Top 40 services provided by BENEFIS HEALTH CARE (WEST CAMPUS)
Services CPT Price Est. Cash Price
Fine needle aspiration of first lesion using ultrasound guidance 10005 $1,206.00 $723.60
Fine needle aspiration of additional lesion using ultrasound guidance 10006 $302.00 $181.20
Fine needle aspiration of first lesion 10021 $277.00 $166.20
Fine needle aspiration of first lesion 10021 $491.00 $294.60
Fluid collection drainage by catheter using imaging guidance, accessed through the skin 10030 $736.00 $441.60
Placement of soft tissue localization device accessed through the skin with imaging guidance, first lesion 10035 $1,240.00 $744.00
Acne surgery 10040 $186.00 $111.60
Drainage of abscess 10060 $338.00 $202.80
Drainage of abscess 10060 $539.00 $323.40
Drainage of abscess 10060 $116.00 $69.60
Drainage of abscess 10060 $267.00 $160.20
Drainage of abscess 10060 $213.00 $127.80
Drainage of multiple abscess 10061 $416.00 $249.60
Drainage of multiple abscess 10061 $660.00 $396.00
Drainage of tailbone cyst 10080 $180.00 $108.00
Drainage of tailbone cyst 10080 $1,125.00 $675.00
Drainage of tailbone cyst 10081 $317.00 $190.20
Drainage of tailbone cyst 10081 $1,185.00 $711.00
Removal of foreign body from tissue, accessed beneath the skin 10120 $152.00 $91.20
Removal of foreign body from tissue, accessed beneath the skin 10120 $699.00 $419.40
Removal of foreign body from tissue, accessed beneath the skin 10121 $2,784.00 $1,670.40
Drainage of blood or fluid accumulation 10140 $2,862.00 $1,717.20
Drainage of blood or fluid accumulation 10140 $266.00 $159.60
Aspiration of abscess, blood accumulation, blister, or cyst 10160 $673.00 $403.80
Aspiration of abscess, blood accumulation, blister, or cyst 10160 $298.00 $178.80
Drainage of wound infection after surgery 10180 $5,030.00 $3,018.00
Drainage of wound infection after surgery 10180 $246.00 $147.60
Removal of inflamed or infected skin, up to 10% of body surface 11000 $1,021.00 $612.60
Removal of inflamed or infected skin, up to 10% of body surface 11000 $725.00 $435.00
Removal of foreign material from skin and tissue at open fracture and/or dislocation 11010 $1,994.00 $1,196.40
Removal of foreign material from skin, tissue, and muscle at open fracture and/or dislocation 11011 $1,214.00 $728.40
Removal of foreign material from skin, tissue, muscle, and bone at open fracture and/or dislocation 11012 $4,833.00 $2,899.80
Removal of skin and tissue first 20 sq cm or less 11042 $118.00 $70.80
Removal of skin and tissue first 20 sq cm or less 11042 $1,008.00 $604.80
Removal of skin and tissue first 20 sq cm or less 11042 $216.00 $129.60
Removal of skin and/or muscle first 20 sq cm or less 11043 $1,115.00 $669.00
Removal of skin and bone first 20 sq cm or less 11044 $3,835.00 $2,301.00
Removal of skin and tissue 11045 $806.00 $483.60
Removal of skin and/or muscle 11046 $1,416.00 $849.60
Removal of skin and bone 11047 $2,834.00 $1,700.40
Removal of single thickened skin growth 11055 $347.00 $208.20
Removal of 2 to 4 thickened skin growths 11056 $107.00 $64.20
Removal of 2 to 4 thickened skin growths 11056 $367.00 $220.20
Removal of more than 4 thickened skin growths 11057 $367.00 $220.20
Tangential biopsy of single skin lesion 11102 $91.00 $54.60
Tangential biopsy of single skin lesion 11102 $368.00 $220.80
Tangential biopsy of additional skin lesion 11103 $52.00 $31.20
Tangential biopsy of additional skin lesion 11103 $93.00 $55.80
Punch biopsy of single skin lesion 11104 $368.00 $220.80
Punch biopsy of single skin lesion 11104 $114.00 $68.40
Punch biopsy of additional skin lesion 11105 $62.00 $37.20
Punch biopsy of additional skin lesion 11105 $93.00 $55.80
Incisional biopsy of single skin lesion 11106 $655.00 $393.00
Incisional biopsy of additional skin lesion 11107 $165.00 $99.00
Removal of up to and including 15 skin tags 11200 $156.00 $93.60
Removal of up to and including 15 skin tags 11200 $368.00 $220.80
Removal of skin tags 11201 $37.00 $22.20
Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs 11300 $181.00 $108.60
Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs 11300 $267.00 $160.20
Shaving of 0.6 centimeters to 1.0 centimeters skin growth of the trunk, arms, or legs 11301 $347.00 $208.20
Shaving of 1.1 to 2.0 centimeters skin growth of the trunk, arms, or legs 11302 $347.00 $208.20
Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs 11303 $304.00 $182.40
Shaving of 0.5 centimeters or less skin growth of scalp, neck, hands, feet, or genitals 11305 $181.00 $108.60
Shaving of 0.6 centimeters to 1.0 centimeters skin growth of scalp, neck, hands, feet, or genitals 11306 $223.00 $133.80
Shaving of 1.1 to 2.0 centimeters skin growth of scalp, neck, hands, feet, or genitals 11307 $263.00 $157.80
Shaving of over 2.0 centimeters skin growth of scalp, neck, hands, feet, or genitals 11308 $278.00 $166.80
Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth 11310 $210.00 $126.00
Shaving of 0.6 centimeters to 1.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth 11311 $530.00 $318.00
Shaving of 1.1 to 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth 11312 $296.00 $177.60
Removal of growth (0.5 centimeters or less) of the trunk, arms or legs 11400 $228.00 $136.80
Removal of growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs 11401 $1,084.00 $650.40
Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs 11402 $664.00 $398.40
Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs 11402 $1,214.00 $728.40
Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs 11403 $1,214.00 $728.40
Removal of growth (3.1 to 4.0 centimeters) of the trunk, arms, or legs 11404 $398.00 $238.80
Removal of growth (4.0 centimeters) of the trunk, arms, or legs 11406 $3,184.00 $1,910.40
Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals 11420 $2,782.00 $1,669.20
Removal of growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals 11421 $1,214.00 $728.40
Removal of growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals 11422 $2,782.00 $1,669.20
Removal of growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals 11423 $2,782.00 $1,669.20
Removal of growth (3.1 to 4.0 centimeters) of the scalp, neck, hands, feet, or genitals 11424 $425.00 $255.00
Removal of growth (3.1 to 4.0 centimeters) of the scalp, neck, hands, feet, or genitals 11424 $2,918.00 $1,750.80
Removal of growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals 11426 $4,833.00 $2,899.80
Removal of growth (0.5 centimeters or less) of the face, ears, eyelids, nose, lips, or mouth 11440 $1,126.00 $675.60
Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth 11441 $1,240.00 $744.00
Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth 11442 $344.00 $206.40
Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth 11442 $2,206.00 $1,323.60
Removal of growth (2.1 to 3.0 centimeters) of face, ears, eyelids, nose, lips, or mouth 11443 $2,917.00 $1,750.20
Removal (3.1 to 4.0 centimeters) growth of face, ears, eyelids, nose, lips, or mouth 11444 $511.00 $306.60
Removal of malignant growth (0.5 centimeters or less) of the trunk, arms, or legs 11600 $352.00 $211.20
Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs 11601 $447.00 $268.20
Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs 11602 $453.00 $271.80
Removal of malignant growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs 11603 $514.00 $308.40
Removal of malignant growth (3.1 to 4 centimeters) of the trunk, arms, or legs 11604 $552.00 $331.20
Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs 11606 $817.00 $490.20
Removal of malignant growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals 11620 $2,782.00 $1,669.20
Removal of malignant growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals 11621 $421.00 $252.60
Removal of malignant growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals 11622 $468.00 $280.80
Removal of malignant growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals 11623 $2,782.00 $1,669.20
Removal of malignant growth (3.1 to 4 centimeters) of the scalp, neck, hands, feet, or genitals 11624 $615.00 $369.00
Removal of malignant growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals 11626 $794.00 $476.40
Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips 11640 $369.00 $221.40
Removal of malignant growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, or lips 11641 $435.00 $261.00
Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips 11642 $496.00 $297.60
Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips 11643 $582.00 $349.20
Removal of malignant growth (3.1 to 4.0 centimeters) of the face, ears, eyelids, nose, or lips 11644 $718.00 $430.80
Removal of malignant growth (over 4.0 centimeters) of the face, ears, eyelids, nose, or lips 11646 $932.00 $559.20
Trimming of fingernails or toenails 11719 $125.00 $75.00
Trimming of fingernails or toenails 11719 $13.00 $7.80
Removal of tissue from 1 to 5 finger or toe nails 11720 $125.00 $75.00
Removal of tissue from 6 or more finger or toe nails 11721 $127.00 $76.20
Removal of tissue from 6 or more finger or toe nails 11721 $82.00 $49.20
Separation of nail plate from nail bed 11730 $98.00 $58.80
Separation of nail plate from nail bed 11730 $347.00 $208.20
Separation of nail plate from nail bed 11732 $152.00 $91.20
Separation of nail plate from nail bed 11732 $38.00 $22.80
Removal of blood accumulation between nail and nail bed 11740 $50.00 $30.00
Removal of blood accumulation between nail and nail bed 11740 $146.00 $87.60
Removal of nail 11750 $210.00 $126.00
Removal of nail 11750 $660.00 $396.00
Biopsy of finger or toe nail 11755 $246.00 $147.60
Repair of finger or toe nail bed 11760 $1,058.00 $634.80
Repair of finger or toe nail bed 11760 $264.00 $158.40
Repair of finger or toe nail bed with graft 11762 $3,177.00 $1,906.20
Removal of skin of finger or toe nail 11765 $215.00 $129.00
Removal of skin of finger or toe nail 11765 $673.00 $403.80
Injection of up to 7 skin growths 11900 $367.00 $220.20
Injection of more than 7 skin growths 11901 $127.00 $76.20
Introduction of pigment into skin (6.1 to 20.0 sq cm) to correct color defect 11921 $364.00 $218.40
Introduction of pigment into skin to correct color defect 11922 $116.00 $69.60
Replacement of tissue expander with permanent prosthesis 11970 $11,744.00 $7,046.40
Removal of tissue expanders 11971 $5,030.00 $3,018.00
Insertion of drug delivery implant into tissue 11981 $241.00 $144.60
Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs 12001 $221.00 $132.60
Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs 12001 $367.00 $220.20
Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs 12001 $92.00 $55.20
Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs 12001 $167.00 $100.20
Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12002 $221.00 $132.60
Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12002 $466.00 $279.60
Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12002 $109.00 $65.40
Repair of wound (7.6 to 12.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12004 $128.00 $76.80
Repair of wound (7.6 to 12.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12004 $221.00 $132.60
Repair of wound (7.6 to 12.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12004 $499.00 $299.40
Repair of wound (12.6 to 20.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12005 $166.00 $99.60
Repair of wound (12.6 to 20.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12005 $617.00 $370.20
Repair of wound (20.1 to 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12006 $673.00 $403.80
Repair of wound (20.1 to 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12006 $200.00 $120.00
Repair of wound (over 30.0 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs 12007 $226.00 $135.60
Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12011 $221.00 $132.60
Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12011 $111.00 $66.60
Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12011 $367.00 $220.20
Repair of wound (2.6 to 5.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12013 $367.00 $220.20
Repair of wound (2.6 to 5.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12013 $221.00 $132.60
Repair of wound (2.6 to 5.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12013 $122.00 $73.20
Repair of wound (5.1 to 7.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12014 $367.00 $220.20
Repair of wound (5.1 to 7.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12014 $141.00 $84.60
Repair of wound (7.6 to 12.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12015 $367.00 $220.20
Repair of wound (7.6 to 12.5 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12015 $172.00 $103.20
Repair of wound (12.6 to 20.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12016 $655.00 $393.00
Repair of wound (12.6 to 20.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes 12016 $382.00 $229.20
Repair of separation of wound closure 12020 $278.00 $166.80
Repair of separation of wound closure 12020 $1,005.00 $603.00
Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs 12031 $393.00 $235.80
Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs 12031 $673.00 $403.80
Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs 12031 $436.00 $261.60
Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12032 $673.00 $403.80
Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12032 $556.00 $333.60
Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12032 $393.00 $235.80
Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12034 $673.00 $403.80
Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12034 $610.00 $366.00
Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12034 $393.00 $235.80
Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12035 $393.00 $235.80
Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12035 $610.00 $366.00
Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12035 $673.00 $403.80
Repair of wound (20.1 to 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12036 $669.00 $401.40
Repair of wound (20.1 to 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12036 $1,005.00 $603.00
Repair of wound (20.1 to 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12036 $1,058.00 $634.80
Repair of wound (over 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs 12037 $3,177.00 $1,906.20
Repair of wound (2.5 centimeters or less) of neck, hands, feet, and/or genitals 12041 $393.00 $235.80
Repair of wound (2.5 centimeters or less) of neck, hands, feet, and/or genitals 12041 $673.00 $403.80
Repair of wound (2.5 centimeters or less) of neck, hands, feet, and/or genitals 12041 $250.00 $150.00
Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals 12042 $285.00 $171.00
Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals 12042 $393.00 $235.80
Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals 12042 $673.00 $403.80
Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals 12044 $1,005.00 $603.00
Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals 12044 $356.00 $213.60
Repair of wound (12.6 to 20.0 centimeters) of neck, hands, feet, and/or genitals 12045 $398.00 $238.80
Repair of wound (20.1 to 30.0 centimeters) of neck, hands, feet, and/or genitals 12046 $528.00 $316.80
Repair of wound (over 30.0 centimeters) of neck, hands, feet, and/or genitals 12047 $3,213.00 $1,927.80
Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth 12051 $256.00 $153.60
Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth 12051 $673.00 $403.80
Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth 12051 $393.00 $235.80
Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12052 $673.00 $403.80
Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12052 $393.00 $235.80
Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12052 $290.00 $174.00
Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12053 $393.00 $235.80
Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12053 $673.00 $403.80
Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12053 $363.00 $217.80
Repair of wound (7.6 to 12.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12054 $673.00 $403.80
Repair of wound (7.6 to 12.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12054 $364.00 $218.40
Repair of wound (7.6 to 12.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12054 $360.00 $216.00
Repair of wound (12.6 to 20.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12055 $673.00 $403.80
Repair of wound (12.6 to 20.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth 12055 $465.00 $279.00
Repair of wound (1.1 to 2.5 centimeters) of trunk 13100 $610.00 $366.00
Repair of wound (2.6 to 7.5 centimeters) of trunk 13101 $392.00 $235.20
Repair of wound (2.6 to 7.5 centimeters) of trunk 13101 $967.00 $580.20
Repair of wound (2.6 to 7.5 centimeters) of trunk 13101 $610.00 $366.00
Repair of wound of trunk 13102 $159.00 $95.40
Repair of wound of trunk 13102 $415.00 $249.00
Repair of wound (1.1 to 2.5 centimeters) of scalp, arms, and/or legs 13120 $1,058.00 $634.80
Repair of wound (1.1 to 2.5 centimeters) of scalp, arms, and/or legs 13120 $557.00 $334.20
Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs 13121 $610.00 $366.00
Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs 13121 $1,058.00 $634.80
Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs 13121 $421.00 $252.60
Repair of wound of scalp, arms, and/or legs 13122 $530.00 $318.00
Repair of wound of scalp, arms, and/or legs 13122 $182.00 $109.20
Repair of wound of scalp, arms, and/or legs 13122 $133.00 $79.80
Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13131 $393.00 $235.80
Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13131 $379.00 $227.40
Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13131 $673.00 $403.80
Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13132 $1,058.00 $634.80
Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13132 $610.00 $366.00
Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13132 $467.00 $280.20
Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13133 $278.00 $166.80
Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13133 $523.00 $313.80
Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 13133 $168.00 $100.80
Repair of wound (1.1 to 2.5 centimeters) of eyelids, nose, ears, and/or lips 13151 $1,058.00 $634.80
Repair of wound (1.1 to 2.5 centimeters) of eyelids, nose, ears, and/or lips 13151 $679.00 $407.40
Repair of wound (1.1 to 2.5 centimeters) of eyelids, nose, ears, and/or lips 13151 $610.00 $366.00
Repair of wound (2.6 to 7.5 centimeters) of eyelids, nose, ears, and/or lips 13152 $1,058.00 $634.80
Repair of wound (2.6 to 7.5 centimeters) of eyelids, nose, ears, and/or lips 13152 $947.00 $568.20
Repair of wound (2.6 to 7.5 centimeters) of eyelids, nose, ears, and/or lips 13152 $610.00 $366.00
Repair of wound of eyelids, nose, ears, and/or lips 13153 $662.00 $397.20
Repair of wound of eyelids, nose, ears, and/or lips 13153 $300.00 $180.00
Second repair of surgical wound 13160 $3,213.00 $1,927.80
Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs 14020 $1,273.00 $763.80
Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs 14020 $3,222.00 $1,933.20
Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs 14021 $1,584.00 $950.40
Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 14040 $1,347.00 $808.20
Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 14040 $3,213.00 $1,927.80
Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 14041 $3,214.00 $1,928.40
Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips 14060 $1,412.00 $847.20
Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of eyelids, nose, ears, and/or lips 14061 $1,837.00 $1,102.20
Tissue transfer repair of wound (30.1 to 60.0 sq centimeters) 14301 $1,958.00 $1,174.80
Tissue transfer repair of wound (30.0 sq centimeters) 14302 $608.00 $364.80
Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children) 15002 $3,214.00 $1,928.40
Preparation of graft site of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children) 15004 $1,022.00 $613.20
Skin graft (2 centimeters) to tip of finger or toe 15050 $1,021.00 $612.60
Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children) 15110 $5,858.00 $3,514.80
Skin graft at trunk, arms, or legs 15111 $2,930.00 $1,758.00
Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children) 15115 $3,417.00 $2,050.20
Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes 15116 $1,779.00 $1,067.40
Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children) 15135 $5,635.00 $3,381.00
Relocation of patient skin (20 sq centimeters or less) to scalp, arms, and/or legs 15220 $3,394.00 $2,036.40
Relocation of patient skin to scalp, arms, and/or legs 15221 $254.00 $152.40
Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (20 sq centimeters or less) 15240 $5,770.00 $3,462.00
Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (20 sq centimeters or less) 15240 $3,305.00 $1,983.00
Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet 15241 $804.00 $482.40
Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) 15260 $1,842.00 $1,105.20
Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) 15271 $3,222.00 $1,933.20
Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs 15272 $806.00 $483.60
Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs (first 100 sq cm or 1% body area of infants and children) 15273 $5,312.00 $3,187.20
Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs 15274 $2,265.00 $1,359.00
Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less) 15275 $278.00 $166.80
Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less) 15275 $3,394.00 $2,036.40
Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes 15276 $1,243.00 $745.80
Application of skin substitute (wound surface great than or equal to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children) 15277 $3,214.00 $1,928.40
Application of skin substitute (wound surface great than or equal to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes 15278 $1,375.00 $825.00
Creation of flap graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet 15574 $3,213.00 $1,927.80
Creation of flap graft to eyelids, nose, ears, lips, or mouth 15576 $1,476.00 $885.60
Transfer of skin flap to forehead, cheeks, chin, neck, underarms, genitals, hands, or feet 15620 $3,214.00 $1,928.40
Transfer of skin flap to eyelids, nose, ears, or lips 15630 $845.00 $507.00
Implantation of biologic implant to soft tissue 15777 $832.00 $499.20
Scraping of skin growth 15786 $203.00 $121.80
Scraping of multiple skin growths 15787 $203.00 $121.80
Chemical peel of skin of face 15788 $870.00 $522.00
Chemical peel of skin of face 15788 $1,054.00 $632.40
Chemical peel of skin of face 15792 $634.00 $380.40
Chemical peel of skin 15793 $1,391.00 $834.60
Removal of excessive skin of lower eyelid 15820 $3,305.00 $1,983.00
Removal of excessive skin of lower eyelid 15820 $1,901.00 $1,140.60
Removal of excessive skin of upper eyelid 15822 $3,305.00 $1,983.00
Removal of excessive skin of upper eyelid 15822 $1,901.00 $1,140.60
Removal of excessive skin and fat of upper eyelid 15823 $3,305.00 $1,983.00
Incision, stretching, and suture of forehead skin 15824 $3,753.00 $2,251.80
Incision, stretching, and suture of forehead skin 15824 $6,270.00 $3,762.00
Incision, stretching, and suture of neck skin 15825 $5,755.00 $3,453.00
Incision, stretching, and suture of neck skin 15825 $3,675.00 $2,205.00
Incision, stretching, and suture of skin 15828 $5,755.00 $3,453.00
Removal of excessive skin at cheek, chin, or neck 15829 $5,755.00 $3,453.00
Removal of excessive skin and tissue beneath the skin of abdomen 15830 $9,941.00 $5,964.60
Removal of excessive skin and tissue beneath the skin of thigh 15832 $4,833.00 $2,899.80
Removal of excessive skin and tissue beneath the skin of thigh 15832 $6,289.00 $3,773.40
Removal of excessive skin and tissue beneath the skin of buttock 15835 $4,833.00 $2,899.80
Removal of excessive skin and tissue beneath the skin of buttock 15835 $3,819.00 $2,291.40
Removal of excessive skin and tissue beneath the skin of arm 15836 $2,220.00 $1,332.00
Removal of additional excessive skin and tissue beneath the skin of abdomen 15847 $2,486.00 $1,491.60
Removal of additional excessive skin and tissue beneath the skin of abdomen 15847 $1,569.00 $941.40
Removal of sutures under anesthesia by other surgeon 15851 $3,394.00 $2,036.40
Dressing change under anesthesia 15852 $130.00 $78.00
Suction assisted removal of fat from head and neck 15876 $5,755.00 $3,453.00
Suction assisted removal of fat from trunk 15877 $5,864.00 $3,518.40
Suction assisted removal of fat from arm 15878 $3,222.00 $1,933.20
Suction assisted removal of fat from leg 15879 $5,635.00 $3,381.00
First degree burn treatment 16000 $294.00 $176.40
First degree burn treatment 16000 $70.00 $42.00
Dressing change and/or removal of burn tissue (less than 5% total body surface) 16020 $82.00 $49.20
Dressing change and/or removal of burn tissue (less than 5% total body surface) 16020 $321.00 $192.60
Dressing change and/or removal of burn tissue (5% to 10% total body surface) 16025 $321.00 $192.60
Dressing change and/or removal of burn tissue (5% to 10% total body surface) 16025 $146.00 $87.60
Dressing change and/or removal of burn tissue (greater than 10% total body surface) 16030 $198.00 $118.80
Dressing change and/or removal of burn tissue (greater than 10% total body surface) 16030 $477.00 $286.20
Destruction of skin growth 17000 $151.00 $90.60
Destruction of skin growth 17000 $267.00 $160.20
Destruction of skin growth 17000 $82.00 $49.20
Destruction of 2-14 skin growths 17003 $8.00 $4.80
Destruction of 2-14 skin growths 17003 $58.00 $34.80
Destruction of 2-14 skin growths 17003 $13.00 $7.80
Destruction of 15 or more skin growths 17004 $309.00 $185.40
Destruction of up to 14 skin growths 17110 $205.00 $123.00
Destruction of up to 14 skin growths 17110 $111.00 $66.60
