LAC 40:I.5157
A. Table 1
| Maximum Fee Allowance Schedule Office of Workers' Compensation | ||||
| CPT Code | Mod | Description | Global Days | Maximum Allowance |
| 00100 | Anesthesia for procedures on salivary glands, including biopsy | 5 + TM | ||
| 00102 | Plastic repair of cleft lip | 6 + TM | ||
| 00103 | Blepharoplasty | 5 + TM | ||
| 00104 | Electroconvulsive therapy | 4 + TM | ||
| 00120 | Ext, mid, and inner ear inc bx; nos | 5 + TM | ||
| 00124 | Otoscopy | 4 + TM | ||
| 00126 | Tympanotomy | 4 + TM | ||
| 00140 | Procedures on eye nos | 5 + TM | ||
| 00142 | Lens surgery | 6 + TM | ||
| 00144 | Corneal transplant | 6 + TM | ||
| 00145 | Vitrectomy | 6 + TM | ||
| 00147 | Iridectomy | 6 + TM | ||
| 00148 | Ophthalmoscopy | 4 + TM | ||
| 00160 | Nose and accessory sinuses nos | 5 + TM | ||
| 00162 | Nose, radical surgery | 7 + TM | ||
| 00164 | Nose, biopsy, soft tissue | 4 + TM | ||
| 00170 | Intraoral procedures, inc bx nos | 5 + TM | ||
| 00172 | Intraoral, repair of cleft palate | 6 + TM | ||
| 00174 | Intraoral exc retropharyngeal tumor | 6 + TM | ||
| 00176 | Intraoral radical surgery | 7 + TM | ||
| 00190 | Procedures on facial bones; nos | 5 + TM | ||
| 00192 | Facial bones; radical surgery | 7 + TM | ||
| 00210 | Intracranial procedures; nos | 11 + TM | ||
| 00211 | Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma | 10 + TM | ||
| 00212 | Subdural taps | 5 + TM | ||
| 00214 | Burr holes | 9 + TM | ||
| 00215 | Skull fracture | 9 + TM | ||
| 00216 | Intracranial vascular procedures | 15 + TM | ||
| 00218 | Intracranial proc sitting position | 13 + TM | ||
| 00220 | Spinal fluid shunting procedures | 10 + TM | ||
| 00222 | Electrocoag intracranial nerve | 6 + TM | ||
| 00300 | Integ sys neck, inc subcut tissue | 5 + TM | ||
| 00320 | Neck procedures exc integ system | 6 + TM | ||
| 00322 | Needle biopsy of thyroid | 3 + TM | ||
| 00326 | Anesth, larynx/trach, < 1 yr | 7 + TM | ||
| 00350 | Major vessels of neck; nos | 10 + TM | ||
| 00352 | Major vesels neck; simple ligation | 5 + TM | ||
| 00400 | Ant integ system chest; nos | 3 + TM | ||
| 00402 | Reconstructive procedures on breast | 5 + TM | ||
| 00404 | Radical/mod radical breast | 5 + TM | ||
| 00406 | Radical/mod breast w/node dissect | 13 + TM | ||
| 00410 | Cardioversion | 4 + TM | ||
| 00450 | Clavicle and scapula; nos | 5 + TM | ||
| 00452 | Clavicle and scapula; radical surgery | 6 + TM | ||
| 00454 | Biopsy of clavicle | 3 + TM | ||
| 00470 | Partial rib resection; nos | 6 + TM | ||
| 00472 | Thoracoplasty | 10 + TM | ||
| 00474 | Rib resection; radical procedures | 13 + TM | ||
| 00500 | Procedures on esophagus | 15 + TM | ||
| 00520 | Closed chest procedures nos | 6 + TM | ||
| 00522 | Needle biopsy of pleura | 4 + TM | ||
| 00524 | Pneumocentesis | 4 + TM | ||
| 00528 | Mediastinoscopy | 8 + TM | ||
| 00529 | Anesth, chest partition view | 11 + TM | ||
| 00530 | Transvenous pacemaker insertion | 4 + TM | ||
| 00532 | Access central venous circulation | 4 + TM | ||
| 00534 | Transvenous cardioverter/defibrill | 7 + TM | ||
| 00537 | Anesth, cardiac electrophys | 7 + TM | ||
| 00539 | Anesth, trach-bronch reconst | 18 + TM | ||
| 00540 | Thoracotomy procedures; nos | 13 + TM | ||
| 00541 | Anesth, one lung ventilation | 15 + TM | ||
| 00542 | Decortication | 15 + TM | ||
| 00546 | Pulmonary resect w/thoracoplasty | 15 + TM | ||
| 00548 | Repair trauma trachea/bronchi | 15 + TM | ||
| 00550 | Anesth, sternal debridement | 10 + TM | ||
| 00560 | Heart, pericardium, w/o pump | 15 + TM | ||
| 00561 | 25 + TM | |||
| 00562 | Heart, pericardium, w/ pump | 20 + TM | ||
| 00563 | Anesth, heart surg w/arrest | 25 + TM | ||
| 00566 | Anesthesia for direct coronary artery bypass grafting; without pump oxygenator | 25 + TM | ||
| 00567 | Anesthesia for direct coronary artery bypass grafting; with pump oxygenator | 18 + TM | ||
| 00580 | Heart, heart/lung transplant | 20 + TM | ||
| 00600 | Cervical spine and cord; nos | 10 + TM | ||
| 00604 | Post cervical laminectomy sitting | 13 + TM | ||
| 00620 | Thoracic spine and cord; nos | 10 + TM | ||
| 00622 | Thoracolumbar sympathectomy | 13 + TM | ||
| 00625 | Anes spine tranthor w/o vent | 13 + TM | ||
| 00626 | Anes, spine transthor w/vent | 15 + TM | ||
| 00630 | Procedures in lumbar region; nos | 8 + TM | ||
| 00632 | Lumbar sympathectomy | 7 + TM | ||
| 00634 | Chemonucleolysis | 10 + TM | ||
| 00635 | Anesth, lumbar puncture | 4 + TM | ||
| 00640 | Anesth, spine manipulat | 3 + TM | ||
| 00670 | Extensive spine/cord procedures | 13 + TM | ||
| 00700 | Upper anterior abdominal wall nos | 3 + TM | ||
| 00702 | Percutaneous liver biopsy | 4 + TM | ||
| 00730 | Upper posterior abdominal wall | 5 + TM | ||
| 00740 | Upper gi endoscopic procedures | 5 + TM | ||
| 00750 | Hernia repairs upper abdomen nos | 4 + TM | ||
| 00752 | Lumbar and ventral hernias | 6 + TM | ||
| 00754 | Omphalocele | 7 + TM | ||
| 00756 | Transabd repair diaphragm hernia | 7 + TM | ||
| 00770 | Major abdominal blood vessels | 15 + TM | ||
| 00790 | Intraperitoneal proc upper abd; nos | 7 + TM | ||
| 00792 | Partial hepatectomy | 13 + TM | ||
| 00794 | Pancreatectomy, partial or total | 8 + TM | ||
| 00796 | Liver transplant (recipient) | 30 + TM | ||
| 00797 | Anesth, surgery for obesity | 11 + TM | ||
| 00800 | Lower anterior abdominal wall; nos | 3 + TM | ||
| 00802 | Panniculectomy | 5 + TM | ||
| 00810 | Intestinal endoscopic procedures | 5 + TM | ||
| 00820 | Lower posterior abdominal wall | 5 + TM | ||
| 00830 | Hernia repairs lower abdomen; nos | 4 + TM | ||
| 00832 | Ventral and incisional hernias | 6 + TM | ||
| 00834 | Anesth, hernia repair< 1 yr | 5 + TM | ||
| 00836 | Anesth hernia repair preemie | 6 + TM | ||
| 00840 | Intraperitoneal proc lower abd; nos | 6 + TM | ||
| 00842 | Amniocentesis | 4 + TM | ||
| 00844 | Abdominoperineal resection | 7 + TM | ||
| 00846 | Radical hysterectomy | 8 + TM | ||
| 00848 | Pelvic exenteration | 8 + TM | ||
| 00851 | Anesth, tubal ligation | 6 + TM | ||
| 00860 | Extraperitoneal proc lower abd; nos | 6 + TM | ||
| 00862 | Renal procedures/donor nephrectomy | 7 + TM | ||
| 00864 | Total cystectomy | 8 + TM | ||
| 00865 | Radical prostatectomy | 7 + TM | ||
| 00866 | Adrenalectomy | 10 + TM | ||
| 00868 | Renal transplant (recipient) | 10 + TM | ||
| 00870 | Cystolithotomy | 5 + TM | ||
| 00872 | Lithotripsy, w/ water bath | 7 + TM | ||
| 00873 | Lithotripsy, w/o water bath | 5 + TM | ||
| 00880 | Major lower abdominal vessels; nos | 15 + TM | ||
| 00882 | Inferior vena cava ligation | 10 + TM | ||
| 00902 | Anorectal procedure | 4 + TM | ||
| 00904 | Radical perineal procedure | 7 + TM | ||
| 00906 | Vulvectomy | 4 + TM | ||
| 00908 | Perineal prostatectomy | 6 + TM | ||
| 00910 | Transurethral procedures; nos | 3 + TM | ||
| 00912 | Tur bladder tumor(s) | 5 + TM | ||
| 00914 | Transurethral resection prostate | 5 + TM | ||
| 00916 | Post turp bleeding | 5 + TM | ||
| 00918 | Fragment/removal ureteral calculus | 5 + TM | ||
| 00920 | Male external genitalia; nos | 3 + TM | ||
| 00921 | Anesth, vasectomy | 3 + TM | ||
| 00922 | Seminal vesicles | 6 + TM | ||
| 00924 | Undescended testis | 4 + TM | ||
| 00926 | Radical orchiectomy, inguinal | 4 + TM | ||
| 00928 | Radical orchiectomy, abdominal | 6 + TM | ||
| 00930 | Orchiopexy, unilateral or bilateral | 4 + TM | ||
| 00932 | Complete amputation of penis | 4 + TM | ||
| 00934 | Rad amp penis w/ biling lymphad | 6 + TM | ||
| 00936 | Rad amp penis w/ biling/iliac lymph | 8 + TM | ||
| 00938 | Insertion of penile prosthesis | 4 + TM | ||
| 00940 | Vaginal procedures; nos | 3 + TM | ||
| 00942 | Colpotomy, colpectomy, colporrhaphy | 4 + TM | ||
| 00944 | Vaginal hysterectomy | 6 + TM | ||
| 00948 | Cervical cerclage | 4 + TM | ||
| 00950 | Culdoscopy | 5 + TM | ||
| 00952 | Hysteroscopy | 4 + TM | ||
| 01112 | Anesth, bone aspirate/bx | 5 + TM | ||
| 01120 | Bony pelvis | 6 + TM | ||
| 01130 | Body cast application or revision | 3 + TM | ||
| 01140 | Interpelviabdominal amputation | 15 + TM | ||
| 01150 | Rad proc tumor pelvis, | 8 + TM | ||
| 01160 | Closed procedures symphysis pubis | 4 + TM | ||
| 01170 | Open proc symphysis pubis/sacroilia | 8 + TM | ||
| 01173 | Anesth, fx repair, pelvis | 12 + TM | ||
| 01180 | Obturator neurectomy; extrapelvic | 3 + TM | ||
| 01190 | Intrapelvic | 4 + TM | ||
| 01200 | Closed procedures hip joint | 4 + TM | ||
| 01202 | Arthroscopic procedures hip joint | 4 + TM | ||
| 01210 | Open procedures hip joint; nos | 6 + TM | ||
| 01212 | Hip disarticulation | 10 + TM | ||
| 01214 | Total hip replacement or revision | 8 + TM | ||
| 01215 | Anesth, revise hip repair | 10 + TM | ||
| 01220 | Closed procedures upper femur | 4 + TM | ||
| 01230 | Open procedures upper femur; nos | 6 + TM | ||
| 01232 | Amputation | 5 + TM | ||
| 01234 | Radical resection | 8 + TM | ||
| 01250 | Nerves, muscles, etc, upper leg | 4 + TM | ||
| 01260 | Veins upper leg, including explore | 3 + TM | ||
| 01270 | Arteries upper leg, inc bypass; nos | 8 + TM | ||
| 01272 | Femoral artery ligation | 4 + TM | ||
| 01274 | Femoral artery embolectomy | 6 + TM | ||
| 01320 | Nerves, muscles, etc, knee | 4 + TM | ||
| 01340 | Closed procedures lower femur | 4 + TM | ||
| 01360 | Open procedures lower of femur | 5 + TM | ||
| 01380 | Closed procedures knee joint | 3 + TM | ||
| 01382 | Arthroscopic procedures knee joint | 3 + TM | ||
| 01390 | Closed procedures uppr tibia/fibula | 3 + TM | ||
| 01392 | Open procedures upper tibia/fibula | 4 + TM | ||
| 01400 | Open procedures on knee joint; nos | 4 + TM | ||
| 01402 | Total knee replacement | 7 + TM | ||
| 01404 | Disarticulation at knee | 5 + TM | ||
| 01420 | Cast apply, remove, repair knee | 3 + TM | ||
| 01430 | Veins of knee and popliteal area; nos | 3 + TM | ||
| 01432 | Arteriovenous fistula | 6 + TM | ||
| 01440 | Arteries knee and popliteal area nos | 5 + TM | ||
| 01442 | Popliteal thromboendarterectomy | 8 + TM | ||
| 01444 | Popliteal excision and graft | 8 + TM | ||
| 01462 | Closed proc lwr leg, ankle, and foot | 3 + TM | ||
| 01464 | Arthroscopic procedures ankle joint | 3 + TM | ||
| 01470 | Nerves, muscles, etc, lower leg | 3 + TM | ||
| 01472 | Repair ruptured achilles tendon, | 5 + TM | ||
| 01474 | Gastrocnemius recession | 5 + TM | ||
| 01480 | Open procedures bones lower leg | 3 + TM | ||
| 01482 | Radical resection | 4 + TM | ||
| 01484 | Osteotomy/osteoplasty tibia/fibula | 4 + TM | ||
| 01486 | Total ankle replacement | 7 + TM | ||
| 01490 | Lower leg cast, removal, or repair | 3 + TM | ||
| 01500 | Arteries lower leg, inc bypass; nos | 8 + TM | ||
| 01502 | Embolectomy, direct or catheter | 6 + TM | ||
| 01520 | Veins of lower leg nos | 3 + TM | ||
| 01522 | Venous thrombectomy, dir catheter | 5 + TM | ||
| 01610 | Nerves, muscles, etc, shoulder | 5 + TM | ||
| 01620 | Closed proc humeral head and neck | 4 + TM | ||
| 01622 | Arthroscopic procedures shoulder | 4 + TM | ||
| 01630 | Open procedures humeral head and neck | 5 + TM | ||
| 01634 | Shoulder disarticulation | 9 + TM | ||
| 01636 | Interthoracoscapular amputation | 15 + TM | ||
| 01638 | Total shoulder replacement | 10 + TM | ||
| 01650 | Arteries of shoulder and axilla nos | 6 + TM | ||
| 01652 | Axillary-brachial aneurysm | 10 + TM | ||
| 01654 | Bypass graft | 8 + TM | ||
| 01656 | Axillaryfemoral bypass graft | 10 + TM | ||
| 01670 | Procedures veins shoulder and axilla | 4 + TM | ||
| 01680 | Shoulder cast, removal, repair nos | 3 + TM | ||
| 01682 | Shoulder spica | 4 + TM | ||
| 01710 | Nerves, muscles, etc, of upper arm | 3 + TM | ||
| 01712 | Tenotomy, elbow to shoulder, open | 5 + TM | ||
| 01714 | Tenoplasty, elbow to shoulder | 5 + TM | ||
| 01716 | Tenodesis, rupt long tendon biceps | 5 + TM | ||
| 01730 | Closed procedures humerus and elbow | 3 + TM | ||
| 01732 | Arthroscopic procedures elbow joint | 3 + TM | ||
| 01740 | Open procedures humerus and elbow nos | 4 + TM | ||
| 01742 | Osteotomy of humerus | 5 + TM | ||
| 01744 | Repair nonunion/malunion of humerus | 5 + TM | ||
| 01756 | Radical procedures | 6 + TM | ||
| 01758 | Excision cyst or tumor of humerus | 5 + TM | ||
| 01760 | Total elbow replacement | 7 + TM | ||
| 01770 | Arteries of upper arm and elbow; nos | 6 + TM | ||
| 01772 | Embolectomy | 6 + TM | ||
| 01780 | Veins of upper arm and elbow; nos | 3 + TM | ||
| 01782 | Phleborrhaphy | 4 + TM | ||
| 01810 | Nerves, muscles, etc, forearm/wrist | 3 + TM | ||
| 01820 | Closed proc lwr arm, wrist or hand | 3 + TM | ||
| 01829 | Anesth, dx wrist arthroscopy | 3 + TM | ||
| 01830 | Open proc lwr arm, wrist or hand | 3 + TM | ||
| 01832 | Total wrist replacement | 6 + TM | ||
| 01840 | Arteries forearm, wrist, and hand nos | 6 + TM | ||
| 01842 | Embolectomy | 6 + TM | ||
| 01844 | Vascular shunt, shunt revision | 6 + TM | ||
| 01850 | Veins forearm, wrist, and hand nos | 3 + TM | ||
| 01852 | Phleborrhaphy | 4 + TM | ||
| 01860 | Forearm, wrist, or hand cast applic | 3 + TM | ||
| 01916 | Arteriograms, needle carotid/vert | 5 + TM | ||
| 01920 | Cardiac catheterization | 7 + TM | ||
| 01922 | CAT/MRI | 7 + TM | ||
| 01924 | Anes, ther interven rad, art | 5 + TM | ||
| 01925 | Anes, ther interven rad, car | 7 + TM | ||
| 01926 | Anes, tx interv rad hrt/cran | 8 + TM | ||
| 01930 | Anes, ther interven rad, vei | 5 + TM | ||
| 01931 | Anes, ther interven rad, tip | 7 + TM | ||
| 01932 | Anes, tx interv rad, th vein | 6 + TM | ||
| 01933 | Anes, tx interv rad, cran v | 7 + TM | ||
| 01935 | Anesth, perc img dx sp proc | 5 + TM | ||
| 01936 | Anesth, perc img tx sp proc | 5 + TM | ||
| 01951 | Anesth, burn, less 4 percent | 3 + TM | ||
| 01952 | Anesth, burn, 4-9 percent | 5 + TM | ||
| 01953 | Anesth, burn, each 9 percent | 1 + TM | ||
| 01958 | Anesth, antepartum manipul | 5 + TM | ||
| 01960 | Anesth, vaginal delivery | 5 + TM | ||
| 01961 | Anesth, cs delivery | 7 + TM | ||
| 01962 | Anesth, emer hysterectomy | 8 + TM | ||
| 01963 | Anesth, cs hysterectomy | 8 + TM | ||
| 01964 | Anesth, abortion pro | 4 + TM | ||
| 01965 | Anesth, inc/missed ab pro | 4 + TM | ||
| 01966 | Anesth, induced ab procedure | 4 + TM | ||
| 01967 | Anesth/analg, vag delivery | 5 + TM | ||
| 01968 | Anes/analg cs deliver add-on | 2 + TM | ||
| 01969 | Anesth/analg cs hyst add-on | 5 + TM | ||
| 01990 | Harvest organ(s) brain dead patient | 7 + TM | ||
| 01991 | Anesth nerve block/inj | 3 + TM | ||
| 01992 | Anesth n block/inj prone | 5 + TM | ||
| 01996 | Daily mgmt epidur/subarach drug adm | $3 | ||
| 01999 | Unlisted anesthesia procedre | BR |
B. Table 2
| CPT Code | Mod | Description | Global Days | Maximum Allowance | Non-Facility Maximum | Facility Maximum |
|---|---|---|---|---|---|---|
| 10021 | Fna w/o image | $305 | ||||
| 10022 | Fna w/image | $278 | ||||
| 10040 | Acne surgery | 10 | $119 | |||
| 10060 | Drainage of skin abscess | 10 | $113 | |||
| 10061 | Drainage of skin abscess | 10 | $226 | |||
| 10080 | Drainage of pilonidal cyst | 10 | $154 | |||
| 10081 | Drainage of pilonidal cyst | 10 | $260 | |||
| 10120 | Remove foreign body | 10 | $121 | |||
| 10121 | Remove foreign body | 10 | $266 | |||
| 10140 | Drainage of hematoma/fluid | 10 | $143 | |||
| 10160 | Puncture drainage of lesion | 10 | $112 | |||
| 10180 | Complex drainage, wound | 10 | $243 | |||
| 11000 | Surgical cleansing of skin | 0 | $96 | |||
| 11001 | Debride infected skin add-on | $42 | ||||
| 11004 | Debride genitalia & perineum | $1,204 | ||||
| 11005 | Debride abdom wall | $1,627 | ||||
| 11006 | Debride genit/per/abdom wall | $1,466 | ||||
| 11008 | Remove mesh from abd wall | $570 | ||||
| 11010 | Debride skin, fx...... | 10 | $591 | |||
| 11011 | Debride skin/muscle, fx. | 0 | $713 | |||
| 11012 | Debride skin/muscle/ bone, fx | 0 | $994 | |||
| 11042 | Cleansing of skin/tissue | 0 | $131 | |||
| 11043 | Cleansing of tissue/muscle | 10 | $282 | |||
| 11044 | Cleansing tissue/muscle/bone | 10 | $397 | |||
| 11046 | Deb musc/fascia add-on | $148 | ||||
| 11047 | Deb bone add-on | $250 | ||||
| 11055 | Trim skin lesion...... | 0 | $40 | |||
| 11056 | Trim skin lesions, 2 to 4. | 0 | $55 | |||
| 11057 | Trim skin lesions, over 4. | 0 | $59 | |||
| 11100 | Biopsy of skin lesion | 0 | $97 | |||
| 11101 | Biopsy, skin add-on... | $56 | ||||
| 11200 | Removal of skin tags | 10 | $82 | |||
| 11201 | Remove skin tags add- on. | $37 | ||||
| 11300 | Shave skin lesion | 0 | $78 | |||
| 11301 | Shave skin lesion | 0 | $112 | |||
| 11302 | Shave skin lesion | 0 | $144 | |||
| 11303 | Shave skin lesion | 0 | $196 | |||
| 11305 | Shave skin lesion | 0 | $89 | |||
| 11306 | Shave skin lesion | 0 | $126 | |||
| 11307 | Shave skin lesion | 0 | $154 | |||
| 11308 | Shave skin lesion | 0 | $212 | |||
| 11310 | Shave skin lesion | 0 | $105 | |||
| 11311 | Shave skin lesion | 0 | $140 | |||
| 11312 | Shave skin lesion | 0 | $172 | |||
| 11313 | Shave skin lesion | 0 | $231 | |||
| 11400 | Removal of skin lesion | 10 | $103 | |||
| 11401 | Removal of skin lesion | 10 | $142 | |||
| 11402 | Removal of skin lesion | 10 | $180 | |||
| 11403 | Removal of skin lesion | 10 | $224 | |||
| 11404 | Removal of skin lesion | 10 | $262 | |||
| 11406 | Removal of skin lesion | 10 | $348 | |||
| 11420 | Removal of skin lesion | 10 | $112 | |||
| 11421 | Removal of skin lesion | 10 | $161 | |||
| 11422 | Removal of skin lesion | 10 | $195 | |||
| 11423 | Removal of skin lesion | 10 | $253 | |||
| 11424 | Removal of skin lesion | 10 | $292 | |||
| 11426 | Removal of skin lesion | 10 | $414 | |||
| 11440 | Removal of skin lesion | 10 | $131 | |||
| 11441 | Removal of skin lesion | 10 | $177 | |||
| 11442 | Removal of skin lesion | 10 | $216 | |||
| 11443 | Removal of skin lesion | 10 | $287 | |||
| 11444 | Removal of skin lesion | 10 | $353 | |||
| 11446 | Removal of skin lesion | 10 | $453 | |||
| 11450 | Removal, sweat gland lesion | 90 | $404 | |||
| 11451 | Removal, sweat gland lesion | 90 | $507 | |||
| 11462 | Removal, sweat gland lesion | 90 | $364 | |||
| 11463 | Removal, sweat gland lesion | 90 | $434 | |||
| 11470 | Removal, sweat gland lesion | 90 | $448 | |||
| 11471 | Removal, sweat gland lesion | 90 | $511 | |||
| 11600 | Removal of skin lesion | 10 | $184 | |||
| 11601 | Removal of skin lesion | 10 | $241 | |||
| 11602 | Removal of skin lesion | 10 | $285 | |||
| 11603 | Removal of skin lesion | 10 | $338 | |||
| 11604 | Removal of skin lesion | 10 | $381 | |||
| 11606 | Removal of skin lesion | 10 | $495 | |||
| 11620 | Removal of skin lesion | 10 | $194 | |||
| 11621 | Removal of skin lesion | 10 | $271 | |||
| 11622 | Removal of skin lesion | 10 | $332 | |||
| 11623 | Removal of skin lesion | 10 | $404 | |||
| 11624 | Removal of skin lesion | 10 | $490 | |||
| 11626 | Removal of skin lesion | 10 | $576 | |||
| 11640 | Removal of skin lesion | 10 | $233 | |||
| 11641 | Removal of skin lesion | 10 | $330 | |||
| 11642 | Removal of skin lesion | 10 | $402 | |||
| 11643 | Removal of skin lesion | 10 | $477 | |||
| 11644 | Removal of skin lesion | 10 | $591 | |||
| 11646 | Removal of skin lesion | 10 | $763 | |||
| 11719 | Trim nail(s).......... | 0 | $30 | |||
| 11720 | Debride nail, 1-5..... | 0 | $49 | |||
| 11721 | Debride nail, 6 or more. | 0 | $80 | |||
| 11730 | Removal of nail plate | 0 | $115 | |||
| 11732 | Remove nail plate, add on. | $60 | ||||
| 11740 | Drain blood from under nail | 0 | $56 | |||
| 11750 | Removal of nail bed | 10 | $280 | |||
| 11752 | Remove nail bed/finger tip | 10 | $393 | |||
| 11755 | Biopsy, nail unit | 0 | $171 | |||
| 11760 | Reconstruction of nail bed | 10 | $181 | |||
| 11762 | Reconstruction of nail bed | 10 | $400 | |||
| 11765 | Excision of nail fold, toe | 10 | $86 | |||
| 11770 | Removal of pilonidal lesion | 10 | $402 | |||
| 11771 | Removal of pilonidal lesion | 90 | $750 | |||
| 11772 | Removal of pilonidal lesion | 90 | $863 | |||
| 11900 | Injection into skin lesions | 0 | $56 | |||
| 11901 | Added skin lesion injections | 0 | $88 | |||
| 11920 | Correct skin color defects | $361 | $243 | |||
| 11921 | Correct skin color defects | $417 | $285 | |||
| 11922 | Correct skin color defects | $64 | ||||
| 11950 | Therapy for contour defects | 0 | $149 | |||
| 11951 | Therapy for contour defects | 0 | $224 | |||
| 11952 | Therapy for contour defects | 0 | $298 | |||
| 11954 | Therapy for contour defects | 0 | $335 | |||
| 11960 | Insert tissue expander(s) | 90 | $1,081 | |||
| 11970 | Replace tissue expander | 90 | $1,187 | |||
| 11971 | Remove tissue expander(s) | 90 | $442 | |||
| 11976 | Removal of contraceptive | 0 | $300 | |||
| 11980 | Implant hormone pellet(s). | $215 | ||||
| 11981 | Insert drug implant device | $279 | ||||
| 11982 | Remove drug implant device | $313 | ||||
| 11983 | Remove/insert drug implant | $436 | ||||
| 12001 | Repair superficial wound(s) | 10 | $161 | |||
| 12002 | Repair superficial wound(s) | 10 | $189 | |||
| 12004 | Repair superficial wound(s) | 10 | $243 | |||
| 12005 | Repair superficial wound(s) | 10 | $313 | |||
| 12006 | Repair superficial wound(s) | 10 | $396 | |||
| 12007 | Repair superficial wound(s) | 10 | $430 | |||
| 12011 | Repair superficial wound(s) | 10 | $178 | |||
| 12013 | Repair superficial wound(s) | 10 | $216 | |||
| 12014 | Repair superficial wound(s) | 10 | $262 | |||
| 12015 | Repair superficial wound(s) | 10 | $347 | |||
| 12016 | Repair superficial wound(s) | 10 | $448 | |||
| 12017 | Repair superficial wound(s) | 10 | $590 | |||
| 12018 | Repair superficial wound(s) | 10 | $787 | |||
| 12020 | Closure of split wound | 10 | $279 | |||
| 12021 | Closure of split wound | 10 | $179 | |||
| 12031 | Layer closure of wound(s) | 10 | $205 | |||
| 12032 | Layer closure of wound(s) | 10 | $253 | |||
| 12034 | Layer closure of wound(s) | 10 | $318 | |||
| 12035 | Layer closure of wound(s) | 10 | $392 | |||
| 12036 | Layer closure of wound(s) | 10 | $474 | |||
| 12037 | Layer closure of wound(s) | 10 | $580 | |||
| 12041 | Layer closure of wound(s) | 10 | $230 | |||
| 12042 | Layer closure of wound(s) | 10 | $282 | |||
| 12044 | Layer closure of wound(s) | 10 | $346 | |||
| 12045 | Layer closure of wound(s) | 10 | $421 | |||
| 12046 | Layer closure of wound(s) | 10 | $523 | |||
| 12047 | Layer closure of wound(s) | 10 | $650 | |||
| 12051 | Layer closure of wound(s) | 10 | $250 | |||
| 12052 | Layer closure of wound(s) | 10 | $307 | |||
| 12053 | Layer closure of wound(s) | 10 | $354 | |||
| 12054 | Layer closure of wound(s) | 10 | $444 | |||
| 12055 | Layer closure of wound(s) | 10 | $566 | |||
| 12056 | Layer closure of wound(s) | 10 | $740 | |||
| 12057 | Layer closure of wound(s) | 10 | $847 | |||
| 13100 | Repair of wound or lesion | 10 | $307 | |||
| 13101 | Repair of wound or lesion | 10 | $436 | |||
| 13102 | Repair wound/lesion add-on | $227 | ||||
| 13120 | Repair of wound or lesion | 10 | $338 | |||
| 13121 | Repair of wound or lesion | 10 | $514 | |||
| 13122 | Repair wound/lesion add-on | $248 | ||||
| 13131 | Repair of wound or lesion | 10 | $421 | |||
| 13132 | Repair of wound or lesion | 10 | $653 | |||
| 13133 | Repair wound/lesion add-on | $349 | ||||
| 13150 | Repair of wound or lesion | 10 | $407 | |||
| 13151 | Repair of wound or lesion | 10 | $510 | |||
| 13152 | Repair of wound or lesion | 10 | $857 | |||
| 13153 | Repair wound/lesion add-on | $388 | ||||
| 13160 | Late closure of wound | 90 | $952 | |||
| 14000 | Skin tissue rearrangement | 90 | $653 | |||
| 14001 | Skin tissue rearrangement | 90 | $941 | |||
| 14020 | Skin tissue rearrangement | 90 | $812 | |||
| 14021 | Skin tissue rearrangement | 90 | $1,169 | |||
| 14040 | Skin tissue rearrangement | 90 | $1,034 | |||
| 14041 | Skin tissue rearrangement | 90 | $1,391 | |||
| 14060 | Skin tissue rearrangement | 90 | $1,193 | |||
| 14061 | Skin tissue rearrangement | 90 | $1,641 | |||
| 14301 | Skin tissue rearrangement | $2,262 | ||||
| 14302 | Skin tissue rearrange add-on | $468 | ||||
| 14350 | Skin tissue rearrangement | 90 | $1,145 | |||
| 15002 | Wound prep trk/arm/leg | $722 | ||||
| 15003 | Wound prep addl 100 cm | $158 | ||||
| 15004 | Wound prep f/n/hf/g | $827 | ||||
| 15005 | Wnd prep f/n/hf/g addl cm | $261 | ||||
| 15040 | Harvest cultured skin graft | $532 | ||||
| 15050 | Skin pinch graft procedure | 90 | $424 | |||
| 15100 | Skin split graft...... | 90 | $1,039 | |||
| 15101 | Skin split graft add- on | $249 | ||||
| 15110 | Epidrm autogrft trnk/arm/leg | $1,810 | ||||
| 15111 | Epidrm autogrft t/a/l add-on | $233 | ||||
| 15115 | Epidrm a-grft face/nck/hf/g | $1,823 | ||||
| 15116 | Epidrm a-grft f/n/hf/g addl | $361 | ||||
| 15120 | Skin split graft...... | 90 | $1,208 | |||
| 15121 | Skin split graft add- on | $410 | ||||
| 15130 | Derm autograft trnk/arm/leg | $1,414 | ||||
| 15131 | Derm autograft t/a/l add-on | $214 | ||||
| 15135 | Derm autograft face/nck/hf/g | $1,834 | ||||
| 15136 | Derm autograft f/n/hf/g add | $183 | ||||
| 15150 | Cult skin grft t/arm/leg | $1,435 | ||||
| 15151 | Cult skin grft t/a/l addl | $247 | ||||
| 15152 | Cult skin graft t/a/l +% | $348 | ||||
| 15155 | Cult skin graft f/n/hf/g | $1,434 | ||||
| 15156 | Cult skin grft f/n/hfg add | $373 | ||||
| 15157 | Cult epiderm grft f/n/hfg +% | $378 | ||||
| 15200 | Skin full graft procedure | 90 | $870 | |||
| 15201 | Skin full graft add-on | $232 | ||||
| 15220 | Skin full graft procedure | 90 | $928 | |||
| 15221 | Skin full graft add-on | $216 | ||||
| 15240 | Skin full graft procedure | 90 | $1,092 | |||
| 15241 | Skin full graft add-on | $319 | ||||
| 15260 | Skin full graft procedure | 90 | $1,275 | |||
| 15261 | Skin full graft add-on | $376 | ||||
| 15271 | Skin sub graft trnk/arm/leg | $297 | ||||
| 15272 | Skin sub graft t/a/l add-on | $56 | ||||
| 15273 | Skin sub grft t/arm/lg child | $611 | ||||
| 15274 | Skn sub grft t/a/l child add | $144 | ||||
| 15275 | Skin sub graft face/nk/hf/g | $319 | ||||
| 15276 | Skin sub graft f/n/hf/g addl | $70 | ||||
| 15277 | Skn sub grft f/n/hf/g child | $616 | ||||
| 15278 | Skn sub grft f/n/hf/g ch add | $169 | ||||
| 15350 | Skin homograft........ | 90 | $537 | |||
| 15570 | Form skin pedicle flap | 90 | $1,051 | |||
| 15572 | Form skin pedicle flap | 90 | $1,004 | |||
| 15574 | Form skin pedicle flap | 90 | $992 | |||
| 15576 | Form skin pedicle flap | 90 | $566 | |||
| 15600 | Skin graft procedure | 90 | $474 | |||
| 15610 | Skin graft procedure | 90 | $475 | |||
| 15620 | Skin graft procedure | 90 | $577 | |||
| 15630 | Skin graft procedure | 90 | $623 | |||
| 15650 | Transfer skin pedicle flap | 90 | $682 | |||
| 15731 | Forehead flap w/vasc pedicle | $2,399 | ||||
| 15732 | Muscle-skin graft, head/neck | 90 | $2,351 | |||
| 15734 | Muscle-skin graft, trunk | 90 | $2,744 | |||
| 15736 | Muscle-skin graft, arm | 90 | $2,441 | |||
| 15738 | Muscle-skin graft, leg | 90 | $2,034 | |||
| 15740 | Island pedicle flap graft | 90 | $1,520 | |||
| 15750 | Neurovascular pedicle graft | 90 | $1,741 | |||
| 15756 | Free muscle flap, microvasc | 90 | $4,826 | |||
| 15757 | Free skin flap, microvasc | 90 | $4,835 | |||
| 15758 | Free fascial flap, microvasc | 90 | $4,826 | |||
| 15760 | Composite skin graft | 90 | $1,181 | |||
| 15770 | Derma-fat-fascia graft | 90 | $1,081 | |||
| 15775 | Hair transplant punch grafts | $596 | ||||
| 15776 | Hair transplant punch grafts | $824 | ||||
| 15777 | Acellular derm matrix implt | $442 | ||||
| 15780 | Abrasion treatment of skin | 90 | $594 | |||
| 15781 | Abrasion treatment of skin | 90 | $625 | |||
| 15782 | Abrasion treatment of skin | 90 | $390 | |||
| 15783 | Abrasion treatment of skin | 90 | $439 | |||
| 15786 | Abrasion treatment of lesion | 10 | $189 | |||
| 15787 | Abrasion, lesions, add on | $41 | ||||
| 15788 | Chemical peel, face, epiderm | 90 | $321 | |||
| 15789 | Chemical peel, face, dermal | 90 | $390 | |||
| 15792 | Chemical peel, nonfacial | 90 | $206 | |||
| 15793 | Chemical peel, nonfacial | 90 | $261 | |||
| 15819 | Plastic surgery, neck | 90 | $1,257 | |||
| 15820 | Revision of lower eyelid | 90 | $830 | |||
| 15821 | Revision of lower eyelid | 90 | $952 | |||
| 15822 | Revision of upper eyelid | 90 | $799 | |||
| 15823 | Revision of upper eyelid | 90 | $1,060 | |||
| 15824 | Removal of forehead wrinkles | BR | ||||
| 15825 | Removal of neck wrinkles | BR | ||||
| 15826 | Removal of brow wrinkles | BR | ||||
| 15828 | Removal of face wrinkles | BR | ||||
| 15829 | Removal of skin wrinkles | BR | ||||
| 15830 | Exc skin abd | $2,470 | ||||
| 15832 | Excise excessive skin tissue | 90 | $1,457 | |||
| 15833 | Excise excessive skin tissue | 90 | $1,229 | |||
| 15834 | Excise excessive skin tissue | 90 | $1,314 | |||
| 15835 | Excise excessive skin tissue | 90 | $1,359 | |||
| 15836 | Excise excessive skin tissue | 90 | $1,113 | |||
| 15837 | Excise excessive skin tissue | 90 | $1,055 | |||
| 15838 | Excise excessive skin tissue | 90 | $949 | |||
| 15839 | Excise excessive skin tissue | 90 | $838 | |||
| 15840 | Graft for face nerve palsy | 90 | $2,130 | |||
| 15841 | Graft for face nerve palsy | 90 | $2,914 | |||
| 15842 | Graft for face nerve palsy | 90 | $4,789 | |||
| 15845 | Skin and muscle repair, face | 90 | $2,129 | |||
| 15850 | Removal of sutures | $176 | ||||
| 15851 | Removal of sutures | 0 | $84 | |||
| 15852 | Dressing change, not for burn | 0 | $97 | |||
| 15860 | Test for blood flow in graft | 0 | $252 | |||
| 15876 | Suction assisted lipectomy | BR | ||||
| 15877 | Suction assisted lipectomy | BR | ||||
| 15878 | Suction assisted lipectomy | BR | ||||
| 15879 | Suction assisted lipectomy | BR | ||||
| 15920 | Removal of tail bone ulcer | 90 | $775 | |||
| 15922 | Removal of tail bone ulcer | 90 | $1,157 | |||
| 15931 | Remove sacrum pressure sore | 90 | $822 | |||
| 15933 | Remove sacrum pressure sore | 90 | $1,274 | |||
| 15934 | Remove sacrum pressure sore | 90 | $1,442 | |||
| 15935 | Remove sacrum pressure sore | 90 | $1,881 | |||
| 15936 | Remove sacrum pressure sore | 90 | $1,702 | |||
| 15937 | Remove sacrum pressure sore | 90 | $2,061 | |||
| 15940 | Removal of pressure sore | 90 | $883 | |||
| 15941 | Removal of pressure sore | 90 | $1,316 | |||
| 15944 | Removal of pressure sore | 90 | $1,505 | |||
| 15945 | Removal of pressure sore | 90 | $1,738 | |||
| 15946 | Remove hip pressure sore. | 90 | $2,841 | |||
| 15950 | Remove thigh pressure sore | 90 | $735 | |||
| 15951 | Remove thigh pressure sore | 90 | $1,332 | |||
| 15952 | Remove thigh pressure sore | 90 | $1,323 | |||
| 15953 | Remove thigh pressure sore | 90 | $1,582 | |||
| 15956 | Remove thigh pressure sore | 90 | $2,408 | |||
| 15958 | Remove thigh pressure sore | 90 | $2,507 | |||
| 15999 | Removal of pressure sore | BR | ||||
| 16000 | Initial treatment of burn(s) | 0 | $90 | |||
| 16020 | Treatment of burn(s) | 0 | $83 | |||
| 16025 | Treatment of burn(s) | 0 | $166 | |||
| 16030 | Treatment of burn(s) | 0 | $190 | |||
| 16035 | Incision of burn scab | 90 | $478 | |||
| 16036 | Escharotomy addl incision | $175 | ||||
| 17000 | Destroy benign/primal lesion lesion | 10 | $80 | |||
| 17003 | Destroy lesions, 2-14 | $28 | ||||
| 17004 | Destroy lesions, 15 or more | 10 | $365 | |||
| 17106 | Destruction of skin lesions | 90 | $471 | |||
| 17107 | Destruction of skin lesions | 90 | $931 | |||
| 17108 | Destruction of skin lesions | 90 | $1,636 | |||
| 17110 | Destruct lesion, 1-14 | 10 | $84 | |||
| 17111 | Destruct lesion, 15 or more | 10 | $120 | |||
| 17250 | Chemical cautery, tissue | 0 | $63 | |||
| 17260 | Destruction of skin lesions | 10 | $148 | |||
| 17261 | Destruction of skin lesions | 10 | $187 | |||
| 17262 | Destruction of skin lesions | 10 | $249 | |||
| 17263 | Destruction of skin lesions | 10 | $298 | |||
| 17264 | Destruction of skin lesions | 10 | $336 | |||
| 17266 | Destruction of skin lesions | 10 | $418 | |||
| 17270 | Destruction of skin lesions | 10 | $193 | |||
| 17271 | Destruction of skin lesions | 10 | $238 | |||
| 17272 | Destruction of skin lesions | 10 | $291 | |||
| 17273 | Destruction of skin lesions | 10 | $342 | |||
| 17274 | Destruction of skin lesions | 10 | $430 | |||
| 17276 | Destruction of skin lesions | 10 | $502 | |||
| 17280 | Destruction of skin lesions | 10 | $207 | |||
| 17281 | Destruction of skin lesions | 10 | $279 | |||
| 17282 | Destruction of skin lesions | 10 | $339 | |||
| 17283 | Destruction of skin lesions | 10 | $416 | |||
| 17284 | Destruction of skin lesions | 10 | $496 | |||
| 17286 | Destruction of skin lesions | 10 | $660 | |||
| 17304 | Chemosurgery of skin lesion | 0 | $891 | |||
| 17311 | Mohs 1 stage h/n/hf/g | $1,352 | ||||
| 17312 | Mohs addl stage | $806 | ||||
| 17313 | Mohs 1 stage t/a/l | $1,233 | ||||
| 17314 | Mohs addl stage t/a/l | $747 | ||||
| 17315 | Mohs surg addl block | $163 | ||||
| 17340 | Cryotherapy of skin | 10 | $73 | |||
| 17360 | Skin peel therapy | 10 | $120 | |||
| 17380 | Hair removal by electrolysis | BR | ||||
| 17999 | Skin tissue procedure | BR | ||||
| 19000 | Drainage of breast lesion | 0 | $91 | |||
| 19001 | Drain breast lesion add-on. | $64 | ||||
| 19020 | Incision of breast lesion | 90 | $358 | |||
| 19030 | Injection for breast X-ray | 0 | $147 | |||
| 19100 | Biopsy of breast | 0 | $145 | |||
| 19101 | Biopsy of breast | 10 | $419 | |||
| 19102 | Bx breast percut w/image | $428 | ||||
| 19103 | Bx breast percut w/device | $1,108 | ||||
| 19105 | Cryosurg ablate fa each | $6,103 | ||||
| 19110 | Nipple exploration | 90 | $505 | |||
| 19112 | Excise breast duct fistula | 90 | $440 | |||
| 19120 | Removal of breast lesion | 90 | $648 | |||
| 19125 | Excision, breast lesion | 90 | $663 | |||
| 19126 | Excision, addl breast lesion | $326 | ||||
| 19160 | Removal of breast tissue | 90 | $826 | |||
| 19260 | Removal of chest wall lesion | 90 | $1,416 | |||
| 19271 | Revision of chest wall | 90 | $2,392 | |||
| 19272 | Extensive chest wall surgery | 90 | $2,452 | |||
| 19290 | Place needle wire, breast | 0 | $126 | |||
| 19291 | Place needle wire, breast. | $86 | ||||
| 19295 | Place breast clip percut | $182 | ||||
| 19296 | Place po breast cath for rad | $8,412 | ||||
| 19297 | Place breast cath for rad | $194 | ||||
| 19298 | Place breast rad tube/caths | $2,245 | ||||
| 19300 | Removal of breast tissue | $1,080 | ||||
| 19301 | Partical mastectomy | $1,345 | ||||
| 19302 | P-mastectomy w/ln removal | $1,855 | ||||
| 19303 | Mast simple complete | $2,084 | ||||
| 19304 | Mast subq | $1,189 | ||||
| 19305 | Mast radical | $2,339 | ||||
| 19306 | Mast rad urban type | $2,482 | ||||
| 19307 | Mast mod rad | $2,469 | ||||
| 19316 | Suspension of breast | 90 | $1,794 | |||
| 19318 | Reduction of large breast | 90 | $2,105 | |||
| 19324 | Enlarge breast | 90 | $674 | |||
| 19325 | Enlarge breast with implant | 90 | $1,066 | |||
| 19328 | Removal of breast implant | 90 | $695 | |||
| 19330 | Removal of implant material | 90 | $836 | |||
| 19340 | Immediate breast prosthesis | $1,284 | ||||
| 19342 | Delayed breast prosthesis | 90 | $1,662 | |||
| 19350 | Breast reconstruction | 90 | $1,181 | |||
| 19355 | Correct inverted nipple(s) | 90 | $934 | |||
| 19357 | Breast reconstruction | 90 | $2,212 | |||
| 19361 | Breast reconstruction | 90 | $2,961 | |||
| 19364 | Breast reconstruction | 90 | $3,388 | |||
| 19366 | Breast reconstruction | 90 | $2,791 | |||
| 19367 | Breast reconstruction | 90 | $3,412 | |||
| 19368 | Breast reconstruction | 90 | $3,861 | |||
| 19369 | Breast reconstruction | 90 | $3,688 | |||
| 19370 | Surgery of breast capsule | 90 | $1,058 | |||
| 19371 | Removal of breast capsule | 90 | $1,295 | |||
| 19380 | Revise breast reconstruction | 90 | $1,297 | |||
| 19396 | Design custom breast implant | 0 | $619 | $312 | ||
| 19499 | Breast surgery procedure | BR | ||||
| 20005 | Incision of deep abscess | 10 | $363 | |||
| 20100 | Explore wound, neck... | 10 | $1,143 | |||
| 20101 | Explore wound, chest.. | 10 | $372 | |||
| 20102 | Explore wound, abdomen | 10 | $458 | |||
| 20103 | Explore wound, extremity | 10 | $615 | |||
| 20150 | Excise epiphyseal bar | 90 | $1,901 | |||
| 20200 | Muscle biopsy | 0 | $196 | |||
| 20205 | Deep muscle biopsy | 0 | $323 | |||
| 20206 | Needle biopsy, muscle | 0 | $148 | |||
| 20220 | Bone biopsy, trocar/needle | 0 | $189 | |||
| 20225 | Bone biopsy, trocar/needle | 0 | $322 | |||
| 20240 | Bone biopsy, excisional | 10 | $396 | |||
| 20245 | Bone biopsy, excisional | 10 | $545 | |||
| 20250 | Open bone biopsy | 10 | $741 | |||
| 20251 | Open bone biopsy | 10 | $844 | |||
| 20500 | Injection of sinus tract | 10 | $112 | |||
| 20501 | Inject sinus tract for X-ray | 0 | $77 | |||
| 20520 | Removal of foreign body | 10 | $184 | |||
| 20525 | Removal of foreign body | 10 | $410 | |||
| 20526 | Ther injection carp tunnel | $156 | ||||
| 20527 | Inj dupuytren cord w/enzyme | $157 | ||||
| 20550 | Inj tendon/ligament/cyst | 0 | $91 | |||
| 20551 | Inj tendon origin/insertion | $123 | ||||
| 20552 | Inj trigger point 1/2 muscl | $113 | ||||
| 20553 | Inject trigger points =/> 3 | $130 | ||||
| 20555 | Place ndl musc/tis for rt | $682 | ||||
| 20560 | Needle Insertion w/o Injection 1 or 2 Muscles | $36.95 | $24.04 | |||
| 20561 | Needle Insertion w/o Injection 3 or more Muscles | $55.06 | $36.40 | |||
| 20600 | Drain/inject joint/bursa | 0 | $84 | |||
| 20605 | Drain/inject joint/bursa | 0 | $84 | |||
| 20610 | Drain/inject joint/bursa | 0 | $92 | |||
| 20612 | Aspirate/inj ganglion cyst | $124 | ||||
| 20615 | Treatment of bone cyst | 10 | $197 | |||
| 20650 | Insert and remove bone pin | 10 | $233 | |||
| 20660 | Apply, remove fixation device | 0 | $304 | |||
| 20661 | Application of head brace | 90 | $619 | |||
| 20662 | Application of pelvis brace | 90 | $927 | |||
| 20663 | Application of thigh brace | 90 | $728 | |||
| 20664 | Halo brace application | 90 | $940 | |||
| 20665 | Removal of fixation device | 10 | $130 | |||
| 20670 | Removal of support implant | 10 | $180 | |||
| 20680 | Removal of support implant | 90 | $503 | |||
| 20690 | Apply bone fixation device | 90 | $550 | |||
| 20692 | Apply bone fixation device | 90 | $907 | |||
| 20693 | Adjust bone fixation device | 90 | $590 | |||
| 20694 | Remove bone fixation device | 90 | $483 | |||
| 20696 | Comp multiplane ext fixation | $2,366 | ||||
| 20697 | Comp ext fixate strut change | $4,357 | ||||
| 20802 | Replantation, arm, complete | 90 | $5,778 | |||
| 20805 | Replant, forearm, complete | 90 | $7,222 | |||
| 20808 | Replantation hand, complete | 90 | $8,745 | |||
| 20816 | Replantation digit, complete | 90 | $4,710 | |||
| 20822 | Replantation digit, complete | 90 | $3,961 | |||
| 20824 | Replantation thumb, complete | 90 | $4,633 | |||
| 20827 | Replantation thumb, complete | 90 | $4,061 | |||
| 20838 | Replantation foot, complete | 90 | $5,911 | |||
| 20900 | Removal of bone for graft | 90 | $586 | |||
| 20902 | Removal of bone for graft | 90 | $885 | |||
| 20910 | Remove cartilage for graft | 90 | $419 | |||
| 20912 | Remove cartilage for graft | 90 | $801 | |||
| 20920 | Removal of fascia for graft | 90 | $658 | |||
| 20922 | Removal of fascia for graft | 90 | $789 | |||
| 20924 | Removal of tendon for graft | 90 | $874 | |||
| 20926 | Removal of tissue for graft | 90 | $567 | |||
| 20930 | Spinal bone allograft | BR | ||||
| 20931 | Spinal bone allograft | $263 | ||||
| 20936 | Spinal bone autograft | BR | ||||
| 20937 | Spinal bone autograft | $402 | ||||
| 20938 | Spinal bone autograft | $434 | ||||
| 20950 | Record fluid pressure, muscle | 0 | $178 | |||
| 20955 | Microvascular fibula graft | 90 | $5,321 | |||
| 20956 | Iliac bone graft, microvasc | 90 | $5,021 | |||
| 20957 | Mt bone graft, microvasc | 90 | $5,079 | |||
| 20962 | Other bone graft, microvasc | 90 | $5,010 | |||
| 20969 | Bone/skin graft, microvasc | 90 | $6,207 | |||
| 20970 | Bone/skin graft, iliac crest | 90 | $6,061 | |||
| 20972 | Bone-skin graft, metatarsal | 90 | $4,522 | |||
| 20973 | Bone-skin graft, great toe | 90 | $5,887 | |||
| 20974 | Electrical bone stimulation | 0 | $325 | |||
| 20975 | Electrical bone stimulation | 0 | $460 | |||
| 20979 | US bone stimulation | $110 | $68 | |||
| 20982 | Ablate bone tumor(s) perq | $7,687 | ||||
| 20985 | Cptr-asst dir ms px | $307 | ||||
| 20999 | Musculoskeletal surgery | BR | ||||
| 21010 | Incision of jaw joint | 90 | $1,432 | |||
| 21011 | Exc face les sc < 2 cm | $730 | ||||
| 21012 | Exc face les sbq 2 cm/> | $703 | ||||
| 21013 | Exc face tum deep < 2 cm | $1,095 | ||||
| 21014 | Exc face tum deep 2 cm/> | $1,090 | ||||
| 21015 | Resection of facial tumor | 90 | $877 | |||
| 21016 | Resect face tum 2 cm/> | $2,172 | ||||
| 21025 | Excision of bone, lower jaw | 90 | $677 | |||
| 21026 | Excision of facial bone(s) | 90 | $563 | |||
| 21029 | Contour of face bone lesion | 90 | $1,219 | |||
| 21030 | Removal of face bone lesion | 90 | $757 | |||
| 21031 | Remove exostosis, mandible | 90 | $425 | |||
| 21032 | Remove exostosis, maxilla | 90 | $602 | |||
| 21034 | Removal of face bone lesion | 90 | $1,627 | |||
| 21040 | Removal of jaw bone lesion | 90 | $355 | |||
| 21044 | Removal of jaw bone lesion | 90 | $1,539 | |||
| 21045 | Extensive jaw surgery | 90 | $2,161 | |||
| 21046 | Remove mandible cyst complex | $2,312 | ||||
| 21047 | Excise lwr jaw cyst w/repair | $2,739 | ||||
| 21048 | Remove maxilla cyst complex | $2,372 | ||||
| 21049 | Excis uppr jaw cyst w/repair | $2,590 | ||||
| 21050 | Removal of jaw joint | 90 | $1,662 | |||
| 21060 | Remove jaw joint cartilage | 90 | $1,571 | |||
| 21070 | Remove coronoid process | 90 | $1,083 | |||
| 21073 | Mnpj of tmj w/anesth | $812 | ||||
| 21076 | Prepare face/oral prosthesis | 10 | $2,008 | |||
| 21077 | Prepare face/oral prosthesis | 90 | $5,049 | |||
| 21079 | Prepare face/oral prosthesis | 90 | $3,548 | |||
| 21080 | Prepare face/oral prosthesis | 90 | $3,899 | $3,206 | ||
| 21081 | Prepare face/oral prosthesis | 90 | $3,593 | $2,935 | ||
| 21082 | Prepare face/oral prosthesis | 90 | $3,403 | $2,762 | ||
| 21083 | Prepare face/oral prosthesis | 90 | $3,172 | $2,492 | ||
| 21084 | Prepare face/oral prosthesis | 90 | $3,703 | $2,969 | ||
| 21085 | Prepare face/oral prosthesis | 10 | $1,707 | $1,313 | ||
| 21086 | Prepare face/oral prosthesis | 90 | $3,825 | $3,192 | ||
| 21087 | Prepare face/oral prosthesis | 90 | $3,808 | $3,159 | ||
| 21088 | Prepare face/oral prosthesis | 90 | BR | |||
| 21089 | Prepare face/oral prosthesis | 90 | BR | |||
| 21100 | Maxillofacial fixation | 90 | $369 | |||
| 21110 | Interdental fixation | 90 | $781 | |||
| 21116 | Injection, jaw joint X-ray | 0 | $114 | |||
| 21120 | Reconstruction of chin | 90 | $620 | |||
| 21121 | Reconstruction of chin | 90 | $975 | |||
| 21122 | Reconstruction of chin | 90 | $1,074 | |||
| 21123 | Reconstruction of chin | 90 | $1,404 | |||
| 21125 | Augmentation lower jaw bone | 90 | $813 | |||
| 21127 | Augmentation lower jaw bone | 90 | $1,364 | |||
| 21137 | Reduction of forehead | 90 | $1,613 | |||
| 21138 | Reduction of forehead | 90 | $1,876 | |||
| 21139 | Reduction of forehead | 90 | $2,293 | |||
| 21141 | Reconstruct midface, lefort | 90 | $2,359 | |||
| 21142 | Reconstruct midface, lefort | 90 | $2,452 | |||
| 21143 | Reconstruct midface, lefort | 90 | $2,548 | |||
| 21145 | Reconstruct midface, lefort | 90 | $2,513 | |||
| 21146 | Reconstruct midface, lefort | 90 | $2,608 | |||
| 21147 | Reconstruct midface, lefort | 90 | $2,728 | |||
| 21150 | Reconstruct midface, lefort | 90 | $3,494 | |||
| 21151 | Reconstruct midface, lefort | 90 | $3,951 | |||
| 21154 | Reconstruct midface, lefort | 90 | $4,626 | |||
| 21155 | Reconstruct midface, lefort | 90 | $4,575 | |||
| 21159 | Reconstruct midface, lefort | 90 | $5,158 | |||
| 21160 | Reconstruct midface, lefort | 90 | $5,420 | |||
| 21172 | Reconstruct orbit/forehead | 90 | $3,854 | |||
| 21175 | Reconstruct orbit/forehead | 90 | $4,745 | |||
| 21179 | Reconstruct entire forehead | 90 | $3,011 | |||
| 21180 | Reconstruct entire forehead | 90 | $3,258 | |||
| 21181 | Contour cranial bone lesion | 90 | $1,500 | |||
| 21182 | Reconstruct cranial bone | 90 | $4,075 | |||
| 21183 | Reconstruct cranial bone | 90 | $4,905 | |||
| 21184 | Reconstruct cranial bone | 90 | $4,958 | |||
| 21188 | Reconstruction of midface | 90 | BR | |||
| 21193 | Reconstruct lower jaw bone | 90 | $2,171 | |||
| 21194 | Reconstruct lower jaw bone | 90 | $2,460 | |||
| 21195 | Reconstruct lower jaw bone | 90 | $2,206 | |||
| 21196 | Reconstruct lower jaw bone | 90 | $2,345 | |||
| 21198 | Reconstruct lower jaw bone | 90 | $2,118 | |||
| 21199 | Reconstr lwr jaw w/advance | $2,142 | ||||
| 21206 | Reconstruct upper jaw bone | 90 | $1,748 | |||
| 21208 | Augmentation of facial bones | 90 | $1,550 | |||
| 21209 | Reduction of facial bones | 90 | $824 | |||
| 21210 | Face bone graft | 90 | $1,635 | |||
| 21215 | Lower jaw bone graft | 90 | $1,809 | |||
| 21230 | Rib cartilage graft | 90 | $1,567 | |||
| 21235 | Ear cartilage graft | 90 | $1,091 | |||
| 21240 | Reconstruction of jaw joint | 90 | $2,560 | |||
| 21242 | Reconstruction of jaw joint | 90 | $2,607 | |||
| 21243 | Reconstruction of jaw joint | 90 | $2,482 | |||
| 21244 | Reconstruction of lower jaw | 90 | $2,132 | |||
| 21245 | Reconstruction of jaw | 90 | $1,689 | |||
| 21246 | Reconstruction of jaw | 90 | $1,524 | |||
| 21247 | Reconstruct lower jaw bone | 90 | $3,575 | |||
| 21248 | Reconstruction of jaw | 90 | $2,246 | |||
| 21249 | Reconstruction of jaw | 90 | $3,926 | |||
| 21255 | Reconstruct lower jaw bone | 90 | $2,641 | |||
| 21256 | Reconstruction of orbit | 90 | $2,558 | |||
| 21260 | Revise eye sockets | 90 | $2,609 | |||
| 21261 | Revise eye sockets | 90 | $3,459 | |||
| 21263 | Revise eye sockets | 90 | $4,490 | |||
| 21267 | Revise eye sockets | 90 | $2,435 | |||
| 21268 | Revise eye sockets | 90 | $2,927 | |||
| 21270 | Augmentation cheek bone | 90 | $1,636 | |||
| 21275 | Revision orbitofacial bones | 90 | $1,466 | |||
| 21280 | Revision of eyelid | 90 | $952 | |||
| 21282 | Revision of eyelid | 90 | $788 | |||
| 21295 | Revision of jaw muscle/bone | 90 | $179 | |||
| 21296 | Revision of jaw muscle/bone | 90 | $553 | |||
| 21299 | Cranio/maxillofacial surgery | BR | ||||
| 21310 | Treatment of nose fracture | 0 | $109 | |||
| 21315 | Treatment of nose fracture | 10 | $243 | |||
| 21320 | Treatment of nose fracture | 10 | $331 | |||
| 21325 | Repair of nose fracture | 90 | $577 | |||
| 21330 | Repair of nose fracture | 90 | $874 | |||
| 21335 | Repair of nose fracture | 90 | $1,511 | |||
| 21336 | Repair nasal septal fracture | 90 | $706 | |||
| 21337 | Repair nasal septal fracture | 90 | $405 | |||
| 21338 | Repair nasoethmoid fracture | 90 | $830 | |||
| 21339 | Repair nasoethmoid fracture | 90 | $1,087 | |||
| 21340 | Repair of nose fracture | 90 | $1,417 | |||
| 21343 | Repair of sinus fracture | 90 | $1,582 | |||
| 21344 | Repair of sinus fracture | 90 | $2,030 | |||
| 21345 | Repair of nose/jaw fracture | 90 | $1,157 | |||
| 21346 | Repair of nose/jaw fracture | 90 | $1,441 | |||
| 21347 | Repair of nose/jaw fracture | 90 | $1,670 | |||
| 21348 | Repair of nose/jaw fracture | 90 | $2,064 | |||
| 21355 | Repair cheek bone fracture | 10 | $372 | |||
| 21356 | Repair cheek bone fracture | 10 | $793 | |||
| 21360 | Repair cheek bone fracture | 90 | $1,006 | |||
| 21365 | Repair cheek bone fracture | 90 | $1,979 | |||
| 21366 | Repair cheek bone fracture | 90 | $2,198 | |||
| 21385 | Repair eye socket fracture | 90 | $1,365 | |||
| 21386 | Repair eye socket fracture | 90 | $1,337 | |||
| 21387 | Repair eye socket fracture | 90 | $1,237 | |||
| 21390 | Repair eye socket fracture | 90 | $1,610 | |||
| 21395 | Repair eye socket fracture | 90 | $1,618 | |||
| 21400 | Treat eye socket fracture | 90 | $228 | |||
| 21401 | Repair eye socket fracture | 90 | $421 | |||
| 21406 | Repair eye socket fracture | 90 | $885 | |||
| 21407 | Repair eye socket fracture | 90 | $1,127 | |||
| 21408 | Repair eye socket fracture | 90 | $1,490 | |||
| 21421 | Treat mouth roof fracture | 90 | $819 | |||
| 21422 | Repair mouth roof fracture | 90 | $1,329 | |||
| 21423 | Repair mouth roof fracture | 90 | $1,466 | |||
| 21431 | Treat craniofacial fracture | 90 | $943 | |||
| 21432 | Repair craniofacial fracture | 90 | $1,109 | |||
| 21433 | Repair craniofacial fracture | 90 | $3,097 | |||
| 21435 | Repair craniofacial fracture | 90 | $2,212 | |||
| 21436 | Repair craniofacial fracture | 90 | $3,039 | |||
| 21440 | Repair dental ridge fracture | 90 | $416 | |||
| 21445 | Repair dental ridge fracture | 90 | $829 | |||
| 21450 | Treat lower jaw fracture | 90 | $416 | |||
| 21451 | Treat lower jaw fracture | 90 | $857 | |||
| 21452 | Treat lower jaw fracture | 90 | $242 | |||
| 21453 | Treat lower jaw fracture | 90 | $876 | |||
| 21454 | Treat lower jaw fracture | 90 | $1,414 | |||
| 21461 | Repair lower jaw fracture | 90 | $1,434 | |||
| 21462 | Repair lower jaw fracture | 90 | $1,617 | |||
| 21465 | Repair lower jaw fracture | 90 | $1,455 | |||
| 21470 | Repair lower jaw fracture | 90 | $2,341 | |||
| 21480 | Reset dislocated jaw | 0 | $117 | |||
| 21485 | Reset dislocated jaw | 90 | $433 | |||
| 21490 | Repair dislocated jaw | 90 | $1,268 | |||
| 21493 | Treat hyoid bone fracture | 90 | $201 | |||
| 21494 | Repair hyoid bone fracture | 90 | $993 | |||
| 21495 | Repair hyoid bone fracture | 90 | $754 | |||
| 21497 | Interdental wiring | 90 | $563 | |||
| 21499 | Head surgery procedure | BR | ||||
| 21501 | Drain neck/chest lesion | 90 | $397 | |||
| 21502 | Drain chest lesion | 90 | $808 | |||
| 21510 | Drainage of bone lesion | 90 | $663 | |||
| 21550 | Biopsy of neck/chest | 10 | $211 | |||
| 21552 | Exc neck les sc 3 cm/> | $927 | ||||
| 21554 | Exc neck tum deep 5 cm/> | $1,517 | ||||
| 21555 | Remove lesion neck/chest | 90 | $421 | |||
| 21556 | Remove lesion neck/chest | 90 | $689 | |||
| 21557 | Remove tumor, neck or chest | 90 | $1,308 | |||
| 21558 | Resect neck tum 5 cm/> | $2,807 | ||||
| 21600 | Partial removal of rib | 90 | $825 | |||
| 21610 | Partial removal of rib | 90 | $1,025 | |||
| 21615 | Removal of rib........ | 90 | $1,532 | |||
| 21616 | Removal of rib and nerves | 90 | $1,407 | |||
| 21620 | Partial removal of sternum | 90 | $1,000 | |||
| 21627 | Sternal debridement | 90 | $850 | |||
| 21630 | Extensive sternum surgery. | 90 | $2,374 | |||
| 21632 | Extensive sternum surgery | 90 | $2,150 | |||
| 21685 | Hyoid myotomy & suspension | $2,118 | ||||
| 21700 | Revision of neck muscle | 90 | $745 | |||
| 21705 | Revision of neck muscle/rib | 90 | $1,050 | |||
| 21720 | Revision of neck muscle | 90 | $694 | |||
| 21725 | Revision of neck muscle | 90 | $859 | |||
| 21740 | Reconstruction of sternum | 90 | $1,844 | |||
| 21750 | Repair of sternum separation | 90 | $1,333 | |||
| 21800 | Treatment of rib fracture | 90 | $124 | |||
| 21805 | Treatment of rib fracture | 90 | $293 | |||
| 21810 | Treatment of rib fracture(s) | 90 | $1,035 | |||
| 21820 | Treat sternum fracture | 90 | $194 | |||
| 21825 | Repair sternum fracture | 90 | $1,051 | |||
| 21899 | Neck/chest surgery procedure | BR | ||||
| 21920 | Biopsy soft tissue of back | 10 | $206 | |||
| 21925 | Biopsy soft tissue of back | 90 | $460 | |||
| 21930 | Remove lesion, back or flank | 90 | $691 | |||
| 21931 | Exc back les sc 3 cm/> | $976 | ||||
| 21932 | Exc back tum deep < 5 cm | $1,371 | ||||
| 21933 | Exc back tum deep 5 cm/> | $1,535 | ||||
| 21935 | Remove tumor of back | 90 | $1,770 | |||
| 21936 | Resect back tum 5 cm/> | $2,919 | ||||
| 22010 | I&d p-spine c/t/cerv-thor | $1,967 | ||||
| 22015 | I&d p-spine l/s/ls | $1,930 | ||||
| 22100 | Remove part of neck vertebra | 90 | $1,309 | |||
| 22101 | Remove part, thorax vertebra | 90 | $1,129 | |||
| 22102 | Remove part, lumbar vertebra | 90 | $976 | |||
| 22103 | Remove extra spine segment | $335 | ||||
| 22110 | Remove part of neck vertebra | 90 | $1,708 | |||
| 22112 | Remove part, thorax vertebra | 90 | $1,637 | |||
| 22114 | Remove part, lumbar vertebra | 90 | $1,417 | |||
| 22206 | Cut spine 3 col thor | $4,913 | ||||
| 22207 | Cut spine 3 col lumb | $4,981 | ||||
| 22208 | Cut spine 3 col addl seg | $1,226 | ||||
| 22210 | Revision of neck spine | 90 | $2,867 | |||
| 22212 | Revision of thorax spine | 90 | $2,708 | |||
| 22214 | Revision of lumbar spine | 90 | $2,544 | |||
| 22216 | Revise, extra spine segment | $818 | ||||
| 22220 | Revision of neck spine | 90 | $2,839 | |||
| 22222 | Revision of thorax spine | 90 | $2,502 | |||
| 22224 | Revision of lumbar spine | 90 | $2,653 | |||
| 22226 | Revise, extra spine segment | $819 | ||||
| 22305 | Treat spine process fracture | 90 | $329 | |||
| 22310 | Treat spine fracture.. | 90 | $426 | |||
| 22315 | Treat spine fracture.. | 90 | $1,120 | |||
| 22318 | Treat odontoid fx w/o graft | 90 | $3,400 | |||
| 22319 | Treat odontoid fx w/ graft | 90 | $3,805 | |||
| 22325 | Treat spine fracture.. | 90 | $2,061 | |||
| 22326 | Treat neck spine fracture | 90 | $2,678 | |||
| 22327 | Treat thorax spine fracture | 90 | $2,619 | |||
| 22328 | Treat each add spine fx | $656 | ||||
| 22505 | Manipulation of spine | 10 | $230 | |||
| 22520 | Percut vertebroplasty thor | $4,580 | ||||
| 22521 | Percut vertebroplasty lumb | $4,587 | ||||
| 22522 | Percut vertebroplasty addl | $464 | ||||
| 22523 | Percut kyphoplasty thor | $15,722 | ||||
| 22524 | Percut kyphoplasty lumbar | $15,598 | ||||
| 22525 | Percut kyphoplasty add-on | $9,755 | ||||
| 22526 | Idet single level | $4,833 | ||||
| 22527 | Idet 1 or more levels | $3,985 | ||||
| 22532 | Lat thorax spine fusion | $3,715 | ||||
| 22533 | Lat lumbar spine fusion | $3,502 | ||||
| 22534 | Lat thor/lumb addl seg | $756 | ||||
| 22548 | Neck spine fusion..... | 90 | $3,611 | |||
| 22551 | Neck spine fuse&remov bel c2 | $3,574 | ||||
| 22552 | Addl neck spine fusion | $820 | ||||
| 22554 | Neck spine fusion..... | 90 | $2,850 | |||
| 22556 | Thorax spine fusion... | 90 | $3,348 | |||
| 22558 | Lumbar spine fusion... | 90 | $3,150 | |||
| 22585 | Additional spinal fusion | $798 | ||||
| 22590 | Spine & skull spinal fusion | 90 | $3,102 | |||
| 22595 | Neck spinal fusion.... | 90 | $3,021 | |||
| 22600 | Neck spine fusion..... | 90 | $2,531 | |||
| 22610 | Thorax spine fusion... | 90 | $2,485 | |||
| 22612 | Lumbar spine fusion... | 90 | $3,083 | |||
| 22614 | Spine fusion, extra segment | $884 | ||||
| 22630 | Lumbar spine fusion... | 90 | $2,945 | |||
| 22632 | Spine fusion, extra segment | $745 | ||||
| 22633 | Lumbar spine fusion combined | $3,842 | ||||
| 22634 | Spine fusion extra segment | $1,037 | ||||
| 22800 | Fusion of spine....... | 90 | $2,850 | |||
| 22802 | Fusion of spine....... | 90 | $4,383 | |||
| 22804 | Fusion of spine....... | 90 | $4,809 | |||
| 22808 | Fusion of spine....... | 90 | $3,368 | |||
| 22810 | Fusion of spine....... | 90 | $3,677 | |||
| 22812 | Fusion of spine....... | 90 | $4,352 | |||
| 22818 | Kyphectomy, 1-2 segments | 90 | $4,421 | |||
| 22819 | Kyphectomy, 3 or more | 90 | $4,781 | |||
| 22830 | Exploration of spinal fusion | 90 | $1,803 | |||
| 22840 | Insert spine fixation device | $1,408 | ||||
| 22841 | Insert spine fixation device | BR | ||||
| 22842 | Insert spine fixation device | $1,457 | ||||
| 22843 | Insert spine fixation device | $1,652 | ||||
| 22844 | Insert spine fixation device | $2,015 | ||||
| 22845 | Insert spine fixation device | $1,343 | ||||
| 22846 | Insert spine fixation device | $1,524 | ||||
| 22847 | Insert spine fixation device | $1,691 | ||||
| 22848 | Insert pelv fixation device | $876 | ||||
| 22849 | Reinsert spinal fixation | 90 | $1,882 | |||
| 22850 | Remove spine fixation device | 90 | $1,391 | |||
| 22851 | Apply spine prosth device | $974 | ||||
| 22852 | Remove spine fixation device | 90 | $1,400 | |||
| 22855 | Remove spine fixation device | 90 | $1,260 | |||
| 22856 | Cerv artific diskectomy | $3,470 | ||||
| 22857 | Lumbar artif diskectomy | $3,413 | ||||
| 22861 | Revise cerv artific disc | $4,137 | ||||
| 22862 | Revise lumbar artif disc | $4,481 | ||||
| 22864 | Remove cerv artif disc | $4,070 | ||||
| 22865 | Remove lumb artif disc | $4,266 | ||||
| 22899 | Spine surgery procedure | BR | ||||
| 22900 | Remove abdominal wall lesion | 90 | $721 | |||
| 22901 | Exc abdl tum deep 5 cm/> | $1,381 | ||||
| 22902 | Exc abd les sc < 3 cm | $899 | ||||
| 22903 | Exc abd les sc 3 cm/> | $903 | ||||
| 22904 | Resect abd tum < 5 cm | $2,184 | ||||
| 22905 | Resect abd tum 5 cm/> | $2,771 | ||||
| 22999 | Abdomen surgery procedure | BR | ||||
| 23000 | Removal of calcium deposits | 90 | $619 | |||
| 23020 | Release shoulder joint | 90 | $1,249 | |||
| 23030 | Drain shoulder lesion | 10 | $402 | |||
| 23031 | Drain shoulder bursa | 10 | $230 | |||
| 23035 | Drain shoulder bone lesion | 90 | $1,237 | |||
| 23040 | Exploratory shoulder surgery | 90 | $1,424 | |||
| 23044 | Exploratory shoulder surgery | 90 | $1,103 | |||
| 23065 | Biopsy shoulder tissues | 10 | $212 | |||
| 23066 | Biopsy shoulder tissues | 90 | $374 | |||
| 23071 | Exc shoulder les sc 3 cm/> | $867 | ||||
| 23073 | Exc shoulder tum deep 5 cm/> | $1,436 | ||||
| 23075 | Removal of shoulder lesion | 10 | $339 | |||
| 23076 | Removal of shoulder lesion | 90 | $801 | |||
| 23077 | Remove tumor of shoulder | 90 | $1,657 | |||
| 23078 | Resect shoulder tum 5 cm/> | $2,949 | ||||
| 23100 | Biopsy of shoulder joint | 90 | $992 | |||
| 23101 | Shoulder joint surgery | 90 | $924 | |||
| 23105 | Remove shoulder joint lining | 90 | $1,331 | |||
| 23106 | Incision of collarbone joint | 90 | $848 | |||
| 23107 | Explore,treat shoulder joint | 90 | $1,368 | |||
| 23120 | Partial removal, collarbone | 90 | $850 | |||
| 23125 | Removal of collarbone | 90 | $1,321 | |||
| 23130 | Remove shoulder bone, part | 90 | $1,135 | |||
| 23140 | Removal of bone lesion | 90 | $802 | |||
| 23145 | Removal of bone lesion | 90 | $1,274 | |||
| 23146 | Removal of bone lesion | 90 | $962 | |||
| 23150 | Removal of humerus lesion | 90 | $1,094 | |||
| 23155 | Removal of humerus lesion | 90 | $1,399 | |||
| 23156 | Removal of humerus lesion | 90 | $1,195 | |||
| 23170 | Remove collarbone lesion | 90 | $840 | |||
| 23172 | Remove shoulder blade lesion | 90 | $859 | |||
| 23174 | Remove humerus lesion | 90 | $1,308 | |||
| 23180 | Remove collar bone lesion | 90 | $1,098 | |||
| 23182 | Remove shoulder blade lesion | 90 | $1,222 | |||
| 23184 | Remove humerus lesion | 90 | $1,475 | |||
| 23190 | Partial removal of scapula | 90 | $980 | |||
| 23195 | Removal of head of humerus | 90 | $1,371 | |||
| 23200 | Removal of collarbone | 90 | $1,520 | |||
| 23210 | Removal of shoulder blade | 90 | $1,545 | |||
| 23220 | Partial removal of humerus. | 90 | $2,035 | |||
| 23330 | Remove shoulder foreign body | 10 | $172 | |||
| 23331 | Remove shoulder foreign body | 90 | $804 | |||
| 23332 | Remove shoulder foreign body | 90 | $1,632 | |||
| 23350 | Injection for shoulder X-ray | 0 | $112 | |||
| 23395 | Muscle transfer, shoulder/arm | 90 | $2,127 | |||
| 23397 | Muscle transfers | 90 | $2,233 | |||
| 23400 | Fixation of shoulder blade | 90 | $1,733 | |||
| 23405 | Incision of tendon & muscle | 90 | $1,195 | |||
| 23406 | Incise tendon(s) & muscle(s) | 90 | $1,545 | |||
| 23410 | Repair of tendon(s)... | 90 | $1,776 | |||
| 23412 | Repair of tendon(s) | 90 | $1,998 | |||
| 23415 | Release of shoulder ligament | 90 | $1,099 | |||
| 23420 | Repair of shoulder.... | 90 | $2,098 | |||
| 23430 | Repair biceps tendon.. | 90 | $1,345 | |||
| 23440 | Remove/transplant tendon | 90 | $1,376 | |||
| 23450 | Repair shoulder capsule | 90 | $1,968 | |||
| 23455 | Repair shoulder capsule | 90 | $2,230 | |||
| 23460 | Repair shoulder capsule | 90 | $2,211 | |||
| 23462 | Repair shoulder capsule | 90 | $2,282 | |||
| 23465 | Repair shoulder capsule | 90 | $2,254 | |||
| 23466 | Repair shoulder capsule | 90 | $2,232 | |||
| 23470 | Reconstruct shoulder joint | 90 | $2,530 | |||
| 23472 | Reconstruct shoulder joint | 90 | $2,749 | |||
| 23480 | Revision of collarbone | 90 | $1,286 | |||
| 23485 | Revision of collarbone | 90 | $1,834 | |||
| 23490 | Reinforce clavicle | 90 | $1,564 | |||
| 23491 | Reinforce shoulder bones | 90 | $2,033 | |||
| 23500 | Treat clavicle fracture | 90 | $270 | |||
| 23505 | Treat clavicle fracture | 90 | $460 | |||
| 23515 | Repair clavicle fracture | 90 | $1,067 | |||
| 23520 | Treat clavicle dislocation | 90 | $255 | |||
| 23525 | Treat clavicle dislocation | 90 | $400 | |||
| 23530 | Repair clavicle dislocation | 90 | $1,027 | |||
| 23532 | Repair clavicle dislocation | 90 | $1,133 | |||
| 23540 | Treat clavicle dislocation | 90 | $272 | |||
| 23545 | Treat clavicle dislocation | 90 | $378 | |||
| 23550 | Repair clavicle dislocation | 90 | $1,176 | |||
| 23552 | Repair clavicle dislocation | 90 | $1,153 | |||
| 23570 | Treat shoulder blade fracture | 90 | $287 | |||
| 23575 | Treat shoulder blade fracture | 90 | $500 | |||
| 23585 | Repair scapula fracture | 90 | $1,232 | |||
| 23600 | Treat humerus fracture | 90 | $430 | |||
| 23605 | Treat humerus fracture | 90 | $714 | |||
| 23615 | Repair humerus fracture | 90 | $1,478 | |||
| 23616 | Repair humerus fracture | 90 | $3,238 | |||
| 23620 | Treat humerus fracture | 90 | $431 | |||
| 23625 | Treat humerus fracture | 90 | $571 | |||
| 23630 | Treat humerus fracture | 90 | $1,171 | |||
| 23650 | Treat shoulder dislocation | 90 | $395 | |||
| 23655 | Treat shoulder dislocation | 90 | $540 | |||
| 23660 | Repair shoulder dislocation | 90 | $1,244 | |||
| 23665 | Treat dislocation/ fracture | 90 | $637 | |||
| 23670 | Treat dislocation/ fracture | 90 | $1,278 | |||
| 23675 | Treat dislocation/fracture | 90 | $718 | |||
| 23680 | Repair dislocation/fracture | 90 | $1,686 | |||
| 23700 | Fixation of shoulder | 10 | $347 | |||
| 23800 | Fusion of shoulder joint | 90 | $2,233 | |||
| 23802 | Fusion of shoulder joint. | 90 | $2,317 | |||
| 23900 | Amputation of arm & girdle | 90 | $2,362 | |||
| 23920 | Amputation at shoulder joint | 90 | $2,123 | |||
| 23921 | Amputation follow-up surgery | 90 | $712 | |||
| 23929 | Shoulder surgery procedure | BR | ||||
| 23930 | Drainage of arm lesion | 10 | $328 | |||
| 23931 | Drainage of arm bursa | 10 | $240 | |||
| 23935 | Drain arm/elbow bone lesion | 90 | $781 | |||
| 24000 | Exploratory elbow surgery | 90 | $946 | |||
| 24006 | Release elbow joint | 90 | $1,204 | |||
| 24065 | Biopsy arm/elbow soft tissue | 10 | $207 | |||
| 24066 | Biopsy arm/elbow soft tissue | 90 | $639 | |||
| 24071 | Exc arm/elbow les sc 3 cm/> | 90 | $843 | |||
| 24073 | Exc arm/elbow les sc 3 cm/> | 90 | $1438 | |||
| 24075 | Ex arm/elbow tum deep 5 cm/> | 90 | $433 | |||
| 24076 | Remove arm/elbow lesion | 90 | $734 | |||
| 24077 | Remove tumor of arm/elbow | 90 | $1,617 | |||
| 24079 | Resect arm/elbow tum 5 cm/> | $2,761 | ||||
| 24100 | Biopsy elbow joint lining. | 90 | $704 | |||
| 24101 | Explore/treat elbow joint | 90 | $1,071 | |||
| 24102 | Remove elbow joint lining | 90 | $1,279 | |||
| 24105 | Removal of elbow bursa | 90 | $555 | |||
| 24110 | Remove humerus lesion | 90 | $1,132 | |||
| 24115 | Remove/graft bone lesion | 90 | $1,267 | |||
| 24116 | Remove/graft bone lesion | 90 | $1,580 | |||
| 24120 | Remove elbow lesion | 90 | $946 | |||
| 24125 | Remove/graft bone lesion | 90 | $977 | |||
| 24126 | Remove/graft bone lesion | 90 | $1,159 | |||
| 24130 | Removal of head of radius | 90 | $974 | |||
| 24134 | Removal of arm bone lesion | 90 | $1,339 | |||
| 24136 | Remove radius bone lesion | 90 | $1,206 | |||
| 24138 | Remove elbow bone lesion | 90 | $1,048 | |||
| 24140 | Partial removal of arm bone | 90 | $1,451 | |||
| 24145 | Partial removal of radius | 90 | $1,116 | |||
| 24147 | Partial removal of elbow | 90 | $1,125 | |||
| 24149 | Radical resection of elbow | 90 | $1,992 | |||
| 24150 | Extensive humerus surgery | 90 | $2,035 | |||
| 24151 | Extensive humerus surgery | 90 | $2,165 | |||
| 24152 | Extensive radius surgery | 90 | $1,237 | |||
| 24155 | Removal of elbow joint | 90 | $1,669 | |||
| 24160 | Remove elbow joint implant | 90 | $925 | |||
| 24164 | Remove radius head implant | 90 | $865 | |||
| 24200 | Removal of arm foreign body | 10 | $166 | |||
| 24201 | Removal of arm foreign body | 90 | $621 | |||
| 24220 | Injection for elbow X-ray | 0 | $133 | |||
| 24300 | Manipulate elbow w/anesth | $853 | ||||
| 24301 | Muscle/tendon transfer | 90 | $1,339 | |||
| 24305 | Arm tendon lengthening | 90 | $822 | |||
| 24310 | Revision of arm tendon | 90 | $726 | |||
| 24320 | Repair of arm tendon | 90 | $1,451 | |||
| 24330 | Revision of arm muscles | 90 | $1,370 | |||
| 24331 | Revision of arm muscles | 90 | $1,508 | |||
| 24340 | Repair of biceps tendon | 90 | $1,128 | |||
| 24341 | Repair arm tendon/muscle | 90 | $1,126 | |||
| 24342 | Repair of ruptured tendon | 90 | $1,571 | |||
| 24343 | Repr elbow lat ligmnt w/tiss | $1,466 | ||||
| 24344 | Reconstruct elbow lat ligmnt | $2,293 | ||||
| 24345 | Repr elbw med ligmnt w/tissu | $1,458 | ||||
| 24346 | Reconstruct elbow med ligmnt | $2,278 | ||||
| 24358 | Repair elbow w/deb open | $1,087 | ||||
| 24359 | Repair elbow deb/attch open | $1,374 | ||||
| 24360 | Reconstruct elbow joint | 90 | $1,923 | |||
| 24361 | Reconstruct elbow joint | 90 | $2,027 | |||
| 24362 | Reconstruct elbow joint | 90 | $2,007 | |||
| 24363 | Replace elbow joint... | 90 | $2,897 | |||
| 24365 | Reconstruct head of radius | 90 | $1,178 | |||
| 24366 | Reconstruct head of radius | 90 | $1,524 | |||
| 24400 | Revision of humerus | 90 | $1,441 | |||
| 24410 | Revision of humerus | 90 | $2,151 | |||
| 24420 | Revision of humerus | 90 | $1,926 | |||
| 24430 | Repair of humerus | 90 | $2,072 | |||
| 24435 | Repair humerus with graft | 90 | $2,220 | |||
| 24470 | Revision of elbow joint | 90 | $1,226 | |||
| 24495 | Decompression of forearm | 90 | $1,022 | |||
| 24498 | Reinforce humerus..... | 90 | $1,696 | |||
| 24500 | Treat humerus fracture | 90 | $418 | |||
| 24505 | Treat humerus fracture | 90 | $711 | |||
| 24515 | Repair humerus fracture | 90 | $1,566 | |||
| 24516 | Repair humerus fracture | 90 | $1,566 | |||
| 24530 | Treat humerus fracture | 90 | $457 | |||
| 24535 | Treat humerus fracture | 90 | $859 | |||
| 24538 | Treat humerus fracture | 90 | $1,281 | |||
| 24545 | Repair humerus fracture | 90 | $1,502 | |||
| 24546 | Repair humerus fracture | 90 | $1,856 | |||
| 24560 | Treat humerus fracture | 90 | $360 | |||
| 24565 | Treat humerus fracture | 90 | $653 | |||
| 24566 | Treat humerus fracture | 90 | $1,005 | |||
| 24575 | Repair humerus fracture | 90 | $1,341 | |||
| 24576 | Treat humerus fracture | 90 | $364 | |||
| 24577 | Treat humerus fracture | 90 | $712 | |||
| 24579 | Repair humerus fracture | 90 | $1,456 | |||
| 24582 | Treat humerus fracture | 90 | $1,098 | |||
| 24586 | Repair elbow fracture | 90 | $2,226 | |||
| 24587 | Repair elbow fracture | 90 | $2,134 | |||
| 24600 | Treat elbow dislocation | 90 | $446 | |||
| 24605 | Treat elbow dislocation | 90 | $549 | |||
| 24615 | Repair elbow dislocation | 90 | $1,383 | |||
| 24620 | Treat elbow fracture | 90 | $777 | |||
| 24635 | Repair elbow fracture | 90 | $1,788 | |||
| 24640 | Treat elbow dislocation | 10 | $159 | |||
| 24650 | Treat radius fracture | 90 | $325 | |||
| 24655 | Treat radius fracture | 90 | $541 | |||
| 24665 | Repair radius fracture | 90 | $1,130 | |||
| 24666 | Repair radius fracture | 90 | $1,468 | |||
| 24670 | Treatment of ulna fracture | 90 | $327 | |||
| 24675 | Treatment of ulna fracture | 90 | $607 | |||
| 24685 | Repair ulna fracture | 90 | $1,279 | |||
| 24800 | Fusion of elbow joint | 90 | $1,614 | |||
| 24802 | Fusion/graft of elbow joint | 90 | $1,922 | |||
| 24900 | Amputation of upper arm | 90 | $1,263 | |||
| 24920 | Amputation of upper arm | 90 | $1,180 | |||
| 24925 | Amputation follow-up surgery | 90 | $965 | |||
| 24930 | Amputation follow-up surgery | 90 | $1,326 | |||
| 24931 | Amputate upper arm & implant | 90 | $1,750 | |||
| 24935 | Revision of amputation | 90 | $2,145 | |||
| 24940 | Revision of upper arm | 90 | BR | |||
| 24999 | Upper arm/elbow surgery | BR | ||||
| 25000 | Incision of tendon sheath | 90 | $586 | |||
| 25001 | Incise flexor carpi radialis | $714 | ||||
| 25020 | Decompression of forearm | 90 | $756 | |||
| 25023 | Decompression of forearm | 90 | $1,287 | |||
| 25024 | Decompress forearm 2 spaces | $1,632 | ||||
| 25025 | Decompress forearm 2 spaces | $2,544 | ||||
| 25028 | Drainage of forearm lesion | 90 | $516 | |||
| 25031 | Drainage of forearm bursa | 90 | $463 | |||
| 25035 | Treat forearm bone lesion | 90 | $1,156 | |||
| 25040 | Explore/treat wrist joint | 90 | $1,013 | |||
| 25065 | Biopsy forearm soft tissues | 10 | $229 | |||
| 25066 | Biopsy forearm soft tissues | 90 | $507 | |||
| 25071 | Exc forearm les sc 3 cm/> | $885 | ||||
| 25073 | Exc forearm tum deep 3 cm/> | $1,106 | ||||
| 25075 | Removal of forearm lesion | 90 | $437 | |||
| 25076 | Removal of forearm lesion | 90 | $652 | |||
| 25077 | Remove tumor, forearm/wrist | 90 | $1,373 | |||
| 25078 | Resect forarm/wrist tum 3cm> | $2,437 | ||||
| 25085 | Incision of wrist capsule | 90 | $848 | |||
| 25100 | Biopsy of wrist joint | 90 | $666 | |||
| 25101 | Explore/treat wrist joint | 90 | $780 | |||
| 25105 | Remove wrist joint lining | 90 | $990 | |||
| 25107 | Remove wrist joint cartilage | 90 | $957 | |||
| 25109 | Excise tendon forearm/wrist | 90 | $1,117 | |||
| 25110 | Remove wrist tendon lesion | 90 | $500 | |||
| 25111 | Remove wrist tendon lesion | 90 | $497 | |||
| 25112 | Reremove wrist tendon lesion | 90 | $621 | |||
| 25115 | Remove wrist/forearm lesion | 90 | $1,036 | |||
| 25116 | Remove wrist/forearm lesion | 90 | $1,132 | |||
| 25118 | Excise wrist tendon sheath | 90 | $762 | |||
| 25119 | Partial removal of ulna | 90 | $1,015 | |||
| 25120 | Removal of forearm lesion | 90 | $946 | |||
| 25125 | Remove/graft forearm lesion | 90 | $1,058 | |||
| 25126 | Remove/graft forearm lesion | 90 | $1,066 | |||
| 25130 | Removal of wrist lesion | 90 | $706 | |||
| 25135 | Remove & graft wrist lesion | 90 | $921 | |||
| 25136 | Remove & graft wrist lesion | 90 | $798 | |||
| 25145 | Remove forearm bone lesion | 90 | $898 | |||
| 25150 | Partial removal of ulna | 90 | $1,015 | |||
| 25151 | Partial removal of radius | 90 | $965 | |||
| 25170 | Extensive forearm surgery | 90 | $1,540 | |||
| 25210 | Removal of wrist bone | 90 | $795 | |||
| 25215 | Removal of wrist bones | 90 | $1,239 | |||
| 25230 | Partial removal of radius | 90 | $798 | |||
| 25240 | Partial removal of ulna | 90 | $862 | |||
| 25246 | Injection for wrist X-ray | 0 | $143 | |||
| 25248 | Remove forearm foreign body | 90 | $646 | |||
| 25250 | Removal of wrist prosthesis | 90 | $910 | |||
| 25251 | Removal of wrist prosthesis | 90 | $1,326 | |||
| 25259 | Manipulate wrist w/anesthes | $859 | ||||
| 25260 | Repair forearm tendon/muscle | 90 | $901 | |||
| 25263 | Repair forearm tendon/muscle | 90 | $1,003 | |||
| 25265 | Repair forearm tendon/muscle | 90 | $1,337 | |||
| 25270 | Repair forearm tendon/muscle | 90 | $682 | |||
| 25272 | Repair forearm tendon/muscle | 90 | $761 | |||
| 25274 | Repair forearm tendon/muscle | 90 | $1,146 | |||
| 25275 | Repair forearm tendon sheath | $1,412 | ||||
| 25280 | Revise wrist/forearm tendon | 90 | $831 | |||
| 25290 | Incise wrist/forearm tendon | 90 | $560 | |||
| 25295 | Release wrist/forearm tendon | 90 | $696 | |||
| 25300 | Fusion of tendons at wrist | 90 | $1,204 | |||
| 25301 | Fusion of tendons at wrist | 90 | $1,136 | |||
| 25310 | Transplant forearm tendon | 90 | $1,132 | |||
| 25312 | Transplant forearm tendon | 90 | $1,275 | |||
| 25315 | Revise palsy hand tendon(s) | 90 | $1,498 | |||
| 25316 | Revise palsy hand tendon(s) | 90 | $1,661 | |||
| 25320 | Repair/revise wrist joint | 90 | $1,500 | |||
| 25332 | Revise wrist joint.... | 90 | $1,636 | |||
| 25335 | Realignment of hand | 90 | $1,776 | |||
| 25337 | Reconstruct ulna/radioulnar | 90 | $1,341 | |||
| 25350 | Revision of radius | 90 | $1,210 | |||
| 25355 | Revision of radius | 90 | $1,428 | |||
| 25360 | Revision of ulna | 90 | $1,082 | |||
| 25365 | Revise radius & ulna | 90 | $1,664 | |||
| 25370 | Revise radius or ulna | 90 | $1,842 | |||
| 25375 | Revise radius & ulna | 90 | $1,878 | |||
| 25390 | Shorten radius/ulna | 90 | $1,428 | |||
| 25391 | Lengthen radius/ulna | 90 | $1,836 | |||
| 25392 | Shorten radius & ulna | 90 | $1,949 | |||
| 25393 | Lengthen radius & ulna | 90 | $2,226 | |||
| 25394 | Repair carpal bone shorten | $1,623 | ||||
| 25400 | Repair radius or ulna | 90 | $1,616 | |||
| 25405 | Repair/graft radius or ulna | 90 | $1,977 | |||
| 25415 | Repair radius & ulna | 90 | $1,839 | |||
| 25420 | Repair/graft radius & ulna | 90 | $2,288 | |||
| 25425 | Repair/graft radius or ulna | 90 | $1,864 | |||
| 25426 | Repair/graft radius & ulna | 90 | $2,037 | |||
| 25430 | Vasc graft into carpal bone | $1,468 | ||||
| 25431 | Repair nonunion carpal bone | $1,634 | ||||
| 25440 | Repair/graft wrist bone | 90 | $1,452 | |||
| 25441 | Reconstruct wrist joint | 90 | $1,806 | |||
| 25442 | Reconstruct wrist joint | 90 | $1,318 | |||
| 25443 | Reconstruct wrist joint | 90 | $1,471 | |||
| 25444 | Reconstruct wrist joint | 90 | $1,589 | |||
| 25445 | Reconstruct wrist joint | 90 | $1,512 | |||
| 25446 | Wrist replacement | 90 | $2,751 | |||
| 25447 | Repair wrist joint(s) | 90 | $1,534 | |||
| 25449 | Remove wrist joint implant | 90 | $1,613 | |||
| 25450 | Revision of wrist joint | 90 | $1,145 | |||
| 25455 | Revision of wrist joint | 90 | $1,365 | |||
| 25490 | Reinforce radius | 90 | $1,362 | |||
| 25491 | Reinforce ulna | 90 | $1,426 | |||
| 25492 | Reinforce radius and ulna | 90 | $1,755 | |||
| 25500 | Treat fracture of radius | 90 | $349 | |||
| 25505 | Treat fracture of radius | 90 | $641 | |||
| 25515 | Repair fracture of radius | 90 | $1,237 | |||
| 25520 | Repair fracture of radius | 90 | $899 | |||
| 25525 | Repair fracture of radius | 90 | $1,746 | |||
| 25526 | Repair fracture of radius | 90 | $1,856 | |||
| 25530 | Treat fracture of ulna | 90 | $335 | |||
| 25535 | Treat fracture of ulna | 90 | $639 | |||
| 25545 | Repair fracture of ulna | 90 | $1,212 | |||
| 25560 | Treat fracture radius & ulna | 90 | $343 | |||
| 25565 | Treat fracture radius & ulna | 90 | $754 | |||
| 25574 | Treat fracture radius & ulna | 90 | $1,225 | |||
| 25575 | Repair fracture radius/ulna | 90 | $1,551 | |||
| 25600 | Treat fracture radius/ulna | 90 | $406 | |||
| 25605 | Treat fracture radius/ulna | 90 | $703 | |||
| 25606 | Treat fx distal radial | $1,372 | ||||
| 25607 | Treat fx rad extra-articul | $1,528 | ||||
| 25608 | Treat fx rad intra-articul | $1,712 | ||||
| 25609 | Treat fx radial 3+ frag | $2,179 | ||||
| 25622 | Treat wrist bone fracture | 90 | $357 | |||
| 25624 | Treat wrist bone fracture | 90 | $604 | |||
| 25628 | Repair wrist bone fracture | 90 | $1,140 | |||
| 25630 | Treat wrist bone fracture | 90 | $369 | |||
| 25635 | Treat wrist bone fracture | 90 | $569 | |||
| 25645 | Repair wrist bone fracture | 90 | $1,025 | |||
| 25650 | Repair wrist bone fracture | 90 | $417 | |||
| 25651 | Pin ulnar styloid fracture | $1,011 | ||||
| 25652 | Treat fracture ulnar styloid | $1,293 | ||||
| 25660 | Treat wrist dislocation | 90 | $468 | |||
| 25670 | Repair wrist dislocation | 90 | $1,113 | |||
| 25671 | Pin radioulnar dislocation | $1,098 | ||||
| 25675 | Treat wrist dislocation | 90 | $500 | |||
| 25676 | Repair wrist dislocation | 90 | $1,131 | |||
| 25680 | Treat wrist fracture | 90 | $597 | |||
| 25685 | Repair wrist fracture | 90 | $1,378 | |||
| 25690 | Treat wrist dislocation | 90 | $763 | |||
| 25695 | Repair wrist dislocation | 90 | $1,144 | |||
| 25800 | Fusion of wrist joint. | 90 | $1,559 | |||
| 25805 | Fusion/graft of wrist joint | 90 | $1,806 | |||
| 25810 | Fusion/graft of wrist joint | 90 | $1,726 | |||
| 25820 | Fusion of hand bones.. | 90 | $1,219 | |||
| 25825 | Fusion hand bones with graft | 90 | $1,545 | |||
| 25830 | Fusion, radioulnar jnt ulna | 90 | $1,520 | |||
| 25900 | Amputation of forearm | 90 | $1,171 | |||
| 25905 | Amputation of forearm | 90 | $1,179 | |||
| 25907 | Amputation follow-up surgery | 90 | $992 | |||
| 25909 | Amputation follow-up | 90 | $1,060 | |||
| 25915 | Amputation of forearm | 90 | $2,085 | |||
| 25920 | Amputate hand at wrist | 90 | $1,153 | |||
| 25922 | Amputate hand at wrist | 90 | $958 | |||
| 25924 | Amputation follow-up surgery | 90 | $1,174 | |||
| 25927 | Amputation of hand | 90 | $1,117 | |||
| 25929 | Amputation follow-up surgery | 90 | $908 | |||
| 25931 | Amputation follow-up surgery | 90 | $906 | |||
| 25999 | Forearm or wrist surgery | BR | ||||
| 26010 | Drainage of finger abscess | 10 | $144 | |||
| 26011 | Drainage of finger abscess | 10 | $278 | |||
| 26020 | Drain hand tendon sheath | 90 | $753 | |||
| 26025 | Drainage of palm bursa | 90 | $809 | |||
| 26030 | Drainage of palm bursa(s) | 90 | $984 | |||
| 26034 | Treat hand bone lesion | 90 | $924 | |||
| 26035 | Decompress fingers/hand | 90 | $1,020 | |||
| 26037 | Decompress fingers/hand | 90 | $998 | |||
| 26040 | Release palm contracture | 90 | $583 | |||
| 26045 | Release palm contracture | 90 | $773 | |||
| 26055 | Incise finger tendon sheath | 90 | $509 | |||
| 26060 | Incision of finger tendon | 90 | $381 | |||
| 26070 | Explore/treat hand joint | 90 | $589 | |||
| 26075 | Explore/treat finger joint | 90 | $680 | |||
