Top 40 services provided by BOLIVAR GENERAL HOSPITAL
Services CPT Price Est. Cash Price
Fine needle aspiration of first lesion using ultrasound guidance 10005 $721.00 $288.40
Fine needle aspiration of additional lesion using ultrasound guidance 10006 $361.00 $144.40
Fine needle aspiration of first lesion using fluoroscopice guidance 10007 $721.00 $288.40
Fine needle aspiration of additional lesion using fluoroscopice guidance 10008 $361.00 $144.40
Fine needle aspiration of first lesion using CT guidance 10009 $721.00 $288.40
Fine needle aspiration of additional lesion using CT guidance 10010 $361.00 $144.40
Fine needle aspiration of first lesion using MR guidance 10011 $721.00 $288.40
Fine needle aspiration of additional lesion using MR guidance 10012 $361.00 $144.40
Fine needle aspiration of first lesion 10021 $268.00 $107.20
Fluid collection drainage by catheter using imaging guidance, accessed through the skin 10030 $220.00 $88.00
Drainage of abscess 10060 $371.00 $148.40
Drainage of multiple abscess 10061 $371.00 $148.40
Removal of foreign body from tissue, accessed beneath the skin 10120 $216.00 $86.40
Drainage of blood or fluid accumulation 10140 $2,017.00 $806.80
Aspiration of abscess, blood accumulation, blister, or cyst 10160 $132.00 $52.80
Drainage of wound infection after surgery 10180 $3,068.00 $1,227.20
Removal of skin and tissue first 20 sq cm or less 11042 $1,220.00 $488.00
Removal of skin and/or muscle first 20 sq cm or less 11043 $1,480.00 $592.00
Removal of skin and bone first 20 sq cm or less 11044 $3,166.00 $1,266.40
Removal of skin and tissue 11045 $651.00 $260.40
Removal of skin and/or muscle 11046 $808.00 $323.20
Removal of skin and bone 11047 $1,580.00 $632.00
Removal of single thickened skin growth 11055 $205.00 $82.00
Removal of 2 to 4 thickened skin growths 11056 $212.00 $84.80
Removal of more than 4 thickened skin growths 11057 $265.00 $106.00
Tangential biopsy of single skin lesion 11102 $239.00 $95.60
Tangential biopsy of additional skin lesion 11103 $165.00 $66.00
Punch biopsy of single skin lesion 11104 $239.00 $95.60
Punch biopsy of additional skin lesion 11105 $165.00 $66.00
Incisional biopsy of single skin lesion 11106 $426.00 $170.40
Incisional biopsy of additional skin lesion 11107 $294.00 $117.60
Trimming of fingernails or toenails 11719 $78.00 $31.20
Removal of tissue from 1 to 5 finger or toe nails 11720 $78.00 $31.20
Removal of tissue from 6 or more finger or toe nails 11721 $78.00 $31.20
Separation of nail plate from nail bed 11730 $245.00 $98.00
Separation of nail plate from nail bed 11732 $170.00 $68.00
Removal of drug delivery implant from tissue 11982 $114.00 $45.60
Repair of separation of wound closure with insertion of packing 12021 $351.00 $140.40
Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less) 15271 $1,714.00 $685.60
Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs 15272 $719.00 $287.60
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 $3,726.00 $1,490.40
Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs 15274 $1,546.00 $618.40
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 (first 25 sq cm or less) 15275 $1,714.00 $685.60
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 $816.00 $326.40
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 (first 100 sq cm or 1% body area of infants and children) 15277 $2,011.00 $804.40
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 $1,008.00 $403.20
Dressing change and/or removal of burn tissue (less than 5% total body surface) 16020 $174.00 $69.60
Dressing change and/or removal of burn tissue (5% to 10% total body surface) 16025 $174.00 $69.60
Dressing change and/or removal of burn tissue (greater than 10% total body surface) 16030 $268.00 $107.20
Application of chemical agent to excessive wound tissue 17250 $215.00 $86.00
Aspiration of breast cyst 19000 $153.00 $61.20
Puncture aspiration of breast cyst 19001 $96.00 $38.40
Injection for X-ray imaging of breast duct 19030 $335.00 $134.00
Biopsy of breast accessed through the skin with stereotactic guidance 19081 $4,187.00 $1,674.80
Biopsy of breast accessed through the skin with stereotactic guidance 19082 $1,046.00 $418.40
Biopsy of breast accessed through the skin with ultrasound guidance 19083 $1,542.00 $616.80
Biopsy of breast accessed through the skin with ultrasound guidance 19084 $771.00 $308.40
Biopsy of breast accessed through the skin with MRI guidance 19085 $2,178.00 $871.20
Biopsy of breast accessed through the skin with MRI guidance 19086 $1,089.00 $435.60
Placement of breast localization devices accessed through the skin with mammographic guidance 19281 $158.00 $63.20
Placement of breast localization devices accessed through the skin with mammographic guidance 19282 $79.00 $31.60
Placement of breast localization devices accessed through the skin with ultrasound guidance 19285 $158.00 $63.20
Placement of breast localization devices accessed through the skin with ultrasound guidance 19285 $316.00 $126.40
Placement of breast localization devices accessed through the skin with ultrasound guidance 19286 $79.00 $31.60
Breast procedure 19499 $2,794.00 $1,117.60
Needle biopsy of muscle, accessed through the skin 20206 $57.00 $22.80
Biopsy of bone using needle or trocar 20220 $808.00 $323.20
Deep biopsy of bone using needle or trocar 20225 $1,112.00 $444.80
Injection for repair of abnormal muscle drainage tract 20500 $1,110.00 $444.00
Injection of abnormal muscle drainage tract for X-ray study 20501 $121.00 $48.40
Removal of foreign body in muscle or tendon 20520 $154.00 $61.60
Injections of tendon sheath, ligament, or muscle membrane 20550 $971.00 $388.40
Injections of tendon sheath, ligament, or muscle membrane 20550 $647.00 $258.80
Injections of trigger points in 1 or 2 muscles 20552 $678.00 $271.20
Injections of trigger points in 3 or more muscles 20553 $807.00 $322.80
Aspiration and/or injection of small joint or joint capsule 20600 $1,007.00 $402.80
Aspiration and/or injection of small joint or joint capsule 20600 $671.00 $268.40
Aspiration and/or injection of small joint or joint capsule with recording and reporting using ultrasound guidance 20604 $481.00 $192.40
Aspiration and/or injection of medium joint or joint capsule 20605 $669.00 $267.60
Aspiration and/or injection of medium joint or joint capsule 20605 $1,004.00 $401.60
Aspiration and/or injection of intermediate joint or joint capsule with recording and reporting using ultrasound guidance 20606 $568.00 $227.20
Aspiration and/or injection of large joint or joint capsule 20610 $1,179.00 $471.60
Aspiration and/or injection of large joint or joint capsule 20610 $786.00 $314.40
Aspiration and/or injection of major joint or joint capsule with recording and reporting using ultrasound guidance 20611 $650.00 $260.00
Aspiration and/or injection of cysts 20612 $158.00 $63.20
Destruction of 1 or more bone growths accessed through the skin 20982 $8,925.00 $3,570.00
Muscle and bone procedure 20999 $2,136.00 $854.40
Musculoskeletal procedure on head 21499 $150.00 $60.00
Incision and drainage of abscess or blood accumulation in soft tissues of neck or chest 21501 $935.00 $374.00
Biopsy of soft tissue of neck or chest 21550 $767.00 $306.80
Neck or chest procedure 21899 $606.00 $242.40
Biopsy of tissue of back or flank 21920 $454.00 $181.60
Biopsy of tissue of back or flank 21925 $1,281.00 $512.40
Injection of bone cement into body of middle spine bone accessed through the skin using imaging guidance 22510 $4,558.00 $1,823.20
Injection of bone cement into body of middle spine bone accessed through the skin using imaging guidance 22511 $4,558.00 $1,823.20
Injection of bone cement into body of middle or lower spine accessed through the skin using imaging guidance 22512 $617.00 $246.80
Injection of bone cement into body of middle spine bone accessed through the skin using imaging guidance 22513 $7,943.00 $3,177.20
Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance 22514 $8,175.00 $3,270.00
Injection of bone cement into body of middle or lower spine bone accessed through the skin using imaging guidance 22515 $3,539.00 $1,415.60
Spine procedure 22899 $315.00 $126.00
Procedure on abdomen, muscle or bone 22999 $77.00 $30.80
Incision to repair joints between shoulder, chest and collar bones 23101 $2,789.00 $1,115.60
Injection of dye for X-ray imaging of shoulder joint 23350 $383.00 $153.20
Shoulder procedure 23929 $392.00 $156.80
Biopsy of soft tissue of upper arm or elbow 24065 $1,900.00 $760.00
Injection of dye for X-ray imaging of elbow joint 24220 $212.00 $84.80
Incision of tendon to repair elbow joint, accessed through the skin 24357 $4,020.00 $1,608.00
Incision of tendon to repair elbow joint, accessed through the skin 24357 $6,030.00 $2,412.00
Biopsy of tissue of forearm and/or wrist 25065 $773.00 $309.20
Injection of dye for X-ray imaging of wrist joint 25246 $343.00 $137.20
Drainage of abscess or blood accumulation in pelvis or hip joint 26990 $1,490.00 $596.00
Biopsy of tissue of pelvis and hip 27040 $1,098.00 $439.20
Biopsy of tissue of pelvis and hip 27041 $1,295.00 $518.00
Injection of dye for X-ray imaging of hip joint 27093 $369.00 $147.60
Injection procedure into sacroiliac joint for anesthetic or steroid 27096 $2,460.00 $984.00
Injection procedure into sacroiliac joint for anesthetic or steroid 27096 $1,640.00 $656.00
Pelvis or hip joint procedure 27299 $174.00 $69.60
Biopsy of thigh or knee region tissue 27323 $1,604.00 $641.60
Biopsy of thigh or knee region tissue 27324 $2,469.00 $987.60
Injection of contrast for imaging of knee joint 27369 $76.00 $30.40
Injection of contrast for imaging of knee joint 27369 $151.00 $60.40
Incision of Achilles tendon, accessed through the skin using local anesthetic 27605 $4,392.00 $1,756.80
Incision of Achilles tendon, accessed through the skin using local anesthetic 27605 $2,928.00 $1,171.20
Injection for X-ray imaging of ankle 27648 $283.00 $113.20
Incision of tissues of muscle compartment of foot and/or toe 28008 $4,056.00 $1,622.40
Incision of tissues of muscle compartment of foot and/or toe 28008 $6,084.00 $2,433.60
Removal of foreign body of foot tissue 28192 $250.00 $100.00
Removal of foreign body of foot tissue 28193 $344.00 $137.60
Application of rigid total contact leg cast 29445 $346.00 $138.40
Strapping, Unna boot 29580 $366.00 $146.40
Strapping, Unna boot 29580 $244.00 $97.60
Application of vein wound compression system lower leg below knee including ankle and foot 29581 $244.00 $97.60
Application of vein wound compression system lower leg below knee including ankle and foot 29581 $366.00 $146.40
Emergent insertion of breathing tube into windpipe cartilage using an endoscope 31500 $700.00 $280.00
Diagnostic examination of voice box using flexible endoscope 31575 $623.00 $249.20
Voice box procedure 31599 $150.00 $60.00
Insertion of stents into windpipe using an endoscope 31631 $1,586.00 $634.40
Insertion of catheter for suction of secretions 31720 $46.00 $18.40
Windpipe or lung airway procedure 31899 $1,312.00 $524.80
Needle biopsy of lining of lung, accessed through the skin 32400 $856.00 $342.40
Needle biopsy of lung or chest tissue, accessed through the skin 32405 $1,109.00 $443.60
Insertion of permanent catheter for drainage of lung fluid 32550 $968.00 $387.20
Removal of fluid from between lung and chest cavity, open procedure 32551 $379.00 $151.60
Removal of tunneled catheter in lung lining 32552 $451.00 $180.40
Removal of fluid from chest cavity 32554 $1,268.00 $507.20
Removal of fluid from chest cavity with imaging guidance 32555 $2,714.00 $1,085.60
Removal of fluid from chest cavity with imaging guidance 32555 $1,809.00 $723.60
Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin 32556 $2,027.00 $810.80
Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin 32556 $1,351.00 $540.40
Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin 32557 $2,221.00 $888.40
Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin 32557 $3,331.00 $1,332.40
Catheter instillation of agent onto lung surface 32560 $266.00 $106.40
Catheter instillations of agent onto lung lining to break up scar tissue 32561 $1,070.00 $428.00
Destruction of growths in one lung, accessed through the skin 32998 $3,700.00 $1,480.00
Lung and lung lining procedure 32999 $142.00 $56.80
Aspiration of fluid from sac that covers the heart 33010 $1,164.00 $465.60
Insertion of catheter for drainage into sac that covers the heart 33015 $430.00 $172.00
Insertion or replacement of permanent pacemaker and upper chamber electrodes 33206 $3,675.00 $1,470.00
Insertion or replacement of permanent pacemaker and lower chamber electrodes 33207 $3,675.00 $1,470.00
Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes 33208 $10,412.00 $4,164.80
Placement of temporary pacemaker leads 33210 $5,350.00 $2,140.00
Conversion to two chamber pacemaker system 33214 $3,853.00 $1,541.20
Repositioning of implanted pacemaker or defibrillator device 33215 $2,613.00 $1,045.20
Insertion of electrode for permanent pacemaker or pacing defibrillator device 33216 $2,053.00 $821.20
Insertion of electrodes for permanent pacemaker or pacing defibrillator device 33217 $2,060.00 $824.00
Repair of electrode for permanent pacemaker or defibrillator device 33218 $5,419.00 $2,167.60
Relocation of pacemaker generator skin pocket 33222 $2,000.00 $800.00
Relocation of defibrillator device skin pocket 33223 $2,000.00 $800.00
Insertion of left heart electrode with attachment to pacemaker or pacing defibrillator device 33224 $8,468.00 $3,387.20
Insertion of left heart electrode for pacing defibrillator device 33225 $9,945.00 $3,978.00
Repositioning of implanted left heart electrode 33226 $1,128.00 $451.20
Removal and replacement of single lead permanent pacemaker pulse generator 33227 $10,235.00 $4,094.00
Removal and replacement of dual lead permanent pacemaker pulse generator 33228 $11,624.00 $4,649.60
Removal and replacement of multiple lead permanent pacemaker pulse generator 33229 $17,885.00 $7,154.00
Removal of permanent pacemaker pulse generator 33233 $1,293.00 $517.20
Removal of electrode from right heart 33234 $1,214.00 $485.60
Removal of electrodes from right heart 33235 $1,463.00 $585.20
Removal of defibrillator pulse generator 33241 $3,087.00 $1,234.80
Removal of defibrillator electrodes 33244 $3,110.00 $1,244.00
Insertion or replacement of single or dual chamber pacing defibrillator leads 33249 $30,278.00 $12,111.20
Removal and replacement of defibrillator pulse generator 33262 $19,966.00 $7,986.40
Removal and replacement of defibrillator pulse generator 33263 $20,439.00 $8,175.60
Removal and replacement of defibrillator pulse generator 33264 $29,869.00 $11,947.60
Insertion or replacement of defibrillator with electrode 33270 $8,969.00 $3,587.60
Insertion of defibrillator electrode 33271 $2,053.00 $821.20
Removal of defibrillator electrode 33272 $1,699.00 $679.60
Repositioning of previously implanted defibrillator electrode 33273 $2,613.00 $1,045.20
Insertion or replacement of permanent leadless pacemaker into lower right chamber of heart via catheter using imaging guidance 33274 $20,849.00 $8,339.60
Removal of permanent leadless pacemaker into lower right chamber of heart via catheter using imaging guidance 33275 $3,587.00 $1,434.80
Insertion of heart rhythm monitor under skin 33285 $10,053.00 $4,021.20
Removal of heart rhythm monitor from under skin 33286 $787.00 $314.80
Insertion of assistive heart blood flow device into aorta, accessed through the skin 33967 $3,140.00 $1,256.00
Removal of blood flow assist device in aorta, accessed through the skin 33968 $1,679.00 $671.60
Insertion of lower heart chamber blood flow assist device through the skin including radiological supervision and interpretation 33990 $6,198.00 $2,479.20
Removal of lower heart chamber blood flow assist device, accessed through the skin 33992 $5,000.00 $2,000.00
Heart surgery procedure 33999 $412.00 $164.80
Insertion of prosthesis for repair of abdominal or groin artery including radiological supervision and interpretation 34709 $3,029.00 $1,211.60
Insertion of needle or catheter into a vein 36000 $110.00 $44.00
Injection to cause blood clot in a diseased or bulging vessel of arm or leg, accessed through the skin 36002 $607.00 $242.80
Injection for X-ray imaging procedure on veins of arm or leg 36005 $434.00 $173.60
Injection for X-ray imaging procedure on veins of arm or leg 36005 $651.00 $260.40
Introduction of catheter into the upper or lower major vein (vena cava) 36010 $70.00 $28.00
Insertion of catheter into vein 36011 $318.00 $127.20
Insertion of catheter into vein 36011 $565.00 $226.00
Insertion of catheter into vein 36012 $1,186.00 $474.40
Insertion of catheter into vein 36012 $1,778.00 $711.20
Insertion of catheter into right heart or main pulmonary (lung) artery 36013 $94.00 $37.60
Insertion of catheter into left or right pulmonary (lung) artery 36014 $597.00 $238.80
Insertion of catheter into left or right pulmonary (lung) artery 36014 $398.00 $159.20
Insertion of catheter into an artery of a lobe of the lung 36015 $418.00 $167.20
Insertion of catheter into an artery of a lobe of the lung 36015 $209.00 $83.60
Insertion of needle or catheter into the carotid (neck) or vertebral (brain) artery 36100 $111.00 $44.40
Insertion of needle or catheter into an artery of arm or leg 36140 $1,179.00 $471.60
Insertion of needle or catheter into aorta 36160 $641.00 $256.40
Insertion of catheter into aorta 36200 $1,686.00 $674.40
Insertion of catheter into aorta 36200 $1,124.00 $449.60
Insertion of catheter into chest or arm artery 36215 $361.00 $144.40
Insertion of catheter into chest or arm artery 36215 $723.00 $289.20
Insertion of catheter into chest or arm artery 36216 $758.00 $303.20
Insertion of catheter into chest or arm artery 36216 $606.00 $242.40
Insertion of catheter into chest or arm artery 36217 $1,038.00 $415.20
Insertion of catheter into chest or arm artery 36217 $692.00 $276.80
Insertion of catheter into chest or arm artery 36218 $62.00 $24.80
Insertion of catheter into chest or arm artery 36218 $125.00 $50.00
Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation 36221 $4,987.00 $1,994.80
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36222 $8,874.00 $3,549.60
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36222 $5,916.00 $2,366.40
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36223 $5,916.00 $2,366.40
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36223 $8,874.00 $3,549.60
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36224 $10,890.00 $4,356.00
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36224 $5,445.00 $2,178.00
Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation 36225 $5,916.00 $2,366.40
Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation 36225 $8,874.00 $3,549.60
Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation 36226 $5,445.00 $2,178.00
Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation 36226 $10,890.00 $4,356.00
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36227 $1,107.00 $442.80
Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation 36227 $824.00 $329.60
