2015 National Physician Fee Schedule Relative Value File ... · 2015 National Physician Fee...

2015 National Physician Fee Schedule Relative Value File January Release

RELEASED 12/23/2014

NON-FACILITY

HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL

10021 Fna w/o image 4.23 70.00 $296.10

10022 Fna w/image 4.02 70.00 $281.40

1003F Level of activity assess 0.00 70.00 $0.00

10030 Guide cathet fluid drainage 22.06 70.00 $1,544.20

1004F Clin symp vol ovrld assess 0.00 70.00 $0.00

10040 Acne surgery 2.86 70.00 $200.20

1005F Asthma symptoms evaluate 0.00 70.00 $0.00

1006F Osteoarthritis assess 0.00 70.00 $0.00

10060 Drainage of skin abscess 3.31 70.00 $231.70

10061 Drainage of skin abscess 5.85 70.00 $409.50

1007F Anti-inflm/anlgsc otc assess 0.00 70.00 $0.00

1008F Gi/renal risk assess 0.00 70.00 $0.00

10080 Drainage of pilonidal cyst 5.08 70.00 $355.60

10081 Drainage of pilonidal cyst 7.61 70.00 $532.70

1010F Severity angina by actvty 0.00 70.00 $0.00

1011F Angina present 0.00 70.00 $0.00

1012F Angina absent 0.00 70.00 $0.00

10120 Remove foreign body 4.32 70.00 $302.40

10121 Remove foreign body 7.75 70.00 $542.50

10140 Drainage of hematoma/fluid 4.62 70.00 $323.40

1015F Copd symptoms assess 0.00 70.00 $0.00

10160 Puncture drainage of lesion 3.69 70.00 $258.30

1018F Assess dyspnea not present 0.00 70.00 $0.00

10180 Complex drainage wound 6.99 70.00 $489.30

1019F Assess dyspnea present 0.00 70.00 $0.00

1022F Pneumo imm status assess 0.00 70.00 $0.00

1026F Co-morbid condition assess 0.00 70.00 $0.00

1030F Influenza imm status assess 0.00 70.00 $0.00

1031F Smoking & 2nd hand assessed 0.00 70.00 $0.00

1032F Smoker/exposed 2nd hnd smoke 0.00 70.00 $0.00

1033F Tobacco nonsmoker nor 2ndhnd 0.00 70.00 $0.00

1034F Current tobacco smoker 0.00 70.00 $0.00

1035F Smokeless tobacco user 0.00 70.00 $0.00

1036F Tobacco non-user 0.00 70.00 $0.00

1038F Persistent asthma 0.00 70.00 $0.00

1039F Intermittent asthma 0.00 70.00 $0.00

1040F Dsm-5 info mdd docd 0.00 70.00 $0.00

1050F History of mole changes 0.00 70.00 $0.00

1052F Type location activityassess 0.00 70.00 $0.00

1055F Visual funct status assess 0.00 70.00 $0.00

1060F Doc perm/cont/parox atr fib 0.00 70.00 $0.00

1061F Doc lack perm+cont+parox fib 0.00 70.00 $0.00

1065F Ischm stroke symp lt3 hrsb/4 0.00 70.00 $0.00

1066F Ischm stroke symp ge3 hrsb/4 0.00 70.00 $0.00

1070F Alarm symp assessed-absent 0.00 70.00 $0.00

1071F Alarm symp assessed-1+ prsnt 0.00 70.00 $0.00

1090F Pres/absn urine incon assess 0.00 70.00 $0.00

1091F Urine incon characterized 0.00 70.00 $0.00

1100F Ptfalls assess-docd ge2>/yr 0.00 70.00 $0.00

11000 Debride infected skin 1.54 70.00 $107.80

11001 Debride infected skin add-on 0.59 70.00 $41.30

11004 Debride genitalia & perineum 16.74 70.00 $1,171.80

11005 Debride abdom wall 22.62 70.00 $1,583.40

11006 Debride genit/per/abdom wall 20.27 70.00 $1,418.90

11008 Remove mesh from abd wall 7.96 70.00 $557.20

1101F Pt falls assess-docd le1/yr 0.00 70.00 $0.00

11010 Debride skin at fx site 13.94 70.00 $975.80

11011 Debride skin musc at fx site 14.98 70.00 $1,048.60

11012 Deb skin bone at fx site 20.15 70.00 $1,410.50

11042 Deb subq tissue 20 sq cm/< 3.31 70.00 $231.70

11043 Deb musc/fascia 20 sq cm/< 6.48 70.00 $453.60

11044 Deb bone 20 sq cm/< 8.96 70.00 $627.20

11045 Deb subq tissue add-on 1.17 70.00 $81.90

11046 Deb musc/fascia add-on 2.07 70.00 $144.90

11047 Deb bone add-on 3.53 70.00 $247.10

11055 Trim skin lesion 1.35 70.00 $94.50

11056 Trim skin lesions 2 to 4 1.65 70.00 $115.50

11057 Trim skin lesions over 4 1.85 70.00 $129.50

1110F Pt lft inpt fac w/in 60 days 0.00 70.00 $0.00

11100 Biopsy skin lesion 2.92 70.00 $204.40

11101 Biopsy skin add-on 0.92 70.00 $64.40

1111F Dschrg med/current med merge 0.00 70.00 $0.00

1116F Auric/peri pain assessed 0.00 70.00 $0.00

1118F Gerd symps assessed 12 month 0.00 70.00 $0.00

1119F Init eval for condition 0.00 70.00 $0.00

11200 Removal of skin tags <w/15 2.49 70.00 $174.30

11201 Remove skin tags add-on 0.53 70.00 $37.10

1121F Subs eval for condition 0.00 70.00 $0.00

1123F Acp discuss/dscn mkr docd 0.00 70.00 $0.00

1124F Acp discuss-no dscnmkr docd 0.00 70.00 $0.00

1125F Amnt pain noted pain prsnt 0.00 70.00 $0.00

1126F Amnt pain noted none prsnt 0.00 70.00 $0.00

1127F New episode for condition 0.00 70.00 $0.00

1128F Subs episode for condition 0.00 70.00 $0.00

1130F Bk pain & fxn assessed 0.00 70.00 $0.00

11300 Shave skin lesion 0.5 cm/< 2.74 70.00 $191.80

11301 Shave skin lesion 0.6-1.0 cm 3.38 70.00 $236.60

11303 Shave skin lesion >2.0 cm 4.39 70.00 $307.30

1134F Epsd bk pain for 6 wks/< 0.00 70.00 $0.00

1135F Epsd bk pain for >6 wks 0.00 70.00 $0.00

1136F Epsd bk pain for 12 wks/< 0.00 70.00 $0.00

1137F Epsd bk pain for >12 wks 0.00 70.00 $0.00

11400 Exc tr-ext b9+marg 0.5 cm< 3.51 70.00 $245.70

11401 Exc tr-ext b9+marg 0.6-1 cm 4.21 70.00 $294.70

11403 Exc tr-ext b9+marg 2.1-3cm/< 5.42 70.00 $379.40

11406 Exc tr-ext b9+marg >4.0 cm 8.88 70.00 $621.60

11420 Exc h-f-nk-sp b9+marg 0.5/< 3.46 70.00 $242.20

11421 Exc h-f-nk-sp b9+marg 0.6-1 4.44 70.00 $310.80

11422 Exc h-f-nk-sp b9+marg 1.1-2 4.96 70.00 $347.20

11423 Exc h-f-nk-sp b9+marg 2.1-3 5.72 70.00 $400.40

11424 Exc h-f-nk-sp b9+marg 3.1-4 6.61 70.00 $462.70

11426 Exc h-f-nk-sp b9+marg >4 cm 9.45 70.00 $661.50

11440 Exc face-mm b9+marg 0.5 cm/< 3.80 70.00 $266.00

11441 Exc face-mm b9+marg 0.6-1 cm 4.76 70.00 $333.20

11446 Exc face-mm b9+marg >4 cm 11.08 70.00 $775.60

11450 Removal sweat gland lesion 10.87 70.00 $760.90

11471 Removal sweat gland lesion 14.38 70.00 $1,006.60

1150F Doc pt rsk death w/in 1yr 0.00 70.00 $0.00

1151F Doc no pt rsk death w/in 1yr 0.00 70.00 $0.00

1152F Doc advncd dis comfort 1st 0.00 70.00 $0.00

1153F Doc advncd dis cmfrt not 1st 0.00 70.00 $0.00

1157F Advnc care plan in rcrd 0.00 70.00 $0.00

1158F Advnc care plan tlk docd 0.00 70.00 $0.00

1159F Med list docd in rcrd 0.00 70.00 $0.00

1160F Rvw meds by rx/dr in rcrd 0.00 70.00 $0.00

11600 Exc tr-ext mal+marg 0.5 cm/< 5.43 70.00 $380.10

11601 Exc tr-ext mal+marg 0.6-1 cm 6.45 70.00 $451.50

11606 Exc tr-ext mal+marg >4 cm 12.75 70.00 $892.50

11620 Exc h-f-nk-sp mal+marg 0.5/< 5.49 70.00 $384.30

11621 Exc s/n/h/f/g mal+mrg 0.6-1 6.49 70.00 $454.30

11622 Exc s/n/h/f/g mal+mrg 1.1-2 7.23 70.00 $506.10

11623 Exc s/n/h/f/g mal+mrg 2.1-3 8.49 70.00 $594.30

11624 Exc s/n/h/f/g mal+mrg 3.1-4 9.57 70.00 $669.90

11626 Exc s/n/h/f/g mal+mrg >4 cm 11.57 70.00 $809.90

11640 Exc f/e/e/n/l mal+mrg 0.5cm< 5.65 70.00 $395.50

11641 Exc f/e/e/n/l mal+mrg 0.6-1 6.71 70.00 $469.70

11642 Exc f/e/e/n/l mal+mrg 1.1-2 7.65 70.00 $535.50

11643 Exc f/e/e/n/l mal+mrg 2.1-3 9.04 70.00 $632.80

11644 Exc f/e/e/n/l mal+mrg 3.1-4 11.17 70.00 $781.90

11646 Exc f/e/e/n/l mal+mrg >4 cm 14.63 70.00 $1,024.10

1170F Fxnl status assessed 0.00 70.00 $0.00

11719 Trim nail(s) any number 0.39 70.00 $27.30

11720 Debride nail 1-5 0.91 70.00 $63.70

11721 Debride nail 6 or more 1.26 70.00 $88.20

11730 Removal of nail plate 2.79 70.00 $195.30

11732 Remove nail plate add-on 1.01 70.00 $70.70

11740 Drain blood from under nail 1.40 70.00 $98.00

1175F Function stat assessed rvwd 0.00 70.00 $0.00

11750 Removal of nail bed 6.31 70.00 $441.70

11752 Remove nail bed/tip 9.21 70.00 $644.70

11755 Biopsy nail unit 3.77 70.00 $263.90

11760 Repair of nail bed 6.47 70.00 $452.90

11762 Reconstruction of nail bed 8.00 70.00 $560.00

11765 Excision of nail fold toe 4.73 70.00 $331.10

11770 Remove pilonidal cyst simple 7.84 70.00 $548.80

11771 Remove pilonidal cyst exten 16.29 70.00 $1,140.30

11772 Remove pilonidal cyst compl 19.81 70.00 $1,386.70

1180F Thromboemb risk assessed 0.00 70.00 $0.00

1181F Neuropsychia sympts assessed 0.00 70.00 $0.00

1182F Neuropsychi sympt 1+present 0.00 70.00 $0.00

1183F Neuropsychiatric symp absent 0.00 70.00 $0.00

11900 Inject skin lesions </w 7 1.56 70.00 $109.20

11901 Inject skin lesions >7 1.96 70.00 $137.20

11920 Correct skin color 6.0 cm/< 4.84 70.00 $338.80

11921 Corect skin color 6.1-20.0cm 5.60 70.00 $392.00

11922 Correct skin color ea 20.0cm 1.73 70.00 $121.10

11950 Tx contour defects 1 cc/< 2.21 70.00 $154.70

11951 Tx contour defects 1.1-5.0cc 3.01 70.00 $210.70

11952 Tx contour defects 5.1-10cc 3.66 70.00 $256.20

11954 Tx contour defects >10.0 cc 4.50 70.00 $315.00

11960 Insert tissue expander(s) 26.95 70.00 $1,886.50

11970 Replace tissue expander 17.40 70.00 $1,218.00

11971 Remove tissue expander(s) 13.33 70.00 $933.10

11976 Remove contraceptive capsule 4.05 70.00 $283.50

11980 Implant hormone pellet(s) 2.66 70.00 $186.20

11981 Insert drug implant device 4.01 70.00 $280.70

11982 Remove drug implant device 4.54 70.00 $317.80

11983 Remove/insert drug implant 6.32 70.00 $442.40

1200F Seizure type& frequ docd 0.00 70.00 $0.00

12001 Rpr s/n/ax/gen/trnk 2.5cm/< 2.53 70.00 $177.10

12002 Rpr s/n/ax/gen/trnk2.6-7.5cm 3.09 70.00 $216.30

12004 Rpr s/n/ax/gen/trk7.6-12.5cm 3.64 70.00 $254.80

12005 Rpr s/n/a/gen/trk12.6-20.0cm 4.72 70.00 $330.40

12006 Rpr s/n/a/gen/trk20.1-30.0cm 5.64 70.00 $394.80

12007 Rpr s/n/ax/gen/trnk >30.0 cm 6.56 70.00 $459.20

12011 Rpr f/e/e/n/l/m 2.5 cm/< 3.10 70.00 $217.00

12013 Rpr f/e/e/n/l/m 2.6-5.0 cm 3.40 70.00 $238.00

12014 Rpr f/e/e/n/l/m 5.1-7.5 cm 4.02 70.00 $281.40

12015 Rpr f/e/e/n/l/m 7.6-12.5 cm 4.86 70.00 $340.20

12016 Rpr fe/e/en/l/m 12.6-20.0 cm 6.04 70.00 $422.80

12017 Rpr fe/e/en/l/m 20.1-30.0 cm 4.42 70.00 $309.40

12018 Rpr f/e/e/n/l/m >30.0 cm 5.02 70.00 $351.40

12020 Closure of split wound 7.95 70.00 $556.50

12021 Closure of split wound 4.65 70.00 $325.50

12031 Intmd rpr s/a/t/ext 2.5 cm/< 6.68 70.00 $467.60

12032 Intmd rpr s/a/t/ext 2.6-7.5 8.54 70.00 $597.80

12034 Intmd rpr s/tr/ext 7.6-12.5 8.80 70.00 $616.00

12035 Intmd rpr s/a/t/ext 12.6-20 10.80 70.00 $756.00

12036 Intmd rpr s/a/t/ext 20.1-30 11.87 70.00 $830.90

12037 Intmd rpr s/tr/ext >30.0 cm 13.64 70.00 $954.80

12041 Intmd rpr n-hf/genit 2.5cm/< 6.82 70.00 $477.40

12042 Intmd rpr n-hf/genit2.6-7.5 8.14 70.00 $569.80

12044 Intmd rpr n-hf/genit7.6-12.5 10.15 70.00 $710.50

12045 Intmd rpr n-hf/genit12.6-20 11.44 70.00 $800.80

12046 Intmd rpr n-hf/genit20.1-30 13.67 70.00 $956.90

12047 Intmd rpr n-hf/genit >30.0cm 15.84 70.00 $1,108.80

1205F Epi etiol synd rvwd and docd 0.00 70.00 $0.00

12051 Intmd rpr face/mm 2.5 cm/< 7.27 70.00 $508.90

12052 Intmd rpr face/mm 2.6-5.0 cm 8.29 70.00 $580.30

12053 Intmd rpr face/mm 5.1-7.5 cm 9.75 70.00 $682.50

12054 Intmd rpr face/mm 7.6-12.5cm 10.38 70.00 $726.60

12055 Intmd rpr face/mm 12.6-20 cm 13.46 70.00 $942.20

12056 Intmd rpr face/mm 20.1-30.0 14.11 70.00 $987.70

12057 Intmd rpr face/mm >30.0 cm 16.48 70.00 $1,153.60

1220F Pt screened for depression 0.00 70.00 $0.00

13100 Cmplx rpr trunk 1.1-2.5 cm 9.44 70.00 $660.80

13101 Cmplx rpr trunk 2.6-7.5 cm 11.16 70.00 $781.20

13102 Cmplx rpr trunk addl 5cm/< 3.45 70.00 $241.50

13120 Cmplx rpr s/a/l 1.1-2.5 cm 9.87 70.00 $690.90

13121 Cmplx rpr s/a/l 2.6-7.5 cm 12.03 70.00 $842.10

13122 Cmplx rpr s/a/l addl 5 cm/> 3.78 70.00 $264.60

13131 Cmplx rpr f/c/c/m/n/ax/g/h/f 10.87 70.00 $760.90

13151 Cmplx rpr e/n/e/l 1.1-2.5 cm 11.93 70.00 $835.10

13152 Cmplx rpr e/n/e/l 2.6-7.5 cm 14.31 70.00 $1,001.70

13153 Cmplx rpr e/n/e/l addl 5cm/< 5.50 70.00 $385.00

13160 Late closure of wound 23.18 70.00 $1,622.60

1400F Prkns diag rviewed 0.00 70.00 $0.00

14000 Tis trnfr trunk 10 sq cm/< 17.63 70.00 $1,234.10

14001 Tis trnfr trunk 10.1-30sqcm 22.67 70.00 $1,586.90

14020 Tis trnfr s/a/l 10 sq cm/< 19.72 70.00 $1,380.40

14021 Tis trnfr s/a/l 10.1-30 sqcm 24.67 70.00 $1,726.90

14040 Tis trnfr f/c/c/m/n/a/g/h/f 21.57 70.00 $1,509.90

14041 Tis trnfr f/c/c/m/n/a/g/h/f 26.69 70.00 $1,868.30

14060 Tis trnfr e/n/e/l 10 sq cm/< 22.00 70.00 $1,540.00

14061 Tis trnfr e/n/e/l10.1-30sqcm 28.72 70.00 $2,010.40

14301 Tis trnfr any 30.1-60 sq cm 30.57 70.00 $2,139.90

14302 Tis trnfr addl 30 sq cm/< 6.38 70.00 $446.60

14350 Filleted finger/toe flap 19.85 70.00 $1,389.50

1450F Symptoms improved/consist 0.00 70.00 $0.00

1451F Sympt show clin import drop 0.00 70.00 $0.00

1460F Qual card diag prior 12 mons 0.00 70.00 $0.00

1461F No qual card diag prior12mon 0.00 70.00 $0.00

1490F Dem severity classified mild 0.00 70.00 $0.00

1491F Dem severity classified mod 0.00 70.00 $0.00

1493F Dem severity class severe 0.00 70.00 $0.00

1494F Cognit assessed and reviewed 0.00 70.00 $0.00

1500F Symptom+sign symm polyneuro 0.00 70.00 $0.00

15002 Wound prep trk/arm/leg 9.85 70.00 $689.50

15003 Wound prep addl 100 cm 2.16 70.00 $151.20

15004 Wound prep f/n/hf/g 11.42 70.00 $799.40

15005 Wnd prep f/n/hf/g addl cm 3.55 70.00 $248.50

1501F Not initial eval for cond 0.00 70.00 $0.00

1502F Pt queried pain fxn w/ instr 0.00 70.00 $0.00

1503F Pt queried symp resp insuff 0.00 70.00 $0.00

1504F Pt has resp insufficiency 0.00 70.00 $0.00

15040 Harvest cultured skin graft 7.21 70.00 $504.70

1505F Pt has no resp insufficiency 0.00 70.00 $0.00

15050 Skin pinch graft 16.14 70.00 $1,129.80

15100 Skin splt grft trnk/arm/leg 24.44 70.00 $1,710.80

15101 Skin splt grft t/a/l add-on 5.29 70.00 $370.30

15110 Epidrm autogrft trnk/arm/leg 23.26 70.00 $1,628.20

15111 Epidrm autogrft t/a/l add-on 3.32 70.00 $232.40

15115 Epidrm a-grft face/nck/hf/g 23.58 70.00 $1,650.60

15116 Epidrm a-grft f/n/hf/g addl 4.81 70.00 $336.70

15120 Skn splt a-grft fac/nck/hf/g 24.19 70.00 $1,693.30

15121 Skn splt a-grft f/n/hf/g add 5.92 70.00 $414.40

15130 Derm autograft trnk/arm/leg 19.34 70.00 $1,353.80

15131 Derm autograft t/a/l add-on 2.62 70.00 $183.40

15135 Derm autograft face/nck/hf/g 23.97 70.00 $1,677.90

15136 Derm autograft f/n/hf/g add 2.72 70.00 $190.40

15150 Cult skin grft t/arm/leg 19.91 70.00 $1,393.70

15151 Cult skin grft t/a/l addl 3.46 70.00 $242.20

15152 Cult skin graft t/a/l +% 4.27 70.00 $298.90

15155 Cult skin graft f/n/hf/g 19.69 70.00 $1,378.30

15156 Cult skin grft f/n/hfg add 4.67 70.00 $326.90

15157 Cult epiderm grft f/n/hfg +% 4.47 70.00 $312.90

15200 Skin full graft trunk 23.55 70.00 $1,648.50

15201 Skin full graft trunk add-on 4.20 70.00 $294.00

15220 Skin full graft sclp/arm/leg 21.85 70.00 $1,529.50

15221 Skin full graft add-on 3.89 70.00 $272.30

15240 Skin full grft face/genit/hf 26.47 70.00 $1,852.90

15260 Skin full graft een & lips 28.68 70.00 $2,007.60

15271 Skin sub graft trnk/arm/leg 4.00 70.00 $280.00

15272 Skin sub graft t/a/l add-on 0.77 70.00 $53.90

15273 Skin sub grft t/arm/lg child 8.45 70.00 $591.50

15274 Skn sub grft t/a/l child add 2.02 70.00 $141.40

15275 Skin sub graft face/nk/hf/g 4.24 70.00 $296.80

15276 Skin sub graft f/n/hf/g addl 0.97 70.00 $67.90

15277 Skn sub grft f/n/hf/g child 9.20 70.00 $644.00

15278 Skn sub grft f/n/hf/g ch add 2.42 70.00 $169.40

15570 Skin pedicle flap trunk 25.93 70.00 $1,815.10

15572 Skin pedicle flap arms/legs 25.19 70.00 $1,763.30

15574 Pedcle fh/ch/ch/m/n/ax/g/h/f 25.97 70.00 $1,817.90

15576 Pedicle e/n/e/l/ntroral 22.87 70.00 $1,600.90

15600 Delay flap trunk 9.17 70.00 $641.90

15610 Delay flap arms/legs 10.10 70.00 $707.00

15620 Delay flap f/c/c/n/ax/g/h/f 12.45 70.00 $871.50

15630 Delay flap eye/nos/ear/lip 13.04 70.00 $912.80

15650 Transfer skin pedicle flap 14.40 70.00 $1,008.00

15731 Forehead flap w/vasc pedicle 32.16 70.00 $2,251.20

15732 Muscle-skin graft head/neck 36.53 70.00 $2,557.10

15734 Muscle-skin graft trunk 42.84 70.00 $2,998.80

15736 Muscle-skin graft arm 37.56 70.00 $2,629.20

15738 Muscle-skin graft leg 39.96 70.00 $2,797.20

15740 Island pedicle flap graft 28.94 70.00 $2,025.80

15750 Neurovascular pedicle flap 26.46 70.00 $1,852.20

15756 Free myo/skin flap microvasc 66.88 70.00 $4,681.60

15757 Free skin flap microvasc 66.29 70.00 $4,640.30

15758 Free fascial flap microvasc 66.14 70.00 $4,629.80

15760 Composite skin graft 24.24 70.00 $1,696.80

15770 Derma-fat-fascia graft 19.22 70.00 $1,345.40

15775 Hair trnspl 1-15 punch grfts 8.29 70.00 $580.30

15776 Hair trnspl >15 punch grafts 13.56 70.00 $949.20

15777 Acellular derm matrix implt 6.16 70.00 $431.20

15780 Dermabrasion total face 24.12 70.00 $1,688.40

15781 Dermabrasion segmental face 15.68 70.00 $1,097.60

15782 Dermabrasion other than face 18.16 70.00 $1,271.20

15783 Dermabrasion suprfl any site 13.71 70.00 $959.70

15786 Abrasion lesion single 6.86 70.00 $480.20

15787 Abrasion lesions add-on 1.38 70.00 $96.60

15788 Chemical peel face epiderm 13.02 70.00 $911.40

15789 Chemical peel face dermal 15.76 70.00 $1,103.20

15792 Chemical peel nonfacial 12.25 70.00 $857.50

15793 Chemical peel nonfacial 13.93 70.00 $975.10

15819 Plastic surgery neck 22.65 70.00 $1,585.50

15820 Revision of lower eyelid 16.19 70.00 $1,133.30

15821 Revision of lower eyelid 17.15 70.00 $1,200.50

15822 Revision of upper eyelid 12.62 70.00 $883.40

15823 Revision of upper eyelid 17.17 70.00 $1,201.90

15824 Removal of forehead wrinkles 0.00 70.00 $0.00

15825 Removal of neck wrinkles 0.00 70.00 $0.00

15826 Removal of brow wrinkles 0.00 70.00 $0.00

15828 Removal of face wrinkles 0.00 70.00 $0.00

15829 Removal of skin wrinkles 0.00 70.00 $0.00

15830 Exc skin abd 33.64 70.00 $2,354.80

15832 Excise excessive skin thigh 26.17 70.00 $1,831.90

15833 Excise excessive skin leg 24.94 70.00 $1,745.80

15834 Excise excessive skin hip 25.40 70.00 $1,778.00

15835 Excise excessive skin buttck 26.81 70.00 $1,876.70

15836 Excise excessive skin arm 22.57 70.00 $1,579.90

15837 Excise excess skin arm/hand 25.28 70.00 $1,769.60

15838 Excise excess skin fat pad 16.35 70.00 $1,144.50

15839 Excise excess skin & tissue 25.10 70.00 $1,757.00

15840 Nerve palsy fascial graft 28.80 70.00 $2,016.00

15841 Nerve palsy muscle graft 46.01 70.00 $3,220.70

15842 Nerve palsy microsurg graft 70.28 70.00 $4,919.60

15845 Skin and muscle repair face 28.63 70.00 $2,004.10

15847 Exc skin abd add-on 0.00 70.00 $0.00

15850 Remove sutures same surgeon 2.46 70.00 $172.20

15851 Remove sutures diff surgeon 2.80 70.00 $196.00

15852 Dressing change not for burn 1.36 70.00 $95.20

15860 Test for blood flow in graft 3.20 70.00 $224.00

15876 Suction lipectomy head&neck 0.00 70.00 $0.00

15877 Suction lipectomy trunk 0.00 70.00 $0.00

15878 Suction lipectomy upr extrem 0.00 70.00 $0.00

15879 Suction lipectomy lwr extrem 0.00 70.00 $0.00

15920 Removal of tail bone ulcer 17.21 70.00 $1,204.70

15922 Removal of tail bone ulcer 22.34 70.00 $1,563.80

15931 Remove sacrum pressure sore 19.70 70.00 $1,379.00

15940 Remove hip pressure sore 20.04 70.00 $1,402.80

15950 Remove thigh pressure sore 16.91 70.00 $1,183.70

15999 Removal of pressure sore 0.00 70.00 $0.00

16000 Initial treatment of burn(s) 1.95 70.00 $136.50

16020 Dress/debrid p-thick burn s 2.32 70.00 $162.40

16025 Dress/debrid p-thick burn m 4.21 70.00 $294.70

16030 Dress/debrid p-thick burn l 5.19 70.00 $363.30

16035 Incision of burn scab initi 5.59 70.00 $391.30

16036 Escharotomy addl incision 2.34 70.00 $163.80

17000 Destruct premalg lesion 1.87 70.00 $130.90

17003 Destruct premalg les 2-14 0.16 70.00 $11.20

17004 Destroy premal lesions 15/> 4.23 70.00 $296.10

17106 Destruction of skin lesions 9.67 70.00 $676.90

17108 Destruction of skin lesions 18.17 70.00 $1,271.90

17110 Destruct b9 lesion 1-14 3.12 70.00 $218.40

17111 Destruct lesion 15 or more 3.70 70.00 $259.00

17250 Chemical cautery tissue 2.24 70.00 $156.80

17311 Mohs 1 stage h/n/hf/g 18.63 70.00 $1,304.10

17312 Mohs addl stage 10.95 70.00 $766.50

17313 Mohs 1 stage t/a/l 17.43 70.00 $1,220.10

17314 Mohs addl stage t/a/l 10.50 70.00 $735.00

17315 Mohs surg addl block 2.25 70.00 $157.50

17340 Cryotherapy of skin 1.47 70.00 $102.90

17360 Skin peel therapy 3.63 70.00 $254.10

17380 Hair removal by electrolysis 0.00 70.00 $0.00

17999 Skin tissue procedure 0.00 70.00 $0.00

19000 Drainage of breast lesion 3.21 70.00 $224.70

19001 Drain breast lesion add-on 0.77 70.00 $53.90

19020 Incision of breast lesion 13.41 70.00 $938.70

19030 Injection for breast x-ray 4.71 70.00 $329.70

19081 Bx breast 1st lesion strtctc 18.86 70.00 $1,320.20

19082 Bx breast add lesion strtctc 15.46 70.00 $1,082.20

19083 Bx breast 1st lesion us imag 18.43 70.00 $1,290.10

19084 Bx breast add lesion us imag 14.88 70.00 $1,041.60

19085 Bx breast 1st lesion mr imag 29.12 70.00 $2,038.40

19086 Bx breast add lesion mr imag 23.26 70.00 $1,628.20

19100 Bx breast percut w/o image 4.31 70.00 $301.70

19101 Biopsy of breast open 9.70 70.00 $679.00

19105 Cryosurg ablate fa each 70.83 70.00 $4,958.10

19110 Nipple exploration 13.79 70.00 $965.30

19112 Excise breast duct fistula 13.14 70.00 $919.80

19120 Removal of breast lesion 14.06 70.00 $984.20

19125 Excision breast lesion 15.63 70.00 $1,094.10

19126 Excision addl breast lesion 4.68 70.00 $327.60

19260 Removal of chest wall lesion 34.63 70.00 $2,424.10

19271 Revision of chest wall 46.86 70.00 $3,280.20

19272 Extensive chest wall surgery 51.44 70.00 $3,600.80

19281 Perq device breast 1st imag 6.80 70.00 $476.00

19282 Perq device breast ea imag 4.76 70.00 $333.20

19283 Perq dev breast 1st strtctc 7.75 70.00 $542.50

19284 Perq dev breast add strtctc 5.73 70.00 $401.10

19285 Perq dev breast 1st us imag 12.64 70.00 $884.80

19286 Perq dev breast add us imag 10.74 70.00 $751.80

19287 Perq dev breast 1st mr guide 24.70 70.00 $1,729.00

19288 Perq dev breast add mr guide 19.84 70.00 $1,388.80

19296 Place po breast cath for rad 110.94 70.00 $7,765.80

19297 Place breast cath for rad 2.74 70.00 $191.80

19298 Place breast rad tube/caths 29.67 70.00 $2,076.90

19300 Removal of breast tissue 14.93 70.00 $1,045.10

19301 Partial mastectomy 18.74 70.00 $1,311.80

19302 P-mastectomy w/ln removal 25.86 70.00 $1,810.20

19303 Mast simple complete 29.03 70.00 $2,032.10

19304 Mast subq 16.48 70.00 $1,153.60

19305 Mast radical 32.38 70.00 $2,266.60

19306 Mast rad urban type 34.43 70.00 $2,410.10

19307 Mast mod rad 34.39 70.00 $2,407.30

19316 Suspension of breast 22.08 70.00 $1,545.60

19318 Reduction of large breast 31.59 70.00 $2,211.30

19324 Enlarge breast 14.07 70.00 $984.90

19325 Enlarge breast with implant 18.39 70.00 $1,287.30

19328 Removal of breast implant 14.17 70.00 $991.90

19330 Removal of implant material 18.15 70.00 $1,270.50

19340 Immediate breast prosthesis 28.74 70.00 $2,011.80

19342 Delayed breast prosthesis 26.42 70.00 $1,849.40

19350 Breast reconstruction 23.45 70.00 $1,641.50

19355 Correct inverted nipple(s) 20.06 70.00 $1,404.20

19361 Breast reconstr w/lat flap 45.16 70.00 $3,161.20

19370 Surgery of breast capsule 19.63 70.00 $1,374.10

19371 Removal of breast capsule 22.46 70.00 $1,572.20

19380 Revise breast reconstruction 22.13 70.00 $1,549.10

19396 Design custom breast implant 8.29 70.00 $580.30

19499 Breast surgery procedure 0.00 70.00 $0.00

2000F Blood pressure measure 0.00 70.00 $0.00

20005 I&d abscess subfascial 8.76 70.00 $613.20

2001F Weight record 0.00 70.00 $0.00

2002F Clin sign vol ovrld assess 0.00 70.00 $0.00

2004F Initial exam involved joints 0.00 70.00 $0.00

2010F Vital signs recorded 0.00 70.00 $0.00

20100 Explore wound neck 17.56 70.00 $1,229.20

20101 Explore wound chest 12.87 70.00 $900.90

20102 Explore wound abdomen 13.97 70.00 $977.90

20103 Explore wound extremity 16.57 70.00 $1,159.90

2014F Mental status assess 0.00 70.00 $0.00

2015F Asthma impairment assessed 0.00 70.00 $0.00

20150 Excise epiphyseal bar 26.08 70.00 $1,825.60

2016F Asthma risk assessed 0.00 70.00 $0.00

2018F Hydration status assess 0.00 70.00 $0.00

2019F Dilated macul exam done 0.00 70.00 $0.00

2020F Dilated fundus eval done 0.00 70.00 $0.00

20200 Muscle biopsy 5.91 70.00 $413.70

20205 Deep muscle biopsy 8.24 70.00 $576.80

20206 Needle biopsy muscle 6.71 70.00 $469.70

2021F Dilat maculor exam done 0.00 70.00 $0.00

2022F Dil retina exam interp rev 0.00 70.00 $0.00

20220 Bone biopsy trocar/needle 4.79 70.00 $335.30

20225 Bone biopsy trocar/needle 14.94 70.00 $1,045.80

2024F 7 field photo interp doc rev 0.00 70.00 $0.00

20240 Bone biopsy excisional 6.23 70.00 $436.10

20245 Bone biopsy excisional 17.70 70.00 $1,239.00

20250 Open bone biopsy 11.35 70.00 $794.50

20251 Open bone biopsy 12.14 70.00 $849.80

2026F Eye image valid to dx rev 0.00 70.00 $0.00

2027F Optic nerve head eval done 0.00 70.00 $0.00

2028F Foot exam performed 0.00 70.00 $0.00

2029F Complete phys skin exam done 0.00 70.00 $0.00

2030F H2o stat docd normal 0.00 70.00 $0.00

2031F H2o stat docd dehydrated 0.00 70.00 $0.00

2035F Tymp memb motion examd 0.00 70.00 $0.00

2040F Bk pn xm on init visit date 0.00 70.00 $0.00

2044F Doc mntl tst b/4 bk trxmnt 0.00 70.00 $0.00

2050F Wound char size etc docd 0.00 70.00 $0.00

20500 Injection of sinus tract 2.98 70.00 $208.60

20501 Inject sinus tract for x-ray 3.36 70.00 $235.20

20520 Removal of foreign body 5.79 70.00 $405.30

20525 Removal of foreign body 13.70 70.00 $959.00

20526 Ther injection carp tunnel 2.20 70.00 $154.00

20527 Inj dupuytren cord w/enzyme 2.40 70.00 $168.00

20550 Inj tendon sheath/ligament 1.68 70.00 $117.60

20551 Inj tendon origin/insertion 1.72 70.00 $120.40

20552 Inj trigger point 1/2 muscl 1.56 70.00 $109.20

20553 Inject trigger points 3/> 1.81 70.00 $126.70

20555 Place ndl musc/tis for rt 9.56 70.00 $669.20

2060F Pt talk eval hlthwkr re mdd 0.00 70.00 $0.00

20600 Drain/inj joint/bursa w/o us 1.35 70.00 $94.50

20604 Drain/inj joint/bursa w/us 2.05 70.00 $143.50

20612 Aspirate/inj ganglion cyst 1.73 70.00 $121.10

20615 Treatment of bone cyst 7.03 70.00 $492.10

20650 Insert and remove bone pin 5.87 70.00 $410.90

20660 Apply rem fixation device 7.19 70.00 $503.30

20661 Application of head brace 14.64 70.00 $1,024.80

20662 Application of pelvis brace 13.34 70.00 $933.80

20663 Application of thigh brace 11.30 70.00 $791.00

20664 Application of halo 25.55 70.00 $1,788.50

20665 Removal of fixation device 2.98 70.00 $208.60

20670 Removal of support implant 10.82 70.00 $757.40

20680 Removal of support implant 17.66 70.00 $1,236.20

20690 Apply bone fixation device 17.14 70.00 $1,199.80

20692 Apply bone fixation device 32.19 70.00 $2,253.30

20693 Adjust bone fixation device 12.87 70.00 $900.90

20694 Remove bone fixation device 12.15 70.00 $850.50

20696 Comp multiplane ext fixation 34.86 70.00 $2,440.20

20697 Comp ext fixate strut change 59.98 70.00 $4,198.60

20802 Replantation arm complete 79.80 70.00 $5,586.00

20805 Replant forearm complete 94.60 70.00 $6,622.00

20808 Replantation hand complete 114.53 70.00 $8,017.10

20816 Replantation digit complete 60.50 70.00 $4,235.00

20822 Replantation digit complete 51.72 70.00 $3,620.40

20824 Replantation thumb complete 58.59 70.00 $4,101.30

20827 Replantation thumb complete 53.16 70.00 $3,721.20

20838 Replantation foot complete 62.20 70.00 $4,354.00

20900 Removal of bone for graft 11.98 70.00 $838.60

20902 Removal of bone for graft 8.28 70.00 $579.60

20910 Remove cartilage for graft 13.11 70.00 $917.70

20912 Remove cartilage for graft 13.75 70.00 $962.50

20920 Removal of fascia for graft 11.31 70.00 $791.70

20922 Removal of fascia for graft 17.31 70.00 $1,211.70

20924 Removal of tendon for graft 14.60 70.00 $1,022.00

20926 Removal of tissue for graft 12.35 70.00 $864.50

20930 Sp bone algrft morsel add-on 0.00 70.00 $0.00

20931 Sp bone algrft struct add-on 3.31 70.00 $231.70

20936 Sp bone agrft local add-on 0.00 70.00 $0.00

20937 Sp bone agrft morsel add-on 4.91 70.00 $343.70

20938 Sp bone agrft struct add-on 5.44 70.00 $380.80

20950 Fluid pressure muscle 7.02 70.00 $491.40

20955 Fibula bone graft microvasc 72.71 70.00 $5,089.70

20956 Iliac bone graft microvasc 76.74 70.00 $5,371.80

20957 Mt bone graft microvasc 60.69 70.00 $4,248.30

20962 Other bone graft microvasc 58.38 70.00 $4,086.60

20969 Bone/skin graft microvasc 79.50 70.00 $5,565.00

20970 Bone/skin graft iliac crest 83.02 70.00 $5,811.40

20972 Bone/skin graft metatarsal 66.11 70.00 $4,627.70

20973 Bone/skin graft great toe 72.90 70.00 $5,103.00

20974 Electrical bone stimulation 2.19 70.00 $153.30

20975 Electrical bone stimulation 5.19 70.00 $363.30

20979 Us bone stimulation 1.47 70.00 $102.90

20982 Ablate bone tumor(s) perq 106.17 70.00 $7,431.90

20983 Ablate bone tumor(s) perq 196.22 70.00 $13,735.40

20985 Cptr-asst dir ms px 4.27 70.00 $298.90

20999 Musculoskeletal surgery 0.00 70.00 $0.00

21010 Incision of jaw joint 21.93 70.00 $1,535.10

21011 Exc face les sc <2 cm 9.93 70.00 $695.10

21012 Exc face les sbq 2 cm/> 9.70 70.00 $679.00

21013 Exc face tum deep < 2 cm 14.81 70.00 $1,036.70

21014 Exc face tum deep 2 cm/> 14.94 70.00 $1,045.80

21015 Resect face/scalp tum < 2 cm 20.30 70.00 $1,421.00

21016 Resect face/scalp tum 2 cm/> 29.39 70.00 $2,057.30

21025 Excision of bone lower jaw 25.76 70.00 $1,803.20

21026 Excision of facial bone(s) 17.83 70.00 $1,248.10

21029 Contour of face bone lesion 21.96 70.00 $1,537.20

21030 Excise max/zygoma b9 tumor 14.97 70.00 $1,047.90

21031 Remove exostosis mandible 11.40 70.00 $798.00

21032 Remove exostosis maxilla 11.56 70.00 $809.20

21034 Excise max/zygoma mal tumor 38.09 70.00 $2,666.30

21040 Excise mandible lesion 15.11 70.00 $1,057.70

21044 Removal of jaw bone lesion 25.41 70.00 $1,778.70

21045 Extensive jaw surgery 35.41 70.00 $2,478.70

21046 Remove mandible cyst complex 32.44 70.00 $2,270.80

21047 Excise lwr jaw cyst w/repair 38.26 70.00 $2,678.20

21048 Remove maxilla cyst complex 33.31 70.00 $2,331.70

21049 Excis uppr jaw cyst w/repair 35.00 70.00 $2,450.00

21050 Removal of jaw joint 24.29 70.00 $1,700.30

21060 Remove jaw joint cartilage 23.45 70.00 $1,641.50

21070 Remove coronoid process 17.81 70.00 $1,246.70

21073 Mnpj of tmj w/anesth 11.38 70.00 $796.60

21076 Prepare face/oral prosthesis 29.09 70.00 $2,036.30

21088 Prepare face/oral prosthesis 0.00 70.00 $0.00

21089 Prepare face/oral prosthesis 0.00 70.00 $0.00

21100 Maxillofacial fixation 33.16 70.00 $2,321.20

21110 Interdental fixation 23.35 70.00 $1,634.50

21116 Injection jaw joint x-ray 4.23 70.00 $296.10

21120 Reconstruction of chin 17.24 70.00 $1,206.80

21125 Augmentation lower jaw bone 89.96 70.00 $6,297.20

21127 Augmentation lower jaw bone 124.47 70.00 $8,712.90

21137 Reduction of forehead 19.94 70.00 $1,395.80

21141 Lefort i-1 piece w/o graft 38.98 70.00 $2,728.60

21142 Lefort i-2 piece w/o graft 41.69 70.00 $2,918.30

21143 Lefort i-3/> piece w/o graft 42.06 70.00 $2,944.20

21145 Lefort i-1 piece w/ graft 47.24 70.00 $3,306.80

21146 Lefort i-2 piece w/ graft 49.20 70.00 $3,444.00

21147 Lefort i-3/> piece w/ graft 52.00 70.00 $3,640.00

21150 Lefort ii anterior intrusion 48.48 70.00 $3,393.60

21151 Lefort ii w/bone grafts 59.29 70.00 $4,150.30

21154 Lefort iii w/o lefort i 63.78 70.00 $4,464.60

21155 Lefort iii w/ lefort i 67.82 70.00 $4,747.40

21159 Lefort iii w/fhdw/o lefort i 69.37 70.00 $4,855.90

21160 Lefort iii w/fhd w/ lefort i 75.27 70.00 $5,268.90

21172 Reconstruct orbit/forehead 50.90 70.00 $3,563.00

21175 Reconstruct orbit/forehead 66.81 70.00 $4,676.70

21179 Reconstruct entire forehead 37.67 70.00 $2,636.90

21180 Reconstruct entire forehead 44.10 70.00 $3,087.00

21181 Contour cranial bone lesion 21.25 70.00 $1,487.50

21182 Reconstruct cranial bone 55.19 70.00 $3,863.30

21188 Reconstruction of midface 45.09 70.00 $3,156.30

21193 Reconst lwr jaw w/o graft 34.26 70.00 $2,398.20

21194 Reconst lwr jaw w/graft 43.24 70.00 $3,026.80

21195 Reconst lwr jaw w/o fixation 38.70 70.00 $2,709.00

21196 Reconst lwr jaw w/fixation 42.66 70.00 $2,986.20

21198 Reconstr lwr jaw segment 33.60 70.00 $2,352.00

21199 Reconstr lwr jaw w/advance 28.97 70.00 $2,027.90

21206 Reconstruct upper jaw bone 35.73 70.00 $2,501.10

21208 Augmentation of facial bones 54.87 70.00 $3,840.90

21209 Reduction of facial bones 23.24 70.00 $1,626.80

21210 Face bone graft 66.10 70.00 $4,627.00

21215 Lower jaw bone graft 118.03 70.00 $8,262.10

21230 Rib cartilage graft 21.93 70.00 $1,535.10

21235 Ear cartilage graft 20.79 70.00 $1,455.30

21240 Reconstruction of jaw joint 32.44 70.00 $2,270.80

21244 Reconstruction of lower jaw 30.80 70.00 $2,156.00

21245 Reconstruction of jaw 31.77 70.00 $2,223.90

21247 Reconstruct lower jaw bone 43.97 70.00 $3,077.90

21255 Reconstruct lower jaw bone 37.96 70.00 $2,657.20

21256 Reconstruction of orbit 34.32 70.00 $2,402.40

21260 Revise eye sockets 32.95 70.00 $2,306.50

21270 Augmentation cheek bone 27.61 70.00 $1,932.70

21275 Revision orbitofacial bones 24.04 70.00 $1,682.80

21280 Revision of eyelid 16.24 70.00 $1,136.80

21282 Revision of eyelid 10.84 70.00 $758.80

21295 Revision of jaw muscle/bone 5.41 70.00 $378.70

21296 Revision of jaw muscle/bone 12.06 70.00 $844.20

21299 Cranio/maxillofacial surgery 0.00 70.00 $0.00

21310 Closed tx nose fx w/o manj 3.75 70.00 $262.50

21315 Closed tx nose fx w/o stablj 7.97 70.00 $557.90

21320 Closed tx nose fx w/ stablj 7.34 70.00 $513.80

21325 Open tx nose fx uncomplicatd 13.70 70.00 $959.00

21330 Open tx nose fx w/skele fixj 16.46 70.00 $1,152.20

21335 Open tx nose & septal fx 20.85 70.00 $1,459.50

21336 Open tx septal fx w/wo stabj 18.51 70.00 $1,295.70

21337 Closed tx septal&nose fx 11.63 70.00 $814.10

21338 Open nasoethmoid fx w/o fixj 21.60 70.00 $1,512.00

21339 Open nasoethmoid fx w/ fixj 24.48 70.00 $1,713.60

21340 Perq tx nasoethmoid fx 22.95 70.00 $1,606.50

21343 Open tx dprsd front sinus fx 34.94 70.00 $2,445.80

21344 Open tx compl front sinus fx 40.06 70.00 $2,804.20

21345 Closed tx nose/jaw fx 22.40 70.00 $1,568.00

21346 Opn tx nasomax fx w/fixj 26.00 70.00 $1,820.00

21347 Opn tx nasomax fx multple 32.72 70.00 $2,290.40

21348 Opn tx nasomax fx w/graft 34.73 70.00 $2,431.10

21355 Perq tx malar fracture 13.87 70.00 $970.90

21356 Opn tx dprsd zygomatic arch 14.41 70.00 $1,008.70

21360 Opn tx dprsd malar fracture 15.47 70.00 $1,082.90

21365 Opn tx complx malar fx 32.02 70.00 $2,241.40

21366 Opn tx complx malar w/grft 33.39 70.00 $2,337.30

21385 Opn tx orbit fx transantral 19.61 70.00 $1,372.70

21386 Opn tx orbit fx periorbital 20.00 70.00 $1,400.00

21387 Opn tx orbit fx combined 20.47 70.00 $1,432.90

21390 Opn tx orbit periorbtl implt 22.77 70.00 $1,593.90

21395 Opn tx orbit periorbt w/grft 28.98 70.00 $2,028.60

21400 Closed tx orbit w/o manipulj 5.55 70.00 $388.50

21401 Closed tx orbit w/manipulj 14.11 70.00 $987.70

21406 Opn tx orbit fx w/o implant 16.44 70.00 $1,150.80

21407 Opn tx orbit fx w/implant 18.51 70.00 $1,295.70

21408 Opn tx orbit fx w/bone grft 25.84 70.00 $1,808.80

21421 Treat mouth roof fracture 24.22 70.00 $1,695.40

21431 Treat craniofacial fracture 22.68 70.00 $1,587.60

21440 Treat dental ridge fracture 16.66 70.00 $1,166.20

21445 Treat dental ridge fracture 22.34 70.00 $1,563.80

21450 Treat lower jaw fracture 18.03 70.00 $1,262.10

21480 Reset dislocated jaw 2.82 70.00 $197.40

21485 Reset dislocated jaw 20.36 70.00 $1,425.20

21490 Repair dislocated jaw 26.61 70.00 $1,862.70

21495 Treat hyoid bone fracture 18.37 70.00 $1,285.90

21497 Interdental wiring 21.27 70.00 $1,488.90

21499 Head surgery procedure 0.00 70.00 $0.00

21501 Drain neck/chest lesion 12.95 70.00 $906.50

21502 Drain chest lesion 14.65 70.00 $1,025.50

21510 Drainage of bone lesion 12.69 70.00 $888.30

21550 Biopsy of neck/chest 7.49 70.00 $524.30

21552 Exc neck les sc 3 cm/> 12.85 70.00 $899.50

21554 Exc neck tum deep 5 cm/> 21.08 70.00 $1,475.60

21555 Exc neck les sc < 3 cm 11.88 70.00 $831.60

21556 Exc neck tum deep < 5 cm 15.25 70.00 $1,067.50

21557 Resect neck thorax tumor<5cm 27.62 70.00 $1,933.40

21558 Resect neck tumor 5 cm/> 38.77 70.00 $2,713.90

21600 Partial removal of rib 16.06 70.00 $1,124.20

21610 Partial removal of rib 35.47 70.00 $2,482.90

21615 Removal of rib 18.06 70.00 $1,264.20

21616 Removal of rib and nerves 21.14 70.00 $1,479.80

21620 Partial removal of sternum 14.55 70.00 $1,018.50

21627 Sternal debridement 15.64 70.00 $1,094.80

21630 Extensive sternum surgery 34.66 70.00 $2,426.20

21632 Extensive sternum surgery 34.80 70.00 $2,436.00

21685 Hyoid myotomy & suspension 28.65 70.00 $2,005.50

21700 Revision of neck muscle 10.63 70.00 $744.10

21705 Revision of neck muscle/rib 15.85 70.00 $1,109.50

21720 Revision of neck muscle 13.83 70.00 $968.10

21725 Revision of neck muscle 15.57 70.00 $1,089.90

21740 Reconstruction of sternum 29.85 70.00 $2,089.50

21742 Repair stern/nuss w/o scope 0.00 70.00 $0.00

21743 Repair sternum/nuss w/scope 0.00 70.00 $0.00

21750 Repair of sternum separation 19.79 70.00 $1,385.30

21805 Treatment of rib fracture 7.81 70.00 $546.70

21811 Optx of rib fx w/fixj scope 17.49 70.00 $1,224.30

21812 Treatment of rib fracture 20.97 70.00 $1,467.90

21813 Treatment of rib fracture 28.54 70.00 $1,997.80

21820 Treat sternum fracture 4.07 70.00 $284.90

21825 Treat sternum fracture 15.60 70.00 $1,092.00

21899 Neck/chest surgery procedure 0.00 70.00 $0.00

21920 Biopsy soft tissue of back 7.30 70.00 $511.00

21925 Biopsy soft tissue of back 12.79 70.00 $895.30

21930 Exc back les sc < 3 cm 13.50 70.00 $945.00

21931 Exc back les sc 3 cm/> 13.52 70.00 $946.40

21932 Exc back tum deep < 5 cm 19.04 70.00 $1,332.80

21933 Exc back tum deep 5 cm/> 21.29 70.00 $1,490.30

21935 Resect back tum < 5 cm 29.54 70.00 $2,067.80

21936 Resect back tum 5 cm/> 40.72 70.00 $2,850.40

22010 I&d p-spine c/t/cerv-thor 27.59 70.00 $1,931.30

22015 I&d abscess p-spine l/s/ls 26.20 70.00 $1,834.00

22100 Remove part of neck vertebra 27.20 70.00 $1,904.00

22101 Remove part thorax vertebra 23.79 70.00 $1,665.30

22102 Remove part lumbar vertebra 23.04 70.00 $1,612.80

22103 Remove extra spine segment 4.10 70.00 $287.00

22110 Remove part of neck vertebra 30.42 70.00 $2,129.40

22112 Remove part thorax vertebra 33.02 70.00 $2,311.40

22114 Remove part lumbar vertebra 28.75 70.00 $2,012.50

22116 Remove extra spine segment 4.14 70.00 $289.80

22206 Incis spine 3 column thorac 71.30 70.00 $4,991.00

22207 Incis spine 3 column lumbar 69.78 70.00 $4,884.60

22208 Incis spine 3 column adl seg 16.75 70.00 $1,172.50

22210 Incis 1 vertebral seg cerv 52.17 70.00 $3,651.90

22212 Incis 1 vertebral seg thorac 43.20 70.00 $3,024.00

22214 Incis 1 vertebral seg lumbar 43.15 70.00 $3,020.50

22216 Incis addl spine segment 10.65 70.00 $745.50

22220 Incis w/discectomy cervical 46.43 70.00 $3,250.10

22222 Incis w/discectomy thoracic 45.26 70.00 $3,168.20

22224 Incis w/discectomy lumbar 45.89 70.00 $3,212.30

22226 Revise extra spine segment 10.59 70.00 $741.30

22305 Closed tx spine process fx 5.47 70.00 $382.90

22310 Closed tx vert fx w/o manj 8.82 70.00 $617.40

22315 Closed tx vert fx w/manj 25.56 70.00 $1,789.20

22318 Treat odontoid fx w/o graft 48.08 70.00 $3,365.60

22319 Treat odontoid fx w/graft 54.13 70.00 $3,789.10

22325 Treat spine fracture 41.71 70.00 $2,919.70

22326 Treat neck spine fracture 43.74 70.00 $3,061.80

22327 Treat thorax spine fracture 43.88 70.00 $3,071.60

22328 Treat each add spine fx 8.33 70.00 $583.10

22505 Manipulation of spine 3.83 70.00 $268.10

22510 Perq cervicothoracic inject 50.11 70.00 $3,507.70

22511 Perq lumbosacral injection 49.65 70.00 $3,475.50

22512 Vertebroplasty addl inject 27.87 70.00 $1,950.90

22513 Perq vertebral augmentation 208.61 70.00 $14,602.70

22526 Idet single level 67.37 70.00 $4,715.90

22527 Idet 1 or more levels 56.07 70.00 $3,924.90

22532 Lat thorax spine fusion 51.88 70.00 $3,631.60

22533 Lat lumbar spine fusion 47.94 70.00 $3,355.80

22534 Lat thor/lumb addl seg 10.55 70.00 $738.50

22548 Neck spine fusion 58.16 70.00 $4,071.20

22551 Neck spine fuse&remov bel c2 50.22 70.00 $3,515.40

22552 Addl neck spine fusion 11.77 70.00 $823.90

22556 Thorax spine fusion 48.86 70.00 $3,420.20

22558 Lumbar spine fusion 44.86 70.00 $3,140.20

22585 Additional spinal fusion 9.67 70.00 $676.90

22586 Prescrl fuse w/ instr l5-s1 59.10 70.00 $4,137.00

22590 Spine & skull spinal fusion 46.26 70.00 $3,238.20

22595 Neck spinal fusion 44.23 70.00 $3,096.10

22610 Thorax spine fusion 36.88 70.00 $2,581.60

22614 Spine fusion extra segment 11.54 70.00 $807.80

22632 Spine fusion extra segment 9.46 70.00 $662.20

22633 Lumbar spine fusion combined 54.19 70.00 $3,793.30

22634 Spine fusion extra segment 14.60 70.00 $1,022.00

22800 Post fusion </6 vert seg 39.35 70.00 $2,754.50

22802 Post fusion 7-12 vert seg 61.10 70.00 $4,277.00

22804 Post fusion 13/> vert seg 70.83 70.00 $4,958.10

22808 Ant fusion 2-3 vert seg 53.89 70.00 $3,772.30

22810 Ant fusion 4-7 vert seg 58.91 70.00 $4,123.70

22812 Ant fusion 8/> vert seg 64.19 70.00 $4,493.30

22818 Kyphectomy 1-2 segments 63.07 70.00 $4,414.90

22819 Kyphectomy 3 or more 81.52 70.00 $5,706.40

22830 Exploration of spinal fusion 23.65 70.00 $1,655.50

22840 Insert spine fixation device 22.37 70.00 $1,565.90

22841 Insert spine fixation device 0.00 70.00 $0.00

22848 Insert pelv fixation device 10.56 70.00 $739.20

22849 Reinsert spinal fixation 37.99 70.00 $2,659.30

22850 Remove spine fixation device 21.07 70.00 $1,474.90

22851 Apply spine prosth device 11.98 70.00 $838.60

22856 Cerv artific diskectomy 46.46 70.00 $3,252.20

22857 Lumbar artif diskectomy 51.55 70.00 $3,608.50

22858 Second level cer diskectomy 14.52 70.00 $1,016.40

22861 Revise cerv artific disc 55.93 70.00 $3,915.10

22862 Revise lumbar artif disc 50.71 70.00 $3,549.70

22864 Remove cerv artif disc 61.60 70.00 $4,312.00

22865 Remove lumb artif disc 59.49 70.00 $4,164.30

22899 Spine surgery procedure 0.00 70.00 $0.00

22900 Exc abdl tum deep < 5 cm 16.23 70.00 $1,136.10

22901 Exc abdl tum deep 5 cm/> 19.15 70.00 $1,340.50

22902 Exc abd les sc < 3 cm 12.54 70.00 $877.80

22903 Exc abd les sc 3 cm/> 12.64 70.00 $884.80

22904 Radical resect abd tumor<5cm 30.34 70.00 $2,123.80

22905 Rad resect abd tumor 5 cm/> 38.31 70.00 $2,681.70

22999 Abdomen surgery procedure 0.00 70.00 $0.00

23000 Removal of calcium deposits 16.80 70.00 $1,176.00

23020 Release shoulder joint 19.83 70.00 $1,388.10

23030 Drain shoulder lesion 12.62 70.00 $883.40

23031 Drain shoulder bursa 12.21 70.00 $854.70

23035 Drain shoulder bone lesion 19.59 70.00 $1,371.30

23040 Exploratory shoulder surgery 20.70 70.00 $1,449.00

23044 Exploratory shoulder surgery 16.46 70.00 $1,152.20

23065 Biopsy shoulder tissues 6.16 70.00 $431.20

23066 Biopsy shoulder tissues 15.91 70.00 $1,113.70

23071 Exc shoulder les sc 3 cm/> 12.05 70.00 $843.50

23073 Exc shoulder tum deep 5 cm/> 19.96 70.00 $1,397.20

23075 Exc shoulder les sc < 3 cm 13.38 70.00 $936.60

23076 Exc shoulder tum deep < 5 cm 15.50 70.00 $1,085.00

23077 Resect shoulder tumor < 5 cm 32.85 70.00 $2,299.50

23078 Resect shoulder tumor 5 cm/> 41.22 70.00 $2,885.40

23100 Biopsy of shoulder joint 14.39 70.00 $1,007.30

23101 Shoulder joint surgery 12.91 70.00 $903.70

23105 Remove shoulder joint lining 18.32 70.00 $1,282.40

23106 Incision of collarbone joint 14.28 70.00 $999.60

23107 Explore treat shoulder joint 18.97 70.00 $1,327.90

23120 Partial removal collar bone 16.80 70.00 $1,176.00

23125 Removal of collar bone 20.44 70.00 $1,430.80

23130 Remove shoulder bone part 17.55 70.00 $1,228.50

23140 Removal of bone lesion 15.18 70.00 $1,062.60

23150 Removal of humerus lesion 19.07 70.00 $1,334.90

23170 Remove collar bone lesion 16.13 70.00 $1,129.10

23172 Remove shoulder blade lesion 16.29 70.00 $1,140.30

23174 Remove humerus lesion 21.84 70.00 $1,528.80

23180 Remove collar bone lesion 19.22 70.00 $1,345.40

23182 Remove shoulder blade lesion 18.97 70.00 $1,327.90

23190 Partial removal of scapula 16.45 70.00 $1,151.50

23195 Removal of head of humerus 21.78 70.00 $1,524.60

23200 Resect clavicle tumor 43.87 70.00 $3,070.90

23210 Resect scapula tumor 51.57 70.00 $3,609.90

23220 Resect prox humerus tumor 56.53 70.00 $3,957.10

23330 Remove shoulder foreign body 6.88 70.00 $481.60

23333 Remove shoulder fb deep 13.08 70.00 $915.60

23334 Shoulder prosthesis removal 30.88 70.00 $2,161.60

23335 Shoulder prosthesis removal 36.78 70.00 $2,574.60

23350 Injection for shoulder x-ray 3.73 70.00 $261.10

23395 Muscle transfer shoulder/arm 37.00 70.00 $2,590.00

23397 Muscle transfers 32.98 70.00 $2,308.60

23400 Fixation of shoulder blade 28.01 70.00 $1,960.70

23405 Incision of tendon & muscle 17.97 70.00 $1,257.90

23406 Incise tendon(s) & muscle(s) 22.18 70.00 $1,552.60

23410 Repair rotator cuff acute 23.67 70.00 $1,656.90

23412 Repair rotator cuff chronic 24.53 70.00 $1,717.10

23415 Release of shoulder ligament 20.09 70.00 $1,406.30

23420 Repair of shoulder 27.89 70.00 $1,952.30

23430 Repair biceps tendon 21.49 70.00 $1,504.30

23440 Remove/transplant tendon 21.76 70.00 $1,523.20

23450 Repair shoulder capsule 27.38 70.00 $1,916.60

23470 Reconstruct shoulder joint 34.70 70.00 $2,429.00

23472 Reconstruct shoulder joint 42.05 70.00 $2,943.50

23473 Revis reconst shoulder joint 46.97 70.00 $3,287.90

23474 Revis reconst shoulder joint 50.80 70.00 $3,556.00

23480 Revision of collar bone 23.68 70.00 $1,657.60

23485 Revision of collar bone 27.49 70.00 $1,924.30

23490 Reinforce clavicle 24.87 70.00 $1,740.90

23491 Reinforce shoulder bones 29.21 70.00 $2,044.70

23500 Treat clavicle fracture 6.20 70.00 $434.00

23505 Treat clavicle fracture 10.07 70.00 $704.90

23515 Treat clavicle fracture 20.71 70.00 $1,449.70

23520 Treat clavicle dislocation 6.61 70.00 $462.70

23530 Treat clavicle dislocation 16.49 70.00 $1,154.30

23570 Treat shoulder blade fx 6.61 70.00 $462.70

23575 Treat shoulder blade fx 11.47 70.00 $802.90

23585 Treat scapula fracture 28.23 70.00 $1,976.10

23600 Treat humerus fracture 9.28 70.00 $649.60

23615 Treat humerus fracture 25.46 70.00 $1,782.20

23650 Treat shoulder dislocation 8.92 70.00 $624.40

23655 Treat shoulder dislocation 11.49 70.00 $804.30

23660 Treat shoulder dislocation 16.66 70.00 $1,166.20

23665 Treat dislocation/fracture 12.12 70.00 $848.40

23670 Treat dislocation/fracture 25.28 70.00 $1,769.60

23700 Fixation of shoulder 5.66 70.00 $396.20

23800 Fusion of shoulder joint 29.61 70.00 $2,072.70

23802 Fusion of shoulder joint 37.11 70.00 $2,597.70

23900 Amputation of arm & girdle 40.15 70.00 $2,810.50

23920 Amputation at shoulder joint 32.56 70.00 $2,279.20

23921 Amputation follow-up surgery 13.19 70.00 $923.30

23929 Shoulder surgery procedure 0.00 70.00 $0.00

23930 Drainage of arm lesion 10.02 70.00 $701.40

23931 Drainage of arm bursa 8.17 70.00 $571.90

23935 Drain arm/elbow bone lesion 14.52 70.00 $1,016.40

24000 Exploratory elbow surgery 13.71 70.00 $959.70

24006 Release elbow joint 20.45 70.00 $1,431.50

24065 Biopsy arm/elbow soft tissue 7.28 70.00 $509.60

24066 Biopsy arm/elbow soft tissue 17.87 70.00 $1,250.90

24071 Exc arm/elbow les sc 3 cm/> 11.65 70.00 $815.50

24073 Ex arm/elbow tum deep 5 cm/> 19.99 70.00 $1,399.30

24075 Exc arm/elbow les sc < 3 cm 13.99 70.00 $979.30

24076 Ex arm/elbow tum deep < 5 cm 15.56 70.00 $1,089.20

24077 Resect arm/elbow tum < 5 cm 29.76 70.00 $2,083.20

24079 Resect arm/elbow tum 5 cm/> 38.21 70.00 $2,674.70

24100 Biopsy elbow joint lining 12.00 70.00 $840.00

24101 Explore/treat elbow joint 14.35 70.00 $1,004.50

24102 Remove elbow joint lining 17.66 70.00 $1,236.20

24105 Removal of elbow bursa 10.04 70.00 $702.80

24115 Remove/graft bone lesion 21.26 70.00 $1,488.20

24120 Remove elbow lesion 15.13 70.00 $1,059.10

24130 Removal of head of radius 14.55 70.00 $1,018.50

24134 Removal of arm bone lesion 21.55 70.00 $1,508.50

24136 Remove radius bone lesion 16.65 70.00 $1,165.50

24138 Remove elbow bone lesion 19.43 70.00 $1,360.10

24140 Partial removal of arm bone 20.24 70.00 $1,416.80

24145 Partial removal of radius 17.04 70.00 $1,192.80

24147 Partial removal of elbow 17.91 70.00 $1,253.70

24149 Radical resection of elbow 33.74 70.00 $2,361.80

24150 Resect distal humerus tumor 45.04 70.00 $3,152.80

24152 Resect radius tumor 39.10 70.00 $2,737.00

24155 Removal of elbow joint 24.61 70.00 $1,722.70

24160 Remove elbow joint implant 36.31 70.00 $2,541.70

24164 Remove radius head implant 20.94 70.00 $1,465.80

24200 Removal of arm foreign body 5.91 70.00 $413.70

24201 Removal of arm foreign body 15.95 70.00 $1,116.50

24220 Injection for elbow x-ray 4.57 70.00 $319.90

24300 Manipulate elbow w/anesth 11.95 70.00 $836.50

24301 Muscle/tendon transfer 21.42 70.00 $1,499.40

24305 Arm tendon lengthening 16.49 70.00 $1,154.30

24310 Revision of arm tendon 13.55 70.00 $948.50

24320 Repair of arm tendon 22.52 70.00 $1,576.40

24330 Revision of arm muscles 20.69 70.00 $1,448.30

24331 Revision of arm muscles 22.67 70.00 $1,586.90

24332 Tenolysis triceps 17.63 70.00 $1,234.10

24340 Repair of biceps tendon 17.58 70.00 $1,230.60

24341 Repair arm tendon/muscle 21.43 70.00 $1,500.10

24342 Repair of ruptured tendon 22.31 70.00 $1,561.70

24343 Repr elbow lat ligmnt w/tiss 20.28 70.00 $1,419.60

24344 Reconstruct elbow lat ligmnt 31.69 70.00 $2,218.30

24345 Repr elbw med ligmnt w/tissu 20.39 70.00 $1,427.30

24346 Reconstruct elbow med ligmnt 31.69 70.00 $2,218.30

24357 Repair elbow perc 12.38 70.00 $866.60

24358 Repair elbow w/deb open 14.99 70.00 $1,049.30

24359 Repair elbow deb/attch open 18.90 70.00 $1,323.00

24360 Reconstruct elbow joint 25.95 70.00 $1,816.50

24363 Replace elbow joint 41.98 70.00 $2,938.60

24365 Reconstruct head of radius 18.41 70.00 $1,288.70

24366 Reconstruct head of radius 19.57 70.00 $1,369.90

24370 Revise reconst elbow joint 44.78 70.00 $3,134.60

24371 Revise reconst elbow joint 51.89 70.00 $3,632.30

24400 Revision of humerus 23.55 70.00 $1,648.50

24430 Repair of humerus 30.45 70.00 $2,131.50

24435 Repair humerus with graft 31.03 70.00 $2,172.10

24470 Revision of elbow joint 19.33 70.00 $1,353.10

24495 Decompression of forearm 15.45 70.00 $1,081.50

24498 Reinforce humerus 25.03 70.00 $1,752.10

24586 Treat elbow fracture 31.22 70.00 $2,185.40

24600 Treat elbow dislocation 10.37 70.00 $725.90

24615 Treat elbow dislocation 20.41 70.00 $1,428.70

24650 Treat radius fracture 7.43 70.00 $520.10

24655 Treat radius fracture 12.39 70.00 $867.30

24665 Treat radius fracture 18.72 70.00 $1,310.40

24666 Treat radius fracture 21.08 70.00 $1,475.60

24670 Treat ulnar fracture 8.29 70.00 $580.30

24675 Treat ulnar fracture 13.01 70.00 $910.70

24685 Treat ulnar fracture 18.79 70.00 $1,315.30

24800 Fusion of elbow joint 23.90 70.00 $1,673.00

24802 Fusion/graft of elbow joint 28.89 70.00 $2,022.30

24900 Amputation of upper arm 20.83 70.00 $1,458.10

24920 Amputation of upper arm 21.12 70.00 $1,478.40

24925 Amputation follow-up surgery 14.67 70.00 $1,026.90

24931 Amputate upper arm & implant 22.12 70.00 $1,548.40

24935 Revision of amputation 26.07 70.00 $1,824.90

24940 Revision of upper arm 0.00 70.00 $0.00

24999 Upper arm/elbow surgery 0.00 70.00 $0.00

25000 Incision of tendon sheath 9.61 70.00 $672.70

25001 Incise flexor carpi radialis 9.83 70.00 $688.10

25020 Decompress forearm 1 space 16.40 70.00 $1,148.00

25023 Decompress forearm 1 space 31.57 70.00 $2,209.90

25024 Decompress forearm 2 spaces 22.35 70.00 $1,564.50

25025 Decompress forearm 2 spaces 35.43 70.00 $2,480.10

25028 Drainage of forearm lesion 14.98 70.00 $1,048.60

25031 Drainage of forearm bursa 10.45 70.00 $731.50

25035 Treat forearm bone lesion 16.70 70.00 $1,169.00

25040 Explore/treat wrist joint 16.12 70.00 $1,128.40

25065 Biopsy forearm soft tissues 7.24 70.00 $506.80

25066 Biopsy forearm soft tissues 10.30 70.00 $721.00

25071 Exc forearm les sc 3 cm/> 12.21 70.00 $854.70

25073 Exc forearm tum deep 3 cm/> 15.28 70.00 $1,069.60

25075 Exc forearm les sc < 3 cm 13.61 70.00 $952.70

25076 Exc forearm tum deep < 3 cm 14.80 70.00 $1,036.00

25077 Resect forearm/wrist tum<3cm 25.47 70.00 $1,782.90

25078 Resect forarm/wrist tum 3cm> 33.52 70.00 $2,346.40

25085 Incision of wrist capsule 12.95 70.00 $906.50

25100 Biopsy of wrist joint 9.92 70.00 $694.40

25101 Explore/treat wrist joint 11.55 70.00 $808.50

25105 Remove wrist joint lining 13.76 70.00 $963.20

25107 Remove wrist joint cartilage 17.68 70.00 $1,237.60

25109 Excise tendon forearm/wrist 15.38 70.00 $1,076.60

25110 Remove wrist tendon lesion 9.75 70.00 $682.50

25111 Remove wrist tendon lesion 9.15 70.00 $640.50

25112 Reremove wrist tendon lesion 11.01 70.00 $770.70

25115 Remove wrist/forearm lesion 21.72 70.00 $1,520.40

25116 Remove wrist/forearm lesion 17.14 70.00 $1,199.80

25118 Excise wrist tendon sheath 10.88 70.00 $761.60

25119 Partial removal of ulna 14.30 70.00 $1,001.00

25120 Removal of forearm lesion 14.23 70.00 $996.10

25125 Remove/graft forearm lesion 17.21 70.00 $1,204.70

25126 Remove/graft forearm lesion 17.18 70.00 $1,202.60

25130 Removal of wrist lesion 12.74 70.00 $891.80

25135 Remove & graft wrist lesion 16.05 70.00 $1,123.50

25136 Remove & graft wrist lesion 14.17 70.00 $991.90

25145 Remove forearm bone lesion 14.85 70.00 $1,039.50

25150 Partial removal of ulna 16.31 70.00 $1,141.70

25151 Partial removal of radius 16.88 70.00 $1,181.60

25170 Resect radius/ulnar tumor 42.78 70.00 $2,994.60

25210 Removal of wrist bone 13.92 70.00 $974.40

25215 Removal of wrist bones 17.69 70.00 $1,238.30

25230 Partial removal of radius 12.38 70.00 $866.60

25240 Partial removal of ulna 12.21 70.00 $854.70

25246 Injection for wrist x-ray 4.62 70.00 $323.40

25248 Remove forearm foreign body 11.87 70.00 $830.90

25250 Removal of wrist prosthesis 15.24 70.00 $1,066.80

25251 Removal of wrist prosthesis 20.32 70.00 $1,422.40

25259 Manipulate wrist w/anesthes 11.90 70.00 $833.00

25260 Repair forearm tendon/muscle 18.05 70.00 $1,263.50

25270 Repair forearm tendon/muscle 14.00 70.00 $980.00

25275 Repair forearm tendon sheath 19.21 70.00 $1,344.70

25280 Revise wrist/forearm tendon 16.09 70.00 $1,126.30

25290 Incise wrist/forearm tendon 12.47 70.00 $872.90

25295 Release wrist/forearm tendon 14.95 70.00 $1,046.50

25300 Fusion of tendons at wrist 19.71 70.00 $1,379.70

25301 Fusion of tendons at wrist 18.42 70.00 $1,289.40

25310 Transplant forearm tendon 17.73 70.00 $1,241.10

25312 Transplant forearm tendon 20.59 70.00 $1,441.30

25315 Revise palsy hand tendon(s) 22.23 70.00 $1,556.10

25316 Revise palsy hand tendon(s) 26.33 70.00 $1,843.10

25320 Repair/revise wrist joint 28.27 70.00 $1,978.90

25332 Revise wrist joint 24.08 70.00 $1,685.60

25335 Realignment of hand 27.18 70.00 $1,902.60

25337 Reconstruct ulna/radioulnar 25.45 70.00 $1,781.50

25350 Revision of radius 19.32 70.00 $1,352.40

25355 Revision of radius 22.08 70.00 $1,545.60

25360 Revision of ulna 18.77 70.00 $1,313.90

25365 Revise radius & ulna 26.36 70.00 $1,845.20

25370 Revise radius or ulna 29.00 70.00 $2,030.00

25375 Revise radius & ulna 27.46 70.00 $1,922.20

25390 Shorten radius or ulna 22.06 70.00 $1,544.20

25391 Lengthen radius or ulna 28.72 70.00 $2,010.40

25392 Shorten radius & ulna 28.95 70.00 $2,026.50

25393 Lengthen radius & ulna 32.34 70.00 $2,263.80

25394 Repair carpal bone shorten 22.90 70.00 $1,603.00

25400 Repair radius or ulna 23.05 70.00 $1,613.50

25405 Repair/graft radius or ulna 29.73 70.00 $2,081.10

25415 Repair radius & ulna 27.90 70.00 $1,953.00

25420 Repair/graft radius & ulna 33.72 70.00 $2,360.40

25425 Repair/graft radius or ulna 27.75 70.00 $1,942.50

25426 Repair/graft radius & ulna 32.44 70.00 $2,270.80

25430 Vasc graft into carpal bone 21.07 70.00 $1,474.90

25431 Repair nonunion carpal bone 22.44 70.00 $1,570.80

25440 Repair/graft wrist bone 22.03 70.00 $1,542.10

25441 Reconstruct wrist joint 26.70 70.00 $1,869.00

25446 Wrist replacement 33.60 70.00 $2,352.00

25447 Repair wrist joints 23.71 70.00 $1,659.70

25449 Remove wrist joint implant 29.56 70.00 $2,069.20

25450 Revision of wrist joint 14.29 70.00 $1,000.30

25455 Revision of wrist joint 16.93 70.00 $1,185.10

25490 Reinforce radius 19.09 70.00 $1,336.30

25491 Reinforce ulna 21.32 70.00 $1,492.40

25492 Reinforce radius and ulna 26.05 70.00 $1,823.50

25500 Treat fracture of radius 7.75 70.00 $542.50

25505 Treat fracture of radius 14.32 70.00 $1,002.40

25530 Treat fracture of ulna 7.46 70.00 $522.20

25535 Treat fracture of ulna 13.99 70.00 $979.30

25545 Treat fracture of ulna 17.89 70.00 $1,252.30

25560 Treat fracture radius & ulna 7.89 70.00 $552.30

25565 Treat fracture radius & ulna 14.83 70.00 $1,038.10

25574 Treat fracture radius & ulna 19.37 70.00 $1,355.90

25575 Treat fracture radius/ulna 25.88 70.00 $1,811.60

25600 Treat fracture radius/ulna 9.33 70.00 $653.10

25605 Treat fracture radius/ulna 15.58 70.00 $1,090.60

25606 Treat fx distal radial 19.05 70.00 $1,333.50

25607 Treat fx rad extra-articul 21.08 70.00 $1,475.60

25608 Treat fx rad intra-articul 23.66 70.00 $1,656.20

25609 Treat fx radial 3+ frag 30.07 70.00 $2,104.90

25622 Treat wrist bone fracture 8.63 70.00 $604.10

25628 Treat wrist bone fracture 20.66 70.00 $1,446.20

25645 Treat wrist bone fracture 16.39 70.00 $1,147.30

25651 Pin ulnar styloid fracture 13.85 70.00 $969.50

25652 Treat fracture ulnar styloid 17.90 70.00 $1,253.00

25660 Treat wrist dislocation 11.69 70.00 $818.30

25670 Treat wrist dislocation 17.34 70.00 $1,213.80

25671 Pin radioulnar dislocation 15.22 70.00 $1,065.40

25680 Treat wrist fracture 13.37 70.00 $935.90

25685 Treat wrist fracture 21.21 70.00 $1,484.70

25800 Fusion of wrist joint 20.98 70.00 $1,468.60

25805 Fusion/graft of wrist joint 24.34 70.00 $1,703.80

25810 Fusion/graft of wrist joint 24.86 70.00 $1,740.20

25820 Fusion of hand bones 17.60 70.00 $1,232.00

25825 Fuse hand bones with graft 21.66 70.00 $1,516.20

25830 Fusion radioulnar jnt/ulna 27.35 70.00 $1,914.50

25900 Amputation of forearm 20.25 70.00 $1,417.50

25920 Amputate hand at wrist 20.05 70.00 $1,403.50

25922 Amputate hand at wrist 17.58 70.00 $1,230.60

25927 Amputation of hand 23.28 70.00 $1,629.60

25999 Forearm or wrist surgery 0.00 70.00 $0.00

26010 Drainage of finger abscess 7.49 70.00 $524.30

26011 Drainage of finger abscess 11.07 70.00 $774.90

26020 Drain hand tendon sheath 12.40 70.00 $868.00

26025 Drainage of palm bursa 12.09 70.00 $846.30

26030 Drainage of palm bursas 14.07 70.00 $984.90

26034 Treat hand bone lesion 15.42 70.00 $1,079.40

26035 Decompress fingers/hand 24.68 70.00 $1,727.60

26037 Decompress fingers/hand 16.17 70.00 $1,131.90

26040 Release palm contracture 8.88 70.00 $621.60

26055 Incise finger tendon sheath 15.86 70.00 $1,110.20

26060 Incision of finger tendon 7.49 70.00 $524.30

26070 Explore/treat hand joint 9.03 70.00 $632.10

26075 Explore/treat finger joint 9.53 70.00 $667.10

26080 Explore/treat finger joint 11.13 70.00 $779.10

26100 Biopsy hand joint lining 9.61 70.00 $672.70

26105 Biopsy finger joint lining 9.67 70.00 $676.90

26110 Biopsy finger joint lining 9.17 70.00 $641.90

26111 Exc hand les sc 1.5 cm/> 11.98 70.00 $838.60

26113 Exc hand tum deep 1.5 cm/> 15.68 70.00 $1,097.60

26115 Exc hand les sc < 1.5 cm 14.35 70.00 $1,004.50

26116 Exc hand tum deep < 1.5 cm 15.08 70.00 $1,055.60

26117 Rad resect hand tumor < 3 cm 21.37 70.00 $1,495.90

26118 Rad resect hand tumor 3 cm/> 30.35 70.00 $2,124.50

26121 Release palm contracture 17.10 70.00 $1,197.00

26123 Release palm contracture 23.86 70.00 $1,670.20

26130 Remove wrist joint lining 13.28 70.00 $929.60

26135 Revise finger joint each 15.69 70.00 $1,098.30

26140 Revise finger joint each 14.40 70.00 $1,008.00

26145 Tendon excision palm/finger 14.65 70.00 $1,025.50

26160 Remove tendon sheath lesion 16.31 70.00 $1,141.70

26170 Removal of palm tendon each 11.60 70.00 $812.00

26180 Removal of finger tendon 12.66 70.00 $886.20

26185 Remove finger bone 15.49 70.00 $1,084.30

26200 Remove hand bone lesion 12.82 70.00 $897.40

26210 Removal of finger lesion 12.62 70.00 $883.40

26215 Remove/graft finger lesion 16.19 70.00 $1,133.30

26230 Partial removal of hand bone 14.27 70.00 $998.90

26235 Partial removal finger bone 14.10 70.00 $987.00

26236 Partial removal finger bone 12.58 70.00 $880.60

26250 Extensive hand surgery 30.89 70.00 $2,162.30

26260 Resect prox finger tumor 23.17 70.00 $1,621.90

26262 Resect distal finger tumor 18.25 70.00 $1,277.50

26320 Removal of implant from hand 9.89 70.00 $692.30

26340 Manipulate finger w/anesth 9.49 70.00 $664.30

26341 Manipulat palm cord post inj 2.82 70.00 $197.40

26350 Repair finger/hand tendon 20.02 70.00 $1,401.40

26352 Repair/graft hand tendon 22.89 70.00 $1,602.30

26390 Revise hand/finger tendon 23.75 70.00 $1,662.50

26410 Repair hand tendon 15.86 70.00 $1,110.20

26415 Excision hand/finger tendon 19.25 70.00 $1,347.50

26416 Graft hand or finger tendon 25.15 70.00 $1,760.50

26418 Repair finger tendon 16.22 70.00 $1,135.40

26420 Repair/graft finger tendon 19.91 70.00 $1,393.70

26432 Repair finger tendon 14.06 70.00 $984.20

26433 Repair finger tendon 14.93 70.00 $1,045.10

26437 Realignment of tendons 17.53 70.00 $1,227.10

26440 Release palm/finger tendon 17.39 70.00 $1,217.30

26442 Release palm & finger tendon 27.19 70.00 $1,903.30

26445 Release hand/finger tendon 16.15 70.00 $1,130.50

26449 Release forearm/hand tendon 19.88 70.00 $1,391.60

26450 Incision of palm tendon 11.44 70.00 $800.80

26455 Incision of finger tendon 11.37 70.00 $795.90

26460 Incise hand/finger tendon 11.03 70.00 $772.10

26471 Fusion of finger tendons 17.24 70.00 $1,206.80

26474 Fusion of finger tendons 17.00 70.00 $1,190.00

26476 Tendon lengthening 16.51 70.00 $1,155.70

26477 Tendon shortening 16.19 70.00 $1,133.30

26478 Lengthening of hand tendon 17.36 70.00 $1,215.20

26479 Shortening of hand tendon 17.19 70.00 $1,203.30

26480 Transplant hand tendon 21.10 70.00 $1,477.00

26483 Transplant/graft hand tendon 23.70 70.00 $1,659.00

26485 Transplant palm tendon 22.70 70.00 $1,589.00

26489 Transplant/graft palm tendon 26.55 70.00 $1,858.50

26490 Revise thumb tendon 22.58 70.00 $1,580.60

26492 Tendon transfer with graft 25.05 70.00 $1,753.50

26494 Hand tendon/muscle transfer 21.99 70.00 $1,539.30

26496 Revise thumb tendon 24.06 70.00 $1,684.20

26497 Finger tendon transfer 24.57 70.00 $1,719.90

26498 Finger tendon transfer 32.75 70.00 $2,292.50

26499 Revision of finger 23.01 70.00 $1,610.70

26500 Hand tendon reconstruction 17.52 70.00 $1,226.40

26502 Hand tendon reconstruction 20.11 70.00 $1,407.70

26508 Release thumb contracture 17.78 70.00 $1,244.60

26510 Thumb tendon transfer 16.69 70.00 $1,168.30

26516 Fusion of knuckle joint 19.66 70.00 $1,376.20

26517 Fusion of knuckle joints 23.42 70.00 $1,639.40

26518 Fusion of knuckle joints 23.20 70.00 $1,624.00

26520 Release knuckle contracture 18.28 70.00 $1,279.60

26525 Release finger contracture 18.29 70.00 $1,280.30

26530 Revise knuckle joint 15.37 70.00 $1,075.90

26531 Revise knuckle with implant 17.84 70.00 $1,248.80

26535 Revise finger joint 12.03 70.00 $842.10

26536 Revise/implant finger joint 19.99 70.00 $1,399.30

26540 Repair hand joint 18.46 70.00 $1,292.20

26541 Repair hand joint with graft 22.58 70.00 $1,580.60

26542 Repair hand joint with graft 19.11 70.00 $1,337.70

26545 Reconstruct finger joint 20.04 70.00 $1,402.80

26546 Repair nonunion hand 28.10 70.00 $1,967.00

26548 Reconstruct finger joint 21.38 70.00 $1,496.60

26550 Construct thumb replacement 47.01 70.00 $3,290.70

26551 Great toe-hand transfer 94.85 70.00 $6,639.50

26553 Single transfer toe-hand 77.67 70.00 $5,436.90

26554 Double transfer toe-hand 90.88 70.00 $6,361.60

26555 Positional change of finger 39.11 70.00 $2,737.70

26556 Toe joint transfer 81.14 70.00 $5,679.80

26560 Repair of web finger 16.70 70.00 $1,169.00

26565 Correct metacarpal flaw 19.20 70.00 $1,344.00

26567 Correct finger deformity 19.10 70.00 $1,337.00

26568 Lengthen metacarpal/finger 25.54 70.00 $1,787.80

26580 Repair hand deformity 43.19 70.00 $3,023.30

26587 Reconstruct extra finger 27.52 70.00 $1,926.40

26590 Repair finger deformity 40.21 70.00 $2,814.70

26591 Repair muscles of hand 12.18 70.00 $852.60

26593 Release muscles of hand 16.86 70.00 $1,180.20

26596 Excision constricting tissue 21.28 70.00 $1,489.60

26600 Treat metacarpal fracture 8.35 70.00 $584.50

26615 Treat metacarpal fracture 16.50 70.00 $1,155.00

26641 Treat thumb dislocation 10.74 70.00 $751.80

26645 Treat thumb fracture 12.24 70.00 $856.80

26650 Treat thumb fracture 13.69 70.00 $958.30

26665 Treat thumb fracture 18.03 70.00 $1,262.10

26670 Treat hand dislocation 9.58 70.00 $670.60

26675 Treat hand dislocation 13.01 70.00 $910.70

26676 Pin hand dislocation 14.30 70.00 $1,001.00

26685 Treat hand dislocation 16.51 70.00 $1,155.70

26686 Treat hand dislocation 17.94 70.00 $1,255.80

26700 Treat knuckle dislocation 9.14 70.00 $639.80

26705 Treat knuckle dislocation 11.89 70.00 $832.30

26706 Pin knuckle dislocation 12.44 70.00 $870.80

26715 Treat knuckle dislocation 16.36 70.00 $1,145.20

26720 Treat finger fracture each 5.62 70.00 $393.40

