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Code · REGISTER · 2000-11-13 · ENVIRONMENTAL PROTECTION AGENCY · Presidential Documents

Presidential Documents. Interim final rule with comment period

148,735 words·~676 min read·/register/2000/11/13/00-28475·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Billing code 3195-01-P 65 219 Monday, November 13, 2000 CORRECTIONS Diedra ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [MT-001-0024, MT-001-0025, MT-001-0026; FRL-6883-6] Clean Air Act Approval and Promulgation of Air Quality Implementation Plan; Montana; East Helena Lead State Implementation Plan Correction In proposed rule document 00-25929 beginning on page 60144 in the issue of Tuesday, October 10, 2000, make the following correction: 1. On page 30147, in the table, under the heading “Description ”, in the fifth line, after “similar”, add “provisions ”. 2.
On the same page, in the first column, in footnote 2, in the 12th line, after “our” add “approval of the modification or alternative. (We caution that our failure to make such”. 3. On the same page, in the second column, in footnote 2, in the first line, “mentodology” should read “methodology”. 4. On the same page, in the same column, in the same footnote, in the fourth line, after “revision” add “in accordance with the provisions of Title I of the Act, pursuant to notice and comment”. 5.
On the same page, in the same column, in footnote 3, in the fifth line, “march” should read “March”. 6. On the same page, in the same column, in the same footnote, in the last line, “Pager” should read “Paper”. 7. On the same page, in the third column, in the same footnote, in the second line, “discuss” should read “discusses” and “provess” should read “process”. 8. On the same page, in the same column, in the same footnote, in the fifth line, “sate” should read “State”; “actucally using” should read “actually issuing”. 9.
On the same page, in the same column, in the same footnote, in the sixth line, “source-specicfic” should read “source-specific ”. 10. On the same page, in the same column, remove the first footnote 4. [FR Doc. C0-25929 Filed 11-9-00; 8:45 am] BILLING CODE 1505-01-D Diedra ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [AL-200018; FRL-6892-2] Approval and Promulgation of State Implementation Plans
(SIP)for the State of Alabama-Call for 1-Hour Attainment Demonstration for the Birmingham, Alabama Marginal Ozone Nonattainment Area Correction In rule document 00-27584 beginning on page 64352 in the issue of Friday, October 27, 2000, make the following correction: §52.66 [Corrected] On page 64357, in the second column, in §52.66(b), in the fourth line, “April 27, 2000” should read “April 27, 2001”. [FR Doc. C0-27584 Filed 11-9-00; 8:45 am] BILLING CODE 1505-01-D Diedra DEPARTMENT OF THE INTERIOR Fish and Wildlife Service 50 CFR Part 17 RIN 1018-AG71 Endangered and Threatened Wildlife and Plants; Determinations of Whether Designation of Critical Habitat Is Prudent for 81 Plants and Proposed Designations for 76 Plants From the Islands of Kauai and Niihau, Hawaii Correction In proposed rule document 00-28214 beginning on page 66808 in the issue of Tuesday, November 7, 2000, make the following correction: On page 66808, in the second column, in the **DATES** section, “December 7, 2000” should read “January 8, 2001”. [FR Doc. C0-28214 Filed 11-9-00; 8:45 am] BILLING CODE 1505-01-D Diedra DEPARTMENT OF JUSTICE Drug Enforcement Administration 21 CFR Part 1313 [DEA-197P] RIN 1117-AA53 Waiver of Advance Notification Requirement to Import Acetone, 2-Butanone (MEK), and Toluene Correction In proposed rule document 00-27426 beginning on page 63822 in the issue of Wednesday, October 25, 2000, make the following correction: On page 63824, in the first column, under the **List of Subjects in 21 CFR Part 1313** , in the fourth line, “recording” should read “recordkeeping”. [FR Doc. C0-27426 Filed 11-9-00; 8:45 am] BILLING CODE 1505-01-D !!Michele LEGAL SERVICES CORPORATION Sunshine Act Meeting of the Board of Directors Correction In notice document 00-28460 beginning on page 66563, in the issue of Monday, November 6, 2000, make the following correction: On page 66563, in the third column, under the heading **Open Session** , in the eighth line, “ Esther Lardent, ABA Director of the Pro Bono Center” should read “Esther Lardent, Representative of the ABA's Standing Committee on Legal Aid and Indigent Defendants”. [FR Doc. C0-28460 Filed 11-9-00; 8:45 am] BILLING CODE 1505-01-D 65 219 Monday, November 13, 2000 Rules and Regulations Part II Department of Health and Human Services Health Care Financing Administration 42 CFR Part 419 Medicare Program; Prospective Payment System for Hospital Outpatient Services; Interim Final Rule DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Care Financing Administration 42 CFR Part 419 [HCFA-1005-IFC] RIN 0938-A156 Medicare Program; Prospective Payment System for Hospital Outpatient Services AGENCY: Health Care Financing Administration (HCFA), HHS. ACTION: Interim final rule with comment period. SUMMARY: This interim final rule with comment period provides for the annual update to the Medicare hospital outpatient prospective payment system conversion factor that is used to calculate the payment amount for each payment group, effective January 1, 2001. It also updates the wage index values and incorporates the year 2001 changes in the procedure codes that are used to make payments under this system. In this rule, we are also responding to public comments received on those portions of the April 7, 2000 final rule with comment period (which established the hospital outpatient prospective payment system) that implemented related provisions of the Balanced Budget Refinement Act
(BBRA)of 1999. In addition, we are responding to public comments on the August 3, 2000 interim final rule with comment period that modified the April 7, 2000 final rule with comment period by revising the criteria used to define new or innovative medical devices, drugs, and biologicals eligible for transitional pass-through payments and correcting the criteria for grandfathering provider-based Federally Qualified Health Centers
(FQHC)into the prospective payment system. DATES: *Effective Date:* These regulations are effective on January 1, 2001. *Comment Period:* We will consider comments if we receive them at the appropriate address, as provided below, no later than 5 p.m. on January 12, 2001. ADDRESSES: Mail written comments (1 original and 3 copies) to the following address: Health Care Financing Administration, Department of Health and Human Services, Attention: HCFA-1005-IFC, P.O. Box 8013, Baltimore, MD 21244-8013. To ensure that mailed comments are received in time for us to consider them, please allow for possible delays in delivering them. If you prefer, you may deliver your written comments (1 original and 3 copies) to one of the following addresses: Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850. Comments mailed to the above addresses may be delayed and received too late for us to consider them. Because of staff and resource limitations, we cannot accept comments by facsimile
(FAX)transmission. In commenting, please refer to file code HCFA-1005-IFC. of the received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, in Room 443-G of the Department's office at 200 Independence Avenue, SW., Washington, DC, on Monday through Friday of each week from 8:30 to 5 p.m. (phone:
(202)690-7890). FOR FURTHER INFORMATION CONTACT: Janet Wellham
(410)786-4510, Chuck Braver,
(410)786-6719, or Jana Petze
(410)786-9374, (for general information). Kity Ahern,
(410)786-4515 (for information related to ambulatory payment classification groups and transitional pass-through payments related to drugs and biologicals). Majorie Baldo,
(410)786-4617 or Barry Levi,
(410)786-4529 (for information related to transitional pass-through payments for medical devices). George Morey
(410)786-4653 (for information related to the criteria for grandfathering provider-based FQHCs into the prospective payment system). SUPPLEMENTARY INFORMATION: Availability of Copies and Electronic Access *Copies:* To order copies of the **Federal Register** containing this document, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order payable to the Superintendent of Documents, or enclose your Visa or Master Card number and expiration date. Credit card orders can also be placed by calling the order desk at
(202)512-1800 or by faxing to
(202)512-2250. The cost for each copy is $8. As an alternative, you can view and photocopy the **Federal Register** document at most libraries designated as Federal Depository Libraries and at many other public and academic libraries throughout the country that receive the **Federal Register** . This **Federal Register** document is also available from the **Federal Register** online database through GPO Access, a service of the U.S. Government Printing Office. The Website address is http://www.access.gpo.gov /nara/index.html. To assist readers in referencing sections contained in this document, we are providing the following table of contents: Table of Contents I. Background A. General Summary of April 7, 2000 Final Rule With Comment Period that Implemented Amendments Enacted by the Balanced Budget Act of 1997 and the Balanced Budget Refinement Act of 1999 B. June 30, 2000 Notice of Delay of Effective Date for the April 7, 2000 Final Rule with Comment Period C. August 3, 2000 Interim Final Rule with Comment Period D. Summary of This Interim Final Rule with Comment Period II. Analysis of, and Responses to, Public Comments on the BBRA 1999 Provisions and the August 3, 2000 Interim Final Rule with Comment Period A. April 7, 2000 BBRA 1999 Provisions 1. Outlier Adjustment 2. Transitional Pass-Through for Additional Costs of Innovative Medical Devices, Drugs, and Biologicals a. Definition of a device b. Eligibility criteria c. Investigational device exemption
(IDE)device d. Removing cost of predicate item e. Excluded costs f. Effect on conversion factor g. Cost significance tests h. Brand-specific versus categorization approaches i. Issues pertaining to specific items j. Pass-through applications process k. Payment for pass-through items l. Focus medical review 3. Budget Neutrality Applied to New Adjustments 4. Limitation on Judicial Review 5. Inclusion in the Hospital Outpatient Prospective Payment System of Certain Implantable Items 6. Payment Weights Based on Median or Mean Hospital Costs 7. Limitation on Variation of Costs of Services Classified Within a Group 8. Annual Review of the Components of the Hospital Outpatient Prospective Payment System 9. Copayment Amounts Not Affected by Pass-Throughs 10. Extension of Cost Reductions 11. Clarification of Congressional Intent Regarding Base Amounts Used in Determining the Hospital Outpatient Prospective Payment System 12. Transitional Corridors for Application of Outpatient Prospective Payment System a. Interim payment versus final settlement b. Payment-to-cost ratios c. Cost-to-charge ratios d. Interim payments limited to 85 percent of the estimated transitional corridor payment e. Providers having more than one 1996 cost report f. Providers having no 1996 cost report g. Prospective payment system delay and transitional corridor payments h. Rural hold-harmless provision i. Covered charges j. Cancer hospitals and transitional corridor payments k. Teaching hospitals and transitional corridor payments 13. Limitation on Coinsurance for a Procedure 14. Reclassification of Certain Hospitals B. August 3, 2000 Interim Final Rule With Comment Period 1. Transitional Pass-Through Provisions a. “Not insignificant” cost criteria b. Definition of medical device 2. Revision to Grandfather Provision for Certain FQHCs and “Look-Alikes” 3. Clarification of Notice of Beneficiary Cost-Sharing Liability 4. Clarification of Protocols for Off-Campus Departments 5. Typographical Errors in the Provider-Based Regulations III. Provisions of This Interim Final Rule With Comment Period A. Changes Relating to the BBRA 1999 Public Comments B. Annual Updates to Components of the Hospital Outpatient Prospective Payment System 1. APC Groups a. New codes b. Deleted codes c. Revisions to correct errors or inconsistencies d. Device-related codes e. Inpatient codes moved to the outpatient setting f. “Two-times” rule g. Inpatient codes moved to outpatient and affected by device h. Newly covered codes i. Pass-through requests for drugs 2. Inpatient Procedures List Update 3. Wage Index Adjustment 4. Conversion Factor Update IV. Waiver of Notice of Proposed Rulemaking V. Collection of Information Requirements VI. Regulatory Impact A. General B. Analysis for Changes in this Interim Final Rule with Comment Period C. Federalism D. Executive Order 12866 and 5 U.S.C. 804(2) Regulation Text *Addenda* *Note to the Addenda* *Addendum A* —List of Hospital Outpatient Ambulatory Payment Classifications with Status Indicators, Relative Weights, Payment Rates, and Coinsurance Amounts—Calendar Year 2001 *Addendum B* —Hospital Outpatient Department
(HOPD)Payment Status by HCPCS Code and Related Information—Calendar Year 2001 Addendum C—[Reserved] *Addendum D* —Status Indicators: How Various Services Are Treated under the Hospital Outpatient Prospective Payment System *Addendum E* —CPT Codes Which Will Be Paid Only As Inpatient Procedures—Calendar Year 2001 *Addendum F* —Wage Index for Urban Areas *Addendum G* —Wage Index for Rural Areas *Addendum H* —Wage Index for Hospitals That Are Reclassified Alphabetical List of Acronyms Appearing in the Interim Final Rule With Comment Period APC Ambulatory payment classification APG Ambulatory patient group ASC Ambulatory surgical center AWP Average wholesale price BBA 1997 Balanced Budget Act of 1997 BBRA 1999 Balanced Budget Refinement Act of 1999 CAT Computerized axial tomography CCI [HCFA's] Correct Coding Initiative CCR Cost center specific cost-to-charge ratio CMHC Community mental health center CORF Comprehensive outpatient rehabilitation facility CPI Consumer Price Index CPT [Physicians'] Current Procedural Terminology, 4th Edition, 2000, copyrighted by the American Medical Association DME Durable medical equipment DMEPOS DME, prosthetics (which include prosthetic devices and implants) orthotics, and supplies DRG Diagnosis-related group FDA Food and Drug Administration FQHC Federally qualified health center HCPCS HCFA Common Procedure Coding System HHA Home health agency ICD-9-CM International Classification of Diseases, Ninth Edition, Clinical Modification IME Indirect medical education JCAHO Joint Commission on Accreditation of Healthcare Organizations MRI Magnetic resonance imaging MSA Metropolitan statistical area NECMA New England County Metropolitan Area PPS Prospective payment system RFA Regulatory Flexibility Act RHC Rural health clinic RRC Rural referral center SCH Sole community hospital SNF Skilled nursing facility I. Background A. General Summary of April 7, 2000 Final Rule With Comment Period That Implemented Amendments Enacted by the Balanced Budget Act of 1997 and the Balanced Budget Refinement Act of 1999 On April 7, 2000, we published in the Federal Register (65 FR 18434) a final rule with comment period to implement a new prospective payment system for hospital outpatient services. This new system establishes prospective payment rates for covered outpatient hospital services using ambulatory payment classification
(APC)groups. The April 7, 2000 final rule with comment period implemented section 4523 of the Balanced Budget Act of 1997 (the BBA 1997), Public Law 105-33, and related sections of the Balanced Budget Refinement Act of 1999 (the BBRA 1999), Public Law 106-113. Section 4523 of the BBA 1997 amended section 1833 of the Social Security Act (the Act) by adding subsection
(t)to provide for implementation of a prospective payment system for hospital outpatient services furnished to Medicare beneficiaries. Section 1833(t) of the Act, as added by the BBA 1997— • Authorizes the Secretary to designate the hospital outpatient services that would be paid under the prospective payment system and requires that the hospital outpatient prospective payment system include hospital inpatient services designated by the Secretary that are covered under Medicare Part B for beneficiaries who are entitled to Part A benefits but who have exhausted them or are otherwise entitled to them. • Sets forth certain requirements for the hospital outpatient prospective payment system, including the requirement that a classification system for covered outpatient services be developed that may consist of groups arranged so that the services within each group are comparable clinically and with respect to the use of resources. • Specifies data requirements for establishing relative payment weights. The weights are to be based on the median hospital costs determined by 1996 claims data and data from the most recent available cost reports. (This provision has subsequently been changed by the BBRA 1999, as discussed later in this preamble.) • Requires that the portion of the Medicare payment and the beneficiary coinsurance that are attributable to labor and labor-related costs be adjusted for geographic wage differences in a budget neutral manner. • Authorizes the Secretary under section 1833(t)(2)(E) of the Act to establish, in a budget neutral manner, other adjustments, such as outlier adjustments or adjustments for certain classes of hospitals, that the Secretary determines to be necessary to ensure equitable payments. • Requires the Secretary to develop a method for controlling unnecessary increases in the volume of covered outpatient services. • Specifies how beneficiary deductibles are to be treated when calculating the Medicare payment and beneficiary coinsurance amounts and requires that rules be established regarding determination of coinsurance amounts for covered services that were not furnished in 1996. The statute freezes beneficiary coinsurance at 20 percent of the national median charges for covered services (or a group of covered services) furnished during 1996 and updated to 1999 using the Secretary's estimated charge growth from 1996 to 1999. • Prescribes the formula for calculating the initial conversion factor used to determine 1999 Medicare payment amounts and the method for updating the conversion factor in subsequent years. • Describes the method for determining the Medicare payment amount and the beneficiary coinsurance amount for services covered under the outpatient prospective payment system. (This section was amended by the BBRA 1999, as discussed later in this preamble.) • Requires the Secretary to establish a procedure whereby hospitals may voluntarily elect to reduce beneficiary copayment for some or all covered services to an amount no less than 20 percent of the Medicare payment amount. Hospitals are further allowed to disseminate information on any such reductions of copayment amounts. Section 4451 of the BBA 1997 added section 1861(v)(1)(T) to the Act, which provides that any reduction in copayment, must not be treated as a bad debt. • Authorizes periodic review and revision of the payment groups, relative payment weights, wage index, and conversion factor. (This section was amended by the BBRA 1999, as discussed later in this preamble.) • Describes how payment is to be made for ambulance services, which are specifically excluded from the hospital outpatient prospective payment system under section 1833(t)(1)(B) of the Act. • Provides that the Secretary may establish a separate conversion factor for services furnished by cancer hospitals that are excluded from the hospital inpatient prospective payment system. • Prohibits administrative or judicial review of the hospital outpatient prospective payment system classification system, the payment groups, relative payment weights, wage adjustment factors, other adjustments, calculation of base amounts, periodic adjustments, and the establishment of a separate conversion factor for those cancer hospitals excluded from hospital inpatient prospective payment system. (This section was expanded by the BBRA 1999, as discussed later in this preamble.) Section 4523(d) of the BBA 1997 made a conforming amendment to section 1833(a)(2)(B) of the Act to provide for payment under the hospital outpatient prospective payment system for some services described in section 1832(a)(2) of the Act that are currently paid on a cost basis and furnished by providers of services, such as comprehensive outpatient rehabilitation facilities (CORFs), home health agencies (HHAs), hospices, and community mental health centers (CMHCs). This amendment provides that partial hospitalization services furnished by CMHCs be paid under the hospital outpatient prospective payment system. Before enactment of section 4521(b) of the BBA 1997, the blended payment formulas for ambulatory surgery centers
(ASC)procedures, radiology, and other diagnostic services, the ASC or physician fee schedule portion were calculated as if the beneficiary paid 20 percent of the ASC rate or physician fee schedule amount instead of the actual amount paid, which was 20 percent of the hospital's billed charges. Section 4521(b) of the BBA 1997, which amended sections 1833(i)(3)(B)(i)(II) and 1833(n)(1)(B)(i) of the Act, corrected this anomaly by changing the blended calculations so that all amounts paid by the beneficiary are subtracted from the total payment in the calculation to determine the amount due from the program. Effective for services furnished on or after October 1, 1997, payment for ASC surgery, radiology, and other diagnostic services calculated by blended payment methods is now calculated by subtracting the full amount of coinsurance due from the beneficiary (based on 20 percent of the hospital's billed charges). Section 1861(v)(1)(S)(ii) of the Act was amended by section 4522 of the BBA 1997 to require that the amounts otherwise payable for hospital outpatient operating costs and capital costs be reduced by 5.8 percent and 10 percent, respectively, through December 31, 1999. (This section was further amended by the BBRA 1999.) (Refer to the April 7, 2000 hospital outpatient prospective payment system final rule with comment period for a more in-depth description of how the changes made by the BBA 1997 and the BBRA 1999 were implemented.) On November 29, 1999, after we had published a proposed rule to implement section 4253 of the BBA 1997, the BBRA 1999 was enacted. The BBRA 1999 made major changes that affected the hospital outpatient prospective payment system that was established by the BBA 1997 and implemented in the April 7, 2000 final rule with comment period. Therefore, in the April 7, 2000 final rule with comment period, we also implemented 14 provisions of the BBRA 1999 that affected the hospital outpatient prospective payment system and solicited public comments on those provisions. The BBRA 1999 provisions on which we solicited comments included the following: 1. Outlier Adjustment Section 201(a) of the BBRA 1999 amended section 1833(t) of the Act by adding a new paragraph
(5)to provide that the Secretary must make payment adjustments (that is, an outlier payment) for covered services whose costs exceed a threshold determined by the Secretary. This section describes how the additional payments are to be calculated and caps the projected outlier payments at no more than 2.5 percent of the total projected payments (sum of both Medicare and beneficiary payments to the hospital) made under the hospital outpatient prospective payment system for years before 2004 and 3.0 percent of the total projected payments for 2004 and subsequent years. 2. Transitional Pass-Through for Additional Costs of Innovative Medical Devices, Drugs, and Biologicals Section 201(b) of the BBRA 1999 added new section 1833(t)(6) to the Act, establishing transitional pass-through payments for certain medical devices, drugs, and biologicals. This provision specifies the types of items for which additional payments must be made; describes the amount of the additional payments; limits these payments to at least 2, but not more than 3 years; and caps the projected payment adjustments annually at 2.5 percent of the total projected payments for hospital outpatient services each year before 2004 and no more than 2.0 percent in subsequent years. Under this provision, the Secretary must reduce pro rata the amount of the additional payments if, before the beginning of a year, he or she estimates that these payments would otherwise exceed the caps. 3. Budget Neutrality Applied to New Adjustments Section 201(c) of the BBRA 1999 amended section 1833(t)(2)(E) of the Act to require that the establishment of outlier and transitional pass-through payment adjustments be made in a budget neutral manner. 4. Limitation on Judicial Review Section 201(d) of the BBRA 1999 amended redesignated section 1833(t)(11) of the Act by extending the prohibition of administrative or judicial review to include the factors for determining outlier payments (that is, the fixed multiple, or a fixed dollar cutoff amount, the marginal cost of care, or applicable total payment percentage), and the determination of additional payments for certain medical devices, drugs, and biologicals, the insignificant cost determination for these items, the duration of the additional payment or portion of the prospective payment system payment amount associated with particular devices, drugs, or biologicals, and any pro rata reduction. 5. Inclusion in the Hospital Outpatient Prospective Payment System of Certain Implantable Items Section 201(e) of the BBRA 1999 amended section 1833(t)(1)(B) of the Act to include as covered hospital outpatient services implantable prosthetics, durable medical equipment (DME), diagnostic x-ray, laboratory, and other tests associated with those implantable items. 6. Payment Weights Based on Median or Mean Hospital Costs Section 201(f) of the BBRA 1999 amended section 1833(t)(2)(C) of the Act, which specifies data requirements for establishing relative payment weights, to allow the Secretary the discretion to base the weights on either the median or mean hospital costs determined by data from the most recent available cost reports. 7. Limitation on Variation of Costs of Services Classified Within a Group Section 201(g) of the BBRA 1999 amended section 1833(t)(2) of the Act to limit the variation of costs of services within each payment classification group by providing that the highest median cost (or mean cost, if elected by the Secretary) for an item or service within the group cannot be more than 2 times greater than the lowest median (or mean) cost for an item or service within the group. The provision allows the Secretary to make exceptions in unusual cases, such as for low volume items and services. 8. Annual Review of the Hospital Outpatient Prospective Payment System Components Section 201(h) of the BBRA 1999 amended redesignated section 1833(t)(8) of the Act to require at least an annual review of the payment groups, relative payment weights, and the wage and other adjustments made by the Secretary to take into account changes in medical practice, the addition of new services, new cost data, and other relevant information and factors. Section 201(h)(2) provides that the first annual review must be conducted in 2001 for application in 2002. The section was further amended to require the Secretary to consult with an expert outside advisory panel composed of an appropriate selection of provider representatives who will review the clinical integrity of the groups and weights and advise the Secretary accordingly. The panel may use data other than those collected or developed by the Department of Health and Human Services
(HHS)for review and advisory purposes. 9. Coinsurance Not Affected by Pass-Throughs Section 201(i) of the BBRA 1999 amended redesignated section 1833(t)(7) of the Act to provide that the beneficiary coinsurance amount will be calculated as if the outlier and transitional pass-throughs had not occurred; that is, there will be no additional coinsurance collected from beneficiaries for the additional payments made to hospitals by Medicare for these adjustments. 10. Extension of Cost Reductions Section 201(k) of the BBRA 1999 amended section 1861(v)(1)(S)(ii) of the Act to extend, until the first date that the hospital outpatient prospective payment system is implemented, the 5.8 and 10 percent reductions for hospital operating and capital costs, respectively. 11. Clarification of Congressional Intent Regarding Base Amounts Used in Determining the Hospital Outpatient Prospective Payment System Section 201(l) of the BBRA 1999 provided that, “With respect to determining the amount of copayments described in paragraph (3)(A)(ii) of section 1833(t) of the Social Security Act, as added by section 4523(a) of BBA, Congress finds that such amount should be determined without regard to such section, in a budget neutral manner with respect to aggregate payments to hospitals, and that the Secretary of Health and Human Services has the authority to determine such amount without regard to such section.” 12. Transitional Corridors for Application of Outpatient Prospective Payment System Section 202 of the BBRA 1999 amended section 1833(t) of the Act by redesignating paragraphs
(7)through
(11)as paragraphs
(8)through (12), respectively, and adding a new paragraph (7), which provides for a transitional adjustment to limit payment reductions under the hospital outpatient prospective payment system. More specifically, from the date the prospective payment system is implemented through 2003, a provider, including a CMHC, will receive an adjustment if its prospective payment system payments for outpatient services furnished during the year is less than a set percentage of its “pre-BBA” amount for that year. The pre-BBA amount is the product of the reasonable costs the hospital incurs for prospective payment system services during the year and the payment-to-cost ratio for covered prospective payment system services furnished during the cost report period ending during 1996. Two categories of hospitals, rural hospitals with 100 or fewer beds and cancer hospitals, will be held harmless under this provision. Small rural hospitals will be held harmless for services furnished before January 1, 2004. The hold-harmless provision applies permanently to cancer centers. Section 202 also requires the Secretary to make interim payments to affected hospitals subject to retrospective adjustments and requires that the provisions of this section do not affect beneficiary coinsurance. Finally, this provision is not subject to budget neutrality. 13. Limitation on Coinsurance for a Procedure Section 204 of the BBRA 1999 amended redesignated section 1833(t)(8) of the Act to provide that the copayment amount for a procedure performed in a year cannot exceed the hospital inpatient deductible for that year. 14. Reclassification of Certain Hospitals Section 401 of the BBRA 1999 added section 1886(d)(8)(E) to the Act to permit reclassification of certain urban hospitals as rural hospitals for purposes of section 1886(d) of the Act. Section 401 added section 1833(t)(13) to the Act to provide that a hospital being treated as a rural hospital under section 1886(d)(8)(E) is also to be treated as a rural hospital under the hospital outpatient prospective payment system. A discussion of how each of these BBRA 1999 provisions was implemented in the April 7, 2000 final rule with comment period appears in section II of this preamble preceding our summary of the public comments received and our responses to those comments. B. June 30, 2000 Notice of Delay of Effective Date for the April 7, 2000 Final Rule With Comment Period On June 30, 2000, we published a notice in the **Federal Register** (65 FR 40535) announcing a delay in the effective date of the April 7, 2000 hospital outpatient prospective payment system final rule with comment period from July 1, 2000 to August 1, 2000. This delay was based on our determination that the appropriate claims processing changes could not feasibly be made to our computer systems and properly tested in time to ensure that proper payments would be made for Medicare hospital outpatient services under the new prospective payment system by the original July 1, 2000 effective date. C. August 3, 2000 Interim Final Rule With Comment Period On August 3, 2000, we published an interim final rule with comment period in the **Federal Register** (65 FR 47670) that changed one criterion and postponed the effective date for two other criteria that a new device, drug, or biological must meet in order for its cost to be considered “not insignificant” for purposes of determining its eligibility for transitional pass-through payments from the hospital outpatient prospective payment system. It also changed the transitional pass-through payment policy to include new single use medical devices that come in contact with human tissue and are surgically implanted or inserted into patients, whether or not the devices remain with the patients following their release. These policies were a departure from those presented in the April 7, 2000 final rule with comment period. The August 3, 2000 rule also corrected a trigger date for grandfathering of provider-based FQHCs to conform with the intent not to disrupt existing FQHCs with longstanding provider-based treatment that we discussed in the April 7, 2000 rule. Under the criteria in the April 7, 2000 final rule with comment period, FQHCs would have been treated as departments of a provider without regard to the criteria for provider-based status if they continued to qualify as FQHCs and were designated as FQHCs before 1995. In accordance with the August 3, 2000 interim final rule with comment period and this interim final rule with comment period, facilities that continue to qualify as FQHCs and were designated as FQHCs or “look-alikes” on or before April 7, 2000 would continue to be treated as provider-based facilities. In addition, we clarified how the requirement for prior notices to beneficiaries is to be applied in emergency situations. We also clarified the protocols for off-campus departments in emergency situations. D. Summary of This Interim Final Rule With Comment Period In section II of this preamble, we— • Respond to public comments received timely on the 14 BBRA 1999 provisions that were included in the April 7, 2000 final rule with comment period. (We received numerous public comments on other aspects of the April 7, 2000 final rule with comment period that were not open for comment. We will not address those comments in this rule.) • Respond to public comments on the August 3, 2000 interim final rule with comment period that revised the criteria for defining new or innovative medical devices, drugs, and biologicals eligible for pass-through payments and corrected the criteria for the grandfathering provision for certain FQHCs as provider-based. In section III of this preamble, we are updating, for services furnished during calendar year 2001, the wage index values and the conversion factor, and revising the APCs to reflect new codes for 2001 effective January 1, 2001. As required under section 1833(t)(8)(A) of the Act, in 2001, we will begin our annual review process of the APC groups, relative weights, and the wage and other adjustments for the prospective payment systems payments that will become effective on January 1, 2002. The statute requires the Secretary to consult with an expert outside advisory panel composed of an appropriate selection of representatives of providers to review (and advise the Secretary concerning) the clinical integrity of the groups and weights. This provision allows these experts to use data other than those collected or developed by us during our review of the APC groups and weights. II. Analysis of, and Responses to, Public Comments on the BBRA 1999 Provisions and the August 3, 2000 Interim Final Rule With Comment Period We received a total of 747 pieces of timely correspondence containing public comments on the April 7, 2000 final rule with comment period. In addition to receiving comments from various organizations throughout the hospital industry, we also received comments from beneficiaries and their families, physicians, health care workers, individual hospitals, professional associations and societies, legal and nonlegal representatives and spokespersons for beneficiaries and hospitals, members of the Congress, and other interested citizens. The majority of the comments addressed the BBRA 1999 provisions relating to the limitation on variation of costs of services classified within a group, the transitional pass-through provision for devices, drugs, and biologicals, and the inclusion of implantable items. We received 13 comments in response to the August 3, 2000 interim final rule with comment period. These comments were submitted by major associations, drug and device manufacturers, providers, a private citizen, and a law firm. More than half of the comments addressed issues for which we did not solicit comments in the August 3, 2000 interim final rule with comment period. Those comments specifically addressed payment policy and typographical errors present in the April 7, 2000 final rule with comment period. The remaining commenters addressed the revisions to the criteria to define new or innovative medical devices, drugs, and biologicals eligible for pass-through payments and corrections to the criteria for the grandfathering provision for certain FQHCs. These commenters took issue with some of the provisions and raised additional concerns regarding our actions. A summary of the public comments and our responses to them appears following the discussion of the April 7, 2000 final rule with comment period. We have carefully reviewed and considered all comments received timely. The modifications that we are making in response to commenters' suggestions and recommendations are summarized in section III.A of this preamble and, as appropriate, reflected in the regulation text. A. April 7, 2000 BBRA 1999 Provisions Below we discuss the implementation of the BBRA 1999 provisions addressed in the April 7, 2000 final rule with comment period and modified in the August 3, 2000 interim final rule with comment period, the public comments received on each provision, and our response to those comments. 1. Outlier Adjustment Section 1833(t)(5) of the Act, as added by section 201(a) of the BBRA 1999, required that the Secretary make an additional payment (that is, an outlier adjustment) for outpatient services for which a hospital's charges, adjusted to cost, exceed a fixed multiple of the sum of the outpatient prospective payment system payment and the transitional pass-through payments. The Secretary is authorized to determine the amount of this fixed multiple and the percent of costs above the threshold that is to be paid under this outlier provision. Under the statute, projected outlier payments may not exceed an “applicable percentage” of projected total program payments. The applicable percentage means a percentage specified by the Secretary (projected percentage of outlier payments relative to total payments), subject to the following limits: For years before 2004, the projected percentage that the Secretary specifies cannot exceed 2.5 percent; for 2004 and later, the projected percentage cannot exceed 3.0 percent. Section 1833(t)(2)(E) of the Act requires that these payments be budget neutral. Section 1833(t)(5)(D) of the Act grants the Secretary authority until 2002 to identify outliers on a bill basis rather than on a specific service basis and to use an overall hospital cost-to-charge ratio
(CCR)to calculate costs on the bill rather than using department-specific CCRs for each hospital. In the April 7, 2000 final rule with comment period, in accordance with the statute, we presented how the additional outlier payments are to be calculated. To set the threshold or fixed multiple and the payment percentage of costs above that multiple for which an outlier payment would be made, we first had to determine what specified percentage of total program payment, up to 2.5 percent, we should select. We decided to set the outlier target at 2.0 percent. In order to set the fixed multiple outlier threshold and payment percentage, we simulated the prospective payment system payments. We calibrated the threshold and the payment percentage applying an iterative process so that the simulated outlier payments were 2.5 percent of simulated total payments. For purposes of the simulation, we set a “target” of 2.5 percent (rather than 2.0 percent), because we believed that a given set of numerical criteria would result in a higher percentage of outlier payments under the simulation using 1996 data than under the prospective payment system. This is because we believe that the 1996 data reflects undercoding of services, which means simulated total payments would likely be understated and, in turn, the percentage of outlier payments would be overstated. In addition, we were not able to fully estimate the amount and distribution of pass-through payments using the 1996 data. Our inability to make these estimates further understated the total payments under the simulation. We believe that a set of numerical criteria that results in simulated outlier payments of 2.5 percent using the 1996 data would result in outlier payments of 2.0 percent under the prospective payment system. The difference arises from the effect of undercoding in the historical data and the payment of pass-throughs under prospective payment system. We set the outlier threshold at 2.5 times the prospective payment system payments. *Comment:* Several commenters asked us to clarify how series bills for services such as chemotherapy that are billed monthly for multiple sessions are treated in determining outlier payments. They also asked that we clarify how bills for multiple clinic visits on the same day are treated in calculating the outlier payment. *Response:* In accordance with section 1833(t)(5)(D) of the Act, until 2002, outliers will be determined on a bill basis rather than on a specific service basis. Therefore, the charges (converted to costs) associated with all services under the hospital outpatient prospective payment system reported on series bills or all payable multiple clinic visits billed on a single claim would be used to determine whether the outlier threshold is exceeded and to calculate the outlier payment. *Comment:* One commenter suggested that we prospectively adjust the conversion factor if we determine that the actual outlier expenditures are less than estimated in a given year. *Response:* Consistent with our outlier policies in other prospective payment systems, we will not adjust the conversion factor for a given year to account for an underestimation (or overestimation) of outlier payments in a previous year. The statute does not provide for such an adjustment to the conversion factor. We set outlier policies prospectively, using the best available data. Outlier payments, like many aspects of a prospective payment system, reflect estimates, and we believe it would be inappropriate to adjust the conversion factor (upward or downward) for a given year simply because an estimate for a previous year ultimately turned out to be inaccurate. If we underestimate or overestimate the percentage of outlier payments, the divergence of our estimate from actual experience might provide information that might help us improve estimates in the future, but it would have no direct effect on the conversion factor for any following year. *Comment:* One commenter urged us to provide additional information about the cost-to-charge ratios that will be used to determine whether a claim exceeds the outlier threshold for payment. The commenter stated that the preamble language on page 18498 of our April 7, 2000 final rule with comment period conflicts with statements contained in Program Memorandum Transmittal No. A-00-23 regarding which cost-to-charge ratio would be used to determine whether a claim meets the outlier threshold requirements for payment. According to the commenter, we stated in the final rule with comment period that we will use a hospital's overall cost-to-charge ratio to make this determination, but stated in the program memorandum that we will use an outpatient cost-to-charge ratio. The commenter asked us to clarify the conflicting statements. *Response:* On September 8, 2000, we issued Program Memorandum Transmittal No. A-00-63, titled “Cost-to-Charge Ratios
(CCRs)for Calculating Certain Payments Under the Hospital Outpatient Prospective Payment System” which describes how we calculated the cost-to-charge ratios that are used to determine payments for outliers, interim transitional corridors, and device pass-throughs for calendar year 2000. That program memorandum defined the cost-to-charge ratio that is used to calculate these payments as the overall hospital outpatient cost-to-charge ratio. This is consistent with what we stated in our April 7, 2000 final rule with comment period. The September program memorandum contains the latest and most complete information available on cost-to-charge ratio calculation for the hospital outpatient prospective payment system. *Comment:* One commenter assumed that we will use department level cost-to-charge ratios after 2002 to determine if a particular outpatient service qualifies for outlier payment. The commenter asked if we will use a “national cost-to-charge mapping procedure” to determine the appropriate department cost-to-charge ratios to use. The commenter expressed concern about the appropriateness of that approach because of the variability among providers in assigning costs to departments. For this reason, the commenter recommended, if we use a national cost-to-charge mapping procedure, we permit providers to request outlier payments if they can demonstrate that the actual department cost-to-charge ratio to which they assign costs for a service results in a cost calculation that meets the outlier threshold. *Response:* We plan to address this issue and seek comments on it in the rulemaking process for the annual update for 2002. *Comment:* One commenter urged us to publish annually the “cost reporting year” used to determine the cost-to-charge ratios that will be used in determining outlier payments. The commenter also asked that we explain how we computed cost-to-charge ratios for hospitals that have merged or been acquired. *Response:* On September 8, 2000, we issued Program Memorandum Transmittal No. A-00-63 that describes the specific criteria we used and provides detailed instructions for calculating the cost-to-charge ratios for hospitals that have merged or been acquired. It also identifies the specific cost reporting year end that was used to calculate each provider's cost-to-charge ratio. *Comment:* One commenter asked that we lower the outlier threshold from 2.5 to 2.0. The commenter strongly recommended that we permanently retain the lowered threshold to ensure appropriate patient care and adequate provider reimbursement. *Response:* We oppose lowering the outlier threshold to 2.0. As discussed in our April 7, 2000 final rule with comment period, we set the outlier threshold at 2.5 by simulating total prospective payment system payments (using 1996 hospital outpatient data) and using an iterative process to calculate a threshold under which outlier payments are projected to equal 2.0 percent of total payments. If we lowered the threshold as the commenter suggests, then the projected percentage of outlier payments would increase and we would have to reduce the conversion factor correspondingly (thus reducing the payment for all non-outlier cases.) 2. Transitional Pass-Through for Additional Costs of Innovative Medical Devices, Drugs, and Biologicals Section 1833(t)(6) of the Act, as added by section 201(b) of the BBRA 1999, requires the Secretary to make additional payments to hospitals, outside the hospital outpatient prospective payment system for a period of 2 to 3 years for specific items. The items designated by the law are the following: Current orphan drugs, as designated under section 526 of the Federal Food, Drug, and Cosmetic Act; current drugs, biologic agents, and brachytherapy devices used for treatment of cancer; current radiopharmaceutical drugs and biological products; and new medical devices, drugs, and biologic agents, in instances where the item was not being paid as a hospital outpatient service as of December 31, 1996, and where the cost of the item is “not insignificant” in relation to the hospital outpatient prospective payment system payment amount. In this context, “current” refers to those items for which hospital outpatient payment is being made on the first date the new prospective payment system is implemented. Section 1833(t)(6)(C)(i) of the Act sets the additional payment amounts for the drugs and biologicals as the amount by which the amount determined under section 1842(o) of the Act (95 percent of the average wholesale price (AWP)) exceeds the portion of the otherwise applicable hospital outpatient department fee schedule amount that the Secretary determines to be associated with the drug or biological. Section 1833(t)(6)(C)(ii) of the Act provides that the additional payment for medical devices be the amount by which the hospital's charges for the device, adjusted to cost, exceed the portion of the otherwise applicable hospital outpatient department fee schedule amount determined by the Secretary to be associated with the device. Under section 1833(t)(6)(D), the total amount of pass-through payments for a given year cannot be projected to exceed an “applicable percentage” of total payments. For a year (or a portion of a year) before 2004, the applicable percentage is 2.5 percent; for 2004 and subsequent years, the applicable percentage is 2.0 percent. If the Secretary estimates that total pass-through payments would exceed the caps, the statute requires the Secretary to reduce the additional payments uniformly to ensure the ceiling is not exceeded. These pass-through payments must be made in a budget neutral manner. In addition, these additional payments do not affect the computation of the beneficiary coinsurance amount. In the April 7, 2000 final rule with comment period, we specified the types of items for which additional payments would be made; described the amount of the additional payments; announced that these payments would be limited to at least 2 years but not more than 3 years; and announced a cap of the projected payment adjustments annually at 2.5 percent of the total projected payments for hospital outpatient services each year before 2004 and no more than 2.0 percent in subsequent years. a. Definition of a Device *Comment:* Some commenters argued that we have adopted a very narrow definition of a device that restricts pass-through payments to prosthetic devices and excludes valuable new nonprosthetics from pass-through consideration. They asserted that the definition of a device should mirror the definition set forth in the Federal Food, Drug, and Cosmetic Act. They agreed that such a definition should exclude capital equipment, reusable items, and incidental supplies. However, they argued that we should clarify and revise our definition of devices to those that are “implanted or inserted” and “remain with the patient after the patient is released from the hospital outpatient department.” *Response:* The definition of a device under the Food, Drug, and Cosmetic Act is extremely broad. In summary, it refers to a device as an instrument, apparatus, implement, machine, contrivance, implant, *in vitro* reagent, or other similar or related article, including any component, part, or accessory, which is— • Recognized in the official national formulary, or the U.S. Pharmacopeia, or any supplement to them; • Intended for the use of the diagnosis of conditions other than diseases such as pregnancy; • Intended to affect the structure or any function of the body of man or other animals; or • Considered an *in vitro* diagnostic product, including those previously regulated as drugs, and which does not achieve any of its principal intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of any of its principal intended purposes. This definition is inappropriate for use in the context of the transitional pass-through payments for several reasons: It would include (as the commenters noted) items that are treated as supplies, reusable items, or capital equipment by Medicare payment systems, including the outpatient prospective payment system. It has a number of inappropriate elements, including reference to pharmaceuticals and to use in animals. Further, it is insufficiently specific for Medicare purposes, as it does not mention medical necessity or the test of whether the cost of a device is “not insignificant” relative to the associated APC. We have instead provided a definition of a device specific to the purposes of the transitional pass-through provision. This definition was presented in the preamble to the April 7, 2000 final rule with comment period and revised in the August 3, 2000 interim final rule with comment period, which added § 413.43(e)(4). In the August 3, 2000 interim final rule with comment period, we revised the criteria that we had set forth in the April 7, 2000 final rule with comment period to define a device. Among the changes included is a revision of the criterion relating to whether a device must remain with the patient. The new criterion (§ 419.43(e)(4)(iv)) includes devices that are surgically implanted or inserted in a patient “whether or not they remain with the patient when the patient is released from the hospital outpatient department.” This change allows pass-through payments for devices that are surgically implanted or inserted even temporarily in a patient providing the devices meet all other requirements for pass-through payments. As a result, nonprosthetic devices, such as cardiac catheters, guidewires, or stents that commenters noted would be excluded, may be eligible for pass-through status. In § 419.43(e)(4)(iv), we have retained the limitation to devices that are surgically implanted or inserted because we believe this offers the best interpretation of section 201(e) of the BBRA 1999, which indicates that implantable devices are to be included in the APCs. To further clarify how we interpret § 419.43(e)(4)(iv), we consider that a device is surgically implanted or inserted if it is introduced into the human body through a surgically created incision. We do not consider an item used to cut or otherwise create a surgical opening to be a device that is surgically implanted or inserted. We consider items used to create incisions, such as scalpels, electrocautery units, biopsy apparatuses, or other commonly used operating room instruments, to be supplies or capital equipment, and hence, in accordance with § 419.43(e)(4)(vi) or (vii), we consider these items not eligible for transitional pass-through payments. We believe the function of these items is different and distinct from that of devices that are used for surgical implantation or insertion. Generally, we would expect that surgical implantation or insertion of a device occurs after the surgeon uses certain primary tools, supplies, or instruments to create the surgical path or site for implanting the device. We have discovered some items that do not meet the requirement of being surgically implanted or inserted were erroneously approved for pass-through payments. Consequently, we will eliminate these items from the list of items eligible for pass-through payments, effective January 1, 2001. *Comment:* One commenter claimed that it was inappropriate for us to change the definition of devices through letters to manufacturers. The commenter believed that this was done outside the rulemaking process. *Response:* We did not make a change to our policy through a letter. As we began to evaluate the hundreds of applications for approval of numerous devices, it was apparent that our definition for new medical devices as published in our April 7, 2000 final rule with comment period would have resulted in denials for items that we believe might warrant pass-through payments. Examples of such potential denials are many types of general and specialty catheters. Based on our experience in reviewing these applications, we decided to change three of the eight specific criteria that a new device must meet in order to be eligible for pass-through payments. We published these changes in our August 3, 2000 interim final rule with comment period. b. Eligibility Criteria *Comment:* Some commenters believed that we should accept and process applications for items while they are undergoing the FDA review process. *Response:* We have accepted and begun processing all applications, including those for which items are pending FDA approval or clearance. However, in those instances where the FDA approval or clearance documentation is missing, the application is considered incomplete. In order for an item to be eligible for transitional pass-through payments, it must have been approved or cleared by the FDA for marketing. We will not make a final determination on any applications that are pending FDA approval or clearance until all the required documentation is submitted. Resources permitting, we will commence preliminary processing of the applications when received. The applying party is responsible for providing us with proper evidence of FDA approval or clearance for any item, once approval or clearance has been obtained. Once we receive documentation of FDA approval or clearance and determine the item is determined to be eligible for transitional pass-through payments, payment for the item will commence at the start of the next quarterly update of pass-through items. *Comment:* Some commenters asked that we clarify that items must meet Medicare coverage requirements in order to qualify for pass-through status. *Response:* As stated in both our April 7, 2000 final rule with comment period and our August 3, 2000 interim final rule with comment, items that qualify for pass-through payments must be covered by Medicare. They must have been determined to be reasonable and necessary for the diagnosis or treatment of an illness or injury or to improve the functioning of a malformed body part, as required by section 1862(a)(1)(A) of the Act. (See § 419.43(e)(4)(iii).) c. Investigational Device Exemption
(IDE)Devices *Comment:* Some commenters recommended that we automatically define as “new” any device that receives an investigational device exemption
(IDE)from the FDA, with a Category B designation. They believed that we should pay for IDE devices through the pass-through payment methodology rather than limit the payment to no more than what is currently paid for an equivalent device. *Response:* As stated in our August 3, 2000 interim final rule with comment period, we have changed the payment methodology for eligible IDE Category B devices so that they will be paid using the transitional pass-through methodology. Since these noninvestigational devices are required to meet the same eligibility criteria as other devices, we determined that they should be paid in a similar manner. However, we do not accept the commenter's recommendation that all IDE Category B devices “automatically” be considered as new. The statute defines “new” medical device on the basis of a date certain (that is, payment for the device was not being made as an hospital outpatient service as of December 31, 1996) rather than based on a class of devices (such as IDEs). d. Removing Cost of Predicate Item *Comment:* Some commenters stated that we did not have adequate data to ensure appropriate removal of the costs for predecessor items (particularly radiopharmaceuticals and devices) from their relevant APCs. They advocated that we reevaluate this provision as soon as possible after implementation of our new system and make necessary changes. *Response:* We will be continuously evaluating our data to remove the costs of predecessor items from the pass-through payments. As of January 1, 2001, a specific dollar amount will be deducted from selected devices (see explanation below). Over time, such deductions will be made, as we are able to make appropriate estimates from the data. e. Excluded Costs *Comment:* A number of commenters stated that the APC construction excluded costs for implantable devices billed with revenue codes 274, 275 and 278. The commenters recommended that implantable devices associated with these revenue codes be included on the pass-through list until data is collected to adequately reflect the cost of such devices. In addition to claims that revenue codes 274, 275 and 278 were not represented in the data, some commenters alleged that implant procedures were infrequently performed on an outpatient basis prior to 1997 and therefore the costs associated with them were not represented in the data used to develop the APC rates. Some commenters recommended, on that basis, that all implantable devices be included for pass-through payment regardless of FDA approval dates. *Response:* Following enactment of the BBRA of 1999, we did not have sufficient time to re-run our data to package the costs of implantable device revenue centers into the APC weights and still be able to publish a final rule in time to implement the prospective payment system by July 1, 2000. As of January 1, 2001, the APC rates will reflect the inclusion of revenue codes 274, 275 and 278. While the aggregate amount of these revenue centers is small (0.3 percent of total charges in 1996), the costs of certain procedures such as implantation of cardiac pacemakers did increase substantially. As detailed in section III.B.1 of this interim final rule, some APC groups were modified because of the inclusion of these revenue centers, and rates for some procedures will increase to reflect these costs. A reduction in an amount equal to the increase in the APC rates will be deducted from the relevant devices that are either eligible for pass-through payments or that can be billed for additional payment through the new technology APCs. f. Effect on Conversion Factor *Comment:* Some commenters believed that lowering the outpatient prospective payment system conversion factor to reflect the 2.5 percent transitional pass-through adjustment could affect hospitals' financial health. They asserted that any risks to the financial health of hospitals resulting from reducing the conversion factor should be balanced against any benefits that would be gained from higher payments for new drugs and devices. Another commenter advocated that we increase the conversion factor if we find that the transitional pass-through payments do not comprise 2.5 percent of the total outpatient prospective payment system payments. *Response:* Section 1833(t)(2)(E), as amended by section 201(c) of the BBRA 1999, requires that transitional pass-through payments be implemented in a budget neutral manner. We set prospective payment system rates prospectively and, consistent with our policies in other aspects of the prospective payment system, we will not adjust (upward or downward) the conversion factor for a given year to account for the difference between 2.5 percent and the actual percentage of pass-through payments in a previous year. g. Cost Significance Tests *Comment:* Some commenters asserted that we could preclude some worthwhile technologies from achieving pass-through status if we set the “not insignificant” cost threshold at 25 percent of the APC payment rate for the relevant procedure with which it is used. They contend that technologies associated with higher payment APCs would be more likely to be disqualified. *Response:* We have lowered the cost threshold from 25 percent to 10 percent of the applicable fee schedule amount for the service associated with the item. This change is effective for services furnished on or after August 1, 2000. *Comment:* A hospital association asked that we clarify how the “not insignificant” criteria will be applied when a new device, drug, or biological is associated with more than one APC. The commenter stated that, under the current provisions of the rule, an item could be determined to be eligible for pass-through payment when used in performing a procedure in one APC, but not another. The commenter suggested that an item that meets the criteria for one APC be treated as a pass-through item for all APCs in which it is used. *Response:* We agree with the stated approach. This has been the policy that we have applied in processing applications. *Comment:* One manufacturer stated that we did not make information available on the “not insignificant” rule in sufficient time for applicants to take the criteria into account in preparing applications for payment effective August 1, 2000. The commenter alleged that the term “not insignificant” can be interpreted widely and caused manufacturers not to apply for all potentially eligible pass-through items. The commenter recommended that we review applications submitted for the following HCPCS codes to be certain that they meet the published cost criteria and remove them from the pass-through list if they do not. The commenter also advocated that we allow other manufacturers to submit applications retroactive to July 1, 2000, to assure that we are not promoting a competitive disadvantage for some companies. HCPCS Codes C1029 C1034 C1061 C1072 C1073 C1074 C1100 C1101 C1155 *Response:* In order for a device to be included on the pass-through list, it must meet the criteria for transitional pass-through payments. These criteria include a test of whether the cost of a device is “not insignificant” relative to the payment for the associated APC. This test was first put forth in the April 7, 2000 final rule with comment period, and subsequently revised in the August 3, 2000 interim final rule with comment period. All the devices denoted by the HCPCS codes listed above were tested and met the 10-percent “not insignificant” test as well as the other applicable criteria. The “not insignificant” test was applied uniformly to all applications that had been received timely. We believe that permitting retroactive applications is unwarranted (and would be inconsistent with principles of prospectivity); moreover, resource and systems constraints would make it infeasible to give retroactive effect to determinations of eligibility for pass-through payments. h. Brand-Specific Versus Categorization Approaches *Comment:* Many commenters criticized us for implementing a brand-specific approach to items on the pass-through list. Device manufacturers in particular recommended a category scheme to classify pass-through devices. Representatives of the device industry also offered to assist us in creating the categories. They argued that a category system would allow devices to be added immediately upon FDA approval. They stated that under a category approach manufacturers would only approach us to obtain new pass-through categories and codes when items reflect a technological advance and are significantly more costly than existing payment amounts. *Response:* We adopted a trade-name specific approach for several reasons. First, such an approach provides better information. Codes that are largely item-specific allow us to track what procedures the items are used with and costs of the items. When the pass-through payments for an item ends, we would expect to have good information for assigning it to relevant APCs and ensuring appropriate payment for these APCs. Adopting a scheme with a significant degree of categorization would require use of averages in making assignments and setting payment rates. Decisions based on these more limited data would be likely to lead to intensified concerns about the appropriateness of APC assignment and payment. Second, this approach permits finer discrimination in eligibility decisions. An item-by-item approach allows us to be sure individual items in fact meet the criteria for eligibility. Of major concern in this instance is whether a device is “new” using the standard of the statute. Section 1833(t)(6)(A) of the Act limits transitional pass-through payment to those devices for which “* * * payment for the device * * * as an outpatient hospital service under this part was not being made as of December 31, 1996.” Adopting categories would in some cases mix “old” and “new” devices. In these instances, either some old devices would get special treatment that they would not be eligible for if they were examined on an item-specific basis, or an entire category could be considered old, thus depriving some new devices from special treatment they would be eligible for if they were examined on an item-specific basis. Third, an item-specific scheme avoids issues associated with the design of categories needed for purposes of transitional pass-through payments. It largely avoids concerns about what items should be in what category or whether new categories should be created to accommodate items that may appear to be little different from those in existing categories. Fourth, an item-specific approach allows us to assure that a newly arriving device can obtain the full period of pass-through status it is arguably eligible for under the statute. A categorization approach would likely lead to latecomers being eligible for pass-through payments for a shorter period. Insofar as revision to APC payment rates reflected the costs of items in the category by the time the category was terminated, the shorter period would be of little consequence. However, if the costs of the late-coming item were significantly higher, this procedure could appear objectionable. A solution in this case would be to create a new code, which could be specific to that item, thus departing from a categorization approach. We recognize that a category approach would lessen concerns about competitive disadvantages that may have been inadvertently created by an item specific approach and about access to specific items by hospitals and their patients. However, we found no satisfactory way of establishing categories that would not run into difficulty regarding the test of whether a device is “new” as described above. Consequently, we are making no change in our approach. *Comment:* Many commenters argued that competitive advantages have resulted and will continue to result from using a brand-specific approach to implementing transitional pass-through payments for devices. Some commenters alleged that our use of the FDA approval date as a proxy for determining payment in concert with the brand-specific approach causes further competitive disadvantages. Some hospitals claimed that the brand-specific approach would create winners and losers if a device that one hospital uses obtains pass-through status, but one that another hospital uses does not. A number of commenters asserted that a category approach would decrease the administrative burden on hospitals, manufacturers, and us that a brand-specific approach for application and approval of new devices now incurs. *Response:* It was never our intent to competitively disadvantage anyone or any product. To the maximum extent possible, given the limitations under the BBRA 1999 and our resource constraints, we have worked closely with the pharmaceutical and medical device industries to identify and resolve such issues. By October 1, 2000, we had determined that more than 700 devices are eligible for pass-through payments. Therefore, we believe that hospitals will receive additional payments for many of the devices they use. i. Issues Pertaining to Specific Items *Comment:* A medical association advocated pass-through status for the following devices: new pacemakers, implantable cardioverter defibrillators, insertable loop recorders, electrophysiology catheters (ablation and diagnostic), intracardiac echocardiography ultrasound catheters, and advanced three-dimensional mapping system catheters. *Response:* All of these items are already on the pass-through list. For a complete list of items approved on the pass-through list, refer to Addendum B of this rule for short descriptions of the items. Refer to Program Memoranda Transmittals Nos. A-00-42, A-00-61 and A-00-72 for the long descriptors for each of the C-codes listed in Addendum B. We are developing an additional program memorandum that we expect to issue shortly. This additional program memorandum will contain a list of additional devices, drugs, and new technology services that will be effective January 1, 2001. *Comment:* Several device manufacturers alleged that the following devices were not included on the pass-through list: PALMAZ Balloon-Expandable Stent Corinthian IQ Biliary Stent SMART Cordis Nitinol Stent CARTO EP Navigation System Catheters HYDROLYSER Catheter Indigo Prostate Seeding Needle Lioresal Intrathecal SynchroMed and SynchroMed EL infusion pumps *Response:* All of these devices have been approved for pass-through payments and assigned C-codes. They have been assigned the following codes: the PALMAZ Balloon-Expandable Stent, C8522; Corinthian IQ Biliary Stent, C5004; SMART Cordis Nitinol Stent, C1372; CARTO EP Navigation System Catheters, C1047; HYDROLYSER Catheter, C1054; Indigo Prostate Seeding Needle, C1706; Lioresal Intrathecal, C9007, C9008, C9009, and C9010; SynchroMed and SynchroMed EL infusion pumps, C8505 and C3800, respectively. *Comment:* Another device manufacturer claimed that the following devices were not included on the pass-through list: Mitek Bone Anchors Innovasive Bone Anchors VAPR and VAPR Thermal T Electrode Gynecare TVT Tension-Free Support for Incontinence System
(TVT)Gynecare Thermachoice Uterine Balloon Therapy System *Response:* Many of the items above have been approved for pass-through status and assigned C-codes. The Mitek and Innovasive Bone Anchors have been assigned to C1109; VAPR and VAPR Thermal T Electrode, to C1323; TVT Single-Use Tension-Free Vaginal Tape, to C1370; and the Gynecare Thermachoice II Catheter, to C1056. However, some of the items included in the Gynecare TVT Tension-Free Support for Incontinence System and the Gynecare Thermachoice Uterine Balloon Therapy System did not meet the criteria for pass-through status and, therefore, are ineligible for additional payments. The eligible pass-through items are listed in Addendum B. *Comment:* A device manufacturer believed that we should have approved the Targis System, which provides prostatic microwave thermotherapy, for pass-through payments. *Response:* We assigned the prostatic microwave thermotherapy procedure to a new technology APC, that is, APC 0980. In making this assignment, we took into account the costs associated with performing this procedure, including the cost of the Targis system. Therefore, we would not also make a pass-through payment for the system. *Comment:* A number of commenters contended that only 39 of the more than 70 eligible radiopharmaceuticals have been given pass-through status. They recommended that we approve the following radiopharmaceuticals for pass-through payments: Strontium Sr 82 Rubidium Rb 82 Generator Sodium Chromate Cr-51 Co 57 Cobaltous Chloride Co 57 Cyanocobalamin Ferrous Citrate Fe59 Fludeoxyglucose F 18 Intrinsic Factor Concentrate Capsules In 111 Imciromab (Myoscint) In 111 Labeled WBCs, Platelets I 123 and I 131 Hippurate Iodinated I 131 Albumin (I 131 Albumin) Iodinated I 125 Albumin (I 125 Albumin) Iothalamate Sodium I 125 Albumin (I125 Iothalamate) Technetium Tc 99m Pertechnetate Technetium Tc 99m Albumin Colloid Technetium Tc 99m Lidofenin Technetium Tc 99m Tebroxime Technetium Tc 99m Nofetumomab (Verluma) Technetium Tc 99m HMPAO labeled WBCs Technetium Tc 99m Human Serum Albumin Technetium Tc 99m Serum Albumin (Tc 99m HSA kit) Xenon XE 127 Gas *Response:* While a number of radiopharmaceuticals are already on the pass-through list, we are unable to add some of the ones listed above because we do not have AWPs for them. The AWPs are the basis for payment for these items and without the AWPs we cannot approve them for pass-through payments. As soon as the AWPs are made available to us, we will complete our review to determine their pass-through status. If eligible, they will be added to the pass-through list during the appropriate quarterly update cycle. *Comment:* One commenter stated that our transitional pass-through policy for devices precludes pass-through eligibility for capital equipment and therefore does not provide a mechanism under our new system for recognizing the incremental costs associated with capital equipment. The commenter recommended that we recognize capital-equipment costs through our new technology APCs. *Response:* Under our new outpatient prospective payment system, capital costs are not paid separately. Payment for these costs are included in the total APC payment amount for each procedure or medical visit and will be updated through our annual updating process. Therefore, the new technology APCs will not be used to make separate payments for capital related costs. *Comment:* A number of commenters claimed that we denied pass-through status for the contrast agents. *Response:* As clarified in our August 3, 2000 interim final rule with comment, contrast agents other than radiopharmaceuticals are considered supplies and are not eligible for pass-through payments. (See § 419.43(e)(4)(vii).) *Comment:* A medical association claimed that we denied pass-through status requests for high dose rate brachytherapy. Another industry group alleged that many brachytherapy related items that manufacturers applied for were excluded from the pass-through list. *Response:* Since publishing our initial list of potentially eligible pass-through items to our website on March 9, 2000, we have added 38 brachytherapy items to our pass-through list. High-dose rate brachytherapy will be eligible for pass-through payment effective for services furnished on or after January 1, 2001. j. Pass-Through Applications Process *Comment:* Some commenters urged that we process transitional pass-through applications in a more timely manner. A few other commenters believed that we should have chosen a date later than July 14, 2000 as the application deadline for the October 1, 2000 quarterly update for pass-through items. *Response:* We have committed considerable resources to process pass-through applications in a timely manner. Since publication of our preliminary list of 149 potentially eligible pass-through items on our website on March 9, 2000, we have approved nearly 1000 additional items for pass-through payments. We have instituted a coding strategy that allows us to assign a temporary HCPCS code immediately to an eligible pass-through item if a national HCPCS code has not been assigned. We have committed to making quarterly updates to the pass-through list, a commitment that is unprecedented in Medicare's history. We have reviewed all applications timely submitted for each update cycle. Unfortunately, however, we have had to defer items with significantly unclear applications or for which sufficient information was not included to determine that the item meets the statutory criteria. We have endeavored to work closely with the applicants to obtain this information and respond timely to their questions. Regarding objections to setting a July 14, 2000 deadline for receipt of pass-through applications for the October 1 update, this deadline was established in order to evaluate the applications and make the necessary systems modifications in time for the October release to our fiscal intermediaries and standard systems maintainers. *Comment:* One commenter believed that we should update our transitional pass-through list more frequently than quarterly. Some other commenters were concerned that the quarterly updating process could potentially create systems problems for both HCFA and hospitals that would delay payments. They believed that such a delay would, in turn, create cash flow difficulties for hospitals. They urged that we develop contingency plans to address cash flow problems resulting from the transitional pass-through process. *Response:* Because of the complexity of our new system, we cannot institute systems changes more frequently than quarterly for pass-through payments. While we believe that making quarterly updates to the pass-through list will present challenges both for HCFA and the hospital industry, we have not been advised that any hospital is experiencing cash flow problems attributable to the transitional pass-through process. *Comment:* One commenter urged us to issue guidelines that detail the planned methodologies, data sources, and associated timelines for updating the pass-through list. *Response:* Since March 10, 2000, we have published information on our website which provides detailed instructions and deadlines for submitting transitional pass-through applications. These instructions have been revised as needed in order to clarify and update information and may be found on the following HCFA website: http://www.hcfa.gov /medlearn/refopps.htm. *Comment:* One commenter claimed that our method and timing of assigning HCPCS codes to eligible transitional pass-through items would preclude Medicare beneficiaries from receiving appropriate treatment. The commenter also alleged that hospitals will not always be adequately reimbursed for their costs for such items and that they will have an incentive to switch to more invasive treatment options with higher costs. *Response:* We have expedited the process of assigning HCPCS codes to pass-through items. When an item is determined eligible for pass-through status, a temporary HCPCS code is assigned immediately in order that hospitals may begin billing the item as soon as it is effective for payment. In addition, section 1833(t)(6)(C)(i) of the Act requires that the hospital's additional payment for drugs and biologicals be determined as the difference between the amount determined under section 1842(o) of the Act (95 percent of AWP) and the portion of the hospital outpatient department fee schedule amount determined by the Secretary to be associated with those items. For devices, the additional payment is the difference between the hospitals' charges adjusted to costs and the portion of the applicable hospital outpatient department fee schedule amount associated with the device. We believe that this payment method will appropriately reimburse hospitals for eligible pass-through items and that hospitals will act in a prudent manner and not compromise their patients' safety and care. k. Payment for Pass-Through Items *Comment:* Several commenters questioned how payment would be made when a pass-through item is included on an outpatient claim. Another commenter stated that our April 7, 2000 final rule with comment period does not state the actual payment amount that will be made for each pass-through item, or provide a good reason for not updating drug and biological average wholesale prices quarterly, or pledge timely correction of payment amount errors. The latter commenter believed that we should make available the actual APC payment rates for pass-through items and institute quarterly pricing-updates for drug and biological APCs. *Response:* Transitional pass-through payments for devices are established by taking the hospital charges for each billed item (on an item-by-item basis), reducing them to cost by use of the hospital's cost-to-charge ratio, and subtracting an amount representing the device cost contained in the APC payments for procedures involving that device. Note that for services furnished prior to January 1, 2001, we have not subtracted an amount for the predicate device that is packaged in the relevant APC. However, we will implement this policy beginning with services furnished on or after January 1, 2001. These calculations are all done in the outpatient prospective payment system pricer. Because there are no predetermined APC payment rates for eligible pass-through devices, we cannot publish them in the same manner as we publish the APC payment rates for other services. For drugs and biologicals, pass-through payments are determined based on 95 percent of the AWP for the eligible drug or biological. We described in our April 7, 2000 final rule (65 FR 18481) the process we used to subtract the cost of the eligible drug or biological contained in the APC payments for procedures involving that drug, radiopharmaceutical or biological. The year 2000 AWPs for pass-through drugs and biologicals on which payments are currently based will be updated annually at the beginning of the next quarter following publication of the updated values. Due to the complexity of our new system, we cannot update AWPs quarterly as requested. *Comment:* A number of commenters stated that the codes for drugs in Addendum K of our April 2000 final rule are specific to the dosage amount dispensed and asked what happens if the dosage dispensed to a patient is not equal to the amount associated with the eligible codes. The commenters requested additional information about how providers should account for these situations. They asked if we would allow providers to bill for the product amount associated with the container opened to treat the patient and round up to the nearest whole billing unit. *Response:* The APC payment amount for drugs and biologicals is established at the lowest dosage level for the specific drug or biological. If the dosage required in treating the patient exceeds the lowest level specified in the HCPCS code descriptor for the drug or biological, providers may bill the number of units necessary to treat the patient and round them up to the nearest unit. To determine the payment for the drug or biological, multiply the number of billed units by the APC payment amount. *Comment:* One commenter stated that the APC payment amount for Eptifibatide, a drug on the pass-through list, does not equal 95 percent of the average wholesale price ($6.28 per 5-mg. service unit). The commenter claimed that the APC payment is 42 percent lower than 95 percent of the AWP. The commenter asked that we correct the payment immediately. *Response:* The correct APC payment amount for Eptifibatide injection, 5 mg. is $12.57, of which $1.68 is the minimum unadjusted coinsurance. *Comment:* One commenter stated that the APC payment amount for Quadramet, a pass-through drug, is incorrect. The commenter claimed the AWP for this drug is $2,975 rather than $2,875, which the commenter believed is the basis for our APC payment amount. The commenter stated that the pass-through payment should be $942.08 instead of $910.42. *Response:* The correct APC payment amount for Quadramet is $942.09. Of this amount, $134.87 is the minimum unadjusted coinsurance. *Comment:* A commenter stated that the APC payment amount for Thyrogen, a pass-through drug, should be $494.00 rather than $404.18 per vial. *Response:* The APC payment amount of $404.18 is for 0.9 mg. units of Thyrogen rather than 1.1 mg., which appears to be the standard vial dosage. However, because Thyrogen is not available in a vial dosage less than 1.1 mg., we are eliminating the APC payment for 0.9 mg. units (HCPCS code J3240) effective for outpatient prospective payment system services furnished on or after January 1, 2001. We have established a new code, C9108, for Thyrogen, 1.1 mg. with an APC payment amount of $494.00. This new code is effective for outpatient prospective payment system services furnished on or after January 1, 2001. *Comment:* A medical association acknowledged our short lead-time for implementing the transitional pass-through provision and urged that we hold a series of face-to-face meetings with physicians and suppliers to clarify and revise our pass-through policies. *Response:* Since publishing our April 7, 2000 final rule with comment period, we have met on numerous occasions with physicians and representatives of hospitals, pharmaceutical companies and device manufacturers. During these meetings, we have discussed our transitional pass-through policies and clarified information regarding the pass-through applications process. *Comment:* One commenter stated that the April 7, 2000 final rule with comment period requiring the submittal of applications for national HCPCS codes to bill eligible transitional pass-through was published after the application deadline had passed. The commenter alleged that some manufacturers obtained information about the pass-through provisions prior to publication of the final rule, submitted their applications timely, and thus dominated the hospital outpatient market. *Response:* On March 9, 2000, we posted information on our website similar to that contained in the April 7, 2000 final rule with comment period about applying for national HCPCS codes for pass-through items. We also discussed the coding deadline with representatives of the pharmaceutical and device manufacturers associations as well as with hospital industry representatives through conference calls, meetings, and e-mails. We note that the instructions and deadline for submitting applications for a national HCPCS code are well established and were published on HCFA's website (http://www.hcfa.gov /medicare/hcpcs.htm) more than a year prior to publication of our April 7, 2000 final rule with comment period. Subsequent to these publications, we adopted a new system for assigning codes exclusively for pass-through items to expedite their availability to the hospital industry and Medicare beneficiaries. Therefore, interested parties applying for pass-through status for items have not been required to obtain national HCPCS codes for these items unless they want to bill other payment systems in addition to the hospital outpatient prospective payment system. l. Focus Medical Review *Comment:* One commenter asked that we clarify why we intend to conduct focused medical review of pass-through eligible drugs, biologicals and medical devices. *Response:* Our goal is to identify inappropriate billing for these services and to ensure that payment is not made for noncovered services. 3. Budget Neutrality Applied to New Adjustments In the April 7, 2000 final rule with comment period, in accordance with section 1833(t)(2)(E) of the Act, as amended by section 201(c) of the BBRA 1999, we made the outlier and transitional pass-through payment adjustments under section 1833(t)(5) and section 1833(t)(6) of the Act, respectively, budget neutral. We did not receive any public comments on this provision. 4. Limitation on Judicial Review In the April 7, 2000 final rule with comment period (65 FR 18503-18504), in accordance with section 1833(t)(12) of the Act (as amended by section 201(d) of the BBRA 1999 and redesignated by section 202(a) of the BBRA 1999), we implemented the extension of the prohibition of administrative or judicial review to include the factors for determining outlier payments (that is, the fixed multiple, or a fixed dollar cutoff amount, the marginal cost of care, or applicable total payment percentage), and the factors used to determine additional payments for certain medical devices, drugs, and biologicals, the insignificant cost determination for these items, the duration of the additional payment or portion of the prospective payment system payment amount associated with particular devices, drugs, or biologicals, and any pro rata reduction. We did not receive any public comments on this provision. 5. Inclusion in the Hospital Outpatient Prospective Payment System of Certain Implantable Items In the April 7, 2000 final rule with comment period, we specified that section 1833(t)(1)(B) of the Act, as amended by section 201(e) of the BBRA 1999, provides that “covered OPD services” include implantable items described in section 1861(s)(3), (6), or
(8)of the Act. The conference report accompanying the BBRA 1999, H.R. Rept. No. 479, 106th Cong., 1st Sess. at 869-870, (1999), expresses the belief of the conferees that the current DMEPOS fee schedule is not appropriate for certain implantable medical items such as pacemakers, defibrillators, cardiac sensors, venous grafts, drug pumps, stents, neurostimulators, and orthopedic implants as well as items that come into contact with internal human tissue during invasive medical procedures, but are not permanently implanted. In the conference report agreement, the conferees state their intention that payment for these items be made through the hospital outpatient prospective payment system, regardless of how they might be classified on current HCFA fee schedules. In the April 7, 2000 final rule with comment period, we included the following in the list of items and services whose costs are included in hospital outpatient prospective payment rates: Prosthetic implants (other than dental) that replace all or part of an internal body organ (including colostomy bags and supplies directly related to colostomy care), and including replacement of these devices; implantable DME; and implantable items used in performing diagnostic x-rays, diagnostic laboratory tests, and other diagnostic tests. In accordance with the BBRA 1999 provision, we require that an implantable item be classified to the group that includes the service to which the item relates. We indicated that we would continue to review the impact of packaging implantables in future updates. For more detailed information on this provision, refer to the April 7, 2000 final rule with comment period (65 FR 18443-18444). *Comment:* Two commenters (hospitals) expressed concern that the APC for the Cyberonics-NeuroCybernetic Prosthesis
(NCP)System, an implantable device used to treat epilepsy patients with partial-onset seizures, will not adequately reimburse hospitals for the cost of the device and the implantation procedure cost. The hospitals recommended that HCFA create a separate APC group for the NCP System implantation. *Response:* The NCP System was approved for pass-through status effective for services furnished on or after August 1, 2000 (see Program Memorandum Transmittal No. A-00-42 issued on July 26, 2000). The two components of this system, the NeuroCybernetic Prosthesis Generator and the NeuroCybernetic Prosthesis Lead, will be paid based on the hospital's charges that are converted to cost using the hospital's assigned cost-to-charge ratio. These devices have been assigned to two separate pass-through APCs (1048 and 1306, respectively) and should be billed using HCPCS code C1048 for the generator and C1306 for each lead. *Comment:* Several commenters from physician practices and a device manufacturer raised concerns that the APC payment level for the Contigen Implant procedure is inadequate to cover the facility costs and the Contigen Implant supplies. According to the commenters, the APC reimbursement amount only covers the 2-3 Contigen Implant syringes used per procedure. The commenters recommended that we map the Contigen Implant procedure and the collagen skin test to higher paying completely new APCs, to more adequately reflect reasonable costs for syringes and skin tests used in the procedure, in addition to appropriate facility fees. Other commenters raised concerns that the separate APC reimbursement for the pre-Contigen Implant procedure testing is inadequate to reimburse for the reasonable cost of the supply. They recommended that we allow payment of Contigen Implant syringes according to the DMEPOS fee schedule. One commenter recommended that we create a special ancillary APC to cover Contigen Implant syringes and the collagen skin test. *Response:* While we understand the commenters' concerns, Contigen Implant syringes do not qualify for transitional pass-through status because they do not meet all of the device criteria set forth in § 419.43(e)(4). Specifically, they are not items that are surgically implanted or inserted in a patient. However, both collagen implant material and the collagen skin test are paid as APCs (that is, APCs 6012 through 6016 and 343, respectively). We will examine data after the first year of billing under the prospective payment system to determine if we are adequately capturing the cost of performing these procedures. As stated in our April 7, 2000 final rule with comment period, we will initiate the annual review process for the various components of our system, including the APC groupings, in calendar year 2001 for services furnished on or after January 1, 2002. We expect to publish our proposed rule for 2002 in the spring of 2001. *Comment:* A device manufacturer inquired as to what will happen when devices are taken off the transitional pass-through list after 2 to 3 years. The commenter stated that the additional expense of these implantable devices will require that HCFA reassign these CPT codes to an APC that is comparable clinically and in terms of resources used at the close of the transition period. If this does not occur, the commenter indicated that hospitals would be seriously underpaid for the use of these technologies and other technologies in similar circumstances. *Response:* As stated above, the BBRA 1999 allows for 2 to 3 years of transitional pass-through payments to be made for new devices, drugs, and biologicals. After the temporary payment period expires for any item, its cost will be packaged with the relative procedure code or medical visit and assigned to the APC group that is clinically related and comparable in resources used. Thus, the APC groupings, weights, and payments will be updated in a subsequent year to include costs associated with former pass-through items. *Comment:* A coalition of health care providers and insurers indicated that providers should be allowed to report all DME, orthotics, and prosthetic devices, both implantable and nonimplantable, on the UB-92 to the fiscal intermediary. The fiscal intermediary should be able to either pay for the item via the DMEPOS fee schedule or through the APC. This also would allow a tracking system for future ratesetting, and consolidate the billing into one claim. This would consolidate all charges on one bill per encounter, which simplifies processing and is consistent with other third party payer claims processing as well as Medicare inpatient claims processing. *Response:* Section 201(e) of the BBRA 1999 amended section 1833(t)(1)(B) of the Act to require that covered outpatient prospective payment system services include implantable medical items, described in section 1861(s)(3), (6), or
(8)of the Act. These items were formerly paid under the DMEPOS fee schedule. The statute is explicit in defining which DME items are payable under the hospital outpatient prospective payment system. Also, we cannot adopt the suggested billing changes for DME as the commenter suggested. All services that are billed through the fiscal intermediaries, whether they are paid under the hospital outpatient prospective payment system or DMEPOS, may be submitted on the UB-92 (or the equivalent electronic transaction). However, there are numerous, very exacting, specific criteria and rules that govern Medicare coverage and payment for nonimplantable DME and oxygen. The DME regional carriers are exclusively qualified to deal with these issues. Therefore, claims for nonimplantable DME and oxygen cannot be billed to the fiscal intermediaries. Instead, providers must continue to submit claims for nonimplantable DME and oxygen to the DME regional carriers using form HCFA-1500 (or the equivalent electronic transaction). It should be noted that if a health care provider submits an electronic claim for these services, the transaction must comply with the standards adopted by the Secretary in the August 17, 2000 final rule (65 FR 50312) Standards for Electronic Transactions. The compliance date of that rule is October 16, 2002. *Comment:* A device manufacturer expressed concern about how the new system will change the payment mechanism for cochlear implants. Under the DMEPOS fee schedule, payments were fixed and unrelated to hospital charges. Now, under the new system, hospitals must properly establish charges that, when multiplied by the ratio of cost to charges, provide an accurate reflection of cost. This manufacturer was concerned that they will have to collect data to determine the charges hospitals have set for these devices and the applicable ratio of cost to charges. They believe the charges may not have been set appropriately to be consistent with the ratio of cost to charges. If not, pass-through payments might be substantially less than the actual cost for these medical devices. This manufacturer indicated that it is working to obtain the required charge and cost report data from providers of cochlear implant procedures and will report back to us once it has these data. The manufacturer requested that we agree to work with them in setting any future update to the payment allowance recognizing the short timeframe available to collect the data. *Response:* We appreciate the commenter's offer to assist us in collecting cost and charge data on cochlear implants billed by hospitals. However, for purposes of making transitional pass-through payments for new medical devices such as cochlear implants, it is not necessary for manufacturers to obtain cost report data from hospitals to assist us in developing hospital-specific, cost-to-charge ratios to calculate these payments. We have already calculated these ratios and assigned them to providers. Each provider is responsible for accurately reporting its charges in order that we may calculate the appropriate payment for the pass-through device. 6. Payment Weights Based on Median or Mean Hospital Costs Section 1833(t)(2)(C) of the Act requires the Secretary to establish relative payment weights for covered hospital outpatient services. This section requires that the weights be developed using data on claims from 1996 and data from the most recent available hospital cost reports. As specified in the April 7, 2000 final rule with comment period (65 FR 18482), section 201(f) of the BBRA 1999 amended section 1833(t)(2)(C) of the Act to authorize the Secretary to base the relative payments weights on median or mean hospital costs. In implementing the BBRA 1999 provision, we decided to adopt as final our previously proposed policy to base the relative payment weights on median (as opposed to mean) costs. We had already used median costs to reconstruct our database for the outpatient prospective payment system group weights and conversion factors in a proposed rule and we believe that this method is still valid, especially considering the time constraints for implementation of the BBRA 1999 provision. We indicated that, among other things, reconstructing our database to evaluate the impact of using mean costs after the BBRA 1999 was enacted would have delayed implementation of the hospital outpatient prospective payment system rule. *Comment:* A group of hospitals urged us to adopt a mean-based APC relative weight system to implement section 201(f) of the BBRA 1999, which authorizes, but does not require, the Secretary to use mean (rather than median) costs in determining the APC payment weights. The commenters contend that use of the geometric mean is standard in the industry as the basis for calculating payment weights for prospective payment systems. They pointed out that the geometric mean is used because costs are not distributed “normally” (that is, there are no negative costs) and that for APCs that include low volume, high costs procedures, the geometric mean is preferable for adequately accounting for these costs. The commenters believed that our use of median costs also forced us to select an arbitrary value for relative weight 1.0, because finding the median of medians is meaningless. The commenters believed that, given the Congress' clarification in section 201(f) of the BBRA 1999, we should at least evaluate the impact of a mean-based system in our system review for 2001. *Response:* We plan to further evaluate the feasibility of using mean rather than median costs for calculating APC payment weights in future updates. In order to make a decision about whether we should change the basis we are using for determining payment weights, we have to analyze and rerun claims data and conduct extensive impact analyses to assess the impact such a change would have on different types of providers and different types of services. 7. Limitation on Variation of Costs of Services Classified Within a Group Section 1833(t)(2) of the Act was amended by section 201(g) of the BBRA 1999 to limit the variation in resource use among the procedures or services within an APC group. Specifically, section 1833(t)(2) of the Act provides that the items and services within a group cannot be considered comparable with respect to the use of resources if the highest cost item or service within a group is more than 2 times greater than the lowest cost item or service within the same group. The Secretary is to use either the mean or median cost of the item or service. Section 1833(t)(2) of the Act, as amended, also allows the Secretary to make exceptions to this limit on the variation of costs within each group in unusual cases such as low volume items and services, although we may not make such an exception in the case of a drug or biological that has been designated as an orphan drug under section 526 of the Federal Food, Drug, and Cosmetic Act. In the April 7, 2000 final rule with comment period, we elected to use the median cost because we have continued to set the relative payment weights for each APC based on median hospital costs. We modified the composition of the APC groups and then made additional changes to the APC in response to public comments on individual or serial APCs. In determining whether or not to accept changes recommended by commenters, we focused on five criteria that are fundamental to the definition of a group within the APC system. The decision to accept or decline a modification to an APC group was determined based on whether the change enhanced, detracted from, or had no effect on the integrity of an APC group within the context of the following five criteria: • Resource homogeneity; • Clinical homogeneity; • Provider concentration; • Frequency of services; and • Minimal opportunity for upcoding and code fragmentation. For a full explanation of these criteria, refer to the April 7, 2000 final rule with comment period (65 FR 18457). After we modified the composition of the APC groups based on the recommendations of commenters, we applied the median cost variation limit required by section 201(g) of the BBRA 1999 to the revised APC groups. As a result of our analysis of the array of median costs within the revised APC groups, we had to split some otherwise clinically homogeneous APC groups into smaller groups. We listed the APC groups that we had designated as exceptions to the “two times” requirement and our reasons for granting the exception. We based the exceptions on factors such as low procedure volume, suspect or incomplete cost data, concerns about inaccurate or incorrect coding, or compelling clinical arguments. We indicated that we would be examining the extent to which the APC reorganization due to the “two times” rule results in upcoding (refer to the April 7, 2000 final rule with comment period (65 FR 18458-18475)). *Comment:* We received requests to examine 51 APCs that commenters alleged violated the “two times” rule. *Response:* We reevaluated the APCs listed below, upon which we received comments, and found that most of them did not warrant revision. We received no new information about these APC groups that would alter our previous decision. These APCs are identified below under numbers 1 and 2. Our review also revealed that a few APC groups did warrant revision and we have reconfigured these APCs accordingly. We have listed these APCs under number 3. In addition, our review identified some APCs that are additional exceptions to the “two times” requirement. These APC groups and our reasons for the exception are listed below under number 4. In reviewing the APC groups for conformance to the “two times” requirement, we exempted from the analysis codes for unlisted services and procedures and those codes that represent less than 2 percent of the claims in the APC (our test for low volume). 1. Taking into account the exemptions mentioned above, the following APC groups that we reviewed based on comments have not been reconfigured: 0005 Level II Needle Biopsy/Aspiration Except Bone Marrow 0076 Endoscopy Lower Airway 0088 Thrombectomy 0090 Level II Implantation/Removal/Revision of Pacemaker, AICD or Vascular Device 0111 Blood Product Exchange 0112 Extracorporeal Photopheresis 0121 Level I Tube changes and Repositioning 0143 Lower GI Endoscopy 0146 Level I Sigmoidoscopy 0149 Level II Anal/Rectal Procedure 0150 Level III Anal/Rectal Procedure 0151 Endoscopic Retrograde Cholangio-Pancreatography
(ERCP)0162 Level III Cystourethroscopy and other Genitourinary Procedures 0260 Level I Plain Film Except Teeth 0262 Plain Film of Teeth 0265 Level I Diagnostic Ultrasound Except Vascular 0268 Guidance Under Ultrasound 0269 Echocardiogram Except Transesophageal 0278 Diagnostic Urography 0280 Level II Diagnostic Angiography and Venography Except Extremity 0282 Level I Computerized Axial Tomography 0283 Level II Computerized Axial Tomography 0284 Magnetic Resonance Imaging 0286 Myocardial Scans 0290 Standard Non-Imaging Nuclear Medicine 0291 Level I Diagnostic Nuclear Medicine Excluding Myocardial Scans 0292 Level II Diagnostic Nuclear Medicine Excluding Myocardial Scans 0294 Level I Therapeutic Nuclear Medicine 0297 Level II Therapeutic Radiologic Procedures 0301 Level II Radiation Therapy 0303 Treatment Device Construction 0304 Level I Therapeutic Radiation Treatment Preparation 0305 Level II Therapeutic Radiation Treatment Preparation 2. The following APC groups were listed in the April 7, 2000 final rule with comment period as exceptions to the “two times” rule and our review found no factual basis for modifying our decision: 0030 Breast Reconstruction/Mastectomy 0264 Level II Miscellaneous Radiology Procedures 0274 Myelography 0279 Level I Diagnostic Angiography and Venography Except Extremity 0311 Radiation Physics Services 0371 Allergy Injections 3. We have reconstructed the four APCs shown below as a result of adding the cost of certain devices used in performing procedures included in these APCs. We discuss this change in section III.B. of this preamble. 0080 Diagnostic Cardiac Catheterization 0081 Non-Coronary Angioplasty or Atherectomy 0082 Coronary Atherectomy 0083 Athrectomy 4. Following are additional exceptions to the “two times” rule and our reasons for the exceptions. We are excepting these APCs from the “two times limit” on an interim basis, until we can review data from the first year of billing under the hospital outpatient prospective payment system. 0142 Small Intestine Endoscopy: The codes in APC 0142 are clinically similar and should show a relative progression of cost with slight increases in complexity. This effect does not occur, presumably due to low volume (although exceeding our low volume threshold) or inconsistent coding. Splitting this APC into two, based on current data, would be unjustified. 0145 Therapeutic Anoscopy: The costs of the codes in this APC are aberrant, with several of them exceeding the costs of more extensive procedures such as sigmoidoscopy and colonoscopy. 0152 Percutaneous Biliary Endoscopic Procedures: The codes in this APC have so few occurrences that we cannot justify splitting the group. Several of the codes call for the use of devices such as stents that may be paid for separately. 0161 Level II Cystourethroscopy and other Genitourinary Procedures: The costs of the codes in this APC are aberrant, with more comprehensive codes costing less than the base codes. 0195 Level V Female Reproductive Procedures: This is a low volume APC, with aberrant cost data. In several instances, codes that are more comprehensive cost less than the related, simpler code. 0296 Level I Therapeutic Radiologic Procedures: We believe the codes at the lower end of the median cost in this APC would be underpaid if we were to move them to a lower-paying APC. 0300 Level I Radiation Therapy: We believe we would underpay codes at the lower end of median cost in this APC if we were to move them to a lower-paying APC. 0312 Radioelement Applications: We believe the costs in this very low volume APC are aberrant. However, the group is completely coherent clinically. The radioactive elements related to these codes would receive separate payment. 0313 Brachytherapy: We believe the costs in this very low volume APC are aberrant. The group is coherent clinically. The radioactive elements related to these codes would receive separate payment. 0314 Hyperthermic Therapies: This APC has an extremely low volume, with aberrant costs. 8. Annual Review of the Components of the Hospital Outpatient Prospective Payment System In the April 7, 2000 final rule with comment period (65 FR 18501-18502), we indicated that, in accordance with section 1833(t)(9) (as redesignated and revised by sections 201(h) and 202(a) of the BBRA 1999), we would review and update annually, for implementation effective January 1 of each year, the APC groups, the relative payment weights, and the wage and other adjustments that are components of the hospital outpatient prospective payment system. In accordance with section 201(h)(2) of the BBRA 1999, an annual review process will begin in calendar year 2001 for the hospital outpatient prospective payments that would take effect for services furnished on or after January 1, 2002. This review process will involve consultation with an expert advisory panel. We will provide notice of the formation of the expert advisory panel in the **Federal Register** . The expert outside advisory panel will review and make recommendations to us on the clinical integrity of the groups and weights and may use data other than those collected or developed by us for their review and advisory functions. We note that in section III of this preamble, we are updating the wage index values and the conversion factor under the hospital outpatient prospective payment system effective for calendar year 2001. We also are making appropriate changes to the APC groups to reflect additions and deletions of CPT codes and changes to a limited number of APCs to incorporate the cost of certain devices used in performing those procedures that were excluded from our initial ratesetting methodology. *Comment:* One commenter stated that the wage index for the Hattiesburg, Mississippi Metropolitan Statistical Area (MSA), .7306, was printed incorrectly in our April 7, 2000 final rule with comment period. The commenter stated that use of this value would result in an underpayment for that area. The commenter further stated that, “the appropriate wage index for the Hattiesburg, Mississippi MSA for the fiscal year 2000 is .7634.” The commenter was concerned that we had previously acknowledged this error and promised to correct it via a program memorandum to fiscal intermediaries dated April 2000 (Transmittal Number A-00-17), but had failed to do so in our April 7, 2000 final rule with comment period. *Response:* We apologize for the confusion. The fiscal year 2000 hospital inpatient prospective payment system wage index value for the Hattiesburg, Mississippi
(MSA)was changed from .7306 to .7634 in accordance with section 153 of the BBRA 1999 that required us to include wage data from Wesley Medical Center in calculating the wage index for this MSA. On August 1, 2000, we published in the **Federal Register** an interim final rule with comment period (65 FR 47026) that included Hattiesburg's new hospital inpatient prospective payment system wage index. For services paid under the hospital outpatient prospective payment system, the new wage index value is effective for services furnished on or after August 1, 2000. 9. Copayment Amounts Not Affected by Pass-Throughs Section 1833(t) of the Act, as established by the BBA of 1997, includes a mechanism designed to achieve a beneficiary coinsurance level equal to 20 percent of the prospectively determined payment rate established for the service. In the April 7, 2000 final rule with comment period, we specified how a copayment amount is calculated annually for each APC group under the hospital outpatient prospective payment system. We also explained that sections 201(a) and
(b)of the BBRA 1999 amended section 1833(t) of the Act to provide for additional payments to hospitals for outlier cases and for certain medical devices, drugs, and biologicals and that these additional payments to hospitals will not affect copayment amounts. Redesignated section 1833(t)(8)(D) of the Act, as amended by section 201(i) of the BBRA 1999, provides that the copayment amount is to be computed as if outlier adjustments, adjustments for certain medical devices, drugs, and biologicals, as well as any other adjustments we may establish under section 1833(t)(2)(E) of the Act, had not occurred. In addition, we specified that section 202 of the BBRA 1999 added a new section 1833(t)(7) to the Act to provide transitional corridor payments to certain hospitals through calendar year 2003 and indefinitely for certain cancer centers. Section 1833(t)(7)(H) of the Act provides that the transitional corridor payment provisions will have no effect on determining copayment amounts. We specified that copayment from beneficiaries will not be collected for the additional payments made to hospitals (outlier and transitional pass-throughs) by Medicare. Beneficiary copayment amounts will be calculated as if the outlier and transitional pass-throughs had not occurred (65 FR 18487-18488). When a drug or device pass-through payment is reduced by the otherwise applicable APC payment amount that is associated with the drug or device, it is only the portion of the payment that represents an additional pass-through payment that is not subject to copayment. The portion that does not represent an additional pass-through payment will be subject to copayment. We did not receive any public comments on this provision. 10. Extension of Cost Reductions In the April 7, 2000 final rule with comment period (65 FR 18439), we announced that, in accordance with section 1861(v)(1)(S)(ii) of the Act (as amended by section 201(k) of the BBRA 1999), the 5.8 and 10 percent reductions for hospital operating and capital costs, respectively, would extend until the first date that the hospital outpatient prospective payment system is implemented (which was August 1, 2000). We did not receive any public comments on this provision. 11. Clarification of Congressional Intent Regarding Base Amounts Used in Determining the Hospital Outpatient Prospective Payment System Section 201(l) of the BBRA 1999 provided that, “With respect to determining the amount of copayments described in paragraph (3)(A)(ii) of section 1833(t) of the Act, as added by section 4523(a) of BBA, Congress finds that such amount should be determined without regard to such section, in a budget neutral manner with respect to aggregate payments to hospitals, and that the Secretary of Health and Human Services has the authority to determine such amount without regard to such section.” In accordance with this provision, in the April 7, 2000 final rule with comment period (65 FR 18482-18493), we explained how we determined APC group weights, calculated an outpatient prospective payment system conversion factor, and determined national prospective payment rates, standardized for area wage variations, for the APC groups. We then explained how we calculated the aggregate hospital outpatient prospective payment to hospitals in a budget neutral manner and how we calculated beneficiary coinsurance amounts for each APC group. We did not receive any public comments on this provision. 12. Transitional Corridors for Application of Outpatient Prospective Payment System Section 1833(t)(7) of the Act, as added by section 202(a)(3) of the BBRA 1999, provides for payment adjustments during a transition period to limit the decline in payments under the outpatient prospective payment system for hospitals. These additional payments are to be implemented without regard to budget neutrality and are in effect through 2003. In the April 7, 2000 final rule with comment period (65 FR 18499-18500), we specified that, from the date the prospective payment system is implemented through 2003, a provider, including a CMHC, will receive an adjustment if its prospective payment system payments for outpatient services furnished during the year is less than a set percentage of its pre-BBA amount for that year. The pre-BBA amount is the product of the reasonable cost the hospital incurs for prospective payment system services furnished during the year and the payment-to-cost ratio for covered prospective payment system services furnished during the cost reporting period ending in calendar year 1996. Additionally, we provided that small rural hospitals with 100 or fewer beds and cancer hospitals will be held harmless under this provision. Small rural hospitals will be held harmless for services furnished before January 1, 2004. The hold-harmless provision applies permanently to cancer centers. We announced that we will make interim payments to the affected hospitals subject to retrospective adjustments and that these provisions do not affect beneficiary coinsurance. Finally, we specified that this provision is not subject to budget neutrality. a. Interim Payment Versus Final Settlement *Comment:* One commenter recommended that we make retroactive payments to hospitals in those “situations where underpayments have been made between the prospective payment system payments as compared to the pre-prospective payment system amounts.” Another commenter asked that we set forth the process that would be used to determine retroactive payment adjustments if the hospital's interim payments are higher or lower than its actual experience. The commenter further asks that we state whether the interim payments will be compared to outpatient payments shown on settled or audited cost reports. *Response:* Final transitional corridor payments are determined based on a provider's settled cost report. At the time the cost report is settled, the reasonable costs incurred by the provider to furnish outpatient prospective payment system services during the calendar year are known and that amount is then multiplied by the provider's 1996 payment-to-cost ratio to calculate the pre-BBA amount. The pre-BBA amount for a calendar year is compared to the actual prospective payment system payments the provider received to determine whether the provider may be entitled to a transitional corridor payment. Although the final transitional corridor payment is based on a settled cost report, beginning in October 2000, we have been making monthly interim payments to providers based on estimates of what their transitional corridor payments should be based on the monthly bills the provider submits. The monthly payments are designed to maintain some additional cash flow to providers that may otherwise realize significant losses on services that are being paid under the prospective payment system. b. Payment-to-Cost Ratios *Comment:* One commenter argued that our formula for calculating the base payment-to-cost ratio for the transitional corridor payments does not comport with the statutory requirements. The commenter stated that we define the denominator of the base payment-to-cost ratio to be “[the] reasonable cost of these services for the period, without applying the cost reductions under section 1861(v)(1)(S) of the Act.” The commenter contends that the phrase “without applying the cost reductions under section 1861(v)(1)(S) of the Act” is not included in section 1833(t)(7)(F)(ii)(II) of the Act, as amended by section 212 of the BBRA 1999. The commenter claimed that by defining the denominator in this manner, the payment-to-cost ratio is understated and transitional corridors payments to hospitals would be reduced. The commenter stated that such a reduction is contrary to Congressional intent and urged us to modify our base payment-to-cost denominator set forth in § 419.70(f)(2)(ii) to exclude the phrase “without applying the cost reduction under section 1861(v)(1)(S) of the Act.” *Response:* The phrase “without applying the cost reductions under section 1861(v)(1)(S) of the Act” was intended to make clear that a hospital's 1996 “reasonable costs” do not include the effects of the reductions in section 1861(v)(1)(S) of the Act. We did not mean to suggest that we were taking the hospital's 1996 “reasonable costs” and then adding back the reductions for purposes of determining the denominator of the base payment-to-cost ratio. We view the hospital's 1996 reasonable costs as the unreduced amount; thus, the denominator of the hospital's base payment-to-cost ratio (1996 reasonable costs) does not reflect the reductions. We believe that our policy is consistent with the purpose of the transitional corridor provision. Under this policy, if a hospital incurs the same amount of costs during the transitional corridor as in 1996, then its pre-BBA amount (the amount that estimates what the hospital would have received in the current year if payments were calculated under the pre-prospective payment system) would be the same as the payments the hospital received in 1996. Under the methodology suggested by the commenter, if a hospital incurs the same amount of costs during the transitional corridor as in 1996, then its pre-BBA amount would be *higher* than the payments the hospital received in 1996. The language in § 419.70(f)(2)(ii) as set forth in the April 7, 2000 final rule with comment period was intended to clarify, not revise, the definition of 1996 reasonable costs, but we recognize that the phrase at issue may have inadvertently caused confusion to the extent it is redundant; accordingly, we are revising that section to remove the phrase. *Comment:* One commenter asked us to clarify the term “payment-to-cost ratio” and the data that will be used to compute the ratio. Several commenters asked why we did not give the 1996 outpatient prospective payment system-specific amounts required to compute the payment-to-cost ratio and the methodology for calculating it. *Response:* The statutory definition of base “payment-to-cost ratio” is fairly straightforward. Under section 1833(t)(7)(F) of the Act, the base payment-to-cost ratio for a given hospital is the ratio of
(1)the hospital's Medicare Part B reimbursement for covered OPD services for the cost reporting period ending during 1996, to
(2)the hospital's reasonable costs for that period. We are in the process of developing program instructions for fiscal intermediaries (for notification to providers) to provide detailed information on how payment-to-cost ratios are calculated. These instructions will be made available as soon as possible. *Comment:* One hospital association recommended that we revise our regulations to explicitly state that we will adjust the provider's 1996 payment-to-cost ratio “whenever subsequent developments occur that affect the data used in the calculation.” The commenter cited final audit adjustments and appeal determinations as examples of adjustments that would warrant changing the 1996 cost data used to calculate the provider's payment-to-cost ratio. The commenter stated that this policy is consistent with similar adjustments made under the prospective payment systems for both inpatient operating and capital-related costs. *Response:* We agree with the commenter. In the event final audit adjustments or appeals result in a change in outpatient costs or payments for the provider's 1996 cost report, the provider's payment-to-cost ratio would be recalculated. *Comment:* One commenter asked for clarification on the treatment of direct graduate medical education costs and education costs for nursing and allied health programs in calculating the payment-to-cost ratio. The commenter assumed that such costs are excluded from the pre-BBA amount because they will continue to be paid on a cost pass-through basis. *Response:* The commenter is correct that direct graduate medical education costs and certain costs of nursing and allied health programs are paid on a cost pass-through basis and will not be included in calculating a provider's pre-BBA amount. *Comment:* One commenter asked that we explain our reasons for basing the transitional corridor interim payments on a 0.8 payment-to-cost ratio. The commenter suggested that a provider be allowed to modify its interim transitional corridor payment if it can show that its payment-to-cost ratio is higher or lower than the 0.8 level. Several commenters questioned why we chose to use a standard 0.8 payment-to-cost ratio for all providers in calculating the interim payment if provider-specific payment-to-cost ratios were available. They stated that 9 of the 10 cancer centers have payment-to-cost ratios that exceed 0.8. *Response:* The standard payment-to-cost ratio of 80 percent is an average value that we calculated for payment-to-cost ratios across all hospitals. We decided to use 80 percent for all providers to permit us to make interim payments as soon as possible following the implementation of the outpatient prospective payment system. If we had attempted to calculate individual payment-to-cost ratios for all providers, it would have delayed, perhaps for several months, the introduction of interim payments. Final transitional corridor payments will be calculated using each provider's payment-to-cost ratio for the relevant year at the time of settlement of the cost report. In the future, as we gain more experience with interim payments, we will consider permitting modification of payment-to-cost ratios to reflect particular circumstances. c. Cost-to-Charge Ratios *Comment:* One commenter stated that the April 7, 2000 final rule with comment period did not explain how the transitional corridor payments would be implemented for the 10 cancer hospitals. The commenter noted that while Program Memorandum Transmittal No. A-00-23 issued by us on April 7, 2000, does describe how these payments are to be calculated it does not clarify how we derived the hospital-specific cost-to-charge ratios used to compute the transitional corridor payments. Several commenters representing the 10 cancer centers stated that the cost-to-charge ratios for their centers that will be used in calculating their transitional corridor, outlier, and transitional pass-through payments are significantly lower than their estimates. They requested that we explain how we determined their ratios and comment on the appropriateness of our methodology. They also asked that we respond to a number of specific questions to allow hospitals to determine whether the cost-to-charge ratios accurately reflect the hospital's cost and provide a fair base for calculating their transitional corridor payments. *Response:* On September 8, 2000, we issued a Program Memorandum Transmittal No. A-00-63, which provides a detailed explanation of how hospital cost-to-charge ratios were calculated. This program memorandum is available on HCFA's internet website at www.hcfa.gov/Medicare. d. Interim Payments Limited to 85 Percent of the Estimated Transitional Corridor Payment *Comment:* One commenter asked why we will only pay 85 percent of the estimated transitional corridor payment as an interim payment. Another commenter recommended that we reconsider our policy to pay providers only 85 percent of their transitional corridor payments on the interim basis. The commenter stated that our policy to withhold 15 percent of each provider's payment until the fiscal intermediary finalizes the provider's cost report is contrary to Congressional intent to preserve hospitals' cash flow and ensure them of an ability to provide outpatient services to beneficiaries, especially those in rural areas. Another commenter stated that retaining 15 percent of each provider's estimated transitional corridor payments until the provider's cost report is settled is contrary to Congressional intent and defers relief provided by statute for several years. *Response:* We limited the interim payment to less than 100 percent of the estimated payment in order to minimize the risk of overpayment. If interim payments exceed the final settled amounts, we would need to initiate recoupment procedures that place additional burden both on the agency and on providers. Eighty-five percent was chosen as a reasonable percentage that prudently balances the cash flow needs of some providers with concerns regarding possible difficulties in the recovery of overpayments. We have used comparable figures in other situations in which we make interim or advance payments. One example where we specified 85 percent for advance payments is in the contingency plan that we published to address the possibility that either our contractors or individual providers would be unable to process claims at the initiation of the outpatient prospective payment system. In the future, as cost reports are settled and we are able to determine how well interim transitional corridor payments relate to final transitional corridor payments, we will reevaluate this aspect of our interim payment policy. e. Providers Having More Than One 1996 Cost Report *Comment:* Several commenters stated that we did not discuss in our final rule how we would calculate the 1996 payment-to-cost ratio in cases where a provider has more than one cost report that is less than 12 full months during the fiscal year ending in 1996. The commenters asked which would be the appropriate cost report to use in calculating the transitional corridor payments. One commenter explained that this situation may occur if ownership changed during the provider's fiscal year ending in 1996. *Response:* The 1996 cost report that will be used to calculate a payment-to-cost ratio is the cost report period that ends in calendar year 1996. If a provider has two cost reports that end in 1996, we will make a decision about which cost report to use on a case-by-case basis, depending on which appeared to be the most representative of the provider's experience in 1996. For example, if one cost report covers a longer period, we would likely use that one. f. Providers Having No 1996 Cost Report *Comment:* One commenter expressed concern about insufficient guidance from us about how transitional corridor payments would be determined for providers that did not file cost reports during 1996. The commenter believed that because the statute is silent on this issue, we have the discretion to develop such policy. The commenter strongly opposed any decisions by us to preclude providers without 1996 cost reports from being eligible to receive transitional corridor payments. Another commenter requested that we treat new hospitals that did not file a 1996 cost report the same as rural hospitals. The commenter contended that the pre-BBA payment level for these hospitals should be based on the hospital's first full cost reporting period, and would be guaranteed at that level through December 31, 2003. Another commenter suggested as an option that we assign a regional average payment-to-cost ratio for existing providers to providers without a 1996 cost report. *Response:* Under the statute, the amount of transitional payments to providers depends on the provider's reimbursement for the 1996 cost reporting period. We intend to monitor the adequacy of payments to providers not having a 1996 cost report, but we believe that a statutory change is required in order to provide transitional payments to providers that did not have a 1996 cost report. g. Prospective Payment System Delay and Transitional Corridor Payments *Comment:* One commenter expressed concern about the potential effect of delaying implementation of the hospital outpatient prospective payment system on the duration of the transitional corridor payments as provided by law. The commenter stated that our decision to delay implementation of the prospective payment system for 1 month, from July 1, 2000 to August 1, 2000, should not result in a 1-month loss of transitional corridor payments for providers. The commenter believed that the 3 1/2 years of corridor payments required by law for non-cancer hospitals paid under the outpatient prospective payment system should not be reduced due to delayed implementation of the prospective payment system. The commenter urged us to seek a legislative change if we determine the 3 1/2 year period for transitional corridor payments must coincide with the first 3 1/2 years of actual prospective payment system implementation. *Response:* For hospitals that do not qualify for the permanent hold-harmless provision applicable to cancer hospitals, the statute provides for transitional corridor payments through the end of calendar year 2003. We will monitor and evaluate prospective payment system payments and will consider whether it would be appropriate to recommend that Congress legislate an extension of transitional corridor payments. h. Rural Hold-Harmless Provision *Comment:* One commenter suggested that we reevaluate the definition of rural outpatient hospitals eligible for the hold-harmless provision and consider including rural hospitals that have 100 to 200 beds, “but whose outpatient volumes are not sufficient to maintain the facilities' finances.” *Response:* The bed size for hospitals to qualify for the rural hospital hold-harmless provision is limited by statute, under section 1833(t)(7)(D)(i) of the Act, to hospitals that have no more than 100 beds. *Comment:* One commenter stated that on page 18501 of the April 7, 2000 final rule with comment period, we state that bed size under the rural hospital hold-harmless provision will be determined in the same manner as it is for the hospital inpatient prospective payment system indirect medical education adjustment. The commenter contended that we have not provided these instructions to fiscal intermediaries. The commenter questioned whether the fiscal intermediaries are using the number of beds reported on the hospital cost reports to determine the bed size. Still another commenter stated that we failed to specify how beds are to be counted under the hospital outpatient prospective payment system. The commenter further stated that our impact analysis published in the April 7, 2000 final rule with comment period suggests that available bed counts shown on the HCFA-2552 cost report S-3 Worksheet are used to determine if a hospital has 100 or fewer beds to qualify for the rural hold-harmless transitional corridor payment provision. The commenter urged us to clarify this issue. *Response:* In Program Memorandum Transmittal No. A-00-23, later revised in June 2000 as Program Memorandum Transmittal No. A-00-36, we provided instructions to fiscal intermediaries concerning how to calculate interim transitional corridor payments. As indicated in the April 7, 2000 final rule with comment period, the bed size used for transitional corridor payments will be the same bed size defined in and used to calculate indirect medical education costs and disproportionate share adjustments under the hospital inpatient prospective payment system. Fiscal intermediaries are instructed to obtain certain provider-specific information needed to make the calculation from the outpatient provider-specific file that they maintain. Certain items on the outpatient provider-specific file, including bed size, are taken directly from the provider file used in processing inpatient claims. *Comment:* One commenter urged that we revise policy for determining bed size for purposes of defining rural providers eligible for the hold-harmless provision. The commenter advocated that we adjust a provider's count of acute inpatient days to account for observation patients occupying acute inpatient beds. *Response:* The commenter did not provide a rationale for their recommendation. We believe that it is appropriate to adopt a policy for purposes of the outpatient prospective payment system that is consistent with the policy for purposes of the inpatient prospective payment system; therefore, we are not making a change at this time. *Comment:* A commenter specifically asked that, for purposes of determining bed size for rural providers, we clarify what year is used to determine bed size. The commenter also asked what our policy is regarding providers that changed their inpatient capacity prior to July 1, 2000, and those that may change this capacity during the 3 1/2 year transition period. The commenter suggested that we permit hospitals to downsize capacity without affecting their eligibility for hold-harmless status. *Response:* Under § 412.105(b), to determine bed size for the rural hold-harmless provision, we calculated bed size on the basis of the provider's cost reporting period. A rural hospital's bed size and, therefore, its eligibility for hold-harmless treatment may change from one cost reporting period to the next. *Comment:* Several commenters asked us to clarify whether a hospital's reclassification for either the wage index area or standardized amount affects its eligibility for the rural hold-harmless payment. The commenter believed that, because the BBRA 1999 statutory provision relevant to the rural hold-harmless provision refers to providers “located in a rural area” rather than the provider's payment status, a provider's geographic reclassification for wages or standardized amount has no bearing on its rural hold-harmless status. A few commenters argued that a geographic reclassification under inpatient prospective payment system for the wage index or the standardized amount is not relevant for purposes of the hold-harmless rural payment provision and that these reclassified hospitals should be included in the rural hold-harmless payment. *Response:* If a hospital is located in a rural area, it will not lose its eligibility for hold-harmless payments if it obtains a geographic reclassification under the inpatient prospective payment system for purposes of determining its wage index or standardized amount. *Comment:* A number of commenters expressed concern about the various aspects of the hold-harmless provision, referring to sections 1886(d)(8)(E) and 1833(t)(13) under section 401 of the BBRA 1999, and asked about a hospital's eligibility for the rural hold-harmless provision. *Response:* Under section 1886(d)(8)(E) of the Act, as added by section 401 of the BBRA 1999, if a hospital submits an application and meets certain criteria, the Secretary treats the hospital as being located in a rural area for purposes of section 1886(d) of the Act. Under section 1833(t)(13) of the Act, as added by section 401(b) of the BBRA 1999, if a hospital is treated as being located in a rural area under section 1886(d)(8)(E) of the Act, then the Secretary shall treat the hospital as being located in a rural area for purposes of the outpatient prospective payment system. Therefore, if a hospital is treated as being located in a rural area under section 1886(d)(8)(E) of the Act, then the hospital is treated as a rural hospital for purposes of the hold-harmless provision. *Comment:* One commenter stated that the 2-month waiting period for interim transitional payments may adversely affect a large number of small rural hospitals. The commenter also believed these hospitals will require a higher interim payment than planned. The commenter asked that we use a hospital-specific impact analyses to create a process for interim payments for these small rural hospitals that would begin concurrently with the start of the prospective payment system. *Response:* In order to calculate interim transitional corridor payments for any hospital, we needed to have some amount of claims that had been processed under the prospective payment system. For this reason, we were not able to begin transitional corridor payments concurrently with the implementation of the prospective payment system. Because of our concerns discussed earlier about having to initiate recoupment procedures in cases of overpayments, we are not increasing interim payments at this time. However, as cost reports are settled and we are able to determine how well interim payments predict final transitional corridor payments, we will be able to reevaluate this policy. i. Covered Charges *Comment:* Several commenters asked that we clarify the definition of “covered charges” used to compute the rural hold-harmless transitional corridor payment. One commenter stated that total procedures and thus the hold-harmless payment will be understated should we eliminate from these calculations the charges for incidental procedures or procedures that the Outpatient Code Editor consolidates into the main procedures. *Response:* In the preamble and the regulation text of the April 7, 2000 final rule with comment period, we refer to “covered hospital outpatient services” to describe the services that are paid under the prospective payment system and, therefore, subject to the transitional corridor provision. To determine a provider's costs for purposes of calculating the pre-BBA amount for both interim payments and for final cost report settlement, we will take into account all costs encompassed under the prospective payment system, including the cost of incidental services that are packaged into the APC rate. These services are identified as those having HCPCS codes with a status indicator of “N” (as listed in Addendum B) and incidental services that may not be billed with HCPCS codes, but which are billed under revenue codes that indicate a packaged service such as observation services, recovery room, supplies and many drugs. *Comment:* One commenter asked us to clarify how charges for packaged services, for example observation services, should be billed when they are the only service provided. The commenter stated that inclusion of charges for these packaged services in the total bill charges are necessary to calculate the proper transitional corridor payment. *Response:* Packaged services will not be the only items that appear on a bill. Packaged services will appear on a bill with the service to which they are incidental. For example, observation services are properly billed with the clinic visit, emergency room visit, surgery, etc., that results in the need for the incidental observation service. j. Cancer Hospitals and Transitional Corridor Payments *Comment:* Several commenters believed that the process described in Program Memorandum Transmittal No. A-00-23 for calculating the hold-harmless transitional corridor payments should be revised because it does not reflect Congressional intent and will not provide the relief to the 10 cancer centers that the Congress intended. These commenters contended that the method described in the program memorandum for calculating the transitional corridor payments will result in a 22 percent loss in outpatient patient revenues for the cancer centers compared to those received in 1998. The commenters further claimed that their revenue losses under the new outpatient prospective payment system may increase an additional 2 percent, or 24 percent in total, because we will not pay claims for any medical visits that are billed in conjunction with related significant procedures. In addition, these commenters urged us to: • Establish an appeal process for providers with cash flow problems that would permit fiscal intermediaries to adjust a provider's cost-to-charge ratio “to rectify ongoing OPPS losses prior to reconciliation.” • Reduce interim payments to the 10 cancer centers by only 5 percent rather than 15 percent. (The commenters contended that this approach would be consistent with the method currently used to determine their inpatient interim payments under the TEFRA cost limits system.) • Pay the 10 cancer centers the balance of the hold-harmless payments due at the time the cost report is subjected to desk review rather than at the time it is settled. (The commenters stated that settlement of the centers' cost reports is completed within 2 to 4 years after a completed cost report is filed, whereas the cost report desk review is generally completed 90 days after it is filed.) *Response:* Medical visits may be billed with significant procedures as long as the medical visit is a separate and distinct service from the significant procedure, even though the significant procedure is related to the medical visit. For example, as a result of an examination performed as part of a clinic or emergency room visit, a patient is determined to need a CT scan or MRI, or as a result of a dermatology examination performed as a clinic visit, a patient also has a surgical procedure to remove a mole. In these types of situations, payment will be made for both a medical visit and a significant procedure. Program Memorandum Transmittal No. A-00-63 provides for adjustment of a provider's cost-to-charge ratio in certain specific situations. In the future, in order to reflect changes in hospital costs and charges, we will allow fiscal intermediaries to make additional updates of a provider's cost-to-charge ratio to ensure that interim payments accurately reflect our best estimates of final transitional corridor payments. Although we limited the interim payment to 85 percent of the estimated payment in order to minimize the risk of overpayment, in the future, as cost reports are settled and we are able to determine how well interim payments predict final transitional corridor payments, we will be able to reevaluate this aspect of our interim payment policy and we will consider permitting modification of payment-to-cost ratios to reflect particular circumstances. The statute indicates that interim payments are made subject to retrospective adjustments based on settled cost reports. However, it is current practice that, depending on the provider's specific situation, a fiscal intermediary may make additional payments as part of a tentative settlement action prior to final settlement of the cost report. k. Teaching Hospitals and Transitional Corridor Payments *Comment:* One commenter urged that we retain the transitional corridor payments permanently for major teaching hospitals. *Response:* Section 1833(t)(7) of the Act provides permanent transitional corridor payments only for cancer hospitals described in section 1886(d)(1)(B)(v) of the Act. As indicated earlier, we will monitor and evaluate the prospective payment system payments and will consider whether it would be appropriate to recommend that Congress extend transitional corridor payments. *Comment:* One commenter stated that while the transitional corridor payments will mitigate some of the losses to teaching hospitals under the prospective payment system compared to the former cost-based payment system, these payments are temporary. The commenter believed that we underestimated the losses that some teaching hospitals will experience. Another commenter urged us to monitor closely the impact of the prospective payment system on major teaching hospitals during the 3 1/2 year transitional corridor payments. The commenter believed that these hospitals will require a payment adjustment after the transitional corridor payment period expires to mitigate their potential financial losses under the prospective payment system. *Response:* As we stated in the preamble of the April 7, 2000 final rule with comment period, we will perform further comprehensive analyses of cost and payment differences between different classes of hospitals as soon as there is a sufficient amount of claims data submitted under the prospective payment system. We will use data from the initial years of the prospective payment system to conduct regression and simulation analyses. In addition, we will carefully track and analyze the additional payments made to hospitals under the transitional corridor provision. These analyses will be used to consider and possibly propose adjustments in the system, particularly beginning in 2004 when the transitional corridor provisions expire. 13. Limitation on Coinsurance for a Procedure In the April 7, 2000 final rule with comment period (65 FR 18488), we specified that, in accordance with section 1833(t)(8) of the Act (as amended by section 204(a) of the BBRA 1999), the coinsurance amount for a procedure performed in a year cannot exceed the hospital inpatient deductible for that year. We specified that we would apply the limitation to the wage-adjusted coinsurance amount (not the unadjusted coinsurance amount) after any Part B deductible amounts are taken into account. Therefore, although the unadjusted coinsurance amount for any APC may be higher or lower than the inpatient hospital deductible, the actual coinsurance amount for an APC, determined after any deductible amounts and adjustments for variations in geographic areas are taken into account, will be limited to the Medicare inpatient hospital deductible. Any reduction in coinsurance that occurs in applying the limitation will be paid to hospitals as additional program payments. *Comment:* One commenter disagreed with our interpretation of the BBRA 1999 provision that amended section 1833(t)(8) of the Act to limit the coinsurance amount for a procedure to the amount of the inpatient hospital deductible. The commenter believed that our interpretation that applies the limitation to coinsurance on an APC by the APC basis is too narrow. The commenter concluded that, at a minimum, the limitation should be more broadly interpreted to apply to the total coinsurance incurred by a beneficiary in connection with an outpatient visit, that is, from the time the beneficiary walks into an outpatient department until he or she is released. However, to implement the provision as envisioned by the Congress, the commenter suggested that we also consider developing a service period unit for outpatient procedures that is similar to the “spell of illness” concept used to define the set of services to which a single inpatient hospital deductible applies. Therefore, when a patient comes to an outpatient department for treatment of a particular condition, his or her coinsurance liability for all the services required for that condition should not exceed the inpatient hospital deductible. The commenter recommended that we apply the limitation regardless of how many or which APCs are billed or the number of visits required for such treatment. *Response:* APCs are based on CPT codes. We believe that the most plausible meaning for “procedure” in this context is a CPT code or, by extension, an APC. Thus we interpret the limitation of coinsurance for a procedure in section 1833(t)(8)(C) of the Act as added by section 204 of the BBRA 1999 to apply in general to APCs. We do not believe that it was the intent of the Congress to apply the coinsurance limitation to the beneficiary's aggregate coinsurance amounts for all outpatient services received during the entire service period for a specific condition or even to the services a beneficiary receives in one day. During the Congressional committee deliberations on this provision before it was enacted, we held technical discussions with committee staff. At their request, we identified the specific 10 APCs in the September 1998 proposed rule that would be likely to have a coinsurance that exceeded the inpatient hospital deductible. The Congressional Budget Office also used that information to project the cost of this statutory provision. Therefore, we believe that our interpretation in the April 7, 2000 final rule with comment period of how the coinsurance limitation is to be applied is consistent with the intent of Congress. *Comment:* Several commenters pointed out that because APCs for drugs and biologicals are defined based on HCPCS codes for the lowest unit of the drug or biological, if we intend to apply the inpatient deductible limit at the APC level, we might disadvantage beneficiaries who receive multiple units. For example, the coinsurance for a specific drug APC may not exceed the inpatient deductible amount. However, if multiple units of the same drug are administered, the coinsurance based on the multiple APCs may, in fact, exceed the inpatient deductible. The commenters believed that the total coinsurance amount for a drug or biological based on the amount administered should be subjected to the inpatient deductible limit. The commenters believed that constructing APCs for drugs based on the lowest unit of the drug is solely a payment convention and does not mean that each dose is a separate “procedure.” Therefore, the commenters contended, a better reading of the statute is that the administration of a drug or biological, regardless of the dose, is one procedure for purposes of applying the hospital outpatient prospective payment system and it would be inappropriate to compare the inpatient deductible limit to anything but the total coinsurance amounts. *Response:* In the case of services that involve the administration of drugs and biologicals in separate APCs, we have concluded that we should apply the limitation on coinsurance to include both the drug or biological (in whatever units it is administered) and the service that leads to its administration. We constructed separate APCs for drugs and biologicals, and established pricing on the basis of the lowest dose, not to reflect CPT codes, but solely as a matter of convenience in administering the payment system. Consequently, we think that the interpretation with the most clinical relevance in this instance is to treat a drug or biological and the service that leads to its administration as a single procedure. We had not proposed separate APCs for drugs and biologicals in the proposed rule for the outpatient prospective payment system and the Congress did not know we would segment APCs at the time it passed the BBRA 1997. Effective for drugs and biologicals furnished on or after January 1, 2001, when multiple units of a drug or biological are furnished to a beneficiary during one day, resulting in multiple APC payments for the same drug, we will aggregate the total coinsurance applicable to the drug or biological, and the aggregated amount cannot exceed the inpatient hospital deductible for the calendar year. In order to accomplish this change in our bill processing systems, we are assigning a new status indicator designated as “K” to APCs for nonpass-through drugs and biologicals (as reflected in Addendum D of this interim final rule with comment period). Effective for services furnished on or after July 1, 2001, in the same circumstances, we will aggregate the total coinsurance applicable to the drug or biological and to the service that resulted in the administration of the drug, and the aggregated amount cannot exceed the inpatient hospital deductible for the calendar year. We are unable to make the latter provision effective earlier because of systems constraints. *Comment:* One commenter stated that the BBRA 1999 requirement that coinsurance for a procedure cannot exceed the inpatient hospital deductible for that year adds confusion to an already complicated formula for determining coinsurance. The commenter stated that the monitoring of coinsurance needed to ensure the limitation is being applied on a procedure basis will add undue burden and increase a provider's costs. To make the hospital outpatient prospective payment system less complicated, the commenter believed that we should consider eliminating the threshold. *Response:* The coinsurance limitation is required by statute. Therefore, a statutory change would be required to eliminate this provision. 14. Reclassification of Certain Hospitals In the August 1, 2000 **Federal Register** (65 FR 47029), we implemented section 401 of the BBRA 1999 for the hospital inpatient prospective payment system. Section 401(a) of the BBRA 1999, which amended section 1886(d)(8) of the Act by adding a new paragraph (E), directs the Secretary to treat any subsection
(d)hospital located in an urban area as being located in the rural area of the State in which the hospital is located if the hospital files an application (in the form and manner determined by the Secretary) and meets certain statutorily specified criteria. Additionally, section 401(a) of the BBRA 1999 includes hospitals “* * * located in an area designated by any law or regulation of such State as a rural area (or is designated by such State as a rural hospital).” A hospital also may seek to qualify for reclassification premised on the fact that, had it been located in a rural area, it would have qualified as a rural referral center or as a sole community hospital. Section 401(b) of the BBRA 1999 made a conforming change to section 1833(t) of the Act. Specifically, section 401(b) added section 1833(t)(13) to the Act which provides that if a hospital is being treated as being located in a rural area under section 1886(d)(8)(E) of the Act (for purposes of section 1886(d) of the Act), the hospital will also be treated under section 1833(t)(13) of the Act as being located in a rural area. In the April 7, 2000 final rule with comment period, we explained that we use the same yearly version of the hospital inpatient prospective payment system wage index (which takes effect each October 1) to adjust the portion of the outpatient prospective payment system payment rate and the coinsurance amount that is attributable to labor-related costs for relative differences in labor and labor-related costs across geographic areas (and that will be applied effective each January 1). This wage index reflects the effects of hospital designations under section 1886(d)(8)(B) of the Act and hospital reclassifications under section 1886(d)(10) of the Act. We did not receive any comments on this conforming change. B. August 3, 2000 Interim Final Rule With Comment Period Following are the issues addressed in the August 3, 2000 interim final rule with comment period, the public comments received on each issue, and our response to those comments. In that interim final rule, we— • Revised the regulation at § 419.43(e)(1)(iv) to change one criterion and postpone the effective date for two other criteria that a new device, drug, or biological must meet in order for its cost to be considered “not insignificant” for purposes of determining its eligibility for transitional pass-through payments; • Changed our interpretation for three of the eight criteria set forth in the April 7, 2000 final rule with comment period for defining a new medical device that would be eligible for transitional pass-through payments and amended § 419.43 by adding new paragraph (e)(4) to include all eight criteria; • Clarified the assignment of “C” codes to eligible pass-through items; • Corrected a trigger date for grandfathering of provider-based FQHCs; and • Clarified our intent regarding prior notice of beneficiary cost-sharing liability in emergency situations. 1. Transitional Pass-Through Provisions a. “Not Insignificant” Cost Criteria Section 1833(t)(6) of the Act, as added by section 201(b) of the BBRA 1999, requires the Secretary to make transitional pass-through payments for post-1996 new drugs, biologicals, and devices for at least 2 but no more than 3 years when the cost of the item is “not insignificant” in relation to the hospital outpatient prospective payment system payment amount. In the April 7, 2000 final rule with comment period, we established three criteria that a new device, drug, or biological must meet to determine whether its costs are not insignificant relative to the APC payment with which the item is associated (65 FR 18480-81). We stated that all of the following cost criteria must be satisfied in order for a new device, drug, or biological to be eligible for transitional pass-through payments: • Its expected reasonable cost exceeds the applicable fee schedule amount determined to be associated with the drug, biological, or device by 25 percent. • The expected reasonable cost of the new drug, biological, or device exceeds the portion of the fee schedule amount determined to be associated with the drug, biological, or device by 25 percent. • The difference between the expected, reasonable cost of the item and the portion of the hospital outpatient department fee schedule amount determined to be associated with the item exceeds 10 percent of the applicable hospital outpatient fee schedule amount. After we published the April 7, 2000 final rule with comment period, we gained considerable experience from reviewing applications for transitional pass-through payments. Based on that experience, we concluded that the 25-percent limitation was too restrictive and could result in limiting Medicare beneficiaries' access to new products. Therefore, in the August 3, 2000 interim final rule with comment period, we changed that criterion to ensure that Medicare beneficiaries would continue to have access to the latest technologies. We now require that the expected reasonable cost of a new drug, biological, or device must exceed 10 percent of the applicable fee schedule amount for the associated service. In addition, we also postponed the effective date of the other two criteria applying to a new device, biologicals, or drugs for which a transitional pass-through payment is first made to on or after January 1, 2003. As stated in the August 3, 2000 interim final rule with comment period, the delay in the effective date for these two criteria is necessary so that we will have sufficient time to gather and analyze data needed to determine the current portion of the fee schedule amounts associated with a device, drug, or biological, which is an essential factor in applying these criteria. *Comment:* Several commenters commended us for revising the one “not insignificant” criterion and postponing the other two criteria until after December 31, 2002. However, some argued that we created an uneven playing field by changing our policies after we published our April 7, 2000 final rule and announced pass-through application deadlines. They claimed that our untimely lowering of the cost threshold from 25 percent to 10 percent unfairly disadvantaged companies that did not submit pass-through applications by the deadline for our August 1, 2000 payments because they believed that their products would not qualify for payment. One commenter recommended that we rapidly process applications submitted for our January 1, 2001 update and change the effective date of that update to November 1, 2000. Another commenter advocated that we apply the 10-percent cost threshold retroactively to all device pass-through applications to ensure equitable treatment for all manufacturers. *Response:* Based on our review of transitional pass-through applications, we believe that we have not applied our policy change inconsistently to applications that we received. The change to the lower cost threshold is effective for services furnished on or after August 1, 2000. If an applicant's product was denied pass-through status because its cost was considered to be “not insignificant” and that applicant can show that our decision was not based on the 10-percent criterion, the applicant may request that we reevaluate the application. In addition, we encourage other interested parties who withheld applications because they believed that their products would not qualify for pass-through status to submit them. Further, we cannot update the pass-through payments effective November 1, 2000 as requested. Adding new pass-through items to our outpatient prospective payment system requires changes to our complex Medicare computerized claims processing systems that we can make only at the beginning of a calendar quarter. *Comment:* One commenter believed that reducing the cost threshold to 10 percent for new devices may be too low. The commenter stated that the lower cost threshold would expose hospitals to financial risk created by the use of new and expensive technology furnished in providing patient care. The commenter advocated that we consider as an option “establishing * * * a floor—or a variable percentage that is higher for low-cost cases and lower for high-cost cases.” *Response:* We believe that this option will require time to evaluate its merits, assess its impact on our systems and determine systems changes that would be required to implement it. Therefore, we will consider this request for possible inclusion in our future proposed rule for outpatient prospective payment system updating that we expect to publish in the spring of 2001. *Comment:* One commenter urged that we grant the public another opportunity to evaluate and comment on all three “not insignificant” cost criteria before implementing them. *Response:* Before we implement all three of these criteria, we plan to provide notice and opportunity for public comment. Since we do not expect to implement two of these criteria before January 1, 2003, we would not expect to publish a proposed rulemaking until the spring of 2002. *Comment:* One commenter asked how we would apply the three “not insignificant” cost criteria in instances when multiple units of a new device are used in performing a procedure. The commenter recommended that we use the “weighted average cost of the product, based on the average number of unit used in a procedure.” *Response:* We plan to fully describe our approach to implementing these three criteria in a future proposed rule. As previously stated, we will not implement two of these criteria before January 1, 2003. Therefore, we do not expect to publish a proposed rulemaking until the spring of 2002. *Comment:* One commenter asked that we clarify how transitional pass-through payments will be incorporated into the APC payments at the end of the 2- to 3-year transitional period for a given device. The commenter also asked how we would prevent the cost for the pass-through items from being diluted significantly by the median cost of other procedures grouped in the same APC. *Response:* We plan to use a methodology similar to that currently used to construct the APC groups to incorporate payment for pass-through items into the APC payments once their pass-through status expires. That is, we have assigned a unique HCPCS code to each eligible pass-through item that will allow us to track its payments and utilization over the 2 to 3 years that it is eligible for pass-through status. The codes will allow us to match the pass-through items to the specific procedures or medical visits with which they are used. After we gain appropriate information about the actual costs a hospital incurs to provide a pass-through item, we will package the cost for the pass-through with that for the relevant procedure or medical visit with which it is used and assign the packaged service to a clinically related APC group with comparable resources. We will limit the cost variation within each group as required by section 1833(t)(2) of the Act, as amended by section 201(g) of the BBRA 1999. In accordance with this provision, the items and services within a group cannot be considered comparable with respect to the use of resources if the highest median cost item or service within a group is more than two times greater than the lowest median cost item or service within the same group. By law, the Secretary is allowed certain exceptions to this requirement, that is, for low volume items and services. *Comment:* One commenter asked if we would provide adequate recognition for multiple devices used in a procedure “if multiple procedure discounting is allowed to cut the pass-through generated recognition of these costs in half.” *Response:* Under the hospital outpatient prospective payment system, devices eligible for pass-through payments are paid separately and not subject to the multiple procedure discounting policy. This policy applies only to the actual surgical procedure that is performed to implant the pass-through device. These procedures are denoted by a status indicator “T” and listed in Addendum B of this rule. *Comment:* One commenter urged us to correct erroneous APC groupings more frequently than during our scheduled quarterly or annual update cycles until we stabilize the hospital outpatient prospective payment system. *Response:* We understand the importance of paying appropriately for services billed under our new outpatient system and are committed to resolving problems that would preclude us from making appropriate payments in a timely manner. However, because of the complexity of our system we cannot commit to making changes other than during the scheduled updating cycles. b. Definition of Medical Device In the April 7, 2000 final rule with comment period, we established eight specific criteria that new or innovative medical devices must meet to be considered eligible for pass-through payments under section 1833(t)(6) of the Act. We stated in that rule that new or innovative medical devices must meet all of the following criteria to be considered eligible for transitional pass-through payments:
(1)They were not recognized for payment as a hospital outpatient service prior to 1997.