Destruction of up to 14 skin growths 17110 $347.00 $208.20
Destruction of 15 or more skin growths 17111 $367.00 $220.20
Application of chemical agent to excessive wound tissue 17250 $94.00 $56.40
Application of chemical agent to excessive wound tissue 17250 $471.00 $282.60
Destruction of malignant growth (0.5 centimeters or less) of trunk, arms, or legs 17260 $173.00 $103.80
Destruction of malignant growth (0.6 to 1.0 centimeters) of trunk, arms, or legs 17261 $265.00 $159.00
Destruction of malignant growth (1.1 to 2.0 centimeters) of trunk, arms, or legs 17262 $310.00 $186.00
Destruction of malignant growth (0.5 centimeters) of scalp, neck, hands, feet, or genitals 17270 $277.00 $166.20
Destruction of malignant growth (0.6 to 1.0 centimeters) of scalp, neck, hands, feet, or genitals 17271 $301.00 $180.60
Destruction of malignant growth (1.1 to 2.0 centimeters) of scalp, neck, hands, feet, or genitals 17272 $341.00 $204.60
Destruction of malignant growth (2.1 to 3.0 centimeters) of scalp, neck, hands, feet, or genitals 17273 $378.00 $226.80
Destruction of malignant growth (0.5 centimeters or less) of face, ears, eyelids, nose, lips, or mouth 17280 $259.00 $155.40
Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth 17281 $325.00 $195.00
Destruction of malignant growth (1.1 to 2.0 centimeters) of face, ears, eyelids, nose, lips, or mouth 17282 $373.00 $223.80
Skin, mucus membrane and beneath the skin procedure 17999 $5,107.00 $3,064.20
Skin, mucus membrane and beneath the skin procedure 17999 $6,402.00 $3,841.20
Aspiration of breast cyst 19000 $652.00 $391.20
Puncture aspiration of breast cyst 19001 $248.00 $148.80
Drainage of breast abscess 19020 $471.00 $282.60
Injection for X-ray imaging of breast duct 19030 $550.00 $330.00
Biopsy of breast accessed through the skin with stereotactic guidance 19081 $1,603.00 $961.80
Biopsy of breast accessed through the skin with stereotactic guidance 19082 $802.00 $481.20
Biopsy of breast accessed through the skin with ultrasound guidance 19083 $2,094.00 $1,256.40
Biopsy of breast accessed through the skin with ultrasound guidance 19084 $1,085.00 $651.00
Biopsy of breast accessed through the skin with MRI guidance 19085 $1,974.00 $1,184.40
Biopsy of breast accessed through the skin with MRI guidance 19086 $955.00 $573.00
Biopsy of breast, open procedure 19101 $5,622.00 $3,373.20
Removal of one or more growth from the breast; a surgical procedure on a female or male also called a mastectomy 19120 $5,859.00 $3,515.40
Removal of one or more growth from the breast; a surgical procedure on a female or male also called a mastectomy 19120 $5,859.00 $3,515.40
Placement of breast localization devices accessed through the skin with mammographic guidance 19281 $736.00 $441.60
Placement of breast localization devices accessed through the skin with mammographic guidance 19282 $135.00 $81.00
Placement of breast localization devices accessed through the skin with ultrasound guidance 19285 $736.00 $441.60
Placement of breast localization devices accessed through the skin with ultrasound guidance 19286 $153.00 $91.80
Removal of extra breast tissue 19300 $8,432.00 $5,059.20
Removal of extra breast tissue 19300 $3,934.00 $2,360.40
Removal of extra breast tissue 19300 $953.00 $571.80
Removal of extra breast tissue 19300 $4,506.00 $2,703.60
Removal of extra breast tissue 19300 $5,622.00 $3,373.20
Enlargement of breast 19316 $9,941.00 $5,964.60
Enlargement of breast 19316 $308.00 $184.80
Enlargement of breast 19316 $4,481.00 $2,688.60
Repositioning of breast on chest 19318 $14,911.00 $8,946.60
Repositioning of breast on chest 19318 $5,910.00 $3,546.00
Enlargement of breast 19324 $15,494.00 $9,296.40
Enlargement of breast with insertion of prosthetic implant 19325 $1,814.00 $1,088.40
Enlargement of breast with insertion of prosthetic implant 19325 $2,195.00 $1,317.00
Enlargement of breast with insertion of prosthetic implant 19325 $2,925.00 $1,755.00
Enlargement of breast with insertion of prosthetic implant 19325 $14,589.00 $8,753.40
Enlargement of breast with insertion of prosthetic implant 19325 $3,678.00 $2,206.80
Enlargement of breast with insertion of prosthetic implant 19325 $17,685.00 $10,611.00
Enlargement of breast with insertion of prosthetic implant 19325 $3,391.00 $2,034.60
Removal of intact breast implant 19328 $5,859.00 $3,515.40
Removal of intact breast implant 19328 $1,394.00 $836.40
Removal of mammary implant material 19330 $4,460.00 $2,676.00
Removal of mammary implant material 19330 $5,622.00 $3,373.20
Insertion of breast prosthesis at time of breast repositioning, removal or reconstruction 19340 $5,026.00 $3,015.60
Insertion of breast prosthesis at time of breast repositioning, removal or reconstruction 19340 $2,821.00 $1,692.60
Insertion of breast prosthesis at time of breast repositioning, removal or reconstruction 19340 $9,941.00 $5,964.60
Insertion of breast prosthesis following breast repositioning, removal or reconstruction 19342 $17,004.00 $10,202.40
Insertion of tissue expander in breast 19357 $4,248.00 $2,548.80
Incision of capsule surrounding breast with freeing of scar tissue, open procedure 19370 $8,535.00 $5,121.00
Removal of capsule surrounding breast 19371 $5,902.00 $3,541.20
Revision of reconstructed breast 19380 $8,207.00 $4,924.20
Exploration of penetrating wound of abdomen, flank, or back 20102 $3,394.00 $2,036.40
Exploration of penetrating wound of arm or leg 20103 $1,214.00 $728.40
Deep biopsy of muscle 20205 $4,948.00 $2,968.80
Needle biopsy of muscle, accessed through the skin 20206 $1,629.00 $977.40
Biopsy of bone using needle or trocar 20220 $2,918.00 $1,750.80
Deep biopsy of bone using needle or trocar 20225 $2,163.00 $1,297.80
Biopsy of bone, open procedure 20240 $3,184.00 $1,910.40
Biopsy of bone, open procedure 20245 $4,829.00 $2,897.40
Injection for repair of abnormal muscle drainage tract 20500 $1,367.00 $820.20
Injection of abnormal muscle drainage tract for X-ray study 20501 $263.00 $157.80
Removal of foreign body in muscle or tendon 20520 $2,862.00 $1,717.20
Removal of deep foreign body in muscle or tendon 20525 $4,833.00 $2,899.80
Injection of carpal tunnel 20526 $522.00 $313.20
Injection of enzyme in palm tissue 20527 $522.00 $313.20
Injections of tendon sheath, ligament, or muscle membrane 20550 $106.00 $63.60
Injections of tendon sheath, ligament, or muscle membrane 20550 $522.00 $313.20
Injections of tendon attachment to bone 20551 $284.00 $170.40
Injections of tendon attachment to bone 20551 $522.00 $313.20
Injections of trigger points in 1 or 2 muscles 20552 $531.00 $318.60
Injections of trigger points in 1 or 2 muscles 20552 $90.00 $54.00
Injections of trigger points in 3 or more muscles 20553 $549.00 $329.40
Injections of trigger points in 3 or more muscles 20553 $117.00 $70.20
Aspiration and/or injection of small joint or joint capsule 20600 $522.00 $313.20
Aspiration and/or injection of small joint or joint capsule 20600 $58.00 $34.80
Aspiration and/or injection of small joint or joint capsule with recording and reporting using ultrasound guidance 20604 $577.00 $346.20
Aspiration and/or injection of medium joint or joint capsule 20605 $50.00 $30.00
Aspiration and/or injection of medium joint or joint capsule 20605 $556.00 $333.60
Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance 20606 $692.00 $415.20
Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance 20606 $96.00 $57.60
Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance 20606 $145.00 $87.00
Aspiration and/or injection of large joint or joint capsule 20610 $63.00 $37.80
Aspiration and/or injection of large joint or joint capsule 20610 $486.00 $291.60
Aspiration and/or injection of large joint or joint capsule 20610 $149.00 $89.40
Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance 20611 $158.00 $94.80
Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance 20611 $224.00 $134.40
Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance 20611 $563.00 $337.80
Aspiration and/or injection of cysts 20612 $531.00 $318.60
Removal of bone implant 20670 $2,782.00 $1,669.20
Removal of deep bone implant 20680 $4,948.00 $2,968.80
Application of uniplane external bone fixation on one arm or leg 20690 $11,744.00 $7,046.40
Application of uniplane external bone fixation on one arm or leg 20690 $1,638.00 $982.80
Adjustment or revision of external bone fixation system under anesthesia 20693 $11,856.00 $7,113.60
Removal of external bone fixation under anesthesia 20694 $2,740.00 $1,644.00
Small bone graft harvest 20900 $11,855.00 $7,113.00
Bone graft harvest 20902 $11,749.00 $7,049.40
Rib cartilage graft 20910 $1,257.00 $754.20
Nasal cartilage graft 20912 $1,349.00 $809.40
Tendon graft 20924 $1,407.00 $844.20
Insertion of device to monitor muscle compartment fluid pressure 20950 $1,243.00 $745.80
Insertion of device to monitor muscle compartment fluid pressure 20950 $726.00 $435.60
Destruction of 1 or more bone growths accessed through the skin 20982 $6,874.00 $4,124.40
Muscle and bone procedure 20999 $3,235.00 $1,941.00
Removal of (less than 2 centimeter) tissue growth beneath the skin of face and scalp 21011 $638.00 $382.80
Injection for X-ray imaging of hinged joint of upper and lower jaw bones 21116 $246.00 $147.60
Closed treatment of broken nasal bone 21310 $135.00 $81.00
Closed treatment of broken nasal bone with stabilization 21320 $4,890.00 $2,934.00
Open treatment of tissue dividing nasal passages 21336 $1,825.00 $1,095.00
Closed treatment of nasal cartilage dividing nasal passages 21337 $4,642.00 $2,785.20
Closed treatment of nasal cartilage dividing nasal passages 21337 $753.00 $451.80
Open treatment of broken eye socket bone with implant 21390 $2,256.00 $1,353.60
Closed treatment of broken jaw bone with manipulation 21451 $756.00 $453.60
Open treatment for broken jaw bone with insertion of hardware and/or oral splint 21470 $3,365.00 $2,019.00
Closed treatment of jaw temporomandibular joint (TMJ) dislocation 21480 $100.00 $60.00
Biopsy of soft tissue of neck or chest 21550 $3,429.00 $2,057.40
Removal of (less than 5 centimeters) muscle growth of neck or front of chest 21556 $4,948.00 $2,968.80
Neck or chest procedure 21899 $229.00 $137.40
Biopsy of tissue of back or flank 21925 $4,723.00 $2,833.80
Removal (3 centimeters or greater) tissue growth beneath the skin of back or flank 21931 $2,918.00 $1,750.80
Injection of bone cement into body of middle spine bone accessed through the skin using imaging guidance 22510 $6,981.00 $4,188.60
Injection of bone cement into body of middle spine bone accessed through the skin using imaging guidance 22511 $6,981.00 $4,188.60
Injection of bone cement into body of middle spine bone accessed through the skin using imaging guidance 22513 $6,981.00 $4,188.60
Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance 22514 $6,747.00 $4,048.20
Injection of bone cement into body of middle or lower spine bone accessed through the skin using imaging guidance 22515 $5,894.00 $3,536.40
Spine procedure 22899 $1,686.00 $1,011.60
Procedure on abdomen, muscle or bone 22999 $3,530.00 $2,118.00
Incision of to repair shoulder joint area 23044 $5,607.00 $3,364.20
Removal (3 centimeters or greater) tissue growth beneath the skin of shoulder area 23071 $2,918.00 $1,750.80
Removal (less than 3 centimeters) tissue growth beneath the skin of shoulder area 23075 $2,782.00 $1,669.20
Partial removal of collar bone 23120 $5,484.00 $3,290.40
Removal or repair of collar bone and shoulder blade joint 23130 $5,484.00 $3,290.40
Removal of cyst or growth of collar bone or shoulder blade 23140 $3,276.00 $1,965.60
Removal of dead collar bone 23170 $3,408.00 $2,044.80
Partial removal of collar bone 23180 $5,484.00 $3,290.40
Injection of dye for X-ray imaging of shoulder joint 23350 $414.00 $248.40
Incision of shoulder tendon 23405 $11,744.00 $7,046.40
Incision of shoulder tendons 23406 $5,457.00 $3,274.20
Repair of torn tendons of shoulder, open procedure 23410 $11,744.00 $7,046.40
Repair of torn tendons of shoulder, open procedure 23412 $11,744.00 $7,046.40
Release of collar bone and shoulder ligament 23415 $11,744.00 $7,046.40
Repair of torn shoulder tendons 23420 $11,744.00 $7,046.40
Anchoring of biceps tendon 23430 $11,744.00 $7,046.40
Reattachment of shoulder joint capsule and cartilage 23455 $11,744.00 $7,046.40
Repair of shoulder joint 23466 $11,744.00 $7,046.40
Incision to repair collar bone 23480 $11,744.00 $7,046.40
Incision to repair collar bone for nonunion of fracture with bone graft 23485 $21,504.00 $12,902.40
Closed treatment of collar bone fracture 23500 $217.00 $130.20
Closed treatment of collar bone broken with manipulation 23505 $350.00 $210.00
Open treatment of collar bone broken 23515 $11,744.00 $7,046.40
Open treatment of collar bone and shoulder joint dislocation 23550 $11,744.00 $7,046.40
Open treatment of collar bone and shoulder joint dislocation with tissue graft 23552 $15,895.00 $9,537.00
Closed treatment of broken upper arm bone with manipulation 23605 $457.00 $274.20
Open treatment of broken upper arm bone 23615 $21,504.00 $12,902.40
Open treatment of broken upper arm bone at shoulder joint 23630 $11,749.00 $7,049.40
Closed treatment of shoulder dislocation with manipulation 23650 $312.00 $187.20
Closed treatment of shoulder dislocation with manipulation under anesthesia 23655 $2,740.00 $1,644.00
Closed treatment of shoulder dislocation with manipulation under anesthesia 23655 $1,117.00 $670.20
Open treatment of shoulder dislocation 23660 $11,855.00 $7,113.00
Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation 23665 $419.00 $251.40
Manipulation of shoulder joint under anesthesia 23700 $2,740.00 $1,644.00
Shoulder procedure 23929 $451.00 $270.60
Drainage of abscess or blood accumulation at upper arm or elbow 23930 $2,782.00 $1,669.20
Incision of elbow with exploration, drainage, or removal of foreign body 24000 $5,607.00 $3,364.20
Incision of elbow with removal of joint capsule 24006 $5,484.00 $3,290.40
Removal (3 centimeters or greater) tissue growth beneath the skin of upper arm or elbow 24071 $3,184.00 $1,910.40
Removal (5 centimeters or greater) muscle growth of upper arm or elbow 24073 $4,833.00 $2,899.80
Removal (less than 3 centimeters) tissue growth beneath the skin of upper arm or elbow 24075 $2,782.00 $1,669.20
Removal (less than 5 centimeters) muscle growth of upper arm or elbow 24076 $4,833.00 $2,899.80
Incision and exploration of elbow joint 24101 $5,484.00 $3,290.40
Removal of elbow joint lining 24102 $5,392.00 $3,235.20
Removal of fluid-filled sac of elbow 24105 $5,484.00 $3,290.40
Removal of elbow or upper forearm bone cyst or growth 24120 $5,484.00 $3,290.40
Removal of forearm bone at elbow joint 24130 $5,484.00 $3,290.40
Injection of dye for X-ray imaging of elbow joint 24220 $374.00 $224.40
Manipulation of elbow under anesthesia 24300 $2,921.00 $1,752.60
Lengthening of tendon of upper arm or elbow 24305 $5,484.00 $3,290.40
Incision of tendon located from elbow to shoulder, open procedure 24310 $5,607.00 $3,364.20
Anchoring of biceps tendon at elbow 24340 $11,744.00 $7,046.40
Repair of tendon or muscle of upper arm or elbow 24341 $11,744.00 $7,046.40
Reinsertion of torn biceps or triceps tendon at elbow 24342 $11,744.00 $7,046.40
Repair of ligament at elbow 24343 $5,484.00 $3,290.40
Repair of ligament at elbow 24344 $11,744.00 $7,046.40
Repair of ligament at elbow 24346 $21,504.00 $12,902.40
Incision of tendon to repair elbow joint, accessed through the skin 24357 $5,484.00 $3,290.40
Removal of tissue and/or bone at elbow, open procedure 24358 $5,484.00 $3,290.40
Removal of tissue and/or bone at elbow with tendon repair, open procedure 24359 $5,484.00 $3,290.40
Prosthetic repair of elbow joint 24363 $33,083.00 $19,849.80
Repair of non-healed upper arm bone with graft 24435 $21,504.00 $12,902.40
Closed treatment of broken upper arm bone with manipulation 24505 $492.00 $295.20
Closed treatment of growth plate or broken upper arm bone at elbow 24530 $694.00 $416.40
Closed treatment of growth plate or broken upper arm bone at elbow with manipulation 24535 $2,468.00 $1,480.80
Closed treatment of growth plate or broken upper arm bone at elbow with manipulation 24535 $1,715.00 $1,029.00
Insertion of hardware to growth plate or broken upper arm bone at elbow, accessed through the skin 24538 $11,744.00 $7,046.40
Closed treatment of broken upper arm bone at shoulder with manipulation 24565 $523.00 $313.80
Open treatment of broken upper arm bone at elbow 24575 $15,895.00 $9,537.00
Open treatment of broken upper arm bone at shoulder 24579 $21,504.00 $12,902.40
Insertion of hardware to broken upper arm bone at shoulder with manipulation, accessed through the skin 24582 $5,607.00 $3,364.20
Open treatment of broken and/or dislocated upper or lower arm bones at elbow 24586 $21,899.00 $13,139.40
Treatment of elbow dislocation 24600 $361.00 $216.60
Treatment of dislocated elbow under anesthesia 24605 $1,311.00 $786.60
Closed treatment of broken and dislocated forearm bones at elbow with manipulation 24620 $1,541.00 $924.60
Closed treatment of dislocated forearm bone of elbow, child 24640 $144.00 $86.40
Closed treatment of broken forearm bone at elbow with manipulation 24655 $928.00 $556.80
Closed treatment of broken forearm bone at elbow with manipulation 24655 $2,921.00 $1,752.60
Open treatment of broken forearm bone at elbow 24665 $11,744.00 $7,046.40
Open treatment of broken forearm bone at elbow with prosthetic replacement 24666 $21,504.00 $12,902.40
Open treatment of broken forearm bone at elbow 24685 $11,744.00 $7,046.40
Upper arm and elbow procedure 24999 $451.00 $270.60
Incision to repair tendon covering at wrist 25000 $2,740.00 $1,644.00
Incision to repair tendon covering at wrist 25001 $2,740.00 $1,644.00
Drainage of infected fluid-filled sac (bursa) of forearm and/or wrist 25031 $3,276.00 $1,965.60
Drainage or removal of foreign body of wrist joint 25040 $5,392.00 $3,235.20
Biopsy of tissue of forearm and/or wrist 25066 $4,833.00 $2,899.80
Removal (3 centimeters or greater) tissue growth beneath the skin at forearm and/or wrist 25071 $3,184.00 $1,910.40
Removal (3 centimeters or greater) muscle growth at forearm and/or wrist 25073 $4,833.00 $2,899.80
Removal (less than 3 centimeters) tissue growth beneath the skin at forearm and/or wrist 25075 $476.00 $285.60
Removal (less than 3 centimeters) tissue growth beneath the skin at forearm and/or wrist 25075 $2,782.00 $1,669.20
Removal (less than 3 centimeters) muscle growth at forearm and/or wrist 25076 $2,782.00 $1,669.20
Incision to repair wrist joint 25105 $5,484.00 $3,290.40
Incision to repair wrist joint with repair of cartilage 25107 $5,484.00 $3,290.40
Removal of tendon of forearm and/or wrist 25109 $3,276.00 $1,965.60
Removal of growth of tendon covering at forearm and/or wrist 25110 $2,740.00 $1,644.00
Removal of cyst at wrist 25111 $2,740.00 $1,644.00
Removal of cyst at wrist 25112 $5,484.00 $3,290.40
Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon 25115 $2,740.00 $1,644.00
Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon 25116 $5,484.00 $3,290.40
Removal of lining of tendon covering of wrist 25118 $5,484.00 $3,290.40
Removal of forearm bone cyst or growth 25120 $5,607.00 $3,364.20
Removal of wrist bone cyst or growth 25130 $5,484.00 $3,290.40
Removal of wrist bone 25210 $5,484.00 $3,290.40
Partial removal of wrist bone 25230 $5,484.00 $3,290.40
Partial removal of forearm bone 25240 $5,484.00 $3,290.40
Injection of dye for X-ray imaging of wrist joint 25246 $414.00 $248.40
Removal of foreign body of forearm or wrist 25248 $5,484.00 $3,290.40
Manipulation of wrist under anesthesia 25259 $2,921.00 $1,752.60
Repair of tendon or muscle of forearm and/or wrist 25260 $1,885.00 $1,131.00
Repair of tendon or muscle of forearm and/or wrist 25260 $5,484.00 $3,290.40
Repair of tendon or muscle of forearm and/or wrist 25263 $5,608.00 $3,364.80
Repair of forearm and/or wrist tendon or muscle 25270 $5,484.00 $3,290.40
Repair of forearm and/or wrist tendon or muscle with graft 25274 $5,488.00 $3,292.80
Repair of forearm and/or wrist tendon covering with graft 25275 $5,484.00 $3,290.40
Lengthening or shortening of tendon of forearm and/or wrist 25280 $5,607.00 $3,364.20
Incision of tendon of forearm and/or wrist, open procedure 25290 $5,724.00 $3,434.40
Removal of scar tissue of tendon of forearm and/or wrist 25295 $3,276.00 $1,965.60
Relocation of tendon of forearm and/or wrist 25310 $5,392.00 $3,235.20
Relocation of tendon of forearm and/or wrist with grafts 25312 $5,484.00 $3,290.40
Repair of wrist joint, open procedure 25320 $11,744.00 $7,046.40
Repair of wrist joint 25332 $5,484.00 $3,290.40
Repair of tendons of outer forearm at wrist joint 25337 $11,744.00 $7,046.40
Incision to repair forearm bone 25350 $11,744.00 $7,046.40
Incision to repair forearm bone 25360 $11,744.00 $7,046.40
Shortening of one of the forearm bones 25390 $11,744.00 $7,046.40
Repair non-healed fracture of forearm bone 25400 $11,182.00 $6,709.20
Repair non-healed fracture of forearm bone with patient-derived bone graft 25405 $11,744.00 $7,046.40
Repair non-healed fracture of forearm bones 25415 $11,182.00 $6,709.20
Repair non-healed fracture of forearm bones with patient-derived bone graft 25420 $11,749.00 $7,049.40
Insertion of vascular bone graft into wrist bone 25430 $5,607.00 $3,364.20
Repair of non-healed wrist bone 25440 $11,744.00 $7,046.40
Removal of forearm bone at wrist 25442 $33,067.00 $19,840.20
Removal of bone joints between wrist and fingers 25447 $5,484.00 $3,290.40
Closed treatment of broken forearm bone 25500 $475.00 $285.00
Closed treatment of broken forearm bone with manipulation 25505 $494.00 $296.40
Closed treatment of broken forearm bone with manipulation 25505 $2,740.00 $1,644.00
Open treatment of broken forearm bone 25515 $11,744.00 $7,046.40
Open treatment of broken forearm bone and closed treatment of joint dislocation 25525 $11,744.00 $7,046.40
Closed treatment of broken forearm bone 25530 $472.00 $283.20
Closed treatment of broken forearm bone with manipulation 25535 $848.00 $508.80
Closed treatment of broken forearm bone with manipulation 25535 $451.00 $270.60
Open treatment of broken forearm bone 25545 $11,744.00 $7,046.40
Closed treatment of broken forearm bones 25560 $511.00 $306.60
Closed treatment of broken forearm bones with manipulation 25565 $2,740.00 $1,644.00
Closed treatment of broken forearm bones with manipulation 25565 $513.00 $307.80
Open treatment of broken forearm bones 25574 $11,182.00 $6,709.20
Open treatment of broken forearm bones 25575 $11,744.00 $7,046.40
Closed treatment of broken forearm bones 25600 $693.00 $415.80
Closed treatment of broken forearm bones 25600 $579.00 $347.40
Closed treatment of broken forearm bones 25600 $603.00 $361.80
Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation 25605 $2,740.00 $1,644.00
Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation 25605 $539.00 $323.40
Insertion of hardware to lower forearm bone broken or growth plate separation, accessed through the skin 25606 $5,484.00 $3,290.40
Open treatment of broken of lower forearm bone or growth plate separation with insertion of hardware 25607 $11,744.00 $7,046.40
Open treatment of broken of lower forearm or growth plate separation with insertion of hardware of 2 fragments 25608 $11,744.00 $7,046.40
Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments 25609 $11,744.00 $7,046.40
Closed treatment of broken wrist bone 25622 $538.00 $322.80
Closed treatment of broken wrist bone with manipulation 25624 $2,921.00 $1,752.60
Open treatment of broken wrist bone 25628 $11,744.00 $7,046.40
Open treatment of broken wrist bone 25645 $5,484.00 $3,290.40
Closed treatment of broken forearm at wrist bone 25650 $341.00 $204.60
Open treatment of broken wrist 25652 $11,182.00 $6,709.20
Open treatment of dislocated 1 or more wrist joint bones 25670 $5,484.00 $3,290.40
Closed treatment of dislocated wrist with manipulation 25675 $436.00 $261.60
Open treatment of broken and dislocated wrist bone 25685 $3,276.00 $1,965.60
Open treatment of dislocated wrist bone 25695 $11,744.00 $7,046.40
Fusion of entire wrist joint 25800 $11,744.00 $7,046.40
Fusion of wrist joint with graft from hip or other bone 25810 $21,504.00 $12,902.40
Fusion of part of wrist joint 25820 $11,182.00 $6,709.20
Fusion of part of wrist joint with patient-derived bone graft 25825 $11,744.00 $7,046.40
Fusion of both forearm bones at wrist 25830 $11,744.00 $7,046.40
Lower arm or wrist procedure 25999 $451.00 $270.60
Drainage of finger abscess 26010 $516.00 $309.60
Drainage of finger abscess 26010 $63.00 $37.80
Drainage of finger abscess 26011 $2,121.00 $1,272.60
Drainage of tendon of finger and/or palm 26020 $5,484.00 $3,290.40
Incision of bone of hand or finger 26034 $2,740.00 $1,644.00
Incision of tissues of hand 26037 $2,921.00 $1,752.60
Release of tissues of palm, accessed through the skin 26040 $2,740.00 $1,644.00
Partial release of tissues of palm, open procedure 26045 $3,276.00 $1,965.60
Incision of tendon covering 26055 $2,740.00 $1,644.00
Exploration, drainage, or removal of foreign body of hand joint 26075 $5,484.00 $3,290.40
Exploration, drainage, or removal of foreign body of hand joint 26080 $2,740.00 $1,644.00
Biopsy of wrist bone 26100 $5,484.00 $3,290.40
Biopsy of finger joint 26110 $2,740.00 $1,644.00
Removal (1.5 centimeters or greater) tissue beneath the skin growth of hand or finger 26111 $4,400.00 $2,640.00
Removal (1.5 centimeters or greater) muscle growth of hand or finger 26113 $2,782.00 $1,669.20
Removal (less than 1.5 centimeters) tissue beneath the skin growth of hand or finger 26115 $2,782.00 $1,669.20
Removal (less than 1.5 centimeters) muscle growth of hand or finger 26116 $2,782.00 $1,669.20
Removal (3 centimeters or greater) tissue growth of hand or finger 26118 $4,833.00 $2,899.80
Removal of tissue of palm 26121 $5,484.00 $3,290.40
Removal of tissue of palm 26123 $5,484.00 $3,290.40