26735 Treat finger fracture each 17.08 70.00 $1,195.60

26756 Pin finger fracture each 11.89 70.00 $832.30

26770 Treat finger dislocation 7.81 70.00 $546.70

26775 Treat finger dislocation 10.90 70.00 $763.00

26776 Pin finger dislocation 12.64 70.00 $884.80

26785 Treat finger dislocation 15.63 70.00 $1,094.10

26820 Thumb fusion with graft 22.33 70.00 $1,563.10

26841 Fusion of thumb 20.44 70.00 $1,430.80

26842 Thumb fusion with graft 22.13 70.00 $1,549.10

26843 Fusion of hand joint 20.92 70.00 $1,464.40

26844 Fusion/graft of hand joint 22.74 70.00 $1,591.80

26850 Fusion of knuckle 19.44 70.00 $1,360.80

26852 Fusion of knuckle with graft 22.38 70.00 $1,566.60

26860 Fusion of finger joint 15.86 70.00 $1,110.20

26861 Fusion of finger jnt add-on 2.99 70.00 $209.30

26862 Fusion/graft of finger joint 20.42 70.00 $1,429.40

26863 Fuse/graft added joint 6.61 70.00 $462.70

26910 Amputate metacarpal bone 20.20 70.00 $1,414.00

26951 Amputation of finger/thumb 18.38 70.00 $1,286.60

26952 Amputation of finger/thumb 18.14 70.00 $1,269.80

26989 Hand/finger surgery 0.00 70.00 $0.00

26990 Drainage of pelvis lesion 17.99 70.00 $1,259.30

26991 Drainage of pelvis bursa 20.09 70.00 $1,406.30

26992 Drainage of bone lesion 27.51 70.00 $1,925.70

27000 Incision of hip tendon 11.94 70.00 $835.80

27001 Incision of hip tendon 15.52 70.00 $1,086.40

27006 Incision of hip tendons 21.17 70.00 $1,481.90

27025 Incision of hip/thigh fascia 26.21 70.00 $1,834.70

27027 Buttock fasciotomy 25.56 70.00 $1,789.20

27030 Drainage of hip joint 27.02 70.00 $1,891.40

27033 Exploration of hip joint 28.00 70.00 $1,960.00

27035 Denervation of hip joint 30.83 70.00 $2,158.10

27036 Excision of hip joint/muscle 29.15 70.00 $2,040.50

27040 Biopsy of soft tissues 9.83 70.00 $688.10

27041 Biopsy of soft tissues 19.76 70.00 $1,383.20

27043 Exc hip pelvis les sc 3 cm/> 13.51 70.00 $945.70

27045 Exc hip/pelv tum deep 5 cm/> 21.58 70.00 $1,510.60

27047 Exc hip/pelvis les sc < 3 cm 13.44 70.00 $940.80

27048 Exc hip/pelv tum deep < 5 cm 17.54 70.00 $1,227.80

27049 Resect hip/pelv tum < 5 cm 38.58 70.00 $2,700.60

27050 Biopsy of sacroiliac joint 11.54 70.00 $807.80

27052 Biopsy of hip joint 16.68 70.00 $1,167.60

27054 Removal of hip joint lining 19.68 70.00 $1,377.60

27057 Buttock fasciotomy w/dbrdmt 29.29 70.00 $2,050.30

27059 Resect hip/pelv tum 5 cm/> 52.56 70.00 $3,679.20

27060 Removal of ischial bursa 13.37 70.00 $935.90

27062 Remove femur lesion/bursa 13.13 70.00 $919.10

27065 Remove hip bone les super 14.89 70.00 $1,042.30

27066 Remove hip bone les deep 23.41 70.00 $1,638.70

27067 Remove/graft hip bone lesion 29.86 70.00 $2,090.20

27070 Part remove hip bone super 24.41 70.00 $1,708.70

27071 Part removal hip bone deep 26.31 70.00 $1,841.70

27075 Resect hip tumor 60.89 70.00 $4,262.30

27076 Resect hip tum incl acetabul 73.74 70.00 $5,161.80

27077 Resect hip tum w/innom bone 82.32 70.00 $5,762.40

27078 Rsect hip tum incl femur 60.05 70.00 $4,203.50

27080 Removal of tail bone 14.78 70.00 $1,034.60

27086 Remove hip foreign body 8.43 70.00 $590.10

27087 Remove hip foreign body 17.98 70.00 $1,258.60

27090 Removal of hip prosthesis 23.80 70.00 $1,666.00

27091 Removal of hip prosthesis 46.14 70.00 $3,229.80

27093 Injection for hip x-ray 5.33 70.00 $373.10

27095 Injection for hip x-ray 6.87 70.00 $480.90

27096 Inject sacroiliac joint 4.56 70.00 $319.20

27097 Revision of hip tendon 19.65 70.00 $1,375.50

27098 Transfer tendon to pelvis 20.01 70.00 $1,400.70

27100 Transfer of abdominal muscle 23.80 70.00 $1,666.00

27105 Transfer of spinal muscle 24.98 70.00 $1,748.60

27110 Transfer of iliopsoas muscle 27.94 70.00 $1,955.80

27111 Transfer of iliopsoas muscle 25.95 70.00 $1,816.50

27120 Reconstruction of hip socket 37.60 70.00 $2,632.00

27122 Reconstruction of hip socket 31.67 70.00 $2,216.90

27125 Partial hip replacement 32.72 70.00 $2,290.40

27130 Total hip arthroplasty 39.18 70.00 $2,742.60

27132 Total hip arthroplasty 48.40 70.00 $3,388.00

27134 Revise hip joint replacement 55.39 70.00 $3,877.30

27140 Transplant femur ridge 25.88 70.00 $1,811.60

27146 Incision of hip bone 37.05 70.00 $2,593.50

27147 Revision of hip bone 42.56 70.00 $2,979.20

27151 Incision of hip bones 46.07 70.00 $3,224.90

27156 Revision of hip bones 49.68 70.00 $3,477.60

27158 Revision of pelvis 40.58 70.00 $2,840.60

27161 Incision of neck of femur 35.10 70.00 $2,457.00

27165 Incision/fixation of femur 39.59 70.00 $2,771.30

27170 Repair/graft femur head/neck 34.01 70.00 $2,380.70

27175 Treat slipped epiphysis 19.25 70.00 $1,347.50

27179 Revise head/neck of femur 28.18 70.00 $1,972.60

27185 Revision of femur epiphysis 16.81 70.00 $1,176.70

27187 Reinforce hip bones 28.60 70.00 $2,002.00

27193 Treat pelvic ring fracture 13.51 70.00 $945.70

27194 Treat pelvic ring fracture 20.52 70.00 $1,436.40

27200 Treat tail bone fracture 5.16 70.00 $361.20

27202 Treat tail bone fracture 15.35 70.00 $1,074.50

27215 Treat pelvic fracture(s) 17.22 70.00 $1,205.40

27220 Treat hip socket fracture 15.23 70.00 $1,066.10

27222 Treat hip socket fracture 28.20 70.00 $1,974.00

27226 Treat hip wall fracture 30.55 70.00 $2,138.50

27227 Treat hip fracture(s) 47.99 70.00 $3,359.30

27228 Treat hip fracture(s) 54.72 70.00 $3,830.40

27230 Treat thigh fracture 13.61 70.00 $952.70

27232 Treat thigh fracture 21.74 70.00 $1,521.80

27250 Treat hip dislocation 5.23 70.00 $366.10

27252 Treat hip dislocation 21.91 70.00 $1,533.70

27267 Cltx thigh fx 12.43 70.00 $870.10

27268 Cltx thigh fx w/mnpj 15.51 70.00 $1,085.70

27269 Optx thigh fx 35.95 70.00 $2,516.50

27275 Manipulation of hip joint 5.25 70.00 $367.50

27279 Arthrodesis sacroiliac joint 16.05 70.00 $1,123.50

27280 Fusion of sacroiliac joint 31.15 70.00 $2,180.50

27282 Fusion of pubic bones 21.50 70.00 $1,505.00

27284 Fusion of hip joint 44.18 70.00 $3,092.60

27286 Fusion of hip joint 47.87 70.00 $3,350.90

27290 Amputation of leg at hip 47.03 70.00 $3,292.10

27295 Amputation of leg at hip 36.34 70.00 $2,543.80

27299 Pelvis/hip joint surgery 0.00 70.00 $0.00

27301 Drain thigh/knee lesion 18.93 70.00 $1,325.10

27303 Drainage of bone lesion 18.32 70.00 $1,282.40

27305 Incise thigh tendon & fascia 13.83 70.00 $968.10

27306 Incision of thigh tendon 10.31 70.00 $721.70

27307 Incision of thigh tendons 13.80 70.00 $966.00

27310 Exploration of knee joint 21.04 70.00 $1,472.80

27323 Biopsy thigh soft tissues 7.68 70.00 $537.60

27324 Biopsy thigh soft tissues 11.39 70.00 $797.30

27325 Neurectomy hamstring 14.66 70.00 $1,026.20

27326 Neurectomy popliteal 14.77 70.00 $1,033.90

27327 Exc thigh/knee les sc < 3 cm 13.12 70.00 $918.40

27328 Exc thigh/knee tum deep <5cm 17.88 70.00 $1,251.60

27329 Resect thigh/knee tum < 5 cm 29.83 70.00 $2,088.10

27330 Biopsy knee joint lining 11.93 70.00 $835.10

27331 Explore/treat knee joint 13.67 70.00 $956.90

27332 Removal of knee cartilage 18.51 70.00 $1,295.70

27333 Removal of knee cartilage 16.86 70.00 $1,180.20

27334 Remove knee joint lining 19.68 70.00 $1,377.60

27335 Remove knee joint lining 21.98 70.00 $1,538.60

27337 Exc thigh/knee les sc 3 cm/> 12.01 70.00 $840.70

27339 Exc thigh/knee tum dep 5cm/> 21.70 70.00 $1,519.00

27340 Removal of kneecap bursa 10.66 70.00 $746.20

27345 Removal of knee cyst 13.82 70.00 $967.40

27347 Remove knee cyst 15.20 70.00 $1,064.00

27350 Removal of kneecap 18.73 70.00 $1,311.10

27355 Remove femur lesion 17.36 70.00 $1,215.20

27356 Remove femur lesion/graft 21.28 70.00 $1,489.60

27357 Remove femur lesion/graft 23.42 70.00 $1,639.40

27358 Remove femur lesion/fixation 8.11 70.00 $567.70

27360 Partial removal leg bone(s) 24.50 70.00 $1,715.00

27364 Resect thigh/knee tum 5 cm/> 45.19 70.00 $3,163.30

27365 Resect femur/knee tumor 59.76 70.00 $4,183.20

27370 Injection for knee x-ray 4.40 70.00 $308.00

27372 Removal of foreign body 17.38 70.00 $1,216.60

27380 Repair of kneecap tendon 17.06 70.00 $1,194.20

27381 Repair/graft kneecap tendon 22.89 70.00 $1,602.30

27385 Repair of thigh muscle 16.50 70.00 $1,155.00

27386 Repair/graft of thigh muscle 23.83 70.00 $1,668.10

27390 Incision of thigh tendon 12.89 70.00 $902.30

27391 Incision of thigh tendons 16.61 70.00 $1,162.70

27392 Incision of thigh tendons 20.53 70.00 $1,437.10

27393 Lengthening of thigh tendon 14.67 70.00 $1,026.90

27394 Lengthening of thigh tendons 18.72 70.00 $1,310.40

27395 Lengthening of thigh tendons 25.33 70.00 $1,773.10

27396 Transplant of thigh tendon 17.73 70.00 $1,241.10

27397 Transplants of thigh tendons 26.43 70.00 $1,850.10

27400 Revise thigh muscles/tendons 20.03 70.00 $1,402.10

27403 Repair of knee cartilage 18.44 70.00 $1,290.80

27405 Repair of knee ligament 19.47 70.00 $1,362.90

27407 Repair of knee ligament 22.84 70.00 $1,598.80

27409 Repair of knee ligaments 27.84 70.00 $1,948.80

27412 Autochondrocyte implant knee 47.85 70.00 $3,349.50

27415 Osteochondral knee allograft 39.76 70.00 $2,783.20

27416 Osteochondral knee autograft 28.30 70.00 $1,981.00

27418 Repair degenerated kneecap 23.81 70.00 $1,666.70

27420 Revision of unstable kneecap 21.29 70.00 $1,490.30

27422 Revision of unstable kneecap 21.38 70.00 $1,496.60

27424 Revision/removal of kneecap 21.57 70.00 $1,509.90

27425 Lat retinacular release open 12.88 70.00 $901.60

27427 Reconstruction knee 20.55 70.00 $1,438.50

27430 Revision of thigh muscles 21.20 70.00 $1,484.00

27435 Incision of knee joint 23.19 70.00 $1,623.30

27437 Revise kneecap 19.05 70.00 $1,333.50

27438 Revise kneecap with implant 24.21 70.00 $1,694.70

27440 Revision of knee joint 23.01 70.00 $1,610.70

27447 Total knee arthroplasty 39.17 70.00 $2,741.90

27448 Incision of thigh 22.03 70.00 $1,542.10

27450 Incision of thigh 29.09 70.00 $2,036.30

27454 Realignment of thigh bone 37.59 70.00 $2,631.30

27455 Realignment of knee 27.20 70.00 $1,904.00

27457 Realignment of knee 27.72 70.00 $1,940.40

27465 Shortening of thigh bone 36.09 70.00 $2,526.30

27466 Lengthening of thigh bone 34.23 70.00 $2,396.10

27468 Shorten/lengthen thighs 38.84 70.00 $2,718.80

27470 Repair of thigh 33.92 70.00 $2,374.40

27472 Repair/graft of thigh 36.51 70.00 $2,555.70

27475 Surgery to stop leg growth 19.07 70.00 $1,334.90

27486 Revise/replace knee joint 40.61 70.00 $2,842.70

27487 Revise/replace knee joint 50.78 70.00 $3,554.60

27488 Removal of knee prosthesis 34.66 70.00 $2,426.20

27495 Reinforce thigh 32.54 70.00 $2,277.80

27496 Decompression of thigh/knee 15.66 70.00 $1,096.20

27500 Treatment of thigh fracture 14.92 70.00 $1,044.40

27516 Treat thigh fx growth plate 14.60 70.00 $1,022.00

27520 Treat kneecap fracture 9.22 70.00 $645.40

27524 Treat kneecap fracture 21.70 70.00 $1,519.00

27530 Treat knee fracture 8.62 70.00 $603.40

27532 Treat knee fracture 17.73 70.00 $1,241.10

27538 Treat knee fracture(s) 13.58 70.00 $950.60

27550 Treat knee dislocation 14.41 70.00 $1,008.70

27560 Treat kneecap dislocation 10.27 70.00 $718.90

27562 Treat kneecap dislocation 13.91 70.00 $973.70

27566 Treat kneecap dislocation 25.78 70.00 $1,804.60

27570 Fixation of knee joint 4.35 70.00 $304.50

27580 Fusion of knee 41.41 70.00 $2,898.70

27590 Amputate leg at thigh 23.42 70.00 $1,639.40

27598 Amputate lower leg at knee 20.88 70.00 $1,461.60

27599 Leg surgery procedure 0.00 70.00 $0.00

27600 Decompression of lower leg 11.96 70.00 $837.20

27603 Drain lower leg lesion 15.16 70.00 $1,061.20

27604 Drain lower leg bursa 14.03 70.00 $982.10

27605 Incision of achilles tendon 9.72 70.00 $680.40

27606 Incision of achilles tendon 8.22 70.00 $575.40

27607 Treat lower leg bone lesion 17.59 70.00 $1,231.30

27610 Explore/treat ankle joint 18.77 70.00 $1,313.90

27612 Exploration of ankle joint 16.25 70.00 $1,137.50

27613 Biopsy lower leg soft tissue 7.14 70.00 $499.80

27614 Biopsy lower leg soft tissue 16.39 70.00 $1,147.30

27615 Resect leg/ankle tum < 5 cm 29.40 70.00 $2,058.00

27616 Resect leg/ankle tum 5 cm/> 36.58 70.00 $2,560.60

27618 Exc leg/ankle tum < 3 cm 12.88 70.00 $901.60

27619 Exc leg/ankle tum deep <5 cm 13.59 70.00 $951.30

27620 Explore/treat ankle joint 13.19 70.00 $923.30

27625 Remove ankle joint lining 16.80 70.00 $1,176.00

27626 Remove ankle joint lining 17.75 70.00 $1,242.50

27630 Removal of tendon lesion 16.06 70.00 $1,124.20

27632 Exc leg/ankle les sc 3 cm/> 11.92 70.00 $834.40

27634 Exc leg/ankle tum dep 5 cm/> 19.74 70.00 $1,381.80

27635 Remove lower leg bone lesion 16.92 70.00 $1,184.40

27637 Remove/graft leg bone lesion 22.03 70.00 $1,542.10

27638 Remove/graft leg bone lesion 22.40 70.00 $1,568.00

27640 Partial removal of tibia 24.12 70.00 $1,688.40

27641 Partial removal of fibula 19.26 70.00 $1,348.20

27645 Resect tibia tumor 51.57 70.00 $3,609.90

27646 Resect fibula tumor 44.73 70.00 $3,131.10

27647 Resect talus/calcaneus tum 29.51 70.00 $2,065.70

27648 Injection for ankle x-ray 4.62 70.00 $323.40

27650 Repair achilles tendon 18.96 70.00 $1,327.20

27652 Repair/graft achilles tendon 19.76 70.00 $1,383.20

27654 Repair of achilles tendon 20.36 70.00 $1,425.20

27656 Repair leg fascia defect 18.22 70.00 $1,275.40

27658 Repair of leg tendon each 10.75 70.00 $752.50

27675 Repair lower leg tendons 13.86 70.00 $970.20

27676 Repair lower leg tendons 17.04 70.00 $1,192.80

27680 Release of lower leg tendon 12.39 70.00 $867.30

27681 Release of lower leg tendons 15.75 70.00 $1,102.50

27685 Revision of lower leg tendon 19.01 70.00 $1,330.70

27686 Revise lower leg tendons 16.22 70.00 $1,135.40

27687 Revision of calf tendon 13.10 70.00 $917.00

27690 Revise lower leg tendon 18.09 70.00 $1,266.30

27691 Revise lower leg tendon 21.61 70.00 $1,512.70

27692 Revise additional leg tendon 3.01 70.00 $210.70

27695 Repair of ankle ligament 13.70 70.00 $959.00

27696 Repair of ankle ligaments 15.84 70.00 $1,108.80

27698 Repair of ankle ligament 18.39 70.00 $1,287.30

27700 Revision of ankle joint 16.76 70.00 $1,173.20

27702 Reconstruct ankle joint 27.98 70.00 $1,958.60

27703 Reconstruction ankle joint 32.08 70.00 $2,245.60

27704 Removal of ankle implant 16.59 70.00 $1,161.30

27705 Incision of tibia 21.65 70.00 $1,515.50

27707 Incision of fibula 11.58 70.00 $810.60

27709 Incision of tibia & fibula 33.87 70.00 $2,370.90

27712 Realignment of lower leg 31.94 70.00 $2,235.80

27715 Revision of lower leg 30.33 70.00 $2,123.10

27720 Repair of tibia 25.23 70.00 $1,766.10

27722 Repair/graft of tibia 25.70 70.00 $1,799.00

27724 Repair/graft of tibia 36.59 70.00 $2,561.30

27725 Repair of lower leg 35.27 70.00 $2,468.90

27726 Repair fibula nonunion 27.88 70.00 $1,951.60

27727 Repair of lower leg 24.55 70.00 $1,718.50

27730 Repair of tibia epiphysis 16.88 70.00 $1,181.60

27732 Repair of fibula epiphysis 12.86 70.00 $900.20

27734 Repair lower leg epiphyses 18.90 70.00 $1,323.00

27740 Repair of leg epiphyses 20.43 70.00 $1,430.10

27742 Repair of leg epiphyses 22.44 70.00 $1,570.80

27745 Reinforce tibia 21.87 70.00 $1,530.90

27750 Treatment of tibia fracture 9.90 70.00 $693.00

27752 Treatment of tibia fracture 15.39 70.00 $1,077.30

27760 Cltx medial ankle fx 9.51 70.00 $665.70

27762 Cltx med ankle fx w/mnpj 13.55 70.00 $948.50

27766 Optx medial ankle fx 17.63 70.00 $1,234.10

27767 Cltx post ankle fx 8.04 70.00 $562.80

27768 Cltx post ankle fx w/mnpj 12.66 70.00 $886.20

27769 Optx post ankle fx 20.91 70.00 $1,463.70

27780 Treatment of fibula fracture 8.72 70.00 $610.40

27781 Treatment of fibula fracture 12.11 70.00 $847.70

27784 Treatment of fibula fracture 20.66 70.00 $1,446.20

27786 Treatment of ankle fracture 9.03 70.00 $632.10

27792 Treatment of ankle fracture 18.83 70.00 $1,318.10

27824 Treat lower leg fracture 8.92 70.00 $624.40

27825 Treat lower leg fracture 15.64 70.00 $1,094.80

27829 Treat lower leg joint 19.70 70.00 $1,379.00

27830 Treat lower leg dislocation 10.77 70.00 $753.90

27831 Treat lower leg dislocation 11.49 70.00 $804.30

27832 Treat lower leg dislocation 21.81 70.00 $1,526.70

27840 Treat ankle dislocation 10.51 70.00 $735.70

27842 Treat ankle dislocation 14.28 70.00 $999.60

27846 Treat ankle dislocation 21.12 70.00 $1,478.40

27848 Treat ankle dislocation 23.47 70.00 $1,642.90

27860 Fixation of ankle joint 4.99 70.00 $349.30

27870 Fusion of ankle joint open 29.76 70.00 $2,083.20

27871 Fusion of tibiofibular joint 19.73 70.00 $1,381.10

27880 Amputation of lower leg 26.82 70.00 $1,877.40

27888 Amputation of foot at ankle 19.92 70.00 $1,394.40

27889 Amputation of foot at ankle 18.87 70.00 $1,320.90

27892 Decompression of leg 15.78 70.00 $1,104.60

27899 Leg/ankle surgery procedure 0.00 70.00 $0.00

28001 Drainage of bursa of foot 8.07 70.00 $564.90

28002 Treatment of foot infection 12.72 70.00 $890.40

28003 Treatment of foot infection 20.37 70.00 $1,425.90

28005 Treat foot bone lesion 16.68 70.00 $1,167.60

28008 Incision of foot fascia 12.49 70.00 $874.30

28010 Incision of toe tendon 6.67 70.00 $466.90

28011 Incision of toe tendons 9.28 70.00 $649.60

28020 Exploration of foot joint 15.76 70.00 $1,103.20

28022 Exploration of foot joint 14.15 70.00 $990.50

28024 Exploration of toe joint 13.37 70.00 $935.90

28035 Decompression of tibia nerve 15.24 70.00 $1,066.80

28039 Exc foot/toe tum sc 1.5 cm/> 14.68 70.00 $1,027.60

28041 Exc foot/toe tum dep 1.5cm/> 13.19 70.00 $923.30

28043 Exc foot/toe tum sc < 1.5 cm 11.53 70.00 $807.10

28045 Exc foot/toe tum deep <1.5cm 14.27 70.00 $998.90

28046 Resect foot/toe tumor < 3 cm 21.04 70.00 $1,472.80

28047 Resect foot/toe tumor 3 cm/> 31.03 70.00 $2,172.10

28050 Biopsy of foot joint lining 13.88 70.00 $971.60

28052 Biopsy of foot joint lining 12.69 70.00 $888.30

28054 Biopsy of toe joint lining 10.84 70.00 $758.80

28055 Neurectomy foot 10.89 70.00 $762.30

28060 Partial removal foot fascia 14.94 70.00 $1,045.80

28062 Removal of foot fascia 16.82 70.00 $1,177.40

28070 Removal of foot joint lining 15.27 70.00 $1,068.90

28072 Removal of foot joint lining 14.90 70.00 $1,043.00

28080 Removal of foot lesion 15.21 70.00 $1,064.70

28086 Excise foot tendon sheath 15.94 70.00 $1,115.80

28088 Excise foot tendon sheath 12.66 70.00 $886.20

28090 Removal of foot lesion 13.62 70.00 $953.40

28092 Removal of toe lesions 12.22 70.00 $855.40

28100 Removal of ankle/heel lesion 17.65 70.00 $1,235.50

28102 Remove/graft foot lesion 17.48 70.00 $1,223.60

28103 Remove/graft foot lesion 11.25 70.00 $787.50

28104 Removal of foot lesion 15.39 70.00 $1,077.30

28106 Remove/graft foot lesion 12.32 70.00 $862.40

28107 Remove/graft foot lesion 14.91 70.00 $1,043.70

28108 Removal of toe lesions 12.81 70.00 $896.70

28110 Part removal of metatarsal 13.41 70.00 $938.70

28111 Part removal of metatarsal 14.32 70.00 $1,002.40

28112 Part removal of metatarsal 14.20 70.00 $994.00

28113 Part removal of metatarsal 17.18 70.00 $1,202.60

28114 Removal of metatarsal heads 31.21 70.00 $2,184.70

28116 Revision of foot 21.80 70.00 $1,526.00

28118 Removal of heel bone 17.15 70.00 $1,200.50

28119 Removal of heel spur 15.18 70.00 $1,062.60

28120 Part removal of ankle/heel 19.55 70.00 $1,368.50

28122 Partial removal of foot bone 17.30 70.00 $1,211.00

28124 Partial removal of toe 13.77 70.00 $963.90

28130 Removal of ankle bone 17.56 70.00 $1,229.20

28140 Removal of metatarsal 17.20 70.00 $1,204.00

28150 Removal of toe 12.36 70.00 $865.20

28171 Resect tarsal tumor 24.43 70.00 $1,710.10

28173 Resect metatarsal tumor 21.94 70.00 $1,535.80

28175 Resect phalanx of toe tumor 14.09 70.00 $986.30

28190 Removal of foot foreign body 7.40 70.00 $518.00

28192 Removal of foot foreign body 13.57 70.00 $949.90

28193 Removal of foot foreign body 15.41 70.00 $1,078.70

28200 Repair of foot tendon 14.13 70.00 $989.10

28202 Repair/graft of foot tendon 17.12 70.00 $1,198.40

28208 Repair of foot tendon 13.73 70.00 $961.10

28210 Repair/graft of foot tendon 16.83 70.00 $1,178.10

28220 Release of foot tendon 13.04 70.00 $912.80

28222 Release of foot tendons 14.53 70.00 $1,017.10

28225 Release of foot tendon 11.78 70.00 $824.60

28226 Release of foot tendons 12.73 70.00 $891.10

28230 Incision of foot tendon(s) 12.64 70.00 $884.80

28232 Incision of toe tendon 11.20 70.00 $784.00

28234 Incision of foot tendon 11.85 70.00 $829.50

28238 Revision of foot tendon 19.56 70.00 $1,369.20

28240 Release of big toe 12.75 70.00 $892.50

28250 Revision of foot fascia 16.79 70.00 $1,175.30

28260 Release of midfoot joint 19.85 70.00 $1,389.50

28261 Revision of foot tendon 28.83 70.00 $2,018.10

28262 Revision of foot and ankle 42.54 70.00 $2,977.80

28264 Release of midfoot joint 24.38 70.00 $1,706.60

28270 Release of foot contracture 14.23 70.00 $996.10

28272 Release of toe joint each 11.42 70.00 $799.40

28280 Fusion of toes 14.86 70.00 $1,040.20

28285 Repair of hammertoe 15.45 70.00 $1,081.50

28286 Repair of hammertoe 12.99 70.00 $909.30

28288 Partial removal of foot bone 17.42 70.00 $1,219.40

28289 Repair hallux rigidus 21.19 70.00 $1,483.30

28290 Correction of bunion 17.11 70.00 $1,197.70

28300 Incision of heel bone 18.83 70.00 $1,318.10

28302 Incision of ankle bone 20.64 70.00 $1,444.80

28304 Incision of midfoot bones 23.96 70.00 $1,677.20

28305 Incise/graft midfoot bones 18.78 70.00 $1,314.60

28306 Incision of metatarsal 17.75 70.00 $1,242.50

28309 Incision of metatarsals 26.28 70.00 $1,839.60

28310 Revision of big toe 15.84 70.00 $1,108.80

28312 Revision of toe 14.98 70.00 $1,048.60

28313 Repair deformity of toe 15.31 70.00 $1,071.70

28315 Removal of sesamoid bone 13.96 70.00 $977.20

28320 Repair of foot bones 17.50 70.00 $1,225.00

28322 Repair of metatarsals 22.82 70.00 $1,597.40

28340 Resect enlarged toe tissue 16.72 70.00 $1,170.40

28341 Resect enlarged toe 19.39 70.00 $1,357.30

28344 Repair extra toe(s) 16.01 70.00 $1,120.70

28345 Repair webbed toe(s) 15.10 70.00 $1,057.00

28360 Reconstruct cleft foot 23.56 70.00 $1,649.20

28400 Treatment of heel fracture 7.12 70.00 $498.40

28405 Treatment of heel fracture 11.41 70.00 $798.70

28406 Treatment of heel fracture 15.16 70.00 $1,061.20

28415 Treat heel fracture 31.91 70.00 $2,233.70

28420 Treat/graft heel fracture 36.25 70.00 $2,537.50

28445 Treat ankle fracture 30.81 70.00 $2,156.70

28446 Osteochondral talus autogrft 35.40 70.00 $2,478.00

28450 Treat midfoot fracture each 6.18 70.00 $432.60

28455 Treat midfoot fracture each 8.27 70.00 $578.90

28456 Treat midfoot fracture 9.18 70.00 $642.60

28465 Treat midfoot fracture each 17.77 70.00 $1,243.90

28470 Treat metatarsal fracture 6.28 70.00 $439.60

28485 Treat metatarsal fracture 15.15 70.00 $1,060.50

28490 Treat big toe fracture 4.18 70.00 $292.60

28505 Treat big toe fracture 19.50 70.00 $1,365.00

28510 Treatment of toe fracture 3.56 70.00 $249.20

28515 Treatment of toe fracture 4.67 70.00 $326.90

28525 Treat toe fracture 16.13 70.00 $1,129.10

28530 Treat sesamoid bone fracture 3.31 70.00 $231.70

28531 Treat sesamoid bone fracture 9.88 70.00 $691.60

28540 Treat foot dislocation 5.52 70.00 $386.40

28546 Treat foot dislocation 16.67 70.00 $1,166.90

28555 Repair foot dislocation 25.48 70.00 $1,783.60

28630 Treat toe dislocation 4.49 70.00 $314.30

28645 Repair toe dislocation 18.91 70.00 $1,323.70

28675 Repair of toe dislocation 17.07 70.00 $1,194.90

28705 Fusion of foot bones 36.28 70.00 $2,539.60

28737 Revision of foot bones 19.95 70.00 $1,396.50

28750 Fusion of big toe joint 23.57 70.00 $1,649.90

28800 Amputation of midfoot 15.73 70.00 $1,101.10

28805 Amputation thru metatarsal 21.19 70.00 $1,483.30

28810 Amputation toe & metatarsal 12.49 70.00 $874.30

28820 Amputation of toe 16.37 70.00 $1,145.90

28825 Partial amputation of toe 15.63 70.00 $1,094.10

28890 Hi enrgy eswt plantar fascia 9.33 70.00 $653.10

28899 Foot/toes surgery procedure 0.00 70.00 $0.00

29000 Application of body cast 8.72 70.00 $610.40

29049 Application of figure eight 2.10 70.00 $147.00

29055 Application of shoulder cast 6.38 70.00 $446.60

29058 Application of shoulder cast 3.58 70.00 $250.60

29065 Application of long arm cast 2.76 70.00 $193.20

29075 Application of forearm cast 2.49 70.00 $174.30

29085 Apply hand/wrist cast 2.74 70.00 $191.80

29086 Apply finger cast 2.21 70.00 $154.70

29105 Apply long arm splint 2.53 70.00 $177.10

29125 Apply forearm splint 1.83 70.00 $128.10

29126 Apply forearm splint 2.21 70.00 $154.70

29130 Application of finger splint 1.16 70.00 $81.20

29131 Application of finger splint 1.46 70.00 $102.20

29200 Strapping of chest 0.85 70.00 $59.50

29240 Strapping of shoulder 0.82 70.00 $57.40

29260 Strapping of elbow or wrist 0.82 70.00 $57.40

29280 Strapping of hand or finger 0.83 70.00 $58.10

29305 Application of hip cast 7.10 70.00 $497.00

29325 Application of hip casts 7.86 70.00 $550.20

29345 Application of long leg cast 3.92 70.00 $274.40

29358 Apply long leg cast brace 4.62 70.00 $323.40

29405 Apply short leg cast 2.34 70.00 $163.80

29440 Addition of walker to cast 1.25 70.00 $87.50

29445 Apply rigid leg cast 3.89 70.00 $272.30

29450 Application of leg cast 4.12 70.00 $288.40

29505 Application long leg splint 2.38 70.00 $166.60

29515 Application lower leg splint 2.05 70.00 $143.50

29520 Strapping of hip 0.88 70.00 $61.60

29530 Strapping of knee 0.80 70.00 $56.00

29540 Strapping of ankle and/or ft 0.73 70.00 $51.10

29550 Strapping of toes 0.54 70.00 $37.80

29580 Application of paste boot 1.49 70.00 $104.30

29581 Apply multlay comprs lwr leg 1.77 70.00 $123.90

29582 Apply multlay comprs upr leg 2.01 70.00 $140.70

29583 Apply multlay comprs upr arm 1.26 70.00 $88.20

29584 Appl multlay comprs arm/hand 2.01 70.00 $140.70

29700 Removal/revision of cast 1.75 70.00 $122.50

29720 Repair of body cast 2.45 70.00 $171.50

29730 Windowing of cast 1.83 70.00 $128.10

29740 Wedging of cast 2.86 70.00 $200.20

29750 Wedging of clubfoot cast 2.74 70.00 $191.80

29799 Casting/strapping procedure 0.00 70.00 $0.00

29800 Jaw arthroscopy/surgery 14.92 70.00 $1,044.40

29804 Jaw arthroscopy/surgery 18.49 70.00 $1,294.30

29805 Shoulder arthroscopy dx 13.60 70.00 $952.00

29806 Shoulder arthroscopy/surgery 30.63 70.00 $2,144.10

29826 Shoulder arthroscopy/surgery 5.10 70.00 $357.00

29827 Arthroscop rotator cuff repr 30.33 70.00 $2,123.10

29828 Arthroscopy biceps tenodesis 26.14 70.00 $1,829.80

29830 Elbow arthroscopy 13.16 70.00 $921.20

29834 Elbow arthroscopy/surgery 13.94 70.00 $975.80

29835 Elbow arthroscopy/surgery 14.50 70.00 $1,015.00

29840 Wrist arthroscopy 13.03 70.00 $912.10

29843 Wrist arthroscopy/surgery 13.95 70.00 $976.50

29844 Wrist arthroscopy/surgery 14.17 70.00 $991.90

29845 Wrist arthroscopy/surgery 16.52 70.00 $1,156.40

29848 Wrist endoscopy/surgery 14.65 70.00 $1,025.50

29850 Knee arthroscopy/surgery 18.01 70.00 $1,260.70

29855 Tibial arthroscopy/surgery 22.64 70.00 $1,584.80

29856 Tibial arthroscopy/surgery 28.81 70.00 $2,016.70

29860 Hip arthroscopy dx 19.26 70.00 $1,348.20

29861 Hip arthro w/fb removal 20.60 70.00 $1,442.00

29862 Hip arthr0 w/debridement 23.19 70.00 $1,623.30

29863 Hip arthr0 w/synovectomy 23.13 70.00 $1,619.10

29866 Autgrft implnt knee w/scope 30.34 70.00 $2,123.80

29867 Allgrft implnt knee w/scope 37.01 70.00 $2,590.70

29868 Meniscal trnspl knee w/scpe 48.49 70.00 $3,394.30

29870 Knee arthroscopy dx 16.78 70.00 $1,174.60

29871 Knee arthroscopy/drainage 14.82 70.00 $1,037.40

29875 Knee arthroscopy/surgery 14.27 70.00 $998.90

29891 Ankle arthroscopy/surgery 19.59 70.00 $1,371.30

29893 Scope plantar fasciotomy 17.64 70.00 $1,234.80

29895 Ankle arthroscopy/surgery 13.93 70.00 $975.10

29900 Mcp joint arthroscopy dx 12.01 70.00 $840.70

29901 Mcp joint arthroscopy surg 15.08 70.00 $1,055.60

29902 Mcp joint arthroscopy surg 13.94 70.00 $975.80

29904 Subtalar arthro w/fb rmvl 18.44 70.00 $1,290.80

29905 Subtalar arthro w/exc 18.70 70.00 $1,309.00

29906 Subtalar arthro w/deb 20.40 70.00 $1,428.00

29907 Subtalar arthro w/fusion 25.32 70.00 $1,772.40

29914 Hip arthro w/femoroplasty 28.55 70.00 $1,998.50

29915 Hip arthro acetabuloplasty 29.08 70.00 $2,035.60

29916 Hip arthro w/labral repair 29.16 70.00 $2,041.20

29999 Arthroscopy of joint 0.00 70.00 $0.00

30000 Drainage of nose lesion 6.56 70.00 $459.20

30020 Drainage of nose lesion 6.64 70.00 $464.80

3006F Cxr doc rev 0.00 70.00 $0.00

3008F Body mass index docd 0.00 70.00 $0.00

30100 Intranasal biopsy 4.04 70.00 $282.80

3011F Lipid panel doc rev 0.00 70.00 $0.00

30110 Removal of nose polyp(s) 6.58 70.00 $460.60

30115 Removal of nose polyp(s) 12.33 70.00 $863.10

30117 Removal of intranasal lesion 24.99 70.00 $1,749.30

30118 Removal of intranasal lesion 21.88 70.00 $1,531.60

30120 Revision of nose 14.79 70.00 $1,035.30

30124 Removal of nose lesion 8.13 70.00 $569.10

30125 Removal of nose lesion 17.34 70.00 $1,213.80

30130 Excise inferior turbinate 10.86 70.00 $760.20

3014F Screen mammo doc rev 0.00 70.00 $0.00

30140 Resect inferior turbinate 12.56 70.00 $879.20

3015F Cerv cancer screen docd 0.00 70.00 $0.00

30150 Partial removal of nose 21.94 70.00 $1,535.80

3016F Pt scrnd unhlthy oh use 0.00 70.00 $0.00

30160 Removal of nose 22.07 70.00 $1,544.90

3017F Colorectal ca screen doc rev 0.00 70.00 $0.00

3018F Pre-prxd rsk et al docd 0.00 70.00 $0.00

3019F Lvef assess planpost dschrge 0.00 70.00 $0.00

3020F Lvf assess 0.00 70.00 $0.00

30200 Injection treatment of nose 3.24 70.00 $226.80

3021F Lvef mod/sever deprs syst 0.00 70.00 $0.00

30210 Nasal sinus therapy 4.29 70.00 $300.30

3022F Lvef >/=40% systolic 0.00 70.00 $0.00

30220 Insert nasal septal button 8.62 70.00 $603.40

3023F Spirom doc rev 0.00 70.00 $0.00

3025F Spirom fev/fvc <70% w/copd 0.00 70.00 $0.00

3027F Spirom fev/fvc>/=70%/w/ocopd 0.00 70.00 $0.00

3028F O2 saturation doc rev 0.00 70.00 $0.00

30300 Remove nasal foreign body 6.57 70.00 $459.90

3035F O2 saturation</=88%/pao</=55 0.00 70.00 $0.00

3037F O2 saturation >88%/pao>55 hg 0.00 70.00 $0.00

3038F Pulm fx w/in 12 mon b/4 surg 0.00 70.00 $0.00

3040F Fev <40% predicted value 0.00 70.00 $0.00

30400 Reconstruction of nose 28.68 70.00 $2,007.60

3042F Fev >/=40% predicted value 0.00 70.00 $0.00

30430 Revision of nose 24.68 70.00 $1,727.60

30435 Revision of nose 35.56 70.00 $2,489.20

3044F Hg a1c level lt 7.0% 0.00 70.00 $0.00

3045F Hg a1c level 7.0-9.0% 0.00 70.00 $0.00

30450 Revision of nose 42.67 70.00 $2,986.90

3046F Hemoglobin a1c level >9.0% 0.00 70.00 $0.00

30460 Revision of nose 23.22 70.00 $1,625.40

30462 Revision of nose 40.40 70.00 $2,828.00

30465 Repair nasal stenosis 27.99 70.00 $1,959.30

3048F Ldl-c <100 mg/dl 0.00 70.00 $0.00

3049F Ldl-c 100-129 mg/dl 0.00 70.00 $0.00

3050F Ldl-c >/= 130 mg/dl 0.00 70.00 $0.00

30520 Repair of nasal septum 17.78 70.00 $1,244.60

30540 Repair nasal defect 19.61 70.00 $1,372.70

30545 Repair nasal defect 24.38 70.00 $1,706.60

3055F Lvef less than/equal to 35% 0.00 70.00 $0.00

3056F Lvef greater than 35% 0.00 70.00 $0.00

30560 Release of nasal adhesions 7.66 70.00 $536.20

30580 Repair upper jaw fistula 18.71 70.00 $1,309.70

3060F Pos microalbuminuria rev 0.00 70.00 $0.00

30600 Repair mouth/nose fistula 16.29 70.00 $1,140.30

3061F Neg microalbuminuria rev 0.00 70.00 $0.00

3062F Pos macroalbuminuria rev 0.00 70.00 $0.00

30620 Intranasal reconstruction 17.80 70.00 $1,246.00

30630 Repair nasal septum defect 17.86 70.00 $1,250.20

3066F Nephropathy doc tx 0.00 70.00 $0.00

3072F Low risk for retinopathy 0.00 70.00 $0.00

3073F Pre-surg eye measures docd 0.00 70.00 $0.00

3074F Syst bp lt 130 mm hg 0.00 70.00 $0.00

3075F Syst bp ge 130 - 139mm hg 0.00 70.00 $0.00

3077F Syst bp >/= 140 mm hg 0.00 70.00 $0.00

3078F Diast bp <80 mm hg 0.00 70.00 $0.00

3079F Diast bp 80-89 mm hg 0.00 70.00 $0.00

3080F Diast bp >/= 90 mm hg 0.00 70.00 $0.00

30801 Ablate inf turbinate superf 6.52 70.00 $456.40

30802 Ablate inf turbinate submuc 8.29 70.00 $580.30

3082F Kt/v <1.2 0.00 70.00 $0.00

3083F Kt/v =/> 1.2 & <1.7 0.00 70.00 $0.00

3084F Kt/v ge 1.7 0.00 70.00 $0.00

3085F Suicide risk assessed 0.00 70.00 $0.00

3088F Mdd mild 0.00 70.00 $0.00

3089F Mdd moderate 0.00 70.00 $0.00

3090F Mdd severe w/o psych 0.00 70.00 $0.00

30901 Control of nosebleed 2.72 70.00 $190.40

30906 Repeat control of nosebleed 8.00 70.00 $560.00

3091F Mdd severe w/psych 0.00 70.00 $0.00

30915 Ligation nasal sinus artery 16.44 70.00 $1,150.80

3092F Mdd in remission 0.00 70.00 $0.00

30920 Ligation upper jaw artery 23.83 70.00 $1,668.10

3093F Doc new diag 1st/addl mdd 0.00 70.00 $0.00

30930 Ther fx nasal inf turbinate 3.52 70.00 $246.40

3095F Central dexa results docd 0.00 70.00 $0.00

3096F Central dexa ordered 0.00 70.00 $0.00

30999 Nasal surgery procedure 0.00 70.00 $0.00

3100F Image test ref carot diam 0.00 70.00 $0.00

31000 Irrigation maxillary sinus 5.24 70.00 $366.80

31002 Irrigation sphenoid sinus 5.51 70.00 $385.70

31020 Exploration maxillary sinus 13.89 70.00 $972.30

31030 Exploration maxillary sinus 19.79 70.00 $1,385.30

31032 Explore sinus remove polyps 16.40 70.00 $1,148.00

31040 Exploration behind upper jaw 21.93 70.00 $1,535.10

31050 Exploration sphenoid sinus 13.82 70.00 $967.40

31051 Sphenoid sinus surgery 18.39 70.00 $1,287.30

31070 Exploration of frontal sinus 12.51 70.00 $875.70

31075 Exploration of frontal sinus 22.26 70.00 $1,558.20

31080 Removal of frontal sinus 29.38 70.00 $2,056.60

31090 Exploration of sinuses 29.17 70.00 $2,041.90

3110F Pres/absn hmrhg/lesion docd 0.00 70.00 $0.00

3111F Ct/mri brain done w/in 24hrs 0.00 70.00 $0.00

3112F Ct/mri brain done 24 hrs 0.00 70.00 $0.00

3115F Quant results activity &symp 0.00 70.00 $0.00

3117F Hf assessment tool completed 0.00 70.00 $0.00

3118F Ny heart assoc class docd 0.00 70.00 $0.00

3119F No eval activity clin symp 0.00 70.00 $0.00

3120F 12-lead ecg performed 0.00 70.00 $0.00

31200 Removal of ethmoid sinus 16.18 70.00 $1,132.60

31225 Removal of upper jaw 53.65 70.00 $3,755.50

31230 Removal of upper jaw 59.37 70.00 $4,155.90

31231 Nasal endoscopy dx 5.97 70.00 $417.90

31233 Nasal/sinus endoscopy dx 7.49 70.00 $524.30

31235 Nasal/sinus endoscopy dx 8.53 70.00 $597.10

31237 Nasal/sinus endoscopy surg 7.37 70.00 $515.90

31239 Nasal/sinus endoscopy surg 17.56 70.00 $1,229.20

31254 Revision of ethmoid sinus 7.87 70.00 $550.90

31255 Removal of ethmoid sinus 11.53 70.00 $807.10

31256 Exploration maxillary sinus 5.71 70.00 $399.70

3126F Esoph bx rprt w/dyspl info 0.00 70.00 $0.00

31267 Endoscopy maxillary sinus 9.16 70.00 $641.20

31276 Sinus endoscopy surgical 14.53 70.00 $1,017.10

31295 Sinus endo w/balloon dil 58.37 70.00 $4,085.90

31299 Sinus surgery procedure 0.00 70.00 $0.00

3130F Upper gi endoscopy performed 0.00 70.00 $0.00

31300 Removal of larynx lesion 36.16 70.00 $2,531.20

3132F Doc ref upper gi endoscopy 0.00 70.00 $0.00

31320 Diagnostic incision larynx 18.73 70.00 $1,311.10

31360 Removal of larynx 59.60 70.00 $4,172.00

31365 Removal of larynx 73.77 70.00 $5,163.90

31367 Partial removal of larynx 63.14 70.00 $4,419.80

31390 Removal of larynx & pharynx 81.78 70.00 $5,724.60

31395 Reconstruct larynx & pharynx 86.07 70.00 $6,024.90

3140F Upper gi endo shows barrtts 0.00 70.00 $0.00

31400 Revision of larynx 28.57 70.00 $1,999.90

3141F Upper gi endo not barrtts 0.00 70.00 $0.00

3142F Barium swallow test ordered 0.00 70.00 $0.00

31420 Removal of epiglottis 23.88 70.00 $1,671.60

3150F Forceps esoph biopsy done 0.00 70.00 $0.00

31500 Insert emergency airway 3.17 70.00 $221.90

31502 Change of windpipe airway 1.00 70.00 $70.00

31505 Diagnostic laryngoscopy 2.36 70.00 $165.20

31510 Laryngoscopy with biopsy 6.06 70.00 $424.20

31511 Remove foreign body larynx 6.04 70.00 $422.80

31512 Removal of larynx lesion 5.92 70.00 $414.40

31513 Injection into vocal cord 3.83 70.00 $268.10

31515 Laryngoscopy for aspiration 5.92 70.00 $414.40

31520 Dx laryngoscopy newborn 4.54 70.00 $317.80

31525 Dx laryngoscopy excl nb 7.23 70.00 $506.10

31526 Dx laryngoscopy w/oper scope 4.55 70.00 $318.50

31527 Laryngoscopy for treatment 5.68 70.00 $397.60

31528 Laryngoscopy and dilation 4.19 70.00 $293.30

31529 Laryngoscopy and dilation 4.70 70.00 $329.00

31530 Laryngoscopy w/fb removal 5.70 70.00 $399.00

31531 Laryngoscopy w/fb & op scope 6.17 70.00 $431.90

31535 Laryngoscopy w/biopsy 5.51 70.00 $385.70

31536 Laryngoscopy w/bx & op scope 6.12 70.00 $428.40

31540 Laryngoscopy w/exc of tumor 7.03 70.00 $492.10

31541 Larynscop w/tumr exc + scope 7.68 70.00 $537.60

31545 Remove vc lesion w/scope 10.51 70.00 $735.70

31546 Remove vc lesion scope/graft 15.99 70.00 $1,119.30

3155F Cytogen test marrow b/4 tx 0.00 70.00 $0.00

31560 Laryngoscop w/arytenoidectom 9.11 70.00 $637.70

31561 Larynscop remve cart + scop 9.96 70.00 $697.20

31570 Laryngoscope w/vc inj 9.73 70.00 $681.10

31571 Laryngoscop w/vc inj + scope 7.26 70.00 $508.20

31576 Laryngoscopy with biopsy 6.39 70.00 $447.30

31577 Remove foreign body larynx 6.92 70.00 $484.40

31578 Removal of larynx lesion 7.95 70.00 $556.50

31584 Treat larynx fracture 43.29 70.00 $3,030.30

31590 Reinnervate larynx 25.45 70.00 $1,781.50

31595 Larynx nerve surgery 21.88 70.00 $1,531.60

31599 Larynx surgery procedure 0.00 70.00 $0.00

3160F Doc fe+ stores b/4 epo thx 0.00 70.00 $0.00

31600 Incision of windpipe 11.49 70.00 $804.30

31610 Incision of windpipe 20.53 70.00 $1,437.10

31611 Surgery/speech prosthesis 15.47 70.00 $1,082.90

31612 Puncture/clear windpipe 2.47 70.00 $172.90

31613 Repair windpipe opening 13.01 70.00 $910.70

31614 Repair windpipe opening 21.69 70.00 $1,518.30

31615 Visualization of windpipe 5.20 70.00 $364.00

31620 Endobronchial us add-on 8.20 70.00 $574.00

31622 Dx bronchoscope/wash 8.92 70.00 $624.40

31623 Dx bronchoscope/brush 9.43 70.00 $660.10

31624 Dx bronchoscope/lavage 8.93 70.00 $625.10

31625 Bronchoscopy w/biopsy(s) 9.49 70.00 $664.30

31626 Bronchoscopy w/markers 12.76 70.00 $893.20

31627 Navigational bronchoscopy 40.13 70.00 $2,809.10

31628 Bronchoscopy/lung bx each 10.60 70.00 $742.00

31629 Bronchoscopy/needle bx each 16.78 70.00 $1,174.60

31630 Bronchoscopy dilate/fx repr 5.79 70.00 $405.30

31631 Bronchoscopy dilate w/stent 6.70 70.00 $469.00

31632 Bronchoscopy/lung bx addl 2.03 70.00 $142.10

31633 Bronchoscopy/needle bx addl 2.51 70.00 $175.70

31634 Bronch w/balloon occlusion 53.50 70.00 $3,745.00

31635 Bronchoscopy w/fb removal 9.97 70.00 $697.90

31636 Bronchoscopy bronch stents 6.41 70.00 $448.70

31637 Bronchoscopy stent add-on 2.14 70.00 $149.80

31638 Bronchoscopy revise stent 7.34 70.00 $513.80

31640 Bronchoscopy w/tumor excise 7.36 70.00 $515.20

31641 Bronchoscopy treat blockage 7.44 70.00 $520.80

31643 Diag bronchoscope/catheter 5.10 70.00 $357.00

31645 Bronchoscopy clear airways 9.22 70.00 $645.40

31646 Bronchoscopy reclear airway 8.29 70.00 $580.30

31647 Bronchial valve init insert 6.44 70.00 $450.80

31648 Bronchial valve remov init 5.86 70.00 $410.20

31649 Bronchial valve remov addl 1.96 70.00 $137.20

31651 Bronchial valve addl insert 2.14 70.00 $149.80

31660 Bronch thermoplsty 1 lobe 6.02 70.00 $421.40

31661 Bronch thermoplsty 2/> lobes 6.30 70.00 $441.00

3170F Flow cyto done b/4 tx 0.00 70.00 $0.00

31717 Bronchial brush biopsy 7.44 70.00 $520.80

31720 Clearance of airways 1.47 70.00 $102.90

31725 Clearance of airways 2.57 70.00 $179.90

31730 Intro windpipe wire/tube 34.89 70.00 $2,442.30

31750 Repair of windpipe 39.47 70.00 $2,762.90

31766 Reconstruction of windpipe 48.91 70.00 $3,423.70

31770 Repair/graft of bronchus 38.88 70.00 $2,721.60

31775 Reconstruct bronchus 35.60 70.00 $2,492.00

31780 Reconstruct windpipe 34.22 70.00 $2,395.40

31781 Reconstruct windpipe 40.42 70.00 $2,829.40

31785 Remove windpipe lesion 30.95 70.00 $2,166.50

31786 Remove windpipe lesion 45.84 70.00 $3,208.80

31800 Repair of windpipe injury 20.41 70.00 $1,428.70

31805 Repair of windpipe injury 23.75 70.00 $1,662.50

31820 Closure of windpipe lesion 12.41 70.00 $868.70

31825 Repair of windpipe defect 17.26 70.00 $1,208.20

31830 Revise windpipe scar 12.68 70.00 $887.60

31899 Airways surgical procedure 0.00 70.00 $0.00

3200F Barium swallow test not req 0.00 70.00 $0.00

32035 Thoracostomy w/rib resection 21.02 70.00 $1,471.40

32036 Thoracostomy w/flap drainage 22.56 70.00 $1,579.20

32096 Open wedge/bx lung infiltr 23.37 70.00 $1,635.90

32097 Open wedge/bx lung nodule 23.37 70.00 $1,635.90

32098 Open biopsy of lung pleura 22.15 70.00 $1,550.50

3210F Grp a strep test performed 0.00 70.00 $0.00

32100 Exploration of chest 23.49 70.00 $1,644.30

32110 Explore/repair chest 42.45 70.00 $2,971.50

32120 Re-exploration of chest 25.23 70.00 $1,766.10

32124 Explore chest free adhesions 26.93 70.00 $1,885.10

32140 Removal of lung lesion(s) 28.96 70.00 $2,027.20

32141 Remove/treat lung lesions 44.27 70.00 $3,098.90

3215F Pt immunity to hep a docd 0.00 70.00 $0.00

32150 Removal of lung lesion(s) 29.22 70.00 $2,045.40

32151 Remove lung foreign body 29.38 70.00 $2,056.60

3216F Pt immunity to hep b docd 0.00 70.00 $0.00

32160 Open chest heart massage 22.86 70.00 $1,600.20

3218F Rna tstng hep c docd done 0.00 70.00 $0.00

3220F Hep c quant rna tstng docd 0.00 70.00 $0.00

32200 Drain open lung lesion 33.26 70.00 $2,328.20

32215 Treat chest lining 23.25 70.00 $1,627.50

32220 Release of lung 45.96 70.00 $3,217.20

32225 Partial release of lung 28.82 70.00 $2,017.40

3230F Note hring tst w/in 6 mon 0.00 70.00 $0.00

32310 Removal of chest lining 26.20 70.00 $1,834.00

32320 Free/remove chest lining 46.40 70.00 $3,248.00

32400 Needle biopsy chest lining 4.34 70.00 $303.80

32405 Percut bx lung/mediastinum 12.80 70.00 $896.00

32440 Remove lung pneumonectomy 45.43 70.00 $3,180.10

32442 Sleeve pneumonectomy 89.58 70.00 $6,270.60

32445 Removal of lung extrapleural 103.29 70.00 $7,230.30

32480 Partial removal of lung 42.92 70.00 $3,004.40

32482 Bilobectomy 46.03 70.00 $3,222.10

32484 Segmentectomy 41.78 70.00 $2,924.60

32486 Sleeve lobectomy 68.44 70.00 $4,790.80

32488 Completion pneumonectomy 70.26 70.00 $4,918.20

32491 Lung volume reduction 42.96 70.00 $3,007.20

3250F Nonprim loc anat bx site tum 0.00 70.00 $0.00

32501 Repair bronchus add-on 7.14 70.00 $499.80

32503 Resect apical lung tumor 52.66 70.00 $3,686.20

32504 Resect apical lung tum/chest 60.42 70.00 $4,229.40

32505 Wedge resect of lung initial 27.07 70.00 $1,894.90

32506 Wedge resect of lung add-on 4.58 70.00 $320.60

32507 Wedge resect of lung diag 4.57 70.00 $319.90

32540 Removal of lung lesion 50.35 70.00 $3,524.50

32550 Insert pleural cath 22.30 70.00 $1,561.00

32551 Insertion of chest tube 4.93 70.00 $345.10

32552 Remove lung catheter 5.34 70.00 $373.80

32553 Ins mark thor for rt perq 16.84 70.00 $1,178.80

32554 Aspirate pleura w/o imaging 5.71 70.00 $399.70

32555 Aspirate pleura w/ imaging 8.21 70.00 $574.70

32556 Insert cath pleura w/o image 15.76 70.00 $1,103.20

32557 Insert cath pleura w/ image 14.52 70.00 $1,016.40

32560 Treat pleurodesis w/agent 6.94 70.00 $485.80

32561 Lyse chest fibrin init day 2.66 70.00 $186.20

32562 Lyse chest fibrin subq day 2.41 70.00 $168.70

3260F Pt cat/pn cat/hist grd docd 0.00 70.00 $0.00

32601 Thoracoscopy diagnostic 8.96 70.00 $627.20

32604 Thoracoscopy wbx sac 14.08 70.00 $985.60

32606 Thoracoscopy w/bx med space 13.42 70.00 $939.40

32607 Thoracoscopy w/bx infiltrate 8.98 70.00 $628.60

32608 Thoracoscopy w/bx nodule 11.02 70.00 $771.40

32609 Thoracoscopy w/bx pleura 7.54 70.00 $527.80

3265F Rna tstng hepc vir ord/docd 0.00 70.00 $0.00

32650 Thoracoscopy w/pleurodesis 19.30 70.00 $1,351.00

32651 Thoracoscopy remove cortex 31.86 70.00 $2,230.20

32652 Thoracoscopy rem totl cortex 48.27 70.00 $3,378.90

32653 Thoracoscopy remov fb/fibrin 30.75 70.00 $2,152.50

32654 Thoracoscopy contrl bleeding 33.21 70.00 $2,324.70

32655 Thoracoscopy resect bullae 27.74 70.00 $1,941.80

32656 Thoracoscopy w/pleurectomy 23.31 70.00 $1,631.70

32658 Thoracoscopy w/sac fb remove 20.82 70.00 $1,457.40

32659 Thoracoscopy w/sac drainage 21.27 70.00 $1,488.90

3266F Hepc gn tstng docd b/4txmnt 0.00 70.00 $0.00

32661 Thoracoscopy w/pericard exc 23.29 70.00 $1,630.30

32662 Thoracoscopy w/mediast exc 25.97 70.00 $1,817.90

32663 Thoracoscopy w/lobectomy 40.72 70.00 $2,850.40

32664 Thoracoscopy w/ th nrv exc 24.74 70.00 $1,731.80

32665 Thoracoscop w/esoph musc exc 36.02 70.00 $2,521.40

32666 Thoracoscopy w/wedge resect 25.30 70.00 $1,771.00

32667 Thoracoscopy w/w resect addl 4.59 70.00 $321.30

32668 Thoracoscopy w/w resect diag 4.58 70.00 $320.60

32669 Thoracoscopy remove segment 39.10 70.00 $2,737.00

3267F Path rprt w/ pt pn cat et al 0.00 70.00 $0.00

32670 Thoracoscopy bilobectomy 46.66 70.00 $3,266.20

32671 Thoracoscopy pneumonectomy 51.97 70.00 $3,637.90

32672 Thoracoscopy for lvrs 44.21 70.00 $3,094.70

32673 Thoracoscopy w/thymus resect 35.41 70.00 $2,478.70

32674 Thoracoscopy lymph node exc 6.30 70.00 $441.00

3268F Psa/t/glsc docd b/4 txmnt 0.00 70.00 $0.00

3269F Bone scn b/4 txmnt/aftr dx 0.00 70.00 $0.00

3270F No bone scn b/4 txmnt/aftrdx 0.00 70.00 $0.00

32701 Thorax stereo rad targetw/tx 6.23 70.00 $436.10

3271F Low risk prostate cancer 0.00 70.00 $0.00

3272F Med risk prostate cancer 0.00 70.00 $0.00

3273F High risk prostate cancer 0.00 70.00 $0.00

3274F Prost cncr rsk not lw/md/hgh 0.00 70.00 $0.00

3278F Serum lvls ca/ipth/lpd ord 0.00 70.00 $0.00

3279F Hgb lvl >/= 13 g/dl 0.00 70.00 $0.00

3280F Hgb lvl 11-12.9 g/dl 0.00 70.00 $0.00

32800 Repair lung hernia 27.73 70.00 $1,941.10

3281F Hgb lvl <11 g/dl 0.00 70.00 $0.00

32810 Close chest after drainage 26.31 70.00 $1,841.70

32815 Close bronchial fistula 81.53 70.00 $5,707.10

32820 Reconstruct injured chest 40.77 70.00 $2,853.90

3284F Iop down >15% of pre-svc lvl 0.00 70.00 $0.00

3285F Iop down <15% of pre-svc lvl 0.00 70.00 $0.00

32850 Donor pneumonectomy 0.00 70.00 $0.00

32851 Lung transplant single 95.83 70.00 $6,708.10

32852 Lung transplant with bypass 105.04 70.00 $7,352.80

32853 Lung transplant double 133.96 70.00 $9,377.20

32854 Lung transplant with bypass 142.19 70.00 $9,953.30

32855 Prepare donor lung single 0.00 70.00 $0.00

32856 Prepare donor lung double 0.00 70.00 $0.00

3288F Fall risk assessment docd 0.00 70.00 $0.00

3290F Pt=d(rh)- and unsensitized 0.00 70.00 $0.00

32900 Removal of rib(s) 41.46 70.00 $2,902.20

32905 Revise & repair chest wall 39.03 70.00 $2,732.10

32906 Revise & repair chest wall 48.21 70.00 $3,374.70

3291F Pt=d(rh)+ or sensitized 0.00 70.00 $0.00

3292F Hiv tstng asked/docd/revwd 0.00 70.00 $0.00

3293F Abo rh blood typing docd 0.00 70.00 $0.00

3294F Grp b strep screening docd 0.00 70.00 $0.00

32940 Revision of lung 36.07 70.00 $2,524.90

32960 Therapeutic pneumothorax 3.61 70.00 $252.70

32997 Total lung lavage 9.87 70.00 $690.90

32998 Perq rf ablate tx pul tumor 84.03 70.00 $5,882.10

32999 Chest surgery procedure 0.00 70.00 $0.00

3300F Ajcc stage docd b/4 thxpy 0.00 70.00 $0.00

3301F Cancer stage docd metast 0.00 70.00 $0.00

33010 Drainage of heart sac 3.49 70.00 $244.30

33011 Repeat drainage of heart sac 3.52 70.00 $246.40

33015 Incision of heart sac 14.74 70.00 $1,031.80

33030 Partial removal of heart sac 58.26 70.00 $4,078.20

33031 Partial removal of heart sac 71.72 70.00 $5,020.40

33050 Resect heart sac lesion 29.25 70.00 $2,047.50

33120 Removal of heart lesion 61.06 70.00 $4,274.20

33140 Heart revascularize (tmr) 46.14 70.00 $3,229.80

33141 Heart tmr w/other procedure 3.82 70.00 $267.40

3315F Er+ or pr+ breast cancer 0.00 70.00 $0.00

3316F Er- or pr- breast cancer 0.00 70.00 $0.00

3317F Path rpt malig cancer docd 0.00 70.00 $0.00

3318F Path rpt malig cancer docd 0.00 70.00 $0.00

3319F X-ray/ct/ultrsnd et al ord 0.00 70.00 $0.00

3320F No xray/ct/ et al ordd 0.00 70.00 $0.00

33202 Insert epicard eltrd open 22.55 70.00 $1,578.50

33203 Insert epicard eltrd endo 23.42 70.00 $1,639.40

33206 Insert heart pm atrial 13.38 70.00 $936.60

33207 Insert heart pm ventricular 14.25 70.00 $997.50

33208 Insrt heart pm atrial & vent 15.42 70.00 $1,079.40

3321F Ajcc cncr 0/ia melan docd 0.00 70.00 $0.00

33210 Insert electrd/pm cath sngl 5.19 70.00 $363.30

33211 Insert card electrodes dual 5.29 70.00 $370.30

33212 Insert pulse gen sngl lead 9.64 70.00 $674.80

33213 Insert pulse gen dual leads 10.07 70.00 $704.90

33214 Upgrade of pacemaker system 14.13 70.00 $989.10

33215 Reposition pacing-defib lead 8.97 70.00 $627.90

33216 Insert 1 electrode pm-defib 11.06 70.00 $774.20

33217 Insert 2 electrode pm-defib 10.85 70.00 $759.50

33218 Repair lead pace-defib one 11.59 70.00 $811.30

3322F Melanomaajcc stage 0 or ia 0.00 70.00 $0.00

33220 Repair lead pace-defib dual 11.60 70.00 $812.00

33221 Insert pulse gen mult leads 10.77 70.00 $753.90

33222 Relocation pocket pacemaker 10.07 70.00 $704.90

33223 Relocate pocket for defib 12.15 70.00 $850.50

33224 Insert pacing lead & connect 14.93 70.00 $1,045.10

33225 L ventric pacing lead add-on 13.56 70.00 $949.20

33226 Reposition l ventric lead 14.34 70.00 $1,003.80

33227 Remove&replace pm gen singl 10.15 70.00 $710.50

33228 Remv&replc pm gen dual lead 10.57 70.00 $739.90

33229 Remv&replc pm gen mult leads 11.09 70.00 $776.30

3323F Clin node stgng docdb/4 surg 0.00 70.00 $0.00

33230 Insrt pulse gen w/dual leads 11.41 70.00 $798.70

33231 Insrt pulse gen w/mult leads 12.03 70.00 $842.10

33233 Removal of pm generator 7.02 70.00 $491.40

33234 Removal of pacemaker system 14.39 70.00 $1,007.30

33235 Removal pacemaker electrode 18.72 70.00 $1,310.40

33236 Remove electrode/thoracotomy 22.74 70.00 $1,591.80

3324F Mri ct scan ord rvwd rqstd 0.00 70.00 $0.00

33240 Insrt pulse gen w/singl lead 10.92 70.00 $764.40

33241 Remove pulse generator 6.61 70.00 $462.70

33243 Remove eltrd/thoracotomy 39.82 70.00 $2,787.40

33244 Remove elctrd transvenously 25.18 70.00 $1,762.60

33249 Insj/rplcmt defib w/lead(s) 26.84 70.00 $1,878.80

3325F Preop asses 4 cataract surg 0.00 70.00 $0.00

33250 Ablate heart dysrhythm focus 43.01 70.00 $3,010.70

33254 Ablate atria lmtd 39.61 70.00 $2,772.70

33255 Ablate atria w/o bypass ext 47.70 70.00 $3,339.00

33256 Ablate atria w/bypass exten 56.75 70.00 $3,972.50

33257 Ablate atria lmtd add-on 16.91 70.00 $1,183.70

33258 Ablate atria x10sv add-on 19.12 70.00 $1,338.40

33259 Ablate atria w/bypass add-on 24.51 70.00 $1,715.70

33262 Rmvl& replc pulse gen 1 lead 11.12 70.00 $778.40

33263 Rmvl & rplcmt dfb gen 2 lead 11.58 70.00 $810.60

33264 Rmvl & rplcmt dfb gen mlt ld 12.06 70.00 $844.20

33265 Ablate atria lmtd endo 39.49 70.00 $2,764.30

33266 Ablate atria x10sv endo 53.83 70.00 $3,768.10

33270 Ins/rep subq defibrillator 17.06 70.00 $1,194.20

33271 Insj subq impltbl dfb elctrd 14.35 70.00 $1,004.50

33272 Rmvl of subq defibrillator 10.56 70.00 $739.20

33273 Repos prev impltbl subq dfb 11.62 70.00 $813.40

3328F Prfrmnc docd 2 wks b/4 surg 0.00 70.00 $0.00

33282 Implant pat-active ht record 6.90 70.00 $483.00

33284 Remove pat-active ht record 6.12 70.00 $428.40

3330F Imaging study ordered (bkp) 0.00 70.00 $0.00

33300 Repair of heart wound 71.22 70.00 $4,985.40

33305 Repair of heart wound 119.45 70.00 $8,361.50

3331F Bk imaging tst not ordered 0.00 70.00 $0.00

33310 Exploratory heart surgery 34.86 70.00 $2,440.20

33315 Exploratory heart surgery 55.78 70.00 $3,904.60

33320 Repair major blood vessel(s) 30.99 70.00 $2,169.30

33321 Repair major vessel 35.05 70.00 $2,453.50

33322 Repair major blood vessel(s) 40.32 70.00 $2,822.40

33330 Insert major vessel graft 41.72 70.00 $2,920.40

33335 Insert major vessel graft 55.05 70.00 $3,853.50

33361 Replace aortic valve perq 39.54 70.00 $2,767.80

33362 Replace aortic valve open 43.23 70.00 $3,026.10

33366 Trcath replace aortic valve 56.08 70.00 $3,925.60

33367 Replace aortic valve w/byp 18.17 70.00 $1,271.90

3340F Mammo assess inc xray docd 0.00 70.00 $0.00

33400 Repair of aortic valve 66.30 70.00 $4,641.00

33401 Valvuloplasty open 42.07 70.00 $2,944.90

33403 Valvuloplasty w/cp bypass 43.15 70.00 $3,020.50

33404 Prepare heart-aorta conduit 51.67 70.00 $3,616.90

33405 Replacement of aortic valve 66.00 70.00 $4,620.00

3341F Mammo assess negative docd 0.00 70.00 $0.00

33415 Revision subvalvular tissue 59.14 70.00 $4,139.80

33416 Revise ventricle muscle 59.10 70.00 $4,137.00

33418 Repair tcat mitral valve 54.00 70.00 $3,780.00

33419 Repair tcat mitral valve 12.69 70.00 $888.30

3342F Mammo assess bengn docd 0.00 70.00 $0.00

33420 Revision of mitral valve 41.91 70.00 $2,933.70

33425 Repair of mitral valve 79.44 70.00 $5,560.80

3343F Mammo probably bengn docd 0.00 70.00 $0.00

33430 Replacement of mitral valve 81.36 70.00 $5,695.20

3344F Mammo assess susp docd 0.00 70.00 $0.00

3345F Mammo assess hghlymalig doc 0.00 70.00 $0.00

33460 Revision of tricuspid valve 71.12 70.00 $4,978.40

33463 Valvuloplasty tricuspid 90.02 70.00 $6,301.40

33464 Valvuloplasty tricuspid 71.01 70.00 $4,970.70

33465 Replace tricuspid valve 80.22 70.00 $5,615.40

33468 Revision of tricuspid valve 71.30 70.00 $4,991.00

33470 Revision of pulmonary valve 35.94 70.00 $2,515.80

33471 Valvotomy pulmonary valve 36.41 70.00 $2,548.70

33475 Replacement pulmonary valve 68.32 70.00 $4,782.40

33476 Revision of heart chamber 44.41 70.00 $3,108.70

33496 Repair prosth valve clot 48.80 70.00 $3,416.00

3350F Mammo bx proven malig docd 0.00 70.00 $0.00

33500 Repair heart vessel fistula 45.72 70.00 $3,200.40

33501 Repair heart vessel fistula 32.68 70.00 $2,287.60

33502 Coronary artery correction 37.09 70.00 $2,596.30

33503 Coronary artery graft 38.48 70.00 $2,693.60

33504 Coronary artery graft 42.54 70.00 $2,977.80

33505 Repair artery w/tunnel 60.01 70.00 $4,200.70

33506 Repair artery translocation 63.02 70.00 $4,411.40

33507 Repair art intramural 50.11 70.00 $3,507.70

33508 Endoscopic vein harvest 0.46 70.00 $32.20

3351F Neg scrn dep symp by deptool 0.00 70.00 $0.00

33510 Cabg vein single 56.17 70.00 $3,931.90

33511 Cabg vein two 61.73 70.00 $4,321.10

33512 Cabg vein three 70.21 70.00 $4,914.70

33513 Cabg vein four 72.27 70.00 $5,058.90

33514 Cabg vein five 76.39 70.00 $5,347.30

33516 Cabg vein six or more 80.01 70.00 $5,600.70

33517 Cabg artery-vein single 5.46 70.00 $382.20

33518 Cabg artery-vein two 12.00 70.00 $840.00

33519 Cabg artery-vein three 15.86 70.00 $1,110.20

3352F No sig dep symp by dep tool 0.00 70.00 $0.00

33521 Cabg artery-vein four 19.01 70.00 $1,330.70

33522 Cabg artery-vein five 21.36 70.00 $1,495.20

33523 Cabg art-vein six or more 24.42 70.00 $1,709.40

3353F Mild-mod dep symp by deptool 0.00 70.00 $0.00

33530 Coronary artery bypass/reop 15.35 70.00 $1,074.50

33533 Cabg arterial single 54.34 70.00 $3,803.80

33534 Cabg arterial two 63.94 70.00 $4,475.80

33535 Cabg arterial three 71.34 70.00 $4,993.80

33536 Cabg arterial four or more 76.98 70.00 $5,388.60

3354F Clin sig dep sym by dep tool 0.00 70.00 $0.00

33545 Repair of heart damage 90.16 70.00 $6,311.20

33548 Restore/remodel ventricle 86.20 70.00 $6,034.00

33572 Open coronary endarterectomy 6.72 70.00 $470.40

33600 Closure of valve 50.35 70.00 $3,524.50

33602 Closure of valve 48.83 70.00 $3,418.10

33606 Anastomosis/artery-aorta 49.05 70.00 $3,433.50

33608 Repair anomaly w/conduit 52.29 70.00 $3,660.30

33610 Repair by enlargement 52.02 70.00 $3,641.40

33611 Repair double ventricle 54.02 70.00 $3,781.40

33612 Repair double ventricle 58.28 70.00 $4,079.60

33615 Repair modified fontan 58.53 70.00 $4,097.10

33617 Repair single ventricle 62.88 70.00 $4,401.60

33619 Repair single ventricle 75.27 70.00 $5,268.90

33620 Apply r&l pulm art bands 44.00 70.00 $3,080.00

33621 Transthor cath for stent 27.22 70.00 $1,905.40

33622 Redo compl cardiac anomaly 98.91 70.00 $6,923.70

33641 Repair heart septum defect 47.55 70.00 $3,328.50

33645 Revision of heart veins 50.31 70.00 $3,521.70

33647 Repair heart septum defects 52.84 70.00 $3,698.80

33660 Repair of heart defects 51.55 70.00 $3,608.50

33670 Repair of heart chambers 57.86 70.00 $4,050.20

33675 Close mult vsd 57.85 70.00 $4,049.50

33676 Close mult vsd w/resection 56.05 70.00 $3,923.50

33677 Cl mult vsd w/rem pul band 58.24 70.00 $4,076.80

33690 Reinforce pulmonary artery 35.12 70.00 $2,458.40

3370F Ajcc brst cncr stage 0 docd 0.00 70.00 $0.00

33720 Repair of heart defect 45.32 70.00 $3,172.40

33722 Repair of heart defect 47.59 70.00 $3,331.30

33724 Repair venous anomaly 44.75 70.00 $3,132.50

33726 Repair pul venous stenosis 59.65 70.00 $4,175.50

33730 Repair heart-vein defect(s) 58.77 70.00 $4,113.90

33732 Repair heart-vein defect 48.29 70.00 $3,380.30

33750 Major vessel shunt 38.72 70.00 $2,710.40

3376F Ajcc brstcncr stage 2 docd 0.00 70.00 $0.00

33764 Major vessel shunt & graft 36.19 70.00 $2,533.30

33768 Cavopulmonary shunting 11.61 70.00 $812.70

33770 Repair great vessels defect 58.69 70.00 $4,108.30

33782 Nikaidoh proc 94.66 70.00 $6,626.20

33783 Nikaidoh proc w/ostia implt 96.85 70.00 $6,779.50

33786 Repair arterial trunk 63.06 70.00 $4,414.20

33788 Revision of pulmonary artery 44.92 70.00 $3,144.40

33800 Aortic suspension 30.32 70.00 $2,122.40

33802 Repair vessel defect 33.30 70.00 $2,331.00

33803 Repair vessel defect 31.70 70.00 $2,219.00

33813 Repair septal defect 34.10 70.00 $2,387.00

3382F Ajcc cln cncr stage 0 docd 0.00 70.00 $0.00

33820 Revise major vessel 28.14 70.00 $1,969.80

33840 Remove aorta constriction 34.07 70.00 $2,384.90

33860 Ascending aortic graft 93.46 70.00 $6,542.20

33870 Transverse aortic arch graft 73.38 70.00 $5,136.60

33875 Thoracic aortic graft 80.05 70.00 $5,603.50

33877 Thoracoabdominal graft 106.43 70.00 $7,450.10

33880 Endovasc taa repr incl subcl 52.97 70.00 $3,707.90

33881 Endovasc taa repr w/o subcl 45.52 70.00 $3,186.40

33883 Insert endovasc prosth taa 32.97 70.00 $2,307.90

33884 Endovasc prosth taa add-on 12.19 70.00 $853.30

33886 Endovasc prosth delayed 28.46 70.00 $1,992.20

33889 Artery transpose/endovas taa 23.34 70.00 $1,633.80

33891 Car-car bp grft/endovas taa 28.64 70.00 $2,004.80

33910 Remove lung artery emboli 76.70 70.00 $5,369.00

33915 Remove lung artery emboli 37.37 70.00 $2,615.90

33916 Surgery of great vessel 122.86 70.00 $8,600.20

33917 Repair pulmonary artery 42.67 70.00 $2,986.90

33920 Repair pulmonary atresia 53.01 70.00 $3,710.70

33922 Transect pulmonary artery 40.32 70.00 $2,822.40

33924 Remove pulmonary shunt 8.33 70.00 $583.10

33925 Rpr pul art unifocal w/o cpb 50.38 70.00 $3,526.60

33926 Repr pul art unifocal w/cpb 74.06 70.00 $5,184.20

33930 Removal of donor heart/lung 0.00 70.00 $0.00

33933 Prepare donor heart/lung 0.00 70.00 $0.00

33935 Transplantation heart/lung 144.79 70.00 $10,135.30

3394F Quant her2 ihc eval brst cx 0.00 70.00 $0.00

33940 Removal of donor heart 0.00 70.00 $0.00

33944 Prepare donor heart 0.00 70.00 $0.00

33945 Transplantation of heart 141.57 70.00 $9,909.90

33946 Ecmo/ecls initiation venous 8.99 70.00 $629.30

33947 Ecmo/ecls initiation artery 9.93 70.00 $695.10

33948 Ecmo/ecls daily mgmt-venous 7.10 70.00 $497.00

33949 Ecmo/ecls daily mgmt artery 6.91 70.00 $483.70

3395F Quant nonher2 ihc brst cx 0.00 70.00 $0.00

33951 Ecmo/ecls insj prph cannula 12.90 70.00 $903.00

33953 Ecmo/ecls insj prph cannula 14.39 70.00 $1,007.30

33955 Ecmo/ecls insj ctr cannula 25.98 70.00 $1,818.60

33956 Ecmo/ecls insj ctr cannula 24.58 70.00 $1,720.60

33957 Ecmo/ecls repos perph cnula 5.77 70.00 $403.90

33963 Ecmo/ecls repos perph cnula 14.64 70.00 $1,024.80

33964 Ecmo/ecls repos perph cnula 14.99 70.00 $1,049.30

33965 Ecmo/ecls rmvl perph cannula 5.77 70.00 $403.90

33966 Ecmo/ecls rmvl prph cannula 6.93 70.00 $485.10

33967 Insert i-aort percut device 7.55 70.00 $528.50

33968 Remove aortic assist device 0.97 70.00 $67.90

33969 Ecmo/ecls rmvl perph cannula 8.50 70.00 $595.00

33970 Aortic circulation assist 10.35 70.00 $724.50

33971 Aortic circulation assist 20.68 70.00 $1,447.60

33973 Insert balloon device 15.03 70.00 $1,052.10

33974 Remove intra-aortic balloon 26.01 70.00 $1,820.70

33975 Implant ventricular device 38.27 70.00 $2,678.90

33976 Implant ventricular device 46.64 70.00 $3,264.80

33977 Remove ventricular device 32.99 70.00 $2,309.30

33978 Remove ventricular device 39.14 70.00 $2,739.80

33979 Insert intracorporeal device 57.06 70.00 $3,994.20

33980 Remove intracorporeal device 52.01 70.00 $3,640.70

33981 Replace vad pump ext 24.43 70.00 $1,710.10

33982 Replace vad intra w/o bp 57.41 70.00 $4,018.70

33983 Replace vad intra w/bp 67.79 70.00 $4,745.30

33984 Ecmo/ecls rmvl prph cannula 8.34 70.00 $583.80

33985 Ecmo/ecls rmvl ctr cannula 16.01 70.00 $1,120.70

33986 Ecmo/ecls rmvl ctr cannula 15.21 70.00 $1,064.70

33987 Artery expos/graft artery 6.10 70.00 $427.00

33988 Insertion of left heart vent 22.68 70.00 $1,587.60

33989 Removal of left heart vent 14.42 70.00 $1,009.40

33990 Insert vad artery access 12.79 70.00 $895.30

33991 Insert vad art&vein access 18.52 70.00 $1,296.40

33992 Remove vad different session 6.23 70.00 $436.10

33993 Reposition vad diff session 5.49 70.00 $384.30

33999 Cardiac surgery procedure 0.00 70.00 $0.00

34001 Removal of artery clot 29.13 70.00 $2,039.10

34111 Removal of arm artery clot 17.69 70.00 $1,238.30

34203 Removal of leg artery clot 28.19 70.00 $1,973.30

34401 Removal of vein clot 43.05 70.00 $3,013.50

3450F Dyspnea scrnd no-mild dysp 0.00 70.00 $0.00

34501 Repair valve femoral vein 26.46 70.00 $1,852.20

34502 Reconstruct vena cava 44.99 70.00 $3,149.30

3451F Dyspnea scrnd mod-high dysp 0.00 70.00 $0.00

34510 Transposition of vein valve 34.82 70.00 $2,437.40

3452F Dyspnea not screened 0.00 70.00 $0.00

34520 Cross-over vein graft 29.30 70.00 $2,051.00

34530 Leg vein fusion 32.34 70.00 $2,263.80

3455F Tb scrng done-interpd 6mon 0.00 70.00 $0.00

3470F Ra disease activity low 0.00 70.00 $0.00

3471F Ra disease activity mod 0.00 70.00 $0.00

3472F Ra disease activity high 0.00 70.00 $0.00

3475F Disease progn ra poor docd 0.00 70.00 $0.00

3476F Disease progn ra good docd 0.00 70.00 $0.00

34800 Endovas aaa repr w/sm tube 33.33 70.00 $2,333.10

34802 Endovas aaa repr w/2-p part 36.86 70.00 $2,580.20

34805 Endovas aaa repr w/long tube 35.48 70.00 $2,483.60

34806 Aneurysm press sensor add-on 2.96 70.00 $207.20

34808 Endovas iliac a device addon 6.17 70.00 $431.90

34812 Xpose for endoprosth femorl 9.98 70.00 $698.60

34813 Femoral endovas graft add-on 7.01 70.00 $490.70

34820 Xpose for endoprosth iliac 14.51 70.00 $1,015.70

34825 Endovasc extend prosth init 20.53 70.00 $1,437.10

34826 Endovasc exten prosth addl 6.08 70.00 $425.60

34830 Open aortic tube prosth repr 52.31 70.00 $3,661.70

34831 Open aortoiliac prosth repr 56.25 70.00 $3,937.50

34832 Open aortofemor prosth repr 56.25 70.00 $3,937.50

34833 Xpose for endoprosth iliac 18.08 70.00 $1,265.60

34834 Xpose endoprosth brachial 8.05 70.00 $563.50

34839 Plnning pt spec fenest graft 0.00 70.00 $0.00

34841 Endovasc visc aorta 1 graft 0.00 70.00 $0.00

34845 Visc & infraren abd 1 prosth 0.00 70.00 $0.00

34848 Visc & infraren abd 4+ prost 0.00 70.00 $0.00

3490F History aids-defining cond 0.00 70.00 $0.00

34900 Endovasc iliac repr w/graft 26.42 70.00 $1,849.40

3491F Hiv unsure baby of hiv+moms 0.00 70.00 $0.00

3492F History cd4+ cell count <350 0.00 70.00 $0.00

3493F No hist cd4+ cell count <350 0.00 70.00 $0.00

3494F Cd4+cell count <200cells/mm3 0.00 70.00 $0.00

3495F Cd4+cell cnt 200-499 cells 0.00 70.00 $0.00

3496F Cd4+ cell count + 500 cells 0.00 70.00 $0.00

3497F Cd4+ cell percentage <15% 0.00 70.00 $0.00

3498F Cd4+ cell =15% (hiv) 0.00 70.00 $0.00

3500F Cd4+cell cnt/% docd as done 0.00 70.00 $0.00

35001 Repair defect of artery 33.42 70.00 $2,339.40

35002 Repair artery rupture neck 33.66 70.00 $2,356.20

35013 Repair artery rupture arm 36.82 70.00 $2,577.40

3502F Hiv rna vrl ld <lmts quantif 0.00 70.00 $0.00

35022 Repair artery rupture chest 42.50 70.00 $2,975.00

3503F Hiv rna vrl ldnot<lmts quntf 0.00 70.00 $0.00

35045 Repair defect of arm artery 29.33 70.00 $2,053.10

35082 Repair artery rupture aorta 64.93 70.00 $4,545.10

3510F Doc tb scrng-rslts interpd 0.00 70.00 $0.00

3511F Chlmyd/gonrh tsts docd done 0.00 70.00 $0.00

35112 Repair artery rupture spleen 55.16 70.00 $3,861.20

3512F Syph scrng docd as done 0.00 70.00 $0.00

35122 Repair artery rupture belly 63.65 70.00 $4,455.50

3513F Hep b scrng docd as done 0.00 70.00 $0.00

35132 Repair artery rupture groin 48.50 70.00 $3,395.00

3514F Hep c scrng docd as done 0.00 70.00 $0.00

35142 Repair artery rupture thigh 39.07 70.00 $2,734.90

3515F Pt has docd immun to hep c 0.00 70.00 $0.00

35152 Repair ruptd popliteal art 41.45 70.00 $2,901.50

3517F Hbv assess&results intrp 1yr 0.00 70.00 $0.00

35180 Repair blood vessel lesion 26.42 70.00 $1,849.40

3520F Cdifficile testing performed 0.00 70.00 $0.00

35301 Rechanneling of artery 33.49 70.00 $2,344.30

