DESCRIPTION CHARGE AMOUNT ACROMIOPLASTY $ 7,343.00 ADENOIDECTOMY, PRIMARY $ 3,007.00 ADENOIDECTOMY, PRIMARY $ 3,266.00 ADENOIDECTOMY, SECONDA $ 1,928.00 ADJACENT TISSUE TRANSF $ 3,229.00 ADJACENT TISSUE TRANSF $ 4,037.00 ADJACENT TISSUE TRANSF $ 4,844.00 ADJACENT TISSUE TRANSF $ 4,844.00 ALLOGRAFT FOR SPINE SU $ 1,417.00 AMPUTATION FINGER OR T $ 5,057.00 AMPUTATION OF FINGER $ 4,336.00 AMPUTATION TOE METATAR $ 2,925.00 AMPUTATION, TOE; INTER $ 2,925.00 ANKLE ARTHROT EXPL/DRA $ 3,413.00 ANTERIOR INSTRUMENTAIO $ 5,451.00 ANTERIOR INSTRUMENTATI $ 9,811.00 ANTICERVICAL DISSECTOM $ 30,520.00 APPLICATION FO SKIN SU $ 3,934.00 APPLICATION FO SKIN SU $ 1,967.00 APPLICATION FO SKIN SU $ 3,934.00 APPLICATION FO SKIN SU $ 3,934.00 APPLICATION FO SKIN SU $ 1,967.00 APPLICATION FO SKIN SU $ 3,934.00 APPLICATION OF UNIPLAN $ 5,296.00 ARM TENDON LENGTHENING $ 4,895.00 ARTH REPAIR OCD LESION $ 7,440.00 ARTH TX OF INTERCONDYL $ 8,928.00 ARTHOTOMY METACARPOPHA $ 4,336.00 ARTHROCENTESIS ASPIRAT $ 796.00 ARTHROCNTS ASPIR&/NJX $ 252.00 ARTHROCNTS ASPIR&/NJX $ 269.00 ARTHROCNTS ASPIR&/NJX $ 269.00 ARTHRODESIS ANT INTERB $ 18,528.00 ARTHRODESIS CERV BELOW $ 18,528.00 ARTHRODESIS POSTERIOR $ 30,520.00 ARTHRODESIS POSTERIOR $ 15,761.00 ARTHRODESIS POSTERIOR $ 30,520.00 ARTHRODESIS TARSALS/ME $ 4,388.00 ARTHRODESIS, ANKLE, AN $ 5,337.00 ARTHRODESIS, ELBOW JOI $ 3,715.00 ARTHRODESIS; SUBTALAR $ 4,388.00 ARTHRODESISGREAT TOEME $ 4,388.00 ARTHRODESISINTERPHALAN $ 6,502.00 ARTHRODESISPOSTERIOR I $ 15,761.00 ARTHRODESISTARSAL/META $ 4,388.00 ARTHRODESISWRIST JOINT $ 8,671.00 ARTHROPLASTY, ANKLE; $ 5,363.00 ARTHROPLASTYMETACARPOP $ 8,671.00 ARTHROSCOP BICEPS TENO $ 8,928.00 ARTHROSCOP ROTATOR CUF $ 8,928.00 ARTHROSCOPIC ASSISTED $ 8,928.00 ARTHROSCOPIC DEBRIDEME $ 7,440.00 ARTHROSCOPIC MENISECTO $ 8,183.00 ARTHROSCOPICALLY AIDED $ 8,928.00 ARTHROSCOPY ABRASION A $ 8,183.00 ARTHROSCOPY ANKLE EXC $ 6,695.00 ARTHROSCOPY ANKLE W/ P $ 6,695.00 ARTHROSCOPY ANKLEDEBRI $ 7,440.00 ARTHROSCOPY ELBOW DEBR $ 8,183.00 ARTHROSCOPY HIP SURGIC $ 8,928.00 ARTHROSCOPY KNEE MED O $ 8,183.00 ARTHROSCOPY KNEES WITH $ 8,183.00 ARTHROSCOPY OF SHOULDE $ 8,928.00 ARTHROSCOPY SHOULDER $ 8,928.00 ARTHROSCOPY SHOULDER L $ 8,928.00 ARTHROSCOPY SHOULDER M $ 8,928.00 ARTHROSCOPY SHOULDER S $ 8,928.00 ARTHROSCOPY SHOULDER W $ 8,928.00 ARTHROSCOPY SHOULDER W $ 8,928.00 ARTHROSCOPY WRIST $ 8,183.00 ARTHROSCOPY WRIST SYNO $ 7,440.00 ARTHROSCOPY, HIP, SURG $ 8,928.00 ARTHROSCOPY, WRIST, SU $ 7,440.00 ARTHROSCOPYKNEE WITH R $ 9,066.00 ARTHROSCOPYKNEESYNOVEC $ 8,183.00 ARTHROTOMY ANKLE SYNOV $ 3,900.00 ARTHROTOMY ELBOWWITH R $ 4,895.00 ARTHROTOMY INTERPHALAN $ 4,336.00 ARTHROTOMY MTP JOINT $ 3,413.00 ARTHROTOMY, WITH SYNOV $ 3,900.00 ARTHROTOMY, WRIST JOIN $ 7,224.00 ASPIR&/NJX GANGLION CS $ 191.00 AXILLARY LYMPHADENECTO $ 4,136.00 AXILLARY LYMPHADENECTO $ 6,826.00 BIOPSY BONE EXCISIONAL $ 2,270.00 BIOPSY BONE OPEN DEEP $ 4,538.00 BIOPSY FINGER JOINT LI $ 3,613.00 BIOPSY FOREARM SOFT TI $ 483.00 BIOPSY HAND JOINT LINI $ 4,336.00 BIOPSY MASS UPPER ARM/ $ 3,671.00 BIOPSY NASOPHARYNX VIS $ 1,098.00 BIOPSY OF BREAST; INCI $ 1,922.00 BIOPSY OF SALIVARY GLA $ 1,748.00 BIOPSY OF SKIN $ 308.00 BIOPSY OF TONGUE; ANTE $ 285.00 BIOPSY OR EXCISION OF $ 4,096.00 BIOPSY, BONE, TROCAR, $ 3,277.00 BIOPSY, INTRANASAL $ 501.00 BIOPSY, MUSCLE; SUPERF $ 695.00 BIOPSY; NASOPHARYNX, S $ 1,716.00 BLEPHAROPLASTY EXTENSI $ 4,070.00 BLEPHAROPLASTY UPPER E $ 4,887.00 BLOOD PATCH $ 1,721.00 BONE BIOPSY TROCAR/NEE $ 1,639.00 BONE GRAFT MAJOR OR LA $ 2,397.00 BONE GRAFTANY DONOR AR $ 1,198.00 BREAST RECONSTRUCTION $ 9,179.00 BUNIONECTOMY $ 3,900.00 BUNIONECTOMY KELLERMCB $ 3,900.00 BX DEEP FOREARM/WRIST $ 4,336.00 BX SKN SUBQ/MUC MEMB E $ 227.00 CANTHOPLASTY (RECONSTR $ 4,070.00 CAPSULECTOMY $ 5,779.00 CAPSULORRHAPHY ANT W/ $ 6,118.00 CAPSULORRHAPHY OR RECO $ 5,779.00 CAPSULOTOMY WRIST JOIN $ 6,502.00 CARPAL TUNNEL SURGERY $ 5,161.00 CARPECTOMY; ALL BONES $ 7,224.00 CARTILAGE GRAFT; COSTO $ 1,765.00 CATARACT REMOVAL INSER $ 7,654.00 CAUTERY AND/OR ABLATIO $ 670.00 CERV LYMPHADENECTOMY M $ 6,144.00 CLAVICULECTOMY; PARTIA $ 6,730.00 CLOSED REDUCTION OF FR $ 335.00 CLOSED TREATMENT NASAL $ 2,215.00 CLOSED TREATMENT OF DI $ 2,891.00 CLOSED TREATMENT OF DI $ 4,336.00 CLOSED TREATMENT OF ME $ 1,445.00 CLOSED TREATMENT OF NA $ 2,952.00 CLOSED TREATMENT OF UL $ 2,447.00 CLOSED TREATMENT OF UL $ 1,445.00 CLOSED TX OF ULNAR SHA $ 2,891.00 CLOSURE OF ENTEROSTOMY $ 10,356.00 COLECTOMY, PARTIAL; WI $ 8,076.00 COLONOSCOPY $ 3,673.00 COLONOSCOPY AND BIOPSY $ 3,317.00 COLONOSCOPY FLEX PROXI $ 3,317.00 COLONOSCOPY HIGH RISK $ 3,317.00 COLONOSCOPY WITH BAND $ 3,673.00 COLONSCOPY NOT HIGH RI $ 3,317.00 COLONSCOPY WITH REMOVA $ 3,317.00 COMPLEX REPAIR OF WOUN $ 2,422.00 CONIZATION OF CERVIX W $ 2,585.00 CONTIN INTRAOPRATIVE N $ 312.00 CONTROL HEMORRHAGE POS $ 392.00 CONTROL NASAL HEMORHAG $ 409.00 CONTROL OF EPISTAXIS C $ 604.00 CORRECTION CLAW FINGER $ 6,502.00 CURETTAGE, POSTPARTUM $ 2,069.00 DBRDMT MSTDC CAVITY CP $ 2,130.00 DEBRIDE SKIN FX $ 3,888.00 DEBRIDE SKIN/MUSCLE/BO $ 5,834.00 DEBRIDE SKIN/TISSUE $ 2,918.00 DEBRIDE TISSUE/MUSCLE $ 3,888.00 DEBRIDE TISSUE/MUSCLE $ 3,888.00 DEBRIDE TISSUE/MUSCLE $ 3,888.00 DEBRIDEMENTSKINSUBCUTA $ 4,861.00 DECOMPRESSION OF TIBIA $ 3,900.00 DECOMPRESSIVE FASCIOTO $ 2,725.00 DELAYED INSERTION OF B $ 4,615.00 DESTROY NERVE FACE MUS $ 1,218.00 DESTROY VAG LESIONS SI $ 647.00 DESTROY VULVA LESION/S $ 3,104.00 DESTRUCT BENIGN LESION $ 640.00 DESTRUCT LESION 15 OR $ 621.00 DESTRUCTION BY NEUROLY $ 2,750.00 DESTRUCTION BY NEUROLY $ 2,750.00 DESTRUCTION BY NEUROLY $ 2,750.00 DESTRUCTION BY NEUROLY $ 2,750.00 DESTRUCTION LESION(S) $ 6,255.00 DESTRUCTION OF CUTANEO $ 785.00 DIAG HYSTEROSCOPY $ 4,775.00 DIAGNOSTIC LAPAROSCOPY $ 2,984.00 DILATION OF ESOPHAGUS $ 392.00 DISCISSION OF SECONDAR $ 3,063.00 DIVISION AND INSETTING $ 6,460.00 DOUBLE OSTEOTOMY $ 3,900.00 DRAIN ARM/ELBOW BONE L $ 4,283.00 DRAIN FINGER ABSCESS C $ 2,891.00 DRAIN HAND TENDON SHEA $ 4,336.00 DRAIN NECK/CHEST LESIO $ 2,952.00 DRAIN SHOULDER LESION $ 3,671.00 DRAIN THIGH/KNEE LESIO $ 3,972.00 DRAINAGE OF ARM LESION $ 2,549.00 DRAINAGE OF FINGER ABS $ 317.00 DRAINAGE OF FOREARM LE $ 4,336.00 DRAINAGE OF HIP JOINT $ 4,538.00 DRAINAGE OF PELVIS LES $ 2,364.00 DRG XTRNL EAR ABSC/HMT $ 302.00 DRILLING FOR INTACT OS $ 8,183.00 DURAL GRAFT, SPINAL969 $ 1,722.00 EACH ADITIONAL INTERSP $ 15,761.00 EAR CARTILAGE GRAFT $ 7,379.00 ELBOW ARTHROSCOPY/SURG $ 8,183.00 ENCL/EXC XTRNL THROMBO $ 294.00 ENDOSCOPIC PLANTAR FAS $ 5,208.00 ENDOSCOPY WITH BALLOON $ 1,716.00 EPIDURAL INJECT CERVIC $ 1,218.00 ESOPHAGOSCOPY, RIGID O $ 1,501.00 ESOPHAGOSCOPY, RIGID T $ 1,501.00 EVAC SUBUNGUAL HEMATOM $ 552.00 EX LESION OF TONGUE PO $ 2,143.00 EXC AURAL POLYP $ 531.00 EXC CYST/ADEN THYRD/TR $ 2,979.00 EXC FACE-MM B9+MARG 0. $ 552.00 EXC FACE-MM B9+MARG 3. $ 2,202.00 EXC FACE-MM MALIG+MARG $ 1,102.00 EXC FACE-MM