Insertion of catheter into artery on one side of neck or chest for diagnosis or treatment including radiological supervision and interpretation 36228 $1,107.00 $442.80
Insertion of catheter into artery on one side of neck or chest for diagnosis or treatment including radiological supervision and interpretation 36228 $824.00 $329.60
Insertion of catheter into abdominal pelvic or leg artery 36245 $2,306.00 $922.40
Insertion of catheter into abdominal pelvic or leg artery 36245 $1,688.00 $675.20
Insertion of catheter into abdominal pelvic or leg artery 36246 $2,722.00 $1,088.80
Insertion of catheter into abdominal pelvic or leg artery 36246 $1,815.00 $726.00
Insertion of catheter into abdominal pelvic or leg artery 36247 $2,614.00 $1,045.60
Insertion of catheter into abdominal pelvic or leg artery 36247 $2,013.00 $805.20
Insertion of catheter into each additional abdominal, pelvic or leg artery 36248 $349.00 $139.60
Insertion of catheter into each additional abdominal, pelvic or leg artery 36248 $182.00 $72.80
Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation 36251 $4,303.00 $1,721.20
Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation 36252 $4,977.00 $1,990.80
Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation 36253 $1,459.00 $583.60
Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation 36254 $1,959.00 $783.60
Insertion of needle into vein for collection of blood sample 36415 $35.00 $14.00
Transfusion of blood or blood products 36430 $253.00 $101.20
Intrauterine fetal transfusion 36460 $235.00 $94.00
Injection of chemical agent into single incompetent vein of leg using ultrasound guidance 36465 $5,785.00 $2,314.00
Injection of chemical agent into single incompetent vein 36470 $197.00 $78.80
Mechanochemical destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance 36473 $4,794.00 $1,917.60
Mechanochemical destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance 36473 $3,196.00 $1,278.40
Mechanochemical destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance 36474 $3,011.00 $1,204.40
Mechanochemical destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance 36474 $2,007.00 $802.80
Laser destruction of incompetent vein of arm or leg using imaging guidance, accessed through the skin 36478 $2,573.00 $1,029.20
Laser destruction of insufficient vein of arm or leg, accessed through the skin using imaging guidance 36479 $3,094.00 $1,237.60
Insertion of catheter into portal vein of liver, accessed through the skin 36481 $626.00 $250.40
Insertion of catheter into vein with collection of blood sample 36500 $358.00 $143.20
Mechanical separation of plasma from opening blood 36514 $3,026.00 $1,210.40
Mechanical separation of plasma and abnormal antibodies from blood 36516 $5,165.00 $2,066.00
Insertion of central venous catheter for infusion, patient younger than 5 years 36555 $1,568.00 $627.20
Insertion of central venous catheter for infusion, patient 5 years or older 36556 $1,332.00 $532.80
Insertion of central venous catheter for infusion, patient younger than 5 years 36557 $2,220.00 $888.00
Insertion of central venous catheter for infusion, patient 5 years or older 36558 $2,096.00 $838.40
Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older 36561 $4,424.00 $1,769.60
Insertion of central venous catheter for infusion, patient younger than 5 years 36568 $842.00 $336.80
Insertion of central venous catheter for infusion, patient 5 years or older 36569 $1,424.00 $569.60
Insertion of central venous catheter for infusion with port beneath the skin, patient 5 years or older 36571 $2,598.00 $1,039.20
Insertion of central venous catheter for infusion using imaging guidance, patient younger than 5 years 36572 $842.00 $336.80
Insertion of central venous catheter for infusion using imaging guidance, patient 5 years or older 36573 $1,424.00 $569.60
Repair of central venous catheter for infusion 36575 $468.00 $187.20
Repair of central venous catheter for infusion 36576 $468.00 $187.20
Catheter replacement of central venous access device 36578 $979.00 $391.60
Replacement of central venous catheter 36580 $1,085.00 $434.00
Replacement of central venous catheter 36581 $3,279.00 $1,311.60
Replacement of central venous catheter 36582 $1,801.00 $720.40
Replacement of catheter in peripheral vein accessed through same vein 36584 $736.00 $294.40
Removal of central venous catheter for infusion 36589 $1,512.00 $604.80
Removal of peripheral venous catheter for infusion 36590 $610.00 $244.00
Collection of blood specimen from a completely implantable venous access device 36591 $222.00 $88.80
Collection of blood specimen from central or peripheral venous catheter 36592 $90.00 $36.00
Declotting infusion of implanted central venous access device or catheter 36593 $597.00 $238.80
Mechanical removal of obstructive material from central venous catheter 36595 $1,063.00 $425.20
Mechanical removal of tissue or obstructive material in central venous catheter 36596 $305.00 $122.00
Repositioning of central venous catheter using fluoroscopic guidance 36597 $325.00 $130.00
Contrast injections for X-ray imaging procedure to evaluate central venous access device 36598 $505.00 $202.00
Arterial puncture withdrawal of blood for diagnosis 36600 $118.00 $47.20
Insertion of arterial catheter for blood sampling or infusion, accessed through the skin 36620 $282.00 $112.80
Insertion of needle for infusion into bone 36680 $277.00 $110.80
Insertion of needle and/or catheter into dialysis circuit, with imaging including radiological supervision and interpretation 36901 $926.00 $370.40
Insertion of needle and/or catheter into dialysis circuit and balloon dilation of dialysis segment, with imaging including radiological supervision and interpretation 36902 $6,352.00 $2,540.80
Insertion of needle and/or catheter into dialysis circuit and insertion of stent in dialysis segment, with imaging including radiological supervision and interpretation 36903 $13,202.00 $5,280.80
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 $6,352.00 $2,540.80
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 $13,202.00 $5,280.80
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 $20,011.00 $8,004.40
Balloon dilation of dialysis segment, accessed through the skin, with imaging including radiological supervision and interpretation 36907 $7,565.00 $3,026.00
Insertion of stent in dialysis segment, with imaging including radiological supervision and interpretation 36908 $15,159.00 $6,063.60
Permanent blockage of dialysis circuit, with imaging including radiological supervision and interpretation 36909 $12,188.00 $4,875.20
Insertion of shunts to bypass blood flow to liver using imaging guidance 37182 $7,546.00 $3,018.40
Revision of shunts to bypass blood flow to liver using imaging guidance 37183 $3,010.00 $1,204.00
Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed through the skin 37184 $6,175.00 $2,470.00
Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed through the skin 37185 $3,088.00 $1,235.20
Removal of blood clot and injections to dissolve blood clot from artery or arterial graft using fluoroscopic guidance, accessed beneath the skin 37186 $4,281.00 $1,712.40
Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance 37187 $7,863.00 $3,145.20
Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance 37188 $4,890.00 $1,956.00
Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation 37191 $8,359.00 $3,343.60
Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation 37192 $2,958.00 $1,183.20
Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation 37193 $5,958.00 $2,383.20
Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation 37197 $4,560.00 $1,824.00
Biopsy of blood vessel via catheter 37200 $1,338.00 $535.20
Insertion of catheter into artery for drug infusion for blood clot including radiological supervision and interpretation 37211 $2,558.00 $1,023.20
Insertion of catheter into vein for drug infusion for blood clot including radiological supervision and interpretation 37212 $2,558.00 $1,023.20
Insertion of catheter into artery or vein for drug infusion for blood clot including radiological supervision and interpretation 37213 $2,631.00 $1,052.40
Removal of catheter in artery or vein including radiological supervision and interpretation 37214 $5,049.00 $2,019.60
Insertion of stents and blood clot protection device in neck artery, open or accessed through the skin 37215 $10,611.00 $4,244.40
Insertion of stents in neck artery, open or accessed through the skin 37216 $7,944.00 $3,177.60
Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure 37220 $12,704.00 $5,081.60
Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure 37220 $8,736.00 $3,494.40
Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure 37221 $27,211.00 $10,884.40
Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure 37221 $18,141.00 $7,256.40
Balloon dilation of groin artery, endovascular, open, or percutaneous approach 37222 $2,109.00 $843.60
Balloon dilation of groin artery, endovascular, open, or percutaneous approach 37222 $4,218.00 $1,687.20
Insertion of stents into groin artery, endovascular, accessed through the skin or open procedure 37223 $13,931.00 $5,572.40
Insertion of stents into groin artery, endovascular, accessed through the skin or open procedure 37223 $6,965.00 $2,786.00
Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure 37224 $18,760.00 $7,504.00
Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure 37224 $12,507.00 $5,002.80
Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure 37225 $20,549.00 $8,219.60
Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure 37225 $30,823.00 $12,329.20
Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure 37226 $23,508.00 $9,403.20
Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure 37226 $35,262.00 $14,104.80
Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure 37227 $43,652.00 $17,460.80
Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure 37227 $29,101.00 $11,640.40
Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure 37228 $11,908.00 $4,763.20
Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure 37228 $17,862.00 $7,144.80
Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure 37229 $26,406.00 $10,562.40
Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure 37229 $17,604.00 $7,041.60
Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37230 $22,017.00 $8,806.80
Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37230 $33,026.00 $13,210.40
Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37231 $15,155.00 $6,062.00
Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37231 $25,944.00 $10,377.60
Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure 37232 $8,170.00 $3,268.00
Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure 37232 $12,255.00 $4,902.00
Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure 37233 $11,864.00 $4,745.60
Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure 37233 $5,932.00 $2,372.80
Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37234 $14,099.00 $5,639.60
Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37234 $7,049.00 $2,819.60
Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37235 $21,577.00 $8,630.80
Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure 37235 $10,788.00 $4,315.20
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 $19,130.00 $7,652.00
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 $9,586.00 $3,834.40
Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation 37238 $19,159.00 $7,663.60
Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation 37239 $9,542.00 $3,816.80
Occlusion of venous malformations (other than hemorrhage) with radiological supervision and interpretation, roadmapping, and imaging guidance 37241 $12,188.00 $4,875.20
Occlusion of artery (other than hemorrhage or tumor) with radiological supervision and interpretation, roadmapping, and imaging guidance 37242 $12,188.00 $4,875.20
Occlusion of tumors or obstructed blood vessel with radiological supervision and interpretation, roadmapping, and imaging guidance 37243 $12,188.00 $4,875.20
Occlusion of arterial or venous hemorrhage with radiological supervision and interpretation, roadmapping, and imaging guidance 37244 $13,263.00 $5,305.20
Balloon dilation of artery, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37246 $6,352.00 $2,540.80
Balloon dilation of artery, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37246 $9,528.00 $3,811.20
Balloon dilation of artery, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37247 $4,754.00 $1,901.60
Balloon dilation of first vein, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37248 $9,528.00 $3,811.20
Balloon dilation of first vein, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37248 $6,352.00 $2,540.80
Balloon dilation of additional vein, accessed through the skin or by open procedure, with imaging including radiological supervision and interpretation 37249 $4,754.00 $1,901.60
Ultrasound evaluation of blood vessel during diagnosis or treatment 37252 $1,745.00 $698.00
Ultrasound evaluation of blood vessel during diagnosis or treatment 37253 $1,408.00 $563.20
Multiple incisions for removal of varicose veins of arm or leg 37765 $2,835.00 $1,134.00
Multiple incisions for removal of varicose veins of arm or leg 37766 $3,618.00 $1,447.20
Blood vessel procedure 37799 $1,453.00 $581.20
Bone marrow biopsy 38221 $1,242.00 $496.80
Bone marrow biopsy and aspiration 38222 $291.00 $116.40
Needle biopsy or removal of lymph nodes 38505 $1,032.00 $412.80
Injection of radioactive dye for X-ray identification of lymph node 38792 $90.00 $36.00
Lymph node procedure 38999 $1,040.00 $416.00
Insertion of needles, catheters, or devices into head and/or neck for radiation delivery 41019 $2,291.00 $916.40
Drainage of abscess of salivary gland 42300 $1,813.00 $725.20
Needle biopsy of salivary gland 42400 $575.00 $230.00
Insertion of stomach tube using an endoscope 43246 $1,879.00 $751.60
Dilation of esophagus 43453 $908.00 $363.20
Esophagus procedure 43499 $328.00 $131.20
Insertion of nasal or oral stomach tube using fluoroscopic guidance 43752 $372.00 $148.80
Repositioning of stomach feeding tube 43761 $41.00 $16.40
Replacement of stomach stoma tube accessed through skin 43762 $314.00 $125.60
Replacement of stomach stoma tube accessed through skin with revision of stoma opening 43763 $314.00 $125.60
Oral introduction of long drainage tube into small bowel 44500 $416.00 $166.40
Assessment and overseeing preparation of donor fecal specimen 44705 $181.00 $72.40
Small bowel procedure 44799 $1,800.00 $720.00
Dilation of rectum and large bowel using an endoscope 45303 $1,280.00 $512.00
Large bowel procedure 45399 $1,011.00 $404.40
Dilation of rectal scar tissue under anesthesia 45910 $1,280.00 $512.00
Needle biopsy of liver, accessed through the skin 47000 $1,415.00 $566.00
Destruction of 1 or more growths in liver, accessed through the skin 47382 $2,869.00 $1,147.60
Liver procedure 47399 $474.00 $189.60
Insertion of catheter (accessed through the skin) into gallbladder using imaging guidance including radiological supervision and interpretation 47490 $760.00 $304.00
Injection of bile duct for X-ray imaging procedure accessed through the skin using imaging guidance including radiological supervision and interpretation 47531 $526.00 $210.40
Injection of bile duct for X-ray imaging procedure accessed through the skin using imaging guidance including radiological supervision and interpretation 47532 $3,266.00 $1,306.40
Placement of drainage catheter of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47533 $3,266.00 $1,306.40
Placement of drainage catheter of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47534 $3,266.00 $1,306.40
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 $3,266.00 $1,306.40
Replacement of liver duct drainage catheter accessed through the skin with imaging and radiological supervision and interpretation 47536 $3,266.00 $1,306.40
Removal of biliary drainage catheter, accessed through the skin using imaging guidance and radiological supervision and interpretation 47537 $724.00 $289.60
Placement of stent of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47538 $6,177.00 $2,470.80
Placement of stent of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47539 $6,177.00 $2,470.80
Placement of stent and drainage catheter of biliary duct, accessed through the skin with imaging including radiological supervision and interpretation 47540 $6,177.00 $2,470.80
Placement of access device into biliary tract, accessed through the skin with imaging including radiological supervision and interpretation 47541 $3,266.00 $1,306.40
Balloon dilation of bile duct accessed through the skin using imaging guidance including radiological supervision and interpretation 47542 $718.00 $287.20
Biopsy of bile duct or liver duct accessed through the skin using imaging guidance with radiological supervision and interpretation 47543 $1,047.00 $418.80
Removal of biliary duct or gallbladder stone, accessed through the skin using imaging guidance and radiological supervision and interpretation 47544 $393.00 $157.20
Biopsy of bile ducts using an endoscope, accessed through the skin 47553 $1,047.00 $418.80
Dilation of bile ducts using an endoscope, accessed through the skin 47555 $737.00 $294.80
Dilation of bile ducts with stent insertion using an endoscope, accessed through the skin 47556 $785.00 $314.00
Insertion of stent into bile duct 47801 $238.00 $95.20
Bile duct procedure 47999 $226.00 $90.40
Needle biopsy of pancreas, accessed through the skin 48102 $518.00 $207.20
Drainage of fluid from abdominal cavity 49082 $1,213.00 $485.20
Drainage of fluid from abdominal cavity using imaging guidance 49083 $1,710.00 $684.00
Irrigation of abdominal cavity 49084 $536.00 $214.40
Needle biopsy of abdominal cavity growth, accessed through the skin 49180 $1,027.00 $410.80
Injection of abnormal fluid accumulation using imaging guidance with radiological supervision and interpretation 49185 $2,546.00 $1,018.40
Injection of air or X-ray contrast material into abdominal cavity 49400 $141.00 $56.40
Fluid collection drainage by catheter using imaging guidance, accessed through the skin 49405 $2,986.00 $1,194.40
Fluid collection drainage by catheter using imaging guidance, accessed through the skin 49406 $2,986.00 $1,194.40
Fluid collection drainage by catheter using imaging guidance, accessed through vagina or rectum 49407 $1,044.00 $417.60
Insertion of abdominal catheter through the skin using imaging guidance including radiological supervision and interpretation 49418 $3,203.00 $1,281.20
Insertion of abdominal cavity catheter for drainage or dialysis, open procedure 49421 $1,970.00 $788.00
Removal of abdominal cavity catheter 49422 $1,223.00 $489.20
Exchange of abdominal cavity drainage catheter using imaging guidance 49423 $663.00 $265.20
Injection of contrast through abdominal cavity catheter for X-ray study 49424 $133.00 $53.20
Insertion of shunt from jugular vein to abdominal cavity 49425 $5,781.00 $2,312.40