(2)They have been approved or cleared for use by the FDA.
(3)They are determined to be reasonable and necessary for the diagnosis or treatment of an illness or injury or to improve the functioning of a malformed body part, as required by section 1862(a)(1)(A) of the Act. We recognize that some investigational devices are refinements of existing technologies or replications of existing technologies and may be considered reasonable and necessary. Therefore, we indicated that we will consider devices for coverage under the hospital outpatient prospective payment system if they have received an FDA investigational device exemption
(IDE)and are classified by the FDA as Category B devices. However, in accordance with regulations at § 405.209, payment for a nonexperimental investigation device is based on, and may not exceed, the amount that would have been paid for a currently used device serving the same medical purpose that has been approved or cleared for marketing by the FDA.
(4)They are an integral and subordinate part of the procedure performed, are used for one patient only, are surgically implanted or inserted, and remain with that patient after the patient is released from the hospital outpatient department.
(5)The associated cost is not insignificant in relation to the APC payment for the service in which the innovative medical equipment is packaged.
(6)They are not equipment, instruments, apparatuses, implements, or items for which depreciation and financing expenses are recovered as depreciable assets as defined in Chapter 1 of the Medicare Provider Reimbursement Manual (HCFA Pub. 15-1).
(7)They are not materials and supplies such as sutures, clips, or customized surgical kits furnished incident to a service or procedure.
(8)They are not materials such as biologicals or synthetics that may be used to replace human skin. In the August 3, 2000 rule, we revised criteria (3), (4), and
(7)and amended § 419.43(e)(4) to include all eight criteria. We stated in that rule that our change in policies reflects experience gained in reviewing and processing transitional pass-through applications for devices since publishing our April 7, 2000 final rule with comment period. With regard to criteria (3), we revised it by removing the cost limitation provision for IDE Category B devices that qualify for transitional pass-through payments. We explained in the August 3, 2000 interim final rule that on review of our policy for such new devices, we believed that it would be more appropriate to remove the cost limitation because they are subjected to the same eligibility requirements as any other device applying for pass-through status and because pass-through payments for a specific device are temporary. For criteria (4), we modified our interpretation of which devices are eligible for transition pass-through payments to include new medical devices that are used for one patient only, are single use, come in contact with human tissue, and are surgically implanted or inserted in a patient during a procedure but may also be removed during that procedure so that the patient leaves the hospital without the device. Our revised interpretation also includes clips that are used as radiological site or tissue markers. As explained in the August 3, 2000 interim final rule, it became apparent, based on experience gained in processing a large number of applications for new medical device pass-through status, that our attempt to distinguish implantable devices using the criteria we had outlined in our April 7, 2000 final rule with comment period had some practical limitations. We also explained that, in some instances, the new medical device is implanted temporarily rather than permanently as indicated in our original policy published in the April 7, 2000 final rule with comment period. However, we did not intend for our policy to exclude new medical devices that are implanted or inserted during a procedure but also may be removed during that procedure so that the patient leaves the hospital without the device. Rather, we believed that these devices should be considered for pass-through payments because they also are implantables. We further stated in the August 3, 2000 interim final rule with comment period that it had become apparent that some implantable clips are expensive and function other than as tools or supplies necessary for a surgeon to perform a surgical procedure. We did not intend to exclude such clips from consideration for pass-through payments. Therefore, we revised our interpretation of which devices are eligible for transitional pass-through status to include also new single use medical devices that may be temporarily implanted or inserted in a patient. Finally, in criterion (7), we became aware of the need, based on our review of pass-through applications, to clarify that supplies include pharmacological imaging and stressing agents, including contrast media but excluding radiopharmaceuticals (for which payment under the transitional pass-through provision is established by section 1833(t)(6)(A) of the Act). *Comment:* One commenter urged that we issue detailed guidelines that clarify whether an IDE Category B device with pass-through status will be assigned only one “C-code” for both its clinical investigation and commercialization. *Response:* Our general policy is to assign only one code to an eligible pass-through item. *Comment:* One commenter asked how we would reconcile differences in pass-through payment differences (over 2 to 3 years) that are made for an eligible IDE Category B device during its clinical investigation phase versus those paid once the device is commercialized. *Response:* Policy decisions regarding the analytical treatment of costs associated with specific items that will be included in our database for constructing APCs will be made in the context of the methodology that we use to derive updated APC weights and payments. This methodology will be fully described in a subsequent proposed rule prior to incorporating the cost for pass-through devices such as eligible IDE Category B devices into our APC payments. *Comment:* One commenter asked that we clarify when the definition of a device includes or excludes all of a device's components. The commenter also asked whether we assigned separate codes for the device's components. *Response:* If a device can be separated into distinct components and such components are considered integral to the functioning of that device, we evaluate the device and all its component parts to determine whether any or all would qualify for transitional pass-through payment. For example, we have approved several implantable neurostimulator systems for pass-through payment. These systems usually include at least two or three separate components such as a generator, leads, and receiver/transmitter. In this case, we have assigned separate HCPCS codes to each of the eligible components. However, if an eligible pass-through item is considered a component of a non-eligible item, such as a piece of capital equipment, only the eligible item will receive a HCPCS code to bill for pass-through payments. *Comment:* One commenter warned us about medical devices that we have approved for pass-through payments such as electrophysiology catheters that the commenter alleges are not single use items. The commenter stated that hospitals use them more than once. The commenter advocated that we advise hospitals not to request additional payments for any approved pass-through item if they reprocess or reuse them. *Response:* In the August 3, 2000 interim final rule with comment period, we revised criterion “d” of the eight medical device eligibility criteria to explicitly preclude pass-through payments for new medical devices other than those that are single use. Therefore, additional payments will not be made for devices that are reprocessed or reused. Hospitals that bill these devices might be considered to be engaging in fraudulent billing practices. *Comment:* A number of the commenters urged that we abandon the use of an individual or brand-specific approach to approving devices for transitional pass-through payments and adopt an approach that distinguishes devices based on categories. The commenters argued that a category approach is more appropriate and more efficient to implement than an individual, item-specific approach. They alleged that the latter approach creates winners and losers and delays timely approval of new technologies. *Response:* As previously stated, we adopted a trade-name specific approach for several reasons. First, such an approach provides better information. Codes that are largely item-specific allow us to track what procedures the items are used with and costs of the items. When the pass-through payments for an item ends, we would expect to have good information for assigning it to relevant APCs and ensuring appropriate payment for these APCs. Adopting a scheme with a significant degree of categorization would require use of averages in making assignments and setting payment rates. Decisions based on these more limited data would likely lead to intensified concerns about the appropriateness of APC assignment and payment. Second, this approach permits finer discrimination in eligibility decisions. An item-by-item approach allows us to be sure individual items in fact meet the criteria for eligibility. Of major concern in this instance is whether a device is “new” using the standard of the statute. Section 1833(t)(6)(A) of the Act limits transitional pass-through payment to those devices for which “ * * * payment for the device * * * as an outpatient hospital service under this part was not being made as of December 31, 1996.” Adopting categories would in some cases mix “old” and “new” devices. In these instances, either some old devices would get special treatment that they would not be eligible for if they were examined on an item-specific basis, or an entire category could be considered old, thus depriving some new devices from special treatment they would be eligible for if they were examined on an item-specific basis. Third, an item-specific scheme avoids issues associated with the design of categories needed for purposes of transitional pass-through payments. It largely avoids concerns about what items should be in what category or whether new categories should be created to accommodate items that may appear to be little different from those in existing categories. Fourth, an item-specific approach allows us to assure that a newly arriving device can obtain the full period of pass-through status it is arguably eligible for under the statute. A categorization approach would likely lead to latecomers being eligible for pass-through payments only for a shorter period. Insofar as revision to APC payment rates reflected the costs of items in the category by the time the category was terminated, the shorter period would be of little consequence. However, if the costs of the late-coming item were significantly higher, this procedure could appear objectionable. A solution in this case would be to create a new code, which could be specific to that item, thus departing from a categorization approach. We recognize that a category approach would lessen concerns about competitive disadvantages that may have been inadvertently created by an item specific approach and about access to specific items by hospitals and their patients. However, we found no satisfactory way of establishing categories that would not run into difficulty regarding the test of whether a device is “new” as described above. Consequently, we are making no change in our approach in response to comments. 2. Revision to Grandfather Provision for Certain FQHCs and “Look-Alikes” In the April 7, 2000 final rule with comment period, which discussed the provider-based status criteria and requirements, we grandfathered FQHCs or “look-alikes” that were designated as such before 1995 in order to assure the continuity of care and access to care for patients of some of these facilities. To meet our original policy intent of helping to ensure that the new criteria do not disrupt the delivery of services to patients of these facilities, in the August 3, 2000 interim final rule with comment period (65 FR 47674), we corrected § 413.65(m) to state that a facility that has since April 7, 1995 furnished only services that were billed as if they had been furnished by a department of a provider will continue to be considered as a department of a provider, without regard to compliance with the provider-based criteria, if the facility—
(1)Received a grant on or before April 7, 2000 under section 330 of the Public Health Service Act and continues to receive funding under such a grant, or is receiving funding from a grant made on or before April 7, 2000 under section 330 of the Public Health Service Act under a contract with recipient of such a grant, and continues to meet the requirements to receive a grant under section 330 of the Public Health Service Act; or
(2)Based on the recommendation of the Public Health Service, was determined by HCFA on or before April 7, 2000 to meet the requirements for receiving a grant under section 330 of the Public Health Service Act, and continues to meet such requirements. We made this change to clarify that grandfathering under § 413.65 is based on continued status as a section 330 of the Public Health Service Act grantee or a “look-alike” facility. We received no comments on this change. 3. Clarification of Notice of Beneficiary Cost-Sharing Liability In the August 3, 2000 interim final rule with comment, we also addressed whether hospitals could reasonably be expected to furnish an exact statement of the patient's financial liability, since the exact scope of services needed may not be known at the time notice must be given. Specifically, we stated that when the extent of care needed is not known before the patient is admitted, the hospital may furnish a written notice to the patient that explains the general fact that the beneficiary will incur a coinsurance liability to the hospital that he or she would not incur if the facility were not provider based. Furthermore, we clarified that the estimate of “potential financial liability” in this written notice may be based on typical or average charges for visits to the facility or organization, while stating that the patient's actual liability will depend upon the actual services furnished by the hospital. *Comment:* One commenter stated that our clarification regarding the notice of beneficiary cost sharing liability was helpful, but recommended that we amend or modify the regulations at § 413.65(g)(7) to reflect such clarification since the wording of the existing regulations states twice that the notice must be given “prior to the delivery of services” without an exclusion for emergency medical conditions. In addition, the regulation states that the hospital has an obligation to notify the beneficiary of the “potential financial liability” not just to provide the beneficiary with “an estimate based upon typical or average charges” in the event that the exact type and extent of care is not known. The commenter also recommended that we require hospitals to only notify the beneficiary of the fact that the beneficiary will incur a coinsurance liability for hospital outpatient services without giving a dollar amount of beneficiary copayment. Such a notice could include a statement that the copayment liability will be determined by us and the beneficiary will be notified of the exact amount once the hospital is notified of the amount determined by us. The commenter believes that an estimate based on charges would “miss the point” of this provision since beneficiary copayment amounts are now determined by HCFA using an APC grouper, not charges. *Response:* We appreciate the commenter's concerns and agree that a change in the regulations is needed to reflect the clarification provided in the August 3, 2000 interim final rule with comment period in a future proposed rule. As we stated in the August 3, 2000 interim final rule with comment period (65 FR 47675), we are developing a proposed rule that will further revise and clarify the notice requirements. We are doing this to allow the public a full opportunity to comment on the changes and to ensure that we have the benefit of all relevant comments. We disagree with the commenter's statement that an estimate based on charges would “miss the point” of this provision since such a notice is required only to give the beneficiary an idea or an example of their “potential financial liability”. As stated in the August 3, 2000 interim final rule with comment period (65 FR 47675), the estimate should state that the beneficiary's “actual liability will depend upon actual services furnished by the hospital.” Also, with the delay in the effective date of the provider-based status regulations until January 10, 2001, hospitals will have at least five months of experience with APC payments under outpatient prospective payment system and should be able to develop an appropriate estimate of a copayment amount based on APCs rather than charges. 4. Clarification of Protocols for Off-Campus Departments In the April 7, 2000 final rule, under new § 489.24(i)(2) we require hospitals to establish protocols for handling individuals with potential emergency conditions who arrive at hospital off-campus departments. Section 489.24(i)(2)(ii) further requires that if the off-campus department is a physical therapy, radiology, or other facility not routinely staffed with physicians, RNs, or LPNs, the department personnel must be given protocols that direct them to contact emergency personnel at the main hospital campus. In the August 3, 2000 interim final rule with comment period, we clarified that § 489.24(i)(2) does not require a delay of an appropriate transfer when the main hospital campus does not have the specialized capability or facilities required by the individual or when the individual's condition is deteriorating so rapidly that the time needed to move the individual to the main hospital campus would significantly jeopardize the individual's life or health. We also stated that the contact with emergency personnel at the main hospital campus should be made either after, or concurrently with, the actions needed to arrange an appropriate transfer under § 489.24(i)(3)(ii), if doing otherwise would significantly jeopardize the individual's life or health. We noted that this clarification does not relieve the off-site department of the responsibility for making this contact, but only clarifies that the contact may be delayed in specific cases when doing otherwise would endanger a patient subject to EMTALA protection. We received no comments on this clarification. 5. Typographical Errors in the Provider-Based Regulations *Comment:* One commenter questioned whether the provider-based regulations in §§ 413.65 and 489.24, as they appeared in the April 7, 2000 final rule with comment period (65 FR 18538), contained typographical errors. *Response:* We are aware of typographical errors in the provider-based regulations as published in the April 7, 2000 final rule with comment period (65 FR 18538) and will be publishing a correction notice (HCFA-1005-CN) to make these corrections. III. Provisions of This Interim Final Rule With Comment Period A. Changes Relating to the BBRA 1999 Public Comments Except for the changes discussed in the preamble, we are adopting the BBRA 1999 provisions implemented in the April 7, 2000 final rule with comment period and the August 3, 2000 interim final rule with comment period, described in section II of this preamble, as final without modification. We are making the following changes to the regulation text as a result of the public comments received: We are revising § 419.41(c)(4)(i) to provide that, effective January 1, 2001, when multiple APCs for a single drug or biological are furnished to a beneficiary on the same day, the inpatient hospital deductible limitation on coinsurance will be applied to the aggregate coinsurance for the drug or biological. The section is further revised to provide that, effective July 1, 2001, the coinsurance amount for the procedure or service that resulted in the administration of the drug or biological will be aggregated with the coinsurance for the drug or biological in applying the limit. We are revising § 419.70(f)(2)(ii) to remove the phrase “without applying the cost reductions under section 1861(v)(1)(S) of the Act”. We recognize that the phase may have inadvertently caused confusion to the extent it is redundant, as pointed out by a commenter. B. Annual Updates to Components of the Hospital Outpatient Prospective Payment System In this interim final rule with comment period, for calendar year 2001, we are updating the wage index and the conversion factor adjustment for covered hospital outpatient services furnished beginning January 1, 2001. We also are updating the existing APC groups to reflect new codes that have been assigned. In accordance with section 1833(t)(9)(A) of the Act and section 201(h)(2) of the BBRA 1999, we will undertake a complete system update in 2001 for hospital outpatient prospective payments. That update will take effect on January 1, 2002. We will consult with an expert outside advisory panel composed of appropriate representatives of providers. This panel will review and advise us concerning the clinical integrity of the APC groups and relative weights. The panel will be allowed to use data other than those we have collected or developed during our review of the APC groups and relative weights. 1. APC Groups We are updating the existing APC groups effective January 1, 2001 to reflect the addition of new CPT and alpha-numeric codes, the deletion of invalid codes, changes to the list of procedures we pay for only in an inpatient setting (the “inpatient list”), the creation of a new status indicator, newly covered procedures, reconfigurations due to the inclusion of device costs, and revisions to correct errors and provide consistency in the placement of codes. a. New Codes There are 936 new codes, 645 of which are “C” codes. “New” in this context means new since the April 7, 2000 final rule with comment period was published. Many of the “C” codes were published in program memoranda over the intervening months. New codes are shown in Addendum B with an asterisk in the column preceding the code. b. Deleted Codes With the exception of “C” codes, codes deleted effective January 1 of each year are given a 3-month grace period in which they will still be recognized. “C” codes are temporary codes used exclusively to bill pass-through items and new technology services and items paid under the hospital prospective payment system. We will retire these codes prospectively at the start of a new calendar quarter based on specific service dates and are not extending the same 3-month grace period to them. We will drop all non “C” codes from APCs effective April l. Deleted codes are shown in Addendum B. They are followed by the letter D. The AMA's CPT books also list deleted codes. c. Revisions to Correct Errors or Inconsistencies We are revising the APCs in order to correct errors and to provide greater consistency in the placement of codes. For example, we had assigned various types of cardiovascular diagnostic tests to four APCs, with rates based on data that, on subsequent review, appeared limited. We are recategorizing these APCs. This recategorization results in three APCs with greater clinical coherence. Medicare covers influenza, pneumococcal, and hepatitis B immunizations routinely, with no copayment or deductible due for flu and pneumonia vaccines or their administration. Other vaccines may be covered in certain circumstances, but are, in fact, given so infrequently that our cost data are limited. We are rearranging the preventive vaccines and assigning the less frequently furnished vaccines based on their reported costs, but within a smaller range. We expect very few immunizations other than influenza and pneumonia to be billed, but if they are billed, we will update our data. We also are changing the APCs to which bone density studies are assigned. The codes used in 1996 captured both central and peripheral bone density studies. Coding changes since that time have separated the two types of studies, but this distinction was not reflected in the 1996 data. In order to better reflect these differences, we are separating the various codes and assigning central dual energy x-ray absorptiometry
(DEXA)bone density studies to a new technology APC. We did not include the codes for transfusion laboratory services (for example, typing and crossmatching) in APCs in the April 7, 2000 final rule with comment period. We are now creating three APCs to capture these codes, and an additional APC to capture fertility procedures. d. Device-Related Codes As described in the April 7, 2000 final rule with comment period, revenue centers 274, 275, and 278 were not included for purposes of calculating the APC rates because prior to the BBRA 1999, we anticipated paying for durable medical equipment and prosthetics (including implantable devices) outside of the outpatient prospective payment system and it was unfeasible to revise our database to reflect the revenue centers in time to publish a final rule and implement the prospective payment system by July 1, 2000. To reflect the inclusion of implantable devices as required under the BBRA 1999, we have recalculated APC rates with these revenue centers included. As a result, the median cost for certain procedures such as inserting pacemakers, replacing leads, and providing neurostimulators increased significantly. In order to recognize these cost increases, which are attributable to the devices, and to aid in the assignment of devices to APCs at the end of the pass-through period, we are reconfiguring certain APCs. That is, we are creating APC groups for the insertion of pacemakers, the replacement of pacemaker electrodes, the implantation of a pacemaker and electrodes, and the removal of a pacemaker. These changes reflect our basic criteria that procedures within an APC group be clinically similar and comparable in terms of resources, with the highest cost item or service within a group being no more than 2 times greater than the lowest cost item or service within the same group. e. Inpatient Codes Moved to the Outpatient Setting In response to numerous requests, we reviewed the composition of the inpatient list. While we continue to believe that we have the majority of the codes assigned properly, for the reasons discussed in section III.B.2. we are persuaded to move a number of codes to the outpatient setting. We are able to place most codes into closely related APCs. f. “Two-times” Rule The BBRA 1999 required us to ensure that no APC contains codes such that the highest median cost in the APC exceed twice the lowest median cost. We undertook an analysis of APCs in relation to this requirement as part of the 2001 update. (Note that the law provides for exceptions based on low volume and other reasons. We consider a code that captures fewer than 2 percent of the services within an APC to be low volume, and we disregard codes for unlisted services or procedures, since we do not know what service or procedure was billed.) For example, moving a radical mastectomy code from the inpatient list to a breast procedure APC caused the group to fail the two-times test. In another instance, as described above, we packaged costs associated with implantable devices into the relevant procedure codes. This change would also cause device-related APCs to fail the two-times test. For these situations and others that failed the two-times test, we are reconfiguring the APCs appropriately. g. Inpatient Codes Moved to Outpatient and Affected by Device Seven codes related to vascular and neurological procedures were moved from the inpatient list into APCs, that were then split according to device use, in response to comments. h. Newly Covered Codes The updated APCs reflect recent HCFA decisions to provide Medicare coverage for an electrical bioimpedance procedure and three magnetic resonance angiography services. The codes for these newly covered services are M0302 and 71555, 73725, and 74185, respectively. i. Pass-Through Requests for Drugs Since publication of the April 7, 2000 final rule with comment period, we have received additional requests for pass-through status for a number of drugs. The codes for the additional eligible pass-through drugs are shown in Addendum B. The following table contains a listing of the changes in the APC groups discussed above. Summary of Changes to APCs New Codes Changes to APC Placement of Existing Codes Revisions or corrections of errors Device-related codes Inpatient moved to outpatient “Two-times” rule Inpatient codes moved to outpatient and affected by device Newly covered codes Pass-through requests for drugs 936 codes added, 645 of which are “C” 111 codes changed 87 codes changed 56 codes changed (12 as of 8/1/2000) 25 codes changed 7 codes changed 4 codes changed 4 codes changed Denoted by asterisk in Addendum B APCs—0004, 0087, 0099, 0100, 0102, 0123, 0282, 0340, 0342, 0346, 0347, 0348, 0349, 0354, 0356, 0602, 0761, 0970, 0971, 0974, 0976, 1044, 1401, 1402, 1403, 1404, 1405, 1406, 1407, and 1409 APCs—0082, 0083, 0089, 0091, 0093, 0103, 0104, 0105, 0106, 0107, 0108, 0109, 0115, 0119, 0124, 0185, 0224, 0225, 0226, 0227, 0228, 0229, 0256, and 1002 APCs—0005, 0020, 0021, 0029, 0046, 0050, 0081, 0114, 0115, 0120, 0121, 0162, 0165, 0194, 0195, 0198 , 0216, 0254, 0256, 0263, 0264, 0279, 0280, 0970, 0974, and 0981. APCs—0028 and 0029 HCPCS—37620, 35011, 36834, 61880, 61888, 33284, 63741 HCPCS—71555, 73725, 74185, M0302 HCPCS—J1650, J2770, J1810, J7315 Addenda A and B reflect changes to the APC groups, effective January 1, 2001. Addendum C, entitled “Hospital Outpatient Department
(HOPD)Payment for Procedures by APC, Calendar Year 2001,” is not published in this interim final rule with comment period, but will be posted on our website at http://www.hcfa.gov /medlearn/refopps.htm. Addendum C will display data similar to those contained in Addenda A and B, but sorted by APCs with each procedure code listed that is assigned to the APC. 2. Inpatient Procedures List Update In the preamble to the April 7, 2000 final rule with comment period, we indicated that, as part of our annual update process, we would update the procedures on the inpatient list. The first annual revision of this list is effective on January 1, 2001. We are removing 44 procedures from the list and placing them in APCs. (Several procedures that were inadvertently left on the inpatient list in the April 7, 2000 final rule with comment period were removed from the list and placed in APCs in August 2000.) The revised list is included in Addendum E. We have attempted to limit the inpatient only list to those procedures that, in current medical practice as understood by our clinical staff, require inpatient care, such as those that are highly invasive, result in major blood loss or temporary deficits of organ systems (such as neurological impairment or respiratory insufficiency), or otherwise require intensive or extensive postoperative care. Insofar as advances in medical practice mitigate concerns about these procedures being performed on an outpatient basis, we will be prepared to remove them from the inpatient list and provide for payment under the hospital outpatient prospective payment system. Since the April 7, 2000 final rule with comment period was published, we have received requests to move a number of procedures from the inpatient list because, based on medical evidence, the procedures can be performed safely in a hospital outpatient setting. These included breast and other cancer procedures, repairs of facial trauma, many orthopedic procedures, several vascular procedures, and some genito-urinary procedures. Among the procedures we are removing from the inpatient list and placing in APCs as a result of these requests are excision of chest wall tumors, several orthopedic repairs, vascular procedures, and ureteral endoscopies. We are moving overnight pulse oximetry from the inpatient list to packaged status. We also are moving several comparable procedures, for example, related ureteral endoscopies. At this time, we are not removing from the inpatient list various spinal procedures, including osteotomies and laminectomies. We also are not removing several open abdominal and retroperitoneal procedures from the inpatient list because many of these procedures involve prolonged invasion of the thoracic cavity, the peritoneum, or the retroperitoneal space. Patients undergoing these procedures typically require prolonged postoperative monitoring. Moreover, the information provided to us by requesters did not provide convincing evidence that these procedures are currently being performed or can be safely performed in an outpatient setting. However, we are aware that, with advances in technology and surgical techniques, many of these procedures may eventually be performed safely in a hospital outpatient setting. We will continue to review all the procedures on the inpatient list and will consider additional requests to move specific procedures to the outpatient setting. We ask that these requests contain detailed rationale along with medical evidence that the procedure may be performed safely in an outpatient setting. We note that, in some instances, requests for removing a particular procedure from the inpatient list may have resulted from a misunderstanding about appropriate coding. Less invasive versions of the procedure on the inpatient list may be in an APC. The presence of certain thoracoscopies on the inpatient list, for example, does not mean that no thoracoscopy will be paid under the outpatient prospective payment system. We also were asked to move several procedures from APCs to the inpatient list. Because of the rapid advance in technology and surgical techniques mentioned above, we believe that if procedures have been assigned APCs, we should not reverse that status unless it becomes obvious that we have made an error. Thus, we are moving to the inpatient setting only one of the codes for which we received a request (open treatment of a knee dislocation, which requires more than outpatient postoperative monitoring), and two other codes (for nephrectomy with total ureterectomy and for escharotomy) that had been assigned APCs in error. Beginning in April 2001, we will, if warranted, revise the inpatient list at least quarterly to better reflect changes in medical practice that permit procedures that were previously performed only in an inpatient setting to be safely and effectively performed in an outpatient setting. In the April 7, 2000 final rule with comment period, we discussed our intent to revise the list as part of the annual update of APCs and asked that interested parties advise us of procedures that can be performed in an outpatient setting. Since we will be making quarterly updates to the outpatient prospective payment system for other purposes, we will also change the inpatient list quarterly, if warranted. Generally, because of systems limitations, 3 months or more are required after a decision is made before we can implement a change. The inpatient list was not a result of a provision of the BBRA 1999; it was included in the September 1998 proposed rule and we responded to comments and made the provision final in the April 7, 2000 final rule with comment. Accordingly, we did not request comments on our policy on the establishment of the inpatient list at that time. Nonetheless, we received a number of comments concerning the existence of this list, the provisions for updating it, and its implications for other Medicare payment systems. We will consider these comments and expect to discuss the matter further in the proposed rule updating the hospital outpatient prospective payment system for 2002, which we will publish in the spring of 2001. 3. Wage Index Adjustment Under section 1833(t)(2)(D) of the Act, we are required to determine a wage adjustment factor to adjust, in a budget neutral manner, the portion of the payment rate and the coinsurance amount that is attributable to labor-related costs for relative differences in labor and labor-related costs across geographic regions under the hospital outpatient prospective payment system. In the April 7, 2000 final rule with comment period, we specified, in regulations at § 419.43(c), that each year we use the hospital inpatient prospective payment system wage index established in accordance with 42 CFR Part 412 to make a wage adjustment for relative differences in labor and labor-related costs across geographic areas under the hospital outpatient prospective payment system. We note that, by statute, we implement the annual update of the hospital inpatient prospective payment system on a fiscal year basis. However, we update the hospital outpatient prospective payment system on a calendar year basis. Therefore, the hospital inpatient prospective payment system wage index values established for urban and rural areas and for reclassified hospitals published in the **Federal Register** on August 1, 2000 (65 FR 47149 through 47157) are being applied for wage adjustments under the hospital outpatient prospective payment system, effective January 1, 2001. The fiscal year 2001 hospital inpatient wage index reflects the effects of hospitals redesignated under section 1886(d)(8)(B) of the Act and hospital reclassifications under section 1886(d)(10) of the Act. After publication of the hospital inpatient wage index values for fiscal year 2001 on August 1, 2000, we discovered several errors in the values for several geographic areas. The correct wage index values for all areas are republished in Addenda F, G, and H of this interim final rule with comment period. In this interim final rule with comment period, we are establishing the methodology that we will use in making adjustments for area wage differences for services furnished in the Virgin Islands. We note that a hospital inpatient prospective payment system wage index value is not calculated for the Virgin Islands because there are no hospitals located in that area that are paid under the inpatient hospital prospective payment system. Because the wage index that we adopted in our April 7, 2000 final rule with comment period does not include a value for adjusting wage differences for the Virgin Islands, we will use the wage index for the Virgin Islands as calculated for the skilled nursing facilities prospective payment system to make this adjustment. The skilled nursing facilities prospective payment system uses the inpatient hospital wage index data to adjust its prospective payment rates for the same fiscal year (that is effective October 1, 2000) as covered by the hospital inpatient prospective payment system wage index values. As stated in the July 31, 2000 skilled nursing facilities prospective payment system final rule (65 FR 46770), “The computation of the wage index * * * incorporate[s] the latest data and methodology used to construct the hospital wage index. For these reasons, the wage index adjustment that we will apply to the Virgin Islands for services furnished on or after January 1, 2001 is 0.6306. Although the wage index for skilled nursing facilities is based on a fiscal year beginning October 1, we will apply the wage index factor for the Virgin Islands that goes into effect on October 1 of each year to the hospital outpatient prospective payment system services furnished during the following calendar year. This is consistent with how we apply the hospital inpatient prospective payment system wage index values to the hospital outpatient prospective payment system services. Consistent with the methodology applicable for services furnished in 2000 (on or after August 1, 2000), in making adjustments for area wage differences for services furnished in 2001, we will recognize 60 percent of the hospital's costs as labor-related costs that are standardized for geographic wage differences. 4. Conversion Factor Update Section 1833(t)(3)(C)(ii) of the Act requires us to update annually the conversion factor used to determine APC payment rates. Section 1833(t)(3)(C)(iii) of the Act provides that the update be equal to the hospital inpatient market basket percentage increase applicable to hospital discharges under section 1886(b)(3)(B)(iii) of the Act, reduced by one percentage point for the years 2000, 2001, and 2002. Thus, the update to the outpatient hospital prospective payment system conversion factor for 2001 is 2.4 percent (3.4 percent minus 1 percent). In accordance with section 1833(t)(9)(B) of the Act, the conversion factor for 2001 also has been adjusted to ensure that the revisions we made to update the wage index are made on a budget-neutral basis. A budget neutrality factor of .9989 was calculated for wage index changes by comparing total payments from our simulation model using the wage index values that will be effective January 1, 2001. The market basket increase of 2.4 percent for 2001 and the required budget neutrality adjustment calculated to be .9989 result in a conversion factor for 2001 of $49.596. IV. Waiver of Notice of Proposed Rulemaking We ordinarily publish a notice of proposed rulemaking in the **Federal Register** and invite public comments on the proposed rule. The notice of proposed rulemaking includes a reference to the legal authority under which the rule is proposed, and the terms and substance of the proposed rule or a description of the subjects and issues involved. This procedure can be waived, however, if an agency finds good cause that a notice-and-comment procedure is impracticable, unnecessary, or contrary to the public interest, and incorporates a statement of the finding and its reasons in the rule. For the reasons set forth below, we find that the circumstances surrounding this interim final rule with comment period make it either unnecessary or impracticable to pursue a notice-and-comment procedure before the provisions of this interim final rule with comment period take effect. As discussed earlier in this interim final rule with comment period, we implemented the hospital outpatient prospective payment system on August 1, 2000 in accordance with the methodology that we set forth in the April 7, 2000 final rule with comment period (65 FR 18434). In section III.I. of the April 7, 2000 final rule with comment period (65 FR 18501), we discuss how we will update the outpatient prospective payment system on an annual basis. We are required under section 1833(t)(3)(C)(ii) of the Act to update annually the conversion factor used to determine the APC payment rates. Under the regulations, 42 CFR 419.43, the wage adjustment under outpatient prospective payment system is based on the hospital inpatient wage index, and we updated the hospital inpatient wage index after the publication of the April 7, 2000 final rule with comment period. Accordingly, in this interim final rule with comment period, we are updating the conversion factor and the wage index adjustment for covered hospital outpatient services furnished beginning January 1, 2001, using the methodology published in the April 7, 2000 final rule with comment period, for which we had previously received comments. We also are updating the existing APC groups to reflect new and deleted CPT codes for 2001 and reconfiguring certain APC groups using more recent data to ensure clinical integrity and consideration of resource use as required by section 1833(t)(8)(A) of the Act and as described in the April 7, 2000 final rule with comment period (65 FR 18456 and 18501). Because these various adjustments are being made in accordance with existing methodology as set forth in the April 7, 2000 final rule with comment period, we believe it is unnecessary to address them further through the notice-and-comment procedure. In addition, we find good cause to waive prior notice-and-comment procedures with respect to the Virgin Islands wage index methodology because it would have been impracticable to undertake and complete notice-and-comment procedures on this issue in time for the Virgin Islands outpatient prospective payment system wage index value to be effective at the same time as the updated outpatient prospective payment system wage index values for all other areas. Accordingly, we find good cause to waive the notice-and-comment procedure with respect to the annual update of the wage index values, conversion factor, and the APC groups. However, we are providing for a 60-day comment period as specified in the “Dates” section of this preamble. II. Collection of Information Requirements This document does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995. VI. Regulatory Impact A. General We have examined the impacts of this interim final with comment period rule as required by Executive Order 12866, the Unfunded Mandates Reform Act of 1965, and the Regulatory Flexibility Act
(RFA)(Public Law 96-354). Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis
(RIA)must be prepared for major rules with economically significant effects ($100 million or more annually). Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in an expenditure in any one year by State, local, or tribal governments, in the aggregate, or by the private sector, of $100 million. This final rule does not mandate any requirements for State, local, or tribal governments. The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations and government agencies. For purposes of the RFA, we consider all hospitals to be small entities. Individuals and States are not included in the definition of a small entity. In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. With the exception of hospitals located in certain New England counties, for purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Metropolitan Statistical Area
(MSA)or New England County Metropolitan Area (NECMA). Section 601(g) of the Social Security Amendments of 1983 (Public Law 98-21) designated hospitals in certain New England counties as belonging to the adjacent NECMA. Thus, for purposes of the hospital outpatient prospective payment system, we classify these hospitals as urban hospitals. B. Analysis for Changes in this Interim Final Rule with Comment Period We implemented the outpatient prospective payment system on August 1, 2000 in accordance with the methodology published in the April 7, 2000 final rule with comment period. In section III.I. of the April 7, 2000 final rule with comment period (65 FR 18501), we discuss how we will update the outpatient prospective payment system on an annual basis. We are required under section 1833(t)(3)(C)(ii) of the Act to update annually the conversion factor used to determine the APC payment rates. We are required under section 1833(t)(8)(A) of the Act to revise not less often than annually the wage and other adjustments. Accordingly, in this interim final rule with comment period, we are updating the conversion factor and the wage index adjustment for covered hospital outpatient services furnished beginning January 1, 2001, using the methodology published in the April 7, 2000 final rule with comment period, for which we had previously received comments. In section IX.B. of the preamble of the April 7, 2000 final rule with comment period, we gave our Office of the Actuary's projection of the additional benefit expenditures from the Medicare Part B Trust Fund resulting from implementation of the hospital outpatient prospective payment system and the hospital outpatient provisions enacted by the BBRA 1999. The impact of implementing the hospital outpatient prospective payment system on the Medicare program is reflected in the table below, which is republished from the April 7, 2000 final rule with comment period (65 FR 18530). The calendar year 2001 increase in total payments to hospitals, which results primarily from the updated conversion factor, is already included as part of HCFA's current law baseline expenditures for hospital outpatient services under the outpatient prospective payment system. Fiscal year Impact (in millions) 2001 $3,030 2002 3,520 2003 4,230 2004 4,670 We also are updating the existing APC groups to reflect new and deleted CPT codes for 2001 and adjusting the groups to reflect more recent data as we described in the April 7, 2000 final rule with comment period. The provisions of this interim final rule with comment period do not measurably alter the effect of the outpatient prospective payment system on the groups of hospitals or geographic areas as projected in Table 2 of the April 7, 2000 final rule with comment period (65 FR 18533-18534). C. Federalism We have examined this interim rule with comment period in accordance with Executive Order 13132, Federalism, and have determined that it will not have any negative impact on the rights, roles, and responsibilities of State, local or Tribal governments. D. Executive Order 12866 and 5 U.S.C. 804(2) The statutory effects of the provisions that are being implemented by this interim final rule with comment period result in expenditures exceeding $100 million per year. Therefore, this interim final rule with comment period is an economically significant rule under Executive Order 12866, and a major rule under 5 U.S.C. 804(2). In accordance with the provisions of Executive Order 12866, this interim final rule with comment period was reviewed by the Office of Management and Budget. List of Subjects in 42 CFR Part 419 Health facilities, Hospitals, Medicare. For the reasons set forth in the preamble, 42 CFR Part 419 is amended as set forth below: PART 419—PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES 1. The authority citation for Part 419 continues to read as follows: Authority: Secs. 1102, 1833(t), and 187l of the Social Security Act (42 U.S.C. 1302, 1395l(t), and 1395hh). 2. Section 419.41 is amended by revising paragraph (c)(4)(i) to read as follows: § 419.41 Calculation of national beneficiary coinsurance amounts and national Medicare program payment amounts.
(c)* * *
(4)* * *
(i)The coinsurance amount for an APC cannot exceed the amount of the inpatient hospital deductible, established in accordance with § 409.82 of this chapter, for that year. For purposes of this paragraph (c)—
(A)Effective for drugs and biologicals furnished on or after January 1, 2001, the coinsurance amount for multiple APCs for a single drug or biological furnished on the same day will be aggregated and treated as the coinsurance amount for one APC.
(B)Effective for drugs and biologicals furnished on or after July 1, 2001, the coinsurance amount for the APC or APCs for a drug or biological furnished on the same day will be aggregated with the coinsurance amount for the APC that reflects the administration of the drug or biological furnished on that day and treated as the coinsurance amount for one APC. 3. Section 419.70 is amended by revising paragraph (f)(2)(ii) to read as follows: § 419.70 Transitional adjustment to limit decline in payment.
(f)* * *
(2)* * *
(ii)The reasonable cost of these services for this period. (Catalog of Federal Domestic Assistance Program No. 93.774, Medicare'Supplementary Medical Insurance Program) Dated: November 1, 2000. Michael M. Hash, Acting Administrator, Health Care Financing Administration. Approved: November 1, 2000. Donna E. Shalala, Secretary. Note to the Addenda: The following Addenda A through H will not appear in the Code of Federal Regulations. Addenda A through H provide various data pertaining to the Medicare hospital outpatient prospective payment system. Addendum A contains the APCs with title, status indicators, relative weight, payment rate, national unadjusted coinsurance, and minimum unadjusted coinsurance. Addendum B differs from Addendum A in that the APC titles are not listed and both HCPCS codes and descriptions appear. Addendum C, entitled “Hospital Outpatient Department
(HOPD)Payment for Procedures by APC, Calendar Year 2001,” is not published in this interim final rule with comment period, but will be posted on our website at (http://www.hcfa.gov /medlearn/refopps.htm). Addendum C will display data similar to those contained in Addenda A and B, but sorted by APCs with each procedure code listed that is assigned to the APC. Addendum D lists the status indicators for how various services are treated under the hospital outpatient prospective payment system. Addendum E lists the procedures that we pay for only in an inpatient setting. Addendum F lists the wage index for urban areas, Addendum G lists the wage index for rural areas, and Addendum H lists the wage index for hospitals that are reclassified. Addendum A.—List of Hospital Outpatient Ambulatory Payment Classification Groups with Status Indicators, Relative Weights, Payment Rates, and Coinsurance Amounts The payment rate (once wage adjusted) is the total payment to the hospital. The coinsurance amount is part of the total payment rate. Those APCs with status indicators “G” or “J” denote the inclusion of drugs that are eligible for pass-through payments. The relative weight column for these drug APCs is empty since payment for pass-through drugs/biologicals is calculated using the average wholesale price for the drug/biological rather than the relative weight. Note also that the only coinsurance column that has been filled is the minimum unadjusted coinsurance column. The coinsurance is applied to the nonpass-through portion of the payment rate for the drug/biological. Those APCs with status indicator “H” denote the inclusion of devices that are eligible for pass-through payments. The relative weight, payment rate, and coinsurance columns are not filled for these APCs. The relative weight and payment rate columns are empty because payment for pass-through devices is determined based on the hospital's submitted charges adjusted to cost using the hospital's cost-to-charge ratio. This calculation is done in the PRICER. The coinsurance columns for these APCs are not filled since the coinsurance is applied to the APC that contains the procedure with which the pass-through device is used rather than to the device APC. Addendum B.—Hospital Outpatient Department
(HOPD)Payment Status by HCPCS Code and Related Information The codes listed in this addendum include the 2001 CPT codes as published in CPT 2001 by the American Medical Association. Also listed are the codes that have been deleted for 2001. These codes are denoted in the CPT column with the subscript letter “D”. These codes are billable through March 31, 2001 for services occurring before January 1, 2001. Deleted codes billed after March 31, 2001 will be rejected. CPT codes appearing for the first time in 2001 are denoted in the CPT column with bolded print. These codes are new for 2001 and are billable effective January 1, 2001. All CPT codes that are paid only as inpatient procedures are denoted by the status indicator “C”. A number of procedures that appeared on the inpatient list in the April 7, 2000 final rule with comment period are now payable under the hospital outpatient prospective payment system. The status indicators for these codes have been updated to reflect their current payment status. Addendum A.—List of Hospital Outpatient Ambulatory Payment Classifications With Status Indicators, Relative Weights, Payment Rates, and Coinsurance Amounts, Calendar Year 2001 APC Group title Status indicator Relative weight Payment rate National unadjusted coinsurance Minimum unadjusted coinsurance 0001 Photochemotherapy S 0.47 $23.31 $8.49 $4.66 0002 Fine needle Biopsy/Aspiration T 0.62 $30.75 $17.66 $6.15 0003 Bone Marrow Biopsy/Aspiration T 0.98 $48.61 $27.99 $9.72 0004 Level I Needle Biopsy/ Aspiration Except Bone Marrow T 1.84 $91.26 $32.57 $18.25 0005 Level II Needle Biopsy /Aspiration Except Bone Marrow T 5.41 $268.32 $119.75 $53.66 0006 Level I Incision & Drainage T 2.00 $99.19 $33.95 $19.84 0007 Level II Incision & Drainage T 3.68 $182.51 $72.03 $36.50 0008 Level III Incision & Drainage T 6.15 $305.02 $113.67 $61.00 0009 Nail Procedures T 0.74 $36.70 $9.63 $7.34 0010 Level I Destruction of Lesion T 0.55 $27.28 $9.86 $5.46 0011 Level II Destruction of Lesion T 2.72 $134.90 $50.01 $26.98 0012 Level I Debridement & Destruction T 0.53 $26.29 $9.18 $5.26 0013 Level II Debridement & Destruction T 0.91 $45.13 $17.66 $9.03 0014 Level III Debridement & Destruction T 1.50 $74.39 $24.55 $14.88 0015 Level IV Debridement & Destruction T 1.77 $87.78 $31.20 $17.56 0016 Level V Debridement & Destruction T 3.53 $175.07 $74.67 $35.01 0017 Level VI Debridement & Destruction T 12.45 $617.47 $289.16 $123.49 0018 Biopsy Skin, Subcutaneous Tissue or Mucous Membrane T 0.94 $46.62 $17.66 $9.32 0019 Level I Excision/ Biopsy T 4.00 $198.39 $78.91 $39.68 0020 Level II Excision/ Biopsy T 6.51 $322.87 $130.53 $64.57 0021 Level III Excision/ Biopsy T 10.49 $520.26 $236.51 $104.05 0022 Level IV Excision/ Biopsy T 12.49 $619.45 $292.94 $123.89 0023 Exploration Penetrating Wound T 1.98 $98.20 $40.37 $19.64 0024 Level I Skin Repair T 2.43 $120.51 $44.50 $24.10 0025 Level II Skin Repair T 3.74 $185.49 $70.66 $37.10 0026 Level III Skin Repair T 12.11 $600.61 $277.92 $120.12 0027 Level IV Skin Repair T 15.80 $783.62 $383.10 $156.72 0028 Level I Incision/Excision Breast T 12.37 $613.52 $303.74 $122.70 0029 Level II Incision/Excision Breast T 31.39 $1,557.05 $820.79 $311.41 0030 Breast Reconstruction T 31.11 $1,543.16 $763.55 $308.63 0032 Placement Transvenous Catheters/Arterial Cutdown T 5.40 $267.82 $119.52 $53.56 0033 Partial Hospitalization P 4.17 $206.82 $48.17 $41.36 0040 Arthrocentesis & Ligament/Tendon Injection T 2.11 $104.65 $40.60 $20.93 0041 Arthroscopy T 24.57 $1,218.58 $592.08 $243.72 0042 Arthroscopically-Aided Procedures T 29.22 $1,449.19 $804.74 $289.84 0043 Closed Treatment Fracture Finger/Toe/Trunk T 1.64 $81.34 $25.46 $16.27 0044 Closed Treatment Fracture/Dislocation Except Finger/Toe/Trunk T 2.17 $107.63 $38.08 $21.53 0045 Bone/Joint Manipulation Under Anesthesia T 11.02 $546.55 $277.12 $109.31 0046 Open/Percutaneous Treatment Fracture or Dislocation T 22.29 $1,105.50 $535.76 $221.10 0047 Arthroplasty without Prosthesis T 22.09 $1,095.58 $537.03 $219.12 0048 Arthroplasty with Prosthesis T 29.06 $1,441.26 $725.94 $288.25 0049 Level I Musculoskeletal Procedures Except Hand and Foot T 15.04 $745.93 $356.95 $149.19 0050 Level II Musculoskeletal Procedures Except Hand and Foot T 21.13 $1,047.96 $513.86 $209.59 0051 Level III Musculoskeletal Procedures Except Hand and Foot T 27.76 $1,376.79 $675.24 $275.36 0052 Level IV Musculoskeletal Procedures Except Hand and Foot T 36.16 $1,793.39 $930.91 $358.68 0053 Level I Hand Musculoskeletal Procedures T 11.32 $561.42 $253.49 $112.28 0054 Level II Hand Musculoskeletal Procedures T 19.66 $975.06 $472.33 $195.01 0055 Level I Foot Musculoskeletal Procedures T 15.47 $767.26 $355.34 $153.45 0056 Level II Foot Musculoskeletal Procedures T 17.30 $858.02 $405.81 $171.60 0057 Bunion Procedures T 21.00 $1,041.52 $496.65 $208.30 0058 Level I Strapping and Cast Application S 1.09 $54.06 $19.27 $10.81 0059 Level II Strapping and Cast Application S 1.74 $86.30 $29.59 $17.26 0060 Manipulation Therapy S 0.77 $38.19 $7.80 $7.64 0070 Thoracentesis/Lavage Procedures T 3.64 $180.53 $79.60 $36.11 0071 Level I Endoscopy Upper Airway T 0.55 $27.28 $14.22 $5.46 0072 Level II Endoscopy Upper Airway T 1.26 $62.49 $41.52 $12.50 0073 Level III Endoscopy Upper Airway T 4.11 $203.84 $91.07 $40.77 0074 Level IV Endoscopy Upper Airway T 13.61 $675.00 $347.54 $135.00 0075 Level V Endoscopy Upper Airway T 18.55 $920.01 $467.29 $184.00 0076 Endoscopy Lower Airway T 8.06 $399.75 $197.05 $79.95 0077 Level I Pulmonary Treatment S 0.43 $21.33 $12.62 $4.27 0078 Level II Pulmonary Treatment S 1.34 $66.46 $29.13 $13.29 0079 Ventilation Initiation and Management S 3.18 $157.72 $107.70 $31.54 0080 Diagnostic Cardiac Catheterization T 31.55 $1,564.75 $838.92 $312.95 0081 Non-Coronary Angioplasty or Atherectomy T 28.81 $1,428.86 $710.91 $285.77 0082 Coronary Atherectomy T 51.01 $2,529.89 $1,351.74 $505.98 0083 Coronary Angioplasty T 29.70 $1,473.00 $794.30 $294.60 0084 Level I Electrophysiologic Evaluation S 10.70 $530.68 $177.79 $106.14 0085 Level II Electrophysiologic Evaluation S 27.06 $1,342.07 $654.48 $268.41 0086 Ablate Heart Dysrhythm Focus S 47.62 $2,361.76 $1,265.37 $472.35 0087 Cardiac Electrophysiologic Recording/Mapping S 9.53 $472.65 $214.72 $94.53 0088 Thrombectomy T 26.49 $1,313.80 $678.68 $262.76 0089 Insertion/Replacement of Permanent Pacemaker and Electrodes T 78.45 $3,890.81 $2,275.19 $778.16 0090 Insertion/Replacement of Pacemaker Pulse Generator T 78.28 $3,882.37 $2,133.88 $776.47 0091 Level I Vascular Ligation T 14.79 $733.52 $348.23 $146.70 0092 Level II Vascular Ligation T 20.21 $1,002.34 $505.37 $200.47 0093 Vascular Repair/Fistula Construction T 12.82 $635.82 $277.34 $127.16 0094 Resuscitation and Cardioversion S 4.51 $223.68 $105.29 $44.74 0095 Cardiac Rehabilitation S 0.64 $31.74 $16.98 $6.35 0096 Non-Invasive Vascular Studies S 2.06 $102.16 $61.48 $20.43 0097 Cardiac Monitoring for 30 days X 1.62 $80.35 $62.40 $16.07 0098 Injection of Sclerosing Solution T 1.19 $59.02 $20.88 $11.80 0099 Electrocardiograms S 0.38 $18.85 $14.68 $3.77 0100 Stress Tests and Continuous ECG X 1.70 $84.32 $71.57 $16.86 0101 Tilt Table Evaluation S 4.47 $221.70 $128.84 $44.34 0102 Electronic Analysis of Pacemakers/other Devices S 0.45 $22.32 $12.62 $4.46 0103 Miscellaneous Vascular Procedures T 13.09 $649.21 $295.70 $129.84 0104 Transcatheter Placement of Intracoronary Stents T 14.94 $740.96 $339.51 $148.19 0105 Revision/Removal of Pacemakers, AICD, or Vascular Device T 15.06 $746.92 $372.32 $149.38 0106 Insertion/Replacement/Repair of Pacemaker Electrodes T 18.96 $940.34 $503.07 $188.07 0107 Insertion of Cardioverter-Defibrillator T 147.51 $7,315.91 $5,086.37 $1,463.18 0108 Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads T 210.84 $10,456.84 $5,484.72 $2,091.37 0109 Removal of Implanted Devices T 6.53 $323.86 $133.51 $64.77 0110 Transfusion S 5.83 $289.15 $122.73 $57.83 0111 Blood Product Exchange S 14.17 $702.77 $300.74 $140.55 0112 Extracorporeal Photopheresis S 39.60 $1,964.01 $663.65 $392.80 0113 Excision Lymphatic System T 13.89 $688.89 $326.55 $137.78 0114 Thyroid/Lymphadenectomy Procedures T 19.56 $970.10 $493.78 $194.02 0115 Cannula/Access Device Procedures T 19.34 $959.19 $506.74 $191.84 0116 Chemotherapy Administration by Other Technique Except Infusion S 2.34 $116.06 $23.21 $23.21 0117 Chemotherapy Administration by Infusion Only S 1.84 $91.26 $71.80 $18.25 0118 Chemotherapy Administration by Both Infusion and Other Technique S 2.90 $143.83 $72.03 $28.77 0119 Implantation of Devices T 9.87 $489.59 $161.50 $97.92 0120 Infusion Therapy Except Chemotherapy T 1.66 $82.33 $42.67 $16.47 0121 Level I Tube changes and Repositioning T 2.36 $117.05 $52.53 $23.41 0122 Level II Tube changes and Repositioning T 5.04 $249.96 $114.93 $49.99 0123 Bone Marrow Harvesting and Bone Marrow/Stem Cell Transplant S 4.13 $204.83 $40.97 $40.97 0124 Revision of Implanted Infusion Pump T 2.55 $126.64 $81.36 $25.33 0130 Level I Laparoscopy T 25.36 $1,257.75 $659.53 $251.55 0131 Level II Laparoscopy T 41.81 $2,073.61 $1,089.88 $414.72 0132 Level III Laparoscopy T 48.91 $2,425.74 $1,239.22 $485.15 0140 Esophageal Dilation without Endoscopy T 4.74 $235.09 $107.24 $47.02 0141 Upper GI Procedures T 7.15 $354.61 $184.67 $70.92 0142 Small Intestine Endoscopy T 7.45 $369.49 $162.42 $73.90 0143 Lower GI Endoscopy T 7.98 $395.78 $199.12 $79.16 0144 Diagnostic Anoscopy T 2.23 $110.60 $49.32 $22.12 0145 Therapeutic Anoscopy T 7.46 $369.98 $179.39 $74.00 0146 Level I Sigmoidoscopy T 2.83 $140.36 $65.15 $28.07 0147 Level II Sigmoidoscopy T 6.26 $310.47 $149.11 $62.09 0148 Level I Anal/Rectal Procedure T 2.34 $116.06 $43.59 $23.21 0149 Level II Anal/Rectal Procedure T 12.86 $637.80 $293.06 $127.56 0150 Level III Anal/Rectal Procedure T 17.68 $876.86 $437.12 $175.37 0151 Endoscopic Retrograde Cholangio-Pancreatography
(ERCP)T 10.53 $522.25 $245.46 $104.45 0152 Percutaneous Biliary Endoscopic Procedures T 8.22 $407.68 $207.38 $81.54 0153 Peritoneal and Abdominal Procedures T 19.62 $973.08 $496.31 $194.62 0154 Hernia/Hydrocele Procedures T 22.43 $1,112.45 $556.98 $222.49 0157 Colorectal Cancer Screening: Barium Enema S 1.79 $88.78 $22.19 0158 Colorectal Cancer Screening: Colonoscopy S 7.98 $395.78 $98.94 0159 Colorectal Cancer Screening: Flexible Sigmoidoscopy S 2.83 $140.36 $35.09 0160 Level I Cystourethroscopy and other Genitourinary Procedures T 5.43 $269.30 $110.11 $53.86 0161 Level II Cystourethroscopy and other Genitourinary Procedures T 10.94 $542.58 $249.36 $108.52 0162 Level III Cystourethroscopy and other Genitourinary Procedures T 17.49 $867.44 $427.49 $173.49 0163 Level IV Cystourethroscopy and other Genitourinary Procedures T 28.98 $1,437.30 $792.58 $287.46 0164 Level I Urinary and Anal Procedures T 2.17 $107.64 $33.03 $21.53 0165 Level II Urinary and Anal Procedures T 3.89 $192.92 $91.76 $38.58 0166 Level I Urethral Procedures T 10.17 $504.39 $218.73 $100.88 0167 Level II Urethral Procedures T 21.06 $1,044.50 $555.84 $208.90 0168 Level III Urethral Procedures T 24.94 $1,236.93 $536.11 $247.39 0169 Lithotripsy T 46.72 $2,317.13 $1,384.20 $463.43 0170 Dialysis for Other Than ESRD Patients S 6.68 $331.30 $72.26 $66.26 0180 Circumcision T 13.62 $675.49 $304.87 $135.10 0181 Penile Procedures T 32.37 $1,605.43 $906.36 $321.09 0182 Insertion of Penile Prosthesis T 52.11 $2,584.45 $1,525.05 $516.89 0183 Testes/Epididymis Procedures T 18.26 $905.62 $448.94 $181.12 0184 Prostate Biopsy T 4.94 $245.01 $122.96 $49.00 0185 Removal or Repair of Penile Prosthesis T 32.37 $1,605.43 $906.36 $321.09 0190 Surgical Hysteroscopy T 17.85 $885.29 $443.89 $177.06 0191 Level I Female Reproductive Procedures T 1.19 $59.02 $17.43 $11.80 0192 Level II Female Reproductive Procedures T 2.38 $118.04 $35.33 $23.61 0193 Level III Female Reproductive Procedures T 8.93 $442.89 $171.13 $88.58 0194 Level IV Female Reproductive Procedures T 16.21 $803.96 $395.94 $160.79 0195 Level V Female Reproductive Procedures T 18.68 $926.46 $483.80 $185.29 0196 Dilatation & Curettage T 14.47 $717.66 $357.98 $143.53 0197 Infertility Procedures T 2.40 $119.03 $49.55 $23.81 0198 Pregnancy and Neonatal Care Procedures T 1.34 $66.46 $33.03 $13.29 0199 Vaginal Delivery T 11.20 $555.48 $157.83 $111.10 0200 Therapeutic Abortion T 13.89 $688.89 $373.23 $137.78 0201 Spontaneous Abortion T 13.00 $644.75 $329.65 $128.95 0210 Spinal Tap T 3.00 $148.79 $62.40 $29.76 0211 Level I Nervous System Injections T 3.32 $164.66 $74.78 $32.93 0212 Level II Nervous System Injections T 3.64 $180.53 $88.78 $36.11 0213 Extended EEG Studies and Sleep Studies S 11.15 $553.00 $290.42 $110.60 0214 Electroencephalogram S 2.32 $115.06 $58.50 $23.01 0215 Level I Nerve and Muscle Tests S 1.15 $57.04 $30.05 $11.41 0216 Level II Nerve and Muscle Tests S 2.87 $142.34 $64.69 $28.47 0217 Level III Nerve and Muscle Tests S 5.87 $291.13 $156.68 $58.23 0220 Level I Nerve Procedures T 13.96 $692.36 $326.21 $138.47 0221 Level II Nerve Procedures T 18.36 $910.58 $463.62 $182.12 0222 Implantation of Neurological Device T 124.43 $6,171.23 $2,955.13 $1,234.25 0223 Implantation of Pain Management Device T 7.05 $349.65 $154.27 $69.93 0224 Implantation of Reservoir/Pump/Shunt T 17.89 $887.27 $453.41 $177.45 0225 Implantation of Neurostimulator Electrodes T 17.72 $878.84 $408.33 $175.77 0226 Implantation of Drug Infusion Reservoir T 5.62 $278.73 $109.42 $55.75 0227 Implantation of Drug Infusion Device T 11.17 $553.99 $330.11 $110.80 0228 Creation of Lumbar Subarachnoid Shunt T 25.06 $1,242.88 $696.46 $248.58 0229 Transcatherter Placement of Intravascular Shunts T 34.81 $1,726.44 $1,030.12 $345.29 0230 Level I Eye Tests S 0.98 $48.61 $22.48 $9.72 0231 Level II Eye Tests S 2.64 $130.94 $59.87 $26.19 0232 Level I Anterior Segment Eye T 6.04 $299.56 $134.66 $59.91 0233 Level II Anterior Segment Eye T 13.79 $683.93 $331.60 $136.79 0234 Level III Anterior Segment Eye Procedures T 20.64 $1,023.66 $502.16 $204.73 0235 Level I Posterior Segment Eye Procedures T 2.94 $145.81 $78.91 $29.16 0236 Level II Posterior Segment Eye Procedures T 6.70 $332.29 $147.96 $66.46 0237 Level III Posterior Segment Eye Procedures T 33.96 $1,684.28 $852.68 $336.86 0238 Level I Repair and Plastic Eye Procedures T 2.80 $138.87 $58.96 $27.77 0239 Level II Repair and Plastic Eye Procedures T 6.26 $310.47 $123.42 $62.09 0240 Level III Repair and Plastic Eye Procedures T 13.47 $668.06 $315.31 $133.61 0241 Level IV Repair and Plastic Eye Procedures T 16.60 $823.30 $384.47 $164.66 0242 Level V Repair and Plastic Eye Procedures T 23.70 $1,175.42 $597.36 $235.08 0243 Strabismus/Muscle Procedures T 17.99 $892.23 $431.39 $178.45 0244 Corneal Transplant T 32.88 $1,630.72 $851.42 $326.14 0245 Cataract Procedures without IOL Insert T 26.55 $1,316.77 $623.85 $263.35 0246 Cataract Procedures with IOL Insert T 26.55 $1,316.77 $623.85 $263.35 0247 Laser Eye Procedures Except Retinal T 4.89 $242.52 $112.86 $48.50 0248 Laser Retinal Procedures T 4.19 $207.81 $94.05 $41.56 0250 Nasal Cauterization/Packing T 2.21 $109.61 $38.54 $21.92 0251 Level I ENT Procedures T 1.68 $83.32 $27.99 $16.66 0252 Level II ENT Procedures T 5.18 $256.90 $114.24 $51.38 0253 Level III ENT Procedures T 12.02 $596.14 $284.00 $119.23 0254 Level IV ENT Procedures T 12.45 $617.47 $272.41 $123.49 0256 Level V ENT Procedures T 25.40 $1,259.74 $623.05 $251.95 0258 Tonsil and Adenoid Procedures T 18.62 $923.48 $462.81 $184.70 0260 Level I Plain Film Except Teeth X 0.79 $39.18 $22.02 $7.84 0261 Level II Plain Film Except Teeth Including Bone Density Measurement X 1.38 $68.44 $38.77 $13.69 0262 Plain Film of Teeth X 0.40 $19.83 $10.90 $3.97 0263 Level I Miscellaneous Radiology Procedures X 1.68 $83.32 $45.88 $16.66 0264 Level II Miscellaneous Radiology Procedures X 3.83 $189.96 $108.97 $37.99 0265 Level I Diagnostic Ultrasound Except Vascular S 1.17 $58.03 $38.08 $11.61 0266 Level II Diagnostic Ultrasound Except Vascular S 1.79 $88.78 $57.35 $17.76 0267 Vascular Ultrasound S 2.72 $134.90 $80.06 $26.98 0268 Guidance Under Ultrasound X 2.23 $110.60 $69.51 $22.12 0269 Echocardiogram Except Transesophageal S 4.40 $218.22 $114.01 $43.64 0270 Transesophageal Echocardiogram S 5.55 $275.25 $150.26 $55.05 0271 Mammography S 0.70 $34.72 $19.50 $6.94 0272 Level I Fluoroscopy X 1.40 $69.43 $39.00 $13.89 0273 Level II Fluoroscopy X 2.49 $123.49 $61.02 $24.70 0274 Myelography S 4.83 $239.55 $128.12 $47.91 0275 Arthrography S 2.74 $135.89 $72.26 $27.18 0276 Level I Digestive Radiology S 1.79 $88.78 $49.78 $17.76 0277 Level II Digestive Radiology S 2.47 $122.50 $69.28 $24.50 0278 Diagnostic Urography S 2.85 $141.35 $81.67 $28.27 0279 Level I Angiography and Venography except Extremity S 6.30 $312.46 $174.57 $62.49 0280 Level II Angiography and Venography except Extremity S 14.98 $742.95 $380.12 $148.59 0281 Venography of Extremity S 4.40 $218.22 $115.16 $43.64 0282 Level I Computerized Axial Tomography S 2.38 $118.04 $94.51 $23.61 0283 Level II Computerized Axial Tomography S 4.89 $242.52 $179.39 $48.50 0284 Magnetic Resonance Imaging S 8.02 $397.76 $257.39 $79.55 0285 Positron Emission Tomography
(PET)S 15.06 $746.92 $415.21 $149.38 0286 Myocardial Scans S 7.28 $361.06 $200.04 $72.21 0290 Standard Non-Imaging Nuclear Medicine S 1.94 $96.21 $55.51 $19.24 0291 Level I Diagnostic Nuclear Medicine Excluding Myocardial Scans S 3.15 $156.22 $93.14 $31.24 0292 Level II Diagnostic Nuclear Medicine Excluding Myocardial Scans S 4.36 $216.24 $126.63 $43.25 0294 Level I Therapeutic Nuclear Medicine S 5.13 $254.43 $144.06 $50.89 0295 Level II Therapeutic Nuclear Medicine S 19.85 $984.48 $609.17 $196.90 0296 Level I Therapeutic Radiologic Procedures S 3.57 $177.06 $100.25 $35.41 0297 Level II Therapeutic Radiologic Procedures S 6.13 $304.03 $172.51 $60.81 0300 Level I Radiation Therapy S 1.98 $98.20 $47.72 $19.64 0301 Level II Radiation Therapy S 2.21 $109.61 $52.53 $21.92 0302 Level III Radiation Therapy S 8.21 $407.18 $216.55 $81.44 0303 Treatment Device Construction X 2.83 $140.36 $69.28 $28.07 0304 Level I Therapeutic Radiation Treatment Preparation X 1.49 $73.90 $41.52 $14.78 0305 Level II Therapeutic Radiation Treatment Preparation X 4.06 $201.36 $97.50 $40.27 0310 Level III Therapeutic Radiation Treatment Preparation X 13.98 $693.35 $339.05 $138.67 0311 Radiation Physics Services X 1.32 $65.46 $31.66 $13.09 0312 Radioelement Applications S 4.09 $202.85 $109.65 $40.57 0313 Brachytherapy S 7.89 $391.31 $164.02 $78.26 0314 Hyperthermic Therapies S 5.88 $291.62 $150.95 $58.32 0320 Electroconvulsive Therapy S 3.68 $182.51 $80.06 $36.50 0321 Biofeedback and Other Training S 1.26 $62.49 $29.25 $12.50 0322 Brief Individual Psychotherapy S 1.32 $65.46 $14.22 $13.09 0323 Extended Individual Psychotherapy S 1.85 $91.75 $22.48 $18.35 0324 Family Psychotherapy S 1.87 $92.74 $20.19 $18.55 0325 Group Psychotherapy S 1.55 $76.88 $19.96 $15.38 0330 Dental Procedures S 1.51 $74.89 $14.98 $14.98 0340 Minor Ancillary Procedures X 1.04 $51.58 $12.85 $10.32 0341 Immunology Tests X 0.13 $6.44 $3.67 $1.29 0342 Level I Pathology X 0.26 $12.90 $8.03 $2.58 0343 Level II Pathology X 0.45 $22.32 $12.16 $4.46 0344 Level III Pathology X 0.79 $39.18 $23.63 $7.84 0345 Transfusion Laboratory Procedures Level I X 0.22 $10.92 $5.37 $2.18 0346 Transfusion Laboratory Procedures Level II X 0.51 $25.49 $12.03 $5.10 0347 Transfusion Laboratory Procedures Level III X 0.84 $41.90 $20.13 $8.38 0348 Fertility Laboratory Procedures X 0.52 $25.57 $5.11 $5.11 0349 Miscellaneous Laboratory Procedures X 0.48 $23.65 $4.73 $4.73 0354 Administration of Influenza/Pneumonia Vaccine K 0.13 $6.33 0355 Level I Immunizations K 0.19 $9.42 $5.05 $1.88 0356 Level II Immunizations K 0.36 $17.86 $4.82 $3.57 0359 Injections X 0.96 $47.61 $9.52 $9.52 0360 Level I Alimentary Tests X 1.38 $68.44 $34.75 $13.69 0361 Level II Alimentary Tests X 3.53 $175.07 $88.09 $35.01 0362 Fitting of Vision Aids X 0.51 $25.30 $9.63 $5.06 0363 Otorhinolaryngologic Function Tests X 2.83 $140.36 $53.22 $28.07 0364 Level I Audiometry X 0.68 $33.72 $13.31 $6.74 0365 Level II Audiometry X 1.47 $72.91 $22.48 $14.58 0367 Level I Pulmonary Test X 0.83 $41.16 $20.65 $8.23 0368 Level II Pulmonary Tests X 1.66 $82.33 $42.44 $16.47 0369 Level III Pulmonary Tests X 2.34 $116.06 $58.50 $23.21 0370 Allergy Tests X 0.57 $28.27 $11.81 $5.65 0371 Allergy Injections X 0.32 $15.87 $3.67 $3.17 0372 Therapeutic Phlebotomy X 0.43 $21.33 $10.09 $4.27 0373 Neuropsychological Testing X 3.21 $159.20 $44.96 $31.84 0374 Monitoring Psychiatric Drugs X 1.17 $58.03 $13.08 $11.61 0600 Low Level Clinic Visits V 0.98 $48.61 $9.72 $9.72 0601 Mid Level Clinic Visits V 1.00 $49.60 $9.92 $9.92 0602 High Level Clinic Visits V 1.66 $82.33 $16.47 $16.47 0610 Low Level Emergency Visits V 1.34 $66.46 $20.65 $13.29 0611 Mid Level Emergency Visits V 2.11 $104.65 $36.47 $20.93 0612 High Level Emergency Visits V 3.19 $158.21 $54.14 $31.64 0620 Critical Care S 8.60 $426.53 $152.78 $85.31 0701 SR 89 chloride, per mCi G $783.75 $95.62 0702 SM 153 lexidronam, 50 mCi G $942.09 $134.87 0704 IN 111 Satumomab pendetide per dose G $712.50 $86.93 0705 TC 99M tetrofosmin, per dose G $136.80 $16.69 0725 Leucovorin calcium inj, 50 mg G $49.73 $6.66 0726 Dexrazoxane hcl injection, 250 mg G $161.11 $21.59 0727 Etidronate disodium inj 300 mg G $63.65 $8.53 0728 Filgrastim 300 mcg injection G $171.38 $22.96 0730 Pamidronate disodium, 30 mg G $232.51 $31.16 0731 Sargramostim injection 50 mcg G $27.42 $3.67 0732 Mesna injection 200 mg G $36.51 $4.89 0733 Non esrd epoetin alpha inj, 1000 u G $11.40 $1.53 0750 Dolasetron mesylate, 10 mg G $14.81 $1.98 0754 Metoclopramide hcl injection up to 10 mg G $2.00 $0.27 0755 Thiethylperazine maleate inj up to 10 mg G $5.02 $0.67 0761 Unspecified oral anti-emetic G $0.60 $0.08 0762 Dronabinol 2.5mg oral G $3.20 $0.48 0763 Dolasetron mesylate oral, 100 mg G $65.21 $8.74 0764 Granisetron hcl injection 100 mcg G $1.85 $0.25 0765 Granisetron hcl 1 mg oral G $44.70 $5.99 0768 Ondansetron hcl injection 1 mg G $6.09 $0.82 0769 Ondansetron hcl 8mg oral G $25.15 $3.37 0800 Leuprolide acetate, 3.75 mg G $492.71 $63.27 0801 Cyclophosphamide oral 25 mg G $2.12 $0.28 0802 Etoposide oral 50 mg G $45.95 $6.16 0803 Melphalan oral 2 mg G $2.07 $0.28 0807 Aldesleukin/single use vial G $569.76 $76.35 0809 Bcg live intravesical vac G $159.39 $19.45 0810 Goserelin acetate implant 3.6 mg G $446.49 $59.83 0811 Carboplatin injection 50 mg G $98.90 $13.25 0812 Carmus bischl nitro inj 100 mg G $103.27 $13.84 0813 Cisplatin 10 mg injection G $42.18 $5.65 0814 Asparaginase injection 10,000 u G $57.41 $7.69 0815 Cyclophosphamide 100 mg inj G $6.13 $0.82 0816 Cyclophosphamide lyophilized 100 mg G $6.13 $0.82 0817 Cytarabine hcl 100 mg inj G $5.94 $0.80 0818 Dactinomycin 0.5 mg G $12.73 $1.71 0819 Dacarbazine 10 mg inj G $1.13 $0.15 0820 Daunorubicin 10 mg G $80.04 $10.73 0821 Daunorubicin citrate liposom 10 mg G $64.60 $8.66 0822 Diethylstilbestrol injection 250 mg G $4.20 $0.56 0823 Docetaxel, 20 mg G $283.65 $38.01 0824 Etoposide 10 mg inj G $4.06 $0.54 0826 Methotrexate Oral 2.5 mg G $2.92 $0.39 0827 Floxuridine injection 500 mg G $129.56 $17.36 0828 Gemcitabine HCL 200 mg G $88.46 $11.85 0830 Irinotecan injection 20 mg G $117.81 $15.79 0831 Ifosfomide injection 1 gm G $141.50 $18.96 0832 Idarubicin hcl injection 5 mg G $341.38 $45.75 0833 Interferon alfacon-1, 1 mcg G $3.91 $0.52 0834 Interferon alfa-2a inj recombinant 3 million u G $33.22 $4.45 0836 Interferon alfa-2b inj recombinant, 1 million G $11.28 $1.51 0838 Interferon gamma 1-b inj, 3 million u G $199.50 $26.73 0839 Mechlorethamine hcl inj 10 mg G $11.01 $1.48 0840 Melphalan hydrochl 50 mg G $363.48 $48.71 0841 Methotrexate sodium inj 5 mg G $0.45 $0.06 0842 Fludarabine phosphate inj 50 mg G $237.03 $31.76 0843 Pegaspargase, singl dose vial G $1,321.65 $177.10 0844 Pentostatin injection, 10 mg G $1,562.75 $209.41 0847 Doxorubicin hcl 10 mg vl chemo G $15.79 $2.12 0849 Rituximab, 100 mg G $420.29 $56.32 0850 Streptozocin injection, 1 gm G $65.79 $8.82 0851 Thiotepa injection, 15 mg G $100.30 $13.44 0852 Topotecan, 4 mg G $573.75 $76.88 0853 Vinblastine sulfate inj, 1 mg G $4.11 $0.55 0854 Vincristine sulfate 1 mg inj G $30.16 $4.04 0855 Vinorelbine tartrate, 10 mg G $75.51 $10.12 0856 Porfimer sodium, 75 mg G $2,603.67 $348.89 0857 Bleomycin sulfate injection 15 u G $294.48 $39.46 0858 Cladribine, 1mg G $53.47 $7.16 0859 Fluorouracil injection 500 mg G $2.75 $0.37 0860 Plicamycin (mithramycin) inj 2.5 mg G $93.80 $12.57 0861 Leuprolide acetate injection 1 mg G $22.90 $3.07 0862 Mitomycin 5 mg inj G $121.65 $16.30 0863 Paclitaxel injection, 30 mg G $173.50 $23.25 0864 Mitoxantrone hcl, 5 mg G $223.02 $29.88 0865 Interferon alfa-n3 inj, human leukocyte derived, 250,000 iu G $7.86 $1.05 0884 Rho d immune globulin inj, 1 dose pkg G $35.91 $4.38 0886 Azathioprine oral 50mg G $1.24 $0.17 0887 Azathioprine parenteral 100 mg G $67.88 $9.10 0888 Cyclosporine oral 100 mg G $5.80 $0.78 0889 Cyclosporin parenteral 250mg G $15.81 $2.12 0890 Lymphocyte immune globulin 250 mg G $249.13 $30.39 0891 Tacrolimus oral per 1 mg G $2.66 $0.36 0900 Alglucerase injection, per 10 u G $37.53 $5.03 0901 Alpha 1 proteinase inhibitor, 10 mg G $2.09 $0.28 0902 Botulinum toxin a, per unit G $4.39 $0.59 0903 Cytomegalovirus imm IV, vial G $370.50 $49.65 0905 Immune globulin 500 mg G $27.28 $3.33 0906 RSV-ivig, 50 mg G $427.73 $57.32 0907 Ganciclovir Sodium 500 mg injection K 0.45 $22.26 $4.45 0908 Tetanus immune globulin inj up to 250 u G $102.60 $13.75 0909 Interferon beta-1a, 33 mcg G $204.73 $27.43 0910 Interferon beta-1b, .25 mg G $57.00 $7.64 0911 Streptokinase per 250,000 iu K 1.76 $87.25 $17.45 0913 Ganciclovir long act implant 4.5 mg G $4,750.00 $636.50 0914 Reteplase, per 37.6mg G $2,612.50 $350.08 0915 Alteplase inj rec, per 10 mg K 3.80 $188.46 $37.69 0916 Imiglucerase, unit G $3.75 $0.50 0917 Pharmacologic stressors K 0.36 $17.86 $3.57 0918 Brachytherapy Seeds, Any type, Each H 0925 Factor viii per iu G $0.88 $0.12 0926 Factor VIII (porcine) per iu G $2.09 $0.28 0927 Factor viii recombinant per iu G $1.17 $0.16 0928 Factor ix complex per iu G $.71 $0.10 0929 Anti-inhibitor per iu G $1.43 $0.19 0930 Antithrombin iii injection per iu G $.82 $0.11 0931 Factor IX non-recombinant, per iu G $0.72 $0.10 0932 Factor IX recombinant, per iu G $1.12 $0.10 0949 Plasma, Pooled Multiple Donor, Solvent/Detergent Treated, Frozen K 2.94 $145.76 $29.15 0950 Blood (Whole) For Transfusion K 2.08 $103.33 $20.67 0952 Cryoprecipitate K 0.70 $34.70 $6.94 0953 Fibrinogen Unit K 0.48 $23.80 $4.76 0954 RBC Leukocytes Reduced K 2.83 $140.35 $28.07 0955 Plasma, Fresh Frozen K 2.26 $111.85 $22.37 0956 Plasma Protein Fraction K 1.26 $62.49 $12.50 0957 Platelet Concentrate K 0.98 $48.55 $9.71 0958 Platelet Rich Plasma K 1.16 $57.54 $11.51 0959 Red Blood Cells K 2.04 $101.31 $20.26 0960 Washed Red Blood Cells K 3.81 $188.75 $37.75 0961 Infusion, Albumin (Human) 5%, 500 ml K 2.77 $137.38 $27.48 0962 Infusion, Albumin (Human) 25%, 50 ml K 1.38 $68.44 $13.69 0970 New Technology— I ($0-$50) T 0.52 $25.79 $5.16 0971 New Technology— II ($50-$100) S 1.55 $76.88 $15.38 0972 New Technology— III ($100-$200) T 3.09 $153.26 $30.65 0973 New Technology— IV ($200-$300) T 5.16 $255.91 $51.18 0974 New Technology— V ($300-$500) S 8.25 $409.17 $81.83 0975 New Technology— VI ($500-$750) T 12.90 $639.79 $127.96 0976 New Technology— VII ($750-$1000) S 18.05 $895.21 $179.04 0977 New Technology— VIII ($1000-$1250) T 23.20 $1,150.63 $230.13 0978 New Technology— IX ($1250-$1500) T 28.36 $1,406.54 $281.31 0979 New Technology— X ($1500-$1750) T 33.51 $1,661.96 $332.39 0980 New Technology— XI ($1750-$2000) T 38.67 $1,917.89 $383.58 0981 New Technology— XII ($2000-$2500) S 46.40 $2,301.26 $460.25 0982 New Technology— XIII ($2500-$3500) T 61.87 $3,068.50 $613.70 0983 New Technology— XIV ($3500-$5000) T 87.65 $4,347.09 $869.42 0984 New Technology— XV ($5000-$6000) T 113.43 $5,625.67 $1,125.13 0987 New Device Technology— I ($0-$250) X $127.86 $25.57 0988 New Device Technology— II ($250-$500) X $383.58 $76.72 0989 New Device Technology— III ($500-$750) X $639.30 $127.86 0990 New Device Technology— IV ($750-$1000) X $895.01 $179.00 0991 New Device Technology— V ($1000-$1500) X $1,278.59 $255.72 0992 New Device Technology— VI ($1500-$2000) X $1,790.03 $358.01 0993 New Device Technology— VII ($2000-$3000) X $2,557.18 $511.44 0994 New Device Technology— VIII ($3000-$4000) X $3,580.05 $716.01 0995 New Device Technology— IX ($4000-$5000) X $4,602.92 $920.58 0996 New Device Technology— X ($5000-$7000) X $6,137.23 $1,227.45 0997 New Device Technology— XI ($7000-$9000) X $8,182.98 $1,636.60 1000 Perclose Closer Prostar Arterial Vascular Closure H 1001 AcuNav-diagnstic ultrsnd ca H 1002 Cochlear Implant System H 1003 Cath, ablation, Livewire TC H 1004 Fast-Cath,Swartz,SAFL,CSTA H 1006 ARRAY post chamb IOL H 1007 Ams 700 penile prosthesis H 1008 Urolume-implt urethral stent H 1009 Plasma, cryoprecipitate-reduced, unit K 0.86 $42.76 $8.55 1010 Blood, L/R, CMV-neg K 2.88 $142.84 $28.57 1011 Platelets, L/R, CMV-neg, unit K 11.86 $588.15 $117.63 1012 Platelet concentrate, L/R, irradiated, unit K 1.92 $95.23 $19.05 1013 Platelet concentrate, L/R, unit K 1.18 $58.30 $11.66 1014 Platelets, aph/pher, L/R, unit K 8.93 $443.11 $88.62 1016 Blood, L/R, froz/deglycerol/washed K 7.15 $354.68 $70.94 1017 Platelets, aph/pher, L/R, CMV-neg, unit K 9.33 $462.54 $92.51 1018 Blood, L/R, irradiated K 3.13 $155.48 $31.10 1019 Platelets, aph/pher, L/R, irradiated, unit K 9.64 $478.09 $95.62 1024 Quinupristin 150 mg/dalfopriston 350 mg J $102.05 $13.67 1025 Marinr CS catheter H 1026 RF Perfrmr cath 5F RF Marinr H 1027 Magic x/short, Radius14mm H 1028 Prcis Twst trnsvg anch sys H 1029 CRE guided balloon dil cath H 1030 Cthtr:Mrshal,Blu Max Utr Dmnd H 1033 Sonicath mdl 37-410 H 1034 SURPASS, Long30 SURPASS-cath H 1035 Cath, Ultra ICE H 1036 R port/reservoir impl dev H 1037 Vaxcelchronic dialysis cath H 1038 UltraCross Imaging Cath H 1039 Wallstent/RP: Trach H 1040 Wallstent/RP TIPS—20/40/60 H 1042 Wallstent, UltraFlex: Bil H 1043 Atherectomy sys, coronary H 1045 I-131 MIBG (ioben-sulfate) O.5mCi G $1,140.00 $139.08 1047 Navi-Star, Noga-Star cath H 1048 NeuroCyberneticPros: gen H 1051 Oasis Thrombectomy Cath H 1053 EnSite 3000 catheter H 1054 Hydrolyser Thromb Cath 6/7F H 1055 Transesoph 210, 210-S Cath H 1056 Thermachoice II Cath H 1057 Micromark Tissue Marker H 1059 Carticel,auto cult-chndr cyte G $14,250.00 $2,010.00 1060 ACS multi-link tristor stent H 1061 ACS Viking Guiding cath H 1063 EndoTak Endurance EZ, RX leads H 1067 Megalink biliary stent H 1068 Pulsar DDD pmkr H 1069 Discovery DR, pmaker H 1071 Pulsar Max, Pulsar SR pmkr H 1072 Guidant: blln dil cath H 1073 Gynecare Morcellator H 1074 RX/OTW Viatrac-peri dil cath H 1075 Guidant: lead H 1076 Ventak mini sc defib H 1077 Ventak VR Prizm VR, sc defib H 1078 Ventak: Prizm, AVIIIDR defib H 1079 CO 57/58 0.5 mCi G $264.10 $32.22 1084 Denileukin diftitox, 300 mcg G $942.88 $126.35 1086 Temozolomide, 5 mg G $5.70 $0.76 1087 I-123 per uCi capsule G $0.84 $0.10 1089 CO 57, 0.5 mCi G $91.20 $11.13 1090 IN 111 Chloride, per mCi G $152.00 $18.54 1091 IN 111 Oxyquinoline, per 5 mCi G $508.25 $62.01 1092 IN 111 Pentetate, per 1.5 mCi G $769.50 $93.88 1094 TC 99M Albumin aggr, per vial J $34.20 $4.17 1095 TC 99M Depreotide, per vial G $760.00 $101.84 1096 TC 99M Exametazime, per dose G $445.31 $63.75 1097 TC 99M Mebrofenin, per vial G $46.76 $5.71 1098 TC 99M Pentetate, per vial G $22.80 $2.78 1099 TC 99M Pyrophosphate, per vial J $42.75 $5.22 1100 Medtronic AVE GT1 guidewire H 1101 Medtronic AVE, AVE Z2 cath H 1102 Synergy Neurostim Genrtr H 1103 Micro Jewel Defibrillator H 1104 RF Conductor Ablative Cath H 1105 Sigma 300VDD pacmker H 1106 SynergyEZ Pt Progrmr H 1107 Torqr, Solist cath H 1108 Reveal Cardiac Recorder H 1109 Implantable anchor: Ethicon H 1110 Stable Mapper, cath electrd H 1111 AneuRxAort-Uni-Ilicstnt&cath H 1112 AneuRx Stent graft/del.cath H 1113 Tlnt Endo Sprng Stnt Grft Sys H 1114 TalntSprgStnt+Graf endo pros H 1115 5038S,5038,5038L pace lead H 1116 CapSureSP pacing Lead H 1117 Ancure Endograft Del Sys H 1118 Sigma300DR LegIIDR,pacemkr H 1119 Sprint6932,6943 defib lead H 1120 Sprint6942,6945 defib lead H 1121 Gem defibrillator H 1122 TC 99M arcitumomab per dose G $926.25 $124.12 1123 Gem II VR defibrillator H 1124 InterStim Test Stim Kit H 1125 Kappa 400SR,Ttopaz II SR pmkr H 1126 Kappa 700 DR pacemakr H 1127 Kappa 700SR,pmkr sgl chamber H 1128 Kappa 700D,Ruby IID pmkr H 1129 Kappa 700VDD,pacmkr H 1130 Sigma 200D,LGCY IID sc pmkr H 1131 Sigma 200DR, pmker H 1132 Sigma 200SR Leg II:sc pac H 1133 Sigma SR, Vita SR, pmaker H 1134 Sigma 300D pmker H 1135 Entity DR 5326L/R, DC, pmkr H 1136 Affinity DR 5330L/R, DC, pmkr H 1137 CardioSEAL implant syst H 1143 AddVent mod 2060BL,VDD H 1144 Afnty SP 5130,Integrity SR,pmkr H 1145 Angio-Seal 6fr, 8fr H 1147 AV Plus DX 1368: lead H 1148 Contour MD sc defib H 1149 Entity DC 5226R-pmker H 1151 Passiveplus DX lead, 10mdls H 1152 LifeSite Access System H 1153 Regency SC+ 2402L pmker H 1154 SPL:SPOI,02,04− defib lead H 1155 Repliform 8 sq cm H 1156 Tr 1102TrSR+ 2260L,2264L,5131 H 1157 Trilogy DCT 23/8L pmkr H 1158 TVL lead SV01,SV02,SV04 H 1159 TVL RV02,RV06,RV07: lead H 1160 TVL-ADX 1559: lead H 1161 Tendril DX, 1388 pacing lead H 1162 TempoDr, TrilogyDR+DC pmkr H 1163 Tendril SDX, 1488T pacing lead H 1164 Iodine-125 brachytx seed H 1166 Cytarabine liposomal, 10 mg G $371.45 $49.77 1167 Epirubicin hcl, 2 mg J $24.94 $3.34 1171 Autosuture site marker stple H 1172 Spacemaker dissect ballon H 1173 Cor stntS540,S670,o-wire stn H 1174 Bard brachytx needle H 1178 Busulfan IV, 6 mg G $26.48 $3.55 1180 Vigor SR, SC, pmkr H 1181 Meridian SSI, SC, pmkr H 1182 Pulsar SSI, SC, pmkr H 1183 Jade IIS, Sigma 300S,SC, pmkr H 1184 Sigma 200S, SC, pmkr H 1188 I 131, per mCi G $5.86 $0.75 1200 TC 99M Sodium Glucoheptonate, per vial G $113.05 $13.79 1201 TC 99M succimer, per vial G $135.66 $16.55 1202 TC 99M Sulfur Colloid, per dose G $38.00 $4.64 1203 Verteporfin for Injection G $1,458.25 $195.41 1205 TC 99M Disofenin, per vial G $427.50 $57.29 1207 Octreotide acetate depot 1mg G $135.10 $16.48 1302 SQ01: lead H 1303 CapSure Fix 6940/4068-110, lead H 1304 Sonicath mdl 37-416,-418 H 1305 Apligraf G $1,157.81 $163.31 1306 NeuroCyberneticPros: lead H 1311 Trilogy DR+/DAO pmkr H 1312 Magic WALLSTENT stent-Mini H 1313 Magic medium, Radius 31mm H 1314 Magic WALLSTENT stent-Long H 1315 Vigor DR, Meridian DR pmkr H 1316 Meridian DDD pmkr H 1317 Discovery SR, pmkr H 1318 Meridian SR pmakr H 1319 Wallstent/RP Enteral--60mm H 1320 Wallstent/RP Iliac Del Sys H 1325 Pallidium −103 seed H 1326 Angio-jet rheolytic thromb cath H 1328 ANS Renew NS trnsmtr H 1333 PALMZA Corinthian bill stent H 1334 Crown,Mini-crown,CrossLC H 1335 Mesh, Prolene H 1336 Constant Flow Imp Pump H 1337 IsoMed 8472-20/35/60 H 1348 I 131 per mCi solution G $146.57 $17.88 1350 Prosta/OncoSeed, RAPID strand, I-125 H 1351 CapSure(Fix)pacing lead H 1352 Gem II defib H 1353 Itrel Interstm neurostim+ext H 1354 Kappa 400DR,Diamond II 820DR H 1355 Kappa 600DR, Vita DR H 1356 Profile MD V-186HV3 sc defib H 1357 Angstrom MD V-190HV3 sc defib H 1358 Affinity DC 5230R-Pacemaker H 1359 Pulsar,Pulsar Max DR,pmkr H 1363 Gem DR, DC, defib H 1364 Photon DR V-230HV3 DC defib H 1365 Guidewire, Hi-Torque14/18/35 H 1366 Guidewire,PTCA, Hi-Torque H 1367 Guidewire, Hi-Torque CrossIt H 1369 ANS Renew Stim Sys recvr H 1370 Tension-Free Vaginal Tape H 1371 Symp Nitinol Transhep Bil Sys H 1372 Cordis Nitinol bil stent H 1375 Stent, coronary, NIR H 1376 ANS Renew Stim Sys lead H 1377 Specify 3988 neuro lead H 1378 InterStim Tx 3080/3886 lead H 1379 Pisces-Quad 3887 lead H 1400 Diphenhydramine hcl 50mg G $1.18 $.16 1401 Prochlorperazine maleate 5mg G $1.31 $.18 1402 Promethazine hcl 12.5mg oral G $.03 $.00 1403 Chlorpromazine hcl 10mg oral G $.55 $.07 1404 Trimethobenzamide hcl 250mg G $.36 $.05 1405 Thiethylperazine maleate10mg G $.69 $.09 1406 Perphenazine 4mg oral G $.71 $.10 1407 Hydroxyzine pamoate 25mg G $.20 $.03 1409 Factor viia recombinant, per 1.2 mg G $1,596.00 $213.86 1410 Prosorba column H 1411 Herculink,OTW SDS bil stent H 1420 StapleTac2 Bone w/Dermis H 1421 StapleTac2 Bone wo Dermis H 1450 Orthosphere Arthroplasty H 1451 Orthosphere Arthroplasty Kit H 1500 Atherectomy sys, peripheral H 1600 TC 99M sestamibi, per syringe G $109.25 $13.33 1601 TC 99M medronate, per dose G $38.38 $4.68 1602 TC 99M apcitide, per vial G $47.50 $5.80 1603 TL 201, mCi G $28.50 $3.48 1604 IN 111 capromab pendetide, per dose G $1,008.90 $135.19 1605 Abciximab injection, 10 mg G $513.02 $68.74 1606 Anistreplase, 30 u G $2,693.80 $360.97 1607 Eptifibatide injection, 5 mg G $12.57 $1.68 1608 Etanercept injection, 25 mg G $134.42 $18.01 1609 Rho(D) immune globulin h, sd, 100 iu G $20.55 $2.51 1611 Hylan G-F 20 injection, 16 mg G $204.87 $27.45 1612 Daclizumab, parenteral, 25 mg G $397.29 $53.24 1613 Trastuzumab, 10 mg G $48.85 $6.55 1614 Valrubicin, 200 mg G $423.23 $56.71 1615 Basiliximab, 20 mg G $1,250.01 $167.50 1616 Histrelin Acetate, 0.5 mg G $14.91 $2.00 1617 Lepirdin, 50 mg G $124.49 $16.68 1618 Von Willebrand factor, per iu G $.95 $.13 1619 Ga 67, per mCi G $25.97 $3.17 1620 TC 99M Bicisate, per vial G $417.53 $55.95 1621 Xe 133, per mCi G $28.50 $3.66 1622 TC 99M Mertiatide, per vial G $185.82 $24.90 1623 TC 99M Gluceptate G $22.61 $2.76 1624 P32 sodium, per mCi G $74.10 $9.04 1625 IN 111 Pentetreotide, per mCi G $283.42 $37.98 1626 TC 99M Oxidronate, per vial G $38.38 $4.68 1627 TC-99 labeled red blood cell, per test G $38.95 $4.75 1628 P32 phosphate chromic, per mCi G $137.12 $16.73 1700 Authen Mick TP brachy needle H 1701 Medtec MT-BT-5201-25 ndl H 1702 WWMT brachytx needle H 1703 Mentor Prostate Brachy H 1704 MT-BT-5001-25/5051-25 H 1705 Best Flexi Brachy Needle H 1706 Indigo Prostate Seeding Ndl H 1707 Varisource Implt Ndl H 1708 UroMed Prostate Seed Ndl H 1709 Remington Brachytx Needle H 1710 US Biopsy Prostate Needle H 1711 MD Tech brachytx needle H 1712 Imagyn brachytx needle H 1790 Iridium 192 HDR H 1791 OncoSeed, Rapid Strand I-125 H 1792 UroMed I-125 Brachy seed H 1793 Bard InterSource P-103 seed H 1794 Bard IsoSeed P-103 seed H 1795 Bard BrachySource I-125 H 1796 SourceTech Med I-125 H 1797 Draximage I-125 seed H 1798 Syncor I-125 PharmaSeed H 1799 I-Plant I-125 Brachytx seed H 1800 Pd-103 brachytx seed H 1801 IoGold I-125 brachytx seed H 1802 Iridium 192 brachytx seeds H 1803 Best Iodine 125 brachytx sds H 1804 Best Palladium 103 seeds H 1805 IsoStar Iodine-125 seeds H 1806 Gold 198 H 1810 D114S Dilatation Cath H 1811 Surgical Dynamics Anchors H 1812 OBL Anchors H 1850 Repliform 14/21 sq cm H 1851 Repliform 24/28 sq cm H 1852 TransCyte, per 247 sq cm H 1853 Suspend, per 8/14 sq cm H 1854 Suspend, per 24/28 sq cm H 1855 Suspend, per 36 sq cm H 1856 Suspend, per 48 sq cm H 1857 Suspend, per 84 sq cm H 1858 DuraDerm, per 8/14 sq cm H 1859 DuraDerm, per 21/24/28 sq cm H 1860 DuraDerm, per 48 sq cm H 1861 DuraDerm, per 36 sq cm H 1862 DuraDerm, per 72 sq cm H 1863 DuraDerm, per 84 sq cm H 1864 SpermaTex, per 13.44 sq cm H 1865 FasLata, per 8/14 sq cm H 1866 FasLata, per 24/28 sq cm H 1867 FasLata, per 36/48 sq cm H 1868 FasLata, per 96 sq cm H 1869 Gore Thyroplasty Dev H 1870 DermMatrix, per 16 sq cm H 1871 DermMatrix, 32 or 64 sq cm H 1872 Dermagraft, per 37.5 sq cm H 1873 Bard 3DMax Mesh H 1929 Maverick PTCA Cath H 1930 Coyote Dil Cath, 20/30/40mm H 1931 Talon Dil Cath H 1932 Scimed Remedy Dil Cath H 1933 Opti-Plast XL/Centurion Cath H 1934 Ultraverse 3.5F Bal Dil Cath H 1935 Workhorse PTA Bal Cath H 1936 Uromax Ultra Bal Dil Cath H 1937 Synergy Balloon Dil Cath H 1938 UroForce Bal Dil Cath H 1939 Raptur, Ninja PTCA Dil Cath H 1940 PowerFlex,OPTA 5/LP Bal Cath H 1941 Jupiter PTA Dil Cath H 1942 Cordis Maxi LD PTA Bal Cath H 1943 RXCrossSail OTW OpenSail H 1944 Rapid Exchange Bil Dil Cath H 1945 Savvy PTA Dil Cath H 1946 R1s Rapid Dil Cath H 1947 Gazelle Bal Dil Cath H 1948 Pursuit Balloon Cath H 1949 Oracle Megasonics Cath H 1979 Visions PV/Avanar US Cath H 1980 Atlantis SR Coronary Cath H 1981 PTCA Catheters H 2000 Orbiter ST Steerable Cath H 2001 Constellation Diag Cath H 2002 Irvine 5F Inquiry Diag EP Cath H 2003 Irvine 6F Inquiry Diag EP Cath H 2004 Biosense EP Cath—Octapolar H 2005 Biosense EP Cath—Hexapolar H 2006 Biosense EP Cath—Decapolar H 2007 Irvine 6F Luma-Cath EP Cath H 2008 7F Luma-Cath EP Cath 81910-15 H 2009 Irvine 7F Luma-Cath EP Cath H 2010 Fixed Curve EP Cath H 2011 Deflectable Tip Cath—Quad H 2012 Celsius Abln Cath H 2013 Celsius Large Abln Cath H 2014 Celsius II Asym Abln Cath H 2015 Celsius II Sym Abln Cath H 2016 Navi-Star DS, Navi-Star Ther H 2017 Navi-Star Abln Cath H 2018 Polaris T Ablation Cath H 2019 EP Deflectable Cath H 2020 Blazer II XP Abln Cath H 2021 SilverFlex EP Cath H 2022 CP Chilli Cooled Abln Cath H 2023 Chilli Cld AblnCath-std, lg H 2100 CP CS Reference Cath H 2101 CP RV Reference Cath H 2102 CP Radii 7F EP Cath H 2103 CP Radii 7F EP Cath w/Track H 2104 Lasso Deflectable Cath H 2151 Veripath Guiding Cath H 2152 Cordis Vista Brite Tip Cath H 2153 Bard Viking Cath H 2200 Arrow-Trerotola PTD Cath H 2300 Varisource Stnd Catheters H 2597 CliniCath/kit 16/18 sgl/dbl H 2598 CliniCath 18/20/24G-single H 2599 CliniCath 16/18G-double H 2601 Bard DL Ureteral Cath H 2602 Vitesse Laser Cath 1.4/1.7mm H 2603 Vitesse Laser Cath 2.0mm H 2604 Vitesse E Laser Cath 2.0mm H 2605 Extreme Laser Catheter H 2606 SpineCath XL Catheter H 2607 SpineCath Intradiscal Cath H 2608 Scimed 6F Wiseguide Cath H 2609 Flexima Bil Drainage Cath H 2610 FlexTipPlus Intraspinal Cath H 2611 AlgoLine Intraspinal Cath H 2612 InDura Catheter H 2700 MycroPhylax Plus SC defib H 2701 Phylax XM SC defib H 2702 Ventak Prizm 2 VR Defib H 2703 Ventak Prizm VR HE Defib H 2704 Ventak Mini IV+ Defib H 2801 Defender IV DR 612 DC defib H 2802 Phylax AV DC defib H 2803 Ventak Prizm DR HE Defib H 2804 Ventak Prizm 2 DR Defib H 2805 Jewel AF 7250 Defib H 2806 GEM VR 7227 Defib H 2807 Contak CD 1823 H 2808 Contak TR 1241 H 3002 EasyTrak Defib Lead H 3001 Kainox SL/RV defib lead H 3003 Endotak SQ Array XP lead H 3004 Intervene Defib Lead H 3400 Siltex Spectrum, Contour Prof H 3401 Saline-Filled Spectrum H 3500 Mentor Alpha I Inf Penile Pros H 3510 AMS 800 Urinary Pros H 3551 Choice/PT Graphix/Luge/Trooper H 3552 Hi-Torque Whisper H 3553 Cordis guidewires H 3554 Jindo guidewire H 3555 Wholey Hi-Torque Plus GW H 3556 Wave/FlowWire Guidewire H 3557 HyTek guidewire H 3800 SynchroMed EL infusion pump H 3801 Arrow/MicroJect PCA Sys H 3851 Elastic UV IOL AA-4203T/TF/TL H 4000 Opus G 4621, 4624 SC pmkr H 4001 Opus S 4121/4124 SC pmkr H 4002 Talent 113 SC pmkr H 4003 Kairos SR SC pmkr H 4004 Actros SR, Actros SLR SC pmkr H 4005 Philos SR/SR-B SC pmkr H 4006 Pulsar Max II SR pmkr H 4007 Marathon SR pmkr H 4008 Discovery II SSI pmkr H 4009 Discovery II SR pmkr H 4300 Integrity AFx DR 5342 pmkr H 4301 Integrity AFx DR 5346 pmkr H 4302 Affinity VDR 5430 pmkr H 4303 Brio 112 DC pmkr H 4304 Brio 212, Talent 213/223 DC pmkr H 4305 Brio 222 DC pmkr H 4306 Brio 220 DC pmkr H 4307 Kairos DR DC pmkr H 4308 Inos2, Inos2+ DC pmkr H 4309 Actros DR,D,DR-A,SLR DC pmkr H 4310 Actros DR-B DC pmkr H 4311 Philos DR/DR-B/SLR DC pmkr H 4312 Pulsar Max II DR pmkr H 4313 Marathon DR pmkr H 4314 Momentum DR pmkr H 4315 Selection AFm pmkr H 4316 Discovery II DR H 4317 Discovery II DDD H 4600 Snynox,Polyrox,Elox,Retrox H 4602 Tendril SDX, 1488K pmkr lead H 4603 Oscor/Flexion pmkr lead H 4604 CrystallineActFix,CapsureFix H 4605 CapSure Epi pmkr lead H 4606 Flextend pmkr lead H 4607 FinelineII/EZ, ThinlineII/EZ H 5000 BX Velocity w/Hepacoat H 5001 Memotherm Bil Stent, sm, med H 5002 Memotherm Bil Stent, large H 5003 Memotherm Bil Stent, x-large H 5004 PalmazCorinthian IQ Bil Stent H 5005 PalmazCorinthian IQ Trans/Bil H 5006 PalmazTrans Bil Stent Sys-Med H 5007 PalmazTrans XL Bil Stent--40mm H 5008 PalmazTrans XL Bil Stent--50mm H 5009 VistaFlex Biliary Stent H 5010 Rapid Exchange Bil Stent Sys H 5011 IntraStent, IntraStent LP H 5012 IntraStent DoubleStrut LD H 5013 IntraStent DoubleStrut, XS H 5014 AVE Bridge Stent Sys-10/17/28 H 5015 AVE/X3 Bridge Sys, 40-100 H 5016 Biliary stent single use cov H 5017 WallstentRP Bil--20/40/60/68mm H 5018 WallstentRP Bil--80/94mm H 5019 Flexima Bil Stent Sys H 5020 Smart Nitinol Stent--20mm H 5021 Smart Nitinol Stent--40/60mm H 5022 Smart Nitinol Stent--80mm H 5023 BX Velocity Stent--8/13mm H 5024 BX Velocity Stent--18mm H 5025 BX Velocity Stent--23mm H 5026 BX Velocity Stent--28/33mm H 5027 BX Velocity w/Hep--8/13mm H 5028 BX Velocity w/Hep--18mm H 5029 BX Velocity w/Hep--23mm H 5030 Stent, coronary, S660 9/12mm H 5031 Stent,coronary, S660 15/18mm H 5032 Stent,coronary, S660 24/30mm H 5033 Niroyal Stent Sys, 9mm H 5034 Niroyal Stent Sys, 12/15mm H 5035 Niroyal Stent Sys, 18mm H 5036 Niroyal Stent Sys, 25mm H 5037 Niroyal Stent Sys, 31mm H 5038 BX Velocity Stent w/Raptor H 5039 IntraCoil Periph Stent--40mm H 5040 IntraCoil Periph Stent--60mm H 5041 BeStent Over-the-Wire 24/30mm H 5042 BeStent Over-the-Wire 18mm H 5043 BeStent Over-the-Wire 15mm H 5044 BeStent Over-the-Wire 9/12mm H 5045 Multilink Tetra Cor Stent Sys H 5046 Radius 20mm cor stent H 5047 Niroyal Elite Cor Stent Sys H 5048 GR II Coronary Stent H 5130 Wilson-Cook Colonic Z-Stent H 5131 Bard Colorectal Stent-60mm H 5132 Bard Colorectal Stent-80mm H 5133 Bard Colorectal Stent-100mm H 5134 Enteral Wallstent—90mm H 5279 Contour/Percuflex Stent H 5280 Inlay Dbl Ureteral Stent H 5281 Wallgraft Trach Sys 70mm H 5282 Wallgraft Trach Sys 20/30/50 H 5283 Wallstent/RP TIPS—80mm H 5284 Wallstent TrachUltraFlex H 5600 Closure dev, VasoSeal ES H 5601 VasoSeal Model 1000 H 6001 Composix Mesh 8/21 in H 6002 Composix Mesh 32 in H 6003 Composix Mesh 48 in H 6004 Composix Mesh 80 in H 6005 Composix Mesh 140 in H 6006 Composix Mesh 144 in H 6012 Pelvicol Collagen 8/14 sq cm H 6013 Pelvicol Collagen 21/24/28 sq cm H 6014 Pelvicol Collagen 36 sq cm H 6015 Pelvicol Collagen 48 sq cm H 6016 Pelvicol Collagen 96 sq cm H 6017 Gore-Tex DualMesh 75/96 sq cm H 6018 Gore-Tex DualMesh 150 sq cm H 6019 Gore-Tex DualMesh 285 sq cm H 6020 Gore-Tex DualMesh 432 sq cm H 6021 Gore-Tex DualMesh 600 sq cm H 6022 Gore-Tex DualMesh 884 sq cm H 6023 Gore-TexPlus 1mm, 75/96sq cm H 6024 Gore-TexPlus 1mm, 150sq cm H 6025 Gore-TexPlus 1mm, 285sq cm H 6026 Gore-TexPlus 1mm, 432sq cm H 6027 Gore-TexPlus 1mm, 600sq cm H 6028 Gore-TexPlus 1mm, 884 sq cm H 6029 Gore-TexPlus 2mm, 150 sq cm H 6030 Gore-TexPlus 2mm, 285 sq cm H 6031 Gore-TexPlus 2mm, 432 sq cm H 6032 Gore-TexPlus 2mm, 600 sq cm H 6033 Gore-TexPlus 2mm, 884 sq cm H 6034 Bard ePTFE: 150 sq cm--2mm H 6035 Bard ePTFE 150 sqcm-1mm,75-2mm H 6036 Bard ePTFE: 50/75 sqcm-1,2mm H 6037 Bard ePTFE: 300 sq cm-1,2mm H 6038 Bard ePTFE: 600 sq cm-1mm H 6039 Bard ePTFE: 884 sq cm-1mm H 6040 Bard ePTFE: 600 sq cm-2mm H 6041 Bard ePTFE: 884 sq cm-2mm H 6050 Female Sling Sys w/wo Matrl H 6051 Stratasis Sling, 20/40 cm H 6052 Stratasis Sling, 60 cm H 6053 Surgisis Soft Graft H 6054 Surgisis Enhanced Graft H 6055 Surgisis Enhanced Tissue H 6056 Surgisis Soft Tissue Graft H 6057 Surgisis Hernia Graft H 6058 SurgiPro Hernia Plug, med/lg H 6080 Male Sling Sys w/wo Matrl H 6200 Exxcel Sft ePTFE vas graft H 6201 Impra Venaflo--10/20cm H 6202 Impra Venaflo-30/40cm H 6203 Impra Venaflo-50cm,vt45 H 6204 Impra Venaflo-stepped H 6205 Impra Carboflo—10cm H 6206 Impra Carboflo—20cm H 6207 Impra Carboflo—30/35/40cm H 6208 Impra Carboflo—40/50cm H 6209 Impra Carboflo—ctrflex H 6210 Exxcel ePTFE vas graft H 6300 Vanguard III Endovas Graft H 6500 Preface Guiding Sheath H 6501 Soft Tip Sheaths H 6502 Perry Exchange Dilator H 6525 Spectranetics Laser Sheath H 6600 Micro Litho Flex Probes H 6650 Fast-Cath Guiding Introducer H 6651 Seal-AwayGuiding Introducer H 6652 Bard Excalibur Introducer H 6700 Focal Seal-L H 7000 Amifostine, 500 mg G $350.31 $46.94 7001 Amphotericin B lipid complex, 50 mg G $95.00 $12.73 7003 Epoprostenol injection 0.5 mg G $16.53 $2.22 7004 Immune globulin 5 gms G $272.80 $33.28 7005 Gonadorelin hydroch, 100 mcg G $14.80 $1.98 7007 Milrinone lactate, per 5 ml, inj K 0.47 $23.31 $4.66 7010 Morphine sulfate (preservative free) 10 mg G $7.41 $.99 7011 Oprelvekin injection, 5 mg G $236.31 $31.67 7014 Fentanyl citrate inj up 2 ml G $0.98 $0.13 7015 Busulfan, oral, 2 mg G $1.73 $0.23 7019 Aprotinin, 10,000 kiu G $196.35 $26.31 7022 Elliot's B solution, per ml G $14.25 $1.91 7023 Treatment for bladder calculi, per 500 ml G $23.54 $3.15 7024 Corticorelin ovine triflutate, per 0.1 mg G $353.88 $45.77 7025 Digoxin immune FAB (Ovine), 40 mg vial G $530.44 $64.71 7026 Ethanolamine oleate, 100 mg G $27.21 $3.65 7027 Fomepizole, 1.5 mg G $728.33 $97.60 7028 Fosphenytoin, 50 mg G $8.55 $1.15 7029 Glatiramer acetate, 20 mg G $27.40 $3.67 7030 Hemin, 1 mg G $0.90 $0.12 7031 Octreotide acetate injection 1mg G $115.34 $15.46 7032 Sermorelin acetate, 0.5 mg G $15.78 $2.11 7033 Somatrem, 5 mg G $199.50 $26.73 7034 Somatropin, 1 mg (any derivation) G $39.90 $5.35 7035 Teniposide, 50 mg G $195.28 $26.17 7036 Urokinase, inj, IV, 250,000 I.U. K 6.78 $336.29 $67.26 7037 Urofollitropin, 75 I.U. G $69.73 $9.34 7038 Muromonab-CD3, 5 mg G $741.00 $99.29 7039 Pegademase bovine inj 25 I.U G $139.33 $18.67 7040 Pentastarch 10% inj, 100 ml G $15.11 $2.04 7041 Tirofiban hydrochloride 12.5 mg G $399.00 $53.47 7042 Capecitabine, oral, 150 mg G $1.94 $0.26 7043 Infliximab injection 10 mg G $58.08 $7.78 7045 Trimetrexate glucoronate 25 mg G $69.83 $9.36 7046 Doxorubicin hcl liposome inj 10 mg G $311.72 $41.77 7047 Droperidol/fentanyl inj G $7.02 $0.90 7048 Alteplase, 1 mg K 0.38 $18.70 $3.74 7049 Filgrastim 480 mcg injection G $273.03 $35.06 7315 Sodium hyaluronate, 20 mg G $125.59 $16.83 8099 Spectranetics Lead Lock Dev H 8100 Adhesion barrier, ADCON-L H 8102 SurgiVision Esoph Coil H 9000 Na chromate Cr51, per 0.25mCi G $259.36 $34.75 9001 Linezolid inj, 200mg J $34.14 $4.57 9002 Tenecteplase, 50mg/vial J $2,612.50 $350.08 9003 Palivizumab, per 50mg J $664.49 $89.04 9004 Gemtuzumab ozogamicin inj,5mg J $1,929.69 $258.58 9005 Reteplase inj, half-kit, 18.8 mg/vial G $1,306.25 $175.04 9006 Tacrolimus inj, per 5mg (1 amp) J $109.83 $14.72 9007 Baclofen Intrathecal kit-1amp G $79.80 $10.69 9008 Baclofen Refill Kit—500mcg G $222.30 $29.79 9009 Baclofen Refill Kit—2000mcg G $467.40 $62.63 9010 Baclofen Refill Kit—4000mcg G $820.80 $109.99 9011 Caffeine Citrate, inj, 1ml G $12.22 $1.57 9100 Iodinated I-131 Albumin G $246.05 $30.02 9102 51 Na chromate, 50mCi G $216.60 $26.43 9103 Na Iothalamate I-125, 10uCi G $12.27 $1.50 9104 Anti-thymocyte globulin,25mg G $251.75 $33.73 9105 Hep B imm glob, per 1 ml G $152.00 $20.37 9106 Sirolimus 1mg/ml J $6.51 $.87 9107 Tinzaparin sodium, 2ml vial J $159.60 $20.50 9108 Thyrotropin Alfa,1.1 mg G $494.00 $70.72 9109 Tirofiban hydrochloride 6.25 mg G $199.50 $28.56 9217 Leuprolide acetate for depot suspension, 7.5 mg G $592.60 $79.40 9500 Platelets, irrad, ea unit K 1.77 $87.97 $17.59 9501 Platelets, pheresis, ea unit K 9.69 $480.75 $96.15 9502 Platelets, pher/irrad, ea unit K 10.52 $521.66 $104.33 9503 Fresh frozen plasma, ea unit K 1.65 $81.83 $16.37 9504 RBC, deglycerolized, ea unit K 4.35 $215.83 $43.17 9505 RBC, irradiated, ea unit K 2.58 $127.86 $25.57 9998 Enoxaparin G $5.53 $0.79 —————————— CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. * Code is new in 2001. Addendum B.—Hospital Outpatient Department
