING TUNNELED PLEURAL CATHETER 538.00
32551 PR TUBE THORACOSTOMY INCLUDES WATER SEAL 454.00
32552 PR REMOVAL OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF 445.00
32554 PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING 1399.00
32555 PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING 1610.00
32557 PR PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING 387.00
32560 PR CHEMICAL PLEURODESIS FOR PERSISTENT PNEUMOTHORAX 180.00
32561 PR INSTILL VIA CHEST TUBE AGENT FOR FIBRINOLYSIS, 1ST DAY 224.00
32604 PR THORACOSCOPY WBX SAC 1147.00
32608 PR THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL 901.00
32609 PR THORACOSCOPY WITH BIOPSYIES OF PLEURA 602.00
32650 PR THORACOSCOPY SURG W/PLEURODESIS 1554.00
32651 PR THORACOSCOPY SURG PART PULM DECORT 2612.00
32652 PR THORACOSCOPY SURG TOT PULM DECORT 3947.00
32653 PR THORACOSCOPY SURG REMOV FB INTRAPLEU 2430.00
32655 PR THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX 2206.00
32666 PR THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT 80M 414.00
32666 PR THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT 2070.00 33010 PR DRAINAGE OF HEART SAC 276.00
33206 PR INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL 1100.00
33207 PR INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR 1131.00
33208 PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT 1113.00
33210 PR INSER HEART TEMP PACER ONE CHMBR 377.00
33211 PR INSER HEART TEMP PACER DUAL CHMBR 428.00
33212 PR INS PM PLS GEN W/EXIST SINGLE LEAD 729.00
33213 PR INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS 877.00
33214 PR UPGRADE OF PACEMAKER SYSTEM 1134.00
33215 PR RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE 716.00
33216 PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB 884.00
33217 PR INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB 816.00
33218 PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB 918.00
33220 PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB 922.00
33221 PR INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS 827.00
33222 PR RELOCATION OF SKIN POCKET FOR PACEMAKER 782.00
33223 PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR 972.00
33224 PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN 1180.00
33225 PR INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN 1064.00
33227 PR REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD 776.00
33228 PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS 814.00
33229 PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD 857.00
33233 PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY 537.00 33235 PR REMV TRANSVEN PACER ELECTRODE,2 LEAD 1515.00
33240 PR INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD 1086.00
33241 PR REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY 534.00
33244 PR RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ 1980.00
33249 PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR 2111.00
33262 PR RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD 863.00
33263 PR RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD 874.00
33264 PR RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD 907.00
33282 PR IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER 758.00
33284 PR RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER 549.00
33300 PR REPAIR HEART WOUND 5734.00
33967 PR INSERT INTRA-AORTIC BALLOON ASST DEVICE 617.00
34502 PR RECONSTRUCT, VENA CAVA 80M 710.00
34502 PR RECONSTRUCT, VENA CAVA 3544.00
34812 PR OPN FEM ART EXPOS DLVR EVASC PROSTH UNI 804.00
35045 PR REPR ANEURYSM/GRFT INS,RADIAL/ULNAR 2389.00
35082 PR REPR ART RUPTURE, ABD AORTA 80M 1034.00
35082 PR REPR ART RUPTURE, ABD AORTA 5167.00
35188 PR REPAIR BLOOD VESSEL LESION 2552.00
35206 PR REPR BL VES DIRECT,UP EXTREM 1831.00
35221 PR REPR BL VES DIRECT,ABD 80M 579.00
35221 PR REPR BL VES DIRECT,ABD 2892.00
35226 PR REPR BL VES DIRECT,LOW EXTREM 1969.00 35301 PR THROMBOENDARTECTMY NECK,NECK INCIS 80M 499.00
35301 PR THROMBOENDARTECTMY NECK,NECK INCIS 2490.00
35761 PR EXPLORATION OF ARTERY/VEIN 943.00
35800 PR EXPLOR POSTOP BLEED,INFEC,CLOT-NECK 1720.00
35820 PR EXPLOR POSTOP BLEED,INFEC,CLOT-CHST 4613.00
35840 PR EXPLOR POSTOP BLEED,INFEC,CLOT-ABD 2647.00
36000 PR PLACE NEEDLE IN VEIN 62.00
36005 PR INJECTION PROC,EXTREMITY,VENOGRAPHY 116.00
36012 PR PLACE CATH IN VEIN,SUBSELECT 1996.00
36140 PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY 1167.00
36215 PR PLACE CATH SELECTIVE ART,NECK 2632.00
36216 PR PLACE CATH SUBSELECT ART,NECK 2874.00
36400 PR VENIPUNC <3 Y/O,FEMORAL,JUGULAR 121.00
36410 PR VENIPUNC NEED PHYS SKILL,DX OR RX 122.00
36415 PR COLLECTION VENOUS BLOOD,VENIPUNCTURE 34.00
36468 PR INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK 366.00
36469 PR INJECTION; SPIDER VEINS,FACE 366.00
36470 PR INJECTION SCLEROSANT SINGLE INCMPTNT VEIN 366.00
36471 PR INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS 425.00
36510 PR CATH, VEIN UMBILICAL NEWBORN 443.00
36555 PR INSERT NON-TUNNEL CV CATH < 5 Y/O 666.00
36556 PR INSERT NON-TUNNEL CV CATH 526.00
36557 PR INSERT TUNNELED CV CATH <5 Y/O 791.00 36558 PR INSERT TUNNELED CV CATH 1955.00
36561 PR INSERT TUNNELED CV CATH 827.00
36563 PR INSERT TUNNELED CV CATH 666.00
36565 PR INSERT TUNNELED CV CATH 833.00
36569 PR INSERT TUNNELED CV CATH 717.00
36571 PR INSERT TUNNELED CV CATH 3224.00
36576 PR REPAIR TUNNELED CV CATH 951.00
36578 PR REPLACE TUNNELED CV CATH 1291.00
36580 PR REPLACE TUNNELED CV CATH 536.00
36589 PR REMOVAL TUNNELED CV CATH 396.00
36590 PR REMOVAL TUNNELED CV CATH 1610.00
36591 PR COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE 119.00
36592 PR COLLECT BLOOD FROM CATHETER VENOUS NOS 119.00
36593 PR DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH 296.00
36597 PR REPOSITION VENOUS CATHETER 143.00
36600 PR WITHDRAWAL OF ARTERIAL BLOOD 144.00
36620 PR INSERT CATH,ART,PERCUT,SHORTTERM 114.00
36625 PR INSERT CATH,ART,CUTDOWN,SHORTTERM 248.00
36680 PR INSERT NEEDLE,INTRAOSSEOUS INFUSN 139.00
36800 PR INSERT CANNULA,VEIN-VEIN 297.00
36821 PR ANASTOMOSIS,AV,ANY SITE 80M 321.00
36821 PR ANASTOMOSIS,AV,ANY SITE 1605.00
36830 PR CREAT AV FISTULA,NON-AUTOGENOUS GRAFT 80M 323.00 36830 PR CREAT AV FISTULA,NON-AUTOGENOUS GRAFT 1612.00
36832 PR REVISE AV FISTULA,W/O THROMBECTOMY 1377.00
37202 PR TRANSCATH RX INFUSE OTHER 712.00
37609 PR TEMPORAL ARTERY LIGATN OR BX 1864.00
37617 PR LIGATN OF ABDOMEN ARTERY 80M 555.00
37617 PR LIGATN OF ABDOMEN ARTERY 2767.00
37618 PR LIGATN OF EXTREMITY ARTERY 920.00
37700 PR LIGATN LONG SAPHENOUS VEIN AT SEPH-FEM JUNC 605.00
37722 PR LIGATE/STRIP LONG SAPH VEIN BELW SEP-FEM JUNC 1146.00
37765 PR PHLEB VEINS - EXTREM - TO 20 1614.00
37765 PR PHLEB VEINS - EXTREM - TO 20 50M 2421.00
37766 PR PHLEB VEINS - EXTREM 20+ 1911.00
37766 PR PHLEB VEINS - EXTREM 20+ 50M 2866.00
37799 PR VASCULAR SURGERY PROCEDURE UNLIST 1655.00
38100 PR REMOVAL SPLEEN, TOTAL 80M 482.00
38100 PR REMOVAL SPLEEN, TOTAL 2409.00
38102 PR REMOVAL SPLEEN, TOTAL W OTHR PROC 588.00
38120 PR LAP,SPLENECTOMY 2459.00
38206 PR PROG CELL HARVEST,TRANSPLANT,AUTOLOGOUS 188.00
38220 PR DIAGNOSTIC BONE MARROW ASPIRATIONS 501.00
38221 PR DIAGNOSTIC BONE MARROW BIOPSIES 501.00
38222 PR DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS 425.00
38232 PR BONE MARROW HARVEST AUTOLOG 479.00 38500 PR BIOPSY/EXCISION, LYMPH NODE(S) 772.00
38505 PR NEEDLE BIOPSY, LYMPH NODE(S) 303.00
38510 PR BX/REMV,LYMPH NODE,DEEP CERV 1191.00
38520 PR BX/REMV,LYMPH NODE,DEEP CERV/SCAL 1112.00
38525 PR BX/REMV,LYMPH NODE,DEEP AXILL 990.00
38525 PR BX/REMV,LYMPH NODE,DEEP AXILL 50M 1485.00
38550 PR REMOVAL CYST HYGROMA 1195.00
38562 PR REMOVAL, PELVIC LYMPH NODES,STAGING 1611.00
38570 PR LAP,LYMPH NODE BX 80M 253.00
38570 PR LAP,LYMPH NODE BX 1263.00
38571 PR LAP,PELVIC LYMPHADENECTOMY 80M 378.00
38571 PR LAP,PELVIC LYMPHADENECTOMY 1883.00
38700 PR REMOVAL NODES, NECK,SUPRAHYOID 1911.00
38724 PR REMOVAL NODES, NECK,CERV MOD RAD 3416.00
38740 PR REMOVE ARMPIT LYMPH NODES SUPERFIC 1641.00
38745 PR REMOVE ARMPITS LYMPH NODES COMPLT 2014.00
38746 PR REMOVE THOR LYMPH NODES RAD REGNL 80M 157.00
38746 PR REMOVE THOR LYMPH NODES RAD REGNL 502.00
38770 PR REMOVE PELVIS LYMPH NODES 80M 324.00
38780 PR REMOVE ABD LYMPH NODES EXTENSIVE 80M 439.00
38780 PR REMOVE ABD LYMPH NODES EXTENSIVE 2189.00
38790 PR INJECTION FOR LYMPHATIC XRAY 203.00
38792 PR INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE 872.00 38999 PR BLOOD/LYMPH SYSTEM PROCEDURE 990.00
39400 PR MEDIASTINOSCOPY INCL BIOPSIES WHEN PERFORMED 1198.00
39540 PR REPAIR DIAPHR HERNIA TRAUMA ACUTE 2056.00
39541 PR REPAIR DIAPHR HERNIA TRAUMA CHR 2241.00
39560 PR RESECT DIAPHRAM,SIMPLE REPAIR 80M 361.00
39560 PR RESECT DIAPHRAM,SIMPLE REPAIR 1803.00
40490 PR BIOPSY OF LIP 308.00
40500 PR LIP SHAVE 1256.00
40510 PR PARTIAL EXCIS LIP,WEDGE PRIM CLOS 1197.00
40520 PR PARTIAL EXCIS LIP,V-EXC PRIM CLOS 1173.00
40654 PR REPAIR LIP,>1/2 VERT HEIGHT 1406.00
40800 PR DRAIN MOUTH ABSC/CYST/HEMATOMA,SIMPL 324.00
40804 PR REMOVAL FOREIGN BODY,MOUTH,SIMPLE 483.00
40806 PR INCISION OF LIP FOLD 266.00
40808 PR BIOPSY OF MOUTH LESION 444.00
40810 PR EXCIS MOUTH MUCOSA/SUB,NO REPAIR 523.00
40812 PR EXCIS MOUTH MUCOSA/SUB,SIMPL REPAIR 2085.00
40814 PR EXCIS MOUTH MUCOSA/SUB,COMPLX REPR 968.00
40816 PR EXCIS MOUTH COMPLEX,EXC THRU MUSCLE 1002.00
40819 PR EXCISE LIP OR CHEEK FOLD 624.00
40820 PR DESTRUC MOUTH LESION/SCAR 1760.00
41000 PR I&D MOUTH/TONG INTRA,LINGUAL 384.00
41006 PR I&D MOUTH/TONG INTRA,SUBLING,DEEP 873.00 41008 PR I&D MOUTH/TONG INTRA,SUBMANDIBULAR 942.00
41010 PR INCISION OF TONGUE FOLD 420.00
41100 PR BIOPSY TONGUE,ANTER 2/3 851.00
41105 PR BIOPSY TONGUE,POSTER 1/3 407.00
41108 PR BIOPSY OF FLOOR OF MOUTH 615.00
41110 PR EXCIS TONGUE LESN 334.00
41112 PR EXCIS TONGUE LESN,ANT 2/3+CLOS 789.00
41113 PR EXCIS TONGUE LESN,POST 1/3 859.00
41115 PR EXCIS TONGUE FOLD 644.00
41116 PR EXCIS FLOOR MOUTH LESION 783.00
41120 PR PART REMOVAL TONGUE,<1/2 2615.00
41150 PR EXCIS TONGUE,MOUTH,JAW 5338.00
41153 PR EXCIS TONGUE,MOUTH,NECK 5729.00
41512 PR TONGUE BASE SUSPENSION, PERM SUTURE 1669.00
41520 PR RECONSTRUCTION, TONGUE FOLD 851.00
41530 PR RADIOFREQUENCY ABLATION TONGUE BASE 2520.00
41800 PR DRAINAGE OF GUM LESION 681.00
41825 PR EXCIS DENTOALVEOLAR LESION 539.00
41899 PR DENTAL SURGERY PROCEDURE 2613.00
42100 PR BIOPSY PALATE/UVULA 357.00
42104 PR EXCIS LESN,PALATE/UVULA 360.00
42106 PR EXCIS LESN,PALATE/UVULA-SIMPL CLOS 639.00
42120 PR REMOVE PALATE/LESION 2508.00 42140 PR EXCISION OF UVULA 612.00
42145 PR PALATOPHAYNGOPLASTY 1672.00
42160 PR DESTRUC LESN PALATE/UVULA 574.00
42299 PR PALATE/UVULA SURG UNLISTED 836.00
42300 PR DRAIN ABSCESS PAROTID,SIMPLE 525.00
42305 PR DRAIN ABSCESS PAROTID,COMPLIC 1057.00
42310 PR DRAIN ABSC-SUBMAX,SUBLING-INTRAORAL 403.00
42320 PR DRAIN ABSC-SUBMAX-EXTERNAL 652.00
42330 PR REMOVAL SALIVARY STONE,UNCOMPLIC 588.00
42335 PR REMOVAL SUBMAND STONE,COMPLICATED 893.00
42405 PR BIOPSY SALIVARY GLAND,INCISIONAL 711.00
42410 PR EXC PAROTD LESN,LATER LOBE 1481.00
42415 PR EXC PAROTD,LAT LOBE,DISSECT 5TH NERV 2615.00
42420 PR EXC PAROTD,TOTAL,DISSECT 5TH NERV 80M 575.00
42420 PR EXC PAROTD,TOTAL,DISSECT 5TH NERV 2873.00
42440 PR EXCISION SUBMAXILLARY GLAND 1001.00
42500 PR REPAIR SALIVARY DUCT SIMPLE 1068.00
42505 PR REPAIR SALIVARY DUCT COMPLICATED 1382.00
42650 PR DILATION OF SALIVARY DUCT 201.00
42700 PR INC/DRAIN PERITONSIL ABSCESS 455.00
42720 PR INC/DRAIN RETROPHARYNG ABSCESS,ORAL 1076.00
42800 PR BIOPSY OROPHARYNX 820.00
42804 PR BIOPSY NASOPHARYNX,SIMPLE 491.00 42808 PR EXCISE PHARYNX LESION 546.00
42809 PR REMOVE PHARYNX FOREIGN BODY 431.00
42810 PR EXCISION BRACH CLFT CYST,SUPERFICIAL 936.00
42820 PR REMOVE TONSILS/ADENOIDS,<12 Y/O 693.00
42821 PR REMOVE TONSILS/ADENOIDS,12+ Y/O 721.00
42825 PR REMOVAL OF TONSILS,<12 Y/O 647.00
42826 PR REMOVAL OF TONSILS,12+ Y/O 616.00
42830 PR REMOVAL ADENOIDS,PRIMARY,<12 Y/O 513.00
42831 PR REMOVAL ADENOIDS,PRIMARY,12+ Y/O 547.00
42835 PR REMOVAL ADENOIDS,SECOND,<12 Y/O 340.00
42870 PR EXCISION OF LINGUAL TONSIL 1442.00
42892 PR RESEC LAT PHARYN WALL/PYRIFRM SIN 4388.00
42960 PR CONTROL THROAT BLEED,SIMPLE 403.00
42962 PR CONTROL THROAT BLEED,SURG INTERVENTN 1274.00
43117 PR PART REMOV ESOPHAGUS,LOWER 2/3 80M 1125.00
43117 PR PART REMOV ESOPHAGUS,LOWER 2/3 5623.00
43121 PR PARTIAL REMOVAL OF ESOPHAGUS 80M 1364.00
43121 PR PARTIAL REMOVAL OF ESOPHAGUS 6815.00
43122 PR PARI REMOV ESOPH,THORACOABDOM 5800.00
43130 PR REMOV ESOPHAG DIVERTIC,CERV APPRCH 80M 382.00
43130 PR REMOV ESOPHAG DIVERTIC,CERV APPRCH 1908.00
43180 PR ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH 1339.00
43191 PR ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH 376.00 43192 PR ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL 415.00