Revision of shunt from jugular vein to abdominal cavity 49426 $4,384.00 $1,753.60
Removal of shunt from jugular vein to abdominal cavity 49429 $2,364.00 $945.60
Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast 49440 $554.00 $221.60
Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast 49441 $1,441.00 $576.40
Insertion of large bowel tube (accessed through the skin) using fluoroscopic guidance with contrast 49442 $3,757.00 $1,502.80
Conversion of stomach tube to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49446 $1,300.00 $520.00
Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49450 $708.00 $283.20
Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49451 $748.00 $299.20
Replacement of stomach to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin 49452 $815.00 $326.00
Mechanical removal of obstructive material in stomach, large, or small bowel tube using fluoroscopic guidance with contrast 49460 $1,044.00 $417.60
Contrast injections for x-ray imaging through existing tube in stomach, small bowel or large bowel, accessed through the skin 49465 $158.00 $63.20
Abdominal procedure 49999 $2,028.00 $811.20
Removal of kidney stone 50060 $1,689.00 $675.60
Needle biopsy of kidney, accessed through the skin 50200 $1,309.00 $523.60
Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin 50382 $2,695.00 $1,078.00
Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin 50384 $2,413.00 $965.20
Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation 50385 $3,580.00 $1,432.00
Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation 50386 $393.00 $157.20
Removal and replacement of stent in kidney and urinary duct (ureter) using fluoroscopic guidance including radiological supervision and interpretation 50387 $1,099.00 $439.60
Removal of kidney drainage tube (ureter) using fluoroscopic guidance 50389 $1,117.00 $446.80
Aspiration and/or injection kidney cyst, accessed through the skin 50390 $1,108.00 $443.20
Injection procedure for x-ray imaging of kidney and urinary duct (ureter) using imaging guidance including radiological supervision and interpretation 50430 $1,181.00 $472.40
Injection procedure for x-ray imaging of kidney and urinary duct (ureter) using imaging guidance including radiological supervision and interpretation 50430 $787.00 $314.80
Injection procedure for x-ray imaging of kidney and urinary duct (ureter) using imaging guidance including radiological supervision and interpretation 50431 $787.00 $314.80
Injection procedure for x-ray imaging of kidney and urinary duct (ureter) using imaging guidance including radiological supervision and interpretation 50431 $1,181.00 $472.40
Placement of catheter of kidney, accessed through the skin using imaging guidance with radiological supervision and interpretation 50432 $2,260.00 $904.00
Placement of catheter of kidney, accessed through the skin using imaging guidance with radiological supervision and interpretation 50432 $3,390.00 $1,356.00
Placement of catheter of kidney and urinary tube (ureter), accessed through the skin using imaging guidance with radiological supervision and interpretation 50433 $3,390.00 $1,356.00
Placement of catheter of kidney and urinary tube (ureter), accessed through the skin using imaging guidance with radiological supervision and interpretation 50433 $2,260.00 $904.00
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 $787.00 $314.80
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 $1,181.00 $472.40
Replacement of kidney drainage catheter accessed through the skin with imaging and radiological supervision and interpretation 50435 $787.00 $314.80
Replacement of kidney drainage catheter accessed through the skin with imaging and radiological supervision and interpretation 50435 $1,181.00 $472.40
Enlargement of existing opening into urinary tract accessed through skin using imaging guidance 50436 $2,362.00 $944.80
Enlargement of existing opening into urinary tract accessed through skin and creation of new access into urine collecting system of kidney, using imaging guidance 50437 $3,974.00 $1,589.60
Removal of kidney foreign body or stone using an endoscopy which is inserted through an already created kidney opening 50561 $1,420.00 $568.00
Destruction of 1 or more growths in one kidney, accessed through the skin 50592 $1,691.00 $676.40
Destruction of growths in one kidney, accessed through the skin 50593 $9,107.00 $3,642.80
Destruction of growths in one kidney, accessed through the skin 50593 $13,661.00 $5,464.40
Injection of urinary duct (ureter) for X-ray imaging 50684 $279.00 $111.60
Change of tube or stent in urinary duct (ureter) 50688 $1,033.00 $413.20
Injection of bladder and urinary duct (ureter) for X-ray imaging 50690 $430.00 $172.00
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50693 $3,365.00 $1,346.00
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50693 $5,048.00 $2,019.20
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50694 $5,048.00 $2,019.20
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50694 $3,365.00 $1,346.00
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50695 $3,365.00 $1,346.00
Placement of stent of urinary duct (ureter), accessed through the skin with imaging including radiological supervision and interpretation 50695 $5,048.00 $2,019.20
Occlusion of urinary duct (ureter) using imaging guidance with radiological supervision and interpretation 50705 $211.00 $84.40
Occlusion of urinary duct (ureter) using imaging guidance with radiological supervision and interpretation 50705 $317.00 $126.80
Balloon dilation treatment of stricture of urinary duct (ureter) using imaging guidance with radiological supervision and interpretation 50706 $211.00 $84.40
Aspiration of bladder with insertion of bladder tube to skin surface 51102 $232.00 $92.80
Injection procedure for X-ray imaging of the bladder or during voiding 51600 $350.00 $140.00
Injection procedure through the bladder and bladder canal (urethra) for X-ray imaging 51610 $100.00 $40.00
Bladder irrigation and/or instillation 51700 $210.00 $84.00
Insertion of temporary bladder catheter 51701 $108.00 $43.20
Insertion of indwelling bladder catheter 51702 $120.00 $48.00
Insertion of indwelling bladder catheter 51703 $282.00 $112.80
Removal of skin suture with change of bladder tube 51705 $130.00 $52.00
Bladder instillation of cancer preventive, inhibiting, or suppressive agent 51720 $709.00 $283.60
Needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51785 $656.00 $262.40
Ultrasound measurement of bladder capacity after voiding 51798 $62.00 $24.80
Urinary system procedure 53899 $211.00 $84.40
Biopsy of vaginal mucous membrane 57100 $560.00 $224.00
Insertion of radiation therapy devices in vagina for radiation therapy 57156 $374.00 $149.60
Biopsy of uterine lining 58100 $272.00 $108.80
Introduction of saline or X-ray contrast material for X-ray imaging of the uterus and tubes 58340 $386.00 $154.40
Insertion of catheter through the cervix into fallopian tube 58345 $554.00 $221.60
Insertion of catheter through the cervix into fallopian tube 58345 $1,108.00 $443.20
Vaginal or abdominal biopsy of ovaries 58900 $2,540.00 $1,016.00
Female genital system (nonobstetric) procedure 58999 $27.00 $10.80
Fetal contraction stress test 59020 $240.00 $96.00
Fetal non-stress test 59025 $358.00 $143.20
Needle biopsy of thyroid, accessed through the skin 60100 $266.00 $106.40
Aspiration and/or injection of thyroid cyst 60300 $53.00 $21.20
Endocrine system procedure 60699 $275.00 $110.00
Aspiration or injection of cerebrospinal fluid shunt tubing or reservoir 61070 $720.00 $288.00
Occlusion of abnormal artery, accessed through the skin 61624 $5,244.00 $2,097.60
Occlusion of head or neck artery, accessed through the skin 61626 $1,673.00 $669.20
Balloon dilation of blood vessel in head, accessed through the skin 61630 $5,854.00 $2,341.60
Removal of blood clot and injection to dissolve blood clot from head artery using fluoroscopic guidance, accessed through skin 61645 $7,800.00 $3,120.00
Infusion of chemical agent into the artery of brain with insertion of catheter and imaging 61650 $2,571.00 $1,028.40
Infusion of chemical agent into the artery of brain with insertion of catheter and imaging 61651 $1,286.00 $514.40
Diagnostic aspiration of spinal disc or tissue, accessed through the skin 62267 $1,172.00 $468.80
Aspiration of spinal cord cyst or fluid-filled cavity, accessed through the skin 62268 $118.00 $47.20
Spinal tap for diagnosis 62270 $1,009.00 $403.60
Spinal tap with drainage of spinal fluid 62272 $1,009.00 $403.60
Injection of blood or blood clot into spinal canal 62273 $1,763.00 $705.20
Injection of dye for X-ray imaging and/or CT of lower spinal canal 62284 $659.00 $263.60
Aspiration of lower spine disc, accessed through the skin 62287 $1,922.00 $768.80
Injection of dye for X-ray imaging of spine disc 62290 $331.00 $132.40
X-ray of upper spinal canal with radiological supervision and interpretation 62302 $1,311.00 $524.40
X-ray of middle spinal canal with radiological supervision and interpretation 62303 $1,235.00 $494.00
Injection of substance into spinal canal of upper or middle back 62320 $1,850.00 $740.00
Injection of substance into spinal canal of upper or middle back using imaging guidance 62321 $2,495.00 $998.00
Injection of substance into spinal canal of upper or middle back using imaging guidance 62321 $1,031.00 $412.40
Injection of substance into spinal canal of upper or middle back using imaging guidance 62321 $687.00 $274.80
Injection of substance into the lower back or lumbar spine 62322 $1,850.00 $740.00
Injection of substance into the lower back or lumbar spine 62322 $1,850.00 $740.00
Injection into the lower back with help of imaging of some type 62323 $687.00 $274.80
Injection into the lower back with help of imaging of some type 62323 $687.00 $274.80
Injection into the lower back with help of imaging of some type 62323 $1,031.00 $412.40
Injection into the lower back with help of imaging of some type 62323 $1,031.00 $412.40
Injection into the lower back with help of imaging of some type 62323 $2,495.00 $998.00
Injection into the lower back with help of imaging of some type 62323 $2,495.00 $998.00
Insertion of indwelling catheter and administration of substance into spinal canal of upper or middle back 62324 $2,210.00 $884.00
Insertion of indwelling catheter and administration of substance into spinal canal of upper or middle back using imaging guidance 62325 $2,279.00 $911.60
Insertion of indwelling catheter and administration of substance into spinal canal of upper or middle back using imaging guidance 62325 $1,298.00 $519.20
Insertion of indwelling catheter and administration of substance into spinal canal of upper or middle back using imaging guidance 62325 $865.00 $346.00
Insertion of indwelling catheter and administration of substance into spinal canal of lower back 62326 $2,210.00 $884.00
Insertion of indwelling catheter and administration of substance into spinal canal of lower back lower back using imaging guidance 62327 $2,279.00 $911.60
Insertion of indwelling catheter and administration of substance into spinal canal of lower back lower back using imaging guidance 62327 $1,298.00 $519.20
Insertion of indwelling catheter and administration of substance into spinal canal of lower back lower back using imaging guidance 62327 $865.00 $346.00
Injection of anesthetic agent, trigeminal nerve 64400 $789.00 $315.60
Injection of anesthetic agent, trigeminal nerve 64400 $1,184.00 $473.60
Injection of anesthetic agent, greater occipital nerve 64405 $1,451.00 $580.40
Injection of anesthetic agent, greater occipital nerve 64405 $967.00 $386.80
Injection of anesthetic agent, brachial (arm) nerve bundle 64415 $1,766.00 $706.40
Injection of anesthetic agent, brachial (arm) nerve bundle 64415 $1,177.00 $470.80
Injection by continuous infusion of anesthetic agent, brachial (arm) nerve bundle 64416 $2,836.00 $1,134.40
Injection by continuous infusion of anesthetic agent, brachial (arm) nerve bundle 64416 $1,891.00 $756.40
Injection of anesthetic agent underarm (axillary) nerve 64417 $1,112.00 $444.80
Injection of anesthetic agent underarm (axillary) nerve 64417 $1,668.00 $667.20
Injection of anesthetic agent, collar bone nerve 64418 $1,710.00 $684.00
Injection of anesthetic agent, collar bone nerve 64418 $1,140.00 $456.00
Injection of anesthetic agent, of rib nerve 64420 $1,427.00 $570.80
Injection of anesthetic agent, of rib nerve 64420 $2,141.00 $856.40
Injection of anesthetic agent of multiple rib nerves 64421 $1,850.00 $740.00
Injection of anesthetic agent of multiple rib nerves 64421 $2,775.00 $1,110.00
Injection of anesthetic agent, groin nerves 64425 $1,802.00 $720.80
Injection of anesthetic agent, groin nerves 64425 $1,201.00 $480.40
Injection of anesthetic agent, pudendal (external genital) nerve 64430 $784.00 $313.60
Injection of anesthetic agent, sciatic nerve 64445 $1,787.00 $714.80
Injection of anesthetic agent, sciatic nerve 64445 $2,681.00 $1,072.40
Injection by continuous infusion of anesthetic agent, sciatic nerve 64446 $1,898.00 $759.20
Injection by continuous infusion of anesthetic agent, sciatic nerve 64446 $2,847.00 $1,138.80
Injection of anesthetic agent, thigh nerve 64447 $1,073.00 $429.20
Injection of anesthetic agent, thigh nerve 64447 $1,610.00 $644.00
Injection by continuous infusion of anesthetic agent, thigh nerve 64448 $1,898.00 $759.20
Injection by continuous infusion of anesthetic agent, thigh nerve 64448 $2,847.00 $1,138.80
Injection of anesthetic agent, other peripheral nerve or branch 64450 $987.00 $394.80
Injection of anesthetic agent, other peripheral nerve or branch 64450 $1,481.00 $592.40
Injection of anesthetic agent, thoracic vertebra 64461 $878.00 $351.20
Injection of anesthetic agent, thoracic vertebra 64462 $439.00 $175.60
Injection of anesthetic agent, thoracic vertebra 64463 $878.00 $351.20
Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance 64479 $1,398.00 $559.20
Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance 64480 $1,248.00 $499.20
Epidural steroid injections for lower back pain 64483 $1,850.00 $740.00
Epidural steroid injections for lower back pain 64483 $2,775.00 $1,110.00
Epidural steroid injections for lower back pain 64483 $1,850.00 $740.00
Epidural steroid injections for lower back pain 64483 $2,775.00 $1,110.00
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance 64484 $925.00 $370.00
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance 64484 $1,388.00 $555.20
Injections of upper or middle spine facet joint using imaging guidance 64490 $1,850.00 $740.00
Injections of upper or middle spine facet joint using imaging guidance 64490 $2,775.00 $1,110.00
Injections of upper or middle spine facet joint using imaging guidance 64491 $925.00 $370.00
Injections of upper or middle spine facet joint using imaging guidance 64491 $1,388.00 $555.20
Injections of upper or middle spine facet joint using imaging guidance 64492 $1,388.00 $555.20
Injections of upper or middle spine facet joint using imaging guidance 64492 $925.00 $370.00
Injections of lower or sacral spine facet joint using imaging guidance 64493 $1,850.00 $740.00
Injections of lower or sacral spine facet joint using imaging guidance 64493 $2,775.00 $1,110.00
Injections of lower or sacral spine facet joint using imaging guidance 64494 $925.00 $370.00
Injections of lower or sacral spine facet joint using imaging guidance 64494 $1,388.00 $555.20
Injections of lower or sacral spine facet joint using imaging guidance 64495 $925.00 $370.00
Injections of lower or sacral spine facet joint using imaging guidance 64495 $1,388.00 $555.20
Injection of anesthetic agent, trigeminal nerve bundle 64505 $1,443.00 $577.20
Injection of anesthetic agent, trigeminal nerve bundle 64505 $962.00 $384.80
Injection of anesthetic agent, sympathetic nerve bundle 64510 $2,775.00 $1,110.00
Injection of anesthetic agent, sympathetic nerve bundle 64510 $1,850.00 $740.00
Injection of anesthetic agent, middle or lower spine sympathetic nerves 64520 $1,578.00 $631.20
Injection of anesthetic agent, abdominal sympathetic nerve bundle 64530 $2,775.00 $1,110.00
Injection of anesthetic agent, abdominal sympathetic nerve bundle 64530 $1,850.00 $740.00
Injection of agent to destroy rib nerve 64620 $1,786.00 $714.40
Destruction of pudendal (external genital) nerve 64630 $1,379.00 $551.60
Destruction of pudendal (external genital) nerve 64630 $919.00 $367.60
Destruction of upper or middle spinal facet joint nerves using imaging guidance 64633 $2,495.00 $998.00
Destruction of upper or middle spinal facet joint nerves using imaging guidance 64633 $3,743.00 $1,497.20
Destruction of upper or middle spinal facet joint nerves with imaging guidance 64634 $925.00 $370.00
Destruction of upper or middle spinal facet joint nerves with imaging guidance 64634 $1,388.00 $555.20
Destruction of lower or sacral spinal facet joint nerves using imaging guidance 64635 $6,006.00 $2,402.40
Destruction of lower or sacral spinal facet joint nerves using imaging guidance 64635 $4,004.00 $1,601.60
Destruction of lower or sacral spinal facet joint nerves with imaging guidance 64636 $925.00 $370.00
Destruction of lower or sacral spinal facet joint nerves with imaging guidance 64636 $1,388.00 $555.20
Injection of agent to destroy abdominal sympathetic nerve bundle 64680 $1,181.00 $472.40
Nervous system procedure 64999 $258.00 $103.20
Fine needle aspiration of orbital contents 67415 $2,052.00 $820.80
Removal of impacted ear wax by washing 69209 $114.00 $45.60
X-ray of eye 70030 $211.00 $84.40
X-ray of eye 70030 $105.00 $42.00
X-ray of mandible, less than 4 views 70100 $162.00 $64.80
X-ray of mandible, minimum of 4 views 70110 $194.00 $77.60
X-ray of mastoid, less than 3 views per side 70120 $177.00 $70.80
X-ray of internal ear canal 70134 $460.00 $184.00
X-ray of bones of face, less than 3 views 70140 $102.00 $40.80
X-ray of bones of face, minimum of 3 views 70150 $197.00 $78.80
X-ray of bones of nose, minimum of 3 views 70160 $149.00 $59.60
X-ray of eye bones, minimum of 4 views 70200 $164.00 $65.60
X-ray of paranasal sinus, less than 3 views 70210 $254.00 $101.60
X-ray of paranasal sinus, complete, minimum of 3 views 70220 $447.00 $178.80
X-ray of bone at base of skull 70240 $132.00 $52.80
X-ray of skull, less than 4 views 70250 $133.00 $53.20
X-ray of skull, complete, minimum of 4 views 70260 $282.00 $112.80
X-ray of jaw joint on one side of the face 70328 $246.00 $98.40
X-ray of jaw joints on both sides of the face 70330 $384.00 $153.60
MRI scan of jaw joints 70336 $626.00 $250.40
X-ray imaging of teeth 70355 $255.00 $102.00
X-ray of soft tissue of neck 70360 $282.00 $112.80
CT scan of the head or brain without contrast or dye 70450 $327.00 $130.80
CT scan of the head or brain without contrast or dye 70450 $327.00 $130.80
CT scan head or brain with contrast 70460 $341.00 $136.40
CT scan head or brain before and after contrast 70470 $341.00 $136.40
CT scan of cranial cavity 70480 $327.00 $130.80
CT scan of cranial cavity with contrast 70481 $520.00 $208.00