MALIG+MARG $ 1,423.00 EXC FACE-MM MALIG+MARG $ 1,790.00 EXC FACE-MM MALIG+MARG $ 2,202.00 EXC FACE-MM MALIG+MARG $ 3,303.00 EXC FACE-MM MLG+MARG > $ 4,404.00 EXC H-F-NK-SP B9+MARG $ 1,572.00 EXC H-F-NK-SP B9+MARG $ 1,709.00 EXC H-F-NK-SP B9+MARG $ 2,202.00 EXC H-F-NK-SP B9+MARG $ 3,303.00 EXC H-F-NK-SP MLG+MAR $ 4,404.00 EXC H-F-NK-SP MLG+MARG $ 1,009.00 EXC H-F-NK-SP MLG+MARG $ 1,194.00 EXC H-F-NK-SP MLG+MARG $ 1,423.00 EXC H-F-NK-SP MLG+MARG $ 2,202.00 EXC H-F-NK-SP MLG+MARG $ 3,303.00 EXC LATERAL LINE PAROT $ 6,038.00 EXC NEUROFIBROMA CUTAN $ 6,021.00 EXC OF TENDONFOREARM/W $ 6,502.00 EXC PAROTID GLAND/TUMO $ 5,143.00 EXC RECTAL TUMOR $ 2,814.00 EXC SKIN ABD $ 6,515.00 EXC SKIN ABD ADD-ON $ 1,418.00 EXC TR-EXT B9+MARG 0.5 $ 1,104.00 EXC TR-EXT B9+MARG 0.6 $ 552.00 EXC TR-EXT MLG+MARG > $ 5,059.00 EXC TR-EXT MLG+MARG 0. $ 780.00 EXC TR-EXT MLG+MARG 1. $ 1,032.00 EXC TR-EXT MLG+MARG 2. $ 2,202.00 EXC TR-EXT MLG+MARG 3. $ 3,303.00 EXC TUMOR PELVIS/HIP A $ 3,687.00 EXC TUMOR PELVIS/HIP A $ 3,687.00 EXC/DEST OF LESION OF $ 1,716.00 EXC/TRANSPOSITION PTER $ 3,829.00 EXCISE EXCESSIVE SKIN $ 4,887.00 EXCISION B9 LESION 11- $ 1,870.00 EXCISION BENIGN LESION $ 2,202.00 EXCISION BRANCHIAL CLE $ 4,287.00 EXCISION DISTAL ULNA P $ 6,502.00 EXCISION LESION EYELID $ 414.00 EXCISION LESION OF PAL $ 2,143.00 EXCISION NEUROM MAJOR $ 6,021.00 EXCISION NEUROMA HAND $ 6,021.00 EXCISION OF BENIGN LES $ 1,583.00 EXCISION OF BENIGN LES $ 941.00 EXCISION OF BONE DISTA $ 6,502.00 EXCISION OF CHALAZION; $ 254.00 EXCISION OF DEEP AXILL $ 4,779.00 EXCISION OF GANGLION W $ 5,779.00 EXCISION OF LESION BEN $ 3,303.00 EXCISION OF LESION EAR $ 988.00 EXCISION OF LESION OF $ 2,925.00 EXCISION OF LESION OF $ 949.00 EXCISION OF LESION OF $ 1,716.00 EXCISION OF LESION OF $ 3,001.00 EXCISION OF LESION OF $ 1,716.00 EXCISION OF LESIONCONJ $ 403.00 EXCISION OF LINGUAL FR $ 501.00 EXCISION OF NEUROFIBRO $ 8,603.00 EXCISION OF NEUROMA DI $ 6,021.00 EXCISION OF OR CURETTA $ 3,413.00 EXCISION OF OTHER BENI $ 2,202.00 EXCISION OF PILONIDAL $ 4,404.00 EXCISION OF PILONIDAL $ 5,506.00 EXCISION OF RECURRENT $ 7,224.00 EXCISION OF SKIN AND S $ 5,506.00 EXCISION OF SUBMAXILLA $ 3,429.00 EXCISION OF TONSIL TAG $ 1,679.00 EXCISION OF TUMOR DEEP $ 3,413.00 EXCISION OR BIOPSY OF $ 3,414.00 EXCISION OR CURETTAGE $ 3,413.00 EXCISION OR DESTRUCTIO $ 3,911.00 EXCISION OTHER BENIGN $ 735.00 EXCISION OTHER BENIGN $ 3,303.00 EXCISION PARTIAL EXT E $ 2,130.00 EXCISION THIGH/KNEE TU $ 3,972.00 EXCISION TUMOR FOOT SO $ 5,245.00 EXCISION TUMOR FOREARM $ 4,336.00 EXCISION TUMOR LEG OR $ 3,997.00 EXCISION TUMOR LEG OR $ 3,997.00 EXCISION TUMOR THIGH O $ 3,972.00 EXCISION TUMOR UPPER A $ 4,283.00 EXCISION TUMOR/MASSSOF $ 4,427.00 EXCISION TUMORSOFT TIS $ 3,688.00 EXCISION TUMORSOFT TIS $ 4,283.00 EXCISION TUMORSOFT TIS $ 3,060.00 EXCISION, EXCESSIVE SK $ 4,887.00 EXCISION, LESION OF PA $ 1,716.00 EXCISION, OLECRANON BU $ 4,283.00 EXCISION, PREPATELLAR $ 3,972.00 EXCISION, TUMOR, FOOT; $ 1,950.00 EXCISION, TUMOR, SOFT $ 5,164.00 EXCISION, TUMOR, SOFT $ 3,688.00 EXCISION, TUMOR, SOFT $ 3,688.00 EXCISION, TUMOR, SOFT $ 4,235.00 EXCISION, TUMOR, SOFT $ 5,813.00 EXCISION, TUMOR, SOFT $ 4,355.00 EXCISION, TUMOR, SOFT $ 4,355.00 EXCISION, TUMOR, SOFT $ 4,152.00 EXCISION, TUMOR, SOFT $ 3,981.00 EXCISION, TUMOR, SOFT $ 2,270.00 EXCISION, TUMOR, SOFT $ 4,345.00 EXCISION, TUMOR, SOFT $ 4,152.00 EXCISIONBENIGN LESIONE $ 2,202.00 EXCISIONEXCESSIVE SKIN $ 5,701.00 