43193 PR ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY 413.00
43194 PR ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY 466.00
43195 PR ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION 449.00
43196 PR ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION 478.00
43200 PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC 497.00
43201 PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ 602.00
43202 PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY 911.00
43204 PR ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES 497.00
43205 PR ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES 778.00
43215 PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY 1060.00
43216 PR ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS 319.00
43217 PR ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE 848.00
43219 ESOPHAGOSCOPY,INSERT TUBE/STENT 390.00
43220 PR ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM 285.00
43226 PR ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION 319.00
43227 PR ESOPHAGOSCOPY FLEXIBLE W BLEEDING CONTROL 973.00
43228 ESOPHAGOSCOPY,ABLATION TUMOR 531.00
43231 PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM 1001.00
43232 PR ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX 1177.00
43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC 1060.00
43236 PR ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION 842.00
43237 PR ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS 500.00 43238 PR EDG INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS 571.00
43239 PR EDG TRANSORAL BIOPSY SINGLE/MULTIPLE 868.00
43241 PR EDG INTRALUMINAL TUBE/CATHETER INSERTION 367.00
43242 PR EDG INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY 650.00
43243 PR EDG INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES 919.00
43244 PR EDG BAND LIGATION ESOPHGEAL/GASTRIC VARICES 1060.00
43245 PR EDG DILATION GASTRIC/DUODENAL STRICTURE 1482.00
43246 PR EDG PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE 1482.00
43247 PR EGD FLEXIBLE FOREIGN BODY REMOVAL 1482.00
43248 PR EDG INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS 868.00
43249 PR EDG BALLOON DILATION ESOPHAGUS <30 MM DIAM 1482.00
43250 PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS 652.00
43251 PR EDG REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH 637.00
43253 PR EDG US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER 646.00
43254 PR EDG TRANSORAL ENDOSCOPIC MUCOSAL RESECTION 687.00
43255 PR EDG TRANSORAL CONTROL BLEEDING ANY METHOD 1482.00
43259 PR EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM 578.00
43260 PR ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING 1694.00
43261 PR ERCP,BIOPSY 2119.00
43262 PR ERCP,SPHINCTEROTOMY 2119.00
43264 PR ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT 2119.00
43265 PR ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD 1098.00
43266 PR EDG ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION 557.00 43268 ERCP,INSERT STENT,BILIARY/PANC 2119.00
43269 ERCP,RMV F.B./CHANGE STENT 939.00
43270 PR EDG ABLATE TUMOR POLYP/LESION W/DILATION& WIRE 1793.00
43271 ERCP,BALLOON DIL DUCTS 1131.00
43272 ERCP,ABLATION TUMOR 885.00
43274 PR ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT 1155.00
43275 PR ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT 956.00
43276 PR ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE 1213.00
43280 PR LAP,ESOPHAGOGAST FUNDOPLASTY 80M 409.00
43280 PR LAP,ESOPHAGOGAST FUNDOPLASTY 2043.00
43281 PR LAP, REPAIR PARAESOPHAGEAL HERNIA, INCL FUNDOPLASTY W/O MESH 80M 704.00
43281 PR LAP, REPAIR PARAESOPHAGEAL HERNIA, INCL FUNDOPLASTY W/O MESH 3513.00
43282 PR LAP, REPAIR PARAESOPHAGEAL HERNIA, INCL FUNDOPLASTY W/ MESH 4035.00
43305 PR REPAIR TRACHEOESOPHAGEAL FISTULA 2606.00
43325 PR ESOPHAGOGASTRIC FUNDOPLASTY+PATCH 80M 612.00
43327 PR ESOPH FUNDOPLASTY LAP 80M 384.00
43327 PR ESOPH FUNDOPLASTY LAP 1918.00
43332 PR PR REPAIR PARAESOPHAGEAL HIATAL HERNIA,LAPAROTOMY, WO MESH 80M 530.00
43332 PR PR REPAIR PARAESOPHAGEAL HIATAL HERNIA,LAPAROTOMY, WO MESH 2650.00
43333 PR TRANSAB ESOPH HIAT HERN RPR 80M 598.00
43333 PR TRANSAB ESOPH HIAT HERN RPR 2989.00
43336 PR THORABD DIAPHR HERN REPAIR 80M 693.00
43336 PR THORABD DIAPHR HERN REPAIR 3465.00 43337 PR PR REPAIR PARAESOPHAGEAL HIATAL HERNIA,THORACOABDOMINAL, W MES 80M 775.00
43337 PR PR REPAIR PARAESOPHAGEAL HIATAL HERNIA,THORACOABDOMINAL, W MESH 3869.00
43450 PR DILATE ESOPHAGUS 355.00
43453 PR DILATE ESOPHAGUS,OVER GUIDE 673.00
43499 PR ESOPHAGUS SURG PROC UNLISTED 508.00
43500 PR SURGICAL OPENING OF STOMACH 1861.00
43501 PR OPEN STOMACH,REPR ULCER,SUTURE 3031.00
43502 PR SURGICAL REPAIR OF STOMACH 3579.00
43610 PR EXCIS STOMACH ULCER,LESN;LOCAL 2321.00
43611 PR EXCIS STOAMCH MALIG 80M 578.00
43611 PR EXCIS STOAMCH MALIG 2888.00
43633 PR REMV STOMACH,PART,DISTAL,ROUX-EN-Y 80M 859.00
43633 PR REMV STOMACH,PART,DISTAL,ROUX-EN-Y 4291.00
43640 PR VAGOTOMY/PYLOROPLASTY,SELECT 80M 652.00
43640 PR VAGOTOMY/PYLOROPLASTY,SELECT 2651.00
43653 PR LAP,GASTROSTOMY,W/O TUBE CONSTR 1370.00
43752 PR PLACEMENT NG/OG TUBE BY PHYSICIAN 221.00
43753 PR PR GASTRIC INTUBATION/ASPIRATION, THERAPEUTIC 49.00
43760 PR CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE 390.00
43761 PR REPOSITION GASTRIC FEEDING TUBE THRU DUODENUM 283.00
43774 PR LAP, REMOVE ADJUST GAST RESTRICT DEVICE/PORT 2280.00
43800 PR RECONSTRUCTION OF PYLORUS 80M 420.00
43800 PR RECONSTRUCTION OF PYLORUS 2093.00 43820 PR GASTROJEJUNOSTOMY 80M 405.00
43820 PR GASTROJEJUNOSTOMY 3184.00
43830 PR GASTROSTOMY,OPEN,W/O TUBE CNSTR 1669.00
43832 PR GASTROSTOMY,OPEN,W/TUBE CNSTR 2438.00
43840 PR REPAIR PERF DUOD/GAST ULC-WND/INJ 80M 619.00
43840 PR REPAIR PERF DUOD/GAST ULC-WND/INJ 3094.00
43848 PR REVISION GASTROPLASTY,OBESITY, NON-GAST RESTRICT DEVICE 80M 910.00
43848 PR REVISION GASTROPLASTY,OBESITY, NON-GAST RESTRICT DEVICE 4544.00
43860 PR REVISE,GASTROJEJUN ANAST,W/O VAGOTOMY 80M 734.00
43860 PR REVISE,GASTROJEJUN ANAST,W/O VAGOTOMY 3664.00
43865 PR REVISE GASTROJEJUN ANAST,W VAGOTOMY 80M 768.00
43870 PR CLOSURE OF GASTROSTOMY,SURGICAL 1611.00
43887 PR REMOVE GASTRIC PORT, OPEN 784
43999 PR STOMACH SURG PROC UNLISTED 523.00
44005 PR FREEING BOWEL ADHESION,ENTEROLYSIS 80M 417.00
44005 PR FREEING BOWEL ADHESION,ENTEROLYSIS 2077.00
44010 PR DUODENOTOMY FOR EXPLOR,BX,FB REMOV 80M 391.00
44010 PR DUODENOTOMY FOR EXPLOR,BX,FB REMOV 1953.00
44015 PR INSERT TUBE-BOWEL,ENTERAL ALIMENT 332.00
44020 PR ENTEROTOMY,NON-DUOD,EXPLOR/BX/FB REMOVAL 80M 454.00
44020 PR ENTEROTOMY,NON-DUOD,EXPLOR/BX/FB REMOVAL 2266.00
44025 PR INCIS COLON FOR EXPLOR,BX,FB REM 2351.00
44050 PR REDUCE VOLVULUS,INTUSS,INTERN HERNIA 2184.00 44055 PR CORRECT MALROTATION OF BOWEL 80M 702.00
44055 PR CORRECT MALROTATION OF BOWEL 3506.00
44110 PR EXCIS BOWEL LESION(S),SINGLE ENTEROTOMY 1917.00
44120 PR RESECT SMALL INTEST,SINGL RESEC/ANAS 80M 550.00
44120 PR RESECT SMALL INTEST,SINGL RESEC/ANAS 2748.00
44121 PR RESECT SMALL INTEST,EACH ADDNL 80M 104.00
44121 PR RESECT SMALL INTEST,EACH ADDNL 543.00
44125 PR RESECT SMALL INTEST W ENTEROSTOMY 2699.00
44130 PR BOWEL TO BOWEL ANASTOMOSIS 3001.00
44139 PR MOBILIZE SPLENIC FLEX 80M 68.00
44139 PR MOBILIZE SPLENIC FLEX 272.00
44140 PR PART REMOVAL COLON W ANASTOMOSIS 80M 517.00
44140 PR PART REMOVAL COLON W ANASTOMOSIS 3025.00
44141 PR PART REMOVAL COLON W COLOSTOMY 80M 856.00
44141 PR PART REMOVAL COLON W COLOSTOMY 4278.00
44143 PR PART REMOVAL COLON W END COLOSTOMY 80M 940.00
44143 PR PART REMOVAL COLON W END COLOSTOMY 3757.00
44144 PR PART REMOVAL COLON W OSTOMY/MUCOFIST 4049.00
44145 PR PART REMOVAL COLON W COLOPROCTOSTOMY 80M 667.00
44145 PR PART REMOVAL COLON W COLOPROCTOSTOMY 3334.00
44146 PR PART REMOVAL COLON W COLOPROC,COLOST 80M 977.00
44146 PR PART REMOVAL COLON W COLOPROC,COLOST 4878.00
44150 PR REMOVAL COLON/ILEOSTOMY 80M 849.00 44150 PR REMOVAL COLON/ILEOSTOMY 4240.00
44155 PR REMOVAL COLON/PROCTECTOMY/ILEOSTOMY 4923.00
44160 PR REMVL COLON & TERM ILEUM W/ILEOCOLOSTOMY 80M 474.00
44160 PR REMVL COLON & TERM ILEUM W/ILEOCOLOSTOMY 2367.00
44180 PR LAP, SURG ENTEROLYSIS 80M 384.00
44180 PR LAP, SURG ENTEROLYSIS 1911.00
44186 PR LAP, SURG JEJUNOSTOMY 1479.00
44188 PR LAP, SURG COLOSTOMY 2934.00
44202 PR LAP,SURG,ENTERECTOMY,RESECT & ANAST 3294.00
44204 PR LAP,SURG,COLECTOMY, PARTIAL, W/ANAST 80M 696.00
44204 PR LAP,SURG,COLECTOMY, PARTIAL, W/ANAST 3480.00
44205 PR LAP,SURG,COLECTOMY,W/REMVL TERM ILEUM 80M 607.00
44205 PR LAP,SURG,COLECTOMY,W/REMVL TERM ILEUM 3030.00
44206 PR LAP,SURG,COLECTOMY,W/END COLOST & CLOSUR 4163.00
44207 PR LAP,SURG,COLECTOMY,W/ANAST 80M 827.00
44207 PR LAP,SURG,COLECTOMY,W/ANAST 4133.00
44208 PR LAP,SURG,COLECTOMY,W/ANAST,W/COLOSTOMY 80M 817.00
44208 PR LAP,SURG,COLECTOMY,W/ANAST,W/COLOSTOMY 4692.00
44213 PR LAP, SURG MOBIL SPLENIC FL DUR PTL COLECTOMY 427.00
44300 PR PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN 1903.00
44310 PR ILEOSTOMY/JEJUNOSTOMY,NONTUBE 2453.00
44312 PR REVISION OF ILEOSTOMY,SIMPLE 1373.00
44314 PR REVISION OF ILEOSTOMY,COMPLICATED 2325.00 44320 PR COLOSTOMY 80M 429.00
44320 PR COLOSTOMY 2142.00
44340 PR REVISION OF COLOSTOMY,SIMPLE 1462.00
44345 PR REVISION OF COLOSTOMY,COMPLICATED 80M 496.00
44345 PR REVISION OF COLOSTOMY,COMPLICATED 2477.00
44346 PR REVIS COLOSTOMY,REPR PARACOLO HERNIA 2678.00
44360 PR ENDOSCOPY UPPER SMALL INTESTINE 531.00
44361 PR SMALL BOWEL ENDOSCOPY,BIOPSY 390.00
44363 PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY 483.00
44365 PR SMALL BOWEL ENDOSCOPY 673.00
44380 PR ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD 390.00
44382 PR ILEOSCOPY THRU STOMA,BIOPSY 531.00
44385 PR NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX 469.00
44388 PR COLONOSCOPY STOMA DX INDUDING COLLJ SPEC SPX 707.00
44389 PR COLONOSCOPY THRU STOMA,BIOPSY 940.00
44392 PR COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS 1079.00
44393 PR COLONOSCOPY THRU STOMA,LESION REMOVAL 1222.00
44394 PR COLONOSCOPY THRU STOMA,LESN RMVL W/SNARE 1153.00
44500 PR INTRO LONG GI TUBE 62.00
44602 PR SUTURE SM INTEST,SINGLE PERF 80M 788.00
44602 PR SUTURE SM INTEST,SINGLE PERF 3151.00
44603 PR SUTURE SM INTEST,MULTPL PERF 80M 726.00
44603 PR SUTURE SM INTEST,MULTPL PERF 3624.00 44604 PR SUTURE LRG INTEST 80M 390.00
44604 PR SUTURE LRG INTEST 1945.00
44620 PR CLOSE ENTEROSTOMY 1964.00
44625 PR CLOSE ENTEROSTOMY,RESEC+ANAST 80M 481.00
44625 PR CLOSE ENTEROSTOMY,RESEC+ANAST 2401.00
44626 PR CLOSE ENTEROSTOMY,RESEC+COLOREC ANAS 80M 538.00
44626 PR CLOSE ENTEROSTOMY,RESEC+COLOREC ANAS 3652.00
44640 PR REPAIR BOWEL-SKIN FISTULA 3282.00
44661 PR REPR BOW-BLAD FIST,W/INTEST/BLAD RESECT 80M 705.00
44661 PR REPR BOW-BLAD FIST,W/INTEST/BLAD RESECT 3518.00
44701 PR INTRAOP COLON LAVAGE ADD-ON 297.00
44799 PR UNLISTED PROCEDURE SMALL INTESTINE 209.00
44800 PR EXCISION MECKEL,OMPHALOMES DUCT 80M 359.00
44800 PR EXCISION MECKEL,OMPHALOMES DUCT 1792.00
44850 PR SUTURE OF MESENTERY 1732.00
44900 PR DRAIN APPENDICEAL ABSCESS, OPEN 1824.00
44950 PR APPENDECTOMY 80M 267.00
44950 PR APPENDECTOMY 1325.00
44955 PR APPENDECTOMY,W OTHR PROC 80M 41.00
44955 PR APPENDECTOMY,W OTHR PROC 195.00
44960 PR APPENDECTOMY,RUPT APPENDX+ABSCESS 80M 330.00
44960 PR APPENDECTOMY,RUPT APPENDX+ABSCESS 1638.00
44970 PR LAP,APPENDECTOMY 80M 522.00 44970 PR LAP,APPENDECTOMY 2732.00
45005 PR I&D RECTAL SUBMUCOSAL ABSCESS 682.00
45020 PR DRAINAGE OF DEEP RECTAL ABSCESS 1503.00
45100 PR BIOPSY OF RECTUM 718.00
45108 PR ANORECTAL MYOMECTOMY 882.00
45110 PR PROCTECTOMY,AP RESECT+OSTOMY 80M 884.00
45110 PR PROCTECTOMY,AP RESECT+OSTOMY 4416.00
45111 PR PROCTECTOMY,PARTIAL 2472.00
45130 PR EXCIS RECTAL PROLAPSE,PERINEAL 2542.00
45171 PR EXCIS RECTAL TUMOR, TRANSANAL, PARTIAL THICKNESS 1414.00
45172 PR EXCIS RECTAL TUMOR, TRANSANAL, FULL THICKNESS 1408.00
45300 PR PROCTOSIGMOIDOSCOPY,RIGID,DIAGNOS 635.00
45303 PR PROCTOSIGMOIDOSCOPY,RIGID,W/DILATION 1209.00
45305 PR PROCTOSIGMOIDOSCOPY,BIOPSY 1254.00
45330 PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD 647.00
45331 PR SIGMOIDOSCOPY,BIOPSY 662.00
45332 PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY 848.00
45333 PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS 700.00
45334 PR SIGMOIDOSCOPY FLX CONTROL BLEEDING 848.00
45337 PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE 497.00
45338 PR SIGMOIDOSCOPY,REMV LESN,SNARE 1143.00
45341 PR SIGMOIDOSCOPY W/ENDOSCOPIC US EXAM 1345.00
45347 PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT 379.00 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD 1060.00
45379 PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S) 1694.00
45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE 1694.00
45381 PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST 962.00