CT scan of cranial cavity before and after contrast 70482 $574.00 $229.60
CT scan of face 70486 $327.00 $130.80
CT scan of face with contrast 70487 $341.00 $136.40
CT scan of face before and after contrast 70488 $354.00 $141.60
CT scan of neck 70490 $327.00 $130.80
CT scan of neck with contrast 70491 $341.00 $136.40
CT scan of neck before and after contrast 70492 $412.00 $164.80
CT scan of blood vessel of head with contrast 70496 $517.00 $206.80
CT scan of neck blood vessels with contrast 70498 $515.00 $206.00
MRI scan bones of the eye, face, and/or neck 70540 $513.00 $205.20
MRI scan bones of the eye, face, and/or neck with contrast 70542 $606.00 $242.40
MRI scan bones of the eye, face, and/or neck before and after contrast 70543 $749.00 $299.60
MRA scan of head blood vessels 70544 $671.00 $268.40
MRA scan of head blood vessels with contrast 70545 $667.00 $266.80
MRA scan of head blood vessels before and after contrast 70546 $1,034.00 $413.60
MRA scan of neck blood vessels 70547 $671.00 $268.40
MRA scan of neck blood vessels with contrast 70548 $717.00 $286.80
MRA scan of neck blood vessels before and after contrast 70549 $1,041.00 $416.40
MRI scan brain 70551 $493.00 $197.20
MRI scan of brain with contrast 70552 $583.00 $233.20
MRI scan of the brain with and without contrast 70553 $665.00 $266.00
MRI scan of the brain with and without contrast 70553 $665.00 $266.00
X-ray of chest, 1 view 71045 $316.00 $126.40
X-ray of the chest, 2 views 71046 $388.00 $155.20
X-ray of the chest, 2 views 71046 $388.00 $155.20
X-ray of chest, 3 views 71047 $406.00 $162.40
X-ray of chest, minimum of 4 views 71048 $438.00 $175.20
X-ray of ribs of one side of body, 2 views 71100 $152.00 $60.80
X-ray of ribs on one side of body including the chest, minimum of 3 views 71101 $244.00 $97.60
X-ray of both sides of the ribs, 3 views 71110 $255.00 $102.00
X-ray of both sides of the ribs including the chest, minimum of 4 views 71111 $273.00 $109.20
X-ray of breast bone, minimum of 2 views 71120 $143.00 $57.20
X-ray of junction of breast and collar bones, minimum of 2 views 71130 $85.00 $34.00
CT scan chest 71250 $327.00 $130.80
CT scan chest with contrast 71260 $341.00 $136.40
CT scan chest before and after contrast 71270 $418.00 $167.20
CT scan of blood vessels in chest with contrast 71275 $526.00 $210.40
MRI scan of chest 71550 $671.00 $268.40
MRI scan of chest with contrast 71551 $935.00 $374.00
MRI scan of chest before and after contrast 71552 $1,122.00 $448.80
MRI scan of blood vessels of chest 71555 $671.00 $268.40
MRI scan of blood vessels of chest 71555 $782.00 $312.80
X-ray of spine, 1 view 72020 $196.00 $78.40
X-ray of spine of neck, 2 or 3 views 72040 $273.00 $109.20
X-ray of upper spine, 4 or 5 views 72050 $381.00 $152.40
X-ray of upper spine, 6 or more views 72052 $429.00 $171.60
X-ray of middle spine, 3 views 72070 $287.00 $114.80
X-ray of middle spine, 3 views 72072 $324.00 $129.60
X-ray of middle and lower spine, 2 views 72080 $269.00 $107.60
X-ray of spine, 2 or 3 views 72082 $305.00 $122.00
X-ray of spine, 4 or 5 views 72083 $350.00 $140.00
X-ray of spine, minimum of 6 views 72084 $382.00 $152.80
X-ray of lower and sacral spine, 2 or 3 views 72100 $491.00 $196.40
X-ray of the lower spine with 4 or more views 72110 $702.00 $280.80
X-ray of the lower spine with 4 or more views 72110 $702.00 $280.80
X-ray lower and sacral spine including bending views minimum 6 views 72114 $776.00 $310.40
X-ray lower and sacral spine including bending views 2 or 3 views 72120 $544.00 $217.60
CT scan of upper spine 72125 $327.00 $130.80
CT scan of upper spine with contrast 72126 $420.00 $168.00
CT scan of upper spine before and after contrast 72127 $521.00 $208.40
CT scan of middle spine 72128 $327.00 $130.80
CT scan of middle spine with contrast 72129 $422.00 $168.80
CT scan of lower spine 72131 $327.00 $130.80
CT scan of lower spine with contrast 72132 $420.00 $168.00
CT scan of lower spine before and after contrast 72133 $518.00 $207.20
MRI scan of upper spinal canal 72141 $493.00 $197.20
MRI scan of upper spinal canal with contrast 72142 $597.00 $238.80
MRI scan of middle spinal canal 72146 $493.00 $197.20
MRI scan of middle spinal canal with contrast 72147 $592.00 $236.80
MRI scan of lower spinal canal 72148 $493.00 $197.20
MRI scan of lower spinal canal with contrast 72149 $586.00 $234.40
MRI scan of upper spinal canal before and after contrast 72156 $670.00 $268.00
MRI scan of middle spinal canal before and after contrast 72157 $672.00 $268.80
MRI scan of lower spinal canal before and after contrast 72158 $667.00 $266.80
X-ray of pelvis, 1 or 2 views 72170 $206.00 $82.40
X-ray of pelvis, minimum of 3 views 72190 $270.00 $108.00
CT scan of pelvic blood vessels with contrast 72191 $542.00 $216.80
CT scan pelvis 72192 $327.00 $130.80
CT scan of the pelvis with contrast or dye 72193 $422.00 $168.80
CT scan of the pelvis with contrast or dye 72193 $422.00 $168.80
CT scan of pelvis before and after contrast 72194 $501.00 $200.40
MRI scan of pelvis 72195 $614.00 $245.60
MRI scan of pelvis with contrast 72196 $658.00 $263.20
MRI scan of pelvis before and after contrast 72197 $797.00 $318.80
MRA scan of pelvic blood vessels 72198 $671.00 $268.40
MRA scan of pelvic blood vessels 72198 $786.00 $314.40
X-ray of sacroiliac joints, less than 3 views 72200 $140.00 $56.00
X-ray of pelvis, minimum of 2 views 72220 $309.00 $123.60
Radiological supervision and interpretation X-ray of upper spinal canal 72240 $1,311.00 $524.40
Radiological supervision and interpretation X-ray of middle spinal canal 72255 $1,235.00 $494.00
Radiological supervision and interpretation X-ray of lower spinal canal 72265 $1,243.00 $497.20
Radiological supervision and interpretation X-ray of spinal canal, 2 or more spinal regions 72270 $1,547.00 $618.80
Radiological supervision and interpretation X-ray of disc of vertebra, upper or middle spine 72285 $1,714.00 $685.60
Radiological supervision and interpretation X-ray of disc of vertebra, lower spine 72295 $1,604.00 $641.60
X-ray of collar bone 73000 $137.00 $54.80
X-ray of collar bone 73000 $274.00 $109.60
X-ray of shoulder blade 73010 $125.00 $50.00
X-ray of shoulder blade 73010 $249.00 $99.60
X-ray of shoulder, 1 view 73020 $474.00 $189.60
X-ray of shoulder, 1 view 73020 $237.00 $94.80
X-ray of shoulder, minimum of 2 views 73030 $320.00 $128.00
X-ray of shoulder, minimum of 2 views 73030 $640.00 $256.00
Radiological supervision and interpretation X-ray of shoulder joint 73040 $1,472.00 $588.80
Radiological supervision and interpretation X-ray of shoulder joint 73040 $736.00 $294.40
X-ray of both collar bones 73050 $130.00 $52.00
X-ray of upper arm, minimum of 2 views 73060 $132.00 $52.80
X-ray of upper arm, minimum of 2 views 73060 $264.00 $105.60
X-ray of elbow, 2 views 73070 $96.00 $38.40
X-ray of elbow, 2 views 73070 $192.00 $76.80
Radiological supervision and interpretation X-ray of elbow 73085 $233.00 $93.20
X-ray of forearm, 2 views 73090 $571.00 $228.40
X-ray of forearm, 2 views 73090 $286.00 $114.40
X-ray of arm in infant minimum of 2 views 73092 $204.00 $81.60
X-ray of arm in infant minimum of 2 views 73092 $102.00 $40.80
X-ray of wrist, 2 views 73100 $140.00 $56.00
X-ray of wrist, 2 views 73100 $280.00 $112.00
X-ray of wrist, minimum of 3 views 73110 $320.00 $128.00
X-ray of wrist, minimum of 3 views 73110 $160.00 $64.00
Radiological supervision and interpretation X-ray of wrist joint 73115 $468.00 $187.20
Radiological supervision and interpretation X-ray of wrist joint 73115 $936.00 $374.40
X-ray of hand, 2 views 73120 $452.00 $180.80
X-ray of hand, 2 views 73120 $226.00 $90.40
X-ray of hand, minimum of 3 views 73130 $281.00 $112.40
X-ray of hand, minimum of 3 views 73130 $561.00 $224.40
X-ray of fingers, minimum of 2 views 73140 $219.00 $87.60
CT scan of arm 73200 $327.00 $130.80
CT scan of arm with contrast 73201 $414.00 $165.60
CT scan of arm before and after contrast 73202 $546.00 $218.40
CT scan of arm blood vessels with contrast 73206 $600.00 $240.00
MRI scan of arm 73218 $671.00 $268.40
MRI scan of arm 73218 $1,342.00 $536.80
MRI scan of arm with contrast 73219 $812.00 $324.80
MRI scan of arm with contrast 73219 $1,624.00 $649.60
MRI scan of arm before and after contrast 73220 $1,978.00 $791.20
MRI scan of arm before and after contrast 73220 $989.00 $395.60
MRI scan of arm joint 73221 $493.00 $197.20
MRI scan of arm joint 73221 $986.00 $394.40
MRI scan of arm joint with contrast 73222 $751.00 $300.40
MRI scan of arm joint with contrast 73222 $1,502.00 $600.80
MRI scan of arm joint before and after contrast 73223 $915.00 $366.00
MRI scan of arm joint before and after contrast 73223 $1,830.00 $732.00
MRA scan of arm blood vessels 73225 $671.00 $268.40
MRA scan of arm blood vessels 73225 $1,626.00 $650.40
MRA scan of arm blood vessels 73225 $1,342.00 $536.80
MRA scan of arm blood vessels 73225 $813.00 $325.20
X-ray of hip with pelvis, 1 view 73501 $170.00 $68.00
X-ray of hip with pelvis, 2-3 views 73502 $326.00 $130.40
X-ray of both hips with pelvis, 2 views 73521 $387.00 $154.80
X-ray of both hips with pelvis, 3-4 views 73522 $314.00 $125.60
Radiological supervision and interpretation X-ray of hip joint 73525 $1,398.00 $559.20
Radiological supervision and interpretation X-ray of hip joint 73525 $699.00 $279.60
X-ray of femur, minimum 2 views 73552 $132.00 $52.80
X-ray of femur, minimum 2 views 73552 $264.00 $105.60
X-ray of knee, 1 or 2 views 73560 $300.00 $120.00
X-ray of knee, 1 or 2 views 73560 $150.00 $60.00
X-ray of knee, 3 views 73562 $167.00 $66.80
X-ray of knee, 3 views 73562 $334.00 $133.60
X-ray of knee, 4 or more views 73564 $204.00 $81.60
X-ray of knee, 4 or more views 73564 $408.00 $163.20
Radiological supervision and interpretation X-ray of knee joint 73580 $498.00 $199.20
X-ray of lower leg, 2 views 73590 $167.00 $66.80
X-ray of lower leg, 2 views 73590 $334.00 $133.60
X-ray of leg in infant minimum of 2 views 73592 $334.00 $133.60
X-ray of leg in infant minimum of 2 views 73592 $167.00 $66.80
X-ray of ankle, 2 views 73600 $484.00 $193.60
X-ray of ankle, 2 views 73600 $242.00 $96.80
X-ray of ankle, minimum of 3 views 73610 $294.00 $117.60
X-ray of ankle, minimum of 3 views 73610 $587.00 $234.80
Radiological supervision and interpretation X-ray of ankle joint 73615 $426.00 $170.40
X-ray of foot, 2 views 73620 $260.00 $104.00
X-ray of foot, 2 views 73620 $130.00 $52.00
X-ray of foot, minimum of 3 views 73630 $167.00 $66.80
X-ray of foot, minimum of 3 views 73630 $334.00 $133.60
X-ray of heel, minimum of 2 views 73650 $139.00 $55.60
X-ray of heel, minimum of 2 views 73650 $278.00 $111.20
X-ray of toes, minimum of 2 views 73660 $211.00 $84.40
CT scan leg 73700 $327.00 $130.80
CT scan leg with contrast injection 73701 $422.00 $168.80
CT scan of leg before and after contrast injection 73702 $537.00 $214.80
MRI scan of leg 73718 $1,206.00 $482.40
MRI scan of leg 73718 $603.00 $241.20
MRI scan of leg with contrast 73719 $1,316.00 $526.40
MRI scan of leg with contrast 73719 $658.00 $263.20
MRI scan of leg before and after contrast 73720 $802.00 $320.80
MRI scan of leg before and after contrast 73720 $1,604.00 $641.60
MRI scan of leg joint 73721 $493.00 $197.20
MRI scan of leg joint 73721 $986.00 $394.40
MRI scan of leg joint with contrast 73722 $1,514.00 $605.60
MRI scan of leg joint with contrast 73722 $757.00 $302.80
MRI scan of leg joint before and after contrast 73723 $914.00 $365.60
MRI scan of leg joint before and after contrast 73723 $1,828.00 $731.20
MRA scan of leg blood vessels 73725 $784.00 $313.60
MRA scan of leg blood vessels 73725 $1,342.00 $536.80
MRA scan of leg blood vessels 73725 $1,568.00 $627.20
X-ray of abdomen, 1 view 74018 $354.00 $141.60
X-ray of abdomen, 2 views 74019 $448.00 $179.20
X-ray of abdomen, minimum of 3 views 74021 $453.00 $181.20
Imaging of abdomen and chest 74022 $604.00 $241.60
CT scan abdomen 74150 $327.00 $130.80
CT scan of the abdomen with contrast or dye 74160 $421.00 $168.40
CT scan of the abdomen with contrast or dye 74160 $421.00 $168.40
CT scan abdomen before and after contrast 74170 $484.00 $193.60
CT scan of abdominal and pelvic blood vessels with contrast 74174 $2,223.00 $889.20
CT scan of abdominal blood vessels with contrast 74175 $545.00 $218.00
CT scan of abdomen and pelvis 74176 $341.00 $136.40
CT scan of abdomen and pelvis with contrast 74177 $554.00 $221.60
CT scan of abdomen and pelvis before and after contrast 74178 $636.00 $254.40
MRI scan of abdomen 74181 $528.00 $211.20
MRI scan of abdomen with contrast 74182 $747.00 $298.80
MRI scan of abdomen before and after contrast 74183 $799.00 $319.60
MRI scan of blood vessels of abdomen 74185 $791.00 $316.40
MRI scan of blood vessels of abdomen 74185 $671.00 $268.40
Radiological supervision and interpretation X-ray of lower abdominal and genital region 74190 $689.00 $275.60
X-ray of esophagus 74220 $539.00 $215.60
Imaging for evaluation of swallowing function 74230 $535.00 $214.00
Radiological supervision and interpretation of removal of foreign bodies in esophagus with balloon catheter 74235 $500.00 $200.00
X-ray of upper digestive tract 74240 $624.00 $249.60
X-ray upper GI series, with small bowel films 74245 $944.00 $377.60
X-ray of upper digestive tract with contrast 74246 $706.00 $282.40
X-ray of upper digestive tract with contrast followed by x-ray of small bowel at later point 74249 $1,268.00 $507.20
X-ray of small intestine 74250 $616.00 $246.40
X-ray of small intestine by small bowel tube 74251 $780.00 $312.00
X-ray of large bowel with contrast 74270 $774.00 $309.60
X-ray of large bowel with contrast 74280 $1,006.00 $402.40
Radiological supervision and interpretation X-ray of bile and/or pancreatic ducts during surgery 74300 $255.00 $102.00
Radiological supervision and interpretation of insertion of catheter into biliary duct using an endoscope 74328 $934.00 $373.60
Radiological supervision and interpretation of placement of long small bowel tube procedure 74340 $488.00 $195.20
Radiological supervision and interpretation of placement (accessed through the skin) of small bowel tube 74355 $207.00 $82.80
Radiological supervision and interpretation of opening of digestive tract procedure 74360 $248.00 $99.20
Radiological supervision and interpretation of dilation of biliary duct (accessed through the skin) 74363 $492.00 $196.80
Imaging of urinary tract using infusion technique 74410 $598.00 $239.20
Imaging of urinary tract using infusion technique with kidney section filming 74415 $558.00 $223.20
Imaging of urinary tract 74420 $501.00 $200.40
Radiological supervision and interpretation X-ray of urinary tract 74425 $501.00 $200.40
Radiological supervision and interpretation X-ray of urinary tract 74425 $1,003.00 $401.20
Radiological supervision and interpretation X-ray of urinary bladder, minimum of 3 views 74430 $564.00 $225.60
Radiological supervision and interpretation X-ray of urinary bladder and urethra 74450 $532.00 $212.80
Radiological supervision and interpretation X-ray of urinary bladder and urethra 74455 $676.00 $270.40
Radiological supervision and interpretation X-ray of kidney cyst, lower back contrast injection 74470 $580.00 $232.00
Radiological supervision and interpretation of dilation of urinary ducts (ureters) or bladder canal (urethra) 74485 $1,669.00 $667.60
Radiological supervision and interpretation of dilation of urinary ducts (ureters) or bladder canal (urethra) 74485 $1,821.00 $728.40
Radiological supervision and interpretation X-ray of uterine tubes and ovaries 74740 $695.00 $278.00
Radiological supervision and interpretation of placement of catheter of uterine tube procedure 74742 $324.00 $129.60
Radiological supervision and interpretation of placement of catheter of uterine tube procedure 74742 $648.00 $259.20
MRI of heart 75557 $538.00 $215.20
MRI of heart before and after contrast 75561 $772.00 $308.80
CT scan of heart with evaluation of blood vessel calcium 75571 $181.00 $72.40
CT scan of heart blood vessels and grafts with contrast dye 75574 $587.00 $234.80
Radiological supervision and interpretation X-ray of chest aorta 75605 $4,392.00 $1,756.80
Radiological supervision and interpretation X-ray of abdominal aorta 75625 $2,523.00 $1,009.20
Radiological supervision and interpretation X-ray of abdominal aorta and both leg arteries 75630 $4,140.00 $1,656.00
CT scan of abdominal aorta and both leg arteries with contrast 75635 $587.00 $234.80
Radiological supervision and interpretation of imaging of spinal artery 75705 $4,948.00 $1,979.20
Radiological supervision and interpretation of imaging of artery of one arm or leg 75710 $3,770.00 $1,508.00
Radiological supervision and interpretation of imaging of arteries of both arms or legs 75716 $4,492.00 $1,796.80
Radiological supervision and interpretation of imaging of abdominal artery 75726 $5,400.00 $2,160.00
Radiological supervision and interpretation of imaging of artery of one adrenal gland 75731 $3,951.00 $1,580.40
Radiological supervision and interpretation of imaging of artery of pelvis 75736 $4,049.00 $1,619.60
Radiological supervision and interpretation of imaging of artery of one lung 75741 $3,240.00 $1,296.00
Radiological supervision and interpretation of imaging of arteries of both lungs 75743 $4,634.00 $1,853.60
Radiological supervision and interpretation of imaging of lung artery, contrast inserted by catheter or injection into vein 75746 $2,252.00 $900.80
Radiological supervision and interpretation of imaging of artery of breast 75756 $2,589.00 $1,035.60
Radiological supervision and interpretation of imaging of artery 75774 $1,895.00 $758.00
Radiological supervision and interpretation of imaging of artery 75774 $2,515.00 $1,006.00
Radiological supervision and interpretation of imaging of previous placed shunt 75809 $538.00 $215.20
Radiological supervision and interpretation X-ray of vein of spleen and liver 75810 $993.00 $397.20
Radiological supervision and interpretation of imaging of vein of one arm or leg 75820 $974.00 $389.60
Radiological supervision and interpretation of imaging of veins of both arms or legs 75822 $1,988.00 $795.20
Radiological supervision and interpretation of imaging of major abdominal vein 75825 $501.00 $200.40
Radiological supervision and interpretation of imaging of major chest vein 75827 $2,250.00 $900.00
Radiological supervision and interpretation of imaging of vein of one kidney 75831 $2,810.00 $1,124.00
Radiological supervision and interpretation of imaging of vein of both kidneys 75833 $3,300.00 $1,320.00
Radiological supervision and interpretation of imaging of vein system in head or neck vein 75860 $2,939.00 $1,175.60
Radiological supervision and interpretation of imaging of vein system in head or neck vein 75860 $2,672.00 $1,068.80
Radiological supervision and interpretation of imaging of liver vein with assessment of blood flow, injection of contrast (accessed through the skin) 75885 $3,443.00 $1,377.20
Radiological supervision and interpretation of imaging of liver vein, injection of contrast (accessed through the skin) 75887 $738.00 $295.20
Radiological supervision and interpretation of imaging of liver vein with assessment of blood flow 75889 $2,944.00 $1,177.60