Removal of tissue of palm 26125 $1,324.00 $794.40
Repair of hand joint 26135 $5,484.00 $3,290.40
Repair of finger joint 26140 $2,740.00 $1,644.00
Repair of tendon, finger and/or hand 26145 $2,740.00 $1,644.00
Removal of growth of tendon finger or hand 26160 $2,740.00 $1,644.00
Removal of tendon of palm 26170 $2,740.00 $1,644.00
Removal of tendon of finger 26180 $2,740.00 $1,644.00
Removal of bone at base of thumb 26185 $2,740.00 $1,644.00
Removal or scraping of hand bone cyst or growth 26200 $3,276.00 $1,965.60
Removal or scraping of hand bone cyst or growth with graft 26205 $12,129.00 $7,277.40
Removal or scraping of finger bone cyst or growth 26210 $2,740.00 $1,644.00
Partial removal of hand bone 26230 $5,484.00 $3,290.40
Partial removal of finger bone 26235 $2,740.00 $1,644.00
Partial removal of finger bone 26236 $3,276.00 $1,965.60
Removal of growth of finger joint 26260 $5,488.00 $3,292.80
Removal of implant from finger or hand 26320 $2,782.00 $1,669.20
Manipulation of finger joint under anesthesia 26340 $2,921.00 $1,752.60
Manipulation of palm pretendinous cord following enzyme injection 26341 $517.00 $310.20
Repair of finger tendon 26350 $5,484.00 $3,290.40
Repair of finger tendon with graft 26352 $5,607.00 $3,364.20
Repair of finger tendon 26356 $5,484.00 $3,290.40
Repair of finger tendon 26357 $5,607.00 $3,364.20
Repair of finger tendon with graft 26358 $5,396.00 $3,237.60
Repair of finger tendon 26370 $5,484.00 $3,290.40
Repair of finger tendon with graft 26372 $11,744.00 $7,046.40
Repair of finger tendon 26373 $5,484.00 $3,290.40
Repair of finger tendon 26390 $11,744.00 $7,046.40
Removal of synthetic rod and insertion of tendon graft at hand or finger 26392 $11,744.00 $7,046.40
Repair of hand tendon 26410 $5,484.00 $3,290.40
Repair of hand tendon with graft 26412 $5,484.00 $3,290.40
Removal of tendon in hand or finger with rod insertion 26415 $2,740.00 $1,644.00
Repair of finger tendon 26418 $1,722.00 $1,033.20
Repair of finger tendon 26418 $5,484.00 $3,290.40
Repair of finger tendon with graft 26420 $5,676.00 $3,405.60
Repair of finger tendon using tissue 26426 $5,484.00 $3,290.40
Closed treatment of finger tendon 26432 $2,740.00 $1,644.00
Repair of finger tendon 26433 $5,484.00 $3,290.40
Repair of finger tendon 26437 $3,276.00 $1,965.60
Removal of scar tissue to release tendon of palm or finger 26440 $2,740.00 $1,644.00
Removal of scar tissue to release tendon of palm and finger 26442 $5,484.00 $3,290.40
Removal of scar tissue to release tendon of palm or finger 26445 $5,484.00 $3,290.40
Removal of scar tissue from tendon of finger and forearm 26449 $5,484.00 $3,290.40
Incision of tendon of finger, open procedure 26455 $3,406.00 $2,043.60
Anchoring of tendon to first joint of finger 26471 $5,484.00 $3,290.40
Anchoring of tendon to third joint of finger 26474 $5,484.00 $3,290.40
Lengthening of tendon of hand or finger 26476 $5,488.00 $3,292.80
Transplant of tendon of hand 26480 $5,484.00 $3,290.40
Transplant of tendon of hand 26483 $5,484.00 $3,290.40
Transplant of tendon to palm 26485 $5,484.00 $3,290.40
Transplant of tendon to palm 26489 $5,484.00 $3,290.40
Transplant of tendon to palm 26490 $5,724.00 $3,434.40
Transplant of tendon thumb, palm, or wrist 26496 $5,724.00 $3,434.40
Transplant of tendon to ring and small fingers 26497 $5,484.00 $3,290.40
Repair of joint capsule of hand and finger 26516 $5,484.00 $3,290.40
Removal of hand or finger joint capsule 26520 $5,484.00 $3,290.40
Repair of joint capsule, hand and finger 26525 $5,484.00 $3,290.40
Repair of joint of hand bone and finger 26530 $5,607.00 $3,364.20
Repair of joint of hand bone and finger 26531 $11,744.00 $7,046.40
Repair of finger joint 26535 $5,607.00 $3,364.20
Repair of finger joint 26536 $11,744.00 $7,046.40
Repair of ligament of hand or finger joint 26540 $5,484.00 $3,290.40
Repair of ligament of hand or finger joint 26541 $5,484.00 $3,290.40
Repair of ligament of hand or finger joint 26545 $5,725.00 $3,435.00
Repair of non-healed hand or finger bone 26546 $11,855.00 $7,113.00
Repair of floor of finger joint 26548 $5,484.00 $3,290.40
Repair of webbed finger 26560 $2,733.00 $1,639.80
Repair of webbed finger 26561 $5,392.00 $3,235.20
Incision of finger 26567 $5,607.00 $3,364.20
Lengthening of hand or finger bone 26568 $11,855.00 $7,113.00
Removal of extra finger 26587 $5,724.00 $3,434.40
Repair of hand muscle 26591 $5,484.00 $3,290.40
Closed treatment of fracture hand bone 26600 $292.00 $175.20
Closed treatment of fracture hand bone 26600 $540.00 $324.00
Closed treatment of fracture of bone of hand with manipulation 26605 $589.00 $353.40
Closed treatment of fracture of bone of hand with manipulation 26605 $451.00 $270.60
Insertion of hardware to broken finger, accessed through the skin 26608 $3,276.00 $1,965.60
Open treatment of broken finger 26615 $5,484.00 $3,290.40
Closed treatment of thumb dislocation with manipulation 26641 $790.00 $474.00
Closed treatment of broken thumb with manipulation 26645 $2,740.00 $1,644.00
Insertion of hardware to broken thumb with manipulation, accessed through the skin 26650 $3,276.00 $1,965.60
Open treatment of broken thumb at wrist 26665 $5,607.00 $3,364.20
Closed treatment of dislocated hand bone with manipulation 26670 $325.00 $195.00
Insertion of hardware to dislocated hand bone at wrist joint with manipulation, accessed through the skin 26676 $5,484.00 $3,290.40
Open treatment of dislocated wrist bone 26685 $5,484.00 $3,290.40
Open treatment of dislocated wrist bone 26686 $6,266.00 $3,759.60
Closed treatment of dislocated hand joint with manipulation 26700 $320.00 $192.00
Closed treatment of dislocated hand joint with manipulation 26700 $321.00 $192.60
Open treatment of dislocated hand joint 26715 $4,840.00 $2,904.00
Closed treatment of broken finger or thumb 26720 $466.00 $279.60
Closed treatment of broken finger or thumb 26720 $448.00 $268.80
Closed treatment of broken finger or thumb with manipulation 26725 $451.00 $270.60
Closed treatment of broken finger or thumb with manipulation 26725 $333.00 $199.80
Insertion of hardware to broken finger or thumb with manipulation, accessed through the skin 26727 $5,484.00 $3,290.40
Open treatment of broken finger 26735 $5,484.00 $3,290.40
Closed treatment of broken hand or finger with manipulation 26742 $361.00 $216.60
Closed treatment of broken hand or finger with manipulation 26742 $2,921.00 $1,752.60
Open treatment of broken hand or finger 26746 $5,484.00 $3,290.40
Closed treatment of broken finger or thumb 26750 $184.00 $110.40
Closed treatment of broken finger or thumb with manipulation 26755 $310.00 $186.00
Insertion of hardware to broken finger or thumb, accessed through the skin 26756 $5,484.00 $3,290.40
Open treatment of broken finger or thumb 26765 $5,484.00 $3,290.40
Closed treatment of dislocated finger joint with manipulation 26770 $507.00 $304.20
Closed treatment of dislocated finger joint with manipulation 26770 $275.00 $165.00
Insertion of hardware to dislocated finger joint with manipulation, accessed through the skin 26776 $3,406.00 $2,043.60
Open treatment of dislocated finger joint 26785 $5,484.00 $3,290.40
Fusion of thumb at wrist 26841 $11,744.00 $7,046.40
Fusion of thumb at wrist with bone graft 26842 $11,744.00 $7,046.40
Fusion of hand joint 26843 $11,744.00 $7,046.40
Fusion of hand joint with bone graft 26844 $11,744.00 $7,046.40
Fusion of finger joint 26850 $11,744.00 $7,046.40
Fusion of finger joint with bone graft 26852 $11,855.00 $7,113.00
Fusion of finger joint 26860 $5,484.00 $3,290.40
Fusion of finger joint 26861 $1,103.00 $661.80
Fusion of finger joint with bone graft 26862 $5,484.00 $3,290.40
Amputation of hand bone, finger, or thumb 26910 $5,607.00 $3,364.20
Amputation of finger or thumb 26951 $5,080.00 $3,048.00
Amputation of finger or thumb 26952 $5,457.00 $3,274.20
Hand or finger procedure 26989 $489.00 $293.40
Removal of bone cyst or growth of hip or pelvic bone 27066 $5,484.00 $3,290.40
Injection of dye for X-ray imaging of hip joint 27093 $425.00 $255.00
Injection procedure into sacroiliac joint for anesthetic or steroid 27096 $1,433.00 $859.80
Injection procedure into sacroiliac joint for anesthetic or steroid 27096 $621.00 $372.60
Injection procedure into sacroiliac joint for anesthetic or steroid 27096 $2,301.00 $1,380.60
Closed treatment of broken tailbone 27200 $179.00 $107.40
Closed treatment of thigh bone fracture with manipulation 27232 $2,114.00 $1,268.40
Closed treatment of broken thigh bone with manipulation 27240 $2,667.00 $1,600.20
Treatment of hip dislocation 27250 $506.00 $303.60
Closed treatment of hip dislocation under anesthesia 27252 $2,109.00 $1,265.40
Treatment of spontaneous hip dislocation under anesthesia 27257 $928.00 $556.80
Closed treatment of dislocated hip prosthesis 27265 $1,128.00 $676.80
Closed treatment of dislocated hip prosthesis under anesthesia 27266 $1,617.00 $970.20
Pelvis or hip joint procedure 27299 $451.00 $270.60
Drainage of abscess or blood collection at thigh or knee region 27301 $4,833.00 $2,899.80
Exploration, drainage, or removal of foreign body in knee joint 27310 $5,484.00 $3,290.40
Biopsy of thigh or knee region tissue 27324 $4,344.00 $2,606.40
Removal (less than 3 centimeters) tissue growth beneath the skin of thigh or knee 27327 $2,782.00 $1,669.20
Removal (less than 5 centimeters) muscle growth of thigh or knee 27328 $4,833.00 $2,899.80
Exploration, biopsy, or removal of loose or foreign body of knee 27331 $5,484.00 $3,290.40
Removal of knee cartilage 27332 $5,392.00 $3,235.20
Removal (3 centimeters or greater) tissue growth beneath the skin of thigh or knee 27337 $4,833.00 $2,899.80
Removal (5 centimeters or greater) muscle growth of thigh or knee 27339 $4,833.00 $2,899.80
Removal of fluid-filled sac (bursa) below knee joint 27340 $5,484.00 $3,290.40
Removal of cyst of membrane covering behind knee joint 27345 $4,006.00 $2,403.60
Removal of growth of knee cartilage or capsule 27347 $5,484.00 $3,290.40
Removal or scraping of cyst or growth of thigh bone 27355 $5,484.00 $3,290.40
Partial removal of bone of thigh and/or lower leg bones 27360 $5,484.00 $3,290.40
Injection of contrast for imaging of knee joint 27369 $406.00 $243.60
Suture of tendon below knee 27380 $11,744.00 $7,046.40
Suture of ruptured muscle of thigh 27385 $11,744.00 $7,046.40
Incision and repair of knee cartilage 27403 $6,274.00 $3,764.40
Repair of torn collateral ligament and/or knee joint capsule 27405 $11,744.00 $7,046.40
Repair of torn cruciate ligament and/or knee joint capsule 27407 $11,182.00 $6,709.20
Implantation of patient's knee cartilage into knee joint 27412 $11,856.00 $7,113.60
Repair of dislocating knee cap 27420 $11,742.00 $7,045.20
Repair of dislocating knee cap 27422 $11,744.00 $7,046.40
Reconstruction of knee joint ligaments 27427 $11,744.00 $7,046.40
Reconstruction of knee joint ligaments, open procedure 27428 $21,504.00 $12,902.40
Reconstruction of knee joint ligaments, open procedure 27429 $15,895.00 $9,537.00
Repair of muscle group above knee joint 27430 $11,749.00 $7,049.40
Closed treatment of broken thigh bone with manipulation 27502 $1,503.00 $901.80
Closed treatment of broken thigh bone with manipulation 27502 $3,166.00 $1,899.60
Closed treatment of broken thigh bone with manipulation 27503 $2,417.00 $1,450.20
Insertion of hardware to stabilize broken thigh bone or separated growth plate, accessed through the skin 27509 $11,182.00 $6,709.20
Closed treatment of broken thigh bone with manipulation 27510 $1,909.00 $1,145.40
Open treatment of knee cap fracture with insertion of hardware and/or removal of knee cap 27524 $11,744.00 $7,046.40
Closed treatment of knee dislocation 27550 $592.00 $355.20
Closed treatment of dislocation of knee cap 27560 $361.00 $216.60
Alignment of knee joint under anesthesia 27570 $2,740.00 $1,644.00
Exploration, drainage, or removal of foreign body of ankle 27610 $5,607.00 $3,364.20
Release of ankle joint capsule 27612 $6,274.00 $3,764.40
Biopsy of soft tissue of leg or ankle 27613 $2,782.00 $1,669.20
Removal of membrane covering of ankle joint 27625 $5,724.00 $3,434.40
Removal of membrane covering ankle joint and tendon 27626 $5,484.00 $3,290.40
Removal of growth of leg and/or ankle tendon lining or capsule 27630 $5,725.00 $3,435.00
Removal (3 centimeters or greater) tissue growth beneath the skin of leg or ankle 27632 $3,184.00 $1,910.40
Removal (5 centimeters or greater) muscle growth of leg or ankle 27634 $4,833.00 $2,899.80
Removal or scraping of cyst or growth of either bone of lower leg 27635 $5,484.00 $3,290.40
Partial removal of shin bone 27640 $5,392.00 $3,235.20
Partial removal of leg bone 27641 $5,484.00 $3,290.40
Injection for X-ray imaging of ankle 27648 $393.00 $235.80
Repair of ruptured Achilles tendon, open or through skin procedure 27650 $5,484.00 $3,290.40
Repair of ruptured Achilles tendon 27654 $12,130.00 $7,278.00
Repair of leg tendon 27658 $5,484.00 $3,290.40
Repair of leg tendon 27659 $11,744.00 $7,046.40
Repair of leg tendon 27664 $11,744.00 $7,046.40
Repair of dislocating lower leg tendons 27675 $5,484.00 $3,290.40
Release of leg and/or ankle tendon 27680 $5,484.00 $3,290.40
Lengthening or shortening of tendon of leg or ankle 27685 $5,607.00 $3,364.20
Lengthening of calf muscle 27687 $5,607.00 $3,364.20
Transplant of tendon and muscle rerouting at lower leg or ankle 27690 $11,744.00 $7,046.40
Transplant of deep tendon with muscle rerouting at lower leg or ankle 27691 $11,744.00 $7,046.40
Repair of disrupted collateral ligament of ankle 27695 $11,855.00 $7,113.00
Repair of disruption of both collateral ligaments of ankle 27696 $11,749.00 $7,049.40
Repair of disrupted collateral ligament of ankle 27698 $11,744.00 $7,046.40
Removal of ankle implant 27704 $5,392.00 $3,235.20
Repair of non-healed fracture of shin bone 27720 $11,744.00 $7,046.40
Repair of non-healed shin bone with insertion of hardware 27726 $11,744.00 $7,046.40
Closed treatment of broken shin bone 27750 $635.00 $381.00
Closed treatment of broken shin bone 27750 $624.00 $374.40
Closed treatment of broken shin bone with manipulation 27752 $528.00 $316.80
Closed treatment of broken shin bone with manipulation 27752 $3,166.00 $1,899.60
Open treatment of broken shin bone with plate or screws 27758 $21,504.00 $12,902.40
Closed treatment of broken ankle with manipulation 27762 $470.00 $282.00
Open treatment of broken ankle 27766 $11,744.00 $7,046.40
Open treatment of broken ankle 27769 $11,744.00 $7,046.40
Closed treatment of broken ankle with manipulation 27781 $2,733.00 $1,639.80
Closed treatment of broken ankle with manipulation 27781 $411.00 $246.60
Open treatment of broken ankle 27784 $11,744.00 $7,046.40
Closed treatment of broken ankle 27786 $662.00 $397.20
Closed treatment of broken ankle with manipulation 27788 $418.00 $250.80
Open treatment of broken ankle 27792 $11,744.00 $7,046.40
Closed treatment of broken ankle 27808 $591.00 $354.60
Closed treatment of broken ankle with manipulation 27810 $2,740.00 $1,644.00
Closed treatment of broken ankle with manipulation 27810 $464.00 $278.40
Open treatment of broken ankle 27814 $11,744.00 $7,046.40
Closed treatment of broken ankle with manipulation 27818 $478.00 $286.80
Open treatment of broken ankle 27822 $11,744.00 $7,046.40
Closed treatment of fracture of lower weight bearing joint of shin bone with traction and/or manipulation 27825 $653.00 $391.80
Open treatment of fracture of lower weight bearing joint of shin bone 27827 $21,504.00 $12,902.40
Open treatment of ligament tear at ankle joint 27829 $11,744.00 $7,046.40
Closed treatment of ankle dislocation 27840 $1,049.00 $629.40
Closed treatment of ankle dislocation under anesthesia 27842 $1,385.00 $831.00
Open treatment of ankle dislocation with repair or internal or external hardware 27848 $11,744.00 $7,046.40
Fusion of foreleg bones at knee or ankle joint 27871 $21,504.00 $12,902.40
Incision of tissue of front and/or lateral muscle compartments of lower leg with removal of muscle and/or nerve 27892 $5,484.00 $3,290.40
Leg or ankle procedure 27899 $470.00 $282.00
Incision of foot bone 28005 $5,676.00 $3,405.60
Incision of tissues of muscle compartment of foot and/or toe 28008 $5,484.00 $3,290.40
Repair of toe tendon, accessed through the skin 28010 $411.00 $246.60
Repair of toe tendon, accessed through the skin 28010 $3,276.00 $1,965.60
Exploration, drainage, or removal of foreign body of foot 28022 $5,607.00 $3,364.20
Exploration, drainage, or removal of foreign body of toe joint 28024 $5,484.00 $3,290.40
Release of nerve between tissue and bone of foot 28035 $3,519.00 $2,111.40
Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe 28039 $3,184.00 $1,910.40
Removal (1.5 centimeters or greater) muscle growth of foot or toe 28041 $5,442.00 $3,265.20
Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe 28043 $3,312.00 $1,987.20
Removal (less than 1.5 centimeters) muscle growth of foot or toe 28045 $4,833.00 $2,899.80
Biopsy of foot bone 28052 $5,488.00 $3,292.80
Biopsy of toe joint 28054 $5,488.00 $3,292.80
Removal of nerve of foot muscle 28055 $3,519.00 $2,111.40
Partial removal of tissue at sole of foot 28060 $5,484.00 $3,290.40
Removal of fibrous nerve growth from between toes 28080 $2,740.00 $1,644.00
Removal of foot tendon 28086 $5,392.00 $3,235.20
Removal of foot tendon 28088 $3,276.00 $1,965.60
Removal of growth of tendon covering or joint capsule of foot 28090 $5,484.00 $3,290.40
Removal of growth of tendon covering or joint capsule of toes 28092 $2,740.00 $1,644.00
Removal or scraping of bone cyst or growth of heel bone 28100 $5,484.00 $3,290.40
Removal or scraping of bone cyst or growth of ankle bone 28104 $5,484.00 $3,290.40
Removal or scraping of bone cyst or growth of toes 28108 $2,740.00 $1,644.00
Removal of bunion at fifth toe joint 28110 $5,484.00 $3,290.40
Removal of bones at second, third, or fourth toe joints 28112 $5,484.00 $3,290.40
Removal of foot bone at fifth toe joint 28113 $5,484.00 $3,290.40
Removal of multiple foot bones 28114 $5,392.00 $3,235.20
Removal of heel bone 28118 $5,607.00 $3,364.20
Removal of heel bone spur 28119 $5,484.00 $3,290.40
Partial removal of foot or heel bone 28120 $5,484.00 $3,290.40
Partial removal of foot or heel bone 28122 $5,484.00 $3,290.40
Partial removal of toe bone 28124 $5,484.00 $3,290.40
Removal of bone at base of toe 28126 $3,276.00 $1,965.60
Partial removal of toe joint 28160 $5,484.00 $3,290.40
Removal of foreign body of foot tissue, accessed beneath the skin 28190 $258.00 $154.80
Removal of foreign body of foot tissue, accessed beneath the skin 28190 $1,125.00 $675.00
Removal of foreign body of foot tissue, accessed beneath the skin 28190 $476.00 $285.60
Removal of foreign body of foot tissue 28192 $2,782.00 $1,669.20
Removal of foreign body of foot tissue 28192 $472.00 $283.20
Removal of foreign body of foot tissue 28193 $531.00 $318.60
Removal of foreign body of foot tissue 28193 $3,184.00 $1,910.40
Repair of foot tendon 28200 $5,488.00 $3,292.80
Repair of foot tendon 28208 $733.00 $439.80
Repair of foot tendon 28208 $5,724.00 $3,434.40
Release of foot tendon 28220 $5,484.00 $3,290.40
Release of foot tendon 28225 $3,276.00 $1,965.60
Incision to lengthen foot tendons, open procedure 28230 $2,740.00 $1,644.00
Incision to lengthen toe tendon, open procedure 28232 $2,740.00 $1,644.00
Incision to release foot tendon, open procedure 28234 $2,740.00 $1,644.00
Advancement of ankle tendon with removal of ankle joint bone 28238 $11,744.00 $7,046.40
Incision to release tissue and muscle of sole of foot 28250 $5,607.00 $3,364.20
Incision of joint capsule of foot and toe 28270 $5,484.00 $3,290.40
Correction of toe joint deformity 28285 $5,484.00 $3,290.40
Correction of toe joint deformity 28285 $979.00 $587.40
Correction of fifth toe joint deformity 28286 $5,457.00 $3,274.20
Removal of foot bone spur 28288 $5,484.00 $3,290.40
Correction of rigid deformity of first joint of big toe 28289 $5,484.00 $3,290.40
Correction of rigid deformity of first joint of big toe using implant 28291 $12,129.00 $7,277.40
Correction of bunion 28292 $5,484.00 $3,290.40
Correction of bunion 28295 $5,457.00 $3,274.20
Correction of bunion 28296 $5,484.00 $3,290.40
Correction of bunion 28297 $11,856.00 $7,113.60
Correction of bunion 28298 $11,744.00 $7,046.40
Correction of bunion 28299 $5,484.00 $3,290.40
Incision to repair heel bone 28300 $12,581.00 $7,548.60
Incision to repair ankle joint bone 28302 $11,744.00 $7,046.40
Incision to correct foot or ankle bones with patient-derived bone graft 28305 $12,615.00 $7,569.00
Incision to straighten big toe bone 28306 $11,744.00 $7,046.40
Incision to straighten toe bone 28308 $5,484.00 $3,290.40
Incision to straighten big toe bone 28310 $5,484.00 $3,290.40
Incision to straighten toe bone 28312 $5,484.00 $3,290.40
Repair of non-healed foot bone 28322 $12,129.00 $7,277.40
Removal of congenital web space deformity of toes 28345 $2,921.00 $1,752.60
Open treatment of broken foot bone 28465 $11,630.00 $6,978.00
Closed treatment of broken foot bone 28470 $451.00 $270.60
Closed treatment of fracture of foot with manipulation 28475 $505.00 $303.00
Insertion of hardware to broken foot bone with manipulation, accessed through the skin 28476 $5,484.00 $3,290.40
Open treatment of broken foot bone 28485 $11,744.00 $7,046.40
Closed treatment of broken great toe 28490 $451.00 $270.60
Closed treatment of broken great toe 28490 $147.00 $88.20
Closed treatment of broken great toe with manipulation 28495 $451.00 $270.60
Insertion of hardware to broken great toe with manipulation, accessed through the skin 28496 $5,392.00 $3,235.20
Closed treatment of broken toe 28510 $466.00 $279.60
Closed treatment of broken toe with manipulation 28515 $162.00 $97.20
Closed treatment of broken toe with manipulation 28515 $467.00 $280.20
Open treatment of broken toe 28525 $5,484.00 $3,290.40
Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin 28576 $2,741.00 $1,644.60
Open treatment of dislocated foot joint 28615 $11,744.00 $7,046.40
Closed treatment of dislocated foot bone 28630 $158.00 $94.80
Closed treatment of dislocated foot bone under anesthesia 28635 $2,733.00 $1,639.80
Open treatment of dislocated foot bone 28645 $5,457.00 $3,274.20
Closed treatment of dislocation of toe joint 28660 $118.00 $70.80
Insertion of hardware to toe joint dislocation with manipulation, accessed through the skin 28666 $5,484.00 $3,290.40
Fusion of foot joint 28725 $21,504.00 $12,902.40
Fusion of multiple foot joints 28730 $21,504.00 $12,902.40
Fusion of foot joint 28740 $11,744.00 $7,046.40
Fusion of great toe 28750 $11,744.00 $7,046.40
Fusion of great toe 28755 $11,744.00 $7,046.40
Fusion of great toe 28760 $11,182.00 $6,709.20
Amputation of foot 28820 $5,484.00 $3,290.40
Amputation of foot 28825 $829.00 $497.40
Amputation of foot 28825 $5,457.00 $3,274.20
Amputation of foot 28825 $5,484.00 $3,290.40
Foot or toe procedure 28899 $451.00 $270.60
Application of figure-of-eight cast 29049 $96.00 $57.60
Application of cast, shoulder to hand (long arm) 29065 $470.00 $282.00
Application of cast, elbow to finger (short arm) 29075 $161.00 $96.60
Application of cast to hand and lower forearm 29085 $169.00 $101.40
Application of cast to finger 29086 $80.00 $48.00
Application of long arm splint (shoulder to hand) 29105 $90.00 $54.00
Application of long arm splint (shoulder to hand) 29105 $163.00 $97.80
Application of non-moveable, short arm splint (forearm to hand) 29125 $228.00 $136.80
Application of non-moveable, short arm splint (forearm to hand) 29125 $68.00 $40.80
Application of moveable, hinged short arm splint (forearm to hand) 29126 $78.00 $46.80
Application of non-moveable, hinged finger splint 29130 $76.00 $45.60
Application of non-moveable, hinged finger splint 29130 $43.00 $25.80
Strapping of shoulder 29240 $58.00 $34.80
Strapping of hand or finger 29280 $51.00 $30.60
Application of long leg cast (thigh to toes) 29345 $250.00 $150.00
Application of short leg cast (below knee to toes) 29405 $277.00 $166.20
Application of short leg cast (below knee to toes) 29405 $82.00 $49.20
Application of rigid total contact leg cast 29445 $475.00 $285.00
Application of long leg splint (thigh to ankle or toes) 29505 $85.00 $51.00
Application of long leg splint (thigh to ankle or toes) 29505 $156.00 $93.60
Application of short leg splint (calf to foot) 29515 $73.00 $43.80
Application of short leg splint (calf to foot) 29515 $134.00 $80.40
Strapping of ankle and/or foot 29540 $39.00 $23.40
Strapping of ankle and/or foot 29540 $153.00 $91.80
Strapping, Unna boot 29580 $260.00 $156.00
Strapping, Unna boot 29580 $197.00 $118.20
Application of vein wound compression system lower leg below knee including ankle and foot 29581 $297.00 $178.20
Application of vein wound compression system lower leg below knee including ankle and foot 29581 $304.00 $182.40
Removal or bivalving of gauntlet, boot, or body cast 29700 $500.00 $300.00
Removal or bivalving of gauntlet, boot, or body cast 29700 $68.00 $40.80
Removal or bivalving of full arm or leg cast 29705 $114.00 $68.40
Removal or bivalving of full arm or leg cast 29705 $514.00 $308.40
Removal or bivalving of shoulder, hip spica, or jacket cast 29710 $499.00 $299.40
Wedging of cast 29740 $499.00 $299.40
Diagnostic examination of shoulder using an endoscope 29805 $5,392.00 $3,235.20
Incision of should joint capsule using an endoscope 29806 $11,744.00 $7,046.40
Repair of shoulder socket cartilage using an endoscope 29807 $11,744.00 $7,046.40
Removal of loose or foreign body of shoulder using an endoscope 29819 $5,484.00 $3,290.40
Partial removal of shoulder joint lining using an endoscope 29820 $11,744.00 $7,046.40
Removal of entire shoulder joint lining using an endoscope 29821 $5,484.00 $3,290.40
Removal of shoulder joint tissue using an endoscope 29822 $5,484.00 $3,290.40
Extensive removal of shoulder joint tissue using an endoscope 29823 $5,484.00 $3,290.40
Partial removal of collar bone at shoulder using an endoscope 29824 $5,484.00 $3,290.40