| 26080 | Explore/treat finger joint | 90 | $526 | |||
| 26100 | Biopsy hand joint lining | 90 | $563 | |||
| 26105 | Biopsy finger joint lining | 90 | $704 | |||
| 26110 | Biopsy finger joint lining | 90 | $484 | |||
| 26111 | Exc hand les sc 1.5 cm/> | $871 | ||||
| 26113 | Exc hand tum deep 1.5 cm/> | $1,142 | ||||
| 26115 | Removal of hand lesion | 90 | $427 | |||
| 26116 | Removal of hand lesion | 90 | $675 | |||
| 26117 | Remove tumor, hand/finger | 90 | $1,007 | |||
| 26118 | Exc hand tum ra 3 cm/> | $2,213 | ||||
| 26121 | Release palm contracture | 90 | $1,298 | |||
| 26123 | Release palm contracture | 90 | $1,478 | |||
| 26125 | Release palm contracture | $543 | ||||
| 26130 | Remove wrist joint lining | 90 | $780 | |||
| 26135 | Revise finger joint, each | 90 | $874 | |||
| 26140 | Revise finger joint, each | 90 | $782 | |||
| 26145 | Tendon excision, palm/finger | 90 | $970 | |||
| 26160 | Remove tendon sheath lesion | 90 | $405 | |||
| 26170 | Removal of palm tendon, each | 90 | $559 | |||
| 26180 | Removal of finger tendon | 90 | $754 | |||
| 26185 | Remove finger bone.... | 90 | $751 | |||
| 26200 | Remove hand bone lesion | 90 | $740 | |||
| 26205 | Remove/graft bone lesion | 90 | $1,039 | |||
| 26210 | Removal of finger lesion | 90 | $674 | |||
| 26215 | Remove/graft finger lesion | 90 | $942 | |||
| 26230 | Partial removal of hand bone | 90 | $900 | |||
| 26235 | Partial removal, finger bone | 90 | $758 | |||
| 26236 | Partial removal, finger bone | 90 | $671 | |||
| 26250 | Extensive hand surgery | 90 | $1,125 | |||
| 26260 | Extensive finger surgery | 90 | $1,094 | |||
| 26262 | Partial removal of finger | 90 | $895 | |||
| 26320 | Removal of implant from hand | 90 | $556 | |||
| 26340 | Manipulate finger w/anesth | $694 | ||||
| 26341 | Manipulat palm cord post inj | $203 | ||||
| 26350 | Repair finger/hand tendon | 90 | $1,050 | |||
| 26352 | Repair/graft hand tendon | 90 | $1,059 | |||
| 26356 | Repair finger/hand tendon | 90 | $1,319 | |||
| 26357 | Repair finger/hand tendon | 90 | $1,127 | |||
| 26358 | Repair/graft hand tendon | 90 | $1,229 | |||
| 26370 | Repair finger/hand tendon | 90 | $1,212 | |||
| 26372 | Repair/graft hand tendon | 90 | $1,330 | |||
| 26373 | Repair finger/hand tendon | 90 | $1,330 | |||
| 26390 | Revise hand/finger tendon | 90 | $1,394 | |||
| 26392 | Repair/graft hand tendon | 90 | $1,570 | |||
| 26410 | Repair hand tendon.... | 90 | $746 | |||
| 26412 | Repair/graft hand tendon | 90 | $913 | |||
| 26415 | Excision, hand/finger tendon | 90 | $1,219 | |||
| 26416 | Graft hand or finger tendon | 90 | $1,469 | |||
| 26418 | Repair finger tendon.. | 90 | $734 | |||
| 26420 | Repair/graft finger tendon | 90 | $921 | |||
| 26426 | Repair finger/hand tendon | 90 | $1,068 | |||
| 26428 | Repair/graft finger tendon | 90 | $1,109 | |||
| 26432 | Repair finger tendon.. | 90 | $661 | |||
| 26433 | Repair finger tendon.. | 90 | $761 | |||
| 26434 | Repair/graft finger tendon | 90 | $821 | |||
| 26437 | Realignment of tendons | 90 | $864 | |||
| 26440 | Release palm/finger tendon | 90 | $821 | |||
| 26442 | Release palm & finger tendon | 90 | $713 | |||
| 26445 | Release hand/finger tendon | 90 | $748 | |||
| 26449 | Release forearm/hand tendon | 90 | $1,125 | |||
| 26450 | Incision of palm tendon | 90 | $525 | |||
| 26455 | Incision of finger tendon | 90 | $496 | |||
| 26460 | Incise hand/finger tendon | 90 | $469 | |||
| 26471 | Fusion of finger tendons | 90 | $857 | |||
| 26474 | Fusion of finger tendons | 90 | $865 | |||
| 26476 | Tendon lengthening.... | 90 | $738 | |||
| 26477 | Tendon shortening..... | 90 | $806 | |||
| 26478 | Lengthening of hand tendon | 90 | $883 | |||
| 26479 | Shortening of hand tendon | 90 | $941 | |||
| 26480 | Transplant hand tendon | 90 | $1,157 | |||
| 26483 | Transplant/graft hand tendon | 90 | $1,258 | |||
| 26485 | Transplant palm tendon | 90 | $1,249 | |||
| 26489 | Transplant/graft palm tendon | 90 | $915 | |||
| 26490 | Revise thumb tendon... | 90 | $1,315 | |||
| 26492 | Tendon transfer with graft | 90 | $1,479 | |||
| 26494 | Hand tendon/muscle tansfer | 90 | $1,172 | |||
| 26496 | Revise thumb tendon | 90 | $1,376 | |||
| 26497 | Finger tendon transfer | 90 | $1,459 | |||
| 26498 | Finger tendon transfer | 90 | $1,937 | |||
| 26499 | Revision of finger | 90 | $1,244 | |||
| 26500 | Hand tendon reconstruction | 90 | $846 | |||
| 26502 | Hand tendon reconstruction | 90 | $917 | |||
| 26508 | Release thumb contracture | 90 | $885 | |||
| 26510 | Thumb tendon transfer | 90 | $699 | |||
| 26516 | Fusion of knuckle joint | 90 | $974 | |||
| 26517 | Fusion of knuckle joints | 90 | $1,178 | |||
| 26518 | Fusion of knuckle joints | 90 | $1,151 | |||
| 26520 | Release knuckle contracture | 90 | $900 | |||
| 26525 | Release finger contracture | 90 | $852 | |||
| 26530 | Revise knuckle joint.. | 90 | $1,057 | |||
| 26531 | Revise knuckle with implant | 90 | $1,271 | |||
| 26535 | Revise finger joint... | 90 | $811 | |||
| 26536 | Revise/implant finger joint | 90 | $1,148 | |||
| 26540 | Repair hand joint..... | 90 | $1,086 | |||
| 26541 | Repair hand joint with graft | 90 | $1,416 | |||
| 26542 | Repair hand joint with graft | 90 | $922 | |||
| 26545 | Reconstruct finger joint | 90 | $900 | |||
| 26546 | Repair nonunion hand.. | 90 | $1,388 | |||
| 26548 | Reconstruct finger joint | 90 | $1,019 | |||
| 26550 | Construct thumb replacement | 90 | $3,377 | |||
| 26551 | Great toe-hand transfer | 90 | $6,628 | |||
| 26553 | Single transfer, toe- hand | 90 | $6,438 | |||
| 26554 | Double transfer, toe- hand | 90 | $7,744 | |||
| 26555 | Positional change of finger | 90 | $2,481 | |||
| 26556 | Toe joint transfer.... | 90 | $6,561 | |||
| 26560 | Repair of web finger | 90 | $747 | |||
| 26561 | Repair of web finger | 90 | $1,484 | |||
| 26562 | Repair of web finger | 90 | $1,488 | |||
| 26565 | Correct metacarpal flaw | 90 | $1,057 | |||
| 26567 | Correct finger deformity | 90 | $955 | |||
| 26568 | Lengthen metacarpal/finger | 90 | $1,405 | |||
| 26580 | Repair hand deformity | 90 | $3,197 | |||
| 26587 | Reconstruct extra finger | 90 | $1,895 | |||
| 26590 | Repair finger deformity | 90 | $2,635 | |||
| 26591 | Repair muscles of hand | 90 | $558 | |||
| 26593 | Release muscles of hand | 90 | $825 | |||
| 26596 | Excision constricting tissue | 90 | $1,291 | |||
| 26597 | Release of scar contracture | 90 | $1,328 | |||
| 26600 | Treat metacarpal fracture | 90 | $253 | |||
| 26605 | Treat metacarpal fracture | 90 | $377 | |||
| 26607 | Treat metacarpal fracture | 90 | $655 | |||
| 26608 | Treat metacarpal fracture | 90 | $655 | |||
| 26615 | Repair metacarpal fracture | 90 | $768 | |||
| 26641 | Treat thumb dislocation | 90 | $353 | |||
| 26645 | Treat thumb fracture | 90 | $479 | |||
| 26650 | Repair thumb fracture | 90 | $718 | |||
| 26665 | Repair thumb fracture | 90 | $1,035 | |||
| 26670 | Treat hand dislocation | 90 | $326 | |||
| 26675 | Treat hand dislocation | 90 | $665 | |||
| 26676 | Pin hand dislocation | 90 | $766 | |||
| 26685 | Repair hand dislocation | 90 | $935 | |||
| 26686 | Repair hand dislocation | 90 | $1,050 | |||
| 26700 | Treat knuckle dislocation | 90 | $320 | |||
| 26705 | Treat knuckle dislocation | 90 | $427 | |||
| 26706 | Pin knuckle dislocation | 90 | $733 | |||
| 26715 | Repair knuckle dislocation | 90 | $728 | |||
| 26720 | Treat finger fracture, each | 90 | $199 | |||
| 26725 | Treat finger fracture, each | 90 | $351 | |||
| 26727 | Treat finger fracture, each | 90 | $549 | |||
| 26735 | Repair finger fracture, each | 90 | $712 | |||
| 26740 | Treat finger fracture, each | 90 | $222 | |||
| 26742 | Treat finger fracture, each | 90 | $425 | |||
| 26746 | Repair finger fracture, each | 90 | $786 | |||
| 26750 | Treat finger fracture, each | 90 | $180 | |||
| 26755 | Treat finger fracture, each | 90 | $297 | |||
| 26756 | Pin finger fracture, each | 90 | $455 | |||
| 26765 | Repair finger fracture, each | 90 | $506 | |||
| 26770 | Treat finger dislocation | 90 | $264 | |||
| 26775 | Treat finger dislocation | 90 | $341 | |||
| 26776 | Pin finger dislocation | 90 | $497 | |||
| 26785 | Repair finger dislocation | 90 | $534 | |||
| 26820 | Thumb fusion with graft | 90 | $1,100 | |||
| 26841 | Fusion of thumb | 90 | $989 | |||
| 26842 | Thumb fusion with graft | 90 | $1,254 | |||
| 26843 | Fusion of hand joint | 90 | $1,039 | |||
| 26844 | Fusion/graft of hand joint | 90 | $1,188 | |||
| 26850 | Fusion of knuckle | 90 | $847 | |||
| 26852 | Fusion of knuckle with graft | 90 | $1,040 | |||
| 26860 | Fusion of finger joint | 90 | $671 | |||
| 26861 | Fusion of finger jnt, add-on | $275 | ||||
| 26862 | Fusion/graft of finger joint | 90 | $926 | |||
| 26863 | Fuse/graft added joint | $538 | ||||
| 26910 | Amputate metacarpal bone | 90 | $940 | |||
| 26951 | Amputation of finger/thumb | 90 | $551 | |||
| 26952 | Amputation of finger/thumb | 90 | $759 | |||
| 26989 | Hand/finger surgery | BR | ||||
| 26990 | Drainage of pelvis lesion | 90 | $735 | |||
| 26991 | Drainage of pelvis bursa | 90 | $577 | |||
| 26992 | Drainage of bone lesion | 90 | $1,633 | |||
| 27000 | Incision of hip tendon | 90 | $618 | |||
| 27001 | Incision of hip tendon | 90 | $760 | |||
| 27003 | Incision of hip tendon | 90 | $1,018 | |||
| 27005 | Incision of hip tendon | 90 | $1,055 | |||
| 27006 | Incision of hip tendons | 90 | $1,138 | |||
| 27025 | Incision of hip/thigh fascia | 90 | $1,225 | |||
| 27027 | Buttock fasciotomy | $1,765 | ||||
| 27030 | Drainage of hip joint | 90 | $1,851 | |||
| 27033 | Exploration of hip joint | 90 | $1,882 | |||
| 27035 | Denervation of hip joint | 90 | $2,197 | |||
| 27036 | Excision of hip joint/muscle | 90 | $1,851 | |||
| 27040 | Biopsy of soft tissues | 10 | $290 | |||
| 27041 | Biopsy of soft tissues | 90 | $988 | |||
| 27043 | Exc hip pelvis les sc 3 cm/> | $976 | ||||
| 27045 | Exc hip/pelv tum deep 5 cm/> | $1,555 | ||||
| 27047 | Remove hip/pelvis lesion | 90 | $765 | |||
| 27048 | Remove hip/pelvis lesion | 90 | $768 | |||
| 27049 | Remove tumor, hip/pelvis | 90 | $1,819 | |||
| 27050 | Biopsy of sacroiliac joint | 90 | $723 | |||
| 27052 | Biopsy of hip joint | 90 | $1,132 | |||
| 27054 | Removal of hip joint lining | 90 | $1,415 | |||
| 27057 | Buttock fasciotomy w/dbrdmt | $1,980 | ||||
| 27059 | Resect hip/pelv tum 5 cm/> | $3,735 | ||||
| 27060 | Removal of ischial bursa | 90 | $661 | |||
| 27062 | Remove femur lesion/bursa | 90 | $685 | |||
| 27065 | Removal of hip bone lesion | 90 | $812 | |||
| 27066 | Removal of hip bone lesion | 90 | $1,300 | |||
| 27067 | Remove/graft hip bone lesion | 90 | $1,855 | |||
| 27070 | Partial removal of hip bone | 90 | $1,519 | |||
| 27071 | Partial removal of hip bone | 90 | $1,654 | |||
| 27075 | Extensive hip surgery | 90 | $2,340 | |||
| 27076 | Extensive hip surgery | 90 | $2,613 | |||
| 27077 | Extensive hip surgery | 90 | $3,080 | |||
| 27078 | Extensive hip surgery | 90 | $1,609 | |||
| 27080 | Removal of tail bone | 90 | $798 | |||
| 27086 | Remove hip foreign body | 10 | $175 | |||
| 27087 | Remove hip foreign body | 90 | $968 | |||
| 27090 | Removal of hip prosthesis | 90 | $1,596 | |||
| 27091 | Removal of hip prosthesis | 90 | $3,108 | |||
| 27093 | Injection for hip X-ray | 0 | $158 | |||
| 27095 | Injection for hip X-ray | 0 | $182 | |||
| 27096 | Inject sacroiliac joint | 0 | BR | |||
| 27097 | Revision of hip tendon | 90 | $1,263 | |||
| 27098 | Transfer tendon to pelvis | 90 | $1,268 | |||
| 27100 | Transfer of abdominal muscle | 90 | $1,393 | |||
| 27105 | Transfer of spinal muscle | 90 | $1,312 | |||
| 27110 | Transfer of iliopsoas muscle | 90 | $1,767 | |||
| 27111 | Transfer of iliopsoas muscle | 90 | $1,750 | |||
| 27120 | Reconstruction of hip socket | 90 | $2,653 | |||
| 27122 | Reconstruction of hip socket | 90 | $2,366 | |||
| 27125 | Partial hip replacement | 90 | $2,324 | |||
| 27130 | Total hip replacement | 90 | $3,500 | |||
| 27132 | Total hip replacement | 90 | $3,936 | |||
| 27134 | Revise hip joint replacement | 90 | $4,573 | |||
| 27137 | Revise hip joint replacement | 90 | $3,583 | |||
| 27138 | Revise hip joint replacement | 90 | $3,524 | |||
| 27140 | Transplant of femur ridge | 90 | $1,713 | |||
| 27146 | Incision of hip bone | 90 | $1,837 | |||
| 27147 | Revision of hip bone | 90 | $2,642 | |||
| 27151 | Incision of hip bones | 90 | $2,775 | |||
| 27156 | Revision of hip bones | 90 | $2,941 | |||
| 27158 | Revision of pelvis.... | 90 | $2,620 | |||
| 27161 | Incision of neck of femur | 90 | $2,253 | |||
| 27165 | Incision/fixation of femur | 90 | $2,520 | |||
| 27170 | Repair/graft femur head/neck | 90 | $2,404 | |||
| 27175 | Treat slipped epiphysis | 90 | $609 | |||
| 27176 | Treat slipped epiphysis | 90 | $1,627 | |||
| 27177 | Repair slipped epiphysis | 90 | $1,996 | |||
| 27178 | Repair slipped epiphysis | 90 | $1,613 | |||
| 27179 | Revise head/neck of femur | 90 | $1,746 | |||
| 27181 | Repair slipped epiphysis | 90 | $2,060 | |||
| 27185 | Revision of femur epiphysis | 90 | $845 | |||
| 27187 | Reinforce hip bones | 90 | $2,229 | |||
| 27193 | Treat pelvic ring fracture | 90 | $527 | |||
| 27194 | Treat pelvic ring fracture | 90 | $930 | |||
| 27200 | Treat tail bone fracture | 90 | $243 | |||
| 27202 | Repair tail bone fracture | 90 | $960 | |||
| 27215 | Pelvic fracture(s) treatment | 90 | $1,768 | |||
| 27216 | Treat pelvic ring fracture | 90 | $1,357 | |||
| 27217 | Treat pelvic ring fracture | 90 | $2,129 | |||
| 27218 | Treat pelvic ring fracture | 90 | $2,528 | |||
| 27220 | Treat hip socket fracture | 90 | $720 | |||
| 27222 | Treat hip socket fracture | 90 | $1,299 | |||
| 27226 | Treat hip wall fracture | 90 | $2,282 | |||
| 27227 | Treat hip fracture(s) | 90 | $2,711 | |||
| 27228 | Treat hip fracture(s) | 90 | $2,906 | |||
| 27230 | Treat fracture of thigh | 90 | $613 | |||
| 27232 | Treat fracture of thigh | 90 | $1,399 | |||
| 27235 | Repair of thigh fracture | 90 | $2,024 | |||
| 27236 | Repair of thigh fracture | 90 | $2,390 | |||
| 27238 | Treatment of thigh fracture | 90 | $756 | |||
| 27240 | Treatment of thigh fracture | 90 | $1,564 | |||
| 27244 | Repair of thigh fracture | 90 | $2,355 | |||
| 27245 | Repair of thigh fracture | 90 | $2,665 | |||
| 27246 | Treatment of thigh fracture | 90 | $626 | |||
| 27248 | Repair of thigh fracture | 90 | $1,720 | |||
| 27250 | Treat hip dislocation | 90 | $705 | |||
| 27252 | Treat hip dislocation | 90 | $1,027 | |||
| 27253 | Repair of hip dislocation | 90 | $1,928 | |||
| 27254 | Repair of hip dislocation | 90 | $2,338 | |||
| 27256 | Treatment of hip dislocation | 10 | $418 | |||
| 27257 | Treatment of hip dislocation | 10 | $720 | |||
| 27258 | Repair of hip dislocation | 90 | $2,150 | |||
| 27259 | Repair of hip dislocation | 90 | $2,693 | |||
| 27265 | Treatment of hip dislocation | 90 | $679 | |||
| 27266 | Treatment of hip dislocation | 90 | $913 | |||
| 27267 | Cltx thigh fx | $906 | ||||
| 27268 | Cltx thigh fx w/mnpj | $1,115 | ||||
| 27269 | Optx thigh fx | $2,585 | ||||
| 27275 | Manipulation of hip joint | 10 | $296 | |||
| 27280 | Fusion of sacroiliac joint | 90 | $1,673 | |||
| 27282 | Fusion of pubic bones | 90 | $1,506 | |||
| 27284 | Fusion of hip joint... | 90 | $2,372 | |||
| 27286 | Fusion of hip joint | 90 | $2,344 | |||
| 27290 | Amputation of leg at hip | 90 | $3,665 | |||
| 27295 | Amputation of leg at hip | 90 | $2,605 | |||
| 27299 | Pelvis/hip joint surgery | BR | ||||
| 27301 | Drain thigh/knee lesion | 90 | $793 | |||
| 27303 | Drainage of bone lesion | 90 | $1,171 | |||
| 27305 | Incise thigh tendon & fascia | 90 | $701 | |||
| 27306 | Incision of thigh tendon | 90 | $555 | |||
| 27307 | Incision of thigh tendons | 90 | $715 | |||
| 27310 | Exploration of knee joint | 90 | $1,434 | |||
| 27323 | Biopsy thigh soft tissues | 10 | $263 | |||
| 27324 | Biopsy, thigh soft tissues. | 90 | $608 | |||
| 27325 | Neurectomy hamstring | $1,050 | ||||
| 27326 | Neurectomy popliteal | $1,063 | ||||
| 27327 | Removal of thigh lesion | 90 | $497 | |||
| 27328 | Removal of thigh lesion | 90 | $717 | |||
| 27329 | Remove tumor, thigh/knee | 90 | $1,810 | |||
| 27330 | Biopsy, knee joint lining | 90 | $819 | |||
| 27331 | Explore/treat knee joint | 90 | $975 | |||
| 27332 | Removal of knee cartilage | 90 | $1,320 | |||
| 27333 | Removal of knee cartilage | 90 | $1,613 | |||
| 27334 | Remove knee joint lining | 90 | $1,397 | |||
| 27335 | Remove knee joint lining | 90 | $1,634 | |||
| 27337 | Exc thigh/knee les sc 3 cm/> | $872 | ||||
| 27339 | Exc thigh/knee tum dep 5cm/> | $1,556 | ||||
| 27340 | Removal of kneecap bursa | 90 | $594 | |||
| 27345 | Removal of knee cyst.. | 90 | $896 | |||
| 27347 | Remove knee cyst...... | 90 | $630 | |||
| 27350 | Removal of kneecap | 90 | $1,307 | |||
| 27355 | Remove femur lesion | 90 | $1,123 | |||
| 27356 | Remove femur lesion/graft | 90 | $1,284 | |||
| 27357 | Remove femur lesion/graft | 90 | $1,407 | |||
| 27358 | Remove femur lesion/fixation | $678 | ||||
| 27360 | Partial removal, leg bone(s) | 90 | $1,583 | |||
| 27364 | Resect thigh/knee tum 5 cm/> | $3,238 | ||||
| 27365 | Extensive leg surgery | 90 | $2,285 | |||
| 27370 | Injection for knee X-ray | 0 | $115 | |||
| 27372 | Removal of foreign body | 90 | $621 | |||
| 27380 | Repair of kneecap tendon | 90 | $1,123 | |||
| 27381 | Repair/graft kneecap tendon | 90 | $1,611 | |||
| 27385 | Repair of thigh muscle tendon | 90 | $1,235 | |||
| 27386 | Repair/graft of thigh muscle | 90 | $1,712 | |||
| 27390 | Incision of thigh tendon | 90 | $770 | |||
| 27391 | Incision of thigh tendons | 90 | $989 | |||
| 27392 | Incision of thigh tendons | 90 | $1,308 | |||
| 27393 | Lengthening of thigh tendon | 90 | $947 | |||
| 27394 | Lengthening of thigh | 90 | $1,124 | |||
| 27395 | Lengthening of thigh tendon | 90 | $1,701 | |||
| 27396 | Transplant of thigh tendon | 90 | $1,160 | |||
| 27397 | Transplants of thigh tendon | 90 | $1,548 | |||
| 27400 | Revise thigh muscles/tendon | 90 | $1,293 | |||
| 27403 | Repair of knee cartilage | 90 | $1,294 | |||
| 27405 | Repair of knee ligament | 90 | $1,403 | |||
| 27407 | Repair of knee ligament | 90 | $1,398 | |||
| 27409 | Repair of knee ligaments | 90 | $2,080 | |||
| 27412 | Autochondrocyte implant knee | $3,438 | ||||
| 27415 | Osteochondral knee allograft | $2,854 | ||||
| 27416 | Osteochondral knee autograft | $2,034 | ||||
| 27418 | Repair degenerated kneecap | 90 | $1,708 | |||
| 27420 | Revision of unstable kneecap | 90 | $1,549 | |||
| 27422 | Revision of unstable kneecap | 90 | $1,547 | |||
| 27424 | Revision/removal of kneecap | 90 | $1,607 | |||
| 27425 | Lateral retinacular release | 90 | $891 | |||
| 27427 | Reconstruction, knee | 90 | $1,676 | |||
| 27428 | Reconstruction, knee | 90 | $2,014 | |||
| 27429 | Reconstruction, knee | 90 | $1,767 | |||
| 27430 | Revision of thigh muscles | 90 | $1,437 | |||
| 27435 | Incision of knee joint | 90 | $1,269 | |||
| 27437 | Revise kneecap | 90 | $1,360 | |||
| 27438 | Revise kneecap with implant | 90 | $1,809 | |||
| 27440 | Revision of knee joint | 90 | $1,658 | |||
| 27441 | Revision of knee joint | 90 | $1,449 | |||
| 27442 | Revision of knee joint | 90 | $1,924 | |||
| 27443 | Revision of knee joint | 90 | $2,219 | |||
| 27445 | Revision of knee joint | 90 | $2,810 | |||
| 27446 | Revision of knee joint | 90 | $2,907 | |||
| 27447 | Total knee replacement | 90 | $3,735 | |||
| 27448 | Incision of thigh | 90 | $1,784 | |||
| 27450 | Incision of thigh | 90 | $2,144 | |||
| 27454 | Realignment of thigh bone | 90 | $2,521 | |||
| 27455 | Realignment of knee | 90 | $1,838 | |||
| 27457 | Realignment of knee | 90 | $1,985 | |||
| 27465 | Shortening of thigh bone | 90 | $1,917 | |||
| 27466 | Lengthening of thigh bone | 90 | $2,180 | |||
| 27468 | Shorten/lengthen thighs | 90 | $2,637 | |||
| 27470 | Repair of thigh | 90 | $2,413 | |||
| 27472 | Repair/graft of thigh | 90 | $2,791 | |||
| 27475 | Surgery to stop leg growth | 90 | $1,244 | |||
| 27477 | Surgery to stop leg growth | 90 | $1,879 | |||
| 27479 | Surgery to stop leg growth | 90 | $1,820 | |||
| 27485 | Surgery to stop leg growth | 90 | $1,286 | |||
| 27486 | Revise knee joint replace | 90 | $3,198 | |||
| 27487 | Revise/replace knee joint | 90 | $3,983 | |||
| 27488 | Removal of knee prosthesis | 90 | $2,382 | |||
| 27495 | Reinforce thigh | 90 | $2,457 | |||
| 27496 | Decompression of thigh/knee | 90 | $710 | |||
| 27497 | Decompression of thigh/knee | 90 | $868 | |||
| 27498 | Decompression of thigh/knee | 90 | $990 | |||
| 27499 | Decompression of thigh/knee | 90 | $1,140 | |||
| 27500 | Treatment of thigh fracture | 90 | $816 | |||
| 27501 | Treatment of thigh fracture | 90 | $816 | |||
| 27502 | Treatment of thigh fracture | 90 | $1,302 | |||
| 27503 | Treatment of thigh fracture | 90 | $1,302 | |||
| 27506 | Repair of thigh fracture | 90 | $2,443 | |||
| 27507 | Treatment of thigh fracture | 90 | $2,225 | |||
| 27508 | Treatment of thigh fracture | 90 | $714 | |||
| 27509 | Treatment of thigh fracture | 90 | $825 | |||
| 27510 | Treatment of thigh fracture | 90 | $1,140 | |||
| 27511 | Treatment of thigh fracture | 90 | $2,199 | |||
| 27513 | Treatment of thigh fracture | 90 | $2,504 | |||
| 27514 | Repair of thigh fracture | 90 | $2,427 | |||
| 27516 | Repair of thigh growth plate | 90 | $740 | |||
| 27517 | Repair of thigh growth plate | 90 | $1,225 | |||
| 27519 | Repair of thigh growth plate | 90 | $2,021 | |||
| 27520 | Treat kneecap fracture | 90 | $437 | |||
| 27524 | Repair of kneecap fracture | 90 | $1,513 | |||
| 27530 | Treatment of knee fracture | 90 | $507 | |||
| 27532 | Treatment of knee fracture | 90 | $949 | |||
| 27535 | Treatment of knee fracture | 90 | $1,694 | |||
| 27536 | Repair of knee fracture | 90 | $1,988 | |||
| 27538 | Treat knee fracture(s) | 90 | $604 | |||
| 27540 | Repair of knee fracture | 90 | $1,775 | |||
| 27550 | Treat knee dislocation | 90 | $599 | |||
| 27552 | Treat knee dislocation | 90 | $804 | |||
| 27556 | Repair of knee dislocation | 90 | $1,975 | |||
| 27557 | Repair of knee dislocation | 90 | $2,324 | |||
| 27558 | Repair of knee dislocation | 90 | $2,392 | |||
| 27560 | Treat kneecap dislocation | 90 | $371 | |||
| 27562 | Treat kneecap dislocation | 90 | $809 | |||
| 27566 | Repair kneecap dislocation | 90 | $1,680 | |||
| 27570 | Fixation of knee joint | 10 | $262 | |||
| 27580 | Fusion of knee........ | 90 | $2,659 | |||
| 27590 | Amputate leg at thigh | 90 | $1,497 | |||
| 27591 | Amputate leg at thigh | 90 | $1,767 | |||
| 27592 | Amputate leg at thigh | 90 | $1,308 | |||
| 27594 | Amputation follow-up surgery | 90 | $753 | |||
| 27596 | Amputation follow-up surgery | 90 | $1,305 | |||
| 27598 | Amputate lower leg at knee | 90 | $1,514 | |||
| 27599 | Leg surgery procedure | BR | ||||
| 27600 | Decompression of lower leg | 90 | $642 | |||
| 27601 | Decompression of lower leg | 90 | $640 | |||
| 27602 | Decompression of lower leg | 90 | $810 | |||
| 27603 | Drain lower leg lesion | 90 | $510 | |||
| 27604 | Drain lower leg bursa | 90 | $382 | |||
| 27605 | Incision of achilles tendon | 10 | $438 | |||
| 27606 | Incision of achilles tendon | 10 | $448 | |||
| 27607 | Treat lower leg bone lesion | 90 | $1,154 | |||
| 27610 | Explore/treat ankle joint | 90 | $1,220 | |||
| 27612 | Exploration of ankle joint | 90 | $1,157 | |||
| 27613 | Biopsy lower leg soft tissue | 10 | $205 | |||
| 27614 | Biopsy lower leg soft tissue | 90 | $686 | |||
| 27615 | Remove tumor, lower leg | 90 | $1,518 | |||
| 27616 | Resect leg/ankle tum 5 cm/> | $2,641 | ||||
| 27618 | Remove lower leg lesion | 90 | $636 | |||
| 27619 | Remove lower leg lesion | 90 | $1,023 | |||
| 27620 | Explore, treat ankle joint | 90 | $898 | |||
| 27625 | Remove ankle joint lining | 90 | $1,285 | |||
| 27626 | Remove ankle joint lining | 90 | $1,458 | |||
| 27630 | Removal of tendon lesion | 90 | $581 | |||
| 27632 | Exc leg/ankle les sc 3 cm/> | $868 | ||||
| 27634 | Exc leg/ankle tum dep 5 cm/> | $1,430 | ||||
| 27635 | Remove lower leg bone lesion | 90 | $1,175 | |||
| 27637 | Remove/graft leg bone lesion | 90 | $1,346 | |||
| 27638 | Remove/graft leg bone lesion | 90 | $1,456 | |||
| 27640 | Partial removal of tibia | 90 | $1,690 | |||
| 27641 | Partial removal of fibula | 90 | $1,180 | |||
| 27645 | Extensive lower leg surgery | 90 | $2,012 | |||
| 27646 | Extensive lower leg surgery | 90 | $1,710 | |||
| 27647 | Extensive ankle/heel surgery | 90 | $1,593 | |||
| 27648 | Injection for ankle X-ray | 0 | $109 | |||
| 27650 | Repair achilles tendon | 90 | $1,378 | |||
| 27652 | Repair/graft achilles tendon | 90 | $1,529 | |||
| 27654 | Repair of achilles tendon | 90 | $1,560 | |||
| 27656 | Repair leg fascia defect | 90 | $570 | |||
| 27658 | Repair of leg tendon, each | 90 | $733 | |||
| 27659 | Repair of leg tendon, each | 90 | $971 | |||
| 27664 | Repair of leg tendon, each | 90 | $722 | |||
| 27665 | Repair of leg tendon, each | 90 | $867 | |||
| 27675 | Repair lower leg tendons | 90 | $1,000 | |||
| 27676 | Repair lower leg tendons | 90 | $1,173 | |||
| 27680 | Release of lower leg tendon | 90 | $778 | |||
| 27681 | Release of lower leg tendons | 90 | $986 | |||
| 27685 | Revision of lower leg tendons | 90 | $811 | |||
| 27686 | Revise lower leg tendons | 90 | $1,073 | |||
| 27687 | Revision of calf tendon | 90 | $853 | |||
| 27690 | Revise lower leg tendon | 90 | $1,113 | |||
| 27691 | Revise lower leg tendon | 90 | $1,374 | |||
| 27692 | Revise additional leg tendons | $283 | ||||
| 27695 | Repair of ankle ligament | 90 | $1,065 | |||
| 27696 | Repair of ankle ligaments | 90 | $1,129 | |||
| 27698 | Repair of ankle ligament | 90 | $1,481 | |||
| 27700 | Revision of ankle joint | 90 | $1,517 | |||
| 27702 | Reconstruct ankle joint | 90 | $2,702 | |||
| 27703 | Reconstruction, ankle joint | 90 | $2,193 | |||
| 27704 | Removal of ankle implant | 90 | $993 | |||
| 27705 | Incision of tibia | 90 | $1,567 | |||
| 27707 | Incision of fibula | 90 | $655 | |||
| 27709 | Incision of tibia & fibula | 90 | $1,659 | |||
| 27712 | Realignment of lower leg | 90 | $1,913 | |||
| 27715 | Revision of lower leg | 90 | $2,049 | |||
| 27720 | Repair of tibia | 90 | $1,924 | |||
| 27722 | Repair/graft of tibia | 90 | $1,633 | |||
| 27724 | Repair/graft of tibia | 90 | $2,212 | |||
| 27725 | Repair of lower leg | 90 | $1,629 | |||
| 27726 | Repair fibula nonunion | $2,021 | ||||
| 27727 | Repair of lower leg | 90 | $1,706 | |||
| 27730 | Repair of tibia epiphysis | 90 | $1,029 | |||
| 27732 | Repair of fibula epiphysis | 90 | $757 | |||
| 27734 | Repair lower leg epiphyses | 90 | $1,179 | |||
| 27740 | Repair of leg epiphyses | 90 | $1,261 | |||
| 27742 | Repair of leg epiphyses | 90 | $1,454 | |||
| 27745 | Reinforce tibia | 90 | $1,398 | |||
| 27750 | Treatment of tibia fracture | 90 | $486 | |||
| 27752 | Treatment of tibia fracture | 90 | $784 | |||
| 27756 | Repair of tibia fracture | 90 | $1,199 | |||
| 27758 | Repair of tibia fracture | 90 | $1,854 | |||
| 27759 | Repair of tibia fracture | 90 | $2,021 | |||
| 27760 | Treatment of ankle fracture | 90 | $408 | |||
| 27762 | Treatment of ankle fracture | 90 | $614 | |||
| 27766 | Repair of ankle fracture | 90 | $1,185 | |||
| 27767 | Cltx post ankle fx | $589 | ||||
| 27768 | Cltx post ankle fx w/mnpj | $912 | ||||
| 27769 | Optx post ankle fx | $1,529 | ||||
| 27780 | Treatment of fibula fracture | 90 | $333 | |||
| 27781 | Treatment of fibula fracture | 90 | $566 | |||
| 27784 | Repair of fibula fracture | 90 | $914 | |||
| 27786 | Treatment of ankle fracture | 90 | $394 | |||
| 27788 | Treatment of ankle fracture | 90 | $569 | |||
| 27792 | Repair of ankle fracture | 90 | $1,104 | |||
| 27808 | Treatment of ankle fracture | 90 | $411 | |||
| 27810 | Treatment of ankle fracture | 90 | $756 | |||
| 27814 | Repair of ankle fracture | 90 | $1,520 | |||
| 27816 | Treatment of ankle fracture | 90 | $483 | |||
| 27818 | Treatment of ankle fracture | 90 | $896 | |||
| 27822 | Repair of ankle fracture | 90 | $1,497 | |||
| 27823 | Repair of ankle fracture | 90 | $1,822 | |||
| 27824 | Treat lower leg fracture | 90 | $483 | |||
| 27825 | Treat lower leg fracture | 90 | $896 | |||
| 27826 | Treat lower leg fracture | 90 | $1,412 | |||
| 27827 | Treat lower leg fracture | 90 | $1,663 | |||
| 27828 | Treat lower leg fracture | 90 | $1,923 | |||
| 27829 | Treat lower leg joint | 90 | $985 | |||
| 27830 | Treat lower leg dislocation | 90 | $511 | |||
| 27831 | Treat lower leg dislocation | 90 | $626 | |||
| 27832 | Repair lower leg dislocation | 90 | $889 | |||
| 27840 | Treat ankle dislocation | 90 | $450 | |||
| 27842 | Treat ankle dislocation | 90 | $586 | |||
| 27846 | Repair ankle dislocation | 90 | $1,346 | |||
| 27848 | Repair ankle dislocation | 90 | $1,425 | |||
| 27860 | Fixation of ankle joint | 10 | $278 | |||
| 27870 | Fusion of ankle joint | 90 | $1,839 | |||
| 27871 | Fusion of tibiofibular joint | 90 | $1,243 | |||
| 27880 | Amputation of lower leg | 90 | $1,462 | |||
| 27881 | Amputation of lower leg | 90 | $1,669 | |||
| 27882 | Amputation of lower leg | 90 | $1,174 | |||
| 27884 | Amputation follow-up surgery | 90 | $806 | |||
| 27886 | Amputation follow-up surgery | 90 | $1,193 | |||
| 27888 | Amputation of foot at ankle | 90 | $1,461 | |||
| 27889 | Amputation of foot at ankle | 90 | $1,331 | |||
| 27892 | Decompression of leg | 90 | $713 | |||
| 27893 | Decompression of leg | 90 | $712 | |||
| 27894 | Decompression of leg | 90 | $882 | |||
| 27899 | Leg/ankle surgery procedure | BR | ||||
| 28001 | Drainage of bursa of foot | 10 | $291 | |||
| 28002 | Treatment of foot infection | 10 | $553 | |||
| 28003 | Treatment of foot infection | 90 | $820 | |||
| 28005 | Treat foot bone lesion | 90 | $1,019 | |||
| 28008 | Incision of foot fascia | 90 | $507 | |||
| 28010 | Incision of toe tendon | 90 | $506 | |||
| 28011 | Incision of toe tendons | 90 | $509 | |||
| 28020 | Exploration of foot joint | 90 | $753 | |||
| 28022 | Exploration of a foot joint | 90 | $528 | |||
| 28024 | Exploration of a toe joint | 90 | $479 | |||
| 28035 | Decompression of tibia nerve | 90 | $860 | |||
| 28039 | Exc foot/toe tum sc 1.5 cm/> | $1,097 | ||||
| 28041 | Exc foot/toe tum dep 1.5cm/> | $980 | ||||
| 28043 | Excision of foot lesion | 90 | $446 | |||
| 28045 | Excision of foot lesion | 90 | $631 | |||
| 28046 | Resection of tumor, foot | 90 | $1,101 | |||
| 28047 | Resect foot/toe tumor 3 cm/> | $2,147 | ||||
| 28050 | Biopsy of foot joint lining | 90 | $650 | |||
| 28052 | Biopsy of foot joint lining | 90 | $563 | |||
| 28054 | Biopsy of toe joint lining | 90 | $406 | |||
| 28055 | Neurectomy foot | $781 | ||||
| 28060 | Partial removal, foot fascia | 90 | $736 | |||
| 28062 | Removal of foot fascia | 90 | $1,002 | |||
| 28070 | Removal of foot joint lining | 90 | $686 | |||
| 28072 | Removal of foot joint lining | 90 | $563 | |||
| 28080 | Removal of foot lesion | 90 | $596 | |||
| 28086 | Excise foot tendon sheath | 90 | $574 | |||
| 28088 | Excise foot tendon sheath | 90 | $541 | |||
| 28090 | Removal of foot lesion | 90 | $591 | |||
| 28092 | Removal of toe lesions | 90 | $481 | |||
| 28100 | Removal of ankle/heel lesion | 90 | $745 | |||
| 28102 | Remove/graft foot lesion | 90 | $1,062 | |||
| 28103 | Remove/graft foot lesion | 90 | $878 | |||
| 28104 | Removal of foot lesion | 90 | $686 | |||
| 28106 | Remove/graft foot lesion | 90 | $988 | |||
| 28107 | Remove/graft foot lesion | 90 | $744 | |||
| 28108 | Removal of toe lesions | 90 | $608 | |||
| 28110 | Part removal of metatarsal | 90 | $544 | |||
| 28111 | Part removal of metatarsal | 90 | $732 | |||
| 28112 | Part removal of metatarsal | 90 | $612 | |||
| 28113 | Part removal of metatarsal | 90 | $639 | |||
| 28114 | Removal of metatarsal heads | 90 | $1,450 | |||
| 28116 | Revision of foot | 90 | $866 | |||
| 28118 | Removal of heel bone | 90 | $845 | |||
| 28119 | Removal of heel spur | 90 | $787 | |||
| 28120 | Part removal of ankle/heel | 90 | $843 | |||
| 28122 | Partial removal of foot bone | 90 | $927 | |||
| 28124 | Partial removal of toe | 90 | $699 | |||
| 28126 | Partial removal of toe | 90 | $586 | |||
| 28130 | Removal of ankle bone | 90 | $1,079 | |||
| 28140 | Removal of metatarsal | 90 | $850 | |||
| 28150 | Removal of toe........ | 90 | $596 | |||
| 28153 | Partial removal of toe | 90 | $595 | |||
| 28160 | Partial removal of toe | 90 | $613 | |||
| 28171 | Extensive foot surgery | 90 | $1,286 | |||
| 28173 | Extensive foot surgery | 90 | $1,038 | |||
| 28175 | Extensive foot surgery | 90 | $818 | |||
| 28190 | Removal of foot foreign body | 10 | $176 | |||
| 28192 | Removal of foot foreign body | 90 | $473 | |||
| 28193 | Removal of foot foreign body | 90 | $575 | |||
| 28200 | Repair of foot tendon | 90 | $732 | |||
| 28202 | Repair/graft of foot tendon | 90 | $918 | |||
| 28208 | Repair of foot tendon | 90 | $573 | |||
| 28210 | Repair/graft of foot tendon | 90 | $861 | |||
| 28220 | Release of foot tendon | 90 | $654 | |||
| 28222 | Release of foot tendons | 90 | $891 | |||
| 28225 | Release of foot tendon | 90 | $493 | |||
| 28226 | Release of foot tendons | 90 | $629 | |||
| 28230 | Incision of foot tendon(s) | 90 | $540 | |||
| 28232 | Incision of toe tendon | 90 | $428 | |||
| 28234 | Incision of foot tendon | 90 | $425 | |||
| 28238 | Revision of foot tendon | 90 | $1,120 | |||
| 28240 | Release of big toe | 90 | $459 | |||
| 28250 | Revision of foot fascia | 90 | $798 | |||
| 28260 | Release of midfoot joint | 90 | $879 | |||
| 28261 | Revision of foot tendon | 90 | $1,092 | |||
| 28262 | Revision of foot and ankle | 90 | $2,038 | |||
| 28264 | Release of midfoot joint | 90 | $1,469 | |||
| 28270 | Release of foot contracture | 90 | $596 | |||
| 28272 | Release of toe joint, each | 90 | $479 | |||
| 28280 | Fusion of toes........ | 90 | $620 | |||
| 28285 | Repair of hammertoe... | 90 | $691 | |||
| 28286 | Repair of hammertoe... | 90 | $644 | |||
| 28288 | Partial removal of foot bone | 90 | $673 | |||
| 28289 | Repair hallux rigidus | 90 | $717 | |||
| 28290 | Correction of bunion.. | 90 | $849 | |||
| 28292 | Correction of bunion | 90 | $994 | |||
| 28293 | Correction of bunion | 90 | $1,330 | |||
| 28294 | Correction of bunion.. | 90 | $1,296 | |||
| 28296 | Correction of bunion | 90 | $1,309 | |||
| 28297 | Correction of bunion | 90 | $1,328 | |||
| 28298 | Correction of bunion | 90 | $1,218 | |||
| 28299 | Correction of bunion | 90 | $1,393 | |||
| 28300 | Incision of heel bone. | 90 | $1,292 | |||
| 28302 | Incision of ankle bone | 90 | $1,355 | |||
| 28304 | Incision of midfoot bones | 90 | $1,186 | |||
| 28305 | Incise/graft midfoot bones | 90 | $1,617 | |||
| 28306 | Incision of metatarsal | 90 | $798 | |||
| 28307 | Incision of metatarsal | 90 | $916 | |||
| 28308 | Incision of metatarsal | 90 | $814 | |||
| 28309 | Incision of metatarsals | 90 | $1,486 | |||
| 28310 | Revision of big toe... | 90 | $745 | |||
| 28312 | Revision of toe | 90 | $659 | |||
| 28313 | Repair deformity of toe | 90 | $625 | |||
| 28315 | Removal of sesamoid bone | 90 | $655 | |||
| 28320 | Repair of foot bones.. | 90 | $1,324 | |||
| 28322 | Repair of metatarsals | 90 | $936 | |||
| 28340 | Resect enlarged toe tissue | 90 | $979 | |||
| 28341 | Resect enlarged toe | 90 | $1,167 | |||
| 28344 | Repair extra toe(s) | 90 | $580 | |||
| 28345 | Repair webbed toe(s) | 90 | $821 | |||
| 26590 | Repair finger deformity | 90 | $2,635 | |||
| 28400 | Treatment of heel fracture | 90 | $353 | |||
| 28405 | Treatment of heel fracture | 90 | $621 | |||
| 28406 | Treatment of heel fracture | 90 | $909 | |||
| 28415 | Repair of heel fracture | 90 | $1,678 | |||
| 28420 | Repair/graft heel fracture | 90 | $2,005 | |||
| 28430 | Treatment of ankle fracture | 90 | $337 | |||
| 28435 | Treatment of ankle fracture | 90 | $504 | |||
| 28436 | Treatment of ankle fracture | 90 | $657 | |||
| 28445 | Repair of ankle fracture | 90 | $1,344 | |||
| 28446 | Osteochondral talus autogrft | $2,544 | ||||
| 28450 | Treat midfoot fracture, each | 90 | $276 | |||
| 28455 | Treat midfoot fracture, each | 90 | $412 | |||
| 28456 | Repair midfoot fracture | 90 | $357 | |||
| 28465 | Repair midfoot fracture, each | 90 | $913 | |||
| 28470 | Treat metatarsal fracture | 90 | $269 | |||
| 28475 | Treat metatarsal fracture | 90 | $381 | |||
| 28476 | Repair metatarsal fracture | 90 | $494 | |||
| 28485 | Repair metatarsal fracture | 90 | $750 | |||
| 28490 | Treat big toe fracture | 90 | $143 | |||
| 28495 | Treat big toe fracture | 90 | $194 | |||
| 28496 | Repair big toe fracture | 90 | $322 | |||
| 28505 | Repair big toe fracture | 90 | $493 | |||
| 28510 | Treatment of toe fracture | 90 | $141 | |||
| 28515 | Treatment of toe fracture | 90 | $184 | |||
| 28525 | Repair of toe fracture | 90 | $384 | |||
| 28530 | Treat sesamoid bone fracture | 90 | $150 | |||
| 28531 | Treat sesamoid bone fracture | 90 | $300 | |||
| 28540 | Treat foot dislocation | 90 | $181 | |||
| 28545 | Treat foot dislocation | 90 | $257 | |||
| 28546 | Treat foot dislocation | 90 | $430 | |||
| 28555 | Repair foot dislocation | 90 | $860 | |||
| 28570 | Treat foot dislocation | 90 | $236 | |||
| 28575 | Treat foot dislocation | 90 | $432 | |||
| 28576 | Treat foot dislocation | 90 | $491 | |||
| 28585 | Repair foot dislocation | 90 | $919 | |||
| 28600 | Treat foot dislocation | 90 | $179 | |||
| 28605 | Treat foot dislocation | 90 | $356 | |||
| 28606 | Treat foot dislocation | 90 | $604 | |||
| 28615 | Repair foot dislocation | 90 | $770 | |||
| 28630 | Treat toe dislocation | 10 | $198 | |||
| 28635 | Treat toe dislocation | 10 | $248 | |||
| 28636 | Treat toe dislocation | 10 | $400 | |||
| 28645 | Repair toe dislocation | 90 | $537 | |||
| 28660 | Treat toe dislocation | 10 | $133 | |||
| 28665 | Treat toe dislocation | 10 | $210 | |||
| 28666 | Treat toe dislocation | 10 | $383 | |||
| 28675 | Repair of toe dislocation | 90 | $431 | |||
| 28705 | Fusion of foot bones.. | 90 | $2,250 | |||
| 28715 | Fusion of foot bones.. | 90 | $1,912 | |||
| 28725 | Fusion of foot bones.. | 90 | $1,590 | |||
| 28730 | Fusion of foot bones | 90 | $1,433 | |||
| 28735 | Fusion of foot bones.. | 90 | $1,542 | |||
| 28737 | Revision of foot bones | 90 | $1,388 | |||
| 28740 | Fusion of foot bones | 90 | $854 | |||
| 28750 | Fusion of big toe joint | 90 | $773 | |||
| 28755 | Fusion of big toe joint | 90 | $611 | |||
| 28760 | Fusion of big toe joint | 90 | $1,006 | |||
| 28800 | Amputation of midfoot | 90 | $1,141 | |||
| 28805 | Amputation thru metatarsal | 90 | $1,067 | |||
| 28810 | Amputation toe & metatarsal | 90 | $721 | |||
| 28820 | Amputation of toe | 90 | $468 | |||
| 28825 | Partial amputation of toe | 90 | $420 | |||
| 28890 | High energy eswt plantar f | $696 | $467 | |||
| 28899 | Foot/toes surgery procedure | BR | ||||
| 29000 | Application of body cast | 0 | $305 | |||
| 29010 | Application of body cast | 0 | $335 | |||
| 29015 | Application of body cast | 0 | $360 | |||
| 29020 | Application of body cast | 0 | $294 | |||
| 29025 | Application of body cast | 0 | $234 | |||
| 29035 | Application of body cast | 0 | $286 | |||
| 29040 | Application of body cast | 0 | $321 | |||
| 29044 | Application of body cast | 0 | $322 | |||
| 29046 | Application of body cast | 0 | $354 | |||
| 29049 | Application of shoulder cast | 0 | $97 | |||
| 29055 | Application of shoulder cast | 0 | $223 | |||
| 29058 | Application of shoulder cast | 0 | $145 | |||
| 29065 | Application of long arm cast | 0 | $128 | |||
| 29075 | Application of forearm cast | 0 | $105 | |||
| 29085 | Apply hand/wrist cast | 0 | $103 | |||
| 29086 | Apply finger cast | $163 | $107 | |||
| 29105 | Apply long arm splint | 0 | $103 | |||
| 29125 | Apply forearm splint | 0 | $72 | |||
| 29126 | Apply forearm splint | 0 | $87 | |||
| 29130 | Application of finger splint | 0 | $49 | |||
| 29131 | Application of finger splint | 0 | $71 | |||
| 29200 | Strapping of chest | 0 | $68 | |||
| 29220 | Strapping of low back | 0 | $76 | |||
| 29240 | Strapping of shoulder | 0 | $72 | |||
| 29260 | Strapping of elbow or wrist | 0 | $58 | |||
| 29280 | Strapping of hand or finger | 0 | $53 | |||
| 29305 | Application of hip cast | 0 | $299 | |||
| 29325 | Application of hip casts | 0 | $322 | |||
| 29345 | Application of long leg cast | 0 | $183 | |||
| 29355 | Application of long leg cast | 0 | $199 | |||
| 29358 | Apply long leg cast brace | 0 | $259 | |||
| 29365 | Application of long leg cast | 0 | $154 | |||
| 29405 | Apply short leg cast | 0 | $126 | |||
| 29425 | Apply short leg cast | 0 | $150 | |||
| 29435 | Apply short leg cast | 0 | $180 | |||
| 29440 | Addition of walker to cast | 0 | $59 | |||
| 29445 | Apply rigid leg cast | 0 | $263 | |||
| 29450 | Application of leg cast | 0 | $103 | |||
| 29505 | Application long leg splint | 0 | $95 | |||
| 29515 | Application lower leg splint | 0 | $90 | |||
| 29520 | Strapping of hip | 0 | $66 | |||
| 29530 | Strapping of knee | 0 | $69 | |||
| 29540 | Strapping of ankle | 0 | $60 | |||
| 29550 | Strapping of toes | 0 | $56 | |||
| 29580 | Application of paste boot | 0 | $100 | |||
| 29581 | Apply multlay comprs lwr leg | $126 | $26 | |||
| 29582 | Apply multlay comprs upr leg | $143 | $32 | |||
| 29583 | Apply multlay comprs upr arm | $89 | $23 | |||
| 29584 | Appl multlay comprs arm/hand | $143 | $32 | |||
| 29590 | Application of foot splint | 0 | $76 | |||
| 29700 | Removal/revision of cast | 0 | $89 | |||
| 29705 | Removal/revision of cast | 0 | $108 | |||
| 29710 | Removal/revision of cast | 0 | $132 | |||
| 29715 | Removal/revision of cast | 0 | $136 | |||
| 29720 | Repair of body cast | 0 | $68 | |||
| 29730 | Windowing of cast | 0 | $75 | |||
| 29740 | Wedging of cast | 0 | $110 | |||
| 29750 | Wedging of clubfoot cast | 0 | $130 | |||
| 29799 | Casting/strapping procedure | BR | ||||
| 29800 | Jaw arthroscopy/surgery | 90 | $691 | |||
| 29804 | Jaw arthroscopy/surgery | 90 | $1,635 | |||
| 29805 | Shoulder arthroscopy dx | $981 | ||||
| 29806 | Shoulder arthroscopy/surgery | $2,210 | ||||
| 29807 | Shoulder arthroscopy/surgery | $2,152 | ||||
| 29819 | Shoulder arthroscopy/surgery | 90 | $1,329 | |||
| 29820 | Shoulder arthroscopy/surgery | 90 | $1,282 | |||
| 29821 | Shoulder arthroscopy/surgery | 90 | $1,515 | |||
| 29822 | Shoulder arthroscopy/surgery | 90 | $1,328 | |||
| 29823 | Shoulder arthroscopy/surgery | 90 | $1,622 | |||
| 29824 | Shoulder arthroscopy/surgery | $1,412 | ||||
| 29825 | Shoulder arthroscopy/surgery | 90 | $1,466 | |||
| 29826 | Shoulder arthroscopy/surgery | 90 | $1,687 | |||
| 29827 | Arthroscop rotator cuff repr | $2,241 | ||||
| 29828 | Arthroscopy biceps tenodesis | $1,926 | ||||
| 29830 | Elbow arthroscopy | 90 | $834 | |||
| 29834 | Elbow arthroscopy/surgery | 90 | $916 | |||
| 29835 | Elbow arthroscopy/surgery | 90 | $945 | |||
| 29836 | Elbow arthroscopy/surgery | 90 | $1,101 | |||
| 29837 | Elbow arthroscopy/surgery | 90 | $1,004 | |||
| 29838 | Elbow arthroscopy/surgery | 90 | $1,105 | |||
| 29840 | Wrist arthroscopy | 90 | $654 | |||
| 29843 | Wrist arthroscopy/surgery | 90 | $876 | |||
| 29844 | Wrist arthroscopy/surgery | 90 | $903 | |||
| 29845 | Wrist arthroscopy/surgery | 90 | $1,097 | |||
| 29846 | Wrist arthroscopy/surgery | 90 | $1,391 | |||
| 29847 | Wrist arthroscopy/surgery | 90 | $1,040 | |||
| 29848 | Wrist endoscopy/ surgery | 90 | $756 | |||
| 29850 | Knee arthroscopy/surgery | 90 | $1,409 | |||
| 29851 | Knee arthroscopy/surgery | 90 | $1,775 | |||
| 29855 | Tibial arthroscopy/surgery | 90 | $1,632 | |||
| 29856 | Tibial arthroscopy/surgery | 90 | $1,901 | |||
| 29860 | Hip arthroscopy, dx... | 90 | $996 | |||
| 29861 | Hip arthroscopy/ surgery | 90 | $1,402 | |||
| 29862 | Hip arthroscopy/ surgery | 90 | $1,536 | |||
| 29863 | Hip arthroscopy/ surgery | 90 | $1,431 | |||
| 29866 | Autgrft implnt knee w/scope | $2,181 | ||||
| 29867 | Allgrft implnt knee w/scope | $2,657 | ||||
| 29868 | Meniscal trnspl knee w/scpe | $3,481 | ||||
| 29870 | Knee arthroscopy, diagnostic | 90 | $679 | |||
| 29871 | Knee arthroscopy/drainage | 90 | $993 | |||
| 29873 | Knee arthroscopy/surgery | $1,089 | ||||
| 29874 | Knee arthroscopy/surgery | 90 | $1,229 | |||
| 29875 | Knee arthroscopy/surgery | 90 | $1,193 | |||
| 29876 | Knee arthroscopy/surgery | 90 | $1,443 | |||
| 29877 | Knee arthroscopy/surgery | 90 | $1,348 | |||
| 29879 | Knee arthroscopy/ surgery | 90 | $1,315 | |||
| 29880 | Knee arthroscopy/surgery | 90 | $1,606 | |||
| 29881 | Knee arthroscopy/surgery | 90 | $1,387 | |||
| 29882 | Knee arthroscopy/surgery | 90 | $1,488 | |||
| 29883 | Knee arthroscopy/surgery | 90 | $1,905 | |||
| 29884 | Knee arthroscopy/surgery | 90 | $1,235 | |||
| 29885 | Knee arthroscopy/surgery | 90 | $1,289 | |||
| 29886 | Knee arthroscopy/surgery | 90 | $1,066 | |||
| 29887 | Knee arthroscopy/surgery | 90 | $1,474 | |||
| 29888 | Knee arthroscopy/surgery | 90 | $2,463 | |||
| 29889 | Knee arthroscopy/surgery | 90 | $1,607 | |||
| 29891 | Ankle arthroscopy/ surgery | 90 | $1,323 | |||
| 29892 | Ankle arthroscopy/ surgery | 90 | $1,370 | |||
| 29893 | Scope, plantar fasciotomy | 90 | $764 | |||
| 29894 | Ankle arthroscopy/surgery | 90 | $1,285 | |||
| 29895 | Ankle arthroscopy/surgery | 90 | $1,221 | |||
| 29897 | Ankle arthroscopy/surgery | 90 | $1,316 | |||
| 29898 | Ankle arthroscopy/surgery | 90 | $1,510 | |||
| 29899 | Ankle arthroscopy/surgery | $2,165 | ||||
| 29900 | Mcp joint arthroscopy dx | $1,000 | ||||
| 29901 | Mcp joint arthroscopy surg | $1,133 | ||||
| 29902 | Mcp joint arthroscopy surg | $1,253 | ||||
| 29904 | Subtalar arthro w/fb rmvl | $1,324 | ||||
| 29905 | Subtalar arthro w/exc | $1,434 | ||||
| 29906 | Subtalar arthro w/deb | $1,509 | ||||
| 29907 | Subtalar arthro w/fusion | $1,820 | ||||
| 29914 | Hip arthro w/femoroplasty | $2,112 | ||||
| 29915 | Hip arthro acetabuloplasty | $2,152 | ||||
| 29916 | Hip arthro w/labral repair | $2,152 | ||||
| 30000 | Drainage of nose lesion | 10 | $143 | |||
| 30020 | Drainage of nose lesion | 10 | $145 | |||
| 30100 | Intranasal biopsy | 0 | $122 | |||
| 30110 | Removal of nose polyp(s) | 10 | $213 | |||
| 30115 | Removal of nose polyp(s) | 90 | $521 | |||
| 30117 | Removal of intranasal lesion | 90 | $439 | |||
| 30118 | Removal of intranasal lesion | 90 | $1,286 | |||
| 30120 | Revision of nose | 90 | $901 | |||
| 30124 | Removal of nose lesion | 90 | $318 | |||
| 30125 | Removal of nose lesion | 90 | $926 | |||
| 30130 | Removal of turbinate bones | 90 | $413 | |||
| 30140 | Removal of turbinate bones | 90 | $511 | |||
| 30150 | Partial removal of nose | 90 | $1,237 | |||
| 30160 | Removal of nose | 90 | $1,573 | |||
| 30200 | Injection treatment of nose | 0 | $84 | |||
| 30210 | Nasal sinus therapy | 10 | $94 | |||
| 30220 | Insert nasal septal button | 10 | $224 | |||
| 30300 | Remove nasal foreign body | 10 | $107 | |||
| 30310 | Remove nasal foreign body | 10 | $263 | |||
| 30320 | Remove nasal foreign body | 90 | $645 | |||
| 30400 | Reconstruction of nose | 90 | $2,146 | |||
| 30410 | Reconstruction of nose | 90 | $2,763 | |||
| 30420 | Reconstruction of nose | 90 | $2,904 | |||
| 30430 | Revision of nose | 90 | $1,976 | |||
| 30435 | Revision of nose | 90 | $2,365 | |||
| 30450 | Revision of nose | 90 | $3,177 | |||
| 30460 | Revision of nose | 90 | $1,345 | |||
| 30462 | Revision of nose | 90 | $2,691 | |||
| 30465 | Repair nasal stenosis | $2,084 | ||||
| 30520 | Repair of nasal septum | 90 | $1,022 | |||
| 30540 | Repair nasal defect | 90 | $1,047 | |||
| 30545 | Repair nasal defect | 90 | $1,603 | |||
| 30560 | Release of nasal adhesions | 10 | $129 | |||
| 30580 | Repair upper jaw fistula | 90 | $942 | |||
| 30600 | Repair mouth/nose fistula | 90 | $708 | |||
| 30620 | Intranasal reconstruction | 90 | $1,082 | |||
| 30630 | Repair nasal septum defect | 90 | $976 | |||
| 30801 | Cauterization inner nose | 10 | $110 | |||
| 30802 | Cauterization inner nose | 10 | $215 | |||
| 30901 | Control of nosebleed | 0 | $130 | |||
| 30903 | Control of nosebleed | 0 | $175 | |||
| 30905 | Control of nosebleed | 0 | $278 | |||
| 30906 | Repeat control of nosebleed | 0 | $258 | |||
| 30915 | Ligation nasal sinus artery | 90 | $863 | |||
| 30920 | Ligation upper jaw artery | 90 | $1,404 | |||
| 30930 | Therapy fracture of nose | 10 | $142 | |||
| 30999 | Nasal surgery procedure | BR | ||||
| 31000 | Irrigation maxillary sinus | 10 | $112 | |||
| 31002 | Irrigation sphenoid sinus | 10 | $168 | |||
| 31020 | Exploration maxillary sinus | 90 | $408 | |||
| 31030 | Exploration maxillary sinus | 90 | $989 | |||
| 31032 | Explore sinus, remove polyps | 90 | $1,118 | |||
| 31040 | Exploration behind upper jaw | 90 | $1,251 | |||
| 31050 | Exploration sphenoid sinus | 90 | $827 | |||
| 31051 | Sphenoid sinus surgery | 90 | $1,120 | |||
| 31070 | Exploration of frontal sinus | 90 | $654 | |||
| 31075 | Exploration of frontal sinus | 90 | $1,429 | |||
| 31080 | Removal of frontal sinus | 90 | $1,491 | |||
| 31081 | Removal of frontal sinus | 90 | $1,666 | |||
| 31084 | Removal of frontal sinus | 90 | $2,060 | |||
| 31085 | Removal of frontal sinus | 90 | $2,180 | |||
| 31086 | Removal of frontal sinus | 90 | $1,699 | |||
| 31087 | Removal of frontal sinus | 90 | $1,689 | |||
| 31090 | Exploration of sinuses | 90 | $1,529 | |||
| 31200 | Removal of ethmoid sinus | 90 | $693 | |||
| 31201 | Removal of ethmoid sinus | 90 | $1,110 | |||
| 31205 | Removal of ethmoid sinus | 90 | $1,309 | |||
| 31225 | Removal of upper jaw | 90 | $2,620 | |||
| 31230 | Removal of upper jaw | 90 | $3,205 | |||
| 31231 | Nasal endoscopy, dx | 0 | $129 | |||
| 31233 | Nasal/sinus endoscopy, dx | 0 | $268 | |||
| 31235 | Nasal/sinus endoscopy, dx | 0 | $469 | |||
| 31237 | Nasal/sinus endoscopy, surg | 0 | $322 | |||
| 31238 | Nasal/sinus endoscopy, surg | 0 | $559 | |||
| 31239 | Nasal/sinus endoscopy, surg | 10 | $1,455 | |||
| 31240 | Nasal/sinus endoscopy, surg | 0 | $448 | |||
| 31254 | Revision of ethmoid sinus | 0 | $790 | |||
| 31255 | Removal of ethmoid sinus | 0 | $1,191 | |||
| 31256 | Exploration maxillary sinus | 0 | $523 | |||
| 31267 | Endoscopy, maxillary sinus | 0 | $805 | |||
| 31276 | Sinus surgical endoscopy | 0 | $1,041 | |||
| 31287 | Nasal/sinus endoscopy, surg | 0 | $671 | |||
| 31288 | Nasal/sinus endoscopy, surg | 0 | $784 | |||
| 31290 | Nasal/sinus endoscopy, surg | 10 | $2,204 | |||
| 31291 | Nasal/sinus endoscopy, surg | 10 | $2,315 | |||
| 31292 | Nasal/sinus endoscopy, surg | 10 | $1,790 | |||
| 31293 | Nasal/sinus endoscopy, surg | 10 | $1,958 | |||
| 31294 | Nasal/sinus endoscopy, surg | 10 | $2,238 | |||
| 31295 | Sinus endo w/balloon dil | $4,436 | $353 | |||
| 31296 | Sinus endo w/balloon dil | $4,496 | $420 | |||
| 31297 | Sinus endo w/balloon dil | $4,422 | $346 | |||
| 31299 | Sinus surgery procedure | BR | ||||
| 31300 | Removal of larynx lesion | 90 | $1,851 | |||
| 31320 | Diagnostic incision larynx | 90 | $630 | |||
| 31360 | Removal of larynx | 90 | $2,601 | |||
| 31365 | Removal of larynx | 90 | $3,685 | |||
| 31367 | Partial removal of larynx | 90 | $2,695 | |||
| 31368 | Partial removal of larynx | 90 | $3,790 | |||
| 31370 | Partial removal of larynx | 90 | $2,659 | |||
| 31375 | Partial removal of larynx | 90 | $2,471 | |||
| 31380 | Partial removal of larynx | 90 | $2,665 | |||
| 31382 | Partial removal of larynx | 90 | $2,573 | |||
| 31390 | Removal of larynx & pharynx | 90 | $4,009 | |||
| 31395 | Reconstruct larynx & pharynx | 90 | $4,622 | |||
| 31400 | Revision of larynx | 90 | $1,259 | |||
| 31420 | Removal of epiglottis | 90 | $1,273 | |||
| 31500 | Insert emergency airway | 0 | $256 | |||
| 31502 | Change of windpipe airway | 0 | $93 | |||
| 31505 | Diagnostic laryngoscopy | 0 | $95 | |||
| 31510 | Laryngoscopy with biopsy | 0 | $180 | |||
| 31511 | Remove foreign body, larynx | 0 | $228 | |||
| 31512 | Removal of larynx lesion | 0 | $287 | |||
| 31513 | Injection into vocal cord | 0 | $396 | |||
| 31515 | Laryngoscopy for Aspiration | 0 | $217 | |||
| 31520 | Diagnostic laryngoscopy | 0 | $311 | |||
| 31525 | Diagnostic laryngoscopy | 0 | $358 | |||
| 31526 | Diagnostic laryngoscopy | 0 | $442 | |||
| 31527 | Laryngoscopy for treatment | 0 | $465 | |||
| 31528 | Laryngoscopy and dilatation | 0 | $378 | |||
| 31529 | Laryngoscopy and dilatation | 0 | $382 | |||
| 31530 | Operative laryngoscopy | 0 | $525 | |||
| 31531 | Operative laryngoscopy | 0 | $671 | |||
| 31535 | Operative laryngoscopy | 0 | $539 | |||
| 31536 | Operative laryngoscopy | 0 | $619 | |||
| 31540 | Operative laryngoscopy | 0 | $711 | |||
| 31541 | Operative laryngoscopy | 0 | $737 | |||
| 31545 | Remove vc lesion w/scope | $776 | ||||
| 31546 | Remove vc lesion scope/graft | $1,179 | ||||
| 31560 | Operative laryngoscopy | 0 | $777 | |||
| 31561 | Operative laryngoscopy | 0 | $1,044 | |||
| 31570 | Laryngoscopy with injection | 0 | $690 | |||
| 31571 | Laryngoscopy with injection | 0 | $702 | |||
| 31575 | Diagnostic laryngoscopy | 0 | $201 | |||
| 31576 | Laryngoscopy with biopsy | 0 | $357 | |||
| 31577 | Remove foreign body, larynx | 0 | $440 | |||
| 31578 | Removal of larynx lesion | 0 | $531 | |||
| 31579 | Diagnostic laryngoscopy. | 0 | $346 | |||
| 31580 | Revision of larynx | 90 | $1,911 | |||
| 31582 | Revision of larynx | 90 | BR | |||
| 31584 | Repair of larynx fracture | 90 | $2,305 | |||
| 31587 | Revision of larynx | 90 | $1,132 | |||
| 31588 | Revision of larynx | 90 | $2,430 | |||
| 31590 | Reinnervate larynx | 90 | $1,904 | |||
| 31595 | Larynx nerve surgery | 90 | $1,074 | |||
| 31599 | Larynx surgery procedure | BR | ||||
| 31600 | Incision of windpipe | 0 | $588 | |||
| 31601 | Incision of windpipe | 0 | $719 | |||
| 31603 | Incision of windpipe | 0 | $641 | |||
| 31605 | Incision of windpipe | 0 | $586 | |||
| 31610 | Incision of windpipe | 90 | $1,095 | |||
| 31611 | Surgery/speech prosthesis | 90 | $1,020 | |||
| 31612 | Puncture/clear windpipe | 0 | $161 | |||
| 31613 | Repair windpipe opening | 90 | $476 | |||
| 31614 | Repair windpipe opening | 90 | $962 | |||
| 31615 | Visualization of windpipe | 0 | $301 | |||
| 31620 | Endobronchial us add-on | $574 | $139 | |||
| 31622 | Dx bronchoscope/wash.. | 0 | $435 | |||
| 31623 | Dx bronchoscope/brush | 0 | $465 | |||
| 31624 | Dx bronchoscope/lavage | 0 | $468 | |||
| 31625 | Bronchoscopy with biopsy | 0 | $535 | |||
| 31626 | Bronchoscopy w/markers | $928 | $425 | |||
| 31627 | Navigational bronchoscopy | $2,700 | $196 | |||
| 31628 | Bronchoscopy with biopsy | 0 | $642 | |||
| 31629 | Bronchoscopy with biopsy | 0 | $568 | |||
| 31630 | Bronchoscopy with repair | 0 | $570 | |||
| 31631 | Bronchoscopy with dilation | 0 | $623 | |||
| 31632 | Bronchoscopy/lung bx addl | $148 | $102 | |||
| 31633 | Bronchoscopy/needle bx addl | $181 | $131 | |||
| 31634 | Bronch w/balloon occlusion | $4,535 | ||||
| 31634 | Bronch w/balloon occlusion | $4,534 | $443 | |||
| 31635 | Remove foreign body, airway | 0 | $619 | |||
| 31636 | Bronchoscopy bronch stents | $469 | ||||
| 31637 | Bronchoscopy stent add-on | $159 | ||||
| 31638 | Bronchoscopy revise stent | $540 | ||||
| 31640 | Bronchoscopy & remove lesion | 0 | $753 | |||
| 31641 | Bronchoscopy, treat blockage | 0 | $928 | |||
| 31643 | Diag bronchoscope/catheter | 0 | $498 | |||
| 31645 | Bronchoscopy, clear airways | 0 | $502 | |||
| 31646 | Bronchoscopy,reclear airways | 0 | $428 | |||
| 31656 | Bronchoscopy, inject for X-ray | 0 | $393 | |||
| 31715 | Injection for bronchus x-ray | 0 | $116 | |||
| 31717 | Bronchial brush biopsy | 0 | $206 | |||
| 31720 | Clearance of airways.. | 0 | $155 | |||
| 31725 | Clearance of airways | 0 | $250 | |||
| 31730 | Intro windpipe wire/tube | 0 | $393 | |||
| 31750 | Repair of windpipe | 90 | $1,347 | |||
| 31755 | Repair of windpipe | 90 | $3,686 | |||
| 31760 | Repair of windpipe | 90 | $2,432 | |||
| 31766 | Reconstruction of windpipe | 90 | $3,421 | |||
| 31770 | Repair/graft of bronchus | 90 | $2,712 | |||
| 31775 | Reconstruct bronchus | 90 | $2,863 | |||
| 31780 | Reconstruct windpipe | 90 | $2,516 | |||
| 31781 | Reconstruct windpipe | 90 | $2,905 | |||
| 31785 | Remove windpipe lesion | 90 | $1,857 | |||
| 31786 | Remove windpipe lesion | 90 | $2,695 | |||
| 31800 | Repair of windpipe injury | 90 | $1,023 | |||
| 31805 | Repair of windpipe injury | 90 | $1,687 | |||
| 31820 | Closure of windpipe lesion | 90 | $577 | |||
| 31825 | Repair of windpipe defect | 90 | $843 | |||
| 31830 | Revise windpipe scar | 90 | $591 | |||
| 31899 | Airways surgical procedure | BR | ||||
| 32035 | Exploration of chest | 90 | $1,031 | |||
| 32036 | Exploration of chest | 90 | $1,133 | |||
| 32096 | Open wedge/bx lung infiltr | $1,703 | ||||
| 32097 | Open wedge/bx lung nodule | $1,703 | ||||
| 32098 | Open biopsy of lung pleura | $1,601 | ||||
| 32100 | Exploration/biopsy of chest | 90 | $1,657 | |||
| 32110 | Explore/repair chest | 90 | $1,790 | |||
| 32120 | Re-exploration of chest | 90 | $1,473 | |||
| 32124 | Explore chest, free adhesions | 90 | $1,704 | |||
| 32140 | Removal of lung lesion(s) | 90 | $1,907 | |||
| 32141 | Remove/treat lung lesions | 90 | $1,989 | |||
| 32150 | Removal of lung lesion(s) | 90 | $1,754 | |||
| 32151 | Remove lung foreign body | 90 | $1,624 | |||
| 32160 | Open chest heart massage | 90 | $1,273 | |||
| 32200 | Drain, open, lung lesion | 90 | $1,760 | |||
| 32201 | Drain, percut, lung lesion | 0 | $653 | |||
| 32215 | Treat chest lining | 90 | $1,342 | |||
| 32220 | Release of lung | 90 | $2,580 | |||
| 32225 | Partial release of lung | 90 | $1,856 | |||
| 32310 | Removal of chest lining | 90 | $1,945 | |||
| 32320 | Free/remove chest lining | 90 | $2,877 | |||
| 32400 | Needle biopsy chest lining | 0 | $238 | |||
| 32405 | Biopsy, lung or mediastinum | 0 | $299 | |||
| 32420 | Puncture/clear lung | 0 | $270 | |||
| 32421 | Thoracentesis for aspiration | $308 | $155 | |||
| 32422 | Thoracentesis w/tube insert | $391 | $249 | |||
| 32440 | Removal of lung | 90 | $2,921 | |||
| 32442 | Sleeve pneumonectomy | 90 | $3,265 | |||
| 32445 | Removal of lung | 90 | $3,377 | |||
| 32480 | Partial removal of lung | 90 | $2,635 | |||
| 32482 | Bilobectomy | 90 | $2,756 | |||
| 32484 | Segmentectomy | 90 | $2,825 | |||
| 32486 | Sleeve lobectomy | 90 | $3,010 | |||
| 32488 | Completion pneumonectomy | 90 | $3,229 | |||
| 32491 | Lung volume reduction | 90 | $2,823 | |||
| 32501 | Repair bronchus add-on | $642 | ||||
| 32503 | Resect apical lung tumor | $3,845 | ||||
| 32504 | Resect apical lung tum/chest | $4,313 | ||||
| 32505 | Wedge resect of lung initial | $1,965 | ||||
| 32506 | Wedge resect of lung add-on | $332 | ||||
| 32507 | Wedge resect of lung diag | $332 | ||||
| 32520 | Remove lung & revise chest | 90 | $3,116 | |||
| 32522 | Remove lung & revise chest | 90 | $3,400 | |||
| 32525 | Remove lung & revise chest | 90 | $3,712 | |||
| 32540 | Removal of lung lesion | 90 | $1,914 | |||
| 32550 | Insert pleural cath | $1,624 | $461 | |||
| 32551 | Insertion of chest tube | $354 | ||||
| 32552 | Remove lung catheter | $396 | $344 | |||
| 32553 | Ins mark thor for rt perq | $1,209 | $428 | |||
| 32560 | Treat pleurodesis w/agent | $507 | $163 | |||
| 32561 | Lyse chest fibrin init day | $194 | $146 | |||
| 32562 | Lyse chest fibrin subq day | $175 | $131 | |||
| 32601 | Thoracoscopy, diagnostic | 0 | $673 | |||
| 32604 | Thoracoscopy, diagnostic | 0 | $941 | |||
| 32606 | Thoracoscopy, diagnostic | 0 | $914 | |||
| 32607 | Thoracoscopy w/bx infiltrate | $653 | ||||
| 32608 | Thoracoscopy w/bx nodule | $802 | ||||
| 32609 | Thoracoscopy w/bx pleura | $554 | ||||
| 32653 | Thoracoscopy, surgical | 90 | $1,754 | |||
| 32654 | Thoracoscopy, surgical | 90 | $1,790 | |||
| 32655 | Thoracoscopy, surgical | 90 | $2,009 | |||
| 32656 | Thoracoscopy, surgical | 90 | $1,970 | |||
| 32657 | Thoracoscopy, surgical | 90 | $2,063 | |||
| 32658 | Thoracoscopy, surgical | 90 | $1,902 | |||
| 32659 | Thoracoscopy, surgical | 90 | $1,946 | |||
| 32661 | Thoracoscopy, surgical | 90 | $1,658 | |||
| 32662 | Thoracoscopy, surgical | 90 | $2,340 | |||
| 32663 | Thoracoscopy, surgical | 90 | $2,677 | |||
| 32664 | Thoracoscopy, surgical | 90 | $1,858 | |||
| 32665 | Thoracoscopy, surgical | 90 | $2,244 | |||
| 32666 | Thoracoscopy w/wedge resect | $1,837 | ||||
| 32667 | Thoracoscopy w/w resect addl | $332 | ||||
| 32668 | Thoracoscopy w/w resect diag | $334 | ||||
| 32669 | Thoracoscopy remove segment | $2,831 | ||||
| 32670 | Thoracoscopy bilobectomy | $3,379 | ||||
| 32671 | Thoracoscopy pneumonectomy | $3,751 | ||||
| 32672 | Thoracoscopy for lvrs | $3,208 | ||||
| 32673 | Thoracoscopy w/thymus resect | $2,530 | ||||
| 32674 | Thoracoscopy lymph node exc | $455 | ||||
| 32900 | Removal of rib(s) | 90 | $1,999 | |||
| 32905 | Revise & repair chest wall | 90 | $2,441 | |||
| 32906 | Revise & repair chest wall | 90 | $3,080 | |||
| 32940 | Revision of lung | 90 | $2,213 | |||
| 32960 | Therapeutic pneumothorax | 0 | $206 | |||
| 32997 | Total lung lavage..... | 0 | $741 | |||
| 32998 | Perq rf ablate tx pul tumor | $5,948 | ||||
| 32999 | Chest surgery procedure | BR | ||||
| 33010 | Drainage of heart sac | 0 | $278 | |||
| 33011 | Repeat drainage of heart sac | 0 | $245 | |||
| 33015 | Incision of heart sac | 90 | $745 | |||
| 33020 | Incision of heart sac | 90 | $1,902 | |||
| 33025 | Incision of heart sac | 90 | $1,946 | |||
| 33030 | Partial removal of heart sac | 90 | $2,985 | |||
| 33031 | Partial removal of heart sac | 90 | $2,506 | |||
| 33050 | Removal of heart sac lesion | 90 | $1,658 | |||
| 33120 | Removal of heart lesion | 90 | $4,009 | |||
| 33130 | Removal of heart lesion | 90 | $2,495 | |||
| 33140 | Heart revascularize (tmr) | 90 | $3,348 | |||
| 33141 | Heart tmr w/other procedure | $280 | ||||
| 33202 | Insert epicard eltrd open | $1,635 | ||||
| 33203 | Insert epicard eltrd endo | $1,686 | ||||
| 33206 | Insertion of heart pacemaker | 90 | $1,101 | |||
| 33207 | Insertion of heart pacemaker | 90 | $1,247 | |||
| 33208 | Insertion of heart pacemaker | 90 | $1,377 | |||
| 33210 | Insertion of heart electrode | 0 | $487 | |||
| 33211 | Insertion of heart electrode | 0 | $494 | |||
| 33212 | Insertion of pulse generator | 90 | $812 | |||
| 33213 | Insertion of pulse generator | 90 | $879 | |||
| 33214 | Upgrade of pacemaker system | 90 | $983 | |||
| 33215 | Reposition pacing-defib lead | 90 | $619 | |||
| 33216 | Revise eltrd pacing- defib | 90 | $769 | |||
| 33217 | Revise eltrd pacing- defib | 90 | $806 | |||
| 33218 | Revise eltrd pacing- defib | 90 | $748 | |||
| 33220 | Revise eltrd pacing- defib | 90 | $760 | |||
| 33221 | Insert pulse gen mult leads | $739 | ||||
| 33222 | Pacemaker aicd pocket | 90 | $800 | |||
| 33223 | Revise pocket, pacing-defib | 90 | $928 | |||
| 33224 | Insert pacing lead & connect | $1,034 | ||||
| 33225 | L ventric pacing lead add-on | $928 | ||||
| 33226 | Reposition l ventric lead | $995 | ||||
| 33227 | Remove&replace pm gen singl | $705 | ||||
| 33228 | Remv&replc pm gen dual lead | $735 | ||||
| 33229 | Remv&replc pm gen mult leads | $766 | ||||
| 33230 | Insrt pulse gen w/dual leads | $795 | ||||
| 33231 | Insrt pulse gen w/mult leads | $825 | ||||
| 33233 | Removal of pacemaker system | 90 | $440 | |||
| 33234 | Removal of pacemaker system | 90 | $814 | |||
| 33235 | Removal pacemaker electrode | 90 | $960 | |||
| 33236 | Remove electrode/thoracotomy | 90 | $1,155 | |||
| 33237 | Removeelectrode/thoracotomy | 90 | $1,680 | |||
| 33238 | Remove electrode/thoracotomy | 90 | $1,872 | |||
| 33240 | Insert pulse generator | 90 | $986 | |||
| 33241 | Remove pulse generator | 90 | $436 | |||
| 33243 | Remove eltrd/ thoracotomy | 90 | $2,408 | |||
| 33244 | Remove eltrd, transven | 90 | $1,333 | |||
| 33249 | Eltrd/insert pace- defib | 90 | $2,100 | |||
| 33250 | Ablate heart dysrhythm focus | 90 | $2,263 | |||
| 33251 | Ablate heart dysrhythm focus | 90 | $2,987 | |||
| 33254 | Ablate atria lmtd | $2,902 | ||||
| 33255 | Ablate atria w/o bypass ext | $3,473 | ||||
| 33256 | Ablate atria w/bypass exten | $4,150 | ||||
| 33257 | Ablate atria lmtd add-on | $1,237 | ||||
| 33258 | Ablate atria x10sv add-on | $1,387 | ||||
| 33259 | Ablate atria w/bypass add-on | $1,796 | ||||
| 33261 | Ablate heart dysrhythm focus | 90 | $3,134 | |||
| 33262 | Remv&replc cvd gen sing lead | $766 | ||||
| 33263 | Remv&replc cvd gen dual lead | $797 | ||||
| 33264 | Remv&replc cvd gen mult lead | $827 | ||||
| 33265 | Ablate atria lmtd endo | $2,870 | ||||
| 33266 | Ablate atria x10sv endo | $3,914 | ||||
| 33282 | Implant pat-active ht record | 90 | $650 | |||
| 33284 | Remove pat-active ht record | 90 | $465 | |||
| 33300 | Repair of heart wound | 90 | $2,347 | |||
| 33305 | Repair of heart wound | 90 | $2,809 | |||
| 33310 | Exploratory heart surgery | 90 | $2,147 | |||
| 33315 | Exploratory heart surgery | 90 | $2,633 | |||
| 33320 | Repair major blood vessel(s) | 90 | $2,382 | |||
| 33321 | Repair major vessel | 90 | $3,087 | |||
| 33322 | Repair major blood vessel(s) | 90 | $3,097 | |||
| 33330 | Insert major vessel graft | 90 | $2,651 | |||
| 33332 | Insert major vessel graft | 90 | $2,797 | |||
| 33335 | Insert major vessel graft | 90 | $3,195 | |||
| 33400 | Repair of aortic valve | 90 | $3,695 | |||
| 33401 | Valvuloplasty, open | 90 | $2,971 | |||
| 33403 | Valvuloplasty, w/cp bypass | 90 | $3,100 | |||
| 33404 | Prepare heart-aorta conduit | 90 | $3,522 | |||
| 33405 | Replacement of aortic valve | 90 | $4,607 | |||
| 33406 | Replacement, aortic valve | 90 | $4,746 | |||
| 33410 | Replacement of aortic valve | 90 | $5,396 | |||
| 33411 | Replacement of aortic valve | 90 | $5,413 | |||
| 33412 | Replacement of aortic valve | 90 | $4,217 | |||
| 33413 | Replacement, aortic valve | 90 | $4,521 | |||
| 33414 | Repair, aortic valve | 90 | $3,874 | |||
| 33415 | Revision, subvalvular tissue | 90 | $3,262 | |||
| 33416 | Revise ventricle muscle | 90 | $4,341 | |||
| 33417 | Repair of aortic valve | 90 | $3,521 | |||
| 33420 | Revision of mitral valve | 90 | $3,041 | |||
| 33422 | Revision of mitral valve | 90 | $4,387 | |||
| 33425 | Repair of mitral valve | 90 | $4,407 | |||
| 33426 | Repair of mitral valve | 90 | $4,518 | |||
| 33427 | Repair of mitral valve | 90 | $5,173 | |||
| 33430 | Replacement of mitral valve | 90 | $4,982 | |||
| 33460 | Revision of tricuspid valve | 90 | $3,709 | |||
| 33463 | Valvuloplasty, tricuspid | 90 | $3,197 | |||
| 33464 | Valvuloplasty, tricuspid | 90 | $3,423 | |||
| 33465 | Replace tricuspid valve | 90 | $4,615 | |||
| 33468 | Revision of tricuspid valve | 90 | $3,664 | |||
| 33470 | Revision of pulmonary valve | 90 | $2,610 | |||
| 33471 | Valvotomy, pulmonary valve | 90 | $2,797 | |||
| 33472 | Revision of pulmonary valve | 90 | $2,865 | |||
| 33474 | Revision of pulmonary valve | 90 | $2,539 | |||
| 33475 | Replacement, pulmonary valve | 90 | $3,617 | |||
| 33476 | Revision of heart chamber | 90 | $3,237 | |||
| 33478 | Revision of heart chamber | 90 | $3,345 | |||
| 33496 | Repair, prosth valve clot | 90 | $4,301 | |||
| 33500 | Repair heart vessel fistula | 90 | $2,993 | |||
| 33501 | Repair heart vessel fistula | 90 | $2,443 | |||
| 33502 | Coronary artery correction | 90 | $2,474 | |||
| 33503 | Coronary artery graft | 90 | $2,460 | |||
| 33504 | Coronary artery graft | 90 | $2,777 | |||
| 33505 | Repair artery w/tunnel | 90 | $3,357 | |||
| 33506 | Repair artery, translocation | 90 | $3,357 | |||
| 33507 | Repair art intramural | $3,634 | ||||
| 33508 | Endoscopic vein harvest | $34 | ||||
| 33510 | Cabg, vein, single | 90 | $4,109 | |||
| 33511 | Cabg, vein, two | 90 | $4,510 | |||
| 33512 | Cabg, vein, three | 90 | $4,912 | |||
| 33513 | Cabg, vein, four | 90 | $5,312 | |||
| 33514 | Cabg, vein, five | 90 | $5,713 | |||
| 33516 | Cabg, vein, six+ | 90 | $6,114 | |||
| 33517 | Cabg, artery-vein, single | $402 | ||||
| 33518 | Cabg, artery-vein, two | $803 | ||||
| 33519 | Cabg, artery-vein, three | $1,204 | ||||
| 33521 | Cabg, artery-vein, four | $1,605 | ||||
| 33522 | Cabg, artery-vein, five | $2,007 | ||||
| 33523 | Cabg, artery-vein, six+ | $2,408 | ||||
| 33530 | Coronary artery, bypass/reop | $1,305 | ||||
| 33533 | Cabg, arterial, single | 90 | $4,234 | |||
| 33534 | Cabg, arterial, two | 90 | $4,761 | |||
| 33535 | Cabg, arterial, three | 90 | $5,288 | |||
| 33536 | Cabg, arterial, four+ | 90 | $5,815 | |||
| 33542 | Removal of heart lesion | 90 | $4,448 | |||
| 33545 | Repair of heart damage | 90 | $5,320 | |||
| 33548 | Restore/remodel ventricle | $6,318 | ||||
| 33572 | Open coronary endarterectomy | $582 | ||||
| 33600 | Closure of valve | 90 | $3,746 | |||
| 33602 | Closure of valve | 90 | $3,617 | |||
| 33606 | Anastomosis/artery-aorta | 90 | $3,874 | |||
| 33608 | Repair anomaly w/conduit | 90 | $3,972 | |||
| 33610 | Repair by enlargement | 90 | $3,874 | |||
| 33611 | Repair double ventricle | 90 | $4,133 | |||
| 33612 | Repair double ventricle | 90 | $4,243 | |||
| 33615 | Repair (simple fontan) | 90 | $4,035 | |||
| 33617 | Repair by modified fontan | 90 | $4,262 | |||
| 33619 | Repair single ventricle | 90 | $4,682 | |||
| 33620 | Apply r&l pulm art bands | $3,513 | ||||
| 33621 | Transthor cath for stent | $1,888 | ||||
| 33622 | Redo compl cardiac anomaly | $7,398 | ||||
| 33641 | Repair heart septum defect | 90 | $3,574 | |||
| 33645 | Revision of heart veins | 90 | $2,978 | |||
| 33647 | Repair heart septum defects | 90 | $3,868 | |||
| 33660 | Repair of heart defects | 90 | $3,739 | |||
| 33665 | Repair of heart defects | 90 | $4,074 | |||
| 33670 | Repair of heart chambers | 90 | $4,208 | |||
| 33675 | Close mult vsd | $4,197 | ||||
| 33676 | Close mult vsd w/resection | $4,483 | ||||
| 33677 | Cl mult vsd w/rem pul band | $4,659 | ||||
| 33681 | Repair heart septum defect | 90 | $3,891 | |||
| 33684 | Repair heart septum defect | 90 | $4,029 | |||
| 33688 | Repair heart septum defect | 90 | $4,018 | |||
| 33690 | Reinforce pulmonary artery | 90 | $2,531 | |||
| 33692 | Repair of heart defects | 90 | $3,874 | |||
| 33694 | Repair of heart defects | 90 | $4,153 | |||
| 33697 | Repair of heart defects. | 90 | $5,344 | |||
| 33702 | Repair of heart defects | 90 | $3,269 | |||
| 33710 | Repair of heart defects | 90 | $4,327 | |||
| 33720 | Repair of heart defect | 90 | $3,269 | |||
| 33722 | Repair of heart defect | 90 | $3,617 | |||
| 33724 | Repair venous anomaly | $3,253 | ||||
| 33726 | Repair pul venous stenosis | $4,343 | ||||
| 33730 | Repair heart-vein defect(s) | 90 | $4,343 | |||
| 33732 | Repair heart-vein defect | 90 | $3,584 | |||
| 33735 | Revision of heart chamber | 90 | $2,706 | |||
| 33736 | Revision of heart chamber | 90 | $2,643 | |||
| 33737 | Revision of heart chamber | 90 | $2,813 | |||
| 33750 | Major vessel shunt | 90 | $2,841 | |||
| 33755 | Major vessel shunt | 90 | $2,825 | |||
| 33762 | Major vessel shunt | 90 | $2,879 | |||
| 33764 | Major vessel shunt and graft | 90 | $2,754 | |||
| 33766 | Major vessel shunt | 90 | $2,842 | |||
| 33767 | Atrial septectomy/septostomy | 90 | $3,100 | |||
| 33768 | Cavopulmonary shunting | $930 | ||||
| 33770 | Repair great vessels defect | 90 | $4,229 | |||
| 33771 | Repair great vessels defect | 90 | $4,392 | |||
| 33774 | Repair great vessels defect | 90 | $3,836 | |||
| 33775 | Repair great vessels defect | 90 | $4,076 | |||
| 33776 | Repair great vessels defect | 90 | $4,306 | |||
| 33777 | Repair great vessels defect | 90 | $4,175 | |||
| 33778 | Repair great vessels defect | 90 | $5,008 | |||
| 33779 | Repair great vessels defect | 90 | $5,173 | |||
| 33780 | Repair great vessels defect | 90 | $5,263 | |||
| 33781 | Repair great vessels defect | 90 | $4,933 | |||
| 33782 | Nikaidoh proc | $6,807 | ||||
| 33783 | Nikaidoh proc w/ostia implt | $7,371 | ||||
| 33786 | Repair arterial trunk | 90 | $4,933 | |||
| 33788 | Revision of pulmonary | 90 | $3,261 | |||
| 33800 | Aortic suspension | 90 | $2,009 | |||
| 33802 | Repair vessel defect | 90 | $2,312 | |||
| 33803 | Repair vessel defect | 90 | $2,565 | |||
| 33813 | Repair septal defect | 90 | $2,622 | |||
| 33814 | Repair septal defect | 90 | $3,417 | |||
| 33820 | Revise major vessel | 90 | $2,062 | |||
| 33822 | Revise major vessel | 90 | $2,236 | |||
| 33824 | Revise major vessel | 90 | $2,489 | |||
| 33840 | Remove aorta constriction | 90 | $2,705 | |||
| 33845 | Remove aorta constriction | 90 | $2,844 | |||
| 33851 | Remove aorta constriction | 90 | $2,854 | |||
| 33852 | Repair septal defect | 90 | $2,938 | |||
| 33853 | Repair septal defect | 90 | $4,004 | |||
| 33860 | Ascending aorta graft | 90 | $5,106 | |||
| 33863 | Ascending aorta graft | 90 | $5,382 | |||
| 33864 | Ascending aortic graft | $6,833 | ||||
| 33870 | Transverse aortic arch graft | 90 | $6,376 | |||
| 33875 | Thoracic aorta graft | 90 | $4,515 | |||
| 33877 | Thoracoabdominal graft | 90 | $6,567 | |||
| 33880 | Endovasc taa repr incl subcl | $3,852 | ||||
| 33881 | Endovasc taa repr w/o subcl | $3,319 | ||||
| 33884 | Endovasc prosth taa add-on | $879 | ||||
| 33886 | Endovasc prosth delayed | $2,087 | ||||
| 33889 | Artery transpose/endovas taa | $1,715 | ||||
| 33910 | Remove lung artery emboli | 90 | $2,780 | |||
| 33915 | Remove lung artery emboli | 90 | $2,341 | |||
| 33916 | Surgery of great vessel | 90 | $3,198 | |||
| 33917 | Repair pulmonary artery | 90 | $3,100 | |||
| 33920 | Repair pulmonary atresia | 90 | $4,067 | |||
| 33922 | Transect pulmonary artery | 90 | $2,971 | |||
| 33924 | Remove pulmonary shunt | $700 | ||||
| 33925 | Rpr pul art unifocal w/o cpb | $3,622 | ||||
| 33926 | Repr pul art unifocal w/cpb | $5,187 | ||||
| 33930 | Removal of donorheart/lung | BR | ||||
| 33935 | Transplantation, heart/lung | 90 | $10,589 | |||
| 33940 | Removal of donor heart | BR | ||||
| 33945 | Transplantation of heart | 90 | BR | |||
| 33960 | External circulation assist | $1,934 | ||||
| 33961 | External circulation assist. | $1,378 | ||||
| 33967 | Insert ia percut device | $539 | ||||
| 33968 | Remove aortic assist device | 90 | $71 | |||
| 33970 | Aortic circulation assist | 0 | $1,174 | |||
| 33971 | Aortic circulation assist | 90 | $717 | |||
| 33973 | Insert balloon device | 0 | $1,295 | |||
| 33974 | Remove intra-aortic balloon | 90 | $1,356 | |||
| 33975 | Implant ventricular device | $2,583 | ||||
| 33976 | Implant ventricular device | $3,519 | ||||
| 33977 | Remove ventricular device | 90 | $2,260 | |||
| 33978 | Remove ventricular device | 90 | $2,583 | |||
| 33979 | Insert intracorporeal device | $4,139 | ||||
| 33980 | Remove intracorporeal device | $3,791 | ||||
| 33981 | Replace vad pump ext | $1,784 | ||||
| 33982 | Replace vad intra w/o bp | $4,175 | ||||
| 33983 | Replace vad intra w/bp | $4,902 | ||||
| 33999 | Cardiac surgery procedure | BR | ||||
| 34001 | Removal of artery clot | 90 | $1,638 | |||
| 34051 | Removal of artery clot | 90 | $1,701 | |||
| 34101 | Removal of artery clot | 90 | $1,330 | |||
| 34111 | Removal of arm artery clot | 90 | $1,158 | |||
| 34151 | Removal of artery clot | 90 | $2,094 | |||
| 34201 | Removal of artery clot | 90 | $1,326 | |||
| 34203 | Removal of leg artery clot | 90 | $1,516 | |||
| 34401 | Removal of vein clot | 90 | $1,494 | |||
| 34421 | Removal of vein clot | 90 | $1,264 | |||
| 34451 | Removal of vein clot | 90 | $1,838 | |||
| 34471 | Removal of vein clot | 90 | $934 | |||
| 34490 | Removal of vein clot | 90 | $1,085 | |||
| 34501 | Repair valve, femoral vein | 90 | $1,947 | |||
| 34502 | Reconstruct, vena cava | 90 | $3,394 | |||
| 34510 | Transposition of vein valve | 90 | $2,493 | |||
| 34520 | Cross-over vein graft | 90 | $1,046 | |||
| 34530 | Leg vein fusion | 90 | $1,502 | |||
| 34800 | Endovas aaa repr w/sm tube | $2,424 | ||||
| 34802 | Endovas aaa repr w/2-p part | $2,684 | ||||
| 34803 | Endovas aaa repr w/3-p part | $2,766 | ||||
| 34804 | Endovas aaa repr w/1-p part | $2,684 | ||||
| 34805 | Endovas aaa repr w/long tube | $2,573 | ||||
| 34806 | Aneurysm press sensor add-on | $220 | ||||
| 34808 | Endovas iliac a device addon | $442 | ||||
| 34812 | Xpose for endoprosth femorl | $727 | ||||
| 34813 | Femoral endovas graft add-on | $511 | ||||
| 34820 | Xpose for endoprosth iliac | $1,046 | ||||
| 34825 | Endovasc extend prosth init | $1,502 | ||||
| 34826 | Endovasc exten prosth addl | $441 | ||||
| 34830 | Open aortic tube prosth repr | $3,839 | ||||
| 34831 | Open aortoiliac prosth repr | $4,128 | ||||
| 34832 | Open aortofemor prosth repr | $4,128 | ||||
| 34833 | Xpose for endoprosth iliac | $1,312 | ||||
| 34834 | Xpose endoprosth brachial | $591 | ||||
| 34900 | Endovasc iliac repr w/graft | $1,917 | ||||
| 35001 | Repair defect of artery | 90 | $2,625 | |||
| 35002 | Repair artery rupture, neck | 90 | $2,441 | |||
| 35005 | Repair defect of artery | 90 | $2,123 | |||
| 35011 | Repair defect of artery | 90 | $1,803 | |||
| 35013 | Repair artery rupture, arm | 90 | $2,385 | |||
| 35021 | Repair defect of artery | 90 | $2,763 | |||
| 35022 | Repair artery rupture, chest | 90 | $2,742 | |||
| 35045 | Repair defect of arm artery | 90 | $1,737 | |||
| 35081 | Repair defect of artery | 90 | $3,651 | |||
| 35082 | Repair artery rupture, aorta | 90 | $3,986 | |||
| 35091 | Repair defect of artery | 90 | $4,299 | |||
| 35092 | Repair artery rupture, aorta | 90 | $4,781 | |||
| 35102 | Repair defect of artery | 90 | $3,912 | |||
| 35103 | Repair artery rupture, groin | 90 | $4,437 | |||