Radiological supervision and interpretation of imaging of liver vein 75891 $3,145.00 $1,258.00
Radiological supervision and interpretation of drawing blood via catheter procedure 75893 $4,224.00 $1,689.60
Radiological supervision and interpretation of obstruction of blood vessel via catheter 75894 $1,901.00 $760.40
Imaging of blood vessel 75898 $1,451.00 $580.40
Imaging of blood vessel 75898 $1,160.00 $464.00
Radiological supervision and interpretation of removal of obstructive material in catheter procedure 75901 $296.00 $118.40
Radiological supervision and interpretation of removal of obstructive material from large vein catheter procedure 75902 $462.00 $184.80
Radiological supervision and interpretation of repair of chest aorta with graft 75956 $2,696.00 $1,078.40
Radiological supervision and interpretation of repair of chest aorta with graft 75957 $2,322.00 $928.80
Radiological supervision and interpretation of placement of blood vessel prosthesis procedure 75958 $1,564.00 $625.60
Radiological supervision and interpretation of biopsy procedure 75970 $1,910.00 $764.00
Radiological supervision and interpretation of change of tube (accessed through the skin) or drainage catheter with contrast monitoring 75984 $309.00 $123.60
Radiological supervision and interpretation of change of tube (accessed through the skin) or drainage catheter with contrast monitoring 75984 $616.00 $246.40
Radiological supervision and interpretation of placement of catheter with drainage (accessed through the skin) procedure 75989 $535.00 $214.00
Imaging guidance for procedure, up to 1 hour 76000 $498.00 $199.20
Imaging from nose to rectum, single view, child 76010 $338.00 $135.20
Imaging for abscess or abnormal drainage tract procedure 76080 $649.00 $259.60
Imaging of surgical specimen 76098 $649.00 $259.60
Single plane imaging procedure 76100 $323.00 $129.20
CT scan limited or follow-up study 76380 $181.00 $72.40
CT scan 76497 $987.00 $394.80
MRI scan 76498 $181.00 $72.40
Ultrasound of brain 76506 $185.00 $74.00
Ultrasound of head and neck 76536 $620.00 $248.00
Ultrasound of chest 76604 $464.00 $185.60
Ultrasound of one breast 76641 $688.00 $275.20
Ultrasound of one breast 76641 $1,023.00 $409.20
Ultrasound of one breast 76642 $602.00 $240.80
Ultrasound of one breast 76642 $888.00 $355.20
Ultrasound of the abdomen 76700 $1,102.00 $440.80
Ultrasound of the abdomen 76700 $1,102.00 $440.80
Ultrasound of abdomen 76705 $812.00 $324.80
Ultrasound evaluation of abdominal aorta to detect bulging (aneurysm) 76706 $528.00 $211.20
Ultrasound behind abdominal cavity 76770 $900.00 $360.00
Ultrasound behind abdominal cavity, limited 76775 $742.00 $296.80
Ultrasound of transplanted kidney 76776 $209.00 $83.60
Ultrasound of spinal canal 76800 $162.00 $64.80
Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) single or first fetus 76801 $215.00 $86.00
Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) 76802 $215.00 $86.00
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $294.00 $117.60
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $294.00 $117.60
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) 76810 $256.00 $102.40
Ultrasound of pregnant uterus, 1 or more fetus(es) 76815 $175.00 $70.00
Vaginal ultrasound of pregnant uterus 76817 $192.00 $76.80
Ultrasound of fetus 76819 $220.00 $88.00
Ultrasound pelvis through vagina 76830 $793.00 $317.20
Ultrasound of pelvis 76856 $704.00 $281.60
Ultrasound of pelvis 76857 $561.00 $224.40
Ultrasound of scrotum 76870 $561.00 $224.40
Partial ultrasound of joint or other non-blood vessel structure of arm or leg 76882 $222.00 $88.80
Ultrasound of hips with manipulation, infant 76885 $527.00 $210.80
Ultrasonic guidance for drainage of sac that covers the heart 76930 $382.00 $152.80
Ultrasound guidance for repair of blood vessel 76936 $881.00 $352.40
Ultrasound guidance for accessing into blood vessel 76937 $613.00 $245.20
Ultrasound guidance for tissue destruction 76940 $552.00 $220.80
Ultrasonic guidance imaging supervision and interpretation for insertion of needle 76942 $1,800.00 $720.00
Ultrasonic guidance imaging supervision and interpretation for insertion of needle 76942 $900.00 $360.00
Ultrasonic guidance imaging supervision and interpretation for amniocentesis 76946 $488.00 $195.20
Ultrasound follow-up study 76970 $217.00 $86.80
Ultrasonic guidance during surgery 76998 $429.00 $171.60
Fluoroscopic guidance for insertion, replacement or removal of central venous access device 77001 $636.00 $254.40
Fluoroscopic guidance for insertion of needle 77002 $717.00 $286.80
Fluoroscopic guidance for insertion of needle 77002 $478.00 $191.20
Fluoroscopic guidance for injection into spine or muscle next to spine 77003 $746.00 $298.40
CT scan guidance for stereotactic localization 77011 $413.00 $165.20
Radiological supervision and interpretation of CT guidance for needle insertion 77012 $341.00 $136.40
CT scan guidance for and monitoring of tissue destruction 77013 $744.00 $297.60
CT scan guidance for insertion of radiation therapy fields 77014 $341.00 $136.40
Radiological supervision and interpretation of MRI guidance for insertion of needle 77021 $1,284.00 $513.60
MRI of one breast 77046 $671.00 $268.40
MRI of both breasts 77047 $671.00 $268.40
MRI of one breast with and without contrast 77048 $1,122.00 $448.80
MRI of both breasts with and without contrast 77049 $1,122.00 $448.80
Radiological supervision and interpretation of imaging of breast duct 77053 $442.00 $176.80
Radiological supervision and interpretation of imaging of breast duct 77053 $221.00 $88.40
Radiological supervision and interpretation of imaging of breast ducts 77054 $397.00 $158.80
Screening digital tomography of both breasts 77063 $73.00 $29.20
Mammography of one breast 77065 $200.00 $80.00
Mammography of both breasts 77066 $255.00 $102.00
Mammogram of both breasts 77067 $211.00 $84.40
Mammogram of both breasts 77067 $211.00 $84.40
Imaging for bone age assessment 77072 $158.00 $63.20
Imaging for bone length assessment 77073 $346.00 $138.40
X-ray of bones 77074 $232.00 $92.80
X-ray survey of forearm or wrist bone density 77075 $332.00 $132.80
X-ray survey of bones, infant 77076 $274.00 $109.60
Imaging of 2 or more joints, single view 77077 $294.00 $117.60
Bone density measurement using dedicated X-ray machine 77080 $454.00 $181.60
Bone density measurement using dedicated X-ray machine 77081 $242.00 $96.80
Management of radiation therapy simulation, simple 77280 $640.00 $256.00
Management of radiation therapy, simulation, intermediate 77285 $953.00 $381.20
Management of radiation therapy, simulation, complex 77290 $1,256.00 $502.40
Respiratory motion management simulation 77293 $1,409.00 $563.60
Management of radiation therapy, 3D 77295 $3,998.00 $1,599.20
Calculation of radiation therapy dose 77300 $436.00 $174.40
Management of modulation radiotherapy planning 77301 $4,197.00 $1,678.80
Radiation therapy plan 77306 $457.00 $182.80
Radiation therapy plan 77307 $714.00 $285.60
Radiation therapy plan 77316 $352.00 $140.80
Radiation therapy plan 77317 $377.00 $150.80
Radiation therapy total body port plan 77321 $989.00 $395.60
Special radiation therapy planning 77331 $438.00 $175.20
Radiation treatment devices, design and construction, simple 77332 $413.00 $165.20
Radiation treatment devices, design and construction, intermediate 77333 $505.00 $202.00
Radiation treatment devices, design and construction, complex 77334 $1,047.00 $418.80
Radiation therapy consultation per week 77336 $539.00 $215.60
Design and construction of device for radiation therapy 77338 $952.00 $380.80
Radiation therapy consultation 77370 $316.00 $126.40
Radiation therapy delivery, stereotactic radiosurgery (SRS) for cranial growths, per session 77372 $7,700.00 $3,080.00
Stereotactic body radiation therapy 1 or more lesions using imaging guidance 77373 $9,394.00 $3,757.60
Radiation therapy delivery 77385 $1,455.00 $582.00
Radiation therapy delivery 77386 $2,286.00 $914.40
Guidance for localization of target delivery of radiation treatment 77387 $705.00 $282.00
Radiation treatment delivery, superficial 77401 $167.00 $66.80
Radiation treatment delivery 77402 $422.00 $168.80
Radiation treatment delivery 77407 $543.00 $217.20
Radiation treatment delivery 77412 $859.00 $343.60
Therapeutic radiology port films 77417 $208.00 $83.20
Special radiation treatment procedure 77470 $1,912.00 $764.80
Application of organ cavity radiation source, simple 77761 $475.00 $190.00
Application of organ cavity radiation source, intermediate 77762 $475.00 $190.00
High dose brachytherapy , 1 channel 77770 $3,375.00 $1,350.00
High dose brachytherapy , 2- 12 channels 77771 $3,715.00 $1,486.00
Application of radiation source, complex 77778 $2,318.00 $927.20
Supervision, handling, loading of radiation 77790 $111.00 $44.40
Nuclear medicine imaging of thyroid 78013 $498.00 $199.20
Nuclear medicine imaging for thyroid uptake measurements 78014 $704.00 $281.60
Nuclear medicine whole body study for thyroid cancer 78018 $1,687.00 $674.80
Imaging of parathyroid 78070 $1,192.00 $476.80
Imaging of parathyroid with nuclear medicine study 78071 $1,192.00 $476.80
Imaging of parathyroid with CT and nuclear medicine study 78072 $1,192.00 $476.80
Imaging of bone marrow limited area 78102 $1,005.00 $402.00
Imaging of lymphatic tissue and lymph node 78195 $783.00 $313.20
Nuclear medicine study of liver 78205 $1,466.00 $586.40
Imaging of liver and spleen 78215 $1,376.00 $550.40
Imaging of liver and bile duct system 78226 $1,534.00 $613.60
Imaging of liver and bile duct system with use of drugs 78227 $1,534.00 $613.60
Imaging of esophagus using radioisotopes 78258 $395.00 $158.00
Stomach emptying study 78264 $1,361.00 $544.40
Acute digestive tract blood loss imaging 78278 $611.00 $244.40
Intestine imaging 78290 $592.00 $236.80
Peritoneal-venous shunt patency test 78291 $539.00 $215.60
Bone and/or joint imaging 78300 $1,330.00 $532.00
Bone and/or joint imaging, whole body 78306 $2,023.00 $809.20
Bone and/or joint imaging, 3 phase study 78315 $2,133.00 $853.20
Nuclear medicine study of bone and/or joint 78320 $2,238.00 $895.20
Nuclear medicine study of vessels of heart using drugs or exercise single study 78451 $3,242.00 $1,296.80
Nuclear medicine study of vessels of heart using drugs or exercise multiple studies 78452 $4,414.00 $1,765.60
Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study 78472 $724.00 $289.60
Nuclear medicine study of blood circulation in the lungs 78580 $1,409.00 $563.60
Nuclear medicine study of lung ventilation and blood circulation in the lungs 78582 $1,869.00 $747.60
Nuclear medicine study with measurement of blood circulation in the lungs and ventilation 78598 $2,203.00 $881.20
Imaging of brain with blood flow, less than 4 static views 78601 $671.00 $268.40
Imaging of brain, blood flow 78610 $608.00 $243.20
Imaging of brain and spinal cord fluid flow at base of brain 78630 $893.00 $357.20
Nuclear medicine study of kidney with assessment of blood flow and function 78707 $714.00 $285.60
Nuclear medicine study of kidney with assessment of blood flow and function 78708 $1,031.00 $412.40
Nuclear medicine study of radioactive material distribution at multiple tumor locations 78801 $1,545.00 $618.00
Nuclear medicine study of radioactive material distribution 78803 $1,750.00 $700.00
Nuclear medicine study of radioactive material distribution at site of inflammation 78805 $1,456.00 $582.40
Nuclear medicine study of radioactive material distribution at sites of inflammation in whole body 78806 $1,456.00 $582.40
Injection of radioactive contrast material into a vein for non-imaging gamma probe 78808 $494.00 $197.60
Nuclear medicine study with CT imaging skull base to mid-thigh 78815 $2,866.00 $1,146.40
Nuclear medicine study with CT imaging whole body 78816 $2,866.00 $1,146.40
Oral administration of radioactive material therapy agent 79005 $1,302.00 $520.80
Radioactive material therapy into vein 79101 $631.00 $252.40
Radioactive material therapy into artery 79445 $1,111.00 $444.40
Basic Metabolic Panel 80048 $79.00 $31.60
Basic Metabolic Panel 80048 $79.00 $31.60
Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) 80051 $66.00 $26.40
Comprehensive Metabolic Panel 80053 $108.00 $43.20
Comprehensive Metabolic Panel 80053 $108.00 $43.20
Lipid Panel 80061 $103.00 $41.20
Lipid Panel 80061 $103.00 $41.20
Kidney function blood test panel 80069 $81.00 $32.40
Acute hepatitis panel 80074 $320.00 $128.00
Liver function blood test panel 80076 $79.00 $31.60
Amikacin (antibiotic) level 80150 $53.00 $21.20
Caffeine level 80155 $142.00 $56.80
Carbamazepine level 80156 $99.00 $39.60
Carbamazepine level 80157 $77.00 $30.80
Cyclosporine level 80158 $114.00 $45.60
Clozapine level 80159 $118.00 $47.20
Digoxin level 80162 $42.00 $16.80
Valproic acid level 80164 $115.00 $46.00
Ethosuximide level 80168 $139.00 $55.60
Everolimus level 80169 $92.00 $36.80
Gentamicin (antibiotic) level 80170 $127.00 $50.80
Gabapentin level 80171 $92.00 $36.80
Haloperidol level 80173 $74.00 $29.60
Lamotrigine level 80175 $111.00 $44.40
Lidocaine level 80176 $79.00 $31.60
Levetiracetam level 80177 $92.00 $36.80
Lithium level 80178 $70.00 $28.00
Oxcarbazepine level 80183 $97.00 $38.80
Phenobarbital level 80184 $88.00 $35.20
Phenytoin level 80185 $40.00 $16.00
Phenytoin level 80186 $57.00 $22.80
Primidone level 80188 $105.00 $42.00
Sirolimus level 80195 $77.00 $30.80
Tacrolimus level 80197 $132.00 $52.80
Theophylline level 80198 $44.00 $17.60
Tobramycin (antibiotic) level 80200 $53.00 $21.20
Topiramate level 80201 $84.00 $33.60
Vancomycin (antibiotic) level 80202 $42.00 $16.80
Zonisamide level 80203 $92.00 $36.80
Quantitation of therapeutic drug 80299 $92.00 $36.80
Testing for presence of drug 80307 $151.00 $60.40
Alkaloids levels 80323 $139.00 $55.60
Amphetamines levels 80324 $139.00 $55.60
Analgesics levels 80329 $139.00 $55.60
Antidepressants levels 80335 $139.00 $55.60
Barbiturates levels 80345 $139.00 $55.60
Benzodiazepines levels 80346 $139.00 $55.60
Cocaine level 80353 $139.00 $55.60
Methadone level 80358 $139.00 $55.60
Opiates levels 80361 $139.00 $55.60
Oxycodone levels 80365 $139.00 $55.60
Propoxyphene level 80367 $139.00 $55.60
Skeletal muscle relaxants levels 80369 $139.00 $55.60
Thyrotropin releasing hormone (TRH) (hypothalamus hormone) stimulation panel, 1 hour 80438 $149.00 $59.60
Urinalysis, by dipstick or tablet reagent not automated without a microscope 81001 $77.00 $30.80
Urinalysis, by dipstick or tablet reagent not automated without a microscope 81001 $77.00 $30.80
Automated urinalysis test 81003 $18.00 $7.20
Urine pregnancy test 81025 $99.00 $39.60
Gene analysis (cystic fibrosis transmembrane conductance regular) common variants 81220 $184.00 $73.60
Gene analysis (prothrombin, coagulation factor II) A variant 81240 $133.00 $53.20
Gene analysis (coagulation factor V) Leiden variant 81241 $151.00 $60.40
Gene analysis (fragile X mental retardation) abnormal alleles 81243 $421.00 $168.40
Gene analysis (hemochromatosis) common variants 81256 $371.00 $148.40
Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants 81291 $287.00 $114.80
Gene analysis (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, antitrypsin, member 1) common variants 81332 $100.00 $40.00
Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma) 81342 $417.00 $166.80
HLA class I typing, low resolution one antigen equivalent 81374 $245.00 $98.00
HLA class II typing low resolution one locus 81376 $375.00 $150.00
HLA class II typing high resolution one locus 81382 $514.00 $205.60
Molecular pathology procedure level 2 81401 $402.00 $160.80
Molecular pathology procedure level 3 81402 $413.00 $165.20
Molecular pathology procedure 81479 $609.00 $243.60
Ketone bodies analysis 82009 $38.00 $15.20
Ketone bodies analysis 82010 $65.00 $26.00
Adrenocorticotropic hormone (ACTH) level 82024 $145.00 $58.00
Albumin (protein) level 82040 $20.00 $8.00
Cerebrospinal fluid, or amniotic fluid albumin (protein) level 82042 $28.00 $11.20
Urine microalbumin (protein) level 82043 $60.00 $24.00
Aldolase (enzyme) level 82085 $55.00 $22.00
Aldosterone hormone level 82088 $140.00 $56.00
Alpha-1-antitrypsin (protein) blood test 82103 $85.00 $34.00
Alpha-1-antitrypsin (protein) blood test 82104 $88.00 $35.20
Alpha-fetoprotein (AFP) level, serum 82105 $91.00 $36.40
Alpha-fetoprotein (AFP) analysis 82107 $190.00 $76.00
Aluminum level 82108 $95.00 $38.00
Amino acid analysis 82131 $125.00 $50.00
Amino acid level, multiple amino acids 82139 $278.00 $111.20
Ammonia level 82140 $85.00 $34.00
Amylase (enzyme) level 82150 $75.00 $30.00
Androstenedione (hormone) level 82157 $102.00 $40.80
Angiotensin l - converting enzyme (ACE) level 82164 $80.00 $32.00
Arsenic level 82175 $82.00 $32.80
Beta-2 microglobulin (protein) level 82232 $78.00 $31.20
Bile acids level 82239 $74.00 $29.60
Bilirubin level 82247 $70.00 $28.00
Bilirubin level 82248 $64.00 $25.60
Specimen analysis for blood 82271 $17.00 $6.80
Stool analysis for blood 82272 $12.00 $4.80
Stool analysis for blood 82274 $85.00 $34.00
Cadmium level 82300 $68.00 $27.20
Vitamin D-3 level 82306 $124.00 $49.60
Calcitonin (hormone) level 82308 $110.00 $44.00
Calcium level 82310 $20.00 $8.00
Calcium level 82330 $42.00 $16.80
Urine calcium level 82340 $51.00 $20.40
Chemical analysis of stone 82360 $75.00 $30.00
Carbon dioxide (bicarbonate) level 82374 $50.00 $20.00
Carboxyhemoglobin (protein) level 82375 $69.00 $27.60
Carcinoembryonic antigen (CEA) protein level 82378 $122.00 $48.80
Catecholamines (organic nitrogen) level 82384 $135.00 $54.00
Ceruloplasmin (protein) level 82390 $68.00 $27.20
Analysis using chemiluminescent technique (light and chemical )reaction 82397 $125.00 $50.00
Blood chloride level 82435 $43.00 $17.20
Urine chloride level 82436 $49.00 $19.60
Chloride level 82438 $53.00 $21.20
Screening test for chlorinated hydrocarbons 82441 $35.00 $14.00
Cholesterol level 82465 $25.00 $10.00
Cholinesterase (enzyme) level, to test for exposure to chemical or liver disease 82480 $52.00 $20.80
Chromium level to test for poisoning or deficiency 82495 $82.00 $32.80
Citrate level 82507 $104.00 $41.60
Collagen cross links test, (urine test to evaluate bone health) 82523 $78.00 $31.20
Copper level 82525 $59.00 $23.60
Cortisol (hormone) measurement 82530 $93.00 $37.20
Cortisol (hormone) measurement 82533 $95.00 $38.00
Chemical analysis using chromatography technique 82542 $116.00 $46.40
Chemical analysis using chromatography technique 82542 $139.00 $55.60
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $46.00 $18.40
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $46.00 $18.40
Creatine kinase (cardiac enzyme) level 82552 $82.00 $32.80
Creatine kinase (cardiac enzyme) level 82553 $70.00 $28.00
Blood creatinine level 82565 $55.00 $22.00
Creatinine level to test for kidney function or muscle injury 82570 $58.00 $23.20
Creatinine clearance measurement to test for kidney function 82575 $103.00 $41.20
Cryofibrinogen (protein) level 82585 $47.00 $18.80
Cryoglobulin (protein) measurement 82595 $52.00 $20.80