45382 PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD 1694.00
45383 PR COLONOSCOPY,ABLATE LESION 1694.00
45384 PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS 1694.00
45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ 1694.00
45386 PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT 1437.00
45388 PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES 1355.00
45390 PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION 1859.00
45391 PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX 700.00
45392 PR COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL 897.00
45393 PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION 616.00
45395 PR LAP, SURG PROCTECTOMY W COLOSTOMY 80M 943.00
45395 PR LAP, SURG PROCTECTOMY W COLOSTOMY 4713.00
45540 PR FIX RECTAL PROLAPSE,ABD APPRCH 80M 458.00
45560 PR REPAIR OF RECTOCELE 80M 287.00
45560 PR REPAIR OF RECTOCELE 1430.00
45800 PR CLOSE RECTUM-BLADDER FISTULA 80M 577.00
45800 PR CLOSE RECTUM-BLADDER FISTULA 2881.00
45915 PR REMV RECTAL OBSTR:FECES/F.B. W ANEST 772.00
45990 PR SURG DIAGNOSTIC EXAM, ANORECTAL 258.00 46020 PR PLACEMENT,SETON 641.00
46040 PR I&D PERIRECTAL ABSCESS 1238.00
46045 PR I&D RECTAL WALL ABSCESS W ANESTH 1028.00
46050 PR I&D PERIANAL ABSCESS,SUPERFICIAL 479.00
46060 PR I&D RECTAL ABSCESS + FISTULECTOMY 1148.00
46080 PR ANAL SPHINCTEROTOMY 612.00
46083 PR INCISE EXTERNAL HEMORRHOID 299.00
46200 PR REMOVAL OF ANAL FISSURE 1035.00
46220 PR EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS 1558.00
46221 PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS 939.00
46230 PR EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS 2438.00
46250 PR HEMORRHOIDECTOMY,EXTERNAL, 2+ COLUMNS/GROUPS 869.00
46255 PR HEMORRHOIDECTOMY,INT/EXT,1 COLUMN/GROUP 1182.00
46260 PR HEMORRHOIDECTOMY,INT/EXT, 2+ COLUMNS/GROUPS 1084.00
46261 PR REMOVE HEMORRHOIDS/FISSURE,COMPLX 1252.00
46270 PR REMOVAL ANAL FISTULA,SUBCUTANEOUS 859.00
46275 PR REMOVAL ANAL FISTULA,INTERSPNINCTERIC 1245.00
46280 PR REMOVAL ANAL FISTULA,TRANS/SUPRA/EXTRAPHINCT, +/-SETON 1077.00
46285 PR REMOVAL ANAL FISTULA,SECOND STAGE 1229.00
46288 PR REPAIR ANAL FISTULA 1315.00
46320 PR EXCISION THROMBOSED HEMORRHOID, EXTERNAL 848.00
46500 PR INJECTION INTO HEMORRHOID(S) 340.00
46505 PR CHEMODENERVATION ANAL SPHINCTER 693.00 46600 PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD 107.00
46606 PR ANOSCOPY AND BIOPSY 546.00
46608 PR ANOSCOPY,REMOVE FOREIGN BODY 578.00
46610 PR ANOSCOPY,REMOVE LESN,FORCEPS/CAUTER 548.00
46612 PR ANOSCOPY,REMOVE LESIONS 2314.00
46615 PR ANOSCOPY,ABLATE LESION 346.00
46707 PR REPARI ANORECTAL FISTULA W/ PLUG 1096.00
46750 PR REPAIR OF ANAL SPHINCTER,ADULT 80M 322.00
46750 PR REPAIR OF ANAL SPHINCTER,ADULT 1609.00
46900 PR DESTRUCT,ANAL LESN(S),SIMPLE,CHEM 590.00
46910 PR ELECTRODESSICATN,ANAL LESN(S) 641.00
46916 PR CRYOSURGERY, ANAL LESION(S) 446.00
46922 PR SURG EXCISION OF ANAL LESION(S) 676.00
46924 PR DESTRUCTION,ANAL LESION(S),EXTENSIVE 1306.00
46930 PR DESTRUCT INTERNAL HEMORRHOID, THERMAL 816.00
46945 PR HEMORRHOIDECTOMY, INT, LIGATION NOT RUBBER BAND, SINGLE 462.00
46946 PR HEMORRHOIDECTOMY, INT, LIGATION NOT RUBBER BAND, 2+ 567.00
46999 PR ANUS SURG PROC UNLISTED 80M 382.00
46999 PR ANUS SURG PROC UNLISTED 1902.00
47000 PR BIOPSY LIVER NEEDLE PERCUTANEOUS 898.00
47001 PR NEEDLE BIOPSY LIVER,W OTHR PROC 298.00
47010 PR DRAINAGE OF LIVER LESION, OPEN 2818.00
47100 PR WEDGE BIOPSY OF LIVER 80M 330.00 47100 PR WEDGE BIOPSY OF LIVER 1957.00
47350 PR REPAIR BLEED LIVER/SUTURE WOUND 3198.00
47379 PR LIVER LAPAROSCOPY PROC UNLISTED 1568.00
47561 PR LAPARO W/CHOLANGIO/BIOPSY 682.00
47562 PR LAP,CHOLECYSTECTOMY 80M 686.00
47562 PR LAP,CHOLECYSTECTOMY 3426.00
47563 PR LAP,CHOLECYSTECTOMY/GRAPH 80M 401.00
47563 PR LAP,CHOLECYSTECTOMY/GRAPH 2002.00
47564 PR LAP,CHOLECYSTECTOMY/EXPLORE 2461.00
47600 PR REMOVAL GALLBLADDER 80M 489.00
47600 PR REMOVAL GALLBLADDER 2440.00
47605 PR REMV GALLBLADDER W CHOLANGIOGRAM 2569.00
47610 PR REMV GALLBLADDER,EXPLOR COMMON DUCT 80M 565.00
47610 PR REMV GALLBLADDER,EXPLOR COMMON DUCT 2820.00
47612 PR REMV GB,W CHOLEDOCHOENTEROSTOMY 80M 497.00
47700 PR EXPLORATION OF BILE DUCTS 80M 485.00
47700 PR EXPLORATION OF BILE DUCTS 2423.00
47711 PR EXCIS BILE DUCT TUMOR,EXTRAHEPATIC 80M 738.00
47711 PR EXCIS BILE DUCT TUMOR,EXTRAHEPATIC 3687.00
47765 PR FUSE LIVER DUCTS & BOWEL 80M 1377.00
47765 PR FUSE LIVER DUCTS & BOWEL 6878.00
47900 PR SUTURE EXTRAHEP BILE DUCT,INJURY 80M 614.00
47900 PR SUTURE EXTRAHEP BILE DUCT,INJURY 3068.00 48100 PR BIOPSY,PANCREAS,OPEN 80M 299.00
48100 PR BIOPSY,PANCREAS,OPEN 1493.00
48105 PR RESECT/DEBRIDE ACUTE NECROT PANCREAS 6675.00
48140 PR PART REMV PANCREAS,DISTAL SUBTOTAL 80M 739.00
48140 PR PART REMV PANCREAS,DISTAL SUBTOTAL 3690.00
48146 PR PANCREATECTOMY 80M 876.00
48146 PR PANCREATECTOMY 4378.00
48548 PR ANAST PANCREAS-JEJUNUM/SIDE-SIDE 80M 968.00
48548 PR ANAST PANCREAS-JEJUNUM/SIDE-SIDE 3869.00
49000 PR EXPLORATORY OF ABDOMEN 80M 540.00
49000 PR EXPLORATORY OF ABDOMEN 2687.00
49002 PR REOPEN RECENT ABD EXPLORATORY 80M 290.00
49002 PR REOPEN RECENT ABD EXPLORATORY 1445.00
49010 PR EXPLORATORY RETROPERITONEAL 80M 429.00
49010 PR EXPLORATORY RETROPERITONEAL 2138.00
49020 PR DRAIN ABD ABSCESS OPEN 80M 717.00
49020 PR DRAIN ABD ABSCESS OPEN 3584.00
49040 PR DRAIN SUBDIAPH/SUBPHR ABSCESS,OPEN 2358.00
49060 PR DRAIN RETROPERITONEAL ABSCESS,OPEN 2593.00
49080 PR PUNCTURE PERITONEAL CAVITY 455.00
49081 PR SUBSEQ PUNCTURE PERIT CAVITY 330.00
49082 PR ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE 741.00
49203 PR EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS 5 CM 80M 541.00 49203 PR EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS 5 CM 2702.00
49204 PR EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS 5.1-10.0 CM 80M 688.00
49204 PR EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS 5.1-10.0 CM 3436.00
49205 PR EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM 3977.00
49250 PR EXCISION OF UMBILICUS 80M 266.00
49250 PR EXCISION OF UMBILICUS 1327.00
49255 PR REMOVAL OF OMENTUM 80M 314.00
49255 PR REMOVAL OF OMENTUM 1560.00
49320 PR LAP,DIAGNOSTIC ABDOMEN 80M 391.00
49320 PR LAP,DIAGNOSTIC ABDOMEN 1950.00
49321 PR LAP,DX SURGICAL ABD W/BIOPSY 2457.00
49322 PR LAP,ABDOMEN,ASPIRATE CYST 80M 463.00
49322 PR LAP,ABDOMEN,ASPIRATE CYST 2304.00
49323 PR LAP,ABDOMEN,DRAIN LYMPHOCELE 1515.00
49329 PR LAP,ABD/PERIT/OMENTUM,UNLIST 80M 493.00
49329 PR LAP,ABD/PERIT/OMENTUM,UNLIST 2457.00
49402 PR REMOVE PERITONEAL FOREIGN BODY 1439.00
49418 PR PR INSERTION TUNNEL INTRAPERITONEAL CATH W IMAGE GUIDANCE 497.00
49422 PR REMOVAL TUNNELED INTRAPERITONEAL CATHETER 905.00
49440 PR INSERT GASTROSTOMY TUBE PERCUTANEOUS 2678.00
49450 PR REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS 162.00
49500 PR REPAIR ING HERNIA,6MO-5YR,REDUC 890.00
49501 PR REPAIR ING HERNIA,6MO-5YR,STRANG 80M 284.00 49501 PR REPAIR ING HERNIA,6MO-5YR,STRANG 1413.00
49505 PR REPAIR ING HERNIA,5+Y/O,REDUCIBL 80M 237.00
49505 PR REPAIR ING HERNIA,5+Y/O,REDUCIBL 1179.00
49505 PR REPAIR ING HERNIA,5+Y/O,REDUCIBL 50M 1769.00
49507 PR REPAIR ING HERNIA,5+Y/O,STRANG 1332.00
49507 PR REPAIR ING HERNIA,5+Y/O,STRANG 50M 1997.00
49520 PR REPAIR RECURR INGUIN HERN,REDUCIBL 1428.00
49520 PR REPAIR RECURR INGUIN HERN,REDUCIBL 50M 2142.00
49521 PR REPAIR RECURR INGUIN HERN,STRANG 1669.00
49525 PR REPAIR SLIDING INGUINAL HERNIA 1298.00
49540 PR REPAIR LUMBAR HERNIA 1518.00
49550 PR REPAIR FEMORAL HERNIA,REDUCIBLE 1304.00
49550 PR REPAIR FEMORAL HERNIA,REDUCIBLE 50M 1956.00
49553 PR REPAIR FEMORAL HERNIA,STRANG 1428.00
49555 PR REPAIR RECURR FEMORAL HERNIA,REDUC 1374.00
49557 PR REPAIR RECURR FEMORAL HERNIA,STRANG 1632.00
49560 PR REPAIR INCISIONAL HERNIA,REDUCIBLE 80M 311.00
49560 PR REPAIR INCISIONAL HERNIA,REDUCIBLE 1547.00
49560 PR REPAIR INCISIONAL HERNIA,REDUCIBLE 50M 2320.00
49561 PR REPAIR INCISIONAL HERNIA,STRANG 80M 412.00
49561 PR REPAIR INCISIONAL HERNIA,STRANG 2055.00
49565 PR REPAIR RECURR INCIS HERNIA,REDUC 80M 347.00
49565 PR REPAIR RECURR INCIS HERNIA,REDUC 1734.00 49566 PR REPAIR RECURR INCIS HERNIA,STRANG 80M 424.00
49566 PR REPAIR RECURR INCIS HERNIA,STRANG 2117.00
49568 PR IMPLANT MESH HERNIA REPAIR/DEBRIDEMENT CLOSURE 599.00
49570 PR REPAIR EPIGASTRIC HERNIA,REDUC 994.00
49572 PR REPAIR EPIGASTRIC HERNIA,STRANG 1221.00
49580 PR REPAIR UMBILICAL HERN,<5Y/O,REDUC 80M 355.00
49585 PR REPAIR UMBILICAL HERN,5+Y/O,REDUC 80M 355.00
49585 PR REPAIR UMBILICAL HERN,5+Y/O,REDUC 879.00
49587 PR REPAIR UMBILICAL HERN,5+Y/O,STRANG 80M 192.00
49587 PR REPAIR UMBILICAL HERN,5+Y/O,STRANG 950.00
49590 PR REPAIR SPIEGELIAN HERNIA 1294.00
49650 PR LAP,INGUINAL HERNIA REPR,INITIAL 1018.00
49650 PR LAP,INGUINAL HERNIA REPR,INITIAL 50M 1527.00
49651 PR LAP,INGUINAL HERNIA REPR,RECUR 1329.00
49651 PR LAP,INGUINAL HERNIA REPR,RECUR 50M 1993.00
49652 PR LAP, VENTRAL HERNIA REPAIR,REDUCIBLE 1683.00
49653 PR LAP, VENTRAL HERNIA REPAIR,INCARCERATED 80M 414.00
49653 PR LAP, VENTRAL HERNIA REPAIR,INCARCERATED 2069.00
49654 PR LAP, INCISIONAL HERNIA REPAIR,REDUCIBLE 2008.00
49655 PR LAP, INCISIONAL HERNIA REPAIR,INCARCERATED 2236.00
49656 PR LAP, RECURRENT INCISIONAL HERNIA REPAIR,REDUCIBLE 80M 402.00
49656 PR LAP, RECURRENT INCISIONAL HERNIA REPAIR,REDUCIBLE 2007.00
49657 PR LAP, RECURRENT INCISIONAL HERNIA REPAIR,INCARCERATED 80M 576.00 49657 PR LAP, RECURRENT INCISIONAL HERNIA REPAIR,INCARCERATED 2876.00
49659 PR LAP,HERNIA REPAIR PROC,UNLIST 80M 382.00
49659 PR LAP,HERNIA REPAIR PROC,UNLIST 1902.00
49900 PR SUTURE ABD WALL-DEHIS/EVISCER 80M 330.00
49900 PR SUTURE ABD WALL-DEHIS/EVISCER 1916.00
49999 PR ABDOMEN SURG PROC UNLISTED 80M 223.00
49999 PR ABDOMEN SURG PROC UNLISTED 1104.00
50080 PR PERCUT REMV KID STONE,UP TO 2 CM 2111.00
50081 PR PERCUT REMV KID STONE,2+ CM 80M 608.00
50081 PR PERCUT REMV KID STONE,2+ CM 3035.00
50220 PR REMV KIDNEY,W/RIB RESECTION 80M 479.00
50220 PR REMV KIDNEY,W/RIB RESECTION 2389.00
50230 PR REMV KIDNEY,RADICAL 80M 609.00
50230 PR REMV KIDNEY,RADICAL 3040.00
50234 PR REMV KIDNEY/URETER,SAME INCIS 2969.00
50240 PR PARTIAL REMOVAL OF KIDNEY 80M 607.00
50240 PR PARTIAL REMOVAL OF KIDNEY 3028.00
50385 PR CHANGE URETERAL STENT VIA TRANSURETH 555.00
50389 PR REMOVE RENAL TUBE W/FLUORO 133.00
50390 PR PERCUT DRAIN/INJECT RENAL CYST 255.00
50395 PR PERCUT DILATN RENAL TRACT 1260.00
50398 PR CHANGE KIDNEY CATH/TUBE 1242.00
50405 PR REVISION RENAL PELVIS,COMPLICATED 80M 671.00 50405 PR REVISION RENAL PELVIS,COMPLICATED 3353.00
50432 PR PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I 1923.00
50435 PR EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I 2251.00
50541 PR LAP,ABLATION OF RENAL CYSTS 80M 438.00
50541 PR LAP,ABLATION OF RENAL CYSTS 2188.00
50543 PR LAP,PARTIAL NEPHRECTOMY 80M 714.00
50543 PR LAP,PARTIAL NEPHRECTOMY 3569.00
50544 PR LAP,PYELOPLASTY 80M 570.00
50544 PR LAP,PYELOPLASTY 2844.00
50545 PR LAP, RADICAL NEPHRECTOMY 80M 638.00
50545 PR LAP, RADICAL NEPHRECTOMY 3186.00
50546 PR NEPHRECTOMY 80M 572.00
50546 PR NEPHRECTOMY 2854.00
50548 PR NEPHRECTOMY, W/PART. URETECTOMY 80M 615.00
50548 PR NEPHRECTOMY, W/PART. URETECTOMY 3071.00
50590 PR LITHOTRIPSY, EXTRACORPORAL SHOCKWAVE (ESWL) 1336.00
50600 PR EXPLORATION OF URETER 2148.00
50650 PR REMOVAL URETER,BLADDER CUFF 2497.00
50690 PR INJECT RETROGRADE/CONDUIT X-RAY 235.00
50760 PR ANASTOMSIS OF URETER 80M 542.00
50760 PR ANASTOMSIS OF URETER 2705.00
50780 PR REIMPLANT URETER,SINGLE URETER 80M 580.00
50780 PR REIMPLANT URETER,SINGLE URETER 2900.00 50951 PR URETER ENDOSCOPY 870.00
51040 PR INCISE/DRAIN BLADDER 80M 235.00
51040 PR INCISE/DRAIN BLADDER 925.00
51050 PR OPEN BLADDER,REMV CALCULUS 80M 219.00
51050 PR OPEN BLADDER,REMV CALCULUS 1093.00
51102 PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER 544.00
51520 PR CYSTOTOMY,EXCIS VESICAL NECK 1359.00
51525 PR CYSTOTOMY,EXCIS BLADDER TIC 2047.00
51530 PR CYSTOTOMY,EXCIS BLADDER TUMOR 1595.00
51565 PR PART REMV BLADDER,REIMPLNT URETER 3130.00
51600 PR INJECTION FOR BLADDER X-RAY 101.00
51700 PR IRRIGATION OF BLADDER 283.00
51701 PR INSERT,NON-INDWELLING BLADDER CATHETER 147.00
51702 PR INSERT,TEMP INDWELLING BLAD CATH,SIMPLE 213.00
51703 PR INSERT,TEMP INDWELLING BLAD CATH,COMP 311.00
51705 PR CHANGE OF BLADDER TUBE,SIMPLE 282.00
51710 PR CHANGE OF BLADDER TUBE,COMPLICATED 310.00
51715 PR ENDOSCOPIC INJECTION/IMPLANT 1543.00
51720 PR INSTILL ANTICANCER AGENT IN BLADDER 427.00
51725 PR SIMPLE CYSTOMETROGRAM 683.00
51726 PR COMPLEX CYSTOMETROGRAM 858.00
51727 PR COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE 710.00
51728 PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES 686.00 51729 PR COMPLEX CYSTOMETROGRAM W/VOID PRESS&URETHRAL PROFILE 738.00
51736 PR URINE FLOW MEASUREMENT 127.00
51741 PR ELECTRO-UROFLOWMETRY, FIRST 118.00