Release or removal of shoulder scar tissue using an endoscope 29825 $5,484.00 $3,290.40
Repair of the shoulder generally called a shoulder arthroscopy 29826 $688.00 $412.80
Repair of the shoulder generally called a shoulder arthroscopy 29826 $688.00 $412.80
Repair of shoulder rotator cuff using an endoscope 29827 $11,744.00 $7,046.40
Release of shoulder biceps tendon using an endoscope 29828 $11,744.00 $7,046.40
Diagnostic examination of elbow joint using an endoscope 29830 $5,484.00 $3,290.40
Removal of loose or foreign body of elbow using an endoscope 29834 $5,484.00 $3,290.40
Partial removal of elbow joint lining using an endoscope 29835 $5,484.00 $3,290.40
Removal of entire elbow joint lining using an endoscope 29836 $11,855.00 $7,113.00
Removal of elbow tissue or frayed cartilage using an endoscope 29837 $5,607.00 $3,364.20
Removal of elbow tissue or frayed cartilage from all joint compartments using an endoscope 29838 $5,484.00 $3,290.40
Diagnostic examination of the wrist using an endoscope 29840 $5,392.00 $3,235.20
Partial removal of wrist joint lining using an endoscope 29844 $5,484.00 $3,290.40
Removal or repair of wrist joint lining using an endoscope 29846 $5,484.00 $3,290.40
Insertion of internal hardware using an endoscope to treat a broken wrist 29847 $11,749.00 $7,049.40
Release of wrist ligament using an endoscope 29848 $2,740.00 $1,644.00
Treatment of knee joint fractures with assistance of an endoscope with fixation 29851 $2,740.00 $1,644.00
Treatment of broken leg bone with assistance of an endoscope 29855 $11,744.00 $7,046.40
Diagnostic examination of knee using an endoscope 29870 $5,484.00 $3,290.40
Release of ligaments at outer aspect of knee joint using an endoscope 29873 $5,484.00 $3,290.40
Removal of loose or foreign body of knee joint using an endoscope 29874 $5,484.00 $3,290.40
Partial removal of knee joint lining using an endoscope 29875 $5,484.00 $3,290.40
Removal of joint lining from two or more knee joint compartments using an endoscope 29876 $5,484.00 $3,290.40
Removal or shaving of knee joint cartilage using an endoscope 29877 $5,484.00 $3,290.40
Repair of knee joint using an endoscope 29879 $5,484.00 $3,290.40
Removal of both knee cartilages using an endoscope 29880 $5,484.00 $3,290.40
Knee cartilage replacement surgery with an endoscope 29881 $5,484.00 $3,290.40
Knee cartilage replacement surgery with an endoscope 29881 $5,484.00 $3,290.40
Repair of knee joint using an endoscope 29882 $5,484.00 $3,290.40
Repair of knee joint using an endoscope 29883 $5,724.00 $3,434.40
Repair of knee joint and removal of scar tissue using an endoscope 29884 $5,484.00 $3,290.40
Repair of knee joint with bone graft using an endoscope 29886 $5,484.00 $3,290.40
Repair of knee joint with bone graft and hardware using an endoscope 29887 $11,855.00 $7,113.00
Repair of anterior cruciate ligament of knee with assistance of an endoscope 29888 $11,744.00 $7,046.40
Repair of posterior cruciate ligament of knee with assistance of an endoscope 29889 $21,504.00 $12,902.40
Removal of bone defect of shin and/or ankle using an endoscope 29891 $5,484.00 $3,290.40
Removal and repair of large bone defect of shin or ankle using an endoscope 29892 $11,744.00 $7,046.40
Removal of loose or foreign body of ankle using an endoscope 29894 $5,484.00 $3,290.40
Partial removal of ankle joint lining using an endoscope 29897 $5,484.00 $3,290.40
Removal of dead or infected ankle joint tissue using an endoscope 29898 $5,484.00 $3,290.40
Fusion of ankle joint using an endoscope 29899 $11,856.00 $7,113.60
Removal of dead or infected finger joint tissue using an endoscope 29901 $5,724.00 $3,434.40
Joint procedure using an endoscope 29999 $451.00 $270.60
Biopsy of lining of nose 30100 $2,464.00 $1,478.40
Biopsy of lining of nose 30100 $267.00 $160.20
Removal of nasal air passage 30130 $4,758.00 $2,854.80
Removal of nasal air passage 30140 $4,760.00 $2,856.00
Insertion of implant to close nasal passage 30220 $2,464.00 $1,478.40
Removal of foreign body in nose 30300 $439.00 $263.40
Removal of foreign body in nose 30300 $239.00 $143.40
Removal of foreign body in nose under anesthesia 30310 $3,128.00 $1,876.80
Removal of foreign body in nose under anesthesia 30310 $4,642.00 $2,785.20
Removal of foreign body in nose under anesthesia 30310 $586.00 $351.60
Reshaping of bone, cartilage, or tip of nose 30410 $9,388.00 $5,632.80
Reshaping of bony cartilage dividing nasal passages 30420 $9,388.00 $5,632.80
Revision to reshape nasal bones after previous repair 30435 $9,292.00 $5,575.20
Revision to reshape nasal bones after previous repair 30435 $3,746.00 $2,247.60
Widening of nasal passage 30465 $9,294.00 $5,576.40
Reshaping of nasal cartilage 30520 $4,892.00 $2,935.20
Repair of openings in nasal cartilage 30630 $4,758.00 $2,854.80
Destruction of soft tissue in nasal passages 30802 $2,339.00 $1,403.40
Simple control of nose bleed 30901 $185.00 $111.00
Simple control of nose bleed 30901 $97.00 $58.20
Complex control of nose bleed 30903 $387.00 $232.20
Complex control of nose bleed 30903 $210.00 $126.00
Control of nose bleed and insertion of packing 30905 $259.00 $155.40
Control of nose bleed and insertion of packing 30905 $481.00 $288.60
Control of nosebleed and insertion of packing 30906 $242.00 $145.20
Control of nosebleed and insertion of packing 30906 $284.00 $170.40
Therapeutic fracture of nasal passages 30930 $4,760.00 $2,856.00
Nasal procedure 30999 $387.00 $232.20
Incision of nasal sinus 31020 $4,758.00 $2,854.80
Diagnostic examination of nasal passages using an endoscope 31231 $390.00 $234.00
Biopsy or removal of nasal polyp or tissue using an endoscope 31237 $601.00 $360.60
Removal of nasal breathing passages using an endoscope 31240 $2,865.00 $1,719.00
Partial removal of nasal sinus using an endoscope 31254 $10,708.00 $6,424.80
Incision of nasal sinus using an endoscope 31256 $5,662.00 $3,397.20
Complete examination of nose and sinuses and removal of nasal sinus using an endoscope 31257 $10,524.00 $6,314.40
Removal of nasal sinus tissue using an endoscope 31267 $10,524.00 $6,314.40
Exploration of nasal sinus using an endoscope 31276 $10,524.00 $6,314.40
Incision of nasal sinus using an endoscope 31287 $10,524.00 $6,314.40
Dilation of nasal sinus using an endoscope 31295 $10,525.00 $6,315.00
Dilation of nasal sinus using an endoscope 31296 $10,708.00 $6,424.80
Dilation of nasal sinus using an endoscope 31297 $3,955.00 $2,373.00
Dilation of nasal sinus using an endoscope 31298 $10,533.00 $6,319.80
Emergent insertion of breathing tube into windpipe cartilage using an endoscope 31500 $658.00 $394.80
Emergent insertion of breathing tube into windpipe cartilage using an endoscope 31500 $305.00 $183.00
Diagnostic examination of voice box using an endoscope 31525 $2,574.00 $1,544.40
Diagnostic examination of voice box using an endoscope 31525 $251.00 $150.60
Removal of foreign body from voice box using an endoscope 31530 $2,849.00 $1,709.40
Removal of foreign body from voice box using an endoscope 31530 $452.00 $271.20
Diagnostic examination of voice box using flexible endoscope 31575 $116.00 $69.60
Diagnostic examination of voice box using flexible endoscope 31575 $351.00 $210.60
Diagnostic examination of voice box using flexible endoscope 31575 $213.00 $127.80
Biopsy of voice box using a flexible endoscope 31576 $415.00 $249.00
Emergent surgical opening of windpipe for insertion of breathing tube 31605 $775.00 $465.00
Emergent surgical opening of windpipe for insertion of breathing tube 31605 $1,598.00 $958.80
Examination of windpipe and lung airways through permanent skin opening to windpipe using an endoscope 31615 $182.00 $109.20
Examination of windpipe and lung airways through permanent skin opening to windpipe using an endoscope 31615 $1,446.00 $867.60
Diagnostic examination of lung airways using an endoscope 31622 $315.00 $189.00
Diagnostic examination of lung airways using an endoscope 31622 $2,647.00 $1,588.20
Examination of lung airways using an endoscope 31623 $2,788.00 $1,672.80
Irrigation and suction of lung airways to obtain cells using an endoscope 31624 $2,849.00 $1,709.40
Irrigation and suction of lung airways to obtain cells using an endoscope 31624 $579.00 $347.40
Biopsy of lung airways using an endoscope 31625 $619.00 $371.40
Insertion of radiation therapy markers into lung airways using an endoscope 31626 $5,743.00 $3,445.80
Computer-assisted image-guided navigation of lung airways using an endoscope 31627 $2,492.00 $1,495.20
Biopsy of one lobe of lung using an endoscope 31628 $697.00 $418.20
Thermal repair of lung airways using an endoscope 31660 $5,743.00 $3,445.80
Thermal repair of lung airways using an endoscope 31661 $5,743.00 $3,445.80
Insertion of catheter for suction of secretions 31720 $404.00 $242.40
Needle biopsy of lining of lung, accessed through the skin 32400 $1,490.00 $894.00
Needle biopsy of lung or chest tissue, accessed through the skin 32405 $1,686.00 $1,011.60
Insertion of permanent catheter for drainage of lung fluid 32550 $2,816.00 $1,689.60
Removal of fluid from between lung and chest cavity, open procedure 32551 $493.00 $295.80
Removal of fluid from between lung and chest cavity, open procedure 32551 $2,127.00 $1,276.20
Removal of tunneled catheter in lung lining 32552 $901.00 $540.60
Insertion of devices in chest cavity for radiation therapy guidance, accessed through the skin 32553 $3,390.00 $2,034.00
Removal of fluid from chest cavity 32554 $543.00 $325.80
Removal of fluid from chest cavity 32554 $1,142.00 $685.20
Removal of fluid from chest cavity with imaging guidance 32555 $1,198.00 $718.80
Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin 32556 $1,757.00 $1,054.20
Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin 32557 $1,257.00 $754.20
Catheter instillation of agent onto lung surface 32560 $1,121.00 $672.60
Catheter instillations of agent onto lung lining to break up scar tissue 32561 $1,291.00 $774.60
Catheter instillations of agent onto lung lining to break up scar tissue 32562 $1,291.00 $774.60
Destruction of growths in one lung, accessed through the skin 32998 $9,865.00 $5,919.00
Lung and lung lining procedure 32999 $1,328.00 $796.80
Aspiration of fluid from sac that covers the heart 33010 $266.00 $159.60
Aspiration of fluid from sac that covers the heart 33010 $2,276.00 $1,365.60
Creation of opening or partial removal of sac that covers the heart 33025 $1,950.00 $1,170.00
Insertion or replacement of permanent pacemaker and upper chamber electrodes 33206 $10,916.00 $6,549.60
Insertion or replacement of permanent pacemaker and lower chamber electrodes 33207 $15,220.00 $9,132.00
Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes 33208 $17,478.00 $10,486.80
Placement of temporary pacemaker leads 33210 $9,183.00 $5,509.80
Insertion of pacemaker pulse generator with existing single lead 33212 $10,581.00 $6,348.60
Insertion of pacemaker pulse generator with existing dual leads 33213 $12,397.00 $7,438.20
Conversion to two chamber pacemaker system 33214 $16,378.00 $9,826.80
Repositioning of implanted pacemaker or defibrillator device 33215 $3,218.00 $1,930.80
Insertion of electrode for permanent pacemaker or pacing defibrillator device 33216 $9,509.00 $5,705.40
Insertion of electrodes for permanent pacemaker or pacing defibrillator device 33217 $9,507.00 $5,704.20
Repair of electrode for permanent pacemaker or defibrillator device 33218 $3,370.00 $2,022.00
Repair of 2 electrodes for permanent pacemaker or defibrillator device 33220 $3,370.00 $2,022.00
Relocation of pacemaker generator skin pocket 33222 $2,732.00 $1,639.20
Relocation of defibrillator device skin pocket 33223 $2,384.00 $1,430.40
Insertion of left heart electrode with attachment to pacemaker or pacing defibrillator device 33224 $21,973.00 $13,183.80
Insertion of left heart electrode for pacing defibrillator device 33225 $17,930.00 $10,758.00
Repositioning of implanted left heart electrode 33226 $3,613.00 $2,167.80
Removal and replacement of single lead permanent pacemaker pulse generator 33227 $13,496.00 $8,097.60
Removal and replacement of dual lead permanent pacemaker pulse generator 33228 $14,490.00 $8,694.00
Removal and replacement of multiple lead permanent pacemaker pulse generator 33229 $22,068.00 $13,240.80
Insertion of pacing defibrillator pulse generator with existing dual leads 33230 $54,520.00 $32,712.00
Insertion of pacing defibrillator pulse generator with existing multiple leads 33231 $52,653.00 $31,591.80
Removal of permanent pacemaker pulse generator 33233 $9,183.00 $5,509.80
Removal of electrode from right heart 33234 $3,370.00 $2,022.00
Removal of electrodes from right heart 33235 $3,370.00 $2,022.00
Insertion of pacing defibrillator pulse generator with existing single lead 33240 $38,594.00 $23,156.40
Removal of defibrillator pulse generator 33241 $3,491.00 $2,094.60
Removal of defibrillator electrodes 33244 $3,491.00 $2,094.60
Insertion or replacement of single or dual chamber pacing defibrillator leads 33249 $60,793.00 $36,475.80
Removal and replacement of defibrillator pulse generator 33262 $46,289.00 $27,773.40
Removal and replacement of defibrillator pulse generator 33263 $47,932.00 $28,759.20
Removal and replacement of defibrillator pulse generator 33264 $47,932.00 $28,759.20
Insertion or replacement of defibrillator with electrode 33270 $56,217.00 $33,730.20
Removal of defibrillator electrode 33272 $5,616.00 $3,369.60
Insertion of heart rhythm monitor under skin 33285 $9,183.00 $5,509.80
Removal of heart rhythm monitor from under skin 33286 $2,007.00 $1,204.20
Repair of defect of aorta in chest 33880 $9,240.00 $5,544.00
Repair of defect of aorta in chest 33881 $9,240.00 $5,544.00
Repair of defect of aorta in chest 33883 $7,575.00 $4,545.00
Repair of defect of aorta in chest 33884 $7,575.00 $4,545.00
Insertion of assistive heart blood flow device into aorta, accessed through the skin 33967 $2,288.00 $1,372.80
Insertion of lower heart chamber blood flow assist device through the skin including radiological supervision and interpretation 33990 $8,459.00 $5,075.40
Removal of lower heart chamber blood flow assist device, accessed through the skin 33992 $4,230.00 $2,538.00
Repositioning of lower heart chamber blood flow assist device with imaging guidance 33993 $2,116.00 $1,269.60
Exposure of one thigh artery for insertion of prosthesis, open procedure 34812 $3,488.00 $2,092.80
Repair of diseased or bulging (aneurysm) artery of forearm 35045 $9,105.00 $5,463.00
Insertion of needle or catheter into a vein 36000 $84.00 $50.40
Injection to cause blood clot in a diseased or bulging vessel of arm or leg, accessed through the skin 36002 $901.00 $540.60
Injection for X-ray imaging procedure on veins of arm or leg 36005 $570.00 $342.00
Introduction of catheter into the upper or lower major vein (vena cava) 36010 $1,127.00 $676.20
Insertion of catheter into vein 36011 $1,480.00 $888.00
Insertion of catheter into vein 36012 $1,632.00 $979.20
Insertion of catheter into right heart or main pulmonary (lung) artery 36013 $1,809.00 $1,085.40
Insertion of catheter into left or right pulmonary (lung) artery 36014 $2,117.00 $1,270.20
Insertion of catheter into an artery of a lobe of the lung 36015 $1,710.00 $1,026.00
Insertion of needle or catheter into the carotid (neck) or vertebral (brain) artery 36100 $1,850.00 $1,110.00
Insertion of needle or catheter into an artery of arm or leg 36140 $1,070.00 $642.00
Insertion of needle or catheter into aorta 36160 $1,593.00 $955.80
Insertion of catheter into aorta 36200 $636.00 $381.60
Insertion of catheter into aorta 36200 $1,417.00 $850.20
Insertion of catheter into chest or arm artery 36215 $2,039.00 $1,223.40
Insertion of catheter into chest or arm artery 36216 $2,582.00 $1,549.20
Insertion of catheter into chest or arm artery 36217 $2,946.00 $1,767.60
Insertion of catheter into chest or arm artery 36218 $500.00 $300.00
Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation 36221 $5,523.00 $3,313.80
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36222 $6,224.00 $3,734.40
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36223 $7,606.00 $4,563.60
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36224 $11,639.00 $6,983.40
Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation 36225 $6,224.00 $3,734.40
Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation 36226 $11,639.00 $6,983.40
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36227 $1,689.00 $1,013.40
Insertion of catheter into artery on one side of neck or chest for diagnosis or treatment including radiological supervision and interpretation 36228 $2,666.00 $1,599.60
Insertion of catheter into abdominal pelvic or leg artery 36245 $1,993.00 $1,195.80
Insertion of catheter into abdominal pelvic or leg artery 36246 $2,313.00 $1,387.80
Insertion of catheter into abdominal pelvic or leg artery 36247 $2,929.00 $1,757.40
Insertion of catheter into each additional abdominal, pelvic or leg artery 36248 $544.00 $326.40
Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation 36251 $5,079.00 $3,047.40
Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation 36252 $5,523.00 $3,313.80
Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation 36253 $5,455.00 $3,273.00
Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation 36254 $6,029.00 $3,617.40
Insertion of needle into upper leg or neck vein, patient younger than 3 years 36400 $169.00 $101.40
Insertion of needle into scalp vein, patient younger than 3 years 36405 $142.00 $85.20
Insertion of needle into vein, patient younger than 3 years 36406 $84.00 $50.40
Insertion of needle into vein, patient 3 years or older 36410 $34.00 $20.40
Insertion of needle into vein, patient 3 years or older 36410 $74.00 $44.40
Insertion of needle into vein for collection of blood sample 36415 $25.00 $15.00
Insertion of needle into vein for collection of blood sample 36415 $26.00 $15.60
Puncture of skin for collection of blood sample 36416 $19.00 $11.40
Transfusion of blood or blood products 36430 $9,254.00 $5,552.40
Transfusion of blood or blood products 36430 $9,255.00 $5,553.00
Transfusion of blood or blood products 36430 $748.00 $448.80
Transfusion of blood or blood products 36430 $97.00 $58.20
Injection of chemical agent into spider veins of arm, leg, or trunk 36468 $511.00 $306.60
Injection of chemical agent into single incompetent vein 36470 $400.00 $240.00
Injection of chemical agent into multiple incompetent veins of one leg 36471 $400.00 $240.00
Destruction of insufficient vein of arm or leg, accessed through the skin 36475 $5,889.00 $3,533.40
Radiofrequency destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance 36476 $5,239.00 $3,143.40
Laser destruction of incompetent vein of arm or leg using imaging guidance, accessed through the skin 36478 $3,237.00 $1,942.20
Laser destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance 36479 $2,022.00 $1,213.20
Insertion of catheter into portal vein of liver, accessed through the skin 36481 $3,305.00 $1,983.00
Mechanical separation of plasma from opening blood 36514 $4,262.00 $2,557.20
Insertion of central venous catheter for infusion, patient younger than 5 years 36555 $1,961.00 $1,176.60
Insertion of central venous catheter for infusion, patient younger than 5 years 36555 $193.00 $115.80
Insertion of central venous catheter for infusion, patient 5 years or older 36556 $2,127.00 $1,276.20
Insertion of central venous catheter for infusion, patient 5 years or older 36556 $232.00 $139.20
Insertion of central venous catheter for infusion, patient younger than 5 years 36557 $5,165.00 $3,099.00
Insertion of central venous catheter for infusion, patient 5 years or older 36558 $4,074.00 $2,444.40
Insertion of central venous catheter and implanted device for infusion beneath the skin, patient younger than 5 years 36560 $3,608.00 $2,164.80
Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older 36561 $3,585.00 $2,151.00
Insertion of central venous catheter and implanted device for infusion beneath the skin 36563 $5,165.00 $3,099.00
Insertion of central venous catheters for infusion, two catheters in two veins 36565 $3,923.00 $2,353.80
Insertion of central venous catheters, two catheters in two veins, and implanted devices for infusion beneath the skin 36566 $5,165.00 $3,099.00
Insertion of central venous catheter for infusion, patient younger than 5 years 36568 $1,413.00 $847.80
Insertion of central venous catheter for infusion, patient 5 years or older 36569 $265.00 $159.00
Insertion of central venous catheter for infusion with port beneath the skin, patient younger than 5 years 36570 $3,549.00 $2,129.40
Insertion of central venous catheter for infusion with port beneath the skin, patient 5 years or older 36571 $5,403.00 $3,241.80
Insertion of central venous catheter for infusion using imaging guidance, patient younger than 5 years 36572 $1,291.00 $774.60
Insertion of central venous catheter for infusion using imaging guidance, patient 5 years or older 36573 $2,276.00 $1,365.60
Repair of central venous catheter for infusion 36575 $933.00 $559.80
Repair of central venous catheter for infusion 36576 $2,235.00 $1,341.00
Catheter replacement of central venous access device 36578 $2,606.00 $1,563.60
Replacement of central venous catheter 36580 $1,471.00 $882.60
Replacement of central venous catheter 36581 $3,185.00 $1,911.00
Replacement of central venous catheter 36582 $3,079.00 $1,847.40
Replacement of central venous catheter 36583 $5,165.00 $3,099.00
Replacement of catheter in peripheral vein accessed through same vein 36584 $1,617.00 $970.20
Replacement of peripheral venous catheter 36585 $3,185.00 $1,911.00
Removal of central venous catheter for infusion 36589 $1,293.00 $775.80
Removal of peripheral venous catheter for infusion 36590 $1,941.00 $1,164.60
Collection of blood specimen from a completely implantable venous access device 36591 $68.00 $40.80
Collection of blood specimen from central or peripheral venous catheter 36592 $142.00 $85.20
Collection of blood specimen from central or peripheral venous catheter 36592 $148.00 $88.80
Collection of blood specimen from central or peripheral venous catheter 36592 $77.00 $46.20
Declotting infusion of implanted central venous access device or catheter 36593 $645.00 $387.00
Declotting infusion of implanted central venous access device or catheter 36593 $89.00 $53.40
Mechanical removal of obstructive material from central venous catheter 36595 $3,521.00 $2,112.60
Mechanical removal of tissue or obstructive material in central venous catheter 36596 $1,523.00 $913.80
Repositioning of central venous catheter using fluoroscopic guidance 36597 $1,413.00 $847.80
Contrast injections for X-ray imaging procedure to evaluate central venous access device 36598 $247.00 $148.20
Arterial puncture withdrawal of blood for diagnosis 36600 $34.00 $20.40
Arterial puncture withdrawal of blood for diagnosis 36600 $210.00 $126.00
Insertion of arterial catheter for blood sampling or infusion, accessed through the skin 36620 $115.00 $69.00
Insertion of arterial catheter for blood sampling or infusion, accessed through the skin 36620 $141.00 $84.60
Insertion of needle for infusion into bone 36680 $168.00 $100.80
Insertion of needle for infusion into bone 36680 $715.00 $429.00
Injection for removal of blood clot from external dialysis cannula 36860 $901.00 $540.60
Insertion of needle and/or catheter into dialysis circuit, with imaging including radiological supervision and interpretation 36901 $1,576.00 $945.60
Insertion of needle and/or catheter into dialysis circuit and balloon dilation of dialysis segment, with imaging including radiological supervision and interpretation 36902 $11,110.00 $6,666.00
Insertion of needle and/or catheter into dialysis circuit and insertion of stent in dialysis segment, with imaging including radiological supervision and interpretation 36903 $22,454.00 $13,472.40
Excision of blood clot and/or infusion to dissolve blood clot in dialysis circuit and balloon dilation of dialysis segment, , accessed through the skin, with imaging including radiological supervision and interpretation 36904 $11,110.00 $6,666.00
Excision of blood clot and/or infusion to dissolve blood clot in dialysis circuit and balloon dilation of dialysis segment, , accessed through the skin, with imaging including radiological supervision and interpretation 36905 $22,454.00 $13,472.40
Excision of blood clot and/or infusion to dissolve blood clot and balloon dilation of dialysis segment, accessed through the skin, with imaging including radiological supervision and interpretation 36906 $34,032.00 $20,419.20
Balloon dilation of dialysis segment, accessed through the skin, with imaging including radiological supervision and interpretation 36907 $28,275.00 $16,965.00
Insertion of stent in dialysis segment, with imaging including radiological supervision and interpretation 36908 $22,516.00 $13,509.60
Permanent blockage of dialysis circuit, with imaging including radiological supervision and interpretation 36909 $16,759.00 $10,055.40
Insertion of shunts to bypass blood flow to liver using imaging guidance 37182 $7,920.00 $4,752.00
Revision of shunts to bypass blood flow to liver using imaging guidance 37183 $15,962.00 $9,577.20
Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed through the skin 37184 $7,085.00 $4,251.00
Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed through the skin 37185 $7,094.00 $4,256.40
Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed beneath the skin 37186 $1,742.00 $1,045.20
Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance 37187 $4,715.00 $2,829.00
Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance 37188 $4,553.00 $2,731.80
Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation 37191 $9,921.00 $5,952.60
Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation 37192 $7,525.00 $4,515.00
Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation 37193 $6,807.00 $4,084.20