Cyanocobalamin (vitamin B-12) level 82607 $48.00 $19.20
Cystatin C (enzyme inhibitor) level 82610 $58.00 $23.20
Dehydroepiandrosterone (DHEA) hormone level 82626 $94.00 $37.60
Dehydroepiandrosterone (DHEA-S) hormone level 82627 $118.00 $47.20
Desoxycorticosterone, 11 (hormone) level 82633 $163.00 $65.20
Dihydroxyvitamin D, 1, 25 level 82652 $185.00 $74.00
Pancreatic elastase (enzyme) measurement 82656 $254.00 $101.60
Erythropoietin (protein) level 82668 $104.00 $41.60
Estradiol (hormone) level 82670 $128.00 $51.20
Estrogen analysis 82671 $152.00 $60.80
Estrogen analysis 82672 $133.00 $53.20
Estriol (hormone) level 82677 $91.00 $36.40
Estrone (hormone) level 82679 $96.00 $38.40
Ethylene glycol (antifreeze) measurement 82693 $146.00 $58.40
Stool fat analysis 82705 $29.00 $11.60
Ferritin (blood protein) level 82728 $42.00 $16.80
Fetal fibronectin (protein) analysis 82731 $314.00 $125.60
Fluoride level 82735 $119.00 $47.60
Folic acid level 82746 $46.00 $18.40
Folic acid level 82747 $73.00 $29.20
Gammaglobulin (immune system protein) measurement 82784 $54.00 $21.60
IgE (immune system protein) level 82785 $86.00 $34.40
Gammaglobulin (immune system protein) measurement 82787 $48.00 $19.20
Blood pH level 82800 $81.00 $32.40
Blood gases measurement 82803 $84.00 $33.60
Blood gas, oxygen saturation measurement 82810 $60.00 $24.00
Gastrin (GI tract hormone) level 82941 $89.00 $35.60
Glucose (sugar) level on body fluid 82945 $51.00 $20.40
Blood glucose (sugar) level 82947 $15.00 $6.00
Blood glucose (sugar) level after receiving dose of glucose 82950 $57.00 $22.80
Blood glucose (sugar) tolerance test 82951 $85.00 $34.00
Blood glucose (sugar) tolerance test 82952 $12.00 $4.80
G6PD (enzyme) level 82955 $71.00 $28.40
Blood glucose (sugar) test performed by hand-held instrument 82962 $44.00 $17.60
Glutamyltransferase (liver enzyme) level 82977 $72.00 $28.80
Gonadotropin, follicle stimulating (reproductive hormone) level 83001 $111.00 $44.40
Gonadotropin, luteinizing (reproductive hormone) level 83002 $114.00 $45.60
Human growth hormone level 83003 $70.00 $28.00
Haptoglobin (serum protein) level 83010 $86.00 $34.40
Heavy metal level 83018 $99.00 $39.60
Hemoglobin analysis and measurement 83020 $75.00 $30.00
Hemoglobin analysis and measurement 83021 $53.00 $21.20
Fetal hemoglobin analysis 83033 $48.00 $19.20
Hemoglobin A1C level 83036 $34.00 $13.60
Methemoglobin (hemoglobin) analysis 83050 $53.00 $21.20
Sulfhemoglobin (hemoglobin) level 83060 $33.00 $13.20
Hemosiderin (hemoglobin breakdown product) analysis 83070 $42.00 $16.80
Homocysteine (amino acid) level 83090 $130.00 $52.00
Homovanillic acid (organic acid) level 83150 $64.00 $25.60
Hydroxyindolacetic acid (product of metabolism) level 83497 $77.00 $30.80
Hydroxyprogesterone, 17-D (synthetic hormone) level 83498 $113.00 $45.20
Analysis of substance using immunoassay technique 83516 $75.00 $30.00
Measurement of substance using immunoassay technique 83519 $134.00 $53.60
Measurement of substance using immunoassay technique 83520 $125.00 $50.00
Insulin measurement 83525 $61.00 $24.40
Insulin measurement 83527 $78.00 $31.20
Iron level 83540 $22.00 $8.80
Iron binding capacity 83550 $28.00 $11.20
Lactic acid level 83605 $33.00 $13.20
Lactate dehydrogenase (enzyme) level 83615 $61.00 $24.40
Stool lactoferrin (immune system protein) analysis 83630 $75.00 $30.00
Lead level 83655 $59.00 $23.60
Fetal lung maturity assessment 83664 $74.00 $29.60
Lipase (fat enzyme) level 83690 $87.00 $34.80
Lipoprotein level 83700 $84.00 $33.60
Lipoprotein measurement 83701 $73.00 $29.20
HDL cholesterol level 83718 $47.00 $18.80
Magnesium level 83735 $23.00 $9.20
Manganese (heavy metal) level 83785 $73.00 $29.20
Mass spectrometry (laboratory testing method) 83789 $139.00 $55.60
Mass spectrometry (laboratory testing method) 83789 $97.00 $38.80
Mercury level 83825 $68.00 $27.20
Metanephrines level 83835 $85.00 $34.00
Myoglobin (muscle protein) level 83874 $75.00 $30.00
Myeloperoxidase (white blood cell enzyme) measurement 83876 $81.00 $32.40
Natriuretic peptide (heart and blood vessel protein) level 83880 $113.00 $45.20
Nephelometry, test method using light 83883 $58.00 $23.20
Measurement of immune substance (oligoclonal bands) 83916 $101.00 $40.40
Organic acid level 83921 $109.00 $43.60
Blood osmolality (concentration) measurement 83930 $22.00 $8.80
Urine osmolality (concentration) measurement 83935 $42.00 $16.80
Oxalate level 83945 $60.00 $24.00
Parathormone (parathyroid hormone) level 83970 $124.00 $49.60
Body fluid pH level 83986 $38.00 $15.20
PCP drug level 83992 $99.00 $39.60
Stool calprotectin (protein) level 83993 $249.00 $99.60
Phenylalanine, PKU (amino acid) level 84030 $109.00 $43.60
Phosphatase (enzyme) level 84075 $64.00 $25.60
Phosphatase (enzyme) level 84078 $122.00 $48.80
Phosphatase (enzyme) measurement 84080 $76.00 $30.40
Phosphate level 84100 $17.00 $6.80
Urine phosphate level 84105 $48.00 $19.20
Urine porphobilinogen (metabolism substance) level 84110 $50.00 $20.00
Cervicovaginal secretion of placenta protein 84112 $175.00 $70.00
Urine porphyrins (metabolism substance) measurement 84120 $85.00 $34.00
Blood potassium level 84132 $20.00 $8.00
Urine potassium level 84133 $47.00 $18.80
Prealbumin (protein) level 84134 $40.00 $16.00
Pregnenolone (reproductive hormone) level 84140 $122.00 $48.80
17-hydroxypregnenolone (hormone) level 84143 $133.00 $53.20
Progesterone (reproductive hormone) level 84144 $81.00 $32.40
Procalcitonin (hormone) level 84145 $226.00 $90.40
Prolactin (milk producing hormone) level 84146 $127.00 $50.80
PSA (prostate specific antigen) measurement 84153 $119.00 $47.60
PSA (prostate specific antigen) measurement 84154 $68.00 $27.20
Total protein level, blood 84155 $54.00 $21.60
Total protein level, urine 84156 $58.00 $23.20
Total protein level, body fluid 84157 $58.00 $23.20
Pregnancy-associated plasma protein-A level 84163 $72.00 $28.80
Protein measurement, serum 84165 $55.00 $22.00
Protein measurement, body fluid 84166 $95.00 $38.00
Protein measurement 84182 $185.00 $74.00
Protoporphyrin (metabolism substance) level 84202 $60.00 $24.00
Proinsulin (pancreatic hormone) level 84206 $141.00 $56.40
Vitamin B-6 level 84207 $123.00 $49.20
Pyruvate (organic acid) level 84210 $69.00 $27.60
Quinine (drug) level 84228 $47.00 $18.80
Chemical receptor analysis 84238 $171.00 $68.40
Renin (kidney enzyme) level 84244 $101.00 $40.40
Vitamin B-2 (riboflavin) level 84252 $170.00 $68.00
Selenium (vitamin) level 84255 $66.00 $26.40
Serotonin (hormone) level 84260 $104.00 $41.60
Sex hormone binding globulin (protein) level 84270 $73.00 $29.20
Blood sodium level 84295 $43.00 $17.20
Urine sodium level 84300 $55.00 $22.00
Sodium level 84302 $39.00 $15.60
Somatomedin (growth factor) level 84305 $105.00 $42.00
Specific gravity (liquid weight) measurement 84315 $13.00 $5.20
Carbohydrate analysis 84376 $39.00 $15.60
Testosterone (hormone) level 84402 $107.00 $42.80
Testosterone (hormone) level 84403 $125.00 $50.00
Vitamin B-1 (thiamine) level 84425 $119.00 $47.60
Thyroglobulin (thyroid related hormone) level 84432 $71.00 $28.40
Thyroxine (thyroid chemical) measurement 84436 $23.00 $9.20
Thyroxine (thyroid chemical) measurement 84439 $29.00 $11.60
Thyroxine binding globulin (thyroid related protein) level 84442 $63.00 $25.20
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $56.00 $22.40
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $56.00 $22.40
Thyroid stimulating immune globulins (thyroid related protein) level 84445 $183.00 $73.20
Vitamin E level 84446 $77.00 $30.80
Liver enzyme (SGOT), level 84450 $67.00 $26.80
Liver enzyme (SGPT), level 84460 $70.00 $28.00
Transferrin (iron binding protein) level 84466 $52.00 $20.80
Triglycerides level 84478 $25.00 $10.00
Thyroid hormone evaluation 84479 $53.00 $21.20
Thyroid hormone, T3 measurement 84480 $89.00 $35.60
Thyroid hormone, T3 measurement 84481 $99.00 $39.60
Thyroid hormone, T3 measurement 84482 $108.00 $43.20
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $64.00 $25.60
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $64.00 $25.60
Tyrosine (amino acid) level 84510 $31.00 $12.40
Urea nitrogen level to assess kidney function 84520 $54.00 $21.60
Urea nitrogen level to assess kidney function 84540 $51.00 $20.40
Urea nitrogen level to assess kidney function 84545 $55.00 $22.00
Uric acid level, blood 84550 $60.00 $24.00
Uric acid level 84560 $60.00 $24.00
Urine vanillylmandelic acid 84585 $79.00 $31.60
Vasoactive intestinal peptide (intestinal hormone) level 84586 $132.00 $52.80
Vitamin A level 84590 $70.00 $28.00
Vitamin K level 84597 $88.00 $35.20
Volatile chemical measurement 84600 $68.00 $27.20
Zinc level 84630 $66.00 $26.40
C-peptide (protein) level 84681 $109.00 $43.60
Gonadotropin, chorionic (reproductive hormone) level 84702 $137.00 $54.80
Gonadotropin (reproductive hormone) analysis 84703 $110.00 $44.00
Chemistry procedures 84999 $138.00 $55.20
White blood cell count 85004 $27.00 $10.80
Red blood cell hemoglobin concentration 85013 $28.00 $11.20
Red blood cell concentration measurement 85014 $17.00 $6.80
Hemoglobin measurement 85018 $26.00 $10.40
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $143.00 $57.20
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $143.00 $57.20
Complete blood cell count (red cells, white blood cell, platelets), automated test 85027 $52.00 $20.80
Red blood cell count, automated test 85041 $21.00 $8.40
Red blood count, automated test 85045 $15.00 $6.00
Automated white blood cell count 85048 $29.00 $11.60
Platelet count, automated test 85049 $44.00 $17.60
Bone marrow, smear interpretation 85097 $172.00 $68.80
Clotting factor II prothrombin, measurement 85210 $144.00 $57.60
Clotting factor V (AcG or proaccelerin) measurement 85220 $158.00 $63.20
Clotting factor VII (proconvertin, stable factor) 85230 $158.00 $63.20
Clotting factor VIII (AHG) measurement 85240 $153.00 $61.20
Clotting factor VIII related antigen measurement 85244 $214.00 $85.60
Clotting factor VIII (VW factor) measurement 85245 $117.00 $46.80
Clotting factor VIII (VW factor) antigen 85246 $129.00 $51.60
Clotting factor IX (PTC or Christmas) measurement 85250 $180.00 $72.00
Clotting factor XIII (fibrin stabilizing) measurement 85290 $175.00 $70.00
Fletcher factor (clotting factor) measurement 85292 $153.00 $61.20
Fitzgerald factor (clotting factor) measurement 85293 $167.00 $66.80
Antithrombin III antigen (clotting inhibitor) activity 85300 $127.00 $50.80
Protein C antigen (clotting inhibitor) measurement 85303 $184.00 $73.60
Protein S (clotting inhibitor) level 85305 $175.00 $70.00
Activated protein resistance assay 85307 $116.00 $46.40
Clotting factor inhibitor test 85335 $150.00 $60.00
Coagulation time measurement 85347 $58.00 $23.20
Coagulation function measurement 85379 $130.00 $52.00
Fibrinogen (factor 1) activity measurement 85384 $51.00 $20.40
Coagulation function screening test with interpretation and report 85390 $24.00 $9.60
Measurement of blood coagulation and fibrinolysis (clot dissolving) function 85397 $203.00 $81.20
Plasminogen (fibrinolytic factor) measurement 85420 $104.00 $41.60
Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation 85460 $91.00 $36.40
Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation 85461 $51.00 $20.40
Heparin assay 85520 $120.00 $48.00
Platelet function test 85576 $131.00 $52.40
Phospholipid test 85598 $110.00 $44.00
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $25.00 $10.00
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $25.00 $10.00
Blood test, clotting time 85611 $38.00 $15.20
Clotting factor X assessment test 85613 $66.00 $26.40
Red blood cell sedimentation rate, to detect inflammation 85652 $25.00 $10.00
Red blood cell sickling measurement 85660 $48.00 $19.20
Thrombin time, fibrinogen screening test 85670 $53.00 $21.20
Coagulation assessment blood test 85730 $41.00 $16.40
Coagulation assessment blood test 85732 $21.00 $8.40
Measurement of antibody to infectious organism 86000 $47.00 $18.80
Measurement of antibody (IgG) to allergic substance 86001 $28.00 $11.20
Measurement of antibody (IgE) to allergic substance 86003 $29.00 $11.60
Antibody identification test for platelet antibodies 86022 $42.00 $16.80
Screening test for autoimmune disorder 86038 $55.00 $22.00
Measurement of antibody for assessment of autoimmune disorder 86039 $88.00 $35.20
Measurement for Strep antibody (strep throat) 86060 $78.00 $31.20
Blood bank physician services for investigation of transfusion reaction with written report 86078 $152.00 $60.80
Measurement C-reactive protein for detection of infection or inflammation 86140 $35.00 $14.00
Measurement C-reactive protein for detection of infection or inflammation 86141 $65.00 $26.00
Beta 2 glycoprotein 1 antibody (autoantibody) measurement 86146 $97.00 $38.80
Cardiolipin antibody (tissue antibody) measurement 86147 $107.00 $42.80
Phospholipid antibody (autoimmune antibody) measurement 86148 $75.00 $30.00
Measurement of cold agglutinin (protein) to screen for infection or disease 86156 $64.00 $25.60
Measurement of cold agglutinin (protein) to detect infection or disease 86157 $83.00 $33.20
Measurement of complement (immune system proteins) 86160 $106.00 $42.40
Measurement of complement function (immune system proteins) 86161 $124.00 $49.60
Measurement of complement (immune system proteins) 86162 $119.00 $47.60
Measurement of antibody for rheumatoid arthritis assessment 86200 $73.00 $29.20
Measurement of DNA antibody 86225 $96.00 $38.40
Measurement of antibody for assessment of autoimmune disorder 86235 $107.00 $42.80
Screening test for antibody to noninfectious agent 86255 $161.00 $64.40
Measurement of antibody to noninfectious agent 86256 $113.00 $45.20
Immunologic analysis for detection of tumor antigen 86300 $109.00 $43.60
Immunologic analysis for detection of tumor antigen 86301 $113.00 $45.20
Immunologic analysis for detection of tumor antigen 86304 $101.00 $40.40
Screening test for mononucleosis (mono) 86308 $71.00 $28.40
Analysis for detection of tumor marker 86316 $142.00 $56.80
Detection of infectious agent antibody 86317 $77.00 $30.80
Immunologic analysis technique on serum 86334 $66.00 $26.40
Immunologic analysis technique on body fluid 86335 $87.00 $34.80
Inhibin A (reproductive organ hormone) measurement 86336 $86.00 $34.40
Intrinsic factor (stomach protein) antibody measurement 86340 $86.00 $34.40
Islet cell (pancreas) antibody measurement 86341 $112.00 $44.80
Analysis of cell function and analysis for genetic marker 86352 $308.00 $123.20
Total cell count for B cells (white blood cells) 86355 $159.00 $63.60
White blood cell antigen measurement 86356 $139.00 $55.60
Total cell count for natural killer cells (white blood cell) 86357 $166.00 $66.40
T cells count, total 86359 $180.00 $72.00
T cell count and ratio 86360 $226.00 $90.40
T cell count and ratio 86361 $150.00 $60.00
Microsomal antibodies (autoantibody) measurement 86376 $103.00 $41.20
Viral neutralization test to detect viral antibody level 86382 $90.00 $36.00
Nitroblue tetrazolium dye test to measure white blood cell function 86384 $173.00 $69.20
Screening test for presence of antibody 86403 $94.00 $37.60
Rheumatoid factor level 86431 $78.00 $31.20
Tuberculosis test 86480 $183.00 $73.20
Syphilis detection test 86592 $65.00 $26.00
Syphilis test 86593 $74.00 $29.60
Analysis for antibody to aspergillus (fungus) 86606 $93.00 $37.20
Analysis for antibody bacteria 86609 $63.00 $25.20
Analysis for antibody to Bartonella (bacteria) 86611 $47.00 $18.80
Analysis for antibody to blastomyces (fungus) 86612 $87.00 $34.80
Analysis for antibody bordetella (respiratory bacteria) 86615 $85.00 $34.00
Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria) 86617 $78.00 $31.20
Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) 86618 $104.00 $41.60
Analysis for antibody to Brucella (bacteria) 86622 $50.00 $20.00
Analysis for antibody to Candida (yeast) 86628 $58.00 $23.20
Analysis for antibody to Chlamydia (bacteria) 86631 $43.00 $17.20
Analysis for antibody (IgM) to Chlamydia (bacteria) 86632 $38.00 $15.20
Analysis for antibody to Coccidioides (bacteria) 86635 $80.00 $32.00
Analysis for antibody to Coxiella burnetii (Q fever bacteria) 86638 $59.00 $23.60
Analysis for antibody to Cytomegalovirus (CMV) 86644 $85.00 $34.00
Analysis for antibody (IgM) to Cytomegalovirus (CMV) 86645 $60.00 $24.00
Analysis for antibody to Diphtheria (bacteria) 86648 $106.00 $42.40
Analysis for antibody to La crosse (California) virus (encephalitis causing virus) 86651 $53.00 $21.20
Analysis for antibody to Eastern equine virus (viral encephalitis) 86652 $53.00 $21.20
Analysis for antibody to St. Louis virus (viral encephalitis) 86653 $53.00 $21.20
Analysis for antibody to Western equine virus (viral encephalitis) 86654 $53.00 $21.20
Analysis for antibody to Enterovirus (gastrointestinal virus) 86658 $83.00 $33.20
Analysis for antibody to Epstein-Barr virus (mononucleosis virus) 86663 $65.00 $26.00
Analysis for antibody to Epstein-Barr virus (mononucleosis virus) 86664 $67.00 $26.80
Analysis for antibody to Epstein-Barr virus (mononucleosis virus) 86665 $83.00 $33.20
Analysis for antibody to Ehrlichia (bacteria transmitted by ticks) 86666 $108.00 $43.20
Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) 86677 $124.00 $49.60
Analysis for antibody to helminth (intestinal worm) 86682 $126.00 $50.40
Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV 86689 $136.00 $54.40
Analysis for antibody to Hepatitis D virus 86692 $97.00 $38.80
Analysis for antibody to Herpes simplex virus 86694 $66.00 $26.40
Analysis for antibody to Herpes simplex virus, type 1 86695 $75.00 $30.00
Analysis for antibody to Herpes simplex virus, type 2 86696 $84.00 $33.60
Analysis for antibody to histoplasma (fungus) 86698 $87.00 $34.80
Analysis for antibody to HIV -1 virus 86701 $110.00 $44.00
Analysis for antibody to HIV-2 virus 86702 $97.00 $38.80
Analysis for antibody to HIV-1 and HIV-2 virus 86703 $109.00 $43.60
Hepatitis B core antibody measurement 86704 $59.00 $23.60
Hepatitis B core antibody (IgM) measurement 86705 $82.00 $32.80
Hepatitis B surface antibody measurement 86706 $90.00 $36.00
Hepatitis Be antibody measurement 86707 $63.00 $25.20
Measurement of Hepatitis A antibody 86708 $75.00 $30.00
Measurement of Hepatitis A antibody (IgM) 86709 $78.00 $31.20
Analysis for antibody to Influenza virus 86710 $60.00 $24.00
Analysis for antibody to lymphocytic choriomeningitis virus (viral meningitis) 86727 $52.00 $20.80
Analysis for antibody to mumps virus 86735 $64.00 $25.60
Analysis for antibody to Mycoplasma (bacteria) 86738 $97.00 $38.80
Analysis for antibody to parvovirus 86747 $71.00 $28.40
Analysis for antibody to Plasmodium (malaria parasite) 86750 $55.00 $22.00
Analysis for antibody to respiratory syncytial virus (RSV) 86756 $87.00 $34.80
Analysis for antibody to Rickettsia (bacteria) 86757 $108.00 $43.20
Analysis for antibody to Rubella (German measles virus) 86762 $78.00 $31.20
Analysis for antibody to Rubeola (measles virus) 86765 $62.00 $24.80
Analysis for antibody to Salmonella (intestinal bacteria) 86768 $40.00 $16.00
Analysis for antibody to Toxoplasma (parasite) 86777 $84.00 $33.60