| 35111 | Repair defect of artery | 90 | $2,514 | |||
| 35112 | Repair artery rupture, | 90 | $2,127 | |||
| 35121 | Repair defect of artery | 90 | $3,334 | |||
| 35122 | Repair artery rupture, belly | 90 | $3,820 | |||
| 35131 | Repair defect of artery | 90 | $2,553 | |||
| 35132 | Repair artery rupture, groin | 90 | $3,020 | |||
| 35141 | Repair defect of artery | 90 | $2,146 | |||
| 35142 | Repair artery rupture, thigh | 90 | $2,404 | |||
| 35151 | Repair defect of artery | 90 | $2,393 | |||
| 35152 | Repair artery rupture, knee | 90 | $1,888 | |||
| 35180 | Repair blood vessel lesion | 90 | $1,488 | |||
| 35182 | Repair blood vessel lesion | 90 | $2,009 | |||
| 35184 | Repair blood vessel lesion | 90 | $1,592 | |||
| 35188 | Repair blood vessel lesion | 90 | $1,615 | |||
| 35189 | Repair blood vessel lesion | 90 | $2,170 | |||
| 35190 | Repair blood vessel lesion | 90 | $1,718 | |||
| 35201 | Repair blood vessel lesion | 90 | $1,480 | |||
| 35206 | Repair blood vessel lesion | 90 | $1,463 | |||
| 35207 | Repair blood vessel lesion | 90 | $1,543 | |||
| 35211 | Repair blood vessel lesion | 90 | $2,557 | |||
| 35216 | Repair blood vessel lesion | 90 | $2,115 | |||
| 35221 | Repair blood vessel lesion | 90 | $2,010 | |||
| 35226 | Repair blood vessel lesion | 90 | $1,444 | |||
| 35231 | Repair blood vessel lesion | 90 | $2,009 | |||
| 35236 | Repair blood vessel lesion | 90 | $1,697 | |||
| 35241 | Repair blood vessel lesion | 90 | $2,637 | |||
| 35246 | Repair blood vessel lesion | 90 | $2,636 | |||
| 35251 | Repair blood vessel lesion | 90 | $1,953 | |||
| 35256 | Repair blood vessel lesion | 90 | $1,765 | |||
| 35261 | Repair blood vessel lesion | 90 | $1,856 | |||
| 35266 | Repair blood vessel lesion | 90 | $1,633 | |||
| 35271 | Repair blood vessel lesion | 90 | $2,495 | |||
| 35276 | Repair blood vessel lesion | 90 | $2,140 | |||
| 35286 | Repair blood vessel lesion | 90 | $1,757 | |||
| 35301 | Rechanneling of artery | 90 | $2,352 | |||
| 35302 | Rechanneling of artery | $2,457 | ||||
| 35303 | Rechanneling of artery | $2,704 | ||||
| 35304 | Rechanneling of artery | $2,779 | ||||
| 35305 | Rechanneling of artery | $2,684 | ||||
| 35306 | Rechanneling of artery | $971 | ||||
| 35311 | Rechanneling of artery | 90 | $3,489 | |||
| 35321 | Rechanneling of artery | 90 | $1,892 | |||
| 35331 | Rechanneling of artery | 90 | $2,701 | |||
| 35341 | Rechanneling of artery | 90 | $3,155 | |||
| 35351 | Rechanneling of artery | 90 | $2,624 | |||
| 35355 | Rechanneling of artery | 90 | $2,373 | |||
| 35361 | Rechanneling of artery | 90 | $3,214 | |||
| 35363 | Rechanneling of artery | 90 | $3,563 | |||
| 35371 | Rechanneling of artery | 90 | $1,806 | |||
| 35372 | Rechanneling of artery | 90 | $1,824 | |||
| 35381 | Rechanneling of artery | 90 | $2,186 | |||
| 35390 | Reoperation, carotid add-on | $366 | ||||
| 35400 | Angioscopy............ | $378 | ||||
| 35450 | Repair arterial blockage | 0 | $1,723 | |||
| 35452 | Repair arterial blockage | 0 | $841 | |||
| 35458 | Repair arterial blockage | 0 | $1,424 | |||
| 35460 | Repair venous blockage | 0 | $705 | |||
| 35471 | Repair arterial blockage | 0 | $1,723 | |||
| 35472 | Repair arterial blockage | 0 | $805 | |||
| 35475 | Repair arterial blockage | 0 | $1,424 | |||
| 35476 | Repair venous blockage | 0 | $705 | |||
| 35500 | Harvest vein for bypass | $693 | ||||
| 35501 | Artery bypass graft | 90 | $2,908 | |||
| 35506 | Artery bypass graft | 90 | $2,905 | |||
| 35508 | Artery bypass graft | 90 | $2,743 | |||
| 35509 | Artery bypass graft | 90 | $2,798 | |||
| 35510 | Artery bypass graft | $2,681 | ||||
| 35511 | Artery bypass graft | 90 | $1,962 | |||
| 35512 | Artery bypass graft | $2,630 | ||||
| 35515 | Artery bypass graft | 90 | $2,157 | |||
| 35516 | Artery bypass graft | 90 | $2,534 | |||
| 35518 | Artery bypass graft | 90 | $2,471 | |||
| 35521 | Artery bypass graft | 90 | $2,525 | |||
| 35522 | Artery bypass graft | $2,551 | ||||
| 35523 | Artery bypass graft | $2,776 | ||||
| 35526 | Artery bypass graft | 90 | $2,408 | |||
| 35531 | Artery bypass graft | 90 | $3,421 | |||
| 35533 | Artery bypass graft | 90 | $3,158 | |||
| 35535 | Artery bypass graft | $3,730 | ||||
| 35536 | Artery bypass graft | 90 | $3,341 | |||
| 35537 | Artery bypass graft | $4,543 | ||||
| 35538 | Artery bypass graft | $5,086 | ||||
| 35539 | Artery bypass graft | $4,778 | ||||
| 35540 | Artery bypass graft | $5,573 | ||||
| 35556 | Artery bypass graft | 90 | $2,682 | |||
| 35558 | Artery bypass graft | 90 | $2,298 | |||
| 35560 | Artery bypass graft | 90 | $3,275 | |||
| 35563 | Artery bypass graft | 90 | $1,688 | |||
| 35565 | Artery bypass graft | 90 | $2,480 | |||
| 35566 | Artery bypass graft | 90 | $3,179 | |||
| 35570 | Artery bypass graft | $3,014 | ||||
| 35571 | Artery bypass graft | 90 | $2,824 | |||
| 35572 | Harvest femoropopliteal vein | $747 | ||||
| 35583 | Vein bypass graft | 90 | $2,870 | |||
| 35585 | Vein bypass graft | 90 | $3,301 | |||
| 35587 | Vein bypass graft | 90 | $3,024 | |||
| 35600 | Harvest art for cabg add-on | $546 | ||||
| 35601 | Artery bypass graft | 90 | $2,715 | |||
| 35606 | Artery bypass graft | 90 | $2,723 | |||
| 35612 | Artery bypass graft | 90 | $2,439 | |||
| 35616 | Artery bypass graft | 90 | $2,450 | |||
| 35621 | Artery bypass graft | 90 | $2,454 | |||
| 35623 | Bypass graft, not vein | 90 | $1,795 | |||
| 35626 | Artery bypass graft | 90 | $3,317 | |||
| 35631 | Artery bypass graft | 90 | $3,157 | |||
| 35632 | Artery bypass graft | $3,542 | ||||
| 35633 | Artery bypass graft | $3,919 | ||||
| 35634 | Artery bypass graft | $3,574 | ||||
| 35636 | Artery bypass graft... | 90 | $2,677 | |||
| 35637 | Artery bypass graft | $3,776 | ||||
| 35638 | Artery bypass graft | $3,848 | ||||
| 35642 | Artery bypass graft | 90 | $2,069 | |||
| 35645 | Artery bypass graft | 90 | $2,080 | |||
| 35646 | Artery bypass graft | 90 | $3,717 | |||
| 35647 | Artery bypass graft | $3,369 | ||||
| 35650 | Artery bypass graft | 90 | $2,359 | |||
| 35654 | Artery bypass graft | 90 | $3,125 | |||
| 35656 | Artery bypass graft | 90 | $2,491 | |||
| 35661 | Artery bypass graft | 90 | $2,165 | |||
| 35663 | Artery bypass graft | 90 | $2,373 | |||
| 35665 | Artery bypass graft | 90 | $2,507 | |||
| 35666 | Artery bypass graft | 90 | $2,833 | |||
| 35671 | Artery bypass graft | 90 | $2,484 | |||
| 35681 | Composite bypass graft | $854 | ||||
| 35682 | Composite bypass graft | $1,260 | ||||
| 35683 | Composite bypass graft | $1,360 | ||||
| 35685 | Bypass graft patency/patch | $432 | ||||
| 35686 | Bypass graft/av fist patency | $359 | ||||
| 35691 | Arterial transposition | 90 | $2,841 | |||
| 35693 | Arterial transposition | 90 | $1,792 | |||
| 35694 | Arterial transposition | 90 | $2,075 | |||
| 35695 | Arterial transposition | 90 | $2,075 | |||
| 35697 | Reimplant artery each | $321 | ||||
| 35700 | Reoperation, bypass graft | $359 | ||||
| 35701 | Exploration, carotid artery | 90 | $851 | |||
| 35721 | Exploration, femoral artery | 90 | $794 | |||
| 35741 | Exploration popliteal artery | 90 | $808 | |||
| 35761 | Exploration of artery/vein | 90 | $813 | |||
| 35800 | Explore neck vessels | 90 | $871 | |||
| 35820 | Explore chest vessels | 90 | $1,487 | |||
| 35840 | Explore abdominal vessels | 90 | $1,225 | |||
| 35860 | Explore limb vessels | 90 | $814 | |||
| 35870 | Repair vessel graft defect | 90 | $2,711 | |||
| 35875 | Removal of clot in graft | 90 | $1,369 | |||
| 35876 | Removal of clot in graft | 90 | $1,612 | |||
| 35879 | Revise graft w/vein | 90 | $2,022 | |||
| 35881 | Revise graft w/vein... | 90 | $2,231 | |||
| 35883 | Revise graft w/nonauto graft | $2,634 | ||||
| 35884 | Revise graft w/vein | $2,704 | ||||
| 35901 | Excision, graft, neck | 90 | $1,125 | |||
| 35903 | Excision, graft, extremity | 90 | $1,223 | |||
| 35905 | Excision, graft, thorax | 90 | $1,808 | |||
| 35907 | Excision, graft, abdomen | 90 | $1,864 | |||
| 36000 | Place needle in vein | $44 | ||||
| 36002 | Pseudoaneurysm injection trt | $331 | $220 | |||
| 36005 | Injection, venography | 0 | $104 | |||
| 36010 | Place catheter in vein | $343 | ||||
| 36011 | Place catheter in vein | $372 | ||||
| 36012 | Place catheter in vein | $461 | ||||
| 36013 | Place catheter in artery | $350 | ||||
| 36014 | Place catheter in artery | $395 | ||||
| 36015 | Place catheter in artery | $461 | ||||
| 36100 | Establish access to artery | $420 | ||||
| 36120 | Establish access to artery | $328 | ||||
| 36140 | Establish access to artery | $259 | ||||
| 36147 | Access av dial grft for eval | $1,800 | $387 | |||
| 36148 | Access av dial grft for proc | $554 | $102 | |||
| 36160 | Establish access to aorta | $368 | ||||
| 36200 | Place catheter in aorta | $427 | ||||
| 36215 | Place catheter in artery | $530 | ||||
| 36216 | Place catheter in artery | $626 | ||||
| 36217 | Place catheter in artery | $746 | ||||
| 36218 | Place catheter in artery. | $136 | ||||
| 36245 | Place catheter in artery | $601 | ||||
| 36246 | Place catheter in artery | $626 | ||||
| 36247 | Place catheter in artery | $746 | ||||
| 36248 | Place catheter in artery. | $136 | ||||
| 36251 | Ins cath ren art 1st unilat | $3,016 | $578 | |||
| 36252 | Ins cath ren art 1st bilat | $3,310 | $753 | |||
| 36253 | Ins cath ren art 2nd+ unilat | $4,614 | $804 | |||
| 36254 | Ins cath ren art 2nd+ bilat | $4,801 | $868 | |||
| 36260 | Insertion of infusion pump | 90 | $1,234 | |||
| 36261 | Revision of infusion pump | 90 | $544 | |||
| 36262 | Removal of infusion pump | 90 | $427 | |||
| 36299 | Vessel injection procedure | BR | ||||
| 36400 | Drawing blood | $20 | ||||
| 36405 | Drawing blood | $47 | ||||
| 36406 | Drawing blood | $25 | ||||
| 36410 | Drawing blood | $30 | ||||
| 36415 | Drawing blood | BR | ||||
| 36420 | Establish access to vein | $112 | ||||
| 36425 | Establish access to vein | $61 | ||||
| 36430 | Blood transfusion service | $73 | ||||
| 36440 | Blood transfusion service | $145 | ||||
| 36450 | Exchange transfusion service | $304 | ||||
| 36455 | Exchange transfusion service | $349 | ||||
| 36460 | Transfusion service, fetal | $748 | ||||
| 36468 | Injection(s);spider veins | BR | ||||
| 36469 | Injection(s);spider veins | BR | ||||
| 36470 | Injection therapy of vein | 10 | $94 | |||
| 36471 | Injection therapy of veins | 10 | $137 | |||
| 36475 | Endovenous rf 1st vein | $3,670 | $740 | |||
| 36476 | Endovenous rf vein add-on | $826 | $364 | |||
| 36478 | Endovenous laser 1st vein | $2,867 | $737 | |||
| 36479 | Endovenous laser vein addon | $858 | $365 | |||
| 36481 | Insertion of catheter, vein | 0 | $914 | |||
| 36500 | Insertion of catheter, vein | 0 | $256 | |||
| 36510 | Insertion of catheter, vein | 0 | $103 | |||
| 36511 | Apheresis wbc | $199 | ||||
| 36512 | Apheresis rbc | $191 | ||||
| 36513 | Apheresis platelets | $210 | ||||
| 36514 | Apheresis plasma | $1,047 | $192 | |||
| 36515 | Apheresis adsorp/reinfuse | $4,529 | $195 | |||
| 36516 | Apheresis selective | $4,112 | $144 | |||
| 36520 | Plasma and/or cell exchange | 0 | $250 | |||
| 36522 | Photopheresis | 0 | $438 | |||
| 36555 | Insert non-tunnel cv cath | $557 | $249 | |||
| 36556 | Insert non-tunnel cv cath | $485 | $252 | |||
| 36557 | Insert tunneled cv cath | $2,127 | $681 | |||
| 36558 | Insert tunneled cv cath | $1,604 | $576 | |||
| 36560 | Insert tunneled cv cath | $2,829 | $760 | |||
| 36561 | Insert tunneled cv cath | $2,463 | $739 | |||
| 36563 | Insert tunneled cv cath | $2,817 | $792 | |||
| 36565 | Insert tunneled cv cath | $2,090 | $734 | |||
| 36566 | Insert tunneled cv cath | $11,204 | $795 | |||
| 36568 | Insert picc cath | $579 | $196 | |||
| 36569 | Insert picc cath | $493 | $186 | |||
| 36570 | Insert picvad cath | $2,415 | $637 | |||
| 36571 | Insert picvad cath | $2,697 | $670 | |||
| 36575 | Repair tunneled cv cath | $339 | $73 | |||
| 36576 | Repair tunneled cv cath | $784 | $404 | |||
| 36578 | Replace tunneled cv cath | $1,065 | $448 | |||
| 36580 | Replace cvad cath | $432 | $137 | |||
| 36581 | Replace tunneled cv cath | $1,555 | $406 | |||
| 36582 | Replace tunneled cv cath | $2,299 | $637 | |||
| 36583 | Replace tunneled cv cath | $2,483 | $670 | |||
| 36584 | Replace picc cath | $403 | $135 | |||
| 36585 | Replace picvad cath | $2,315 | $578 | |||
| 36589 | Removal tunneled cv cath | $343 | $289 | |||
| 36590 | Removal tunneled cv cath | $611 | $428 | |||
| 36591 | Draw blood off venous device | $46 | ||||
| 36592 | Collect blood from picc | $52 | ||||
| 36593 | Declot vascular device | $61 | ||||
| 36595 | Mech remov tunneled cv cath | $1,139 | $379 | |||
| 36596 | Mech remov tunneled cv cath | $271 | $92 | |||
| 36597 | Reposition venous catheter | $251 | $124 | |||
| 36598 | Inj w/fluor eval cv device | $225 | $74 | |||
| 36600 | Withdrawal of arterial blood | $44 | ||||
| 36620 | Insertion catheter, artery | 0 | $138 | |||
| 36625 | Insertion catheter, artery | 0 | $223 | |||
| 36640 | Insertion catheter, artery | 0 | $341 | |||
| 36660 | Insertion catheter, artery | 0 | $138 | |||
| 36680 | Insert needle, bone cavity | 0 | $180 | |||
| 36800 | Insertion of cannula.. | 0 | $338 | |||
| 36810 | Insertion of cannula | 0 | $677 | |||
| 36815 | Insertion of cannula | 0 | $474 | |||
| 36818 | Av fuse uppr arm cephalic | $1,441 | ||||
| 36819 | Av fusion by basilic vein | 90 | $1,588 | |||
| 36820 | Av fusion/forearm vein | $1,734 | ||||
| 36821 | Av fusion direct any site | 90 | $1,202 | |||
| 36822 | Insertion of cannula(s) | 90 | $870 | |||
| 36823 | Insertion of cannula(s) | $2,805 | ||||
| 36825 | Artery-vein graft..... | 90 | $1,522 | |||
| 36830 | Artery-vein graft | 90 | $1,465 | |||
| 36831 | Av fistula excision... | 90 | $824 | |||
| 36832 | Av fistula revision... | 90 | $1,372 | |||
| 36833 | Av fistula revision... | 90 | $1,248 | |||
| 36835 | Artery to vein shunt.. | 90 | $811 | |||
| 36838 | Dist revas ligation hemo | $2,480 | ||||
| 36860 | External cannula declotting | 0 | $356 | |||
| 36861 | Cannula declotting | 0 | $555 | |||
| 36870 | Percut thrombect av fistula | $3,924 | $623 | |||
| 37140 | Revision of circulation | 90 | $2,948 | |||
| 37145 | Revision of circulation | 90 | $2,974 | |||
| 37160 | Revision of circulation | 90 | $2,950 | |||
| 37180 | Revision of circulation | 90 | $2,840 | |||
| 37181 | Splice spleen/kidney veins | 90 | $3,192 | |||
| 37182 | Insert hepatic shunt (tips) | $1,731 | ||||
| 37183 | Remove hepatic shunt (tips) | $11,797 | $807 | |||
| 37184 | Prim art mech thrombectomy | $4,710 | $939 | |||
| 37185 | Prim art m-thrombect add-on | $1,532 | $347 | |||
| 37186 | Sec art m-thrombect add-on | $2,965 | $526 | |||
| 37187 | Venous mech thrombectomy | $4,459 | $843 | |||
| 37188 | Venous m-thrombectomy add-on | $3,745 | $600 | |||
| 37191 | Ins endovas vena cava filtr | $5,485 | $494 | |||
| 37192 | Redo endovas vena cava filtr | $3,678 | $764 | |||
| 37193 | Rem endovas vena cava filter | $3,510 | $764 | |||
| 37195 | Thrombolytic therapy, stroke | $605 | ||||
| 37200 | Transcatheter biopsy | 0 | $445 | |||
| 37201 | Transcatheter therapy infuse | 0 | $948 | |||
| 37202 | Transcatheter therapy | 0 | $742 | |||
| 37203 | Transcatheter retrieval | 0 | $658 | |||
| 37204 | Transcatheter occlusion | 0 | $2,371 | |||
| 37205 | Transcatheter stent | 0 | $981 | |||
| 37206 | Transcatheter stent add-on. | $487 | ||||
| 37207 | Transcatheter stent | 0 | $981 | |||
| 37208 | Transcatheter stent add-on | $479 | ||||
| 37209 | Exchange arterial catheter | 0 | $174 | |||
| 37210 | Embolization uterine fibroid | $7,372 | $1,071 | |||
| 37215 | Transcath stent cca w/eps | $2,269 | ||||
| 37216 | Transcath stent cca w/o eps | $2,111 | ||||
| 37220 | Iliac revasc | $6,769 | $875 | |||
| 37221 | Iliac revasc w/stent | $10,110 | $1,066 | |||
| 37222 | Iliac revasc add-on | $1,941 | $397 | |||
| 37223 | Iliac revasc w/stent add-on | $5,541 | $450 | |||
| 37224 | Fem/popl revas w/tla | $8,142 | $963 | |||
| 37225 | Fem/popl revas w/ather | $23,125 | $1,301 | |||
| 37226 | Fem/popl revasc w/stent | $19,512 | $1,073 | |||
| 37227 | Fem/popl revasc stnt & ather | $31,278 | $1,571 | |||
| 37228 | Tib/per revasc w/tla | $11,636 | $1,178 | |||
| 37229 | Tib/per revasc w/ather | $22,868 | $1,523 | |||
| 37230 | Tib/per revasc w/stent | $18,117 | $1,469 | |||
| 37231 | Tib/per revasc stent & ather | $29,130 | $1,597 | |||
| 37232 | Tib/per revasc add-on | $2,601 | $426 | |||
| 37233 | Tibper revasc w/ather add-on | $3,157 | $701 | |||
| 37234 | Revsc opn/prq tib/pero stent | $8,335 | $583 | |||
| 37235 | Tib/per revasc stnt & ather | $8,890 | $828 | |||
| 37250 | Iv us first vessel add on | $249 | ||||
| 37251 | Iv us each add vessel add-on | $193 | ||||
| 37500 | Endoscopy ligate perf veins | $1,483 | ||||
| 37565 | Ligation of neck vein | 90 | $616 | |||
| 37600 | Ligation of neck artery | 90 | $737 | |||
| 37605 | Ligation of neck artery | 90 | $795 | |||
| 37606 | Ligation of neck artery | 90 | $816 | |||
| 37607 | Ligation of fistula | 90 | $681 | |||
| 37609 | Temporal artery procedure | 10 | $345 | |||
| 37615 | Ligation of neck artery | 90 | $833 | |||
| 37616 | Ligation of chest artery | 90 | $1,397 | |||
| 37617 | Ligation of abdomen artery | 90 | $1,680 | |||
| 37618 | Ligation of extremity artery | 90 | $704 | |||
| 37619 | Ligation of inf vena cava | $3,429 | ||||
| 37650 | Revision of major vein | 90 | $676 | |||
| 37660 | Revision of major vein | 90 | $1,242 | |||
| 37700 | Revise leg vein | 90 | $559 | |||
| 37718 | Ligate/strip short leg vein | $943 | ||||
| 37722 | Ligate/strip long leg vein | $1,042 | ||||
| 37735 | Removal of leg veins/lesion | 90 | $1,410 | |||
| 37760 | Revision of leg veins | 90 | $1,338 | |||
| 37761 | Ligate leg veins open | $1,186 | ||||
| 37765 | Stab phleb veins xtr 10-20 | $1,413 | ||||
| 37766 | Phleb veins - extrem 20+ | $1,660 | $1,173 | |||
| 37780 | Revision of leg vein | 90 | $408 | |||
| 37785 | Revise secondary varicosity | 90 | $334 | |||
| 37788 | Revascularization, penis | 90 | $2,851 | |||
| 37790 | Penile venous occlusion | 90 | $861 | |||
| 37799 | Vascular surgery procedure | BR | ||||
| 38100 | Removal of spleen, total | 90 | $1,582 | |||
| 38101 | Removal of spleen, partial | 90 | $1,494 | |||
| 38102 | Removal of spleen, total | $546 | ||||
| 38115 | Repair of ruptured spleen | 90 | $1,538 | |||
| 38120 | Laparoscopy, splenectomy | $2,187 | ||||
| 38129 | Laparoscope proc, spleen | BR | ||||
| 38200 | Injection for spleen X-ray | 0 | $319 | |||
| 38204 | Bl donor search management | $209 | ||||
| 38205 | Harvest allogenic stem cells | $163 | ||||
| 38206 | Harvest auto stem cells | $168 | ||||
| 38207 | Cryopreserve stem cells | $92 | ||||
| 38208 | Thaw preserved stem cells | $59 | ||||
| 38209 | Wash harvest stem cells | $25 | ||||
| 38210 | T-cell depletion of harvest | $164 | ||||
| 38211 | Tumor cell deplete of harvst | $149 | ||||
| 38212 | Rbc depletion of harvest | $97 | ||||
| 38213 | Platelet deplete of harvest | $25 | ||||
| 38214 | Volume deplete of harvest | $84 | ||||
| 38215 | Harvest stem cell concentrte | $97 | ||||
| 38220 | Bone marrow aspiration | $324 | $124 | |||
| 38221 | Bone marrow biopsy | $332 | $152 | |||
| 38230 | Bone marrow collection | 10 | $436 | |||
| 38232 | Bone marrow harvest autolog | $383 | ||||
| 38240 | Bone marrow/stem transplant | $308 | ||||
| 38241 | Bone marrow transplantation | $312 | ||||
| 38242 | Lymphocyte infuse transplant | $196 | ||||
| 38300 | Drainage lymph node lesion | 10 | $154 | |||
| 38305 | Drainage lymph node lesion | 90 | $465 | |||
| 38308 | Incision of lymph channels | 90 | $593 | |||
| 38380 | Thoracic duct procedure | 90 | $831 | |||
| 38381 | Thoracic duct procedure | 90 | $1,498 | |||
| 38382 | Thoracic duct procedure | 90 | $1,076 | |||
| 38500 | Biopsy/removal,lymph node(s) | 10 | $335 | |||
| 38505 | Needle biopsy, lymph node(s) | 0 | $172 | |||
| 38510 | Biopsy/removal,lymph node(s) | 90 | $488 | |||
| 38520 | Biopsy/removal,lymph node(s) | 90 | $595 | |||
| 38525 | Biopsy/removal,lymph node(s) | 90 | $531 | |||
| 38530 | Biopsy/removal,lymph node(s) | 90 | $683 | |||
| 38542 | Explore deep node(s), neck | 90 | $727 | |||
| 38550 | Removal, neck/armpit lesion | 90 | $750 | |||
| 38555 | Removal, neck/armpit lesion | 90 | $1,649 | |||
| 38562 | Removal, pelvic lymph nodes | 90 | $1,256 | |||
| 38564 | Removal, abdomen lymph nodes | 90 | $1,338 | |||
| 38570 | Laparoscopy, lymph node biop | 10 | $1,101 | |||
| 38571 | Laparoscopy, lymphadenectomy | 10 | $1,619 | |||
| 38572 | Laparoscopy, lymphadenectomy | 10 | $1,977 | |||
| 38589 | Laparoscope proc, lymphatic | BR | ||||
| 38700 | Removal of lymph nodes, neck | 90 | $1,310 | |||
| 38720 | Removal of lymph nodes, neck | 90 | $2,128 | |||
| 38724 | Removal of lymph nodes, neck | 90 | $2,094 | |||
| 38740 | Remove armpit lymph nodes | 90 | $850 | |||
| 38745 | Remove armpits lymph nodes | 90 | $1,283 | |||
| 38746 | Remove thoracic lymph nodes | $508 | ||||
| 38747 | Remove abdominal lymph v | $560 | ||||
| 38760 | Remove groin lymph nodes | 90 | $1,145 | |||
| 38765 | Remove groin lymph nodes | 90 | $2,129 | |||
| 38770 | Remove pelvis lymph nodes | 90 | $2,069 | |||
| 38780 | Remove abdomen lymph nodes | 90 | $2,432 | |||
| 38790 | Inject for lymphatic X ray | 0 | $757 | |||
| 38792 | Identify sentinel node | 0 | $84 | |||
| 38794 | Access thoracic lymph duct | 90 | $515 | |||
| 38900 | Io map of sent lymph node | $279 | ||||
| 38999 | Blood/lymph system procedure | BR | ||||
| 39000 | Exploration of chest.. | 90 | $982 | |||
| 39010 | Exploration of chest.. | 90 | $1,790 | |||
| 39200 | Removal chest lesion | 90 | $1,849 | |||
| 39220 | Removal chest lesion | 90 | $2,402 | |||
| 39400 | Visualization of chest | 10 | $792 | |||
| 39499 | Chest procedure | BR | ||||
| 39501 | Repair diaphragm laceration | 90 | $1,800 | |||
| 39503 | Repair of diaphragm hernia | 90 | $4,342 | |||
| 39540 | Repair of diaphragm hernia | 90 | $1,882 | |||
| 39541 | Repair of diaphragm hernia | 90 | $1,957 | |||
| 39545 | Revision of diaphragm | 90 | $1,624 | |||
| 39560 | Resect diaphragm, simple | 90 | $1,645 | |||
| 39561 | Resect diaphragm, complex | 90 | $2,601 | |||
| 39599 | Diaphragm surgery procedure | BR | ||||
| 40490 | Biopsy of lip | 0 | $144 | |||
| 40500 | Partial excision of lip | 90 | $797 | |||
| 40510 | Partial excision of lip | 90 | $796 | |||
| 40520 | Partial excision of lip | 90 | $689 | |||
| 40525 | Reconstruct lip with flap | 90 | $1,274 | |||
| 40527 | Reconstruct lip with flap | 90 | $1,524 | |||
| 40530 | Partial removal of lip | 90 | $778 | |||
| 40650 | Repair lip | 90 | $610 | |||
| 40652 | Repair lip | 90 | $716 | |||
| 40654 | Repair lip | 90 | $899 | |||
| 40700 | Repair cleft lip/nasal | 90 | $1,541 | |||
| 40701 | Repair cleft lip/nasal | 90 | $2,553 | |||
| 40702 | Repair cleft lip/nasal | 90 | $1,615 | |||
| 40720 | Repair cleft lip/nasal | 90 | $1,720 | |||
| 40761 | Repair cleft lip/nasal | 90 | $1,882 | |||
| 40799 | Lip surgery procedure | BR | ||||
| 40800 | Drainage of mouth lesion | 10 | $137 | |||
| 40801 | Drainage of mouth lesion | 10 | $308 | |||
| 40804 | Removal foreign body, mouth | 10 | $130 | |||
| 40805 | Removal foreign body, mouth | 10 | $385 | |||
| 40806 | Incision of lip fold | 0 | $49 | |||
| 40808 | Biopsy of mouth lesion | 10 | $124 | |||
| 40810 | Excision of mouth lesion | 10 | $180 | |||
| 40812 | Excise/repair mouth lesion | 10 | $277 | |||
| 40814 | Excise/repair mouth lesion | 90 | $483 | |||
| 40816 | Excision of mouth lesion | 90 | $501 | |||
| 40818 | Excise oral mucosa for graft | 90 | $334 | |||
| 40819 | Excise lip or cheek fold | 90 | $257 | |||
| 40820 | Treatment of mouth lesion | 10 | $129 | |||
| 40830 | Repair mouth laceration | 10 | $174 | |||
| 40831 | Repair mouth laceration | 10 | $323 | |||
| 40840 | Reconstruction of mouth | 90 | $1,672 | $1,282 | ||
| 40842 | Reconstruction of mouth | 90 | $1,683 | $1,341 | ||
| 40843 | Reconstruction of mouth | 90 | $2,291 | $1,825 | ||
| 40844 | Reconstruction of mouth | 90 | $2,851 | $2,321 | ||
| 40845 | Reconstruction of mouth | 90 | $3,084 | $2,582 | ||
| 40899 | Mouth surgery procedure | BR | ||||
| 41000 | Drainage of mouth lesion | 10 | $148 | |||
| 41005 | Drainage of mouth lesion | 10 | $135 | |||
| 41006 | Drainage of mouth lesion | 90 | $294 | |||
| 41007 | Drainage of mouth lesion | 90 | $431 | |||
| 41008 | Drainage of mouth lesion | 90 | $307 | |||
| 41009 | Drainage of mouth lesion | 90 | $496 | |||
| 41010 | Incision of tongue fold | 10 | $113 | |||
| 41015 | Drainage of mouth lesion | 90 | $332 | |||
| 41016 | Drainage of mouth lesion | 90 | $551 | |||
| 41017 | Drainage of mouth lesion | 90 | $373 | |||
| 41018 | Drainage of mouth lesion | 90 | $641 | |||
| 41019 | Place needles h&n for rt | $941 | ||||
| 41100 | Biopsy of tongue | 10 | $175 | |||
| 41105 | Biopsy of tongue | 10 | $179 | |||
| 41108 | Biopsy of floor of mouth | 10 | $138 | |||
| 41110 | Excision of tongue lesion | 10 | $206 | |||
| 41112 | Excision of tongue lesion | 90 | $372 | |||
| 41113 | Excision of tongue lesion | 90 | $486 | |||
| 41114 | Excision of tongue lesion | 90 | $1,062 | |||
| 41115 | Excision of tongue fold | 10 | $258 | |||
| 41116 | Excision of mouth lesion | 90 | $363 | |||
| 41120 | Partial removal of tongue | 90 | $1,203 | |||
| 41130 | Partial removal of tongue | 90 | $1,449 | |||
| 41135 | Tongue and neck surgery | 90 | $2,578 | |||
| 41140 | Removal of tongue | 90 | $3,171 | |||
| 41145 | Tongue removal; neck surgery | 90 | $3,774 | |||
| 41150 | Tongue, mouth, jaw surgery | 90 | $2,887 | |||
| 41153 | Tongue, mouth, neck surgery | 90 | $3,484 | |||
| 41155 | Tongue, jaw, & neck surgery | 90 | $4,042 | |||
| 41250 | Repair tongue laceration | 10 | $215 | |||
| 41251 | Repair tongue laceration | 10 | $318 | |||
| 41252 | Repair tongue laceration | 10 | $392 | |||
| 41500 | Fixation of tongue | 90 | $500 | |||
| 41510 | Tongue to lip surgery | 90 | $446 | |||
| 41512 | Tongue suspension | $1,348 | ||||
| 41520 | Reconstruction, tongue fold | 90 | $410 | |||
| 41530 | Tongue base vol reduction | $7,038 | $872 | |||
| 41599 | Tongue and mouth surgery | BR | ||||
| 41800 | Drainage of gum lesion | 10 | $133 | |||
| 41805 | Removal foreign body, gum | 10 | $150 | |||
| 41806 | Removal foreign body, jawbone | 10 | $314 | |||
| 41820 | Excision, gum, each quadrant | BR | ||||
| 41821 | Excision of gum flap | BR | ||||
| 41822 | Excision of gum lesion | 10 | $605 | $382 | ||
| 41823 | Excision of gum lesion | 90 | $891 | $677 | ||
| 41825 | Excision of gum lesion | 10 | $205 | |||
| 41826 | Excision of gum lesion | 10 | $320 | |||
| 41827 | Excision of gum lesion | 90 | $526 | |||
| 41828 | Excision of gum lesion | 10 | $509 | |||
| 41830 | Removal of gum tissue | 10 | $817 | $593 | ||
| 41850 | Treatment of gum lesion | BR | ||||
| 41870 | Gum graft | BR | ||||
| 41872 | Repair gum............ | 90 | $397 | |||
| 41874 | Repair tooth socket... | 90 | $467 | |||
| 41899 | Dental surgery procedure | BR | ||||
| 42000 | Drainage mouth roof lesion | 10 | $132 | |||
| 42100 | Biopsy roof of mouth | 10 | $151 | |||
| 42104 | Excision lesion, mouth roof | 10 | $240 | |||
| 42106 | Excision lesion, mouth roof | 10 | $358 | |||
| 42107 | Excision lesion, mouth roof | 90 | $681 | |||
| 42120 | Remove palate/lesion | 90 | $999 | |||
| 42140 | Excision of uvula | 90 | $215 | |||
| 42145 | Repair, palate, pharynx/uvula | 90 | $1,449 | |||
| 42160 | Treatment mouth roof lesion | 10 | $244 | |||
| 42180 | Repair palate | 10 | $350 | |||
| 42182 | Repair palate | 10 | $540 | |||
| 42200 | Reconstruct cleft palate | 90 | $1,241 | |||
| 42205 | Reconstruct cleft palate | 90 | $1,456 | |||
| 42210 | Reconstruct cleft palate | 90 | $1,662 | |||
| 42215 | Reconstruct cleft palate | 90 | $1,201 | |||
| 42220 | Reconstruct cleft palate | 90 | $910 | |||
| 42225 | Reconstruct cleft palate | 90 | $1,208 | |||
| 42226 | Lengthening of palate | 90 | $1,286 | |||
| 42227 | Lengthening of palate | 90 | $1,181 | |||
| 42235 | Repair palate | 90 | $959 | |||
| 42260 | Repair nose to lip fistula | 90 | $608 | |||
| 42280 | Preparation, palate mold | 10 | $259 | |||
| 42281 | Insertion, palate prosthesis | 10 | $241 | |||
| 42299 | Palate/uvula surgery | BR | ||||
| 42300 | Drainage of salivary gland | 10 | $210 | |||
| 42305 | Drainage of salivary gland | 90 | $569 | |||
| 42310 | Drainage of salivary gland | 10 | $189 | |||
| 42320 | Drainage of salivary gland | 10 | $308 | |||
| 42330 | Removal of salivary stone | 10 | $239 | |||
| 42335 | Removal of salivary stone | 90 | $422 | |||
| 42340 | Removal of salivary stone | 90 | $650 | |||
| 42400 | Biopsy of salivary gland | 0 | $119 | |||
| 42405 | Biopsy of salivary gland | 10 | $353 | |||
| 42408 | Excision of salivary cyst | 90 | $569 | |||
| 42409 | Drainage of salivary cyst | 90 | $412 | |||
| 42410 | Excise parotid gland/lesion | 90 | $1,115 | |||
| 42415 | Excise parotid gland/lesion | 90 | $2,158 | |||
| 42420 | Excise parotid gland/lesion | 90 | $2,500 | |||
| 42425 | Excise parotid gland/lesion | 90 | $1,762 | |||
| 42426 | Excise parotid gland/lesion | 90 | $3,342 | |||
| 42440 | Excision submaxillary gland | 90 | $1,103 | |||
| 42450 | Excision sublingual gland | 90 | $577 | |||
| 42500 | Repair salivary duct | 90 | $650 | |||
| 42505 | Repair salivary duct | 90 | $1,000 | |||
| 42507 | Parotid duct diversion | 90 | $799 | |||
| 42508 | Parotid duct diversion | 90 | $1,217 | |||
| 42509 | Parotid duct diversion | 90 | $1,389 | |||
| 42510 | Parotid duct diversion | 90 | $1,148 | |||
| 42550 | Injection for salivary X-ray | 0 | $122 | |||
| 42600 | Closure of salivary fistula | 90 | $633 | |||
| 42650 | Dilation of salivary duct | 0 | $85 | |||
| 42660 | Dilation of salivary duct | 0 | $120 | |||
| 42665 | Ligation of salivary duct | 90 | $334 | |||
| 42699 | Salivary surgery procedure | BR | ||||
| 42700 | Drainage of tonsil abscess | 10 | $179 | |||
| 42720 | Drainage of throat abscess | 10 | $334 | |||
| 42725 | Drainage of throat abscess | 90 | $891 | |||
| 42800 | Biopsy of throat | 10 | $153 | |||
| 42802 | Biopsy of throat | 10 | $187 | |||
| 42804 | Biopsy of upper nose/throat | 10 | $171 | |||
| 42806 | Biopsy of upper nose/throat | 10 | $220 | |||
| 42808 | Excise pharynx lesion | 10 | $358 | |||
| 42809 | Remove pharynx foreign body | 10 | $189 | |||
| 42810 | Excision of neck cyst | 90 | $483 | |||
| 42815 | Excision of neck cyst | 90 | $1,157 | |||
| 42820 | Remove tonsils and adenoids | 90 | $500 | |||
| 42821 | Remove tonsils and adenoids | 90 | $602 | |||
| 42825 | Removal of tonsils | 90 | $438 | |||
| 42826 | Removal of tonsils | 90 | $530 | |||
| 42830 | Removal of adenoids | 90 | $327 | |||
| 42831 | Removal of adenoids | 90 | $370 | |||
| 42835 | Removal of adenoids | 90 | $296 | |||
| 42836 | Removal of adenoids | 90 | $439 | |||
| 42842 | Extensive surgery of throat | 90 | $1,101 | |||
| 42844 | Extensive surgery of throat | 90 | $1,759 | |||
| 42845 | Extensive surgery of throat | 90 | $3,024 | |||
| 42860 | Excision of tonsil tags | 90 | $300 | |||
| 42870 | Excision of lingual tonsil | 90 | $549 | |||
| 42890 | Partial removal of pharynx | 90 | $1,536 | |||
| 42892 | Revision of pharyngeal walls | 90 | $1,850 | |||
| 42894 | Revision of pharyngeal walls | 90 | $2,730 | |||
| 42900 | Repair throat wound | 10 | $689 | |||
| 42950 | Reconstruction of throat | 90 | $1,321 | |||
| 42953 | Repair throat, esophagus | 90 | $1,096 | |||
| 42955 | Surgical opening of throat | 90 | $726 | |||
| 42960 | Control throat bleeding | 10 | $247 | |||
| 42961 | Control throat bleeding | 90 | $504 | |||
| 42962 | Control throat bleeding | 90 | $942 | |||
| 42970 | Control nose/throat bleeding | 90 | $418 | |||
| 42971 | Control nose/throat bleeding | 90 | $623 | |||
| 42972 | Control nose/throat bleeding | 90 | $838 | |||
| 42999 | Throat surgery procedure | BR | ||||
| 43020 | Incision of esophagus | 90 | $1,063 | |||
| 43030 | Throat muscle surgery | 90 | $1,240 | |||
| 43045 | Incision of esophagus. | 90 | $2,471 | |||
| 43100 | Excision of esophagus lesion | 90 | $1,208 | |||
| 43101 | Excision of esophagus lesion | 90 | $1,957 | |||
| 43107 | Removal of esophagus | 90 | $3,788 | |||
| 43108 | Removal of esophagus | 90 | $4,388 | |||
| 43112 | Removal of esophagus | 90 | $3,888 | |||
| 43113 | Removal of esophagus | 90 | $4,457 | |||
| 43116 | Partial removal of esophagus | 90 | $4,180 | |||
| 43117 | Partial removal of esophagus | 90 | $4,096 | |||
| 43118 | Partial removal of esophagus | 90 | $4,318 | |||
| 43121 | Partial removal of esophagus | 90 | $3,727 | |||
| 43122 | Partial removal of esophagus | 90 | $3,727 | |||
| 43123 | Partial removal of esophagus | 90 | $4,318 | |||
| 43124 | Removal of esophagus | 90 | $3,616 | |||
| 43130 | Removal of esophagus pouch | 90 | $1,614 | |||
| 43135 | Removal of esophagus pouch | 90 | $2,053 | |||
| 43200 | Esophagus endoscopy | 0 | $301 | |||
| 43201 | Esoph scope w/submucous inj | $654 | $267 | |||
| 43202 | Esophagus endoscopy, biopsy | 0 | $362 | |||
| 43204 | Esophagus endoscopy & inject | 0 | $639 | |||
| 43205 | Esophagus endoscopy/ligation | 0 | $469 | |||
| 43215 | Esophagus endoscopy | 0 | $494 | |||
| 43216 | Esophagus endoscopy/ligation | 0 | $512 | |||
| 43217 | Esophagus endoscopy | 0 | $512 | |||
| 43219 | Esophagus endoscopy | 0 | $484 | |||
| 43220 | Esophagus endoscopy, dilation | 0 | $364 | |||
| 43226 | Esophagus endoscopy, dilation | 0 | $428 | |||
| 43227 | Esophagus endoscopy, repair | 0 | $605 | |||
| 43228 | Esophagus endoscopy, ablation | 0 | $633 | |||
| 43231 | Esoph endoscopy w/us exam | $401 | ||||
| 43232 | Esoph endoscopy w/us fn bx | $546 | ||||
| 43234 | Upper gi endoscopy, exam | 0 | $360 | |||
| 43235 | Upper gi endoscopy, diagnosis | 0 | $427 | |||
| 43236 | Uppr gi scope w/submuc inj | $795 | $364 | |||
| 43237 | Endoscopic us exam esoph | $490 | ||||
| 43238 | Uppr gi endoscopy w/us fn bx | $612 | ||||
| 43239 | Upper gi endoscopy, biopsy | 0 | $486 | |||
| 43240 | Esoph endoscope w/drain cyst | $831 | ||||
| 43241 | Upper gi endoscopy with Tube | 0 | $502 | |||
| 43242 | Uppr gi endoscopy w/us fn bx | $887 | ||||
| 43243 | Upper gi endoscopy & inject | 0 | $749 | |||
| 43244 | Upper gi endoscopy/ligation | 0 | $569 | |||
| 43245 | Operative upper gi endoscopy | 0 | $580 | |||
| 43246 | Place gastrostomy tube | 0 | $738 | |||
| 43247 | Operative upper gi endoscopy | 0 | $582 | |||
| 43248 | Upper gi endoscopy/guidewire | 0 | $392 | |||
| 43249 | Esophagus endoscopy, dilation | 0 | $485 | |||
| 43250 | Upper gi endoscopy/tumor | 0 | $634 | |||
| 43251 | Operative upper gi endoscopy | 0 | $634 | |||
| 43255 | Operative upper gi endoscopy | 0 | $737 | |||
| 43256 | Uppr gi endoscopy w/stent | $532 | ||||
| 43257 | Uppr gi scope w/thrml txmnt | $679 | ||||
| 43258 | Operative upper gi endoscopy | 0 | $732 | |||
| 43259 | Endoscopic ultrasound exam | 0 | $486 | |||
| 43260 | Endoscopy,bile duct/pancreas | 0 | $873 | |||
| 43261 | Endoscopy,bile duct/pancreas | 0 | $895 | |||
| 43262 | Endoscopy,bile duct/pancreas | 0 | $1,202 | |||
| 43263 | Endoscopy,bile duct/pancreas | 0 | $878 | |||
| 43264 | Endoscopy,bile duct/pancreas | 0 | $1,305 | |||
| 43265 | Endoscopy,bile duct/pancreas | 0 | $1,148 | |||
| 43267 | Endoscopy,bile duct/pancreas | 0 | $1,082 | |||
| 43268 | Endoscopy,bile duct/pancreas | 0 | $1,181 | |||
| 43269 | Endoscopy,bile duct/pancreas | 0 | $985 | |||
| 43271 | Endoscopy,bile duct/pancreas | 0 | $1,099 | |||
| 43272 | Endoscopy,bile duct/pancreas | 0 | $949 | |||
| 43273 | Endoscopic pancreatoscopy | $264 | ||||
| 43279 | Lap myotomy heller | $2,691 | ||||
| 43280 | Laparoscopy, fundoplasty | 90 | $2,250 | |||
| 43281 | Lap paraesophag hern repair | $3,211 | ||||
| 43282 | Lap paraesoph her rpr w/mesh | $3,611 | ||||
| 43283 | Lap esoph lengthening | $333 | ||||
| 43289 | Laparoscope proc, esoph | BR | ||||
| 43300 | Repair of esophagus | 90 | $1,533 | |||
| 43305 | Repair esophagus and fistula | 90 | $2,239 | |||
| 43310 | Repair of esophagus | 90 | $3,145 | |||
| 43312 | Repair esophagus and fistula | 90 | $3,064 | |||
| 43313 | Esophagoplasty congenital | $6,062 | ||||
| 43314 | Tracheo-esophagoplasty cong | $6,054 | ||||
| 43320 | Fuse esophagus & stomach. | 90 | $2,087 | |||
| 43325 | Revise esophagus & stomach | 90 | $2,020 | |||
| 43327 | Esoph fundoplasty lap | $1,698 | ||||
| 43328 | Esoph fundoplasty thor | $2,484 | ||||
| 43330 | Repair of esophagus... | 90 | $2,075 | |||
| 43331 | Repair of esophagus | 90 | $2,244 | |||
| 43332 | Transab esoph hiat hern rpr | $2,418 | ||||
| 43333 | Transab esoph hiat hern rpr | $2,625 | ||||
| 43334 | Transthor diaphrag hern rpr | $2,647 | ||||
| 43335 | Transthor diaphrag hern rpr | $2,850 | ||||
| 43336 | Thorabd diaphr hern repair | $3,126 | ||||
| 43337 | Thorabd diaphr hern repair | $3,421 | ||||
| 43338 | Esoph lengthening | $273 | ||||
| 43340 | Fuse esophagus & intestine | 90 | $2,062 | |||
| 43341 | Fuse esophagus & intestine | 90 | $1,892 | |||
| 43350 | Surgical opening, esophagus | 90 | $1,436 | |||
| 43351 | Surgical opening, esophagus | 90 | $1,680 | |||
| 43352 | Surgical opening, esophagus | 90 | $1,505 | |||
| 43360 | Gastrointestinal repair | 90 | $3,613 | |||
| 43361 | Gastrointestinal repair | 90 | $4,180 | |||
| 43400 | Ligate esophagus veins | 90 | $1,982 | |||
| 43401 | Esophagus surgery for veins | 90 | $1,967 | |||
| 43405 | Ligate/staple esophagus | 90 | $2,227 | |||
| 43410 | Repair esophagus wound | 90 | $1,420 | |||
| 43415 | Repair esophagus wound | 90 | $2,251 | |||
| 43420 | Repair esophagus opening | 90 | $1,193 | |||
| 43425 | Repair esophagus opening | 90 | $2,029 | |||
| 43450 | Dilate esophagus | 0 | $150 | |||
| 43453 | Dilate esophagus | 0 | $222 | |||
| 43456 | Dilate esophagus | 0 | $441 | |||
| 43458 | Dilation of esophagus | 0 | $269 | |||
| 43460 | Pressure treatment esophagus | 0 | $398 | |||
| 43496 | Free jejunum flap, microvasc | 90 | BR | |||
| 43499 | Esophagus surgery procedure | BR | ||||
| 43500 | Surgical opening of stomach | 90 | $1,057 | |||
| 43501 | Surgical repair of stomach | 90 | $1,794 | |||
| 43502 | Surgical repair of stomach | 90 | $1,836 | |||
| 43510 | Surgical opening of stomach | 90 | $1,327 | |||
| 43520 | Incision of pyloric muscle | 90 | $875 | |||
| 43605 | Biopsy of stomach | 90 | $1,092 | |||
| 43610 | Excision of stomach lesion | 90 | $1,415 | |||
| 43611 | Excision of stomach lesion | 90 | $1,580 | |||
| 43620 | Removal of stomach | 90 | $2,803 | |||
| 43621 | Removal of stomach | 90 | $2,835 | |||
| 43622 | Removal of stomach | 90 | $2,930 | |||
| 43631 | Removal of stomach, partial | 90 | $2,349 | |||
| 43632 | Removal stomach, partial | 90 | $2,349 | |||
| 43633 | Removal stomach, partial | 90 | $2,380 | |||
| 43634 | Removal stomach, partial | 90 | $3,206 | |||
| 43635 | Partial removal of stomach | $241 | ||||
| 43640 | Vagotomy & pylorus repair | 90 | $1,827 | |||
| 43641 | Vagotomy & pylorus repair | 90 | $1,826 | |||
| 43644 | Lap gastric bypass/roux-en-y | $3,594 | ||||
| 43645 | Lap gastr bypass incl smll i | $3,848 | ||||
| 43651 | Laparoscopy, vagus nerve | 90 | $1,360 | |||
| 43652 | Laparoscopy, vagus nerve | 90 | $1,588 | |||
| 43653 | Laparoscopy, gastrostomy | 90 | $1,191 | |||
| 43659 | Laparoscope proc, stom | BR | ||||
| 43752 | Nasal/orogastric w/stent | $83 | ||||
| 43753 | Tx gastro intub w/asp | $43 | ||||
| 43754 | Dx gastr intub w/asp spec | $174 | $66 | |||
| 43755 | Dx gastr intub w/asp specs | $263 | $119 | |||
| 43756 | Dx duod intub w/asp spec | $484 | $107 | |||
| 43757 | Dx duod intub w/asp specs | $683 | $162 | |||
| 43760 | Change gastrostomy tube | 0 | $133 | |||
| 43761 | Reposition gastrostomy tube | 0 | $226 | |||
| 43770 | Lap place gastr adj device | $2,322 | ||||
| 43771 | Lap revise gastr adj device | $2,637 | ||||
| 43772 | Lap rmvl gastr adj device | $1,981 | ||||
| 43773 | Lap replace gastr adj device | $2,635 | ||||
| 43774 | Lap rmvl gastr adj all parts | $1,995 | ||||
| 43775 | Lap sleeve gastrectomy | $2,653 | ||||
| 43800 | Reconstruction of pylorus | 90 | $1,256 | |||
| 43810 | Fusion of stomach and bowel | 90 | $1,363 | |||
| 43820 | Fusion of stomach and bowel | 90 | $1,499 | |||
| 43825 | Fusion of stomach and bowel | 90 | $1,888 | |||
| 43830 | Place gastrostomy tube | 90 | $1,003 | |||
| 43831 | Place gastrostomy tube | 90 | $888 | |||
| 43832 | Place gastrostomy tube | 90 | $1,474 | |||
| 43840 | Repair of stomach lesion | 90 | $1,413 | |||
| 43842 | Gastroplasty for obesity | 90 | $2,126 | |||
| 43843 | Gastroplasty for obesity | 90 | $2,131 | |||
| 43845 | Gastroplasty duodenal switch | $4,059 | ||||
| 43846 | Gastric bypass for obesity | 90 | $2,556 | |||
| 43847 | Gastric bypass for obesity | 90 | $2,147 | |||
| 43848 | Revision gastroplasty | 90 | $2,814 | |||
| 43850 | Revise stomach-bowel fusion | 90 | $2,267 | |||
| 43855 | Revise stomach-bowel fusion | 90 | $2,257 | |||
| 43860 | Revise stomach-bowel fusion | 90 | $2,273 | |||
| 43865 | Revise stomach-bowel fusion | 90 | $2,514 | |||
| 43870 | Repair stomach opening | 90 | $953 | |||
| 43880 | Repair stomach-bowel fistula | 90 | $1,993 | |||
| 43886 | Revise gastric port open | $754 | ||||
| 43887 | Remove gastric port open | $681 | ||||
| 43888 | Change gastric port open | $954 | ||||
| 43999 | Stomach surgery procedure | BR | ||||
| 44005 | Freeing of bowel adhesion | 90 | $1,596 | |||
| 44010 | Incision of small bowel | 90 | $1,244 | |||
| 44015 | Insert needle cath bowel | $390 | ||||
| 44020 | Exploration of small bowel | 90 | $1,427 | |||
| 44021 | Decompress small bowel | 90 | $1,368 | |||
| 44025 | Incision of large bowel | 90 | $1,446 | |||
| 44050 | Reduce bowel obstruction | 90 | $1,378 | |||
| 44055 | Correct malrotation of bowel | 90 | $1,500 | |||
| 44100 | Biopsy of bowel | 0 | $250 | |||
| 44110 | Excision of bowel lesion(s) | 90 | $1,293 | |||
| 44111 | Excision of bowel lesion(s) | 90 | $1,618 | |||
| 44120 | Removal of small intestine | 90 | $1,793 | |||
| 44121 | Removal of small intestine | $508 | ||||
| 44125 | Removal of small intestine | 90 | $1,916 | |||
| 44126 | Enterectomy w/o taper cong | $5,115 | ||||
| 44127 | Enterectomy w/taper cong | $5,912 | ||||
| 44128 | Enterectomy cong add-on | $504 | ||||
| 44130 | Bowel to bowel fusion | 90 | $1,575 | |||
| 44139 | Mobilization of colon | $257 | ||||
| 44140 | Partial removal of colon | 90 | $2,189 | |||
| 44141 | Partial removal of colon | 90 | $2,261 | |||
| 44143 | Partial removal of colon | 90 | $2,128 | |||
| 44144 | Partial removal of colon | 90 | $2,107 | |||
| 44145 | Partial removal of colon | 90 | $2,707 | |||
| 44146 | Partial removal of colon | 90 | $2,921 | |||
| 44147 | Partial removal of colon | 90 | $2,534 | |||
| 44150 | Removal of colon | 90 | $2,623 | |||
| 44151 | Removal of colon/ileostomy | 90 | $2,150 | |||
| 44155 | Removal of colon | 90 | $2,991 | |||
| 44156 | Removal of colon/ileostomy | 90 | $2,436 | |||
| 44157 | Colectomy w/ileoanal anast | $4,527 | ||||
| 44160 | Removal of colon | 90 | $2,068 | |||
| 44180 | Lap enterolysis | $1,910 | ||||
| 44186 | Lap jejunostomy | $1,355 | ||||
| 44187 | Lap ileo/jejuno-stomy | $2,311 | ||||
| 44188 | Lap colostomy | $2,557 | ||||
| 44202 | Laparo, resect intestine | 90 | BR | |||
| 44203 | Lap resect s/intestine addl | $504 | ||||
| 44204 | Laparo partial colectomy | $3,206 | ||||
| 44205 | Lap colectomy part w/ileum | $2,789 | ||||
| 44206 | Lap part colectomy w/stoma | $3,658 | ||||
| 44207 | L colectomy/coloproctostomy | $3,811 | ||||
| 44208 | L colectomy/coloproctostomy | $4,148 | ||||
| 44210 | Laparo total proctocolectomy | $3,748 | ||||
| 44211 | Lap colectomy w/proctectomy | $4,693 | ||||
| 44212 | Laparo total proctocolectomy | $4,313 | ||||
| 44213 | Lap mobil splenic fl add-on | $393 | ||||
| 44227 | Lap close enterostomy | $3,476 | ||||
| 44300 | Open bowel to skin | 90 | $1,069 | |||
| 44310 | Ileostomy/jejunostomy | 90 | $1,389 | |||
| 44312 | Revision of ileostomy | 90 | $628 | |||
| 44314 | Revision of ileostomy | 90 | $1,250 | |||
| 44316 | Devise bowel pouch | 90 | $1,746 | |||
| 44320 | Colostomy | 90 | $1,446 | |||
| 44322 | Colostomy with biopsies | 90 | $1,505 | |||
| 44340 | Revision of colostomy | 90 | $492 | |||
| 44345 | Revision of colostomy | 90 | $1,127 | |||
| 44346 | Revision of colostomy | 90 | $1,356 | |||
| 44360 | Small bowel endoscopy | 0 | $494 | |||
| 44361 | Small bowel endoscopy, biopsy | 0 | $567 | |||
| 44363 | Small bowel endoscopy | 0 | $516 | |||
| 44364 | Small bowel endoscopy | 0 | $679 | |||
| 44365 | Small bowel endoscopy | 0 | $671 | |||
| 44366 | Small bowel endoscopy | 0 | $799 | |||
| 44369 | Small bowel endoscopy | 0 | $866 | |||
| 44370 | Small bowel endoscopy/stent | $600 | ||||
| 44372 | Small bowel endoscopy | 0 | $812 | |||
| 44373 | Small bowel endoscopy | 0 | $682 | |||
| 44376 | Small bowel endoscopy | 0 | $668 | |||
| 44377 | Small bowel endoscopy | 0 | $707 | |||
| 44378 | Small bowel endoscopy | 0 | $922 | |||
| 44379 | S bowel endoscope w/stent | $921 | ||||
| 44380 | Small bowel endoscopy | 0 | $278 | |||
| 44382 | Small bowel endoscopy | 0 | $355 | |||
| 44383 | Ileoscopy w/stent | $339 | ||||
| 44385 | Endoscopy of bowel pouch | 0 | $348 | |||
| 44386 | Endoscopy, bowel pouch, biops | 0 | $270 | |||
| 44388 | Colon endoscopy | 0 | $491 | |||
| 44389 | Colonoscopy with biopsy | 0 | $537 | |||
| 44390 | Colonoscopy for foreign body | 0 | $477 | |||
| 44391 | Colonoscopy for bleeding | 0 | $717 | |||
| 44392 | Colonoscopy & polypectomy | 0 | $707 | |||
| 44393 | Colonoscopy, lesion removal | 0 | $775 | |||
| 44394 | Colonoscopy w/snare | 0 | $707 | |||
| 44397 | Colonoscopy w/stent | $579 | ||||
| 44500 | Intro, gastrointestinal tube | 0 | $46 | |||
| 44602 | Suture, small intestine | 90 | $1,345 | |||
| 44603 | Suture, small intestine | 90 | $1,698 | |||
| 44604 | Suture, large intestine | 90 | $1,592 | |||
| 44605 | Repair of bowel lesion | 90 | $1,790 | |||
| 44615 | Intestinal stricturoplasty | 90 | $1,323 | |||
| 44620 | Repair bowel opening | 90 | $1,195 | |||
| 44625 | Repair bowel opening.. | 90 | $1,716 | |||
| 44626 | Repair bowel opening.. | 90 | $2,541 | |||
| 44640 | Repair bowel-skin fistula | 90 | $1,503 | |||
| 44650 | Repair bowel fistula | 90 | $1,596 | |||
| 44660 | Repair bowel-bladder fistula | 90 | $1,606 | |||
| 44661 | Repair bowel-bladder fistula | 90 | $2,259 | |||
| 44680 | Surgical revision, intestine | 90 | $1,718 | |||
| 44700 | Suspend bowel w/prosthesis | 90 | $1,923 | |||
| 44701 | Intraop colon lavage add-on | $348 | ||||
| 44720 | Prep donor intestine/venous | $507 | ||||
| 44721 | Prep donor intestine/artery | $798 | ||||
| 44799 | Intestine surgery procedure | BR | ||||
| 44800 | Excision of bowel pouch | 90 | $1,164 | |||
| 44820 | Excision of mesentery lesion | 90 | $1,155 | |||
| 44850 | Repair of mesentery | 90 | $1,092 | |||
| 44899 | Bowel surgery procedure | BR | ||||
| 44900 | Drain app abscess, open | 90 | $1,004 | |||
| 44901 | Drain app abscess, percut | 0 | $457 | |||
| 44950 | Appendectomy | 90 | $847 | |||
| 44955 | Appendectomy add-on... | $248 | ||||
| 44960 | Appendectomy | 90 | $1,197 | |||
| 44970 | Laparoscopy, appendectomy | 90 | $1,246 | |||
| 44979 | Laparoscope proc, app. | BR | ||||
| 45000 | Drainage of pelvic abscess | 90 | $433 | |||
| 45005 | Drainage of rectal abscess | 10 | $245 | |||
| 45020 | Drainage of rectal abscess | 90 | $533 | |||
| 45100 | Biopsy of rectum | 90 | $397 | |||
| 45108 | Removal of anorectal lesion | 90 | $530 | |||
| 45110 | Removal of rectum..... | 90 | $2,993 | |||
| 45111 | Partial removal of rectum. | 90 | $2,121 | |||
| 45112 | Removal of rectum..... | 90 | $3,139 | |||
| 45113 | Partial proctectomy | 90 | $3,088 | |||
| 45114 | Partial removal of rectum | 90 | $2,886 | |||
| 45116 | Partial removal of rectum | 90 | $2,280 | |||
| 45119 | Remove rectum w/reservoir | 90 | $3,158 | |||
| 45120 | Removal of rectum..... | 90 | $3,066 | |||
| 45121 | Removal of rectum and colon | 90 | $2,852 | |||
| 45123 | Partial proctectomy | 90 | $1,927 | |||
| 45126 | Pelvic exenteration... | 90 | $4,017 | |||
| 45130 | Excision of rectal prolapse | 90 | $1,680 | |||
| 45135 | Excision of rectal prolapse | 90 | $2,464 | |||
| 45136 | Excise ileoanal reservior | $3,800 | ||||
| 45150 | Excision of rectal stricture | 90 | $657 | |||
| 45160 | Excision of rectal lesion | 90 | $1,541 | |||
| 45171 | Exc rect tum transanal part | $1,254 | ||||
| 45172 | Exc rect tum transanal full | $1,696 | ||||
| 45190 | Destruction rectal tumor | 90 | $984 | |||
| 45300 | Proctosigmoidoscopy | 0 | $94 | |||
| 45303 | Proctosigmoidoscopy | 0 | $96 | |||
| 45305 | Proctosigmoidoscopy; biopsy | 0 | $141 | |||
| 45307 | Proctosigmoidoscopy | 0 | $224 | |||
| 45308 | Proctosigmoidoscopy | 0 | $229 | |||
| 45309 | Proctosigmoidoscopy | 0 | $229 | |||
| 45315 | Proctosigmoidoscopy | 0 | $239 | |||
| 45317 | Proctosigmoidoscopy | 0 | $296 | |||
| 45320 | Proctosigmoidoscopy | 0 | $360 | |||
| 45321 | Proctosigmoidoscopy | 0 | $273 | |||
| 45327 | Proctosigmoidoscopy w/stent | $254 | ||||
| 45330 | Sigmoidoscopy, diagnostic | 0 | $164 | |||
| 45331 | Sigmoidoscopy and biopsy | 0 | $215 | |||
| 45332 | Sigmoidoscopy | 0 | $275 | |||
| 45333 | Sigmoidoscopy & polypectomy | 0 | $330 | |||
| 45334 | Sigmoidoscopy for bleeding | 0 | $420 | |||
| 45335 | Sigmoidoscopy w/submuc inj | $585 | ||||
| 45337 | Sigmoidoscopy, decompression | 0 | $417 | |||
| 45338 | Sigmoidoscopy | 0 | $330 | |||
| 45339 | Sigmoidoscopy | 0 | $474 | |||
| 45340 | Sig w/balloon dilation | $1,036 | $242 | |||
| 45341 | Sigmoidoscopy w/ultrasound | $329 | ||||
| 45342 | Sigmoidoscopy w/us guide bx | $502 | ||||
| 45345 | Sigmoidoscopy w/stent | $365 | ||||
| 45355 | Surgical colonoscopy | 0 | $339 | |||
| 45378 | Diagnostic colonoscopy | 0 | $582 | |||
| 45379 | Colonoscopy | 0 | $744 | |||
| 45380 | Colonoscopy and biopsy | 0 | $651 | |||
| 45381 | Colonoscopy submucous inj | $984 | $512 | |||
| 45382 | Colonoscopy,control bleeding | 0 | $850 | |||
| 45383 | Colonoscopy, lesion removal | 0 | $871 | |||
| 45384 | Colonoscopy | 0 | $880 | |||
| 45385 | Colonoscopy, lesion removal | 0 | $880 | |||
| 45386 | Colonoscopy dilate stricture | $1,412 | $554 | |||
| 45387 | Colonoscopy w/stent | $725 | ||||
| 45391 | Colonoscopy w/endoscope us | $619 | ||||
| 45392 | Colonoscopy w/endoscopic fnb | $797 | ||||
| 45395 | Lap removal of rectum | $4,152 | ||||
| 45397 | Lap remove rectum w/pouch | $4,490 | ||||
| 45400 | Laparoscopic proc | $2,409 | ||||
| 45402 | Lap proctopexy w/sig resect | $3,193 | ||||
| 45500 | Repair of rectum | 90 | $973 | |||
| 45505 | Repair of rectum | 90 | $924 | |||
| 45520 | Treatment of rectal prolapse | 0 | $90 | |||
| 45540 | Correct rectal prolapse | 90 | $1,697 | |||
| 45541 | Correct rectal prolapse | 90 | $1,557 | |||
| 45550 | Repair rectum;remove sigmoid | 90 | $1,930 | |||
| 45560 | Repair of rectocele | 90 | $938 | |||
| 45562 | Exploration/repair of rectum | 90 | $1,456 | |||
| 45563 | Exploration/repair of rectum | 90 | $2,297 | |||
| 45800 | Repair rectumbladder fistula | 90 | $1,701 | |||
| 45805 | Repair fistula; colostomy | 90 | $2,110 | |||
| 45820 | Repair rectourethral fistula | 90 | $1,665 | |||
| 45825 | Repair fistula; colostomy | 90 | $1,910 | |||
| 45900 | Reduction of rectal prolapse | 10 | $168 | |||
| 45905 | Dilation of anal sphincter | 10 | $166 | |||
| 45910 | Dilation of rectal narrowing | 10 | $203 | |||
| 45915 | Remove rectal obstruction | 10 | $210 | |||
| 45990 | Surg dx exam anorectal | $222 | ||||
| 45999 | Rectum surgery procedure | BR | ||||
| 46020 | Placement of seton | $573 | $487 | |||
| 46030 | Removal of rectal marker | 10 | $118 | |||
| 46040 | Incision of rectal abscess | 90 | $490 | |||
| 46045 | Incision of rectal abscess | 90 | $434 | |||
| 46050 | Incision of anal abscess | 10 | $131 | |||
| 46060 | Incision of rectal abscess | 90 | $815 | |||
| 46070 | Incision of anal septum | 90 | $307 | |||
| 46080 | Incision of anal sphincter | 10 | $348 | |||
| 46083 | Incise external hemorrhoid | 10 | $146 | |||
| 46200 | Removal of anal fissure | 90 | $494 | |||
| 46220 | Removal of anal tab | 10 | $161 | |||
| 46221 | Ligation of hemorrhoid(s) | 10 | $155 | |||
| 46230 | Removal of anal tabs | 10 | $246 | |||
| 46250 | Hemorrhoidectomy | 90 | $542 | |||
| 46255 | Hemorrhoidectomy | 90 | $745 | |||
| 46257 | Remove hemorrhoids & fissure | 90 | $863 | |||
| 46258 | Remove hemorrhoids & fistula | 90 | $945 | |||
| 46260 | Hemorrhoidectomy | 90 | $992 | |||
| 46261 | Remove hemorrhoids & fissure | 90 | $1,026 | |||
| 46262 | Remove hemorrhoids & fistula | 90 | $1,054 | |||
| 46270 | Removal of anal fistula | 90 | $407 | |||
| 46275 | Removal of anal fistula | 90 | $777 | |||
| 46280 | Removal of anal fistula | 90 | $917 | |||
| 46285 | Removal of anal fistula | 90 | $467 | |||
| 46288 | Repair of anal fistula | 90 | $786 | |||
| 46320 | Removal of hemorrhoid clot | 10 | $170 | |||
| 46505 | Chemodenervation anal musc | $594 | $498 | |||
| 46600 | Diagnostic anoscopy | 0 | $58 | |||
| 46604 | Anoscopy and dilation | 0 | $124 | |||
| 46606 | Anoscopy and biopsy | 0 | $87 | |||
| 46608 | Anoscopy;remove foreign body | 0 | $192 | |||
| 46610 | Anoscopy; remove lesion | 0 | $178 | |||
| 46611 | Anoscopy | 0 | $178 | |||
| 46612 | Anoscopy; remove lesions | 0 | $227 | |||
| 46614 | Anoscopy; control bleeding | 0 | $270 | |||
| 46615 | Anoscopy | 0 | $318 | |||
| 46700 | Repair of anal stricture | 90 | $976 | |||
| 46705 | Repair of anal stricture | 90 | $761 | |||
| 46706 | Repr of anal fistula w/glue | $347 | ||||
| 46707 | Repair anorectal fist w/plug | $963 | ||||
| 46710 | Repr per/vag pouch sngl proc | $2,270 | ||||
| 46712 | Repr per/vag pouch dbl proc | $4,249 | ||||
| 46715 | Repair of anovaginal fistula | 90 | $783 | |||
| 46716 | Repair of anovaginal fistula | 90 | $1,348 | |||
| 46730 | Construction of absent anus | 90 | $2,392 | |||
| 46735 | Construction of absent anus | 90 | $2,901 | |||
| 46740 | Construction of absent anus | 90 | $2,571 | |||
| 46742 | Repair, imperforated anus | 90 | $3,504 | |||
| 46744 | Repair, cloacal anomaly | 90 | $3,934 | |||
| 46746 | Repair, cloacal anomaly | 90 | $4,304 | |||
| 46748 | Repair, cloacal anomaly | 90 | $4,795 | |||
| 46750 | Repair of anal sphincter | 90 | $1,032 | |||
| 46751 | Repair of anal sphincter | 90 | $907 | |||
| 46753 | Reconstruction of anus | 90 | $846 | |||
| 46754 | Removal of suture from anus | 10 | $234 | |||
| 46760 | Repair of anal sphincter | 90 | $1,333 | |||
| 46761 | Repair of anal sphincter | 90 | $1,299 | |||
| 46762 | Implant artificial sphincter | 90 | $1,146 | |||
| 46900 | Destruction, anal lesion(s) | 10 | $160 | |||
| 46910 | Destruction, anal lesion(s) | 10 | $180 | |||
| 46916 | Cryosurgery, anal lesion(s) | 10 | $180 | |||
| 46917 | Laser surgery,anal lesion(s) | 10 | $287 | |||
| 46922 | Excision of anal lesion(s) | 10 | $235 | |||
| 46924 | Destruction, anal lesion(s) | 10 | $406 | |||
| 46930 | Destroy internal hemorrhoids | $422 | $306 | |||
| 46940 | Treatment of anal fissure | 10 | $206 | |||
| 46942 | Treatment of anal fissure | 10 | $181 | |||
| 46945 | Ligation of hemorrhoids | 90 | $270 | |||
| 46946 | Ligation of hemorrhoids | 90 | $364 | |||
| 46947 | Hemorrhoidopexy by stapling | $797 | ||||
| 46999 | Anus surgery procedure | BR | ||||
| 47000 | Needle biopsy of liver | 0 | $342 | |||
| 47001 | Needle biopsy, liver add-on | $234 | ||||
| 47010 | Open drainage, liver lesion | 90 | $1,302 | |||
| 47011 | Percut drain, liver lesion | 0 | $538 | |||
| 47015 | Inject/aspirate liver cyst | 90 | $1,166 | |||
| 47100 | Wedge biopsy of liver | 90 | $833 | |||
| 47120 | Partial removal of liver | 90 | $2,440 | |||
| 47122 | Extensive removal of liver | 90 | $3,802 | |||
| 47125 | Partial removal of liver | 90 | $3,519 | |||
| 47130 | Partial removal of liver | 90 | $3,867 | |||
| 47133 | Removal of donor liver | BR | ||||
| 47135 | Transplantation of liver | 90 | $10,022 | |||
| 47136 | Transplantation of liver | 90 | $7,373 | |||
| 47140 | Partial removal donor liver | $7,241 | ||||
| 47141 | Partial removal donor liver | $8,173 | ||||
| 47142 | Partial removal donor liver | $9,745 | ||||
| 47146 | Prep donor liver/venous | $683 | ||||
| 47147 | Prep donor liver/arterial | $796 | ||||
| 47300 | Surgery for liver lesion | 90 | $1,276 | |||
| 47350 | Repair liver wound.... | 90 | $1,509 | |||
| 47360 | Repair liver wound.... | 90 | $2,128 | |||
| 47361 | Repair liver wound.... | 90 | $3,402 | |||
| 47362 | Repair liver wound.... | 90 | $1,333 | |||
| 47370 | Laparo ablate liver tumor rf | $2,552 | ||||
| 47371 | Laparo ablate liver cryosurg | $2,606 | ||||
| 47380 | Open ablate liver tumor rf | $2,954 | ||||
| 47381 | Open ablate liver tumor cryo | $3,070 | ||||
| 47399 | Liver surgery procedure | BR | ||||
| 47400 | Incision of liver duct | 90 | $2,038 | |||
| 47420 | Incision of bile duct | 90 | $1,975 | |||
| 47425 | Incision of bile duct | 90 | $2,049 | |||
| 47460 | Incise bile duct sphincter | 90 | $2,187 | |||
| 47480 | Incision of gallbladder | 90 | $1,221 | |||
| 47490 | Incision of gallbladder | 90 | $707 | |||
| 47500 | Injection for liver X-rays | 0 | $256 | |||
| 47505 | Injection for liver X-rays | 0 | $158 | |||
| 47510 | Insert catheter, bile duct | 90 | $744 | |||
| 47511 | Insert bile duct drain | 90 | $922 | |||
| 47525 | Change bile duct catheter | 10 | $507 | |||
| 47530 | Revise/reinsert bile tube | 90 | $589 | |||
| 47550 | Bile duct endoscopy add-on | $341 | ||||
| 47552 | Biliary endoscopy, thru skin | 0 | $539 | |||
| 47553 | Biliary endoscopy, thru skin | 0 | $763 | |||
| 47554 | Biliary endoscopy, thru skin | 0 | $967 | |||
| 47555 | Biliary endoscopy, thru skin | 0 | $742 | |||
| 47556 | Biliary endoscopy, thru skin | 0 | $814 | |||
| 47560 | Laparoscopy w/cholangio | 90 | $556 | |||
| 47561 | Laparo w/cholangio/biopsy | 0 | $610 | |||
| 47562 | Laparoscopic cholecystectomy | 90 | $1,558 | |||
| 47563 | Laparo cholecystectomy graph | 90 | $1,483 | |||
| 47564 | Laparo cholecystectomy explr | 90 | $2,309 | |||
| 47570 | Laparo cholecystoenterostomy | 90 | $1,608 | |||
| 47579 | Laparoscope proc, biliary | BR | ||||
| 47600 | Removal of gallbladder | 90 | $1,401 | |||
| 47605 | Removal of gallbladder | 90 | $1,517 | |||
| 47610 | Removal of gallbladder | 90 | $1,785 | |||
| 47612 | Removal of gallbladder | 90 | $2,267 | |||
| 47620 | Removal of gallbladder | 90 | $2,080 | |||
| 47630 | Remove bile duct stone | 90 | $882 | |||
| 47700 | Exploration of bile ducts | 90 | $1,625 | |||
| 47701 | Bile duct revision | 90 | $2,597 | |||
| 47711 | Excision of bile duct tumor | 90 | $2,288 | |||
| 47712 | Excision of bile duct tumor | 90 | $2,678 | |||
| 47715 | Excision of bile duct cyst | 90 | $1,729 | |||
| 47720 | Fuse gallbladder & bowel | 90 | $1,627 | |||
| 47721 | Fuse upper gi structures | 90 | $2,004 | |||
| 47740 | Fuse gallbladder & bowel | 90 | $1,860 | |||
| 47741 | Fuse gallbladder & bowel | 90 | $2,352 | |||
| 47760 | Fuse bile ducts and bowel. | 90 | $2,515 | |||
| 47765 | Fuse liver ducts & bowel. | 90 | $2,668 | |||
| 47780 | Fuse bile ducts and bowel | 90 | $2,563 | |||
| 47785 | Fuse bile ducts and bowel | 90 | $2,815 | |||
| 47800 | Reconstruction of bile ducts | 90 | $2,362 | |||
| 47801 | Placement, bile duct support | 90 | $1,244 | |||
| 47802 | Fuse liver duct & intestine | 90 | $1,984 | |||
| 47900 | Suture bile duct injury | 90 | $2,190 | |||
| 47999 | Bile tract surgery procedure | BR | ||||
| 48000 | Drainage of abdomen | 90 | $1,526 | |||
| 48001 | Placement of drain, pancreas | 90 | $1,809 | |||
| 48020 | Removal of pancreatic stone | 90 | $1,510 | |||
| 48100 | Biopsy of pancreas | 90 | $1,076 | |||
| 48102 | Needle biopsy, pancreas | 10 | $502 | |||
| 48105 | Resect/debride pancreas | $5,918 | ||||
| 48120 | Removal of pancreas lesion | 90 | $1,740 | |||
| 48140 | Partial removal of pancreas | 90 | $2,434 | |||
| 48145 | Partial removal of pancreas | 90 | $2,687 | |||
| 48146 | Pancreatectomy | 90 | $2,841 | |||
| 48148 | Removal of pancreatic duct | 90 | $1,722 | |||
| 48150 | Partial removal of pancreas | 90 | $4,350 | |||
| 48152 | Pancreatectomy | 90 | $4,125 | |||
| 48153 | Pancreatectomy | 90 | $4,350 | |||
| 48154 | Pancreatectomy | 90 | $4,125 | |||
| 48155 | Removal of pancreas | 90 | $3,122 | |||
| 48160 | Pancreas removal, transplant | BR | ||||
| 48400 | Injection, intraop add on | $221 | ||||
| 48500 | Surgery of pancreas cyst | 90 | $1,573 | |||
| 48510 | Drain pancreatic pseudocyst | 90 | $1,547 | |||
| 48511 | Drain pancreatic pseudocyst | 0 | $551 | |||
| 48520 | Fuse pancreas cyst and bowel | 90 | $1,890 | |||
| 48540 | Fuse pancreas cyst and bowel | 90 | $2,201 | |||
| 48545 | Pancreatorrhaphy | 90 | $1,706 | |||
| 48547 | Duodenal exclusion | 90 | $2,467 | |||
| 48548 | Fuse pancreas and bowel | $3,448 | ||||
| 48550 | Donor pancreatectomy | BR | ||||
| 48552 | Prep donor pancreas/venous | $488 | ||||
| 48554 | Transplantallograft pancreas | 90 | $5,322 | |||
| 48556 | Removal, allograft pancreas | 90 | $2,648 | |||
| 48999 | Pancreas surgery procedure | BR | ||||
| 49000 | Exploration of abdomen | 90 | $1,217 | |||
| 49002 | Reopening of abdomen | 90 | $1,179 | |||
| 49010 | Exploration behind abdomen | 90 | $1,377 | |||
| 49020 | Drain abdominal abscess | 90 | $1,666 | |||
| 49021 | Drain abdominal abscess | 0 | $596 | |||
| 49040 | Drain, open, abdom abscess | 90 | $1,266 | |||
| 49041 | Drain, percut, abdom abscess | 0 | $565 | |||
| 49060 | Drain, open, retrop abscess | 90 | $1,324 | |||
| 49061 | Drain, percut, retroper absc | 0 | $531 | |||
| 49062 | Drain to peritoneal cavity | 90 | $1,414 | |||
| 49082 | Abd paracentesis | $337 | $143 | |||
| 49084 | Peritoneal lavage | $204 | ||||
| 49180 | Biopsy, abdominal mass | 0 | $249 | |||
| 49204 | Exc abd tum over 5 cm | $3,154 | ||||
| 49205 | Exc abd tum over 10 cm | $3,618 | ||||
| 49215 | Excise sacral spine tumor | 90 | $2,204 | |||
| 49220 | Multiple surgery, abdomen | 90 | $2,017 | |||
| 49250 | Excision of umbilicus | 90 | $913 | |||
| 49255 | Removal of omentum | 90 | $733 | |||
| 49320 | Diag laparo separate proc | 10 | $680 | |||
| 49321 | Laparoscopy, biopsy... | 10 | $720 | |||
| 49322 | Laparoscopy, aspiration | 10 | $771 | |||
| 49323 | Laparo drain lymphocele | 90 | $1,343 | |||
| 49324 | Lap insert tunnel ip cath | $820 | ||||
| 49325 | Lap revision perm ip cath | $875 | ||||
| 49326 | Lap w/omentopexy add-on | $393 | ||||
| 49327 | Lap ins device for rt | $269 | ||||
| 49329 | Laparo proc, abdm/per/oment | BR | ||||
| 49400 | Air injection into abdomen | 0 | $224 | |||
| 49402 | Remove foreign body adbomen | $1,772 | ||||
| 49411 | Ins mark abd/pel for rt perq | $1,143 | ||||
| 49412 | Ins device for rt guide open | $167 | ||||
| 49418 | Insert tun ip cath perc | $3,273 | ||||
| 49419 | Insert tun ip cath w/port | $917 | ||||
| 49421 | Insert abdominal drain | 90 | $697 | |||
| 49422 | Remove perm cannula/catheter | 10 | $756 | |||
| 49423 | Exchange drainage catheter | 0 | $185 | |||
| 49424 | Assess cyst, contrast inject | 0 | $98 | |||
| 49425 | Insert abdomen-venous drain | 90 | $1,486 | |||
| 49426 | Revise abdomen-venous shunt | 90 | $1,064 | |||
| 49427 | Injection, abdominal shunt | 0 | $101 | |||
| 49428 | Ligation of shunt | 10 | $228 | |||
| 49429 | Removal of shunt | 10 | $731 | |||
| 49435 | Insert subq exten to ip cath | $251 | ||||
| 49436 | Embedded ip cath exit-site | $385 | ||||
| 49440 | Place gastrostomy tube perc | $2,176 | ||||
| 49441 | Place duod/jej tube perc | $2,422 | $522 | |||
| 49442 | Place cecostomy tube perc | $1,916 | $443 | |||
| 49446 | Change g-tube to g-j perc | $2,051 | $332 | |||
| 49450 | Replace g/c tube perc | $1,357 | $136 | |||
| 49451 | Replace duod/jej tube perc | $1,483 | $187 | |||
| 49452 | Replace g-j tube perc | $1,823 | $287 | |||
| 49460 | Fix g/colon tube w/device | $1,528 | $99 | |||
| 49465 | Fluoro exam of g/colon tube | $351 | $62 | |||
| 49491 | Rpr hern preemie reduc | $1,590 | ||||
| 49492 | Rpr ing hern premie blocked | $1,983 | ||||
| 49495 | Repair inguinal hernia, init | 90 | $830 | |||
| 49496 | Repair inguinal hernia, init | 90 | $1,026 | |||
| 49500 | Repair inguinal hernia | 90 | $733 | |||
| 49501 | Repair inguinal hernia, init | 90 | $948 | |||
| 49505 | Repair inguinal hernia | 90 | $823 | |||
| 49507 | Repair, inguinal hernia | 90 | $957 | |||
| 49520 | Rerepair inguinal hernia | 90 | $1,006 | |||
| 49521 | Repair inguinal hernia, rec | 90 | $1,101 | |||
| 49525 | Repair inguinal hernia | 90 | $969 | |||
| 49540 | Repair lumbar hernia | 90 | $1,008 | |||
| 49550 | Repair femoral hernia | 90 | $898 | |||
| 49553 | Repair femoral hernia, init | 90 | $919 | |||
| 49555 | Repair femoral hernia | 90 | $1,035 | |||
| 49557 | Repair femoral hernia, recur | 90 | $1,137 | |||
| 49560 | Repair abdominal hernia | 90 | $1,170 | |||
| 49561 | Repair incisional hernia | 90 | $1,290 | |||
| 49565 | Rerepair abdominal hernia | 90 | $1,228 | |||
| 49566 | Repair incisional hernia | 90 | $1,356 | |||
| 49568 | Hernia repair w/mesh.. | $557 | ||||
| 49570 | Repair epigastric hernia | 90 | $691 | |||
| 49572 | Repair, epigastric hernia | 90 | $859 | |||
| 49580 | Repair umbilical hernia | 90 | $598 | |||
| 49582 | Repair umbilical hernia | 90 | $756 | |||
| 49585 | Repair umbilical hernia | 90 | $727 | |||
| 49587 | Repair umbilical hernia | 90 | $797 | |||
| 49590 | Repair abdominal hernia | 90 | $948 | |||
| 49600 | Repair umbilical lesion | 90 | $1,099 | |||
| 49605 | Repair umbilical lesion | 90 | $2,284 | |||
| 49606 | Repair umbilical lesion | 90 | $1,925 | |||
| 49610 | Repair umbilical lesion | 90 | $1,174 | |||
| 49611 | Repair umbilical lesion | 90 | $1,263 | |||
| 49650 | Laparo hernia repair initial | 90 | $888 | |||
| 49651 | Laparo hernia repair recur | 90 | $1,157 | |||
| 49652 | Lap vent/abd hernia repair | $1,433 | ||||
| 49653 | Lap vent/abd hern proc comp | $1,790 | ||||
| 49654 | Lap inc hernia repair | $1,627 | ||||
| 49655 | Lap inc hern repair comp | $1,989 | ||||
| 49656 | Lap inc hernia repair recur | $1,767 | ||||
| 49657 | Lap inc hern recur comp | $2,538 | ||||
| 49659 | Laparo proc, hernia repair | BR | ||||
| 49900 | Repair of abdominal wall | 90 | $634 | |||
| 49904 | Omental flap extra-abdom | $3,019 | ||||
| 49905 | Omental flap | $763 | ||||
| 49906 | Free omental flap, microvasc | 90 | BR | |||
| 49999 | Abdomen surgery procedure | BR | ||||
| 50010 | Exploration of kidney | 90 | $1,469 | |||
| 50020 | Renal abscess, open drain. | 90 | $1,638 | |||
| 50021 | Renal abscess, percut drain | 0 | $522 | |||
| 50040 | Drainage of kidney | 90 | $1,529 | |||
| 50045 | Exploration of kidney | 90 | $1,783 | |||
| 50060 | Removal of kidney stone | 90 | $2,227 | |||
| 50065 | Incision of kidney | 90 | $2,471 | |||
| 50070 | Incision of kidney | 90 | $2,362 | |||
| 50075 | Removal of kidney stone | 90 | $3,012 | |||
| 50080 | Removal of kidney stone | 90 | $1,935 | |||
| 50081 | Removal of kidney stone | 90 | $2,618 | |||
| 50100 | Revise kidney blood vessels | 90 | $1,897 | |||
| 50120 | Exploration of kidney | 90 | $1,922 | |||
| 50125 | Explore and drain kidney | 90 | $1,955 | |||
| 50130 | Removal of kidney stone | 90 | $2,136 | |||
| 50135 | Exploration of kidney | 90 | $2,607 | |||
| 50200 | Biopsy of kidney | 0 | $387 | |||
| 50205 | Biopsy of kidney | 90 | $1,347 | |||
| 50220 | Removal of kidney | 90 | $2,175 | |||
| 50225 | Removal of kidney | 90 | $2,630 | |||
| 50230 | Removal of kidney | 90 | $2,888 | |||
| 50234 | Removal of kidney & ureter | 90 | $2,790 | |||
| 50236 | Removal of kidney & ureter | 90 | $3,031 | |||
| 50240 | Partial removal of kidney | 90 | $2,686 | |||
| 50250 | Cryoablate renal mass open | $2,494 | ||||
| 50280 | Removal of kidney lesion | 90 | $1,886 | |||
| 50290 | Removal of kidney lesion | 90 | $1,681 | |||
| 50300 | Removal of donor kidney | BR | ||||
| 50320 | Removal of donor kidney | 90 | $2,787 | |||
| 50327 | Prep renal graft/venous | $448 | ||||
| 50328 | Prep renal graft/arterial | $391 | ||||
| 50329 | Prep renal graft/ureteral | $360 | ||||
| 50340 | Removal of kidney | 90 | $1,802 | |||
| 50360 | Transplantation of kidney | 90 | $4,131 | |||
| 50365 | Transplantation of kidney | 90 | $4,752 | |||
| 50370 | Remove transplanted kidney | 90 | $1,840 | |||
| 50380 | Reimplantation of kidney | 90 | $2,005 | |||
| 50382 | Change ureter stent percut | $2,473 | $554 | |||
| 50384 | Remove ureter stent percut | $1,993 | $502 | |||
| 50385 | Change stent via transureth | $2,388 | $470 | |||
| 50386 | Remove stent via transureth | $1,555 | $355 | |||
| 50387 | Change ext/int ureter stent | $1,148 | $201 | |||
| 50389 | Remove renal tube w/fluoro | $606 | $110 | |||
| 50390 | Drainage of kidney lesion | 0 | $360 | |||
| 50391 | Instll rx agnt into rnal tub | $247 | $201 | |||
| 50392 | Insert kidney drain | 0 | $577 | |||
| 50393 | Insert ureteral tube | 0 | $719 | |||
| 50394 | Injection for kidney X-ray | 0 | $97 | |||
| 50395 | Create passage to kidney | 0 | $621 | |||
| 50396 | Measure kidney pressure | 0 | $187 | |||
| 50398 | Change kidney tube | 0 | $145 | |||
| 50400 | Revision of kidney/ureter | 90 | $2,343 | |||
| 50405 | Revision of kidney/ureter | 90 | $2,936 | |||
| 50500 | Repair of kidney wound | 90 | $2,292 | |||
| 50520 | Close kidney-skin fistula | 90 | $1,967 | |||
| 50525 | Repair renal-abdomen fistula | 90 | $2,491 | |||
| 50526 | Repair renal-abdomen fistula | 90 | $2,256 | |||
| 50540 | Revision of horseshoe kidney | 90 | $2,414 | |||
| 50541 | Laparo ablate renal cyst | 90 | BR | |||
| 50542 | Laparo ablate renal mass | $2,386 | ||||
| 50543 | Laparo partial nephrectomy | $3,048 | ||||
| 50544 | Laparoscopy, pyeloplasty | 90 | $2,552 | |||
| 50545 | Laparo radical nephrectomy | $2,747 | ||||
| 50546 | Laparoscopic nephrectomy | 90 | $2,460 | |||
| 50547 | Laparo removal donor kidney | 90 | $3,321 | |||
| 50548 | Laparo-asst remove k/ureter | 90 | $2,756 | |||
| 50549 | Laparoscope proc, renal | BR | ||||
| 50551 | Kidney endoscopy | 0 | $566 | |||
| 50553 | Kidney endoscopy | 0 | $554 | |||
| 50555 | Kidney endoscopy & biopsy | 0 | $827 | |||
| 50557 | Kidney endoscopy & treatment | 0 | $837 | |||
| 50561 | Kidney endoscopy & treatment | 0 | $935 | |||
| 50562 | Renal scope w/tumor resect | $1,190 | ||||
| 50570 | Kidney endoscopy | 0 | $789 | |||
| 50572 | Kidney endoscopy | 0 | $1,300 | |||
| 50574 | Kidney endoscopy & biopsy | 0 | $1,327 | |||
| 50575 | Kidney endoscopy | 0 | $1,762 | |||
| 50576 | Kidney endoscopy & treatment | 0 | $1,448 | |||
| 50580 | Kidney endoscopy & treatment | 0 | $1,118 | |||
| 50590 | Fragmenting of kidney stone | 90 | $1,466 | |||
| 50592 | Perc rf ablate renal tumor | $6,199 | $732 | |||
| 50593 | Perc cryo ablate renal tum | $9,224 | $978 | |||
| 50600 | Exploration of ureter | 90 | $1,804 | |||
| 50605 | Insert ureteral support | 90 | $1,495 | |||
| 50610 | Removal of ureter stone | 90 | $1,968 | |||
| 50620 | Removal of ureter stone | 90 | $1,899 | |||
| 50630 | Removal of ureter stone | 90 | $1,976 | |||
| 50650 | Removal of ureter | 90 | $2,098 | |||
| 50660 | Removal of ureter | 90 | $2,299 | |||
| 50684 | Injection for ureter X-ray | 0 | $93 | |||
| 50686 | Measure ureter pressure | 0 | $136 | |||
| 50688 | Change of ureter tube | 10 | $111 | |||
| 50690 | Injection for ureter X-ray | 0 | $107 | |||
| 50700 | Revision of ureter | 90 | $1,979 | |||
| 50715 | Release of ureter | 90 | $2,148 | |||
| 50722 | Release of ureter | 90 | $1,939 | |||
| 50725 | Release/revise ureter | 90 | $2,189 | |||
| 50727 | Revise ureter | 90 | $952 | |||
| 50728 | Revise ureter | 90 | $1,402 | |||
| 50740 | Fusion of ureter & kidney | 90 | $2,267 | |||
| 50750 | Fusion of ureter & kidney | 90 | $2,367 | |||
| 50760 | Fusion of ureters | 90 | $2,271 | |||
| 50770 | Splicing of ureters | 90 | $2,471 | |||
| 50780 | Reimplant ureter in bladder | 90 | $2,291 | |||
| 50782 | Reimplant ureter in bladder | 90 | $2,369 | |||
| 50783 | Reimplant ureter in bladder | 90 | $2,436 | |||
| 50785 | Reimplant ureter in bladder | 90 | $2,574 | |||
| 50800 | Implant ureter in bowel | 90 | $2,073 | |||
| 50810 | Fusion of ureter & bowel | 90 | $2,298 | |||
| 50815 | Urine shunt to bowel | 90 | $2,877 | |||
| 50820 | Construct bowel bladder | 90 | $2,946 | |||
| 50825 | Construct bowel bladder | 90 | $4,252 | |||
| 50830 | Revise urine flow | 90 | $3,716 | |||
| 50840 | Replace ureter by bowel | 90 | $2,323 | |||
| 50845 | Appendico-vesicostomy | 90 | $2,460 | |||
| 50860 | Transplant ureter to skin | 90 | $1,846 | |||
| 50900 | Repair of ureter | 90 | $1,678 | |||
| 50920 | Closure ureter/skin fistula | 90 | $1,680 | |||
| 50930 | Closure ureter/bowel fistula | 90 | $2,218 | |||
| 50940 | Release of ureter | 90 | $1,722 | |||
| 50945 | Laparoscopy ureterolithotomy | 90 | $1,990 | |||
| 50947 | Laparo new ureter/bladder | $2,829 | ||||
| 50948 | Laparo new ureter/bladder | $2,608 | ||||
| 50951 | Endoscopy of ureter | 0 | $544 | |||
| 50953 | Endoscopy of ureter | 0 | $571 | |||
| 50955 | Ureter endoscopy & biopsy | 0 | $677 | |||
| 50957 | Ureter endoscopy & treatment | 0 | $676 | |||
| 50961 | Ureter endoscopy & treatment | 0 | $633 | |||
| 50970 | Ureter endoscopy | 0 | $909 | |||
| 50972 | Ureter endoscopy & catheter | 0 | $609 | |||
| 50974 | Ureter endoscopy & biopsy | 0 | $1,192 | |||
| 50976 | Ureter endoscopy & treatment | 0 | $1,138 | |||
| 50980 | Ureter endoscopy & treatment | 0 | $728 | |||
| 51020 | Incise & treat bladder | 90 | $964 | |||
| 51030 | Incise & treat bladder | 90 | $779 | |||
| 51040 | Incise & drain bladder | 90 | $803 | |||
| 51045 | Incise bladder, drain ureter | 90 | $815 | |||
| 51050 | Removal of bladder stone | 90 | $982 | |||
| 51060 | Removal of ureter stone | 90 | $1,443 | |||
| 51065 | Removal of ureter stone | 90 | $1,122 | |||
| 51080 | Drainage of bladder abscess | 90 | $791 | |||
| 51100 | Drain bladder by needle | $124 | $79 | |||
| 51101 | Drain bladder by trocar/cath | $255 | $108 | |||
| 51102 | Drain bl w/cath insertion | $458 | $295 | |||
| 51500 | Removal of bladder cyst | 90 | $1,247 | |||
| 51520 | Removal of bladder lesion | 90 | $1,281 | |||
| 51525 | Removal of bladder lesion | 90 | $1,735 | |||
| 51530 | Removal of bladder lesion | 90 | $1,529 | |||
| 51535 | Repair of ureter lesion | 90 | $1,440 | |||
| 51550 | Partial removal of bladder | 90 | $1,856 | |||
| 51555 | Partial removal of bladder | 90 | $2,348 | |||
| 51565 | Revise bladder & ureter(s) | 90 | $2,656 | |||
| 51570 | Removal of bladder | 90 | $2,792 | |||
| 51575 | Removal of bladder & nodes | 90 | $3,755 | |||
| 51580 | Remove bladder; revise tract | 90 | $3,552 | |||
| 51585 | Removal of bladder & nodes | 90 | $4,231 | |||
| 51590 | Remove bladder; revise tract | 90 | $4,056 | |||
| 51595 | Remove bladder; revise tract | 90 | $5,054 | |||
| 51596 | Remove bladder, create pouch | 90 | $5,281 | |||
| 51597 | Removal of pelvic structures | 90 | $4,970 | |||
| 51600 | Injection for bladder X-ray | 0 | $84 | |||
| 51605 | Preparation for bladder xray | 0 | $103 | |||
| 51610 | Injection for bladder X-ray | 0 | $133 | |||
| 51700 | Irrigation of bladder | 0 | $80 | |||
| 51701 | Insert bladder catheter | $110 | $56 | |||
| 51705 | Change of bladder tube | 10 | $100 | |||
| 51715 | Endoscopic injection/implant | 0 | $472 | |||
| 51720 | Treatment of bladder lesion | 0 | $175 | |||
| 51725 | Simple cystometrogram | 0 | $187 | |||
| 51725 | 26 | Simple cystometrogram | 0 | $157 | ||
| 51725 | TC | Simple cystometrogram | 0 | $30 | ||
| 51726 | Complex cystometrogram | 0 | $222 | |||
| 51726 | 26 | Complex cystometrogram | 0 | $185 | ||
| 51726 | TC | Complex cystometrogram | 0 | $38 | ||
| 51727 | Cystometrogram w/up | 0 | $425 | |||
| 51728 | 26 | Cystometrogram w/vp | 0 | $217 | ||
| 51728 | TC | Cystometrogram w/vp | 0 | $431 | ||
| 51728 | Cystometrogram w/vp | 0 | $648 | |||
| 51729 | 26 | Cystometrogram w/vp&up | 0 | $264 | ||
| 51729 | TC | Cystometrogram w/vp&up | 0 | $442 | ||
| 51729 | Cystometrogram w/vp&up | 0 | $707 | |||
| 51736 | Urine flow measurement | 0 | $91 | |||
| 51736 | 26 | Urine flow measurement | 0 | $80 | ||
| 51736 | TC | Urine flow measurement | 0 | $12 | ||
| 51741 | Electro-uroflowmetry, first | 0 | $155 | |||
| 51741 | 26 | Electro-uroflowmetry, first | 0 | $139 | ||
| 51741 | TC | Electro-uroflowmetry, first | 0 | $17 | ||
| 51784 | Anal/urinary muscle study | 0 | $188 | |||
| 51784 | 26 | Anal/urinary muscle study | 0 | $158 | ||
| 51784 | TC | Anal/urinary muscle study | 0 | $30 | ||
| 51785 | Anal/urinary muscle study | 0 | $190 | |||
| 51785 | 26 | Anal/urinary muscle study | 0 | $160 | ||
| 51785 | TC | Anal/urinary muscle study | 0 | $31 | ||
| 51792 | Urinary reflex study | 0 | $229 | |||
| 51792 | 26 | Urinary reflex study | 0 | $124 | ||
| 51792 | TC | Urinary reflex study | 0 | $105 | ||
| 51797 | Intraabdominal pressure test | 0 | $189 | |||
| 51797 | 26 | Intraabdominal pressure test | 0 | $154 | ||
| 51797 | TC | Intraabdominal pressure test | 0 | $35 | ||
| 51800 | Revision of bladder/urethra | 90 | $2,110 | |||
| 51820 | Revision of urinary tract | 90 | $1,797 | |||