35306 Rechanneling of artery 13.25 70.00 $927.50

35390 Reoperation carotid add-on 4.73 70.00 $331.10

35400 Angioscopy 4.42 70.00 $309.40

35450 Repair arterial blockage 14.85 70.00 $1,039.50

35452 Repair arterial blockage 10.11 70.00 $707.70

35460 Repair venous blockage 9.26 70.00 $648.20

35476 Repair venous blockage 40.60 70.00 $2,842.00

3550F Low rsk thromboembolism 0.00 70.00 $0.00

35500 Harvest vein for bypass 9.46 70.00 $662.20

35501 Art byp grft ipsilat carotid 44.55 70.00 $3,118.50

35506 Art byp grft subclav-carotid 37.83 70.00 $2,648.10

35508 Art byp grft carotid-vertbrl 39.42 70.00 $2,759.40

35509 Art byp grft contral carotid 41.98 70.00 $2,938.60

3551F Intrmed rsk thromboembolism 0.00 70.00 $0.00

35510 Art byp grft carotid-brchial 36.51 70.00 $2,555.70

35511 Art byp grft subclav-subclav 33.26 70.00 $2,328.20

35512 Art byp grft subclav-brchial 40.79 70.00 $2,855.30

35515 Art byp grft subclav-vertbrl 45.12 70.00 $3,158.40

35516 Art byp grft subclav-axilary 36.22 70.00 $2,535.40

35518 Art byp grft axillary-axilry 33.90 70.00 $2,373.00

3552F Hgh risk for thromboembolism 0.00 70.00 $0.00

35521 Art byp grft axill-femoral 36.39 70.00 $2,547.30

35522 Art byp grft axill-brachial 36.00 70.00 $2,520.00

35523 Art byp grft brchl-ulnr-rdl 38.28 70.00 $2,679.60

35525 Art byp grft brachial-brchl 34.04 70.00 $2,382.80

35526 Art byp grft aor/carot/innom 51.17 70.00 $3,581.90

35531 Art byp grft aorcel/aormesen 59.91 70.00 $4,193.70

35533 Art byp grft axill/fem/fem 44.70 70.00 $3,129.00

35535 Art byp grft hepatorenal 56.49 70.00 $3,954.30

35536 Art byp grft splenorenal 50.16 70.00 $3,511.20

35537 Art byp grft aortoiliac 70.14 70.00 $4,909.80

35538 Art byp grft aortobi-iliac 69.29 70.00 $4,850.30

35539 Art byp grft aortofemoral 65.09 70.00 $4,556.30

35540 Art byp grft aortbifemoral 76.05 70.00 $5,323.50

3555F Pt inr measurement performed 0.00 70.00 $0.00

35556 Art byp grft fem-popliteal 41.51 70.00 $2,905.70

35558 Art byp grft fem-femoral 36.37 70.00 $2,545.90

35560 Art byp grft aortorenal 50.59 70.00 $3,541.30

35563 Art byp grft ilioiliac 44.87 70.00 $3,140.90

35565 Art byp grft iliofemoral 39.36 70.00 $2,755.20

35566 Art byp fem-ant-post tib/prl 49.55 70.00 $3,468.50

35570 Art byp tibial-tib/peroneal 45.02 70.00 $3,151.40

35571 Art byp pop-tibl-prl-other 39.43 70.00 $2,760.10

35572 Harvest femoropopliteal vein 10.22 70.00 $715.40

35583 Vein byp grft fem-popliteal 43.06 70.00 $3,014.20

35585 Vein byp fem-tibial peroneal 49.82 70.00 $3,487.40

35587 Vein byp pop-tibl peroneal 40.68 70.00 $2,847.60

35600 Harvest art for cabg add-on 7.47 70.00 $522.90

35601 Art byp common ipsi carotid 41.59 70.00 $2,911.30

35606 Art byp carotid-subclavian 34.91 70.00 $2,443.70

35612 Art byp subclav-subclavian 30.98 70.00 $2,168.60

35616 Art byp subclav-axillary 32.71 70.00 $2,289.70

35621 Art byp axillary-femoral 32.65 70.00 $2,285.50

35623 Art byp axillary-pop-tibial 38.97 70.00 $2,727.90

35626 Art byp aorsubcl/carot/innom 46.44 70.00 $3,250.80

35631 Art byp aor-celiac-msn-renal 54.90 70.00 $3,843.00

35632 Art byp ilio-celiac 53.64 70.00 $3,754.80

35633 Art byp ilio-mesenteric 59.73 70.00 $4,181.10

35634 Art byp iliorenal 54.32 70.00 $3,802.40

35636 Art byp spenorenal 47.32 70.00 $3,312.40

35637 Art byp aortoiliac 51.61 70.00 $3,612.70

35638 Art byp aortobi-iliac 52.30 70.00 $3,661.00

35642 Art byp carotid-vertebral 33.91 70.00 $2,373.70

35645 Art byp subclav-vertebrl 28.05 70.00 $1,963.50

35646 Art byp aortobifemoral 50.92 70.00 $3,564.40

35647 Art byp aortofemoral 45.95 70.00 $3,216.50

35650 Art byp axillary-axillary 32.29 70.00 $2,260.30

35654 Art byp axill-fem-femoral 40.71 70.00 $2,849.70

35656 Art byp femoral-popliteal 32.15 70.00 $2,250.50

35661 Art byp femoral-femoral 32.18 70.00 $2,252.60

35663 Art byp ilioiliac 37.45 70.00 $2,621.50

35665 Art byp iliofemoral 34.76 70.00 $2,433.20

35666 Art byp fem-ant-post tib/prl 37.49 70.00 $2,624.30

35671 Art byp pop-tibl-prl-other 33.13 70.00 $2,319.10

35681 Composite byp grft pros&vein 2.37 70.00 $165.90

35682 Composite byp grft 2 veins 10.48 70.00 $733.60

35683 Composite byp grft 3/> segmt 12.17 70.00 $851.90

35685 Bypass graft patency/patch 5.90 70.00 $413.00

35686 Bypass graft/av fist patency 4.79 70.00 $335.30

35691 Art trnsposj vertbrl carotid 28.02 70.00 $1,961.40

35693 Art trnsposj subclavian 24.72 70.00 $1,730.40

35694 Art trnsposj subclav carotid 29.27 70.00 $2,048.90

35695 Art trnsposj carotid subclav 30.40 70.00 $2,128.00

35697 Reimplant artery each 4.38 70.00 $306.60

3570F Rprt bone scint xref w xray 0.00 70.00 $0.00

35700 Reoperation bypass graft 4.53 70.00 $317.10

35701 Exploration carotid artery 16.58 70.00 $1,160.60

3572F Pt consid poss risk fx 0.00 70.00 $0.00

35721 Exploration femoral artery 13.46 70.00 $942.20

3573F Pt not consid poss risk fx 0.00 70.00 $0.00

35741 Exploration popliteal artery 15.07 70.00 $1,054.90

35761 Exploration of artery/vein 11.48 70.00 $803.60

35800 Explore neck vessels 20.90 70.00 $1,463.00

35820 Explore chest vessels 58.55 70.00 $4,098.50

35840 Explore abdominal vessels 34.61 70.00 $2,422.70

35860 Explore limb vessels 24.76 70.00 $1,733.20

35870 Repair vessel graft defect 36.91 70.00 $2,583.70

35875 Removal of clot in graft 17.58 70.00 $1,230.60

35876 Removal of clot in graft 27.97 70.00 $1,957.90

35879 Revise graft w/vein 27.32 70.00 $1,912.40

35883 Revise graft w/nonauto graft 35.84 70.00 $2,508.80

35901 Excision graft neck 14.57 70.00 $1,019.90

35903 Excision graft extremity 16.69 70.00 $1,168.30

35905 Excision graft thorax 52.08 70.00 $3,645.60

35907 Excision graft abdomen 56.64 70.00 $3,964.80

36000 Place needle in vein 0.72 70.00 $50.40

36002 Pseudoaneurysm injection trt 4.67 70.00 $326.90

36005 Injection ext venography 9.18 70.00 $642.60

36010 Place catheter in vein 14.27 70.00 $998.90

36011 Place catheter in vein 23.76 70.00 $1,663.20

36012 Place catheter in vein 24.55 70.00 $1,718.50

36013 Place catheter in artery 22.21 70.00 $1,554.70

36100 Establish access to artery 13.99 70.00 $979.30

36147 Access av dial grft for eval 23.77 70.00 $1,663.90

36148 Access av dial grft for proc 7.45 70.00 $521.50

36160 Establish access to aorta 14.10 70.00 $987.00

36200 Place catheter in aorta 17.80 70.00 $1,246.00

36218 Place catheter in artery 5.25 70.00 $367.50

36221 Place cath thoracic aorta 31.14 70.00 $2,179.80

36222 Place cath carotid/inom art 36.07 70.00 $2,524.90

36223 Place cath carotid/inom art 43.29 70.00 $3,030.30

36224 Place cath carotd art 54.00 70.00 $3,780.00

36225 Place cath subclavian art 41.78 70.00 $2,924.60

36226 Place cath vertebral art 52.74 70.00 $3,691.80

36227 Place cath xtrnl carotid 7.47 70.00 $522.90

36228 Place cath intracranial art 35.90 70.00 $2,513.00

36245 Ins cath abd/l-ext art 1st 38.95 70.00 $2,726.50

36246 Ins cath abd/l-ext art 2nd 25.42 70.00 $1,779.40

36247 Ins cath abd/l-ext art 3rd 44.90 70.00 $3,143.00

36248 Ins cath abd/l-ext art addl 4.35 70.00 $304.50

36251 Ins cath ren art 1st unilat 40.50 70.00 $2,835.00

36252 Ins cath ren art 1st bilat 43.99 70.00 $3,079.30

36253 Ins cath ren art 2nd+ unilat 64.50 70.00 $4,515.00

36254 Ins cath ren art 2nd+ bilat 62.75 70.00 $4,392.50

36260 Insertion of infusion pump 18.71 70.00 $1,309.70

36261 Revision of infusion pump 10.49 70.00 $734.30

36262 Removal of infusion pump 8.84 70.00 $618.80

36299 Vessel injection procedure 0.00 70.00 $0.00

36400 Bl draw < 3 yrs fem/jugular 0.80 70.00 $56.00

36405 Bl draw <3 yrs scalp vein 0.75 70.00 $52.50

36406 Bl draw <3 yrs other vein 0.58 70.00 $40.60

36410 Non-routine bl draw 3/> yrs 0.48 70.00 $33.60

36415 Routine venipuncture 0.00 70.00 $0.00

36416 Capillary blood draw 0.00 70.00 $0.00

36420 Vein access cutdown < 1 yr 1.46 70.00 $102.20

36425 Vein access cutdown > 1 yr 1.15 70.00 $80.50

36430 Blood transfusion service 0.98 70.00 $68.60

36440 Bl push transfuse 2 yr/< 1.62 70.00 $113.40

36450 Bl exchange/transfuse nb 3.42 70.00 $239.40

36455 Bl exchange/transfuse non-nb 3.72 70.00 $260.40

36460 Transfusion service fetal 9.99 70.00 $699.30

36468 Injection(s) spider veins 0.00 70.00 $0.00

36470 Injection therapy of vein 4.27 70.00 $298.90

36471 Injection therapy of veins 4.99 70.00 $349.30

36475 Endovenous rf 1st vein 43.66 70.00 $3,056.20

36476 Endovenous rf vein add-on 8.45 70.00 $591.50

36478 Endovenous laser 1st vein 34.17 70.00 $2,391.90

36479 Endovenous laser vein addon 8.78 70.00 $614.60

36481 Insertion of catheter vein 58.66 70.00 $4,106.20

3650F Eeg ordered rvwd reqstd 0.00 70.00 $0.00

36500 Insertion of catheter vein 5.27 70.00 $368.90

36510 Insertion of catheter vein 2.64 70.00 $184.80

36511 Apheresis wbc 2.65 70.00 $185.50

36512 Apheresis rbc 2.72 70.00 $190.40

36513 Apheresis platelets 2.79 70.00 $195.30

36514 Apheresis plasma 15.16 70.00 $1,061.20

36515 Apheresis adsorp/reinfuse 58.24 70.00 $4,076.80

36516 Apheresis selective 58.80 70.00 $4,116.00

36522 Photopheresis 39.45 70.00 $2,761.50

36555 Insert non-tunnel cv cath 7.23 70.00 $506.10

36556 Insert non-tunnel cv cath 6.65 70.00 $465.50

36557 Insert tunneled cv cath 29.14 70.00 $2,039.80

36568 Insert picc cath 8.64 70.00 $604.80

36569 Insert picc cath 7.12 70.00 $498.40

36570 Insert picvad cath 33.86 70.00 $2,370.20

36571 Insert picvad cath 37.26 70.00 $2,608.20

36575 Repair tunneled cv cath 4.73 70.00 $331.10

36576 Repair tunneled cv cath 11.10 70.00 $777.00

36578 Replace tunneled cv cath 14.88 70.00 $1,041.60

36580 Replace cvad cath 6.13 70.00 $429.10

36584 Replace picc cath 5.82 70.00 $407.40

36585 Replace picvad cath 33.01 70.00 $2,310.70

36589 Removal tunneled cv cath 4.74 70.00 $331.80

36590 Removal tunneled cv cath 8.40 70.00 $588.00

36591 Draw blood off venous device 0.66 70.00 $46.20

36592 Collect blood from picc 0.74 70.00 $51.80

36593 Declot vascular device 0.87 70.00 $60.90

36595 Mech remov tunneled cv cath 16.67 70.00 $1,166.90

36596 Mech remov tunneled cv cath 3.80 70.00 $266.00

36597 Reposition venous catheter 3.66 70.00 $256.20

36598 Inj w/fluor eval cv device 3.13 70.00 $219.10

36600 Withdrawal of arterial blood 0.90 70.00 $63.00

36620 Insertion catheter artery 1.47 70.00 $102.90

36680 Insert needle bone cavity 1.70 70.00 $119.00

36800 Insertion of cannula 3.58 70.00 $250.60

36818 Av fuse uppr arm cephalic 20.44 70.00 $1,430.80

36819 Av fuse uppr arm basilic 21.67 70.00 $1,516.90

36820 Av fusion/forearm vein 21.52 70.00 $1,506.40

36821 Av fusion direct any site 19.62 70.00 $1,373.40

36823 Insertion of cannula(s) 40.34 70.00 $2,823.80

36825 Artery-vein autograft 23.66 70.00 $1,656.20

36830 Artery-vein nonautograft 19.73 70.00 $1,381.10

36831 Open thrombect av fistula 18.25 70.00 $1,277.50

36832 Av fistula revision open 22.37 70.00 $1,565.90

36833 Av fistula revision 23.93 70.00 $1,675.10

36835 Artery to vein shunt 14.67 70.00 $1,026.90

36838 Dist revas ligation hemo 33.84 70.00 $2,368.80

36860 External cannula declotting 5.92 70.00 $414.40

36861 Cannula declotting 3.85 70.00 $269.50

36870 Percut thrombect av fistula 52.17 70.00 $3,651.90

3700F Psych disorders assessed 0.00 70.00 $0.00

37140 Revision of circulation 67.20 70.00 $4,704.00

37181 Splice spleen/kidney veins 67.20 70.00 $4,704.00

37182 Insert hepatic shunt (tips) 24.42 70.00 $1,709.40

37183 Remove hepatic shunt (tips) 168.10 70.00 $11,767.00

37184 Prim art mech thrombectomy 64.79 70.00 $4,535.30

37185 Prim art m-thrombect add-on 20.50 70.00 $1,435.00

37186 Sec art m-thrombect add-on 39.27 70.00 $2,748.90

37187 Venous mech thrombectomy 58.82 70.00 $4,117.40

37188 Venous m-thrombectomy add-on 50.20 70.00 $3,514.00

37191 Ins endovas vena cava filtr 74.98 70.00 $5,248.60

37192 Redo endovas vena cava filtr 47.84 70.00 $3,348.80

37193 Rem endovas vena cava filter 45.67 70.00 $3,196.90

37195 Thrombolytic therapy stroke 0.00 70.00 $0.00

37197 Remove intrvas foreign body 43.34 70.00 $3,033.80

3720F Cognit impairment assessed 0.00 70.00 $0.00

37200 Transcatheter biopsy 6.45 70.00 $451.50

37202 Transcatheter therapy infuse 8.78 70.00 $614.60

37211 Thrombolytic art therapy 11.73 70.00 $821.10

37212 Thrombolytic venous therapy 10.28 70.00 $719.60

37213 Thromblytic art/ven therapy 7.25 70.00 $507.50

37214 Cessj therapy cath removal 3.99 70.00 $279.30

37215 Transcath stent cca w/eps 31.90 70.00 $2,233.00

37216 Transcath stent cca w/o eps 0.00 70.00 $0.00

37217 Stent placemt retro carotid 32.94 70.00 $2,305.80

37218 Stent placemt ante carotid 24.06 70.00 $1,684.20

37220 Iliac revasc 89.92 70.00 $6,294.40

37221 Iliac revasc w/stent 132.59 70.00 $9,281.30

37222 Iliac revasc add-on 25.23 70.00 $1,766.10

37223 Iliac revasc w/stent add-on 73.88 70.00 $5,171.60

37224 Fem/popl revas w/tla 109.10 70.00 $7,637.00

37225 Fem/popl revas w/ather 313.80 70.00 $21,966.00

37226 Fem/popl revasc w/stent 258.06 70.00 $18,064.20

37227 Fem/popl revasc stnt & ather 423.76 70.00 $29,663.20

37228 Tib/per revasc w/tla 155.15 70.00 $10,860.50

37229 Tib/per revasc w/ather 309.59 70.00 $21,671.30

37230 Tib/per revasc w/stent 236.72 70.00 $16,570.40

37231 Tib/per revasc stent & ather 380.32 70.00 $26,622.40

37232 Tib/per revasc add-on 34.62 70.00 $2,423.40

37233 Tibper revasc w/ather add-on 41.88 70.00 $2,931.60

37234 Revsc opn/prq tib/pero stent 110.40 70.00 $7,728.00

37235 Tib/per revasc stnt & ather 118.57 70.00 $8,299.90

37236 Open/perq place stent 1st 118.06 70.00 $8,264.20

37237 Open/perq place stent ea add 70.77 70.00 $4,953.90

37238 Open/perq place stent same 117.02 70.00 $8,191.40

37239 Open/perq place stent ea add 57.75 70.00 $4,042.50

37241 Vasc embolize/occlude venous 130.70 70.00 $9,149.00

37242 Vasc embolize/occlude artery 220.30 70.00 $15,421.00

37243 Vasc embolize/occlude organ 278.10 70.00 $19,467.00

37244 Vasc embolize/occlude bleed 194.62 70.00 $13,623.40

3725F Screen depression performed 0.00 70.00 $0.00

37250 Iv us first vessel add-on 3.14 70.00 $219.80

37251 Iv us each add vessel add-on 2.36 70.00 $165.20

3750F Ptnotrcvngsteroid>/=10mg/day 0.00 70.00 $0.00

37500 Endoscopy ligate perf veins 18.88 70.00 $1,321.60

37501 Vascular endoscopy procedure 0.00 70.00 $0.00

3751F Electrodiag polyneuro 6 mn 0.00 70.00 $0.00

3752F No electrodiag polyneuro 6mn 0.00 70.00 $0.00

3753F Pt has symp&signs neuropathy 0.00 70.00 $0.00

3754F Screening tests dm done 0.00 70.00 $0.00

3755F Cog&behav imprmnt scrng done 0.00 70.00 $0.00

3756F Pt w/pseudobulb affect/als 0.00 70.00 $0.00

37565 Ligation of neck vein 21.37 70.00 $1,495.90

3757F Pt w/o pseudobulbaffect/als 0.00 70.00 $0.00

3758F Pt ref pulm fx test/peakflow 0.00 70.00 $0.00

3759F Pt scrn dysphag/wt loss/nutr 0.00 70.00 $0.00

3760F Pt w/ dysphag/wt loss/nutr 0.00 70.00 $0.00

37600 Ligation of neck artery 21.16 70.00 $1,481.20

37606 Ligation of neck artery 14.21 70.00 $994.70

37607 Ligation of a-v fistula 11.07 70.00 $774.90

37609 Temporal artery procedure 8.91 70.00 $623.70

3761F Pt w/o dysphag/wt loss/nutr 0.00 70.00 $0.00

37616 Ligation of chest artery 32.29 70.00 $2,260.30

37617 Ligation of abdomen artery 39.21 70.00 $2,744.70

37618 Ligation of extremity artery 11.17 70.00 $781.90

37619 Ligation of inf vena cava 47.70 70.00 $3,339.00

3762F Patient is dysarthric 0.00 70.00 $0.00

3763F Patient is not dysarthric 0.00 70.00 $0.00

37650 Revision of major vein 13.62 70.00 $953.40

37660 Revision of major vein 38.09 70.00 $2,666.30

37700 Revise leg vein 7.32 70.00 $512.40

37718 Ligate/strip short leg vein 12.83 70.00 $898.10

37722 Ligate/strip long leg vein 14.04 70.00 $982.80

37735 Removal of leg veins/lesion 17.24 70.00 $1,206.80

3775F Adenoma detected screening 0.00 70.00 $0.00

3776F Adenoma not detect screening 0.00 70.00 $0.00

37760 Ligate leg veins radical 18.02 70.00 $1,261.40

37761 Ligate leg veins open 16.31 70.00 $1,141.70

37765 Stab phleb veins xtr 10-20 18.90 70.00 $1,323.00

37766 Phleb veins - extrem 20+ 22.44 70.00 $1,570.80

37780 Revision of leg vein 7.57 70.00 $529.90

37785 Ligate/divide/excise vein 10.37 70.00 $725.90

37788 Revascularization penis 36.26 70.00 $2,538.20

37790 Penile venous occlusion 13.97 70.00 $977.90

37799 Vascular surgery procedure 0.00 70.00 $0.00

38100 Removal of spleen total 33.37 70.00 $2,335.90

38101 Removal of spleen partial 33.74 70.00 $2,361.80

38102 Removal of spleen total 7.60 70.00 $532.00

38115 Repair of ruptured spleen 36.94 70.00 $2,585.80

38120 Laparoscopy splenectomy 30.45 70.00 $2,131.50

38129 Laparoscope proc spleen 0.00 70.00 $0.00

38200 Injection for spleen x-ray 3.90 70.00 $273.00

38204 Bl donor search management 2.91 70.00 $203.70

38205 Harvest allogeneic stem cell 2.36 70.00 $165.20

38206 Harvest auto stem cells 2.38 70.00 $166.60

38207 Cryopreserve stem cells 1.28 70.00 $89.60

38208 Thaw preserved stem cells 0.80 70.00 $56.00

38209 Wash harvest stem cells 0.34 70.00 $23.80

38210 T-cell depletion of harvest 2.28 70.00 $159.60

38211 Tumor cell deplete of harvst 2.06 70.00 $144.20

38212 Rbc depletion of harvest 1.36 70.00 $95.20

38213 Platelet deplete of harvest 0.34 70.00 $23.80

38214 Volume deplete of harvest 1.17 70.00 $81.90

38215 Harvest stem cell concentrte 1.36 70.00 $95.20

38220 Bone marrow aspiration 4.67 70.00 $326.90

38221 Bone marrow biopsy 4.76 70.00 $333.20

38230 Bone marrow harvest allogen 5.70 70.00 $399.00

38232 Bone marrow harvest autolog 5.86 70.00 $410.20

38240 Transplt allo hct/donor 6.42 70.00 $449.40

38241 Transplt autol hct/donor 4.83 70.00 $338.10

38242 Transplt allo lymphocytes 3.42 70.00 $239.40

38243 Transplj hematopoietic boost 3.42 70.00 $239.40

38300 Drainage lymph node lesion 7.85 70.00 $549.50

38305 Drainage lymph node lesion 13.34 70.00 $933.80

38308 Incision of lymph channels 12.80 70.00 $896.00

38380 Thoracic duct procedure 16.14 70.00 $1,129.80

38500 Biopsy/removal lymph nodes 9.49 70.00 $664.30

38505 Needle biopsy lymph nodes 3.63 70.00 $254.10

38510 Biopsy/removal lymph nodes 14.92 70.00 $1,044.40

38530 Biopsy/removal lymph nodes 15.77 70.00 $1,103.90

38542 Explore deep node(s) neck 14.93 70.00 $1,045.10

38550 Removal neck/armpit lesion 14.65 70.00 $1,025.50

38555 Removal neck/armpit lesion 29.07 70.00 $2,034.90

38562 Removal pelvic lymph nodes 20.32 70.00 $1,422.40

38564 Removal abdomen lymph nodes 20.34 70.00 $1,423.80

38570 Laparoscopy lymph node biop 15.51 70.00 $1,085.70

38571 Laparoscopy lymphadenectomy 23.00 70.00 $1,610.00

38572 Laparoscopy lymphadenectomy 28.45 70.00 $1,991.50

38589 Laparoscope proc lymphatic 0.00 70.00 $0.00

38700 Removal of lymph nodes neck 23.28 70.00 $1,629.60

38740 Remove armpit lymph nodes 20.03 70.00 $1,402.10

38745 Remove armpit lymph nodes 25.27 70.00 $1,768.90

38746 Remove thoracic lymph nodes 6.28 70.00 $439.60

38747 Remove abdominal lymph nodes 7.75 70.00 $542.50

38760 Remove groin lymph nodes 24.30 70.00 $1,701.00

38765 Remove groin lymph nodes 37.33 70.00 $2,613.10

38770 Remove pelvis lymph nodes 23.26 70.00 $1,628.20

38780 Remove abdomen lymph nodes 29.60 70.00 $2,072.00

38790 Inject for lymphatic x-ray 2.42 70.00 $169.40

38792 Ra tracer id of sentinl node 1.14 70.00 $79.80

38794 Access thoracic lymph duct 8.70 70.00 $609.00

38900 Io map of sent lymph node 3.99 70.00 $279.30

38999 Blood/lymph system procedure 0.00 70.00 $0.00

39200 Resect mediastinal cyst 25.57 70.00 $1,789.90

39220 Resect mediastinal tumor 33.11 70.00 $2,317.70

39400 Mediastinoscopy incl biopsy 14.78 70.00 $1,034.60

39499 Chest procedure 0.00 70.00 $0.00

39501 Repair diaphragm laceration 24.60 70.00 $1,722.00

39503 Repair of diaphragm hernia 178.42 70.00 $12,489.40

39545 Revision of diaphragm 25.91 70.00 $1,813.70

39560 Resect diaphragm simple 23.09 70.00 $1,616.30

39561 Resect diaphragm complex 35.88 70.00 $2,511.60

39599 Diaphragm surgery procedure 0.00 70.00 $0.00

4000F Tobacco use txmnt counseling 0.00 70.00 $0.00

4001F Tobacco use txmnt pharmacol 0.00 70.00 $0.00

4003F Pt ed write/oral pts w/ hf 0.00 70.00 $0.00

4004F Pt tobacco screen rcvd tlk 0.00 70.00 $0.00

4005F Pharm thx for op rxd 0.00 70.00 $0.00

4008F Beta-blocker therapy rxd/tkn 0.00 70.00 $0.00

4010F Ace/arb therapy rxd/taken 0.00 70.00 $0.00

4011F Oral antiplatelet therapy rx 0.00 70.00 $0.00

4012F Warfarin therapy rx 0.00 70.00 $0.00

4013F Statin therapy/currently tkn 0.00 70.00 $0.00

4014F Written discharge instr prvd 0.00 70.00 $0.00

4015F Persist asthma medicine ctrl 0.00 70.00 $0.00

4016F Anti-inflm/anlgsc agent rx 0.00 70.00 $0.00

4017F Gi prophylaxis for nsaid rx 0.00 70.00 $0.00

4018F Therapy exercise joint rx 0.00 70.00 $0.00

4019F Doc recpt counsl vit d/calc+ 0.00 70.00 $0.00

4025F Inhaled bronchodilator rx 0.00 70.00 $0.00

4030F Oxygen therapy rx 0.00 70.00 $0.00

4033F Pulmonary rehab rec 0.00 70.00 $0.00

4035F Influenza imm rec 0.00 70.00 $0.00

4037F Influenza imm order/admin 0.00 70.00 $0.00

4040F Pneumoc vac/admin/rcvd 0.00 70.00 $0.00

4041F Doc order cefazolin/cefurox 0.00 70.00 $0.00

4042F Doc antibio not given 0.00 70.00 $0.00

4043F Doc order given stop antibio 0.00 70.00 $0.00

4044F Doc order given vte prophylx 0.00 70.00 $0.00

4045F Empiric antibiotic rx 0.00 70.00 $0.00

4046F Doc antibio given b/4 surg 0.00 70.00 $0.00

4049F Doc order given stop antibio 0.00 70.00 $0.00

40490 Biopsy of lip 3.68 70.00 $257.60

4050F Ht care plan doc 0.00 70.00 $0.00

40500 Partial excision of lip 14.56 70.00 $1,019.20

4051F Referred for an av fistula 0.00 70.00 $0.00

40510 Partial excision of lip 13.97 70.00 $977.90

4052F Hemodialysis via av fistula 0.00 70.00 $0.00

40520 Partial excision of lip 14.12 70.00 $988.40

40525 Reconstruct lip with flap 15.93 70.00 $1,115.10

40527 Reconstruct lip with flap 17.87 70.00 $1,250.90

4053F Hemodialysis via av graft 0.00 70.00 $0.00

40530 Partial removal of lip 15.55 70.00 $1,088.50

4054F Hemodialysis via catheter 0.00 70.00 $0.00

4055F Pt rcvng periton dialysis 0.00 70.00 $0.00

4056F Approp oral rehyd recommd 0.00 70.00 $0.00

4058F Ped gastro ed given caregvr 0.00 70.00 $0.00

4060F Psych svcs provided 0.00 70.00 $0.00

4062F Pt referral psych docd 0.00 70.00 $0.00

4063F Antidepres rxthxpy not rxd 0.00 70.00 $0.00

4064F Antidepressant rx 0.00 70.00 $0.00

4065F Antipsychotic rx 0.00 70.00 $0.00

40650 Repair lip 12.59 70.00 $881.30

40652 Repair lip 14.18 70.00 $992.60

40654 Repair lip 16.37 70.00 $1,145.90

4066F Ect provided 0.00 70.00 $0.00

4067F Pt referral for ect docd 0.00 70.00 $0.00

4069F Vte prophylaxis rcvd 0.00 70.00 $0.00

4070F Dvt prophylx recvd day 2 0.00 70.00 $0.00

40700 Repair cleft lip/nasal 29.07 70.00 $2,034.90

4073F Oral antiplat thx rx dischrg 0.00 70.00 $0.00

4075F Anticoag thx rx at dischrg 0.00 70.00 $0.00

4077F Doc t-pa admin considered 0.00 70.00 $0.00

4079F Doc rehab svcs considered 0.00 70.00 $0.00

40799 Lip surgery procedure 0.00 70.00 $0.00

40800 Drainage of mouth lesion 6.17 70.00 $431.90

40804 Removal foreign body mouth 6.17 70.00 $431.90

40805 Removal foreign body mouth 9.43 70.00 $660.10

40806 Incision of lip fold 3.13 70.00 $219.10

40808 Biopsy of mouth lesion 5.44 70.00 $380.80

40810 Excision of mouth lesion 6.01 70.00 $420.70

40812 Excise/repair mouth lesion 8.42 70.00 $589.40

40814 Excise/repair mouth lesion 11.27 70.00 $788.90

40818 Excise oral mucosa for graft 10.48 70.00 $733.60

40819 Excise lip or cheek fold 9.17 70.00 $641.90

40820 Treatment of mouth lesion 7.74 70.00 $541.80

40830 Repair mouth laceration 7.74 70.00 $541.80

40831 Repair mouth laceration 9.81 70.00 $686.70

4084F Aspirin recvd w/in 24 hrs 0.00 70.00 $0.00

40840 Reconstruction of mouth 23.60 70.00 $1,652.00

4086F Aspirin/clopidogrel rxd 0.00 70.00 $0.00

40899 Mouth surgery procedure 0.00 70.00 $0.00

4090F Pt rcvng epo thxpy 0.00 70.00 $0.00

4095F Pt not rcvng epo thxpy 0.00 70.00 $0.00

4100F Biphos thxpy vein ord/recvd 0.00 70.00 $0.00

41010 Incision of tongue fold 5.87 70.00 $410.90

41018 Drainage of mouth lesion 14.75 70.00 $1,032.50

41019 Place needles h&n for rt 13.37 70.00 $935.90

4110F Int mam art used for cabg 0.00 70.00 $0.00

41100 Biopsy of tongue 4.89 70.00 $342.30

41105 Biopsy of tongue 4.97 70.00 $347.90

41108 Biopsy of floor of mouth 4.31 70.00 $301.70

41110 Excision of tongue lesion 6.16 70.00 $431.20

41114 Excision of tongue lesion 18.56 70.00 $1,299.20

41115 Excision of tongue fold 7.17 70.00 $501.90

41120 Partial removal of tongue 30.45 70.00 $2,131.50

41130 Partial removal of tongue 37.69 70.00 $2,638.30

41135 Tongue and neck surgery 62.57 70.00 $4,379.90

41140 Removal of tongue 62.87 70.00 $4,400.90

41145 Tongue removal neck surgery 79.56 70.00 $5,569.20

4115F Beta blckr admin w/in 24 hrs 0.00 70.00 $0.00

41150 Tongue mouth jaw surgery 63.17 70.00 $4,421.90

41153 Tongue mouth neck surgery 68.97 70.00 $4,827.90

41155 Tongue jaw & neck surgery 86.81 70.00 $6,076.70

4120F Antibiot rxd/given 0.00 70.00 $0.00

4124F Antibiot not rxd/given 0.00 70.00 $0.00

41250 Repair tongue laceration 7.81 70.00 $546.70

4130F Topical prep rx aoe 0.00 70.00 $0.00

4131F Syst antimicrobial thx rx 0.00 70.00 $0.00

4132F No syst antimicrobial thx rx 0.00 70.00 $0.00

4133F Antihist/decong rx/recom 0.00 70.00 $0.00

4134F No antihist/decong rx/recom 0.00 70.00 $0.00

4135F Systemic corticosteroids rx 0.00 70.00 $0.00

4136F Syst corticosteroids not rx 0.00 70.00 $0.00

4140F Inhaled corticosteroids rxd 0.00 70.00 $0.00

4142F Corticoster sparng thrpy rxd 0.00 70.00 $0.00

4144F Alt long-term cntrl med rxd 0.00 70.00 $0.00

4145F 2+ anti-hyprtnsv agents tkn 0.00 70.00 $0.00

4148F Hep a vac injxn admin/recvd 0.00 70.00 $0.00

4149F Hep b vac injxn admin/recvd 0.00 70.00 $0.00

4150F Pt recvng antivir txmnt hepc 0.00 70.00 $0.00

41500 Fixation of tongue 13.27 70.00 $928.90

4151F Pt not recvng antiv hep c 0.00 70.00 $0.00

41510 Tongue to lip surgery 11.59 70.00 $811.30

41512 Tongue suspension 18.47 70.00 $1,292.90

41520 Reconstruction tongue fold 10.35 70.00 $724.50

4153F Combo pegintf/rib rx 0.00 70.00 $0.00

41530 Tongue base vol reduction 92.44 70.00 $6,470.80

4155F Hep a vac series prev recvd 0.00 70.00 $0.00

4157F Hep b vac series prev recvd 0.00 70.00 $0.00

4158F Pt edu re alcoh drnkng done 0.00 70.00 $0.00

4159F Contrcp talk b/4 antiv txmnt 0.00 70.00 $0.00

41599 Tongue and mouth surgery 0.00 70.00 $0.00

4163F Pt couns 4 txmnt opt prost 0.00 70.00 $0.00

4164F Adjv hrmnl thxpy rxd 0.00 70.00 $0.00

4165F 3d-crt/imrt received 0.00 70.00 $0.00

4167F Hd bed tilted 1st day vent 0.00 70.00 $0.00

4168F Pt care icu&vent w/in 24hrs 0.00 70.00 $0.00

4169F No pt care icu/vent in 24hrs 0.00 70.00 $0.00

4171F Pt rcvng esa thxpy 0.00 70.00 $0.00

4172F Pt not rcvng esa thxpy 0.00 70.00 $0.00

4174F Couns potent glauc impct 0.00 70.00 $0.00

4175F Vis 20/40/> w/in 90 days 0.00 70.00 $0.00

4176F Talk re uv light pt/crgvr 0.00 70.00 $0.00

4177F Talk pt/crgvr re areds prev 0.00 70.00 $0.00

4178F Antid glbln rcvd w/in 26wks 0.00 70.00 $0.00

4179F Tamoxifen/ai prescribed 0.00 70.00 $0.00

4180F Adjv thxpyrxd/rcvd colon ca 0.00 70.00 $0.00

41800 Drainage of gum lesion 7.81 70.00 $546.70

41805 Removal foreign body gum 7.25 70.00 $507.50

41806 Removal foreign body jawbone 10.39 70.00 $727.30

4181F Conformal radn thxpy rcvd 0.00 70.00 $0.00

4182F No conformal radn thxpy 0.00 70.00 $0.00

41820 Excision gum each quadrant 0.00 70.00 $0.00

41821 Excision of gum flap 0.00 70.00 $0.00

41822 Excision of gum lesion 9.06 70.00 $634.20

41830 Removal of gum tissue 11.54 70.00 $807.80

4185F Continuous ppi or h2ra rcvd 0.00 70.00 $0.00

41850 Treatment of gum lesion 0.00 70.00 $0.00

4186F No cont ppi or h2ra rcvd 0.00 70.00 $0.00

4187F Anti rheum drugthxpyrxd/gvn 0.00 70.00 $0.00

41870 Gum graft 0.00 70.00 $0.00

41872 Repair gum 10.92 70.00 $764.40

41874 Repair tooth socket 11.05 70.00 $773.50

4188F Approp ace/arb tstng done 0.00 70.00 $0.00

4189F Approp digoxin tstng done 0.00 70.00 $0.00

41899 Dental surgery procedure 0.00 70.00 $0.00

4190F Approp diuretic tstng done 0.00 70.00 $0.00

4191F Approp anticonvuls tstng 0.00 70.00 $0.00

4192F Pt not rcvng glucoco thxpy 0.00 70.00 $0.00

4193F Pt rcvng<10mg daily predniso 0.00 70.00 $0.00

4194F Pt rcvng10mg daily predniso 0.00 70.00 $0.00

4195F Pt rcvng anti-rheum thxpy ra 0.00 70.00 $0.00

4196F Ptnot rcvng anti-rhm thxpyra 0.00 70.00 $0.00

4200F External beam to prost only 0.00 70.00 $0.00

42000 Drainage mouth roof lesion 4.58 70.00 $320.60

4201F Extrnl beam other than prost 0.00 70.00 $0.00

4210F Ace/arb thxpy for mos/> 0.00 70.00 $0.00

42100 Biopsy roof of mouth 4.38 70.00 $306.60

42104 Excision lesion mouth roof 6.27 70.00 $438.90

42120 Remove palate/lesion 28.89 70.00 $2,022.30

42140 Excision of uvula 7.33 70.00 $513.10

42145 Repair palate pharynx/uvula 20.47 70.00 $1,432.90

42160 Treatment mouth roof lesion 6.75 70.00 $472.50

42180 Repair palate 7.05 70.00 $493.50

42182 Repair palate 9.26 70.00 $648.20

4220F Digoxin thxpy for 6 mos/> 0.00 70.00 $0.00

42200 Reconstruct cleft palate 24.64 70.00 $1,724.80

4221F Diuretic thxpy for 6 mos/> 0.00 70.00 $0.00

42226 Lengthening of palate 25.94 70.00 $1,815.80

42227 Lengthening of palate 24.32 70.00 $1,702.40

42235 Repair palate 21.31 70.00 $1,491.70

42260 Repair nose to lip fistula 25.03 70.00 $1,752.10

42280 Preparation palate mold 4.80 70.00 $336.00

42281 Insertion palate prosthesis 5.93 70.00 $415.10

42299 Palate/uvula surgery 0.00 70.00 $0.00

4230F Anticonv thxpy for 6 mos/> 0.00 70.00 $0.00

42300 Drainage of salivary gland 6.06 70.00 $424.20

42330 Removal of salivary stone 6.73 70.00 $471.10

4240F Instr xrcz back pain 12 wks 0.00 70.00 $0.00

42400 Biopsy of salivary gland 3.07 70.00 $214.90

42405 Biopsy of salivary gland 8.63 70.00 $604.10

42408 Excision of salivary cyst 13.10 70.00 $917.00

42409 Drainage of salivary cyst 9.65 70.00 $675.50

42410 Excise parotid gland/lesion 18.00 70.00 $1,260.00

4242F Sprvsd xrcz back pn >12 wks 0.00 70.00 $0.00

42440 Excise submaxillary gland 11.95 70.00 $836.50

4245F Pt instr nrml lifest 0.00 70.00 $0.00

42450 Excise sublingual gland 13.14 70.00 $919.80

4248F Pt instr no bd rest 4 days/> 0.00 70.00 $0.00

4250F Wrmng 4 surg normothermia 0.00 70.00 $0.00

42500 Repair salivary duct 12.58 70.00 $880.60

42505 Repair salivary duct 16.11 70.00 $1,127.70

42507 Parotid duct diversion 14.87 70.00 $1,040.90

4255F Anesth 60 min/> as docd 0.00 70.00 $0.00

42550 Injection for salivary x-ray 3.88 70.00 $271.60

4256F Anesthe <60 min as docd 0.00 70.00 $0.00

4260F Wound srfc culturetech used 0.00 70.00 $0.00

42600 Closure of salivary fistula 13.87 70.00 $970.90

4261F Tech other than surfc cultr 0.00 70.00 $0.00

4265F Wet-dry dressings rx recmd 0.00 70.00 $0.00

42650 Dilation of salivary duct 2.42 70.00 $169.40

4266F No wet-dry drssings rx recmd 0.00 70.00 $0.00

42660 Dilation of salivary duct 3.68 70.00 $257.60

42665 Ligation of salivary duct 9.01 70.00 $630.70

4267F Comprssion thxpy prescribed 0.00 70.00 $0.00

4268F Pt ed re comp thxpy rcvd 0.00 70.00 $0.00

4269F Appropos mthd offloading rxd 0.00 70.00 $0.00

42699 Salivary surgery procedure 0.00 70.00 $0.00

4270F Pt rcvng anti r-viral thxpy 0.00 70.00 $0.00

42700 Drainage of tonsil abscess 5.50 70.00 $385.00

4271F Pt rcvng anti r-viral thxpy 0.00 70.00 $0.00

42720 Drainage of throat abscess 13.14 70.00 $919.80

42725 Drainage of throat abscess 23.74 70.00 $1,661.80

4274F Flu immuno admind rcvd 0.00 70.00 $0.00

4276F Potent antivir thxpy rxd 0.00 70.00 $0.00

4279F Pcp prophylaxis rxd 0.00 70.00 $0.00

4280F Pcp prophylax rxd 3mon low % 0.00 70.00 $0.00

42800 Biopsy of throat 4.60 70.00 $322.00

42804 Biopsy of upper nose/throat 5.64 70.00 $394.80

42806 Biopsy of upper nose/throat 6.33 70.00 $443.10

42808 Excise pharynx lesion 6.55 70.00 $458.50

42809 Remove pharynx foreign body 5.02 70.00 $351.40

42810 Excision of neck cyst 11.24 70.00 $786.80

42815 Excision of neck cyst 16.25 70.00 $1,137.50

42820 Remove tonsils and adenoids 8.40 70.00 $588.00

42821 Remove tonsils and adenoids 8.72 70.00 $610.40

42825 Removal of tonsils 7.58 70.00 $530.60

42826 Removal of tonsils 7.28 70.00 $509.60

42830 Removal of adenoids 6.02 70.00 $421.40

42842 Extensive surgery of throat 28.86 70.00 $2,020.20

42860 Excision of tonsil tags 5.47 70.00 $382.90

42870 Excision of lingual tonsil 16.77 70.00 $1,173.90

42890 Partial removal of pharynx 40.85 70.00 $2,859.50

42892 Revision of pharyngeal walls 54.33 70.00 $3,803.10

42894 Revision of pharyngeal walls 68.10 70.00 $4,767.00

4290F Pt scrned for inj drug use 0.00 70.00 $0.00

42900 Repair throat wound 9.82 70.00 $687.40

4293F Pt scrnd hgh-risk sex behav 0.00 70.00 $0.00

42950 Reconstruction of throat 22.98 70.00 $1,608.60

42953 Repair throat esophagus 27.66 70.00 $1,936.20

42955 Surgical opening of throat 21.78 70.00 $1,524.60

42960 Control throat bleeding 4.95 70.00 $346.50

42961 Control throat bleeding 12.27 70.00 $858.90

42962 Control throat bleeding 15.05 70.00 $1,053.50

42970 Control nose/throat bleeding 12.01 70.00 $840.70

42971 Control nose/throat bleeding 13.26 70.00 $928.20

42972 Control nose/throat bleeding 14.84 70.00 $1,038.80

42999 Throat surgery procedure 0.00 70.00 $0.00

4300F Pt rcvng warf thxpy 0.00 70.00 $0.00

4301F Pt not rcvng warf thxpy 0.00 70.00 $0.00

43020 Incision of esophagus 16.38 70.00 $1,146.60

43030 Throat muscle surgery 15.04 70.00 $1,052.80

43045 Incision of esophagus 37.99 70.00 $2,659.30

4305F Pt ed re ft care inspct rcvd 0.00 70.00 $0.00

4306F Pt tlk psych & rx opd addic 0.00 70.00 $0.00

43100 Excision of esophagus lesion 18.17 70.00 $1,271.90

43101 Excision of esophagus lesion 30.85 70.00 $2,159.50

43107 Removal of esophagus 74.43 70.00 $5,210.10

43116 Partial removal of esophagus 151.59 70.00 $10,611.30

43130 Removal of esophagus pouch 22.81 70.00 $1,596.70

43135 Removal of esophagus pouch 43.42 70.00 $3,039.40

43180 Esophagoscopy rigid trnso 16.18 70.00 $1,132.60

43191 Esophagoscopy rigid trnso dx 4.45 70.00 $311.50

43192 Esophagoscp rig trnso inject 4.94 70.00 $345.80

43193 Esophagoscp rig trnso biopsy 4.93 70.00 $345.10

43194 Esophagoscp rig trnso rem fb 5.56 70.00 $389.20

43195 Esophagoscopy rigid balloon 5.39 70.00 $377.30

43196 Esophagoscp guide wire dilat 5.71 70.00 $399.70

43197 Esophagoscopy flex dx brush 5.39 70.00 $377.30

43198 Esophagosc flex trnsn biopsy 6.06 70.00 $424.20

4320F Pt talk psychsoc&rx oh dpnd 0.00 70.00 $0.00

43200 Esophagoscopy flexible brush 7.75 70.00 $542.50

43201 Esoph scope w/submucous inj 7.92 70.00 $554.40

43202 Esophagoscopy flex biopsy 10.40 70.00 $728.00

43204 Esoph scope w/sclerosis inj 4.22 70.00 $295.40

43205 Esophagus endoscopy/ligation 4.35 70.00 $304.50

43206 Esoph optical endomicroscopy 9.46 70.00 $662.20

43211 Esophagoscop mucosal resect 7.27 70.00 $508.90

43212 Esophagoscop stent placement 5.79 70.00 $405.30

43213 Esophagoscopy retro balloon 35.34 70.00 $2,473.80

43214 Esophagosc dilate balloon 30 5.86 70.00 $410.20

43215 Esophagoscopy flex remove fb 11.73 70.00 $821.10

43216 Esophagoscopy lesion removal 12.04 70.00 $842.80

43217 Esophagoscopy snare les remv 12.83 70.00 $898.10

4322F Crgvr prov w/ ed addl rsrcs 0.00 70.00 $0.00

43220 Esophagoscopy balloon <30mm 32.49 70.00 $2,274.30

43226 Esoph endoscopy dilation 10.91 70.00 $763.70

43227 Esophagoscopy control bleed 11.33 70.00 $793.10

43229 Esophagoscopy lesion ablate 20.88 70.00 $1,461.60

43231 Esophagoscop ultrasound exam 11.58 70.00 $810.60

43232 Esophagoscopy w/us needle bx 13.76 70.00 $963.20

43233 Egd balloon dil esoph30 mm/> 6.91 70.00 $483.70

43235 Egd diagnostic brush wash 8.99 70.00 $629.30

43236 Uppr gi scope w/submuc inj 11.20 70.00 $784.00

43237 Endoscopic us exam esoph 6.00 70.00 $420.00

43238 Egd us fine needle bx/aspir 7.14 70.00 $499.80

43239 Egd biopsy single/multiple 11.48 70.00 $803.60

4324F Pt queried prkns complic 0.00 70.00 $0.00

43240 Egd w/transmural drain cyst 11.89 70.00 $832.30

43241 Egd tube/cath insertion 4.40 70.00 $308.00

43242 Egd us fine needle bx/aspir 8.05 70.00 $563.50

43243 Egd injection varices 7.25 70.00 $507.50

43244 Egd varices ligation 7.52 70.00 $526.40

43245 Egd dilate stricture 17.69 70.00 $1,238.30

43246 Egd place gastrostomy tube 6.11 70.00 $427.70

43247 Egd remove foreign body 11.71 70.00 $819.70

43248 Egd guide wire insertion 11.83 70.00 $828.10

43249 Esoph egd dilation <30 mm 31.03 70.00 $2,172.10

4325F Med txmnt options rvwd w/pt 0.00 70.00 $0.00

43250 Egd cautery tumor polyp 13.13 70.00 $919.10

43251 Egd remove lesion snare 14.42 70.00 $1,009.40

43252 Egd optical endomicroscopy 10.59 70.00 $741.30

43253 Egd us transmural injxn/mark 8.05 70.00 $563.50

43254 Egd endo mucosal resection 8.25 70.00 $577.50

43255 Egd control bleeding any 12.40 70.00 $868.00

43257 Egd w/thrml txmnt gerd 7.11 70.00 $497.70

43259 Egd us exam duodenum/jejunum 6.93 70.00 $485.10

4326F Pt asked re symp auto dysfxn 0.00 70.00 $0.00

43260 Ercp w/specimen collection 9.82 70.00 $687.40

43261 Endo cholangiopancreatograph 10.28 70.00 $719.60

43262 Endo cholangiopancreatograph 10.85 70.00 $759.50

43263 Ercp sphincter pressure meas 10.88 70.00 $761.60

43264 Ercp remove duct calculi 11.06 70.00 $774.20

43265 Ercp lithotripsy calculi 13.12 70.00 $918.40

43266 Egd endoscopic stent place 6.92 70.00 $484.40

43270 Egd lesion ablation 21.75 70.00 $1,522.50

43273 Endoscopic pancreatoscopy 3.58 70.00 $250.60

43274 Ercp duct stent placement 14.00 70.00 $980.00

43275 Ercp remove forgn body duct 11.42 70.00 $799.40

43276 Ercp stent exchange w/dilate 14.57 70.00 $1,019.90

43277 Ercp ea duct/ampulla dilate 11.48 70.00 $803.60

43278 Ercp lesion ablate w/dilate 13.11 70.00 $917.70

43279 Lap myotomy heller 37.48 70.00 $2,623.60

4328F Pt asked re sleep disturb 0.00 70.00 $0.00

43280 Laparoscopy fundoplasty 31.31 70.00 $2,191.70

43281 Lap paraesophag hern repair 44.74 70.00 $3,131.80

43282 Lap paraesoph her rpr w/mesh 50.31 70.00 $3,521.70

43283 Lap esoph lengthening 4.62 70.00 $323.40

43289 Laparoscope proc esoph 0.00 70.00 $0.00

4330F Cnslng epi spec sfty issues 0.00 70.00 $0.00

43300 Repair of esophagus 17.82 70.00 $1,247.40

43305 Repair esophagus and fistula 31.63 70.00 $2,214.10

43310 Repair of esophagus 43.00 70.00 $3,010.00

43312 Repair esophagus and fistula 46.72 70.00 $3,270.40

43313 Esophagoplasty congenital 75.26 70.00 $5,268.20

43314 Tracheo-esophagoplasty cong 81.22 70.00 $5,685.40

43320 Fuse esophagus & stomach 40.46 70.00 $2,832.20

43325 Revise esophagus & stomach 38.98 70.00 $2,728.60

43327 Esoph fundoplasty lap 23.65 70.00 $1,655.50

43328 Esoph fundoplasty thor 33.01 70.00 $2,310.70

43330 Esophagomyotomy abdominal 38.65 70.00 $2,705.50

43331 Esophagomyotomy thoracic 39.19 70.00 $2,743.30

43332 Transab esoph hiat hern rpr 33.66 70.00 $2,356.20

43333 Transab esoph hiat hern rpr 36.64 70.00 $2,564.80

43334 Transthor diaphrag hern rpr 36.48 70.00 $2,553.60

43335 Transthor diaphrag hern rpr 39.20 70.00 $2,744.00

43336 Thorabd diaphr hern repair 44.15 70.00 $3,090.50

43337 Thorabd diaphr hern repair 47.45 70.00 $3,321.50

43338 Esoph lengthening 3.38 70.00 $236.60

43340 Fuse esophagus & intestine 39.93 70.00 $2,795.10

43341 Fuse esophagus & intestine 42.95 70.00 $3,006.50

43351 Surgical opening esophagus 40.37 70.00 $2,825.90

43352 Surgical opening esophagus 31.19 70.00 $2,183.30

43360 Gastrointestinal repair 69.10 70.00 $4,837.00

43361 Gastrointestinal repair 74.55 70.00 $5,218.50

4340F Cnslng chldbrng women epi 0.00 70.00 $0.00

43400 Ligate esophagus veins 44.10 70.00 $3,087.00

43401 Esophagus surgery for veins 45.52 70.00 $3,186.40

43405 Ligate/staple esophagus 44.67 70.00 $3,126.90

43410 Repair esophagus wound 30.51 70.00 $2,135.70

43415 Repair esophagus wound 74.61 70.00 $5,222.70

43420 Repair esophagus opening 29.50 70.00 $2,065.00

43425 Repair esophagus opening 42.21 70.00 $2,954.70

43450 Dilate esophagus 1/mult pass 6.12 70.00 $428.40

43453 Dilate esophagus 27.92 70.00 $1,954.40

43460 Pressure treatment esophagus 6.38 70.00 $446.60

43496 Free jejunum flap microvasc 0.00 70.00 $0.00

43499 Esophagus surgery procedure 0.00 70.00 $0.00

4350F Cnslng provided symp mngmnt 0.00 70.00 $0.00

43500 Surgical opening of stomach 22.68 70.00 $1,587.60

43501 Surgical repair of stomach 39.00 70.00 $2,730.00

43502 Surgical repair of stomach 44.19 70.00 $3,093.30

43510 Surgical opening of stomach 27.37 70.00 $1,915.90

43520 Incision of pyloric muscle 19.86 70.00 $1,390.20

43605 Biopsy of stomach 24.16 70.00 $1,691.20

43610 Excision of stomach lesion 28.40 70.00 $1,988.00

43611 Excision of stomach lesion 35.33 70.00 $2,473.10

43620 Removal of stomach 57.03 70.00 $3,992.10

43631 Removal of stomach partial 41.99 70.00 $2,939.30

43635 Removal of stomach partial 3.27 70.00 $228.90

43640 Vagotomy & pylorus repair 34.07 70.00 $2,384.90

43641 Vagotomy & pylorus repair 34.81 70.00 $2,436.70

43644 Lap gastric bypass/roux-en-y 50.14 70.00 $3,509.80

43645 Lap gastr bypass incl smll i 53.58 70.00 $3,750.60

43647 Lap impl electrode antrum 0.00 70.00 $0.00

43648 Lap revise/remv eltrd antrum 0.00 70.00 $0.00

43651 Laparoscopy vagus nerve 18.94 70.00 $1,325.80

43652 Laparoscopy vagus nerve 22.13 70.00 $1,549.10

43653 Laparoscopy gastrostomy 16.54 70.00 $1,157.80

43659 Laparoscope proc stom 0.00 70.00 $0.00

43752 Nasal/orogastric w/tube plmt 1.19 70.00 $83.30

43753 Tx gastro intub w/asp 0.62 70.00 $43.40

43754 Dx gastr intub w/asp spec 3.73 70.00 $261.10

43755 Dx gastr intub w/asp specs 3.98 70.00 $278.60

43756 Dx duod intub w/asp spec 5.89 70.00 $412.30

43757 Dx duod intub w/asp specs 8.42 70.00 $589.40

43760 Change gastrostomy tube 13.98 70.00 $978.60

43761 Reposition gastrostomy tube 3.36 70.00 $235.20

43770 Lap place gastr adj device 32.35 70.00 $2,264.50

43771 Lap revise gastr adj device 36.75 70.00 $2,572.50

43772 Lap rmvl gastr adj device 27.52 70.00 $1,926.40

43773 Lap replace gastr adj device 37.04 70.00 $2,592.80

43774 Lap rmvl gastr adj all parts 27.75 70.00 $1,942.50

43775 Lap sleeve gastrectomy 0.00 70.00 $0.00

43800 Reconstruction of pylorus 26.89 70.00 $1,882.30

43810 Fusion of stomach and bowel 29.50 70.00 $2,065.00

43830 Place gastrostomy tube 20.20 70.00 $1,414.00

43840 Repair of stomach lesion 39.30 70.00 $2,751.00

43842 V-band gastroplasty 33.03 70.00 $2,312.10

43843 Gastroplasty w/o v-band 37.10 70.00 $2,597.00

43845 Gastroplasty duodenal switch 56.85 70.00 $3,979.50

43846 Gastric bypass for obesity 46.68 70.00 $3,267.60

43847 Gastric bypass incl small i 52.24 70.00 $3,656.80

43848 Revision gastroplasty 55.72 70.00 $3,900.40

43850 Revise stomach-bowel fusion 47.20 70.00 $3,304.00

43870 Repair stomach opening 20.62 70.00 $1,443.40

43880 Repair stomach-bowel fistula 46.15 70.00 $3,230.50

43881 Impl/redo electrd antrum 0.00 70.00 $0.00

43882 Revise/remove electrd antrum 0.00 70.00 $0.00

43886 Revise gastric port open 10.45 70.00 $731.50

43887 Remove gastric port open 9.43 70.00 $660.10

43888 Change gastric port open 13.27 70.00 $928.90

43999 Stomach surgery procedure 0.00 70.00 $0.00

4400F Rehab thxpy options w/pt 0.00 70.00 $0.00

44005 Freeing of bowel adhesion 31.64 70.00 $2,214.80

44010 Incision of small bowel 25.09 70.00 $1,756.30

44015 Insert needle cath bowel 4.14 70.00 $289.80

44020 Explore small intestine 28.20 70.00 $1,974.00

44021 Decompress small bowel 28.23 70.00 $1,976.10

44025 Incision of large bowel 28.55 70.00 $1,998.50

44050 Reduce bowel obstruction 27.05 70.00 $1,893.50

44055 Correct malrotation of bowel 43.08 70.00 $3,015.60

44100 Biopsy of bowel 3.23 70.00 $226.10

44110 Excise intestine lesion(s) 24.65 70.00 $1,725.50

44111 Excision of bowel lesion(s) 28.45 70.00 $1,991.50

44120 Removal of small intestine 35.39 70.00 $2,477.30

44121 Removal of small intestine 7.03 70.00 $492.10

44125 Removal of small intestine 34.16 70.00 $2,391.20

44126 Enterectomy w/o taper cong 71.52 70.00 $5,006.40

44127 Enterectomy w/taper cong 82.71 70.00 $5,789.70

44128 Enterectomy cong add-on 7.09 70.00 $496.30

44130 Bowel to bowel fusion 37.98 70.00 $2,658.60

44132 Enterectomy cadaver donor 0.00 70.00 $0.00

44133 Enterectomy live donor 0.00 70.00 $0.00

44135 Intestine transplnt cadaver 0.00 70.00 $0.00

44136 Intestine transplant live 0.00 70.00 $0.00

44137 Remove intestinal allograft 0.00 70.00 $0.00

44139 Mobilization of colon 3.52 70.00 $246.40

44140 Partial removal of colon 38.83 70.00 $2,718.10

44150 Removal of colon 54.17 70.00 $3,791.90

44151 Removal of colon/ileostomy 62.33 70.00 $4,363.10

44157 Colectomy w/ileoanal anast 63.23 70.00 $4,426.10

44158 Colectomy w/neo-rectum pouch 61.28 70.00 $4,289.60

44160 Removal of colon 35.93 70.00 $2,515.10

44180 Lap enterolysis 26.58 70.00 $1,860.60

44186 Lap jejunostomy 18.87 70.00 $1,320.90

44187 Lap ileo/jejuno-stomy 32.06 70.00 $2,244.20

44188 Lap colostomy 35.45 70.00 $2,481.50

44202 Lap enterectomy 40.10 70.00 $2,807.00

44203 Lap resect s/intestine addl 7.09 70.00 $496.30

44204 Laparo partial colectomy 44.54 70.00 $3,117.80

44205 Lap colectomy part w/ileum 38.75 70.00 $2,712.50

44206 Lap part colectomy w/stoma 50.79 70.00 $3,555.30

44207 L colectomy/coloproctostomy 52.78 70.00 $3,694.60

44208 L colectomy/coloproctostomy 57.66 70.00 $4,036.20

44210 Laparo total proctocolectomy 51.59 70.00 $3,611.30

44211 Lap colectomy w/proctectomy 62.99 70.00 $4,409.30

44212 Laparo total proctocolectomy 59.42 70.00 $4,159.40

44213 Lap mobil splenic fl add-on 5.48 70.00 $383.60

44227 Lap close enterostomy 48.34 70.00 $3,383.80

44238 Laparoscope proc intestine 0.00 70.00 $0.00

44300 Open bowel to skin 24.32 70.00 $1,702.40

44310 Ileostomy/jejunostomy 30.21 70.00 $2,114.70

44312 Revision of ileostomy 17.06 70.00 $1,194.20

44314 Revision of ileostomy 29.04 70.00 $2,032.80

44316 Devise bowel pouch 40.97 70.00 $2,867.90

44320 Colostomy 34.76 70.00 $2,433.20

44322 Colostomy with biopsies 28.92 70.00 $2,024.40

44340 Revision of colostomy 18.05 70.00 $1,263.50

44360 Small bowel endoscopy 4.45 70.00 $311.50

44361 Small bowel endoscopy/biopsy 4.91 70.00 $343.70

44370 Small bowel endoscopy/stent 8.14 70.00 $569.80

44377 Small bowel endoscopy/biopsy 9.13 70.00 $639.10

44379 S bowel endoscope w/stent 12.44 70.00 $870.80

44380 Small bowel endoscopy br/wa 1.96 70.00 $137.20

44381 Small bowel endoscopy br/wa 0.00 70.00 $0.00

44385 Endoscopy of bowel pouch 7.58 70.00 $530.60

44386 Endoscopy bowel pouch/biop 10.10 70.00 $707.00

44388 Colonoscopy thru stoma spx 10.06 70.00 $704.20

44389 Colonoscopy with biopsy 11.27 70.00 $788.90

44390 Colonoscopy for foreign body 13.21 70.00 $924.70

44391 Colonoscopy for bleeding 14.20 70.00 $994.00

44392 Colonoscopy & polypectomy 12.52 70.00 $876.40

44394 Colonoscopy w/snare 14.15 70.00 $990.50

44401 Colonoscopy with ablation 0.00 70.00 $0.00

44402 Colonoscopy w/stent plcmt 0.00 70.00 $0.00

44403 Colonoscopy w/resection 0.00 70.00 $0.00

44404 Colonoscopy w/injection 0.00 70.00 $0.00

44405 Colonoscopy w/dilation 0.00 70.00 $0.00

44406 Colonoscopy w/ultrasound 0.00 70.00 $0.00

44407 Colonoscopy w/ndl aspir/bx 0.00 70.00 $0.00

44408 Colonoscopy w/decompression 0.00 70.00 $0.00

4450F Self-care ed provided to pt 0.00 70.00 $0.00

44500 Intro gastrointestinal tube 0.71 70.00 $49.70

44602 Suture small intestine 40.84 70.00 $2,858.80

44603 Suture small intestine 46.93 70.00 $3,285.10

44604 Suture large intestine 30.65 70.00 $2,145.50

44605 Repair of bowel lesion 37.80 70.00 $2,646.00

44615 Intestinal stricturoplasty 31.02 70.00 $2,171.40

44620 Repair bowel opening 25.14 70.00 $1,759.80

44640 Repair bowel-skin fistula 40.58 70.00 $2,840.60

44650 Repair bowel fistula 42.06 70.00 $2,944.20

44660 Repair bowel-bladder fistula 38.64 70.00 $2,704.80

44661 Repair bowel-bladder fistula 44.91 70.00 $3,143.70

44680 Surgical revision intestine 30.87 70.00 $2,160.90

4470F Icd counseling provided 0.00 70.00 $0.00

44700 Suspend bowel w/prosthesis 29.53 70.00 $2,067.10

44701 Intraop colon lavage add-on 4.88 70.00 $341.60

44705 Prepare fecal microbiota 0.00 70.00 $0.00

44715 Prepare donor intestine 0.00 70.00 $0.00

44720 Prep donor intestine/venous 7.99 70.00 $559.30

44721 Prep donor intestine/artery 11.17 70.00 $781.90

44799 Unlisted px small intestine 0.00 70.00 $0.00

4480F Pt rcvng ace/arb b-blockertx 0.00 70.00 $0.00

44800 Excision of bowel pouch 22.14 70.00 $1,549.80

4481F Pt rcvng ace/arb blker >3mos 0.00 70.00 $0.00

44820 Excision of mesentery lesion 24.55 70.00 $1,718.50

44850 Repair of mesentery 21.74 70.00 $1,521.80

44899 Bowel surgery procedure 0.00 70.00 $0.00

44900 Drain appendix abscess open 22.42 70.00 $1,569.40

44950 Appendectomy 18.56 70.00 $1,299.20

44955 Appendectomy add-on 2.43 70.00 $170.10

44960 Appendectomy 25.26 70.00 $1,768.20

44970 Laparoscopy appendectomy 17.35 70.00 $1,214.50

44979 Laparoscope proc app 0.00 70.00 $0.00

4500F Ref to outpt card rehab prog 0.00 70.00 $0.00

45000 Drainage of pelvic abscess 12.15 70.00 $850.50

45005 Drainage of rectal abscess 7.77 70.00 $543.90

45020 Drainage of rectal abscess 16.44 70.00 $1,150.80

4510F Prev cardrehab qualcardevent 0.00 70.00 $0.00

45100 Biopsy of rectum 8.65 70.00 $605.50

45108 Removal of anorectal lesion 10.65 70.00 $745.50

45110 Removal of rectum 53.51 70.00 $3,745.70

45111 Partial removal of rectum 31.47 70.00 $2,202.90

45113 Partial proctectomy 54.65 70.00 $3,825.50

45119 Remove rectum w/reservoir 56.49 70.00 $3,954.30

45121 Removal of rectum and colon 47.62 70.00 $3,333.40

45123 Partial proctectomy 32.45 70.00 $2,271.50

45126 Pelvic exenteration 78.56 70.00 $5,499.20

45130 Excision of rectal prolapse 31.49 70.00 $2,204.30

45135 Excision of rectal prolapse 39.88 70.00 $2,791.60

45136 Excise ileoanal reservior 52.17 70.00 $3,651.90

45150 Excision of rectal stricture 10.34 70.00 $723.80

45160 Excision of rectal lesion 29.61 70.00 $2,072.70

45171 Exc rect tum transanal part 17.34 70.00 $1,213.80

45172 Exc rect tum transanal full 23.40 70.00 $1,638.00

45190 Destruction rectal tumor 20.04 70.00 $1,402.80

4525F Neuropsychia interven order 0.00 70.00 $0.00

4526F Neuropsychia interven rcvd 0.00 70.00 $0.00

45300 Proctosigmoidoscopy dx 3.53 70.00 $247.10

45303 Proctosigmoidoscopy dilate 27.58 70.00 $1,930.60

45305 Proctosigmoidoscopy w/bx 5.58 70.00 $390.60

45307 Proctosigmoidoscopy fb 6.39 70.00 $447.30

45308 Proctosigmoidoscopy removal 6.28 70.00 $439.60

45317 Proctosigmoidoscopy bleed 6.93 70.00 $485.10

45320 Proctosigmoidoscopy ablate 7.01 70.00 $490.70

45321 Proctosigmoidoscopy volvul 3.10 70.00 $217.00

45327 Proctosigmoidoscopy w/stent 3.54 70.00 $247.80

45330 Diagnostic sigmoidoscopy 3.91 70.00 $273.70

45331 Sigmoidoscopy and biopsy 4.64 70.00 $324.80

45332 Sigmoidoscopy w/fb removal 8.32 70.00 $582.40

45333 Sigmoidoscopy & polypectomy 8.46 70.00 $592.20

45334 Sigmoidoscopy for bleeding 4.68 70.00 $327.60

45335 Sigmoidoscopy w/submuc inj 7.83 70.00 $548.10

45337 Sigmoidoscopy & decompress 4.09 70.00 $286.30

45338 Sigmoidoscopy w/tumr remove 9.08 70.00 $635.60

45340 Sig w/tndsc balloon dilation 13.86 70.00 $970.20

45341 Sigmoidoscopy w/ultrasound 4.46 70.00 $312.20

45342 Sigmoidoscopy w/us guide bx 6.77 70.00 $473.90

45346 Sigmoidoscopy w/ablation 0.00 70.00 $0.00

45347 Sigmoidoscopy w/plcmt stent 0.00 70.00 $0.00

45349 Sigmoidoscopy w/resection 0.00 70.00 $0.00

45350 Sgmdsc w/band ligation 0.00 70.00 $0.00

45378 Diagnostic colonoscopy 11.06 70.00 $774.20

45378 53 Diagnostic colonoscopy 3.91 70.00 $273.70

45379 Colonoscopy w/fb removal 14.25 70.00 $997.50

45380 Colonoscopy and biopsy 13.18 70.00 $922.60

45381 Colonoscopy submucous njx 13.24 70.00 $926.80

45382 Colonoscopy w/control bleed 17.12 70.00 $1,198.40

45384 Colonoscopy w/lesion removal 13.21 70.00 $924.70

45385 Colonoscopy w/lesion removal 14.88 70.00 $1,041.60

45386 Colonoscopy w/balloon dilat 18.96 70.00 $1,327.20

45388 Colonoscopy w/ablation 0.00 70.00 $0.00

45389 Colonoscopy w/stent plcmt 0.00 70.00 $0.00

45390 Colonoscopy w/resection 0.00 70.00 $0.00

45391 Colonoscopy w/endoscope us 8.43 70.00 $590.10

45392 Colonoscopy w/endoscopic fnb 10.73 70.00 $751.10

45393 Colonoscopy w/decompression 0.00 70.00 $0.00

45395 Lap removal of rectum 57.35 70.00 $4,014.50

45397 Lap remove rectum w/pouch 62.45 70.00 $4,371.50

45398 Colonoscopy w/band ligation 0.00 70.00 $0.00

45399 Unlisted procedure colon 0.00 70.00 $0.00

4540F Disease modif pharmacothxpy 0.00 70.00 $0.00

45400 Laparoscopic proc 32.95 70.00 $2,306.50

45402 Lap proctopexy w/sig resect 44.02 70.00 $3,081.40

4541F Pt offered tx for pseudobulb 0.00 70.00 $0.00

45499 Laparoscope proc rectum 0.00 70.00 $0.00

4550F Noninvas resp support talk 0.00 70.00 $0.00

45500 Repair of rectum 15.14 70.00 $1,059.80

45505 Repair of rectum 17.16 70.00 $1,201.20

4551F Nutritional support offered 0.00 70.00 $0.00

4552F Pt ref for speech lang path 0.00 70.00 $0.00

45520 Treatment of rectal prolapse 4.53 70.00 $317.10

4553F Pt asst re end life issues 0.00 70.00 $0.00

4554F Pt recvd inhal anesthetic 0.00 70.00 $0.00

45540 Correct rectal prolapse 30.68 70.00 $2,147.60

45541 Correct rectal prolapse 27.14 70.00 $1,899.80

4555F Pt recvd no inhal anesthic 0.00 70.00 $0.00

45550 Repair rectum/remove sigmoid 42.25 70.00 $2,957.50

4556F Pt w/ 3+ post-op nausea&vom 0.00 70.00 $0.00

45560 Repair of rectocele 19.87 70.00 $1,390.90

45562 Exploration/repair of rectum 33.12 70.00 $2,318.40

45563 Exploration/repair of rectum 47.74 70.00 $3,341.80

4557F Pt w/o 3+ post-opnausea&vom 0.00 70.00 $0.00

4558F Pt recvd 2 rx anti-emet agt 0.00 70.00 $0.00

4559F 1 bodytemp >=35.5cw/in 30min 0.00 70.00 $0.00

4560F Anesth w/o gen/neurax anesth 0.00 70.00 $0.00

4561F Pt w/ coronary artery stent 0.00 70.00 $0.00

4562F Pt w/o coronary artery stent 0.00 70.00 $0.00

4563F Pt recvd aspirin w/in 24 hrs 0.00 70.00 $0.00

45800 Repair rect/bladder fistula 35.83 70.00 $2,508.10

45805 Repair fistula w/colostomy 39.90 70.00 $2,793.00

45820 Repair rectourethral fistula 32.41 70.00 $2,268.70

45825 Repair fistula w/colostomy 41.80 70.00 $2,926.00

45900 Reduction of rectal prolapse 5.90 70.00 $413.00

45905 Dilation of anal sphincter 4.89 70.00 $342.30

45910 Dilation of rectal narrowing 5.62 70.00 $393.40

45915 Remove rectal obstruction 9.49 70.00 $664.30

45990 Surg dx exam anorectal 3.12 70.00 $218.40

45999 Rectum surgery procedure 0.00 70.00 $0.00

46020 Placement of seton 7.92 70.00 $554.40

46030 Removal of rectal marker 3.99 70.00 $279.30

46040 Incision of rectal abscess 15.35 70.00 $1,074.50

46045 Incision of rectal abscess 12.52 70.00 $876.40

46050 Incision of anal abscess 5.76 70.00 $403.20

46060 Incision of rectal abscess 13.72 70.00 $960.40

46070 Incision of anal septum 6.33 70.00 $443.10

46080 Incision of anal sphincter 7.08 70.00 $495.60

46083 Incise external hemorrhoid 5.02 70.00 $351.40

46200 Removal of anal fissure 12.79 70.00 $895.30

46220 Excise anal ext tag/papilla 5.90 70.00 $413.00

46221 Ligation of hemorrhoid(s) 7.73 70.00 $541.10

46230 Removal of anal tags 7.81 70.00 $546.70

46250 Remove ext hem groups 2+ 13.27 70.00 $928.90

46255 Remove int/ext hem 1 group 14.54 70.00 $1,017.80

46257 Remove in/ex hem grp & fiss 12.12 70.00 $848.40

46258 Remove in/ex hem grp w/fistu 13.43 70.00 $940.10

46260 Remove in/ex hem groups 2+ 13.71 70.00 $959.70

46261 Remove in/ex hem grps & fiss 15.01 70.00 $1,050.70

46262 Remove in/ex hem grps w/fist 15.96 70.00 $1,117.20

46270 Remove anal fist subq 14.57 70.00 $1,019.90

46275 Remove anal fist inter 15.45 70.00 $1,081.50

46280 Remove anal fist complex 13.53 70.00 $947.10

46285 Remove anal fist 2 stage 15.30 70.00 $1,071.00

46288 Repair anal fistula 15.86 70.00 $1,110.20

46320 Removal of hemorrhoid clot 5.25 70.00 $367.50

46500 Injection into hemorrhoid(s) 6.85 70.00 $479.50

46505 Chemodenervation anal musc 8.15 70.00 $570.50

46600 Diagnostic anoscopy spx 2.52 70.00 $176.40

46601 Diagnostic anoscopy 0.00 70.00 $0.00

46604 Anoscopy and dilation 17.86 70.00 $1,250.20

46606 Anoscopy and biopsy 6.43 70.00 $450.10

46607 Diagnostic anoscopy & biopsy 0.00 70.00 $0.00

46608 Anoscopy remove for body 6.79 70.00 $475.30

46610 Anoscopy remove lesion 6.46 70.00 $452.20

46611 Anoscopy 4.99 70.00 $349.30

46612 Anoscopy remove lesions 7.85 70.00 $549.50

46614 Anoscopy control bleeding 3.68 70.00 $257.60

46615 Anoscopy 4.13 70.00 $289.10

46700 Repair of anal stricture 18.86 70.00 $1,320.20

46705 Repair of anal stricture 13.91 70.00 $973.70

46706 Repr of anal fistula w/glue 5.07 70.00 $354.90

46707 Repair anorectal fist w/plug 13.65 70.00 $955.50

46710 Repr per/vag pouch sngl proc 30.23 70.00 $2,116.10

46712 Repr per/vag pouch dbl proc 57.82 70.00 $4,047.40

46715 Rep perf anoper fistu 15.61 70.00 $1,092.70

46716 Rep perf anoper/vestib fistu 30.78 70.00 $2,154.60

46730 Construction of absent anus 56.71 70.00 $3,969.70

46742 Repair of imperforated anus 64.29 70.00 $4,500.30

46744 Repair of cloacal anomaly 101.94 70.00 $7,135.80

46750 Repair of anal sphincter 21.74 70.00 $1,521.80

46753 Reconstruction of anus 16.65 70.00 $1,165.50

46754 Removal of suture from anus 8.48 70.00 $593.60

46762 Implant artificial sphincter 26.64 70.00 $1,864.80

46900 Destruction anal lesion(s) 6.95 70.00 $486.50

46910 Destruction anal lesion(s) 7.31 70.00 $511.70

46916 Cryosurgery anal lesion(s) 6.52 70.00 $456.40

46917 Laser surgery anal lesions 12.86 70.00 $900.20

46922 Excision of anal lesion(s) 7.63 70.00 $534.10

46924 Destruction anal lesion(s) 15.32 70.00 $1,072.40

46930 Destroy internal hemorrhoids 5.91 70.00 $413.70

46940 Treatment of anal fissure 6.57 70.00 $459.90

46942 Treatment of anal fissure 6.22 70.00 $435.40

46945 Remove by ligat int hem grp 8.84 70.00 $618.80

46946 Remove by ligat int hem grps 9.03 70.00 $632.10

46947 Hemorrhoidopexy by stapling 10.99 70.00 $769.30

46999 Anus surgery procedure 0.00 70.00 $0.00

47000 Needle biopsy of liver 10.35 70.00 $724.50

47001 Needle biopsy liver add-on 3.02 70.00 $211.40

47010 Open drainage liver lesion 34.82 70.00 $2,437.40

47015 Inject/aspirate liver cyst 33.64 70.00 $2,354.80

47100 Wedge biopsy of liver 24.44 70.00 $1,710.80

47120 Partial removal of liver 67.42 70.00 $4,719.40

47122 Extensive removal of liver 99.38 70.00 $6,956.60

47133 Removal of donor liver 0.00 70.00 $0.00

47135 Transplantation of liver 141.47 70.00 $9,902.90

47136 Transplantation of liver 121.57 70.00 $8,509.90

47140 Partial removal donor liver 92.80 70.00 $6,496.00

47143 Prep donor liver whole 0.00 70.00 $0.00

47144 Prep donor liver 3-segment 0.00 70.00 $0.00

47145 Prep donor liver lobe split 0.00 70.00 $0.00

47146 Prep donor liver/venous 9.59 70.00 $671.30

47147 Prep donor liver/arterial 11.12 70.00 $778.40

47300 Surgery for liver lesion 32.82 70.00 $2,297.40

47350 Repair liver wound 39.64 70.00 $2,774.80

47370 Laparo ablate liver tumor rf 36.07 70.00 $2,524.90

47371 Laparo ablate liver cryosurg 36.37 70.00 $2,545.90

47379 Laparoscope procedure liver 0.00 70.00 $0.00

47380 Open ablate liver tumor rf 41.67 70.00 $2,916.90

47381 Open ablate liver tumor cryo 38.92 70.00 $2,724.40

47382 Percut ablate liver rf 142.43 70.00 $9,970.10

47383 Perq abltj lvr cryoablation 215.51 70.00 $15,085.70

47399 Liver surgery procedure 0.00 70.00 $0.00

47400 Incision of liver duct 62.45 70.00 $4,371.50

47420 Incision of bile duct 38.82 70.00 $2,717.40

47425 Incision of bile duct 39.57 70.00 $2,769.90

47460 Incise bile duct sphincter 36.71 70.00 $2,569.70

47480 Incision of gallbladder 25.32 70.00 $1,772.40

47490 Incision of gallbladder 9.62 70.00 $673.40

47500 Injection for liver x-rays 2.80 70.00 $196.00

47505 Injection for liver x-rays 1.08 70.00 $75.60

47510 Insert catheter bile duct 13.64 70.00 $954.80

47511 Insert bile duct drain 16.70 70.00 $1,169.00

47525 Change bile duct catheter 14.80 70.00 $1,036.00

47530 Revise/reinsert bile tube 39.22 70.00 $2,745.40

47550 Bile duct endoscopy add-on 4.81 70.00 $336.70

47552 Biliary endo perq dx w/speci 9.13 70.00 $639.10

47553 Biliary endoscopy thru skin 9.06 70.00 $634.20

47560 Laparoscopy w/cholangio 7.80 70.00 $546.00

47561 Laparo w/cholangio/biopsy 8.56 70.00 $599.20

47562 Laparoscopic cholecystectomy 19.00 70.00 $1,330.00

47563 Laparo cholecystectomy/graph 20.63 70.00 $1,444.10

47564 Laparo cholecystectomy/explr 32.14 70.00 $2,249.80

47570 Laparo cholecystoenterostomy 22.44 70.00 $1,570.80

47579 Laparoscope proc biliary 0.00 70.00 $0.00

47600 Removal of gallbladder 30.86 70.00 $2,160.20

47630 Remove bile duct stone 15.46 70.00 $1,082.20

47700 Exploration of bile ducts 30.44 70.00 $2,130.80

47701 Bile duct revision 50.26 70.00 $3,518.20

47711 Excision of bile duct tumor 44.91 70.00 $3,143.70

47712 Excision of bile duct tumor 57.92 70.00 $4,054.40

47715 Excision of bile duct cyst 38.51 70.00 $2,695.70

47720 Fuse gallbladder & bowel 33.40 70.00 $2,338.00

47721 Fuse upper gi structures 39.21 70.00 $2,744.70

47760 Fuse bile ducts and bowel 65.34 70.00 $4,573.80

47765 Fuse liver ducts & bowel 88.12 70.00 $6,168.40

47800 Reconstruction of bile ducts 45.75 70.00 $3,202.50

47801 Placement bile duct support 29.01 70.00 $2,030.70

47802 Fuse liver duct & intestine 44.20 70.00 $3,094.00

47900 Suture bile duct injury 39.76 70.00 $2,783.20

47999 Bile tract surgery procedure 0.00 70.00 $0.00

48000 Drainage of abdomen 54.47 70.00 $3,812.90

48001 Placement of drain pancreas 66.96 70.00 $4,687.20

48020 Removal of pancreatic stone 34.09 70.00 $2,386.30

48100 Biopsy of pancreas open 25.49 70.00 $1,784.30

48102 Needle biopsy pancreas 15.25 70.00 $1,067.50

48105 Resect/debride pancreas 82.47 70.00 $5,772.90

48120 Removal of pancreas lesion 32.02 70.00 $2,241.40

48140 Partial removal of pancreas 45.23 70.00 $3,166.10

48146 Pancreatectomy 54.42 70.00 $3,809.40

48148 Removal of pancreatic duct 36.15 70.00 $2,530.50

48152 Pancreatectomy 83.65 70.00 $5,855.50

48153 Pancreatectomy 89.60 70.00 $6,272.00

48154 Pancreatectomy 84.03 70.00 $5,882.10

48155 Removal of pancreas 52.50 70.00 $3,675.00

48160 Pancreas removal/transplant 0.00 70.00 $0.00

48400 Injection intraop add-on 3.12 70.00 $218.40

48500 Surgery of pancreatic cyst 33.31 70.00 $2,331.70

48510 Drain pancreatic pseudocyst 31.76 70.00 $2,223.20

48520 Fuse pancreas cyst and bowel 31.65 70.00 $2,215.50

48540 Fuse pancreas cyst and bowel 37.97 70.00 $2,657.90

48545 Pancreatorrhaphy 38.95 70.00 $2,726.50

48547 Duodenal exclusion 51.98 70.00 $3,638.60

48548 Fuse pancreas and bowel 48.30 70.00 $3,381.00

48550 Donor pancreatectomy 0.00 70.00 $0.00

48551 Prep donor pancreas 0.00 70.00 $0.00

48552 Prep donor pancreas/venous 6.87 70.00 $480.90

48554 Transpl allograft pancreas 73.95 70.00 $5,176.50

48556 Removal allograft pancreas 36.86 70.00 $2,580.20

48999 Pancreas surgery procedure 0.00 70.00 $0.00

49000 Exploration of abdomen 22.27 70.00 $1,558.90

49002 Reopening of abdomen 30.27 70.00 $2,118.90

49010 Exploration behind abdomen 26.96 70.00 $1,887.20

49020 Drainage abdom abscess open 46.09 70.00 $3,226.30

49040 Drain open abdom abscess 28.94 70.00 $2,025.80

49060 Drain open retroperi abscess 31.79 70.00 $2,225.30

49062 Drain to peritoneal cavity 21.41 70.00 $1,498.70

49082 Abd paracentesis 5.51 70.00 $385.70

49083 Abd paracentesis w/imaging 8.34 70.00 $583.80

49084 Peritoneal lavage 3.16 70.00 $221.20

49180 Biopsy abdominal mass 4.68 70.00 $327.60

49203 Exc abd tum 5 cm or less 34.65 70.00 $2,425.50

49204 Exc abd tum over 5 cm 44.30 70.00 $3,101.00

49205 Exc abd tum over 10 cm 50.82 70.00 $3,557.40

49215 Excise sacral spine tumor 63.61 70.00 $4,452.70

49220 Multiple surgery abdomen 28.11 70.00 $1,967.70

49250 Excision of umbilicus 16.88 70.00 $1,181.60

49255 Removal of omentum 22.81 70.00 $1,596.70

49320 Diag laparo separate proc 9.38 70.00 $656.60

49321 Laparoscopy biopsy 9.94 70.00 $695.80

49322 Laparoscopy aspiration 10.61 70.00 $742.70

49323 Laparo drain lymphocele 18.45 70.00 $1,291.50

49324 Lap insert tunnel ip cath 11.28 70.00 $789.60

49325 Lap revision perm ip cath 12.03 70.00 $842.10

49326 Lap w/omentopexy add-on 5.50 70.00 $385.00

49327 Lap ins device for rt 3.79 70.00 $265.30

49329 Laparo proc abdm/per/oment 0.00 70.00 $0.00

49400 Air injection into abdomen 3.92 70.00 $274.40

49402 Remove foreign body adbomen 24.73 70.00 $1,731.10

49405 Image cath fluid colxn visc 24.88 70.00 $1,741.60

49406 Image cath fluid peri/retro 24.91 70.00 $1,743.70

49407 Image cath fluid trns/vgnl 20.84 70.00 $1,458.80

49411 Ins mark abd/pel for rt perq 15.62 70.00 $1,093.40

49412 Ins device for rt guide open 2.39 70.00 $167.30

49418 Insert tun ip cath perc 40.74 70.00 $2,851.80

49419 Insert tun ip cath w/port 12.87 70.00 $900.90

49421 Ins tun ip cath for dial opn 6.69 70.00 $468.30