51772 PR URETHRA PRESSURE PROFILE 593.00
51784 PR ANAL/URINARY MUSCLE STUDY 491.00
51785 PR ANAL/URINARY MUSCLE STUDY,NEEDLE 624.00
51792 PR URINARY REFLEX STUDY 538.00
51797 PR VOIDING PRESS STUDY INTRA-ABDOMINAL VOID 303.00
51798 PR MEAS,POST-VOID RES,US,NON-IMAGING 42.00
51840 PR ANTER VESICOURETHROPEXY,SIMPLE 2859.00
51845 PR ABD-VAGINAL VESICAL NECK SUSPENSN 1706.00
51860 PR REPAIR BLADDER WOUND/INJ,SIMPLE 80M 330.00
51860 PR REPAIR BLADDER WOUND/INJ,SIMPLE 1639.00
51865 PR REPAIR BLADDER WOUND/INJ,COMPLIC 80M 374.00
51880 PR CLOSE CYSTOSTOMY 80M 200.00
51880 PR CLOSE CYSTOSTOMY 996.00
51999 PR LAP PROCEDURE, UNLISTED, BLADDER 80M 410.00
51999 PR LAP PROCEDURE, UNLISTED, BLADDER 2047.00
52000 PR CYSTOURETHROSCOPY 80M 102.00
52000 PR CYSTOURETHROSCOPY 512.00
52001 PR CYSTOURETHROSCOPY W/IRRIG & EVAC CLOTS 896.00
52005 PR CYSTOURETHROSCOPY,URETER CATHETER 80M 137.00
52005 PR CYSTOURETHROSCOPY,URETER CATHETER 675.00 52007 PR CYSTOURETHROSCOPY,URETERAL BIOPSY 1073.00
52204 PR CYSTOURETHROSCOPY,BIOPSIES 2582.00
52214 PR CYSTOURETHROSCOPY,FULGURATN 1602.00
52224 PR CYSTOURETHROSCOPY,FULGUR <.5CM LESN 1701.00
52234 PR CYSTOURETHROSCOPY,FULGUR .5-2CM LESN 559.00
52235 PR CYSTOURETHROSCOPY,FULGUR 2-5CM LESN 660.00
52240 PR CYSTOURETHROSCOPY,FULGUR >5CM LESN 1224.00
52250 PR CYSTOURETHROSCOPY,INSERT RADIOACTIV 556.00
52260 PR CYSTOSCOPY,DIL BLADDER,GEN ANESTH 480.00
52275 PR CYSTOSCOPY,INTERN URETHROTOMY,MALE 1150.00
52276 PR CYSTOSCOPY,DIR VIS INT URETHROTOMY 608.00
52281 PR CYSTOSCOPY,DIL URETHRAL STRICTURE 1785.00
52287 PR CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER 747.00
52310 PR CYSTOSCOPY,REMV CALCULUS,SIMPLE 1783.00
52315 PR CYSTOSCOPY,REMV CALCULUS,COMPLIC 984.00
52317 PR REMOVE BLADDER STONE,<2.5CM 1948.00
52318 PR REMOVE BLADDER STONE,>2.5CM 1078.00
52320 PR CYSTOSCOPY,REMV URETERAL STONE 563.00
52332 PR CYSTOSCOPY,INSERT URETERAL STENT 80M 192.00
52332 PR CYSTOSCOPY,INSERT URETERAL STENT 1254.00
52341 PR CYSTOSCOPY,TX URETERAL STRICTURE 662.00
52344 PR CYSTO/URETEROSCOPY,TX URETER STRICT 870.00
52351 PR CYSTO/URETERO/PYELOSCOPY, DX 80M 152.00 52351 PR CYSTO/URETERO/PYELOSCOPY, DX 747.00
52352 PR CYSTO/URETERO/PYELOSCOPY, CALCULUS TX 830.00
52353 PR CYSTO/URETERO/PYELOSCOPY W/LITHOTRIPSY 915.00
52354 PR CYSTO/URETERO/PYELOSC,BX &/OR FULG LESN 992.00
52356 PR CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT 990.00
52402 PR CYSTOURETHRO CUT EJACUL DUCT 635.00
52441 PR CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE 3099.00
52442 PR CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL 2391.00
52450 PR TRANSURETHRAL INCISION OF PROSTATE 1123.00
52500 PR TRANSURETHRAL RESEC BLADDER NECK 1166.00
52601 PR TRANSURETHRAL ELEC-SURG PROSTATECTOM 1938.00
52630 PR REMV RESID OBSTRUC PROSTATE,>1 YR 930.00
52640 PR RELIEVE POSTOP BLADDER CONTRACTURE 756.00
52648 PR LASER VAPORIZATION SURGERY PROSTATE, COMPLETE 4517.00
52649 PR PROSTATE LASER ENUCLEATION 1989.00
53020 PR INCISION OF URETHRAL MEATUS 223.00
53260 PR EXCIS URETHRAL POLYP(S) 802.00
53265 PR EXCIS URETHRAL CARUNCLE 528.00
53270 PR EXCIS SKENE'S GLANDS 796.00
53410 PR RECONSTRUC ANT MALE URETHRA 80M 472.00
53410 PR RECONSTRUC ANT MALE URETHRA 2357.00
53445 PR INSERT,INFLATABLE SPHINCTER 80M 364.00
53445 PR INSERT,INFLATABLE SPHINCTER 1818.00 53450 PR URETHRAL MEATAL REVISION 990.00
53600 PR DIL URETHRA STRIC,MALE,INITIAL 391.00
53601 PR DIL URETHRA STRIC,MALE,SUBSEQ 174.00
53605 PR DIL URETHRA STRIC,MALE,GEN ANESTH 147.00
53660 PR DIL URETHRA,FEMALE,INITIAL 160.00
53661 PR DIL URETHRA,FEMALE,SUBSEQUENT 159.00
53850 PR PROSTATIC MICROWAVE THERMOTX 5638.00
54001 PR SLITTING OF PREPUCE 439.00
54015 PR INCIS/DRAIN PENIS,DEEP 749.00
54050 PR DESTR PENIS LESN,SIMPL,CHEMICAL 267.00
54056 PR DESTR PENIS LESN,SIMPL,CRYOSURG 208.00
54060 PR DESTR PENIS LESN,SIMPL,SURG EXCIS 439.00
54065 PR DESTR PENIS LESN,EXTENSIVE 479.00
54100 PR BX,PENIS (SEPARATE PROCEDURE) 1854.00
54120 PR REMOVAL PENIS,PARTIAL 80M 307.00
54120 PR REMOVAL PENIS,PARTIAL 1528.00
54150 PR CIRCUMCISION,CLAMP,NEWBORN W/ ANESTH 314.00
54160 PR CIRCUMCISION,OTHER,<28 D/O 470.00
54161 PR CIRCUMCISION,OTHER,28+ D/O 456.00
54162 PR LYSIS/EXCIS,PENILE POSTCIRCUM ADHESIONS 610.00
54163 PR REPAIR,INCOMPLETE CIRCUMCISION 524.00
54164 PR FRENULOTOMY,PENIS 455.00
54200 PR INJECT PROC PENILE PLAQUE 259.00 54220 PR IRRIGAT CORPUS CAVERN,PRIAPISM 500.00
54235 PR INJECT CORPORA CAVERN,PHARM AGNT 218.00
54360 PR PENIS PLASTIC SURG,CORRECT ANGULATN 1737.00
54400 PR INSERT SEMI-RIGID PENILE PROSTHESIS 1280.00
54401 PR INSERT SELF-CONTD PENILE PROSTHESIS 1569.00
54405 PR INSERT,INFLATABLE PENILE PROSTHESIS 80M 386.00
54405 PR INSERT,INFLATABLE PENILE PROSTHESIS 1924.00
54408 PR REPAIR,INFLATABLE PENILE PROSTHESIS 80M 381.00
54408 PR REPAIR,INFLATABLE PENILE PROSTHESIS 1901.00
54410 PR REPLACE,INFLATABLE PENILE PROSTHESIS 1976.00
54411 PR REMOV/REPLC PENIS PROS COMP 2478.00
54415 PR REMOVAL,PENILE PROSTHESIS W/O REPLACMT 1291.00
54416 PR REPLACE,PENILE PROSTHESIS 1643.00
54417 PR REMV/REPLC PENIS PROS COMPL 2166.00
54420 PR CORPORA-SAPHEN VEIN SHUNT 1621.00
54430 PR CORPORA CAVER-SPONGIOSA SHUNT 1548.00
54450 PR PREPUTIAL STRETCHING 169.00
54505 PR BIOPSY OF TESTIS,INCISIONAL 500.00
54520 PR REMOVAL TESTIS,SIMPLE 779.00
54520 PR REMOVAL TESTIS,SIMPLE 50M 1169.00
54530 PR REMOVAL TESTIS,RADICAL 1216.00
54550 PR EXPLORE UNDESC TESTIS,INGUIN/SCROTAL 1186.00
54560 PR EXPLORE UNDESC TESTIS,ABDOMINAL 1671.00 54600 PR REDUCE TESTIS TORSION 1048.00
54640 PR ORCHIOPEXY,INGUNIAL APPROACH 80M 224.00
54640 PR ORCHIOPEXY,INGUNIAL APPROACH 1119.00
54660 PR INSERT TESTICULAR PROSTHESIS 867.00
54670 PR REPAIR TESTIS INJURY 993.00
54700 PR INCIS/DRAIN SCROTUM/TESTIS,EPIDIDYM 509.00
54830 PR EXCIS EPIDIDYMIS LOCAL LESION 905.00
54840 PR EXCIS SPERMATOCELE 769.00
54860 PR REMOVAL OF EPIDIDYMIS,UNILAT 1014.00
54861 PR REMOVAL OF EPIDIDYMIS,BILAT 1382.00
55000 PR DRAINAGE OF HYDROCELE,TUNICA 288.00
55040 PR REMOVAL OF HYDROCELE,TUNICA,UNILAT 907.00
55041 PR REMOVAL OF HYDROCELE,TUNICA,BILAT 1233.00
55060 PR REPAIR OF HYDROCELE,TUNICA 912.00
55100 PR DRAINAGE SCROTAL WALL ABSCESS 524.00
55110 PR EXPLORE SCROTUM 928.00
55120 PR REMOVAL OF SCROTAL FOR.BODY 857.00
55150 PR REMOVAL OF SCROTUM 80M 239.00
55150 PR REMOVAL OF SCROTUM 1188.00
55180 PR REVISION OF SCROTUM,COMPLICATED 1659.00
55250 VASECTOMY, UNILAT/BILAT, W/POSTOP SEMEN EXAM 1040.00
55300 PR PREPARATION, SPERM DUCT X-RAY 453.00
55400 PR REPAIR OF SPERM DUCT 1216.00 55500 PR REMV HYDROCELE,SPERM CORD,UNILAT 946.00
55520 PR REMOVAL OF SPERM CORD LESION 1034.00
55520 PR REMOVAL OF SPERM CORD LESION 50M 1551.00
55530 PR EXCISE VARICOCELE 854.00
55700 PR BIOPSY OF PROSTATE,NEEDLE/PUNCH 1432.00
55842 PR REMV PROSTATE,RETROPUB,RAD,LTD NODES 80M 682.00
55842 PR REMV PROSTATE,RETROPUB,RAD,LTD NODES 3405.00
55866 PR LAP,PROSTATECTOMY,RADICAL,W/NERVE SPARE,INCL ROBOTIC 80M 826.00
55866 PR LAP,PROSTATECTOMY,RADICAL,W/NERVE SPARE,INCL ROBOTIC 4127.00
55876 PR PLACE RADIOTHER DEVICE/MARKER, PROSTATE 1535.00
55899 PR MALE GENITAL SURG PROC UNLISTED 854.00
56405 PR I&D OF VULVA/PERINEUM ABSCESS 331.00
56420 PR I&D BARTHOLIN GLAND ABSCESS 373.00
56440 PR MARSUP BARTHOLIN GLAND CYST 723.00
56441 PR LYSIS OF LABIAL LESION(S) 352.00
56442 PR HYMENOTOMY, SIMPLE INCISION 403.00
56501 PR DESTRUCTION,LESION(S),VULVA,SIMPLE 2126.00
56515 PR DESTRUCTION,LESION(S),VULVA;EXTENSIVE 2220.00
56605 PR BIOPSY VULVA/PERINEUM,ONE LESN 389.00
56606 PR BX,VULVA/PERINEUM,ADDL LESION 92.00
56620 PR PART SIMPLE REMV VULVA 80M 287.00
56620 PR PART SIMPLE REMV VULVA 1424.00
56700 PR PARTIAL REMOVAL OF HYMEN 80M 120.00 56700 PR PARTIAL REMOVAL OF HYMEN 595.00
56740 PR EXCIS BARTHOLIN GLAND/CYST 1155.00
56800 PR REPAIR OF VAGINA 80M 115.00
56800 PR REPAIR OF VAGINA 564.00
56810 PR REPAIR OF PERINEUM,NON OBSTETRICAL 80M 469.00
56810 PR REPAIR OF PERINEUM,NON OBSTETRICAL 2339.00
56820 PR COLPOSCOPY,VULVA 266.00
56821 PR COLPOSCOPY,VULVA,W/BIOPSY(S) 350.00
57000 PR EXPLORATION OF VAGINA 1005.00
57010 PR EXPLOR VAGINA/DRAIN PELVIC ABSCESS 913.00
57020 PR DRAINAGE OF PELVIC FLUID 776.00
57022 PR I&D VAGINAL HEMATOMA,OBSTET/POSTPART 388.00
57023 PR I&D VAGINAL HEMATOMA, NON-OB 663.00
57061 PR DESTRUCT,VAGINAL LESION(S),SIMPLE 2014.00
57065 PR DESTRUCT,VAGINAL LESION(S),EXTENSIVE 773.00
57100 PR BIOPSY OF VAGINA,SIMPLE 758.00
57105 PR BIOPSY OF VAGINA,EXTENSIVE 2142.00
57106 PR REMOVE VAGINA WALL, PARTIAL 1148.00
57110 PR COMPLETE REMOVAL OF VAGINA WALL 80M 398.00
57110 PR COMPLETE REMOVAL OF VAGINA WALL 1984.00
57120 PR CLOSURE OF VAGINA 80M 619.00
57120 PR CLOSURE OF VAGINA 3083.00
57130 PR EXCIS VAGINAL SEPTUM 80M 436.00 57130 PR EXCIS VAGINAL SEPTUM 2179.00
57135 PR EXCIS VAGINAL CYST/TUMOR 80M 79.00
57135 PR EXCIS VAGINAL CYST/TUMOR 2298.00
57160 PR FIT/INSERT INTRAVAG SUPPORT DEVICE 200.00
57170 PR FITTING OF DIAPHRAGM/CAP 148.00
57180 PR TREAT VAGINAL BLEEDING 343.00
57200 PR REPAIR OF VAGINA 80M 127.00
57200 PR REPAIR OF VAGINA 627.00
57210 PR REPAIR VAGINA/PERINEUM 80M 627.00
57210 PR REPAIR VAGINA/PERINEUM 3135.00
57240 PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO 80M 384.00
57240 PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO 1904.00
57250 PR POST COLPORRHAPHY,RECTUM/VAGINA 80M 388.00
57250 PR POST COLPORRHAPHY,RECTUM/VAGINA 1935.00
57260 PR CMBND ANTERPOST COLPORRAPHY W/CYSTO 80M 518.00
57260 PR CMBND ANTERPOST COLPORRAPHY W/CYSTO 2590.00
57265 PR CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR 80M 693.00
57265 PR CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR 2767.00
57267 PR INSERT MESH/PELVIC FLR ADDON 80M 127.00
57267 PR INSERT MESH/PELVIC FLR ADDON 637.00
57268 PR REPAIR ENTEROCELE,VAG APPRCH 80M 202.00
57268 PR REPAIR ENTEROCELE,VAG APPRCH 2520.00
57280 PR SUSPENSION OF VAGINA,ABD APPRCH 80M 646.00 57280 PR SUSPENSION OF VAGINA,ABD APPRCH 3219.00
57282 PR REPR VAGINAL PROLAPSE,SACROSP LIG 80M 631.00
57282 PR REPR VAGINAL PROLAPSE,SACROSP LIG 2520.00
57283 PR REPR VAGINAL PROLAPSE,UTEROSACRAL 80M 296.00
57283 PR REPR VAGINAL PROLAPSE,UTEROSACRAL 1476.00
57284 PR PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPROACH 80M 371.00
57284 PR PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPROACH 1850.00
57287 PR REMV/REVS SLING FOR STRES INCONTINENCE 80M 269.00
57287 PR REMV/REVS SLING FOR STRES INCONTINENCE 1339.00
57288 PR SLING OPER STRES INCONTINENCE 80M 518.00
57288 PR SLING OPER STRES INCONTINENCE 2590.00
57295 PR REVISION VAGINAL GRAFT, VAG APPROACH 80M 209.00
57295 PR REVISION VAGINAL GRAFT, VAG APPROACH 1032.00
57296 PR REVISE VAG GRAFT OPEN ABD 2188.00
57300 PR REPAIR RECTO-VAG FISTULA 2339.00
57307 PR FISTULA REPAIR & COLOSTOMY 80M 482.00
57308 PR XPERINEAL CLOS RECTOVAG FISTULA 2073.00
57335 PR REVISE VAGINA FOR INTERSEC STATE 2567.00
57400 PR DILATION OF VAGINA W ANESTH 80M 68.00
57400 PR DILATION OF VAGINA W ANESTH 322.00
57410 PR PELVIC EXAMINATION W ANESTH 344.00
57415 PR REMOVAL VAGINAL FOR.BODY W ANESTH 333.00
57420 PR COLPOSCOPY,ENTIRE VAGINA 423.00 57421 PR COLPOSCOPY,ENTIRE VAGINA,W/BIOPSY(S) 363.00
57425 PR LAPAROSCOPY, SURG, COLPOPEXY 2075.00
57452 PR COLPOSCOPY,CERVIX W/ADJ VAGINA 371.00
57454 PR COLPOSC,CERVIX W/ADJ VAG,W/BX & CURETTAGE 475.00
57455 PR COLPOSCOPY,CERVIX W/ADJ VAGINA,W/BX 287.00
57456 PR COLPOSCOPY,CERVIX W/ADJ VAGINA, CURETTAG 437.00
57460 PR COLPOSCOPY,CERVIX W/ADJ VAG,W/LOOP BX 2181.00
57461 PR COLPOSCOPY,CERVIX W/ADJ VAG,W/LOOP CONIZ 882.00
57500 PR BIOPSY CERVIX, 1 OR MORE, OR EXCISION OF LESION 709.00
57505 PR ENDOCERVICAL CURETTAGE 789.00
57510 PR CAUTERIZATION,CERVIX,ELECTRO/THERMAL 2129.00
57511 PR CRYOCAUTERY OF CERVIX 345.00
57520 PR CONIZATION CERVIX,KNIFE/LASER 1488.00
57522 PR CONIZATION CERVIX,LOOP ELECTRD 2176.00
57530 PR REMOVAL OF CERVIX 80M 227.00
57530 PR REMOVAL OF CERVIX 1133.00
57540 PR REMV CERV STUMP,ABD APPRCH 1527.00
57550 PR REMV CERV STUMP,VAG APPRCH 871.00
57556 PR REMOVE CERVIX REPAIR BOWEL 80M 387.00
57556 PR REMOVE CERVIX REPAIR BOWEL 1543.00
57700 PR REVISION OF CERVIX,NON OBSTETRICAL 909.00
57720 PR PLASTIC REPR CERVIX,VAG APPRCH 633.00
57800 PR DILATION OF CERVICAL CANAL 764.00 58100 PR BIOPSY OF UTERUS LINING 245.00
58110 PR ENDOMET BIOPSY DONE W/COLPOSCOPY 101.00
58120 PR DILATION/CURETTAGE,DIAGNOSTIC 925.00
58140 PR MYOMECTOMY 1-4,W/TOT 250GMS/<,ABD APPRCH 80M 561.00
58140 PR MYOMECTOMY 1-4,W/TOT 250GMS/<,ABD APPRCH 2797.00
58145 PR EXCIS UTERINE FIBROID,VAG APPRCH 1995.00
58146 PR MYOMECTOMY 5/>,TOT>250 GMS,ABD APPRCH 80M 479.00
58146 PR MYOMECTOMY 5/>,TOT>250 GMS,ABD APPRCH 2390.00
58150 PR TOTAL ABDOM HYSTERECTOMY 80M 1017.00
58150 PR TOTAL ABDOM HYSTERECTOMY 5076.00
58152 PR TOTAL ABD HYSTERECTOMY+BLAD REPR 80M 880.00
58152 PR TOTAL ABD HYSTERECTOMY+BLAD REPR 4392.00
58180 PR SUPRACERV ABD HYSTERECTOMY 80M 650.00
58180 PR SUPRACERV ABD HYSTERECTOMY 3237.00