EXCISIONTUMORFOREARM A $ 4,336.00 EXCISIONTUMORSOFT TISS $ 3,688.00 EXCISIONTUMORSOFT TISS $ 3,688.00 EXCISIONTUMORTHIGH OR $ 2,270.00 EXPLORATION OF KNEE JO $ 3,972.00 EXPLORATION OF SPINAL $ 8,721.00 EXPLORATORY ELBOW SURG $ 4,283.00 EXPLORE WOUND EXTREMIT $ 3,027.00 EXPLORE/TREAT HAND JOI $ 4,336.00 EXPLORE/TREAT WRIST JO $ 7,224.00 EXTENSOR TENDON REPAIR $ 5,057.00 EXTRACAP CATAR REM W/I $ 8,420.00 FACIOTOMY PALMARFOR DU $ 6,502.00 FASCIECTOMY PARTIAL PL $ 7,224.00 FASCIECTOMYPALM ONLYWI $ 6,502.00 FASCIETOMY PARTIAL PAL $ 3,613.00 FASCIOTOMY PALMER PERC $ 6,502.00 FASCIOTOMY, FOOT AND/O $ 2,925.00 FISSURECTOMY $ 2,412.00 FISTULECTOMY $ 2,412.00 FISTULECTOMY SUBMUSCUL $ 2,814.00 FIXATION OF SHOULDER $ 2,447.00 FLEXIBLE SIGMOIDOSCOPY $ 277.00 FNA W/O IMAGE $ 345.00 FRACTURE NASAL TURBINA $ 4,693.00 FULL THICK GRAFT ADD'L $ 3,229.00 FULL THICKNESS SKIN GR $ 6,460.00 FULLTHICKNESS GRAFT AR $ 6,460.00 FUSION OF BIG TOE JOIN $ 4,388.00 FUSION OF KNUCKLE $ 6,502.00 FUSION OF KNUCKLE WITH $ 7,224.00 HALLUX RIGIDUS CORRECT $ 3,413.00 HALLUX RIGIDUS CORRECT $ 9,376.00 HALLUX VALGUS(BUNION) $ 3,900.00 HALLUX VALGUS(BUNION) $ 3,900.00 HAMMER TOE REPAIR $ 3,413.00 HEMORRHOIDECTOMY BY SI $ 335.00 HEMORRHOIDECTOMY INT&E $ 2,814.00 HEMORRHOIDECTOMY INTER $ 2,412.00 HEMORRHOIDECTOMY, INTE $ 2,814.00 HIP ARTHROSCOPY/SURGER $ 8,928.00 HIP ARTHROSCOPY/SURGER $ 12,997.00 HYSTEROSCOPY ABLATION $ 4,138.00 HYSTEROSCOPY W/ REMOVA $ 3,104.00 HYSTEROSCOPY WITH D&C/ $ 2,585.00 HYSTSC OCCLUSION PLMT $ 3,448.00 I & D PILONIDAL CYST $ 487.00 I&D LEG/ANKLE ABSCESS/ $ 1,950.00 IMMEDIATE BREAST PROST $ 3,690.00 IMMEDIATE OR DELAYED B $ 4,615.00 IMPLANT NEUROELECTRODE $ 7,741.00 IMPLANT NON BIODEGRADA $ 796.00 IMPLANT OF BIOLOGIC IM $ 2,758.00 IMPLANTATION OF MESH O $ 2,062.00 IMPLANTATION OF NERVE $ 5,161.00 INCISION AND DRAINAGE $ 487.00 INCISION AND DRAINAGE $ 3,606.00 INCISION AND DRAINAGE $ 1,945.00 INCISION AND REMOVAL O $ 1,083.00 INCISION FOR IMPLANTAT $ 860.00 INCISION OF ACHILLES T $ 2,438.00 INCISION OF HEEL BONE $ 3,413.00 INCISION OF LINGUAL FR $ 1,286.00 INCISION OF METATARSAL $ 3,413.00 INCISION OF METATARSAL $ 3,413.00 INJ FORAMEN EPIDURAL C $ 1,218.00 INJ FORAMEN EPIDURAL L $ 1,350.00 INJ PLATELET RICH PLAS $ 748.00 INJECT SACROILIAC JOIN $ 473.00 INJECTION ANESTHETIC-B $ 1,218.00 INJECTION CERVICAL OR $ 1,382.00 INJECTION CERVICAL/THO $ 1,382.00 INJECTION FACET LUMBAR $ 1,382.00 INJECTION FACET LUMBAR $ 1,382.00 INJECTION INTO SKIN LE $ 857.00 INJECTION LUMBAR SACRA $ 1,218.00 INJECTION LUMBAR SACRA $ 1,218.00 INJECTION LUMBAR SACRA $ 1,218.00 INJECTION OF SCLEROSIN $ 1,311.00 INJECTION PROCEDURE FO $ 1,308.00 INJECTIONS(S), DIAG OR $ 1,382.00 iNJECTIONS(S), DIAG OR $ 1,382.00 INJECTTION LUMBAR GANG $ 1,628.00 INSERT ANT SEGMENT DRA $ 5,138.00 INSERT GROSHONG TUNNEL $ 1,967.00 INSERT INTERBODY BIOME $ 2,575.00 INSERT IOL W/ CATARACT $ 6,890.00 INSERTION NASAL SEPTAL $ 3,911.00 INSERTION PE TUBES (ON $ 3,134.00 INSERTION SPINAL NEURO $ 23,340.00 INSJ TEMP NDWELLG BLDR $ 236.00 INTERMED CLOSURE WOUND $ 757.00 INTERNAL NERVE REVISIO $ 3,440.00 INTERPOSTION ARTHROPLA $ 7,224.00 INTRADISCAL ELECTROTHE $ 1,578.00 INVASIVE IMPLANT ELECT $ 1,100.00 IRIDOTOMY/IRIDECTOMY B $ 3,063.00 KNEE ARTHROPLASTY COND $ 23,980.00 KNEE ARTHROS DEBRIDEME $ 8,183.00 KNEE ARTHROSCOPY W/LAT $ 8,183.00 KNEE ARTHROSCOPY WITH $ 8,183.00 KNEE ARTHROSCOPY/DRAIN $ 8,183.00 LAMINECTOMY FOR IMPLAN $ 19,096.00 LAMINECTOMY, FACETECTO $ 15,260.00 LAMINOTOMY ADD'L LUMBA $ 15,260.00 LAMINOTOMY SINGLE LUMB $ 15,260.00 LAMINOTOMY WITH DECOMP $ 15,260.00 LAP CHOLE W/ GRAMS $ 3,730.00 LAP HERNIA REPAIR INCA $ 5,245.00 LAP PARAESOPHAGEAL HER $ 31,143.00 LAP SURGICAL REPAIR IN $ 4,634.00 LAPAROSCOPIC HERNIA RE $ 5,245.00 LAPAROSCOPY REPAIR INC $ 5,245.00 LAPAROSCOPY REPAIR INC $ 5,245.00 LAPAROSCOPY SURGICAL E $ 16,181.00 LAPAROSCOPY TUBAL CAUT $ 3,060.00 LAPAROSCOPY W/EXCISION $ 4,138.00 LAPAROSCOPY, SURGICAL, $ 5,245.00 LAPAROSCOPY, SURGICAL; $ 4,161.00 LAPAROSCOPYREPAIR RECU $ 4,476.00 LAPIDUS-TYPE PROCEDURE $ 3,900.00 LAPS JEJUNOSTOMY $ 2,010.00 LARYNGOPLASTY MEDIALIZ $ 7,417.00 LARYNGOSCOPY DIRECT OP $ 5,474.00 LARYNGOSCOPY DIRECT OP $ 6,257.00 LARYNGOSCOPY DIRECT W $ 3,128.00 LARYNGOSCOPY DIRECT W/ $ 3,911.00 LARYNGOSCOPY DIRECT W/ $ 5,084.00 LARYNGOSCOPY FLEXIBLE $ 1,565.00 LARYNGOSCOPY, DIRECT, $ 4,693.00 LAT RETINACULAR RELEAS $ 5,673.00 LATERAL CANTHOPEXY $ 5,904.00 LAVAGE BY CANNULATION $ 496.00 LAVAGE BY CANNULATIONM $ 409.00 LAYER CLOSURE OF WOUND $ 421.00 LAYER CLOSURE OF WOUND $ 572.00 LAYER CLOSURE OF WOUND $ 1,615.00 LAYER CLOSURE OF WOUND $ 624.00 LAYER CLOSURE OF WOUND $ 674.00 LAYER CLOSURE OF WOUND $ 1,212.00 LAYER CLOSURE OF WOUND $ 1,615.00 LENGTHENING OF HAND TE $ 4,696.00 LESION REMOVAL COLONOS $ 3,317.00 LIG INT HEMORRHOIDS 1 $ 269.00 LIGATION ARTERIES; INT $ 7,039.00 LIGATION OR BIOPSY, TE $ 1,414.00 MAM0PLASTY AUGMENTATIO $ 3,803.00 MANIPULATION OF KNEE J $ 2,270.00 MASTECTOMY MODIFIED RA $ 3,270.00 MASTECTOMY PARTIAL $ 4,629.00 MASTECTOMY, RADICAL, I $ 10,788.00 MASTECTOMY, SIMPLE, CO $ 3,270.00 MASTECTOMY, SUBCUTANEO $ 3,493.00 MASTOPEXY $ 3,229.00 MASTOTOMY W/ EXPLOR & $ 2,307.00 MUSCLE-SKIN GRAFT ARM $ 8,073.00 MYRINGOTOMY (ONE OR BO $ 2,130.00 NASAL ENDOSCOPY DIAGNO $ 1,519.00 NASAL ENDOSCOPY WITH A $ 6,833.00 NASAL/ENDOSCOPY TOTAL $ 10,500.00 NASAL/ENDOSCOPY TOTAL $ 10,500.00 NASAL/ENDOSCOPY TOTAL $ 10,500.00 NASAL/ENDOSCOPY WITH $ 6,833.00 NASAL/SINUS ENDOS SURG $ 6,833.00 NASAL/SINUS ENDOSCOPY $ 6,833.00 NASAL/SINUS ENDOSCOPY $ 7,593.00 NASAL/SINUS ENDOSCOPY $ 7,821.00 NASAL/SINUS ENDOSCOPY $ 9,474.00 NASAL/SINUS ENDOSCOPY, $ 6,257.00 NASAL/SINUS ENDOSCOPYS $ 6,075.00 NASAL/SINUS ENDOSCOPYS $ 7,821.00 NBLK INJ SCIATIC CONT $ 1,743.00 NBLOCK INJ AXILLARY $ 1,218.00 NBLOCK INJ INTERCOST M $ 1,218.00 NBLOCK INJ INTERCOST S $ 1,218.00 NBLOCK STELLATE GANGLI $ 1,093.00 NECK/CHEST SURGERY PRO $ 4,500.00 NEG PRESSURE WOUND THE $ 261.00 NERVE PEDICLE TRANSFER $ 4,926.00 NERVE REPAIR WITH SYNT $ 5,835.00 NEUROPLASTY; NERVE OF $ 3,440.00 NIPPLE/AREOLA RECONSTR $ 3,690.00 NJX 1 TDN ORIGIN/INSJ $ 269.00 NJX 1/MLT TRIGGER POIN $ 283.00 NJX 1/MLT TRIGGER POIN $ 347.00 NJX ANES FEM NRV 1 $ 1,218.00 NJX ANES OTH PRPH NRV/ $ 1,218.00 NJX ANES SCIATIC NRV 1 $ 1,350.00 NJX ANES SPHENOPALATIN $ 449.00 NJX PX HIP ARTHG ANES $ 2,181.00 NJX PX HIP ARTHG W/O A $ 379.00 NJX THER CARPL TUNNEL $ 191.00 OP TX OF TARSOMETATARS $ 3,413.00 OPEN PERIPROSTHETIC CA $ 3,690.00 OPEN REDUCTION INTERNA $ 5,508.00 OPEN TREATMENT OF ACRO $ 5,508.00 OPEN TREATMENT OF ACRO $ 6,118.00 OPEN TREATMENT OF ARTI $ 5,779.00 OPEN TREATMENT OF BIMA $ 4,388.00 OPEN TREATMENT OF CLAV $ 5,508.00 OPEN TREATMENT OF DIST $ 3,613.00 OPEN TREATMENT OF DIST $ 3,900.00 OPEN TREATMENT OF FRAC $ 5,673.00 OPEN TREATMENT OF HUME $ 5,508.00 OPEN TREATMENT OF INTE $ 5,057.00 OPEN TREATMENT OF MEDI $ 3,900.00 OPEN TREATMENT OF META $ 5,779.00 OPEN TREATMENT