(HOPD)Payment Status by HCPCS Code and Related Information CPT/ HCPCS HOPD Status Indicator Description APC Relative Weight Payment Rate National Unadjusted Coinsurance Minimum Unadjusted Coinsurance 00100 N Anesth, salivary gland 00102 N Anesth, repair of cleft lip 00103 N Anesth, blepharoplasty 00104 N Anesth, electroshock 00120 N Anesth, ear surgery 00124 N Anesth, ear exam 00126 N Anesth, tympanotomy 00140 N Anesth, procedures on eye 00142 N Anesth, lens surgery 00144 N Anesth, corneal transplant 00145 N Anesth, vitrectomy 00147 N Anesth, iridectomy 00148 N Anesth, eye exam 00160 N Anesth, nose/sinus surgery 00162 N Anesth, nose/sinus surgery 00164 N Anesth, biopsy of nose 00170 N Anesth, procedure on mouth 00172 N Anesth, cleft palate repair 00174 N Anesth, pharyngeal surgery 00176 N Anesth, pharyngeal surgery 00190 N Anesth, facial bone surgery 00192 N Anesth, facial bone surgery 00210 N Anesth, open head surgery 00212 N Anesth, skull drainage 00214 N Anesth, skull drainage 00215 N Anesth, skull fracture 00216 N Anesth, head vessel surgery 00218 N Anesth, special head surgery 00220 N Anesth, spinal fluid shunt 00222 N Anesth, head nerve surgery 00300 N Anesth, head/neck/ptrunk 00320 N Anesth, neck organ surgery 00322 N Anesth, biopsy of thyroid 00350 N Anesth, neck vessel surgery 00352 N Anesth, neck vessel surgery 00400 N Anesth, skin, ext/per/atrunk 00402 N Anesth, surgery of breast 00404 N Anesth, surgery of breast 00406 N Anesth, surgery of breast 00410 N Anesth, correct heart rhythm 00420 N Anesth, skin surgery, back 00450 N Anesth, surgery of shoulder 00452 N Anesth, surgery of shoulder 00454 N Anesth, collar bone biopsy 00470 N Anesth, removal of rib 00472 N Anesth, chest wall repair 00474 N Anesth, surgery of rib(s) 00500 N Anesth, esophageal surgery 00520 N Anesth, chest procedure 00522 N Anesth, chest lining biopsy 00524 N Anesth, chest drainage 00528 N Anesth, chest partition view 00530 N Anesth, pacemaker insertion 00532 N Anesth, vascular access 00534 N Anesth, cardioverter/defib *00537 N Anesth, cardiac electrophys 00540 N Anesth, chest surgery 00542 N Anesth, release of lung 00544 N Anesth, chest lining removal 00546 N Anesth, lung,chest wall surg 00548 N Anesth, trachea,bronchi surg *00550 N Anesth, sternal debridement 00560 N Anesth, open heart surgery 00562 N Anesth, open heart surgery *00563 N Anesth, openproc w/pump *00566 N Anesth CABG w/o pump 00580 N Anesth heart/lung transplant 00600 N Anesth, spine, cord surgery 00604 N Anesth, surgery of vertebra 00620 N Anesth, spine, cord surgery 00622 N Anesth, removal of nerves 00630 N Anesth, spine, cord surgery 00632 N Anesth, removal of nerves 00634 N Anesth for chemonucleolysis *00635 N Anesth, lumbar puncture 00670 N Anesth, spine, cord surgery 00700 N Anesth, abdominal wall surg 00702 N Anesth, for liver biopsy 00730 N Anesth, abdominal wall surg 00740 N Anesth, upper gi visualize 00750 N Anesth, repair of hernia 00752 N Anesth, repair of hernia 00754 N Anesth, repair of hernia 00756 N Anesth, repair of hernia 00770 N Anesth, blood vessel repair 00790 N Anesth, surg upper abdomen 00792 N Anesth, part liver removal 00794 N Anesth, pancreas removal 00796 N Anesth, for liver transplant 00800 N Anesth, abdominal wall surg 00802 N Anesth, fat layer removal 00810 N Anesth, low intestine scope 00820 N Anesth, abdominal wall surg 00830 N Anesth, repair of hernia 00832 N Anesth, repair of hernia 00840 N Anesth, surg lower abdomen 00842 N Anesth, amniocentesis 00844 N Anesth, pelvis surgery 00846 N Anesth, hysterectomy 00848 N Anesth, pelvic organ surg 00850 N Anesth, cesarean section 00855 N Anesth, hysterectomy 00857 N Analgesia, labor & c-section 00860 N Anesth, surgery of abdomen 00862 N Anesth, kidney/ureter surg 00864 N Anesth, removal of bladder 00865 N Anesth, removal of prostate 00866 N Anesth, removal of adrenal 00868 N Anesth, kidney transplant 00870 N Anesth, bladder stone surg 00872 N Anesth kidney stone destruct 00873 N Anesth kidney stone destruct 00880 N Anesth, abdomen vessel surg 00882 N Anesth, major vein ligation 00884 N Anesth, major vein revision 00900D N Anesth, perineal procedure 00902 N Anesth, anorectal surgery 00904 N Anesth, perineal surgery 00906 N Anesth, removal of vulva 00908 N Anesth, removal of prostate 00910 N Anesth, bladder surgery 00912 N Anesth, bladder tumor surg 00914 N Anesth, removal of prostate 00916 N Anesth, bleeding control 00918 N Anesth, stone removal 00920 N Anesth, genitalia surgery 00922 N Anesth, sperm duct surgery 27280 C Fusion of sacroiliac joint 27282 C Fusion of pubic bones 27284 C Fusion of hip joint 27286 C Fusion of hip joint 27290 C Amputation of leg at hip 27295 C Amputation of leg at hip 27299 T Pelvis/hip joint surgery 0043 1.64 $81.34 $25.46 $16.27 27301 T Drain thigh/knee lesion 0008 6.15 $305.02 $113.67 $61.00 27303 C Drainage of bone lesion 27305 T Incise thigh tendon & fascia 0049 15.04 $745.93 $356.95 $149.19 27306 T Incision of thigh tendon 0049 15.04 $745.93 $356.95 $149.19 27307 T Incision of thigh tendons 0049 15.04 $745.93 $356.95 $149.19 27310 T Exploration of knee joint 0050 21.13 $1,047.96 $513.86 $209.59 27315 T Partial removal, thigh nerve 0220 13.96 $692.36 $326.21 $138.47 27320 T Partial removal, thigh nerve 0220 13.96 $692.36 $326.21 $138.47 27323 T Biopsy, thigh soft tissues 0021 10.49 $520.26 $236.51 $104.05 27324 T Biopsy, thigh soft tissues 0022 12.49 $619.45 $292.94 $123.89 27327 T Removal of thigh lesion 0022 12.49 $619.45 $292.94 $123.89 27328 T Removal of thigh lesion 0022 12.49 $619.45 $292.94 $123.89 27329 T Remove tumor, thigh/knee 0022 12.49 $619.45 $292.94 $123.89 27330 T Biopsy, knee joint lining 0050 21.13 $1,047.96 $513.86 $209.59 27331 T Explore/treat knee joint 0050 21.13 $1,047.96 $513.86 $209.59 27332 T Removal of knee cartilage 0050 21.13 $1,047.96 $513.86 $209.59 27333 T Removal of knee cartilage 0050 21.13 $1,047.96 $513.86 $209.59 27334 T Remove knee joint lining 0050 21.13 $1,047.96 $513.86 $209.59 27335 T Remove knee joint lining 0050 21.13 $1,047.96 $513.86 $209.59 27340 T Removal of kneecap bursa 0049 15.04 $745.93 $356.95 $149.19 27345 T Removal of knee cyst 0049 15.04 $745.93 $356.95 $149.19 27347 T Remove knee cyst 0049 15.04 $745.93 $356.95 $149.19 27350 T Removal of kneecap 0050 21.13 $1,047.96 $513.86 $209.59 27355 T Remove femur lesion 0050 21.13 $1,047.96 $513.86 $209.59 27356 T Remove femur lesion/graft 0050 21.13 $1,047.96 $513.86 $209.59 27357 T Remove femur lesion/graft 0050 21.13 $1,047.96 $513.86 $209.59 27358 T Remove femur lesion/fixation 0050 21.13 $1,047.96 $513.86 $209.59 27360 T Partial removal, leg bone(s) 0050 21.13 $1,047.96 $513.86 $209.59 27365 C Extensive leg surgery 27370 N Injection for knee x-ray 27372 T Removal of foreign body 0022 12.49 $619.45 $292.94 $123.89 27380 T Repair of kneecap tendon 0049 15.04 $745.93 $356.95 $149.19 27381 T Repair/graft kneecap tendon 0049 15.04 $745.93 $356.95 $149.19 27385 T Repair of thigh muscle 0049 15.04 $745.93 $356.95 $149.19 27386 T Repair/graft of thigh muscle 0049 15.04 $745.93 $356.95 $149.19 27390 T Incision of thigh tendon 0049 15.04 $745.93 $356.95 $149.19 27391 T Incision of thigh tendons 0049 15.04 $745.93 $356.95 $149.19 27392 T Incision of thigh tendons 0049 15.04 $745.93 $356.95 $149.19 27393 T Lengthening of thigh tendon 0050 21.13 $1,047.96 $513.86 $209.59 27394 T Lengthening of thigh tendons 0050 21.13 $1,047.96 $513.86 $209.59 27395 T Lengthening of thigh tendons 0051 27.76 $1,376.79 $675.24 $275.36 27396 T Transplant of thigh tendon 0050 21.13 $1,047.96 $513.86 $209.59 27397 T Transplants of thigh tendons 0051 27.76 $1,376.79 $675.24 $275.36 27400 T Revise thigh muscles/tendons 0051 27.76 $1,376.79 $675.24 $275.36 27403 T Repair of knee cartilage 0050 21.13 $1,047.96 $513.86 $209.59 27405 T Repair of knee ligament 0051 27.76 $1,376.79 $675.24 $275.36 27407 T Repair of knee ligament 0051 27.76 $1,376.79 $675.24 $275.36 27409 T Repair of knee ligaments 0051 27.76 $1,376.79 $675.24 $275.36 27418 T Repair degenerated kneecap 0051 27.76 $1,376.79 $675.24 $275.36 27420 T Revision of unstable kneecap 0051 27.76 $1,376.79 $675.24 $275.36 27422 T Revision of unstable kneecap 0051 27.76 $1,376.79 $675.24 $275.36 27424 T Revision/removal of kneecap 0051 27.76 $1,376.79 $675.24 $275.36 27425 T Lateral retinacular release 0050 21.13 $1,047.96 $513.86 $209.59 27427 T Reconstruction, knee 0052 36.16 $1,793.39 $930.91 $358.68 27428 T Reconstruction, knee 0052 36.16 $1,793.39 $930.91 $358.68 27429 T Reconstruction, knee 0052 36.16 $1,793.39 $930.91 $358.68 27430 T Revision of thigh muscles 0051 27.76 $1,376.79 $675.24 $275.36 27435 T Incision of knee joint 0051 27.76 $1,376.79 $675.24 $275.36 27437 T Revise kneecap 0047 22.09 $1,095.58 $537.03 $219.12 27438 T Revise kneecap with implant 0048 29.06 $1,441.26 $725.94 $288.25 27440 T Revision of knee joint 0047 22.09 $1,095.58 $537.03 $219.12 27441 T Revision of knee joint 0047 22.09 $1,095.58 $537.03 $219.12 27442 T Revision of knee joint 0047 22.09 $1,095.58 $537.03 $219.12 27443 T Revision of knee joint 0047 22.09 $1,095.58 $537.03 $219.12 27445 C Revision of knee joint 27446 C Revision of knee joint 27447 C Total knee replacement 27448 C Incision of thigh 27450 C Incision of thigh 27454 C Realignment of thigh bone 27455 C Realignment of knee 27457 C Realignment of knee 27465 C Shortening of thigh bone 27466 C Lengthening of thigh bone 27468 C Shorten/lengthen thighs 27470 C Repair of thigh 27472 C Repair/graft of thigh 27475 C Surgery to stop leg growth 27477 C Surgery to stop leg growth 27479 C Surgery to stop leg growth 27485 C Surgery to stop leg growth 27486 C Revise/replace knee joint 27487 C Revise/replace knee joint 27488 C Removal of knee prosthesis 27495 C Reinforce thigh 27496 T Decompression of thigh/knee 0049 15.04 $745.93 $356.95 $149.19 27497 T Decompression of thigh/knee 0049 15.04 $745.93 $356.95 $149.19 27498 T Decompression of thigh/knee 0049 15.04 $745.93 $356.95 $149.19 27499 T Decompression of thigh/knee 0049 15.04 $745.93 $356.95 $149.19 27500 T Treatment of thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27501 T Treatment of thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27502 T Treatment of thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27503 T Treatment of thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27506 C Treatment of thigh fracture 27507 C Treatment of thigh fracture 27508 T Treatment of thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27509 T Treatment of thigh fracture 0046 22.29 $1,105.50 $535.76 $221.10 27510 T Treatment of thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27511 C Treatment of thigh fracture 27513 C Treatment of thigh fracture 27514 C Treatment of thigh fracture 27516 T Treat thigh fx growth plate 0044 2.17 $107.63 $38.08 $21.53 27517 T Treat thigh fx growth plate 0044 2.17 $107.63 $38.08 $21.53 27519 C Treat thigh fx growth plate 27520 T Treat kneecap fracture 0044 2.17 $107.63 $38.08 $21.53 27524 T Treat kneecap fracture 0046 22.29 $1,105.50 $535.76 $221.10 27530 T Treat knee fracture 0044 2.17 $107.63 $38.08 $21.53 27532 T Treat knee fracture 0044 2.17 $107.63 $38.08 $21.53 27535 C Treat knee fracture 27536 C Treat knee fracture 27538 T Treat knee fracture(s) 0044 2.17 $107.63 $38.08 $21.53 27540 C Treat knee fracture 27550 T Treat knee dislocation 0044 2.17 $107.63 $38.08 $21.53 27552 T Treat knee dislocation 0045 11.02 $546.55 $277.12 $109.31 27556 C Treat knee dislocation 27557 C Treat knee dislocation 27558 C Treat knee dislocation 27560 T Treat kneecap dislocation 0044 2.17 $107.63 $38.08 $21.53 27562 T Treat kneecap dislocation 0045 11.02 $546.55 $277.12 $109.31 27566 T Treat kneecap dislocation 0046 22.29 $1,105.50 $535.76 $221.10 27570 T Fixation of knee joint 0045 11.02 $546.55 $277.12 $109.31 27580 C Fusion of knee 27590 C Amputate leg at thigh 27591 C Amputate leg at thigh 27592 C Amputate leg at thigh 27594 T Amputation follow-up surgery 0049 15.04 $745.93 $356.95 $149.19 27596 C Amputation follow-up surgery 27598 C Amputate lower leg at knee 27599 T Leg surgery procedure 0044 2.17 $107.63 $38.08 $21.53 27600 T Decompression of lower leg 0049 15.04 $745.93 $356.95 $149.19 27601 T Decompression of lower leg 0049 15.04 $745.93 $356.95 $149.19 27602 T Decompression of lower leg 0049 15.04 $745.93 $356.95 $149.19 27603 T Drain lower leg lesion 0008 6.15 $305.02 $113.67 $61.00 27604 T Drain lower leg bursa 0049 15.04 $745.93 $356.95 $149.19 27605 T Incision of achilles tendon 0055 15.47 $767.26 $355.34 $153.45 00924 N Anesth, testis exploration 00926 N Anesth, removal of testis 00928 N Anesth, removal of testis 00930 N Anesth, testis suspension 00932 N Anesth, amputation of penis 00934 N Anesth, penis, nodes removal 00936 N Anesth, penis, nodes removal 00938 N Anesth, insert penis device 00940 N Anesth, vaginal procedures 00942 N Anesth, surgery on vagina 00944 N Anesth, vaginal hysterectomy 00946 N Anesth, vaginal delivery 00948 N Anesth, repair of cervix 00950 N Anesth, vaginal endoscopy 00952 N Anesth, hysteroscope/graph 00955 N Analgesia, vaginal delivery 01000 N Anesth, skin surgery, pelvis 01110 N Anesth, skin surgery, pelvis *01112 N Anesth, bone aspirate/bx 01120 N Anesth, pelvis surgery 01130 N Anesth, body cast procedure 01140 N Anesth, amputation at pelvis 01150 N Anesth, pelvic tumor surgery 01160 N Anesth, pelvis procedure 01170 N Anesth, pelvis surgery 01180 N Anesth, pelvis nerve removal 01190 N Anesth, pelvis nerve removal 01200 N Anesth, hip joint procedure 01202 N Anesth, arthroscopy of hip 01210 N Anesth, hip joint surgery 01212 N Anesth, hip disarticulation 01214 N Anesth, replacement of hip *01215 N Anesth, revise hip repair 01220 N Anesth, procedure on femur 01230 N Anesth, surgery of femur 01232 N Anesth, amputation of femur 01234 N Anesth, radical femur surg 01240 N Anesth, upper leg skin surg 01250 N Anesth, upper leg surgery 01260 N Anesth, upper leg veins surg 01270 N Anesth, thigh arteries surg 01272 N Anesth, femoral artery surg 01274 N Anesth, femoral embolectomy 01300 N Anesth, skin surgery, knee 01320 N Anesth, knee area surgery 01340 N Anesth, knee area procedure 01360 N Anesth, knee area surgery 01380 N Anesth, knee joint procedure 01382 N Anesth, knee arthroscopy 01390 N Anesth, knee area procedure 01392 N Anesth, knee area surgery 01400 N Anesth, knee joint surgery 01402 N Anesth, replacement of knee 01404 N Anesth, amputation at knee 01420 N Anesth, knee joint casting 01430 N Anesth, knee veins surgery 01432 N Anesth, knee vessel surg 01440 N Anesth, knee arteries surg 01442 N Anesth, knee artery surg 01444 N Anesth, knee artery repair 01460 N Anesth, lower leg skin surg 01462 N Anesth, lower leg procedure 01464 N Anesth, ankle arthroscopy 01470 N Anesth, lower leg surgery 01472 N Anesth, achilles tendon surg 01474 N Anesth, lower leg surgery 01480 N Anesth, lower leg bone surg 01482 N Anesth, radical leg surgery 01484 N Anesth, lower leg revision 01486 N Anesth, ankle replacement 01490 N Anesth, lower leg casting 01500 N Anesth, leg arteries surg 01502 N Anesth, lwr leg embolectomy 01520 N Anesth, lower leg vein surg 01522 N Anesth, lower leg vein surg 01600 N Anesth, shoulder skin surg 01610 N Anesth, surgery of shoulder 01620 N Anesth, shoulder procedure 01622 N Anesth, shoulder arthroscopy 01630 N Anesth, surgery of shoulder 01632 N Anesth, surgery of shoulder 01634 N Anesth, shoulder joint amput 01636 N Anesth, forequarter amput 01638 N Anesth, shoulder replacement 01650 N Anesth, shoulder artery surg 01652 N Anesth, shoulder vessel surg 01654 N Anesth, shoulder vessel surg 01656 N Anesth, arm-leg vessel surg 01670 N Anesth, shoulder vein surg 01680 N Anesth, shoulder casting 01682 N Anesth, airplane cast 01700 N Anesth, elbow area skin surg 01710 N Anesth, elbow area surgery 01712 N Anesth, uppr arm tendon surg 01714 N Anesth, uppr arm tendon surg 01716 N Anesth, biceps tendon repair 01730 N Anesth, uppr arm procedure 01732 N Anesth, elbow arthroscopy 01740 N Anesth, upper arm surgery 01742 N Anesth, humerus surgery 01744 N Anesth, humerus repair 01756 N Anesth, radical humerus surg 01758 N Anesth, humeral lesion surg 01760 N Anesth, elbow replacement 01770 N Anesth, uppr arm artery surg 01772 N Anesth, uppr arm embolectomy 01780 N Anesth, upper arm vein surg 01782 N Anesth, uppr arm vein repair 01784D N Anesth, av fistula repair 01800 N Anesth, lower arm skin surg 01810 N Anesth, lower arm surgery 01820 N Anesth, lower arm procedure 01830 N Anesth, lower arm surgery 01832 N Anesth, wrist replacement 01840 N Anesth, lwr arm artery surg 01842 N Anesth, lwr arm embolectomy 01844 N Anesth, vascular shunt surg 01850 N Anesth, lower arm vein surg 01852 N Anesth, lwr arm vein repair 01860 N Anesth, lower arm casting 01900 N Anesth, uterus/tube inject 01902 N Anesth, burr holes, skull 01904 N Anesth, skull x-ray inject 01906 N Anesth, lumbar myelography 01908 N Anesth, cervical myelography 01910 N Anesth, skull myelography 01912 N Anesth, lumbar diskography 01914 N Anesth, cervical diskography 01916 N Anesth, head arteriogram 01918 N Anesth, limb arteriogram 01920 N Anesth, catheterize heart 01921 N Anesth, vessel surgery 01922 N Anesth, cat or MRI scan *01951 N Anesth, burn, less 1 percent *01952 N Anesth, burn, 1-9 percent *01953 N Anesth, burn, each 9 percent 01990 N Support for organ donor 01995 N Regional anesthesia, limb 01996 N Manage daily drug therapy 01999 N Unlisted anesth procedure 10040 T Acne surgery of skin abscess 0006 2.00 $99.19 $33.95 $19.84 10060 T Drainage of skin abscess 0006 2.00 $99.19 $33.95 $19.84 10061 T Drainage of skin abscess 0006 2.00 $99.19 $33.95 $19.84 10080 T Drainage of pilonidal cyst 0006 2.00 $99.19 $33.95 $19.84 10081 T Drainage of pilonidal cyst 0007 3.68 $182.51 $72.03 $36.50 10120 T Remove foreign body 0006 2.00 $99.19 $33.95 $19.84 10121 T Remove foreign body 0020 6.51 $322.87 $130.53 $64.57 10140 T Drainage of hematoma/fluid 0007 3.68 $182.51 $72.03 $36.50 10160 T Puncture drainage of lesion 0006 2.00 $99.19 $33.95 $19.84 10180 T Complex drainage, wound 0007 3.68 $182.51 $72.03 $36.50 11000 T Debride infected skin 0015 1.77 $87.78 $31.20 $17.56 11001 T Debride infected skin add-on 0015 1.77 $87.78 $31.20 $17.56 11010 T Debride skin, fx 0022 12.49 $619.45 $292.94 $123.89 11011 T Debride skin/muscle, fx 0022 12.49 $619.45 $292.94 $123.89 11012 T Debride skin/muscle/bone, fx 0022 12.49 $619.45 $292.94 $123.89 11040 T Debride skin, partial 0015 1.77 $87.78 $31.20 $17.56 11041 T Debride skin, full 0015 1.77 $87.78 $31.20 $17.56 11042 T Debride skin/tissue 0016 3.53 $175.07 $74.67 $35.01 11043 T Debride tissue/muscle 0016 3.53 $175.07 $74.67 $35.01 11044 T Debride tissue/muscle/bone 0017 12.45 $617.47 $289.16 $123.49 11055 T Trim skin lesion 0015 1.77 $87.78 $31.20 $17.56 11056 T Trim skin lesions, 2 to 4 0015 1.77 $87.78 $31.20 $17.56 11057 T Trim skin lesions, over 4 0015 1.77 $87.78 $31.20 $17.56 11100 T Biopsy of skin lesion 0018 0.94 $46.62 $17.66 $9.32 11101 T Biopsy, skin add-on 0018 0.94 $46.62 $17.66 $9.32 11200 T Removal of skin tags 0015 1.77 $87.78 $31.20 $17.56 11201 T Remove skin tags add-on 0015 1.77 $87.78 $31.20 $17.56 11300 T Shave skin lesion 0013 0.91 $45.13 $17.66 $9.03 11301 T Shave skin lesion 0013 0.91 $45.13 $17.66 $9.03 11302 T Shave skin lesion 0014 1.50 $74.39 $24.55 $14.88 11303 T Shave skin lesion 0015 1.77 $87.78 $31.20 $17.56 11305 T Shave skin lesion 0013 0.91 $45.13 $17.66 $9.03 11306 T Shave skin lesion 0013 0.91 $45.13 $17.66 $9.03 11307 T Shave skin lesion 0014 1.50 $74.39 $24.55 $14.88 11308 T Shave skin lesion 0015 1.77 $87.78 $31.20 $17.56 11310 T Shave skin lesion 0013 0.91 $45.13 $17.66 $9.03 11311 T Shave skin lesion 0013 0.91 $45.13 $17.66 $9.03 11312 T Shave skin lesion 0015 1.77 $87.78 $31.20 $17.56 11313 T Shave skin lesion 0016 3.53 $175.07 $74.67 $35.01 11400 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11401 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11402 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11403 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11404 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11406 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11420 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11421 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11422 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11423 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11424 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11426 T Removal of skin lesion 0022 12.49 $619.45 $292.94 $123.89 11440 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11441 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11442 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11443 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11444 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11446 T Removal of skin lesion 0022 12.49 $619.45 $292.94 $123.89 11450 T Removal, sweat gland lesion 0022 12.49 $619.45 $292.94 $123.89 11451 T Removal, sweat gland lesion 0022 12.49 $619.45 $292.94 $123.89 11462 T Removal, sweat gland lesion 0022 12.49 $619.45 $292.94 $123.89 11463 T Removal, sweat gland lesion 0022 12.49 $619.45 $292.94 $123.89 11470 T Removal, sweat gland lesion 0022 12.49 $619.45 $292.94 $123.89 11471 T Removal, sweat gland lesion 0022 12.49 $619.45 $292.94 $123.89 11600 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11601 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11602 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11603 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11604 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11606 T Removal of skin lesion 0021 10.49 $520.26 $236.51 $104.05 11620 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11621 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11622 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11623 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11624 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11626 T Removal of skin lesion 0022 12.49 $619.45 $292.94 $123.89 11640 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11641 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11642 T Removal of skin lesion 0019 4.00 $198.39 $78.91 $39.68 11643 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11644 T Removal of skin lesion 0020 6.51 $322.87 $130.53 $64.57 11646 T Removal of skin lesion 0022 12.49 $619.45 $292.94 $123.89 11719 T Trim nail(s) 0009 0.74 $36.70 $9.63 $7.34 11720 T Debride nail, 1-5 0009 0.74 $36.70 $9.63 $7.34 11721 T Debride nail, 6 or more 0009 0.74 $36.70 $9.63 $7.34 11730 T Removal of nail plate 0013 0.91 $45.13 $17.66 $9.03 11732 T Remove nail plate, add-on 0012 0.53 $26.29 $9.18 $5.26 11740 T Drain blood from under nail 0009 0.74 $36.70 $9.63 $7.34 11750 T Removal of nail bed 0019 4.00 $198.39 $78.91 $39.68 11752 T Remove nail bed/finger tip 0022 12.49 $619.45 $292.94 $123.89 11755 T Biopsy, nail unit 0019 4.00 $198.39 $78.91 $39.68 11760 T Repair of nail bed 0024 2.43 $120.51 $44.50 $24.10 11762 T Reconstruction of nail bed 0024 2.43 $120.51 $44.50 $24.10 11765 T Excision of nail fold, toe 0015 1.77 $87.78 $31.20 $17.56 11770 T Removal of pilonidal lesion 0021 10.49 $520.26 $236.51 $104.05 11771 T Removal of pilonidal lesion 0022 12.49 $619.45 $292.94 $123.89 11772 T Removal of pilonidal lesion 0022 12.49 $619.45 $292.94 $123.89 11900 T Injection into skin lesions 0012 0.53 $26.29 $9.18 $5.26 11901 T Added skin lesions injection 0013 0.91 $45.13 $17.66 $9.03 11920 T Correct skin color defects 0024 2.43 $120.51 $44.50 $24.10 11921 T Correct skin color defects 0024 2.43 $120.51 $44.50 $24.10 11922 T Correct skin color defects 0024 2.43 $120.51 $44.50 $24.10 11950 T Therapy for contour defects 0024 2.43 $120.51 $44.50 $24.10 11951 T Therapy for contour defects 0024 2.43 $120.51 $44.50 $24.10 11952 T Therapy for contour defects 0024 2.43 $120.51 $44.50 $24.10 11954 T Therapy for contour defects 0024 2.43 $120.51 $44.50 $24.10 11960 T Insert tissue expander(s) 0026 12.11 $600.61 $277.92 $120.12 11970 T Replace tissue expander 0026 12.11 $600.61 $277.92 $120.12 11971 T Remove tissue expander(s) 0022 12.49 $619.45 $292.94 $123.89 11975 E Insert contraceptive cap 11976 T Removal of contraceptive cap 0019 4.00 $198.39 $78.91 $39.68 11977 E Removal/reinsert contra cap 11980 X Implant hormone pellet(s) 0340 1.04 $51.58 $12.85 $10.32 12001 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12002 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12004 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12005 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12006 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12007 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12011 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12013 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12014 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12015 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12016 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12017 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12018 T Repair superficial wound(s) 0024 2.43 $120.51 $44.50 $24.10 12020 T Closure of split wound 0024 2.43 $120.51 $44.50 $24.10 12021 T Closure of split wound 0024 2.43 $120.51 $44.50 $24.10 12031 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12032 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12034 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12035 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12036 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12037 T Layer closure of wound(s) 0026 12.11 $600.61 $277.92 $120.12 12041 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12042 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12044 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12045 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12046 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12047 T Layer closure of wound(s) 0026 12.11 $600.61 $277.92 $120.12 12051 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12052 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12053 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12054 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12055 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12056 T Layer closure of wound(s) 0024 2.43 $120.51 $44.50 $24.10 12057 T Layer closure of wound(s) 0026 12.11 $600.61 $277.92 $120.12 13100 T Repair of wound or lesion 0025 3.74 $185.49 $70.66 $37.10 13101 T Repair of wound or lesion 0025 3.74 $185.49 $70.66 $37.10 13102 T Repair wound/lesion add-on 0025 3.74 $185.49 $70.66 $37.10 13120 T Repair of wound or lesion 0025 3.74 $185.49 $70.66 $37.10 13121 T Repair of wound or lesion 0025 3.74 $185.49 $70.66 $37.10 13122 T Repair wound/lesion add-on 0025 3.74 $185.49 $70.66 $37.10 13131 T Repair of wound or lesion 0025 3.74 $185.49 $70.66 $37.10 13132 T Repair of wound or lesion 0025 3.74 $185.49 $70.66 $37.10 13133 T Repair wound/lesion add-on 0025 3.74 $185.49 $70.66 $37.10 13150 T Repair of wound or lesion 0026 12.11 $600.61 $277.92 $120.12 13151 T Repair of wound or lesion 0025 3.74 $185.49 $70.66 $37.10 13152 T Repair of wound or lesion 0025 3.74 $185.49 $70.66 $37.10 13153 T Repair wound/lesion add-on 0025 3.74 $185.49 $70.66 $37.10 13160 T Late closure of wound 0026 12.11 $600.61 $277.92 $120.12 14000 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14001 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14020 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14021 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14040 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14041 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14060 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14061 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14300 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 14350 T Skin tissue rearrangement 0026 12.11 $600.61 $277.92 $120.12 15000 T Skin graft 0026 12.11 $600.61 $277.92 $120.12 15001 T Skin graft add-on 0026 12.11 $600.61 $277.92 $120.12 15050 T Skin pinch graft 0026 12.11 $600.61 $277.92 $120.12 15100 T Skin split graft 0026 12.11 $600.61 $277.92 $120.12 15101 T Skin split graft add-on 0026 12.11 $600.61 $277.92 $120.12 15120 T Skin split graft 0026 12.11 $600.61 $277.92 $120.12 15121 T Skin split graft add-on 0026 12.11 $600.61 $277.92 $120.12 15200 T Skin full graft 0026 12.11 $600.61 $277.92 $120.12 15201 T Skin full graft add-on 0026 12.11 $600.61 $277.92 $120.12 15220 T Skin full graft 0026 12.11 $600.61 $277.92 $120.12 15221 T Skin full graft add-on 0026 12.11 $600.61 $277.92 $120.12 15240 T Skin full graft 0026 12.11 $600.61 $277.92 $120.12 15241 T Skin full graft add-on 0026 12.11 $600.61 $277.92 $120.12 15260 T Skin full graft 0026 12.11 $600.61 $277.92 $120.12 15261 T Skin full graft add-on 0026 12.11 $600.61 $277.92 $120.12 *15342 T Cultured skin graft, 25 cm 0025 3.74 $185.49 $70.66 $37.10 *15343 T Culture skin graft addl 25 cm 0025 3.74 $185.49 $70.66 $37.10 15350 T Skin homograft 0026 12.11 $600.61 $277.92 $120.12 15351 T Skin homograft add-on 0026 12.11 $600.61 $277.92 $120.12 15400 T Skin heterograft 0026 12.11 $600.61 $277.92 $120.12 15401 T Skin heterograft add-on 0026 12.11 $600.61 $277.92 $120.12 15570 T Form skin pedicle flap 0026 12.11 $600.61 $277.92 $120.12 15572 T Form skin pedicle flap 0026 12.11 $600.61 $277.92 $120.12 15574 T Form skin pedicle flap 0026 12.11 $600.61 $277.92 $120.12 15576 T Form skin pedicle flap 0026 12.11 $600.61 $277.92 $120.12 15600 T Skin graft 0026 12.11 $600.61 $277.92 $120.12 15610 T Skin graft 0026 12.11 $600.61 $277.92 $120.12 15620 T Skin graft 0026 12.11 $600.61 $277.92 $120.12 15630 T Skin graft 0026 12.11 $600.61 $277.92 $120.12 15650 T Transfer skin pedicle flap 0026 12.11 $600.61 $277.92 $120.12 15732 T Muscle-skin graft, head/neck 0027 15.80 $783.62 $383.10 $156.72 15734 T Muscle-skin graft, trunk 0027 15.80 $783.62 $383.10 $156.72 15736 T Muscle-skin graft, arm 0027 15.80 $783.62 $383.10 $156.72 15738 T Muscle-skin graft, leg 0027 15.80 $783.62 $383.10 $156.72 15740 T Island pedicle flap graft 0027 15.80 $783.62 $383.10 $156.72 15750 T Neurovascular pedicle graft 0027 15.80 $783.62 $383.10 $156.72 15756 C Free muscle flap, microvasc 15757 C Free skin flap, microvasc 15758 C Free fascial flap, microvasc 15760 T Composite skin graft 0027 15.80 $783.62 $383.10 $156.72 15770 T Derma-fat-fascia graft 0027 15.80 $783.62 $383.10 $156.72 15775 T Hair transplant punch grafts 0026 12.11 $600.61 $277.92 $120.12 15776 T Hair transplant punch grafts 0026 12.11 $600.61 $277.92 $120.12 15780 T Abrasion treatment of skin 0022 12.49 $619.45 $292.94 $123.89 15781 T Abrasion treatment of skin 0022 12.49 $619.45 $292.94 $123.89 15782 T Abrasion treatment of skin 0022 12.49 $619.45 $292.94 $123.89 15783 T Abrasion treatment of skin 0015 1.77 $87.78 $31.20 $17.56 15786 T Abrasion, lesion, single 0013 0.91 $45.13 $17.66 $9.03 15787 T Abrasion, lesions, add-on 0016 3.53 $175.07 $74.67 $35.01 15788 T Chemical peel, face, epiderm 0013 0.91 $45.13 $17.66 $9.03 15789 T Chemical peel, face, dermal 0015 1.77 $87.78 $31.20 $17.56 15792 T Chemical peel, nonfacial 0016 3.53 $175.07 $74.67 $35.01 15793 T Chemical peel, nonfacial 0016 3.53 $175.07 $74.67 $35.01 15810 T Salabrasion 0016 3.53 $175.07 $74.67 $35.01 15811 T Salabrasion 0022 12.49 $619.45 $292.94 $123.89 15819 T Plastic surgery, neck 0026 12.11 $600.61 $277.92 $120.12 15820 T Revision of lower eyelid 0026 12.11 $600.61 $277.92 $120.12 15821 T Revision of lower eyelid 0026 12.11 $600.61 $277.92 $120.12 15822 T Revision of upper eyelid 0026 12.11 $600.61 $277.92 $120.12 15823 T Revision of upper eyelid 0026 12.11 $600.61 $277.92 $120.12 15824 T Removal of forehead wrinkles 0027 15.80 $783.62 $383.10 $156.72 15825 T Removal of neck wrinkles 0026 12.11 $600.61 $277.92 $120.12 15826 T Removal of brow wrinkles 0027 15.80 $783.62 $383.10 $156.72 15828 T Removal of face wrinkles 0027 15.80 $783.62 $383.10 $156.72 15829 T Removal of skin wrinkles 0026 12.11 $600.61 $277.92 $120.12 15831 T Excise excessive skin tissue 0027 15.80 $783.62 $383.10 $156.72 15832 T Excise excessive skin tissue 0027 15.80 $783.62 $383.10 $156.72 15833 T Excise excessive skin tissue 0027 15.80 $783.62 $383.10 $156.72 15834 T Excise excessive skin tissue 0027 15.80 $783.62 $383.10 $156.72 15835 T Excise excessive skin tissue 0026 12.11 $600.61 $277.92 $120.12 15836 T Excise excessive skin tissue 0027 15.80 $783.62 $383.10 $156.72 15837 T Excise excessive skin tissue 0027 15.80 $783.62 $383.10 $156.72 15838 T Excise excessive skin tissue 0022 12.49 $619.45 $292.94 $123.89 15839 T Excise excessive skin tissue 0027 15.80 $783.62 $383.10 $156.72 15840 T Graft for face nerve palsy 0027 15.80 $783.62 $383.10 $156.72 15841 T Graft for face nerve palsy 0027 15.80 $783.62 $383.10 $156.72 15842 T Graft for face nerve palsy 0027 15.80 $783.62 $383.10 $156.72 15845 T Skin and muscle repair, face 0027 15.80 $783.62 $383.10 $156.72 15850 T Removal of sutures 0013 0.91 $45.13 $17.66 $9.03 15851 T Removal of sutures 0013 0.91 $45.13 $17.66 $9.03 15852 T Dressing change,not for burn 0012 0.53 $26.29 $9.18 $5.26 15860 N Test for blood flow in graft 15876 T Suction assisted lipectomy 0027 15.80 $783.62 $383.10 $156.72 15877 T Suction assisted lipectomy 0027 15.80 $783.62 $383.10 $156.72 15878 T Suction assisted lipectomy 0027 15.80 $783.62 $383.10 $156.72 15879 T Suction assisted lipectomy 0027 15.80 $783.62 $383.10 $156.72 15920 T Removal of tail bone ulcer 0022 12.49 $619.45 $292.94 $123.89 15922 T Removal of tail bone ulcer 0027 15.80 $783.62 $383.10 $156.72 15931 T Remove sacrum pressure sore 0022 12.49 $619.45 $292.94 $123.89 15933 T Remove sacrum pressure sore 0022 12.49 $619.45 $292.94 $123.89 15934 T Remove sacrum pressure sore 0027 15.80 $783.62 $383.10 $156.72 15935 T Remove sacrum pressure sore 0027 15.80 $783.62 $383.10 $156.72 15936 T Remove sacrum pressure sore 0027 15.80 $783.62 $383.10 $156.72 15937 T Remove sacrum pressure sore 0027 15.80 $783.62 $383.10 $156.72 15940 T Remove hip pressure sore 0022 12.49 $619.45 $292.94 $123.89 15941 T Remove hip pressure sore 0022 12.49 $619.45 $292.94 $123.89 15944 T Remove hip pressure sore 0027 15.80 $783.62 $383.10 $156.72 15945 T Remove hip pressure sore 0027 15.80 $783.62 $383.10 $156.72 15946 T Remove hip pressure sore 0027 15.80 $783.62 $383.10 $156.72 15950 T Remove thigh pressure sore 0022 12.49 $619.45 $292.94 $123.89 15951 T Remove thigh pressure sore 0022 12.49 $619.45 $292.94 $123.89 15952 T Remove thigh pressure sore 0027 15.80 $783.62 $383.10 $156.72 15953 T Remove thigh pressure sore 0027 15.80 $783.62 $383.10 $156.72 15956 T Remove thigh pressure sore 0027 15.80 $783.62 $383.10 $156.72 15958 T Remove thigh pressure sore 0027 15.80 $783.62 $383.10 $156.72 15999 T Removal of pressure sore 0022 12.49 $619.45 $292.94 $123.89 16000 T Initial treatment of burn(s) 0015 1.77 $87.78 $31.20 $17.56 16010 T Treatment of burn(s) 0015 1.77 $87.78 $31.20 $17.56 16015 T Treatment of burn(s) 0017 12.45 $617.47 $289.16 $123.49 16020 T Treatment of burn(s) 0015 1.77 $87.78 $31.20 $17.56 16025 T Treatment of burn(s) 0014 1.50 $74.39 $24.55 $14.88 16030 T Treatment of burn(s) 0015 1.77 $87.78 $31.20 $17.56 16035 C Incision of burn scab, initl *16036 C Incise burn scab, addl incis 17000 T Destroy benign/premal lesion 0010 0.55 $27.28 $9.86 $5.46 17003 T Destroy lesions, 2-14 0010 0.55 $27.28 $9.86 $5.46 17004 T Destroy lesions, 15 or more 0011 2.72 $134.90 $50.01 $26.98 17106 T Destruction of skin lesions 0011 2.72 $134.90 $50.01 $26.98 17107 T Destruction of skin lesions 0011 2.72 $134.90 $50.01 $26.98 17108 T Destruction of skin lesions 0011 2.72 $134.90 $50.01 $26.98 17110 T Destruct lesion, 1-14 0010 0.55 $27.28 $9.86 $5.46 17111 T Destruct lesion, 15 or more 0011 2.72 $134.90 $50.01 $26.98 17250 T Chemical cautery, tissue 0014 1.50 $74.39 $24.55 $14.88 17260 T Destruction of skin lesions 0013 0.91 $45.13 $17.66 $9.03 17261 T Destruction of skin lesions 0013 0.91 $45.13 $17.66 $9.03 17262 T Destruction of skin lesions 0013 0.91 $45.13 $17.66 $9.03 17263 T Destruction of skin lesions 0013 0.91 $45.13 $17.66 $9.03 17264 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17266 T Destruction of skin lesions 0016 3.53 $175.07 $74.67 $35.01 17270 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17271 T Destruction of skin lesions 0013 0.91 $45.13 $17.66 $9.03 17272 T Destruction of skin lesions 0013 0.91 $45.13 $17.66 $9.03 17273 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17274 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17276 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17280 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17281 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17282 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17283 T Destruction of skin lesions 0015 1.77 $87.78 $31.20 $17.56 17284 T Destruction of skin lesions 0016 3.53 $175.07 $74.67 $35.01 17286 T Destruction of skin lesions 0016 3.53 $175.07 $74.67 $35.01 17304 T Chemosurgery of skin lesion 0020 6.51 $322.87 $130.53 $64.57 17305 T 2nd stage chemosurgery 0020 6.51 $322.87 $130.53 $64.57 17306 T 3rd stage chemosurgery 0020 6.51 $322.87 $130.53 $64.57 17307 T Followup skin lesion therapy 0020 6.51 $322.87 $130.53 $64.57 17310 T Extensive skin chemosurgery 0020 6.51 $322.87 $130.53 $64.57 17340 T Cryotherapy of skin 0012 0.53 $26.29 $9.18 $5.26 17360 T Skin peel therapy 0016 3.53 $175.07 $74.67 $35.01 17380 T Hair removal by electrolysis 0016 3.53 $175.07 $74.67 $35.01 17999 T Skin tissue procedure 0004 1.84 $91.26 $32.57 $18.25 19000 T Drainage of breast lesion 0004 1.84 $91.26 $32.57 $18.25 19001 T Drain breast lesion add-on 0004 1.84 $91.26 $32.57 $18.25 19020 T Incision of breast lesion 0008 6.15 $305.02 $113.67 $61.00 19030 N Injection for breast x-ray 19100 T Bx breast percut w/o image 0005 5.41 $268.32 $119.75 $53.66 19101 T Biopsy of breast, open 0028 12.37 $613.52 $303.74 $122.70 *19102 T Bx breast percut w/ image 0005 5.41 $268.32 $119.75 $53.66 *19103 S Bx breast percut w/device 0974 8.25 $409.17 $81.83 19110 T Nipple exploration 0028 12.37 $613.52 $303.74 $122.70 19112 T Excise breast duct fistula 0028 12.37 $613.52 $303.74 $122.70 19120 T Removal of breast lesion 0028 12.37 $613.52 $303.74 $122.70 19125 T Excision, breast lesion 0028 12.37 $613.52 $303.74 $122.70 19126 T Excision, addl breast lesion 0028 12.37 $613.52 $303.74 $122.70 19140 T Removal of breast tissue 0028 12.37 $613.52 $303.74 $122.70 19160 T Removal of breast tissue 0028 12.37 $613.52 $303.74 $122.70 19162 T Remove breast tissue, nodes 0029 31.39 $1,557.05 $820.79 $311.41 19180 T Removal of breast 0029 31.39 $1,557.05 $820.79 $311.41 19182 T Removal of breast 0028 12.37 $613.52 $303.74 $122.70 19200 C Removal of breast 19220 C Removal of breast 19240 T Removal of breast 0029 31.39 $1,557.05 $820.79 $311.41 19260 T Removal of chest wall lesion 0021 10.49 $520.26 $236.51 $104.05 19271 C Revision of chest wall 19272 C Extensive chest wall surgery 19290 T Place needle wire, breast 0028 12.37 $613.52 $303.74 $122.70 19291 T Place needle wire, breast 0028 12.37 $613.52 $303.74 $122.70 *19295 S Place breast clip, percut 0971 1.55 $76.88 $15.38 19316 T Suspension of breast 0029 31.39 $1,557.05 $820.79 $311.41 19318 T Reduction of large breast 0029 31.39 $1,557.05 $820.79 $311.41 19324 T Enlarge breast 0029 31.39 $1,557.05 $820.79 $311.41 19325 T Enlarge breast with implant 0030 31.11 $1,543.16 $763.55 $308.63 19328 T Removal of breast implant 0028 12.37 $613.52 $303.74 $122.70 19330 T Removal of implant material 0028 12.37 $613.52 $303.74 $122.70 19340 T Immediate breast prosthesis 0030 31.11 $1,543.16 $763.55 $308.63 19342 T Delayed breast prosthesis 0030 31.11 $1,543.16 $763.55 $308.63 19350 T Breast reconstruction 0028 12.37 $613.52 $303.74 $122.70 19355 T Correct inverted nipple(s) 0028 12.37 $613.52 $303.74 $122.70 19357 T Breast reconstruction 0030 31.11 $1,543.16 $763.55 $308.63 19361 C Breast reconstruction 19364 C Breast reconstruction 19366 T Breast reconstruction 0029 31.39 $1,557.05 $820.79 $311.41 19367 C Breast reconstruction 19368 C Breast reconstruction 19369 C Breast reconstruction 19370 T Surgery of breast capsule 0028 12.37 $613.52 $303.74 $122.70 19371 T Removal of breast capsule 0029 31.39 $1,557.05 $820.79 $311.41 19380 T Revise breast reconstruction 0029 31.39 $1,557.05 $820.79 $311.41 19396 T Design custom breast implant 0028 12.37 $613.52 $303.74 $122.70 19499 T Breast surgery procedure 0004 1.84 $91.26 $32.57 $18.25 20000 T Incision of abscess 0006 2.00 $99.19 $33.95 $19.84 20005 T Incision of deep abscess 0049 15.04 $745.93 $356.95 $149.19 20100 T Explore wound, neck 0023 1.98 $98.20 $40.37 $19.64 20101 T Explore wound, chest 0026 12.11 $600.61 $277.92 $120.12 20102 T Explore wound, abdomen 0026 12.11 $600.61 $277.92 $120.12 20103 T Explore wound, extremity 0023 1.98 $98.20 $40.37 $19.64 20150 T Excise epiphyseal bar 0051 27.76 $1,376.79 $675.24 $275.36 20200 T Muscle biopsy 0020 6.51 $322.87 $130.53 $64.57 20205 T Deep muscle biopsy 0021 10.49 $520.26 $236.51 $104.05 20206 T Needle biopsy, muscle 0005 5.41 $268.32 $119.75 $53.66 20220 T Bone biopsy, trocar/needle 0019 4.00 $198.39 $78.91 $39.68 20225 T Bone biopsy, trocar/needle 0020 6.51 $322.87 $130.53 $64.57 20240 T Bone biopsy, excisional 0022 12.49 $619.45 $292.94 $123.89 20245 T Bone biopsy, excisional 0022 12.49 $619.45 $292.94 $123.89 20250 T Open bone biopsy 0049 15.04 $745.93 $356.95 $149.19 20251 T Open bone biopsy 0049 15.04 $745.93 $356.95 $149.19 20500 T Injection of sinus tract 0252 5.18 $256.90 $114.24 $51.38 20501 N Inject sinus tract for x-ray 20520 T Removal of foreign body 0019 4.00 $198.39 $78.91 $39.68 20525 T Removal of foreign body 0022 12.49 $619.45 $292.94 $123.89 20550 T Inject tendon/ligament/cyst 0040 2.11 $104.65 $40.60 $20.93 20600 T Drain/inject, joint/bursa 0040 2.11 $104.65 $40.60 $20.93 20605 T Drain/inject, joint/bursa 0040 2.11 $104.65 $40.60 $20.93 20610 T Drain/inject, joint/bursa 0040 2.11 $104.65 $40.60 $20.93 20615 T Treatment of bone cyst 0004 1.84 $91.26 $32.57 $18.25 20650 T Insert and remove bone pin 0049 15.04 $745.93 $356.95 $149.19 20660 C Apply,remove fixation device 20661 C Application of head brace 20662 C Application of pelvis brace 20663 C Application of thigh brace 20664 C Halo brace application 20665 N Removal of fixation device 20670 T Removal of support implant 0021 10.49 $520.26 $236.51 $104.05 20680 T Removal of support implant 0022 12.49 $619.45 $292.94 $123.89 20690 T Apply bone fixation device 0050 21.13 $1,047.96 $513.86 $209.59 20692 T Apply bone fixation device 0050 21.13 $1,047.96 $513.86 $209.59 20693 T Adjust bone fixation device 0049 15.04 $745.93 $356.95 $149.19 20694 T Remove bone fixation device 0049 15.04 $745.93 $356.95 $149.19 20802 C Replantation, arm, complete 20805 C Replant, forearm, complete 20808 C Replantation hand, complete 20816 C Replantation digit, complete 20822 C Replantation digit, complete 20824 C Replantation thumb, complete 20827 C Replantation thumb, complete 20838 C Replantation foot, complete 20900 T Removal of bone for graft 0050 21.13 $1,047.96 $513.86 $209.59 20902 T Removal of bone for graft 0050 21.13 $1,047.96 $513.86 $209.59 20910 T Remove cartilage for graft 0026 12.11 $600.61 $277.92 $120.12 20912 T Remove cartilage for graft 0026 12.11 $600.61 $277.92 $120.12 20920 T Removal of fascia for graft 0026 12.11 $600.61 $277.92 $120.12 20922 T Removal of fascia for graft 0026 12.11 $600.61 $277.92 $120.12 20924 T Removal of tendon for graft 0050 21.13 $1,047.96 $513.86 $209.59 20926 T Removal of tissue for graft 0026 12.11 $600.61 $277.92 $120.12 20930 C Spinal bone allograft 20931 C Spinal bone allograft 20936 C Spinal bone autograft 20937 C Spinal bone autograft 20938 C Spinal bone autograft 20950 T Fluid pressure, muscle 0008 6.15 $305.02 $113.67 $61.00 20955 C Fibula bone graft, microvasc 20956 C Iliac bone graft, microvasc 20957 C Mt bone graft, microvasc 20962 C Other bone graft, microvasc 20969 C Bone/skin graft, microvasc 20970 C Bone/skin graft, iliac crest 20972 C Bone/skin graft, metatarsal 20973 C Bone/skin graft, great toe 20974 A Electrical bone stimulation 20975 T Electrical bone stimulation 0049 15.04 $745.93 $356.95 $149.19 20979 E Us bone stimulation 20999 N Musculoskeletal surgery 21010 T Incision of jaw joint 0254 12.45 $617.47 $272.41 $123.49 21015 T Resection of facial tumor 0254 12.45 $617.47 $272.41 $123.49 21025 T Excision of bone, lower jaw 0256 25.40 $1,259.74 $623.05 $251.95 21026 T Excision of facial bone(s) 0256 25.40 $1,259.74 $623.05 $251.95 21029 T Contour of face bone lesion 0256 25.40 $1,259.74 $623.05 $251.95 21030 T Removal of face bone lesion 0254 12.45 $617.47 $272.41 $123.49 21031 T Remove exostosis, mandible 0253 12.02 $596.14 $284.00 $119.23 21032 T Remove exostosis, maxilla 0253 12.02 $596.14 $284.00 $119.23 21034 T Removal of face bone lesion 0256 25.40 $1,259.74 $623.05 $251.95 21040 T Removal of jaw bone lesion 0253 12.02 $596.14 $284.00 $119.23 21041 T Removal of jaw bone lesion 0256 25.40 $1,259.74 $623.05 $251.95 21044 T Removal of jaw bone lesion 0256 25.40 $1,259.74 $623.05 $251.95 21045 C Extensive jaw surgery 21050 T Removal of jaw joint 0256 25.40 $1,259.74 $623.05 $251.95 21060 T Remove jaw joint cartilage 0256 25.40 $1,259.74 $623.05 $251.95 21070 T Remove coronoid process 0256 25.40 $1,259.74 $623.05 $251.95 21076 T Prepare face/oral prosthesis 0254 12.45 $617.47 $272.41 $123.49 21077 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21079 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21080 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21081 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21082 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21083 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21084 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21085 T Prepare face/oral prosthesis 0253 12.02 $596.14 $284.00 $119.23 21086 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21087 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21088 T Prepare face/oral prosthesis 0256 25.40 $1,259.74 $623.05 $251.95 21089 T Prepare face/oral prosthesis 0253 12.02 $596.14 $284.00 $119.23 21100 T Maxillofacial fixation 0256 25.40 $1,259.74 $623.05 $251.95 21110 T Interdental fixation 0254 12.45 $617.47 $272.41 $123.49 21116 N Injection, jaw joint x-ray 21120 T Reconstruction of chin 0254 12.45 $617.47 $272.41 $123.49 21121 T Reconstruction of chin 0254 12.45 $617.47 $272.41 $123.49 21122 T Reconstruction of chin 0254 12.45 $617.47 $272.41 $123.49 21123 T Reconstruction of chin 0254 12.45 $617.47 $272.41 $123.49 21125 T Augmentation, lower jaw bone 0254 12.45 $617.47 $272.41 $123.49 21127 T Augmentation, lower jaw bone 0256 25.40 $1,259.74 $623.05 $251.95 21137 T Reduction of forehead 0254 12.45 $617.47 $272.41 $123.49 21138 T Reduction of forehead 0256 25.40 $1,259.74 $623.05 $251.95 21139 T Reduction of forehead 0256 25.40 $1,259.74 $623.05 $251.95 21141 C Reconstruct midface, lefort 21142 C Reconstruct midface, lefort 21143 C Reconstruct midface, lefort 21145 C Reconstruct midface, lefort 21146 C Reconstruct midface, lefort 21147 C Reconstruct midface, lefort 21150 C Reconstruct midface, lefort 21151 C Reconstruct midface, lefort 21154 C Reconstruct midface, lefort 21155 C Reconstruct midface, lefort 21159 C Reconstruct midface, lefort 21160 C Reconstruct midface, lefort 21172 C Reconstruct orbit/forehead 21175 C Reconstruct orbit/forehead 21179 C Reconstruct entire forehead 21180 C Reconstruct entire forehead 21181 T Contour cranial bone lesion 0254 12.45 $617.47 $272.41 $123.49 21182 C Reconstruct cranial bone 21183 C Reconstruct cranial bone 21184 C Reconstruct cranial bone 21188 C Reconstruction of midface 21193 C Reconst lwr jaw w/o graft 21194 C Reconst lwr jaw w/ graft 21195 C Reconst lwr jaw w/o fixation 21196 C Reconst lwr jaw w/fixation 21198 T Reconst lwr jaw segment 0256 25.40 $1,259.74 $623.05 $251.95 *21199 T Reconst lwr jaw w/advance 0256 25.40 $1,259.74 $623.05 $251.95 21206 T Reconstruct upper jaw bone 0256 25.40 $1,259.74 $623.05 $251.95 21208 T Augmentation of facial bones 0256 25.40 $1,259.74 $623.05 $251.95 21209 T Reduction of facial bones 0256 25.40 $1,259.74 $623.05 $251.95 21210 T Face bone graft 0256 25.40 $1,259.74 $623.05 $251.95 21215 T Lower jaw bone graft 0256 25.40 $1,259.74 $623.05 $251.95 21230 T Rib cartilage graft 0256 25.40 $1,259.74 $623.05 $251.95 21235 T Ear cartilage graft 0254 12.45 $617.47 $272.41 $123.49 21240 T Reconstruction of jaw joint 0256 25.40 $1,259.74 $623.05 $251.95 21242 T Reconstruction of jaw joint 0256 25.40 $1,259.74 $623.05 $251.95 21243 T Reconstruction of jaw joint 0256 25.40 $1,259.74 $623.05 $251.95 21244 T Reconstruction of lower jaw 0256 25.40 $1,259.74 $623.05 $251.95 21245 T Reconstruction of jaw 0256 25.40 $1,259.74 $623.05 $251.95 21246 T Reconstruction of jaw 0256 25.40 $1,259.74 $623.05 $251.95 21247 C Reconstruct lower jaw bone 21248 T Reconstruction of jaw 0256 25.40 $1,259.74 $623.05 $251.95 21249 T Reconstruction of jaw 0256 25.40 $1,259.74 $623.05 $251.95 21255 C Reconstruct lower jaw bone 21256 C Reconstruction of orbit 21260 T Revise eye sockets 0256 25.40 $1,259.74 $623.05 $251.95 21261 T Revise eye sockets 0256 25.40 $1,259.74 $623.05 $251.95 21263 T Revise eye sockets 0256 25.40 $1,259.74 $623.05 $251.95 21267 T Revise eye sockets 0256 25.40 $1,259.74 $623.05 $251.95 21268 C Revise eye sockets 21270 T Augmentation, cheek bone 0256 25.40 $1,259.74 $623.05 $251.95 21275 T Revision, orbitofacial bones 0256 25.40 $1,259.74 $623.05 $251.95 21280 T Revision of eyelid 0256 25.40 $1,259.74 $623.05 $251.95 21282 T Revision of eyelid 0253 12.02 $596.14 $284.00 $119.23 21295 T Revision of jaw muscle/bone 0253 12.02 $596.14 $284.00 $119.23 21296 T Revision of jaw muscle/bone 0254 12.45 $617.47 $272.41 $123.49 21299 T Cranio/maxillofacial surgery 0253 12.02 $596.14 $284.00 $119.23 21300 T Treatment of skull fracture 0253 12.02 $596.14 $284.00 $119.23 21310 T Treatment of nose fracture 0253 12.02 $596.14 $284.00 $119.23 21315 T Treatment of nose fracture 0253 12.02 $596.14 $284.00 $119.23 21320 T Treatment of nose fracture 0253 12.02 $596.14 $284.00 $119.23 21325 T Treatment of nose fracture 0253 12.02 $596.14 $284.00 $119.23 21330 T Treatment of nose fracture 0254 12.45 $617.47 $272.41 $123.49 21335 T Treatment of nose fracture 0254 12.45 $617.47 $272.41 $123.49 21336 T Treat nasal septal fracture 0046 22.29 $1,105.50 $535.76 $221.10 21337 T Treat nasal septal fracture 0253 12.02 $596.14 $284.00 $119.23 21338 T Treat nasoethmoid fracture 0254 12.45 $617.47 $272.41 $123.49 21339 T Treat nasoethmoid fracture 0254 12.45 $617.47 $272.41 $123.49 21340 T Treatment of nose fracture 0256 25.40 $1,259.74 $623.05 $251.95 21343 C Treatment of sinus fracture 21344 C Treatment of sinus fracture 21345 T Treat nose/jaw fracture 0254 12.45 $617.47 $272.41 $123.49 21346 C Treat nose/jaw fracture 21347 C Treat nose/jaw fracture 21348 C Treat nose/jaw fracture 21355 T Treat cheek bone fracture 0256 25.40 $1,259.74 $623.05 $251.95 21356 C Treat cheek bone fracture 21360 C Treat cheek bone fracture 21365 C Treat cheek bone fracture 21366 C Treat cheek bone fracture 21385 C Treat eye socket fracture 21386 C Treat eye socket fracture 21387 C Treat eye socket fracture 21390 C Treat eye socket fracture 21395 C Treat eye socket fracture 21400 T Treat eye socket fracture 0252 5.18 $256.90 $114.24 $51.38 21401 T Treat eye socket fracture 0253 12.02 $596.14 $284.00 $119.23 21406 T Treat eye socket fracture 0256 25.40 $1,259.74 $623.05 $251.95 21407 T Treat eye socket fracture 0256 25.40 $1,259.74 $623.05 $251.95 21408 C Treat eye socket fracture 21421 T Treat mouth roof fracture 0254 12.45 $617.47 $272.41 $123.49 21422 C Treat mouth roof fracture 21423 C Treat mouth roof fracture 21431 C Treat craniofacial fracture 21432 C Treat craniofacial fracture 21433 C Treat craniofacial fracture 21435 C Treat craniofacial fracture 21436 C Treat craniofacial fracture 21440 T Treat dental ridge fracture 0253 12.02 $596.14 $284.00 $119.23 21445 T Treat dental ridge fracture 0254 12.45 $617.47 $272.41 $123.49 21450 T Treat lower jaw fracture 0251 1.68 $83.32 $27.99 $16.66 21451 T Treat lower jaw fracture 0254 12.45 $617.47 $272.41 $123.49 21452 T Treat lower jaw fracture 0253 12.02 $596.14 $284.00 $119.23 21453 T Treat lower jaw fracture 0256 25.40 $1,259.74 $623.05 $251.95 21454 T Treat lower jaw fracture 0254 12.45 $617.47 $272.41 $123.49 21461 T Treat lower jaw fracture 0256 25.40 $1,259.74 $623.05 $251.95 21462 T Treat lower jaw fracture 0256 25.40 $1,259.74 $623.05 $251.95 21465 T Treat lower jaw fracture 0256 25.40 $1,259.74 $623.05 $251.95 21470 T Treat lower jaw fracture 0256 25.40 $1,259.74 $623.05 $251.95 21480 T Reset dislocated jaw 0251 1.68 $83.32 $27.99 $16.66 21485 T Reset dislocated jaw 0253 12.02 $596.14 $284.00 $119.23 21490 T Repair dislocated jaw 0256 25.40 $1,259.74 $623.05 $251.95 21493 T Treat hyoid bone fracture 0252 5.18 $256.90 $114.24 $51.38 21494 T Treat hyoid bone fracture 0252 5.18 $256.90 $114.24 $51.38 21495 C Treat hyoid bone fracture 21497 T Interdental wiring 0253 12.02 $596.14 $284.00 $119.23 21499 T Head surgery procedure 0253 12.02 $596.14 $284.00 $119.23 21501 T Drain neck/chest lesion 0008 6.15 $305.02 $113.67 $61.00 21502 T Drain chest lesion 0050 21.13 $1,047.96 $513.86 $209.59 21510 C Drainage of bone lesion 21550 T Biopsy of neck/chest 0019 4.00 $198.39 $78.91 $39.68 21555 T Remove lesion, neck/chest 0022 12.49 $619.45 $292.94 $123.89 21556 T Remove lesion, neck/chest 0022 12.49 $619.45 $292.94 $123.89 21557 C Remove tumor, neck/chest 21600 T Partial removal of rib 0050 21.13 $1,047.96 $513.86 $209.59 21610 T Partial removal of rib 0050 21.13 $1,047.96 $513.86 $209.59 21615 C Removal of rib 21616 C Removal of rib and nerves 21620 C Partial removal of sternum 21627 C Sternal debridement 21630 C Extensive sternum surgery 21632 C Extensive sternum surgery 21700 T Revision of neck muscle 0008 6.15 $305.02 $113.67 $61.00 21705 C Revision of neck muscle/rib 21720 T Revision of neck muscle 0008 6.15 $305.02 $113.67 $61.00 21725 T Revision of neck muscle 0008 6.15 $305.02 $113.67 $61.00 21740 C Reconstruction of sternum 21750 C Repair of sternum separation 21800 T Treatment of rib fracture 0043 1.64 $81.34 $25.46 $16.27 21805 T Treatment of rib fracture 0046 22.29 $1,105.50 $535.76 $221.10 21810 C Treatment of rib fracture(s) 21820 T Treat sternum fracture 0043 1.64 $81.34 $25.46 $16.27 21825 C Treat sternum fracture 21899 T Neck/chest surgery procedure 0252 5.18 $256.90 $114.24 $51.38 21920 T Biopsy soft tissue of back 0020 6.51 $322.87 $130.53 $64.57 21925 T Biopsy soft tissue of back 0022 12.49 $619.45 $292.94 $123.89 21930 T Remove lesion, back or flank 0022 12.49 $619.45 $292.94 $123.89 21935 T Remove tumor, back 0022 12.49 $619.45 $292.94 $123.89 22100 C Remove part of neck vertebra 22101 C Remove part, thorax vertebra 22102 C Remove part, lumbar vertebra 22103 C Remove extra spine segment 22110 C Remove part of neck vertebra 22112 C Remove part, thorax vertebra 22114 C Remove part, lumbar vertebra 22116 C Remove extra spine segment 22210 C Revision of neck spine 22212 C Revision of thorax spine 22214 C Revision of lumbar spine 22216 C Revise, extra spine segment 22220 C Revision of neck spine 22222 C Revision of thorax spine 22224 C Revision of lumbar spine 22226 C Revise, extra spine segment 22305 T Treat spine process fracture 0043 1.64 $81.34 $25.46 $16.27 22310 T Treat spine fracture 0043 1.64 $81.34 $25.46 $16.27 22315 T Treat spine fracture 0043 1.64 $81.34 $25.46 $16.27 22318 C Treat odontoid fx w/o graft 22319 C Treat odontoid fx w/graft 22325 C Treat spine fracture 22326 C Treat neck spine fracture 22327 C Treat thorax spine fracture 22328 C Treat each add spine fx 22505 T Manipulation of spine 0045 11.02 $546.55 $277.12 $109.31 *22520 T Percut vertebroplasty thor 0049 15.04 $745.93 $356.95 $149.19 *22521 T Percut vertebroplasty lumb 0049 15.04 $745.93 $356.95 $149.19 *22522 T Percut vertebroplasty addl 0049 15.04 $745.93 $356.95 $149.19 22548 C Neck spine fusion 22554 C Neck spine fusion 22556 C Thorax spine fusion 22558 C Lumbar spine fusion 22585 C Additional spinal fusion 22590 C Spine & skull spinal fusion 22595 C Neck spinal fusion 22600 C Neck spine fusion 22610 C Thorax spine fusion 22612 C Lumbar spine fusion 22614 C Spine fusion, extra segment 22630 C Lumbar spine fusion 22632 C Spine fusion, extra segment 22800 C Fusion of spine 22802 C Fusion of spine 22804 C Fusion of spine 22808 C Fusion of spine 22810 C Fusion of spine 22812 C Fusion of spine 22818 C Kyphectomy, 1-2 segments 22819 C Kyphectomy, 3 or more 22830 C Exploration of spinal fusion 22840 C Insert spine fixation device 22841 C Insert spine fixation device 22842 C Insert spine fixation device 22843 C Insert spine fixation device 22844 C Insert spine fixation device 22845 C Insert spine fixation device 22846 C Insert spine fixation device 22847 C Insert spine fixation device 22848 C Insert pelv fixation device 22849 C Reinsert spinal fixation 22850 C Remove spine fixation device 22851 C Apply spine prosth device 22852 C Remove spine fixation device 22855 C Remove spine fixation device 22899 T Spine surgery procedure 0043 1.64 $81.34 $25.46 $16.27 22900 T Remove abdominal wall lesion 0022 12.49 $619.45 $292.94 $123.89 22999 T Abdomen surgery procedure 0022 12.49 $619.45 $292.94 $123.89 23000 T Removal of calcium deposits 0021 10.49 $520.26 $236.51 $104.05 23020 T Release shoulder joint 0051 27.76 $1,376.79 $675.24 $275.36 23030 T Drain shoulder lesion 0008 6.15 $305.02 $113.67 $61.00 23031 T Drain shoulder bursa 0008 6.15 $305.02 $113.67 $61.00 23035 C Drain shoulder bone lesion 23040 T Exploratory shoulder surgery 0050 21.13 $1,047.96 $513.86 $209.59 23044 T Exploratory shoulder surgery 0050 21.13 $1,047.96 $513.86 $209.59 23065 T Biopsy shoulder tissues 0021 10.49 $520.26 $236.51 $104.05 23066 T Biopsy shoulder tissues 0022 12.49 $619.45 $292.94 $123.89 23075 T Removal of shoulder lesion 0021 10.49 $520.26 $236.51 $104.05 23076 T Removal of shoulder lesion 0022 12.49 $619.45 $292.94 $123.89 23077 T Remove tumor of shoulder 0022 12.49 $619.45 $292.94 $123.89 23100 T Biopsy of shoulder joint 0049 15.04 $745.93 $356.95 $149.19 23101 T Shoulder joint surgery 0050 21.13 $1,047.96 $513.86 $209.59 23105 T Remove shoulder joint lining 0050 21.13 $1,047.96 $513.86 $209.59 23106 T Incision of collarbone joint 0050 21.13 $1,047.96 $513.86 $209.59 23107 T Explore treat shoulder joint 0050 21.13 $1,047.96 $513.86 $209.59 23120 T Partial removal, collar bone 0051 27.76 $1,376.79 $675.24 $275.36 23125 C Removal of collar bone 23130 T Remove shoulder bone, part 0051 27.76 $1,376.79 $675.24 $275.36 23140 T Removal of bone lesion 0049 15.04 $745.93 $356.95 $149.19 23145 T Removal of bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 23146 T Removal of bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 23150 T Removal of humerus lesion 0050 21.13 $1,047.96 $513.86 $209.59 23155 T Removal of humerus lesion 0050 21.13 $1,047.96 $513.86 $209.59 23156 T Removal of humerus lesion 0050 21.13 $1,047.96 $513.86 $209.59 23170 T Remove collar bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 23172 T Remove shoulder blade lesion 0050 21.13 $1,047.96 $513.86 $209.59 23174 T Remove humerus lesion 0050 21.13 $1,047.96 $513.86 $209.59 23180 T Remove collar bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 23182 T Remove shoulder blade lesion 0050 21.13 $1,047.96 $513.86 $209.59 23184 T Remove humerus lesion 0050 21.13 $1,047.96 $513.86 $209.59 23190 T Partial removal of scapula 0050 21.13 $1,047.96 $513.86 $209.59 23195 C Removal of head of humerus 23200 C Removal of collar bone 23210 C Removal of shoulder blade 23220 C Partial removal of humerus 23221 C Partial removal of humerus 23222 C Partial removal of humerus 23330 T Remove shoulder foreign body 0019 4.00 $198.39 $78.91 $39.68 23331 T Remove shoulder foreign body 0022 12.49 $619.45 $292.94 $123.89 23332 C Remove shoulder foreign body 23350 N Injection for shoulder x-ray 23395 C Muscle transfer,shoulder/arm 23397 C Muscle transfers 23400 C Fixation of shoulder blade 23405 T Incision of tendon & muscle 0050 21.13 $1,047.96 $513.86 $209.59 23406 T Incise tendon(s) & muscle(s) 0050 21.13 $1,047.96 $513.86 $209.59 23410 T Repair of tendon(s) 0052 36.16 $1,793.39 $930.91 $358.68 23412 T Repair of tendon(s) 0052 36.16 $1,793.39 $930.91 $358.68 23415 T Release of shoulder ligament 0051 27.76 $1,376.79 $675.24 $275.36 23420 T Repair of shoulder 0052 36.16 $1,793.39 $930.91 $358.68 23430 T Repair biceps tendon 0052 36.16 $1,793.39 $930.91 $358.68 23440 C Remove/transplant tendon 23450 T Repair shoulder capsule 0052 36.16 $1,793.39 $930.91 $358.68 23455 T Repair shoulder capsule 0052 36.16 $1,793.39 $930.91 $358.68 23460 T Repair shoulder capsule 0052 36.16 $1,793.39 $930.91 $358.68 23462 T Repair shoulder capsule 0052 36.16 $1,793.39 $930.91 $358.68 23465 T Repair shoulder capsule 0052 36.16 $1,793.39 $930.91 $358.68 23466 T Repair shoulder capsule 0052 36.16 $1,793.39 $930.91 $358.68 23470 C Reconstruct shoulder joint 23472 C Reconstruct shoulder joint 23480 T Revision of collar bone 0051 27.76 $1,376.79 $675.24 $275.36 23485 T Revision of collar bone 0051 27.76 $1,376.79 $675.24 $275.36 23490 T Reinforce clavicle 0051 27.76 $1,376.79 $675.24 $275.36 23491 T Reinforce shoulder bones 0051 27.76 $1,376.79 $675.24 $275.36 23500 T Treat clavicle fracture 0043 1.64 $81.34 $25.46 $16.27 23505 T Treat clavicle fracture 0043 1.64 $81.34 $25.46 $16.27 23515 T Treat clavicle fracture 0046 22.29 $1,105.50 $535.76 $221.10 23520 T Treat clavicle dislocation 0043 1.64 $81.34 $25.46 $16.27 23525 T Treat clavicle dislocation 0043 1.64 $81.34 $25.46 $16.27 23530 T Treat clavicle dislocation 0046 22.29 $1,105.50 $535.76 $221.10 23532 T Treat clavicle dislocation 0046 22.29 $1,105.50 $535.76 $221.10 23540 T Treat clavicle dislocation 0043 1.64 $81.34 $25.46 $16.27 23545 T Treat clavicle dislocation 0043 1.64 $81.34 $25.46 $16.27 23550 T Treat clavicle dislocation 0046 22.29 $1,105.50 $535.76 $221.10 23552 T Treat clavicle dislocation 0046 22.29 $1,105.50 $535.76 $221.10 23570 T Treat shoulder blade fx 0043 1.64 $81.34 $25.46 $16.27 23575 T Treat shoulder blade fx 0043 1.64 $81.34 $25.46 $16.27 23585 T Treat scapula fracture 0046 22.29 $1,105.50 $535.76 $221.10 23600 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 23605 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 23615 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 23616 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 23620 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 23625 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 23630 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 23650 T Treat shoulder dislocation 0043 1.64 $81.34 $25.46 $16.27 23655 T Treat shoulder dislocation 0045 11.02 $546.55 $277.12 $109.31 23660 T Treat shoulder dislocation 0046 22.29 $1,105.50 $535.76 $221.10 23665 T Treat dislocation/fracture 0044 2.17 $107.63 $38.08 $21.53 23670 T Treat dislocation/fracture 0046 22.29 $1,105.50 $535.76 $221.10 23675 T Treat dislocation/fracture 0044 2.17 $107.63 $38.08 $21.53 23680 T Treat dislocation/fracture 0046 22.29 $1,105.50 $535.76 $221.10 23700 T Fixation of shoulder 0045 11.02 $546.55 $277.12 $109.31 23800 T Fusion of shoulder joint 0051 27.76 $1,376.79 $675.24 $275.36 23802 T Fusion of shoulder joint 0051 27.76 $1,376.79 $675.24 $275.36 23900 C Amputation of arm & girdle 23920 C Amputation at shoulder joint 23921 T Amputation follow-up surgery 0026 12.11 $600.61 $277.92 $120.12 23929 T Shoulder surgery procedure 0043 1.64 $81.34 $25.46 $16.27 23930 T Drainage of arm lesion 0008 6.15 $305.02 $113.67 $61.00 23931 T Drainage of arm bursa 0008 6.15 $305.02 $113.67 $61.00 23935 T Drain arm/elbow bone lesion 0049 15.04 $745.93 $356.95 $149.19 24000 T Exploratory elbow surgery 0050 21.13 $1,047.96 $513.86 $209.59 24006 T Release elbow joint 0050 21.13 $1,047.96 $513.86 $209.59 24065 T Biopsy arm/elbow soft tissue 0020 6.51 $322.87 $130.53 $64.57 24066 T Biopsy arm/elbow soft tissue 0020 6.51 $322.87 $130.53 $64.57 24075 T Remove arm/elbow lesion 0021 10.49 $520.26 $236.51 $104.05 24076 T Remove arm/elbow lesion 0022 12.49 $619.45 $292.94 $123.89 24077 T Remove tumor of arm/elbow 0022 12.49 $619.45 $292.94 $123.89 24100 T Biopsy elbow joint lining 0049 15.04 $745.93 $356.95 $149.19 24101 T Explore/treat elbow joint 0050 21.13 $1,047.96 $513.86 $209.59 24102 T Remove elbow joint lining 0050 21.13 $1,047.96 $513.86 $209.59 24105 T Removal of elbow bursa 0049 15.04 $745.93 $356.95 $149.19 24110 T Remove humerus lesion 0049 15.04 $745.93 $356.95 $149.19 24115 T Remove/graft bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 24116 T Remove/graft bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 24120 T Remove elbow lesion 0049 15.04 $745.93 $356.95 $149.19 24125 T Remove/graft bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 24126 T Remove/graft bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 24130 T Removal of head of radius 0050 21.13 $1,047.96 $513.86 $209.59 24134 T Removal of arm bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 24136 T Remove radius bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 24138 T Remove elbow bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 24140 T Partial removal of arm bone 0050 21.13 $1,047.96 $513.86 $209.59 24145 T Partial removal of radius 0050 21.13 $1,047.96 $513.86 $209.59 24147 T Partial removal of elbow 0050 21.13 $1,047.96 $513.86 $209.59 24149 C Radical resection of elbow 24150 C Extensive humerus surgery 24151 C Extensive humerus surgery 24152 C Extensive radius surgery 24153 C Extensive radius surgery 24155 T Removal of elbow joint 0051 27.76 $1,376.79 $675.24 $275.36 24160 T Remove elbow joint implant 0050 21.13 $1,047.96 $513.86 $209.59 24164 T Remove radius head implant 0050 21.13 $1,047.96 $513.86 $209.59 24200 T Removal of arm foreign body 0019 4.00 $198.39 $78.91 $39.68 24201 T Removal of arm foreign body 0021 10.49 $520.26 $236.51 $104.05 24220 N Injection for elbow x-ray 24301 T Muscle/tendon transfer 0050 21.13 $1,047.96 $513.86 $209.59 24305 T Arm tendon lengthening 0050 21.13 $1,047.96 $513.86 $209.59 24310 T Revision of arm tendon 0049 15.04 $745.93 $356.95 $149.19 24320 T Repair of arm tendon 0051 27.76 $1,376.79 $675.24 $275.36 24330 T Revision of arm muscles 0051 27.76 $1,376.79 $675.24 $275.36 24331 T Revision of arm muscles 0051 27.76 $1,376.79 $675.24 $275.36 24340 T Repair of biceps tendon 0051 27.76 $1,376.79 $675.24 $275.36 24341 T Repair arm tendon/muscle 0051 27.76 $1,376.79 $675.24 $275.36 24342 T Repair of ruptured tendon 0051 27.76 $1,376.79 $675.24 $275.36 24350 T Repair of tennis elbow 0050 21.13 $1,047.96 $513.86 $209.59 24351 T Repair of tennis elbow 0050 21.13 $1,047.96 $513.86 $209.59 24352 T Repair of tennis elbow 0050 21.13 $1,047.96 $513.86 $209.59 24354 T Repair of tennis elbow 0050 21.13 $1,047.96 $513.86 $209.59 24356 T Revision of tennis elbow 0050 21.13 $1,047.96 $513.86 $209.59 24360 T Reconstruct elbow joint 0047 22.09 $1,095.58 $537.03 $219.12 24361 T Reconstruct elbow joint 0048 29.06 $1,441.26 $725.94 $288.25 24362 T Reconstruct elbow joint 0048 29.06 $1,441.26 $725.94 $288.25 24363 T Replace elbow joint 0048 29.06 $1,441.26 $725.94 $288.25 24365 T Reconstruct head of radius 0047 22.09 $1,095.58 $537.03 $219.12 24366 T Reconstruct head of radius 0048 29.06 $1,441.26 $725.94 $288.25 24400 T Revision of humerus 0050 21.13 $1,047.96 $513.86 $209.59 24410 T Revision of humerus 0050 21.13 $1,047.96 $513.86 $209.59 24420 T Revision of humerus 0051 27.76 $1,376.79 $675.24 $275.36 24430 T Repair of humerus 0051 27.76 $1,376.79 $675.24 $275.36 24435 T Repair humerus with graft 0051 27.76 $1,376.79 $675.24 $275.36 24470 T Revision of elbow joint 0051 27.76 $1,376.79 $675.24 $275.36 24495 T Decompression of forearm 0050 21.13 $1,047.96 $513.86 $209.59 24498 T Reinforce humerus 0051 27.76 $1,376.79 $675.24 $275.36 24500 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 24505 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 24515 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24516 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24530 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 24535 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 24538 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24545 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24546 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24560 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 24565 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 24566 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24575 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24576 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 24577 T Treat humerus fracture 0044 2.17 $107.63 $38.08 $21.53 24579 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24582 T Treat humerus fracture 0046 22.29 $1,105.50 $535.76 $221.10 24586 T Treat elbow fracture 0046 22.29 $1,105.50 $535.76 $221.10 24587 T Treat elbow fracture 0046 22.29 $1,105.50 $535.76 $221.10 24600 T Treat elbow dislocation 0044 2.17 $107.63 $38.08 $21.53 24605 T Treat elbow dislocation 0045 11.02 $546.55 $277.12 $109.31 24615 T Treat elbow dislocation 0046 22.29 $1,105.50 $535.76 $221.10 24620 T Treat elbow fracture 0044 2.17 $107.63 $38.08 $21.53 24635 T Treat elbow fracture 0046 22.29 $1,105.50 $535.76 $221.10 24640 T Treat elbow dislocation 0044 2.17 $107.63 $38.08 $21.53 24650 T Treat radius fracture 0044 2.17 $107.63 $38.08 $21.53 24655 T Treat radius fracture 0044 2.17 $107.63 $38.08 $21.53 24665 T Treat radius fracture 0046 22.29 $1,105.50 $535.76 $221.10 24666 T Treat radius fracture 0046 22.29 $1,105.50 $535.76 $221.10 24670 T Treat ulnar fracture 0044 2.17 $107.63 $38.08 $21.53 24675 T Treat ulnar fracture 0044 2.17 $107.63 $38.08 $21.53 24685 T Treat ulnar fracture 0046 22.29 $1,105.50 $535.76 $221.10 24800 T Fusion of elbow joint 0051 27.76 $1,376.79 $675.24 $275.36 24802 T Fusion/graft of elbow joint 0051 27.76 $1,376.79 $675.24 $275.36 24900 C Amputation of upper arm 24920 C Amputation of upper arm 24925 T Amputation follow-up surgery 0049 15.04 $745.93 $356.95 $149.19 24930 C Amputation follow-up surgery 24931 C Amputate upper arm & implant 24935 T Revision of amputation 0052 36.16 $1,793.39 $930.91 $358.68 24940 C Revision of upper arm 24999 T Upper arm/elbow surgery 0044 2.17 $107.63 $38.08 $21.53 25000 T Incision of tendon sheath 0049 15.04 $745.93 $356.95 $149.19 25020 T Decompression of forearm 0049 15.04 $745.93 $356.95 $149.19 25023 T Decompression of forearm 0050 21.13 $1,047.96 $513.86 $209.59 25028 T Drainage of forearm lesion 0049 15.04 $745.93 $356.95 $149.19 25031 T Drainage of forearm bursa 0049 15.04 $745.93 $356.95 $149.19 25035 T Treat forearm bone lesion 0049 15.04 $745.93 $356.95 $149.19 25040 T Explore/treat wrist joint 0050 21.13 $1,047.96 $513.86 $209.59 25065 T Biopsy forearm soft tissues 0020 6.51 $322.87 $130.53 $64.57 25066 T Biopsy forearm soft tissues 0022 12.49 $619.45 $292.94 $123.89 25075 T Removal of forearm lesion 0020 6.51 $322.87 $130.53 $64.57 25076 T Removal of forearm lesion 0022 12.49 $619.45 $292.94 $123.89 25077 T Remove tumor, forearm/wrist 0022 12.49 $619.45 $292.94 $123.89 25085 T Incision of wrist capsule 0049 15.04 $745.93 $356.95 $149.19 25100 T Biopsy of wrist joint 0049 15.04 $745.93 $356.95 $149.19 25101 T Explore/treat wrist joint 0050 21.13 $1,047.96 $513.86 $209.59 25105 T Remove wrist joint lining 0050 21.13 $1,047.96 $513.86 $209.59 25107 T Remove wrist joint cartilage 0050 21.13 $1,047.96 $513.86 $209.59 25110 T Remove wrist tendon lesion 0049 15.04 $745.93 $356.95 $149.19 25111 T Remove wrist tendon lesion 0053 11.32 $561.42 $253.49 $112.28 25112 T Reremove wrist tendon lesion 0053 11.32 $561.42 $253.49 $112.28 25115 T Remove wrist/forearm lesion 0049 15.04 $745.93 $356.95 $149.19 25116 T Remove wrist/forearm lesion 0049 15.04 $745.93 $356.95 $149.19 25118 T Excise wrist tendon sheath 0050 21.13 $1,047.96 $513.86 $209.59 25119 T Partial removal of ulna 0050 21.13 $1,047.96 $513.86 $209.59 25120 T Removal of forearm lesion 0050 21.13 $1,047.96 $513.86 $209.59 25125 T Remove/graft forearm lesion 0050 21.13 $1,047.96 $513.86 $209.59 25126 T Remove/graft forearm lesion 0050 21.13 $1,047.96 $513.86 $209.59 25130 T Removal of wrist lesion 0050 21.13 $1,047.96 $513.86 $209.59 25135 T Remove & graft wrist lesion 0050 21.13 $1,047.96 $513.86 $209.59 25136 T Remove & graft wrist lesion 0050 21.13 $1,047.96 $513.86 $209.59 25145 T Remove forearm bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 25150 T Partial removal of ulna 0050 21.13 $1,047.96 $513.86 $209.59 25151 T Partial removal of radius 0050 21.13 $1,047.96 $513.86 $209.59 25170 C Extensive forearm surgery 25210 T Removal of wrist bone 0054 19.66 $975.06 $472.33 $195.01 25215 T Removal of wrist bones 0054 19.66 $975.06 $472.33 $195.01 25230 T Partial removal of radius 0050 21.13 $1,047.96 $513.86 $209.59 25240 T Partial removal of ulna 0050 21.13 $1,047.96 $513.86 $209.59 25246 N Injection for wrist x-ray 25248 T Remove forearm foreign body 0049 15.04 $745.93 $356.95 $149.19 25250 T Removal of wrist prosthesis 0050 21.13 $1,047.96 $513.86 $209.59 25251 T Removal of wrist prosthesis 0050 21.13 $1,047.96 $513.86 $209.59 25260 T Repair forearm tendon/muscle 0050 21.13 $1,047.96 $513.86 $209.59 25263 T Repair forearm tendon/muscle 0050 21.13 $1,047.96 $513.86 $209.59 25265 T Repair forearm tendon/muscle 0050 21.13 $1,047.96 $513.86 $209.59 25270 T Repair forearm tendon/muscle 0050 21.13 $1,047.96 $513.86 $209.59 25272 T Repair forearm tendon/muscle 0050 21.13 $1,047.96 $513.86 $209.59 25274 T Repair forearm tendon/muscle 0050 21.13 $1,047.96 $513.86 $209.59 25280 T Revise wrist/forearm tendon 0050 21.13 $1,047.96 $513.86 $209.59 25290 T Incise wrist/forearm tendon 0050 21.13 $1,047.96 $513.86 $209.59 25295 T Release wrist/forearm tendon 0049 15.04 $745.93 $356.95 $149.19 25300 T Fusion of tendons at wrist 0050 21.13 $1,047.96 $513.86 $209.59 25301 T Fusion of tendons at wrist 0050 21.13 $1,047.96 $513.86 $209.59 27606 T Incision of achilles tendon 0049 15.04 $745.93 $356.95 $149.19 27607 T Treat lower leg bone lesion 0049 15.04 $745.93 $356.95 $149.19 27610 T Explore/treat ankle joint 0050 21.13 $1,047.96 $513.86 $209.59 27612 T Exploration of ankle joint 0050 21.13 $1,047.96 $513.86 $209.59 27613 T Biopsy lower leg soft tissue 0020 6.51 $322.87 $130.53 $64.57 27614 T Biopsy lower leg soft tissue 0022 12.49 $619.45 $292.94 $123.89 27615 T Remove tumor, lower leg 0046 22.29 $1,105.50 $535.76 $221.10 27618 T Remove lower leg lesion 0021 10.49 $520.26 $236.51 $104.05 27619 T Remove lower leg lesion 0022 12.49 $619.45 $292.94 $123.89 27620 T Explore/treat ankle joint 0050 21.13 $1,047.96 $513.86 $209.59 27625 T Remove ankle joint lining 0050 21.13 $1,047.96 $513.86 $209.59 27626 T Remove ankle joint lining 0050 21.13 $1,047.96 $513.86 $209.59 27630 T Removal of tendon lesion 0049 15.04 $745.93 $356.95 $149.19 27635 T Remove lower leg bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 27637 T Remove/graft leg bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 27638 T Remove/graft leg bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 27640 T Partial removal of tibia 0051 27.76 $1,376.79 $675.24 $275.36 27641 T Partial removal of fibula 0050 21.13 $1,047.96 $513.86 $209.59 27645 C Extensive lower leg surgery 27646 C Extensive lower leg surgery 27647 T Extensive ankle/heel surgery 0051 27.76 $1,376.79 $675.24 $275.36 27648 N Injection for ankle x-ray 27650 T Repair achilles tendon 0051 27.76 $1,376.79 $675.24 $275.36 27652 T Repair/graft achilles tendon 0051 27.76 $1,376.79 $675.24 $275.36 27654 T Repair of achilles tendon 0051 27.76 $1,376.79 $675.24 $275.36 27656 T Repair leg fascia defect 0049 15.04 $745.93 $356.95 $149.19 27658 T Repair of leg tendon, each 0049 15.04 $745.93 $356.95 $149.19 27659 T Repair of leg tendon, each 0049 15.04 $745.93 $356.95 $149.19 27664 T Repair of leg tendon, each 0049 15.04 $745.93 $356.95 $149.19 27665 T Repair of leg tendon, each 0050 21.13 $1,047.96 $513.86 $209.59 27675 T Repair lower leg tendons 0049 15.04 $745.93 $356.95 $149.19 27676 T Repair lower leg tendons 0050 21.13 $1,047.96 $513.86 $209.59 27680 T Release of lower leg tendon 0050 21.13 $1,047.96 $513.86 $209.59 27681 T Release of lower leg tendons 0050 21.13 $1,047.96 $513.86 $209.59 27685 T Revision of lower leg tendon 0050 21.13 $1,047.96 $513.86 $209.59 27686 T Revise lower leg tendons 0050 21.13 $1,047.96 $513.86 $209.59 27687 T Revision of calf tendon 0050 21.13 $1,047.96 $513.86 $209.59 27690 T Revise lower leg tendon 0051 27.76 $1,376.79 $675.24 $275.36 27691 T Revise lower leg tendon 0051 27.76 $1,376.79 $675.24 $275.36 27692 T Revise additional leg tendon 0051 27.76 $1,376.79 $675.24 $275.36 27695 T Repair of ankle ligament 0050 21.13 $1,047.96 $513.86 $209.59 27696 T Repair of ankle ligaments 0050 21.13 $1,047.96 $513.86 $209.59 27698 T Repair of ankle ligament 0050 21.13 $1,047.96 $513.86 $209.59 27700 T Revision of ankle joint 0047 22.09 $1,095.58 $537.03 $219.12 27702 C Reconstruct ankle joint 27703 C Reconstruction, ankle joint 27704 T Removal of ankle implant 0049 15.04 $745.93 $356.95 $149.19 27705 T Incision of tibia 0051 27.76 $1,376.79 $675.24 $275.36 27707 T Incision of fibula 0049 15.04 $745.93 $356.95 $149.19 27709 T Incision of tibia & fibula 0050 21.13 $1,047.96 $513.86 $209.59 27712 C Realignment of lower leg 27715 C Revision of lower leg 27720 C Repair of tibia 27722 C Repair/graft of tibia 27724 C Repair/graft of tibia 27725 C Repair of lower leg 27727 C Repair of lower leg 27730 T Repair of tibia epiphysis 0050 21.13 $1,047.96 $513.86 $209.59 27732 T Repair of fibula epiphysis 0050 21.13 $1,047.96 $513.86 $209.59 27734 T Repair lower leg epiphyses 0050 21.13 $1,047.96 $513.86 $209.59 27740 T Repair of leg epiphyses 0050 21.13 $1,047.96 $513.86 $209.59 27742 T Repair of leg epiphyses 0051 27.76 $1,376.79 $675.24 $275.36 27745 T Reinforce tibia 0051 27.76 $1,376.79 $675.24 $275.36 27750 T Treatment of tibia fracture 0044 2.17 $107.63 $38.08 $21.53 27752 T Treatment of tibia fracture 0044 2.17 $107.63 $38.08 $21.53 27756 T Treatment of tibia fracture 0046 22.29 $1,105.50 $535.76 $221.10 27758 T Treatment of tibia fracture 0046 22.29 $1,105.50 $535.76 $221.10 27759 T Treatment of tibia fracture 0046 22.29 $1,105.50 $535.76 $221.10 27760 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 27762 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 27766 T Treatment of ankle fracture 0046 22.29 $1,105.50 $535.76 $221.10 27780 T Treatment of fibula fracture 0044 2.17 $107.63 $38.08 $21.53 27781 T Treatment of fibula fracture 0044 2.17 $107.63 $38.08 $21.53 27784 T Treatment of fibula fracture 0046 22.29 $1,105.50 $535.76 $221.10 27786 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 27788 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 27792 T Treatment of ankle fracture 0046 22.29 $1,105.50 $535.76 $221.10 27808 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 27810 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 27814 T Treatment of ankle fracture 0046 22.29 $1,105.50 $535.76 $221.10 27816 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 27818 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 27822 T Treatment of ankle fracture 0046 22.29 $1,105.50 $535.76 $221.10 27823 T Treatment of ankle fracture 0046 22.29 $1,105.50 $535.76 $221.10 27824 T Treat lower leg fracture 0044 2.17 $107.63 $38.08 $21.53 27825 T Treat lower leg fracture 0044 2.17 $107.63 $38.08 $21.53 27826 T Treat lower leg fracture 0046 22.29 $1,105.50 $535.76 $221.10 27827 T Treat lower leg fracture 0046 22.29 $1,105.50 $535.76 $221.10 27828 T Treat lower leg fracture 0046 22.29 $1,105.50 $535.76 $221.10 27829 T Treat lower leg joint 0046 22.29 $1,105.50 $535.76 $221.10 27830 T Treat lower leg dislocation 0044 2.17 $107.63 $38.08 $21.53 27831 T Treat lower leg dislocation 0045 11.02 $546.55 $277.12 $109.31 27832 T Treat lower leg dislocation 0046 22.29 $1,105.50 $535.76 $221.10 27840 T Treat ankle dislocation 0044 2.17 $107.63 $38.08 $21.53 27842 T Treat ankle dislocation 0045 11.02 $546.55 $277.12 $109.31 27846 T Treat ankle dislocation 0046 22.29 $1,105.50 $535.76 $221.10 27848 T Treat ankle dislocation 0046 22.29 $1,105.50 $535.76 $221.10 27860 T Fixation of ankle joint 0045 11.02 $546.55 $277.12 $109.31 27870 T Fusion of ankle joint 0051 27.76 $1,376.79 $675.24 $275.36 27871 T Fusion of tibiofibular joint 0051 27.76 $1,376.79 $675.24 $275.36 27880 C Amputation of lower leg 27881 C Amputation of lower leg 27882 C Amputation of lower leg 27884 T Amputation follow-up surgery 0049 15.04 $745.93 $356.95 $149.19 27886 C Amputation follow-up surgery 27888 C Amputation of foot at ankle 27889 T Amputation of foot at ankle 0050 21.13 $1,047.96 $513.86 $209.59 27892 T Decompression of leg 0049 15.04 $745.93 $356.95 $149.19 27893 T Decompression of leg 0049 15.04 $745.93 $356.95 $149.19 27894 T Decompression of leg 0049 15.04 $745.93 $356.95 $149.19 27899 T Leg/ankle surgery procedure 0044 2.17 $107.63 $38.08 $21.53 28001 T Drainage of bursa of foot 0008 6.15 $305.02 $113.67 $61.00 28002 T Treatment of foot infection 0049 15.04 $745.93 $356.95 $149.19 28003 T Treatment of foot infection 0049 15.04 $745.93 $356.95 $149.19 28005 T Treat foot bone lesion 0055 15.47 $767.26 $355.34 $153.45 28008 T Incision of foot fascia 0055 15.47 $767.26 $355.34 $153.45 28010 T Incision of toe tendon 0055 15.47 $767.26 $355.34 $153.45 28011 T Incision of toe tendons 0055 15.47 $767.26 $355.34 $153.45 28020 T Exploration of foot joint 0055 15.47 $767.26 $355.34 $153.45 28022 T Exploration of foot joint 0055 15.47 $767.26 $355.34 $153.45 28024 T Exploration of toe joint 0055 15.47 $767.26 $355.34 $153.45 28030 T Removal of foot nerve 0220 13.96 $692.36 $326.21 $138.47 28035 T Decompression of tibia nerve 0220 13.96 $692.36 $326.21 $138.47 28043 T Excision of foot lesion 0021 10.49 $520.26 $236.51 $104.05 28045 T Excision of foot lesion 0055 15.47 $767.26 $355.34 $153.45 28046 T Resection of tumor, foot 0055 15.47 $767.26 $355.34 $153.45 28050 T Biopsy of foot joint lining 0055 15.47 $767.26 $355.34 $153.45 28052 T Biopsy of foot joint lining 0055 15.47 $767.26 $355.34 $153.45 28054 T Biopsy of toe joint lining 0055 15.47 $767.26 $355.34 $153.45 28060 T Partial removal, foot fascia 0056 17.30 $858.02 $405.81 $171.60 28062 T Removal of foot fascia 0056 17.30 $858.02 $405.81 $171.60 28070 T Removal of foot joint lining 0056 17.30 $858.02 $405.81 $171.60 28072 T Removal of foot joint lining 0056 17.30 $858.02 $405.81 $171.60 28080 T Removal of foot lesion 0055 15.47 $767.26 $355.34 $153.45 28086 T Excise foot tendon sheath 0055 15.47 $767.26 $355.34 $153.45 28088 T Excise foot tendon sheath 0055 15.47 $767.26 $355.34 $153.45 28090 T Removal of foot lesion 0055 15.47 $767.26 $355.34 $153.45 28092 T Removal of toe lesions 0055 15.47 $767.26 $355.34 $153.45 28100 T Removal of ankle/heel lesion 0055 15.47 $767.26 $355.34 $153.45 28102 T Remove/graft foot lesion 0056 17.30 $858.02 $405.81 $171.60 28103 T Remove/graft foot lesion 0056 17.30 $858.02 $405.81 $171.60 28104 T Removal of foot lesion 0055 15.47 $767.26 $355.34 $153.45 28106 T Remove/graft foot lesion 0056 17.30 $858.02 $405.81 $171.60 28107 T Remove/graft foot lesion 0056 17.30 $858.02 $405.81 $171.60 28108 T Removal of toe lesions 0055 15.47 $767.26 $355.34 $153.45 28110 T Part removal of metatarsal 0057 21.00 $1,041.52 $496.65 $208.30 28111 T Part removal of metatarsal 0055 15.47 $767.26 $355.34 $153.45 28112 T Part removal of metatarsal 0055 15.47 $767.26 $355.34 $153.45 28113 T Part removal of metatarsal 0055 15.47 $767.26 $355.34 $153.45 28114 T Removal of metatarsal heads 0055 15.47 $767.26 $355.34 $153.45 28116 T Revision of foot 0055 15.47 $767.26 $355.34 $153.45 28118 T Removal of heel bone 0055 15.47 $767.26 $355.34 $153.45 28119 T Removal of heel spur 0055 15.47 $767.26 $355.34 $153.45 28120 T Part removal of ankle/heel 0055 15.47 $767.26 $355.34 $153.45 28122 T Partial removal of foot bone 0055 15.47 $767.26 $355.34 $153.45 28124 T Partial removal of toe 0055 15.47 $767.26 $355.34 $153.45 28126 T Partial removal of toe 0055 15.47 $767.26 $355.34 $153.45 28130 T Removal of ankle bone 0055 15.47 $767.26 $355.34 $153.45 28140 T Removal of metatarsal 0055 15.47 $767.26 $355.34 $153.45 28150 T Removal of toe 0055 15.47 $767.26 $355.34 $153.45 28153 T Partial removal of toe 0055 15.47 $767.26 $355.34 $153.45 28160 T Partial removal of toe 0055 15.47 $767.26 $355.34 $153.45 28171 T Extensive foot surgery 0055 15.47 $767.26 $355.34 $153.45 28173 T Extensive foot surgery 0055 15.47 $767.26 $355.34 $153.45 28175 T Extensive foot surgery 0055 15.47 $767.26 $355.34 $153.45 28190 T Removal of foot foreign body 0019 4.00 $198.39 $78.91 $39.68 28192 T Removal of foot foreign body 0021 10.49 $520.26 $236.51 $104.05 28193 T Removal of foot foreign body 0020 6.51 $322.87 $130.53 $64.57 28200 T Repair of foot tendon 0055 15.47 $767.26 $355.34 $153.45 28202 T Repair/graft of foot tendon 0056 17.30 $858.02 $405.81 $171.60 28208 T Repair of foot tendon 0055 15.47 $767.26 $355.34 $153.45 28210 T Repair/graft of foot tendon 0055 15.47 $767.26 $355.34 $153.45 28220 T Release of foot tendon 0055 15.47 $767.26 $355.34 $153.45 28222 T Release of foot tendons 0055 15.47 $767.26 $355.34 $153.45 28225 T Release of foot tendon 0055 15.47 $767.26 $355.34 $153.45 28226 T Release of foot tendons 0055 15.47 $767.26 $355.34 $153.45 28230 T Incision of foot tendon(s) 0055 15.47 $767.26 $355.34 $153.45 28232 T Incision of toe tendon 0055 15.47 $767.26 $355.34 $153.45 28234 T Incision of foot tendon 0055 15.47 $767.26 $355.34 $153.45 28238 T Revision of foot tendon 0056 17.30 $858.02 $405.81 $171.60 28240 T Release of big toe 0055 15.47 $767.26 $355.34 $153.45 28250 T Revision of foot fascia 0056 17.30 $858.02 $405.81 $171.60 28260 T Release of midfoot joint 0056 17.30 $858.02 $405.81 $171.60 28261 T Revision of foot tendon 0056 17.30 $858.02 $405.81 $171.60 28262 T Revision of foot and ankle 0056 17.30 $858.02 $405.81 $171.60 28264 T Release of midfoot joint 0056 17.30 $858.02 $405.81 $171.60 28270 T Release of foot contracture 0055 15.47 $767.26 $355.34 $153.45 28272 T Release of toe joint, each 0055 15.47 $767.26 $355.34 $153.45 28280 T Fusion of toes 0055 15.47 $767.26 $355.34 $153.45 28285 T Repair of hammertoe 0055 15.47 $767.26 $355.34 $153.45 28286 T Repair of hammertoe 0055 15.47 $767.26 $355.34 $153.45 28288 T Partial removal of foot bone 0056 17.30 $858.02 $405.81 $171.60 28289 T Repair hallux rigidus 0056 17.30 $858.02 $405.81 $171.60 28290 T Correction of bunion 0057 21.00 $1,041.52 $496.65 $208.30 28292 T Correction of bunion 0057 21.00 $1,041.52 $496.65 $208.30 28293 T Correction of bunion 0057 21.00 $1,041.52 $496.65 $208.30 28294 T Correction of bunion 0057 21.00 $1,041.52 $496.65 $208.30 28296 T Correction of bunion 0057 21.00 $1,041.52 $496.65 $208.30 28297 T Correction of bunion 0057 21.00 $1,041.52 $496.65 $208.30 28298 T Correction of bunion 0057 21.00 $1,041.52 $496.65 $208.30 28299 T Correction of bunion 0057 21.00 $1,041.52 $496.65 $208.30 28300 T Incision of heel bone 0056 17.30 $858.02 $405.81 $171.60 28302 T Incision of ankle bone 0056 17.30 $858.02 $405.81 $171.60 28304 T Incision of midfoot bones 0056 17.30 $858.02 $405.81 $171.60 28305 T Incise/graft midfoot bones 0056 17.30 $858.02 $405.81 $171.60 28306 T Incision of metatarsal 0056 17.30 $858.02 $405.81 $171.60 28307 T Incision of metatarsal 0056 17.30 $858.02 $405.81 $171.60 28308 T Incision of metatarsal 0056 17.30 $858.02 $405.81 $171.60 28309 T Incision of metatarsals 0056 17.30 $858.02 $405.81 $171.60 28310 T Revision of big toe 0055 15.47 $767.26 $355.34 $153.45 28312 T Revision of toe 0055 15.47 $767.26 $355.34 $153.45 28313 T Repair deformity of toe 0055 15.47 $767.26 $355.34 $153.45 28315 T Removal of sesamoid bone 0055 15.47 $767.26 $355.34 $153.45 28320 T Repair of foot bones 0056 17.30 $858.02 $405.81 $171.60 28322 T Repair of metatarsals 0056 17.30 $858.02 $405.81 $171.60 28340 T Resect enlarged toe tissue 0055 15.47 $767.26 $355.34 $153.45 28341 T Resect enlarged toe 0055 15.47 $767.26 $355.34 $153.45 28344 T Repair extra toe(s) 0056 17.30 $858.02 $405.81 $171.60 28345 T Repair webbed toe(s) 0056 17.30 $858.02 $405.81 $171.60 28360 T Reconstruct cleft foot 0056 17.30 $858.02 $405.81 $171.60 28400 T Treatment of heel fracture 0044 2.17 $107.63 $38.08 $21.53 28405 T Treatment of heel fracture 0044 2.17 $107.63 $38.08 $21.53 28406 T Treatment of heel fracture 0046 22.29 $1,105.50 $535.76 $221.10 28415 T Treat heel fracture 0046 22.29 $1,105.50 $535.76 $221.10 28420 T Treat/graft heel fracture 0046 22.29 $1,105.50 $535.76 $221.10 28430 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 28435 T Treatment of ankle fracture 0044 2.17 $107.63 $38.08 $21.53 28436 T Treatment of ankle fracture 0046 22.29 $1,105.50 $535.76 $221.10 28445 T Treat ankle fracture 0046 22.29 $1,105.50 $535.76 $221.10 28450 T Treat midfoot fracture, each 0044 2.17 $107.63 $38.08 $21.53 28455 T Treat midfoot fracture, each 0044 2.17 $107.63 $38.08 $21.53 28456 T Treat midfoot fracture 0046 22.29 $1,105.50 $535.76 $221.10 28465 T Treat midfoot fracture, each 0046 22.29 $1,105.50 $535.76 $221.10 28470 T Treat metatarsal fracture 0044 2.17 $107.63 $38.08 $21.53 28475 T Treat metatarsal fracture 0044 2.17 $107.63 $38.08 $21.53 28476 T Treat metatarsal fracture 0046 22.29 $1,105.50 $535.76 $221.10 28485 T Treat metatarsal fracture 0046 22.29 $1,105.50 $535.76 $221.10 28490 T Treat big toe fracture 0043 1.64 $81.34 $25.46 $16.27 28495 T Treat big toe fracture 0043 1.64 $81.34 $25.46 $16.27 28496 T Treat big toe fracture 0046 22.29 $1,105.50 $535.76 $221.10 28505 T Treat big toe fracture 0046 22.29 $1,105.50 $535.76 $221.10 28510 T Treatment of toe fracture 0043 1.64 $81.34 $25.46 $16.27 28515 T Treatment of toe fracture 0043 1.64 $81.34 $25.46 $16.27 28525 T Treat toe fracture 0046 22.29 $1,105.50 $535.76 $221.10 28530 T Treat sesamoid bone fracture 0044 2.17 $107.63 $38.08 $21.53 28531 T Treat sesamoid bone fracture 0046 22.29 $1,105.50 $535.76 $221.10 28540 T Treat foot dislocation 0044 2.17 $107.63 $38.08 $21.53 28545 T Treat foot dislocation 0045 11.02 $546.55 $277.12 $109.31 28546 T Treat foot dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28555 T Repair foot dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28570 T Treat foot dislocation 0044 2.17 $107.63 $38.08 $21.53 28575 T Treat foot dislocation 0045 11.02 $546.55 $277.12 $109.31 28576 T Treat foot dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28585 T Repair foot dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28600 T Treat foot dislocation 0044 2.17 $107.63 $38.08 $21.53 28605 T Treat foot dislocation 0045 11.02 $546.55 $277.12 $109.31 28606 T Treat foot dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28615 T Repair foot dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28630 T Treat toe dislocation 0043 1.64 $81.34 $25.46 $16.27 28635 T Treat toe dislocation 0045 11.02 $546.55 $277.12 $109.31 28636 T Treat toe dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28645 T Repair toe dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28660 T Treat toe dislocation 0043 1.64 $81.34 $25.46 $16.27 28665 T Treat toe dislocation 0045 11.02 $546.55 $277.12 $109.31 28666 T Treat toe dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28675 T Repair of toe dislocation 0046 22.29 $1,105.50 $535.76 $221.10 28705 T Fusion of foot bones 0056 17.30 $858.02 $405.81 $171.60 28715 T Fusion of foot bones 0056 17.30 $858.02 $405.81 $171.60 28725 T Fusion of foot bones 0056 17.30 $858.02 $405.81 $171.60 28730 T Fusion of foot bones 0056 17.30 $858.02 $405.81 $171.60 28735 T Fusion of foot bones 0056 17.30 $858.02 $405.81 $171.60 28737 T Revision of foot bones 0055 15.47 $767.26 $355.34 $153.45 28740 T Fusion of foot bones 0056 17.30 $858.02 $405.81 $171.60 28750 T Fusion of big toe joint 0055 15.47 $767.26 $355.34 $153.45 28755 T Fusion of big toe joint 0055 15.47 $767.26 $355.34 $153.45 28760 T Fusion of big toe joint 0056 17.30 $858.02 $405.81 $171.60 28800 C Amputation of midfoot 28805 C Amputation thru metatarsal 28810 T Amputation toe & metatarsal 0055 15.47 $767.26 $355.34 $153.45 28820 T Amputation of toe 0055 15.47 $767.26 $355.34 $153.45 28825 T Partial amputation of toe 0055 15.47 $767.26 $355.34 $153.45 28899 T Foot/toes surgery procedure 0043 1.64 $81.34 $25.46 $16.27 29000 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29010 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29015 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29020 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29025 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29035 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29040 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29044 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29046 S Application of body cast 0059 1.74 $86.30 $29.59 $17.26 29049 S Application of figure eight 0059 1.74 $86.30 $29.59 $17.26 29055 S Application of shoulder cast 0059 1.74 $86.30 $29.59 $17.26 29058 S Application of shoulder cast 0059 1.74 $86.30 $29.59 $17.26 29065 S Application of long arm cast 0059 1.74 $86.30 $29.59 $17.26 29075 S Application of forearm cast 0059 1.74 $86.30 $29.59 $17.26 29085 S Apply hand/wrist cast 0059 1.74 $86.30 $29.59 $17.26 29105 S Apply long arm splint 0059 1.74 $86.30 $29.59 $17.26 29125 S Apply forearm splint 0059 1.74 $86.30 $29.59 $17.26 29126 S Apply forearm splint 0059 1.74 $86.30 $29.59 $17.26 29130 S Application of finger splint 0059 1.74 $86.30 $29.59 $17.26 29131 S Application of finger splint 0059 1.74 $86.30 $29.59 $17.26 29200 S Strapping of chest 0059 1.74 $86.30 $29.59 $17.26 29220 S Strapping of low back 0059 1.74 $86.30 $29.59 $17.26 29240 S Strapping of shoulder 0059 1.74 $86.30 $29.59 $17.26 29260 S Strapping of elbow or wrist 0059 1.74 $86.30 $29.59 $17.26 29280 S Strapping of hand or finger 0059 1.74 $86.30 $29.59 $17.26 29305 S Application of hip cast 0059 1.74 $86.30 $29.59 $17.26 29325 S Application of hip casts 0059 1.74 $86.30 $29.59 $17.26 29345 S Application of long leg cast 0059 1.74 $86.30 $29.59 $17.26 29355 S Application of long leg cast 0059 1.74 $86.30 $29.59 $17.26 29358 S Apply long leg cast brace 0059 1.74 $86.30 $29.59 $17.26 29365 S Application of long leg cast 0059 1.74 $86.30 $29.59 $17.26 29405 S Apply short leg cast 0059 1.74 $86.30 $29.59 $17.26 29425 S Apply short leg cast 0059 1.74 $86.30 $29.59 $17.26 29435 S Apply short leg cast 0059 1.74 $86.30 $29.59 $17.26 29440 S Addition of walker to cast 0059 1.74 $86.30 $29.59 $17.26 29445 S Apply rigid leg cast 0059 1.74 $86.30 $29.59 $17.26 29450 S Application of leg cast 0059 1.74 $86.30 $29.59 $17.26 29505 S Application, long leg splint 0058 1.09 $54.06 $19.27 $10.81 29515 S Application lower leg splint 0058 1.09 $54.06 $19.27 $10.81 29520 S Strapping of hip 0058 1.09 $54.06 $19.27 $10.81 29530 S Strapping of knee 0058 1.09 $54.06 $19.27 $10.81 29540 S Strapping of ankle 0058 1.09 $54.06 $19.27 $10.81 29550 S Strapping of toes 0058 1.09 $54.06 $19.27 $10.81 29580 S Application of paste boot 0058 1.09 $54.06 $19.27 $10.81 29590 S Application of foot splint 0058 1.09 $54.06 $19.27 $10.81 29700 S Removal/revision of cast 0058 1.09 $54.06 $19.27 $10.81 29705 S Removal/revision of cast 0058 1.09 $54.06 $19.27 $10.81 29710 S Removal/revision of cast 0058 1.09 $54.06 $19.27 $10.81 29715 S Removal/revision of cast 0058 1.09 $54.06 $19.27 $10.81 29720 S Repair of body cast 0058 1.09 $54.06 $19.27 $10.81 29730 S Windowing of cast 0058 1.09 $54.06 $19.27 $10.81 29740 S Wedging of cast 0058 1.09 $54.06 $19.27 $10.81 29750 S Wedging of clubfoot cast 0058 1.09 $54.06 $19.27 $10.81 29799 S Casting/strapping procedure 0058 1.09 $54.06 $19.27 $10.81 29800 T Jaw arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29804 T Jaw arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29815 T Shoulder arthroscopy 0041 24.57 $1,218.58 $592.08 $243.72 29819 T Shoulder arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29820 T Shoulder arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29821 T Shoulder arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29822 T Shoulder arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29823 T Shoulder arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29825 T Shoulder arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29826 T Shoulder arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29830 T Elbow arthroscopy 0041 24.57 $1,218.58 $592.08 $243.72 29834 T Elbow arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29835 T Elbow arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29836 T Elbow arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29837 T Elbow arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29838 T Elbow arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29840 T Wrist arthroscopy 0041 24.57 $1,218.58 $592.08 $243.72 29843 T Wrist arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29844 T Wrist arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29845 T Wrist arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29846 T Wrist arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29847 T Wrist arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29848 T Wrist endoscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29850 T Knee arthroscopy/surgery 0042 29.22 $1,449.19 $804.74 $289.84 29851 T Knee arthroscopy/surgery 0042 29.22 $1,449.19 $804.74 $289.84 29855 T Tibial arthroscopy/surgery 0042 29.22 $1,449.19 $804.74 $289.84 29856 T Tibial arthroscopy/surgery 0042 29.22 $1,449.19 $804.74 $289.84 29860 T Hip arthroscopy, dx 0041 24.57 $1,218.58 $592.08 $243.72 29861 T Hip arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29862 T Hip arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29863 T Hip arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29870 T Knee arthroscopy, dx 0041 24.57 $1,218.58 $592.08 $243.72 29871 T Knee arthroscopy/drainage 0041 24.57 $1,218.58 $592.08 $243.72 29874 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29875 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29876 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29877 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29879 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29880 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29881 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29882 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29883 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29884 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29885 T Knee arthroscopy/surgery 0042 29.22 $1,449.19 $804.74 $289.84 29886 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29887 T Knee arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29888 T Knee arthroscopy/surgery 0042 29.22 $1,449.19 $804.74 $289.84 29889 T Knee arthroscopy/surgery 0042 29.22 $1,449.19 $804.74 $289.84 29891 T Ankle arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29892 T Ankle arthroscopy/surgery 0042 29.22 $1,449.19 $804.74 $289.84 29893 T Scope, plantar fasciotomy 0055 15.47 $767.26 $355.34 $153.45 29894 T Ankle arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29895 T Ankle arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29897 T Ankle arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29898 T Ankle arthroscopy/surgery 0041 24.57 $1,218.58 $592.08 $243.72 29909 T Arthroscopy of joint 0041 24.57 $1,218.58 $592.08 $243.72 30000 T Drainage of nose lesion 0251 1.68 $83.32 $27.99 $16.66 30020 T Drainage of nose lesion 0251 1.68 $83.32 $27.99 $16.66 30100 T Intranasal biopsy 0252 5.18 $256.90 $114.24 $51.38 30110 T Removal of nose polyp(s) 0253 12.02 $596.14 $284.00 $119.23 30115 T Removal of nose polyp(s) 0253 12.02 $596.14 $284.00 $119.23 30117 T Removal of intranasal lesion 0253 12.02 $596.14 $284.00 $119.23 30118 T Removal of intranasal lesion 0254 12.45 $617.47 $272.41 $123.49 30120 T Revision of nose 0253 12.02 $596.14 $284.00 $119.23 30124 T Removal of nose lesion 0252 5.18 $256.90 $114.24 $51.38 30125 T Removal of nose lesion 0256 25.40 $1,259.74 $623.05 $251.95 30130 T Removal of turbinate bones 0253 12.02 $596.14 $284.00 $119.23 30140 T Removal of turbinate bones 0253 12.02 $596.14 $284.00 $119.23 30150 T Partial removal of nose 0256 25.40 $1,259.74 $623.05 $251.95 30160 T Removal of nose 0256 25.40 $1,259.74 $623.05 $251.95 30200 T Injection treatment of nose 0253 12.02 $596.14 $284.00 $119.23 30210 T Nasal sinus therapy 0252 5.18 $256.90 $114.24 $51.38 30220 T Insert nasal septal button 0252 5.18 $256.90 $114.24 $51.38 30300 T Remove nasal foreign body 0251 1.68 $83.32 $27.99 $16.66 30310 T Remove nasal foreign body 0253 12.02 $596.14 $284.00 $119.23 30320 T Remove nasal foreign body 0253 12.02 $596.14 $284.00 $119.23 30400 T Reconstruction of nose 0256 25.40 $1,259.74 $623.05 $251.95 30410 T Reconstruction of nose 0256 25.40 $1,259.74 $623.05 $251.95 30420 T Reconstruction of nose 0256 25.40 $1,259.74 $623.05 $251.95 30430 T Revision of nose 0254 12.45 $617.47 $272.41 $123.49 30435 T Revision of nose 0256 25.40 $1,259.74 $623.05 $251.95 30450 T Revision of nose 0256 25.40 $1,259.74 $623.05 $251.95 30460 T Revision of nose 0256 25.40 $1,259.74 $623.05 $251.95 30462 T Revision of nose 0256 25.40 $1,259.74 $623.05 $251.95 *30465 T Repair nasal stenosis 0256 25.40 $1,259.74 $623.05 $251.95 30520 T Repair of nasal septum 0256 25.40 $1,259.74 $623.05 $251.95 30540 T Repair nasal defect 0256 25.40 $1,259.74 $623.05 $251.95 30545 T Repair nasal defect 0256 25.40 $1,259.74 $623.05 $251.95 30560 T Release of nasal adhesions 0251 1.68 $83.32 $27.99 $16.66 30580 T Repair upper jaw fistula 0256 25.40 $1,259.74 $623.05 $251.95 30600 T Repair mouth/nose fistula 0256 25.40 $1,259.74 $623.05 $251.95 30620 T Intranasal reconstruction 0256 25.40 $1,259.74 $623.05 $251.95 30630 T Repair nasal septum defect 0254 12.45 $617.47 $272.41 $123.49 30801 T Cauterization, inner nose 0252 5.18 $256.90 $114.24 $51.38 30802 T Cauterization, inner nose 0253 12.02 $596.14 $284.00 $119.23 30901 T Control of nosebleed 0250 2.21 $109.61 $38.54 $21.92 30903 T Control of nosebleed 0250 2.21 $109.61 $38.54 $21.92 30905 T Control of nosebleed 0250 2.21 $109.61 $38.54 $21.92 30906 T Repeat control of nosebleed 0250 2.21 $109.61 $38.54 $21.92 30915 T Ligation, nasal sinus artery 0091 14.79 $733.52 $348.23 $146.70 30920 T Ligation, upper jaw artery 0092 20.21 $1,002.34 $505.37 $200.47 30930 T Therapy, fracture of nose 0253 12.02 $596.14 $284.00 $119.23 30999 T Nasal surgery procedure 0251 1.68 $83.32 $27.99 $16.66 31000 T Irrigation, maxillary sinus 0251 1.68 $83.32 $27.99 $16.66 31002 T Irrigation, sphenoid sinus 0252 5.18 $256.90 $114.24 $51.38 31020 T Exploration, maxillary sinus 0253 12.02 $596.14 $284.00 $119.23 31030 T Exploration, maxillary sinus 0256 25.40 $1,259.74 $623.05 $251.95 31032 T Explore sinus,remove polyps 0256 25.40 $1,259.74 $623.05 $251.95 31040 T Exploration behind upper jaw 0254 12.45 $617.47 $272.41 $123.49 31050 T Exploration, sphenoid sinus 0256 25.40 $1,259.74 $623.05 $251.95 31051 T Sphenoid sinus surgery 0256 25.40 $1,259.74 $623.05 $251.95 31070 T Exploration of frontal sinus 0254 12.45 $617.47 $272.41 $123.49 31075 T Exploration of frontal sinus 0256 25.40 $1,259.74 $623.05 $251.95 31080 T Removal of frontal sinus 0256 25.40 $1,259.74 $623.05 $251.95 31081 T Removal of frontal sinus 0256 25.40 $1,259.74 $623.05 $251.95 31084 T Removal of frontal sinus 0256 25.40 $1,259.74 $623.05 $251.95 31085 T Removal of frontal sinus 0256 25.40 $1,259.74 $623.05 $251.95 31086 T Removal of frontal sinus 0256 25.40 $1,259.74 $623.05 $251.95 31087 T Removal of frontal sinus 0256 25.40 $1,259.74 $623.05 $251.95 31090 T Exploration of sinuses 0256 25.40 $1,259.74 $623.05 $251.95 31200 T Removal of ethmoid sinus 0256 25.40 $1,259.74 $623.05 $251.95 31201 T Removal of ethmoid sinus 0256 25.40 $1,259.74 $623.05 $251.95 31205 T Removal of ethmoid sinus 0256 25.40 $1,259.74 $623.05 $251.95 31225 C Removal of upper jaw 31230 C Removal of upper jaw 31231 T Nasal endoscopy, dx 0071 0.55 $27.28 $14.22 $5.46 31233 T Nasal/sinus endoscopy, dx 0072 1.26 $62.49 $41.52 $12.50 31235 T Nasal/sinus endoscopy, dx 0074 13.61 $675.00 $347.54 $135.00 31237 T Nasal/sinus endoscopy, surg 0074 13.61 $675.00 $347.54 $135.00 31238 T Nasal/sinus endoscopy, surg 0074 13.61 $675.00 $347.54 $135.00 31239 T Nasal/sinus endoscopy, surg 0075 18.55 $920.01 $467.29 $184.00 31240 T Nasal/sinus endoscopy, surg 0074 13.61 $675.00 $347.54 $135.00 31254 T Revision of ethmoid sinus 0075 18.55 $920.01 $467.29 $184.00 31255 T Removal of ethmoid sinus 0075 18.55 $920.01 $467.29 $184.00 31256 T Exploration maxillary sinus 0075 18.55 $920.01 $467.29 $184.00 31267 T Endoscopy, maxillary sinus 0075 18.55 $920.01 $467.29 $184.00 31276 T Sinus endoscopy, surgical 0075 18.55 $920.01 $467.29 $184.00 31287 T Nasal/sinus endoscopy, surg 0075 18.55 $920.01 $467.29 $184.00 31288 T Nasal/sinus endoscopy, surg 0075 18.55 $920.01 $467.29 $184.00 31290 C Nasal/sinus endoscopy, surg 31291 C Nasal/sinus endoscopy, surg 31292 C Nasal/sinus endoscopy, surg 31293 C Nasal/sinus endoscopy, surg 31294 C Nasal/sinus endoscopy, surg 31299 T Sinus surgery procedure 0252 5.18 $256.90 $114.24 $51.38 31300 T Removal of larynx lesion 0256 25.40 $1,259.74 $623.05 $251.95 31320 T Diagnostic incision, larynx 0256 25.40 $1,259.74 $623.05 $251.95 31360 C Removal of larynx 31365 C Removal of larynx 31367 C Partial removal of larynx 31368 C Partial removal of larynx 31370 C Partial removal of larynx 31375 C Partial removal of larynx 31380 C Partial removal of larynx 31382 C Partial removal of larynx 31390 C Removal of larynx & pharynx 31395 C Reconstruct larynx & pharynx 31400 T Revision of larynx 0256 25.40 $1,259.74 $623.05 $251.95 31420 T Removal of epiglottis 0256 25.40 $1,259.74 $623.05 $251.95 31500 S Insert emergency airway 0094 4.51 $223.68 $105.29 $44.74 31502 T Change of windpipe airway 0121 2.36 $117.05 $52.53 $23.41 31505 T Diagnostic laryngoscopy 0072 1.26 $62.49 $41.52 $12.50 31510 T Laryngoscopy with biopsy 0074 13.61 $675.00 $347.54 $135.00 31511 T Remove foreign body, larynx 0072 1.26 $62.49 $41.52 $12.50 31512 T Removal of larynx lesion 0074 13.61 $675.00 $347.54 $135.00 31513 T Injection into vocal cord 0073 4.11 $203.84 $91.07 $40.77 31515 T Laryngoscopy for aspiration 0074 13.61 $675.00 $347.54 $135.00 31520 T Diagnostic laryngoscopy 0072 1.26 $62.49 $41.52 $12.50 31525 T Diagnostic laryngoscopy 0074 13.61 $675.00 $347.54 $135.00 31526 T Diagnostic laryngoscopy 0074 13.61 $675.00 $347.54 $135.00 31527 T Laryngoscopy for treatment 0075 18.55 $920.01 $467.29 $184.00 31528 T Laryngoscopy and dilatation 0074 13.61 $675.00 $347.54 $135.00 31529 T Laryngoscopy and dilatation 0074 13.61 $675.00 $347.54 $135.00 31530 T Operative laryngoscopy 0075 18.55 $920.01 $467.29 $184.00 31531 T Operative laryngoscopy 0075 18.55 $920.01 $467.29 $184.00 31535 T Operative laryngoscopy 0075 18.55 $920.01 $467.29 $184.00 31536 T Operative laryngoscopy 0075 18.55 $920.01 $467.29 $184.00 31540 T Operative laryngoscopy 0075 18.55 $920.01 $467.29 $184.00 31541 T Operative laryngoscopy 0075 18.55 $920.01 $467.29 $184.00 31560 T Operative laryngoscopy 0075 18.55 $920.01 $467.29 $184.00 31561 T Operative laryngoscopy 0075 18.55 $920.01 $467.29 $184.00 31570 T Laryngoscopy with injection 0075 18.55 $920.01 $467.29 $184.00 31571 T Laryngoscopy with injection 0075 18.55 $920.01 $467.29 $184.00 31575 T Diagnostic laryngoscopy 0071 0.55 $27.28 $14.22 $5.46 31576 T Laryngoscopy with biopsy 0074 13.61 $675.00 $347.54 $135.00 31577 T Remove foreign body, larynx 0073 4.11 $203.84 $91.07 $40.77 31578 T Removal of larynx lesion 0074 13.61 $675.00 $347.54 $135.00 31579 T Diagnostic laryngoscopy 0073 4.11 $203.84 $91.07 $40.77 31580 T Revision of larynx 0256 25.40 $1,259.74 $623.05 $251.95 31582 C Revision of larynx 31584 C Treat larynx fracture 31585 T Treat larynx fracture 0253 12.02 $596.14 $284.00 $119.23 31586 T Treat larynx fracture 0256 25.40 $1,259.74 $623.05 $251.95 31587 C Revision of larynx 31588 T Revision of larynx 0256 25.40 $1,259.74 $623.05 $251.95 31590 T Reinnervate larynx 0256 25.40 $1,259.74 $623.05 $251.95 31595 T Larynx nerve surgery 0256 25.40 $1,259.74 $623.05 $251.95 31599 T Larynx surgery procedure 0253 12.02 $596.14 $284.00 $119.23 31600 T Incision of windpipe 0254 12.45 $617.47 $272.41 $123.49 31601 T Incision of windpipe 0254 12.45 $617.47 $272.41 $123.49 31603 T Incision of windpipe 0254 12.45 $617.47 $272.41 $123.49 31605 T Incision of windpipe 0254 12.45 $617.47 $272.41 $123.49 31610 T Incision of windpipe 0254 12.45 $617.47 $272.41 $123.49 31611 T Surgery/speech prosthesis 0254 12.45 $617.47 $272.41 $123.49 31612 T Puncture/clear windpipe 0253 12.02 $596.14 $284.00 $119.23 31613 T Repair windpipe opening 0254 12.45 $617.47 $272.41 $123.49 31614 T Repair windpipe opening 0256 25.40 $1,259.74 $623.05 $251.95 31615 T Visualization of windpipe 0076 8.06 $399.75 $197.05 $79.95 31622 T Dx bronchoscope/wash 0076 8.06 $399.75 $197.05 $79.95 31623 T Dx bronchoscope/brush 0076 8.06 $399.75 $197.05 $79.95 31624 T Dx bronchoscope/lavage 0076 8.06 $399.75 $197.05 $79.95 31625 T Bronchoscopy with biopsy 0076 8.06 $399.75 $197.05 $79.95 31628 T Bronchoscopy with biopsy 0076 8.06 $399.75 $197.05 $79.95 31629 T Bronchoscopy with biopsy 0076 8.06 $399.75 $197.05 $79.95 31630 T Bronchoscopy with repair 0076 8.06 $399.75 $197.05 $79.95 31631 T Bronchoscopy with dilation 0076 8.06 $399.75 $197.05 $79.95 31635 T Remove foreign body, airway 0076 8.06 $399.75 $197.05 $79.95 31640 T Bronchoscopy & remove lesion 0076 8.06 $399.75 $197.05 $79.95 31641 T Bronchoscopy, treat blockage 0076 8.06 $399.75 $197.05 $79.95 31643 T Diag bronchoscope/catheter 0076 8.06 $399.75 $197.05 $79.95 31645 T Bronchoscopy, clear airways 0076 8.06 $399.75 $197.05 $79.95 31646 T Bronchoscopy, reclear airway 0076 8.06 $399.75 $197.05 $79.95 31656 T Bronchoscopy, inj for xray 0076 8.06 $399.75 $197.05 $79.95 31700 T Insertion of airway catheter 0072 1.26 $62.49 $41.52 $12.50 31708 N Instill airway contrast dye 31710 N Insertion of airway catheter 31715 N Injection for bronchus x-ray 31717 T Bronchial brush biopsy 0073 4.11 $203.84 $91.07 $40.77 31720 T Clearance of airways 0072 1.26 $62.49 $41.52 $12.50 31725 C Clearance of airways 31730 T Intro, windpipe wire/tube 0073 4.11 $203.84 $91.07 $40.77 31750 T Repair of windpipe 0256 25.40 $1,259.74 $623.05 $251.95 31755 T Repair of windpipe 0256 25.40 $1,259.74 $623.05 $251.95 31760 C Repair of windpipe 31766 C Reconstruction of windpipe 31770 C Repair/graft of bronchus 31775 C Reconstruct bronchus 31780 C Reconstruct windpipe 31781 C Reconstruct windpipe 31785 C Remove windpipe lesion 31786 C Remove windpipe lesion 31800 C Repair of windpipe injury 31805 C Repair of windpipe injury 31820 T Closure of windpipe lesion 0253 12.02 $596.14 $284.00 $119.23 31825 T Repair of windpipe defect 0254 12.45 $617.47 $272.41 $123.49 31830 T Revise windpipe scar 0254 12.45 $617.47 $272.41 $123.49 31899 T Airways surgical procedure 0076 8.06 $399.75 $197.05 $79.95 32000 T Drainage of chest 0070 3.64 $180.53 $79.60 $36.11 32002 T Treatment of collapsed lung 0070 3.64 $180.53 $79.60 $36.11 32005 T Treat lung lining chemically 0070 3.64 $180.53 $79.60 $36.11 32020 T Insertion of chest tube 0070 3.64 $180.53 $79.60 $36.11 32035 C Exploration of chest 32036 C Exploration of chest 32095 C Biopsy through chest wall 32100 C Exploration/biopsy of chest 32110 C Explore/repair chest 32120 C Re-exploration of chest 32124 C Explore chest free adhesions 32140 C Removal of lung lesion(s) 32141 C Remove/treat lung lesions 32150 C Removal of lung lesion(s) 32151 C Remove lung foreign body 32160 C Open chest heart massage 32200 C Drain, open, lung lesion 32201 C Drain, percut, lung lesion 32215 C Treat chest lining 32220 C Release of lung 32225 C Partial release of lung 32310 C Removal of chest lining 32320 C Free/remove chest lining 32400 T Needle biopsy chest lining 0005 5.41 $268.32 $119.75 $53.66 32402 C Open biopsy chest lining 32405 T Biopsy, lung or mediastinum 0005 5.41 $268.32 $119.75 $53.66 32420 T Puncture/clear lung 0070 3.64 $180.53 $79.60 $36.11 32440 C Removal of lung 32442 C Sleeve pneumonectomy 32445 C Removal of lung 32480 C Partial removal of lung 32482 C Bilobectomy 32484 C Segmentectomy 32486 C Sleeve lobectomy 32488 C Completion pneumonectomy 32491 C Lung volume reduction 32500 C Partial removal of lung 32501 C Repair bronchus add-on 32520 C Remove lung & revise chest 32522 C Remove lung & revise chest 32525 C Remove lung & revise chest 32540 C Removal of lung lesion 32601 T Thoracoscopy, diagnostic 0076 8.06 $399.75 $197.05 $79.95 32602 T Thoracoscopy, diagnostic 0076 8.06 $399.75 $197.05 $79.95 32603 T Thoracoscopy, diagnostic 0076 8.06 $399.75 $197.05 $79.95 32604 T Thoracoscopy, diagnostic 0076 8.06 $399.75 $197.05 $79.95 32605 T Thoracoscopy, diagnostic 0076 8.06 $399.75 $197.05 $79.95 32606 T Thoracoscopy, diagnostic 0076 8.06 $399.75 $197.05 $79.95 32650 C Thoracoscopy, surgical 32651 C Thoracoscopy, surgical 32652 C Thoracoscopy, surgical 32653 C Thoracoscopy, surgical 32654 C Thoracoscopy, surgical 32655 C Thoracoscopy, surgical 32656 C Thoracoscopy, surgical 32657 C Thoracoscopy, surgical 32658 C Thoracoscopy, surgical 32659 C Thoracoscopy, surgical 32660 C Thoracoscopy, surgical 32661 C Thoracoscopy, surgical 32662 C Thoracoscopy, surgical 32663 C Thoracoscopy, surgical 32664 C Thoracoscopy, surgical 32665 C Thoracoscopy, surgical 32800 C Repair lung hernia 32810 C Close chest after drainage 32815 C Close bronchial fistula 32820 C Reconstruct injured chest 32850 C Donor pneumonectomy 32851 C Lung transplant, single 32852 C Lung transplant with bypass 32853 C Lung transplant, double 32854 C Lung transplant with bypass 32900 C Removal of rib(s) 32905 C Revise & repair chest wall 32906 C Revise & repair chest wall 32940 C Revision of lung 32960 T Therapeutic pneumothorax 0070 3.64 $180.53 $79.60 $36.11 32997 C Total lung lavage 32999 T Chest surgery procedure 0070 3.64 $180.53 $79.60 $36.11 33010 T Drainage of heart sac 0070 3.64 $180.53 $79.60 $36.11 33011 T Repeat drainage of heart sac 0070 3.64 $180.53 $79.60 $36.11 33015 C Incision of heart sac 33020 C Incision of heart sac 33025 C Incision of heart sac 33030 C Partial removal of heart sac 33031 C Partial removal of heart sac 33050 C Removal of heart sac lesion 33120 C Removal of heart lesion 33130 C Removal of heart lesion 33140 C Heart revascularize