49422 Remove tunneled ip cath 10.98 70.00 $768.60

49423 Exchange drainage catheter 15.62 70.00 $1,093.40

49424 Assess cyst contrast inject 4.16 70.00 $291.20

49425 Insert abdomen-venous drain 21.07 70.00 $1,474.90

49426 Revise abdomen-venous shunt 17.66 70.00 $1,236.20

49427 Injection abdominal shunt 1.31 70.00 $91.70

49428 Ligation of shunt 15.45 70.00 $1,081.50

49429 Removal of shunt 13.27 70.00 $928.90

49435 Insert subq exten to ip cath 3.47 70.00 $242.90

49436 Embedded ip cath exit-site 5.40 70.00 $378.00

49440 Place gastrostomy tube perc 29.60 70.00 $2,072.00

49441 Place duod/jej tube perc 33.14 70.00 $2,319.80

49442 Place cecostomy tube perc 27.54 70.00 $1,927.80

49446 Change g-tube to g-j perc 28.45 70.00 $1,991.50

49450 Replace g/c tube perc 18.97 70.00 $1,327.90

49451 Replace duod/jej tube perc 20.69 70.00 $1,448.30

49452 Replace g-j tube perc 25.60 70.00 $1,792.00

49460 Fix g/colon tube w/device 20.85 70.00 $1,459.50

49465 Fluoro exam of g/colon tube 4.62 70.00 $323.40

49491 Rpr hern preemie reduc 21.58 70.00 $1,510.60

49492 Rpr ing hern premie blocked 24.75 70.00 $1,732.50

49495 Rpr ing hernia baby reduc 10.72 70.00 $750.40

49496 Rpr ing hernia baby blocked 15.76 70.00 $1,103.20

49500 Rpr ing hernia init reduce 11.85 70.00 $829.50

49501 Rpr ing hernia init blocked 17.50 70.00 $1,225.00

49505 Prp i/hern init reduc >5 yr 15.01 70.00 $1,050.70

49507 Prp i/hern init block >5 yr 16.89 70.00 $1,182.30

49520 Rerepair ing hernia reduce 18.24 70.00 $1,276.80

49521 Rerepair ing hernia blocked 20.67 70.00 $1,446.90

49525 Repair ing hernia sliding 16.52 70.00 $1,156.40

49540 Repair lumbar hernia 19.43 70.00 $1,360.10

49550 Rpr rem hernia init reduce 16.61 70.00 $1,162.70

49553 Rpr fem hernia init blocked 18.22 70.00 $1,275.40

49555 Rerepair fem hernia reduce 17.20 70.00 $1,204.00

49557 Rerepair fem hernia blocked 20.89 70.00 $1,462.30

49560 Rpr ventral hern init reduc 21.28 70.00 $1,489.60

49561 Rpr ventral hern init block 26.89 70.00 $1,882.30

49565 Rerepair ventrl hern reduce 22.18 70.00 $1,552.60

49566 Rerepair ventrl hern block 27.12 70.00 $1,898.40

49568 Hernia repair w/mesh 7.76 70.00 $543.20

49570 Rpr epigastric hern reduce 11.96 70.00 $837.20

49572 Rpr epigastric hern blocked 14.88 70.00 $1,041.60

49580 Rpr umbil hern reduc < 5 yr 9.58 70.00 $670.60

49582 Rpr umbil hern block < 5 yr 13.92 70.00 $974.40

49585 Rpr umbil hern reduc > 5 yr 12.82 70.00 $897.40

49587 Rpr umbil hern block > 5 yr 13.70 70.00 $959.00

49590 Repair spigelian hernia 16.52 70.00 $1,156.40

49600 Repair umbilical lesion 20.07 70.00 $1,404.90

49650 Lap ing hernia repair init 12.34 70.00 $863.80

49651 Lap ing hernia repair recur 16.05 70.00 $1,123.50

49652 Lap vent/abd hernia repair 21.49 70.00 $1,504.30

49653 Lap vent/abd hern proc comp 26.82 70.00 $1,877.40

49654 Lap inc hernia repair 24.43 70.00 $1,710.10

49655 Lap inc hern repair comp 29.85 70.00 $2,089.50

49656 Lap inc hernia repair recur 26.55 70.00 $1,858.50

49657 Lap inc hern recur comp 38.17 70.00 $2,671.90

49659 Laparo proc hernia repair 0.00 70.00 $0.00

49900 Repair of abdominal wall 23.54 70.00 $1,647.80

49904 Omental flap extra-abdom 41.11 70.00 $2,877.70

49905 Omental flap intra-abdom 10.23 70.00 $716.10

49906 Free omental flap microvasc 0.00 70.00 $0.00

49999 Abdomen surgery procedure 0.00 70.00 $0.00

50010 Exploration of kidney 21.42 70.00 $1,499.40

50020 Renal abscess open drain 29.04 70.00 $2,032.80

50040 Drainage of kidney 26.60 70.00 $1,862.00

5005F Pt counsld on exam for moles 0.00 70.00 $0.00

50060 Removal of kidney stone 32.72 70.00 $2,290.40

50065 Incision of kidney 34.71 70.00 $2,429.70

50070 Incision of kidney 34.02 70.00 $2,381.40

5010F Macul result phy/qhp mng dm 0.00 70.00 $0.00

50100 Revise kidney blood vessels 31.19 70.00 $2,183.30

50125 Explore and drain kidney 28.21 70.00 $1,974.70

5015F Doc fx & test/txmnt for op 0.00 70.00 $0.00

5020F Txmnts 2 phys/qhp by 1 mon 0.00 70.00 $0.00

50200 Renal biopsy perq 17.49 70.00 $1,224.30

50205 Renal biopsy open 21.71 70.00 $1,519.70

50220 Remove kidney open 30.05 70.00 $2,103.50

50225 Removal kidney open complex 34.47 70.00 $2,412.90

50230 Removal kidney open radical 36.81 70.00 $2,576.70

50234 Removal of kidney & ureter 37.33 70.00 $2,613.10

50236 Removal of kidney & ureter 42.11 70.00 $2,947.70

50240 Partial removal of kidney 37.99 70.00 $2,659.30

50250 Cryoablate renal mass open 34.91 70.00 $2,443.70

50280 Removal of kidney lesion 27.42 70.00 $1,919.40

50290 Removal of kidney lesion 25.77 70.00 $1,803.90

50300 Remove cadaver donor kidney 0.00 70.00 $0.00

50320 Remove kidney living donor 43.40 70.00 $3,038.00

50323 Prep cadaver renal allograft 0.00 70.00 $0.00

50325 Prep donor renal graft 0.00 70.00 $0.00

50327 Prep renal graft/venous 6.29 70.00 $440.30

50328 Prep renal graft/arterial 5.51 70.00 $385.70

50329 Prep renal graft/ureteral 5.31 70.00 $371.70

50340 Removal of kidney 27.36 70.00 $1,915.20

50360 Transplantation of kidney 69.91 70.00 $4,893.70

50365 Transplantation of kidney 81.94 70.00 $5,735.80

50370 Remove transplanted kidney 34.61 70.00 $2,422.70

50380 Reimplantation of kidney 57.85 70.00 $4,049.50

50382 Change ureter stent percut 33.76 70.00 $2,363.20

50384 Remove ureter stent percut 26.87 70.00 $1,880.90

50385 Change stent via transureth 32.46 70.00 $2,272.20

50386 Remove stent via transureth 21.11 70.00 $1,477.70

50387 Change ext/int ureter stent 15.46 70.00 $1,082.20

50389 Remove renal tube w/fluoro 8.44 70.00 $590.80

50390 Drainage of kidney lesion 2.81 70.00 $196.70

50391 Instll rx agnt into rnal tub 3.50 70.00 $245.00

50392 Insert kidney drain 5.19 70.00 $363.30

50393 Insert ureteral tube 6.31 70.00 $441.70

50394 Injection for kidney x-ray 2.96 70.00 $207.20

50395 Create passage to kidney 5.19 70.00 $363.30

50396 Measure kidney pressure 3.44 70.00 $240.80

50398 Change kidney tube 14.20 70.00 $994.00

50400 Revision of kidney/ureter 33.19 70.00 $2,323.30

50405 Revision of kidney/ureter 40.11 70.00 $2,807.70

5050F Plan 2 main dr by 1 month 0.00 70.00 $0.00

50500 Repair of kidney wound 33.11 70.00 $2,317.70

50520 Close kidney-skin fistula 29.74 70.00 $2,081.80

50525 Repair renal-abdomen fistula 43.78 70.00 $3,064.60

50526 Repair renal-abdomen fistula 40.94 70.00 $2,865.80

50540 Revision of horseshoe kidney 32.94 70.00 $2,305.80

50541 Laparo ablate renal cyst 26.37 70.00 $1,845.90

50542 Laparo ablate renal mass 33.46 70.00 $2,342.20

50543 Laparo partial nephrectomy 42.69 70.00 $2,988.30

50544 Laparoscopy pyeloplasty 35.75 70.00 $2,502.50

50545 Laparo radical nephrectomy 38.47 70.00 $2,692.90

50546 Laparoscopic nephrectomy 34.53 70.00 $2,417.10

50547 Laparo removal donor kidney 46.35 70.00 $3,244.50

50548 Laparo remove w/ureter 38.69 70.00 $2,708.30

50549 Laparoscope proc renal 0.00 70.00 $0.00

50551 Kidney endoscopy 10.28 70.00 $719.60

50555 Kidney endoscopy & biopsy 11.79 70.00 $825.30

50557 Kidney endoscopy & treatment 11.99 70.00 $839.30

50561 Kidney endoscopy & treatment 13.57 70.00 $949.90

50562 Renal scope w/tumor resect 16.70 70.00 $1,169.00

50572 Kidney endoscopy 15.30 70.00 $1,071.00

50574 Kidney endoscopy & biopsy 16.26 70.00 $1,138.20

50575 Kidney endoscopy 20.55 70.00 $1,438.50

50576 Kidney endoscopy & treatment 16.22 70.00 $1,135.40

50580 Kidney endoscopy & treatment 17.48 70.00 $1,223.60

50590 Fragmenting of kidney stone 20.51 70.00 $1,435.70

50592 Perc rf ablate renal tumor 89.35 70.00 $6,254.50

50593 Perc cryo ablate renal tum 131.67 70.00 $9,216.90

5060F Fndngs mammo 2pt w/in 3 days 0.00 70.00 $0.00

50600 Exploration of ureter 26.96 70.00 $1,887.20

50605 Insert ureteral support 28.34 70.00 $1,983.80

50610 Removal of ureter stone 27.14 70.00 $1,899.80

5062F Mammo result com to pt 5 day 0.00 70.00 $0.00

50650 Removal of ureter 29.71 70.00 $2,079.70

50660 Removal of ureter 32.82 70.00 $2,297.40

50684 Injection for ureter x-ray 3.01 70.00 $210.70

50686 Measure ureter pressure 4.50 70.00 $315.00

50688 Change of ureter tube/stent 2.30 70.00 $161.00

50690 Injection for ureter x-ray 2.81 70.00 $196.70

50700 Revision of ureter 26.57 70.00 $1,859.90

50715 Release of ureter 35.17 70.00 $2,461.90

50725 Release/revise ureter 31.92 70.00 $2,234.40

50727 Revise ureter 14.57 70.00 $1,019.90

50728 Revise ureter 20.02 70.00 $1,401.40

50740 Fusion of ureter & kidney 35.39 70.00 $2,477.30

50750 Fusion of ureter & kidney 33.11 70.00 $2,317.70

50760 Fusion of ureters 32.47 70.00 $2,272.90

50770 Splicing of ureters 33.11 70.00 $2,317.70

50780 Reimplant ureter in bladder 31.88 70.00 $2,231.60

50800 Implant ureter in bowel 26.60 70.00 $1,862.00

50810 Fusion of ureter & bowel 40.41 70.00 $2,828.70

50815 Urine shunt to intestine 35.09 70.00 $2,456.30

50820 Construct bowel bladder 37.83 70.00 $2,648.10

50825 Construct bowel bladder 47.52 70.00 $3,326.40

50830 Revise urine flow 51.75 70.00 $3,622.50

50840 Replace ureter by bowel 35.27 70.00 $2,468.90

50845 Appendico-vesicostomy 35.83 70.00 $2,508.10

50860 Transplant ureter to skin 27.14 70.00 $1,899.80

50900 Repair of ureter 24.38 70.00 $1,706.60

50920 Closure ureter/skin fistula 25.29 70.00 $1,770.30

50930 Closure ureter/bowel fistula 31.65 70.00 $2,215.50

50945 Laparoscopy ureterolithotomy 27.95 70.00 $1,956.50

50947 Laparo new ureter/bladder 39.88 70.00 $2,791.60

50948 Laparo new ureter/bladder 36.62 70.00 $2,563.40

50949 Laparoscope proc ureter 0.00 70.00 $0.00

50951 Endoscopy of ureter 10.74 70.00 $751.80

50953 Endoscopy of ureter 11.38 70.00 $796.60

50955 Ureter endoscopy & biopsy 12.16 70.00 $851.20

50957 Ureter endoscopy & treatment 12.28 70.00 $859.60

50970 Ureter endoscopy 10.69 70.00 $748.30

50972 Ureter endoscopy & catheter 10.33 70.00 $723.10

50974 Ureter endoscopy & biopsy 13.61 70.00 $952.70

5100F Rsk fx ref w/n 24 hrs xray 0.00 70.00 $0.00

51020 Incise & treat bladder 13.40 70.00 $938.00

51030 Incise & treat bladder 13.47 70.00 $942.90

51040 Incise & drain bladder 8.27 70.00 $578.90

51045 Incise bladder/drain ureter 14.07 70.00 $984.90

51050 Removal of bladder stone 13.52 70.00 $946.40

51065 Remove ureter calculus 16.58 70.00 $1,160.60

51080 Drainage of bladder abscess 11.69 70.00 $818.30

51100 Drain bladder by needle 1.77 70.00 $123.90

51101 Drain bladder by trocar/cath 3.55 70.00 $248.50

51102 Drain bl w/cath insertion 6.46 70.00 $452.20

51500 Removal of bladder cyst 18.24 70.00 $1,276.80

51520 Removal of bladder lesion 17.03 70.00 $1,192.10

51535 Repair of ureter lesion 22.36 70.00 $1,565.20

51550 Partial removal of bladder 27.69 70.00 $1,938.30

51555 Partial removal of bladder 36.44 70.00 $2,550.80

51565 Revise bladder & ureter(s) 37.36 70.00 $2,615.20

51570 Removal of bladder 42.49 70.00 $2,974.30

51575 Removal of bladder & nodes 52.31 70.00 $3,661.70

51580 Remove bladder/revise tract 54.44 70.00 $3,810.80

51585 Removal of bladder & nodes 60.62 70.00 $4,243.40

51596 Remove bladder/create pouch 67.49 70.00 $4,724.30

51597 Removal of pelvic structures 65.91 70.00 $4,613.70

51600 Injection for bladder x-ray 5.20 70.00 $364.00

51605 Preparation for bladder xray 1.09 70.00 $76.30

51610 Injection for bladder x-ray 3.04 70.00 $212.80

51700 Irrigation of bladder 2.36 70.00 $165.20

51701 Insert bladder catheter 1.54 70.00 $107.80

51702 Insert temp bladder cath 1.98 70.00 $138.60

51703 Insert bladder cath complex 3.68 70.00 $257.60

51705 Change of bladder tube 2.58 70.00 $180.60

51710 Change of bladder tube 3.65 70.00 $255.50

51715 Endoscopic injection/implant 8.27 70.00 $578.90

51720 Treatment of bladder lesion 3.10 70.00 $217.00

51725 Simple cystometrogram 5.31 70.00 $371.70

51725 TC Simple cystometrogram 3.11 70.00 $217.70

51725 26 Simple cystometrogram 2.20 70.00 $154.00

51726 Complex cystometrogram 7.43 70.00 $520.10

51726 TC Complex cystometrogram 4.97 70.00 $347.90

51726 26 Complex cystometrogram 2.46 70.00 $172.20

51727 Cystometrogram w/up 8.80 70.00 $616.00

51727 TC Cystometrogram w/up 5.72 70.00 $400.40

51727 26 Cystometrogram w/up 3.08 70.00 $215.60

51728 Cystometrogram w/vp 8.87 70.00 $620.90

51728 TC Cystometrogram w/vp 5.87 70.00 $410.90

51728 26 Cystometrogram w/vp 3.00 70.00 $210.00

51729 Cystometrogram w/vp&up 9.61 70.00 $672.70

51729 TC Cystometrogram w/vp&up 5.97 70.00 $417.90

51729 26 Cystometrogram w/vp&up 3.64 70.00 $254.80

51736 Urine flow measurement 0.44 70.00 $30.80

51736 TC Urine flow measurement 0.20 70.00 $14.00

51736 26 Urine flow measurement 0.24 70.00 $16.80

51741 Electro-uroflowmetry first 0.45 70.00 $31.50

51741 TC Electro-uroflowmetry first 0.21 70.00 $14.70

51741 26 Electro-uroflowmetry first 0.24 70.00 $16.80

51784 Anal/urinary muscle study 5.44 70.00 $380.80

51784 TC Anal/urinary muscle study 3.23 70.00 $226.10

51784 26 Anal/urinary muscle study 2.21 70.00 $154.70

51785 Anal/urinary muscle study 7.14 70.00 $499.80

51785 TC Anal/urinary muscle study 4.73 70.00 $331.10

51785 26 Anal/urinary muscle study 2.41 70.00 $168.70

51792 Urinary reflex study 5.96 70.00 $417.20

51792 TC Urinary reflex study 4.38 70.00 $306.60

51792 26 Urinary reflex study 1.58 70.00 $110.60

51797 Intraabdominal pressure test 3.16 70.00 $221.20

51797 TC Intraabdominal pressure test 2.02 70.00 $141.40

51797 26 Intraabdominal pressure test 1.14 70.00 $79.80

51798 Us urine capacity measure 0.53 70.00 $37.10

51800 Revision of bladder/urethra 29.96 70.00 $2,097.20

51820 Revision of urinary tract 35.06 70.00 $2,454.20

51840 Attach bladder/urethra 18.81 70.00 $1,316.70

51841 Attach bladder/urethra 22.21 70.00 $1,554.70

51845 Repair bladder neck 16.80 70.00 $1,176.00

51860 Repair of bladder wound 21.41 70.00 $1,498.70

51865 Repair of bladder wound 25.77 70.00 $1,803.90

51880 Repair of bladder opening 13.44 70.00 $940.80

51900 Repair bladder/vagina lesion 23.90 70.00 $1,673.00

51920 Close bladder-uterus fistula 21.89 70.00 $1,532.30

51925 Hysterectomy/bladder repair 32.31 70.00 $2,261.70

51940 Correction of bladder defect 47.13 70.00 $3,299.10

51960 Revision of bladder & bowel 39.86 70.00 $2,790.20

51980 Construct bladder opening 20.44 70.00 $1,430.80

51990 Laparo urethral suspension 21.56 70.00 $1,509.20

51992 Laparo sling operation 24.18 70.00 $1,692.60

51999 Laparoscope proc bla 0.00 70.00 $0.00

5200F Eval appros surg thxpy epi 0.00 70.00 $0.00

52000 Cystoscopy 5.80 70.00 $406.00

52001 Cystoscopy removal of clots 10.57 70.00 $739.90

52005 Cystoscopy & ureter catheter 7.51 70.00 $525.70

52007 Cystoscopy and biopsy 12.53 70.00 $877.10

52010 Cystoscopy & duct catheter 10.36 70.00 $725.20

52204 Cystoscopy w/biopsy(s) 10.43 70.00 $730.10

52214 Cystoscopy and treatment 18.60 70.00 $1,302.00

52224 Cystoscopy and treatment 19.49 70.00 $1,364.30

52234 Cystoscopy and treatment 7.08 70.00 $495.60

52250 Cystoscopy and radiotracer 6.90 70.00 $483.00

52270 Cystoscopy & revise urethra 10.06 70.00 $704.20

52275 Cystoscopy & revise urethra 13.57 70.00 $949.90

52282 Cystoscopy implant stent 9.71 70.00 $679.70

52287 Cystoscopy chemodenervation 8.81 70.00 $616.70

52317 Remove bladder stone 22.73 70.00 $1,591.10

52318 Remove bladder stone 13.64 70.00 $954.80

52325 Cystoscopy stone removal 9.24 70.00 $646.80

52327 Cystoscopy inject material 7.55 70.00 $528.50

52334 Create passage to kidney 7.37 70.00 $515.90

52341 Cysto w/ureter stricture tx 8.17 70.00 $571.90

52342 Cysto w/up stricture tx 8.91 70.00 $623.70

52343 Cysto w/renal stricture tx 9.92 70.00 $694.40

52344 Cysto/uretero stricture tx 10.65 70.00 $745.50

52345 Cysto/uretero w/up stricture 11.36 70.00 $795.20

52346 Cystouretero w/renal strict 12.88 70.00 $901.60

52351 Cystouretero & or pyeloscope 8.72 70.00 $610.40

52352 Cystouretero w/stone remove 10.22 70.00 $715.40

52353 Cystouretero w/lithotripsy 11.29 70.00 $790.30

52354 Cystouretero w/biopsy 12.00 70.00 $840.00

52355 Cystouretero w/excise tumor 13.44 70.00 $940.80

52356 Cysto/uretero w/lithotripsy 11.97 70.00 $837.90

52400 Cystouretero w/congen repr 13.72 70.00 $960.40

52402 Cystourethro cut ejacul duct 7.68 70.00 $537.60

52441 Cystourethro w/implant 34.90 70.00 $2,443.00

52442 Cystourethro w/addl implant 26.69 70.00 $1,868.30

52450 Incision of prostate 13.45 70.00 $941.50

5250F Asthma discharge plan presnt 0.00 70.00 $0.00

52500 Revision of bladder neck 13.99 70.00 $979.30

52601 Prostatectomy (turp) 24.26 70.00 $1,698.20

52630 Remove prostate regrowth 11.45 70.00 $801.50

52640 Relieve bladder contracture 9.01 70.00 $630.70

52647 Laser surgery of prostate 50.24 70.00 $3,516.80

52648 Laser surgery of prostate 51.71 70.00 $3,619.70

52649 Prostate laser enucleation 23.61 70.00 $1,652.70

52700 Drainage of prostate abscess 12.62 70.00 $883.40

53000 Incision of urethra 4.26 70.00 $298.20

53040 Drainage of urethra abscess 11.24 70.00 $786.80

53060 Drainage of urethra abscess 5.26 70.00 $368.20

53080 Drainage of urinary leakage 12.23 70.00 $856.10

53085 Drainage of urinary leakage 18.61 70.00 $1,302.70

53200 Biopsy of urethra 4.48 70.00 $313.60

53210 Removal of urethra 22.16 70.00 $1,551.20

53215 Removal of urethra 26.64 70.00 $1,864.80

53220 Treatment of urethra lesion 13.06 70.00 $914.20

53230 Removal of urethra lesion 17.39 70.00 $1,217.30

53235 Removal of urethra lesion 18.13 70.00 $1,269.10

53240 Surgery for urethra pouch 12.16 70.00 $851.20

53250 Removal of urethra gland 11.33 70.00 $793.10

53270 Removal of urethra gland 5.87 70.00 $410.90

53275 Repair of urethra defect 7.54 70.00 $527.80

53400 Revise urethra stage 1 22.98 70.00 $1,608.60

53405 Revise urethra stage 2 25.07 70.00 $1,754.90

53410 Reconstruction of urethra 28.11 70.00 $1,967.70

53420 Reconstruct urethra stage 1 24.12 70.00 $1,688.40

53425 Reconstruct urethra stage 2 26.87 70.00 $1,880.90

53431 Reconstruct urethra/bladder 33.13 70.00 $2,319.10

53440 Male sling procedure 21.60 70.00 $1,512.00

53442 Remove/revise male sling 22.45 70.00 $1,571.50

53444 Insert tandem cuff 22.75 70.00 $1,592.50

53445 Insert uro/ves nck sphincter 21.60 70.00 $1,512.00

53446 Remove uro sphincter 18.40 70.00 $1,288.00

53447 Remove/replace ur sphincter 23.19 70.00 $1,623.30

53448 Remov/replc ur sphinctr comp 36.74 70.00 $2,571.80

53449 Repair uro sphincter 17.53 70.00 $1,227.10

53450 Revision of urethra 11.72 70.00 $820.40

53500 Urethrlys transvag w/ scope 21.48 70.00 $1,503.60

53502 Repair of urethra injury 13.95 70.00 $976.50

53505 Repair of urethra injury 13.93 70.00 $975.10

53510 Repair of urethra injury 18.09 70.00 $1,266.30

53515 Repair of urethra injury 22.83 70.00 $1,598.10

53520 Repair of urethra defect 15.94 70.00 $1,115.80

53600 Dilate urethra stricture 2.37 70.00 $165.90

53660 Dilation of urethra 1.99 70.00 $139.30

53850 Prostatic microwave thermotx 58.45 70.00 $4,091.50

53852 Prostatic rf thermotx 53.89 70.00 $3,772.30

53855 Insert prost urethral stent 21.85 70.00 $1,529.50

53860 Transurethral rf treatment 44.14 70.00 $3,089.80

53899 Urology surgery procedure 0.00 70.00 $0.00

54000 Slitting of prepuce 4.21 70.00 $294.70

54001 Slitting of prepuce 5.25 70.00 $367.50

54015 Drain penis lesion 8.78 70.00 $614.60

54050 Destruction penis lesion(s) 3.76 70.00 $263.20

54056 Cryosurgery penis lesion(s) 4.03 70.00 $282.10

54057 Laser surg penis lesion(s) 3.84 70.00 $268.80

54060 Excision of penis lesion(s) 5.09 70.00 $356.30

54100 Biopsy of penis 5.63 70.00 $394.10

54105 Biopsy of penis 7.52 70.00 $526.40

54110 Treatment of penis lesion 17.89 70.00 $1,252.30

54111 Treat penis lesion graft 22.98 70.00 $1,608.60

54112 Treat penis lesion graft 26.91 70.00 $1,883.70

54115 Treatment of penis lesion 12.91 70.00 $903.70

54120 Partial removal of penis 18.13 70.00 $1,269.10

54125 Removal of penis 23.30 70.00 $1,631.00

54130 Remove penis & nodes 34.24 70.00 $2,396.80

54135 Remove penis & nodes 43.41 70.00 $3,038.70

54150 Circumcision w/regionl block 4.39 70.00 $307.30

54160 Circumcision neonate 6.24 70.00 $436.80

54161 Circum 28 days or older 5.64 70.00 $394.80

54162 Lysis penil circumic lesion 7.29 70.00 $510.30

54163 Repair of circumcision 6.26 70.00 $438.20

54164 Frenulotomy of penis 5.54 70.00 $387.80

54205 Treatment of penis lesion 15.25 70.00 $1,067.50

54230 Prepare penis study 2.76 70.00 $193.20

54231 Dynamic cavernosometry 4.00 70.00 $280.00

54235 Penile injection 2.58 70.00 $180.60

54240 Penis study 2.83 70.00 $198.10

54240 TC Penis study 0.99 70.00 $69.30

54240 26 Penis study 1.84 70.00 $128.80

54250 Penis study 3.46 70.00 $242.20

54250 TC Penis study 0.31 70.00 $21.70

54250 26 Penis study 3.15 70.00 $220.50

54300 Revision of penis 18.40 70.00 $1,288.00

54328 Revise penis/urethra 26.97 70.00 $1,887.90

54340 Secondary urethral surgery 16.34 70.00 $1,143.80

54352 Reconstruct urethra/penis 40.67 70.00 $2,846.90

54360 Penis plastic surgery 20.68 70.00 $1,447.60

54380 Repair penis 22.93 70.00 $1,605.10

54385 Repair penis 29.86 70.00 $2,090.20

54390 Repair penis and bladder 35.90 70.00 $2,513.00

54400 Insert semi-rigid prosthesis 15.18 70.00 $1,062.60

54401 Insert self-contd prosthesis 18.77 70.00 $1,313.90

54405 Insert multi-comp penis pros 23.19 70.00 $1,623.30

54406 Remove muti-comp penis pros 20.96 70.00 $1,467.20

54408 Repair multi-comp penis pros 22.67 70.00 $1,586.90

54410 Remove/replace penis prosth 24.65 70.00 $1,725.50

54411 Remov/replc penis pros comp 29.45 70.00 $2,061.50

54415 Remove self-contd penis pros 15.17 70.00 $1,061.90

54416 Remv/repl penis contain pros 20.34 70.00 $1,423.80

54417 Remv/replc penis pros compl 25.79 70.00 $1,805.30

54435 Revision of penis 11.93 70.00 $835.10

54440 Repair of penis 0.00 70.00 $0.00

54450 Preputial stretching 1.99 70.00 $139.30

54500 Biopsy of testis 2.15 70.00 $150.50

54505 Biopsy of testis 6.01 70.00 $420.70

54512 Excise lesion testis 15.53 70.00 $1,087.10

54520 Removal of testis 9.36 70.00 $655.20

54522 Orchiectomy partial 16.92 70.00 $1,184.40

54530 Removal of testis 14.47 70.00 $1,012.90

54535 Extensive testis surgery 21.36 70.00 $1,495.20

54550 Exploration for testis 14.11 70.00 $987.70

54560 Exploration for testis 19.48 70.00 $1,363.60

54600 Reduce testis torsion 12.97 70.00 $907.90

54620 Suspension of testis 8.61 70.00 $602.70

54640 Suspension of testis 13.75 70.00 $962.50

54650 Orchiopexy (fowler-stephens) 20.40 70.00 $1,428.00

54660 Revision of testis 10.23 70.00 $716.10

54670 Repair testis injury 11.60 70.00 $812.00

54680 Relocation of testis(es) 22.58 70.00 $1,580.60

54690 Laparoscopy orchiectomy 18.86 70.00 $1,320.20

54692 Laparoscopy orchiopexy 21.79 70.00 $1,525.30

54699 Laparoscope proc testis 0.00 70.00 $0.00

54700 Drainage of scrotum 6.17 70.00 $431.90

54800 Biopsy of epididymis 3.63 70.00 $254.10

54830 Remove epididymis lesion 10.67 70.00 $746.90

54840 Remove epididymis lesion 9.19 70.00 $643.30

54860 Removal of epididymis 12.00 70.00 $840.00

54861 Removal of epididymis 16.23 70.00 $1,136.10

54865 Explore epididymis 10.27 70.00 $718.90

54900 Fusion of spermatic ducts 23.21 70.00 $1,624.70

54901 Fusion of spermatic ducts 30.58 70.00 $2,140.60

55000 Drainage of hydrocele 3.34 70.00 $233.80

55040 Removal of hydrocele 9.70 70.00 $679.00

55041 Removal of hydroceles 14.63 70.00 $1,024.10

55060 Repair of hydrocele 10.91 70.00 $763.70

55100 Drainage of scrotum abscess 6.13 70.00 $429.10

55110 Explore scrotum 11.10 70.00 $777.00

55120 Removal of scrotum lesion 10.25 70.00 $717.50

55150 Removal of scrotum 14.14 70.00 $989.80

55175 Revision of scrotum 10.39 70.00 $727.30

55180 Revision of scrotum 19.77 70.00 $1,383.90

55200 Incision of sperm duct 12.36 70.00 $865.20

55250 Removal of sperm duct(s) 10.88 70.00 $761.60

55300 Prepare sperm duct x-ray 5.38 70.00 $376.60

55400 Repair of sperm duct 14.29 70.00 $1,000.30

55450 Ligation of sperm duct 10.19 70.00 $713.30

55500 Removal of hydrocele 11.36 70.00 $795.20

55520 Removal of sperm cord lesion 13.05 70.00 $913.50

55530 Revise spermatic cord veins 10.11 70.00 $707.70

55535 Revise spermatic cord veins 12.33 70.00 $863.10

55540 Revise hernia & sperm veins 15.95 70.00 $1,116.50

55550 Laparo ligate spermatic vein 12.27 70.00 $858.90

55559 Laparo proc spermatic cord 0.00 70.00 $0.00

55600 Incise sperm duct pouch 12.07 70.00 $844.90

55605 Incise sperm duct pouch 15.16 70.00 $1,061.20

55650 Remove sperm duct pouch 20.55 70.00 $1,438.50

55680 Remove sperm pouch lesion 10.06 70.00 $704.20

55700 Biopsy of prostate 6.18 70.00 $432.60

55705 Biopsy of prostate 7.65 70.00 $535.50

55706 Prostate saturation sampling 10.68 70.00 $747.60

55720 Drainage of prostate abscess 12.94 70.00 $905.80

55725 Drainage of prostate abscess 18.20 70.00 $1,274.00

55801 Removal of prostate 31.36 70.00 $2,195.20

55810 Extensive prostate surgery 37.83 70.00 $2,648.10

55860 Surgical exposure prostate 25.11 70.00 $1,757.70

55866 Laparo radical prostatectomy 49.77 70.00 $3,483.90

55870 Electroejaculation 5.01 70.00 $350.70

55873 Cryoablate prostate 200.47 70.00 $14,032.90

55875 Transperi needle place pros 21.87 70.00 $1,530.90

55876 Place rt device/marker pros 3.85 70.00 $269.50

55899 Genital surgery procedure 0.00 70.00 $0.00

55920 Place needles pelvic for rt 12.78 70.00 $894.60

55970 Sex transformation m to f 0.00 70.00 $0.00

55980 Sex transformation f to m 0.00 70.00 $0.00

56405 I & d of vulva/perineum 3.12 70.00 $218.40

56420 Drainage of gland abscess 3.46 70.00 $242.20

56440 Surgery for vulva lesion 5.19 70.00 $363.30

56441 Lysis of labial lesion(s) 4.13 70.00 $289.10

56442 Hymenotomy 1.35 70.00 $94.50

56501 Destroy vulva lesions sim 3.72 70.00 $260.40

56515 Destroy vulva lesion/s compl 6.45 70.00 $451.50

56605 Biopsy of vulva/perineum 2.34 70.00 $163.80

56606 Biopsy of vulva/perineum 1.07 70.00 $74.90

56620 Partial removal of vulva 14.86 70.00 $1,040.20

56625 Complete removal of vulva 18.05 70.00 $1,263.50

56630 Extensive vulva surgery 26.60 70.00 $1,862.00

56700 Partial removal of hymen 5.31 70.00 $371.70

56740 Remove vagina gland lesion 8.58 70.00 $600.60

56800 Repair of vagina 6.87 70.00 $480.90

56805 Repair clitoris 32.49 70.00 $2,274.30

56810 Repair of perineum 7.40 70.00 $518.00

56820 Exam of vulva w/scope 3.19 70.00 $223.30

56821 Exam/biopsy of vulva w/scope 4.21 70.00 $294.70

57000 Exploration of vagina 5.25 70.00 $367.50

57010 Drainage of pelvic abscess 12.30 70.00 $861.00

57020 Drainage of pelvic fluid 2.63 70.00 $184.10

57022 I & d vaginal hematoma pp 4.78 70.00 $334.60

57023 I & d vag hematoma non-ob 8.84 70.00 $618.80

57061 Destroy vag lesions simple 3.24 70.00 $226.80

57065 Destroy vag lesions complex 5.58 70.00 $390.60

57100 Biopsy of vagina 2.54 70.00 $177.80

57105 Biopsy of vagina 3.88 70.00 $271.60

57106 Remove vagina wall partial 14.10 70.00 $987.00

57107 Remove vagina tissue part 41.73 70.00 $2,921.10

57109 Vaginectomy partial w/nodes 50.31 70.00 $3,521.70

57110 Remove vagina wall complete 25.43 70.00 $1,780.10

57111 Remove vagina tissue compl 45.53 70.00 $3,187.10

57112 Vaginectomy w/nodes compl 53.85 70.00 $3,769.50

57120 Closure of vagina 14.47 70.00 $1,012.90

57130 Remove vagina lesion 5.03 70.00 $352.10

57135 Remove vagina lesion 5.45 70.00 $381.50

57150 Treat vagina infection 1.28 70.00 $89.60

57155 Insert uteri tandem/ovoids 12.13 70.00 $849.10

57156 Ins vag brachytx device 5.58 70.00 $390.60

57160 Insert pessary/other device 2.17 70.00 $151.90

57170 Fitting of diaphragm/cap 1.72 70.00 $120.40

57180 Treat vaginal bleeding 4.00 70.00 $280.00

57200 Repair of vagina 8.61 70.00 $602.70

57210 Repair vagina/perineum 10.46 70.00 $732.20

57230 Repair of urethral lesion 11.20 70.00 $784.00

57240 Repair bladder & vagina 19.10 70.00 $1,337.00

57250 Repair rectum & vagina 19.24 70.00 $1,346.80

57260 Repair of vagina 23.71 70.00 $1,659.70

57265 Extensive repair of vagina 25.96 70.00 $1,817.20

57267 Insert mesh/pelvic flr addon 7.31 70.00 $511.70

57268 Repair of bowel bulge 13.74 70.00 $961.80

57270 Repair of bowel pouch 22.69 70.00 $1,588.30

57280 Suspension of vagina 27.16 70.00 $1,901.20

57282 Colpopexy extraperitoneal 14.22 70.00 $995.40

57283 Colpopexy intraperitoneal 19.61 70.00 $1,372.70

57284 Repair paravag defect open 23.22 70.00 $1,625.40

57285 Repair paravag defect vag 19.13 70.00 $1,339.10

57287 Revise/remove sling repair 19.37 70.00 $1,355.90

57288 Repair bladder defect 20.38 70.00 $1,426.60

57289 Repair bladder & vagina 20.91 70.00 $1,463.70

57291 Construction of vagina 15.04 70.00 $1,052.80

57292 Construct vagina with graft 23.19 70.00 $1,623.30

57295 Revise vag graft via vagina 13.57 70.00 $949.90

57296 Revise vag graft open abd 26.59 70.00 $1,861.30

57300 Repair rectum-vagina fistula 16.21 70.00 $1,134.70

57305 Repair rectum-vagina fistula 26.89 70.00 $1,882.30

57307 Fistula repair & colostomy 30.96 70.00 $2,167.20

57308 Fistula repair transperine 18.15 70.00 $1,270.50

57310 Repair urethrovaginal lesion 13.18 70.00 $922.60

57311 Repair urethrovaginal lesion 15.01 70.00 $1,050.70

57320 Repair bladder-vagina lesion 15.11 70.00 $1,057.70

57330 Repair bladder-vagina lesion 21.21 70.00 $1,484.70

57335 Repair vagina 31.86 70.00 $2,230.20

57400 Dilation of vagina 3.79 70.00 $265.30

57410 Pelvic examination 3.09 70.00 $216.30

57415 Remove vaginal foreign body 4.56 70.00 $319.20

57420 Exam of vagina w/scope 3.37 70.00 $235.90

57421 Exam/biopsy of vag w/scope 4.49 70.00 $314.30

57423 Repair paravag defect lap 26.01 70.00 $1,820.70

57425 Laparoscopy surg colpopexy 27.58 70.00 $1,930.60

57426 Revise prosth vag graft lap 24.01 70.00 $1,680.70

57452 Exam of cervix w/scope 3.10 70.00 $217.00

57454 Bx/curett of cervix w/scope 4.35 70.00 $304.50

57455 Biopsy of cervix w/scope 4.07 70.00 $284.90

57456 Endocerv curettage w/scope 3.83 70.00 $268.10

57460 Bx of cervix w/scope leep 8.00 70.00 $560.00

57461 Conz of cervix w/scope leep 9.06 70.00 $634.20

57500 Biopsy of cervix 3.63 70.00 $254.10

57505 Endocervical curettage 2.89 70.00 $202.30

57510 Cauterization of cervix 3.72 70.00 $260.40

57511 Cryocautery of cervix 4.13 70.00 $289.10

57513 Laser surgery of cervix 4.13 70.00 $289.10

57520 Conization of cervix 8.71 70.00 $609.70

57522 Conization of cervix 7.47 70.00 $522.90

57530 Removal of cervix 9.92 70.00 $694.40

57531 Removal of cervix radical 53.10 70.00 $3,717.00

57540 Removal of residual cervix 22.85 70.00 $1,599.50

57545 Remove cervix/repair pelvis 23.33 70.00 $1,633.10

57550 Removal of residual cervix 11.54 70.00 $807.80

57555 Remove cervix/repair vagina 17.06 70.00 $1,194.20

57556 Remove cervix repair bowel 16.13 70.00 $1,129.10

57558 D&c of cervical stump 3.55 70.00 $248.50

57700 Revision of cervix 8.80 70.00 $616.00

57800 Dilation of cervical canal 1.73 70.00 $121.10

58100 Biopsy of uterus lining 3.09 70.00 $216.30

58110 Bx done w/colposcopy add-on 1.37 70.00 $95.90

58120 Dilation and curettage 7.34 70.00 $513.80

58140 Myomectomy abdom method 26.27 70.00 $1,838.90

58145 Myomectomy vag method 15.59 70.00 $1,091.30

58146 Myomectomy abdom complex 32.72 70.00 $2,290.40

58150 Total hysterectomy 28.94 70.00 $2,025.80

58152 Total hysterectomy 35.69 70.00 $2,498.30

58180 Partial hysterectomy 27.47 70.00 $1,922.90

58200 Extensive hysterectomy 39.24 70.00 $2,746.80

58240 Removal of pelvis contents 83.64 70.00 $5,854.80

58260 Vaginal hysterectomy 23.49 70.00 $1,644.30

58262 Vag hyst including t/o 26.23 70.00 $1,836.10

58263 Vag hyst w/t/o & vag repair 28.11 70.00 $1,967.70

58267 Vag hyst w/urinary repair 30.01 70.00 $2,100.70

58270 Vag hyst w/enterocele repair 25.07 70.00 $1,754.90

58275 Hysterectomy/revise vagina 28.08 70.00 $1,965.60

58280 Hysterectomy/revise vagina 29.86 70.00 $2,090.20

58290 Vag hyst complex 32.63 70.00 $2,284.10

58291 Vag hyst incl t/o complex 35.34 70.00 $2,473.80

58292 Vag hyst t/o & repair compl 37.28 70.00 $2,609.60

58293 Vag hyst w/uro repair compl 38.76 70.00 $2,713.20

58294 Vag hyst w/enterocele compl 34.55 70.00 $2,418.50

58300 Insert intrauterine device 1.98 70.00 $138.60

58301 Remove intrauterine device 2.69 70.00 $188.30

58321 Artificial insemination 2.16 70.00 $151.20

58322 Artificial insemination 2.43 70.00 $170.10

58323 Sperm washing 0.44 70.00 $30.80

58340 Catheter for hysterography 3.36 70.00 $235.20

58345 Reopen fallopian tube 7.92 70.00 $554.40

58346 Insert heyman uteri capsule 12.59 70.00 $881.30

58350 Reopen fallopian tube 2.74 70.00 $191.80

58353 Endometr ablate thermal 28.34 70.00 $1,983.80

58356 Endometrial cryoablation 52.94 70.00 $3,705.80

58400 Suspension of uterus 12.47 70.00 $872.90

58410 Suspension of uterus 22.81 70.00 $1,596.70

58520 Repair of ruptured uterus 22.77 70.00 $1,593.90

58540 Revision of uterus 25.79 70.00 $1,805.30

58541 Lsh uterus 250 g or less 20.38 70.00 $1,426.60

58542 Lsh w/t/o ut 250 g or less 23.29 70.00 $1,630.30

58543 Lsh uterus above 250 g 23.56 70.00 $1,649.20

58544 Lsh w/t/o uterus above 250 g 25.73 70.00 $1,801.10

58545 Laparoscopic myomectomy 25.80 70.00 $1,806.00

58546 Laparo-myomectomy complex 31.92 70.00 $2,234.40

58548 Lap radical hyst 54.50 70.00 $3,815.00

58550 Laparo-asst vag hysterectomy 25.08 70.00 $1,755.60

58552 Laparo-vag hyst incl t/o 28.16 70.00 $1,971.20

58553 Laparo-vag hyst complex 32.21 70.00 $2,254.70

58554 Laparo-vag hyst w/t/o compl 37.76 70.00 $2,643.20

58555 Hysteroscopy dx sep proc 8.59 70.00 $601.30

58558 Hysteroscopy biopsy 11.24 70.00 $786.80

58559 Hysteroscopy lysis 9.71 70.00 $679.70

58560 Hysteroscopy resect septum 10.98 70.00 $768.60

58561 Hysteroscopy remove myoma 15.55 70.00 $1,088.50

58562 Hysteroscopy remove fb 11.66 70.00 $816.20

58563 Hysteroscopy ablation 46.85 70.00 $3,279.50

58565 Hysteroscopy sterilization 52.67 70.00 $3,686.90

58570 Tlh uterus 250 g or less 22.17 70.00 $1,551.90

58571 Tlh w/t/o 250 g or less 25.64 70.00 $1,794.80

58572 Tlh uterus over 250 g 28.98 70.00 $2,028.60

58573 Tlh w/t/o uterus over 250 g 34.63 70.00 $2,424.10

58578 Laparo proc uterus 0.00 70.00 $0.00

58579 Hysteroscope procedure 0.00 70.00 $0.00

58600 Division of fallopian tube 10.32 70.00 $722.40

58605 Division of fallopian tube 9.35 70.00 $654.50

58611 Ligate oviduct(s) add-on 2.20 70.00 $154.00

58615 Occlude fallopian tube(s) 6.92 70.00 $484.40

58660 Laparoscopy lysis 19.19 70.00 $1,343.30

58661 Laparoscopy remove adnexa 18.50 70.00 $1,295.00

58662 Laparoscopy excise lesions 20.21 70.00 $1,414.70

58670 Laparoscopy tubal cautery 10.35 70.00 $724.50

58671 Laparoscopy tubal block 10.33 70.00 $723.10

58672 Laparoscopy fimbrioplasty 20.86 70.00 $1,460.20

58673 Laparoscopy salpingostomy 22.69 70.00 $1,588.30

58679 Laparo proc oviduct-ovary 0.00 70.00 $0.00

58700 Removal of fallopian tube 22.31 70.00 $1,561.70

58720 Removal of ovary/tube(s) 21.00 70.00 $1,470.00

58740 Adhesiolysis tube ovary 25.21 70.00 $1,764.70

58750 Repair oviduct 25.92 70.00 $1,814.40

58752 Revise ovarian tube(s) 24.75 70.00 $1,732.50

58760 Fimbrioplasty 22.98 70.00 $1,608.60

58770 Create new tubal opening 24.19 70.00 $1,693.30

58800 Drainage of ovarian cyst(s) 9.01 70.00 $630.70

58805 Drainage of ovarian cyst(s) 11.46 70.00 $802.20

58820 Drain ovary abscess open 8.84 70.00 $618.80

58822 Drain ovary abscess percut 19.86 70.00 $1,390.20

58825 Transposition ovary(s) 21.73 70.00 $1,521.10

58900 Biopsy of ovary(s) 11.71 70.00 $819.70

58920 Partial removal of ovary(s) 20.29 70.00 $1,420.30

58925 Removal of ovarian cyst(s) 21.32 70.00 $1,492.40

58940 Removal of ovary(s) 15.02 70.00 $1,051.40

58943 Removal of ovary(s) 33.64 70.00 $2,354.80

58950 Resect ovarian malignancy 32.41 70.00 $2,268.70

58953 Tah rad dissect for debulk 58.30 70.00 $4,081.00

58954 Tah rad debulk/lymph remove 63.22 70.00 $4,425.40

58956 Bso omentectomy w/tah 39.67 70.00 $2,776.90

58957 Resect recurrent gyn mal 45.62 70.00 $3,193.40

58958 Resect recur gyn mal w/lym 50.09 70.00 $3,506.30

58960 Exploration of abdomen 28.00 70.00 $1,960.00

58970 Retrieval of oocyte 6.32 70.00 $442.40

58974 Transfer of embryo 0.00 70.00 $0.00

58976 Transfer of embryo 6.94 70.00 $485.80

58999 Genital surgery procedure 0.00 70.00 $0.00

59000 Amniocentesis diagnostic 3.61 70.00 $252.70

59001 Amniocentesis therapeutic 5.24 70.00 $366.80

59012 Fetal cord puncture prenatal 5.91 70.00 $413.70

59015 Chorion biopsy 4.50 70.00 $315.00

59020 Fetal contract stress test 2.04 70.00 $142.80

59020 TC Fetal contract stress test 0.96 70.00 $67.20

59020 26 Fetal contract stress test 1.08 70.00 $75.60

59025 Fetal non-stress test 1.38 70.00 $96.60

59025 TC Fetal non-stress test 0.52 70.00 $36.40

59025 26 Fetal non-stress test 0.86 70.00 $60.20

59030 Fetal scalp blood sample 2.89 70.00 $202.30

59050 Fetal monitor w/report 1.48 70.00 $103.60

59051 Fetal monitor/interpret only 1.22 70.00 $85.40

59070 Transabdom amnioinfus w/us 11.81 70.00 $826.70

59072 Umbilical cord occlud w/us 13.45 70.00 $941.50

59074 Fetal fluid drainage w/us 11.33 70.00 $793.10

59076 Fetal shunt placement w/us 13.45 70.00 $941.50

59100 Remove uterus lesion 24.19 70.00 $1,693.30

59120 Treat ectopic pregnancy 23.02 70.00 $1,611.40

59140 Treat ectopic pregnancy 11.60 70.00 $812.00

59160 D & c after delivery 5.88 70.00 $411.60

59200 Insert cervical dilator 2.07 70.00 $144.90

59300 Episiotomy or vaginal repair 5.58 70.00 $390.60

59350 Repair of uterus 8.20 70.00 $574.00

59400 Obstetrical care 60.62 70.00 $4,243.40

59412 Antepartum manipulation 3.02 70.00 $211.40

59414 Deliver placenta 2.67 70.00 $186.90

59425 Antepartum care only 13.15 70.00 $920.50

59426 Antepartum care only 23.55 70.00 $1,648.50

59430 Care after delivery 5.35 70.00 $374.50

59510 Cesarean delivery 66.97 70.00 $4,687.90

59514 Cesarean delivery only 26.68 70.00 $1,867.60

59515 Cesarean delivery 36.65 70.00 $2,565.50

59525 Remove uterus after cesarean 14.14 70.00 $989.80

59610 Vbac delivery 63.51 70.00 $4,445.70

59612 Vbac delivery only 26.66 70.00 $1,866.20

59614 Vbac care after delivery 33.17 70.00 $2,321.90

59618 Attempted vbac delivery 67.90 70.00 $4,753.00

59620 Attempted vbac delivery only 27.61 70.00 $1,932.70

59622 Attempted vbac after care 37.63 70.00 $2,634.10

59812 Treatment of miscarriage 9.17 70.00 $641.90

59820 Care of miscarriage 10.93 70.00 $765.10

59821 Treatment of miscarriage 11.01 70.00 $770.70

59830 Treat uterus infection 12.63 70.00 $884.10

59840 Abortion 6.28 70.00 $439.60

59841 Abortion 11.05 70.00 $773.50

59850 Abortion 9.97 70.00 $697.90

59851 Abortion 11.51 70.00 $805.70

59852 Abortion 14.42 70.00 $1,009.40

59855 Abortion 12.01 70.00 $840.70

59856 Abortion 14.12 70.00 $988.40

59857 Abortion 14.84 70.00 $1,038.80

59866 Abortion (mpr) 6.22 70.00 $435.40

59870 Evacuate mole of uterus 13.61 70.00 $952.70

59871 Remove cerclage suture 3.88 70.00 $271.60

59897 Fetal invas px w/us 0.00 70.00 $0.00

59898 Laparo proc ob care/deliver 0.00 70.00 $0.00

59899 Maternity care procedure 0.00 70.00 $0.00

60000 Drain thyroid/tongue cyst 4.56 70.00 $319.20

6005F Care level rationale doc 0.00 70.00 $0.00

6010F Dysphag test done b/4 eating 0.00 70.00 $0.00

60100 Biopsy of thyroid 3.24 70.00 $226.80

6015F Dysphag test done b/4 eating 0.00 70.00 $0.00

6020F Npo (nothing-mouth) ordered 0.00 70.00 $0.00

60200 Remove thyroid lesion 19.02 70.00 $1,331.40

60210 Partial thyroid excision 20.39 70.00 $1,427.30

60212 Partial thyroid excision 29.12 70.00 $2,038.40

60220 Partial removal of thyroid 20.39 70.00 $1,427.30

60225 Partial removal of thyroid 26.91 70.00 $1,883.70

60240 Removal of thyroid 26.53 70.00 $1,857.10

60254 Extensive thyroid surgery 48.41 70.00 $3,388.70

60260 Repeat thyroid surgery 31.55 70.00 $2,208.50

60280 Remove thyroid duct lesion 12.77 70.00 $893.90

60281 Remove thyroid duct lesion 16.95 70.00 $1,186.50

6030F Max sterile barriers follwd 0.00 70.00 $0.00

60300 Aspir/inj thyroid cyst 3.39 70.00 $237.30

6040F Appro rad ds dvcs techs docd 0.00 70.00 $0.00

6045F Radxps in end rprt4fluro pxd 0.00 70.00 $0.00

60500 Explore parathyroid glands 27.85 70.00 $1,949.50

60502 Re-explore parathyroids 37.19 70.00 $2,603.30

60505 Explore parathyroid glands 40.10 70.00 $2,807.00

60512 Autotransplant parathyroid 7.07 70.00 $494.90

60520 Removal of thymus gland 30.25 70.00 $2,117.50

60540 Explore adrenal gland 30.50 70.00 $2,135.00

60545 Explore adrenal gland 35.13 70.00 $2,459.10

60600 Remove carotid body lesion 40.63 70.00 $2,844.10

60605 Remove carotid body lesion 57.91 70.00 $4,053.70

60650 Laparoscopy adrenalectomy 34.39 70.00 $2,407.30

60659 Laparo proc endocrine 0.00 70.00 $0.00

60699 Endocrine surgery procedure 0.00 70.00 $0.00

6070F Pt asked/cnsld aed effects 0.00 70.00 $0.00

6080F Pt/caregiver queried falls 0.00 70.00 $0.00

6090F Pt/caregiver counsel safety 0.00 70.00 $0.00

6100F Verify pt site pxd docd 0.00 70.00 $0.00

61000 Remove cranial cavity fluid 3.15 70.00 $220.50

61001 Remove cranial cavity fluid 2.35 70.00 $164.50

6101F Safety counseling dementia 0.00 70.00 $0.00

6102F Safety counseling dem order 0.00 70.00 $0.00

61020 Remove brain cavity fluid 3.07 70.00 $214.90

61026 Injection into brain canal 2.99 70.00 $209.30

61050 Remove brain canal fluid 2.47 70.00 $172.90

61055 Injection into brain canal 3.52 70.00 $246.40

61070 Brain canal shunt procedure 1.67 70.00 $116.90

6110F Counsel prov driving risks 0.00 70.00 $0.00

61105 Twist drill hole 13.70 70.00 $959.00

61107 Drill skull for implantation 9.35 70.00 $654.50

61108 Drill skull for drainage 26.92 70.00 $1,884.40

61120 Burr hole for puncture 22.14 70.00 $1,549.80

61140 Pierce skull for biopsy 37.27 70.00 $2,608.90

61150 Pierce skull for drainage 40.26 70.00 $2,818.20

61154 Pierce skull & remove clot 37.50 70.00 $2,625.00

61210 Pierce skull implant device 11.00 70.00 $770.00

61215 Insert brain-fluid device 14.84 70.00 $1,038.80

61250 Pierce skull & explore 25.73 70.00 $1,801.10

61253 Pierce skull & explore 27.41 70.00 $1,918.70

61304 Open skull for exploration 48.43 70.00 $3,390.10

61305 Open skull for exploration 59.75 70.00 $4,182.50

61312 Open skull for drainage 61.57 70.00 $4,309.90

61316 Implt cran bone flap to abdo 2.62 70.00 $183.40

61322 Decompressive craniotomy 70.36 70.00 $4,925.20

61323 Decompressive lobectomy 71.04 70.00 $4,972.80

61330 Decompress eye socket 44.37 70.00 $3,105.90

61332 Explore/biopsy eye socket 51.31 70.00 $3,591.70

61333 Explore orbit/remove lesion 52.44 70.00 $3,670.80

61340 Subtemporal decompression 42.95 70.00 $3,006.50

61343 Incise skull (press relief) 64.98 70.00 $4,548.60

61345 Relieve cranial pressure 60.69 70.00 $4,248.30

61450 Incise skull for surgery 57.22 70.00 $4,005.40

61458 Incise skull for brain wound 59.40 70.00 $4,158.00

6150F Pt notrcvng1st antitnf txmnt 0.00 70.00 $0.00

61500 Removal of skull lesion 38.71 70.00 $2,709.70

61501 Remove infected skull bone 33.99 70.00 $2,379.30

61510 Removal of brain lesion 64.61 70.00 $4,522.70

61512 Remove brain lining lesion 75.40 70.00 $5,278.00

61514 Removal of brain abscess 56.50 70.00 $3,955.00

61517 Implt brain chemotx add-on 2.62 70.00 $183.40

61519 Remove brain lining lesion 87.26 70.00 $6,108.20

61522 Removal of brain abscess 65.07 70.00 $4,554.90

61531 Implant brain electrodes 36.25 70.00 $2,537.50

61535 Remove brain electrodes 29.63 70.00 $2,074.10

61537 Removal of brain tissue 72.77 70.00 $5,093.90

61541 Incision of brain tissue 63.93 70.00 $4,475.10

61544 Remove & treat brain lesion 56.58 70.00 $3,960.60

61545 Excision of brain tumor 94.77 70.00 $6,633.90

61546 Removal of pituitary gland 68.68 70.00 $4,807.60

61548 Removal of pituitary gland 46.28 70.00 $3,239.60

61550 Release of skull seams 28.17 70.00 $1,971.90

61552 Release of skull seams 32.16 70.00 $2,251.20

61556 Incise skull/sutures 50.65 70.00 $3,545.50

61557 Incise skull/sutures 49.92 70.00 $3,494.40

61558 Excision of skull/sutures 49.47 70.00 $3,462.90

61559 Excision of skull/sutures 71.09 70.00 $4,976.30

61563 Excision of skull tumor 58.89 70.00 $4,122.30

61564 Excision of skull tumor 71.59 70.00 $5,011.30

61567 Incision of brain tissue 69.85 70.00 $4,889.50

61570 Remove foreign body brain 55.53 70.00 $3,887.10

61571 Incise skull for brain wound 59.14 70.00 $4,139.80

61575 Skull base/brainstem surgery 74.58 70.00 $5,220.60

61576 Skull base/brainstem surgery 98.88 70.00 $6,921.60

61580 Craniofacial approach skull 72.67 70.00 $5,086.90

61584 Orbitocranial approach/skull 84.10 70.00 $5,887.00

61586 Resect nasopharynx skull 71.19 70.00 $4,983.30

61590 Infratemporal approach/skull 88.19 70.00 $6,173.30

61591 Infratemporal approach/skull 90.57 70.00 $6,339.90

61595 Transtemporal approach/skull 68.77 70.00 $4,813.90

61596 Transcochlear approach/skull 70.75 70.00 $4,952.50

61597 Transcondylar approach/skull 85.45 70.00 $5,981.50

61598 Transpetrosal approach/skull 84.03 70.00 $5,882.10

61600 Resect/excise cranial lesion 61.87 70.00 $4,330.90

61610 Transect artery sinus 55.50 70.00 $3,885.00

61611 Transect artery sinus 10.76 70.00 $753.20

61612 Transect artery sinus 40.37 70.00 $2,825.90

61613 Remove aneurysm sinus 97.50 70.00 $6,825.00

61615 Resect/excise lesion skull 79.71 70.00 $5,579.70

61616 Resect/excise lesion skull 97.65 70.00 $6,835.50

61618 Repair dura 38.08 70.00 $2,665.60

61619 Repair dura 42.14 70.00 $2,949.80

61623 Endovasc tempory vessel occl 16.44 70.00 $1,150.80

61624 Transcath occlusion cns 33.31 70.00 $2,331.70

61626 Transcath occlusion non-cns 25.06 70.00 $1,754.20

61630 Intracranial angioplasty 38.52 70.00 $2,696.40

61635 Intracran angioplsty w/stent 40.68 70.00 $2,847.60

61640 Dilate ic vasospasm init 17.85 70.00 $1,249.50

61641 Dilate ic vasospasm add-on 6.29 70.00 $440.30

61642 Dilate ic vasospasm add-on 12.56 70.00 $879.20

61680 Intracranial vessel surgery 66.57 70.00 $4,659.90

61697 Brain aneurysm repr complx 125.31 70.00 $8,771.70

61698 Brain aneurysm repr complx 138.22 70.00 $9,675.40

61700 Brain aneurysm repr simple 101.08 70.00 $7,075.60

61702 Inner skull vessel surgery 120.04 70.00 $8,402.80

61703 Clamp neck artery 40.36 70.00 $2,825.20

61705 Revise circulation to head 77.51 70.00 $5,425.70

61711 Fusion of skull arteries 76.83 70.00 $5,378.10

61720 Incise skull/brain surgery 37.73 70.00 $2,641.10

61735 Incise skull/brain surgery 47.26 70.00 $3,308.20

61750 Incise skull/brain biopsy 41.58 70.00 $2,910.60

61751 Brain biopsy w/ct/mr guide 40.82 70.00 $2,857.40

61770 Incise skull for treatment 48.30 70.00 $3,381.00

61781 Scan proc cranial intra 7.01 70.00 $490.70

61782 Scan proc cranial extra 5.10 70.00 $357.00

61783 Scan proc spinal 6.91 70.00 $483.70

61790 Treat trigeminal nerve 25.97 70.00 $1,817.90

61791 Treat trigeminal tract 33.37 70.00 $2,335.90

61796 Srs cranial lesion simple 30.05 70.00 $2,103.50

61797 Srs cran les simple addl 6.60 70.00 $462.00

61798 Srs cranial lesion complex 41.03 70.00 $2,872.10

61799 Srs cran les complex addl 9.09 70.00 $636.30

61800 Apply srs headframe add-on 4.60 70.00 $322.00

61850 Implant neuroelectrodes 29.14 70.00 $2,039.80

61863 Implant neuroelectrode 44.57 70.00 $3,119.90

61864 Implant neuroelectrde addl 8.52 70.00 $596.40

61867 Implant neuroelectrode 67.51 70.00 $4,725.70

61868 Implant neuroelectrde addl 14.89 70.00 $1,042.30

61880 Revise/remove neuroelectrode 16.74 70.00 $1,171.80

61885 Insrt/redo neurostim 1 array 15.10 70.00 $1,057.00

61886 Implant neurostim arrays 24.84 70.00 $1,738.80

61888 Revise/remove neuroreceiver 11.62 70.00 $813.40

62000 Treat skull fracture 30.56 70.00 $2,139.20

62005 Treat skull fracture 37.75 70.00 $2,642.50

62010 Treatment of head injury 45.51 70.00 $3,185.70

62100 Repair brain fluid leakage 47.29 70.00 $3,310.30

62115 Reduction of skull defect 39.82 70.00 $2,787.40

62117 Reduction of skull defect 58.38 70.00 $4,086.60

62120 Repair skull cavity lesion 48.03 70.00 $3,362.10

62121 Incise skull repair 47.01 70.00 $3,290.70

62140 Repair of skull defect 30.46 70.00 $2,132.20

62141 Repair of skull defect 33.70 70.00 $2,359.00

62142 Remove skull plate/flap 26.09 70.00 $1,826.30

62143 Replace skull plate/flap 30.81 70.00 $2,156.70

62145 Repair of skull & brain 41.71 70.00 $2,919.70

62146 Repair of skull with graft 36.41 70.00 $2,548.70

62147 Repair of skull with graft 43.33 70.00 $3,033.10

62148 Retr bone flap to fix skull 3.79 70.00 $265.30

62160 Neuroendoscopy add-on 5.69 70.00 $398.30

62161 Dissect brain w/scope 45.14 70.00 $3,159.80

62162 Remove colloid cyst w/scope 56.17 70.00 $3,931.90

62163 Zneuroendoscopy w/fb removal 36.34 70.00 $2,543.80

62164 Remove brain tumor w/scope 62.09 70.00 $4,346.30

62165 Remove pituit tumor w/scope 45.31 70.00 $3,171.70

62180 Establish brain cavity shunt 47.58 70.00 $3,330.60

62194 Replace/irrigate catheter 14.38 70.00 $1,006.60

62201 Brain cavity shunt w/scope 35.63 70.00 $2,494.10

62225 Replace/irrigate catheter 15.48 70.00 $1,083.60

62230 Replace/revise brain shunt 24.88 70.00 $1,741.60

62252 Csf shunt reprogram 2.46 70.00 $172.20

62252 TC Csf shunt reprogram 1.11 70.00 $77.70

62252 26 Csf shunt reprogram 1.35 70.00 $94.50

62256 Remove brain cavity shunt 17.71 70.00 $1,239.70

62258 Replace brain cavity shunt 33.16 70.00 $2,321.20

62263 Epidural lysis mult sessions 18.01 70.00 $1,260.70

62264 Epidural lysis on single day 11.93 70.00 $835.10

62267 Interdiscal perq aspir dx 7.14 70.00 $499.80

62268 Drain spinal cord cyst 7.60 70.00 $532.00

62269 Needle biopsy spinal cord 7.80 70.00 $546.00

62270 Spinal fluid tap diagnostic 4.56 70.00 $319.20

62272 Drain cerebro spinal fluid 5.75 70.00 $402.50

62273 Inject epidural patch 4.94 70.00 $345.80

62280 Treat spinal cord lesion 8.54 70.00 $597.80

62281 Treat spinal cord lesion 6.66 70.00 $466.20

62282 Treat spinal canal lesion 8.39 70.00 $587.30

62284 Injection for myelogram 5.21 70.00 $364.70

62287 Percutaneous diskectomy 16.50 70.00 $1,155.00

62290 Inject for spine disk x-ray 9.52 70.00 $666.40

62291 Inject for spine disk x-ray 9.61 70.00 $672.70

62292 Injection into disk lesion 16.79 70.00 $1,175.30

62294 Injection into spinal artery 22.83 70.00 $1,598.10

62302 Myelography lumbar injection 6.95 70.00 $486.50

62310 Inject spine cerv/thoracic 6.83 70.00 $478.10

62311 Inject spine lumbar/sacral 6.29 70.00 $440.30

62318 Inject spine w/cath crv/thrc 6.52 70.00 $456.40

62319 Inject spine w/cath lmb/scrl 4.77 70.00 $333.90

62350 Implant spinal canal cath 11.61 70.00 $812.70

62351 Implant spinal canal cath 25.16 70.00 $1,761.20

62355 Remove spinal canal catheter 7.83 70.00 $548.10

62360 Insert spine infusion device 8.82 70.00 $617.40

62361 Implant spine infusion pump 12.61 70.00 $882.70

62362 Implant spine infusion pump 11.22 70.00 $785.40

62365 Remove spine infusion device 8.65 70.00 $605.50

62367 Analyze spine infus pump 1.16 70.00 $81.20

62368 Analyze sp inf pump w/reprog 1.61 70.00 $112.70

62369 Anal sp inf pmp w/reprg&fill 3.43 70.00 $240.10

62370 Anl sp inf pmp w/mdreprg&fil 3.62 70.00 $253.40

63001 Remove spine lamina 1/2 crvl 36.53 70.00 $2,557.10

63003 Remove spine lamina 1/2 thrc 36.37 70.00 $2,545.90

63005 Remove spine lamina 1/2 lmbr 34.65 70.00 $2,425.50

63011 Remove spine lamina 1/2 scrl 32.17 70.00 $2,251.90

63012 Remove lamina/facets lumbar 34.82 70.00 $2,437.40

63015 Remove spine lamina >2 crvcl 43.67 70.00 $3,056.90

63016 Remove spine lamina >2 thrc 44.64 70.00 $3,124.80

63017 Remove spine lamina >2 lmbr 36.80 70.00 $2,576.00

63020 Neck spine disk surgery 34.14 70.00 $2,389.80

63030 Low back disk surgery 28.29 70.00 $1,980.30

63035 Spinal disk surgery add-on 5.64 70.00 $394.80

63040 Laminotomy single cervical 40.80 70.00 $2,856.00

63042 Laminotomy single lumbar 37.83 70.00 $2,648.10

63043 Laminotomy addl cervical 0.00 70.00 $0.00

63044 Laminotomy addl lumbar 0.00 70.00 $0.00

63045 Remove spine lamina 1 crvl 37.40 70.00 $2,618.00

63046 Remove spine lamina 1 thrc 35.34 70.00 $2,473.80

63047 Remove spine lamina 1 lmbr 32.25 70.00 $2,257.50

63048 Remove spinal lamina add-on 6.24 70.00 $436.80

63050 Cervical laminoplsty 2/> seg 43.48 70.00 $3,043.60

63051 C-laminoplasty w/graft/plate 50.10 70.00 $3,507.00

63055 Decompress spinal cord thrc 47.98 70.00 $3,358.60

63056 Decompress spinal cord lmbr 43.42 70.00 $3,039.40

63057 Decompress spine cord add-on 9.41 70.00 $658.70

63064 Decompress spinal cord thrc 51.99 70.00 $3,639.30

63066 Decompress spine cord add-on 6.17 70.00 $431.90

63075 Neck spine disk surgery 39.64 70.00 $2,774.80

63076 Neck spine disk surgery 7.27 70.00 $508.90

63077 Spine disk surgery thorax 43.93 70.00 $3,075.10

63078 Spine disk surgery thorax 5.56 70.00 $389.20

63081 Remove vert body dcmprn crvl 51.45 70.00 $3,601.50

63082 Remove vertebral body add-on 7.85 70.00 $549.50

63085 Remove vert body dcmprn thrc 56.05 70.00 $3,923.50

63087 Remov vertbr dcmprn thrclmbr 70.57 70.00 $4,939.90

63090 Remove vert body dcmprn lmbr 56.81 70.00 $3,976.70

63101 Remove vert body dcmprn thrc 68.20 70.00 $4,774.00

63102 Remove vert body dcmprn lmbr 66.62 70.00 $4,663.40

63170 Incise spinal cord tract(s) 47.33 70.00 $3,313.10

63172 Drainage of spinal cyst 42.13 70.00 $2,949.10

63173 Drainage of spinal cyst 51.30 70.00 $3,591.00

63180 Revise spinal cord ligaments 44.15 70.00 $3,090.50

63182 Revise spinal cord ligaments 48.47 70.00 $3,392.90

63185 Incise spine nrv half segmnt 33.36 70.00 $2,335.20

63190 Incise spine nrv >2 segmnts 36.70 70.00 $2,569.00

63191 Incise spine accessory nerve 40.92 70.00 $2,864.40

63194 Incise spine & cord cervical 47.45 70.00 $3,321.50

63195 Incise spine & cord thoracic 33.66 70.00 $2,356.20

63196 Incise spine&cord 2 trx crvl 39.12 70.00 $2,738.40

63197 Incise spine&cord 2 trx thrc 50.86 70.00 $3,560.20

63198 Incise spin&cord 2 stgs crvl 46.08 70.00 $3,225.60

63199 Incise spin&cord 2 stgs thrc 48.34 70.00 $3,383.80

63200 Release spinal cord lumbar 45.21 70.00 $3,164.70

63250 Revise spinal cord vsls crvl 88.43 70.00 $6,190.10

63251 Revise spinal cord vsls thrc 90.38 70.00 $6,326.60

63252 Revise spine cord vsl thrlmb 90.37 70.00 $6,325.90

63265 Excise intraspinl lesion crv 49.13 70.00 $3,439.10

63266 Excise intrspinl lesion thrc 50.66 70.00 $3,546.20

63267 Excise intrspinl lesion lmbr 40.22 70.00 $2,815.40

63268 Excise intrspinl lesion scrl 42.74 70.00 $2,991.80

63270 Excise intrspinl lesion crvl 61.76 70.00 $4,323.20

63271 Excise intrspinl lesion thrc 61.33 70.00 $4,293.10

63272 Excise intrspinl lesion lmbr 55.67 70.00 $3,896.90

63273 Excise intrspinl lesion scrl 55.46 70.00 $3,882.20

63275 Bx/exc xdrl spine lesn crvl 53.22 70.00 $3,725.40

63276 Bx/exc xdrl spine lesn thrc 52.72 70.00 $3,690.40

63277 Bx/exc xdrl spine lesn lmbr 45.63 70.00 $3,194.10

63278 Bx/exc xdrl spine lesn scrl 47.20 70.00 $3,304.00

63280 Bx/exc idrl spine lesn crvl 62.79 70.00 $4,395.30

63281 Bx/exc idrl spine lesn thrc 61.86 70.00 $4,330.20

63282 Bx/exc idrl spine lesn lmbr 58.19 70.00 $4,073.30

63283 Bx/exc idrl spine lesn scrl 56.46 70.00 $3,952.20

63285 Bx/exc idrl imed lesn cervl 77.88 70.00 $5,451.60

63286 Bx/exc idrl imed lesn thrc 77.01 70.00 $5,390.70

63287 Bx/exc idrl imed lesn thrlmb 81.74 70.00 $5,721.80

63290 Bx/exc xdrl/idrl lsn any lvl 83.14 70.00 $5,819.80

63295 Repair laminectomy defect 9.98 70.00 $698.60

63300 Remove vert xdrl body crvcl 54.16 70.00 $3,791.20

63301 Remove vert xdrl body thrc 64.05 70.00 $4,483.50

63302 Remove vert xdrl body thrlmb 64.80 70.00 $4,536.00

63303 Remov vert xdrl bdy lmbr/sac 68.89 70.00 $4,822.30

63304 Remove vert idrl body crvcl 69.93 70.00 $4,895.10

63305 Remove vert idrl body thrc 74.45 70.00 $5,211.50

63306 Remov vert idrl bdy thrclmbr 58.09 70.00 $4,066.30

63307 Remov vert idrl bdy lmbr/sac 63.82 70.00 $4,467.40

63600 Remove spinal cord lesion 26.20 70.00 $1,834.00

63610 Stimulation of spinal cord 11.25 70.00 $787.50

63615 Remove lesion of spinal cord 31.04 70.00 $2,172.80

63620 Srs spinal lesion 32.99 70.00 $2,309.30

63621 Srs spinal lesion addl 7.54 70.00 $527.80

63661 Remove spine eltrd perq aray 16.53 70.00 $1,157.10

63662 Remove spine eltrd plate 24.51 70.00 $1,715.70

63663 Revise spine eltrd perq aray 22.47 70.00 $1,572.90

63664 Revise spine eltrd plate 25.07 70.00 $1,754.90

63685 Insrt/redo spine n generator 10.64 70.00 $744.80

63688 Revise/remove neuroreceiver 10.74 70.00 $751.80

63700 Repair of spinal herniation 33.88 70.00 $2,371.60

63707 Repair spinal fluid leakage 26.82 70.00 $1,877.40

63709 Repair spinal fluid leakage 32.17 70.00 $2,251.90

63710 Graft repair of spine defect 31.59 70.00 $2,211.30

63740 Install spinal shunt 28.27 70.00 $1,978.90

63741 Install spinal shunt 19.92 70.00 $1,394.40

63744 Revision of spinal shunt 19.94 70.00 $1,395.80

63746 Removal of spinal shunt 17.74 70.00 $1,241.80

64400 N block inj trigeminal 3.63 70.00 $254.10

64402 N block inj facial 3.71 70.00 $259.70

64405 N block inj occipital 2.88 70.00 $201.60

64408 N block inj vagus 3.32 70.00 $232.40

64410 N block inj phrenic 3.42 70.00 $239.40

64412 N block inj spinal accessor 4.05 70.00 $283.50

64413 N block inj cervical plexus 3.68 70.00 $257.60

64415 N block inj brachial plexus 3.34 70.00 $233.80

64416 N block cont infuse b plex 2.27 70.00 $158.90

64417 N block inj axillary 3.67 70.00 $256.90

64418 N block inj suprascapular 4.17 70.00 $291.90

64420 N block inj intercost sng 3.20 70.00 $224.00

64421 N block inj intercost mlt 4.26 70.00 $298.20

64425 N block inj ilio-ing/hypogi 3.74 70.00 $261.80

64430 N block inj pudendal 3.98 70.00 $278.60

64435 N block inj paracervical 3.85 70.00 $269.50

64445 N block inj sciatic sng 3.84 70.00 $268.80

64446 N blk inj sciatic cont inf 2.28 70.00 $159.60

64447 N block inj fem single 3.39 70.00 $237.30

64448 N block inj fem cont inf 2.03 70.00 $142.10

64449 N block inj lumbar plexus 2.40 70.00 $168.00

64450 N block other peripheral 2.28 70.00 $159.60

64455 N block inj plantar digit 1.35 70.00 $94.50

64479 Inj foramen epidural c/t 6.70 70.00 $469.00

64480 Inj foramen epidural add-on 3.21 70.00 $224.70

64483 Inj foramen epidural l/s 6.22 70.00 $435.40

64484 Inj foramen epidural add-on 2.48 70.00 $173.60

64486 Tap block unil by injection 3.53 70.00 $247.10

64487 Tap block uni by infusion 4.31 70.00 $301.70

64488 Tap block bi injection 4.34 70.00 $303.80

64489 Tap block bi by infusion 6.03 70.00 $422.10

64490 Inj paravert f jnt c/t 1 lev 5.41 70.00 $378.70

64493 Inj paravert f jnt l/s 1 lev 4.90 70.00 $343.00

64505 N block spenopalatine gangl 2.98 70.00 $208.60

64508 N block carotid sinus s/p 1.80 70.00 $126.00

64510 N block stellate ganglion 3.62 70.00 $253.40

64517 N block inj hypogas plxs 5.14 70.00 $359.80

64520 N block lumbar/thoracic 5.28 70.00 $369.60

64530 N block inj celiac pelus 5.42 70.00 $379.40

64550 Apply neurostimulator 0.45 70.00 $31.50

64553 Implant neuroelectrodes 6.09 70.00 $426.30

64566 Neuroeltrd stim post tibial 3.44 70.00 $240.80

64568 Inc for vagus n elect impl 19.30 70.00 $1,351.00

64569 Revise/repl vagus n eltrd 22.98 70.00 $1,608.60

64570 Remove vagus n eltrd 19.50 70.00 $1,365.00

64585 Revise/remove neuroelectrode 6.98 70.00 $488.60

64590 Insrt/redo pn/gastr stimul 7.54 70.00 $527.80

64595 Revise/rmv pn/gastr stimul 6.99 70.00 $489.30

64600 Injection treatment of nerve 10.91 70.00 $763.70

64605 Injection treatment of nerve 16.71 70.00 $1,169.70

64610 Injection treatment of nerve 20.88 70.00 $1,461.60

64611 Chemodenerv saliv glands 3.35 70.00 $234.50

64612 Destroy nerve face muscle 3.74 70.00 $261.80

64615 Chemodenerv musc migraine 4.21 70.00 $294.70

64616 Chemodenerv musc neck dyston 3.57 70.00 $249.90

64617 Chemodener muscle larynx emg 5.42 70.00 $379.40

64632 N block inj common digit 2.44 70.00 $170.80

64633 Destroy cerv/thor facet jnt 11.85 70.00 $829.50

64634 Destroy c/th facet jnt addl 5.29 70.00 $370.30

64635 Destroy lumb/sac facet jnt 11.75 70.00 $822.50

64636 Destroy l/s facet jnt addl 4.84 70.00 $338.80

64642 Chemodenerv 1 extremity 1-4 4.04 70.00 $282.80

64643 Chemodenerv 1 extrem 1-4 ea 2.68 70.00 $187.60

64644 Chemodenerv 1 extrem 5/> mus 4.65 70.00 $325.50

64645 Chemodenerv 1 extrem 5/> ea 3.26 70.00 $228.20

64646 Chemodenerv trunk musc 1-5 4.39 70.00 $307.30

64647 Chemodenerv trunk musc 6/> 5.07 70.00 $354.90

64650 Chemodenerv eccrine glands 2.22 70.00 $155.40

64653 Chemodenerv eccrine glands 2.71 70.00 $189.70

64702 Revise finger/toe nerve 14.33 70.00 $1,003.10

64704 Revise hand/foot nerve 9.07 70.00 $634.90

64708 Revise arm/leg nerve 14.34 70.00 $1,003.80

64712 Revision of sciatic nerve 16.45 70.00 $1,151.50

64713 Revision of arm nerve(s) 20.78 70.00 $1,454.60

64714 Revise low back nerve(s) 18.63 70.00 $1,304.10

64716 Revision of cranial nerve 15.35 70.00 $1,074.50

64718 Revise ulnar nerve at elbow 17.00 70.00 $1,190.00

64719 Revise ulnar nerve at wrist 11.47 70.00 $802.90

64721 Carpal tunnel surgery 12.33 70.00 $863.10

64722 Relieve pressure on nerve(s) 10.68 70.00 $747.60

64726 Release foot/toe nerve 7.91 70.00 $553.70

64727 Internal nerve revision 5.35 70.00 $374.50

64732 Incision of brow nerve 10.91 70.00 $763.70

64734 Incision of cheek nerve 14.67 70.00 $1,026.90

64736 Incision of chin nerve 11.45 70.00 $801.50

64738 Incision of jaw nerve 13.25 70.00 $927.50

64740 Incision of tongue nerve 13.12 70.00 $918.40

64742 Incision of facial nerve 13.15 70.00 $920.50

64744 Incise nerve back of head 14.53 70.00 $1,017.10

64746 Incise diaphragm nerve 12.50 70.00 $875.00

64755 Incision of stomach nerves 26.59 70.00 $1,861.30

64760 Incision of vagus nerve 14.83 70.00 $1,038.10

64763 Incise hip/thigh nerve 14.69 70.00 $1,028.30

64766 Incise hip/thigh nerve 16.35 70.00 $1,144.50

64771 Sever cranial nerve 17.14 70.00 $1,199.80

64772 Incision of spinal nerve 16.40 70.00 $1,148.00

64774 Remove skin nerve lesion 11.98 70.00 $838.60

64776 Remove digit nerve lesion 11.16 70.00 $781.20

64778 Digit nerve surgery add-on 4.10 70.00 $287.00

64782 Remove limb nerve lesion 12.94 70.00 $905.80

64783 Limb nerve surgery add-on 6.35 70.00 $444.50

64784 Remove nerve lesion 20.96 70.00 $1,467.20

64786 Remove sciatic nerve lesion 31.29 70.00 $2,190.30

64787 Implant nerve end 7.08 70.00 $495.60

64788 Remove skin nerve lesion 11.77 70.00 $823.90

64790 Removal of nerve lesion 24.35 70.00 $1,704.50

64792 Removal of nerve lesion 31.14 70.00 $2,179.80

64795 Biopsy of nerve 5.57 70.00 $389.90

64802 Sympathectomy cervical 19.15 70.00 $1,340.50

64804 Remove sympathetic nerves 27.12 70.00 $1,898.40

64820 Sympathectomy digital artery 20.92 70.00 $1,464.40

64823 Sympathectomy supfc palmar 22.74 70.00 $1,591.80

64831 Repair of digit nerve 19.68 70.00 $1,377.60

64832 Repair nerve add-on 9.76 70.00 $683.20

64834 Repair of hand or foot nerve 21.21 70.00 $1,484.70

64837 Repair nerve add-on 10.97 70.00 $767.90

64840 Repair of leg nerve 27.89 70.00 $1,952.30

64856 Repair/transpose nerve 29.20 70.00 $2,044.00

64857 Repair arm/leg nerve 30.27 70.00 $2,118.90

64858 Repair sciatic nerve 34.10 70.00 $2,387.00

64859 Nerve surgery 7.31 70.00 $511.70

64861 Repair of arm nerves 36.59 70.00 $2,561.30

64862 Repair of low back nerves 33.13 70.00 $2,319.10

64864 Repair of facial nerve 25.10 70.00 $1,757.00

64865 Repair of facial nerve 31.98 70.00 $2,238.60

64866 Fusion of facial/other nerve 33.17 70.00 $2,321.90

64868 Fusion of facial/other nerve 29.28 70.00 $2,049.60

64872 Subsequent repair of nerve 3.43 70.00 $240.10

64874 Repair & revise nerve add-on 4.77 70.00 $333.90

64876 Repair nerve/shorten bone 4.89 70.00 $342.30

64885 Nerve graft head/neck </4 cm 32.27 70.00 $2,258.90

64886 Nerve graft head/neck >4 cm 37.42 70.00 $2,619.40

64890 Nerve graft hand/foot </4 cm 31.50 70.00 $2,205.00

64891 Nerve graft hand/foot >4 cm 33.56 70.00 $2,349.20

64892 Nerve graft arm/leg <4 cm 30.41 70.00 $2,128.70

64893 Nerve graft arm/leg >4 cm 32.71 70.00 $2,289.70

64895 Nerve graft hand/foot </4 cm 38.92 70.00 $2,724.40

64896 Nerve graft hand/foot >4 cm 46.97 70.00 $3,287.90

64897 Nerve graft arm/leg </4 cm 36.53 70.00 $2,557.10

64898 Nerve graft arm/leg >4 cm 39.66 70.00 $2,776.20

64901 Nerve graft add-on 16.22 70.00 $1,135.40

64902 Nerve graft add-on 18.78 70.00 $1,314.60

64905 Nerve pedicle transfer 29.52 70.00 $2,066.40

64907 Nerve pedicle transfer 42.69 70.00 $2,988.30

64910 Nerve repair w/allograft 23.74 70.00 $1,661.80

64911 Neurorraphy w/vein autograft 29.22 70.00 $2,045.40

64999 Nervous system surgery 0.00 70.00 $0.00

65091 Revise eye 17.91 70.00 $1,253.70

65093 Revise eye with implant 17.71 70.00 $1,239.70

65101 Removal of eye 20.83 70.00 $1,458.10

65103 Remove eye/insert implant 21.70 70.00 $1,519.00

65105 Remove eye/attach implant 23.97 70.00 $1,677.90

65110 Removal of eye 34.49 70.00 $2,414.30

65112 Remove eye/revise socket 40.00 70.00 $2,800.00

65114 Remove eye/revise socket 41.95 70.00 $2,936.50

65125 Revise ocular implant 12.89 70.00 $902.30