OF PHAL $ 5,779.00 OPEN TREATMENT OF PROX $ 3,900.00 OPEN TREATMENT OF TRIM $ 5,363.00 OPEN TREATMENT OF ULNA $ 5,779.00 OPEN TX DISTAL FEMOARL $ 3,815.00 OPEN TX FX TIBIA/FIBUL $ 4,875.00 OPEN TX METATARSAL FX $ 3,413.00 OPEN TX OF FX OF WT BE $ 3,900.00 OPEN TX OF TIBIAL FX P $ 3,815.00 OPEN TX OF TRIMAL FX W $ 5,363.00 OPEN TX SCAPHOID FRACT $ 5,779.00 OPEN TX TARSAL FX W/ W $ 3,413.00 ORIF CALCANEAL FX W/ O $ 3,981.00 ORIF CARPALS/METACARPA $ 5,779.00 ORIF GREAT TOE/PHALANX $ 3,900.00 ORIF HUMERUS EPICONDYL $ 5,508.00 ORIF RADIUS NECK FRACT $ 5,508.00 ORIF SHAFT OF RADIUS $ 5,779.00 OSTCHNDRL ALGRFT KNE O $ 6,240.00 OSTECTOMY COMPLETE 5TH $ 2,925.00 OSTECTOMY COMPLETE MET $ 3,413.00 OSTECTOMY COMPLETE OTH $ 3,413.00 OSTECTOMY, CALCANEUS; $ 3,413.00 OSTECTOMY, EXCISION OF $ 3,900.00 OSTECTOMYCALCANEUS; FO $ 3,900.00 OSTECTOMYPARTIALEXOSTE $ 3,413.00 OSTEOTOMY SHORTENING O $ 3,413.00 OSTEOTOMY TARSAL BONES $ 3,413.00 OSTEOTOMY THAN FIRST M $ 3,413.00 OSTEOTOMY; PHALANX OF $ 7,224.00 OSTEOTOMY; ULNA $ 6,502.00 PALATOPHARYNGOPLASTY $ 3,857.00 PARATHYROID AUTOTRANSP $ 4,906.00 PARATHYROIDECTOMY/EXPL $ 7,631.00 PARAVAGINAL DEFECT REP $ 6,500.00 PART REMOVAL OF METATA $ 3,413.00 PARTIAL EXCISION BONE $ 4,388.00 PARTIAL EXCISION OF BO $ 2,925.00 PARTIAL HYSTERECTOMY $ 13,081.00 PARTIAL REMOVAL FOOT F $ 3,900.00 PARTIAL REMOVAL OF ELB $ 6,118.00 PARTIAL REMOVAL OF FOO $ 3,413.00 PARTIAL THYROID LOBECT $ 3,707.00 PERC FIX CMC FX W/ MAN $ 4,336.00 PERCUT FIXATION PHALAN $ 2,891.00 PERCUTANEOUS SKELETAL $ 2,891.00 PERCUTANEOUS SKELETAL $ 2,891.00 PERIPROSTHETIC CAPSULE $ 3,690.00 PHALANGECTOMY, TOE, EA $ 2,925.00 PHALANX OSTEOTOMY AKIN $ 3,900.00 PIN HAND DISLOCATION $ 2,891.00 PINCH GRAFT SINGLE OR $ 1,615.00 PLMT SETON $ 169.00 POSTERIOR NON SEGMENTA $ 9,811.00 POSTERIOR SEGMENTAL IN $ 10,327.00 PRIMARY REPAIR EXT TNE $ 2,925.00 PRIMARY REPAIR FLEXR T $ 2,438.00 PUNCTURE DRAINAGE OF L $ 323.00 RADICAL EXCISION EXTEN $ 6,502.00 RADICAL RESECTION OF T $ 5,164.00 REALIGNMENT OF TENDONS $ 5,419.00 RECONSTRUCT ANKLE JOIN $ 6,214.00 RECONSTRUCT ELBOW MED $ 6,118.00 RECONSTRUCTION COLLATE $ 7,949.00 REDUCTION MAMMAPLASTY $ 3,690.00 REINSERTION OF RUPTURE $ 6,118.00 RELEASE ELBOW JOINT $ 4,283.00 RELEASE HAND/FINGER TE $ 4,696.00 RELEASE KNUCKLE CONTRA $ 5,779.00 RELEASE OF FOOT CONTRA $ 2,925.00 RELEASE OF LOWER LEG T $ 2,925.00 RELEASE PALM & FINGER $ 5,779.00 RELEASE WRIST/FOREARM $ 5,779.00 REMOV TUNNELED VENOUS $ 1,965.00 REMOVAL FOREARM LESION $ 5,779.00 REMOVAL HAND LESION DE $ 4,336.00 REMOVAL HAND LESION SU $ 3,613.00 REMOVAL IMPACTED CERUM $ 2,130.00 REMOVAL LENS MATERIAL $ 6,124.00 REMOVAL OF BREAST LESI $ 2,307.00 REMOVAL OF FINGER LESI $ 4,336.00 REMOVAL OF FINGER TEND $ 5,779.00 REMOVAL OF FOOT FASCIA $ 4,388.00 REMOVAL OF FOOT FOREIG $ 975.00 REMOVAL OF FOOT LESION $ 2,925.00 REMOVAL OF FOREIGN BOD $ 552.00 REMOVAL OF FOREIGN BOD $ 3,783.00 REMOVAL OF FOREIGN BOD $ 4,538.00 REMOVAL OF FOREIGN BOD $ 1,950.00 REMOVAL OF FOREIGN BOD $ 4,500.00 REMOVAL OF FOREIGN BOD $ 3,911.00 REMOVAL OF FOREIGN BOD $ 2,130.00 REMOVAL OF HARDWARE DE $ 10,642.00 REMOVAL OF INTACT MAMM $ 1,846.00 REMOVAL OF MAMMARY IMP $ 1,846.00 REMOVAL OF NAIL BED $ 2,202.00 REMOVAL OF NAIL PLATE $ 2,137.00 REMOVAL OF NERVE LESIO $ 6,882.00 REMOVAL OF POSTERIOR S $ 8,721.00 REMOVAL OF PROSTHESIS $ 21,795.00 REMOVAL OF SKIN TAGS U $ 436.00 REMOVAL OF SKIN WRINKL $ 8,144.00 REMOVAL OF TENDON LESI $ 2,925.00 REMOVAL OF