Infusion of drug into a vein to dissolve blood clot obstructing blood flow to brain 37195 $3,079.00 $1,847.40
Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation 37197 $4,845.00 $2,907.00
Biopsy of blood vessel via catheter 37200 $6,240.00 $3,744.00
Insertion of catheter into artery for drug infusion for blood clot including radiological supervision and interpretation 37211 $5,165.00 $3,099.00
Insertion of catheter into artery for drug infusion for blood clot including radiological supervision and interpretation 37211 $9,093.00 $5,455.80
Insertion of catheter into vein for drug infusion for blood clot including radiological supervision and interpretation 37212 $3,108.00 $1,864.80
Insertion of catheter into artery or vein for drug infusion for blood clot including radiological supervision and interpretation 37213 $5,386.00 $3,231.60
Removal of catheter in artery or vein including radiological supervision and interpretation 37214 $4,215.00 $2,529.00
Removal of catheter in artery or vein including radiological supervision and interpretation 37214 $5,386.00 $3,231.60
Insertion of stents and blood clot protection device in neck artery, open or accessed through the skin 37215 $10,901.00 $6,540.60
Insertion of stents in neck artery, open or accessed through the skin 37216 $9,877.00 $5,926.20
Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure 37220 $11,001.00 $6,600.60
Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure 37221 $16,877.00 $10,126.20
Balloon dilation of groin artery, endovascular, open, or percutaneous approach 37222 $9,718.00 $5,830.80
Insertion of stents into groin artery, endovascular, accessed through the skin or open procedure 37223 $9,718.00 $5,830.80
Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure 37224 $10,203.00 $6,121.80
Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure 37225 $20,252.00 $12,151.20
Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure 37226 $20,252.00 $12,151.20
Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure 37227 $34,657.00 $20,794.20
Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure 37228 $12,836.00 $7,701.60
Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure 37229 $20,252.00 $12,151.20
Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37230 $22,019.00 $13,211.40
Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37231 $36,163.00 $21,697.80
Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure 37232 $9,718.00 $5,830.80
Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure 37233 $20,252.00 $12,151.20
Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37234 $9,720.00 $5,832.00
Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37235 $12,469.00 $7,481.40
Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation 37236 $21,378.00 $12,826.80
Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation 37237 $12,396.00 $7,437.60
Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation 37238 $23,628.00 $14,176.80
Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation 37239 $11,427.00 $6,856.20
Occlusion of venous malformations (other than hemorrhage) with radiological supervision and interpretation, roadmapping, and imaging guidance 37241 $22,800.00 $13,680.00
Occlusion of artery (other than hemorrhage or tumor) with radiological supervision and interpretation, roadmapping, and imaging guidance 37242 $26,094.00 $15,656.40
Occlusion of tumors or obstructed blood vessel with radiological supervision and interpretation, roadmapping, and imaging guidance 37243 $23,610.00 $14,166.00
Occlusion of arterial or venous hemorrhage with radiological supervision and interpretation, roadmapping, and imaging guidance 37244 $22,800.00 $13,680.00
Balloon dilation of artery, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37246 $9,935.00 $5,961.00
Balloon dilation of artery, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37247 $8,231.00 $4,938.60
Balloon dilation of first vein, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37248 $11,110.00 $6,666.00
Balloon dilation of additional vein, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37249 $8,231.00 $4,938.60
Ultrasound evaluation of blood vessel during diagnosis or treatment 37252 $2,228.00 $1,336.80
Ultrasound evaluation of blood vessel during diagnosis or treatment 37253 $1,550.00 $930.00
Multiple incisions for removal of varicose veins of arm or leg 37765 $3,573.00 $2,143.80
Multiple incisions for removal of varicose veins of arm or leg 37766 $3,573.00 $2,143.80
Blood vessel procedure 37799 $1,038.00 $622.80
Injection procedure for X-ray imaging of the spleen and portal (liver) vein 38200 $1,166.00 $699.60
Collection of stem cells for transplantation 38206 $3,034.00 $1,820.40
Freezing, preservation, and storage of stem cells for transplantation 38207 $8,926.00 $5,355.60
Diagnostic bone marrow aspiration 38220 $2,121.00 $1,272.60
Bone marrow biopsy 38221 $162.00 $97.20
Bone marrow biopsy 38221 $1,629.00 $977.40
Bone marrow biopsy 38221 $300.00 $180.00
Bone marrow biopsy and aspiration 38222 $2,919.00 $1,751.40
Bone marrow biopsy and aspiration 38222 $173.00 $103.80
Transplantation of patient's bone marrow or blood-derived stem cells 38241 $2,621.00 $1,572.60
Biopsy or removal of lymph nodes, open procedure 38500 $5,859.00 $3,515.40
Needle biopsy or removal of lymph nodes 38505 $1,662.00 $997.20
Biopsy or removal of lymph nodes of neck, open procedure 38510 $5,902.00 $3,541.20
Injection of radioactive dye for X-ray identification of lymph node 38792 $696.00 $417.60
Biopsy of lip 40490 $240.00 $144.00
Removal of wedge of lip tissue 40510 $893.00 $535.80
Repair of lip and border 40650 $318.00 $190.80
Repair of vertical lip wound extending to half of lip 40652 $672.00 $403.20
Lip procedure 40799 $401.00 $240.60
Lip procedure 40799 $430.00 $258.00
Lip procedure 40799 $373.00 $223.80
Incision of abscess, cyst, or blood accumulation in mouth 40800 $1,125.00 $675.00
Incision of abscess, cyst, or blood accumulation in mouth 40800 $217.00 $130.20
Removal of embedded foreign body of mouth 40804 $222.00 $133.20
Incision of tissue joining lip and gums 40806 $997.00 $598.20
Biopsy of mouth 40808 $356.00 $213.60
Removal of growth of tissue of mouth 40810 $4,758.00 $2,854.80
Removal of growth of mouth 40812 $4,892.00 $2,935.20
Removal of tissue at dental edge and cheek 40819 $2,339.00 $1,403.40
Suture of (2.5 centimeter or less) mouth laceration 40830 $274.00 $164.40
Suture of (2.5 centimeter or less) mouth laceration 40830 $395.00 $237.00
Drainage of abscess, cyst, or blood accumulation of tongue 41000 $305.00 $183.00
Incision of tissue connecting tongue and floor of mouth 41010 $2,338.00 $1,402.80
Insertion of needles, catheters, or devices into head and/or neck for radiation delivery 41019 $5,631.00 $3,378.60
Biopsy of tongue 41100 $996.00 $597.60
Biopsy of tongue 41105 $322.00 $193.20
Biopsy of floor of mouth 41108 $280.00 $168.00
Removal of growth of tongue 41110 $4,642.00 $2,785.20
Removal of growth of tongue 41110 $2,554.00 $1,532.40
Removal of growth of tongue 41112 $2,554.00 $1,532.40
Removal of growth of tongue 41112 $4,642.00 $2,785.20
Removal of tissue connecting tongue and floor of mouth 41115 $2,338.00 $1,402.80
Repair of (2.5 centimeter or less) laceration to floor of mouth or tongue 41251 $401.00 $240.60
Repair of (2.5 centimeter or less) laceration to floor of mouth or tongue 41251 $438.00 $262.80
Repair of (over 2.6 laceration) to floor of mouth or tongue 41252 $499.00 $299.40
Repair of (over 2.6 laceration) to floor of mouth or tongue 41252 $996.00 $597.60
Drainage of abscess, cyst, or blood accumulation of dental bone 41800 $415.00 $249.00
Drainage of abscess, cyst, or blood accumulation of dental bone 41800 $281.00 $168.60
Biopsy of roof of mouth 42100 $290.00 $174.00
Removal of growth of roof of mouth 42104 $4,760.00 $2,856.00
Removal of growth of roof of mouth 42106 $512.00 $307.20
Removal of soft tissue at roof of mouth 42140 $4,642.00 $2,785.20
Removal of soft tissue at roof of mouth 42145 $9,388.00 $5,632.80
Removal of salivary gland stone 42330 $4,758.00 $2,854.80
Needle biopsy of salivary gland 42400 $1,662.00 $997.20
Needle biopsy of salivary gland 42400 $1,206.00 $723.60
Biopsy of salivary gland 42405 $4,642.00 $2,785.20
Injection of dye for X-ray of salivary glands 42550 $509.00 $305.40
Drainage of tonsil abscess 42700 $855.00 $513.00
Drainage of tonsil abscess 42700 $186.00 $111.60
Drainage of tonsil abscess 42700 $359.00 $215.40
Biopsy of back of throat 42800 $319.00 $191.40
Removal or destruction of throat growth 42808 $4,760.00 $2,856.00
Removal of foreign body from throat 42809 $220.00 $132.00
Removal of tonsils for children under 12 42820 $9,295.00 $5,577.00
Removal of tonsils for children under 12 42820 $9,295.00 $5,577.00
Removal of tonsils and adenoid glands patient age 12 or over 42821 $4,892.00 $2,935.20
Removal of tonsils patient younger than age 12 42825 $9,295.00 $5,577.00
Removal of tonsils patient age 12 or over 42826 $4,892.00 $2,935.20
Removal of adenoids patient younger than age 12 42830 $8,991.00 $5,394.60
Removal of adenoids patient age 12 or over 42831 $4,758.00 $2,854.80
Removal of adenoids patient younger than age 12 42835 $4,892.00 $2,935.20
Diagnostic examination of esophagus using an endoscope 43200 $401.00 $240.60
Upper endoscopy; diagnostic exam to diagnose or treat conditions in the upper part of your digestive tract. 43235 $1,851.00 $1,110.60
Upper endoscopy; diagnostic exam to diagnose or treat conditions in the upper part of your digestive tract. 43235 $1,851.00 $1,110.60
Biopsy (or surgical procedure to remove tissue) for the upper digestive tract 43239 $1,985.00 $1,191.00
Biopsy (or surgical procedure to remove tissue) for the upper digestive tract 43239 $1,985.00 $1,191.00
Tying of dilated veins of stomach and/or esophagus using an endoscope 43244 $2,378.00 $1,426.80
Insertion of stomach tube using an endoscope 43246 $701.00 $420.60
Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using an endoscope 43247 $1,565.00 $939.00
Insertion of guide wire with dilation of esophagus using an endoscope 43248 $1,841.00 $1,104.60
Insertion of nasal or oral stomach tube using fluoroscopic guidance 43752 $113.00 $67.80
Insertion of stomach tube and aspirations of gastric contents 43753 $54.00 $32.40
Insertion of stomach tube and aspirations of gastric contents 43753 $539.00 $323.40
Repositioning of stomach feeding tube 43761 $992.00 $595.20
Replacement of stomach stoma tube accessed through skin 43762 $88.00 $52.80
Replacement of stomach stoma tube accessed through skin 43762 $482.00 $289.20
Stomach procedure 43999 $1,610.00 $966.00
Oral introduction of long drainage tube into small bowel 44500 $1,151.00 $690.60
Assessment and overseeing preparation of donor fecal specimen 44705 $1,585.00 $951.00
Diagnostic colonoscopy; used to diagnose abnormalities in the large intestines and rectum 45378 $1,594.00 $956.40
Diagnostic colonoscopy; used to diagnose abnormalities in the large intestines and rectum 45378 $1,594.00 $956.40
Removal of impacted stool or foreign body under anesthesia 45915 $329.00 $197.40
Drainage of rectal abscess 46040 $3,421.00 $2,052.60
Drainage of rectal abscess 46040 $507.00 $304.20
Drainage of rectal abscess 46050 $910.00 $546.00
Drainage of rectal abscess 46050 $205.00 $123.00
Incision of engorged external hemorrhoid 46083 $177.00 $106.20
Incision of engorged external hemorrhoid 46083 $505.00 $303.00
Diagnostic examination of the anus using an endoscope 46600 $92.00 $55.20
Diagnostic examination of the anus using an endoscope 46600 $338.00 $202.80
Removal of foreign body in anus using an endoscope 46608 $247.00 $148.20
Needle biopsy of liver, accessed through the skin 47000 $1,629.00 $977.40
Injection and/or drainage of liver abscesses or cysts 47015 $2,610.00 $1,566.00
Destruction of 1 or more growths in liver, accessed through the skin 47382 $10,215.00 $6,129.00
Insertion of catheter (accessed through the skin) into gallbladder using imaging guidance including radiological supervision and interpretation 47490 $4,133.00 $2,479.80
Injection of bile duct for X-ray imaging procedure accessed through the skin using imaging guidance including radiological supervision and interpretation 47531 $3,768.00 $2,260.80
Injection of bile duct for X-ray imaging procedure accessed through the skin using imaging guidance including radiological supervision and interpretation 47532 $3,768.00 $2,260.80
Placement of drainage catheter of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47533 $3,408.00 $2,044.80
Placement of drainage catheter of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47534 $3,408.00 $2,044.80
Conversion of external biliary drainage catheter to internal-external biliary drainage catheter accessed through the skin using imaging guidance with study of bile ducts and radiological supervision and interpretation 47535 $5,216.00 $3,129.60
Replacement of liver duct drainage catheter accessed through the skin with imaging and radiological supervision and interpretation 47536 $3,903.00 $2,341.80
Removal of biliary drainage catheter, accessed through the skin using imaging guidance and radiological supervision and interpretation 47537 $1,158.00 $694.80
Placement of stent of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47538 $9,865.00 $5,919.00
Placement of stent of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47539 $9,865.00 $5,919.00
Placement of stent and drainage catheter of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47540 $9,865.00 $5,919.00
Placement of access device into biliary tract, accessed through the skin with imaging including radiological supervision and interpretation 47541 $5,216.00 $3,129.60
Biopsy of bile duct or liver duct accessed through the skin using imaging guidance with radiological supervision and interpretation 47543 $1,982.00 $1,189.20
Removal of biliary duct or gallbladder stone, accessed through the skin using imaging guidance and radiological supervision and interpretation 47544 $561.00 $336.60
Insertion of stent into bile duct 47801 $7,673.00 $4,603.80
Bile duct procedure 47999 $5,278.00 $3,166.80
Needle biopsy of pancreas, accessed through the skin 48102 $1,686.00 $1,011.60
Pancreas procedure 48999 $645.00 $387.00
Drainage of fluid from abdominal cavity 49082 $226.00 $135.60
Drainage of fluid from abdominal cavity 49082 $1,609.00 $965.40
Drainage of fluid from abdominal cavity using imaging guidance 49083 $275.00 $165.00
Drainage of fluid from abdominal cavity using imaging guidance 49083 $1,390.00 $834.00
Irrigation of abdominal cavity 49084 $1,427.00 $856.20
Needle biopsy of abdominal cavity growth, accessed through the skin 49180 $1,629.00 $977.40
Injection of air or X-ray contrast material into abdominal cavity 49400 $518.00 $310.80
Fluid collection drainage by catheter using imaging guidance, accessed through the skin 49405 $2,792.00 $1,675.20
Fluid collection drainage by catheter using imaging guidance, accessed through the skin 49406 $2,792.00 $1,675.20
Fluid collection drainage by catheter using imaging guidance, accessed through vagina or rectum 49407 $1,768.00 $1,060.80
Insertion of devices in abdominal cavity for radiation therapy guidance, accessed through the skin 49411 $2,248.00 $1,348.80
Insertion of abdominal catheter through the skin using imaging guidance including radiological supervision and interpretation 49418 $5,740.00 $3,444.00
Removal of abdominal cavity catheter 49422 $4,246.00 $2,547.60
Exchange of abdominal cavity drainage catheter using imaging guidance 49423 $1,604.00 $962.40
Injection of contrast through abdominal cavity catheter for X-ray study 49424 $222.00 $133.20
Injection for X-ray study of shunt from jugular vein to abdominal cavity 49427 $317.00 $190.20
Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast 49440 $1,044.00 $626.40
Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast 49440 $1,820.00 $1,092.00
Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast 49441 $1,757.00 $1,054.20
Insertion of large bowel tube (accessed through the skin) using fluoroscopic guidance with contrast 49442 $1,734.00 $1,040.40
Conversion of stomach tube to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49446 $912.00 $547.20
Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49450 $955.00 $573.00
Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49450 $667.00 $400.20
Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49451 $923.00 $553.80
Replacement of stomach to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49452 $955.00 $573.00
Mechanical removal of obstructive material in stomach, large, or small bowel tube using fluoroscopic guidance with contrast 49460 $955.00 $573.00
Contrast injections for x-ray imaging through existing tube in stomach, small bowel or large bowel, accessed through the skin 49465 $309.00 $185.40
Abdominal procedure 49999 $4,038.00 $2,422.80
Needle biopsy of kidney, accessed through the skin 50200 $1,686.00 $1,011.60
Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin 50384 $3,790.00 $2,274.00
Removal and replacement of stent in kidney and urinary duct (ureter) using fluoroscopic guidance including radiological supervision and interpretation 50387 $2,756.00 $1,653.60
Removal of kidney drainage tube (ureter) using fluoroscopic guidance 50389 $882.00 $529.20
Aspiration and/or injection kidney cyst, accessed through the skin 50390 $1,506.00 $903.60
Injection procedure for x-ray imaging of kidney and urinary duct (ureter) using imaging guidance including radiological supervision and interpretation 50430 $1,258.00 $754.80
Injection procedure for x-ray imaging of kidney and urinary duct (ureter) using imaging guidance including radiological supervision and interpretation 50431 $1,138.00 $682.80
Placement of catheter of kidney, accessed through the skin using imaging guidance with radiological supervision and interpretation 50432 $3,439.00 $2,063.40
Placement of catheter of kidney and urinary tube (ureter), accessed through the skin using imaging guidance with radiological supervision and interpretation 50433 $3,610.00 $2,166.00
Conversion of nephrostomy catheter to nephroureteral catheter accessed through the skin using imaging guidance with study of kidney and ureter and radiological supervision and interpretation 50434 $1,258.00 $754.80
Replacement of kidney drainage catheter accessed through the skin with imaging and radiological supervision and interpretation 50435 $1,764.00 $1,058.40
Destruction of 1 or more growths in one kidney, accessed through the skin 50592 $8,927.00 $5,356.20
Biopsy of urinary duct using imaging guidance with radiological supervision and interpretation 50606 $2,304.00 $1,382.40
Injection of urinary duct (ureter) for X-ray imaging 50684 $265.00 $159.00
Change of tube or stent in urinary duct (ureter) 50688 $2,167.00 $1,300.20
Injection of bladder and urinary duct (ureter) for X-ray imaging 50690 $440.00 $264.00
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50693 $5,375.00 $3,225.00
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50694 $5,375.00 $3,225.00
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50695 $5,375.00 $3,225.00
Needle aspiration of bladder 51100 $482.00 $289.20
Aspiration of bladder with insertion of bladder tube to skin surface 51102 $406.00 $243.60
Injection procedure for X-ray imaging of the bladder or during voiding 51600 $423.00 $253.80
Injection procedure through the bladder and bladder canal (urethra) for X-ray imaging 51610 $363.00 $217.80
Bladder irrigation and/or instillation 51700 $300.00 $180.00
Insertion of temporary bladder catheter 51701 $100.00 $60.00
Insertion of temporary bladder catheter 51701 $158.00 $94.80
Insertion of indwelling bladder catheter 51702 $146.00 $87.60
Insertion of indwelling bladder catheter 51702 $70.00 $42.00
Insertion of indwelling bladder catheter 51703 $301.00 $180.60
Removal of skin suture with change of bladder tube 51705 $440.00 $264.00
Removal of skin suture with change of bladder tube 51705 $275.00 $165.00
Removal of skin suture with change of bladder tube 51705 $266.00 $159.60
Removal of suture around skin surface tube with change of bladder tube 51710 $252.00 $151.20
Removal of suture around skin surface tube with change of bladder tube 51710 $1,312.00 $787.20
Injection or implant of synthetic material into bladder and/or bladder canal (urethra) using an endoscope 51715 $514.00 $308.40
Bladder instillation of cancer preventive, inhibiting, or suppressive agent 51720 $194.00 $116.40
Insertion of device into bladder to measure pressure of urine flow 51725 $341.00 $204.60
Insertion of electronic device into bladder with measurement of urine flow pressure 51726 $478.00 $286.80
Insertion of electronic device into bladder with bladder canal (urethra) pressure studies 51727 $572.00 $343.20
Insertion of electronic device into bladder with voiding pressure studies 51728 $568.00 $340.80
Insertion of electronic device into bladder with voiding and bladder canal (urethra) pressure studies 51729 $618.00 $370.80
Electronic assessment of bladder emptying 51741 $30.00 $18.00
Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784 $347.00 $208.20
Needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51785 $482.00 $289.20
Insertion of device into the abdomen with measurement of pressure and urine flow rate 51797 $111.00 $66.60
Ultrasound measurement of bladder capacity after voiding 51798 $162.00 $97.20
Ultrasound measurement of bladder capacity after voiding 51798 $55.00 $33.00
Ultrasound measurement of bladder capacity after voiding 51798 $29.00 $17.40
Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope 52000 $648.00 $388.80
Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope 52000 $1,303.00 $781.80
Irrigation and removal of multiple blood clots from bladder and bladder canal (urethra) using an endoscope 52001 $733.00 $439.80
Insertion of catheter into urinary duct (ureter) using an endoscope 52005 $473.00 $283.80
Biopsy of the bladder using an endoscope 52204 $717.00 $430.20
Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope 52224 $1,235.00 $741.00
Destruction and/or removal of (0.5 to 2.0 centimeters) small growths of the bladder using an endoscope 52234 $663.00 $397.80
Destruction and/or removal of large growths of the bladder using an endoscope 52240 $1,057.00 $634.20
Dilation of bladder canal (urethra) using an endoscope 52281 $483.00 $289.80
Dilation of bladder canal (urethra) using an endoscope 52281 $3,620.00 $2,172.00
Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope 52310 $430.00 $258.00
Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope 52310 $3,670.00 $2,202.00
Complicated removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope 52315 $809.00 $485.40
Insertion of stent in urinary duct (ureter) using an endoscope 52332 $912.00 $547.20
Treatment of stricture in urinary duct (ureter) using an endoscope 52341 $779.00 $467.40
Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope 52601 $2,277.00 $1,366.20
Dilation of narrowing of bladder canal (urethra), male 53600 $148.00 $88.80
Dilation of narrowing of bladder canal (urethra), male 53601 $145.00 $87.00
Dilation of narrowing of bladder canal (urethra), male 53620 $206.00 $123.60
Dilation of narrowing of bladder canal (urethra), male 53621 $195.00 $117.00
Dilation of bladder canal (urethra), female 53660 $127.00 $76.20
Dilation of bladder canal (urethra), female 53661 $125.00 $75.00
Urinary system procedure 53899 $520.00 $312.00
Biopsy of penis 54100 $358.00 $214.80
Injection of drug into erectile tissue at sides and back of penis 54220 $454.00 $272.40
Injection of drug into erectile tissue at sides and back of penis 54220 $196.00 $117.60
Injection procedure to induce erection 54235 $161.00 $96.60
Repositioning of foreskin including scar tissue removal 54450 $68.00 $40.80
Removal of testis (testicle) 54520 $890.00 $534.00
Incision and drainage of sperm reservoir, testis, and/or scrotal area 54700 $584.00 $350.40
Aspiration of fluid collection in testicle and sperm reservoir 55000 $211.00 $126.60
Incision and drainage of abscess in scrotal sac of testicle 55100 $2,681.00 $1,608.60
Incision and drainage of abscess in scrotal sac of testicle 55100 $211.00 $126.60
Removal of sperm duct 55250 $687.00 $412.20
Biopsy of prostate gland 55700 $2,167.00 $1,300.20
Biopsy of prostate gland 55700 $403.00 $241.80
Insertion of needles or catheters into prostate for radiation therapy 55875 $5,663.00 $3,397.80
Insertion of radiation therapy devices in prostate gland for radiation therapy guidance 55876 $241.00 $144.60
Male genital system procedure 55899 $295.00 $177.00
Incision and drainage of female genitals abscess 56405 $576.00 $345.60
Incision and drainage of female genitals abscess 56405 $111.00 $66.60
Incision and drainage of female genital gland abscess 56420 $319.00 $191.40
Incision and drainage of female genital gland abscess 56420 $123.00 $73.80
Biopsy of external female genitals 56605 $152.00 $91.20
Partial removal of external female genitals 56620 $4,918.00 $2,950.80
Examination of external female genitals using an endoscope 56820 $204.00 $122.40
Examination and biopsy of external female genitals using an endoscope 56821 $270.00 $162.00
Destruction of multiple vaginal growths 57065 $352.00 $211.20
Biopsy of vaginal mucous membrane 57100 $162.00 $97.20
Excision of vaginal cyst or tumor 57135 $350.00 $210.00
Irrigation of vagina and/or application of drug to treat infection 57150 $85.00 $51.00
Insertion of radiation therapy devices in uterus for radiation therapy 57155 $427.00 $256.20
Insertion of radiation therapy devices in vagina for radiation therapy 57156 $188.00 $112.80
Fitting and insertion of vaginal support device 57160 $142.00 $85.20
Pelvic examination under anesthesia 57410 $303.00 $181.80
Examination of the vagina using an endoscope 57420 $214.00 $128.40
Biopsy of vagina and cervix using an endoscope 57421 $286.00 $171.60