65130 Insert ocular implant 20.65 70.00 $1,445.50

65135 Insert ocular implant 20.95 70.00 $1,466.50

65140 Attach ocular implant 22.79 70.00 $1,595.30

65150 Revise ocular implant 16.29 70.00 $1,140.30

65155 Reinsert ocular implant 23.87 70.00 $1,670.90

65175 Removal of ocular implant 18.54 70.00 $1,297.80

65205 Remove foreign body from eye 1.58 70.00 $110.60

65235 Remove foreign body from eye 20.13 70.00 $1,409.10

65270 Repair of eye wound 7.53 70.00 $527.10

65275 Repair of eye wound 16.33 70.00 $1,143.10

65290 Repair of eye socket wound 13.87 70.00 $970.90

65400 Removal of eye lesion 19.19 70.00 $1,343.30

65410 Biopsy of cornea 4.04 70.00 $282.80

65430 Corneal smear 3.24 70.00 $226.80

65435 Curette/treat cornea 2.24 70.00 $156.80

65436 Curette/treat cornea 10.95 70.00 $766.50

65450 Treatment of corneal lesion 9.19 70.00 $643.30

65600 Revision of cornea 11.14 70.00 $779.80

65710 Corneal transplant 31.28 70.00 $2,189.60

65756 Corneal trnspl endothelial 33.52 70.00 $2,346.40

65757 Prep corneal endo allograft 0.00 70.00 $0.00

65767 Corneal tissue transplant 0.00 70.00 $0.00

65770 Revise cornea with implant 39.79 70.00 $2,785.30

65771 Radial keratotomy 0.00 70.00 $0.00

65772 Correction of astigmatism 12.74 70.00 $891.80

65775 Correction of astigmatism 15.60 70.00 $1,092.00

65778 Cover eye w/membrane 38.92 70.00 $2,724.40

65779 Cover eye w/membrane suture 34.58 70.00 $2,420.60

65780 Ocular reconst transplant 25.14 70.00 $1,759.80

65800 Drainage of eye 3.37 70.00 $235.90

65810 Drainage of eye 13.17 70.00 $921.90

65815 Drainage of eye 18.01 70.00 $1,260.70

65820 Relieve inner eye pressure 21.14 70.00 $1,479.80

65850 Incision of eye 23.73 70.00 $1,661.10

65855 Laser surgery of eye 9.55 70.00 $668.50

65860 Incise inner eye adhesions 8.73 70.00 $611.10

65865 Incise inner eye adhesions 13.38 70.00 $936.60

65870 Incise inner eye adhesions 16.71 70.00 $1,169.70

65900 Remove eye lesion 27.25 70.00 $1,907.50

65920 Remove implant of eye 22.29 70.00 $1,560.30

65930 Remove blood clot from eye 18.04 70.00 $1,262.80

66020 Injection treatment of eye 5.25 70.00 $367.50

66030 Injection treatment of eye 4.68 70.00 $327.60

66130 Remove eye lesion 19.65 70.00 $1,375.50

66150 Glaucoma surgery 24.64 70.00 $1,724.80

66172 Incision of eye 42.80 70.00 $2,996.00

66174 Translum dil eye canal 26.80 70.00 $1,876.00

66175 Trnslum dil eye canal w/stnt 28.07 70.00 $1,964.90

66179 Aqueous shunt eye w/o graft 30.48 70.00 $2,133.60

66180 Aqueous shunt eye w/graft 32.17 70.00 $2,251.90

66183 Insert ant drainage device 29.13 70.00 $2,039.10

66184 Revision of aqueous shunt 22.19 70.00 $1,553.30

66185 Revise aqueous shunt eye 23.89 70.00 $1,672.30

66220 Repair eye lesion 21.02 70.00 $1,471.40

66225 Repair/graft eye lesion 26.35 70.00 $1,844.50

66250 Follow-up surgery of eye 21.14 70.00 $1,479.80

66500 Incision of iris 10.00 70.00 $700.00

66505 Incision of iris 10.96 70.00 $767.20

66600 Remove iris and lesion 23.52 70.00 $1,646.40

66605 Removal of iris 29.88 70.00 $2,091.60

66625 Removal of iris 12.13 70.00 $849.10

66630 Removal of iris 16.10 70.00 $1,127.00

66635 Removal of iris 16.26 70.00 $1,138.20

66680 Repair iris & ciliary body 14.64 70.00 $1,024.80

66682 Repair iris & ciliary body 18.01 70.00 $1,260.70

66700 Destruction ciliary body 12.72 70.00 $890.40

66710 Ciliary transsleral therapy 12.43 70.00 $870.10

66711 Ciliary endoscopic ablation 18.14 70.00 $1,269.80

66761 Revision of iris 8.36 70.00 $585.20

66762 Revision of iris 13.41 70.00 $938.70

66770 Removal of inner eye lesion 14.93 70.00 $1,045.10

66820 Incision secondary cataract 11.11 70.00 $777.70

66821 After cataract laser surgery 9.32 70.00 $652.40

66825 Reposition intraocular lens 21.47 70.00 $1,502.90

66830 Removal of lens lesion 20.14 70.00 $1,409.80

66840 Removal of lens material 19.71 70.00 $1,379.70

66920 Extraction of lens 21.33 70.00 $1,493.10

66982 Cataract surgery complex 22.49 70.00 $1,574.30

66983 Cataract surg w/iol 1 stage 20.75 70.00 $1,452.50

66984 Cataract surg w/iol 1 stage 18.10 70.00 $1,267.00

66985 Insert lens prosthesis 21.77 70.00 $1,523.90

66986 Exchange lens prosthesis 25.68 70.00 $1,797.60

66990 Ophthalmic endoscope add-on 2.57 70.00 $179.90

66999 Eye surgery procedure 0.00 70.00 $0.00

67005 Partial removal of eye fluid 13.36 70.00 $935.20

67010 Partial removal of eye fluid 15.35 70.00 $1,074.50

67015 Release of eye fluid 16.41 70.00 $1,148.70

67025 Replace eye fluid 20.52 70.00 $1,436.40

67027 Implant eye drug system 24.09 70.00 $1,686.30

67028 Injection eye drug 2.88 70.00 $201.60

67030 Incise inner eye strands 15.05 70.00 $1,053.50

67031 Laser surgery eye strands 10.97 70.00 $767.90

67036 Removal of inner eye fluid 25.48 70.00 $1,783.60

67039 Laser treatment of retina 27.31 70.00 $1,911.70

67040 Laser treatment of retina 29.51 70.00 $2,065.70

67041 Vit for macular pucker 32.63 70.00 $2,284.10

67042 Vit for macular hole 32.63 70.00 $2,284.10

67043 Vit for membrane dissect 34.43 70.00 $2,410.10

67101 Repair detached retina 22.14 70.00 $1,549.80

67112 Rerepair detached retina 37.51 70.00 $2,625.70

67113 Repair retinal detach cplx 49.34 70.00 $3,453.80

67115 Release encircling material 14.13 70.00 $989.10

67120 Remove eye implant material 18.56 70.00 $1,299.20

67121 Remove eye implant material 25.69 70.00 $1,798.30

67141 Treatment of retina 14.81 70.00 $1,036.70

67145 Treatment of retina 14.90 70.00 $1,043.00

67208 Treatment of retinal lesion 16.93 70.00 $1,185.10

67220 Treatment of choroid lesion 15.12 70.00 $1,058.40

67221 Ocular photodynamic ther 8.11 70.00 $567.70

67225 Eye photodynamic ther add-on 0.84 70.00 $58.80

67229 Tr retinal les preterm inf 32.99 70.00 $2,309.30

67250 Reinforce eye wall 22.06 70.00 $1,544.20

67255 Reinforce/graft eye wall 19.32 70.00 $1,352.40

67299 Eye surgery procedure 0.00 70.00 $0.00

67311 Revise eye muscle 16.92 70.00 $1,184.40

67312 Revise two eye muscles 20.13 70.00 $1,409.10

67314 Revise eye muscle 19.04 70.00 $1,332.80

67316 Revise two eye muscles 22.68 70.00 $1,587.60

67318 Revise eye muscle(s) 19.93 70.00 $1,395.10

67320 Revise eye muscle(s) add-on 9.14 70.00 $639.80

67331 Eye surgery follow-up add-on 8.67 70.00 $606.90

67332 Rerevise eye muscles add-on 9.41 70.00 $658.70

67334 Revise eye muscle w/suture 8.55 70.00 $598.50

67335 Eye suture during surgery 4.23 70.00 $296.10

67340 Revise eye muscle add-on 10.17 70.00 $711.90

67343 Release eye tissue 18.48 70.00 $1,293.60

67345 Destroy nerve of eye muscle 6.88 70.00 $481.60

67346 Biopsy eye muscle 5.51 70.00 $385.70

67399 Unlisted px extraocular musc 0.00 70.00 $0.00

67405 Explore/drain eye socket 22.41 70.00 $1,568.70

67412 Explore/treat eye socket 24.05 70.00 $1,683.50

67414 Explr/decompress eye socket 37.46 70.00 $2,622.20

67415 Aspiration orbital contents 2.97 70.00 $207.90

67440 Explore/drain eye socket 34.07 70.00 $2,384.90

67445 Explr/decompress eye socket 39.64 70.00 $2,774.80

67500 Inject/treat eye socket 2.22 70.00 $155.40

67550 Insert eye socket implant 27.24 70.00 $1,906.80

67560 Revise eye socket implant 27.93 70.00 $1,955.10

67570 Decompress optic nerve 32.67 70.00 $2,286.90

67599 Orbit surgery procedure 0.00 70.00 $0.00

67700 Drainage of eyelid abscess 7.54 70.00 $527.80

67710 Incision of eyelid 6.28 70.00 $439.60

67715 Incision of eyelid fold 6.70 70.00 $469.00

67800 Remove eyelid lesion 3.59 70.00 $251.30

67801 Remove eyelid lesions 4.58 70.00 $320.60

67805 Remove eyelid lesions 5.69 70.00 $398.30

67808 Remove eyelid lesion(s) 10.42 70.00 $729.40

67810 Biopsy eyelid & lid margin 4.84 70.00 $338.80

67820 Revise eyelashes 1.41 70.00 $98.70

67840 Remove eyelid lesion 7.75 70.00 $542.50

67850 Treat eyelid lesion 6.04 70.00 $422.80

67875 Closure of eyelid by suture 4.82 70.00 $337.40

67900 Repair brow defect 18.07 70.00 $1,264.90

67901 Repair eyelid defect 21.34 70.00 $1,493.80

67908 Repair eyelid defect 13.92 70.00 $974.40

67909 Revise eyelid defect 15.15 70.00 $1,060.50

67911 Revise eyelid defect 15.90 70.00 $1,113.00

67912 Correction eyelid w/implant 24.87 70.00 $1,740.90

67930 Repair eyelid wound 10.28 70.00 $719.60

67935 Repair eyelid wound 16.78 70.00 $1,174.60

67938 Remove eyelid foreign body 6.78 70.00 $474.60

67971 Reconstruction of eyelid 20.48 70.00 $1,433.60

68020 Incise/drain eyelid lining 3.38 70.00 $236.60

68040 Treatment of eyelid lesions 1.76 70.00 $123.20

68100 Biopsy of eyelid lining 4.78 70.00 $334.60

68110 Remove eyelid lining lesion 6.35 70.00 $444.50

68130 Remove eyelid lining lesion 15.18 70.00 $1,062.60

68200 Treat eyelid by injection 1.16 70.00 $81.20

68320 Revise/graft eyelid lining 20.43 70.00 $1,430.10

68330 Revise eyelid lining 17.04 70.00 $1,192.80

68340 Separate eyelid adhesions 15.36 70.00 $1,075.20

68371 Harvest eye tissue alograft 11.67 70.00 $816.90

68399 Eyelid lining surgery 0.00 70.00 $0.00

68400 Incise/drain tear gland 8.01 70.00 $560.70

68420 Incise/drain tear sac 9.04 70.00 $632.80

68440 Incise tear duct opening 2.88 70.00 $201.60

68500 Removal of tear gland 27.58 70.00 $1,930.60

68505 Partial removal tear gland 27.45 70.00 $1,921.50

68510 Biopsy of tear gland 12.59 70.00 $881.30

68520 Removal of tear sac 19.42 70.00 $1,359.40

68525 Biopsy of tear sac 7.49 70.00 $524.30

68530 Clearance of tear duct 12.06 70.00 $844.20

68540 Remove tear gland lesion 26.27 70.00 $1,838.90

68550 Remove tear gland lesion 30.48 70.00 $2,133.60

68700 Repair tear ducts 17.09 70.00 $1,196.30

68705 Revise tear duct opening 6.66 70.00 $466.20

68720 Create tear sac drain 21.38 70.00 $1,496.60

68745 Create tear duct drain 21.48 70.00 $1,503.60

68750 Create tear duct drain 22.23 70.00 $1,556.10

68760 Close tear duct opening 5.66 70.00 $396.20

68761 Close tear duct opening 4.17 70.00 $291.90

68770 Close tear system fistula 17.81 70.00 $1,246.70

68801 Dilate tear duct opening 3.51 70.00 $245.70

68810 Probe nasolacrimal duct 6.81 70.00 $476.70

68816 Probe nl duct w/balloon 20.90 70.00 $1,463.00

68840 Explore/irrigate tear ducts 3.61 70.00 $252.70

68850 Injection for tear sac x-ray 1.73 70.00 $121.10

68899 Tear duct system surgery 0.00 70.00 $0.00

69000 Drain external ear lesion 5.32 70.00 $372.40

69005 Drain external ear lesion 6.13 70.00 $429.10

69020 Drain outer ear canal lesion 6.63 70.00 $464.10

69090 Pierce earlobes 0.00 70.00 $0.00

69100 Biopsy of external ear 2.85 70.00 $199.50

69105 Biopsy of external ear canal 4.01 70.00 $280.70

69110 Remove external ear partial 13.08 70.00 $915.60

69120 Removal of external ear 11.55 70.00 $808.50

69140 Remove ear canal lesion(s) 25.21 70.00 $1,764.70

69145 Remove ear canal lesion(s) 11.36 70.00 $795.20

69150 Extensive ear canal surgery 30.16 70.00 $2,111.20

69155 Extensive ear/neck surgery 47.96 70.00 $3,357.20

69200 Clear outer ear canal 3.50 70.00 $245.00

69205 Clear outer ear canal 2.92 70.00 $204.40

69210 Remove impacted ear wax uni 1.40 70.00 $98.00

69220 Clean out mastoid cavity 3.91 70.00 $273.70

69222 Clean out mastoid cavity 6.27 70.00 $438.90

69300 Revise external ear 20.93 70.00 $1,465.10

69310 Rebuild outer ear canal 31.34 70.00 $2,193.80

69320 Rebuild outer ear canal 43.97 70.00 $3,077.90

69399 Outer ear surgery procedure 0.00 70.00 $0.00

69420 Incision of eardrum 5.47 70.00 $382.90

69421 Incision of eardrum 4.30 70.00 $301.00

69424 Remove ventilating tube 3.65 70.00 $255.50

69433 Create eardrum opening 5.78 70.00 $404.60

69436 Create eardrum opening 4.63 70.00 $324.10

69440 Exploration of middle ear 19.81 70.00 $1,386.70

69450 Eardrum revision 15.66 70.00 $1,096.20

69501 Mastoidectomy 21.06 70.00 $1,474.20

69502 Mastoidectomy 28.03 70.00 $1,962.10

69505 Remove mastoid structures 34.64 70.00 $2,424.80

69511 Extensive mastoid surgery 35.48 70.00 $2,483.60

69530 Extensive mastoid surgery 47.59 70.00 $3,331.30

69535 Remove part of temporal bone 77.21 70.00 $5,404.70

69540 Remove ear lesion 5.95 70.00 $416.50

69550 Remove ear lesion 29.96 70.00 $2,097.20

69601 Mastoid surgery revision 30.14 70.00 $2,109.80

69610 Repair of eardrum 11.01 70.00 $770.70

69620 Repair of eardrum 19.88 70.00 $1,391.60

69631 Repair eardrum structures 25.46 70.00 $1,782.20

69632 Rebuild eardrum structures 31.02 70.00 $2,171.40

69635 Repair eardrum structures 35.47 70.00 $2,482.90

69641 Revise middle ear & mastoid 29.98 70.00 $2,098.60

69650 Release middle ear bone 23.14 70.00 $1,619.80

69660 Revise middle ear bone 26.76 70.00 $1,873.20

69666 Repair middle ear structures 23.34 70.00 $1,633.80

69667 Repair middle ear structures 23.32 70.00 $1,632.40

69670 Remove mastoid air cells 27.16 70.00 $1,901.20

69676 Remove middle ear nerve 23.93 70.00 $1,675.10

69700 Close mastoid fistula 19.72 70.00 $1,380.40

69710 Implant/replace hearing aid 0.00 70.00 $0.00

69711 Remove/repair hearing aid 24.82 70.00 $1,737.40

69714 Implant temple bone w/stimul 31.08 70.00 $2,175.60

69715 Temple bne implnt w/stimulat 38.30 70.00 $2,681.00

69717 Temple bone implant revision 32.56 70.00 $2,279.20

69718 Revise temple bone implant 38.69 70.00 $2,708.30

69720 Release facial nerve 34.53 70.00 $2,417.10

69740 Repair facial nerve 33.65 70.00 $2,355.50

69745 Repair facial nerve 35.78 70.00 $2,504.60

69799 Middle ear surgery procedure 0.00 70.00 $0.00

69801 Incise inner ear 5.61 70.00 $392.70

69805 Explore inner ear 30.37 70.00 $2,125.90

69806 Explore inner ear 27.24 70.00 $1,906.80

69820 Establish inner ear window 24.66 70.00 $1,726.20

69840 Revise inner ear window 26.22 70.00 $1,835.40

69905 Remove inner ear 26.41 70.00 $1,848.70

69910 Remove inner ear & mastoid 29.30 70.00 $2,051.00

69915 Incise inner ear nerve 44.35 70.00 $3,104.50

69930 Implant cochlear device 35.32 70.00 $2,472.40

69949 Inner ear surgery procedure 0.00 70.00 $0.00

69950 Incise inner ear nerve 51.44 70.00 $3,600.80

69960 Release inner ear canal 55.55 70.00 $3,888.50

69970 Remove inner ear lesion 61.81 70.00 $4,326.70

69979 Temporal bone surgery 0.00 70.00 $0.00

69990 Microsurgery add-on 6.51 70.00 $455.70

70010 Contrast x-ray of brain 2.05 70.00 $143.50

70015 Contrast x-ray of brain 4.34 70.00 $303.80

70015 TC Contrast x-ray of brain 2.63 70.00 $184.10

70015 26 Contrast x-ray of brain 1.71 70.00 $119.70

70030 X-ray eye for foreign body 0.77 70.00 $53.90

70030 TC X-ray eye for foreign body 0.53 70.00 $37.10

70030 26 X-ray eye for foreign body 0.24 70.00 $16.80

7010F Pt info into recall system 0.00 70.00 $0.00

70100 X-ray exam of jaw <4views 0.92 70.00 $64.40

70100 TC X-ray exam of jaw <4views 0.66 70.00 $46.20

70100 26 X-ray exam of jaw <4views 0.26 70.00 $18.20

70110 X-ray exam of jaw 4/> views 1.06 70.00 $74.20

70110 TC X-ray exam of jaw 4/> views 0.70 70.00 $49.00

70110 26 X-ray exam of jaw 4/> views 0.36 70.00 $25.20

70120 X-ray exam of mastoids 0.95 70.00 $66.50

70120 TC X-ray exam of mastoids 0.69 70.00 $48.30

70120 26 X-ray exam of mastoids 0.26 70.00 $18.20

70130 X-ray exam of mastoids 1.53 70.00 $107.10

70130 TC X-ray exam of mastoids 1.04 70.00 $72.80

70130 26 X-ray exam of mastoids 0.49 70.00 $34.30

70134 X-ray exam of middle ear 1.44 70.00 $100.80

70134 TC X-ray exam of middle ear 0.94 70.00 $65.80

70134 26 X-ray exam of middle ear 0.50 70.00 $35.00

70140 X-ray exam of facial bones 0.83 70.00 $58.10

70140 TC X-ray exam of facial bones 0.53 70.00 $37.10

70140 26 X-ray exam of facial bones 0.30 70.00 $21.00

70150 X-ray exam of facial bones 1.16 70.00 $81.20

70150 TC X-ray exam of facial bones 0.78 70.00 $54.60

70150 26 X-ray exam of facial bones 0.38 70.00 $26.60

70160 X-ray exam of nasal bones 0.91 70.00 $63.70

70160 TC X-ray exam of nasal bones 0.66 70.00 $46.20

70160 26 X-ray exam of nasal bones 0.25 70.00 $17.50

70170 X-ray exam of tear duct 0.00 70.00 $0.00

70170 TC X-ray exam of tear duct 0.00 70.00 $0.00

70170 26 X-ray exam of tear duct 0.44 70.00 $30.80

70190 X-ray exam of eye sockets 0.98 70.00 $68.60

70190 TC X-ray exam of eye sockets 0.66 70.00 $46.20

70190 26 X-ray exam of eye sockets 0.32 70.00 $22.40

7020F Mammo assess cat in dbase 0.00 70.00 $0.00

70200 X-ray exam of eye sockets 1.18 70.00 $82.60

70200 TC X-ray exam of eye sockets 0.78 70.00 $54.60

70200 26 X-ray exam of eye sockets 0.40 70.00 $28.00

70210 X-ray exam of sinuses 0.83 70.00 $58.10

70210 TC X-ray exam of sinuses 0.58 70.00 $40.60

70210 26 X-ray exam of sinuses 0.25 70.00 $17.50

70220 X-ray exam of sinuses 1.04 70.00 $72.80

70220 TC X-ray exam of sinuses 0.68 70.00 $47.60

70220 26 X-ray exam of sinuses 0.36 70.00 $25.20

70240 X-ray exam pituitary saddle 0.84 70.00 $58.80

70240 TC X-ray exam pituitary saddle 0.55 70.00 $38.50

70240 26 X-ray exam pituitary saddle 0.29 70.00 $20.30

7025F Pt infosys alarm 4 nxt mammo 0.00 70.00 $0.00

70250 X-ray exam of skull 1.00 70.00 $70.00

70250 TC X-ray exam of skull 0.64 70.00 $44.80

70250 26 X-ray exam of skull 0.36 70.00 $25.20

70260 X-ray exam of skull 1.26 70.00 $88.20

70260 TC X-ray exam of skull 0.77 70.00 $53.90

70260 26 X-ray exam of skull 0.49 70.00 $34.30

70300 X-ray exam of teeth 0.42 70.00 $29.40

70300 TC X-ray exam of teeth 0.25 70.00 $17.50

70300 26 X-ray exam of teeth 0.17 70.00 $11.90

70310 X-ray exam of teeth 1.08 70.00 $75.60

70310 TC X-ray exam of teeth 0.84 70.00 $58.80

70310 26 X-ray exam of teeth 0.24 70.00 $16.80

70320 Full mouth x-ray of teeth 1.50 70.00 $105.00

70320 TC Full mouth x-ray of teeth 1.14 70.00 $79.80

70320 26 Full mouth x-ray of teeth 0.36 70.00 $25.20

70328 X-ray exam of jaw joint 0.87 70.00 $60.90

70328 TC X-ray exam of jaw joint 0.60 70.00 $42.00

70328 26 X-ray exam of jaw joint 0.27 70.00 $18.90

70330 X-ray exam of jaw joints 1.32 70.00 $92.40

70330 TC X-ray exam of jaw joints 0.95 70.00 $66.50

70330 26 X-ray exam of jaw joints 0.37 70.00 $25.90

70332 X-ray exam of jaw joint 2.30 70.00 $161.00

70332 TC X-ray exam of jaw joint 1.39 70.00 $97.30

70332 26 X-ray exam of jaw joint 0.91 70.00 $63.70

70336 Magnetic image jaw joint 8.97 70.00 $627.90

70336 TC Magnetic image jaw joint 6.88 70.00 $481.60

70336 26 Magnetic image jaw joint 2.09 70.00 $146.30

70350 X-ray head for orthodontia 0.55 70.00 $38.50

70350 TC X-ray head for orthodontia 0.26 70.00 $18.20

70350 26 X-ray head for orthodontia 0.29 70.00 $20.30

70355 Panoramic x-ray of jaws 0.57 70.00 $39.90

70355 TC Panoramic x-ray of jaws 0.25 70.00 $17.50

70355 26 Panoramic x-ray of jaws 0.32 70.00 $22.40

70360 X-ray exam of neck 0.78 70.00 $54.60

70360 TC X-ray exam of neck 0.54 70.00 $37.80

70360 26 X-ray exam of neck 0.24 70.00 $16.80

70370 Throat x-ray & fluoroscopy 2.26 70.00 $158.20

70370 TC Throat x-ray & fluoroscopy 1.80 70.00 $126.00

70370 26 Throat x-ray & fluoroscopy 0.46 70.00 $32.20

70371 Speech evaluation complex 2.53 70.00 $177.10

70371 TC Speech evaluation complex 1.33 70.00 $93.10

70371 26 Speech evaluation complex 1.20 70.00 $84.00

70373 Contrast x-ray of larynx 2.14 70.00 $149.80

70373 TC Contrast x-ray of larynx 1.51 70.00 $105.70

70373 26 Contrast x-ray of larynx 0.63 70.00 $44.10

70380 X-ray exam of salivary gland 1.01 70.00 $70.70

70380 TC X-ray exam of salivary gland 0.74 70.00 $51.80

70380 26 X-ray exam of salivary gland 0.27 70.00 $18.90

70390 X-ray exam of salivary duct 2.63 70.00 $184.10

70390 TC X-ray exam of salivary duct 2.09 70.00 $146.30

70390 26 X-ray exam of salivary duct 0.54 70.00 $37.80

70450 Ct head/brain w/o dye 3.25 70.00 $227.50

70450 TC Ct head/brain w/o dye 2.04 70.00 $142.80

70450 26 Ct head/brain w/o dye 1.21 70.00 $84.70

70460 Ct head/brain w/dye 4.54 70.00 $317.80

70460 TC Ct head/brain w/dye 2.93 70.00 $205.10

70460 26 Ct head/brain w/dye 1.61 70.00 $112.70

70470 Ct head/brain w/o & w/dye 5.37 70.00 $375.90

70470 TC Ct head/brain w/o & w/dye 3.56 70.00 $249.20

70470 26 Ct head/brain w/o & w/dye 1.81 70.00 $126.70

70480 Ct orbit/ear/fossa w/o dye 6.53 70.00 $457.10

70480 TC Ct orbit/ear/fossa w/o dye 4.71 70.00 $329.70

70480 26 Ct orbit/ear/fossa w/o dye 1.82 70.00 $127.40

70481 Ct orbit/ear/fossa w/dye 7.72 70.00 $540.40

70481 TC Ct orbit/ear/fossa w/dye 5.76 70.00 $403.20

70481 26 Ct orbit/ear/fossa w/dye 1.96 70.00 $137.20

70482 Ct orbit/ear/fossa w/o&w/dye 8.45 70.00 $591.50

70482 TC Ct orbit/ear/fossa w/o&w/dye 6.39 70.00 $447.30

70482 26 Ct orbit/ear/fossa w/o&w/dye 2.06 70.00 $144.20

70486 Ct maxillofacial w/o dye 3.92 70.00 $274.40

70486 TC Ct maxillofacial w/o dye 2.71 70.00 $189.70

70486 26 Ct maxillofacial w/o dye 1.21 70.00 $84.70

70487 Ct maxillofacial w/dye 4.72 70.00 $330.40

70487 TC Ct maxillofacial w/dye 3.11 70.00 $217.70

70487 26 Ct maxillofacial w/dye 1.61 70.00 $112.70

70488 Ct maxillofacial w/o & w/dye 5.74 70.00 $401.80

70488 TC Ct maxillofacial w/o & w/dye 3.94 70.00 $275.80

70488 26 Ct maxillofacial w/o & w/dye 1.80 70.00 $126.00

70490 Ct soft tissue neck w/o dye 5.40 70.00 $378.00

70490 TC Ct soft tissue neck w/o dye 3.58 70.00 $250.60

70490 26 Ct soft tissue neck w/o dye 1.82 70.00 $127.40

70491 Ct soft tissue neck w/dye 6.60 70.00 $462.00

70491 TC Ct soft tissue neck w/dye 4.63 70.00 $324.10

70491 26 Ct soft tissue neck w/dye 1.97 70.00 $137.90

70492 Ct sft tsue nck w/o & w/dye 7.78 70.00 $544.60

70492 TC Ct sft tsue nck w/o & w/dye 5.72 70.00 $400.40

70492 26 Ct sft tsue nck w/o & w/dye 2.06 70.00 $144.20

70496 Ct angiography head 8.28 70.00 $579.60

70496 TC Ct angiography head 5.78 70.00 $404.60

70496 26 Ct angiography head 2.50 70.00 $175.00

70498 Ct angiography neck 8.23 70.00 $576.10

70498 TC Ct angiography neck 5.74 70.00 $401.80

70498 26 Ct angiography neck 2.49 70.00 $174.30

70540 Mri orbit/face/neck w/o dye 10.03 70.00 $702.10

70540 TC Mri orbit/face/neck w/o dye 8.13 70.00 $569.10

70540 26 Mri orbit/face/neck w/o dye 1.90 70.00 $133.00

70542 Mri orbit/face/neck w/dye 11.29 70.00 $790.30

70542 TC Mri orbit/face/neck w/dye 8.98 70.00 $628.60

70542 26 Mri orbit/face/neck w/dye 2.31 70.00 $161.70

70543 Mri orbt/fac/nck w/o &w/dye 13.79 70.00 $965.30

70543 TC Mri orbt/fac/nck w/o &w/dye 10.74 70.00 $751.80

70543 26 Mri orbt/fac/nck w/o &w/dye 3.05 70.00 $213.50

70544 Mr angiography head w/o dye 11.00 70.00 $770.00

70544 TC Mr angiography head w/o dye 9.29 70.00 $650.30

70544 26 Mr angiography head w/o dye 1.71 70.00 $119.70

70545 Mr angiography head w/dye 10.82 70.00 $757.40

70545 TC Mr angiography head w/dye 9.12 70.00 $638.40

70545 26 Mr angiography head w/dye 1.70 70.00 $119.00

70546 Mr angiograph head w/o&w/dye 16.82 70.00 $1,177.40

70546 TC Mr angiograph head w/o&w/dye 14.25 70.00 $997.50

70546 26 Mr angiograph head w/o&w/dye 2.57 70.00 $179.90

70547 Mr angiography neck w/o dye 11.04 70.00 $772.80

70547 TC Mr angiography neck w/o dye 9.34 70.00 $653.80

70547 26 Mr angiography neck w/o dye 1.70 70.00 $119.00

70548 Mr angiography neck w/dye 11.59 70.00 $811.30

70548 TC Mr angiography neck w/dye 9.88 70.00 $691.60

70548 26 Mr angiography neck w/dye 1.71 70.00 $119.70

70549 Mr angiograph neck w/o&w/dye 16.89 70.00 $1,182.30

70549 TC Mr angiograph neck w/o&w/dye 14.32 70.00 $1,002.40

70549 26 Mr angiograph neck w/o&w/dye 2.57 70.00 $179.90

70551 Mri brain stem w/o dye 6.44 70.00 $450.80

70551 TC Mri brain stem w/o dye 4.34 70.00 $303.80

70551 26 Mri brain stem w/o dye 2.10 70.00 $147.00

70552 Mri brain stem w/dye 8.97 70.00 $627.90

70552 TC Mri brain stem w/dye 6.42 70.00 $449.40

70552 26 Mri brain stem w/dye 2.55 70.00 $178.50

70553 Mri brain stem w/o & w/dye 10.58 70.00 $740.60

70553 TC Mri brain stem w/o & w/dye 7.32 70.00 $512.40

70553 26 Mri brain stem w/o & w/dye 3.26 70.00 $228.20

70554 Fmri brain by tech 12.65 70.00 $885.50

70554 TC Fmri brain by tech 9.59 70.00 $671.30

70554 26 Fmri brain by tech 3.06 70.00 $214.20

70555 Fmri brain by phys/psych 0.00 70.00 $0.00

70555 TC Fmri brain by phys/psych 0.00 70.00 $0.00

70555 26 Fmri brain by phys/psych 3.72 70.00 $260.40

70557 Mri brain w/o dye 0.00 70.00 $0.00

70557 TC Mri brain w/o dye 0.00 70.00 $0.00

70557 26 Mri brain w/o dye 4.28 70.00 $299.60

70558 Mri brain w/dye 0.00 70.00 $0.00

70558 TC Mri brain w/dye 0.00 70.00 $0.00

70558 26 Mri brain w/dye 4.73 70.00 $331.10

70559 Mri brain w/o & w/dye 0.00 70.00 $0.00

70559 TC Mri brain w/o & w/dye 0.00 70.00 $0.00

70559 26 Mri brain w/o & w/dye 4.74 70.00 $331.80

71010 Chest x-ray 1 view frontal 0.63 70.00 $44.10

71010 TC Chest x-ray 1 view frontal 0.37 70.00 $25.90

71010 26 Chest x-ray 1 view frontal 0.26 70.00 $18.20

71015 Chest x-ray stereo frontal 0.77 70.00 $53.90

71015 TC Chest x-ray stereo frontal 0.46 70.00 $32.20

71015 26 Chest x-ray stereo frontal 0.31 70.00 $21.70

71020 Chest x-ray 2vw frontal&latl 0.78 70.00 $54.60

71020 TC Chest x-ray 2vw frontal&latl 0.47 70.00 $32.90

71020 26 Chest x-ray 2vw frontal&latl 0.31 70.00 $21.70

71021 Chest x-ray frnt lat lordotc 0.95 70.00 $66.50

71021 TC Chest x-ray frnt lat lordotc 0.56 70.00 $39.20

71021 26 Chest x-ray frnt lat lordotc 0.39 70.00 $27.30

71022 Chest x-ray frnt lat oblique 1.17 70.00 $81.90

71022 TC Chest x-ray frnt lat oblique 0.70 70.00 $49.00

71022 26 Chest x-ray frnt lat oblique 0.47 70.00 $32.90

71023 Chest x-ray and fluoroscopy 1.78 70.00 $124.60

71023 TC Chest x-ray and fluoroscopy 1.23 70.00 $86.10

71023 26 Chest x-ray and fluoroscopy 0.55 70.00 $38.50

71030 Chest x-ray 4/> views 1.16 70.00 $81.20

71030 TC Chest x-ray 4/> views 0.72 70.00 $50.40

71030 26 Chest x-ray 4/> views 0.44 70.00 $30.80

71034 Chest x-ray&fluoro 4/> views 2.36 70.00 $165.20

71034 TC Chest x-ray&fluoro 4/> views 1.70 70.00 $119.00

71034 26 Chest x-ray&fluoro 4/> views 0.66 70.00 $46.20

71035 Chest x-ray special views 0.91 70.00 $63.70

71035 TC Chest x-ray special views 0.65 70.00 $45.50

71035 26 Chest x-ray special views 0.26 70.00 $18.20

71100 X-ray exam ribs uni 2 views 0.85 70.00 $59.50

71100 TC X-ray exam ribs uni 2 views 0.53 70.00 $37.10

71100 26 X-ray exam ribs uni 2 views 0.32 70.00 $22.40

71101 X-ray exam unilat ribs/chest 1.01 70.00 $70.70

71101 TC X-ray exam unilat ribs/chest 0.63 70.00 $44.10

71101 26 X-ray exam unilat ribs/chest 0.38 70.00 $26.60

71110 X-ray exam ribs bil 3 views 1.04 70.00 $72.80

71110 TC X-ray exam ribs bil 3 views 0.65 70.00 $45.50

71110 26 X-ray exam ribs bil 3 views 0.39 70.00 $27.30

71111 X-ray exam ribs/chest4/> vws 1.32 70.00 $92.40

71111 TC X-ray exam ribs/chest4/> vws 0.86 70.00 $60.20

71111 26 X-ray exam ribs/chest4/> vws 0.46 70.00 $32.20

71120 X-ray exam breastbone 2/>vws 0.82 70.00 $57.40

71120 TC X-ray exam breastbone 2/>vws 0.53 70.00 $37.10

71120 26 X-ray exam breastbone 2/>vws 0.29 70.00 $20.30

71130 X-ray strenoclavic jt 3/>vws 1.01 70.00 $70.70

71130 TC X-ray strenoclavic jt 3/>vws 0.68 70.00 $47.60

71130 26 X-ray strenoclavic jt 3/>vws 0.33 70.00 $23.10

71250 Ct thorax w/o dye 5.04 70.00 $352.80

71250 TC Ct thorax w/o dye 3.59 70.00 $251.30

71250 26 Ct thorax w/o dye 1.45 70.00 $101.50

71260 Ct thorax w/dye 6.42 70.00 $449.40

71260 TC Ct thorax w/dye 4.65 70.00 $325.50

71260 26 Ct thorax w/dye 1.77 70.00 $123.90

71270 Ct thorax w/o & w/dye 7.70 70.00 $539.00

71270 TC Ct thorax w/o & w/dye 5.74 70.00 $401.80

71270 26 Ct thorax w/o & w/dye 1.96 70.00 $137.20

71275 Ct angiography chest 8.41 70.00 $588.70

71275 TC Ct angiography chest 5.81 70.00 $406.70

71275 26 Ct angiography chest 2.60 70.00 $182.00

71550 Mri chest w/o dye 11.61 70.00 $812.70

71550 TC Mri chest w/o dye 9.54 70.00 $667.80

71550 26 Mri chest w/o dye 2.07 70.00 $144.90

71551 Mri chest w/dye 12.83 70.00 $898.10

71551 TC Mri chest w/dye 10.36 70.00 $725.20

71551 26 Mri chest w/dye 2.47 70.00 $172.90

71552 Mri chest w/o & w/dye 16.26 70.00 $1,138.20

71552 TC Mri chest w/o & w/dye 13.02 70.00 $911.40

71552 26 Mri chest w/o & w/dye 3.24 70.00 $226.80

71555 Mri angio chest w or w/o dye 11.16 70.00 $781.20

71555 TC Mri angio chest w or w/o dye 8.60 70.00 $602.00

71555 26 Mri angio chest w or w/o dye 2.56 70.00 $179.20

72010 X-ray exam spine ap&lat 1.97 70.00 $137.90

72010 TC X-ray exam spine ap&lat 1.30 70.00 $91.00

72010 26 X-ray exam spine ap&lat 0.67 70.00 $46.90

72020 X-ray exam of spine 1 view 0.61 70.00 $42.70

72020 TC X-ray exam of spine 1 view 0.39 70.00 $27.30

72020 26 X-ray exam of spine 1 view 0.22 70.00 $15.40

72040 X-ray exam neck spine 2-3 vw 0.93 70.00 $65.10

72040 TC X-ray exam neck spine 2-3 vw 0.60 70.00 $42.00

72040 26 X-ray exam neck spine 2-3 vw 0.33 70.00 $23.10

72050 X-ray exam neck spine 4/5vws 1.25 70.00 $87.50

72050 TC X-ray exam neck spine 4/5vws 0.80 70.00 $56.00

72050 26 X-ray exam neck spine 4/5vws 0.45 70.00 $31.50

72052 X-ray exam neck spine 6/>vws 1.57 70.00 $109.90

72052 TC X-ray exam neck spine 6/>vws 1.04 70.00 $72.80

72052 26 X-ray exam neck spine 6/>vws 0.53 70.00 $37.10

72069 X-ray exam trunk spine stand 0.90 70.00 $63.00

72069 TC X-ray exam trunk spine stand 0.57 70.00 $39.90

72069 26 X-ray exam trunk spine stand 0.33 70.00 $23.10

72070 X-ray exam thorac spine 2vws 0.88 70.00 $61.60

72070 TC X-ray exam thorac spine 2vws 0.55 70.00 $38.50

72070 26 X-ray exam thorac spine 2vws 0.33 70.00 $23.10

72072 X-ray exam thorac spine 3vws 0.96 70.00 $67.20

72072 TC X-ray exam thorac spine 3vws 0.65 70.00 $45.50

72072 26 X-ray exam thorac spine 3vws 0.31 70.00 $21.70

72074 X-ray exam thorac spine4/>vw 1.09 70.00 $76.30

72074 TC X-ray exam thorac spine4/>vw 0.78 70.00 $54.60

72074 26 X-ray exam thorac spine4/>vw 0.31 70.00 $21.70

72080 X-ray exam trunk spine 2 vws 0.94 70.00 $65.80

72080 TC X-ray exam trunk spine 2 vws 0.60 70.00 $42.00

72080 26 X-ray exam trunk spine 2 vws 0.34 70.00 $23.80

72090 X-ray exam scloiosis erect 1.20 70.00 $84.00

72090 TC X-ray exam scloiosis erect 0.76 70.00 $53.20

72090 26 X-ray exam scloiosis erect 0.44 70.00 $30.80

72100 X-ray exam l-s spine 2/3 vws 0.98 70.00 $68.60

72100 TC X-ray exam l-s spine 2/3 vws 0.65 70.00 $45.50

72100 26 X-ray exam l-s spine 2/3 vws 0.33 70.00 $23.10

72110 X-ray exam l-2 spine 4/>vws 1.37 70.00 $95.90

72110 TC X-ray exam l-2 spine 4/>vws 0.91 70.00 $63.70

72110 26 X-ray exam l-2 spine 4/>vws 0.46 70.00 $32.20

72114 X-ray exam l-s spine bending 1.75 70.00 $122.50

72114 TC X-ray exam l-s spine bending 1.27 70.00 $88.90

72114 26 X-ray exam l-s spine bending 0.48 70.00 $33.60

72120 X-ray bend only l-s spine 1.13 70.00 $79.10

72120 TC X-ray bend only l-s spine 0.79 70.00 $55.30

72120 26 X-ray bend only l-s spine 0.34 70.00 $23.80

72125 Ct neck spine w/o dye 5.16 70.00 $361.20

72125 TC Ct neck spine w/o dye 3.64 70.00 $254.80

72125 26 Ct neck spine w/o dye 1.52 70.00 $106.40

72126 Ct neck spine w/dye 6.42 70.00 $449.40

72126 TC Ct neck spine w/dye 4.68 70.00 $327.60

72126 26 Ct neck spine w/dye 1.74 70.00 $121.80

72127 Ct neck spine w/o & w/dye 7.57 70.00 $529.90

72127 TC Ct neck spine w/o & w/dye 5.77 70.00 $403.90

72127 26 Ct neck spine w/o & w/dye 1.80 70.00 $126.00

72128 Ct chest spine w/o dye 5.04 70.00 $352.80

72128 TC Ct chest spine w/o dye 3.62 70.00 $253.40

72128 26 Ct chest spine w/o dye 1.42 70.00 $99.40

72129 Ct chest spine w/dye 6.42 70.00 $449.40

72129 TC Ct chest spine w/dye 4.69 70.00 $328.30

72129 26 Ct chest spine w/dye 1.73 70.00 $121.10

72130 Ct chest spine w/o & w/dye 7.58 70.00 $530.60

72130 TC Ct chest spine w/o & w/dye 5.78 70.00 $404.60

72130 26 Ct chest spine w/o & w/dye 1.80 70.00 $126.00

72131 Ct lumbar spine w/o dye 5.01 70.00 $350.70

72131 TC Ct lumbar spine w/o dye 3.59 70.00 $251.30

72131 26 Ct lumbar spine w/o dye 1.42 70.00 $99.40

72132 Ct lumbar spine w/dye 6.40 70.00 $448.00

72132 TC Ct lumbar spine w/dye 4.66 70.00 $326.20

72132 26 Ct lumbar spine w/dye 1.74 70.00 $121.80

72133 Ct lumbar spine w/o & w/dye 7.58 70.00 $530.60

72133 TC Ct lumbar spine w/o & w/dye 5.77 70.00 $403.90

72133 26 Ct lumbar spine w/o & w/dye 1.81 70.00 $126.70

72141 Mri neck spine w/o dye 6.25 70.00 $437.50

72141 TC Mri neck spine w/o dye 4.15 70.00 $290.50

72141 26 Mri neck spine w/o dye 2.10 70.00 $147.00

72142 Mri neck spine w/dye 9.07 70.00 $634.90

72142 TC Mri neck spine w/dye 6.52 70.00 $456.40

72142 26 Mri neck spine w/dye 2.55 70.00 $178.50

72146 Mri chest spine w/o dye 6.25 70.00 $437.50

72146 TC Mri chest spine w/o dye 4.15 70.00 $290.50

72146 26 Mri chest spine w/o dye 2.10 70.00 $147.00

72147 Mri chest spine w/dye 9.01 70.00 $630.70

72147 TC Mri chest spine w/dye 6.46 70.00 $452.20

72147 26 Mri chest spine w/dye 2.55 70.00 $178.50

72148 Mri lumbar spine w/o dye 6.22 70.00 $435.40

72148 TC Mri lumbar spine w/o dye 4.11 70.00 $287.70

72148 26 Mri lumbar spine w/o dye 2.11 70.00 $147.70

72149 Mri lumbar spine w/dye 8.96 70.00 $627.20

72149 TC Mri lumbar spine w/dye 6.41 70.00 $448.70

72149 26 Mri lumbar spine w/dye 2.55 70.00 $178.50

72156 Mri neck spine w/o & w/dye 10.64 70.00 $744.80

72156 TC Mri neck spine w/o & w/dye 7.38 70.00 $516.60

72156 26 Mri neck spine w/o & w/dye 3.26 70.00 $228.20

72157 Mri chest spine w/o & w/dye 10.67 70.00 $746.90

72157 TC Mri chest spine w/o & w/dye 7.39 70.00 $517.30

72157 26 Mri chest spine w/o & w/dye 3.28 70.00 $229.60

72158 Mri lumbar spine w/o & w/dye 10.61 70.00 $742.70

72158 TC Mri lumbar spine w/o & w/dye 7.33 70.00 $513.10

72158 26 Mri lumbar spine w/o & w/dye 3.28 70.00 $229.60

72159 Mr angio spine w/o&w/dye 11.71 70.00 $819.70

72159 TC Mr angio spine w/o&w/dye 9.11 70.00 $637.70

72159 26 Mr angio spine w/o&w/dye 2.60 70.00 $182.00

72170 X-ray exam of pelvis 0.77 70.00 $53.90

72170 TC X-ray exam of pelvis 0.51 70.00 $35.70

72170 26 X-ray exam of pelvis 0.26 70.00 $18.20

72190 X-ray exam of pelvis 1.07 70.00 $74.90

72190 TC X-ray exam of pelvis 0.75 70.00 $52.50

72190 26 X-ray exam of pelvis 0.32 70.00 $22.40

72191 Ct angiograph pelv w/o&w/dye 8.53 70.00 $597.10

72191 TC Ct angiograph pelv w/o&w/dye 5.96 70.00 $417.20

72191 26 Ct angiograph pelv w/o&w/dye 2.57 70.00 $179.90

72192 Ct pelvis w/o dye 4.10 70.00 $287.00

72192 TC Ct pelvis w/o dye 2.55 70.00 $178.50

72192 26 Ct pelvis w/o dye 1.55 70.00 $108.50

72193 Ct pelvis w/dye 6.32 70.00 $442.40

72193 TC Ct pelvis w/dye 4.67 70.00 $326.90

72193 26 Ct pelvis w/dye 1.65 70.00 $115.50

72194 Ct pelvis w/o & w/dye 7.29 70.00 $510.30

72194 TC Ct pelvis w/o & w/dye 5.56 70.00 $389.20

72194 26 Ct pelvis w/o & w/dye 1.73 70.00 $121.10

72195 Mri pelvis w/o dye 10.53 70.00 $737.10

72195 TC Mri pelvis w/o dye 8.45 70.00 $591.50

72195 26 Mri pelvis w/o dye 2.08 70.00 $145.60

72196 Mri pelvis w/dye 11.53 70.00 $807.10

72196 TC Mri pelvis w/dye 9.05 70.00 $633.50

72196 26 Mri pelvis w/dye 2.48 70.00 $173.60

72197 Mri pelvis w/o & w/dye 14.19 70.00 $993.30

72197 TC Mri pelvis w/o & w/dye 10.95 70.00 $766.50

72197 26 Mri pelvis w/o & w/dye 3.24 70.00 $226.80

72198 Mr angio pelvis w/o & w/dye 11.27 70.00 $788.90

72198 TC Mr angio pelvis w/o & w/dye 8.72 70.00 $610.40

72198 26 Mr angio pelvis w/o & w/dye 2.55 70.00 $178.50

72200 X-ray exam si joints 0.79 70.00 $55.30

72200 TC X-ray exam si joints 0.54 70.00 $37.80

72200 26 X-ray exam si joints 0.25 70.00 $17.50

72202 X-ray exam si joints 3/> vws 0.92 70.00 $64.40

72202 TC X-ray exam si joints 3/> vws 0.65 70.00 $45.50

72202 26 X-ray exam si joints 3/> vws 0.27 70.00 $18.90

72220 X-ray exam sacrum tailbone 0.78 70.00 $54.60

72220 TC X-ray exam sacrum tailbone 0.53 70.00 $37.10

72220 26 X-ray exam sacrum tailbone 0.25 70.00 $17.50

72240 Myelography neck spine 2.76 70.00 $193.20

72240 TC Myelography neck spine 1.45 70.00 $101.50

72240 26 Myelography neck spine 1.31 70.00 $91.70

72255 Myelography thoracic spine 2.74 70.00 $191.80

72255 TC Myelography thoracic spine 1.43 70.00 $100.10

72255 26 Myelography thoracic spine 1.31 70.00 $91.70

72265 Myelography l-s spine 2.58 70.00 $180.60

72265 TC Myelography l-s spine 1.39 70.00 $97.30

72265 26 Myelography l-s spine 1.19 70.00 $83.30

72270 Myelogphy 2/> spine regions 3.57 70.00 $249.90

72270 TC Myelogphy 2/> spine regions 1.67 70.00 $116.90

72270 26 Myelogphy 2/> spine regions 1.90 70.00 $133.00

72275 Epidurography 3.24 70.00 $226.80

72275 TC Epidurography 2.12 70.00 $148.40

72275 26 Epidurography 1.12 70.00 $78.40

72285 Discography cerv/thor spine 3.21 70.00 $224.70

72285 TC Discography cerv/thor spine 1.47 70.00 $102.90

72285 26 Discography cerv/thor spine 1.74 70.00 $121.80

72295 X-ray of lower spine disk 2.75 70.00 $192.50

72295 TC X-ray of lower spine disk 1.53 70.00 $107.10

72295 26 X-ray of lower spine disk 1.22 70.00 $85.40

73000 X-ray exam of collar bone 0.78 70.00 $54.60

73000 TC X-ray exam of collar bone 0.53 70.00 $37.10

73000 26 X-ray exam of collar bone 0.25 70.00 $17.50

73010 X-ray exam of shoulder blade 0.84 70.00 $58.80

73010 TC X-ray exam of shoulder blade 0.57 70.00 $39.90

73010 26 X-ray exam of shoulder blade 0.27 70.00 $18.90

73020 X-ray exam of shoulder 0.65 70.00 $45.50

73020 TC X-ray exam of shoulder 0.42 70.00 $29.40

73020 26 X-ray exam of shoulder 0.23 70.00 $16.10

73030 X-ray exam of shoulder 0.81 70.00 $56.70

73030 TC X-ray exam of shoulder 0.53 70.00 $37.10

73030 26 X-ray exam of shoulder 0.28 70.00 $19.60

73040 Contrast x-ray of shoulder 2.82 70.00 $197.40

73040 TC Contrast x-ray of shoulder 2.03 70.00 $142.10

73040 26 Contrast x-ray of shoulder 0.79 70.00 $55.30

73050 X-ray exam of shoulders 1.00 70.00 $70.00

73050 TC X-ray exam of shoulders 0.69 70.00 $48.30

73050 26 X-ray exam of shoulders 0.31 70.00 $21.70

73060 X-ray exam of humerus 0.75 70.00 $52.50

73060 TC X-ray exam of humerus 0.49 70.00 $34.30

73060 26 X-ray exam of humerus 0.26 70.00 $18.20

73070 X-ray exam of elbow 0.77 70.00 $53.90

73070 TC X-ray exam of elbow 0.53 70.00 $37.10

73070 26 X-ray exam of elbow 0.24 70.00 $16.80

73080 X-ray exam of elbow 0.88 70.00 $61.60

73080 TC X-ray exam of elbow 0.62 70.00 $43.40

73080 26 X-ray exam of elbow 0.26 70.00 $18.20

73085 Contrast x-ray of elbow 2.76 70.00 $193.20

73085 TC Contrast x-ray of elbow 1.95 70.00 $136.50

73085 26 Contrast x-ray of elbow 0.81 70.00 $56.70

73090 X-ray exam of forearm 0.72 70.00 $50.40

73090 TC X-ray exam of forearm 0.48 70.00 $33.60

73090 26 X-ray exam of forearm 0.24 70.00 $16.80

73092 X-ray exam of arm infant 0.76 70.00 $53.20

73092 TC X-ray exam of arm infant 0.53 70.00 $37.10

73092 26 X-ray exam of arm infant 0.23 70.00 $16.10

73100 X-ray exam of wrist 0.82 70.00 $57.40

73100 TC X-ray exam of wrist 0.57 70.00 $39.90

73100 26 X-ray exam of wrist 0.25 70.00 $17.50

73110 X-ray exam of wrist 0.99 70.00 $69.30

73110 TC X-ray exam of wrist 0.73 70.00 $51.10

73110 26 X-ray exam of wrist 0.26 70.00 $18.20

73115 Contrast x-ray of wrist 3.00 70.00 $210.00

73115 TC Contrast x-ray of wrist 2.19 70.00 $153.30

73115 26 Contrast x-ray of wrist 0.81 70.00 $56.70

73120 X-ray exam of hand 0.73 70.00 $51.10

73120 TC X-ray exam of hand 0.49 70.00 $34.30

73120 26 X-ray exam of hand 0.24 70.00 $16.80

73130 X-ray exam of hand 0.85 70.00 $59.50

73130 TC X-ray exam of hand 0.60 70.00 $42.00

73130 26 X-ray exam of hand 0.25 70.00 $17.50

73140 X-ray exam of finger(s) 0.87 70.00 $60.90

73140 TC X-ray exam of finger(s) 0.67 70.00 $46.90

73140 26 X-ray exam of finger(s) 0.20 70.00 $14.00

73200 Ct upper extremity w/o dye 5.01 70.00 $350.70

73200 TC Ct upper extremity w/o dye 3.59 70.00 $251.30

73200 26 Ct upper extremity w/o dye 1.42 70.00 $99.40

73201 Ct upper extremity w/dye 6.23 70.00 $436.10

73201 TC Ct upper extremity w/dye 4.58 70.00 $320.60

73201 26 Ct upper extremity w/dye 1.65 70.00 $115.50

73202 Ct uppr extremity w/o&w/dye 7.78 70.00 $544.60

73202 TC Ct uppr extremity w/o&w/dye 6.05 70.00 $423.50

73202 26 Ct uppr extremity w/o&w/dye 1.73 70.00 $121.10

73206 Ct angio upr extrm w/o&w/dye 9.15 70.00 $640.50

73206 TC Ct angio upr extrm w/o&w/dye 6.59 70.00 $461.30

73206 26 Ct angio upr extrm w/o&w/dye 2.56 70.00 $179.20

73218 Mri upper extremity w/o dye 10.20 70.00 $714.00

73218 TC Mri upper extremity w/o dye 8.29 70.00 $580.30

73218 26 Mri upper extremity w/o dye 1.91 70.00 $133.70

73219 Mri upper extremity w/dye 11.32 70.00 $792.40

73219 TC Mri upper extremity w/dye 8.99 70.00 $629.30

73219 26 Mri upper extremity w/dye 2.33 70.00 $163.10

73220 Mri uppr extremity w/o&w/dye 14.00 70.00 $980.00

73220 TC Mri uppr extremity w/o&w/dye 10.93 70.00 $765.10

73220 26 Mri uppr extremity w/o&w/dye 3.07 70.00 $214.90

73221 Mri joint upr extrem w/o dye 6.60 70.00 $462.00

73221 TC Mri joint upr extrem w/o dye 4.66 70.00 $326.20

73221 26 Mri joint upr extrem w/o dye 1.94 70.00 $135.80

73222 Mri joint upr extrem w/dye 10.61 70.00 $742.70

73222 TC Mri joint upr extrem w/dye 8.29 70.00 $580.30

73222 26 Mri joint upr extrem w/dye 2.32 70.00 $162.40

73223 Mri joint upr extr w/o&w/dye 13.15 70.00 $920.50

73223 TC Mri joint upr extr w/o&w/dye 10.08 70.00 $705.60

73223 26 Mri joint upr extr w/o&w/dye 3.07 70.00 $214.90

73225 Mr angio upr extr w/o&w/dye 11.32 70.00 $792.40

73225 TC Mr angio upr extr w/o&w/dye 8.89 70.00 $622.30

73225 26 Mr angio upr extr w/o&w/dye 2.43 70.00 $170.10

73500 X-ray exam of hip 0.74 70.00 $51.80

73500 TC X-ray exam of hip 0.48 70.00 $33.60

73500 26 X-ray exam of hip 0.26 70.00 $18.20

73510 X-ray exam of hip 1.04 70.00 $72.80

73510 26 X-ray exam of hip 0.32 70.00 $22.40

73520 X-ray exam of hips 1.11 70.00 $77.70

73520 TC X-ray exam of hips 0.71 70.00 $49.70

73520 26 X-ray exam of hips 0.40 70.00 $28.00

73525 Contrast x-ray of hip 2.85 70.00 $199.50

73525 TC Contrast x-ray of hip 2.03 70.00 $142.10

73525 26 Contrast x-ray of hip 0.82 70.00 $57.40

73530 X-ray exam of hip 0.00 70.00 $0.00

73530 26 X-ray exam of hip 0.42 70.00 $29.40

73540 X-ray exam of pelvis & hips 1.10 70.00 $77.00

73540 TC X-ray exam of pelvis & hips 0.81 70.00 $56.70

73540 26 X-ray exam of pelvis & hips 0.29 70.00 $20.30

73550 X-ray exam of thigh 0.76 70.00 $53.20

73550 TC X-ray exam of thigh 0.50 70.00 $35.00

73550 26 X-ray exam of thigh 0.26 70.00 $18.20

73560 X-ray exam of knee 1 or 2 0.82 70.00 $57.40

73560 TC X-ray exam of knee 1 or 2 0.55 70.00 $38.50

73560 26 X-ray exam of knee 1 or 2 0.27 70.00 $18.90

73562 X-ray exam of knee 3 0.96 70.00 $67.20

73562 TC X-ray exam of knee 3 0.68 70.00 $47.60

73562 26 X-ray exam of knee 3 0.28 70.00 $19.60

73564 X-ray exam knee 4 or more 1.12 70.00 $78.40

73564 TC X-ray exam knee 4 or more 0.78 70.00 $54.60

73564 26 X-ray exam knee 4 or more 0.34 70.00 $23.80

73565 X-ray exam of knees 0.92 70.00 $64.40

73565 TC X-ray exam of knees 0.65 70.00 $45.50

73565 26 X-ray exam of knees 0.27 70.00 $18.90

73580 Contrast x-ray of knee joint 3.22 70.00 $225.40

73580 TC Contrast x-ray of knee joint 2.42 70.00 $169.40

73580 26 Contrast x-ray of knee joint 0.80 70.00 $56.00

73590 X-ray exam of lower leg 0.74 70.00 $51.80

73590 TC X-ray exam of lower leg 0.49 70.00 $34.30

73590 26 X-ray exam of lower leg 0.25 70.00 $17.50

73592 X-ray exam of leg infant 0.76 70.00 $53.20

73592 TC X-ray exam of leg infant 0.53 70.00 $37.10

73592 26 X-ray exam of leg infant 0.23 70.00 $16.10

73600 X-ray exam of ankle 0.76 70.00 $53.20

73600 TC X-ray exam of ankle 0.52 70.00 $36.40

73600 26 X-ray exam of ankle 0.24 70.00 $16.80

73610 X-ray exam of ankle 0.88 70.00 $61.60

73610 TC X-ray exam of ankle 0.62 70.00 $43.40

73610 26 X-ray exam of ankle 0.26 70.00 $18.20

73615 Contrast x-ray of ankle 2.77 70.00 $193.90

73615 TC Contrast x-ray of ankle 1.94 70.00 $135.80

73615 26 Contrast x-ray of ankle 0.83 70.00 $58.10

73620 X-ray exam of foot 0.72 70.00 $50.40

73620 TC X-ray exam of foot 0.50 70.00 $35.00

73620 26 X-ray exam of foot 0.22 70.00 $15.40

73630 X-ray exam of foot 0.81 70.00 $56.70

73630 TC X-ray exam of foot 0.57 70.00 $39.90

73630 26 X-ray exam of foot 0.24 70.00 $16.80

73650 X-ray exam of heel 0.75 70.00 $52.50

73650 TC X-ray exam of heel 0.52 70.00 $36.40

73650 26 X-ray exam of heel 0.23 70.00 $16.10

73660 X-ray exam of toe(s) 0.78 70.00 $54.60

73660 TC X-ray exam of toe(s) 0.59 70.00 $41.30

73660 26 X-ray exam of toe(s) 0.19 70.00 $13.30

73700 Ct lower extremity w/o dye 5.01 70.00 $350.70

73700 TC Ct lower extremity w/o dye 3.59 70.00 $251.30

73700 26 Ct lower extremity w/o dye 1.42 70.00 $99.40

73701 Ct lower extremity w/dye 6.32 70.00 $442.40

73701 TC Ct lower extremity w/dye 4.67 70.00 $326.90

73701 26 Ct lower extremity w/dye 1.65 70.00 $115.50

73702 Ct lwr extremity w/o&w/dye 7.65 70.00 $535.50

73702 TC Ct lwr extremity w/o&w/dye 5.94 70.00 $415.80

73702 26 Ct lwr extremity w/o&w/dye 1.71 70.00 $119.70

73706 Ct angio lwr extr w/o&w/dye 9.84 70.00 $688.80

73706 TC Ct angio lwr extr w/o&w/dye 7.16 70.00 $501.20

73706 26 Ct angio lwr extr w/o&w/dye 2.68 70.00 $187.60

73718 Mri lower extremity w/o dye 10.22 70.00 $715.40

73718 TC Mri lower extremity w/o dye 8.31 70.00 $581.70

73718 26 Mri lower extremity w/o dye 1.91 70.00 $133.70

73719 Mri lower extremity w/dye 11.34 70.00 $793.80

73719 TC Mri lower extremity w/dye 9.03 70.00 $632.10

73719 26 Mri lower extremity w/dye 2.31 70.00 $161.70

73720 Mri lwr extremity w/o&w/dye 14.09 70.00 $986.30

73720 TC Mri lwr extremity w/o&w/dye 11.02 70.00 $771.40

73720 26 Mri lwr extremity w/o&w/dye 3.07 70.00 $214.90

73721 Mri jnt of lwr extre w/o dye 6.59 70.00 $461.30

73721 TC Mri jnt of lwr extre w/o dye 4.66 70.00 $326.20

73721 26 Mri jnt of lwr extre w/o dye 1.93 70.00 $135.10

73722 Mri joint of lwr extr w/dye 10.70 70.00 $749.00

73722 TC Mri joint of lwr extr w/dye 8.37 70.00 $585.90

73722 26 Mri joint of lwr extr w/dye 2.33 70.00 $163.10

73723 Mri joint lwr extr w/o&w/dye 13.21 70.00 $924.70

73723 TC Mri joint lwr extr w/o&w/dye 10.14 70.00 $709.80

73723 26 Mri joint lwr extr w/o&w/dye 3.07 70.00 $214.90

73725 Mr ang lwr ext w or w/o dye 11.30 70.00 $791.00

73725 TC Mr ang lwr ext w or w/o dye 8.73 70.00 $611.10

73725 26 Mr ang lwr ext w or w/o dye 2.57 70.00 $179.90

74000 X-ray exam of abdomen 0.66 70.00 $46.20

74000 TC X-ray exam of abdomen 0.40 70.00 $28.00

74000 26 X-ray exam of abdomen 0.26 70.00 $18.20

74022 X-ray exam series abdomen 1.23 70.00 $86.10

74022 TC X-ray exam series abdomen 0.78 70.00 $54.60

74022 26 X-ray exam series abdomen 0.45 70.00 $31.50

74150 Ct abdomen w/o dye 4.20 70.00 $294.00

74150 TC Ct abdomen w/o dye 2.51 70.00 $175.70

74150 26 Ct abdomen w/o dye 1.69 70.00 $118.30

74160 Ct abdomen w/dye 6.46 70.00 $452.20

74160 TC Ct abdomen w/dye 4.65 70.00 $325.50

74160 26 Ct abdomen w/dye 1.81 70.00 $126.70

74170 Ct abdomen w/o & w/dye 7.35 70.00 $514.50

74170 TC Ct abdomen w/o & w/dye 5.36 70.00 $375.20

74170 26 Ct abdomen w/o & w/dye 1.99 70.00 $139.30

74174 Ct angio abd&pelv w/o&w/dye 10.91 70.00 $763.70

74174 TC Ct angio abd&pelv w/o&w/dye 7.77 70.00 $543.90

74174 26 Ct angio abd&pelv w/o&w/dye 3.14 70.00 $219.80

74175 Ct angio abdom w/o & w/dye 8.60 70.00 $602.00

74175 TC Ct angio abdom w/o & w/dye 6.02 70.00 $421.40

74175 26 Ct angio abdom w/o & w/dye 2.58 70.00 $180.60

74176 Ct abd & pelvis w/o contrast 5.62 70.00 $393.40

74176 TC Ct abd & pelvis w/o contrast 3.13 70.00 $219.10

74176 26 Ct abd & pelvis w/o contrast 2.49 70.00 $174.30

74177 Ct abd & pelv w/contrast 8.74 70.00 $611.80

74177 TC Ct abd & pelv w/contrast 6.13 70.00 $429.10

74177 26 Ct abd & pelv w/contrast 2.61 70.00 $182.70

74178 Ct abd & pelv 1/> regns 9.89 70.00 $692.30

74178 TC Ct abd & pelv 1/> regns 7.02 70.00 $491.40

74178 26 Ct abd & pelv 1/> regns 2.87 70.00 $200.90

74181 Mri abdomen w/o dye 9.32 70.00 $652.40

74181 TC Mri abdomen w/o dye 7.25 70.00 $507.50

74181 26 Mri abdomen w/o dye 2.07 70.00 $144.90

74182 Mri abdomen w/dye 12.75 70.00 $892.50

74182 TC Mri abdomen w/dye 10.28 70.00 $719.60

74182 26 Mri abdomen w/dye 2.47 70.00 $172.90

74183 Mri abdomen w/o & w/dye 14.22 70.00 $995.40

74183 TC Mri abdomen w/o & w/dye 10.98 70.00 $768.60

74183 26 Mri abdomen w/o & w/dye 3.24 70.00 $226.80

74185 Mri angio abdom w orw/o dye 11.30 70.00 $791.00

74185 TC Mri angio abdom w orw/o dye 8.75 70.00 $612.50

74185 26 Mri angio abdom w orw/o dye 2.55 70.00 $178.50

74190 X-ray exam of peritoneum 0.00 70.00 $0.00

74190 TC X-ray exam of peritoneum 0.00 70.00 $0.00

74190 26 X-ray exam of peritoneum 0.68 70.00 $47.60

74210 Contrst x-ray exam of throat 2.17 70.00 $151.90

74210 TC Contrst x-ray exam of throat 1.66 70.00 $116.20

74210 26 Contrst x-ray exam of throat 0.51 70.00 $35.70

74220 Contrast x-ray esophagus 2.48 70.00 $173.60

74220 TC Contrast x-ray esophagus 1.82 70.00 $127.40

74220 26 Contrast x-ray esophagus 0.66 70.00 $46.20

74230 Cine/vid x-ray throat/esoph 3.60 70.00 $252.00

74230 TC Cine/vid x-ray throat/esoph 2.84 70.00 $198.80

74230 26 Cine/vid x-ray throat/esoph 0.76 70.00 $53.20

74235 Remove esophagus obstruction 0.00 70.00 $0.00

74235 TC Remove esophagus obstruction 0.00 70.00 $0.00

74235 26 Remove esophagus obstruction 1.80 70.00 $126.00

74240 X-ray upper gi delay w/o kub 3.19 70.00 $223.30

74240 TC X-ray upper gi delay w/o kub 2.19 70.00 $153.30

74240 26 X-ray upper gi delay w/o kub 1.00 70.00 $70.00

74241 X-rayupper gi delay w/kub 3.29 70.00 $230.30

74241 TC X-rayupper gi delay w/kub 2.31 70.00 $161.70

74241 26 X-rayupper gi delay w/kub 0.98 70.00 $68.60

74245 X-ray upper gi&small intest 4.80 70.00 $336.00

74245 TC X-ray upper gi&small intest 3.50 70.00 $245.00

74245 26 X-ray upper gi&small intest 1.30 70.00 $91.00

74246 Contrst x-ray uppr gi tract 3.59 70.00 $251.30

74246 TC Contrst x-ray uppr gi tract 2.58 70.00 $180.60

74246 26 Contrst x-ray uppr gi tract 1.01 70.00 $70.70

74250 X-ray exam of small bowel 2.92 70.00 $204.40

74250 TC X-ray exam of small bowel 2.24 70.00 $156.80

74250 26 X-ray exam of small bowel 0.68 70.00 $47.60

74261 Ct colonography dx 13.64 70.00 $954.80

74261 TC Ct colonography dx 10.19 70.00 $713.30

74261 26 Ct colonography dx 3.45 70.00 $241.50

74262 Ct colonography dx w/dye 15.25 70.00 $1,067.50

74262 TC Ct colonography dx w/dye 11.66 70.00 $816.20

74262 26 Ct colonography dx w/dye 3.59 70.00 $251.30

74263 Ct colonography screening 21.17 70.00 $1,481.90

74263 TC Ct colonography screening 17.93 70.00 $1,255.10

74263 26 Ct colonography screening 3.24 70.00 $226.80

74270 Contrast x-ray exam of colon 4.20 70.00 $294.00

74270 TC Contrast x-ray exam of colon 3.21 70.00 $224.70

74270 26 Contrast x-ray exam of colon 0.99 70.00 $69.30

74290 Contrast x-ray gallbladder 1.96 70.00 $137.20

74290 TC Contrast x-ray gallbladder 1.50 70.00 $105.00

74290 26 Contrast x-ray gallbladder 0.46 70.00 $32.20

74300 X-ray bile ducts/pancreas 0.00 70.00 $0.00

74300 TC X-ray bile ducts/pancreas 0.00 70.00 $0.00

74300 26 X-ray bile ducts/pancreas 0.53 70.00 $37.10

74301 X-rays at surgery add-on 0.00 70.00 $0.00

74301 TC X-rays at surgery add-on 0.00 70.00 $0.00

74301 26 X-rays at surgery add-on 0.31 70.00 $21.70

74305 X-ray bile ducts/pancreas 0.00 70.00 $0.00

74305 TC X-ray bile ducts/pancreas 0.00 70.00 $0.00

74305 26 X-ray bile ducts/pancreas 0.60 70.00 $42.00

74320 Contrast x-ray of bile ducts 2.61 70.00 $182.70

74320 TC Contrast x-ray of bile ducts 1.86 70.00 $130.20

74320 26 Contrast x-ray of bile ducts 0.75 70.00 $52.50

74327 X-ray bile stone removal 3.77 70.00 $263.90

74327 TC X-ray bile stone removal 2.79 70.00 $195.30

74327 26 X-ray bile stone removal 0.98 70.00 $68.60

74328 X-ray bile duct endoscopy 0.00 70.00 $0.00

74328 TC X-ray bile duct endoscopy 0.00 70.00 $0.00

74328 26 X-ray bile duct endoscopy 1.04 70.00 $72.80

74329 X-ray for pancreas endoscopy 0.00 70.00 $0.00

74329 TC X-ray for pancreas endoscopy 0.00 70.00 $0.00

74329 26 X-ray for pancreas endoscopy 1.03 70.00 $72.10

74330 X-ray bile/panc endoscopy 0.00 70.00 $0.00

74330 TC X-ray bile/panc endoscopy 0.00 70.00 $0.00

74330 26 X-ray bile/panc endoscopy 1.32 70.00 $92.40

74340 X-ray guide for gi tube 0.00 70.00 $0.00

74340 TC X-ray guide for gi tube 0.00 70.00 $0.00

74340 26 X-ray guide for gi tube 0.78 70.00 $54.60

74355 X-ray guide intestinal tube 0.00 70.00 $0.00

74355 TC X-ray guide intestinal tube 0.00 70.00 $0.00

74355 26 X-ray guide intestinal tube 1.12 70.00 $78.40

74360 X-ray guide gi dilation 0.00 70.00 $0.00

74360 TC X-ray guide gi dilation 0.00 70.00 $0.00

74360 26 X-ray guide gi dilation 0.81 70.00 $56.70

74363 X-ray bile duct dilation 0.00 70.00 $0.00

74363 TC X-ray bile duct dilation 0.00 70.00 $0.00

74363 26 X-ray bile duct dilation 1.26 70.00 $88.20

74400 Contrst x-ray urinary tract 3.06 70.00 $214.20

74400 TC Contrst x-ray urinary tract 2.37 70.00 $165.90

74400 26 Contrst x-ray urinary tract 0.69 70.00 $48.30

74430 Contrast x-ray bladder 1.04 70.00 $72.80

74430 TC Contrast x-ray bladder 0.59 70.00 $41.30

74430 26 Contrast x-ray bladder 0.45 70.00 $31.50

74440 X-ray male genital tract 2.23 70.00 $156.10

74440 TC X-ray male genital tract 1.71 70.00 $119.70

74440 26 X-ray male genital tract 0.52 70.00 $36.40

74445 X-ray exam of penis 0.00 70.00 $0.00

74445 TC X-ray exam of penis 0.00 70.00 $0.00

74445 26 X-ray exam of penis 1.65 70.00 $115.50

74450 X-ray urethra/bladder 0.00 70.00 $0.00

74450 TC X-ray urethra/bladder 0.00 70.00 $0.00

74450 26 X-ray urethra/bladder 0.47 70.00 $32.90

74455 X-ray urethra/bladder 2.28 70.00 $159.60

74455 TC X-ray urethra/bladder 1.82 70.00 $127.40

74455 26 X-ray urethra/bladder 0.46 70.00 $32.20

74470 X-ray exam of kidney lesion 0.00 70.00 $0.00

74470 TC X-ray exam of kidney lesion 0.00 70.00 $0.00

74470 26 X-ray exam of kidney lesion 0.75 70.00 $52.50

74475 X-ray control cath insert 2.59 70.00 $181.30

74475 TC X-ray control cath insert 1.84 70.00 $128.80

74475 26 X-ray control cath insert 0.75 70.00 $52.50

74480 X-ray control cath insert 2.59 70.00 $181.30

74480 TC X-ray control cath insert 1.84 70.00 $128.80

74480 26 X-ray control cath insert 0.75 70.00 $52.50

74485 X-ray guide gu dilation 2.57 70.00 $179.90

74485 TC X-ray guide gu dilation 1.84 70.00 $128.80

74485 26 X-ray guide gu dilation 0.73 70.00 $51.10

74710 X-ray measurement of pelvis 1.12 70.00 $78.40

74710 TC X-ray measurement of pelvis 0.62 70.00 $43.40

74710 26 X-ray measurement of pelvis 0.50 70.00 $35.00

74740 X-ray female genital tract 2.11 70.00 $147.70

74740 TC X-ray female genital tract 1.56 70.00 $109.20

74740 26 X-ray female genital tract 0.55 70.00 $38.50

74742 X-ray fallopian tube 0.00 70.00 $0.00

74742 TC X-ray fallopian tube 0.00 70.00 $0.00

74742 26 X-ray fallopian tube 0.89 70.00 $62.30

74775 X-ray exam of perineum 0.00 70.00 $0.00

74775 TC X-ray exam of perineum 0.00 70.00 $0.00

74775 26 X-ray exam of perineum 0.90 70.00 $63.00

75557 Cardiac mri for morph 8.92 70.00 $624.40

75557 TC Cardiac mri for morph 5.61 70.00 $392.70

75557 26 Cardiac mri for morph 3.31 70.00 $231.70

75559 Cardiac mri w/stress img 12.15 70.00 $850.50

75559 TC Cardiac mri w/stress img 8.09 70.00 $566.30

75559 26 Cardiac mri w/stress img 4.06 70.00 $284.20

75561 Cardiac mri for morph w/dye 11.90 70.00 $833.00

75561 TC Cardiac mri for morph w/dye 8.24 70.00 $576.80

75561 26 Cardiac mri for morph w/dye 3.66 70.00 $256.20

75563 Card mri w/stress img & dye 14.12 70.00 $988.40

75563 TC Card mri w/stress img & dye 9.92 70.00 $694.40

75563 26 Card mri w/stress img & dye 4.20 70.00 $294.00

75565 Card mri veloc flow mapping 1.55 70.00 $108.50

75565 TC Card mri veloc flow mapping 1.20 70.00 $84.00

75565 26 Card mri veloc flow mapping 0.35 70.00 $24.50

75571 Ct hrt w/o dye w/ca test 2.82 70.00 $197.40

75571 TC Ct hrt w/o dye w/ca test 2.00 70.00 $140.00

75571 26 Ct hrt w/o dye w/ca test 0.82 70.00 $57.40

75572 Ct hrt w/3d image 7.98 70.00 $558.60

75572 TC Ct hrt w/3d image 5.51 70.00 $385.70

75572 26 Ct hrt w/3d image 2.47 70.00 $172.90

75573 Ct hrt w/3d image congen 10.91 70.00 $763.70

75573 TC Ct hrt w/3d image congen 7.36 70.00 $515.20

75573 26 Ct hrt w/3d image congen 3.55 70.00 $248.50

75574 Ct angio hrt w/3d image 11.74 70.00 $821.80

75574 TC Ct angio hrt w/3d image 8.38 70.00 $586.60

75574 26 Ct angio hrt w/3d image 3.36 70.00 $235.20

75600 Contrast exam thoracic aorta 5.62 70.00 $393.40

75600 TC Contrast exam thoracic aorta 4.88 70.00 $341.60

75600 26 Contrast exam thoracic aorta 0.74 70.00 $51.80

75605 Contrast exam thoracic aorta 3.92 70.00 $274.40

75605 TC Contrast exam thoracic aorta 2.31 70.00 $161.70

75605 26 Contrast exam thoracic aorta 1.61 70.00 $112.70

75625 Contrast exam abdominl aorta 3.92 70.00 $274.40

75625 TC Contrast exam abdominl aorta 2.30 70.00 $161.00

75625 26 Contrast exam abdominl aorta 1.62 70.00 $113.40

75630 X-ray aorta leg arteries 4.85 70.00 $339.50

75630 TC X-ray aorta leg arteries 2.30 70.00 $161.00

75630 26 X-ray aorta leg arteries 2.55 70.00 $178.50

75635 Ct angio abdominal arteries 10.65 70.00 $745.50

75635 TC Ct angio abdominal arteries 7.25 70.00 $507.50

75635 26 Ct angio abdominal arteries 3.40 70.00 $238.00

75658 Artery x-rays arm 4.70 70.00 $329.00

75658 TC Artery x-rays arm 2.83 70.00 $198.10

75658 26 Artery x-rays arm 1.87 70.00 $130.90

75705 Artery x-rays spine 6.64 70.00 $464.80

75705 TC Artery x-rays spine 3.60 70.00 $252.00

75705 26 Artery x-rays spine 3.04 70.00 $212.80

75710 Artery x-rays arm/leg 4.53 70.00 $317.10

75710 TC Artery x-rays arm/leg 2.99 70.00 $209.30

75710 26 Artery x-rays arm/leg 1.54 70.00 $107.80

75716 Artery x-rays arms/legs 5.25 70.00 $367.50

75716 TC Artery x-rays arms/legs 3.41 70.00 $238.70

75716 26 Artery x-rays arms/legs 1.84 70.00 $128.80

75726 Artery x-rays abdomen 4.23 70.00 $296.10

75726 TC Artery x-rays abdomen 2.62 70.00 $183.40

75726 26 Artery x-rays abdomen 1.61 70.00 $112.70

75731 Artery x-rays adrenal gland 4.80 70.00 $336.00

75731 TC Artery x-rays adrenal gland 3.19 70.00 $223.30

75731 26 Artery x-rays adrenal gland 1.61 70.00 $112.70

75733 Artery x-rays adrenals 5.14 70.00 $359.80

75733 TC Artery x-rays adrenals 3.33 70.00 $233.10

75733 26 Artery x-rays adrenals 1.81 70.00 $126.70

75736 Artery x-rays pelvis 4.59 70.00 $321.30

75736 TC Artery x-rays pelvis 2.93 70.00 $205.10

75736 26 Artery x-rays pelvis 1.66 70.00 $116.20

75741 Artery x-rays lung 4.28 70.00 $299.60

75741 TC Artery x-rays lung 2.46 70.00 $172.20

75741 26 Artery x-rays lung 1.82 70.00 $127.40

75743 Artery x-rays lungs 4.79 70.00 $335.30

75743 TC Artery x-rays lungs 2.49 70.00 $174.30

75743 26 Artery x-rays lungs 2.30 70.00 $161.00

75746 Artery x-rays lung 4.31 70.00 $301.70

75746 TC Artery x-rays lung 2.73 70.00 $191.10

75746 26 Artery x-rays lung 1.58 70.00 $110.60

75756 Artery x-rays chest 4.78 70.00 $334.60

75756 TC Artery x-rays chest 3.11 70.00 $217.70

75756 26 Artery x-rays chest 1.67 70.00 $116.90

75774 Artery x-ray each vessel 2.47 70.00 $172.90

75774 TC Artery x-ray each vessel 1.96 70.00 $137.20

75774 26 Artery x-ray each vessel 0.51 70.00 $35.70

75791 Av dialysis shunt imaging 9.00 70.00 $630.00

75791 TC Av dialysis shunt imaging 6.66 70.00 $466.20

75791 26 Av dialysis shunt imaging 2.34 70.00 $163.80

75801 Lymph vessel x-ray arm/leg 0.00 70.00 $0.00

75801 TC Lymph vessel x-ray arm/leg 0.00 70.00 $0.00

75801 26 Lymph vessel x-ray arm/leg 1.29 70.00 $90.30

75803 Lymph vessel x-ray arms/legs 0.00 70.00 $0.00

75803 TC Lymph vessel x-ray arms/legs 0.00 70.00 $0.00

75803 26 Lymph vessel x-ray arms/legs 1.72 70.00 $120.40

75805 Lymph vessel x-ray trunk 0.00 70.00 $0.00

75805 TC Lymph vessel x-ray trunk 0.00 70.00 $0.00

75805 26 Lymph vessel x-ray trunk 1.18 70.00 $82.60

75807 Lymph vessel x-ray trunk 0.00 70.00 $0.00

75807 TC Lymph vessel x-ray trunk 0.00 70.00 $0.00

75807 26 Lymph vessel x-ray trunk 1.72 70.00 $120.40

75809 Nonvascular shunt x-ray 2.78 70.00 $194.60

75809 TC Nonvascular shunt x-ray 2.11 70.00 $147.70

75809 26 Nonvascular shunt x-ray 0.67 70.00 $46.90

75810 Vein x-ray spleen/liver 0.00 70.00 $0.00

75810 TC Vein x-ray spleen/liver 0.00 70.00 $0.00

75810 26 Vein x-ray spleen/liver 1.68 70.00 $117.60

75820 Vein x-ray arm/leg 3.25 70.00 $227.50

75820 TC Vein x-ray arm/leg 2.25 70.00 $157.50

75820 26 Vein x-ray arm/leg 1.00 70.00 $70.00

75822 Vein x-ray arms/legs 3.87 70.00 $270.90

75822 TC Vein x-ray arms/legs 2.38 70.00 $166.60

75822 26 Vein x-ray arms/legs 1.49 70.00 $104.30

75825 Vein x-ray trunk 3.86 70.00 $270.20

75825 TC Vein x-ray trunk 2.24 70.00 $156.80

75825 26 Vein x-ray trunk 1.62 70.00 $113.40

75827 Vein x-ray chest 3.89 70.00 $272.30

75827 TC Vein x-ray chest 2.30 70.00 $161.00

75827 26 Vein x-ray chest 1.59 70.00 $111.30

75831 Vein x-ray kidney 3.96 70.00 $277.20

75831 TC Vein x-ray kidney 2.41 70.00 $168.70

75831 26 Vein x-ray kidney 1.55 70.00 $108.50

75833 Vein x-ray kidneys 4.75 70.00 $332.50

75833 TC Vein x-ray kidneys 2.56 70.00 $179.20

75833 26 Vein x-ray kidneys 2.19 70.00 $153.30

75840 Vein x-ray adrenal gland 4.19 70.00 $293.30

75840 TC Vein x-ray adrenal gland 2.55 70.00 $178.50

75840 26 Vein x-ray adrenal gland 1.64 70.00 $114.80

75842 Vein x-ray adrenal glands 5.09 70.00 $356.30

75842 TC Vein x-ray adrenal glands 2.94 70.00 $205.80

75842 26 Vein x-ray adrenal glands 2.15 70.00 $150.50

75860 Vein x-ray neck 4.06 70.00 $284.20

75860 TC Vein x-ray neck 2.45 70.00 $171.50

75860 26 Vein x-ray neck 1.61 70.00 $112.70

75870 Vein x-ray skull 4.18 70.00 $292.60

75870 TC Vein x-ray skull 2.54 70.00 $177.80

75870 26 Vein x-ray skull 1.64 70.00 $114.80

75872 Vein x-ray skull epidural 4.20 70.00 $294.00

75872 TC Vein x-ray skull epidural 2.56 70.00 $179.20

75872 26 Vein x-ray skull epidural 1.64 70.00 $114.80

75880 Vein x-ray eye socket 4.10 70.00 $287.00

75880 TC Vein x-ray eye socket 3.08 70.00 $215.60

75880 26 Vein x-ray eye socket 1.02 70.00 $71.40

75885 Vein x-ray liver w/hemodynam 4.45 70.00 $311.50

75885 TC Vein x-ray liver w/hemodynam 2.47 70.00 $172.90

75885 26 Vein x-ray liver w/hemodynam 1.98 70.00 $138.60

75887 Vein x-ray liver w/o hemodyn 4.51 70.00 $315.70

75887 TC Vein x-ray liver w/o hemodyn 2.50 70.00 $175.00

75887 26 Vein x-ray liver w/o hemodyn 2.01 70.00 $140.70

75889 Vein x-ray liver w/hemodynam 4.06 70.00 $284.20

75889 TC Vein x-ray liver w/hemodynam 2.49 70.00 $174.30

75889 26 Vein x-ray liver w/hemodynam 1.57 70.00 $109.90

75891 Vein x-ray liver 4.11 70.00 $287.70

75891 TC Vein x-ray liver 2.51 70.00 $175.70

75891 26 Vein x-ray liver 1.60 70.00 $112.00

75893 Venous sampling by catheter 3.34 70.00 $233.80

75893 TC Venous sampling by catheter 2.57 70.00 $179.90

75893 26 Venous sampling by catheter 0.77 70.00 $53.90

75894 X-rays transcath therapy 0.00 70.00 $0.00

75894 TC X-rays transcath therapy 0.00 70.00 $0.00

75894 26 X-rays transcath therapy 1.90 70.00 $133.00

75896 X-rays transcath therapy 0.00 70.00 $0.00

75896 TC X-rays transcath therapy 0.00 70.00 $0.00

75896 26 X-rays transcath therapy 1.97 70.00 $137.90

75898 Follow-up angiography 0.00 70.00 $0.00

75898 TC Follow-up angiography 0.00 70.00 $0.00

75898 26 Follow-up angiography 2.44 70.00 $170.80

75901 Remove cva device obstruct 4.91 70.00 $343.70

75901 TC Remove cva device obstruct 4.25 70.00 $297.50

75901 26 Remove cva device obstruct 0.66 70.00 $46.20

75902 Remove cva lumen obstruct 2.01 70.00 $140.70

75902 TC Remove cva lumen obstruct 1.47 70.00 $102.90

75902 26 Remove cva lumen obstruct 0.54 70.00 $37.80

75945 Intravascular us 0.00 70.00 $0.00

75945 TC Intravascular us 0.00 70.00 $0.00

75945 26 Intravascular us 0.57 70.00 $39.90

75946 Intravascular us add-on 0.00 70.00 $0.00

75946 TC Intravascular us add-on 0.00 70.00 $0.00

75946 26 Intravascular us add-on 0.57 70.00 $39.90

75952 Endovasc repair abdom aorta 0.00 70.00 $0.00

75952 TC Endovasc repair abdom aorta 0.00 70.00 $0.00

75952 26 Endovasc repair abdom aorta 6.56 70.00 $459.20

75953 Abdom aneurysm endovas rpr 0.00 70.00 $0.00

75953 TC Abdom aneurysm endovas rpr 0.00 70.00 $0.00

75953 26 Abdom aneurysm endovas rpr 1.99 70.00 $139.30

75954 Iliac aneurysm endovas rpr 0.00 70.00 $0.00

75954 TC Iliac aneurysm endovas rpr 0.00 70.00 $0.00

75954 26 Iliac aneurysm endovas rpr 3.32 70.00 $232.40

75956 Xray endovasc thor ao repr 0.00 70.00 $0.00

75956 TC Xray endovasc thor ao repr 0.00 70.00 $0.00

75956 26 Xray endovasc thor ao repr 10.22 70.00 $715.40

75957 Xray endovasc thor ao repr 0.00 70.00 $0.00

75957 TC Xray endovasc thor ao repr 0.00 70.00 $0.00

75957 26 Xray endovasc thor ao repr 8.76 70.00 $613.20

75958 Xray place prox ext thor ao 0.00 70.00 $0.00

75958 TC Xray place prox ext thor ao 0.00 70.00 $0.00

75958 26 Xray place prox ext thor ao 5.83 70.00 $408.10

75959 Xray place dist ext thor ao 0.00 70.00 $0.00

75959 TC Xray place dist ext thor ao 0.00 70.00 $0.00

75959 26 Xray place dist ext thor ao 5.02 70.00 $351.40

75962 TC Repair arterial blockage 3.16 70.00 $221.20

75962 26 Repair arterial blockage 0.73 70.00 $51.10

75964 Repair artery blockage each 2.42 70.00 $169.40

75964 TC Repair artery blockage each 1.93 70.00 $135.10

75964 26 Repair artery blockage each 0.49 70.00 $34.30

75966 TC Repair arterial blockage 3.00 70.00 $210.00