58200 PR TOTAL ABD HYSTEREC+LTD NODES 4305.00
58260 PR VAGINAL HYSTERECTOMY,UTERUS 250 GMS/< 80M 826.00
58260 PR VAGINAL HYSTERECTOMY,UTERUS 250 GMS/< 3303.00
58262 PR VAG HYST,RMV TUBE/OVARY 80M 867.00
58262 PR VAG HYST,RMV TUBE/OVARY 4316.00
58263 PR VAG HYST,RMV TUBE/OVARY,FIX ENTEROCE 80M 911.00
58263 PR VAG HYST,RMV TUBE/OVARY,FIX ENTEROCE 4545.00
58267 PR VAG HYST,REV VAG/URETHRA 80M 469.00
58267 PR VAG HYST,REV VAG/URETHRA 2337.00 58270 PR VAG HYST,REV VAG/URETHR,FIX ENTEROCE 80M 366.00
58270 PR VAG HYST,REV VAG/URETHR,FIX ENTEROCE 1824.00
58290 PR VAG HYST,UTERUS >250 GMS 80M 778.00
58290 PR VAG HYST,UTERUS >250 GMS 3882.00
58291 PR VAG HYST,UTERUS >250 GMS,REM TUBE/OVARY 80M 522.00
58291 PR VAG HYST,UTERUS >250 GMS,REM TUBE/OVARY 2598.00
58292 PR VAG HYST T/O & REPAIR COMPL 80M 626.00
58292 PR VAG HYST T/O & REPAIR COMPL 3126.00
58293 PR VAG HYST W/URO REPAIR COMPL 80M 597.00
58293 PR VAG HYST W/URO REPAIR COMPL 2981.00
58294 PR VAG HYST W/ENTEROCELE COMPL 80M 480.00
58294 PR VAG HYST W/ENTEROCELE COMPL 2398.00
58300 PR INSERT INTRAUTERINE DEVICE 224.00
58301 PR REMOVE INTRAUTERINE DEVICE 237.00
58321 PR ARTIF INSEMINATION,INTRA-CERVICAL 202.00
58322 PR ARTIF INSEMINATION,INTRA-UTERINE 242.00
58340 PR CATH/INJECT HYSTEROSALPINGOGRAM 629.00
58345 PR REOPEN FALLOPIAN TUBE,TRANSCERV CATH 631.00
58350 PR REOPEN FALLOPIAN TUBE,CHROMOTUBATION 310.00
58353 PR ENDOMETRIAL ABLATION, THERMAL 3458.00
58356 PR ENDOMETRIAL CRYOABLATION 5986.00
58520 PR REPAIR RUPTURED UTERUS,NON OBSTECTR 80M 329.00
58520 PR REPAIR RUPTURED UTERUS,NON OBSTECTR 1632.00 58540 PR REVISION OF UTERINE ANOMALY 80M 533.00
58540 PR REVISION OF UTERINE ANOMALY 2127.00
58541 PR LAP, SUPRACERVIAL HYSTERECTOMY, <250G 80M 730.00
58541 PR LAP, SUPRACERVIAL HYSTERECTOMY, <250G 3641.00
58542 PR LAP, SUPRACERVIAL HYSTERECTOMY W/ TUBE&OV, <250G 80M 807.00
58542 PR LAP, SUPRACERVIAL HYSTERECTOMY W/ TUBE&OV, <250G 4028.00
58543 PR LAP, SUPRACERVIAL HYSTERECTOMY, >250G 80M 821.00
58543 PR LAP, SUPRACERVIAL HYSTERECTOMY, >250G 4096.00
58544 PR LAP, SUPRACERVIAL HYSTERECTOMY W/ TUBE&OV, >250G 80M 889.00
58544 PR LAP, SUPRACERVIAL HYSTERECTOMY W/ TUBE&OV, >250G 4432.00
58545 PR LAP,MYOMECTOMY 1-4,TOT WT 250 GMS 80M 693.00
58545 PR LAP,MYOMECTOMY 1-4,TOT WT 250 GMS 3454.00
58546 PR LAP,MYOMECTOMY 5/>,TOTAL WT >250 GMS 2561.00
58550 PR LAP,VAG HYST,UTERUS 250GMS/< 80M 757.00
58550 PR LAP,VAG HYST,UTERUS 250GMS/< 3787.00
58552 PR LAP,VAG HYST,UTERUS 250GMS/<,SALP-OOPH 80M 1017.00
58552 PR LAP,VAG HYST,UTERUS 250GMS/<,SALP-OOPH 5076.00
58553 PR LAP,VAG HYST,UTERUS >250GMS 80M 1017.00
58553 PR LAP,VAG HYST,UTERUS >250GMS 5076.00
58554 PR LAP,VAG HYST,UTERUS >250GMS,SALP-OOPH 80M 1017.00
58554 PR LAP,VAG HYST,UTERUS >250GMS,SALP-OOPH 5076.00
58555 PR HYSTEROSCOPY,DX,SEP PROC 80M 218.00
58555 PR HYSTEROSCOPY,DX,SEP PROC 1086.00 58558 PR HYSTEROSCOPY,W/ENDO BX 80M 290.00
58558 PR HYSTEROSCOPY,W/ENDO BX 1443.00
58559 PR HYSTEROSCOPY,LYSIS ADHESIONS 1850.00
58561 PR HYSTEROSCOPY,RMV MYOMA 1321.00
58562 PR HYSTEROSCOPY,RMV FB 654.00
58563 PR HYSTEROSCOPY,W/ENDOMETRIAL ABLATION 80M 978.00
58563 PR HYSTEROSCOPY,W/ENDOMETRIAL ABLATION 3909.00
58565 PR HYSTEROSCOPY, STERILIZE W IMPLANTS 4398.00
58570 PR LAPAROSCOPY W TOT HYSTERECT UTERUS 250 GRAM OR LESS 80M 459.00
58570 PR LAPAROSCOPY W TOT HYSTERECT UTERUS 250 GRAM OR LESS 2294.00
58571 PR LAPAROSCOPY W TOT HYSTERECTUTERUS <=250 GRAM W TUBE/OVARY 80M 521.00
58571 PR LAPAROSCOPY W TOT HYSTERECTUTERUS <=250 GRAM W TUBE/OVARY 2596.00
58572 PR LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS > 250 GRAM 2778.00
58573 PR LAPAROSCOPY TOT HYSTERECTOMY UTERUS >250 GRAM W TUBE/OVARY 80M 620.00
58573 PR LAPAROSCOPY TOT HYSTERECTOMY UTERUS >250 GRAM W TUBE/OVARY 3099.00
58578 PR UTERUS LAPAROSCOPY PROC UNLISTED 2662.00
58600 PR LIGATE FALLOPIAN TUBE 819.00
58605 PR LIGATE FALLOPIAN TUBE,POSTPARTUM 80M 315.00
58605 PR LIGATE FALLOPIAN TUBE,POSTPARTUM 1570.00
58611 PR LIGATION,FALLOPIAN TUBE W/C-SECTION 80M 158.00
58611 PR LIGATION,FALLOPIAN TUBE W/C-SECTION 780.00
58615 PR OCCLUDE FALLOPIAN TUBE BY DEVICE 80M 168.00
58615 PR OCCLUDE FALLOPIAN TUBE BY DEVICE 540.00 58660 PR LAP,LYSIS OF ADHESIONS 80M 494.00
58660 PR LAP,LYSIS OF ADHESIONS 2457.00
58661 PR LAP,RMV ADNEXAL STRUCTURE 80M 600.00
58661 PR LAP,RMV ADNEXAL STRUCTURE 2989.00
58662 PR LAP,FULGURATE/EXCISE LESIONS 80M 493.00
58662 PR LAP,FULGURATE/EXCISE LESIONS 2457.00
58670 PR LAP,TUBAL CAUTERY 2102.00
58671 PR LAP,TUBAL BLOCK BY DEVICE 80M 401.00
58671 PR LAP,TUBAL BLOCK BY DEVICE 1995.00
58672 PR LAP,FIMBRIOPLASTY 1729.00
58673 PR LAP,SALPINGOSTOMY 2520.00
58679 PR LAP,OVIDUCT/OVARY,UNLIST PROC 741.00
58700 PR REMOVAL OF FALLOPIAN TUBE 80M 598.00
58700 PR REMOVAL OF FALLOPIAN TUBE 2989.00
58720 PR REMOVAL OF OVARY/TUBE(S) 80M 600.00
58720 PR REMOVAL OF OVARY/TUBE(S) 2989.00
58740 PR LYSIS ADNEXAL ADHESIONS 80M 432.00
58740 PR LYSIS ADNEXAL ADHESIONS 2149.00
58750 PR REPAIR OVIDUCT 4747.00
58760 PR FIMBRIOPLASTY 4229.00
58770 PR CREATE NEW TUBAL OPENING 3083.00
58800 PR DRAIN OVARIAN CYST(S),VAG APPRCH 789.00
58805 PR DRAIN OVARIAN CYST(S),ABD APPRCH 2034.00 58900 PR BIOPSY OF OVARY(S) 923.00
58920 PR PARTIAL REMOVAL OF OVARY(S) 80M 314.00
58920 PR PARTIAL REMOVAL OF OVARY(S) 1562.00
58925 PR REMOVAL OF OVARIAN CYST(S) 80M 571.00
58925 PR REMOVAL OF OVARIAN CYST(S) 2847.00
58940 PR REMOVAL OF OVARY(S) 80M 715.00
58940 PR REMOVAL OF OVARY(S) 2847.00
58943 PR OOPHORECTORMY FOR MALIG, W/BX 2595.00
58950 PR INITIAL RESEC OVAR MAL+BIL OVAR+OMENTUM 80M 556.00
58950 PR INITIAL RESEC OVAR MAL+BIL OVAR+OMENTUM 2656.00
58953 PR BIL SALP-OOPH W/OMENTECT,TAH,RAD DISSECT 80M 794.00
58953 PR BIL SALP-OOPH W/OMENTECT,TAH,RAD DISSECT 3958.00
58999 PR FEMALE GENITAL SURG PROC UNLISTED 80M 382.00
58999 PR FEMALE GENITAL SURG PROC UNLISTED 1902.00
59000 PR AMNIOCENTESIS,DIAGNOSTIC 287.00
59025 PR FETAL NON-STRESS TEST 146.00
59120 PR TREAT ECTOPIC PREG,RMV TUBE/OVARY 80M 621.00
59120 PR TREAT ECTOPIC PREG,RMV TUBE/OVARY 3099.00
59121 PR TREAT ECTOPIC PREG,NON REMVAL 4006.00
59136 PR RX ECTOP PREG,UTER WALL,PART HYSTREC 1920.00
59150 PR RX ECTOP PREG BY LAPAROSCOPE 1647.00
59151 PR RX ECTOP PREG BY SCOPE,RMV TUBE/OVRY 80M 587.00
59151 PR RX ECTOP PREG BY SCOPE,RMV TUBE/OVRY 2929.00 59160 PR D&C AFTER DELIVERY 80M 288.00
59160 PR D&C AFTER DELIVERY 893.00
59200 PR INSERT CERVICAL DILATOR 160.00
59300 PR EPISIOTOMY/VAGINAL REPR BY OTHR MD 405.00
59320 PR REVISION CERVIX W PREG,VAG APPRCH 1465.00
59400 PR FULL ROUT OBSTE CARE,VAGINAL DELIV 3700.00
59409 PR OBSTETRICAL CARE,VAG DELIV ONLY 2699.00
59410 PR OBSTE CARE,VAG DELIV+POSTPARTUM 2699.00
59412 PR ANTEPARTUM HEAD MANIPULATION 80M 122.00
59412 PR ANTEPARTUM HEAD MANIPULATION 594.00
59414 PR DELIVER PLACENTA 893.00
59425 PR ANTEPARTUM CARE ONLY, 4-6 VISITS 1164.00
59426 PR ANTEPARTUM CARE ONLY, >7 VISITS 1517.00
59430 PR CARE AFTER DELIVERY ONLY 330.00
59510 PR FULL ROUT OBSTE CARE,CESAREAN DELIV 4192.00
59514 PR CESAREAN DELIVERY ONLY 80M 605.00
59514 PR CESAREAN DELIVERY ONLY 3011.00
59515 PR CESAREAN DELIVERY+POSTPARTUM CARE 3160.00
59525 PR REMOVE UTERUS AFTER CESAREAN 80M 361.00
59525 PR REMOVE UTERUS AFTER CESAREAN 1437.00
59610 PR ROUT OB CARE,VAG DELIV,PREV C-SEC 3907.00
59612 PR VAG DELIV ONLY,PREV C-SECTN 3423.00
59614 PR VAG DELIV+POSTPARTUM CARE,PREV C-SEC 3546.00 59618 PR ROUT OB CARE,C-SEC,PREV C-SEC 5392.00
59620 PR C-SEC ONLY,PREV C-SEC 80M 475.00
59620 PR C-SEC ONLY,PREV C-SEC 2364.00
59622 PR C-SEC+POSTPARTUM CARE,PREV C-SEC 4625.00
59812 PR SURG RX INCOMPLETE ABORTN 893.00
59820 PR SURG RX MISSED ABORTN,1ST TRI 893.00
59821 PR SURG RX MISSED ABORTN,2ND TRI 1089.00
59841 PR INDUCED ABORTN BY DIL/EVAC 1093.00
59850 PR INDUCED ABORTN BY INTRA-AMNIOT INJ 851.00
59855 PR INDUCED AB BY VAG SUPPOS 820.00
59870 PR EVACUATE MOLE OF UTERUS 80M 213.00
59870 PR EVACUATE MOLE OF UTERUS 1061.00
59871 PR REMOVE CERCLAGE SUTURE 373.00
60210 PR PARTIAL EXCISION THYROID,UNILAT 1688.00
60220 PR THYROID LOBECTOMY,UNILAT 80M 332.00
60220 PR THYROID LOBECTOMY,UNILAT 1657.00
60240 PR THYROIDECTOMY 80M 483.00
60240 PR THYROIDECTOMY 2414.00
60252 PR THYROIDECTOMY,MALIG,LTD NECK SURG 80M 625.00
60252 PR THYROIDECTOMY,MALIG,LTD NECK SURG 3123.00
60254 PR THYROIDECTOMY W RAD NECK SURGERY 80M 803.00
60254 PR THYROIDECTOMY W RAD NECK SURGERY 4010.00
60260 PR THYROIDECTOMY POST PREV THYR SURG 80M 507.00 60260 PR THYROIDECTOMY POST PREV THYR SURG 2535.00
60271 PR THYROIDECTOMY=SUBSTERNAL,TRANSCERV 80M 483.00
60271 PR THYROIDECTOMY=SUBSTERNAL,TRANSCERV 2412.00
60280 PR EXCIS THYROID DUCT CYST/SINUS 1059.00
60300 PR ASPIRATION AND/OR INJECTION THYROID CYST 292.00
60500 PR EXPLORE PARATHYROID GLANDS 80M 443.00
60500 PR EXPLORE PARATHYROID GLANDS 2211.00
60540 PR EXCISE ADRENAL GLAND 80M 499.00
60540 PR EXCISE ADRENAL GLAND 2491.00
61650 PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST 1235.00
62270 PR SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC 489.00
62310 PR NJX DX/THER SBST EPIDURAL/SUBRACH CERV/THORACIC 556.00
62311 PR NJX DX/THER SBST EPIDURAL/SUBARACH LUMBAR/SACRAL 570.00
62350 PR IMP SPINAL CANAL CATH 924.00
62355 PR REMOVE SPINAL CANAL CATHETER 610.00
62360 PR INSERT SPINE INFUSN DEVICE,SUBCUT 739.00
62362 PR IMPLANT/ REPLACE INFUSION PUMP, PROGRAMMABLE 928.00
62365 PR REMOVE INFUSN DEVICE/PUMP 686.00
63001 PR LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG, CERVICAL 2728.00
63003 PR LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG, THORACIC 2928.00
63003 PR LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG, THORACIC 50M 4392.00
63005 PR LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG, LUMBAR 2666.00
63017 PR LAMINECTOMY,>2 SGMT,LUMBAR 2933.00 63020 PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC 2669.00
63020 PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC 50M 4004.00
63030 PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR 80M 514.00
63030 PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR 2566.00
63030 PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR 50M 3849.00
63035 PR LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR 549.00
63035 PR LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR 50M 824.00
63040 PR LAMINOTOMY 2298.00
63040 PR LAMINOTOMY 50M 3448.00
63042 PR REDO EXCIS LUMBAR DISC 3560.00
63042 PR REDO EXCIS LUMBAR DISC 50M 5339.00
63044 PR REDO EXCIS CERV DISC, ADDN LUMB INTERSPC 761.00
63046 PR LAMINEC/FACETECT/FORAMIN,THORACIC 1 SEG 2906.00
63075 PR DISK SURG,ANTER,CERVICAL,SINGLE LVL 80M 612.00
63075 PR DISK SURG,ANTER,CERVICAL,SINGLE LVL 3056.00
63076 PR DISK SURG,ANTER,CERV,EA ADDNL LVL 80M 113.00
63076 PR DISK SURG,ANTER,CERV,EA ADDNL LVL 561.00
63081 PR REMV VERT BODY,CERV,ONE SGMT 80M 788.00
63081 PR REMV VERT BODY,CERV,ONE SGMT 3940.00
63267 PR EXCIS INTRASP LESN,XDURAL,LUMBAR 3108.00
63655 PR SURG IMPLNT NEUROELECT,EPIDURAL 1885.00
63661 PR REMOVE SPINAL NEUROSTIM ELECTRODE PERC ARRAY, INCL FLUORO 1423.00
63685 PR IMPLANT NEUROSTIM/RECEIVER 843.00 63688 PR REVISE/REMOVE NEUROSTIM/RECEIVER 852.00
64405 PR INJECT NERV BLCK,GREAT OCCIPTL 244.00
64421 PR INJECT NERV BLCK,INTERCOST,MULTPL 284.00
64425 PR INJECT NERV BLCK,ILIOINGU/ILIOHYP 641.00
64450 PR INJECT NERV BLCK,OTHR PERIPH NERV 437.00
64455 PR INJECT PLANTAR COMMON DIGITAL NERVE 282.00
64530 PR INJECT NERV BLCK,CELIAC PLEXUS 222.00
64550 PR APPLICATION OF SURFACE NEUROSTIMULATOR 22.00
64590 PR IMPLANT GASTRIC NEUROSTIM/RECEIVER 666.00
64610 PR INJECT 5TH N.-2,3 DIV,F.OVALE,XRAY 1131.00
64612 PR DEST,NERVE,FACIAL 415.00
64614 PR CHEMODENERVATION EXTREMITY&/TRUNK MUSCLE 994.00
64615 PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE 446.00
64650 PR CHEMODENERV ECCRINE GLANDS BOTH AXILLAE 267.00
64704 PR REVISE/REPAIR HAND/FOOT NERVE 773.00
64708 PR NEUROPLASTY OTHER ARM/LEG NERVE,OPEN 1156.00
64718 PR REVISE ULNAR NERVE AT ELBOW 1337.00
64719 PR REVISE ULNAR NERVE AT WRIST 932.00
64721 PR REVISE MEDIAN N/CARPAL TUNNEL SURG 1087.00
64721 PR REVISE MEDIAN N/CARPAL TUNNEL SURG 50M 1631.00
64722 PR RELIEVE PRESSURE ON NERVE(S) 835.00
64774 PR EXCISE CUTANEOUS NEUROMA 994.00
64782 PR EXCISE HAND/FOOT NEUROMA 1083.00 64784 PR EXCISE MAJOR PERIPHERAL NEUROMA 1759.00
64790 PR EXCISE MAJOR PERIPH NEUROFIBROMA 1906.00
64831 PR REPAIR OF DIGIT NERVE 1656.00
64832 PR REPAIR EACH ADDNL DIGIT NERVE 808.00
64857 PR REPAIR MAJOR PERIPHERAL NERVE 2515.00
64999 PR NERVOUS SYSTEM SURG PROC UNLISTED 573.00
65205 PR REMV F.B.,EYE,SUPERF CONJUNC 177.00
65210 PR REMV F.B.,EYE,EMBED CONJUNC 158.00
65220 PR REMV F.B.,EYE,CORNEA,NO SLIT 122.00
67700 PR DRAINAGE OF EYELID ABSCESS 665.00
67800 PR EXCIS CHALAZION,SINGLE 300.00
67810 PR BIOPSY OF EYELID 513.00
67820 PR REVISE EYELASHES,FORCEPS 359.00
67840 PR REMOVE EYELID LESN (NOT CHALAZION) 658.00
67875 PR TEMP CLOSURE EYELID BY SUTURE 422.00