Examination of the vagina and cervix using an endoscope 57452 $200.00 $120.00
Biopsy and scraping of the cervix using an endoscope 57454 $281.00 $168.60
Biopsy of cervix using an endoscope 57455 $263.00 $157.80
Scraping of the cervix using an endoscope 57456 $248.00 $148.80
Biopsy of cervix using an endoscope 57460 $523.00 $313.80
Biopsy of cervix or excision of local growths 57500 $238.00 $142.80
Removal or destruction of cervix 57522 $483.00 $289.80
Dilation of tissue at uterine opening (cervix) 57800 $63.00 $37.80
Biopsy of uterine lining 58100 $202.00 $121.20
Placement of intra-uterine device (IUD) for pregnancy prevention 58300 $109.00 $65.40
Removal of intra-uterine device (IUD) for pregnancy prevention 58301 $176.00 $105.60
Removal of intra-uterine device (IUD) for pregnancy prevention 58301 $97.00 $58.20
Removal of intra-uterine device (IUD) for pregnancy prevention 58301 $660.00 $396.00
Introduction of saline or X-ray contrast material for X-ray imaging of the uterus and tubes 58340 $592.00 $355.20
Abdominal removal of uterus (greater than 250 grams), tubes, and/or ovaries using an endoscope 58573 $3,716.00 $2,229.60
Vaginal or abdominal biopsy of ovaries 58900 $4,558.00 $2,734.80
Abdominal aspiration of fluid surrounding fetus for diagnosis 59000 $1,385.00 $831.00
Abdominal aspiration to reduce amount of fluid surrounding fetus using ultrasound guidance 59001 $1,810.00 $1,086.00
Fetal contraction stress test 59020 $581.00 $348.60
Fetal non-stress test 59025 $581.00 $348.60
Fetal non-stress test 59025 $92.00 $55.20
Turning of fetus from breech to presenting position 59412 $4,340.00 $2,604.00
Vaginal delivery of placenta 59414 $4,132.00 $2,479.20
Post-delivery care 59430 $344.00 $206.40
Cesarean delivery 59514 $5,042.00 $3,025.20
Cesarean delivery 59514 $2,606.00 $1,563.60
Treatment of incomplete abortion 59812 $4,918.00 $2,950.80
Treatment of first trimester missed abortion 59820 $702.00 $421.20
Needle biopsy of thyroid, accessed through the skin 60100 $1,206.00 $723.60
Needle biopsy of thyroid, accessed through the skin 60100 $938.00 $562.80
Endocrine system procedure 60699 $5,386.00 $3,231.60
Spinal puncture in upper spine with injection of substance 61055 $929.00 $557.40
Aspiration or injection of cerebrospinal fluid shunt tubing or reservoir 61070 $1,211.00 $726.60
Insertion of brain drainage catheter or fluid pressure recording or monitoring device 61107 $1,153.00 $691.80
Balloon occlusion of head or neck artery 61623 $12,836.00 $7,701.60
Occlusion of abnormal artery, accessed through the skin 61624 $6,809.00 $4,085.40
Occlusion of head or neck artery, accessed through the skin 61626 $15,799.00 $9,479.40
Computer-assisted procedure outside the brain 61782 $2,164.00 $1,298.40
Insertion or replacement of brain neurostimulator generator or receiver 61885 $40,055.00 $24,033.00
Insertion or replacement of brain neurostimulator generator or receiver 61886 $60,851.00 $36,510.60
Reprogramming of programmable brain and spinal fluid shunt 62252 $161.00 $96.60
Diagnostic aspiration of spinal disc or tissue, accessed through the skin 62267 $919.00 $551.40
Aspiration of spinal cord cyst or fluid-filled cavity, accessed through the skin 62268 $3,420.00 $2,052.00
Needle biopsy of spinal cord, accessed beneath the skin 62269 $1,629.00 $977.40
Spinal tap for diagnosis 62270 $159.00 $95.40
Spinal tap for diagnosis 62270 $1,244.00 $746.40
Spinal tap with drainage of spinal fluid 62272 $1,244.00 $746.40
Injection of blood or blood clot into spinal canal 62273 $1,523.00 $913.80
Injection of spinal canal to destroy nerve 62282 $1,614.00 $968.40
Injection of dye for X-ray imaging and/or CT of lower spinal canal 62284 $835.00 $501.00
Injection of dye for X-ray imaging of spine disc 62290 $2,274.00 $1,364.40
Injection of dye for X-ray imaging of spine disc 62291 $958.00 $574.80
X-ray of upper spinal canal with radiological supervision and interpretation 62302 $1,572.00 $943.20
X-ray of middle spinal canal with radiological supervision and interpretation 62303 $1,373.00 $823.80
X-ray of lower spinal canal with radiological supervision and interpretation 62304 $1,572.00 $943.20
X-ray of lower spinal canal with radiological supervision and interpretation 62305 $1,572.00 $943.20
Injection of substance into spinal canal of upper or middle back using imaging guidance 62321 $1,169.00 $701.40
Injection of substance into the lower back or lumbar spine 62322 $1,246.00 $747.60
Injection of substance into the lower back or lumbar spine 62322 $1,246.00 $747.60
Injection into the lower back with help of imaging of some type 62323 $1,246.00 $747.60
Injection into the lower back with help of imaging of some type 62323 $1,246.00 $747.60
Injection into the lower back with help of imaging of some type 62323 $1,169.00 $701.40
Injection into the lower back with help of imaging of some type 62323 $1,169.00 $701.40
Implantation or replacement of spinal canal drug infusion device beneath skin 62360 $35,134.00 $21,080.40
Removal of spinal canal drug infusion pump or device, accessed beneath the skin 62365 $9,340.00 $5,604.00
Electronic analysis of spinal canal drug infusion pump 62367 $462.00 $277.20
Electronic analysis and reprogramming of spinal canal drug infusion pump 62368 $462.00 $277.20
Electronic analysis reprogramming and refill of spinal canal drug infusion pump 62369 $428.00 $256.80
Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician 62370 $428.00 $256.80
Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine 63030 $11,744.00 $7,046.40
Implantation of spinal neurostimulator electrodes, accessed through the skin 63650 $12,921.00 $7,752.60
Implantation of spinal neurostimulator electrodes 63655 $40,055.00 $24,033.00
Revision and replacement of spinal neurostimulator electrodes 63663 $11,800.00 $7,080.00
Insertion of spinal neurostimulator pulse generator or receiver 63685 $60,133.00 $36,079.80
Injection of anesthetic agent, trigeminal nerve 64400 $124.00 $74.40
Injection of anesthetic agent, trigeminal nerve 64400 $490.00 $294.00
Injection of anesthetic agent, greater occipital nerve 64405 $486.00 $291.60
Injection of anesthetic agent, greater occipital nerve 64405 $100.00 $60.00
Injection of anesthetic agent, brachial (arm) nerve bundle 64415 $1,440.00 $864.00
Injection of anesthetic agent underarm (axillary) nerve 64417 $1,440.00 $864.00
Injection of anesthetic agent, collar bone nerve 64418 $1,142.00 $685.20
Injection of anesthetic agent, of rib nerve 64420 $613.00 $367.80
Injection of anesthetic agent of multiple rib nerves 64421 $1,318.00 $790.80
Injection of anesthetic agent, groin nerves 64425 $750.00 $450.00
Injection of anesthetic agent, pudendal (external genital) nerve 64430 $1,455.00 $873.00
Injection of anesthetic agent, pudendal (external genital) nerve 64430 $1,592.00 $955.20
Injection of anesthetic agent, sciatic nerve 64445 $1,318.00 $790.80
Injection of anesthetic agent, thigh nerve 64447 $1,246.00 $747.60
Injection of anesthetic agent, thigh nerve 64447 $148.00 $88.80
Injection by continuous infusion of anesthetic agent into lumbar nerve bundle, posterior approach 64449 $1,852.00 $1,111.20
Injection of anesthetic agent, other peripheral nerve or branch 64450 $106.00 $63.60
Injection of anesthetic agent, other peripheral nerve or branch 64450 $1,177.00 $706.20
Injections of anesthetic and/or steroid drug into nerve of foot 64455 $1,246.00 $747.60
Injections of anesthetic and/or steroid drug into nerve of foot 64455 $51.00 $30.60
Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance 64479 $1,440.00 $864.00
Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance 64480 $994.00 $596.40
Epidural steroid injections for lower back pain 64483 $1,440.00 $864.00
Epidural steroid injections for lower back pain 64483 $1,440.00 $864.00
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance 64484 $925.00 $555.00
Injections of local anesthetic for pain control and abdominal wall analgesia on one side 64486 $255.00 $153.00
Injections of local anesthetic for pain control and abdominal wall analgesia on both sides 64488 $507.00 $304.20
Injections of upper or middle spine facet joint using imaging guidance 64490 $1,440.00 $864.00
Injections of upper or middle spine facet joint using imaging guidance 64491 $435.00 $261.00
Injections of upper or middle spine facet joint using imaging guidance 64492 $435.00 $261.00
Injections of lower or sacral spine facet joint using imaging guidance 64493 $1,987.00 $1,192.20
Injections of lower or sacral spine facet joint using imaging guidance 64494 $349.00 $209.40
Injections of lower or sacral spine facet joint using imaging guidance 64495 $349.00 $209.40
Injection of anesthetic agent, sympathetic nerve bundle 64510 $1,455.00 $873.00
Injection of anesthetic agent, middle or lower spine sympathetic nerves 64520 $1,455.00 $873.00
Injection of anesthetic agent, abdominal sympathetic nerve bundle 64530 $1,440.00 $864.00
Implantation of peripheral nerve neurostimulator electrodes, accessed through the skin 64555 $13,101.00 $7,860.60
Implantation of lower leg neurostimulator electrode, accessed through the skin 64566 $222.00 $133.20
Incision to implant muscle neurostimulator electrodes 64580 $38,912.00 $23,347.20
Revision or removal of peripheral neurostimulator electrode array 64585 $6,230.00 $3,738.00
Insertion or replacement of peripheral or gastric neurostimulator generator 64590 $455.00 $273.00
Injection of chemical for destruction of nerve muscles on one side of face 64612 $158.00 $94.80
Injection of chemical for destruction of nerve muscles on one side of face 64612 $351.00 $210.60
Injection of chemical for destruction of facial and neck nerve muscles on both sides of face 64615 $486.00 $291.60
Injection of chemical for destruction of nerve muscles on one side of neck excluding voice box accessed through the skin 64616 $514.00 $308.40
Injection of chemical for destruction of nerve muscles on one side of voice box accessed through the skin 64617 $832.00 $499.20
Injection of agent to destroy rib nerve 64620 $1,455.00 $873.00
Destruction of pudendal (external genital) nerve 64630 $1,455.00 $873.00
Destruction of upper or middle spinal facet joint nerves using imaging guidance 64633 $3,519.00 $2,111.40
Destruction of upper or middle spinal facet joint nerves with imaging guidance 64634 $321.00 $192.60
Destruction of lower or sacral spinal facet joint nerves using imaging guidance 64635 $3,519.00 $2,111.40
Destruction of lower or sacral spinal facet joint nerves with imaging guidance 64636 $321.00 $192.60
Destruction of peripheral nerve or branch 64640 $1,440.00 $864.00
Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles 64642 $173.00 $103.80
Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles 64642 $832.00 $499.20
Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles 64643 $418.00 $250.80
Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles 64644 $295.00 $177.00
Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles 64644 $1,246.00 $747.60
Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles 64645 $210.00 $126.00
Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles 64645 $418.00 $250.80
Injection of chemical for destruction of nerve muscles on trunk, 5 or more muscles 64646 $832.00 $499.20
Injection of chemical for destruction of nerve muscles on trunk, 5 or more muscles 64646 $271.00 $162.60
Injection of chemical for destruction of nerve muscles on trunk, 6 or more muscles 64647 $920.00 $552.00
Release of nerve of finger 64702 $3,135.00 $1,881.00
Release of nerve of hand or foot 64704 $3,519.00 $2,111.40
Release of nerve of arm or leg, open procedure 64708 $3,519.00 $2,111.40
Release of major nerve of arm or leg, open procedure 64713 $3,519.00 $2,111.40
Release and/or relocation of ulnar nerve at elbow 64718 $3,519.00 $2,111.40
Release and/or relocation ulnar nerve at wrist 64719 $3,519.00 $2,111.40
Release and/or relocation of median nerve of hand 64721 $3,519.00 $2,111.40
Release and/or relocation of median nerve of hand 64721 $3,519.00 $2,111.40
Release of unspecified nerve 64722 $3,519.00 $2,111.40
Release of nerve requiring use of operating microscope 64727 $634.00 $380.40
Incision or removal of spinal nerve 64772 $3,519.00 $2,111.40
Removal of growth of skin nerve 64774 $3,135.00 $1,881.00
Removal of growth of finger or toe nerve 64776 $3,520.00 $2,112.00
Removal of growth of hand or foot nerve 64782 $3,519.00 $2,111.40
Removal of growth of hand or foot nerve 64783 $829.00 $497.40
Removal of growth of peripheral nerve 64784 $3,519.00 $2,111.40
Removal of growth of sciatic nerve 64786 $9,340.00 $5,604.00
Implantation of nerve end into bone or muscle 64787 $1,837.00 $1,102.20
Biopsy of nerve 64795 $3,484.00 $2,090.40
Removal of finger or toe sympathetic nerve 64820 $3,624.00 $2,174.40
Removal of sympathetic radial (lower arm) artery nerve 64821 $5,724.00 $3,434.40
Removal of sympathetic ulnar (lower arm) artery nerve 64822 $5,724.00 $3,434.40
Removal of sympathetic palmar (hand) nerve 64823 $3,038.00 $1,822.80
Suture of hand or foot digital nerve 64831 $9,340.00 $5,604.00
Suture of hand or foot digital nerve 64832 $1,288.00 $772.80
Suture of median motor thenar nerve (hand) 64835 $7,643.00 $4,585.80
Suture of ulnar nerve (forearm or hand) 64836 $7,643.00 $4,585.80
Suture of peripheral nerve, arm or leg, with relocation to new site 64856 $9,340.00 $5,604.00
Suture of peripheral nerve, arm or leg 64857 $9,340.00 $5,604.00
Placement of (up to 4 centimeter length) arm or leg nerve graft 64892 $9,340.00 $5,604.00
Repair of nerve with graft 64910 $9,340.00 $5,604.00
Repair of nerve using vein graft 64911 $9,499.00 $5,699.40
Repair of nerve using nerve graft 64912 $9,499.00 $5,699.40
Nervous system procedure 64999 $526.00 $315.60
Nervous system procedure 64999 $522.00 $313.20
Nervous system procedure 64999 $1,686.00 $1,011.60
Nervous system procedure 64999 $515.00 $309.00
Removal of eye contents 65091 $6,387.00 $3,832.20
Removal of eye contents with insertion of implant 65093 $6,244.00 $3,746.40
Removal of ocular implant 65175 $6,244.00 $3,746.40
Removal of foreign body in external eye, conjunctiva 65205 $230.00 $138.00
Removal of foreign body in external eye, conjunctiva 65205 $58.00 $34.80
Removal of foreign body, external eye, cornea 65220 $55.00 $33.00
Removal of foreign body, external eye, cornea with slit lamp examination 65222 $70.00 $42.00
Removal of foreign body, external eye, cornea with slit lamp examination 65222 $227.00 $136.20
Removal of foreign body from inside the eye or lens 65235 $3,989.00 $2,393.40
Removal or relocation of corneal conjunctiva 65426 $3,829.00 $2,297.40
Removal of outer layer of cornea 65435 $1,745.00 $1,047.00
Destruction of lesion of cornea 65450 $606.00 $363.60
Aspiration of eye fluid 65800 $4,133.00 $2,479.80
Removal of implanted lens in eye 65920 $4,157.00 $2,494.20
Creation of shunt to improve eye fluid flow with graft 66180 $7,690.00 $4,614.00
Insertion of eye fluid drainage device 66183 $7,608.00 $4,564.80
Revision or repair of operative wound of eye 66250 $3,829.00 $2,297.40
Repair of iris and lens tissue 66680 $3,989.00 $2,393.40
Repair of iris and lens tissue 66682 $4,105.00 $2,463.00
Removal of recurring cataract in lens capsule 66820 $4,105.00 $2,463.00
Repositioning of lens prosthesis 66825 $4,227.00 $2,536.20
Aspiration removal of lens material 66840 $4,104.00 $2,462.40
Fragmenting, aspiration, and removal of lens material 66850 $4,104.00 $2,462.40
Removal of lens material 66852 $7,692.00 $4,615.20
Removal of lens material and capsule 66920 $4,105.00 $2,463.00
Removal of cataract with insertion of lens 66982 $4,269.00 $2,561.40
Removal of cataract with insertion of lens 66983 $4,104.00 $2,462.40
Removal of one cataracts from an eye 66984 $4,269.00 $2,561.40
Insertion of lens prosthesis 66985 $4,104.00 $2,462.40
Exchange of lens prosthesis 66986 $4,104.00 $2,462.40
Examination of eye using an endoscope 66990 $246.00 $147.60
Anterior (front) eye procedure 66999 $4,105.00 $2,463.00
Aspiration or release of eye fluid between the lens and retina 67015 $4,133.00 $2,479.80
Injection of synthetic eye fluid 67025 $4,133.00 $2,479.80
Injection of drug into eye 67028 $702.00 $421.20
Removal of eye fluid (vitreous) between the lens and retina 67036 $7,690.00 $4,614.00
Laser destruction of eye fluid (vitreous) between the lens and retina 67039 $7,912.00 $4,747.20
Laser destruction of eye fluid (vitreous) between the lens and retina 67040 $7,912.00 $4,747.20
Removal of membrane from the retina 67041 $7,690.00 $4,614.00
Removal of membrane from the retina, pars plana approach 67042 $7,912.00 $4,747.20
Repair of detached retina, 1 or more sessions 67101 $4,105.00 $2,463.00
Repair of detached retina, 1 or more sessions 67105 $1,059.00 $635.40
Repair of detached retina and drainage of eye fluid between lens and retina 67107 $7,693.00 $4,615.80
Repair of detached retina and drainage of eye fluid between lens and retina 67108 $7,912.00 $4,747.20
Repair of detached retina and drainage of eye fluid between lens and retina 67113 $8,125.00 $4,875.00
Removal of implant material from inside the eye 67121 $4,105.00 $2,463.00
Preventive retinal detachment treatment by heat or freezing, 1 or more sessions 67141 $612.00 $367.20
Repair of defect of sclera with graft 67255 $4,104.00 $2,462.40
Bone cavity of eye procedure 67599 $581.00 $348.60
Incision and drainage of eyelid abscess 67700 $271.00 $162.60
Incision and drainage of eyelid abscess 67700 $581.00 $348.60
Incision of corner of eye at eyelids 67715 $688.00 $412.80
Incision of corner of eye at eyelids 67715 $3,919.00 $2,351.40
Removal of eyelid growth 67800 $129.00 $77.40
Removal of multiple growths of different eyelids 67805 $612.00 $367.20
Biopsy of eyelid 67810 $319.00 $191.40
Removal of eyelid growth 67840 $1,750.00 $1,050.00
Temporary closure of eyelids by suture 67875 $322.00 $193.20
Creation of permanent eyelid margin scarring 67880 $3,829.00 $2,297.40
Repair of brow paralysis 67900 $3,772.00 $2,263.20
Repair of brow paralysis 67900 $1,112.00 $667.20
Extensive repair of turning-outward eyelid defect 67917 $3,919.00 $2,351.40
Suture repair of turning-inward eyelid defect 67921 $3,829.00 $2,297.40
Repair of turning-inward eyelid defect 67923 $3,830.00 $2,298.00
Repair of turning-inward eyelid defect 67924 $3,829.00 $2,297.40
Removal of embedded foreign body in eyelid 67938 $591.00 $354.60
Enlargement of eyelid margin 67950 $3,919.00 $2,351.40
Removal of up to one-fourth of the eyelid involving lid margin 67961 $3,772.00 $2,263.20
Incision and drainage of eye cyst 68020 $1,787.00 $1,072.20
Biopsy of sclera 68100 $3,830.00 $2,298.00
Removal of (up to 1 centimeter) growth of sclera 68110 $3,829.00 $2,297.40
Removal of (over 1 centimeter) growth of sclera 68115 $3,772.00 $2,263.20
Destruction of growth of sclera 68135 $3,830.00 $2,298.00
Relocation of conjunctival flap 68362 $3,829.00 $2,297.40
Operation of conjunctiva 68399 $581.00 $348.60
Insertion of probe into the tear duct under anesthesia 68811 $3,829.00 $2,297.40
Probing of nasal-tear duct with balloon catheter dilation 68816 $3,829.00 $2,297.40
Probing of nasal-tear duct 68840 $606.00 $363.60
Injection of contrast for X-ray imaging of tear sac 68850 $566.00 $339.60
Incision and drainage of external ear abscess or blood accumulation 69000 $1,240.00 $744.00
Incision and drainage of external ear abscess or blood accumulation 69000 $275.00 $165.00
Biopsy of ear 69100 $187.00 $112.20
Biopsy of ear canal 69105 $3,055.00 $1,833.00
Removal of soft tissue growth of ear canal 69145 $4,835.00 $2,901.00
Removal of foreign body from ear canal 69200 $126.00 $75.60
Removal of foreign body from ear canal 69200 $232.00 $139.20
Removal of foreign body from ear canal under anesthesia 69205 $2,782.00 $1,669.20
Removal of impacted ear wax by washing 69209 $122.00 $73.20
Removal of impacted ear wax by washing 69209 $25.00 $15.00
Removal of impacted ear wax by washing 69209 $34.00 $20.40
Removal of impact ear wax, one ear 69210 $175.00 $105.00
Removal of impact ear wax, one ear 69210 $52.00 $31.20
Removal of skin debris and drainage of mastoid cavity 69220 $260.00 $156.00
Repair of protruding ear 69300 $928.00 $556.80
Incision, aspiration, and/or inflation of eardrum 69420 $361.00 $216.60
Incision, aspiration, and inflation of eardrum under anesthesia 69421 $4,890.00 $2,934.00
Removal of implanted eardrum tube under anesthesia 69424 $4,890.00 $2,934.00
Incision of eardrum with insertion of eardrum tube under local or topical anesthesia 69433 $382.00 $229.20
Ear tube surgery (myringotomy) is the insertion of tube into the incision in the eardrum to allow fluid to drain out of the ear. 69436 $2,338.00 $1,402.80
Ear tube surgery (myringotomy) is the insertion of tube into the incision in the eardrum to allow fluid to drain out of the ear. 69436 $2,338.00 $1,402.80
Incision of ear canal with release of scar tissue 69450 $4,758.00 $2,854.80
Repair of eardrum 69610 $4,892.00 $2,935.20
Repair of defect or perforation of eardrum 69620 $4,890.00 $2,934.00
Repair of eardrum and ear canal with opening to ear bones 69631 $9,295.00 $5,577.00
Repair of eardrum, ear canal, and bones 69632 $9,388.00 $5,632.80
Repair of eardrum, ear canal and bones with removal of mastoid bone 69644 $9,518.00 $5,710.80
Temporal bone implantation of cochlear stimulating system, accessed through the skin 69714 $22,206.00 $13,323.60
Middle ear procedure 69799 $408.00 $244.80
Incision of fluid canals of inner ear with infusion of drugs, transcanal approach 69801 $2,465.00 $1,479.00
Use of operating microscope 69990 $58.00 $34.80
Radiological supervision and interpretation X-ray of lower back portion of brain 70010 $1,248.00 $748.80
Radiological supervision and interpretation X-ray of brain and spinal cord with contrast 70015 $1,955.00 $1,173.00
X-ray of mandible, less than 4 views 70100 $189.00 $113.40
X-ray of mandible, minimum of 4 views 70110 $310.00 $186.00
X-ray of bones of face, less than 3 views 70140 $233.00 $139.80
X-ray of bones of face, minimum of 3 views 70150 $323.00 $193.80
X-ray of bones of nose, minimum of 3 views 70160 $197.00 $118.20
Radiological supervision and interpretation X-ray of tear drainage structure of eye 70170 $686.00 $411.60
X-ray of paranasal sinus, less than 3 views 70210 $173.00 $103.80
X-ray of paranasal sinus, complete, minimum of 3 views 70220 $201.00 $120.60
X-ray of bone at base of skull 70240 $189.00 $113.40
X-ray of skull, less than 4 views 70250 $249.00 $149.40
X-ray of skull, complete, minimum of 4 views 70260 $310.00 $186.00
X-ray of teeth, single view 70300 $91.00 $54.60
X-ray of teeth, less than full mouth 70310 $593.00 $355.80
X-ray of teeth, full mouth 70320 $298.00 $178.80
X-ray of jaw joints on both sides of the face 70330 $205.00 $123.00
MRI scan of jaw joints 70336 $1,594.00 $956.40
X-ray imaging of teeth 70355 $146.00 $87.60
X-ray of soft tissue of neck 70360 $197.00 $118.20
Imaging of voice box with speech evaluation 70371 $532.00 $319.20
X-ray of salivary gland 70380 $189.00 $113.40
Radiological supervision and interpretation X-ray of salivary structure 70390 $686.00 $411.60
CT scan of the head or brain without contrast or dye 70450 $1,278.00 $766.80
CT scan of the head or brain without contrast or dye 70450 $1,278.00 $766.80
CT scan head or brain with contrast 70460 $1,350.00 $810.00
CT scan head or brain before and after contrast 70470 $1,626.00 $975.60
CT scan of cranial cavity 70480 $1,165.00 $699.00
CT scan of cranial cavity with contrast 70481 $1,357.00 $814.20
CT scan of cranial cavity before and after contrast 70482 $1,531.00 $918.60
CT scan of face 70486 $1,107.00 $664.20
CT scan of face with contrast 70487 $1,386.00 $831.60
CT scan of face before and after contrast 70488 $2,045.00 $1,227.00
CT scan of neck 70490 $1,147.00 $688.20
CT scan of neck with contrast 70491 $1,411.00 $846.60
CT scan of neck before and after contrast 70492 $1,629.00 $977.40
CT scan of blood vessel of head with contrast 70496 $1,642.00 $985.20
CT scan of neck blood vessels with contrast 70498 $1,642.00 $985.20
MRI scan bones of the eye, face, and/or neck 70540 $1,818.00 $1,090.80
MRI scan bones of the eye, face, and/or neck before and after contrast 70543 $2,529.00 $1,517.40
MRA scan of head blood vessels 70544 $2,127.00 $1,276.20
MRA scan of head blood vessels with contrast 70545 $2,400.00 $1,440.00
MRA scan of head blood vessels before and after contrast 70546 $3,217.00 $1,930.20
MRA scan of neck blood vessels 70547 $2,007.00 $1,204.20
MRA scan of neck blood vessels before and after contrast 70549 $3,224.00 $1,934.40
MRI scan brain 70551 $1,971.00 $1,182.60
MRI scan of brain with contrast 70552 $2,093.00 $1,255.80
MRI scan of the brain with and without contrast 70553 $2,469.00 $1,481.40
MRI scan of the brain with and without contrast 70553 $2,469.00 $1,481.40
X-ray of chest, 1 view 71045 $233.00 $139.80
X-ray of chest, 1 view 71045 $224.00 $134.40
X-ray of the chest, 2 views 71046 $246.00 $147.60
X-ray of the chest, 2 views 71046 $234.00 $140.40
X-ray of the chest, 2 views 71046 $234.00 $140.40
X-ray of the chest, 2 views 71046 $246.00 $147.60
X-ray of chest, 3 views 71047 $347.00 $208.20
X-ray of chest, minimum of 4 views 71048 $347.00 $208.20
X-ray of ribs of one side of body, 2 views 71100 $323.00 $193.80
X-ray of ribs on one side of body including the chest, minimum of 3 views 71101 $310.00 $186.00
X-ray of both sides of the ribs, 3 views 71110 $300.00 $180.00
X-ray of both sides of the ribs including the chest, minimum of 4 views 71111 $310.00 $186.00
X-ray of breast bone, minimum of 2 views 71120 $197.00 $118.20
X-ray of junction of breast and collar bones, minimum of 2 views 71130 $197.00 $118.20
CT scan chest 71250 $1,278.00 $766.80
CT scan chest with contrast 71260 $1,631.00 $978.60
CT scan chest before and after contrast 71270 $1,757.00 $1,054.20
CT scan of blood vessels in chest with contrast 71275 $2,223.00 $1,333.80