| 51840 | Attach bladder/urethra | 90 | $1,447 | |||
| 51841 | Attach bladder/urethra | 90 | $1,741 | |||
| 51845 | Repair bladder neck | 90 | $1,477 | |||
| 51860 | Repair of bladder wound | 90 | $1,394 | |||
| 51865 | Repair of bladder wound | 90 | $1,856 | |||
| 51880 | Repair of bladder opening | 90 | $899 | |||
| 51900 | Repair bladder/vagina lesion | 90 | $1,751 | |||
| 51920 | Close bladder-uterus fistula | 90 | $1,332 | |||
| 51925 | Hysterectomy/bladder repair | 90 | $1,876 | |||
| 51940 | Correction of bladder defect | 90 | $3,268 | |||
| 51960 | Revision of bladder & bowel | 90 | $3,174 | |||
| 51980 | Construct bladder opening | 90 | $1,320 | |||
| 51990 | Laparo urethral suspension | 90 | $1,574 | |||
| 51992 | Laparo sling operation | 90 | $1,788 | |||
| 52000 | Cystoscopy | 0 | $246 | |||
| 52001 | Cystoscopy removal of clots | $743 | $582 | |||
| 52005 | Cystoscopy & ureter catheter | 0 | $339 | |||
| 52007 | Cystoscopy and biopsy | 0 | $433 | |||
| 52010 | Cystoscopy & duct catheter | 0 | $362 | |||
| 52204 | Cystoscopy | 0 | $354 | |||
| 52214 | Cystoscopy and treatment | 0 | $481 | |||
| 52224 | Cystoscopy and treatment | 0 | $448 | |||
| 52234 | Cystoscopy and treatment | 0 | $693 | |||
| 52235 | Cystoscopy and treatment | 0 | $980 | |||
| 52240 | Cystoscopy and treatment | 0 | $1,516 | |||
| 52250 | Cystoscopy & radiotracer | 0 | $542 | |||
| 52260 | Cystoscopy & treatment | 0 | $442 | |||
| 52265 | Cystoscopy & treatment | 0 | $313 | |||
| 52270 | Cystoscopy & revise urethra | 0 | $542 | |||
| 52275 | Cystoscopy & revise urethra | 0 | $599 | |||
| 52276 | Cystoscopy and treatment | 0 | $634 | |||
| 52277 | Cystoscopy and treatment | 0 | $812 | |||
| 52281 | Cystoscopy and treatment | 0 | $394 | |||
| 52282 | Cystoscopy, implant stent | 0 | $845 | |||
| 52283 | Cystoscopy and treatment | 0 | $383 | |||
| 52285 | Cystoscopy and treatment | 0 | $485 | |||
| 52290 | Cystoscopy and treatment | 0 | $508 | |||
| 52300 | Cystoscopy and treatment | 0 | $623 | |||
| 52301 | Cystoscopy and treatment | 0 | $639 | |||
| 52305 | Cystoscopy and treatment | 0 | $649 | |||
| 52310 | Cystoscopy and treatment | 0 | $432 | |||
| 52315 | Cystoscopy and treatment | 0 | $686 | |||
| 52317 | Remove bladder stone.. | 0 | $1,205 | |||
| 52318 | Remove bladder stone | 0 | $1,263 | |||
| 52320 | Cystoscopy and treatment | 0 | $710 | |||
| 52325 | Cystoscopy, stone removal | 0 | $981 | |||
| 52327 | Cystoscopy, inject material | 0 | $647 | |||
| 52330 | Cystoscopy and treatment | 0 | $628 | |||
| 52332 | Cystoscopy and treatment | 0 | $451 | |||
| 52334 | Create passage to kidney | 0 | $602 | |||
| 52341 | Cysto w/ureter stricture tx | $592 | ||||
| 52343 | Cysto w/renal stricture tx | $716 | ||||
| 52344 | Cysto/uretero stricture tx | $778 | ||||
| 52345 | Cysto/uretero w/up stricture | $829 | ||||
| 52346 | Cystouretero w/renal strict | $938 | ||||
| 52351 | Cystouretero & or pyeloscope | $643 | ||||
| 52352 | Cystouretero w/stone remove | $755 | ||||
| 52353 | Cystouretero w/lithotripsy | $867 | ||||
| 52354 | Cystouretero w/biopsy | $803 | ||||
| 52355 | Cystouretero w/excise tumor | $955 | ||||
| 52400 | Cystouretero w/congen repr | $977 | ||||
| 52402 | Cystourethro cut ejacul duct | $546 | ||||
| 52450 | Incision of prostate | 90 | $888 | |||
| 52500 | Revision of bladder neck | 90 | $1,132 | |||
| 52601 | Prostatectomy (TURP).. | 90 | $1,724 | |||
| 52630 | Remove prostate regrowth | 90 | $1,269 | |||
| 52640 | Relieve bladder contracture | 90 | $927 | |||
| 52647 | Laser surgery of prostate | 90 | $1,432 | |||
| 52648 | Laser surgery of prostate | 90 | $1,518 | |||
| 52649 | Prostate laser enucleation | $1,666 | ||||
| 52700 | Drainage of prostate abscess | 90 | $705 | |||
| 53000 | Incision of urethra | 10 | $279 | |||
| 53010 | Incision of urethra | 90 | $489 | |||
| 53020 | Incision of urethra | 0 | $190 | |||
| 53025 | Incision of urethra | 0 | $143 | |||
| 53040 | Drainage of urethra abscess | 90 | $570 | |||
| 53060 | Drainage of urethra abscess | 10 | $224 | |||
| 53080 | Drainage of urinary leakage | 90 | $729 | |||
| 53085 | Drainage of urinary leakage | 90 | $1,213 | |||
| 53200 | Biopsy of urethra | 0 | $270 | |||
| 53210 | Removal of urethra | 90 | $1,347 | |||
| 53215 | Removal of urethra | 90 | $1,809 | |||
| 53220 | Treatment of urethra lesion | 90 | $838 | |||
| 53230 | Removal of urethra lesion | 90 | $1,258 | |||
| 53235 | Removal of urethra lesion | 90 | $1,071 | |||
| 53240 | Surgery for urethra pouch | 90 | $766 | |||
| 53250 | Removal of urethra gland | 90 | $717 | |||
| 53260 | Treatment of urethra lesion | 10 | $298 | |||
| 53265 | Treatment of urethra lesion | 10 | $366 | |||
| 53270 | Removal of urethra gland | 10 | $280 | |||
| 53275 | Repair of urethra defect | 10 | $495 | |||
| 53400 | Revise urethra, 1st stage | 90 | $1,417 | |||
| 53405 | Revise urethra, 2nd stage | 90 | $1,790 | |||
| 53410 | Reconstruction of urethra | 90 | $1,769 | |||
| 53415 | Reconstruction of urethra | 90 | $2,231 | |||
| 53420 | Reconstruct urethra, stage 1 | 90 | $1,785 | |||
| 53425 | Reconstruct urethra, stage 2 | 90 | $1,792 | |||
| 53430 | Reconstruction of urethra | 90 | $1,661 | |||
| 53431 | Reconstruct urethra/bladder | $2,359 | ||||
| 53440 | Correct bladder function | 90 | $1,843 | |||
| 53442 | Remove perineal prosthesis | 90 | $1,004 | |||
| 53444 | Insert tandem cuff | $1,620 | ||||
| 53445 | Correct urine flow control | 90 | $2,395 | |||
| 53446 | Remove uro sphincter | $1,312 | ||||
| 53447 | Remove artificial sphincter | 90 | $1,587 | |||
| 53448 | Remov/replc ur sphinctr comp | $2,616 | ||||
| 53449 | Correct artificial sphincter | 90 | $1,302 | |||
| 53450 | Revision of urethra | 90 | $618 | |||
| 53460 | Revision of urethra | 90 | $665 | |||
| 53500 | Urethrlys transvag w/ scope | $1,545 | ||||
| 53502 | Repair of urethra injury | 90 | $903 | |||
| 53505 | Repair of urethra injury | 90 | $914 | |||
| 53510 | Repair of urethra injury | 90 | $1,219 | |||
| 53515 | Repair of urethra injury | 90 | $1,601 | |||
| 53520 | Repair of urethra defect | 90 | $1,039 | |||
| 53600 | Dilate urethra stricture | 0 | $111 | |||
| 53601 | Dilate urethra stricture | 0 | $92 | |||
| 53605 | Dilate urethra stricture | 0 | $127 | |||
| 53620 | Dilate urethra stricture | 0 | $152 | |||
| 53621 | Dilate urethra stricture | 0 | $125 | |||
| 53660 | Dilation of urethra | 0 | $73 | |||
| 53661 | Dilation of urethra | 0 | $71 | |||
| 53665 | Dilation of urethra | 0 | $82 | |||
| 53850 | Prostatic microwave thermotx | 90 | $1,185 | |||
| 53852 | Prostatic rf thermotx | 90 | $1,236 | |||
| 53855 | Insert prost urethral stent | $1,553 | $167 | |||
| 53860 | Transurethral rf treatment | $3,129 | $480 | |||
| 53899 | Urology surgery procedure | BR | ||||
| 54000 | Slitting of prepuce | 10 | $156 | |||
| 54001 | Slitting of prepuce | 10 | $217 | |||
| 54015 | Drain penis lesion | 10 | $431 | |||
| 54050 | Destruction, penis lesion(s) | 10 | $113 | |||
| 54055 | Destruction, penis lesion(s) | 10 | $132 | |||
| 54056 | Cryosurgery, penis lesion(s) | 10 | $125 | |||
| 54057 | Laser surg, penis lesion(s) | 10 | $228 | |||
| 54060 | Excision of penis lesion(s) | 10 | $224 | |||
| 54065 | Destruction, penis lesion(s) | 10 | $361 | |||
| 54100 | Biopsy of penis....... | 0 | $224 | |||
| 54105 | Biopsy of penis | 10 | $324 | |||
| 54110 | Treatment of penis lesion | 90 | $1,155 | |||
| 54111 | Treat penis lesion, graft | 90 | $1,641 | |||
| 54112 | Treat penis lesion, graft | 90 | $1,920 | |||
| 54115 | Treatment of penis lesion | 90 | $729 | |||
| 54120 | Partial removal of penis | 90 | $1,156 | |||
| 54125 | Removal of penis | 90 | $1,807 | |||
| 54130 | Remove penis & nodes | 90 | $2,470 | |||
| 54135 | Remove penis & nodes | 90 | $3,150 | |||
| 54150 | Circumcision | 10 | $168 | |||
| 54160 | Circumcision | 10 | $305 | |||
| 54161 | Circumcision | 10 | $398 | |||
| 54162 | Lysis penil circumic lesion | $518 | $403 | |||
| 54163 | Repair of circumcision | $446 | ||||
| 54164 | Frenulotomy of penis | $394 | ||||
| 54200 | Treatment of penis lesion | 10 | $96 | |||
| 54205 | Treatment of penis lesion | 90 | $908 | |||
| 54220 | Treatment of penis lesion | 0 | $296 | |||
| 54230 | Prepare penis study | 0 | $199 | |||
| 54231 | Dynamic cavernosometry | 0 | $313 | |||
| 54235 | Penile injection | 0 | $117 | |||
| 54240 | Penis study | 0 | $172 | |||
| 54240 | 26 | Penis study | 0 | $133 | ||
| 54240 | TC | Penis study | 0 | $39 | ||
| 54250 | Penis study | 0 | $220 | |||
| 54250 | 26 | Penis study | 0 | $196 | ||
| 54250 | TC | Penis study | 0 | $24 | ||
| 54300 | Revision of penis | 90 | $1,260 | |||
| 54304 | Revision of penis | 90 | $1,536 | |||
| 54308 | Reconstruction of urethra | 90 | $1,286 | |||
| 54312 | Reconstruction of urethra | 90 | $1,659 | |||
| 54316 | Reconstruction of urethra | 90 | $2,013 | |||
| 54318 | Reconstruction of urethra | 90 | $1,353 | |||
| 54322 | Reconstruction of urethra | 90 | $1,465 | |||
| 54324 | Reconstruction of urethra | 90 | $1,948 | |||
| 54326 | Reconstruction of urethra | 90 | $1,865 | |||
| 54328 | Revise penis, urethra | 90 | $1,894 | |||
| 54332 | Revise penis, urethra | 90 | $2,111 | |||
| 54336 | Revise penis, urethra | 90 | $2,771 | |||
| 54340 | Secondary urethral surgery | 90 | $1,078 | |||
| 54344 | Secondary urethral surgery | 90 | $2,331 | |||
| 54348 | Secondary urethral surgery | 90 | $2,062 | |||
| 54352 | Reconstruct urethra, penis | 90 | $2,939 | |||
| 54360 | Penis plastic surgery | 90 | $1,356 | |||
| 54380 | Repair penis | 90 | $1,611 | |||
| 54385 | Repair penis | 90 | $1,848 | |||
| 54390 | Repair penis and bladder | 90 | $2,557 | |||
| 54400 | Insert semi-rigid prosthesis | 90 | $1,544 | |||
| 54401 | Insert self-contd prosthesis | 90 | $1,925 | |||
| 54405 | Insert multi-comp prosthesis | 90 | $2,411 | |||
| 54406 | Remove muti-comp penis pros | $1,492 | ||||
| 54408 | Repair multi-comp penis pros | $1,615 | ||||
| 54410 | Remove/replace penis prosth | $1,756 | ||||
| 54411 | Remov/replc penis pros comp | $2,095 | ||||
| 54415 | Remove self-contd penis pros | $1,080 | ||||
| 54416 | Remv/repl penis contain pros | $1,452 | ||||
| 54417 | Remv/replc penis pros compl | $1,837 | ||||
| 54420 | Revision of penis | 90 | $1,371 | |||
| 54430 | Revision of penis | 90 | $1,221 | |||
| 54435 | Revision of penis | 90 | $720 | |||
| 54440 | Repair of penis | 90 | BR | |||
| 54450 | Preputial stretching | 0 | $133 | |||
| 54500 | Biopsy of testis | 0 | $127 | |||
| 54505 | Biopsy of testis | 10 | $389 | |||
| 54512 | Excise lesion testis | $1,106 | ||||
| 54520 | Removal of testis | 90 | $762 | |||
| 54522 | Orchiectomy partial | $1,206 | ||||
| 54530 | Removal of testis | 90 | $1,142 | |||
| 54535 | Extensive testis surgery | 90 | $1,486 | |||
| 54550 | Exploration for testis | 90 | $936 | |||
| 54560 | Exploration for testis | 90 | $1,310 | |||
| 54600 | Reduce testis torsion | 90 | $828 | |||
| 54620 | Suspension of testis | 10 | $591 | |||
| 54640 | Suspension of testis | 90 | $1,082 | |||
| 54650 | Orchiopexy (fowler-stephens) | 90 | $1,392 | |||
| 54660 | Revision of testis | 90 | $605 | |||
| 54670 | Repair testis injury | 90 | $827 | |||
| 54680 | Relocation of testis(es) | 90 | $1,453 | |||
| 54690 | Laparoscopy, orchiectomy | 90 | $1,532 | |||
| 54692 | Laparoscopy, orchiopexy | 90 | $1,551 | |||
| 54699 | Laparoscope proc, testis | BR | ||||
| 54700 | Drainage of scrotum | 10 | $311 | |||
| 54800 | Biopsy of epididymis | 0 | $318 | |||
| 54830 | Remove epididymis lesion | 90 | $635 | |||
| 54840 | Remove epididymis lesion | 90 | $732 | |||
| 54860 | Removal of epididymis | 90 | $828 | |||
| 54861 | Removal of epididymis | 90 | $1,172 | |||
| 54865 | Explore epididymis | $732 | ||||
| 54900 | Fusion of spermatic ducts | 90 | $1,588 | |||
| 54901 | Fusion of spermatic ducts | 90 | $2,180 | |||
| 55000 | Drainage of hydrocele | 0 | $133 | |||
| 55040 | Removal of hydrocele | 90 | $749 | |||
| 55041 | Removal of hydroceles | 90 | $1,109 | |||
| 55060 | Repair of hydrocele | 90 | $698 | |||
| 55100 | Drainage of scrotum abscess | 10 | $194 | |||
| 55110 | Explore scrotum | 90 | $647 | |||
| 55120 | Removal of scrotum lesion | 90 | $480 | |||
| 55150 | Removal of scrotum | 90 | $895 | |||
| 55175 | Revision of scrotum | 90 | $701 | |||
| 55180 | Revision of scrotum | 90 | $1,255 | |||
| 55200 | Incision of sperm duct | 90 | $447 | |||
| 55250 | Removal of sperm duct(s) | 90 | $434 | |||
| 55300 | Preparation, sperm duct X-ray | 0 | $460 | |||
| 55400 | Repair of sperm duct | 90 | $1,092 | |||
| 55450 | Ligation of sperm duct | 10 | $484 | |||
| 55500 | Removal of hydrocele | 90 | $716 | |||
| 55520 | Removal of sperm cord lesion | 90 | $662 | |||
| 55530 | Revise spermatic cord veins | 90 | $797 | |||
| 55535 | Revise spermatic cord veins | 90 | $786 | |||
| 55540 | Revise hernia & sperm veins | 90 | $899 | |||
| 55550 | Laparo ligate spermatic vein | 90 | $874 | |||
| 55559 | Laparo proc, spermatic cord | BR | ||||
| 55600 | Incise sperm duct pouch | 90 | $775 | |||
| 55605 | Incise sperm duct pouch | 90 | $976 | |||
| 55650 | Remove sperm duct pouch | 90 | $1,363 | |||
| 55680 | Remove sperm pouch lesion | 90 | $682 | |||
| 55700 | Biopsy of prostate | 0 | $229 | |||
| 55705 | Biopsy of prostate | 10 | $575 | |||
| 55706 | Prostate saturation sampling | $749 | ||||
| 55720 | Drainage of prostate abscess | 90 | $808 | |||
| 55725 | Drainage of prostate abscess | 90 | $982 | |||
| 55801 | Removal of prostate | 90 | $2,156 | |||
| 55810 | Extensive prostate surgery | 90 | $2,893 | |||
| 55812 | Extensive prostate surgery | 90 | $3,205 | |||
| 55815 | Extensive prostate surgery | 90 | $3,971 | |||
| 55821 | Removal of prostate | 90 | $1,977 | |||
| 55831 | Removal of prostate | 90 | $2,145 | |||
| 55840 | Extensive prostate surgery | 90 | $2,791 | |||
| 55842 | Extensive prostate surgery | 90 | $3,096 | |||
| 55845 | Extensive prostate surgery | 90 | $3,842 | |||
| 55860 | Surgical exposure, prostate | 90 | $1,498 | |||
| 55862 | Extensive prostate surgery | 90 | $2,122 | |||
| 55865 | Extensive prostate surgery | 90 | $3,437 | |||
| 55866 | Laparo radical prostatectomy | $3,553 | ||||
| 55870 | Electroejaculation | 0 | $357 | |||
| 55873 | Cryoablate prostate | $13,774 | $1,548 | |||
| 55875 | Transperi needle place pros | $1,556 | ||||
| 55876 | Place rt device/marker pros | $270 | $202 | |||
| 55899 | Genital surgery procedure | BR | ||||
| 55920 | Place needles pelvic for rt | $894 | ||||
| 55970 | Sex transformation, m to f | BR | ||||
| 55980 | Sex transformation, f to m | BR | ||||
| 56405 | I & d of vulva/perineum | 10 | $164 | |||
| 56420 | Drainage of gland abscess | 10 | $161 | |||
| 56440 | Surgery for vulva lesion | 10 | $421 | |||
| 56441 | Lysis of labial lesion(s) | 10 | $274 | |||
| 56442 | Hymenotomy | $101 | ||||
| 56501 | Destruction, vulva lesion(s) | 10 | $152 | |||
| 56515 | Destruction, vulva lesion(s) | 10 | $374 | |||
| 56605 | Biopsy of vulva/perineum | 0 | $120 | |||
| 56606 | Biopsy of vulva/ perineum | $87 | ||||
| 56620 | Partial removal of vulva | 90 | $1,031 | |||
| 56625 | Complete removal of vulva | 90 | $1,351 | |||
| 56630 | Extensive vulva surgery | 90 | $2,016 | |||
| 56631 | Extensive vulva surgery | 90 | $2,749 | |||
| 56632 | Extensive vulva surgery | 90 | $3,008 | |||
| 56633 | Extensive vulva surgery | 90 | $2,247 | |||
| 56634 | Extensive vulva surgery | 90 | $2,994 | |||
| 56637 | Extensive vulva surgery | 90 | $3,154 | |||
| 56640 | Extensive vulva surgery | 90 | $3,143 | |||
| 56700 | Partial removal of hymen | 10 | $325 | |||
| 56720 | Incision of hymen | 0 | $91 | |||
| 56740 | Remove vagina gland lesion | 10 | $497 | |||
| 56800 | Repair of vagina | 10 | $511 | |||
| 56805 | Repair clitoris....... | 90 | $2,203 | |||
| 56810 | Repair of perineum | 10 | $503 | |||
| 56820 | Exam of vulva w/scope | $231 | $179 | |||
| 56821 | Exam/biopsy of vulva w/scope | $305 | $240 | |||
| 57000 | Exploration of vagina | 10 | $375 | |||
| 57010 | Drainage of pelvic abscess | 90 | $607 | |||
| 57020 | Drainage of pelvic fluid | 0 | $163 | |||
| 57022 | I & d vaginal hematoma pp | $355 | ||||
| 57023 | I & d vag hematoma non-ob | $657 | ||||
| 57061 | Destruction vagina lesion(s) | 10 | $155 | |||
| 57065 | Destruction vagina lesion(s) | 10 | $467 | |||
| 57100 | Biopsy of vagina | 0 | $122 | |||
| 57105 | Biopsy of vagina | 10 | $251 | |||
| 57106 | Remove vagina wall, partial | 90 | $680 | |||
| 57107 | Remove vagina tissue, part. | 90 | $2,278 | |||
| 57109 | Vaginectomy partial w/nodes | 90 | $2,800 | |||
| 57110 | Remove vagina wall, complete | 90 | $1,666 | |||
| 57111 | Remove vagina tissue, complete | 90 | $2,775 | |||
| 57112 | Vaginectomy w/nodes, complete | 90 | $2,954 | |||
| 57120 | Closure of vagina | 90 | $1,078 | |||
| 57130 | Remove vagina lesion | 10 | $395 | |||
| 57135 | Remove vagina lesion | 10 | $350 | |||
| 57150 | Treat vagina infection | 0 | $83 | |||
| 57155 | Insert uteri tandems/ovoids | $890 | ||||
| 57156 | Ins vag brachytx device | $391 | $291 | |||
| 57160 | Insert pessary/other device | 0 | $100 | |||
| 57170 | Fitting of diaphragm/cap | 0 | $91 | |||
| 57180 | Treat vaginal bleeding | 10 | $156 | |||
| 57200 | Repair of vagina | 90 | $495 | |||
| 57210 | Repair vagina/perineum | 90 | $613 | |||
| 57220 | Revision of urethra | 90 | $645 | |||
| 57230 | Repair of urethral lesion | 90 | $677 | |||
| 57240 | Repair bladder & vagina | 90 | $997 | |||
| 57250 | Repair rectum & vagina | 90 | $975 | |||
| 57260 | Repair of vagina | 90 | $1,283 | |||
| 57265 | Extensive repair of vagina | 90 | $1,337 | |||
| 57267 | Insert mesh/pelvic flr addon | $539 | ||||
| 57268 | Repair of bowel bulge | 90 | $1,039 | |||
| 57270 | Repair of bowel pouch | 90 | $1,107 | |||
| 57280 | Suspension of vagina | 90 | $1,326 | |||
| 57282 | Repair of vaginal prolapse | 90 | $1,322 | |||
| 57283 | Colpopexy intraperitoneal | $1,455 | ||||
| 57284 | Repair paravaginal defect. | 90 | $1,535 | |||
| 57285 | Repair paravag defect vag | $1,415 | ||||
| 57287 | Revise/remove sling repair | $1,411 | ||||
| 57288 | Repair bladder defect | 90 | $1,729 | |||
| 57289 | Repair bladder & vagina | 90 | $1,126 | |||
| 57291 | Construction of vagina | 90 | $991 | |||
| 57292 | Construct vagina with graft | 90 | $1,435 | |||
| 57295 | Revise vag graft via vagina | $1,003 | ||||
| 57296 | Revise vag graft open abd | $2,011 | ||||
| 57300 | Repair rectum-vagina fistula | 90 | $1,160 | |||
| 57305 | Repair rectum-vagina fistula | 90 | $1,260 | |||
| 57307 | Fistula repair & colostomy | 90 | $1,235 | |||
| 57308 | Fistula repair, transperine | 90 | $1,264 | |||
| 57310 | Repair urethrovaginal lesion | 90 | $773 | |||
| 57311 | Repair urethrovaginal lesion | 90 | $936 | |||
| 57320 | Repair bladder-vagina lesion | 90 | $1,279 | |||
| 57330 | Repair bladder-vagina lesion | 90 | $1,470 | |||
| 57335 | Repair vagina......... | 90 | $1,899 | |||
| 57400 | Dilation of vagina | 0 | $87 | |||
| 57410 | Pelvic examination | 0 | $71 | |||
| 57415 | Removal vaginal foreign body | 10 | $94 | |||
| 57420 | Exam of vagina w/scope | $241 | $189 | |||
| 57421 | Exam/biopsy of vag w/scope | $324 | $257 | |||
| 57423 | Repair paravag defect lap | $1,938 | ||||
| 57425 | Laparoscopy surg colpopexy | $2,045 | ||||
| 57426 | Revise prosth vag graft lap | $1,790 | ||||
| 57452 | Examination of vagina | 0 | $126 | |||
| 57454 | Vagina examination & biopsy | 0 | $194 | |||
| 57455 | Biopsy of cervix w/scope | $299 | ||||
| 57456 | Endocerv curettage w/scope | $280 | $217 | |||
| 57460 | Cervix excision....... | 0 | $371 | |||
| 57461 | Conz of cervix w/scope leep | $664 | $395 | |||
| 57500 | Biopsy of cervix | 0 | $118 | |||
| 57505 | Endocervical curettage | 10 | $131 | |||
| 57510 | Cauterization of cervix | 10 | $175 | |||
| 57511 | Cryocautery of cervix | 10 | $203 | |||
| 57513 | Laser surgery of cervix | 10 | $376 | |||
| 57520 | Conization of cervix.. | 90 | $585 | |||
| 57522 | Conization of cervix | 90 | $521 | |||
| 57530 | Removal of cervix | 90 | $624 | |||
| 57531 | Removal of cervix, radical | 90 | $3,399 | |||
| 57540 | Removal of residual cervix | 90 | $1,010 | |||
| 57545 | Remove cervix, repair pelvis | 90 | $866 | |||
| 57550 | Removal of residual cervix | 90 | $935 | |||
| 57555 | Remove cervix, repair vagina | 90 | $1,445 | |||
| 57556 | Remove cervix, repair bowel | 90 | $1,340 | |||
| 57558 | D&c of cervical stump | $260 | $238 | |||
| 57700 | Revision of cervix | 90 | $427 | |||
| 57720 | Revision of cervix | 90 | $505 | |||
| 57800 | Dilation of cervical canal | 0 | $96 | |||
| 57820 | D&c of residual cervix | 10 | $308 | |||
| 58100 | Biopsy of uterus lining | 0 | $113 | |||
| 58110 | Bx done w/colposcopy add-on | $100 | $86 | |||
| 58120 | Dilation and curettage (d&c) | 10 | $405 | |||
| 58140 | Removal of uterus lesion | 90 | $1,249 | |||
| 58145 | Removal of uterus lesion | 90 | $1,214 | |||
| 58146 | Myomectomy abdom complex | $2,444 | ||||
| 58150 | Total hysterectomy | 90 | $1,745 | |||
| 58152 | Total hysterectomy.... | 90 | $2,007 | |||
| 58180 | Partial hysterectomy | 90 | $1,482 | |||
| 58200 | Extensive hysterectomy | 90 | $2,557 | |||
| 58210 | Extensive hysterectomy | 90 | $3,229 | |||
| 58240 | Removal of pelvis contents | 90 | $4,507 | |||
| 58260 | Vaginal hysterectomy | 90 | $1,617 | |||
| 58262 | Vaginal hysterectomy | 90 | $1,736 | |||
| 58263 | Vaginal hysterectomy | 90 | $1,897 | |||
| 58267 | Hysterectomy & vagina repair | 90 | $1,978 | |||
| 58270 | Hysterectomy & vagina repair | 90 | $1,779 | |||
| 58275 | Hysterectomy, revise vagina | 90 | $1,935 | |||
| 58280 | Hysterectomy, revise vagina | 90 | $1,923 | |||
| 58285 | Extensive hysterectomy | 90 | $2,247 | |||
| 58290 | Vag hyst complex | 90 | $2,434 | |||
| 58291 | Vag hyst incl t/o complex | 90 | $2,637 | |||
| 58292 | Vag hyst t/o & repair compl | 90 | $2,785 | |||
| 58294 | Vag hyst w/enterocele compl | 90 | $2,582 | |||
| 58300 | Insert intrauterine device | 0 | $136 | |||
| 58301 | Remove intrauterine device | 0 | $90 | |||
| 58290 | Vag hyst complex | 90 | $2,434 | |||
| 58321 | Artificial insemination | 0 | $126 | |||
| 58322 | Artificial insemination | 0 | $139 | |||
| 58323 | Sperm washing | 0 | $26 | |||
| 58340 | Catheter for hysterography | 0 | $332 | |||
| 58345 | Reopen fallopian tube | 10 | $602 | |||
| 58346 | Insert heyman uteri capsule | 90 | $937 | |||
| 58350 | Reopen fallopian tube | 10 | $150 | |||
| 58353 | Endometr ablate thermal | 10 | $2,065 | $459 | ||
| 58356 | Endometrial cryoablation | 10 | $3,878 | $727 | ||
| 58400 | Suspension of uterus | 90 | $882 | |||
| 58410 | Suspension of uterus | 90 | $931 | |||
| 58520 | Repair of ruptured uterus | 90 | $820 | |||
| 58540 | Revision of uterus | 90 | $1,143 | |||
| 58541 | Lsh uterus 250 g or less | $1,828 | ||||
| 58542 | Lsh w/t/o ut 250 g or less | $2,042 | ||||
| 58543 | Lsh uterus above 250 g | $2,076 | ||||
| 58544 | Lsh w/t/o uterus above 250 g | $2,250 | ||||
| 58545 | Laparoscopic myomectomy | $1,893 | ||||
| 58546 | Laparo-myomectomy complex | $2,387 | ||||
| 58548 | Lap radical hyst | $3,841 | ||||
| 58550 | Laparo-asst vag hysterectomy | 10 | $1,867 | |||
| 58552 | Laparo-vag hyst incl t/o | $2,076 | ||||
| 58553 | Laparo-vag hyst complex | $2,403 | ||||
| 58554 | Laparo-vag hyst w/t/o compl | $2,781 | ||||
| 58555 | Hysteroscopy, dx, sep proc | 0 | $633 | |||
| 58558 | Hysteroscopy, biopsy.. | 0 | $823 | $559 | ||
| 58559 | Hysteroscopy, lysis... | 0 | $727 | |||
| 58560 | Hysteroscopy, resect septum | 0 | $820 | |||
| 58561 | Hysteroscopy, remove myoma | 0 | $1,160 | |||
| 58562 | Hysteroscopy, remove fb | 0 | $853 | $607 | ||
| 58563 | Hysteroscopy, ablation | 0 | $3,409 | $719 | ||
| 58565 | Hysteroscopy sterilization | $3,854 | $908 | |||
| 58570 | Tlh uterus 250 g or less | $1,966 | ||||
| 58571 | Tlh w/t/o 250 g or less | $2,191 | ||||
| 58572 | Tlh uterus over 250 g | $2,452 | ||||
| 58573 | Tlh w/t/o uterus over 250 g | $2,807 | ||||
| 58578 | Laparo proc, uterus... | BR | ||||
| 58579 | Hysteroscope procedure | BR | ||||
| 58600 | Division of fallopian tube | 90 | $800 | |||
| 58605 | Division of fallopian tube | 90 | $629 | |||
| 58611 | Ligate oviduct(s) add- on | $84 | ||||
| 58615 | Occlude fallopian tube(s) | 10 | $503 | |||
| 58660 | Laparoscopy, lysis.... | 90 | $1,421 | |||
| 58661 | Laparoscopy, remove adnexa | 10 | $1,362 | |||
| 58662 | Laparoscopy, excise lesions | 90 | $1,491 | |||
| 58670 | Laparoscopy, tubal cautery | 90 | $772 | |||
| 58671 | Laparoscopy, tubal block. | 90 | $772 | |||
| 58672 | Laparoscopy, fimbrioplasty | 90 | $1,558 | |||
| 58673 | Laparoscopy, salpingostomy | 90 | $1,692 | |||
| 58679 | Laparo proc, oviduct- ovary | BR | ||||
| 58700 | Removal of fallopian tube | 90 | $960 | |||
| 58720 | Removal of ovary/tube(s) | 90 | $1,085 | |||
| 58740 | Revise fallopian tube(s) | 90 | $1,057 | |||
| 58750 | Repair oviduct(s) | 90 | $1,175 | |||
| 58752 | Revise ovarian tube(s) | 90 | $1,105 | |||
| 58760 | Remove tubal obstruction | 90 | $953 | |||
| 58770 | Create new tubal opening | 90 | $945 | |||
| 58800 | Drainage of ovarian cyst(s) | 90 | $495 | |||
| 58805 | Drainage of ovarian cyst(s) | 90 | $934 | |||
| 58820 | Drain ovary abscess, open | 90 | $530 | |||
| 58822 | Drainage of ovarian abscess | 90 | $747 | |||
| 58823 | Drain pelvic abscess, percut | 0 | $441 | |||
| 58825 | Transposition, ovary(s) | 90 | $749 | |||
| 58900 | Biopsy of ovary(s) | 90 | $832 | |||
| 58920 | Partial removal of ovary(s) | 90 | $1,025 | |||
| 58925 | Removal of ovarian cyst(s) | 90 | $1,015 | |||
| 58940 | Removal of ovary(s) | 90 | $1,016 | |||
| 58943 | Removal of ovary(s) | 90 | $2,281 | |||
| 58950 | Resect ovarian malignancy | 90 | $1,963 | |||
| 58951 | Resect ovarian malignancy | 90 | $3,016 | |||
| 58952 | Resect ovarian malignancy | 90 | $3,071 | |||
| 58953 | Tah rad dissect for debulk | $4,122 | ||||
| 58954 | Tah rad debulk/lymph remove | $4,467 | ||||
| 58956 | Bso omentectomy w/tah | $2,813 | ||||
| 58957 | Resect recurrent gyn mal | $3,222 | ||||
| 58958 | Resect recur gyn mal w/lym | $3,541 | ||||
| 58960 | Exploration of abdomen | 90 | $1,845 | |||
| 58970 | Retrieval of oocyte | 0 | $447 | |||
| 58974 | Transfer of embryo.... | 0 | BR | |||
| 58976 | Transfer of embryo.... | 0 | $494 | |||
| 58999 | Genital surgery procedure | BR | ||||
| 59000 | Amniocentesis | 0 | $173 | |||
| 59001 | Amniocentesis therapeutic | $382 | ||||
| 59012 | Fetal cord puncture,prenatal | 0 | $452 | |||
| 59015 | Chorion biopsy | 0 | $248 | |||
| 59020 | Fetal contract stress test | 0 | $164 | |||
| 59020 | 26 | Fetal contract stress test | 0 | $122 | ||
| 59020 | TC | Fetal contract stress test | 0 | $43 | ||
| 59025 | Fetal non-stress test | 0 | $89 | |||
| 59025 | 26 | Fetal non-stress test | 0 | $71 | ||
| 59025 | TC | Fetal non-stress test | 0 | $19 | ||
| 59030 | Fetal scalp blood sample | 0 | $268 | |||
| 59050 | Fetal monitor w/report | $122 | ||||
| 59051 | Fetal monitor/interpret only | $119 | ||||
| 59070 | Transabdom amnioinfus w/us | $855 | $656 | |||
| 59072 | Umbilical cord occlud w/us | $1,098 | ||||
| 59074 | Fetal fluid drainage w/us | $894 | $673 | |||
| 59076 | Fetal shunt placement w/us | $1,098 | ||||
| 59100 | Remove uterus lesion | 90 | $784 | |||
| 59120 | Treat ectopic pregnancy | 90 | $1,167 | |||
| 59121 | Treat ectopic pregnancy | 90 | $952 | |||
| 59130 | Treat ectopic pregnancy | 90 | $1,030 | |||
| 59135 | Treat ectopic pregnancy | 90 | $1,699 | |||
| 59136 | Treat ectopic pregnancy | 90 | $1,158 | |||
| 59140 | Treat ectopic pregnancy | 90 | $711 | |||
| 59150 | Treat ectopic pregnancy | 90 | $844 | |||
| 59151 | Treat ectopic pregnancy | 90 | $1,168 | |||
| 59160 | D & c after delivery.. | 10 | $439 | |||
| 59200 | Insert cervical dilator | 0 | $103 | |||
| 59300 | Episiotomy or vaginal repair | 0 | $248 | |||
| 59320 | Revision of cervix | 0 | $331 | |||
| 59325 | Revision of cervix | 0 | $514 | |||
| 59350 | Repair of uterus | 0 | $659 | |||
| 59400 | Obstetrical care | $2,793 | ||||
| 59409 | Obstetrical care | $1,767 | ||||
| 59410 | Obstetrical care | $1,921 | ||||
| 59412 | Antepartum manipulation | $228 | ||||
| 59414 | Deliver placenta | $215 | ||||
| 59425 | Antepartum care only | $537 | ||||
| 59426 | Antepartum care only | $920 | ||||
| 59430 | Care after delivery | $174 | ||||
| 59510 | Cesarean delivery | $3,149 | ||||
| 59514 | Cesarean delivery only | $2,048 | ||||
| 59515 | Cesarean delivery | $2,201 | ||||
| 59525 | Remove uterus after cesarean | $923 | ||||
| 59610 | Vbac delivery......... | $2,930 | ||||
| 59612 | Vbac delivery only.... | $1,816 | ||||
| 59614 | Vbac care after delivery | $1,972 | ||||
| 59618 | Attempted vbac delivery | $3,311 | ||||
| 59620 | Attempted vbac delivery only | $2,110 | ||||
| 59622 | Attempted vbac after care | $2,277 | ||||
| 59812 | Treatment of miscarriage | 90 | $530 | |||
| 59820 | Care of miscarriage | 90 | $584 | |||
| 59821 | Treatment of miscarriage | 90 | $539 | |||
| 59830 | Treat uterus infection | 90 | $780 | |||
| 59840 | Abortion | 10 | $483 | |||
| 59841 | Abortion | 10 | $549 | |||
| 59850 | Abortion | 90 | $730 | |||
| 59851 | Abortion | 90 | $763 | |||
| 59852 | Abortion | 90 | $1,025 | |||
| 59855 | Abortion | 90 | $624 | |||
| 59856 | Abortion | 90 | $942 | |||
| 59857 | Abortion | 90 | $1,146 | |||
| 59866 | Abortion (mpr)........ | 0 | $512 | |||
| 59870 | Evacuate mole of uterus | 90 | $543 | |||
| 59871 | Remove cerclage suture | 0 | $302 | |||
| 59898 | Laparo proc, ob care/deliver | BR | ||||
| 59899 | Maternity care procedure | BR | ||||
| 60000 | Drain thyroid/tongue cyst | 10 | $171 | |||
| 60100 | Biopsy of thyroid..... | 0 | $173 | |||
| 60200 | Remove thyroid lesion | 90 | $1,125 | |||
| 60210 | Partial excision thyroid | 90 | $1,459 | |||
| 60212 | Partial thyroid excision | 90 | $1,838 | |||
| 60220 | Partial removal of thyroid | 90 | $1,427 | |||
| 60225 | Partial removal of thyroid | 90 | $1,840 | |||
| 60240 | Removal of thyroid | 90 | $1,996 | |||
| 60252 | Removal of thyroid | 90 | $2,237 | |||
| 60254 | Extensive thyroid surgery | 90 | $2,758 | |||
| 60260 | Repeat thyroid surgery | 90 | $1,451 | |||
| 60270 | Removal of thyroid.... | 90 | $2,385 | |||
| 60271 | Removal of thyroid | 90 | $1,999 | |||
| 60280 | Remove thyroid duct lesion | 90 | $989 | |||
| 60281 | Remove thyroid duct lesion | 90 | $991 | |||
| 60300 | Aspir/inj thyroid cyst | $235 | $101 | |||
| 60500 | Explore parathyroid glands | 90 | $2,058 | |||
| 60502 | Re-explore parathyroids | 90 | $2,334 | |||
| 60505 | Explore parathyroid glands | 90 | $2,523 | |||
| 60512 | Autotransplant parathyroid | $508 | ||||
| 60520 | Removal of thymus gland | 90 | $2,247 | |||
| 60521 | Removal thymus gland | 90 | $2,366 | |||
| 60522 | Removal of thymus gland | 90 | $2,643 | |||
| 60540 | Explore adrenal gland | 90 | $2,112 | |||
| 60545 | Explore adrenal gland | 90 | $2,487 | |||
| 60600 | Remove carotid body lesion | 90 | $2,086 | |||
| 60605 | Remove carotid body lesion | 90 | $2,203 | |||
| 60650 | Laparoscopy adrenalectomy | $2,465 | ||||
| 60659 | Laparo proc, endocrine | BR | ||||
| 60699 | Endocrine surgery procedure | BR | ||||
| 61000 | Remove cranial cavity fluid | 0 | $200 | |||
| 61001 | Remove cranial cavity fluid | 0 | $180 | |||
| 61020 | Remove brain cavity fluid | 0 | $210 | |||
| 61026 | Injection into brain canal | 0 | $279 | |||
| 61050 | Remove brain canal fluid | 0 | $205 | |||
| 61055 | Injection into brain canal | 0 | $295 | |||
| 61070 | Brain canal shunt procedure | 0 | $101 | |||
| 61105 | Twist drill hole...... | 90 | $813 | |||
| 61107 | Drill skull for implantation | 0 | $847 | |||
| 61108 | Drill skull for drainage | 90 | $1,774 | |||
| 61120 | Burr hole for puncture | 90 | $1,112 | |||
| 61140 | Pierce skull for biopsy | 90 | $2,232 | |||
| 61150 | Pierce skull for drainage | 90 | $2,382 | |||
| 61151 | Pierce skull for drainage | 90 | $984 | |||
| 61154 | Pierce skull, remove clot | 90 | $2,438 | |||
| 61156 | Pierce skull for drainage | 90 | $2,440 | |||
| 61210 | Pierce skull; implant device | 0 | $971 | |||
| 61215 | Insert brain-fluid device | 90 | $1,464 | |||
| 61250 | Pierce skull & explore | 90 | $1,452 | |||
| 61253 | Pierce skull & explore | 90 | $1,721 | |||
| 61304 | Open skull for exploration | 90 | $3,641 | |||
| 61305 | Open skull for exploration | 90 | $4,172 | |||
| 61312 | Open skull for drainage | 90 | $3,478 | |||
| 61313 | Open skull for drainage | 90 | $3,466 | |||
| 61314 | Open skull for drainage | 90 | $3,757 | |||
| 61315 | Open skull for drainage | 90 | $3,878 | |||
| 61316 | Implt cran bone flap to abdo | $183 | ||||
| 61320 | Open skull for drainage | 90 | $3,258 | |||
| 61321 | Open skull for drainage | 90 | $3,542 | |||
| 61322 | Decompressive craniotomy | $4,954 | ||||
| 61323 | Decompressive lobectomy | $4,975 | ||||
| 61330 | Decompress eye socket | 90 | $2,112 | |||
| 61332 | Explore/biopsy eye socket | 90 | $3,508 | |||
| 61333 | Explore orbit; remove lesion | 90 | $3,573 | |||
| 61334 | Explore orbit; remove object | 90 | $2,374 | |||
| 61340 | Relieve cranial pressure | 90 | $2,046 | |||
| 61343 | Incise skull, pressure relief | 90 | $4,473 | |||
| 61345 | Relieve cranial pressure | 90 | $3,397 | |||
| 61440 | Incise skull for surgery | 90 | $3,436 | |||
| 61450 | Incise skull for surgery | 90 | $3,409 | |||
| 61458 | Incise skull for brain wound | 90 | $4,114 | |||
| 61460 | Incise skull for surgery | 90 | $3,948 | |||
| 61470 | Incise skull for surgery | 90 | $2,632 | |||
| 61480 | Incise skull for surgery | 90 | $2,380 | |||
| 61490 | Incise skull for surgery | 90 | $2,089 | |||
| 61500 | Removal of skull lesion | 90 | $2,873 | |||
| 61501 | Remove infected skull bone | 90 | $2,448 | |||
| 61510 | Removal of brain lesion | 90 | $3,916 | |||
| 61512 | Remove brain lining lesion | 90 | $4,145 | |||
| 61514 | Removal of brain abscess | 90 | $3,804 | |||
| 61516 | Removal of brain lesion | 90 | $3,814 | |||
| 61517 | Implt brain chemotx add-on | $181 | ||||
| 61518 | Removal of brain lesion | 90 | $4,795 | |||
| 61519 | Remove brain lining lesion | 90 | $5,014 | |||
| 61520 | Removal of brain lesion | 90 | $5,528 | |||
| 61521 | Removal of brain lesion | 90 | $5,543 | |||
| 61522 | Removal of brain abscess | 90 | $3,631 | |||
| 61524 | Removal of brain lesion | 90 | $4,150 | |||
| 61526 | Removal of brain lesion | 90 | $4,849 | |||
| 61530 | Removal of brain lesion | 90 | $6,260 | |||
| 61531 | Implant brain electrodes | 90 | $2,636 | |||
| 61533 | Implant brain electrodes | 90 | $3,098 | |||
| 61534 | Removal of brain lesion | 90 | $1,948 | |||
| 61535 | Remove brain electrodes | 90 | $1,355 | |||
| 61536 | Removal of brain lesion | 90 | $3,920 | |||
| 61537 | Removal of brain tissue | $5,128 | ||||
| 61538 | Removal of brain tissue | 90 | $4,396 | |||
| 61539 | Removal of brain tissue | 90 | $4,041 | |||
| 61540 | Removal of brain tissue | $4,552 | ||||
| 61541 | Incision of brain tissue | 90 | $3,577 | |||
| 61542 | Removal of brain tissue | 90 | $3,624 | |||
| 61543 | Removal of brain tissue | 90 | $2,856 | |||
| 61544 | Remove & treat brain lesion | 90 | $3,822 | |||
| 61545 | Excision of brain tumor | 90 | $4,598 | |||
| 61546 | Removal of pituitary gland | 90 | $4,326 | |||
| 61548 | Removal of pituitary gland | 90 | $3,465 | |||
| 61550 | Release of skull seams | 90 | $1,923 | |||
| 61552 | Release of skull seams | 90 | $2,516 | |||
| 61556 | Incise skull/sutures | 90 | $3,555 | |||
| 61557 | Incise skull/sutures | 90 | $3,509 | |||
| 61558 | Excision of skull/sutures | 90 | $3,917 | |||
| 61559 | Excision of skull/sutures | 90 | $3,786 | |||
| 61563 | Excision of skull tumor | 90 | $4,128 | |||
| 61564 | Excision of skull tumor | 90 | $5,016 | |||
| 61567 | Incision of brain tissue | $5,345 | ||||
| 61570 | Remove brain foreign body | 90 | $3,003 | |||
| 61571 | Incise skull for brain wound | 90 | $3,262 | |||
| 61575 | Skull base/brainstem surgery | 90 | $4,982 | |||
| 61576 | Skull base/brainstem surgery | 90 | $4,669 | |||
| 61580 | Craniofacial approach, skull | 90 | $3,823 | |||
| 61581 | Craniofacial approach, skull | 90 | $4,339 | |||
| 61582 | Craniofacial approach, skull | 90 | $3,939 | |||
| 61583 | Craniofacial approach, skull | 90 | $4,494 | |||
| 61584 | Orbitocranial approach/skull | 90 | $4,352 | |||
| 61585 | Orbitocranial approach/skull | 90 | $4,869 | |||
| 61586 | Resect nasopharynx, skull. | 90 | $3,400 | |||
| 61590 | Infratemporal approach/skull | 90 | $5,295 | |||
| 61591 | Infratemporal approach/skull | 90 | $5,554 | |||
| 61592 | Orbitocranial approach/skull | 90 | $5,037 | |||
| 61595 | Transtemporal approach/skull | 90 | $3,720 | |||
| 61596 | Transcochlear approach/skull | 90 | $4,521 | |||
| 61597 | Transcondylar approach/skull | 90 | $4,779 | |||
| 61598 | Transpetrosal approach/skull | 90 | $4,210 | |||
| 61600 | Resect/excise cranial lesion | 90 | $3,229 | |||
| 61601 | Resect/excise cranial lesion | 90 | $3,462 | |||
| 61605 | Resect/excise cranial lesion | 90 | $3,655 | |||
| 61606 | Resect/excise cranial lesion | 90 | $4,895 | |||
| 61607 | Resect/excise cranial lesion | 90 | $4,572 | |||
| 61608 | Resect/excise cranial lesion | 90 | $5,320 | |||
| 61609 | Transect artery, sinus | $1,275 | ||||
| 61610 | Transect artery, sinus | $3,762 | ||||
| 61611 | Transect artery, sinus | $945 | ||||
| 61612 | Transect artery, sinus | $3,551 | ||||
| 61613 | Remove aneurysm, sinus | 90 | $5,218 | |||
| 61615 | Resect/excise lesion, skull | 90 | $4,017 | |||
| 61616 | Resect/excise lesion, skull | 90 | $5,463 | |||
| 61618 | Repair dura | 90 | $2,066 | |||
| 61619 | Repair dura | 90 | $2,583 | |||
| 61623 | Endovasc tempory vessel occl | $1,147 | ||||
| 61624 | Occlusion/embolization cath | 0 | $2,635 | |||
| 61626 | Occlusion/embolization cath | 0 | $2,173 | |||
| 61630 | Intracranial angioplasty | $2,577 | ||||
| 61635 | Intracran angioplsty w/stent | $2,837 | ||||
| 61640 | Dilate ic vasospasm init | $1,288 | ||||
| 61641 | Dilate ic vasospasm add-on | $453 | ||||
| 61642 | Dilate ic vasospasm add-on | $905 | ||||
| 61680 | Intracranial vessel surgery | 90 | $5,189 | |||
| 61682 | Intracranial vessel surgery | 90 | $5,937 | |||
| 61684 | Intracranial vessel surgery | 90 | $5,131 | |||
| 61686 | Intracranial vessel surgery | 90 | $6,203 | |||
| 61690 | Intracranial vessel surgery | 90 | $4,628 | |||
| 61692 | Intracranial vessel surgery | 90 | $4,963 | |||
| 61697 | Brain aneurysm repr complx | $8,800 | ||||
| 61698 | Brain aneurysm repr complx | $9,656 | ||||
| 61700 | Inner skull vessel surgery | 90 | $5,110 | |||
| 61702 | Inner skull vessel surgery | 90 | $5,813 | |||
| 61703 | Clamp neck artery | 90 | $2,175 | |||
| 61705 | Revise circulation to head | 90 | $4,966 | |||
| 61708 | Revise circulation to head | 90 | $4,326 | |||
| 61710 | Revise circulation to head | 90 | $3,293 | |||
| 61711 | Fusion of skull arteries | 90 | $5,229 | |||
| 61720 | Incise skull/brain surgery | 90 | $3,010 | |||
| 61735 | Incise skull/brain surgery | 90 | $2,233 | |||
| 61750 | Incise skull; brain biopsy | 90 | $2,469 | |||
| 61751 | Brain biopsy w/ ct/mr guide | 90 | $2,774 | |||
| 61760 | Implant brain electrodes | 90 | $2,943 | |||
| 61770 | Incise skull for treatment | 90 | $2,687 | |||
| 61781 | Scan proc cranial intra | $489 | ||||
| 61782 | Scan proc cranial extra | $402 | ||||
| 61783 | Scan proc spinal | $489 | ||||
| 61790 | Treat trigeminal nerve | 90 | $2,040 | |||
| 61791 | Treat trigeminal tract | 90 | $1,785 | |||
| 61796 | Srs cranial lesion simple | $2,096 | ||||
| 61797 | Srs cran les simple addl | $453 | ||||
| 61798 | Srs cranial lesion complex | $2,860 | ||||
| 61799 | Srs cran les complex addl | $626 | ||||
| 61800 | Apply srs headframe add-on | $317 | ||||
| 61850 | Implant neuroelectrodes | 90 | $1,797 | |||
| 61860 | Implant neuroelectrodes | 90 | $2,236 | |||
| 61863 | Implant neuroelectrode | $3,137 | ||||
| 61864 | Implant neuroelectrde addl | $592 | ||||
| 61867 | Implant neuroelectrode | $4,760 | ||||
| 61868 | Implant neuroelectrde addl | $1,042 | ||||
| 61870 | Implant neuroelectrodes | 90 | $763 | |||
| 61875 | Implant neuroelectrodes | 90 | $1,217 | |||
| 61880 | Revise/remove neuroelectrode | 90 | $791 | |||
| 61885 | Implant neurostim one array | 90 | $619 | |||
| 61886 | Implant neurostim arrays | 90 | $1,778 | |||
| 61888 | Revise/remove neuroreceiver | 10 | $409 | |||
| 62000 | Repair of skull fracture | 90 | $1,270 | |||
| 62005 | Repair of skull fracture | 90 | $1,974 | |||
| 62010 | Treatment of head injury | 90 | $2,903 | |||
| 62100 | Repair brain fluid leakage | 90 | $3,265 | |||
| 62115 | Reduction of skull defect | 90 | $2,611 | |||
| 62116 | Reduction of skull defect | 90 | $3,699 | |||
| 62117 | Reduction of skull defect | 90 | $3,234 | |||
| 62120 | Repair skull cavity lesion | 90 | $3,564 | |||
| 62121 | Incise skull repair | 90 | $2,915 | |||
| 62140 | Repair of skull defect | 90 | $2,014 | |||
| 62141 | Repair of skull defect | 90 | $2,471 | |||
| 62142 | Remove skull plate/flap | 90 | $1,810 | |||
| 62143 | Replace skull plate/flap | 90 | $1,623 | |||
| 62145 | Repair of skull & brain | 90 | $2,346 | |||
| 62146 | Repair of skull with graft | 90 | $2,000 | |||
| 62147 | Repair of skull with graft | 90 | $2,399 | |||
| 62148 | Retr bone flap to fix skull | $264 | ||||
| 62160 | Neuroendoscopy add-on | $394 | ||||
| 62161 | Dissect brain w/scope | $3,159 | ||||
| 62162 | Remove colloid cyst w/scope | $3,942 | ||||
| 62163 | Zneuroendoscopy w/fb removal | $2,557 | ||||
| 62164 | Remove brain tumor w/scope | $4,359 | ||||
| 62165 | Remove pituit tumor w/scope | $3,244 | ||||
| 62180 | Establish brain cavity shunt | 90 | $2,098 | |||
| 62190 | Establish brain cavity shunt | 90 | $1,994 | |||
| 62192 | Establish brain cavity shunt | 90 | $2,020 | |||
| 62194 | Replace/irrigate catheter | 10 | $353 | |||
| 62200 | Establish brain cavity shunt | 90 | $2,356 | |||
| 62201 | Establish brain cavity shunt | 90 | $1,600 | |||
| 62220 | Establish brain cavity shunt | 90 | $2,197 | |||
| 62223 | Establish brain cavity shunt | 90 | $2,281 | |||
| 62225 | Replace/irrigate catheter | 90 | $714 | |||
| 62230 | Replace/revise brain shunt | 90 | $1,512 | |||
| 62252 | TC | Csf shunt reprogram | $96 | |||
| 62252 | 26 | Csf shunt reprogram | $82 | |||
| 62252 | Csf shunt reprogram | $178 | ||||
| 62256 | Remove brain cavity shunt | 90 | $952 | |||
| 62258 | Replace brain cavity shunt | 90 | $2,189 | |||
| 62263 | Lysis epidural adhesions | 0 | ||||
| 62263 | Lysis epidural adhesions | 0 | $1,462 | $721 | ||
| 62264 | Epidural lysis on single day | $918 | $505 | |||
| 62267 | Interdiscal perq aspir dx | $504 | $322 | |||
| 62268 | Drain spinal cord cyst | 0 | $510 | |||
| 62269 | Needle biopsy spinal cord | 0 | $432 | |||
| 62270 | Spinal fluid tap, diagnostic | 0 | $135 | |||
| 62272 | Drain spinal fluid | 0 | $176 | |||
| 62273 | Treat epidural spine lesion | 0 | $251 | |||
| 62280 | Treat spinal cord lesion | 10 | $295 | |||
| 62281 | Treat spinal cord lesion | 10 | $266 | |||
| 62282 | Treat spinal canal lesion | 10 | $352 | |||
| 62284 | Injection for myelogram | 0 | $279 | |||
| 62287 | Percutaneous diskectomy | 90 | $1,197 | |||
| 62290 | Inject for spine disk X-ray | 0 | $402 | |||
| 62291 | Inject for spine disk X-ray | 0 | $393 | |||
| 62292 | Injection into disk lesion | 90 | $1,450 | |||
| 62294 | Injection into spinal artery | 90 | $1,032 | |||
| 62310 | Inject spine c/t...... | 0 | BR | |||
| 62311 | Inject spine l/s (cd) | 0 | BR | |||
| 62318 | Inject spine w/cath, c t | 0 | $530 | |||
| 62319 | Inject spine w/cath l/ s (cd) | 0 | $364 | $203 | ||
| 62350 | Implant spinal canal cath | 90 | $800 | |||
| 62351 | Implant spinal canal cath | 90 | $1,199 | |||
| 62355 | Remove spinal canal catheter | 90 | $659 | |||
| 62360 | Insert spine infusion device | 90 | $305 | |||
| 62361 | Implant spine infusion pump | 90 | $630 | |||
| 62362 | Implant spine infusion pump | 90 | $823 | |||
| 62365 | Remove spine infusion device | 90 | $667 | |||
| 62367 | Analyze spine infusion pump | BR | ||||
| 62367 | 26 | Analyze spine infusion pump | $59 | |||
| 62367 | TC | Analyze spine infusion pump | BR | |||
| 62368 | Analyze spine infusion pump | BR | ||||
| 62368 | 26 | Analyze spine infusion pump | $93 | |||
| 62368 | TC | Analyze spine infusion pump | BR | |||
| 62369 | Anal sp inf pmp w/reprg&fill | $256 | $72 | |||
| 62370 | Anl sp inf pmp w/mdreprg&fil | $268 | $97 | |||
| 63001 | Removal of spinal lamina | 90 | $2,582 | |||
| 63003 | Removal of spinal lamina | 90 | $2,534 | |||
| 63005 | Removal of spinal lamina | 90 | $2,403 | |||
| 63011 | Removal of spinal lamina | 90 | $1,626 | |||
| 63012 | Removal of spinal lamina | 90 | $2,508 | |||
| 63015 | Removal of spinal lamina | 90 | $2,994 | |||
| 63016 | Removal of spinal lamina | 90 | $3,104 | |||
| 63017 | Removal of spinal lamina | 90 | $2,900 | |||
| 63020 | Neck spine disk surgery | 90 | $2,331 | |||
| 63030 | Low back disk surgery | 90 | $1,906 | |||
| 63035 | Spinal disk surgery add-on | $498 | ||||
| 63040 | Neck spine disk surgery | 90 | $3,139 | |||
| 63042 | Low back disk surgery | 90 | $3,140 | |||
| 63045 | Removal of spinal lamina | 90 | $2,949 | |||
| 63046 | Removal of spinal lamina | 90 | $2,939 | |||
| 63047 | Removal of spinal lamina | 90 | $2,819 | |||
| 63048 | Remove spinal lamina add-on | $530 | ||||
| 63050 | Cervical laminoplasty | $3,231 | ||||
| 63051 | C-laminoplasty w/graft/plate | $3,577 | ||||
| 63055 | Decompress spinal cord | 90 | $3,439 | |||
| 63056 | Decompress spinal cord | 90 | $3,114 | |||
| 63057 | Decompress spine cord add-on | $691 | ||||
| 63064 | Decompress spinal cord | 90 | $3,622 | |||
| 63066 | Decompress spine cord add-on | $433 | ||||
| 63075 | Neck spine disk surgery | 90 | $2,871 | |||
| 63076 | Neck spine disk surgery | $640 | ||||
| 63077 | Spine disk surgery, thorax | 90 | $2,962 | |||
| 63078 | Spine disk surgery, thorax | $442 | ||||
| 63081 | Removal of vertebral body | 90 | $3,741 | |||
| 63082 | Remove vertebral body add-on | $699 | ||||
| 63085 | Removal of vertebral body | 90 | $4,045 | |||
| 63086 | Remove vertebral body add-on | $522 | ||||
| 63087 | Removal of vertebral body | 90 | $4,294 | |||
| 63088 | Remove vertebral body add-on | $691 | ||||
| 63090 | Removal of vertebral body | 90 | $4,270 | |||
| 63091 | Remove vertebral body add-on | $428 | ||||
| 63101 | Removal of vertebral body | $4,842 | ||||
| 63102 | Removal of vertebral body | $4,673 | ||||
| 63103 | Remove vertebral body add-on | $607 | ||||
| 63170 | Incise spinal cord tract(s) | 90 | $2,856 | |||
| 63172 | Drainage of spinal cyst | 90 | $3,047 | |||
| 63173 | Drainage of spinal cyst | 90 | $2,667 | |||
| 63180 | Revise spinal cord ligaments | 90 | $2,153 | |||
| 63182 | Revise spinal cord ligaments | 90 | $2,658 | |||
| 63185 | Incise spinal column/nerves | 90 | $2,288 | |||
| 63190 | Incise spinal column/nerves | 90 | $2,901 | |||
| 63191 | Incise spinal column/nerves | 90 | $2,242 | |||
| 63194 | Incise spinal column & cord | 90 | $2,327 | |||
| 63195 | Incise spinal column & cord | 90 | $2,345 | |||
| 63196 | Incise spinal column & cord | 90 | $2,689 | |||
| 63197 | Incise spinal column & cord | 90 | $2,574 | |||
| 63198 | Incise spinal column & cord | 90 | $2,971 | |||
| 63199 | Incise spinal column & cord | 90 | $3,391 | |||
| 63200 | Release of spinal cord | 90 | $2,264 | |||
| 63250 | Revise spinal cord vessels | 90 | $5,088 | |||
| 63251 | Revise spinal cord vessels | 90 | $4,666 | |||
| 63252 | Revise spinal cord vessels | 90 | $5,140 | |||
| 63265 | Excise intraspinal lesion | 90 | $3,252 | |||
| 63266 | Excise intraspinal lesion | 90 | $3,528 | |||
| 63267 | Excise intraspinal lesion | 90 | $3,020 | |||
| 63268 | Excise intraspinal lesion | 90 | $2,286 | |||
| 63270 | Excise intraspinal lesion | 90 | $3,285 | |||
| 63271 | Excise intraspinal lesion | 90 | $3,989 | |||
| 63272 | Excise intraspinal lesion | 90 | $3,617 | |||
| 63273 | Excise intraspinal lesion | 90 | $3,068 | |||
| 63275 | Biopsy/excise spinal tumor | 90 | $3,891 | |||
| 63276 | Biopsy/excise spinal tumor | 90 | $3,659 | |||
| 63277 | Biopsy/excise spinal tumor | 90 | $3,363 | |||
| 63278 | Biopsy/excise spinal tumor | 90 | $3,320 | |||
| 63280 | Biopsy/excise spinal tumor | 90 | $4,233 | |||
| 63281 | Biopsy/excise spinal tumor | 90 | $4,180 | |||
| 63282 | Biopsy/excise spinal tumor | 90 | $3,788 | |||
| 63283 | Biopsy/excise spinal tumor | 90 | $3,241 | |||
| 63285 | Biopsy/excise spinal tumor | 90 | $4,475 | |||
| 63286 | Biopsy/excise spinal tumor | 90 | $4,786 | |||
| 63287 | Biopsy/excise spinal tumor | 90 | $4,578 | |||
| 63290 | Biopsy/excise spinal tumor | 90 | $4,732 | |||
| 63295 | Repair of laminectomy defect | $692 | ||||
| 63300 | Removal of vertebral body | 90 | $2,978 | |||
| 63301 | Removal of vertebral body | 90 | $3,335 | |||
| 63302 | Removal of vertebral body | 90 | $3,538 | |||
| 63303 | Removal of vertebral body | 90 | $3,566 | |||
| 63304 | Removal of vertebral body | 90 | $3,674 | |||
| 63305 | Removal of vertebral body | 90 | $3,940 | |||
| 63306 | Removal of vertebral body | 90 | $3,923 | |||
| 63307 | Removal of vertebral body | 90 | $4,022 | |||
| 63308 | Remove vertebral body add-on | $691 | ||||
| 63600 | Remove spinal cord lesion | 90 | $1,870 | |||
| 63610 | Stimulation of spinal cord | 0 | $1,240 | |||
| 63615 | Remove lesion of spinal cord | 90 | $2,051 | |||
| 63620 | Srs spinal lesion | $2,311 | ||||
| 63621 | Srs spinal lesion addl | $520 | ||||
| 63650 | Implant neuroelectrodes | 90 | $1,059 | |||
| 63655 | Implant neuroelectrodes | 90 | $1,704 | |||
| 63660 | Revise/remove neuroelectrode | 90 | $962 | |||
| 63661 | Remove spine eltrd perq aray | $1,234 | $667 | |||
| 63662 | Remove spine eltrd plate | $1,626 | ||||
| 63663 | Revise spine eltrd perq aray | $1,754 | $973 | |||
| 63664 | Revise spine eltrd plate | $1,665 | ||||
| 63685 | Implant neuroreceiver | 90 | $1,073 | |||
| 63688 | Revise/remove neuroreceiver | 90 | $871 | |||
| 63700 | Repair of spinal herniation | 90 | $2,712 | |||
| 63702 | Repair of spinal herniation | 90 | $2,968 | |||
| 63704 | Repair of spinal herniation | 90 | $3,443 | |||
| 63706 | Repair of spinal herniation | 90 | $3,830 | |||
| 63707 | Repair spinal fluid leakage | 90 | $1,867 | |||
| 63709 | Repair spinal fluid leakage | 90 | $2,375 | |||
| 63710 | Graft repair of spine defect | 90 | $1,723 | |||
| 63740 | Install spinal shunt | 90 | $1,994 | |||
| 63741 | Install spinal shunt | 90 | $1,475 | |||
| 63744 | Revision of spinal shunt | 90 | $1,180 | |||
| 63746 | Removal of spinal shunt | 90 | $864 | |||
| 64400 | Injection for nerve block | 0 | $117 | |||
| 64402 | Injection for nerve block | 0 | $139 | |||
| 64405 | Injection for nerve block | 0 | $144 | |||
| 64408 | Injection for nerve block | 0 | $182 | |||
| 64410 | Injection for nerve block | 0 | $163 | |||
| 64412 | Injection for nerve block | 0 | $133 | |||
| 64413 | Injection for nerve block | 0 | $158 | |||
| 64415 | Injection for nerve block | 0 | $129 | |||
| 64417 | Injection for nerve block | 0 | $158 | |||
| 64418 | Injection for nerve block | 0 | $161 | |||
| 64420 | Injection for nerve block | 0 | $134 | |||
| 64421 | Injection for nerve block | 0 | $190 | |||
| 64425 | Injection for nerve block | 0 | $172 | |||
| 64430 | Injection for nerve block | 0 | $162 | |||
| 64435 | Injection for nerve block | 0 | $143 | |||
| 64445 | Injection for nerve block | 0 | $145 | |||
| 64446 | N blk inj sciatic cont inf | $169 | ||||
| 64447 | N block inj fem single | $255 | $138 | |||
| 64448 | N block inj fem cont inf | $151 | ||||
| 64449 | N block inj lumbar plexus | $176 | ||||
| 64450 | Injection for nerve block | 0 | $131 | |||
| 64455 | N block inj plantar digit | $98 | $73 | |||
| 64479 | Inj foramen epidural c t | 0 | BR | |||
| 64480 | Inj foramen epidural add-on | 0 | BR | |||
| 64483 | Inj foramen epidural l s | 0 | BR | |||
| 64484 | Inj foramen epidural add-on | BR | ||||
| 64490 | Inj paravert f jnt c/t 1 lev | BR | ||||
| 64491 | Inj paravert f jnt c/t 2 lev | BR | ||||
| 64492 | Inj paravert f jnt c/t 3 lev | BR | ||||
| 64493 | Inj paravert f jnt l/s 1 lev | BR | ||||
| 64494 | Inj paravert f jnt l/s 2 lev | BR | ||||
| 64495 | Inj paravert f jnt l/s 3 lev | BR | ||||
| 64505 | Injection for nerve block | 0 | $145 | |||
| 64508 | Injection for nerve block | 0 | $159 | |||
| 64510 | Injection for nerve block | 0 | $150 | |||
| 64517 | N block inj hypogas plxs | $391 | $266 | |||
| 64520 | Injection for nerve block | 0 | $159 | |||
| 64530 | Injection for nerve block | 0 | $215 | |||
| 64550 | Apply neurostimulator | 0 | $47 | |||
| 64553 | Implant neuroelectrodes | 10 | $240 | |||
| 64555 | Implant neuroelectrodes | 10 | $194 | |||
| 64561 | Implant neuroelectrodes | $1,629 | $813 | |||
| 64565 | Implant neuroelectrodes | 10 | $181 | |||
| 64566 | Neuroeltrd stim post tibial | $275 | ||||
| 64568 | Inc for vagus n elect impl | $1,319 | ||||
| 64569 | Revise/repl vagus n eltrd | $1,441 | ||||
| 64570 | Remove vagus n eltrd | $1,160 | ||||
| 64575 | Implant neuroelectrodes | 90 | $548 | |||
| 64580 | Implant neuroelectrodes | 90 | $506 | |||
| 64581 | Implant neuroelectrodes | $1,376 | ||||
| 64585 | Revise/remove neuroelectrode | 10 | $217 | |||
| 64590 | Implant neuroreceiver | 10 | $322 | |||
| 64595 | Revise/remove neuroreceiver | 10 | $213 | |||
| 64600 | Injection treatment of nerve | 10 | $373 | |||
| 64605 | Injection treatment of nerve | 10 | $528 | |||
| 64610 | Injection treatment of nerve | 10 | $1,113 | |||
| 64611 | Chemodenerv saliv glands | $208 | $186 | |||
| 64612 | Destroy nerve, face muscle | 10 | $272 | |||
| 64613 | Destroy nerve, spine muscle | 10 | $250 | |||
| 64614 | Destroy nerve extrem musc | BR | ||||
| 64620 | Injection treatment of nerve | 10 | $301 | |||
| 64630 | Injection treatment of nerve | 10 | $359 | |||
| 64632 | N block inj common digit | BR | ||||
| 64633 | Destroy cerv/thor facet jnt | BR | ||||
| 64634 | Destroy c/th facet jnt addl | BR | ||||
| 64635 | Destroy lumb/sac facet jnt | BR | ||||
| 64636 | Destroy l/s facet jnt addl | BR | ||||
| 64640 | Injection treatment of nerve | 10 | $248 | |||
| 64650 | Chemodenerv eccrine glands | $251 | $83 | |||
| 64653 | Chemodenerv eccrine glands | $294 | $108 | |||
| 64680 | Injection treatment of nerve | 10 | $321 | |||
| 64681 | Injection treatment of nerve | $774 | $408 | |||
| 64702 | Revise finger/toe nerve | 90 | $633 | |||
| 64704 | Revise hand/foot nerve | 90 | $748 | |||
| 64708 | Revise arm/leg nerve | 90 | $1,011 | |||
| 64712 | Revision of sciatic nerve | 90 | $1,278 | |||
| 64713 | Revision of arm nerve(s) | 90 | $1,519 | |||
| 64714 | Revise low back nerve(s) | 90 | $1,233 | |||
| 64716 | Revision of cranial nerve | 90 | $800 | |||
| 64718 | Revise ulnar nerve at elbow | 90 | $943 | |||
| 64719 | Revise ulnar nerve at wrist | 90 | $745 | |||
| 64721 | Carpal tunnel surgery | 90 | $688 | |||
| 64722 | Relieve pressure on nerve(s) | 90 | $829 | |||
| 64726 | Release foot/toe nerve | 90 | $337 | |||
| 64727 | Internal nerve revision | $488 | ||||
| 64732 | Incision of brow nerve | 90 | $651 | |||
| 64734 | Incision of cheek nerve | 90 | $701 | |||
| 64736 | Incision of chin nerve | 90 | $657 | |||
| 64738 | Incision of jaw nerve | 90 | $787 | |||
| 64740 | Incision of tongue nerve | 90 | $785 | |||
| 64742 | Incision of facial nerve | 90 | $804 | |||
| 64744 | Incise nerve, back of head | 90 | $854 | |||
| 64746 | Incise diaphragm nerve | 90 | $719 | |||
| 64752 | Incision of vagus nerve | 90 | $808 | |||
| 64755 | Incision of stomach nerves | 90 | $1,830 | |||
| 64760 | Incision of vagus nerve | 90 | $1,040 | |||
| 64761 | Incision of pelvis nerve | 90 | $798 | |||
| 64763 | Incise hip/thigh nerve | 90 | $880 | |||
| 64766 | Incise hip/thigh nerve | 90 | $1,145 | |||
| 64771 | Sever cranial nerve | 90 | $1,001 | |||
| 64772 | Incision of spinal nerve | 90 | $1,053 | |||
| 64774 | Remove skin nerve lesion | 90 | $570 | |||
| 64776 | Remove digit nerve lesion | 90 | $570 | |||
| 64778 | Digit nerve surgery add-on | $427 | ||||
| 64782 | Remove limb nerve lesion | 90 | $777 | |||
| 64783 | Limb nerve surgery add on | $510 | ||||
| 64784 | Remove nerve lesion | 90 | $1,137 | |||
| 64786 | Remove sciatic nerve lesion | 90 | $2,117 | |||
| 64787 | Implant nerve end | $593 | ||||
| 64788 | Remove skin nerve lesion | 90 | $598 | |||
| 64790 | Removal of nerve lesion | 90 | $1,365 | |||
| 64792 | Removal of nerve lesion | 90 | $1,774 | |||
| 64795 | Biopsy of nerve | 0 | $409 | |||
| 64802 | Remove sympathetic nerves | 90 | $1,042 | |||
| 64804 | Remove sympathetic nerves | 90 | $2,043 | |||
| 64809 | Remove sympathetic nerves | 90 | $1,797 | |||
| 64818 | Remove sympathetic nerves | 90 | $1,396 | |||
| 64820 | Remove sympathetic nerves | 90 | $1,191 | |||
| 64821 | Remove sympathetic nerves | $1,481 | ||||
| 64822 | Remove sympathetic nerves | $1,436 | ||||
| 64823 | Remove sympathetic nerves | $1,633 | ||||
| 64831 | Repair of digit nerve | 90 | $906 | |||
| 64832 | Repair nerve add-on... | $548 | ||||
| 64834 | Repair of hand or foot nerve | 90 | $980 | |||
| 64835 | Repair of hand or foot nerve | 90 | $1,237 | |||
| 64836 | Repair of hand or foot nerve | 90 | $1,302 | |||
| 64837 | Repair nerve add-on... | $802 | ||||
| 64840 | Repair of leg nerve | 90 | $1,651 | |||
| 64856 | Repair/transpose nerve | 90 | $1,592 | |||
| 64857 | Repair arm/leg nerve | 90 | $1,735 | |||
| 64858 | Repair sciatic nerve | 90 | $2,019 | |||
| 64859 | Nerve surgery......... | $574 | ||||
| 64861 | Repair of arm nerves | 90 | $2,318 | |||
| 64862 | Repair of low back nerves | 90 | $2,924 | |||
| 64864 | Repair of facial nerve | 90 | $1,479 | |||
| 64865 | Repair of facial nerve | 90 | $2,021 | |||
| 64866 | Fusion of facial/other nerve | 90 | $1,980 | |||
| 64868 | Fusion of facial/other nerve | 90 | $1,842 | |||
| 64870 | Fusion of facial/other nerve | 90 | $2,180 | |||
| 64872 | Subsequent repair of nerve | $248 | ||||
| 64874 | Repair and revise nerve | $351 | ||||
| 64876 | Repair nerve; shorten bone | $379 | ||||
| 64885 | Nerve graft, head or neck | 90 | $2,188 | |||
| 64886 | Nerve graft, head or neck | 90 | $2,609 | |||
| 64890 | Nerve graft, hand or foot | 90 | $2,034 | |||
| 64891 | Nerve graft, hand or foot | 90 | $1,937 | |||
| 64892 | Nerve graft, arm or leg | 90 | $1,881 | |||
| 64893 | Nerve graft, arm or leg | 90 | $2,181 | |||
| 64895 | Nerve graft, hand or foot | 90 | $2,414 | |||
| 64896 | Nerve graft, hand or foot | 90 | $2,748 | |||
| 64897 | Nerve graft, arm or leg | 90 | $2,299 | |||
| 64898 | Nerve graft, arm or leg | 90 | $2,488 | |||
| 64901 | Nerve graft add-on.... | $1,442 | ||||
| 64902 | Nerve graft add-on.... | $1,685 | ||||
| 64905 | Nerve pedicle transfer | 90 | $1,651 | |||
| 64907 | Nerve pedicle transfer | 90 | $2,369 | |||
| 64910 | Nerve repair w/allograft | $1,740 | ||||
| 64911 | Neurorraphy w/vein autograft | $2,185 | ||||
| 64999 | Nervous system surgery | BR | ||||
| 65091 | Revise eye | 90 | $1,031 | |||
| 65093 | Revise eye with implant | 90 | $1,141 | |||
| 65101 | Removal of eye | 90 | $1,086 | |||
| 65103 | Remove eye/insert implant | 90 | $1,176 | |||
| 65105 | Remove eye/attach implant | 90 | $1,302 | |||
| 65110 | Removal of eye | 90 | $2,146 | |||
| 65112 | Remove eye, revise socket | 90 | $2,031 | |||
| 65114 | Remove eye, revise socket | 90 | $2,217 | |||
| 65125 | Revise ocular implant | 90 | $435 | |||
| 65130 | Insert ocular implant | 90 | $1,126 | |||
| 65135 | Insert ocular implant | 90 | $899 | |||
| 65140 | Attach ocular implant | 90 | $992 | |||
| 65150 | Revise ocular implant | 90 | $1,147 | |||
| 65155 | Reinsert ocular implant | 90 | $1,534 | |||
| 65175 | Removal of ocular implant | 90 | $978 | |||
| 65205 | Remove foreign body from eye | 0 | $83 | |||
| 65210 | Remove foreign body from eye | 0 | $95 | |||
| 65220 | Remove foreign body from eye | 0 | $91 | |||
| 65222 | Remove foreign body from eye | 0 | $109 | |||
| 65235 | Remove foreign body from eye | 90 | $922 | |||
| 65260 | Remove foreign body from eye | 90 | $1,376 | |||
| 65265 | Remove foreign body from eye | 90 | $1,599 | |||
| 65270 | Repair of eye wound | 10 | $219 | |||
| 65272 | Repair of eye wound | 90 | $376 | |||
| 65273 | Repair of eye wound | 90 | $518 | |||
| 65275 | Repair of eye wound | 90 | $407 | |||
| 65280 | Repair of eye wound | 90 | $1,181 | |||
| 65285 | Repair of eye wound | 90 | $1,767 | |||
| 65286 | Repair of eye wound | 90 | $722 | |||
| 65290 | Repair of eye socket wound | 90 | $824 | |||
| 65400 | Removal of eye lesion | 90 | $879 | |||
| 65410 | Biopsy of cornea | 0 | $225 | |||
| 65420 | Removal of eye lesion | 90 | $600 | |||
| 65426 | Removal of eye lesion | 90 | $854 | |||
| 65430 | Corneal smear | 0 | $103 | |||
| 65435 | Curette/treat cornea | 0 | $123 | |||
| 65436 | Curette/treat cornea | 90 | $397 | |||
| 65450 | Treatment of corneal lesion | 90 | $462 | |||
| 65600 | Revision of cornea | 90 | $418 | |||
| 65710 | Corneal transplant | 90 | $2,051 | |||
| 65730 | Corneal transplant | 90 | $2,450 | |||
| 65750 | Corneal transplant | 90 | $2,557 | |||
| 65755 | Corneal transplant | 90 | $2,618 | |||
| 65756 | Corneal trnspl endothelial | $2,411 | ||||
| 65760 | Revision of cornea | BR | ||||
| 65765 | Revision of cornea | BR | ||||
| 65767 | Corneal tissue transplant | BR | ||||
| 65770 | Revise cornea with implant | 90 | $2,200 | |||
| 65771 | Radial keratotomy | BR | ||||
| 65772 | Correction of astigmatism | 90 | $691 | |||
| 65775 | Correction of astigmatism | 90 | $1,037 | |||
| 65778 | Cover eye w/membrane | $2,775 | $150 | |||
| 65779 | Cover eye w/membrane suture | $2,471 | $592 | |||
| 65780 | Ocular reconst transplant | $1,849 | ||||
| 65781 | Ocular reconst transplant | $2,713 | ||||
| 65782 | Ocular reconst transplant | $2,470 | ||||
| 65800 | Drainage of eye | 0 | $264 | |||
| 65805 | Drainage of eye | 0 | $271 | |||
| 65810 | Drainage of eye | 90 | $731 | |||
| 65815 | Drainage of eye | 90 | $671 | |||
| 65820 | Relieve inner eye pressure | 90 | $1,250 | |||
| 65850 | Incision of eye | 90 | $1,692 | |||
| 65855 | Laser surgery of eye | 90 | $985 | |||
| 65860 | Incise inner eye adhesions | 90 | $689 | |||
| 65865 | Incise inner eye adhesions | 90 | $907 | |||
| 65870 | Incise inner eye adhesions | 90 | $857 | |||
| 65875 | Incise inner eye adhesions | 90 | $903 | |||
| 65880 | Incise inner eye adhesions | 90 | $985 | |||
| 65900 | Remove eye lesion | 90 | $1,364 | |||
| 65920 | Remove implant from eye | 90 | $1,182 | |||
| 65930 | Remove blood clot from eye | 90 | $1,071 | |||
| 66020 | Injection treatment of eye | 10 | $280 | |||
| 66030 | Injection treatment of eye | 10 | $126 | |||
| 66130 | Remove eye lesion | 90 | $927 | |||
| 66150 | Glaucoma surgery | 90 | $1,301 | |||
| 66155 | Glaucoma surgery | 90 | $1,243 | |||
| 66160 | Glaucoma surgery | 90 | $1,473 | |||
| 66165 | Glaucoma surgery | 90 | $1,267 | |||
| 66170 | Glaucoma surgery | 90 | $1,706 | |||
| 66172 | Incision of eye | 90 | $1,873 | |||
| 66174 | Translum dil eye canal | $2,017 | ||||
| 66175 | Trnslum dil eye canal w/stnt | $2,276 | ||||
| 66180 | Implant eye shunt | 90 | $2,166 | |||
| 66185 | Revise eye shunt | 90 | $1,290 | |||
| 66220 | Repair eye lesion | 90 | $964 | |||
| 66225 | Repair/graft eye lesion | 90 | $1,883 | |||
| 66250 | Follow-up surgery of eye | 90 | $935 | |||
| 66500 | Incision of iris | 90 | $600 | |||
| 66505 | Incision of iris | 90 | $522 | |||
| 66600 | Remove iris and lesion | 90 | $1,281 | |||
| 66605 | Removal of iris | 90 | $1,762 | |||
| 66625 | Removal of iris | 90 | $964 | |||
| 66630 | Removal of iris | 90 | $1,006 | |||
| 66635 | Removal of iris | 90 | $1,064 | |||
| 66680 | Repair iris & ciliary body | 90 | $843 | |||
| 66682 | Repair iris and ciliary body | 90 | $961 | |||
| 66700 | Destruction, ciliary body | 90 | $771 | |||
| 66710 | Destruction, ciliary body | 90 | $836 | |||
| 66711 | Ciliary endoscopic ablation | $1,295 | ||||
| 66720 | Destruction, ciliary body | 90 | $806 | |||
| 66740 | Destruction, ciliary body | 90 | $828 | |||
| 66761 | Revision of iris | 90 | $854 | |||
| 66762 | Revision of iris | 90 | $992 | |||
| 66770 | Removal of inner eye lesion | 90 | $927 | |||
| 66820 | Incision, secondary cataract | 90 | $642 | |||
| 66821 | After cataract laser surgery | 90 | $637 | |||
| 66825 | Reposition intraocular lens | 90 | $1,093 | |||
| 66830 | Removal of lens lesion | 90 | $1,124 | |||
| 66840 | Removal of lens material | 90 | $1,251 | |||
| 66850 | Removal of lens material | 90 | $1,501 | |||
| 66852 | Removal of lens material | 90 | $1,806 | |||
| 66920 | Extraction of lens | 90 | $1,407 | |||
| 66930 | Extraction of lens | 90 | $1,473 | |||
| 66940 | Extraction of lens | 90 | $1,421 | |||
| 66982 | Cataract surgery complex | $2,227 | ||||
| 66983 | Remove cataract, insert lens | 90 | $1,771 | |||
| 66984 | Remove cataract, insert lens | 90 | $1,895 | |||
| 66985 | Insert lens prosthesis | 90 | $1,391 | |||
| 66986 | Exchange lens prosthesis | 90 | $1,743 | |||
| 66990 | Ophthalmic endoscope add-on | $184 | ||||
| 66999 | Eye surgery procedure | BR | ||||
| 67005 | Partial removal of eye fluid | 90 | $1,793 | |||
| 67010 | Partial removal of eye fluid | 90 | $1,720 | |||
| 67015 | Release of eye fluid | 90 | $955 | |||
| 67025 | Replace eye fluid | 90 | $959 | |||
| 67027 | Implant eye drug system. | 90 | $1,517 | |||
| 67028 | Injection eye drug | 0 | $420 | |||
| 67030 | Incise inner eye strands | 90 | $943 | |||
| 67031 | Laser surgery, eye strands | 90 | $1,118 | |||
| 67036 | Removal of inner eye fluid | 90 | $2,629 | |||
| 67039 | Laser treatment of retina | 90 | $3,025 | |||
| 67040 | Laser treatment of retina | 90 | $3,339 | |||
| 67041 | Vit for macular pucker | $2,778 | ||||
| 67042 | Vit for macular hole | $3,176 | ||||
| 67043 | Vit for membrane dissect | $3,396 | ||||
| 67101 | Repair, detached retina | 90 | $1,340 | |||
| 67105 | Repair detached retina | 90 | $1,201 | |||
| 67107 | Repair detached retina | 90 | $2,249 | |||
| 67108 | Repair detached retina | 90 | $3,158 | |||
| 67110 | Repair detached retina | 90 | $1,744 | |||
| 67112 | Rerepair detached retina. | 90 | $2,424 | |||
| 67113 | Repair retinal detach cplx | $3,660 | ||||
| 67115 | Release, encircling material | 90 | $871 | |||
| 67120 | Remove eye implant material | 90 | $931 | |||
| 67121 | Remove eye implant material | 90 | $1,421 | |||
| 67141 | Treatment of retina | 90 | $961 | |||
| 67145 | Treatment of retina | 90 | $983 | |||
| 67208 | Treatment of retinal lesion | 90 | $1,036 | |||
| 67210 | Treatment of retinal lesion | 90 | $1,272 | |||
| 67218 | Treatment of retinal lesion | 90 | $1,893 | |||
| 67220 | Treatment of choroid lesion | 90 | $1,403 | |||
| 67221 | Ocular photodynamic ther | $595 | $447 | |||
| 67225 | Eye photodynamic ther add-on | $60 | $57 | |||
| 67227 | Treatment of retinal lesion | 90 | $1,120 | |||
| 67228 | Treatment of retinal lesion | 90 | $1,576 | |||
| 67229 | Tr retinal les preterm inf | $2,262 | ||||
| 67250 | Reinforce eye wall | 90 | $1,115 | |||
| 67255 | Reinforce/graft eye wall | 90 | $1,697 | |||
| 67299 | Eye surgery procedure | BR | ||||
| 67311 | Revise eye muscle..... | 90 | $1,025 | |||
| 67312 | Revise two eye muscles | 90 | $1,256 | |||
| 67314 | Revise eye muscle | 90 | $1,268 | |||
| 67316 | Revise two eye muscles | 90 | $1,430 | |||
| 67318 | Revise eye muscle(s).. | 90 | $1,055 | |||
| 67320 | Revise eye muscle(s) add-on | $986 | ||||
| 67331 | Eye surgery follow-up add-on | $902 | ||||
| 67332 | Rerevise eye muscles add-on | $1,005 | ||||
| 67334 | Revise eye muscle w/suture | $746 | ||||
| 67335 | Eye suture during surgery | $412 | ||||
| 67340 | Revise eye muscle add- on | $929 | ||||
| 67343 | Release eye tissue | 90 | $930 | |||
| 67345 | Destroy nerve of eye muscle | 10 | $381 | |||
| 67346 | Biopsy eye muscle | $434 | ||||
| 67399 | Eye muscle surgery procedure | BR | ||||
| 67400 | Explore/biopsy eye socket | 90 | $1,514 | |||
| 67405 | Explore/drain eye socket | 90 | $1,245 | |||
| 67412 | Explore/treat eye socket | 90 | $1,523 | |||
| 67413 | Explore/treat eye socket | 90 | $1,304 | |||
| 67414 | Explore/decompress eye socket | 90 | $1,337 | |||
| 67415 | Aspiration orbital contents | 0 | $276 | |||
| 67420 | Explore/treat eye socket | 90 | $2,212 | |||
| 67430 | Explore/treat eye socket | 90 | $1,698 | |||
| 67440 | Explore/drain eye socket | 90 | $2,075 | |||
| 67445 | Explore/decompress eye socket | 90 | $1,774 | |||
| 67450 | Explore/biopsy eye socket | 90 | $2,050 | |||
| 67500 | Inject/treat eye socket | 0 | $112 | |||
| 67505 | Inject/treat eye socket | 0 | $136 | |||
| 67515 | Inject/treat eye socket | 0 | $86 | |||
| 67550 | Insert eye socket implant | 90 | $1,417 | |||
| 67560 | Revise eye socket implant | 90 | $1,337 | |||
| 67570 | Decompress optic nerve | 90 | $1,449 | |||
| 67599 | Orbit surgery procedure | BR | ||||
| 67700 | Drainage of eyelid abscess | 10 | $129 | |||
| 67710 | Incision of eyelid | 10 | $145 | |||
| 67715 | Incision of eyelid fold | 10 | $195 | |||
| 67800 | Remove eyelid lesion | 10 | $166 | |||
| 67801 | Remove eyelid lesions | 10 | $236 | |||
| 67805 | Remove eyelid lesions | 10 | $257 | |||
| 67808 | Remove eyelid lesion(s) | 90 | $411 | |||
| 67810 | Biopsy of eyelid | 0 | $166 | |||
| 67820 | Revise eyelashes | 0 | $91 | |||
| 67825 | Revise eyelashes...... | 10 | $236 | |||
| 67830 | Revise eyelashes | 10 | $322 | |||
| 67835 | Revise eyelashes | 90 | $962 | |||
| 67840 | Remove eyelid lesion | 10 | $232 | |||
| 67850 | Treat eyelid lesion | 10 | $178 | |||
| 67875 | Closure of eyelid by suture | 0 | $235 | |||
| 67880 | Revision of eyelid | 90 | $546 | |||
| 67882 | Revision of eyelid | 90 | $796 | |||
| 67900 | Repair brow defect | 90 | $603 | |||
| 67901 | Repair eyelid defect | 90 | $1,178 | |||
| 67902 | Repair eyelid defect | 90 | $1,228 | |||
| 67903 | Repair eyelid defect | 90 | $1,254 | |||
| 67904 | Repair eyelid defect | 90 | $1,215 | |||
| 67906 | Repair eyelid defect | 90 | $882 | |||
| 67908 | Repair eyelid defect | 90 | $1,013 | |||
| 67909 | Revise eyelid defect | 90 | $903 | |||
| 67911 | Revise eyelid defect | 90 | $1,092 | |||
| 67912 | Correction eyelid w/implant | $1,817 | $1,024 | |||
| 67914 | Repair eyelid defect | 90 | $704 | |||
| 67915 | Repair eyelid defect | 90 | $313 | |||
| 67916 | Repair eyelid defect | 90 | $850 | |||
| 67917 | Repair eyelid defect | 90 | $977 | |||
| 67921 | Repair eyelid defect | 90 | $520 | |||
| 67922 | Repair eyelid defect | 90 | $300 | |||
| 67923 | Repair eyelid defect | 90 | $917 | |||
| 67924 | Repair eyelid defect | 90 | $951 | |||
| 67930 | Repair eyelid wound | 10 | $348 | |||
| 67935 | Repair eyelid wound | 90 | $715 | |||
| 67938 | Remove eyelid foreign body | 10 | $130 | |||
| 67950 | Revision of eyelid | 90 | $943 | |||
| 67961 | Revision of eyelid | 90 | $938 | |||
| 67966 | Revision of eyelid | 90 | $1,162 | |||
| 67971 | Reconstruction of eyelid | 90 | $1,479 | |||
| 67973 | Reconstruction of eyelid | 90 | $1,914 | |||
| 67974 | Reconstruction of eyelid | 90 | $1,947 | |||
| 67975 | Reconstruction of eyelid | 90 | $941 | |||
| 67999 | Eyelid surgery procedure | BR | ||||
| 68020 | Incise/drain eyelid lining | 10 | $132 | |||
| 68040 | Treatment of eyelid lesions | 0 | $94 | |||
| 68100 | Biopsy of eyelid lining | 0 | $171 | |||
| 68110 | Remove eyelid lining lesion | 10 | $215 | |||
| 68115 | Remove eyelid lining lesion | 10 | $308 | |||
| 68130 | Remove eyelid lining lesion | 90 | $642 | |||
| 68135 | Remove eyelid lining lesion | 10 | $182 | |||
| 68200 | Treat eyelid by injection | 0 | $75 | |||
| 68320 | Revise/graft eyelid lining | 90 | $882 | |||
| 68325 | Revise/graft eyelid lining | 90 | $1,198 | |||
| 68326 | Revise/graft eyelid lining | 90 | $1,124 | |||
| 68328 | Revise/graft eyelid lining | 90 | $1,377 | |||
| 68330 | Revise eyelid lining | 90 | $767 | |||
| 68335 | Revise/graft eyelid lining | 90 | $1,259 | |||
| 68340 | Separate eyelid adhesions | 90 | $511 | |||
| 68360 | Revise eyelid lining | 90 | $703 | |||
| 68362 | Revise eyelid lining | 90 | $1,088 | |||
| 68371 | Harvest eye tissue alograft | $839 | ||||
| 68399 | Eyelid lining surgery | BR | ||||
| 68400 | Incise/drain tear gland | 10 | $192 | |||
| 68420 | Incise/drain tear sac | 10 | $236 | |||
| 68440 | Incise tear duct opening | 10 | $120 | |||
| 68500 | Removal of tear gland | 90 | $1,333 | |||
| 68505 | Partial removal tear gland | 90 | $1,386 | |||
| 68510 | Biopsy of tear gland | 0 | $607 | |||
| 68520 | Removal of tear sac | 90 | $1,184 | |||
| 68525 | Biopsy of tear sac | 0 | $591 | |||
| 68530 | Clearance of tear duct | 10 | $469 | |||
| 68540 | Remove tear gland lesion | 90 | $1,339 | |||
| 68550 | Remove tear gland lesion | 90 | $1,752 | |||
| 68700 | Repair tear ducts | 90 | $640 | |||
| 68705 | Revise tear duct opening | 10 | $218 | |||
| 68720 | Create tear sac drain | 90 | $1,407 | |||
| 68745 | Create tear duct drain | 90 | $1,079 | |||
| 68750 | Create tear duct drain | 90 | $1,570 | |||
| 68760 | Close tear duct opening | 10 | $187 | |||
| 68761 | Close tear duct opening | 10 | $161 | |||
| 68770 | Close tear system fistula | 90 | $785 | |||
| 68801 | Dilate tear duct opening | 10 | $170 | |||
| 68810 | Probe nasolacrimal duct | 10 | $269 | |||
| 68811 | Probe nasolacrimal duct | 10 | $298 | |||
| 68815 | Probe nasolacrimal duct | 10 | $446 | |||
| 68816 | Probe nl duct w/balloon | $1,519 | $533 | |||
| 68840 | Explore/irrigate tear ducts | 10 | $124 | |||
| 68850 | Injection for tear sac X-ray | 0 | $96 | |||
| 68899 | Tear duct system surgery | BR | ||||
| 69000 | Drain external ear lesion | 10 | $126 | |||
| 69005 | Drain external ear lesion | 10 | $237 | |||
| 69020 | Drain outer ear canal lesion | 10 | $136 | |||
| 69090 | Pierce earlobes | BR | ||||
| 69100 | Biopsy of external ear | 0 | $106 | |||
| 69105 | Biopsy of external ear canal | 0 | $124 | |||
| 69110 | Partial removal external ear | 90 | $449 | |||
| 69120 | Removal of external ear | 90 | $340 | |||
| 69140 | Remove ear canal lesion(s) | 90 | $1,173 | |||
| 69145 | Remove ear canal lesion(s) | 90 | $378 | |||
| 69150 | Extensive ear canal surgery | 90 | $1,750 | |||
| 69155 | Extensive ear/neck surgery | 90 | $2,447 | |||
| 69200 | Clear outer ear canal | 0 | $87 | |||
| 69205 | Clear outer ear canal | 10 | $165 | |||
| 69210 | Remove impacted ear wax | 0 | $61 | |||
| 69220 | Clean out mastoid cavity | 0 | $98 | |||
| 69222 | Clean out mastoid cavity | 10 | $154 | |||
| 69300 | Revise external ear | $1,565 | $1,009 | |||
| 69310 | Rebuild outer ear canal | 90 | $1,523 | |||
| 69320 | Rebuild outer ear canal | 90 | $2,329 | |||
| 69399 | Outer ear surgery procedure | $0 | ||||
| 69400 | Inflate middle ear canal | 0 | $94 | |||
| 69401 | Inflate middle ear canal | 0 | $65 | |||
| 69405 | Catheterize middle ear canal | 10 | $220 | |||
| 69410 | Inset middle ear baffle | 0 | $71 | |||
| 69420 | Incision of eardrum | 10 | $145 | |||
| 69421 | Incision of eardrum | 10 | $209 | |||
| 69424 | Remove ventilating tube | 0 | $108 | |||
| 69433 | Create eardrum opening | 10 | $209 | |||
| 69436 | Create eardrum opening | 10 | $302 | |||
| 69440 | Exploration of middle ear | 90 | $1,199 | |||
| 69450 | Eardrum revision | 90 | $1,132 | |||
| 69501 | Mastoidectomy | 90 | $1,478 | |||
| 69502 | Mastoidectomy | 90 | $1,895 | |||
| 69505 | Remove mastoid structures | 90 | $2,156 | |||
| 69511 | Extensive mastoid surgery | 90 | $2,245 | |||
| 69530 | Extensive mastoid surgery | 90 | $2,582 | |||
| 69535 | Remove part of temporal bone | 90 | $4,432 | |||
| 69540 | Remove ear lesion | 10 | $181 | |||
| 69550 | Remove ear lesion | 90 | $2,061 | |||
| 69552 | Remove ear lesion | 90 | $2,650 | |||
| 69554 | Remove ear lesion | 90 | $3,630 | |||
| 69601 | Mastoid surgery revision | 90 | $2,008 | |||
| 69602 | Mastoid surgery revision | 90 | $2,208 | |||
| 69603 | Mastoid surgery revision | 90 | $2,323 | |||
| 69604 | Mastoid surgery revision | 90 | $2,765 | |||
| 69605 | Mastoid surgery revision | 90 | $2,467 | |||
| 69610 | Repair of eardrum | 10 | $383 | |||
| 69620 | Repair of eardrum | 90 | $1,170 | |||
| 69631 | Repair eardrum structures | 90 | $1,761 | |||
| 69632 | Rebuild eardrum structures | 90 | $2,126 | |||
| 69633 | Rebuild eardrum structures | 90 | $2,056 | |||
| 69635 | Repair eardrum structures | 90 | $2,237 | |||
| 69636 | Rebuild eardrum structures | 90 | $2,551 | |||
| 69637 | Rebuild eardrum structures | 90 | $2,565 | |||
| 69641 | Revise middle ear & mastoid | 90 | $2,157 | |||
| 69642 | Revise middle ear & mastoid | 90 | $2,775 | |||
| 69643 | Revise middle ear & mastoid | 90 | $2,672 | |||
| 69644 | Revise middle ear & mastoid | 90 | $2,968 | |||
| 69645 | Revise middle ear & mastoid | 90 | $2,826 | |||
| 69646 | Revise middle ear & mastoid | 90 | $2,953 | |||
| 69650 | Release middle ear bone | 90 | $1,610 | |||
| 69660 | Revise middle ear bone | 90 | $2,055 | |||
| 69661 | Revise middle ear bone | 90 | $2,527 | |||
| 69662 | Revise middle ear bone | 90 | $2,478 | |||
| 69666 | Repair middle ear structures | 90 | $1,807 | |||
| 69667 | Repair middle ear structures | 90 | $1,783 | |||