Analysis for antibody (IgM) to Toxoplasma (parasite) 86778 $89.00 $35.60
Analysis for antibody, Treponema pallidum 86780 $67.00 $26.80
Analysis for antibody to varicella-zoster virus (chicken pox) 86787 $80.00 $32.00
Analysis for antibody (IgM) to West Nile virus 86788 $104.00 $41.60
Analysis for antibody to West Nile virus 86789 $101.00 $40.40
Analysis for antibody to virus 86790 $95.00 $38.00
Thyroglobulin (thyroid protein) antibody measurement 86800 $78.00 $31.20
Hepatitis C antibody measurement 86803 $100.00 $40.00
Immunologic analysis for autoimmune disease 86812 $160.00 $64.00
Screening test for red blood cell antibodies 86850 $32.00 $12.80
Removal of antibodies from surface of red blood cell 86860 $92.00 $36.80
Identification of red blood cell antibodies 86870 $144.00 $57.60
Red blood cell antibody detection test 86880 $75.00 $30.00
Red blood cell antibody level 86886 $80.00 $32.00
Processing and storage of blood unit or component 86890 $151.00 $60.40
Blood group typing (ABO) 86900 $18.00 $7.20
Blood typing for Rh (D) antigen 86901 $22.00 $8.80
Screening test for compatible blood unit 86902 $83.00 $33.20
Blood typing for red blood cell antigens 86905 $74.00 $29.60
Blood typing for Rh (D) antigen 86906 $121.00 $48.40
Blood unit compatibility test 86920 $47.00 $18.80
Blood unit compatibility test 86921 $59.00 $23.60
Blood unit compatibility test 86922 $50.00 $20.00
Blood unit compatibility test 86923 $120.00 $48.00
Pooling of platelets or other blood products 86965 $79.00 $31.60
Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement 86970 $74.00 $29.60
Pretreatment of serum for use in red blood cell antibody analysis and measurement 86976 $47.00 $18.80
Pretreatment of serum for use in red blood cell antibody analysis and measurement 86977 $47.00 $18.80
Pretreatment of serum for use in red blood cell antibody analysis and measurement 86978 $84.00 $33.60
Splitting of blood or blood products 86985 $34.00 $13.60
Concentration of specimen for infectious agents 87015 $47.00 $18.80
Bacterial blood culture 87040 $35.00 $14.00
Stool culture 87046 $55.00 $22.00
Bacterial culture 87070 $101.00 $40.40
Bacterial culture 87075 $159.00 $63.60
Bacterial culture for anaerobic isolates 87076 $91.00 $36.40
Bacterial culture for aerobic isolates 87077 $25.00 $10.00
Screening test for pathogenic organisms 87081 $30.00 $12.00
Bacterial colony count, urine 87086 $45.00 $18.00
Fungal culture (mold or yeast) of skin, hair, or nail 87101 $72.00 $28.80
Fungal culture (mold or yeast) 87102 $82.00 $32.80
Fungal blood culture (mold or yeast) 87103 $43.00 $17.20
Fungal culture, yeast 87106 $34.00 $13.60
Culture for identification of yeast 87107 $43.00 $17.20
Culture for acid-fast bacilli 87116 $82.00 $32.80
Identification of mycobacteria (TB or TB like organism) 87118 $65.00 $26.00
Identification of organisms by immunologic analysis 87140 $40.00 $16.00
Identification of organisms by immunologic analysis 87147 $44.00 $17.60
Identification of organisms by genetic analysis 87153 $318.00 $127.20
Macroscopic examination (visual inspection) of insect 87168 $42.00 $16.80
Macroscopic examination (visual inspection) of parasite 87169 $42.00 $16.80
Pinworm test 87172 $39.00 $15.60
Tissue preparation for culture 87176 $56.00 $22.40
Smear for parasites 87177 $58.00 $23.20
Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) 87181 $51.00 $20.40
Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) 87184 $88.00 $35.20
Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) 87185 $45.00 $18.00
Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) 87186 $126.00 $50.40
Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) 87188 $32.00 $12.80
Antimicrobial study, mycobacteria (TB organism family) 87190 $10.00 $4.00
Special stain for microorganism 87205 $24.00 $9.60
Special stain for microorganism 87206 $60.00 $24.00
Special stain for microorganism 87207 $76.00 $30.40
Special stain for parasites 87209 $78.00 $31.20
Smear for infectious agents 87210 $53.00 $21.20
Tissue fungi or parasites 87220 $26.00 $10.40
Microbial toxin or antitoxin assay 87230 $76.00 $30.40
Tissue culture inoculation for virus isolation 87252 $126.00 $50.40
Tissue culture for virus isolation 87253 $100.00 $40.00
Virus isolation 87254 $113.00 $45.20
Virus isolation 87255 $182.00 $72.80
Detection test for legionella pneumophila (water borne bacteria) 87278 $81.00 $32.40
Detection test for aspergillus (fungus) 87305 $93.00 $37.20
Detection test for clostridium difficile toxins (stool pathogen) 87324 $46.00 $18.40
Detection test for cryptosporidium (parasite) 87328 $66.00 $26.40
Detection test for giardia (intestinal parasite) 87329 $79.00 $31.60
Qualitative or semiquantitative detection test for helicobacter pylori in stool, multiple-step method 87338 $109.00 $43.60
Detection test for Hepatitis B surface antigen 87340 $60.00 $24.00
Detection test for Hepatitis Be surface antigen 87350 $54.00 $21.60
Detection test for histoplasma capsulatum (parasite) 87385 $96.00 $38.40
Detection test for Rotavirus 87425 $80.00 $32.00
Detection test for Strep (Streptococcus, group A) 87430 $70.00 $28.00
Immunologic analysis for detection of organism 87449 $156.00 $62.40
Test for detecting nucleic acid of organism causing infection of central nervous system 87483 $858.00 $343.20
Detection test for Chlamydia pneumoniae 87486 $126.00 $50.40
Detection test for chlamydia 87491 $146.00 $58.40
Detection test for clostridium difficile 87493 $199.00 $79.60
Detection test for Cytomegalovirus (CMV) 87496 $148.00 $59.20
Detection test for cytomegalovirus, quantification 87497 $267.00 $106.80
Detection test for enterovirus (intestinal virus) 87498 $189.00 $75.60
Detection test for digestive tract pathogen 87505 $198.00 $79.20
Detection test for Hepatitis B virus 87517 $182.00 $72.80
Detection test for Hepatitis C virus 87522 $245.00 $98.00
Detection test for herpes simplex virus 87529 $200.00 $80.00
Detection test for HIV-1 virus 87535 $235.00 $94.00
Detection test for HIV-1 virus 87536 $251.00 $100.40
Detection test for Mycobacteria species (bacteria) 87550 $60.00 $24.00
Detection test for Mycoplasma pneumoniae (bacteria) 87581 $142.00 $56.80
Detection test for Neisseria gonorrhoeae (gonorrhoeae bacteria) 87591 $141.00 $56.40
Detection test for human papillomavirus (hpv) 87624 $104.00 $41.60
Detection test for human papillomavirus (hpv) 87625 $208.00 $83.20
Detection test for multiple types of respiratory virus 87631 $477.00 $190.80
Detection test for multiple types of respiratory virus 87633 $1,055.00 $422.00
Detection test for Staphylococcus aureus, methicillin resistant (MRSA bacteria) 87641 $198.00 $79.20
Detection test for Strep (Streptococcus, group B) 87653 $212.00 $84.80
Detection test for Trichomonas vaginalis (genital parasite) 87661 $155.00 $62.00
Detection test for organism 87798 $200.00 $80.00
Detection test for organism 87799 $231.00 $92.40
Detection test for multiple organisms 87801 $198.00 $79.20
Detection test for influenza virus 87804 $75.00 $30.00
Detection test for respiratory syncytial virus (RSV) 87807 $87.00 $34.80
Detection test for identification of organism 87899 $72.00 $28.80
Infectious agent drug susceptibility analysis 87900 $493.00 $197.20
Analysis test for Hepatitis C virus 87902 $612.00 $244.80
Analysis test for HIV-1 virus 87903 $912.00 $364.80
Analysis test for HIV-1 virus 87904 $127.00 $50.80
Cell examination of body fluid 88104 $78.00 $31.20
Cell examination of specimen 88108 $114.00 $45.60
Cell examination of specimen 88112 $102.00 $40.80
Pap test (Pap smear) 88142 $69.00 $27.60
Examination of cervical or vaginal slide for hormonal evaluation 88155 $21.00 $8.40
Screening examination of specimen cells 88161 $66.00 $26.40
Pap test (Pap smear) 88164 $31.00 $12.40
Evaluation of fine needle aspirate 88172 $41.00 $16.40
Evaluation of fine needle aspirate with interpretation and report 88173 $137.00 $54.80
Pap test 88175 $152.00 $60.80
Flow cytometry technique for DNA or cell analysis 88184 $146.00 $58.40
Flow cytometry technique for DNA or cell analysis 88185 $91.00 $36.40
Tissue culture to identify white blood cell disorders 88230 $344.00 $137.60
Tissue culture for disorders of amniotic fluid or placenta cells 88235 $435.00 $174.00
Cryopreservation, freezing and storage of cells 88240 $48.00 $19.20
Chromosome analysis of amniotic fluid or placenta for genetic defects 88267 $531.00 $212.40
Chromosome analysis of amniotic fluid for genetic defects 88269 $492.00 $196.80
DNA testing for genetic defects 88271 $176.00 $70.40
Chromosome analysis for genetic defects 88273 $172.00 $68.80
Genetic testing 88274 $181.00 $72.40
Genetic testing 88275 $184.00 $73.60
Chromosome analysis for genetic defects 88280 $147.00 $58.80
Genetic studies 88299 $50.00 $20.00
Pathology examination of tissue using a microscope, limited examination 88300 $68.00 $27.20
Pathology examination of tissue using a microscope 88302 $117.00 $46.80
Pathology examination of tissue using a microscope, moderately low complexity 88304 $158.00 $63.20
Pathology examination of tissue using a microscope, intermediate complexity 88305 $222.00 $88.80
Pathology examination of tissue using a microscope, moderately high complexity 88307 $325.00 $130.00
Pathology examination of tissue using a microscope, high complexity 88309 $404.00 $161.60
Preparation of tissue for examination by removing any calcium present 88311 $22.00 $8.80
Special stained specimen slides to identify organisms including interpretation and report 88312 $138.00 $55.20
Special stained specimen slides to examine tissue including interpretation and report 88313 $131.00 $52.40
Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report 88314 $134.00 $53.60
Evaluation of specimen enzymes 88319 $200.00 $80.00
Surgical pathology consultation and report 88321 $148.00 $59.20
Comprehensive surgical pathology consultation and report 88325 $402.00 $160.80
Pathology examination of specimen during surgery 88329 $51.00 $20.40
Pathology examination of tissue during surgery 88331 $173.00 $69.20
Pathology examination of specimen during surgery 88332 $67.00 $26.80
Special stained specimen slides to examine tissue 88341 $201.00 $80.40
Tissue or cell analysis by immunologic technique 88342 $201.00 $80.40
Special stained specimen slides to examine tissue 88344 $201.00 $80.40
Antibody evaluation 88346 $120.00 $48.00
Microscopic genetic analysis of tumor 88360 $165.00 $66.00
Microscopic genetic analysis of tumor 88361 $262.00 $104.80
Analysis of genetic material 88365 $293.00 $117.20
Body fluid cell count 89050 $79.00 $31.60
Body fluid cell count with cell identification 89051 $90.00 $36.00
White blood cell measure, stool specimen 89055 $25.00 $10.00
Crystal identification from tissue or body fluid 89060 $55.00 $22.00
Fat stain of stool, urine, or respiratory secretions 89125 $25.00 $10.00
Examination of stool for meat fibers 89160 $28.00 $11.20
Nasal smear for eosinophils (allergy related white blood cells) 89190 $44.00 $17.60
Sputum specimen collection 89220 $57.00 $22.80
Sweat collection 89230 $149.00 $59.60
Semen evaluation volume, sperm count, motility and analysis 89320 $97.00 $38.80
Semen analysis for sperm presence 89321 $56.00 $22.40
Administration of 1 vaccine 90471 $54.00 $21.60
Administration of vaccine 90472 $27.00 $10.80
Psychotherapy, 30 minutes 90832 $213.00 $85.20
Psychotherapy, 60 minutes 90837 $385.00 $154.00
Group psychotherapy 90853 $237.00 $94.80
Hemodialysis procedure with one physician evaluation 90935 $499.00 $199.60
Dialysis procedure including one evaluation 90945 $374.00 $149.60
Measurement of esophageal swallowing movement 91010 $1,530.00 $612.00
Monitoring and recording of gastroesophageal reflux with pH electrode insertion including analysis and interpretation 91035 $1,480.00 $592.00
Imaging of digestive tract done from the inside of the digestive tract 91110 $3,150.00 $1,260.00
Study of anorectal pressure generated by muscles surrounding anus (sphincter) 91122 $1,390.00 $556.00
Measuring the stiffness in the liver via elastography 91200 $191.00 $76.40
Treatment of speech, language, voice, communication, and/or hearing processing disorder 92507 $299.00 $119.60
Group treatment of speech, language, voice, communication, and/or hearing processing disorder 92508 $59.00 $23.60
Examination of the nose and throat using an endoscope 92511 $199.00 $79.60
Evaluation of speech fluency 92521 $228.00 $91.20
Evaluation of speech sound production 92522 $228.00 $91.20
Evaluation of speech sound production with evaluation of language comprehension and expression 92523 $228.00 $91.20
Behavioral and qualitative analysis of voice and resonance 92524 $228.00 $91.20
Treatment of swallowing and/or oral feeding function 92526 $303.00 $121.20
Placement of scalp electrodes for assessment and recording of responses from several areas of the nerve-brain hearing system, infant 92586 $370.00 $148.00
Evaluation of patient with prescription of speech-generating and alternative communication device 92607 $351.00 $140.40
Evaluation and prescription of speech-generating and alternative communication device 92608 $197.00 $78.80
Therapeutic services for use of speech-generating device with programming 92609 $232.00 $92.80
Evaluation of swallowing function 92610 $210.00 $84.00
Fluoroscopic and video recorded motion evaluation of swallowing function 92611 $290.00 $116.00
Balloon dilation of narrowed or blocked major coronary artery or branch (accessed through the skin) 92920 $12,079.00 $4,831.60
Balloon dilation of narrowed or blocked major coronary artery or branch (accessed through the skin) 92921 $5,578.00 $2,231.20
Removal of plaque of major coronary artery or branch, accessed through the skin 92924 $16,117.00 $6,446.80
Removal of plaque of major coronary artery or branch, accessed through the skin 92925 $8,455.00 $3,382.00
Catheter insertion of stents in major coronary artery or branch, accessed through the skin 92928 $16,974.00 $6,789.60
Catheter insertion of stents in major coronary artery or branch, accessed through the skin 92928 $18,362.00 $7,344.80
Catheter placement of stents in major coronary artery or branch, accessed through the skin 92929 $7,916.00 $3,166.40
Catheter placement of stents in major coronary artery or branch, accessed through the skin 92929 $9,138.00 $3,655.20
Removal of plaque and insertion of stent in major coronary artery or branch, accessed through the skin 92933 $19,832.00 $7,932.80
Removal of plaque and insertion of stent in major coronary artery or branch, accessed through the skin 92933 $18,512.00 $7,404.80
Removal of plaque and insertion of stent in major coronary artery or branch, accessed through the skin 92934 $9,148.00 $3,659.20
Removal of plaque and insertion of stent in major coronary artery or branch, accessed through the skin 92934 $7,326.00 $2,930.40
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 92937 $18,553.00 $7,421.20
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 92937 $18,204.00 $7,281.60
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 92938 $9,936.00 $3,974.40
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 92938 $8,708.00 $3,483.20
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel during heart attack, accessed through the skin 92941 $18,932.00 $7,572.80
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel during heart attack, accessed through the skin 92941 $18,163.00 $7,265.20
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 92943 $18,833.00 $7,533.20
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 92943 $18,248.00 $7,299.20
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 92944 $8,419.00 $3,367.60
Insertion of stent, removal of plaque and/or balloon dilation of coronary vessel, accessed through the skin 92944 $8,675.00 $3,470.00
Attempt to restart heart and lungs 92950 $850.00 $340.00
Temporary pacemaker to regulate heart beat 92953 $485.00 $194.00
External shock to heart to regulate heart beat 92960 $1,050.00 $420.00
Removal of blood clot in heart artery, accessed through the skin 92973 $3,190.00 $1,276.00
Infusion of drug into vein to dissolve coronary blood clot 92977 $875.00 $350.00
Ultrasound evaluation of heart blood vessel or graft 92978 $3,046.00 $1,218.40
Ultrasound evaluation of heart blood vessel or graft 92979 $2,075.00 $830.00
Catheter based repair of left lower heart (aortic) valve, accessed through the skin 92986 $11,292.00 $4,516.80
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $361.00 $144.40
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $361.00 $144.40
Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring 93017 $380.00 $152.00
Heart rhythm tracing of 48-hour EKG 93225 $282.00 $112.80
Heart rhythm analysis, interpretation and report of 48-hour EKG 93226 $282.00 $112.80
Ultrasound examination of congenital heart defect 93303 $2,021.00 $808.40
Ultrasound examination of congenital heart defect 93303 $1,448.00 $579.20
Follow-up or limited ultrasound examination of congenital heart defect 93304 $1,250.00 $500.00
Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function 93306 $3,025.00 $1,210.00
Follow-up or limited ultrasound examination of heart 93308 $832.00 $332.80
Insertion of probe in esophagus for heart ultrasound examination including interpretation and report 93312 $2,414.00 $965.60
Insertion of probe in esophagus for heart ultrasound examination including interpretation and report 93312 $2,580.00 $1,032.00
Insertion of probe in esophagus for heart ultrasound examination 93313 $1,056.00 $422.40
Ultrasound examination of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report 93350 $1,801.00 $720.40
Injection of X-ray contrast material for ultrasound examination of the heart 93352 $150.00 $60.00
Insertion of catheter for diagnostic evaluation of right heart structures 93451 $5,800.00 $2,320.00
Insertion of catheter into left heart for diagnosis 93452 $6,966.00 $2,786.40
Insertion of catheter into left heart for diagnosis 93452 $6,966.00 $2,786.40
Insertion of catheter into right and left heart for diagnosis 93453 $7,680.00 $3,072.00
Insertion of catheter for imaging of heart blood vessels or grafts 93454 $10,046.00 $4,018.40
Insertion of catheter for imaging of heart blood vessels or grafts 93455 $8,765.00 $3,506.00
Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts 93456 $11,155.00 $4,462.00
Insertion of catheter in right heart for imaging of blood vessels or grafts 93457 $12,259.00 $4,903.60
Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart 93458 $17,896.00 $7,158.40
Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart 93459 $16,042.00 $6,416.80
Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart 93460 $17,362.00 $6,944.80
Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart 93461 $17,317.00 $6,926.80
Insertion of catheter into left heart for diagnosis 93462 $7,021.00 $2,808.40
Drug infusion during cardiac catheterization 93463 $712.00 $284.80
Insertion of catheter into right upper heart chamber and pulmonary (lung) artery for monitoring purposes 93503 $572.00 $228.80
Biopsy of the wall dividing the left and right heart 93505 $5,898.00 $2,359.20