MRI scan of chest 71550 $2,124.00 $1,274.40
MRI scan of chest before and after contrast 71552 $3,053.00 $1,831.80
MRI scan of blood vessels of chest 71555 $1,996.00 $1,197.60
X-ray of spine, 1 view 72020 $189.00 $113.40
X-ray of spine of neck, 2 or 3 views 72040 $259.00 $155.40
X-ray of upper spine, 4 or 5 views 72050 $360.00 $216.00
X-ray of upper spine, 6 or more views 72052 $499.00 $299.40
X-ray of middle spine, 3 views 72070 $257.00 $154.20
X-ray of middle spine, 3 views 72072 $347.00 $208.20
X-ray of middle spine, minimum of 4 views 72074 $372.00 $223.20
X-ray of middle and lower spine, 2 views 72080 $197.00 $118.20
X-ray of spine, 1 view 72081 $216.00 $129.60
X-ray of spine, 2 or 3 views 72082 $269.00 $161.40
X-ray of spine, 4 or 5 views 72083 $455.00 $273.00
X-ray of spine, minimum of 6 views 72084 $440.00 $264.00
X-ray of lower and sacral spine, 2 or 3 views 72100 $298.00 $178.80
X-ray of the lower spine with 4 or more views 72110 $351.00 $210.60
X-ray of the lower spine with 4 or more views 72110 $351.00 $210.60
X-ray lower and sacral spine including bending views minimum 6 views 72114 $392.00 $235.20
X-ray lower and sacral spine including bending views 2 or 3 views 72120 $310.00 $186.00
CT scan of upper spine 72125 $1,378.00 $826.80
CT scan of upper spine with contrast 72126 $1,643.00 $985.80
CT scan of upper spine before and after contrast 72127 $1,928.00 $1,156.80
CT scan of middle spine 72128 $1,378.00 $826.80
CT scan of middle spine with contrast 72129 $1,944.00 $1,166.40
CT scan of middle spine before and after contrast 72130 $2,917.00 $1,750.20
CT scan of lower spine 72131 $1,378.00 $826.80
CT scan of lower spine with contrast 72132 $1,608.00 $964.80
CT scan of lower spine before and after contrast 72133 $1,928.00 $1,156.80
MRI scan of upper spinal canal 72141 $1,671.00 $1,002.60
MRI scan of upper spinal canal with contrast 72142 $2,108.00 $1,264.80
MRI scan of middle spinal canal 72146 $1,674.00 $1,004.40
MRI scan of middle spinal canal with contrast 72147 $1,872.00 $1,123.20
MRI scan of lower spinal canal 72148 $1,672.00 $1,003.20
MRI scan of lower spinal canal with contrast 72149 $2,130.00 $1,278.00
MRI scan of upper spinal canal before and after contrast 72156 $2,514.00 $1,508.40
MRI scan of middle spinal canal before and after contrast 72157 $2,307.00 $1,384.20
MRI scan of lower spinal canal before and after contrast 72158 $2,400.00 $1,440.00
X-ray of pelvis, 1 or 2 views 72170 $197.00 $118.20
X-ray of pelvis, minimum of 3 views 72190 $229.00 $137.40
CT scan of pelvic blood vessels with contrast 72191 $1,864.00 $1,118.40
CT scan pelvis 72192 $1,147.00 $688.20
CT scan of the pelvis with contrast or dye 72193 $1,480.00 $888.00
CT scan of the pelvis with contrast or dye 72193 $1,480.00 $888.00
CT scan of pelvis before and after contrast 72194 $1,723.00 $1,033.80
MRI scan of pelvis 72195 $1,879.00 $1,127.40
MRI scan of pelvis with contrast 72196 $2,064.00 $1,238.40
MRI scan of pelvis before and after contrast 72197 $2,573.00 $1,543.80
MRA scan of pelvic blood vessels 72198 $2,022.00 $1,213.20
MRA scan of pelvic blood vessels 72198 $3,033.00 $1,819.80
X-ray of sacroiliac joints, less than 3 views 72200 $189.00 $113.40
X-ray of sacroiliac joints, 3 or more views 72202 $201.00 $120.60
X-ray of pelvis, minimum of 2 views 72220 $197.00 $118.20
Radiological supervision and interpretation X-ray of disc of vertebra, upper or middle spine 72285 $6,764.00 $4,058.40
Radiological supervision and interpretation X-ray of disc of vertebra, lower spine 72295 $6,764.00 $4,058.40
X-ray of collar bone 73000 $197.00 $118.20
X-ray of shoulder blade 73010 $204.00 $122.40
X-ray of shoulder, 1 view 73020 $197.00 $118.20
X-ray of shoulder, minimum of 2 views 73030 $230.00 $138.00
Radiological supervision and interpretation X-ray of shoulder joint 73040 $1,111.00 $666.60
X-ray of both collar bones 73050 $201.00 $120.60
X-ray of upper arm, minimum of 2 views 73060 $223.00 $133.80
X-ray of elbow, 2 views 73070 $197.00 $118.20
X-ray of elbow, minimum of 3 views 73080 $194.00 $116.40
Radiological supervision and interpretation X-ray of elbow 73085 $1,111.00 $666.60
X-ray of forearm, 2 views 73090 $140.00 $84.00
X-ray of arm in infant minimum of 2 views 73092 $300.00 $180.00
X-ray of wrist, 2 views 73100 $140.00 $84.00
X-ray of wrist, minimum of 3 views 73110 $201.00 $120.60
Radiological supervision and interpretation X-ray of wrist joint 73115 $1,111.00 $666.60
X-ray of hand, 2 views 73120 $236.00 $141.60
X-ray of hand, minimum of 3 views 73130 $201.00 $120.60
X-ray of fingers, minimum of 2 views 73140 $140.00 $84.00
CT scan of arm 73200 $1,290.00 $774.00
CT scan of arm with contrast 73201 $1,385.00 $831.00
CT scan of arm before and after contrast 73202 $1,653.00 $991.80
CT scan of arm blood vessels with contrast 73206 $2,492.00 $1,495.20
MRI scan of arm 73218 $1,872.00 $1,123.20
MRI scan of arm before and after contrast 73220 $2,576.00 $1,545.60
MRI scan of arm joint 73221 $1,237.00 $742.20
MRI scan of arm joint with contrast 73222 $1,963.00 $1,177.80
MRI scan of arm joint before and after contrast 73223 $2,396.00 $1,437.60
MRA scan of arm blood vessels 73225 $1,957.00 $1,174.20
MRA scan of arm blood vessels 73225 $1,396.00 $837.60
MRA scan of arm blood vessels 73225 $1,615.00 $969.00
X-ray of hip with pelvis, 1 view 73501 $172.00 $103.20
X-ray of hip with pelvis, 2-3 views 73502 $201.00 $120.60
X-ray of hip with pelvis, minimum of 4 views 73503 $249.00 $149.40
X-ray of both hips with pelvis, 2 views 73521 $240.00 $144.00
X-ray of both hips with pelvis, 3-4 views 73522 $257.00 $154.20
X-ray of both hips with pelvis, minimum of 5 views 73523 $440.00 $264.00
Radiological supervision and interpretation X-ray of hip joint 73525 $1,111.00 $666.60
X-ray of femur, 1 view 73551 $141.00 $84.60
X-ray of femur, minimum 2 views 73552 $145.00 $87.00
X-ray of knee, 1 or 2 views 73560 $201.00 $120.60
X-ray of knee, 3 views 73562 $306.00 $183.60
X-ray of knee, 4 or more views 73564 $311.00 $186.60
X-ray of both knees, standing, front to back view 73565 $329.00 $197.40
Radiological supervision and interpretation X-ray of knee joint 73580 $1,111.00 $666.60
X-ray of lower leg, 2 views 73590 $241.00 $144.60
X-ray of leg in infant minimum of 2 views 73592 $189.00 $113.40
X-ray of ankle, 2 views 73600 $197.00 $118.20
X-ray of ankle, minimum of 3 views 73610 $230.00 $138.00
Radiological supervision and interpretation X-ray of ankle joint 73615 $1,111.00 $666.60
X-ray of foot, 2 views 73620 $195.00 $117.00
X-ray of foot, minimum of 3 views 73630 $230.00 $138.00
X-ray of heel, minimum of 2 views 73650 $233.00 $139.80
X-ray of toes, minimum of 2 views 73660 $189.00 $113.40
CT scan leg 73700 $1,290.00 $774.00
CT scan leg with contrast injection 73701 $1,607.00 $964.20
CT scan of leg before and after contrast injection 73702 $1,862.00 $1,117.20
CT scan of lower leg blood vessels with contrast 73706 $1,801.00 $1,080.60
MRI scan of leg 73718 $1,859.00 $1,115.40
MRI scan of leg with contrast 73719 $2,089.00 $1,253.40
MRI scan of leg before and after contrast 73720 $2,595.00 $1,557.00
MRI scan of leg joint 73721 $1,237.00 $742.20
MRI scan of leg joint with contrast 73722 $1,994.00 $1,196.40
MRI scan of leg joint before and after contrast 73723 $2,392.00 $1,435.20
MRA scan of leg blood vessels 73725 $1,375.00 $825.00
MRA scan of leg blood vessels 73725 $2,034.00 $1,220.40
MRA scan of leg blood vessels 73725 $1,594.00 $956.40
X-ray of abdomen, 1 view 74018 $224.00 $134.40
X-ray of abdomen, 2 views 74019 $341.00 $204.60
Imaging of abdomen and chest 74022 $359.00 $215.40
CT scan abdomen 74150 $1,284.00 $770.40
CT scan of the abdomen with contrast or dye 74160 $1,510.00 $906.00
CT scan of the abdomen with contrast or dye 74160 $1,510.00 $906.00
CT scan abdomen before and after contrast 74170 $1,778.00 $1,066.80
CT scan of abdominal and pelvic blood vessels with contrast 74174 $2,448.00 $1,468.80
CT scan of abdominal blood vessels with contrast 74175 $1,794.00 $1,076.40
CT scan of abdomen and pelvis 74176 $2,041.00 $1,224.60
CT scan of abdomen and pelvis with contrast 74177 $2,677.00 $1,606.20
CT scan of abdomen and pelvis before and after contrast 74178 $3,204.00 $1,922.40
MRI scan of abdomen 74181 $1,627.00 $976.20
MRI scan of abdomen before and after contrast 74183 $2,585.00 $1,551.00
MRI scan of blood vessels of abdomen 74185 $2,021.00 $1,212.60
MRI scan of blood vessels of abdomen 74185 $3,032.00 $1,819.20
Radiological supervision and interpretation X-ray of lower abdominal and genital region 74190 $2,417.00 $1,450.20
X-ray of esophagus 74220 $387.00 $232.20
Imaging for evaluation of swallowing function 74230 $367.00 $220.20
Radiological supervision and interpretation of removal of foreign bodies in esophagus with balloon catheter 74235 $635.00 $381.00
X-ray of upper digestive tract 74240 $549.00 $329.40
X-ray of upper digestive tract, kidneys, urinary ducts (ureters), and bladder 74241 $514.00 $308.40
X-ray upper GI series, with small bowel films 74245 $724.00 $434.40
X-ray of upper digestive tract with contrast 74246 $517.00 $310.20
X-ray of upper digestive tract, kidneys, urinary ducts (ureters), and bladder with contrast 74247 $593.00 $355.80
X-ray of upper digestive tract with contrast followed by x-ray of small bowel at later point 74249 $799.00 $479.40
X-ray of small intestine 74250 $480.00 $288.00
X-ray of large bowel with contrast 74270 $671.00 $402.60
X-ray of large bowel with contrast 74280 $887.00 $532.20
Imaging of colon using enema 74283 $567.00 $340.20
Radiological supervision and interpretation X-ray of bile and/or pancreatic ducts during surgery 74300 $266.00 $159.60
Imaging of bile duct and/or pancreas 74301 $500.00 $300.00
Radiological supervision and interpretation of insertion of catheter into biliary duct using an endoscope 74328 $973.00 $583.80
Radiological supervision and interpretation of insertion of catheter into pancreatic duct using an endoscope 74329 $356.00 $213.60
Placement of catheter of gallbladder and pancreas under imaging using an endoscope 74330 $658.00 $394.80
Radiological supervision and interpretation of placement of long small bowel tube procedure 74340 $1,030.00 $618.00
Radiological supervision and interpretation of placement of long small bowel tube procedure 74340 $643.00 $385.80
Radiological supervision and interpretation of opening of digestive tract procedure 74360 $483.00 $289.80
Radiological supervision and interpretation of dilation of biliary duct (accessed through the skin) 74363 $430.00 $258.00
Imaging of urinary tract with injection of contrast into a vein 74400 $845.00 $507.00
Imaging of urinary tract 74420 $874.00 $524.40
Radiological supervision and interpretation X-ray of urinary tract 74425 $585.00 $351.00
Radiological supervision and interpretation X-ray of urinary bladder, minimum of 3 views 74430 $845.00 $507.00
Radiological supervision and interpretation X-ray of urinary bladder and urethra 74450 $845.00 $507.00
Radiological supervision and interpretation X-ray of urinary bladder and urethra 74455 $845.00 $507.00
Radiological supervision and interpretation X-ray of kidney cyst, lower back contrast injection 74470 $2,417.00 $1,450.20
Radiological supervision and interpretation of dilation of urinary ducts (ureters) or bladder canal (urethra) 74485 $3,941.00 $2,364.60
Radiological supervision and interpretation X-ray of uterine tubes and ovaries 74740 $1,042.00 $625.20
CT scan of heart with evaluation of blood vessel calcium 75571 $455.00 $273.00
CT scan of congenital heart structure defect with contrast 75573 $1,602.00 $961.20
CT scan of heart blood vessels and grafts with contrast dye 75574 $1,659.00 $995.40
Radiological supervision and interpretation X-ray of chest aorta 75605 $8,427.00 $5,056.20
Radiological supervision and interpretation X-ray of abdominal aorta 75625 $7,152.00 $4,291.20
Radiological supervision and interpretation X-ray of abdominal aorta and both leg arteries 75630 $5,196.00 $3,117.60
CT scan of abdominal aorta and both leg arteries with contrast 75635 $2,514.00 $1,508.40
Radiological supervision and interpretation of imaging of spinal artery 75705 $14,758.00 $8,854.80
Radiological supervision and interpretation of imaging of artery of one arm or leg 75710 $5,377.00 $3,226.20
Radiological supervision and interpretation of imaging of arteries of both arms or legs 75716 $5,377.00 $3,226.20
Radiological supervision and interpretation of imaging of abdominal artery 75726 $10,805.00 $6,483.00
Radiological supervision and interpretation of imaging of artery of one adrenal gland 75731 $8,426.00 $5,055.60
Radiological supervision and interpretation of imaging of arteries of both adrenal glands 75733 $8,426.00 $5,055.60
Radiological supervision and interpretation of imaging of artery of pelvis 75736 $8,427.00 $5,056.20
Radiological supervision and interpretation of imaging of artery of one lung 75741 $8,426.00 $5,055.60
Radiological supervision and interpretation of imaging of arteries of both lungs 75743 $8,427.00 $5,056.20
Radiological supervision and interpretation of imaging of lung artery, contrast inserted by catheter or injection into vein 75746 $2,708.00 $1,624.80
Radiological supervision and interpretation of imaging of artery of breast 75756 $2,708.00 $1,624.80
Radiological supervision and interpretation of imaging of artery of breast 75756 $5,495.00 $3,297.00
Radiological supervision and interpretation of imaging of artery 75774 $1,794.00 $1,076.40
Radiological supervision and interpretation of imaging of previous placed shunt 75809 $257.00 $154.20
Radiological supervision and interpretation X-ray of vein of spleen and liver 75810 $8,426.00 $5,055.60
Radiological supervision and interpretation of imaging of vein of one arm or leg 75820 $2,145.00 $1,287.00
Radiological supervision and interpretation of imaging of veins of both arms or legs 75822 $2,417.00 $1,450.20
Radiological supervision and interpretation of imaging of major abdominal vein 75825 $8,427.00 $5,056.20
Radiological supervision and interpretation of imaging of major chest vein 75827 $2,801.00 $1,680.60
Radiological supervision and interpretation of imaging of vein of one kidney 75831 $8,427.00 $5,056.20
Radiological supervision and interpretation of imaging of vein of both kidneys 75833 $8,426.00 $5,055.60
Radiological supervision and interpretation of imaging of vein of one adrenal gland 75840 $8,426.00 $5,055.60
Radiological supervision and interpretation of imaging of veins of both adrenal glands 75842 $8,426.00 $5,055.60
Radiological supervision and interpretation of imaging of vein system in head or neck vein 75860 $5,495.00 $3,297.00
Radiological supervision and interpretation of imaging of vein system in head or neck vein 75860 $2,708.00 $1,624.80
Radiological supervision and interpretation of imaging of vein system of head 75870 $1,042.00 $625.20
Radiological supervision and interpretation of imaging of vein system of head 75870 $2,275.00 $1,365.00
Radiological supervision and interpretation X-ray of spinal canal vein 75872 $2,708.00 $1,624.80
Radiological supervision and interpretation of imaging of liver vein with assessment of blood flow, injection of contrast (accessed through the skin) 75885 $8,427.00 $5,056.20
Radiological supervision and interpretation of imaging of liver vein, injection of contrast (accessed through the skin) 75887 $2,708.00 $1,624.80
Radiological supervision and interpretation of imaging of liver vein with assessment of blood flow 75889 $8,427.00 $5,056.20
Radiological supervision and interpretation of imaging of liver vein 75891 $8,426.00 $5,055.60
Radiological supervision and interpretation of drawing blood via catheter procedure 75893 $8,610.00 $5,166.00
Radiological supervision and interpretation of obstruction of blood vessel via catheter 75894 $6,872.00 $4,123.20
Imaging of blood vessel 75898 $1,680.00 $1,008.00
Radiological supervision and interpretation of removal of obstructive material in catheter procedure 75901 $809.00 $485.40
Radiological supervision and interpretation of removal of obstructive material from large vein catheter procedure 75902 $305.00 $183.00
Radiological supervision and interpretation of repair of chest aorta with graft 75956 $4,165.00 $2,499.00
Radiological supervision and interpretation of repair of chest aorta with graft 75957 $4,165.00 $2,499.00
Radiological supervision and interpretation of placement of blood vessel prosthesis procedure 75958 $4,833.00 $2,899.80
Radiological supervision and interpretation of placement of blood vessel prosthesis procedure 75959 $4,833.00 $2,899.80
Radiological supervision and interpretation of biopsy procedure 75970 $2,188.00 $1,312.80
Radiological supervision and interpretation of change of tube (accessed through the skin) or drainage catheter with contrast monitoring 75984 $610.00 $366.00
Radiological supervision and interpretation of placement of catheter with drainage (accessed through the skin) procedure 75989 $379.00 $227.40
Imaging guidance for procedure, up to 1 hour 76000 $528.00 $316.80
Imaging from nose to rectum, single view, child 76010 $189.00 $113.40
Imaging for abscess or abnormal drainage tract procedure 76080 $1,042.00 $625.20
Imaging of surgical specimen 76098 $1,035.00 $621.00
Single plane imaging procedure 76100 $381.00 $228.60
3D radiographic procedure 76376 $275.00 $165.00
3D radiographic procedure with computerized image postprocessing 76377 $543.00 $325.80
CT scan limited or follow-up study 76380 $654.00 $392.40
Ultrasound of brain 76506 $507.00 $304.20
Ultrasound of eye disease, growth, or structure 76512 $132.00 $79.20
Ultrasound of head and neck 76536 $508.00 $304.80
Ultrasound of chest 76604 $457.00 $274.20
Ultrasound of one breast 76641 $250.00 $150.00
Ultrasound of one breast 76642 $250.00 $150.00
Ultrasound of the abdomen 76700 $543.00 $325.80
Ultrasound of the abdomen 76700 $543.00 $325.80
Ultrasound of abdomen 76705 $478.00 $286.80
Ultrasound evaluation of abdominal aorta to detect bulging (aneurysm) 76706 $436.00 $261.60
Ultrasound behind abdominal cavity 76770 $538.00 $322.80
Ultrasound behind abdominal cavity, limited 76775 $442.00 $265.20
Ultrasound of transplanted kidney 76776 $627.00 $376.20
Ultrasound of spinal canal 76800 $412.00 $247.20
Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) single or first fetus 76801 $442.00 $265.20
Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) 76802 $140.00 $84.00
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $534.00 $320.40
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $89.00 $53.40
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $534.00 $320.40
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $89.00 $53.40
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) 76810 $265.00 $159.00
Abdominal ultrasound of pregnant uterus single or first fetus 76811 $626.00 $375.60
Abdominal ultrasound of pregnant uterus 76812 $406.00 $243.60
Ultrasound of pregnant uterus (first trimester) single or first fetus 76813 $442.00 $265.20
Ultrasound of pregnant uterus (first trimester), abdominal or vaginal approach 76814 $167.00 $100.20
Ultrasound of pregnant uterus, 1 or more fetus(es) 76815 $442.00 $265.20
Ultrasound re-evaluation of pregnant uterus, per fetus 76816 $412.00 $247.20
Vaginal ultrasound of pregnant uterus 76817 $457.00 $274.20
Ultrasound and monitoring of heart of fetus 76818 $457.00 $274.20
Ultrasound of fetal umbilical artery flow rate 76820 $361.00 $216.60
Ultrasound pelvis through vagina 76830 $457.00 $274.20
Ultrasound pelvis through vagina 76830 $138.00 $82.80
Ultrasound of uterus 76831 $626.00 $375.60
Ultrasound of pelvis 76857 $478.00 $286.80
Ultrasound of pelvis 76857 $411.00 $246.60
Ultrasound of scrotum 76870 $501.00 $300.60
Ultrasound of rectum 76872 $133.00 $79.80
Ultrasound of prostate 76873 $309.00 $185.40
Complete ultrasound of joint of arm or leg 76881 $489.00 $293.40
Partial ultrasound of joint or other non-blood vessel structure of arm or leg 76882 $297.00 $178.20
Ultrasound of hips, infant 76886 $409.00 $245.40
Ultrasound guidance for repair of blood vessel 76936 $992.00 $595.20
Ultrasound guidance for accessing into blood vessel 76937 $278.00 $166.80
Ultrasound guidance for tissue destruction 76940 $228.00 $136.80
Ultrasonic guidance imaging supervision and interpretation for insertion of needle 76942 $591.00 $354.60
Ultrasonic guidance imaging supervision and interpretation for insertion of needle 76942 $134.00 $80.40
Ultrasonic guidance imaging supervision and interpretation for amniocentesis 76946 $76.00 $45.60
Ultrasonic guidance for administration of radiation therapy 76965 $162.00 $97.20
Ultrasound follow-up study 76970 $432.00 $259.20
Ultrasonic guidance during surgery 76998 $1,116.00 $669.60
Fluoroscopic guidance for insertion, replacement or removal of central venous access device 77001 $536.00 $321.60
Fluoroscopic guidance for insertion of needle 77002 $505.00 $303.00
Fluoroscopic guidance for insertion of needle 77002 $509.00 $305.40
Fluoroscopic guidance for injection into spine or muscle next to spine 77003 $358.00 $214.80
CT scan guidance for stereotactic localization 77011 $901.00 $540.60
Radiological supervision and interpretation of CT guidance for needle insertion 77012 $1,635.00 $981.00
CT scan guidance for and monitoring of tissue destruction 77013 $2,168.00 $1,300.80
Radiological supervision and interpretation of MRI guidance for insertion of needle 77021 $1,657.00 $994.20
MRI of one breast 77046 $2,072.00 $1,243.20
MRI of both breasts 77047 $2,849.00 $1,709.40
MRI of one breast with and without contrast 77048 $3,108.00 $1,864.80
MRI of both breasts with and without contrast 77049 $4,274.00 $2,564.40
Radiological supervision and interpretation of imaging of breast duct 77053 $1,042.00 $625.20
Radiological supervision and interpretation of imaging of breast ducts 77054 $2,011.00 $1,206.60
Digital tomography of one breast 77061 $71.00 $42.60
Digital tomography of both breasts 77062 $71.00 $42.60
Screening digital tomography of both breasts 77063 $71.00 $42.60
Mammography of one breast 77065 $358.00 $214.80
Mammography of one breast 77065 $254.00 $152.40
Mammography of both breasts 77066 $337.00 $202.20
Mammogram of both breasts 77067 $270.00 $162.00
Mammogram of both breasts 77067 $270.00 $162.00
Imaging for bone age assessment 77072 $194.00 $116.40
Imaging for bone length assessment 77073 $201.00 $120.60
X-ray of bones 77074 $310.00 $186.00
X-ray survey of forearm or wrist bone density 77075 $442.00 $265.20
X-ray survey of bones, infant 77076 $389.00 $233.40
Imaging of 2 or more joints, single view 77077 $201.00 $120.60
Bone density measurement using dedicated X-ray machine 77080 $308.00 $184.80
Bone density measurement using dedicated X-ray machine 77081 $221.00 $132.60
Management of radiation therapy, simple 77261 $87.00 $52.20
Management of radiation therapy, intermediate 77262 $106.00 $63.60
Management of radiation therapy, complex 77263 $155.00 $93.00
Management of radiation therapy simulation, simple 77280 $984.00 $590.40
Management of radiation therapy, simulation, complex 77290 $1,799.00 $1,079.40
Management of radiation therapy, 3D 77295 $5,053.00 $3,031.80
Calculation of radiation therapy dose 77300 $544.00 $326.40
Management of modulation radiotherapy planning 77301 $7,179.00 $4,307.40
Radiation therapy plan 77306 $2,629.00 $1,577.40
Radiation therapy plan 77307 $4,528.00 $2,716.80
Radiation therapy plan 77316 $2,060.00 $1,236.00
Radiation therapy total body port plan 77321 $1,019.00 $611.40
Special radiation therapy planning 77331 $377.00 $226.20
Radiation treatment devices, design and construction, simple 77332 $699.00 $419.40
Radiation treatment devices, design and construction, intermediate 77333 $724.00 $434.40
Radiation treatment devices, design and construction, complex 77334 $991.00 $594.60
Radiation therapy consultation per week 77336 $798.00 $478.80
Design and construction of device for radiation therapy 77338 $1,228.00 $736.80
Radiation therapy consultation 77370 $956.00 $573.60
Radiation therapy delivery, stereotactic radiosurgery (SRS) for cranial growths, per session 77372 $12,160.00 $7,296.00
Stereotactic body radiation therapy 1 or more lesions using imaging guidance 77373 $6,507.00 $3,904.20
Radiation therapy delivery 77385 $2,258.00 $1,354.80
Radiation therapy delivery 77386 $4,272.00 $2,563.20
Guidance for localization of target delivery of radiation treatment 77387 $900.00 $540.00
Guidance for localization of target delivery of radiation treatment 77387 $84.00 $50.40
Radiation treatment delivery 77402 $646.00 $387.60
Radiation treatment delivery 77412 $1,008.00 $604.80
Therapeutic radiology port films 77417 $1,220.00 $732.00
Radiation treatment management, 5 treatments 77427 $173.00 $103.80
Radiation treatment management, 1 or 2 treatments 77431 $270.00 $162.00
Stereotactic radiation treatment management of brain lesions, complete course of treatment consisting of 1 session 77432 $512.00 $307.20
Stereotactic radiation treatment management of 1 or more lesions using imaging guidance, per treatment course 77435 $772.00 $463.20
Special radiation treatment procedure 77470 $1,401.00 $840.60
High dose brachytherapy , 1 channel 77770 $1,646.00 $987.60
High dose brachytherapy , 2- 12 channels 77771 $1,747.00 $1,048.20
High dose brachytherapy , more than 12 channels 77772 $1,687.00 $1,012.20
Nuclear medicine imaging for thyroid uptake measurements 78012 $462.00 $277.20
Nuclear medicine imaging of thyroid 78013 $1,038.00 $622.80
Nuclear medicine imaging for thyroid uptake measurements 78014 $1,181.00 $708.60
Nuclear medicine limited study for thyroid cancer 78015 $1,253.00 $751.80
Nuclear medicine additional studies for thyroid cancer 78016 $1,331.00 $798.60
Nuclear medicine whole body study for thyroid cancer 78018 $1,471.00 $882.60
Nuclear medicine study for thyroid cancer 78020 $303.00 $181.80
Imaging of parathyroid 78070 $1,338.00 $802.80