67900 PR REPAIR BROW PTOSIS 1328.00
67908 PR FIX LID PTOSIS,FASANELLA-SERVAT 1171.00
67917 PR FIX ECTROPION,ENTENSV LID REPAIR 1478.00
67924 PR FIX ENTROPION,EXTENSV LID REPAIR 1468.00
67938 PR REMOVE EYELID FOREIGN BODY,EMBEDDED 599.00
67950 PR CANTHOPLASTY 1420.00
67961 PR REVISION OF EYELID,< 1/4 LID MARGIN 1318.00
68110 PR EXCIS CONJUNC LESN,=<1 CM 566.00 68720 PR CREATE TEAR SAC-NASAL FISTULA 1841.00
69000 PR DRAIN EXT EAR ABSC/BLOOD,SIMPLE 417.00
69000 PR DRAIN EXT EAR ABSC/BLOOD,SIMPLE 50M 626.00
69005 PR DRAIN EXT EAR ABSC/BLOOD,COMPLIC 2076.00
69020 PR DRAIN EXT AUD CANAL ABSCESS 561.00
69100 PR BIOPSY OF EXTERNAL EAR 389.00
69105 PR BIOPSY OF EXT AUDITORY CANAL 1889.00
69140 PR REMV EXT CANAL EXOSTOSIS 2102.00
69145 PR REMV EXT CANAL SOFT TISSUE LESN 947.00
69145 PR REMV EXT CANAL SOFT TISSUE LESN 50M 1421.00
69150 PR RAD EXCIS EXT CANAL LESN 2553.00
69150 PR RAD EXCIS EXT CANAL LESN 50M 3829.00
69200 PR REMV EXT CANAL FOREIGN BODY 167.00
69200 PR REMV EXT CANAL FOREIGN BODY 50M 250.00
69205 PR REMV EXT CANAL F.B.,GEN ANESTH 244.00
69209 PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT 81.00
69209 PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT 50M 122.00
69210 PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT 150.00
69210 PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT 50M 225.00
69220 PR DEBRIDE MASTOID CAVITY,SIMPLE 334.00
69222 PR DEBRIDE MASTOID CAVITY,COMPLEX 533.00
69310 PR RECONSTRUCTION,EXT AUDITORY CANAL 2721.00
69401 PR INFLATE MIDDLE EAR CANAL 218.00 69420 PR INCISION EARDRUM,ASPIR 478.00
69424 PR VENT TUBE REMVL REQ GEN ANESTHESIA 319.00
69433 PR CREATE EARDRUM OPENING,LOCAL ANESTH 841.00
69433 PR CREATE EARDRUM OPENING,LOCAL ANESTH 50M 1261.00
69436 PR CREATE EARDRUM OPENING,GEN ANESTH 387.00
69436 PR CREATE EARDRUM OPENING,GEN ANESTH 50M 580.00
69535 PR RESECT TEMPORAL BONE,EXTERN APPRCH 6519.00
69535 PR RESECT TEMPORAL BONE,EXTERN APPRCH 50M 9763.00
69540 PR REMV AURAL POLYP 524.00
69610 PR REPAIR TYMPANIC MEMBRANE 925.00
69620 PR MYRINGOPLASTY 1667.00
69631 PR TYMPANOPLASTY 2106.00
69643 PR TYMPANOPLAS/MASTOIDEC,INTACT WALL 2908.00
69644 PR TYMPANOPLAS/MASTOID,INTCT WALL,REBLD 3619.00
69645 PR TYMPANOPLAS/MASTOIDEC,RADICAL/COMPLE 3569.00
69990 PR MICROSURG TECHNIQUES,REQ OPER MICROSCOPE 476.00
71010 PR RADIOLOGIC EXAM, CHEST; SINGLE VIEW, FRONTAL 127.00
71090 PR INSERTION PACEMAKER, FLUOROSCOPY & RADIOGRAPHY, RADIOLOGICAL S&I 63.00
71100 PR RADIOLOGIC EXAM, RIBS, UNILAT; 2 VIEWS 149.00
71101 PR RADIOLOGIC EXAM, RIBS, UNILAT; W/POSTEROANTERIOR CHEST, 3+ VIEWS 167.00
71110 PR RADIOLOGIC EXAM, RIBS, BILAT; 3 VIEWS 170.00
71120 PR RADIOLOGIC EXAM; STERNUM, 2+ VIEWS 73.00
72020 PR RADIOLOGIC EXAM, SPINE, SINGLE VIEW, SPECIFY LEVEL 129.00 72040 CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS 166.00
72050 PR RADIOLOGIC EXAM, SPINE, CERVICAL; 4+ VIEWS 248.00
72052 PR RADIOLOGIC EXAM, SPINE, CERVICAL; COMPLETE W/OBLIQUE & FLEXION &/OR EXTENSION STUDIE 283.00
72069 PR RADIOLOGIC EXAM, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS) 160.00
72070 PR RADIOLOGIC EXAM, SPINE; THORACIC, 2 VIEWS 154.00
72080 CHG RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS 159.00
72090 PR RADIOLOGIC EXAM, SPINE; SCOLIOSIS STUDY, W/SUPINE & ERECT STUDIES 239.00
72100 PR RADIOLOGIC EXAM, SPINE, LUMBOSACRAL; 2 OR 3 VIEWS 170.00
72110 PR RADIOLOGIC EXAM, SPINE, LUMBOSACRAL; 4+ VIEWS 255.00
72114 PR RADIOLOGIC EXAM, SPINE, LUMBOSACRAL; COMPLETE, W/BENDING VIEWS 301.00
72120 PR RADIOLOGIC EXAM, SPINE, LUMBOSACRAL; BENDING VIEWS ONLY, 4+ VIEWS 196.00
72170 PR RADIOLOGIC EXAM, PELVIS; 1 OR 2 VIEWS 136.00
72190 PR RADIOLOGIC EXAM, PELVIS; COMPLETE, 3+ VIEWS 173.00
72200 PR RADIOLOGIC EXAM, SACROILIAC JOINTS; < 3 VIEWS 144.00
72202 PR RADIOLOGIC EXAM, SACROILIAC JOINTS; 3+ VIEWS 155.00
72220 PR RADIOLOGIC EXAM, SACRUM & COCCYX, 2+ VIEWS 143.00
73000 PR RADIOLOGIC EXAM; CLAVICLE, COMPLETE 141.00
73010 PR RADIOLOGIC EXAM; SCAPULA, COMPLETE 145.00
73020 PR RADIOLOGIC EXAM, SHOULDER; 1 VIEW 127.00
73030 PR RADIOLOGIC EXAM, SHOULDER; COMPLETE, 2+ VIEWS 146.00
73050 PR RADIOLOGIC EXAM; ACROMIOCLAVICULAR JOINTS, BILAT W/WO WEIGHTS 165.00
73060 PR RADIOLOGIC EXAM; HUMERUS, 2+ VIEWS 143.00
73070 PR RADIOLOGIC EXAM, ELBOW; 2 VIEWS 141.00 73080 PR RADIOLOGIC EXAM, ELBOW; COMPLETE, 3+ VIEWS 154.00
73090 PR RADIOLOGIC EXAM; FOREARM, 2 VIEWS 138.00
73100 PR RADIOLOGIC EXAM, WRIST; 2 VIEWS 146.00
73110 PR RADIOLOGIC EXAM, WRIST; COMPLETE, 3+ VIEWS 159.00
73120 PR RADIOLOGIC EXAM, HAND; 2 VIEWS 137.00
73130 PR RADIOLOGIC EXAM, HAND; 3+ VIEWS 149.00
73140 PR RADIOLOGIC EXAM, FINGER(S), 2+ VIEWS 147.00
73500 PR RADIOLOGIC EXAM, HIP, UNILAT; 1 VIEW 135.00
73501 CHG RADEX HIP UNILATERAL WITH PELVIS 1 VIEW 107.00
73502 CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS 122.00
73503 CHG RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS 180.00
73510 PR RADIOLOGIC EXAM, HIP, UNILAT; COMPLETE, 2+ VIEWS 165.00
73520 PR RADIOLOGIC EXAM, HIPS, BILAT, 2+ VIEWS, W/AP VIEW, PELVIS 199.00
73521 CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS 99.00
73522 CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS 122.00
73540 PR RADIOLOGIC EXAM, PELVIS & HIPS, INFANT/CHILD, 2+ VIEWS 170.00
73551 CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW 105.00
73552 CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS 110.00
73560 PR RADIOLOGIC EXAM, KNEE; 1/2 VIEWS 145.00
73562 PR RADIOLOGIC EXAM, KNEE; 3 VIEWS 171.00
73564 PR RADIOLOGIC EXAM, KNEE; COMPLETE, 4+ VIEWS 173.00
73565 PR RADIOLOGIC EXAM, KNEE; BOTH KNEES, STANDING, ANTEROPOSTERIOR 153.00
73590 PR RADIOLOGIC EXAM; TIBIA & FIBULA, TWO VIEWS 137.00 73600 PR RADIOLOGIC EXAM, ANKLE; 2 VIEWS 141.00
73610 PR RADIOLOGIC EXAM, ANKLE; COMPLETE, 3+ VIEWS 149.00
73620 PR RADIOLOGIC EXAM, FOOT; 2 VIEWS 136.00
73630 PR RADIOLOGIC EXAM, FOOT; COMPLETE, 3+ VIEWS 148.00
73650 PR RADIOLOGIC EXAM; CALCANEUS, 2+ VIEWS 138.00
73660 PR RADIOLOGIC EXAM; TOE(S), 2+ VIEWS 143.00
74300 PR CHOLANGIOGRAPHY &/OR PANCREATOGRAPHY; INTRAOPERATIVE, RADIOLOGICAL S&I 44
74420 PR UROGRAPHY, RETROGRADE, W/WO KUB 42.00
74430 PR CYSTOGRAPHY, 3+ VIEWS, RADIOLOGICAL S&I 38.00
75605 PR AORTOGRAPHY, THORACIC, SERIALOGRAPHY, RADIOLOGICAL S&I 138.00
75625 PR AORTOGRAPHY, ABDOMINAL, SERIALOGRAPHY, RADIOLOGICAL S&I 135.00
75630 PR AORTOGRAPHY, ABDOMINAL & BILAT ILIOFEMORAL LOWER EXTREMITY, CATHETER, RADIOLOGICA 213.00
75710 PR ANGIOGRAPHY, EXTREMITY, UNILAT, RADIOLOGICAL S&I 433.00
75774 PR ANGIOGRAPHY, SELECTIVE, ADD'L VESSEL(S), RADIOLOGICAL S&I 43.00
75820 PR VENOGRAPHY, EXTREMITY, UNILAT, RADIOLOGICAL S&I 84.00
75860 PR VENOGRAPHY, SINUS/JUGULAR, CATHETER, RADIOLOGICAL S&I 134.00
76000 PR FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME 21.00
76098 PR RADIOLOGICAL EXAM, SURGICAL SPECIMEN 46.00
76120 PR CINE/VIDEO X-RAYS 44.00
76536 PR ULTRASOUND, HEAD/NECK TISSUES, B-SCAN/REAL TIME W/IMAGE DOCUMENTATION 282
76642 CHG US BREAST UNI REAL TIME WITH IMAGE LIMITED 220.00
76645 PR ULTRASOUND, BREAST(S), B-SCAN/REAL TIME W/IMAGE DOCUMENTATION 214.00
76700 PR ULTRASOUND, ABDOMINAL, B-SCAN &/OR REAL TIME W/IMAGE DOCUMENTATION; COMPLETE 360.00 76705 PR ULTRASOUND, ABDOMINAL, B-SCAN &/OR REAL TIME W/IMAGE DOCUMENTATION; LIMITED 471.00
76770 PR ULTRASOUND, RETROPERITONEUM, B-SCAN/REAL TIME; COMPLETE 336.00
76775 PR ULTRASOUND, RETROPERITONEUM, B-SCAN/REAL TIME; LIMITED 236.00
76801 PR US, PREG UTER, REAL TIME W/IMG DOCUMNT, FETAL & MATERNAL, 1ST TRIMEST, TRNSABD; SINGL 457.00
76802 PR US, PREG UTER, REAL TIME W/IMG DOCUMNT, FETAL & MATERNAL, 1ST TRIMEST, TRNSABD; EA AD 504.00
76805 PR US, PREG UTER, RLTIME W/IMG DOCUMNT, FETAL & MATERNL, 1ST TRIMST, TRNSABD; SINGL/1ST A 457.00
76810 PR US, PREG UTER, REAL TIME W/IMAGE DOCUMENT EA ADD'L GEST 503.00
76811 PR US, PREG UTER, REAL TIME W/IMG DOC, FETL & MTRNL, + DETL FETL EXM, TRNSABD; SINGL/1ST AD 489.00
76812 PR US, PREG UTER, REAL TIME W/IMG DOC, FETAL & MTRNL, + DETAIL FETAL EXAM, TRANSABD; EA AD 543.00
76815 PR OB ULTRASOUND, LIMITED 247.00
76816 PR US, PREGNANT UTERUS, REAL TIME W/IMAGE DOCUMENT, FOLLOW-UP, TRANSABD APPROACH, PE 236.00
76817 PR US, PREGNANT UTERUS, REAL TIME W/IMAGE DOCUMENT, TRANSVAGINAL 222.00
76818 PR FETAL BIOPHYSICAL PROFILE; W/NON-STRESS TESTING 459.00
76819 PR FETAL BIOPHYSICAL PROFILE; W/O NON-STRESS TESTING 459.00
76830 PR ECHOGRAPHY, TRANSVAGINAL 466.00
76831 PR SALINE INFUSION SONOHYSTEROGRAPHY, W/COLOR FLOW DOPPLER, WHEN PERFORMED 441.00
76856 PR ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN &/OR REAL TIME W/IMAGE DOCUMENTATION; CO 429.00
76857 PR ECHOGRAPHY, PELVIC - NON-OB, LIMITED 227.00
76872 PR US, TRANSRECTAL 347.00
76880 PR ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN &/OR REAL TIME W/IMAGE DOCUMENTATION 271.00
76882 PR US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG 271.00
76936 PR US GUIDANCE, COMPRESSION REPAIR, PSEUDO-ANEURYSM/AV FISTULAE 235.00
76937 PR US GUIDE, VASC ACCESS, REQ EVAL, POTENTIAL SITES, VESSEL PATENCY, NEEDLE ENTRY, W/REC 38.00 76942 PR US GUIDANCE, NEEDLE PLACEMENT, RADIOLOGICAL S&I 220.00
76999 PR UNLISTED ULTRASOUND PROCEDURE 347.00
77001 PR FLUOROSCOPIC GUIDANCE 44.00
77001 PR FLUOROSCOPIC GUIDANCE 26 44.00
77002 PR FLUOROSCOPIC GUIDANCE 65.00
77031 PR STEREOTACTIC LOCALIZATION 184.00
77071 PR X-RAY STRESS VIEW 112.00
78195 PR LYMPHATICS & LYMPH GLANDS IMAGING 134.00
78451 PR MYOCARDIAL PERFUSION IMAGING 155.00
78452 PR MYOCARDIAL PERFUSION IMAGING 183.00
78492 PR MYOCARDIAL PET; MULTIPLE STUDIES, REST &/OR STRESS 208.00
80053 PR COMPREHENSIVE METABOLIC PANEL 20.00
80061 PR LIPID PANEL 26.00
80100 PR DRUG SCREEN QUALITATE/MULTI 26.00
80101 PR DRUG SCREEN, QUALITATIVE; SINGLE DRUG CLASS METHOD, EACH DRUG CLASS 23.00
81000 PR URINALYSIS, DIP STICK/TABLET REAGENT; NON-AUTOMATED W/MICROSCOPY 34.00
81002 PR URINALYSIS, DIP STICK/TABLET REAGENT; NON-AUTOMATED, W/O MICROSCOPY 23.00
81003 PR URINALYSIS, DIP STICK/TABLET REAGENT; AUTOMATED, W/O MICROSCOPY 34.00
81007 PR URINE SCREEN FOR BACTERIA 46.00
81015 PR MICROSCOPIC EXAM OF URINE 34.00
81025 PR URINE PREGNANCY TEST, VISUAL COLOR COMPARISON METHODS 57.00
82120 PR AMINES VAGINAL FLUID QUAL 14.00
82175 PR ASSAY OF ARSENIC 33.00 82270 PR BLOOD, OCCULT, BY PEROXIDASE ACTIVITY, QUALITATIVE; FECES, 1-3 SIMULTANEOUS DETERMINA 29.00
82272 PR TEST FECES BLOOD PEROXIDASE 27.00
82274 PR ASSAY TEST FOR BLOOD FECAL 53.00
82300 PR CADMIUM 40.00
82947 PR ASSAY GLUCOSE BLOOD QUANT 14.00
82948 PR GLUCOSE; BLOOD, REAGENT STRIP 29.00
82962 PR GLUCOSE, BLOOD, GLUCOSE MONITORING DEVICE(S) CLEARED BY FDA SPECIFICALLY FOR HOME 29.00
83655 PR LEAD 20.00
83825 PR ASSAY OF MERCURY 22.00
83986 PR PH, BODY FLUID, EXCEPT BLOOD 12.00
84153 PR PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL 34.00
84154 PR ASSAY OF PSA FREE 32.00
85018 PR BLOOD COUNT; HEMOGLOBIN 34.00
85025 PR COMPLETE CBC W/AUTO DIFF WBC 32.00
85060 PR BLOOD SMEAR, PERIPHERAL, INTERPRETATION, PHYSICIAN W/WRITTEN REPORT 69.00
85097 PR BONE MARROW, SMEAR INTERPRETATION 236.00
85536 PR IRON STAIN PERIPHERAL BLOOD 69.00
85610 PR PROTHROMBIN TIME 14.00
86304 PR IMMUNOASSAY TUMOR CA 125 37.00
86308 PR HETEROPHILE ANTIBODIES; SCREENING 33.00
86510 PR HISTOPLASMOSIS SKIN TEST 49.00
86580 PR SKIN TEST; TUBERCULOSIS, INTRADERMAL 41.00
86703 PR HIV-1/HIV-2 1 RESULT ANTBDY 30.00 86706 PR HEPATITIS B SURFACE ANTIBODY (HBSAB) 20.00
86803 PR HEPATITIS C AB TEST 27.00
87210 PR SMEAR, PRIMARY SOURCE W/INTERPRETATION; WET MOUNT, FOR INFECTIOUS AGENTS 29.00
87220 PR TISSUE EXAM BY KOH SLIDE OF SAMPLES FROM SKIN/HAIR/NAILS, FUNGI/ECTOPARASITE OVA/MIT 58.00
87804 PR INFECTIOUS AGENT, IMMUNOASSAY, DIRECT OBSERVATION; INFLUENZA 39.00
87880 PR INFECTIOUS AGENT, IMMUNOASSAY, DIRECT OBSERVATION; STREPOCOCCUS GROUP A 58.00
88150 PR CYTOPATHOLOGY, SLIDES, CERVICAL/VAGINAL; MANUAL SCREEN 27.00
88720 PR BILIRUBIN TOTAL TRANSCUT 43.00
89060 PR CRYSTAL ID, LIGHT MICROSCOPY, BODY FLUID, EXCEPT URINE 161.00
89300 PR SEMEN ANALYSIS; PRESENCE &/OR MOTILITY, SPERM W/HUHNER TEST (POST COITAL) 32.00
90283 PR HUMAN IG IV 214.00
90371 PR HEP B IG IM 324.00
90378 PR RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG EA 1204.00
90384 PR RH IG, FULL-DOSE, IM 237.00
90389 PR TETANUS IG IM 391.00
90460 PR IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX 40.00
90461 PR IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT 18.00
90465 PR IMMUNIZ ADMIN,1 SINGLE/COMB,<8YRS 42.00
90466 PR IMMUNIZ,ADMIN,EACH ADDL,<8YRS 26.00
90470 PR IMMUNIZ ADMIN, IM/INTRANASAL, W COUNSEL, H1N1 15.00
90471 PR IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID 37.00
90472 PR IMMUNIZ,ADMIN,EACH ADDL 37.00
90473 PR IMMUNIZ ADMIN,INTRANASAL/ORAL,1 VAC/TOX 37.00 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE 148.00