(tmr)*33141 C Heart TMR w/ other procedure 33200 C Insertion of heart pacemaker 33201 C Insertion of heart pacemaker 33206 T Insertion of heart pacemaker 0089 78.45 $3,890.81 $2,275.19 $778.16 33207 T Insertion of heart pacemaker 0089 78.45 $3,890.81 $2,275.19 $778.16 33208 T Insertion of heart pacemaker 0089 78.45 $3,890.81 $2,275.19 $778.16 33210 T Insertion of heart electrode 0106 18.96 $940.34 $503.07 $188.07 33211 T Insertion of heart electrode 0106 18.96 $940.34 $503.07 $188.07 33212 T Insertion of pulse generator 0090 78.28 $3,882.37 $2,133.88 $776.47 33213 T Insertion of pulse generator 0090 78.28 $3,882.37 $2,133.88 $776.47 33214 T Upgrade of pacemaker system 0089 78.45 $3,890.81 $2,275.19 $778.16 33216 T Revise eltrd pacing-defib 0106 18.96 $940.34 $503.07 $188.07 33217 T Revise eltrd pacing-defib 0106 18.96 $940.34 $503.07 $188.07 33218 T Revise eltrd pacing-defib 0106 18.96 $940.34 $503.07 $188.07 33220 T Revise eltrd pacing-defib 0106 18.96 $940.34 $503.07 $188.07 33222 T Revise pocket, pacemaker 0026 12.11 $600.61 $277.92 $120.12 33223 T Revise pocket, pacing-defib 0026 12.11 $600.61 $277.92 $120.12 33233 T Removal of pacemaker system 0105 15.06 $746.92 $372.32 $149.38 33234 T Removal of pacemaker system 0105 15.06 $746.92 $372.32 $149.38 33235 T Removal pacemaker electrode 0105 15.06 $746.92 $372.32 $149.38 33236 C Remove electrode/thoracotomy 33237 C Remove electrode/thoracotomy 33238 C Remove electrode/thoracotomy 33240 T Insert pulse generator 0107 147.51 $7,315.91 $5,086.37 $1,463.18 33241 T Remove pulse generator 0105 15.06 $746.92 $372.32 $149.38 33243 C Remove eltrd/thoracotomy 33244 T Remove eltrd, transven 0105 15.06 $746.92 $372.32 $149.38 33245 C Insert epic eltrd pace-defib 33246 C Insert epic eltrd/generator 33249 T Eltrd/insert pace-defib 0108 210.84 $10,456.84 $5,484.72 $2,091.37 33250 C Ablate heart dysrhythm focus 33251 C Ablate heart dysrhythm focus 33253 C Reconstruct atria 33261 C Ablate heart dysrhythm focus 33282 S Implant pat-active ht record 0974 8.25 $409.17 $81.83 33284 T Remove pat-active ht record 0109 6.53 $323.86 $133.51 $64.77 33300 C Repair of heart wound 33305 C Repair of heart wound 33310 C Exploratory heart surgery 33315 C Exploratory heart surgery 33320 C Repair major blood vessel(s) 33321 C Repair major vessel 33322 C Repair major blood vessel(s) 33330 C Insert major vessel graft 33332 C Insert major vessel graft 33335 C Insert major vessel graft 33400 C Repair of aortic valve 33401 C Valvuloplasty, open 33403 C Valvuloplasty, w/cp bypass 33404 C Prepare heart-aorta conduit 33405 C Replacement of aortic valve 33406 C Replacement of aortic valve 33410 C Replacement of aortic valve 33411 C Replacement of aortic valve 33412 C Replacement of aortic valve 33413 C Replacement of aortic valve 33414 C Repair of aortic valve 33415 C Revision, subvalvular tissue 33416 C Revise ventricle muscle 33417 C Repair of aortic valve 33420 C Revision of mitral valve 33422 C Revision of mitral valve 33425 C Repair of mitral valve 33426 C Repair of mitral valve 33427 C Repair of mitral valve 33430 C Replacement of mitral valve 33460 C Revision of tricuspid valve 33463 C Valvuloplasty, tricuspid 33464 C Valvuloplasty, tricuspid 33465 C Replace tricuspid valve 33468 C Revision of tricuspid valve 33470 C Revision of pulmonary valve 33471 C Valvotomy, pulmonary valve 33472 C Revision of pulmonary valve 33474 C Revision of pulmonary valve 33475 C Replacement, pulmonary valve 33476 C Revision of heart chamber 33478 C Revision of heart chamber 33496 C Repair, prosth valve clot 33500 C Repair heart vessel fistula 33501 C Repair heart vessel fistula 33502 C Coronary artery correction 33503 C Coronary artery graft 33504 C Coronary artery graft 33505 C Repair artery w/tunnel 33506 C Repair artery, translocation 33510 C CABG, vein, single 33511 C CABG, vein, two 33512 C CABG, vein, three 33513 C CABG, vein, four 33514 C CABG, vein, five 33516 C Cabg, vein, six or more 33517 C CABG, artery-vein, single 33518 C CABG, artery-vein, two 33519 C CABG, artery-vein, three 33521 C CABG, artery-vein, four 33522 C CABG, artery-vein, five 33523 C Cabg, art-vein, six or more 33530 C Coronary artery, bypass/reop 33533 C CABG, arterial, single 33534 C CABG, arterial, two 33535 C CABG, arterial, three 33536 C Cabg, arterial, four or more 33542 C Removal of heart lesion 33545 C Repair of heart damage 33572 C Open coronary endarterectomy 33600 C Closure of valve 33602 C Closure of valve 33606 C Anastomosis/artery-aorta 33608 C Repair anomaly w/conduit 33610 C Repair by enlargement 33611 C Repair double ventricle 33612 C Repair double ventricle 33615 C Repair, simple fontan 33617 C Repair, modified fontan 33619 C Repair single ventricle 33641 C Repair heart septum defect 33645 C Revision of heart veins 33647 C Repair heart septum defects 33660 C Repair of heart defects 33665 C Repair of heart defects 33670 C Repair of heart chambers 33681 C Repair heart septum defect 33684 C Repair heart septum defect 33688 C Repair heart septum defect 33690 C Reinforce pulmonary artery 33692 C Repair of heart defects 33694 C Repair of heart defects 33697 C Repair of heart defects 33702 C Repair of heart defects 33710 C Repair of heart defects 33720 C Repair of heart defect 33722 C Repair of heart defect 33730 C Repair heart-vein defect(s) 33732 C Repair heart-vein defect 33735 C Revision of heart chamber 33736 C Revision of heart chamber 33737 C Revision of heart chamber 33750 C Major vessel shunt 33755 C Major vessel shunt 33762 C Major vessel shunt 33764 C Major vessel shunt & graft 33766 C Major vessel shunt 33767 C Major vessel shunt 33770 C Repair great vessels defect 33771 C Repair great vessels defect 33774 C Repair great vessels defect 33775 C Repair great vessels defect 33776 C Repair great vessels defect 33777 C Repair great vessels defect 33778 C Repair great vessels defect 33779 C Repair great vessels defect 33780 C Repair great vessels defect 33781 C Repair great vessels defect 33786 C Repair arterial trunk 33788 C Revision of pulmonary artery 33800 C Aortic suspension 33802 C Repair vessel defect 33803 C Repair vessel defect 33813 C Repair septal defect 33814 C Repair septal defect 33820 C Revise major vessel 33822 C Revise major vessel 33824 C Revise major vessel 33840 C Remove aorta constriction 33845 C Remove aorta constriction 33851 C Remove aorta constriction 33852 C Repair septal defect 33853 C Repair septal defect 33860 C Ascending aortic graft 33861 C Ascending aortic graft 33863 C Ascending aortic graft 33870 C Transverse aortic arch graft 33875 C Thoracic aortic graft 33877 C Thoracoabdominal graft 33910 C Remove lung artery emboli 33915 C Remove lung artery emboli 33916 C Surgery of great vessel 33917 C Repair pulmonary artery 33918 C Repair pulmonary atresia 33919 C Repair pulmonary atresia 33920 C Repair pulmonary atresia 33922 C Transect pulmonary artery 33924 C Remove pulmonary shunt 33930 C Removal of donor heart/lung 33935 C Transplantation, heart/lung 33940 C Removal of donor heart 33945 C Transplantation of heart 33960 C External circulation assist 33961 C External circulation assist 33968 C Remove aortic assist device 33970 C Aortic circulation assist 33971 C Aortic circulation assist 33973 C Insert balloon device 33974 C Remove intra-aortic balloon 33975 C Implant ventricular device 33976 C Implant ventricular device 33977 C Remove ventricular device 33978 C Remove ventricular device 33999 T Cardiac surgery procedure 0070 3.64 $180.53 $79.60 $36.11 34001 C Removal of artery clot 34051 C Removal of artery clot 34101 T Removal of artery clot 0088 26.49 $1,313.80 $678.68 $262.76 34111 T Removal of arm artery clot 0088 26.49 $1,313.80 $678.68 $262.76 34151 C Removal of artery clot 34201 T Removal of artery clot 0088 26.49 $1,313.80 $678.68 $262.76 34203 T Removal of leg artery clot 0088 26.49 $1,313.80 $678.68 $262.76 34401 C Removal of vein clot 34421 T Removal of vein clot 0088 26.49 $1,313.80 $678.68 $262.76 34451 C Removal of vein clot 34471 T Removal of vein clot 0088 26.49 $1,313.80 $678.68 $262.76 34490 T Removal of vein clot 0088 26.49 $1,313.80 $678.68 $262.76 34501 T Repair valve, femoral vein 0088 26.49 $1,313.80 $678.68 $262.76 34502 C Reconstruct vena cava 34510 T Transposition of vein valve 0088 26.49 $1,313.80 $678.68 $262.76 34520 T Cross-over vein graft 0088 26.49 $1,313.80 $678.68 $262.76 34530 T Leg vein fusion 0088 26.49 $1,313.80 $678.68 $262.76 *34800 C Endovasc abdo repair w/tube *34802 C Endovasc abdo repr w/device *34804 C Endovasc abdo repr w/device *34808 C Endovasc abdo occlud device *34812 C xpose for endoprosth, aortic *34813 C xpose for endoprosth, femoral *34820 C xpose for endoprosth, iliac *34825 C endovasc extend prosth, init *34826 C endovasc extend prosth,addl *34830 C open aortic tube prosth repr *34831 C open aortoiliac prosth repr *34832 C open aortofemor prosth repr 35001 C Repair defect of artery 35002 C Repair artery rupture, neck 35005 C Repair defect of artery 35011 T Repair defect of artery 0093 12.82 $635.82 $277.34 $127.16 35013 C Repair artery rupture, arm 35021 C Repair defect of artery 35022 C Repair artery rupture, chest 35045 C Repair defect of arm artery 35081 C Repair defect of artery 35082 C Repair artery rupture, aorta 35091 C Repair defect of artery 35092 C Repair artery rupture, aorta 35102 C Repair defect of artery 35103 C Repair artery rupture, groin 35111 C Repair defect of artery 35112 C Repair artery rupture,spleen 35121 C Repair defect of artery 35122 C Repair artery rupture, belly 35131 C Repair defect of artery 35132 C Repair artery rupture, groin 35141 C Repair defect of artery 35142 C Repair artery rupture, thigh 35151 C Repair defect of artery 35152 C Repair artery rupture, knee 35161 C Repair defect of artery 35162 C Repair artery rupture 35180 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35182 C Repair blood vessel lesion 35184 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35188 T Repair blood vessel lesion 0088 26.49 $1,313.80 $678.68 $262.76 35189 C Repair blood vessel lesion 35190 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35201 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35206 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35207 T Repair blood vessel lesion 0088 26.49 $1,313.80 $678.68 $262.76 35211 C Repair blood vessel lesion 35216 C Repair blood vessel lesion 35221 C Repair blood vessel lesion 35226 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35231 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35236 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35241 C Repair blood vessel lesion 35246 C Repair blood vessel lesion 35251 C Repair blood vessel lesion 35256 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35261 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35266 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35271 C Repair blood vessel lesion 35276 C Repair blood vessel lesion 35281 C Repair blood vessel lesion 35286 T Repair blood vessel lesion 0093 12.82 $635.82 $277.34 $127.16 35301 C Rechanneling of artery 35311 C Rechanneling of artery 35321 T Rechanneling of artery 0093 12.82 $635.82 $277.34 $127.16 35331 C Rechanneling of artery 35341 C Rechanneling of artery 35351 C Rechanneling of artery 35355 C Rechanneling of artery 35361 C Rechanneling of artery 35363 C Rechanneling of artery 35371 C Rechanneling of artery 35372 C Rechanneling of artery 35381 C Rechanneling of artery 35390 C Reoperation, carotid add-on 35400 C Angioscopy 35450 C Repair arterial blockage 35452 C Repair arterial blockage 35454 C Repair arterial blockage 35456 C Repair arterial blockage 35458 T Repair arterial blockage 0081 28.81 $1,428.86 $710.91 $285.77 35459 T Repair arterial blockage 0081 28.81 $1,428.86 $710.91 $285.77 35460 T Repair venous blockage 0081 28.81 $1,428.86 $710.91 $285.77 35470 T Repair arterial blockage 0081 28.81 $1,428.86 $710.91 $285.77 35471 T Repair arterial blockage 0081 28.81 $1,428.86 $710.91 $285.77 35472 T Repair arterial blockage 0081 28.81 $1,428.86 $710.91 $285.77 35473 T Repair arterial blockage 0081 28.81 $1,428.86 $710.91 $285.77 35474 T Repair arterial blockage 0081 28.81 $1,428.86 $710.91 $285.77 35475 T Repair arterial blockage 0081 28.81 $1,428.86 $710.91 $285.77 35476 T Repair venous blockage 0081 28.81 $1,428.86 $710.91 $285.77 35480 C Atherectomy, open 35481 T Atherectomy, open 0081 28.81 $1,428.86 $710.91 $285.77 35482 C Atherectomy, open 35483 C Atherectomy, open 35484 T Atherectomy, open 0081 28.81 $1,428.86 $710.91 $285.77 35485 T Atherectomy, open 0081 28.81 $1,428.86 $710.91 $285.77 35490 T Atherectomy, percutaneous 0081 28.81 $1,428.86 $710.91 $285.77 35491 T Atherectomy, percutaneous 0081 28.81 $1,428.86 $710.91 $285.77 35492 T Atherectomy, percutaneous 0081 28.81 $1,428.86 $710.91 $285.77 35493 T Atherectomy, percutaneous 0081 28.81 $1,428.86 $710.91 $285.77 35494 T Atherectomy, percutaneous 0081 28.81 $1,428.86 $710.91 $285.77 35495 T Atherectomy, percutaneous 0081 28.81 $1,428.86 $710.91 $285.77 35500 T Harvest vein for bypass 0091 14.79 $733.52 $348.23 $146.70 35501 C Artery bypass graft 35506 C Artery bypass graft 35507 C Artery bypass graft 35508 C Artery bypass graft 35509 C Artery bypass graft 35511 C Artery bypass graft 35515 C Artery bypass graft 35516 C Artery bypass graft 35518 C Artery bypass graft 35521 C Artery bypass graft 35526 C Artery bypass graft 35531 C Artery bypass graft 35533 C Artery bypass graft 35536 C Artery bypass graft 35541 C Artery bypass graft 35546 C Artery bypass graft 35548 C Artery bypass graft 35549 C Artery bypass graft 35551 C Artery bypass graft 35556 C Artery bypass graft 35558 C Artery bypass graft 35560 C Artery bypass graft 35563 C Artery bypass graft 35565 C Artery bypass graft 35566 C Artery bypass graft 35571 C Artery bypass graft 35582 C Vein bypass graft 35583 C Vein bypass graft 35585 C Vein bypass graft 35587 C Vein bypass graft *35600 C Harvest artery for CABG 35601 C Artery bypass graft 35606 C Artery bypass graft 35612 C Artery bypass graft 35616 C Artery bypass graft 35621 C Artery bypass graft 35623 C Bypass graft, not vein 35626 C Artery bypass graft 35631 C Artery bypass graft 35636 C Artery bypass graft 35641 C Artery bypass graft 35642 C Artery bypass graft 35645 C Artery bypass graft 35646 C Artery bypass graft 35650 C Artery bypass graft 35651 C Artery bypass graft 35654 C Artery bypass graft 35656 C Artery bypass graft 35661 C Artery bypass graft 35663 C Artery bypass graft 35665 C Artery bypass graft 35666 C Artery bypass graft 35671 C Artery bypass graft 35681 C Composite bypass graft 35682 C Composite bypass graft 35683 C Composite bypass graft 35691 C Arterial transposition 35693 C Arterial transposition 35694 C Arterial transposition 35695 C Arterial transposition 35700 C Reoperation, bypass graft 35701 C Exploration, carotid artery 35721 C Exploration, femoral artery 35741 C Exploration popliteal artery 35761 T Exploration of artery/vein 0115 19.34 $959.19 $506.74 $191.84 35800 C Explore neck vessels 35820 C Explore chest vessels 35840 C Explore abdominal vessels 35860 T Explore limb vessels 0115 19.34 $959.19 $506.74 $191.84 35870 C Repair vessel graft defect 35875 T Removal of clot in graft 0088 26.49 $1,313.80 $678.68 $262.76 35876 T Removal of clot in graft 0088 26.49 $1,313.80 $678.68 $262.76 35879 T Revise graft w/vein 0088 26.49 $1,313.80 $678.68 $262.76 35881 T Revise graft w/vein 0088 26.49 $1,313.80 $678.68 $262.76 35901 C Excision, graft, neck 35903 T Excision, graft, extremity 0115 19.34 $959.19 $506.74 $191.84 35905 C Excision, graft, thorax 35907 C Excision, graft, abdomen 36000 N Place needle in vein 36005 N Injection, venography 36010 N Place catheter in vein 36011 N Place catheter in vein 36012 N Place catheter in vein 36013 N Place catheter in artery 36014 N Place catheter in artery 36015 N Place catheter in artery 36100 N Establish access to artery 36120 N Establish access to artery 36140 N Establish access to artery 36145 N Artery to vein shunt 36160 N Establish access to aorta 36200 N Place catheter in aorta 36215 N Place catheter in artery 36216 N Place catheter in artery 36217 N Place catheter in artery 36218 N Place catheter in artery 36245 N Place catheter in artery 36246 N Place catheter in artery 36247 N Place catheter in artery 36248 N Place catheter in artery 36260 T Insertion of infusion pump 0119 9.87 $489.59 $161.50 $97.92 36261 T Revision of infusion pump 0124 2.55 $126.64 $81.36 $25.33 36262 T Removal of infusion pump 0109 6.53 $323.86 $133.51 $64.77 36299 T Vessel injection procedure 0089 78.45 $3,890.81 $2,275.19 $778.16 36400 N Drawing blood 36405 N Drawing blood 36406 N Drawing blood 36410 N Drawing blood 36415 E Drawing blood 36420 T Establish access to vein 0032 5.40 $267.82 $119.52 $53.56 36425 T Establish access to vein 0032 5.40 $267.82 $119.52 $53.56 36430 S Blood transfusion service 0110 5.83 $289.15 $122.73 $57.83 36440 S Blood transfusion service 0110 5.83 $289.15 $122.73 $57.83 36450 S Exchange transfusion service 0110 5.83 $289.15 $122.73 $57.83 36455 S Exchange transfusion service 0110 5.83 $289.15 $122.73 $57.83 36460 S Transfusion service, fetal 0110 5.83 $289.15 $122.73 $57.83 36468 T Injection(s), spider veins 0098 1.19 $59.02 $20.88 $11.80 36469 T Injection(s), spider veins 0098 1.19 $59.02 $20.88 $11.80 36470 T Injection therapy of vein 0098 1.19 $59.02 $20.88 $11.80 36471 T Injection therapy of veins 0098 1.19 $59.02 $20.88 $11.80 36481 N Insertion of catheter, vein 36488 T Insertion of catheter, vein 0032 5.40 $267.82 $119.52 $53.56 36489 T Insertion of catheter, vein 0032 5.40 $267.82 $119.52 $53.56 36490 T Insertion of catheter, vein 0032 5.40 $267.82 $119.52 $53.56 36491 T Insertion of catheter, vein 0032 5.40 $267.82 $119.52 $53.56 36493 T Repositioning of cvc 0032 5.40 $267.82 $119.52 $53.56 36500 N Insertion of catheter, vein 36510 C Insertion of catheter, vein 36520 S Plasma and/or cell exchange 0111 14.17 $702.77 $300.74 $140.55 36521 S Apheresis w/ adsorp/reinfuse 0111 14.17 $702.77 $300.74 $140.55 36522 S Photopheresis 0112 39.60 $1,964.01 $663.65 $392.80 36530 T Insertion of infusion pump 0119 9.87 $489.59 $161.50 $97.92 36531 T Revision of infusion pump 0124 2.55 $126.64 $81.36 $25.33 36532 T Removal of infusion pump 0109 6.53 $323.86 $133.51 $64.77 36533 T Insertion of access device 0115 19.34 $959.19 $506.74 $191.84 36534 T Revision of access device 0103 13.09 $649.21 $295.70 $129.84 36535 T Removal of access device 0109 6.53 $323.86 $133.51 $64.77 *36540 N Collect blood venous device 36550 T Declot vascular device 0970 0.52 $25.79 $5.16 36600 N Withdrawal of arterial blood 36620 N Insertion catheter, artery 36625 N Insertion catheter, artery 36640 T Insertion catheter, artery 0032 5.40 $267.82 $119.52 $53.56 36660 C Insertion catheter, artery 36680 T Insert needle, bone cavity 0120 1.66 $82.33 $42.67 $16.47 36800 T Insertion of cannula 0115 19.34 $959.19 $506.74 $191.84 36810 T Insertion of cannula 0115 19.34 $959.19 $506.74 $191.84 36815 T Insertion of cannula 0115 19.34 $959.19 $506.74 $191.84 36819 T Av fusion by basilic vein 0093 12.82 $635.82 $277.34 $127.16 36821 T Av fusion direct any site 0088 26.49 $1,313.80 $678.68 $262.76 36822 C Insertion of cannula(s) 36823 C Insertion of cannula(s) 36825 T Artery-vein graft 0088 26.49 $1,313.80 $678.68 $262.76 36830 T Artery-vein graft 0088 26.49 $1,313.80 $678.68 $262.76 36831 T Av fistula excision 0088 26.49 $1,313.80 $678.68 $262.76 36832 T Av fistula revision 0088 26.49 $1,313.80 $678.68 $262.76 36833 T Av fistula revision 0088 26.49 $1,313.80 $678.68 $262.76 36834 T Repair A-V aneurysm 0093 12.82 $635.82 $277.34 $127.16 36835 T Artery to vein shunt 0115 19.34 $959.19 $506.74 $191.84 36860 T External cannula declotting 0115 19.34 $959.19 $506.74 $191.84 36861 T Cannula declotting 0115 19.34 $959.19 $506.74 $191.84 *36870 T AV fistula revision, open 0093 12.82 $635.82 $277.34 $127.16 37140 C Revision of circulation 37145 C Revision of circulation 37160 C Revision of circulation 37180 C Revision of circulation 37181 C Splice spleen/kidney veins 37195 C Thrombolytic therapy, stroke 37200 T Transcatheter biopsy 0005 5.41 $268.32 $119.75 $53.66 37201 T Transcatheter therapy infuse 0120 1.66 $82.33 $42.67 $16.47 37202 T Transcatheter therapy infuse 0120 1.66 $82.33 $42.67 $16.47 37203 T Transcatheter retrieval 0103 13.09 $649.21 $295.70 $129.84 37204 T Transcatheter occlusion 0103 13.09 $649.21 $295.70 $129.84 37205 T Transcatheter stent 0229 34.81 $1,726.44 $1,030.12 $345.29 37206 T Transcatheter stent add-on 0229 34.81 $1,726.44 $1,030.12 $345.29 37207 T Transcatheter stent 0229 34.81 $1,726.44 $1,030.12 $345.29 37208 T Transcatheter stent add-on 0229 34.81 $1,726.44 $1,030.12 $345.29 37209 T Exchange arterial catheter 0103 13.09 $649.21 $295.70 $129.84 37250 T Iv us first vessel add-on 0103 13.09 $649.21 $295.70 $129.84 37251 T Iv us each add vessel add-on 0103 13.09 $649.21 $295.70 $129.84 37565 T Ligation of neck vein 0093 12.82 $635.82 $277.34 $127.16 37600 T Ligation of neck artery 0093 12.82 $635.82 $277.34 $127.16 37605 T Ligation of neck artery 0091 14.79 $733.52 $348.23 $146.70 37606 T Ligation of neck artery 0091 14.79 $733.52 $348.23 $146.70 37607 T Ligation of a-v fistula 0092 20.21 $1,002.34 $505.37 $200.47 37609 T Temporal artery procedure 0020 6.51 $322.87 $130.53 $64.57 37615 T Ligation of neck artery 0091 14.79 $733.52 $348.23 $146.70 37616 C Ligation of chest artery 37617 C Ligation of abdomen artery 37618 C Ligation of extremity artery 37620 T Revision of major vein 0091 14.79 $733.52 $348.23 $146.70 37650 T Revision of major vein 0091 14.79 $733.52 $348.23 $146.70 37660 C Revision of major vein 37700 T Revise leg vein 0091 14.79 $733.52 $348.23 $146.70 37720 T Removal of leg vein 0092 20.21 $1,002.34 $505.37 $200.47 37730 T Removal of leg veins 0092 20.21 $1,002.34 $505.37 $200.47 37735 T Removal of leg veins/lesion 0092 20.21 $1,002.34 $505.37 $200.47 37760 T Revision of leg veins 0091 14.79 $733.52 $348.23 $146.70 37780 T Revision of leg vein 0091 14.79 $733.52 $348.23 $146.70 37785 T Revise secondary varicosity 0091 14.79 $733.52 $348.23 $146.70 37788 C Revascularization, penis 37790 T Penile venous occlusion 0181 32.37 $1,605.43 $906.36 $321.09 37799 T Vascular surgery procedure 0020 6.51 $322.87 $130.53 $64.57 38100 C Removal of spleen, total 38101 C Removal of spleen, partial 38102 C Removal of spleen, total 38115 C Repair of ruptured spleen 38120 T Laparoscopy, splenectomy 0131 41.81 $2,073.61 $1,089.88 $414.72 38129 T Laparoscope proc, spleen 0130 25.36 $1,257.75 $659.53 $251.55 38200 N Injection for spleen x-ray 38230 S Bone marrow collection 0123 4.13 $204.83 $40.97 $40.97 38231 S Stem cell collection 0111 14.17 $702.77 $300.74 $140.55 38240 S Bone marrow/stem transplant 0123 4.13 $204.83 $40.97 $40.97 38241 S Bone marrow/stem transplant 0123 4.13 $204.83 $40.97 $40.97 38300 T Drainage, lymph node lesion 0008 6.15 $305.02 $113.67 $61.00 38305 T Drainage, lymph node lesion 0008 6.15 $305.02 $113.67 $61.00 38308 T Incision of lymph channels 0113 13.89 $688.89 $326.55 $137.78 38380 C Thoracic duct procedure 38381 C Thoracic duct procedure 38382 C Thoracic duct procedure 38500 T Biopsy/removal, lymph nodes 0113 13.89 $688.89 $326.55 $137.78 38505 T Needle biopsy, lymph nodes 0005 5.41 $268.32 $119.75 $53.66 38510 T Biopsy/removal, lymph nodes 0113 13.89 $688.89 $326.55 $137.78 38520 T Biopsy/removal, lymph nodes 0113 13.89 $688.89 $326.55 $137.78 38525 T Biopsy/removal, lymph nodes 0113 13.89 $688.89 $326.55 $137.78 38530 T Biopsy/removal, lymph nodes 0113 13.89 $688.89 $326.55 $137.78 38542 T Explore deep node(s), neck 0114 19.56 $970.10 $493.78 $194.02 38550 T Removal, neck/armpit lesion 0113 13.89 $688.89 $326.55 $137.78 38555 T Removal, neck/armpit lesion 0114 19.56 $970.10 $493.78 $194.02 38562 C Removal, pelvic lymph nodes 38564 C Removal, abdomen lymph nodes 38570 T Laparoscopy, lymph node biop 0131 41.81 $2,073.61 $1,089.88 $414.72 38571 T Laparoscopy, lymphadenectomy 0132 48.91 $2,425.74 $1,239.22 $485.15 38572 T Laparoscopy, lymphadenectomy 0131 41.81 $2,073.61 $1,089.88 $414.72 38589 T Laparoscope proc, lymphatic 0130 25.36 $1,257.75 $659.53 $251.55 38700 C Removal of lymph nodes, neck 38720 T Removal of lymph nodes, neck 0114 19.56 $970.10 $493.78 $194.02 38724 C Removal of lymph nodes, neck 38740 T Remove armpit lymph nodes 0114 19.56 $970.10 $493.78 $194.02 38745 T Remove armpit lymph nodes 0114 19.56 $970.10 $493.78 $194.02 38746 C Remove thoracic lymph nodes 38747 C Remove abdominal lymph nodes 38760 T Remove groin lymph nodes 0114 19.56 $970.10 $493.78 $194.02 38765 C Remove groin lymph nodes 38770 C Remove pelvis lymph nodes 38780 C Remove abdomen lymph nodes 38790 N Inject for lymphatic x-ray 38792 N Identify sentinel node 38794 N Access thoracic lymph duct 38999 T Blood/lymph system procedure 0008 6.15 $305.02 $113.67 $61.00 39000 C Exploration of chest 39010 C Exploration of chest 39200 C Removal chest lesion 39220 C Removal chest lesion 39400 T Visualization of chest 0076 8.06 $399.75 $197.05 $79.95 39499 C Chest procedure 39501 C Repair diaphragm laceration 39502 C Repair paraesophageal hernia 39503 C Repair of diaphragm hernia 39520 C Repair of diaphragm hernia 39530 C Repair of diaphragm hernia 39531 C Repair of diaphragm hernia 39540 C Repair of diaphragm hernia 39541 C Repair of diaphragm hernia 39545 C Revision of diaphragm 39560 C Resect diaphragm, simple 39561 C Resect diaphragm, complex 39599 C Diaphragm surgery procedure 40490 T Biopsy of lip 0252 5.18 $256.90 $114.24 $51.38 40500 T Partial excision of lip 0253 12.02 $596.14 $284.00 $119.23 40510 T Partial excision of lip 0254 12.45 $617.47 $272.41 $123.49 40520 T Partial excision of lip 0253 12.02 $596.14 $284.00 $119.23 40525 T Reconstruct lip with flap 0254 12.45 $617.47 $272.41 $123.49 40527 T Reconstruct lip with flap 0254 12.45 $617.47 $272.41 $123.49 40530 T Partial removal of lip 0254 12.45 $617.47 $272.41 $123.49 40650 T Repair lip 0253 12.02 $596.14 $284.00 $119.23 40652 T Repair lip 0253 12.02 $596.14 $284.00 $119.23 40654 T Repair lip 0254 12.45 $617.47 $272.41 $123.49 40700 T Repair cleft lip/nasal 0256 25.40 $1,259.74 $623.05 $251.95 40701 T Repair cleft lip/nasal 0256 25.40 $1,259.74 $623.05 $251.95 40702 T Repair cleft lip/nasal 0256 25.40 $1,259.74 $623.05 $251.95 40720 T Repair cleft lip/nasal 0256 25.40 $1,259.74 $623.05 $251.95 40761 T Repair cleft lip/nasal 0256 25.40 $1,259.74 $623.05 $251.95 40799 T Lip surgery procedure 0253 12.02 $596.14 $284.00 $119.23 40800 T Drainage of mouth lesion 0251 1.68 $83.32 $27.99 $16.66 40801 T Drainage of mouth lesion 0252 5.18 $256.90 $114.24 $51.38 40804 T Removal, foreign body, mouth 0251 1.68 $83.32 $27.99 $16.66 40805 T Removal, foreign body, mouth 0252 5.18 $256.90 $114.24 $51.38 40806 T Incision of lip fold 0251 1.68 $83.32 $27.99 $16.66 40808 T Biopsy of mouth lesion 0251 1.68 $83.32 $27.99 $16.66 40810 T Excision of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 40812 T Excise/repair mouth lesion 0252 5.18 $256.90 $114.24 $51.38 40814 T Excise/repair mouth lesion 0253 12.02 $596.14 $284.00 $119.23 40816 T Excision of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 40818 T Excise oral mucosa for graft 0251 1.68 $83.32 $27.99 $16.66 40819 T Excise lip or cheek fold 0252 5.18 $256.90 $114.24 $51.38 40820 T Treatment of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 40830 T Repair mouth laceration 0251 1.68 $83.32 $27.99 $16.66 40831 T Repair mouth laceration 0253 12.02 $596.14 $284.00 $119.23 40840 T Reconstruction of mouth 0254 12.45 $617.47 $272.41 $123.49 40842 T Reconstruction of mouth 0254 12.45 $617.47 $272.41 $123.49 40843 T Reconstruction of mouth 0254 12.45 $617.47 $272.41 $123.49 40844 T Reconstruction of mouth 0256 25.40 $1,259.74 $623.05 $251.95 40845 T Reconstruction of mouth 0256 25.40 $1,259.74 $623.05 $251.95 40899 T Mouth surgery procedure 0252 5.18 $256.90 $114.24 $51.38 41000 T Drainage of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 41005 T Drainage of mouth lesion 0251 1.68 $83.32 $27.99 $16.66 41006 T Drainage of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 41007 T Drainage of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 41008 T Drainage of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 41009 T Drainage of mouth lesion 0251 1.68 $83.32 $27.99 $16.66 41010 T Incision of tongue fold 0253 12.02 $596.14 $284.00 $119.23 41015 T Drainage of mouth lesion 0252 5.18 $256.90 $114.24 $51.38 41016 T Drainage of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 41017 T Drainage of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 41018 T Drainage of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 41100 T Biopsy of tongue 0252 5.18 $256.90 $114.24 $51.38 41105 T Biopsy of tongue 0253 12.02 $596.14 $284.00 $119.23 41108 T Biopsy of floor of mouth 0252 5.18 $256.90 $114.24 $51.38 41110 T Excision of tongue lesion 0253 12.02 $596.14 $284.00 $119.23 41112 T Excision of tongue lesion 0253 12.02 $596.14 $284.00 $119.23 41113 T Excision of tongue lesion 0253 12.02 $596.14 $284.00 $119.23 41114 T Excision of tongue lesion 0254 12.45 $617.47 $272.41 $123.49 41115 T Excision of tongue fold 0253 12.02 $596.14 $284.00 $119.23 41116 T Excision of mouth lesion 0253 12.02 $596.14 $284.00 $119.23 41120 T Partial removal of tongue 0256 25.40 $1,259.74 $623.05 $251.95 41130 C Partial removal of tongue 41135 C Tongue and neck surgery 41140 C Removal of tongue 41145 C Tongue removal, neck surgery 41150 C Tongue, mouth, jaw surgery 41153 C Tongue, mouth, neck surgery 41155 C Tongue, jaw, & neck surgery 41250 T Repair tongue laceration 0251 1.68 $83.32 $27.99 $16.66 41251 T Repair tongue laceration 0253 12.02 $596.14 $284.00 $119.23 41252 T Repair tongue laceration 0253 12.02 $596.14 $284.00 $119.23 41500 T Fixation of tongue 0253 12.02 $596.14 $284.00 $119.23 41510 T Tongue to lip surgery 0253 12.02 $596.14 $284.00 $119.23 41520 T Reconstruction, tongue fold 0253 12.02 $596.14 $284.00 $119.23 41599 T Tongue and mouth surgery 0251 1.68 $83.32 $27.99 $16.66 41800 T Drainage of gum lesion 0251 1.68 $83.32 $27.99 $16.66 41805 T Removal foreign body, gum 0253 12.02 $596.14 $284.00 $119.23 41806 T Removal foreign body,jawbone 0253 12.02 $596.14 $284.00 $119.23 41820 T Excision, gum, each quadrant 0252 5.18 $256.90 $114.24 $51.38 41821 T Excision of gum flap 0252 5.18 $256.90 $114.24 $51.38 41822 T Excision of gum lesion 0253 12.02 $596.14 $284.00 $119.23 41823 T Excision of gum lesion 0253 12.02 $596.14 $284.00 $119.23 41825 T Excision of gum lesion 0253 12.02 $596.14 $284.00 $119.23 41826 T Excision of gum lesion 0253 12.02 $596.14 $284.00 $119.23 41827 T Excision of gum lesion 0253 12.02 $596.14 $284.00 $119.23 41828 T Excision of gum lesion 0253 12.02 $596.14 $284.00 $119.23 41830 T Removal of gum tissue 0253 12.02 $596.14 $284.00 $119.23 41850 T Treatment of gum lesion 0253 12.02 $596.14 $284.00 $119.23 41870 T Gum graft 0253 12.02 $596.14 $284.00 $119.23 41872 T Repair gum 0253 12.02 $596.14 $284.00 $119.23 41874 T Repair tooth socket 0253 12.02 $596.14 $284.00 $119.23 41899 T Dental surgery procedure 0253 12.02 $596.14 $284.00 $119.23 42000 T Drainage mouth roof lesion 0251 1.68 $83.32 $27.99 $16.66 42100 T Biopsy roof of mouth 0252 5.18 $256.90 $114.24 $51.38 42104 T Excision lesion, mouth roof 0253 12.02 $596.14 $284.00 $119.23 42106 T Excision lesion, mouth roof 0253 12.02 $596.14 $284.00 $119.23 42107 T Excision lesion, mouth roof 0254 12.45 $617.47 $272.41 $123.49 42120 T Remove palate/lesion 0256 25.40 $1,259.74 $623.05 $251.95 42140 T Excision of uvula 0252 5.18 $256.90 $114.24 $51.38 42145 T Repair palate, pharynx/uvula 0254 12.45 $617.47 $272.41 $123.49 42160 T Treatment mouth roof lesion 0253 12.02 $596.14 $284.00 $119.23 42180 T Repair palate 0251 1.68 $83.32 $27.99 $16.66 42182 T Repair palate 0256 25.40 $1,259.74 $623.05 $251.95 42200 T Reconstruct cleft palate 0256 25.40 $1,259.74 $623.05 $251.95 42205 T Reconstruct cleft palate 0256 25.40 $1,259.74 $623.05 $251.95 42210 T Reconstruct cleft palate 0256 25.40 $1,259.74 $623.05 $251.95 42215 T Reconstruct cleft palate 0256 25.40 $1,259.74 $623.05 $251.95 42220 T Reconstruct cleft palate 0256 25.40 $1,259.74 $623.05 $251.95 42225 T Reconstruct cleft palate 0256 25.40 $1,259.74 $623.05 $251.95 42226 T Lengthening of palate 0256 25.40 $1,259.74 $623.05 $251.95 42227 T Lengthening of palate 0256 25.40 $1,259.74 $623.05 $251.95 42235 T Repair palate 0254 12.45 $617.47 $272.41 $123.49 42260 T Repair nose to lip fistula 0253 12.02 $596.14 $284.00 $119.23 42280 T Preparation, palate mold 0251 1.68 $83.32 $27.99 $16.66 42281 T Insertion, palate prosthesis 0253 12.02 $596.14 $284.00 $119.23 42299 T Palate/uvula surgery 0251 1.68 $83.32 $27.99 $16.66 42300 T Drainage of salivary gland 0253 12.02 $596.14 $284.00 $119.23 42305 T Drainage of salivary gland 0253 12.02 $596.14 $284.00 $119.23 42310 T Drainage of salivary gland 0251 1.68 $83.32 $27.99 $16.66 42320 T Drainage of salivary gland 0251 1.68 $83.32 $27.99 $16.66 42325 T Create salivary cyst drain 0252 5.18 $256.90 $114.24 $51.38 42326 T Create salivary cyst drain 0252 5.18 $256.90 $114.24 $51.38 42330 T Removal of salivary stone 0252 5.18 $256.90 $114.24 $51.38 42335 T Removal of salivary stone 0253 12.02 $596.14 $284.00 $119.23 42340 T Removal of salivary stone 0253 12.02 $596.14 $284.00 $119.23 42400 T Biopsy of salivary gland 0004 1.84 $91.26 $32.57 $18.25 42405 T Biopsy of salivary gland 0253 12.02 $596.14 $284.00 $119.23 42408 T Excision of salivary cyst 0253 12.02 $596.14 $284.00 $119.23 42409 T Drainage of salivary cyst 0253 12.02 $596.14 $284.00 $119.23 42410 T Excise parotid gland/lesion 0256 25.40 $1,259.74 $623.05 $251.95 42415 T Excise parotid gland/lesion 0256 25.40 $1,259.74 $623.05 $251.95 42420 T Excise parotid gland/lesion 0256 25.40 $1,259.74 $623.05 $251.95 42425 T Excise parotid gland/lesion 0256 25.40 $1,259.74 $623.05 $251.95 42426 C Excise parotid gland/lesion 42440 T Excise submaxillary gland 0256 25.40 $1,259.74 $623.05 $251.95 42450 T Excise sublingual gland 0253 12.02 $596.14 $284.00 $119.23 42500 T Repair salivary duct 0254 12.45 $617.47 $272.41 $123.49 42505 T Repair salivary duct 0256 25.40 $1,259.74 $623.05 $251.95 42507 T Parotid duct diversion 0256 25.40 $1,259.74 $623.05 $251.95 42508 T Parotid duct diversion 0256 25.40 $1,259.74 $623.05 $251.95 42509 T Parotid duct diversion 0256 25.40 $1,259.74 $623.05 $251.95 42510 T Parotid duct diversion 0256 25.40 $1,259.74 $623.05 $251.95 42550 N Injection for salivary x-ray 42600 T Closure of salivary fistula 0253 12.02 $596.14 $284.00 $119.23 42650 T Dilation of salivary duct 0252 5.18 $256.90 $114.24 $51.38 42660 T Dilation of salivary duct 0252 5.18 $256.90 $114.24 $51.38 42665 T Ligation of salivary duct 0253 12.02 $596.14 $284.00 $119.23 42699 T Salivary surgery procedure 0253 12.02 $596.14 $284.00 $119.23 42700 T Drainage of tonsil abscess 0251 1.68 $83.32 $27.99 $16.66 42720 T Drainage of throat abscess 0253 12.02 $596.14 $284.00 $119.23 42725 T Drainage of throat abscess 0256 25.40 $1,259.74 $623.05 $251.95 42800 T Biopsy of throat 0252 5.18 $256.90 $114.24 $51.38 42802 T Biopsy of throat 0253 12.02 $596.14 $284.00 $119.23 42804 T Biopsy of upper nose/throat 0253 12.02 $596.14 $284.00 $119.23 42806 T Biopsy of upper nose/throat 0253 12.02 $596.14 $284.00 $119.23 42808 T Excise pharynx lesion 0253 12.02 $596.14 $284.00 $119.23 42809 T Remove pharynx foreign body 0251 1.68 $83.32 $27.99 $16.66 42810 T Excision of neck cyst 0253 12.02 $596.14 $284.00 $119.23 42815 T Excision of neck cyst 0256 25.40 $1,259.74 $623.05 $251.95 42820 T Remove tonsils and adenoids 0258 18.62 $923.48 $462.81 $184.70 42821 T Remove tonsils and adenoids 0258 18.62 $923.48 $462.81 $184.70 42825 T Removal of tonsils 0258 18.62 $923.48 $462.81 $184.70 42826 T Removal of tonsils 0258 18.62 $923.48 $462.81 $184.70 42830 T Removal of adenoids 0258 18.62 $923.48 $462.81 $184.70 42831 T Removal of adenoids 0258 18.62 $923.48 $462.81 $184.70 42835 T Removal of adenoids 0258 18.62 $923.48 $462.81 $184.70 42836 T Removal of adenoids 0258 18.62 $923.48 $462.81 $184.70 42842 C Extensive surgery of throat 42844 T Extensive surgery of throat 0256 25.40 $1,259.74 $623.05 $251.95 42845 C Extensive surgery of throat 42860 T Excision of tonsil tags 0258 18.62 $923.48 $462.81 $184.70 42870 T Excision of lingual tonsil 0258 18.62 $923.48 $462.81 $184.70 42890 T Partial removal of pharynx 0256 25.40 $1,259.74 $623.05 $251.95 42892 T Revision of pharyngeal walls 0256 25.40 $1,259.74 $623.05 $251.95 42894 C Revision of pharyngeal walls 42900 T Repair throat wound 0253 12.02 $596.14 $284.00 $119.23 42950 T Reconstruction of throat 0254 12.45 $617.47 $272.41 $123.49 42953 C Repair throat, esophagus 42955 T Surgical opening of throat 0254 12.45 $617.47 $272.41 $123.49 42960 T Control throat bleeding 0250 2.21 $109.61 $38.54 $21.92 42961 C Control throat bleeding 42962 T Control throat bleeding 0256 25.40 $1,259.74 $623.05 $251.95 42970 T Control nose/throat bleeding 0250 2.21 $109.61 $38.54 $21.92 42971 C Control nose/throat bleeding 42972 T Control nose/throat bleeding 0253 12.02 $596.14 $284.00 $119.23 42999 T Throat surgery procedure 0252 5.18 $256.90 $114.24 $51.38 43020 T Incision of esophagus 0254 12.45 $617.47 $272.41 $123.49 43030 C Throat muscle surgery 43045 C Incision of esophagus 43100 C Excision of esophagus lesion 43101 C Excision of esophagus lesion 43107 C Removal of esophagus 43108 C Removal of esophagus 43112 C Removal of esophagus 43113 C Removal of esophagus 43116 C Partial removal of esophagus 43117 C Partial removal of esophagus 43118 C Partial removal of esophagus 43121 C Partial removal of esophagus 43122 C Parital removal of esophagus 43123 C Partial removal of esophagus 43124 C Removal of esophagus 43130 T Removal of esophagus pouch 0254 12.45 $617.47 $272.41 $123.49 43135 C Removal of esophagus pouch 43200 T Esophagus endoscopy 0141 7.15 $354.61 $184.67 $70.92 43202 T Esophagus endoscopy, biopsy 0141 7.15 $354.61 $184.67 $70.92 43204 T Esophagus endoscopy & inject 0141 7.15 $354.61 $184.67 $70.92 43205 T Esophagus endoscopy/ligation 0141 7.15 $354.61 $184.67 $70.92 43215 T Esophagus endoscopy 0141 7.15 $354.61 $184.67 $70.92 43216 T Esophagus endoscopy/lesion 0141 7.15 $354.61 $184.67 $70.92 43217 T Esophagus endoscopy 0141 7.15 $354.61 $184.67 $70.92 43219 T Esophagus endoscopy 0141 7.15 $354.61 $184.67 $70.92 43220 T Esoph endoscopy, dilation 0141 7.15 $354.61 $184.67 $70.92 43226 T Esoph endoscopy, dilation 0141 7.15 $354.61 $184.67 $70.92 43227 T Esoph endoscopy, repair 0141 7.15 $354.61 $184.67 $70.92 43228 T Esoph endoscopy, ablation 0141 7.15 $354.61 $184.67 $70.92 *43231 T Esoph endoscopy w/ US exam 0141 7.15 $354.61 $184.67 $70.92 *43232 T Esoph endoscopy w/ US fn bx 0141 7.15 $354.61 $184.67 $70.92 43234 T Upper GI endoscopy, exam 0141 7.15 $354.61 $184.67 $70.92 43235 T Uppr gi endoscopy, diagnosis 0141 7.15 $354.61 $184.67 $70.92 43239 T Upper GI endoscopy, biopsy 0141 7.15 $354.61 $184.67 $70.92 *43240 T Esoph endoscopy w/ drain cyst 0141 7.15 $354.61 $184.67 $70.92 43241 T Upper GI endoscopy with tube 0141 7.15 $354.61 $184.67 $70.92 *43242 T Uppr GI endoscopy w/ US fn bx 0141 7.15 $354.61 $184.67 $70.92 43243 T Upper GI endoscopy & inject 0141 7.15 $354.61 $184.67 $70.92 43244 T Upper GI endoscopy/ligation 0141 7.15 $354.61 $184.67 $70.92 43245 T Operative upper GI endoscopy 0141 7.15 $354.61 $184.67 $70.92 43246 T Place gastrostomy tube 0141 7.15 $354.61 $184.67 $70.92 43247 T Operative upper GI endoscopy 0141 7.15 $354.61 $184.67 $70.92 43248 T Uppr gi endoscopy/guide wire 0141 7.15 $354.61 $184.67 $70.92 43249 T Esoph endoscopy, dilation 0141 7.15 $354.61 $184.67 $70.92 43250 T Upper GI endoscopy/tumor 0141 7.15 $354.61 $184.67 $70.92 43251 T Operative upper GI endoscopy 0141 7.15 $354.61 $184.67 $70.92 43255 T Operative upper GI endoscopy 0141 7.15 $354.61 $184.67 $70.92 *43256 T Uppr GI endoscopy w/ stent 0141 7.15 $354.61 $184.67 $70.92 43258 T Operative upper GI endoscopy 0141 7.15 $354.61 $184.67 $70.92 43259 T Endoscopic ultrasound exam 0141 7.15 $354.61 $184.67 $70.92 43260 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43261 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43262 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43263 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43264 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43265 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43267 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43268 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43269 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43271 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43272 T Endo cholangiopancreatograph 0151 10.53 $522.25 $245.46 $104.45 43280 T Laparoscopy, fundoplasty 0132 48.91 $2,425.74 $1,239.22 $485.15 43289 T Laparoscope proc, esoph 0130 25.36 $1,257.75 $659.53 $251.55 43300 C Repair of esophagus 43305 C Repair esophagus and fistula 43310 C Repair of esophagus 43312 C Repair esophagus and fistula 43320 C Fuse esophagus & stomach 43324 C Revise esophagus & stomach 43325 C Revise esophagus & stomach 43326 C Revise esophagus & stomach 43330 C Repair of esophagus 43331 C Repair of esophagus 43340 C Fuse esophagus & intestine 43341 C Fuse esophagus & intestine 43350 C Surgical opening, esophagus 43351 C Surgical opening, esophagus 43352 C Surgical opening, esophagus 43360 C Gastrointestinal repair 43361 C Gastrointestinal repair *44383 T Ileoscopy through stoma w/stent 0142 7.45 $369.49 $162.42 $73.90 43400 C Ligate esophagus veins 43401 C Esophagus surgery for veins 43405 C Ligate/staple esophagus 43410 C Repair esophagus wound 43415 C Repair esophagus wound 43420 C Repair esophagus opening 43425 C Repair esophagus opening 43450 T Dilate esophagus 0140 4.74 $235.09 $107.24 $47.02 43453 T Dilate esophagus 0140 4.74 $235.09 $107.24 $47.02 43456 T Dilate esophagus 0140 4.74 $235.09 $107.24 $47.02 43458 T Dilate esophagus 0140 4.74 $235.09 $107.24 $47.02 43460 C Pressure treatment esophagus 43496 C Free jejunum flap, microvasc 43499 T Esophagus surgery procedure 0140 4.74 $235.09 $107.24 $47.02 43500 C Surgical opening of stomach 43501 C Surgical repair of stomach 43502 C Surgical repair of stomach 43510 C Surgical opening of stomach 43520 C Incision of pyloric muscle 43600 T Biopsy of stomach 0141 7.15 $354.61 $184.67 $70.92 43605 C Biopsy of stomach 43610 C Excision of stomach lesion 43611 C Excision of stomach lesion 43620 C Removal of stomach 43621 C Removal of stomach 43622 C Removal of stomach 43631 C Removal of stomach, partial 43632 C Removal of stomach, partial 43633 C Removal of stomach, partial 43634 C Removal of stomach, partial 43635 C Removal of stomach, partial 43638 C Removal of stomach, partial 43639 C Removal of stomach, partial 43640 C Vagotomy & pylorus repair 43641 C Vagotomy & pylorus repair 43651 T Laparoscopy, vagus nerve 0132 48.91 $2,425.74 $1,239.22 $485.15 43652 T Laparoscopy, vagus nerve 0132 48.91 $2,425.74 $1,239.22 $485.15 43653 T Laparoscopy, gastrostomy 0131 41.81 $2,073.61 $1,089.88 $414.72 43659 T Laparoscope proc, stom 0130 25.36 $1,257.75 $659.53 $251.55 *43752 E Nasal/orogastric w/stent 43750 T Place gastrostomy tube 0141 7.15 $354.61 $184.67 $70.92 43760 T Change gastrostomy tube 0121 2.36 $117.05 $52.53 $23.41 43761 T Reposition gastrostomy tube 0121 2.36 $117.05 $52.53 $23.41 43800 C Reconstruction of pylorus 43810 C Fusion of stomach and bowel 43820 C Fusion of stomach and bowel 43825 C Fusion of stomach and bowel 43830 T Place gastrostomy tube 0141 7.15 $354.61 $184.67 $70.92 43831 T Place gastrostomy tube 0141 7.15 $354.61 $184.67 $70.92 43832 C Place gastrostomy tube 43840 C Repair of stomach lesion 43842 C Gastroplasty for obesity 43843 C Gastroplasty for obesity 43846 C Gastric bypass for obesity 43847 C Gastric bypass for obesity 43848 C Revision gastroplasty 43850 C Revise stomach-bowel fusion 43855 C Revise stomach-bowel fusion 43860 C Revise stomach-bowel fusion 43865 C Revise stomach-bowel fusion 43870 T Repair stomach opening 0025 3.74 $185.49 $70.66 $37.10 43880 C Repair stomach-bowel fistula 43999 T Stomach surgery procedure 0121 2.36 $117.05 $52.53 $23.41 44005 C Freeing of bowel adhesion 44010 C Incision of small bowel 44015 C Insert needle cath bowel 44020 C Exploration of small bowel 44021 C Decompress small bowel 44025 C Incision of large bowel 44050 C Reduce bowel obstruction 44055 C Correct malrotation of bowel 44100 T Biopsy of bowel 0141 7.15 $354.61 $184.67 $70.92 44110 C Excision of bowel lesion(s) 44111 C Excision of bowel lesion(s) 44120 C Removal of small intestine 44121 C Removal of small intestine 44125 C Removal of small intestine 44130 C Bowel to bowel fusion *44132 C Enterectomy, cadaver donor *44133 C Enterectomy, live donor *44135 C Intestine transplnt, cadaver *44136 C Intestine transplnt, live 44139 C Mobilization of colon 44140 C Partial removal of colon 44141 C Partial removal of colon 44143 C Partial removal of colon 44144 C Partial removal of colon 44145 C Partial removal of colon 44146 C Partial removal of colon 44147 C Partial removal of colon 44150 C Removal of colon 44151 C Removal of colon/ileostomy 44152 C Removal of colon/ileostomy 44153 C Removal of colon/ileostomy 44155 C Removal of colon/ileostomy 44156 C Removal of colon/ileostomy 44160 C Removal of colon 44200 T Laparoscopy, enterolysis 0131 41.81 $2,073.61 $1,089.88 $414.72 44201 T Laparoscopy, jejunostomy 0131 41.81 $2,073.61 $1,089.88 $414.72 44202 C Laparo, resect intestine 44209 T Laparoscope proc, intestine 0130 25.36 $1,257.75 $659.53 $251.55 44300 C Open bowel to skin 44310 C Ileostomy/jejunostomy 44312 T Revision of ileostomy 0026 12.11 $600.61 $277.92 $120.12 44314 C Revision of ileostomy 44316 C Devise bowel pouch 44320 C Colostomy 44322 C Colostomy with biopsies 44340 T Revision of colostomy 0026 12.11 $600.61 $277.92 $120.12 44345 C Revision of colostomy 44346 C Revision of colostomy 44360 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44361 T Small bowel endoscopy/biopsy 0142 7.45 $369.49 $162.42 $73.90 44363 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44364 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44365 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44366 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44369 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 *44370 T Small bowel endoscopy/stent 0142 7.45 $369.49 $162.42 $73.90 44372 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44373 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44376 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44377 T Small bowel endoscopy/biopsy 0142 7.45 $369.49 $162.42 $73.90 44378 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 *44379 T Small bowel endoscopy/stent 0142 7.45 $369.49 $162.42 $73.90 44380 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44382 T Small bowel endoscopy 0142 7.45 $369.49 $162.42 $73.90 44385 T Endoscopy of bowel pouch 0143 7.98 $395.78 $199.12 $79.16 44386 T Endoscopy, bowel pouch/biop 0143 7.98 $395.78 $199.12 $79.16 44388 T Colon endoscopy 0143 7.98 $395.78 $199.12 $79.16 44389 T Colonoscopy with biopsy 0143 7.98 $395.78 $199.12 $79.16 44390 T Colonoscopy for foreign body 0143 7.98 $395.78 $199.12 $79.16 44391 T Colonoscopy for bleeding 0143 7.98 $395.78 $199.12 $79.16 44392 T Colonoscopy & polypectomy 0143 7.98 $395.78 $199.12 $79.16 44393 T Colonoscopy, lesion removal 0143 7.98 $395.78 $199.12 $79.16 44394 T Colonoscopy w/snare 0143 7.98 $395.78 $199.12 $79.16 *44397 T Colonoscopy w/stent 0143 7.98 $395.78 $199.12 $79.16 44500 T Intro, gastrointestinal tube 0121 2.36 $117.05 $52.53 $23.41 44602 C Suture, small intestine 44603 C Suture, small intestine 44604 C Suture, large intestine 44605 C Repair of bowel lesion 44615 C Intestinal stricturoplasty 44620 C Repair bowel opening 44625 C Repair bowel opening 44626 C Repair bowel opening 44640 C Repair bowel-skin fistula 44650 C Repair bowel fistula 44660 C Repair bowel-bladder fistula 44661 C Repair bowel-bladder fistula 44680 C Surgical revision, intestine 44700 C Suspend bowel w/prosthesis 44799 T Intestine surgery procedure 0142 7.45 $369.49 $162.42 $73.90 44800 C Excision of bowel pouch 44820 C Excision of mesentery lesion 44850 C Repair of mesentery 44899 C Bowel surgery procedure 44900 C Drain app abscess, open 44901 C Drain app abscess, percut 44950 C Appendectomy 44955 C Appendectomy add-on 44960 C Appendectomy 44970 T Laparoscopy, appendectomy 0130 25.36 $1,257.75 $659.53 $251.55 44979 T Laparoscope proc, app 0130 25.36 $1,257.75 $659.53 $251.55 45000 T Drainage of pelvic abscess 0149 12.86 $637.80 $293.06 $127.56 45005 T Drainage of rectal abscess 0148 2.34 $116.06 $43.59 $23.21 45020 T Drainage of rectal abscess 0149 12.86 $637.80 $293.06 $127.56 45100 T Biopsy of rectum 0149 12.86 $637.80 $293.06 $127.56 45108 T Removal of anorectal lesion 0150 17.68 $876.86 $437.12 $175.37 45110 C Removal of rectum 45111 C Partial removal of rectum 45112 C Removal of rectum 45113 C Partial proctectomy 45114 C Partial removal of rectum 45116 C Partial removal of rectum 45119 C Remove rectum w/reservoir 45120 C Removal of rectum 45121 C Removal of rectum and colon 45123 C Partial proctectomy 45126 C Pelvic exenteration 45130 C Excision of rectal prolapse 45135 C Excision of rectal prolapse 45150 T Excision of rectal stricture 0150 17.68 $876.86 $437.12 $175.37 45160 T Excision of rectal lesion 0150 17.68 $876.86 $437.12 $175.37 45170 T Excision of rectal lesion 0150 17.68 $876.86 $437.12 $175.37 45190 T Destruction, rectal tumor 0150 17.68 $876.86 $437.12 $175.37 45300 T Proctosigmoidoscopy 0146 2.83 $140.36 $65.15 $28.07 45303 T Proctosigmoidoscopy 0146 2.83 $140.36 $65.15 $28.07 45305 T Proctosigmoidoscopy & biopsy 0146 2.83 $140.36 $65.15 $28.07 45307 T Proctosigmoidoscopy 0146 2.83 $140.36 $65.15 $28.07 45308 T Proctosigmoidoscopy 0147 6.26 $310.47 $149.11 $62.09 45309 T Proctosigmoidoscopy 0147 6.26 $310.47 $149.11 $62.09 45315 T Proctosigmoidoscopy 0147 6.26 $310.47 $149.11 $62.09 45317 T Proctosigmoidoscopy 0146 2.83 $140.36 $65.15 $28.07 45320 T Proctosigmoidoscopy 0147 6.26 $310.47 $149.11 $62.09 45321 T Proctosigmoidoscopy 0147 6.26 $310.47 $149.11 $62.09 *45327 T Proctosigmoidoscopy w/stent 0147 6.26 $310.47 $149.11 $62.09 45330 T Diagnostic sigmoidoscopy 0146 2.83 $140.36 $65.15 $28.07 45331 T Sigmoidoscopy and biopsy 0146 2.83 $140.36 $65.15 $28.07 45332 T Sigmoidoscopy w/fb removal 0146 2.83 $140.36 $65.15 $28.07 45333 T Sigmoidoscopy & polypectomy 0147 6.26 $310.47 $149.11 $62.09 45334 T Sigmoidoscopy for bleeding 0147 6.26 $310.47 $149.11 $62.09 45337 T Sigmoidoscopy & decompress 0147 6.26 $310.47 $149.11 $62.09 45338 T Sigmoidoscopy w/tumr remove 0147 6.26 $310.47 $149.11 $62.09 45339 T Sigmoidoscopy w/ablate tumr 0147 6.26 $310.47 $149.11 $62.09 *45341 T Sigmoidoscopy w/ultrasound 0147 6.26 $310.47 $149.11 $62.09 *45342 T Sigmoidoscopy w/ US guide bx 0147 6.26 $310.47 $149.11 $62.09 *45345 T Sigmoidoscopy w/stent 0147 6.26 $310.47 $149.11 $62.09 45355 T Surgical colonoscopy 0143 7.98 $395.78 $199.12 $79.16 45378 T Diagnostic colonoscopy 0143 7.98 $395.78 $199.12 $79.16 45379 T Colonoscopy 0143 7.98 $395.78 $199.12 $79.16 45380 T Colonoscopy and biopsy 0143 7.98 $395.78 $199.12 $79.16 45382 T Colonoscopy/control bleeding 0143 7.98 $395.78 $199.12 $79.16 45383 T Lesion removal colonoscopy 0143 7.98 $395.78 $199.12 $79.16 45384 T Colonoscopy 0143 7.98 $395.78 $199.12 $79.16 45385 T Lesion removal colonoscopy 0143 7.98 $395.78 $199.12 $79.16 *45387 T Colonoscopy w/stent 0143 7.98 $395.78 $199.12 $79.16 45500 T Repair of rectum 0150 17.68 $876.86 $437.12 $175.37 45505 T Repair of rectum 0150 17.68 $876.86 $437.12 $175.37 45520 T Treatment of rectal prolapse 0098 1.19 $59.02 $20.88 $11.80 45540 C Correct rectal prolapse 45541 C Correct rectal prolapse 45550 C Repair rectum/remove sigmoid 45560 T Repair of rectocele 0150 17.68 $876.86 $437.12 $175.37 45562 C Exploration/repair of rectum 45563 C Exploration/repair of rectum 45800 C Repair rect/bladder fistula 45805 C Repair fistula w/colostomy 45820 C Repair rectourethral fistula 45825 C Repair fistula w/colostomy 45900 T Reduction of rectal prolapse 0148 2.34 $116.06 $43.59 $23.21 45905 T Dilation of anal sphincter 0149 12.86 $637.80 $293.06 $127.56 45910 T Dilation of rectal narrowing 0149 12.86 $637.80 $293.06 $127.56 45915 T Remove rectal obstruction 0148 2.34 $116.06 $43.59 $23.21 45999 T Rectum surgery procedure 0148 2.34 $116.06 $43.59 $23.21 46030 T Removal of rectal marker 0149 12.86 $637.80 $293.06 $127.56 46040 T Incision of rectal abscess 0148 2.34 $116.06 $43.59 $23.21 46045 T Incision of rectal abscess 0150 17.68 $876.86 $437.12 $175.37 46050 T Incision of anal abscess 0148 2.34 $116.06 $43.59 $23.21 46060 T Incision of rectal abscess 0150 17.68 $876.86 $437.12 $175.37 46070 T Incision of anal septum 0148 2.34 $116.06 $43.59 $23.21 46080 T Incision of anal sphincter 0149 12.86 $637.80 $293.06 $127.56 46083 T Incise external hemorrhoid 0148 2.34 $116.06 $43.59 $23.21 46200 T Removal of anal fissure 0150 17.68 $876.86 $437.12 $175.37 46210 T Removal of anal crypt 0149 12.86 $637.80 $293.06 $127.56 46211 T Removal of anal crypts 0150 17.68 $876.86 $437.12 $175.37 46220 T Removal of anal tab 0149 12.86 $637.80 $293.06 $127.56 46221 T Ligation of hemorrhoid(s) 0148 2.34 $116.06 $43.59 $23.21 46230 T Removal of anal tabs 0149 12.86 $637.80 $293.06 $127.56 46250 T Hemorrhoidectomy 0150 17.68 $876.86 $437.12 $175.37 46255 T Hemorrhoidectomy 0150 17.68 $876.86 $437.12 $175.37 46257 T Remove hemorrhoids & fissure 0150 17.68 $876.86 $437.12 $175.37 46258 T Remove hemorrhoids & fistula 0150 17.68 $876.86 $437.12 $175.37 46260 T Hemorrhoidectomy 0150 17.68 $876.86 $437.12 $175.37 46261 T Remove hemorrhoids & fissure 0150 17.68 $876.86 $437.12 $175.37 46262 T Remove hemorrhoids & fistula 0150 17.68 $876.86 $437.12 $175.37 46270 T Removal of anal fistula 0150 17.68 $876.86 $437.12 $175.37 46275 T Removal of anal fistula 0150 17.68 $876.86 $437.12 $175.37 46280 T Removal of anal fistula 0150 17.68 $876.86 $437.12 $175.37 46285 T Removal of anal fistula 0150 17.68 $876.86 $437.12 $175.37 46288 T Repair anal fistula 0150 17.68 $876.86 $437.12 $175.37 46320 T Removal of hemorrhoid clot 0148 2.34 $116.06 $43.59 $23.21 46500 T Injection into hemorrhoids 0148 2.34 $116.06 $43.59 $23.21 46600 N Diagnostic anoscopy 46604 T Anoscopy and dilation 0144 2.23 $110.60 $49.32 $22.12 46606 T Anoscopy and biopsy 0145 7.46 $369.98 $179.39 $74.00 46608 T Anoscopy/ remove for body 0144 2.23 $110.60 $49.32 $22.12 46610 T Anoscopy/remove lesion 0145 7.46 $369.98 $179.39 $74.00 46611 T Anoscopy 0145 7.46 $369.98 $179.39 $74.00 46612 T Anoscopy/ remove lesions 0145 7.46 $369.98 $179.39 $74.00 46614 T Anoscopy/control bleeding 0145 7.46 $369.98 $179.39 $74.00 46615 T Anoscopy 0145 7.46 $369.98 $179.39 $74.00 46700 T Repair of anal stricture 0150 17.68 $876.86 $437.12 $175.37 46705 C Repair of anal stricture 46715 C Repair of anovaginal fistula 46716 C Repair of anovaginal fistula 46730 C Construction of absent anus 46735 C Construction of absent anus 46740 C Construction of absent anus 46742 C Repair of imperforated anus 46744 C Repair of cloacal anomaly 46746 C Repair of cloacal anomaly 46748 C Repair of cloacal anomaly 46750 T Repair of anal sphincter 0150 17.68 $876.86 $437.12 $175.37 46751 C Repair of anal sphincter 46753 T Reconstruction of anus 0150 17.68 $876.86 $437.12 $175.37 46754 T Removal of suture from anus 0149 12.86 $637.80 $293.06 $127.56 46760 T Repair of anal sphincter 0150 17.68 $876.86 $437.12 $175.37 46761 T Repair of anal sphincter 0150 17.68 $876.86 $437.12 $175.37 46762 T Implant artificial sphincter 0150 17.68 $876.86 $437.12 $175.37 46900 T Destruction, anal lesion(s) 0016 3.53 $175.07 $74.67 $35.01 46910 T Destruction, anal lesion(s) 0016 3.53 $175.07 $74.67 $35.01 46916 T Cryosurgery, anal lesion(s) 0016 3.53 $175.07 $74.67 $35.01 46917 T Laser surgery, anal lesions 0014 1.50 $74.39 $24.55 $14.88 46922 T Excision of anal lesion(s) 0017 12.45 $617.47 $289.16 $123.49 46924 T Destruction, anal lesion(s) 0017 12.45 $617.47 $289.16 $123.49 46934 T Destruction of hemorrhoids 0148 2.34 $116.06 $43.59 $23.21 46935 T Destruction of hemorrhoids 0148 2.34 $116.06 $43.59 $23.21 46936 T Destruction of hemorrhoids 0149 12.86 $637.80 $293.06 $127.56 46937 T Cryotherapy of rectal lesion 0150 17.68 $876.86 $437.12 $175.37 46938 T Cryotherapy of rectal lesion 0150 17.68 $876.86 $437.12 $175.37 46940 T Treatment of anal fissure 0149 12.86 $637.80 $293.06 $127.56 46942 T Treatment of anal fissure 0149 12.86 $637.80 $293.06 $127.56 46945 T Ligation of hemorrhoids 0148 2.34 $116.06 $43.59 $23.21 46946 T Ligation of hemorrhoids 0148 2.34 $116.06 $43.59 $23.21 46999 T Anus surgery procedure 0149 12.86 $637.80 $293.06 $127.56 47000 T Needle biopsy of liver 0005 5.41 $268.32 $119.75 $53.66 47001 C Needle biopsy, liver add-on 47010 C Open drainage, liver lesion 47011 C Percut drain, liver lesion 47015 C Inject/aspirate liver cyst 47100 C Wedge biopsy of liver 47120 C Partial removal of liver 47122 C Extensive removal of liver 47125 C Partial removal of liver 47130 C Partial removal of liver 47133 C Removal of donor liver 47134 C Partial removal, donor liver 47135 C Transplantation of liver 47136 C Transplantation of liver 47300 C Surgery for liver lesion 47350 C Repair liver wound 47360 C Repair liver wound 47361 C Repair liver wound 47362 C Repair liver wound *47379 T Laparoscope procedure, liver 0130 25.36 $1,257.75 $659.53 $251.55 47399 T Liver surgery procedure 0005 5.41 $268.32 $119.75 $53.66 47400 C Incision of liver duct 47420 C Incision of bile duct 47425 C Incision of bile duct 47460 C Incise bile duct sphincter 47480 C Incision of gallbladder 47490 C Incision of gallbladder 47500 N Injection for liver x-rays 47505 N Injection for liver x-rays 47510 T Insert catheter, bile duct 0152 8.22 $407.68 $207.38 $81.54 47511 T Insert bile duct drain 0152 8.22 $407.68 $207.38 $81.54 47525 T Change bile duct catheter 0122 5.04 $249.96 $114.93 $49.99 47530 T Revise/reinsert bile tube 0121 2.36 $117.05 $52.53 $23.41 47550 C Bile duct endoscopy add-on 47552 T Biliary endoscopy thru skin 0152 8.22 $407.68 $207.38 $81.54 47553 T Biliary endoscopy thru skin 0152 8.22 $407.68 $207.38 $81.54 47554 T Biliary endoscopy thru skin 0152 8.22 $407.68 $207.38 $81.54 47555 T Biliary endoscopy thru skin 0152 8.22 $407.68 $207.38 $81.54 47556 T Biliary endoscopy thru skin 0152 8.22 $407.68 $207.38 $81.54 47560 T Laparoscopy w/cholangio 0130 25.36 $1,257.75 $659.53 $251.55 47561 T Laparo w/cholangio/biopsy 0130 25.36 $1,257.75 $659.53 $251.55 47562 T Laparoscopic cholecystectomy 0131 41.81 $2,073.61 $1,089.88 $414.72 47563 T Laparo cholecystectomy/graph 0131 41.81 $2,073.61 $1,089.88 $414.72 47564 T Laparo cholecystectomy/explr 0131 41.81 $2,073.61 $1,089.88 $414.72 47570 C Laparo cholecystoenterostomy 47579 T Laparoscope proc, biliary 0130 25.36 $1,257.75 $659.53 $251.55 47600 C Removal of gallbladder 47605 C Removal of gallbladder 47610 C Removal of gallbladder 47612 C Removal of gallbladder 47620 C Removal of gallbladder 47630 T Remove bile duct stone 0152 8.22 $407.68 $207.38 $81.54 47700 C Exploration of bile ducts 47701 C Bile duct revision 47711 C Excision of bile duct tumor 47712 C Excision of bile duct tumor 47715 C Excision of bile duct cyst 47716 C Fusion of bile duct cyst 47720 C Fuse gallbladder & bowel 47721 C Fuse upper gi structures 47740 C Fuse gallbladder & bowel 47741 C Fuse gallbladder & bowel 47760 C Fuse bile ducts and bowel 47765 C Fuse liver ducts & bowel 47780 C Fuse bile ducts and bowel 47785 C Fuse bile ducts and bowel 47800 C Reconstruction of bile ducts 47801 C Placement, bile duct support 47802 C Fuse liver duct & intestine 47900 C Suture bile duct injury 47999 T Bile tract surgery procedure 0121 2.36 $117.05 $52.53 $23.41 48000 C Drainage of abdomen 48001 C Placement of drain, pancreas 48005 C Resect/debride pancreas 48020 C Removal of pancreatic stone 48100 C Biopsy of pancreas 48102 T Needle biopsy, pancreas 0005 5.41 $268.32 $119.75 $53.66 48120 C Removal of pancreas lesion 48140 C Partial removal of pancreas 48145 C Partial removal of pancreas 48146 C Pancreatectomy 48148 C Removal of pancreatic duct 48150 C Partial removal of pancreas 48152 C Pancreatectomy 48153 C Pancreatectomy 48154 C Pancreatectomy 48155 C Removal of pancreas 48160 E Pancreas removal/transplant 48180 C Fuse pancreas and bowel 48400 C Injection, intraop add-on 48500 C Surgery of pancreas cyst 48510 C Drain pancreatic pseudocyst 48511 C Drain pancreatic pseudocyst 48520 C Fuse pancreas cyst and bowel 48540 C Fuse pancreas cyst and bowel 48545 C Pancreatorrhaphy 48547 C Duodenal exclusion 48550 E Donor pancreatectomy 48554 E Transpl allograft pancreas 48556 C Removal, allograft pancreas 48999 T Pancreas surgery procedure 0005 5.41 $268.32 $119.75 $53.66 49000 C Exploration of abdomen 49002 C Reopening of abdomen 49010 C Exploration behind abdomen 49020 C Drain abdominal abscess 49021 C Drain abdominal abscess 49040 C Drain, open, abdom abscess 49041 C Drain, percut, abdom abscess 49060 C Drain, open, retrop abscess 49061 C Drain, percut, retroper absc 49062 C Drain to peritoneal cavity 49080 T Puncture, peritoneal cavity 0070 3.64 $180.53 $79.60 $36.11 49081 T Removal of abdominal fluid 0070 3.64 $180.53 $79.60 $36.11 49085 T Remove abdomen foreign body 0153 19.62 $973.08 $496.31 $194.62 49180 T Biopsy, abdominal mass 0005 5.41 $268.32 $119.75 $53.66 49200 C Removal of abdominal lesion 49201 C Removal of abdominal lesion 49215 C Excise sacral spine tumor 49220 C Multiple surgery, abdomen 49250 T Excision of umbilicus 0153 19.62 $973.08 $496.31 $194.62 49255 C Removal of omentum 49320 T Diag laparo separate proc 0130 25.36 $1,257.75 $659.53 $251.55 49321 T Laparoscopy, biopsy 0130 25.36 $1,257.75 $659.53 $251.55 49322 T Laparoscopy, aspiration 0130 25.36 $1,257.75 $659.53 $251.55 49323 T Laparo drain lymphocele 0130 25.36 $1,257.75 $659.53 $251.55 49329 T Laparo proc, abdm/per/oment 0130 25.36 $1,257.75 $659.53 $251.55 49400 N Air injection into abdomen 49420 T Insert abdominal drain 0153 19.62 $973.08 $496.31 $194.62 49421 T Insert abdominal drain 0153 19.62 $973.08 $496.31 $194.62 49422 T Remove perm cannula/catheter 0105 15.06 $746.92 $372.32 $149.38 49423 T Exchange drainage catheter 0153 19.62 $973.08 $496.31 $194.62 49424 N Assess cyst, contrast inject 49425 C Insert abdomen-venous drain 49426 T Revise abdomen-venous shunt 0153 19.62 $973.08 $496.31 $194.62 49427 N Injection, abdominal shunt 49428 C Ligation of shunt 49429 T Removal of shunt 0105 15.06 $746.92 $372.32 $149.38 49495 T Repair inguinal hernia, init 0154 22.43 $1,112.45 $556.98 $222.49 49496 T Repair inguinal hernia, init 0154 22.43 $1,112.45 $556.98 $222.49 49500 T Repair inguinal hernia 0154 22.43 $1,112.45 $556.98 $222.49 49501 T Repair inguinal hernia, init 0154 22.43 $1,112.45 $556.98 $222.49 49505 T Repair inguinal hernia 0154 22.43 $1,112.45 $556.98 $222.49 49507 T Repair inguinal hernia 0154 22.43 $1,112.45 $556.98 $222.49 49520 T Rerepair inguinal hernia 0154 22.43 $1,112.45 $556.98 $222.49 49521 T Repair inguinal hernia, rec 0154 22.43 $1,112.45 $556.98 $222.49 49525 T Repair inguinal hernia 0154 22.43 $1,112.45 $556.98 $222.49 49540 T Repair lumbar hernia 0154 22.43 $1,112.45 $556.98 $222.49 49550 T Repair femoral hernia 0154 22.43 $1,112.45 $556.98 $222.49 49553 T Repair femoral hernia, init 0154 22.43 $1,112.45 $556.98 $222.49 49555 T Repair femoral hernia 0154 22.43 $1,112.45 $556.98 $222.49 49557 T Repair femoral hernia, recur 0154 22.43 $1,112.45 $556.98 $222.49 49560 T Repair abdominal hernia 0154 22.43 $1,112.45 $556.98 $222.49 49561 T Repair incisional hernia 0154 22.43 $1,112.45 $556.98 $222.49 49565 T Rerepair abdominal hernia 0154 22.43 $1,112.45 $556.98 $222.49 49566 T Repair incisional hernia 0154 22.43 $1,112.45 $556.98 $222.49 49568 T Hernia repair w/mesh 0154 22.43 $1,112.45 $556.98 $222.49 49570 T Repair epigastric hernia 0154 22.43 $1,112.45 $556.98 $222.49 49572 T Repair epigastric hernia 0154 22.43 $1,112.45 $556.98 $222.49 49580 T Repair umbilical hernia 0154 22.43 $1,112.45 $556.98 $222.49 49582 T Repair umbilical hernia 0154 22.43 $1,112.45 $556.98 $222.49 49585 T Repair umbilical hernia 0154 22.43 $1,112.45 $556.98 $222.49 49587 T Repair umbilical hernia 0154 22.43 $1,112.45 $556.98 $222.49 49590 T Repair abdominal hernia 0154 22.43 $1,112.45 $556.98 $222.49 49600 T Repair umbilical lesion 0154 22.43 $1,112.45 $556.98 $222.49 49605 C Repair umbilical lesion 49606 C Repair umbilical lesion 49610 C Repair umbilical lesion 49611 C Repair umbilical lesion 49650 T Laparo hernia repair initial 0131 41.81 $2,073.61 $1,089.88 $414.72 49651 T Laparo hernia repair recur 0131 41.81 $2,073.61 $1,089.88 $414.72 49659 T Laparo proc, hernia repair 0131 41.81 $2,073.61 $1,089.88 $414.72 49900 C Repair of abdominal wall 49905 C Omental flap 49906 C Free omental flap, microvasc 49999 T Abdomen surgery procedure 0121 2.36 $117.05 $52.53 $23.41 50010 C Exploration of kidney 50020 C Renal abscess, open drain 50021 C Renal abscess, percut drain 50040 C Drainage of kidney 50045 C Exploration of kidney 50060 C Removal of kidney stone 50065 C Incision of kidney 50070 C Incision of kidney 50075 C Removal of kidney stone 50080 T Removal of kidney stone 0163 28.98 $1,437.30 $792.58 $287.46 50081 T Removal of kidney stone 0163 28.98 $1,437.30 $792.58 $287.46 50100 C Revise kidney blood vessels 50120 C Exploration of kidney 50125 C Explore and drain kidney 50130 C Removal of kidney stone 50135 C Exploration of kidney 50200 T Biopsy of kidney 0005 5.41 $268.32 $119.75 $53.66 50205 C Biopsy of kidney 50220 C Removal of kidney 50225 C Removal of kidney 50230 C Removal of kidney 50234 C Removal of kidney & ureter 50236 C Removal of kidney & ureter 50240 C Partial removal of kidney 50280 C Removal of kidney lesion 50290 C Removal of kidney lesion 50300 C Removal of donor kidney 50320 C Removal of donor kidney 50340 C Removal of kidney 50360 C Transplantation of kidney 50365 C Transplantation of kidney 50370 C Remove transplanted kidney 50380 C Reimplantation of kidney 50390 T Drainage of kidney lesion 0005 5.41 $268.32 $119.75 $53.66 50392 T Insert kidney drain 0160 5.43 $269.30 $110.11 $53.86 50393 T Insert ureteral tube 0160 5.43 $269.30 $110.11 $53.86 50394 N Injection for kidney x-ray 50395 T Create passage to kidney 0160 5.43 $269.30 $110.11 $53.86 50396 T Measure kidney pressure 0165 3.89 $192.92 $91.76 $38.58 50398 T Change kidney tube 0122 5.04 $249.96 $114.93 $49.99 50400 C Revision of kidney/ureter 50405 C Revision of kidney/ureter 50500 C Repair of kidney wound 50520 C Close kidney-skin fistula 50525 C Repair renal-abdomen fistula 50526 C Repair renal-abdomen fistula 50540 C Revision of horseshoe kidney 50541 T Laparo ablate renal cyst 0131 41.81 $2,073.61 $1,089.88 $414.72 50544 T Laparoscopy, pyeloplasty 0131 41.81 $2,073.61 $1,089.88 $414.72 *50545 C Laparo radical nephrectomy 50546 C Laparoscopic nephrectomy 50547 C Laparo removal donor kidney 50548 C Laparo-asst remove k/ureter 50549 T Laparoscope proc, renal 0130 25.36 $1,257.75 $659.53 $251.55 50551 T Kidney endoscopy 0161 10.94 $542.58 $249.36 $108.52 50553 T Kidney endoscopy 0161 10.94 $542.58 $249.36 $108.52 50555 T Kidney endoscopy & biopsy 0161 10.94 $542.58 $249.36 $108.52 50557 T Kidney endoscopy & treatment 0161 10.94 $542.58 $249.36 $108.52 50559 T Renal endoscopy/radiotracer 0161 10.94 $542.58 $249.36 $108.52 50561 T Kidney endoscopy & treatment 0161 10.94 $542.58 $249.36 $108.52 50570 C Kidney endoscopy 50572 C Kidney endoscopy 50574 C Kidney endoscopy & biopsy 50575 C Kidney endoscopy 50576 C Kidney endoscopy & treatment 50578 C Renal endoscopy/radiotracer 50580 C Kidney endoscopy & treatment 50590 T Fragmenting of kidney stone 0169 46.72 $2,317.13 $1,384.20 $463.43 50600 C Exploration of ureter 50605 C Insert ureteral support 50610 C Removal of ureter stone 50620 C Removal of ureter stone 50630 C Removal of ureter stone 50650 C Removal of ureter 50660 C Removal of ureter 50684 N Injection for ureter x-ray 50686 T Measure ureter pressure 0165 3.89 $192.92 $91.76 $38.58 50688 T Change of ureter tube 0121 2.36 $117.05 $52.53 $23.41 50690 N Injection for ureter x-ray 50700 C Revision of ureter 50715 C Release of ureter 50722 C Release of ureter 50725 C Release/revise ureter 50727 C Revise ureter 50728 C Revise ureter 50740 C Fusion of ureter & kidney 50750 C Fusion of ureter & kidney 50760 C Fusion of ureters 50770 C Splicing of ureters 50780 C Reimplant ureter in bladder 50782 C Reimplant ureter in bladder 50783 C Reimplant ureter in bladder 50785 C Reimplant ureter in bladder 50800 C Implant ureter in bowel 50810 C Fusion of ureter & bowel 50815 C Urine shunt to bowel 50820 C Construct bowel bladder 50825 C Construct bowel bladder 50830 C Revise urine flow 50840 C Replace ureter by bowel 50845 C Appendico-vesicostomy 50860 C Transplant ureter to skin 50900 C Repair of ureter 50920 C Closure ureter/skin fistula 50930 C Closure ureter/bowel fistula 50940 C Release of ureter 50945 T Laparoscopy ureterolithotomy 0131 41.81 $2,073.61 $1,089.88 $414.72 *50947 T Laparoscopy new ureter/bladder 0130 25.36 $1,257.75 $659.53 $251.55 *50948 T Laparoscopy new ureter/bladder 0130 25.36 $1,257.75 $659.53 $251.55 *50949 T Laparoscope proc, ureter 0130 25.36 $1,257.75 $659.53 $251.55 50951 T Endoscopy of ureter 0162 17.49 $867.44 $427.49 $173.49 50953 T Endoscopy of ureter 0162 17.49 $867.44 $427.49 $173.49 50955 T Ureter endoscopy & biopsy 0162 17.49 $867.44 $427.49 $173.49 50957 T Ureter endoscopy & treatment 0162 17.49 $867.44 $427.49 $173.49 50959 T Ureter endoscopy & tracer 0162 17.49 $867.44 $427.49 $173.49 50961 T Ureter endoscopy & treatment 0162 17.49 $867.44 $427.49 $173.49 50970 T Ureter endoscopy 0162 17.49 $867.44 $427.49 $173.49 50972 T Ureter endoscopy & catheter 0162 17.49 $867.44 $427.49 $173.49 50974 T Ureter endoscopy & biopsy 0162 17.49 $867.44 $427.49 $173.49 50976 T Ureter endoscopy & treatment 0162 17.49 $867.44 $427.49 $173.49 50978 T Ureter endoscopy & tracer 0162 17.49 $867.44 $427.49 $173.49 50980 T Ureter endoscopy & treatment 0162 17.49 $867.44 $427.49 $173.49 51000 T Drainage of bladder 0165 3.89 $192.92 $91.76 $38.58 51005 T Drainage of bladder 0164 2.17 $107.64 $33.03 $21.53 51010 T Drainage of bladder 0165 3.89 $192.92 $91.76 $38.58 51020 T Incise & treat bladder 0162 17.49 $867.44 $427.49 $173.49 51030 T Incise & treat bladder 0162 17.49 $867.44 $427.49 $173.49 51040 T Incise & drain bladder 0162 17.49 $867.44 $427.49 $173.49 51045 T Incise bladder/drain ureter 0162 17.49 $867.44 $427.49 $173.49 51050 T Removal of bladder stone 0162 17.49 $867.44 $427.49 $173.49 51060 C Removal of ureter stone 51065 T Removal of ureter stone 0162 17.49 $867.44 $427.49 $173.49 51080 T Drainage of bladder abscess 0008 6.15 $305.02 $113.67 $61.00 51500 T Removal of bladder cyst 0154 22.43 $1,112.45 $556.98 $222.49 51520 T Removal of bladder lesion 0162 17.49 $867.44 $427.49 $173.49 51525 C Removal of bladder lesion 51530 C Removal of bladder lesion 51535 C Repair of ureter lesion 51550 C Partial removal of bladder 51555 C Partial removal of bladder 51565 C Revise bladder & ureter(s) 51570 C Removal of bladder 51575 C Removal of bladder & nodes 51580 C Remove bladder/revise tract 51585 C Removal of bladder & nodes 51590 C Remove bladder/revise tract 51595 C Remove bladder/revise tract 51596 C Remove bladder/create pouch 51597 C Removal of pelvic structures 51600 N Injection for bladder x-ray 51605 N Preparation for bladder xray 51610 N Injection for bladder x-ray 51700 T Irrigation of bladder 0164 2.17 $107.64 $33.03 $21.53 51705 T Change of bladder tube 0121 2.36 $117.05 $52.53 $23.41 51710 T Change of bladder tube 0121 2.36 $117.05 $52.53 $23.41 51715 T Endoscopic injection/implant 0167 21.06 $1,044.50 $555.84 $208.90 51720 T Treatment of bladder lesion 0165 3.89 $192.92 $91.76 $38.58 51725 T Simple cystometrogram 0165 3.89 $192.92 $91.76 $38.58 51726 T Complex cystometrogram 0165 3.89 $192.92 $91.76 $38.58 51736 T Urine flow measurement 0164 2.17 $107.64 $33.03 $21.53 51741 T Electro-uroflowmetry, first 0164 2.17 $107.64 $33.03 $21.53 51772 T Urethra pressure profile 0165 3.89 $192.92 $91.76 $38.58 51784 T Anal/urinary muscle study 0164 2.17 $107.64 $33.03 $21.53 51785 T Anal/urinary muscle study 0164 2.17 $107.64 $33.03 $21.53 51792 T Urinary reflex study 0165 3.89 $192.92 $91.76 $38.58 51795 T Urine voiding pressure study 0164 2.17 $107.64 $33.03 $21.53 51797 T Intraabdominal pressure test 0164 2.17 $107.64 $33.03 $21.53 51800 C Revision of bladder/urethra 51820 C Revision of urinary tract 51840 C Attach bladder/urethra 51841 C Attach bladder/urethra 51845 C Repair bladder neck 51860 C Repair of bladder wound 51865 C Repair of bladder wound 51880 T Repair of bladder opening 0162 17.49 $867.44 $427.49 $173.49 51900 C Repair bladder/vagina lesion 51920 C Close bladder-uterus fistula 51925 C Hysterectomy/bladder repair 51940 C Correction of bladder defect 51960 C Revision of bladder & bowel 51980 C Construct bladder opening 51990 T Laparo urethral suspension 0131 41.81 $2,073.61 $1,089.88 $414.72 51992 T Laparo sling operation 0132 48.91 $2,425.74 $1,239.22 $485.15 52000 T Cystoscopy 0160 5.43 $269.30 $110.11 $53.86 52005 T Cystoscopy & ureter catheter 0161 10.94 $542.58 $249.36 $108.52 52007 T Cystoscopy and biopsy 0161 10.94 $542.58 $249.36 $108.52 52010 T Cystoscopy & duct catheter 0161 10.94 $542.58 $249.36 $108.52 52204 T Cystoscopy 0161 10.94 $542.58 $249.36 $108.52 52214 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52224 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52234 T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 52235 T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 52240 T Cystoscopy and treatment 0163 28.98 $1,437.30 $792.58 $287.46 52250 T Cystoscopy and radiotracer 0162 17.49 $867.44 $427.49 $173.49 52260 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52265 T Cystoscopy and treatment 0160 5.43 $269.30 $110.11 $53.86 52270 T Cystoscopy & revise urethra 0161 10.94 $542.58 $249.36 $108.52 52275 T Cystoscopy & revise urethra 0161 10.94 $542.58 $249.36 $108.52 52276 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52277 T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 52281 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52282 T Cystoscopy, implant stent 0162 17.49 $867.44 $427.49 $173.49 52283 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52285 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52290 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52300 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52301 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52305 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52310 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52315 T Cystoscopy and treatment 0161 10.94 $542.58 $249.36 $108.52 52317 T Remove bladder stone 0162 17.49 $867.44 $427.49 $173.49 52318 T Remove bladder stone 0162 17.49 $867.44 $427.49 $173.49 52320 T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 52325 T Cystoscopy, stone removal 0162 17.49 $867.44 $427.49 $173.49 52327 T Cystoscopy, inject material 0161 10.94 $542.58 $249.36 $108.52 52330 T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 52332 T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 52334 T Create passage to kidney 0162 17.49 $867.44 $427.49 $173.49 52335D T Endoscopy of urinary tract 0162 17.49 $867.44 $427.49 $173.49 52336D T Cystoscopy, stone removal 0162 17.49 $867.44 $427.49 $173.49 52337D T Cystoscopy, stone removal 0162 17.49 $867.44 $427.49 $173.49 52338D T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 52339D T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 52340D T Cystoscopy and treatment 0162 17.49 $867.44 $427.49 $173.49 *52341 T Cysto w/ureter stricture treatment 0162 17.49 $867.44 $427.49 $173.49 *52342 T Cysto w/up stricture treatment 0162 17.49 $867.44 $427.49 $173.49 *52343 T Cysto w/renal stricture treatment 0162 17.49 $867.44 $427.49 $173.49 *52344 T Cysto/uretero, stone removal 0162 17.49 $867.44 $427.49 $173.49 *52345 T Cysto/uretero w/up stricture 0162 17.49 $867.44 $427.49 $173.49 *52346 T Cystouretero w/renal strict 0162 17.49 $867.44 $427.49 $173.49 *52351 T Cystouretero &/or pyeloscope 0161 10.94 $542.58 $249.36 $108.52 *52352 T Cystouretero w/stone removal 0162 17.49 $867.44 $427.49 $173.49 *52353 T Cystouretero w/lithotripsy 0162 17.49 $867.44 $427.49 $173.49 *52354 T Cystouretero w/biopsy 0162 17.49 $867.44 $427.49 $173.49 *52355 T Cystouretero w/excise tumor 0162 17.49 $867.44 $427.49 $173.49 *52400 T Cystouretero w/congen repr 0162 17.49 $867.44 $427.49 $173.49 52450 T Incision of prostate 0162 17.49 $867.44 $427.49 $173.49 52500 T Revision of bladder neck 0162 17.49 $867.44 $427.49 $173.49 52510 T Dilation prostatic urethra 0161 10.94 $542.58 $249.36 $108.52 52601 T Prostatectomy
(TURP)0163 28.98 $1,437.30 $792.58 $287.46 52606 T Control postop bleeding 0162 17.49 $867.44 $427.49 $173.49 52612 T Prostatectomy, first stage 0163 28.98 $1,437.30 $792.58 $287.46 52614 T Prostatectomy, second stage 0163 28.98 $1,437.30 $792.58 $287.46 52620 T Remove residual prostate 0163 28.98 $1,437.30 $792.58 $287.46 52630 T Remove prostate regrowth 0163 28.98 $1,437.30 $792.58 $287.46 52640 T Relieve bladder contracture 0162 17.49 $867.44 $427.49 $173.49 52647 T Laser surgery of prostate 0163 28.98 $1,437.30 $792.58 $287.46 52648 T Laser surgery of prostate 0163 28.98 $1,437.30 $792.58 $287.46 52700 T Drainage of prostate abscess 0162 17.49 $867.44 $427.49 $173.49 53000 T Incision of urethra 0166 10.17 $504.39 $218.73 $100.88 53010 T Incision of urethra 0166 10.17 $504.39 $218.73 $100.88 53020 T Incision of urethra 0166 10.17 $504.39 $218.73 $100.88 53025 T Incision of urethra 0166 10.17 $504.39 $218.73 $100.88 53040 T Drainage of urethra abscess 0166 10.17 $504.39 $218.73 $100.88 53060 T Drainage of urethra abscess 0166 10.17 $504.39 $218.73 $100.88 53080 T Drainage of urinary leakage 0166 10.17 $504.39 $218.73 $100.88 53085 C Drainage of urinary leakage 53200 T Biopsy of urethra 0166 10.17 $504.39 $218.73 $100.88 53210 T Removal of urethra 0168 24.94 $1,236.93 $536.11 $247.39 53215 T Removal of urethra 0168 24.94 $1,236.93 $536.11 $247.39 53220 T Treatment of urethra lesion 0168 24.94 $1,236.93 $536.11 $247.39 53230 T Removal of urethra lesion 0168 24.94 $1,236.93 $536.11 $247.39 53235 T Removal of urethra lesion 0168 24.94 $1,236.93 $536.11 $247.39 53240 T Surgery for urethra pouch 0168 24.94 $1,236.93 $536.11 $247.39 53250 T Removal of urethra gland 0166 10.17 $504.39 $218.73 $100.88 53260 T Treatment of urethra lesion 0166 10.17 $504.39 $218.73 $100.88 53265 T Treatment of urethra lesion 0166 10.17 $504.39 $218.73 $100.88 53270 T Removal of urethra gland 0167 21.06 $1,044.50 $555.84 $208.90 53275 T Repair of urethra defect 0166 10.17 $504.39 $218.73 $100.88 53400 T Revise urethra, stage 1 0168 24.94 $1,236.93 $536.11 $247.39 53405 T Revise urethra, stage 2 0168 24.94 $1,236.93 $536.11 $247.39 53410 T Reconstruction of urethra 0168 24.94 $1,236.93 $536.11 $247.39 53415 C Reconstruction of urethra 53420 T Reconstruct urethra, stage 1 0168 24.94 $1,236.93 $536.11 $247.39 53425 T Reconstruct urethra, stage 2 0168 24.94 $1,236.93 $536.11 $247.39 53430 T Reconstruction of urethra 0168 24.94 $1,236.93 $536.11 $247.39 53440 T Correct bladder function 0182 52.11 $2,584.45 $1,525.05 $516.89 53442 T Remove perineal prosthesis 0166 10.17 $504.39 $218.73 $100.88 53443 C Reconstruction of urethra 53445 T Correct urine flow control 0182 52.11 $2,584.45 $1,525.05 $516.89 53447 T Remove artificial sphincter 0168 24.94 $1,236.93 $536.11 $247.39 53449 T Correct artificial sphincter 0168 24.94 $1,236.93 $536.11 $247.39 53450 T Revision of urethra 0168 24.94 $1,236.93 $536.11 $247.39 53460 T Revision of urethra 0168 24.94 $1,236.93 $536.11 $247.39 53502 T Repair of urethra injury 0166 10.17 $504.39 $218.73 $100.88 53505 T Repair of urethra injury 0167 21.06 $1,044.50 $555.84 $208.90 53510 T Repair of urethra injury 0166 10.17 $504.39 $218.73 $100.88 53515 T Repair of urethra injury 0168 24.94 $1,236.93 $536.11 $247.39 53520 T Repair of urethra defect 0168 24.94 $1,236.93 $536.11 $247.39 53600 T Dilate urethra stricture 0164 2.17 $107.64 $33.03 $21.53 53601 T Dilate urethra stricture 0164 2.17 $107.64 $33.03 $21.53 53605 T Dilate urethra stricture 0161 10.94 $542.58 $249.36 $108.52 53620 T Dilate urethra stricture 0165 3.89 $192.92 $91.76 $38.58 53621 T Dilate urethra stricture 0164 2.17 $107.64 $33.03 $21.53 53660 T Dilation of urethra 0164 2.17 $107.64 $33.03 $21.53 53661 T Dilation of urethra 0164 2.17 $107.64 $33.03 $21.53 53665 T Dilation of urethra 0166 10.17 $504.39 $218.73 $100.88 53670 N Insert urinary catheter 53675 T Insert urinary catheter 0164 2.17 $107.64 $33.03 $21.53 53850 T Prostatic microwave thermotx 0980 38.67 $1,917.89 $383.58 53852 T Prostatic rf thermotx 0980 38.67 $1,917.89 $383.58 53899 T Urology surgery procedure 0165 3.89 $192.92 $91.76 $38.58 54000 T Slitting of prepuce 0166 10.17 $504.39 $218.73 $100.88 54001 T Slitting of prepuce 0166 10.17 $504.39 $218.73 $100.88 54015 T Drain penis lesion 0008 6.15 $305.02 $113.67 $61.00 54050 T Destruction, penis lesion(s) 0013 0.91 $45.13 $17.66 $9.03 54055 T Destruction, penis lesion(s) 0016 3.53 $175.07 $74.67 $35.01 54056 T Cryosurgery, penis lesion(s) 0013 0.91 $45.13 $17.66 $9.03 54057 T Laser surg, penis lesion(s) 0017 12.45 $617.47 $289.16 $123.49 54060 T Excision of penis lesion(s) 0017 12.45 $617.47 $289.16 $123.49 54065 T Destruction, penis lesion(s) 0017 12.45 $617.47 $289.16 $123.49 54100 T Biopsy of penis 0020 6.51 $322.87 $130.53 $64.57 54105 T Biopsy of penis 0021 10.49 $520.26 $236.51 $104.05 54110 T Treatment of penis lesion 0181 32.37 $1,605.43 $906.36 $321.09 54111 T Treat penis lesion, graft 0181 32.37 $1,605.43 $906.36 $321.09 54112 T Treat penis lesion, graft 0181 32.37 $1,605.43 $906.36 $321.09 54115 T Treatment of penis lesion 0008 6.15 $305.02 $113.67 $61.00 54120 T Partial removal of penis 0181 32.37 $1,605.43 $906.36 $321.09 54125 C Removal of penis 54130 C Remove penis & nodes 54135 C Remove penis & nodes 54150 T Circumcision 0180 13.62 $675.49 $304.87 $135.10 54152 T Circumcision 0180 13.62 $675.49 $304.87 $135.10 54160 T Circumcision 0180 13.62 $675.49 $304.87 $135.10 54161 T Circumcision 0180 13.62 $675.49 $304.87 $135.10 54200 T Treatment of penis lesion 0165 3.89 $192.92 $91.76 $38.58 54205 T Treatment of penis lesion 0181 32.37 $1,605.43 $906.36 $321.09 54220 T Treatment of penis lesion 0165 3.89 $192.92 $91.76 $38.58 54230 N Prepare penis study 54231 T Dynamic cavernosometry 0165 3.89 $192.92 $91.76 $38.58 54235 T Penile injection 0164 2.17 $107.64 $33.03 $21.53 54240 T Penis study 0164 2.17 $107.64 $33.03 $21.53 54250 T Penis study 0165 3.89 $192.92 $91.76 $38.58 54300 T Revision of penis 0181 32.37 $1,605.43 $906.36 $321.09 54304 T Revision of penis 0181 32.37 $1,605.43 $906.36 $321.09 54308 T Reconstruction of urethra 0181 32.37 $1,605.43 $906.36 $321.09 54312 T Reconstruction of urethra 0181 32.37 $1,605.43 $906.36 $321.09 54316 T Reconstruction of urethra 0181 32.37 $1,605.43 $906.36 $321.09 54318 T Reconstruction of urethra 0181 32.37 $1,605.43 $906.36 $321.09 54322 T Reconstruction of urethra 0181 32.37 $1,605.43 $906.36 $321.09 54324 T Reconstruction of urethra 0181 32.37 $1,605.43 $906.36 $321.09 54326 T Reconstruction of urethra 0181 32.37 $1,605.43 $906.36 $321.09 54328 T Revise penis/urethra 0181 32.37 $1,605.43 $906.36 $321.09 54332 C Revise penis/urethra 54336 C Revise penis/urethra 54340 T Secondary urethral surgery 0181 32.37 $1,605.43 $906.36 $321.09 54344 T Secondary urethral surgery 0181 32.37 $1,605.43 $906.36 $321.09 54348 T Secondary urethral surgery 0181 32.37 $1,605.43 $906.36 $321.09 54352 T Reconstruct urethra/penis 0181 32.37 $1,605.43 $906.36 $321.09 54360 T Penis plastic surgery 0181 32.37 $1,605.43 $906.36 $321.09 54380 T Repair penis 0181 32.37 $1,605.43 $906.36 $321.09 54385 T Repair penis 0181 32.37 $1,605.43 $906.36 $321.09 54390 C Repair penis and bladder 54400 T Insert semi-rigid prosthesis 0182 52.11 $2,584.45 $1,525.05 $516.89 54401 T Insert self-contd prosthesis 0182 52.11 $2,584.45 $1,525.05 $516.89 54402 T Remove penis prosthesis 0185 32.37 $1,605.43 $906.36 $321.09 54405 T Insert multi-comp prosthesis 0182 52.11 $2,584.45 $1,525.05 $516.89 54407 T Remove multi-comp prosthesis 0185 32.37 $1,605.43 $906.36 $321.09 54409 T Revise penis prosthesis 0185 32.37 $1,605.43 $906.36 $321.09 54420 T Revision of penis 0181 32.37 $1,605.43 $906.36 $321.09 54430 C Revision of penis 54435 T Revision of penis 0181 32.37 $1,605.43 $906.36 $321.09 54440 T Repair of penis 0181 32.37 $1,605.43 $906.36 $321.09 54450 T Preputial stretching 0165 3.89 $192.92 $91.76 $38.58 54500 T Biopsy of testis 0005 5.41 $268.32 $119.75 $53.66 54505 T Biopsy of testis 0183 18.26 $905.62 $448.94 $181.12 54510 T Removal of testis lesion 0183 18.26 $905.62 $448.94 $181.12 *54512 T Excise lesion testis 0183 18.26 $905.62 $448.94 $181.12 54520 T Removal of testis 0183 18.26 $905.62 $448.94 $181.12 *54522 T Orchiectomy, partial 0183 18.26 $905.62 $448.94 $181.12 54530 T Removal of testis 0154 22.43 $1,112.45 $556.98 $222.49 54535 C Extensive testis surgery 54550 T Exploration for testis 0154 22.43 $1,112.45 $556.98 $222.49 54560 C Exploration for testis 54600 T Reduce testis torsion 0183 18.26 $905.62 $448.94 $181.12 54620 T Suspension of testis 0183 18.26 $905.62 $448.94 $181.12 54640 T Suspension of testis 0154 22.43 $1,112.45 $556.98 $222.49 54650 C Orchiopexy (Fowler-Stephens) 54660 T Revision of testis 0183 18.26 $905.62 $448.94 $181.12 54670 T Repair testis injury 0183 18.26 $905.62 $448.94 $181.12 54680 T Relocation of testis(es) 0183 18.26 $905.62 $448.94 $181.12 54690 T Laparoscopy, orchiectomy 0131 41.81 $2,073.61 $1,089.88 $414.72 54692 T Laparoscopy, orchiopexy 0132 48.91 $2,425.74 $1,239.22 $485.15 54699 T Laparoscope proc, testis 0130 25.36 $1,257.75 $659.53 $251.55 54700 T Drainage of scrotum 0183 18.26 $905.62 $448.94 $181.12 54800 T Biopsy of epididymis 0004 1.84 $91.26 $32.57 $18.25 54820 T Exploration of epididymis 0183 18.26 $905.62 $448.94 $181.12 54830 T Remove epididymis lesion 0183 18.26 $905.62 $448.94 $181.12 54840 T Remove epididymis lesion 0183 18.26 $905.62 $448.94 $181.12 54860 T Removal of epididymis 0183 18.26 $905.62 $448.94 $181.12 54861 T Removal of epididymis 0183 18.26 $905.62 $448.94 $181.12 54900 T Fusion of spermatic ducts 0183 18.26 $905.62 $448.94 $181.12 54901 T Fusion of spermatic ducts 0183 18.26 $905.62 $448.94 $181.12 55000 T Drainage of hydrocele 0004 1.84 $91.26 $32.57 $18.25 55040 T Removal of hydrocele 0154 22.43 $1,112.45 $556.98 $222.49 55041 T Removal of hydroceles 0154 22.43 $1,112.45 $556.98 $222.49 55060 T Repair of hydrocele 0183 18.26 $905.62 $448.94 $181.12 55100 T Drainage of scrotum abscess 0008 6.15 $305.02 $113.67 $61.00 55110 T Explore scrotum 0183 18.26 $905.62 $448.94 $181.12 55120 T Removal of scrotum lesion 0183 18.26 $905.62 $448.94 $181.12 55150 T Removal of scrotum 0183 18.26 $905.62 $448.94 $181.12 55175 T Revision of scrotum 0183 18.26 $905.62 $448.94 $181.12 55180 T Revision of scrotum 0183 18.26 $905.62 $448.94 $181.12 55200 T Incision of sperm duct 0183 18.26 $905.62 $448.94 $181.12 55250 T Removal of sperm duct(s) 0183 18.26 $905.62 $448.94 $181.12 55300 N Prepare, sperm duct x-ray 55400 T Repair of sperm duct 0183 18.26 $905.62 $448.94 $181.12 55450 T Ligation of sperm duct 0183 18.26 $905.62 $448.94 $181.12 55500 T Removal of hydrocele 0183 18.26 $905.62 $448.94 $181.12 55520 T Removal of sperm cord lesion 0183 18.26 $905.62 $448.94 $181.12 55530 T Revise spermatic cord veins 0183 18.26 $905.62 $448.94 $181.12 55535 T Revise spermatic cord veins 0154 22.43 $1,112.45 $556.98 $222.49 55540 T Revise hernia & sperm veins 0154 22.43 $1,112.45 $556.98 $222.49 55550 T Laparo ligate spermatic vein 0131 41.81 $2,073.61 $1,089.88 $414.72 55559 T Laparo proc, spermatic cord 0130 25.36 $1,257.75 $659.53 $251.55 55600 C Incise sperm duct pouch 55605 C Incise sperm duct pouch 55650 C Remove sperm duct pouch 55680 T Remove sperm pouch lesion 0183 18.26 $905.62 $448.94 $181.12 55700 T Biopsy of prostate 0184 4.94 $245.01 $122.96 $49.00 55705 T Biopsy of prostate 0184 4.94 $245.01 $122.96 $49.00 55720 T Drainage of prostate abscess 0162 17.49 $867.44 $427.49 $173.49 55725 T Drainage of prostate abscess 0162 17.49 $867.44 $427.49 $173.49 55801 C Removal of prostate 55810 C Extensive prostate surgery 55812 C Extensive prostate surgery 55815 C Extensive prostate surgery 55821 C Removal of prostate 55831 C Removal of prostate 55840 C Extensive prostate surgery 55842 C Extensive prostate surgery 55845 C Extensive prostate surgery 55859 T Percut/needle insert, pros 0162 17.49 $867.44 $427.49 $173.49 55860 T Surgical exposure, prostate 0165 3.89 $192.92 $91.76 $38.58 55862 C Extensive prostate surgery 55865 C Extensive prostate surgery 55870 T Electroejaculation 0197 2.40 $119.03 $49.55 $23.81 *55873 T Cryoablate prostate 0980 38.67 $1,917.89 $383.58 55899 T Genital surgery procedure 0164 2.17 $107.64 $33.03 $21.53 55970 E Sex transformation, M to F 55980 E Sex transformation, F to M 56405 T I & D of vulva/perineum 0192 2.38 $118.04 $35.33 $23.61 56420 T Drainage of gland abscess 0192 2.38 $118.04 $35.33 $23.61 56440 T Surgery for vulva lesion 0194 16.21 $803.96 $395.94 $160.79 56441 T Lysis of labial lesion(s) 0193 8.93 $442.89 $171.13 $88.58 56501 T Destruction, vulva lesion(s) 0016 3.53 $175.07 $74.67 $35.01 56515 T Destruction, vulva lesion(s) 0017 12.45 $617.47 $289.16 $123.49 56605 T Biopsy of vulva/perineum 0019 4.00 $198.39 $78.91 $39.68 56606 T Biopsy of vulva/perineum 0019 4.00 $198.39 $78.91 $39.68 56620 T Partial removal of vulva 0195 18.68 $926.46 $483.80 $185.29 56625 T Complete removal of vulva 0195 18.68 $926.46 $483.80 $185.29 56630 C Extensive vulva surgery 56631 C Extensive vulva surgery 56632 C Extensive vulva surgery 56633 C Extensive vulva surgery 56634 C Extensive vulva surgery 56637 C Extensive vulva surgery 56640 C Extensive vulva surgery 56700 T Partial removal of hymen 0194 16.21 $803.96 $395.94 $160.79 56720 T Incision of hymen 0193 8.93 $442.89 $171.13 $88.58 56740 T Remove vagina gland lesion 0194 16.21 $803.96 $395.94 $160.79 56800 T Repair of vagina 0194 16.21 $803.96 $395.94 $160.79 56805 T Repair clitoris 0194 16.21 $803.96 $395.94 $160.79 56810 T Repair of perineum 0194 16.21 $803.96 $395.94 $160.79 57000 T Exploration of vagina 0194 16.21 $803.96 $395.94 $160.79 57010 T Drainage of pelvic abscess 0194 16.21 $803.96 $395.94 $160.79 57020 T Drainage of pelvic fluid 0193 8.93 $442.89 $171.13 $88.58 *57022 T I & D vaginal hematoma, OB 0007 3.68 $182.51 $72.03 $36.50 *57023 T I & D vaginal hematoma, trauma 0007 3.68 $182.51 $72.03 $36.50 57061 T Destruction vagina lesion(s) 0194 16.21 $803.96 $395.94 $160.79 57065 T Destruction vagina lesion(s) 0194 16.21 $803.96 $395.94 $160.79 57100 T Biopsy of vagina 0192 2.38 $118.04 $35.33 $23.61 57105 T Biopsy of vagina 0194 16.21 $803.96 $395.94 $160.79 57106 T Remove vagina wall, partial 0194 16.21 $803.96 $395.94 $160.79 57107 T Remove vagina tissue, part 0194 16.21 $803.96 $395.94 $160.79 57109 T Vaginectomy partial w/nodes 0194 16.21 $803.96 $395.94 $160.79 57110 C Remove vagina wall, complete 57111 C Remove vagina tissue, compl 57112 C Vaginectomy w/nodes, compl 57120 T Closure of vagina 0194 16.21 $803.96 $395.94 $160.79 57130 T Remove vagina lesion 0194 16.21 $803.96 $395.94 $160.79 57135 T Remove vagina lesion 0194 16.21 $803.96 $395.94 $160.79 57150 T Treat vagina infection 0192 2.38 $118.04 $35.33 $23.61 57160 T Insert pessary/other device 0191 1.19 $59.02 $17.43 $11.80 57170 T Fitting of diaphragm/cap 0191 1.19 $59.02 $17.43 $11.80 57180 T Treat vaginal bleeding 0192 2.38 $118.04 $35.33 $23.61 57200 T Repair of vagina 0194 16.21 $803.96 $395.94 $160.79 57210 T Repair vagina/perineum 0194 16.21 $803.96 $395.94 $160.79 57220 T Revision of urethra 0195 18.68 $926.46 $483.80 $185.29 57230 T Repair of urethral lesion 0194 16.21 $803.96 $395.94 $160.79 57240 T Repair bladder & vagina 0195 18.68 $926.46 $483.80 $185.29 57250 T Repair rectum & vagina 0195 18.68 $926.46 $483.80 $185.29 57260 T Repair of vagina 0195 18.68 $926.46 $483.80 $185.29 57265 T Extensive repair of vagina 0195 18.68 $926.46 $483.80 $185.29 57268 T Repair of bowel bulge 0195 18.68 $926.46 $483.80 $185.29 57270 C Repair of bowel pouch 57280 C Suspension of vagina 57282 C Repair of vaginal prolapse 57284 T Repair paravaginal defect 0195 18.68 $926.46 $483.80 $185.29 *57287 T Revise/remove sling repair 0195 18.68 $926.46 $483.80 $185.29 57288 T Repair bladder defect 0195 18.68 $926.46 $483.80 $185.29 57289 T Repair bladder & vagina 0195 18.68 $926.46 $483.80 $185.29 57291 T Construction of vagina 0195 18.68 $926.46 $483.80 $185.29 57292 C Construct vagina with graft 57300 T Repair rectum-vagina fistula 0195 18.68 $926.46 $483.80 $185.29 57305 C Repair rectum-vagina fistula 57307 C Fistula repair & colostomy 57308 C Fistula repair, transperine 57310 T Repair urethrovaginal lesion 0195 18.68 $926.46 $483.80 $185.29 57311 C Repair urethrovaginal lesion 57320 T Repair bladder-vagina lesion 0195 18.68 $926.46 $483.80 $185.29 57330 T Repair bladder-vagina lesion 0195 18.68 $926.46 $483.80 $185.29 57335 C Repair vagina 57400 T Dilation of vagina 0194 16.21 $803.96 $395.94 $160.79 57410 T Pelvic examination 0194 16.21 $803.96 $395.94 $160.79 57415 T Remove vaginal foreign body 0194 16.21 $803.96 $395.94 $160.79 57452 T Examination of vagina 0191 1.19 $59.02 $17.43 $11.80 57454 T Vagina examination & biopsy 0192 2.38 $118.04 $35.33 $23.61 57460 T Cervix excision 0193 8.93 $442.89 $171.13 $88.58 57500 T Biopsy of cervix 0193 8.93 $442.89 $171.13 $88.58 57505 T Endocervical curettage 0192 2.38 $118.04 $35.33 $23.61 57510 T Cauterization of cervix 0193 8.93 $442.89 $171.13 $88.58 57511 T Cryocautery of cervix 0192 2.38 $118.04 $35.33 $23.61 57513 T Laser surgery of cervix 0193 8.93 $442.89 $171.13 $88.58 57520 T Conization of cervix 0194 16.21 $803.96 $395.94 $160.79 57522 T Conization of cervix 0195 18.68 $926.46 $483.80 $185.29 57530 T Removal of cervix 0195 18.68 $926.46 $483.80 $185.29 57531 C Removal of cervix, radical 57540 C Removal of residual cervix 57545 C Remove cervix/repair pelvis 57550 T Removal of residual cervix 0195 18.68 $926.46 $483.80 $185.29 57555 T Remove cervix/repair vagina 0195 18.68 $926.46 $483.80 $185.29 57556 T Remove cervix, repair bowel 0195 18.68 $926.46 $483.80 $185.29 57700 T Revision of cervix 0194 16.21 $803.96 $395.94 $160.79 57720 T Revision of cervix 0194 16.21 $803.96 $395.94 $160.79 57800 T Dilation of cervical canal 0193 8.93 $442.89 $171.13 $88.58 57820 T D & c of residual cervix 0196 14.47 $717.66 $357.98 $143.53 58100 T Biopsy of uterus lining 0191 1.19 $59.02 $17.43 $11.80 58120 T Dilation and curettage 0196 14.47 $717.66 $357.98 $143.53 58140 C Removal of uterus lesion 58145 T Removal of uterus lesion 0195 18.68 $926.46 $483.80 $185.29 58150 C Total hysterectomy 58152 C Total hysterectomy 58180 C Partial hysterectomy 58200 C Extensive hysterectomy 58210 C Extensive hysterectomy 58240 C Removal of pelvis contents 58260 C Vaginal hysterectomy 58262 C Vaginal hysterectomy 58263 C Vaginal hysterectomy 58267 C Hysterectomy & vagina repair 58270 C Hysterectomy & vagina repair 58275 C Hysterectomy/revise vagina 58280 C Hysterectomy/revise vagina 58285 C Extensive hysterectomy 58300 E Insert intrauterine device 58301 T Remove intrauterine device 0191 1.19 $59.02 $17.43 $11.80 58321 T Artificial insemination 0197 2.40 $119.03 $49.55 $23.81 58322 T Artificial insemination 0197 2.40 $119.03 $49.55 $23.81 58323 T Sperm washing 0197 2.40 $119.03 $49.55 $23.81 58340 N Catheter for hysterography 58345 T Reopen fallopian tube 0194 16.21 $803.96 $395.94 $160.79 58350 T Reopen fallopian tube 0194 16.21 $803.96 $395.94 $160.79 *58353 T Endometr ablate, thermal 0193 8.93 $442.89 $171.13 $88.58 58400 C Suspension of uterus 58410 C Suspension of uterus 58520 C Repair of ruptured uterus 58540 C Revision of uterus 58550 T Laparo-asst vag hysterectomy 0132 48.91 $2,425.74 $1,239.22 $485.15 58551 T Laparoscopy, remove myoma 0131 41.81 $2,073.61 $1,089.88 $414.72 58555 T Hysteroscopy, dx, sep proc 0191 1.19 $59.02 $17.43 $11.80 58558 T Hysteroscopy, biopsy 0190 17.85 $885.29 $443.89 $177.06 58559 T Hysteroscopy, lysis 0190 17.85 $885.29 $443.89 $177.06 58560 T Hysteroscopy, resect septum 0190 17.85 $885.29 $443.89 $177.06 58561 T Hysteroscopy, remove myoma 0190 17.85 $885.29 $443.89 $177.06 58562 T Hysteroscopy, remove fb 0190 17.85 $885.29 $443.89 $177.06 58563 T Hysteroscopy, ablation 0190 17.85 $885.29 $443.89 $177.06 58578 T Laparo proc, uterus 0190 17.85 $885.29 $443.89 $177.06 58579 T Hysteroscope procedure 0190 17.85 $885.29 $443.89 $177.06 58600 T Division of fallopian tube 0194 16.21 $803.96 $395.94 $160.79 58605 C Division of fallopian tube 58611 C Ligate oviduct(s) add-on 58615 T Occlude fallopian tube(s) 0194 16.21 $803.96 $395.94 $160.79 58660 T Laparoscopy, lysis 0131 41.81 $2,073.61 $1,089.88 $414.72 58661 T Laparoscopy, remove adnexa 0131 41.81 $2,073.61 $1,089.88 $414.72 58662 T Laparoscopy, excise lesions 0131 41.81 $2,073.61 $1,089.88 $414.72 58670 T Laparoscopy, tubal cautery 0131 41.81 $2,073.61 $1,089.88 $414.72 58671 T Laparoscopy, tubal block 0131 41.81 $2,073.61 $1,089.88 $414.72 58672 T Laparoscopy, fimbrioplasty 0131 41.81 $2,073.61 $1,089.88 $414.72 58673 T Laparoscopy, salpingostomy 0131 41.81 $2,073.61 $1,089.88 $414.72 58679 T Laparo proc, oviduct-ovary 0130 25.36 $1,257.75 $659.53 $251.55 58700 C Removal of fallopian tube 58720 C Removal of ovary/tube(s) 58740 C Revise fallopian tube(s) 58750 C Repair oviduct 58752 C Revise ovarian tube(s) 58760 C Remove tubal obstruction 58770 C Create new tubal opening 58800 T Drainage of ovarian cyst(s) 0195 18.68 $926.46 $483.80 $185.29 58805 C Drainage of ovarian cyst(s) 58820 T Drain ovary abscess, open 0195 18.68 $926.46 $483.80 $185.29 58822 C Drain ovary abscess, percut 58823 C Drain pelvic abscess, percut 58825 C Transposition, ovary(s) 58900 T Biopsy of ovary(s) 0195 18.68 $926.46 $483.80 $185.29 58920 T Partial removal of ovary(s) 0195 18.68 $926.46 $483.80 $185.29 58925 T Removal of ovarian cyst(s) 0195 18.68 $926.46 $483.80 $185.29 58940 C Removal of ovary(s) 58943 C Removal of ovary(s) 58950 C Resect ovarian malignancy 58951 C Resect ovarian malignancy 58952 C Resect ovarian malignancy 58960 C Exploration of abdomen 58970 T Retrieval of oocyte 0194 16.21 $803.96 $395.94 $160.79 58974 T Transfer of embryo 0197 2.40 $119.03 $49.55 $23.81 58976 T Transfer of embryo 0197 2.40 $119.03 $49.55 $23.81 58999 T Genital surgery procedure 0019 4.00 $198.39 $78.91 $39.68 59000 T Amniocentesis 0198 1.34 $66.46 $33.03 $13.29 59012 T Fetal cord puncture,prenatal 0198 1.34 $66.46 $33.03 $13.29 59015 T Chorion biopsy 0198 1.34 $66.46 $33.03 $13.29 59020 T Fetal contract stress test 0198 1.34 $66.46 $33.03 $13.29 59025 T Fetal non-stress test 0198 1.34 $66.46 $33.03 $13.29 59030 T Fetal scalp blood sample 0198 1.34 $66.46 $33.03 $13.29 59050 T Fetal monitor w/report 0198 1.34 $66.46 $33.03 $13.29 59051 E Fetal monitor/interpret only 59100 C Remove uterus lesion 59120 C Treat ectopic pregnancy 59121 C Treat ectopic pregnancy 59130 C Treat ectopic pregnancy 59135 C Treat ectopic pregnancy 59136 C Treat ectopic pregnancy 59140 C Treat ectopic pregnancy 59150 T Treat ectopic pregnancy 0131 41.81 $2,073.61 $1,089.88 $414.72 59151 T Treat ectopic pregnancy 0131 41.81 $2,073.61 $1,089.88 $414.72 59160 T D & c after delivery 0196 14.47 $717.66 $357.98 $143.53 59200 T Insert cervical dilator 0191 1.19 $59.02 $17.43 $11.80 59300 T Episiotomy or vaginal repair 0194 16.21 $803.96 $395.94 $160.79 59320 T Revision of cervix 0194 16.21 $803.96 $395.94 $160.79 59325 C Revision of cervix 59350 C Repair of uterus 59400 E Obstetrical care 59409 T Obstetrical care 0199 11.20 $555.48 $157.83 $111.10 59410 E Obstetrical care 59412 T Antepartum manipulation 0199 11.20 $555.48 $157.83 $111.10 59414 T Deliver placenta 0199 11.20 $555.48 $157.83 $111.10 59425 E Antepartum care only 59426 E Antepartum care only 59430 E Care after delivery 59510 E Cesarean delivery 59514 C Cesarean delivery only 59515 E Cesarean delivery 59525 C Remove uterus after cesarean 59610 E Vbac delivery 59612 T Vbac delivery only 0199 11.20 $555.48 $157.83 $111.10 59614 E Vbac care after delivery 59618 E Attempted vbac delivery 59620 C Attempted vbac delivery only 59622 E Attempted vbac after care 59812 T Treatment of miscarriage 0201 13.00 $644.75 $329.65 $128.95 59820 T Care of miscarriage 0201 13.00 $644.75 $329.65 $128.95 59821 T Treatment of miscarriage 0201 13.00 $644.75 $329.65 $128.95 59830 C Treat uterus infection 59840 T Abortion 0200 13.89 $688.89 $373.23 $137.78 59841 T Abortion 0200 13.89 $688.89 $373.23 $137.78 59850 C Abortion 59851 C Abortion 59852 C Abortion 59855 C Abortion 59856 C Abortion 59857 C Abortion 59866 T Abortion