Imaging of parathyroid with nuclear medicine study 78071 $2,417.00 $1,450.20
Imaging of bone marrow limited area 78102 $1,133.00 $679.80
Imaging of bone marrow multiple areas 78103 $1,133.00 $679.80
Imaging of bone marrow whole body 78104 $1,135.00 $681.00
Imaging of lymphatic tissue and lymph node 78195 $1,620.00 $972.00
Imaging of liver 78201 $2,500.00 $1,500.00
Imaging of liver blood flow 78202 $2,500.00 $1,500.00
Imaging of liver and spleen 78215 $1,221.00 $732.60
Imaging of liver and spleen with blood flow 78216 $1,221.00 $732.60
Imaging of liver and bile duct system 78226 $1,278.00 $766.80
Imaging of liver and bile duct system with use of drugs 78227 $1,534.00 $920.40
Imaging of salivary gland 78230 $1,062.00 $637.20
Imaging of salivary gland 78231 $1,062.00 $637.20
Nuclear medicine study of salivary gland 78232 $1,062.00 $637.20
Stomach and esophagus regurgitation study 78262 $1,181.00 $708.60
Stomach emptying study 78264 $1,350.00 $810.00
Stomach emptying and small bowel transit study 78265 $761.00 $456.60
Stomach emptying and small bowel with colon transit study 78266 $1,009.00 $605.40
Acute digestive tract blood loss imaging 78278 $1,627.00 $976.20
Intestine imaging 78290 $1,631.00 $978.60
Peritoneal-venous shunt patency test 78291 $1,156.00 $693.60
Bone and/or joint imaging 78300 $1,062.00 $637.20
Bone and/or joint imaging, multiple areas 78305 $1,066.00 $639.60
Bone and/or joint imaging, whole body 78306 $1,175.00 $705.00
Bone and/or joint imaging, 3 phase study 78315 $1,617.00 $970.20
Non-cardiac vascular flow imaging 78445 $1,042.00 $625.20
Nuclear medicine study of vessels of heart using drugs or exercise single study 78451 $3,775.00 $2,265.00
Nuclear medicine study of vessels of heart using drugs or exercise multiple studies 78452 $3,775.00 $2,265.00
Nuclear medicine single study of vessels of heart using drugs or exercise 78453 $3,775.00 $2,265.00
Nuclear medicine multiple studies of vessels of heart at rest, using drugs, or exercise 78454 $3,775.00 $2,265.00
Venography for blood clot in vein, one leg or arm 78457 $2,500.00 $1,500.00
Venography for blood clot in veins, both legs or arms 78458 $1,042.00 $625.20
Nuclear medicine study of heart muscle following heart attack 78466 $1,254.00 $752.40
Nuclear medicine study of heart muscle following heart attack with evaluation of blood ejection from heart 78468 $1,254.00 $752.40
Nuclear medicine study of heart muscle following heart attack 78469 $2,500.00 $1,500.00
Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study 78472 $1,222.00 $733.20
Nuclear medicine study of heart function wall motion at rest and stress with evaluation of blood ejection from heart, multiple studies 78473 $1,254.00 $752.40
Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study 78481 $1,254.00 $752.40
Nuclear medicine study of heart wall motion at rest and stress with evaluation of blood ejection from heart, multiple studies 78483 $3,775.00 $2,265.00
Nuclear medicine study heart muscle at rest or stress single study 78491 $4,287.00 $2,572.20
Nuclear medicine study heart muscle at rest and/or stress multiple studies 78492 $4,287.00 $2,572.20
Nuclear medicine study of blood circulation in the lungs 78580 $1,132.00 $679.20
Nuclear medicine study of lung ventilation and blood circulation in the lungs 78582 $1,767.00 $1,060.20
Nuclear medicine study with measurement of blood circulation in the lungs 78597 $1,081.00 $648.60
Nuclear medicine study with measurement of blood circulation in the lungs and ventilation 78598 $1,739.00 $1,043.40
Imaging of brain, less than 4 static views 78600 $876.00 $525.60
Imaging of brain with blood flow, less than 4 static views 78601 $1,746.00 $1,047.60
Imaging of brain with blood flow, minimum of 4 static views 78605 $1,746.00 $1,047.60
Imaging of brain with blood flow, minimum of 4 static views 78606 $1,746.00 $1,047.60
Nuclear medicine study brain with metabolic evaluation 78608 $6,372.00 $3,823.20
Imaging of brain, blood flow 78610 $1,746.00 $1,047.60
Imaging of brain and spinal cord fluid flow at base of brain 78630 $1,746.00 $1,047.60
Imaging of brain and spinal cord fluid flow in brain compartments (ventricles) 78635 $1,746.00 $1,047.60
Imaging of brain and spinal cord fluid flow shunt evaluation 78645 $1,746.00 $1,047.60
Imaging of brain and spinal cord fluid leakage detection and localization 78650 $2,500.00 $1,500.00
Nuclear medicine study of tear drainage structure of eye 78660 $876.00 $525.60
Imaging of kidney 78700 $1,364.00 $818.40
Nuclear medicine study of kidney with assessment of blood flow 78701 $1,364.00 $818.40
Nuclear medicine study of kidney with assessment of blood flow and function 78707 $1,364.00 $818.40
Nuclear medicine study of kidney with assessment of blood flow and function 78708 $1,413.00 $847.80
Nuclear medicine study of kidney with assessment of blood flow and function 78709 $1,627.00 $976.20
Nuclear medicine study of remaining urine in bladder 78730 $320.00 $192.00
Nuclear medicine backwash of urine into kidney 78740 $1,364.00 $818.40
Nuclear medicine study of testicles and blood vessel flow 78761 $1,364.00 $818.40
Nuclear medicine study of radioactive material distribution at tumor location 78800 $1,253.00 $751.80
Nuclear medicine study of radioactive material distribution at multiple tumor locations 78801 $1,253.00 $751.80
Nuclear medicine study of radioactive material distribution at tumor locations in whole body, single day imaging 78802 $2,500.00 $1,500.00
Nuclear medicine study of radioactive material distribution 78803 $2,500.00 $1,500.00
Nuclear medicine study of radioactive material distribution 78803 $1,362.00 $817.20
Nuclear medicine study of radioactive material distribution 78803 $1,364.00 $818.40
Nuclear medicine study of radioactive material distribution 78803 $1,588.00 $952.80
Nuclear medicine study of radioactive material distribution 78803 $2,149.00 $1,289.40
Nuclear medicine study of radioactive material distribution 78803 $3,785.00 $2,271.00
Nuclear medicine study of radioactive material distribution of whole body, requiring 2 or more days imaging 78804 $3,785.00 $2,271.00
Nuclear medicine study of radioactive material distribution at site of inflammation 78805 $2,500.00 $1,500.00
Nuclear medicine study of radioactive material distribution at sites of inflammation in whole body 78806 $2,500.00 $1,500.00
Nuclear medicine study of radioactive material distribution at site of inflammation 78807 $2,149.00 $1,289.40
Nuclear medicine study with CT imaging 78814 $7,768.00 $4,660.80
Nuclear medicine study with CT imaging skull base to mid-thigh 78815 $8,572.00 $5,143.20
Nuclear medicine study with CT imaging whole body 78816 $8,776.00 $5,265.60
Radioactive material therapy into vein 79101 $869.00 $521.40
Radioactive material therapy into vein 79403 $1,209.00 $725.40
Radioactive material therapy into artery 79445 $591.00 $354.60
Blood test, basic group of blood chemicals 80047 $111.00 $66.60
Basic Metabolic Panel 80048 $60.00 $36.00
Basic Metabolic Panel 80048 $60.00 $36.00
General health panel 80050 $271.00 $162.60
Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) 80051 $85.00 $51.00
Comprehensive Metabolic Panel 80053 $155.00 $93.00
Comprehensive Metabolic Panel 80053 $155.00 $93.00
Obstetric blood test panel 80055 $385.00 $231.00
Lipid Panel 80061 $93.00 $55.80
Lipid Panel 80061 $93.00 $55.80
Kidney function blood test panel 80069 $67.00 $40.20
Acute hepatitis panel 80074 $307.00 $184.20
Liver function blood test panel 80076 $72.00 $43.20
Amikacin (antibiotic) level 80150 $57.00 $34.20
Caffeine level 80155 $54.00 $32.40
Carbamazepine level 80156 $100.00 $60.00
Cyclosporine level 80158 $57.00 $34.20
Digoxin level 80162 $92.00 $55.20
Digoxin level 80163 $218.00 $130.80
Valproic acid level 80164 $97.00 $58.20
Valproic acid level 80165 $43.00 $25.80
Ethosuximide level 80168 $70.00 $42.00
Everolimus level 80169 $182.00 $109.20
Gentamicin (antibiotic) level 80170 $162.00 $97.20
Haloperidol level 80173 $94.00 $56.40
Lidocaine level 80176 $81.00 $48.60
Lithium level 80178 $61.00 $36.60
Oxcarbazepine level 80183 $136.00 $81.60
Phenobarbital level 80184 $101.00 $60.60
Phenobarbital level 80184 $36.00 $21.60
Phenytoin level 80185 $92.00 $55.20
Phenytoin level 80186 $86.00 $51.60
Primidone level 80188 $47.00 $28.20
Procainamide level 80192 $83.00 $49.80
Quinidine level 80194 $75.00 $45.00
Sirolimus level 80195 $52.00 $31.20
Tacrolimus level 80197 $59.00 $35.40
Theophylline level 80198 $94.00 $56.40
Theophylline level 80198 $76.00 $45.60
Tobramycin (antibiotic) level 80200 $72.00 $43.20
Topiramate level 80201 $65.00 $39.00
Vancomycin (antibiotic) level 80202 $134.00 $80.40
Quantitation of therapeutic drug 80299 $61.00 $36.60
Quantitation of therapeutic drug 80299 $305.00 $183.00
Quantitation of therapeutic drug 80299 $170.00 $102.00
Quantitation of therapeutic drug 80299 $54.00 $32.40
Quantitation of therapeutic drug 80299 $52.00 $31.20
Quantitation of therapeutic drug 80299 $156.00 $93.60
Quantitation of therapeutic drug 80299 $41.00 $24.60
Quantitation of therapeutic drug 80299 $220.00 $132.00
Quantitation of therapeutic drug 80299 $158.00 $94.80
Quantitation of therapeutic drug 80299 $232.00 $139.20
Quantitation of therapeutic drug 80299 $75.00 $45.00
Quantitation of therapeutic drug 80299 $100.00 $60.00
Quantitation of therapeutic drug 80299 $86.00 $51.60
Quantitation of therapeutic drug 80299 $300.00 $180.00
Quantitation of therapeutic drug 80299 $182.00 $109.20
Quantitation of therapeutic drug 80299 $248.00 $148.80
Quantitation of therapeutic drug 80299 $57.00 $34.20
Quantitation of therapeutic drug 80299 $85.00 $51.00
Quantitation of therapeutic drug 80299 $47.00 $28.20
Quantitation of therapeutic drug 80299 $113.00 $67.80
Testing for presence of drug 80305 $67.00 $40.20
Testing for presence of drug 80305 $108.00 $64.80
Testing for presence of drug 80305 $46.00 $27.60
Testing for presence of drug 80305 $35.00 $21.00
Testing for presence of drug 80307 $84.00 $50.40
Testing for presence of drug 80307 $16.00 $9.60
Testing for presence of drug 80307 $34.00 $20.40
Testing for presence of drug 80307 $104.00 $62.40
Testing for presence of drug 80307 $160.00 $96.00
Testing for presence of drug 80307 $145.00 $87.00
Testing for presence of drug 80307 $172.00 $103.20
Testing for presence of drug 80307 $152.00 $91.20
Alcohols levels 80320 $259.00 $155.40
Alcohols levels 80320 $76.00 $45.60
Alcohols levels 80321 $181.00 $108.60
Alkaloids levels 80323 $59.00 $35.40
Amphetamines levels 80324 $43.00 $25.80
Amphetamines levels 80324 $85.00 $51.00
Amphetamines levels 80326 $101.00 $60.60
Anabolic steroids levels 80327 $75.00 $45.00
Analgesics levels 80329 $152.00 $91.20
Analgesics levels 80329 $135.00 $81.00
Antidepressants levels 80333 $59.00 $35.40
Antidepressants levels 80335 $55.00 $33.00
Antidepressants levels 80336 $110.00 $66.00
Antidepressants levels 80337 $62.00 $37.20
Antidepressants levels 80338 $173.00 $103.80
Antiepileptics levels 80339 $104.00 $62.40
Antipsychotics levels 80342 $115.00 $69.00
Barbiturates levels 80345 $75.00 $45.00
Benzodiazepines levels 80346 $75.00 $45.00
Benzodiazepines levels 80346 $61.00 $36.60
Benzodiazepines levels 80347 $51.00 $30.60
Buprenorphine level 80348 $130.00 $78.00
Cannabinoids levels 80349 $62.00 $37.20
Cannabinoids levels 80352 $123.00 $73.80
Cocaine level 80353 $61.00 $36.60
Cocaine level 80353 $169.00 $101.40
Fentanyl level 80354 $167.00 $100.20
Heroin metabolite level 80356 $213.00 $127.80
Ketamine and norketamine levels 80357 $241.00 $144.60
Methadone level 80358 $85.00 $51.00
Methadone level 80358 $113.00 $67.80
Methylenedioxyamphetamines levels 80359 $42.00 $25.20
Methylphenidate level 80360 $153.00 $91.80
Opiates levels 80361 $68.00 $40.80
Opiates levels 80361 $214.00 $128.40
Opiates levels 80361 $67.00 $40.20
Opioids levels 80364 $153.00 $91.80
Oxycodone levels 80365 $205.00 $123.00
Oxycodone levels 80365 $25.00 $15.00
Propoxyphene level 80367 $113.00 $67.80
Skeletal muscle relaxants levels 80369 $59.00 $35.40
Skeletal muscle relaxants levels 80369 $397.00 $238.20
Tramadol level 80373 $78.00 $46.80
Drugs or substances measurement 80375 $171.00 $102.60
Drugs or substances measurement 80377 $199.00 $119.40
Comprehensive, clinical pathology consultation 80502 $56.00 $33.60
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $15.00 $9.00
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $16.00 $9.60
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $16.00 $9.60
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $23.00 $13.80
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $15.00 $9.00
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $23.00 $13.80
Urinalysis, by dipstick or tablet reagent not automated without a microscope 81001 $41.00 $24.60
Urinalysis, by dipstick or tablet reagent not automated without a microscope 81001 $41.00 $24.60
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $14.00 $8.40
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $14.00 $8.40
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $19.00 $11.40
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $19.00 $11.40
Automated urinalysis test 81003 $24.00 $14.40
Analysis of urine 81005 $17.00 $10.20
Urinalysis using microscope 81015 $22.00 $13.20
Urine pregnancy test 81025 $43.00 $25.80
Urine volume measurement 81050 $22.00 $13.20
Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common variants 81121 $656.00 $393.60
Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants 81162 $1,892.00 $1,135.20
Gene analysis (ABL proto-oncogene 1, non-receptor tyrosine kinase) 81170 $563.00 $337.80
Gene analysis (androgen receptor) for characterization of alleles 81204 $354.00 $212.40
Translocation analysis (BCR/ABL1) minor breakpoint 81206 $527.00 $316.20
Gene analysis (v-raf murine sarcoma viral oncogene homolog B1) 81210 $358.00 $214.80
Gene analysis (calreticulin), common variants 81219 $620.00 $372.00
Gene analysis (cystic fibrosis transmembrane conductance regular) common variants 81220 $580.00 $348.00
Gene analysis (cystic fibrosis transmembrane conductance regular) known familial variants 81221 $605.00 $363.00
Gene analysis (cystic fibrosis transmembrane conductance regular) duplication or deletion variants 81222 $698.00 $418.80
Gene analysis (cystic fibrosis transmembrane conductance regular) full gene sequence 81223 $698.00 $418.80
Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants 81225 $908.00 $544.80
Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common variants 81226 $951.00 $570.60
Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 9) common variants 81227 $407.00 $244.20
Genome-wide microarray analysis for copy number and single nucleotide polymorphism variants 81229 $2,108.00 $1,264.80
Gene analysis (dihydropyrimidine dehydrogenase) for common variant 81232 $708.00 $424.80
Gene analysis (epidermal growth factor receptor), common variants 81235 $669.00 $401.40
Gene analysis (prothrombin, coagulation factor II) A variant 81240 $147.00 $88.20
Gene analysis (coagulation factor V) Leiden variant 81241 $160.00 $96.00
Gene analysis (Fanconi anemia, complementation group C) common variant 81242 $259.00 $155.40
Gene analysis (fragile X mental retardation) abnormal alleles 81243 $333.00 $199.80
Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants 81245 $241.00 $144.60
Test for detecting genes associated with blood cancer 81246 $156.00 $93.60
Gene analysis (hemochromatosis) common variants 81256 $277.00 $166.20
Gene analysis (alpha globin 1 and alpha globin 2) full sequence analysis 81259 $684.00 $410.40
Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population amplified methodology 81261 $640.00 $384.00
Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population direct probe methodology 81262 $320.00 $192.00
Gene rearrangement analysis (immunoglobulin heavy chain locus), variable region somatic mutation analysis 81263 $846.00 $507.60
Gene rearrangement analysis (immunoglobulin kappa light chain locus) to detect abnormal clonal population 81264 $429.00 $257.40
Gene analysis (Janus kinase 2) variant 81270 $427.00 $256.20
Gene analysis (Huntingtin) for abnormal alleles 81271 $347.00 $208.20
Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), targeted sequence 81272 $456.00 $273.60
Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), D816 variants 81273 $243.00 $145.80
Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons 12 and 13 81275 $489.00 $293.40
Gene analysis (O-6-methylguanine-DNA methyltransferase) for promoter methylation 81287 $646.00 $387.60
Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants 81291 $150.00 $90.00
Microsatellite instability analysis 81301 $1,116.00 $669.60
Gene analysis (nucleophosmin) exon 12 variants 81310 $520.00 $312.00
Gene analysis for cancer (neuroblastoma) 81311 $796.00 $477.60
Test for detecting genes associated with prostate cancer 81313 $605.00 $363.00
Gene analysis ((platelet-derived growth factor receptor, alpha polypeptide) targeted sequence 81314 $938.00 $562.80
Gene analysis (peripheral myelin protein 22), duplication or deletion analysis 81324 $1,135.00 $681.00
Gene analysis (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) common variants 81332 $77.00 $46.20
Gene analysis (T cell antigen receptor beta) amplification methodology 81340 $349.00 $209.40
Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma) 81342 $349.00 $209.40
Gene analysis (UDP glucuronosyltransferase 1 family, polypeptide A1) common variants 81350 $968.00 $580.80
Gene analysis (vitamin K epoxide reductase complex subunit 1) common variants 81355 $407.00 $244.20
HLA class I typing low resolution 81372 $256.00 $153.60
HLA class I typing low resolution one locus 81373 $333.00 $199.80
HLA class I typing, low resolution one antigen equivalent 81374 $240.00 $144.00
HLA class II typing low resolution HLA-DRB1/3/4/5 and -DQB1 81375 $256.00 $153.60
HLA class II typing low resolution one locus 81376 $103.00 $61.80
HLA class II typing low resolution one locus 81376 $271.00 $162.60
HLA class I typing high resolution one allele or allele group 81381 $281.00 $168.60
Molecular pathology procedure level 1 81400 $390.00 $234.00
Molecular pathology procedure level 2 81401 $362.00 $217.20
Molecular pathology procedure level 2 81401 $646.00 $387.60
Molecular pathology procedure level 2 81401 $327.00 $196.20
Molecular pathology procedure level 2 81401 $486.00 $291.60
Molecular pathology procedure level 4 81403 $550.00 $330.00
Molecular pathology procedure level 5 81404 $738.00 $442.80
Molecular pathology procedure level 6 81405 $603.00 $361.80
Molecular pathology procedure level 7 81406 $681.00 $408.60
Molecular pathology procedure level 7 81406 $1,999.00 $1,199.40
Molecular pathology procedure level 7 81406 $3,129.00 $1,877.40
Molecular pathology procedure level 8 81407 $1,999.00 $1,199.40
Molecular pathology procedure level 9 81408 $2,411.00 $1,446.60
Test for detecting genes 81440 $2,860.00 $1,716.00
Test for detecting genes associated with cancer of body organ 81445 $1,274.00 $764.40
Test for detecting genes associated with cancer of body organ 81445 $12,000.00 $7,200.00
Test for detecting genes associated with blood related cancer 81450 $2,455.00 $1,473.00
Test for detecting genes associated with cancer 81455 $2,320.00 $1,392.00
Test for detecting genes associated with disease 81460 $2,860.00 $1,716.00
Molecular pathology procedure 81479 $2,920.00 $1,752.00
Molecular pathology procedure 81479 $1,592.00 $955.20
Molecular pathology procedure 81479 $3,672.00 $2,203.20
Molecular pathology procedure 81479 $603.00 $361.80
Molecular pathology procedure 81479 $723.00 $433.80
Molecular pathology procedure 81479 $7.00 $4.20
Fetal congenital abnormalities, biochemical assays of four analytes (afp, ue3, hcg [any form], dia) utilizing maternal serum, algorithm reported as a risk score 81511 $161.00 $96.60
Biochemical assays for evaluation of chronic Hepatitis C virus infection 81596 $250.00 $150.00
Ketone bodies analysis 82010 $98.00 $58.80
Chemical analysis for genetic disorder 82016 $40.00 $24.00
Chemical test for genetic disorder 82017 $80.00 $48.00
Adrenocorticotropic hormone (ACTH) level 82024 $115.00 $69.00
Albumin (protein) level 82040 $26.00 $15.60
Albumin (protein) level 82040 $30.00 $18.00
Cerebrospinal fluid, or amniotic fluid albumin (protein) level 82042 $42.00 $25.20
Cerebrospinal fluid, or amniotic fluid albumin (protein) level 82042 $25.00 $15.00
Urine microalbumin (protein) level 82043 $41.00 $24.60
Aldolase (enzyme) level 82085 $43.00 $25.80
Aldosterone hormone level 82088 $121.00 $72.60
Alpha-1-antitrypsin (protein) blood test 82103 $47.00 $28.20
Alpha-1-antitrypsin (protein) blood test 82104 $20.00 $12.00
Alpha-fetoprotein (AFP) level, serum 82105 $115.00 $69.00
Alpha-fetoprotein (AFP) level, serum 82105 $46.00 $27.60
Aluminum level 82108 $76.00 $45.60
Amino acid analysis 82131 $104.00 $62.40
Aminolevulinic acid (protein) level 82135 $107.00 $64.20
Aminolevulinic acid (protein) level 82135 $159.00 $95.40
Amino acid level, multiple amino acids 82136 $147.00 $88.20
Amino acid level, multiple amino acids 82136 $30.00 $18.00
Amino acid level, multiple amino acids 82139 $187.00 $112.20
Ammonia level 82140 $98.00 $58.80
Amylase (enzyme) level 82150 $71.00 $42.60
Amylase (enzyme) level 82150 $238.00 $142.80
Androstanediol glucuronide (hormone) level 82154 $187.00 $112.20
Androstenedione (hormone) level 82157 $88.00 $52.80
Angiotensin l - converting enzyme (ACE) level 82164 $96.00 $57.60
Angiotensin l - converting enzyme (ACE) level 82164 $48.00 $28.80
Apolipoprotein level 82172 $43.00 $25.80
Arsenic level 82175 $36.00 $21.60
Arsenic level 82175 $24.00 $14.40
Arsenic level 82175 $68.00 $40.80
Ascorbic acid (Vitamin C) level, blood 82180 $65.00 $39.00
Beta-2 microglobulin (protein) level 82232 $191.00 $114.60
Beta-2 microglobulin (protein) level 82232 $51.00 $30.60
Bile acids level 82239 $76.00 $45.60
Bilirubin level 82247 $32.00 $19.20
Bilirubin level 82247 $37.00 $22.20
Bilirubin level 82248 $32.00 $19.20
Bilirubin level 82248 $39.00 $23.40
Stool analysis for bilirubin 82252 $33.00 $19.80
Biotinidase (enzyme) level 82261 $30.00 $18.00
Stool analysis for blood to screen for colon tumors 82270 $21.00 $12.60
Specimen analysis for blood 82271 $38.00 $22.80
Stool analysis for blood 82272 $40.00 $24.00
Stool analysis for blood 82274 $75.00 $45.00
Cadmium level 82300 $69.00 $41.40
Vitamin D-3 level 82306 $184.00 $110.40
Calcitonin (hormone) level 82308 $81.00 $48.60
Calcium level 82310 $37.00 $22.20
Calcium level 82330 $151.00 $90.60
Urine calcium level 82340 $46.00 $27.60
Infrared analysis of stone 82365 $50.00 $30.00
Carbohydrate deficient transferrin (protein) level 82373 $81.00 $48.60
Carbon dioxide (bicarbonate) level 82374 $35.00 $21.00
Carboxyhemoglobin (protein) level 82375 $114.00 $68.40
Carcinoembryonic antigen (CEA) protein level 82378 $126.00 $75.60
Carcinoembryonic antigen (CEA) protein level 82378 $218.00 $130.80
Carnitine level 82379 $67.00 $40.20
Carotene level 82380 $57.00 $34.20
Catecholamines (organic nitrogen) level 82384 $70.00 $42.00
Ceruloplasmin (protein) level 82390 $109.00 $65.40
Analysis using chemiluminescent technique (light and chemical )reaction 82397 $65.00 $39.00
Analysis using chemiluminescent technique (light and chemical )reaction 82397 $28.00 $16.80
Blood chloride level 82435 $33.00 $19.80
Urine chloride level 82436 $41.00 $24.60
Chloride level 82438 $39.00 $23.40
Chloride level 82438 $25.00 $15.00
Cholesterol level 82465 $32.00 $19.20
Cholinesterase (enzyme) level, to test for exposure to chemical or liver disease 82480 $65.00 $39.00
Cholinesterase (enzyme) level 82482 $100.00 $60.00
Chromium level to test for poisoning or deficiency 82495 $178.00 $106.80
Chromium level to test for poisoning or deficiency 82495 $60.00 $36.00
Citrate level 82507 $73.00 $43.80
Collagen cross links test, (urine test to evaluate bone health) 82523 $61.00 $36.60
Copper level 82525 $49.00 $29.40
Copper level 82525 $73.00 $43.80
Cortisol (hormone) measurement 82530 $54.00 $32.40
Cortisol (hormone) measurement 82533 $216.00 $129.60
Cortisol (hormone) measurement 82533 $233.00 $139.80
Chemical analysis using chromatography technique 82542 $171.00 $102.60
Chemical analysis using chromatography technique 82542 $114.00 $68.40
Chemical analysis using chromatography technique 82542 $337.00 $202.20
Chemical analysis using chromatography technique 82542 $83.00 $49.80
Chemical analysis using chromatography technique 82542 $145.00 $87.00
Chemical analysis using chromatography technique 82542 $190.00 $114.00
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $42.00 $25.20
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $59.00 $35.40
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $59.00 $35.40
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $42.00 $25.20
Creatine kinase (cardiac enzyme) level 82553 $104.00 $62.40
Blood creatinine level 82565 $36.00 $21.60
Creatinine level to test for kidney function or muscle injury 82570 $41.00 $24.60
Creatinine clearance measurement to test for kidney function 82575 $75.00 $45.00
Cryofibrinogen (protein) level 82585 $30.00 $18.00
Cryoglobulin (protein) measurement 82595 $30.00 $18.00
Cyanide measurement 82600 $82.00 $49.20
Cyanocobalamin (vitamin B-12) level 82607 $99.00 $59.40
Cystatin C (enzyme inhibitor) level 82610 $72.00 $43.20
Dehydroepiandrosterone (DHEA) hormone level 82626 $49.00 $29.40
Dehydroepiandrosterone (DHEA-S) hormone level 82627 $67.00 $40.20
Deoxycortisol, 11 (hormone) level 82634 $85.00 $51.00
Dihydroxyvitamin D, 1, 25 level 82652 $115.00 $69.00
Pancreatic elastase (enzyme) measurement 82656 $116.00 $69.60
Enzyme activity measurement 82657 $54.00 $32.40
Enzyme activity measurement 82657 $144.00 $86.40
Enzyme activity measurement 82658 $147.00 $88.20
Electrophoresis, laboratory testing technique 82664 $99.00 $59.40
Erythropoietin (protein) level 82668 $57.00 $34.20
Estradiol (hormone) level 82670 $220.00 $132.00