TISSUE FROM $ 7,593.00 REMOVAL OF TOE LESIONS $ 2,925.00 REMOVAL SUTURES OTHER $ 239.00 REMOVAL SWEAT GLAND LE $ 3,303.00 REMOVE ARM/ELBOW LESIO $ 3,060.00 REMOVE BONE FIXATION D $ 3,783.00 REMOVE DRUG IMPLANT DE $ 775.00 REMOVE ELBOW LESION $ 4,283.00 REMOVE FEMUR LESION/BU $ 5,106.00 REMOVE FOREIGN BODY $ 487.00 REMOVE KNEE JOINT LINI $ 6,240.00 REMOVE LESION NECK/CHE $ 3,688.00 REMOVE LOWER LEG BONE $ 3,900.00 REMOVE LOWER LEG LESIO $ 2,438.00 REMOVE SPINAL LAMINA A $ 7,631.00 REMOVE TENDON SHEATH L $ 4,336.00 REMOVE TISSUE EXPANDER $ 1,853.00 REMOVE WRIST JOINT CAR $ 6,502.00 REMOVE WRIST/FOREARM L $ 6,502.00 REP BLEPHAROPTOSIS LEV $ 3,562.00 REPAIR ACHILLES W/ TEN $ 5,363.00 REPAIR AND RECONSTRUCT $ 6,502.00 REPAIR ARM/LEG NERVE $ 6,882.00 REPAIR COMPLEX 26-75 c $ 2,422.00 REPAIR COMPLEX WOUNDFA $ 3,229.00 REPAIR COMPLEXEYELIDSN $ 3,229.00 REPAIR DEGENERATED KNE $ 4,538.00 REPAIR EXTENSOR TENDON $ 6,502.00 REPAIR FINGER TENDON $ 4,336.00 REPAIR FOREARM TENDON/ $ 6,502.00 REPAIR HAND JOINT $ 6,502.00 REPAIR HAND TENDON $ 4,336.00 REPAIR INCISIONAL HERN $ 6,716.00 REPAIR INITIAL INCISIO $ 5,969.00 REPAIR INITIAL INCISIO $ 6,716.00 REPAIR INITIAL INGUINA $ 4,161.00 REPAIR INITIAL INGUINA $ 4,476.00 REPAIR LAT COLLATERAL $ 6,118.00 REPAIR LOWER LEG TENDO $ 3,900.00 REPAIR MUSCLES OF HAND $ 6,502.00 REPAIR NONUNION HAND $ 6,502.00 REPAIR OF ANKLE LIGAME $ 4,388.00 REPAIR OF BROW PTOSIS $ 4,070.00 REPAIR OF DIGIT NERVE $ 6,882.00 REPAIR OF ECTROPION; S $ 3,052.00 REPAIR OF FOOT TENDON $ 3,900.00 REPAIR OF KNEE LIGAMEN $ 5,673.00 REPAIR OF METATARSALS $ 4,388.00 REPAIR OF NAIL BED $ 2,202.00 REPAIR OF NASAL VESTIB $ 7,821.00 REPAIR OF NONUNION OR $ 3,900.00 REPAIR OF RUPTURED MUS $ 6,118.00 REPAIR OF TIBIA $ 3,900.00 REPAIR OR ADVANCEMENT $ 6,502.00 REPAIR PERONEAL TENSON $ 4,875.00 REPAIR PRIMARY OPEN OR $ 4,388.00 REPAIR TENDON/MUSCLE U $ 6,118.00 REPAIR, COMPLEX, TRUNK $ 809.00 REPAIR, COMPLEX, TRUNK $ 2,422.00 REPAIR/GRAFT OF FOOT T $ 4,388.00 REPAIR/GRAFT RADIUS OR $ 7,224.00 REPAIR/TRANSPOSE NERVE $ 7,741.00 REPLACE TISSUE EXPANDE $ 1,853.00 REPLACEMENT, COMPLETE, $ 1,590.00 REPOSITIONING OF IOL L $ 6,124.00 RESECT/TRANSPL LONG TE $ 6,118.00 REVISE ADDITIONAL LEG $ 408.00 REVISE ARM/LEG NERVE $ 6,882.00 REVISE FINGER JOINT EA $ 5,779.00 REVISE ULNAR NERVE AT $ 6,882.00 REVISE ULNAR NERVE AT $ 6,882.00 REVISE WRIST/FOREARM T $ 6,502.00 REVISION HIP ARTHROPLA $ 39,447.00 REVISION MASTOIDECTOMY $ 6,389.00 REVISION OF CALF TENDO $ 4,388.00 REVISION OF CERVIX $ 2,069.00 REVISION OF FOOT TENDO $ 4,875.00 REVISION OF HIP ARTHRO $ 27,259.00 REVISION OF HIP ARTHRO $ 38,478.00 REVISION OF KNEE ALL C $ 23,980.00 REVISION OF KNEE REPLA $ 21,800.00 REVISION OF RECONSTRUC $ 2,677.00 REVISION OF STAPEDECTO $ 5,858.00 REVISION OF UNSTABLE K $ 5,106.00 REVISION OR REMOVAL OF $ 6,882.00 REVISION TOTAL ANKLE $ 6,214.00 REVISION TOTAL SHOULDE $ 12,386.00 RHINOPLASTY $ 7,039.00 RHINOPLASTY FOR NASAL $ 6,257.00 RMVL INTRAUTERINE DEV $ 131.00 ROTATOR CUFF REPAIR $ 7,343.00 ROTATOR CUFF REPAIRPAR $ 5,508.00 RPR CPLX TRNK EA 5 CM/ $ 976.00 SACROILIAC JT INJ THER $ 2,411.00 SECONDARY CLOSURE OF S $ 1,615.00 SEPTOPLASTY $ 6,833.00 SESAMOIDECTOMYFIRST TO $ 3,413.00 SHAVE SKIN LESION $ 552.00 SHAVING OF EPIDERMAL $ 552.00 SHAVING OF EPIDERMAL L $ 552.00 SHAVING OF EPIDERMAL L $ 552.00 SHAVING OF EPIDERMAL O $ 552.00 SHAVING OF EPIDERMAL O $ 552.00 SHAVING OF EPIDERMAL O $ 552.00 SHAVING OF EPIDERMAL O $ 552.00 