(mpr)0198 1.34 $66.46 $33.03 $13.29 59870 T Evacuate mole of uterus 0201 13.00 $644.75 $329.65 $128.95 59871 T Remove cerclage suture 0194 16.21 $803.96 $395.94 $160.79 59898 T Laparo proc, ob care/deliver 0130 25.36 $1,257.75 $659.53 $251.55 59899 T Maternity care procedure 0198 1.34 $66.46 $33.03 $13.29 60000 T Drain thyroid/tongue cyst 0253 12.02 $596.14 $284.00 $119.23 60001 T Aspirate/inject thyriod cyst 0002 0.62 $30.75 $17.66 $6.15 60100 T Biopsy of thyroid 0004 1.84 $91.26 $32.57 $18.25 60200 T Remove thyroid lesion 0114 19.56 $970.10 $493.78 $194.02 60210 T Partial thyroid excision 0114 19.56 $970.10 $493.78 $194.02 60212 T Parital thyroid excision 0114 19.56 $970.10 $493.78 $194.02 60220 T Partial removal of thyroid 0114 19.56 $970.10 $493.78 $194.02 60225 T Partial removal of thyroid 0114 19.56 $970.10 $493.78 $194.02 60240 T Removal of thyroid 0114 19.56 $970.10 $493.78 $194.02 60252 T Removal of thyroid 0256 25.40 $1,259.74 $623.05 $251.95 60254 C Extensive thyroid surgery 60260 T Repeat thyroid surgery 0256 25.40 $1,259.74 $623.05 $251.95 60270 C Removal of thyroid 60271 C Removal of thyroid 60280 T Remove thyroid duct lesion 0114 19.56 $970.10 $493.78 $194.02 60281 T Remove thyroid duct lesion 0114 19.56 $970.10 $493.78 $194.02 60500 T Explore parathyroid glands 0256 25.40 $1,259.74 $623.05 $251.95 60502 C Re-explore parathyroids 60505 C Explore parathyroid glands 60512 T Autotransplant parathyroid 0020 6.51 $322.87 $130.53 $64.57 60520 C Removal of thymus gland 60521 C Removal of thymus gland 60522 C Removal of thymus gland 60540 C Explore adrenal gland 60545 C Explore adrenal gland 60600 C Remove carotid body lesion 60605 C Remove carotid body lesion 60650 C Laparoscopy adrenalectomy 60659 T Laparo proc, endocrine 0130 25.36 $1,257.75 $659.53 $251.55 60699 T Endocrine surgery procedure 0004 1.84 $91.26 $32.57 $18.25 61000 T Remove cranial cavity fluid 0212 3.64 $180.53 $88.78 $36.11 61001 T Remove cranial cavity fluid 0212 3.64 $180.53 $88.78 $36.11 61020 T Remove brain cavity fluid 0212 3.64 $180.53 $88.78 $36.11 61026 T Injection into brain canal 0212 3.64 $180.53 $88.78 $36.11 61050 T Remove brain canal fluid 0212 3.64 $180.53 $88.78 $36.11 61055 T Injection into brain canal 0212 3.64 $180.53 $88.78 $36.11 61070 T Brain canal shunt procedure 0212 3.64 $180.53 $88.78 $36.11 61105 C Twist drill hole 61107 C Drill skull for implantation 61108 C Drill skull for drainage 61120 C Burr hole for puncture 61140 C Pierce skull for biopsy 61150 C Pierce skull for drainage 61151 C Pierce skull for drainage 61154 C Pierce skull & remove clot 61156 C Pierce skull for drainage 61210 C Pierce skull, implant device 61215 T Insert brain-fluid device 0224 17.89 $887.27 $453.41 $177.45 61250 C Pierce skull & explore 61253 C Pierce skull & explore 61304 C Open skull for exploration 61305 C Open skull for exploration 61312 C Open skull for drainage 61313 C Open skull for drainage 61314 C Open skull for drainage 61315 C Open skull for drainage 61320 C Open skull for drainage 61321 C Open skull for drainage 61330 T Decompress eye socket 0256 25.40 $1,259.74 $623.05 $251.95 61332 C Explore/biopsy eye socket 61333 C Explore orbit/remove lesion 61334 C Explore orbit/remove object 61340 C Relieve cranial pressure 61343 C Incise skull (press relief) 61345 C Relieve cranial pressure 61440 C Incise skull for surgery 61450 C Incise skull for surgery 61458 C Incise skull for brain wound 61460 C Incise skull for surgery 61470 C Incise skull for surgery 61480 C Incise skull for surgery 61490 C Incise skull for surgery 61500 C Removal of skull lesion 61501 C Remove infected skull bone 61510 C Removal of brain lesion 61512 C Remove brain lining lesion 61514 C Removal of brain abscess 61516 C Removal of brain lesion 61518 C Removal of brain lesion 61519 C Remove brain lining lesion 61520 C Removal of brain lesion 61521 C Removal of brain lesion 61522 C Removal of brain abscess 61524 C Removal of brain lesion 61526 C Removal of brain lesion 61530 C Removal of brain lesion 61531 C Implant brain electrodes 61533 C Implant brain electrodes 61534 C Removal of brain lesion 61535 C Remove brain electrodes 61536 C Removal of brain lesion 61538 C Removal of brain tissue 61539 C Removal of brain tissue 61541 C Incision of brain tissue 61542 C Removal of brain tissue 61543 C Removal of brain tissue 61544 C Remove & treat brain lesion 61545 C Excision of brain tumor 61546 C Removal of pituitary gland 61548 C Removal of pituitary gland 61550 C Release of skull seams 61552 C Release of skull seams 61556 C Incise skull/sutures 61557 C Incise skull/sutures 61558 C Excision of skull/sutures 61559 C Excision of skull/sutures 61563 C Excision of skull tumor 61564 C Excision of skull tumor 61570 C Remove foreign body, brain 61571 C Incise skull for brain wound 61575 C Skull base/brainstem surgery 61576 C Skull base/brainstem surgery 61580 C Craniofacial approach, skull 61581 C Craniofacial approach, skull 61582 C Craniofacial approach, skull 61583 C Craniofacial approach, skull 61584 C Orbitocranial approach/skull 61585 C Orbitocranial approach/skull 61586 C Resect nasopharynx, skull 61590 C Infratemporal approach/skull 61591 C Infratemporal approach/skull 61592 C Orbitocranial approach/skull 61595 C Transtemporal approach/skull 61596 C Transcochlear approach/skull 61597 C Transcondylar approach/skull 61598 C Transpetrosal approach/skull 61600 C Resect/excise cranial lesion 61601 C Resect/excise cranial lesion 61605 C Resect/excise cranial lesion 61606 C Resect/excise cranial lesion 61607 C Resect/excise cranial lesion 61608 C Resect/excise cranial lesion 61609 C Transect artery, sinus 61610 C Transect artery, sinus 61611 C Transect artery, sinus 61612 C Transect artery, sinus 61613 C Remove aneurysm, sinus 61615 C Resect/excise lesion, skull 61616 C Resect/excise lesion, skull 61618 C Repair dura 61619 C Repair dura 61624 C Occlusion/embolization cath 61626 C Occlusion/embolization cath 61680 C Intracranial vessel surgery 61682 C Intracranial vessel surgery 61684 C Intracranial vessel surgery 61686 C Intracranial vessel surgery 61690 C Intracranial vessel surgery 61692 C Intracranial vessel surgery *61697 C Brain aneurysm repair, complex *61698 C Brain aneurysm repair, complex 61700 C Inner skull vessel surgery 61702 C Inner skull vessel surgery 61703 C Clamp neck artery 61705 C Revise circulation to head 61708 C Revise circulation to head 61710 C Revise circulation to head 61711 C Fusion of skull arteries 61720 C Incise skull/brain surgery 61735 C Incise skull/brain surgery 61750 C Incise skull/brain biopsy 61751 C Brain biopsy w/ ct/mr guide 61760 C Implant brain electrodes 61770 C Incise skull for treatment 61790 T Treat trigeminal nerve 0220 13.96 $692.36 $326.21 $138.47 61791 C Treat trigeminal tract 61793 E Focus radiation beam 61795 S Brain surgery using computer 0302 8.21 $407.18 $216.55 $81.44 61850 C Implant neuroelectrodes 61860 C Implant neuroelectrodes 61862 C Implant neurostimul, subcort 61870 C Implant neuroelectrodes 61875 C Implant neuroelectrodes 61880 T Revise/remove neuroelectrode 0105 15.06 $746.92 $372.32 $149.38 61885 T Implant neurostim one array 0222 124.43 $6,171.23 $2,955.13 $1,234.25 61886 T Implant neurostim arrays 0222 124.43 $6,171.23 $2,955.13 $1,234.25 61888 T Revise/remove neuroreceiver 0105 15.06 $746.92 $372.32 $149.38 62000 C Treat skull fracture 62005 C Treat skull fracture 62010 C Treatment of head injury 62100 C Repair brain fluid leakage 62115 C Reduction of skull defect 62116 C Reduction of skull defect 62117 C Reduction of skull defect 62120 C Repair skull cavity lesion 62121 C Incise skull repair 62140 C Repair of skull defect 62141 C Repair of skull defect 62142 C Remove skull plate/flap 62143 C Replace skull plate/flap 62145 C Repair of skull & brain 62146 C Repair of skull with graft 62147 C Repair of skull with graft 62180 C Establish brain cavity shunt 62190 C Establish brain cavity shunt 62192 C Establish brain cavity shunt 62194 T Replace/irrigate catheter 0121 2.36 $117.05 $52.53 $23.41 62200 C Establish brain cavity shunt 62201 C Establish brain cavity shunt 62220 C Establish brain cavity shunt 62223 C Establish brain cavity shunt 62225 T Replace/irrigate catheter 0121 2.36 $117.05 $52.53 $23.41 62230 T Replace/revise brain shunt 0224 17.89 $887.27 $453.41 $177.45 *62252 S CSF shunt reprogram 0102 0.45 $22.32 $12.62 $4.46 62256 C Remove brain cavity shunt 62258 C Replace brain cavity shunt 62263 T Lysis epidural adhesions 0212 3.64 $180.53 $88.78 $36.11 62268 T Drain spinal cord cyst 0212 3.64 $180.53 $88.78 $36.11 62269 T Needle biopsy, spinal cord 0005 5.41 $268.32 $119.75 $53.66 62270 T Spinal fluid tap, diagnostic 0210 3.00 $148.79 $62.40 $29.76 62272 T Drain spinal fluid 0210 3.00 $148.79 $62.40 $29.76 62273 T Treat epidural spine lesion 0212 3.64 $180.53 $88.78 $36.11 62280 T Treat spinal cord lesion 0212 3.64 $180.53 $88.78 $36.11 62281 T Treat spinal cord lesion 0212 3.64 $180.53 $88.78 $36.11 62282 T Treat spinal canal lesion 0212 3.64 $180.53 $88.78 $36.11 62284 N Injection for myelogram 62287 T Percutaneous diskectomy 0220 13.96 $692.36 $326.21 $138.47 62290 N Inject for spine disk x-ray 62291 N Inject for spine disk x-ray 62292 T Injection into disk lesion 0212 3.64 $180.53 $88.78 $36.11 62294 T Injection into spinal artery 0212 3.64 $180.53 $88.78 $36.11 62310 T Inject spine c/t 0212 3.64 $180.53 $88.78 $36.11 62311 T Inject spine l/s
(cd)0212 3.64 $180.53 $88.78 $36.11 62318 T Inject spine w/cath, c/t 0212 3.64 $180.53 $88.78 $36.11 62319 T Inject spine w/cath l/s
(cd)0212 3.64 $180.53 $88.78 $36.11 62350 T Implant spinal canal cath 0223 7.05 $349.65 $154.27 $69.93 62351 C Implant spinal canal cath 62355 T Remove spinal canal catheter 0105 15.06 $746.92 $372.32 $149.38 62360 T Insert spine infusion device 0226 5.62 $278.73 $109.42 $55.75 62361 T Implant spine infusion pump 0227 11.17 $553.99 $330.11 $110.80 62362 T Implant spine infusion pump 0227 11.17 $553.99 $330.11 $110.80 62365 T Remove spine infusion device 0105 15.06 $746.92 $372.32 $149.38 62367 S Analyze spine infusion pump 0102 0.45 $22.32 $12.62 $4.46 62368 S Analyze spine infusion pump 0102 0.45 $22.32 $12.62 $4.46 63001 C Removal of spinal lamina 63003 C Removal of spinal lamina 63005 C Removal of spinal lamina 63011 C Removal of spinal lamina 63012 C Removal of spinal lamina 63015 C Removal of spinal lamina 63016 C Removal of spinal lamina 63017 C Removal of spinal lamina 63020 C Neck spine disk surgery 63030 C Low back disk surgery 63035 C Spinal disk surgery add-on 63040 C Neck spine disk surgery 63042 C Low back disk surgery *63043 C Laminotomy, addl cervical *63044 C Laminotomy, addl lumbar 63045 C Removal of spinal lamina 63046 C Removal of spinal lamina 63047 C Removal of spinal lamina 63048 C Remove spinal lamina add-on 63055 C Decompress spinal cord 63056 C Decompress spinal cord 63057 C Decompress spine cord add-on 63064 C Decompress spinal cord 63066 C Decompress spine cord add-on 63075 C Neck spine disk surgery 63076 C Neck spine disk surgery 63077 C Spine disk surgery, thorax 63078 C Spine disk surgery, thorax 63081 C Removal of vertebral body 63082 C Remove vertebral body add-on 63085 C Removal of vertebral body 63086 C Remove vertebral body add-on 63087 C Removal of vertebral body 63088 C Remove vertebral body add-on 63090 C Removal of vertebral body 63091 C Remove vertebral body add-on 63170 C Incise spinal cord tract(s) 63172 C Drainage of spinal cyst 63173 C Drainage of spinal cyst 63180 C Revise spinal cord ligaments 63182 C Revise spinal cord ligaments 63185 C Incise spinal column/nerves 63190 C Incise spinal column/nerves 63191 C Incise spinal column/nerves 63194 C Incise spinal column & cord 63195 C Incise spinal column & cord 63196 C Incise spinal column & cord 63197 C Incise spinal column & cord 63198 C Incise spinal column & cord 63199 C Incise spinal column & cord 63200 C Release of spinal cord 63250 C Revise spinal cord vessels 63251 C Revise spinal cord vessels 63252 C Revise spinal cord vessels 63265 C Excise intraspinal lesion 63266 C Excise intraspinal lesion 63267 C Excise intraspinal lesion 63268 C Excise intraspinal lesion 63270 C Excise intraspinal lesion 63271 C Excise intraspinal lesion 63272 C Excise intraspinal lesion 63273 C Excise intraspinal lesion 63275 C Biopsy/excise spinal tumor 63276 C Biopsy/excise spinal tumor 63277 C Biopsy/excise spinal tumor 63278 C Biopsy/excise spinal tumor 63280 C Biopsy/excise spinal tumor 63281 C Biopsy/excise spinal tumor 63282 C Biopsy/excise spinal tumor 63283 C Biopsy/excise spinal tumor 63285 C Biopsy/excise spinal tumor 63286 C Biopsy/excise spinal tumor 63287 C Biopsy/excise spinal tumor 63290 C Biopsy/excise spinal tumor 63300 C Removal of vertebral body 63301 C Removal of vertebral body 63302 C Removal of vertebral body 63303 C Removal of vertebral body 63304 C Removal of vertebral body 63305 C Removal of vertebral body 63306 C Removal of vertebral body 63307 C Removal of vertebral body 63308 C Remove vertebral body add-on 63600 T Remove spinal cord lesion 0220 13.96 $692.36 $326.21 $138.47 63610 T Stimulation of spinal cord 0220 13.96 $692.36 $326.21 $138.47 63615 T Remove lesion of spinal cord 0220 13.96 $692.36 $326.21 $138.47 63650 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 63655 C Implant neuroelectrodes 63660 T Revise/remove neuroelectrode 0105 15.06 $746.92 $372.32 $149.38 63685 T Implant neuroreceiver 0222 124.43 $6,171.23 $2,955.13 $1,234.25 63688 T Revise/remove neuroreceiver 0105 15.06 $746.92 $372.32 $149.38 63700 C Repair of spinal herniation 63702 C Repair of spinal herniation 63704 C Repair of spinal herniation 63706 C Repair of spinal herniation 63707 C Repair spinal fluid leakage 63709 C Repair spinal fluid leakage 63710 C Graft repair of spine defect 63740 C Install spinal shunt 63741 T Install spinal shunt 0228 25.06 $1,242.88 $696.46 $248.58 63744 T Revision of spinal shunt 0228 25.06 $1,242.88 $696.46 $248.58 63746 T Removal of spinal shunt 0109 6.53 $323.86 $133.51 $64.77 64400 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64402 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64405 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64408 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64410 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64412 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64413 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64415 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64417 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64418 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64420 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64421 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64425 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64430 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64435 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64445 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64450 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64470 T Inj paravertebral c/t 0211 3.32 $164.66 $74.78 $32.93 64472 T Inj paravertebral c/t add-on 0211 3.32 $164.66 $74.78 $32.93 64475 T Inj paravertebral l/s 0211 3.32 $164.66 $74.78 $32.93 64476 T Inj paravertebral l/s add-on 0211 3.32 $164.66 $74.78 $32.93 64479 T Inj foramen epidural c/t 0211 3.32 $164.66 $74.78 $32.93 64480 T Inj foramen epidural add-on 0211 3.32 $164.66 $74.78 $32.93 64483 T Inj foramen epidural l/s 0211 3.32 $164.66 $74.78 $32.93 64484 T Inj foramen epidural add-on 0211 3.32 $164.66 $74.78 $32.93 64505 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64508 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64510 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64520 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64530 T Injection for nerve block 0211 3.32 $164.66 $74.78 $32.93 64550 A Apply neurostimulator 64553 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 64555 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 64560 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 64565 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 64573 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 64575 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 64577 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 64580 T Implant neuroelectrodes 0225 17.72 $878.84 $408.33 $175.77 64585 T Revise/remove neuroelectrode 0105 15.06 $746.92 $372.32 $149.38 64590 T Implant neuroreceiver 0222 124.43 $6,171.23 $2,955.13 $1,234.25 64595 T Revise/remove neuroreceiver 0105 15.06 $746.92 $372.32 $149.38 64600 T Injection treatment of nerve 0211 3.32 $164.66 $74.78 $32.93 64605 T Injection treatment of nerve 0211 3.32 $164.66 $74.78 $32.93 64610 T Injection treatment of nerve 0211 3.32 $164.66 $74.78 $32.93 64612 T Destroy nerve, face muscle 0211 3.32 $164.66 $74.78 $32.93 64613 T Destroy nerve, spine muscle 0211 3.32 $164.66 $74.78 $32.93 *64614 S Desrtoy nerve, extrem musc 0971 1.55 $76.88 $15.38 64620 T Injection treatment of nerve 0211 3.32 $164.66 $74.78 $32.93 64622 T Destr paravertebrl nerve l/s 0211 3.32 $164.66 $74.78 $32.93 64623 T Destr paravertebral n add-on 0211 3.32 $164.66 $74.78 $32.93 64626 T Destr paravertebrl nerve c/t 0211 3.32 $164.66 $74.78 $32.93 64627 T Destr paravertebral n add-on 0211 3.32 $164.66 $74.78 $32.93 64630 T Injection treatment of nerve 0211 3.32 $164.66 $74.78 $32.93 64640 T Injection treatment of nerve 0211 3.32 $164.66 $74.78 $32.93 64680 T Injection treatment of nerve 0211 3.32 $164.66 $74.78 $32.93 64702 T Revise finger/toe nerve 0220 13.96 $692.36 $326.21 $138.47 64704 T Revise hand/foot nerve 0220 13.96 $692.36 $326.21 $138.47 64708 T Revise arm/leg nerve 0220 13.96 $692.36 $326.21 $138.47 64712 T Revision of sciatic nerve 0220 13.96 $692.36 $326.21 $138.47 64713 T Revision of arm nerve(s) 0220 13.96 $692.36 $326.21 $138.47 64714 T Revise low back nerve(s) 0220 13.96 $692.36 $326.21 $138.47 64716 T Revision of cranial nerve 0220 13.96 $692.36 $326.21 $138.47 64718 T Revise ulnar nerve at elbow 0220 13.96 $692.36 $326.21 $138.47 64719 T Revise ulnar nerve at wrist 0220 13.96 $692.36 $326.21 $138.47 64721 T Carpal tunnel surgery 0220 13.96 $692.36 $326.21 $138.47 64722 T Relieve pressure on nerve(s) 0220 13.96 $692.36 $326.21 $138.47 64726 T Release foot/toe nerve 0220 13.96 $692.36 $326.21 $138.47 64727 T Internal nerve revision 0220 13.96 $692.36 $326.21 $138.47 64732 T Incision of brow nerve 0220 13.96 $692.36 $326.21 $138.47 64734 T Incision of cheek nerve 0220 13.96 $692.36 $326.21 $138.47 64736 T Incision of chin nerve 0220 13.96 $692.36 $326.21 $138.47 64738 T Incision of jaw nerve 0220 13.96 $692.36 $326.21 $138.47 64740 T Incision of tongue nerve 0220 13.96 $692.36 $326.21 $138.47 64742 T Incision of facial nerve 0220 13.96 $692.36 $326.21 $138.47 64744 T Incise nerve, back of head 0220 13.96 $692.36 $326.21 $138.47 64746 T Incise diaphragm nerve 0220 13.96 $692.36 $326.21 $138.47 64752 C Incision of vagus nerve 64755 C Incision of stomach nerves 64760 C Incision of vagus nerve 64761 T Incision of pelvis nerve 0220 13.96 $692.36 $326.21 $138.47 64763 C Incise hip/thigh nerve 64766 C Incise hip/thigh nerve 64771 T Sever cranial nerve 0220 13.96 $692.36 $326.21 $138.47 64772 T Incision of spinal nerve 0220 13.96 $692.36 $326.21 $138.47 64774 T Remove skin nerve lesion 0220 13.96 $692.36 $326.21 $138.47 64776 T Remove digit nerve lesion 0220 13.96 $692.36 $326.21 $138.47 64778 T Digit nerve surgery add-on 0220 13.96 $692.36 $326.21 $138.47 64782 T Remove limb nerve lesion 0220 13.96 $692.36 $326.21 $138.47 64783 T Limb nerve surgery add-on 0220 13.96 $692.36 $326.21 $138.47 64784 T Remove nerve lesion 0220 13.96 $692.36 $326.21 $138.47 64786 T Remove sciatic nerve lesion 0221 18.36 $910.58 $463.62 $182.12 64787 T Implant nerve end 0220 13.96 $692.36 $326.21 $138.47 64788 T Remove skin nerve lesion 0220 13.96 $692.36 $326.21 $138.47 64790 T Removal of nerve lesion 0220 13.96 $692.36 $326.21 $138.47 64792 T Removal of nerve lesion 0221 18.36 $910.58 $463.62 $182.12 64795 T Biopsy of nerve 0220 13.96 $692.36 $326.21 $138.47 64802 C Remove sympathetic nerves 64804 C Remove sympathetic nerves 64809 C Remove sympathetic nerves 64818 C Remove sympathetic nerves 64820 C Remove sympathetic nerves 64831 T Repair of digit nerve 0221 18.36 $910.58 $463.62 $182.12 64832 T Repair nerve add-on 0221 18.36 $910.58 $463.62 $182.12 64834 T Repair of hand or foot nerve 0221 18.36 $910.58 $463.62 $182.12 64835 T Repair of hand or foot nerve 0221 18.36 $910.58 $463.62 $182.12 64836 T Repair of hand or foot nerve 0221 18.36 $910.58 $463.62 $182.12 64837 T Repair nerve add-on 0221 18.36 $910.58 $463.62 $182.12 64840 T Repair of leg nerve 0221 18.36 $910.58 $463.62 $182.12 64856 T Repair/transpose nerve 0221 18.36 $910.58 $463.62 $182.12 64857 T Repair arm/leg nerve 0221 18.36 $910.58 $463.62 $182.12 64858 T Repair sciatic nerve 0221 18.36 $910.58 $463.62 $182.12 64859 T Nerve surgery 0221 18.36 $910.58 $463.62 $182.12 64861 T Repair of arm nerves 0221 18.36 $910.58 $463.62 $182.12 64862 T Repair of low back nerves 0221 18.36 $910.58 $463.62 $182.12 64864 T Repair of facial nerve 0221 18.36 $910.58 $463.62 $182.12 64865 T Repair of facial nerve 0221 18.36 $910.58 $463.62 $182.12 64866 C Fusion of facial/other nerve 64868 C Fusion of facial/other nerve 64870 T Fusion of facial/other nerve 0221 18.36 $910.58 $463.62 $182.12 64872 T Subsequent repair of nerve 0221 18.36 $910.58 $463.62 $182.12 64874 T Repair & revise nerve add-on 0221 18.36 $910.58 $463.62 $182.12 64876 T Repair nerve/shorten bone 0221 18.36 $910.58 $463.62 $182.12 64885 T Nerve graft, head or neck 0221 18.36 $910.58 $463.62 $182.12 64886 T Nerve graft, head or neck 0221 18.36 $910.58 $463.62 $182.12 64890 T Nerve graft, hand or foot 0221 18.36 $910.58 $463.62 $182.12 64891 T Nerve graft, hand or foot 0221 18.36 $910.58 $463.62 $182.12 64892 T Nerve graft, arm or leg 0221 18.36 $910.58 $463.62 $182.12 64893 T Nerve graft, arm or leg 0221 18.36 $910.58 $463.62 $182.12 64895 T Nerve graft, hand or foot 0221 18.36 $910.58 $463.62 $182.12 64896 T Nerve graft, hand or foot 0221 18.36 $910.58 $463.62 $182.12 64897 T Nerve graft, arm or leg 0221 18.36 $910.58 $463.62 $182.12 64898 T Nerve graft, arm or leg 0221 18.36 $910.58 $463.62 $182.12 64901 T Nerve graft add-on 0221 18.36 $910.58 $463.62 $182.12 64902 T Nerve graft add-on 0221 18.36 $910.58 $463.62 $182.12 64905 T Nerve pedicle transfer 0221 18.36 $910.58 $463.62 $182.12 64907 T Nerve pedicle transfer 0221 18.36 $910.58 $463.62 $182.12 64999 T Nervous system surgery 0211 3.32 $164.66 $74.78 $32.93 65091 T Revise eye 0242 23.70 $1,175.42 $597.36 $235.08 65093 T Revise eye with implant 0241 16.60 $823.30 $384.47 $164.66 65101 T Removal of eye 0242 23.70 $1,175.42 $597.36 $235.08 65103 T Remove eye/insert implant 0242 23.70 $1,175.42 $597.36 $235.08 65105 T Remove eye/attach implant 0242 23.70 $1,175.42 $597.36 $235.08 65110 T Removal of eye 0242 23.70 $1,175.42 $597.36 $235.08 65112 T Remove eye/revise socket 0242 23.70 $1,175.42 $597.36 $235.08 65114 T Remove eye/revise socket 0242 23.70 $1,175.42 $597.36 $235.08 65125 T Revise ocular implant 0240 13.47 $668.06 $315.31 $133.61 65130 T Insert ocular implant 0241 16.60 $823.30 $384.47 $164.66 65135 T Insert ocular implant 0241 16.60 $823.30 $384.47 $164.66 65140 T Attach ocular implant 0242 23.70 $1,175.42 $597.36 $235.08 65150 T Revise ocular implant 0241 16.60 $823.30 $384.47 $164.66 65155 T Reinsert ocular implant 0242 23.70 $1,175.42 $597.36 $235.08 65175 T Removal of ocular implant 0240 13.47 $668.06 $315.31 $133.61 65205 S Remove foreign body from eye 0231 2.64 $130.94 $59.87 $26.19 65210 S Remove foreign body from eye 0231 2.64 $130.94 $59.87 $26.19 65220 S Remove foreign body from eye 0231 2.64 $130.94 $59.87 $26.19 65222 S Remove foreign body from eye 0231 2.64 $130.94 $59.87 $26.19 65235 T Remove foreign body from eye 0232 6.04 $299.56 $134.66 $59.91 65260 T Remove foreign body from eye 0237 33.96 $1,684.28 $852.68 $336.86 65265 T Remove foreign body from eye 0237 33.96 $1,684.28 $852.68 $336.86 65270 T Repair of eye wound 0240 13.47 $668.06 $315.31 $133.61 65272 T Repair of eye wound 0232 6.04 $299.56 $134.66 $59.91 65273 C Repair of eye wound 65275 T Repair of eye wound 0233 13.79 $683.93 $331.60 $136.79 65280 T Repair of eye wound 0233 13.79 $683.93 $331.60 $136.79 65285 T Repair of eye wound 0234 20.64 $1,023.66 $502.16 $204.73 65286 T Repair of eye wound 0232 6.04 $299.56 $134.66 $59.91 65290 T Repair of eye socket wound 0243 17.99 $892.23 $431.39 $178.45 65400 T Removal of eye lesion 0232 6.04 $299.56 $134.66 $59.91 65410 T Biopsy of cornea 0233 13.79 $683.93 $331.60 $136.79 65420 T Removal of eye lesion 0233 13.79 $683.93 $331.60 $136.79 65426 T Removal of eye lesion 0233 13.79 $683.93 $331.60 $136.79 65430 S Corneal smear 0231 2.64 $130.94 $59.87 $26.19 65435 T Curette/treat cornea 0239 6.26 $310.47 $123.42 $62.09 65436 T Curette/treat cornea 0232 6.04 $299.56 $134.66 $59.91 65450 T Treatment of corneal lesion 0232 6.04 $299.56 $134.66 $59.91 65600 T Revision of cornea 0240 13.47 $668.06 $315.31 $133.61 65710 T Corneal transplant 0244 32.88 $1,630.72 $851.42 $326.14 65730 T Corneal transplant 0244 32.88 $1,630.72 $851.42 $326.14 65750 T Corneal transplant 0244 32.88 $1,630.72 $851.42 $326.14 65755 T Corneal transplant 0244 32.88 $1,630.72 $851.42 $326.14 65760 E Revision of cornea 65765 E Revision of cornea 65767 E Corneal tissue transplant 65770 T Revise cornea with implant 0244 32.88 $1,630.72 $851.42 $326.14 65771 E Radial keratotomy 65772 T Correction of astigmatism 0232 6.04 $299.56 $134.66 $59.91 65775 T Correction of astigmatism 0233 13.79 $683.93 $331.60 $136.79 65800 T Drainage of eye 0232 6.04 $299.56 $134.66 $59.91 65805 T Drainage of eye 0233 13.79 $683.93 $331.60 $136.79 65810 T Drainage of eye 0233 13.79 $683.93 $331.60 $136.79 65815 T Drainage of eye 0233 13.79 $683.93 $331.60 $136.79 65820 T Relieve inner eye pressure 0232 6.04 $299.56 $134.66 $59.91 65850 T Incision of eye 0234 20.64 $1,023.66 $502.16 $204.73 65855 T Laser surgery of eye 0247 4.89 $242.52 $112.86 $48.50 65860 T Incise inner eye adhesions 0247 4.89 $242.52 $112.86 $48.50 65865 T Incise inner eye adhesions 0233 13.79 $683.93 $331.60 $136.79 65870 T Incise inner eye adhesions 0233 13.79 $683.93 $331.60 $136.79 65875 T Incise inner eye adhesions 0233 13.79 $683.93 $331.60 $136.79 65880 T Incise inner eye adhesions 0232 6.04 $299.56 $134.66 $59.91 65900 T Remove eye lesion 0232 6.04 $299.56 $134.66 $59.91 65920 T Remove implant from eye 0233 13.79 $683.93 $331.60 $136.79 65930 T Remove blood clot from eye 0233 13.79 $683.93 $331.60 $136.79 66020 T Injection treatment of eye 0232 6.04 $299.56 $134.66 $59.91 66030 T Injection treatment of eye 0232 6.04 $299.56 $134.66 $59.91 66130 T Remove eye lesion 0233 13.79 $683.93 $331.60 $136.79 66150 T Glaucoma surgery 0233 13.79 $683.93 $331.60 $136.79 66155 T Glaucoma surgery 0234 20.64 $1,023.66 $502.16 $204.73 66160 T Glaucoma surgery 0234 20.64 $1,023.66 $502.16 $204.73 66165 T Glaucoma surgery 0234 20.64 $1,023.66 $502.16 $204.73 66170 T Glaucoma surgery 0234 20.64 $1,023.66 $502.16 $204.73 66172 T Incision of eye 0234 20.64 $1,023.66 $502.16 $204.73 66180 T Implant eye shunt 0234 20.64 $1,023.66 $502.16 $204.73 66185 T Revise eye shunt 0234 20.64 $1,023.66 $502.16 $204.73 66220 T Repair eye lesion 0236 6.70 $332.29 $147.96 $66.46 66225 T Repair/graft eye lesion 0234 20.64 $1,023.66 $502.16 $204.73 66250 T Follow-up surgery of eye 0233 13.79 $683.93 $331.60 $136.79 66500 T Incision of iris 0232 6.04 $299.56 $134.66 $59.91 66505 T Incision of iris 0232 6.04 $299.56 $134.66 $59.91 66600 T Remove iris and lesion 0233 13.79 $683.93 $331.60 $136.79 66605 T Removal of iris 0233 13.79 $683.93 $331.60 $136.79 66625 T Removal of iris 0232 6.04 $299.56 $134.66 $59.91 66630 T Removal of iris 0233 13.79 $683.93 $331.60 $136.79 66635 T Removal of iris 0233 13.79 $683.93 $331.60 $136.79 66680 T Repair iris & ciliary body 0233 13.79 $683.93 $331.60 $136.79 66682 T Repair iris & ciliary body 0233 13.79 $683.93 $331.60 $136.79 66700 T Destruction, ciliary body 0232 6.04 $299.56 $134.66 $59.91 66710 T Destruction, ciliary body 0232 6.04 $299.56 $134.66 $59.91 66720 T Destruction, ciliary body 0232 6.04 $299.56 $134.66 $59.91 66740 T Destruction, ciliary body 0233 13.79 $683.93 $331.60 $136.79 66761 T Revision of iris 0247 4.89 $242.52 $112.86 $48.50 66762 T Revision of iris 0247 4.89 $242.52 $112.86 $48.50 66770 T Removal of inner eye lesion 0247 4.89 $242.52 $112.86 $48.50 66820 T Incision, secondary cataract 0232 6.04 $299.56 $134.66 $59.91 66821 T After cataract laser surgery 0247 4.89 $242.52 $112.86 $48.50 66825 T Reposition intraocular lens 0233 13.79 $683.93 $331.60 $136.79 66830 T Removal of lens lesion 0232 6.04 $299.56 $134.66 $59.91 66840 T Removal of lens material 0245 26.55 $1,316.77 $623.85 $263.35 66850 T Removal of lens material 0245 26.55 $1,316.77 $623.85 $263.35 66852 T Removal of lens material 0245 26.55 $1,316.77 $623.85 $263.35 66920 T Extraction of lens 0245 26.55 $1,316.77 $623.85 $263.35 66930 T Extraction of lens 0245 26.55 $1,316.77 $623.85 $263.35 66940 T Extraction of lens 0245 26.55 $1,316.77 $623.85 $263.35 *66982 T Cataract surgery, complex 0246 26.55 $1,316.77 $623.85 $263.35 66983 T Remove cataract/insert lens 0246 26.55 $1,316.77 $623.85 $263.35 66984 T Remove cataract/insert lens 0246 26.55 $1,316.77 $623.85 $263.35 66985 T Insert lens prosthesis 0246 26.55 $1,316.77 $623.85 $263.35 66986 T Exchange lens prosthesis 0246 26.55 $1,316.77 $623.85 $263.35 66999 T Eye surgery procedure 0247 4.89 $242.52 $112.86 $48.50 67005 T Partial removal of eye fluid 0237 33.96 $1,684.28 $852.68 $336.86 67010 T Partial removal of eye fluid 0237 33.96 $1,684.28 $852.68 $336.86 67015 T Release of eye fluid 0237 33.96 $1,684.28 $852.68 $336.86 67025 T Replace eye fluid 0237 33.96 $1,684.28 $852.68 $336.86 67027 T Implant eye drug system 0237 33.96 $1,684.28 $852.68 $336.86 67028 T Injection eye drug 0236 6.70 $332.29 $147.96 $66.46 67030 T Incise inner eye strands 0236 6.70 $332.29 $147.96 $66.46 67031 T Laser surgery, eye strands 0247 4.89 $242.52 $112.86 $48.50 67036 T Removal of inner eye fluid 0237 33.96 $1,684.28 $852.68 $336.86 67038 T Strip retinal membrane 0237 33.96 $1,684.28 $852.68 $336.86 67039 T Laser treatment of retina 0237 33.96 $1,684.28 $852.68 $336.86 67040 T Laser treatment of retina 0237 33.96 $1,684.28 $852.68 $336.86 67101 T Repair detached retina 0236 6.70 $332.29 $147.96 $66.46 67105 T Repair detached retina 0248 4.19 $207.81 $94.05 $41.56 67107 T Repair detached retina 0237 33.96 $1,684.28 $852.68 $336.86 67108 T Repair detached retina 0237 33.96 $1,684.28 $852.68 $336.86 67110 T Repair detached retina 0236 6.70 $332.29 $147.96 $66.46 67112 T Rerepair detached retina 0237 33.96 $1,684.28 $852.68 $336.86 67115 T Release encircling material 0236 6.70 $332.29 $147.96 $66.46 67120 T Remove eye implant material 0236 6.70 $332.29 $147.96 $66.46 67121 T Remove eye implant material 0237 33.96 $1,684.28 $852.68 $336.86 67141 T Treatment of retina 0235 2.94 $145.81 $78.91 $29.16 67145 T Treatment of retina 0248 4.19 $207.81 $94.05 $41.56 67208 T Treatment of retinal lesion 0235 2.94 $145.81 $78.91 $29.16 67210 T Treatment of retinal lesion 0248 4.19 $207.81 $94.05 $41.56 67218 T Treatment of retinal lesion 0237 33.96 $1,684.28 $852.68 $336.86 67220 T Treatment of choroid lesion 0237 33.96 $1,684.28 $852.68 $336.86 *67221 T Treatment of choroid lesion 0235 2.94 $145.81 $78.91 $29.16 67227 T Treatment of retinal lesion 0235 2.94 $145.81 $78.91 $29.16 67228 T Treatment of retinal lesion 0248 4.19 $207.81 $94.05 $41.56 67250 T Reinforce eye wall 0240 13.47 $668.06 $315.31 $133.61 67255 T Reinforce/graft eye wall 0237 33.96 $1,684.28 $852.68 $336.86 67299 T Eye surgery procedure 0248 4.19 $207.81 $94.05 $41.56 67311 T Revise eye muscle 0243 17.99 $892.23 $431.39 $178.45 67312 T Revise two eye muscles 0243 17.99 $892.23 $431.39 $178.45 67314 T Revise eye muscle 0243 17.99 $892.23 $431.39 $178.45 67316 T Revise two eye muscles 0243 17.99 $892.23 $431.39 $178.45 67318 T Revise eye muscle(s) 0243 17.99 $892.23 $431.39 $178.45 67320 T Revise eye muscle(s) add-on 0243 17.99 $892.23 $431.39 $178.45 67331 T Eye surgery follow-up add-on 0243 17.99 $892.23 $431.39 $178.45 67332 T Rerevise eye muscles add-on 0243 17.99 $892.23 $431.39 $178.45 67334 T Revise eye muscle w/suture 0243 17.99 $892.23 $431.39 $178.45 67335 T Eye suture during surgery 0243 17.99 $892.23 $431.39 $178.45 67340 T Revise eye muscle add-on 0243 17.99 $892.23 $431.39 $178.45 67343 T Release eye tissue 0243 17.99 $892.23 $431.39 $178.45 67345 T Destroy nerve of eye muscle 0238 2.80 $138.87 $58.96 $27.77 67350 S Biopsy eye muscle 0231 2.64 $130.94 $59.87 $26.19 67399 T Eye muscle surgery procedure 0243 17.99 $892.23 $431.39 $178.45 67400 T Explore/biopsy eye socket 0241 16.60 $823.30 $384.47 $164.66 67405 T Explore/drain eye socket 0241 16.60 $823.30 $384.47 $164.66 67412 T Explore/treat eye socket 0241 16.60 $823.30 $384.47 $164.66 67413 T Explore/treat eye socket 0241 16.60 $823.30 $384.47 $164.66 67414 T Explr/decompress eye socket 0242 23.70 $1,175.42 $597.36 $235.08 67415 T Aspiration, orbital contents 0239 6.26 $310.47 $123.42 $62.09 67420 T Explore/treat eye socket 0242 23.70 $1,175.42 $597.36 $235.08 67430 T Explore/treat eye socket 0242 23.70 $1,175.42 $597.36 $235.08 67440 T Explore/drain eye socket 0242 23.70 $1,175.42 $597.36 $235.08 67445 T Explr/decompress eye socket 0242 23.70 $1,175.42 $597.36 $235.08 67450 T Explore/biopsy eye socket 0242 23.70 $1,175.42 $597.36 $235.08 67500 S Inject/treat eye socket 0231 2.64 $130.94 $59.87 $26.19 67505 T Inject/treat eye socket 0238 2.80 $138.87 $58.96 $27.77 67515 T Inject/treat eye socket 0239 6.26 $310.47 $123.42 $62.09 67550 T Insert eye socket implant 0242 23.70 $1,175.42 $597.36 $235.08 67560 T Revise eye socket implant 0241 16.60 $823.30 $384.47 $164.66 67570 T Decompress optic nerve 0242 23.70 $1,175.42 $597.36 $235.08 67599 T Orbit surgery procedure 0239 6.26 $310.47 $123.42 $62.09 67700 T Drainage of eyelid abscess 0238 2.80 $138.87 $58.96 $27.77 67710 T Incision of eyelid 0239 6.26 $310.47 $123.42 $62.09 67715 T Incision of eyelid fold 0240 13.47 $668.06 $315.31 $133.61 67800 T Remove eyelid lesion 0238 2.80 $138.87 $58.96 $27.77 67801 T Remove eyelid lesions 0239 6.26 $310.47 $123.42 $62.09 67805 T Remove eyelid lesions 0238 2.80 $138.87 $58.96 $27.77 67808 T Remove eyelid lesion(s) 0240 13.47 $668.06 $315.31 $133.61 67810 T Biopsy of eyelid 0238 2.80 $138.87 $58.96 $27.77 67820 T Revise eyelashes 0238 2.80 $138.87 $58.96 $27.77 67825 T Revise eyelashes 0238 2.80 $138.87 $58.96 $27.77 67830 T Revise eyelashes 0239 6.26 $310.47 $123.42 $62.09 67835 T Revise eyelashes 0240 13.47 $668.06 $315.31 $133.61 67840 T Remove eyelid lesion 0239 6.26 $310.47 $123.42 $62.09 67850 T Treat eyelid lesion 0239 6.26 $310.47 $123.42 $62.09 67875 T Closure of eyelid by suture 0239 6.26 $310.47 $123.42 $62.09 67880 T Revision of eyelid 0232 6.04 $299.56 $134.66 $59.91 67882 T Revision of eyelid 0240 13.47 $668.06 $315.31 $133.61 67900 T Repair brow defect 0240 13.47 $668.06 $315.31 $133.61 67901 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67902 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67903 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67904 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67906 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67908 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67909 T Revise eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67911 T Revise eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67914 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67915 T Repair eyelid defect 0239 6.26 $310.47 $123.42 $62.09 67916 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67917 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67921 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67922 T Repair eyelid defect 0239 6.26 $310.47 $123.42 $62.09 67923 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67924 T Repair eyelid defect 0240 13.47 $668.06 $315.31 $133.61 67930 T Repair eyelid wound 0240 13.47 $668.06 $315.31 $133.61 67935 T Repair eyelid wound 0240 13.47 $668.06 $315.31 $133.61 67938 T Remove eyelid foreign body 0238 2.80 $138.87 $58.96 $27.77 67950 T Revision of eyelid 0240 13.47 $668.06 $315.31 $133.61 67961 T Revision of eyelid 0240 13.47 $668.06 $315.31 $133.61 67966 T Revision of eyelid 0240 13.47 $668.06 $315.31 $133.61 67971 T Reconstruction of eyelid 0241 16.60 $823.30 $384.47 $164.66 67973 T Reconstruction of eyelid 0241 16.60 $823.30 $384.47 $164.66 67974 T Reconstruction of eyelid 0241 16.60 $823.30 $384.47 $164.66 67975 T Reconstruction of eyelid 0240 13.47 $668.06 $315.31 $133.61 67999 T Revision of eyelid 0240 13.47 $668.06 $315.31 $133.61 68020 T Incise/drain eyelid lining 0240 13.47 $668.06 $315.31 $133.61 68040 T Treatment of eyelid lesions 0239 6.26 $310.47 $123.42 $62.09 68100 T Biopsy of eyelid lining 0232 6.04 $299.56 $134.66 $59.91 68110 S Remove eyelid lining lesion 0231 2.64 $130.94 $59.87 $26.19 68115 T Remove eyelid lining lesion 0239 6.26 $310.47 $123.42 $62.09 68130 T Remove eyelid lining lesion 0233 13.79 $683.93 $331.60 $136.79 68135 T Remove eyelid lining lesion 0239 6.26 $310.47 $123.42 $62.09 68200 S Treat eyelid by injection 0230 0.98 $48.61 $22.48 $9.72 68320 T Revise/graft eyelid lining 0240 13.47 $668.06 $315.31 $133.61 68325 T Revise/graft eyelid lining 0242 23.70 $1,175.42 $597.36 $235.08 68326 T Revise/graft eyelid lining 0241 16.60 $823.30 $384.47 $164.66 68328 T Revise/graft eyelid lining 0241 16.60 $823.30 $384.47 $164.66 68330 T Revise eyelid lining 0233 13.79 $683.93 $331.60 $136.79 68335 T Revise/graft eyelid lining 0241 16.60 $823.30 $384.47 $164.66 68340 T Separate eyelid adhesions 0240 13.47 $668.06 $315.31 $133.61 68360 T Revise eyelid lining 0234 20.64 $1,023.66 $502.16 $204.73 68362 T Revise eyelid lining 0234 20.64 $1,023.66 $502.16 $204.73 68399 T Eyelid lining surgery 0239 6.26 $310.47 $123.42 $62.09 68400 T Incise/drain tear gland 0238 2.80 $138.87 $58.96 $27.77 68420 T Incise/drain tear sac 0240 13.47 $668.06 $315.31 $133.61 68440 T Incise tear duct opening 0238 2.80 $138.87 $58.96 $27.77 68500 T Removal of tear gland 0241 16.60 $823.30 $384.47 $164.66 68505 T Partial removal, tear gland 0241 16.60 $823.30 $384.47 $164.66 68510 T Biopsy of tear gland 0240 13.47 $668.06 $315.31 $133.61 68520 T Removal of tear sac 0241 16.60 $823.30 $384.47 $164.66 68525 T Biopsy of tear sac 0240 13.47 $668.06 $315.31 $133.61 68530 T Clearance of tear duct 0240 13.47 $668.06 $315.31 $133.61 68540 T Remove tear gland lesion 0241 16.60 $823.30 $384.47 $164.66 68550 T Remove tear gland lesion 0242 23.70 $1,175.42 $597.36 $235.08 68700 T Repair tear ducts 0241 16.60 $823.30 $384.47 $164.66 68705 T Revise tear duct opening 0238 2.80 $138.87 $58.96 $27.77 68720 T Create tear sac drain 0242 23.70 $1,175.42 $597.36 $235.08 68745 T Create tear duct drain 0241 16.60 $823.30 $384.47 $164.66 68750 T Create tear duct drain 0242 23.70 $1,175.42 $597.36 $235.08 68760 T Close tear duct opening 0238 2.80 $138.87 $58.96 $27.77 68761 S Close tear duct opening 0231 2.64 $130.94 $59.87 $26.19 68770 T Close tear system fistula 0240 13.47 $668.06 $315.31 $133.61 68801 S Dilate tear duct opening 0231 2.64 $130.94 $59.87 $26.19 68810 S Probe nasolacrimal duct 0231 2.64 $130.94 $59.87 $26.19 68811 T Probe nasolacrimal duct 0240 13.47 $668.06 $315.31 $133.61 68815 T Probe nasolacrimal duct 0240 13.47 $668.06 $315.31 $133.61 68840 S Explore/irrigate tear ducts 0231 2.64 $130.94 $59.87 $26.19 68850 N Injection for tear sac x-ray 68899 S Tear duct system surgery 0231 2.64 $130.94 $59.87 $26.19 69000 T Drain external ear lesion 0006 2.00 $99.19 $33.95 $19.84 69005 T Drain external ear lesion 0007 3.68 $182.51 $72.03 $36.50 69020 T Drain outer ear canal lesion 0006 2.00 $99.19 $33.95 $19.84 69090 E Pierce earlobes 69100 T Biopsy of external ear 0019 4.00 $198.39 $78.91 $39.68 69105 T Biopsy of external ear canal 0253 12.02 $596.14 $284.00 $119.23 69110 T Remove external ear, partial 0020 6.51 $322.87 $130.53 $64.57 69120 T Removal of external ear 0253 12.02 $596.14 $284.00 $119.23 69140 T Remove ear canal lesion(s) 0254 12.45 $617.47 $272.41 $123.49 69145 T Remove ear canal lesion(s) 0020 6.51 $322.87 $130.53 $64.57 69150 C Extensive ear canal surgery 69155 C Extensive ear/neck surgery 69200 X Clear outer ear canal 0340 1.04 $51.58 $12.85 $10.32 69205 T Clear outer ear canal 0022 12.49 $619.45 $292.94 $123.89 69210 X Remove impacted ear wax 0340 1.04 $51.58 $12.85 $10.32 69220 T Clean out mastoid cavity 0012 0.53 $26.29 $9.18 $5.26 69222 T Clean out mastoid cavity 0253 12.02 $596.14 $284.00 $119.23 69300 T Revise external ear 0254 12.45 $617.47 $272.41 $123.49 69310 T Rebuild outer ear canal 0256 25.40 $1,259.74 $623.05 $251.95 69320 T Rebuild outer ear canal 0256 25.40 $1,259.74 $623.05 $251.95 69399 T Outer ear surgery procedure 0252 5.18 $256.90 $114.24 $51.38 69400 T Inflate middle ear canal 0251 1.68 $83.32 $27.99 $16.66 69401 N Inflate middle ear canal 69405 T Catheterize middle ear canal 0252 5.18 $256.90 $114.24 $51.38 69410 T Inset middle ear (baffle) 0252 5.18 $256.90 $114.24 $51.38 69420 T Incision of eardrum 0252 5.18 $256.90 $114.24 $51.38 69421 T Incision of eardrum 0253 12.02 $596.14 $284.00 $119.23 69424 T Remove ventilating tube 0252 5.18 $256.90 $114.24 $51.38 69433 T Create eardrum opening 0252 5.18 $256.90 $114.24 $51.38 69436 T Create eardrum opening 0253 12.02 $596.14 $284.00 $119.23 69440 T Exploration of middle ear 0253 12.02 $596.14 $284.00 $119.23 69450 T Eardrum revision 0256 25.40 $1,259.74 $623.05 $251.95 69501 T Mastoidectomy 0256 25.40 $1,259.74 $623.05 $251.95 69502 C Mastoidectomy 69505 T Remove mastoid structures 0256 25.40 $1,259.74 $623.05 $251.95 69511 T Extensive mastoid surgery 0256 25.40 $1,259.74 $623.05 $251.95 69530 T Extensive mastoid surgery 0256 25.40 $1,259.74 $623.05 $251.95 69535 C Remove part of temporal bone 69540 T Remove ear lesion 0253 12.02 $596.14 $284.00 $119.23 69550 T Remove ear lesion 0256 25.40 $1,259.74 $623.05 $251.95 69552 T Remove ear lesion 0256 25.40 $1,259.74 $623.05 $251.95 69554 C Remove ear lesion 69601 T Mastoid surgery revision 0256 25.40 $1,259.74 $623.05 $251.95 69602 T Mastoid surgery revision 0256 25.40 $1,259.74 $623.05 $251.95 69603 T Mastoid surgery revision 0256 25.40 $1,259.74 $623.05 $251.95 69604 T Mastoid surgery revision 0256 25.40 $1,259.74 $623.05 $251.95 69605 T Mastoid surgery revision 0256 25.40 $1,259.74 $623.05 $251.95 69610 T Repair of eardrum 0253 12.02 $596.14 $284.00 $119.23 69620 T Repair of eardrum 0253 12.02 $596.14 $284.00 $119.23 69631 T Repair eardrum structures 0256 25.40 $1,259.74 $623.05 $251.95 69632 T Rebuild eardrum structures 0256 25.40 $1,259.74 $623.05 $251.95 69633 T Rebuild eardrum structures 0256 25.40 $1,259.74 $623.05 $251.95 69635 T Repair eardrum structures 0256 25.40 $1,259.74 $623.05 $251.95 69636 T Rebuild eardrum structures 0256 25.40 $1,259.74 $623.05 $251.95 69637 T Rebuild eardrum structures 0256 25.40 $1,259.74 $623.05 $251.95 69641 T Revise middle ear & mastoid 0256 25.40 $1,259.74 $623.05 $251.95 69642 T Revise middle ear & mastoid 0256 25.40 $1,259.74 $623.05 $251.95 69643 T Revise middle ear & mastoid 0256 25.40 $1,259.74 $623.05 $251.95 69644 T Revise middle ear & mastoid 0256 25.40 $1,259.74 $623.05 $251.95 69645 T Revise middle ear & mastoid 0256 25.40 $1,259.74 $623.05 $251.95 69646 T Revise middle ear & mastoid 0256 25.40 $1,259.74 $623.05 $251.95 69650 T Release middle ear bone 0254 12.45 $617.47 $272.41 $123.49 69660 T Revise middle ear bone 0256 25.40 $1,259.74 $623.05 $251.95 69661 T Revise middle ear bone 0256 25.40 $1,259.74 $623.05 $251.95 69662 T Revise middle ear bone 0256 25.40 $1,259.74 $623.05 $251.95 69666 T Repair middle ear structures 0256 25.40 $1,259.74 $623.05 $251.95 69667 T Repair middle ear structures 0256 25.40 $1,259.74 $623.05 $251.95 69670 T Remove mastoid air cells 0256 25.40 $1,259.74 $623.05 $251.95 69676 T Remove middle ear nerve 0256 25.40 $1,259.74 $623.05 $251.95 69700 T Close mastoid fistula 0256 25.40 $1,259.74 $623.05 $251.95 69710 E Implant/replace hearing aid 69711 T Remove/repair hearing aid 0256 25.40 $1,259.74 $623.05 $251.95 *69714 T Implant temple bone w/stimul 0256 25.40 $1,259.74 $623.05 $251.95 *69715 T Temple bne implnt w/stimulat 0256 25.40 $1,259.74 $623.05 $251.95 *69717 T Temple bone implant revision 0256 25.40 $1,259.74 $623.05 $251.95 *69718 T Revise temple bone implant 0256 25.40 $1,259.74 $623.05 $251.95 69720 T Release facial nerve 0256 25.40 $1,259.74 $623.05 $251.95 69725 T Release facial nerve 0256 25.40 $1,259.74 $623.05 $251.95 69740 T Repair facial nerve 0256 25.40 $1,259.74 $623.05 $251.95 69745 T Repair facial nerve 0256 25.40 $1,259.74 $623.05 $251.95 69799 T Middle ear surgery procedure 0253 12.02 $596.14 $284.00 $119.23 69801 T Incise inner ear 0256 25.40 $1,259.74 $623.05 $251.95 69802 T Incise inner ear 0256 25.40 $1,259.74 $623.05 $251.95 69805 T Explore inner ear 0256 25.40 $1,259.74 $623.05 $251.95 69806 T Explore inner ear 0256 25.40 $1,259.74 $623.05 $251.95 69820 T Establish inner ear window 0256 25.40 $1,259.74 $623.05 $251.95 69840 T Revise inner ear window 0256 25.40 $1,259.74 $623.05 $251.95 69905 T Remove inner ear 0256 25.40 $1,259.74 $623.05 $251.95 69910 T Remove inner ear & mastoid 0256 25.40 $1,259.74 $623.05 $251.95 69915 T Incise inner ear nerve 0256 25.40 $1,259.74 $623.05 $251.95 69930 T Implant cochlear device 0256 25.40 $1,259.74 $623.05 $251.95 69949 T Inner ear surgery procedure 0253 12.02 $596.14 $284.00 $119.23 69950 C Incise inner ear nerve 69955 T Release facial nerve 0256 25.40 $1,259.74 $623.05 $251.95 69960 T Release inner ear canal 0256 25.40 $1,259.74 $623.05 $251.95 69970 C Remove inner ear lesion 69979 T Temporal bone surgery 0252 5.18 $256.90 $114.24 $51.38 69990 N Microsurgery add-on 70010 S Contrast x-ray of brain 0274 4.83 $239.55 $128.12 $47.91 70015 S Contrast x-ray of brain 0274 4.83 $239.55 $128.12 $47.91 70030 X X-ray eye for foreign body 0260 0.79 $39.18 $22.02 $7.84 70100 X X-ray exam of jaw 0260 0.79 $39.18 $22.02 $7.84 70110 X X-ray exam of jaw 0260 0.79 $39.18 $22.02 $7.84 70120 X X-ray exam of mastoids 0260 0.79 $39.18 $22.02 $7.84 70130 X X-ray exam of mastoids 0260 0.79 $39.18 $22.02 $7.84 70134 X X-ray exam of middle ear 0261 1.38 $68.44 $38.77 $13.69 70140 X X-ray exam of facial bones 0260 0.79 $39.18 $22.02 $7.84 70150 X X-ray exam of facial bones 0260 0.79 $39.18 $22.02 $7.84 70160 X X-ray exam of nasal bones 0260 0.79 $39.18 $22.02 $7.84 70170 X X-ray exam of tear duct 0263 1.68 $83.32 $45.88 $16.66 70190 X X-ray exam of eye sockets 0260 0.79 $39.18 $22.02 $7.84 70200 X X-ray exam of eye sockets 0260 0.79 $39.18 $22.02 $7.84 70210 X X-ray exam of sinuses 0260 0.79 $39.18 $22.02 $7.84 70220 X X-ray exam of sinuses 0260 0.79 $39.18 $22.02 $7.84 70240 X X-ray exam, pituitary saddle 0260 0.79 $39.18 $22.02 $7.84 70250 X X-ray exam of skull 0260 0.79 $39.18 $22.02 $7.84 70260 X X-ray exam of skull 0261 1.38 $68.44 $38.77 $13.69 70300 X X-ray exam of teeth 0262 0.40 $19.83 $10.90 $3.97 70310 X X-ray exam of teeth 0262 0.40 $19.83 $10.90 $3.97 70320 X Full mouth x-ray of teeth 0262 0.40 $19.83 $10.90 $3.97 70328 X X-ray exam of jaw joint 0260 0.79 $39.18 $22.02 $7.84 70330 X X-ray exam of jaw joints 0260 0.79 $39.18 $22.02 $7.84 70332 S X-ray exam of jaw joint 0275 2.74 $135.89 $72.26 $27.18 70336 S Magnetic image, jaw joint 0284 8.02 $397.76 $257.39 $79.55 70350 X X-ray head for orthodontia 0260 0.79 $39.18 $22.02 $7.84 70355 X Panoramic x-ray of jaws 0260 0.79 $39.18 $22.02 $7.84 70360 X X-ray exam of neck 0260 0.79 $39.18 $22.02 $7.84 70370 X Throat x-ray & fluoroscopy 0273 2.49 $123.49 $61.02 $24.70 70371 X Speech evaluation, complex 0272 1.40 $69.43 $39.00 $13.89 70373 X Contrast x-ray of larynx 0263 1.68 $83.32 $45.88 $16.66 70380 X X-ray exam of salivary gland 0260 0.79 $39.18 $22.02 $7.84 70390 X X-ray exam of salivary duct 0263 1.68 $83.32 $45.88 $16.66 70450 S CAT scan of head or brain 0283 4.89 $242.52 $179.39 $48.50 70460 S Contrast CAT scan of head 0283 4.89 $242.52 $179.39 $48.50 70470 S Contrast CAT scans of head 0283 4.89 $242.52 $179.39 $48.50 70480 S CAT scan of skull 0283 4.89 $242.52 $179.39 $48.50 70481 S Contrast CAT scan of skull 0283 4.89 $242.52 $179.39 $48.50 70482 S Contrast CAT scans of skull 0283 4.89 $242.52 $179.39 $48.50 70486 S Cat scan of face/jaw 0282 2.38 $118.04 $94.51 $23.61 70487 S Contrast CAT scan, face/jaw 0283 4.89 $242.52 $179.39 $48.50 70488 S Contrast cat scans, face/jaw 0283 4.89 $242.52 $179.39 $48.50 70490 S CAT scan of neck tissue 0283 4.89 $242.52 $179.39 $48.50 70491 S Contrast CAT of neck tissue 0283 4.89 $242.52 $179.39 $48.50 70492 S Contrast CAT of neck tissue 0283 4.89 $242.52 $179.39 $48.50 *70496 S Ct angiography, head 0283 4.89 $242.52 $179.39 $48.50 *70498 S Ct angiography, neck 0283 4.89 $242.52 $179.39 $48.50 70540 S Magnetic image, face/neck 0284 8.02 $397.76 $257.39 $79.55 70541D S MR angiography 0284 8.02 $397.76 $257.39 $79.55 *70542 S MR (eg, proton) imaging 0284 8.02 $397.76 $257.39 $79.55 *70543 S MR (eg, proton) imaging 0284 8.02 $397.76 $257.39 $79.55 *70544 S MR angiography 0284 8.02 $397.76 $257.39 $79.55 *70545 S MR angiography 0284 8.02 $397.76 $257.39 $79.55 *70546 S MR angiography 0284 8.02 $397.76 $257.39 $79.55 *70547 S MR angiography 0284 8.02 $397.76 $257.39 $79.55 *70548 S MR angiography 0284 8.02 $397.76 $257.39 $79.55 *70549 S MR angiography 0284 8.02 $397.76 $257.39 $79.55 70551 S Magnetic image, brain
(MRI)0284 8.02 $397.76 $257.39 $79.55 70552 S Magnetic image, brain
(MRI)0284 8.02 $397.76 $257.39 $79.55 70553 S Magnetic image, brain
(mri)0284 8.02 $397.76 $257.39 $79.55 71010 X Chest x-ray 0260 0.79 $39.18 $22.02 $7.84 71015 X Chest x-ray 0260 0.79 $39.18 $22.02 $7.84 71020 X Chest x-ray 0260 0.79 $39.18 $22.02 $7.84 71021 X Chest x-ray 0260 0.79 $39.18 $22.02 $7.84 71022 X Chest x-ray 0260 0.79 $39.18 $22.02 $7.84 71023 X Chest x-ray and fluoroscopy 0272 1.40 $69.43 $39.00 $13.89 71030 X Chest x-ray 0260 0.79 $39.18 $22.02 $7.84 71034 X Chest x-ray and fluoroscopy 0272 1.40 $69.43 $39.00 $13.89 71035 X Chest x-ray 0260 0.79 $39.18 $22.02 $7.84 71036D X X-ray guidance for biopsy 0273 2.49 $123.49 $61.02 $24.70 71040 X Contrast x-ray of bronchi 0263 1.68 $83.32 $45.88 $16.66 71060 X Contrast x-ray of bronchi 0263 1.68 $83.32 $45.88 $16.66 71090 X X-ray & pacemaker insertion 0273 2.49 $123.49 $61.02 $24.70 71100 X X-ray exam of ribs 0260 0.79 $39.18 $22.02 $7.84 71101 X X-ray exam of ribs/chest 0260 0.79 $39.18 $22.02 $7.84 71110 X X-ray exam of ribs 0260 0.79 $39.18 $22.02 $7.84 71111 X X-ray exam of ribs/ chest 0261 1.38 $68.44 $38.77 $13.69 71120 X X-ray exam of breastbone 0260 0.79 $39.18 $22.02 $7.84 71130 X X-ray exam of breastbone 0260 0.79 $39.18 $22.02 $7.84 71250 S Cat scan of chest 0283 4.89 $242.52 $179.39 $48.50 71260 S Contrast CAT scan of chest 0283 4.89 $242.52 $179.39 $48.50 71270 S Contrast CAT scans of chest 0283 4.89 $242.52 $179.39 $48.50 *71275 S CT angiography, chest 0283 4.89 $242.52 $179.39 $48.50 71550 S Magnetic image, chest
(mri)0284 8.02 $397.76 $257.39 $79.55 *71551 S MRI chest w/ dye 0284 8.02 $397.76 $257.39 $79.55 *71552 S MRI chest w/o dye 0284 8.02 $397.76 $257.39 $79.55 71555 S Magnetic image, chest
(mra)0284 8.02 $397.76 $257.39 $79.55 72010 X X-ray exam of spine 0261 1.38 $68.44 $38.77 $13.69 72020 X X-ray exam of spine 0260 0.79 $39.18 $22.02 $7.84 72040 X X-ray exam of neck spine 0260 0.79 $39.18 $22.02 $7.84 72050 X X-ray exam of neck spine 0261 1.38 $68.44 $38.77 $13.69 72052 X X-ray exam of neck spine 0261 1.38 $68.44 $38.77 $13.69 72069 X X-ray exam of trunk spine 0260 0.79 $39.18 $22.02 $7.84 72070 X X-ray exam of thoracic spine 0260 0.79 $39.18 $22.02 $7.84 72072 X X-ray exam of thoracic spine 0260 0.79 $39.18 $22.02 $7.84 72074 X X-ray exam of thoracic spine 0260 0.79 $39.18 $22.02 $7.84 72080 X X-ray exam of trunk spine 0260 0.79 $39.18 $22.02 $7.84 72090 X X-ray exam of trunk spine 0260 0.79 $39.18 $22.02 $7.84 72100 X X-ray exam of lower spine 0260 0.79 $39.18 $22.02 $7.84 72110 X X-ray exam of lower spine 0261 1.38 $68.44 $38.77 $13.69 72114 X X-ray exam of lower spine 0261 1.38 $68.44 $38.77 $13.69 72120 X X-ray exam of lower spine 0260 0.79 $39.18 $22.02 $7.84 72125 S CAT scan of neck spine 0283 4.89 $242.52 $179.39 $48.50 72126 S Contrast CAT scan of neck 0283 4.89 $242.52 $179.39 $48.50 72127 S Contrast CAT scans of neck 0283 4.89 $242.52 $179.39 $48.50 72128 S CAT scan of thorax spine 0283 4.89 $242.52 $179.39 $48.50 72129 S Contrast CAT scan of thorax 0283 4.89 $242.52 $179.39 $48.50 72130 S Contrast CAT scans of thorax 0283 4.89 $242.52 $179.39 $48.50 72131 S CAT scan of lower spine 0283 4.89 $242.52 $179.39 $48.50 72132 S Contrast CAT of lower spine 0283 4.89 $242.52 $179.39 $48.50 72133 S Contrst cat scans, low spine 0283 4.89 $242.52 $179.39 $48.50 72141 S Magnetic image, neck spine 0284 8.02 $397.76 $257.39 $79.55 72142 S Magnetic image, neck spine 0284 8.02 $397.76 $257.39 $79.55 72146 S Magnetic image, chest spine 0284 8.02 $397.76 $257.39 $79.55 72147 S Magnetic image, chest spine 0284 8.02 $397.76 $257.39 $79.55 72148 S Magnetic image, lumbar spine 0284 8.02 $397.76 $257.39 $79.55 72149 S Magnetic image, lumbar spine 0284 8.02 $397.76 $257.39 $79.55 72156 S Magnetic image, neck spine 0284 8.02 $397.76 $257.39 $79.55 72157 S Magnetic image, chest spine 0284 8.02 $397.76 $257.39 $79.55 72158 S Magnetic image, lumbar spine 0284 8.02 $397.76 $257.39 $79.55 72159 E Magnetic image, spine
(mra)72170 X X-ray exam of pelvis 0260 0.79 $39.18 $22.02 $7.84 72190 X X-ray exam of pelvis 0260 0.79 $39.18 $22.02 $7.84 *72191 S CT angiograph pelv w/o & w/ dye 0283 4.89 $242.52 $179.39 $48.50 72192 S CAT scan of pelvis 0283 4.89 $242.52 $179.39 $48.50 72193 S Contrast CAT scan of pelvis 0283 4.89 $242.52 $179.39 $48.50 72194 S Contrast CAT scans of pelvis 0283 4.89 $242.52 $179.39 $48.50 *72195 S MRI pelvis w/o dye 0284 8.02 $397.76 $257.39 $79.55 72196 S Magnetic image, pelvis 0284 8.02 $397.76 $257.39 $79.55 *72197 S MRI pelvis w/o & w/ dye 0284 8.02 $397.76 $257.39 $79.55 72198 E Magnetic image, pelvis
(mra)72200 X X-ray exam sacroiliac joints 0260 0.79 $39.18 $22.02 $7.84 72202 X X-ray exam sacroiliac joints 0260 0.79 $39.18 $22.02 $7.84 72220 X X-ray exam of tailbone 0260 0.79 $39.18 $22.02 $7.84 72240 S Contrast x-ray of neck spine 0274 4.83 $239.55 $128.12 $47.91 72255 S Contrast x-ray, thorax spine 0274 4.83 $239.55 $128.12 $47.91 72265 S Contrast x-ray, lower spine 0274 4.83 $239.55 $128.12 $47.91 72270 S Contrast x-ray of spine 0274 4.83 $239.55 $128.12 $47.91 72275 S Epidurography 0274 4.83 $239.55 $128.12 $47.91 72285 S X-ray c/t spine disk 0274 4.83 $239.55 $128.12 $47.91 72295 S X-ray of lower spine disk 0274 4.83 $239.55 $128.12 $47.91 73000 X X-ray exam of collar bone 0260 0.79 $39.18 $22.02 $7.84 73010 X X-ray exam of shoulder blade 0260 0.79 $39.18 $22.02 $7.84 73020 X X-ray exam of shoulder 0260 0.79 $39.18 $22.02 $7.84 73030 X X-ray exam of shoulder 0260 0.79 $39.18 $22.02 $7.84 73040 S Contrast x-ray of shoulder 0275 2.74 $135.89 $72.26 $27.18 73050 X X-ray exam of shoulders 0260 0.79 $39.18 $22.02 $7.84 73060 X X-ray exam of humerus 0260 0.79 $39.18 $22.02 $7.84 73070 X X-ray exam of elbow 0260 0.79 $39.18 $22.02 $7.84 73080 X X-ray exam of elbow 0260 0.79 $39.18 $22.02 $7.84 73085 S Contrast x-ray of elbow 0275 2.74 $135.89 $72.26 $27.18 73090 X X-ray exam of forearm 0260 0.79 $39.18 $22.02 $7.84 73092 X X-ray exam of arm, infant 0260 0.79 $39.18 $22.02 $7.84 73100 X X-ray exam of wrist 0260 0.79 $39.18 $22.02 $7.84 73110 X X-ray exam of wrist 0260 0.79 $39.18 $22.02 $7.84 73115 S Contrast x-ray of wrist 0275 2.74 $135.89 $72.26 $27.18 73120 X X-ray exam of hand 0260 0.79 $39.18 $22.02 $7.84 73130 X X-ray exam of hand 0260 0.79 $39.18 $22.02 $7.84 73140 X X-ray exam of finger(s) 0260 0.79 $39.18 $22.02 $7.84 73200 S CAT scan of arm 0283 4.89 $242.52 $179.39 $48.50 73201 S Contrast CAT scan of arm 0283 4.89 $242.52 $179.39 $48.50 73202 S Contrast CAT scans of arm 0283 4.89 $242.52 $179.39 $48.50 *73206 S CT angio upr extrm w/o & w/ dye 0283 4.89 $242.52 $179.39 $48.50 *73218 S MRI upper extrm w/o dye 0284 8.02 $397.76 $257.39 $79.55 *73219 S MRI upper extrm w/ dye 0284 8.02 $397.76 $257.39 $79.55 73220 S Magnetic image, arm/hand 0284 8.02 $397.76 $257.39 $79.55 73221 S Magnetic image, joint of arm 0284 8.02 $397.76 $257.39 $79.55 *73222 S MRI joint upr extrm w/ dye 0284 8.02 $397.76 $257.39 $79.55 *73223 S MRI joint upr extrm w/o & w/ dye 0284 8.02 $397.76 $257.39 $79.55 73225 E Magnetic image, upper
(mra)73500 X X-ray exam of hip 0260 0.79 $39.18 $22.02 $7.84 73510 X X-ray exam of hip 0260 0.79 $39.18 $22.02 $7.84 73520 X X-ray exam of hips 0260 0.79 $39.18 $22.02 $7.84 73525 S Contrast x-ray of hip 0275 2.74 $135.89 $72.26 $27.18 73530 X X-ray exam of hip 0261 1.38 $68.44 $38.77 $13.69 73540 X X-ray exam of pelvis & hips 0260 0.79 $39.18 $22.02 $7.84 73542 S X-ray exam, sacroiliac joint 0275 2.74 $135.89 $72.26 $27.18 73550 X X-ray exam of thigh 0260 0.79 $39.18 $22.02 $7.84 73560 X X-ray exam of knee, 1 or 2 0260 0.79 $39.18 $22.02 $7.84 73562 X X-ray exam of knee, 3 0260 0.79 $39.18 $22.02 $7.84 73564 X X-ray exam, knee, 4 or more 0260 0.79 $39.18 $22.02 $7.84 73565 X X-ray exam of knees 0260 0.79 $39.18 $22.02 $7.84 73580 S Contrast x-ray of knee joint 0275 2.74 $135.89 $72.26 $27.18 73590 X X-ray exam of lower leg 0260 0.79 $39.18 $22.02 $7.84 73592 X X-ray exam of leg, infant 0261 1.38 $68.44 $38.77 $13.69 73600 X X-ray exam of ankle 0260 0.79 $39.18 $22.02 $7.84 73610 X X-ray exam of ankle 0260 0.79 $39.18 $22.02 $7.84 73615 S Contrast x-ray of ankle 0275 2.74 $135.89 $72.26 $27.18 73620 X X-ray exam of foot 0260 0.79 $39.18 $22.02 $7.84 73630 X X-ray exam of foot 0260 0.79 $39.18 $22.02 $7.84 73650 X X-ray exam of heel 0260 0.79 $39.18 $22.02 $7.84 73660 X X-ray exam of toe(s) 0260 0.79 $39.18 $22.02 $7.84 73700 S CAT scan of leg 0283 4.89 $242.52 $179.39 $48.50 73701 S Contrast CAT scan of leg 0283 4.89 $242.52 $179.39 $48.50 73702 S Contrast CAT scans of leg 0283 4.89 $242.52 $179.39 $48.50 *73706 S CT angio lwr extr w/o & w/ dye 0283 4.89 $242.52 $179.39 $48.50 *73718 S MRI lower extrem w/o dye 0284 8.02 $397.76 $257.39 $79.55 *73719 S MRI lower extrem w/ dye 0284 8.02 $397.76 $257.39 $79.55 73720 S Magnetic image, leg/foot 0284 8.02 $397.76 $257.39 $79.55 73721 S Magnetic image, joint of leg 0284 8.02 $397.76 $257.39 $79.55 *73722 S MRI joint lwr extrm w/ dye 0284 8.02 $397.76 $257.39 $79.55 *73723 S MRI joint lwr extrm w/o & w/ dye 0284 8.02 $397.76 $257.39 $79.55 73725 S Magnetic image/lower
(mra)0284 8.02 $397.76 $257.39 $79.55 74000 X X-ray exam of abdomen 0260 0.79 $39.18 $22.02 $7.84 74010 X X-ray exam of abdomen 0260 0.79 $39.18 $22.02 $7.84 74020 X X-ray exam of abdomen 0260 0.79 $39.18 $22.02 $7.84 74022 X X-ray exam series, abdomen 0261 1.38 $68.44 $38.77 $13.69 74150 S CAT scan of abdomen 0283 4.89 $242.52 $179.39 $48.50 74160 S Contrast CAT scan of abdomen 0283 4.89 $242.52 $179.39 $48.50 74170 S Contrast CAT scans, abdomen 0283 4.89 $242.52 $179.39 $48.50 *74175 S CT angio abdom w/o & w/ dye 0283 4.89 $242.52 $179.39 $48.50 74181 S Magnetic image/abdomen
(mri)0284 8.02 $397.76 $257.39 $79.55 *74182 S MRI abdomen w/ dye 0284 8.02 $397.76 $257.39 $79.55 *74183 S MRI abdomen w/o & w/ dye 0284 8.02 $397.76 $257.39 $79.55 74185 S Magnetic image/abdomen
(MRA)0284 8.02 $397.76 $257.39 $79.55 74190 X X-ray exam of peritoneum 0263 1.68 $83.32 $45.88 $16.66 74210 S Contrst x-ray exam of throat 0276 1.79 $88.78 $49.78 $17.76 74220 S Contrast x-ray, esophagus 0276 1.79 $88.78 $49.78 $17.76 74230 S Cinema x-ray, throat/esoph 0276 1.79 $88.78 $49.78 $17.76 74235 S Remove esophagus obstruction 0296 3.57 $177.06 $100.25 $35.41 74240 S X-ray exam, upper gi tract 0276 1.79 $88.78 $49.78 $17.76 74241 S X-ray exam, upper gi tract 0276 1.79 $88.78 $49.78 $17.76 74245 S X-ray exam, upper gi tract 0277 2.47 $122.50 $69.28 $24.50 74246 S Contrst x-ray uppr gi tract 0276 1.79 $88.78 $49.78 $17.76 74247 S Contrst x-ray uppr gi tract 0276 1.79 $88.78 $49.78 $17.76 74249 S Contrst x-ray uppr gi tract 0277 2.47 $122.50 $69.28 $24.50 74250 S X-ray exam of small bowel 0276 1.79 $88.78 $49.78 $17.76 74251 S X-ray exam of small bowel 0277 2.47 $122.50 $69.28 $24.50 74260 S X-ray exam of small bowel 0277 2.47 $122.50 $69.28 $24.50 74270 S Contrast x-ray exam of colon 0276 1.79 $88.78 $49.78 $17.76 74280 S Contrast x-ray exam of colon 0277 2.47 $122.50 $69.28 $24.50 74283 S Contrast x-ray exam of colon 0276 1.79 $88.78 $49.78 $17.76 74290 S Contrast x-ray, gallbladder 0276 1.79 $88.78 $49.78 $17.76 74291 S Contrast x-rays, gallbladder 0276 1.79 $88.78 $49.78 $17.76 74300 X X-ray bile ducts/pancreas 0263 1.68 $83.32 $45.88 $16.66 74301 X X-rays at surgery add-on 0263 1.68 $83.32 $45.88 $16.66 74305 X X-ray bile ducts/pancreas 0263 1.68 $83.32 $45.88 $16.66 74320 X Contrast x-ray of bile ducts 0264 3.83 $189.96 $108.97 $37.99 74327 S X-ray bile stone removal 0296 3.57 $177.06 $100.25 $35.41 74328 X Xray bile duct endoscopy 0264 3.83 $189.96 $108.97 $37.99 74329 X X-ray for pancreas endoscopy 0264 3.83 $189.96 $108.97 $37.99 74330 X X-ray bile/panc endoscopy 0264 3.83 $189.96 $108.97 $37.99 74340 X X-ray guide for GI tube 0272 1.40 $69.43 $39.00 $13.89 74350 X X-ray guide, stomach tube 0264 3.83 $189.96 $108.97 $37.99 74355 X X-ray guide, intestinal tube 0264 3.83 $189.96 $108.97 $37.99 74360 S X-ray guide, GI dilation 0296 3.57 $177.06 $100.25 $35.41 74363 S X-ray, bile duct dilation 0297 6.13 $304.03 $172.51 $60.81 74400 S Contrst x-ray, urinary tract 0278 2.85 $141.35 $81.67 $28.27 74410 S Contrst x-ray, urinary tract 0278 2.85 $141.35 $81.67 $28.27 74415 S Contrst x-ray, urinary tract 0278 2.85 $141.35 $81.67 $28.27 74420 S Contrst x-ray, urinary tract 0278 2.85 $141.35 $81.67 $28.27 74425 S Contrst x-ray, urinary tract 0278 2.85 $141.35 $81.67 $28.27 74430 S Contrast x-ray, bladder 0278 2.85 $141.35 $81.67 $28.27 74440 S X-ray, male genital tract 0278 2.85 $141.35 $81.67 $28.27 74445 S X-ray exam of penis 0278 2.85 $141.35 $81.67 $28.27 74450 S X-ray, urethra/bladder 0278 2.85 $141.35 $81.67 $28.27 74455 S X-ray, urethra/bladder 0278 2.85 $141.35 $81.67 $28.27 74470 X X-ray exam of kidney lesion 0264 3.83 $189.96 $108.97 $37.99 74475 S X-ray control, cath insert 0297 6.13 $304.03 $172.51 $60.81 74480 S X-ray control, cath insert 0297 6.13 $304.03 $172.51 $60.81 74485 S X-ray guide, GU dilation 0296 3.57 $177.06 $100.25 $35.41 74710 X X-ray measurement of pelvis 0260 0.79 $39.18 $22.02 $7.84 74740 X X-ray, female genital tract 0264 3.83 $189.96 $108.97 $37.99 74742 X X-ray, fallopian tube 0264 3.83 $189.96 $108.97 $37.99 74775 S X-ray exam of perineum 0278 2.85 $141.35 $81.67 $28.27 75552 S Magnetic image, myocardium 0284 8.02 $397.76 $257.39 $79.55 75553 S Magnetic image, myocardium 0284 8.02 $397.76 $257.39 $79.55 75554 S Cardiac MRI/function 0284 8.02 $397.76 $257.39 $79.55 75555 S Cardiac MRI/limited study 0284 8.02 $397.76 $257.39 $79.55 75556 E Cardiac MRI/flow mapping 75600 S Contrast x-ray exam of aorta 0280 14.98 $742.95 $380.12 $148.59 75605 S Contrast x-ray exam of aorta 0280 14.98 $742.95 $380.12 $148.59 75625 S Contrast x-ray exam of aorta 0280 14.98 $742.95 $380.12 $148.59 75630 S X-ray aorta, leg arteries 0280 14.98 $742.95 $380.12 $148.59 *75635 S CT angio abdominal arteries 0283 4.89 $242.52 $179.39 $48.50 75650 S Artery x-rays, head & neck 0280 14.98 $742.95 $380.12 $148.59 75658 S Artery x-rays, arm 0280 14.98 $742.95 $380.12 $148.59 75660 S Artery x-rays, head & neck 0279 6.30 $312.46 $174.57 $62.49 75662 S Artery x-rays, head & neck 0279 6.30 $312.46 $174.57 $62.49 75665 S Artery x-rays, head & neck 0280 14.98 $742.95 $380.12 $148.59 75671 S Artery x-rays, head & neck 0280 14.98 $742.95 $380.12 $148.59 75676 S Artery x-rays, neck 0280 14.98 $742.95 $380.12 $148.59 75680 S Artery x-rays, neck 0280 14.98 $742.95 $380.12 $148.59 75685 S Artery x-rays, spine 0279 6.30 $312.46 $174.57 $62.49 75705 S Artery x-rays, spine 0279 6.30 $312.46 $174.57 $62.49 75710 S Artery x-rays, arm/leg 0280 14.98 $742.95 $380.12 $148.59 75716 S Artery x-rays, arms/legs 0280 14.98 $742.95 $380.12 $148.59 75722 S Artery x-rays, kidney 0280 14.98 $742.95 $380.12 $148.59 75724 S Artery x-rays, kidneys 0280 14.98 $742.95 $380.12 $148.59 75726 S Artery x-rays, abdomen 0280 14.98 $742.95 $380.12 $148.59 75731 S Artery x-rays, adrenal gland 0280 14.98 $742.95 $380.12 $148.59 75733 S Artery x-rays, adrenals 0280 14.98 $742.95 $380.12 $148.59 75736 S Artery x-rays, pelvis 0280 14.98 $742.95 $380.12 $148.59 75741 S Artery x-rays, lung 0279 6.30 $312.46 $174.57 $62.49 75743 S Artery x-rays, lungs 0280 14.98 $742.95 $380.12 $148.59 75746 S Artery x-rays, lung 0279 6.30 $312.46 $174.57 $62.49 75756 S Artery x-rays, chest 0279 6.30 $312.46 $174.57 $62.49 75774 S Artery x-ray, each vessel 0280 14.98 $742.95 $380.12 $148.59 75790 S Visualize A-V shunt 0281 4.40 $218.22 $115.16 $43.64 75801 X Lymph vessel x-ray, arm/leg 0264 3.83 $189.96 $108.97 $37.99 75803 X Lymph vessel x-ray,arms/legs 0264 3.83 $189.96 $108.97 $37.99 75805 X Lymph vessel x-ray, trunk 0264 3.83 $189.96 $108.97 $37.99 75807 X Lymph vessel x-ray, trunk 0264 3.83 $189.96 $108.97 $37.99 75809 X Nonvascular shunt, x-ray 0264 3.83 $189.96 $108.97 $37.99 75810 S Vein x-ray, spleen/liver 0279 6.30 $312.46 $174.57 $62.49 75820 S Vein x-ray, arm/leg 0281 4.40 $218.22 $115.16 $43.64 75822 S Vein x-ray, arms/legs 0281 4.40 $218.22 $115.16 $43.64 75825 S Vein x-ray, trunk 0279 6.30 $312.46 $174.57 $62.49 75827 S Vein x-ray, chest 0279 6.30 $312.46 $174.57 $62.49 75831 S Vein x-ray, kidney 0279 6.30 $312.46 $174.57 $62.49 75833 S Vein x-ray, kidneys 0279 6.30 $312.46 $174.57 $62.49 75840 S Vein x-ray, adrenal gland 0279 6.30 $312.46 $174.57 $62.49 75842 S Vein x-ray, adrenal glands 0279 6.30 $312.46 $174.57 $62.49 75860 S Vein x-ray, neck 0279 6.30 $312.46 $174.57 $62.49 75870 S Vein x-ray, skull 0279 6.30 $312.46 $174.57 $62.49 75872 S Vein x-ray, skull 0279 6.30 $312.46 $174.57 $62.49 75880 S Vein x-ray, eye socket 0279 6.30 $312.46 $174.57 $62.49 75885 S Vein x-ray, liver 0279 6.30 $312.46 $174.57 $62.49 75887 S Vein x-ray, liver 0280 14.98 $742.95 $380.12 $148.59 75889 S Vein x-ray, liver 0279 6.30 $312.46 $174.57 $62.49 75891 S Vein x-ray, liver 0279 6.30 $312.46 $174.57 $62.49 75893 N Venous sampling by catheter 75894 S X-rays, transcath therapy 0297 6.13 $304.03 $172.51 $60.81 75896 S X-rays, transcath therapy 0297 6.13 $304.03 $172.51 $60.81 75898 X Follow-up angiogram 0264 3.83 $189.96 $108.97 $37.99 75900 C Arterial catheter exchange 75940 X X-ray placement, vein filter 0264 3.83 $189.96 $108.97 $37.99 75945 S Intravascular us 0267 2.72 $134.90 $80.06 $26.98 75946 S Intravascular us add-on 0267 2.72 $134.90 $80.06 $26.98 *75952 C Abdom aneurysm endovas repr *75953 C Abdom aneurysm endovas repr 75960 S Transcatheter intro, stent 0279 6.30 $312.46 $174.57 $62.49 75961 S Retrieval, broken catheter 0279 6.30 $312.46 $174.57 $62.49 75962 S Repair arterial blockage 0280 14.98 $742.95 $380.12 $148.59 75964 S Repair artery blockage, each 0279 6.30 $312.46 $174.57 $62.49 75966 S Repair arterial blockage 0280 14.98 $742.95 $380.12 $148.59 75968 S Repair artery blockage, each 0279 6.30 $312.46 $174.57 $62.49 75970 S Vascular biopsy 0279 6.30 $312.46 $174.57 $62.49 75978 S Repair venous blockage 0279 6.30 $312.46 $174.57 $62.49 75980 S Contrast xray exam bile duct 0297 6.13 $304.03 $172.51 $60.81 75982 S Contrast xray exam bile duct 0297 6.13 $304.03 $172.51 $60.81 75984 S Xray control catheter change 0296 3.57 $177.06 $100.25 $35.41 75989 X Abscess drainage under x-ray 0273 2.49 $123.49 $61.02 $24.70 75992 S Atherectomy, x-ray exam 0279 6.30 $312.46 $174.57 $62.49 75993 T Atherectomy, x-ray exam 0081 28.81 $1,428.86 $710.91 $285.77 75994 T Atherectomy, x-ray exam 0081 28.81 $1,428.86 $710.91 $285.77 75995 S Atherectomy, x-ray exam 0279 6.30 $312.46 $174.57 $62.49 75996 T Atherectomy, x-ray exam 0081 28.81 $1,428.86 $710.91 $285.77 76000 X Fluoroscope examination 0272 1.40 $69.43 $39.00 $13.89 76001 X Fluoroscope exam, extensive 0273 2.49 $123.49 $61.02 $24.70 76003 X Needle localization by x-ray 0272 1.40 $69.43 $39.00 $13.89 76005 X Fluoroguide for spine inject 0273 2.49 $123.49 $61.02 $24.70 76006 X X-ray stress view 0261 1.38 $68.44 $38.77 $13.69 76010 X X-ray, nose to rectum 0260 0.79 $39.18 $22.02 $7.84 *76012 S Percut vertebroplasty fluor 0274 4.83 $239.55 $128.12 $47.91 *76013 S Percut vertebroplasty CT 0274 4.83 $239.55 $128.12 $47.91 76020 X X-rays for bone age 0261 1.38 $68.44 $38.77 $13.69 76040 X X-rays, bone evaluation 0260 0.79 $39.18 $22.02 $7.84 76061 X X-rays, bone survey 0261 1.38 $68.44 $38.77 $13.69 76062 X X-rays, bone survey 0261 1.38 $68.44 $38.77 $13.69 76065 X X-rays, bone evaluation 0261 1.38 $68.44 $38.77 $13.69 76066 X Joint(s) survey, single film 0260 0.79 $39.18 $22.02 $7.84 76070 E CT scan, bone density study 76075 S Dual energy x-ray study 0971 1.55 $76.88 $15.38 76076 T Dual energy x-ray study 0970 0.52 $25.79 $5.16 76078 X Photodensitometry 0261 1.38 $68.44 $38.77 $13.69 76080 X X-ray exam of fistula 0263 1.68 $83.32 $45.88 $16.66 76086 X X-ray of mammary duct 0263 1.68 $83.32 $45.88 $16.66 76088 X X-ray of mammary ducts 0263 1.68 $83.32 $45.88 $16.66 76090 S Mammogram, one breast 0271 0.70 $34.72 $19.50 $6.94 76091 S Mammogram, both breasts 0271 0.70 $34.72 $19.50 $6.94 76092 A Mammogram, screening 76093 S Magnetic image, breast 0284 8.02 $397.76 $257.39 $79.55 76094 S Magnetic image, both breasts 0284 8.02 $397.76 $257.39 $79.55 76095 X Stereotactic breast biopsy 0264 3.83 $189.96 $108.97 $37.99 76096 X X-ray of needle wire, breast 0263 1.68 $83.32 $45.88 $16.66 76098 X X-ray exam, breast specimen 0260 0.79 $39.18 $22.02 $7.84 76100 X X-ray exam of body section 0261 1.38 $68.44 $38.77 $13.69 76101 X Complex body section x-ray 0263 1.68 $83.32 $45.88 $16.66 76102 X Complex body section x-rays 0264 3.83 $189.96 $108.97 $37.99 76120 X Cinematic x-rays 0261 1.38 $68.44 $38.77 $13.69 76125 X Cinematic x-rays add-on 0261 1.38 $68.44 $38.77 $13.69 76140 E X-ray consultation 76150 X X-ray exam, dry process 0260 0.79 $39.18 $22.02 $7.84 76350 N Special x-ray contrast study 76355 S CAT scan for localization 0283 4.89 $242.52 $179.39 $48.50 76360 S CAT scan for needle biopsy 0283 4.89 $242.52 $179.39 $48.50 76365D S CAT scan for cyst aspiration 0283 4.89 $242.52 $179.39 $48.50 76370 S CAT scan for therapy guide 0282 2.38 $118.04 $94.51 $23.61 76375 S 3d/holograph reconstr add-on 0282 2.38 $118.04 $94.51 $23.61 76380 S CAT scan follow-up study 0282 2.38 $118.04 $94.51 $23.61 76390 S Mr spectroscopy 0284 8.02 $397.76 $257.39 $79.55 *76393 X MR guidance for needle place 0273 2.49 $123.49 $61.02 $24.70 76400 S Magnetic image, bone marrow 0284 8.02 $397.76 $257.39 $79.55 76499 X Radiographic procedure 0260 0.79 $39.18 $22.02 $7.84 76506 S Echo exam of head 0266 1.79 $88.78 $57.35 $17.76 76511 S Echo exam of eye 0266 1.79 $88.78 $57.35 $17.76 76512 S Echo exam of eye 0266 1.79 $88.78 $57.35 $17.76 76513 S Echo exam of eye, water bath 0265 1.17 $58.03 $38.08 $11.61 76516 S Echo exam of eye 0266 1.79 $88.78 $57.35 $17.76 76519 S Echo exam of eye 0266 1.79 $88.78 $57.35 $17.76 76529 S Echo exam of eye 0265 1.17 $58.03 $38.08 $11.61 76536 S Echo exam of head and neck 0265 1.17 $58.03 $38.08 $11.61 76604 S Echo exam of chest 0266 1.79 $88.78 $57.35 $17.76 76645 S Echo exam of breast(s) 0265 1.17 $58.03 $38.08 $11.61 76700 S Echo exam of abdomen 0266 1.79 $88.78 $57.35 $17.76 76705 S Echo exam of abdomen 0266 1.79 $88.78 $57.35 $17.76 76770 S Echo exam abdomen back wall 0266 1.79 $88.78 $57.35 $17.76 76775 S Echo exam abdomen back wall 0266 1.79 $88.78 $57.35 $17.76 76778 S Echo exam kidney transplant 0266 1.79 $88.78 $57.35 $17.76 76800 S Echo exam spinal canal 0266 1.79 $88.78 $57.35 $17.76 76805 S Echo exam of pregnant uterus 0266 1.79 $88.78 $57.35 $17.76 76810 S Echo exam of pregnant uterus 0265 1.17 $58.03 $38.08 $11.61 76815 S Echo exam of pregnant uterus 0265 1.17 $58.03 $38.08 $11.61 76816 S Echo exam follow-up/repeat 0265 1.17 $58.03 $38.08 $11.61 76818 S Fetal biophysical profile 0266 1.79 $88.78 $57.35 $17.76 *76819 S Fetl biophys profil w/o stress 0266 1.79 $88.78 $57.35 $17.76 76825 S Echo exam of fetal heart 0269 4.40 $218.22 $114.01 $43.64 76826 S Echo exam of fetal heart 0269 4.40 $218.22 $114.01 $43.64 76827 S Echo exam of fetal heart 0269 4.40 $218.22 $114.01 $43.64 76828 S Echo exam of fetal heart 0269 4.40 $218.22 $114.01 $43.64 76830 S Echo exam, transvaginal 0266 1.79 $88.78 $57.35 $17.76 76831 S Echo exam, uterus 0266 1.79 $88.78 $57.35 $17.76 76856 S Echo exam of pelvis 0266 1.79 $88.78 $57.35 $17.76 76857 S Echo exam of pelvis 0265 1.17 $58.03 $38.08 $11.61 76870 S Echo exam of scrotum 0266 1.79 $88.78 $57.35 $17.76 76872 S Echo exam, transrectal 0266 1.79 $88.78 $57.35 $17.76 76873 S Echograp trans r, pros study 0266 1.79 $88.78 $57.35 $17.76 76880 S Echo exam of extremity 0266 1.79 $88.78 $57.35 $17.76 76885 S Echo exam, infant hips 0266 1.79 $88.78 $57.35 $17.76 76886 S Echo exam, infant hips 0266 1.79 $88.78 $57.35 $17.76 76930 X Echo guide for heart sac tap 0268 2.23 $110.60 $69.51 $22.12 76932 X Echo guide for heart biopsy 0268 2.23 $110.60 $69.51 $22.12 76934D X Echo guide for chest tap 0268 2.23 $110.60 $69.51 $22.12 76936 X Echo guide for artery repair 0268 2.23 $110.60 $69.51 $22.12 76938D X Echo exam for drainage 0268 2.23 $110.60 $69.51 $22.12 76941 X Echo guide for transfusion 0268 2.23 $110.60 $69.51 $22.12 76942 X Echo guide for biopsy 0268 2.23 $110.60 $69.51 $22.12 76945 X Echo guide, villus sampling 0268 2.23 $110.60 $69.51 $22.12 76946 X Echo guide for amniocentesis 0268 2.23 $110.60 $69.51 $22.12 76948 X Echo guide, ova aspiration 0268 2.23 $110.60 $69.51 $22.12 76950 X Echo guidance radiotherapy 0268 2.23 $110.60 $69.51 $22.12 76960D X Echo guidance radiotherapy 0268 2.23 $110.60 $69.51 $22.12 76965 X Echo guidance radiotherapy 0268 2.23 $110.60 $69.51 $22.12 76970 S Ultrasound exam follow-up 0265 1.17 $58.03 $38.08 $11.61 76975 S GI endoscopic ultrasound 0266 1.79 $88.78 $57.35 $17.76 76977 S Us bone density measure 0265 1.17 $58.03 $38.08 $11.61 76986 S Echo exam at surgery 0266 1.79 $88.78 $57.35 $17.76 76999 S Echo examination procedure 0266 1.79 $88.78 $57.35 $17.76 77261 E Radiation therapy planning 77262 E Radiation therapy planning 77263 E Radiation therapy planning 77280 X Set radiation therapy field 0304 1.49 $73.90 $41.52 $14.78 77285 X Set radiation therapy field 0305 4.06 $201.36 $97.50 $40.27 77290 X Set radiation therapy field 0305 4.06 $201.36 $97.50 $40.27 77295 X Set radiation therapy field 0310 13.98 $693.35 $339.05 $138.67 77299 E Radiation therapy planning 77300 X Radiation therapy dose plan 0304 1.49 $73.90 $41.52 $14.78 77305 X Radiation therapy dose plan 0304 1.49 $73.90 $41.52 $14.78 77310 X Radiation therapy dose plan 0304 1.49 $73.90 $41.52 $14.78 77315 X Radiation therapy dose plan 0305 4.06 $201.36 $97.50 $40.27 77321 X Radiation therapy port plan 0305 4.06 $201.36 $97.50 $40.27 77326 X Radiation therapy dose plan 0305 4.06 $201.36 $97.50 $40.27 77327 X Radiation therapy dose plan 0305 4.06 $201.36 $97.50 $40.27 77328 X Radiation therapy dose plan 0305 4.06 $201.36 $97.50 $40.27 77331 X Special radiation dosimetry 0304 1.49 $73.90 $41.52 $14.78 77332 X Radiation treatment aid(s) 0303 2.83 $140.36 $69.28 $28.07 77333 X Radiation treatment aid(s) 0303 2.83 $140.36 $69.28 $28.07 77334 X Radiation treatment aid(s) 0303 2.83 $140.36 $69.28 $28.07 77336 X Radiation physics consult 0311 1.32 $65.46 $31.66 $13.09 77370 X Radiation physics consult 0311 1.32 $65.46 $31.66 $13.09 77399 X External radiation dosimetry 0311 1.32 $65.46 $31.66 $13.09 77401 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77402 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77403 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77404 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77406 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77407 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77408 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77409 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77411 S Radiation treatment delivery 0301 2.21 $109.61 $52.53 $21.92 77412 S Radiation treatment delivery 0301 2.21 $109.61 $52.53 $21.92 77413 S Radiation treatment delivery 0301 2.21 $109.61 $52.53 $21.92 77414 S Radiation treatment delivery 0300 1.98 $98.20 $47.72 $19.64 77416 S Radiation treatment delivery 0301 2.21 $109.61 $52.53 $21.92 77417 X Radiology port film(s) 0260 0.79 $39.18 $22.02 $7.84 77427 E Radiation tx management, x5 77431 E Radiation therapy management 77432 E Stereotactic radiation trmt 77470 S Special radiation treatment 0302 8.21 $407.18 $216.55 $81.44 77499 E Radiation therapy management 77520 S Proton beam delivery 0974 8.25 $409.17 $81.83 *77522 S Proton trmt, simple w/ comp 0974 8.25 $409.17 $81.83 77523 S Proton beam delivery 0976 18.05 $895.21 $179.04 *77525 S Proton treatment, complex 0976 18.05 $895.21 $179.04 77600 S Hyperthermia treatment 0314 5.88 $291.62 $150.95 $58.32 77605 S Hyperthermia treatment 0314 5.88 $291.62 $150.95 $58.32 77610 S Hyperthermia treatment 0314 5.88 $291.62 $150.95 $58.32 77615 S Hyperthermia treatment 0314 5.88 $291.62 $150.95 $58.32 77620 S Hyperthermia treatment 0314 5.88 $291.62 $150.95 $58.32 77750 S Infuse radioactive materials 0301 2.21 $109.61 $52.53 $21.92 77761 S Radioelement application 0312 4.09 $202.85 $109.65 $40.57 77762 S Radioelement application 0312 4.09 $202.85 $109.65 $40.57 77763 S Radioelement application 0312 4.09 $202.85 $109.65 $40.57 77776 S Radioelement application 0312 4.09 $202.85 $109.65 $40.57 77777 S Radioelement application 0312 4.09 $202.85 $109.65 $40.57 77778 S Radioelement application 0312 4.09 $202.85 $109.65 $40.57 77781 S High intensity brachytherapy 0313 7.89 $391.31 $164.02 $78.26 77782 S High intensity brachytherapy 0313 7.89 $391.31 $164.02 $78.26 77783 S High intensity brachytherapy 0313 7.89 $391.31 $164.02 $78.26 77784 S High intensity brachytherapy 0313 7.89 $391.31 $164.02 $78.26 77789 S Radioelement application 0300 1.98 $98.20 $47.72 $19.64 77790 N Radioelement handling 77799 S Radium/radioisotope therapy 0313 7.89 $391.31 $164.02 $78.26 78000 S Thyroid, single uptake 0290 1.94 $96.21 $55.51 $19.24 78001 S Thyroid, multiple uptakes 0290 1.94 $96.21 $55.51 $19.24 78003 S Thyroid suppress/stimul 0290 1.94 $96.21 $55.51 $19.24 78006 S Thyroid imaging with uptake 0291 3.15 $156.22 $93.14 $31.24 78007 S Thyroid image, mult uptakes 0291 3.15 $156.22 $93.14 $31.24 78010 S Thyroid imaging 0290 1.94 $96.21 $55.51 $19.24 78011 S Thyroid imaging with flow 0290 1.94 $96.21 $55.51 $19.24 78015 S Thyroid met imaging 0291 3.15 $156.22 $93.14 $31.24 78016 S Thyroid met imaging/studies 0292 4.36 $216.24 $126.63 $43.25 78018 S Thyroid met imaging, body 0292 4.36 $216.24 $126.63 $43.25 78020 S Thyroid met uptake 0292 4.36 $216.24 $126.63 $43.25 78070 S Parathyroid nuclear imaging 0292 4.36 $216.24 $126.63 $43.25 78075 S Adrenal nuclear imaging 0292 4.36 $216.24 $126.63 $43.25 78099 S Endocrine nuclear procedure 0290 1.94 $96.21 $55.51 $19.24 78102 S Bone marrow imaging, ltd 0291 3.15 $156.22 $93.14 $31.24 78103 S Bone marrow imaging, mult 0292 4.36 $216.24 $126.63 $43.25 78104 S Bone marrow imaging, body 0292 4.36 $216.24 $126.63 $43.25 78110 S Plasma volume, single 0291 3.15 $156.22 $93.14 $31.24 78111 S Plasma volume, multiple 0291 3.15 $156.22 $93.14 $31.24 78120 S Red cell mass, single 0291 3.15 $156.22 $93.14 $31.24 78121 S Red cell mass, multiple 0291 3.15 $156.22 $93.14 $31.24 78122 S Blood volume 0292 4.36 $216.24 $126.63 $43.25 78130 S Red cell survival study 0292 4.36 $216.24 $126.63 $43.25 78135 S Red cell survival kinetics 0292 4.36 $216.24 $126.63 $43.25 78140 S Red cell sequestration 0292 4.36 $216.24 $126.63 $43.25 78160 S Plasma iron turnover 0292 4.36 $216.24 $126.63 $43.25 78162 S Iron absorption exam 0292 4.36 $216.24 $126.63 $43.25 78170 S Red cell iron utilization 0292 4.36 $216.24 $126.63 $43.25 78172 S Total body iron estimation 0292 4.36 $216.24 $126.63 $43.25 78185 S Spleen imaging 0291 3.15 $156.22 $93.14 $31.24 78190 S Platelet survival, kinetics 0291 3.15 $156.22 $93.14 $31.24 78191 S Platelet survival 0291 3.15 $156.22 $93.14 $31.24 78195 S Lymph system imaging 0292 4.36 $216.24 $126.63 $43.25 78199 S Blood/lymph nuclear exam 0290 1.94 $96.21 $55.51 $19.24 78201 S Liver imaging 0291 3.15 $156.22 $93.14 $31.24 78202 S Liver imaging with flow 0291 3.15 $156.22 $93.14 $31.24 78205 S Liver imaging
(3D)0292 4.36 $216.24 $126.63 $43.25 78206 S Liver image
(3d)w/flow 0292 4.36 $216.24 $126.63 $43.25 78215 S Liver and spleen imaging 0291 3.15 $156.22 $93.14 $31.24 78216 S Liver & spleen image/flow 0291 3.15 $156.22 $93.14 $31.24 78220 S Liver function study 0292 4.36 $216.24 $126.63 $43.25 78223 S Hepatobiliary imaging 0292 4.36 $216.24 $126.63 $43.25 78230 S Salivary gland imaging 0291 3.15 $156.22 $93.14 $31.24 78231 S Serial salivary imaging 0291 3.15 $156.22 $93.14 $31.24 78232 S Salivary gland function exam 0291 3.15 $156.22 $93.14 $31.24 78258 S Esophageal motility study 0291 3.15 $156.22 $93.14 $31.24 78261 S Gastric mucosa imaging 0291 3.15 $156.22 $93.14 $31.24 78262 S Gastroesophageal reflux exam 0291 3.15 $156.22 $93.14 $31.24 78264 S Gastric emptying study 0292 4.36 $216.24 $126.63 $43.25 78267 A Breath tst attain/anal c-14 78268 A Breath test analysis, c-14 78270 S Vit B-12 absorption exam 0290 1.94 $96.21 $55.51 $19.24 78271 S Vit B-12 absorp exam, IF 0290 1.94 $96.21 $55.51 $19.24 78272 S Vit B-12 absorp, combined 0291 3.15 $156.22 $93.14 $31.24 78278 S Acute GI blood loss imaging 0292 4.36 $216.24 $126.63 $43.25 78282 S GI protein loss exam 0290 1.94 $96.21 $55.51 $19.24 78290 S Meckel's divert exam 0291 3.15 $156.22 $93.14 $31.24 78291 S Leveen/shunt patency exam 0292 4.36 $216.24 $126.63 $43.25 78299 S GI nuclear procedure 0290 1.94 $96.21 $55.51 $19.24 78300 S Bone imaging, limited area 0291 3.15 $156.22 $93.14 $31.24 78305 S Bone imaging, multiple areas 0292 4.36 $216.24 $126.63 $43.25 78306 S Bone imaging, whole body 0292 4.36 $216.24 $126.63 $43.25 78315 S Bone imaging, 3 phase 0292 4.36 $216.24 $126.63 $43.25 78320 S Bone imaging
(3D)0292 4.36 $216.24 $126.63 $43.25 78350 X Bone mineral, single photon 0261 1.38 $68.44 $38.77 $13.69 78351 E Bone mineral, dual photon 78399 S Musculoskeletal nuclear exam 0290 1.94 $96.21 $55.51 $19.24 78414 S Non-imaging heart function 0292 4.36 $216.24 $126.63 $43.25 78428 S Cardiac shunt imaging 0292 4.36 $216.24 $126.63 $43.25 78445 S Vascular flow imaging 0291 3.15 $156.22 $93.14 $31.24 78455 S Venous thrombosis study 0291 3.15 $156.22 $93.14 $31.24 78456 S Acute venous thrombus image 0291 3.15 $156.22 $93.14 $31.24 78457 S Venous thrombosis imaging 0291 3.15 $156.22 $93.14 $31.24 78458 S Ven thrombosis images, bilat 0291 3.15 $156.22 $93.14 $31.24 78459 E Heart muscle imaging
(PET)78460 S Heart muscle blood, single 0286 7.28 $361.06 $200.04 $72.21 78461 S Heart muscle blood, multiple 0286 7.28 $361.06 $200.04 $72.21 78464 S Heart image (3d), single 0286 7.28 $361.06 $200.04 $72.21 78465 S Heart image (3d), multiple 0286 7.28 $361.06 $200.04 $72.21 78466 S Heart infarct image 0292 4.36 $216.24 $126.63 $43.25 78468 S Heart infarct image
(ef)0292 4.36 $216.24 $126.63 $43.25 78469 S Heart infarct image
(3D)0292 4.36 $216.24 $126.63 $43.25 78472 S Gated heart, planar, single 0286 7.28 $361.06 $200.04 $72.21 78473 S Gated heart, multiple 0286 7.28 $361.06 $200.04 $72.21 78478 S Heart wall motion add-on 0286 7.28 $361.06 $200.04 $72.21 78480 S Heart function add-on 0286 7.28 $361.06 $200.04 $72.21 78481 S Heart first pass, single 0286 7.28 $361.06 $200.04 $72.21 78483 S Heart first pass, multiple 0286 7.28 $361.06 $200.04 $72.21 78491 E Heart image (pet), single 78492 E Heart image (pet), multiple 78494 S Heart image, spect 0296 3.57 $177.06 $100.25 $35.41 78496 S Heart first pass add-on 0296 3.57 $177.06 $100.25 $35.41 78499 S Cardiovascular nuclear exam 0292 4.36 $216.24 $126.63 $43.25 78580 S Lung perfusion imaging 0291 3.15 $156.22 $93.14 $31.24 78584 S Lung V/Q image single breath 0292 4.36 $216.24 $126.63 $43.25 78585 S Lung V/Q imaging 0292 4.36 $216.24 $126.63 $43.25 78586 S Aerosol lung image, single 0292 4.36 $216.24 $126.63 $43.25 78587 S Aerosol lung image, multiple 0292 4.36 $216.24 $126.63 $43.25 78588 S Perfusion lung image 0292 4.36 $216.24 $126.63 $43.25 78591 S Vent image, 1 breath, 1 proj 0291 3.15 $156.22 $93.14 $31.24 78593 S Vent image, 1 proj, gas 0292 4.36 $216.24 $126.63 $43.25 78594 S Vent image, mult proj, gas 0292 4.36 $216.24 $126.63 $43.25 78596 S Lung differential function 0292 4.36 $216.24 $126.63 $43.25 78599 S Respiratory nuclear exam 0291 3.15 $156.22 $93.14 $31.24 78600 S Brain imaging, ltd static 0292 4.36 $216.24 $126.63 $43.25 78601 S Brain imaging, ltd w/ flow 0292 4.36 $216.24 $126.63 $43.25 78605 S Brain imaging, complete 0291 3.15 $156.22 $93.14 $31.24 78606 S Brain imaging, compl w/flow 0292 4.36 $216.24 $126.63 $43.25 78607 S Brain imaging
(3D)0292 4.36 $216.24 $126.63 $43.25 78608 E Brain imaging
(PET)78609 E Brain imaging
(PET)78610 S Brain flow imaging only 0291 3.15 $156.22 $93.14 $31.24 78615 S Cerebral blood flow imaging 0292 4.36 $216.24 $126.63 $43.25 78630 S Cerebrospinal fluid scan 0292 4.36 $216.24 $126.63 $43.25 78635 S CSF ventriculography 0292 4.36 $216.24 $126.63 $43.25 78645 S CSF shunt evaluation 0292 4.36 $216.24 $126.63 $43.25 78647 S Cerebrospinal fluid scan 0292 4.36 $216.24 $126.63 $43.25 78650 S CSF leakage imaging 0292 4.36 $216.24 $126.63 $43.25 78660 S Nuclear exam of tear flow 0291 3.15 $156.22 $93.14 $31.24 78699 S Nervous system nuclear exam 0292 4.36 $216.24 $126.63 $43.25 78700 S Kidney imaging, static 0291 3.15 $156.22 $93.14 $31.24 78701 S Kidney imaging with flow 0291 3.15 $156.22 $93.14 $31.24 78704 S Imaging renogram 0292 4.36 $216.24 $126.63 $43.25 78707 S Kidney flow/function image 0292 4.36 $216.24 $126.63 $43.25 78708 S Kidney flow/function image 0292 4.36 $216.24 $126.63 $43.25 78709 S Kidney flow/function image 0292 4.36 $216.24 $126.63 $43.25 78710 S Kidney imaging
(3D)0292 4.36 $216.24 $126.63 $43.25 78715 S Renal vascular flow exam 0291 3.15 $156.22 $93.14 $31.24 78725 S Kidney function study 0291 3.15 $156.22 $93.14 $31.24 78730 S Urinary bladder retention 0291 3.15 $156.22 $93.14 $31.24 78740 S Ureteral reflux study 0291 3.15 $156.22 $93.14 $31.24 78760 S Testicular imaging 0291 3.15 $156.22 $93.14 $31.24 78761 S Testicular imaging/flow 0291 3.15 $156.22 $93.14 $31.24 78799 S Genitourinary nuclear exam 0292 4.36 $216.24 $126.63 $43.25 78800 S Tumor imaging, limited area 0292 4.36 $216.24 $126.63 $43.25 78801 S Tumor imaging, mult areas 0292 4.36 $216.24 $126.63 $43.25 78802 S Tumor imaging, whole body 0292 4.36 $216.24 $126.63 $43.25 78803 S Tumor imaging
(3D)0292 4.36 $216.24 $126.63 $43.25 78805 S Abscess imaging, ltd area 0292 4.36 $216.24 $126.63 $43.25 78806 S Abscess imaging, whole body 0292 4.36 $216.24 $126.63 $43.25 78807 S Nuclear localization/abscess 0292 4.36 $216.24 $126.63 $43.25 78810 E Tumor imaging
(PET)78890 N Nuclear medicine data proc 78891 N Nuclear med data proc 78990 N Provide diag radionuclide(s) 78999 S Nuclear diagnostic exam 0291 3.15 $156.22 $93.14 $31.24 79000 S Init hyperthyroid therapy 0294 5.13 $254.43 $144.06 $50.89 79001 S Repeat hyperthyroid therapy 0294 5.13 $254.43 $144.06 $50.89 79020 S Thyroid ablation 0294 5.13 $254.43 $144.06 $50.89 79030 S Thyroid ablation, carcinoma 0294 5.13 $254.43 $144.06 $50.89 79035 S Thyroid metastatic therapy 0294 5.13 $254.43 $144.06 $50.89 79100 S Hematopoetic nuclear therapy 0294 5.13 $254.43 $144.06 $50.89 79200 S Intracavitary nuclear trmt 0295 19.85 $984.48 $609.17 $196.90 79300 S Interstitial nuclear therapy 0294 5.13 $254.43 $144.06 $50.89 79400 S Nonhemato nuclear therapy 0295 19.85 $984.48 $609.17 $196.90 79420 S Intravascular nuclear ther 0295 19.85 $984.48 $609.17 $196.90 79440 S Nuclear joint therapy 0294 5.13 $254.43 $144.06 $50.89 79900 N Provide ther radiopharm(s) 79999 S Nuclear medicine therapy 0294 5.13 $254.43 $144.06 $50.89 80048 A Basic metabolic panel 80050 A General health panel 80051 A Electrolyte panel 80053 A Comprehen metabolic panel 80055 A Obstetric panel 80061 A Lipid panel 80069 A Renal function panel 80072 A Arthritis panel 80074 A Acute hepatitis panel 80076 A Hepatic function panel 80090 A Torch antibody panel 80100 A Drug screen 80101 A Drug screen 80102 A Drug confirmation 80103 N Drug analysis, tissue prep 80150 A Assay of amikacin 80152 A Assay of amitriptyline 80154 A Assay of benzodiazepines 80156 A Assay of carbamazepine *80157 A Assay of carbamazepine, free 80158 A Assay of cyclosporine 80160 A Assay of desipramine 80162 A Assay of digoxin 80164 A Assay, dipropylacetic acid 80166 A Assay of doxepin 80168 A Assay of ethosuximide 80170 A Assay of gentamicin 80172 A Assay of gold *80173 A Assay of haloperidol 80174 A Assay of imipramine 80176 A Assay of lidocaine 80178 A Assay of lithium 80182 A Assay of nortriptyline 80184 A Assay of phenobarbital 80185 A Assay of phenytoin, total 80186 A Assay of phenytoin, free 80188 A Assay of primidone 80190 A Assay of procainamide 80192 A Assay of procainamide 80194 A Assay of quinidine 80196 A Assay of salicylate 80197 A Assay of tacrolimus 80198 A Assay of theophylline 80200 A Assay of tobramycin 80201 A Assay of topiramate 80202 A Assay of vancomycin 80299 A Quantitative assay, drug 80400 A Acth stimulation panel 80402 A Acth stimulation panel 80406 A Acth stimulation panel 80408 A Aldosterone suppression eval 80410 A Calcitonin stimul panel 80412 A CRH stimulation panel 80414 A Testosterone response 80415 A Estradiol response panel 80416 A Renin stimulation panel 80417 A Renin stimulation panel 80418 A Pituitary evaluation panel 80420 A Dexamethasone panel 80422 A Glucagon tolerance panel 80424 A Glucagon tolerance panel 80426 A Gonadotropin hormone panel 80428 A Growth hormone panel 80430 A Growth hormone panel 80432 A Insulin suppression panel 80434 A Insulin tolerance panel 80435 A Insulin tolerance panel 80436 A Metyrapone panel 80438 A TRH stimulation panel 80439 A TRH stimulation panel 80440 A TRH stimulation panel 80500 X Lab pathology consultation 0343 0.45 $22.32 $12.16 $4.46 80502 X Lab pathology consultation 0343 0.45 $22.32 $12.16 $4.46 81000 A Urinalysis, nonauto w/scope 81001 A Urinalysis, auto w/scope 81002 A Urinalysis nonauto w/o scope 81003 A Urinalysis, auto, w/o scope 81005 A Urinalysis 81007 A Urine screen for bacteria 81015 A Microscopic exam of urine 81020 A Urinalysis, glass test 81025 A Urine pregnancy test 81050 A Urinalysis, volume measure 81099 X Urinalysis test procedure 0349 0.48 $23.65 $4.73 $4.73 82000 A Assay of blood acetaldehyde 82003 A Assay of acetaminophen 82009 A Test for acetone/ketones 82010 A Acetone assay 82013 A Acetylcholinesterase assay 82016 A Acylcarnitines, qual 82017 A Acylcarnitines, quant 82024 A Assay of acth 82030 A Assay of adp & amp 82040 A Assay of serum albumin 82042 A Assay of urine albumin 82043 A Microalbumin, quantitative 82044 A Microalbumin, semiquant 82055 A Assay of ethanol 82075 A Assay of breath ethanol 82085 A Assay of aldolase 82088 A Assay of aldosterone 82101 A Assay of urine alkaloids 82103 A Alpha-1-antitrypsin, total 82104 A Alpha-1-antitrypsin, pheno 82105 A Alpha-fetoprotein, serum 82106 A Alpha-fetoprotein, amniotic 82108 A Assay of aluminum 82120 A Amines, vaginal fluid qual 82127 A Amino acid, single qual 82128 A Amino acids, mult qual 82131 A Amino acids, single quant 82135 A Assay, aminolevulinic acid 82136 A Amino acids, quant, 2-5 82139 A Amino acids, quan, 6 or more 82140 A Assay of ammonia 82143 A Amniotic fluid scan 82145 A Assay of amphetamines 82150 A Assay of amylase 82154 A Androstanediol glucuronide 82157 A Assay of androstenedione 82160 A Assay of androsterone 82163 A Assay of angiotensin II 82164 A Angiotensin I enzyme test 82172 A Assay of apolipoprotein 82175 A Assay of arsenic 82180 A Assay of ascorbic acid 82190 A Atomic absorption 82205 A Assay of barbiturates 82232 A Assay of beta-2 protein 82239 A Bile acids, total 82240 A Bile acids, cholylglycine 82247 A Bilirubin, total 82248 A Bilirubin, direct 82251D A Assay of bilirubin 82252 A Fecal bilirubin test 82261 A Assay of biotinidase 82270 A Test for blood, feces 82273 A Test for blood, other source 82286 A Assay of bradykinin 82300 A Assay of cadmium 82306 A Assay of vitamin D 82307 A Assay of vitamin D 82308 A Assay of calcitonin 82310 A Assay of calcium 82330 A Assay of calcium 82331 A Calcium infusion test 82340 A Assay of calcium in urine 82355 A Calculus (stone) analysis 82360 A Calculus (stone) assay 82365 A Calculus (stone) assay 82370 A X-ray assay, calculus *82373 A Carb deficient transferrin 82374 A Assay, blood carbon dioxide 82375 A Assay, blood carbon monoxide 82376 A Test for carbon monoxide 82378 A Carcinoembryonic antigen 82379 A Assay of carnitine 82380 A Assay of carotene 82382 A Assay, urine catecholamines 82383 A Assay, blood catecholamines 82384 A Assay, three catecholamines 82387 A Assay of cathepsin-d 82390 A Assay of ceruloplasmin 82397 A Chemiluminescent assay 82415 A Assay of chloramphenicol 82435 A Assay of blood chloride 82436 A Assay of urine chloride 82438 A Assay, other fluid chlorides 82441 A Test for chlorohydrocarbons 82465 A Assay of serum cholesterol 82480 A Assay, serum cholinesterase 82482 A Assay, rbc cholinesterase 82485 A Assay, chondroitin sulfate 82486 A Gas/liquid chromatography 82487 A Paper chromatography 82488 A Paper chromatography 82489 A Thin layer chromatography 82491 A Chromotography, quant, sing 82492 A Chromotography, quant, mult 82495 A Assay of chromium 82507 A Assay of citrate 82520 A Assay of cocaine 82523 A Collagen crosslinks 82525 A Assay of copper 82528 A Assay of corticosterone 82530 A Cortisol, free 82533 A Total cortisol 82540 A Assay of creatine 82541 A Column chromotography, qual 82542 A Column chromotography, quant 82543 A Column chromotograph/isotope 82544 A Column chromotograph/isotope 82550 A Assay of ck
(cpk)82552 A Assay of cpk in blood 82553 A Creatine, MB fraction 82554 A Creatine, isoforms 82565 A Assay of creatinine 82570 A Assay of urine creatinine 82575 A Creatinine clearance test 82585 A Assay of cryofibrinogen 82595 A Assay of cryoglobulin 82600 A Assay of cyanide 82607 A Vitamin B-12 82608 A B-12 binding capacity 82615 A Test for urine cystines 82626 A Dehydroepiandrosterone 82627 A Dehydroepiandrosterone 82633 A Desoxycorticosterone 82634 A Deoxycortisol 82638 A Assay of dibucaine number 82646 A Assay of dihydrocodeinone 82649 A Assay of dihydromorphinone 82651 A Assay of dihydrotestosterone 82652 A Assay of dihydroxyvitamin d 82654 A Assay of dimethadione 82657 A Enzyme cell activity 82658 A Enzyme cell activity, ra 82664 A Electrophoretic test 82666 A Assay of epiandrosterone 82668 A Assay of erythropoietin 82670 A Assay of estradiol 82671 A Assay of estrogens 82672 A Assay of estrogen 82677 A Assay of estriol 82679 A Assay of estrone 82690 A Assay of ethchlorvynol 82693 A Assay of ethylene glycol 82696 A Assay of etiocholanolone 82705 A Fats/lipids, feces, qual 82710 A Fats/lipids, feces, quant 82715 A Assay of fecal fat 82725 A Assay of blood fatty acids 82726 A Long chain fatty acids 82728 A Assay of ferritin 82731 A Assay of fetal fibronectin 82735 A Assay of fluoride 82742 A Assay of flurazepam 82746 A Blood folic acid serum 82747 A Assay of folic acid, rbc 82757 A Assay of semen fructose 82759 A Assay of rbc galactokinase 82760 A Assay of galactose 82775 A Assay galactose transferase 82776 A Galactose transferase test 82784 A Assay of gammaglobulin igm 82785 A Assay of gammaglobulin ige 82787 A Igg 1, 2, 3 and 4 82800 A Blood pH 82803 A Blood gases: pH, pO2 & pCO2 82805 A Blood gases W/O2 saturation 82810 A Blood gases, O2 sat only 82820 A Hemoglobin-oxygen affinity 82926 A Assay of gastric acid 82928 A Assay of gastric acid 82938 A Gastrin test 82941 A Assay of gastrin 82943 A Assay of glucagon *82945 A Glucose, body fluid other than blood 82946 A Glucagon tolerance test 82947 A Assay of glucose, quant 82948 A Reagent strip/blood glucose 82950 A Glucose test 82951 A Glucose tolerance test
(GTT)82952 A GTT-added samples 82953 A Glucose-tolbutamide test 82955 A Assay of g6pd enzyme 82960 A Test for G6PD enzyme 82962 A Glucose blood test 82963 A Assay of glucosidase 82965 A Assay of gdh enzyme 82975 A Assay of glutamine 82977 A Assay of GGT 82978 A Assay of glutathione 82979 A Assay, rbc glutathione 82980 A Assay of glutethimide 82985 A Glycated protein 83001 A Gonadotropin
(FSH)83002 A Gonadotropin
(LH)83003 A Assay, growth hormone
(hgh)83008 A Assay of guanosine 83010 A Assay of haptoglobin, quant 83012 A Assay of haptoglobins 83013 A H pylori breath tst analysis 83014 A H pylori drug admin/collect 83015 A Heavy metal screen 83018 A Quantitative screen, metals 83020 A Hemoglobin electrophoresis 83021 A Hemoglobin chromotography 83026 A Hemoglobin, copper sulfate 83030 A Fetal hemoglobin assay 83033 A Fetal fecal hemoglobin assay 83036 A Glycated hemoglobin test 83045 A Blood methemoglobin test 83050 A Blood methemoglobin assay 83051 A Assay of plasma hemoglobin 83055 A Blood sulfhemoglobin test 83060 A Blood sulfhemoglobin assay 83065 A Assay of hemoglobin heat 83068 A Hemoglobin stability screen 83069 A Assay of urine hemoglobin 83070 A Assay of hemosiderin, qual 83071 A Assay of hemosiderin, quant 83080 A Assay of b hexosaminidase 83088 A Assay of histamine *83090 A Homocystine 83150 A Assay of for hva 83491 A Assay of corticosteroids 83497 A Assay of 5-hiaa 83498 A Assay of progesterone 83499 A Assay of progesterone 83500 A Assay, free hydroxyproline 83505 A Assay, total hydroxyproline 83516 A Immunoassay, nonantibody 83518 A Immunoassay, dipstick 83519 A Immunoassay, nonantibody 83520 A Immunoassay, RIA 83525 A Assay of insulin 83527 A Assay of insulin 83528 A Assay of intrinsic factor 83540 A Assay of iron 83550 A Iron binding test 83570 A Assay of idh enzyme 83582 A Assay of ketogenic steroids 83586 A Assay 17- ketosteroids 83593 A Fractionation, ketosteroids 83605 A Assay of lactic acid 83615 A Lactate
(LDH)enzyme 83625 A Assay of ldh enzymes 83632 A Placental lactogen 83633 A Test urine for lactose 83634 A Assay of urine for lactose 83655 A Assay of lead 83661 A Assay of l/s ratio 83662 A L/S ratio, foam stability *83663 A Fetal lung maturity, fluor polar *83664 A Fetal lung maturity, lam body dens 83670 A Assay of lap enzyme 83690 A Assay of lipase 83715 A Assay of blood lipoproteins 83716 A Assay of blood lipoproteins 83718 A Assay of lipoprotein 83719 A Assay of blood lipoprotein 83721 A Assay of blood lipoprotein 83727 A Assay of lrh hormone 83735 A Assay of magnesium 83775 A Assay of md enzyme 83785 A Assay of manganese 83788 A Mass spectrometry qual 83789 A Mass spectrometry quant 83805 A Assay of meprobamate 83825 A Assay of mercury 83835 A Assay of metanephrines 83840 A Assay of methadone 83857 A Assay of methemalbumin 83858 A Assay of methsuximide 83864 A Mucopolysaccharides 83866 A Mucopolysaccharides screen 83872 A Assay synovial fluid mucin 83873 A Assay of csf protein 83874 A Assay of myoglobin 83883 A Assay, nephelometry not spec 83885 A Assay of nickel 83887 A Assay of nicotine 83890 A Molecule isolate 83891 A Molecule isolate nucleic 83892 A Molecular diagnostics 83893 A Molecule dot/slot/blot 83894 A Molecule gel electrophor 83896 A Molecular diagnostics 83897 A Molecule nucleic transfer 83898 A Molecule nucleic ampli 83901 A Molecule nucleic ampli 83902 A Molecular diagnostics 83903 A Molecule mutation scan 83904 A Molecule mutation identify 83905 A Molecule mutation identify 83906 A Molecule mutation identify 83912 A Genetic examination 83915 A Assay of nucleotidase 83916 A Oligoclonal bands 83918 A Assay, organic acids quant 83919 A Assay, organic acids qual *83921 A Assay, organic acid, single, quant 83925 A Assay of opiates 83930 A Assay of blood osmolality 83935 A Assay of urine osmolality 83937 A Assay of osteocalcin 83945 A Assay of oxalate 83970 A Assay of parathormone 83986 A Assay of body fluid acidity 83992 A Assay for phencyclidine 84022 A Assay of phenothiazine 84030 A Assay of blood pku 84035 A Assay of phenylketones 84060 A Assay acid phosphatase 84061 A Phosphatase, forensic exam 84066 A Assay prostate phosphatase 84075 A Assay alkaline phosphatase 84078 A Assay alkaline phosphatase 84080 A Assay alkaline phosphatases 84081 A Amniotic fluid enzyme test 84085 A Assay of rbc pg6d enzyme 84087 A Assay phosphohexose enzymes 84100 A Assay of phosphorus 84105 A Assay of urine phosphorus 84106 A Test for porphobilinogen 84110 A Assay of porphobilinogen 84119 A Test urine for porphyrins 84120 A Assay of urine porphyrins 84126 A Assay of feces porphyrins 84127 A Assay of feces porphyrins 84132 A Assay of serum potassium 84133 A Assay of urine potassium 84134 A Assay of prealbumin 84135 A Assay of pregnanediol 84138 A Assay of pregnanetriol 84140 A Assay of pregnenolone 84143 A Assay of 17-hydroxypregneno 84144 A Assay of progesterone 84146 A Assay of prolactin 84150 A Assay of prostaglandin *84152 A PSA, complexed 84153 A Assay of psa, total 84154 A Assay of psa, free 84155 A Assay of protein 84160 A Assay of serum protein 84165 A Assay of serum proteins 84181 A Western blot test 84182 A Protein, western blot test 84202 A Assay RBC protoporphyrin 84203 A Test RBC protoporphyrin 84206 A Assay of proinsulin 84207 A Assay of vitamin b-6 84210 A Assay of pyruvate 84220 A Assay of pyruvate kinase 84228 A Assay of quinine 84233 A Assay of estrogen 84234 A Assay of progesterone 84235 A Assay of endocrine hormone 84238 A Assay, nonendocrine receptor 84244 A Assay of renin 84252 A Assay of vitamin b-2 84255 A Assay of selenium 84260 A Assay of serotonin 84270 A Assay of sex hormone globul 84275 A Assay of sialic acid 84285 A Assay of silica 84295 A Assay of serum sodium 84300 A Assay of urine sodium 84305 A Assay of somatomedin 84307 A Assay of somatostatin 84311 A Spectrophotometry 84315 A Body fluid specific gravity 84375 A Chromatogram assay, sugars 84376 A Sugars, single, qual 84377 A Sugars, multiple, qual 84378 A Sugars single quant 84379 A Sugars multiple quant 84392 A Assay of urine sulfate 84402 A Assay of testosterone 84403 A Assay of total testosterone 84425 A Assay of vitamin b-1 84430 A Assay of thiocyanate 84432 A Assay of thyroglobulin 84436 A Assay of total thyroxine 84437 A Assay of neonatal thyroxine 84439 A Assay of free thyroxine 84442 A Assay of thyroid activity 84443 A Assay thyroid stim hormone 84445 A Assay of tsi 84446 A Assay of vitamin e 84449 A Assay of transcortin 84450 A Transferase
(SGOT)84460 A Alanine amino
(SGPT)84466 A Assay of transferrin 84478 A Assay of triglycerides 84479 A Assay of thyroid (t3 or t4) 84480 A Assay, triiodothyronine
(t3)84481 A Free assay (FT-3) 84482 A T3 reverse 84484 A Assay of troponin, quant 84485 A Assay duodenal fluid trypsin 84488 A Test feces for trypsin 84490 A Assay of feces for trypsin 84510 A Assay of tyrosine 84512 A Assay of troponin, qual 84520 A Assay of urea nitrogen 84525 A Urea nitrogen semi-quant 84540 A Assay of urine/urea-n 84545 A Urea-N clearance test 84550 A Assay of blood/uric acid 84560 A Assay of urine/uric acid 84577 A Assay of feces/urobilinogen 84578 A Test urine urobilinogen 84580 A Assay of urine urobilinogen 84583 A Assay of urine urobilinogen 84585 A Assay of urine vma 84586 A Assay of vip 84588 A Assay of vasopressin 84590 A Assay of vitamin a *84591 A Vitamin, NOS 84597 A Assay of vitamin k 84600 A Assay of volatiles 84620 A Xylose tolerance test 84630 A Assay of zinc 84681 A Assay of c-peptide 84702 A Chorionic gonadotropin test 84703 A Chorionic gonadotropin assay 84830 A Ovulation tests 84999 X Clinical chemistry test 0349 0.48 $23.65 $4.73 $4.73 85002 A Bleeding time test 85007 A Differential WBC count 85008 A Nondifferential WBC count 85009 A Differential WBC count 85013 A Hematocrit 85014 A Hematocrit 85018 A Hemoglobin 85021 A Automated hemogram 85022 A Automated hemogram 85023 A Automated hemogram 85024 A Automated hemogram 85025 A Automated hemogram 85027 A Automated hemogram 85031 A Manual hemogram, cbc 85041 A Red blood cell
(RBC)count 85044 A Reticulocyte count 85045 A Reticulocyte count 85046 A Reticyte/hgb concentrate 85048 A White blood cell