90633 PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE 148.00
90634 PR HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE 130.00
90636 PR HEPA/HEPB VACCINE ADULT IM 209.00
90645 PR HIB VACCINE, HBOC, 4-DOSE, IM 79.00
90648 PR HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE 79.00
90649 PR 4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE 352.00
90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE 393.00
90654 PR INFLUENZA VACC IIV3 SPLIT VIRUS PRSRV FREE ID 18.00
90655 PR IIV3 VACC PRESRV FREE CHILD 6-35 MONTHS IM USE 18.00
90656 PR IIV3 VACC PRESERVATIVE FREE 3 YRS & OLDER IM USE 22.00
90657 PR IIV3 VACCINE TO CHILD 6-35 MONTHS FOR IM USE 18.00
90658 PR IIV3 VACCINE 3 YRS & OLDER FOR IM USE 22.00
90660 PR LAIV3 VACCINE LIVE FOR INTRANASAL USE 55.00
90662 PR IIV VACCINE PRESERV FREE INCREASED AG COUNT IM 101
90669 PR PNEUMOCOCCAL CONJ VACCINE 7 VALENT IM 153.00
90670 PR PCV13 VACCINE FOR INTRAMUSCULAR USE 361.00
90672 PR LAIV4 VACCINE FOR INTRANASAL USE 37.00
90680 PR RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE 172.00
90685 PR IIV4 PRESRV FREE VACC CHILD 6-35 MO FOR IM USE 38.00
90686 PR IIV4 VACC PRESRV FREE 3 YRS & OLDER IM USE 38.00
90687 PR IIV4 VACCINE CHILD 6-35 MO FOR IM USE 18.00
90688 PR IIV4 VACCINE 3 YRS & OLDER FOR IM USE 38.00 90690 PR TYPHOID VACCINE ORAL 97.00
90696 PR DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE 135.00
90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE 193.00
90700 PR DTAP IMMUNIZATION, IM 63.00
90701 PR DTP IMMUNIZATION, IM 54.00
90702 PR DT VACCINE YOUNGER THAN 7 YRS FOR IM USE 111.00
90703 PR TETANUS IMMUNIZATION, IM 34.00
90704 PR MUMPS VACCINE SC 49.00
90705 PR MEASLES IMMUNIZATION, SUBCUT 55.00
90706 PR RUBELLA IMMUNIZATION, SUBCUT 60.00
90707 PR MMR VIRUS IMMUNIZATION, SUBCUT 138.00
90710 PR MEASLES, MUMPS, RUBELLA, & VARICELLA VACCINE (MMRV), SUBQ 415.00
90712 PR ORAL POLIOVIRUS IMMUNIZATN,LIVE,OPC 67.00
90713 PR POLIOMYELITIS VACCINE (IPV), INACTIV, SUBQ 66.00
90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE 72.00
90715 PR TDAP VACCINE =>7 YO, IM 97.00
90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE 248.00
90718 PR TD IMMUNIZATION,IM/JET>7YO 32.00
90719 PR DIPHTHERIA VACCINE IM 33.00
90720 PR DTP/HIB VACCINE,IM 73.00
90721 PR DTAP/HIB VACCINE INTRAMUSCULAR 91.00
90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR 147.00
90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE 177.00 90733 PR MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE 272.00
90734 PR MENACWY CONJUGATE VACCINE GROUPS ACYW-135 IM USE 248.00
90736 PR (ZOSTAVAX) ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE 476.00
90744 PR HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM 89.00
90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE 120.00
90747 PR HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM 102.00
90748 PR HIB-HEPB VACCINE FOR INTRAMUSCULAR USE 89.00
90750 PR (SHINGRIX) HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX 305.00
90785 PR PSYCHOTHERAPY COMPLEX INTERACTIVE 34.00
90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION 311.00
90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES 348.00
90832 PR PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES 152.00
90833 PR PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN 155.00
90834 PR PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES 201.00
90836 PR PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN 197.00
90837 PR PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES 301.00
90838 PR PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN 260.00
90839 PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES 312.00
90840 PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES 150.00
90846 PR FAMILY PSYCHOTHERAPY,NO PT 243.00
90847 PR FAMILY PSYCHOTHERAPY W PHYS 252.00
90853 PR GROUP PSYCHOTHERAPY 62.00
91034 PR GERD TST W/ NASAL PH ELECTROD 471.00 91110 PR GI TRACT CAPSULE ENDOSCOPY 2316.00
92499 PR EYE SERVICE OR PROCEDURE 20.00
92502 PR EAR AND THROAT EXAMINATION 235.00
92504 PR EAR MICROSCOPY EXAMINATION 77.00
92504 PR EAR MICROSCOPY EXAMINATION 50M 115.00
92511 PR NASOPHARYNGOSCOPY 339.00
92537 PR CALORIC VESTIBULAR TEST W/REC BI BITHERMAL 304.00
92540 PR VESTIBULAR EVAL NYSTAG FOVL&PERPH STIM OSCIL TRACKING 187.00
92541 PR SPONTANEOUS NYSTAGMUS TEST 136.00
92542 PR POSITIONAL NYSTAGMUS TEST 68.00
92543 PR CALORIC VESTIBULAR TEST 182.00
92544 PR OPTOKINETIC NYSTAGMUS TEST 90.00
92545 PR OSCILLATING TRACKING TEST 181.00
92546 PR SINUSOIDAL ROTATIONAL TEST 284.00
92547 PR SUPPLEMENTAL ELECTRICAL TEST 14.00
92550 PR TYMPANOMETRY & REFLEX THRESH 71.00
92551 PR PURE TONE HEARING TEST, AIR 42.00
92552 PR PURE TONE AUDIOMETRY, AIR 60.00
92553 PR AUDIOMETRY, AIR & BONE 113.00
92555 PR SPEECH THRESHOLD AUDIOMETRY 51.00
92556 PR SPEECH AUDIOMETRY COMPLETE 67.00
92557 PR COMPREHENSIVE HEARING TEST 153.00
92558 PR EVOKED AUDITORY TEST QUAL 147.00 92562 PR LOUDNESS BALANCE TEST 98.00
92563 PR TONE DECAY HEARING TEST 92.00
92564 PR SISI HEARING TEST 92.00
92565 PR STENGER TEST PURE TONE 92.00
92567 PR TYMPANOMETRY 65.00
92568 PR ACOUSTIC REFL THRESHOLD TST 92.00
92570 PR ACOUSTIC IMMITANCE TESTING 147.00
92571 PR FILTERED SPEECH HEARING TEST 92.00
92575 PR SENSORINEURAL ACUITY TEST 92.00
92577 PR STENGER TEST SPEECH 41.00
92579 PR VISUAL AUDIOMETRY (VRA) 157.00
92582 PR CONDITIONING PLAY AUDIOMETRY 127.00
92583 PR SELECT PICTURE AUDIOMETRY 92.00
92587 PR DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD 136.00
92588 PR EVOKED AUDITORY TST COMPLETE 152.00
92590 PR HEARING AID EXAM ONE EAR 101.00
92591 PR HEARING AID EXAM BOTH EARS 235.00
92592 PR HEARING AID CHECK ONE EAR 63.00
92593 PR HEARING AID CHECK BOTH EARS 115.00
92594 PR ELECTRO HEARNG AID TEST ONE 63.00
92595 PR ELECTRO HEARNG AID TST BOTH 89.00
92625 PR TINNITUS ASSESSMENT 150.00
92700 PR OTORHINOLARYNG SERVICE/PROC UNLISTED 73.00 92950 PR HEART/LUNG RESUSCITATION (CPR) 614.00
92953 PR TEMPORARY EXTERNAL PACING 29.00
92960 PR CARDIOVERSION, ELECTIVE;EXTERN 514.00
92961 PR CARDIOVERSION, ELECTIVE;INTERN 557.00
92975 PR THROMBOLYSIS,CORONARY,IA INFUSN 1868.00
92977 PR THROMBOLYSIS,CORONARY,IV INFUSN 607.00
93000 PR ELECTROCARDIOGRAM, COMPLETE 96.00
93005 PR ELECTROCARDIOGRAM, TRACING 44.00
93010 PR ELECTROCARDIOGRAM REPORT 52.00
93012 TELEPH TRAN, POST-SYMPTOM ECG STRIPS 203.00
93016 PR PR CARDIAC STRESS TST,DR SUPERV ONLY 182.00
93018 PR CARDIAC STRESS TST,INTERP/REPT ONLY 182.00
93024 PR CARDIAC DRUG STRESS TEST 380.00
93040 PR RHYTHM ECG WITH REPORT 83.00
93042 PR RHYTHM ECG, REPORT 52.00
93227 PR EXT ECG RECORD CONTIN 48 HR, PHYS REVIEW&INTERP 301.00
93228 PR EXT MOBILE CV TELEMETRY, PHYS REVIEW/INTERP W/REPORT 60.00
93237 ECG MONITOR/24 HRS, COMPUTERIZED MONITOR, DR INTERP 57.00
93272 PR EXT ECG,PT DEMAND EVENT, SYMPT MEMORY LOOP, PHYS REVIEW&INTERP 65.00
93279 PR PROGRAM EVAL (IN PERSON) IMPLANT DEVICE,PACEMAKER,1 LEAD 177.00
93280 PR PROGRAM EVAL (IN PERSON) IMPLANT DEVICE,PACEMAKER,2 LEAD 196.00
93281 PR PROGRAM EVAL (IN PERSON) IMPLANT DEVICE,PACEMAKER,MULT LEAD 214.00
93282 PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB 216.00 93283 PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB 245.00
93284 PR PROGRAM EVAL (IN PERSON) IMPLANT DEVICE,CARDVERT/DEFIB,MULT LEAD 272.00
93285 PR PROGRAM EVAL (IN PERSON) IMPLANT DEVICE,IMPLANT LOOP RECORDER 107.00
93286 PR PERI-PROC PROG EVAL (IN PERSON) IMPLANT DEVICE,PACEMAKER 37.00
93287 PR PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB 52.00
93288 PR INTERROG EVAL, IN PERSON,PACEMAKER 159.00
93289 PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB 209.00
93290 PR INTERROG EVAL, IN PERSON,CV MONITOR 77.00
93291 PR INTERROG EVAL, IN PERSON,IMPLANT LOOP REC 65.00
93292 PR INTERROG EVAL, IN PERSON,WEARABLE DEFIB 165.00
93293 PR TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL 40.00
93294 PR INTERROG EVAL, REMOTE, UP TO 90 DAYS,PACEMAKER 83.00
93295 PR INTERROGATION EVAL REMOTE
93297 PR INTERROG EVAL, REMOTE, UP TO 30 DAYS,CV MONITOR 63.00
93299 PR ICM/ILR REMOTE TECH SERV 107.00
93303 PR ECHO XTHORACIC,CONG ANOM,COMPLETE 154.00
93306 PR ECHO HEART XTHORACIC, COMPLETE W DOPPLER 161.00
93307 PR ECHO HEART XTHORACIC, COMPLETE, W/O DOPPLER 115.00
93308 PR ECHO HEART XTHORACIC,LIMITED 134.00
93312 PR ECHO HEART, TRANESOPHAGEAL,COMPLETE 261.00
93317 PR ECHO TRANSESOPH,CONG ANOM,ACQ,INTERP 213.00
93320 PR DOPPLER ECHO HEART,COMPLETE 55.00
93321 PR DOPPLER ECHO HEART,LIMITED,F/U 68.00 93325 PR DOPPLER COLOR FLOW VELOCITY MAP 19.00
93350 PR ECHO HEART XTHORACIC, STRESS/REST 179.00
93351 PR ECHO HEART XTHORACIC, STRESS/REST, W CONTIN ECG 198.00
93352 PR ECHO CONTRAST AGENT DURING STRESS ECHO 103.00
93451 PR RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT 490.00
93452 PR LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/INTERP 579.00
93453 PR RIGHT & LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/INTERP 753.00
93454 PR CATH PLACE/CORONARY ANGIO, IMG SUPER/INTERP 584.00
93455 PR CATH PLACE/CORONARY ANGIO, IMG SUPER/INTERP, BYPASS ANGIO 675.00
93456 PR CATH PLACE/CORONARY ANGIO, IMG SUPER/INTERP,W RIGHT HEART CATH 1064.00
93457 PR CATH PLACE/CORON ANGIO, IMG SUPER/INTERP, BYPASS ANGIO,W R HEART CATH 831.00
93458 PR CATH PLACE/CORON ANGIO, IMG SUPER/INTERP,W LEFT HEART VENTRICULOGRAPHY 712.00
93459 PR CATH PLACE/CORON ANGIO, IMG SUPER/INTERP, BYPASS ANGIO,W L HRT VENTRIC 802.00
93460 PR CATH PLACE/CORON ANGIO, IMG SUPER/INTERP,R&L HRT CATH, L HRT VENTRIC 894.00
93461 PR CATH PLACE/COR ANG,IMG SUPR/INTRP,BYPASS ANG, R&L CATH, L HRT VENTRIC 1380.00
93463 PR MEDICATION ADMIN & HEMODYNAMIC MEASURMENT 244.00
93501 RIGHT HEART CATHETERIZATION 378.00
93503 PR INSERT/PLACE FLOW DIRECT CATH 316.00
93508 CORON CATH PLACEMNT,ANGIO,NO LH CATH 539.00
93510 LEFT HEART CATH,PERCUTANEOUS 523.00
93514 LEFT HEART CATH,LV PUNCTURE 882.00
93526 RT/LT HEART CATHETERS 755.00
93527 RT/INTACT TRANSSEPT LT HEART CATH 947.00 93539 INJECT W CARD CATH OF OTHR ARTER 53.00
93540 INJECT W CARD CATH COR BYPASS GRFT 56.00
93543 INJECT W CARD CATH LV/LA ANGIO 43.00
93544 INJECT W CARD CATH AORTOGRAPHY 38.00
93545 INJECT W CARD CATH SEL CORONARY 46.00
93555 IMAGING SUPERVSN W CARD CATH 103.00
93556 IMAGING SUPERVSN W CARD CATH+OTHR 103.00
93566 PR INJECT SELECT RIGHT VENT/ATRIAL ANGIO DURING HEART CATH 100.00
93567 PR INJECT SUPRAVALVULAR AORTOGRAPHY DURING HEART CATH 145.00
93568 PR INJECT PULMONARY ANGIOGRAPHY DURING HEART CATH 360.00
93580 PR PERC CLOS,CONG INTERATRIAL COMMUN W/IMPL 2260.00
93640 PR EVAL CARDIOVERT LEADS,INITIAL 451.00
93641 PR EVAL CARDIOVERT LEADS/PULS GEN 762.00
93642 PR EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS 627.00
93660 TILT TABLE EVALUATION 235.00
93724 PR ANALYZE PACER SYS 615.00
93750 PR INTERROGATE VENT ASSIST DEV, IN PERSON, W PHYSICIAN ANALYSIS 226.00
93799 PR CARDIOVASCULAR PROC UNLISTED 2090.00
93923 PR NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVELS 54.00
94010 PR BREATHING CAPACITY TEST 113.00
94060 PR EVAL OF BRONCHOSPASM 166.00
94070 PR EVAL OF BRONCHOSPASM,PROLONGED 213.00
94150 PR VITAL CAPACITY TEST 54.00 94375 PR RESPIRATORY FLOW VOLUME LOOP 193.00
94620 PR PULMONARY STRESS TESTING,SIMPLE 164.00
94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT 55.00
94664 PR DEMO &/OR EVAL,PT USE,AEROSOL DEVICE 34.00
94726 PR PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST 132.00
94727 PR GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL 104.00
94729 PR DIFFUSING CAPACITY 132.00
94760 PR NONINVASV OXYGEN SATUR;SINGLE 29.00
94761 PR NONINVASV OXYGEN SATUR,MULTIPLE 40.00
95115 PR IMMUNOTHERAPY, ONE INJECTION 38.00
95117 PR IMMUNOTHERAPY, 2+ INJECTIONS 41.00
95251 PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R 87.00
95810 PR POLYSOMNOGRAPHY, 4 OR MORE 288.00
95811 PR POLYSOMNOGRAPHY W/CPAP 299.00
95867 PR EMG,NEEDLE,CRANIAL NERVE SUPP MUS,UNILAT 195.00
95920 PR INTRAOPERATIVE NERVE TESTING ADD-ON 380.00
95992 PR CANALITH REPOSITIONING PROCEDURE, PER DAY 122.00
96110 PR DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM 33.00
96111 PR DEVELOPMENTAL TESTING W/INTERP & REPORT 245.00
96116 PR NEUROBEHAVIORAL STATUS EXAM BY PSYCH/PHYS 169.00
96118 PR NEUROPSYCH TESTING BY PSYCH/PHYS 244.00
96127 PR BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT 21.00
96360 PR IV INFUSION, HYDRATION, 31-60 MIN 291.00 96361 PR IV INFUSION, HYDRATION, EA ADD HOUR 65.00
96365 PR IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR 416.00
96365 PR IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR FAC 416.00
96366 PR IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,EA ADD HOUR 65.00
96367 PR IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR 131.00
96368 PR IV INFUSION, THERAP/PROPH/DIAGNOST,CONCURRENT INFUSION 57.00