Injection for X-ray imaging of aorta above heart valve 93567 $897.00 $358.80
Injection for X-ray imaging of pulmonary (lung) artery from heart 93568 $1,279.00 $511.60
Ultrasound evaluation of heart blood vessel during diagnosis or treatment 93571 $3,212.00 $1,284.80
Ultrasound evaluation of heart blood vessel during diagnosis or treatment 93572 $1,466.00 $586.40
Catheter based closure of congenital heart defect with implant, accessed through the skin 93580 $16,301.00 $6,520.40
Insertion of catheter for recording upper heart rhythm 93600 $2,445.00 $978.00
Insertion of catheter for recording upper heart rhythm 93602 $2,336.00 $934.40
Insertion of catheter for recording of right lower heart chamber rhythm 93603 $3,210.00 $1,284.00
Insertion of catheter for recording to identify origin of abnormal heart rhythm 93609 $4,436.00 $1,774.40
Insertion of temporary pacemaker electrode for diagnostic upper heart pacing 93610 $2,579.00 $1,031.60
Insertion of temporary pacemaker electrode for diagnostic lower heart pacing 93612 $3,038.00 $1,215.20
Insertion of catheters for 3D mapping of electrical impulses to heart muscles 93613 $6,619.00 $2,647.60
Insertion of catheters for recording and pacing right upper and lower heart rhythm 93619 $5,782.00 $2,312.80
Insertion of catheters for recording, pacing, and attempted induction of abnormal rhythm in right upper and lower heart 93620 $10,620.00 $4,248.00
Insertion of catheters for recording, pacing, and attempted induction of abnormal rhythm in left upper heart 93621 $7,023.00 $2,809.20
Insertion of catheters for recording, pacing, and attempted induction of abnormal rhythm in left lower heart 93622 $6,691.00 $2,676.40
Programmed heart rhythm stimulation after drug infusion into a vein 93623 $4,469.00 $1,787.60
Insertion of catheters for assessment of heart pacing, recording, or attempted induction of abnormal rhythm 93624 $2,979.00 $1,191.60
Intra-operative heart pacing and mapping of abnormal heart rhythm for surgical correction 93631 $3,622.00 $1,448.80
Evaluation of single or dual chamber pacing cardioverter-defibrillator and generator at time of implantation or replacement 93641 $2,485.00 $994.00
Evaluation of single or dual chamber pacing cardioverter-defibrillator with programming or reprogramming 93642 $2,643.00 $1,057.20
Evaluation implantable defibrillator 93644 $2,230.00 $892.00
Insertion of catheters for creation of complete heart block 93650 $9,127.00 $3,650.80
Evaluation and insertion of catheters for creation of complete heart block 93653 $23,190.00 $9,276.00
Evaluation and insertion of catheters for recording, pacing, and attempted induction of abnormal heart rhythm 93654 $24,901.00 $9,960.40
Insertion of catheters for treatment of abnormal heart rhythm 93655 $8,668.00 $3,467.20
Evaluation and insertion of catheters for recording, pacing, and treatment of abnormal heart rhythm 93656 $29,953.00 $11,981.20
Destruction of tissue of right or left upper heart chamber via catheter for treatment of abnormal heart rhythm 93657 $8,745.00 $3,498.00
Evaluation of heart function using tilt table 93660 $1,639.00 $655.60
Ultrasound evaluation of heart blood vessel 93662 $3,958.00 $1,583.20
Physician services for outpatient heart cardiac rehabilitation per session 93797 $237.00 $94.80
Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session 93798 $259.00 $103.60
Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck 93880 $1,284.00 $513.60
Ultrasound study of arteries of both arms and legs 93922 $271.00 $108.40
Ultrasound study of arteries of both arms and legs 93923 $356.00 $142.40
Ultrasound study of arteries and arterial grafts of both legs 93925 $510.00 $204.00
Ultrasound study of arteries and arterial grafts of one leg or limited 93926 $255.00 $102.00
Ultrasound study of arteries and arterial grafts of both arms 93930 $510.00 $204.00
Ultrasound study of arteries and arterial grafts of one arm or limited 93931 $255.00 $102.00
Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers 93970 $1,397.00 $558.80
Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers 93971 $938.00 $375.20
Ultrasound limited scan of abdominal, pelvic, and/or scrotal arterial inflow and venous outflow 93976 $649.00 $259.60
Ultrasound scan of blood flow of aorta, vena cava, bypass graphs, or one side of the groin or limited scan 93979 $544.00 $217.60
Ultrasound of dialysis access 93990 $237.00 $94.80
Ventilation assistance and management, hospital inpatient or observation 94002 $1,021.00 $408.40
Ventilation assistance and management, hospital inpatient or observation 94003 $870.00 $348.00
Measurement and graphic recording of total and timed exhaled air capacity 94010 $143.00 $57.20
Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration 94060 $337.00 $134.80
Multiple measurements and graphic recordings of the amount and speed of breathed air, before and following medication administration 94070 $503.00 $201.20
Measurement of largest amount of air exhaled from lungs 94150 $42.00 $16.80
Single measurement of remaining air or lung capacity after exhalation 94250 $56.00 $22.40
Administration of medication through breathing tube 94610 $150.00 $60.00
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $214.00 $85.60
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $214.00 $85.60
Inhaled pneumonia treatment 94642 $330.00 $132.00
Respiratory inhaled aerosol treatment to relieve airway obstruction 94645 $91.00 $36.40
Initiation and management of continued pressured respiratory assistance by mask or breathing tube 94660 $350.00 $140.00
Demonstration and/or evaluation of patient use of aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device 94664 $83.00 $33.20
Demonstration and/or evaluation of manual maneuvers to chest wall to assist movement of lung secretions 94667 $163.00 $65.20
Manual maneuvers to chest wall to assist movement of lung secretions 94668 $42.00 $16.80
Determination of lung volumes using plethysmography 94726 $127.00 $50.80
Determination of lung volumes using gas dilution or washout 94727 $102.00 $40.80
Measurement of lung diffusing capacity 94729 $240.00 $96.00
Overnight measurement of oxygen saturation in blood using ear or finger device 94762 $109.00 $43.60
Measurement of exhaled carbon dioxide gas 94770 $185.00 $74.00
Rapid desensitization procedure, each hour 95180 $257.00 $102.80
Study of sleep and wake patterns including interpretation and report, minimum of 72 hours to 14 consecutive days of recording 95803 $288.00 $115.20
Diagnostic test for sleep disorder 95805 $3,173.00 $1,269.20
Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort 95806 $1,014.00 $405.60
Sleep monitoring of patient (6 years or older) in sleep lab 95810 $5,151.00 $2,060.40
Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube 95811 $5,551.00 $2,220.40
Measurement of brain wave (EEG) activity, 41-60 minutes 95812 $485.00 $194.00
Measurement of brain wave (EEG) activity greater than 1 hour 95813 $650.00 $260.00
Measurement and recording of brain wave (EEG) activity, awake and drowsy 95816 $514.00 $205.60
Measurement and recording of brain wave (EEG) activity, awake and asleep 95819 $514.00 $205.60
Measurement and recording of brain wave (EEG) activity, in coma or asleep 95822 $498.00 $199.20
Measurement and recording of brain wave (EEG) activity, cerebral death evaluation 95824 $498.00 $199.20
Measurement and recording of brain wave (EEG) activity, overnight 95827 $650.00 $260.00
Manual muscle testing of arm, leg or trunk 95831 $42.00 $16.80
Needle measurement and recording of electrical activity of muscles of arm or leg 95860 $239.00 $95.60
Needle measurement and recording of electrical activity of muscles of arms or legs 95861 $423.00 $169.20
Needle measurement and recording of electrical activity of muscles in arms or legs 95863 $607.00 $242.80
Needle measurement and recording of electrical activity of muscles in arms or legs 95864 $791.00 $316.40
Needle measurement and recording of electrical activity of middle spine muscles 95869 $162.00 $64.80
Needle measurement and recording of electrical activity of muscles in arm or leg or muscles in trunk or head, limited study 95870 $146.00 $58.40
Needle measurement and recording electrical activity of muscles including jitter blocking and/or fiber density using single electrode 95872 $550.00 $220.00
Needle measurement and recording of electrical activity of muscles of arm or leg limited study 95885 $137.00 $54.80
Needle measurement and recording of electrical activity of muscles of arm or leg complete study 95886 $147.00 $58.80
Needle measurement and recording of electrical activity of head or trunk muscles 95887 $103.00 $41.20
Nerve transmission studies, 1-2 studies 95907 $176.00 $70.40
Nerve transmission studies, 3-4 studies 95908 $298.00 $119.20
Nerve transmission studies, 5-6 studies 95909 $420.00 $168.00
Nerve transmission studies, 7-8 studies 95910 $542.00 $216.80
Nerve transmission studies, 9-10 studies 95911 $664.00 $265.60
Nerve transmission studies, 11-12 studies 95912 $786.00 $314.40
Nerve transmission studies, 13 or more studies 95913 $908.00 $363.20
Measurement of nerve conduction patterns of eye blink reflex 95933 $155.00 $62.00
Testing with stimulation for assessment of function at muscle-nerve junction 95937 $109.00 $43.60
Monitoring and localization of seizure activity over 24-hour period using 16-channel electroencephalograph (EEG) 95951 $3,415.00 $1,366.00
Monitoring and localization of seizure activity over 24-hour period using portable 16-channel electroencephalograph (EEG) 95953 $2,363.00 $945.20
Repositioning maneuvers for treatment of vertigo, per day 95992 $156.00 $62.40
Developmental test administration by qualified health care professional with interpretation and report, first 60 minutes 96112 $240.00 $96.00
Developmental test administration by qualified health care professional with interpretation and report, additonal 30 minutes 96113 $100.00 $40.00
Hydration infusion into a vein 31 minutes to 1 hour 96360 $148.00 $59.20
Hydration infusion into a vein 96361 $62.00 $24.80
Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour 96365 $188.00 $75.20
Infusion into a vein for therapy, prevention, or diagnosis 96366 $62.00 $24.80
Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour 96367 $48.00 $19.20
Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion 96368 $48.00 $19.20
Infusion into tissue for therapy or prevention up to 1 hour 96369 $151.00 $60.40
Infusion into tissue for therapy or prevention, beneath the skin 96370 $40.00 $16.00
Infusion for therapy or prevention, beneath the skin 96371 $150.00 $60.00
Injection beneath the skin or into muscle for therapy, diagnosis, or prevention 96372 $107.00 $42.80
Injection of drug or substance into a vein for therapy, diagnosis, or prevention 96374 $170.00 $68.00
Injection of different drug or substance into a vein for therapy, diagnosis, or prevention 96375 $148.00 $59.20
Injection of drug or substance into a vein for therapy, diagnosis, or prevention, in a facility 96376 $148.00 $59.20
Application of on-body injector for injection under skin 96377 $107.00 $42.80
Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle 96401 $196.00 $78.40
Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle 96402 $186.00 $74.40
Infusion of chemotherapy into a vein using push technique 96409 $264.00 $105.60
Infusion of different chemotherapy drug or substance into a vein 96411 $186.00 $74.40
Infusion of chemotherapy into a vein up to 1 hour 96413 $302.00 $120.80
Infusion of chemotherapy into a vein 96415 $76.00 $30.40
Prolonged chemotherapy infusion into a vein by portable or implanted pump more than 8 hours 96416 $451.00 $180.40
Infusion of different chemotherapy drug or substance into a vein up to 1 hour 96417 $186.00 $74.40
Injection of chemotherapy using push technique into an artery 96420 $235.00 $94.00
Chemotherapy infusion into abdominal cavity 96446 $602.00 $240.80
Chemotherapy administration into spinal canal requiring spinal tap 96450 $1,001.00 $400.40
Refilling and maintenance of portable pump 96521 $188.00 $75.20
Irrigation of implanted venous access drug delivery device 96523 $61.00 $24.40
Chemotherapy injection into brain through reservoir beneath the skin 96542 $188.00 $75.20
Application of ultraviolet light to skin 96900 $138.00 $55.20
Application of mechanical traction to 1 or more areas 97012 $55.00 $22.00
Application of electrical stimulation to 1 or more areas, unattended by physical therapist 97014 $78.00 $31.20
Application of blood vessel compression or decompression device to 1 or more areas 97016 $101.00 $40.40
Application of hot wax bath to 1 or more areas 97018 $39.00 $15.60
Application of whirlpool therapy to 1 or more areas 97022 $91.00 $36.40
Application of low energy heat (infrared) to 1 or more areas 97026 $10.00 $4.00
Application of electrical stimulation to 1 or more areas, each 15 minutes 97032 $80.00 $32.00
Application of medication through skin using electrical current, each 15 minutes 97033 $91.00 $36.40
Therapeutic hot and cold baths to 1 or more areas, each 15 minutes 97034 $51.00 $20.40
Application of ultrasound to 1 or more areas, each 15 minutes 97035 $98.00 $39.20
Physical therapy treatment to 1 or more areas, Hubbard tank, each 15 minutes 97036 $91.00 $36.40
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $92.00 $36.80
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $92.00 $36.80
Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112 $75.00 $30.00
Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes 97113 $120.00 $48.00
Training for walking to 1 or more areas for 15 minutes 97116 $78.00 $31.20
Training for walking to 1 or more areas for 15 minutes 97116 $78.00 $31.20
Manual (physical) therapy techniques to 1 or more regions, each 15 minutes 97140 $97.00 $38.80
Therapeutic procedures in a group setting 97150 $56.00 $22.40
Physical therapy evaluation session for 20 minutes 97161 $200.00 $80.00
Physical therapy evaluation session for 20 minutes 97161 $200.00 $80.00
Evaluation of physical therapy, typically 30 minutes 97162 $220.00 $88.00
Evaluation of physical therapy, typically 45 minutes 97163 $240.00 $96.00
Re-evaluation of physical therapy, typically 20 minutes 97164 $100.00 $40.00
Evaluation of occupational therapy, typically 30 minutes 97165 $200.00 $80.00
Evaluation of occupational therapy, typically 45 minutes 97166 $220.00 $88.00
Evaluation of occupational therapy established plan of care, typically 60 minutes 97167 $240.00 $96.00
Re-evaluation of occupational therapy established plan of care, typically 30 minutes 97168 $100.00 $40.00
Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes 97530 $115.00 $46.00
Self-care or home management training, each 15 minutes 97535 $65.00 $26.00
Community or work reintegration training, each 15 minutes 97537 $57.00 $22.80
Wheelchair management, each 15 minutes 97542 $58.00 $23.20
Work hardening or conditioning, first 2 hours 97545 $246.00 $98.40
Work hardening or conditioning 97546 $99.00 $39.60
Removal of tissue from wounds per session 97597 $249.00 $99.60
Removal of tissue from wounds per session 97598 $189.00 $75.60
Removal of tissue from wounds per session 97602 $193.00 $77.20
Negative pressure wound therapy, surface area less than or equal to 50 square centimeters, per session 97605 $224.00 $89.60
Negative pressure wound therapy, surface area greater than 50 square centimeters, per session 97606 $310.00 $124.00
Negative pressure wound therapy surface area less than or equal to 50 square centimeters per session 97607 $584.00 $233.60
Negative pressure wound therapy surface area greater than 50 square centimeters 97608 $716.00 $286.40
Physical performance test or measurement with report, each 15 minutes 97750 $86.00 $34.40
Assistive technology assessment to enhance functional performance, each 15 minutes 97755 $71.00 $28.40
Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk, per 15 minutes 97760 $87.00 $34.80
Training in use of prosthesis for arms and/or legs, per 15 minutes 97761 $101.00 $40.40
Management and/or training in use of orthotics (supports, braces, or splints) for arms, legs, and/or trunk, per 15 minutes 97763 $80.00 $32.00
Medical nutrition therapy, assessment and intervention, each 15 minutes 97802 $50.00 $20.00
Medical nutrition therapy re-assessment and intervention, each 15 minutes 97803 $50.00 $20.00
Education and training for patient self-management, each 30 minutes 98960 $175.00 $70.00
Moderate sedation services by physician also performing a procedure, patient younger than 5 years of age, first 15 minutes 99151 $87.00 $34.80
Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes 99152 $87.00 $34.80
Moderate sedation services by physician also performing a procedure, additional 15 minutes 99153 $33.00 $13.20
Moderate sedation services by physician not performing a procedure, patient 5 years of age or older, first 15 minutes 99155 $87.00 $34.80
Moderate sedation services by physician not performing a procedure, patient 5 years of age or older, first 15 minutes 99156 $87.00 $34.80
Moderate sedation services by physician not performing a procedure, each additional 15 minutes 99157 $33.00 $13.20
Management and supervision of oxygen chamber therapy per session 99183 $1,788.00 $715.20
Therapeutic removal of whole blood to correct blood level imbalance 99195 $68.00 $27.20
New patient office or other outpatient visit, typically 10 minutes 99201 $116.00 $46.40
New patient office or other outpatient visit, typically 20 minutes 99202 $155.00 $62.00
New patient office or other outpatient visit, typically 30 minutes 99203 $192.00 $76.80
New patient office or other outpatient visit, typically 45 minutes 99204 $266.00 $106.40
Established patient office or other outpatient visit, typically 5 minutes 99211 $112.00 $44.80
Established patient office or other outpatient visit, typically 10 minutes 99212 $120.00 $48.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $140.00 $56.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $140.00 $56.00
Established patient office or other outpatient, visit typically 25 minutes 99214 $163.00 $65.20
Established patient office or other outpatient, visit typically 40 minutes 99215 $206.00 $82.40
Emergency department visit, self limited or minor problem 99281 $295.00 $118.00
Emergency department visit, low to moderately severe problem 99282 $512.00 $204.80
Emergency department visit facility fees for a visit of moderate severity 99283 $851.00 $340.40
Emergency department visit facility fees for a visit of moderate severity 99283 $851.00 $340.40
Emergency department visit facility fees for a visit of high to moderate severity 99284 $1,387.00 $554.80
Emergency department visit facility fees for a visit of high to moderate severity 99284 $1,387.00 $554.80
Emergency department visit, problem with significant threat to life or function 99285 $2,679.00 $1,071.60
Critical care delivery critically ill or injured patient, first 30-74 minutes 99291 $2,979.00 $1,191.60
Critical care delivery critically ill or injured patient 99292 $333.00 $133.20