| 69670 | Remove mastoid air cells | 90 | $1,579 | |||
| 69676 | Remove middle ear nerve | 90 | $1,318 | |||
| 69700 | Close mastoid fistula | 90 | $1,181 | |||
| 69710 | Implant/replace hearing aid | BR | ||||
| 69711 | Remove/repair hearing aid | 90 | $1,345 | |||
| 69714 | Implant temple bone w/stimul | $2,301 | ||||
| 69715 | Temple bne implnt w/stimulat | $2,844 | ||||
| 69717 | Temple bone implant revision | $2,420 | ||||
| 69718 | Revise temple bone implant | $2,874 | ||||
| 69720 | Release facial nerve | 90 | $2,449 | |||
| 69725 | Release facial nerve | 90 | $2,488 | |||
| 69740 | Repair facial nerve | 90 | $2,047 | |||
| 69745 | Repair facial nerve | 90 | $2,378 | |||
| 69799 | Middle ear surgery procedure | BR | ||||
| 69801 | Incise inner ear...... | 90 | $1,388 | |||
| 69802 | Incise inner ear | 90 | $1,763 | |||
| 69805 | Explore inner ear | 90 | $2,047 | |||
| 69806 | Explore inner ear | 90 | $2,450 | |||
| 69820 | Establish inner ear window | 90 | $1,415 | |||
| 69840 | Revise inner ear window | 90 | $1,349 | |||
| 69905 | Remove inner ear | 90 | $2,070 | |||
| 69910 | Remove inner ear & mastoid | 90 | $2,541 | |||
| 69915 | Incise inner ear nerve | 90 | $2,805 | |||
| 69930 | Implant cochlear device | 90 | $3,188 | |||
| 69949 | Inner ear surgery procedure | BR | ||||
| 69950 | Incise inner ear nerve | 90 | $2,935 | |||
| 69955 | Release facial nerve | 90 | $3,161 | |||
| 69960 | Release inner ear canal | 90 | $2,798 | |||
| 69970 | Remove inner ear lesion | 90 | $3,133 | |||
| 69979 | Temporal bone surgery | BR | ||||
| 69990 | Microsurgery add-on... | $424 | ||||
| 70010 | Contrast X-ray of brain | $438 | ||||
| 70010 | 26 | Contrast X-ray of brain | $127 | |||
| 70010 | TC | Contrast X-ray of brain | $311 | |||
| 70015 | Contrast X-ray of brain | $224 | ||||
| 70015 | 26 | Contrast X-ray of brain | $127 | |||
| 70015 | TC | Contrast X-ray of brain | $98 | |||
| 70030 | X-ray eye for foreign body | $49 | ||||
| 70030 | 26 | X-ray eye for foreign body | $19 | |||
| 70030 | TC | X-ray eye for foreign body | $31 | |||
| 70100 | X-ray exam of jaw | $58 | ||||
| 70100 | 26 | X-ray exam of jaw | $20 | |||
| 70100 | TC | X-ray exam of jaw | $38 | |||
| 70110 | X-ray exam of jaw | $73 | ||||
| 70110 | 26 | X-ray exam of jaw | $28 | |||
| 70110 | TC | X-ray exam of jaw | $45 | |||
| 70120 | X-ray exam of mastoids | $65 | ||||
| 70120 | 26 | X-ray exam of mastoids | $20 | |||
| 70120 | TC | X-ray exam of mastoids | $45 | |||
| 70130 | X-ray exam of mastoids | $94 | ||||
| 70130 | 26 | X-ray exam of mastoids | $37 | |||
| 70130 | TC | X-ray exam of mastoids | $57 | |||
| 70134 | X-ray exam of middle ear | $90 | ||||
| 70134 | 26 | X-ray exam of middle ear | $37 | |||
| 70134 | TC | X-ray exam of middle ear | $54 | |||
| 70140 | X-ray exam of facial bones | $66 | ||||
| 70140 | 26 | X-ray exam of facial bones | $21 | |||
| 70140 | TC | X-ray exam of facial bones | $45 | |||
| 70150 | X-ray exam of facial bones | $85 | ||||
| 70150 | 26 | X-ray exam of facial bones | $28 | |||
| 70150 | TC | X-ray exam of facial bones | $57 | |||
| 70160 | X-ray exam of nasal bones | $56 | ||||
| 70160 | 26 | X-ray exam of nasal bones | $19 | |||
| 70160 | TC | X-ray exam of nasal bones | $38 | |||
| 70170 | X-ray exam of tear duct | $101 | ||||
| 70170 | 26 | X-ray exam of tear duct | $33 | |||
| 70170 | TC | X-ray exam of tear duct | $68 | |||
| 70190 | X-ray exam of eye sockets | $68 | ||||
| 70190 | 26 | X-ray exam of eye sockets | $23 | |||
| 70190 | TC | X-ray exam of eye sockets | $45 | |||
| 70200 | X-ray exam of eye sockets | $87 | ||||
| 70200 | 26 | X-ray exam of eye sockets | $31 | |||
| 70200 | TC | X-ray exam of eye sockets | $57 | |||
| 70210 | X-ray exam of sinuses | $63 | ||||
| 70210 | 26 | X-ray exam of sinuses | $19 | |||
| 70210 | TC | X-ray exam of sinuses | $45 | |||
| 70220 | X-ray exam of sinuses | $84 | ||||
| 70220 | 26 | X-ray exam of sinuses | $28 | |||
| 70220 | TC | X-ray exam of sinuses | $57 | |||
| 70240 | X-ray exam pituitary saddle | $51 | ||||
| 70240 | 26 | X-ray exam pituitary saddle | $21 | |||
| 70240 | TC | X-ray exam pituitary saddle | $31 | |||
| 70250 | X-ray exam of skull | $71 | ||||
| 70250 | 26 | X-ray exam of skull | $26 | |||
| 70250 | TC | X-ray exam of skull | $45 | |||
| 70260 | X-ray exam of skull | $101 | ||||
| 70260 | 26 | X-ray exam of skull | $37 | |||
| 70260 | TC | X-ray exam of skull | $65 | |||
| 70300 | X-ray exam of teeth | $31 | ||||
| 70300 | 26 | X-ray exam of teeth | $12 | |||
| 70300 | TC | X-ray exam of teeth | $19 | |||
| 70310 | X-ray exam of teeth | $47 | ||||
| 70310 | 26 | X-ray exam of teeth | $17 | |||
| 70310 | TC | X-ray exam of teeth | $31 | |||
| 70320 | Full mouth X-ray of teeth | $81 | ||||
| 70320 | 26 | Full mouth X-ray of teeth | $24 | |||
| 70320 | TC | Full mouth X-ray of teeth | $57 | |||
| 70328 | X-ray exam of jaw joint | $56 | ||||
| 70328 | 26 | X-ray exam of jaw joint | $20 | |||
| 70328 | TC | X-ray exam of jaw joint | $36 | |||
| 70330 | X-ray exam of jaw joints | $87 | ||||
| 70330 | 26 | X-ray exam of jaw joints | $26 | |||
| 70330 | TC | X-ray exam of jaw joints | $61 | |||
| 70332 | X-ray exam of jaw joint | $210 | ||||
| 70332 | 26 | X-ray exam of jaw joint | $59 | |||
| 70332 | TC | X-ray exam of jaw joint | $151 | |||
| 70336 | Magnetic image jaw joint | $906 | ||||
| 70336 | 26 | Magnetic image jaw joint | $102 | |||
| 70336 | TC | Magnetic image jaw joint | $804 | |||
| 70350 | X-ray head for orthodontia | $45 | ||||
| 70350 | 26 | X-ray head for orthodontia | $19 | |||
| 70350 | TC | X-ray head for orthodontia | $27 | |||
| 70355 | Panoramic X-ray of jaws | $63 | ||||
| 70355 | 26 | Panoramic X-ray of jaws | $21 | |||
| 70355 | TC | Panoramic X-ray of jaws | $42 | |||
| 70360 | X-ray exam of neck | $49 | ||||
| 70360 | 26 | X-ray exam of neck | $19 | |||
| 70360 | TC | X-ray exam of neck | $31 | |||
| 70370 | Throat X-ray & fluoroscopy | $128 | ||||
| 70370 | 26 | Throat X-ray & fluoroscopy | $35 | |||
| 70370 | TC | Throat X-ray & fluoroscopy | $94 | |||
| 70371 | Speech evaluation, complex | $241 | ||||
| 70371 | 26 | Speech evaluation, complex | $91 | |||
| 70371 | TC | Speech evaluation, complex | $151 | |||
| 70373 | Contrast X-ray of larynx | $175 | ||||
| 70373 | 26 | Contrast X-ray of larynx | $47 | |||
| 70373 | TC | Contrast X-ray of larynx | $129 | |||
| 70380 | X-ray exam of salivary gland | $67 | ||||
| 70380 | 26 | X-ray exam of salivary gland | $19 | |||
| 70380 | TC | X-ray exam of salivary gland | $49 | |||
| 70390 | X-ray exam of salivary duct | $169 | ||||
| 70390 | 26 | X-ray exam of salivary duct | $41 | |||
| 70390 | TC | X-ray exam of salivary duct | $129 | |||
| 70450 | Cat scan of head or brain | $430 | ||||
| 70450 | 26 | Cat scan of head or brain | $91 | |||
| 70450 | TC | Cat scan of head or brain | $339 | |||
| 70460 | Contrast cat scan of head | $528 | ||||
| 70460 | 26 | Contrast cat scan of head | $122 | |||
| 70460 | TC | Contrast cat scan of head | $406 | |||
| 70470 | Contrast cat scans of head | $643 | ||||
| 70470 | 26 | Contrast cat scans of head | $136 | |||
| 70470 | TC | Contrast cat scans of head | $507 | |||
| 70480 | Cat scan of skull | $476 | ||||
| 70480 | 26 | Cat scan of skull | $138 | |||
| 70480 | TC | Cat scan of skull | $339 | |||
| 70481 | Contrast cat scan of skull | $554 | ||||
| 70481 | 26 | Contrast cat scan of skull | $148 | |||
| 70481 | TC | Contrast cat scan of skull | $406 | |||
| 70482 | Contrast cat scans of skull | $663 | ||||
| 70482 | 26 | Contrast cat scans of skull | $156 | |||
| 70482 | TC | Contrast cat scans of skull | $507 | |||
| 70486 | Cat scan of face, jaw | $461 | ||||
| 70486 | 26 | Cat scan of face, jaw | $122 | |||
| 70486 | TC | Cat scan of face, jaw | $339 | |||
| 70487 | Contrast cat scan, face/jaw | $545 | ||||
| 70487 | 26 | Contrast cat scan, face/jaw | $139 | |||
| 70487 | TC | Contrast cat scan, face/jaw | $406 | |||
| 70488 | Contrast cat scans face/jaw | $660 | ||||
| 70488 | 26 | Contrast cat scans face/jaw | $153 | |||
| 70488 | TC | Contrast cat scans face/jaw | $507 | |||
| 70490 | Cat scan of neck tissue | $476 | ||||
| 70490 | 26 | Cat scan of neck tissue | $138 | |||
| 70490 | TC | Cat scan of neck tissue | $339 | |||
| 70491 | Contrast cat of neck tissue | $554 | ||||
| 70491 | 26 | Contrast cat of neck tissue | $148 | |||
| 70491 | TC | Contrast cat of neck tissue | $406 | |||
| 70492 | Contrast cat of neck tissue | $663 | ||||
| 70492 | 26 | Contrast cat of neck tissue | $156 | |||
| 70492 | TC | Contrast cat of neck tissue | $507 | |||
| 70496 | 26 | Ct angiography head | $174 | |||
| 70496 | TC | Ct angiography head | $881 | |||
| 70496 | Ct angiography head | $1,055 | ||||
| 70498 | 26 | Ct angiography neck | $174 | |||
| 70498 | TC | Ct angiography neck | $919 | |||
| 70498 | Ct angiography neck | $1,093 | ||||
| 70540 | Magnetic image, face, neck | $963 | ||||
| 70540 | 26 | Magnetic image, face, neck | $159 | |||
| 70540 | TC | Magnetic image, face, neck | $804 | |||
| 70542 | 26 | Mri orbit/face/neck w/dye | $161 | |||
| 70542 | TC | Mri orbit/face/neck w/dye | $807 | |||
| 70542 | Mri orbit/face/neck w/dye | $969 | ||||
| 70543 | 26 | Mri orbt/fac/nck w/o & w/dye | $213 | |||
| 70543 | TC | Mri orbt/fac/nck w/o & w/dye | $966 | |||
| 70543 | Mri orbt/fac/nck w/o & w/dye | $1,180 | ||||
| 70544 | 26 | Mr angiography head w/o dye | $120 | |||
| 70544 | TC | Mr angiography head w/o dye | $849 | |||
| 70544 | Mr angiography head w/o dye | $969 | ||||
| 70545 | 26 | Mr angiography head w/dye | $119 | |||
| 70545 | TC | Mr angiography head w/dye | $829 | |||
| 70545 | Mr angiography head w/dye | $948 | ||||
| 70546 | 26 | Mr angiograph head w/o&w/dye | $180 | |||
| 70546 | TC | Mr angiograph head w/o&w/dye | $1,281 | |||
| 70546 | Mr angiograph head w/o&w/dye | $1,461 | ||||
| 70547 | 26 | Mr angiography neck w/o dye | $120 | |||
| 70547 | TC | Mr angiography neck w/o dye | $849 | |||
| 70547 | Mr angiography neck w/o dye | $968 | ||||
| 70548 | 26 | Mr angiography neck w/dye | $120 | |||
| 70548 | TC | Mr angiography neck w/dye | $910 | |||
| 70548 | Mr angiography neck w/dye | $1,030 | ||||
| 70549 | 26 | Mr angiograph neck w/o&w/dye | $179 | |||
| 70549 | TC | Mr angiograph neck w/o&w/dye | $1,286 | |||
| 70549 | Mr angiograph neck w/o&w/dye | $1,465 | ||||
| 70551 | Magnetic image, brain | $963 | ||||
| 70551 | 26 | Magnetic image, brain | $159 | |||
| 70551 | TC | Magnetic image, brain | $804 | |||
| 70552 | Magnetic image, brain | $1,155 | ||||
| 70552 | 26 | Magnetic image, brain | $192 | |||
| 70552 | TC | Magnetic image, brain | $964 | |||
| 70553 | Magnetic image, brain | $2,039 | ||||
| 70553 | 26 | Magnetic image, brain | $255 | |||
| 70553 | TC | Magnetic image, brain | $1,785 | |||
| 70554 | 26 | Fmri brain by tech | $211 | |||
| 70554 | TC | Fmri brain by tech | $818 | |||
| 70554 | Fmri brain by tech | $1,029 | ||||
| 70555 | Fmri brain by phys/psych | $261 | ||||
| 70557 | Mri brain w/o dye | $348 | ||||
| 70558 | Mri brain w/dye | $327 | ||||
| 70559 | Mri brain w/o & w/dye | $330 | ||||
| 71010 | Chest x-ray 1 view frontal | $45 | ||||
| 71010 | TC | Chest x-ray 1 view frontal | $26 | |||
| 71010 | 26 | Chest x-ray 1 view frontal | $19 | |||
| 71015 | Chest x-ray stereo frontal | $56 | ||||
| 71015 | TC | Chest x-ray stereo frontal | $34 | |||
| 71015 | 26 | Chest x-ray stereo frontal | $22 | |||
| 71020 | Chest x-ray 2vw frontal&latl | $56 | ||||
| 71020 | TC | Chest x-ray 2vw frontal&latl | $34 | |||
| 71020 | 26 | Chest x-ray 2vw frontal&latl | $22 | |||
| 71021 | Chest x-ray frnt lat lordotc | $68 | ||||
| 71021 | TC | Chest x-ray frnt lat lordotc | $40 | |||
| 71021 | 26 | Chest x-ray frnt lat lordotc | $28 | |||
| 71022 | Chest x-ray frnt lat oblique | $84 | ||||
| 71022 | TC | Chest x-ray frnt lat oblique | $50 | |||
| 71022 | 26 | Chest x-ray frnt lat oblique | $34 | |||
| 71023 | Chest x-ray and fluoroscopy | $127 | ||||
| 71023 | TC | Chest x-ray and fluoroscopy | $89 | |||
| 71023 | 26 | Chest x-ray and fluoroscopy | $39 | |||
| 71030 | Chest x-ray 4/> views | $84 | ||||
| 71030 | TC | Chest x-ray 4/> views | $51 | |||
| 71030 | 26 | Chest x-ray 4/> views | $32 | |||
| 71034 | Chest x-ray&fluoro 4/> views | $167 | ||||
| 71034 | TC | Chest x-ray&fluoro 4/> views | $119 | |||
| 71034 | 26 | Chest x-ray&fluoro 4/> views | $48 | |||
| 71035 | Chest x-ray special views | $66 | ||||
| 71035 | TC | Chest x-ray special views | $47 | |||
| 71035 | 26 | Chest x-ray special views | $19 | |||
| 71100 | X-ray exam ribs uni 2 views | $66 | ||||
| 71100 | TC | X-ray exam ribs uni 2 views | $43 | |||
| 71100 | 26 | X-ray exam ribs uni 2 views | $23 | |||
| 71101 | X-ray exam unilat ribs/chest | $73 | ||||
| 71101 | TC | X-ray exam unilat ribs/chest | $45 | |||
| 71101 | 26 | X-ray exam unilat ribs/chest | $28 | |||
| 71110 | X-ray exam ribs bil 3 views | $75 | ||||
| 71110 | TC | X-ray exam ribs bil 3 views | $47 | |||
| 71110 | 26 | X-ray exam ribs bil 3 views | $28 | |||
| 71111 | X-ray exam ribs/chest4/> vws | $96 | ||||
| 71111 | TC | X-ray exam ribs/chest4/> vws | $62 | |||
| 71111 | 26 | X-ray exam ribs/chest4/> vws | $34 | |||
| 71120 | X-ray exam breastbone 2/>vws | $59 | ||||
| 71120 | TC | X-ray exam breastbone 2/>vws | $39 | |||
| 71120 | 26 | X-ray exam breastbone 2/>vws | $21 | |||
| 71130 | X-ray strenoclavic jt 3/>vws | $72 | ||||
| 71130 | TC | X-ray strenoclavic jt 3/>vws | $49 | |||
| 71130 | 26 | X-ray strenoclavic jt 3/>vws | $23 | |||
| 71250 | Ct thorax w/o dye | $363 | ||||
| 71250 | TC | Ct thorax w/o dye | $259 | |||
| 71250 | 26 | Ct thorax w/o dye | $104 | |||
| 71260 | Ct thorax w/dye | $461 | ||||
| 71260 | TC | Ct thorax w/dye | $334 | |||
| 71260 | 26 | Ct thorax w/dye | $127 | |||
| 71270 | Ct thorax w/o & w/dye | $553 | ||||
| 71270 | TC | Ct thorax w/o & w/dye | $413 | |||
| 71270 | 26 | Ct thorax w/o & w/dye | $141 | |||
| 71275 | Ct angiography chest | $836 | ||||
| 71550 | Magnetic image, chest | $976 | ||||
| 71550 | 26 | Magnetic image, chest | $173 | |||
| 71550 | TC | Magnetic image, chest | $804 | |||
| 71551 | 26 | Mri chest w/dye | $173 | |||
| 71551 | TC | Mri chest w/dye | $944 | |||
| 71551 | Mri chest w/dye | $1,117 | ||||
| 71552 | 26 | Mri chest w/o & w/dye | $224 | |||
| 71552 | TC | Mri chest w/o & w/dye | $1,165 | |||
| 71552 | Mri chest w/o & w/dye | $1,389 | ||||
| 71555 | Magnetic imaging/chest | $991 | ||||
| 72020 | X-ray exam of spine 1 view | $44 | ||||
| 72020 | TC | X-ray exam of spine 1 view | $29 | |||
| 72020 | 26 | X-ray exam of spine 1 view | $16 | |||
| 72040 | X-ray exam neck spine 2-3 vw | $66 | ||||
| 72040 | TC | X-ray exam neck spine 2-3 vw | $44 | |||
| 72040 | 26 | X-ray exam neck spine 2-3 vw | $23 | |||
| 72050 | X-ray exam neck spine 4/5vws | $90 | ||||
| 72050 | TC | X-ray exam neck spine 4/5vws | $58 | |||
| 72050 | 26 | X-ray exam neck spine 4/5vws | $32 | |||
| 72052 | X-ray exam neck spine 6/>vws | $113 | ||||
| 72052 | TC | X-ray exam neck spine 6/>vws | $76 | |||
| 72052 | 26 | X-ray exam neck spine 6/>vws | $37 | |||
| 72070 | X-ray exam thorac spine 2vws | $68 | ||||
| 72070 | TC | X-ray exam thorac spine 2vws | $45 | |||
| 72070 | 26 | X-ray exam thorac spine 2vws | $23 | |||
| 72072 | X-ray exam thorac spine 3vws | $69 | ||||
| 72072 | TC | X-ray exam thorac spine 3vws | $47 | |||
| 72072 | 26 | X-ray exam thorac spine 3vws | $22 | |||
| 72074 | X-ray exam thorac spine4/>vw | $79 | ||||
| 72074 | TC | X-ray exam thorac spine4/>vw | $56 | |||
| 72074 | 26 | X-ray exam thorac spine4/>vw | $22 | |||
| 72080 | X-ray exam thoracolmb 2/> vw | $61 | ||||
| 72080 | TC | X-ray exam trunk spine 2 vws | $39 | |||
| 72080 | 26 | X-ray exam trunk spine 2 vws | $22 | |||
| 72081 | X-ray exam entire spi 1 vw | $78 | ||||
| 72081 | TC | X-ray exam entire spi 1 vw | $51 | |||
| 72081 | 26 | X-ray exam entire spi 1 vw | $27 | |||
| 72082 | X-ray exam entire spi 2/3 vw | $125 | ||||
| 72082 | TC | X-ray exam entire spi 2/3 vw | $92 | |||
| 72082 | 26 | X-ray exam entire spi 2/3 vw | $33 | |||
| 72083 | X-ray exam entire spi 4/5 vw | $136 | ||||
| 72083 | TC | X-ray exam entire spi 4/5 vw | $100 | |||
| 72083 | 26 | X-ray exam entire spi 4/5 vw | $36 | |||
| 72084 | X-ray exam entire spi 6/> vw | $162 | ||||
| 72084 | TC | X-ray exam entire spi 6/> vw | $121 | |||
| 72084 | 26 | X-ray exam entire spi 6/> vw | $41 | |||
| 72100 | X-ray exam l-s spine 2/3 vws | $70 | ||||
| 72100 | TC | X-ray exam l-s spine 2/3 vws | $47 | |||
| 72100 | 26 | X-ray exam l-s spine 2/3 vws | $23 | |||
| 72110 | X-ray exam l-2 spine 4/>vws | $98 | ||||
| 72110 | TC | X-ray exam l-2 spine 4/>vws | $66 | |||
| 72110 | 26 | X-ray exam l-2 spine 4/>vws | $32 | |||
| 72114 | X-ray exam l-s spine bending | $125 | ||||
| 72114 | TC | X-ray exam l-s spine bending | $92 | |||
| 72114 | 26 | X-ray exam l-s spine bending | $34 | |||
| 72120 | X-ray bend only l-s spine | $81 | ||||
| 72120 | TC | X-ray bend only l-s spine | $58 | |||
| 72120 | 26 | X-ray bend only l-s spine | $23 | |||
| 72125 | Ct neck spine w/o dye | $371 | ||||
| 72125 | TC | Ct neck spine w/o dye | $262 | |||
| 72125 | 26 | Ct neck spine w/o dye | $109 | |||
| 72126 | Ct neck spine w/dye | $460 | ||||
| 72126 | TC | Ct neck spine w/dye | $336 | |||
| 72126 | 26 | Ct neck spine w/dye | $124 | |||
| 72127 | Ct neck spine w/o & w/dye | $545 | ||||
| 72127 | TC | Ct neck spine w/o & w/dye | $415 | |||
| 72127 | 26 | Ct neck spine w/o & w/dye | $129 | |||
| 72128 | Ct chest spine w/o dye | $363 | ||||
| 72128 | TC | Ct chest spine w/o dye | $260 | |||
| 72128 | 26 | Ct chest spine w/o dye | $102 | |||
| 72129 | Ct chest spine w/dye | $461 | ||||
| 72129 | TC | Ct chest spine w/dye | $337 | |||
| 72129 | 26 | Ct chest spine w/dye | $124 | |||
| 72130 | Ct chest spine w/o & w/dye | $548 | ||||
| 72130 | TC | Ct chest spine w/o & w/dye | $419 | |||
| 72130 | 26 | Ct chest spine w/o & w/dye | $129 | |||
| 72131 | Ct lumbar spine w/o dye | $361 | ||||
| 72131 | TC | Ct lumbar spine w/o dye | $259 | |||
| 72131 | 26 | Ct lumbar spine w/o dye | $102 | |||
| 72132 | Ct lumbar spine w/dye | $460 | ||||
| 72132 | TC | Ct lumbar spine w/dye | $335 | |||
| 72132 | 26 | Ct lumbar spine w/dye | $124 | |||
| 72133 | Ct lumbar spine w/o & w/dye | $544 | ||||
| 72133 | TC | Ct lumbar spine w/o & w/dye | $415 | |||
| 72133 | 26 | Ct lumbar spine w/o & w/dye | $129 | |||
| 72141 | Mri neck spine w/o dye | $450 | ||||
| 72141 | TC | Mri neck spine w/o dye | $299 | |||
| 72141 | 26 | Mri neck spine w/o dye | $152 | |||
| 72142 | Mri neck spine w/dye | $654 | ||||
| 72142 | TC | Mri neck spine w/dye | $470 | |||
| 72142 | 26 | Mri neck spine w/dye | $183 | |||
| 72146 | Mri chest spine w/o dye | $450 | ||||
| 72146 | TC | Mri chest spine w/o dye | $299 | |||
| 72146 | 26 | Mri chest spine w/o dye | $152 | |||
| 72147 | Mri chest spine w/dye | $646 | ||||
| 72147 | TC | Mri chest spine w/dye | $465 | |||
| 72147 | 26 | Mri chest spine w/dye | $182 | |||
| 72148 | Mri lumbar spine w/o dye | $448 | ||||
| 72148 | TC | Mri lumbar spine w/o dye | $297 | |||
| 72148 | 26 | Mri lumbar spine w/o dye | $152 | |||
| 72149 | Mri lumbar spine w/dye | $646 | ||||
| 72149 | TC | Mri lumbar spine w/dye | $463 | |||
| 72149 | 24 | Mri lumbar spine w/dye | $183 | |||
| 72156 | Mri neck spine w/o & w/dye | $763 | ||||
| 72156 | TC | Mri neck spine w/o & w/dye | $529 | |||
| 72156 | 26 | Mri neck spine w/o & w/dye | $234 | |||
| 72157 | Mri chest spine w/o & w/dye | $764 | ||||
| 72157 | TC | Mri chest spine w/o & w/dye | $531 | |||
| 72157 | 26 | Mri chest spine w/o & w/dye | $234 | |||
| 72158 | Mri lumbar spine w/o & w/dye | $761 | ||||
| 72158 | TC | Mri lumbar spine w/o & w/dye | $528 | |||
| 72158 | 26 | Mri lumbar spine w/o & w/dye | $234 | |||
| 72159 | MR angio spine w/o&w/dye | $838 | ||||
| 72159 | TC | MR angio spine w/o&w/dye | $654 | |||
| 72159 | 26 | MR angio spine w/o&w/dye | $184 | |||
| 72170 | X-ray exam of pelvis | $64 | ||||
| 72170 | TC | X-ray exam of pelvis | $46 | |||
| 72170 | 26 | X-ray exam of pelvis | $18 | |||
| 72190 | X-ray exam of pelvis | $77 | ||||
| 72190 | TC | X-ray exam of pelvis | $54 | |||
| 72190 | 26 | X-ray exam of pelvis | $22 | |||
| 72191 | Ct angiograph pelv w/o&w/dye | $885 | ||||
| 72192 | Cat scan of pelvis | $540 | ||||
| 72192 | 26 | Cat scan of pelvis | $117 | |||
| 72192 | TC | Cat scan of pelvis | $424 | |||
| 72193 | Contrast cat scan of pelvis | $614 | ||||
| 72193 | 26 | Contrast cat scan of pelvis | $124 | |||
| 72193 | TC | Contrast cat scan of pelvis | $490 | |||
| 72194 | Contrast cat scans of pelvis | $738 | ||||
| 72194 | 26 | Contrast cat scans of pelvis | $130 | |||
| 72194 | TC | Contrast cat scans of pelvis | $609 | |||
| 72195 | 26 | Mri pelvis w/o dye | $147 | |||
| 72195 | TC | Mri pelvis w/o dye | $749 | |||
| 72195 | Mri pelvis w/o dye | $896 | ||||
| 72196 | Magnetic image, pelvis | $976 | ||||
| 72196 | 26 | Magnetic image, pelvis | $173 | |||
| 72196 | TC | Magnetic image, pelvis | $804 | |||
| 72197 | 26 | Mri pelvis w/o & w/dye | $224 | |||
| 72197 | TC | Mri pelvis w/o & w/dye | $987 | |||
| 72197 | Mri pelvis w/o & w/dye | $1,211 | ||||
| 72198 | Magnetic imaging/pelvis(mri) | $990 | ||||
| 72198 | 26 | Magnetic imaging/pelvis(mri) | $187 | |||
| 72198 | TC | Magnetic imaging/pelvis(mri) | $804 | |||
| 72200 | X-ray exam sacroiliac joints | $56 | ||||
| 72200 | 26 | X-ray exam sacroiliac joints | $19 | |||
| 72200 | TC | X-ray exam sacroiliac joints | $38 | |||
| 72202 | X-ray exam sacroiliac joints | $66 | ||||
| 72202 | 26 | X-ray exam sacroiliac joints | $21 | |||
| 72202 | TC | X-ray exam sacroiliac joints | $45 | |||
| 72220 | X-ray exam of tailbone | $60 | ||||
| 72220 | 26 | X-ray exam of tailbone | $19 | |||
| 72220 | TC | X-ray exam of tailbone | $42 | |||
| 72240 | Contrast X-ray of neck spine | $438 | ||||
| 72240 | 26 | Contrast X-ray of neck spine | $98 | |||
| 72240 | TC | Contrast X-ray of neck spine | $341 | |||
| 72255 | Contrast X-ray thorax spine | $409 | ||||
| 72255 | 26 | Contrast X-ray thorax spine | $98 | |||
| 72255 | TC | Contrast X-ray thorax spine | $311 | |||
| 72265 | Contrast X-ray lower spine | $382 | ||||
| 72265 | 26 | Contrast X-ray lower spine | $90 | |||
| 72265 | TC | Contrast X-ray lower spine | $292 | |||
| 72270 | Contrast X-ray of spine | $579 | ||||
| 72270 | 26 | Contrast X-ray of spine | $143 | |||
| 72270 | TC | Contrast X-ray of spine | $437 | |||
| 72275 | Epidurography......... | BR | ||||
| 72275 | 26 | Epidurography......... | BR | |||
| 72275 | TC | Epidurography......... | BR | |||
| 72285 | X-ray c/t spine disk.. | $712 | ||||
| 72285 | 26 | X-ray c/t spine disk.. | $87 | |||
| 72285 | TC | X-ray c/t spine disk.. | $626 | |||
| 72291 | Perq verte/sacroplsty fluor | $147 | ||||
| 72292 | Perq verte/sacroplsty ct | $149 | ||||
| 72295 | X-ray of lower spine disk | $653 | ||||
| 72295 | 26 | X-ray of lower spine disk | $90 | |||
| 72295 | TC | X-ray of lower spine disk | $563 | |||
| 73000 | X-ray exam of collarbone | $55 | ||||
| 73000 | 26 | X-ray exam of collarbone | $17 | |||
| 73000 | TC | X-ray exam of collarbone | $38 | |||
| 73010 | X-ray exam of shoulder blade | $56 | ||||
| 73010 | 26 | X-ray exam of shoulder blade | $19 | |||
| 73010 | TC | X-ray exam of shoulder blade | $38 | |||
| 73020 | X-ray exam of shoulder | $51 | ||||
| 73020 | 26 | X-ray exam of shoulder | $17 | |||
| 73020 | TC | X-ray exam of shoulder | $35 | |||
| 73030 | X-ray exam of shoulder | $61 | ||||
| 73030 | 26 | X-ray exam of shoulder | $19 | |||
| 73030 | TC | X-ray exam of shoulder | $42 | |||
| 73040 | Contrast X-ray of shoulder | $210 | ||||
| 73040 | 26 | Contrast X-ray of shoulder | $59 | |||
| 73040 | TC | Contrast X-ray of shoulder | $151 | |||
| 73050 | X-ray exam of shoulders | $70 | ||||
| 73050 | 26 | X-ray exam of shoulders | $21 | |||
| 73050 | TC | X-ray exam of shoulders | $49 | |||
| 73060 | X-ray exam of humerus | $60 | ||||
| 73060 | 26 | X-ray exam of humerus | $19 | |||
| 73060 | TC | X-ray exam of humerus | $42 | |||
| 73070 | X-ray exam of elbow | $54 | ||||
| 73070 | 26 | X-ray exam of elbow | $17 | |||
| 73070 | TC | X-ray exam of elbow | $38 | |||
| 73080 | X-ray exam of elbow | $60 | ||||
| 73080 | 26 | X-ray exam of elbow | $19 | |||
| 73080 | TC | X-ray exam of elbow | $42 | |||
| 73085 | Contrast X-ray of elbow | $210 | ||||
| 73085 | 26 | Contrast X-ray of elbow | $59 | |||
| 73085 | TC | Contrast X-ray of elbow | $151 | |||
| 73090 | X-ray exam of forearm | $55 | ||||
| 73090 | 26 | X-ray exam of forearm | $17 | |||
| 73090 | TC | X-ray exam of forearm | $38 | |||
| 73092 | X-ray exam of arm, infant | $53 | ||||
| 73092 | 26 | X-ray exam of arm, infant | $17 | |||
| 73092 | TC | X-ray exam of arm, infant | $36 | |||
| 73100 | X-ray exam of wrist | $53 | ||||
| 73100 | 26 | X-ray exam of wrist | $17 | |||
| 73100 | TC | X-ray exam of wrist | $36 | |||
| 73110 | X-ray exam of wrist | $57 | ||||
| 73110 | 26 | X-ray exam of wrist | $19 | |||
| 73110 | TC | X-ray exam of wrist | $39 | |||
| 73115 | Contrast X-ray of wrist | $173 | ||||
| 73115 | 26 | Contrast X-ray of wrist | $59 | |||
| 73115 | TC | Contrast X-ray of wrist | $114 | |||
| 73120 | X-ray exam of hand | $53 | ||||
| 73120 | 26 | X-ray exam of hand | $17 | |||
| 73120 | TC | X-ray exam of hand | $36 | |||
| 73130 | X-ray exam of hand | $57 | ||||
| 73130 | 26 | X-ray exam of hand | $19 | |||
| 73130 | TC | X-ray exam of hand | $39 | |||
| 73140 | X-ray exam of finger(s) | $45 | ||||
| 73140 | 26 | X-ray exam of finger(s) | $14 | |||
| 73140 | TC | X-ray exam of finger(s) | $31 | |||
| 73200 | Cat scan of arm | $472 | ||||
| 73200 | 26 | Cat scan of arm | $117 | |||
| 73200 | TC | Cat scan of arm | $356 | |||
| 73201 | Contrast cat scan of arm | $548 | ||||
| 73201 | 26 | Contrast cat scan of arm | $124 | |||
| 73201 | TC | Contrast cat scan of arm | $424 | |||
| 73202 | Contrast cat scans of arm | $663 | ||||
| 73202 | 26 | Contrast cat scans of arm | $130 | |||
| 73202 | TC | Contrast cat scans of arm | $533 | |||
| 73206 | 26 | Ct angio upr extrm w/o&w/dye | $179 | |||
| 73206 | TC | Ct angio upr extrm w/o&w/dye | $578 | |||
| 73206 | Ct angio upr extrm w/o&w/dye | $757 | ||||
| 73218 | 26 | Mri upper extremity w/o dye | $135 | |||
| 73218 | TC | Mri upper extremity w/o dye | $749 | |||
| 73218 | Mri upper extremity w/o dye | $884 | ||||
| 73219 | 26 | Mri upper extremity w/dye | $162 | |||
| 73219 | TC | Mri upper extremity w/dye | $815 | |||
| 73219 | Mri upper extremity w/dye | $977 | ||||
| 73220 | Magnetic image, arm, hand | $963 | ||||
| 73220 | 26 | Magnetic image, arm, hand | $159 | |||
| 73220 | TC | Magnetic image, arm, hand | $804 | |||
| 73221 | Magnetic image, joint of arm | $906 | ||||
| 73221 | 26 | Magnetic image, joint of arm | $102 | |||
| 73221 | TC | Magnetic image, joint of arm | $804 | |||
| 73222 | 26 | Mri joint upr extrem w/dye | $162 | |||
| 73222 | TC | Mri joint upr extrem w/dye | $749 | |||
| 73222 | Mri joint upr extrem w/dye | $911 | ||||
| 73223 | 26 | Mri joint upr extr w/o&w/dye | $215 | |||
| 73223 | TC | Mri joint upr extr w/o&w/dye | $914 | |||
| 73223 | Mri joint upr extr w/o&w/dye | $1,129 | ||||
| 73225 | Magnetic imaging/upper | $980 | ||||
| 73225 | 26 | Magnetic imaging/upper | $177 | |||
| 73225 | TC | Magnetic imaging/upper | $804 | |||
| 73500 | X-ray exam of hip | $53 | ||||
| 73500 | 26 | X-ray exam of hip | $19 | |||
| 73500 | TC | X-ray exam of hip | $35 | |||
| 73510 | X-ray exam of hip | $64 | ||||
| 73510 | 26 | X-ray exam of hip | $23 | |||
| 73510 | TC | X-ray exam of hip | $42 | |||
| 73520 | X-ray exam of hips | $77 | ||||
| 73520 | 26 | X-ray exam of hips | $28 | |||
| 73520 | TC | X-ray exam of hips | $49 | |||
| 73525 | Contrast X-ray of hip | $210 | ||||
| 73525 | 26 | Contrast X-ray of hip | $59 | |||
| 73525 | TC | Contrast X-ray of hip | $151 | |||
| 73530 | X-ray exam of hip | $69 | ||||
| 73530 | 26 | X-ray exam of hip | $31 | |||
| 73530 | TC | X-ray exam of hip | $38 | |||
| 73540 | X-ray exam of pelvis & hips | $63 | ||||
| 73540 | 26 | X-ray exam of pelvis & hips | $22 | |||
| 73540 | TC | X-ray exam of pelvis & hips | $42 | |||
| 73550 | X-ray exam of thigh | $60 | ||||
| 73550 | 26 | X-ray exam of thigh | $19 | |||
| 73550 | TC | X-ray exam of thigh | $42 | |||
| 73560 | X-ray exam of knee, 1 or 2 | $56 | ||||
| 73560 | 26 | X-ray exam of knee, 1 or 2 | $18 | |||
| 73560 | TC | X-ray exam of knee, 1 or 2 | $39 | |||
| 73562 | X-ray exam of knee, 3 | $62 | ||||
| 73562 | 26 | X-ray exam of knee, 3 | $20 | |||
| 73562 | TC | X-ray exam of knee, 3 | $43 | |||
| 73564 | X-ray exam, knee, 4 or more | $70 | ||||
| 73564 | 26 | X-ray exam, knee, 4 or more | $24 | |||
| 73564 | TC | X-ray exam, knee, 4 or more | $46 | |||
| 73565 | X-ray exam of knee | $54 | ||||
| 73565 | 26 | X-ray exam of knee | $18 | |||
| 73565 | TC | X-ray exam of knee | $36 | |||
| 73580 | Contrast X-ray of knee joint | $248 | ||||
| 73580 | 26 | Contrast X-ray of knee joint | $59 | |||
| 73580 | TC | Contrast X-ray of knee joint | $189 | |||
| 73590 | X-ray exam of lower leg | $56 | ||||
| 73590 | 26 | X-ray exam of lower leg | $18 | |||
| 73590 | TC | X-ray exam of lower leg | $38 | |||
| 73592 | X-ray exam of leg, infant | $53 | ||||
| 73592 | 26 | X-ray exam of leg, infant | $17 | |||
| 73592 | TC | X-ray exam of leg, infant | $36 | |||
| 73600 | X-ray exam of ankle | $53 | ||||
| 73600 | 26 | X-ray exam of ankle | $17 | |||
| 73600 | TC | X-ray exam of ankle | $36 | |||
| 73610 | X-ray exam of ankle | $57 | ||||
| 73610 | 26 | X-ray exam of ankle | $19 | |||
| 73610 | TC | X-ray exam of ankle | $39 | |||
| 73615 | Contrast X-ray of ankle | $210 | ||||
| 73615 | 26 | Contrast X-ray of ankle | $59 | |||
| 73615 | TC | Contrast X-ray of ankle | $151 | |||
| 73620 | X-ray exam of foot | $53 | ||||
| 73620 | 26 | X-ray exam of foot | $17 | |||
| 73620 | TC | X-ray exam of foot | $36 | |||
| 73630 | X-ray exam of foot | $57 | ||||
| 73630 | 26 | X-ray exam of foot | $19 | |||
| 73630 | TC | X-ray exam of foot | $39 | |||
| 73650 | X-ray exam of heel | $52 | ||||
| 73650 | 26 | X-ray exam of heel | $17 | |||
| 73650 | TC | X-ray exam of heel | $35 | |||
| 73660 | X-ray exam of toe(s).. | $45 | ||||
| 73660 | 26 | X-ray exam of toe(s).. | $14 | |||
| 73660 | TC | X-ray exam of toe(s).. | $31 | |||
| 73700 | Cat scan of leg | $472 | ||||
| 73700 | 26 | Cat scan of leg | $117 | |||
| 73700 | TC | Cat scan of leg | $356 | |||
| 73701 | Contrast cat scan of leg | $548 | ||||
| 73701 | 26 | Contrast cat scan of leg | $124 | |||
| 73701 | TC | Contrast cat scan of leg | $424 | |||
| 73702 | Contrast cat scans of leg | $663 | ||||
| 73702 | 26 | Contrast cat scans of leg | $130 | |||
| 73702 | TC | Contrast cat scans of leg | $533 | |||
| 73706 | 26 | Ct angio lwr extr w/o&w/dye | $189 | |||
| 73706 | TC | Ct angio lwr extr w/o&w/dye | $656 | |||
| 73706 | Ct angio lwr extr w/o&w/dye | $845 | ||||
| 73718 | 26 | Mri lower extremity w/o dye | $135 | |||
| 73718 | TC | Mri lower extremity w/o dye | $739 | |||
| 73718 | Mri lower extremity w/o dye | $874 | ||||
| 73719 | 26 | Mri lower extremity w/dye | $162 | |||
| 73719 | TC | Mri lower extremity w/dye | $824 | |||
| 73719 | Mri lower extremity w/dye | $986 | ||||
| 73720 | Magnetic image, leg, foot | $963 | ||||
| 73720 | 26 | Magnetic image, leg, foot | $159 | |||
| 73720 | TC | Magnetic image, leg, foot | $804 | |||
| 73721 | Magnetic image, joint of leg | $906 | ||||
| 73721 | 26 | Magnetic image, joint of leg | $102 | |||
| 73721 | TC | Magnetic image, joint of leg | $804 | |||
| 73722 | 26 | Mri joint of lwr extr w/dye | $164 | |||
| 73722 | TC | Mri joint of lwr extr w/dye | $774 | |||
| 73722 | Mri joint of lwr extr w/dye | $937 | ||||
| 73723 | 26 | Mri joint lwr extr w/o&w/dye | $214 | |||
| 73723 | TC | Mri joint lwr extr w/o&w/dye | $919 | |||
| 73723 | Mri joint lwr extr w/o&w/dye | $1,133 | ||||
| 73725 | Magnetic imaging/lower (MRI) | $987 | ||||
| 73725 | 26 | Magnetic imaging/lower (MRI) | $183 | |||
| 73725 | TC | Magnetic imaging/lower (MRI) | $804 | |||
| 74000 | X-ray exam of abdomen | $57 | ||||
| 74000 | 26 | X-ray exam of abdomen | $19 | |||
| 74000 | TC | X-ray exam of abdomen | $38 | |||
| 74010 | X-ray exam of abdomen | $67 | ||||
| 74010 | 26 | X-ray exam of abdomen | $26 | |||
| 74010 | TC | X-ray exam of abdomen | $42 | |||
| 74020 | X-ray exam of abdomen | $75 | ||||
| 74020 | 26 | X-ray exam of abdomen | $30 | |||
| 74020 | TC | X-ray exam of abdomen | $45 | |||
| 74022 | X-ray exam series, abdomen | $88 | ||||
| 74022 | 26 | X-ray exam series, abdomen | $35 | |||
| 74022 | TC | X-ray exam series, abdomen | $54 | |||
| 74150 | Cat scan of abdomen | $533 | ||||
| 74150 | 26 | Cat scan of abdomen | $127 | |||
| 74150 | TC | Cat scan of abdomen | $406 | |||
| 74160 | Contrast cat scan of abdomen | $626 | ||||
| 74160 | 26 | Contrast cat scan of abdomen | $136 | |||
| 74160 | TC | Contrast cat scan of abdomen | $490 | |||
| 74170 | Contrast cat scans, abdomen | $759 | ||||
| 74170 | 26 | Contrast cat scans, abdomen | $151 | |||
| 74170 | TC | Contrast cat scans, abdomen | $609 | |||
| 74174 | 26 | Ct angio abd&pelv w/o&w/dye | $220 | |||
| 74174 | TC | Ct angio abd&pelv w/o&w/dye | $936 | |||
| 74174 | Ct angio abd&pelv w/o&w/dye | $1,156 | ||||
| 74175 | 26 | Ct angio abdom w/o & w/dye | $190 | |||
| 74175 | TC | Ct angio abdom w/o & w/dye | $752 | |||
| 74175 | Ct angio abdom w/o & w/dye | $941 | ||||
| 74176 | 26 | Ct abd & pelvis | $174 | |||
| 74176 | TC | Ct abd & pelvis | $293 | |||
| 74176 | Ct abd & pelvis | $467 | ||||
| 74177 | 26 | Ct abd & pelv w/contrast | $181 | |||
| 74177 | TC | Ct abd & pelv w/contrast | $555 | |||
| 74177 | Ct abd & pelv w/contrast | $736 | ||||
| 74178 | 26 | Ct abd & pelv 1/> regns | $201 | |||
| 74178 | TC | Ct abd & pelv 1/> regns | $733 | |||
| 74178 | Ct abd & pelv 1/> regns | $935 | ||||
| 74181 | Magnetic image, abdomen (MRI) | $976 | ||||
| 74181 | 26 | Magnetic image, abdomen (MRI) | $173 | |||
| 74181 | TC | Magnetic image, abdomen (MRI) | $804 | |||
| 74182 | 26 | Mri abdomen w/dye | $172 | |||
| 74182 | TC | Mri abdomen w/dye | $918 | |||
| 74182 | Mri abdomen w/dye | $1,090 | ||||
| 74183 | 26 | Mri abdomen w/o & w/dye | $224 | |||
| 74183 | TC | Mri abdomen w/o & w/dye | $991 | |||
| 74183 | Mri abdomen w/o & w/dye | $1,215 | ||||
| 74185 | Magnetic image, abdomen (MRI) | $990 | ||||
| 74185 | 26 | Magnetic image, abdomen (MRI) | $187 | |||
| 74185 | TC | Magnetic image, abdomen (MRI) | $804 | |||
| 74190 | X-ray exam of peritoneum | $126 | ||||
| 74190 | 26 | X-ray exam of peritoneum | $33 | |||
| 74190 | TC | X-ray exam of peritoneum | $94 | |||
| 74210 | Contrast X-ray exam of throat | $123 | ||||
| 74210 | 26 | Contrast X-ray exam of throat | $38 | |||
| 74210 | TC | Contrast X-ray exam of throat | $85 | |||
| 74220 | Contrast X-ray exam, esophagus | $135 | ||||
| 74220 | 26 | Contrast X-ray exam, esophagus | $50 | |||
| 74220 | TC | Contrast X-ray exam, esophagus | $85 | |||
| 74230 | Cinema X-ray throat/esophagus | $152 | ||||
| 74230 | 26 | Cinema X-ray throat/esophagus | $59 | |||
| 74230 | TC | Cinema X-ray throat/esophagus | $94 | |||
| 74235 | Remove esophagus obstruction | $316 | ||||
| 74235 | 26 | Remove esophagus obstruction | $127 | |||
| 74235 | TC | Remove esophagus obstruction | $189 | |||
| 74240 | X-ray exam upper gi tract | $180 | ||||
| 74240 | 26 | X-ray exam upper gi tract | $75 | |||
| 74240 | TC | X-ray exam upper gi tract | $105 | |||
| 74241 | X-ray exam upper gi tract | $182 | ||||
| 74241 | 26 | X-ray exam upper gi tract | $75 | |||
| 74241 | TC | X-ray exam upper gi tract | $108 | |||
| 74245 | X-ray exam upper gi tract | $269 | ||||
| 74245 | 26 | X-ray exam upper gi tract | $98 | |||
| 74245 | TC | X-ray exam upper gi tract | $172 | |||
| 74246 | Contrast X-ray upper gi tract | $194 | ||||
| 74246 | 26 | Contrast X-ray upper gi tract | $75 | |||
| 74246 | TC | Contrast X-ray upper gi tract | $119 | |||
| 74247 | Contrast X-ray upper gi tract | $196 | ||||
| 74247 | 26 | Contrast X-ray upper gi tract | $75 | |||
| 74247 | TC | Contrast X-ray upper gi tract | $122 | |||
| 74249 | Contrast X-ray upper gi tract | $283 | ||||
| 74249 | 26 | Contrast X-ray upper gi tract | $98 | |||
| 74249 | TC | Contrast X-ray upper gi tract | $185 | |||
| 74250 | X-ray exam of small bowel | $144 | ||||
| 74250 | 26 | X-ray exam of small bowel | $51 | |||
| 74250 | TC | X-ray exam of small bowel | $94 | |||
| 74251 | X-ray exam of small bowel | $144 | ||||
| 74251 | 26 | X-ray exam of small bowel | $51 | |||
| 74251 | TC | X-ray exam of small bowel | $94 | |||
| 74260 | X-ray exam of small bowel | $161 | ||||
| 74260 | 26 | X-ray exam of small bowel | $54 | |||
| 74260 | TC | X-ray exam of small bowel | $108 | |||
| 74261 | 26 | Ct colonography dx | $239 | |||
| 74261 | TC | Ct colonography dx | $874 | |||
| 74261 | Ct colonography dx | $1,113 | ||||
| 74262 | 26 | Ct colonography dx w/dye | $254 | |||
| 74262 | TC | Ct colonography dx w/dye | $1,045 | |||
| 74262 | Ct colonography dx w/dye | $1,298 | ||||
| 74263 | 26 | Ct colonography screening | $236 | |||
| 74263 | TC | Ct colonography screening | $1,426 | |||
| 74263 | Ct colonography screening | $1,662 | ||||
| 74270 | Contrast X-ray exam of colon | $198 | ||||
| 74270 | 26 | Contrast X-ray exam of colon | $75 | |||
| 74270 | TC | Contrast X-ray exam of colon | $123 | |||
| 74280 | Contrast X-ray exam of colon | $267 | ||||
| 74280 | 26 | Contrast X-ray exam of colon | $107 | |||
| 74280 | TC | Contrast X-ray exam of colon | $161 | |||
| 74283 | Contrast X-ray exam of colon | $402 | ||||
| 74283 | 26 | Contrast X-ray exam of colon | $210 | |||
| 74283 | TC | Contrast X-ray exam of colon | $192 | |||
| 74290 | Contrast X-ray, gallbladder | $88 | ||||
| 74290 | 26 | Contrast X-ray, gallbladder | $35 | |||
| 74290 | TC | Contrast X-ray, gallbladder | $54 | |||
| 74291 | Contrast X-ray, gallbladder | $52 | ||||
| 74291 | 26 | Contrast X-ray, gallbladder | $21 | |||
| 74291 | TC | Contrast X-ray, gallbladder | $31 | |||
| 74300 | X-ray bile ducts, pancreas | $47 | ||||
| 74300 | 26 | X-ray bile ducts, pancreas | $39 | |||
| 74300 | TC | X-ray bile ducts, pancreas | BR | |||
| 74301 | X-rays at surgery add- on | BR | ||||
| 74301 | 26 | X-rays at surgery add- on | $22 | |||
| 74301 | TC | X-rays at surgery add- on | BR | |||
| 74305 | X-ray bile ducts, pancreas | $102 | ||||
| 74305 | 26 | X-ray bile ducts, pancreas | $45 | |||
| 74305 | TC | X-ray bile ducts, pancreas | $57 | |||
| 74320 | Contrast X-ray of bile ducts | $285 | ||||
| 74320 | 26 | Contrast X-ray of bile ducts | $59 | |||
| 74320 | TC | Contrast x-ray of bile ducts | $226 | |||
| 74327 | X-ray for bile stone removal | $203 | ||||
| 74327 | 26 | X-ray for bile stone removal | $76 | |||
| 74327 | TC | X-ray for bile stone removal | $127 | |||
| 74328 | Xray for bile duct endoscopy | $301 | ||||
| 74328 | 26 | Xray for bile duct endoscopy | $76 | |||
| 74328 | TC | Xray for bile duct endoscopy | $226 | |||
| 74329 | X-ray for pancreas endoscopy | $301 | ||||
| 74329 | 26 | X-ray for pancreas endoscopy | $76 | |||
| 74329 | TC | X-ray for pancreas endoscopy | $226 | |||
| 74330 | Xray,bile/pancreas endoscopy | $301 | ||||
| 74330 | 26 | Xray,bile/pancreas endoscopy | $76 | |||
| 74330 | TC | Xray,bile/pancreas endoscopy | $226 | |||
| 74340 | X-ray guide for gi tube | $248 | ||||
| 74340 | 26 | X-ray guide for gi tube | $59 | |||
| 74340 | TC | X-ray guide for gi tube | $189 | |||
| 74355 | X-ray guide, intestinal tube | $271 | ||||
| 74355 | 26 | X-ray guide, intestinal tube | $82 | |||
| 74355 | TC | X-ray guide, intestinal tube | $189 | |||
| 74360 | X-ray guide, gi dilation | $285 | ||||
| 74360 | 26 | X-ray guide, gi dilation | $59 | |||
| 74360 | TC | X-ray guide, gi dilation | $226 | |||
| 74363 | X-ray, bile duct dilation | $532 | ||||
| 74363 | 26 | X-ray, bile duct dilation | $95 | |||
| 74363 | TC | X-ray, bile duct dilation | $437 | |||
| 74400 | Contrast X-ray urinary tract | $174 | ||||
| 74400 | 26 | Contrast X-ray urinary tract | $53 | |||
| 74400 | TC | Contrast X-ray urinary tract | $122 | |||
| 74410 | Contrast X-ray urinary tract | $193 | ||||
| 74410 | 26 | Contrast X-ray urinary tract | $53 | |||
| 74410 | TC | Contrast X-ray urinary tract | $140 | |||
| 74415 | Contrast X-ray urinary tract | $205 | ||||
| 74415 | 26 | Contrast X-ray urinary tract | $53 | |||
| 74415 | TC | Contrast X-ray urinary tract | $152 | |||
| 74420 | Contrast X-ray urinary tract | $227 | ||||
| 74420 | 26 | Contrast X-ray urinary tract | $38 | |||
| 74420 | TC | Contrast X-ray urinary tract | $189 | |||
| 74425 | Contrast X-ray urinary tract | $131 | ||||
| 74425 | 26 | Contrast X-ray urinary tract | $38 | |||
| 74425 | TC | Contrast X-ray urinary tract | $94 | |||
| 74430 | Contrast X-ray of bladder | $110 | ||||
| 74430 | 26 | Contrast X-ray of bladder | $35 | |||
| 74430 | TC | Contrast X-ray of bladder | $76 | |||
| 74440 | X-ray exam male genital tract | $122 | ||||
| 74440 | 26 | X-ray exam male genital tract | $41 | |||
| 74440 | TC | X-ray exam male genital tract | $82 | |||
| 74445 | X-ray exam of penis | $203 | ||||
| 74445 | 26 | X-ray exam of penis | $122 | |||
| 74445 | TC | X-ray exam of penis | $82 | |||
| 74450 | X-ray exam urethra/bladder | $140 | ||||
| 74450 | 26 | X-ray exam urethra/bladder | $35 | |||
| 74450 | TC | X-ray exam urethra/bladder | $105 | |||
| 74455 | X-ray exam urethra/bladder | $149 | ||||
| 74455 | 26 | X-ray exam urethra/bladder | $35 | |||
| 74455 | TC | X-ray exam urethra/bladder | $114 | |||
| 74470 | X-ray exam of kidney lesion | $149 | ||||
| 74470 | 26 | X-ray exam of kidney lesion | $59 | |||
| 74470 | TC | X-ray exam of kidney lesion | $90 | |||
| 74475 | X-ray control catheter insert | $351 | ||||
| 74475 | 26 | X-ray control catheter insert | $59 | |||
| 74475 | TC | X-ray control catheter insert | $292 | |||
| 74480 | X-ray control catheter insert | $351 | ||||
| 74480 | 26 | X-ray control catheter insert | $59 | |||
| 74480 | TC | X-ray control catheter insert | $292 | |||
| 74485 | X-ray guide, gu dilation | $285 | ||||
| 74485 | 26 | X-ray guide, gu dilation | $59 | |||
| 74485 | TC | X-ray guide, gu dilation | $226 | |||
| 74710 | X-ray measurement of | $112 | ||||
| 74710 | 26 | X-ray measurement of | $37 | |||
| 74710 | TC | X-ray measurement of | $76 | |||
| 74740 | X-ray female genital tract | $134 | ||||
| 74740 | 26 | X-ray female genital tract | $41 | |||
| 74740 | TC | X-ray female genital tract | $94 | |||
| 74742 | X-ray fallopian tube | $290 | ||||
| 74742 | 26 | X-ray fallopian tube | $64 | |||
| 74742 | TC | X-ray fallopian tube | $226 | |||
| 74775 | X-ray exam of perineum | $173 | ||||
| 74775 | 26 | X-ray exam of perineum | $68 | |||
| 74775 | TC | X-ray exam of perineum | $105 | |||
| 75557 | 26 | Cardiac mri for morph | $234 | |||
| 75557 | TC | Cardiac mri for morph | $534 | |||
| 75557 | Cardiac mri for morph | $768 | ||||
| 75559 | 26 | Cardiac mri w/stress img | $291 | |||
| 75559 | TC | Cardiac mri w/stress img | $770 | |||
| 75559 | Cardiac mri w/stress img | $1,062 | ||||
| 75561 | 26 | Cardiac mri for morph w/dye | $258 | |||
| 75561 | TC | Cardiac mri for morph w/dye | $768 | |||
| 75561 | Cardiac mri for morph w/dye | $1,026 | ||||
| 75563 | 26 | Card mri w/stress img & dye | $298 | |||
| 75563 | TC | Card mri w/stress img & dye | $916 | |||
| 75563 | Card mri w/stress img & dye | $1,214 | ||||
| 75565 | 26 | Card mri veloc flow mapping | $25 | |||
| 75565 | TC | Card mri veloc flow mapping | $111 | |||
| 75565 | Card mri veloc flow mapping | $136 | ||||
| 75571 | 26 | Ct hrt w/o dye w/ca test | $57 | |||
| 75571 | TC | Ct hrt w/o dye w/ca test | $179 | |||
| 75571 | Ct hrt w/o dye w/ca test | $235 | ||||
| 75572 | 26 | Ct hrt w/3d image | $172 | |||
| 75572 | TC | Ct hrt w/3d image | $473 | |||
| 75572 | Ct hrt w/3d image | $645 | ||||
| 75573 | 26 | Ct hrt w/3d image congen | $252 | |||
| 75573 | TC | Ct hrt w/3d image congen | $634 | |||
| 75573 | Ct hrt w/3d image congen | $886 | ||||
| 75574 | 26 | Ct angio hrt w/3d image | $237 | |||
| 75574 | TC | Ct angio hrt w/3d image | $719 | |||
| 75574 | Ct angio hrt w/3d image | $956 | ||||
| 75600 | Contrast X-ray exam of | $956 | ||||
| 75600 | 26 | Contrast X-ray exam of | $53 | |||
| 75600 | TC | Contrast X-ray exam of | $903 | |||
| 75605 | Contrast X-ray exam of | $1,025 | ||||
| 75605 | 26 | Contrast X-ray exam of | $122 | |||
| 75605 | TC | Contrast X-ray exam of | $903 | |||
| 75625 | Contrast X-ray exam of | $1,025 | ||||
| 75625 | 26 | Contrast X-ray exam of | $122 | |||
| 75625 | TC | Contrast X-ray exam of | $903 | |||
| 75630 | X-ray aorta, leg arteries | $1,082 | ||||
| 75630 | 26 | X-ray aorta, leg arteries | $140 | |||
| 75630 | TC | X-ray aorta, leg arteries | $942 | |||
| 75635 | 26 | Ct angio abdominal arteries | $238 | |||
| 75635 | TC | Ct angio abdominal arteries | $689 | |||
| 75635 | Ct angio abdominal arteries | $927 | ||||
| 75650 | Artery X-rays, head & neck | $1,063 | ||||
| 75650 | 26 | Artery X-rays, head & neck | $160 | |||
| 75650 | TC | Artery X-rays, head & neck | $903 | |||
| 75658 | X-ray exam of arm arteries | $1,043 | ||||
| 75658 | 26 | X-ray exam of arm arteries | $140 | |||
| 75658 | TC | X-ray exam of arm arteries | $903 | |||
| 75660 | Artery X-rays, head & neck | $1,043 | ||||
| 75660 | 26 | Artery X-rays, head & neck | $140 | |||
| 75660 | TC | Artery X-rays, head & neck | $903 | |||
| 75662 | Artery X-rays, head & neck | $1,081 | ||||
| 75662 | 26 | Artery X-rays, head & neck | $178 | |||
| 75662 | TC | Artery X-rays, head & neck | $903 | |||
| 75665 | Artery X-rays, head & neck | $1,043 | ||||
| 75665 | 26 | Artery X-rays, head & neck | $140 | |||
| 75665 | TC | Artery X-rays, head & neck | $903 | |||
| 75671 | Artery X-rays, head & neck | $1,081 | ||||
| 75671 | 26 | Artery X-rays, head & neck | $178 | |||
| 75671 | TC | Artery X-rays, head & neck | $903 | |||
| 75676 | Artery X-rays, neck | $1,043 | ||||
| 75676 | 26 | Artery X-rays, neck | $140 | |||
| 75676 | TC | Artery X-rays, neck | $903 | |||
| 75680 | Artery X-rays, neck | $1,081 | ||||
| 75680 | 26 | Artery X-rays, neck | $178 | |||
| 75680 | TC | Artery X-rays, neck | $903 | |||
| 75685 | Artery X-rays, spine | $1,043 | ||||
| 75685 | 26 | Artery X-rays, spine | $140 | |||
| 75685 | TC | Artery X-rays, spine | $903 | |||
| 75705 | Artery X-rays, spine | $1,137 | ||||
| 75705 | 26 | Artery X-rays, spine | $234 | |||
| 75705 | TC | Artery X-rays, spine | $903 | |||
| 75710 | Artery X-rays, arm/leg | $1,025 | ||||
| 75710 | 26 | Artery X-rays, arm/leg | $122 | |||
| 75710 | TC | Artery X-rays, arm/leg | $903 | |||
| 75716 | Artery X-rays, arms/legs | $1,043 | ||||
| 75716 | 26 | Artery X-rays, arms/legs | $140 | |||
| 75716 | TC | Artery X-rays, arms/legs | $903 | |||
| 75726 | Artery X-rays, abdomen | $1,025 | ||||
| 75726 | 26 | Artery X-rays, abdomen | $122 | |||
| 75726 | TC | Artery X-rays, abdomen | $903 | |||
| 75731 | Artery X-rays, adrenal | $1,025 | ||||
| 75731 | 26 | Artery X-rays, adrenal | $122 | |||
| 75731 | TC | Artery X-rays, adrenal | $903 | |||
| 75733 | Artery X-rays,adrenal | $1,043 | ||||
| 75733 | 26 | Artery X-rays,adrenal | $140 | |||
| 75733 | TC | Artery X-rays,adrenal | $903 | |||
| 75736 | Artery X-rays, pelvis | $1,025 | ||||
| 75736 | 26 | Artery X-rays, pelvis | $122 | |||
| 75736 | TC | Artery X-rays, pelvis | $903 | |||
| 75741 | Artery X-rays, lung | $1,043 | ||||
| 75741 | 26 | Artery X-rays, lung | $140 | |||
| 75741 | TC | Artery X-rays, lung | $903 | |||
| 75743 | Artery X-rays, lungs | $1,081 | ||||
| 75743 | 26 | Artery X-rays, lungs | $178 | |||
| 75743 | TC | Artery X-rays, lungs | $903 | |||
| 75746 | Artery X-rays, lung | $1,025 | ||||
| 75746 | 26 | Artery X-rays, lung | $122 | |||
| 75746 | TC | Artery X-rays, lung | $903 | |||
| 75756 | Artery X-rays, chest | $1,025 | ||||
| 75756 | 26 | Artery X-rays, chest | $122 | |||
| 75756 | TC | Artery X-rays, chest | $903 | |||
| 75774 | Artery X-ray, each vessel | $977 | ||||
| 75774 | 26 | Artery X-ray, each vessel | $37 | |||
| 75774 | TC | Artery X-ray, each vessel | $940 | |||
| 75791 | 26 | Av dialysis shunt imaging | $168 | |||
| 75791 | TC | Av dialysis shunt imaging | $532 | |||
| 75791 | Av dialysis shunt imaging | $700 | ||||
| 75801 | Lymph vessel X-ray, arm/leg | $476 | ||||
| 75801 | 26 | Lymph vessel X-ray, arm/leg | $87 | |||
| 75801 | TC | Lymph vessel X-ray, arm/leg | $389 | |||
| 75803 | Lymph vessel X-ray, arm/leg | $514 | ||||
| 75803 | 26 | Lymph vessel X-ray, arm/leg | $125 | |||
| 75803 | TC | Lymph vessel X-ray, arm/leg | $389 | |||
| 75805 | Lymph vessel X-ray, trunk | $524 | ||||
| 75805 | 26 | Lymph vessel X-ray, trunk | $87 | |||
| 75805 | TC | Lymph vessel X-ray, trunk | $437 | |||
| 75807 | Lymph vessel X-ray, trunk | $562 | ||||
| 75807 | 26 | Lymph vessel X-ray, trunk | $125 | |||
| 75807 | TC | Lymph vessel X-ray, trunk | $437 | |||
| 75809 | Nonvascular shunt, X-ray | $106 | ||||
| 75809 | 26 | Nonvascular shunt, X-ray | $49 | |||
| 75809 | TC | Nonvascular shunt, X-ray | $57 | |||
| 75810 | Vein X-ray, spleen/liver | $1,025 | ||||
| 75810 | 26 | Vein X-ray, spleen/liver | $122 | |||
| 75810 | TC | Vein X-ray, spleen/liver | $903 | |||
| 75820 | Vein X-ray, arm/leg | $144 | ||||
| 75820 | 26 | Vein X-ray, arm/leg | $76 | |||
| 75820 | TC | Vein X-ray, arm/leg | $68 | |||
| 75822 | Vein X-ray, arms/legs | $220 | ||||
| 75822 | 26 | Vein X-ray, arms/legs | $114 | |||
| 75822 | TC | Vein X-ray, arms/legs | $107 | |||
| 75825 | Vein X-ray, trunk | $1,025 | ||||
| 75825 | 26 | Vein X-ray, trunk | $122 | |||
| 75825 | TC | Vein X-ray, trunk | $903 | |||
| 75827 | Vein X-ray, chest | $1,025 | ||||
| 75827 | 26 | Vein X-ray, chest | $122 | |||
| 75827 | TC | Vein X-ray, chest | $903 | |||
| 75831 | Vein X-ray, kidney | $1,025 | ||||
| 75831 | 26 | Vein X-ray, kidney | $122 | |||
| 75831 | TC | Vein X-ray, kidney | $903 | |||
| 75833 | Vein X-ray, kidneys | $1,063 | ||||
| 75833 | 26 | Vein X-ray, kidneys | $160 | |||
| 75833 | TC | Vein X-ray, kidneys | $903 | |||
| 75840 | Vein X-ray, adrenal gland | $1,025 | ||||
| 75840 | 26 | Vein X-ray, adrenal gland | $122 | |||
| 75840 | TC | Vein X-ray, adrenal gland | $903 | |||
| 75842 | Vein X-ray, adrenal glands | $1,063 | ||||
| 75842 | 26 | Vein X-ray, adrenal glands | $160 | |||
| 75842 | TC | Vein X-ray, adrenal glands | $903 | |||
| 75860 | Vein X-ray, neck | $1,025 | ||||
| 75860 | 26 | Vein X-ray, neck | $122 | |||
| 75860 | TC | Vein X-ray, neck | $903 | |||
| 75870 | Vein X-ray, skull | $1,025 | ||||
| 75870 | 26 | Vein X-ray, skull | $122 | |||
| 75870 | TC | Vein X-ray, skull | $903 | |||
| 75872 | Vein X-ray, skull | $1,025 | ||||
| 75872 | 26 | Vein X-ray, skull | $122 | |||
| 75872 | TC | Vein X-ray, skull | $903 | |||
| 75880 | Vein X-ray, eye socket | $144 | ||||
| 75880 | 26 | Vein X-ray, eye socket | $76 | |||
| 75880 | TC | Vein X-ray, eye socket | $68 | |||
| 75885 | Vein X-ray, liver | $1,058 | ||||
| 75885 | 26 | Vein X-ray, liver | $155 | |||
| 75885 | TC | Vein X-ray, liver | $903 | |||
| 75887 | Vein X-ray, liver | $1,058 | ||||
| 75887 | 26 | Vein X-ray, liver | $155 | |||
| 75887 | TC | Vein X-ray, liver | $903 | |||
| 75889 | Vein X-ray, liver | $1,025 | ||||
| 75889 | 26 | Vein X-ray, liver | $122 | |||
| 75889 | TC | Vein X-ray, liver | $903 | |||
| 75891 | Vein X-ray, liver | $1,025 | ||||
| 75891 | 26 | Vein X-ray, liver | $122 | |||
| 75891 | TC | Vein X-ray, liver | $903 | |||
| 75893 | Venous sampling by catheter | $962 | ||||
| 75893 | 26 | Venous sampling by catheter | $59 | |||
| 75893 | TC | Venous sampling by catheter | $903 | |||
| 75894 | X-rays, transcatheter therapy | $1,871 | ||||
| 75894 | 26 | X-rays, transcatheter therapy | $140 | |||
| 75894 | TC | X-rays, transcatheter therapy | $1,731 | |||
| 75896 | X-rays, transcatheter therapy | $1,644 | ||||
| 75896 | 26 | X-rays, transcatheter therapy | $140 | |||
| 75896 | TC | X-rays, transcatheter therapy | $1,504 | |||
| 75898 | Follow-up angiogram | $253 | ||||
| 75898 | 26 | Follow-up angiogram | $178 | |||
| 75898 | TC | Follow-up angiogram | $76 | |||
| 75900 | Arterial catheter exchange | $1,540 | ||||
| 75900 | 26 | Arterial catheter exchange | $53 | |||
| 75900 | TC | Arterial catheter exchange | $1,488 | |||
| 75901 | 26 | Remove cva device obstruct | $49 | |||
| 75901 | TC | Remove cva device obstruct | $321 | |||
| 75901 | Remove cva device obstruct | $370 | ||||
| 75902 | 26 | Remove cva lumen obstruct | $40 | |||
| 75902 | TC | Remove cva lumen obstruct | $121 | |||
| 75902 | Remove cva lumen obstruct | $160 | ||||
| 75945 | Intravascular us...... | $385 | ||||
| 75945 | 26 | Intravascular us...... | $45 | |||
| 75945 | TC | Intravascular us...... | $341 | |||
| 75946 | Intravascular us add- on | $216 | ||||
| 75946 | 26 | Intravascular us add- on | $45 | |||
| 75946 | TC | Intravascular us add- on | $171 | |||
| 75952 | Endovasc repair abdom aorta | $474 | ||||
| 75953 | Abdom aneurysm endovas rpr | $144 | ||||
| 75954 | Iliac aneurysm endovas rpr | $236 | ||||
| 75956 | Xray endovasc thor ao repr | $741 | ||||
| 75957 | Xray endovasc thor ao repr | $635 | ||||
| 75958 | Xray place prox ext thor ao | $424 | ||||
| 75959 | Xray place dist ext thor ao | $368 | ||||
| 75960 | Transcatheter intro, stent | $1,156 | ||||
| 75960 | 26 | Transcatheter intro, stent | $89 | |||
| 75960 | TC | Transcatheter intro, stent | $1,068 | |||
| 75961 | Retrieval, broken catheter | $1,208 | ||||
| 75961 | 26 | Retrieval, broken catheter | $455 | |||
| 75961 | TC | Retrieval, broken catheter | $753 | |||
| 75962 | Repair arterial blockage | $1,188 | ||||
| 75962 | 26 | Repair arterial blockage | $59 | |||
| 75962 | TC | Repair arterial blockage | $1,129 | |||
| 75964 | Repair artery blockage, each | $664 | ||||
| 75964 | 26 | Repair artery blockage, each | $38 | |||
| 75964 | TC | Repair artery blockage, each | $626 | |||
| 75966 | Repair artery blockage, each | $1,269 | ||||
| 75966 | 26 | Repair artery blockage, each | $140 | |||
| 75966 | TC | Repair artery blockage, each | $1,129 | |||
| 75968 | Repair artery blockage, each | $664 | ||||
| 75968 | 26 | Repair artery blockage, each | $38 | |||
| 75968 | TC | Repair artery blockage, each | $626 | |||
| 75970 | Vascular biopsy | $917 | ||||
| 75970 | 26 | Vascular biopsy | $90 | |||
| 75970 | TC | Vascular biopsy | $828 | |||
| 75978 | Repair venous blockage | $1,204 | ||||
| 75978 | 26 | Repair venous blockage | $76 | |||
| 75978 | TC | Repair venous blockage | $1,129 | |||
| 75980 | Contrast X-ray exam bile duct | $544 | ||||
| 75980 | 26 | Contrast X-ray exam bile duct | $155 | |||
| 75980 | TC | Contrast X-ray exam bile duct | $389 | |||
| 75982 | Contrast X-ray exam bile duct | $592 | ||||
| 75982 | 26 | Contrast X-ray exam bile duct | $155 | |||
| 75982 | TC | Contrast X-ray exam bile duct | $437 | |||
| 75984 | X-ray control catheter change | $218 | ||||
| 75984 | 26 | X-ray control catheter change | $78 | |||
| 75984 | TC | X-ray control catheter change | $140 | |||
| 75989 | Abscess drainage under X-ray | $358 | ||||
| 75989 | 26 | Abscess drainage under X-ray | $122 | |||
| 75989 | TC | Abscess drainage under X-ray | $235 | |||
| 76000 | Fluoroscope examination | $115 | ||||
| 76000 | 26 | Fluoroscope examination | $18 | |||
| 76000 | TC | Fluoroscope examination | $97 | |||
| 76001 | Fluoroscope exam, extensive | $262 | ||||
| 76001 | 26 | Fluoroscope exam, extensive | $73 | |||
| 76001 | TC | Fluoroscope exam, extensive | $189 | |||
| 76010 | X-ray, nose to rectum | $57 | ||||
| 76010 | 26 | X-ray, nose to rectum | $19 | |||
| 76010 | TC | X-ray, nose to rectum | $38 | |||
| 76080 | X-ray exam of fistula | $135 | ||||
| 76080 | 26 | X-ray exam of fistula | $57 | |||
| 76080 | TC | X-ray exam of fistula | $79 | |||
| 76098 | X-ray exam, breast specimen | $47 | ||||
| 76098 | 26 | X-ray exam, breast specimen | $17 | |||
| 76098 | TC | X-ray exam, breast specimen | $31 | |||
| 76100 | X-ray exam of body section | $153 | ||||
| 76100 | 26 | X-ray exam of body section | $63 | |||
| 76100 | TC | X-ray exam of body section | $90 | |||
| 76101 | Complex body section X-ray | $165 | ||||
| 76101 | 26 | Complex body section X-ray | $63 | |||
| 76101 | TC | Complex body section X-ray | $102 | |||
| 76102 | Complex body section X-ray | $188 | ||||
| 76102 | 26 | Complex body section X-ray | $63 | |||
| 76102 | TC | Complex body section X-ray | $125 | |||
| 76120 | Cinematic X-rays | $117 | ||||
| 76120 | 26 | Cinematic X-rays | $41 | |||
| 76120 | TC | Cinematic X-rays | $76 | |||
| 76125 | Cinematic X-rays add- on | $87 | ||||
| 76125 | 26 | Cinematic X-rays add- on | $29 | |||
| 76125 | TC | Cinematic X-rays add- on | $59 | |||
| 76140 | X-ray consultation | BR | ||||
| 76376 | 26 | 3d render w/o postprocess | $20 | |||
| 76376 | TC | 3d render w/o postprocess | $103 | |||
| 76376 | 3d render w/o postprocess | $122 | ||||
| 76377 | 26 | 3d rendering w/postprocess | $79 | |||
| 76377 | TC | 3d rendering w/postprocess | $85 | |||
| 76377 | 3d rendering w/postprocess | $164 | ||||
| 76380 | Cat scan follow-up study | $357 | ||||
| 76380 | 26 | Cat scan follow-up study | $105 | |||
| 76380 | TC | Cat scan follow-up study | $252 | |||
| 76390 | Mr spectroscopy....... | $986 | ||||
| 76390 | 26 | Mr spectroscopy....... | $150 | |||
| 76390 | TC | Mr spectroscopy....... | $836 | |||
| 76499 | Radiographic procedure | BR | ||||
| 76499 | 26 | Radiographic procedure | BR | |||
| 76499 | TC | Radiographic procedure | BR | |||
| 76506 | Echo exam of head | $170 | ||||
| 76506 | 26 | Echo exam of head | $68 | |||
| 76506 | TC | Echo exam of head | $102 | |||
| 76510 | 26 | Ophth us b & quant a | $197 | |||
| 76510 | TC | Ophth us b & quant a | $164 | |||
| 76510 | Ophth us b & quant a | $361 | ||||
| 76511 | Echo exam of eye | $177 | ||||
| 76511 | 26 | Echo exam of eye | $87 | |||
| 76511 | TC | Echo exam of eye | $90 | |||
| 76512 | Echo exam of eye | $182 | ||||
| 76512 | 26 | Echo exam of eye | $72 | |||
| 76512 | TC | Echo exam of eye | $110 | |||
| 76513 | Echo exam of eye, water bath | $186 | ||||
| 76513 | 26 | Echo exam of eye, water bath | $72 | |||
| 76513 | TC | Echo exam of eye, water bath | $114 | |||
| 76514 | 26 | Echo exam of eye thickness | $20 | |||
| 76514 | TC | Echo exam of eye thickness | $11 | |||
| 76514 | Echo exam of eye thickness | $31 | ||||
| 76516 | Echo exam of eye | $149 | ||||
| 76516 | 26 | Echo exam of eye | $59 | |||
| 76516 | TC | Echo exam of eye | $90 | |||
| 76519 | Echo exam of eye | $149 | ||||
| 76519 | 26 | Echo exam of eye | $59 | |||
| 76519 | TC | Echo exam of eye | $90 | |||
| 76529 | Echo exam of eye | $160 | ||||
| 76529 | 26 | Echo exam of eye | $62 | |||
| 76529 | TC | Echo exam of eye | $98 | |||
| 76536 | Echo exam of head and neck | $163 | ||||
| 76536 | 26 | Echo exam of head and neck | $61 | |||
| 76536 | TC | Echo exam of head and neck | $102 | |||
| 76604 | Echo exam of chest | $154 | ||||
| 76604 | 26 | Echo exam of chest | $61 | |||
| 76604 | TC | Echo exam of chest | $94 | |||
| 76645 | Echo exam of breast | $135 | ||||
| 76645 | 26 | Echo exam of breast | $59 | |||
| 76645 | TC | Echo exam of breast | $76 | |||
| 76700 | Echo exam of abdomen | $229 | ||||
| 76700 | 26 | Echo exam of abdomen | $87 | |||
| 76700 | TC | Echo exam of abdomen | $142 | |||
| 76705 | Echo exam of abdomen | $166 | ||||
| 76705 | 26 | Echo exam of abdomen | $64 | |||
| 76705 | TC | Echo exam of abdomen | $102 | |||
| 76770 | Echo exam abdomen back wall | $222 | ||||
| 76770 | 26 | Echo exam abdomen back wall | $80 | |||
| 76770 | TC | Echo exam abdomen back wall | $142 | |||
| 76775 | Echo exam abdomen back wall | $165 | ||||
| 76775 | 26 | Echo exam abdomen back wall | $63 | |||
| 76775 | TC | Echo exam abdomen back wall | $102 | |||
| 76776 | 26 | Us exam k transpl w/doppler | $76 | |||
| 76776 | TC | Us exam k transpl w/doppler | $245 | |||
| 76776 | Us exam k transpl w/doppler | $321 | ||||
| 76778 | TC | $142 | ||||
| 76800 | Echo exam spinal canal | $223 | ||||
| 76800 | 26 | Echo exam spinal canal | $122 | |||
| 76800 | TC | Echo exam spinal canal | $102 | |||
| 76801 | 26 | Ob us < 14 wks single fetus | $99 | |||
| 76801 | TC | Ob us < 14 wks single fetus | $167 | |||
| 76801 | Ob us < 14 wks single fetus | $266 | ||||
| 76802 | 26 | Ob us < 14 wks addl fetus | $84 | |||
| 76802 | TC | Ob us < 14 wks addl fetus | $56 | |||
| 76802 | Ob us < 14 wks addl fetus | $140 | ||||
| 76805 | Echo exam of pregnant uterus | $257 | ||||
| 76805 | 26 | Echo exam of pregnant uterus | $107 | |||
| 76805 | TC | Echo exam of pregnant uterus | $151 | |||
| 76810 | Echo exam of pregnant uterus | $511 | ||||
| 76810 | 26 | Echo exam of pregnant uterus | $211 | |||
| 76810 | TC | Echo exam of pregnant uterus | $301 | |||
| 76811 | 26 | Ob us detailed sngl fetus | $196 | |||
| 76811 | TC | Ob us detailed sngl fetus | $194 | |||
| 76811 | Ob us detailed sngl fetus | $390 | ||||
| 76812 | 26 | Ob us detailed addl fetus | $184 | |||
| 76812 | TC | Ob us detailed addl fetus | $262 | |||
| 76812 | Ob us detailed addl fetus | $446 | ||||
| 76813 | 26 | Ob us nuchal meas 1 gest | $123 | |||
| 76813 | TC | Ob us nuchal meas 1 gest | $138 | |||
| 76813 | Ob us nuchal meas 1 gest | $261 | ||||
| 76814 | 26 | Ob us nuchal meas add-on | $103 | |||
| 76814 | TC | Ob us nuchal meas add-on | $67 | |||
| 76814 | Ob us nuchal meas add-on | $170 | ||||
| 76815 | Echo exam of pregnant uterus | $175 | ||||
| 76815 | 26 | Echo exam of pregnant uterus | $69 | |||
| 76815 | TC | Echo exam of pregnant uterus | $106 | |||
| 76816 | Echo exam followup or repeat | $142 | ||||
| 76816 | 26 | Echo exam followup or repeat | $62 | |||
| 76816 | TC | Echo exam followup or repeat | $80 | |||
| 76817 | 26 | Transvaginal us obstetric | $77 | |||
| 76817 | TC | Transvaginal us obstetric | $138 | |||
| 76817 | Transvaginal us obstetric | $215 | ||||
| 76818 | Fetal biophysical profile | $199 | ||||
| 76818 | 26 | Fetal biophysical profile | $83 | |||
| 76818 | TC | Fetal biophysical profile | $117 | |||
| 76819 | 26 | Fetal biophys profil w/o nst | $79 | |||
| 76819 | TC | Fetal biophys profil w/o nst | $108 | |||
| 76819 | Fetal biophys profil w/o nst | $187 | ||||
| 76820 | 26 | Umbilical artery echo | $52 | |||
| 76820 | TC | Umbilical artery echo | $33 | |||
| 76820 | Umbilical artery echo | $85 | ||||
| 76821 | 26 | Middle cerebral artery echo | $74 | |||
| 76821 | TC | Middle cerebral artery echo | $129 | |||
| 76821 | Middle cerebral artery echo | $203 | ||||
| 76825 | Echo exam of fetal heart | $239 | ||||
| 76825 | 26 | Echo exam of fetal heart | $98 | |||
| 76825 | TC | Echo exam of fetal heart | $142 | |||
| 76826 | Echo exam of fetal heart | $162 | ||||
| 76826 | 26 | Echo exam of fetal heart | $111 | |||
| 76826 | TC | Echo exam of fetal heart | $52 | |||
| 76827 | Echo exam of fetal heart | $220 | ||||
| 76827 | 26 | Echo exam of fetal heart | $94 | |||
| 76827 | TC | Echo exam of fetal heart | $126 | |||
| 76828 | Echo exam of fetal heart | $143 | ||||
| 76828 | 26 | Echo exam of fetal heart | $61 | |||
| 76828 | TC | Echo exam of fetal heart | $82 | |||
| 76830 | Echo exam, transvaginal | $185 | ||||
| 76830 | 26 | Echo exam, transvaginal | $75 | |||
| 76830 | TC | Echo exam, transvaginal | $110 | |||
| 76831 | Echo exam, uterus..... | $189 | ||||
| 76831 | 26 | Echo exam, uterus..... | $75 | |||
| 76831 | TC | Echo exam, uterus..... | $114 | |||
| 76856 | Echo exam of pelvis | $185 | ||||
| 76856 | 26 | Echo exam of pelvis | $75 | |||
| 76856 | TC | Echo exam of pelvis | $110 | |||
| 76857 | Echo exam of pelvis | $117 | ||||
| 76857 | 26 | Echo exam of pelvis | $41 | |||
| 76857 | TC | Echo exam of pelvis | $76 | |||
| 76870 | Echo exam of scrotum | $179 | ||||
| 76870 | 26 | Echo exam of scrotum | $69 | |||
| 76870 | TC | Echo exam of scrotum | $110 | |||
| 76872 | Echo exam, transrectal | $187 | ||||
| 76872 | 26 | Echo exam, transrectal | $73 | |||
| 76872 | TC | Echo exam, transrectal | $114 | |||
| 76873 | Echograp trans r, pros study | 358 | ||||
| 76873 | 26 | Echograp trans r, pros study | $157 | |||
| 76873 | TC | Echograp trans r, pros study | $200 | |||
| 76881 | 26 | Us xtr non-vasc complete | $63 | |||
| 76881 | TC | Us xtr non-vasc complete | $190 | |||
| 76881 | Us xtr non-vasc complete | $254 | ||||
| 76882 | 26 | Us xtr non-vasc lmtd | $50 | |||
| 76882 | TC | Us xtr non-vasc lmtd | $22 | |||
| 76882 | Us xtr non-vasc lmtd | $72 | ||||
| 76885 | Echo exam, infant hips | $190 | ||||
| 76885 | 26 | Echo exam, infant hips | $76 | |||
| 76885 | TC | Echo exam, infant hips | $114 | |||
| 76886 | Echo exam, infant hips | $170 | ||||
| 76886 | 26 | Echo exam, infant hips | $64 | |||
| 76886 | TC | Echo exam, infant hips | $106 | |||
| 76930 | Echo guide for heart sac tap | $183 | ||||
| 76930 | 26 | Echo guide for heart sac tap | $73 | |||
| 76930 | TC | Echo guide for heart sac tap | $110 | |||
| 76932 | Echo guide for heart biopsy | $183 | ||||
| 76932 | 26 | Echo guide for heart biopsy | $73 | |||
| 76932 | TC | Echo guide for heart biopsy | $110 | |||
| 76936 | Echo guide for artery repair | $600 | ||||
| 76936 | 26 | Echo guide for artery repair | $153 | |||
| 76936 | TC | Echo guide for artery repair | $447 | |||
| 76937 | 26 | Us guide vascular access | $30 | |||
| 76937 | TC | Us guide vascular access | $42 | |||
| 76937 | Us guide vascular access | $72 | ||||
| 76940 | Us guide tissue ablation | $213 | ||||
| 76941 | Echo guide for transfusion | $252 | ||||
| 76941 | 26 | Echo guide for transfusion | $144 | |||
| 76941 | TC | Echo guide for transfusion | $109 | |||
| 76942 | Echo guide for biopsy | $183 | ||||
| 76942 | 26 | Echo guide for biopsy | $73 | |||
| 76942 | TC | Echo guide for biopsy | $110 | |||
| 76945 | Echo guide, villus sampling | $205 | ||||
| 76945 | 26 | Echo guide, villus sampling | $97 | |||
| 76945 | TC | Echo guide, villus sampling | $109 | |||
| 76946 | Echo guide for amniocentesis | $151 | ||||
| 76946 | 26 | Echo guide for amniocentesis | $41 | |||
| 76946 | TC | Echo guide for amniocentesis | $110 | |||
| 76948 | Echo guide, ova aspiration | $151 | ||||
| 76948 | 26 | Echo guide, ova aspiration | $41 | |||
| 76948 | TC | Echo guide, ova aspiration | $110 | |||
| 76950 | Echo guidance radiotherapy | $157 | ||||
| 76950 | 26 | Echo guidance radiotherapy | $63 | |||
| 76950 | TC | Echo guidance radiotherapy | $94 | |||
| 76965 | Echo guidance radiotherapy | $611 | ||||
| 76965 | 26 | Echo guidance radiotherapy | $195 | |||
| 76965 | TC | Echo guidance radiotherapy | $416 | |||
| 76970 | Ultrasound exam follow-up | $119 | ||||
| 76970 | 26 | Ultrasound exam follow-up | $43 | |||
| 76970 | TC | Ultrasound exam follow-up | $76 | |||
| 76975 | Gi endoscopic ultrasound | $195 | ||||
| 76975 | 26 | Gi endoscopic ultrasound | $85 | |||
| 76975 | TC | Gi endoscopic ultrasound | $110 | |||
| 76977 | Us bone density measure | $85 | ||||
| 76977 | 26 | Us bone density measure | $22 | |||
| 76977 | TC | Us bone density measure | $62 | |||
| 76998 | Us guide intraop | $134 | ||||
| 76999 | Echo examination procedure | BR | ||||
| 76999 | 26 | Echo examination procedure | BR | |||
| 76999 | TC | Echo examination procedure | BR | |||
| 77001 | 26 | Fluoroguide for vein device | $38 | |||
| 77001 | TC | Fluoroguide for vein device | $210 | |||
| 77001 | Fluoroguide for vein device | $248 | ||||
| 77002 | 26 | Needle localization by xray | $57 | |||
| 77002 | TC | Needle localization by xray | $107 | |||
| 77002 | Needle localization by xray | $163 | ||||
| 77003 | 26 | Fluoroguide for spine inject | $64 | |||
| 77003 | TC | Fluoroguide for spine inject | $73 | |||
| 77003 | Fluoroguide for spine inject | $136 | ||||
| 77011 | 26 | Ct scan for localization | $125 | |||
| 77011 | TC | Ct scan for localization | $357 | |||
| 77011 | Ct scan for localization | $482 | ||||
| 77012 | 26 | Ct scan for needle biopsy | $113 | |||
| 77012 | TC | Ct scan for needle biopsy | $151 | |||
| 77012 | Ct scan for needle biopsy | $265 | ||||
| 77013 | Ct guide for tissue ablation | $405 | ||||
| 77014 | 26 | Ct scan for therapy guide | $86 | |||
| 77014 | TC | Ct scan for therapy guide | $171 | |||
| 77014 | Ct scan for therapy guide | $257 | ||||
| 77021 | 26 | Mr guidance for needle place | $151 | |||
| 77021 | TC | Mr guidance for needle place | $659 | |||
| 77021 | Mr guidance for needle place | $810 | ||||
| 77022 | Mri for tissue ablation | $427 | ||||
| 77031 | 26 | Stereotact guide for brst bx | $161 | |||
| 77031 | TC | Stereotact guide for brst bx | $105 | |||
| 77031 | Stereotact guide for brst bx | $267 | ||||
| 77032 | 26 | Guidance for needle breast | $56 | |||
| 77032 | TC | Guidance for needle breast | $50 | |||
| 77032 | Guidance for needle breast | $106 | ||||
| 77051 | 26 | Computer dx mammogram add-on | $6 | |||
| 77051 | TC | Computer dx mammogram add-on | $15 | |||
| 77051 | Computer dx mammogram add-on | $21 | ||||
| 77052 | 26 | Comp screen mammogram add-on | $6 | |||
| 77052 | TC | Comp screen mammogram add-on | $14 | |||
| 77052 | Comp screen mammogram add-on | $20 | ||||
| 77053 | 26 | X-ray of mammary duct | $35 | |||
| 77053 | TC | X-ray of mammary duct | $85 | |||
| 77053 | X-ray of mammary duct | $121 | ||||
| 77054 | 26 | X-ray of mammary ducts | $45 | |||
| 77054 | TC | X-ray of mammary ducts | $119 | |||
| 77054 | X-ray of mammary ducts | $164 | ||||
| 77055 | 26 | Mammogram one breast | $70 | |||
| 77055 | TC | Mammogram one breast | $109 | |||
| 77055 | Mammogram one breast | $179 | ||||
| 77056 | 26 | Mammogram both breasts | $87 | |||
| 77056 | TC | Mammogram both breasts | $142 | |||
| 77056 | Mammogram both breasts | $229 | ||||
| 77057 | 26 | Mammogram screening | $70 | |||
| 77057 | TC | Mammogram screening | $93 | |||
| 77057 | Mammogram screening | $164 | ||||
| 77058 | 26 | Mri one breast | $162 | |||
| 77058 | TC | Mri one breast | $1,135 | |||
| 77058 | Mri one breast | $1,297 | ||||
| 77059 | 26 | Mri both breasts | $162 | |||
| 77059 | TC | Mri both breasts | $1,131 | |||
| 77059 | Mri both breasts | $1,293 | ||||
| 77071 | X-ray stress view | $109 | ||||
| 77072 | 26 | X-rays for bone age | $19 | |||
| 77072 | TC | X-rays for bone age | $29 | |||
| 77072 | X-rays for bone age | $48 | ||||
| 77073 | 26 | X-rays bone length studies | $30 | |||
| 77073 | TC | X-rays bone length studies | $51 | |||
| 77073 | X-rays bone length studies | $81 | ||||
| 77074 | 26 | X-rays bone survey limited | $45 | |||
| 77074 | TC | X-rays bone survey limited | $98 | |||
| 77074 | X-rays bone survey limited | $144 | ||||
| 77075 | 26 | X-rays bone survey complete | $54 | |||
| 77075 | TC | X-rays bone survey complete | $162 | |||
| 77075 | X-rays bone survey complete | $216 | ||||
| 77076 | 26 | X-rays bone survey infant | $72 | |||
| 77076 | TC | X-rays bone survey infant | $160 | |||
| 77076 | X-rays bone survey infant | $232 | ||||
| 77077 | 26 | Joint survey single view | $35 | |||
| 77077 | TC | Joint survey single view | $51 | |||
| 77077 | Joint survey single view | $85 | ||||
| 77078 | 26 | Ct bone density axial | $25 | |||
| 77078 | TC | Ct bone density axial | $256 | |||
| 77078 | Ct bone density axial | $281 | ||||
| 77080 | 26 | Dxa bone density axial | $21 | |||
| 77080 | TC | Dxa bone density axial | $84 | |||
| 77080 | Dxa bone density axial | $105 | ||||
| 77081 | 26 | Dxa bone density/peripheral | $23 | |||
| 77081 | TC | Dxa bone density/peripheral | $35 | |||
| 77081 | Dxa bone density/peripheral | $58 | ||||
| 77082 | 26 | Dxa bone density vert fx | $18 | |||
| 77082 | TC | Dxa bone density vert fx | $40 | |||
| 77082 | Dxa bone density vert fx | $58 | ||||
| 77084 | 26 | Magnetic image bone marrow | $160 | |||
| 77084 | TC | Magnetic image bone marrow | $756 | |||
| 77084 | Magnetic image bone marrow | $916 | ||||
| 77261 | Radiation therapy planning | $150 | ||||
| 77262 | Radiation therapy planning | $226 | ||||
| 77263 | Radiation therapy planning | $336 | ||||
| 77280 | Set radiation therapy field | $325 | ||||
| 77280 | 26 | Set radiation therapy field | $76 | |||
| 77280 | TC | Set radiation therapy field | $250 | |||
| 77285 | Set radiation therapy field | $512 | ||||
| 77285 | 26 | Set radiation therapy field | $112 | |||
| 77285 | TC | Set radiation therapy field | $400 | |||
| 77290 | Set radiation therapy field | $635 | ||||
| 77290 | 26 | Set radiation therapy field | $168 | |||
| 77290 | TC | Set radiation therapy field | $467 | |||
| 77295 | Set radiation therapy field | $2,558 | ||||
| 77295 | 26 | Set radiation therapy field | $472 | |||
| 77295 | TC | Set radiation therapy field | $2,086 | |||
| 77299 | Radiation therapy planning | BR | ||||
| 77299 | 26 | Radiation therapy planning | BR | |||
| 77299 | TC | Radiation therapy planning | BR | |||
| 77300 | Radiation therapy dose plan | $163 | ||||
| 77300 | 26 | Radiation therapy dose plan | $67 | |||
| 77300 | TC | Radiation therapy dose plan | $96 | |||
| 77301 | 26 | Radiotherapy dose plan imrt | $815 | |||
| 77301 | TC | Radiotherapy dose plan imrt | $2,998 | |||
| 77301 | Radiotherapy dose plan imrt | $3,813 | ||||
| 77305 | Radiation therapy dose plan | $210 | ||||
| 77305 | 26 | Radiation therapy dose plan | $76 | |||
| 77305 | TC | Radiation therapy dose plan | $134 | |||
| 77310 | Radiation therapy dose plan | $280 | ||||
| 77310 | 26 | Radiation therapy dose plan | $112 | |||
| 77310 | TC | Radiation therapy dose plan | $168 | |||
| 77315 | Radiation therapy dose plan | $360 | ||||
| 77315 | 26 | Radiation therapy dose plan | $168 | |||
| 77315 | TC | Radiation therapy dose plan | $192 | |||
| 77321 | Radiation therapy port plan | $391 | ||||
| 77321 | 26 | Radiation therapy port plan | $102 | |||
| 77321 | TC | Radiation therapy port plan | $290 | |||
| 77326 | Radiation therapy dose plan | $270 | ||||
| 77326 | 26 | Radiation therapy dose plan | $100 | |||
| 77326 | TC | Radiation therapy dose plan | $171 | |||
| 77327 | Radiation therapy dose plan | $399 | ||||
| 77327 | 26 | Radiation therapy dose plan | $150 | |||
| 77327 | TC | Radiation therapy dose plan | $250 | |||
| 77328 | Radiation therapy dose plan | $579 | ||||
| 77328 | 26 | Radiation therapy dose plan | $224 | |||
| 77328 | TC | Radiation therapy dose plan | $356 | |||
| 77331 | Special radiation dosimetry | $130 | ||||
| 77331 | 26 | Special radiation dosimetry | $94 | |||
| 77331 | TC | Special radiation dosimetry | $37 | |||
| 77332 | Radiation treatment aid(s) | $155 | ||||
| 77332 | 26 | Radiation treatment aid(s) | $59 | |||
| 77332 | TC | Radiation treatment aid(s) | $96 | |||
| 77333 | Radiation treatment aid(s) | $227 | ||||
| 77333 | 26 | Radiation treatment aid(s) | $91 | |||
| 77333 | TC | Radiation treatment aid(s) | $137 | |||
| 77334 | Radiation treatment aid(s) | $364 | ||||
| 77334 | 26 | Radiation treatment aid(s) | $132 | |||
| 77334 | TC | Radiation treatment aid(s) | $233 | |||
| 77336 | Radiation physics consult. | $223 | ||||
| 77338 | 26 | Design mlc device for imrt | $438 | |||
| 77338 | TC | Design mlc device for imrt | $576 | |||
| 77338 | Design mlc device for imrt | $1,014 | ||||
| 77370 | Radiation physics consult | $251 | ||||
| 77372 | Srs linear based | $1,651 | ||||
| 77373 | Sbrt delivery | $3,176 | ||||
| 77401 | Radiation treatment delivery | $128 | ||||
| 77402 | Radiation treatment delivery | $128 | ||||
| 77403 | Radiation treatment delivery | $128 | ||||
| 77404 | Radiation treatment delivery | $128 | ||||
| 77406 | Radiation treatment delivery | $128 | ||||
| 77407 | Radiation treatment delivery | $150 | ||||
| 77408 | Radiation treatment delivery | $150 | ||||
| 77409 | Radiation treatment delivery | $150 | ||||
| 77411 | Radiation treatment delivery | $150 | ||||
| 77412 | Radiation treatment delivery | $168 | ||||
| 77413 | Radiation treatment delivery | $168 | ||||
| 77414 | Radiation treatment delivery | $168 | ||||
| 77416 | Radiation treatment delivery | $168 | ||||
| 77417 | Radiology port film(s) | $43 | ||||
| 77418 | Radiation tx delivery imrt | $896 | ||||
| 77421 | 26 | Stereoscopic x-ray guidance | $39 | |||
| 77421 | TC | Stereoscopic x-ray guidance | $114 | |||
| 77421 | Stereoscopic x-ray guidance | $153 | ||||
| 77422 | Neutron beam tx simple | $540 | ||||
| 77423 | Neutron beam tx complex | $541 | ||||
| 77427 | Radiation tx management, x5 | $366 | ||||
| 77427 | Radiation tx management x5 | $366 | ||||
| 77431 | Radiation therapy management | $194 | ||||
| 77432 | Stereotactic radiation trmt | $939 | ||||
| 77435 | Sbrt management | $1,246 | ||||
| 77469 | Io radiation tx management | $618 | ||||
| 77470 | Special radiation treatment | $1,022 | ||||
| 77470 | 26 | Special radiation treatment | $224 | |||
| 77470 | TC | Special radiation treatment | $799 | |||
| 77499 | Radiation therapy management | BR | ||||
| 77499 | 26 | Radiation therapy management | BR | |||
| 77499 | TC | Radiation therapy management | BR | |||
| 77520 | Proton beam delivery.. | BR | ||||
| 77523 | Proton beam delivery.. | BR | ||||
| 77600 | Hyperthermia treatment | $386 | ||||
| 77600 | 26 | Hyperthermia treatment | $168 | |||
| 77600 | TC | Hyperthermia treatment | $218 | |||
| 77605 | Hyperthermia treatment | $515 | ||||