96369 PR SUBCUT INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR 291.00
96370 PR SUBCUT INFUSION, THERAP/PROPH/DIAGNOST,EA ADD HOUR 65.00
96371 PR SUBCUT INFUSION, THERAP/PROPH/DIAGNOST,ADD PUMP SET 131.00
96372 PR INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT 40.00
96373 PR INJECTION,THERAP/PROPH/DIAGNOST, INTRA-ARTERIAL 137.00
96374 PR INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, INITIAL DRUG 137.00
96375 PR INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG 131.00
96376 PR INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, SAME DRUG 57.00
96377 PR APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION 40.00
96401 PR CHEMOTHER,NON-HORMONE ANTI-NEOPL, SUB-Q/IM 131.00
96402 PR CHEMOTHER HORMON ANTINEOPL SUB-Q/IM 131.00
96405 PR INTRALESIONAL CHEMO ADMIN,<8 LESN 131.00
96406 PR INTRALESIONAL CHEMO ADMIN,8+ LESN 131.00
96409 PR CHEMOTHER, IV PUSH, SNGL DRUG 264.00
96411 PR CHEMOTHER, IV PUSH,EA ADD DRUG 264.00
96413 PR CHEMOTHER, IV INFUSION, 1 HR 378.00
96415 PR CHEMOTHER, IV INFUSION, EA HR 131.00 96416 PR CHEMOTHER PROLONG INFUSE W/PUMP 378.00
96417 PR CHEMOTHER, IV INFUSE, EACH SEQU INFUS 131.00
96420 PR CHEMO IA PUSH TECNIQUE 264.00
96422 PR CHEMO IA INFUSION UP TO 1 HR 378.00
96423 PR CHEMO IA INFUSE EACH ADDL HR 131.00
96425 PR CHEMOTHERAPY INFUSION METHOD 378.00
96450 PR CHEMOTHER,CNS,W/LUMBAR PUNCTURE 378.00
96521 PR REFILL/MAINT, PORTABLE PUMP 291.00
96522 PR REFILL/MAINT SYSTEMIC PUMP/RESVR 291.00
96523 PR IRRIG IMPLANTED DRUG DELIVERY DEVICE 92.00
96920 PR LASER TX,PSORIASIS,AREA <250SQCM 431.00
97597 PR DEBRIDEMENT OPEN WOUND 20 SQ CM< 167.00
97598 PR DEBRIDEMENT OPEN WOUND EA ADDL 20 SQ CM 62.00
97605 PR NEGATIVE PRESSURE WOUND THERAPY DME
97606 PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM 107.00
97802 PR MED NUTR THER, 1ST, INDIV, EA 15 MIN 45.00
97803 PR MED NUTR THER, SUBSQ, INDIV, EA 15 MIN 45.00
97804 PR MED NUTR THER, GROUP, EA 30 MIN 31.00
98925 PR OSTEOPATHIC MANIP,1-2 BODY REGN 97.00
99000 PR SPECIMEN HANDLING,DR OFF->LAB 23.00
99051 PR MED SERV EVE/WKEND/HOLIDAY 62.00
99081 PR WORK COMP PROGRESS REPORT 20.00
99143 PR MOD CONS SED BY SAME PHYS, < 5 YRS, 1ST 30 MIN 68.00 99145 PR MOD CONS SED BY SAME PHYS, EA ADD 15 MIN 79.00
99151 PR MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS 57.00
99152 PR MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS 30.00
99153 PR MOD SED SAME PHYS/QHP EACH ADDL 15 MINS 29.00
99173 PR VISUAL SCREENING TEST, BILAT 20.00
99183 PR HYPERBARIC OXYGEN THERAPY 392.00
99190 PR SPECIAL PUMP SERVICES 831.00
99195 PR PHLEBOTOMY 92.00
99201 PR OFFICE/OUTPT VISIT,NEW,LEVL I 101.00
99202 PR OFFICE/OUTPT VISIT,NEW,LEVL II 151.00
99203 PR OFFICE/OUTPT VISIT,NEW,LEVL III 215.00
99204 PR OFFICE/OUTPT VISIT,NEW,LEVL IV 314.00
99205 PR OFFICE/OUTPT VISIT,NEW,LEVL V 415.00
99211 PR OFFICE/OUTPT VISIT,EST,LEVL I 72.00
99212 PR OFFICE/OUTPT VISIT,EST,LEVL II 124.00
99213 PR OFFICE/OUTPT VISIT,EST,LEVL III 152.00
99214 PR OFFICE/OUTPT VISIT,EST,LEVL IV 212.00
99215 PR OFFICE/OUTPT VISIT,EST,LEVL V 293.00
99217 PR OBSERVATION CARE DISCHARGE MANAGEMENT 137.00
99218 PR INITIAL OBSERVATION CARE/DAY 30 MINUTES 169.00
99219 PR INITIAL OBSERVATION CARE/DAY 50 MINUTES 227.00
99220 PR INITIAL OBSERVATION CARE/DAY 70 MINUTES 287.00
99221 PR INITIAL HOSPITAL CARE,LEVL I 168.00 99222 PR INITIAL HOSPITAL CARE,LEVL II 271.00
99223 PR INITIAL HOSPITAL CARE,LEVL III 518.00
99224 PR SUBSEQUENT OBSERVATION CARE,LEVEL I 66.00
99225 PR SUBSEQUENT OBSERVATION CARE,LEVEL II 118.00
99226 PR SUBSEQUENT OBSERVATION CARE,LEVEL III 173.00
99231 PR SUBSEQUENT HOSPITAL CARE,LEVL I 87.00
99232 PR SUBSEQUENT HOSPITAL CARE,LEVL II 134.00
99233 PR SUBSEQUENT HOSPITAL CARE,LEVL III 189.00
99234 PR OBSERV/HOSP SAME DATE,LEVL III 213.00
99235 PR OBSERV/HOSP SAME DATE,LEVL IV 403.00
99236 PR OBSERV/HOSP SAME DATE,LEVL V 518.00
99238 PR HOSPITAL DISCHARGE DAY,<30 MIN 160.00
99239 PR HOSPITAL DISCHARGE DAY,>30 MIN 214.00
99241 PR OFFICE CONSULTATION,LEVEL I 119.00
99242 PR OFFICE CONSULTATION,LEVEL II 211.00
99243 PR OFFICE CONSULTATION,LEVEL III 276.00
99244 PR OFFICE CONSULTATION,LEVEL IV 390.00
99245 PR OFFICE CONSULTATION,LEVEL V 512.00
99251 PR INPATIENT CONSULT,LEVL I 95.00
99252 PR INPATIENT CONSULT,LEVL II 170.00
99253 PR INPATIENT CONSULT,LEVL III 228.00
99254 PR INPATIENT CONSULT,LEVL IV 325.00
99255 PR INPATIENT CONSULT,LEVL V 448.00 99281 PR EMERGENCY DEPT VISIT,LEVEL I 44.00
99282 PR EMERGENCY DEPT VISIT,LEVEL II 69.00
99283 PR EMERGENCY DEPT VISIT,LEVEL III 148.00
99284 PR EMERGENCY DEPT VISIT,LEVEL IV 232.00
99285 PR EMERGENCY DEPT VISIT,LEVEL V 361.00
99291 PR CRITICAL CARE, E/M 30-74 MINUTES 529.00
99292 PR CRITICAL CARE, ADDL 30 MIN 266.00
99304 PR NURSING FACILITY CARE, INIT, LOW SEVERITY 149.00
99305 PR NURSING FACILITY CARE, INIT, MOD SEVERITY 198.00
99306 PR NURSING FACILITY CARE, INIT, HIGH SEVERITY 255.00
99307 PR NURSING FAC CARE, SUBSEQ, IMPROVING 79.00
99308 PR NURSING FAC CARE, SUBSEQ, MINOR COMPLIC 124.00
99309 PR NURSING FAC CARE, SUBSEQ, SIGNIF COMPLIC 172.00
99310 PR NURSING FAC CARE, SUBSEQ, UNSTABLE PT 219.00
99315 PR NURSING FAC DISCHRGE DAY,1-30 MIN 149.00
99316 PR NURSING FAC DISCHRGE DAY,MORE 30 MIN 187.00
99318 PR ANNUAL NURSING FAC ASSESSMNT, STABLE 150.00
99324 PR DOMICIL/R-HOME VISIT NEW PAT 120.00
99325 PR DOMICIL/R-HOME VISIT NEW PAT 169.00
99326 PR DOMICIL/R-HOME VISIT NEW PAT 222.00
99334 PR DOMICIL/REST-HOME VISIT EST PAT, MINOR 96.00
99335 PR DOMICIL/REST-HOME VISIT EST PAT, LOW-MOD SEVER 156.00
99336 PR DOMICIL/REST-HOME VISIT EST PAT, MOD-HIGH SEVER 239.00 99337 PR DOMICIL/REST-HOME VISIT EST PAT, HIGH SEVERITY 352.00
99341 PR HOME VISIT,NEW PATIENT,LEVEL I 124.00
99342 PR HOME VISIT,NEW PATIENT,LEVEL II 156.00
99343 PR HOME VISIT,NEW PATIENT,LEVEL III 202.00
99344 PR HOME VISIT,NEW PATIENT,LEVEL IV 286.00
99345 PR HOME VISIT,NEW PATIENT,LEVEL V 385.00
99347 PR HOME VISIT,ESTAB PATIENT,LEVEL I 97.00
99348 PR HOME VISIT,ESTAB PATIENT,LEVEL II 124.00
99349 PR HOME VISIT,ESTAB PATIENT,LEVEL III 180.00
99350 PR HOME VISIT,ESTAB PATIENT,LEVEL IV 286.00
99354 PR PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON 1ST HR 218.00
99355 PR PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON ADDL 30 232.00
99356 PR PROLONGED SERVICE I/P REQ UNIT/FLOOR TIME 1ST HR 407.00
99357 PR PROLONGED SVC I/P REQ UNIT/FLOOR TIME EA 30 MIN 203.00
99358 PR PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR 209.00
99359 PR PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MIN 110.00
99360 PR PHYSICIAN STANDBY SERV,EA 30 MIN 203.00
99363 PR ANTICOAGULANT MGMT INITIAL 274.00
99364 PR ANTICOAGULANT MGMT SUBSEQ 97.00
99374 PR HOME HEALTH CARE SUPERV,15-29 MIN 158.00
99375 PR HOME HEALTH CARE SUPERV,30+ MIN 292.00
99377 PR HOSPICE CARE SUPERVISION 161.00
99378 PR HOSPICE CARE SUPERVISION,30+ MIN 330.00 99379 PR NURSING FAC CARE SUPERVISION 161.00
99380 PR NURSING FAC CARE SUPERVISION 292.00
99381 PR PREVENTIVE VISIT,NEW, AGE < 1 YR 189.00
99382 PR PREVENTIVE VISIT,NEW,AGE 01-04 198.00
99383 PR PREVENTIVE VISIT,NEW,AGE 05-11 204.00
99384 PR PREVENTIVE VISIT,NEW,AGE 12-17 215.00
99385 PR PREVENTIVE VISIT,NEW,AGE 18-39 215.00
99386 PR PREVENTIVE VISIT,NEW,AGE 40-64 245.00
99387 PR PREVENTIVE VISIT,NEW,AGE 65 & OVER 281.00
99391 PR PREVENTIVE VISIT,EST, AGE < 1 YR 157.00
99392 PR PREVENTIVE VISIT,EST,AGE 01-04 173.00
99393 PR PREVENTIVE VISIT,EST,AGE 05-11 178.00
99394 PR PREVENTIVE VISIT,EST,AGE 12-17 198.00
99395 PR PREVENTIVE VISIT,EST,AGE 18-39 183.00
99396 PR PREVENTIVE VISIT,EST,AGE 40-64 202.00
99397 PR PREVENTIVE VISIT,EST,AGE 65 & OVER 215.00
99401 PR PREVENT COUNSEL,INDIV,15 MIN 23.00
99402 PR PREVENT COUNSEL,INDIV,30 MIN 41.00
99403 PR PREVENT COUNSEL,INDIV,45 MIN 55.00
99406 PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES 45.00
99407 PR TOBACCO USE CESSATION INTENSIVE >10 MINUTES 72.00
99450 PR BASIC LIFE DISABILITY EXAM 123.00
99460 PR INITIAL NORMAL NEWBORN CARE, HOSPITAL OR BIRTH CENTER 245.00 99461 PR INIT NB EM PER DAY NON-FAC 310.00
99462 PR SUBSEQUENT HOSPITAL CARE, NORMAL NEWBORN 115.00
99463 PR INITIAL NORMAL NEWBORN CARE, SAME DAY DISCHARGE 245.00
99464 PR ATTENDANCE AT DELIVERY W INITIAL STABILIZATION 188.00
99465 PR DELIVERY/BIRTHING ROOM RESUSCITATION 324.00
99466 PR CRITICAL CARE INTERFACILITY TRANSPORT, <=24 MO, 30-74 MIN 593.00
99468 PR INITIAL HOSP NEONATE 28 DAY OR LESS, CRITICALLY ILL 1814.00
99469 PR SUBSEQUENT HOSP NEONATE 28 DAY OR LESS, CRITICALLY ILL 791.00
99471 PR INITIAL PED CRITICAL CARE 29 DAY THRU 24 MO 1756.00
99475 PR INITIAL PED CRITICAL CARE 2 YR THRU 5 YR 1265.00
99477 PR INITIAL HOSP NEONATE 28 DAY OR LESS, NOT CRITICALLY ILL 692.00
99479 PR SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS 287.00
99480 PR SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS 265.00
99495 PR TRANSITIONAL CARE MANAGE SERVICE 14 DAY DISCHRGE 399.00
99496 PR TRANSITIONAL CARE MANAGE SERVICE 7 DAY DISCHARGE 560.00
99497 PR ADVANCE CARE PLANNING FIRST 30 MINS 189.00
99498 PR ADVANCE CARE PLANNING EA ADDL 30 MINS 179.00
0232T INJECT PLATELET RICH PLASMA W/IMG HARVEST/PREPARATOIN 800.00
0358T PR BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R 25.00
A4550 SURGICAL TRAYS 89.00
A4561 PESSARY RUBBER, ANY TYPE 202.00
A4565 SLINGS 19.00
A4570 SPLINT 51.00 A4590 SPECIAL CASTING MATERIAL 216.00
C1878 MATRL FOR VOCAL CORD 679.00
C9272 INJ, DENOSUMAB 64.00
C9276 CABAZITAXEL INJECTION 416.00
C9295 PR INJECTION, CARFILZOMIB 68.00
D7210 REM IMP TOOTH W MUCOPER FLP 523.00
G0008 ADMIN INFLUENZA VIRUS VAC 37.00
G0009 ADMIN PNEUMOCOCCAL VACCINE 37.00
G0101 CA SCREEN;PELVIC/BREAST EXAM 110.00
G0102 PROSTATE CA SCREENING; DRE 34.00
G0105 COLORECTAL SCRN; HI RISK IND 1060.00
G0108 DIAB MANAGE TRN PER INDIV 90.00
G0109 DIAB MANAGE TRN IND/GROUP 51.00
G0121 COLON CA SCRN NOT HI RSK IND 1060.00
G0127 TRIM NAIL(S) 60.00
G0179 MD RECERTIFICATION HHA PT 92.00
G0180 MD CERTIFICATION HHA PATIENT 148.00
G0181 HOME HEALTH CARE SUPERVISION 292.00
G0182 HOSPICE CARE SUPERVISION 330.00
G0248 PR DEMONSTRATE USE HOME INR MON 424.00
G0250 PR MD INR TEST REVIE INTER MGMT 40.00
G0278 ILIAC ART ANGIO,CARDIAC CATH 33.00
G0289 ARTHRO, LOOSE BODY + CHONDRO 203.00 G0296 PR COUNSEL VST FOR LUNG CNCR SCREEN USING LOW DOSE CT 143.00
G0328 PR COLOREC CA SCR; FOB TST IMMUNO 1-3 53.00
G0364 PR BONE MARROW ASPIRATE &BIOPSY 207.00
G0372 MD SERVICE REQUIRED FOR PMD 39.00
G0402 INITIAL PREVENTIVE EXAM 266.00
G0403 EKG FOR INITIAL PREVENT EXAM 96.00
G0405 PR EKG INTERPRET & REPORT PREVE 52.00
G0438 ANNUAL WELLNESS VISIT; INCL PPPS, INITIAL VISIT 384.00
G0439 ANNUAL WELLNESS VISIT; INCL PPPS, SUBSEQ VISIT 269.00
G0443 BRIEF ALCOHOL MISUSE COUNSEL 63.00
G0463 PR HOSPITAL OUTPT CLINIC VISIT XM1 72.00
G0463 PR HOSPITAL OUTPT CLINIC VISIT XM2 96.00
G0463 PR HOSPITAL OUTPT CLINIC VISIT XM3 126.00
G0463 PR HOSPITAL OUTPT CLINIC VISIT XM4 126.00
G0463 PR HOSPITAL OUTPT CLINIC VISIT XM5 173.00
G0463 PR HOSPITAL OUTPT CLINIC VISIT XM6 234.00
G0498 PR CHEMO EXTEND IV INFUS W/PUMP FAC 378.00
G0513 PR PROLONG PREV SVCS, FIRST 30M 156.00
G6021 PR UNLISTED PX SMALL INTESTINE 799.00
G6024 PR LESION REMOVAL COLONOSCOPY 1355.00
J7300 INTRAUT COPPER CONTRACEPTIVE 1700.00
LPGEM PR LPGEM LIPOGEMS 3750
P9612 CATHETERIZE FOR URINE SPEC 11.00 Q0091 OBTAINING SCREEN PAP SMEAR 88.00
Q0111 WET MOUNTS/ W PREPARATIONS 34.00
Q2026 RADIESSE INJECTION 679.00
Q2027 SCULPTRA INJECTION 759.00
Q2035 AFLURIA VACC, 3 YRS & >, IM 22.00
Q2036 FLULAVAL VACC, 3 YRS & >, IM 22.00
Q2037 FLUVIRIN VACC, 3 YRS & >, IM 22.00
Q2038 FLUZONE VACC, 3 YRS & >, IM 22.00
Q2039 PR INFLUENZA VIRUS VACCINE, NOS 18.00
Q2050 PR DOXORUBICIN INJ 10MG 2869.00
Q2051 PR INJECTION, ZOLEDRONIC ACID, NOT OTHERWISE SPECIFIED, 1MG 925.00
Q4006 CAST SUP LONG ARM ADULT FBRG 85.00
Q4008 CAST SUP LONG ARM PED FBRGLS 30.00
Q4010 CAST SUP SHT ARM ADULT FBRGL 58.00
Q4012 CAST SUP SHT ARM PED FBRGLAS 30.00
Q4014 CAST SUP GAUNTLET FIBERGLASS 78.00
Q4016 CAST SUP GAUNTLET PED FBRGLS 27.00
Q4016 CAST SUP GAUNTLET PED FBRGLS PRO 27.00
Q4018 CAST SUP LNG ARM SPLINT FBRG 42.00
Q4020 CAST SUP LNG ARM SPLNT PED F 21.00
Q4022 CAST SUP SHT ARM SPLINT FBRG 37.00
Q4024 CAST SUP SHT ARM SPLNT PED F 19.00
Q4030 CAST SUP LONG LEG FIBERGLASS 131.00 Q4032 CAST SUP LNG LEG PED FBRGLS 110.00
Q4038 CAST SUP SHRT LEG FIBERGLASS 119.00
Q4040 CAST SUP SHRT LEG PED FBRGLS 61.00
Q4042 CAST SUP LNG LEG SPLNT FBRGL 66.00
Q4046 CAST SUP SHT LEG SPLNT FBRGL 48.00
S0020 INJECTION, BUPIVICAINE HYDRO 29.00
S0023 INJECTION, CIMETIDINE HYDROC 86.00
S9445 PR SOFP,FAM PLAN, IND, 10MIN 18.00
S9446 PT EDUCATION NOC GROUP 18.00
V5010 ASSESSMENT FOR HEARING AID 262.00
V5011 HEARING AID FITTING/CHECKING 471.00
V5020 CONFORMITY EVALUATION 262.00
V5275 EAR IMPRESSION 53.00
V5281 PR ALD FM/DM SYSTEM, MONAURAL 1936.00