SHAVING OF EPIDERMAL O $ 552.00 SHAVING OF EPIDERMAL O $ 552.00 SHOULDER ARTHROSCOPY/S $ 8,928.00 SIALOLITHOTOMY; SUBMAN $ 1,716.00 SIALOLITHOTOMY; SUBMAN $ 2,572.00 SIGMOIDOSCOPY, FLEXIBL $ 1,610.00 SIGMOIDOSCOPY, FLEXIBL $ 1,610.00 SIGMOIDOSCOPYFLEXIBLE $ 403.00 SIMPLE REPAIR 25CM OR $ 405.00 SIMPLE REPAIR 26 TO 75 $ 488.00 SKIN FULL GRAFT TRUNK $ 6,460.00 SKIN FULL GRAFT TRUNK $ 3,229.00 SKIN FULL GRFT FACE/GE $ 6,460.00 SKIN SPLT GRFT TRNK/AR $ 5,653.00 SKIN TISSUE PROCEDURE $ 181.00 SKIN TISSUE REARRANGEM $ 3,229.00 SKN SPLT A-GRFT FAC/NC $ 6,460.00 SPINAL BONE ALLOGRAFT $ 1,417.00 SPINAL BONE AUTOGRAFT $ 1,582.00 SPINAL PUNCTURE, LUMBA $ 568.00 STAPEDECTOMY OR STAPED $ 5,325.00 STERIOTACTIC COMPUTER $ 436.00 SUBMUCOUS RESECT INFER $ 9,470.00 SUCTION ASSISTED LIPEC $ 4,887.00 SUTURE OF INFRAPATELLA $ 3,972.00 SUTURE OF QUADRICEPS/H $ 4,538.00 SUTURESECONDARY REPAIR $ 4,388.00 SYNDACTYLIZATION TOES $ 3,900.00 SYNOVECTOMY EXTENSOR T $ 4,336.00 SYNOVECTOMY MAJOR TWO $ 8,183.00 SYNOVECTOMY TENDON SHE $ 5,779.00 SYNOVECTOMY, CARPOMETA $ 6,502.00 SYNOVECTOMY, TENDON SH $ 2,925.00 T&A OVER AGE 12 $ 2,036.00 T&A UNDER AGE 12 $ 2,437.00 TENDON PULLEY RECONSTR $ 4,336.00 TENDON PULLEY RECONSTR $ 5,779.00 TENDON SHEATH INCISION $ 4,336.00 TENDON TRANSFER $ 6,502.00 TENDON TRANSFER DORSUM $ 7,224.00 TENODESIS OF BICEPS TE $ 5,508.00 TENODESIS OF LONG TEND $ 5,508.00 TENOLYSIS FLEXOR TENDO $ 4,696.00 TENOLYSIS, EXTENSOR, F $ 1,950.00 TENOLYSIS, TRICEPS $ 4,895.00 TENOTOMY ELBOW LATERAL $ 6,118.00 TENOTOMY ELVOW LAT/MED $ 3,598.00 TENOTOMY OPEN TENDON F $ 1,950.00 TENOTOMY PERCUTANEOUS $ 3,413.00 TENOTOMY, FLEXOR, FING $ 4,336.00 TENOTOMY, PERCUTANEOUS $ 1,401.00 THERAPY FOR CONTOUR DE $ 872.00 THYROIDECTOMY, INCL SU $ 18,330.00 THYROIDECTOMY, INCLUDI $ 18,804.00 THYROIDECTOMY, REMOVAL $ 18,330.00 THYROIDECTOMY, TOTAL O $ 18,330.00 THYROIDECTOMY, TOTAL O $ 21,601.00 THYROIDECTOMYTOTAL OR $ 18,330.00 TISSUE GRAFTS OTHER $ 1,262.00 TONSILLECTOMY $ 3,007.00 TONSILLECTOMY UNDER AG $ 1,893.00 TOTAL HIP REPLACEMENT $ 41,702.00 TOTAL KNEE ARTHROPLAST $ 33,814.00 TOTAL SHOULDER ARTHROP $ 7,343.00 TOTAL THYROID LOBECTOM $ 18,330.00 TRACHEOTOMY TUBE CHANG $ 554.00 TRANSECTION/AVULSION O $ 6,021.00 TRANSFER OR TRANSPLANT $ 4,875.00 TRANSFORAMINAL EPIDURA $ 1,218.00 TRANSFORAMINAL EPIDURA $ 1,350.00 TRANSPLANT HAND TENDON $ 6,502.00 TRANSPLANTATION FLEXOR $ 6,502.00 TREAT FX DISTAL RADIAL $ 3,613.00 TREAT FX RAD EXTRA-ART $ 3,981.00 TREAT FX RAD INTRA-ART $ 3,981.00 TREAT FX RADIAL 3+ FRA $ 5,969.00 TREAT LOWER LEG JOINT $ 4,388.00 TREAT MIDFOOT FRACTURE $ 975.00 TREAT THUMB FRACTURE $ 2,167.00 TREAT ULNAR FRACTURE $ 1,225.00 TRIGGER FINGER RELEASE $ 5,779.00 TRIGGER POINT INJECTIO $ 269.00 TUBE REMOVAL $ 1,098.00 TX OF SUPERFICIAL WOUN $ 691.00 TYMPANIC MEMBRANE REPA $ 2,048.00 TYMPANOPLASTY WITH MAS $ 6,389.00 TYMPANOPLASTY WITH MAS $ 6,389.00 TYMPANOPLASTY WITHOUT $ 5,325.00 TYMPANOPLASTY WITHOUT $ 5,325.00 UMBILICAL HERNIA REPAI $ 4,476.00 UMBILICAL HERNIA REPAI $ 5,223.00 UNLISTED LAPAROSCOPIC $ 5,245.00 UNLISTED LAPAROSCOPY P $ 7,867.00 UNLISTED PROCEDURE, L $ 3,236.00 UNLISTED PROCEDURE, AR $ 8,074.00 UNLISTED PROCEDURE, FE $ 4,360.00 UNLISTED PROCEDURE, HU $ 3,918.00 UNLISTED PROCEDURE, NE $ 1,091.00 UNLISTED PROCEDURE, PE $ 9,266.00 UPPER GASTROINTESTINAL $ 1,643.00 UPPER GASTROINTESTINAL $ 1,716.00 USE OF OPERATION MICRO $ 327.00 WND PREP CH/INF F/N/HF $ 4,844.00 WRIST ENDOSCOPY/SURGER $ 5,208.00