| 77605 | 26 | Hyperthermia treatment | $224 | |||
| 77605 | TC | Hyperthermia treatment | $292 | |||
| 77610 | Hyperthermia treatment | $386 | ||||
| 77610 | 26 | Hyperthermia treatment | $168 | |||
| 77610 | TC | Hyperthermia treatment | $218 | |||
| 77615 | Hyperthermia treatment | $515 | ||||
| 77615 | 26 | Hyperthermia treatment | $224 | |||
| 77615 | TC | Hyperthermia treatment | $292 | |||
| 77620 | Hyperthermia treatment | $386 | ||||
| 77620 | 26 | Hyperthermia treatment | $168 | |||
| 77620 | TC | Hyperthermia treatment | $218 | |||
| 77750 | Infuse radioactive materials | 90 | $586 | |||
| 77750 | 26 | Infuse radioactive materials | 90 | $491 | ||
| 77750 | TC | Infuse radioactive materials | 90 | $96 | ||
| 77761 | Radioelement application | 90 | $562 | |||
| 77761 | 26 | Radioelement application | 90 | $381 | ||
| 77761 | TC | Radioelement application | 90 | $181 | ||
| 77762 | Radioelement application | 90 | $832 | |||
| 77762 | 26 | Radioelement application | 90 | $573 | ||
| 77762 | TC | Radioelement application | 90 | $259 | ||
| 77763 | Radioelement application | 90 | $1,179 | |||
| 77763 | 26 | Radioelement application | 90 | $857 | ||
| 77763 | TC | Radioelement application | 90 | $322 | ||
| 77776 | Radioelement application | $656 | ||||
| 77776 | 26 | Radioelement application | $500 | |||
| 77776 | TC | Radioelement application | $157 | |||
| 77777 | Radioelement application | 90 | $1,052 | |||
| 77777 | 26 | Radioelement application | 90 | $748 | ||
| 77777 | TC | Radioelement application | 90 | $304 | ||
| 77778 | Radioelement application | 90 | $1,488 | |||
| 77778 | 26 | Radioelement application | 90 | $1,120 | ||
| 77778 | TC | Radioelement application | 90 | $368 | ||
| 77785 | 26 | Hdr brachytx 1 channel | $145 | |||
| 77785 | TC | Hdr brachytx 1 channel | $357 | |||
| 77785 | Hdr brachytx 1 channel | $502 | ||||
| 77786 | 26 | Hdr brachytx 2-12 channel | $332 | |||
| 77786 | TC | Hdr brachytx 2-12 channel | $792 | |||
| 77786 | Hdr brachytx 2-12 channel | $1,123 | ||||
| 77787 | 26 | Hdr brachytx over 12 chan | $501 | |||
| 77787 | TC | Hdr brachytx over 12 chan | $1,429 | |||
| 77787 | Hdr brachytx over 12 chan | $1,930 | ||||
| 77789 | Radioelement application | 90 | $145 | |||
| 77789 | 26 | Radioelement application | 90 | $112 | ||
| 77789 | TC | Radioelement application | 90 | $33 | ||
| 77790 | Radioelement handling | $149 | ||||
| 77790 | 26 | Radioelement handling | $112 | |||
| 77790 | TC | Radioelement handling | $37 | |||
| 77799 | Radium/radioisotope therapy | BR | ||||
| 77799 | 26 | Radium/radioisotope therapy | BR | |||
| 77799 | TC | Radium/radioisotope therapy | BR | |||
| 78000 | Thyroid, single uptake | $90 | ||||
| 78000 | 26 | Thyroid, single uptake | $21 | |||
| 78000 | TC | Thyroid, single uptake | $70 | |||
| 78001 | Thyroid, multiple uptakes | $122 | ||||
| 78001 | 26 | Thyroid, multiple uptakes | $28 | |||
| 78001 | TC | Thyroid, multiple uptakes | $94 | |||
| 78003 | Thyroid suppress/stimul | $105 | ||||
| 78003 | 26 | Thyroid suppress/stimul | $35 | |||
| 78003 | TC | Thyroid suppress/stimul | $70 | |||
| 78006 | Thyroid,imaging with uptake | $224 | ||||
| 78006 | 26 | Thyroid,imaging with uptake | $53 | |||
| 78006 | TC | Thyroid,imaging with uptake | $172 | |||
| 78007 | Thyroid,imaging with uptake | $239 | ||||
| 78007 | 26 | Thyroid,imaging with uptake | $54 | |||
| 78007 | TC | Thyroid,imaging with uptake | $185 | |||
| 78010 | Thyroid imaging | $172 | ||||
| 78010 | 26 | Thyroid imaging | $42 | |||
| 78010 | TC | Thyroid imaging | $131 | |||
| 78011 | Thyroid imaging with flow | $222 | ||||
| 78011 | 26 | Thyroid imaging with flow | $49 | |||
| 78011 | TC | Thyroid imaging with flow | $173 | |||
| 78015 | Thyroid met imaging | $258 | ||||
| 78015 | 26 | Thyroid met imaging | $73 | |||
| 78015 | TC | Thyroid met imaging | $185 | |||
| 78016 | Thyroid met imaging/studies | $339 | ||||
| 78016 | 26 | Thyroid met imaging/studies | $89 | |||
| 78016 | TC | Thyroid met imaging/studies | $250 | |||
| 78018 | Thyroid, met imaging, body | $491 | ||||
| 78018 | 26 | Thyroid, met imaging, body | $102 | |||
| 78018 | TC | Thyroid, met imaging, body | $390 | |||
| 78020 | Thyroid met uptake.... | $60 | ||||
| 78020 | 26 | Thyroid met uptake.... | $45 | |||
| 78020 | TC | Thyroid met uptake.... | $15 | |||
| 78070 | Parathyroid nuclear imaging | $186 | ||||
| 78070 | 26 | Parathyroid nuclear imaging | $56 | |||
| 78070 | TC | Parathyroid nuclear imaging | $131 | |||
| 78075 | Adrenal nuclear imaging | $469 | ||||
| 78075 | 26 | Adrenal nuclear imaging | $80 | |||
| 78075 | TC | Adrenal nuclear imaging | $390 | |||
| 78099 | Endocrine nuclear procedure | BR | ||||
| 78099 | 26 | Endocrine nuclear procedure | BR | |||
| 78099 | TC | Endocrine nuclear procedure | BR | |||
| 78102 | Bone marrow imaging, ltd | $206 | ||||
| 78102 | 26 | Bone marrow imaging, ltd | $60 | |||
| 78102 | TC | Bone marrow imaging, ltd | $147 | |||
| 78103 | Bone marrow imaging, mult | $308 | ||||
| 78103 | 26 | Bone marrow imaging, mult | $81 | |||
| 78103 | TC | Bone marrow imaging, mult | $227 | |||
| 78104 | Bone marrow imaging, body | $378 | ||||
| 78104 | 26 | Bone marrow imaging, body | $87 | |||
| 78104 | TC | Bone marrow imaging, body | $292 | |||
| 78110 | Plasma volume, single | $91 | ||||
| 78110 | 26 | Plasma volume, single | $20 | |||
| 78110 | TC | Plasma volume, single | $71 | |||
| 78111 | Plasma volume, multiple | $209 | ||||
| 78111 | 26 | Plasma volume, multiple | $24 | |||
| 78111 | TC | Plasma volume, multiple | $185 | |||
| 78120 | Red cell mass, single | $150 | ||||
| 78120 | 26 | Red cell mass, single | $26 | |||
| 78120 | TC | Red cell mass, single | $125 | |||
| 78121 | Red cell mass, multiple | $243 | ||||
| 78121 | 26 | Red cell mass, multiple | $35 | |||
| 78121 | TC | Red cell mass, multiple | $208 | |||
| 78122 | Blood volume.......... | $391 | ||||
| 78122 | 26 | Blood volume.......... | $47 | |||
| 78122 | TC | Blood volume.......... | $344 | |||
| 78130 | Red cell survival study | $271 | ||||
| 78130 | 26 | Red cell survival study | $66 | |||
| 78130 | TC | Red cell survival study | $205 | |||
| 78135 | Red cell survival kinetics | $418 | ||||
| 78135 | 26 | Red cell survival kinetics | $69 | |||
| 78135 | TC | Red cell survival kinetics | $350 | |||
| 78140 | Red cell sequestration | $348 | ||||
| 78140 | 26 | Red cell sequestration | $66 | |||
| 78140 | TC | Red cell sequestration | $283 | |||
| 78185 | Spleen imaging | $213 | ||||
| 78185 | 26 | Spleen imaging | $43 | |||
| 78185 | TC | Spleen imaging | $170 | |||
| 78190 | Platelet survival, kinetics | $527 | ||||
| 78190 | 26 | Platelet survival, kinetics | $117 | |||
| 78190 | TC | Platelet survival, kinetics | $411 | |||
| 78191 | Platelet survival | $592 | ||||
| 78191 | 26 | Platelet survival | $66 | |||
| 78191 | TC | Platelet survival | $526 | |||
| 78195 | Lymph system imaging | $368 | ||||
| 78195 | 26 | Lymph system imaging | $76 | |||
| 78195 | TC | Lymph system imaging | $292 | |||
| 78199 | Blood/lymph nuclear exam | BR | ||||
| 78199 | 26 | Blood/lymph nuclear exam | BR | |||
| 78199 | TC | Blood/lymph nuclear exam | BR | |||
| 78201 | Liver imaging | $216 | ||||
| 78201 | 26 | Liver imaging | $47 | |||
| 78201 | TC | Liver imaging | $170 | |||
| 78202 | Liver imaging with flow | $262 | ||||
| 78202 | 26 | Liver imaging with flow | $56 | |||
| 78202 | TC | Liver imaging with flow | $207 | |||
| 78205 | Liver imaging (3D).... | $516 | ||||
| 78205 | 26 | Liver imaging (3D).... | $75 | |||
| 78205 | TC | Liver imaging (3D).... | $441 | |||
| 78206 | Liver image (3d) w/ flow | $516 | ||||
| 78206 | 26 | Liver image (3d) w/ flow | $89 | |||
| 78206 | TC | Liver image (3d) w/ flow | $428 | |||
| 78215 | Liver and spleen imaging | $263 | ||||
| 78215 | 26 | Liver and spleen imaging | $53 | |||
| 78215 | TC | Liver and spleen imaging | $210 | |||
| 78216 | Liver & spleen image, flow | $312 | ||||
| 78216 | 26 | Liver & spleen image, flow | $62 | |||
| 78216 | TC | Liver & spleen image, flow | $250 | |||
| 78220 | Liver function study | $320 | ||||
| 78226 | 26 | Hepatobiliary system imaging | $73 | |||
| 78226 | TC | Hepatobiliary system imaging | $601 | |||
| 78226 | Hepatobiliary system imaging | $674 | ||||
| 78227 | 26 | Hepatobil syst image w/drug | $88 | |||
| 78227 | TC | Hepatobil syst image w/drug | $835 | |||
| 78227 | Hepatobil syst image w/drug | $923 | ||||
| 78230 | Salivary gland imaging | $206 | ||||
| 78230 | 26 | Salivary gland imaging | $49 | |||
| 78230 | TC | Salivary gland imaging | $157 | |||
| 78231 | Serial salivary imaging | $284 | ||||
| 78231 | 26 | Serial salivary imaging | $57 | |||
| 78231 | TC | Serial salivary imaging | $227 | |||
| 78232 | Salivary gland function exam | $305 | ||||
| 78232 | 26 | Salivary gland function exam | $52 | |||
| 78232 | TC | Salivary gland function exam | $254 | |||
| 78258 | Esophageal motility study | $287 | ||||
| 78258 | 26 | Esophageal motility study | $80 | |||
| 78258 | TC | Esophageal motility study | $207 | |||
| 78261 | Gastric mucosa imaging | $369 | ||||
| 78261 | 26 | Gastric mucosa imaging | $75 | |||
| 78261 | TC | Gastric mucosa imaging | $294 | |||
| 78262 | Gastroesophageal reflux exam | $378 | ||||
| 78262 | 26 | Gastroesophageal reflux exam | $74 | |||
| 78262 | TC | Gastroesophageal reflux exam | $305 | |||
| 78264 | Gastric emptying study | $380 | ||||
| 78264 | 26 | Gastric emptying study | $84 | |||
| 78264 | TC | Gastric emptying study | $296 | |||
| 78267 | Breath tst attain/anal c-14 | BR | ||||
| 78268 | Breath test analysis, c-14 | BR | ||||
| 78270 | Vit b-12 absorption exam | $133 | ||||
| 78270 | 26 | Vit b-12 absorption exam | $22 | |||
| 78270 | TC | Vit b-12 absorption exam | $112 | |||
| 78271 | Vit b-12 absorp exam, if | $140 | ||||
| 78271 | 26 | Vit b-12 absorp exam, if | $22 | |||
| 78271 | TC | Vit b-12 absorp exam, if | $119 | |||
| 78272 | Vit b-12 absorp, combined | $196 | ||||
| 78272 | 26 | Vit b-12 absorp, combined | $30 | |||
| 78272 | TC | Vit b-12 absorp, combined | $167 | |||
| 78278 | Acute gi blood loss imaging | $456 | ||||
| 78278 | 26 | Acute gi blood loss imaging | $107 | |||
| 78278 | TC | Acute gi blood loss imaging | $350 | |||
| 78282 | Gi protein loss exam | BR | ||||
| 78282 | 26 | Gi protein loss exam | $41 | |||
| 78282 | TC | Gi protein loss exam | BR | |||
| 78290 | Meckel's divert exam | $292 | ||||
| 78290 | 26 | Meckel's divert exam | $74 | |||
| 78290 | TC | Meckel's divert exam | $218 | |||
| 78291 | Leveen/shunt patency exam | $313 | ||||
| 78291 | 26 | Leveen/shunt patency exam | $94 | |||
| 78291 | TC | Leveen/shunt patency exam | $220 | |||
| 78299 | Gi nuclear procedure | BR | ||||
| 78299 | 26 | Gi nuclear procedure | BR | |||
| 78299 | TC | Gi nuclear procedure | BR | |||
| 78300 | Bone imaging, limited area | $247 | ||||
| 78300 | 26 | Bone imaging, limited area | $68 | |||
| 78300 | TC | Bone imaging, limited area | $180 | |||
| 78305 | Bone imaging, multiple areas | $353 | ||||
| 78305 | 26 | Bone imaging, multiple areas | $90 | |||
| 78305 | TC | Bone imaging, multiple areas | $263 | |||
| 78306 | Bone imaging, whole body | $399 | ||||
| 78306 | 26 | Bone imaging, whole body | $93 | |||
| 78306 | TC | Bone imaging, whole body | $307 | |||
| 78315 | Bone imaging, 3 phase | $452 | ||||
| 78315 | 26 | Bone imaging, 3 phase | $110 | |||
| 78315 | TC | Bone imaging, 3 phase | $343 | |||
| 78320 | Bone imaging (3d) | $535 | ||||
| 78320 | 26 | Bone imaging (3d) | $112 | |||
| 78320 | TC | Bone imaging (3d) | $424 | |||
| 78350 | Bone mineral, single photon | $80 | ||||
| 78350 | 26 | Bone mineral, single photon | $24 | |||
| 78350 | TC | Bone mineral, single photon | $57 | |||
| 78351 | Bone mineral, dual photon | $55 | ||||
| 78399 | Musculoskeletal nuclear exam | BR | ||||
| 78399 | 26 | Musculoskeletal nuclear exam | BR | |||
| 78399 | TC | Musculoskeletal nuclear exam | BR | |||
| 78414 | Non-imaging heart function | BR | ||||
| 78414 | 26 | Non-imaging heart function | $48 | |||
| 78414 | TC | Non-imaging heart function | BR | |||
| 78428 | Cardiac shunt imaging | $246 | ||||
| 78428 | 26 | Cardiac shunt imaging | $84 | |||
| 78428 | TC | Cardiac shunt imaging | $162 | |||
| 78445 | Vascular flow imaging | $191 | ||||
| 78445 | 26 | Vascular flow imaging | $52 | |||
| 78445 | TC | Vascular flow imaging | $139 | |||
| 78451 | 26 | Ht muscle image spect sing | $136 | |||
| 78451 | TC | Ht muscle image spect sing | $606 | |||
| 78451 | Ht muscle image spect sing | $742 | ||||
| 78452 | 26 | Ht muscle image spect mult | $160 | |||
| 78452 | TC | Ht muscle image spect mult | $875 | |||
| 78452 | Ht muscle image spect mult | $1,035 | ||||
| 78453 | 26 | Ht muscle image planar sing | $99 | |||
| 78453 | TC | Ht muscle image planar sing | $541 | |||
| 78453 | Ht muscle image planar sing | $639 | ||||
| 78454 | 26 | Ht musc image planar mult | $131 | |||
| 78454 | TC | Ht musc image planar mult | $782 | |||
| 78454 | Ht musc image planar mult | $913 | ||||
| 78456 | Acute venous thrombus image | $797 | ||||
| 78456 | 26 | Acute venous thrombus image | $100 | |||
| 78456 | TC | Acute venous thrombus | $697 | |||
| 78457 | Venous thrombosis imaging | $279 | ||||
| 78457 | 26 | Venous thrombosis imaging | $80 | |||
| 78457 | TC | Venous thrombosis imaging | $199 | |||
| 78458 | Ven thrombosis images, bilat | $384 | ||||
| 78458 | 26 | Ven thrombosis images, bilat | $96 | |||
| 78458 | TC | Ven thrombosis images, bilat | $288 | |||
| 78459 | Heart muscle imaging (PET) | BR | ||||
| 78459 | 26 | Heart muscle imaging (PET) | $225 | |||
| 78459 | TC | Heart muscle imaging (PET) | BR | |||
| 78466 | Heart infarct image | $264 | ||||
| 78466 | 26 | Heart infarct image | $75 | |||
| 78466 | TC | Heart infarct image | $189 | |||
| 78468 | Heart infarct image, ef | $348 | ||||
| 78468 | 26 | Heart infarct image, ef | $86 | |||
| 78468 | TC | Heart infarct image, ef | $263 | |||
| 78469 | Heart infarct image (3D) | $486 | ||||
| 78469 | 26 | Heart infarct image (3D) | $96 | |||
| 78469 | TC | Heart infarct image (3D) | $390 | |||
| 78472 | Gated heart, planar, single | $515 | ||||
| 78472 | 26 | Gated heart, planar, single | $103 | |||
| 78472 | TC | Gated heart, planar, single | $413 | |||
| 78473 | Gated heart, multiple | $770 | ||||
| 78473 | 26 | Gated heart, multiple | $154 | |||
| 78473 | TC | Gated heart, multiple | $616 | |||
| 78481 | Heart first pass, single | $493 | ||||
| 78481 | 26 | Heart first pass, single | $103 | |||
| 78481 | TC | Heart first pass, single | $390 | |||
| 78483 | Heart first pass, multiple | $743 | ||||
| 78483 | 26 | Heart first pass, multiple | $155 | |||
| 78483 | TC | Heart first pass, multiple | $588 | |||
| 78491 | Heart image (pet), single | BR | ||||
| 78491 | 26 | Heart image (pet), single | $196 | |||
| 78491 | TC | Heart image (pet), single | BR | |||
| 78492 | Heart image (pet), multiple | BR | ||||
| 78492 | 26 | Heart image (pet), multiple | $224 | |||
| 78492 | TC | Heart image (pet), multiple | BR | |||
| 78494 | Heart image, spect.... | $525 | ||||
| 78494 | 26 | Heart image, spect.... | $112 | |||
| 78494 | TC | Heart image, spect.... | $413 | |||
| 78496 | Heart first pass add- on | $183 | ||||
| 78496 | 26 | Heart first pass add- on | $52 | |||
| 78496 | TC | Heart first pass add- on | $131 | |||
| 78499 | Cardiovascular nuclear exam | BR | ||||
| 78499 | 26 | Cardiovascular nuclear exam | BR | |||
| 78499 | TC | Cardiovascular nuclear exam | BR | |||
| 78579 | 26 | Lung ventilation imaging | $48 | |||
| 78579 | TC | Lung ventilation imaging | $310 | |||
| 78579 | Lung ventilation imaging | $359 | ||||
| 78580 | Lung perfusion imaging | $327 | ||||
| 78580 | 26 | Lung perfusion imaging | $80 | |||
| 78580 | TC | Lung perfusion imaging | $247 | |||
| 78582 | 26 | Lung ventilat&perfus imaging | $104 | |||
| 78582 | TC | Lung ventilat&perfus imaging | $557 | |||
| 78582 | Lung ventilat&perfus imaging | $662 | ||||
| 78597 | 26 | Lung perfusion differential | $72 | |||
| 78597 | TC | Lung perfusion differential | $333 | |||
| 78597 | Lung perfusion differential | $404 | ||||
| 78598 | 26 | Lung perf&ventilat diferentl | $82 | |||
| 78598 | TC | Lung perf&ventilat diferentl | $539 | |||
| 78598 | Lung perf&ventilat diferentl | $621 | ||||
| 78599 | Respiratory nuclear exam | BR | ||||
| 78599 | 26 | Respiratory nuclear exam | BR | |||
| 78599 | TC | Respiratory nuclear exam | BR | |||
| 78600 | Brain imaging, ltd static | $254 | ||||
| 78600 | 26 | Brain imaging, ltd static | $47 | |||
| 78600 | TC | Brain imaging, ltd static | $207 | |||
| 78605 | Brain imaging, complete | $302 | ||||
| 78605 | 26 | Brain imaging, complete | $59 | |||
| 78605 | TC | Brain imaging, complete | $244 | |||
| 78606 | Brain imaging comp & flow | $346 | ||||
| 78606 | 26 | Brain imaging comp & flow | $69 | |||
| 78606 | TC | Brain imaging comp & flow | $278 | |||
| 78607 | Brain imaging (3d) | $601 | ||||
| 78607 | 26 | Brain imaging (3d) | $131 | |||
| 78607 | TC | Brain imaging (3d) | $470 | |||
| 78608 | Brain imaging (pet) | $145 | ||||
| 78609 | Brain imaging (pet) | $156 | ||||
| 78610 | Brain flow imaging only | $146 | ||||
| 78610 | 26 | Brain flow imaging only | $33 | |||
| 78610 | TC | Brain flow imaging only | $114 | |||
| 78630 | Cerebrospinal fluid scan | $435 | ||||
| 78630 | 26 | Cerebrospinal fluid scan | $74 | |||
| 78630 | TC | Cerebrospinal fluid scan | $362 | |||
| 78635 | Csf ventriculography | $249 | ||||
| 78635 | 26 | Csf ventriculography | $66 | |||
| 78635 | TC | Csf ventriculography | $183 | |||
| 78645 | Csf shunt evaluation | $308 | ||||
| 78645 | 26 | Csf shunt evaluation | $62 | |||
| 78645 | TC | Csf shunt evaluation | $247 | |||
| 78647 | Cerebrospinal fluid scan | $515 | ||||
| 78647 | 26 | Cerebrospinal fluid scan | $96 | |||
| 78647 | TC | Cerebrospinal fluid scan | $419 | |||
| 78650 | Csf leakage imaging | $399 | ||||
| 78650 | 26 | Csf leakage imaging | $66 | |||
| 78650 | TC | Csf leakage imaging | $333 | |||
| 78660 | Nuclear exam of tear flow | $214 | ||||
| 78660 | 26 | Nuclear exam of tear flow | $56 | |||
| 78660 | TC | Nuclear exam of tear flow | $158 | |||
| 78699 | Nervous system nuclear exam | BR | ||||
| 78699 | 26 | Nervous system nuclear exam | BR | |||
| 78699 | TC | Nervous system nuclear exam | BR | |||
| 78700 | Kidney imaging, static | $266 | ||||
| 78700 | 26 | Kidney imaging, static | $48 | |||
| 78700 | TC | Kidney imaging, static | $218 | |||
| 78701 | Kidney imaging with flow | $308 | ||||
| 78701 | 26 | Kidney imaging with flow | $53 | |||
| 78701 | TC | Kidney imaging with flow | $255 | |||
| 78707 | Kidney flow/function image | $433 | ||||
| 78707 | 26 | Kidney flow/function image | $99 | |||
| 78707 | TC | Kidney flow/function image | $334 | |||
| 78708 | Kidney flow/function image | $452 | ||||
| 78708 | 26 | Kidney flow/function image | $118 | |||
| 78708 | TC | Kidney flow/function image | $334 | |||
| 78709 | Kidney flow/function image | $467 | ||||
| 78709 | 26 | Kidney flow/function image | $133 | |||
| 78709 | TC | Kidney flow/function image | $334 | |||
| 78710 | Kidney imaging (3D)... | $511 | ||||
| 78710 | 26 | Kidney imaging (3D)... | $70 | |||
| 78710 | TC | Kidney imaging (3D)... | $441 | |||
| 78725 | Kidney function study | $172 | ||||
| 78725 | 26 | Kidney function study | $39 | |||
| 78725 | TC | Kidney function study | $133 | |||
| 78730 | Urinary bladder retention | $143 | ||||
| 78730 | 26 | Urinary bladder retention | $38 | |||
| 78730 | TC | Urinary bladder retention | $105 | |||
| 78740 | Ureteral reflux study | $217 | ||||
| 78740 | 26 | Ureteral reflux study | $59 | |||
| 78740 | TC | Ureteral reflux study | $158 | |||
| 78761 | Testicular imaging & flow | $306 | ||||
| 78761 | 26 | Testicular imaging & flow | $77 | |||
| 78761 | TC | Testicular imaging & flow | $229 | |||
| 78799 | Genitourinary nuclear exam | BR | ||||
| 78799 | 26 | Genitourinary nuclear exam | BR | |||
| 78799 | TC | Genitourinary nuclear exam | BR | |||
| 78800 | Tumor imaging, limited area | $323 | ||||
| 78800 | 26 | Tumor imaging, limited area | $69 | |||
| 78800 | TC | Tumor imaging, limited area | $254 | |||
| 78801 | Tumor imaging, mult areas | $388 | ||||
| 78801 | 26 | Tumor imaging, mult areas | $85 | |||
| 78801 | TC | Tumor imaging, mult areas | $304 | |||
| 78802 | Tumor imaging, whole body | $490 | ||||
| 78802 | 26 | Tumor imaging, whole body | $93 | |||
| 78802 | TC | Tumor imaging, whole body | $397 | |||
| 78803 | Tumor imaging (3D).... | $602 | ||||
| 78803 | 26 | Tumor imaging (3D).... | $113 | |||
| 78803 | TC | Tumor imaging (3D).... | $490 | |||
| 78804 | 26 | Tumor imaging whole body | $103 | |||
| 78804 | TC | Tumor imaging whole body | $1,085 | |||
| 78804 | Tumor imaging whole body | $1,188 | ||||
| 78805 | Abscess imaging, ltd area | $330 | ||||
| 78805 | 26 | Abscess imaging, ltd area | $76 | |||
| 78805 | TC | Abscess imaging, ltd area | $254 | |||
| 78806 | Abscess imaging, whole body | $544 | ||||
| 78806 | 26 | Abscess imaging, whole body | $83 | |||
| 78806 | TC | Abscess imaging, whole body | $462 | |||
| 78807 | Nuclear localization/abscess | $586 | ||||
| 78807 | 26 | Nuclear localization/abscess | $117 | |||
| 78807 | TC | Nuclear localization/abscess | $470 | |||
| 78808 | Iv inj ra drug dx study | $84 | ||||
| 78811 | Pet image ltd area | $158 | ||||
| 78812 | Pet image skull-thigh | $192 | ||||
| 78813 | Pet image full body | $201 | ||||
| 78814 | Pet image w/ct lmtd | $221 | ||||
| 78815 | Pet image w/ct skull-thigh | $243 | ||||
| 78816 | Pet image w/ct full body | $245 | ||||
| 78990 | Provide diag radionuclide(s) | BR | ||||
| 78999 | Nuclear diagnostic exam | BR | ||||
| 78999 | 26 | Nuclear diagnostic exam | BR | |||
| 78999 | TC | Nuclear diagnostic exam | BR | |||
| 79005 | 26 | Nuclear rx oral admin | $176 | |||
| 79005 | TC | Nuclear rx oral admin | $95 | |||
| 79005 | Nuclear rx oral admin | $271 | ||||
| 79101 | 26 | Nuclear rx iv admin | $204 | |||
| 79101 | TC | Nuclear rx iv admin | $102 | |||
| 79101 | Nuclear rx iv admin | $306 | ||||
| 79200 | Intracavitary nuc treatment | $403 | ||||
| 79200 | 26 | Intracavitary nuc treatment | $214 | |||
| 79200 | TC | Intracavitary nuc treatment | $189 | |||
| 79300 | Interstitial nuclear therapy | BR | ||||
| 79300 | 26 | Interstitial nuclear therapy | $172 | |||
| 79300 | TC | Interstitial nuclear therapy | BR | |||
| 79403 | 26 | Hematopoietic nuclear tx | $218 | |||
| 79403 | TC | Hematopoietic nuclear tx | $156 | |||
| 79403 | Hematopoietic nuclear tx | $374 | ||||
| 79440 | Nuclear joint therapy | $403 | ||||
| 79440 | 26 | Nuclear joint therapy | $214 | |||
| 79440 | TC | Nuclear joint therapy | $189 | |||
| 79445 | Nuclear rx intra-arterial | $236 | ||||
| 79900 | Provide ther radiopharm(s) | BR | ||||
| 80048 | Basic metabolic panel | BR | ||||
| 80050 | General health panel.. | BR | ||||
| 80050 | 26 | General health panel.. | BR | |||
| 80050 | TC | General health panel.. | BR | |||
| 80051 | Electrolyte panel..... | BR | ||||
| 80053 | Comprehen metabolic panel | BR | ||||
| 80055 | Obstetric panel....... | $106 | ||||
| 80055 | 26 | Obstetric panel....... | $43 | |||
| 80055 | TC | Obstetric panel....... | $63 | |||
| 80061 | Lipid panel | $88 | ||||
| 80061 | 26 | Lipid panel | $43 | |||
| 80061 | TC | Lipid panel | $45 | |||
| 80069 | Renal function panel.. | BR | ||||
| 80074 | Acute hepatitis panel | BR | ||||
| 80076 | Hepatic function panel | BR | ||||
| 80100 | Drug screen | $71 | ||||
| 80100 | 26 | Drug screen | $20 | |||
| 80100 | TC | Drug screen | $51 | |||
| 80101 | Drug screen | $65 | ||||
| 80101 | 26 | Drug screen | $18 | |||
| 80101 | TC | Drug screen | $47 | |||
| 80102 | Drug confirmation | $106 | ||||
| 80102 | 26 | Drug confirmation | $33 | |||
| 80102 | TC | Drug confirmation | $73 | |||
| 80103 | Drug analysis, tissue | BR | ||||
| 80103 | 26 | Drug analysis, tissue | BR | |||
| 80103 | TC | Drug analysis, tissue | BR | |||
| 80150 | Assay of amikacin | $75 | ||||
| 80150 | 26 | Assay of amikacin | $24 | |||
| 80150 | TC | Assay of amikacin | $51 | |||
| 80152 | Assay of amitriptyline | $81 | ||||
| 80152 | 26 | Assay of amitriptyline | $26 | |||
| 80152 | TC | Assay of amitriptyline | $55 | |||
| 80154 | Assay of benzodiazepin | $92 | ||||
| 80154 | 26 | Assay of benzodiazepin | $29 | |||
| 80154 | TC | Assay of benzodiazepin | $63 | |||
| 80156 | Assay carbamazepine | $65 | ||||
| 80156 | 26 | Assay carbamazepine | $20 | |||
| 80156 | TC | Assay carbamazepine | $45 | |||
| 80158 | Assay of cyclosporine | BR | ||||
| 80158 | 26 | Assay of cyclosporine | BR | |||
| 80158 | TC | Assay of cyclosporine | BR | |||
| 80160 | Assay of desipramine | BR | ||||
| 80160 | 26 | Assay of desipramine | BR | |||
| 80160 | TC | Assay of desipramine | BR | |||
| 80162 | Assay for digoxin | $61 | ||||
| 80162 | 26 | Assay for digoxin | $18 | |||
| 80162 | TC | Assay for digoxin | $43 | |||
| 80164 | Assay, dipropylacetic | BR | ||||
| 80164 | 26 | Assay, dipropylacetic | BR | |||
| 80164 | TC | Assay, dipropylacetic | BR | |||
| 80166 | Assay of doxepin | $65 | ||||
| 80166 | 26 | Assay of doxepin | $18 | |||
| 80166 | TC | Assay of doxepin | $47 | |||
| 80168 | Assay of ethosuximide | $82 | ||||
| 80168 | 26 | Assay of ethosuximide | $33 | |||
| 80168 | TC | Assay of ethosuximide | $49 | |||
| 80170 | Gentamicin | $84 | ||||
| 80170 | 26 | Gentamicin | $29 | |||
| 80170 | TC | Gentamicin | $55 | |||
| 80172 | Assay for gold | $83 | ||||
| 80172 | 26 | Assay for gold | $24 | |||
| 80172 | TC | Assay for gold | $59 | |||
| 80174 | Assay of imipramine | $77 | ||||
| 80174 | 26 | Assay of imipramine | $22 | |||
| 80174 | TC | Assay of imipramine | $55 | |||
| 80176 | Assay for lidocaine | $65 | ||||
| 80176 | 26 | Assay for lidocaine | $20 | |||
| 80176 | TC | Assay for lidocaine | $45 | |||
| 80178 | Assay for lithium | $32 | ||||
| 80178 | 26 | Assay for lithium | $12 | |||
| 80178 | TC | Assay for lithium | $20 | |||
| 80182 | Assay for nortriptylin | BR | ||||
| 80182 | 26 | Assay for nortriptylin | BR | |||
| 80182 | TC | Assay for nortriptylin | BR | |||
| 80184 | Assay for phenobarbita | BR | ||||
| 80184 | 26 | Assay for phenobarbita | BR | |||
| 80184 | TC | Assay for phenobarbita | BR | |||
| 80185 | Assay for phenytoin | $67 | ||||
| 80185 | 26 | Assay for phenytoin | $18 | |||
| 80185 | TC | Assay for phenytoin | $49 | |||
| 80186 | Assay for phenytoin, f | BR | ||||
| 80186 | 26 | Assay for phenytoin, f | BR | |||
| 80186 | TC | Assay for phenytoin, f | BR | |||
| 80188 | Assay for primidone | $65 | ||||
| 80188 | 26 | Assay for primidone | $20 | |||
| 80188 | TC | Assay for primidone | $45 | |||
| 80190 | Assay for procainamide | $77 | ||||
| 80190 | 26 | Assay for procainamide | $24 | |||
| 80190 | TC | Assay for procainamide | $53 | |||
| 80192 | Assay for procainamide | BR | ||||
| 80192 | 26 | Assay for procainamide | BR | |||
| 80192 | TC | Assay for procainamide | BR | |||
| 80194 | Assay for quinidine | $61 | ||||
| 80194 | 26 | Assay for quinidine | $18 | |||
| 80194 | TC | Assay for quinidine | $43 | |||
| 80196 | Assay for salicylate | $34 | ||||
| 80196 | 26 | Assay for salicylate | $10 | |||
| 80196 | TC | Assay for salicylate | $24 | |||
| 80197 | Assay of tacrolimus... | BR | ||||
| 80198 | Assay for theophylline | $51 | ||||
| 80198 | 26 | Assay for theophylline | $12 | |||
| 80198 | TC | Assay for theophylline | $39 | |||
| 80200 | Assay for tobramycin | $79 | ||||
| 80200 | 26 | Assay for tobramycin | $26 | |||
| 80200 | TC | Assay for tobramycin | $53 | |||
| 80201 | Assay of topiramate... | BR | ||||
| 80202 | Assay for vancomycin | BR | ||||
| 80202 | 26 | Assay for vancomycin | BR | |||
| 80202 | TC | Assay for vancomycin | BR | |||
| 80299 | Quantitative assay, dr | BR | ||||
| 80299 | 26 | Quantitative assay, dr | BR | |||
| 80299 | TC | Quantitative assay, dr | BR | |||
| 80400 | Acth stimulation panel | $141 | ||||
| 80400 | 26 | Acth stimulation panel | $41 | |||
| 80400 | TC | Acth stimulation panel | $100 | |||
| 80402 | Acth stimulation panel | $254 | ||||
| 80402 | 26 | Acth stimulation panel | $79 | |||
| 80402 | TC | Acth stimulation panel | $175 | |||
| 80406 | Acth stimulation panel | $254 | ||||
| 80406 | 26 | Acth stimulation panel | $79 | |||
| 80406 | TC | Acth stimulation panel | $175 | |||
| 80408 | Aldosterone suppressio | $312 | ||||
| 80408 | 26 | Aldosterone suppressio | $102 | |||
| 80408 | TC | Aldosterone suppressio | $210 | |||
| 80410 | Calcitonin stimul panel. | $289 | ||||
| 80410 | 26 | Calcitonin stimul panel. | $92 | |||
| 80410 | TC | Calcitonin stimul panel. | $197 | |||
| 80412 | CRH stimulation panel | $570 | ||||
| 80412 | 26 | CRH stimulation panel | $163 | |||
| 80412 | TC | CRH stimulation panel | $407 | |||
| 80414 | Testosterone response | $306 | ||||
| 80414 | 26 | Testosterone response | $98 | |||
| 80414 | TC | Testosterone response | $208 | |||
| 80415 | Estradiol response pan | $252 | ||||
| 80415 | 26 | Estradiol response pan | $61 | |||
| 80415 | TC | Estradiol response pan | $191 | |||
| 80416 | Renin stimulation panel | BR | ||||
| 80417 | Renin stimulation panel | BR | ||||
| 80418 | Pituitary evaluation p | $1,303 | ||||
| 80418 | 26 | Pituitary evaluation p | $350 | |||
| 80418 | TC | Pituitary evaluation p | $953 | |||
| 80420 | Dexamethasone panel | $197 | ||||
| 80420 | 26 | Dexamethasone panel | $61 | |||
| 80420 | TC | Dexamethasone panel | $136 | |||
| 80422 | Glucagon tolerance pan | $116 | ||||
| 80422 | 26 | Glucagon tolerance pan | $35 | |||
| 80422 | TC | Glucagon tolerance pan | $81 | |||
| 80424 | Glucagon tolerance pan | $173 | ||||
| 80424 | 26 | Glucagon tolerance pan | $51 | |||
| 80424 | TC | Glucagon tolerance pan | $122 | |||
| 80426 | Gonadotropin hormone p | $269 | ||||
| 80426 | 26 | Gonadotropin hormone p | $53 | |||
| 80426 | TC | Gonadotropin hormone p | $216 | |||
| 80428 | Growth hormone panel | $171 | ||||
| 80428 | 26 | Growth hormone panel | $37 | |||
| 80428 | TC | Growth hormone panel | $134 | |||
| 80430 | Growth hormone panel | $183 | ||||
| 80430 | 26 | Growth hormone panel | $47 | |||
| 80430 | TC | Growth hormone panel | $136 | |||
| 80432 | Insulin suppression pa | $448 | ||||
| 80432 | 26 | Insulin suppression pa | $106 | |||
| 80432 | TC | Insulin suppression pa | $342 | |||
| 80434 | Insulin tolerance pane | $214 | ||||
| 80434 | 26 | Insulin tolerance pane | $61 | |||
| 80434 | TC | Insulin tolerance pane | $153 | |||
| 80435 | Insulin tolerance pane | $220 | ||||
| 80435 | 26 | Insulin tolerance pane | $61 | |||
| 80435 | TC | Insulin tolerance pane | $159 | |||
| 80436 | Metyrapone panel | $222 | ||||
| 80436 | 26 | Metyrapone panel | $65 | |||
| 80436 | TC | Metyrapone panel | $157 | |||
| 80438 | TRH stimulation panel | $89 | ||||
| 80438 | 26 | TRH stimulation panel | $22 | |||
| 80438 | TC | TRH stimulation panel | $67 | |||
| 80439 | TRH stimulation panel | $119 | ||||
| 80439 | 26 | TRH stimulation panel | $29 | |||
| 80439 | TC | TRH stimulation panel | $90 | |||
| 80440 | TRH stimulation panel | $149 | ||||
| 80440 | 26 | TRH stimulation panel | $49 | |||
| 80440 | TC | TRH stimulation panel | $100 | |||
| 80500 | Lab pathology consulta | $63 | ||||
| 80500 | 26 | Lab pathology consulta | $63 | |||
| 80500 | TC | Lab pathology consulta | $0 | |||
| 80502 | Lab pathology consulta | $132 | ||||
| 80502 | 26 | Lab pathology consulta | $132 | |||
| 80502 | TC | Lab pathology consulta | $0 | |||
| 81000 | Urinalysis, nonauto w/scope | $16 | ||||
| 81000 | 26 | Urinalysis, nonauto w/scope | $7 | |||
| 81000 | TC | Urinalysis, nonauto w/scope | $9 | |||
| 81001 | Urinalysis, auto w/ scope | $16 | ||||
| 81001 | 26 | Urinalysis, auto w/ scope | $7 | |||
| 81001 | TC | Urinalysis, auto w/ scope | $9 | |||
| 81002 | Urinalysis nonauto w/o scope | $14 | ||||
| 81002 | 26 | Urinalysis nonauto w/o scope | $7 | |||
| 81002 | TC | Urinalysis nonauto w/o scope | $7 | |||
| 81003 | Urinalysis, auto, w/o scope | $10 | ||||
| 81003 | 26 | Urinalysis, auto, w/o scope | $4 | |||
| 81003 | TC | Urinalysis, auto, w/o scope | $6 | |||
| 81005 | Urinalysis | $6 | ||||
| 81005 | 26 | Urinalysis | $2 | |||
| 81005 | TC | Urinalysis | $4 | |||
| 81007 | Urine screen for bacte | $6 | ||||
| 81007 | 26 | Urine screen for bacte | $2 | |||
| 81007 | TC | Urine screen for bacte | $4 | |||
| 81015 | Microscopic exam of ur | $10 | ||||
| 81015 | 26 | Microscopic exam of ur | $4 | |||
| 81015 | TC | Microscopic exam of ur | $6 | |||
| 81020 | Urinalysis, glass test | BR | ||||
| 81025 | Urine pregnancy test | $8 | ||||
| 81025 | 26 | Urine pregnancy test | $4 | |||
| 81025 | TC | Urine pregnancy test | $4 | |||
| 81050 | Urinalysis, volume mea | BR | ||||
| 81050 | 26 | Urinalysis, volume mea | BR | |||
| 81050 | TC | Urinalysis, volume mea | BR | |||
| 81099 | Urinalysis test proced | BR | ||||
| 81099 | 26 | Urinalysis test proced | BR | |||
| 81099 | TC | Urinalysis test proced | BR | |||
| 82000 | Assay blood acetaldehy | $47 | ||||
| 82000 | 26 | Assay blood acetaldehy | $14 | |||
| 82000 | TC | Assay blood acetaldehy | $33 | |||
| 82003 | Assay acetaminophen | $67 | ||||
| 82003 | 26 | Assay acetaminophen | $18 | |||
| 82003 | TC | Assay acetaminophen | $49 | |||
| 82009 | Test for acetone/keton | $18 | ||||
| 82009 | 26 | Test for acetone/keton | $6 | |||
| 82009 | TC | Test for acetone/keton | $12 | |||
| 82010 | Acetone assay | $43 | ||||
| 82010 | 26 | Acetone assay | $14 | |||
| 82010 | TC | Acetone assay | $29 | |||
| 82013 | Acetylcholinesterase a | $47 | ||||
| 82013 | 26 | Acetylcholinesterase a | $14 | |||
| 82013 | TC | Acetylcholinesterase a | $33 | |||
| 82016 | Acylcarnitines, qual.. | BR | ||||
| 82017 | Acylcarnitines, quant | BR | ||||
| 82024 | ACTH | $143 | ||||
| 82024 | 26 | ACTH | $43 | |||
| 82024 | TC | ACTH | $100 | |||
| 82030 | ADP & AMP | $82 | ||||
| 82030 | 26 | ADP & AMP | $33 | |||
| 82030 | TC | ADP & AMP | $49 | |||
| 82040 | Assay serum albumin | $20 | ||||
| 82040 | 26 | Assay serum albumin | $6 | |||
| 82040 | TC | Assay serum albumin | $14 | |||
| 82042 | Assay urine albumin | $22 | ||||
| 82042 | 26 | Assay urine albumin | $6 | |||
| 82042 | TC | Assay urine albumin | $16 | |||
| 82043 | Microalbumin, quantita | BR | ||||
| 82043 | 26 | Microalbumin, quantita | BR | |||
| 82043 | TC | Microalbumin, quantita | BR | |||
| 82044 | Microalbumin, semiquan | BR | ||||
| 82044 | 26 | Microalbumin, semiquan | BR | |||
| 82044 | TC | Microalbumin, semiquan | BR | |||
| 82055 | Assay ethanol | $61 | ||||
| 82055 | 26 | Assay ethanol | $18 | |||
| 82055 | TC | Assay ethanol | $43 | |||
| 82075 | Assay breath ethanol | $59 | ||||
| 82075 | 26 | Assay breath ethanol | $18 | |||
| 82075 | TC | Assay breath ethanol | $41 | |||
| 82085 | Assay of aldolase | $47 | ||||
| 82085 | 26 | Assay of aldolase | $14 | |||
| 82085 | TC | Assay of aldolase | $33 | |||
| 82088 | Aldosterone | $169 | ||||
| 82088 | 26 | Aldosterone | $53 | |||
| 82088 | TC | Aldosterone | $116 | |||
| 82101 | Assay of urine alkaloi | $112 | ||||
| 82101 | 26 | Assay of urine alkaloi | $35 | |||
| 82101 | TC | Assay of urine alkaloi | $77 | |||
| 82103 | Alpha-1-antitrypsin, t | BR | ||||
| 82103 | 26 | Alpha-1-antitrypsin, t | BR | |||
| 82103 | TC | Alpha-1-antitrypsin, t | BR | |||
| 82104 | Alpha-1-antitrypsin, p | BR | ||||
| 82104 | 26 | Alpha-1-antitrypsin, p | BR | |||
| 82104 | TC | Alpha-1-antitrypsin, p | BR | |||
| 82105 | Alpha-fetoprotein, ser | BR | ||||
| 82105 | 26 | Alpha-fetoprotein, ser | BR | |||
| 82105 | TC | Alpha-fetoprotein, ser | BR | |||
| 82106 | Alpha-fetoprotein; amn | BR | ||||
| 82106 | 26 | Alpha-fetoprotein; amn | BR | |||
| 82106 | TC | Alpha-fetoprotein; amn | BR | |||
| 82108 | Assay, aluminum | $85 | ||||
| 82108 | 26 | Assay, aluminum | $26 | |||
| 82108 | TC | Assay, aluminum | $59 | |||
| 82120 | Amines, vaginal fluid qual | BR | ||||
| 82127 | Amino acid, single qual | $54 | ||||
| 82127 | 26 | Amino acid, single qual | $14 | |||
| 82127 | TC | Amino acid, single qual | $40 | |||
| 82128 | Amino acids, mult qual | $54 | ||||
| 82128 | 26 | Amino acids, mult qual | $14 | |||
| 82128 | TC | Amino acids, mult qual | $40 | |||
| 82131 | Amino acids, single quant | BR | ||||
| 82131 | 26 | Amino acids, single quant | BR | |||
| 82131 | TC | Amino acids, single quant | BR | |||
| 82135 | Assay, aminolevulinic | $77 | ||||
| 82135 | 26 | Assay, aminolevulinic | $24 | |||
| 82135 | TC | Assay, aminolevulinic | $53 | |||
| 82136 | Amino acids, quant, 2- 5 | BR | ||||
| 82136 | 26 | Amino acids, quant, 2- 5 | BR | |||
| 82136 | TC | Amino acids, quant, 2- 5 | BR | |||
| 82139 | Amino acids, quan, 6 or more | BR | ||||
| 82139 | 26 | Amino acids, quan, 6 or more | BR | |||
| 82139 | TC | Amino acids, quan, 6 or more | BR | |||
| 82140 | Assay of ammonia | $75 | ||||
| 82140 | 26 | Assay of ammonia | $22 | |||
| 82140 | TC | Assay of ammonia | $53 | |||
| 82143 | Amniotic fluid scan | $53 | ||||
| 82143 | 26 | Amniotic fluid scan | $16 | |||
| 82143 | TC | Amniotic fluid scan | $37 | |||
| 82145 | Assay of amphetamines | $65 | ||||
| 82145 | 26 | Assay of amphetamines | $18 | |||
| 82145 | TC | Assay of amphetamines | $47 | |||
| 82150 | Assay of amylase | $30 | ||||
| 82150 | 26 | Assay of amylase | $10 | |||
| 82150 | TC | Assay of amylase | $20 | |||
| 82154 | Androstanediol glucuro | BR | ||||
| 82154 | 26 | Androstanediol glucuro | BR | |||
| 82154 | TC | Androstanediol glucuro | BR | |||
| 82157 | Assay of androstenedio | $108 | ||||
| 82157 | 26 | Assay of androstenedio | $33 | |||
| 82157 | TC | Assay of androstenedio | $75 | |||
| 82160 | Androsterone assay | $122 | ||||
| 82160 | 26 | Androsterone assay | $41 | |||
| 82160 | TC | Androsterone assay | $81 | |||
| 82163 | Assay of angiotensin I | $79 | ||||
| 82163 | 26 | Assay of angiotensin I | $22 | |||
| 82163 | TC | Assay of angiotensin I | $57 | |||
| 82164 | Angiotensin I enzyme t | $59 | ||||
| 82164 | 26 | Angiotensin I enzyme t | $18 | |||
| 82164 | TC | Angiotensin I enzyme t | $41 | |||
| 82172 | Apolipoprotein | $65 | ||||
| 82172 | 26 | Apolipoprotein | $20 | |||
| 82172 | TC | Apolipoprotein | $45 | |||
| 82175 | Assay of arsenic | $90 | ||||
| 82175 | 26 | Assay of arsenic | $29 | |||
| 82175 | TC | Assay of arsenic | $61 | |||
| 82180 | Assay of ascorbic acid | $49 | ||||
| 82180 | 26 | Assay of ascorbic acid | $16 | |||
| 82180 | TC | Assay of ascorbic acid | $33 | |||
| 82190 | Atomic absorption | BR | ||||
| 82190 | 26 | Atomic absorption | BR | |||
| 82190 | TC | Atomic absorption | BR | |||
| 82205 | Assay of barbiturates | $63 | ||||
| 82205 | 26 | Assay of barbiturates | $18 | |||
| 82205 | TC | Assay of barbiturates | $45 | |||
| 82232 | Beta-2 protein | $81 | ||||
| 82232 | 26 | Beta-2 protein | $26 | |||
| 82232 | TC | Beta-2 protein | $55 | |||
| 82239 | Bile acids, total | BR | ||||
| 82239 | 26 | Bile acids, total | BR | |||
| 82239 | TC | Bile acids, total | BR | |||
| 82240 | Bile acids, cholylglyc | $92 | ||||
| 82240 | 26 | Bile acids, cholylglyc | $29 | |||
| 82240 | TC | Bile acids, cholylglyc | $63 | |||
| 82247 | Bilirubin, total...... | BR | ||||
| 82247 | 26 | Bilirubin, total...... | BR | |||
| 82247 | TC | Bilirubin, total...... | BR | |||
| 82248 | Bilirubin, direct..... | BR | ||||
| 82248 | 26 | Bilirubin, direct..... | BR | |||
| 82248 | TC | Bilirubin, direct..... | BR | |||
| 82252 | Fecal bilirubin test | $20 | ||||
| 82252 | 26 | Fecal bilirubin test | $6 | |||
| 82252 | TC | Fecal bilirubin test | $14 | |||
| 82261 | Assay of biotinidase.. | BR | ||||
| 82270 | Test for blood, feces | $12 | ||||
| 82270 | 26 | Test for blood, feces | $5 | |||
| 82270 | TC | Test for blood, feces | $7 | |||
| 82286 | Assay of bradykinin | $22 | ||||
| 82286 | 26 | Assay of bradykinin | $6 | |||
| 82286 | TC | Assay of bradykinin | $16 | |||
| 82300 | Assay cadmium | $90 | ||||
| 82300 | 26 | Assay cadmium | $29 | |||
| 82300 | TC | Assay cadmium | $61 | |||
| 82306 | Assay of vitamin D | $147 | ||||
| 82306 | 26 | Assay of vitamin D | $49 | |||
| 82306 | TC | Assay of vitamin D | $98 | |||
| 82308 | Assay of calcitonin | $116 | ||||
| 82308 | 26 | Assay of calcitonin | $35 | |||
| 82308 | TC | Assay of calcitonin | $81 | |||
| 82310 | Assay calcium | $20 | ||||
| 82310 | 26 | Assay calcium | $6 | |||
| 82310 | TC | Assay calcium | $14 | |||
| 82330 | Assay calcium | $69 | ||||
| 82330 | 26 | Assay calcium | $20 | |||
| 82330 | TC | Assay calcium | $49 | |||
| 82331 | Calcium infusion test | $26 | ||||
| 82331 | 26 | Calcium infusion test | $8 | |||
| 82331 | TC | Calcium infusion test | $18 | |||
| 82340 | Assay calcium in urine | $24 | ||||
| 82340 | 26 | Assay calcium in urine | $8 | |||
| 82340 | TC | Assay calcium in urine | $16 | |||
| 82355 | Calculus (stone) analy | $57 | ||||
| 82355 | 26 | Calculus (stone) analy | $18 | |||
| 82355 | TC | Calculus (stone) analy | $39 | |||
| 82360 | Calculus (stone) assay | $57 | ||||
| 82360 | 26 | Calculus (stone) assay | $18 | |||
| 82360 | TC | Calculus (stone) assay | $39 | |||
| 82365 | Calculus (stone) assay | $57 | ||||
| 82365 | 26 | Calculus (stone) assay | $16 | |||
| 82365 | TC | Calculus (stone) assay | $41 | |||
| 82370 | X-ray assay, calculus | $43 | ||||
| 82370 | 26 | X-ray assay, calculus | $14 | |||
| 82370 | TC | X-ray assay, calculus | $29 | |||
| 82374 | Assay blood carbon dio | $18 | ||||
| 82374 | 26 | Assay blood carbon dio | $6 | |||
| 82374 | TC | Assay blood carbon dio | $12 | |||
| 82375 | Assay blood carbon mon | $63 | ||||
| 82375 | 26 | Assay blood carbon mon | $18 | |||
| 82375 | TC | Assay blood carbon mon | $45 | |||
| 82376 | Test for carbon monoxi | $20 | ||||
| 82376 | 26 | Test for carbon monoxi | $6 | |||
| 82376 | TC | Test for carbon monoxi | $14 | |||
| 82378 | Carcinoembryonic antig | BR | ||||
| 82378 | 26 | Carcinoembryonic antig | BR | |||
| 82378 | TC | Carcinoembryonic antig | BR | |||
| 82379 | Assay of carnitine.... | BR | ||||
| 82380 | Assay carotene | $41 | ||||
| 82380 | 26 | Assay carotene | $12 | |||
| 82380 | TC | Assay carotene | $29 | |||
| 82382 | Assay urine catecholam | $71 | ||||
| 82382 | 26 | Assay urine catecholam | $22 | |||
| 82382 | TC | Assay urine catecholam | $49 | |||
| 82383 | Assay blood catecholam | $116 | ||||
| 82383 | 26 | Assay blood catecholam | $35 | |||
| 82383 | TC | Assay blood catecholam | $81 | |||
| 82384 | Assay three catecholam | $116 | ||||
| 82384 | 26 | Assay three catecholam | $35 | |||
| 82384 | TC | Assay three catecholam | $81 | |||
| 82387 | Cathepsin-D | BR | ||||
| 82387 | 26 | Cathepsin-D | BR | |||
| 82387 | TC | Cathepsin-D | BR | |||
| 82390 | Assay ceruloplasmin | $47 | ||||
| 82390 | 26 | Assay ceruloplasmin | $14 | |||
| 82390 | TC | Assay ceruloplasmin | $33 | |||
| 82397 | Chemiluminescent assay | BR | ||||
| 82397 | 26 | Chemiluminescent assay | BR | |||
| 82397 | TC | Chemiluminescent assay | BR | |||
| 82415 | Assay chloramphenicol | $53 | ||||
| 82415 | 26 | Assay chloramphenicol | $16 | |||
| 82415 | TC | Assay chloramphenicol | $37 | |||
| 82435 | Assay blood chloride | $16 | ||||
| 82435 | 26 | Assay blood chloride | $4 | |||
| 82435 | TC | Assay blood chloride | $12 | |||
| 82436 | Assay urine chloride | $26 | ||||
| 82436 | 26 | Assay urine chloride | $8 | |||
| 82436 | TC | Assay urine chloride | $18 | |||
| 82438 | Assay other fluid chlo | $24 | ||||
| 82438 | 26 | Assay other fluid chlo | $8 | |||
| 82438 | TC | Assay other fluid chlo | $16 | |||
| 82441 | Test for chlorohydroca | $30 | ||||
| 82441 | 26 | Test for chlorohydroca | $10 | |||
| 82441 | TC | Test for chlorohydroca | $20 | |||
| 82465 | Assay serum cholestero | $16 | ||||
| 82465 | 26 | Assay serum cholestero | $4 | |||
| 82465 | TC | Assay serum cholestero | $12 | |||
| 82480 | Assay serum cholineste | $45 | ||||
| 82480 | 26 | Assay serum cholineste | $12 | |||
| 82480 | TC | Assay serum cholineste | $33 | |||
| 82482 | Assay rbc cholinestera | $53 | ||||
| 82482 | 26 | Assay rbc cholinestera | $16 | |||
| 82482 | TC | Assay rbc cholinestera | $37 | |||
| 82485 | Assay chondroitin sulf | $69 | ||||
| 82485 | 26 | Assay chondroitin sulf | $16 | |||
| 82485 | TC | Assay chondroitin sulf | $53 | |||
| 82486 | Gas/liquid chromatography | $79 | ||||
| 82486 | 26 | Gas/liquid chromatography | $26 | |||
| 82486 | TC | Gas/liquid chromatography | $53 | |||
| 82487 | Paper chromatography | $81 | ||||
| 82487 | 26 | Paper chromatography | $26 | |||
| 82487 | TC | Paper chromatography | $55 | |||
| 82488 | Paper chromatography | $108 | ||||
| 82488 | 26 | Paper chromatography | $37 | |||
| 82488 | TC | Paper chromatography | $71 | |||
| 82489 | Thin layer chromatogra | $88 | ||||
| 82489 | 26 | Thin layer chromatogra | $29 | |||
| 82489 | TC | Thin layer chromatogra | $59 | |||
| 82491 | Chromotography, quant, sing | BR | ||||
| 82491 | 26 | Chromotography, quant, sing | BR | |||
| 82491 | TC | Chromotography, quant, sing | BR | |||
| 82492 | Chromotography, quant, sing mult | BR | ||||
| 82495 | Assay chromium | $90 | ||||
| 82495 | 26 | Assay chromium | $31 | |||
| 82495 | TC | Assay chromium | $59 | |||
| 82507 | Assay citrate | $104 | ||||
| 82507 | 26 | Assay citrate | $31 | |||
| 82507 | TC | Assay citrate | $73 | |||
| 82520 | Assay for cocaine | $51 | ||||
| 82520 | 26 | Assay for cocaine | $16 | |||
| 82520 | TC | Assay for cocaine | $35 | |||
| 82523 | Collagen crosslinks... | BR | ||||
| 82525 | Assay copper | $63 | ||||
| 82525 | 26 | Assay copper | $18 | |||
| 82525 | TC | Assay copper | $45 | |||
| 82528 | Assay corticosterone | $75 | ||||
| 82528 | 26 | Assay corticosterone | $24 | |||
| 82528 | TC | Assay corticosterone | $51 | |||
| 82530 | Cortisol, free | BR | ||||
| 82530 | 26 | Cortisol, free | BR | |||
| 82530 | TC | Cortisol, free | BR | |||
| 82533 | Total cortisol | $65 | ||||
| 82533 | 26 | Total cortisol | $18 | |||
| 82533 | TC | Total cortisol | $47 | |||
| 82540 | Assay creatine | $18 | ||||
| 82540 | 26 | Assay creatine | $6 | |||
| 82540 | TC | Assay creatine | $12 | |||
| 82541 | Column chromotography, qual | BR | ||||
| 82542 | Column chromotography, quant | BR | ||||
| 82543 | Column chromotograph/ isotope | BR | ||||
| 82544 | Column chromotograph/isotope | BR | ||||
| 82550 | Assay CK (CPK) | $30 | ||||
| 82550 | 26 | Assay CK (CPK) | $8 | |||
| 82550 | TC | Assay CK (CPK) | $22 | |||
| 82552 | Assay CPK in blood | $61 | ||||
| 82552 | 26 | Assay CPK in blood | $18 | |||
| 82552 | TC | Assay CPK in blood | $43 | |||
| 82553 | Creatine, MB fraction | BR | ||||
| 82553 | 26 | Creatine, MB fraction | BR | |||
| 82553 | TC | Creatine, MB fraction | BR | |||
| 82554 | Creatine, isoforms | BR | ||||
| 82554 | 26 | Creatine, isoforms | BR | |||
| 82554 | TC | Creatine, isoforms | BR | |||
| 82565 | Assay creatinine | $24 | ||||
| 82565 | 26 | Assay creatinine | $4 | |||
| 82565 | TC | Assay creatinine | $20 | |||
| 82570 | Assay urine creatinine | $24 | ||||
| 82570 | 26 | Assay urine creatinine | $6 | |||
| 82570 | TC | Assay urine creatinine | $18 | |||
| 82575 | Creatinine clearance t | $49 | ||||
| 82575 | 26 | Creatinine clearance t | $16 | |||
| 82575 | TC | Creatinine clearance t | $33 | |||
| 82585 | Assay cryofibrinogen | $28 | ||||
| 82585 | 26 | Assay cryofibrinogen | $6 | |||
| 82585 | TC | Assay cryofibrinogen | $22 | |||
| 82595 | Assay cryoglobulin | $32 | ||||
| 82595 | 26 | Assay cryoglobulin | $10 | |||
| 82595 | TC | Assay cryoglobulin | $22 | |||
| 82600 | Assay cyanide | $75 | ||||
| 82600 | 26 | Assay cyanide | $22 | |||
| 82600 | TC | Assay cyanide | $53 | |||
| 82607 | Vitamin B-12 | $77 | ||||
| 82607 | 26 | Vitamin B-12 | $22 | |||
| 82607 | TC | Vitamin B-12 | $55 | |||
| 82608 | B-12 binding capacity | $75 | ||||
| 82608 | 26 | B-12 binding capacity | $24 | |||
| 82608 | TC | B-12 binding capacity | $51 | |||
| 82615 | Test for urine cystine | $32 | ||||
| 82615 | 26 | Test for urine cystine | $10 | |||
| 82615 | TC | Test for urine cystine | $22 | |||
| 82626 | Dehydroepiandrosterone | $112 | ||||
| 82626 | 26 | Dehydroepiandrosterone | $37 | |||
| 82626 | TC | Dehydroepiandrosterone | $75 | |||
| 82627 | Dehydroepiandrosterone | BR | ||||
| 82627 | 26 | Dehydroepiandrosterone | BR | |||
| 82627 | TC | Dehydroepiandrosterone | BR | |||
| 82633 | Desoxycorticosterone | $151 | ||||
| 82633 | 26 | Desoxycorticosterone | $45 | |||
| 82633 | TC | Desoxycorticosterone | $106 | |||
| 82634 | Deoxycortisol | $151 | ||||
| 82634 | 26 | Deoxycortisol | $45 | |||
| 82634 | TC | Deoxycortisol | $106 | |||
| 82638 | Assay dibucaine number | $45 | ||||
| 82638 | 26 | Assay dibucaine number | $14 | |||
| 82638 | TC | Assay dibucaine number | $31 | |||
| 82646 | Assay of dihydrocodein | $69 | ||||
| 82646 | 26 | Assay of dihydrocodein | $20 | |||
| 82646 | TC | Assay of dihydrocodein | $49 | |||
| 82649 | Assay of dihydromorphi | $82 | ||||
| 82649 | 26 | Assay of dihydromorphi | $33 | |||
| 82649 | TC | Assay of dihydromorphi | $49 | |||
| 82651 | Dihydrotestosterone as | $82 | ||||
| 82651 | 26 | Dihydrotestosterone as | $33 | |||
| 82651 | TC | Dihydrotestosterone as | $49 | |||
| 82652 | Assay, dihydroxyvitami | $165 | ||||
| 82652 | 26 | Assay, dihydroxyvitami | $49 | |||
| 82652 | TC | Assay, dihydroxyvitami | $116 | |||
| 82654 | Assay of dimethadione | $69 | ||||
| 82654 | 26 | Assay of dimethadione | $20 | |||
| 82654 | TC | Assay of dimethadione | $49 | |||
| 82657 | Enzyme cell activity.. | BR | ||||
| 82658 | Enzyme cell activity, ra. | BR | ||||
| 82664 | Electrophoretic test | $75 | ||||
| 82664 | 26 | Electrophoretic test | $24 | |||
| 82664 | TC | Electrophoretic test | $51 | |||
| 82666 | Epiandrosterone assay | $110 | ||||
| 82666 | 26 | Epiandrosterone assay | $33 | |||
| 82666 | TC | Epiandrosterone assay | $77 | |||
| 82668 | Erythropoietin | $85 | ||||
| 82668 | 26 | Erythropoietin | $26 | |||
| 82668 | TC | Erythropoietin | $59 | |||
| 82670 | Estradiol | $114 | ||||
| 82670 | 26 | Estradiol | $35 | |||
| 82670 | TC | Estradiol | $79 | |||
| 82671 | Estrogens assay | $114 | ||||
| 82671 | 26 | Estrogens assay | $33 | |||
| 82671 | TC | Estrogens assay | $81 | |||
| 82672 | Estrogen assay | $108 | ||||
| 82672 | 26 | Estrogen assay | $31 | |||
| 82672 | TC | Estrogen assay | $77 | |||
| 82677 | Estriol | $98 | ||||
| 82677 | 26 | Estriol | $33 | |||
| 82677 | TC | Estriol | $65 | |||
| 82679 | Estrone | $129 | ||||
| 82679 | 26 | Estrone | $39 | |||
| 82679 | TC | Estrone | $90 | |||
| 82690 | Ethchlorvynol | $100 | ||||
| 82690 | 26 | Ethchlorvynol | $41 | |||
| 82690 | TC | Ethchlorvynol | $59 | |||
| 82693 | Ethylene glycol | BR | ||||
| 82693 | 26 | Ethylene glycol | BR | |||
| 82693 | TC | Ethylene glycol | BR | |||
| 82696 | Etiocholanolone | $108 | ||||
| 82696 | 26 | Etiocholanolone | $37 | |||
| 82696 | TC | Etiocholanolone | $71 | |||
| 82705 | Fats/lipids,feces,qual | $26 | ||||
| 82705 | 26 | Fats/lipids,feces,qual | $10 | |||
| 82705 | TC | Fats/lipids,feces,qual | $16 | |||
| 82710 | Fats/lipids,feces,quan | $79 | ||||
| 82710 | 26 | Fats/lipids,feces,quan | $24 | |||
| 82710 | TC | Fats/lipids,feces,quan | $55 | |||
| 82715 | Fecal fat assay | $61 | ||||
| 82715 | 26 | Fecal fat assay | $20 | |||
| 82715 | TC | Fecal fat assay | $41 | |||
| 82725 | Assay blood fatty acid | $53 | ||||
| 82725 | 26 | Assay blood fatty acid | $16 | |||
| 82725 | TC | Assay blood fatty acid | $37 | |||
| 82726 | Long chain fatty acids | BR | ||||
| 82728 | Assay ferritin | $47 | ||||
| 82728 | 26 | Assay ferritin | $14 | |||
| 82728 | TC | Assay ferritin | $33 | |||
| 82731 | Assay of fetal fibronectin. | BR | ||||
| 82735 | Assay fluoride | $67 | ||||
| 82735 | 26 | Assay fluoride | $22 | |||
| 82735 | TC | Assay fluoride | $45 | |||
| 82742 | Assay of flurazepam | $79 | ||||
| 82742 | 26 | Assay of flurazepam | $24 | |||
| 82742 | TC | Assay of flurazepam | $55 | |||
| 82746 | Blood folic acid serum | $73 | ||||
| 82746 | 26 | Blood folic acid serum | $24 | |||
| 82746 | TC | Blood folic acid serum | $49 | |||
| 82747 | Folic acid, RBC | BR | ||||
| 82747 | 26 | Folic acid, RBC | BR | |||
| 82747 | TC | Folic acid, RBC | BR | |||
| 82757 | Assay semen fructose | $67 | ||||
| 82757 | 26 | Assay semen fructose | $20 | |||
| 82757 | TC | Assay semen fructose | $47 | |||
| 82759 | RBC galactokinase assay | $71 | ||||
| 82759 | 26 | RBC galactokinase assay | $22 | |||
| 82759 | TC | RBC galactokinase assay | $49 | |||
| 82760 | Assay galactose | $51 | ||||
| 82760 | 26 | Assay galactose | $16 | |||
| 82760 | TC | Assay galactose | $35 | |||
| 82775 | Assay galactose transf | $87 | ||||
| 82775 | 26 | Assay galactose transf | $26 | |||
| 82775 | TC | Assay galactose transf | $61 | |||
| 82776 | Galactose transferase | $26 | ||||
| 82776 | 26 | Galactose transferase | $6 | |||
| 82776 | TC | Galactose transferase | $20 | |||
| 82784 | Assay gammaglobulin Ig | $28 | ||||
| 82784 | 26 | Assay gammaglobulin Ig | $8 | |||
| 82784 | TC | Assay gammaglobulin Ig | $20 | |||
| 82785 | Assay, gammaglobulin I | $61 | ||||
| 82785 | 26 | Assay, gammaglobulin I | $20 | |||
| 82785 | TC | Assay, gammaglobulin I | $41 | |||
| 82787 | IgG1, 2, 3 and 4 | BR | ||||
| 82787 | 26 | IgG1, 2, 3 and 4 | BR | |||
| 82787 | TC | IgG1, 2, 3 and 4 | BR | |||
| 82800 | Blood pH | $43 | ||||
| 82800 | 26 | Blood pH | $12 | |||
| 82800 | TC | Blood pH | $31 | |||
| 82803 | Blood gases: pH, pO2 & | $100 | ||||
| 82803 | 26 | Blood gases: pH, pO2 & | $31 | |||
| 82803 | TC | Blood gases: pH, pO2 & | $69 | |||
| 82805 | Blood gases W/02 satur | $53 | ||||
| 82805 | 26 | Blood gases W/02 satur | $16 | |||
| 82805 | TC | Blood gases W/02 satur | $37 | |||
| 82810 | Blood gases, O2 sat on | $53 | ||||
| 82810 | 26 | Blood gases, O2 sat on | $16 | |||
| 82810 | TC | Blood gases, O2 sat on | $37 | |||
| 82820 | Hemoglobin-oxygen affi | BR | ||||
| 82820 | 26 | Hemoglobin-oxygen affi | BR | |||
| 82820 | TC | Hemoglobin-oxygen affi | BR | |||
| 82938 | Gastrin test | $90 | ||||
| 82938 | 26 | Gastrin test | $31 | |||
| 82938 | TC | Gastrin test | $59 | |||
| 82941 | Assay of gastrin | $88 | ||||
| 82941 | 26 | Assay of gastrin | $29 | |||
| 82941 | TC | Assay of gastrin | $59 | |||
| 82943 | Assay of glucagon | $71 | ||||
| 82943 | 26 | Assay of glucagon | $22 | |||
| 82943 | TC | Assay of glucagon | $49 | |||
| 82946 | Glucagon tolerance test | $55 | ||||
| 82946 | 26 | Glucagon tolerance test | $14 | |||
| 82946 | TC | Glucagon tolerance test | $41 | |||
| 82947 | Assay quantitative, gl | $20 | ||||
| 82947 | 26 | Assay quantitative, gl | $6 | |||
| 82947 | TC | Assay quantitative, gl | $14 | |||
| 82948 | Reagent strip/blood gl | $10 | ||||
| 82948 | 26 | Reagent strip/blood gl | $4 | |||
| 82948 | TC | Reagent strip/blood gl | $6 | |||
| 82950 | Glucose test | $22 | ||||
| 82950 | 26 | Glucose test | $8 | |||
| 82950 | TC | Glucose test | $14 | |||
| 82951 | Glucose tolerance test | $43 | ||||
| 82951 | 26 | Glucose tolerance test | $14 | |||
| 82951 | TC | Glucose tolerance test | $29 | |||
| 82952 | GTT-added samples | $20 | ||||
| 82952 | 26 | GTT-added samples | $6 | |||
| 82952 | TC | GTT-added samples | $14 | |||
| 82953 | Glucose-tolbutamide test | $77 | ||||
| 82953 | 26 | Glucose-tolbutamide test | $26 | |||
| 82953 | TC | Glucose-tolbutamide test | $51 | |||
| 82955 | Assay G6PD enzyme | $49 | ||||
| 82955 | 26 | Assay G6PD enzyme | $14 | |||
| 82955 | TC | Assay G6PD enzyme | $35 | |||
| 82960 | Test for G6PD enzyme | $26 | ||||
| 82960 | 26 | Test for G6PD enzyme | $8 | |||
| 82960 | TC | Test for G6PD enzyme | $18 | |||
| 82962 | Glucose blood test | BR | ||||
| 82962 | 26 | Glucose blood test | BR | |||
| 82962 | TC | Glucose blood test | BR | |||
| 82963 | Glucosidase assay | $102 | ||||
| 82963 | 26 | Glucosidase assay | $33 | |||
| 82963 | TC | Glucosidase assay | $69 | |||
| 82965 | Assay GDH enzyme | $36 | ||||
| 82965 | 26 | Assay GDH enzyme | $12 | |||
| 82965 | TC | Assay GDH enzyme | $24 | |||
| 82975 | Assay glutamine | $53 | ||||
| 82975 | 26 | Assay glutamine | $16 | |||
| 82975 | TC | Assay glutamine | $37 | |||
| 82977 | Assay of GGT | $30 | ||||
| 82977 | 26 | Assay of GGT | $8 | |||
| 82977 | TC | Assay of GGT | $22 | |||
| 82978 | Glutathione assay | $49 | ||||
| 82978 | 26 | Glutathione assay | $14 | |||
| 82978 | TC | Glutathione assay | $35 | |||
| 82979 | Assay RBC glutathione | $34 | ||||
| 82979 | 26 | Assay RBC glutathione | $10 | |||
| 82979 | TC | Assay RBC glutathione | $24 | |||
| 82980 | Assay of glutethimide | $79 | ||||
| 82980 | 26 | Assay of glutethimide | $18 | |||
| 82980 | TC | Assay of glutethimide | $61 | |||
| 82985 | Glycated protein | $77 | ||||
| 82985 | 26 | Glycated protein | $22 | |||
| 82985 | TC | Glycated protein | $55 | |||
| 83001 | Gonadotropin (FSH) | $75 | ||||
| 83001 | 26 | Gonadotropin (FSH) | $22 | |||
| 83001 | TC | Gonadotropin (FSH) | $53 | |||
| 83002 | Gonadotropin (LH) | $79 | ||||
| 83002 | 26 | Gonadotropin (LH) | $24 | |||
| 83002 | TC | Gonadotropin (LH) | $55 | |||
| 83003 | Assay growth hormone | $67 | ||||
| 83003 | 26 | Assay growth hormone | $18 | |||
| 83003 | TC | Assay growth hormone | $49 | |||
| 83008 | Assay guanosine | $63 | ||||
| 83008 | 26 | Assay guanosine | $18 | |||
| 83008 | TC | Assay guanosine | $45 | |||
| 83010 | Quant assay haptoglobi | $51 | ||||
| 83010 | 26 | Quant assay haptoglobi | $16 | |||
| 83010 | TC | Quant assay haptoglobi | $35 | |||
| 83012 | Assay haptoglobins | $67 | ||||
| 83012 | 26 | Assay haptoglobins | $26 | |||
| 83012 | TC | Assay haptoglobins | $41 | |||
| 83013 | H pylori breath tst analysis. | BR | ||||
| 83014 | H pylori drug admin/collect | BR | ||||
| 83015 | Heavy metal screen | $96 | ||||
| 83015 | 26 | Heavy metal screen | $29 | |||
| 83015 | TC | Heavy metal screen | $67 | |||
| 83018 | Quantitative screen, m | $106 | ||||
| 83018 | 26 | Quantitative screen, m | $31 | |||
| 83018 | TC | Quantitative screen, m | $75 | |||
| 83020 | Hemoglobin electrophoresis | $78 | ||||
| 83020 | 26 | Hemoglobin electrophoresis | $40 | |||
| 83020 | TC | Hemoglobin electrophoresis | $38 | |||
| 83021 | Hemoglobin chromotography | BR | ||||
| 83026 | Hemoglobin, copper sul | BR | ||||
| 83026 | 26 | Hemoglobin, copper sul | BR | |||
| 83026 | TC | Hemoglobin, copper sul | BR | |||
| 83030 | Fetal hemoglobin assay | $34 | ||||
| 83030 | 26 | Fetal hemoglobin assay | $12 | |||
| 83030 | TC | Fetal hemoglobin assay | $22 | |||
| 83033 | Fetal fecal hemoglobin | $28 | ||||
| 83033 | 26 | Fetal fecal hemoglobin | $8 | |||
| 83033 | TC | Fetal fecal hemoglobin | $20 | |||
| 83036 | Glycated hemoglobin test | $28 | ||||
| 83036 | 26 | Glycated hemoglobin test | $10 | |||
| 83036 | TC | Glycated hemoglobin test | $18 | |||
| 83045 | Blood methemoglobin test | $24 | ||||
| 83045 | 26 | Blood methemoglobin test | $8 | |||
| 83045 | TC | Blood methemoglobin test | $16 | |||
| 83050 | Blood methemoglobin assay | $36 | ||||
| 83050 | 26 | Blood methemoglobin assay | $12 | |||
| 83050 | TC | Blood methemoglobin as | $24 | |||
| 83051 | Assay plasma hemoglobin | $36 | ||||
| 83051 | 26 | Assay plasma hemoglobin | $12 | |||
| 83051 | TC | Assay plasma hemoglobin | $24 | |||
| 83055 | Blood sulfhemoglobin test | $24 | ||||
| 83055 | 26 | Blood sulfhemoglobin test | $8 | |||
| 83055 | TC | Blood sulfhemoglobin test | $16 | |||
| 83060 | Blood sulfhemoglobin a | $43 | ||||
| 83060 | 26 | Blood sulfhemoglobin a | $12 | |||
| 83060 | TC | Blood sulfhemoglobin a | $31 | |||
| 83065 | Hemoglobin heat assay | $34 | ||||
| 83065 | 26 | Hemoglobin heat assay | $12 | |||
| 83065 | TC | Hemoglobin heat assay | $22 | |||
| 83068 | Hemoglobin stability s | $39 | ||||
| 83068 | 26 | Hemoglobin stability s | $10 | |||
| 83068 | TC | Hemoglobin stability s | $29 | |||
| 83069 | Assay urine hemoglobin | $20 | ||||
| 83069 | 26 | Assay urine hemoglobin | $6 | |||
| 83069 | TC | Assay urine hemoglobin | $14 | |||
| 83070 | Qualt assay hemosideri | $24 | ||||
| 83070 | 26 | Qualt assay hemosideri | $8 | |||
| 83070 | TC | Qualt assay hemosideri | $16 | |||
| 83071 | Quant assay of hemosid | $34 | ||||
| 83071 | 26 | Quant assay of hemosid | $10 | |||
| 83071 | TC | Quant assay of hemosid | $24 | |||
| 83080 | Assay of b hexosaminidase | BR | ||||
| 83088 | Assay histamine | $112 | ||||
| 83088 | 26 | Assay histamine | $35 | |||
| 83088 | TC | Assay histamine | $77 | |||
| 83150 | Assay for HVA | $92 | ||||
| 83150 | 26 | Assay for HVA | $31 | |||
| 83150 | TC | Assay for HVA | $61 | |||
| 83491 | Assay of corticosteroi | $69 | ||||
| 83491 | 26 | Assay of corticosteroi | $20 | |||
| 83491 | TC | Assay of corticosteroi | $49 | |||
| 83497 | Assay 5-HIAA | $65 | ||||
| 83497 | 26 | Assay 5-HIAA | $20 | |||
| 83497 | TC | Assay 5-HIAA | $45 | |||
| 83498 | Assay of progesterone | $116 | ||||
| 83498 | 26 | Assay of progesterone | $39 | |||
| 83498 | TC | Assay of progesterone | $77 | |||
| 83499 | Assay of progesterone | $96 | ||||
| 83499 | 26 | Assay of progesterone | $29 | |||
| 83499 | TC | Assay of progesterone | $67 | |||
| 83500 | Assay free hydroxyprol | $127 | ||||
| 83500 | 26 | Assay free hydroxyprol | $41 | |||
| 83500 | TC | Assay free hydroxyprol | $86 | |||
| 83505 | Assay total hydroxypro | $143 | ||||
| 83505 | 26 | Assay total hydroxypro | $41 | |||
| 83505 | TC | Assay total hydroxypro | $102 | |||
| 83516 | Immunoassay, nonantibody | BR | ||||
| 83518 | Immunoassay, dipstick | BR | ||||
| 83518 | 26 | Immunoassay, dipstick | BR | |||
| 83518 | TC | Immunoassay, dipstick | BR | |||
| 83519 | Immunoassay, nonantibody | BR | ||||
| 83519 | 26 | Immunoassay, nonantibody | BR | |||
| 83519 | TC | Immunoassay, nonantibody | BR | |||
| 83520 | Immunoassay, RIA | BR | ||||
| 83520 | 26 | Immunoassay, RIA | BR | |||
| 83520 | TC | Immunoassay, RIA | BR | |||
| 83525 | Assay of insulin | $57 | ||||
| 83525 | 26 | Assay of insulin | $16 | |||
| 83525 | TC | Assay of insulin | $41 | |||
| 83527 | Assay of insulin | $65 | ||||
| 83527 | 26 | Assay of insulin | $20 | |||
| 83527 | TC | Assay of insulin | $45 | |||
| 83528 | Assay intrinsic factor | $81 | ||||
| 83528 | 26 | Assay intrinsic factor | $26 | |||
| 83528 | TC | Assay intrinsic factor | $55 | |||
| 83540 | Assay iron | $32 | ||||
| 83540 | 26 | Assay iron | $8 | |||
| 83540 | TC | Assay iron | $24 | |||
| 83550 | Iron binding test | $39 | ||||
| 83550 | 26 | Iron binding test | $10 | |||
| 83550 | TC | Iron binding test | $29 | |||
| 83570 | Assay IDH enzyme | $45 | ||||
| 83570 | 26 | Assay IDH enzyme | $14 | |||
| 83570 | TC | Assay IDH enzyme | $31 | |||
| 83582 | Assay ketogenic steroi | $63 | ||||
| 83582 | 26 | Assay ketogenic steroi | $16 | |||
| 83582 | TC | Assay ketogenic steroi | $47 | |||
| 83586 | Assay 17-(17-KS)ketost | $71 | ||||
| 83586 | 26 | Assay 17-(17-KS)ketost | $24 | |||
| 83586 | TC | Assay 17-(17-KS)ketost | $47 | |||
| 83593 | Fractionation ketoster | $112 | ||||
| 83593 | 26 | Fractionation ketoster | $35 | |||
| 83593 | TC | Fractionation ketoster | $77 | |||
| 83605 | Lactic acid assay | $36 | ||||
| 83605 | 26 | Lactic acid assay | $12 | |||
| 83605 | TC | Lactic acid assay | $24 | |||
| 83615 | Lactate (LD) (LDH) enz | $30 | ||||
| 83615 | 26 | Lactate (LD) (LDH) enz | $10 | |||
| 83615 | TC | Lactate (LD) (LDH) enz | $20 | |||
| 83625 | Assay LDH enzymes | $45 | ||||
| 83625 | 26 | Assay LDH enzymes | $12 | |||
| 83625 | TC | Assay LDH enzymes | $33 | |||
| 83632 | Placental lactogen | $79 | ||||
| 83632 | 26 | Placental lactogen | $26 | |||
| 83632 | TC | Placental lactogen | $53 | |||
| 83633 | Test urine for lactose | $28 | ||||
| 83633 | 26 | Test urine for lactose | $8 | |||
| 83633 | TC | Test urine for lactose | $20 | |||
| 83634 | Assay urine for lactos | $59 | ||||
| 83634 | 26 | Assay urine for lactos | $18 | |||
| 83634 | TC | Assay urine for lactos | $41 | |||
| 83655 | Assay for lead | $57 | ||||
| 83655 | 26 | Assay for lead | $16 | |||
| 83655 | TC | Assay for lead | $41 | |||
| 83661 | Assay L/S ratio | $32 | ||||
| 83661 | 26 | Assay L/S ratio | $10 | |||
| 83661 | TC | Assay L/S ratio | $22 | |||
| 83662 | L/S ratio, foam stabil | BR | ||||
| 83662 | 26 | L/S ratio, foam stabil | BR | |||
| 83662 | TC | L/S ratio, foam stabil | BR | |||
| 83670 | Assay LAP enzyme | $34 | ||||
| 83670 | 26 | Assay LAP enzyme | $10 | |||
| 83670 | TC | Assay LAP enzyme | $24 | |||
| 83690 | Assay lipase | $34 | ||||
| 83690 | 26 | Assay lipase | $12 | |||
| 83690 | TC | Assay lipase | $22 | |||
| 83718 | Blood lipoprotein assa | $36 | ||||
| 83718 | 26 | Blood lipoprotein assa | $10 | |||
| 83718 | TC | Blood lipoprotein assa | $26 | |||
| 83719 | Assay of blood lipoprotein | $51 | ||||
| 83719 | 26 | Assay of blood lipoprotein | $17 | |||
| 83719 | TC | Assay of blood lipoprotein | $34 | |||
| 83721 | Assay of blood lipoprotein | BR | ||||
| 83721 | 26 | Assay of blood lipoprotein | BR | |||
| 83721 | TC | Assay of blood lipoprotein | BR | |||
| 83727 | LRH hormone assay | $81 | ||||
| 83727 | 26 | LRH hormone assay | $26 | |||
| 83727 | TC | LRH hormone assay | $55 | |||
| 83735 | Assay magnesium | $28 | ||||
| 83735 | 26 | Assay magnesium | $10 | |||
| 83735 | TC | Assay magnesium | $18 | |||
| 83775 | Assay of md enzyme | $32 | ||||
| 83775 | 26 | Assay of md enzyme | $10 | |||
| 83775 | TC | Assay of md enzyme | $22 | |||
| 83785 | Assay of manganese | $110 | ||||
| 83785 | 26 | Assay of manganese | $33 | |||
| 83785 | TC | Assay of manganese | $77 | |||
| 83788 | Mass spectrometry qual | BR | ||||
| 83789 | Mass spectrometry quant | BR | ||||
| 83805 | Assay of meprobamate | $84 | ||||
| 83805 | 26 | Assay of meprobamate | $29 | |||
| 83805 | TC | Assay of meprobamate | $55 | |||
| 83825 | Assay mercury | $63 | ||||
| 83825 | 26 | Assay mercury | $20 | |||
| 83825 | TC | Assay mercury | $43 | |||
| 83835 | Assay metanephrines | $77 | ||||
| 83835 | 26 | Assay metanephrines | $22 | |||
| 83835 | TC | Assay metanephrines | $55 | |||
| 83840 | Assay methadone | $79 | ||||
| 83840 | 26 | Assay methadone | $26 | |||
| 83840 | TC | Assay methadone | $53 | |||
| 83857 | Assay methemalbumin | $51 | ||||
| 83857 | 26 | Assay methemalbumin | $16 | |||
| 83857 | TC | Assay methemalbumin | $35 | |||
| 83858 | Assay methsuximide | $69 | ||||
| 83858 | 26 | Assay methsuximide | $22 | |||
| 83858 | TC | Assay methsuximide | $47 | |||
| 83864 | Mucopolysaccharides | $59 | ||||
| 83864 | 26 | Mucopolysaccharides | $16 | |||
| 83864 | TC | Mucopolysaccharides | $43 | |||
| 83866 | Mucopolysaccharides sc | $51 | ||||
| 83866 | 26 | Mucopolysaccharides sc | $14 | |||
| 83866 | TC | Mucopolysaccharides sc | $37 | |||
| 83872 | Assay synovial fluid m | $24 | ||||
| 83872 | 26 | Assay synovial fluid m | $8 | |||
| 83872 | TC | Assay synovial fluid m | $16 | |||
| 83873 | Assay, CSF protein | $102 | ||||
| 83873 | 26 | Assay, CSF protein | $35 | |||
| 83873 | TC | Assay, CSF protein | $67 | |||
| 83874 | Myoglobin | $49 | ||||
| 83874 | 26 | Myoglobin | $16 | |||
| 83874 | TC | Myoglobin | $33 | |||
| 83883 | Nephelometry, not spec | BR | ||||
| 83883 | 26 | Nephelometry, not spec | BR | |||
| 83883 | TC | Nephelometry, not spec | BR | |||
| 83885 | Assay for nickel | $85 | ||||
| 83885 | 26 | Assay for nickel | $26 | |||
| 83885 | TC | Assay for nickel | $59 | |||
| 83887 | Assay nicotine | $110 | ||||
| 83887 | 26 | Assay nicotine | $33 | |||
| 83887 | TC | Assay nicotine | $77 | |||
| 83890 | Molecule isolate...... | BR | ||||
| 83890 | 26 | Molecule isolate...... | BR | |||
| 83890 | TC | Molecule isolate...... | BR | |||
| 83891 | Molecule isolate nucleic. | BR | ||||
| 83892 | Molecular diagnostics | BR | ||||
| 83892 | 26 | Molecular diagnostics | BR | |||
| 83892 | TC | Molecular diagnostics | BR | |||
| 83893 | Molecule dot/slot/blot | BR | ||||
| 83894 | Molecule gel electrophor. | BR | ||||
| 83894 | 26 | Molecule gel electrophor. | BR | |||
| 83894 | TC | Molecule gel electrophor. | BR | |||
| 83896 | Molecular diagnostics | BR | ||||
| 83896 | 26 | Molecular diagnostics | BR | |||
| 83896 | TC | Molecular diagnostics | BR | |||
| 83897 | Molecule nucleic transfer | BR | ||||
| 83898 | Molecule nucleic ampli | BR | ||||
| 83898 | 26 | Molecule nucleic ampli | BR | |||
| 83898 | TC | Molecule nucleic ampli | BR | |||
| 83901 | Molecule nucleic ampli | BR | ||||
| 83902 | Molecular diagnostics | BR | ||||
| 83903 | Molecule mutation scan | BR | ||||
| 83904 | Molecule mutation identify | BR | ||||
| 83905 | Molecule mutation identify | BR | ||||
| 83906 | Molecule mutation identify | BR | ||||
| 83912 | Genetic examination | $73 | ||||
| 83912 | 26 | Genetic examination | $20 | |||
| 83912 | TC | Genetic examination | $53 | |||
| 83915 | Assay nucleotidase | $57 | ||||
| 83915 | 26 | Assay nucleotidase | $18 | |||
| 83915 | TC | Assay nucleotidase | $39 | |||
| 83916 | Oligoclonal bands | $102 | ||||
| 83916 | 26 | Oligoclonal bands | $35 | |||
| 83916 | TC | Oligoclonal bands | $67 | |||
| 83918 | Assay, organic acids quant | $67 | ||||
| 83918 | 26 | Assay, organic acids quant | $19 | |||
| 83918 | TC | Assay, organic acids quant | $48 | |||
| 83919 | Assay, organic acids qual | BR | ||||
| 83925 | Opiates | BR | ||||
| 83925 | 26 | Opiates | BR | |||
| 83925 | TC | Opiates | BR | |||
| 83930 | Assay blood osmolality | $32 | ||||
| 83930 | 26 | Assay blood osmolality | $10 | |||
| 83930 | TC | Assay blood osmolality | $22 | |||
| 83935 | Assay urine osmolality | $32 | ||||
| 83935 | 26 | Assay urine osmolality | $10 | |||
| 83935 | TC | Assay urine osmolality | $22 | |||
| 83937 | Assay for osteocalcin | BR | ||||
| 83937 | 26 | Assay for osteocalcin | BR | |||
| 83937 | TC | Assay for osteocalcin | BR | |||
| 83945 | Assay of oxalate …. | BR | ||||
| 83970 | Assay of parathormone | $173 | ||||
| 83970 | 26 | Assay of parathormone | $57 | |||
| 83970 | TC | Assay of parathormone | $116 | |||
| 83986 | Assay body fluid acidi | $16 | ||||
| 83986 | 26 | Assay body fluid acidi | $6 | |||
| 83986 | TC | Assay body fluid acidi | $10 | |||
| 83992 | Assay for phencyclidin | $75 | ||||
| 83992 | 26 | Assay for phencyclidin | $22 | |||
| 83992 | TC | Assay for phencyclidin | $53 | |||
| 84022 | Assay of phenothiazine | $77 | ||||
| 84022 | 26 | Assay of phenothiazine | $24 | |||
| 84022 | TC | Assay of phenothiazine | $53 | |||
| 84030 | Assay blood PKU | $20 | ||||
| 84030 | 26 | Assay blood PKU | $6 | |||
| 84030 | TC | Assay blood PKU | $14 | |||
| 84035 | Assay phenylketones | $22 | ||||
| 84035 | 26 | Assay phenylketones | $6 | |||
| 84035 | TC | Assay phenylketones | $16 | |||
| 84060 | Assay acid phosphatase | $67 | ||||
| 84060 | 26 | Assay acid phosphatase | $22 | |||
| 84060 | TC | Assay acid phosphatase | $45 | |||
| 84061 | Phosphatase, forensic | BR | ||||
| 84061 | 26 | Phosphatase, forensic | BR | |||
| 84061 | TC | Phosphatase, forensic | BR | |||
| 84066 | Assay prostate phospha | $34 | ||||
| 84066 | 26 | Assay prostate phospha | $12 | |||
| 84066 | TC | Assay prostate phospha | $22 | |||
| 84075 | Assay alkaline phospha | $22 | ||||
| 84075 | 26 | Assay alkaline phospha | $6 | |||
| 84075 | TC | Assay alkaline phospha | $16 | |||
| 84078 | Assay alkaline phospha | $36 | ||||
| 84078 | 26 | Assay alkaline phospha | $10 | |||
| 84078 | TC | Assay alkaline phospha | $26 | |||
| 84080 | Assay alkaline phospha | $67 | ||||
| 84080 | 26 | Assay alkaline phospha | $20 | |||
| 84080 | TC | Assay alkaline phospha | $47 | |||
| 84081 | Amniotic fluid enzyme | $86 | ||||
| 84081 | 26 | Amniotic fluid enzyme | $29 | |||
| 84081 | TC | Amniotic fluid enzyme | $57 | |||
| 84085 | Assay RBC PG6D enzyme | $28 | ||||
| 84085 | 26 | Assay RBC PG6D enzyme | $10 | |||
| 84085 | TC | Assay RBC PG6D enzyme | $18 | |||
| 84087 | Assay phosphohexose en | $49 | ||||
| 84087 | 26 | Assay phosphohexose en | $14 | |||
| 84087 | TC | Assay phosphohexose en | $35 | |||
| 84100 | Assay phosphorus | $20 | ||||
| 84100 | 26 | Assay phosphorus | $6 | |||
| 84100 | TC | Assay phosphorus | $14 | |||
| 84105 | Assay urine phosphorus | $20 | ||||
| 84105 | 26 | Assay urine phosphorus | $6 | |||
| 84105 | TC | Assay urine phosphorus | $14 | |||
| 84106 | Test for porphobilinog | $18 | ||||
| 84106 | 26 | Test for porphobilinog | $4 | |||
| 84106 | TC | Test for porphobilinog | $14 | |||
| 84110 | Assay porphobilinogen | $41 | ||||
| 84110 | 26 | Assay porphobilinogen | $12 | |||
| 84110 | TC | Assay porphobilinogen | $29 | |||
| 84119 | Test urine for porphyr | $41 | ||||
| 84119 | 26 | Test urine for porphyr | $12 | |||
| 84119 | TC | Test urine for porphyr | $29 | |||
| 84120 | Assay urine porphyrins | $71 | ||||
| 84120 | 26 | Assay urine porphyrins | $20 | |||
| 84120 | TC | Assay urine porphyrins | $51 | |||
| 84126 | Assay feces porphyrins | $131 | ||||
| 84126 | 26 | Assay feces porphyrins | $39 | |||
| 84126 | TC | Assay feces porphyrins | $92 | |||
| 84127 | Porphyrins, feces | BR | ||||
| 84127 | 26 | Porphyrins, feces | BR | |||
| 84127 | TC | Porphyrins, feces | BR | |||
| 84132 | Assay serum potassium | $20 | ||||
| 84132 | 26 | Assay serum potassium | $6 | |||
| 84132 | TC | Assay serum potassium | $14 | |||
| 84133 | Assay urine potassium | $20 | ||||
| 84133 | 26 | Assay urine potassium | $6 | |||
| 84133 | TC | Assay urine potassium | $14 | |||
| 84134 | Prealbumin | BR | ||||
| 84134 | 26 | Prealbumin | BR | |||
| 84134 | TC | Prealbumin | BR | |||
| 84135 | Assay pregnanediol | $108 | ||||
| 84135 | 26 | Assay pregnanediol | $37 | |||
| 84135 | TC | Assay pregnanediol | $71 | |||
| 84138 | Assay pregnanetriol | $106 | ||||
| 84138 | 26 | Assay pregnanetriol | $35 | |||
| 84138 | TC | Assay pregnanetriol | $71 | |||
| 84140 | Assay for pregnenolone | $77 | ||||
| 84140 | 26 | Assay for pregnenolone | $16 | |||
| 84140 | TC | Assay for pregnenolone | $61 | |||
| 84143 | Assay/17-hydroxypregne | $116 | ||||
| 84143 | 26 | Assay/17-hydroxypregne | $39 | |||
| 84143 | TC | Assay/17-hydroxypregne | $77 | |||
| 84144 | Assay progesterone | $71 | ||||
| 84144 | 26 | Assay progesterone | $14 | |||
| 84144 | TC | Assay progesterone | $57 | |||
| 84146 | Assay for prolactin | $100 | ||||
| 84146 | 26 | Assay for prolactin | $33 | |||
| 84146 | TC | Assay for prolactin | $67 | |||
| 84150 | Assay of prostaglandin | $127 | ||||
| 84150 | 26 | Assay of prostaglandin | $39 | |||
| 84150 | TC | Assay of prostaglandin | $88 | |||
| 84153 | Assay of psa, total... | BR | ||||
| 84153 | 26 | Assay of psa, total... | BR | |||
| 84153 | TC | Assay of psa, total... | BR | |||
| 84154 | Assay of psa, free.... | BR | ||||
| 84155 | Assay protein | $22 | ||||
| 84155 | 26 | Assay protein | $8 | |||
| 84155 | TC | Assay protein | $14 | |||
| 84160 | Assay serum protein | $22 | ||||
| 84160 | 26 | Assay serum protein | $8 | |||
| 84160 | TC | Assay serum protein | $14 | |||
| 84165 | Assay serum proteins | $47 | ||||
| 84165 | 26 | Assay serum proteins | $16 | |||
| 84165 | TC | Assay serum proteins | $31 | |||
| 84181 | Western blot test | $40 | ||||
| 84181 | 26 | Western blot test | BR | |||
| 84181 | TC | Western blot test | BR | |||
| 84182 | Protein, western blot | $37 | ||||
| 84182 | 26 | Protein, western blot | BR | |||
| 84182 | TC | Protein, western blot | BR | |||
| 84202 | Assay RBC protoporphyr | $73 | ||||
| 84202 | 26 | Assay RBC protoporphyr | $24 | |||
| 84202 | TC | Assay RBC protoporphyr | $49 | |||
| 84203 | Test RBC protoporphyri | $30 | ||||
| 84203 | 26 | Test RBC protoporphyri | $10 | |||
| 84203 | TC | Test RBC protoporphyri | $20 | |||
| 84206 | Assay of proinsulin | $59 | ||||
| 84206 | 26 | Assay of proinsulin | $18 | |||
| 84206 | TC | Assay of proinsulin | $41 | |||
| 84207 | Assay vitamin B-6 | $102 | ||||
| 84207 | 26 | Assay vitamin B-6 | $31 | |||
| 84207 | TC | Assay vitamin B-6 | $71 | |||
| 84210 | Assay pyruvate | $47 | ||||
| 84210 | 26 | Assay pyruvate | $18 | |||
| 84210 | TC | Assay pyruvate | $29 | |||
| 84220 | Assay pyruvate kinase | $49 | ||||
| 84220 | 26 | Assay pyruvate kinase | $16 | |||
| 84220 | TC | Assay pyruvate kinase | $33 | |||
| 84228 | Assay quinine | $59 | ||||
| 84228 | 26 | Assay quinine | $18 | |||
| 84228 | TC | Assay quinine | $41 | |||
| 84233 | Assay estrogen | $216 | ||||
| 84233 | 26 | Assay estrogen | $65 | |||
| 84233 | TC | Assay estrogen | $151 | |||
| 84234 | Assay progesterone | $216 | ||||
| 84234 | 26 | Assay progesterone | $65 | |||
| 84234 | TC | Assay progesterone | $151 | |||
| 84235 | Assay endocrine hormon | $212 | ||||
| 84235 | 26 | Assay endocrine hormon | $63 | |||
| 84235 | TC | Assay endocrine hormon | $149 | |||
| 84238 | Assay non-endocrine re | $179 | ||||
| 84238 | 26 | Assay non-endocrine re | $59 | |||
| 84238 | TC | Assay non-endocrine re | $120 | |||
| 84244 | Assay of renin | $96 | ||||
| 84244 | 26 | Assay of renin | $33 | |||
| 84244 | TC | Assay of renin | $63 | |||
| 84252 | Assay vitamin B-2 | $87 | ||||
| 84252 | 26 | Assay vitamin B-2 | $26 | |||
| 84252 | TC | Assay vitamin B-2 | $61 | |||
| 84255 | Assay selenium | $110 | ||||
| 84255 | 26 | Assay selenium | $33 | |||
| 84255 | TC | Assay selenium | $77 | |||
| 84260 | Assay serotonin | $102 | ||||
| 84260 | 26 | Assay serotonin | $31 | |||
| 84260 | TC | Assay serotonin | $71 | |||