(WBC)count 85060 X Blood smear interpretation 0342 0.26 $12.90 $8.03 $2.58 85095 T Bone marrow aspiration 0003 0.98 $48.61 $27.99 $9.72 85097 X Bone marrow interpretation 0344 0.79 $39.18 $23.63 $7.84 85102 T Bone marrow biopsy 0003 0.98 $48.61 $27.99 $9.72 85130 A Chromogenic substrate assay 85170 A Blood clot retraction 85175 A Blood clot lysis time 85210 A Blood clot factor II test 85220 A Blood clot factor V test 85230 A Blood clot factor VII test 85240 A Blood clot factor VIII test 85244 A Blood clot factor VIII test 85245 A Blood clot factor VIII test 85246 A Blood clot factor VIII test 85247 A Blood clot factor VIII test 85250 A Blood clot factor IX test 85260 A Blood clot factor X test 85270 A Blood clot factor XI test 85280 A Blood clot factor XII test 85290 A Blood clot factor XIII test 85291 A Blood clot factor XIII test 85292 A Blood clot factor assay 85293 A Blood clot factor assay 85300 A Antithrombin III test 85301 A Antithrombin III test 85302 A Blood clot inhibitor antigen 85303 A Blood clot inhibitor test 85305 A Blood clot inhibitor assay 85306 A Blood clot inhibitor test *85307 A Activated protein C resistance 85335 A Factor inhibitor test 85337 A Thrombomodulin 85345 A Coagulation time 85347 A Coagulation time 85348 A Coagulation time 85360 A Euglobulin lysis 85362 A Fibrin degradation products 85366 A Fibrinogen test 85370 A Fibrinogen test 85378 A Fibrin degradation 85379 A Fibrin degradation 85384 A Fibrinogen 85385 A Fibrinogen 85390 A Fibrinolysins screen 85400 A Fibrinolytic plasmin 85410 A Fibrinolytic antiplasmin 85415 A Fibrinolytic plasminogen 85420 A Fibrinolytic plasminogen 85421 A Fibrinolytic plasminogen 85441 A Heinz bodies, direct 85445 A Heinz bodies, induced 85460 A Hemoglobin, fetal 85461 A Hemoglobin, fetal 85475 A Hemolysin 85520 A Heparin assay 85525 A Heparin 85530 A Heparin-protamine tolerance 85535 A Iron stain, blood cells *85536 A Iron stain, peripheral blood 85540 A Wbc alkaline phosphatase 85547 A RBC mechanical fragility 85549 A Muramidase 85555 A RBC osmotic fragility 85557 A RBC osmotic fragility 85576 A Blood platelet aggregation 85585 A Blood platelet estimation 85590 A Platelet count, manual 85595 A Platelet count, automated 85597 A Platelet neutralization 85610 A Prothrombin time 85611 A Prothrombin test 85612 A Viper venom prothrombin time 85613 A Russell viper venom, diluted 85635 A Reptilase test 85651 A Rbc sed rate, nonautomated 85652 A Rbc sed rate, automated 85660 A RBC sickle cell test 85670 A Thrombin time, plasma 85675 A Thrombin time, titer 85705 A Thromboplastin inhibition 85730 A Thromboplastin time, partial 85732 A Thromboplastin time, partial 85810 A Blood viscosity examination 85999 X Hematology procedure 0349 0.48 $23.65 $4.73 $4.73 86000 A Agglutinins, febrile *86001 A Allergen specific IgE, quant/semiquant 86003 A Allergen specific IgE 86005 A Allergen specific IgE 86021 A WBC antibody identification 86022 A Platelet antibodies 86023 A Immunoglobulin assay 86038 A Antinuclear antibodies 86039 A Antinuclear antibodies
(ANA)86060 A Antistreptolysin o, titer 86063 A Antistreptolysin o, screen 86077 X Physician blood bank service 0343 0.45 $22.32 $12.16 $4.46 86078 X Physician blood bank service 0344 0.79 $39.18 $23.63 $7.84 86079 X Physician blood bank service 0344 0.79 $39.18 $23.63 $7.84 86140 A C-reactive protein *86146 A Beta 2 glycoprotein I antibody 86147 A Cardiolipin antibody 86148 A Phospholipid antibody 86155 A Chemotaxis assay 86156 A Cold agglutinin, screen 86157 A Cold agglutinin, titer 86160 A Complement, antigen 86161 A Complement/function activity 86162 A Complement, total
(CH50)86171 A Complement fixation, each 86185 A Counterimmunoelectrophoresis 86215 A Deoxyribonuclease, antibody 86225 A DNA antibody 86226 A DNA antibody, single strand 86235 A Nuclear antigen antibody 86243 A Fc receptor 86255 A Fluorescent antibody, screen 86256 A Fluorescent antibody, titer 86277 A Growth hormone antibody 86280 A Hemagglutination inhibition *86294 A Tumor antigen, qual or semiquant *86300 A Tumor antigen, quant; CA 15-3 *86301 A Tumor antigen, quant; CA 19-9 *86304 A Tumor antigen, quant; CA 125 86308 A Heterophile antibodies 86309 A Heterophile antibodies 86310 A Heterophile antibodies 86316 A Immunoassay, tumor antigen 86317 A Immunoassay,infectious agent 86318 A Immunoassay,infectious agent 86320 A Serum immunoelectrophoresis 86325 A Other immunoelectrophoresis 86327 A Immunoelectrophoresis assay 86329 A Immunodiffusion 86331 A Immunodiffusion ouchterlony 86332 A Immune complex assay 86334 A Immunofixation procedure 86337 A Insulin antibodies 86340 A Intrinsic factor antibody 86341 A Islet cell antibody 86343 A Leukocyte histamine release 86344 A Leukocyte phagocytosis 86353 A Lymphocyte transformation 86359 A T cells, total count 86360 A T cell, absolute count/ratio 86361 A T cell, absolute count 86376 A Microsomal antibody 86378 A Migration inhibitory factor 86382 A Neutralization test, viral 86384 A Nitroblue tetrazolium dye 86403 A Particle agglutination test 86406 A Particle agglutination test 86430 A Rheumatoid factor test 86431 A Rheumatoid factor, quant 86485 X Skin test, candida 0341 0.13 $6.44 $3.67 $1.29 86490 X Coccidioidomycosis skin test 0341 0.13 $6.44 $3.67 $1.29 86510 X Histoplasmosis skin test 0341 0.13 $6.44 $3.67 $1.29 86580 X TB intradermal test 0341 0.13 $6.44 $3.67 $1.29 86585 X TB tine test 0341 0.13 $6.44 $3.67 $1.29 86586 X Skin test, unlisted 0341 0.13 $6.44 $3.67 $1.29 86590 A Streptokinase, antibody 86592 A Blood serology, qualitative 86593 A Blood serology, quantitative 86602 A Antinomyces antibody 86603 A Adenovirus antibody 86606 A Aspergillus antibody 86609 A Bacterium antibody *86611 A Bartonella antibody 86612 A Blastomyces antibody 86615 A Bordetella antibody 86617 A Lyme disease antibody 86618 A Lyme disease antibody 86619 A Borrelia antibody 86622 A Brucella antibody 86625 A Campylobacter antibody 86628 A Candida antibody 86631 A Chlamydia antibody 86632 A Chlamydia igm antibody 86635 A Coccidioides antibody 86638 A Q fever antibody 86641 A Cryptococcus antibody 86644 A CMV antibody 86645 A CMV antibody, IgM 86648 A Diphtheria antibody 86651 A Encephalitis antibody 86652 A Encephalitis antibody 86653 A Encephalitis antibody 86654 A Encephalitis antibody 86658 A Enterovirus antibody 86663 A Epstein-barr antibody 86664 A Epstein-barr antibody 86665 A Epstein-barr antibody *86666 A Erlichia antibody 86668 A Francisella tularensis 86671 A Fungus antibody 86674 A Giardia lamblia antibody 86677 A Helicobacter pylori 86682 A Helminth antibody *86683 A Fecal hgb antibody 86684 A Hemophilus influenza 86687 A Htlv-i antibody 86688 A Htlv-ii antibody 86689 A HTLV/HIV confirmatory test 86692 A Hepatitis, delta agent *86696 A Herpes simplex type 2 antibody 86694 A Herpes simplex test 86695 A Herpes simplex test 86698 A Histoplasma 86701 A HIV-1 86702 A HIV-2 86703 A HIV-1/HIV-2, single assay 86704 A Hep b core antibody, igg/igm 86705 A Hep b core antibody, igm 86706 A Hep b surface antibody 86707 A Hep be antibody 86708 A Hep a antibody, igg/igm 86709 A Hep a antibody, igm 86710 A Influenza virus antibody 86713 A Legionella antibody 86717 A Leishmania antibody 86720 A Leptospira antibody 86723 A Listeria monocytogenes ab 86727 A Lymph choriomeningitis ab 86729 A Lympho venereum antibody 86732 A Mucormycosis antibody 86735 A Mumps antibody 86738 A Mycoplasma antibody 86741 A Neisseria meningitidis 86744 A Nocardia antibody 86747 A Parvovirus antibody 86750 A Malaria antibody 86753 A Protozoa antibody nos 86756 A Respiratory virus antibody *86757 A Rickettsia antibody 86759 A Rotavirus antibody 86762 A Rubella antibody 86765 A Rubeola antibody 86768 A Salmonella antibody 86771 A Shigella antibody 86774 A Tetanus antibody 86777 A Toxoplasma antibody 86778 A Toxoplasma antibody, igm 86781 A Treponema pallidum, confirm 86784 A Trichinella antibody 86787 A Varicella-zoster antibody 86790 A Virus antibody nos 86793 A Yersinia antibody 86800 A Thyroglobulin antibody 86803 A Hepatitis c ab test 86804 A Hep c ab test, confirm 86805 A Lymphocytotoxicity assay 86806 A Lymphocytotoxicity assay 86807 A Cytotoxic antibody screening 86808 A Cytotoxic antibody screening 86812 A HLA typing, A, B, or C 86813 A HLA typing, A, B, or C 86816 A HLA typing, DR/DQ 86817 A HLA typing, DR/DQ 86821 A Lymphocyte culture, mixed 86822 A Lymphocyte culture, primed 86849 X Immunology procedure 0349 0.48 $23.65 $4.73 $4.73 86850 X RBC antibody screen 0346 0.51 $25.49 $12.03 $5.10 86860 X RBC antibody elution 0345 0.22 $10.92 $5.37 $2.18 86870 X RBC antibody identification 0347 0.84 $41.90 $20.13 $8.38 86880 A Coombs test 86885 A Coombs test 86886 A Coombs test 86890 X Autologous blood process 0347 0.84 $41.90 $20.13 $8.38 86891 X Autologous blood, op salvage 0345 0.22 $10.92 $5.37 $2.18 86900 A Blood typing, ABO 86901 X Blood typing, Rh
(D)0345 0.22 $10.92 $5.37 $2.18 86903 A Blood typing, antigen screen 86904 A Blood typing, patient serum 86905 A Blood typing, RBC antigens 86906 A Blood typing, Rh phenotype 86910 E Blood typing, paternity test 86911 E Blood typing, antigen system 86915 X Bone marrow/stem cell prep 0347 0.84 $41.90 $20.13 $8.38 86920 X Compatibility test 0346 0.51 $25.49 $12.03 $5.10 86921 X Compatibility test 0346 0.51 $25.49 $12.03 $5.10 86922 X Compatibility test 0346 0.51 $25.49 $12.03 $5.10 86927 X Plasma, fresh frozen 0347 0.84 $41.90 $20.13 $8.38 86930 X Frozen blood prep 0347 0.84 $41.90 $20.13 $8.38 86931 X Frozen blood thaw 0347 0.84 $41.90 $20.13 $8.38 86932 X Frozen blood freeze/thaw 0347 0.84 $41.90 $20.13 $8.38 86940 A Hemolysins/agglutinins, auto 86941 A Hemolysins/agglutinins 86945 X Blood product/irradiation 0346 0.51 $25.49 $12.03 $5.10 86950 X Leukacyte transfusion 0347 0.84 $41.90 $20.13 $8.38 86965 X Pooling blood platelets 0346 0.51 $25.49 $12.03 $5.10 86970 X RBC pretreatment 0345 0.22 $10.92 $5.37 $2.18 86971 X RBC pretreatment 0346 0.51 $25.49 $12.03 $5.10 86972 X RBC pretreatment 0345 0.22 $10.92 $5.37 $2.18 86975 X RBC pretreatment, serum 0346 0.51 $25.49 $12.03 $5.10 86976 X RBC pretreatment, serum 0347 0.84 $41.90 $20.13 $8.38 86977 X RBC pretreatment, serum 0346 0.51 $25.49 $12.03 $5.10 86978 X RBC pretreatment, serum 0345 0.22 $10.92 $5.37 $2.18 86985 X Split blood or products 0347 0.84 $41.90 $20.13 $8.38 86999 X Transfusion procedure 0346 0.51 $25.49 $12.03 $5.10 87001 A Small animal inoculation 87003 A Small animal inoculation 87015 A Specimen concentration 87040 A Blood culture for bacteria 87045 A Stool culture for bacteria *87046 A Stool culture for bacteria 87060D A Nose/throat culture, bact 87070 A Culture specimen, bacteria *87071 A Culture specimen, bacteria 87072D A Culture of specimen by kit *87073 A Culture specimen, bacteria 87075 A Culture specimen, bacteria 87076 A Bacteria identification *87077 A Culture specimen, bacteria 87081 A Bacteria culture screen 87082 A Culture of specimen by kit 87083D A Culture of specimen by kit 87084 A Culture of specimen by kit 87085D A Culture of specimen by kit 87086 A Urine culture/colony count 87087D A Urine bacteria culture 87088 A Urine bacteria culture 87101 A Skin fungus culture 87102 A Fungus isolation culture 87103 A Blood fungus culture 87106 A Fungus identification *87107 A Culture specimen, fungi 87109 A Mycoplasma culture 87110 A Culture, chlamydia 87116 A Mycobacteria culture 87117D A Mycobacteria culture 87118 A Mycobacteria identification 87140 A Culture typing, fluorescent 87143 A Culture typing, GLC method 87145D A Culture typing, phage method 87147 A Culture typing, serologic *87149 A Culture typing 87151D A Culture typing, serologic *87152 A Culture typing 87155D A Culture typing, precipitin 87158 A Culture typing, added method 87163D A Special microbiology culture 87164 A Dark field examination 87166 A Dark field examination *87168 A Macroscopic exam, arthropod *87169 A Macroscopic exam, arthropod *87172 A Pinworm exam 87174D A Endotoxin, bacterial 87175D A Assay, endotoxin, bacterial 87176 A Endotoxin, bacterial 87177 A Ova and parasites smears 87181 A Antibiotic sensitivity, each 87184 A Antibiotic sensitivity, each *87185 A Susceptibility study 87186 A Antibiotic sensitivity, MIC 87187 A Antibiotic sensitivity, MBC 87188 A Antibiotic sensitivity, each 87190 A TB antibiotic sensitivity 87192D A Antibiotic sensitivity, each 87197 A Bactericidal level, serum 87205 A Smear, stain & interpret 87206 A Smear, stain & interpret 87207 A Smear, stain & interpret 87208D A Smear, stain & interpret 87210 A Smear, stain & interpret 87211D A Smear, stain & interpret 87220 A Tissue exam for fungi 87230 A Assay, toxin or antitoxin 87250 A Virus inoculation for test 87252 A Virus inoculation for test 87253 A Virus inoculation for test *87254 A Virus isolation 87260 A Adenovirus ag, dfa 87265 A Pertussis ag, dfa 87270 A Chylmd trach ag, dfa 87272 A Cryptosporidum ag, dfa *87273 A Identify infectious agent 87274 A Herpes simplex ag, dfa *87275 A Identify infectious agent 87276 A Influenza ag, dfa *87277 A Identify infectious agent 87278 A Legion pneumo ag, dfa *87279 A Identify infectious agent 87280 A Resp syncytial ag, dfa *87281 A Identify infectious agent *87283 A Identify infectious agent 87285 A Trepon pallidum ag, dfa 87290 A Varicella ag, dfa 87299 A Ag detection nos, dfa *87300 A Identify infectious agent 87301 A Adenovirus ag, eia 87320 A Chylmd trach ag, eia 87324 A Clostridium ag, eia *87327 A Identify infectious agent 87328 A Cryptospor ag, eia 87332 A Cytomegalovirus ag, eia 87335 A E coli 0157 ag, eia *87336 A Identify infectious agent *87337 A Identify infectious agent 87338 A Hpylori, stool, eia *87339 A Identify infectious agent 87340 A Hepatitis b surface ag, eia *87341 A Identify infectious agent 87350 A Hepatitis be ag, eia 87380 A Hepatitis delta ag, eia 87385 A Histoplasma capsul ag, eia 87390 A Hiv-1 ag, eia 87391 A Hiv-2 ag, eia *87400 A Identify infectious agent 87420 A Resp syncytial ag, eia 87425 A Rotavirus ag, eia *87427 A Identify infectious agent 87430 A Strep a ag, eia 87449 A Ag detect nos, eia, mult 87450 A Ag detect nos, eia, single *87451 A Identify infectious agent 87470 A Bartonella, dna, dir probe 87471 A Bartonella, dna, amp probe 87472 A Bartonella, dna, quant 87475 A Lyme dis, dna, dir probe 87476 A Lyme dis, dna, amp probe 87477 A Lyme dis, dna, quant 87480 A Candida, dna, dir probe 87481 A Candida, dna, amp probe 87482 A Candida, dna, quant 87485 A Chylmd pneum, dna, dir probe 87486 A Chylmd pneum, dna, amp probe 87487 A Chylmd pneum, dna, quant 87490 A Chylmd trach, dna, dir probe 87491 A Chylmd trach, dna, amp probe 87492 A Chylmd trach, dna, quant 87495 A Cytomeg, dna, dir probe 87496 A Cytomeg, dna, amp probe 87497 A Cytomeg, dna, quant 87510 A Gardner vag, dna, dir probe 87511 A Gardner vag, dna, amp probe 87512 A Gardner vag, dna, quant 87515 A Hepatitis b, dna, dir probe 87516 A Hepatitis b , dna, amp probe 87517 A Hepatitis b , dna, quant 87520 A Hepatitis c , rna, dir probe 87521 A Hepatitis c , rna, amp probe 87522 A Hepatitis c, rna, quant 87525 A Hepatitis g , dna, dir probe 87526 A Hepatitis g, dna, amp probe 87527 A Hepatitis g, dna, quant 87528 A Hsv, dna, dir probe 87529 A Hsv, dna, amp probe 87530 A Hsv, dna, quant 87531 A Hhv-6, dna, dir probe 87532 A Hhv-6, dna, amp probe 87533 A Hhv-6, dna, quant 87534 A Hiv-1, dna, dir probe 87535 A Hiv-1, dna, amp probe 87536 A Hiv-1, dna, quant 87537 A Hiv-2, dna, dir probe 87538 A Hiv-2, dna, amp probe 87539 A Hiv-2, dna, quant 87540 A Legion pneumo, dna, dir prob 87541 A Legion pneumo, dna, amp prob 87542 A Legion pneumo, dna, quant 87550 A Mycobacteria, dna, dir probe 87551 A Mycobacteria, dna, amp probe 87552 A Mycobacteria, dna, quant 87555 A M.tuberculo, dna, dir probe 87556 A M.tuberculo, dna, amp probe 87557 A M.tuberculo, dna, quant 87560 A M.avium-intra, dna, dir prob 87561 A M.avium-intra, dna, amp prob 87562 A M.avium-intra, dna, quant 87580 A M.pneumon, dna, dir probe 87581 A M.pneumon, dna, amp probe 87582 A M.pneumon, dna, quant 87590 A N.gonorrhoeae, dna, dir prob 87591 A N.gonorrhoeae, dna, amp prob 87592 A N.gonorrhoeae, dna, quant 87620 A Hpv, dna, dir probe 87621 A Hpv, dna, amp probe 87622 A Hpv, dna, quant 87650 A Strep a, dna, dir probe 87651 A Strep a, dna, amp probe 87652 A Strep a, dna, quant 87797 A Detect agent nos, dna, dir 87798 A Detect agent nos, dna, amp 87799 A Detect agent nos, dna, quant *87800 A Identify infectious agent *87801 A Identify infectious agent 87810 A Chylmd trach assay w/optic 87850 A N. gonorrhoeae assay w/optic 87880 A Strep a assay w/optic 87899 A Agent nos assay w/optic *87901 A Infectious agent genotype *87903 A Infectious agent phenotype *87904 A Infectious agent phenotype 87999 X Microbiology procedure 0349 0.48 $23.65 $4.73 $4.73 88000 E Autopsy (necropsy), gross 88005 E Autopsy (necropsy), gross 88007 E Autopsy (necropsy), gross 88012 E Autopsy (necropsy), gross 88014 E Autopsy (necropsy), gross 88016 E Autopsy (necropsy), gross 88020 E Autopsy (necropsy), complete 88025 E Autopsy (necropsy), complete 88027 E Autopsy (necropsy), complete 88028 E Autopsy (necropsy), complete 88029 E Autopsy (necropsy), complete 88036 E Limited autopsy 88037 E Limited autopsy 88040 E Forensic autopsy (necropsy) 88045 E Coroner's autopsy (necropsy) 88099 E Necropsy (autopsy) procedure 88104 X Cytopathology, fluids 0343 0.45 $22.32 $12.16 $4.46 88106 X Cytopathology, fluids 0343 0.45 $22.32 $12.16 $4.46 88107 X Cytopathology, fluids 0343 0.45 $22.32 $12.16 $4.46 88108 X Cytopath, concentrate tech 0343 0.45 $22.32 $12.16 $4.46 88125 X Forensic cytopathology 0343 0.45 $22.32 $12.16 $4.46 88130 A Sex chromatin identification 88140 A Sex chromatin identification 88141 N Cytopath, c/v, interpret 88142 A Cytopath, c/v, thin layer 88143 A Cytopath c/v thin layer redo 88144 A Cytopath, c/v thin lyr redo 88145 A Cytopath, c/v thin lyr sel 88147 A Cytopath, c/v, automated 88148 A Cytopath, c/v, auto rescreen 88150 A Cytopath, c/v, manual 88152 A Cytopath, c/v, auto redo 88153 A Cytopath, c/v, redo 88154 A Cytopath, c/v, select 88155 A Cytopath, c/v, index add-on 88160 X Cytopath smear, other source 0342 0.26 $12.90 $8.03 $2.58 88161 X Cytopath smear, other source 0343 0.45 $22.32 $12.16 $4.46 88162 X Cytopath smear, other source 0343 0.45 $22.32 $12.16 $4.46 88164 A Cytopath tbs, c/v, manual 88165 A Cytopath tbs, c/v, redo 88166 A Cytopath tbs, c/v, auto redo 88167 A Cytopath tbs, c/v, select 88170 T Fine needle aspiration 0002 0.62 $30.75 $17.66 $6.15 88171 T Fine needle aspiration 0002 0.62 $30.75 $17.66 $6.15 88172 X Evaluation of smear 0343 0.45 $22.32 $12.16 $4.46 88173 X Interpretation of smear 0343 0.45 $22.32 $12.16 $4.46 88180 X Cell marker study 0344 0.79 $39.18 $23.63 $7.84 88182 X Cell marker study 0344 0.79 $39.18 $23.63 $7.84 88199 X Cytopathology procedure 0349 0.48 $23.65 $4.73 $4.73 88230 A Tissue culture, lymphocyte 88233 A Tissue culture, skin/biopsy 88235 A Tissue culture, placenta 88237 A Tissue culture, bone marrow 88239 A Tissue culture, tumor 88240 A Cell cryopreserve/storage 88241 A Frozen cell preparation 88245 A Chromosome analysis, 20-25 88248 A Chromosome analysis, 50-100 88249 A Chromosome analysis, 100 88261 A Chromosome analysis, 5 88262 A Chromosome analysis, 15-20 88263 A Chromosome analysis, 45 88264 A Chromosome analysis, 20-25 88267 A Chromosome analys, placenta 88269 A Chromosome analys, amniotic 88271 A Cytogenetics, dna probe 88272 A Cytogenetics, 3-5 88273 A Cytogenetics, 10-30 88274 A Cytogenetics, 25-99 88275 A Cytogenetics, 100-300 88280 A Chromosome karyotype study 88283 A Chromosome banding study 88285 A Chromosome count, additional 88289 A Chromosome study, additional 88291 A Cyto/molecular report 88299 X Cytogenetic study 0342 0.26 $12.90 $8.03 $2.58 88300 X Surgical path, gross 0342 0.26 $12.90 $8.03 $2.58 88302 X Tissue exam by pathologist 0342 0.26 $12.90 $8.03 $2.58 88304 X Tissue exam by pathologist 0343 0.45 $22.32 $12.16 $4.46 88305 X Tissue exam by pathologist 0343 0.45 $22.32 $12.16 $4.46 88307 X Tissue exam by pathologist 0344 0.79 $39.18 $23.63 $7.84 88309 X Tissue exam by pathologist 0344 0.79 $39.18 $23.63 $7.84 88311 X Decalcify tissue 0342 0.26 $12.90 $8.03 $2.58 88312 X Special stains 0343 0.45 $22.32 $12.16 $4.46 88313 X Special stains 0342 0.26 $12.90 $8.03 $2.58 88314 X Histochemical stain 0343 0.45 $22.32 $12.16 $4.46 88318 X Chemical histochemistry 0343 0.45 $22.32 $12.16 $4.46 88319 X Enzyme histochemistry 0342 0.26 $12.90 $8.03 $2.58 88321 X Microslide consultation 0342 0.26 $12.90 $8.03 $2.58 88323 X Microslide consultation 0343 0.45 $22.32 $12.16 $4.46 88325 X Comprehensive review of data 0343 0.45 $22.32 $12.16 $4.46 88329 X Pathology consult in surgery 0343 0.45 $22.32 $12.16 $4.46 88331 X Pathology consult in surgery 0343 0.45 $22.32 $12.16 $4.46 88332 X Pathology consult in surgery 0343 0.45 $22.32 $12.16 $4.46 88342 X Immunocytochemistry 0344 0.79 $39.18 $23.63 $7.84 88346 X Immunofluorescent study 0343 0.45 $22.32 $12.16 $4.46 88347 X Immunofluorescent study 0344 0.79 $39.18 $23.63 $7.84 88348 X Electron microscopy 0344 0.79 $39.18 $23.63 $7.84 88349 X Scanning electron microscopy 0344 0.79 $39.18 $23.63 $7.84 88355 X Analysis, skeletal muscle 0344 0.79 $39.18 $23.63 $7.84 88356 X Analysis, nerve 0344 0.79 $39.18 $23.63 $7.84 88358 X Analysis, tumor 0344 0.79 $39.18 $23.63 $7.84 88362 X Nerve teasing preparations 0343 0.45 $22.32 $12.16 $4.46 88365 X Tissue hybridization 0344 0.79 $39.18 $23.63 $7.84 88371 A Protein, western blot tissue 88372 A Protein analysis w/probe 88399 X Surgical pathology procedure 0349 0.48 $23.65 $4.73 $4.73 *88400 A Bilirubin total, trascutaneous 89050 A Body fluid cell count 89051 A Body fluid cell count 89060 A Exam,synovial fluid crystals 89100 X Sample intestinal contents 0361 3.53 $175.07 $88.09 $35.01 89105 X Sample intestinal contents 0360 1.38 $68.44 $34.75 $13.69 89125 A Specimen fat stain 89130 X Sample stomach contents 0360 1.38 $68.44 $34.75 $13.69 89132 X Sample stomach contents 0360 1.38 $68.44 $34.75 $13.69 89135 X Sample stomach contents 0360 1.38 $68.44 $34.75 $13.69 89136 X Sample stomach contents 0360 1.38 $68.44 $34.75 $13.69 89140 X Sample stomach contents 0360 1.38 $68.44 $34.75 $13.69 89141 X Sample stomach contents 0361 3.53 $175.07 $88.09 $35.01 89160 A Exam feces for meat fibers 89190 A Nasal smear for eosinophils 89250 X Fertilization of oocyte 0348 0.52 $25.57 $5.11 $5.11 89251 X Culture oocyte w/embryos 0348 0.52 $25.57 $5.11 $5.11 89252 X Assist oocyte fertilization 0348 0.52 $25.57 $5.11 $5.11 89253 X Embryo hatching 0348 0.52 $25.57 $5.11 $5.11 89254 X Oocyte identification 0348 0.52 $25.57 $5.11 $5.11 89255 X Prepare embryo for transfer 0348 0.52 $25.57 $5.11 $5.11 89256 X Prepare cryopreserved embryo 0348 0.52 $25.57 $5.11 $5.11 89257 X Sperm identification 0348 0.52 $25.57 $5.11 $5.11 89258 X Cryopreservation, embryo 0348 0.52 $25.57 $5.11 $5.11 89259 X Cryopreservation, sperm 0348 0.52 $25.57 $5.11 $5.11 89260 X Sperm isolation, simple 0348 0.52 $25.57 $5.11 $5.11 89261 X Sperm isolation, complex 0348 0.52 $25.57 $5.11 $5.11 89264 X Identify sperm tissue 0348 0.52 $25.57 $5.11 $5.11 89300 A Semen analysis 89310 A Semen analysis 89320 A Semen analysis *89321 A Semen analysis 89325 A Sperm antibody test 89329 A Sperm evaluation test 89330 A Evaluation, cervical mucus 89350 X Sputum specimen collection 0344 0.79 $39.18 $23.63 $7.84 89355 A Exam feces for starch 89360 X Collect sweat for test 0344 0.79 $39.18 $23.63 $7.84 89365 A Water load test 89399 X Pathology lab procedure 0349 0.48 $23.65 $4.73 $4.73 90281 E Human ig, im 90283 E Human ig, iv 90287 E Botulinum antitoxin 90288 E Botulism ig, iv 90291 E Cmv ig, iv 90296 K Diphtheria antitoxin 0356 0.36 $17.86 $4.82 $3.57 90371 K Hep b ig, im 0356 0.36 $17.86 $4.82 $3.57 90375 K Rabies ig, im/sc 0356 0.36 $17.86 $4.82 $3.57 90376 K Rabies ig, heat treated 0356 0.36 $17.86 $4.82 $3.57 90378 K Rsv ig, im 0356 0.36 $17.86 $4.82 $3.57 90379 K Rsv ig, iv 0356 0.36 $17.86 $4.82 $3.57 90384 E Rh ig, full-dose, im 90385 K Rh ig, minidose, im 0356 0.36 $17.86 $4.82 $3.57 90386 E Rh ig, iv 90389 K Tetanus ig, im 0356 0.36 $17.86 $4.82 $3.57 90393 K Vaccina ig, im 0356 0.36 $17.86 $4.82 $3.57 90396 K Varicella-zoster ig, im 0356 0.36 $17.86 $4.82 $3.57 90399 E Immune globulin 90471 N Immunization admin 90472 N Immunization admin, each add 90476 K Adenovirus vaccine, type 4 0356 0.36 $17.86 $4.82 $3.57 90477 K Adenovirus vaccine, type 7 0356 0.36 $17.86 $4.82 $3.57 90581 K Anthrax vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90585 K Bcg vaccine, percut 0356 0.36 $17.86 $4.82 $3.57 90586 K Bcg vaccine, intravesical 0356 0.36 $17.86 $4.82 $3.57 90632 K Hep a vaccine, adult im 0356 0.36 $17.86 $4.82 $3.57 90633 K Hep a vacc, ped/adol, 2 dose 0356 0.36 $17.86 $4.82 $3.57 90634 K Hep a vacc, ped/adol, 3 dose 0356 0.36 $17.86 $4.82 $3.57 90636 K Hep a/hep b vacc, adult im 0356 0.36 $17.86 $4.82 $3.57 90645 K Hib vaccine, hboc, im 0355 0.19 $9.42 $5.05 $1.88 90646 K Hib vaccine, prp-d, im 0355 0.19 $9.42 $5.05 $1.88 90647 K Hib vaccine, prp-omp, im 0355 0.19 $9.42 $5.05 $1.88 90648 K Hib vaccine, prp-t, im 0355 0.19 $9.42 $5.05 $1.88 90657 K Flu vaccine, 6-35 mo, im 0354 0.13 $6.33 90658 K Flu vaccine, 3 yrs, im 0354 0.13 $6.33 90659 K Flu vaccine, whole, im 0354 0.13 $6.33 90660 K Flu vaccine, nasal 0354 0.13 $6.33 90665 K Lyme disease vaccine, im 0356 0.36 $17.86 $4.82 $3.57 90669 K Pneumococcal vaccine, ped 0356 0.36 $17.86 $4.82 $3.57 90675 K Rabies vaccine, im 0356 0.36 $17.86 $4.82 $3.57 90676 K Rabies vaccine, id 0356 0.36 $17.86 $4.82 $3.57 90680 K Rotovirus vaccine, oral 0356 0.36 $17.86 $4.82 $3.57 90690 K Typhoid vaccine, oral 0356 0.36 $17.86 $4.82 $3.57 90691 K Typhoid vaccine, im 0356 0.36 $17.86 $4.82 $3.57 90692 K Typhoid vaccine, h-p, sc/id 0356 0.36 $17.86 $4.82 $3.57 90693 K Typhoid vaccine, akd, sc 0356 0.36 $17.86 $4.82 $3.57 90700 K Dtap vaccine, im 0355 0.19 $9.42 $5.05 $1.88 90701 K Dtp vaccine, im 0356 0.36 $17.86 $4.82 $3.57 90702 K Dt vaccine, im 0355 0.19 $9.42 $5.05 $1.88 90703 K Tetanus vaccine, im 0356 0.36 $17.86 $4.82 $3.57 90704 K Mumps vaccine, sc 0355 0.19 $9.42 $5.05 $1.88 90705 K Measles vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90706 K Rubella vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90707 K Mmr vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90708 K Measles-rubella vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90709 K Rubella & mumps vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90710 K Mmrv vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90712 K Oral poliovirus vaccine 0356 0.36 $17.86 $4.82 $3.57 90713 K Poliovirus, ipv, sc 0355 0.19 $9.42 $5.05 $1.88 90716 K Chicken pox vaccine, sc 0355 0.19 $9.42 $5.05 $1.88 90717 K Yellow fever vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90718 K Td vaccine, im 0356 0.36 $17.86 $4.82 $3.57 90719 K Diphtheria vaccine, im 0356 0.36 $17.86 $4.82 $3.57 90720 K Dtp/hib vaccine, im 0355 0.19 $9.42 $5.05 $1.88 90721 K Dtap/hib vaccine, im 0355 0.19 $9.42 $5.05 $1.88 *90723 K DTAP-HepB-IPV vaccine 0356 0.36 $17.86 $4.82 $3.57 90725 K Cholera vaccine, injectable 0356 0.36 $17.86 $4.82 $3.57 90727 K Plague vaccine, im 0355 0.19 $9.42 $5.05 $1.88 90732 K Pneumococcal vaccine, adult 0354 0.13 $6.33 90733 K Meningococcal vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 90735 K Encephalitis vaccine, sc 0356 0.36 $17.86 $4.82 $3.57 *90740 K Hep B vaccine, 3 dose sched 0356 0.36 $17.86 $4.82 $3.57 *90743 K Hep B vaccine, 2 dose sched 0356 0.36 $17.86 $4.82 $3.57 90744 K Hep b vaccine, ped/adol, im 0356 0.36 $17.86 $4.82 $3.57 90746 K Hep b vaccine, adult, im 0356 0.36 $17.86 $4.82 $3.57 90747 K Hep b vaccine, ill pat, im 0356 0.36 $17.86 $4.82 $3.57 90748 K Hep b/hib vaccine, im 0356 0.36 $17.86 $4.82 $3.57 90749 K Vaccine toxoid 0355 0.19 $9.42 $5.05 $1.88 90780 E IV infusion therapy, 1 hour 90781 E IV infusion, additional hour 90782 X Injection, sc/im 0359 0.96 $47.61 $9.52 $9.52 90783 X Injection, ia 0359 0.96 $47.61 $9.52 $9.52 90784 X Injection, iv 0359 0.96 $47.61 $9.52 $9.52 90788 X Injection of antibiotic 0359 0.96 $47.61 $9.52 $9.52 90799 X Ther/prophylactic/dx inject 0359 0.96 $47.61 $9.52 $9.52 90801 S Psy dx interview 0323 1.85 $91.75 $22.48 $18.35 90802 S Intac psy dx interview 0323 1.85 $91.75 $22.48 $18.35 90804 S Psytx, office, 20-30 min 0322 1.32 $65.46 $14.22 $13.09 90805 S Psytx, off, 20-30 min w/e&m 0322 1.32 $65.46 $14.22 $13.09 90806 S Psytx, off, 45-50 min 0323 1.85 $91.75 $22.48 $18.35 90807 S Psytx, off, 45-50 min w/e&m 0323 1.85 $91.75 $22.48 $18.35 90808 S Psytx, office, 75-80 min 0323 1.85 $91.75 $22.48 $18.35 90809 S Psytx, off, 75-80, w/e&m 0323 1.85 $91.75 $22.48 $18.35 90810 S Intac psytx, off, 20-30 min 0322 1.32 $65.46 $14.22 $13.09 90811 S Intac psytx, 20-30, w/e&m 0322 1.32 $65.46 $14.22 $13.09 90812 S Intac psytx, off, 45-50 min 0323 1.85 $91.75 $22.48 $18.35 90813 S Intac psytx, 45-50 min w/e&m 0323 1.85 $91.75 $22.48 $18.35 90814 S Intac psytx, off, 75-80 min 0323 1.85 $91.75 $22.48 $18.35 90815 S Intac psytx, 75-80 w/e&m 0323 1.85 $91.75 $22.48 $18.35 90816 S Psytx, hosp, 20-30 min 0322 1.32 $65.46 $14.22 $13.09 90817 S Psytx, hosp, 20-30 min w/e&m 0322 1.32 $65.46 $14.22 $13.09 90818 S Psytx, hosp, 45-50 min 0323 1.85 $91.75 $22.48 $18.35 90819 S Psytx, hosp, 45-50 min w/e&m 0323 1.85 $91.75 $22.48 $18.35 90821 S Psytx, hosp, 75-80 min 0323 1.85 $91.75 $22.48 $18.35 90822 S Psytx, hosp, 75-80 min w/e&m 0323 1.85 $91.75 $22.48 $18.35 90823 S Intac psytx, hosp, 20-30 min 0322 1.32 $65.46 $14.22 $13.09 90824 S Intac psytx, hsp 20-30 w/e&m 0322 1.32 $65.46 $14.22 $13.09 90826 S Intac psytx, hosp, 45-50 min 0323 1.85 $91.75 $22.48 $18.35 90827 S Intac psytx, hsp 45-50 w/e&m 0323 1.85 $91.75 $22.48 $18.35 90828 S Intac psytx, hosp, 75-80 min 0323 1.85 $91.75 $22.48 $18.35 90829 S Intac psytx, hsp 75-80 w/e&m 0323 1.85 $91.75 $22.48 $18.35 90845 S Psychoanalysis 0323 1.85 $91.75 $22.48 $18.35 90846 S Family psytx w/o patient 0324 1.87 $92.74 $20.19 $18.55 90847 S Family psytx w/patient 0324 1.87 $92.74 $20.19 $18.55 90849 S Multiple family group psytx 0325 1.55 $76.88 $19.96 $15.38 90853 S Group psychotherapy 0325 1.55 $76.88 $19.96 $15.38 90857 S Intac group psytx 0325 1.55 $76.88 $19.96 $15.38 90862 X Medication management 0374 1.17 $58.03 $13.08 $11.61 90865 S Narcosynthesis 0323 1.85 $91.75 $22.48 $18.35 90870 S Electroconvulsive therapy 0320 3.68 $182.51 $80.06 $36.50 90871 S Electroconvulsive therapy 0320 3.68 $182.51 $80.06 $36.50 90875 E Psychophysiological therapy 90876 E Psychophysiological therapy 90880 S Hypnotherapy 0323 1.85 $91.75 $22.48 $18.35 90882 E Environmental manipulation 90885 N Psy evaluation of records 90887 N Consultation with family 90889 N Preparation of report 90899 S Psychiatric service/therapy 0322 1.32 $65.46 $14.22 $13.09 90901 S Biofeedback train, any meth 0321 1.26 $62.49 $29.25 $12.50 90911 S Biofeedback peri/uro/rectal 0321 1.26 $62.49 $29.25 $12.50 90918 A ESRD related services, month 90919 A ESRD related services, month 90920 A ESRD related services, month 90921 A ESRD related services, month 90922 A ESRD related services, day 90923 A Esrd related services, day 90924 A Esrd related services, day 90925 A Esrd related services, day 90935 S Hemodialysis, one evaluation 0170 6.68 $331.30 $72.26 $66.26 90937 E Hemodialysis, repeated eval *90940 N Hemodyalysis access study 90945 S Dialysis, one evaluation 0170 6.68 $331.30 $72.26 $66.26 90947 E Dialysis, repeated eval 90989 E Dialysis training, complete 90993 E Dialysis training, incompl 90997 E Hemoperfusion 90999 E Dialysis procedure 91000 X Esophageal intubation 0361 3.53 $175.07 $88.09 $35.01 91010 X Esophagus motility study 0361 3.53 $175.07 $88.09 $35.01 91011 X Esophagus motility study 0361 3.53 $175.07 $88.09 $35.01 91012 X Esophagus motility study 0361 3.53 $175.07 $88.09 $35.01 91020 X Gastric motility 0361 3.53 $175.07 $88.09 $35.01 91030 X Acid perfusion of esophagus 0360 1.38 $68.44 $34.75 $13.69 91032 X Esophagus, acid reflux test 0361 3.53 $175.07 $88.09 $35.01 91033 X Prolonged acid reflux test 0361 3.53 $175.07 $88.09 $35.01 91052 X Gastric analysis test 0361 3.53 $175.07 $88.09 $35.01 91055 X Gastric intubation for smear 0360 1.38 $68.44 $34.75 $13.69 91060 X Gastric saline load test 0361 3.53 $175.07 $88.09 $35.01 91065 X Breath hydrogen test 0360 1.38 $68.44 $34.75 $13.69 91100 X Pass intestine bleeding tube 0360 1.38 $68.44 $34.75 $13.69 91105 X Gastric intubation treatment 0360 1.38 $68.44 $34.75 $13.69 91122 T Anal pressure record 0165 3.89 $192.92 $91.76 $38.58 *91132 X Electrogastrography 0360 1.38 $68.44 $34.75 $13.69 *91133 X Electrogastrography 0360 1.38 $68.44 $34.75 $13.69 91299 X Gastroenterology procedure 0360 1.38 $68.44 $34.75 $13.69 92002 V Eye exam, new patient 0601 1.00 $49.60 $9.92 $9.92 92004 V Eye exam, new patient 0602 1.66 $82.33 $16.47 $16.47 92012 V Eye exam established pat 0601 1.00 $49.60 $9.92 $9.92 92014 V Eye exam & treatment 0602 1.66 $82.33 $16.47 $16.47 92015 E Refraction 92018 S New eye exam & treatment 0231 2.64 $130.94 $59.87 $26.19 92019 S Eye exam & treatment 0231 2.64 $130.94 $59.87 $26.19 92020 S Special eye evaluation 0230 0.98 $48.61 $22.48 $9.72 92060 S Special eye evaluation 0230 0.98 $48.61 $22.48 $9.72 92065 S Orthoptic/pleoptic training 0230 0.98 $48.61 $22.48 $9.72 92070 N Fitting of contact lens 92081 S Visual field examination(s) 0230 0.98 $48.61 $22.48 $9.72 92082 S Visual field examination(s) 0230 0.98 $48.61 $22.48 $9.72 92083 S Visual field examination(s) 0230 0.98 $48.61 $22.48 $9.72 92100 N Serial tonometry exam(s) 92120 S Tonography & eye evaluation 0230 0.98 $48.61 $22.48 $9.72 92130 S Water provocation tonography 0230 0.98 $48.61 $22.48 $9.72 92135 S Opthalmic dx imaging 0231 2.64 $130.94 $59.87 $26.19 92140 S Glaucoma provocative tests 0231 2.64 $130.94 $59.87 $26.19 92225 S Special eye exam, initial 0230 0.98 $48.61 $22.48 $9.72 92226 S Special eye exam, subsequent 0231 2.64 $130.94 $59.87 $26.19 92230 S Eye exam with photos 0231 2.64 $130.94 $59.87 $26.19 92235 S Eye exam with photos 0231 2.64 $130.94 $59.87 $26.19 92240 S Icg angiography 0231 2.64 $130.94 $59.87 $26.19 92250 S Eye exam with photos 0230 0.98 $48.61 $22.48 $9.72 92260 S Ophthalmoscopy/dynamometry 0230 0.98 $48.61 $22.48 $9.72 92265 S Eye muscle evaluation 0230 0.98 $48.61 $22.48 $9.72 92270 S Electro-oculography 0230 0.98 $48.61 $22.48 $9.72 92275 S Electroretinography 0216 2.87 $142.34 $64.69 $28.47 92283 S Color vision examination 0230 0.98 $48.61 $22.48 $9.72 92284 S Dark adaptation eye exam 0231 2.64 $130.94 $59.87 $26.19 92285 S Eye photography 0230 0.98 $48.61 $22.48 $9.72 92286 S Internal eye photography 0231 2.64 $130.94 $59.87 $26.19 92287 S Internal eye photography 0231 2.64 $130.94 $59.87 $26.19 92310 E Contact lens fitting 92311 X Contact lens fitting 0362 0.51 $25.30 $9.63 $5.06 92312 X Contact lens fitting 0362 0.51 $25.30 $9.63 $5.06 92313 X Contact lens fitting 0362 0.51 $25.30 $9.63 $5.06 92314 E Prescription of contact lens 92315 X Prescription of contact lens 0362 0.51 $25.30 $9.63 $5.06 92316 X Prescription of contact lens 0362 0.51 $25.30 $9.63 $5.06 92317 X Prescription of contact lens 0362 0.51 $25.30 $9.63 $5.06 92325 X Modification of contact lens 0362 0.51 $25.30 $9.63 $5.06 92326 X Replacement of contact lens 0362 0.51 $25.30 $9.63 $5.06 92330 S Fitting of artificial eye 0230 0.98 $48.61 $22.48 $9.72 92335 N Fitting of artificial eye 92340 E Fitting of spectacles 92341 E Fitting of spectacles 92342 E Fitting of spectacles 92352 X Special spectacles fitting 0362 0.51 $25.30 $9.63 $5.06 92353 X Special spectacles fitting 0362 0.51 $25.30 $9.63 $5.06 92354 X Special spectacles fitting 0362 0.51 $25.30 $9.63 $5.06 92355 X Special spectacles fitting 0362 0.51 $25.30 $9.63 $5.06 92358 X Eye prosthesis service 0362 0.51 $25.30 $9.63 $5.06 92370 E Repair & adjust spectacles 92371 X Repair & adjust spectacles 0362 0.51 $25.30 $9.63 $5.06 92390 E Supply of spectacles 92391 E Supply of contact lenses 92392 E Supply of low vision aids 92393 E Supply of artificial eye 92395 E Supply of spectacles 92396 E Supply of contact lenses 92499 S Eye service or procedure 0230 0.98 $48.61 $22.48 $9.72 92502 T Ear and throat examination 0251 1.68 $83.32 $27.99 $16.66 92504 N Ear microscopy examination 92506 A Speech/hearing evaluation 92507 A Speech/hearing therapy 92508 A Speech/hearing therapy 92510 A Rehab for ear implant 92511 T Nasopharyngoscopy 0071 0.55 $27.28 $14.22 $5.46 92512 X Nasal function studies 0363 2.83 $140.36 $53.22 $28.07 92516 X Facial nerve function test 0363 2.83 $140.36 $53.22 $28.07 92520 X Laryngeal function studies 0363 2.83 $140.36 $53.22 $28.07 92525 E Oral function evaluation 92526 A Oral function therapy 92531 N Spontaneous nystagmus study 92532 N Positional nystagmus study 92533 N Caloric vestibular test 92534 N Optokinetic nystagmus 92541 X Spontaneous nystagmus test 0363 2.83 $140.36 $53.22 $28.07 92542 X Positional nystagmus test 0363 2.83 $140.36 $53.22 $28.07 92543 X Caloric vestibular test 0363 2.83 $140.36 $53.22 $28.07 92544 X Optokinetic nystagmus test 0363 2.83 $140.36 $53.22 $28.07 92545 X Oscillating tracking test 0363 2.83 $140.36 $53.22 $28.07 92546 X Sinusoidal rotational test 0363 2.83 $140.36 $53.22 $28.07 92547 X Supplemental electrical test 0363 2.83 $140.36 $53.22 $28.07 92548 X Posturography 0363 2.83 $140.36 $53.22 $28.07 92551 E Pure tone hearing test, air 92552 X Pure tone audiometry, air 0364 0.68 $33.72 $13.31 $6.74 92553 X Audiometry, air & bone 0364 0.68 $33.72 $13.31 $6.74 92555 X Speech threshold audiometry 0364 0.68 $33.72 $13.31 $6.74 92556 X Speech audiometry, complete 0364 0.68 $33.72 $13.31 $6.74 92557 X Comprehensive hearing test 0365 1.47 $72.91 $22.48 $14.58 92559 E Group audiometric testing 92560 E Bekesy audiometry, screen 92561 X Bekesy audiometry, diagnosis 0365 1.47 $72.91 $22.48 $14.58 92562 X Loudness balance test 0365 1.47 $72.91 $22.48 $14.58 92563 X Tone decay hearing test 0365 1.47 $72.91 $22.48 $14.58 92564 X Sisi hearing test 0365 1.47 $72.91 $22.48 $14.58 92565 X Stenger test, pure tone 0365 1.47 $72.91 $22.48 $14.58 92567 X Tympanometry 0364 0.68 $33.72 $13.31 $6.74 92568 X Acoustic reflex testing 0365 1.47 $72.91 $22.48 $14.58 92569 X Acoustic reflex decay test 0365 1.47 $72.91 $22.48 $14.58 92571 X Filtered speech hearing test 0365 1.47 $72.91 $22.48 $14.58 92572 X Staggered spondaic word test 0365 1.47 $72.91 $22.48 $14.58 92573 X Lombard test 0365 1.47 $72.91 $22.48 $14.58 92575 X Sensorineural acuity test 0365 1.47 $72.91 $22.48 $14.58 92576 X Synthetic sentence test 0365 1.47 $72.91 $22.48 $14.58 92577 X Stenger test, speech 0365 1.47 $72.91 $22.48 $14.58 92579 X Visual audiometry
(vra)0365 1.47 $72.91 $22.48 $14.58 92582 X Conditioning play audiometry 0365 1.47 $72.91 $22.48 $14.58 92583 X Select picture audiometry 0365 1.47 $72.91 $22.48 $14.58 92584 X Electrocochleography 0363 2.83 $140.36 $53.22 $28.07 92585 S Auditory evoked potential 0216 2.87 $142.34 $64.69 $28.47 *92586 S Auditory evoked potentials, ltd 0971 1.55 $76.88 $15.38 92587 X Evoked auditory test 0363 2.83 $140.36 $53.22 $28.07 92588 X Evoked auditory test 0363 2.83 $140.36 $53.22 $28.07 92589 X Auditory function test(s) 0365 1.47 $72.91 $22.48 $14.58 92590 E Hearing aid exam, one ear 92591 E Hearing aid exam, both ears 92592 E Hearing aid check, one ear 92593 E Hearing aid check, both ears 92594 E Electro hearng aid test, one 92595 E Electro hearng aid tst, both 92596 X Ear protector evaluation 0365 1.47 $72.91 $22.48 $14.58 92597D E Voice prosthetic evaluation 92598D E Voice prosthetic modification 92599 X ENT procedure/service 0364 0.68 $33.72 $13.31 $6.74 92950 S Heart/lung resuscitation cpr 0094 4.51 $223.68 $105.29 $44.74 92953 S Temporary external pacing 0094 4.51 $223.68 $105.29 $44.74 92960 S Cardioversion electric, ext 0094 4.51 $223.68 $105.29 $44.74 92961 S Cardioversion, electric, int 0094 4.51 $223.68 $105.29 $44.74 92970 C Cardioassist, internal 92971 C Cardioassist, external 92975 C Dissolve clot, heart vessel 92977 T Dissolve clot, heart vessel 0120 1.66 $82.33 $42.67 $16.47 92978 S Intravasc us, heart add-on 0267 2.72 $134.90 $80.06 $26.98 92979 S Intravasc us, heart add-on 0267 2.72 $134.90 $80.06 $26.98 92980 T Insert intracoronary stent 0104 14.94 $740.96 $339.51 $148.19 92981 T Insert intracoronary stent 0104 14.94 $740.96 $339.51 $148.19 92982 T Coronary artery dilation 0082 51.01 $2,529.89 $1,351.74 $505.98 92984 T Coronary artery dilation 0082 51.01 $2,529.89 $1,351.74 $505.98 92986 C Revision of aortic valve 92987 C Revision of mitral valve 92990 C Revision of pulmonary valve 92992 C Revision of heart chamber 92993 C Revision of heart chamber 92995 T Coronary atherectomy 0083 29.70 $1,473.00 $794.30 $294.60 92996 T Coronary atherectomy add-on 0083 29.70 $1,473.00 $794.30 $294.60 92997 C Pul art balloon repr, percut 92998 C Pul art balloon repr, percut 93000 E Electrocardiogram, complete 93005 X Electrocardiogram, tracing 0099 0.38 $18.85 $14.68 $3.77 93010 E Electrocardiogram report 93012 X Transmission of ecg 0097 1.62 $80.35 $62.40 $16.07 93014 E Report on transmitted ecg 93015 E Cardiovascular stress test 93016 E Cardiovascular stress test 93017 X Cardiovascular stress test 0100 1.70 $84.32 $71.57 $16.86 93018 E Cardiovascular stress test 93024 X Cardiac drug stress test 0100 1.70 $84.32 $71.57 $16.86 93040 E Rhythm ECG with report 93041 X Rhythm ECG, tracing 0099 0.38 $18.85 $14.68 $3.77 93042 E Rhythm ECG, report 93224 E ECG monitor/report, 24 hrs 93225 X ECG monitor/record, 24 hrs 0100 1.70 $84.32 $71.57 $16.86 93226 X ECG monitor/report, 24 hrs 0100 1.70 $84.32 $71.57 $16.86 93227 E ECG monitor/review, 24 hrs 93230 E ECG monitor/report, 24 hrs 93231 X Ecg monitor/record, 24 hrs 0100 1.70 $84.32 $71.57 $16.86 93232 X ECG monitor/report, 24 hrs 0100 1.70 $84.32 $71.57 $16.86 93233 E ECG monitor/review, 24 hrs 93235 E ECG monitor/report, 24 hrs 93236 X ECG monitor/report, 24 hrs 0100 1.70 $84.32 $71.57 $16.86 93237 E ECG monitor/review, 24 hrs 93268 E ECG record/review 93270 X ECG recording 0097 1.62 $80.35 $62.40 $16.07 93271 X Ecg/monitoring and analysis 0097 1.62 $80.35 $62.40 $16.07 93272 E Ecg/review,interpret only 93278 X ECG/signal-averaged 0099 0.38 $18.85 $14.68 $3.77 93303 S Echo transthoracic 0269 4.40 $218.22 $114.01 $43.64 93304 S Echo transthoracic 0269 4.40 $218.22 $114.01 $43.64 93307 S Echo exam of heart 0269 4.40 $218.22 $114.01 $43.64 93308 S Echo exam of heart 0269 4.40 $218.22 $114.01 $43.64 93312 S Echo transesophageal 0270 5.55 $275.25 $150.26 $55.05 93313 S Echo transesophageal 0270 5.55 $275.25 $150.26 $55.05 93314 N Echo transesophageal 93315 S Echo transesophageal 0270 5.55 $275.25 $150.26 $55.05 93316 S Echo transesophageal 0270 5.55 $275.25 $150.26 $55.05 93317 N Echo transesophageal *93318 S Echo transesophageal 0270 5.55 $275.25 $150.26 $55.05 93320 S Doppler echo exam, heart 0269 4.40 $218.22 $114.01 $43.64 93321 S Doppler echo exam, heart 0269 4.40 $218.22 $114.01 $43.64 93325 S Doppler color flow add-on 0269 4.40 $218.22 $114.01 $43.64 93350 S Echo transthoracic 0269 4.40 $218.22 $114.01 $43.64 93501 T Right heart catheterization 0080 31.55 $1,564.75 $838.92 $312.95 93503 T Insert/place heart catheter 0103 13.09 $649.21 $295.70 $129.84 93505 T Biopsy of heart lining 0103 13.09 $649.21 $295.70 $129.84 93508 N Cath placement, angiography 93510 T Left heart catheterization 0080 31.55 $1,564.75 $838.92 $312.95 93511 T Left heart catheterization 0080 31.55 $1,564.75 $838.92 $312.95 93514 T Left heart catheterization 0080 31.55 $1,564.75 $838.92 $312.95 93524 T Left heart catheterization 0080 31.55 $1,564.75 $838.92 $312.95 93526 T Rt & Lt heart catheters 0080 31.55 $1,564.75 $838.92 $312.95 93527 T Rt & Lt heart catheters 0080 31.55 $1,564.75 $838.92 $312.95 93528 T Rt & Lt heart catheters 0080 31.55 $1,564.75 $838.92 $312.95 93529 T Rt, Lt heart catheterization 0080 31.55 $1,564.75 $838.92 $312.95 93530 T Rt heart cath, congenital 0080 31.55 $1,564.75 $838.92 $312.95 93531 T R & l heart cath, congenital 0080 31.55 $1,564.75 $838.92 $312.95 93532 T R & l heart cath, congenital 0080 31.55 $1,564.75 $838.92 $312.95 93533 T R & l heart cath, congenital 0080 31.55 $1,564.75 $838.92 $312.95 93536 T Insert circulation assi 0103 13.09 $649.21 $295.70 $129.84 93539 N Injection, cardiac cath 93540 N Injection, cardiac cath 93541 N Injection for lung angiogram 93542 N Injection for heart x-rays 93543 N Injection for heart x-rays 93544 N Injection for aortography 93545 N Inject for coronary x-rays 93555 N Imaging, cardiac cath 93556 N Imaging, cardiac cath 93561 N Cardiac output measurement 93562 N Cardiac output measurement 93571 N Heart flow reserve measure 93572 N Heart flow reserve measure 93600 S Bundle of His recording 0087 9.53 $472.65 $214.72 $94.53 93602 S Intra-atrial recording 0087 9.53 $472.65 $214.72 $94.53 93603 S Right ventricular recording 0087 9.53 $472.65 $214.72 $94.53 93607 S Left ventricular recording 0087 9.53 $472.65 $214.72 $94.53 93609 S Mapping of tachycardia 0087 9.53 $472.65 $214.72 $94.53 93610 S Intra-atrial pacing 0087 9.53 $472.65 $214.72 $94.53 93612 S Intraventricular pacing 0087 9.53 $472.65 $214.72 $94.53 93615 S Esophageal recording 0087 9.53 $472.65 $214.72 $94.53 93616 S Esophageal recording 0087 9.53 $472.65 $214.72 $94.53 93618 S Heart rhythm pacing 0087 9.53 $472.65 $214.72 $94.53 93619 S Electrophysiology evaluation 0085 27.06 $1,342.07 $654.48 $268.41 93620 S Electrophysiology evaluation 0085 27.06 $1,342.07 $654.48 $268.41 93621 S Electrophysiology evaluation 0085 27.06 $1,342.07 $654.48 $268.41 93622 S Electrophysiology evaluation 0085 27.06 $1,342.07 $654.48 $268.41 93623 S Stimulation, pacing heart 0087 9.53 $472.65 $214.72 $94.53 93624 S Electrophysiologic study 0087 9.53 $472.65 $214.72 $94.53 93631 S Heart pacing, mapping 0087 9.53 $472.65 $214.72 $94.53 93640 S Evaluation heart device 0084 10.70 $530.68 $177.79 $106.14 93641 S Electrophysiology evaluation 0084 10.70 $530.68 $177.79 $106.14 93642 S Electrophysiology evaluation 0084 10.70 $530.68 $177.79 $106.14 93650 S Ablate heart dysrhythm focus 0086 47.62 $2,361.76 $1,265.37 $472.35 93651 S Ablate heart dysrhythm focus 0086 47.62 $2,361.76 $1,265.37 $472.35 93652 S Ablate heart dysrhythm focus 0086 47.62 $2,361.76 $1,265.37 $472.35 93660 S Tilt table evaluation 0101 4.47 $221.70 $128.84 $44.34 *93662 S Intracardiac ECG 0270 5.55 $275.25 $150.26 $55.05 *93668 E Peripheral vascular rehab 93720 E Total body plethysmography 93721 S Plethysmography tracing 0096 2.06 $102.16 $61.48 $20.43 93722 E Plethysmography report 93724 S Analyze pacemaker system 0102 0.45 $22.32 $12.62 $4.46 93727 S Analyze ilr system 0102 0.45 $22.32 $12.62 $4.46 93731 S Analyze pacemaker system 0102 0.45 $22.32 $12.62 $4.46 93732 S Analyze pacemaker system 0102 0.45 $22.32 $12.62 $4.46 93733 S Telephone analy, pacemaker 0102 0.45 $22.32 $12.62 $4.46 93734 S Analyze pacemaker system 0102 0.45 $22.32 $12.62 $4.46 93735 S Analyze pacemaker system 0102 0.45 $22.32 $12.62 $4.46 93736 S Telephone analy, pacemaker 0102 0.45 $22.32 $12.62 $4.46 93737 S Analyze cardio/defibrillator 0102 0.45 $22.32 $12.62 $4.46 93738 S Analyze cardio/defibrillator 0102 0.45 $22.32 $12.62 $4.46 93740 S Temperature gradient studies 0096 2.06 $102.16 $61.48 $20.43 93741 S Analyze ht pace device sngl 0102 0.45 $22.32 $12.62 $4.46 93742 S Analyze ht pace device sngl 0102 0.45 $22.32 $12.62 $4.46 93743 S Analyze ht pace device dual 0102 0.45 $22.32 $12.62 $4.46 93744 S Analyze ht pace device dual 0102 0.45 $22.32 $12.62 $4.46 93760 E Cephalic thermogram 93762 E Peripheral thermogram 93770 N Measure venous pressure 93784 E Ambulatory BP monitoring 93786 E Ambulatory BP recording 93788 E Ambulatory BP analysis 93790 E Review/report BP recording 93797 S Cardiac rehab 0095 0.64 $31.74 $16.98 $6.35 93798 S Cardiac rehab/monitor 0095 0.64 $31.74 $16.98 $6.35 93799 S Cardiovascular procedure 0096 2.06 $102.16 $61.48 $20.43 93875 S Extracranial study 0096 2.06 $102.16 $61.48 $20.43 93880 S Extracranial study 0267 2.72 $134.90 $80.06 $26.98 93882 S Extracranial study 0267 2.72 $134.90 $80.06 $26.98 93886 S Intracranial study 0267 2.72 $134.90 $80.06 $26.98 93888 S Intracranial study 0267 2.72 $134.90 $80.06 $26.98 93922 S Extremity study 0096 2.06 $102.16 $61.48 $20.43 93923 S Extremity study 0096 2.06 $102.16 $61.48 $20.43 93924 S Extremity study 0096 2.06 $102.16 $61.48 $20.43 93925 S Lower extremity study 0267 2.72 $134.90 $80.06 $26.98 93926 S Lower extremity study 0267 2.72 $134.90 $80.06 $26.98 93930 S Upper extremity study 0267 2.72 $134.90 $80.06 $26.98 93931 S Upper extremity study 0267 2.72 $134.90 $80.06 $26.98 93965 S Extremity study 0096 2.06 $102.16 $61.48 $20.43 93970 S Extremity study 0267 2.72 $134.90 $80.06 $26.98 93971 S Extremity study 0267 2.72 $134.90 $80.06 $26.98 93975 S Vascular study 0267 2.72 $134.90 $80.06 $26.98 93976 S Vascular study 0267 2.72 $134.90 $80.06 $26.98 93978 S Vascular study 0267 2.72 $134.90 $80.06 $26.98 93979 S Vascular study 0267 2.72 $134.90 $80.06 $26.98 93980 S Penile vascular study 0267 2.72 $134.90 $80.06 $26.98 93981 S Penile vascular study 0267 2.72 $134.90 $80.06 $26.98 93990 S Doppler flow testing 0267 2.72 $134.90 $80.06 $26.98 94010 X Breathing capacity test 0367 0.83 $41.16 $20.65 $8.23 94014 X Patient recorded spirometry 0369 2.34 $116.06 $58.50 $23.21 94015 X Patient recorded spirometry 0369 2.34 $116.06 $58.50 $23.21 94016 X Review patient spirometry 0369 2.34 $116.06 $58.50 $23.21 94060 X Evaluation of wheezing 0368 1.66 $82.33 $42.44 $16.47 94070 X Evaluation of wheezing 0369 2.34 $116.06 $58.50 $23.21 94150 N Vital capacity test 94200 X Lung function test (MBC/MVV) 0367 0.83 $41.16 $20.65 $8.23 94240 X Residual lung capacity 0368 1.66 $82.33 $42.44 $16.47 94250 X Expired gas collection 0367 0.83 $41.16 $20.65 $8.23 94260 X Thoracic gas volume 0368 1.66 $82.33 $42.44 $16.47 94350 X Lung nitrogen washout curve 0368 1.66 $82.33 $42.44 $16.47 94360 X Measure airflow resistance 0368 1.66 $82.33 $42.44 $16.47 94370 X Breath airway closing volume 0368 1.66 $82.33 $42.44 $16.47 94375 X Respiratory flow volume loop 0367 0.83 $41.16 $20.65 $8.23 94400 X CO2 breathing response curve 0367 0.83 $41.16 $20.65 $8.23 94450 X Hypoxia response curve 0367 0.83 $41.16 $20.65 $8.23 94620 X Pulmonary stress test/simple 0368 1.66 $82.33 $42.44 $16.47 94621 X Pulm stress test/complex 0369 2.34 $116.06 $58.50 $23.21 94640 S Airway inhalation treatment 0077 0.43 $21.33 $12.62 $4.27 94642 S Aerosol inhalation treatment 0078 1.34 $66.46 $29.13 $13.29 94650 S Pressure breathing
(IPPB)0077 0.43 $21.33 $12.62 $4.27 94651 S Pressure breathing
(IPPB)0077 0.43 $21.33 $12.62 $4.27 94652 C Pressure breathing
(IPPB)94656 S Initial ventilator mgmt 0079 3.18 $157.72 $107.70 $31.54 94657 S Continued ventilator mgmt 0079 3.18 $157.72 $107.70 $31.54 94660 S Pos airway pressure, CPAP 0079 3.18 $157.72 $107.70 $31.54 94662 S Neg press ventilation, cnp 0079 3.18 $157.72 $107.70 $31.54 94664 S Aerosol or vapor inhalations 0077 0.43 $21.33 $12.62 $4.27 94665 S Aerosol or vapor inhalations 0077 0.43 $21.33 $12.62 $4.27 94667 S Chest wall manipulation 0077 0.43 $21.33 $12.62 $4.27 94668 S Chest wall manipulation 0077 0.43 $21.33 $12.62 $4.27 94680 X Exhaled air analysis, o2 0367 0.83 $41.16 $20.65 $8.23 94681 X Exhaled air analysis, o2/co2 0368 1.66 $82.33 $42.44 $16.47 94690 X Exhaled air analysis 0367 0.83 $41.16 $20.65 $8.23 94720 X Monoxide diffusing capacity 0367 0.83 $41.16 $20.65 $8.23 94725 X Membrane diffusion capacity 0368 1.66 $82.33 $42.44 $16.47 94750 X Pulmonary compliance study 0368 1.66 $82.33 $42.44 $16.47 94760 N Measure blood oxygen level 94761 N Measure blood oxygen level 94762 N Measure blood oxygen level 94770 X Exhaled carbon dioxide test 0367 0.83 $41.16 $20.65 $8.23 94772 X Breath recording, infant 0369 2.34 $116.06 $58.50 $23.21 94799 X Pulmonary service/procedure 0367 0.83 $41.16 $20.65 $8.23 95004 X Allergy skin tests 0370 0.57 $28.27 $11.81 $5.65 95010 X Sensitivity skin tests 0370 0.57 $28.27 $11.81 $5.65 95015 X Sensitivity skin tests 0370 0.57 $28.27 $11.81 $5.65 95024 X Allergy skin tests 0370 0.57 $28.27 $11.81 $5.65 95027 X Skin end point titration 0370 0.57 $28.27 $11.81 $5.65 95028 X Allergy skin tests 0370 0.57 $28.27 $11.81 $5.65 95044 X Allergy patch tests 0370 0.57 $28.27 $11.81 $5.65 95052 X Photo patch test 0370 0.57 $28.27 $11.81 $5.65 95056 X Photosensitivity tests 0370 0.57 $28.27 $11.81 $5.65 95060 X Eye allergy tests 0370 0.57 $28.27 $11.81 $5.65 95065 X Nose allergy test 0370 0.57 $28.27 $11.81 $5.65 95070 X Bronchial allergy tests 0369 2.34 $116.06 $58.50 $23.21 95071 X Bronchial allergy tests 0369 2.34 $116.06 $58.50 $23.21 95075 X Ingestion challenge test 0361 3.53 $175.07 $88.09 $35.01 95078 X Provocative testing 0370 0.57 $28.27 $11.81 $5.65 95115 X Immunotherapy, one injection 0371 0.32 $15.87 $3.67 $3.17 95117 X Immunotherapy injections 0371 0.32 $15.87 $3.67 $3.17 95120 E Immunotherapy, one injection 95125 E Immunotherapy, many antigens 95130 E Immunotherapy, insect venom 95131 E Immunotherapy, insect venoms 95132 E Immunotherapy, insect venoms 95133 E Immunotherapy, insect venoms 95134 E Immunotherapy, insect venoms 95144 X Antigen therapy services 0371 0.32 $15.87 $3.67 $3.17 95145 X Antigen therapy services 0371 0.32 $15.87 $3.67 $3.17 95146 X Antigen therapy services 0371 0.32 $15.87 $3.67 $3.17 95147 X Antigen therapy services 0371 0.32 $15.87 $3.67 $3.17 95148 X Antigen therapy services 0371 0.32 $15.87 $3.67 $3.17 95149 X Antigen therapy services 0371 0.32 $15.87 $3.67 $3.17 95165 X Antigen therapy services 0371 0.32 $15.87 $3.67 $3.17 95170 X Antigen therapy services 0371 0.32 $15.87 $3.67 $3.17 95180 X Rapid desensitization 0370 0.57 $28.27 $11.81 $5.65 95199 X Allergy immunology services 0370 0.57 $28.27 $11.81 $5.65 95805 S Multiple sleep latency test 0213 11.15 $553.00 $290.42 $110.60 95806 S Sleep study, unattended 0213 11.15 $553.00 $290.42 $110.60 95807 S Sleep study, attended 0213 11.15 $553.00 $290.42 $110.60 95808 S Polysomnography, 1-3 0213 11.15 $553.00 $290.42 $110.60 95810 S Polysomnography, 4 or more 0213 11.15 $553.00 $290.42 $110.60 95811 S Polysomnography w/cpap 0213 11.15 $553.00 $290.42 $110.60 95812 S Electroencephalogram
(EEG)0213 11.15 $553.00 $290.42 $110.60 95813 S Electroencephalogram
(EEG)0213 11.15 $553.00 $290.42 $110.60 95816 S Electroencephalogram
(EEG)0214 2.32 $115.06 $58.50 $23.01 95819 S Electroencephalogram
(EEG)0214 2.32 $115.06 $58.50 $23.01 95822 S Sleep electroencephalogram 0214 2.32 $115.06 $58.50 $23.01 95824 S Electroencephalography 0214 2.32 $115.06 $58.50 $23.01 95827 S Night electroencephalogram 0213 11.15 $553.00 $290.42 $110.60 95829 S Surgery electrocorticogram 0214 2.32 $115.06 $58.50 $23.01 95830 E Insert electrodes for EEG 95831 N Limb muscle testing, manual 95832 N Hand muscle testing, manual 95833 N Body muscle testing, manual 95834 N Body muscle testing, manual 95851 N Range of motion measurements 95852 N Range of motion measurements 95857 S Tensilon test 0215 1.15 $57.04 $30.05 $11.41 95858 S Tensilon test & myogram 0215 1.15 $57.04 $30.05 $11.41 95860 S Muscle test, one limb 0215 1.15 $57.04 $30.05 $11.41 95861 S Muscle test, two limbs 0215 1.15 $57.04 $30.05 $11.41 95863 S Muscle test, 3 limbs 0216 2.87 $142.34 $64.69 $28.47 95864 S Muscle test, 4 limbs 0215 1.15 $57.04 $30.05 $11.41 95867 S Muscle test, head or neck 0216 2.87 $142.34 $64.69 $28.47 95868 S Muscle test, head or neck 0216 2.87 $142.34 $64.69 $28.47 95869 S Muscle test, thor paraspinal 0215 1.15 $57.04 $30.05 $11.41 95870 S Muscle test, nonparaspinal 0215 1.15 $57.04 $30.05 $11.41 95872 S Muscle test, one fiber 0215 1.15 $57.04 $30.05 $11.41 95875 S Limb exercise test 0217 5.87 $291.13 $156.68 $58.23 95900 S Motor nerve conduction test 0215 1.15 $57.04 $30.05 $11.41 95903 S Motor nerve conduction test 0215 1.15 $57.04 $30.05 $11.41 95904 S Sense/mixed n conduction tst 0215 1.15 $57.04 $30.05 $11.41 95920 S Intraop nerve test add-on 0216 2.87 $142.34 $64.69 $28.47 95921 S Autonomic nerv function test 0216 2.87 $142.34 $64.69 $28.47 95922 S Autonomic nerv function test 0216 2.87 $142.34 $64.69 $28.47 95923 S Autonomic nerv function test 0216 2.87 $142.34 $64.69 $28.47 95925 S Somatosensory testing 0216 2.87 $142.34 $64.69 $28.47 95926 S Somatosensory testing 0216 2.87 $142.34 $64.69 $28.47 95927 S Somatosensory testing 0216 2.87 $142.34 $64.69 $28.47 95930 S Visual evoked potential test 0216 2.87 $142.34 $64.69 $28.47 95933 S Blink reflex test 0215 1.15 $57.04 $30.05 $11.41 95934 S H-reflex test 0215 1.15 $57.04 $30.05 $11.41 95936 S H-reflex test 0216 2.87 $142.34 $64.69 $28.47 95937 S Neuromuscular junction test 0215 1.15 $57.04 $30.05 $11.41 95950 S Ambulatory eeg monitoring 0217 5.87 $291.13 $156.68 $58.23 95951 S EEG monitoring/videorecord 0213 11.15 $553.00 $290.42 $110.60 95953 S EEG monitoring/computer 0213 11.15 $553.00 $290.42 $110.60 95954 S EEG monitoring/giving drugs 0213 11.15 $553.00 $290.42 $110.60 95955 S EEG during surgery 0214 2.32 $115.06 $58.50 $23.01 95956 N Eeg monitoring, cable/radio 95957 N EEG digital analysis 95958 S EEG monitoring/function test 0213 11.15 $553.00 $290.42 $110.60 95961 S Electrode stimulation, brain 0216 2.87 $142.34 $64.69 $28.47 95962 S Electrode stim, brain add-on 0216 2.87 $142.34 $64.69 $28.47 95970 S Analyze neurostim, no prog 0102 0.45 $22.32 $12.62 $4.46 95971 S Analyze neurostim, simple 0102 0.45 $22.32 $12.62 $4.46 95972 S Analyze neurostim, complex 0102 0.45 $22.32 $12.62 $4.46 95973 S Analyze neurostim, complex 0102 0.45 $22.32 $12.62 $4.46 95974 S Cranial neurostim, complex 0102 0.45 $22.32 $12.62 $4.46 95975 S Cranial neurostim, complex 0102 0.45 $22.32 $12.62 $4.46 95999 N Neurological procedure 96100 X Psychological testing 0373 3.21 $159.20 $44.96 $31.84 96105 X Assessment of aphasia 0373 3.21 $159.20 $44.96 $31.84 96110 X Developmental test, lim 0373 3.21 $159.20 $44.96 $31.84 96111 X Developmental test, extend 0373 3.21 $159.20 $44.96 $31.84 96115 X Neurobehavior status exam 0373 3.21 $159.20 $44.96 $31.84 96117 X Neuropsych test battery 0373 3.21 $159.20 $44.96 $31.84 96400 E Chemotherapy, sc/im 96405 E Intralesional chemo admin 96406 E Intralesional chemo admin 96408 E Chemotherapy, push technique 96410 E Chemotherapy,infusion method 96412 E Chemo, infuse method add-on 96414 E Chemo, infuse method add-on 96420 E Chemotherapy, push technique 96422 E Chemotherapy,infusion method 96423 E Chemo, infuse method add-on 96425 E Chemotherapy,infusion method 96440 E Chemotherapy, intracavitary 96445 E Chemotherapy, intracavitary 96450 E Chemotherapy, into CNS 96520 E Pump refilling, maintenance 96530 E Pump refilling, maintenance 96542 E Chemotherapy injection 96545 E Provide chemotherapy agent 96549 E Chemotherapy, unspecified 96570 T Photodynamic tx, 30 min 0973 5.16 $255.91 $51.18 96571 T Photodynamic tx, addl 15 min 0973 5.16 $255.91 $51.18 96900 S Ultraviolet light therapy 0001 0.47 $23.31 $8.49 $4.66 96902 N Trichogram 96910 S Photochemotherapy with UV-B 0001 0.47 $23.31 $8.49 $4.66 96912 S Photochemotherapy with UV-A 0001 0.47 $23.31 $8.49 $4.66 96913 S Photochemotherapy, UV-A or B 0001 0.47 $23.31 $8.49 $4.66 96999 S Dermatological procedure 0001 0.47 $23.31 $8.49 $4.66 97001 A Pt evaluation 97002 A Pt re-evaluation 97003 A Ot evaluation 97004 A Ot re-evaluation 97010 A Hot or cold packs therapy 97012 A Mechanical traction therapy 97014 A Electric stimulation therapy 97016 A Vasopneumatic device therapy 97018 A Paraffin bath therapy 97020 A Microwave therapy 97022 A Whirlpool therapy 97024 A Diathermy treatment 97026 A Infrared therapy 97028 A Ultraviolet therapy 97032 A Electrical stimulation 97033 A Electric current therapy 97034 A Contrast bath therapy 97035 A Ultrasound therapy 97036 A Hydrotherapy 97039 A Physical therapy treatment 97110 A Therapeutic exercises 97112 A Neuromuscular reeducation 97113 A Aquatic therapy/exercises 97116 A Gait training therapy 97124 A Massage therapy 97139 A Physical medicine procedure 97140 A Manual therapy 97150 A Group therapeutic procedures 97504 A Orthotic training 97520 A Prosthetic training 97530 A Therapeutic activities *97532 A Cognitive skills development *97533 A Sensory integration 97535 A Self care mngment training 97537 A Community/work reintegration 97542 A Wheelchair mngment training 97545 A Work hardening 97546 A Work hardening add-on *97601 A Wound care selective *97602 N Wound care non-selective 97703 A Prosthetic checkout 97750 A Physical performance test 97770D A Cognitive skills development 97780 E Acupuncture w/o stimul 97781 E Acupuncture w/stimul 97799 A Physical medicine procedure *97802 E Medical nutrition *97803 E Medical nutrition *97804 E Medical nutrition 98925 S Osteopathic manipulation 0060 0.77 $38.19 $7.80 $7.64 98926 S Osteopathic manipulation 0060 0.77 $38.19 $7.80 $7.64 98927 S Osteopathic manipulation 0060 0.77 $38.19 $7.80 $7.64 98928 S Osteopathic manipulation 0060 0.77 $38.19 $7.80 $7.64 98929 S Osteopathic manipulation 0060 0.77 $38.19 $7.80 $7.64 98940 S Chiropractic manipulation 0060 0.77 $38.19 $7.80 $7.64 98941 S Chiropractic manipulation 0060 0.77 $38.19 $7.80 $7.64 98942 S Chiropractic manipulation 0060 0.77 $38.19 $7.80 $7.64 98943 E Chiropractic manipulation 99000 E Specimen handling 99001 E Specimen handling 99002 E Device handling 99024 E Postop follow-up visit 99025 E Initial surgical evaluation 99050 E Medical services after hrs 99052 E Medical services at night 99054 E Medical servcs, unusual hrs 99056 E Non-office medical services 99058 E Office emergency care 99070 E Special supplies 99071 E Patient education materials 99075 E Medical testimony 99078 E Group health education 99080 E Special reports or forms 99082 E Unusual physician travel 99090 E Computer data analysis 99100 E Special anesthesia service 99116 E Anesthesia with hypothermia 99135 E Special anesthesia procedure 99140 E Emergency anesthesia 99141 N Sedation, iv/im or inhalant 99142 N Sedation, oral/rectal/nasal 99170 T Anogenital exam, child 0192 2.38 $118.04 $35.33 $23.61 *99172 E Visual function screening 99173 E Visual screening test 99175 N Induction of vomiting 99183 E Hyperbaric oxygen therapy 99185 N Regional hypothermia 99186 N Total body hypothermia 99190 C Special pump services 99191 C Special pump services 99192 C Special pump services 99195 X Phlebotomy 0372 0.43 $21.33 $10.09 $4.27 99199 E Special service/proc/report 99201 V Office/outpatient visit, new 0600 0.98 $48.61 $9.72 $9.72 99202 V Office/outpatient visit, new 0600 0.98 $48.61 $9.72 $9.72 99203 V Office/outpatient visit, new 0601 1.00 $49.60 $9.92 $9.92 99204 V Office/outpatient visit, new 0602 1.66 $82.33 $16.47 $16.47 99205 V Office/outpatient visit, new 0602 1.66 $82.33 $16.47 $16.47 99211 V Office/outpatient visit, est 0600 0.98 $48.61 $9.72 $9.72 99212 V Office/outpatient visit, est 0600 0.98 $48.61 $9.72 $9.72 99213 V Office/outpatient visit, est 0601 1.00 $49.60 $9.92 $9.92 99214 V Office/outpatient visit, est 0602 1.66 $82.33 $16.47 $16.47 99215 V Office/outpatient visit, est 0602 1.66 $82.33 $16.47 $16.47 99217 N Observation care discharge 99218 N Observation care 99219 N Observation care 99220 N Observation care 99221 E Initial hospital care 99222 E Initial hospital care 99223 E Initial hospital care 99231 E Subsequent hospital care 99232 E Subsequent hospital care 99233 E Subsequent hospital care 99234 N Observ/hosp same date 99235 N Observ/hosp same date 99236 N Observ/hosp same date 99238 E Hospital discharge day 99239 E Hospital discharge day 99241 V Office consultation 0600 0.98 $48.61 $9.72 $9.72 99242 V Office consultation 0600 0.98 $48.61 $9.72 $9.72 99243 V Office consultation 0601 1.00 $49.60 $9.92 $9.92 99244 V Office consultation 0602 1.66 $82.33 $16.47 $16.47 99245 V Office consultation 0602 1.66 $82.33 $16.47 $16.47 99251 C Initial inpatient consult 99252 C Initial inpatient consult 99253 C Initial inpatient consult 99254 C Initial inpatient consult 99255 C Initial inpatient consult 99261 C Follow-up inpatient consult 99262 C Follow-up inpatient consult 99263 C Follow-up inpatient consult 99271 V Confirmatory consultation 0600 0.98 $48.61 $9.72 $9.72 99272 V Confirmatory consultation 0600 0.98 $48.61 $9.72 $9.72 99273 V Confirmatory consultation 0601 1.00 $49.60 $9.92 $9.92 99274 V Confirmatory consultation 0602 1.66 $82.33 $16.47 $16.47 99275 V Confirmatory consultation 0602 1.66 $82.33 $16.47 $16.47 99281 V Emergency dept visit 0610 1.34 $66.46 $20.65 $13.29 99282 V Emergency dept visit 0610 1.34 $66.46 $20.65 $13.29 99283 V Emergency dept visit 0611 2.11 $104.65 $36.47 $20.93 99284 V Emergency dept visit 0612 3.19 $158.21 $54.14 $31.64 99285 V Emergency dept visit 0612 3.19 $158.21 $54.14 $31.64 99288 E Direct advanced life support 99291 S Critical care, first hour 0620 8.60 $426.53 $152.78 $85.31 99292 N Critical care, addl 30 min 99295 C Neonatal critical care 99296 C Neonatal critical care 99297 C Neonatal critical care 99298 C Neonatal critical care 99301 E Nursing facility care 99302 E Nursing facility care 99303 E Nursing facility care 99311 E Nursing fac care, subseq 99312 E Nursing fac care, subseq 99313 E Nursing fac care, subseq 99315 E Nursing fac discharge day 99316 E Nursing fac discharge day 99321 E Rest home visit, new patient 99322 E Rest home visit, new patient 99323 E Rest home visit, new patient 99331 E Rest home visit, est pat 99332 E Rest home visit, est pat 99333 E Rest home visit, est pat 99341 E Home visit, new patient 99342 E Home visit, new patient 99343 E Home visit, new patient 99344 E Home visit, new patient 99345 E Home visit, new patient 99347 E Home visit, est patient 99348 E Home visit, est patient 99349 E Home visit, est patient 99350 E Home visit, est patient 99354 N Prolonged service, office 99355 N Prolonged service, office 99356 C Prolonged service, inpatient 99357 C Prolonged service, inpatient 99358 N Prolonged serv, w/o contact 99359 N Prolonged serv, w/o contact 99360 E Physician standby services 99361 E Physician/team conference 99362 E Physician/team conference 99371 E Physician phone consultation 99372 E Physician phone consultation 99373 E Physician phone consultation 99374 E Home health care supervision 99375D E Home health care supervision 99377 E Hospice care supervision 99378D E Hospice care supervision 99379 E Nursing fac care supervision 99380 E Nursing fac care supervision 99381 E Prev visit, new, infant 99382 E Prev visit, new, age 1-4 99383 E Prev visit, new, age 5-11 99384 E Prev visit, new, age 12-17 99385 E Prev visit, new, age 18-39 99386 E Prev visit, new, age 40-64 99387 E Prev visit, new, 65 & over 99391 E Prev visit, est, infant 99392 E Prev visit, est, age 1-4 99393 E Prev visit, est, age 5-11 99394 E Prev visit, est, age 12-17 99395 E Prev visit, est, age 18-39 99396 E Prev visit, est, age 40-64 99397 E Prev visit, est, 65 & over 99401 E Preventive counseling, indiv 99402 E Preventive counseling, indiv 99403 E Preventive counseling, indiv 99404 E Preventive counseling, indiv 99411 E Preventive counseling, group 99412 E Preventive counseling, group 99420 E Health risk assessment test 99429 E Unlisted preventive service 99431 N Initial care, normal newborn 99432 N Newborn care, not in hosp 99433 C Normal newborn care/hospital 99435 E Newborn discharge day hosp 99436 N Attendance, birth 99440 S Newborn resuscitation 0094 4.51 $223.68 $105.29 $44.74 99450 E Life/disability evaluation 99455 E Disability examination 99456 E Disability examination 99499 E Unlisted e&m service A0021 E Outside state ambulance serv A0030D A Air ambulance service A0040D A Helicopter ambulance service A0050D A Water amb service emergency A0080 E Noninterest escort in non er A0090 E Interest escort in non er A0100 E Nonemergency transport taxi A0110 E Nonemergency transport bus A0120 E Noner transport mini-bus A0130 E Noner transport wheelch van A0140 E Nonemergency transport air A0160 E Noner transport case worker A0170 E Noner transport parking fees A0180 E Noner transport lodgng recip A0190 E Noner transport meals recip A0200 E Noner transport lodgng escrt A0210 E Noner transport meals escort A0225 A Neonatal emergency transport A0300D A Ambulance basic non-emer all A0302D A Ambulance basic emergeny all A0304D A Amb adv non-er no serv all A0306D A Amb adv non-er spec serv all A0308D A Amb adv er no spec serv all A0310D A Amb adv er spec serv all A0320D A Amb basic non-er + supplies A0322D A Amb basic emerg + supplies A0324D A Adv non-er serv sep mileage A0326D A Adv non-er no serv sep mile A0328D A Adv er no serv sep mileage A0330D A Adv er spec serv sep mile A0340D A Amb basic non-er + mileage A0342D A Ambul basic emer + mileage A0344D A Amb adv non-er no serv +mile A0346D A Amb adv non-er serv + mile A0348D A Adv emer no spec serv + mile A0350D A Adv emer spec serv + mileage A0360D A Basic non-er sep mile & supp A0362D A Basic emer sep mile & supply A0364D A Adv non-er no serv sep mi&su A0366D A Adv non-er serv sep mil&supp A0368 A Adv er no serv sep mile&supp A0370D A Adv er spec serv sep mi&supp A0380D A Basic life support mileage A0382 A Basic support routine suppls A0384 A Bls defibrillation supplies A0390D A Advanced life support mileag A0392 A Als defibrillation supplies A0394 A Als IV drug therapy supplies A0396 A Als esophageal intub suppls A0398 A Als routine disposble suppls A0420 A Ambulance waiting 1/2 hr A0422 A Ambulance O2 life sustaining A0424 A Extra ambulance attendant A0425 A Ground mileage A0426 A Als 1 A0427 A ALS1-emergency A0428 A bls A0429 A BLS-emergency A0430 A Fixed wing air transport A0431 A Rotary wing air transport A0432 A PI volunteer ambulance co A0433 A als 2 A0434 A Specialty care transport A0435 A Fixed wing air mileage A0436 A Rotary wing air mileage A0888 E Noncovered ambulance mileage A0999 A Unlisted ambulance service A4206 E 1 CC sterile syringe&needle A4207 E 2 CC sterile syringe&needle A4208 E 3 CC sterile syringe&needle A4209 E 5+ CC sterile syringe&needle A4210 E Nonneedle injection device A4211 E Supp for self-adm injections A4212 E Non coring needle or stylet A4213 E 20+ CC syringe only A4214 A 30 CC sterile water/saline A4215 E Sterile needle A4220 E Infusion pump refill kit A4221 A Maint drug infus cath per wk A4222 A Drug infusion pump supplies A4230 A Infus insulin pump non needl A4231 A Infusion insulin pump needle A4232 A Syringe w/needle insulin 3cc A4244 E Alcohol or peroxide per pint A4245 E Alcohol wipes per box A4246 E Betadine/phisohex solution A4247 E Betadine/iodine swabs/wipes A4250 E Urine reagent strips/tablets A4253 A Blood glucose/reagent strips A4254 A Battery for glucose monitor A4255 A Glucose monitor platforms A4256 A Calibrator solution/chips A4258 A Lancet device each A4259 A Lancets per box A4260 E Levonorgestrel implant A4261 E Cervical cap contraceptive A4262 N Temporary tear duct plug A4263 N Permanent tear duct plug A4265 A Paraffin A4270 A Disposable endoscope sheath A4280 A Brst prsths adhsv attchmnt A4290 N Sacral nerve stim test lead A4300 A Cath impl vasc access portal A4301 A Implantable access syst perc A4305 A Drug delivery system >=50 ML A4306 A Drug delivery system <=5 ML A4310 A Insert tray w/o bag/cath A4311 A Catheter w/o bag 2-way latex A4312 A Cath w/o bag 2-way silicone A4313 A Catheter w/bag 3-way A4314 A Cath w/drainage 2-way latex A4315 A Cath w/drainage 2-way silcne A4316 A Cath w/drainage 3-way A4319 A Sterile H2O irrigation solut A4320 A Irrigation tray A4321 A Cath therapeutic irrig agent A4322 A Irrigation syringe A4323 A Saline irrigation solution A4324 A Male ext cath w/adh coating A4325 A Male ext cath w/adh strip A4326 A Male external catheter A4327 A Fem urinary collect dev cup A4328 A Fem urinary collect pouch A4329 A External catheter start set A4330 A Stool collection pouch A4331 A Extension drainage tubing A4332 A Lubricant for cath insertion A4333 A Urinary cath anchor device A4334 A Urinary cath leg strap A4335 A Incontinence supply A4338 A Indwelling catheter latex A4340 A Indwelling catheter special A4344 A Cath indw foley 2 way silicn A4346 A Cath indw foley 3 way A4347 A Male external catheter A4348 A Male ext cath extended wear A4351 A Straight tip urine catheter A4352 A Coude tip urinary catheter A4353 A Intermittent urinary cath A4354 A Cath insertion tray w/bag A4355 A Bladder irrigation tubing A4356 A Ext ureth clmp or compr dvc A4357 A Bedside drainage bag A4358 A Urinary leg bag A4359 A Urinary suspensory w/o leg b A4361 A Ostomy face plate A4362 A Solid skin barrier A4364 A Ostomy/cath adhesive A4365 A Ostomy adhesive remover wipe A4367 A Ostomy belt A4368 A Ostomy filter A4369 A Skin barrier liquid per oz A4370 A Skin barrier paste per oz A4371 A Skin barrier powder per oz A4372 A Skin barrier solid 4x4 equiv A4373 A Skin barrier with flange A4374 A Skin barrier extended wear A4375 A Drainable plastic pch w fcpl A4376 A Drainable rubber pch w fcplt A4377 A Drainable plstic pch w/o fp A4378 A Drainable rubber pch w/o fp A4379 A Urinary plastic pouch w fcpl A4380 A Urinary rubber pouch w fcplt A4381 A Urinary plastic pouch w/o fp A4382 A Urinary hvy plstc pch w/o fp A4383 A Urinary rubber pouch w/o fp A4384 A Ostomy faceplt/silicone ring A4385 A Ost skn barrier sld ext wear A4386 A Ost skn barrier w flng ex wr A4387 A Ost clsd pouch w att st barr A4388 A Drainable pch w ex wear barr A4389 A Drainable pch w st wear barr A4390 A Drainable pch ex wear convex A4391 A Urinary pouch w ex wear barr A4392 A Urinary pouch w st wear barr A4393 A Urine pch w ex wear bar conv A4394 A Ostomy pouch liq deodorant A4395 A Ostomy pouch solid deodorant A4396 A Peristomal hernia supprt blt A4397 A Irrigation supply sleeve A4398 A Ostomy irrigation bag A4399 A Ostomy irrig cone/cath w brs A4400 A Ostomy irrigation set A4402 A Lubricant per ounce A4404 A Ostomy ring each A4421 A Ostomy supply misc A4454 A Tape all types all sizes A4455 A Adhesive remover per ounce A4460 A Elastic compression bandage A4462 A Abdmnl drssng holder/binder A4464 A Joint support device/garment A4465 A Non-elastic extremity binder A4470 A Gravlee jet washer A4480 A Vabra aspirator A4481 A Tracheostoma filter A4483 A Moisture exchanger A4490 E Above knee surgical stocking A4495 E Thigh length surg stocking A4500 E Below knee surgical stocking A4510 E Full length surg stocking A4550 E Surgical trays A4554 E Disposable underpads A4556 A Electrodes, pair A4557 A Lead wires, pair A4558 A Conductive paste or gel A4560D A Pessary A4561 N Pessary rubber, any type A4562 N Pessary, non rubber,any type A4565 A Slings A4570 N Splint A4572 A Rib belt A4575 E Hyperbaric o2 chamber disps A4580 N Cast supplies (plaster) A4590 N Special casting material A4595 A TENS suppl 2 lead per month A4608 A Transtracheal oxygen cath A4611 A Heavy duty battery A4612 A Battery cables A4613 A Battery charger A4614 A Hand-held PEFR meter A4615 A Cannula nasal A4616 A Tubing (oxygen) per foot A4617 A Mouth piece A4618 A Breathing circuits A4619 A Face tent A4620 A Variable concentration mask A4621 A Tracheotomy mask or collar A4622 A Tracheostomy or larngectomy A4623 A Tracheostomy inner cannula A4624 A Tracheal suction tube A4625 A Trach care kit for new trach A4626 A Tracheostomy cleaning brush A4627 E Spacer bag/reservoir A4628 A Oropharyngeal suction cath A4629 A Tracheostomy care kit A4630 A Repl bat t.e.n.s. own by pt A4631 A Wheelchair battery A4635 A Underarm crutch pad A4636 A Handgrip for cane etc A4637 A Repl tip cane/crutch/walker A4640 A Alternating pressure pad A4641 N Diagnostic imaging agent A4642 G Satumomab pendetide per dose 0704 $712.50 $86.93 A4643 N High dose contrast MRI A4644 N Contrast 100-199 MGs iodine A4645 N Contrast 200-299 MGs iodine A4646 N Contrast 300-399 MGs iodine A4647 N Supp- paramagnetic contr mat A4649 A Surgical supplies A4650 A Supp esrd centrifuge A4655 A Esrd syringe/needle A4660 A Esrd blood pressure device A4663 A Esrd blood pressure cuff A4670 E Auto blood pressure monitor A4680 A Activated carbon filters A4690 A Dialyzers A4700 A Standard dialysate solution A4705 A Bicarb dialysate solution A4712 A Sterile water A4714 A Treated water for dialysis A4730 A Fistula cannulation set dial A4735 A Local/topical anesthetics A4740 A Esrd shunt accessory A4750 A Arterial or venous tubing A4755 A Arterial and venous tubing A4760 A Standard testing solution A4765 A Dialysate concentrate A4770 A Blood testing supplies A4771 A Blood clotting time tube A4772 A Dextrostick/glucose strips A4773 A Hemostix A4774 A Ammonia test paper A4780 A Esrd sterilizing agent A4790 A Esrd cleansing agents A4800 A Heparin/antidote dialysis A4820 A Supplies hemodialysis kit A4850 A Rubber tipped hemostats A4860 A Disposable catheter caps A4870 A Plumbing/electrical work A4880 A Water storage tanks A4890 A Contracts/repair/maintenance A4900 A Capd supply kit A4901 A Ccpd supply kit A4905 A Ipd supply kit A4910 A Esrd nonmedical supplies A4912 A Gomco drain bottle A4913 A Esrd supply A4914 A Preparation kit A4918 A Venous pressure clamp A4919 A Supp dialysis dialyzer holde A4920 A Harvard pressure clamp A4921 A Measuring cylinder A4927 A Gloves A5051 A Pouch clsd w barr attached A5052 A Clsd ostomy pouch w/o barr A5053 A Clsd ostomy pouch faceplate A5054 A Clsd ostomy pouch w/flange A5055 A Stoma cap A5061 A Pouch drainable w barrier at A5062 A Drnble ostomy pouch w/o barr A5063 A Drain ostomy pouch w/flange A5064 E Drain ostomy pouch w/fceplte A5065D E Drain ostomy pouch w/fceplte A5071 A Urinary pouch w/barrier A5072 A Urinary pouch w/o barrier A5073 A Urinary pouch on barr w/flng A5074 E Urinary pouch w/faceplate A5075 E Urinary pouch on faceplate A5081 A Continent stoma plug A5082 A Continent stoma catheter A5093 A Ostomy accessory convex inse A5102 A Bedside drain btl w/wo tube A5105 A Urinary suspensory A5112 A Urinary leg bag A5113 A Latex leg strap A5114 A Foam/fabric leg strap A5119 A Skin barrier wipes box pr 50 A5121 A Solid skin barrier 6x6 A5122 A Solid skin barrier 8x8 A5123 A Skin barrier with flange A5126 A Disk/foam pad +or- adhesive A5131 A Appliance cleaner A5149D A Incontinence/ostomy supply A5200 A Percutaneous catheter anchor A5500 A Diab shoe for density insert A5501 A Diabetic custom molded shoe A5502 A Diabetic shoe density insert A5503 A Diabetic shoe w/roller/rockr A5504 A Diabetic shoe with wedge A5505 A Diab shoe w/metatarsal bar A5506 A Diabetic shoe w/off set heel A5507 A Modification diabetic shoe A5508 A Diabetic deluxe shoe A6020 A Collagen wound dressing A6021 A Collagen dressing <=16 sq in A6022 A Collagen drsg>6<=48 sq in A6023 A Collagen dressing >48 sq in A6024 A Collagen dsg wound filler A6025 E Silicone gel sheet, each A6154 A Wound pouch each A6196 A Alginate dressing <=16 sq in A6197 A Alginate drsg >16 <=48 sq in A6198 A alginate dressing > 48 sq in A6199 A Alginate drsg wound filler A6200 A Compos drsg <=16 no border A6201 A Compos drsg >16<=48 no bdr A6202 A Compos drsg >48 no border A6203 A Composite drsg <= 16 sq in A6204 A Composite drsg >16<=48 sq in A6205 A Composite drsg > 48 sq in A6206 A Contact layer <= 16 sq in A6207 A Contact layer >16<= 48 sq in A6208 A Contact layer > 48 sq in A6209 A Foam drsg <=16 sq in w/o bdr A6210 A Foam drg >16<=48 sq in w/o b A6211 A Foam drg > 48 sq in w/o brdr A6212 A Foam drg <=16 sq in w/border A6213 A Foam drg >16<=48 sq in w/bdr A6214 A Foam drg > 48 sq in w/border A6215 A Foam dressing wound filler A6216 A Non-sterile gauze<=16 sq in A6217 A Non-sterile gauze>16<=48 sq A6218 A Non-sterile gauze > 48 sq in A6219 A Gauze <= 16 sq in w/border A6220 A Gauze >16 <=48 sq in w/bordr A6221 A Gauze > 48 sq in w/border A6222 A Gauze <=16 in no w/sal w/o b A6223 A Gauze >16<=48 no w/sal w/o b A6224 A Gauze > 48 in no w/sal w/o b A6228 A Gauze <= 16 sq in water/sal A6229 A Gauze >16<=48 sq in watr/sal A6230 A Gauze > 48 sq in water/salne A6231 A Hydrogel dsg<=16 sq in A6232 A Hydrogel dsg>16<=48 sq in A6233 A Hydrogel dressing >48 sq in A6234 A Hydrocolld drg <=16 w/o bdr A6235 A Hydrocolld drg >16<=48 w/o b A6236 A Hydrocolld drg > 48 in w/o b A6237 A Hydrocolld drg <=16 in w/bdr A6238 A Hydrocolld drg >16<=48 w/bdr A6239 A Hydrocolld drg > 48 in w/bdr A6240 A Hydrocolld drg filler paste A6241 A Hydrocolloid drg filler dry A6242 A Hydrogel drg <=16 in w/o bdr A6243 A Hydrogel drg >16<=48 w/o bdr A6244 A Hydrogel drg >48 in w/o bdr A6245 A Hydrogel drg <= 16 in w/bdr A6246 A Hydrogel drg >16<=48 in w/b A6247 A Hydrogel drg > 48 sq in w/b A6248 A Hydrogel drsg gel filler A6250 A Skin seal protect moisturizr A6251 A Absorpt drg <=16 sq in w/o b A6252 A Absorpt drg >16 <=48 w/o bdr A6253 A Absorpt drg > 48 sq in w/o b A6254 A Absorpt drg <=16 sq in w/bdr A6255 A Absorpt drg >16<=48 in w/bdr A6256 A Absorpt drg > 48 sq in w/bdr A6257 A Transparent film <= 16 sq in A6258 A Transparent film >16<=48 in A6259 A Transparent film > 48 sq in A6260 A Wound cleanser any type/size A6261 A Wound filler gel/paste /oz A6262 A Wound filler dry form / gram A6263 A Non-sterile elastic gauze/yd A6264 A Non-sterile no elastic gauze A6265 A Tape per 18 sq inches A6266 A Impreg gauze no h2O/sal/yard A6402 A Sterile gauze <= 16 sq in A6403 A Sterile gauze>16 <= 48 sq in A6404 A Sterile gauze > 48 sq in A6405 A Sterile elastic gauze /yd A6406 A Sterile non-elastic gauze/yd A7000 A Disposable canister for pump A7001 A Nondisposable pump canister A7002 A Tubing used w suction pump A7003 A Nebulizer administration set A7004 A Disposable nebulizer sml vol A7005 A Nondisposable nebulizer set A7006 A Filtered nebulizer admin set A7007 A Lg vol nebulizer disposable A7008 A Disposable nebulizer prefill A7009 A Nebulizer reservoir bottle A7010 A Disposable corrugated tubing A7011 A Nondispos corrugated tubing A7012 A Nebulizer water collec devic A7013 A Disposable compressor filter A7014 A Compressor nondispos filter A7015 A Aerosol mask used w nebulize A7016 A Nebulizer dome & mouthpiece A7017 A Nebulizer not used w oxygen A7018 A Water distilled w/nebulizer A7019 A Saline solution dispenser A7020 A Sterile H2O or NSS w lgv neb A7501 A Tracheostoma valve w diaphra A7502 A Replacement diaphragm/fplate A7503 A HMES filter holder or cap A7504 A Tracheostoma HMES filter A7505 A HMES or trach valve housing A7506 A HMES/trachvalve adhesivedisk A7507 A Integrated filter & holder A7508 A Housing & Integrated Adhesiv A7509 A Heat & moisture exchange sys A9150 E Misc/exper non-prescript dru A9160 E Podiatrist non-covered servi A9170 E Chiropractor non-covered ser A9190 E Misc/expe personal comfort i A9270 E Non-covered item or service A9300 E Exercise equipment *A9500 G Technetium TC 99m sestamibi 1600 $109.25 $13.33 A9502 G Technetium TC99M tetrofosmin 0705 $136.80 $16.69 *A9503 G Technetium TC 99m medronate 1601 $38.38 $4.68 *A9504 G Technetium tc 99m apcitide 1602 $47.50 $5.80 *A9505 G Thallous chloride TL 201/mci 1603 $28.50 $3.48 *A9507 G Indium/111 capromab pendetid 1604 $1,008.90 $135.19 A9508 G Iobenguane sulfate I-131 1045 $1,140.00 $139.08 A9510 G Technetium TC99m Disofenin 1205 $427.50 $57.29 A9600 G Strontium-89 chloride 0701 $783.75 $95.62 A9605 G Samarium sm153 lexidronamm 0702 $942.09 $134.87 A9700 N Echocardiography Contrast A9900 E Supply/accessory/service A9901 E Delivery/set up/dispensing B4034 A Enter feed supkit syr by day B4035 A Enteral feed supp pump per d B4036 A Enteral feed sup kit grav by B4081 A Enteral ng tubing w/ stylet B4082 A Enteral ng tubing w/o stylet B4083 A Enteral stomach tube levine B4084 A Gastrostomy/jejunostomy tubi B4085 A Gastrostomy tube w/ring each B4150 A Enteral formulae category i B4151 A Enteral formulae category i- B4152 A Enteral formulae category ii B4153 A Enteral formulae category ii B4154 A Enteral formulae category IV B4155 A Enteral formulae category v B4156 A Enteral formulae category vi B4164 A Parenteral 50% dextrose solu B4168 A Parenteral sol amino acid 3. B4172 A Parenteral sol amino acid 5. B4176 A Parenteral sol amino acid 7- B4178 A Parenteral sol amino acid > B4180 A Parenteral sol carb > 50% B4184 A Parenteral sol lipids 10% B4186 A Parenteral sol lipids 20% B4189 A Parenteral sol amino acid & B4193 A Parenteral sol 52-73 gm prot B4197 A Parenteral sol 74-100 gm pro B4199 A Parenteral sol > 100gm prote B4216 A Parenteral nutrition additiv B4220 A Parenteral supply kit premix B4222 A Parenteral supply kit homemi B4224 A Parenteral administration ki B5000 A Parenteral sol renal-amirosy B5100 A Parenteral sol hepatic-fream B5200 A Parenteral sol stres-brnch c B9000 A Enter infusion pump w/o alrm B9002 A Enteral infusion pump w/ ala B9004 A Parenteral infus pump portab B9006 A Parenteral infus pump statio B9998 A Enteral supp not otherwise c B9999 A Parenteral supp not othrws c C1000 H PerclosClosr ProstarArt Vas 1000 C1001 H AcuNav-diagnstic ultrsnd ca 1001 C1003 H Cath, ablation, Livewire TC 1003 C1004 H Fast-Cath,Swartz,SAFL,CSTA 1004 C1005D E Sensar IOL C1006 H ARRAY post chamb IOL 1006 C1007 H Ams 700 penile prosthesis 1007 C1008 H Urolume-implt uretheral stent 1008 C1009 K Plasma, cryoprecipitate-reduced, unit 1009 0.86 $42.76 $8.55 C1010 K Blood, L/R, CMV-neg 1010 2.88 $142.84 $28.57 C1011 K Platelets, L/R, CMV-neg, unit 1011 11.86 $588.15 $117.63 C1012 K Platelet concentrate, L/R, irradiated, unit 1012 1.92 $95.23 $19.05 C1013 K Platelet concentrate, L/R, unit 1013 1.18 $58.30 $11.66 C1014 K Platelets, aph/pher, L/R, unit 1014 8.93 $443.11 $88.62 C1016 K Blood, L/R, froz/deglycerol/washed 1016 7.15 $354.68 $70.94 C1017 K Platelets, aph/pher, L/R, CMV-neg, unit 1017 9.33 $462.54 $92.51 C1018 K Blood, L/R, irradiated 1018 3.13 $155.48 $31.10 C1019 K Platelets, aph/pher, L/R, irradiated, unit 1019 9.64 $478.09 $95.62 C1024 J Quinupristin 150 mg/dalfopriston 350 mg 1024 $159.60 $20.50 C1025 H Marinr CS Cath 1025 C1026 H RF Perfrmr cath 5F RF Marinr 1026 C1027 H Magic x/short, Radius14mm 1027 C1028 H Prcis Twst trnsvg anch sys 1028 C1029 H CRE guided balloon dil cath 1029 C1030 H Cthtr:Mrshal,Blu Max Utr Dmnd 1030 C1031D E MR Comp/mod LeVeen ned elect C1033 H Sonicath mdl 37-410 1033 C1034 H SURPASS, Long30 SURPASS-cath 1034 C1035 H Cath, Ultra ICE 1035 C1036 H R port/reservoir impl dev 1036 C1037 H Vaxcelchronic dialysis cath 1037 C1038 H UltraCross Imaging Cath 1038 C1039 H Wallstent, tracheobronchial 1039 C1040 H WALLSTENT: TIPS (shunt) 1040 C1042 H Wallstent, biliary 1042 C1043 H Atherectomy sys, coronary 1043 C1045 G I-131 MIBG (ioben-sulfate) O.5mCi 1045 $1,140.00 $139.08 C1047 H Noga/Navi-Star cath 1047 C1048 H NeuroCyberneticPros: gen 1048 C1050 H Prosorba column 1410 C1051 H Oasis Thrombectomy Cath 1051 C1053 H EnSite 3000 catheter 1053 C1054 H Hydrolyser Thromb Cath 6/7F 1054 C1055 H Transesoph 210, 210-S Cath 1055 C1056 H Thermachoice II Cath 1056 C1057 H Micromark Tissue Marker 1057 C1059 G Carticel,auto cult-chndr cyte 1059 $14,250.00 $2,010.00 C1060 H ACS multi-link tristor/ultra 1060 *C1061 H ACS Viking Guiding cath 1061 *C1063 H EndoTak Endurance EZ, RX lead 1063 *C1067 H Megalink biliary stent 1067 *C1068 H Pulsar DDD pmkr 1068 *C1069 H Discovery DR, pmaker 1069 *C1071 H Pulsar Max, Pulsar SR pmkr 1071 *C1072 H Guidant: blln dil cath 1072 *C1073 H Morcellator 1073 *C1074 H RX/OTW Viatrac-peri dil cath 1074 *C1075 H Guidant: lead 1075 *C1076 H Ventak mini sc defib 1076 *C1077 H Ventak VR Prizm VR, sc defib 1077 *C1078 H Ventak: Prizm, AVIIIDR defib 1078 *C1079 G CO 57/58 0.5 mCi 1079 $264.10 $32.22 *C1084 G Denileukin diftitox, 300 mcg 1084 $942.88 $126.35 *C1086 G Temozolomide, 5 mg 1086 $5.70 $.76 *C1087 G I-123 per uCi capsule 1087 $.84 $.10 *C1088 T LaserOptic tx sys 0980 38.67 $1,917.89 $383.58 *C1089 G CO 57, 0.5 mCi 1089 $91.20 $11.13 *C1090 G IN 111 Chloride, per mCi 1090 $152.00 $18.54 *C1091 G IN 111 Oxyquinoline, per 5 mCi 1091 $508.25 $62.01 *C1092 G IN 111 Pentetate, per 1.5 mCi 1092 $769.50 $93.88 *C1094 J TC 99M Albumin aggr, per vial 1094 $102.05 $13.67 *C1095 G TC 99M Depreotide, per vial 1095 $760.00 $101.84 *C1096 G TC 99M Exametazime, per dose 1096 $34.20 $4.17 *C1097 G TC 99M Mebrofenin, per vial 1097 $445.31 $63.75 *C1098 G TC 99M Pentetate, per vial 1098 $46.76 $5.71 *C1099 J TC 99M Pyrophosphate, per vial 1099 $42.75 $5.22 *C1100 H Medtronic AVE GT1 guidewire 1100 *C1101 H MedtronicAVE Zuma guidecath 1101 *C1102 H Syngergy Neurostim Genrtr 1102 *C1103 H Micro Jewel Defibrillator 1103 *C1104 H RF Conductor Ablative Cath 1104 *C1105 H Sigma 300VDD pacmker 1105 *C1106 H SynergyEZ Pt Progrmr 1106 *C1107 H Torqr, Solist cath 1107 *C1109 H Implantable anchor: Ethicon 1109 *C1110 H Stable Mapper, cath electrd 1110 *C1111 H AneuRxAort-Uni-Ilicstnt&cath 1111 *C1112 H AneuRx Stent graft/del.cath 1112 *C1113 H Tlnt Endo Sprng Stnt Grft Sys 1113 *C1114 H TalntSprgStnt+Graf endo pros 1114 *C1115 H 5038S,5038,5038L pace lead 1115 *C1116 H CapSureSP pacing Lead 1116 *C1117 H Ancure Endograft Del Sys 1117 *C1118 H Sigma300DR LegIIDR,pacemkr 1118 *C1119 H Sprint6932,6943 defib lead 1119 *C1120 H Sprint6942,6945 defib lead 1120 *C1121 H Gem defibrillator 1121 *C1122 G TC 99M arcitumomab per dose 1122 $22.80 $2.78 *C1123 H Gem II VR defibrillator 1123 *C1124 H InterStim Test Stim Kit 1124 *C1125 H Kappa 400SR,Ttopaz II SR pmkr 1125 *C1126 H Kappa 700 DR pacemakr 1126 *C1127 H Kappa 700SR,pmkr sgl chamber 1127 *C1128 H Kappa 700D,Ruby IID pmkr 1128 *C1129 H Kappa 700VDD,pacmkr 1129 *C1130 H Sigm200D,LGCY IID sc pmkr 1130 *C1131 H Sigma 200DR, pmker 1131 *C1132 H Sigma300,200SR Leg II:sc pac 1132 *C1133 H Sigma SR, Vita SR, pmaker 1133 *C1134 H Sigma 300D pmker 1134 *C1135 H Entity DR 5326L/R 1135 *C1136 H Affinity DR 5330L/R 1136 *C1137 H CardioSEAL implant syst 1137 *C1143 H AddVent mod 2060BL,VDD 1143 *C1144 H Afnty SR 5130,Integrity SR,pmkr 1144 *C1145 H Angio-Seal 6fr, 8fr 1145 C1146D E VETT tube *C1147 H AV Plus DX 1368: lead 1147 *C1148 H Contour MD sc defib 1148 *C1149 H Entity DC 5226R, 5226 pmkr 1149 *C1151 H Passiveplus DX lead, 10mdls 1151 *C1152 H LifeSite Access System 1152 *C1153 H Regency SC+ 2402L pmker 1153 *C1154 H SPL:SPOI,02,04- defib lead 1154 *C1155 H Repliform 8 sq cm 1155 *C1156 H Tr 1102TrSR+ 2260L,2264L,5131 1156 *C1157 H Trilogy DCT 2318L pmkr 1157 *C1158 H TVL lead SV01,SV02,SV04 1158 *C1159 H TVL RV02,RV06,RV07: lead 1159 *C1160 H TVL-ADX 1559: lead 1160 *C1161 H Tendril DX, 1388 pacing lead 1161 *C1162 H TempoDr, TrilogyDR+DC pmkr 1162 *C1163 H Tendril SDX, 1488T pacing lead 1163 *C1164 H Iodine-125 brachytx seed 1164 *C1166 G Cytarabine liposomal, 10 mg 1166 $371.45 $49.77 *C1167 J Epirubicin hcl, 2 mg 1167 $24.94 $3.34 C1170D E ABBI disp biopsy device *C1171 H Autosuture site marker stple 1171 *C1172 H Spacemaker dissect ballon 1172 *C1173 H Cor stnt S540, S670, o-wire stn 1173 *C1174 H Bard brachytx needle 1174 C1175D E Biopsy device, MIBB Device C1176D E Mammotome HH Probe w/Vac Sys C1177D E 11-G Mammotome Probe *C1178 G Busulfan IV, 6 mg 1178 $26.48 $3.55 C1179D E 14-G Mammotome Probe *C1180 H Vigor SR, SC, pmkr 1180 *C1181 H Meridian SSI, SC, pmkr 1181 *C1182 H Pulsar SSI, SC, pmkr 1182 *C1183 H Jade IIS, Sigma 300S,SC, pmkr 1183 *C1184 H Sigma 200S, SC, pmkr 1184 *C1188 G I 131, per mCi 1188 $5.86 $.75 *C1200 G TC 99M Sodium Glucoheptonate, per vial 1200 $113.05 $13.79 *C1201 G TC 99M succimer, per vial 1201 $135.66 $16.55 *C1202 G TC 99M Sulfur Colloid, per dose 1202 $38.00 $4.64 *C1203 G Verteporfin for Injection 1203 $1,458.25 $195.41 *C1205 G TC 99M Disofenin, per vial 1205 $427.50 $57.29 *C1207 G Octreotide acetate depot 1mg 1207 $135.10 $16.48 *C1300 S Hyperbaric O2 per 30 min under pressure 0971 1.55 $76.88 $15.38 *C1302 H Lead, defibrillator, TVL SQ01 1302 *C1303 H CapSure Fix 6940/4068-110, lead 1303 *C1304 H Sonicath mdl 37-416,-418 1304 *C1305 G Apligraf 1305 $1,157.81 $163.31 *C1306 H NeuroCyberneticPros: lead 1306 *C1311 H Trilogy DR+/DAO pmkr 1311 *C1312 H Magic WALLSTENTstent-Mini 1312 *C1313 H Magic medium, Radius 31mm 1313 *C1314 H Magic WALLSTENT stent-Long 1314 *C1315 H Vigor DR, Meridian DR pmkr 1315 *C1316 H Meridian DDD pmkr 1316 *C1317 H Discovery SR, pmkr 1317 *C1318 H Meridian SR pmakr 1318 *C1319 H WALLSTENT: enteral 1319 *C1320 H WALLSTENT:iliac 1320 C1321D E Palate/Base of Tongue electr C1322D E Turbinate Somnoplasty electr C1323D E VAPR/T disp electrode C1324D E Ligasure disposable electrode *C1325 H Pallidium -103 seed 1325 *C1326 H Angio-jet rheolytic thromb cath 1326 *C1328 H ANS Renew NS trnsmtr 1328 C1329D E Versapoint disp electrode *C1333 H PALMAZ Corinthian bill stent 1333 *C1334 H Crown,Mini-crown,CrossLC 1334 *C1335 H Mesh, Prolene 1335 *C1336 H Constant Flow Imp Pump 1336 *C1337 H IsoMed 8472-20/35/60 1337 *C1348 G I 131 per mCi solution 1348 $146.57 $17.88 *C1350 H ProstaSeed, I125, per source 1350 *C1351 H CapSure Fix lead 1351 *C1352 H Gem II defib 1352 *C1353 H Itrel Interstm neurostim+ext 1353 *C1354 H Kappa 400DR,Diamond II 820DR 1354 *C1355 H Kappa 600DR, Vita DR 1355 *C1356 H Profile MD V-186HV3 sc defib 1356 *C1357 H Angstrom MD V-190HV3 sc defib 1357 *C1358 H Affinity DC 5230R, 5230 pmkr 1358 *C1359 H Pulsar,Pulsar Max DR,pmkr 1359 *C1360D T Ocular photodynamic therapy 0235 2.94 $145.81 $78.91 $29.16 *C1361 H Reveal Cardiac Recorder 1108 *C1362 H Herculink,OTW SDS bil stent 1411 *C1363 H Gem DR, DC, defib 1363 *C1364 H Photon DR V-230HV3 DC defib 1364 *C1365 H Guidewire, Hi-Torque14/18/35 1365 *C1366 H Guidewire,PTCA, Hi-Torque 1366 *C1367 H Guidewire, Hi-Torque CrossIt 1367 C1368D E On-Q Pain Mgt Sys *C1369 H ANS Renew Stim Sys recvr 1369 *C1370 H Tension-Free Vaginal Tape 1370 *C1371 H Symp Nitinol Transhep Bil Sys 1371 *C1372 H Cordis Nitinol bil stent 1372 *C1375 H Stent, coronary, NIR 1375 *C1376 H ANS Renew Stim Sys lead/ex 1376 *C1377 H Specify 3988 neuro lead 1377 *C1378 H InterStim Tx 3080/3886 lead 1378 *C1379 H Pisces-Quad 3887 lead 1379 *C1420 H StapleTac2 Bone w/Dermis 1420 *C1421 H StapleTac2 Bone wo Dermis 1421 *C1450 H Orthosphere Arthroplasty 1450 *C1451 H Orthosphere Arthroplasty Kit 1451 *C1500 H Atherectomy sys, peripheral 1500 *C1700 H Authen Mick TP brachy needle 1700 *C1701 H Medtec MT-BT-5201 -25 ndl 1701 *C1702 H WWMT brachytx needle 1702 *C1703 H Mentor Prostate Brachy 1703 *C1704 H MT-BT-5001-25/5051-25 1704 *C1705 H Best Flexi Brachy Needle 1705 *C1706 H Indigo Prostate Seeding Ndl 1706 *C1707 H Varisource Implt Ndl 1707 *C1708 H UroMed Prostate Seed Ndl 1708 *C1709 H Remington Brachytx Needle 1709 *C1710 H US Biopsy Prostate Needle 1710 *C1711 H MD Tech brachytx needle 1711 *C1712 H Imagyn brachytx needle 1712 *C1790 H Iridium 192 HDR 1790 *C1791 H OncoSeed, Rapid Strand I-125 1791 *C1792 H UroMed I-125 Brachy seed 1792 *C1793 H Bard InterSource P-103 seed 1793 *C1794 H Bard IsoSeed P-103 seed 1794 *C1795 H Bard BrachySource I-125 1795 *C1796 H SourceTech Med I-125 1796 *C1797 H Draximage I-125 seed 1797 *C1798 H Syncor I-125 PharmaSeed 1798 *C1799 H I-Plant I-125 Brachytx seed 1799 *C1800 H Pd-103 brachytx seed 1800 *C1801 H IoGold I-125 brachytx seed 1801 *C1802 H Brachytherapy seed, Iridium 192 1802 *C1803 H Best Iodine 125 brachytx sds 1803 *C1804 H Best Palladium 103 seeds 1804 *C1805 H IsoStar Iodine-125 seeds 1805 *C1806 H Gold 198 brachy seeds 1806 *C1810 H D114S Dilatation Cath 1810 *C1811 H Surgical Dynamics Anchors 1811 *C1812 H OBL Anchors 1812 *C1850 H Repliform 14/21 sq cm 1850 *C1851 H Repliform 24/28 sq cm 1851 *C1852 H TransCyte, per 247 sq cm 1852 *C1853 H Suspend, per 8/14 sq cm 1853 *C1854 H Suspend, per 24/28 sq cm 1854 *C1855 H Suspend, per 36 sq cm 1855 *C1856 H Suspend, per 48 sq cm 1856 *C1857 H Suspend, per 84 sq cm 1857 *C1858 H DuraDerm, per 8/14 sq cm 1858 *C1859 H DuraDerm, per 21/24/28 sq cm 1859 *C1860 H DuraDerm, per 48 sq cm 1860 *C1861 H DuraDerm, per 36 sq cm 1861 *C1862 H DuraDerm, per 72 sq cm 1862 *C1863 H DuraDerm, per 84 sq cm 1863 *C1864 H SpermaTex,per 13.44 sq cm 1864 *C1865 H FasLata, per 8/14 sq cm 1865 *C1866 H FasLata, per 24/28 sq cm 1866 *C1867 H FasLata, per 36/48 sq cm 1867 *C1868 H FasLata, per 96 sq cm 1868 *C1869 H Gore Thyroplasty Dev 1869 *C1870 H DermMatrix, per 16 sq cm 1870 *C1871 H DermMatrix, 32 or 64 sq cm 1871 *C1872 H Dermagraft, per 37.5 sq cm 1872 *C1873 H Bard 3DMax Mesh 1873 *C1929 H Maverick PTCA Cath 1929 *C1930 H Coyote Dil Cath,20/30/40mm 1930 *C1931 H Talon Dil Cath 1931 *C1932 H Scimed Remedy Dil Cath 1932 *C1933 H Opti-Plast XL/Centurion Cath 1933 *C1934 H Ultraverse 3.5F Bal Dil Cath 1934 *C1935 H Workhorse PTA Bal Cath 1935 *C1936 H Uromax Ultra Bal Dil Cath 1936 *C1937 H Synergy Balloon Dil Cath 1937 *C1938 H UroForce Bal Dil Cath 1938 *C1939 H Raptor, Ninja PTCA Dil Cath 1939 *C1940 H PowerFlex,OPTA 5/LP Bal Cath 1940 *C1941 H Jupiter PTA Dil Cath 1941 *C1942 H Cordis Maxi LD PTA Bal Cath 1942 *C1943 H RXCrossSail OTW OpenSail 1943 *C1944 H Rapid Exchange Bil Dil Cath 1944 *C1945 H Savvy PTA Dil Cath 1945 *C1946 H R1s Rapid Dil Cath 1946 *C1947 H Gazelle Bal Dil Cath 1947 *C1948 H Pursuit Balloon Cath 1948 *C1949 H Oracle Megasonics Cath 1949 *C1979 H Visions PV/Avanar US Cath 1979 *C1980 H Atlantis SR Coronary Cath 1980 *C1981 H PTCA Catheters 1981 *C2000 H Orbiter ST Steerable Cath 2000 *C2001 H Constellation Diag Cath 2001 *C2002 H Irvine 5F Inquiry Diag EP Cath 2002 *C2003 H Irvine 6F Inquiry Diag EP Cath 2003 *C2004 H Biosense EP Cath--Octapolar 2004 *C2005 H Biosense EP Cath--Hexapolar 2005 *C2006 H Biosense EP Cath--Decapolar 2006 *C2007 H Irvine 6F Luma-Cath EP Cath 2007 *C2008 H Luma-Cath EP Cath 81910-15 2008 *C2009 H Irvine 7F Luma-Cath EP Cath 2009 *C2010 H Fixed Curve EP Cath 2010 *C2011 H Deflectable Tip Cath--Quad 2011 *C2012 H Celsius Abln Cath 2012 *C2013 H Celsius Large Abln Cath 2013 *C2014 H Celsius II Asym Abln Cath 2014 *C2015 H Celsius II Sym Abln Cath 2015 *C2016 H Navi-Star DS, Navi-Star Ther 2016 *C2017 H Navi-Star Abln Cath 2017 *C2018 H Polaris T Ablation Cath 2018 *C2019 H EP Deflectable Cath 2019 *C2020 H Catheter, ablation, Blazer II XP 2020 *C2021 H SilverFlex EP Cath 2021 *C2022 H CP Chilli Cooled Abln Cath 2022 *C2023 H Chilli Cld AblnCath-std, lg 2023 *C2100 H CP CS Reference Cath 2100 *C2101 H CP RV Reference Cath 2101 *C2102 H CP Radii 7F EP Cath 2102 *C2103 H CP Radii 7F EP Cath w/Track 2103 *C2104 H Lasso Deflectable Cath 2104 *C2151 H Veripath Guiding Cath 2151 *C2152 H Cordis Vista Brite Tip Cath 2152 *C2153 H Bard Viking Cath 2153 *C2200 H Arrow-Trerotola PTD Cath 2200 *C2300 H Varisource Stnd Catheters 2300 *C2597 H CliniCath/kit 16/18 sgl/dbl 2597 *C2598 H CliniCath 18/20/24G-single 2598 *C2599 H CliniCath 16/18G-double 2599 C2600D E Gold Probe Catheter *C2601 H Bard DL Ureteral Cath 2601 *C2602 H Vitesse Laser Cath 1.4/1.7mm 2602 *C2603 H Vitesse Laser Cath 2.0mm 2603 *C2604 H Vitesse E Laser Cath 2.0mm 2604 *C2605 H Extreme Laser Catheter 2605 *C2606 H SpineCath XL Catheter 2606 *C2607 H SpineCath Intradiscal Cath 2607 *C2608 H Scimed 6F Wiseguide Cath 2608 *C2609 H Flexima Bil Drainage Cath 2609 *C2610 H FlexTipPlus Intraspinal Cath 2610 *C2611 H AlgoLine Intraspinal Cath 2611 *C2612 H InDura Catheter 2612 *C2676 E Response CV Catheter *C2700 H MycroPhylax Plus SC defib 2700 *C2701 H Phylax XM SC defib 2701 *C2702 H Ventak Prizm 2 VR Defib 2702 *C2703 H Ventak Prizm VR HE Defib 2703 *C2704 H Ventak Mini IV+ Defib 2704 *C2801 H Defender IV DR 612 DC defib 2801 *C2802 H Phylax AV DC defib 2802 *C2803 H Ventak Prizm DR HE Defib 2803 *C2804 H Ventak Prizm 2 DR Defib 2804 *C2805 H Jewel AF 7250 Defib 2805 *C2806 H GEM VR 7227 Defib 2806 *C2807 H Contak CD 1823 2807 *C2808 H Contak TR 1241 2808 *C3001 H Kainox SL/RV defib lead 3001 *C3002 H EasyTrak Defib Lead 3002 *C3003 H Endotak SQ Array XP lead 3003 *C3004 H Intervene Defib Lead 3004 *C3400 H Siltex Spectrum,Contour Prof 3400 *C3401 H Saline-Filled Spectrum 3401 *C3500 H Mentor Alpha I Inf Penile Pros 3500 *C3510 H AMS 800 Urinary Pros 3510 *C3551 H Choice/PT Graphix/Luge/Trooper 3551 *C3552 H Hi-Torque Whisper 3552 *C3553 H Cordis guidewires 3553 *C3554 H Jindo guidewire 3554 *C3555 H Wholey Hi-Torque Plus GW 3555 *C3556 H Wave/FlowWire Guidewire 3556 *C3557 H HyTek guidewire 3557 *C3800 H SynchroMed EL infusion pump 3800 *C3801 H Arrow/MicroJect PCA Sys 3801 *C3851 H Elastic UV IOL AA-4203T/TF/TL 3851 *C4000 H Opus G 4621, 4624 SC pmkr 4000 *C4001 H Opus S 4121/4124 SC pmkr 4001 *C4002 H Talent 113 SC pmkr 4002 *C4003 H Kairos SR SC pmkr 4003 *C4004 H Actros SR, Actros SLR SC pmkr 4004 *C4005 H Philos SR/SR-B SC pmkr 4005 *C4006 H Pulsar Max II SR pmkr 4006 *C4007 H Marathon SR pmkr 4007 *C4008 H Discovery II SSI pmkr 4008 *C4009 H Discovery II SR pmkr 4009 *C4300 H Integrity AFx DR 5342 pmkr 4300 *C4301 H Integrity AFx DR 5346 pmkr 4301 *C4302 H Affinity VDR 5430 pmkr 4302 *C4303 H Brio 112 DC pmkr 4303 *C4304 H Brio 212, Talent 213/223 DC pmkr 4304 *C4305 H Brio 222 DC pmkr 4305 *C4306 H Brio 220 DC pmkr 4306 *C4307 H Kairos DR DC pmkr 4307 *C4308 H Inos2, Inos2+ DC pmkr 4308 *C4309 H Actros DR,D,DR-A,SLR DC pmkr 4309 *C4310 H Actros DR-B DC pmkr 4310 *C4311 H Philos DR/DR-B/SLR DC pmkr 4311 *C4312 H Pulsar Max II DR pmkr 4312 *C4313 H Marathon DR pmkr 4313 *C4314 H Momentum DR pmkr 4314 *C4315 H Selection AFm pmkr 4315 *C4316 H Discovery II DR 4316 *C4317 H Discovery II DDD 4317 *C4600 H Snynox,Polyrox,Elox,Retrox 4600 *C4601 E Aescula LV pmkr lead *C4602 H Tendril SDX, 1488K pmkr lead 4602 *C4603 H Oscor/Flexion pmkr lead 4603 *C4604 H CrystallineActFix,CapsureFix 4604 *C4605 H CapSure Epi pmkr lead 4605 *C4606 H Flextend pmkr lead 4606 *C4607 H FinelineII/EZ, ThinlineII/EZ 4607 *C5000 H BX Velocity w/Hepacoat 5000 *C5001 H Memotherm Bil Stent, sm, med 5001 *C5002 H Memotherm Bil Stent, large 5002 *C5003 H Memotherm Bil Stent, x-large 5003 *C5004 H PalmazCorinthian IQ Bil Stent 5004 *C5005 H PalmazCorinthian IQ Trans/Bil 5005 *C5006 H PalmazTrans Bil Stent Sys-Med 5006 *C5007 H PalmazTrans XL Bil Stent--40mm 5007 *C5008 H PalmazTrans XL Bil Stent--50mm 5008 *C5009 H Stent, biliary, Biliary VistaFlex Stent 5009 *C5010 H Rapid Exchange Bil Stent Sys 5010 *C5011 H Stent, biliary, IntraStent, IntraStent LP 5011 *C5012 H Stent, biliary, IntraStent DoubleStrut LD 5012 *C5013 H IntraStent DoubleStrut, XS 5013 *C5014 H AVE Bridge Stent Sys-10/17/28 5014 *C5015 H AVE/X3 Bridge Sys, 40-100 5015 *C5016 H Biliary stent single use cov 5016 *C5017 H WallstentRP Bil--20/40/60/68mm 5017 *C5018 H WallstentRP Bil--80/94mm 5018 *C5019 H Flexima Bil Stent Sys 5019 *C5020 H Smart Nitinol Stent--20mm 5020 *C5021 H Smart Nitinol Stent--40/60mm 5021 *C5022 H Smart Nitinol Stent--80mm 5022 *C5023 H BX Velocity Stent--8/13mm 5023 *C5024 H BX Velocity Stent--18mm 5024 *C5025 H BX Velocity Stent--23mm 5025 *C5026 H BX Velocity Stent--28/33mm 5026 *C5027 H BX Velocity w/Hep--8/13mm 5027 *C5028 H BX Velocity w/Hep--18mm 5028 *C5029 H BX Velocity w/Hep--23mm 5029 *C5030 H Stent, coronary, S660 9/12mm 5030 *C5031 H Stent,coronary, S660 15/18mm 5031 *C5032 H Stent,coronary, S660 24/30mm 5032 *C5033 H Niroyal Stent Sys, 9mm 5033 *C5034 H Niroyal Stent Sys, 12/15mm 5034 *C5035 H Niroyal Stent Sys, 18mm 5035 *C5036 H Niroyal Stent Sys, 25mm 5036 *C5037 H Niroyal Stent Sys, 31mm 5037 *C5038 H BX Velocity Stent w/Raptor 5038 *C5039 H IntraCoil Periph Stent--40mm 5039 *C5040 H IntraCoil Periph Stent--60mm 5040 *C5041 H BeStent Over-the-Wire 24/30mm 5041 *C5042 H BeStent Over-the-Wire 18mm 5042 *C5043 H BeStent Over-the-Wire 15mm 5043 *C5044 H BeStent Over-the-Wire 9/12mm 5044 *C5045 H Multilink Tetra Cor Stent Sys 5045 *C5046 H Radius 20mm cor stent 5046 *C5047 H Niroyal Elite Cor Stent Sys 5047 *C5048 H GR II Coronary Stent 5048 *C5130 H Wilson-Cook Colonic Z-Stent 5130 *C5131 H Bard Colorectal Stent-60mm 5131 *C5132 H Bard Colorectal Stent-80mm 5132 *C5133 H Bard Colorectal Stent-100mm 5133 *C5134 H Enteral Wallstent--90mm 5134 *C5279 H Contour/Percuflex Stent 5279 *C5280 H Inlay Dbl Ureteral Stent 5280 *C5281 H Wallgraft Trach Sys 70mm 5281 *C5282 H Wallgraft Trach Sys 20/30/50 5282 *C5283 H Wallstent/RP TIPS --80mm 5283 *C5284 H Wallstent TrachUltraFlex 5284 *C5600 H Closure dev, VasoSeal ES 5600 *C5601 H VasoSeal Model 1000 5601 *C6001 H Composix Mesh 8/21 in 6001 *C6002 H Composix Mesh 32 in 6002 *C6003 H Composix Mesh 48 in 6003 *C6004 H Composix Mesh 80 in 6004 *C6005 H Composix Mesh 140 in 6005 *C6006 H Composix Mesh 144 in 6006 *C6012 H Pelvicol Collagen 8/14 sq cm 6012 *C6013 H Pelvicol Collagen 21/24/28 sq cm 6013 *C6014 H Pelvicol Collagen 40sq cm 6014 *C6015 H Pelvicol Collagen 48 sq cm 6015 *C6016 H Pelvicol Collagen 96 sq cm 6016 *C6017 H Gore-Tex DualMesh 75/96 sq cm 6017 *C6018 H Gore-Tex DualMesh 150 sq cm 6018 *C6019 H Gore-Tex DualMesh 285 sq cm 6019 *C6020 H Gore-Tex DualMesh 432 sq cm 6020 *C6021 H Gore-Tex DualMesh 600 sq cm 6021 *C6022 H Gore-Tex DualMesh 884 sq cm 6022 *C6023 H Gore-TexPlus 1mm, 75/96sq cm 6023 *C6024 H Gore-TexPlus 1mm, 150sq cm 6024 *C6025 H Gore-TexPlus 1mm, 285sq cm 6025 *C6026 H Gore-TexPlus 1mm, 432sq cm 6026 *C6027 H Gore-TexPlus 1mm, 600sq cm 6027 *C6028 H Gore-TexPlus 1mm, 884 sq cm 6028 *C6029 H Gore-TexPlus 2mm, 150 sq cm 6029 *C6030 H Gore-TexPlus 2mm, 285 sq cm 6030 *C6031 H Gore-TexPlus 2mm, 432 sq cm 6031 *C6032 H Gore-TexPlus 2mm, 600 sq cm 6032 *C6033 H Gore-TexPlus 2mm, 884 sq cm 6033 *C6034 H Bard ePTFE: 15 sq cm--2mm 6034 *C6035 H Bard ePTFE150sqcm-1mm,75-2mm 6035 *C6036 H Bard ePTFE: 50/75sqcm-1,2mm 6036 *C6037 H Bard ePTFE: 300sq cm-1,2mm 6037 *C6038 H Bard ePTFE: 600sq cm-1mm 6038 *C6039 H Bard ePTFE: 884sq cm-1mm 6039 *C6040 H Bard ePTFE: 600sq cm-2mm 6040 *C6041 H Bard ePTFE: 884sq cm-2mm 6041 *C6050 H Female Sling Sys w/wo Matrl 6050 *C6051 H Stratasis Urethral Sling, 20/40 cm 6051 *C6052 H Stratasis Urethral Sling, 60 cm 6052 *C6053 H Surgisis Soft Graft 6053 *C6054 H Surgisis Enhanced Graft 6054 *C6055 H Surgisis Enhanced Tissue 6055 *C6056 H Surgisis Soft Tissue Graft 6056 *C6057 H Surgisis Hernia Graft 6057 *C6058 H SurgiPro Hernia Plug, med/lg 6058 *C6080 H Male Sling Sys w/wo Matrl 6080 *C6200 H Exxcel Sft ePTFE vas graft 6200 *C6201 H Impra Venaflo--10/20cm 6201 *C6202 H Impra Venaflo-30/40cm 6202 *C6203 H Impra Venaflo-50cm,vt45 6203 *C6204 H Impra Venaflo-stepped 6204 *C6205 H Impra Carboflo--10cm 6205 *C6206 H Impra Carboflo--20cm 6206 *C6207 H Impra Carboflo--30/35/40cm 6207 *C6208 H Impra Carboflo--40/50cm 6208 *C6209 H Impra Carboflo--ctrflex 6209 *C6210 H Exxcel ePTFE vas graft 6210 *C6300 H Vanguard III Endovas Graft 6300 *C6500 H Preface Guiding Sheath 6500 *C6501 H Sheath, Soft Tip Sheaths 6501 *C6502 H Perry Exchange Dilator 6502 *C6525 H Spectranetics Laser Sheath 6525 *C6600 H Micro Litho Flex Probes 6600 *C6650 H Fast-Cath Guiding Introducer 6650 *C6651 H Seal-AwayGuiding Introducer 6651 *C6652 H Bard Excalibur Introducer 6652 *C6700 H Focal Seal-L 6700 *C8099 H Spectranetics Lead Lock Dev 8099 C8100 H Adhesion barrier, ADCON-L 8100 *C8102 H SurgiVision Esoph Coil 8102 C8103D E Capio Capturing Dev *C8500 X Atherocath-GTO 0991 $1,278.59 $255.72 *C8501 X Pacemaker, single chamber, Vigor SSI 0992 $1,790.03 $358.01 *C8502 X Livewire Steerable EP Cath 0988 $383.58 $76.72 *C8503 X SyncroMed Vas Cath 0988 $383.58 $76.72 *C8504 X VasoSeal Hemostasis Dev 0987 $127.86 $25.57 *C8505 X SynchroMed Infusion Pump 0997 $8,182.98 $1,636.60 *C8506 X Pmkr leads 4057M,4058M 0990 $895.01 $179.00 *C8507 X 6721L/M/S,6939 lead 0990 $895.01 $179.00 *C8508 X Lead, defibrillator, CapSure 4965 0990 $895.01 $179.00 *C8509 X Transvene 6933/6937 lead 0990 $895.01 $179.00 *C8510 X Lead, defibrillator, DP-3238 0990 $895.01 $179.00 *C8511 X Lead, defibrillator, EndoTak DSP 0996 $6,137.23 $1,227.45 *C8512 X On-Point,Pisces-Quad lead 0990 $895.01 $179.00 *C8513 X Pisces,Resume II lead 0990 $895.01 $179.00 *C8514 X Dura II Penile Pros 0993 $2,557.18 $511.44 *C8515D X Alpha 1 narrow base prosthesis 0995 $4,602.92 $920.58 *C8516 X Mentor Acu-Form/Mal Pros 0992 $1,790.03 $358.01 *C8517D X Ambicor prosthesis 0994 $3,580.05 $716.01 *C8518 X Pacemaker, dual chamber, Vigor DDD 0994 $3,580.05 $716.01 *C8519 X Pacemaker, dual chamber, Vista DDD 0994 $3,580.05 $716.01 *C8520 X Pacemaker, single chamber, Legacy II S 0992 $1,790.03 $358.01 *C8521 X Medtronic Mattrix rcvr/trmr 0997 $8,182.98 $1,636.60 *C8522 X Palmaz Bal Stent 0990 $895.01 $179.00 *C8523 X Wallstent Trans Bil 0991 $1,278.59 $255.72 *C8524 X Wallstent Esop 0991 $1,278.59 $255.72 *C8525 X Esoph stent--double 0992 $1,790.03 $358.01 *C8526 X OptiPlast XT 5F PTA Cath 0987 $127.86 $25.57 *C8528 X MS Classique Balloon Dilation Catheter 0987 $127.86 $25.57 *C8529 X Crista Cath II Def 20-Pole 0990 $895.01 $179.00 *C8530 X Gel-Filled/Smooth Mammary Pros 0989 $639.30 $127.86 *C8531 X Wilson-Cook Esoph Z-Stent 0989 $639.30 $127.86 *C8532 X UltraFlex Esoph 0991 $1,278.59 $255.72 *C8533 X SynchroMed Vas Cath 8700A/V 0988 $383.58 $76.72 *C8534 X AMS Malleable 650 Penile Prosthesis 0992 $1,790.03 $358.01 *C8535 X Za/Spiral Z Bil Stent 0990 $895.01 $179.00 *C8536 X Esoph Z Metal Stent 0991 $1,278.59 $255.72 *C8539 X Quantum Dil Balloon 0987 $127.86 $25.57 *C8540 X Flex-EZ Bal Dilator 0988 $383.58 $76.72 *C8541 X Carson/Passprt Dil 0988 $383.58 $76.72 *C8542 X UrethraMax Dil Cath 0987 $127.86 $25.57 *C8543 X Amplatz Renal Dil 0987 $127.86 $25.57 *C8550 X Livewire 5F, 7F EP Cath 0989 $639.30 $127.86 *C8551 X Livewire 7F Duo-Decapolar 0990 $895.01 $179.00 *C8552 X Santuro Fixed Curve Cath 0989 $639.30 $127.86 *C8597 X Wisdom ST guidewire 0987 $127.86 $25.57 *C8598 X SV Guidewire-5/8/14cm 0987 $127.86 $25.57 *C8599 X Stabilizer XS guidewire 0987 $127.86 $25.57 *C8600 X Shinobi Plus guidewire 0987 $127.86 $25.57 *C8650 X XL Check-Flo Introducer 0987 $127.86 $25.57 *C8724 X Octad neuro lead 0991 $1,278.59 $255.72 *C8725 X SymMix neuro lead 0990 $895.01 $179.00 *C8748 X Endotak SQ Patch defib lead 0990 $895.01 $179.00 *C8749 X Endotak SQ Array defib lead 0993 $2,557.18 $511.44 *C8750 X Unity VDDR dc pmkr 0994 $3,580.05 $716.01 *C8775 X 2188 Cor pmkr lead 0991 $1,278.59 $255.72 *C8776 X Innomedica pmkr lead 0990 $895.01 $179.00 *C8777 X Unipass pmkr lead 0991 $1,278.59 $255.72 *C8800 X Lg Palmaz Bil Stent 0990 $895.01 $179.00 *C8801 X Gianturco Bil Z Stent 0989 $639.30 $127.86 *C8802 X Oasis Stent Intro Sys 0987 $127.86 $25.57 *C8830 X Gianturco-Roubin Cor Snt 0991 $1,278.59 $255.72 *C8890 X Perfluoron, per 2ml 0987 $127.86 $25.57 *C8891 X Perfluoron, per 5/7ml 0988 $383.58 $76.72 C9000 G Na chromate Cr51, per 0.25mCi 9000 $259.36 $34.75 C9001 J Linezolid inj, 200mg 9001 $34.14 $4.57 C9002 J Tenecteplase, 50mg/vial 9002 $2,612.50 $350.08 C9003 J Palivizumab, per 50mg 9003 $664.49 $89.04 C9004 J Gemtuzumab ozogamicin inj,5mg 9004 $1,929.69 $258.58 C9005 G reteplase, 18.1 mg (one single-use vial) 9005 $1,306.25 $175.04 C9006 J Tacrolimus inj, per 5mg (1 amp) 9006 $109.83 $14.72 C9007 G Baclofen Intrathecal kit-1amp 9007 $79.80 $10.69 C9008 G Baclofen Refill Kit--500mcg 9008 $222.30 $29.79 C9009 G Baclofen Refill Kit--2000mcg 9009 $467.40 $62.63 C9010 G Baclofen Refill Kit--4000mcg 9010 $820.80 $109.99 C9011 G Caffeine Citrate, inj, 1ml 9011 $12.22 $1.57 *C9100 G Iodinated I-131 Albumin 9100 $246.05 $30.02 C9102 G 51 Na chromate, 50uCi 9102 $216.60 $26.43 C9103 G Na Iothalamate I-125, 10uCi 9103 $12.27 $1.50 C9104 G Anti-thymocyte globulin,25mg 9104 $251.75 $33.73 C9105 G Hep B imm glob, per 1 ml 9105 $152.00 $20.37 C9106 J Sirolimus 1mg/ml 9106 $6.51 $.87 *C9107 J Tinzaparin sodium, 2ml vial 9107 $159.60 $20.50 C9108 G Thyrotropin alfa, 1.1 mg 9108 $494.00 $70.72 C9109 G Tirofiban hcl, 6.25 mg 9109 $199.50 $28.56 C9500 K Platelets, irradiated, each unit 9500 1.77 $87.97 $17.59 C9501 K Platelets, pheresis, each unit 9501 9.69 $480.75 $96.15 C9502 K Platelets, pheresis, irradiated, each unit 9502 10.52 $521.66 $104.33 C9503 K Fresh frzn plasma, donor retested, unit 9503 1.65 $81.83 $16.37 C9504 K Red blood cells, deglycerolized, unit 9504 4.35 $215.83 $43.17 C9505 K Red blood cells, irradiated, each unit 9505 2.58 $127.86 $25.57 *C9700 T Water-induced thermotherapy 0977 23.20 $1,150.63 $230.13 *C9701 S Stretta Procedure 0976 18.05 $895.21 $179.04 *C9702 S Chkmate Intra Brachytx Sys 0981 46.40 $2,301.26 $460.25 D0120 E Periodic oral evaluation D0140 E Limit oral eval problm focus D0150 S Comprehensve oral evaluation 0330 1.51 $74.89 $14.98 $14.98 D0160 E Extensv oral eval prob focus D0170 E Re-eval,est pt,problem focus D0210 E Intraor complete film series D0220 E Intraoral periapical first f D0230 E Intraoral periapical ea add D0240 S Intraoral occlusal film 0330 1.51 $74.89 $14.98 $14.98 D0250 S Extraoral first film 0330 1.51 $74.89 $14.98 $14.98 D0260 S Extraoral ea additional film 0330 1.51 $74.89 $14.98 $14.98 D0270 S Dental bitewing single film 0330 1.51 $74.89 $14.98 $14.98 D0272 S Dental bitewings two films 0330 1.51 $74.89 $14.98 $14.98 D0274 S Dental bitewings four films 0330 1.51 $74.89 $14.98 $14.98 D0277 S Vert bitewings-sev to eight 0330 1.51 $74.89 $14.98 $14.98 D0290 E Dental film skull/facial bon D0310 E Dental saliography D0320 E Dental tmj arthrogram incl i D0321 E Dental other tmj films D0322 E Dental tomographic survey D0330 E Dental panoramic film D0340 E Dental cephalometric film D0350 E Oral/facial images D0415 E Bacteriologic study D0425 E Caries susceptibility test D0460 S Pulp vitality test 0330 1.51 $74.89 $14.98 $14.98 D0470 E Diagnostic casts D0472 S Gross exam, prep & report 0330 1.51 $74.89 $14.98 $14.98 D0473 S Micro exam, prep & report 0330 1.51 $74.89 $14.98 $14.98 D0474 S Micro w exam of surg margins 0330 1.51 $74.89 $14.98 $14.98 D0480 S Cytopath smear prep & report 0330 1.51 $74.89 $14.98 $14.98 D0501 S Histopathologic examinations 0330 1.51 $74.89 $14.98 $14.98 D0502 S Other oral pathology procedu 0330 1.51 $74.89 $14.98 $14.98 D0999 S Unspecified diagnostic proce 0330 1.51 $74.89 $14.98 $14.98 D1110 E Dental prophylaxis adult D1120 E Dental prophylaxis child D1201 E Topical fluor w prophy child D1203 E Topical fluor w/o prophy chi D1204 E Topical fluor w/o prophy adu D1205 E Topical fluoride w/ prophy a D1310 E Nutri counsel-control caries D1320 E Tobacco counseling D1330 E Oral hygiene instruction D1351 E Dental sealant per tooth D1510 S Space maintainer fxd unilat 0330 1.51 $74.89 $14.98 $14.98 D1515 S Fixed bilat space maintainer 0330 1.51 $74.89 $14.98 $14.98 D1520 S Remove unilat space maintain 0330 1.51 $74.89 $14.98 $14.98 D1525 S Remove bilat space maintain 0330 1.51 $74.89 $14.98 $14.98 D1550 S Recement space maintainer 0330 1.51 $74.89 $14.98 $14.98 D2110 E Amalgam one surface primary D2120 E Amalgam two surfaces primary D2130 E Amalgam three surfaces prima D2131 E Amalgam four/more surf prima D2140 E Amalgam one surface permanen D2150 E Amalgam two surfaces permane D2160 E Amalgam three surfaces perma D2161 E Amalgam 4 or > surfaces perm D2330 E Resin one surface-anterior D2331 E Resin two surfaces-anterior D2332 E Resin three surfaces-anterio D2335 E Resin 4/> surf or w incis an D2336 E Composite resin crown D2337 E Compo resin crown ant-perm D2380 E Resin one surf poster primar D2381 E Resin two surf poster primar D2382 E Resin three/more surf post p D2385 E Resin one surf poster perman D2386 E Resin two surf poster perman D2387 E Resin three/more surf post p D2388 E Resin four/more, post perm D2410 E Dental gold foil one surface D2420 E Dental gold foil two surface D2430 E Dental gold foil three surfa D2510 E Dental inlay metalic 1 surf D2520 E Dental inlay metallic 2 surf D2530 E Dental inlay metl 3/more sur D2542 E Dental onlay metallic 2 surf D2543 E Dental onlay metallic 3 surf D2544 E Dental onlay metl 4/more sur D2610 E Inlay porcelain/ceramic 1 su D2620 E Inlay porcelain/ceramic 2 su D2630 E Dental onlay porc 3/more sur D2642 E Dental onlay porcelin 2 surf D2643 E Dental onlay porcelin 3 surf D2644 E Dental onlay porc 4/more sur D2650 E Inlay composite/resin one su D2651 E Inlay composite/resin two su D2652 E Dental inlay resin 3/mre sur D2662 E Dental onlay resin 2 surface D2663 E Dental onlay resin 3 surface D2664 E Dental onlay resin 4/mre sur D2710 E Crown resin laboratory D2720 E Crown resin w/ high noble me D2721 E Crown resin w/ base metal D2722 E Crown resin w/ noble metal D2740 E Crown porcelain/ceramic subs D2750 E Crown porcelain w/ h noble m D2751 E Crown porcelain fused base m D2752 E Crown porcelain w/ noble met D2780 E Crown 3/4 cast hi noble met D2781 E Crown 3/4 cast base metal D2782 E Crown 3/4 cast noble metal D2783 E Crown 3/4 porcelain/ceramic D2790 E Crown full cast high noble m D2791 E Crown full cast base metal D2792 E Crown full cast noble metal D2799 E Provisional crown D2910 E Dental recement inlay D2920 E Dental recement crown D2930 E Prefab stnlss steel crwn pri D2931 E Prefab stnlss steel crown pe D2932 E Prefabricated resin crown D2933 E Prefab stainless steel crown D2940 E Dental sedative filling D2950 E Core build-up incl any pins D2951 E Tooth pin retention D2952 E Post and core cast + crown D2953 E Each addtnl cast post D2954 E Prefab post/core + crown D2955 E Post removal D2957 E Each addtnl prefab post D2960 E Laminate labial veneer D2961 E Lab labial veneer resin D2962 E Lab labial veneer porcelain D2970 S Temporary- fractured tooth 0330 1.51 $74.89 $14.98 $14.98 D2980 E Crown repair D2999 S Dental unspec restorative pr 0330 1.51 $74.89 $14.98 $14.98 D3110 E Pulp cap direct D3120 E Pulp cap indirect D3220 E Therapeutic pulpotomy D3221 E Gross pulpal debridement D3230 E Pulpal therapy anterior prim D3240 E Pulpal therapy posterior pri D3310 E Anterior D3320 E Root canal therapy 2 canals D3330 E Root canal therapy 3 canals D3331 E Non-surg tx root canal obs D3332 E Incomplete endodontic tx D3333 E Internal root repair D3346 E Retreat root canal anterior D3347 E Retreat root canal bicuspid D3348 E Retreat root canal molar D3351 E Apexification/recalc initial D3352 E Apexification/recalc interim D3353 E Apexification/recalc final D3410 E Apicoect/perirad surg anter D3421 E Root surgery bicuspid D3425 E Root surgery molar D3426 E Root surgery ea add root D3430 E Retrograde filling D3450 E Root amputation D3460 S Endodontic endosseous implan 0330 1.51 $74.89 $14.98 $14.98 D3470 E Intentional replantation D3910 E Isolation- tooth w rubb dam D3920 E Tooth splitting D3950 E Canal prep/fitting of dowel D3999 S Endodontic procedure 0330 1.51 $74.89 $14.98 $14.98 D4210 E Gingivectomy/plasty per quad D4211 E Gingivectomy/plasty per toot D4220 E Gingival curettage per quadr D4240 E Gingival flap proc w/ planin D4245 E Apically positioned flap D4249 E Crown lengthen hard tissue D4260 S Osseous surgery per quadrant 0330 1.51 $74.89 $14.98 $14.98 D4263 S Bone replce graft first site 0330 1.51 $74.89 $14.98 $14.98 D4264 S Bone replce graft each add 0330 1.51 $74.89 $14.98 $14.98 D4266 E Guided tiss regen resorble D4267 E Guided tiss regen nonresorb D4268 S Surgical revision procedure 0330 1.51 $74.89 $14.98 $14.98 D4270 S Pedicle soft tissue graft pr 0330 1.51 $74.89 $14.98 $14.98 D4271 S Free soft tissue graft proc 0330 1.51 $74.89 $14.98 $14.98 D4273 S Subepithelial tissue graft 0330 1.51 $74.89 $14.98 $14.98 D4274 E Distal/proximal wedge proc D4320 E Provision splnt intracoronal D4321 E Provisional splint extracoro D4341 E Periodontal scaling & root D4355 S Full mouth debridement 0330 1.51 $74.89 $14.98 $14.98 D4381 S Localized chemo delivery 0330 1.51 $74.89 $14.98 $14.98 D4910 E Periodontal maint procedures D4920 E Unscheduled dressing change D4999 E Unspecified periodontal proc D5110 E Dentures complete maxillary D5120 E Dentures complete mandible D5130 E Dentures immediat maxillary D5140 E Dentures immediat mandible D5211 E Dentures maxill part resin D5212 E Dentures mand part resin D5213 E Dentures maxill part metal D5214 E Dentures mandibl part metal D5281 E Removable partial denture D5410 E Dentures adjust cmplt maxil D5411 E Dentures adjust cmplt mand D5421 E Dentures adjust part maxill D5422 E Dentures adjust part mandbl D5510 E Dentur repr broken compl bas D5520 E Replace denture teeth complt D5610 E Dentures repair resin base D5620 E Rep part denture cast frame D5630 E Rep partial denture clasp D5640 E Replace part denture teeth D5650 E Add tooth to partial denture D5660 E Add clasp to partial denture D5710 E Dentures rebase cmplt maxil D5711 E Dentures rebase cmplt mand D5720 E Dentures rebase part maxill D5721 E Dentures rebase part mandbl D5730 E Denture reln cmplt maxil ch D5731 E Denture reln cmplt mand chr D5740 E Denture reln part maxil chr D5741 E Denture reln part mand chr D5750 E Denture reln cmplt max lab D5751 E Denture reln cmplt mand lab D5760 E Denture reln part maxil lab D5761 E Denture reln part mand lab D5810 E Denture interm cmplt maxill D5811 E Denture interm cmplt mandbl D5820 E Denture interm part maxill D5821 E Denture interm part mandbl D5850 E Denture tiss conditn maxill D5851 E Denture tiss condtin mandbl D5860 E Overdenture complete D5861 E Overdenture partial D5862 E Precision attachment D5867 E Replacement of precision att D5875 E Prosthesis modification D5899 E Removable prosthodontic proc D5911 S Facial moulage sectional 0330 1.51 $74.89 $14.98 $14.98 D5912 S Facial moulage complete 0330 1.51 $74.89 $14.98 $14.98 D5913 E Nasal prosthesis D5914 E Auricular prosthesis D5915 E Orbital prosthesis D5916 E Ocular prosthesis D5919 E Facial prosthesis D5922 E Nasal septal prosthesis D5923 E Ocular prosthesis interim D5924 E Cranial prosthesis D5925 E Facial augmentation implant D5926 E Replacement nasal prosthesis D5927 E Auricular replacement D5928 E Orbital replacement D5929 E Facial replacement D5931 E Surgical obturator D5932 E Postsurgical obturator D5933 E Refitting of obturator D5934 E Mandibular flange prosthesis D5935 E Mandibular denture prosth D5936 E Temp obturator prosthesis D5937 E Trismus appliance D5951 E Feeding aid D5952 E Pediatric speech aid D5953 E Adult speech aid D5954 E Superimposed prosthesis D5955 E Palatal lift prosthesis D5958 E Intraoral con def inter plt D5959 E Intraoral con def mod palat D5960 E Modify speech aid prosthesis D5982 E Surgical stent D5983 S Radiation applicator 0330 1.51 $74.89 $14.98 $14.98 D5984 S Radiation shield 0330 1.51 $74.89 $14.98 $14.98 D5985 S Radiation cone locator 0330 1.51 $74.89 $14.98 $14.98 D5986 E Fluoride applicator D5987 S Commissure splint 0330 1.51 $74.89 $14.98 $14.98 D5988 E Surgical splint D5999 E Maxillofacial prosthesis D6010 E Odontics endosteal implant D6020 E Odontics abutment placement D6040 E Odontics eposteal implant D6050 E Odontics transosteal implnt D6055 E Implant connecting bar D6056 E Prefabricated abutment D6057 E Custom abutment D6058 E Abutment supported crown D6059 E Abutment supported mtl crown D6060 E Abutment supported mtl crown D6061 E Abutment supported mtl crown D6062 E Abutment supported mtl crown D6063 E Abutment supported mtl crown D6064 E Abutment supported mtl crown D6065 E Implant supported crown D6066 E Implant supported mtl crown D6067 E Implant supported mtl crown D6068 E Abutment supported retainer D6069 E Abutment supported retainer D6070 E Abutment supported retainer D6071 E Abutment supported retainer D6072 E Abutment supported retainer D6073 E Abutment supported retainer D6074 E Abutment supported retainer D6075 E Implant supported retainer D6076 E Implant supported retainer D6077 E Implant supported retainer D6078 E Implnt/abut suprtd fixd dent D6079 E Implnt/abut suprtd fixd dent D6080 E Implant maintenance D6090 E Repair implant D6095 E Odontics repr abutment D6100 E Removal of implant D6199 E Implant procedure D6210 E Prosthodont high noble metal D6211 E Bridge base metal cast D6212 E Bridge noble metal cast D6240 E Bridge porcelain high noble D6241 E Bridge porcelain base metal D6242 E Bridge porcelain nobel metal D6245 E Bridge porcelain/ceramic D6250 E Bridge resin w/high noble D6251 E Bridge resin base metal D6252 E Bridge resin w/noble metal D6519 E Inlay/onlay porce/ceramic D6520 E Dental retainer two surfaces D6530 E Retainer metallic 3+ surface D6543 E Dental retainr onlay 3 surf D6544 E Dental retainr onlay 4/more D6545 E Dental retainr cast metl D6548 E Porcelain/ceramic retainer D6720 E Retain crown resin w hi nble D6721 E Crown resin w/base metal D6722 E Crown resin w/noble metal D6740 E Crown porcelain/ceramic D6750 E Crown porcelain high noble D6751 E Crown porcelain base metal D6752 E Crown porcelain noble metal D6780 E Crown 3/4 high noble metal D6781 E Crown 3/4 cast based metal D6782 E Crown 3/4 cast noble metal D6783 E Crown 3/4 porcelain/ceramic D6790 E Crown full high noble metal D6791 E Crown full base metal cast D6792 E Crown full noble metal cast D6920 S Dental connector bar 0330 1.51 $74.89 $14.98 $14.98 D6930 E Dental recement bridge D6940 E Stress breaker D6950 E Precision attachment D6970 E Post & core plus retainer D6971 E Cast post bridge retainer D6972 E Prefab post & core plus reta D6973 E Core build up for retainer D6975 E Coping metal D6976 E Each addtnl cast post D6977 E Each addtl prefab post D6980 E Bridge repair D6999 E Fixed prosthodontic proc D7110 S Oral surgery single tooth 0330 1.51 $74.89 $14.98 $14.98 D7120 S Each add tooth extraction 0330 1.51 $74.89 $14.98 $14.98 D7130 S Tooth root removal 0330 1.51 $74.89 $14.98 $14.98 D7210 S Rem imp tooth w mucoper flp 0330 1.51 $74.89 $14.98 $14.98 D7220 S Impact tooth remov soft tiss 0330 1.51 $74.89 $14.98 $14.98 D7230 S Impact tooth remov part bony 0330 1.51 $74.89 $14.98 $14.98 D7240 S Impact tooth remov comp bony 0330 1.51 $74.89 $14.98 $14.98 D7241 S Impact tooth rem bony w/comp 0330 1.51 $74.89 $14.98 $14.98 D7250 S Tooth root removal 0330 1.51 $74.89 $14.98 $14.98 D7260 S Oral antral fistula closure 0330 1.51 $74.89 $14.98 $14.98 D7270 E Tooth reimplantation D7272 E Tooth transplantation D7280 E Exposure impact tooth orthod D7281 E Exposure tooth aid eruption D7285 E Biopsy of oral tissue hard D7286 E Biopsy of oral tissue soft D7290 E Repositioning of teeth D7291 S Transseptal fiberotomy 0330 1.51 $74.89 $14.98 $14.98 D7310 E Alveoplasty w/ extraction D7320 E Alveoplasty w/o extraction D7340 E Vestibuloplasty ridge extens D7350 E Vestibuloplasty exten graft D7410 E Rad exc lesion up to 1.25 cm D7420 E Lesion > 1.25 cm D7430 E Exc benign tumor to 1.25 cm D7431 E Benign tumor exc > 1.25 cm D7440 E Malig tumor exc to 1.25 cm D7441 E Malig tumor > 1.25 cm D7450 E Rem odontogen cyst to 1.25cm D7451 E Rem odontogen cyst > 1.25 cm D7460 E Rem nonodonto cyst to 1.25cm D7461 E Rem nonodonto cyst > 1.25 cm D7465 E Lesion destruction D7471 E Rem exostosis any site D7480 E Partial ostectomy D7490 E Mandible resection D7510 E I&d absc intraoral soft tiss D7520 E I&d abscess extraoral D7530 E Removal fb skin/areolar tiss D7540 E Removal of fb reaction D7550 E Removal of sloughed off bone D7560 E Maxillary sinusotomy D7610 E Maxilla open reduct simple D7620 E Clsd reduct simpl maxilla fx D7630 E Open red simpl mandible fx D7640 E Clsd red simpl mandible fx D7650 E Open red simp malar/zygom fx D7660 E Clsd red simp malar/zygom fx D7670 E Closd rductn splint alveolus D7680 E Reduct simple facial bone fx D7710 E Maxilla open reduct compound D7720 E Clsd reduct compd maxilla fx D7730 E Open reduct compd mandble fx D7740 E Clsd reduct compd mandble fx D7750 E Open red comp malar/zygma fx D7760 E Clsd red comp malar/zygma fx D7770 E Open reduc compd alveolus fx D7780 E Reduct compnd facial bone fx D7810 E Tmj open reduct-dislocation D7820 E Closed tmp manipulation D7830 E Tmj manipulation under anest D7840 E Removal of tmj condyle D7850 E Tmj meniscectomy D7852 E Tmj repair of joint disc D7854 E Tmj excisn of joint membrane D7856 E Tmj cutting of a muscle D7858 E Tmj reconstruction D7860 E Tmj cutting into joint D7865 E Tmj reshaping components D7870 E Tmj aspiration joint fluid D7871 E Lysis + lavage w catheters D7872 E Tmj diagnostic arthroscopy D7873 E Tmj arthroscopy lysis adhesn D7874 E Tmj arthroscopy disc reposit D7875 E Tmj arthroscopy synovectomy D7876 E Tmj arthroscopy discectomy D7877 E Tmj arthroscopy debridement D7880 E Occlusal orthotic appliance D7899 E Tmj unspecified therapy D7910 E Dent sutur recent wnd to 5cm D7911 E Dental suture wound to 5 cm D7912 E Suture complicate wnd > 5 cm D7920 E Dental skin graft D7940 S Reshaping bone orthognathic 0330 1.51 $74.89 $14.98 $14.98 D7941 E Bone cutting ramus closed D7943 E Cutting ramus open w/graft D7944 E Bone cutting segmented D7945 E Bone cutting body mandible D7946 E Reconstruction maxilla total D7947 E Reconstruct maxilla segment D7948 E Reconstruct midface no graft D7949 E Reconstruct midface w/graft D7950 E Mandible graft D7955 E Repair maxillofacial defects D7960 E Frenulectomy/frenulotomy D7970 E Excision hyperplastic tissue D7971 E Excision pericoronal gingiva D7980 E Sialolithotomy D7981 E Excision of salivary gland D7982 E Sialodochoplasty D7983 E Closure of salivary fistula D7990 E Emergency tracheotomy D7991 E Dental coronoidectomy D7995 E Synthetic graft facial bones D7996 E Implant mandible for augment D7997 E Appliance removal D7999 E Oral surgery procedure D8010 E Limited dental tx primary D8020 E Limited dental tx transition D8030 E Limited dental tx adolescent D8040 E Limited dental tx adult D8050 E Intercep dental tx primary D8060 E Intercep dental tx transitn D8070 E Compre dental tx transition D8080 E Compre dental tx adolescent D8090 E Compre dental tx adult D8210 E Orthodontic rem appliance tx D8220 E Fixed appliance therapy habt D8660 E Preorthodontic tx visit D8670 E Periodic orthodontc tx visit D8680 E Orthodontic retention D8690 E Orthodontic treatment D8691 E Repair ortho appliance D8692 E Replacement retainer D8999 E Orthodontic procedure D9110 N Tx dental pain minor proc D9210 E Dent anesthesia w/o surgery D9211 E Regional block anesthesia D9212 E Trigeminal block anesthesia D9215 E Local anesthesia D9220 E General anesthesia D9221 E General anesthesia ea ad 15m D9230 N Analgesia D9241 E Intravenous sedation D9242 E IV sedation ea ad 30 m D9248 N Sedation (non-iv) D9310 E Dental consultation D9410 E Dental house call D9420 E Hospital call D9430 E Office visit during hours D9440 E Office visit after hours D9610 E Dent therapeutic drug inject D9630 S Other drugs/medicaments 0330 1.51 $74.89 $14.98 $14.98 D9910 E Dent appl desensitizing med D9911 E Appl desensitizing resin D9920 E Behavior management D9930 S Treatment of complications 0330 1.51 $74.89 $14.98 $14.98 D9940 S Dental occlusal guard 0330 1.51 $74.89 $14.98 $14.98 D9941 E Fabrication athletic guard D9950 S Occlusion analysis 0330 1.51 $74.89 $14.98 $14.98 D9951 S Limited occlusal adjustment 0330 1.51 $74.89 $14.98 $14.98 D9952 S Complete occlusal adjustment 0330 1.51 $74.89 $14.98 $14.98 D9970 E Enamel microabrasion D9971 E Odontoplasty 1-2 teeth D9972 E Extrnl bleaching per arch D9973 E Extrnl bleaching per tooth D9974 E Intrnl bleaching per tooth D9999 E Adjunctive procedure E0100 A Cane adjust/fixed with tip E0105 A Cane adjust/fixed quad/3 pro E0110 A Crutch forearm pair E0111 A Crutch forearm each E0112 A Crutch underarm pair wood E0113 A Crutch underarm each wood E0114 A Crutch underarm pair no wood E0116 A Crutch underarm each no wood E0130 A Walker rigid adjust/fixed ht E0135 A Walker folding adjust/fixed E0141 A Rigid walker wheeled wo seat E0142 A Walker rigid wheeled with se E0143 A Walker folding wheeled w/o s E0144 A Enclosed walker w rear seat E0145 A Walker whled seat/crutch att E0146 A Folding walker wheels w seat E0147 A Walker variable wheel resist E0148 A Heavyduty walker no wheels E0149 A Heavy duty wheeled walker E0153 A Forearm crutch platform atta E0154 A Walker platform attachment E0155 A Walker wheel attachment,pair E0156 A Walker seat attachment E0157 A Walker crutch attachment E0158 A Walker leg extenders set of4 E0159 A Brake for wheeled walker E0160 A Sitz type bath or equipment E0161 A Sitz bath/equipment w/faucet E0162 A Sitz bath chair E0163 A Commode chair stationry fxd E0164 A Commode chair mobile fixed a E0165 A Commode chair stationry det E0166 A Commode chair mobile detach E0167 A Commode chair pail or pan E0168 A Heavyduty/wide commode chair E0175 A Commode chair foot rest E0176 A Air pressre pad/cushion nonp E0177 A Water press pad/cushion nonp E0178 A Gel pressre pad/cushion nonp E0179 A Dry pressre pad/cushion nonp E0180 A Press pad alternating w pump E0181 A Press pad alternating w/ pum E0182 A Pressure pad alternating pum E0184 A Dry pressure mattress E0185 A Gel pressure mattress pad E0186 A Air pressure mattress E0187 A Water pressure mattress E0188 E Synthetic sheepskin pad E0189 E Lambswool sheepskin pad E0191 A Protector heel or elbow E0192 A Pad wheelchr low press/posit E0193 A Powered air flotation bed E0194 A Air fluidized bed E0196 A Gel pressure mattress E0197 A Air pressure pad for mattres E0198 A Water pressure pad for mattr E0199 A Dry pressure pad for mattres E0200 A Heat lamp without stand E0202 A Phototherapy light w/ photom E0205 A Heat lamp with stand E0210 A Electric heat pad standard E0215 A Electric heat pad moist E0217 A Water circ heat pad w pump E0218 E Water circ cold pad w pump E0220 A Hot water bottle E0225 A Hydrocollator unit E0230 A Ice cap or collar E0235 A Paraffin bath unit portable E0236 A Pump for water circulating p E0238 A Heat pad non-electric moist E0239 A Hydrocollator unit portable E0241 E Bath tub wall rail E0242 E Bath tub rail floor E0243 E Toilet rail E0244 E Toilet seat raised E0245 E Tub stool or bench E0246 E Transfer tub rail attachment E0249 A Pad water circulating heat u E0250 A Hosp bed fixed ht w/ mattres E0251 A Hosp bed fixd ht w/o mattres E0255 A Hospital bed var ht w/ mattr E0256 A Hospital bed var ht w/o matt E0260 A Hosp bed semi-electr w/ matt E0261 A Hosp bed semi-electr w/o mat E0265 A Hosp bed total electr w/ mat E0266 A Hosp bed total elec w/o matt E0270 E Hospital bed institutional t E0271 A Mattress innerspring E0272 A Mattress foam rubber E0273 E Bed board E0274 E Over-bed table E0275 A Bed pan standard E0276 A Bed pan fracture E0277 A Powered pres-redu air mattrs E0280 A Bed cradle E0290 A Hosp bed fx ht w/o rails w/m E0291 A Hosp bed fx ht w/o rail w/o E0292 A Hosp bed var ht w/o rail w/o E0293 A Hosp bed var ht w/o rail w/ E0294 A Hosp bed semi-elect w/ mattr E0295 A Hosp bed semi-elect w/o matt E0296 A Hosp bed total elect w/ matt E0297 A Hosp bed total elect w/o mat E0298 A Heavyduty/xtra wide hosp bed E0305 A Rails bed side half length E0310 A Rails bed side full length E0315 E Bed accessory brd/tbl/supprt E0325 A Urinal male jug-type E0326 A Urinal female jug-type E0350 E Control unit bowel system E0352 E Disposable pack w/bowel syst E0370 E Air elevator for heel E0371 A Nonpower mattress overlay E0372 A Powered air mattress overlay E0373 A Nonpowered pressure mattress E0424 A Stationary compressed gas O2 E0425 E Gas system stationary compre E0430 E Oxygen system gas portable E0431 A Portable gaseous O2 E0434 A Portable liquid O2 E0435 E Oxygen system liquid portabl E0439 A Stationary liquid O2 E0440 E Oxygen system liquid station E0441 A Oxygen contents gas per/unit E0442 A Oxygen contents liq per/unit E0443 A Port O2 contents gas/unit E0444 A Port O2 contents liq/unit E0450 A Volume vent stationary/porta E0455 A Oxygen tent excl croup/ped t E0457 A Chest shell E0459 A Chest wrap E0460 A Neg press vent portabl/statn E0462 A Rocking bed w/ or w/o side r E0480 A Percussor elect/pneum home m E0500 A Ippb all types E0550 A Humidif extens supple w ippb E0555 A Humidifier for use w/ regula E0560 A Humidifier supplemental w/ i E0565 A Compressor air power source E0570 A Nebulizer with compression E0571 A Aerosol compressor for svneb E0572 A Aerosol compressor adjust pr E0574 A Ultrasonic generator w svneb E0575 A Nebulizer ultrasonic E0580 A Nebulizer for use w/ regulat E0585 A Nebulizer w/ compressor & he E0590 A Dispensing fee dme neb drug E0600 A Suction pump portab hom modl E0601 A Cont airway pressure device E0602 E Breast pump E0605 A Vaporizer room type E0606 A Drainage board postural E0607 A Blood glucose monitor home E0608 A Apnea monitor E0609 A Blood gluc mon w/special fea E0610 A Pacemaker monitr audible/vis E0615 A Pacemaker monitr digital/vis E0616 N Cardiac event recorder E0617 A Automatic ext defibrillator E0621 A Patient lift sling or seat E0625 E Patient lift bathroom or toi E0627 A Seat lift incorp lift-chair E0628 A Seat lift for pt furn-electr E0629 A Seat lift for pt furn-non-el E0630 A Patient lift hydraulic E0635 A Patient lift electric E0650 A Pneuma compresor non-segment E0651 A Pneum compressor segmental E0652 A Pneum compres w/cal pressure E0655 A Pneumatic appliance half arm E0660 A Pneumatic appliance full leg E0665 A Pneumatic appliance full arm E0666 A Pneumatic appliance half leg E0667 A Seg pneumatic appl full leg E0668 A Seg pneumatic appl full arm E0669 A Seg pneumatic appli half leg E0671 A Pressure pneum appl full leg E0672 A Pressure pneum appl full arm E0673 A Pressure pneum appl half leg E0690 A Ultraviolet cabinet E0700 E Safety equipment E0710 E Restraints any type E0720 A Tens two lead E0730 A Tens four lead E0731 A Conductive garment for tens/ E0740 E Incontinence treatment systm E0744 A Neuromuscular stim for scoli E0745 A Neuromuscular stim for shock E0746 E Electromyograph biofeedback E0747 A Elec osteogen stim not spine E0748 A Elec osteogen stim spinal E0749 N Elec osteogen stim implanted E0751D N Pulse generator or receiver E0753 N Neurostimulator electrodes E0755 E Electronic salivary reflex s E0756 N Implantable pulse generator E0757 N Implantable RF receiver E0758 A External RF transmitter E0760 E Osteogen ultrasound stimltor E0765 A Nerve stimulator for tx n&v E0776 A Iv pole E0779 A Amb infusion pump mechanical E0780 A Mech amb infusion pump <8hrs E0781 A External ambulatory infus pu E0782 N Non-programble infusion pump E0783 N Programmable infusion pump E0784 A Ext amb infusn pump insulin E0785 N Replacement impl pump cathet E0786 N Implantable pump replacement E0791 A Parenteral infusion pump sta E0830 A Ambulatory traction device E0840 A Tract frame attach headboard E0850 A Traction stand free standing E0855 A Cervical traction equipment E0860 A Tract equip cervical tract E0870 A Tract frame attach footboard E0880 A Trac stand free stand extrem E0890 A Traction frame attach pelvic E0900 A Trac stand free stand pelvic E0910 A Trapeze bar attached to bed E0920 A Fracture frame attached to b E0930 A Fracture frame free standing E0935 A Exercise device passive moti E0940 A Trapeze bar free standing E0941 A Gravity assisted traction de E0942 A Cervical head harness/halter E0943 A Cervical pillow E0944 A Pelvic belt/harness/boot E0945 A Belt/harness extremity E0946 A Fracture frame dual w cross E0947 A Fracture frame attachmnts pe E0948 A Fracture frame attachmnts ce E0950 E Tray E0951 E Loop heel E0952 E Loop tie E0953 E Pneumatic tire E0954 E Wheelchair semi-pneumatic ca E0958 E Whlchr att- conv 1 arm drive E0959 E Amputee adapter E0961 E Wheelchair brake extension E0962 A Wheelchair 1 inch cushion E0963 A Wheelchair 2 inch cushion E0964 A Wheelchair 3 inch cushion E0965 A Wheelchair 4 inch cushion E0966 E Wheelchair head rest extensi E0967 E Wheelchair hand rims E0968 E Wheelchair commode seat E0969 E Wheelchair narrowing device E0970 E Wheelchair no. 2 footplates E0971 E Wheelchair anti-tipping devi E0972 A Transfer board or device E0973 E Wheelchair adjustabl height E0974 E Wheelchair grade-aid E0975 E Wheelchair reinforced seat u E0976 E Wheelchair reinforced back u E0977 E Wheelchair wedge cushion E0978 E Wheelchair belt w/airplane b E0979 E Wheelchair belt with velcro E0980 E Wheelchair safety vest E0990 E Whellchair elevating leg res E0991 E Wheelchair upholstry seat E0992 E Wheelchair solid seat insert E0993 E Wheelchair back upholstery E0994 E Wheelchair arm rest E0995 E Wheelchair calf rest E0996 E Wheelchair tire solid E0997 E Wheelchair caster w/ a fork E0998 E Wheelchair caster w/o a fork E0999 E Wheelchr pneumatic tire w/wh E1000 E Wheelchair tire pneumatic ca E1001 E Wheelchair wheel E1031 A Rollabout chair with casters E1035 A Patient transfer system E1050 E Whelchr fxd full length arms E1060 E Wheelchair detachable arms E1065 E Wheelchair power attachment E1066 E Wheelchair battery charger E1069 E Wheelchair deep cycle batter E1070 E Wheelchair detachable foot r E1083 E Hemi-wheelchair fixed arms E1084 E Hemi-wheelchair detachable a E1085 E Hemi-wheelchair fixed arms E1086 E Hemi-wheelchair detachable a E1087 E Wheelchair lightwt fixed arm E1088 E Wheelchair lightweight det a E1089 E Wheelchair lightwt fixed arm E1090 E Wheelchair lightweight det a E1091 E Wheelchair youth E1092 E Wheelchair wide w/ leg rests E1093 E Wheelchair wide w/ foot rest E1100 E Whchr s-recl fxd arm leg res E1110 E Wheelchair semi-recl detach E1130 E Whlchr stand fxd arm ft rest E1140 E Wheelchair standard detach a E1150 E Wheelchair standard w/ leg r E1160 E Wheelchair fixed arms E1170 E Whlchr ampu fxd arm leg rest E1171 E Wheelchair amputee w/o leg r E1172 E Wheelchair amputee detach ar E1180 E Wheelchair amputee w/ foot r E1190 E Wheelchair amputee w/ leg re E1195 E Wheelchair amputee heavy dut E1200 E Wheelchair amputee fixed arm E1210 E Whlchr moto ful arm leg rest E1211 E Wheelchair motorized w/ det E1212 E Wheelchair motorized w full E1213 E Wheelchair motorized w/ det E1220 E Whlchr special size/constrc E1221 E Wheelchair spec size w foot E1222 E Wheelchair spec size w/ leg E1223 E Wheelchair spec size w foot E1224 E Wheelchair spec size w/ leg E1225 E Wheelchair spec sz semi-recl E1226 E Wheelchair spec sz full-recl E1227 E Wheelchair spec sz spec ht a E1228 E Wheelchair spec sz spec ht b E1230 A Power operated vehicle E1240 E Whchr litwt det arm leg rest E1250 E Wheelchair lightwt fixed arm E1260 E Wheelchair lightwt foot rest E1270 E Wheelchair lightweight leg r E1280 E Whchr h-duty det arm leg res E1285 E Wheelchair heavy duty fixed E1290 E Wheelchair hvy duty detach a E1295 E Wheelchair heavy duty fixed E1296 E Wheelchair special seat heig E1297 E Wheelchair special seat dept E1298 E Wheelchair spec seat depth/w E1300 E Whirlpool portable E1310 A Whirlpool non-portable E1340 A Repair for DME, per 15 min E1353 A Oxygen supplies regulator E1355 A Oxygen supplies stand/rack E1372 A Oxy suppl heater for nebuliz E1375D A Oxygen suppl nebulizer porta E1377D E Oxygen concentrator to 244 c E1378D E Oxygen concentrator to 488 c E1379D E Oxygen concentrator to 732 c E1380D E Oxygen concentrator to 976 c E1381D E Oxygen concentrat to 1220 cu E1382D E Oxygen concentrat to 1464 cu E1383D E Oxygen concentrat to 1708 cu E1384D E Oxygen concentrat to 1952 cu E1385D E Oxygen concentrator > 1952 c E1390 A Oxygen concentrator E1399 A Durable medical equipment mi E1405 A O2/water vapor enrich w/heat E1406 A O2/water vapor enrich w/o he E1510 A Kidney dialysate delivry sys E1520 A Heparin infusion pump for di E1530 A Air bubble detector for dial E1540 A Pressure alarm for dialysis E1550 A Bath conductivity meter E1560 A Blood leak detector for dial E1570 A Adjustable chair for esrd pt E1575 A Transducer protector/fluid b E1580 A Unipuncture control system E1590 A Hemodialysis machine E1592 A Auto interm peritoneal dialy E1594 A Cycler dialysis machine E1600 A Deliv/install equip for dial E1610 A Reverse osmosis water purifi E1615 A Deionizer water purification E1620 A Blood pump for dialysis E1625 A Water softening system E1630 A Reciprocating peritoneal dia E1632 A Wearable artificial kidney E1635 A Compact travel hemodialyzer E1636 A Sorbent cartridges for dialy E1640 A Replacement components for d E1699 A Dialysis equipment unspecifi E1700 A Jaw motion rehab system E1701 A Repl cushions for jaw motion E1702 A Repl measr scales jaw motion E1800 A Adjust elbow ext/flex device E1805 A Adjust wrist ext/flex device E1810 A Adjust knee ext/flex device E1815 A Adjust ankle ext/flex device E1820 A Soft interface material E1825 A Adjust finger ext/flex devc E1830 A Adjust toe ext/flex device E1900 A Speech communication device G0001 A Drawing blood for specimen G0002 N Temporary urinary catheter G0004 E ECG transm phys review & int G0005 X ECG 24 hour recording 0097 1.62 $80.35 $62.40 $16.07 G0006 X ECG transmission & analysis 0097 1.62 $80.35 $62.40 $16.07 G0007 N ECG phy review & interpret G0008 K Admin influenza virus vac 0354 0.13 $6.33 G0009 K Admin pneumococcal vaccine 0354 0.13 $6.33 G0010 N Admin hepatitis b vaccine G0015 X Post symptom ECG tracing 0097 1.62 $80.35 $62.40 $16.07 G0016 E Post symptom ECG md review G0025 X Collagen skin test kit 0343 0.45 $22.32 $12.16 $4.46 G0026 A Fecal leukocyte examination G0027 A Semen analysis G0030 S PET imaging prev PET single 0285 15.06 $746.92 $415.21 $149.38 G0031 S PET imaging prev PET multple 0285 15.06 $746.92 $415.21 $149.38 G0032 S PET follow SPECT 78464 singl 0285 15.06 $746.92 $415.21 $149.38 G0033 S PET follow SPECT 78464 mult 0285 15.06 $746.92 $415.21 $149.38 G0034 S PET follow SPECT 76865 singl 0285 15.06 $746.92 $415.21 $149.38 G0035 S PET follow SPECT 78465 mult 0285 15.06 $746.92 $415.21 $149.38 G0036 S PET follow cornry angio sing 0285 15.06 $746.92 $415.21 $149.38 G0037 S PET follow cornry angio mult 0285 15.06 $746.92 $415.21 $149.38 G0038 S PET follow myocard perf sing 0285 15.06 $746.92 $415.21 $149.38 G0039 S PET follow myocard perf mult 0285 15.06 $746.92 $415.21 $149.38 G0040 S PET follow stress echo singl 0285 15.06 $746.92 $415.21 $149.38 G0041 S PET follow stress echo mult 0285 15.06 $746.92 $415.21 $149.38 G0042 S PET follow ventriculogm sing 0285 15.06 $746.92 $415.21 $149.38 G0043 S PET follow ventriculogm mult 0285 15.06 $746.92 $415.21 $149.38 G0044 S PET following rest ECG singl 0285 15.06 $746.92 $415.21 $149.38 G0045 S PET following rest ECG mult 0285 15.06 $746.92 $415.21 $149.38 G0046 S PET follow stress ECG singl 0285 15.06 $746.92 $415.21 $149.38 G0047 S PET follow stress ECG mult 0285 15.06 $746.92 $415.21 $149.38 G0050 S Residual urine by ultrasound 0265 1.17 $58.03 $38.08 $11.61 G0101 V CA screen;pelvic/breast exam 0601 1.00 $49.60 $9.92 $9.92 G0102 N Prostate ca screening; dre G0103 A Psa, total screening G0104 S CA screen;flexi sigmoidscope 0159 2.83 $140.36 $35.09 G0105 S Colorectal scrn; hi risk ind 0158 7.98 $395.78 $98.94 G0106 S Colon CA screen;barium enema 0157 1.79 $88.78 $22.19 G0107 A CA screen; fecal blood test G0108 A Diab manage trn per indiv G0109 A Diab manage trn ind/group G0110 A Nett pulm-rehab educ; ind G0111 A Nett pulm-rehab educ; group G0112 A Nett;nutrition guid, initial G0113 A Nett;nutrition guid,subseqnt G0114 A Nett; psychosocial consult G0115 A Nett; psychological testing G0116 A Nett; psychosocial counsel G0120 S Colon ca scrn; barium enema 0157 1.79 $88.78 $22.19 G0121 E Colon ca scrn not hi rsk ind G0122 S Colon ca scrn; barium enema 0157 1.79 $88.78 $22.19 G0123 A Screen cerv/vag thin layer G0124 A Screen c/v thin layer by MD G0125 S Lung image
(PET)0981 46.40 $2,301.26 $460.25 G0126 S Lung image
(PET)staging 0981 46.40 $2,301.26 $460.25 G0127 T Trim nail(s) 0009 0.74 $36.70 $9.63 $7.34 G0128 E CORF skilled nursing service G0129 P Partial hosp prog service 0033 4.17 $206.82 $48.17 $41.36 G0130 X Single energy x-ray study 0261 1.38 $68.44 $38.77 $13.69 G0131 S CT scan, bone density study 0282 2.38 $118.04 $94.51 $23.61 G0132 S CT scan, bone density study 0282 2.38 $118.04 $94.51 $23.61 G0141 E Scr c/v cyto,autosys and md G0143 A Scr c/v cyto,thinlayer,rescr G0144 A Scr c/v cyto,thinlayer,rescr G0145 A Scr c/v cyto,thinlayer,rescr G0147 A Scr c/v cyto, automated sys G0148 A Scr c/v cyto, autosys, rescr G0151 E HHCP-serv of pt,ea 15 min G0152 E HHCP-serv of ot,ea 15 min G0153 E HHCP-svs of s/l path,ea 15mn G0154 E HHCP-svs of rn,ea 15 min G0155 E HHCP-svs of csw,ea 15 min G0156 E HHCP-svs of aide,ea 15 min G0159D T Perc declot dialysis graft 0103 13.09 $649.21 $295.70 $129.84 *G0160D S Cryo. ablation, prostate 0981 46.40 $2,301.26 $460.25 G0161D X Echo guide for cryo probes 0268 2.23 $110.60 $69.51 $22.12 G0163 S Pet for rec of colorectal ca 0981 46.40 $2,301.26 $460.25 G0164 S Pet for lymphoma staging 0981 46.40 $2,301.26 $460.25 G0165 S Pet,rec of melanoma/met ca 0981 46.40 $2,301.26 $460.25 G0166 T Extrnl counterpulse, per tx 0972 3.09 $153.26 $30.65 G0167 E Hyperbaric oz tx;no md reqrd G0168 T Wound closure by adhesive 0970 0.52 $25.79 $5.16 G0169D T Removal tissue; no anesthsia 0013 0.91 $45.13 $17.66 $9.03 G0170D T Skin biograft 0025 3.74 $185.49 $70.66 $37.10 G0171D T Skin biograft add-on 0025 3.74 $185.49 $70.66 $37.10 G0172D P Partial hosp prog service 0033 4.17 $206.82 $48.17 $41.36 G0173 S Stereotactic radiosurgery 0302 8.21 $407.18 $216.55 $81.44 G0174 S IMRT , per session 0302 8.21 $407.18 $216.55 $81.44 G0175 V Interdisciplinary team conf 0602 1.66 $82.33 $16.47 $16.47 *G0176 P OPPS/PHP;activity therapy 0033 4.17 $206.82 $48.17 $41.36 *G0177 P OPPS/PHP; train & educ serv 0033 4.17 $206.82 $48.17 $41.36 *G0178 S Intensity modulated radiation 0302 8.21 $407.18 $216.55 $81.44 *G0179 E Phys recertification, HHA pt *G0180 E Phys certification, HHA pt *G0181 E Home health care supervision *G0182 E Hospice care supervision *G0183 T Ocular photodynamic therapy 0235 2.94 $145.81 $78.91 $29.16 *G0184 T Ocular photocoagulation 0235 33.96 $1,684.28 $852.68 $336.86 *G0185 T Transpuppillary thermotx 0235 6.70 $332.29 $147.96 $66.46 *G0186 T Dstry eye lesn,fdr vssl tech 0235 6.70 $332.29 $147.96 $66.46 *G0187 T Dstry mclr drusen,photocoag 0235 33.96 $1,684.28 $852.68 $336.86 *G0188 X Xray lwr extrmty-full lngth 1.38 $68.44 $38.77 $13.69 *G0190 N Immunization administration *G0191 N Immunization admin,each add *G0192 N Immunization oral/intranasal *G0195 A Clinical eval, swallowing *G0196 A Radioisotope eval, swallowing *G0197 A Eval, speech generating device *G0198 A Trng, speech generating device *G0199 A Re-evaluation, speech device *G0200 A Eval, voice prosthetic *G0201 A Trng, voice prosthetic *G9001 E Coordinated care fee *G9002 E Coordinated care fee *G9003 E Coordinated care fee *G9004 E Coordinated care fee *G9005 E Coordinated care fee *G9006 E Coordinated care fee *G9007 E Coordinated care fee *G9008 E Coordinated care fee *G9016 A Demo-smoking cessation coun J0120 N Tetracyclin injection *J0130 G Abciximab injection 1605 $513.02 $68.74 J0150 K Injection adenosine 6 MG 0917 0.36 $17.86 $3.57 J0151 E Adenosine injection J0170 N Adrenalin epinephrin inject J0190 N Inj biperiden lactate/5 mg J0200 N Alatrofloxacin mesylate J0205 G Alglucerase injection 0900 $37.53 $5.03 J0207 G Amifostine 7000 $350.31 $46.94 J0210 N Methyldopate hcl injection J0256 G Alpha 1 proteinase inhibitor 0901 $2.09 $.28 J0270 E Alprostadil for injection J0275 E Alprostadil urethral suppos J0280 N Aminophyllin 250 MG inj J0282 N Amiodarone HCl J0285 N Amphotericin B J0286 G Amphotericin B lipid complex 7001 $95.00 $12.73 J0290 N Ampicillin 500 MG inj J0295 N Ampicillin sodium per 1.5 gm J0300 N Amobarbital 125 MG inj J0330 N Succinycholine chloride inj J0340 N Nandrolon phenpropionate inj *J0350 G Injection anistreplase 30 u 1606 $2,693.80 $360.97 J0360 N Hydralazine hcl injection J0380 N Inj metaraminol bitartrate J0390 N Chloroquine injection J0395 N Arbutamine HCl injection J0400 N Inj trimethaphan camsylate J0456 N Azithromycin J0460 N Atropine sulfate injection J0470 N Dimecaprol injection J0475 N Baclofen 10 MG injection J0476 E Baclofen 50 mcg intrathecal trial J0500 N Dicyclomine injection J0510 N Benzquinamide injection J0515 N Inj benztropine mesylate J0520 N Bethanechol chloride inject J0530 N Penicillin g benzathine inj J0540 N Penicillin g benzathine inj J0550 N Penicillin g benzathine inj J0560 N Penicillin g benzathine inj J0570 N Penicillin g benzathine inj J0580 N Penicillin g benzathine inj J0585 G Botulinum toxin a per unit 0902 $4.39 $.59 J0590 N Ethylnorepinephrine hcl inj J0600 N Edetate calcium disodium inj J0610 N Calcium gluconate injection J0620 N Calcium glycer & lact/10 ML J0630 N Calcitonin salmon injection J0635 N Calcitriol injection J0640 G Leucovorin calcium injection 0725 $49.73 $6.66 J0670 N Inj mepivacaine HCL/10 ml J0690 N Cefazolin sodium injection J0694 N Cefoxitin sodium injection J0695 N Cefonocid sodium injection J0696 N Ceftriaxone sodium injection J0697 N Sterile cefuroxime injection J0698 N Cefotaxime sodium injection J0702 N Betamethasone acet&sod phosp J0704 N Betamethasone sod phosp/4 MG J0710 N Cephapirin sodium injection J0713 N Inj ceftazidime per 500 mg J0715 N Ceftizoxime sodium / 500 MG J0720 N Chloramphenicol sodium injec J0725 N Chorionic gonadotropin/1000u J0730 N Chlorpheniramin maleate inj J0735 N Clonidine hydrochloride J0740 N Cidofovir injection J0743 N Cilastatin sodium injection J0745 N Inj codeine phosphate /30 MG J0760 N Colchicine injection J0770 N Colistimethate sodium inj J0780 N Prochlorperazine injection J0800 N Corticotropin injection J0810 N Cortisone injection J0835 N Inj cosyntropin per 0.25 MG J0850 G Cytomegalovirus imm IV /vial 0903 $370.50 $49.65 J0895 N Deferoxamine mesylate inj J0900 N Testosterone enanthate inj J0945 N Brompheniramine maleate inj J0970 N Estradiol valerate injection J1000 N Depo-estradiol cypionate inj J1020 N Methylprednisolone 20 MG inj J1030 N Methylprednisolone 40 MG inj J1040 N Methylprednisolone 80 MG inj J1050 N Medroxyprogesterone inj J1055 E Medrxyprogester acetate inj J1060 N Testosterone cypionate 1 ML J1070 N Testosterone cypionat 100 MG J1080 N Testosterone cypionat 200 MG J1090 N Testosterone cypionate 50 MG J1095 N Inj dexamethasone acetate J1100 N Dexamethasone sodium phos J1110 N Inj dihydroergotamine mesylt J1120 N Acetazolamid sodium injectio J1160 N Digoxin injection J1165 N Phenytoin sodium injection J1170 N Hydromorphone injection J1180 N Dyphylline injection J1190 G Dexrazoxane HCl injection 0726 $161.11 $21.59 J1200 N Diphenhydramine hcl injectio J1205 N Chlorothiazide sodium inj J1212 N Dimethyl sulfoxide 50% 50 ML J1230 N Methadone injection J1240 N Dimenhydrinate injection J1245 K Dipyridamole injection 0917 0.36 $17.86 $3.57 J1250 N Inj dobutamine HCL/250 mg J1260 G Dolasetron mesylate 0750 $14.81 $1.98 J1320 N Amitriptyline injection J1325 G Epoprostenol injection 7003 $16.53 $2.22 *J1327 G Eptifibatide injection 1607 $12.57 $1.68 J1330 N Ergonovine maleate injection J1362 N Erythromycin glucep / 250 MG J1364 N Erythro lactobionate /500 MG J1380 N Estradiol valerate 10 MG inj J1390 N Estradiol valerate 20 MG inj J1410 N Inj estrogen conjugate 25 MG J1435 N Injection estrone per 1 MG J1436 G Etidronate disodium inj 0727 $63.65 $8.53 *J1438 G Etanercept injection 1608 $134.42 $18.01 J1440 G Filgrastim 300 mcg injection 0728 $171.38 $22.96 J1441 G Filgrastim 480 mcg injection 7049 $273.03 $35.06 J1450 N Fluconazole J1452 N Intraocular Fomivirsen na 1.65 MG J1455 N Foscarnet sodium injection J1460 N Gamma globulin 1 CC inj J1470 E Gamma globulin 2 CC inj J1480 E Gamma globulin 3 CC inj J1490 E Gamma globulin 4 CC inj J1500 E Gamma globulin 5 CC inj J1510 E Gamma globulin 6 CC inj J1520 E Gamma globulin 7 CC inj J1530 E Gamma globulin 8 CC inj J1540 E Gamma globulin 9 CC inj J1550 E Gamma globulin 10 CC inj J1560 E Gamma globulin > 10 CC inj J1561 G Immune globulin 500 mg 0905 $27.28 $3.33 J1562D G Immune globulin 5 gms 7004 $272.80 $33.28 J1563D N IV immune globulin 1 GM J1565 G RSV-ivig 0906 $427.73 $57.32 J1570 K Ganciclovir sodium injection 0907 0.45 $22.26 $4.45 J1580 N Garamycin gentamicin inj J1600 N Gold sodium thiomaleate inj J1610 N Glucagon hydrochloride/1 MG J1620 G Gonadorelin hydroch/ 100 mcg 7005 $14.80 $1.98 J1626 G Granisetron HCl injection 0764 $1.85 $.25 J1630 N Haloperidol injection J1631 N Haloperidol decanoate inj J1642 N Inj heparin sodium per 10 u J1644 N Inj heparin sodium per 1000u J1645 N Dalteparin sodium J1650 G Enoxaparin sodium 10 mg 9998 $5.53 $.79 J1670 G Tetanus immune globulin inj 0908 $102.60 $13.75 J1690 N Prednisolone tebutate inj J1700 N Hydrocortisone acetate inj J1710 N Hydrocortisone sodium ph inj J1720 N Hydrocortisone sodium succ i J1730 N Diazoxide injection J1739 N Hydroxyprogesterone cap 125 J1741 N Hydroxyprogesterone cap 250 J1742 N Ibutilide fumarate injection J1745 G Infliximab injection 7043 $58.08 $7.78 J1750 N Iron dextran J1785 G Injection imiglucerase /unit 0916 $3.75 $.50 J1790 N Droperidol injection J1800 N Propranolol injection J1810 G Droperidol/fentanyl inj 7047 $7.02 $.90 J1820 N Insulin injection J1825 G Interferon beta-1a 0909 $204.73 $27.43 J1830 G Interferon beta-1b / .25 MG 0910 $57.00 $7.64 J1840 N Kanamycin sulfate 500 MG inj J1850 N Kanamycin sulfate 75 MG inj J1885 N Ketorolac tromethamine inj J1890 N Cephalothin sodium injection J1910 N Kutapressin injection J1930 N Propiomazine injection J1940 N Furosemide injection J1950 G Leuprolide acetate /3.75 MG 0800 $492.71 $63.27 J1955 N Inj levocarnitine per 1 gm J1956 N Levofloxacin injection J1960 N Levorphanol tartrate inj J1970 N Methotrimeprazine injection J1980 N Hyoscyamine sulfate inj J1990 N Chlordiazepoxide injection J2000 N Lidocaine injection J2010 N Lincomycin injection J2060 N Lorazepam injection J2150 N Mannitol injection J2175 N Meperidine hydrochl /100 MG J2180 N Meperidine/promethazine inj J2210 N Methylergonovin maleate inj J2240 N Metocurine iodide injection J2250 N Inj midazolam hydrochloride J2260 K Inj milrinone lactate / 5 ML 7007 0.47 $23.31 $4.66 J2270 N Morphine sulfate injection J2271 N Morphine so4 injection 100mg J2275 G Morphine sulfate injection 7010 $7.41 $.99 J2300 N Inj nalbuphine hydrochloride J2310 N Inj naloxone hydrochloride J2320 N Nandrolone decanoate 50 MG J2321 N Nandrolone decanoate 100 MG J2322 N Nandrolone decanoate 200 MG J2330 N Thiothixene injection J2350 N Niacinamide/niacin injection J2352 G Octreotide acetate injection 7031 $115.34 $15.46 J2355 G Oprelvekin injection 7011 $236.31 $31.67 J2360 N Orphenadrine injection J2370 N Phenylephrine hcl injection J2400 N Chloroprocaine hcl injection J2405 G Ondansetron hcl injection 0768 $6.09 $.82 J2410 N Oxymorphone hcl injection J2430 G Pamidronate disodium /30 MG 0730 $232.51 $31.16 J2440 N Papaverin hcl injection J2460 N Oxytetracycline injection J2480 N Hydrochlorides of opium inj J2500 N Paricalcitol J2510 N Penicillin g procaine inj J2512 N Inj pentagastrin per 2 ML J2515 N Pentobarbital sodium inj J2540 N Penicillin g potassium inj J2543 N Piperacillin/tazobactam J2545 A Pentamidine isethionte/300mg J2550 N Promethazine hcl injection J2560 N Phenobarbital sodium inj J2590 N Oxytocin injection J2597 E Inj desmopressin acetate J2640 N Prednisolone sodium ph inj J2650 N Prednisolone acetate inj J2670 N Totazoline hcl injection J2675 N Inj progesterone per 50 MG J2680 N Fluphenazine decanoate 25 MG J2690 N Procainamide hcl injection J2700 N Oxacillin sodium injection J2710 N Neostigmine methylslfte inj J2720 N Inj protamine sulfate/10 MG J2725 N Inj protirelin per 250 mcg J2730 N Pralidoxime chloride inj J2760 N Phentolaine mesylate inj J2765 G Metoclopramide hcl injection 0754 $2.00 $.27 J2770 G Quinupristin/dalfopristin 1024 $102.05 $13.67 J2780 N Ranitidine hydrochloride inj J2790 G Rho d immune globulin inj 0884 $35.91 $4.38 *J2792 G Rho(D) immune globulin h, sd 1609 $20.55 $2.51 J2795 N Ropivacaine HCl injection J2800 N Methocarbamol injection J2810 N Inj theophylline per 40 MG J2820 G Sargramostim injection 0731 $27.42 $3.67 J2860 N Secobarbital sodium inj J2910 N Aurothioglucose injection J2912 N Sodium chloride injection J2915 N NA Ferric Gluconate Complex J2920 N Methylprednisolone injection J2930 N Methylprednisolone injection J2950 N Promazine hcl injection J2970 N Methicillin sodium injection J2993 G Reteplase injection 9005 $1,306.25 $175.04 J2994D G Reteplase double bolus 0914 $2,612.50 $350.08 J2995 K Inj streptokinase /250000 IU 0911 1.76 $87.25 $17.45 J2996D K Alteplase recombinant inj 0915 3.80 $188.46 $37.69 J2997 G Alteplase recombinant, 1 mg 7048 0.38 $18.70 $3.74 J3000 N Streptomycin injection J3010 G Fentanyl citrate injection 7014 $.98 $.13 J3030 N Sumatriptan succinate / 6 MG J3070 N Pentazocine hcl injection J3080 N Chlorprothixene injection J3105 N Terbutaline sulfate inj J3120 N Testosterone enanthate inj J3130 N Testosterone enanthate inj J3140 N Testosterone suspension inj J3150 N Testosteron propionate inj J3230 N Chlorpromazine hcl injection *J3240 E Thyrotropin injection J3245 G Tirofiban hydrochloride 7041 $399.00 $53.47 J3250 N Trimethobenzamide hcl inj J3260 N Tobramycin sulfate injection J3265 N Injection torsemide 10 mg/ml J3270 N Imipramine hcl injection J3280 G Thiethylperazine maleate inj 0755 $5.02 $.67 J3301 N Triamcinolone acetonide inj J3302 N Triamcinolone diacetate inj J3303 N Triamcinolone hexacetonl inj J3305 G Inj trimetrexate glucoronate 7045 $69.83 $9.36 J3310 N Perphenazine injection J3320 N Spectinomycn di-hcl inj J3350 N Urea injection J3360 N Diazepam injection J3364 N Urokinase 5000 IU injection J3365 K Urokinase 250,000 IU inj 7036 6.78 $336.29 $67.26 J3370 N Vancomycin hcl injection J3390 N Methoxamine injection J3400 N Triflupromazine hcl inj J3410 N Hydroxyzine hcl injection J3420 N Vitamin b12 injection J3430 N Vitamin k phytonadione inj J3450 N Mephentermine sulfate inj J3470 N Hyaluronidase injection J3475 N Inj magnesium sulfate J3480 N Inj potassium chloride J3485 N Zidovudine J3490 N Drugs unclassified injection J3520 E Edetate disodium per 150 mg J3530 N Nasal vaccine inhalation J3535 E Metered dose inhaler drug J3570 E Laetrile amygdalin vit B17 J7030 N Normal saline solution infus J7040 N Normal saline solution infus J7042 N 5% dextrose/normal saline J7050 N Normal saline solution infus J7051 N Sterile saline/water J7060 N 5% dextrose/water J7070 N D5w infusion J7100 N Dextran 40 infusion J7110 N Dextran 75 infusion J7120 N Ringers lactate infusion J7130 N Hypertonic saline solution J7190 G Factor viii 0925 $.88 $.12 J7191 G Factor VIII (porcine) 0926 $2.09 $.28 J7192 G Factor viii recombinant 0927 $1.17 $.16 J7194 G Factor ix complex 0928 $.71 $.10 J7197 G Antithrombin iii injection 0930 $.82 $.11 J7198 G Anti-inhibitor 0929 $1.43 $.19 J7199 E Hemophilia clot factor noc J7300 E Intraut copper contraceptive J7310 G Ganciclovir long act implant 0913 $4,750.00 $636.50 J7315 G Sodium hyaluronate injection 7315 $125.59 $16.83 *J7320 G Hylan G-F 20 injection 1611 $204.87 $27.45 J7330 G Cultured chondrocytes implnt 1059 $14,250.00 $2,010.00 J7500 G Azathioprine oral 50mg 0886 $1.24 $.17 J7501 G Azathioprine parenteral 0887 $67.88 $9.10 J7502 G Cyclosporine oral 100 mg 0888 $5.80 $.78 J7504 G Lymphocyte immune globulin 0890 $249.13 $30.39 J7505 G Muromonab-CD3, 5 mg 7038 $741.00 $99.29 J7506 N Prednisone oral J7507 G Tacrolimus oral per 1 MG 0891 $2.66 $.36 J7508 E Tacrolimus oral per 5 MG J7509 N Methylprednisolone oral J7510 N Prednisolone oral per 5 mg *J7513 G Daclizumab, parenteral 1612 $397.29 $53.24 J7515 N Cyclosporine oral 25 mg J7516 G Cyclosporin parenteral 250mg 0889 $15.81 $2.12 J7517 N Mycophenolate mofetil oral J7520 G Sirolimus, oral 9106 $6.51 $.87 J7525 E Tacrolimus injection J7599 E Immunosuppressive drug noc J7608 A Acetylcysteine inh sol u d J7610D A Acetylcysteine 10% injection J7615D A Acetylcysteine 20% injection J7618 A Albuterol inh sol con J7619 A Albuterol inh sol u d J7620D A Albuterol sulfate .083%/ml J7625D A Albuterol sulfate .5% inj J7627D A Bitolterolmesylate inhal sol J7628 A Bitolterol mes inhal sol con J7629 A Bitolterol mes inh sol u d J7630D A Cromolyn sodium injection J7631 A Cromolyn sodium inh sol u d J7635 A Atropine inhal sol con J7636 A Atropine inhal sol unit dose J7637 A Dexamethasone inhal sol con J7638 A Dexamethasone inhal sol u d J7639 A Dornase alpha inhal sol u d J7640D A Epinephrine injection J7642 A Glycopyrrolate inhal sol con J7643 A Glycopyrrolate inhal sol u d J7644 A Ipratropium brom inh sol u d J7645D A Ipratropium bromide .02%/ml J7648 A Isoetharine hcl inh sol con J7649 A Isoetharine hcl inh sol u d J7650D A Isoetharine hcl .1% inj J7651D A Isoetharine hcl .125% inj J7652D A Isoetharine hcl .167% inj J7653D A Isoetharine hcl .2%/ inj J7654D A Isoetharine hcl .25% inj J7655D A Isoetharine hcl 1% inj J7658 A Isoproterenolhcl inh sol con J7659 A Isoproterenol hcl inh sol ud J7660D A Isoproterenol hcl .5% inj J7665D A Isoproterenol hcl 1% inj J7668 A Metaproterenol inh sol con J7669 A Metaproterenol inh sol u d J7670D A Metaproterenol sulfate .4% J7672D A Metaproterenol sulfate .6% J7675D A Metaproterenol sulfate 5% J7680 A Terbutaline so4 inh sol con J7681 A Terbutaline so4 inh sol u d J7682 A Tobramycin inhalation sol J7683 A Triamcinolone inh sol con J7684 A Triamcinolone inh sol u d J7699 A Inhalation solution for DME J7799 A Non-inhalation drug for DME J8499 E Oral prescrip drug non chemo J8510 G Oral busulfan 7015 $1.73 $.23 J8520 G Capecitabine, oral, 150 mg 7042 $1.94 $.26 J8521 N Capecitabine, oral, 500 mg J8530 G Cyclophosphamide oral 25 MG 0801 $2.12 $.28 J8560 G Etoposide oral 50 MG 0802 $45.95 $6.16 J8600 G Melphalan oral 2 MG 0803 $2.07 $.30 J8610 G Methotrexate oral 2.5 MG 0826 $2.92 $.39 J8700 G Temozolmide, oral 5 mg 1086 $5.70 $.76 J8999 E Oral prescription drug chemo J9000 G Doxorubic hcl 10 MG vl chemo 0847 $15.79 $2.12 J9001 G Doxorubicin hcl liposome inj 7046 $311.72 $41.77 J9015 G Aldesleukin/single use vial 0807 $569.76 $76.35 J9020 G Asparaginase injection 0814 $57.41 $7.69 J9031 G Bcg live intravesical vac 0809 $159.39 $19.45 J9040 G Bleomycin sulfate injection 0857 $294.48 $39.46 J9045 G Carboplatin injection 0811 $98.90 $13.25 J9050 G Carmus bischl nitro inj 0812 $103.27 $13.84 J9060 G Cisplatin 10 MG injection 0813 $42.18 $5.65 J9062 E Cisplatin 50 MG injection J9065 G Inj cladribine per 1 MG 0858 $53.47 $7.16 J9070 G Cyclophosphamide 100 MG inj 0815 $6.13 $.82 J9080 E Cyclophosphamide 200 MG inj J9090 E Cyclophosphamide 500 MG inj J9091 E Cyclophosphamide 1.0 grm inj J9092 E Cyclophosphamide 2.0 grm inj J9093 G Cyclophosphamide lyophilized 0816 $6.13 $.82 J9094 E Cyclophosphamide lyophilized J9095 E Cyclophosphamide lyophilized J9096 E Cyclophosphamide lyophilized J9097 E Cyclophosphamide lyophilized J9100 G Cytarabine hcl 100 MG inj 0817 $5.94 $.80 J9110 E Cytarabine hcl 500 MG inj J9120 G Dactinomycin actinomycin d 0818 $12.73 $1.71 J9130 G Dacarbazine 10 MG inj 0819 $1.13 $.15 J9140 E Dacarbazine 200 MG inj J9150 G Daunorubicin 0820 $80.04 $10.73 J9151 G Daunorubicin citrate liposom 0821 $64.60 $8.66 J9160 G Denileukin diftitox, 300 mcg 1084 $942.88 $126.35 J9165 G Diethylstilbestrol injection 0822 $4.20 $.56 J9170 G Docetaxel 0823 $283.65 $38.01 J9180 E Epirubicin HCl injection J9181 G Etoposide 10 MG inj 0824 $4.06 $.54 J9182 E Etoposide 100 MG inj J9185 G Fludarabine phosphate inj 0842 $237.03 $31.76 J9190 G Fluorouracil injection 0859 $2.75 $.37 J9200 G Floxuridine injection 0827 $129.56 $17.36 J9201 G Gemcitabine HCl 0828 $88.46 $11.85 J9202 G Goserelin acetate implant 0810 $446.49 $59.83 J9206 G Irinotecan injection 0830 $117.81 $15.79 J9208 G Ifosfomide injection 0831 $141.50 $18.96 J9209 G Mesna injection 0732 $36.51 $4.89 J9211 G Idarubicin hcl injection 0832 $341.38 $45.75 J9212 G Interferon alfacon-1 0833 $3.91 $.52 J9213 G Interferon alfa-2a inj 0834 $33.22 $4.45 J9214 G Interferon alfa-2b inj 0836 $11.28 $1.51 J9215 G Interferon alfa-n3 inj 0865 $7.86 $1.05 J9216 G Interferon gamma 1-b inj 0838 $199.50 $26.73 J9217 G Leuprolide acetate suspnsion 9217 $592.60 $79.40 J9218 G Leuprolide acetate injection 0861 $22.90 $3.07 J9219 N Leuprolide acetate implant J9230 G Mechlorethamine hcl inj 0839 $11.01 $1.48 J9245 G Inj melphalan hydrochl 50 MG 0840 $363.48 $48.71 J9250 G Methotrexate sodium inj 0841 $.45 $.06 J9260 E Methotrexate sodium inj J9265 G Paclitaxel injection 0863 $173.50 $23.25 J9266 G Pegaspargase/singl dose vial 0843 $1,321.65 $177.10 J9268 G Pentostatin injection 0844 $1,562.75 $209.41 J9270 G Plicamycin (mithramycin) inj 0860 $93.80 $12.57 J9280 G Mitomycin 5 MG inj 0862 $121.65 $16.30 J9290 E Mitomycin 20 MG inj J9291 E Mitomycin 40 MG inj J9293 G Mitoxantrone hydrochl / 5 MG 0864 $223.02 $29.88 J9310 G Rituximab cancer treatment 0849 $420.29 $56.32 J9320 G Streptozocin injection 0850 $65.79 $8.82 J9340 G Thiotepa injection 0851 $100.30 $13.44 J9350 G Topotecan 0852 $573.75 $76.88 *J9355 G Trastuzumab 1613 $48.85 $6.55 *J9357 G Valrubicin, 200 mg 1614 $423.23 $56.71 J9360 G Vinblastine sulfate inj 0853 $4.11 $.55 J9370 G Vincristine sulfate 1 MG inj 0854 $30.16 $4.04 J9375 E Vincristine sulfate 2 MG inj J9380 E Vincristine sulfate 5 MG inj J9390 G Vinorelbine tartrate/10 mg 0855 $75.51 $10.12 J9600 G Porfimer sodium 0856 $2,603.67 $348.89 J9999 E Chemotherapy drug K0001 A Standard wheelchair K0002 A Stnd hemi (low seat) whlchr K0003 A Lightweight wheelchair K0004 A High strength ltwt whlchr K0005 A Ultralightweight wheelchair K0006 A Heavy duty wheelchair K0007 A Extra heavy duty wheelchair K0008 A Cstm manual wheelchair/base K0009 A Other manual wheelchair/base K0010 A Stnd wt frame power whlchr K0011 A Stnd wt pwr whlchr w control K0012 A Ltwt portbl power whlchr K0013 A Custom power whlchr base K0014 A Other power whlchr base K0015 A Detach non-adjus hght armrst K0016 A Detach adjust armrst cmplete K0017 A Detach adjust armrest base K0018 A Detach adjust armrst upper K0019 A Arm pad each K0020 A Fixed adjust armrest pair K0021 A Anti-tipping device each K0022 A Reinforced back upholstery K0023 A Planr back insrt foam w/strp K0024 A Plnr back insrt foam w/hrdwr K0025 A Hook-on headrest extension K0026 A Back upholst lgtwt whlchr K0027 A Back upholst other whlchr K0028 A Manual fully reclining back K0029 A Reinforced seat upholstery K0030 A Solid plnr seat sngl dnsfoam K0031 A Safety belt/pelvic strap K0032 A Seat uphols lgtwt whlchr K0033 A Seat upholstery other whlchr K0034 A Heel loop each K0035 A Heel loop with ankle strap K0036 A Toe loop each K0037 A High mount flip-up footrest K0038 A Leg strap each K0039 A Leg strap h style each K0040 A Adjustable angle footplate K0041 A Large size footplate each K0042 A Standard size footplate each K0043 A Ftrst lower extension tube K0044 A Ftrst upper hanger bracket K0045 A Footrest complete assembly K0046 A Elevat legrst low extension K0047 A Elevat legrst up hangr brack K0048 A Elevate legrest complete K0049 A Calf pad each K0050 A Ratchet assembly K0051 A Cam relese assem ftrst/lgrst K0052 A Swingaway detach footrest K0053 A Elevate footrest articulate K0054 A Seat wdth 10-12/15/17/20 wc K0055 A Seat dpth 15/17/18 ltwt wc K0056 A Seat ht <17 or >=21 ltwt wc K0057 A Seat wdth 19/20 hvy dty wc K0058 A Seat dpth 17/18 power wc K0059 A Plastic coated handrim each K0060 A Steel handrim each K0061 A Aluminum handrim each K0062 A Handrim 8-10 vert/obliq proj K0063 A Hndrm 12-16 vert/obliq proj K0064 A Zero pressure tube flat free K0065 A Spoke protectors K0066 A Solid tire any size each K0067 A Pneumatic tire any size each K0068 A Pneumatic tire tube each K0069 A Rear whl complete solid tire K0070 A Rear whl compl pneum tire K0071 A Front castr compl pneum tire K0072 A Frnt cstr cmpl sem-pneum tir K0073 A Caster pin lock each K0074 A Pneumatic caster tire each K0075 A Semi-pneumatic caster tire K0076 A Solid caster tire each K0077 A Front caster assem complete K0078 A Pneumatic caster tire tube K0079 A Wheel lock extension pair K0080 A Anti-rollback device pair K0081 A Wheel lock assembly complete K0082 A 22 nf deep cycl acid battery K0083 A 22 nf gel cell battery each K0084 A Grp 24 deep cycl acid battry K0085 A Group 24 gel cell battery K0086 A U-1 lead acid battery each K0087 A U-1 gel cell battery each K0088 A Battry chrgr acid/gel cell K0089 A Battery charger dual mode K0090 A Rear tire power wheelchair K0091 A Rear tire tube power whlchr K0092 A Rear assem cmplt powr whlchr K0093 A Rear zero pressure tire tube K0094 A Wheel tire for power base K0095 A Wheel tire tube each base K0096 A Wheel assem powr base complt K0097 A Wheel zero presure tire tube K0098 A Drive belt power wheelchair K0099 A Pwr wheelchair front caster K0100 A Amputee adapter pair K0101 A One-arm drive attachment K0102 A Crutch and cane holder K0103 A Transfer board < 25″ K0104 A Cylinder tank carrier K0105 A Iv hanger K0106 A Arm trough each K0107 A Wheelchair tray K0108 A W/c component-accessory NOS K0112 A Trunk vest supprt innr frame K0113 A Trunk vest suprt w/o inr frm K0114 A Whlchr back suprt inr frame K0115 A Back module orthotic system K0116 A Back & seat modul orthot sys K0182D A Water distilled w/ nebulizer K0183 A Nasal application device K0184 A Nasal pillows/seals pair K0185 A Pos airway pressure headgear K0186 A Pos airway prssure chinstrap K0187 A Pos airway pressure tubing K0188 A Pos airway pressure filter K0189 A Filter nondisposable w PAP K0195 A Elevating whlchair leg rests K0268 A Humidifier nonheated w PAP K0269D A Aerosol compressor cpap dev K0270D A Ultrasonic generator w nebul K0280D A Extension drainage tubing K0281D A Lubricant catheter insertion K0283D A Saline solution dispenser K0407D A Urinary cath skin attachment K0408D A Urinary cath leg strap K0409D A Sterile H2O irrigation solut K0410D A Male ext cath w/adh coating K0411D A Male ext cath w/adh strip K0415 E RX antiemetic drg, oral NOS K0416 E Rx antiemetic drg,rectal NOS K0440D A Nasal prosthesis K0441D A Midfacial prosthesis K0442D A Orbital prosthesis K0443D A Upper facial prosthesis K0444D A Hemi-facial prosthesis K0445D A Auricular prosthesis K0446D A Partial facial prosthesis K0447D A Nasal septal prosthesis K0448D A Unspec maxillofacial prosth K0449D A Repair maxillofacial prosth K0450D A Liq adhes for facial prosth K0451D A Adhesive remover wipes K0452 A Wheelchair bearings K0455 A Pump uninterrupted infusion K0456D A Heavyduty/xtra wide hosp bed K0457D A Heavyduty/wide commode chair K0458D A Heavyduty walker no wheels K0459D A Heavy duty wheeled walker K0460 A WC power add-on joystick K0461 A WC power add-on tiller cntrl K0462 A Temporary replacement eqpmnt K0501D A Aerosol compressor for svneb K0529D A Sterile H20 or nss w lv neb K0531 A Heated humidifier used w pap K0532 A Noninvasive assist wo backup K0533 A Noninvasive assist w backup K0534 A Invasive assist w backup K0535D A Gauze, impregnated hydrogel K0536D A Gauze, impregnated hydrogel K0537D A Gauze, impregnated hydrogel K0541 A Speech generating device K0542 A Speech generating device K0543 A Speech generating device K0544 A Speech generating device K0545 A Speech generating software K0546 A Accessory for sgd,mntng syst K0547 A Accessory for sgd,not clasfd L0100 A Cerv craniosten helmet mold L0110 A Cerv craniostenosis hel non- L0120 A Cerv flexible non-adjustable L0130 A Flex thermoplastic collar mo L0140 A Cervical semi-rigid adjustab L0150 A Cerv semi-rig adj molded chn L0160 A Cerv semi-rig wire occ/mand L0170 A Cervical collar molded to pt L0172 A Cerv col thermplas foam 2 pi L0174 A Cerv col foam 2 piece w thor L0180 A Cer post col occ/man sup adj L0190 A Cerv collar supp adj cerv ba L0200 A Cerv col supp adj bar & thor L0210 A Thoracic rib belt L0220 A Thor rib belt custom fabrica L0300 A TLSO flex surgical support L0310 A Tlso flexible custom fabrica L0315 A Tlso flex elas rigid post pa L0317 A Tlso flex hypext elas post p L0320 A Tlso a-p contrl w apron frnt L0330 A Tlso ant-pos-lateral control L0340 A Tlso a-p-l-rotary with apron L0350 A Tlso flex compress jacket cu L0360 A Tlso flex compress jacket mo L0370 A Tlso a-p-l-rotary hyperexten L0380 A Tlso a-p-l-rot w/ pos extens L0390 A Tlso a-p-l control molded L0400 A Tlso a-p-l w interface mater L0410 A Tlso a-p-l two piece constr L0420 A Tlso a-p-l 2 piece w interfa L0430 A Tlso a-p-l w interface custm L0440 A Tlso a-p-l overlap frnt cust L0500 A Lso flex surgical support L0510 A Lso flexible custom fabricat L0515 A Lso flex elas w/ rig post pa L0520 A Lso a-p-l control with apron L0530 A Lso ant-pos control w apron L0540 A Lso lumbar flexion a-p-l L0550 A Lso a-p-l control molded L0560 A Lso a-p-l w interface L0565 A Lso a-p-l control custom L0600 A Sacroiliac flex surg support L0610 A Sacroiliac flexible custm fa L0620 A Sacroiliac semi-rig w apron L0700 A Ctlso a-p-l control molded L0710 A Ctlso a-p-l control w/ inter L0810 A Halo cervical into jckt vest L0820 A Halo cervical into body jack L0830 A Halo cerv into milwaukee typ L0860 A Magnetic resonanc image comp L0900 A Torso/ptosis support L0910 A Torso & ptosis supp custm fa L0920 A Torso/pendulous abd support L0930 A Pendulous abdomen supp custm L0940 A Torso/postsurgical support L0950 A Post surg support custom fab L0960 A Post surgical support pads L0970 A Tlso corset front L0972 A Lso corset front L0974 A Tlso full corset L0976 A Lso full corset L0978 A Axillary crutch extension L0980 A Peroneal straps pair L0982 A Stocking supp grips set of f L0984 A Protective body sock each L0999 A Add to spinal orthosis NOS L1000 A Ctlso milwauke initial model L1010 A Ctlso axilla sling L1020 A Kyphosis pad L1025 A Kyphosis pad floating L1030 A Lumbar bolster pad L1040 A Lumbar or lumbar rib pad L1050 A Sternal pad L1060 A Thoracic pad L1070 A Trapezius sling L1080 A Outrigger L1085 A Outrigger bil w/ vert extens L1090 A Lumbar sling L1100 A Ring flange plastic/leather L1110 A Ring flange plas/leather mol L1120 A Covers for upright each L1200 A Furnsh initial orthosis only L1210 A Lateral thoracic extension L1220 A Anterior thoracic extension L1230 A Milwaukee type superstructur L1240 A Lumbar derotation pad L1250 A Anterior asis pad L1260 A Anterior thoracic derotation L1270 A Abdominal pad L1280 A Rib gusset (elastic) each L1290 A Lateral trochanteric pad L1300 A Body jacket mold to patient L1310 A Post-operative body jacket L1499 A Spinal orthosis NOS L1500 A Thkao mobility frame L1510 A Thkao standing frame L1520 A Thkao swivel walker L1600 A Abduct hip flex frejka w cvr L1610 A Abduct hip flex frejka covr L1620 A Abduct hip flex pavlik harne L1630 A Abduct control hip semi-flex L1640 A Pelv band/spread bar thigh c L1650 A HO abduction hip adjustable L1660 A HO abduction static plastic L1680 A Pelvic & hip control thigh c L1685 A Post-op hip abduct custom fa L1686 A HO post-op hip abduction L1690 A Combination bilateral HO L1700 A Leg perthes orth toronto typ L1710 A Legg perthes orth newington L1720 A Legg perthes orthosis trilat L1730 A Legg perthes orth scottish r L1750 A Legg perthes sling L1755 A Legg perthes patten bottom t L1800 A Knee orthoses elas w stays L1810 A Ko elastic with joints L1815 A Elastic with condylar pads L1820 A Ko elas w/ condyle pads & jo L1825 A Ko elastic knee cap L1830 A Ko immobilizer canvas longit L1832 A KO adj jnt pos rigid support L1834 A Ko w/0 joint rigid molded to L1840 A Ko derot ant cruciate custom L1843 A KO single upright custom fit L1844 A Ko w/adj jt rot cntrl molded L1845 A Ko w/ adj flex/ext rotat cus L1846 A Ko w adj flex/ext rotat mold L1847 A KO adjustable w air chambers L1850 A Ko swedish type L1855 A Ko plas doub upright jnt mol L1858 A Ko polycentric pneumatic pad L1860 A Ko supracondylar socket mold L1870 A Ko doub upright lacers molde L1880 A Ko doub upright cuffs/lacers L1885 A Knee upright w/resistance L1900 A Afo sprng wir drsflx calf bd L1902 A Afo ankle gauntlet L1904 A Afo molded ankle gauntlet L1906 A Afo multiligamentus ankle su L1910 A Afo sing bar clasp attach sh L1920 A Afo sing upright w/ adjust s L1930 A Afo plastic L1940 A Afo molded to patient plasti L1945 A Afo molded plas rig ant tib L1950 A Afo spiral molded to pt plas L1960 A Afo pos solid ank plastic mo L1970 A Afo plastic molded w/ankle j L1980 A Afo sing solid stirrup calf L1990 A Afo doub solid stirrup calf L2000 A Kafo sing fre stirr thi/calf L2010 A Kafo sng solid stirrup w/o j L2020 A Kafo dbl solid stirrup band/ L2030 A Kafo dbl solid stirrup w/o j L2035 A KAFO plastic pediatric size L2036 A Kafo plas doub free knee mol L2037 A Kafo plas sing free knee mol L2038 A Kafo w/o joint multi-axis an L2039 A KAFO,plstic,medlat rotat con L2040 A Hkafo torsion bil rot straps L2050 A Hkafo torsion cable hip pelv L2060 A Hkafo torsion ball bearing j L2070 A Hkafo torsion unilat rot str L2080 A Hkafo unilat torsion cable L2090 A Hkafo unilat torsion ball br L2102 A Afo tibial fx cast plstr mol L2104 A Afo tib fx cast synthetic mo L2106 A Afo tib fx cast plaster mold L2108 A Afo tib fx cast molded to pt L2112 A Afo tibial fracture soft L2114 A Afo tib fx semi-rigid L2116 A Afo tibial fracture rigid L2122 A Kafo fem fx cast plaster mol L2124 A Kafo fem fx cast synthet mol L2126 A Kafo fem fx cast thermoplas L2128 A Kafo fem fx cast molded to p L2132 A Kafo femoral fx cast soft L2134 A Kafo fem fx cast semi-rigid L2136 A Kafo femoral fx cast rigid L2180 A Plas shoe insert w ank joint L2182 A Drop lock knee L2184 A Limited motion knee joint L2186 A Adj motion knee jnt lerman t L2188 A Quadrilateral brim L2190 A Waist belt L2192 A Pelvic band & belt thigh fla L2200 A Limited ankle motion ea jnt L2210 A Dorsiflexion assist each joi L2220 A Dorsi & plantar flex ass/res L2230 A Split flat caliper stirr & p L2240 A Round caliper and plate atta L2250 A Foot plate molded stirrup at L2260 A Reinforced solid stirrup L2265 A Long tongue stirrup L2270 A Varus/valgus strap padded/li L2275 A Plastic mod low ext pad/line L2280 A Molded inner boot L2300 A Abduction bar jointed adjust L2310 A Abduction bar-straight L2320 A Non-molded lacer L2330 A Lacer molded to patient mode L2335 A Anterior swing band L2340 A Pre-tibial shell molded to p L2350 A Prosthetic type socket molde L2360 A Extended steel shank L2370 A Patten bottom L2375 A Torsion ank & half solid sti L2380 A Torsion straight knee joint L2385 A Straight knee joint heavy du L2390 A Offset knee joint each L2395 A Offset knee joint heavy duty L2397 A Suspension sleeve lower ext L2405 A Knee joint drop lock ea jnt L2415 A Knee joint cam lock each joi L2425 A Knee disc/dial lock/adj flex L2430 A Knee jnt ratchet lock ea jnt L2435 A Knee joint polycentric joint L2492 A Knee lift loop drop lock rin L2500 A Thi/glut/ischia wgt bearing L2510 A Th/wght bear quad-lat brim m L2520 A Th/wght bear quad-lat brim c L2525 A Th/wght bear nar m-l brim mo L2526 A Th/wght bear nar m-l brim cu L2530 A Thigh/wght bear lacer non-mo L2540 A Thigh/wght bear lacer molded L2550 A Thigh/wght bear high roll cu L2570 A Hip clevis type 2 posit jnt L2580 A Pelvic control pelvic sling L2600 A Hip clevis/thrust bearing fr L2610 A Hip clevis/thrust bearing lo L2620 A Pelvic control hip heavy dut L2622 A Hip joint adjustable flexion L2624 A Hip adj flex ext abduct cont L2627 A Plastic mold recipro hip & c L2628 A Metal frame recipro hip & ca L2630 A Pelvic control band & belt u L2640 A Pelvic control band & belt b L2650 A Pelv & thor control gluteal L2660 A Thoracic control thoracic ba L2670 A Thorac cont paraspinal uprig L2680 A Thorac cont lat support upri L2750 A Plating chrome/nickel pr bar L2755 A Carbon graphite lamination L2760 A Extension per extension per L2770 A Low ext orthosis per bar/jnt L2780 A Non-corrosive finish L2785 A Drop lock retainer each L2795 A Knee control full kneecap L2800 A Knee cap medial or lateral p L2810 A Knee control condylar pad L2820 A Soft interface below knee se L2830 A Soft interface above knee se L2840 A Tibial length sock fx or equ L2850 A Femoral lgth sock fx or equa L2860 A Torsion mechanism knee/ankle L2999 A Lower extremity orthosis NOS L3000 E Ft insert ucb berkeley shell L3001 E Foot insert remov molded spe L3002 E Foot insert plastazote or eq L3003 E Foot insert silicone gel eac L3010 E Foot longitudinal arch suppo L3020 E Foot longitud/metatarsal sup L3030 E Foot arch support remov prem L3040 E Ft arch suprt premold longit L3050 E Foot arch supp premold metat L3060 E Foot arch supp longitud/meta L3070 E Arch suprt att to sho longit L3080 E Arch supp att to shoe metata L3090 E Arch supp att to shoe long/m L3100 E Hallus-valgus nght dynamic s L3140 E Abduction rotation bar shoe L3150 E Abduct rotation bar w/o shoe L3160 E Shoe styled positioning dev L3170 E Foot plastic heel stabilizer L3201 E Oxford w supinat/pronat inf L3202 E Oxford w/ supinat/pronator c L3203 E Oxford w/ supinator/pronator L3204 E Hightop w/ supp/pronator inf L3206 E Hightop w/ supp/pronator chi L3207 E Hightop w/ supp/pronator jun L3208 E Surgical boot each infant L3209 E Surgical boot each child L3211 E Surgical boot each junior L3212 E Benesch boot pair infant L3213 E Benesch boot pair child L3214 E Benesch boot pair junior L3215 E Orthopedic ftwear ladies oxf L3216 E Orthoped ladies shoes dpth i L3217 E Ladies shoes hightop depth i L3218 E Ladies surgical boot each L3219 E Orthopedic mens shoes oxford L3221 E Orthopedic mens shoes dpth i L3222 E Mens shoes hightop depth inl L3223 E Mens surgical boot each L3224 A Woman's shoe oxford brace L3225 A Man's shoe oxford brace L3230 E Custom shoes depth inlay L3250 E Custom mold shoe remov prost L3251 E Shoe molded to pt silicone s L3252 E Shoe molded plastazote cust L3253 E Shoe molded plastazote cust L3254 E Orth foot non-stndard size/w L3255 E Orth foot non-standard size/ L3257 E Orth foot add charge split s L3260 E Ambulatory surgical boot eac L3265 E Plastazote sandal each L3300 E Sho lift taper to metatarsal L3310 E Shoe lift elev heel/sole neo L3320 E Shoe lift elev heel/sole cor L3330 E Lifts elevation metal extens L3332 E Shoe lifts tapered to one-ha L3334 E Shoe lifts elevation heel /i L3340 E Shoe wedge sach L3350 E Shoe heel wedge L3360 E Shoe sole wedge outside sole L3370 E Shoe sole wedge between sole L3380 E Shoe clubfoot wedge L3390 E Shoe outflare wedge L3400 E Shoe metatarsal bar wedge ro L3410 E Shoe metatarsal bar between L3420 E Full sole/heel wedge btween L3430 E Sho heel count plast reinfor L3440 E Heel leather reinforced L3450 E Shoe heel sach cushion type L3455 E Shoe heel new leather standa L3460 E Shoe heel new rubber standar L3465 E Shoe heel thomas with wedge L3470 E Shoe heel thomas extend to b L3480 E Shoe heel pad & depress for L3485 E Shoe heel pad removable for L3500 E Ortho shoe add leather insol L3510 E Orthopedic shoe add rub insl L3520 E O shoe add felt w leath insl L3530 E Ortho shoe add half sole L3540 E Ortho shoe add full sole L3550 E O shoe add standard toe tap L3560 E O shoe add horseshoe toe tap L3570 E O shoe add instep extension L3580 E O shoe add instep velcro clo L3590 E O shoe convert to sof counte L3595 E Ortho shoe add march bar L3600 E Trans shoe calip plate exist L3610 E Trans shoe caliper plate new L3620 E Trans shoe solid stirrup exi L3630 E Trans shoe solid stirrup new L3640 E Shoe dennis browne splint bo L3649 E Orthopedic shoe modifica NOS L3650 A Shlder fig 8 abduct restrain L3660 A Abduct restrainer canvas&web L3670 A Acromio/clavicular canvas&we L3675 A Canvas vest SO L3700 A Elbow orthoses elas w stays L3710 A Elbow elastic with metal joi L3720 A Forearm/arm cuffs free motio L3730 A Forearm/arm cuffs ext/flex a L3740 A Cuffs adj lock w/ active con L3760 A EO withjoint, Prefabricated L3800 A Whfo short opponen no attach L3805 A Whfo long opponens no attach L3807 A Whfo w inflatable airchamber L3810 A Whfo thumb abduction bar L3815 A Whfo second m.p. abduction a L3820 A Whfo ip ext asst w/ mp ext s L3825 A Whfo m.p. extension stop L3830 A Whfo m.p. extension assist L3835 A Whfo m.p. spring extension a L3840 A Whfo spring swivel thumb L3845 A Whfo thumb ip ext ass w/ mp L3850 A Action wrist w/ dorsiflex as L3855 A Whfo adj m.p. flexion contro L3860 A Whfo adj m.p. flex ctrl & i. L3890 E Torsion mechanism wrist/elbo L3900 A Hinge extension/flex wrist/f L3901 A Hinge ext/flex wrist finger L3902 A Whfo ext power compress gas L3904 A Whfo electric custom fitted L3906 A Wrist gauntlet molded to pt L3907 A Whfo wrst gauntlt thmb spica L3908 A Wrist cock-up non-molded L3910 A Whfo swanson design L3912 A Flex glove w/elastic finger L3914 A WHO wrist extension cock-up L3916 A Whfo wrist extens w/ outrigg L3918 A HFO knuckle bender L3920 A Knuckle bender with outrigge L3922 A Knuckle bend 2 seg to flex j L3923 A HFO, no joint, prefabricated L3924 A Oppenheimer L3926 A Thomas suspension L3928 A Finger extension w/ clock sp L3930 A Finger extension with wrist L3932 A Safety pin spring wire L3934 A Safety pin modified L3936 A Palmer L3938 A Dorsal wrist L3940 A Dorsal wrist w/ outrigger at L3942 A Reverse knuckle bender L3944 A Reverse knuckle bend w/ outr L3946 A HFO composite elastic L3948 A Finger knuckle bender L3950 A Oppenheimer w/ knuckle bend L3952 A Oppenheimer w/ rev knuckle 2 L3954 A Spreading hand L3956 A Add joint upper ext orthosis L3960 A Sewho airplan desig abdu pos L3962 A Sewho erbs palsey design abd L3963 A Molded w/ articulating elbow L3964 A Seo mobile arm sup att to wc L3965 A Arm supp att to wc rancho ty L3966 A Mobile arm supports reclinin L3968 A Friction dampening arm supp L3969 A Monosuspension arm/hand supp L3970 A Elevat proximal arm support L3972 A Offset/lat rocker arm w/ ela L3974 A Mobile arm support supinator L3980 A Upp ext fx orthosis humeral L3982 A Upper ext fx orthosis rad/ul L3984 A Upper ext fx orthosis wrist L3985 A Forearm hand fx orth w/ wr h L3986 A Humeral rad/ulna wrist fx or L3995 A Sock fracture or equal each L3999 A Upper limb orthosis NOS L4000 A Repl girdle milwaukee orth L4010 A Replace trilateral socket br L4020 A Replace quadlat socket brim L4030 A Replace socket brim cust fit L4040 A Replace molded thigh lacer L4045 A Replace non-molded thigh lac L4050 A Replace molded calf lacer L4055 A Replace non-molded calf lace L4060 A Replace high roll cuff L4070 A Replace prox & dist upright L4080 A Repl met band kafo-afo prox L4090 A Repl met band kafo-afo calf/ L4100 A Repl leath cuff kafo prox th L4110 A Repl leath cuff kafo-afo cal L4130 A Replace pretibial shell L4205 A Ortho dvc repair per 15 min L4210 A Orth dev repair/repl minor p L4350 A Pneumatic ankle cntrl splint L4360 A Pneumatic walking splint L4370 A Pneumatic full leg splint L4380 A Pneumatic knee splint L4392 A Replace AFO soft interface L4394 A Replace foot drop spint L4396 A Static AFO L4398 A Foot drop splint recumbent L5000 A Sho insert w arch toe filler L5010 A Mold socket ank hgt w/ toe f L5020 A Tibial tubercle hgt w/ toe f L5050 A Ank symes mold sckt sach ft L5060 A Symes met fr leath socket ar L5100 A Molded socket shin sach foot L5105 A Plast socket jts/thgh lacer L5150 A Mold sckt ext knee shin sach L5160 A Mold socket bent knee shin s L5200 A Kne sing axis fric shin sach L5210 A No knee/ankle joints w/ ft b L5220 A No knee joint with artic ali L5230 A Fem focal defic constant fri L5250 A Hip canad sing axi cons fric L5270 A Tilt table locking hip sing L5280 A Hemipelvect canad sing axis L5300 A Bk sach soft cover & finish L5310 A Knee disart sach soft cv/fin L5320 A Ak open end sach soft cv/fin L5330 A Hip canadian sach sft cv/fin L5340 A Hemipelvectomy canad cv/fin L5400 A Postop dress & 1 cast chg bk L5410 A Postop dsg bk ea add cast ch L5420 A Postop dsg & 1 cast chg ak/d L5430 A Postop dsg ak ea add cast ch L5450 A Postop app non-wgt bear dsg L5460 A Postop app non-wgt bear dsg L5500 A Init bk ptb plaster direct L5505 A Init ak ischal plstr direct L5510 A Prep BK ptb plaster molded L5520 A Perp BK ptb thermopls direct L5530 A Prep BK ptb thermopls molded L5535 A Prep BK ptb open end socket L5540 A Prep BK ptb laminated socket L5560 A Prep AK ischial plast molded L5570 A Prep AK ischial direct form L5580 A Prep AK ischial thermo mold L5585 A Prep AK ischial open end L5590 A Prep AK ischial laminated L5595 A Hip disartic sach thermopls L5600 A Hip disart sach laminat mold L5610 A Above knee hydracadence L5611 A Ak 4 bar link w/fric swing L5613 A Ak 4 bar ling w/hydraul swig L5614 A 4-bar link above knee w/swng L5616 A Ak univ multiplex sys frict L5617 A AK/BK self-aligning unit ea L5618 A Test socket symes L5620 A Test socket below knee L5622 A Test socket knee disarticula L5624 A Test socket above knee L5626 A Test socket hip disarticulat L5628 A Test socket hemipelvectomy L5629 A Below knee acrylic socket L5630 A Syme typ expandabl wall sckt L5631 A Ak/knee disartic acrylic soc L5632 A Symes type ptb brim design s L5634 A Symes type poster opening so L5636 A Symes type medial opening so L5637 A Below knee total contact L5638 A Below knee leather socket L5639 A Below knee wood socket L5640 A Knee disarticulat leather so L5642 A Above knee leather socket L5643 A Hip flex inner socket ext fr L5644 A Above knee wood socket L5645 A Ak flexibl inner socket ext L5646 A Below knee air cushion socke L5647 A Below knee suction socket L5648 A Above knee air cushion socke L5649 A Isch containmt/narrow m-l so L5650 A Tot contact ak/knee disart s L5651 A Ak flex inner socket ext fra L5652 A Suction susp ak/knee disart L5653 A Knee disart expand wall sock L5654 A Socket insert symes L5655 A Socket insert below knee L5656 A Socket insert knee articulat L5658 A Socket insert above knee L5660 A Sock insrt syme silicone gel L5661 A Multi-durometer symes L5662 A Socket insert bk silicone ge L5663 A Sock knee disartic silicone L5664 A Socket insert ak silicone ge L5665 A Multi-durometer below knee L5666 A Below knee cuff suspension L5667 A Socket insert w lock lower L5668 A Socket insert w/o lock lower L5669 A Below knee socket w/o lock L5670 A Bk molded supracondylar susp L5672 A Bk removable medial brim sus L5674 A Bk latex sleeve suspension/e L5675 A Bk latex sleeve susp/eq hvy L5676 A Bk knee joints single axis p L5677 A Bk knee joints polycentric p L5678 A Bk joint covers pair L5680 A Bk thigh lacer non-molded L5682 A Bk thigh lacer glut/ischia m L5684 A Bk fork strap L5686 A Bk back check L5688 A Bk waist belt webbing L5690 A Bk waist belt padded and lin L5692 A Ak pelvic control belt light L5694 A Ak pelvic control belt pad/l L5695 A Ak sleeve susp neoprene/equa L5696 A Ak/knee disartic pelvic join L5697 A Ak/knee disartic pelvic band L5698 A Ak/knee disartic silesian ba L5699 A Shoulder harness L5700 A Replace socket below knee L5701 A Replace socket above knee L5702 A Replace socket hip L5704 A Custom shape covr below knee L5705 A Custm shape cover above knee L5706 A Custm shape cvr knee disart L5707 A Custm shape cover hip disart L5710 A Kne-shin exo sng axi mnl loc L5711 A Knee-shin exo mnl lock ultra L5712 A Knee-shin exo frict swg & st L5714 A Knee-shin exo variable frict L5716 A Knee-shin exo mech stance ph L5718 A Knee-shin exo frct swg & sta L5722 A Knee-shin pneum swg frct exo L5724 A Knee-shin exo fluid swing ph L5726 A Knee-shin ext jnts fld swg e L5728 A Knee-shin fluid swg & stance L5780 A Knee-shin pneum/hydra pneum L5785 A Exoskeletal bk ultralt mater L5790 A Exoskeletal ak ultra-light m L5795 A Exoskel hip ultra-light mate L5810 A Endoskel knee-shin mnl lock L5811 A Endo knee-shin mnl lck ultra L5812 A Endo knee-shin frct swg & st L5814 A Endo knee-shin hydral swg ph L5816 A Endo knee-shin polyc mch sta L5818 A Endo knee-shin frct swg & st L5822 A Endo knee-shin pneum swg frc L5824 A Endo knee-shin fluid swing p L5826 A Miniature knee joint L5828 A Endo knee-shin fluid swg/sta L5830 A Endo knee-shin pneum/swg pha L5840 A Multi-axial knee/shin system L5845 A Knee-shin sys stance flexion L5846 A Knee-shin sys microprocessor L5850 A Endo ak/hip knee extens assi L5855 A Mech hip extension assist L5910 A Endo below knee alignable sy L5920 A Endo ak/hip alignable system L5925 A Above knee manual lock L5930 A High activity knee frame L5940 A Endo bk ultra-light material L5950 A Endo ak ultra-light material L5960 A Endo hip ultra-light materia L5962 A Below knee flex cover system L5964 A Above knee flex cover system L5966 A Hip flexible cover system L5968 A Multiaxial ankle w dorsiflex L5970 A Foot external keel sach foot L5972 A Flexible keel foot L5974 A Foot single axis ankle/foot L5975 A Combo ankle/foot prosthesis L5976 A Energy storing foot L5978 A Ft prosth multiaxial ankl/ft L5979 A Multi-axial ankle/ft prosth L5980 A Flex foot system L5981 A Flex-walk sys low ext prosth L5982 A Exoskeletal axial rotation u L5984 A Endoskeletal axial rotation L5985 A Lwr ext dynamic prosth pylon L5986 A Multi-axial rotation unit L5987 A Shank ft w vert load pylon L5988 A Vertical shock reducing pylo L5999 A Lowr extremity prosthes NOS L6000 A Par hand robin-aids thum rem L6010 A Hand robin-aids little/ring L6020 A Part hand robin-aids no fing L6050 A Wrst MLd sck flx hng tri pad L6055 A Wrst mold sock w/exp interfa L6100 A Elb mold sock flex hinge pad L6110 A Elbow mold sock suspension t L6120 A Elbow mold doub splt soc ste L6130 A Elbow stump activated lock h L6200 A Elbow mold outsid lock hinge L6205 A Elbow molded w/ expand inter L6250 A Elbow inter loc elbow forarm L6300 A Shlder disart int lock elbow L6310 A Shoulder passive restor comp L6320 A Shoulder passive restor cap L6350 A Thoracic intern lock elbow L6360 A Thoracic passive restor comp L6370 A Thoracic passive restor cap L6380 A Postop dsg cast chg wrst/elb L6382 A Postop dsg cast chg elb dis/ L6384 A Postop dsg cast chg shlder/t L6386 A Postop ea cast chg & realign L6388 A Postop applicat rigid dsg on L6400 A Below elbow prosth tiss shap L6450 A Elb disart prosth tiss shap L6500 A Above elbow prosth tiss shap L6550 A Shldr disar prosth tiss shap L6570 A Scap thorac prosth tiss shap L6580 A Wrist/elbow bowden cable mol L6582 A Wrist/elbow bowden cbl dir f L6584 A Elbow fair lead cable molded L6586 A Elbow fair lead cable dir fo L6588 A Shdr fair lead cable molded L6590 A Shdr fair lead cable direct L6600 A Polycentric hinge pair L6605 A Single pivot hinge pair L6610 A Flexible metal hinge pair L6615 A Disconnect locking wrist uni L6616 A Disconnect insert locking wr L6620 A Flexion-friction wrist unit L6623 A Spring-ass rot wrst w/ latch L6625 A Rotation wrst w/ cable lock L6628 A Quick disconn hook adapter o L6629 A Lamination collar w/ couplin L6630 A Stainless steel any wrist L6632 A Latex suspension sleeve each L6635 A Lift assist for elbow L6637 A Nudge control elbow lock L6640 A Shoulder abduction joint pai L6641 A Excursion amplifier pulley t L6642 A Excursion amplifier lever ty L6645 A Shoulder flexion-abduction j L6650 A Shoulder universal joint L6655 A Standard control cable extra L6660 A Heavy duty control cable L6665 A Teflon or equal cable lining L6670 A Hook to hand cable adapter L6672 A Harness chest/shlder saddle L6675 A Harness figure of 8 sing con L6676 A Harness figure of 8 dual con L6680 A Test sock wrist disart/bel e L6682 A Test sock elbw disart/above L6684 A Test socket shldr disart/tho L6686 A Suction socket L6687 A Frame typ socket bel elbow/w L6688 A Frame typ sock above elb/dis L6689 A Frame typ socket shoulder di L6690 A Frame typ sock interscap-tho L6691 A Removable insert each L6692 A Silicone gel insert or equal L6693 A Lockingelbow forearm cntrbal L6700 A Terminal device model #3 L6705 A Terminal device model #5 L6710 A Terminal device model #5x L6715 A Terminal device model #5xa L6720 A Terminal device model #6 L6725 A Terminal device model #7 L6730 A Terminal device model #7lo L6735 A Terminal device model #8 L6740 A Terminal device model #8x L6745 A Terminal device model #88x L6750 A Terminal device model #10p L6755 A Terminal device model #10x L6765 A Terminal device model #12p L6770 A Terminal device model #99x L6775 A Terminal device model #555 L6780 A Terminal device model #ss555 L6790 A Hooks-accu hook or equal L6795 A Hooks-2 load or equal L6800 A Hooks-aprl vc or equal L6805 A Modifier wrist flexion unit L6806 A Trs grip vc or equal L6807 A Term device grip1/2 or equal L6808 A Term device infant or child L6809 A Trs super sport passive L6810 A Pincher tool otto bock or eq L6825 A Hands dorrance vo L6830 A Hand aprl vc L6835 A Hand sierra vo L6840 A Hand becker imperial L6845 A Hand becker lock grip L6850 A Term dvc-hand becker plylite L6855 A Hand robin-aids vo L6860 A Hand robin-aids vo soft L6865 A Hand passive hand L6867 A Hand detroit infant hand L6868 A Passive inf hand steeper/hos L6870 A Hand child mitt L6872 A Hand nyu child hand L6873 A Hand mech inf steeper or equ L6875 A Hand bock vc L6880 A Hand bock vo L6890 A Production glove L6895 A Custom glove L6900 A Hand restorat thumb/1 finger L6905 A Hand restoration multiple fi L6910 A Hand restoration no fingers L6915 A Hand restoration replacmnt g L6920 A Wrist disarticul switch ctrl L6925 A Wrist disart myoelectronic c L6930 A Below elbow switch control L6935 A Below elbow myoelectronic ct L6940 A Elbow disarticulation switch L6945 A Elbow disart myoelectronic c L6950 A Above elbow switch control L6955 A Above elbow myoelectronic ct L6960 A Shldr disartic switch contro L6965 A Shldr disartic myoelectronic L6970 A Interscapular-thor switch ct L6975 A Interscap-thor myoelectronic L7010 A Hand otto back steeper/eq sw L7015 A Hand sys teknik village swit L7020 A Electronic greifer switch ct L7025 A Electron hand myoelectronic L7030 A Hand sys teknik vill myoelec L7035 A Electron greifer myoelectro L7040 A Prehensile actuator hosmer s L7045 A Electron hook child michigan L7170 A Electronic elbow hosmer swit L7180 A Electronic elbow utah myoele L7185 A Electron elbow adolescent sw L7186 A Electron elbow child switch L7190 A Elbow adolescent myoelectron L7191 A Elbow child myoelectronic ct L7260 A Electron wrist rotator otto L7261 A Electron wrist rotator utah L7266 A Servo control steeper or equ L7272 A Analogue control unb or equa L7274 A Proportional ctl 12 volt uta L7360 A Six volt bat otto bock/eq ea L7362 A Battery chrgr six volt otto L7364 A Twelve volt battery utah/equ L7366 A Battery chrgr 12 volt utah/e L7499 A Upper extremity prosthes NOS L7500 A Prosthetic dvc repair hourly L7510 A Prosthetic device repair rep L7520 A Repair prosthesis per 15 min L7900 A Vacuum erection system L8000 A Mastectomy bra L8010 A Mastectomy sleeve L8015 A Ext breastprosthesis garment L8020 A Mastectomy form L8030 A Breast prosthesis silicone/e L8035 A Custom breast prosthesis L8039 A Breast prosthesis NOS L8040 A Nasal prosthesis L8041 A Midfacial prosthesis L8042 A Orbital prosthesis L8043 A Upper facial prosthesis L8044 A Hemi-facial prosthesis L8045 A Auricular prosthesis L8046 A Partial facial prosthesis L8047 A Nasal septal prosthesis L8048 A Unspec maxillofacial prosth L8049 A Repair maxillofacial prosth L8100 E Compression stocking BK18-30 L8110 E Compression stocking BK30-40 L8120 E Compression stocking BK40-50 L8130 E Gc stocking thighlngth 18-30 L8140 E Gc stocking thighlngth 30-40 L8150 E Gc stocking thighlngth 40-50 L8160 E Gc stocking full lngth 18-30 L8170 E Gc stocking full lngth 30-40 L8180 E Gc stocking full lngth 40-50 L8190 E Gc stocking waistlngth 18-30 L8195 E Gc stocking waistlngth 30-40 L8200 E Gc stocking waistlngth 40-50 L8210 E Gc stocking custom made L8220 E Gc stocking lymphedema L8230 E Gc stocking garter belt L8239 E G compression stocking NOS L8300 A Truss single w/ standard pad L8310 A Truss double w/ standard pad L8320 A Truss addition to std pad wa L8330 A Truss add to std pad scrotal L8400 A Sheath below knee L8410 A Sheath above knee L8415 A Sheath upper limb L8417 A Pros sheath/sock w gel cushn L8420 A Prosthetic sock multi ply BK L8430 A Prosthetic sock multi ply AK L8435 A Pros sock multi ply upper lm L8440 A Shrinker below knee L8460 A Shrinker above knee L8465 A Shrinker upper limb L8470 A Pros sock single ply BK L8480 A Pros sock single ply AK L8485 A Pros sock single ply upper l L8490 A Air seal suction reten systm L8499 A Unlisted misc prosthetic ser L8500 A Artificial larynx L8501 A Tracheostomy speaking valve L8600 N Implant breast silicone/eq L8603 N Collagen imp urinary 2.5 CC L8606 N Synthetic implnt urinary 1ml L8610 N Ocular implant L8612 N Aqueous shunt prosthesis L8613 N Ossicular implant *L8614 H Cochlear device/system 1002 L8619 A Replace cochlear processor L8630 N Metacarpophalangeal implant L8641 N Metatarsal joint implant L8642 N Hallux implant L8658 N Interphalangeal joint implnt L8670 N Vascular graft, synthetic L8699 N Prosthetic implant NOS L9900 A O&P supply/accessory/service M0064 X Visit for drug monitoring 0374 1.17 $58.03 $13.08 $11.61 M0075 E Cellular therapy M0076 E Prolotherapy M0100 E Intragastric hypothermia M0300 E IV chelationtherapy M0301 E Fabric wrapping of aneurysm M0302 T Assessment of cardiac output 0970 0.52 $25.79 $5.16 P2028 A Cephalin floculation test P2029 A Congo red blood test P2031 E Hair analysis P2033 A Blood thymol turbidity P2038 A Blood mucoprotein P3000 A Screen pap by tech w md supv P3001 E Screening pap smear by phys P7001 E Culture bacterial urine P9010 K Whole blood for transfusion 0950 2.08 $103.33 $20.67 P9011 E Blood split unit P9012 K Cryoprecipitate each unit 0952 0.70 $34.70 $6.94 P9013D K Unit/s blood fibrinogen 0953 0.48 $23.80 $4.76 P9016 K Leukocyte poor blood, unit 0954 2.83 $140.35 $28.07 P9017 K One donor fresh frozn plasma 0955 2.26 $111.85 $22.37 P9018D K Plasma protein fract, unit 0956 1.26 $62.49 $12.50 P9019 K Platelet concentrate unit 0957 0.98 $48.55 $9.71 P9020 K Plaelet rich plasma unit 0958 1.16 $57.54 $11.51 P9021 K Red blood cells unit 0959 2.04 $101.31 $20.26 P9022 K Washed red blood cells unit 0960 3.81 $188.75 $37.75 P9023 K Frozen plasma, pooled, sd 0949 2.94 $145.76 $29.15 P9031 K Platelets leukocytes reduced 0954 2.83 $140.35 $28.07 P9032 K Platelets, irradiated 9500 1.77 $87.97 $17.59 P9033 K Platelets leukoreduced irrad 0954 2.83 $140.35 $28.07 P9034 K Platelets, pheresis 9501 9.69 $480.75 $96.15 P9035 K Platelet pheres leukoreduced 9501 9.69 $480.75 $96.15 P9036 K Platelet pheresis irradiated 9502 10.52 $521.66 $104.33 P9037 K Plate pheres leukoredu irrad 9501 9.69 $480.75 $96.15 P9038 K RBC irradiated 9505 2.58 $127.86 $25.57 P9039 K RBC deglycerolized 9504 4.35 $215.83 $43.17 P9040 K RBC leukoreduced irradiated 9504 4.35 $215.83 $43.17 P9041 K Albumin(human), 5%, 500 ML 0961 2.77 $137.38 $27.48 P9042 K Albumin (human), 25%, 50 ML 0962 1.38 $68.44 $13.69 P9043 K Plasma protein fraction 0956 1.26 $62.49 $12.50 P9044 K Cryoprecipitate reduced plasma 1009 0.86 $42.76 $8.55 P9603 A One-way allow prorated miles P9604 A One-way allow prorated trip P9612 N Catheterize for urine spec P9615 N Urine specimen collect mult Q0034D K Admin of influenza vaccine 0354 0.13 $6.33 Q0035 X Cardiokymography 0100 1.70 $84.32 $71.57 $16.86 Q0081 T Infusion ther other than che 0120 1.66 $82.33 $42.67 $16.47 Q0082D P Activity therapy w/partial h 0033 4.17 $206.82 $48.17 $41.36 Q0083 S Chemo by other than infusion 0116 2.34 $116.06 $23.21 $23.21 Q0084 S Chemotherapy by infusion 0117 1.84 $91.26 $71.80 $18.25 Q0085 S Chemo by both infusion and o 0118 2.90 $143.83 $72.03 $28.77 Q0086 A Physical therapy evaluation/ Q0091 T Obtaining screen pap smear 0191 1.19 $59.02 $17.43 $11.80 Q0092 N Set up port xray equipment Q0111 A Wet mounts/ w preparations Q0112 A Potassium hydroxide preps Q0113 A Pinworm examinations Q0114 A Fern test Q0115 A Post-coital mucous exam Q0136 G Non esrd epoetin alpha inj 0733 $11.40 $1.53 Q0144 E Azithromycin dihydrate, oral Q0156D K Human albumin 5% 0961 2.77 $137.38 $27.48 Q0157D K Human albumin 25% 0962 1.38 $68.44 $13.69 Q0160 G Factor IX non-recombinant 0931 $.72 $.10 Q0161 G Factor IX recombinant 0932 $1.12 $.10 Q0163 G Diphenhydramine HCl 50mg 1400 $1.18 $.16 Q0164 G Prochlorperazine maleate 5mg 1401 $1.31 $.18 Q0165 E Prochlorperazine maleate10mg Q0166 G Granisetron HCl 1 mg oral 0765 $44.70 $5.99 Q0167 G Dronabinol 2.5mg oral 0762 $3.20 $.48 Q0168 E Dronabinol 5mg oral Q0169 G Promethazine HCl 12.5mg oral 1402 $.03 Q0170 E Promethazine HCl 25 mg oral Q0171 G Chlorpromazine HCl 10mg oral 1403 $.55 $.07 Q0172 E Chlorpromazine HCl 25mg oral Q0173 G Trimethobenzamide HCl 250mg 1404 $.36 $.05 Q0174 G Thiethylperazine maleate10mg 1405 $.69 $.09 Q0175 G Perphenazine 4mg oral 1406 $.71 $.10 Q0176 E Perphenazine 8mg oral Q0177 G Hydroxyzine pamoate 25mg 1407 $.20 $.03 Q0178 E Hydroxyzine pamoate 50mg Q0179 G Ondansetron HCl 8mg oral 0769 $25.15 $3.37 Q0180 G Dolasetron mesylate oral 0763 $65.21 $8.74 Q0181 G Unspecified oral anti-emetic 0761 $.60 $.08 Q0183 N Nonmetabolic active tissue Q0184 N Metabolically active tissue Q0185 N Metabolic active D/E tissue Q0186D E Paramedic intercept, rural Q0187 G Factor viia recombinant 1409 $1,596.00 $213.86 Q0188D N Contrast medium Q1001 E Ntiol category 1 Q1002 E Ntiol category 2 Q1003 E Ntiol category 3 Q1004 E Ntiol category 4 Q1005 E Ntiol category 5 Q2001 N Cabergoline, 0.5 mg, oral Q2002 G Elliot's B solution, per ml 7022 $14.25 $1.91 Q2003 G Aprotinin, 10,000 kiu 7019 $196.35 $26.31 Q2004 G Treatment for bladder calculi, per 500 ml 7023 $23.54 $3.15 Q2005 G Corticorelin ovine triflutate, per 0.1 mg 7024 $353.88 $45.77 Q2006 G Digoxin immune FAB (Ovine), 40 mg vial 7025 $530.44 $64.71 Q2007 G Ethanolamine oleate, 100 mg 7026 $27.21 $3.65 Q2008 G Fomepizole, 1.5 mg 7027 $728.33 $97.60 Q2009 G Fosphenytoin, 50 mg 7028 $8.55 $1.15 Q2010 G Glatiramer acetate, 20 mg 7029 $27.40 $3.67 Q2011 G Hemin, 1 mg 7030 $.90 $.12 Q2012 G Pegademase bovine inj 25 I.U 7039 $139.33 $18.67 Q2013 G Pentastarch 10% inj, 100 ml 7040 $15.11 $2.04 Q2014 G Sermorelin acetate, 0.5 mg 7032 $15.78 $2.11 Q2015 G Somatrem, 5 mg 7033 $199.50 $26.73 Q2016 G Somatropin, 1 mg (any derivation) 7034 $39.90 $5.35 Q2017 G Teniposide, 50 mg 7035 $195.28 $26.17 Q2018 G Urofollitropin, 75 I.U. 7037 $69.73 $9.34 *Q2019 G Basiliximab, 20 mg 1615 $1,250.01 $167.50 *Q2020 G Histrelin Acetate, 0.5 mg 1616 $14.91 $2.00 *Q2021 G Lepirdin, 50 mg 1617 $124.49 $16.68 *Q2022 G Von Willebrand factor, per iu 1618 $.95 $.13 Q3001 H Brachytherapy Seeds 0918 *Q3002 G Ga 67, per mCi 1619 $25.97 $3.17 *Q3003 G TC 99M Bicisate, per vial 1620 $417.53 $55.95 *Q3004 G Xe 133, per mCi 1621 $28.50 $3.66 *Q3005 G TC 99M Mertiatide, per vial 1622 $185.82 $24.90 *Q3006 G TC 99M Gluceptate 1623 $22.61 $2.76 *Q3007 G P32 sodium, per mCi 1624 $74.10 $9.04 *Q3008 G IN 111 Pentetreotide, per mCi 1625 $283.42 $37.98 *Q3009 G TC 99M Oxidronate, per vial 1626 $38.38 $4.68 *Q3010 G TC-99 labeled red blood cell, per test 1627 $38.95 $4.75 *Q3011 G P32 phosphate chromic, per mCi 1628 $137.12 $16.73 Q9920 A Epoetin with hct <= 20 Q9921 A Epoetin with hct = 21 Q9922 A Epoetin with hct = 22 Q9923 A Epoetin with hct = 23 Q9924 A Epoetin with hct = 24 Q9925 A Epoetin with hct = 25 Q9926 A Epoetin with hct = 26 Q9927 A Epoetin with hct = 27 Q9928 A Epoetin with hct = 28 Q9929 A Epoetin with hct = 29 Q9930 A Epoetin with hct = 30 Q9931 A Epoetin with hct = 31 Q9932 A Epoetin with hct = 32 Q9933 A Epoetin with hct = 33 Q9934 A Epoetin with hct = 34 Q9935 A Epoetin with hct = 35 Q9936 A Epoetin with hct = 36 Q9937 A Epoetin with hct = 37 Q9938 A Epoetin with hct = 38 Q9939 A Epoetin with hct = 39 Q9940 A Epoetin with hct >= 40 R0070 N Transport portable x-ray R0075 N Transport port x-ray multipl R0076 N Transport portable EKG V2020 A Vision svcs frames purchases V2025 E Eyeglasses delux frames V2100 A Lens spher single plano 4.00 V2101 A Single visn sphere 4.12-7.00 V2102 A Singl visn sphere 7.12-20.00 V2103 A Spherocylindr 4.00d/12-2.00d V2104 A Spherocylindr 4.00d/2.12-4d V2105 A Spherocylinder 4.00d/4.25-6d V2106 A Spherocylinder 4.00d/>6.00d V2107 A Spherocylinder 4.25d/12-2d V2108 A Spherocylinder 4.25d/2.12-4d V2109 A Spherocylinder 4.25d/4.25-6d V2110 A Spherocylinder 4.25d/over 6d V2111 A Spherocylindr 7.25d/.25-2.25 V2112 A Spherocylindr 7.25d/2.25-4d V2113 A Spherocylindr 7.25d/4.25-6d V2114 A Spherocylinder over 12.00d V2115 A Lens lenticular bifocal V2116 A Nonaspheric lens bifocal V2117 A Aspheric lens bifocal V2118 A Lens aniseikonic single V2199 A Lens single vision not oth c V2200 A Lens spher bifoc plano 4.00d V2201 A Lens sphere bifocal 4.12-7.0 V2202 A Lens sphere bifocal 7.12-20. V2203 A Lens sphcyl bifocal 4.00d/.1 V2204 A Lens sphcy bifocal 4.00d/2.1 V2205 A Lens sphcy bifocal 4.00d/4.2 V2206 A Lens sphcy bifocal 4.00d/ove V2207 A Lens sphcy bifocal 4.25-7d/. V2208 A Lens sphcy bifocal 4.25-7/2. V2209 A Lens sphcy bifocal 4.25-7/4. V2210 A Lens sphcy bifocal 4.25-7/ov V2211 A Lens sphcy bifo 7.25-12/.25- V2212 A Lens sphcyl bifo 7.25-12/2.2 V2213 A Lens sphcyl bifo 7.25-12/4.2 V2214 A Lens sphcyl bifocal over 12. V2215 A Lens lenticular bifocal V2216 A Lens lenticular nonaspheric V2217 A Lens lenticular aspheric bif V2218 A Lens aniseikonic bifocal V2219 A Lens bifocal seg width over V2220 A Lens bifocal add over 3.25d V2299 A Lens bifocal speciality V2300 A Lens sphere trifocal 4.00d V2301 A Lens sphere trifocal 4.12-7. V2302 A Lens sphere trifocal 7.12-20 V2303 A Lens sphcy trifocal 4.0/.12- V2304 A Lens sphcy trifocal 4.0/2.25 V2305 A Lens sphcy trifocal 4.0/4.25 V2306 A Lens sphcyl trifocal 4.00/>6 V2307 A Lens sphcy trifocal 4.25-7/. V2308 A Lens sphc trifocal 4.25-7/2. V2309 A Lens sphc trifocal 4.25-7/4. V2310 A Lens sphc trifocal 4.25-7/>6 V2311 A Lens sphc trifo 7.25-12/.25- V2312 A Lens sphc trifo 7.25-12/2.25 V2313 A Lens sphc trifo 7.25-12/4.25 V2314 A Lens sphcyl trifocal over 12 V2315 A Lens lenticular trifocal V2316 A Lens lenticular nonaspheric V2317 A Lens lenticular aspheric tri V2318 A Lens aniseikonic trifocal V2319 A Lens trifocal seg width > 28 V2320 A Lens trifocal add over 3.25d V2399 A Lens trifocal speciality V2410 A Lens variab asphericity sing V2430 A Lens variable asphericity bi V2499 A Variable asphericity lens V2500 A Contact lens pmma spherical V2501 A Cntct lens pmma-toric/prism V2502 A Contact lens pmma bifocal V2503 A Cntct lens pmma color vision V2510 A Cntct gas permeable sphericl V2511 A Cntct toric prism ballast V2512 A Cntct lens gas permbl bifocl V2513 A Contact lens extended wear V2520 A Contact lens hydrophilic V2521 A Cntct lens hydrophilic toric V2522 A Cntct lens hydrophil bifocl V2523 A Cntct lens hydrophil extend V2530 A Contact lens gas impermeable V2531 A Contact lens gas permeable V2599 A Contact lens/es other type V2600 A Hand held low vision aids V2610 A Single lens spectacle mount V2615 A Telescop/othr compound lens V2623 A Plastic eye prosth custom V2624 A Polishing artifical eye V2625 A Enlargemnt of eye prosthesis V2626 A Reduction of eye prosthesis V2627 A Scleral cover shell V2628 A Fabrication & fitting V2629 A Prosthetic eye other type V2630 N Anter chamber intraocul lens V2631 N Iris support intraoclr lens V2632 N Post chmbr intraocular lens V2700 A Balance lens V2710 A Glass/plastic slab off prism V2715 A Prism lens/es V2718 A Fresnell prism press-on lens V2730 A Special base curve V2740 A Rose tint plastic V2741 A Non-rose tint plastic V2742 A Rose tint glass V2743 A Non-rose tint glass V2744 A Tint photochromatic lens/es V2750 A Anti-reflective coating V2755 A UV lens/es V2760 A Scratch resistant coating V2770 A Occluder lens/es V2780 A Oversize lens/es V2781 E Progressive lens per lens V2785 F Corneal tissue processing V2790 N Amniotic membrane V2799 A Miscellaneous vision service V5008 E Hearing screening V5010 E Assessment for hearing aid V5011 E