75966 26 Repair arterial blockage 1.82 70.00 $127.40

75968 Repair artery blockage each 2.49 70.00 $174.30

75968 TC Repair artery blockage each 1.99 70.00 $139.30

75968 26 Repair artery blockage each 0.50 70.00 $35.00

75970 Vascular biopsy 0.00 70.00 $0.00

75970 TC Vascular biopsy 0.00 70.00 $0.00

75970 26 Vascular biopsy 1.16 70.00 $81.20

75978 Repair venous blockage 3.85 70.00 $269.50

75978 TC Repair venous blockage 3.12 70.00 $218.40

75978 26 Repair venous blockage 0.73 70.00 $51.10

75980 Contrast xray exam bile duct 0.00 70.00 $0.00

75980 TC Contrast xray exam bile duct 0.00 70.00 $0.00

75980 26 Contrast xray exam bile duct 2.07 70.00 $144.90

75982 Contrast xray exam bile duct 0.00 70.00 $0.00

75982 TC Contrast xray exam bile duct 0.00 70.00 $0.00

75982 26 Contrast xray exam bile duct 2.05 70.00 $143.50

75984 Xray control catheter change 2.99 70.00 $209.30

75984 TC Xray control catheter change 1.99 70.00 $139.30

75984 26 Xray control catheter change 1.00 70.00 $70.00

75989 Abscess drainage under x-ray 3.41 70.00 $238.70

75989 TC Abscess drainage under x-ray 1.73 70.00 $121.10

75989 26 Abscess drainage under x-ray 1.68 70.00 $117.60

76000 Fluoroscope examination 1.32 70.00 $92.40

76000 TC Fluoroscope examination 1.07 70.00 $74.90

76000 26 Fluoroscope examination 0.25 70.00 $17.50

76001 Fluoroscope exam extensive 0.00 70.00 $0.00

76001 TC Fluoroscope exam extensive 0.00 70.00 $0.00

76001 26 Fluoroscope exam extensive 1.04 70.00 $72.80

76010 X-ray nose to rectum 0.73 70.00 $51.10

76010 TC X-ray nose to rectum 0.47 70.00 $32.90

76010 26 X-ray nose to rectum 0.26 70.00 $18.20

76080 X-ray exam of fistula 1.55 70.00 $108.50

76080 TC X-ray exam of fistula 0.80 70.00 $56.00

76080 26 X-ray exam of fistula 0.75 70.00 $52.50

76098 X-ray exam breast specimen 0.46 70.00 $32.20

76098 TC X-ray exam breast specimen 0.23 70.00 $16.10

76098 26 X-ray exam breast specimen 0.23 70.00 $16.10

76100 X-ray exam of body section 2.60 70.00 $182.00

76100 TC X-ray exam of body section 1.69 70.00 $118.30

76100 26 X-ray exam of body section 0.91 70.00 $63.70

76101 Complex body section x-ray 3.72 70.00 $260.40

76101 TC Complex body section x-ray 2.72 70.00 $190.40

76101 26 Complex body section x-ray 1.00 70.00 $70.00

76102 Complex body section x-rays 4.89 70.00 $342.30

76102 TC Complex body section x-rays 3.89 70.00 $272.30

76102 26 Complex body section x-rays 1.00 70.00 $70.00

76120 Cine/video x-rays 2.55 70.00 $178.50

76120 TC Cine/video x-rays 1.98 70.00 $138.60

76120 26 Cine/video x-rays 0.57 70.00 $39.90

76125 Cine/video x-rays add-on 0.00 70.00 $0.00

76125 TC Cine/video x-rays add-on 0.00 70.00 $0.00

76125 26 Cine/video x-rays add-on 0.42 70.00 $29.40

76140 X-ray consultation 0.00 70.00 $0.00

76376 3d render w/intrp postproces 0.64 70.00 $44.80

76376 TC 3d render w/intrp postproces 0.36 70.00 $25.20

76376 26 3d render w/intrp postproces 0.28 70.00 $19.60

76377 3d render w/intrp postproces 1.80 70.00 $126.00

76377 TC 3d render w/intrp postproces 0.68 70.00 $47.60

76377 26 3d render w/intrp postproces 1.12 70.00 $78.40

76380 Cat scan follow-up study 4.11 70.00 $287.70

76380 TC Cat scan follow-up study 2.72 70.00 $190.40

76380 26 Cat scan follow-up study 1.39 70.00 $97.30

76390 Mr spectroscopy 12.49 70.00 $874.30

76390 TC Mr spectroscopy 10.50 70.00 $735.00

76390 26 Mr spectroscopy 1.99 70.00 $139.30

76496 Fluoroscopic procedure 0.00 70.00 $0.00

76496 TC Fluoroscopic procedure 0.00 70.00 $0.00

76496 26 Fluoroscopic procedure 0.00 70.00 $0.00

76497 Ct procedure 0.00 70.00 $0.00

76497 TC Ct procedure 0.00 70.00 $0.00

76497 26 Ct procedure 0.00 70.00 $0.00

76498 Mri procedure 0.00 70.00 $0.00

76498 TC Mri procedure 0.00 70.00 $0.00

76498 26 Mri procedure 0.00 70.00 $0.00

76499 Radiographic procedure 0.00 70.00 $0.00

76499 TC Radiographic procedure 0.00 70.00 $0.00

76499 26 Radiographic procedure 0.00 70.00 $0.00

76506 Echo exam of head 3.35 70.00 $234.50

76506 TC Echo exam of head 2.44 70.00 $170.80

76506 26 Echo exam of head 0.91 70.00 $63.70

76510 Ophth us b & quant a 4.80 70.00 $336.00

76510 TC Ophth us b & quant a 2.29 70.00 $160.30

76510 26 Ophth us b & quant a 2.51 70.00 $175.70

76511 Ophth us quant a only 2.90 70.00 $203.00

76511 TC Ophth us quant a only 1.39 70.00 $97.30

76511 26 Ophth us quant a only 1.51 70.00 $105.70

76512 Ophth us b w/non-quant a 2.62 70.00 $183.40

76512 TC Ophth us b w/non-quant a 1.12 70.00 $78.40

76512 26 Ophth us b w/non-quant a 1.50 70.00 $105.00

76513 Echo exam of eye water bath 2.71 70.00 $189.70

76513 TC Echo exam of eye water bath 1.69 70.00 $118.30

76513 26 Echo exam of eye water bath 1.02 70.00 $71.40

76514 Echo exam of eye thickness 0.43 70.00 $30.10

76514 TC Echo exam of eye thickness 0.15 70.00 $10.50

76514 26 Echo exam of eye thickness 0.28 70.00 $19.60

76516 Echo exam of eye 2.22 70.00 $155.40

76516 TC Echo exam of eye 1.34 70.00 $93.80

76516 26 Echo exam of eye 0.88 70.00 $61.60

76519 Echo exam of eye 2.38 70.00 $166.60

76519 26 Echo exam of eye 0.88 70.00 $61.60

76529 Echo exam of eye 2.25 70.00 $157.50

76529 26 Echo exam of eye 0.92 70.00 $64.40

76536 Us exam of head and neck 3.28 70.00 $229.60

76536 TC Us exam of head and neck 2.49 70.00 $174.30

76536 26 Us exam of head and neck 0.79 70.00 $55.30

76604 Us exam chest 2.49 70.00 $174.30

76604 TC Us exam chest 1.71 70.00 $119.70

76604 26 Us exam chest 0.78 70.00 $54.60

76641 Ultrasound breast complete 3.06 70.00 $214.20

76641 TC Ultrasound breast complete 2.01 70.00 $140.70

76641 26 Ultrasound breast complete 1.05 70.00 $73.50

76642 Ultrasound breast limited 2.52 70.00 $176.40

76642 TC Ultrasound breast limited 1.54 70.00 $107.80

76642 26 Ultrasound breast limited 0.98 70.00 $68.60

76700 Us exam abdom complete 3.47 70.00 $242.90

76700 TC Us exam abdom complete 2.32 70.00 $162.40

76700 26 Us exam abdom complete 1.15 70.00 $80.50

76705 Echo exam of abdomen 2.59 70.00 $181.30

76705 TC Echo exam of abdomen 1.75 70.00 $122.50

76705 26 Echo exam of abdomen 0.84 70.00 $58.80

76770 Us exam abdo back wall comp 3.19 70.00 $223.30

76770 TC Us exam abdo back wall comp 2.15 70.00 $150.50

76770 26 Us exam abdo back wall comp 1.04 70.00 $72.80

76775 Us exam abdo back wall lim 1.62 70.00 $113.40

76775 TC Us exam abdo back wall lim 0.81 70.00 $56.70

76775 26 Us exam abdo back wall lim 0.81 70.00 $56.70

76776 Us exam k transpl w/doppler 4.42 70.00 $309.40

76776 TC Us exam k transpl w/doppler 3.34 70.00 $233.80

76776 26 Us exam k transpl w/doppler 1.08 70.00 $75.60

76800 Us exam spinal canal 3.89 70.00 $272.30

76800 TC Us exam spinal canal 2.28 70.00 $159.60

76800 26 Us exam spinal canal 1.61 70.00 $112.70

76801 Ob us < 14 wks single fetus 3.52 70.00 $246.40

76801 TC Ob us < 14 wks single fetus 2.06 70.00 $144.20

76801 26 Ob us < 14 wks single fetus 1.46 70.00 $102.20

76802 Ob us < 14 wks addl fetus 1.86 70.00 $130.20

76802 TC Ob us < 14 wks addl fetus 0.64 70.00 $44.80

76802 26 Ob us < 14 wks addl fetus 1.22 70.00 $85.40

76805 Ob us >/= 14 wks sngl fetus 4.04 70.00 $282.80

76805 TC Ob us >/= 14 wks sngl fetus 2.58 70.00 $180.60

76805 26 Ob us >/= 14 wks sngl fetus 1.46 70.00 $102.20

76810 Ob us >/= 14 wks addl fetus 2.69 70.00 $188.30

76810 TC Ob us >/= 14 wks addl fetus 1.24 70.00 $86.80

76810 26 Ob us >/= 14 wks addl fetus 1.45 70.00 $101.50

76811 Ob us detailed sngl fetus 5.16 70.00 $361.20

76811 TC Ob us detailed sngl fetus 2.35 70.00 $164.50

76811 26 Ob us detailed sngl fetus 2.81 70.00 $196.70

76812 Ob us detailed addl fetus 5.85 70.00 $409.50

76812 TC Ob us detailed addl fetus 3.20 70.00 $224.00

76812 26 Ob us detailed addl fetus 2.65 70.00 $185.50

76813 Ob us nuchal meas 1 gest 3.45 70.00 $241.50

76813 TC Ob us nuchal meas 1 gest 1.70 70.00 $119.00

76813 26 Ob us nuchal meas 1 gest 1.75 70.00 $122.50

76814 Ob us nuchal meas add-on 2.32 70.00 $162.40

76814 TC Ob us nuchal meas add-on 0.85 70.00 $59.50

76814 26 Ob us nuchal meas add-on 1.47 70.00 $102.90

76815 Ob us limited fetus(s) 2.40 70.00 $168.00

76815 TC Ob us limited fetus(s) 1.45 70.00 $101.50

76815 26 Ob us limited fetus(s) 0.95 70.00 $66.50

76816 Ob us follow-up per fetus 3.26 70.00 $228.20

76816 TC Ob us follow-up per fetus 2.01 70.00 $140.70

76816 26 Ob us follow-up per fetus 1.25 70.00 $87.50

76817 Transvaginal us obstetric 2.76 70.00 $193.20

76817 TC Transvaginal us obstetric 1.66 70.00 $116.20

76817 26 Transvaginal us obstetric 1.10 70.00 $77.00

76818 Fetal biophys profile w/nst 3.45 70.00 $241.50

76818 TC Fetal biophys profile w/nst 1.89 70.00 $132.30

76818 26 Fetal biophys profile w/nst 1.56 70.00 $109.20

76819 Fetal biophys profil w/o nst 2.52 70.00 $176.40

76819 TC Fetal biophys profil w/o nst 1.39 70.00 $97.30

76819 26 Fetal biophys profil w/o nst 1.13 70.00 $79.10

76820 Umbilical artery echo 1.34 70.00 $93.80

76820 TC Umbilical artery echo 0.61 70.00 $42.70

76820 26 Umbilical artery echo 0.73 70.00 $51.10

76821 Middle cerebral artery echo 2.63 70.00 $184.10

76821 TC Middle cerebral artery echo 1.60 70.00 $112.00

76821 26 Middle cerebral artery echo 1.03 70.00 $72.10

76825 Echo exam of fetal heart 7.85 70.00 $549.50

76825 TC Echo exam of fetal heart 5.42 70.00 $379.40

76825 26 Echo exam of fetal heart 2.43 70.00 $170.10

76830 Transvaginal us non-ob 3.46 70.00 $242.20

76830 TC Transvaginal us non-ob 2.46 70.00 $172.20

76830 26 Transvaginal us non-ob 1.00 70.00 $70.00

76831 Echo exam uterus 3.36 70.00 $235.20

76831 TC Echo exam uterus 2.30 70.00 $161.00

76831 26 Echo exam uterus 1.06 70.00 $74.20

76856 Us exam pelvic complete 3.10 70.00 $217.00

76856 TC Us exam pelvic complete 2.13 70.00 $149.10

76856 26 Us exam pelvic complete 0.97 70.00 $67.90

76857 Us exam pelvic limited 1.33 70.00 $93.10

76857 TC Us exam pelvic limited 0.64 70.00 $44.80

76857 26 Us exam pelvic limited 0.69 70.00 $48.30

76870 Us exam scrotum 1.88 70.00 $131.60

76870 TC Us exam scrotum 0.99 70.00 $69.30

76870 26 Us exam scrotum 0.89 70.00 $62.30

76872 Us transrectal 2.64 70.00 $184.80

76872 TC Us transrectal 1.69 70.00 $118.30

76872 26 Us transrectal 0.95 70.00 $66.50

76873 Echograp trans r pros study 4.69 70.00 $328.30

76873 TC Echograp trans r pros study 2.50 70.00 $175.00

76873 26 Echograp trans r pros study 2.19 70.00 $153.30

76881 Us xtr non-vasc complete 3.29 70.00 $230.30

76881 TC Us xtr non-vasc complete 2.39 70.00 $167.30

76881 26 Us xtr non-vasc complete 0.90 70.00 $63.00

76882 Us xtr non-vasc lmtd 1.02 70.00 $71.40

76882 TC Us xtr non-vasc lmtd 0.32 70.00 $22.40

76882 26 Us xtr non-vasc lmtd 0.70 70.00 $49.00

76885 Us exam infant hips dynamic 4.08 70.00 $285.60

76885 TC Us exam infant hips dynamic 3.05 70.00 $213.50

76885 26 Us exam infant hips dynamic 1.03 70.00 $72.10

76886 Us exam infant hips static 3.01 70.00 $210.70

76886 TC Us exam infant hips static 2.12 70.00 $148.40

76886 26 Us exam infant hips static 0.89 70.00 $62.30

76930 Echo guide cardiocentesis 0.00 70.00 $0.00

76930 TC Echo guide cardiocentesis 0.00 70.00 $0.00

76930 26 Echo guide cardiocentesis 0.95 70.00 $66.50

76932 Echo guide for heart biopsy 0.00 70.00 $0.00

76932 TC Echo guide for heart biopsy 0.00 70.00 $0.00

76932 26 Echo guide for heart biopsy 0.94 70.00 $65.80

76936 Echo guide for artery repair 7.74 70.00 $541.80

76936 TC Echo guide for artery repair 4.87 70.00 $340.90

76936 26 Echo guide for artery repair 2.87 70.00 $200.90

76937 Us guide vascular access 0.91 70.00 $63.70

76937 TC Us guide vascular access 0.49 70.00 $34.30

76937 26 Us guide vascular access 0.42 70.00 $29.40

76940 Us guide tissue ablation 0.00 70.00 $0.00

76940 TC Us guide tissue ablation 0.00 70.00 $0.00

76940 26 Us guide tissue ablation 3.01 70.00 $210.70

76941 Echo guide for transfusion 0.00 70.00 $0.00

76941 TC Echo guide for transfusion 0.00 70.00 $0.00

76941 26 Echo guide for transfusion 1.96 70.00 $137.20

76942 Echo guide for biopsy 1.70 70.00 $119.00

76942 TC Echo guide for biopsy 0.76 70.00 $53.20

76942 26 Echo guide for biopsy 0.94 70.00 $65.80

76945 Echo guide villus sampling 0.00 70.00 $0.00

76945 TC Echo guide villus sampling 0.00 70.00 $0.00

76945 26 Echo guide villus sampling 1.00 70.00 $70.00

76946 Echo guide for amniocentesis 0.93 70.00 $65.10

76946 TC Echo guide for amniocentesis 0.37 70.00 $25.90

76946 26 Echo guide for amniocentesis 0.56 70.00 $39.20

76948 Echo guide ova aspiration 0.93 70.00 $65.10

76948 TC Echo guide ova aspiration 0.37 70.00 $25.90

76948 26 Echo guide ova aspiration 0.56 70.00 $39.20

76965 Echo guidance radiotherapy 2.54 70.00 $177.80

76965 TC Echo guidance radiotherapy 0.66 70.00 $46.20

76965 26 Echo guidance radiotherapy 1.88 70.00 $131.60

76970 Ultrasound exam follow-up 2.63 70.00 $184.10

76970 TC Ultrasound exam follow-up 2.05 70.00 $143.50

76970 26 Ultrasound exam follow-up 0.58 70.00 $40.60

76975 Gi endoscopic ultrasound 0.00 70.00 $0.00

76975 TC Gi endoscopic ultrasound 0.00 70.00 $0.00

76975 26 Gi endoscopic ultrasound 1.25 70.00 $87.50

76977 Us bone density measure 0.20 70.00 $14.00

76977 TC Us bone density measure 0.12 70.00 $8.40

76977 26 Us bone density measure 0.08 70.00 $5.60

76998 Us guide intraop 0.00 70.00 $0.00

76998 TC Us guide intraop 0.00 70.00 $0.00

76998 26 Us guide intraop 1.85 70.00 $129.50

76999 Echo examination procedure 0.00 70.00 $0.00

76999 TC Echo examination procedure 0.00 70.00 $0.00

76999 26 Echo examination procedure 0.00 70.00 $0.00

77001 Fluoroguide for vein device 1.97 70.00 $137.90

77001 TC Fluoroguide for vein device 1.44 70.00 $100.80

77001 26 Fluoroguide for vein device 0.53 70.00 $37.10

77002 Needle localization by xray 2.59 70.00 $181.30

77002 TC Needle localization by xray 1.80 70.00 $126.00

77002 26 Needle localization by xray 0.79 70.00 $55.30

77003 Fluoroguide for spine inject 2.40 70.00 $168.00

77003 TC Fluoroguide for spine inject 1.54 70.00 $107.80

77003 26 Fluoroguide for spine inject 0.86 70.00 $60.20

77011 Ct scan for localization 6.17 70.00 $431.90

77011 TC Ct scan for localization 4.42 70.00 $309.40

77011 26 Ct scan for localization 1.75 70.00 $122.50

77012 Ct scan for needle biopsy 3.50 70.00 $245.00

77012 TC Ct scan for needle biopsy 1.87 70.00 $130.90

77012 26 Ct scan for needle biopsy 1.63 70.00 $114.10

77013 Ct guide for tissue ablation 0.00 70.00 $0.00

77013 TC Ct guide for tissue ablation 0.00 70.00 $0.00

77013 26 Ct guide for tissue ablation 5.72 70.00 $400.40

77014 Ct scan for therapy guide 3.28 70.00 $229.60

77014 TC Ct scan for therapy guide 2.05 70.00 $143.50

77014 26 Ct scan for therapy guide 1.23 70.00 $86.10

77021 Mr guidance for needle place 11.55 70.00 $808.50

77021 TC Mr guidance for needle place 9.40 70.00 $658.00

77021 26 Mr guidance for needle place 2.15 70.00 $150.50

77022 Mri for tissue ablation 0.00 70.00 $0.00

77022 TC Mri for tissue ablation 0.00 70.00 $0.00

77022 26 Mri for tissue ablation 6.23 70.00 $436.10

77051 Computer dx mammogram add-on 0.25 70.00 $17.50

77051 TC Computer dx mammogram add-on 0.16 70.00 $11.20

77051 26 Computer dx mammogram add-on 0.09 70.00 $6.30

77052 Comp screen mammogram add-on 0.25 70.00 $17.50

77052 TC Comp screen mammogram add-on 0.16 70.00 $11.20

77052 26 Comp screen mammogram add-on 0.09 70.00 $6.30

77053 X-ray of mammary duct 1.63 70.00 $114.10

77053 TC X-ray of mammary duct 1.12 70.00 $78.40

77053 26 X-ray of mammary duct 0.51 70.00 $35.70

77054 X-ray of mammary ducts 2.14 70.00 $149.80

77054 TC X-ray of mammary ducts 1.49 70.00 $104.30

77054 26 X-ray of mammary ducts 0.65 70.00 $45.50

77055 Mammogram one breast 2.52 70.00 $176.40

77055 TC Mammogram one breast 1.52 70.00 $106.40

77055 26 Mammogram one breast 1.00 70.00 $70.00

77056 Mammogram both breasts 3.24 70.00 $226.80

77056 TC Mammogram both breasts 2.00 70.00 $140.00

77056 26 Mammogram both breasts 1.24 70.00 $86.80

77057 Mammogram screening 2.31 70.00 $161.70

77057 TC Mammogram screening 1.31 70.00 $91.70

77057 26 Mammogram screening 1.00 70.00 $70.00

77058 Mri one breast 15.18 70.00 $1,062.60

77058 TC Mri one breast 12.85 70.00 $899.50

77058 26 Mri one breast 2.33 70.00 $163.10

77059 Mri both breasts 15.02 70.00 $1,051.40

77059 TC Mri both breasts 12.69 70.00 $888.30

77059 26 Mri both breasts 2.33 70.00 $163.10

77061 Breast tomosynthesis uni 0.00 70.00 $0.00

77061 TC Breast tomosynthesis uni 0.00 70.00 $0.00

77061 26 Breast tomosynthesis uni 0.00 70.00 $0.00

77062 Breast tomosynthesis bi 0.00 70.00 $0.00

77062 TC Breast tomosynthesis bi 0.00 70.00 $0.00

77062 26 Breast tomosynthesis bi 0.00 70.00 $0.00

77063 Breast tomosynthesis bi 1.57 70.00 $109.90

77063 TC Breast tomosynthesis bi 0.72 70.00 $50.40

77063 26 Breast tomosynthesis bi 0.85 70.00 $59.50

77071 X-ray stress view 1.36 70.00 $95.20

77072 X-rays for bone age 0.65 70.00 $45.50

77072 TC X-rays for bone age 0.38 70.00 $26.60

77072 26 X-rays for bone age 0.27 70.00 $18.90

77073 X-rays bone length studies 1.02 70.00 $71.40

77073 TC X-rays bone length studies 0.60 70.00 $42.00

77073 26 X-rays bone length studies 0.42 70.00 $29.40

77074 X-rays bone survey limited 1.79 70.00 $125.30

77074 TC X-rays bone survey limited 1.15 70.00 $80.50

77074 26 X-rays bone survey limited 0.64 70.00 $44.80

77075 X-rays bone survey complete 2.44 70.00 $170.80

77075 TC X-rays bone survey complete 1.67 70.00 $116.90

77075 26 X-rays bone survey complete 0.77 70.00 $53.90

77076 X-rays bone survey infant 2.67 70.00 $186.90

77076 TC X-rays bone survey infant 1.67 70.00 $116.90

77076 26 X-rays bone survey infant 1.00 70.00 $70.00

77077 Joint survey single view 1.06 70.00 $74.20

77077 TC Joint survey single view 0.58 70.00 $40.60

77077 26 Joint survey single view 0.48 70.00 $33.60

77078 Ct bone density axial 3.19 70.00 $223.30

77078 TC Ct bone density axial 2.84 70.00 $198.80

77078 26 Ct bone density axial 0.35 70.00 $24.50

77080 Dxa bone density axial 1.16 70.00 $81.20

77080 TC Dxa bone density axial 0.87 70.00 $60.90

77080 26 Dxa bone density axial 0.29 70.00 $20.30

77081 Dxa bone density/peripheral 0.79 70.00 $55.30

77081 TC Dxa bone density/peripheral 0.48 70.00 $33.60

77081 26 Dxa bone density/peripheral 0.31 70.00 $21.70

77084 Magnetic image bone marrow 10.97 70.00 $767.90

77084 TC Magnetic image bone marrow 8.66 70.00 $606.20

77084 26 Magnetic image bone marrow 2.31 70.00 $161.70

77085 Dxa bone density study 1.58 70.00 $110.60

77085 TC Dxa bone density study 1.15 70.00 $80.50

77085 26 Dxa bone density study 0.43 70.00 $30.10

77086 Fracture assessment via dxa 1.00 70.00 $70.00

77086 TC Fracture assessment via dxa 0.75 70.00 $52.50

77086 26 Fracture assessment via dxa 0.25 70.00 $17.50

77261 Radiation therapy planning 2.13 70.00 $149.10

77280 Set radiation therapy field 7.59 70.00 $531.30

77280 TC Set radiation therapy field 6.58 70.00 $460.60

77280 26 Set radiation therapy field 1.01 70.00 $70.70

77285 Set radiation therapy field 11.96 70.00 $837.20

77290 Set radiation therapy field 14.29 70.00 $1,000.30

77293 Respirator motion mgmt simul 12.99 70.00 $909.30

77293 TC Respirator motion mgmt simul 10.09 70.00 $706.30

77293 26 Respirator motion mgmt simul 2.90 70.00 $203.00

77295 3-d radiotherapy plan 13.68 70.00 $957.60

77295 TC 3-d radiotherapy plan 7.46 70.00 $522.20

77295 26 3-d radiotherapy plan 6.22 70.00 $435.40

77299 TC Radiation therapy planning 0.00 70.00 $0.00

77299 26 Radiation therapy planning 0.00 70.00 $0.00

77300 Radiation therapy dose plan 1.77 70.00 $123.90

77300 TC Radiation therapy dose plan 0.87 70.00 $60.90

77300 26 Radiation therapy dose plan 0.90 70.00 $63.00

77301 Radiotherapy dose plan imrt 54.29 70.00 $3,800.30

77301 TC Radiotherapy dose plan imrt 42.72 70.00 $2,990.40

77301 26 Radiotherapy dose plan imrt 11.57 70.00 $809.90

77306 Telethx isodose plan simple 4.07 70.00 $284.90

77306 TC Telethx isodose plan simple 2.05 70.00 $143.50

77306 26 Telethx isodose plan simple 2.02 70.00 $141.40

77307 Telethx isodose plan cplx 7.97 70.00 $557.90

77307 TC Telethx isodose plan cplx 3.76 70.00 $263.20

77307 26 Telethx isodose plan cplx 4.21 70.00 $294.70

77316 Brachytx isodose plan simple 5.22 70.00 $365.40

77316 TC Brachytx isodose plan simple 3.20 70.00 $224.00

77316 26 Brachytx isodose plan simple 2.02 70.00 $141.40

77317 Brachytx isodose intermed 6.83 70.00 $478.10

77317 TC Brachytx isodose intermed 4.17 70.00 $291.90

77317 26 Brachytx isodose intermed 2.66 70.00 $186.20

77318 Brachytx isodose complex 9.87 70.00 $690.90

77318 TC Brachytx isodose complex 5.66 70.00 $396.20

77318 26 Brachytx isodose complex 4.21 70.00 $294.70

77321 Special teletx port plan 2.58 70.00 $180.60

77321 TC Special teletx port plan 1.21 70.00 $84.70

77321 26 Special teletx port plan 1.37 70.00 $95.90

77331 Special radiation dosimetry 1.79 70.00 $125.30

77331 TC Special radiation dosimetry 0.53 70.00 $37.10

77331 26 Special radiation dosimetry 1.26 70.00 $88.20

77332 Radiation treatment aid(s) 2.31 70.00 $161.70

77332 TC Radiation treatment aid(s) 1.52 70.00 $106.40

77332 26 Radiation treatment aid(s) 0.79 70.00 $55.30

77336 Radiation physics consult 2.15 70.00 $150.50

77338 Design mlc device for imrt 14.15 70.00 $990.50

77338 TC Design mlc device for imrt 7.93 70.00 $555.10

77338 26 Design mlc device for imrt 6.22 70.00 $435.40

77370 Radiation physics consult 3.27 70.00 $228.90

77371 Srs multisource 0.00 70.00 $0.00

77372 Srs linear based 29.73 70.00 $2,081.10

77373 Sbrt delivery 37.75 70.00 $2,642.50

77385 Ntsty modul rad tx dlvr smpl 0.00 70.00 $0.00

77386 Ntsty modul rad tx dlvr cplx 0.00 70.00 $0.00

77387 Guidance for radiaj tx dlvr 0.00 70.00 $0.00

77399 External radiation dosimetry 0.00 70.00 $0.00

77399 TC External radiation dosimetry 0.00 70.00 $0.00

77399 26 External radiation dosimetry 0.00 70.00 $0.00

77401 Radiation treatment delivery 0.58 70.00 $40.60

77417 Radiology port film(s) 0.30 70.00 $21.00

77422 Neutron beam tx simple 0.94 70.00 $65.80

77423 Neutron beam tx complex 1.83 70.00 $128.10

77424 Io rad tx delivery by x-ray 0.00 70.00 $0.00

77425 Io rad tx deliver by elctrns 0.00 70.00 $0.00

77427 Radiation tx management x5 5.22 70.00 $365.40

77431 Radiation therapy management 2.86 70.00 $200.20

77432 Stereotactic radiation trmt 11.71 70.00 $819.70

77435 Sbrt management 17.67 70.00 $1,236.90

77469 Io radiation tx management 9.01 70.00 $630.70

77470 Special radiation treatment 4.36 70.00 $305.20

77470 TC Special radiation treatment 1.33 70.00 $93.10

77470 26 Special radiation treatment 3.03 70.00 $212.10

77499 Radiation therapy management 0.00 70.00 $0.00

77499 TC Radiation therapy management 0.00 70.00 $0.00

77499 26 Radiation therapy management 0.00 70.00 $0.00

77520 Proton trmt simple w/o comp 0.00 70.00 $0.00

77522 Proton trmt simple w/comp 0.00 70.00 $0.00

77523 Proton trmt intermediate 0.00 70.00 $0.00

77525 Proton treatment complex 0.00 70.00 $0.00

77600 Hyperthermia treatment 11.30 70.00 $791.00

77600 TC Hyperthermia treatment 9.04 70.00 $632.80

77600 26 Hyperthermia treatment 2.26 70.00 $158.20

77605 Hyperthermia treatment 21.39 70.00 $1,497.30

77605 TC Hyperthermia treatment 18.38 70.00 $1,286.60

77620 Hyperthermia treatment 13.04 70.00 $912.80

77620 TC Hyperthermia treatment 10.57 70.00 $739.90

77750 Infuse radioactive materials 10.39 70.00 $727.30

77750 TC Infuse radioactive materials 3.14 70.00 $219.80

77750 26 Infuse radioactive materials 7.25 70.00 $507.50

77761 Apply intrcav radiat simple 10.87 70.00 $760.90

77761 TC Apply intrcav radiat simple 5.35 70.00 $374.50

77761 26 Apply intrcav radiat simple 5.52 70.00 $386.40

77762 Apply intrcav radiat interm 15.36 70.00 $1,075.20

77762 TC Apply intrcav radiat interm 6.16 70.00 $431.20

77762 26 Apply intrcav radiat interm 9.20 70.00 $644.00

77763 Apply intrcav radiat compl 20.49 70.00 $1,434.30

77763 TC Apply intrcav radiat compl 7.96 70.00 $557.20

77763 26 Apply intrcav radiat compl 12.53 70.00 $877.10

77776 Apply interstit radiat simpl 13.13 70.00 $919.10

77776 TC Apply interstit radiat simpl 6.43 70.00 $450.10

77776 26 Apply interstit radiat simpl 6.70 70.00 $469.00

77777 Apply interstit radiat inter 16.44 70.00 $1,150.80

77777 TC Apply interstit radiat inter 5.49 70.00 $384.30

77777 26 Apply interstit radiat inter 10.95 70.00 $766.50

77778 Apply interstit radiat compl 24.43 70.00 $1,710.10

77778 TC Apply interstit radiat compl 8.09 70.00 $566.30

77778 26 Apply interstit radiat compl 16.34 70.00 $1,143.80

77785 Hdr brachytx 1 channel 6.70 70.00 $469.00

77785 TC Hdr brachytx 1 channel 4.65 70.00 $325.50

77785 26 Hdr brachytx 1 channel 2.05 70.00 $143.50

77786 Hdr brachytx 2-12 channel 13.73 70.00 $961.10

77786 TC Hdr brachytx 2-12 channel 9.01 70.00 $630.70

77786 26 Hdr brachytx 2-12 channel 4.72 70.00 $330.40

77787 Hdr brachytx over 12 chan 21.89 70.00 $1,532.30

77787 TC Hdr brachytx over 12 chan 14.80 70.00 $1,036.00

77787 26 Hdr brachytx over 12 chan 7.09 70.00 $496.30

77789 Apply surface radiation 3.33 70.00 $233.10

77789 TC Apply surface radiation 1.68 70.00 $117.60

77789 26 Apply surface radiation 1.65 70.00 $115.50

77790 Radiation handling 2.71 70.00 $189.70

77790 TC Radiation handling 1.21 70.00 $84.70

77790 26 Radiation handling 1.50 70.00 $105.00

77799 Radium/radioisotope therapy 0.00 70.00 $0.00

77799 TC Radium/radioisotope therapy 0.00 70.00 $0.00

77799 26 Radium/radioisotope therapy 0.00 70.00 $0.00

78012 Thyroid uptake measurement 2.31 70.00 $161.70

78012 TC Thyroid uptake measurement 2.04 70.00 $142.80

78012 26 Thyroid uptake measurement 0.27 70.00 $18.90

78013 Thyroid imaging w/blood flow 5.51 70.00 $385.70

78013 TC Thyroid imaging w/blood flow 5.00 70.00 $350.00

78013 26 Thyroid imaging w/blood flow 0.51 70.00 $35.70

78014 Thyroid imaging w/blood flow 6.99 70.00 $489.30

78014 TC Thyroid imaging w/blood flow 6.30 70.00 $441.00

78014 26 Thyroid imaging w/blood flow 0.69 70.00 $48.30

78015 Thyroid met imaging 6.39 70.00 $447.30

78015 TC Thyroid met imaging 5.47 70.00 $382.90

78015 26 Thyroid met imaging 0.92 70.00 $64.40

78016 Thyroid met imaging/studies 8.21 70.00 $574.70

78016 TC Thyroid met imaging/studies 7.23 70.00 $506.10

78016 26 Thyroid met imaging/studies 0.98 70.00 $68.60

78018 Thyroid met imaging body 9.04 70.00 $632.80

78018 TC Thyroid met imaging body 7.87 70.00 $550.90

78018 26 Thyroid met imaging body 1.17 70.00 $81.90

78020 Thyroid met uptake 2.42 70.00 $169.40

78020 TC Thyroid met uptake 1.63 70.00 $114.10

78020 26 Thyroid met uptake 0.79 70.00 $55.30

78070 Parathyroid planar imaging 8.72 70.00 $610.40

78070 TC Parathyroid planar imaging 7.60 70.00 $532.00

78070 26 Parathyroid planar imaging 1.12 70.00 $78.40

78071 Parathyrd planar w/wo subtrj 10.39 70.00 $727.30

78071 TC Parathyrd planar w/wo subtrj 8.72 70.00 $610.40

78071 26 Parathyrd planar w/wo subtrj 1.67 70.00 $116.90

78072 Parathyrd planar w/spect&ct 11.89 70.00 $832.30

78072 TC Parathyrd planar w/spect&ct 9.72 70.00 $680.40

78072 26 Parathyrd planar w/spect&ct 2.17 70.00 $151.90

78075 Adrenal cortex & medulla img 13.13 70.00 $919.10

78075 TC Adrenal cortex & medulla img 12.07 70.00 $844.90

78075 26 Adrenal cortex & medulla img 1.06 70.00 $74.20

78099 Endocrine nuclear procedure 0.00 70.00 $0.00

78099 TC Endocrine nuclear procedure 0.00 70.00 $0.00

78099 26 Endocrine nuclear procedure 0.00 70.00 $0.00

78102 Bone marrow imaging ltd 4.92 70.00 $344.40

78102 TC Bone marrow imaging ltd 4.16 70.00 $291.20

78102 26 Bone marrow imaging ltd 0.76 70.00 $53.20

78103 Bone marrow imaging mult 6.40 70.00 $448.00

78103 TC Bone marrow imaging mult 5.40 70.00 $378.00

78103 26 Bone marrow imaging mult 1.00 70.00 $70.00

78104 Bone marrow imaging body 7.10 70.00 $497.00

78104 TC Bone marrow imaging body 6.03 70.00 $422.10

78104 26 Bone marrow imaging body 1.07 70.00 $74.90

78110 Plasma volume single 2.98 70.00 $208.60

78110 TC Plasma volume single 2.70 70.00 $189.00

78110 26 Plasma volume single 0.28 70.00 $19.60

78111 Plasma volume multiple 2.79 70.00 $195.30

78111 TC Plasma volume multiple 2.48 70.00 $173.60

78111 26 Plasma volume multiple 0.31 70.00 $21.70

78120 Red cell mass single 2.72 70.00 $190.40

78120 TC Red cell mass single 2.39 70.00 $167.30

78120 26 Red cell mass single 0.33 70.00 $23.10

78121 Red cell mass multiple 3.05 70.00 $213.50

78121 TC Red cell mass multiple 2.60 70.00 $182.00

78121 26 Red cell mass multiple 0.45 70.00 $31.50

78122 Blood volume 2.78 70.00 $194.60

78122 TC Blood volume 2.19 70.00 $153.30

78122 26 Blood volume 0.59 70.00 $41.30

78130 Red cell survival study 4.56 70.00 $319.20

78130 TC Red cell survival study 3.74 70.00 $261.80

78130 26 Red cell survival study 0.82 70.00 $57.40

78135 Red cell survival kinetics 10.18 70.00 $712.60

78135 TC Red cell survival kinetics 9.26 70.00 $648.20

78135 26 Red cell survival kinetics 0.92 70.00 $64.40

78140 Red cell sequestration 3.93 70.00 $275.10

78140 TC Red cell sequestration 3.08 70.00 $215.60

78140 26 Red cell sequestration 0.85 70.00 $59.50

78185 Spleen imaging 6.15 70.00 $430.50

78185 TC Spleen imaging 5.58 70.00 $390.60

78185 26 Spleen imaging 0.57 70.00 $39.90

78190 Platelet survival kinetics 11.40 70.00 $798.00

78190 TC Platelet survival kinetics 9.85 70.00 $689.50

78190 26 Platelet survival kinetics 1.55 70.00 $108.50

78191 Platelet survival 4.83 70.00 $338.10

78191 TC Platelet survival 3.95 70.00 $276.50

78191 26 Platelet survival 0.88 70.00 $61.60

78195 Lymph system imaging 10.33 70.00 $723.10

78195 TC Lymph system imaging 8.66 70.00 $606.20

78195 26 Lymph system imaging 1.67 70.00 $116.90

78199 Blood/lymph nuclear exam 0.00 70.00 $0.00

78199 TC Blood/lymph nuclear exam 0.00 70.00 $0.00

78199 26 Blood/lymph nuclear exam 0.00 70.00 $0.00

78201 Liver imaging 5.46 70.00 $382.20

78201 TC Liver imaging 4.85 70.00 $339.50

78201 26 Liver imaging 0.61 70.00 $42.70

78202 Liver imaging with flow 5.82 70.00 $407.40

78202 TC Liver imaging with flow 5.15 70.00 $360.50

78202 26 Liver imaging with flow 0.67 70.00 $46.90

78205 Liver imaging (3d) 6.10 70.00 $427.00

78205 TC Liver imaging (3d) 5.14 70.00 $359.80

78205 26 Liver imaging (3d) 0.96 70.00 $67.20

78206 Liver image (3d) with flow 9.97 70.00 $697.90

78206 TC Liver image (3d) with flow 8.63 70.00 $604.10

78206 26 Liver image (3d) with flow 1.34 70.00 $93.80

78215 Liver and spleen imaging 5.63 70.00 $394.10

78215 TC Liver and spleen imaging 4.95 70.00 $346.50

78215 26 Liver and spleen imaging 0.68 70.00 $47.60

78216 Liver & spleen image/flow 3.64 70.00 $254.80

78216 TC Liver & spleen image/flow 2.85 70.00 $199.50

78216 26 Liver & spleen image/flow 0.79 70.00 $55.30

78226 Hepatobiliary system imaging 9.62 70.00 $673.40

78226 TC Hepatobiliary system imaging 8.58 70.00 $600.60

78226 26 Hepatobiliary system imaging 1.04 70.00 $72.80

78227 Hepatobil syst image w/drug 13.04 70.00 $912.80

78227 TC Hepatobil syst image w/drug 11.78 70.00 $824.60

78227 26 Hepatobil syst image w/drug 1.26 70.00 $88.20

78230 Salivary gland imaging 5.01 70.00 $350.70

78230 TC Salivary gland imaging 4.38 70.00 $306.60

78230 26 Salivary gland imaging 0.63 70.00 $44.10

78231 Serial salivary imaging 3.75 70.00 $262.50

78231 TC Serial salivary imaging 3.02 70.00 $211.40

78231 26 Serial salivary imaging 0.73 70.00 $51.10

78232 Salivary gland function exam 2.86 70.00 $200.20

78232 TC Salivary gland function exam 2.28 70.00 $159.60

78232 26 Salivary gland function exam 0.58 70.00 $40.60

78258 Esophageal motility study 6.38 70.00 $446.60

78258 TC Esophageal motility study 5.36 70.00 $375.20

78258 26 Esophageal motility study 1.02 70.00 $71.40

78261 Gastric mucosa imaging 7.34 70.00 $513.80

78261 TC Gastric mucosa imaging 6.35 70.00 $444.50

78261 26 Gastric mucosa imaging 0.99 70.00 $69.30

78262 Gastroesophageal reflux exam 7.07 70.00 $494.90

78262 TC Gastroesophageal reflux exam 6.13 70.00 $429.10

78262 26 Gastroesophageal reflux exam 0.94 70.00 $65.80

78264 Gastric emptying study 8.40 70.00 $588.00

78264 TC Gastric emptying study 7.28 70.00 $509.60

78264 26 Gastric emptying study 1.12 70.00 $78.40

78267 Breath tst attain/anal c-14 0.00 70.00 $0.00

78268 Breath test analysis c-14 0.00 70.00 $0.00

78270 Vit b-12 absorption exam 2.94 70.00 $205.80

78270 TC Vit b-12 absorption exam 2.64 70.00 $184.80

78270 26 Vit b-12 absorption exam 0.30 70.00 $21.00

78271 Vit b-12 absrp exam int fac 2.62 70.00 $183.40

78271 TC Vit b-12 absrp exam int fac 2.33 70.00 $163.10

78271 26 Vit b-12 absrp exam int fac 0.29 70.00 $20.30

78272 Vit b-12 absorp combined 2.81 70.00 $196.70

78272 TC Vit b-12 absorp combined 2.43 70.00 $170.10

78272 26 Vit b-12 absorp combined 0.38 70.00 $26.60

78278 Acute gi blood loss imaging 10.14 70.00 $709.80

78278 TC Acute gi blood loss imaging 8.74 70.00 $611.80

78278 26 Acute gi blood loss imaging 1.40 70.00 $98.00

78282 Gi protein loss exam 0.00 70.00 $0.00

78282 TC Gi protein loss exam 0.00 70.00 $0.00

78282 26 Gi protein loss exam 0.55 70.00 $38.50

78290 Meckels divert exam 9.66 70.00 $676.20

78290 TC Meckels divert exam 8.70 70.00 $609.00

78290 26 Meckels divert exam 0.96 70.00 $67.20

78291 Leveen/shunt patency exam 7.22 70.00 $505.40

78291 TC Leveen/shunt patency exam 6.02 70.00 $421.40

78291 26 Leveen/shunt patency exam 1.20 70.00 $84.00

78299 Gi nuclear procedure 0.00 70.00 $0.00

78299 TC Gi nuclear procedure 0.00 70.00 $0.00

78299 26 Gi nuclear procedure 0.00 70.00 $0.00

78300 Bone imaging limited area 5.23 70.00 $366.10

78300 TC Bone imaging limited area 4.34 70.00 $303.80

78300 26 Bone imaging limited area 0.89 70.00 $62.30

78305 Bone imaging multiple areas 6.69 70.00 $468.30

78305 TC Bone imaging multiple areas 5.53 70.00 $387.10

78305 26 Bone imaging multiple areas 1.16 70.00 $81.20

78306 Bone imaging whole body 7.31 70.00 $511.70

78306 TC Bone imaging whole body 6.11 70.00 $427.70

78306 26 Bone imaging whole body 1.20 70.00 $84.00

78315 Bone imaging 3 phase 10.08 70.00 $705.60

78315 TC Bone imaging 3 phase 8.65 70.00 $605.50

78315 26 Bone imaging 3 phase 1.43 70.00 $100.10

78320 Bone imaging (3d) 6.61 70.00 $462.70

78320 TC Bone imaging (3d) 5.18 70.00 $362.60

78320 26 Bone imaging (3d) 1.43 70.00 $100.10

78350 Bone mineral single photon 0.93 70.00 $65.10

78350 TC Bone mineral single photon 0.62 70.00 $43.40

78350 26 Bone mineral single photon 0.31 70.00 $21.70

78351 Bone mineral dual photon 0.43 70.00 $30.10

78399 Musculoskeletal nuclear exam 0.00 70.00 $0.00

78399 TC Musculoskeletal nuclear exam 0.00 70.00 $0.00

78399 26 Musculoskeletal nuclear exam 0.00 70.00 $0.00

78414 Non-imaging heart function 0.00 70.00 $0.00

78414 TC Non-imaging heart function 0.00 70.00 $0.00

78414 26 Non-imaging heart function 0.64 70.00 $44.80

78428 Cardiac shunt imaging 5.24 70.00 $366.80

78428 TC Cardiac shunt imaging 4.17 70.00 $291.90

78428 26 Cardiac shunt imaging 1.07 70.00 $74.90

78445 Vascular flow imaging 5.21 70.00 $364.70

78445 TC Vascular flow imaging 4.54 70.00 $317.80

78445 26 Vascular flow imaging 0.67 70.00 $46.90

78451 Ht muscle image spect sing 9.90 70.00 $693.00

78451 TC Ht muscle image spect sing 8.00 70.00 $560.00

78451 26 Ht muscle image spect sing 1.90 70.00 $133.00

78452 Ht muscle image spect mult 13.71 70.00 $959.70

78452 TC Ht muscle image spect mult 11.47 70.00 $802.90

78452 26 Ht muscle image spect mult 2.24 70.00 $156.80

78453 Ht muscle image planar sing 8.83 70.00 $618.10

78453 TC Ht muscle image planar sing 7.44 70.00 $520.80

78453 26 Ht muscle image planar sing 1.39 70.00 $97.30

78454 Ht musc image planar mult 12.64 70.00 $884.80

78454 TC Ht musc image planar mult 10.76 70.00 $753.20

78454 26 Ht musc image planar mult 1.88 70.00 $131.60

78456 Acute venous thrombus image 9.30 70.00 $651.00

78456 TC Acute venous thrombus image 7.92 70.00 $554.40

78456 26 Acute venous thrombus image 1.38 70.00 $96.60

78457 Venous thrombosis imaging 5.08 70.00 $355.60

78457 TC Venous thrombosis imaging 4.02 70.00 $281.40

78457 26 Venous thrombosis imaging 1.06 70.00 $74.20

78458 Ven thrombosis images bilat 5.95 70.00 $416.50

78458 TC Ven thrombosis images bilat 4.68 70.00 $327.60

78458 26 Ven thrombosis images bilat 1.27 70.00 $88.90

78459 Heart muscle imaging (pet) 0.00 70.00 $0.00

78459 TC Heart muscle imaging (pet) 0.00 70.00 $0.00

78459 26 Heart muscle imaging (pet) 2.06 70.00 $144.20

78466 Heart infarct image 5.65 70.00 $395.50

78466 TC Heart infarct image 4.66 70.00 $326.20

78466 26 Heart infarct image 0.99 70.00 $69.30

78468 Heart infarct image (ef) 5.60 70.00 $392.00

78468 TC Heart infarct image (ef) 4.50 70.00 $315.00

78468 26 Heart infarct image (ef) 1.10 70.00 $77.00

78469 Heart infarct image (3d) 6.60 70.00 $462.00

78469 TC Heart infarct image (3d) 5.31 70.00 $371.70

78469 26 Heart infarct image (3d) 1.29 70.00 $90.30

78472 Gated heart planar single 6.67 70.00 $466.90

78472 TC Gated heart planar single 5.31 70.00 $371.70

78472 26 Gated heart planar single 1.36 70.00 $95.20

78473 Gated heart multiple 8.37 70.00 $585.90

78473 TC Gated heart multiple 6.36 70.00 $445.20

78473 26 Gated heart multiple 2.01 70.00 $140.70

78481 Heart first pass single 5.06 70.00 $354.20

78481 TC Heart first pass single 3.71 70.00 $259.70

78481 26 Heart first pass single 1.35 70.00 $94.50

78483 Heart first pass multiple 6.89 70.00 $482.30

78483 TC Heart first pass multiple 4.87 70.00 $340.90

78483 26 Heart first pass multiple 2.02 70.00 $141.40

78491 Heart image (pet) single 0.00 70.00 $0.00

78491 TC Heart image (pet) single 0.00 70.00 $0.00

78491 26 Heart image (pet) single 2.07 70.00 $144.90

78492 Heart image (pet) multiple 0.00 70.00 $0.00

78492 TC Heart image (pet) multiple 0.00 70.00 $0.00

78492 26 Heart image (pet) multiple 2.60 70.00 $182.00

78494 Heart image spect 6.49 70.00 $454.30

78494 TC Heart image spect 4.85 70.00 $339.50

78494 26 Heart image spect 1.64 70.00 $114.80

78496 Heart first pass add-on 1.28 70.00 $89.60

78496 TC Heart first pass add-on 0.59 70.00 $41.30

78496 26 Heart first pass add-on 0.69 70.00 $48.30

78499 Cardiovascular nuclear exam 0.00 70.00 $0.00

78499 TC Cardiovascular nuclear exam 0.00 70.00 $0.00

78499 26 Cardiovascular nuclear exam 0.00 70.00 $0.00

78579 Lung ventilation imaging 5.35 70.00 $374.50

78579 TC Lung ventilation imaging 4.69 70.00 $328.30

78579 26 Lung ventilation imaging 0.66 70.00 $46.20

78580 Lung perfusion imaging 6.92 70.00 $484.40

78580 TC Lung perfusion imaging 5.89 70.00 $412.30

78580 26 Lung perfusion imaging 1.03 70.00 $72.10

78582 Lung ventilat&perfus imaging 9.72 70.00 $680.40

78582 TC Lung ventilat&perfus imaging 8.22 70.00 $575.40

78582 26 Lung ventilat&perfus imaging 1.50 70.00 $105.00

78597 Lung perfusion differential 5.86 70.00 $410.20

78597 TC Lung perfusion differential 4.84 70.00 $338.80

78597 26 Lung perfusion differential 1.02 70.00 $71.40

78598 Lung perf&ventilat diferentl 8.89 70.00 $622.30

78598 TC Lung perf&ventilat diferentl 7.71 70.00 $539.70

78598 26 Lung perf&ventilat diferentl 1.18 70.00 $82.60

78599 Respiratory nuclear exam 0.00 70.00 $0.00

78599 TC Respiratory nuclear exam 0.00 70.00 $0.00

78599 26 Respiratory nuclear exam 0.00 70.00 $0.00

78600 Brain image < 4 views 5.34 70.00 $373.80

78600 TC Brain image < 4 views 4.72 70.00 $330.40

78600 26 Brain image < 4 views 0.62 70.00 $43.40

78601 Brain image w/flow < 4 views 6.23 70.00 $436.10

78601 TC Brain image w/flow < 4 views 5.52 70.00 $386.40

78601 26 Brain image w/flow < 4 views 0.71 70.00 $49.70

78605 Brain image 4+ views 5.76 70.00 $403.20

78605 TC Brain image 4+ views 5.01 70.00 $350.70

78605 26 Brain image 4+ views 0.75 70.00 $52.50

78606 Brain image w/flow 4 + views 9.66 70.00 $676.20

78606 TC Brain image w/flow 4 + views 8.77 70.00 $613.90

78606 26 Brain image w/flow 4 + views 0.89 70.00 $62.30

78607 Brain imaging (3d) 10.23 70.00 $716.10

78607 TC Brain imaging (3d) 8.55 70.00 $598.50

78607 26 Brain imaging (3d) 1.68 70.00 $117.60

78608 Brain imaging (pet) 0.00 70.00 $0.00

78608 TC Brain imaging (pet) 0.00 70.00 $0.00

78608 26 Brain imaging (pet) 2.09 70.00 $146.30

78609 Brain imaging (pet) 2.17 70.00 $151.90

78609 TC Brain imaging (pet) 0.00 70.00 $0.00

78609 26 Brain imaging (pet) 2.17 70.00 $151.90

78610 Brain flow imaging only 5.05 70.00 $353.50

78610 TC Brain flow imaging only 4.63 70.00 $324.10

78610 26 Brain flow imaging only 0.42 70.00 $29.40

78630 Cerebrospinal fluid scan 9.86 70.00 $690.20

78630 TC Cerebrospinal fluid scan 8.90 70.00 $623.00

78630 26 Cerebrospinal fluid scan 0.96 70.00 $67.20

78635 Csf ventriculography 9.89 70.00 $692.30

78635 TC Csf ventriculography 9.01 70.00 $630.70

78635 26 Csf ventriculography 0.88 70.00 $61.60

78645 Csf shunt evaluation 9.40 70.00 $658.00

78645 TC Csf shunt evaluation 8.61 70.00 $602.70

78645 26 Csf shunt evaluation 0.79 70.00 $55.30

78647 Cerebrospinal fluid scan 10.19 70.00 $713.30

78647 TC Cerebrospinal fluid scan 8.94 70.00 $625.80

78647 26 Cerebrospinal fluid scan 1.25 70.00 $87.50

78650 Csf leakage imaging 9.70 70.00 $679.00

78650 TC Csf leakage imaging 8.84 70.00 $618.80

78650 26 Csf leakage imaging 0.86 70.00 $60.20

78660 Nuclear exam of tear flow 5.11 70.00 $357.70

78660 TC Nuclear exam of tear flow 4.38 70.00 $306.60

78660 26 Nuclear exam of tear flow 0.73 70.00 $51.10

78699 Nervous system nuclear exam 0.00 70.00 $0.00

78699 TC Nervous system nuclear exam 0.00 70.00 $0.00

78699 26 Nervous system nuclear exam 0.00 70.00 $0.00

78700 Kidney imaging morphol 4.97 70.00 $347.90

78700 TC Kidney imaging morphol 4.35 70.00 $304.50

78700 26 Kidney imaging morphol 0.62 70.00 $43.40

78701 Kidney imaging with flow 6.10 70.00 $427.00

78701 TC Kidney imaging with flow 5.43 70.00 $380.10

78701 26 Kidney imaging with flow 0.67 70.00 $46.90

78707 K flow/funct image w/o drug 6.73 70.00 $471.10

78707 TC K flow/funct image w/o drug 5.41 70.00 $378.70

78707 26 K flow/funct image w/o drug 1.32 70.00 $92.40

78708 K flow/funct image w/drug 5.03 70.00 $352.10

78708 TC K flow/funct image w/drug 3.34 70.00 $233.80

78708 26 K flow/funct image w/drug 1.69 70.00 $118.30

78709 K flow/funct image multiple 10.48 70.00 $733.60

78709 TC K flow/funct image multiple 8.56 70.00 $599.20

78709 26 K flow/funct image multiple 1.92 70.00 $134.40

78710 Kidney imaging (3d) 5.73 70.00 $401.10

78710 TC Kidney imaging (3d) 4.89 70.00 $342.30

78710 26 Kidney imaging (3d) 0.84 70.00 $58.80

78725 Kidney function study 3.13 70.00 $219.10

78725 TC Kidney function study 2.62 70.00 $183.40

78725 26 Kidney function study 0.51 70.00 $35.70

78730 Urinary bladder retention 2.22 70.00 $155.40

78730 TC Urinary bladder retention 2.00 70.00 $140.00

78730 26 Urinary bladder retention 0.22 70.00 $15.40

78740 Ureteral reflux study 6.34 70.00 $443.80

78740 TC Ureteral reflux study 5.55 70.00 $388.50

78740 26 Ureteral reflux study 0.79 70.00 $55.30

78761 Testicular imaging w/flow 6.11 70.00 $427.70

78761 TC Testicular imaging w/flow 5.09 70.00 $356.30

78761 26 Testicular imaging w/flow 1.02 70.00 $71.40

78799 Genitourinary nuclear exam 0.00 70.00 $0.00

78799 TC Genitourinary nuclear exam 0.00 70.00 $0.00

78799 26 Genitourinary nuclear exam 0.00 70.00 $0.00

78800 Tumor imaging limited area 5.52 70.00 $386.40

78800 TC Tumor imaging limited area 4.58 70.00 $320.60

78800 26 Tumor imaging limited area 0.94 70.00 $65.80

78801 Tumor imaging mult areas 7.55 70.00 $528.50

78801 TC Tumor imaging mult areas 6.42 70.00 $449.40

78801 26 Tumor imaging mult areas 1.13 70.00 $79.10

78802 Tumor imaging whole body 9.42 70.00 $659.40

78802 TC Tumor imaging whole body 8.22 70.00 $575.40

78802 26 Tumor imaging whole body 1.20 70.00 $84.00

78803 Tumor imaging (3d) 9.89 70.00 $692.30

78803 TC Tumor imaging (3d) 8.41 70.00 $588.70

78803 26 Tumor imaging (3d) 1.48 70.00 $103.60

78804 Tumor imaging whole body 16.55 70.00 $1,158.50

78804 TC Tumor imaging whole body 15.07 70.00 $1,054.90

78804 26 Tumor imaging whole body 1.48 70.00 $103.60

78805 Abscess imaging ltd area 5.27 70.00 $368.90

78805 TC Abscess imaging ltd area 4.25 70.00 $297.50

78805 26 Abscess imaging ltd area 1.02 70.00 $71.40

78806 Abscess imaging whole body 9.68 70.00 $677.60

78806 TC Abscess imaging whole body 8.49 70.00 $594.30

78806 26 Abscess imaging whole body 1.19 70.00 $83.30

78807 Nuclear localization/abscess 9.90 70.00 $693.00

78807 TC Nuclear localization/abscess 8.44 70.00 $590.80

78807 26 Nuclear localization/abscess 1.46 70.00 $102.20

78808 Iv inj ra drug dx study 1.27 70.00 $88.90

78811 Pet image ltd area 0.00 70.00 $0.00

78811 TC Pet image ltd area 0.00 70.00 $0.00

78811 26 Pet image ltd area 2.24 70.00 $156.80

78812 Pet image skull-thigh 0.00 70.00 $0.00

78812 TC Pet image skull-thigh 0.00 70.00 $0.00

78812 26 Pet image skull-thigh 2.75 70.00 $192.50

78813 Pet image full body 0.00 70.00 $0.00

78813 TC Pet image full body 0.00 70.00 $0.00

78813 26 Pet image full body 2.87 70.00 $200.90

78814 Pet image w/ct lmtd 0.00 70.00 $0.00

78814 TC Pet image w/ct lmtd 0.00 70.00 $0.00

78814 26 Pet image w/ct lmtd 3.19 70.00 $223.30

78815 Pet image w/ct skull-thigh 0.00 70.00 $0.00

78815 TC Pet image w/ct skull-thigh 0.00 70.00 $0.00

78815 26 Pet image w/ct skull-thigh 3.50 70.00 $245.00

78816 Pet image w/ct full body 0.00 70.00 $0.00

78816 TC Pet image w/ct full body 0.00 70.00 $0.00

78816 26 Pet image w/ct full body 3.52 70.00 $246.40

78999 Nuclear diagnostic exam 0.00 70.00 $0.00

78999 TC Nuclear diagnostic exam 0.00 70.00 $0.00

78999 26 Nuclear diagnostic exam 0.00 70.00 $0.00

79005 Nuclear rx oral admin 3.86 70.00 $270.20

79005 TC Nuclear rx oral admin 1.38 70.00 $96.60

79005 26 Nuclear rx oral admin 2.48 70.00 $173.60

79101 Nuclear rx iv admin 4.03 70.00 $282.10

79101 TC Nuclear rx iv admin 1.35 70.00 $94.50

79101 26 Nuclear rx iv admin 2.68 70.00 $187.60

79200 Nuclear rx intracav admin 3.84 70.00 $268.80

79200 TC Nuclear rx intracav admin 1.46 70.00 $102.20

79200 26 Nuclear rx intracav admin 2.38 70.00 $166.60

79300 Nuclr rx interstit colloid 0.00 70.00 $0.00

79300 TC Nuclr rx interstit colloid 0.00 70.00 $0.00

79300 26 Nuclr rx interstit colloid 2.05 70.00 $143.50

79403 Hematopoietic nuclear tx 5.38 70.00 $376.60

79403 TC Hematopoietic nuclear tx 2.27 70.00 $158.90

79403 26 Hematopoietic nuclear tx 3.11 70.00 $217.70

79440 Nuclear rx intra-articular 3.64 70.00 $254.80

79440 TC Nuclear rx intra-articular 1.13 70.00 $79.10

79440 26 Nuclear rx intra-articular 2.51 70.00 $175.70

79445 Nuclear rx intra-arterial 0.00 70.00 $0.00

79445 TC Nuclear rx intra-arterial 0.00 70.00 $0.00

79445 26 Nuclear rx intra-arterial 3.37 70.00 $235.90

79999 Nuclear medicine therapy 0.00 70.00 $0.00

79999 TC Nuclear medicine therapy 0.00 70.00 $0.00

79999 26 Nuclear medicine therapy 0.00 70.00 $0.00

80047 Metabolic panel ionized ca 0.00 58.28 $0.00

80048 Metabolic panel total ca 0.00 58.28 $0.00

80050 General health panel 0.00 58.28 $0.00

80051 Electrolyte panel 0.00 58.28 $0.00

80053 Comprehen metabolic panel 0.00 58.28 $0.00

80055 Obstetric panel 0.00 58.28 $0.00

80061 Lipid panel 0.00 58.28 $0.00

80069 Renal function panel 0.00 58.28 $0.00

80074 Acute hepatitis panel 0.00 58.28 $0.00

80076 Hepatic function panel 0.00 58.28 $0.00

80150 Assay of amikacin 0.00 58.28 $0.00

80155 Drug screen quant caffeine 0.00 58.28 $0.00

80156 Assay carbamazepine total 0.00 58.28 $0.00

80157 Assay carbamazepine free 0.00 58.28 $0.00

80158 Assay of cyclosporine 0.00 58.28 $0.00

80159 Drug screen quant clozapine 0.00 58.28 $0.00

80162 Assay of digoxin total 0.00 58.28 $0.00

80163 Assay of digoxin free 0.00 58.28 $0.00

80164 Assay dipropylacetic acd tot 0.00 58.28 $0.00

80165 Dipropylacetic acid free 0.00 58.28 $0.00

80168 Assay of ethosuximide 0.00 58.28 $0.00

80169 Drug screen quant everolimus 0.00 58.28 $0.00

80170 Assay of gentamicin 0.00 58.28 $0.00

80171 Drug screen quant gabapentin 0.00 58.28 $0.00

80173 Assay of haloperidol 0.00 58.28 $0.00

80175 Drug screen quan lamotrigine 0.00 58.28 $0.00

80176 Assay of lidocaine 0.00 58.28 $0.00

80177 Drug scrn quan levetiracetam 0.00 58.28 $0.00

80178 Assay of lithium 0.00 58.28 $0.00

80180 Drug scrn quan mycophenolate 0.00 58.28 $0.00

80183 Drug scrn quant oxcarbazepin 0.00 58.28 $0.00

80184 Assay of phenobarbital 0.00 58.28 $0.00

80185 Assay of phenytoin total 0.00 58.28 $0.00

80186 Assay of phenytoin free 0.00 58.28 $0.00

80188 Assay of primidone 0.00 58.28 $0.00

80190 Assay of procainamide 0.00 58.28 $0.00

80192 Assay of procainamide 0.00 58.28 $0.00

80194 Assay of quinidine 0.00 58.28 $0.00

80195 Assay of sirolimus 0.00 58.28 $0.00

80197 Assay of tacrolimus 0.00 58.28 $0.00

80198 Assay of theophylline 0.00 58.28 $0.00

80199 Drug screen quant tiagabine 0.00 58.28 $0.00

80200 Assay of tobramycin 0.00 58.28 $0.00

80201 Assay of topiramate 0.00 58.28 $0.00

80202 Assay of vancomycin 0.00 58.28 $0.00

80203 Drug screen quant zonisamide 0.00 58.28 $0.00

80299 Quantitative assay drug 0.00 58.28 $0.00

80300 Drug screen non tlc devices 0.00 58.28 $0.00

80301 Drug screen class list a 0.00 58.28 $0.00

80302 Drug screen prsmptv 1 class 0.00 58.28 $0.00

80303 Drug screen one/mult class 0.00 58.28 $0.00

80304 Drug screen one/mult class 0.00 58.28 $0.00

80320 Drug screen quantalcohols 0.00 58.28 $0.00

80321 Alcohols biomarkers 1or 2 0.00 58.28 $0.00

80322 Alcohols biomarkers 3/more 0.00 58.28 $0.00

80323 Alkaloids nos 0.00 58.28 $0.00

80324 Drug screen amphetamines 1/2 0.00 58.28 $0.00

80325 Amphetamines 3or 4 0.00 58.28 $0.00

80326 Amphetamines 5 or more 0.00 58.28 $0.00

80327 Anabolic steroid 1 or 2 0.00 58.28 $0.00

80328 Anabolic steroid 3 or more 0.00 58.28 $0.00

80329 Analgesics non-opioid 1 or 2 0.00 58.28 $0.00

80330 Analgesics non-opioid 3-5 0.00 58.28 $0.00

80331 Analgesics non-opioid 6/more 0.00 58.28 $0.00

80332 Antidepressants class 1 or 2 0.00 58.28 $0.00

80333 Antidepressants class 3-5 0.00 58.28 $0.00

80334 Antidepressants class 6/more 0.00 58.28 $0.00

80335 Antidepressant tricyclic 1/2 0.00 58.28 $0.00

80336 Antidepressant tricyclic 3-5 0.00 58.28 $0.00

80337 Tricyclic & cyclicals 6/more 0.00 58.28 $0.00

80338 Antidepressant not specified 0.00 58.28 $0.00

80339 Antiepileptics nos 1-3 0.00 58.28 $0.00

80340 Antiepileptics nos 4-6 0.00 58.28 $0.00

80341 Antiepileptics nos 7/more 0.00 58.28 $0.00

80342 Antipsychotics nos 1-3 0.00 58.28 $0.00

80343 Antipsychotics nos 4-6 0.00 58.28 $0.00

80344 Antipsychotics nos 7/more 0.00 58.28 $0.00

80345 Drug screening barbiturates 0.00 58.28 $0.00

80346 Benzodiazepines1-12 0.00 58.28 $0.00

80347 Benzodiazepines 13 or more 0.00 58.28 $0.00

80348 Drug screening buprenorphine 0.00 58.28 $0.00

80349 Cannabinoids natural 0.00 58.28 $0.00

80350 Cannabinoids synthetic 1-3 0.00 58.28 $0.00

80351 Cannabinoids synthetic 4-6 0.00 58.28 $0.00

80352 Cannabinoid synthetic 7/more 0.00 58.28 $0.00

80353 Drug screening cocaine 0.00 58.28 $0.00

80354 Drug screening fentanyl 0.00 58.28 $0.00

80355 Gabapentin non-blood 0.00 58.28 $0.00

80356 Heroin metabolite 0.00 58.28 $0.00

80357 Ketamine and norketamine 0.00 58.28 $0.00

80358 Drug screening methadone 0.00 58.28 $0.00

80359 Methylenedioxyamphetamines 0.00 58.28 $0.00

80360 Methylphenidate 0.00 58.28 $0.00

80361 Opiates 1 or more 0.00 58.28 $0.00

80362 Opioids & opiate analogs 1/2 0.00 58.28 $0.00

80363 Opioids & opiate analogs 3/4 0.00 58.28 $0.00

80364 Opioid &opiate analog 5/more 0.00 58.28 $0.00

80365 Drug screening oxycodone 0.00 58.28 $0.00

80366 Drug screening pregabalin 0.00 58.28 $0.00

80367 Drug screening propoxyphene 0.00 58.28 $0.00

80368 Sedative hypnotics 0.00 58.28 $0.00

80369 Skeletal muscle relaxant 1/2 0.00 58.28 $0.00

80370 Skel musc relaxant 3 or more 0.00 58.28 $0.00

80371 Stimulants synthetic 0.00 58.28 $0.00

80372 Drug screening tapentadol 0.00 58.28 $0.00

80373 Drug screening tramadol 0.00 58.28 $0.00

80374 Stereoisomer analysis 0.00 58.28 $0.00

80375 Drug/substance nos 1-3 0.00 58.28 $0.00

80376 Drug/substance nos 4-6 0.00 58.28 $0.00

80377 Drug/substance nos 7/more 0.00 58.28 $0.00

80400 Acth stimulation panel 0.00 58.28 $0.00

80408 Aldosterone suppression eval 0.00 58.28 $0.00

80410 Calcitonin stimul panel 0.00 58.28 $0.00

80412 Crh stimulation panel 0.00 58.28 $0.00

80414 Testosterone response 0.00 58.28 $0.00

80415 Estradiol response panel 0.00 58.28 $0.00

80416 Renin stimulation panel 0.00 58.28 $0.00

80417 Renin stimulation panel 0.00 58.28 $0.00

80418 Pituitary evaluation panel 0.00 58.28 $0.00

80420 Dexamethasone panel 0.00 58.28 $0.00

80422 Glucagon tolerance panel 0.00 58.28 $0.00

80424 Glucagon tolerance panel 0.00 58.28 $0.00

80426 Gonadotropin hormone panel 0.00 58.28 $0.00

80428 Growth hormone panel 0.00 58.28 $0.00

80430 Growth hormone panel 0.00 58.28 $0.00

80432 Insulin suppression panel 0.00 58.28 $0.00

80434 Insulin tolerance panel 0.00 58.28 $0.00

80435 Insulin tolerance panel 0.00 58.28 $0.00

80436 Metyrapone panel 0.00 58.28 $0.00

80438 Trh stimulation panel 0.00 58.28 $0.00

80439 Trh stimulation panel 0.00 58.28 $0.00

80500 Lab pathology consultation 0.65 58.28 $37.88

80502 Lab pathology consultation 2.05 58.28 $119.47

81000 Urinalysis nonauto w/scope 0.00 58.28 $0.00

81001 Urinalysis auto w/scope 0.00 58.28 $0.00

81002 Urinalysis nonauto w/o scope 0.00 58.28 $0.00

81003 Urinalysis auto w/o scope 0.00 58.28 $0.00

81005 Urinalysis 0.00 58.28 $0.00

81007 Urine screen for bacteria 0.00 58.28 $0.00

81015 Microscopic exam of urine 0.00 58.28 $0.00

81020 Urinalysis glass test 0.00 58.28 $0.00

81025 Urine pregnancy test 0.00 58.28 $0.00

81050 Urinalysis volume measure 0.00 58.28 $0.00

81099 Urinalysis test procedure 0.00 58.28 $0.00

81161 Dmd dup/delet analysis 0.00 58.28 $0.00

81200 Aspa gene 0.00 58.28 $0.00

81201 Apc gene full sequence 0.00 58.28 $0.00

81202 Apc gene known fam variants 0.00 58.28 $0.00

81203 Apc gene dup/delet variants 0.00 58.28 $0.00

81205 Bckdhb gene 0.00 58.28 $0.00

81206 Bcr/abl1 gene major bp 0.00 58.28 $0.00

81207 Bcr/abl1 gene minor bp 0.00 58.28 $0.00

81208 Bcr/abl1 gene other bp 0.00 58.28 $0.00

81209 Blm gene 0.00 58.28 $0.00

81210 Braf gene 0.00 58.28 $0.00

81211 Brca1&2 seq & com dup/del 0.00 58.28 $0.00

81212 Brca1&2 185&5385&6174 var 0.00 58.28 $0.00

81213 Brca1&2 uncom dup/del var 0.00 58.28 $0.00

81214 Brca1 full seq & com dup/del 0.00 58.28 $0.00

81215 Brca1 gene known fam variant 0.00 58.28 $0.00

81216 Brca2 gene full sequence 0.00 58.28 $0.00

81217 Brca2 gene known fam variant 0.00 58.28 $0.00

81220 Cftr gene com variants 0.00 58.28 $0.00

81221 Cftr gene known fam variants 0.00 58.28 $0.00

81222 Cftr gene dup/delet variants 0.00 58.28 $0.00

81223 Cftr gene full sequence 0.00 58.28 $0.00

81224 Cftr gene intron poly t 0.00 58.28 $0.00

81225 Cyp2c19 gene com variants 0.00 58.28 $0.00

81226 Cyp2d6 gene com variants 0.00 58.28 $0.00

81227 Cyp2c9 gene com variants 0.00 58.28 $0.00

81228 Cytogen micrarray copy nmbr 0.00 58.28 $0.00

81229 Cytogen m array copy no&snp 0.00 58.28 $0.00

81235 Egfr gene com variants 0.00 58.28 $0.00

81240 F2 gene 0.00 58.28 $0.00

81241 F5 gene 0.00 58.28 $0.00

81242 Fancc gene 0.00 58.28 $0.00

81243 Fmr1 gene detection 0.00 58.28 $0.00

81244 Fmr1 gene characterization 0.00 58.28 $0.00

81245 Flt3 gene 0.00 58.28 $0.00

81246 Flt3 gene analysis 0.00 58.28 $0.00

81250 G6pc gene 0.00 58.28 $0.00

81251 Gba gene 0.00 58.28 $0.00

81252 Gjb2 gene full sequence 0.00 58.28 $0.00

81253 Gjb2 gene known fam variants 0.00 58.28 $0.00

81254 Gjb6 gene com variants 0.00 58.28 $0.00

81255 Hexa gene 0.00 58.28 $0.00

81256 Hfe gene 0.00 58.28 $0.00

81257 Hba1/hba2 gene 0.00 58.28 $0.00

81260 Ikbkap gene 0.00 58.28 $0.00

81261 Igh gene rearrange amp meth 0.00 58.28 $0.00

81262 Igh gene rearrang dir probe 0.00 58.28 $0.00

81263 Igh vari regional mutation 0.00 58.28 $0.00

81264 Igk rearrangeabn clonal pop 0.00 58.28 $0.00

81265 Str markers specimen anal 0.00 58.28 $0.00

81266 Str markers spec anal addl 0.00 58.28 $0.00

81267 Chimerism anal no cell selec 0.00 58.28 $0.00

81268 Chimerism anal w/cell select 0.00 58.28 $0.00

81270 Jak2 gene 0.00 58.28 $0.00

81275 Kras gene 0.00 58.28 $0.00

81280 Long qt synd gene full seq 0.00 58.28 $0.00

81281 Long qt synd known fam var 0.00 58.28 $0.00

81282 Long qt syn gene dup/dlt var 0.00 58.28 $0.00

81287 Mgmt gene methylation anal 0.00 58.28 $0.00

81288 Mlh1 gene 0.00 58.28 $0.00

81290 Mcoln1 gene 0.00 58.28 $0.00

81291 Mthfr gene 0.00 58.28 $0.00

81292 Mlh1 gene full seq 0.00 58.28 $0.00

81293 Mlh1 gene known variants 0.00 58.28 $0.00

81294 Mlh1 gene dup/delete variant 0.00 58.28 $0.00

81295 Msh2 gene full seq 0.00 58.28 $0.00

81296 Msh2 gene known variants 0.00 58.28 $0.00

81297 Msh2 gene dup/delete variant 0.00 58.28 $0.00

81298 Msh6 gene full seq 0.00 58.28 $0.00

81299 Msh6 gene known variants 0.00 58.28 $0.00

81300 Msh6 gene dup/delete variant 0.00 58.28 $0.00

81301 Microsatellite instability 0.00 58.28 $0.00

81302 Mecp2 gene full seq 0.00 58.28 $0.00

81303 Mecp2 gene known variant 0.00 58.28 $0.00

81304 Mecp2 gene dup/delet variant 0.00 58.28 $0.00

81310 Npm1 gene 0.00 58.28 $0.00

81313 Pca3/klk3 antigen 0.00 58.28 $0.00

81315 Pml/raralpha com breakpoints 0.00 58.28 $0.00

81316 Pml/raralpha 1 breakpoint 0.00 58.28 $0.00

81317 Pms2 gene full seq analysis 0.00 58.28 $0.00

81318 Pms2 known familial variants 0.00 58.28 $0.00

81319 Pms2 gene dup/delet variants 0.00 58.28 $0.00

81321 Pten gene full sequence 0.00 58.28 $0.00

81322 Pten gene known fam variant 0.00 58.28 $0.00

81323 Pten gene dup/delet variant 0.00 58.28 $0.00

81324 Pmp22 gene dup/delet 0.00 58.28 $0.00

81325 Pmp22 gene full sequence 0.00 58.28 $0.00

81326 Pmp22 gene known fam variant 0.00 58.28 $0.00

81330 Smpd1 gene common variants 0.00 58.28 $0.00

81331 Snrpn/ube3a gene 0.00 58.28 $0.00

81332 Serpina1 gene 0.00 58.28 $0.00

81340 Trb@ gene rearrange amplify 0.00 58.28 $0.00

81341 Trb@ gene rearrange dirprobe 0.00 58.28 $0.00

81342 Trg gene rearrangement anal 0.00 58.28 $0.00

81350 Ugt1a1 gene 0.00 58.28 $0.00

81355 Vkorc1 gene 0.00 58.28 $0.00

81370 Hla i & ii typing lr 0.00 58.28 $0.00

81371 Hla i & ii type verify lr 0.00 58.28 $0.00

81372 Hla i typing complete lr 0.00 58.28 $0.00

81373 Hla i typing 1 locus lr 0.00 58.28 $0.00

81374 Hla i typing 1 antigen lr 0.00 58.28 $0.00

81375 Hla ii typing ag equiv lr 0.00 58.28 $0.00

81376 Hla ii typing 1 locus lr 0.00 58.28 $0.00

81377 Hla ii type 1 ag equiv lr 0.00 58.28 $0.00

81378 Hla i & ii typing hr 0.00 58.28 $0.00

81379 Hla i typing complete hr 0.00 58.28 $0.00

81380 Hla i typing 1 locus hr 0.00 58.28 $0.00

81381 Hla i typing 1 allele hr 0.00 58.28 $0.00

81382 Hla ii typing 1 loc hr 0.00 58.28 $0.00

81383 Hla ii typing 1 allele hr 0.00 58.28 $0.00

81400 Mopath procedure level 1 0.00 58.28 $0.00

81410 Aortic dysfunction/dilation 0.00 58.28 $0.00

81411 Aortic dysfunction/dilation 0.00 58.28 $0.00

81415 Exome sequence analysis 0.00 58.28 $0.00

81416 Exome sequence analysis 0.00 58.28 $0.00

81417 Exome re-evaluation 0.00 58.28 $0.00

81420 Fetal chrmoml aneuploidy 0.00 58.28 $0.00

81425 Genome sequence analysis 0.00 58.28 $0.00

81426 Genome sequence analysis 0.00 58.28 $0.00

81427 Genome re-evaluation 0.00 58.28 $0.00

81430 Hearing loss sequence analys 0.00 58.28 $0.00

81431 Hearing loss dup/del analys 0.00 58.28 $0.00

81435 Hereditary colon cancer 0.00 58.28 $0.00

81436 Hereditary colon ca synd 0.00 58.28 $0.00

81440 Mitochondrial gene 0.00 58.28 $0.00

81445 Targeted genomic seq analys 0.00 58.28 $0.00

81460 Whole mitochondrial genome 0.00 58.28 $0.00

81465 Whole mitochondrial genome 0.00 58.28 $0.00

81470 X-linked intellectual dblt 0.00 58.28 $0.00

81471 X-linked intellectual dblt 0.00 58.28 $0.00

81479 Unlisted molecular pathology 0.00 58.28 $0.00

81500 Onco (ovar) two proteins 0.00 58.28 $0.00

81503 Onco (ovar) five proteins 0.00 58.28 $0.00

81504 Oncology tissue of origin 0.00 58.28 $0.00

81506 Endo assay seven anal 0.00 58.28 $0.00

81507 Fetal aneuploidy trisom risk 0.00 58.28 $0.00

81508 Ftl cgen abnor two proteins 0.00 58.28 $0.00

81509 Ftl cgen abnor 3 proteins 0.00 58.28 $0.00

81510 Ftl cgen abnor three anal 0.00 58.28 $0.00

81511 Ftl cgen abnor four anal 0.00 58.28 $0.00

81512 Ftl cgen abnor five anal 0.00 58.28 $0.00

81519 Oncology breast mrna 0.00 58.28 $0.00

81599 Unlisted maaa 0.00 58.28 $0.00

82009 Test for acetone/ketones 0.00 58.28 $0.00

82010 Acetone assay 0.00 58.28 $0.00

82013 Acetylcholinesterase assay 0.00 58.28 $0.00

82016 Acylcarnitines qual 0.00 58.28 $0.00

82017 Acylcarnitines quant 0.00 58.28 $0.00

82024 Assay of acth 0.00 58.28 $0.00

82030 Assay of adp & amp 0.00 58.28 $0.00

82040 Assay of serum albumin 0.00 58.28 $0.00

82042 Assay of urine albumin 0.00 58.28 $0.00

82043 Microalbumin quantitative 0.00 58.28 $0.00

82044 Microalbumin semiquant 0.00 58.28 $0.00

82045 Albumin ischemia modified 0.00 58.28 $0.00

82075 Assay of breath ethanol 0.00 58.28 $0.00

82085 Assay of aldolase 0.00 58.28 $0.00

82088 Assay of aldosterone 0.00 58.28 $0.00

82103 Alpha-1-antitrypsin total 0.00 58.28 $0.00

82104 Alpha-1-antitrypsin pheno 0.00 58.28 $0.00

82105 Alpha-fetoprotein serum 0.00 58.28 $0.00

82106 Alpha-fetoprotein amniotic 0.00 58.28 $0.00

82107 Alpha-fetoprotein l3 0.00 58.28 $0.00

82108 Assay of aluminum 0.00 58.28 $0.00

82120 Amines vaginal fluid qual 0.00 58.28 $0.00

82127 Amino acid single qual 0.00 58.28 $0.00

82128 Amino acids mult qual 0.00 58.28 $0.00

82131 Amino acids single quant 0.00 58.28 $0.00

82135 Assay aminolevulinic acid 0.00 58.28 $0.00

82136 Amino acids quant 2-5 0.00 58.28 $0.00

82139 Amino acids quan 6 or more 0.00 58.28 $0.00

82140 Assay of ammonia 0.00 58.28 $0.00

82143 Amniotic fluid scan 0.00 58.28 $0.00

82150 Assay of amylase 0.00 58.28 $0.00

82154 Androstanediol glucuronide 0.00 58.28 $0.00

82157 Assay of androstenedione 0.00 58.28 $0.00

82160 Assay of androsterone 0.00 58.28 $0.00

82163 Assay of angiotensin ii 0.00 58.28 $0.00

82164 Angiotensin i enzyme test 0.00 58.28 $0.00

82172 Assay of apolipoprotein 0.00 58.28 $0.00

82175 Assay of arsenic 0.00 58.28 $0.00

82180 Assay of ascorbic acid 0.00 58.28 $0.00

82190 Atomic absorption 0.00 58.28 $0.00

82232 Assay of beta-2 protein 0.00 58.28 $0.00

82239 Bile acids total 0.00 58.28 $0.00

82240 Bile acids cholylglycine 0.00 58.28 $0.00

82247 Bilirubin total 0.00 58.28 $0.00

82248 Bilirubin direct 0.00 58.28 $0.00

82252 Fecal bilirubin test 0.00 58.28 $0.00

82261 Assay of biotinidase 0.00 58.28 $0.00

82270 Occult blood feces 0.00 58.28 $0.00

82271 Occult blood other sources 0.00 58.28 $0.00

82272 Occult bld feces 1-3 tests 0.00 58.28 $0.00

82274 Assay test for blood fecal 0.00 58.28 $0.00

82286 Assay of bradykinin 0.00 58.28 $0.00

82300 Assay of cadmium 0.00 58.28 $0.00

82306 Vitamin d 25 hydroxy 0.00 58.28 $0.00

82308 Assay of calcitonin 0.00 58.28 $0.00

82310 Assay of calcium 0.00 58.28 $0.00

82330 Assay of calcium 0.00 58.28 $0.00

82331 Calcium infusion test 0.00 58.28 $0.00

82340 Assay of calcium in urine 0.00 58.28 $0.00

82355 Calculus analysis qual 0.00 58.28 $0.00

82360 Calculus assay quant 0.00 58.28 $0.00

82365 Calculus spectroscopy 0.00 58.28 $0.00

82370 X-ray assay calculus 0.00 58.28 $0.00

82373 Assay c-d transfer measure 0.00 58.28 $0.00

82374 Assay blood carbon dioxide 0.00 58.28 $0.00

82375 Assay carboxyhb quant 0.00 58.28 $0.00

82376 Assay carboxyhb qual 0.00 58.28 $0.00

82378 Carcinoembryonic antigen 0.00 58.28 $0.00

82379 Assay of carnitine 0.00 58.28 $0.00

82380 Assay of carotene 0.00 58.28 $0.00

82382 Assay urine catecholamines 0.00 58.28 $0.00

82383 Assay blood catecholamines 0.00 58.28 $0.00

82384 Assay three catecholamines 0.00 58.28 $0.00

82387 Assay of cathepsin-d 0.00 58.28 $0.00

82390 Assay of ceruloplasmin 0.00 58.28 $0.00

82397 Chemiluminescent assay 0.00 58.28 $0.00

82415 Assay of chloramphenicol 0.00 58.28 $0.00

82435 Assay of blood chloride 0.00 58.28 $0.00

82436 Assay of urine chloride 0.00 58.28 $0.00

82438 Assay other fluid chlorides 0.00 58.28 $0.00

82441 Test for chlorohydrocarbons 0.00 58.28 $0.00

82465 Assay bld/serum cholesterol 0.00 58.28 $0.00

82480 Assay serum cholinesterase 0.00 58.28 $0.00

82482 Assay rbc cholinesterase 0.00 58.28 $0.00

82485 Assay chondroitin sulfate 0.00 58.28 $0.00

82486 Gas/liquid chromatography 0.00 58.28 $0.00

82487 Paper chromatography 0.00 58.28 $0.00

82488 Paper chromatography 0.00 58.28 $0.00

82489 Thin layer chromatography 0.00 58.28 $0.00

82491 Chromotography quant sing 0.00 58.28 $0.00

82492 Chromotography quant mult 0.00 58.28 $0.00

82495 Assay of chromium 0.00 58.28 $0.00