| 84270 | Sex hormone globulin | BR | ||||
| 84270 | 26 | Sex hormone globulin | BR | |||
| 84270 | TC | Sex hormone globulin | BR | |||
| 84275 | Assay sialic acid | $69 | ||||
| 84275 | 26 | Assay sialic acid | $20 | |||
| 84275 | TC | Assay sialic acid | $49 | |||
| 84285 | Assay silica | $112 | ||||
| 84285 | 26 | Assay silica | $33 | |||
| 84285 | TC | Assay silica | $79 | |||
| 84295 | Assay serum sodium | $18 | ||||
| 84295 | 26 | Assay serum sodium | $6 | |||
| 84295 | TC | Assay serum sodium | $12 | |||
| 84300 | Assay urine sodium | $18 | ||||
| 84300 | 26 | Assay urine sodium | $6 | |||
| 84300 | TC | Assay urine sodium | $12 | |||
| 84305 | Somatomedin | BR | ||||
| 84305 | 26 | Somatomedin | BR | |||
| 84305 | TC | Somatomedin | BR | |||
| 84307 | Somatostatin | BR | ||||
| 84307 | 26 | Somatostatin | BR | |||
| 84307 | TC | Somatostatin | BR | |||
| 84311 | Spectrophotometry | BR | ||||
| 84311 | 26 | Spectrophotometry | BR | |||
| 84311 | TC | Spectrophotometry | BR | |||
| 84315 | Body fluid specific gr | $10 | ||||
| 84315 | 26 | Body fluid specific gr | $4 | |||
| 84315 | TC | Body fluid specific gr | $6 | |||
| 84375 | Chromatogram assay, su | $69 | ||||
| 84375 | 26 | Chromatogram assay, su | $20 | |||
| 84375 | TC | Chromatogram assay, su | $49 | |||
| 84376 | Sugars, single, qual.. | BR | ||||
| 84377 | Sugars, multiple, qual | BR | ||||
| 84378 | Sugars single quant... | BR | ||||
| 84379 | Sugars multiple quant | BR | ||||
| 84392 | Assay urine sulfate | BR | ||||
| 84392 | 26 | Assay urine sulfate | BR | |||
| 84392 | TC | Assay urine sulfate | BR | |||
| 84402 | Testosterone | BR | ||||
| 84402 | 26 | Testosterone | BR | |||
| 84402 | TC | Testosterone | BR | |||
| 84403 | Assay total testostero | $123 | ||||
| 84403 | 26 | Assay total testostero | $37 | |||
| 84403 | TC | Assay total testostero | $86 | |||
| 84425 | Assay vitamin B-1 | $102 | ||||
| 84425 | 26 | Assay vitamin B-1 | $33 | |||
| 84425 | TC | Assay vitamin B-1 | $69 | |||
| 84430 | Assay thiocyanate | $57 | ||||
| 84430 | 26 | Assay thiocyanate | $18 | |||
| 84430 | TC | Assay thiocyanate | $39 | |||
| 84432 | Thyroglobulin | BR | ||||
| 84432 | 26 | Thyroglobulin | BR | |||
| 84432 | TC | Thyroglobulin | BR | |||
| 84436 | Assay, total thyroxine | $26 | ||||
| 84436 | 26 | Assay, total thyroxine | $6 | |||
| 84436 | TC | Assay, total thyroxine | $20 | |||
| 84437 | Assay neonatal thyroxi | $24 | ||||
| 84437 | 26 | Assay neonatal thyroxi | $8 | |||
| 84437 | TC | Assay neonatal thyroxi | $16 | |||
| 84439 | Assay, free thyroxine | $30 | ||||
| 84439 | 26 | Assay, free thyroxine | $8 | |||
| 84439 | TC | Assay, free thyroxine | $22 | |||
| 84442 | Thyroid activity (TBG) | $49 | ||||
| 84442 | 26 | Thyroid activity (TBG) | $12 | |||
| 84442 | TC | Thyroid activity (TBG) | $37 | |||
| 84443 | Assay thyroid stim hor | $59 | ||||
| 84443 | 26 | Assay thyroid stim hor | $14 | |||
| 84443 | TC | Assay thyroid stim hor | $45 | |||
| 84445 | Thyroid immunoglobulin | $181 | ||||
| 84445 | 26 | Thyroid immunoglobulin | $55 | |||
| 84445 | TC | Thyroid immunoglobulin | $126 | |||
| 84446 | Assay vitamin E | $65 | ||||
| 84446 | 26 | Assay vitamin E | $20 | |||
| 84446 | TC | Assay vitamin E | $45 | |||
| 84449 | Assay for transcortin | BR | ||||
| 84449 | 26 | Assay for transcortin | BR | |||
| 84449 | TC | Assay for transcortin | BR | |||
| 84450 | Transferase (AST) (SGO | $20 | ||||
| 84450 | 26 | Transferase (AST) (SGO | $6 | |||
| 84450 | TC | Transferase (AST) (SGO | $14 | |||
| 84460 | Alanine amino (ALT) (S | $24 | ||||
| 84460 | 26 | Alanine amino (ALT) (S | $8 | |||
| 84460 | TC | Alanine amino (ALT) (S | $16 | |||
| 84466 | Transferrin | BR | ||||
| 84466 | 26 | Transferrin | BR | |||
| 84466 | TC | Transferrin | BR | |||
| 84478 | Assay triglycerides | $22 | ||||
| 84478 | 26 | Assay triglycerides | $6 | |||
| 84478 | TC | Assay triglycerides | $16 | |||
| 84479 | Assay of thyroid (t3 or t4). | $30 | ||||
| 84479 | 26 | Assay of thyroid (t3 or t4). | $11 | |||
| 84479 | TC | Assay of thyroid (t3 or t4). | $19 | |||
| 84480 | Assay triiodothyronine | $47 | ||||
| 84480 | 26 | Assay triiodothyronine | $16 | |||
| 84480 | TC | Assay triiodothyronine | $31 | |||
| 84481 | Free assay (FT-3) | $88 | ||||
| 84481 | 26 | Free assay (FT-3) | $29 | |||
| 84481 | TC | Free assay (FT-3) | $59 | |||
| 84482 | T3 reverse | BR | ||||
| 84482 | 26 | T3 reverse | BR | |||
| 84482 | TC | T3 reverse | BR | |||
| 84484 | Assay of troponin, quant. | BR | ||||
| 84485 | Assay duodenal fluid t | $28 | ||||
| 84485 | 26 | Assay duodenal fluid t | $8 | |||
| 84485 | TC | Assay duodenal fluid t | $20 | |||
| 84488 | Test feces for trypsin | $28 | ||||
| 84488 | 26 | Test feces for trypsin | $8 | |||
| 84488 | TC | Test feces for trypsin | $20 | |||
| 84490 | Assay feces for trypsin | $28 | ||||
| 84490 | 26 | Assay feces for trypsin | $8 | |||
| 84490 | TC | Assay feces for trypsin | $20 | |||
| 84510 | Assay tyrosine | $51 | ||||
| 84510 | 26 | Assay tyrosine | $16 | |||
| 84510 | TC | Assay tyrosine | $35 | |||
| 84512 | Assay of troponin, qual. | BR | ||||
| 84520 | Assay urea nitrogen | $22 | ||||
| 84520 | 26 | Assay urea nitrogen | $6 | |||
| 84520 | TC | Assay urea nitrogen | $16 | |||
| 84525 | Urea nitrogen semi-qua | $14 | ||||
| 84525 | 26 | Urea nitrogen semi-qua | $4 | |||
| 84525 | TC | Urea nitrogen semi-qua | $10 | |||
| 84540 | Assay urine urea-N | $24 | ||||
| 84540 | 26 | Assay urine urea-N | $8 | |||
| 84540 | TC | Assay urine urea-N | $16 | |||
| 84545 | Urea-N clearance test | $34 | ||||
| 84545 | 26 | Urea-N clearance test | $10 | |||
| 84545 | TC | Urea-N clearance test | $24 | |||
| 84550 | Assay blood uric acid | $22 | ||||
| 84550 | 26 | Assay blood uric acid | $8 | |||
| 84550 | TC | Assay blood uric acid | $14 | |||
| 84560 | Assay urine uric acid | $22 | ||||
| 84560 | 26 | Assay urine uric acid | $6 | |||
| 84560 | TC | Assay urine uric acid | $16 | |||
| 84577 | Assay feces urobilinogen | $63 | ||||
| 84577 | 26 | Assay feces urobilinogen | $20 | |||
| 84577 | TC | Assay feces urobilinogen | $43 | |||
| 84578 | Test urine urobilinogen | $14 | ||||
| 84578 | 26 | Test urine urobilinogen | $4 | |||
| 84578 | TC | Test urine urobilinogen | $10 | |||
| 84580 | Assay urine urobilinogen | $32 | ||||
| 84580 | 26 | Assay urine urobilinogen | $10 | |||
| 84580 | TC | Assay urine urobilinogen | $22 | |||
| 84583 | Assay urine urobilinogen | $20 | ||||
| 84583 | 26 | Assay urine urobilinogen | $6 | |||
| 84583 | TC | Assay urine urobilinogen | $14 | |||
| 84585 | Assay urine VMA | $67 | ||||
| 84585 | 26 | Assay urine VMA | $20 | |||
| 84585 | TC | Assay urine VMA | $47 | |||
| 84586 | VIP assay | BR | ||||
| 84586 | 26 | VIP assay | BR | |||
| 84586 | TC | VIP assay | BR | |||
| 84588 | Assay vasopressin | $108 | ||||
| 84588 | 26 | Assay vasopressin | $37 | |||
| 84588 | TC | Assay vasopressin | $71 | |||
| 84590 | Assay vitamin-A | $61 | ||||
| 84590 | 26 | Assay vitamin-A | $20 | |||
| 84590 | TC | Assay vitamin-A | $41 | |||
| 84597 | Assay vitamin-K | $69 | ||||
| 84597 | 26 | Assay vitamin-K | $20 | |||
| 84597 | TC | Assay vitamin-K | $49 | |||
| 84600 | Assay for volatiles | $81 | ||||
| 84600 | 26 | Assay for volatiles | $24 | |||
| 84600 | TC | Assay for volatiles | $57 | |||
| 84620 | Xylose tolerance test | $55 | ||||
| 84620 | 26 | Xylose tolerance test | $16 | |||
| 84620 | TC | Xylose tolerance test | $39 | |||
| 84630 | Assay zinc | $51 | ||||
| 84630 | 26 | Assay zinc | $16 | |||
| 84630 | TC | Assay zinc | $35 | |||
| 84681 | Assay C-peptide | $98 | ||||
| 84681 | 26 | Assay C-peptide | $33 | |||
| 84681 | TC | Assay C-peptide | $65 | |||
| 84702 | Chorionic gonadotropin | $75 | ||||
| 84702 | 26 | Chorionic gonadotropin | $24 | |||
| 84702 | TC | Chorionic gonadotropin | $51 | |||
| 84703 | Chorionic gonadotropin | $71 | ||||
| 84703 | 26 | Chorionic gonadotropin | $22 | |||
| 84703 | TC | Chorionic gonadotropin | $49 | |||
| 84830 | Ovulation tests | BR | ||||
| 84830 | 26 | Ovulation tests | BR | |||
| 84830 | TC | Ovulation tests | BR | |||
| 84999 | Clinical chemistry test | BR | ||||
| 84999 | 26 | Clinical chemistry test | BR | |||
| 84999 | TC | Clinical chemistry test | BR | |||
| 85002 | Bleeding time test | $18 | ||||
| 85002 | 26 | Bleeding time test | $6 | |||
| 85002 | TC | Bleeding time test | $12 | |||
| 85007 | Differential WBC count | $12 | ||||
| 85007 | 26 | Differential WBC count | $4 | |||
| 85007 | TC | Differential WBC count | $8 | |||
| 85008 | Nondifferential WBC co | BR | ||||
| 85008 | 26 | Nondifferential WBC co | BR | |||
| 85008 | TC | Nondifferential WBC co | BR | |||
| 85009 | Differential WBC count | $16 | ||||
| 85009 | 26 | Differential WBC count | $6 | |||
| 85009 | TC | Differential WBC count | $10 | |||
| 85013 | Hematocrit | BR | ||||
| 85013 | 26 | Hematocrit | BR | |||
| 85013 | TC | Hematocrit | BR | |||
| 85014 | Hematocrit | $8 | ||||
| 85014 | 26 | Hematocrit | $2 | |||
| 85014 | TC | Hematocrit | $6 | |||
| 85018 | Hemoglobinen | $10 | ||||
| 85018 | 26 | Hemoglobin | $4 | |||
| 85018 | TC | Hemoglobin | $6 | |||
| 85025 | Automated hemogram | $41 | ||||
| 85025 | 26 | Automated hemogram | $12 | |||
| 85025 | TC | Automated hemogram | $29 | |||
| 85027 | Automated hemogram | $36 | ||||
| 85027 | 26 | Automated hemogram | $12 | |||
| 85027 | TC | Automated hemogram | $24 | |||
| 85041 | Red blood cell (RBC) | $14 | ||||
| 85041 | 26 | Red blood cell (RBC) | $6 | |||
| 85041 | TC | Red blood cell (RBC) | $8 | |||
| 85044 | Reticulocyte count | $18 | ||||
| 85044 | 26 | Reticulocyte count | $6 | |||
| 85044 | TC | Reticulocyte count | $12 | |||
| 85045 | Reticulocyte count | BR | ||||
| 85045 | 26 | Reticulocyte count | BR | |||
| 85045 | TC | Reticulocyte count | BR | |||
| 85046 | Reticyte/hgb concentrate. | BR | ||||
| 85048 | White blood cell (WBC) | $14 | ||||
| 85048 | 26 | White blood cell (WBC) | $6 | |||
| 85048 | TC | White blood cell (WBC) | $8 | |||
| 85060 | Blood smear interpreta | $49 | ||||
| 85060 | 26 | Blood smear interpreta | $14 | |||
| 85060 | TC | Blood smear interpreta | $35 | |||
| 85097 | Bone marrow interpreta | $112 | ||||
| 85097 | 26 | Bone marrow interpreta | $112 | |||
| 85097 | TC | Bone marrow interpreta | $0 | |||
| 85130 | Chromogenic substrate | BR | ||||
| 85130 | 26 | Chromogenic substrate | BR | |||
| 85130 | TC | Chromogenic substrate | BR | |||
| 85170 | Blood clot retraction | $18 | ||||
| 85170 | 26 | Blood clot retraction | $6 | |||
| 85170 | TC | Blood clot retraction | $12 | |||
| 85175 | Blood clot lysis time | $18 | ||||
| 85175 | 26 | Blood clot lysis time | $6 | |||
| 85175 | TC | Blood clot lysis time | $12 | |||
| 85210 | Blood clot factor II test | $57 | ||||
| 85210 | 26 | Blood clot factor II test | $16 | |||
| 85210 | TC | Blood clot factor II test | $41 | |||
| 85220 | Blood clot factor V test | $88 | ||||
| 85220 | 26 | Blood clot factor V test | $29 | |||
| 85220 | TC | Blood clot factor V test | $59 | |||
| 85230 | Blood clot factor VII | $87 | ||||
| 85230 | 26 | Blood clot factor VII | $26 | |||
| 85230 | TC | Blood clot factor VII | $61 | |||
| 85240 | Blood clot factor VIII | $90 | ||||
| 85240 | 26 | Blood clot factor VIII | $29 | |||
| 85240 | TC | Blood clot factor VIII | $61 | |||
| 85244 | Blood clot factor VIII | $102 | ||||
| 85244 | 26 | Blood clot factor VIII | $35 | |||
| 85244 | TC | Blood clot factor VIII | $67 | |||
| 85245 | Blood clot factor VIII | BR | ||||
| 85245 | 26 | Blood clot factor VIII | BR | |||
| 85245 | TC | Blood clot factor VIII | BR | |||
| 85246 | Blood clot factor VIII | BR | ||||
| 85246 | 26 | Blood clot factor VIII | BR | |||
| 85246 | TC | Blood clot factor VIII | BR | |||
| 85247 | Blood clot factor VIII | BR | ||||
| 85247 | 26 | Blood clot factor VIII | BR | |||
| 85247 | TC | Blood clot factor VIII | BR | |||
| 85250 | Blood clot factor IX test | $91 | ||||
| 85250 | 26 | Blood clot factor IX test | $26 | |||
| 85250 | TC | Blood clot factor IX test | $65 | |||
| 85260 | Blood clot factor X test | $91 | ||||
| 85260 | 26 | Blood clot factor X test | $26 | |||
| 85260 | TC | Blood clot factor X test | $65 | |||
| 85270 | Blood clot factor XI test | $91 | ||||
| 85270 | 26 | Blood clot factor XI test | $26 | |||
| 85270 | TC | Blood clot factor XI test | $65 | |||
| 85280 | Blood clot factor XII | $91 | ||||
| 85280 | 26 | Blood clot factor XII | $26 | |||
| 85280 | TC | Blood clot factor XII | $65 | |||
| 85290 | Blood clot factor XIII | $83 | ||||
| 85290 | 26 | Blood clot factor XIII | $24 | |||
| 85290 | TC | Blood clot factor XIII | $59 | |||
| 85291 | Blood clot factor XIII | $38 | ||||
| 85291 | 26 | Blood clot factor XIII | $12 | |||
| 85291 | TC | Blood clot factor XIII | $26 | |||
| 85292 | Blood clot factor assay | $96 | ||||
| 85292 | 26 | Blood clot factor assay | $33 | |||
| 85292 | TC | Blood clot factor assay | $63 | |||
| 85293 | Blood clot factor assay | $96 | ||||
| 85293 | 26 | Blood clot factor assay | $33 | |||
| 85293 | TC | Blood clot factor assay | $63 | |||
| 85300 | Antithrombin III test | $55 | ||||
| 85300 | 26 | Antithrombin III test | $18 | |||
| 85300 | TC | Antithrombin III test | $37 | |||
| 85301 | Antithrombin III test | $55 | ||||
| 85301 | 26 | Antithrombin III test | $18 | |||
| 85301 | TC | Antithrombin III test | $37 | |||
| 85302 | Blood clot inhibitor assay | $61 | ||||
| 85302 | 26 | Blood clot inhibitor assay | $20 | |||
| 85302 | TC | Blood clot inhibitor assay | $41 | |||
| 85303 | Blood clot inhibitor test | BR | ||||
| 85303 | 26 | Blood clot inhibitor test | BR | |||
| 85303 | TC | Blood clot inhibitor test | BR | |||
| 85305 | Blood clot inhibitor assay | BR | ||||
| 85305 | 26 | Blood clot inhibitor assay | BR | |||
| 85305 | TC | Blood clot inhibitor assay | BR | |||
| 85306 | Blood clot inhibitor test | BR | ||||
| 85306 | 26 | Blood clot inhibitor test | BR | |||
| 85306 | TC | Blood clot inhibitor test | BR | |||
| 85335 | Factor inhibitor test | BR | ||||
| 85335 | 26 | Factor inhibitor test | BR | |||
| 85335 | TC | Factor inhibitor test | BR | |||
| 85337 | Thrombomodulin | BR | ||||
| 85337 | 26 | Thrombomodulin | BR | |||
| 85337 | TC | Thrombomodulin | BR | |||
| 85345 | Coagulation time | $22 | ||||
| 85345 | 26 | Coagulation time | $6 | |||
| 85345 | TC | Coagulation time | $16 | |||
| 85347 | Coagulation time | $16 | ||||
| 85347 | 26 | Coagulation time | $4 | |||
| 85347 | TC | Coagulation time | $12 | |||
| 85348 | Coagulation time | $18 | ||||
| 85348 | 26 | Coagulation time | $6 | |||
| 85348 | TC | Coagulation time | $12 | |||
| 85360 | Euglobulin lysis | $30 | ||||
| 85360 | 26 | Euglobulin lysis | $8 | |||
| 85360 | TC | Euglobulin lysis | $22 | |||
| 85362 | Fibrin degradation pro | $34 | ||||
| 85362 | 26 | Fibrin degradation pro | $14 | |||
| 85362 | TC | Fibrin degradation pro | $20 | |||
| 85366 | Fibrinogen test | BR | ||||
| 85366 | 26 | Fibrinogen test | BR | |||
| 85366 | TC | Fibrinogen test | BR | |||
| 85370 | Fibrinogen test | BR | ||||
| 85370 | 26 | Fibrinogen test | BR | |||
| 85370 | TC | Fibrinogen test | BR | |||
| 85378 | Fibrin degradation | BR | ||||
| 85378 | 26 | Fibrin degradation | BR | |||
| 85378 | TC | Fibrin degradation | BR | |||
| 85379 | Fibrin degradation | BR | ||||
| 85379 | 26 | Fibrin degradation | BR | |||
| 85379 | TC | Fibrin degradation | BR | |||
| 85384 | Fibrinogen | BR | ||||
| 85384 | 26 | Fibrinogen | BR | |||
| 85384 | TC | Fibrinogen | BR | |||
| 85385 | Fibrinogen | BR | ||||
| 85385 | 26 | Fibrinogen | BR | |||
| 85385 | TC | Fibrinogen | BR | |||
| 85390 | Fibrinolysins screen | $18 | ||||
| 85390 | 26 | Fibrinolysins screen | $4 | |||
| 85390 | TC | Fibrinolysins screen | $14 | |||
| 85396 | Clotting assay whole blood | $40 | ||||
| 85400 | Fibrinolytic plasmin | $22 | ||||
| 85400 | 26 | Fibrinolytic plasmin | $6 | |||
| 85400 | TC | Fibrinolytic plasmin | $16 | |||
| 85410 | Fibrinolytic antiplasm | $22 | ||||
| 85410 | 26 | Fibrinolytic antiplasm | $6 | |||
| 85410 | TC | Fibrinolytic antiplasm | $16 | |||
| 85415 | Fibrinolytic plasminog | BR | ||||
| 85415 | 26 | Fibrinolytic plasminog | BR | |||
| 85415 | TC | Fibrinolytic plasminog | BR | |||
| 85420 | Fibrinolytic plasminog | $32 | ||||
| 85420 | 26 | Fibrinolytic plasminog | $8 | |||
| 85420 | TC | Fibrinolytic plasminog | $24 | |||
| 85421 | Fibrinolytic plasminog | $73 | ||||
| 85421 | 26 | Fibrinolytic plasminog | $22 | |||
| 85421 | TC | Fibrinolytic plasminog | $51 | |||
| 85441 | Heinz bodies; direct | $14 | ||||
| 85441 | 26 | Heinz bodies; direct | $4 | |||
| 85441 | TC | Heinz bodies; direct | $10 | |||
| 85445 | Heinz bodies; induced | $30 | ||||
| 85445 | 26 | Heinz bodies; induced | $10 | |||
| 85445 | TC | Heinz bodies; induced | $20 | |||
| 85460 | Hemoglobin, fetal..... | $32 | ||||
| 85460 | 26 | Hemoglobin, fetal..... | $9 | |||
| 85460 | TC | Hemoglobin, fetal..... | $23 | |||
| 85461 | Hemoglobin, fetal | BR | ||||
| 85475 | Hemolysin | BR | ||||
| 85475 | 26 | Hemolysin | BR | |||
| 85475 | TC | Hemolysin | BR | |||
| 85520 | Heparin assay | $43 | ||||
| 85520 | 26 | Heparin assay | $12 | |||
| 85520 | TC | Heparin assay | $31 | |||
| 85525 | Heparin | BR | ||||
| 85525 | 26 | Heparin | BR | |||
| 85525 | TC | Heparin | BR | |||
| 85530 | Heparin-protamine tole | $73 | ||||
| 85530 | 26 | Heparin-protamine tole | $22 | |||
| 85530 | TC | Heparin-protamine tole | $51 | |||
| 85540 | Wbc alkaline phosphata | $43 | ||||
| 85540 | 26 | Wbc alkaline phosphata | $12 | |||
| 85540 | TC | Wbc alkaline phosphata | $31 | |||
| 85547 | RBC mechanical fragili | $45 | ||||
| 85547 | 26 | RBC mechanical fragili | $12 | |||
| 85547 | TC | RBC mechanical fragili | $33 | |||
| 85549 | Muramidase | $86 | ||||
| 85549 | 26 | Muramidase | $29 | |||
| 85549 | TC | Muramidase | $57 | |||
| 85555 | RBC osmotic fragility | $32 | ||||
| 85555 | 26 | RBC osmotic fragility | $10 | |||
| 85555 | TC | RBC osmotic fragility | $22 | |||
| 85557 | RBC osmotic fragility | $63 | ||||
| 85557 | 26 | RBC osmotic fragility | $18 | |||
| 85557 | TC | RBC osmotic fragility | $45 | |||
| 85576 | Blood platelet aggrega | $41 | ||||
| 85576 | 26 | Blood platelet aggrega | $10 | |||
| 85597 | Platelet neutralizatio | BR | ||||
| 85597 | 26 | Platelet neutralizatio | BR | |||
| 85597 | TC | Platelet neutralizatio | BR | |||
| 85610 | Prothrombin time | $12 | ||||
| 85610 | 26 | Prothrombin time | $4 | |||
| 85610 | TC | Prothrombin time | $8 | |||
| 85611 | Prothrombin test | BR | ||||
| 85611 | 26 | Prothrombin test | BR | |||
| 85611 | TC | Prothrombin test | BR | |||
| 85612 | Viper venom prothrombi | $43 | ||||
| 85612 | 26 | Viper venom prothrombi | $12 | |||
| 85612 | TC | Viper venom prothrombi | $31 | |||
| 85613 | Russell viper venom, d | BR | ||||
| 85613 | 26 | Russell viper venom, d | BR | |||
| 85613 | TC | Russell viper venom, d | BR | |||
| 85635 | Reptilase test | $51 | ||||
| 85635 | 26 | Reptilase test | $16 | |||
| 85635 | TC | Reptilase test | $35 | |||
| 85651 | Rbc sed rate, nonautomated | $15 | ||||
| 85651 | 26 | Rbc sed rate, nonautomated | $3 | |||
| 85651 | TC | Rbc sed rate, nonautomated | $10 | |||
| 85652 | Rbc sed rate, automated | BR | ||||
| 85660 | RBC sickle cell test | $18 | ||||
| 85660 | 26 | RBC sickle cell test | $6 | |||
| 85660 | TC | RBC sickle cell test | $12 | |||
| 85670 | Thrombin time, plasma | $24 | ||||
| 85670 | 26 | Thrombin time, plasma | $6 | |||
| 85670 | TC | Thrombin time, plasma | $18 | |||
| 85675 | Thrombin time, titer | $24 | ||||
| 85675 | 26 | Thrombin time, titer | $8 | |||
| 85675 | TC | Thrombin time, titer | $16 | |||
| 85705 | Thromboplastin inhibit | BR | ||||
| 85705 | 26 | Thromboplastin inhibit | BR | |||
| 85705 | TC | Thromboplastin inhibit | BR | |||
| 85730 | Thromboplastin time, p | $20 | ||||
| 85730 | 26 | Thromboplastin time, p | $6 | |||
| 85730 | TC | Thromboplastin time, p | $14 | |||
| 85732 | Thromboplastin time, p | $32 | ||||
| 85732 | 26 | Thromboplastin time, p | $10 | |||
| 85732 | TC | Thromboplastin time, p | $22 | |||
| 85810 | Blood viscosity examin | $37 | ||||
| 85810 | 26 | Blood viscosity examin | $8 | |||
| 85810 | TC | Blood viscosity examin | $29 | |||
| 85999 | Hematology procedure | BR | ||||
| 85999 | 26 | Hematology procedure | BR | |||
| 85999 | TC | Hematology procedure | BR | |||
| 86000 | Agglutinins; febrile | $34 | ||||
| 86000 | 26 | Agglutinins; febrile | $12 | |||
| 86000 | TC | Agglutinins; febrile | $22 | |||
| 86003 | Allergen specific IgE | BR | ||||
| 86003 | 26 | Allergen specific IgE | BR | |||
| 86003 | TC | Allergen specific IgE | BR | |||
| 86005 | Allergen specific IgE | BR | ||||
| 86005 | 26 | Allergen specific IgE | BR | |||
| 86005 | TC | Allergen specific IgE | BR | |||
| 86021 | WBC antibody identific | $77 | ||||
| 86021 | 26 | WBC antibody identific | $22 | |||
| 86021 | TC | WBC antibody identific | $55 | |||
| 86022 | Platelet antibodies | $108 | ||||
| 86022 | 26 | Platelet antibodies | $35 | |||
| 86022 | TC | Platelet antibodies | $73 | |||
| 86023 | Immunoglobulin assay | $53 | ||||
| 86023 | 26 | Immunoglobulin assay | $18 | |||
| 86023 | TC | Immunoglobulin assay | $35 | |||
| 86038 | Antinuclear antibodies | $63 | ||||
| 86038 | 26 | Antinuclear antibodies | $20 | |||
| 86038 | TC | Antinuclear antibodies | $43 | |||
| 86039 | Antinuclear antibodies | BR | ||||
| 86039 | 26 | Antinuclear antibodies | BR | |||
| 86039 | TC | Antinuclear antibodies | BR | |||
| 86060 | Antistreptolysin O titer | $24 | ||||
| 86060 | 26 | Antistreptolysin O titer | $6 | |||
| 86060 | TC | Antistreptolysin O titer | $18 | |||
| 86063 | Antistreptolysin O screen | $41 | ||||
| 86063 | 26 | Antistreptolysin O screen | $12 | |||
| 86063 | TC | Antistreptolysin O screen | $29 | |||
| 86077 | Physician blood bank s | $169 | ||||
| 86077 | 26 | Physician blood bank s | $51 | |||
| 86077 | TC | Physician blood bank s | $118 | |||
| 86078 | Physician blood bank s | $169 | ||||
| 86078 | 26 | Physician blood bank s | $51 | |||
| 86078 | TC | Physician blood bank s | $118 | |||
| 86079 | Physician blood bank s | $147 | ||||
| 86079 | 26 | Physician blood bank s | $49 | |||
| 86079 | TC | Physician blood bank s | $98 | |||
| 86140 | C-reactive protein | $26 | ||||
| 86140 | 26 | C-reactive protein | $8 | |||
| 86140 | TC | C-reactive protein | $18 | |||
| 86147 | Cardiolipin antibody | BR | ||||
| 86147 | 26 | Cardiolipin antibody | BR | |||
| 86147 | TC | Cardiolipin antibody | BR | |||
| 86148 | Phospholipid antibody | BR | ||||
| 86155 | Chemotaxis assay | $51 | ||||
| 86155 | 26 | Chemotaxis assay | $16 | |||
| 86155 | TC | Chemotaxis assay | $35 | |||
| 86156 | Cold agglutinin screen | BR | ||||
| 86156 | 26 | Cold agglutinin screen | BR | |||
| 86156 | TC | Cold agglutinin screen | BR | |||
| 86157 | Cold agglutinin, titer | BR | ||||
| 86157 | 26 | Cold agglutinin, titer | BR | |||
| 86157 | TC | Cold agglutinin, titer | BR | |||
| 86160 | Complement, antigen | BR | ||||
| 86160 | 26 | Complement, antigen | BR | |||
| 86160 | TC | Complement, antigen | BR | |||
| 86161 | Complement/function ac | BR | ||||
| 86161 | 26 | Complement/function ac | BR | |||
| 86161 | TC | Complement/function ac | BR | |||
| 86162 | Complement, total (CH5 | $102 | ||||
| 86162 | 26 | Complement, total (CH5 | $35 | |||
| 86162 | TC | Complement, total (CH5 | $67 | |||
| 86171 | Complement fixation, each | $49 | ||||
| 86171 | 26 | Complement fixation, each | $14 | |||
| 86171 | TC | Complement fixation, each | $35 | |||
| 86185 | Counterimmunoelectroph | $36 | ||||
| 86185 | 26 | Counterimmunoelectroph | $12 | |||
| 86185 | TC | Counterimmunoelectroph | $24 | |||
| 86215 | Deoxyribonuclease, ant | $67 | ||||
| 86215 | 26 | Deoxyribonuclease, ant | $22 | |||
| 86215 | TC | Deoxyribonuclease, ant | $45 | |||
| 86225 | DNA antibody | $67 | ||||
| 86225 | 26 | DNA antibody | $20 | |||
| 86225 | TC | DNA antibody | $47 | |||
| 86226 | DNA antibody, single s | BR | ||||
| 86226 | 26 | DNA antibody, single s | BR | |||
| 86226 | TC | DNA antibody, single s | BR | |||
| 86235 | Nuclear antigen antibody | $61 | ||||
| 86235 | 26 | Nuclear antigen antibody | $18 | |||
| 86235 | TC | Nuclear antigen antibody | $43 | |||
| 86243 | Fc receptor | $94 | ||||
| 86243 | 26 | Fc receptor | $29 | |||
| 86243 | TC | Fc receptor | $65 | |||
| 86255 | Fluorescent antibody, screen | $76 | ||||
| 86255 | 26 | Fluorescent antibody, screen | $41 | |||
| 86255 | TC | Fluorescent antibody, | $35 | |||
| 86256 | Fluorescent antibody | $49 | ||||
| 86256 | 26 | Fluorescent antibody | $16 | |||
| 86256 | TC | Fluorescent antibody | $33 | |||
| 86277 | Growth hormone antibody | $77 | ||||
| 86277 | 26 | Growth hormone antibody | $26 | |||
| 86277 | TC | Growth hormone antibody | $51 | |||
| 86280 | Hemagglutination inhib | $28 | ||||
| 86280 | 26 | Hemagglutination inhib | $6 | |||
| 86280 | TC | Hemagglutination inhib | $22 | |||
| 86308 | Heterophile antibodies | BR | ||||
| 86308 | 26 | Heterophile antibodies | BR | |||
| 86308 | TC | Heterophile antibodies | BR | |||
| 86309 | Heterophile antibodies | BR | ||||
| 86309 | 26 | Heterophile antibodies | BR | |||
| 86309 | TC | Heterophile antibodies | BR | |||
| 86310 | Heterophile antibodies | $36 | ||||
| 86310 | 26 | Heterophile antibodies | $12 | |||
| 86310 | TC | Heterophile antibodies | $24 | |||
| 86316 | Immunoassay, tumor ant | $69 | ||||
| 86316 | 26 | Immunoassay, tumor ant | $20 | |||
| 86316 | TC | Immunoassay, tumor ant | $49 | |||
| 86317 | Immunoassay,infectious agent | $64 | ||||
| 86317 | 26 | Immunoassay,infectious agent | $20 | |||
| 86317 | TC | Immunoassay,infectious agent | $44 | |||
| 86318 | Immunoassay,infectious agent | $64 | ||||
| 86318 | 26 | Immunoassay,infectious agent | $26 | |||
| 86318 | TC | Immunoassay,infectious agent | $38 | |||
| 86320 | Serum immunoelectropho | $92 | ||||
| 86320 | 26 | Serum immunoelectropho | $37 | |||
| 86320 | TC | Serum immunoelectropho | $55 | |||
| 86325 | Other immunoelectropho | $92 | ||||
| 86325 | 26 | Other immunoelectropho | $31 | |||
| 86325 | TC | Other immunoelectropho | $61 | |||
| 86327 | Immunoelectrophoresis | $116 | ||||
| 86327 | 26 | Immunoelectrophoresis | $37 | |||
| 86327 | TC | Immunoelectrophoresis | $79 | |||
| 86328 | IA Infectious Agt Antibody SARS-COV-2 COVID-19 | $90 | ||||
| 86329 | Immunodiffusion | $69 | ||||
| 86329 | 26 | Immunodiffusion | $22 | |||
| 86329 | TC | Immunodiffusion | $47 | |||
| 86331 | Immunodiffusion ouchte | $61 | ||||
| 86331 | 26 | Immunodiffusion ouchte | $18 | |||
| 86331 | TC | Immunodiffusion ouchte | $43 | |||
| 86332 | Immune complex assay | $102 | ||||
| 86332 | 26 | Immune complex assay | $35 | |||
| 86332 | TC | Immune complex assay | $67 | |||
| 86334 | Immunofixation procedure | $121 | ||||
| 86334 | 26 | Immunofixation procedure | $35 | |||
| 86334 | TC | Immunofixation procedure | $86 | |||
| 86335 | Immunfix e-phorsis/urine/csf | $40 | ||||
| 86337 | Insulin antibodies | $102 | ||||
| 86337 | 26 | Insulin antibodies | $35 | |||
| 86337 | TC | Insulin antibodies | $67 | |||
| 86340 | Intrinsic factor antibody | $73 | ||||
| 86340 | 26 | Intrinsic factor antibody | $24 | |||
| 86340 | TC | Intrinsic factor antibody | $49 | |||
| 86341 | Islet cell antibody | BR | ||||
| 86341 | 26 | Islet cell antibody | BR | |||
| 86341 | TC | Islet cell antibody | BR | |||
| 86343 | Leukocyte histamine re | $61 | ||||
| 86343 | 26 | Leukocyte histamine re | $20 | |||
| 86343 | TC | Leukocyte histamine re | $41 | |||
| 86344 | Leukocyte phagocytosis | $40 | ||||
| 86344 | 26 | Leukocyte phagocytosis | $14 | |||
| 86344 | TC | Leukocyte phagocytosis | $26 | |||
| 86353 | Lymphocyte transformat | $189 | ||||
| 86353 | 26 | Lymphocyte transformat | $57 | |||
| 86353 | TC | Lymphocyte transformat | $132 | |||
| 86359 | T cells, total count | BR | ||||
| 86359 | 26 | T cells, total count | BR | |||
| 86359 | TC | T cells, total count | BR | |||
| 86360 | T cell, absolute count ratio | BR | ||||
| 86360 | 26 | T cell, absolute count ratio | BR | |||
| 86360 | TC | T cell, absolute count ratio | BR | |||
| 86361 | T cell, absolute count | BR | ||||
| 86769 | Anb Severe Aqt Respir Synd SARS-COV-2 COVID 19 | $84 | ||||
| 86376 | Microsomal antibody | $65 | ||||
| 86376 | 26 | Microsomal antibody | $20 | |||
| 86376 | TC | Microsomal antibody | $45 | |||
| 86378 | Migration inhibitory f | $86 | ||||
| 86378 | 26 | Migration inhibitory f | $29 | |||
| 86378 | TC | Migration inhibitory f | $57 | |||
| 86382 | Neutralization test, viral | $85 | ||||
| 86382 | 26 | Neutralization test, viral | $26 | |||
| 86382 | TC | Neutralization test, viral | $59 | |||
| 86384 | Nitroblue tetrazolium | $47 | ||||
| 86384 | 26 | Nitroblue tetrazolium | $16 | |||
| 86384 | TC | Nitroblue tetrazolium | $31 | |||
| 86403 | Particle agglutination test | $38 | ||||
| 86403 | 26 | Particle agglutination test | $8 | |||
| 86403 | TC | Particle agglutination test | $30 | |||
| 86406 | Particle agglutination | BR | ||||
| 86430 | Rheumatoid factor test | $24 | ||||
| 86430 | 26 | Rheumatoid factor test | $8 | |||
| 86430 | TC | Rheumatoid factor test | $16 | |||
| 86431 | Rheumatoid factor, qua | $32 | ||||
| 86431 | 26 | Rheumatoid factor, qua | $12 | |||
| 86431 | TC | Rheumatoid factor, qua | $20 | |||
| 86485 | Skin test, candida | BR | ||||
| 86485 | 26 | Skin test, candida | BR | |||
| 86485 | TC | Skin test, candida | BR | |||
| 86486 | Skin test nos antigen | $11 | ||||
| 86490 | Coccidioidomycosis skin | $32 | ||||
| 86490 | 26 | Coccidioidomycosis skin | $10 | |||
| 86490 | TC | Coccidioidomycosis skin | $22 | |||
| 86510 | Histoplasmosis skin test | $24 | ||||
| 86510 | 26 | Histoplasmosis skin test | $8 | |||
| 86510 | TC | Histoplasmosis skin test | $16 | |||
| 86580 | TB intradermal test | $24 | ||||
| 86580 | 26 | TB intradermal test | $8 | |||
| 86580 | TC | TB intradermal test | $16 | |||
| 86590 | Streptokinase, antibody | $34 | ||||
| 86590 | 26 | Streptokinase, antibody | $12 | |||
| 86590 | TC | Streptokinase, antibody | $22 | |||
| 86592 | Blood serology, quality | $16 | ||||
| 86592 | 26 | Blood serology, quality | $4 | |||
| 86592 | TC | Blood serology, quality | $12 | |||
| 86593 | Blood serology, quantity | $20 | ||||
| 86593 | 26 | Blood serology, quantity | $6 | |||
| 86593 | TC | Blood serology, quantity | $14 | |||
| 86602 | Antinomyces antibody | BR | ||||
| 86602 | 26 | Antinomyces antibody | BR | |||
| 86602 | TC | Antinomyces antibody | BR | |||
| 86603 | Adenovirus, antibody | BR | ||||
| 86603 | 26 | Adenovirus, antibody | BR | |||
| 86603 | TC | Adenovirus, antibody | BR | |||
| 86606 | Aspergillus antibody | BR | ||||
| 86606 | 26 | Aspergillus antibody | BR | |||
| 86606 | TC | Aspergillus antibody | BR | |||
| 86609 | Bacterium, antibody | BR | ||||
| 86609 | 26 | Bacterium, antibody | BR | |||
| 86609 | TC | Bacterium, antibody | BR | |||
| 86612 | Blastomyces, antibody | BR | ||||
| 86612 | 26 | Blastomyces, antibody | BR | |||
| 86612 | TC | Blastomyces, antibody | BR | |||
| 86615 | Bordetella antibody | BR | ||||
| 86615 | 26 | Bordetella antibody | BR | |||
| 86615 | TC | Bordetella antibody | BR | |||
| 86617 | Lyme disease antibody | BR | ||||
| 86618 | Lyme disease antibody | BR | ||||
| 86618 | 26 | Lyme disease antibody | BR | |||
| 86618 | TC | Lyme disease antibody | BR | |||
| 86619 | Borrelia antibody | BR | ||||
| 86619 | 26 | Borrelia antibody | BR | |||
| 86619 | TC | Borrelia antibody | BR | |||
| 86622 | Brucella, antibody | BR | ||||
| 86622 | 26 | Brucella, antibody | BR | |||
| 86622 | TC | Brucella, antibody | BR | |||
| 86625 | Campylobacter, antibody | BR | ||||
| 86625 | 26 | Campylobacter, antibody | BR | |||
| 86625 | TC | Campylobacter, antibody | BR | |||
| 86628 | Candida, antibody | BR | ||||
| 86628 | 26 | Candida, antibody | BR | |||
| 86628 | TC | Candida, antibody | BR | |||
| 86631 | Chlamydia, antibody | BR | ||||
| 86631 | 26 | Chlamydia, antibody | BR | |||
| 86631 | TC | Chlamydia, antibody | BR | |||
| 86632 | Chlamydia, IgM, antibody | BR | ||||
| 86632 | 26 | Chlamydia, IgM, antibody | BR | |||
| 86632 | TC | Chlamydia, IgM, antibody | BR | |||
| 86635 | Coccidioides, antibody | BR | ||||
| 86635 | 26 | Coccidioides, antibody | BR | |||
| 86635 | TC | Coccidioides, antibody | BR | |||
| 86638 | Q fever antibody | BR | ||||
| 86638 | 26 | Q fever antibody | BR | |||
| 86638 | TC | Q fever antibody | BR | |||
| 86641 | Cryptococcus antibody | BR | ||||
| 86641 | 26 | Cryptococcus antibody | BR | |||
| 86641 | TC | Cryptococcus antibody | BR | |||
| 86644 | CMV antibody | BR | ||||
| 86644 | 26 | CMV antibody | BR | |||
| 86644 | TC | CMV antibody | BR | |||
| 86645 | CMV antibody, IgM | BR | ||||
| 86645 | 26 | CMV antibody, IgM | BR | |||
| 86645 | TC | CMV antibody, IgM | BR | |||
| 86648 | Diphtheria antibody | BR | ||||
| 86648 | 26 | Diphtheria antibody | BR | |||
| 86648 | TC | Diphtheria antibody | BR | |||
| 86651 | Encephalitis antibody | BR | ||||
| 86651 | 26 | Encephalitis antibody | BR | |||
| 86651 | TC | Encephalitis antibody | BR | |||
| 86652 | Encephalitis antibody | BR | ||||
| 86652 | 26 | Encephalitis antibody | BR | |||
| 86652 | TC | Encephalitis antibody | BR | |||
| 86653 | Encephalitis, antibody | BR | ||||
| 86653 | 26 | Encephalitis, antibody | BR | |||
| 86653 | TC | Encephalitis, antibody | BR | |||
| 86654 | Encephalitis, antibody | BR | ||||
| 86654 | 26 | Encephalitis, antibody | BR | |||
| 86654 | TC | Encephalitis, antibody | BR | |||
| 86658 | Enterovirus, antibody | BR | ||||
| 86658 | 26 | Enterovirus, antibody | BR | |||
| 86658 | TC | Enterovirus, antibody | BR | |||
| 86663 | Epstein-barr antibody | BR | ||||
| 86663 | 26 | Epstein-barr antibody | BR | |||
| 86663 | TC | Epstein-barr antibody | BR | |||
| 86664 | Epstein-barr antibody | BR | ||||
| 86664 | 26 | Epstein-barr antibody | BR | |||
| 86664 | TC | Epstein-barr antibody | BR | |||
| 86665 | Epstein-barr, antibody | BR | ||||
| 86665 | 26 | Epstein-barr, antibody | BR | |||
| 86665 | TC | Epstein-barr, antibody | BR | |||
| 86668 | Francisella tularensis | BR | ||||
| 86668 | 26 | Francisella tularensis | BR | |||
| 86668 | TC | Francisella tularensis | BR | |||
| 86671 | Fungus, antibody | BR | ||||
| 86671 | 26 | Fungus, antibody | BR | |||
| 86671 | TC | Fungus, antibody | BR | |||
| 86674 | Giardia lamblia | BR | ||||
| 86674 | 26 | Giardia lamblia | BR | |||
| 86674 | TC | Giardia lamblia | BR | |||
| 86677 | Helicobacter pylori | BR | ||||
| 86677 | 26 | Helicobacter pylori | BR | |||
| 86677 | TC | Helicobacter pylori | BR | |||
| 86682 | Helminth, antibody | BR | ||||
| 86682 | 26 | Helminth, antibody | BR | |||
| 86682 | TC | Helminth, antibody | BR | |||
| 86684 | Hemophilus influenza | BR | ||||
| 86684 | 26 | Hemophilus influenza | BR | |||
| 86684 | TC | Hemophilus influenza | BR | |||
| 86687 | HTLV I | $20 | ||||
| 86687 | 26 | HTLV I | $6 | |||
| 86687 | TC | HTLV I | $14 | |||
| 86688 | HTLV-II | BR | ||||
| 86688 | 26 | HTLV-II | BR | |||
| 86688 | TC | HTLV-II | BR | |||
| 86689 | HTLV/HIV confirmatory | $20 | ||||
| 86689 | 26 | HTLV/HIV confirmatory | $6 | |||
| 86689 | TC | HTLV/HIV confirmatory | $14 | |||
| 86692 | Hepatitis, delta agent | BR | ||||
| 86692 | 26 | Hepatitis, delta agent | BR | |||
| 86692 | TC | Hepatitis, delta agent | BR | |||
| 86694 | Herpes simplex test | BR | ||||
| 86694 | 26 | Herpes simplex test | BR | |||
| 86694 | TC | Herpes simplex test | BR | |||
| 86695 | Herpes simplex test | BR | ||||
| 86695 | 26 | Herpes simplex test | BR | |||
| 86695 | TC | Herpes simplex test | BR | |||
| 86698 | Histoplasma | BR | ||||
| 86698 | 26 | Histoplasma | BR | |||
| 86698 | TC | Histoplasma | BR | |||
| 86701 | HIV-1 | BR | ||||
| 86701 | 26 | HIV-1 | BR | |||
| 86701 | TC | HIV-1 | BR | |||
| 86702 | HIV-2 | BR | ||||
| 86702 | 26 | HIV-2 | BR | |||
| 86702 | TC | HIV-2 | BR | |||
| 86703 | HIV-1/HIV-2, single assay | BR | ||||
| 86703 | 26 | HIV-1/HIV-2, single assay | BR | |||
| 86703 | TC | HIV-1/HIV-2, single assay | BR | |||
| 86704 | Hep b core antibody, | BR | ||||
| 86705 | Hep b core antibody, igm | BR | ||||
| 86706 | Hep b surface antibody | BR | ||||
| 86707 | Hep be antibody....... | BR | ||||
| 86708 | Hep a antibody, igg/ igm | BR | ||||
| 86709 | Hep a antibody, igm... | BR | ||||
| 86710 | Influenza virus antibody | BR | ||||
| 86710 | 26 | Influenza virus antibody | BR | |||
| 86710 | TC | Influenza virus antibody | BR | |||
| 86713 | Legionella | BR | ||||
| 86713 | 26 | Legionella | BR | |||
| 86713 | TC | Legionella | BR | |||
| 86717 | Leishmania | BR | ||||
| 86717 | 26 | Leishmania | BR | |||
| 86717 | TC | Leishmania | BR | |||
| 86720 | Leptospira | BR | ||||
| 86720 | 26 | Leptospira | BR | |||
| 86720 | TC | Leptospira | BR | |||
| 86723 | Listeria monocytogenes | BR | ||||
| 86723 | 26 | Listeria monocytogenes | BR | |||
| 86723 | TC | Listeria monocytogenes | BR | |||
| 86727 | Lymph choriomeningitis | BR | ||||
| 86727 | 26 | Lymph choriomeningitis | BR | |||
| 86727 | TC | Lymph choriomeningitis | BR | |||
| 86729 | Lympho venereum | BR | ||||
| 86729 | 26 | Lympho venereum | BR | |||
| 86729 | TC | Lympho venereum | BR | |||
| 86732 | Mucormycosis | BR | ||||
| 86732 | 26 | Mucormycosis | BR | |||
| 86732 | TC | Mucormycosis | BR | |||
| 86735 | Mumps | $24 | ||||
| 86735 | 26 | Mumps | $8 | |||
| 86735 | TC | Mumps | $16 | |||
| 86738 | Mycoplasma | BR | ||||
| 86738 | 26 | Mycoplasma | BR | |||
| 86738 | TC | Mycoplasma | BR | |||
| 86741 | Neisseria meningitidis | BR | ||||
| 86741 | 26 | Neisseria meningitidis | BR | |||
| 86741 | TC | Neisseria meningitidis | BR | |||
| 86744 | Nocardia | BR | ||||
| 86744 | 26 | Nocardia | BR | |||
| 86744 | TC | Nocardia | BR | |||
| 86747 | Parvovirus | BR | ||||
| 86747 | 26 | Parvovirus | BR | |||
| 86747 | TC | Parvovirus | BR | |||
| 86750 | Malaria | BR | ||||
| 86750 | 26 | Malaria | BR | |||
| 86750 | TC | Malaria | BR | |||
| 86753 | Protozoa, not elsewhere | BR | ||||
| 86753 | 26 | Protozoa, not elsewhere | BR | |||
| 86753 | TC | Protozoa, not elsewhere | BR | |||
| 86756 | Respiratory virus | BR | ||||
| 86756 | 26 | Respiratory virus | BR | |||
| 86756 | TC | Respiratory virus | BR | |||
| 86759 | Rotavirus | BR | ||||
| 86759 | 26 | Rotavirus | BR | |||
| 86759 | TC | Rotavirus | BR | |||
| 86762 | Rubella | BR | ||||
| 86762 | 26 | Rubella | BR | |||
| 86762 | TC | Rubella | BR | |||
| 86765 | Rubeola | BR | ||||
| 86765 | 26 | Rubeola | BR | |||
| 86765 | TC | Rubeola | BR | |||
| 86768 | Salmonella | BR | ||||
| 86768 | 26 | Salmonella | BR | |||
| 86768 | TC | Salmonella | BR | |||
| 86771 | Shigella | BR | ||||
| 86771 | 26 | Shigella | BR | |||
| 86771 | TC | Shigella | BR | |||
| 86774 | Tetanus | BR | ||||
| 86774 | 26 | Tetanus | BR | |||
| 86774 | TC | Tetanus | BR | |||
| 86777 | Toxoplasma | BR | ||||
| 86777 | 26 | Toxoplasma | BR | |||
| 86777 | TC | Toxoplasma | BR | |||
| 86778 | Toxoplasma, IgM | BR | ||||
| 86778 | 26 | Toxoplasma, IgM | BR | |||
| 86778 | TC | Toxoplasma, IgM | BR | |||
| 86784 | Trichinella | BR | ||||
| 86784 | 26 | Trichinella | BR | |||
| 86784 | TC | Trichinella | BR | |||
| 86787 | Varicella-zoster | BR | ||||
| 86787 | 26 | Varicella-zoster | BR | |||
| 86787 | TC | Varicella-zoster | BR | |||
| 86790 | Virus, not specified | BR | ||||
| 86790 | 26 | Virus, not specified | BR | |||
| 86790 | TC | Virus, not specified | BR | |||
| 86793 | Yersinia | BR | ||||
| 86793 | 26 | Yersinia | BR | |||
| 86793 | TC | Yersinia | BR | |||
| 86800 | Thyroglobulin antibody | $79 | ||||
| 86800 | 26 | Thyroglobulin antibody | $26 | |||
| 86800 | TC | Thyroglobulin antibody | $53 | |||
| 86803 | Hepatitis c ab test... | BR | ||||
| 86804 | Hep c ab test, confirm | BR | ||||
| 86805 | Lymphocytotoxicity assay | $179 | ||||
| 86805 | 26 | Lymphocytotoxicity assay | $61 | |||
| 86805 | TC | Lymphocytotoxicity assay | $118 | |||
| 86806 | Lymphocytotoxicity assay | $161 | ||||
| 86806 | 26 | Lymphocytotoxicity assay | $53 | |||
| 86806 | TC | Lymphocytotoxicity assay | $108 | |||
| 86807 | Cytotoxic antibody scr | $137 | ||||
| 86807 | 26 | Cytotoxic antibody scr | $41 | |||
| 86807 | TC | Cytotoxic antibody scr | $96 | |||
| 86808 | Cytotoxic antibody scr | $98 | ||||
| 86808 | 26 | Cytotoxic antibody scr | $29 | |||
| 86808 | TC | Cytotoxic antibody scr | $69 | |||
| 86812 | HLA typing, A, B, or C | $244 | ||||
| 86812 | 26 | HLA typing, A, B, or C | $73 | |||
| 86812 | TC | HLA typing, A, B, or C | $171 | |||
| 86813 | HLA typing, A, B, or C | $187 | ||||
| 86813 | 26 | HLA typing, A, B, or C | $57 | |||
| 86813 | TC | HLA typing, A, B, or C | $130 | |||
| 86816 | HLA typing, DR/DQ | $119 | ||||
| 86816 | 26 | HLA typing, DR/DQ | $35 | |||
| 86816 | TC | HLA typing, DR/DQ | $84 | |||
| 86817 | HLA typing, DR/DQ | $246 | ||||
| 86817 | 26 | HLA typing, DR/DQ | $73 | |||
| 86817 | TC | HLA typing, DR/DQ | $173 | |||
| 86821 | Lymphocyte culture, mi | $226 | ||||
| 86821 | 26 | Lymphocyte culture, mi | $67 | |||
| 86821 | TC | Lymphocyte culture, mi | $159 | |||
| 86822 | Lymphocyte culture, pr | $177 | ||||
| 86822 | 26 | Lymphocyte culture, pr | $59 | |||
| 86822 | TC | Lymphocyte culture, pr | $118 | |||
| 86849 | Immunology procedure | BR | ||||
| 86849 | 26 | Immunology procedure | BR | |||
| 86849 | TC | Immunology procedure | BR | |||
| 86850 | RBC antibody screen | $22 | ||||
| 86850 | 26 | RBC antibody screen | $8 | |||
| 86850 | TC | RBC antibody screen | $14 | |||
| 86860 | RBC antibody elution | $84 | ||||
| 86860 | 26 | RBC antibody elution | $29 | |||
| 86860 | TC | RBC antibody elution | $55 | |||
| 86870 | RBC antibody identific | BR | ||||
| 86870 | 26 | RBC antibody identific | BR | |||
| 86870 | TC | RBC antibody identific | BR | |||
| 86880 | Coombs test | $24 | ||||
| 86880 | 26 | Coombs test | $8 | |||
| 86880 | TC | Coombs test | $16 | |||
| 86885 | Coombs test | BR | ||||
| 86885 | 26 | Coombs test | BR | |||
| 86885 | TC | Coombs test | BR | |||
| 86886 | Coombs test | $26 | ||||
| 86886 | 26 | Coombs test | $8 | |||
| 86886 | TC | Coombs test | $18 | |||
| 86890 | Autologous blood proce | BR | ||||
| 86890 | 26 | Autologous blood proce | BR | |||
| 86890 | TC | Autologous blood proce | BR | |||
| 86891 | Autologous blood, op s | $169 | ||||
| 86891 | 26 | Autologous blood, op s | $51 | |||
| 86891 | TC | Autologous blood, op s | $118 | |||
| 86900 | Blood typing, ABO | $20 | ||||
| 86900 | 26 | Blood typing, ABO | $6 | |||
| 86900 | TC | Blood typing, ABO | $14 | |||
| 86901 | Blood typing, Rh (D) | $22 | ||||
| 86901 | 26 | Blood typing, Rh (D) | $8 | |||
| 86901 | TC | Blood typing, Rh (D) | $14 | |||
| 86904 | Blood typing, patient | $36 | ||||
| 86904 | 26 | Blood typing, patient | $12 | |||
| 86904 | TC | Blood typing, patient | $24 | |||
| 86905 | Blood typing, RBC anti | $16 | ||||
| 86905 | 26 | Blood typing, RBC anti | $4 | |||
| 86905 | TC | Blood typing, RBC anti | $12 | |||
| 86906 | Blood typing, Rh pheno | BR | ||||
| 86906 | 26 | Blood typing, Rh pheno | BR | |||
| 86906 | TC | Blood typing, Rh pheno | BR | |||
| 86910 | Blood typing, paternity test | $155 | ||||
| 86910 | 26 | Blood typing, paternity test | $47 | |||
| 86910 | TC | Blood typing, paternity test | $108 | |||
| 86911 | Blood typing, antigen | BR | ||||
| 86911 | 26 | Blood typing, antigen | BR | |||
| 86911 | TC | Blood typing, antigen | BR | |||
| 86920 | Compatibility test | $39 | ||||
| 86920 | 26 | Compatibility test | $8 | |||
| 86920 | TC | Compatibility test | $31 | |||
| 86921 | Compatibility test | $45 | ||||
| 86921 | 26 | Compatibility test | $14 | |||
| 86921 | TC | Compatibility test | $31 | |||
| 86922 | Compatibility test | $45 | ||||
| 86922 | 26 | Compatibility test | $14 | |||
| 86922 | TC | Compatibility test | $31 | |||
| 86927 | Plasma, fresh frozen | BR | ||||
| 86927 | 26 | Plasma, fresh frozen | BR | |||
| 86927 | TC | Plasma, fresh frozen | BR | |||
| 86930 | Frozen blood prep | $286 | ||||
| 86930 | 26 | Frozen blood prep | $86 | |||
| 86930 | TC | Frozen blood prep | $200 | |||
| 86931 | Frozen blood thaw | $286 | ||||
| 86931 | 26 | Frozen blood thaw | $86 | |||
| 86931 | TC | Frozen blood thaw | $200 | |||
| 86932 | Frozen blood, freeze/t | $296 | ||||
| 86932 | 26 | Frozen blood, freeze/t | $90 | |||
| 86932 | TC | Frozen blood, freeze/t | $206 | |||
| 86940 | Hemolysins/ agglutinins, auto | $34 | ||||
| 86940 | 26 | Hemolysins/ agglutinins, auto | $10 | |||
| 86940 | TC | Hemolysins/ agglutinins, auto | $24 | |||
| 86941 | Hemolysins/agglutinins | $57 | ||||
| 86941 | 26 | Hemolysins/agglutinins | $16 | |||
| 86941 | TC | Hemolysins/agglutinins | $41 | |||
| 86945 | Blood product/irradiation | $65 | ||||
| 86945 | 26 | Blood product/irradiation | $20 | |||
| 86945 | TC | Blood product/irradiation | $45 | |||
| 86950 | Leukacyte transfusion | $183 | ||||
| 86950 | 26 | Leukacyte transfusion | $55 | |||
| 86950 | TC | Leukacyte transfusion | $128 | |||
| 86965 | Pooling blood platelet | $49 | ||||
| 86965 | 26 | Pooling blood platelet | $14 | |||
| 86965 | TC | Pooling blood platelet | $35 | |||
| 86970 | RBC pretreatment | $77 | ||||
| 86970 | 26 | RBC pretreatment | $22 | |||
| 86970 | TC | RBC pretreatment | $55 | |||
| 86971 | RBC pretreatment | $39 | ||||
| 86971 | 26 | RBC pretreatment | $10 | |||
| 86971 | TC | RBC pretreatment | $29 | |||
| 86972 | RBC pretreatment | $38 | ||||
| 86972 | 26 | RBC pretreatment | $12 | |||
| 86972 | TC | RBC pretreatment | $26 | |||
| 86975 | RBC pretreatment, serum | $100 | ||||
| 86975 | 26 | RBC pretreatment, serum | $31 | |||
| 86975 | TC | RBC pretreatment, serum | $69 | |||
| 86976 | RBC pretreatment, serum | $100 | ||||
| 86976 | 26 | RBC pretreatment, serum | $31 | |||
| 86976 | TC | RBC pretreatment, serum | $69 | |||
| 86977 | RBC pretreatment, serum | $100 | ||||
| 86977 | 26 | RBC pretreatment, serum | $31 | |||
| 86977 | TC | RBC pretreatment, serum | $69 | |||
| 86978 | RBC pretreatment, serum | $121 | ||||
| 86978 | 26 | RBC pretreatment, serum | $37 | |||
| 86978 | TC | RBC pretreatment, serum | $84 | |||
| 86985 | Split blood or product | BR | ||||
| 86985 | 26 | Split blood or product | BR | |||
| 86985 | TC | Split blood or product | BR | |||
| 86999 | Transfusion procedure | BR | ||||
| 86999 | 26 | Transfusion procedure | BR | |||
| 86999 | TC | Transfusion procedure | BR | |||
| 87001 | Small animal inoculation | $65 | ||||
| 87001 | 26 | Small animal inoculation | $20 | |||
| 87001 | TC | Small animal inoculation | $45 | |||
| 87003 | Small animal inoculation | $75 | ||||
| 87003 | 26 | Small animal inoculation | $24 | |||
| 87003 | TC | Small animal inoculation | $51 | |||
| 87015 | Specimen concentration | $30 | ||||
| 87015 | 26 | Specimen concentration | $10 | |||
| 87015 | TC | Specimen concentration | $20 | |||
| 87040 | Blood culture for bact | $34 | ||||
| 87040 | 26 | Blood culture for bact | $12 | |||
| 87040 | TC | Blood culture for bact | $22 | |||
| 87045 | Stool culture for bact | $43 | ||||
| 87045 | 26 | Stool culture for bact | $14 | |||
| 87045 | TC | Stool culture for bact | $29 | |||
| 87070 | Culture specimen, bact | $26 | ||||
| 87070 | 26 | Culture specimen, bact | $8 | |||
| 87070 | TC | Culture specimen, bact | $18 | |||
| 87075 | Culture specimen, bact | $34 | ||||
| 87075 | 26 | Culture specimen, bact | $12 | |||
| 87075 | TC | Culture specimen, bact | $22 | |||
| 87076 | Bacteria identification | $47 | ||||
| 87076 | 26 | Bacteria identification | $16 | |||
| 87076 | TC | Bacteria identification | $31 | |||
| 87081 | Bacteria culture screen | $22 | ||||
| 87081 | 26 | Bacteria culture screen | $6 | |||
| 87081 | TC | Bacteria culture screen | $16 | |||
| 87084 | Culture of specimen by | $45 | ||||
| 87084 | 26 | Culture of specimen by | $14 | |||
| 87084 | TC | Culture of specimen by | $31 | |||
| 87086 | Urine culture, colony | $26 | ||||
| 87086 | 26 | Urine culture, colony | $6 | |||
| 87086 | TC | Urine culture, colony | $20 | |||
| 87088 | Urine bacteria culture | $34 | ||||
| 87088 | 26 | Urine bacteria culture | $12 | |||
| 87088 | TC | Urine bacteria culture | $22 | |||
| 87101 | Skin fungus culture | $38 | ||||
| 87101 | 26 | Skin fungus culture | $12 | |||
| 87101 | TC | Skin fungus culture | $26 | |||
| 87102 | Fungus isolation cultu | $38 | ||||
| 87102 | 26 | Fungus isolation cultu | $12 | |||
| 87102 | TC | Fungus isolation cultu | $26 | |||
| 87103 | Blood fungus culture | $59 | ||||
| 87103 | 26 | Blood fungus culture | $20 | |||
| 87103 | TC | Blood fungus culture | $39 | |||
| 87106 | Fungus identification | $49 | ||||
| 87106 | 26 | Fungus identification | $14 | |||
| 87106 | TC | Fungus identification | $35 | |||
| 87109 | Mycoplasma culture | $51 | ||||
| 87109 | 26 | Mycoplasma culture | $16 | |||
| 87109 | TC | Mycoplasma culture | $35 | |||
| 87110 | Culture, chlamydia | $61 | ||||
| 87110 | 26 | Culture, chlamydia | $18 | |||
| 87110 | TC | Culture, chlamydia | $43 | |||
| 87116 | Mycobacteria culture | $49 | ||||
| 87116 | 26 | Mycobacteria culture | $14 | |||
| 87116 | TC | Mycobacteria culture | $35 | |||
| 87118 | Mycobacteria identific | $49 | ||||
| 87118 | 26 | Mycobacteria identific | $14 | |||
| 87118 | TC | Mycobacteria identific | $35 | |||
| 87140 | Culture typing, fluore | $47 | ||||
| 87140 | 26 | Culture typing, fluore | $14 | |||
| 87140 | TC | Culture typing, fluore | $33 | |||
| 87143 | Culture typing, GLC me | $63 | ||||
| 87143 | 26 | Culture typing, GLC me | $20 | |||
| 87143 | TC | Culture typing, GLC me | $43 | |||
| 87147 | Culture typing, serolo | $51 | ||||
| 87147 | 26 | Culture typing, serolo | $16 | |||
| 87147 | TC | Culture typing, serolo | $35 | |||
| 87158 | Culture typing, added | $18 | ||||
| 87158 | 26 | Culture typing, added | $4 | |||
| 87158 | TC | Culture typing, added | $14 | |||
| 87163 | Special microbiology c | $57 | ||||
| 87163 | 26 | Special microbiology c | $18 | |||
| 87163 | TC | Special microbiology c | $39 | |||
| 87164 | Dark field examination | $47 | ||||
| 87164 | 26 | Dark field examination | $16 | |||
| 87164 | TC | Dark field examination | $31 | |||
| 87166 | Dark field examination | $47 | ||||
| 87166 | 26 | Dark field examination | $14 | |||
| 87166 | TC | Dark field examination | $33 | |||
| 87176 | Endotoxin, bacterial | $30 | ||||
| 87176 | 26 | Endotoxin, bacterial | $10 | |||
| 87176 | TC | Endotoxin, bacterial | $20 | |||
| 87177 | Ova and parasites smear | $34 | ||||
| 87177 | 26 | Ova and parasites smear | $12 | |||
| 87177 | TC | Ova and parasites smear | $22 | |||
| 87181 | Antibiotic sensitivity | $24 | ||||
| 87181 | 26 | Antibiotic sensitivity | $8 | |||
| 87181 | TC | Antibiotic sensitivity | $16 | |||
| 87184 | Antibiotic sensitivity, each | $27 | ||||
| 87184 | 26 | Antibiotic sensitivity, each | $7 | |||
| 87184 | TC | Antibiotic sensitivity, each | $20 | |||
| 87186 | Antibiotic sensitivity | $30 | ||||
| 87186 | 26 | Antibiotic sensitivity | $8 | |||
| 87186 | TC | Antibiotic sensitivity | $22 | |||
| 87187 | Antibiotic sensitivity | $39 | ||||
| 87187 | 26 | Antibiotic sensitivity | $6 | |||
| 87187 | TC | Antibiotic sensitivity | $33 | |||
| 87188 | Antibiotic sensitivity | $34 | ||||
| 87188 | 26 | Antibiotic sensitivity | $10 | |||
| 87188 | TC | Antibiotic sensitivity | $24 | |||
| 87190 | TB antibiotic sensitivity | $14 | ||||
| 87190 | 26 | TB antibiotic sensitivity | $4 | |||
| 87190 | TC | TB antibiotic sensitivity | $10 | |||
| 87197 | Bactericidal level, serum | $55 | ||||
| 87197 | 26 | Bactericidal level, serum | $18 | |||
| 87197 | TC | Bactericidal level, serum | $37 | |||
| 87205 | Smear, stain & interpret | $20 | ||||
| 87205 | 26 | Smear, stain & interpret | $6 | |||
| 87205 | TC | Smear, stain & interpret | $14 | |||
| 87206 | Smear, stain & interpret | $28 | ||||
| 87206 | 26 | Smear, stain & interpret | $6 | |||
| 87206 | TC | Smear, stain & interpret | $22 | |||
| 87207 | Smear, stain & interpret | $18 | ||||
| 87207 | 26 | Smear, stain & interpret | $6 | |||
| 87207 | TC | Smear, stain & interpret | $12 | |||
| 87210 | Smear, stain & interpret | $16 | ||||
| 87210 | 26 | Smear, stain & interpret | $4 | |||
| 87210 | TC | Smear, stain & interpret | $12 | |||
| 87220 | Tissue exam for fungi | $22 | ||||
| 87220 | 26 | Tissue exam for fungi | $8 | |||
| 87220 | TC | Tissue exam for fungi | $14 | |||
| 87230 | Assay, toxin or antitoxin | $65 | ||||
| 87230 | 26 | Assay, toxin or antitoxin | $20 | |||
| 87230 | TC | Assay, toxin or antito | $45 | |||
| 87250 | Virus inoculation for test | $61 | ||||
| 87250 | 26 | Virus inoculation for test | $24 | |||
| 87250 | TC | Virus inoculation for test | $37 | |||
| 87252 | Virus inoculation for test | $83 | ||||
| 87252 | 26 | Virus inoculation for test | $26 | |||
| 87252 | TC | Virus inoculation for test | $57 | |||
| 87253 | Virus inoculation for test | $61 | ||||
| 87253 | 26 | Virus inoculation for test | $18 | |||
| 87253 | TC | Virus inoculation for test | $43 | |||
| 87260 | Adenovirus ag, dfa.... | BR | ||||
| 87265 | Pertussis ag, dfa..... | BR | ||||
| 87270 | Chylmd trach ag, dfa.. | BR | ||||
| 87272 | Cryptosporidum ag, dfa | BR | ||||
| 87274 | Herpes simplex ag, dfa | BR | ||||
| 87276 | Influenza ag, dfa..... | BR | ||||
| 87278 | Legion pneumo ag, dfa. | BR | ||||
| 87280 | Resp syncytial ag, dfa | BR | ||||
| 87285 | Trepon pallidum ag, dfa. | BR | ||||
| 87290 | Varicella ag, dfa..... | BR | ||||
| 87299 | Ag detection nos, dfa. | BR | ||||
| 87301 | Adenovirus ag, eia.... | BR | ||||
| 87320 | Chylmd trach ag, eia.. | BR | ||||
| 87324 | Clostridium ag, eia... | BR | ||||
| 87328 | Cryptospor ag, eia | BR | ||||
| 87332 | Cytomegalovirus ag, eia | BR | ||||
| 87335 | E coli 0157 ag, eia... | BR | ||||
| 87338 | Hpylori, stool, eia... | BR | ||||
| 87340 | Hepatitis b surface ag, eia | BR | ||||
| 87350 | Hepatitis be ag, eia.. | BR | ||||
| 87380 | Hepatitis delta ag, eia | BR | ||||
| 87385 | Histoplasma capsul ag, eia | BR | ||||
| 87390 | Hiv-1 ag, eia......... | BR | ||||
| 87391 | Hiv-2 ag, eia......... | BR | ||||
| 87420 | Resp syncytial ag, eia | BR | ||||
| 87425 | Rotavirus ag, eia..... | BR | ||||
| 87430 | Strep a ag, eia....... | BR | ||||
| 87449 | Ag detect nos, eia, mult | BR | ||||
| 87450 | Ag detect nos, eia, single | BR | ||||
| 87470 | Bartonella, dna, dir probe | BR | ||||
| 87471 | Bartonella, dna, amp probe | BR | ||||
| 87472 | Bartonella, dna, quant | BR | ||||
| 87475 | Lyme dis, dna, dir probe | BR | ||||
| 87476 | Lyme dis, dna, amp probe | BR | ||||
| 87477 | Lyme dis, dna, quant.. | BR | ||||
| 87480 | Candida, dna, dir probe | BR | ||||
| 87481 | Candida, dna, amp probe | BR | ||||
| 87482 | Candida, dna, quant... | BR | ||||
| 87485 | Chylmd pneum, dna, dir probe | BR | ||||
| 87486 | Chylmd pneum, dna, amp probe | BR | ||||
| 87487 | Chylmd pneum, dna, quant | BR | ||||
| 87490 | Chylmd trach, dna, dir probe | BR | ||||
| 87491 | Chylmd trach, dna, amp v | BR | ||||
| 87492 | Chylmd trach, dna, quant | BR | ||||
| 87495 | Cytomeg, dna, dir probe | BR | ||||
| 87496 | Cytomeg, dna, amp probe | BR | ||||
| 87497 | Cytomeg, dna, quant... | BR | ||||
| 87510 | Gardner vag, dna, dir probe | BR | ||||
| 87511 | Gardner vag, dna, amp probe | BR | ||||
| 87512 | Gardner vag, dna, quant | BR | ||||
| 87515 | Hepatitis b, dna, dir probe | BR | ||||
| 87516 | Hepatitis b , dna, amp probe | BR | ||||
| 87517 | Hepatitis b , dna, quant | BR | ||||
| 87520 | Hepatitis c , rna, dir probe | BR | ||||
| 87521 | Hepatitis c , rna, amp probe | BR | ||||
| 87522 | Hepatitis c, rna, quant | BR | ||||
| 87525 | Hepatitis g , dna, dir probe | BR | ||||
| 87526 | Hepatitis g, dna, amp probe | BR | ||||
| 87527 | Hepatitis g, dna, quant | BR | ||||
| 87528 | Hsv, dna, dir probe... | BR | ||||
| 87529 | Hsv, dna, amp probe... | BR | ||||
| 87530 | Hsv, dna, quant....... | BR | ||||
| 87531 | Hhv-6, dna, dir probe | BR | ||||
| 87532 | Hhv-6, dna, amp probe | BR | ||||
| 87533 | Hhv-6, dna, quant..... | BR | ||||
| 87534 | Hiv-1, dna, dir probe | BR | ||||
| 87535 | Hiv-1, dna, amp probe | BR | ||||
| 87536 | Hiv-1, dna, quant..... | BR | ||||
| 87537 | Hiv-2, dna, dir probe | BR | ||||
| 87538 | Hiv-2, dna, amp probe | BR | ||||
| 87539 | Hiv-2, dna, quant..... | BR | ||||
| 87540 | Legion pneumo, dna, dir probe | BR | ||||
| 87541 | Legion pneumo, dna, amp probe | BR | ||||
| 87542 | Legion pneumo, dna, quant | BR | ||||
| 87550 | Mycobacteria, dna, dir probe | BR | ||||
| 87551 | Mycobacteria, dna, amp probe | BR | ||||
| 87552 | Mycobacteria, dna, quant | BR | ||||
| 87555 | M.tuberculo, dna, dir probe | BR | ||||
| 87556 | M.tuberculo, dna, amp probe | BR | ||||
| 87557 | M.tuberculo, dna, quant. | BR | ||||
| 87560 | M.avium-intra, dna, dir probe | BR | ||||
| 87561 | M.avium-intra, dna, amp | BR | ||||
| 87562 | M.avium-intra, dna, quant | BR | ||||
| 87580 | M.pneumon, dna, dir probe | BR | ||||
| 87581 | M.pneumon, dna, amp probe | BR | ||||
| 87582 | M.pneumon, dna, quant | BR | ||||
| 87590 | N.gonorrhoeae, dna, dir probe | BR | ||||
| 87591 | N.gonorrhoeae, dna, amp probe | BR | ||||
| 87592 | N.gonorrhoeae, dna, quant | BR | ||||
| 87620 | Hpv, dna, dir probe... | BR | ||||
| 87621 | Hpv, dna, amp probe... | BR | ||||
| 87622 | Hpv, dna, quant....... | BR | ||||
| 87635 | IADNA SARS-COV-2 COVID-19 Amplified Probe TQ | $103 | ||||
| 87650 | Strep a, dna, dir probe | BR | ||||
| 87651 | Strep a, dna, amp probe | BR | ||||
| 87652 | Strep a, dna, quant... | BR | ||||
| 87797 | Detect agent nos, dna, dir | BR | ||||
| 87798 | Detect agent nos, dna, amp | BR | ||||
| 87799 | Detect agent nos, dna, quant | BR | ||||
| 87810 | Chylmd trach assay w/optic | BR | ||||
| 87850 | N. gonorrhoeae assay w | BR | ||||
| 87880 | Strep a assay w/optic | BR | ||||
| 87899 | Agent nos assay w/optic | BR | ||||
| 87999 | Microbiology procedure | BR | ||||
| 87999 | 26 | Microbiology procedure | BR | |||
| 87999 | TC | Microbiology procedure | BR | |||
| 88000 | Autopsy (necropsy), gross | $815 | ||||
| 88000 | 26 | Autopsy (necropsy), gross | $815 | |||
| 88000 | TC | Autopsy (necropsy), gross | $0 | |||
| 88005 | Autopsy (necropsy), gross | $917 | ||||
| 88005 | 26 | Autopsy (necropsy), gross | $917 | |||
| 88005 | TC | Autopsy (necropsy), gross | $0 | |||
| 88007 | Autopsy (necropsy), gross | $1,019 | ||||
| 88007 | 26 | Autopsy (necropsy), gross | $1,019 | |||
| 88007 | TC | Autopsy (necropsy), gross | $0 | |||
| 88012 | Autopsy (necropsy), gross | $856 | ||||
| 88012 | 26 | Autopsy (necropsy), gross | $856 | |||
| 88012 | TC | Autopsy (necropsy), gross | $0 | |||
| 88014 | Autopsy (necropsy), gross | $856 | ||||
| 88014 | 26 | Autopsy (necropsy), gross | $856 | |||
| 88014 | TC | Autopsy (necropsy), gross | $0 | |||
| 88016 | Autopsy (necropsy), gross | $815 | ||||
| 88016 | 26 | Autopsy (necropsy), gross | $815 | |||
| 88016 | TC | Autopsy (necropsy), gross | $0 | |||
| 88020 | Autopsy (necropsy), co | $1,019 | ||||
| 88020 | 26 | Autopsy (necropsy), co | $1,019 | |||
| 88020 | TC | Autopsy (necropsy), co | $0 | |||
| 88025 | Autopsy (necropsy), co | $1,120 | ||||
| 88025 | 26 | Autopsy (necropsy), co | $1,120 | |||
| 88025 | TC | Autopsy (necropsy), co | $0 | |||
| 88027 | Autopsy (necropsy), co | $1,222 | ||||
| 88027 | 26 | Autopsy (necropsy), co | $1,222 | |||
| 88027 | TC | Autopsy (necropsy), co | $0 | |||
| 88028 | Autopsy (necropsy), co | $1,059 | ||||
| 88028 | 26 | Autopsy (necropsy), co | $1,059 | |||
| 88028 | TC | Autopsy (necropsy), co | $0 | |||
| 88029 | Autopsy (necropsy), co | $1,059 | ||||
| 88029 | 26 | Autopsy (necropsy), co | $1,059 | |||
| 88029 | TC | Autopsy (necropsy), co | $0 | |||
| 88036 | Limited autopsy | $876 | ||||
| 88036 | 26 | Limited autopsy | $876 | |||
| 88036 | TC | Limited autopsy | $0 | |||
| 88037 | Limited autopsy | $713 | ||||
| 88037 | 26 | Limited autopsy | $713 | |||
| 88037 | TC | Limited autopsy | $0 | |||
| 88040 | Forensic autopsy (necr | $2,648 | ||||
| 88040 | 26 | Forensic autopsy (necr | $2,648 | |||
| 88040 | TC | Forensic autopsy (necr | $0 | |||
| 88045 | Coroner's autopsy (nec | BR | ||||
| 88045 | 26 | Coroner's autopsy (nec | BR | |||
| 88045 | TC | Coroner's autopsy (nec | BR | |||
| 88099 | Necropsy (autopsy) pro | BR | ||||
| 88099 | 26 | Necropsy (autopsy) pro | BR | |||
| 88099 | TC | Necropsy (autopsy) pro | BR | |||
| 88104 | Cytopathology, fluids | $73 | ||||
| 88104 | 26 | Cytopathology, fluids | $57 | |||
| 88104 | TC | Cytopathology, fluids | $16 | |||
| 88106 | Cytopathology, fluids | $102 | ||||
| 88106 | 26 | Cytopathology, fluids | $31 | |||
| 88106 | TC | Cytopathology, fluids | $71 | |||
| 88108 | Cytopath, concentrate tech | $77 | ||||
| 88108 | 26 | Cytopath, concentrate tech | $59 | |||
| 88108 | TC | Cytopath, concentrate tech | $19 | |||
| 88112 | 26 | Cytopath cell enhance tech | $117 | |||
| 88112 | TC | Cytopath cell enhance tech | $91 | |||
| 88112 | Cytopath cell enhance tech | $208 | ||||
| 88120 | 26 | Cytp urne 3-5 probes ea spec | $108 | |||
| 88120 | TC | Cytp urne 3-5 probes ea spec | $865 | |||
| 88120 | Cytp urne 3-5 probes ea spec | $973 | ||||
| 88121 | 26 | Cytp urine 3-5 probes cmptr | $96 | |||
| 88121 | TC | Cytp urine 3-5 probes cmptr | $742 | |||
| 88121 | Cytp urine 3-5 probes cmptr | $838 | ||||
| 88125 | Forensic cytopathology | $129 | ||||
| 88125 | 26 | Forensic cytopathology | $39 | |||
| 88125 | TC | Forensic cytopathology | $90 | |||
| 88130 | Sex chromatin identifi | $49 | ||||
| 88130 | 26 | Sex chromatin identifi | $14 | |||
| 88130 | TC | Sex chromatin identifi | $35 | |||
| 88140 | Sex chromatin identifi | $34 | ||||
| 88140 | 26 | Sex chromatin identifi | $10 | |||
| 88140 | TC | Sex chromatin identifi | $24 | |||
| 88141 | Cytopath, c/v, interpret | $70 | ||||
| 88142 | Cytopath, c/v, thin layer | BR | ||||
| 88143 | Cytopath c/v thin layer redo | BR | ||||
| 88147 | Cytopath, c/v, automated | BR | ||||
| 88148 | Cytopath, c/v, auto rescreen | BR | ||||
| 88150 | Cytopath, c/v, manual | $23 | ||||
| 88150 | 26 | Cytopath, c/v, manual | $8 | |||
| 88150 | TC | Cytopath, c/v, manual | $15 | |||
| 88152 | Cytopath, c/v, auto redo | BR | ||||
| 88153 | Cytopath, c/v, redo... | BR | ||||
| 88154 | Cytopath, c/v, select | BR | ||||
| 88155 | Cytopath, c/v, index add-on | $25 | ||||
| 88155 | 26 | Cytopath, c/v, index add-on | $7 | |||
| 88155 | TC | Cytopath, c/v, index add-on | $18 | |||
| 88160 | Cytopath smear, other | $73 | ||||
| 88160 | 26 | Cytopath smear, other | $22 | |||
| 88160 | TC | Cytopath smear, other | $51 | |||
| 88161 | Cytopath smear, other | $102 | ||||
| 88161 | 26 | Cytopath smear, other | $31 | |||
| 88161 | TC | Cytopath smear, other | $71 | |||
| 88162 | Cytopath smear, other | $143 | ||||
| 88162 | 26 | Cytopath smear, other | $43 | |||
| 88162 | TC | Cytopath smear, other | $100 | |||
| 88164 | Cytopath tbs, c/v, manual | BR | ||||
| 88165 | Cytopath tbs, c/v, redo | BR | ||||
| 88166 | Cytopath tbs, c/v, auto redo | BR | ||||
| 88167 | Cytopath tbs, c/v, select | BR | ||||
| 88172 | Evaluation of smear | $128 | ||||
| 88172 | 26 | Evaluation of smear | $102 | |||
| 88172 | TC | Evaluation of smear | $26 | |||
| 88173 | Interpretation of smear | $128 | ||||
| 88173 | 26 | Interpretation of smear | $128 | |||
| 88173 | TC | Interpretation of smear | $0 | |||
| 88177 | 26 | Cytp fna eval ea addl | $43 | |||
| 88177 | TC | Cytp fna eval ea addl | $14 | |||
| 88177 | Cytp fna eval ea addl | $57 | ||||
| 88182 | Cell marker study | $163 | ||||
| 88182 | 26 | Cell marker study | $61 | |||
| 88182 | TC | Cell marker study | $102 | |||
| 88184 | Flowcytometry/ tc 1 marker | $165 | ||||
| 88185 | Flowcytometry/tc add-on | $100 | ||||
| 88187 | Flowcytometry/read 2-8 | $139 | ||||
| 88188 | Flowcytometry/read 9-15 | $176 | ||||
| 88189 | Flowcytometry/read 16 & > | $213 | ||||
| 88199 | Cytopathology procedure | BR | ||||
| 88199 | 26 | Cytopathology procedure | BR | |||
| 88199 | TC | Cytopathology procedure | BR | |||
| 88230 | Tissue culture, lymphocyte | $482 | ||||
| 88230 | 26 | Tissue culture, lymphocyte | $143 | |||
| 88230 | TC | Tissue culture, lymphocyte | $339 | |||
| 88233 | Tissue culture, skin/b | $448 | ||||
| 88233 | 26 | Tissue culture, skin/b | $134 | |||
| 88233 | TC | Tissue culture, skin/b | $314 | |||
| 88235 | Tissue culture, placenta | $469 | ||||
| 88235 | 26 | Tissue culture, placenta | $141 | |||
| 88235 | TC | Tissue culture, placenra | $328 | |||
| 88237 | Tissue culture, bone | $526 | ||||
| 88237 | 26 | Tissue culture, bone | $158 | |||
| 88237 | TC | Tissue culture, bone | $368 | |||
| 88239 | Tissue culture, tumor | $613 | ||||
| 88239 | 26 | Tissue culture, tumor | $184 | |||
| 88239 | TC | Tissue culture, tumor | $429 | |||
| 88240 | Cell cryopreserve/ storage | BR | ||||
| 88241 | Frozen cell preparation | BR | ||||
| 88245 | Chromosome analysis, 20- | $617 | ||||
| 88245 | 26 | Chromosome analysis, 20- | $184 | |||
| 88245 | TC | Chromosome analysis, 20- | $433 | |||
| 88248 | Chromosome analysis, 50- | $721 | ||||
| 88248 | 26 | Chromosome analysis, 50- | $217 | |||
| 88248 | TC | Chromosome analysis, 50- | $504 | |||
| 88249 | Chromosome analysis, 100 | BR | ||||
| 88261 | Chromosome analysis, 5 | $736 | ||||
| 88261 | 26 | Chromosome analysis, 5 | $221 | |||
| 88261 | TC | Chromosome analysis, 5 | $515 | |||
| 88262 | Chromosome analysis, 1 | $580 | ||||
| 88262 | 26 | Chromosome analysis, 1 | $175 | |||
| 88262 | TC | Chromosome analysis, 1 | $405 | |||
| 88263 | Chromosome analysis, 4 | $489 | ||||
| 88263 | 26 | Chromosome analysis, 4 | $147 | |||
| 88263 | TC | Chromosome analysis, 4 | $342 | |||
| 88264 | Chromosome analysis, 20-25 | BR | ||||
| 88267 | Chromosome analysis:pl | $890 | ||||
| 88267 | 26 | Chromosome analysis:pl | $267 | |||
| 88267 | TC | Chromosome analysis:pl | $623 | |||
| 88269 | Chromosome analysis:am | $489 | ||||
| 88269 | 26 | Chromosome analysis:am | $163 | |||
| 88269 | TC | Chromosome analysis:am | $326 | |||
| 88271 | Cytogenetics, dna probe | BR | ||||
| 88272 | Cytogenetics, 3-5..... | BR | ||||
| 88273 | Cytogenetics, 10-30... | BR | ||||
| 88274 | Cytogenetics, 25-99... | BR | ||||
| 88275 | Cytogenetics, 100-300 | BR | ||||
| 88280 | Chromosome karyotype s | $114 | ||||
| 88280 | 26 | Chromosome karyotype s | $35 | |||
| 88280 | TC | Chromosome karyotype s | $79 | |||
| 88283 | Chromosome banding stu | $224 | ||||
| 88283 | 26 | Chromosome banding stu | $67 | |||
| 88283 | TC | Chromosome banding stu | $157 | |||
| 88285 | Chromosome count: addi | $61 | ||||
| 88285 | 26 | Chromosome count: addi | $18 | |||
| 88285 | TC | Chromosome count: addi | $43 | |||
| 88289 | Chromosome study: addi | $114 | ||||
| 88289 | 26 | Chromosome study: addi | $35 | |||
| 88289 | TC | Chromosome study: addi | $79 | |||
| 88291 | Cyto/molecular report | $52 | ||||
| 88299 | Cytogenetic study | BR | ||||
| 88299 | 26 | Cytogenetic study | BR | |||
| 88299 | TC | Cytogenetic study | BR | |||
| 88300 | Surg path, gross | $47 | ||||
| 88300 | 26 | Surg path, gross | $37 | |||
| 88300 | TC | Surg path, gross | $10 | |||
| 88302 | Tissue exam by pathologist | $99 | ||||
| 88302 | 26 | Tissue exam by pathologist | $79 | |||
| 88302 | TC | Tissue exam by pathologist | $20 | |||
| 88304 | Tissue exam by pathologist | $128 | ||||
| 88304 | 26 | Tissue exam by pathologist | $102 | |||
| 88304 | TC | Tissue exam by pathologist | $26 | |||
| 88305 | Tissue exam by pathologist | $130 | ||||
| 88305 | 26 | Tissue exam by pathologist | $91 | |||
| 88305 | TC | Tissue exam by pathologist | $39 | |||
| 88307 | Tissue exam by pathologist | $229 | ||||
| 88307 | 26 | Tissue exam by pathologist | $170 | |||
| 88307 | TC | Tissue exam by pathologist | $59 | |||
| 88309 | Tissue exam by pathologist | $591 | ||||
| 88309 | 26 | Tissue exam by pathologist | $473 | |||
| 88309 | TC | Tissue exam by pathologist | $118 | |||
| 88311 | Decalcify tissue | $45 | ||||
| 88311 | 26 | Decalcify tissue | $37 | |||
| 88311 | TC | Decalcify tissue | $8 | |||
| 88312 | Special stains | $45 | ||||
| 88312 | 26 | Special stains | $14 | |||
| 88312 | TC | Special stains | $31 | |||
| 88313 | Special stains | $45 | ||||
| 88313 | 26 | Special stains | $14 | |||
| 88313 | TC | Special stains | $31 | |||
| 88314 | Histochemical stain | $41 | ||||
| 88314 | 26 | Histochemical stain | $12 | |||
| 88314 | TC | Histochemical stain | $29 | |||
| 88319 | Enzyme histochemistry | $50 | ||||
| 88319 | 26 | Enzyme histochemistry | $24 | |||
| 88319 | TC | Enzyme histochemistry | $26 | |||
| 88321 | Microslide consultation | $81 | ||||
| 88323 | Microslide consultation | $143 | ||||
| 88323 | 26 | Microslide consultation | $143 | |||
| 88323 | TC | Microslide consultation | $0 | |||
| 88325 | Comprehensive review o | $102 | ||||
| 88325 | 26 | Comprehensive review o | $102 | |||
| 88325 | TC | Comprehensive review o | $0 | |||
| 88329 | Pathology consult in s | $96 | ||||
| 88329 | 26 | Pathology consult in s | $96 | |||
| 88329 | TC | Pathology consult in s | $0 | |||
| 88331 | Pathology consult in s | $189 | ||||
| 88331 | 26 | Pathology consult in s | $128 | |||
| 88331 | TC | Pathology consult in s | $61 | |||
| 88332 | Pathology consult in s | $100 | ||||
| 88332 | 26 | Pathology consult in s | $67 | |||
| 88332 | TC | Pathology consult in s | $33 | |||
| 88334 | 26 | Intraop cyto path consult 2 | $77 | |||
| 88334 | TC | Intraop cyto path consult 2 | $49 | |||
| 88334 | Intraop cyto path consult 2 | $126 | ||||
| 88342 | Immunocytochemistry | $100 | ||||
| 88342 | 26 | Immunocytochemistry | $67 | |||
| 88342 | TC | Immunocytochemistry | $33 | |||
| 88346 | Immunofluorescent stud | $204 | ||||
| 88346 | 26 | Immunofluorescent stud | $143 | |||
| 88346 | TC | Immunofluorescent stud | $61 | |||
| 88347 | Immunofluorescent stud | $244 | ||||
| 88347 | 26 | Immunofluorescent stud | $183 | |||
| 88347 | TC | Immunofluorescent stud | $61 | |||
| 88348 | Electron microscopy | $351 | ||||
| 88348 | 26 | Electron microscopy | $267 | |||
| 88348 | TC | Electron microscopy | $84 | |||
| 88349 | Scanning electron micr | $351 | ||||
| 88349 | 26 | Scanning electron micr | $267 | |||
| 88349 | TC | Scanning electron micr | $84 | |||
| 88355 | Analysis, skeletal mus | $200 | ||||
| 88355 | 26 | Analysis, skeletal mus | $149 | |||
| 88355 | TC | Analysis, skeletal mus | $51 | |||
| 88356 | Analysis, nerve | $200 | ||||
| 88356 | 26 | Analysis, nerve | $149 | |||
| 88356 | TC | Analysis, nerve | $51 | |||
| 88358 | Analysis, tumor | $200 | ||||
| 88358 | 26 | Analysis, tumor | $149 | |||
| 88358 | TC | Analysis, tumor | $51 | |||
| 88360 | 26 | Tumor immunohistochem/manual | $106 | |||
| 88360 | TC | Tumor immunohistochem/manual | $139 | |||
| 88360 | Tumor immunohistochem/manual | $245 | ||||
| 88361 | 26 | Tumor immunohistochem/comput | $116 | |||
| 88361 | TC | Tumor immunohistochem/comput | $190 | |||
| 88361 | Tumor immunohistochem/comput | $306 | ||||
| 88362 | Nerve teasing preparations | $635 | ||||
| 88362 | 26 | Nerve teasing preparations | $224 | |||
| 88362 | TC | Nerve teasing preparations | $412 | |||
| 88363 | Xm archive tissue molec anal | $73 | $32 | |||
| 88365 | Tissue hybridization | $47 | ||||
| 88365 | 26 | Tissue hybridization | $47 | |||
| 88365 | TC | Tissue hybridization | $0 | |||
| 88367 | 26 | Insitu hybridization auto | $126 | |||
| 88367 | TC | Insitu hybridization auto | $419 | |||
| 88367 | Insitu hybridization auto | $544 | ||||
| 88368 | 26 | Insitu hybridization manual | $126 | |||
| 88368 | TC | Insitu hybridization manual | $324 | |||
| 88368 | Insitu hybridization manual | $451 | ||||
| 88371 | Protein, western blot | BR | ||||
| 88371 | 26 | Protein, western blot | $39 | |||
| 88371 | TC | Protein, western blot | BR | |||
| 88372 | Protein analysis w/pro | BR | ||||
| 88372 | 26 | Protein analysis w/pro | $33 | |||
| 88372 | TC | Protein analysis w/pro | BR | |||
| 88380 | 26 | Microdissection laser | $155 | |||
| 88380 | TC | Microdissection laser | $204 | |||
| 88380 | Microdissection laser | $359 | ||||
| 88381 | 26 | Microdissection manual | $102 | |||
| 88381 | TC | Microdissection manual | $183 | |||
| 88381 | Microdissection manual | $284 | ||||
| 88385 | 26 | Eval molecul probes 51-250 | $127 | |||
| 88385 | TC | Eval molecul probes 51-250 | $978 | |||
| 88385 | Eval molecul probes 51-250 | $1,104 | ||||
| 88386 | 26 | Eval molecul probes 251-500 | $166 | |||
| 88386 | TC | Eval molecul probes 251-500 | $1,029 | |||
| 88386 | Eval molecul probes 251-500 | $1,195 | ||||
| 88387 | 26 | Tiss exam molecular study | $13 | |||
| 88387 | TC | Tiss exam molecular study | $59 | |||
| 88387 | Tiss exam molecular study | $72 | ||||
| 88388 | 26 | Tiss ex molecul study add-on | $47 | |||
| 88388 | TC | Tiss ex molecul study add-on | $17 | |||
| 88388 | Tiss ex molecul study add-on | $63 | ||||
| 88399 | Surgical pathology pro | BR | ||||
| 88399 | 26 | Surgical pathology pro | BR | |||
| 88399 | TC | Surgical pathology pro | BR | |||
| 89049 | Chct for mal hyperthermia | $545 | ||||
| 89050 | Body fluid cell count | $18 | ||||
| 89050 | 26 | Body fluid cell count | $6 | |||
| 89050 | TC | Body fluid cell count | $12 | |||
| 89051 | Body fluid cell count | $24 | ||||
| 89051 | 26 | Body fluid cell count | $8 | |||
| 89051 | TC | Body fluid cell count | $16 | |||
| 89060 | Exam,synovial fluid cr | $24 | ||||
| 89060 | 26 | Exam,synovial fluid cr | $8 | |||
| 89060 | TC | Exam,synovial fluid cr | $16 | |||
| 89125 | Specimen fat stain | $26 | ||||
| 89125 | 26 | Specimen fat stain | $8 | |||
| 89125 | TC | Specimen fat stain | $18 | |||
| 89160 | Exam feces for meat fibers | $12 | ||||
| 89160 | 26 | Exam feces for meat fibers | $4 | |||
| 89160 | TC | Exam feces for meat fibers | $8 | |||
| 89190 | Nasal smear for eosino | $18 | ||||
| 89190 | 26 | Nasal smear for eosino | $6 | |||
| 89190 | TC | Nasal smear for eosino | $12 | |||
| 89220 | Sputum specimen collection | $33 | ||||
| 89230 | Collect sweat for test | $5 | ||||
| 89250 | Fertilization of oocyte | BR | ||||
| 89251 | Culture oocyte w/ embryos | BR | ||||
| 89252 | Assist oocyte fertilization | BR | ||||
| 89253 | Embryo hatching....... | BR | ||||
| 89254 | Oocyte identification | BR | ||||
| 89255 | Prepare embryo for transfer | BR | ||||
| 89256 | Prepare cryopreserved embryo | BR | ||||
| 89257 | Sperm identification.. | BR | ||||
| 89258 | Cryopreservation, embryo | BR | ||||
| 89259 | Cryopreservation, sperm | BR | ||||
| 89260 | Sperm isolation, simple | BR | ||||
| 89261 | Sperm isolation, complex | BR | ||||
| 89264 | Identify sperm tissue | BR | ||||
| 89300 | Semen analysis........ | $39 | ||||
| 89300 | 26 | Semen analysis........ | $13 | |||
| 89300 | TC | Semen analysis........ | $26 | |||
| 89310 | Semen analysis | $36 | ||||
| 89310 | 26 | Semen analysis | $10 | |||
| 89310 | TC | Semen analysis | $26 | |||
| 89320 | Semen analysis | $43 | ||||
| 89320 | 26 | Semen analysis | $12 | |||
| 89320 | TC | Semen analysis | $31 | |||
| 89325 | Sperm antibody test | $36 | ||||
| 89325 | 26 | Sperm antibody test | $10 | |||
| 89325 | TC | Sperm antibody test | $26 | |||
| 89329 | Sperm evaluation test | $128 | ||||
| 89329 | 26 | Sperm evaluation test | $47 | |||
| 89329 | TC | Sperm evaluation test | $81 | |||
| 89330 | Evaluation, cervical m | $36 | ||||
| 89330 | 26 | Evaluation, cervical m | $10 | |||
| 89330 | TC | Evaluation, cervical m | $26 | |||
| 90281 | Human ig, im.......... | BR | ||||
| 90283 | Human ig, iv.......... | BR | ||||
| 90287 | Botulinum antitoxin... | BR | ||||
| 90288 | Botulism ig, iv....... | BR | ||||
| 90291 | Cmv ig, iv............ | BR | ||||
| 90296 | Diphtheria antitoxin.. | BR | ||||
| 90371 | Hep b ig, im.......... | BR | ||||
| 90375 | Rabies ig, im/sc...... | BR | ||||
| 90376 | Rabies ig, heat treated. | BR | ||||
| 90378 | Rsv ig, im............ | BR | ||||
| 90379 | Rsv ig, iv............ | BR | ||||
| 90384 | Rh ig, full-dose, im.. | BR | ||||
| 90385 | Rh ig, minidose, im... | BR | ||||
| 90386 | Rh ig, iv............. | BR | ||||
| 90389 | Tetanus ig, im........ | BR | ||||
| 90393 | Vaccina ig, im........ | BR | ||||
| 90396 | Varicella-zoster ig, im | BR | ||||
| 90399 | Immune globulin....... | BR | ||||
| 90460 | Im admin 1st/only component | $50 | ||||
| 90461 | Im admin each addl component | $26 | ||||
| 90471 | Immunization admin.... | $51 | ||||
| 90472 | Immunization admin, each add | $26 | ||||
| 90473 | Immune admin oral/nasal | $50 | ||||
| 90474 | Immune admin oral/nasal addl | $26 | ||||
| 90476 | Adenovirus vaccine, type 4 | BR | ||||
| 90477 | Adenovirus vaccine, type 7 | BR | ||||
| 90581 | Anthrax vaccine, sc... | BR | ||||
| 90585 | Bcg vaccine, percut... | BR | ||||
| 90586 | Bcg vaccine, intravesical | BR | ||||
| 90632 | Hep a vaccine, adult im | BR | ||||
| 90633 | Hep a vacc, ped/adol, 2 dose | BR | ||||
| 90634 | Hep a vacc, ped/adol, 3 dose | BR | ||||
| 90636 | Hep a/hep b vacc, adult im | BR | ||||
| 90645 | Hib vaccine, hboc, im | BR | ||||
| 90646 | Hib vaccine, prp-d, im | BR | ||||
| 90647 | Hib vaccine, prp-omp, im | BR | ||||
| 90648 | Hib vaccine, prp-t, im | BR | ||||
| 90657 | Flu vaccine, 6-35 mo, im | BR | ||||
| 90658 | Flu vaccine, 3 yrs, im | BR | ||||