Hearing aid fitting/checking V5014 E Hearing aid repair/modifying V5020 E Conformity evaluation V5030 E Body-worn hearing aid air V5040 E Body-worn hearing aid bone V5050 E Body-worn hearing aid in ear V5060 E Behind ear hearing aid V5070 E Glasses air conduction V5080 E Glasses bone conduction V5090 E Hearing aid dispensing fee V5100 E Body-worn bilat hearing aid V5110 E Hearing aid dispensing fee V5120 E Body-worn binaur hearing aid V5130 E In ear binaural hearing aid V5140 E Behind ear binaur hearing ai V5150 E Glasses binaural hearing aid V5160 E Dispensing fee binaural V5170 E Within ear cros hearing aid V5180 E Behind ear cros hearing aid V5190 E Glasses cros hearing aid V5200 E Cros hearing aid dispens fee V5210 E In ear bicros hearing aid V5220 E Behind ear bicros hearing ai V5230 E Glasses bicros hearing aid V5240 E Dispensing fee bicros V5299 E Hearing service V5336 E Repair communication device V5362 A Speech screening V5363 A Language screening V5364 A Dysphagia screening 25310 T Transplant forearm tendon 0051 27.76 $1,376.79 $675.24 $275.36 25312 T Transplant forearm tendon 0051 27.76 $1,376.79 $675.24 $275.36 25315 T Revise palsy hand tendon(s) 0051 27.76 $1,376.79 $675.24 $275.36 25316 T Revise palsy hand tendon(s) 0051 27.76 $1,376.79 $675.24 $275.36 25320 T Repair/revise wrist joint 0051 27.76 $1,376.79 $675.24 $275.36 25332 T Revise wrist joint 0047 22.09 $1,095.58 $537.03 $219.12 25335 T Realignment of hand 0051 27.76 $1,376.79 $675.24 $275.36 25337 T Reconstruct ulna/radioulnar 0051 27.76 $1,376.79 $675.24 $275.36 25350 T Revision of radius 0051 27.76 $1,376.79 $675.24 $275.36 25355 T Revision of radius 0051 27.76 $1,376.79 $675.24 $275.36 25360 T Revision of ulna 0050 21.13 $1,047.96 $513.86 $209.59 25365 T Revise radius & ulna 0050 21.13 $1,047.96 $513.86 $209.59 25370 T Revise radius or ulna 0051 27.76 $1,376.79 $675.24 $275.36 25375 T Revise radius & ulna 0051 27.76 $1,376.79 $675.24 $275.36 25390 C Shorten radius or ulna 25391 C Lengthen radius or ulna 25392 C Shorten radius & ulna 25393 C Lengthen radius & ulna 25400 T Repair radius or ulna 0050 21.13 $1,047.96 $513.86 $209.59 25405 T Repair/graft radius or ulna 0050 21.13 $1,047.96 $513.86 $209.59 25415 T Repair radius & ulna 0050 21.13 $1,047.96 $513.86 $209.59 25420 C Repair/graft radius & ulna 25425 T Repair/graft radius or ulna 0051 27.76 $1,376.79 $675.24 $275.36 25426 T Repair/graft radius & ulna 0051 27.76 $1,376.79 $675.24 $275.36 25440 T Repair/graft wrist bone 0051 27.76 $1,376.79 $675.24 $275.36 25441 T Reconstruct wrist joint 0048 29.06 $1,441.26 $725.94 $288.25 25442 T Reconstruct wrist joint 0048 29.06 $1,441.26 $725.94 $288.25 25443 T Reconstruct wrist joint 0048 29.06 $1,441.26 $725.94 $288.25 25444 T Reconstruct wrist joint 0048 29.06 $1,441.26 $725.94 $288.25 25445 T Reconstruct wrist joint 0048 29.06 $1,441.26 $725.94 $288.25 25446 T Wrist replacement 0048 29.06 $1,441.26 $725.94 $288.25 25447 T Repair wrist joint(s) 0047 22.09 $1,095.58 $537.03 $219.12 25449 T Remove wrist joint implant 0047 22.09 $1,095.58 $537.03 $219.12 25450 T Revision of wrist joint 0051 27.76 $1,376.79 $675.24 $275.36 25455 T Revision of wrist joint 0051 27.76 $1,376.79 $675.24 $275.36 25490 T Reinforce radius 0051 27.76 $1,376.79 $675.24 $275.36 25491 T Reinforce ulna 0051 27.76 $1,376.79 $675.24 $275.36 25492 T Reinforce radius and ulna 0051 27.76 $1,376.79 $675.24 $275.36 25500 T Treat fracture of radius 0044 2.17 $107.63 $38.08 $21.53 25505 T Treat fracture of radius 0044 2.17 $107.63 $38.08 $21.53 25515 T Treat fracture of radius 0046 22.29 $1,105.50 $535.76 $221.10 25520 T Treat fracture of radius 0044 2.17 $107.63 $38.08 $21.53 25525 T Treat fracture of radius 0046 22.29 $1,105.50 $535.76 $221.10 25526 T Treat fracture of radius 0046 22.29 $1,105.50 $535.76 $221.10 25530 T Treat fracture of ulna 0044 2.17 $107.63 $38.08 $21.53 25535 T Treat fracture of ulna 0044 2.17 $107.63 $38.08 $21.53 25545 T Treat fracture of ulna 0046 22.29 $1,105.50 $535.76 $221.10 25560 T Treat fracture radius & ulna 0044 2.17 $107.63 $38.08 $21.53 25565 T Treat fracture radius & ulna 0044 2.17 $107.63 $38.08 $21.53 25574 T Treat fracture radius & ulna 0046 22.29 $1,105.50 $535.76 $221.10 25575 T Treat fracture radius/ulna 0046 22.29 $1,105.50 $535.76 $221.10 25600 T Treat fracture radius/ulna 0044 2.17 $107.63 $38.08 $21.53 25605 T Treat fracture radius/ulna 0044 2.17 $107.63 $38.08 $21.53 25611 T Treat fracture radius/ulna 0046 22.29 $1,105.50 $535.76 $221.10 25620 T Treat fracture radius/ulna 0046 22.29 $1,105.50 $535.76 $221.10 25622 T Treat wrist bone fracture 0044 2.17 $107.63 $38.08 $21.53 25624 T Treat wrist bone fracture 0044 2.17 $107.63 $38.08 $21.53 25628 T Treat wrist bone fracture 0046 22.29 $1,105.50 $535.76 $221.10 25630 T Treat wrist bone fracture 0044 2.17 $107.63 $38.08 $21.53 25635 T Treat wrist bone fracture 0044 2.17 $107.63 $38.08 $21.53 25645 T Treat wrist bone fracture 0046 22.29 $1,105.50 $535.76 $221.10 25650 T Treat wrist bone fracture 0044 2.17 $107.63 $38.08 $21.53 25660 T Treat wrist dislocation 0044 2.17 $107.63 $38.08 $21.53 25670 T Treat wrist dislocation 0046 22.29 $1,105.50 $535.76 $221.10 25675 T Treat wrist dislocation 0044 2.17 $107.63 $38.08 $21.53 25676 T Treat wrist dislocation 0046 22.29 $1,105.50 $535.76 $221.10 25680 T Treat wrist fracture 0044 2.17 $107.63 $38.08 $21.53 25685 T Treat wrist fracture 0046 22.29 $1,105.50 $535.76 $221.10 25690 T Treat wrist dislocation 0044 2.17 $107.63 $38.08 $21.53 25695 T Treat wrist dislocation 0046 22.29 $1,105.50 $535.76 $221.10 25800 T Fusion of wrist joint 0051 27.76 $1,376.79 $675.24 $275.36 25805 T Fusion/graft of wrist joint 0051 27.76 $1,376.79 $675.24 $275.36 25810 T Fusion/graft of wrist joint 0051 27.76 $1,376.79 $675.24 $275.36 25820 T Fusion of hand bones 0053 11.32 $561.42 $253.49 $112.28 25825 T Fuse hand bones with graft 0054 19.66 $975.06 $472.33 $195.01 25830 T Fusion, radioulnar jnt/ulna 0051 27.76 $1,376.79 $675.24 $275.36 25900 C Amputation of forearm 25905 C Amputation of forearm 25907 T Amputation follow-up surgery 0049 15.04 $745.93 $356.95 $149.19 25909 C Amputation follow-up surgery 25915 C Amputation of forearm 25920 C Amputate hand at wrist 25922 T Amputate hand at wrist 0049 15.04 $745.93 $356.95 $149.19 25924 C Amputation follow-up surgery 25927 C Amputation of hand 25929 T Amputation follow-up surgery 0026 12.11 $600.61 $277.92 $120.12 25931 C Amputation follow-up surgery 25999 T Forearm or wrist surgery 0044 2.17 $107.63 $38.08 $21.53 26010 T Drainage of finger abscess 0006 2.00 $99.19 $33.95 $19.84 26011 T Drainage of finger abscess 0007 3.68 $182.51 $72.03 $36.50 26020 T Drain hand tendon sheath 0053 11.32 $561.42 $253.49 $112.28 26025 T Drainage of palm bursa 0053 11.32 $561.42 $253.49 $112.28 26030 T Drainage of palm bursa(s) 0053 11.32 $561.42 $253.49 $112.28 26034 T Treat hand bone lesion 0053 11.32 $561.42 $253.49 $112.28 26035 T Decompress fingers/hand 0053 11.32 $561.42 $253.49 $112.28 26037 T Decompress fingers/hand 0053 11.32 $561.42 $253.49 $112.28 26040 T Release palm contracture 0054 19.66 $975.06 $472.33 $195.01 26045 T Release palm contracture 0054 19.66 $975.06 $472.33 $195.01 26055 T Incise finger tendon sheath 0053 11.32 $561.42 $253.49 $112.28 26060 T Incision of finger tendon 0053 11.32 $561.42 $253.49 $112.28 26070 T Explore/treat hand joint 0053 11.32 $561.42 $253.49 $112.28 26075 T Explore/treat finger joint 0053 11.32 $561.42 $253.49 $112.28 26080 T Explore/treat finger joint 0053 11.32 $561.42 $253.49 $112.28 26100 T Biopsy hand joint lining 0053 11.32 $561.42 $253.49 $112.28 26105 T Biopsy finger joint lining 0053 11.32 $561.42 $253.49 $112.28 26110 T Biopsy finger joint lining 0053 11.32 $561.42 $253.49 $112.28 26115 T Removal of hand lesion 0022 12.49 $619.45 $292.94 $123.89 26116 T Removal of hand lesion 0022 12.49 $619.45 $292.94 $123.89 26117 T Remove tumor, hand/finger 0022 12.49 $619.45 $292.94 $123.89 26121 T Release palm contracture 0054 19.66 $975.06 $472.33 $195.01 26123 T Release palm contracture 0054 19.66 $975.06 $472.33 $195.01 26125 T Release palm contracture 0054 19.66 $975.06 $472.33 $195.01 26130 T Remove wrist joint lining 0053 11.32 $561.42 $253.49 $112.28 26135 T Revise finger joint, each 0054 19.66 $975.06 $472.33 $195.01 26140 T Revise finger joint, each 0053 11.32 $561.42 $253.49 $112.28 26145 T Tendon excision, palm/finger 0053 11.32 $561.42 $253.49 $112.28 26160 T Remove tendon sheath lesion 0053 11.32 $561.42 $253.49 $112.28 26170 T Removal of palm tendon, each 0053 11.32 $561.42 $253.49 $112.28 26180 T Removal of finger tendon 0053 11.32 $561.42 $253.49 $112.28 26185 T Remove finger bone 0053 11.32 $561.42 $253.49 $112.28 26200 T Remove hand bone lesion 0053 11.32 $561.42 $253.49 $112.28 26205 T Remove/graft bone lesion 0054 19.66 $975.06 $472.33 $195.01 26210 T Removal of finger lesion 0053 11.32 $561.42 $253.49 $112.28 26215 T Remove/graft finger lesion 0053 11.32 $561.42 $253.49 $112.28 26230 T Partial removal of hand bone 0053 11.32 $561.42 $253.49 $112.28 26235 T Partial removal, finger bone 0053 11.32 $561.42 $253.49 $112.28 26236 T Partial removal, finger bone 0053 11.32 $561.42 $253.49 $112.28 26250 T Extensive hand surgery 0053 11.32 $561.42 $253.49 $112.28 26255 T Extensive hand surgery 0054 19.66 $975.06 $472.33 $195.01 26260 T Extensive finger surgery 0053 11.32 $561.42 $253.49 $112.28 26261 T Extensive finger surgery 0053 11.32 $561.42 $253.49 $112.28 26262 T Partial removal of finger 0053 11.32 $561.42 $253.49 $112.28 26320 T Removal of implant from hand 0020 6.51 $322.87 $130.53 $64.57 26350 T Repair finger/hand tendon 0054 19.66 $975.06 $472.33 $195.01 26352 T Repair/graft hand tendon 0054 19.66 $975.06 $472.33 $195.01 26356 T Repair finger/hand tendon 0054 19.66 $975.06 $472.33 $195.01 26357 T Repair finger/hand tendon 0054 19.66 $975.06 $472.33 $195.01 26358 T Repair/graft hand tendon 0054 19.66 $975.06 $472.33 $195.01 26370 T Repair finger/hand tendon 0054 19.66 $975.06 $472.33 $195.01 26372 T Repair/graft hand tendon 0054 19.66 $975.06 $472.33 $195.01 26373 T Repair finger/hand tendon 0054 19.66 $975.06 $472.33 $195.01 26390 T Revise hand/finger tendon 0054 19.66 $975.06 $472.33 $195.01 26392 T Repair/graft hand tendon 0054 19.66 $975.06 $472.33 $195.01 26410 T Repair hand tendon 0053 11.32 $561.42 $253.49 $112.28 26412 T Repair/graft hand tendon 0054 19.66 $975.06 $472.33 $195.01 26415 T Excision, hand/finger tendon 0054 19.66 $975.06 $472.33 $195.01 26416 T Graft hand or finger tendon 0054 19.66 $975.06 $472.33 $195.01 26418 T Repair finger tendon 0053 11.32 $561.42 $253.49 $112.28 26420 T Repair/graft finger tendon 0054 19.66 $975.06 $472.33 $195.01 26426 T Repair finger/hand tendon 0054 19.66 $975.06 $472.33 $195.01 26428 T Repair/graft finger tendon 0054 19.66 $975.06 $472.33 $195.01 26432 T Repair finger tendon 0053 11.32 $561.42 $253.49 $112.28 26433 T Repair finger tendon 0053 11.32 $561.42 $253.49 $112.28 26434 T Repair/graft finger tendon 0054 19.66 $975.06 $472.33 $195.01 26437 T Realignment of tendons 0053 11.32 $561.42 $253.49 $112.28 26440 T Release palm/finger tendon 0053 11.32 $561.42 $253.49 $112.28 26442 T Release palm & finger tendon 0054 19.66 $975.06 $472.33 $195.01 26445 T Release hand/finger tendon 0053 11.32 $561.42 $253.49 $112.28 26449 T Release forearm/hand tendon 0054 19.66 $975.06 $472.33 $195.01 26450 T Incision of palm tendon 0053 11.32 $561.42 $253.49 $112.28 26455 T Incision of finger tendon 0053 11.32 $561.42 $253.49 $112.28 26460 T Incise hand/finger tendon 0053 11.32 $561.42 $253.49 $112.28 26471 T Fusion of finger tendons 0053 11.32 $561.42 $253.49 $112.28 26474 T Fusion of finger tendons 0053 11.32 $561.42 $253.49 $112.28 26476 T Tendon lengthening 0053 11.32 $561.42 $253.49 $112.28 26477 T Tendon shortening 0053 11.32 $561.42 $253.49 $112.28 26478 T Lengthening of hand tendon 0053 11.32 $561.42 $253.49 $112.28 26479 T Shortening of hand tendon 0053 11.32 $561.42 $253.49 $112.28 26480 T Transplant hand tendon 0054 19.66 $975.06 $472.33 $195.01 26483 T Transplant/graft hand tendon 0054 19.66 $975.06 $472.33 $195.01 26485 T Transplant palm tendon 0054 19.66 $975.06 $472.33 $195.01 26489 T Transplant/graft palm tendon 0054 19.66 $975.06 $472.33 $195.01 26490 T Revise thumb tendon 0054 19.66 $975.06 $472.33 $195.01 26492 T Tendon transfer with graft 0054 19.66 $975.06 $472.33 $195.01 26494 T Hand tendon/muscle transfer 0054 19.66 $975.06 $472.33 $195.01 26496 T Revise thumb tendon 0054 19.66 $975.06 $472.33 $195.01 26497 T Finger tendon transfer 0054 19.66 $975.06 $472.33 $195.01 26498 T Finger tendon transfer 0054 19.66 $975.06 $472.33 $195.01 26499 T Revision of finger 0054 19.66 $975.06 $472.33 $195.01 26500 T Hand tendon reconstruction 0053 11.32 $561.42 $253.49 $112.28 26502 T Hand tendon reconstruction 0054 19.66 $975.06 $472.33 $195.01 26504 T Hand tendon reconstruction 0054 19.66 $975.06 $472.33 $195.01 26508 T Release thumb contracture 0053 11.32 $561.42 $253.49 $112.28 26510 T Thumb tendon transfer 0054 19.66 $975.06 $472.33 $195.01 26516 T Fusion of knuckle joint 0054 19.66 $975.06 $472.33 $195.01 26517 T Fusion of knuckle joints 0054 19.66 $975.06 $472.33 $195.01 26518 T Fusion of knuckle joints 0054 19.66 $975.06 $472.33 $195.01 26520 T Release knuckle contracture 0053 11.32 $561.42 $253.49 $112.28 26525 T Release finger contracture 0053 11.32 $561.42 $253.49 $112.28 26530 T Revise knuckle joint 0047 22.09 $1,095.58 $537.03 $219.12 26531 T Revise knuckle with implant 0048 29.06 $1,441.26 $725.94 $288.25 26535 T Revise finger joint 0047 22.09 $1,095.58 $537.03 $219.12 26536 T Revise/implant finger joint 0048 29.06 $1,441.26 $725.94 $288.25 26540 T Repair hand joint 0053 11.32 $561.42 $253.49 $112.28 26541 T Repair hand joint with graft 0054 19.66 $975.06 $472.33 $195.01 26542 T Repair hand joint with graft 0053 11.32 $561.42 $253.49 $112.28 26545 T Reconstruct finger joint 0054 19.66 $975.06 $472.33 $195.01 26546 T Repair nonunion hand 0054 19.66 $975.06 $472.33 $195.01 26548 T Reconstruct finger joint 0054 19.66 $975.06 $472.33 $195.01 26550 T Construct thumb replacement 0054 19.66 $975.06 $472.33 $195.01 26551 C Great toe-hand transfer 26553 C Single transfer, toe-hand 26554 C Double transfer, toe-hand 26555 T Positional change of finger 0054 19.66 $975.06 $472.33 $195.01 26556 C Toe joint transfer 26560 T Repair of web finger 0053 11.32 $561.42 $253.49 $112.28 26561 T Repair of web finger 0054 19.66 $975.06 $472.33 $195.01 26562 T Repair of web finger 0054 19.66 $975.06 $472.33 $195.01 26565 T Correct metacarpal flaw 0054 19.66 $975.06 $472.33 $195.01 26567 T Correct finger deformity 0054 19.66 $975.06 $472.33 $195.01 26568 T Lengthen metacarpal/finger 0054 19.66 $975.06 $472.33 $195.01 26580 T Repair hand deformity 0054 19.66 $975.06 $472.33 $195.01 26585 T Repair finger deformity 0054 19.66 $975.06 $472.33 $195.01 26587 T Reconstruct extra finger 0053 11.32 $561.42 $253.49 $112.28 26590 T Repair finger deformity 0054 19.66 $975.06 $472.33 $195.01 26591 T Repair muscles of hand 0054 19.66 $975.06 $472.33 $195.01 26593 T Release muscles of hand 0053 11.32 $561.42 $253.49 $112.28 26596 T Excision constricting tissue 0054 19.66 $975.06 $472.33 $195.01 26597 T Release of scar contracture 0054 19.66 $975.06 $472.33 $195.01 26600 T Treat metacarpal fracture 0044 2.17 $107.63 $38.08 $21.53 26605 T Treat metacarpal fracture 0044 2.17 $107.63 $38.08 $21.53 26607 T Treat metacarpal fracture 0044 2.17 $107.63 $38.08 $21.53 26608 T Treat metacarpal fracture 0046 22.29 $1,105.50 $535.76 $221.10 26615 T Treat metacarpal fracture 0046 22.29 $1,105.50 $535.76 $221.10 26641 T Treat thumb dislocation 0044 2.17 $107.63 $38.08 $21.53 26645 T Treat thumb fracture 0044 2.17 $107.63 $38.08 $21.53 26650 T Treat thumb fracture 0046 22.29 $1,105.50 $535.76 $221.10 26665 T Treat thumb fracture 0046 22.29 $1,105.50 $535.76 $221.10 26670 T Treat hand dislocation 0044 2.17 $107.63 $38.08 $21.53 26675 T Treat hand dislocation 0045 11.02 $546.55 $277.12 $109.31 26676 T Pin hand dislocation 0046 22.29 $1,105.50 $535.76 $221.10 26685 T Treat hand dislocation 0046 22.29 $1,105.50 $535.76 $221.10 26686 T Treat hand dislocation 0046 22.29 $1,105.50 $535.76 $221.10 26700 T Treat knuckle dislocation 0043 1.64 $81.34 $25.46 $16.27 26705 T Treat knuckle dislocation 0045 11.02 $546.55 $277.12 $109.31 26706 T Pin knuckle dislocation 0044 2.17 $107.63 $38.08 $21.53 26715 T Treat knuckle dislocation 0046 22.29 $1,105.50 $535.76 $221.10 26720 T Treat finger fracture, each 0043 1.64 $81.34 $25.46 $16.27 26725 T Treat finger fracture, each 0043 1.64 $81.34 $25.46 $16.27 26727 T Treat finger fracture, each 0046 22.29 $1,105.50 $535.76 $221.10 26735 T Treat finger fracture, each 0046 22.29 $1,105.50 $535.76 $221.10 26740 T Treat finger fracture, each 0043 1.64 $81.34 $25.46 $16.27 26742 T Treat finger fracture, each 0044 2.17 $107.63 $38.08 $21.53 26746 T Treat finger fracture, each 0046 22.29 $1,105.50 $535.76 $221.10 26750 T Treat finger fracture, each 0043 1.64 $81.34 $25.46 $16.27 26755 T Treat finger fracture, each 0043 1.64 $81.34 $25.46 $16.27 26756 T Pin finger fracture, each 0046 22.29 $1,105.50 $535.76 $221.10 26765 T Treat finger fracture, each 0046 22.29 $1,105.50 $535.76 $221.10 26770 T Treat finger dislocation 0043 1.64 $81.34 $25.46 $16.27 26775 T Treat finger dislocation 0045 11.02 $546.55 $277.12 $109.31 26776 T Pin finger dislocation 0046 22.29 $1,105.50 $535.76 $221.10 26785 T Treat finger dislocation 0046 22.29 $1,105.50 $535.76 $221.10 26820 T Thumb fusion with graft 0054 19.66 $975.06 $472.33 $195.01 26841 T Fusion of thumb 0054 19.66 $975.06 $472.33 $195.01 26842 T Thumb fusion with graft 0054 19.66 $975.06 $472.33 $195.01 26843 T Fusion of hand joint 0054 19.66 $975.06 $472.33 $195.01 26844 T Fusion/graft of hand joint 0054 19.66 $975.06 $472.33 $195.01 26850 T Fusion of knuckle 0054 19.66 $975.06 $472.33 $195.01 26852 T Fusion of knuckle with graft 0054 19.66 $975.06 $472.33 $195.01 26860 T Fusion of finger joint 0054 19.66 $975.06 $472.33 $195.01 26861 T Fusion of finger jnt, add-on 0054 19.66 $975.06 $472.33 $195.01 26862 T Fusion/graft of finger joint 0054 19.66 $975.06 $472.33 $195.01 26863 T Fuse/graft added joint 0054 19.66 $975.06 $472.33 $195.01 26910 T Amputate metacarpal bone 0054 19.66 $975.06 $472.33 $195.01 26951 T Amputation of finger/thumb 0053 11.32 $561.42 $253.49 $112.28 26952 T Amputation of finger/thumb 0053 11.32 $561.42 $253.49 $112.28 26989 T Hand/finger surgery 0043 1.64 $81.34 $25.46 $16.27 26990 T Drainage of pelvis lesion 0049 15.04 $745.93 $356.95 $149.19 26991 T Drainage of pelvis bursa 0049 15.04 $745.93 $356.95 $149.19 26992 C Drainage of bone lesion 27000 T Incision of hip tendon 0049 15.04 $745.93 $356.95 $149.19 27001 T Incision of hip tendon 0050 21.13 $1,047.96 $513.86 $209.59 27003 T Incision of hip tendon 0050 21.13 $1,047.96 $513.86 $209.59 27005 C Incision of hip tendon 27006 C Incision of hip tendons 27025 C Incision of hip/thigh fascia 27030 C Drainage of hip joint 27033 T Exploration of hip joint 0051 27.76 $1,376.79 $675.24 $275.36 27035 C Denervation of hip joint 27036 C Excision of hip joint/muscle 27040 T Biopsy of soft tissues 0021 10.49 $520.26 $236.51 $104.05 27041 T Biopsy of soft tissues 0022 12.49 $619.45 $292.94 $123.89 27047 T Remove hip/pelvis lesion 0022 12.49 $619.45 $292.94 $123.89 27048 T Remove hip/pelvis lesion 0022 12.49 $619.45 $292.94 $123.89 27049 T Remove tumor, hip/pelvis 0022 12.49 $619.45 $292.94 $123.89 27050 T Biopsy of sacroiliac joint 0049 15.04 $745.93 $356.95 $149.19 27052 T Biopsy of hip joint 0049 15.04 $745.93 $356.95 $149.19 27054 C Removal of hip joint lining 27060 T Removal of ischial bursa 0049 15.04 $745.93 $356.95 $149.19 27062 T Remove femur lesion/bursa 0049 15.04 $745.93 $356.95 $149.19 27065 T Removal of hip bone lesion 0049 15.04 $745.93 $356.95 $149.19 27066 T Removal of hip bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 27067 T Remove/graft hip bone lesion 0050 21.13 $1,047.96 $513.86 $209.59 27070 C Partial removal of hip bone 27071 C Partial removal of hip bone 27075 C Extensive hip surgery 27076 C Extensive hip surgery 27077 C Extensive hip surgery 27078 C Extensive hip surgery 27079 C Extensive hip surgery 27080 T Removal of tail bone 0050 21.13 $1,047.96 $513.86 $209.59 27086 T Remove hip foreign body 0019 4.00 $198.39 $78.91 $39.68 27087 T Remove hip foreign body 0049 15.04 $745.93 $356.95 $149.19 27090 C Removal of hip prosthesis 27091 C Removal of hip prosthesis 27093 N Injection for hip x-ray 27095 N Injection for hip x-ray 27096 N Inject sacroiliac joint 27097 T Revision of hip tendon 0050 21.13 $1,047.96 $513.86 $209.59 27098 T Transfer tendon to pelvis 0050 21.13 $1,047.96 $513.86 $209.59 27100 T Transfer of abdominal muscle 0051 27.76 $1,376.79 $675.24 $275.36 27105 T Transfer of spinal muscle 0051 27.76 $1,376.79 $675.24 $275.36 27110 T Transfer of iliopsoas muscle 0051 27.76 $1,376.79 $675.24 $275.36 27111 T Transfer of iliopsoas muscle 0051 27.76 $1,376.79 $675.24 $275.36 27120 C Reconstruction of hip socket 27122 C Reconstruction of hip socket 27125 C Partial hip replacement 27130 C Total hip replacement 27132 C Total hip replacement 27134 C Revise hip joint replacement 27137 C Revise hip joint replacement 27138 C Revise hip joint replacement 27140 C Transplant femur ridge 27146 C Incision of hip bone 27147 C Revision of hip bone 27151 C Incision of hip bones 27156 C Revision of hip bones 27158 C Revision of pelvis 27161 C Incision of neck of femur 27165 C Incision/fixation of femur 27170 C Repair/graft femur head/neck 27175 C Treat slipped epiphysis 27176 C Treat slipped epiphysis 27177 C Treat slipped epiphysis 27178 C Treat slipped epiphysis 27179 C Revise head/neck of femur 27181 C Treat slipped epiphysis 27185 C Revision of femur epiphysis 27187 C Reinforce hip bones 27193 T Treat pelvic ring fracture 0044 2.17 $107.63 $38.08 $21.53 27194 T Treat pelvic ring fracture 0045 11.02 $546.55 $277.12 $109.31 27200 T Treat tail bone fracture 0043 1.64 $81.34 $25.46 $16.27 27202 T Treat tail bone fracture 0046 22.29 $1,105.50 $535.76 $221.10 27215 C Treat pelvic fracture(s) 27216 C Treat pelvic ring fracture 27217 C Treat pelvic ring fracture 27218 C Treat pelvic ring fracture 27220 T Treat hip socket fracture 0044 2.17 $107.63 $38.08 $21.53 27222 C Treat hip socket fracture 27226 C Treat hip wall fracture 27227 C Treat hip fracture(s) 27228 C Treat hip fracture(s) 27230 T Treat thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27232 C Treat thigh fracture 27235 C Treat thigh fracture 27236 C Treat thigh fracture 27238 T Treat thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27240 C Treat thigh fracture 27244 C Treat thigh fracture 27245 C Treat thigh fracture 27246 T Treat thigh fracture 0044 2.17 $107.63 $38.08 $21.53 27248 C Treat thigh fracture 27250 T Treat hip dislocation 0044 2.17 $107.63 $38.08 $21.53 27252 T Treat hip dislocation 0045 11.02 $546.55 $277.12 $109.31 27253 C Treat hip dislocation 27254 C Treat hip dislocation 27256 T Treat hip dislocation 0044 2.17 $107.63 $38.08 $21.53 27257 T Treat hip dislocation 0045 11.02 $546.55 $277.12 $109.31 27258 C Treat hip dislocation 27259 C Treat hip dislocation 27265 T Treat hip dislocation 0044 2.17 $107.63 $38.08 $21.53 27266 T Treat hip dislocation 0047 22.09 $1,095.58 $537.03 $219.12 27275 T Manipulation of hip joint 0045 11.02 $546.55 $277.12 $109.31 CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. * Code is new in 2001. Addendum C—[Reserved] Addendum D.—Status Indicators: How Various Services Are Treated Under the Hospital Outpatient Prospective Payment System Indicator Service Status A Pulmonary Rehabilitation Clinical Trial Not Paid Under Ourpatient PPS. C Inpatient Procedures Admit Patient; Bill as Inpatient. A Durable Medical Equipment, Prosthetics and Orthotics DMEPOS Fee Schedule. E Non-Covered Items and Services Not Paid Under Outpatient PPS. A Physical, Occupational and Speech Therapy Rehabilitation Fee Schedule. A Ambulance Ambulance Fee Schedule. A EPO for ESRD Patients National Rate. A Clinical Diagnostic Laboratory Services Laboratory Fee Schedule. A Physician Services for ESRD Patients Not Paid Under Outpatient PPS. A Screening Mammography Lower of Charges or National Rate. N Incidental Services, packaged into APC Rate Packaged. P Partial Hospitalization Paid Per Diem APC. S Significant Procedure, Not Discounted When Multiple Paid Under Outpatient PPS. T Significant Procedure, Multiple Procedure Reduction Applies Paid Under Outpatient PPS. V Visit to Clinic or Emergency Department Paid Under Outpatient PPS. X Ancillary Service Paid Under Outpatient PPS. F Acquisition of Corneal Tissue Paid at Reasonable Cost. G Current Drug/Biological Pass-Through Additional Payment. H Device Pass-Through Additional Payment. J New Drug/Biological Pass-Through Additional Payment. K Non Pass-Through Drug/Biological Paid Under Outpatient PPS. —————————— CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. * Code is new in 2001. Addendum E.—CPT Codes Which Will Be Paid Only as Inpatient Procedures [Calendar Year 2001] CPT/ HCPCS HOPD status indicator Description 15756 C Free muscle flap, microvasc 15757 C Free skin flap, microvasc 15758 C Free fascial flap, microvasc 16035 C Incision of burn scab * 16036 C Incision of burn scab 19200 C Removal of breast 19220 C Removal of breast 19271 C Revision of chest wall 19272 C Extensive chest wall surgery 19361 C Breast reconstruction 19364 C Breast reconstruction 19367 C Breast reconstruction 19368 C Breast reconstruction 19369 C Breast reconstruction 20660 C Apply, remove fixation device 20661 C Application of head brace 20662 C Application of pelvis brace 20663 C Application of thigh brace 20664 C Halo brace application 20802 C Replantation, arm, complete 20805 C Replant, forearm, complete 20808 C Replantation hand, complete 20816 C Replantation digit, complete 20822 C Replantation digit, complete 20824 C Replantation thumb, complete 20827 C Replantation thumb, complete 20838 C Replantation foot, complete 20930 C Spinal bone allograft 20931 C Spinal bone allograft 20936 C Spinal bone autograft 20937 C Spinal bone autograft 20938 C Spinal bone autograft 20955 C Fibula bone graft, microvasc 20956 C Iliac bone graft, microvasc 20957 C Mt bone graft, microvasc 20962 C Other bone graft, microvasc 20969 C Bone/skin graft, microvasc 20970 C Bone/skin graft, iliac crest 20972 C Bone/skin graft, metatarsal 20973 C Bone/skin graft, great toe 21045 C Extensive jaw surgery 21141 C Reconstruct midface, lefort 21142 C Reconstruct midface, lefort 21143 C Reconstruct midface, lefort 21145 C Reconstruct midface, lefort 21146 C Reconstruct midface, lefort 21147 C Reconstruct midface, lefort 21150 C Reconstruct midface, lefort 21151 C Reconstruct midface, lefort 21154 C Reconstruct midface, lefort 21155 C Reconstruct midface, lefort 21159 C Reconstruct midface, lefort 21160 C Reconstruct midface, lefort 21172 C Reconstruct orbit/forehead 21175 C Reconstruct orbit/forehead 21179 C Reconstruct entire forehead 21180 C Reconstruct entire forehead 21182 C Reconstruct cranial bone 21183 C Reconstruct cranial bone 21184 C Reconstruct cranial bone 21188 C Reconstruction of midface 21193 C Reconstruct lower jaw bone 21194 C Reconstruct lower jaw bone 21195 C Reconstruct lower jaw bone 21196 C Reconstruct lower jaw bone 21247 C Reconstruct lower jaw bone 21255 C Reconstruct lower jaw bone 21256 C Reconstruction of orbit 21268 C Revise eye sockets 21343 C Treatment of sinus fracture 21344 C Treatment of sinus fracture 21346 C Treat nose/jaw fracture 21347 C Treat nose/jaw fracture 21348 C Treat nose/jaw fracture 21356 C Treat cheek bone fracture 21360 C Treat cheek bone fracture 21365 C Treat cheek bone fracture 21366 C Treat cheek bone fracture 21385 C Treat eye socket fracture 21386 C Treat eye socket fracture 21387 C Treat eye socket fracture 21390 C Treat eye socket fracture 21395 C Treat eye socket fracture 21408 C Treat eye socket fracture 21422 C Treat mouth roof fracture 21423 C Treat mouth roof fracture 21431 C Treat craniofacial fracture 21432 C Treat craniofacial fracture 21433 C Treat craniofacial fracture 21435 C Treat craniofacial fracture 21436 C Treat craniofacial fracture 21495 C Treat hyoid bone fracture 21510 C Drainage of bone lesion 21557 C Remove tumor, neck/chest 21615 C Removal of rib 21616 C Removal of rib and nerves 21620 C Partial removal of sternum 21627 C Sternal debridement 21630 C Extensive sternum surgery 21632 C Extensive sternum surgery 21705 C Revision of neck muscle/rib 21740 C Reconstruction of sternum 21750 C Repair of sternum separation 21810 C Treatment of rib fracture(s) 21825 C Treat sternum fracture 22100 C Remove part of neck vertebra 22101 C Remove part, thorax vertebra 22102 C Remove part, lumbar vertebra 22103 C Remove extra spine segment 22110 C Remove part of neck vertebra 22112 C Remove part, thorax vertebra 22114 C Remove part, lumbar vertebra 22116 C Remove extra spine segment 22210 C Revision of neck spine 22212 C Revision of thorax spine 22214 C Revision of lumbar spine 22216 C Revise, extra spine segment 22220 C Revision of neck spine 22222 C Revision of thorax spine 22224 C Revision of lumbar spine 22226 C Revise, extra spine segment 22318 C Treat odontoid fx w/o graft 22319 C Treat odontoid fx w/graft 22325 C Treat spine fracture 22326 C Treat neck spine fracture 22327 C Treat thorax spine fracture 22328 C Treat each add spine fx 22548 C Neck spine fusion 22554 C Neck spine fusion 22556 C Thorax spine fusion 22558 C Lumbar spine fusion 22585 C Additional spinal fusion 22590 C Spine & skull spinal fusion 22595 C Neck spinal fusion 22600 C Neck spine fusion 22610 C Thorax spine fusion 22612 C Lumbar spine fusion 22614 C Spine fusion, extra segment 22630 C Lumbar spine fusion 22632 C Spine fusion, extra segment 22800 C Fusion of spine 22802 C Fusion of spine 22804 C Fusion of spine 22808 C Fusion of spine 22810 C Fusion of spine 22812 C Fusion of spine 22818 C Kyphectomy, 1-2 segments 22819 C Kyphectomy, 3 or more 22830 C Exploration of spinal fusion 22840 C Insert spine fixation device 22841 C Insert spine fixation device 22842 C Insert spine fixation device 22843 C Insert spine fixation device 22844 C Insert spine fixation device 22845 C Insert spine fixation device 22846 C Insert spine fixation device 22847 C Insert spine fixation device 22848 C Insert pelv fixation device 22849 C Reinsert spinal fixation 22850 C Remove spine fixation device 22851 C Apply spine prosth device 22852 C Remove spine fixation device 22855 C Remove spine fixation device 23035 C Drain shoulder bone lesion 23125 C Removal of collar bone 23195 C Removal of head of humerus 23200 C Removal of collar bone 23210 C Removal of shoulder blade 23220 C Partial removal of humerus 23221 C Partial removal of humerus 23222 C Partial removal of humerus 23332 C Remove shoulder foreign body 23395 C Muscle transfer, shoulder/arm 23397 C Muscle transfers 23400 C Fixation of shoulder blade 23440 C Remove/transplant tendon 23470 C Reconstruct shoulder joint 23472 C Reconstruct shoulder joint 23900 C Amputation of arm & girdle 23920 C Amputation at shoulder joint 24149 C Radical resection of elbow 24150 C Extensive humerus surgery 24151 C Extensive humerus surgery 24152 C Extensive radius surgery 24153 C Extensive radius surgery 24900 C Amputation of upper arm 24920 C Amputation of upper arm 24930 C Amputation follow-up surgery 24931 C Amputate upper arm & implant 24940 C Revision of upper arm 25170 C Extensive forearm surgery 25390 C Shorten radius or ulna 25391 C Lengthen radius or ulna 25392 C Shorten radius & ulna 25393 C Lengthen radius & ulna 25420 C Repair/graft radius & ulna 25900 C Amputation of forearm 25905 C Amputation of forearm 25909 C Amputation follow-up surgery 25915 C Amputation of forearm 25920 C Amputate hand at wrist 25924 C Amputation follow-up surgery 25927 C Amputation of hand 25931 C Amputation follow-up surgery 26551 C Great toe-hand transfer 26553 C Single transfer, toe-hand 26554 C Double transfer, toe-hand 26556 C Toe joint transfer 26992 C Drainage of bone lesion 27005 C Incision of hip tendon 27006 C Incision of hip tendons 27025 C Incision of hip/thigh fascia 27030 C Drainage of hip joint 27035 C Denervation of hip joint 27036 C Excision of hip joint/muscle 27054 C Removal of hip joint lining 27070 C Partial removal of hip bone 27071 C Partial removal of hip bone 27075 C Extensive hip surgery 27076 C Extensive hip surgery 27077 C Extensive hip surgery 27078 C Extensive hip surgery 27079 C Extensive hip surgery 27090 C Removal of hip prosthesis 27091 C Removal of hip prosthesis 27120 C Reconstruction of hip socket 27122 C Reconstruction of hip socket 27125 C Partial hip replacement 27130 C Total hip replacement 27132 C Total hip replacement 27134 C Revise hip joint replacement 27137 C Revise hip joint replacement 27138 C Revise hip joint replacement 27140 C Transplant femur ridge 27146 C Incision of hip bone 27147 C Revision of hip bone 27151 C Incision of hip bones 27156 C Revision of hip bones 27158 C Revision of pelvis 27161 C Incision of neck of femur 27165 C Incision/fixation of femur 27170 C Repair/graft femur head/neck 27175 C Treat slipped epiphysis 27176 C Treat slipped epiphysis 27177 C Treat slipped epiphysis 27178 C Treat slipped epiphysis 27179 C Revise head/neck of femur 27181 C Treat slipped epiphysis 27185 C Revision of femur epiphysis 27187 C Reinforce hip bones 27215 C Treat pelvic fracture(s) 27216 C Treat pelvic ring fracture 27217 C Treat pelvic ring fracture 27218 C Treat pelvic ring fracture 27222 C Treat hip socket fracture 27226 C Treat hip wall fracture 27227 C Treat hip fracture(s) 27228 C Treat hip fracture(s) 27232 C Treat thigh fracture 27235 C Treat thigh fracture 27236 C Treat thigh fracture 27240 C Treat thigh fracture 27244 C Treat thigh fracture 27245 C Treat thigh fracture 27248 C Treat thigh fracture 27253 C Treat hip dislocation 27254 C Treat hip dislocation 27258 C Treat hip dislocation 27259 C Treat hip dislocation 27280 C Fusion of sacroiliac joint 27282 C Fusion of pubic bones 27284 C Fusion of hip joint 27286 C Fusion of hip joint 27290 C Amputation of leg at hip 27295 C Amputation of leg at hip 27303 C Drainage of bone lesion 27365 C Extensive leg surgery 27445 C Revision of knee joint 27446 C Revision of knee joint 27447 C Total knee replacement 27448 C Incision of thigh 27450 C Incision of thigh 27454 C Realignment of thigh bone 27455 C Realignment of knee 27457 C Realignment of knee 27465 C Shortening of thigh bone 27466 C Lengthening of thigh bone 27468 C Shorten/lengthen thighs 27470 C Repair of thigh 27472 C Repair/graft of thigh 27475 C Surgery to stop leg growth 27477 C Surgery to stop leg growth 27479 C Surgery to stop leg growth 27485 C Surgery to stop leg growth 27486 C Revise/replace knee joint 27487 C Revise/replace knee joint 27488 C Removal of knee prosthesis 27495 C Reinforce thigh 27506 C Treatment of thigh fracture 27507 C Treatment of thigh fracture 27511 C Treatment of thigh fracture 27513 C Treatment of thigh fracture 27514 C Treatment of thigh fracture 27519 C Treat thigh fx growth plate 27535 C Treat knee fracture 27536 C Treat knee fracture 27540 C Treat knee fracture 27556 C Treat knee dislocation 27557 C Treat knee dislocation 27558 C Treat knee dislocation 27580 C Fusion of knee 27590 C Amputate leg at thigh 27591 C Amputate leg at thigh 27592 C Amputate leg at thigh 27596 C Amputation follow-up surgery 27598 C Amputate lower leg at knee 27645 C Extensive lower leg surgery 27646 C Extensive lower leg surgery 27702 C Reconstruct ankle joint 27703 C Reconstruction, ankle joint 27712 C Realignment of lower leg 27715 C Revision of lower leg 27720 C Repair of tibia 27722 C Repair/graft of tibia 27724 C Repair/graft of tibia 27725 C Repair of lower leg 27727 C Repair of lower leg 27880 C Amputation of lower leg 27881 C Amputation of lower leg 27882 C Amputation of lower leg 27886 C Amputation follow-up surgery 27888 C Amputation of foot at ankle 28800 C Amputation of midfoot 28805 C Amputation thru metatarsal 31225 C Removal of upper jaw 31230 C Removal of upper jaw 31290 C Nasal/sinus endoscopy, surg 31291 C Nasal/sinus endoscopy, surg 31292 C Nasal/sinus endoscopy, surg 31293 C Nasal/sinus endoscopy, surg 31294 C Nasal/sinus endoscopy, surg 31360 C Removal of larynx 31365 C Removal of larynx 31367 C Partial removal of larynx 31368 C Partial removal of larynx 31370 C Partial removal of larynx 31375 C Partial removal of larynx 31380 C Partial removal of larynx 31382 C Partial removal of larynx 31390 C Removal of larynx & pharynx 31395 C Reconstruct larynx & pharynx 31582 C Revision of larynx 31584 C Treat larynx fracture 31587 C Revision of larynx 31725 C Clearance of airways 31760 C Repair of windpipe 31766 C Reconstruction of windpipe 31770 C Repair/graft of bronchus 31775 C Reconstruct bronchus 31780 C Reconstruct windpipe 31781 C Reconstruct windpipe 31785 C Remove windpipe lesion 31786 C Remove windpipe lesion 31800 C Repair of windpipe injury 31805 C Repair of windpipe injury 32035 C Exploration of chest 32036 C Exploration of chest 32095 C Biopsy through chest wall 32100 C Exploration/biopsy of chest 32110 C Explore/repair chest 32120 C Re-exploration of chest 32124 C Explore chest free adhesions 32140 C Removal of lung lesion(s) 32141 C Remove/treat lung lesions 32150 C Removal of lung lesion(s) 32151 C Remove lung foreign body 32160 C Open chest heart massage 32200 C Drain, open, lung lesion 32201 C Drain, percut, lung lesion 32215 C Treat chest lining 32220 C Release of lung 32225 C Partial release of lung 32310 C Removal of chest lining 32320 C Free/remove chest lining 32402 C Open biopsy chest lining 32440 C Removal of lung 32442 C Sleeve pneumonectomy 32445 C Removal of lung 32480 C Partial removal of lung 32482 C Bilobectomy 32484 C Segmentectomy 32486 C Sleeve lobectomy 32488 C Completion pneumonectomy 32491 C Lung volume reduction 32500 C Partial removal of lung 32501 C Repair bronchus add-on 32520 C Remove lung & revise chest 32522 C Remove lung & revise chest 32525 C Remove lung & revise chest 32540 C Removal of lung lesion 32650 C Thoracoscopy, surgical 32651 C Thoracoscopy, surgical 32652 C Thoracoscopy, surgical 32653 C Thoracoscopy, surgical 32654 C Thoracoscopy, surgical 32655 C Thoracoscopy, surgical 32656 C Thoracoscopy, surgical 32657 C Thoracoscopy, surgical 32658 C Thoracoscopy, surgical 32659 C Thoracoscopy, surgical 32660 C Thoracoscopy, surgical 32661 C Thoracoscopy, surgical 32662 C Thoracoscopy, surgical 32663 C Thoracoscopy, surgical 32664 C Thoracoscopy, surgical 32665 C Thoracoscopy, surgical 32800 C Repair lung hernia 32810 C Close chest after drainage 32815 C Close bronchial fistula 32820 C Reconstruct injured chest 32850 C Donor pneumonectomy 32851 C Lung transplant, single 32852 C Lung transplant with bypass 32853 C Lung transplant, double 32854 C Lung transplant with bypass 32900 C Removal of rib(s) 32905 C Revise & repair chest wall 32906 C Revise & repair chest wall 32940 C Revision of lung 32997 C Total lung lavage 33015 C Incision of heart sac 33020 C Incision of heart sac 33025 C Incision of heart sac 33030 C Partial removal of heart sac 33031 C Partial removal of heart sac 33050 C Removal of heart sac lesion 33120 C Removal of heart lesion 33130 C Removal of heart lesion 33140 C Heart revascularize
(tmr)* 33141 C Heart revascularize
(tmr)33200 C Insertion of heart pacemaker 33201 C Insertion of heart pacemaker 33236 C Remove electrode/thoracotomy 33237 C Remove electrode/thoracotomy 33238 C Remove electrode/thoracotomy 33243 C Remove eltrd/thoracotomy 33245 C Insert epic eltrd pace-defib 33246 C Insert epic eltrd/generator 33250 C Ablate heart dysrhythm focus 33251 C Ablate heart dysrhythm focus 33253 C Reconstruct atria 33261 C Ablate heart dysrhythm focus 33300 C Repair of heart wound 33305 C Repair of heart wound 33310 C Exploratory heart surgery 33315 C Exploratory heart surgery 33320 C Repair major blood vessel(s) 33321 C Repair major vessel 33322 C Repair major blood vessel(s) 33330 C Insert major vessel graft 33332 C Insert major vessel graft 33335 C Insert major vessel graft 33400 C Repair of aortic valve 33401 C Valvuloplasty, open 33403 C Valvuloplasty, w/cp bypass 33404 C Prepare heart-aorta conduit 33405 C Replacement of aortic valve 33406 C Replacement of aortic valve 33410 C Replacement of aortic valve 33411 C Replacement of aortic valve 33412 C Replacement of aortic valve 33413 C Replacement of aortic valve 33414 C Repair of aortic valve 33415 C Revision, subvalvular tissue 33416 C Revise ventricle muscle 33417 C Repair of aortic valve 33420 C Revision of mitral valve 33422 C Revision of mitral valve 33425 C Repair of mitral valve 33426 C Repair of mitral valve 33427 C Repair of mitral valve 33430 C Replacement of mitral valve 33460 C Revision of tricuspid valve 33463 C Valvuloplasty, tricuspid 33464 C Valvuloplasty, tricuspid 33465 C Replace tricuspid valve 33468 C Revision of tricuspid valve 33470 C Revision of pulmonary valve 33471 C Valvotomy, pulmonary valve 33472 C Revision of pulmonary valve 33474 C Revision of pulmonary valve 33475 C Replacement, pulmonary valve 33476 C Revision of heart chamber 33478 C Revision of heart chamber 33496 C Repair, prosth valve clot 33500 C Repair heart vessel fistula 33501 C Repair heart vessel fistula 33502 C Coronary artery correction 33503 C Coronary artery graft 33504 C Coronary artery graft 33505 C Repair artery w/tunnel 33506 C Repair artery, translocation 33510 C CABG, vein, single 33511 C CABG, vein, two 33512 C CABG, vein, three 33513 C CABG, vein, four 33514 C CABG, vein, five 33516 C Cabg, vein, six or more 33517 C CABG, artery-vein, single 33518 C CABG, artery-vein, two 33519 C CABG, artery-vein, three 33521 C CABG, artery-vein, four 33522 C CABG, artery-vein, five 33523 C Cabg, art-vein, six or more 33530 C Coronary artery, bypass/reop 33533 C CABG, arterial, single 33534 C CABG, arterial, two 33535 C CABG, arterial, three 33536 C Cabg, arterial, four or more 33542 C Removal of heart lesion 33545 C Repair of heart damage 33572 C Open coronary endarterectomy 33600 C Closure of valve 33602 C Closure of valve 33606 C Anastomosis/artery-aorta 33608 C Repair anomaly w/conduit 33610 C Repair by enlargement 33611 C Repair double ventricle 33612 C Repair double ventricle 33615 C Repair, simple fontan 33617 C Repair, modified fontan 33619 C Repair single ventricle 33641 C Repair heart septum defect 33645 C Revision of heart veins 33647 C Repair heart septum defects 33660 C Repair of heart defects 33665 C Repair of heart defects 33670 C Repair of heart chambers 33681 C Repair heart septum defect 33684 C Repair heart septum defect 33688 C Repair heart septum defect 33690 C Reinforce pulmonary artery 33692 C Repair of heart defects 33694 C Repair of heart defects 33697 C Repair of heart defects 33702 C Repair of heart defects 33710 C Repair of heart defects 33720 C Repair of heart defect 33722 C Repair of heart defect 33730 C Repair heart-vein defect(s) 33732 C Repair heart-vein defect 33735 C Revision of heart chamber 33736 C Revision of heart chamber 33737 C Revision of heart chamber 33750 C Major vessel shunt 33755 C Major vessel shunt 33762 C Major vessel shunt 33764 C Major vessel shunt & graft 33766 C Major vessel shunt 33767 C Major vessel shunt 33770 C Repair great vessels defect 33771 C Repair great vessels defect 33774 C Repair great vessels defect 33775 C Repair great vessels defect 33776 C Repair great vessels defect 33777 C Repair great vessels defect 33778 C Repair great vessels defect 33779 C Repair great vessels defect 33780 C Repair great vessels defect 33781 C Repair great vessels defect 33786 C Repair arterial trunk 33788 C Revision of pulmonary artery 33800 C Aortic suspension 33802 C Repair vessel defect 33803 C Repair vessel defect 33813 C Repair septal defect 33814 C Repair septal defect 33820 C Revise major vessel 33822 C Revise major vessel 33824 C Revise major vessel 33840 C Remove aorta constriction 33845 C Remove aorta constriction 33851 C Remove aorta constriction 33852 C Repair septal defect 33853 C Repair septal defect 33860 C Ascending aortic graft 33861 C Ascending aortic graft 33863 C Ascending aortic graft 33870 C Transverse aortic arch graft 33875 C Thoracic aortic graft 33877 C Thoracoabdominal graft 33910 C Remove lung artery emboli 33915 C Remove lung artery emboli 33916 C Surgery of great vessel 33917 C Repair pulmonary artery 33918 C Repair pulmonary atresia 33919 C Repair pulmonary atresia 33920 C Repair pulmonary atresia 33922 C Transect pulmonary artery 33924 C Remove pulmonary shunt 33930 C Removal of donor heart/lung 33935 C Transplantation, heart/lung 33940 C Removal of donor heart 33945 C Transplantation of heart 33960 C External circulation assist 33961 C External circulation assist 33968 C Remove aortic assist device 33970 C Aortic circulation assist 33971 C Aortic circulation assist 33973 C Insert balloon device 33974 C Remove intra-aortic balloon 33975 C Implant ventricular device 33976 C Implant ventricular device 33977 C Remove ventricular device 33978 C Remove ventricular device 34001 C Removal of artery clot 34051 C Removal of artery clot 34151 C Removal of artery clot 34401 C Removal of vein clot 34451 C Removal of vein clot 34502 C Reconstruct vena cava * 34800 C Repair abdominal aortic aneurysm * 34802 C Repair abdominal aortic aneurysm * 34804 C Repair abdominal aortic aneurysm * 34808 C Repair abdominal aortic aneurysm * 34812 C Repair abdominal aortic aneurysm * 34813 C Repair abdominal aortic aneurysm * 34820 C Repair abdominal aortic aneurysm * 34825 C Repair abdominal aortic aneurysm * 34826 C Repair abdominal aortic aneurysm * 34830 C Repair abdominal aortic aneurysm * 34831 C Repair abdominal aortic aneurysm * 34832 C Repair abdominal aortic aneurysm 35001 C Repair defect of artery 35002 C Repair artery rupture, neck 35005 C Repair defect of artery 35013 C Repair artery rupture, arm 35021 C Repair defect of artery 35022 C Repair artery rupture, chest 35045 C Repair defect of arm artery 35081 C Repair defect of artery 35082 C Repair artery rupture, aorta 35091 C Repair defect of artery 35092 C Repair artery rupture, aorta 35102 C Repair defect of artery 35103 C Repair artery rupture, groin 35111 C Repair defect of artery 35112 C Repair artery rupture,spleen 35121 C Repair defect of artery 35122 C Repair artery rupture, belly 35131 C Repair defect of artery 35132 C Repair artery rupture, groin 35141 C Repair defect of artery 35142 C Repair artery rupture, thigh 35151 C Repair defect of artery 35152 C Repair artery rupture, knee 35161 C Repair defect of artery 35162 C Repair artery rupture 35182 C Repair blood vessel lesion 35189 C Repair blood vessel lesion 35211 C Repair blood vessel lesion 35216 C Repair blood vessel lesion 35221 C Repair blood vessel lesion 35241 C Repair blood vessel lesion 35246 C Repair blood vessel lesion 35251 C Repair blood vessel lesion 35271 C Repair blood vessel lesion 35276 C Repair blood vessel lesion 35281 C Repair blood vessel lesion 35301 C Rechanneling of artery 35311 C Rechanneling of artery 35331 C Rechanneling of artery 35341 C Rechanneling of artery 35351 C Rechanneling of artery 35355 C Rechanneling of artery 35361 C Rechanneling of artery 35363 C Rechanneling of artery 35371 C Rechanneling of artery 35372 C Rechanneling of artery 35381 C Rechanneling of artery 35390 C Reoperation, carotid add-on 35400 C Angioscopy 35450 C Repair arterial blockage 35452 C Repair arterial blockage 35454 C Repair arterial blockage 35456 C Repair arterial blockage 35480 C Atherectomy, open 35482 C Atherectomy, open 35483 C Atherectomy, open 35501 C Artery bypass graft 35506 C Artery bypass graft 35507 C Artery bypass graft 35508 C Artery bypass graft 35509 C Artery bypass graft 35511 C Artery bypass graft 35515 C Artery bypass graft 35516 C Artery bypass graft 35518 C Artery bypass graft 35521 C Artery bypass graft 35526 C Artery bypass graft 35531 C Artery bypass graft 35533 C Artery bypass graft 35536 C Artery bypass graft 35541 C Artery bypass graft 35546 C Artery bypass graft 35548 C Artery bypass graft 35549 C Artery bypass graft 35551 C Artery bypass graft 35556 C Artery bypass graft 35558 C Artery bypass graft 35560 C Artery bypass graft 35563 C Artery bypass graft 35565 C Artery bypass graft 35566 C Artery bypass graft 35571 C Artery bypass graft 35582 C Vein bypass graft 35583 C Vein bypass graft 35585 C Vein bypass graft 35587 C Vein bypass graft * 35600 C Harvest artery graft 35601 C Artery bypass graft 35606 C Artery bypass graft 35612 C Artery bypass graft 35616 C Artery bypass graft 35621 C Artery bypass graft 35623 C Bypass graft, not vein 35626 C Artery bypass graft 35631 C Artery bypass graft 35636 C Artery bypass graft 35641 C Artery bypass graft 35642 C Artery bypass graft 35645 C Artery bypass graft 35646 C Artery bypass graft 35650 C Artery bypass graft 35651 C Artery bypass graft 35654 C Artery bypass graft 35656 C Artery bypass graft 35661 C Artery bypass graft 35663 C Artery bypass graft 35665 C Artery bypass graft 35666 C Artery bypass graft 35671 C Artery bypass graft 35681 C Composite bypass graft 35682 C Composite bypass graft 35683 C Composite bypass graft 35691 C Arterial transposition 35693 C Arterial transposition 35694 C Arterial transposition 35695 C Arterial transposition 35700 C Reoperation, bypass graft 35701 C Exploration, carotid artery 35721 C Exploration, femoral artery 35741 C Exploration popliteal artery 35800 C Explore neck vessels 35820 C Explore chest vessels 35840 C Explore abdominal vessels 35870 C Repair vessel graft defect 35901 C Excision, graft, neck 35905 C Excision, graft, thorax 35907 C Excision, graft, abdomen 36510 C Insertion of catheter, vein 36660 C Insertion catheter, artery 36822 C Insertion of cannula(s) 36823 C Insertion of cannula(s) 37140 C Revision of circulation 37145 C Revision of circulation 37160 C Revision of circulation 37180 C Revision of circulation 37181 C Splice spleen/kidney veins 37195 C Thrombolytic therapy, stroke 37616 C Ligation of chest artery 37617 C Ligation of abdomen artery 37618 C Ligation of extremity artery 37660 C Revision of major vein 37788 C Revascularization, penis 38100 C Removal of spleen, total 38101 C Removal of spleen, partial 38102 C Removal of spleen, total 38115 C Repair of ruptured spleen 38380 C Thoracic duct procedure 38381 C Thoracic duct procedure 38382 C Thoracic duct procedure 38562 C Removal, pelvic lymph nodes 38564 C Removal, abdomen lymph nodes 38700 C Removal of lymph nodes, neck 38724 C Removal of lymph nodes, neck 38746 C Remove thoracic lymph nodes 38747 C Remove abdominal lymph nodes 38765 C Remove groin lymph nodes 38770 C Remove pelvis lymph nodes 38780 C Remove abdomen lymph nodes 39000 C Exploration of chest 39010 C Exploration of chest 39200 C Removal chest lesion 39220 C Removal chest lesion 39499 C Chest procedure 39501 C Repair diaphragm laceration 39502 C Repair paraesophageal hernia 39503 C Repair of diaphragm hernia 39520 C Repair of diaphragm hernia 39530 C Repair of diaphragm hernia 39531 C Repair of diaphragm hernia 39540 C Repair of diaphragm hernia 39541 C Repair of diaphragm hernia 39545 C Revision of diaphragm 39560 C Resect diaphragm, simple 39561 C Resect diaphragm, complex 39599 C Diaphragm surgery procedure 41130 C Partial removal of tongue 41135 C Tongue and neck surgery 41140 C Removal of tongue 41145 C Tongue removal, neck surgery 41150 C Tongue, mouth, jaw surgery 41153 C Tongue, mouth, neck surgery 41155 C Tongue, jaw, & neck surgery 42426 C Excise parotid gland/lesion 42842 C Extensive surgery of throat 42845 C Extensive surgery of throat 42894 C Revision of pharyngeal walls 42953 C Repair throat, esophagus 42961 C Control throat bleeding 42971 C Control nose/throat bleeding 43030 C Throat muscle surgery 43045 C Incision of esophagus 43100 C Excision of esophagus lesion 43101 C Excision of esophagus lesion 43107 C Removal of esophagus 43108 C Removal of esophagus 43112 C Removal of esophagus 43113 C Removal of esophagus 43116 C Partial removal of esophagus 43117 C Partial removal of esophagus 43118 C Partial removal of esophagus 43121 C Partial removal of esophagus 43122 C Parital removal of esophagus 43123 C Partial removal of esophagus 43124 C Removal of esophagus 43135 C Removal of esophagus pouch 43300 C Repair of esophagus 43305 C Repair esophagus and fistula 43310 C Repair of esophagus 43312 C Repair esophagus and fistula 43320 C Fuse esophagus & stomach 43324 C Revise esophagus & stomach 43325 C Revise esophagus & stomach 43326 C Revise esophagus & stomach 43330 C Repair of esophagus 43331 C Repair of esophagus 43340 C Fuse esophagus & intestine 43341 C Fuse esophagus & intestine 43350 C Surgical opening, esophagus 43351 C Surgical opening, esophagus 43352 C Surgical opening, esophagus 43360 C Gastrointestinal repair 43361 C Gastrointestinal repair 43400 C Ligate esophagus veins 43401 C Esophagus surgery for veins 43405 C Ligate/staple esophagus 43410 C Repair esophagus wound 43415 C Repair esophagus wound 43420 C Repair esophagus opening 43425 C Repair esophagus opening 43460 C Pressure treatment esophagus 43496 C Free jejunum flap, microvasc 43500 C Surgical opening of stomach 43501 C Surgical repair of stomach 43502 C Surgical repair of stomach 43510 C Surgical opening of stomach 43520 C Incision of pyloric muscle 43605 C Biopsy of stomach 43610 C Excision of stomach lesion 43611 C Excision of stomach lesion 43620 C Removal of stomach 43621 C Removal of stomach 43622 C Removal of stomach 43631 C Removal of stomach, partial 43632 C Removal of stomach, partial 43633 C Removal of stomach, partial 43634 C Removal of stomach, partial 43635 C Removal of stomach, partial 43638 C Removal of stomach, partial 43639 C Removal of stomach, partial 43640 C Vagotomy & pylorus repair 43641 C Vagotomy & pylorus repair 43800 C Reconstruction of pylorus 43810 C Fusion of stomach and bowel 43820 C Fusion of stomach and bowel 43825 C Fusion of stomach and bowel 43832 C Place gastrostomy tube 43840 C Repair of stomach lesion 43842 C Gastroplasty for obesity 43843 C Gastroplasty for obesity 43846 C Gastric bypass for obesity 43847 C Gastric bypass for obesity 43848 C Revision gastroplasty 43850 C Revise stomach-bowel fusion 43855 C Revise stomach-bowel fusion 43860 C Revise stomach-bowel fusion 43865 C Revise stomach-bowel fusion 43880 C Repair stomach-bowel fistula 44005 C Freeing of bowel adhesion 44010 C Incision of small bowel 44015 C Insert needle cath bowel 44020 C Exploration of small bowel 44021 C Decompress small bowel 44025 C Incision of large bowel 44050 C Reduce bowel obstruction 44055 C Correct malrotation of bowel 44110 C Excision of bowel lesion(s) 44111 C Excision of bowel lesion(s) 44120 C Removal of small intestine 44121 C Removal of small intestine 44125 C Removal of small intestine * 44130 C Bowel to bowel fusion * 44132 C Donor enterectomy * 44133 C Donor enterectomy * 44135 C Intestinal allotransplantation * 44136 C Intestinal allotransplantation 44139 C Mobilization of colon 44140 C Partial removal of colon 44141 C Partial removal of colon 44143 C Partial removal of colon 44144 C Partial removal of colon 44145 C Partial removal of colon 44146 C Partial removal of colon 44147 C Partial removal of colon 44150 C Removal of colon 44151 C Removal of colon/ileostomy 44152 C Removal of colon/ileostomy 44153 C Removal of colon/ileostomy 44155 C Removal of colon/ileostomy 44156 C Removal of colon/ileostomy 44160 C Removal of colon 44202 C Laparo, resect intestine 44300 C Open bowel to skin 44310 C Ileostomy/jejunostomy 44314 C Revision of ileostomy 44316 C Devise bowel pouch 44320 C Colostomy 44322 C Colostomy with biopsies 44345 C Revision of colostomy 44346 C Revision of colostomy 44602 C Suture, small intestine 44603 C Suture, small intestine 44604 C Suture, large intestine 44605 C Repair of bowel lesion 44615 C Intestinal stricturoplasty 44620 C Repair bowel opening 44625 C Repair bowel opening 44626 C Repair bowel opening 44640 C Repair bowel-skin fistula 44650 C Repair bowel fistula 44660 C Repair bowel-bladder fistula 44661 C Repair bowel-bladder fistula 44680 C Surgical revision, intestine 44700 C Suspend bowel w/prosthesis 44800 C Excision of bowel pouch 44820 C Excision of mesentery lesion 44850 C Repair of mesentery 44899 C Bowel surgery procedure 44900 C Drain app abscess, open 44901 C Drain app abscess, percut 44950 C Appendectomy 44955 C Appendectomy add-on 44960 C Appendectomy 45110 C Removal of rectum 45111 C Partial removal of rectum 45112 C Removal of rectum 45113 C Partial proctectomy 45114 C Partial removal of rectum 45116 C Partial removal of rectum 45119 C Remove rectum w/reservoir 45120 C Removal of rectum 45121 C Removal of rectum and colon 45123 C Partial proctectomy 45126 C Pelvic exenteration 45130 C Excision of rectal prolapse 45135 C Excision of rectal prolapse 45540 C Correct rectal prolapse 45541 C Correct rectal prolapse 45550 C Repair rectum/remove sigmoid 45562 C Exploration/repair of rectum 45563 C Exploration/repair of rectum 45800 C Repair rect/bladder fistula 45805 C Repair fistula w/colostomy 45820 C Repair rectourethral fistula 45825 C Repair fistula w/colostomy 46705 C Repair of anal stricture 46715 C Repair of anovaginal fistula 46716 C Repair of anovaginal fistula 46730 C Construction of absent anus 46735 C Construction of absent anus 46740 C Construction of absent anus 46742 C Repair of imperforated anus 46744 C Repair of cloacal anomaly 46746 C Repair of cloacal anomaly 46748 C Repair of cloacal anomaly 46751 C Repair of anal sphincter 47001 C Needle biopsy, liver add-on 47010 C Open drainage, liver lesion 47011 C Percut drain, liver lesion 47015 C Inject/aspirate liver cyst 47100 C Wedge biopsy of liver 47120 C Partial removal of liver 47122 C Extensive removal of liver 47125 C Partial removal of liver 47130 C Partial removal of liver 47133 C Removal of donor liver 47134 C Partial removal, donor liver 47135 C Transplantation of liver 47136 C Transplantation of liver 47300 C Surgery for liver lesion 47350 C Repair liver wound 47360 C Repair liver wound 47361 C Repair liver wound 47362 C Repair liver wound 47400 C Incision of liver duct 47420 C Incision of bile duct 47425 C Incision of bile duct 47460 C Incise bile duct sphincter 47480 C Incision of gallbladder 47490 C Incision of gallbladder 47550 C Bile duct endoscopy add-on 47570 C Laparo cholecystoenterostomy 47600 C Removal of gallbladder 47605 C Removal of gallbladder 47610 C Removal of gallbladder 47612 C Removal of gallbladder 47620 C Removal of gallbladder 47700 C Exploration of bile ducts 47701 C Bile duct revision 47711 C Excision of bile duct tumor 47712 C Excision of bile duct tumor 47715 C Excision of bile duct cyst 47716 C Fusion of bile duct cyst 47720 C Fuse gallbladder & bowel 47721 C Fuse upper gi structures 47740 C Fuse gallbladder & bowel 47741 C Fuse gallbladder & bowel 47760 C Fuse bile ducts and bowel 47765 C Fuse liver ducts & bowel 47780 C Fuse bile ducts and bowel 47785 C Fuse bile ducts and bowel 47800 C Reconstruction of bile ducts 47801 C Placement, bile duct support 47802 C Fuse liver duct & intestine 47900 C Suture bile duct injury 48000 C Drainage of abdomen 48001 C Placement of drain, pancreas 48005 C Resect/debride pancreas 48020 C Removal of pancreatic stone 48100 C Biopsy of pancreas 48120 C Removal of pancreas lesion 48140 C Partial removal of pancreas 48145 C Partial removal of pancreas 48146 C Pancreatectomy 48148 C Removal of pancreatic duct 48150 C Partial removal of pancreas 48152 C Pancreatectomy 48153 C Pancreatectomy 48154 C Pancreatectomy 48155 C Removal of pancreas 48180 C Fuse pancreas and bowel 48400 C Injection, intraop add-on 48500 C Surgery of pancreas cyst 48510 C Drain pancreatic pseudocyst 48511 C Drain pancreatic pseudocyst 48520 C Fuse pancreas cyst and bowel 48540 C Fuse pancreas cyst and bowel 48545 C Pancreatorrhaphy 48547 C Duodenal exclusion 48556 C Removal, allograft pancreas 49000 C Exploration of abdomen 49002 C Reopening of abdomen 49010 C Exploration behind abdomen 49020 C Drain abdominal abscess 49021 C Drain abdominal abscess 49040 C Drain, open, abdom abscess 49041 C Drain, percut, abdom abscess 49060 C Drain, open, retrop abscess 49061 C Drain, percut, retroper absc 49062 C Drain to peritoneal cavity 49200 C Removal of abdominal lesion 49201 C Removal of abdominal lesion 49215 C Excise sacral spine tumor 49220 C Multiple surgery, abdomen 49255 C Removal of omentum 49425 C Insert abdomen-venous drain 49428 C Ligation of shunt 49605 C Repair umbilical lesion 49606 C Repair umbilical lesion 49610 C Repair umbilical lesion 49611 C Repair umbilical lesion 49900 C Repair of abdominal wall 49905 C Omental flap 49906 C Free omental flap, microvasc 50010 C Exploration of kidney 50020 C Renal abscess, open drain 50021 C Renal abscess, percut drain 50040 C Drainage of kidney 50045 C Exploration of kidney 50060 C Removal of kidney stone 50065 C Incision of kidney 50070 C Incision of kidney 50075 C Removal of kidney stone 50100 C Revise kidney blood vessels 50120 C Exploration of kidney 50125 C Explore and drain kidney 50130 C Removal of kidney stone 50135 C Exploration of kidney 50205 C Biopsy of kidney 50220 C Removal of kidney 50225 C Removal of kidney 50230 C Removal of kidney 50234 C Removal of kidney & ureter 50236 C Removal of kidney & ureter 50240 C Partial removal of kidney 50280 C Removal of kidney lesion 50290 C Removal of kidney lesion 50300 C Removal of donor kidney 50320 C Removal of donor kidney 50340 C Removal of kidney 50360 C Transplantation of kidney 50365 C Transplantation of kidney 50370 C Remove transplanted kidney 50380 C Reimplantation of kidney 50400 C Revision of kidney/ureter 50405 C Revision of kidney/ureter 50500 C Repair of kidney wound 50520 C Close kidney-skin fistula 50525 C Repair renal-abdomen fistula 50526 C Repair renal-abdomen fistula 50540 C Revision of horseshoe kidney * 50545 C Laparoscopic nephrectomy 50546 C Laparoscopic nephrectomy 50547 C Laparo removal donor kidney 50548 C Laparo-asst remove k/ureter 50570 C Kidney endoscopy 50572 C Kidney endoscopy 50574 C Kidney endoscopy & biopsy 50575 C Kidney endoscopy 50576 C Kidney endoscopy & treatment 50578 C Renal endoscopy/radiotracer 50580 C Kidney endoscopy & treatment 50600 C Exploration of ureter 50605 C Insert ureteral support 50610 C Removal of ureter stone 50620 C Removal of ureter stone 50630 C Removal of ureter stone 50650 C Removal of ureter 50660 C Removal of ureter 50700 C Revision of ureter 50715 C Release of ureter 50722 C Release of ureter 50725 C Release/revise ureter 50727 C Revise ureter 50728 C Revise ureter 50740 C Fusion of ureter & kidney 50750 C Fusion of ureter & kidney 50760 C Fusion of ureters 50770 C Splicing of ureters 50780 C Reimplant ureter in bladder 50782 C Reimplant ureter in bladder 50783 C Reimplant ureter in bladder 50785 C Reimplant ureter in bladder 50800 C Implant ureter in bowel 50810 C Fusion of ureter & bowel 50815 C Urine shunt to bowel 50820 C Construct bowel bladder 50825 C Construct bowel bladder 50830 C Revise urine flow 50840 C Replace ureter by bowel 50845 C Appendico-vesicostomy 50860 C Transplant ureter to skin 50900 C Repair of ureter 50920 C Closure ureter/skin fistula 50930 C Closure ureter/bowel fistula 50940 C Release of ureter 51060 C Removal of ureter stone 51525 C Removal of bladder lesion 51530 C Removal of bladder lesion 51535 C Repair of ureter lesion 51550 C Partial removal of bladder 51555 C Partial removal of bladder 51565 C Revise bladder & ureter(s) 51570 C Removal of bladder 51575 C Removal of bladder & nodes 51580 C Remove bladder/revise tract 51585 C Removal of bladder & nodes 51590 C Remove bladder/revise tract 51595 C Remove bladder/revise tract 51596 C Remove bladder/create pouch 51597 C Removal of pelvic structures 51800 C Revision of bladder/urethra 51820 C Revision of urinary tract 51840 C Attach bladder/urethra 51841 C Attach bladder/urethra 51845 C Repair bladder neck 51860 C Repair of bladder wound 51865 C Repair of bladder wound 51900 C Repair bladder/vagina lesion 51920 C Close bladder-uterus fistula 51925 C Hysterectomy/bladder repair 51940 C Correction of bladder defect 51960 C Revision of bladder & bowel 51980 C Construct bladder opening 53085 C Drainage of urinary leakage 53415 C Reconstruction of urethra 53443 C Reconstruction of urethra 54125 C Removal of penis 54130 C Remove penis & nodes 54135 C Remove penis & nodes 54332 C Revise penis/urethra 54336 C Revise penis/urethra 54390 C Repair penis and bladder 54430 C Revision of penis 54535 C Extensive testis surgery 54560 C Exploration for testis 54650 C Orchiopexy (Fowler-Stephens) 55600 C Incise sperm duct pouch 55605 C Incise sperm duct pouch 55650 C Remove sperm duct pouch 55801 C Removal of prostate 55810 C Extensive prostate surgery 55812 C Extensive prostate surgery 55815 C Extensive prostate surgery 55821 C Removal of prostate 55831 C Removal of prostate 55840 C Extensive prostate surgery 55842 C Extensive prostate surgery 55845 C Extensive prostate surgery 55862 C Extensive prostate surgery 55865 C Extensive prostate surgery 56630 C Extensive vulva surgery 56631 C Extensive vulva surgery 56632 C Extensive vulva surgery 56633 C Extensive vulva surgery 56634 C Extensive vulva surgery 56637 C Extensive vulva surgery 56640 C Extensive vulva surgery 57110 C Remove vagina wall, complete 57111 C Remove vagina tissue, compl 57112 C Vaginectomy w/nodes, compl 57270 C Repair of bowel pouch 57280 C Suspension of vagina 57282 C Repair of vaginal prolapse 57292 C Construct vagina with graft 57305 C Repair rectum-vagina fistula 57307 C Fistula repair & colostomy 57308 C Fistula repair, transperine 57311 C Repair urethrovaginal lesion 57335 C Repair vagina 57531 C Removal of cervix, radical 57540 C Removal of residual cervix 57545 C Remove cervix/repair pelvis 58140 C Removal of uterus lesion 58150 C Total hysterectomy 58152 C Total hysterectomy 58180 C Partial hysterectomy 58200 C Extensive hysterectomy 58210 C Extensive hysterectomy 58240 C Removal of pelvis contents 58260 C Vaginal hysterectomy 58262 C Vaginal hysterectomy 58263 C Vaginal hysterectomy 58267 C Hysterectomy & vagina repair 58270 C Hysterectomy & vagina repair 58275 C Hysterectomy/revise vagina 58280 C Hysterectomy/revise vagina 58285 C Extensive hysterectomy 58400 C Suspension of uterus 58410 C Suspension of uterus 58520 C Repair of ruptured uterus 58540 C Revision of uterus 58605 C Division of fallopian tube 58611 C Ligate oviduct(s) add-on 58700 C Removal of fallopian tube 58720 C Removal of ovary/tube(s) 58740 C Revise fallopian tube(s) 58750 C Repair oviduct 58752 C Revise ovarian tube(s) 58760 C Remove tubal obstruction 58770 C Create new tubal opening 58805 C Drainage of ovarian cyst(s) 58822 C Drain ovary abscess, percut 58823 C Drain pelvic abscess, percut 58825 C Transposition, ovary(s) 58940 C Removal of ovary(s) 58943 C Removal of ovary(s) 58950 C Resect ovarian malignancy 58951 C Resect ovarian malignancy 58952 C Resect ovarian malignancy 58960 C Exploration of abdomen 59100 C Remove uterus lesion 59120 C Treat ectopic pregnancy 59121 C Treat ectopic pregnancy 59130 C Treat ectopic pregnancy 59135 C Treat ectopic pregnancy 59136 C Treat ectopic pregnancy 59140 C Treat ectopic pregnancy 59325 C Revision of cervix 59350 C Repair of uterus 59514 C Cesarean delivery only 59525 C Remove uterus after cesarean 59620 C Attempted vbac delivery only 59830 C Treat uterus infection 59850 C Abortion 59851 C Abortion 59852 C Abortion 59855 C Abortion 59856 C Abortion 59857 C Abortion 60254 C Extensive thyroid surgery 60270 C Removal of thyroid 60271 C Removal of thyroid 60502 C Re-explore parathyroids 60505 C Explore parathyroid glands 60520 C Removal of thymus gland 60521 C Removal of thymus gland 60522 C Removal of thymus gland 60540 C Explore adrenal gland 60545 C Explore adrenal gland 60600 C Remove carotid body lesion 60605 C Remove carotid body lesion 60650 C Laparoscopy adrenalectomy 61105 C Twist drill hole 61107 C Drill skull for implantation 61108 C Drill skull for drainage 61120 C Burr hole for puncture 61140 C Pierce skull for biopsy 61150 C Pierce skull for drainage 61151 C Pierce skull for drainage 61154 C Pierce skull & remove clot 61156 C Pierce skull for drainage 61210 C Pierce skull, implant device 61250 C Pierce skull & explore 61253 C Pierce skull & explore 61304 C Open skull for exploration 61305 C Open skull for exploration 61312 C Open skull for drainage 61313 C Open skull for drainage 61314 C Open skull for drainage 61315 C Open skull for drainage 61320 C Open skull for drainage 61321 C Open skull for drainage 61332 C Explore/biopsy eye socket 61333 C Explore orbit/remove lesion 61334 C Explore orbit/remove object 61340 C Relieve cranial pressure 61343 C Incise skull (press relief) 61345 C Relieve cranial pressure 61440 C Incise skull for surgery 61450 C Incise skull for surgery 61458 C Incise skull for brain wound 61460 C Incise skull for surgery 61470 C Incise skull for surgery 61480 C Incise skull for surgery 61490 C Incise skull for surgery 61500 C Removal of skull lesion 61501 C Remove infected skull bone 61510 C Removal of brain lesion 61512 C Remove brain lining lesion 61514 C Removal of brain abscess 61516 C Removal of brain lesion 61518 C Removal of brain lesion 61519 C Remove brain lining lesion 61520 C Removal of brain lesion 61521 C Removal of brain lesion 61522 C Removal of brain abscess 61524 C Removal of brain lesion 61526 C Removal of brain lesion 61530 C Removal of brain lesion 61531 C Implant brain electrodes 61533 C Implant brain electrodes 61534 C Removal of brain lesion 61535 C Remove brain electrodes 61536 C Removal of brain lesion 61538 C Removal of brain tissue 61539 C Removal of brain tissue 61541 C Incision of brain tissue 61542 C Removal of brain tissue 61543 C Removal of brain tissue 61544 C Remove & treat brain lesion 61545 C Excision of brain tumor 61546 C Removal of pituitary gland 61548 C Removal of pituitary gland 61550 C Release of skull seams 61552 C Release of skull seams 61556 C Incise skull/sutures 61557 C Incise skull/sutures 61558 C Excision of skull/sutures 61559 C Excision of skull/sutures 61563 C Excision of skull tumor 61564 C Excision of skull tumor 61570 C Remove foreign body, brain 61571 C Incise skull for brain wound 61575 C Skull base/brainstem surgery 61576 C Skull base/brainstem surgery 61580 C Craniofacial approach, skull 61581 C Craniofacial approach, skull 61582 C Craniofacial approach, skull 61583 C Craniofacial approach, skull 61584 C Orbitocranial approach/skull 61585 C Orbitocranial approach/skull 61586 C Resect nasopharynx, skull 61590 C Infratemporal approach/skull 61591 C Infratemporal approach/skull 61592 C Orbitocranial approach/skull 61595 C Transtemporal approach/skull 61596 C Transcochlear approach/skull 61597 C Transcondylar approach/skull 61598 C Transpetrosal approach/skull 61600 C Resect/excise cranial lesion 61601 C Resect/excise cranial lesion 61605 C Resect/excise cranial lesion 61606 C Resect/excise cranial lesion 61607 C Resect/excise cranial lesion 61608 C Resect/excise cranial lesion 61609 C Transect artery, sinus 61610 C Transect artery, sinus 61611 C Transect artery, sinus 61612 C Transect artery, sinus 61613 C Remove aneurysm, sinus 61615 C Resect/excise lesion, skull 61616 C Resect/excise lesion, skull 61618 C Repair dura 61619 C Repair dura 61624 C Occlusion/embolization cath 61626 C Occlusion/embolization cath 61680 C Intracranial vessel surgery 61682 C Intracranial vessel surgery 61684 C Intracranial vessel surgery 61686 C Intracranial vessel surgery 61690 C Intracranial vessel surgery 61692 C Intracranial vessel surgery * 61697 C Intracranial aneurysm surgery * 61698 C Intracranial aneurysm surgery 61700 C Inner skull vessel surgery 61702 C Inner skull vessel surgery 61703 C Clamp neck artery 61705 C Revise circulation to head 61708 C Revise circulation to head 61710 C Revise circulation to head 61711 C Fusion of skull arteries 61720 C Incise skull/brain surgery 61735 C Incise skull/brain surgery 61750 C Incise skull/brain biopsy 61751 C Brain biopsy w/ ct/mr guide 61760 C Implant brain electrodes 61770 C Incise skull for treatment 61791 C Treat trigeminal tract 61850 C Implant neuroelectrodes 61860 C Implant neuroelectrodes 61862 C Implant neurostimul, subcort 61870 C Implant neuroelectrodes 61875 C Implant neuroelectrodes 62000 C Treat skull fracture 62005 C Treat skull fracture 62010 C Treatment of head injury 62100 C Repair brain fluid leakage 62115 C Reduction of skull defect 62116 C Reduction of skull defect 62117 C Reduction of skull defect 62120 C Repair skull cavity lesion 62121 C Incise skull repair 62140 C Repair of skull defect 62141 C Repair of skull defect 62142 C Remove skull plate/flap 62143 C Replace skull plate/flap 62145 C Repair of skull & brain 62146 C Repair of skull with graft 62147 C Repair of skull with graft 62180 C Establish brain cavity shunt 62190 C Establish brain cavity shunt 62192 C Establish brain cavity shunt 62200 C Establish brain cavity shunt 62201 C Establish brain cavity shunt 62220 C Establish brain cavity shunt 62223 C Establish brain cavity shunt 62256 C Remove brain cavity shunt 62258 C Replace brain cavity shunt 62351 C Implant spinal canal cath 63001 C Removal of spinal lamina 63003 C Removal of spinal lamina 63005 C Removal of spinal lamina 63011 C Removal of spinal lamina 63012 C Removal of spinal lamina 63015 C Removal of spinal lamina 63016 C Removal of spinal lamina 63017 C Removal of spinal lamina 63020 C Neck spine disk surgery 63030 C Low back disk surgery 63035 C Spinal disk surgery add-on 63040 C Neck spine disk surgery 63042 C Low back disk surgery * 63043 C Repair of skull * 63044 C Repair of skull 63045 C Removal of spinal lamina 63046 C Removal of spinal lamina 63047 C Removal of spinal lamina 63048 C Remove spinal lamina add-on 63055 C Decompress spinal cord 63056 C Decompress spinal cord 63057 C Decompress spine cord add-on 63064 C Decompress spinal cord 63066 C Decompress spine cord add-on 63075 C Neck spine disk surgery 63076 C Neck spine disk surgery 63077 C Spine disk surgery, thorax 63078 C Spine disk surgery, thorax 63081 C Removal of vertebral body 63082 C Remove vertebral body add-on 63085 C Removal of vertebral body 63086 C Remove vertebral body add-on 63087 C Removal of vertebral body 63088 C Remove vertebral body add-on 63090 C Removal of vertebral body 63091 C Remove vertebral body add-on 63170 C Incise spinal cord tract(s) 63172 C Drainage of spinal cyst 63173 C Drainage of spinal cyst 63180 C Revise spinal cord ligaments 63182 C Revise spinal cord ligaments 63185 C Incise spinal column/nerves 63190 C Incise spinal column/nerves 63191 C Incise spinal column/nerves 63194 C Incise spinal column & cord 63195 C Incise spinal column & cord 63196 C Incise spinal column & cord 63197 C Incise spinal column & cord 63198 C Incise spinal column & cord 63199 C Incise spinal column & cord 63200 C Release of spinal cord 63250 C Revise spinal cord vessels 63251 C Revise spinal cord vessels 63252 C Revise spinal cord vessels 63265 C Excise intraspinal lesion 63266 C Excise intraspinal lesion 63267 C Excise intraspinal lesion 63268 C Excise intraspinal lesion 63270 C Excise intraspinal lesion 63271 C Excise intraspinal lesion 63272 C Excise intraspinal lesion 63273 C Excise intraspinal lesion 63275 C Biopsy/excise spinal tumor 63276 C Biopsy/excise spinal tumor 63277 C Biopsy/excise spinal tumor 63278 C Biopsy/excise spinal tumor 63280 C Biopsy/excise spinal tumor 63281 C Biopsy/excise spinal tumor 63282 C Biopsy/excise spinal tumor 63283 C Biopsy/excise spinal tumor 63285 C Biopsy/excise spinal tumor 63286 C Biopsy/excise spinal tumor 63287 C Biopsy/excise spinal tumor 63290 C Biopsy/excise spinal tumor 63300 C Removal of vertebral body 63301 C Removal of vertebral body 63302 C Removal of vertebral body 63303 C Removal of vertebral body 63304 C Removal of vertebral body 63305 C Removal of vertebral body 63306 C Removal of vertebral body 63307 C Removal of vertebral body 63308 C Remove vertebral body add-on 63655 C Implant neuroelectrodes 63700 C Repair of spinal herniation 63702 C Repair of spinal herniation 63704 C Repair of spinal herniation 63706 C Repair of spinal herniation 63707 C Repair spinal fluid leakage 63709 C Repair spinal fluid leakage 63710 C Graft repair of spine defect 63740 C Install spinal shunt 64752 C Incision of vagus nerve 64755 C Incision of stomach nerves 64760 C Incision of vagus nerve 64763 C Incise hip/thigh nerve 64766 C Incise hip/thigh nerve 64802 C Remove sympathetic nerves 64804 C Remove sympathetic nerves 64809 C Remove sympathetic nerves 64818 C Remove sympathetic nerves 64820 C Remove sympathetic nerves 64866 C Fusion of facial/other nerve 64868 C Fusion of facial/other nerve 65273 C Repair of eye wound 69150 C Extensive ear canal surgery 69155 C Extensive ear/neck surgery 69502 C Mastoidectomy 69535 C Remove part of temporal bone 69554 C Remove ear lesion 69950 C Incise inner ear nerve 69970 C Remove inner ear lesion 75900 C Arterial catheter exchange * 75952 C Abdominal aortic aneurysm repair * 75953 C Abdominal aortic aneurysm repair 92970 C Cardioassist, internal 92971 C Cardioassist, external 92975 C Dissolve clot, heart vessel 92986 C Revision of aortic valve 92987 C Revision of mitral valve 92990 C Revision of pulmonary valve 92992 C Revision of heart chamber 92993 C Revision of heart chamber 92997 C Pul art balloon repr, percut 92998 C Pul art balloon repr, percut 94652 C Pressure breathing
(IPPB)99190 C Special pump services 99191 C Special pump services 99192 C Special pump services 99251 C Initial inpatient consult 99252 C Initial inpatient consult 99253 C Initial inpatient consult 99254 C Initial inpatient consult 99255 C Initial inpatient consult 99261 C Follow-up inpatient consult 99262 C Follow-up inpatient consult 99263 C Follow-up inpatient consult 99295 C Neonatal critical care 99296 C Neonatal critical care 99297 C Neonatal critical care 99298 C Neonatal critical care 99356 C Prolonged service, inpatient 99357 C Prolonged service, inpatient 99433 C Normal newborn care/hospital CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. * Code is new in 2001. Addendum F—Wage Index for Urban Areas Urban Area (Constituent Counties) Wage Index 0040 Abilene, −+* 0.8240 Taylor, TX 0060 Aguadilla, PR 0.4391 Aguada, PR Aguadilla, PR Moca, PR 0080 Akron, OH 0.9736 Portage, OH Summit, OH 0120 Albany, GA 0.9933 Dougherty, GA Lee, GA 0160 Albany-Schenectady-Troy, NY 0.8549 Albany, NY Montgomery, NY Rensselaer, NY Saratoga, NY Schenectady, NY Schoharie, NY 0200 Albuquerque, NM 0.9136 Bernalillo, NM Sandoval, NM Valencia, NM 0220 Alexandria, LA 0.8170 Rapides, LA 0240 Allentown-Bethlehem-Easton, PA 0.9925 Carbon, PA Lehigh, PA Northampton, PA 0280 Altoona, PA 0.9346 Blair, PA 0320 Amarillo, TX Potter, TX 0.8715 Randall, TX 0380 Anchorage, AK 1.2865 Anchorage, AK 0440 Ann Arbor, MI 1.1254 Lenawee, MI Livingston, MI Washtenaw, MI 0450 Anniston, AL 0.8284 Calhoun, AL 0460 Appleton-Oshkosh-Neenah, WI 0.9052 Calumet, WI Outagamie, WI Winnebago, WI 0470 Arecibo, PR 0.4525 Arecibo, PR Camuy, PR Hatillo, PR 0480 Asheville, NC 0.9516 Buncombe, NC Madison, NC 0500 Athens, GA 0.9739 Clarke, GA Madison, GA Oconee, GA 0520 Atlanta, GA 1 1.0096 Barrow, GA Bartow, GA Carroll, GA Cherokee, GA Clayton, GA Cobb, GA Coweta, GA DeKalb, GA Douglas, GA Fayette, GA Forsyth, GA Fulton, GA Gwinnett, GA Henry, GA Newton, GA Paulding, GA Pickens, GA Rockdale, GA Spalding, GA Walton, GA 0560 Atlantic-Cape May, NJ 1.1182 Atlantic, NJ Cape May, NJ 0580 Auburn-Opelika, AL 0.8106 Lee, AL 0600 Augusta-Aiken, GA-SC 0.9160 Columbia, GA McDuffie, GA Richmond, GA Aiken, SC Edgefield, SC 0640 Austin-San Marcos, TX 1 0.9577 Bastrop, TX Caldwell, TX Hays, TX Travis, TX Williamson, TX 0680 Bakersfield, CA 2 0.9861 Kern, CA 0720 Baltimore, MD 1 0.9365 Anne Arundel, MD Baltimore County, MD Baltimore City, MD Carroll, MD Harford, MD Howard, MD Queen Anne's, MD 0733 Bangor, ME 0.9561 Penobscot, ME 0743 Barnstable-Yarmouth, MA 1.3839 Barnstable, MA 0760 Baton Rouge, LA 0.8842 Ascension, LA East Baton Rouge, LA Livingston, LA West Baton Rouge, LA 0840 Beaumont-Port Arthur, TX 0.8744 Hardin, TX Jefferson, TX Orange, TX 0860 Bellingham, WA 1.1439 Whatcom, WA 0870 Benton Harbor, MI 2 0.9021 Berrien, MI 0875 Bergen-Passaic, NJ 1 1.1605 Bergen, NJ Passaic, NJ 0880 Billings, MT 0.9591 Yellowstone, MT 0920 Biloxi-Gulfport-Pascagoula, MS 0.8236 Hancock, MS Harrison, MS Jackson, MS 0960 Binghamton, NY 0.8690 Broome, NY Tioga, NY 1000 Birmingham, AL 0.8477 Blount, AL Jefferson, AL St. Clair, AL Shelby, AL 1010 Bismarck, ND 0.7897 Burleigh, ND Morton, ND 1020 Bloomington, IN 0.8733 Monroe, IN 1040 Bloomington-Normal, IL 0.9156 McLean, IL 1080 Boise City, ID 0.9042 Ada, ID Canyon, ID 1123 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (MA Hospitals) 1 , 2 1.1204 Bristol, MA Essex, MA Middlesex, MA Norfolk, MA Plymouth, MA Suffolk, MA Worcester, MA Hillsborough, NH Merrimack, NH Rockingham, NH Strafford, NH 1123 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (NH Hospitals) 1 1.1160 Bristol, MA Essex, MA Middlesex, MA Norfolk, MA Plymouth, MA Suffolk, MA Worcester, MA Hillsborough, NH Merrimack, NH Rockingham, NH Strafford, NH 1125 Boulder-Longmont, CO 0.9731 Boulder, CO 1145 Brazoria, TX 0.8658 Brazoria, TX 1150 Bremerton, WA 1.0975 Kitsap, WA 1240 Brownsville-Harlingen-San Benito, TX 0.8722 Cameron, TX 1260 Bryan-College Station, TX 0.8237 Brazos, TX 1280 Buffalo-Niagara Falls, NY 1 0.9580 Erie, NY Niagara, NY 1303 Burlington, VT 1.0735 Chittenden, VT Franklin, VT Grand Isle, VT 1310 Caguas, PR 0.4562 Caguas, PR Cayey, PR Cidra, PR Gurabo, PR San Lorenzo, PR 1320 Canton-Massillon, OH 2 0.8670 Carroll, OH Stark, OH 1350 Casper, WY 2 0.8817 Natrona, WY 1360 Cedar Rapids, IA 0.8736 Linn, IA 1400 Champaign-Urbana, IL 0.9198 Champaign, IL 1440 Charleston-North Charleston, SC 0.9067 Berkeley, SC Charleston, SC Dorchester, SC 1480 Charleston, WV 0.9240 Kanawha, WV Putnam, WV 1520 Charlotte-Gastonia-Rock Hill, NC-SC 1 0.9391 Cabarrus, NC Gaston, NC Lincoln, NC Mecklenburg, NC Rowan, NC Stanly, NC Union, NC York, SC 1540 Charlottesville, VA 1.0789 Albemarle, VA Charlottesville City, VA Fluvanna, VA Greene, VA 1560 Chattanooga, TN-GA 0.9833 Catoosa, GA Dade, GA Walker, GA Hamilton, TN Marion, TN 1580 Cheyenne, WY 2 0.8817 Laramie, WY 1600 Chicago, IL 1 1.1146 Cook, IL DeKalb, IL DuPage, IL Grundy, IL Kane, IL Kendall, IL Lake, IL McHenry, IL Will, IL 1620 Chico-Paradise, CA 0.9918 Butte, CA 1640 Cincinnati, OH-KY-IN 1 0.9415 Dearborn, IN Ohio, IN Boone, KY Campbell, KY Gallatin, KY Grant, KY Kenton, KY Pendleton, KY Brown, OH Clermont, OH Hamilton, OH Warren, OH 1660 Clarksville-Hopkinsville, TN-KY 0.8277 Christian, KY Montgomery, TN 1680 Cleveland-Lorain-Elyria, OH 1 0.9593 Ashtabula, OH Cuyahoga, OH Geauga, OH Lake, OH Lorain, OH Medina, OH 1720 Colorado Springs, CO 0.9697 El Paso, CO 1740 Columbia, MO 0.8961 Boone, MO 1760 Columbia, SC 0.9554 Lexington, SC Richland, SC 1800 Columbus, GA-AL Russell, AL 0.8568 Chattahoochee, GA Harris, GA Muscogee, GA 1840 Columbus, OH 1 0.9619 Delaware, OH Fairfield, OH Franklin, OH Licking, OH Madison, OH Pickaway, OH 1880 Corpus Christi, TX 0.8726 Nueces, TX San Patricio, TX 1890 Corvallis, OR 1.1326 Benton, OR 1900 Cumberland, MD-WV (MD Hospitals) 2 0.8651 Allegany, MD Mineral, WV 1900 Cumberland, MD-WV (WV Hospital) 0.8369 Allegany, MD Mineral, WV 1920 Dallas, TX 1 0.9913 Collin, TX Dallas, TX Denton, TX Ellis, TX Henderson, TX Hunt, TX Kaufman, TX Rockwall, TX 1950 Danville, VA 0.8589 Danville City, VA Pittsylvania, VA 1960 Davenport-Moline-Rock Island, IA-IL 0.8898 Scott, IA Henry, IL Rock Island, IL 2000 Dayton-Springfield, OH 0.9442 Clark, OH Greene, OH Miami, OH Montgomery, OH 2020 Daytona Beach, FL 0.9147 Flagler, FL Volusia, FL 2030 Decatur, AL 0.8534 Lawrence, AL Morgan, AL 2040 Decatur, IL 2 0.8160 Macon, IL 2080 Denver, CO 1 1.0181 Adams, CO Arapahoe, CO Denver, CO Douglas, CO Jefferson, CO 2120 Des Moines, IA 0.9118 Dallas, IA Polk, IA Warren, IA 2160 Detroit, MI 1 1.0510 Lapeer, MI Macomb, MI Monroe, MI Oakland, MI St. Clair, MI Wayne, MI 2180 Dothan, AL 0.8013 Dale, AL Houston, AL 2190 Dover, DE 1.0078 Kent, DE 2200 Dubuque, IA 0.8746 Dubuque, IA 2240 Duluth-Superior, MN-WI 1.0043 St. Louis, MN Douglas, WI 2281 Dutchess County, NY 0.9491 Dutchess, NY 2290 Eau Claire, WI 2 0.8880 Chippewa, WI Eau Claire, WI 2320 El Paso, TX 0.9346 El Paso, TX 2330 Elkhart-Goshen, IN 0.9145 Elkhart, IN 2335 Elmira, NY 0.8546 Chemung, NY 2340 Enid, OK 0.8610 Garfield, OK 2360 Erie, PA 0.8985 Erie, PA 2400 Eugene-Springfield, OR 1.0965 Lane, OR 2440 Evansville-Henderson, IN-KY (IN Hospitals) 2 0.8602 Posey, IN Vanderburgh, IN Warrick, IN Henderson, KY 2440 Evansville-Henderson, IN-KY (KY Hospitals) 0.8173 Posey, IN Vanderburgh, IN Warrick, IN Henderson, KY 2520 Fargo-Moorhead, ND-MN 0.8749 Clay, MN Cass, ND 2560 Fayetteville, NC 0.8655 Cumberland, NC 2580 Fayetteville-Springdale-Rogers, AR 0.7910 Benton, AR Washington, AR 2620 Flagstaff, AZ-UT 1.0686 Coconino, AZ Kane, UT 2640 Flint, MI 1.1205 Genesee, MI 2650 Florence, AL 0.7652 Colbert, AL Lauderdale, AL 2655 Florence, SC 0.8777 Florence, SC 2670 Fort Collins-Loveland, CO 1.0647 Larimer, CO 2680 1 Ft. Lauderdale, FL 1.0152 Broward, FL 2700 Fort Myers-Cape Coral, FL 0.9247 Lee, FL 2710 Fort Pierce-Port St. Lucie, FL 0.9622 Martin, FL St. Lucie, FL 2720 Fort Smith, AR-OK 0.8052 Crawford, AR Sebastian, AR Sequoyah, OK 2750 Fort Walton Beach, FL 0.9607 Okaloosa, FL 2760 Fort Wayne, IN 0.8665 Adams, IN Allen, IN De Kalb, IN Huntington, IN Wells, IN Whitley, IN 2800 Forth Worth-Arlington, TX 1 0.9527 Hood, TX Johnson, TX Parker, TX Tarrant, TX 2840 Fresno, CA 1.0104 Fresno, CA Madera, CA 2880 Gadsden, AL 0.8423 Etowah, AL 2900 Gainesville, FL 1.0074 Alachua, FL 2920 Galveston-Texas City, TX 0.9918 Galveston, TX 2960 Gary, IN 0.9454 Lake, IN Porter, IN 2975 Glens Falls, NY 2 0.8499 Warren, NY Washington, NY 2980 Goldsboro, NC 2 0.8441 Wayne, NC 2985 Grand Forks, ND-MN 0.8954 Polk, MN Grand Forks, ND 2995 Grand Junction, CO 0.9471 Mesa, CO 3000 Grand Rapids-Muskegon-Holland, MI 1 1.0248 Allegan, MI Kent, MI Muskegon, MI Ottawa, MI 3040 Great Falls, MT 0.9330 Cascade, MT 3060 Greeley, CO 0.9814 Weld, CO 3080 Green Bay, WI 0.9308 Brown, WI 3120 Greensboro-Winston-Salem-High Point, NC 1 0.9124 Alamance, NC Davidson, NC Davie, NC Forsyth, NC Guilford, NC Randolph, NC Stokes, NC Yadkin, NC 3150 Greenville, NC 0.9384 Pitt, NC 3160 Greenville-Spartanburg-Anderson, SC 0.9003 Anderson, SC Cherokee, SC Greenville, SC Pickens, SC Spartanburg, SC 3180 Hagerstown, MD 0.9409 Washington, MD 3200 Hamilton-Middletown, OH 0.9061 Butler, OH 3240 Harrisburg-Lebanon-Carlisle, PA 0.9386 Cumberland, PA Dauphin, PA Lebanon, PA Perry, PA 3283 Hartford, CT 1 , 2 1.1715 Hartford, CT Litchfield, CT Middlesex, CT Tolland, CT 3285 Hattiesburg, MS 2 0.7491 Forrest, MS Lamar, MS 3290 Hickory-Morganton-Lenoir, NC 0.8755 Alexander, NC Burke, NC Caldwell, NC Catawba, NC 3320 Honolulu, HI 1.1866 Honolulu, HI 3350 Houma, LA 0.8086 Lafourche, LA Terrebonne, LA 3360 Houston, TX 1 0.9732 Chambers, TX Fort Bend, TX Harris, TX Liberty, TX Montgomery, TX Waller, TX 3400 Huntington-Ashland, WV-KY-OH 0.9876 Boyd, KY Carter, KY Greenup, KY Lawrence, OH Cabell, WV Wayne, WV 3440 Huntsville, AL 0.8932 Limestone, AL Madison, AL 3480 Indianapolis, IN 1 0.9787 Boone, IN Hamilton, IN Hancock, IN Hendricks, IN Johnson, IN Madison, IN Marion, IN Morgan, IN Shelby, IN 3500 Iowa City, IA 0.9657 Johnson, IA 3520 Jackson, MI 0.9134 Jackson, MI 3560 Jackson, MS 0.8812 Hinds, MS Madison, MS Rankin, MS 3580 Jackson, TN 0.8796 Madison, TN Chester, TN 3600 Jacksonville, FL 1 0.9208 Clay, FL Duval, FL Nassau, FL St. Johns, FL 3605 Jacksonville, NC 2 0.8441 Onslow, NC 3610 Jamestown, NY 2 0.8499 Chautauqua, NY 3620 Janesville-Beloit, WI 0.9585 Rock, WI 3640 Jersey City, NJ 1.1573 Hudson, NJ 3660 Johnson City-Kingsport-Bristol, TN-VA 0.8328 Carter, TN Hawkins, TN Sullivan, TN Unicoi, TN Washington, TN Bristol City, VA Scott, VA Washington, VA 3680 Johnstown, PA 0.8578 Cambria, PA Somerset, PA 3700 Jonesboro, AR 0.7832 Craighead, AR 3710 Joplin, MO 0.8148 Jasper, MO Newton, MO 3720 Kalamazoo-Battlecreek, MI 1.0453 Calhoun, MI Kalamazoo, MI Van Buren, MI 3740 Kankakee, IL 0.9902 Kankakee, IL 3760 Kansas City, KS-MO 1 0.9661 Johnson, KS Leavenworth, KS Miami, KS Wyandotte, KS Cass, MO Clay, MO Clinton, MO Jackson, MO Lafayette, MO Platte, MO Ray, MO 3800 Kenosha, WI 0.9611 Kenosha, WI 3810 Killeen-Temple, TX 1.0119 Bell, TX Coryell, TX 3840 Knoxville, TN 0.8340 Anderson, TN Blount, TN Knox, TN Loudon, TN Sevier, TN Union, TN 3850 Kokomo, IN 0.9525 Howard, IN Tipton, IN 3870 La Crosse, WI-MN 0.9211 Houston, MN La Crosse, WI 3880 Lafayette, LA 0.8490 Acadia, LA Lafayette, LA St. Landry, LA St. Martin, LA 3920 Lafayette, IN 0.8834 Clinton, IN Tippecanoe, IN 3960 Lake Charles, LA 2 0.7713 Calcasieu, LA 3980 Lakeland-Winter Haven, FL 0.8928 Polk, FL 4000 Lancaster, PA 0.9259 Lancaster, PA 4040 Lansing-East Lansing, MI 0.9934 Clinton, MI Eaton, MI Ingham, MI 4080 Laredo, TX 0.8168 Webb, TX 4100 Las Cruces, NM 0.8658 Dona Ana, NM 4120 Las Vegas, NV-AZ 1 1.0796 Mohave, AZ Clark, NV Nye, NV 4150 Lawrence, KS 0.8190 Douglas, KS 4200 Lawton, OK 0.8996 Comanche, OK 4243 Lewiston-Auburn, ME 0.9036 Androscoggin, ME 4280 Lexington, KY 0.8866 Bourbon, KY Clark, KY Fayette, KY Jessamine, KY Madison, KY Scott, KY Woodford, KY 4320 Lima, OH 0.9320 Allen, OH Auglaize, OH 4360 Lincoln, NE 0.9666 Lancaster, NE 4400 Little Rock-North Little Rock, AR 0.8906 Faulkner, AR Lonoke, AR Pulaski, AR Saline, AR 4420 Longview-Marshall, TX 0.8922 Gregg, TX Harrison, TX Upshur, TX 4480 Los Angeles-Long Beach, CA 1 1.2033 Los Angeles, CA 4520 Louisville, KY-IN 0.9350 Clark, IN Floyd, IN Harrison, IN Scott, IN Bullitt, KY Jefferson, KY Oldham, KY 4600 Lubbock, TX 0.8838 Lubbock, TX 4640 Lynchburg, VA 0.8867 Amherst, VA Bedford, VA Bedford City, VA Campbell, VA Lynchburg City, VA 4680 Macon, GA 0.8974 Bibb, GA Houston, GA Jones, GA Peach, GA Twiggs, GA 4720 Madison, WI 1.0271 Dane, WI 4800 Mansfield, OH 0.8690 Crawford, OH Richland, OH 4840 Mayaguez, PR 0.4589 Anasco, PR Cabo Rojo, PR Hormigueros, PR Mayaguez, PR Sabana Grande, PR San German, PR 4880 McAllen-Edinburg-Mission, TX 0.8566 Hidalgo, TX 4890 Medford-Ashland, OR 1.0344 Jackson, OR 4900 Melbourne-Titusville-Palm Bay, FL 0.9688 Brevard, Fl 4920 Memphis, TN-AR-MS 1 0.8723 Crittenden, AR DeSoto, MS Fayette, TN Shelby, TN Tipton, TN 4940 Merced, CA 2 0.9861 Merced, CA 5000 Miami, FL 1 1.0059 Dade, FL 5015 Middlesex-Somerset-Hunterdon, NJ 1 1.0333 Hunterdon, NJ Middlesex, NJ Somerset, NJ 5080 Milwaukee-Waukesha, WI 1 0.9767 Milwaukee, WI Ozaukee, WI Washington, WI Waukesha, WI 5120 Minneapolis-St. Paul, MN-WI 1 1.1017 Anoka, MN Carver, MN Chisago, MN Dakota, MN Hennepin, MN Isanti, MN Ramsey, MN Scott, MN Sherburne, MN Washington, MN Wright, MN Pierce, WI St. Croix, WI 5140 Missoula, MT 0.9332 Missoula, MT 5160 Mobile, AL 0.8163 Baldwin, AL Mobile, AL 5170 Modesto, CA 1.0396 Stanislaus, CA 5190 Monmouth-Ocean, NJ 1 1.1283 Monmouth, NJ Ocean, NJ 5200 Monroe, LA 0.8396 Ouachita, LA 5240 Montgomery, AL 0.7653 Autauga, AL Elmore, AL Montgomery, AL 5280 Muncie, IN 1.0969 Delaware, IN 5330 Myrtle Beach, SC 0.8440 Horry, SC 5345 Naples, FL 0.9661 Collier, FL 5360 Nashville, TN 1 0.9490 Cheatham, TN Davidson, TN Dickson, TN Robertson, TN Rutherford, TN Sumner, TN Williamson, TN Wilson, TN 5380 Nassau-Suffolk, NY 1 1.3932 Nassau, NY Suffolk, NY 5483 New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT 1 1.2034 Fairfield, CT New Haven, CT 5523 New London-Norwich, CT 1.2063 New London, CT 5560 New Orleans, LA 1 0.9295 Jefferson, LA Orleans, LA Plaquemines, LA St. Bernard, LA St. Charles, LA St. James, LA St. John The Baptist, LA St. Tammany, LA 5600 New York, NY 1 1.4651 Bronx, NY Kings, NY New York, NY Putnam, NY Queens, NY Richmond, NY Rockland, NY Westchester, NY 5640 Newark, NJ 1 1.0757 Essex, NJ Morris, NJ Sussex, NJ Union, NJ Warren, NJ 5660 Newburgh, NY-PA 1.0847 Orange, NY Pike, PA 5720 Norfolk-Virginia Beach-Newport News, VA-NC 1 0.8422 Currituck, NC Chesapeake City, VA Gloucester, VA Hampton City, VA Isle of Wight, VA James City, VA Mathews, VA Newport News City, VA Norfolk City, VA Poquoson City, VA Portsmouth City, VA Suffolk City, VA Virginia Beach City VA Williamsburg City, VA York, VA 5775 Oakland, CA 1 1.4983 Alameda, CA Contra Costa, CA 5790 Ocala, FL 0.9243 Marion, FL 5800 Odessa-Midland, TX 0.9205 Ector, TX Midland, TX 5880 Oklahoma City, OK 1 0.8822 Canadian, OK Cleveland, OK Logan, OK McClain, OK Oklahoma, OK Pottawatomie, OK 5910 Olympia, WA 1.0677 Thurston, WA 5920 Omaha, NE-IA 0.9572 Pottawattamie, IA Cass, NE Douglas, NE Sarpy, NE Washington, NE 5945 Orange County, CA 1 1.1411 Orange, CA 5960 Orlando, FL 1 0.9610 Lake, FL Orange, FL Osceola, FL Seminole, FL 5990 Owensboro, KY 0.8159 Daviess, KY 6015 Panama City, FL 0.9010 Bay, FL 6020 Parkersburg-Marietta, WV-OH (WV Hospitals) 0.8274 Washington, OH Wood, WV 6020 Parkersburg-Marietta, WV-OH (OH Hospitals) 2 0.8670 Washington, OH Wood, WV 6080 Pensacola, FL 2 0.8928 Escambia, FL Santa Rosa, FL 6120 Peoria-Pekin, IL 0.8646 Peoria, IL Tazewell, IL Woodford, IL 6160 Philadelphia, PA-NJ 1 1.0937 Burlington, NJ Camden, NJ Gloucester, NJ Salem, NJ Bucks, PA Chester, PA Delaware, PA Montgomery, PA Philadelphia, PA 6200 Phoenix-Mesa, AZ 1 0.9669 Maricopa, AZ Pinal, AZ 6240 Pine Bluff, AR 0.7791 Jefferson, AR 6280 Pittsburgh, PA 1 0.9741 Allegheny, PA Beaver, PA Butler, PA Fayette, PA Washington, PA Westmoreland, PA 6323 Pittsfield, MA 2 1.1204 Berkshire, MA 6340 Pocatello, ID 0.9076 Bannock, ID 6360 Ponce, PR 0.5006 Guayanilla, PR Juana Diaz, PR Penuelas, PR Ponce, PR Villalba, PR Yauco, PR 6403 Portland, ME 0.9748 Cumberland, ME Sagadahoc, ME York, ME 6440 Portland-Vancouver, 1 OR-WA 1.0910 Clackamas, OR Columbia, OR Multnomah, OR Washington, OR Yamhill, OR Clark, WA 6483 Providence-Warwick-Pawtucket, RI 1 1.0864 Bristol, RI Kent, RI Newport, RI Providence, RI Washington, RI 6520 Provo-Orem, UT 1.0041 Utah, UT 6560 Pueblo, CO 2 0.8968 Pueblo, CO 6580 Punta Gorda, FL 0.9613 Charlotte, FL 6600 Racine, WI 0.9246 Racine, WI 6640 Raleigh-Durham-Chapel Hill, NC 1 0.9646 Chatham, NC Durham, NC Franklin, NC Johnston, NC Orange, NC Wake, NC 6660 Rapid City, SD 0.8865 Pennington, SD 6680 Reading, PA 0.9152 Berks, PA 690 Redding, CA 1.1664 Shasta, CA 6720 Reno, NV 1.0550 Washoe, NV 6740 Richland-Kennewick-Pasco, WA 1.1460 Benton, WA Franklin, WA 6760 Richmond-Petersburg, VA 0.9617 Charles City County, VA Chesterfield, VA Colonial Heights City, VA Dinwiddie, VA Goochland, VA Hanover, VA Henrico, VA Hopewell City, VA New Kent, VA Petersburg City, VA Powhatan, VA Prince George, VA Richmond City, VA 6780 Riverside-San Bernardino, CA 1 1.1115 Riverside, CA San Bernardino, CA 6800 Roanoke, VA 0.8782 Botetourt, VA Roanoke, VA Roanoke City, VA Salem City, VA 6820 Rochester, MN 1.1315 Olmsted, MN 6840 Rochester, NY 1 0.9182 Genesee, NY Livingston, NY Monroe, NY Ontario, NY Orleans, NY Wayne, NY 6880 Rockford, IL 0.8819 Boone, IL Ogle, IL Winnebago, IL 6895 Rocky Mount, NC 0.8849 Edgecombe, NC Nash, NC 6920 Sacramento, CA 1 1.1957 El Dorado, CA Placer, CA Sacramento, CA 6960 Saginaw-Bay City-Midland, MI 0.9575 Bay, MI Midland, MI Saginaw, MI 6980 St. Cloud, MN 1.0016 Benton, MN Stearns, MN 7000 St. Joseph, MO 0.9071 Andrew, MO Buchanan, MO 7040 St. Louis, MO-IL 1 0.9049 Clinton, IL Jersey, IL Madison, IL Monroe, IL St. Clair, IL Franklin, MO Jefferson, MO Lincoln, MO St. Charles, MO St. Louis, MO St. Louis City, MO Warren, MO 7080 Salem, OR 1.0132 Marion, OR Polk, OR 7120 Salinas, CA 1.4502 Monterey, CA 7160 Salt Lake City-Ogden, UT 1 0.9811 Davis, UT Salt Lake, UT Weber, UT 7200 San Angelo, TX 0.8083 Tom Green, TX 7240 San Antonio, TX 1 0.8580 Bexar, TX Comal, TX Guadalupe, TX Wilson, TX 7320 San Diego, CA 1 1.1784 San Diego, CA 7360 San Francisco, CA 1 1.4193 Marin, CA San Francisco, CA San Mateo, CA 7400 San Jose, CA 1 1.3564 Santa Clara, CA 7440 San Juan-Bayamon, PR 1 0.4690 Aguas Buenas, PR Barceloneta, PR Bayamon, PR Canovanas, PR Carolina, PR Catano, PR Ceiba, PR Comerio, PR Corozal, PR Dorado, PR Fajardo, PR Florida, PR Guaynabo, PR Humacao, PR Juncos, PR Los Piedras, PR Loiza, PR Luguillo, PR Manati, PR Morovis, PR Naguabo, PR Naranjito, PR Rio Grande, PR San Juan, PR Toa Alta, PR Toa Baja, PR Trujillo Alto, PR Vega Alta, PR Vega Baja, PR Yabucoa, PR 7460 San Luis Obispo-Atascadero-Paso Robles, CA 1.0673 San Luis Obispo, CA 7480 Santa Barbara-Santa Maria-Lompoc, CA 1.0597 Santa Barbara, CA 7485 Santa Cruz-Watsonville, CA 1.4095 Santa Cruz, CA 7490 Santa Fe, NM 1.0537 Los Alamos, NM Santa Fe, NM 7500 Santa Rosa, CA 1.2646 Sonoma, CA 7510 Sarasota-Bradenton, FL 0.9809 Manatee, FL Sarasota, FL 7520 Savannah, GA 0.9697 Bryan, GA Chatham, GA Effingham, GA 7560 Scranton-Wilkes-Barre-Hazleton, PA 2 0.8578 Columbia, PA Lackawanna, PA Luzerne, PA Wyoming, PA 7600 Seattle-Bellevue-Everett, WA 1 1.1016 Island, WA King, WA Snohomish, WA 7610 Sharon, PA 2 0.8578 Mercer, PA 7620 Sheboygan, WI 2 0.8880 Sheboygan, WI 7640 Sherman-Denison, TX 0.8795 Grayson, TX 7680 Shreveport-Bossier City, LA 0.8750 Bossier, LA Caddo, LA Webster, LA 7720 Sioux City, IA-NE 0.8473 Woodbury, IA Dakota, NE 7760 Sioux Falls, SD 0.8790 Lincoln, SD Minnehaha, SD 7800 South Bend, IN 1.0029 St. Joseph, IN 7840 Spokane, WA 1.0513 Spokane, WA 7880 Springfield, IL 0.8685 Menard, IL Sangamon, IL 7920 Springfield, MO 0.8488 Christian, MO Greene, MO Webster, MO 8003 Springfield, MA 2 1.1204 Hampden, MA Hampshire, MA 8050 State College, PA 0.9038 Centre, PA 8080 Steubenville-Weirton, OH-WV 2 (OH Hospitals) 0.8670 Jefferson, OH Brooke, WV Hancock, WV 8080 Steubenville-Weirton, OH-WV (WV Hospitals) 0.8548 Jefferson, OH Brooke, WV Hancock, WV 8120 Stockton-Lodi, CA 1.0629 San Joaquin, CA 8140 Sumter, SC 2 0.8370 Sumter, SC 8160 Syracuse, NY 0.9594 Cayuga, NY Madison, NY Onondaga, NY Oswego, NY 8200 Tacoma, WA 1.1564 Pierce, WA 8240 Tallahassee, FL 2 0.8928 Gadsden, FL Leon, FL 8280 Tampa-St. Petersburg-Clearwater, FL 1 0.9099 Hernando, FL Hillsborough, FL Pasco, FL Pinellas, FL 8320 Terre Haute, IN 2 0.8602 Clay, IN Vermillion, IN Vigo, IN 8360 Texarkana, AR-Texarkana, TX 0.8427 Miller, AR Bowie, TX 8400 Toledo, OH 0.9664 Fulton, OH Lucas, OH Wood, OH 8440 Topeka, KS 0.9117 Shawnee, KS 8480 Trenton, NJ 1.0137 Mercer, NJ 8520 Tucson, AZ 0.8821 Pima, AZ 8560 Tulsa, OK 0.8454 Creek, OK Osage, OK Rogers, OK Tulsa, OK Wagoner, OK 8600 Tuscaloosa, AL 0.8064 Tuscaloosa, AL 8640 Tyler, TX 0.9404 Smith, TX 8680 Utica-Rome, NY 0.8560 Herkimer, NY Oneida, NY 8720 Vallejo-Fairfield-Napa, CA 1.2266 Napa, CA Solano, CA 8735 Ventura, CA 1.0479 Ventura, CA 8750 Victoria, TX 0.8154 Victoria, TX 8760 Vineland-Millville-Bridgeton, NJ 1.0501 Cumberland, NJ 8780 Visalia-Tulare-Porterville, CA 2 0.9861 Tulare, CA 8800 Waco, TX 0.8314 McLennan, TX 8840 Washington, DC-MD-VA-WV 1 1.0755 District of Columbia, DC Calvert, MD Charles, MD Frederick, MD Montgomery, MD Prince Georges, MD Alexandria City, VA Arlington, VA Clarke, VA Culpeper, VA Fairfax, VA Fairfax City, VA Falls Church City, VA Fauquier, VA Fredericksburg City, VA King George, VA Loudoun, VA Manassas City, VA Manassas Park City, VA Prince William, VA Spotsylvania, VA Stafford, VA Warren, VA Berkeley, WV Jefferson, WV 8920 Waterloo-Cedar Falls, IA 0.8802 Black Hawk, IA 8940 Wausau, WI 0.9426 Marathon, WI 8960 1 West Palm Beach-Boca Raton, FL 0.9615 Palm Beach, FL 9000 Wheeling, WV-OH 2 (WV Hospitals) 0.8231 Belmont, OH Marshall, WV Ohio, WV 9000 Wheeling, WV-OH 2 (OH Hospitals) 0.8670 Belmont, OH Marshall, WV Ohio, WV 9040 Wichita, KS 0.9544 Butler, KS Harvey, KS Sedgwick, KS 9080 Wichita Falls, TX 0.7668 Archer, TX Wichita, TX 9140 Williamsport, PA 2 0.8578 Lycoming, PA 9160 Wilmington-Newark, DE-MD 1.1191 New Castle, DE Cecil, MD 9200 Wilmington, NC 0.9402 New Hanover, NC Brunswick, NC 9260 Yakima, WA 2 1.0434 Yakima, WA 9270 Yolo, CA 1.0199 Yolo, CA 9280 York, PA 0.9264 York, PA 9320 Youngstown-Warren, OH 0.9543 Columbiana, OH Mahoning, OH Trumbull, OH 9340 Yuba City, CA 1.0706 Sutter, CA Yuba, CA 9360 Yuma, AZ 0.9529 Yuma, AZ 1 Large Urban Area 2 Hospitals geographically located in the area are assigned the statewide rural wage index for FY 2001. Addendum G—Wage Index for Rural Areas Nonurban area DWage index Alabama 0.7528 Alaska 1.2392 Arizona 0.8317 Arkansas 0.7445 California 0.9861 Colorado 0.8968 Connecticut 1.1715 Delaware 0.9074 Florida 0.8928 Georgia 0.8329 Hawaii 1.1059 Idaho 0.8678 Illinois 0.8160 Indiana 0.8602 Iowa 0.8030 Kansas 0.7605 Kentucky 0.7931 Louisiana 0.7713 Maine 0.8766 Maryland 0.8651 Massachusetts 1.1204 Michigan 0.9021 Minnesota 0.8881 Mississippi 0.7491 Missouri 0.7707 Montana 0.8688 Nebraska 0.8109 Nevada 0.9232 New Hampshire 0.9845 New Jersey 1 New Mexico 0.8497 New York 0.8499 North Carolina 0.8441 North Dakota 0.7716 Ohio 0.8670 Oklahoma 0.7491 Oregon 1.0132 Pennsylvania 0.8578 Puerto Rico 0.4264 Rhode Island 1 South Carolina 0.8370 South Dakota 0.7570 Tennessee 0.7838 Texas 0.7507 Utah 0.9037 Vermont 0.9409 Virginia 0.8189 Washington 1.0434 West Virginia 0.8231 Wisconsin 0.8880 Wyoming 0.8817 1 All counties within the State are classified as urban. Addendum H—Wage Index for Hospitals That Are Reclassified Area Wage Index Abilene, TX 0.8240 Akron, OH 0.9736 Alexandria, LA 0.8170 Amarillo, TX 0.8715 Anchorage, AK 1.2865 Ann Arbor, MI 1.1064 Atlanta, GA 1.0096 Atlantic-Cape May, NJ 1.0822 Augusta-Aiken, GA-SC 0.9160 Barnstable-Yarmouth, MA 1.3583 Baton Rouge, LA 0.8734 Benton Harbor, MI 0.9021 Bergen-Passaic, NJ 1.1605 Billings, MT 0.9591 Binghamton, NY 0.8690 Birmingham, AL 0.8477 Bismarck, ND 0.7897 Bloomington-Normal, IL 0.9156 Boise City, ID 0.9042 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (NH, RI, and VT Hospitals) 1.1160 Burlington, VT 1.0236 Casper, WY 0.8817 Champaign-Urbana, IL 0.9084 Charleston-North Charleston, SC 0.9067 Charleston, WV 0.8904 Charlotte-Gastonia-Rock Hill, NC-SC 0.9391 Chattanooga, TN-GA 0.9624 Chicago, IL 1.1015 Cincinnati, OH-KY-IN 0.9415 Clarksville-Hopkinsville, TN-KY 0.8277 Cleveland-Lorain-Elyria, OH 0.9593 Columbia, MO 0.8756 Columbia, SC 0.9433 Columbus, OH 0.9619 Dallas, TX 0.9913 Danville, VA 0.8212 Davenport-Moline-Rock Island, IA-IL 0.8898 Dayton-Springfield, OH 0.9442 Denver, CO 1.0181 Des Moines, IA 0.9011 Dothan, AL 0.8013 Dover, DE 0.9769 Duluth-Superior, MN-WI 1.0043 Eau Claire, WI 0.8880 Erie, PA 0.8985 Eugene-Springfield, OR 1.0965 Fargo-Moorhead, ND-MN 0.8517 Fayetteville, NC 0.8469 Flagstaff, AZ-UT 1.0525 Flint, MI 1.1058 Florence, AL 0.7652 Florence, SC 0.8777 Fort Collins-Loveland, CO 1.0647 Ft. Lauderdale, FL 1.0152 Fort Pierce-Port St. Lucie, FL 0.9622 Fort Smith, AR-OK 0.7947 Fort Walton Beach, FL 0.9358 Fort Wayne, IN 0.8665 Forth Worth-Arlington, TX 0.9527 Gadsden, AL 0.8423 Grand Forks, ND-MN 0.8954 Grand Junction, CO 0.9471 Grand Rapids-Muskegon-Holland, MI 1.0248 Great Falls, MT 0.9330 Greeley, CO 0.9573 Green Bay, WI 0.9308 Greensboro-Winston-Salem-High Point, NC 0.9124 Greenville, NC 0.9172 Greenville-Spartanburg-Anderson, SC 0.9003 Harrisburg-Lebanon-Carlisle, PA 0.9386 Hartford, CT (MA Hospital) 1.1420 Hattiesburg, MS 0.7491 Hickory-Morganton-Lenoir, NC 0.8577 Honolulu, HI 1.1866 Houston, TX 0.9732 Huntington-Ashland, WV-KY-OH 0.9605 Huntsville, AL 0.8779 Indianapolis, IN 0.9787 Jackson, MS 0.8698 Jackson, TN 0.8796 Jacksonville, FL 0.9208 Jersey City, NJ 1.1573 Johnson City-Kingsport-Bristol, TN-VA 0.8328 Joplin, MO 0.8148 Kalamazoo-Battlecreek, MI 1.0291 Kansas City, KS-MO 0.9509 Knoxville, TN 0.8340 Kokomo, IN 0.9525 Lafayette, LA 0.8490 Lansing-East Lansing, MI 0.9934 Las Cruces, NM 0.8510 Las Vegas, NV-AZ 1.0796 Lexington, KY 0.8712 Lima, OH 0.9320 Lincoln, NE 0.9666 Little Rock-North Little Rock, AR 0.8791 Longview-Marshall, TX 0.8732 Los Angeles-Long Beach, CA 1.2033 Louisville, KY-IN 0.9350 Lynchburg, VA 0.8749 Macon, GA 0.8974 Madison, WI 1.0271 Mansfield, OH 0.8690 Memphis, TN-AR-MS 0.8584 Milwaukee-Waukesha, WI 0.9767 Minneapolis-St. Paul, MN-WI 1.1017 Missoula, MT 0.9332 Mobile, AL 0.8163 Monmouth-Ocean, NJ 1.1283 Montgomery, AL 0.7653 Myrtle Beach, SC (NC Hospital) 0.8441 Nashville, TN 0.9301 New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT 1.2034 New London-Norwich, CT 1.1926 New Orleans, LA 0.9295 New York, NY 1.4463 Newburgh, NY-PA 1.0317 Norfolk-Virginia Beach-Newport News, VA-NC 0.8441 Oakland, CA 1.4983 Ocala, FL 0.9243 Odessa-Midland, TX 0.9074 Oklahoma City, OK 0.8822 Omaha, NE-IA 0.9572 Orange County, CA 1.1411 Orlando, FL 0.9610 Peoria-Pekin, IL 0.8646 Philadelphia, PA-NJ 1.0937 Pine Bluff, AR 0.7680 Pittsburgh, PA 0.9575 Pittsfield, MA (VT Hospital) 0.9914 Pocatello, ID 0.8715 Portland, ME 0.9629 Portland-Vancouver, OR-WA 1.0910 Provo-Orem, UT 1.0041 Raleigh-Durham-Chapel Hill, NC 0.9646 Rapid City, SD 0.8865 Redding, CA 1.1664 Reno, NV 1.0438 Richland-Kennewick-Pasco, WA 1.1147 Roanoke, VA 0.8782 Rochester, MN 1.1315 Rockford, IL 0.8819 Sacramento, CA 1.1957 Saginaw-Bay City-Midland, MI 0.9575 St. Cloud, MN 1.0016 St. Joseph, MO 0.8848 St. Louis, MO-IL 0.9049 Salinas, CA 1.4502 Salt Lake City-Ogden, UT 0.9811 San Diego, CA 1.1784 Santa Cruz-Watsonville, CA 1.3897 Santa Fe, NM 1.0000 Santa Rosa, CA 1.2398 Seattle-Bellevue-Everett, WA 1.1016 Sherman-Denison, TX 0.8795 Sioux City, IA-NE 0.8473 South Bend, IN 1.0029 Spokane, WA 1.0333 Springfield, IL 0.8685 Springfield, MO 0.8212 Syracuse, NY 0.9594 Tampa-St. Petersburg-Clearwater, FL 0.9099 Texarkana, AR-Texarkana, TX 0.8427 Toledo, OH 0.9664 Topeka, KS 0.9117 Tucson, AZ 0.8821 Tulsa, OK 0.8454 Tuscaloosa, AL 0.8064 Tyler, TX 0.9141 Victoria, TX 0.8154 Washington, DC-MD-VA-WV 1.0755 Waterloo-Cedar Falls, IA 0.8802 Wausau, WI 0.9426 Wichita, KS 0.9262 Rural Alabama 0.7528 Rural Florida 0.8928 Rural Illinois 0.8160 Rural Louisiana 0.7713 Rural Michigan 0.9021 Rural Minnesota 0.8881 Rural Missouri 0.7707 Rural Montana 0.8688 Rural Oregon 1.0132 Rural Texas 0.7507 Rural Washington 1.0434 Rural West Virginia 0.8231 Rural Wisconsin 0.8880 Rural Wyoming (NE Hospital) 0.8671 [FR Doc. 00-28475 Filed 11-2-00; 11:43 am]
Connectionstraces to 4
10 references not yet in our index
  • 40 CFR 52
  • 50 CFR 17
  • 21 CFR 1313
  • 42 CFR 419
  • Pub. L. 105-33
  • Pub. L. 106-113
  • 42 CFR 412
  • 42 CFR 419.43
  • Pub. L. 96-354
  • Pub. L. 98-21
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U.S.C.§ 804
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U.S.C.§ 1302
Cite40 CFR 52
Cite50 CFR 17
Cite21 CFR 1313
Cite42 CFR 419
Pub. L.Pub. L. 105-33
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