82507 Assay of citrate 0.00 58.28 $0.00

82523 Collagen crosslinks 0.00 58.28 $0.00

82525 Assay of copper 0.00 58.28 $0.00

82528 Assay of corticosterone 0.00 58.28 $0.00

82530 Cortisol free 0.00 58.28 $0.00

82533 Total cortisol 0.00 58.28 $0.00

82540 Assay of creatine 0.00 58.28 $0.00

82541 Column chromotography qual 0.00 58.28 $0.00

82542 Column chromotography quant 0.00 58.28 $0.00

82543 Column chromotograph/isotope 0.00 58.28 $0.00

82544 Column chromotograph/isotope 0.00 58.28 $0.00

82550 Assay of ck (cpk) 0.00 58.28 $0.00

82552 Assay of cpk in blood 0.00 58.28 $0.00

82553 Creatine mb fraction 0.00 58.28 $0.00

82554 Creatine isoforms 0.00 58.28 $0.00

82565 Assay of creatinine 0.00 58.28 $0.00

82570 Assay of urine creatinine 0.00 58.28 $0.00

82575 Creatinine clearance test 0.00 58.28 $0.00

82585 Assay of cryofibrinogen 0.00 58.28 $0.00

82595 Assay of cryoglobulin 0.00 58.28 $0.00

82600 Assay of cyanide 0.00 58.28 $0.00

82607 Vitamin b-12 0.00 58.28 $0.00

82608 B-12 binding capacity 0.00 58.28 $0.00

82610 Cystatin c 0.00 58.28 $0.00

82615 Test for urine cystines 0.00 58.28 $0.00

82626 Dehydroepiandrosterone 0.00 58.28 $0.00

82627 Dehydroepiandrosterone 0.00 58.28 $0.00

82633 Desoxycorticosterone 0.00 58.28 $0.00

82634 Deoxycortisol 0.00 58.28 $0.00

82638 Assay of dibucaine number 0.00 58.28 $0.00

82652 Vit d 1 25-dihydroxy 0.00 58.28 $0.00

82656 Pancreatic elastase fecal 0.00 58.28 $0.00

82657 Enzyme cell activity 0.00 58.28 $0.00

82658 Enzyme cell activity ra 0.00 58.28 $0.00

82664 Electrophoretic test 0.00 58.28 $0.00

82668 Assay of erythropoietin 0.00 58.28 $0.00

82670 Assay of estradiol 0.00 58.28 $0.00

82671 Assay of estrogens 0.00 58.28 $0.00

82672 Assay of estrogen 0.00 58.28 $0.00

82677 Assay of estriol 0.00 58.28 $0.00

82679 Assay of estrone 0.00 58.28 $0.00

82693 Assay of ethylene glycol 0.00 58.28 $0.00

82696 Assay of etiocholanolone 0.00 58.28 $0.00

82705 Fats/lipids feces qual 0.00 58.28 $0.00

82710 Fats/lipids feces quant 0.00 58.28 $0.00

82715 Assay of fecal fat 0.00 58.28 $0.00

82725 Assay of blood fatty acids 0.00 58.28 $0.00

82726 Long chain fatty acids 0.00 58.28 $0.00

82728 Assay of ferritin 0.00 58.28 $0.00

82731 Assay of fetal fibronectin 0.00 58.28 $0.00

82735 Assay of fluoride 0.00 58.28 $0.00

82746 Assay of folic acid serum 0.00 58.28 $0.00

82747 Assay of folic acid rbc 0.00 58.28 $0.00

82757 Assay of semen fructose 0.00 58.28 $0.00

82759 Assay of rbc galactokinase 0.00 58.28 $0.00

82760 Assay of galactose 0.00 58.28 $0.00

82775 Assay galactose transferase 0.00 58.28 $0.00

82776 Galactose transferase test 0.00 58.28 $0.00

82777 Galectin-3 0.00 58.28 $0.00

82784 Assay iga/igd/igg/igm each 0.00 58.28 $0.00

82785 Assay of ige 0.00 58.28 $0.00

82787 Igg 1 2 3 or 4 each 0.00 58.28 $0.00

82800 Blood ph 0.00 58.28 $0.00

82803 Blood gases any combination 0.00 58.28 $0.00

82805 Blood gases w/o2 saturation 0.00 58.28 $0.00

82810 Blood gases o2 sat only 0.00 58.28 $0.00

82820 Hemoglobin-oxygen affinity 0.00 58.28 $0.00

82930 Gastric analy w/ph ea spec 0.00 58.28 $0.00

82938 Gastrin test 0.00 58.28 $0.00

82941 Assay of gastrin 0.00 58.28 $0.00

82943 Assay of glucagon 0.00 58.28 $0.00

82945 Glucose other fluid 0.00 58.28 $0.00

82946 Glucagon tolerance test 0.00 58.28 $0.00

82947 Assay glucose blood quant 0.00 58.28 $0.00

82948 Reagent strip/blood glucose 0.00 58.28 $0.00

82950 Glucose test 0.00 58.28 $0.00

82951 Glucose tolerance test (gtt) 0.00 58.28 $0.00

82952 Gtt-added samples 0.00 58.28 $0.00

82955 Assay of g6pd enzyme 0.00 58.28 $0.00

82960 Test for g6pd enzyme 0.00 58.28 $0.00

82962 Glucose blood test 0.00 58.28 $0.00

82963 Assay of glucosidase 0.00 58.28 $0.00

82965 Assay of gdh enzyme 0.00 58.28 $0.00

82977 Assay of ggt 0.00 58.28 $0.00

82978 Assay of glutathione 0.00 58.28 $0.00

82979 Assay rbc glutathione 0.00 58.28 $0.00

82985 Assay of glycated protein 0.00 58.28 $0.00

83001 Assay of gonadotropin (fsh) 0.00 58.28 $0.00

83002 Assay of gonadotropin (lh) 0.00 58.28 $0.00

83003 Assay growth hormone (hgh) 0.00 58.28 $0.00

83006 Growth stimulation gene 2 0.00 58.28 $0.00

83009 H pylori (c-13) blood 0.00 58.28 $0.00

83010 Assay of haptoglobin quant 0.00 58.28 $0.00

83012 Assay of haptoglobins 0.00 58.28 $0.00

83013 H pylori (c-13) breath 0.00 58.28 $0.00

83014 H pylori drug admin 0.00 58.28 $0.00

83015 Heavy metal screen 0.00 58.28 $0.00

83018 Quantitative screen metals 0.00 58.28 $0.00

83020 Hemoglobin electrophoresis 0.00 58.28 $0.00

83020 26 Hemoglobin electrophoresis 0.53 58.28 $30.89

83021 Hemoglobin chromotography 0.00 58.28 $0.00

83026 Hemoglobin copper sulfate 0.00 58.28 $0.00

83030 Fetal hemoglobin chemical 0.00 58.28 $0.00

83033 Fetal hemoglobin assay qual 0.00 58.28 $0.00

83036 Glycosylated hemoglobin test 0.00 58.28 $0.00

83037 Glycosylated hb home device 0.00 58.28 $0.00

83045 Blood methemoglobin test 0.00 58.28 $0.00

83050 Blood methemoglobin assay 0.00 58.28 $0.00

83051 Assay of plasma hemoglobin 0.00 58.28 $0.00

83060 Blood sulfhemoglobin assay 0.00 58.28 $0.00

83065 Assay of hemoglobin heat 0.00 58.28 $0.00

83068 Hemoglobin stability screen 0.00 58.28 $0.00

83069 Assay of urine hemoglobin 0.00 58.28 $0.00

83070 Assay of hemosiderin qual 0.00 58.28 $0.00

83080 Assay of b hexosaminidase 0.00 58.28 $0.00

83088 Assay of histamine 0.00 58.28 $0.00

83090 Assay of homocystine 0.00 58.28 $0.00

83150 Assay of homovanillic acid 0.00 58.28 $0.00

83491 Assay of corticosteroids 17 0.00 58.28 $0.00

83497 Assay of 5-hiaa 0.00 58.28 $0.00

83498 Assay of progesterone 17-d 0.00 58.28 $0.00

83499 Assay of progesterone 20- 0.00 58.28 $0.00

83500 Assay free hydroxyproline 0.00 58.28 $0.00

83505 Assay total hydroxyproline 0.00 58.28 $0.00

83516 Immunoassay nonantibody 0.00 58.28 $0.00

83518 Immunoassay dipstick 0.00 58.28 $0.00

83519 Ria nonantibody 0.00 58.28 $0.00

83520 Immunoassay quant nos nonab 0.00 58.28 $0.00

83525 Assay of insulin 0.00 58.28 $0.00

83527 Assay of insulin 0.00 58.28 $0.00

83528 Assay of intrinsic factor 0.00 58.28 $0.00

83540 Assay of iron 0.00 58.28 $0.00

83550 Iron binding test 0.00 58.28 $0.00

83570 Assay of idh enzyme 0.00 58.28 $0.00

83582 Assay of ketogenic steroids 0.00 58.28 $0.00

83586 Assay 17- ketosteroids 0.00 58.28 $0.00

83593 Fractionation ketosteroids 0.00 58.28 $0.00

83605 Assay of lactic acid 0.00 58.28 $0.00

83615 Lactate (ld) (ldh) enzyme 0.00 58.28 $0.00

83625 Assay of ldh enzymes 0.00 58.28 $0.00

83630 Lactoferrin fecal (qual) 0.00 58.28 $0.00

83631 Lactoferrin fecal (quant) 0.00 58.28 $0.00

83632 Placental lactogen 0.00 58.28 $0.00

83633 Test urine for lactose 0.00 58.28 $0.00

83655 Assay of lead 0.00 58.28 $0.00

83661 L/s ratio fetal lung 0.00 58.28 $0.00

83662 Foam stability fetal lung 0.00 58.28 $0.00

83663 Fluoro polarize fetal lung 0.00 58.28 $0.00

83664 Lamellar bdy fetal lung 0.00 58.28 $0.00

83670 Assay of lap enzyme 0.00 58.28 $0.00

83690 Assay of lipase 0.00 58.28 $0.00

83695 Assay of lipoprotein(a) 0.00 58.28 $0.00

83698 Assay lipoprotein pla2 0.00 58.28 $0.00

83700 Lipopro bld electrophoretic 0.00 58.28 $0.00

83701 Lipoprotein bld hr fraction 0.00 58.28 $0.00

83704 Lipoprotein bld by nmr 0.00 58.28 $0.00

83718 Assay of lipoprotein 0.00 58.28 $0.00

83719 Assay of blood lipoprotein 0.00 58.28 $0.00

83721 Assay of blood lipoprotein 0.00 58.28 $0.00

83727 Assay of lrh hormone 0.00 58.28 $0.00

83735 Assay of magnesium 0.00 58.28 $0.00

83775 Assay malate dehydrogenase 0.00 58.28 $0.00

83785 Assay of manganese 0.00 58.28 $0.00

83788 Mass spectrometry qual 0.00 58.28 $0.00

83789 Mass spectrometry quant 0.00 58.28 $0.00

83825 Assay of mercury 0.00 58.28 $0.00

83835 Assay of metanephrines 0.00 58.28 $0.00

83857 Assay of methemalbumin 0.00 58.28 $0.00

83861 Microfluid analy tears 0.00 58.28 $0.00

83864 Mucopolysaccharides 0.00 58.28 $0.00

83872 Assay synovial fluid mucin 0.00 58.28 $0.00

83873 Assay of csf protein 0.00 58.28 $0.00

83874 Assay of myoglobin 0.00 58.28 $0.00

83876 Assay myeloperoxidase 0.00 58.28 $0.00

83880 Assay of natriuretic peptide 0.00 58.28 $0.00

83883 Assay nephelometry not spec 0.00 58.28 $0.00

83885 Assay of nickel 0.00 58.28 $0.00

83915 Assay of nucleotidase 0.00 58.28 $0.00

83916 Oligoclonal bands 0.00 58.28 $0.00

83918 Organic acids total quant 0.00 58.28 $0.00

83919 Organic acids qual each 0.00 58.28 $0.00

83921 Organic acid single quant 0.00 58.28 $0.00

83930 Assay of blood osmolality 0.00 58.28 $0.00

83935 Assay of urine osmolality 0.00 58.28 $0.00

83937 Assay of osteocalcin 0.00 58.28 $0.00

83945 Assay of oxalate 0.00 58.28 $0.00

83950 Oncoprotein her-2/neu 0.00 58.28 $0.00

83951 Oncoprotein dcp 0.00 58.28 $0.00

83970 Assay of parathormone 0.00 58.28 $0.00

83986 Assay ph body fluid nos 0.00 58.28 $0.00

83987 Exhaled breath condensate 0.00 58.28 $0.00

83992 Assay for phencyclidine 0.00 58.28 $0.00

83993 Assay for calprotectin fecal 0.00 58.28 $0.00

84030 Assay of blood pku 0.00 58.28 $0.00

84035 Assay of phenylketones 0.00 58.28 $0.00

84060 Assay acid phosphatase 0.00 58.28 $0.00

84061 Phosphatase forensic exam 0.00 58.28 $0.00

84066 Assay prostate phosphatase 0.00 58.28 $0.00

84075 Assay alkaline phosphatase 0.00 58.28 $0.00

84078 Assay alkaline phosphatase 0.00 58.28 $0.00

84080 Assay alkaline phosphatases 0.00 58.28 $0.00

84081 Assay phosphatidylglycerol 0.00 58.28 $0.00

84085 Assay of rbc pg6d enzyme 0.00 58.28 $0.00

84087 Assay phosphohexose enzymes 0.00 58.28 $0.00

84100 Assay of phosphorus 0.00 58.28 $0.00

84105 Assay of urine phosphorus 0.00 58.28 $0.00

84106 Test for porphobilinogen 0.00 58.28 $0.00

84110 Assay of porphobilinogen 0.00 58.28 $0.00

84112 Eval amniotic fluid protein 0.00 58.28 $0.00

84119 Test urine for porphyrins 0.00 58.28 $0.00

84120 Assay of urine porphyrins 0.00 58.28 $0.00

84126 Assay of feces porphyrins 0.00 58.28 $0.00

84132 Assay of serum potassium 0.00 58.28 $0.00

84133 Assay of urine potassium 0.00 58.28 $0.00

84134 Assay of prealbumin 0.00 58.28 $0.00

84135 Assay of pregnanediol 0.00 58.28 $0.00

84138 Assay of pregnanetriol 0.00 58.28 $0.00

84140 Assay of pregnenolone 0.00 58.28 $0.00

84143 Assay of 17-hydroxypregneno 0.00 58.28 $0.00

84144 Assay of progesterone 0.00 58.28 $0.00

84145 Procalcitonin (pct) 0.00 58.28 $0.00

84146 Assay of prolactin 0.00 58.28 $0.00

84150 Assay of prostaglandin 0.00 58.28 $0.00

84152 Assay of psa complexed 0.00 58.28 $0.00

84153 Assay of psa total 0.00 58.28 $0.00

84154 Assay of psa free 0.00 58.28 $0.00

84155 Assay of protein serum 0.00 58.28 $0.00

84156 Assay of protein urine 0.00 58.28 $0.00

84157 Assay of protein other 0.00 58.28 $0.00

84160 Assay of protein any source 0.00 58.28 $0.00

84163 Pappa serum 0.00 58.28 $0.00

84165 Protein e-phoresis serum 0.00 58.28 $0.00

84165 26 Protein e-phoresis serum 0.53 58.28 $30.89

84166 Protein e-phoresis/urine/csf 0.00 58.28 $0.00

84166 26 Protein e-phoresis/urine/csf 0.53 58.28 $30.89

84181 Western blot test 0.00 58.28 $0.00

84181 26 Western blot test 0.53 58.28 $30.89

84182 Protein western blot test 0.00 58.28 $0.00

84182 26 Protein western blot test 0.53 58.28 $30.89

84202 Assay rbc protoporphyrin 0.00 58.28 $0.00

84203 Test rbc protoporphyrin 0.00 58.28 $0.00

84206 Assay of proinsulin 0.00 58.28 $0.00

84207 Assay of vitamin b-6 0.00 58.28 $0.00

84210 Assay of pyruvate 0.00 58.28 $0.00

84220 Assay of pyruvate kinase 0.00 58.28 $0.00

84228 Assay of quinine 0.00 58.28 $0.00

84233 Assay of estrogen 0.00 58.28 $0.00

84234 Assay of progesterone 0.00 58.28 $0.00

84235 Assay of endocrine hormone 0.00 58.28 $0.00

84238 Assay nonendocrine receptor 0.00 58.28 $0.00

84244 Assay of renin 0.00 58.28 $0.00

84255 Assay of selenium 0.00 58.28 $0.00

84260 Assay of serotonin 0.00 58.28 $0.00

84270 Assay of sex hormone globul 0.00 58.28 $0.00

84275 Assay of sialic acid 0.00 58.28 $0.00

84285 Assay of silica 0.00 58.28 $0.00

84295 Assay of serum sodium 0.00 58.28 $0.00

84300 Assay of urine sodium 0.00 58.28 $0.00

84302 Assay of sweat sodium 0.00 58.28 $0.00

84305 Assay of somatomedin 0.00 58.28 $0.00

84307 Assay of somatostatin 0.00 58.28 $0.00

84311 Spectrophotometry 0.00 58.28 $0.00

84315 Body fluid specific gravity 0.00 58.28 $0.00

84375 Chromatogram assay sugars 0.00 58.28 $0.00

84376 Sugars single qual 0.00 58.28 $0.00

84377 Sugars multiple qual 0.00 58.28 $0.00

84378 Sugars single quant 0.00 58.28 $0.00

84379 Sugars multiple quant 0.00 58.28 $0.00

84392 Assay of urine sulfate 0.00 58.28 $0.00

84402 Assay of free testosterone 0.00 58.28 $0.00

84403 Assay of total testosterone 0.00 58.28 $0.00

84430 Assay of thiocyanate 0.00 58.28 $0.00

84431 Thromboxane urine 0.00 58.28 $0.00

84432 Assay of thyroglobulin 0.00 58.28 $0.00

84436 Assay of total thyroxine 0.00 58.28 $0.00

84437 Assay of neonatal thyroxine 0.00 58.28 $0.00

84439 Assay of free thyroxine 0.00 58.28 $0.00

84442 Assay of thyroid activity 0.00 58.28 $0.00

84443 Assay thyroid stim hormone 0.00 58.28 $0.00

84445 Assay of tsi globulin 0.00 58.28 $0.00

84446 Assay of vitamin e 0.00 58.28 $0.00

84449 Assay of transcortin 0.00 58.28 $0.00

84450 Transferase (ast) (sgot) 0.00 58.28 $0.00

84460 Alanine amino (alt) (sgpt) 0.00 58.28 $0.00

84466 Assay of transferrin 0.00 58.28 $0.00

84478 Assay of triglycerides 0.00 58.28 $0.00

84479 Assay of thyroid (t3 or t4) 0.00 58.28 $0.00

84480 Assay triiodothyronine (t3) 0.00 58.28 $0.00

84481 Free assay (ft-3) 0.00 58.28 $0.00

84482 T3 reverse 0.00 58.28 $0.00

84484 Assay of troponin quant 0.00 58.28 $0.00

84485 Assay duodenal fluid trypsin 0.00 58.28 $0.00

84488 Test feces for trypsin 0.00 58.28 $0.00

84490 Assay of feces for trypsin 0.00 58.28 $0.00

84510 Assay of tyrosine 0.00 58.28 $0.00

84512 Assay of troponin qual 0.00 58.28 $0.00

84520 Assay of urea nitrogen 0.00 58.28 $0.00

84525 Urea nitrogen semi-quant 0.00 58.28 $0.00

84540 Assay of urine/urea-n 0.00 58.28 $0.00

84545 Urea-n clearance test 0.00 58.28 $0.00

84550 Assay of blood/uric acid 0.00 58.28 $0.00

84560 Assay of urine/uric acid 0.00 58.28 $0.00

84577 Assay of feces/urobilinogen 0.00 58.28 $0.00

84578 Test urine urobilinogen 0.00 58.28 $0.00

84580 Assay of urine urobilinogen 0.00 58.28 $0.00

84583 Assay of urine urobilinogen 0.00 58.28 $0.00

84585 Assay of urine vma 0.00 58.28 $0.00

84586 Assay of vip 0.00 58.28 $0.00

84588 Assay of vasopressin 0.00 58.28 $0.00

84590 Assay of vitamin a 0.00 58.28 $0.00

84591 Assay of nos vitamin 0.00 58.28 $0.00

84597 Assay of vitamin k 0.00 58.28 $0.00

84600 Assay of volatiles 0.00 58.28 $0.00

84620 Xylose tolerance test 0.00 58.28 $0.00

84630 Assay of zinc 0.00 58.28 $0.00

84681 Assay of c-peptide 0.00 58.28 $0.00

84702 Chorionic gonadotropin test 0.00 58.28 $0.00

84703 Chorionic gonadotropin assay 0.00 58.28 $0.00

84704 Hcg free betachain test 0.00 58.28 $0.00

84830 Ovulation tests 0.00 58.28 $0.00

84999 Clinical chemistry test 0.00 58.28 $0.00

85002 Bleeding time test 0.00 58.28 $0.00

85004 Automated diff wbc count 0.00 58.28 $0.00

85007 Bl smear w/diff wbc count 0.00 58.28 $0.00

85008 Bl smear w/o diff wbc count 0.00 58.28 $0.00

85009 Manual diff wbc count b-coat 0.00 58.28 $0.00

85013 Spun microhematocrit 0.00 58.28 $0.00

85014 Hematocrit 0.00 58.28 $0.00

85018 Hemoglobin 0.00 58.28 $0.00

85025 Complete cbc w/auto diff wbc 0.00 58.28 $0.00

85027 Complete cbc automated 0.00 58.28 $0.00

85032 Manual cell count each 0.00 58.28 $0.00

85041 Automated rbc count 0.00 58.28 $0.00

85044 Manual reticulocyte count 0.00 58.28 $0.00

85045 Automated reticulocyte count 0.00 58.28 $0.00

85046 Reticyte/hgb concentrate 0.00 58.28 $0.00

85048 Automated leukocyte count 0.00 58.28 $0.00

85049 Automated platelet count 0.00 58.28 $0.00

85055 Reticulated platelet assay 0.00 58.28 $0.00

85060 Blood smear interpretation 0.70 58.28 $40.80

85097 Bone marrow interpretation 2.50 58.28 $145.70

85130 Chromogenic substrate assay 0.00 58.28 $0.00

85170 Blood clot retraction 0.00 58.28 $0.00

85175 Blood clot lysis time 0.00 58.28 $0.00

85210 Clot factor ii prothrom spec 0.00 58.28 $0.00

85220 Blooc clot factor v test 0.00 58.28 $0.00

85230 Clot factor vii proconvertin 0.00 58.28 $0.00

85240 Clot factor viii ahg 1 stage 0.00 58.28 $0.00

85244 Clot factor viii reltd antgn 0.00 58.28 $0.00

85245 Clot factor viii vw ristoctn 0.00 58.28 $0.00

85246 Clot factor viii vw antigen 0.00 58.28 $0.00

85247 Clot factor viii multimetric 0.00 58.28 $0.00

85250 Clot factor ix ptc/chrstmas 0.00 58.28 $0.00

85260 Clot factor x stuart-power 0.00 58.28 $0.00

85270 Clot factor xi pta 0.00 58.28 $0.00

85280 Clot factor xii hageman 0.00 58.28 $0.00

85290 Clot factor xiii fibrin stab 0.00 58.28 $0.00

85291 Clot factor xiii fibrin scrn 0.00 58.28 $0.00

85292 Clot factor fletcher fact 0.00 58.28 $0.00

85293 Clot factor wght kininogen 0.00 58.28 $0.00

85300 Antithrombin iii activity 0.00 58.28 $0.00

85301 Antithrombin iii antigen 0.00 58.28 $0.00

85302 Clot inhibit prot c antigen 0.00 58.28 $0.00

85303 Clot inhibit prot c activity 0.00 58.28 $0.00

85305 Clot inhibit prot s total 0.00 58.28 $0.00

85306 Clot inhibit prot s free 0.00 58.28 $0.00

85307 Assay activated protein c 0.00 58.28 $0.00

85335 Factor inhibitor test 0.00 58.28 $0.00

85337 Thrombomodulin 0.00 58.28 $0.00

85345 Coagulation time lee & white 0.00 58.28 $0.00

85347 Coagulation time activated 0.00 58.28 $0.00

85348 Coagulation time otr method 0.00 58.28 $0.00

85360 Euglobulin lysis 0.00 58.28 $0.00

85362 Fibrin degradation products 0.00 58.28 $0.00

85366 Fibrinogen test 0.00 58.28 $0.00

85370 Fibrinogen test 0.00 58.28 $0.00

85378 Fibrin degrade semiquant 0.00 58.28 $0.00

85379 Fibrin degradation quant 0.00 58.28 $0.00

85380 Fibrin degradj d-dimer 0.00 58.28 $0.00

85384 Fibrinogen activity 0.00 58.28 $0.00

85385 Fibrinogen antigen 0.00 58.28 $0.00

85390 Fibrinolysins screen i&r 0.00 58.28 $0.00

85390 26 Fibrinolysins screen i&r 0.53 58.28 $30.89

85396 Clotting assay whole blood 0.58 58.28 $33.80

85397 Clotting funct activity 0.00 58.28 $0.00

85400 Fibrinolytic plasmin 0.00 58.28 $0.00

85410 Fibrinolytic antiplasmin 0.00 58.28 $0.00

85415 Fibrinolytic plasminogen 0.00 58.28 $0.00

85441 Heinz bodies direct 0.00 58.28 $0.00

85445 Heinz bodies induced 0.00 58.28 $0.00

85460 Hemoglobin fetal 0.00 58.28 $0.00

85461 Hemoglobin fetal 0.00 58.28 $0.00

85475 Hemolysin acid 0.00 58.28 $0.00

85520 Heparin assay 0.00 58.28 $0.00

85525 Heparin neutralization 0.00 58.28 $0.00

85530 Heparin-protamine tolerance 0.00 58.28 $0.00

85536 Iron stain peripheral blood 0.00 58.28 $0.00

85540 Wbc alkaline phosphatase 0.00 58.28 $0.00

85547 Rbc mechanical fragility 0.00 58.28 $0.00

85549 Muramidase 0.00 58.28 $0.00

85555 Rbc osmotic fragility 0.00 58.28 $0.00

85557 Rbc osmotic fragility 0.00 58.28 $0.00

85576 Blood platelet aggregation 0.00 58.28 $0.00

85576 26 Blood platelet aggregation 0.53 58.28 $30.89

85597 Phospholipid pltlt neutraliz 0.00 58.28 $0.00

85598 Hexagnal phosph pltlt neutrl 0.00 58.28 $0.00

85610 Prothrombin time 0.00 58.28 $0.00

85611 Prothrombin test 0.00 58.28 $0.00

85612 Viper venom prothrombin time 0.00 58.28 $0.00

85613 Russell viper venom diluted 0.00 58.28 $0.00

85635 Reptilase test 0.00 58.28 $0.00

85651 Rbc sed rate nonautomated 0.00 58.28 $0.00

85652 Rbc sed rate automated 0.00 58.28 $0.00

85660 Rbc sickle cell test 0.00 58.28 $0.00

85670 Thrombin time plasma 0.00 58.28 $0.00

85675 Thrombin time titer 0.00 58.28 $0.00

85705 Thromboplastin inhibition 0.00 58.28 $0.00

85730 Thromboplastin time partial 0.00 58.28 $0.00

85732 Thromboplastin time partial 0.00 58.28 $0.00

85810 Blood viscosity examination 0.00 58.28 $0.00

85999 Hematology procedure 0.00 58.28 $0.00

86000 Agglutinins febrile antigen 0.00 58.28 $0.00

86001 Allergen specific igg 0.00 58.28 $0.00

86003 Allergen specific ige 0.00 58.28 $0.00

86005 Allergen specific ige 0.00 58.28 $0.00

86021 Wbc antibody identification 0.00 58.28 $0.00

86022 Platelet antibodies 0.00 58.28 $0.00

86023 Immunoglobulin assay 0.00 58.28 $0.00

86038 Antinuclear antibodies 0.00 58.28 $0.00

86039 Antinuclear antibodies (ana) 0.00 58.28 $0.00

86060 Antistreptolysin o titer 0.00 58.28 $0.00

86063 Antistreptolysin o screen 0.00 58.28 $0.00

86077 Phys blood bank serv xmatch 1.58 58.28 $92.08

86078 Phys blood bank serv reactj 1.57 58.28 $91.50

86079 Phys blood bank serv authrj 1.54 58.28 $89.75

86140 C-reactive protein 0.00 58.28 $0.00

86141 C-reactive protein hs 0.00 58.28 $0.00

86146 Beta-2 glycoprotein antibody 0.00 58.28 $0.00

86147 Cardiolipin antibody ea ig 0.00 58.28 $0.00

86148 Anti-phospholipid antibody 0.00 58.28 $0.00

86152 Cell enumeration & id 0.00 58.28 $0.00

86153 26 Cell enumeration phys interp 0.99 58.28 $57.70

86155 Chemotaxis assay 0.00 58.28 $0.00

86156 Cold agglutinin screen 0.00 58.28 $0.00

86157 Cold agglutinin titer 0.00 58.28 $0.00

86160 Complement antigen 0.00 58.28 $0.00

86161 Complement/function activity 0.00 58.28 $0.00

86162 Complement total (ch50) 0.00 58.28 $0.00

86171 Complement fixation each 0.00 58.28 $0.00

86185 Counterimmunoelectrophoresis 0.00 58.28 $0.00

86200 Ccp antibody 0.00 58.28 $0.00

86215 Deoxyribonuclease antibody 0.00 58.28 $0.00

86225 Dna antibody native 0.00 58.28 $0.00

86226 Dna antibody single strand 0.00 58.28 $0.00

86235 Nuclear antigen antibody 0.00 58.28 $0.00

86243 Fc receptor 0.00 58.28 $0.00

86255 Fluorescent antibody screen 0.00 58.28 $0.00

86255 26 Fluorescent antibody screen 0.53 58.28 $30.89

86256 Fluorescent antibody titer 0.00 58.28 $0.00

86256 26 Fluorescent antibody titer 0.53 58.28 $30.89

86277 Growth hormone antibody 0.00 58.28 $0.00

86280 Hemagglutination inhibition 0.00 58.28 $0.00

86294 Immunoassay tumor qual 0.00 58.28 $0.00

86300 Immunoassay tumor ca 15-3 0.00 58.28 $0.00

86301 Immunoassay tumor ca 19-9 0.00 58.28 $0.00

86304 Immunoassay tumor ca 125 0.00 58.28 $0.00

86305 Human epididymis protein 4 0.00 58.28 $0.00

86308 Heterophile antibody screen 0.00 58.28 $0.00

86309 Heterophile antibody titer 0.00 58.28 $0.00

86310 Heterophile antibody absrbj 0.00 58.28 $0.00

86316 Immunoassay tumor other 0.00 58.28 $0.00

86317 Immunoassay infectious agent 0.00 58.28 $0.00

86318 Immunoassay infectious agent 0.00 58.28 $0.00

86320 Serum immunoelectrophoresis 0.00 58.28 $0.00

86320 26 Serum immunoelectrophoresis 0.53 58.28 $30.89

86325 Other immunoelectrophoresis 0.00 58.28 $0.00

86325 26 Other immunoelectrophoresis 0.53 58.28 $30.89

86327 Immunoelectrophoresis assay 0.00 58.28 $0.00

86327 26 Immunoelectrophoresis assay 0.61 58.28 $35.55

86329 Immunodiffusion nes 0.00 58.28 $0.00

86331 Immunodiffusion ouchterlony 0.00 58.28 $0.00

86332 Immune complex assay 0.00 58.28 $0.00

86334 Immunofix e-phoresis serum 0.00 58.28 $0.00

86334 26 Immunofix e-phoresis serum 0.53 58.28 $30.89

86335 Immunfix e-phorsis/urine/csf 0.00 58.28 $0.00

86335 26 Immunfix e-phorsis/urine/csf 0.53 58.28 $30.89

86336 Inhibin a 0.00 58.28 $0.00

86337 Insulin antibodies 0.00 58.28 $0.00

86340 Intrinsic factor antibody 0.00 58.28 $0.00

86341 Islet cell antibody 0.00 58.28 $0.00

86343 Leukocyte histamine release 0.00 58.28 $0.00

86344 Leukocyte phagocytosis 0.00 58.28 $0.00

86352 Cell function assay w/stim 0.00 58.28 $0.00

86353 Lymphocyte transformation 0.00 58.28 $0.00

86355 B cells total count 0.00 58.28 $0.00

86356 Mononuclear cell antigen 0.00 58.28 $0.00

86357 Nk cells total count 0.00 58.28 $0.00

86359 T cells total count 0.00 58.28 $0.00

86360 T cell absolute count/ratio 0.00 58.28 $0.00

86361 T cell absolute count 0.00 58.28 $0.00

86367 Stem cells total count 0.00 58.28 $0.00

86376 Microsomal antibody each 0.00 58.28 $0.00

86378 Migration inhibitory factor 0.00 58.28 $0.00

86382 Neutralization test viral 0.00 58.28 $0.00

86384 Nitroblue tetrazolium dye 0.00 58.28 $0.00

86386 Nuclear matrix protein 22 0.00 58.28 $0.00

86403 Particle agglut antbdy scrn 0.00 58.28 $0.00

86406 Particle agglut antbdy titr 0.00 58.28 $0.00

86430 Rheumatoid factor test qual 0.00 58.28 $0.00

86431 Rheumatoid factor quant 0.00 58.28 $0.00

86480 Tb test cell immun measure 0.00 58.28 $0.00

86481 Tb ag response t-cell susp 0.00 58.28 $0.00

86485 Skin test candida 0.00 58.28 $0.00

86486 Skin test nos antigen 0.14 58.28 $8.16

86490 Coccidioidomycosis skin test 0.19 58.28 $11.07

86510 Histoplasmosis skin test 0.17 58.28 $9.91

86580 Tb intradermal test 0.22 58.28 $12.82

86590 Streptokinase antibody 0.00 58.28 $0.00

86592 Syphilis test non-trep qual 0.00 58.28 $0.00

86593 Syphilis test non-trep quant 0.00 58.28 $0.00

86602 Antinomyces antibody 0.00 58.28 $0.00

86603 Adenovirus antibody 0.00 58.28 $0.00

86606 Aspergillus antibody 0.00 58.28 $0.00

86609 Bacterium antibody 0.00 58.28 $0.00

86611 Bartonella antibody 0.00 58.28 $0.00

86612 Blastomyces antibody 0.00 58.28 $0.00

86615 Bordetella antibody 0.00 58.28 $0.00

86617 Lyme disease antibody 0.00 58.28 $0.00

86618 Lyme disease antibody 0.00 58.28 $0.00

86619 Borrelia antibody 0.00 58.28 $0.00

86622 Brucella antibody 0.00 58.28 $0.00

86625 Campylobacter antibody 0.00 58.28 $0.00

86628 Candida antibody 0.00 58.28 $0.00

86631 Chlamydia antibody 0.00 58.28 $0.00

86632 Chlamydia igm antibody 0.00 58.28 $0.00

86635 Coccidioides antibody 0.00 58.28 $0.00

86638 Q fever antibody 0.00 58.28 $0.00

86641 Cryptococcus antibody 0.00 58.28 $0.00

86644 Cmv antibody 0.00 58.28 $0.00

86645 Cmv antibody igm 0.00 58.28 $0.00

86648 Diphtheria antibody 0.00 58.28 $0.00

86651 Encephalitis californ antbdy 0.00 58.28 $0.00

86652 Encephaltis east eqne anbdy 0.00 58.28 $0.00

86653 Encephaltis st louis antbody 0.00 58.28 $0.00

86654 Encephaltis west eqne antbdy 0.00 58.28 $0.00

86658 Enterovirus antibody 0.00 58.28 $0.00

86663 Epstein-barr antibody 0.00 58.28 $0.00

86664 Epstein-barr nuclear antigen 0.00 58.28 $0.00

86665 Epstein-barr capsid vca 0.00 58.28 $0.00

86666 Ehrlichia antibody 0.00 58.28 $0.00

86668 Francisella tularensis 0.00 58.28 $0.00

86671 Fungus nes antibody 0.00 58.28 $0.00

86674 Giardia lamblia antibody 0.00 58.28 $0.00

86677 Helicobacter pylori antibody 0.00 58.28 $0.00

86682 Helminth antibody 0.00 58.28 $0.00

86684 Hemophilus influenza antibdy 0.00 58.28 $0.00

86687 Htlv-i antibody 0.00 58.28 $0.00

86688 Htlv-ii antibody 0.00 58.28 $0.00

86689 Htlv/hiv confirmj antibody 0.00 58.28 $0.00

86692 Hepatitis delta agent antbdy 0.00 58.28 $0.00

86694 Herpes simplex nes antbdy 0.00 58.28 $0.00

86695 Herpes simplex type 1 test 0.00 58.28 $0.00

86696 Herpes simplex type 2 test 0.00 58.28 $0.00

86698 Histoplasma antibody 0.00 58.28 $0.00

86701 Hiv-1antibody 0.00 58.28 $0.00

86702 Hiv-2 antibody 0.00 58.28 $0.00

86703 Hiv-1/hiv-2 1 result antbdy 0.00 58.28 $0.00

86704 Hep b core antibody total 0.00 58.28 $0.00

86705 Hep b core antibody igm 0.00 58.28 $0.00

86706 Hep b surface antibody 0.00 58.28 $0.00

86707 Hepatitis be antibody 0.00 58.28 $0.00

86708 Hepatitis a total antibody 0.00 58.28 $0.00

86709 Hepatitis a igm antibody 0.00 58.28 $0.00

86710 Influenza virus antibody 0.00 58.28 $0.00

86711 John cunningham antibody 0.00 58.28 $0.00

86713 Legionella antibody 0.00 58.28 $0.00

86717 Leishmania antibody 0.00 58.28 $0.00

86720 Leptospira antibody 0.00 58.28 $0.00

86723 Listeria monocytogenes 0.00 58.28 $0.00

86727 Lymph choriomeningitis ab 0.00 58.28 $0.00

86729 Lympho venereum antibody 0.00 58.28 $0.00

86732 Mucormycosis antibody 0.00 58.28 $0.00

86735 Mumps antibody 0.00 58.28 $0.00

86738 Mycoplasma antibody 0.00 58.28 $0.00

86741 Neisseria meningitidis 0.00 58.28 $0.00

86744 Nocardia antibody 0.00 58.28 $0.00

86747 Parvovirus antibody 0.00 58.28 $0.00

86750 Malaria antibody 0.00 58.28 $0.00

86753 Protozoa antibody nos 0.00 58.28 $0.00

86756 Respiratory virus antibody 0.00 58.28 $0.00

86757 Rickettsia antibody 0.00 58.28 $0.00

86759 Rotavirus antibody 0.00 58.28 $0.00

86762 Rubella antibody 0.00 58.28 $0.00

86765 Rubeola antibody 0.00 58.28 $0.00

86768 Salmonella antibody 0.00 58.28 $0.00

86771 Shigella antibody 0.00 58.28 $0.00

86774 Tetanus antibody 0.00 58.28 $0.00

86777 Toxoplasma antibody 0.00 58.28 $0.00

86778 Toxoplasma antibody igm 0.00 58.28 $0.00

86780 Treponema pallidum 0.00 58.28 $0.00

86784 Trichinella antibody 0.00 58.28 $0.00

86787 Varicella-zoster antibody 0.00 58.28 $0.00

86788 West nile virus ab igm 0.00 58.28 $0.00

86789 West nile virus antibody 0.00 58.28 $0.00

86790 Virus antibody nos 0.00 58.28 $0.00

86793 Yersinia antibody 0.00 58.28 $0.00

86800 Thyroglobulin antibody 0.00 58.28 $0.00

86803 Hepatitis c ab test 0.00 58.28 $0.00

86804 Hep c ab test confirm 0.00 58.28 $0.00

86805 Lymphocytotoxicity assay 0.00 58.28 $0.00

86806 Lymphocytotoxicity assay 0.00 58.28 $0.00

86807 Cytotoxic antibody screening 0.00 58.28 $0.00

86808 Cytotoxic antibody screening 0.00 58.28 $0.00

86812 Hla typing a b or c 0.00 58.28 $0.00

86813 Hla typing a b or c 0.00 58.28 $0.00

86816 Hla typing dr/dq 0.00 58.28 $0.00

86817 Hla typing dr/dq 0.00 58.28 $0.00

86821 Lymphocyte culture mixed 0.00 58.28 $0.00

86822 Lymphocyte culture primed 0.00 58.28 $0.00

86825 Hla x-math non-cytotoxic 0.00 58.28 $0.00

86826 Hla x-match noncytotoxc addl 0.00 58.28 $0.00

86828 Hla class i&ii antibody qual 0.00 58.28 $0.00

86829 Hla class i/ii antibody qual 0.00 58.28 $0.00

86830 Hla class i phenotype qual 0.00 58.28 $0.00

86831 Hla class ii phenotype qual 0.00 58.28 $0.00

86832 Hla class i high defin qual 0.00 58.28 $0.00

86833 Hla class ii high defin qual 0.00 58.28 $0.00

86834 Hla class i semiquant panel 0.00 58.28 $0.00

86835 Hla class ii semiquant panel 0.00 58.28 $0.00

86849 Immunology procedure 0.00 58.28 $0.00

86850 Rbc antibody screen 0.00 58.28 $0.00

86860 Rbc antibody elution 0.00 58.28 $0.00

86870 Rbc antibody identification 0.00 58.28 $0.00

86880 Coombs test direct 0.00 58.28 $0.00

86885 Coombs test indirect qual 0.00 58.28 $0.00

86886 Coombs test indirect titer 0.00 58.28 $0.00

86890 Autologous blood process 0.00 58.28 $0.00

86891 Autologous blood op salvage 0.00 58.28 $0.00

86900 Blood typing serologic abo 0.00 58.28 $0.00

86901 Blood typing serologic rh(d) 0.00 58.28 $0.00

86902 Blood type antigen donor ea 0.00 58.28 $0.00

86904 Blood typing patient serum 0.00 58.28 $0.00

86905 Blood typing rbc antigens 0.00 58.28 $0.00

86906 Bld typing serologic rh phnt 0.00 58.28 $0.00

86910 Blood typing paternity test 0.00 58.28 $0.00

86911 Blood typing antigen system 0.00 58.28 $0.00

86920 Compatibility test spin 0.00 58.28 $0.00

86921 Compatibility test incubate 0.00 58.28 $0.00

86922 Compatibility test antiglob 0.00 58.28 $0.00

86923 Compatibility test electric 0.00 58.28 $0.00

86927 Plasma fresh frozen 0.00 58.28 $0.00

86930 Frozen blood prep 0.00 58.28 $0.00

86931 Frozen blood thaw 0.00 58.28 $0.00

86932 Frozen blood freeze/thaw 0.00 58.28 $0.00

86940 Hemolysins/agglutinins auto 0.00 58.28 $0.00

86941 Hemolysins/agglutinins 0.00 58.28 $0.00

86945 Blood product/irradiation 0.00 58.28 $0.00

86950 Leukacyte transfusion 0.00 58.28 $0.00

86960 Vol reduction of blood/prod 0.00 58.28 $0.00

86965 Pooling blood platelets 0.00 58.28 $0.00

86970 Rbc pretx incubatj w/chemicl 0.00 58.28 $0.00

86971 Rbc pretx incubatj w/enzymes 0.00 58.28 $0.00

86972 Rbc pretx incubatj w/density 0.00 58.28 $0.00

86975 Rbc serum pretx incubj drugs 0.00 58.28 $0.00

86976 Rbc serum pretx id dilution 0.00 58.28 $0.00

86977 Rbc serum pretx incubj/inhib 0.00 58.28 $0.00

86978 Rbc pretreatment serum 0.00 58.28 $0.00

86985 Split blood or products 0.00 58.28 $0.00

86999 Transfusion procedure 0.00 58.28 $0.00

87003 Small animal inoculation 0.00 58.28 $0.00

87015 Specimen infect agnt concntj 0.00 58.28 $0.00

87040 Blood culture for bacteria 0.00 58.28 $0.00

87045 Feces culture aerobic bact 0.00 58.28 $0.00

87046 Stool cultr aerobic bact ea 0.00 58.28 $0.00

87070 Culture othr specimn aerobic 0.00 58.28 $0.00

87071 Culture aerobic quant other 0.00 58.28 $0.00

87073 Culture bacteria anaerobic 0.00 58.28 $0.00

87075 Cultr bacteria except blood 0.00 58.28 $0.00

87076 Culture anaerobe ident each 0.00 58.28 $0.00

87077 Culture aerobic identify 0.00 58.28 $0.00

87081 Culture screen only 0.00 58.28 $0.00

87084 Culture of specimen by kit 0.00 58.28 $0.00

87086 Urine culture/colony count 0.00 58.28 $0.00

87088 Urine bacteria culture 0.00 58.28 $0.00

87101 Skin fungi culture 0.00 58.28 $0.00

87102 Fungus isolation culture 0.00 58.28 $0.00

87103 Blood fungus culture 0.00 58.28 $0.00

87106 Fungi identification yeast 0.00 58.28 $0.00

87107 Fungi identification mold 0.00 58.28 $0.00

87109 Mycoplasma 0.00 58.28 $0.00

87110 Chlamydia culture 0.00 58.28 $0.00

87116 Mycobacteria culture 0.00 58.28 $0.00

87118 Mycobacteric identification 0.00 58.28 $0.00

87140 Culture type immunofluoresc 0.00 58.28 $0.00

87143 Culture typing glc/hplc 0.00 58.28 $0.00

87147 Culture type immunologic 0.00 58.28 $0.00

87149 Dna/rna direct probe 0.00 58.28 $0.00

87150 Dna/rna amplified probe 0.00 58.28 $0.00

87152 Culture type pulse field gel 0.00 58.28 $0.00

87153 Dna/rna sequencing 0.00 58.28 $0.00

87158 Culture typing added method 0.00 58.28 $0.00

87164 Dark field examination 0.00 58.28 $0.00

87164 26 Dark field examination 0.53 58.28 $30.89

87166 Dark field examination 0.00 58.28 $0.00

87168 Macroscopic exam arthropod 0.00 58.28 $0.00

87169 Macroscopic exam parasite 0.00 58.28 $0.00

87172 Pinworm exam 0.00 58.28 $0.00

87176 Tissue homogenization cultr 0.00 58.28 $0.00

87177 Ova and parasites smears 0.00 58.28 $0.00

87181 Microbe susceptible diffuse 0.00 58.28 $0.00

87184 Microbe susceptible disk 0.00 58.28 $0.00

87185 Microbe susceptible enzyme 0.00 58.28 $0.00

87186 Microbe susceptible mic 0.00 58.28 $0.00

87187 Microbe susceptible mlc 0.00 58.28 $0.00

87188 Microbe suscept macrobroth 0.00 58.28 $0.00

87190 Microbe suscept mycobacteri 0.00 58.28 $0.00

87197 Bactericidal level serum 0.00 58.28 $0.00

87205 Smear gram stain 0.00 58.28 $0.00

87206 Smear fluorescent/acid stai 0.00 58.28 $0.00

87207 Smear special stain 0.00 58.28 $0.00

87207 26 Smear special stain 0.53 58.28 $30.89

87209 Smear complex stain 0.00 58.28 $0.00

87210 Smear wet mount saline/ink 0.00 58.28 $0.00

87220 Tissue exam for fungi 0.00 58.28 $0.00

87230 Assay toxin or antitoxin 0.00 58.28 $0.00

87250 Virus inoculate eggs/animal 0.00 58.28 $0.00

87252 Virus inoculation tissue 0.00 58.28 $0.00

87253 Virus inoculate tissue addl 0.00 58.28 $0.00

87254 Virus inoculation shell via 0.00 58.28 $0.00

87255 Genet virus isolate hsv 0.00 58.28 $0.00

87260 Adenovirus ag if 0.00 58.28 $0.00

87265 Pertussis ag if 0.00 58.28 $0.00

87267 Enterovirus antibody dfa 0.00 58.28 $0.00

87269 Giardia ag if 0.00 58.28 $0.00

87270 Chlamydia trachomatis ag if 0.00 58.28 $0.00

87271 Cytomegalovirus dfa 0.00 58.28 $0.00

87272 Cryptosporidium ag if 0.00 58.28 $0.00

87273 Herpes simplex 2 ag if 0.00 58.28 $0.00

87274 Herpes simplex 1 ag if 0.00 58.28 $0.00

87275 Influenza b ag if 0.00 58.28 $0.00

87276 Influenza a ag if 0.00 58.28 $0.00

87277 Legionella micdadei ag if 0.00 58.28 $0.00

87278 Legion pneumophilia ag if 0.00 58.28 $0.00

87279 Parainfluenza ag if 0.00 58.28 $0.00

87280 Respiratory syncytial ag if 0.00 58.28 $0.00

87281 Pneumocystis carinii ag if 0.00 58.28 $0.00

87283 Rubeola ag if 0.00 58.28 $0.00

87285 Treponema pallidum ag if 0.00 58.28 $0.00

87290 Varicella zoster ag if 0.00 58.28 $0.00

87299 Antibody detection nos if 0.00 58.28 $0.00

87300 Ag detection polyval if 0.00 58.28 $0.00

87301 Adenovirus ag eia 0.00 58.28 $0.00

87305 Aspergillus ag eia 0.00 58.28 $0.00

87320 Chylmd trach ag eia 0.00 58.28 $0.00

87324 Clostridium ag eia 0.00 58.28 $0.00

87327 Cryptococcus neoform ag eia 0.00 58.28 $0.00

87328 Cryptosporidium ag eia 0.00 58.28 $0.00

87329 Giardia ag eia 0.00 58.28 $0.00

87332 Cytomegalovirus ag eia 0.00 58.28 $0.00

87335 E coli 0157 ag eia 0.00 58.28 $0.00

87336 Entamoeb hist dispr ag eia 0.00 58.28 $0.00

87337 Entamoeb hist group ag eia 0.00 58.28 $0.00

87338 Hpylori stool eia 0.00 58.28 $0.00

87339 H pylori ag eia 0.00 58.28 $0.00

87340 Hepatitis b surface ag eia 0.00 58.28 $0.00

87341 Hepatitis b surface ag eia 0.00 58.28 $0.00

87350 Hepatitis be ag eia 0.00 58.28 $0.00

87380 Hepatitis delta ag eia 0.00 58.28 $0.00

87385 Histoplasma capsul ag eia 0.00 58.28 $0.00

87389 Hiv-1 ag w/hiv-1 & hiv-2 ab 0.00 58.28 $0.00

87390 Hiv-1 ag eia 0.00 58.28 $0.00

87391 Hiv-2 ag eia 0.00 58.28 $0.00

87400 Influenza a/b ag eia 0.00 58.28 $0.00

87420 Resp syncytial ag eia 0.00 58.28 $0.00

87425 Rotavirus ag eia 0.00 58.28 $0.00

87427 Shiga-like toxin ag eia 0.00 58.28 $0.00

87430 Strep a ag eia 0.00 58.28 $0.00

87449 Ag detect nos eia mult 0.00 58.28 $0.00

87450 Ag detect nos eia single 0.00 58.28 $0.00

87451 Ag detect polyval eia mult 0.00 58.28 $0.00

87470 Bartonella dna dir probe 0.00 58.28 $0.00

87471 Bartonella dna amp probe 0.00 58.28 $0.00

87472 Bartonella dna quant 0.00 58.28 $0.00

87475 Lyme dis dna dir probe 0.00 58.28 $0.00

87476 Lyme dis dna amp probe 0.00 58.28 $0.00

87477 Lyme dis dna quant 0.00 58.28 $0.00

87480 Candida dna dir probe 0.00 58.28 $0.00

87481 Candida dna amp probe 0.00 58.28 $0.00

87482 Candida dna quant 0.00 58.28 $0.00

87485 Chylmd pneum dna dir probe 0.00 58.28 $0.00

87486 Chylmd pneum dna amp probe 0.00 58.28 $0.00

87487 Chylmd pneum dna quant 0.00 58.28 $0.00

87490 Chylmd trach dna dir probe 0.00 58.28 $0.00

87491 Chylmd trach dna amp probe 0.00 58.28 $0.00

87492 Chylmd trach dna quant 0.00 58.28 $0.00

87493 C diff amplified probe 0.00 58.28 $0.00

87495 Cytomeg dna dir probe 0.00 58.28 $0.00

87496 Cytomeg dna amp probe 0.00 58.28 $0.00

87497 Cytomeg dna quant 0.00 58.28 $0.00

87498 Enterovirus probe&revrs trns 0.00 58.28 $0.00

87500 Vanomycin dna amp probe 0.00 58.28 $0.00

87501 Influenza dna amp prob 1+ 0.00 58.28 $0.00

87502 Influenza dna amp probe 0.00 58.28 $0.00

87503 Influenza dna amp prob addl 0.00 58.28 $0.00

87505 Nfct agent detection gi 0.00 58.28 $0.00

87506 Iadna-dna/rna probe tq 6-11 0.00 58.28 $0.00

87507 Iadna-dna/rna probe tq 12-25 0.00 58.28 $0.00

87510 Gardner vag dna dir probe 0.00 58.28 $0.00

87511 Gardner vag dna amp probe 0.00 58.28 $0.00

87512 Gardner vag dna quant 0.00 58.28 $0.00

87515 Hepatitis b dna dir probe 0.00 58.28 $0.00

87516 Hepatitis b dna amp probe 0.00 58.28 $0.00

87517 Hepatitis b dna quant 0.00 58.28 $0.00

87520 Hepatitis c rna dir probe 0.00 58.28 $0.00

87521 Hepatitis c probe&rvrs trnsc 0.00 58.28 $0.00

87522 Hepatitis c revrs trnscrpj 0.00 58.28 $0.00

87525 Hepatitis g dna dir probe 0.00 58.28 $0.00

87526 Hepatitis g dna amp probe 0.00 58.28 $0.00

87527 Hepatitis g dna quant 0.00 58.28 $0.00

87528 Hsv dna dir probe 0.00 58.28 $0.00

87529 Hsv dna amp probe 0.00 58.28 $0.00

87530 Hsv dna quant 0.00 58.28 $0.00

87531 Hhv-6 dna dir probe 0.00 58.28 $0.00

87532 Hhv-6 dna amp probe 0.00 58.28 $0.00

87533 Hhv-6 dna quant 0.00 58.28 $0.00

87534 Hiv-1 dna dir probe 0.00 58.28 $0.00

87535 Hiv-1 probe&reverse trnscrpj 0.00 58.28 $0.00

87536 Hiv-1 quant&revrse trnscrpj 0.00 58.28 $0.00

87537 Hiv-2 dna dir probe 0.00 58.28 $0.00

87538 Hiv-2 probe&revrse trnscripj 0.00 58.28 $0.00

87539 Hiv-2 quant&revrse trnscripj 0.00 58.28 $0.00

87540 Legion pneumo dna dir prob 0.00 58.28 $0.00

87541 Legion pneumo dna amp prob 0.00 58.28 $0.00

87542 Legion pneumo dna quant 0.00 58.28 $0.00

87550 Mycobacteria dna dir probe 0.00 58.28 $0.00

87551 Mycobacteria dna amp probe 0.00 58.28 $0.00

87552 Mycobacteria dna quant 0.00 58.28 $0.00

87555 M.tuberculo dna dir probe 0.00 58.28 $0.00

87556 M.tuberculo dna amp probe 0.00 58.28 $0.00

87557 M.tuberculo dna quant 0.00 58.28 $0.00

87560 M.avium-intra dna dir prob 0.00 58.28 $0.00

87561 M.avium-intra dna amp prob 0.00 58.28 $0.00

87562 M.avium-intra dna quant 0.00 58.28 $0.00

87580 M.pneumon dna dir probe 0.00 58.28 $0.00

87581 M.pneumon dna amp probe 0.00 58.28 $0.00

87582 M.pneumon dna quant 0.00 58.28 $0.00

87590 N.gonorrhoeae dna dir prob 0.00 58.28 $0.00

87591 N.gonorrhoeae dna amp prob 0.00 58.28 $0.00

87592 N.gonorrhoeae dna quant 0.00 58.28 $0.00

87623 Hpv low-risk types 0.00 58.28 $0.00

87624 Hpv high-risk types 0.00 58.28 $0.00

87625 Hpv types 16 & 18 only 0.00 58.28 $0.00

87631 Resp virus 3-5 targets 0.00 58.28 $0.00

87640 Staph a dna amp probe 0.00 58.28 $0.00

87641 Mr-staph dna amp probe 0.00 58.28 $0.00

87650 Strep a dna dir probe 0.00 58.28 $0.00

87651 Strep a dna amp probe 0.00 58.28 $0.00

87652 Strep a dna quant 0.00 58.28 $0.00

87653 Strep b dna amp probe 0.00 58.28 $0.00

87660 Trichomonas vagin dir probe 0.00 58.28 $0.00

87661 Trichomonas vaginalis amplif 0.00 58.28 $0.00

87797 Detect agent nos dna dir 0.00 58.28 $0.00

87798 Detect agent nos dna amp 0.00 58.28 $0.00

87799 Detect agent nos dna quant 0.00 58.28 $0.00

87800 Detect agnt mult dna direc 0.00 58.28 $0.00

87801 Detect agnt mult dna ampli 0.00 58.28 $0.00

87802 Strep b assay w/optic 0.00 58.28 $0.00

87803 Clostridium toxin a w/optic 0.00 58.28 $0.00

87804 Influenza assay w/optic 0.00 58.28 $0.00

87806 Hiv antigen w/hiv antibodies 0.00 58.28 $0.00

87807 Rsv assay w/optic 0.00 58.28 $0.00

87808 Trichomonas assay w/optic 0.00 58.28 $0.00

87809 Adenovirus assay w/optic 0.00 58.28 $0.00

87810 Chylmd trach assay w/optic 0.00 58.28 $0.00

87850 N. gonorrhoeae assay w/optic 0.00 58.28 $0.00

87880 Strep a assay w/optic 0.00 58.28 $0.00

87899 Agent nos assay w/optic 0.00 58.28 $0.00

87900 Phenotype infect agent drug 0.00 58.28 $0.00

87901 Genotype dna hiv reverse t 0.00 58.28 $0.00

87902 Genotype dna/rna hep c 0.00 58.28 $0.00

87903 Phenotype dna hiv w/culture 0.00 58.28 $0.00

87904 Phenotype dna hiv w/clt add 0.00 58.28 $0.00

87905 Sialidase enzyme assay 0.00 58.28 $0.00

87906 Genotype dna/rna hiv 0.00 58.28 $0.00

87910 Genotype cytomegalovirus 0.00 58.28 $0.00

87912 Genotype dna hepatitis b 0.00 58.28 $0.00

87999 Microbiology procedure 0.00 58.28 $0.00

88000 Autopsy (necropsy) gross 0.00 58.28 $0.00

88020 Autopsy (necropsy) complete 0.00 58.28 $0.00

88036 Limited autopsy 0.00 58.28 $0.00

88037 Limited autopsy 0.00 58.28 $0.00

88040 Forensic autopsy (necropsy) 0.00 58.28 $0.00

88045 Coroners autopsy (necropsy) 0.00 58.28 $0.00

88099 Necropsy (autopsy) procedure 0.00 58.28 $0.00

88104 Cytopath fl nongyn smears 2.10 58.28 $122.39

88104 TC Cytopath fl nongyn smears 1.27 58.28 $74.02

88104 26 Cytopath fl nongyn smears 0.83 58.28 $48.37

88106 Cytopath fl nongyn filter 2.46 58.28 $143.37

88106 TC Cytopath fl nongyn filter 1.90 58.28 $110.73

88106 26 Cytopath fl nongyn filter 0.56 58.28 $32.64

88108 Cytopath concentrate tech 2.37 58.28 $138.12

88108 TC Cytopath concentrate tech 1.71 58.28 $99.66

88108 26 Cytopath concentrate tech 0.66 58.28 $38.46

88112 Cytopath cell enhance tech 1.81 58.28 $105.49

88112 TC Cytopath cell enhance tech 1.01 58.28 $58.86

88112 26 Cytopath cell enhance tech 0.80 58.28 $46.62

88120 Cytp urne 3-5 probes ea spec 17.43 58.28 $1,015.82

88120 TC Cytp urne 3-5 probes ea spec 15.78 58.28 $919.66

88120 26 Cytp urne 3-5 probes ea spec 1.65 58.28 $96.16

88121 Cytp urine 3-5 probes cmptr 15.50 58.28 $903.34

88121 TC Cytp urine 3-5 probes cmptr 14.06 58.28 $819.42

88121 26 Cytp urine 3-5 probes cmptr 1.44 58.28 $83.92

88125 Forensic cytopathology 0.74 58.28 $43.13

88125 TC Forensic cytopathology 0.33 58.28 $19.23

88125 26 Forensic cytopathology 0.41 58.28 $23.89

88130 Sex chromatin identification 0.00 58.28 $0.00

88140 Sex chromatin identification 0.00 58.28 $0.00

88141 Cytopath c/v interpret 0.91 58.28 $53.03

88142 Cytopath c/v thin layer 0.00 58.28 $0.00

88143 Cytopath c/v thin layer redo 0.00 58.28 $0.00

88147 Cytopath c/v automated 0.00 58.28 $0.00

88148 Cytopath c/v auto rescreen 0.00 58.28 $0.00

88150 Cytopath c/v manual 0.00 58.28 $0.00

88152 Cytopath c/v auto redo 0.00 58.28 $0.00

88153 Cytopath c/v redo 0.00 58.28 $0.00

88154 Cytopath c/v select 0.00 58.28 $0.00

88155 Cytopath c/v index add-on 0.00 58.28 $0.00

88160 Cytopath smear other source 1.88 58.28 $109.57

88160 TC Cytopath smear other source 1.13 58.28 $65.86

88160 26 Cytopath smear other source 0.75 58.28 $43.71

88164 Cytopath tbs c/v manual 0.00 58.28 $0.00

88165 Cytopath tbs c/v redo 0.00 58.28 $0.00

88166 Cytopath tbs c/v auto redo 0.00 58.28 $0.00

88167 Cytopath tbs c/v select 0.00 58.28 $0.00

88172 Cytp dx eval fna 1st ea site 1.59 58.28 $92.67

88172 TC Cytp dx eval fna 1st ea site 0.55 58.28 $32.05

88172 26 Cytp dx eval fna 1st ea site 1.04 58.28 $60.61

88173 Cytopath eval fna report 4.24 58.28 $247.11

88173 TC Cytopath eval fna report 2.22 58.28 $129.38

88173 26 Cytopath eval fna report 2.02 58.28 $117.73

88174 Cytopath c/v auto in fluid 0.00 58.28 $0.00

88175 Cytopath c/v auto fluid redo 0.00 58.28 $0.00

88177 Cytp fna eval ea addl 0.86 58.28 $50.12

88177 TC Cytp fna eval ea addl 0.22 58.28 $12.82

88177 26 Cytp fna eval ea addl 0.64 58.28 $37.30

88182 Cell marker study 3.04 58.28 $177.17

88182 TC Cell marker study 2.03 58.28 $118.31

88182 26 Cell marker study 1.01 58.28 $58.86

88184 Flowcytometry/ tc 1 marker 2.63 58.28 $153.28

88185 Flowcytometry/tc add-on 1.60 58.28 $93.25

88187 Flowcytometry/read 2-8 2.02 58.28 $117.73

88188 Flowcytometry/read 9-15 2.57 58.28 $149.78

88189 Flowcytometry/read 16 & > 3.17 58.28 $184.75

88199 Cytopathology procedure 0.00 58.28 $0.00

88199 TC Cytopathology procedure 0.00 58.28 $0.00

88199 26 Cytopathology procedure 0.00 58.28 $0.00

88230 Tissue culture lymphocyte 0.00 58.28 $0.00

88233 Tissue culture skin/biopsy 0.00 58.28 $0.00

88235 Tissue culture placenta 0.00 58.28 $0.00

88237 Tissue culture bone marrow 0.00 58.28 $0.00

88239 Tissue culture tumor 0.00 58.28 $0.00

88240 Cell cryopreserve/storage 0.00 58.28 $0.00

88241 Frozen cell preparation 0.00 58.28 $0.00

88245 Chromosome analysis 20-25 0.00 58.28 $0.00

88249 Chromosome analysis 100 0.00 58.28 $0.00

88267 Chromosome analys placenta 0.00 58.28 $0.00

88269 Chromosome analys amniotic 0.00 58.28 $0.00

88271 Cytogenetics dna probe 0.00 58.28 $0.00

88272 Cytogenetics 3-5 0.00 58.28 $0.00

88273 Cytogenetics 10-30 0.00 58.28 $0.00

88274 Cytogenetics 25-99 0.00 58.28 $0.00

88275 Cytogenetics 100-300 0.00 58.28 $0.00

88280 Chromosome karyotype study 0.00 58.28 $0.00

88283 Chromosome banding study 0.00 58.28 $0.00

88285 Chromosome count additional 0.00 58.28 $0.00

88289 Chromosome study additional 0.00 58.28 $0.00

88291 Cyto/molecular report 0.89 58.28 $51.87

88299 Cytogenetic study 0.00 58.28 $0.00

88300 Surgical path gross 0.43 58.28 $25.06

88300 TC Surgical path gross 0.30 58.28 $17.48

88300 26 Surgical path gross 0.13 58.28 $7.58

88302 Tissue exam by pathologist 0.90 58.28 $52.45

88302 TC Tissue exam by pathologist 0.70 58.28 $40.80

88302 26 Tissue exam by pathologist 0.20 58.28 $11.66

88311 Decalcify tissue 0.59 58.28 $34.39

88311 TC Decalcify tissue 0.23 58.28 $13.40

88311 26 Decalcify tissue 0.36 58.28 $20.98

88312 Special stains group 1 2.73 58.28 $159.10

88312 TC Special stains group 1 1.95 58.28 $113.65

88312 26 Special stains group 1 0.78 58.28 $45.46

88313 Special stains group 2 1.90 58.28 $110.73

88313 TC Special stains group 2 1.55 58.28 $90.33

88313 26 Special stains group 2 0.35 58.28 $20.40

88314 Histochemical stains add-on 2.09 58.28 $121.81

88314 TC Histochemical stains add-on 1.45 58.28 $84.51

88314 26 Histochemical stains add-on 0.64 58.28 $37.30

88319 Enzyme histochemistry 2.48 58.28 $144.53

88319 TC Enzyme histochemistry 1.69 58.28 $98.49

88319 26 Enzyme histochemistry 0.79 58.28 $46.04

88321 Microslide consultation 2.70 58.28 $157.36

88323 Microslide consultation 4.26 58.28 $248.27

88323 TC Microslide consultation 1.76 58.28 $102.57

88323 26 Microslide consultation 2.50 58.28 $145.70

88325 Comprehensive review of data 6.03 58.28 $351.43

88329 Path consult introp 1.65 58.28 $96.16

88331 Path consult intraop 1 bloc 2.89 58.28 $168.43

88331 TC Path consult intraop 1 bloc 1.09 58.28 $63.53

88331 26 Path consult intraop 1 bloc 1.80 58.28 $104.90

88332 Path consult intraop addl 1.27 58.28 $74.02

88332 TC Path consult intraop addl 0.38 58.28 $22.15

88332 26 Path consult intraop addl 0.89 58.28 $51.87

88333 Intraop cyto path consult 1 3.05 58.28 $177.75

88333 TC Intraop cyto path consult 1 1.24 58.28 $72.27

88333 26 Intraop cyto path consult 1 1.81 58.28 $105.49

88334 Intraop cyto path consult 2 1.87 58.28 $108.98

88334 TC Intraop cyto path consult 2 0.76 58.28 $44.29

88334 26 Intraop cyto path consult 2 1.11 58.28 $64.69

88341 Immunohisto antibody slide 1.89 58.28 $110.15

88341 TC Immunohisto antibody slide 1.28 58.28 $74.60

88341 26 Immunohisto antibody slide 0.61 58.28 $35.55

88342 Immunohisto antibody stain 2.53 58.28 $147.45

88342 TC Immunohisto antibody stain 1.51 58.28 $88.00

88342 26 Immunohisto antibody stain 1.02 58.28 $59.45

88344 Immunohisto antibody slide 3.27 58.28 $190.58

88344 TC Immunohisto antibody slide 2.15 58.28 $125.30

88344 26 Immunohisto antibody slide 1.12 58.28 $65.27

88346 Immunofluorescent study 3.09 58.28 $180.09

88346 TC Immunofluorescent study 1.87 58.28 $108.98

88346 26 Immunofluorescent study 1.22 58.28 $71.10

88347 Immunofluorescent study 2.60 58.28 $151.53

88347 TC Immunofluorescent study 1.40 58.28 $81.59

88347 26 Immunofluorescent study 1.20 58.28 $69.94

88348 Electron microscopy 9.70 58.28 $565.32

88348 TC Electron microscopy 7.52 58.28 $438.27

88348 26 Electron microscopy 2.18 58.28 $127.05

88355 Analysis skeletal muscle 4.89 58.28 $284.99

88355 TC Analysis skeletal muscle 2.56 58.28 $149.20

88355 26 Analysis skeletal muscle 2.33 58.28 $135.79

88356 Analysis nerve 5.75 58.28 $335.11

88356 TC Analysis nerve 2.33 58.28 $135.79

88356 26 Analysis nerve 3.42 58.28 $199.32

88358 Analysis tumor 2.36 58.28 $137.54

88358 TC Analysis tumor 1.09 58.28 $63.53

88358 26 Analysis tumor 1.27 58.28 $74.02

88360 Tumor immunohistochem/manual 3.80 58.28 $221.46

88360 TC Tumor immunohistochem/manual 2.25 58.28 $131.13

88360 26 Tumor immunohistochem/manual 1.55 58.28 $90.33

88361 Tumor immunohistochem/comput 4.74 58.28 $276.25

88361 TC Tumor immunohistochem/comput 3.06 58.28 $178.34

88361 26 Tumor immunohistochem/comput 1.68 58.28 $97.91

88362 Nerve teasing preparations 8.28 58.28 $482.56

88362 TC Nerve teasing preparations 5.13 58.28 $298.98

88362 26 Nerve teasing preparations 3.15 58.28 $183.58

88363 Xm archive tissue molec anal 0.64 58.28 $37.30

88364 Insitu hybridization (fish) 2.72 58.28 $158.52

88364 TC Insitu hybridization (fish) 1.96 58.28 $114.23

88364 26 Insitu hybridization (fish) 0.76 58.28 $44.29

88367 Insitu hybridization auto 3.00 58.28 $174.84

88367 TC Insitu hybridization auto 2.01 58.28 $117.14

88367 26 Insitu hybridization auto 0.99 58.28 $57.70

88368 Insitu hybridization manual 3.04 58.28 $177.17

88368 TC Insitu hybridization manual 1.89 58.28 $110.15

88368 26 Insitu hybridization manual 1.15 58.28 $67.02

88369 M/phmtrc alysishquant/semiq 2.06 58.28 $120.06

88369 TC M/phmtrc alysishquant/semiq 1.36 58.28 $79.26

88369 26 M/phmtrc alysishquant/semiq 0.70 58.28 $40.80

88371 Protein western blot tissue 0.00 58.28 $0.00

88371 26 Protein western blot tissue 0.53 58.28 $30.89

88372 Protein analysis w/probe 0.00 58.28 $0.00

88372 26 Protein analysis w/probe 0.53 58.28 $30.89

88373 M/phmtrc alys ishquant/semiq 1.69 58.28 $98.49

88373 TC M/phmtrc alys ishquant/semiq 1.10 58.28 $64.11

88373 26 M/phmtrc alys ishquant/semiq 0.59 58.28 $34.39

88375 Optical endomicroscpy interp 1.34 58.28 $78.10

88380 Microdissection laser 3.71 58.28 $216.22

88380 TC Microdissection laser 2.13 58.28 $124.14

88380 26 Microdissection laser 1.58 58.28 $92.08

88381 Microdissection manual 3.48 58.28 $202.81

88381 TC Microdissection manual 2.75 58.28 $160.27

88381 26 Microdissection manual 0.73 58.28 $42.54

88387 Tiss exam molecular study 1.20 58.28 $69.94

88387 TC Tiss exam molecular study 0.28 58.28 $16.32

88387 26 Tiss exam molecular study 0.92 58.28 $53.62

88388 Tiss ex molecul study add-on 0.96 58.28 $55.95

88388 TC Tiss ex molecul study add-on 0.27 58.28 $15.74

88388 26 Tiss ex molecul study add-on 0.69 58.28 $40.21

88399 Surgical pathology procedure 0.00 58.28 $0.00

88399 TC Surgical pathology procedure 0.00 58.28 $0.00

88399 26 Surgical pathology procedure 0.00 58.28 $0.00

88720 Bilirubin total transcut 0.00 58.28 $0.00

88738 Hgb quant transcutaneous 0.00 58.28 $0.00

88740 Transcutaneous carboxyhb 0.00 58.28 $0.00

88741 Transcutaneous methb 0.00 58.28 $0.00

88749 In vivo lab service 0.00 58.28 $0.00

89049 Chct for mal hyperthermia 6.76 58.28 $393.97

89050 Body fluid cell count 0.00 58.28 $0.00

89051 Body fluid cell count 0.00 58.28 $0.00

89055 Leukocyte assessment fecal 0.00 58.28 $0.00

89060 Exam synovial fluid crystals 0.00 58.28 $0.00

89060 26 Exam synovial fluid crystals 0.53 58.28 $30.89

89125 Specimen fat stain 0.00 58.28 $0.00

89160 Exam feces for meat fibers 0.00 58.28 $0.00

89190 Nasal smear for eosinophils 0.00 58.28 $0.00

89220 Sputum specimen collection 0.44 58.28 $25.64

89230 Collect sweat for test 0.07 58.28 $4.08

89240 Pathology lab procedure 0.00 58.28 $0.00

89250 Cultr oocyte/embryo <4 days 0.00 58.28 $0.00

89251 Cultr oocyte/embryo <4 days 0.00 58.28 $0.00

89253 Embryo hatching 0.00 58.28 $0.00

89254 Oocyte identification 0.00 58.28 $0.00

89255 Prepare embryo for transfer 0.00 58.28 $0.00

89257 Sperm identification 0.00 58.28 $0.00

89258 Cryopreservation embryo(s) 0.00 58.28 $0.00

89259 Cryopreservation sperm 0.00 58.28 $0.00

89260 Sperm isolation simple 0.00 58.28 $0.00

89261 Sperm isolation complex 0.00 58.28 $0.00

89264 Identify sperm tissue 0.00 58.28 $0.00

89268 Insemination of oocytes 0.00 58.28 $0.00

89272 Extended culture of oocytes 0.00 58.28 $0.00

89280 Assist oocyte fertilization 0.00 58.28 $0.00

89281 Assist oocyte fertilization 0.00 58.28 $0.00

89290 Biopsy oocyte polar body 0.00 58.28 $0.00

89291 Biopsy oocyte polar body 0.00 58.28 $0.00

89300 Semen analysis w/huhner 0.00 58.28 $0.00

89310 Semen analysis w/count 0.00 58.28 $0.00

89320 Semen anal vol/count/mot 0.00 58.28 $0.00

89321 Semen anal sperm detection 0.00 58.28 $0.00

89322 Semen anal strict criteria 0.00 58.28 $0.00

89325 Sperm antibody test 0.00 58.28 $0.00

89329 Sperm evaluation test 0.00 58.28 $0.00

89330 Evaluation cervical mucus 0.00 58.28 $0.00

89331 Retrograde ejaculation anal 0.00 58.28 $0.00

89335 Cryopreserve testicular tiss 0.00 58.28 $0.00

89337 Cryopreservation oocyte(s) 0.00 58.28 $0.00

89342 Storage/year embryo(s) 0.00 58.28 $0.00

89343 Storage/year sperm/semen 0.00 58.28 $0.00

89344 Storage/year reprod tissue 0.00 58.28 $0.00

89346 Storage/year oocyte(s) 0.00 58.28 $0.00

89352 Thawing cryopresrved embryo 0.00 58.28 $0.00

89353 Thawing cryopresrved sperm 0.00 58.28 $0.00

89354 Thaw cryoprsvrd reprod tiss 0.00 58.28 $0.00

89356 Thawing cryopresrved oocyte 0.00 58.28 $0.00

89398 Unlisted reprod med lab proc 0.00 58.28 $0.00

9001F Aortic aneurysm<5cm diam ct 0.00 44.28 $0.00

9002F Aortic aneurysm 5-5.4cm diam 0.00 44.28 $0.00

9003F Aortic anrysm5.5-5.9cm diam 0.00 44.28 $0.00

9004F Aortic anrysm 6/> cm diam 0.00 44.28 $0.00

9005F Asympt carot/vrtbrbas sten 0.00 44.28 $0.00

9006F Sympt sten-tia/strk<120days 0.00 44.28 $0.00

9007F Other carot sten 120 days/> 0.00 44.28 $0.00

90281 Human ig im 0.00 44.28 $0.00

90283 Human ig iv 0.00 44.28 $0.00

90284 Human ig sc 0.00 44.28 $0.00

90287 Botulinum antitoxin 0.00 44.28 $0.00

90288 Botulism ig iv 0.00 44.28 $0.00

90291 Cmv ig iv 0.00 44.28 $0.00

90296 Diphtheria antitoxin 0.00 44.28 $0.00

90371 Hep b ig im 0.00 44.28 $0.00

90375 Rabies ig im/sc 0.00 44.28 $0.00

90376 Rabies ig heat treated 0.00 44.28 $0.00

90378 Rsv mab im 50mg 0.00 44.28 $0.00

90384 Rh ig full-dose im 0.00 44.28 $0.00

90385 Rh ig minidose im 0.00 44.28 $0.00

90386 Rh ig iv 0.00 44.28 $0.00

90389 Tetanus ig im 0.00 44.28 $0.00

90393 Vaccina ig im 0.00 44.28 $0.00

90396 Varicella-zoster ig im 0.00 44.28 $0.00

90399 Immune globulin 0.00 44.28 $0.00

90460 Im admin 1st/only component 0.71 44.28 $31.44

90461 Im admin each addl component 0.36 44.28 $15.94

90471 Immunization admin 0.71 44.28 $31.44

90472 Immunization admin each add 0.36 44.28 $15.94

90473 Immune admin oral/nasal 0.71 44.28 $31.44

90474 Immune admin oral/nasal addl 0.36 44.28 $15.94

90476 Adenovirus vaccine type 4 0.00 44.28 $0.00

90477 Adenovirus vaccine type 7 0.00 44.28 $0.00

90581 Anthrax vaccine sc or im 0.00 44.28 $0.00

90585 Bcg vaccine percut 0.00 44.28 $0.00

90586 Bcg vaccine intravesical 0.00 44.28 $0.00

90630 Flu vacc iiv4 no preserv id 0.00 44.28 $0.00

90632 Hep a vaccine adult im 0.00 44.28 $0.00

90633 Hep a vacc ped/adol 2 dose 0.00 44.28 $0.00

90634 Hep a vacc ped/adol 3 dose 0.00 44.28 $0.00

90636 Hep a/hep b vacc adult im 0.00 44.28 $0.00

90644 Meningoccl hib vac 4 dose im 0.00 44.28 $0.00

90645 Hib vaccine hboc im 0.00 44.28 $0.00

90646 Hib vaccine prp-d im 0.00 44.28 $0.00

90647 Hib vaccine prp-omp im 0.00 44.28 $0.00

90648 Hib vaccine prp-t im 0.00 44.28 $0.00

90649 Hpv vaccine 4 valent im 0.00 44.28 $0.00

90650 Hpv vaccine 2 valent im 0.00 44.28 $0.00

90651 Hpv vaccine non valent im 0.00 44.28 $0.00

90653 Flu vaccine adjuvant im 0.00 44.28 $0.00

90654 Flu vacc iiv3 no preserv id 0.00 44.28 $0.00

90655 Flu vac no prsv 3 val 6-35 m 0.00 44.28 $0.00

90656 Flu vaccine no preserv 3 & > 0.00 44.28 $0.00

90657 Flu vaccine 3 yrs im 0.00 44.28 $0.00

90658 Flu vaccine 3 yrs & > im 0.00 44.28 $0.00

90660 Flu vaccine nasal 0.00 44.28 $0.00

90661 Flu vacc cell cult prsv free 0.00 44.28 $0.00

90662 Flu vacc prsv free inc antig 0.00 44.28 $0.00

90664 Flu vacc pandemic intranasal 0.00 44.28 $0.00

90666 Flu vac pandem prsrv free im 0.00 44.28 $0.00

90667 Flu vac pandemic adjuvant im 0.00 44.28 $0.00

90668 Flu vac pandemic splt im 0.00 44.28 $0.00

90669 Pneumococcal vacc 7 val im 0.00 44.28 $0.00

90672 Flu vaccine 4 valent nasal 0.00 44.28 $0.00

90673 Flu vacc riv3 no preserv 0.00 44.28 $0.00

90675 Rabies vaccine im 0.00 44.28 $0.00

90676 Rabies vaccine id 0.00 44.28 $0.00

90680 Rotovirus vacc 3 dose oral 0.00 44.28 $0.00

90681 Rotavirus vacc 2 dose oral 0.00 44.28 $0.00

90685 Flu vac no prsv 4 val 6-35 m 0.00 44.28 $0.00

90686 Flu vac no prsv 4 val 3 yrs+ 0.00 44.28 $0.00

90687 Flu vaccine 4 val 6-35 mo im 0.00 44.28 $0.00

90688 Flu vacc 4 val 3 yrs plus im 0.00 44.28 $0.00

90690 Typhoid vaccine oral 0.00 44.28 $0.00

90691 Typhoid vaccine im 0.00 44.28 $0.00

90692 Typhoid vaccine h-p sc/id 0.00 44.28 $0.00

90693 Typhoid vaccine akd sc 0.00 44.28 $0.00

90696 Dtap-ipv vacc 4-6 yr im 0.00 44.28 $0.00

90698 Dtap-hib-ip vaccine im 0.00 44.28 $0.00

90700 Dtap vaccine < 7 yrs im 0.00 44.28 $0.00

90702 Dt vaccine < 7 yrs im 0.00 44.28 $0.00

90703 Tetanus vaccine im 0.00 44.28 $0.00

90704 Mumps vaccine sc 0.00 44.28 $0.00

90705 Measles vaccine sc 0.00 44.28 $0.00

90706 Rubella vaccine sc 0.00 44.28 $0.00

90707 Mmr vaccine sc 0.00 44.28 $0.00

90708 Measles-rubella vaccine sc 0.00 44.28 $0.00

90710 Mmrv vaccine sc 0.00 44.28 $0.00

90712 Oral poliovirus vaccine 0.00 44.28 $0.00

90713 Poliovirus ipv sc/im 0.00 44.28 $0.00

90714 Td vaccine no prsrv 7/> im 0.00 44.28 $0.00

90715 Tdap vaccine 7 yrs/> im 0.00 44.28 $0.00

90716 Chicken pox vaccine sc 0.00 44.28 $0.00

90717 Yellow fever vaccine sc 0.00 44.28 $0.00

90719 Diphtheria vaccine im 0.00 44.28 $0.00

90720 Dtp/hib vaccine im 0.00 44.28 $0.00

90721 Dtap/hib vaccine im 0.00 44.28 $0.00

90723 Dtap-hep b-ipv vaccine im 0.00 44.28 $0.00

90725 Cholera vaccine injectable 0.00 44.28 $0.00

90727 Plague vaccine im 0.00 44.28 $0.00

90733 Meningococcal vaccine sc 0.00 44.28 $0.00

90734 Meningococcal vaccine im 0.00 44.28 $0.00

90735 Encephalitis vaccine sc 0.00 44.28 $0.00

90736 Zoster vacc sc 0.00 44.28 $0.00

90738 Inactivated je vacc im 0.00 44.28 $0.00

90739 Hep b vacc adult 2 dose im 0.00 44.28 $0.00

90740 Hepb vacc ill pat 3 dose im 0.00 44.28 $0.00

90743 Hep b vacc adol 2 dose im 0.00 44.28 $0.00

90744 Hepb vacc ped/adol 3 dose im 0.00 44.28 $0.00

90746 Hep b vacc adult 3 dose im 0.00 44.28 $0.00

90747 Hepb vacc ill pat 4 dose im 0.00 44.28 $0.00

90748 Hep b/hib vaccine im 0.00 44.28 $0.00

90749 Vaccine toxoid 0.00 44.28 $0.00

90785 Psytx complex interactive 0.40 44.28 $17.71

90791 Psych diagnostic evaluation 3.67 44.28 $162.51

90792 Psych diag eval w/med srvcs 4.12 44.28 $182.43

90832 Psytx pt&/family 30 minutes 1.79 44.28 $79.26

90833 Psytx pt&/fam w/e&m 30 min 1.84 44.28 $81.48

90839 Psytx crisis initial 60 min 3.72 44.28 $164.72

90840 Psytx crisis ea addl 30 min 1.78 44.28 $78.82

90845 Psychoanalysis 2.55 44.28 $112.91

90846 Family psytx w/o patient 2.87 44.28 $127.08

90847 Family psytx w/patient 2.99 44.28 $132.40

90849 Multiple family group psytx 0.99 44.28 $43.84

90853 Group psychotherapy 0.72 44.28 $31.88

90863 Pharmacologic mgmt w/psytx 0.00 44.28 $0.00

90865 Narcosynthesis 4.73 44.28 $209.44

90867 Tcranial magn stim tx plan 0.00 44.28 $0.00

90868 Tcranial magn stim tx deli 0.00 44.28 $0.00

90869 Tcran magn stim redetemine 0.00 44.28 $0.00

90870 Electroconvulsive therapy 4.99 44.28 $220.96

90875 Psychophysiological therapy 1.73 44.28 $76.60

90876 Psychophysiological therapy 3.07 44.28 $135.94

90880 Hypnotherapy 2.84 44.28 $125.76

90882 Environmental manipulation 0.00 44.28 $0.00

90885 Psy evaluation of records 1.40 44.28 $61.99

90887 Consultation with family 2.50 44.28 $110.70

90889 Preparation of report 0.00 44.28 $0.00

90899 Psychiatric service/therapy 0.00 44.28 $0.00

90901 Biofeedback train any meth 1.07 44.28 $47.38

90911 Biofeedback peri/uro/rectal 2.38 44.28 $105.39

90935 Hemodialysis one evaluation 2.05 44.28 $90.77

90937 Hemodialysis repeated eval 2.94 44.28 $130.18

90940 Hemodialysis access study 0.00 44.28 $0.00

90945 Dialysis one evaluation 2.42 44.28 $107.16

90947 Dialysis repeated eval 3.50 44.28 $154.98

90951 Esrd serv 4 visits p mo <2yr 26.52 44.28 $1,174.31

90952 Esrd serv 2-3 vsts p mo <2yr 0.00 44.28 $0.00

90953 Esrd serv 1 visit p mo <2yrs 0.00 44.28 $0.00

90954 Esrd serv 4 vsts p mo 2-11 23.09 44.28 $1,022.43

90955 Esrd srv 2-3 vsts p mo 2-11 12.92 44.28 $572.10

90956 Esrd srv 1 visit p mo 2-11 9.04 44.28 $400.29

90957 Esrd srv 4 vsts p mo 12-19 18.20 44.28 $805.90

90958 Esrd srv 2-3 vsts p mo 12-19 12.28 44.28 $543.76

90959 Esrd serv 1 vst p mo 12-19 8.35 44.28 $369.74

90960 Esrd srv 4 visits p mo 20+ 8.01 44.28 $354.68

90961 Esrd srv 2-3 vsts p mo 20+ 6.74 44.28 $298.45

90962 Esrd serv 1 visit p mo 20+ 5.19 44.28 $229.81

90963 Esrd home pt serv p mo <2yrs 15.39 44.28 $681.47

90964 Esrd home pt serv p mo 2-11 13.41 44.28 $593.79

90965 Esrd home pt serv p mo 12-19 12.79 44.28 $566.34

90966 Esrd home pt serv p mo 20+ 6.71 44.28 $297.12

90967 Esrd home pt serv p day <2 0.51 44.28 $22.58

90968 Esrd home pt srv p day 2-11 0.44 44.28 $19.48

90969 Esrd home pt srv p day 12-19 0.43 44.28 $19.04

90970 Esrd home pt serv p day 20+ 0.22 44.28 $9.74

90989 Dialysis training complete 0.00 44.28 $0.00

90993 Dialysis training incompl 0.00 44.28 $0.00

90997 Hemoperfusion 2.67 44.28 $118.23

90999 Dialysis procedure 0.00 44.28 $0.00

91010 Esophagus motility study 5.03 44.28 $222.73

91010 TC Esophagus motility study 3.09 44.28 $136.83

91010 26 Esophagus motility study 1.94 44.28 $85.90

91013 Esophgl motil w/stim/perfus 0.68 44.28 $30.11

91013 TC Esophgl motil w/stim/perfus 0.41 44.28 $18.15

91013 26 Esophgl motil w/stim/perfus 0.27 44.28 $11.96

91020 Gastric motility studies 6.63 44.28 $293.58

91020 TC Gastric motility studies 4.49 44.28 $198.82

91020 26 Gastric motility studies 2.14 44.28 $94.76

91022 Duodenal motility study 4.82 44.28 $213.43

91022 TC Duodenal motility study 2.67 44.28 $118.23

91022 26 Duodenal motility study 2.15 44.28 $95.20

91030 Acid perfusion of esophagus 3.89 44.28 $172.25

91030 TC Acid perfusion of esophagus 2.54 44.28 $112.47

91030 26 Acid perfusion of esophagus 1.35 44.28 $59.78

91034 Gastroesophageal reflux test 5.32 44.28 $235.57

91034 TC Gastroesophageal reflux test 3.89 44.28 $172.25

91034 26 Gastroesophageal reflux test 1.43 44.28 $63.32

91035 G-esoph reflx tst w/electrod 13.70 44.28 $606.64

91035 TC G-esoph reflx tst w/electrod 11.32 44.28 $501.25

91035 26 G-esoph reflx tst w/electrod 2.38 44.28 $105.39

91037 Esoph imped function test 4.58 44.28 $202.80

91037 TC Esoph imped function test 3.12 44.28 $138.15

91037 26 Esoph imped function test 1.46 44.28 $64.65

91038 Esoph imped funct test > 1hr 12.89 44.28 $570.77