| 90660 | Flu vaccine, nasal.... | BR | ||||
| 90665 | Lyme disease vaccine, im | BR | ||||
| 90669 | Pneumococcal vaccine, ped | BR | ||||
| 90675 | Rabies vaccine, im.... | BR | ||||
| 90676 | Rabies vaccine, id.... | BR | ||||
| 90680 | Rotovirus vaccine, oral | BR | ||||
| 90690 | Typhoid vaccine, oral | BR | ||||
| 90691 | Typhoid vaccine, im... | BR | ||||
| 90692 | Typhoid vaccine, h-p, sc/id | BR | ||||
| 90693 | Typhoid vaccine, akd, sc | BR | ||||
| 90700 | Dtap vaccine, im...... | BR | ||||
| 90701 | Dtp vaccine, im....... | BR | ||||
| 90702 | Dt vaccine, im........ | BR | ||||
| 90703 | Tetanus vaccine, im... | BR | ||||
| 90704 | Mumps vaccine, sc..... | BR | ||||
| 90705 | Measles vaccine, sc... | BR | ||||
| 90706 | Rubella vaccine, sc... | BR | ||||
| 90707 | Mmr vaccine, sc....... | BR | ||||
| 90708 | Measles-rubella vaccine, sc | BR | ||||
| 90710 | Mmrv vaccine, sc...... | BR | ||||
| 90712 | Oral poliovirus vaccine | BR | ||||
| 90713 | Poliovirus, ipv, sc... | BR | ||||
| 90716 | Chicken pox vaccine, sc | BR | ||||
| 90717 | Yellow fever vaccine, sc | BR | ||||
| 90718 | Td vaccine, im........ | BR | ||||
| 90719 | Diphtheria vaccine, im | BR | ||||
| 90720 | Dtp/hib vaccine, im... | BR | ||||
| 90721 | Dtap/hib vaccine, im.. | BR | ||||
| 90725 | Cholera vaccine, injectable | BR | ||||
| 90727 | Plague vaccine, im.... | BR | ||||
| 90732 | Pneumococcal vaccine, adult | BR | ||||
| 90733 | Meningococcal vaccine, sc | BR | ||||
| 90735 | Encephalitis vaccine, sc | BR | ||||
| 90744 | Hep b vaccine, ped/ adol, im | BR | ||||
| 90746 | Hep b vaccine, adult, im | BR | ||||
| 90747 | Hep b vaccine, ill pat, im | BR | ||||
| 90748 | Hep b/hib vaccine, im | BR | ||||
| 90749 | Vaccine toxoid........ | BR | ||||
| 90791 | Psychiatric Diagnostic Evaluation | BR | ||||
| 90792 | Psychiatric Diagnostic Eval W/Medical Services | BR | ||||
| 90801 | Psy dx interview...... | $257 | ||||
| 90802 | Intac psy dx interview | $255 | ||||
| 90804 | Psytx, office, 20-30 min | $116 | ||||
| 90805 | Psytx, off, 20-30 min w/e&m | $127 | ||||
| 90806 | Psytx, off, 45-50 min | $178 | ||||
| 90807 | Psytx, off, 45-50 min w/e&m | $189 | ||||
| 90808 | Psytx, office, 75-80 min | $283 | ||||
| 90809 | Psytx, off, 75-80, w/ e&m | $292 | ||||
| 90810 | Intac psytx, off, 20- 30 min | $140 | ||||
| 90811 | Intac psytx, 20-30, w/ e&m | $152 | ||||
| 90812 | Intac psytx, off, 45- 50 min | $191 | ||||
| 90813 | Intac psytx, 45-50 min w/e&m | $201 | ||||
| 90814 | Intac psytx, off, 75- 80 min | $262 | ||||
| 90815 | Intac psytx, 75-80 w/ e&m | $272 | ||||
| 90816 | Psytx, hosp, 20-30 min | $120 | ||||
| 90817 | Psytx, hosp, 20-30 min w/e&m | $131 | ||||
| 90818 | Psytx, hosp, 45-50 min | $181 | ||||
| 90819 | Psytx, hosp, 45-50 min w/e&m | $192 | ||||
| 90821 | Psytx, hosp, 75-80 min | $286 | ||||
| 90822 | Psytx, hosp, 75-80 min w/e&m | $296 | ||||
| 90823 | Intac psytx, hosp, 20- 30 min | $145 | ||||
| 90824 | Intac psytx, hsp 20-30 w/e&m | $155 | ||||
| 90826 | Intac psytx, hosp, 45- 50 min | $194 | ||||
| 90827 | Intac psytx, hsp 45-50 w/e&m | $204 | ||||
| 90828 | Intac psytx, hosp, 75- 80 min | $267 | ||||
| 90829 | Intac psytx, hsp 75-80 w/e&m | $274 | ||||
| 90832 | Psychotherapy W/Patient 30 Minutes | BR | ||||
| 90833 | Psychotherapy W/Patient W/E&M Srvcs 30 Min | BR | ||||
| 90834 | Psychotherapy W/Patient 45 Minutes | BR | ||||
| 90836 | Psychotherapy W/Patient W/E&M Srvcs 45 Min | BR | ||||
| 90837 | Psychotherapy W/Patient 60 Minutes | BR | ||||
| 90838 | Psychotherapy W/Patient W/E&M Srvcs 60 Min | BR | ||||
| 90845 | Psychoanalysis........ | $162 | ||||
| 90846 | Family psytx w/o patient | $180 | ||||
| 90847 | Family psytx w/patient | $206 | ||||
| 90849 | Multiple family group psytx | $63 | ||||
| 90853 | Group psychotherapy... | $63 | ||||
| 90857 | Intac group psytx..... | $59 | ||||
| 90862 | Medication management | $97 | ||||
| 90863 | Pharmacologic Management W/Psychotherapy | BR | ||||
| 90865 | Narcosynthesis........ | $307 | ||||
| 90867 | Tcranial magn stim tx plan | $772 | $357 | |||
| 90868 | Tcranial magn stim tx deli | $372 | $49 | |||
| 90869 | Tcran magn stim redetemine | $954 | $238 | |||
| 90870 | Electroconvulsive therapy | 0 | $178 | |||
| 90875 | Psychophysiological therapy | $135 | ||||
| 90876 | Psychophysiological therapy | $204 | ||||
| 90880 | Hypnotherapy.......... | $208 | ||||
| 90882 | Environmental manipulation | BR | ||||
| 90885 | Psy evaluation of records | $94 | ||||
| 90887 | Consultation with family | $131 | ||||
| 90889 | Preparation of report | BR | ||||
| 90899 | Psychiatric service/therapy | BR | ||||
| 90901 | Biofeedback train, any meth | 0 | $98 | |||
| 90911 | Biofeedback peri/uro/ rectal | 0 | $153 | |||
| 90935 | Hemodialysis, one evaluation | 0 | $193 | |||
| 90937 | Hemodialysis, repeated eval | 0 | $348 | |||
| 90945 | Dialysis, one evaluation | 0 | $179 | |||
| 90947 | Dialysis, repeated eval | 0 | $302 | |||
| 90951 | Esrd serv 4 visits p mo <2 | $1,902 | ||||
| 90954 | Esrd serv 4 vsts p mo 2-11 | $1,650 | ||||
| 90955 | Esrd srv 2-3 vsts p mo 2-11 | $930 | ||||
| 90956 | Esrd srv 1 visit p mo 2-11 | $646 | ||||
| 90957 | Esrd srv 4 vsts p mo 12-19 | $1,313 | ||||
| 90958 | Esrd srv 2-3 vsts p mo 12-19 | $890 | ||||
| 90959 | Esrd serv 1 vst p mo 12-19 | $603 | ||||
| 90960 | Esrd srv 4 visits p mo 20+ | $581 | ||||
| 90961 | Esrd srv 2-3 vsts p mo 20+ | $488 | ||||
| 90962 | Esrd serv 1 visit p mo 20+ | $378 | ||||
| 90963 | Esrd home pt serv p mo <2 | $1,109 | ||||
| 90964 | Esrd home pt serv p mo 2-11 | $967 | ||||
| 90965 | Esrd home pt serv p mo 12-19 | $922 | ||||
| 90966 | Esrd home pt serv p mo 20+ | $488 | ||||
| 90967 | Esrd home pt serv p day <2 | $36 | ||||
| 90968 | Esrd home pt srv p day 2-11 | $31 | ||||
| 90969 | Esrd home pt srv p day 12-19 | $30 | ||||
| 90970 | Esrd home pt serv p day 20+ | $16 | ||||
| 90989 | Dialysis training/complete | BR | ||||
| 90993 | Dialysis training/incomplete | BR | ||||
| 90997 | Hemoperfusion | 0 | $308 | |||
| 90999 | Dialysis procedure | BR | ||||
| 91010 | Esophagus motility study | 0 | $241 | |||
| 91010 | 26 | Esophagus motility study | 0 | $179 | ||
| 91010 | TC | Esophagus motility study | 0 | $62 | ||
| 91013 | 26 | Esophgl motil w/stim/perfus | $20 | |||
| 91013 | TC | Esophgl motil w/stim/perfus | $30 | |||
| 91013 | Esophgl motil w/stim/perfus | $50 | ||||
| 91020 | Gastric motility...... | 0 | $262 | |||
| 91020 | 26 | Gastric motility...... | 0 | $204 | ||
| 91020 | TC | Gastric motility...... | 0 | $58 | ||
| 91022 | 26 | Duodenal motility study | $160 | |||
| 91022 | TC | Duodenal motility study | $204 | |||
| 91022 | Duodenal motility study | $364 | ||||
| 91030 | Acid perfusion of esophagus | 0 | $128 | |||
| 91030 | 26 | Acid perfusion of esophagus | 0 | $112 | ||
| 91030 | TC | Acid perfusion of esophagus | 0 | $17 | ||
| 91034 | 26 | Gastroesophageal reflux test | $106 | |||
| 91034 | TC | Gastroesophageal reflux test | $294 | |||
| 91034 | Gastroesophageal reflux test | $400 | ||||
| 91035 | 26 | G-esoph reflx tst w/electrod | $175 | |||
| 91035 | TC | G-esoph reflx tst w/electrod | $851 | |||
| 91035 | G-esoph reflx tst w/electrod | $1,026 | ||||
| 91037 | 26 | Esoph imped function test | $109 | |||
| 91037 | TC | Esoph imped function test | $234 | |||
| 91037 | Esoph imped function test | $343 | ||||
| 91038 | 26 | Esoph imped funct test > 1h | $122 | |||
| 91038 | TC | Esoph imped funct test > 1h | $867 | |||
| 91038 | Esoph imped funct test > 1h | $988 | ||||
| 91040 | 26 | Esoph balloon distension tst | $96 | |||
| 91040 | TC | Esoph balloon distension tst | $496 | |||
| 91040 | Esoph balloon distension tst | $592 | ||||
| 91065 | Breath hydrogen test | 0 | $94 | |||
| 91065 | 26 | Breath hydrogen test | 0 | $69 | ||
| 91065 | TC | Breath hydrogen test | 0 | $26 | ||
| 91110 | 26 | Gi tract capsule endoscopy | $405 | |||
| 91110 | TC | Gi tract capsule endoscopy | $1,495 | |||
| 91110 | Gi tract capsule endoscopy | $1,900 | ||||
| 91111 | 26 | Esophageal capsule endoscopy | $110 | |||
| 91111 | TC | Esophageal capsule endoscopy | $1,445 | |||
| 91111 | Esophageal capsule endoscopy | $1,556 | ||||
| 91117 | Colon motility 6 hr study | $289 | $310 | |||
| 91120 | 26 | Rectal sensation test | $105 | |||
| 91120 | TC | Rectal sensation test | $719 | |||
| 91120 | Rectal sensation test | $824 | ||||
| 91122 | Anal pressure record | 0 | $264 | |||
| 91122 | 26 | Anal pressure record | 0 | $210 | ||
| 91122 | TC | Anal pressure record | 0 | $54 | ||
| 91132 | 26 | Electrogastrography | $58 | |||
| 91132 | TC | Electrogastrography | $270 | |||
| 91132 | Electrogastrography | $328 | ||||
| 91133 | 26 | Electrogastrography w/test | $74 | |||
| 91133 | TC | Electrogastrography w/test | $307 | |||
| 91133 | Electrogastrography w/test | $381 | ||||
| 91299 | Gastroenterology procedure | BR | ||||
| 91299 | 26 | Gastroenterology procedure | BR | |||
| 91299 | TC | Gastroenterology procedure | BR | |||
| 92002 | Eye exam, new patient | $108 | ||||
| 92004 | Eye exam, new patient | $157 | ||||
| 92012 | Eye exam established pt | $91 | ||||
| 92014 | Eye exam & treatment | $115 | ||||
| 92015 | Refraction | $41 | $39 | |||
| 92018 | New eye exam & treatment | $143 | ||||
| 92019 | Eye exam & treatment | $129 | ||||
| 92020 | Special eye evaluation | $52 | ||||
| 92025 | 26 | Corneal topography | $41 | |||
| 92025 | TC | Corneal topography | $37 | |||
| 92025 | Corneal topography | $78 | ||||
| 92060 | Special eye evaluation | $81 | ||||
| 92060 | 26 | Special eye evaluation | $66 | |||
| 92060 | TC | Special eye evaluation | $14 | |||
| 92065 | Orthoptic/pleoptic training | $52 | ||||
| 92065 | 26 | Orthoptic/pleoptic training | $41 | |||
| 92065 | TC | Orthoptic/pleoptic training | $12 | |||
| 92071 | Contact lens fitting for tx | $77 | $69 | |||
| 92072 | Fit contac lens for managmnt | $246 | $197 | |||
| 92081 | Visual field examination(s) | $49 | ||||
| 92081 | 26 | Visual field examination(s) | $38 | |||
| 92081 | TC | Visual field examination(s) | $11 | |||
| 92082 | Visual field examination(s) | $67 | ||||
| 92082 | 26 | Visual field examination(s) | $53 | |||
| 92082 | TC | Visual field examination(s) | $14 | |||
| 92083 | Visual field examination(s) | $98 | ||||
| 92083 | 26 | Visual field examination(s) | $77 | |||
| 92083 | TC | Visual field examination(s) | $21 | |||
| 92100 | Serial tonometry exam(s) | $91 | ||||
| 92132 | 26 | Cmptr ophth dx img ant segmt | $42 | |||
| 92132 | TC | Cmptr ophth dx img ant segmt | $34 | |||
| 92132 | Cmptr ophth dx img ant segmt | $77 | ||||
| 92133 | 26 | Cmptr ophth img optic nerve | $59 | |||
| 92133 | TC | Cmptr ophth img optic nerve | $33 | |||
| 92133 | Cmptr ophth img optic nerve | $93 | ||||
| 92134 | 26 | Cptr ophth dx img post segmt | $59 | |||
| 92134 | TC | Cptr ophth dx img post segmt | $33 | |||
| 92134 | Cptr ophth dx img post segmt | $93 | ||||
| 92136 | 26 | Ophthalmic biometry | $64 | |||
| 92136 | TC | Ophthalmic biometry | $119 | |||
| 92136 | Ophthalmic biometry | $183 | ||||
| 92140 | Glaucoma provocative tests | $67 | ||||
| 92225 | Special eye exam, initial | $73 | ||||
| 92226 | Special eye exam, subsequent | $66 | ||||
| 92227 | Remote dx retinal imaging | $25 | ||||
| 92228 | 26 | Remote retinal imaging mgmt | $43 | |||
| 92228 | TC | Remote retinal imaging mgmt | $28 | |||
| 92228 | Remote retinal imaging mgmt | $71 | ||||
| 92230 | Eye exam with photos.. | $119 | ||||
| 92235 | Eye exam with photos.. | $175 | ||||
| 92235 | 26 | Eye exam with photos.. | $98 | |||
| 92235 | TC | Eye exam with photos.. | $77 | |||
| 92240 | Icg angiography....... | $199 | ||||
| 92240 | 26 | Icg angiography....... | $121 | |||
| 92240 | TC | Icg angiography....... | $77 | |||
| 92250 | Eye exam with photos | $63 | ||||
| 92250 | 26 | Eye exam with photos | $49 | |||
| 92250 | TC | Eye exam with photos | $13 | |||
| 92260 | Ophthalmoscopy/dynamometry | $77 | ||||
| 92265 | Eye muscle evaluation | $83 | ||||
| 92265 | 26 | Eye muscle evaluation | $65 | |||
| 92265 | TC | Eye muscle evaluation | $18 | |||
| 92270 | Electro-oculography... | $109 | ||||
| 92270 | 26 | Electro-oculography... | $84 | |||
| 92270 | TC | Electro-oculography... | $24 | |||
| 92275 | Electroretinography... | $138 | ||||
| 92275 | 26 | Electroretinography... | $108 | |||
| 92275 | TC | Electroretinography... | $30 | |||
| 92283 | Color vision examination | $40 | ||||
| 92283 | 26 | Color vision examination | $31 | |||
| 92283 | TC | Color vision examination | $9 | |||
| 92284 | Dark adaptation eye exam | $47 | ||||
| 92284 | 26 | Dark adaptation eye exam | $34 | |||
| 92284 | TC | Dark adaptation eye exam | $13 | |||
| 92285 | Eye photography....... | $35 | ||||
| 92285 | 26 | Eye photography....... | $26 | |||
| 92285 | TC | Eye photography....... | $8 | |||
| 92286 | Internal eye photography | $131 | ||||
| 92286 | 26 | Internal eye photography | $101 | |||
| 92286 | TC | Internal eye photography | $30 | |||
| 92287 | Internal eye photography | $171 | ||||
| 92310 | Contact lens fitting | BR | ||||
| 92311 | Contact lens fitting | $143 | ||||
| 92312 | Contact lens fitting | $173 | ||||
| 92313 | Contact lens fitting | $130 | ||||
| 92314 | Prescription of contact lens | BR | ||||
| 92315 | Prescription of contact lens | $82 | ||||
| 92316 | Prescription of contact lens | $119 | ||||
| 92317 | Prescription of contact lens | $61 | ||||
| 92325 | Modification of contact lens | $28 | ||||
| 92326 | Replacement of contact lens | $115 | ||||
| 92340 | Fitting of spectacles | $71 | $38 | |||
| 92341 | Fitting of spectacles | $81 | $48 | |||
| 92342 | Fitting of spectacles | $88 | $55 | |||
| 92352 | Special spectacles fitting | $48 | ||||
| 92353 | Special spectacles fitting | $65 | ||||
| 92354 | Special spectacles fitting | $605 | ||||
| 92355 | Special spectacles fitting | $294 | ||||
| 92358 | Eye prosthesis service | $69 | ||||
| 92370 | Repair & adjust spectacles | $63 | $34 | |||
| 92371 | Repair & adjust spectacles | $44 | ||||
| 92502 | Ear and throat examination | 0 | $195 | |||
| 92504 | Ear microscopy examination | $33 | ||||
| 92506 | Speech/hearing evaluation | $109 | ||||
| 92507 | Speech/hearing therapy | $72 | ||||
| 92508 | Speech/hearing therapy | $41 | ||||
| 92511 | Nasopharyngoscopy | 0 | $126 | |||
| 92512 | Nasal function studies | $77 | ||||
| 92516 | Facial nerve function test | $66 | ||||
| 92520 | Laryngeal function studies | $96 | ||||
| 92521 | Evaluation Of Speech Fluency (Stutter Clutter) | BR | ||||
| 92522 | Evaluation Of Speech Sound Production Articulate | BR | ||||
| 92523 | Eval Speech Sound Product Language Comprehension | BR | ||||
| 92524 | Behavioral & Qualit Analysis Voice And Resonance | BR | ||||
| 92526 | Oral function therapy | $86 | ||||
| 92531 | Spontaneous nystagmus study | BR | ||||
| 92532 | Positional nystagmus study | BR | ||||
| 92533 | Caloric vestibular test | BR | ||||
| 92534 | Optokinetic nystagmus | BR | ||||
| 92541 | Spontaneous nystagmus test | $81 | ||||
| 92541 | 26 | Spontaneous nystagmus test | $64 | |||
| 92541 | TC | Spontaneous nystagmus test | $17 | |||
| 92542 | Positional nystagmus test | $71 | ||||
| 92542 | 26 | Positional nystagmus test | $52 | |||
| 92542 | TC | Positional nystagmus test | $20 | |||
| 92543 | Caloric vestibular test | $91 | ||||
| 92543 | 26 | Caloric vestibular test | $60 | |||
| 92543 | TC | Caloric vestibular test | $31 | |||
| 92544 | Optokinetic nystagmus test | $55 | ||||
| 92544 | 26 | Optokinetic nystagmus test | $40 | |||
| 92544 | TC | Optokinetic nystagmus test | $16 | |||
| 92545 | Oscillating tracking test | $47 | ||||
| 92545 | 26 | Oscillating tracking test | $32 | |||
| 92545 | TC | Oscillating tracking test | $16 | |||
| 92546 | Sinusoidal rotational test | $60 | ||||
| 92546 | 26 | Sinusoidal rotational test | $41 | |||
| 92546 | TC | Sinusoidal rotational test | $19 | |||
| 92547 | Supplemental electrical test | $44 | ||||
| 92548 | Posturography......... | $181 | ||||
| 92548 | 26 | Posturography......... | $68 | |||
| 92548 | TC | Posturography......... | $113 | |||
| 92551 | Pure tone hearing test, air | $24 | ||||
| 92552 | Pure tone audiometry, air | $33 | ||||
| 92553 | Audiometry, air & bone | $50 | ||||
| 92555 | Speech threshold audiometry | $29 | ||||
| 92556 | Speech audiometry, complete | $44 | ||||
| 92557 | Comprehensive hearing test | $92 | ||||
| 92559 | Group audiometric testing | BR | ||||
| 92560 | Bekesy audiometry, screen | BR | ||||
| 92561 | Bekesy audiometry, diagnosis | $54 | ||||
| 92562 | Loudness balance test | $31 | ||||
| 92563 | Tone decay hearing test | $28 | ||||
| 92564 | Sisi hearing test | $35 | ||||
| 92565 | Stenger test, pure tone | $30 | ||||
| 92567 | Tympanometry | $40 | ||||
| 92568 | Acoustic reflex testing | $28 | ||||
| 92570 | Acoustic immitance testing | $66 | $61 | |||
| 92571 | Filtered speech hearing test | $29 | ||||
| 92572 | Staggered spondaic word test | $7 | ||||
| 92575 | Sensorineural acuity test | $23 | ||||
| 92576 | Synthetic sentence test | $33 | ||||
| 92577 | Stenger test, speech | $54 | ||||
| 92579 | Visual audiometry (vra) | $55 | ||||
| 92582 | Conditioning play audiometry | $54 | ||||
| 92583 | Select picture audiometry | $67 | ||||
| 92584 | Electrocochleography | $185 | ||||
| 92585 | Auditory evoked potential | $272 | ||||
| 92585 | 26 | Auditory evoked potential | $131 | |||
| 92585 | TC | Auditory evoked potential | $141 | |||
| 92586 | Auditor evoke potent limit | $174 | ||||
| 92587 | Evoked auditory test | $113 | ||||
| 92587 | 26 | Evoked auditory test | $18 | |||
| 92587 | TC | Evoked auditory test | $95 | |||
| 92588 | Evoked auditory test.. | $159 | ||||
| 92588 | 26 | Evoked auditory test.. | $47 | |||
| 92588 | TC | Evoked auditory test.. | $113 | |||
| 92589 | Auditory function test(s) | $41 | ||||
| 92590 | Hearing aid exam, one ear | BR | ||||
| 92591 | Hearing aid exam, both ears | BR | ||||
| 92592 | Hearing aid check, one ear | BR | ||||
| 92593 | Hearing aid check, both ears | BR | ||||
| 92594 | Electro hearing aid test,one | BR | ||||
| 92595 | Electro hearing aid test,both | BR | ||||
| 92596 | Ear protector evaluation | $45 | ||||
| 92597 | Oral speech device eval | $182 | ||||
| 92601 | Cochlear implt f/up exam < 7 | $286 | $244 | |||
| 92602 | Reprogram cochlear implt < 7 | $183 | $139 | |||
| 92603 | Cochlear implt f/up exam 7 > | $302 | $249 | |||
| 92604 | Reprogram cochlear implt 7 > | $181 | $138 | |||
| 92605 | Ex for nonspeech device rx | $187 | $179 | |||
| 92606 | Non-speech device service | $167 | $143 | |||
| 92607 | Ex for speech device rx 1hr | $232 | ||||
| 92608 | Ex for speech device rx addl | $88 | ||||
| 92609 | Use of speech device service | $180 | ||||
| 92610 | Evaluate swallowing function | $155 | $138 | |||
| 92611 | Motion fluoroscopy/swallow | $174 | ||||
| 92612 | Endoscopy swallow tst (fees) | $351 | $139 | |||
| 92613 | Endoscopy swallow tst (fees) | $79 | ||||
| 92614 | Laryngoscopic sensory test | $316 | $141 | |||
| 92615 | Eval laryngoscopy sense tst | $70 | $69 | |||
| 92616 | Fees w/laryngeal sense test | $421 | $205 | |||
| 92617 | Interprt fees/laryngeal test | $86 | $85 | |||
| 92618 | Ex for nonspeech dev rx add | $67 | $66 | |||
| 92620 | Auditory function 60 min | $192 | $169 | |||
| 92621 | Auditory function + 15 min | $46 | $39 | |||
| 92625 | Tinnitus assessment | $143 | $127 | |||
| 92626 | Eval aud rehab status | $185 | $155 | |||
| 92627 | Eval aud status rehab add-on | $46 | $36 | |||
| 92640 | Aud brainstem implt programg | $251 | $213 | |||
| 92950 | Heart/lung resuscitation(cpr | 0 | $442 | |||
| 92953 | Temporary external pacing | 0 | $137 | |||
| 92960 | Cardioversion electric, ext | 0 | $302 | |||
| 92961 | Cardioversion, electric, int | 0 | BR | |||
| 92970 | Cardioassist, internal | 0 | $524 | |||
| 92971 | Cardioassist, external | 0 | $210 | |||
| 92973 | Percut coronary thrombectomy | $365 | ||||
| 92974 | Cath place cardio brachytx | $333 | ||||
| 92975 | Dissolve clot, heart vessel | 0 | $947 | |||
| 92977 | Dissolve clot, heart vessel | $583 | ||||
| 92978 | Intravasc us, heart add-on | $544 | ||||
| 92978 | 26 | Intravasc us, heart add-on | $203 | |||
| 92978 | TC | Intravasc us, heart add-on | $341 | |||
| 92979 | Intravasc us, heart add-on | $334 | ||||
| 92979 | 26 | Intravasc us, heart add-on | $163 | |||
| 92979 | TC | Intravasc us, heart add-on | $171 | |||
| 92980 | Insert intracoronary stent | 0 | $2,273 | |||
| 92981 | Insert intracoronary stent | $608 | ||||
| 92982 | Coronary artery dilation | 0 | $1,929 | |||
| 92984 | Coronary artery dilation | $442 | ||||
| 92986 | Revision of aortic valve | 90 | $2,356 | |||
| 92987 | Revision of mitral valve | 90 | $1,124 | |||
| 92990 | Revision of pulmonary valve | 90 | $1,878 | |||
| 92992 | Revision of heart chamber | 90 | BR | |||
| 92993 | Revision of heart chamber | 90 | BR | |||
| 92995 | Coronary atherectomy.. | 0 | $1,103 | |||
| 92996 | Coronary atherectomy add-on | $481 | ||||
| 92997 | Pul art balloon repr, percut | 0 | $1,067 | |||
| 92998 | Pul art balloon repr, percut | $700 | ||||
| 93000 | Electrocardiogram, complete | $56 | ||||
| 93005 | Electrocardiogram, tracing | $33 | ||||
| 93010 | Electrocardiogram report | $24 | ||||
| 93015 | Cardiovascular stress test | $233 | ||||
| 93016 | Cardiovascular stress test | $61 | ||||
| 93017 | Cardiovascular stress test | $122 | ||||
| 93018 | Cardiovascular stress test | $50 | ||||
| 93024 | Cardiac drug stress test | $285 | ||||
| 93024 | 26 | Cardiac drug stress test | $203 | |||
| 93024 | TC | Cardiac drug stress test | $82 | |||
| 93025 | 26 | Microvolt t-wave assess | $76 | |||
| 93025 | TC | Microvolt t-wave assess | $259 | |||
| 93025 | Microvolt t-wave assess | $335 | ||||
| 93040 | Rhythm ecg with report | $31 | ||||
| 93041 | Rhythm ecg, tracing | $11 | ||||
| 93042 | Rhythm ecg, report | $21 | ||||
| 93224 | Ecg monitor/report, 24 hrs | $345 | ||||
| 93225 | Ecg monitor/record, 24 hrs | $90 | ||||
| 93226 | Ecg monitor/report, 24 hrs | $159 | ||||
| 93227 | Ecg monitor/review, 24 hrs | $97 | ||||
| 93228 | Remote 30 day ecg rev/report | $52 | ||||
| 93229 | 26 | Remote 30 day ecg tech supp | $1,423 | |||
| 93268 | ECG record/review..... | $284 | ||||
| 93268 | 26 | ECG record/review..... | BR | |||
| 93268 | TC | ECG record/review..... | BR | |||
| 93270 | ECG recording | $89 | ||||
| 93271 | ECG/monitoring and analysis | $173 | ||||
| 93272 | ECG/review, interpret only | $68 | ||||
| 93278 | Ecg/signal-averaged | $161 | ||||
| 93278 | 26 | Ecg/signal-averaged | $75 | |||
| 93278 | TC | Ecg/signal-averaged | $87 | |||
| 93279 | TC | Pm device progr eval sngl | $65 | |||
| 93279 | 26 | Pm device progr eval sngl | $34 | |||
| 93279 | Pm device progr eval sngl | $99 | ||||
| 93280 | 26 | Pm device progr eval dual | $77 | |||
| 93280 | TC | Pm device progr eval dual | $38 | |||
| 93280 | Pm device progr eval dual | $115 | ||||
| 93281 | 26 | Pm device progr eval multi | $89 | |||
| 93281 | TC | Pm device progr eval multi | $45 | |||
| 93281 | Pm device progr eval multi | $134 | ||||
| 93282 | 26 | Icd device prog eval 1 sngl | $84 | |||
| 93282 | TC | Icd device prog eval 1 sngl | $39 | |||
| 93282 | Icd device prog eval 1 sngl | $123 | ||||
| 93283 | 26 | Icd device progr eval dual | $114 | |||
| 93283 | TC | Icd device progr eval dual | $45 | |||
| 93283 | Icd device progr eval dual | $159 | ||||
| 93284 | 26 | Icd device progr eval mult | $124 | |||
| 93284 | TC | Icd device progr eval mult | $52 | |||
| 93284 | Icd device progr eval mult | $176 | ||||
| 93285 | 26 | Ilr device eval progr | $51 | |||
| 93285 | TC | Ilr device eval progr | $31 | |||
| 93285 | Ilr device eval progr | $82 | ||||
| 93286 | 26 | Pre-op pm device eval | $30 | |||
| 93286 | TC | Pre-op pm device eval | $22 | |||
| 93286 | Pre-op pm device eval | $52 | ||||
| 93287 | 26 | Pre-op icd device eval | $45 | |||
| 93287 | TC | Pre-op icd device eval | $25 | |||
| 93287 | Pre-op icd device eval | $70 | ||||
| 93288 | 26 | Pm device eval in person | $43 | |||
| 93288 | TC | Pm device eval in person | $31 | |||
| 93288 | Pm device eval in person | $74 | ||||
| 93289 | 26 | Icd device interrogate | $91 | |||
| 93289 | TC | Icd device interrogate | $38 | |||
| 93289 | Icd device interrogate | $130 | ||||
| 93290 | 26 | Icm device eval | $43 | |||
| 93290 | TC | Icm device eval | $18 | |||
| 93290 | Icm device eval | $61 | ||||
| 93291 | 26 | Ilr device interrogate | $43 | |||
| 93291 | TC | Ilr device interrogate | $29 | |||
| 93291 | Ilr device interrogate | $71 | ||||
| 93292 | 26 | Wcd device interrogate | $43 | |||
| 93292 | TC | Wcd device interrogate | $22 | |||
| 93292 | Wcd device interrogate | $64 | ||||
| 93293 | 26 | Pm phone r-strip device eval | $31 | |||
| 93293 | TC | Pm phone r-strip device eval | $75 | |||
| 93293 | Pm phone r-strip device eval | $107 | ||||
| 93294 | Pm device interrogate remote | $66 | ||||
| 93295 | Icd device interrogat remote | $130 | ||||
| 93296 | Pm/icd remote tech serv | $52 | ||||
| 93297 | Icm device interrogat remote | $52 | ||||
| 93298 | Ilr device interrogat remote | $52 | ||||
| 93303 | Echo transthoracic.... | $452 | ||||
| 93303 | 26 | Echo transthoracic.... | $162 | |||
| 93303 | TC | Echo transthoracic.... | $291 | |||
| 93304 | Echo transthoracic.... | $245 | ||||
| 93304 | 26 | Echo transthoracic.... | $99 | |||
| 93304 | TC | Echo transthoracic.... | $146 | |||
| 93306 | 26 | Tte w/doppler complete | $129 | |||
| 93306 | TC | Tte w/doppler complete | $261 | |||
| 93306 | Tte w/doppler complete | $390 | ||||
| 93307 | Echo exam of heart.... | $423 | ||||
| 93307 | 26 | Echo exam of heart.... | $132 | |||
| 93307 | TC | Echo exam of heart.... | $291 | |||
| 93308 | Echo exam of heart | $231 | ||||
| 93308 | 26 | Echo exam of heart | $90 | |||
| 93308 | TC | Echo exam of heart | $141 | |||
| 93312 | Echo transesophageal.. | $539 | ||||
| 93312 | 26 | Echo transesophageal.. | $250 | |||
| 93312 | TC | Echo transesophageal.. | $289 | |||
| 93313 | Echo exam of heart | $119 | ||||
| 93314 | Echo exam of heart | $397 | ||||
| 93314 | 26 | Echo exam of heart | $119 | |||
| 93314 | TC | Echo exam of heart | $278 | |||
| 93315 | Echo transesophageal.. | $584 | ||||
| 93315 | 26 | Echo transesophageal.. | $295 | |||
| 93315 | TC | Echo transesophageal.. | $289 | |||
| 93316 | Echo transesophageal.. | $124 | ||||
| 93317 | Echo transesophageal.. | $470 | ||||
| 93317 | 26 | Echo transesophageal.. | $181 | |||
| 93317 | TC | Echo transesophageal.. | $289 | |||
| 93318 | Echo transesophageal intraop | $228 | ||||
| 93320 | Doppler echo exam, heart | $185 | ||||
| 93320 | 26 | Doppler echo exam, heart | $56 | |||
| 93320 | TC | Doppler echo exam, heart | $129 | |||
| 93321 | Doppler echo exam, heart | $107 | ||||
| 93321 | 26 | Doppler echo exam, heart | $22 | |||
| 93321 | TC | Doppler echo exam, heart | $84 | |||
| 93325 | Doppler color flow add on | $229 | ||||
| 93325 | 26 | Doppler color flow add on | $8 | |||
| 93325 | TC | Doppler color flow add on | $220 | |||
| 93350 | Echo transthoracic.... | $248 | ||||
| 93350 | 26 | Echo transthoracic.... | $114 | |||
| 93350 | TC | Echo transthoracic.... | $133 | |||
| 93351 | 26 | Stress tte complete | $174 | |||
| 93351 | TC | Stress tte complete | $304 | |||
| 93351 | Stress tte complete | $478 | ||||
| 93352 | Admin ecg contrast agent | $67 | ||||
| 93451 | 26 | Right heart cath | $303 | |||
| 93451 | TC | Right heart cath | $1,343 | |||
| 93451 | Right heart cath | $1,646 | ||||
| 93452 | 26 | Left hrt cath w/ventrclgrphy | $531 | |||
| 93452 | TC | Left hrt cath w/ventrclgrphy | $1,283 | |||
| 93452 | Left hrt cath w/ventrclgrphy | $1,813 | ||||
| 93453 | 26 | R&l hrt cath w/ventriclgrphy | $695 | |||
| 93453 | TC | R&l hrt cath w/ventriclgrphy | $1,679 | |||
| 93453 | R&l hrt cath w/ventriclgrphy | $2,374 | ||||
| 93454 | 26 | Coronary artery angio s&i | $534 | |||
| 93454 | TC | Coronary artery angio s&i | $1,335 | |||
| 93454 | Coronary artery angio s&i | $1,869 | ||||
| 93455 | 26 | Coronary art/grft angio s&i | $617 | |||
| 93455 | TC | Coronary art/grft angio s&i | $1,565 | |||
| 93455 | Coronary art/grft angio s&i | $2,183 | ||||
| 93456 | 26 | R hrt coronary artery angio | $684 | |||
| 93456 | TC | R hrt coronary artery angio | $1,654 | |||
| 93456 | R hrt coronary artery angio | $2,339 | ||||
| 93457 | 26 | R hrt art/grft angio | $767 | |||
| 93457 | TC | R hrt art/grft angio | $1,884 | |||
| 93457 | R hrt art/grft angio | $2,651 | ||||
| 93458 | 26 | L hrt artery/ventricle angio | $653 | |||
| 93458 | TC | L hrt artery/ventricle angio | $1,603 | |||
| 93458 | L hrt artery/ventricle angio | $2,256 | ||||
| 93459 | 26 | L hrt art/grft angio | $735 | |||
| 93459 | TC | L hrt art/grft angio | $1,756 | |||
| 93459 | L hrt art/grft angio | $2,491 | ||||
| 93460 | 26 | R&l hrt art/ventricle angio | $818 | |||
| 93460 | TC | R&l hrt art/ventricle angio | $1,846 | |||
| 93460 | R&l hrt art/ventricle angio | $2,664 | ||||
| 93461 | 26 | R&l hrt art/ventricle angio | $903 | |||
| 93461 | TC | R&l hrt art/ventricle angio | $2,152 | |||
| 93461 | R&l hrt art/ventricle angio | $3,055 | ||||
| 93462 | L hrt cath trnsptl puncture | $416 | ||||
| 93463 | Drug admin & hemodynmic meas | $220 | ||||
| 93464 | 26 | Exercise w/hemodynamic meas | $194 | |||
| 93464 | TC | Exercise w/hemodynamic meas | $355 | |||
| 93464 | Exercise w/hemodynamic meas | $549 | ||||
| 93503 | Insert/place heart catheter | 0 | $366 | |||
| 93505 | Biopsy of heart lining | 0 | $703 | |||
| 93505 | 26 | Biopsy of heart lining | 0 | $557 | ||
| 93505 | TC | Biopsy of heart lining | 0 | $147 | ||
| 93530 | Rt heart cath, congenital | 0 | $1,814 | |||
| 93530 | 26 | Rt heart cath, congenital | 0 | $548 | ||
| 93530 | TC | Rt heart cath, congenital | 0 | $1,266 | ||
| 93531 | R & l heart cath, congenital | 0 | $4,588 | |||
| 93531 | 26 | R & l heart cath, congenital | 0 | $973 | ||
| 93531 | TC | R & l heart cath, congenital | 0 | $3,615 | ||
| 93532 | R & l heart cath, congenital | 0 | $4,016 | |||
| 93532 | 26 | R & l heart cath, congenital | 0 | $497 | ||
| 93532 | TC | R & l heart cath, congenital | 0 | $3,519 | ||
| 93533 | R & l heart cath, congenital | 0 | $4,209 | |||
| 93533 | 26 | R & l heart cath, congenital | 0 | $690 | ||
| 93533 | TC | R & l heart cath, congenital | 0 | $3,519 | ||
| 93536 | Insert circulation assist | 0 | $900 | |||
| 93562 | 0 | $87 | ||||
| 93562 | 26 | 0 | $63 | |||
| 93562 | TC | 0 | $24 | |||
| 93563 | Inject congenital card cath | $115 | ||||
| 93564 | Inject hrt congntl art/grft | $117 | ||||
| 93565 | Inject l ventr/atrial angio | $89 | ||||
| 93566 | Inject r ventr/atrial angio | $369 | $87 | |||
| 93567 | Inject suprvlv aortography | $298 | $99 | |||
| 93568 | Inject pulm art hrt cath | $334 | $90 | |||
| 93571 | Heart flow reserve measure | $519 | ||||
| 93571 | 26 | Heart flow reserve measure | $178 | |||
| 93571 | TC | Heart flow reserve measure | $341 | |||
| 93572 | Heart flow reserve measure | $476 | ||||
| 93572 | 26 | Heart flow reserve measure | $143 | |||
| 93572 | TC | Heart flow reserve measure | $333 | |||
| 93580 | Transcath closure of asd | $2,029 | ||||
| 93581 | Transcath closure of vsd | $2,739 | ||||
| 93600 | Bundle of his recording | 0 | $518 | |||
| 93600 | 26 | Bundle of his recording | 0 | $377 | ||
| 93600 | TC | Bundle of his recording | 0 | $142 | ||
| 93602 | Intra-atrial recording | 0 | $366 | |||
| 93602 | 26 | Intra-atrial recording | 0 | $285 | ||
| 93602 | TC | Intra-atrial recording | 0 | $81 | ||
| 93603 | Right ventricular recording | 0 | $438 | |||
| 93603 | 26 | Right ventricular recording | 0 | $316 | ||
| 93603 | TC | Right ventricular recording | 0 | $122 | ||
| 93609 | Mapping of tachycardia | 0 | $1,201 | |||
| 93609 | 26 | Mapping of tachycardia | 0 | $1,004 | ||
| 93609 | TC | Mapping of tachycardia | 0 | $197 | ||
| 93610 | Intra-atrial pacing | 0 | $488 | |||
| 93610 | 26 | Intra-atrial pacing | 0 | $390 | ||
| 93610 | TC | Intra-atrial pacing | 0 | $98 | ||
| 93612 | Intraventricular pacing | 0 | $509 | |||
| 93612 | 26 | Intraventricular pacing | 0 | $392 | ||
| 93612 | TC | Intraventricular pacing | 0 | $118 | ||
| 93613 | Electrophys map 3d add-on | $779 | ||||
| 93615 | Esophageal recording | 0 | $119 | |||
| 93615 | 26 | Esophageal recording | 0 | $96 | ||
| 93615 | TC | Esophageal recording | 0 | $23 | ||
| 93616 | Esophageal recording | 0 | $231 | |||
| 93616 | 26 | Esophageal recording | 0 | $208 | ||
| 93616 | TC | Esophageal recording | 0 | $23 | ||
| 93618 | Heart rhythm pacing | 0 | $1,018 | |||
| 93618 | 26 | Heart rhythm pacing | 0 | $731 | ||
| 93618 | TC | Heart rhythm pacing | 0 | $287 | ||
| 93619 | Electrophysiology evaluation | 0 | $1,647 | |||
| 93619 | 26 | Electrophysiology evaluation | 0 | $1,067 | ||
| 93619 | TC | Electrophysiology evaluation | 0 | $580 | ||
| 93620 | Electrophysiology evaluation | 0 | $1,636 | |||
| 93620 | 26 | Electrophysiology evaluation | 0 | $963 | ||
| 93620 | TC | Electrophysiology evaluation | 0 | $673 | ||
| 93621 | Electrophysiology evaluation | 0 | BR | |||
| 93621 | 26 | Electrophysiology evaluation | 0 | $1,122 | ||
| 93621 | TC | Electrophysiology evaluation | 0 | BR | ||
| 93622 | Electrophysiology evaluation | 0 | BR | |||
| 93622 | 26 | Electrophysiology evaluation | 0 | $1,129 | ||
| 93622 | TC | Electrophysiology evaluation | 0 | BR | ||
| 93623 | Stimulation, pacing heart | BR | ||||
| 93623 | 26 | Stimulation, pacing heart | $388 | |||
| 93623 | TC | Stimulation, pacing heart | BR | |||
| 93624 | Electrophysiologic study | 0 | $710 | |||
| 93624 | 26 | Electrophysiologic study | 0 | $567 | ||
| 93624 | TC | Electrophysiologic study | 0 | $144 | ||
| 93631 | Heart pacing, mapping | 0 | $1,458 | |||
| 93631 | 26 | Heart pacing, mapping | 0 | $993 | ||
| 93631 | TC | Heart pacing, mapping | 0 | $465 | ||
| 93640 | Evaluation heart device | 0 | $1,064 | |||
| 93640 | 26 | Evaluation heart device | 0 | $525 | ||
| 93640 | TC | Evaluation heart device | 0 | $539 | ||
| 93641 | Electrophysiology evaluation | 0 | $1,398 | |||
| 93641 | 26 | Electrophysiology evaluation | 0 | $859 | ||
| 93641 | TC | Electrophysiology evaluation | 0 | $539 | ||
| 93642 | Electrophysiology evaluation | 0 | $1,255 | |||
| 93642 | 26 | Electrophysiology evaluation | 0 | $716 | ||
| 93642 | TC | Electrophysiology evaluation | 0 | $539 | ||
| 93650 | Ablate heart dysrhythm focus | 0 | $1,972 | |||
| 93651 | Ablate heart dysrhythm focus | 0 | $2,507 | |||
| 93652 | Ablate heart dysrhythm focus | 0 | $2,609 | |||
| 93660 | Tilt table evaluation | 0 | $424 | |||
| 93660 | 26 | Tilt table evaluation | 0 | $236 | ||
| 93660 | TC | Tilt table evaluation | 0 | $188 | ||
| 93662 | Intracardiac ecg (ice) | $285 | ||||
| 93668 | Peripheral vascular rehab | $39 | ||||
| 93701 | Bioimpedance cv analysis | $49 | ||||
| 93724 | Analyze pacemaker system | 0 | $852 | |||
| 93724 | 26 | Analyze pacemaker system | 0 | $565 | ||
| 93724 | TC | Analyze pacemaker system | 0 | $287 | ||
| 93740 | Temperature gradient studies | $46 | ||||
| 93740 | 26 | Temperature gradient studies | $35 | |||
| 93740 | TC | Temperature gradient studies | $12 | |||
| 93750 | Interrogation vad in person | $109 | $91 | |||
| 93770 | Measure venous pressure | $27 | ||||
| 93770 | 26 | Measure venous pressure | $25 | |||
| 93770 | TC | Measure venous pressure | $3 | |||
| 93784 | Ambulatory bp monitoring | $112 | ||||
| 93786 | Ambulatory bp recording | $62 | ||||
| 93788 | Ambulatory bp analysis | $11 | ||||
| 93790 | Review/report bp recording | $38 | ||||
| 93797 | Cardiac rehab | 0 | $35 | |||
| 93798 | Cardiac rehab/monitor | 0 | $56 | |||
| 93799 | Cardiovascular procedure | BR | ||||
| 93799 | 26 | Cardiovascular procedure | BR | |||
| 93799 | TC | Cardiovascular procedure | BR | |||
| 93880 | Extracranial study | $341 | ||||
| 93880 | 26 | Extracranial study | $79 | |||
| 93880 | TC | Extracranial study | $263 | |||
| 93882 | Extracranial study.... | $237 | ||||
| 93882 | 26 | Extracranial study.... | $46 | |||
| 93882 | TC | Extracranial study.... | $191 | |||
| 93886 | Intracranial study | $381 | ||||
| 93886 | 26 | Intracranial study | $119 | |||
| 93886 | TC | Intracranial study | $263 | |||
| 93888 | Intracranial study.... | $282 | ||||
| 93888 | 26 | Intracranial study.... | $64 | |||
| 93888 | TC | Intracranial study.... | $218 | |||
| 93892 | 26 | Tcd emboli detect w/o inj | $118 | |||
| 93892 | TC | Tcd emboli detect w/o inj | $567 | |||
| 93892 | Tcd emboli detect w/o inj | $685 | ||||
| 93893 | 26 | Tcd emboli detect w/inj | $118 | |||
| 93893 | TC | Tcd emboli detect w/inj | $576 | |||
| 93893 | Tcd emboli detect w/inj | $694 | ||||
| 93922 | Extremity study | $130 | ||||
| 93922 | 26 | Extremity study | $42 | |||
| 93922 | TC | Extremity study | $88 | |||
| 93923 | Extremity study | $245 | ||||
| 93923 | 26 | Extremity study | $80 | |||
| 93923 | TC | Extremity study | $166 | |||
| 93924 | Extremity study | $267 | ||||
| 93924 | 26 | Extremity study | $87 | |||
| 93924 | TC | Extremity study | $181 | |||
| 93925 | Lower extremity study | $341 | ||||
| 93925 | 26 | Lower extremity study | $79 | |||
| 93925 | TC | Lower extremity study | $263 | |||
| 93926 | Lower extremity study | $239 | ||||
| 93926 | 26 | Lower extremity study | $45 | |||
| 93926 | TC | Lower extremity study | $193 | |||
| 93930 | Upper extremity study | $328 | ||||
| 93930 | 26 | Upper extremity study | $66 | |||
| 93930 | TC | Upper extremity study | $263 | |||
| 93931 | Upper extremity study | $245 | ||||
| 93931 | 26 | Upper extremity study | $40 | |||
| 93931 | TC | Upper extremity study | $205 | |||
| 93965 | Extremity study | $143 | ||||
| 93965 | 26 | Extremity study | $61 | |||
| 93965 | TC | Extremity study | $83 | |||
| 93970 | Extremity study | $355 | ||||
| 93970 | 26 | Extremity study | $93 | |||
| 93970 | TC | Extremity study | $263 | |||
| 93971 | Extremity study....... | $264 | ||||
| 93971 | 26 | Extremity study....... | $50 | |||
| 93971 | TC | Extremity study....... | $213 | |||
| 93975 | Vascular study........ | $526 | ||||
| 93975 | 26 | Vascular study........ | $162 | |||
| 93975 | TC | Vascular study........ | $364 | |||
| 93976 | Vascular study........ | $351 | ||||
| 93976 | 26 | Vascular study........ | $108 | |||
| 93976 | TC | Vascular study........ | $243 | |||
| 93978 | Vascular study | $350 | ||||
| 93978 | 26 | Vascular study | $88 | |||
| 93978 | TC | Vascular study | $263 | |||
| 93979 | Vascular study........ | $248 | ||||
| 93979 | 26 | Vascular study........ | $50 | |||
| 93979 | TC | Vascular study........ | $199 | |||
| 93980 | Penile vascular study | $455 | ||||
| 93980 | 26 | Penile vascular study | $192 | |||
| 93980 | TC | Penile vascular study | $263 | |||
| 93981 | Penile vascular study | $318 | ||||
| 93981 | 26 | Penile vascular study | $76 | |||
| 93981 | TC | Penile vascular study | $243 | |||
| 93982 | Aneurysm pressure sens study | $88 | ||||
| 93990 | Doppler flow testing | $218 | ||||
| 93990 | 26 | Doppler flow testing | $32 | |||
| 93990 | TC | Doppler flow testing | $186 | |||
| 94002 | Vent mgmt inpat init day | $193 | ||||
| 94003 | Vent mgmt inpat subq day | $137 | ||||
| 94004 | Vent mgmt nf per day | $101 | ||||
| 94005 | Home vent mgmt supervision | $189 | ||||
| 94010 | Breathing capacity test | $61 | ||||
| 94010 | 26 | Breathing capacity test | $30 | |||
| 94010 | TC | Breathing capacity test | $31 | |||
| 94011 | Spirometry up to 2 yrs old | $209 | ||||
| 94012 | Spirmtry w/brnchdil inf-2 yr | $330 | ||||
| 94013 | Meas lung vol thru 2 yrs | $69 | ||||
| 94014 | Patient recorded spirometry | $83 | ||||
| 94015 | Patient recorded spirometry | BR | ||||
| 94016 | Review patient spirometry | $52 | ||||
| 94060 | Evaluation of wheezing | $114 | ||||
| 94060 | 26 | Evaluation of wheezing | $44 | |||
| 94060 | TC | Evaluation of wheezing | $70 | |||
| 94070 | Evaluation of wheezing | $177 | ||||
| 94070 | 26 | Evaluation of wheezing | $68 | |||
| 94070 | TC | Evaluation of wheezing | $110 | |||
| 94150 | Vital capacity test | $24 | ||||
| 94150 | 26 | Vital capacity test | $17 | |||
| 94150 | TC | Vital capacity test | $7 | |||
| 94200 | Lung function test (mbc/mvv) | $38 | ||||
| 94200 | 26 | Lung function test (mbc/mvv) | $20 | |||
| 94200 | TC | Lung function test (mbc/mvv) | $19 | |||
| 94250 | Expired gas collection | $28 | ||||
| 94250 | 26 | Expired gas collection | $19 | |||
| 94250 | TC | Expired gas collection | $10 | |||
| 94375 | Respiratory flow volume loop | $73 | ||||
| 94375 | 26 | Respiratory flow volume loop | $38 | |||
| 94375 | TC | Respiratory flow volume loop | $35 | |||
| 94400 | Co2 breathing response curve | $96 | ||||
| 94400 | 26 | Co2 breathing response curve | $71 | |||
| 94400 | TC | Co2 breathing response curve | $26 | |||
| 94450 | Hypoxia response curve | $75 | ||||
| 94450 | 26 | Hypoxia response curve | $47 | |||
| 94450 | TC | Hypoxia response curve | $28 | |||
| 94452 | 26 | Hast w/report | $30 | |||
| 94452 | TC | Hast w/report | $89 | |||
| 94452 | Hast w/report | $118 | ||||
| 94453 | 26 | Hast w/oxygen titrate | $38 | |||
| 94453 | TC | Hast w/oxygen titrate | $123 | |||
| 94453 | Hast w/oxygen titrate | $162 | ||||
| 94610 | Surfactant admin thru tube | $125 | ||||
| 94620 | Pulmonary stress test/simple | $216 | ||||
| 94620 | 26 | Pulmonary stress test/simple | $109 | |||
| 94620 | TC | Pulmonary stress test/simple | $107 | |||
| 94621 | Pulm stress test/ complex | $216 | ||||
| 94621 | 26 | Pulm stress test/ complex | $109 | |||
| 94621 | TC | Pulm stress test/ complex | $107 | |||
| 94640 | Airway inhalation treatment | $30 | ||||
| 94642 | Aerosol inhalation treatment | BR | ||||
| 94644 | Cbt 1st hour | $92 | ||||
| 94645 | Cbt each addl hour | $29 | ||||
| 94660 | Pos airway pressure, cpap | $109 | ||||
| 94662 | Neg pressure ventilation,cnp | $77 | ||||
| 94664 | Aerosol or vapor inhalations | $39 | ||||
| 94665 | Aerosol or vapor inhalations | $37 | ||||
| 94668 | Chest wall manipulation | $26 | ||||
| 94680 | Exhaled air analysis: o2 | $84 | ||||
| 94680 | 26 | Exhaled air analysis: o2 | $44 | |||
| 94680 | TC | Exhaled air analysis: o2 | $40 | |||
| 94681 | Exhaled air analysis: o2,co2 | $147 | ||||
| 94681 | 26 | Exhaled air analysis: o2,co2 | $45 | |||
| 94681 | TC | Exhaled air analysis: o2,co2 | $103 | |||
| 94690 | Exhaled air analysis | $48 | ||||
| 94690 | 26 | Exhaled air analysis | $9 | |||
| 94690 | TC | Exhaled air analysis | $40 | |||
| 94726 | 26 | Pulm funct tst plethysmograp | $26 | |||
| 94726 | TC | Pulm funct tst plethysmograp | $85 | |||
| 94726 | Pulm funct tst plethysmograp | $111 | ||||
| 94727 | 26 | Pulm function test by gas | $26 | |||
| 94727 | TC | Pulm function test by gas | $61 | |||
| 94727 | Pulm function test by gas | $87 | ||||
| 94728 | 26 | Pulm funct test oscillometry | $26 | |||
| 94728 | TC | Pulm funct test oscillometry | $61 | |||
| 94728 | Pulm funct test oscillometry | $87 | ||||
| 94729 | 26 | C02/membane diffuse capacity | $17 | |||
| 94729 | TC | C02/membane diffuse capacity | $93 | |||
| 94729 | C02/membane diffuse capacity | $110 | ||||
| 94750 | Pulmonary compliance study | $80 | ||||
| 94750 | 26 | Pulmonary compliance study | $38 | |||
| 94750 | TC | Pulmonary compliance study | $42 | |||
| 94760 | Measure blood oxygen level | $19 | ||||
| 94761 | Measure blood oxygen level | $50 | ||||
| 94762 | Measure blood oxygen level | $84 | ||||
| 94770 | Exhaled carbon dioxide test | $50 | ||||
| 94770 | 26 | Exhaled carbon dioxide test | $24 | |||
| 94770 | TC | Exhaled carbon dioxide test | $26 | |||
| 94772 | Breath recording, infant | BR | ||||
| 94772 | 26 | Breath recording, infant | BR | |||
| 94772 | TC | Breath recording, infant | BR | |||
| 94780 | Car seat/bed test 60 min | $104 | $48 | |||
| 94781 | Car seat/bed test + 30 min | $41 | $17 | |||
| 94799 | Pulmonary service/procedure | BR | ||||
| 94799 | 26 | Pulmonary service/procedure | BR | |||
| 94799 | TC | Pulmonary service/procedure | BR | |||
| 95004 | Allergy skin tests | $7 | ||||
| 95010 | Sensitivity skin tests | $19 | ||||
| 95012 | Exhaled nitric oxide meas | $40 | ||||
| 95015 | Sensitivity skin tests | $19 | ||||
| 95024 | Allergy skin tests | $11 | ||||
| 95027 | Skin end point titration | $11 | ||||
| 95028 | Allergy skin tests | $17 | ||||
| 95044 | Allergy patch tests | $14 | ||||
| 95052 | Photo patch test | $18 | ||||
| 95056 | Photosensitivity tests | $13 | ||||
| 95060 | Eye allergy tests | $25 | ||||
| 95065 | Nose allergy test | $14 | ||||
| 95070 | Bronchial allergy tests | $155 | ||||
| 95071 | Bronchial allergy tests | $199 | ||||
| 95075 | Ingestion challenge test | $208 | ||||
| 95115 | Immunotherapy, one injection | 0 | $32 | |||
| 95117 | Immunotherapy injections | 0 | $37 | |||
| 95120 | Immunotherapy,single antigen | BR | ||||
| 95125 | Immunotherapy, many antigen | BR | ||||
| 95130 | Immunotherapy, insect venom | BR | ||||
| 95131 | Immunotherapy, insect venoms | BR | ||||
| 95132 | Immunotherapy, insect venoms | BR | ||||
| 95133 | Immunotherapy, insect venoms | BR | ||||
| 95134 | Immunotherapy, insect venoms | BR | ||||
| 95144 | Antigen therapy services | 0 | $26 | $7 | ||
| 95145 | Antigen therapy services | 0 | $32 | |||
| 95146 | Antigen therapy services | 0 | $44 | |||
| 95147 | Antigen therapy services | 0 | $62 | |||
| 95148 | Antigen therapy services | 0 | $63 | |||
| 95149 | Antigen therapy services | 0 | $78 | |||
| 95165 | Antigen therapy services | 0 | $15 | |||
| 95170 | Antigen therapy services | 0 | $20 | |||
| 95180 | Rapid desensitization | 0 | $153 | |||
| 95199 | Allergy immunology services | 0 | BR | |||
| 95250 | Glucose monitoring cont | $329 | ||||
| 95251 | Gluc monitor cont phys i&r | $89 | ||||
| 95800 | 26 | Slp stdy unattended | $105 | |||
| 95800 | TC | Slp stdy unattended | $227 | |||
| 95800 | Slp stdy unattended | $332 | ||||
| 95801 | 26 | Slp stdy unatnd w/anal | $100 | |||
| 95801 | TC | Slp stdy unatnd w/anal | $79 | |||
| 95801 | Slp stdy unatnd w/anal | $179 | ||||
| 95803 | 26 | Actigraphy testing | $91 | |||
| 95803 | TC | Actigraphy testing | $249 | |||
| 95803 | Actigraphy testing | $340 | ||||
| 95805 | Multiple sleep latency test | $571 | ||||
| 95805 | 26 | Multiple sleep latency test | $178 | |||
| 95805 | TC | Multiple sleep latency test | $392 | |||
| 95806 | Sleep study, unattended | $650 | ||||
| 95806 | 26 | Sleep study, unattended | $276 | |||
| 95806 | TC | Sleep study, unattended | $374 | |||
| 95807 | Sleep study, attended | $738 | ||||
| 95807 | 26 | Sleep study, attended | $239 | |||
| 95807 | TC | Sleep study, attended | $499 | |||
| 95808 | Polysomnography, 1-3 | $708 | ||||
| 95808 | 26 | Polysomnography, 1-3 | $332 | |||
| 95808 | TC | Polysomnography, 1-3 | $377 | |||
| 95810 | Polysomnography, 4 or more | $708 | ||||
| 95810 | 26 | Polysomnography, 4 or more | $332 | |||
| 95810 | TC | Polysomnography, 4 or more | $377 | |||
| 95811 | Polysomnography w/cpap | $967 | ||||
| 95811 | 26 | Polysomnography w/cpap | $444 | |||
| 95811 | TC | Polysomnography w/cpap | $523 | |||
| 95812 | Electroencephalogram (EEG) | $216 | ||||
| 95812 | 26 | Electroencephalogram (EEG) | $113 | |||
| 95812 | TC | Electroencephalogram (EEG) | $102 | |||
| 95813 | Electroencephalogram (EEG) | $261 | ||||
| 95813 | 26 | Electroencephalogram (EEG) | $159 | |||
| 95813 | TC | Electroencephalogram (EEG) | $102 | |||
| 95816 | Electroencephalogram (EEG) | $200 | ||||
| 95816 | 26 | Electroencephalogram (EEG) | $100 | |||
| 95816 | TC | Electroencephalogram (EEG) | $100 | |||
| 95819 | Electroencephalogram (EEG) | $216 | ||||
| 95819 | 26 | Electroencephalogram (EEG) | $113 | |||
| 95819 | TC | Electroencephalogram (EEG) | $103 | |||
| 95822 | Sleep electroencephalogram | $251 | ||||
| 95822 | 26 | Sleep electroencephalogram | $119 | |||
| 95822 | TC | Sleep electroencephalogram | $132 | |||
| 95824 | Electroencephalography | $127 | ||||
| 95824 | 26 | Electroencephalography | $97 | |||
| 95824 | TC | Electroencephalography | $31 | |||
| 95827 | Night electroencephalogram | $310 | ||||
| 95827 | 26 | Night electroencephalogram | $144 | |||
| 95827 | TC | Night electroencephalogram | $166 | |||
| 95829 | Surgery electrocorticogram | $485 | ||||
| 95829 | 26 | Surgery electrocorticogram | $474 | |||
| 95829 | TC | Surgery electrocorticogram | $12 | |||
| 95830 | Insert electrodes for eeg | $181 | ||||
| 95831 | Limb muscle testing, manual | $44 | ||||
| 95832 | Hand muscle testing, manual | $40 | ||||
| 95833 | Body muscle testing, manual | $64 | ||||
| 95834 | Body muscle testing, manual | $91 | ||||
| 95851 | Range of motion measurements | $38 | ||||
| 95852 | Range of motion measurements | $26 | ||||
| 95857 | Tensilon test | $77 | ||||
| 95860 | Muscle test, one limb | $147 | ||||
| 95860 | 26 | Muscle test, one limb | $119 | |||
| 95860 | TC | Muscle test, one limb | $28 | |||
| 95861 | Muscle test, two limbs | $253 | ||||
| 95861 | 26 | Muscle test, two limbs | $197 | |||
| 95861 | TC | Muscle test, two limbs | $56 | |||
| 95863 | Muscle test, 3 limbs.. | $300 | ||||
| 95863 | 26 | Muscle test, 3 limbs.. | $230 | |||
| 95863 | TC | Muscle test, 3 limbs.. | $70 | |||
| 95864 | Muscle test, 4 limbs.. | $394 | ||||
| 95864 | 26 | Muscle test, 4 limbs.. | $260 | |||
| 95864 | TC | Muscle test, 4 limbs.. | $134 | |||
| 95865 | 26 | Muscle test larynx | $168 | |||
| 95865 | TC | Muscle test larynx | $96 | |||
| 95865 | Muscle test larynx | $264 | ||||
| 95866 | 26 | Muscle test hemidiaphragm | $132 | |||
| 95866 | TC | Muscle test hemidiaphragm | $109 | |||
| 95866 | Muscle test hemidiaphragm | $241 | ||||
| 95867 | Muscle test, head or neck | $131 | ||||
| 95867 | 26 | Muscle test, head or neck | $89 | |||
| 95867 | TC | Muscle test, head or neck | $42 | |||
| 95868 | Muscle test, head or neck | $253 | ||||
| 95868 | 26 | Muscle test, head or neck | $203 | |||
| 95868 | TC | Muscle test, head or neck | $51 | |||
| 95869 | Muscle test, thor paraspinal | $65 | ||||
| 95869 | 26 | Muscle test, thor paraspinal | $49 | |||
| 95869 | TC | Muscle test, thor paraspinal | $17 | |||
| 95870 | Muscle test, nonparaspinal | $65 | ||||
| 95870 | 26 | Muscle test, nonparaspinal | $49 | |||
| 95870 | TC | Muscle test, nonparaspinal | $17 | |||
| 95872 | Muscle test, one fiber | $203 | ||||
| 95872 | 26 | Muscle test, one fiber | $157 | |||
| 95872 | TC | Muscle test, one fiber | $46 | |||
| 95873 | 26 | Guide nerv destr elec stim | $41 | |||
| 95873 | TC | Guide nerv destr elec stim | $107 | |||
| 95873 | Guide nerv destr elec stim | $148 | ||||
| 95874 | 26 | Guide nerv destr needle emg | $40 | |||
| 95874 | TC | Guide nerv destr needle emg | $102 | |||
| 95874 | Guide nerv destr needle emg | $142 | ||||
| 95875 | Limb exercise test | $144 | ||||
| 95875 | 26 | Limb exercise test | $113 | |||
| 95875 | TC | Limb exercise test | $31 | |||
| 95885 | 26 | Musc tst done w/nerv tst lim | $37 | |||
| 95885 | TC | Musc tst done w/nerv tst lim | $78 | |||
| 95885 | Musc tst done w/nerv tst lim | $115 | ||||
| 95886 | 26 | Musc test done w/n test comp | $98 | |||
| 95886 | TC | Musc test done w/n test comp | $82 | |||
| 95886 | Musc test done w/n test comp | $181 | ||||
| 95887 | 26 | Musc tst done w/n tst nonext | $77 | |||
| 95887 | TC | Musc tst done w/n tst nonext | $84 | |||
| 95887 | Musc tst done w/n tst nonext | $161 | ||||
| 95900 | Motor nerve conduction test | $75 | ||||
| 95900 | 26 | Motor nerve conduction test | $54 | |||
| 95900 | TC | Motor nerve conduction test | $21 | |||
| 95903 | Motor nerve conduction test | $87 | ||||
| 95903 | 26 | Motor nerve conduction test | $68 | |||
| 95903 | TC | Motor nerve conduction test | $19 | |||
| 95904 | Sense/mixed n conduction test | $64 | ||||
| 95904 | 26 | Sense/mixed n conduction test | $47 | |||
| 95904 | TC | Sense/mixed n conduction test | $17 | |||
| 95905 | 26 | Motor/sens nrve conduct test | $6 | |||
| 95905 | TC | Motor/sens nrve conduct test | $133 | |||
| 95905 | Motor/sens nrve conduct test | $138 | ||||
| 95920 | Intraop nerve test add on | $348 | ||||
| 95920 | 26 | Intraop nerve test add on | $250 | |||
| 95920 | TC | Intraop nerve test add on | $97 | |||
| 95921 | Autonomic nerv function test | $117 | ||||
| 95921 | 26 | Autonomic nerv function test | $89 | |||
| 95921 | TC | Autonomic nerv function test | $28 | |||
| 95922 | Autonomic nerv function test | $123 | ||||
| 95922 | 26 | Autonomic nerv function test | $94 | |||
| 95922 | TC | Autonomic nerv function test | $28 | |||
| 95923 | Autonomic nerv function test | $117 | ||||
| 95923 | 26 | Autonomic nerv function test | $89 | |||
| 95923 | TC | Autonomic nerv function test | $28 | |||
| 95925 | Somatosensory testing | $148 | ||||
| 95925 | 26 | Somatosensory testing | $80 | |||
| 95925 | TC | Somatosensory testing | $68 | |||
| 95926 | Somatosensory testing | $149 | ||||
| 95926 | 26 | Somatosensory testing | $81 | |||
| 95926 | TC | Somatosensory testing | $68 | |||
| 95927 | Somatosensory testing | $149 | ||||
| 95927 | 26 | Somatosensory testing | $81 | |||
| 95927 | TC | Somatosensory testing. | $68 | |||
| 95928 | 26 | C motor evoked uppr limbs | $159 | |||
| 95928 | TC | C motor evoked uppr limbs | $399 | |||
| 95928 | C motor evoked uppr limbs | $558 | ||||
| 95929 | 26 | C motor evoked lwr limbs | $159 | |||
| 95929 | TC | C motor evoked lwr limbs | $403 | |||
| 95929 | C motor evoked lwr limbs | $562 | ||||
| 95930 | Visual evoked potential test | $81 | ||||
| 95930 | 26 | Visual evoked potential test | $62 | |||
| 95930 | TC | Visual evoked potential test | $19 | |||
| 95933 | Blink reflex test | $138 | ||||
| 95933 | 26 | Blink reflex test | $81 | |||
| 95933 | TC | Blink reflex test | $58 | |||
| 95934 | H-reflex test......... | $77 | ||||
| 95934 | 26 | H-reflex test......... | $60 | |||
| 95934 | TC | H-reflex test......... | $17 | |||
| 95936 | H-reflex test......... | $80 | ||||
| 95936 | 26 | H-reflex test......... | $63 | |||
| 95936 | TC | H-reflex test......... | $17 | |||
| 95937 | Neuromuscular junction test | $102 | ||||
| 95937 | 26 | Neuromuscular junction test | $77 | |||
| 95937 | TC | Neuromuscular junction test | $25 | |||
| 95938 | 26 | Somatosensory testing | $91 | |||
| 95938 | TC | Somatosensory testing | $517 | |||
| 95938 | Somatosensory testing | $608 | ||||
| 95939 | 26 | C motor evoked upr&lwr limbs | $239 | |||
| 95939 | TC | C motor evoked upr&lwr limbs | $714 | |||
| 95939 | C motor evoked upr&lwr limbs | $952 | ||||
| 95950 | Ambulatory EEG monitoring | $670 | ||||
| 95950 | 26 | Ambulatory EEG monitoring | $190 | |||
| 95950 | TC | Ambulatory EEG monitoring | $480 | |||
| 95951 | EEG monitoring/videorecord | $1,131 | ||||
| 95951 | 26 | EEG monitoring/videorecord | $553 | |||
| 95951 | TC | EEG monitoring/videorecord | $578 | |||
| 95953 | EEG monitoring/computer | $774 | ||||
| 95953 | 26 | EEG monitoring/computer | $311 | |||
| 95953 | TC | EEG monitoring/computer | $464 | |||
| 95954 | EEG monitoring/giving drugs | $344 | ||||
| 95954 | 26 | EEG monitoring/giving drugs | $306 | |||
| 95954 | TC | EEG monitoring/giving drugs | $37 | |||
| 95955 | EEG during surgery | $298 | ||||
| 95955 | 26 | EEG during surgery | $152 | |||
| 95955 | TC | EEG during surgery | $146 | |||
| 95956 | EEG monitoring/cable/radio | $796 | ||||
| 95956 | 26 | EEG monitoring/cable/radio | $332 | |||
| 95956 | TC | EEG monitoring/cable/radio | $464 | |||
| 95957 | EEG digital analysis.. | $319 | ||||
| 95957 | 26 | EEG digital analysis.. | $191 | |||
| 95957 | TC | EEG digital analysis.. | $128 | |||
| 95958 | EEG monitoring/function test | $684 | ||||
| 95958 | 26 | EEG monitoring/function test | $557 | |||
| 95958 | TC | EEG monitoring/function test | $128 | |||
| 95961 | Electrode stimulation, brain | $414 | ||||
| 95961 | 26 | Electrode stimulation, brain | $317 | |||
| 95961 | TC | Electrode stimulation, brain | $97 | |||
| 95962 | Electrode stim, brain add-on | $432 | ||||
| 95962 | 26 | Electrode stim, brain add-on | $334 | |||
| 95962 | TC | Electrode stim, brain add-on | $97 | |||
| 95965 | Meg spontaneous | $862 | ||||
| 95966 | Meg evoked single | $430 | ||||
| 95967 | Meg evoked each addl | $377 | ||||
| 95970 | Analyze neurostim, no prog | $47 | ||||
| 95971 | Analyze neurostim, simple | $76 | ||||
| 95972 | Analyze neurostim,complex | $140 | ||||
| 95973 | Analyze neurostim,complex | $89 | ||||
| 95974 | Cranial neurostim, complex | $283 | ||||
| 95975 | Cranial neurostim, complex | $169 | ||||
| 95978 | Analyze neurostim brain/1h | $488 | $381 | |||
| 95979 | Analyz neurostim brain addon | $210 | $175 | |||
| 95980 | Io anal gast n-stim init | $96 | ||||
| 95981 | Io anal gast n-stim subsq | $67 | $36 | |||
| 95982 | Io ga n-stim subsq w/reprog | $108 | $73 | |||
| 95990 | Spin/brain pump refil & main | $188 | ||||
| 95991 | Spin/brain pump refil & main | $254 | $82 | |||
| 95992 | Canalith repositioning proc | $87 | $77 | |||
| 95999 | Neurological procedure | BR | ||||
| 96000 | Motion analysis video/3d | $204 | ||||
| 96001 | Motion test w/ft press meas | $203 | ||||
| 96002 | Dynamic surface emg | $44 | ||||
| 96003 | Dynamic fine wire emg | $40 | ||||
| 96004 | Phys review of motion tests | $232 | ||||
| 96020 | Functional brain mapping | $350 | ||||
| 96040 | Genetic counseling 30 min | $94 | ||||
| 96101 | Psycho testing by psych/phys | $169 | ||||
| 96102 | Psycho testing by technician | $165 | ||||
| 96103 | Psycho testing admin by comp | $139 | ||||
| 96105 | Assessment Aphasia W/Interp & Report Per Hour | BR | ||||
| 96110 | Developmental screen | $20 | ||||
| 96116 | Neurobehavioral status exam | $184 | ||||
| 96118 | Neuropsych tst by psych/phys | $184 | ||||
| 96119 | Neuropsych testing by tec | $140 | ||||
| 96120 | Neuropsych tst admin w/comp | $190 | ||||
| 96125 | Cognitive test by hc pro | $210 | ||||
| 96150 | Assess hlth/behave init | $41 | ||||
| 96151 | Assess hlth/behave subseq | $40 | ||||
| 96152 | Intervene hlth/behave indiv | $38 | ||||
| 96153 | Intervene hlth/behave group | $9 | ||||
| 96154 | Interv hlth/behav fam w/pt | $37 | ||||
| 96155 | Interv hlth/behav fam no pt | $46 | ||||
| 96156 | Health Behavior Assessment/Re-Assessment | BR | ||||
| 96157 | Health Behavior Ivntj Indiv F2f 1st 30 Min | BR | ||||
| 96158 | Health Behavior Ivntj Indiv F2f Ea Addl 15 Min | BR | ||||
| 96360 | Hydration iv infusion init | $114 | ||||
| 96361 | Hydrate iv infusion add-on | $30 | ||||
| 96365 | Ther/proph/diag iv inf init | $146 | ||||
| 96366 | Ther/proph/diag iv inf addon | $44 | ||||
| 96367 | Tx/proph/dg addl seq iv inf | $63 | ||||
| 96368 | Ther/diag concurrent inf | $38 | ||||
| 96369 | Sc ther infusion up to 1 hr | $395 | ||||
| 96370 | Sc ther infusion addl hr | $32 | ||||
| 96371 | Sc ther infusion reset pump | $177 | ||||
| 96372 | Ther/proph/diag inj sc/im | $50 | ||||
| 96373 | Ther/proph/diag inj ia | $41 | ||||
| 96374 | Ther/proph/diag inj iv push | $111 | ||||
| 96375 | Tx/pro/dx inj new drug addon | $44 | ||||
| 96401 | Chemo anti-neopl sq/im | $147 | ||||
| 96402 | Chemo hormon antineopl sq/im | $64 | ||||
| 96405 | Intralesional chemo admin | 0 | $66 | |||
| 96406 | Intralesional chemo admin | 0 | $100 | |||
| 96409 | Chemo iv push sngl drug | $217 | ||||
| 96411 | Chemo iv push addl drug | $122 | ||||
| 96413 | Chemo iv infusion 1 hr | $265 | ||||
| 96415 | Chemo iv infusion addl hr | $60 | ||||
| 96416 | Chemo prolong infuse w/pump | $253 | ||||
| 96417 | Chemo iv infus each addl seq | $138 | ||||
| 96420 | Chemotherapy, push technique | $91 | ||||
| 96422 | Chemotherapy,infusion method | $89 | ||||
| 96423 | Chemo, infuse method add-on | $36 | ||||
| 96425 | Chemotherapy, infusion | $103 | ||||
| 96440 | Chemotherapy, intracavitary | 0 | $230 | |||
| 96446 | Chemotx admn prtl cavity | $395 | ||||
| 96521 | Refill/maint portable pump | $274 | ||||
| 96522 | Refill/maint pump/resvr syst | $219 | ||||
| 96523 | Irrig drug delivery device | $49 | ||||
| 96542 | Chemotherapy injection | $187 | ||||
| 96549 | Chemotherapy, unspecified | BR | ||||
| 96567 | Photodynamic tx skin | $281 | ||||
| 96570 | Photodynamic tx, 30 min | $118 | ||||
| 96571 | Photodynamic tx, addl 15 min | $54 | ||||
| 96900 | Ultraviolet light therapy | $29 | ||||
| 96902 | Trichogram............ | $50 | ||||
| 96904 | Whole body photography | $144 | ||||
| 96910 | Photochemotherapy with uv-b | $42 | ||||
| 96912 | Photochemotherapy with uv-a | $49 | ||||
| 96913 | Photochemotherapy, uv-a or b | $266 | ||||
| 96920 | Laser tx skin < 250 sq cm | $360 | ||||
| 96921 | Laser tx skin 250-500 sq cm | $370 | ||||
| 96922 | Laser tx skin > 500 sq cm | $515 | ||||
| 96999 | Dermatological procedure | BR | ||||
| 97001 | Pt evaluation......... | $117 | ||||
| 97002 | Pt re-evaluation...... | $49 | ||||
| 97003 | Ot evaluation......... | $120 | ||||
| 97004 | Ot re-evaluation...... | $50 | ||||
| 97010 | Hot or cold packs therapy | $19 | ||||
| 97012 | Mechanical traction therapy | $30 | ||||
| 97014 | Electric stimulation therapy | $30 | ||||
| 97016 | Vasopneumatic device therapy | $35 | ||||
| 97018 | Paraffin bath therapy | $36 | ||||
| 97022 | Whirlpool therapy | $29 | ||||
| 97024 | Diathermy treatment | $28 | ||||
| 97026 | Infrared therapy | $30 | ||||
| 97028 | Ultraviolet therapy | $26 | ||||
| 97032 | Electrical stimulation | $28 | ||||
| 97033 | Electric current therapy | $29 | ||||
| 97034 | Contrast bath therapy | $22 | ||||
| 97035 | Ultrasound therapy | $23 | ||||
| 97036 | Hydrotherapy | $43 | ||||
| 97039 | Physical therapy treatment | $31 | ||||
| 97110 | Therapeutic exercises | $43 | ||||
| 97112 | Neuromuscular reeducation | $42 | ||||
| 97113 | Aquatic therapy/exercises | $46 | ||||
| 97116 | Gait training therapy | $38 | ||||
| 97124 | Massage therapy....... | $34 | ||||
| 97129 | Ther IVNTJ Cog Funcj CNTCT 1ST 15 Minutes | BR | ||||
| 97130 | Ther IVNTJ Cog Funcj CNTCT EA Addl 15 Minutes | BR | ||||
| 97139 | Physical medicine procedure | $27 | ||||
| 97140 | Manual therapy........ | $44 | ||||
| 97150 | Group therapeutic procedures | $34 | ||||
| 97161 | Physical Therapy Evaluation Low Complex 20 Mins | BR | ||||
| 97162 | Physical Therapy Evaluation Mod Complex 30 Mins | BR | ||||
| 97163 | Physical Therapy Evaluation High Complex 45 Mins | BR | ||||
| 97164 | Physical Therapy Re-Eval Est Plan Care 20 Mins | BR | ||||
| 97165 | Occupational Therapy Eval Low Complex 30 Mins | BR | ||||
| 97166 | Occupational Therapy Eval Mod Complex 45 Mins | BR | ||||
| 97167 | Occupational Therapy Eval High Complex 60 Mins | BR | ||||
| 97168 | Occupational Ther Re-Eval Est Plan Care 30 Mins | BR | ||||
| 97530 | Therapeutic activities | $44 | ||||
| 97532 | Cognitive skills development | $54 | ||||
| 97533 | Sensory integration | $59 | ||||
| 97535 | Self care mngment training | $45 | ||||
| 97537 | Community/work reintegration | $45 | ||||
| 97542 | Wheelchair mngment v | $31 | ||||
| 97545 | Work hardening, initial 2 hours | $88 | ||||
| 97546 | Work hardening add-on, each additional 60 minutes, up to 6 additional hours | $44 | ||||
| 97597 | Rmvl devital tis 20 cm/< | $155 | ||||
| 97598 | Rmvl devital tis addl 20 cm< | $51 | ||||
| 97605 | Neg press wound tx < 50 cm | $86 | ||||
| 97606 | Neg press wound tx > 50 cm | $92 | ||||
| 97750 | Physical performance test | $50 | ||||
| 97755 | Assistive technology assessment (e.g., to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact by provider, with written report, each 15 minutes | $39 | ||||
| 97760 | Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(s), lower extremity(s) and/or trunk, each 15 minutes | $39 | ||||
| 97761 | Prosthetic training, upper and/or lower extremity(s), each 15 minutes | $35 | ||||
| 97762 | Checkout for orthotic/prosthetic use, established patient, each 15 minutes | $68 | ||||
| 97799 | Physical medicine procedure | $43 | ||||
| 97802 | Medical nutrition indiv in | $73 | ||||
| 97803 | Med nutrition indiv subseq | $63 | ||||
| 97804 | Medical nutrition group | $32 | ||||
| 97810 | Acupunct w/o stimul 15 min | $73 | ||||
| 97811 | Acupunct w/o stimul addl 15m | $55 | ||||
| 97813 | Acupunct w/stimul 15 min | $78 | ||||
| 97814 | Acupunct w/stimul addl 15m | $64 | ||||
| 98925 | Osteopathic manipulation | 0 | $51 | |||
| 98926 | Osteopathic manipulation | 0 | $77 | |||
| 98927 | Osteopathic manipulation | 0 | $91 | |||
| 98928 | Osteopathic manipulation | 0 | $105 | |||
| 98929 | Osteopathic manipulation | 0 | $114 | |||
| 98940 | Chiropractic manipulation | 0 | $52 | |||
| 98941 | Chiropractic manipulation | 0 | $68 | |||
| 98942 | Chiropractic manipulation | 0 | $84 | |||
| 98943 | Chiropractic manipulation | $50 | ||||
| 98960 | Self-mgmt educ & train 1 pt | $55 | ||||
| 98961 | Self-mgmt educ/train 2-4 pt | $27 | ||||
| 98962 | Self-mgmt educ/train 5-8 pt | $20 | ||||
| 98966 | Hc pro phone call 5-10 min | $28 | $25 | |||
| 98967 | Hc pro phone call 11-20 min | $54 | $51 | |||
| 98968 | Hc pro phone call 21-30 min | $80 | $77 | |||
| 98970 | QNHP Ol Digital ASSMT&MGMT Est Pt <7 D 5-10 Min | $25 | ||||
| 98971 | QNHP OL Digital Assmt and Mgmt Est PT <7 D 11-20 MIN | $65 | ||||
| 98972 | QNHP OL Digital Assmt and Mgmt Est PT <7 D 21+ MIN | $150 | ||||
| 99000 | Specimen handling | BR | ||||
| 99001 | Specimen handling | BR | ||||
| 99002 | Device handling | BR | ||||
| 99024 | Post-op follow-up visit | BR | ||||
| 99050 | Medical services, after hours | BR | ||||
| 99056 | Non-office medical services | BR | ||||
| 99058 | Office emergency care | BR | ||||
| 99070 | Special supplies | BR | ||||
| 99071 | Patient education materials | BR | ||||
| 99075 | Medical testimony | BR | ||||
| 99078 | Group health education | BR | ||||
| 99080 | Special reports or forms | BR | ||||
| 99082 | Unusual physician travel | BR | ||||
| 99090 | Computer data analysis | BR | ||||
| 99091 | Collect/review data from pt | $115 | ||||
| 99100 | Special anesthesia service. | BR | ||||
| 99116 | Anesthesia with hypothermia | BR | ||||
| 99135 | Special anesthesia procedure | BR | ||||
| 99140 | Emergency anesthesia.. | $35 | ||||
| 99143 | Mod cs by same phys < 5 yrs | BR | ||||
| 99144 | Mod cs by same phys 5 yrs + | BR | ||||
| 99145 | Mod cs by same phys add-on | BR | ||||
| 99148 | Mod cs diff phys < 5 yrs | BR | ||||
| 99149 | Mod cs diff phys 5 yrs + | BR | ||||
| 99150 | Mod cs diff phys add-on | BR | ||||
| 99170 | Anogenital exam, child | 0 | $263 | $178 | ||
| 99173 | Visual screening test | $6 | ||||
| 99174 | Ocular photoscreening | $59 | ||||
| 99175 | Induction of vomiting | $101 | ||||
| 99183 | Hyperbaric oxygen therapy | $292 | ||||
| 99190 | Special pump services | BR | ||||
| 99191 | Special pump services | BR | ||||
| 99192 | Special pump services | BR | ||||
| 99195 | Phlebotomy | $32 | ||||
| 99199 | Special service/proc/ report | BR | ||||
| 99201 | Office/outpatient visit, new | $56 | ||||
| 99202 | Office/outpatient visit, new | $89 | ||||
| 99203 | Office/outpatient visit, new | $122 | ||||
| 99204 | Office/outpatient visit, new | $182 | ||||
| 99205 | Office/outpatient visit, new | $229 | ||||
| 99211 | Office/outpatient visit, est | $27 | ||||
| 99212 | Office/outpatient visit, est | $48 | ||||
| 99213 | Office/outpatient visit, est | $68 | ||||
| 99214 | Office/outpatient visit, est | $105 | ||||
| 99215 | Office/outpatient visit, est | $166 | ||||
| 99217 | Observation care discharge. | $131 | ||||
| 99218 | Observation care | $129 | ||||
| 99219 | Observation care | $205 | ||||
| 99220 | Observation care | $258 | ||||
| 99221 | Initial hospital care | $127 | ||||
| 99222 | Initial hospital care | $210 | ||||
| 99223 | Initial hospital care | $268 | ||||
| 99224 | Subsequent observation care | $81 | ||||
| 99225 | Subsequent observation care | $146 | ||||
| 99226 | Subsequent observation care | $210 | ||||
| 99231 | Subsequent hospital care | $66 | ||||
| 99232 | Subsequent hospital care | $97 | ||||
| 99233 | Subsequent hospital care | $135 | ||||
| 99234 | Observ/hosp same date | $240 | ||||
| 99235 | Observ/hosp same date | $327 | ||||
| 99236 | Observ/hosp same date | $398 | ||||
| 99238 | Hospital discharge day | $131 | ||||
| 99239 | Hospital discharge day | $166 | ||||
| 99241 | Office consultation | $90 | ||||
| 99242 | Office consultation... | $161 | ||||
| 99243 | Office consultation | $180 | ||||
| 99244 | Office consultation | $252 | ||||
| 99245 | Office consultation | $341 | ||||
| 99251 | Initial inpatient consult | $92 | ||||
| 99252 | Initial inpatient consult | $140 | ||||
| 99253 | Initial inpatient consult | $185 | ||||
| 99254 | Initial inpatient consult | $254 | ||||
| 99255 | Initial inpatient consult | $343 | ||||
| 99274 | Confirmatory consultation | $217 | ||||
| 99275 | Confirmatory consultation | $299 | ||||
| 99281 | Emergency dept visit | $40 | ||||
| 99282 | Emergency dept visit | $63 | ||||
| 99283 | Emergency dept visit | $114 | ||||
| 99284 | Emergency dept visit | $173 | ||||
| 99285 | Emergency dept visit.. | $296 | ||||
| 99288 | Direct advanced life support | BR | ||||
| 99291 | Critical care, first hour | $392 | ||||
| 99292 | Critical care, addl 30 min | $191 | ||||
| 99295 | Neonatal critical care | $896 | ||||
| 99296 | Neonatal critical care | $821 | ||||
| 99297 | Neonatal critical care | $445 | ||||
| 99298 | Neonatal critical care | $281 | ||||
| 99301 | Nursing facility care | $121 | ||||
| 99302 | Nursing facility care | $156 | ||||
| 99303 | Nursing facility care | $213 | ||||
| 99304 | Nursing facility care init | $190 | ||||
| 99305 | Nursing facility care init | $270 | ||||
| 99306 | Nursing facility care init | $342 | ||||
| 99307 | Nursing fac care subseq | $90 | ||||
| 99308 | Nursing fac care subseq | $140 | ||||
| 99309 | Nursing fac care subseq | $184 | ||||
| 99310 | Nursing fac care subseq | $273 | ||||
| 99311 | Nursing fac care, subseq | $68 | ||||
| 99312 | Nursing fac care, subseq | $102 | ||||
| 99313 | Nursing fac care, subseq | $138 | ||||
| 99315 | Nursing fac discharge day | $120 | ||||
| 99316 | Nursing fac discharge day | $148 | ||||
| 99318 | Annual nursing fac assessmnt | $195 | ||||
| 99321 | Rest home visit, new patient | $79 | ||||
| 99322 | Rest home visit, new patient | $112 | ||||
| 99323 | Rest home visit, new patient | $147 | ||||
| 99324 | Domicil/r-home visit new pat | $114 | ||||
| 99325 | Domicil/r-home visit new pat | $163 | ||||
| 99326 | Domicil/r-home visit new pat | $284 | ||||
| 99327 | Domicil/r-home visit new pat | $378 | ||||
| 99328 | Domicil/r-home visit new pat | $438 | ||||
| 99331 | Rest home visit, estab pat | $64 | ||||
| 99332 | Rest home visit, estab pat | $84 | ||||
| 99333 | Rest home visit, estab pat | $103 | ||||
| 99334 | Domicil/r-home visit est pat | $123 | ||||
| 99335 | Domicil/r-home visit est pat | $192 | ||||
| 99336 | Domicil/r-home visit est pat | $273 | ||||
| 99337 | Domicil/r-home visit est pat | $392 | ||||
| 99339 | Domicil/r-home care supervis | $157 | ||||
| 99340 | Domicil/r-home care supervis | $220 | ||||
| 99341 | Home visit, new patient | $112 | ||||
| 99342 | Home visit, new patient | $156 | ||||
| 99343 | Home visit, new patient | $225 | ||||
| 99344 | Home visit, new patient | $289 | ||||
| 99345 | Home visit, new patient | $346 | ||||
| 99347 | Home visit, est. patient | $88 | ||||
| 99348 | Home visit, est patient | $131 | ||||
| 99349 | Home visit, est patient | $194 | ||||
| 99350 | Home visit, est patient | $280 | ||||
| 99354 | Prolonged service, office | $190 | ||||
| 99355 | Prolonged service, office | $187 | ||||
| 99356 | Prolonged service, inpatient | $182 | ||||
| 99357 | Prolonged service, inpatient | $183 | ||||
| 99358 | Prolonged serv, w/o contact | $190 | ||||
| 99359 | Prolonged serv, w/o contact | $187 | ||||
| 99360 | Physician standby services | $127 | ||||
| 99361 | Physician/team conference | BR | ||||
| 99362 | Physician/team conference | BR | ||||
| 99363 | Anticoag mgmt init | $255 | $170 | |||
| 99364 | Anticoag mgmt subseq | $87 | $65 | |||
| 99366 | Team conf w/pat by hc pro | $86 | $84 | |||
| 99367 | Team conf w/o pat by phys | $115 | ||||
| 99368 | Team conf w/o pat by hc pro | $74 | ||||
| 99371 | Physician phone consultation | BR | ||||
| 99372 | Physician phone consultation | BR | ||||
| 99373 | Physician phone consultation | BR | ||||
| 99374 | Home health care | $125 | ||||
| 99375 | Home health care supervision | $171 | ||||
| 99377 | Hospice care supervision | $125 | ||||
| 99378 | Hospice care supervision | $172 | ||||
| 99379 | Nursing fac care supervision | $125 | ||||
| 99380 | Nursing fac care supervision | $174 | ||||
| 99381 | Prev visit, new, infant | $175 | ||||
| 99382 | Preventive visit, new, age 1-4 | $231 | $164 | |||
| 99383 | Preventive visit, new, age 5-11 | $241 | $174 | |||
| 99384 | Preventive visit,new,12-17 | $272 | $206 | |||
| 99385 | Preventive visit,new,18-39 | $264 | $198 | |||
| 99386 | Preventive visit,new,40-64 | $306 | $240 | |||
| 99387 | Preventive visit, new, 65&over | $332 | $258 | |||
| 99391 | Prev visit, est, infant | $147 | ||||
| 99392 | Preventive visit,est,age 1-4 | $213 | $155 | |||
| 99393 | Preventive visit,est,age5-11 | $212 | $155 | |||
| 99394 | Preventive visit,est,12-17 | $232 | $174 | |||
| 99395 | Preventive visit,est,18-39 | $237 | $179 | |||
| 99396 | Preventive visit,est,40-64 | $255 | ||||
| 99397 | Preventive visit, est, 65&over | $273 | $206 | |||
| 99401 | Preventive counseling, | $68 | ||||
| 99402 | Preventive counseling, indiv | $124 | $101 | |||
| 99403 | Preventive counseling, indiv | $174 | $150 | |||
| 99404 | Preventive counseling, indiv | $224 | $200 | |||
| 99406 | Behav chng smoking 3-10 min | $28 | $25 | |||
| 99407 | Behav chng smoking > 10 min | $55 | $52 | |||
| 99408 | Audit/dast 15-30 min | $71 | $66 | |||
| 99409 | Audit/dast over 30 min | $137 | $134 | |||
| 99411 | Preventive counseling, group | $22 | ||||
| 99412 | Preventive counseling, group | $43 | $25 | |||
| 99420 | Health risk assessment test | $22 | ||||
| 99421 | Online Digital E/M SVC Est Pt <7 D 5-10 Minutes | $31 | $27 | |||
| 99422 | Online Digital E/M SVC Est Pt <7 D 11-20 Minutes | $62 | $55 | |||
| 99423 | Online Digital E/M SVC Est Pt <7 D 21+ Minutes | $100 | $87 | |||
| 99429 | Unlisted preventive service | BR | ||||
| 99431 | Initial care, normal newborn | BR | ||||
| 99432 | Newborn care not in hospital | BR | ||||
| 99433 | Normal newborn care, hospital | BR | ||||
| 99435 | Newborn discharge day hosp | $207 | ||||
| 99436 | Attendance, birth..... | $209 | ||||
| 99440 | Newborn resuscitation | $455 | ||||
| 99441 | Phone e/m by phys 5-10 min | $28 | $25 | |||
| 99442 | Phone e/m by phys 11-20 min | $54 | $51 | |||
| 99443 | Phone e/m by phys 21-30 min | $80 | $77 | |||
| 99444 | Online e/m by phys | $72 | ||||
| 99450 | Life/disability evaluation | BR | ||||
| 99455 | Disability examination | BR | ||||
| 99456 | Disability examination | BR | ||||
| 99460 | Init nb em per day hosp | $201 | ||||
| 99461 | Init nb em per day non-fac | $198 | ||||
| 99462 | Sbsq nb em per day hosp | $89 | ||||
| 99463 | Same day nb discharge | $237 | ||||
| 99464 | Attendance at delivery | $150 | ||||
| 99465 | Nb resuscitation | $299 | ||||
| 99466 | Ped crit care transport | $556 | ||||
| 99467 | Ped crit care transport addl | $249 | ||||
| 99468 | Neonate crit care initial | $1,890 | ||||
| 99469 | Neonate crit care subsq | $859 | ||||
| 99471 | Ped critical care initial | $1,607 | ||||
| 99472 | Ped critical care subsq | $820 | ||||
| 99475 | Ped crit care age 2-5 init | $1,148 | ||||
| 99476 | Ped crit care age 2-5 subsq | $699 | ||||
| 99477 | Init day hosp neonate care | $703 | ||||
| 99478 | Ic lbw inf < 1500 gm subsq | $278 | ||||
| 99479 | Ic lbw inf 1500-2500 g subsq | $260 | ||||
| 99480 | Ic inf pbw 2501-5000 g subsq | $244 | ||||
| 99495 | Transitional Care Mange Srvc 14 Day Discharge | BR | ||||
| 99496 | Transitonal Care Mange Srvc 7 Day Discharge | BR | ||||
| 99499 | Unlisted e/m service | BR |
C. Table 3
| Code | Mod | Description | Global Days | Maximum Allowance | Non-Facility Maximum | Facility Maximum |
|---|---|---|---|---|---|---|
| C9803 | COVID-19 Specimen Collection HOPD | BR | ||||
| G2010 | Remot Image Submit By PT | $24 | ||||
| G2012 | Brief Check In By MD/QHP | $27 | ||||
| G2023 | Specimen Collect COVID-19 | $47 | ||||
| G2024 | Spec Coll SNF/Lab COVID-19 | $51 | ||||
| G2061 | Qual NonMD Est PT 5-10M | $25 | ||||
| G2062 | Qual NonMD Est PT 11-20M | $43 | ||||
| G2063 | Qual NonMD Est PT 21>Min | $68 | ||||
| U0001 | 2019-NCOV Diagnostic P | $72 | ||||
| U0002 | COVID-19 Lab Test Non-CDC | $103 | ||||
| U0003 | SARS-COV-2 COVID-19 Amp Prb Htt | $200 | ||||
| U0004 | COVID-19 Lab Test Non-CDC Htt | $200 |
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1034.2.
HISTORICAL NOTE: Promulgated by the Department of Labor, Office of Workers' Compensation, LR 19:54 (January 1993), repromulgated LR 19:212 (February 1993), amended LR 20:1299 (November 1994), LR 27:314 (March 2001), amended by the Workforce Commission, Office of Workers’ Compensation, LR 39:1854 (July 2013), LR 40:379 (February 2014), amended by the Workforce Commission, Office of Workers’ Compensation Administration, LR 42:1696 (October 2016), LR 46:1401 (October 2020).