91038 TC Esoph imped funct test > 1hr 11.21 44.28 $496.38

91038 26 Esoph imped funct test > 1hr 1.68 44.28 $74.39

91040 Esoph balloon distension tst 12.45 44.28 $551.29

91040 TC Esoph balloon distension tst 11.01 44.28 $487.52

91040 26 Esoph balloon distension tst 1.44 44.28 $63.76

91065 Breath hydrogen/methane test 2.30 44.28 $101.84

91065 TC Breath hydrogen/methane test 2.00 44.28 $88.56

91065 26 Breath hydrogen/methane test 0.30 44.28 $13.28

91110 Gi tract capsule endoscopy 25.31 44.28 $1,120.73

91110 TC Gi tract capsule endoscopy 19.85 44.28 $878.96

91110 26 Gi tract capsule endoscopy 5.46 44.28 $241.77

91111 Esophageal capsule endoscopy 20.76 44.28 $919.25

91111 TC Esophageal capsule endoscopy 19.27 44.28 $853.28

91111 26 Esophageal capsule endoscopy 1.49 44.28 $65.98

91112 Gi wireless capsule measure 30.79 44.28 $1,363.38

91112 TC Gi wireless capsule measure 27.64 44.28 $1,223.90

91112 26 Gi wireless capsule measure 3.15 44.28 $139.48

91117 Colon motility 6 hr study 4.02 44.28 $178.01

91120 Rectal sensation test 12.20 44.28 $540.22

91120 TC Rectal sensation test 10.74 44.28 $475.57

91120 26 Rectal sensation test 1.46 44.28 $64.65

91122 Anal pressure record 6.38 44.28 $282.51

91122 TC Anal pressure record 3.83 44.28 $169.59

91122 26 Anal pressure record 2.55 44.28 $112.91

91132 Electrogastrography 4.22 44.28 $186.86

91132 TC Electrogastrography 3.44 44.28 $152.32

91132 26 Electrogastrography 0.78 44.28 $34.54

91133 Electrogastrography w/test 4.89 44.28 $216.53

91133 TC Electrogastrography w/test 3.91 44.28 $173.13

91133 26 Electrogastrography w/test 0.98 44.28 $43.39

91200 Liver elastography 1.01 44.28 $44.72

91200 TC Liver elastography 0.60 44.28 $26.57

91200 26 Liver elastography 0.41 44.28 $18.15

91299 Gastroenterology procedure 0.00 44.28 $0.00

91299 TC Gastroenterology procedure 0.00 44.28 $0.00

91299 26 Gastroenterology procedure 0.00 44.28 $0.00

92002 Eye exam new patient 2.28 44.28 $100.96

92004 Eye exam new patient 4.17 44.28 $184.65

92012 Eye exam establish patient 2.40 44.28 $106.27

92014 Eye exam&tx estab pt 1/>vst 3.47 44.28 $153.65

92015 Determine refractive state 0.56 44.28 $24.80

92018 New eye exam & treatment 4.10 44.28 $181.55

92019 Eye exam & treatment 2.03 44.28 $89.89

92020 Special eye evaluation 0.75 44.28 $33.21

92025 Corneal topography 1.07 44.28 $47.38

92025 TC Corneal topography 0.50 44.28 $22.14

92025 26 Corneal topography 0.57 44.28 $25.24

92060 Special eye evaluation 1.83 44.28 $81.03

92060 TC Special eye evaluation 0.75 44.28 $33.21

92060 26 Special eye evaluation 1.08 44.28 $47.82

92065 Orthoptic/pleoptic training 1.51 44.28 $66.86

92065 TC Orthoptic/pleoptic training 1.00 44.28 $44.28

92065 26 Orthoptic/pleoptic training 0.51 44.28 $22.58

92071 Contact lens fitting for tx 1.07 44.28 $47.38

92072 Fit contac lens for managmnt 3.79 44.28 $167.82

92081 Visual field examination(s) 0.96 44.28 $42.51

92081 TC Visual field examination(s) 0.50 44.28 $22.14

92081 26 Visual field examination(s) 0.46 44.28 $20.37

92100 Serial tonometry exam(s) 2.26 44.28 $100.07

92132 Cmptr ophth dx img ant segmt 0.98 44.28 $43.39

92132 TC Cmptr ophth dx img ant segmt 0.44 44.28 $19.48

92132 26 Cmptr ophth dx img ant segmt 0.54 44.28 $23.91

92133 Cmptr ophth img optic nerve 1.24 44.28 $54.91

92133 TC Cmptr ophth img optic nerve 0.45 44.28 $19.93

92133 26 Cmptr ophth img optic nerve 0.79 44.28 $34.98

92134 Cptr ophth dx img post segmt 1.27 44.28 $56.24

92134 TC Cptr ophth dx img post segmt 0.46 44.28 $20.37

92134 26 Cptr ophth dx img post segmt 0.81 44.28 $35.87

92136 Ophthalmic biometry 2.54 44.28 $112.47

92136 TC Ophthalmic biometry 1.66 44.28 $73.50

92136 26 Ophthalmic biometry 0.88 44.28 $38.97

92140 Glaucoma provocative tests 1.77 44.28 $78.38

92145 Corneal hysteresis deter 0.44 44.28 $19.48

92145 TC Corneal hysteresis deter 0.19 44.28 $8.41

92145 26 Corneal hysteresis deter 0.25 44.28 $11.07

92225 Special eye exam initial 0.76 44.28 $33.65

92226 Special eye exam subsequent 0.70 44.28 $31.00

92227 Remote dx retinal imaging 0.41 44.28 $18.15

92228 Remote retinal imaging mgmt 1.00 44.28 $44.28

92228 TC Remote retinal imaging mgmt 0.39 44.28 $17.27

92228 26 Remote retinal imaging mgmt 0.61 44.28 $27.01

92230 Eye exam with photos 1.63 44.28 $72.18

92235 TC Eye exam with photos 1.76 44.28 $77.93

92235 26 Eye exam with photos 1.33 44.28 $58.89

92240 Icg angiography 7.17 44.28 $317.49

92240 TC Icg angiography 5.37 44.28 $237.78

92240 26 Icg angiography 1.80 44.28 $79.70

92250 TC Eye exam with photos 1.54 44.28 $68.19

92250 26 Eye exam with photos 0.68 44.28 $30.11

92260 Ophthalmoscopy/dynamometry 0.52 44.28 $23.03

92265 Eye muscle evaluation 2.42 44.28 $107.16

92265 TC Eye muscle evaluation 1.10 44.28 $48.71

92265 26 Eye muscle evaluation 1.32 44.28 $58.45

92270 Electro-oculography 2.59 44.28 $114.69

92270 TC Electro-oculography 1.42 44.28 $62.88

92270 26 Electro-oculography 1.17 44.28 $51.81

92275 Electroretinography 4.13 44.28 $182.88

92275 TC Electroretinography 2.62 44.28 $116.01

92275 26 Electroretinography 1.51 44.28 $66.86

92283 Color vision examination 1.58 44.28 $69.96

92283 TC Color vision examination 1.31 44.28 $58.01

92283 26 Color vision examination 0.27 44.28 $11.96

92284 Dark adaptation eye exam 1.76 44.28 $77.93

92284 TC Dark adaptation eye exam 1.40 44.28 $61.99

92284 26 Dark adaptation eye exam 0.36 44.28 $15.94

92285 Eye photography 0.58 44.28 $25.68

92285 TC Eye photography 0.49 44.28 $21.70

92285 26 Eye photography 0.09 44.28 $3.99

92286 Internal eye photography 1.08 44.28 $47.82

92286 TC Internal eye photography 0.45 44.28 $19.93

92286 26 Internal eye photography 0.63 44.28 $27.90

92287 Internal eye photography 3.88 44.28 $171.81

92287 TC Internal eye photography 2.56 44.28 $113.36

92287 26 Internal eye photography 1.32 44.28 $58.45

92310 Contact lens fitting 2.70 44.28 $119.56

92314 Prescription of contact lens 2.25 44.28 $99.63

92315 Rx cntact lens aphakia 1 eye 2.05 44.28 $90.77

92316 Rx cntact lens aphakia 2 eye 2.58 44.28 $114.24

92317 Rx corneoscleral cntact lens 2.14 44.28 $94.76

92325 Modification of contact lens 1.19 44.28 $52.69

92326 Replacement of contact lens 0.99 44.28 $43.84

92340 Fit spectacles monofocal 1.00 44.28 $44.28

92341 Fit spectacles bifocal 1.14 44.28 $50.48

92342 Fit spectacles multifocal 1.23 44.28 $54.46

92352 Fit aphakia spectcl monofocl 1.14 44.28 $50.48

92353 Fit aphakia spectcl multifoc 1.33 44.28 $58.89

92354 Fit spectacles single system 0.38 44.28 $16.83

92355 Fit spectacles compound lens 0.59 44.28 $26.13

92358 Aphakia prosth service temp 0.32 44.28 $14.17

92370 Repair & adjust spectacles 0.87 44.28 $38.52

92371 Repair & adjust spectacles 0.33 44.28 $14.61

92499 Eye service or procedure 0.00 44.28 $0.00

92499 TC Eye service or procedure 0.00 44.28 $0.00

92499 26 Eye service or procedure 0.00 44.28 $0.00

92502 Ear and throat examination 2.75 44.28 $121.77

92504 Ear microscopy examination 0.85 44.28 $37.64

92507 Speech/hearing therapy 2.23 44.28 $98.74

92508 Speech/hearing therapy 0.66 44.28 $29.22

92511 Nasopharyngoscopy 3.85 44.28 $170.48

92512 Nasal function studies 1.73 44.28 $76.60

92516 Facial nerve function test 1.99 44.28 $88.12

92520 Laryngeal function studies 2.12 44.28 $93.87

92521 Evaluation of speech fluency 3.04 44.28 $134.61

92522 Evaluate speech production 2.60 44.28 $115.13

92523 Speech sound lang comprehen 5.30 44.28 $234.68

92524 Behavral qualit analys voice 2.54 44.28 $112.47

92526 Oral function therapy 2.42 44.28 $107.16

92531 Spontaneous nystagmus study 0.00 44.28 $0.00

92532 Positional nystagmus test 0.00 44.28 $0.00

92533 Caloric vestibular test 0.00 44.28 $0.00

92534 Optokinetic nystagmus test 0.00 44.28 $0.00

92540 Basic vestibular evaluation 2.87 44.28 $127.08

92540 TC Basic vestibular evaluation 0.63 44.28 $27.90

92540 26 Basic vestibular evaluation 2.24 44.28 $99.19

92541 Spontaneous nystagmus test 0.63 44.28 $27.90

92541 TC Spontaneous nystagmus test 0.04 44.28 $1.77

92541 26 Spontaneous nystagmus test 0.59 44.28 $26.13

92542 Positional nystagmus test 0.74 44.28 $32.77

92542 TC Positional nystagmus test 0.04 44.28 $1.77

92542 26 Positional nystagmus test 0.70 44.28 $31.00

92543 Caloric vestibular test 0.45 44.28 $19.93

92543 TC Caloric vestibular test 0.29 44.28 $12.84

92543 26 Caloric vestibular test 0.16 44.28 $7.08

92544 Optokinetic nystagmus test 0.44 44.28 $19.48

92544 TC Optokinetic nystagmus test 0.04 44.28 $1.77

92544 26 Optokinetic nystagmus test 0.40 44.28 $17.71

92545 Oscillating tracking test 0.41 44.28 $18.15

92545 TC Oscillating tracking test 0.04 44.28 $1.77

92545 26 Oscillating tracking test 0.37 44.28 $16.38

92546 Sinusoidal rotational test 2.90 44.28 $128.41

92546 TC Sinusoidal rotational test 2.48 44.28 $109.81

92546 26 Sinusoidal rotational test 0.42 44.28 $18.60

92547 Supplemental electrical test 0.18 44.28 $7.97

92548 Posturography 2.91 44.28 $128.85

92548 TC Posturography 2.17 44.28 $96.09

92548 26 Posturography 0.74 44.28 $32.77

92550 Tympanometry & reflex thresh 0.59 44.28 $26.13

92551 Pure tone hearing test air 0.34 44.28 $15.06

92552 Pure tone audiometry air 0.88 44.28 $38.97

92553 Audiometry air & bone 1.04 44.28 $46.05

92555 Speech threshold audiometry 0.65 44.28 $28.78

92556 Speech audiometry complete 1.05 44.28 $46.49

92557 Comprehensive hearing test 1.05 44.28 $46.49

92558 Evoked auditory test qual 0.00 44.28 $0.00

92559 Group audiometric testing 0.00 44.28 $0.00

92560 Bekesy audiometry screen 0.00 44.28 $0.00

92561 Bekesy audiometry diagnosis 1.06 44.28 $46.94

92562 Loudness balance test 1.30 44.28 $57.56

92563 Tone decay hearing test 0.87 44.28 $38.52

92564 Sisi hearing test 0.80 44.28 $35.42

92565 Stenger test pure tone 0.44 44.28 $19.48

92567 Tympanometry 0.41 44.28 $18.15

92568 Acoustic refl threshold tst 0.44 44.28 $19.48

92570 Acoustic immitance testing 0.90 44.28 $39.85

92571 Filtered speech hearing test 0.77 44.28 $34.10

92572 Staggered spondaic word test 0.88 44.28 $38.97

92575 Sensorineural acuity test 2.00 44.28 $88.56

92576 Synthetic sentence test 0.99 44.28 $43.84

92577 Stenger test speech 0.45 44.28 $19.93

92579 Visual audiometry (vra) 1.27 44.28 $56.24

92582 Conditioning play audiometry 2.01 44.28 $89.00

92583 Select picture audiometry 1.43 44.28 $63.32

92584 Electrocochleography 2.08 44.28 $92.10

92585 Auditor evoke potent compre 3.81 44.28 $168.71

92585 TC Auditor evoke potent compre 3.06 44.28 $135.50

92585 26 Auditor evoke potent compre 0.75 44.28 $33.21

92586 Auditor evoke potent limit 2.35 44.28 $104.06

92587 Evoked auditory test limited 0.61 44.28 $27.01

92587 TC Evoked auditory test limited 0.09 44.28 $3.99

92587 26 Evoked auditory test limited 0.52 44.28 $23.03

92588 Evoked auditory tst complete 0.93 44.28 $41.18

92588 TC Evoked auditory tst complete 0.11 44.28 $4.87

92588 26 Evoked auditory tst complete 0.82 44.28 $36.31

92590 Hearing aid exam one ear 0.00 44.28 $0.00

92591 Hearing aid exam both ears 0.00 44.28 $0.00

92592 Hearing aid check one ear 0.00 44.28 $0.00

92593 Hearing aid check both ears 0.00 44.28 $0.00

92594 Electro hearng aid test one 0.00 44.28 $0.00

92595 Electro hearng aid tst both 0.00 44.28 $0.00

92596 Ear protector evaluation 1.18 44.28 $52.25

92597 Oral speech device eval 2.03 44.28 $89.89

92601 Cochlear implt f/up exam <7 3.88 44.28 $171.81

92602 Reprogram cochlear implt 7/> 2.52 44.28 $111.59

92603 Cochlear implt f/up exam 7/> 4.21 44.28 $186.42

92604 Reprogram cochlear implt 7/> 2.50 44.28 $110.70

92605 Ex for nonspeech device rx 2.65 44.28 $117.34

92606 Non-speech device service 2.37 44.28 $104.94

92607 Ex for speech device rx 1hr 3.50 44.28 $154.98

92608 Ex for speech device rx addl 1.50 44.28 $66.42

92609 Use of speech device service 3.12 44.28 $138.15

92610 Evaluate swallowing function 2.39 44.28 $105.83

92611 Motion fluoroscopy/swallow 2.44 44.28 $108.04

92612 Endoscopy swallow tst (fees) 4.88 44.28 $216.09

92613 Endoscopy swallow tst (fees) 1.09 44.28 $48.27

92614 Laryngoscopic sensory test 4.07 44.28 $180.22

92615 Eval laryngoscopy sense tst 0.95 44.28 $42.07

92616 Fees w/laryngeal sense test 5.80 44.28 $256.82

92617 Interprt fees/laryngeal test 1.18 44.28 $52.25

92618 Ex for nonspeech dev rx add 0.96 44.28 $42.51

92620 Auditory function 60 min 2.65 44.28 $117.34

92621 Auditory function + 15 min 0.63 44.28 $27.90

92625 Tinnitus assessment 1.97 44.28 $87.23

92626 Eval aud rehab status 2.53 44.28 $112.03

92627 Eval aud status rehab add-on 0.62 44.28 $27.45

92630 Aud rehab pre-ling hear loss 0.00 44.28 $0.00

92633 Aud rehab postling hear loss 0.00 44.28 $0.00

92640 Aud brainstem implt programg 3.20 44.28 $141.70

92700 Ent procedure/service 0.00 44.28 $0.00

92920 Prq cardiac angioplast 1 art 15.84 44.28 $701.40

92921 Prq cardiac angio addl art 0.00 44.28 $0.00

92924 Prq card angio/athrect 1 art 18.79 44.28 $832.02

92925 Prq card angio/athrect addl 0.00 44.28 $0.00

92928 Prq card stent w/angio 1 vsl 17.57 44.28 $778.00

92929 Prq card stent w/angio addl 0.00 44.28 $0.00

92933 Prq card stent/ath/angio 19.66 44.28 $870.54

92934 Prq card stent/ath/angio 0.00 44.28 $0.00

92937 Prq revasc byp graft 1 vsl 17.56 44.28 $777.56

92938 Prq revasc byp graft addl 0.00 44.28 $0.00

92941 Prq card revasc mi 1 vsl 19.69 44.28 $871.87

92943 Prq card revasc chronic 1vsl 19.67 44.28 $870.99

92944 Prq card revasc chronic addl 0.00 44.28 $0.00

92950 Heart/lung resuscitation cpr 8.63 44.28 $382.14

92953 Temporary external pacing 0.32 44.28 $14.17

92960 Cardioversion electric ext 5.84 44.28 $258.60

92961 Cardioversion electric int 7.54 44.28 $333.87

92970 Cardioassist internal 5.38 44.28 $238.23

92971 Cardioassist external 2.92 44.28 $129.30

92973 Prq coronary mech thrombect 5.15 44.28 $228.04

92974 Cath place cardio brachytx 4.70 44.28 $208.12

92975 Dissolve clot heart vessel 11.37 44.28 $503.46

92977 Dissolve clot heart vessel 1.62 44.28 $71.73

92978 Intravasc us heart add-on 0.00 44.28 $0.00

92978 TC Intravasc us heart add-on 0.00 44.28 $0.00

92978 26 Intravasc us heart add-on 2.83 44.28 $125.31

92979 Intravasc us heart add-on 0.00 44.28 $0.00

92979 TC Intravasc us heart add-on 0.00 44.28 $0.00

92979 26 Intravasc us heart add-on 2.26 44.28 $100.07

92986 Revision of aortic valve 38.63 44.28 $1,710.54

92992 Revision of heart chamber 0.00 44.28 $0.00

92993 Revision of heart chamber 0.00 44.28 $0.00

92997 Pul art balloon repr percut 19.23 44.28 $851.50

92998 Pul art balloon repr percut 9.41 44.28 $416.67

93000 Electrocardiogram complete 0.48 44.28 $21.25

93005 Electrocardiogram tracing 0.24 44.28 $10.63

93010 Electrocardiogram report 0.24 44.28 $10.63

93015 Cardiovascular stress test 2.15 44.28 $95.20

93024 Cardiac drug stress test 3.17 44.28 $140.37

93024 TC Cardiac drug stress test 1.55 44.28 $68.63

93024 26 Cardiac drug stress test 1.62 44.28 $71.73

93025 Microvolt t-wave assess 4.61 44.28 $204.13

93025 TC Microvolt t-wave assess 3.56 44.28 $157.64

93025 26 Microvolt t-wave assess 1.05 44.28 $46.49

93040 Rhythm ecg with report 0.36 44.28 $15.94

93041 Rhythm ecg tracing 0.16 44.28 $7.08

93042 Rhythm ecg report 0.20 44.28 $8.86

93224 Ecg monit/reprt up to 48 hrs 2.59 44.28 $114.69

93228 Remote 30 day ecg rev/report 0.74 44.28 $32.77

93229 Remote 30 day ecg tech supp 19.02 44.28 $842.21

93260 Prgrmg dev eval impltbl sys 1.89 44.28 $83.69

93260 TC Prgrmg dev eval impltbl sys 0.63 44.28 $27.90

93260 26 Prgrmg dev eval impltbl sys 1.26 44.28 $55.79

93261 Interrogate subq defib 1.73 44.28 $76.60

93261 TC Interrogate subq defib 0.63 44.28 $27.90

93261 26 Interrogate subq defib 1.10 44.28 $48.71

93268 Ecg record/review 5.78 44.28 $255.94

93270 Remote 30 day ecg rev/report 0.26 44.28 $11.51

93271 Ecg/monitoring and analysis 4.80 44.28 $212.54

93272 Ecg/review interpret only 0.72 44.28 $31.88

93278 Ecg/signal-averaged 0.86 44.28 $38.08

93278 TC Ecg/signal-averaged 0.51 44.28 $22.58

93278 26 Ecg/signal-averaged 0.35 44.28 $15.50

93279 Pm device progr eval sngl 1.40 44.28 $61.99

93279 TC Pm device progr eval sngl 0.49 44.28 $21.70

93279 26 Pm device progr eval sngl 0.91 44.28 $40.29

93280 Pm device progr eval dual 1.65 44.28 $73.06

93280 TC Pm device progr eval dual 0.56 44.28 $24.80

93280 26 Pm device progr eval dual 1.09 44.28 $48.27

93281 Pm device progr eval multi 1.92 44.28 $85.02

93281 TC Pm device progr eval multi 0.65 44.28 $28.78

93281 26 Pm device progr eval multi 1.27 44.28 $56.24

93282 Prgrmg eval implantable dfb 1.79 44.28 $79.26

93282 TC Prgrmg eval implantable dfb 0.58 44.28 $25.68

93282 26 Prgrmg eval implantable dfb 1.21 44.28 $53.58

93285 Ilr device eval progr 1.19 44.28 $52.69

93285 TC Ilr device eval progr 0.45 44.28 $19.93

93285 26 Ilr device eval progr 0.74 44.28 $32.77

93286 Peri-px pacemaker device evl 0.77 44.28 $34.10

93286 TC Peri-px pacemaker device evl 0.34 44.28 $15.06

93286 26 Peri-px pacemaker device evl 0.43 44.28 $19.04

93287 Peri-px device eval & prgr 1.02 44.28 $45.17

93287 TC Peri-px device eval & prgr 0.37 44.28 $16.38

93287 26 Peri-px device eval & prgr 0.65 44.28 $28.78

93288 Pm device eval in person 1.06 44.28 $46.94

93288 TC Pm device eval in person 0.45 44.28 $19.93

93288 26 Pm device eval in person 0.61 44.28 $27.01

93289 Interrog device eval heart 1.84 44.28 $81.48

93289 TC Interrog device eval heart 0.55 44.28 $24.35

93289 26 Interrog device eval heart 1.29 44.28 $57.12

93290 Icm device eval 0.87 44.28 $38.52

93290 TC Icm device eval 0.27 44.28 $11.96

93290 26 Icm device eval 0.60 44.28 $26.57

93291 Ilr device interrogate 1.01 44.28 $44.72

93291 TC Ilr device interrogate 0.41 44.28 $18.15

93291 26 Ilr device interrogate 0.60 44.28 $26.57

93292 Wcd device interrogate 0.91 44.28 $40.29

93292 TC Wcd device interrogate 0.31 44.28 $13.73

93292 26 Wcd device interrogate 0.60 44.28 $26.57

93293 Pm phone r-strip device eval 1.51 44.28 $66.86

93293 TC Pm phone r-strip device eval 1.07 44.28 $47.38

93293 26 Pm phone r-strip device eval 0.44 44.28 $19.48

93294 Pm device interrogate remote 0.96 44.28 $42.51

93295 Dev interrog remote 1/2/mlt 1.91 44.28 $84.57

93296 Pm/icd remote tech serv 0.73 44.28 $32.32

93297 Icm device interrogat remote 0.75 44.28 $33.21

93298 Ilr device interrogat remote 0.75 44.28 $33.21

93299 Icm/ilr remote tech serv 0.00 44.28 $0.00

93303 Echo transthoracic 6.69 44.28 $296.23

93303 TC Echo transthoracic 4.89 44.28 $216.53

93303 26 Echo transthoracic 1.80 44.28 $79.70

93304 Echo transthoracic 4.36 44.28 $193.06

93304 TC Echo transthoracic 3.33 44.28 $147.45

93304 26 Echo transthoracic 1.03 44.28 $45.61

93306 Tte w/doppler complete 6.40 44.28 $283.39

93306 TC Tte w/doppler complete 4.61 44.28 $204.13

93306 26 Tte w/doppler complete 1.79 44.28 $79.26

93307 Tte w/o doppler complete 3.67 44.28 $162.51

93307 TC Tte w/o doppler complete 2.39 44.28 $105.83

93307 26 Tte w/o doppler complete 1.28 44.28 $56.68

93308 Tte f-up or lmtd 3.51 44.28 $155.42

93308 TC Tte f-up or lmtd 2.78 44.28 $123.10

93308 26 Tte f-up or lmtd 0.73 44.28 $32.32

93312 Echo transesophageal 8.62 44.28 $381.69

93312 TC Echo transesophageal 5.18 44.28 $229.37

93312 26 Echo transesophageal 3.44 44.28 $152.32

93318 Echo transesophageal intraop 0.00 44.28 $0.00

93318 TC Echo transesophageal intraop 0.00 44.28 $0.00

93318 26 Echo transesophageal intraop 3.41 44.28 $150.99

93320 Doppler echo exam heart 1.54 44.28 $68.19

93320 TC Doppler echo exam heart 1.02 44.28 $45.17

93320 26 Doppler echo exam heart 0.52 44.28 $23.03

93321 Doppler echo exam heart 0.78 44.28 $34.54

93321 TC Doppler echo exam heart 0.57 44.28 $25.24

93321 26 Doppler echo exam heart 0.21 44.28 $9.30

93325 Doppler color flow add-on 0.74 44.28 $32.77

93325 TC Doppler color flow add-on 0.64 44.28 $28.34

93325 26 Doppler color flow add-on 0.10 44.28 $4.43

93350 Stress tte only 6.78 44.28 $300.22

93350 TC Stress tte only 4.76 44.28 $210.77

93350 26 Stress tte only 2.02 44.28 $89.45

93351 Stress tte complete 7.62 44.28 $337.41

93351 TC Stress tte complete 5.20 44.28 $230.26

93351 26 Stress tte complete 2.42 44.28 $107.16

93352 Admin ecg contrast agent 0.96 44.28 $42.51

93355 Echo transesophageal (tee) 6.43 44.28 $284.72

93451 Right heart cath 22.21 44.28 $983.46

93451 TC Right heart cath 18.03 44.28 $798.37

93451 26 Right heart cath 4.18 44.28 $185.09

93452 Left hrt cath w/ventrclgrphy 25.11 44.28 $1,111.87

93452 TC Left hrt cath w/ventrclgrphy 17.76 44.28 $786.41

93452 26 Left hrt cath w/ventrclgrphy 7.35 44.28 $325.46

93453 R&l hrt cath w/ventriclgrphy 32.33 44.28 $1,431.57

93453 TC R&l hrt cath w/ventriclgrphy 22.66 44.28 $1,003.38

93453 26 R&l hrt cath w/ventriclgrphy 9.67 44.28 $428.19

93454 Coronary artery angio s&i 25.41 44.28 $1,125.15

93454 TC Coronary artery angio s&i 18.01 44.28 $797.48

93454 26 Coronary artery angio s&i 7.40 44.28 $327.67

93455 Coronary art/grft angio s&i 29.59 44.28 $1,310.25

93455 TC Coronary art/grft angio s&i 21.02 44.28 $930.77

93455 26 Coronary art/grft angio s&i 8.57 44.28 $379.48

93456 R hrt coronary artery angio 31.81 44.28 $1,408.55

93456 TC R hrt coronary artery angio 22.29 44.28 $987.00

93456 26 R hrt coronary artery angio 9.52 44.28 $421.55

93457 R hrt art/grft angio 35.91 44.28 $1,590.09

93457 TC R hrt art/grft angio 25.27 44.28 $1,118.96

93457 26 R hrt art/grft angio 10.64 44.28 $471.14

93458 L hrt artery/ventricle angio 30.45 44.28 $1,348.33

93458 TC L hrt artery/ventricle angio 21.44 44.28 $949.36

93458 26 L hrt artery/ventricle angio 9.01 44.28 $398.96

93459 L hrt art/grft angio 33.64 44.28 $1,489.58

93459 TC L hrt art/grft angio 23.48 44.28 $1,039.69

93459 26 L hrt art/grft angio 10.16 44.28 $449.88

93460 R&l hrt art/ventricle angio 36.12 44.28 $1,599.39

93460 TC R&l hrt art/ventricle angio 24.78 44.28 $1,097.26

93460 26 R&l hrt art/ventricle angio 11.34 44.28 $502.14

93461 R&l hrt art/ventricle angio 41.30 44.28 $1,828.76

93461 TC R&l hrt art/ventricle angio 28.78 44.28 $1,274.38

93461 26 R&l hrt art/ventricle angio 12.52 44.28 $554.39

93462 L hrt cath trnsptl puncture 6.03 44.28 $267.01

93463 Drug admin & hemodynmic meas 2.82 44.28 $124.87

93464 Exercise w/hemodynamic meas 7.76 44.28 $343.61

93464 TC Exercise w/hemodynamic meas 5.28 44.28 $233.80

93464 26 Exercise w/hemodynamic meas 2.48 44.28 $109.81

93503 Insert/place heart catheter 3.70 44.28 $163.84

93505 Biopsy of heart lining 21.69 44.28 $960.43

93505 TC Biopsy of heart lining 14.94 44.28 $661.54

93505 26 Biopsy of heart lining 6.75 44.28 $298.89

93530 Rt heart cath congenital 0.00 44.28 $0.00

93530 TC Rt heart cath congenital 0.00 44.28 $0.00

93530 26 Rt heart cath congenital 6.50 44.28 $287.82

93531 R & l heart cath congenital 0.00 44.28 $0.00

93531 TC R & l heart cath congenital 0.00 44.28 $0.00

93531 26 R & l heart cath congenital 12.69 44.28 $561.91

93561 Cardiac output measurement 0.00 44.28 $0.00

93561 TC Cardiac output measurement 0.00 44.28 $0.00

93561 26 Cardiac output measurement 0.70 44.28 $31.00

93562 Card output measure subsq 0.00 44.28 $0.00

93562 TC Card output measure subsq 0.00 44.28 $0.00

93562 26 Card output measure subsq 0.23 44.28 $10.18

93563 Inject congenital card cath 1.71 44.28 $75.72

93564 Inject hrt congntl art/grft 1.79 44.28 $79.26

93565 Inject l ventr/atrial angio 1.34 44.28 $59.34

93566 Inject r ventr/atrial angio 4.85 44.28 $214.76

93567 Inject suprvlv aortography 4.02 44.28 $178.01

93568 Inject pulm art hrt cath 4.36 44.28 $193.06

93571 Heart flow reserve measure 0.00 44.28 $0.00

93571 TC Heart flow reserve measure 0.00 44.28 $0.00

93571 26 Heart flow reserve measure 2.83 44.28 $125.31

93572 Heart flow reserve measure 0.00 44.28 $0.00

93572 TC Heart flow reserve measure 0.00 44.28 $0.00

93572 26 Heart flow reserve measure 2.26 44.28 $100.07

93580 Transcath closure of asd 28.30 44.28 $1,253.12

93581 Transcath closure of vsd 38.68 44.28 $1,712.75

93582 Perq transcath closure pda 19.51 44.28 $863.90

93583 Perq transcath septal reduxn 21.75 44.28 $963.09

93600 Bundle of his recording 0.00 44.28 $0.00

93600 TC Bundle of his recording 0.00 44.28 $0.00

93600 26 Bundle of his recording 3.48 44.28 $154.09

93602 Intra-atrial recording 0.00 44.28 $0.00

93602 TC Intra-atrial recording 0.00 44.28 $0.00

93602 26 Intra-atrial recording 3.41 44.28 $150.99

93603 Right ventricular recording 0.00 44.28 $0.00

93603 TC Right ventricular recording 0.00 44.28 $0.00

93603 26 Right ventricular recording 3.41 44.28 $150.99

93609 Map tachycardia add-on 0.00 44.28 $0.00

93609 TC Map tachycardia add-on 0.00 44.28 $0.00

93609 26 Map tachycardia add-on 8.16 44.28 $361.32

93610 Intra-atrial pacing 0.00 44.28 $0.00

93610 TC Intra-atrial pacing 0.00 44.28 $0.00

93610 26 Intra-atrial pacing 4.83 44.28 $213.87

93612 Intraventricular pacing 0.00 44.28 $0.00

93612 TC Intraventricular pacing 0.00 44.28 $0.00

93612 26 Intraventricular pacing 4.80 44.28 $212.54

93613 Electrophys map 3d add-on 11.49 44.28 $508.78

93615 Esophageal recording 0.00 44.28 $0.00

93615 TC Esophageal recording 0.00 44.28 $0.00

93615 26 Esophageal recording 1.48 44.28 $65.53

93616 Esophageal recording 0.00 44.28 $0.00

93616 TC Esophageal recording 0.00 44.28 $0.00

93616 26 Esophageal recording 1.85 44.28 $81.92

93618 Heart rhythm pacing 0.00 44.28 $0.00

93618 TC Heart rhythm pacing 0.00 44.28 $0.00

93618 26 Heart rhythm pacing 6.92 44.28 $306.42

93619 Electrophysiology evaluation 0.00 44.28 $0.00

93619 TC Electrophysiology evaluation 0.00 44.28 $0.00

93619 26 Electrophysiology evaluation 11.88 44.28 $526.05

93623 Stimulation pacing heart 0.00 44.28 $0.00

93623 TC Stimulation pacing heart 0.00 44.28 $0.00

93623 26 Stimulation pacing heart 4.69 44.28 $207.67

93624 Electrophysiologic study 0.00 44.28 $0.00

93624 TC Electrophysiologic study 0.00 44.28 $0.00

93624 26 Electrophysiologic study 7.55 44.28 $334.31

93631 Heart pacing mapping 0.00 44.28 $0.00

93631 TC Heart pacing mapping 0.00 44.28 $0.00

93631 26 Heart pacing mapping 11.74 44.28 $519.85

93640 Evaluation heart device 0.00 44.28 $0.00

93640 TC Evaluation heart device 0.00 44.28 $0.00

93640 26 Evaluation heart device 5.66 44.28 $250.62

93650 Ablate heart dysrhythm focus 17.47 44.28 $773.57

93653 Ep & ablate supravent arrhyt 24.58 44.28 $1,088.40

93654 Ep & ablate ventric tachy 32.70 44.28 $1,447.96

93655 Ablate arrhythmia add on 12.28 44.28 $543.76

93656 Tx atrial fib pulm vein isol 32.84 44.28 $1,454.16

93657 Tx l/r atrial fib addl 12.27 44.28 $543.32

93660 Tilt table evaluation 4.46 44.28 $197.49

93660 TC Tilt table evaluation 1.79 44.28 $79.26

93660 26 Tilt table evaluation 2.67 44.28 $118.23

93662 Intracardiac ecg (ice) 0.00 44.28 $0.00

93662 TC Intracardiac ecg (ice) 0.00 44.28 $0.00

93662 26 Intracardiac ecg (ice) 4.14 44.28 $183.32

93668 Peripheral vascular rehab 0.54 44.28 $23.91

93701 Bioimpedance cv analysis 0.69 44.28 $30.55

93702 Bis xtracell fluid analysis 3.20 44.28 $141.70

93724 Analyze pacemaker system 7.74 44.28 $342.73

93724 TC Analyze pacemaker system 0.80 44.28 $35.42

93724 26 Analyze pacemaker system 6.94 44.28 $307.30

93740 Temperature gradient studies 0.23 44.28 $10.18

93745 Set-up cardiovert-defibrill 0.00 44.28 $0.00

93745 TC Set-up cardiovert-defibrill 0.00 44.28 $0.00

93745 26 Set-up cardiovert-defibrill 0.00 44.28 $0.00

93750 Interrogation vad in person 1.58 44.28 $69.96

93770 Measure venous pressure 0.23 44.28 $10.18

93784 Ambulatory bp monitoring 1.52 44.28 $67.31

93786 Ambulatory bp recording 0.84 44.28 $37.20

93788 Ambulatory bp analysis 0.15 44.28 $6.64

93790 Review/report bp recording 0.53 44.28 $23.47

93797 Cardiac rehab 0.46 44.28 $20.37

93798 Cardiac rehab/monitor 0.71 44.28 $31.44

93799 Cardiovascular procedure 0.00 44.28 $0.00

93799 TC Cardiovascular procedure 0.00 44.28 $0.00

93799 26 Cardiovascular procedure 0.00 44.28 $0.00

93880 Extracranial bilat study 5.71 44.28 $252.84

93880 TC Extracranial bilat study 4.59 44.28 $203.25

93880 26 Extracranial bilat study 1.12 44.28 $49.59

93882 Extracranial uni/ltd study 3.64 44.28 $161.18

93882 TC Extracranial uni/ltd study 2.94 44.28 $130.18

93882 26 Extracranial uni/ltd study 0.70 44.28 $31.00

93886 Intracranial complete study 8.12 44.28 $359.55

93886 TC Intracranial complete study 6.80 44.28 $301.10

93886 26 Intracranial complete study 1.32 44.28 $58.45

93888 Intracranial limited study 4.22 44.28 $186.86

93888 TC Intracranial limited study 3.50 44.28 $154.98

93888 26 Intracranial limited study 0.72 44.28 $31.88

93890 Tcd vasoreactivity study 8.22 44.28 $363.98

93890 TC Tcd vasoreactivity study 6.78 44.28 $300.22

93890 26 Tcd vasoreactivity study 1.44 44.28 $63.76

93892 Tcd emboli detect w/o inj 9.53 44.28 $421.99

93892 TC Tcd emboli detect w/o inj 7.86 44.28 $348.04

93892 26 Tcd emboli detect w/o inj 1.67 44.28 $73.95

93893 Tcd emboli detect w/inj 9.78 44.28 $433.06

93893 TC Tcd emboli detect w/inj 8.11 44.28 $359.11

93893 26 Tcd emboli detect w/inj 1.67 44.28 $73.95

93895 Carotid intima atheroma eval 0.00 44.28 $0.00

93895 TC Carotid intima atheroma eval 0.00 44.28 $0.00

93895 26 Carotid intima atheroma eval 0.00 44.28 $0.00

93922 Upr/l xtremity art 2 levels 2.53 44.28 $112.03

93922 TC Upr/l xtremity art 2 levels 2.18 44.28 $96.53

93922 26 Upr/l xtremity art 2 levels 0.35 44.28 $15.50

93923 Upr/lxtr art stdy 3+ lvls 3.92 44.28 $173.58

93923 TC Upr/lxtr art stdy 3+ lvls 3.29 44.28 $145.68

93923 26 Upr/lxtr art stdy 3+ lvls 0.63 44.28 $27.90

93924 Lwr xtr vasc stdy bilat 4.89 44.28 $216.53

93924 TC Lwr xtr vasc stdy bilat 4.19 44.28 $185.53

93924 26 Lwr xtr vasc stdy bilat 0.70 44.28 $31.00

93925 Lower extremity study 7.37 44.28 $326.34

93925 TC Lower extremity study 6.25 44.28 $276.75

93925 26 Lower extremity study 1.12 44.28 $49.59

93926 Lower extremity study 4.34 44.28 $192.18

93926 TC Lower extremity study 3.63 44.28 $160.74

93926 26 Lower extremity study 0.71 44.28 $31.44

93930 Upper extremity study 5.92 44.28 $262.14

93930 TC Upper extremity study 4.80 44.28 $212.54

93930 26 Upper extremity study 1.12 44.28 $49.59

93931 Upper extremity study 3.68 44.28 $162.95

93931 TC Upper extremity study 2.97 44.28 $131.51

93931 26 Upper extremity study 0.71 44.28 $31.44

93965 Extremity study 3.41 44.28 $150.99

93965 TC Extremity study 2.92 44.28 $129.30

93965 26 Extremity study 0.49 44.28 $21.70

93970 Extremity study 5.58 44.28 $247.08

93970 26 Extremity study 0.99 44.28 $43.84

93971 Extremity study 3.43 44.28 $151.88

93971 26 Extremity study 0.64 44.28 $28.34

93975 Vascular study 7.97 44.28 $352.91

93975 TC Vascular study 6.35 44.28 $281.18

93975 26 Vascular study 1.62 44.28 $71.73

93976 Vascular study 4.62 44.28 $204.57

93976 26 Vascular study 1.14 44.28 $50.48

93978 Vascular study 5.40 44.28 $239.11

93978 26 Vascular study 1.11 44.28 $49.15

93979 Vascular study 3.41 44.28 $150.99

93979 26 Vascular study 0.70 44.28 $31.00

93980 Penile vascular study 3.38 44.28 $149.67

93980 TC Penile vascular study 1.66 44.28 $73.50

93980 26 Penile vascular study 1.72 44.28 $76.16

93981 Penile vascular study 2.03 44.28 $89.89

93981 TC Penile vascular study 1.43 44.28 $63.32

93981 26 Penile vascular study 0.60 44.28 $26.57

93982 Aneurysm pressure sens study 1.23 44.28 $54.46

93990 Doppler flow testing 4.56 44.28 $201.92

93990 TC Doppler flow testing 3.84 44.28 $170.04

93990 26 Doppler flow testing 0.72 44.28 $31.88

93998 Noninvas vasc dx study proc 0.00 44.28 $0.00

94002 Vent mgmt inpat init day 2.63 44.28 $116.46

94003 Vent mgmt inpat subq day 1.90 44.28 $84.13

94004 Vent mgmt nf per day 1.38 44.28 $61.11

94005 Home vent mgmt supervision 2.63 44.28 $116.46

94010 Breathing capacity test 1.02 44.28 $45.17

94010 TC Breathing capacity test 0.78 44.28 $34.54

94010 26 Breathing capacity test 0.24 44.28 $10.63

94011 Spirometry up to 2 yrs old 2.84 44.28 $125.76

94012 Spirmtry w/brnchdil inf-2 yr 4.69 44.28 $207.67

94013 Meas lung vol thru 2 yrs 0.88 44.28 $38.97

94014 Patient recorded spirometry 1.58 44.28 $69.96

94015 Patient recorded spirometry 0.86 44.28 $38.08

94016 Review patient spirometry 0.72 44.28 $31.88

94060 Evaluation of wheezing 1.72 44.28 $76.16

94060 TC Evaluation of wheezing 1.35 44.28 $59.78

94060 26 Evaluation of wheezing 0.37 44.28 $16.38

94070 Evaluation of wheezing 1.68 44.28 $74.39

94070 TC Evaluation of wheezing 0.87 44.28 $38.52

94070 26 Evaluation of wheezing 0.81 44.28 $35.87

94150 Vital capacity test 0.72 44.28 $31.88

94150 TC Vital capacity test 0.61 44.28 $27.01

94150 26 Vital capacity test 0.11 44.28 $4.87

94200 Lung function test (mbc/mvv) 0.72 44.28 $31.88

94200 TC Lung function test (mbc/mvv) 0.56 44.28 $24.80

94200 26 Lung function test (mbc/mvv) 0.16 44.28 $7.08

94250 Expired gas collection 0.74 44.28 $32.77

94250 TC Expired gas collection 0.59 44.28 $26.13

94250 26 Expired gas collection 0.15 44.28 $6.64

94375 Respiratory flow volume loop 1.11 44.28 $49.15

94375 TC Respiratory flow volume loop 0.69 44.28 $30.55

94375 26 Respiratory flow volume loop 0.42 44.28 $18.60

94400 Co2 breathing response curve 1.60 44.28 $70.85

94400 TC Co2 breathing response curve 1.05 44.28 $46.49

94400 26 Co2 breathing response curve 0.55 44.28 $24.35

94450 Hypoxia response curve 1.88 44.28 $83.25

94450 TC Hypoxia response curve 1.33 44.28 $58.89

94450 26 Hypoxia response curve 0.55 44.28 $24.35

94452 Hast w/report 1.63 44.28 $72.18

94452 TC Hast w/report 1.22 44.28 $54.02

94452 26 Hast w/report 0.41 44.28 $18.15

94453 Hast w/oxygen titrate 2.26 44.28 $100.07

94453 TC Hast w/oxygen titrate 1.72 44.28 $76.16

94453 26 Hast w/oxygen titrate 0.54 44.28 $23.91

94610 Surfactant admin thru tube 1.60 44.28 $70.85

94620 Pulmonary stress test/simple 1.58 44.28 $69.96

94620 TC Pulmonary stress test/simple 0.72 44.28 $31.88

94620 26 Pulmonary stress test/simple 0.86 44.28 $38.08

94621 Pulm stress test/complex 4.63 44.28 $205.02

94621 TC Pulm stress test/complex 2.68 44.28 $118.67

94621 26 Pulm stress test/complex 1.95 44.28 $86.35

94640 Airway inhalation treatment 0.52 44.28 $23.03

94642 Aerosol inhalation treatment 0.00 44.28 $0.00

94644 Cbt 1st hour 1.23 44.28 $54.46

94645 Cbt each addl hour 0.39 44.28 $17.27

94660 Pos airway pressure cpap 1.77 44.28 $78.38

94662 Neg press ventilation cnp 0.97 44.28 $42.95

94664 Evaluate pt use of inhaler 0.49 44.28 $21.70

94667 Chest wall manipulation 0.74 44.28 $32.77

94668 Chest wall manipulation 0.81 44.28 $35.87

94669 Mechanical chest wall oscill 1.00 44.28 $44.28

94680 Exhaled air analysis o2 1.62 44.28 $71.73

94680 TC Exhaled air analysis o2 1.26 44.28 $55.79

94680 26 Exhaled air analysis o2 0.36 44.28 $15.94

94681 Exhaled air analysis o2/co2 1.51 44.28 $66.86

94681 TC Exhaled air analysis o2/co2 1.23 44.28 $54.46

94681 26 Exhaled air analysis o2/co2 0.28 44.28 $12.40

94690 Exhaled air analysis 1.40 44.28 $61.99

94690 TC Exhaled air analysis 1.29 44.28 $57.12

94690 26 Exhaled air analysis 0.11 44.28 $4.87

94726 Pulm funct tst plethysmograp 1.49 44.28 $65.98

94726 TC Pulm funct tst plethysmograp 1.14 44.28 $50.48

94726 26 Pulm funct tst plethysmograp 0.35 44.28 $15.50

94727 Pulm function test by gas 1.19 44.28 $52.69

94727 TC Pulm function test by gas 0.84 44.28 $37.20

94727 26 Pulm function test by gas 0.35 44.28 $15.50

94728 Pulm funct test oscillometry 1.11 44.28 $49.15

94728 TC Pulm funct test oscillometry 0.76 44.28 $33.65

94728 26 Pulm funct test oscillometry 0.35 44.28 $15.50

94729 Co/membane diffuse capacity 1.54 44.28 $68.19

94729 TC Co/membane diffuse capacity 1.28 44.28 $56.68

94729 26 Co/membane diffuse capacity 0.26 44.28 $11.51

94750 Pulmonary compliance study 2.29 44.28 $101.40

94750 TC Pulmonary compliance study 1.97 44.28 $87.23

94750 26 Pulmonary compliance study 0.32 44.28 $14.17

94760 Measure blood oxygen level 0.09 44.28 $3.99

94770 Exhaled carbon dioxide test 0.21 44.28 $9.30

94772 Breath recording infant 0.00 44.28 $0.00

94772 TC Breath recording infant 0.00 44.28 $0.00

94772 26 Breath recording infant 0.00 44.28 $0.00

94774 Ped home apnea rec compl 0.00 44.28 $0.00

94775 Ped home apnea rec hk-up 0.00 44.28 $0.00

94776 Ped home apnea rec downld 0.00 44.28 $0.00

94777 Ped home apnea rec report 0.00 44.28 $0.00

94780 Car seat/bed test 60 min 1.77 44.28 $78.38

94781 Car seat/bed test + 30 min 0.65 44.28 $28.78

94799 Pulmonary service/procedure 0.00 44.28 $0.00

94799 TC Pulmonary service/procedure 0.00 44.28 $0.00

94799 26 Pulmonary service/procedure 0.00 44.28 $0.00

95004 Percut allergy skin tests 0.18 44.28 $7.97

95012 Exhaled nitric oxide meas 0.55 44.28 $24.35

95017 Perq & icut allg test venoms 0.22 44.28 $9.74

95018 Perq&ic allg test drugs/biol 0.53 44.28 $23.47

95024 Icut allergy test drug/bug 0.22 44.28 $9.74

95027 Icut allergy titrate-airborn 0.13 44.28 $5.76

95028 Icut allergy test-delayed 0.38 44.28 $16.83

95044 Allergy patch tests 0.16 44.28 $7.08

95052 Photo patch test 0.19 44.28 $8.41

95056 Photosensitivity tests 1.25 44.28 $55.35

95060 Eye allergy tests 0.99 44.28 $43.84

95065 Nose allergy test 0.71 44.28 $31.44

95070 Bronchial allergy tests 0.85 44.28 $37.64

95071 Bronchial allergy tests 0.98 44.28 $43.39

95076 Ingest challenge ini 120 min 3.27 44.28 $144.80

95079 Ingest challenge addl 60 min 2.33 44.28 $103.17

95115 Immunotherapy one injection 0.25 44.28 $11.07

95117 Immunotherapy injections 0.29 44.28 $12.84

95120 Immunotherapy one injection 0.00 44.28 $0.00

95125 Immunotherapy 2/> injections 0.00 44.28 $0.00

95130 Immntx 1 sting insect 0.00 44.28 $0.00

95131 Immntx 2 sting insects 0.00 44.28 $0.00

95144 Antigen therapy services 0.35 44.28 $15.50

95180 Rapid desensitization 3.77 44.28 $166.94

95199 Allergy immunology services 0.00 44.28 $0.00

95250 Glucose monitoring cont 4.44 44.28 $196.60

95251 Gluc monitor cont phys i&r 1.22 44.28 $54.02

95782 Polysom <6 yrs 4/> paramtrs 25.73 44.28 $1,139.32

95782 TC Polysom <6 yrs 4/> paramtrs 22.27 44.28 $986.12

95782 26 Polysom <6 yrs 4/> paramtrs 3.46 44.28 $153.21

95783 Polysom <6 yrs cpap/bilvl 35.10 44.28 $1,554.23

95783 TC Polysom <6 yrs cpap/bilvl 30.91 44.28 $1,368.69

95783 26 Polysom <6 yrs cpap/bilvl 4.19 44.28 $185.53

95800 Slp stdy unattended 5.07 44.28 $224.50

95800 TC Slp stdy unattended 3.60 44.28 $159.41

95800 26 Slp stdy unattended 1.47 44.28 $65.09

95801 Slp stdy unatnd w/anal 2.59 44.28 $114.69

95801 TC Slp stdy unatnd w/anal 1.19 44.28 $52.69

95801 26 Slp stdy unatnd w/anal 1.40 44.28 $61.99

95803 Actigraphy testing 3.99 44.28 $176.68

95803 TC Actigraphy testing 2.77 44.28 $122.66

95803 26 Actigraphy testing 1.22 44.28 $54.02

95805 Multiple sleep latency test 11.82 44.28 $523.39

95805 TC Multiple sleep latency test 10.15 44.28 $449.44

95805 26 Multiple sleep latency test 1.67 44.28 $73.95

95806 Sleep study unatt&resp efft 4.74 44.28 $209.89

95806 TC Sleep study unatt&resp efft 3.02 44.28 $133.73

95806 26 Sleep study unatt&resp efft 1.72 44.28 $76.16

95807 Sleep study attended 13.20 44.28 $584.50

95807 TC Sleep study attended 11.45 44.28 $507.01

95807 26 Sleep study attended 1.75 44.28 $77.49

95808 Polysom any age 1-3> param 16.97 44.28 $751.43

95808 TC Polysom any age 1-3> param 14.52 44.28 $642.95

95808 26 Polysom any age 1-3> param 2.45 44.28 $108.49

95810 Polysom 6/> yrs 4/> param 17.50 44.28 $774.90

95810 TC Polysom 6/> yrs 4/> param 14.06 44.28 $622.58

95810 26 Polysom 6/> yrs 4/> param 3.44 44.28 $152.32

95811 Polysom 6/>yrs cpap 4/> parm 18.38 44.28 $813.87

95811 TC Polysom 6/>yrs cpap 4/> parm 14.81 44.28 $655.79

95811 26 Polysom 6/>yrs cpap 4/> parm 3.57 44.28 $158.08

95812 Eeg 41-60 minutes 11.79 44.28 $522.06

95812 TC Eeg 41-60 minutes 10.16 44.28 $449.88

95812 26 Eeg 41-60 minutes 1.63 44.28 $72.18

95813 Eeg over 1 hour 14.11 44.28 $624.79

95813 TC Eeg over 1 hour 11.49 44.28 $508.78

95813 26 Eeg over 1 hour 2.62 44.28 $116.01

95816 Eeg awake and drowsy 10.11 44.28 $447.67

95816 TC Eeg awake and drowsy 8.48 44.28 $375.49

95816 26 Eeg awake and drowsy 1.63 44.28 $72.18

95819 Eeg awake and asleep 11.53 44.28 $510.55

95819 TC Eeg awake and asleep 9.90 44.28 $438.37

95819 26 Eeg awake and asleep 1.63 44.28 $72.18

95822 Eeg coma or sleep only 10.43 44.28 $461.84

95822 TC Eeg coma or sleep only 8.80 44.28 $389.66

95822 26 Eeg coma or sleep only 1.63 44.28 $72.18

95824 Eeg cerebral death only 0.00 44.28 $0.00

95824 TC Eeg cerebral death only 0.00 44.28 $0.00

95824 26 Eeg cerebral death only 1.14 44.28 $50.48

95827 Eeg all night recording 22.10 44.28 $978.59

95827 TC Eeg all night recording 20.48 44.28 $906.85

95827 26 Eeg all night recording 1.62 44.28 $71.73

95829 Surgery electrocorticogram 53.11 44.28 $2,351.71

95829 TC Surgery electrocorticogram 43.72 44.28 $1,935.92

95829 26 Surgery electrocorticogram 9.39 44.28 $415.79

95830 Insert electrodes for eeg 6.94 44.28 $307.30

95831 Limb muscle testing manual 0.87 44.28 $38.52

95832 Hand muscle testing manual 0.86 44.28 $38.08

95833 Body muscle testing manual 1.06 44.28 $46.94

95834 Body muscle testing manual 1.43 44.28 $63.32

95851 Range of motion measurements 0.52 44.28 $23.03

95852 Range of motion measurements 0.46 44.28 $20.37

95857 Cholinesterase challenge 1.52 44.28 $67.31

95860 Muscle test one limb 3.47 44.28 $153.65

95860 TC Muscle test one limb 2.00 44.28 $88.56

95860 26 Muscle test one limb 1.47 44.28 $65.09

95861 Muscle test 2 limbs 4.87 44.28 $215.64

95861 TC Muscle test 2 limbs 2.54 44.28 $112.47

95861 26 Muscle test 2 limbs 2.33 44.28 $103.17

95865 Muscle test larynx 4.07 44.28 $180.22

95865 TC Muscle test larynx 1.69 44.28 $74.83

95865 26 Muscle test larynx 2.38 44.28 $105.39

95866 Muscle test hemidiaphragm 3.76 44.28 $166.49

95866 TC Muscle test hemidiaphragm 1.84 44.28 $81.48

95866 26 Muscle test hemidiaphragm 1.92 44.28 $85.02

95867 Muscle test cran nerv unilat 2.63 44.28 $116.46

95867 TC Muscle test cran nerv unilat 1.45 44.28 $64.21

95867 26 Muscle test cran nerv unilat 1.18 44.28 $52.25

95868 Muscle test cran nerve bilat 3.73 44.28 $165.16

95868 TC Muscle test cran nerve bilat 1.94 44.28 $85.90

95868 26 Muscle test cran nerve bilat 1.79 44.28 $79.26

95869 Muscle test thor paraspinal 2.30 44.28 $101.84

95869 TC Muscle test thor paraspinal 1.74 44.28 $77.05

95869 26 Muscle test thor paraspinal 0.56 44.28 $24.80

95870 Muscle test nonparaspinal 2.49 44.28 $110.26

95870 TC Muscle test nonparaspinal 1.94 44.28 $85.90

95870 26 Muscle test nonparaspinal 0.55 44.28 $24.35

95872 Muscle test one fiber 5.59 44.28 $247.53

95872 TC Muscle test one fiber 1.22 44.28 $54.02

95872 26 Muscle test one fiber 4.37 44.28 $193.50

95873 Guide nerv destr elec stim 2.11 44.28 $93.43

95873 TC Guide nerv destr elec stim 1.53 44.28 $67.75

95873 26 Guide nerv destr elec stim 0.58 44.28 $25.68

95874 Guide nerv destr needle emg 2.03 44.28 $89.89

95874 TC Guide nerv destr needle emg 1.47 44.28 $65.09

95874 26 Guide nerv destr needle emg 0.56 44.28 $24.80

95875 Limb exercise test 3.41 44.28 $150.99

95875 TC Limb exercise test 1.76 44.28 $77.93

95875 26 Limb exercise test 1.65 44.28 $73.06

95885 Musc tst done w/nerv tst lim 1.65 44.28 $73.06

95885 TC Musc tst done w/nerv tst lim 1.12 44.28 $49.59

95885 26 Musc tst done w/nerv tst lim 0.53 44.28 $23.47

95886 Musc test done w/n test comp 2.57 44.28 $113.80

95886 TC Musc test done w/n test comp 1.27 44.28 $56.24

95886 26 Musc test done w/n test comp 1.30 44.28 $57.56

95887 Musc tst done w/n tst nonext 2.30 44.28 $101.84

95887 TC Musc tst done w/n tst nonext 1.22 44.28 $54.02

95887 26 Musc tst done w/n tst nonext 1.08 44.28 $47.82

95905 Motor &/ sens nrve cndj test 2.02 44.28 $89.45

95905 TC Motor &/ sens nrve cndj test 1.94 44.28 $85.90

95905 26 Motor &/ sens nrve cndj test 0.08 44.28 $3.54

95907 Nvr cndj tst 1-2 studies 2.74 44.28 $121.33

95907 TC Nvr cndj tst 1-2 studies 1.23 44.28 $54.46

95907 26 Nvr cndj tst 1-2 studies 1.51 44.28 $66.86

95908 Nrv cndj tst 3-4 studies 3.52 44.28 $155.87

95908 TC Nrv cndj tst 3-4 studies 1.61 44.28 $71.29

95908 26 Nrv cndj tst 3-4 studies 1.91 44.28 $84.57

95909 Nrv cndj tst 5-6 studies 4.17 44.28 $184.65

95909 TC Nrv cndj tst 5-6 studies 1.89 44.28 $83.69

95909 26 Nrv cndj tst 5-6 studies 2.28 44.28 $100.96

95910 Nrv cndj test 7-8 studies 5.54 44.28 $245.31

95910 TC Nrv cndj test 7-8 studies 2.49 44.28 $110.26

95910 26 Nrv cndj test 7-8 studies 3.05 44.28 $135.05

95913 Nrv cndj test 13/> studies 8.33 44.28 $368.85

95913 TC Nrv cndj test 13/> studies 3.01 44.28 $133.28

95913 26 Nrv cndj test 13/> studies 5.32 44.28 $235.57

95921 Autonomic nrv parasym inervj 2.47 44.28 $109.37

95921 TC Autonomic nrv parasym inervj 1.18 44.28 $52.25

95921 26 Autonomic nrv parasym inervj 1.29 44.28 $57.12

95922 Autonomic nrv adrenrg inervj 2.83 44.28 $125.31

95922 TC Autonomic nrv adrenrg inervj 1.46 44.28 $64.65

95922 26 Autonomic nrv adrenrg inervj 1.37 44.28 $60.66

95923 Autonomic nrv syst funj test 5.40 44.28 $239.11

95923 TC Autonomic nrv syst funj test 4.10 44.28 $181.55

95923 26 Autonomic nrv syst funj test 1.30 44.28 $57.56

95924 Ans parasymp & symp w/tilt 4.32 44.28 $191.29

95924 TC Ans parasymp & symp w/tilt 1.81 44.28 $80.15

95924 26 Ans parasymp & symp w/tilt 2.51 44.28 $111.14

95925 Somatosensory testing 4.43 44.28 $196.16

95925 TC Somatosensory testing 3.63 44.28 $160.74

95925 26 Somatosensory testing 0.80 44.28 $35.42

95928 C motor evoked uppr limbs 7.30 44.28 $323.24

95928 TC C motor evoked uppr limbs 5.03 44.28 $222.73

95928 26 C motor evoked uppr limbs 2.27 44.28 $100.52

95929 C motor evoked lwr limbs 7.29 44.28 $322.80

95929 TC C motor evoked lwr limbs 5.07 44.28 $224.50

95929 26 C motor evoked lwr limbs 2.22 44.28 $98.30

95930 Visual evoked potential test 3.62 44.28 $160.29

95930 TC Visual evoked potential test 3.10 44.28 $137.27

95930 26 Visual evoked potential test 0.52 44.28 $23.03

95933 Blink reflex test 2.37 44.28 $104.94

95933 TC Blink reflex test 1.48 44.28 $65.53

95933 26 Blink reflex test 0.89 44.28 $39.41

95937 Neuromuscular junction test 2.34 44.28 $103.62

95937 TC Neuromuscular junction test 1.36 44.28 $60.22

95937 26 Neuromuscular junction test 0.98 44.28 $43.39

95939 C motor evoked upr&lwr limbs 14.17 44.28 $627.45

95939 TC C motor evoked upr&lwr limbs 10.73 44.28 $475.12

95939 26 C motor evoked upr&lwr limbs 3.44 44.28 $152.32

95940 Ionm in operatng room 15 min 0.93 44.28 $41.18

95941 Ionm remote/>1 pt or per hr 0.00 44.28 $0.00

95943 Parasymp&symp hrt rate test 0.00 44.28 $0.00

95943 TC Parasymp&symp hrt rate test 0.00 44.28 $0.00

95943 26 Parasymp&symp hrt rate test 0.00 44.28 $0.00

95950 Ambulatory eeg monitoring 9.26 44.28 $410.03

95950 TC Ambulatory eeg monitoring 7.00 44.28 $309.96

95950 26 Ambulatory eeg monitoring 2.26 44.28 $100.07

95951 Eeg monitoring/videorecord 0.00 44.28 $0.00

95951 TC Eeg monitoring/videorecord 0.00 44.28 $0.00

95951 26 Eeg monitoring/videorecord 9.27 44.28 $410.48

95953 Eeg monitoring/computer 11.80 44.28 $522.50

95953 TC Eeg monitoring/computer 7.15 44.28 $316.60

95953 26 Eeg monitoring/computer 4.65 44.28 $205.90

95954 Eeg monitoring/giving drugs 12.94 44.28 $572.98

95954 TC Eeg monitoring/giving drugs 9.40 44.28 $416.23

95954 26 Eeg monitoring/giving drugs 3.54 44.28 $156.75

95955 Eeg during surgery 6.02 44.28 $266.57

95955 TC Eeg during surgery 4.50 44.28 $199.26

95955 26 Eeg during surgery 1.52 44.28 $67.31

95956 Eeg monitor technol attended 47.02 44.28 $2,082.05

95956 TC Eeg monitor technol attended 41.59 44.28 $1,841.61

95956 26 Eeg monitor technol attended 5.43 44.28 $240.44

95957 Eeg digital analysis 8.92 44.28 $394.98

95957 TC Eeg digital analysis 5.93 44.28 $262.58

95957 26 Eeg digital analysis 2.99 44.28 $132.40

95958 Eeg monitoring/function test 16.39 44.28 $725.75

95958 TC Eeg monitoring/function test 10.03 44.28 $444.13

95958 26 Eeg monitoring/function test 6.36 44.28 $281.62

95961 Electrode stimulation brain 8.18 44.28 $362.21

95961 TC Electrode stimulation brain 3.71 44.28 $164.28

95961 26 Electrode stimulation brain 4.47 44.28 $197.93

95962 Electrode stim brain add-on 7.23 44.28 $320.14

95962 TC Electrode stim brain add-on 2.46 44.28 $108.93

95962 26 Electrode stim brain add-on 4.77 44.28 $211.22

95965 Meg spontaneous 0.00 44.28 $0.00

95965 TC Meg spontaneous 0.00 44.28 $0.00

95965 26 Meg spontaneous 12.27 44.28 $543.32

95966 Meg evoked single 0.00 44.28 $0.00

95966 TC Meg evoked single 0.00 44.28 $0.00

95966 26 Meg evoked single 6.18 44.28 $273.65

95967 Meg evoked each addl 0.00 44.28 $0.00

95967 TC Meg evoked each addl 0.00 44.28 $0.00

95967 26 Meg evoked each addl 5.41 44.28 $239.55

95970 Analyze neurostim no prog 1.89 44.28 $83.69

95971 Analyze neurostim simple 1.62 44.28 $71.73

95972 Analyze neurostim complex 1.56 44.28 $69.08

95973 Analyze neurostim complex 1.14 44.28 $50.48

95974 Cranial neurostim complex 5.89 44.28 $260.81

95975 Cranial neurostim complex 3.16 44.28 $139.92

95978 Analyze neurostim brain/1h 7.05 44.28 $312.17

95979 Analyz neurostim brain addon 3.07 44.28 $135.94

95980 Io anal gast n-stim init 1.31 44.28 $58.01

95981 Io anal gast n-stim subsq 0.90 44.28 $39.85

95982 Io ga n-stim subsq w/reprog 1.50 44.28 $66.42

95990 Spin/brain pump refil & main 2.54 44.28 $112.47

95991 Spin/brain pump refil & main 3.41 44.28 $150.99

95992 Canalith repositioning proc 1.20 44.28 $53.14

95999 Neurological procedure 0.00 44.28 $0.00

96000 Motion analysis video/3d 2.70 44.28 $119.56

96001 Motion test w/ft press meas 2.87 44.28 $127.08

96002 Dynamic surface emg 0.62 44.28 $27.45

96003 Dynamic fine wire emg 0.54 44.28 $23.91

96004 Phys review of motion tests 3.33 44.28 $147.45

96020 Functional brain mapping 0.00 44.28 $0.00

96020 TC Functional brain mapping 0.00 44.28 $0.00

96020 26 Functional brain mapping 4.78 44.28 $211.66

96040 Genetic counseling 30 min 1.33 44.28 $58.89

96101 Psycho testing by psych/phys 2.24 44.28 $99.19

96102 Psycho testing by technician 1.79 44.28 $79.26

96103 Psycho testing admin by comp 0.77 44.28 $34.10

96105 Assessment of aphasia 2.93 44.28 $129.74

96110 Developmental screen w/score 0.27 44.28 $11.96

96111 Developmental test extend 3.61 44.28 $159.85

96116 Neurobehavioral status exam 2.62 44.28 $116.01

96118 Neuropsych tst by psych/phys 2.74 44.28 $121.33

96119 Neuropsych testing by tec 2.28 44.28 $100.96

96120 Neuropsych tst admin w/comp 1.35 44.28 $59.78

96125 Cognitive test by hc pro 3.30 44.28 $146.12

96127 Brief emotional/behav assmt 0.15 44.28 $6.64

96150 Assess hlth/behave init 0.61 44.28 $27.01

96151 Assess hlth/behave subseq 0.58 44.28 $25.68

96152 Intervene hlth/behave indiv 0.55 44.28 $24.35

96153 Intervene hlth/behave group 0.13 44.28 $5.76

96154 Interv hlth/behav fam w/pt 0.54 44.28 $23.91

96155 Interv hlth/behav fam no pt 0.64 44.28 $28.34

96360 Hydration iv infusion init 1.62 44.28 $71.73

96361 Hydrate iv infusion add-on 0.43 44.28 $19.04

96365 Ther/proph/diag iv inf init 1.96 44.28 $86.79

96366 Ther/proph/diag iv inf addon 0.53 44.28 $23.47

96367 Tx/proph/dg addl seq iv inf 0.85 44.28 $37.64

96368 Ther/diag concurrent inf 0.58 44.28 $25.68

96369 Sc ther infusion up to 1 hr 5.48 44.28 $242.65

96370 Sc ther infusion addl hr 0.43 44.28 $19.04

96371 Sc ther infusion reset pump 2.53 44.28 $112.03

96372 Ther/proph/diag inj sc/im 0.71 44.28 $31.44

96373 Ther/proph/diag inj ia 0.55 44.28 $24.35

96374 Ther/proph/diag inj iv push 1.60 44.28 $70.85

96375 Tx/pro/dx inj new drug addon 0.63 44.28 $27.90

96376 Tx/pro/dx inj same drug adon 0.00 44.28 $0.00

96379 Ther/prop/diag inj/inf proc 0.00 44.28 $0.00

96401 Chemo anti-neopl sq/im 2.10 44.28 $92.99

96402 Chemo hormon antineopl sq/im 0.91 44.28 $40.29

96405 Chemo intralesional up to 7 2.30 44.28 $101.84

96406 Chemo intralesional over 7 3.34 44.28 $147.90

96409 Chemo iv push sngl drug 3.11 44.28 $137.71

96411 Chemo iv push addl drug 1.74 44.28 $77.05

96413 Chemo iv infusion 1 hr 3.80 44.28 $168.26

96415 Chemo iv infusion addl hr 0.79 44.28 $34.98

96416 Chemo prolong infuse w/pump 3.94 44.28 $174.46

96417 Chemo iv infus each addl seq 1.76 44.28 $77.93

96420 Chemo ia push tecnique 2.92 44.28 $129.30

96422 Chemo ia infusion up to 1 hr 4.78 44.28 $211.66

96423 Chemo ia infuse each addl hr 2.22 44.28 $98.30

96425 Chemotherapy infusion method 5.07 44.28 $224.50

96440 Chemotherapy intracavitary 24.22 44.28 $1,072.46

96446 Chemotx admn prtl cavity 5.66 44.28 $250.62

96450 Chemotherapy into cns 5.13 44.28 $227.16

96521 Refill/maint portable pump 3.88 44.28 $171.81

96522 Refill/maint pump/resvr syst 3.20 44.28 $141.70

96523 Irrig drug delivery device 0.70 44.28 $31.00

96542 Chemotherapy injection 3.37 44.28 $149.22

96549 Chemotherapy unspecified 0.00 44.28 $0.00

96567 Photodynamic tx skin 3.79 44.28 $167.82

96570 Photodynmc tx 30 min add-on 1.63 44.28 $72.18

96571 Photodynamic tx addl 15 min 0.75 44.28 $33.21

96900 Ultraviolet light therapy 0.58 44.28 $25.68

96902 Trichogram 0.61 44.28 $27.01

96904 Whole body photography 1.77 44.28 $78.38

96910 Photochemotherapy with uv-b 2.01 44.28 $89.00

96912 Photochemotherapy with uv-a 2.58 44.28 $114.24

96913 Photochemotherapy uv-a or b 3.63 44.28 $160.74

96920 Laser tx skin < 250 sq cm 4.37 44.28 $193.50

96921 Laser tx skin 250-500 sq cm 4.83 44.28 $213.87

96922 Laser tx skin >500 sq cm 6.68 44.28 $295.79

96999 Dermatological procedure 0.00 44.28 $0.00

97001 Pt evaluation 2.11 44.28 $93.43

97002 Pt re-evaluation 1.18 44.28 $52.25

97003 Ot evaluation 2.39 44.28 $105.83

97004 Ot re-evaluation 1.48 44.28 $65.53

97005 Athletic train eval 0.00 44.28 $0.00

97006 Athletic train reeval 0.00 44.28 $0.00

97010 Hot or cold packs therapy 0.17 44.28 $7.53

97012 Mechanical traction therapy 0.45 44.28 $19.93

97014 Electric stimulation therapy 0.45 44.28 $19.93

97016 Vasopneumatic device therapy 0.54 44.28 $23.91

97018 Paraffin bath therapy 0.31 44.28 $13.73

97022 Whirlpool therapy 0.66 44.28 $29.22

97024 Diathermy eg microwave 0.18 44.28 $7.97

97026 Infrared therapy 0.17 44.28 $7.53

97028 Ultraviolet therapy 0.21 44.28 $9.30

97032 Electrical stimulation 0.54 44.28 $23.91

97033 Electric current therapy 0.92 44.28 $40.74

97034 Contrast bath therapy 0.51 44.28 $22.58

97035 Ultrasound therapy 0.36 44.28 $15.94

97036 Hydrotherapy 0.94 44.28 $41.62

97039 Physical therapy treatment 0.00 44.28 $0.00

97110 Therapeutic exercises 0.91 44.28 $40.29

97112 Neuromuscular reeducation 0.94 44.28 $41.62

97113 Aquatic therapy/exercises 1.21 44.28 $53.58

97116 Gait training therapy 0.80 44.28 $35.42

97124 Massage therapy 0.75 44.28 $33.21

97139 Physical medicine procedure 0.00 44.28 $0.00

97140 Manual therapy 1/> regions 0.84 44.28 $37.20

97150 Group therapeutic procedures 0.49 44.28 $21.70

97530 Therapeutic activities 0.98 44.28 $43.39

97532 Cognitive skills development 0.75 44.28 $33.21

97533 Sensory integration 0.82 44.28 $36.31

97535 Self care mngment training 0.98 44.28 $43.39

97537 Community/work reintegration 0.85 44.28 $37.64

97542 Wheelchair mngment training 0.86 44.28 $38.08

97545 Work hardening 0.00 44.28 $0.00

97546 Work hardening add-on 0.00 44.28 $0.00

97597 Rmvl devital tis 20 cm/< 2.15 44.28 $95.20

97598 Rmvl devital tis addl 20cm/< 0.71 44.28 $31.44

97602 Wound(s) care non-selective 0.00 44.28 $0.00

97605 Neg press wound tx </=50 cm 1.23 44.28 $54.46

97606 Neg press wound tx >50 cm 1.46 44.28 $64.65

97607 Neg press wnd tx </=50 sq cm 0.00 44.28 $0.00

97608 Neg press wound tx >50 cm 0.00 44.28 $0.00

97610 Low frequency non-thermal us 3.43 44.28 $151.88

97750 Physical performance test 0.93 44.28 $41.18

97755 Assistive technology assess 1.01 44.28 $44.72

97760 Orthotic mgmt and training 1.07 44.28 $47.38

97761 Prosthetic training 0.93 44.28 $41.18

97762 C/o for orthotic/prosth use 1.35 44.28 $59.78

97799 Physical medicine procedure 0.00 44.28 $0.00

97802 Medical nutrition indiv in 0.98 44.28 $43.39

97803 Med nutrition indiv subseq 0.84 44.28 $37.20

97804 Medical nutrition group 0.45 44.28 $19.93

97810 Acupunct w/o stimul 15 min 1.03 44.28 $45.61

97811 Acupunct w/o stimul addl 15m 0.77 44.28 $34.10

97813 Acupunct w/stimul 15 min 1.10 44.28 $48.71

97814 Acupunct w/stimul addl 15m 0.87 44.28 $38.52

98925 Osteopath manj 1-2 regions 0.88 44.28 $38.97

98940 Chiropract manj 1-2 regions 0.79 44.28 $34.98

98941 Chiropract manj 3-4 regions 1.15 44.28 $50.92

98942 Chiropractic manj 5 regions 1.50 44.28 $66.42

98943 Chiropract manj xtrspinl 1/> 0.77 44.28 $34.10

98960 Self-mgmt educ & train 1 pt 0.79 44.28 $34.98

98961 Self-mgmt educ/train 2-4 pt 0.38 44.28 $16.83

98962 Self-mgmt educ/train 5-8 pt 0.28 44.28 $12.40

98966 Hc pro phone call 5-10 min 0.40 44.28 $17.71

98969 Online service by hc pro 0.00 44.28 $0.00

99000 Specimen handling office-lab 0.00 44.28 $0.00

99001 Specimen handling pt-lab 0.00 44.28 $0.00

99002 Device handling phys/qhp 0.00 44.28 $0.00

99024 Postop follow-up visit 0.00 44.28 $0.00

99026 In-hospital on call service 0.00 44.28 $0.00

99027 Out-of-hosp on call service 0.00 44.28 $0.00

99050 Medical services after hrs 0.00 44.28 $0.00

99051 Med serv eve/wkend/holiday 0.00 44.28 $0.00

99053 Med serv 10pm-8am 24 hr fac 0.00 44.28 $0.00

99056 Med service out of office 0.00 44.28 $0.00

99058 Office emergency care 0.00 44.28 $0.00

99060 Out of office emerg med serv 0.00 44.28 $0.00

99070 Special supplies phys/qhp 0.00 44.28 $0.00

99071 Patient education materials 0.00 44.28 $0.00

99075 Medical testimony 0.00 44.28 $0.00

99078 Group health education 0.00 44.28 $0.00

99080 Special reports or forms 0.00 44.28 $0.00

99082 Unusual physician travel 0.00 44.28 $0.00

99090 Computer data analysis 0.00 44.28 $0.00

99091 Collect/review data from pt 1.59 44.28 $70.41

99100 Special anesthesia service 0.00 44.28 $0.00

99116 Anesthesia with hypothermia 0.00 44.28 $0.00

99135 Special anesthesia procedure 0.00 44.28 $0.00

99140 Emergency anesthesia 0.00 44.28 $0.00

99143 Mod sedat phys/qhp <5 yrs 0.00 44.28 $0.00

99144 Mod sedat phys/qhp 5yrs/> 0.00 44.28 $0.00

99145 Mod sedat phys/qhp ea 15 min 0.00 44.28 $0.00

99148 Mod sed diff phys/qhp<5 yrs 0.00 44.28 $0.00

99149 Mod sed diff phys/qhp 5/>yrs 0.00 44.28 $0.00

99150 Mod sed diff phys/qhp add on 0.00 44.28 $0.00

99170 Anogenital exam child w imag 4.51 44.28 $199.70

99172 Ocular function screen 0.00 44.28 $0.00

99173 Visual acuity screen 0.09 44.28 $3.99

99174 Ocular instrumnt screen bil 0.00 44.28 $0.00

99175 Induction of vomiting 0.48 44.28 $21.25

99183 Hyperbaric oxygen therapy 3.15 44.28 $139.48

99184 Hypothermia ill neonate 6.62 44.28 $293.13

99188 App topical fluoride varnish 0.00 44.28 $0.00

99190 Special pump services 0.00 44.28 $0.00

99195 Phlebotomy 2.83 44.28 $125.31

99199 Special service/proc/report 0.00 44.28 $0.00

99201 Office/outpatient visit new 1.23 44.28 $54.46

99211 Office/outpatient visit est 0.56 44.28 $24.80

99217 Observation care discharge 2.05 44.28 $90.77

99218 Initial observation care 2.83 44.28 $125.31

99221 Initial hospital care 2.87 44.28 $127.08

99224 Subsequent observation care 1.11 44.28 $49.15

99231 Subsequent hospital care 1.10 44.28 $48.71

99234 Observ/hosp same date 3.78 44.28 $167.38

99238 Hospital discharge day 2.06 44.28 $91.22

99239 Hospital discharge day 3.03 44.28 $134.17

99241 Office consultation 1.37 44.28 $60.66

99251 Inpatient consultation 1.39 44.28 $61.55

99281 Emergency dept visit 0.59 44.28 $26.13

99288 Direct advanced life support 0.00 44.28 $0.00

99291 Critical care first hour 7.77 44.28 $344.06

99292 Critical care addl 30 min 3.46 44.28 $153.21

99304 Nursing facility care init 2.58 44.28 $114.24

99307 Nursing fac care subseq 1.25 44.28 $55.35

99315 Nursing fac discharge day 2.05 44.28 $90.77

99316 Nursing fac discharge day 2.96 44.28 $131.07

99318 Annual nursing fac assessmnt 2.70 44.28 $119.56

99324 Domicil/r-home visit new pat 1.55 44.28 $68.63

99334 Domicil/r-home visit est pat 1.69 44.28 $74.83

99339 Domicil/r-home care supervis 2.20 44.28 $97.42

99340 Domicil/r-home care supervis 3.07 44.28 $135.94

99341 Home visit new patient 1.54 44.28 $68.19

99347 Home visit est patient 1.56 44.28 $69.08

99354 Prolonged service office 2.81 44.28 $124.43

99355 Prolonged service office 2.73 44.28 $120.88

99356 Prolonged service inpatient 2.59 44.28 $114.69

99357 Prolonged service inpatient 2.56 44.28 $113.36

99358 Prolong service w/o contact 3.09 44.28 $136.83

99359 Prolong serv w/o contact add 1.48 44.28 $65.53

99360 Physician standby services 1.73 44.28 $76.60

99363 Anticoagulant mgmt initial 3.60 44.28 $159.41

99364 Anticoagulant mgmt subseq 1.22 44.28 $54.02

99366 Team conf w/pat by hc prof 1.21 44.28 $53.58

99367 Team conf w/o pat by phys 1.59 44.28 $70.41

99368 Team conf w/o pat by hc pro 1.04 44.28 $46.05

99374 Home health care supervision 1.97 44.28 $87.23

99375 Home health care supervision 2.97 44.28 $131.51

99377 Hospice care supervision 1.97 44.28 $87.23

99378 Hospice care supervision 2.97 44.28 $131.51

99379 Nursing fac care supervision 1.97 44.28 $87.23

99380 Nursing fac care supervision 2.97 44.28 $131.51

99381 Init pm e/m new pat infant 3.12 44.28 $138.15

99382 Init pm e/m new pat 1-4 yrs 3.26 44.28 $144.35

99383 Prev visit new age 5-11 3.39 44.28 $150.11

99387 Init pm e/m new pat 65+ yrs 4.67 44.28 $206.79

99391 Per pm reeval est pat infant 2.80 44.28 $123.98

99392 Prev visit est age 1-4 2.99 44.28 $132.40

99397 Per pm reeval est pat 65+ yr 3.85 44.28 $170.48

99401 Preventive counseling indiv 1.02 44.28 $45.17

99406 Behav chng smoking 3-10 min 0.40 44.28 $17.71

99407 Behav chng smoking > 10 min 0.77 44.28 $34.10

99408 Audit/dast 15-30 min 0.99 44.28 $43.84

99409 Audit/dast over 30 min 1.94 44.28 $85.90

99411 Preventive counseling group 0.46 44.28 $20.37

99412 Preventive counseling group 0.61 44.28 $27.01

99420 Health risk assessment test 0.31 44.28 $13.73

99429 Unlisted preventive service 0.00 44.28 $0.00

99441 Phone e/m phys/qhp 5-10 min 0.40 44.28 $17.71

99444 Online e/m by phys/qhp 0.00 44.28 $0.00

99446 Interprof phone/online 5-10 0.00 44.28 $0.00

99449 Interprof phone/online 31/> 0.00 44.28 $0.00

99450 Basic life disability exam 0.00 44.28 $0.00

99455 Work related disability exam 0.00 44.28 $0.00

99456 Disability examination 0.00 44.28 $0.00

99460 Init nb em per day hosp 2.80 44.28 $123.98

99461 Init nb em per day non-fac 2.53 44.28 $112.03

99462 Sbsq nb em per day hosp 1.17 44.28 $51.81

99463 Same day nb discharge 3.38 44.28 $149.67

99464 Attendance at delivery 2.10 44.28 $92.99

99465 Nb resuscitation 4.25 44.28 $188.19

99466 Ped crit care transport 6.95 44.28 $307.75

99467 Ped crit care transport addl 3.49 44.28 $154.54

99468 Neonate crit care initial 25.87 44.28 $1,145.52

99469 Neonate crit care subsq 11.21 44.28 $496.38

99471 Ped critical care initial 24.60 44.28 $1,089.29

99472 Ped critical care subsq 11.51 44.28 $509.66

99475 Ped crit care age 2-5 init 16.25 44.28 $719.55

99476 Ped crit care age 2-5 subsq 9.79 44.28 $433.50

99477 Init day hosp neonate care 10.17 44.28 $450.33

99478 Ic lbw inf < 1500 gm subsq 3.99 44.28 $176.68

99479 Ic lbw inf 1500-2500 g subsq 3.51 44.28 $155.42

99480 Ic inf pbw 2501-5000 g subsq 3.37 44.28 $149.22

99485 Suprv interfacilty transport 2.17 44.28 $96.09

99486 Suprv interfac trnsport addl 1.89 44.28 $83.69

99487 Cmplx chron care w/o pt vsit 0.00 44.28 $0.00

99489 Cmplx chron care addl 30 min 0.00 44.28 $0.00

99490 Chron care mgmt srvc 20 min 1.20 44.28 $53.14

99495 Trans care mgmt 14 day disch 4.63 44.28 $205.02

99496 Trans care mgmt 7 day disch 6.50 44.28 $287.82

99497 Advncd care plan 30 min 0.00 44.28 $0.00

99498 Advncd care plan addl 30 min 0.00 44.28 $0.00

99499 Unlisted e&m service 0.00 44.28 $0.00

99500 Home visit prenatal 0.00 44.28 $0.00

99501 Home visit postnatal 0.00 44.28 $0.00

99502 Home visit nb care 0.00 44.28 $0.00

99503 Home visit resp therapy 0.00 44.28 $0.00

99504 Home visit mech ventilator 0.00 44.28 $0.00

99505 Home visit stoma care 0.00 44.28 $0.00

99506 Home visit im injection 0.00 44.28 $0.00

99507 Home visit cath maintain 0.00 44.28 $0.00

99509 Home visit day life activity 0.00 44.28 $0.00

99510 Home visit sing/m/fam couns 0.00 44.28 $0.00

99511 Home visit fecal/enema mgmt 0.00 44.28 $0.00

99512 Home visit for hemodialysis 0.00 44.28 $0.00

99600 Home visit nos 0.00 44.28 $0.00

99601 Home infusion/visit 2 hrs 0.00 44.28 $0.00

99602 Home infusion each addtl hr 0.00 44.28 $0.00

99605 Mtms by pharm np 15 min 0.00 44.28 $0.00

99606 Mtms by pharm est 15 min 0.00 44.28 $0.00

99607 Mtms by pharm addl 15 min 0.00 44.28 $0.00

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