70 FR 165 pgs. 50680-50886 - Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Correction

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Type: PRORULEVolume: 70Number: 165Pages: 50680 - 50886

Docket number: [CMS-1501-CN]

FR document: [FR Doc. 05-16699 Filed 8-18-05; 2:44 pm]

Agency: Health and Human Services Department

Sub Agency: Centers for Medicare Medicaid Services

Official PDF Version: PDF Version

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare Medicaid Services

42 CFR Parts 419 and 485

[CMS-1501-CN]

RIN 0938-AN46

Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Correction

AGENCY:

Centers for Medicare Medicaid Services (CMS), HHS.

ACTION:

Proposed rule; correction.

SUMMARY:

This document corrects technical errors that appeared in the proposed rule published in the Federal Register on July 25, 2005 entitled "Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Proposed Rule."

FOR FURTHER INFORMATION CONTACT:

Rebecca Kane, (410) 786-0378.

SUPPLEMENTARY INFORMATION:

I. Background

FR Doc. 05-14448 contains our proposed rule to update the Medicare Outpatient Prospective Payment System for calendar year (CY) 2006. We have identified a number of technical errors in the "Summary of Errors" section and are correcting them in the "Correction of Errors" section below.

II. Summary of Errors

A. Corrections Related to the Rural Adjustment Calculation

The calendar year (CY) 2006 Outpatient Prospective Payment System (OPPS) proposed rule that we published in the Federal Register on July 25, 2005 included a proposed 6.6 percent adjustment for rural sole community hospitals. The calculations used to develop the conversion factor and budget neutrality scalar inadvertently incorporated this adjustment as 6.4 percent. The rural adjustment is used in calculations that determine the scalar and conversion factor, and therefore affects the payment rates and copayment amounts published in the proposed rule. The corrected scalar is 1.003753831, and the corrected conversion factor is $59.343. The various changes to the preamble are specified under section III. of this correction notice. In addition to preamble text changes, we are correcting specific tables and addenda which also reflected the inadvertent use of a 6.4 percent rural adjustment factor, which we have described below.

On page 42709, we published Table 11. We are correcting the last column of this table to present the corrected proposed CY 2006 payment amounts. In section III. of this notice, we republish Table 11 as corrected.

On pages 42761-42762, we published Table 33. In section III. of this notice, we republish Table 33 as corrected.

On pages 42764-42775, we published Addendum A, which provides the payment rates and copayment amounts for Ambulatory Payment Classification (APC) groups used for payment purposes under the OPPS. A corrected Addendum A is posted on the OPPS Web site at http://www.cms.hhs.gov/providers/hopps/2006p/1501p.asp.

On pages 42776-42965, we published Addendum B, which provides the payment rates and copayment amounts for services payable under OPPS. A corrected Addendum B, including additional technical errors affecting HCPCS codes 78814, 78815, 78816, 91035, and 95950 is posted on the OPPS Web site at http://www.cms.hhs.gov/providers/hopps/2006p/1501p.asp.

We are posting the corrected Addendum A and Addendum B on our Web site rather than publishing them in this notice because of the large volume of data included in these addenda. Hard copies of these tables are available by contacting the CMS staff member identified above.

We note that as soon as we discovered these inadvertent errors that affected the payment rates noted in the proposed rule, we posted the corrections on the CMS Web site at: http://www.cms.hhs.gov/providers/hopps/2006p/1501p.asp.

B. Other Corrections

We also noted other typographical, formatting, and other technical errors in the proposed rule.

On page 42714, we published Table 15. The proposed "unadjusted" and "adjusted" CY 2006 APC median cost for APC 0085 Level II Electrophysiologic Evaluation contained a typographical error and should read $2,123.38. We are correcting this under section III. of this notice.

On page 42761, column 2 includes a comparison that discusses the differences in copayments from CY 2005 to CY 2006. While the analysis of this example is correct, the example incorrectly identifies the comparison as being the "minimum unadjusted copayment" rather than the "national unadjusted copayment". We are making this correction under section III. of this notice to refer to the "national unadjusted copayment".

On page 42737, we published Table 26, which inadvertently excluded C2636 (Brachytherapy linear source, Palladium -103, per 1 mm) which was accurately described in the text of page 42736 as a proposed separately payable brachytherapy source. In section III. of the notice we append the excluded row to correct table 26 as published.

The other technical, typographical, formatting, and other errors that appeared on various other pages of the Federal Register are corrected as noted in section III. of this notice.

III. Correction of Errors

In FR Doc. 05-14448 of July 25, 2005 (70 FR 42674), make the following corrections:

1. On page 42690, in column 3, in the last paragraph, in line 20, the figure "0.999207669" is corrected to read "1.003753831".

2. On page 42691, in column 1, in the second full paragraph, line 8, the year "2006" is corrected to read "2007".

3. On page 42694,

a. In column 1, in the second full paragraph, in line 8, the figure "$240.51" is corrected to read "$241.57".

b. In column 1, in the second full paragraph, in line 8, the figure "$48.10" is corrected to read "$48.31".

c. In column 3, in the third full paragraph, in line 8, the figure "1.002015212" is corrected to read "1.002023412".

d. In column 3, in the third full paragraph, in line 18, the figure "0.99652023" is corrected to read "0.99639633".

e. In column 3, in the last partial paragraph, in line 5, the figure "1.002015212" is corrected to read "1.002023412".

4. On page 42695,

a. In column 1, in the first partial paragraph, in line 5, the figure "0.99652023" is corrected to read "0.99639633".

b. In column 1, in the first partial paragraph, in line 7, the figure "$59.350" is corrected to read "$59.343".

5. On page 42703,

a. In column 1, in the second full paragraph, in line 5, the figure "$9.95" is corrected to read "$7.00".

b. In column 1, in the second full paragraph, in line 5, the figure "40" is corrected to read "28".

c. In column 1, in the second full paragraph, in line 6, the figure "$24.89" is corrected to read "$25.00".

6. On page 42709,

a. In column 1, in the first full paragraph, in line 22, the figure "$1,297" is corrected to read "$1,274".

b. In column 1, in the first full paragraph, in line 23, the figure "$1,366" is corrected to read "$1,244".

c. In column 1, in the first full paragraph, in line 25, the figure "$1,100" is corrected to read "$1,025".

d. Table 11 is corrected to read as follows:

HCPCS	Descriptor	CY 2005 APC	CY 2005 status indicator	Proposed CY 2006 APC	Proposed CY 2006 status indicator	CY 2005 payment amount	Proposed CY 2006 payment amount
0027T	Endoscopic epidural lysis	1547	T	0220	T	$850	$1,030.11
33225	L ventric pacing lead add-on	1525	S	0418	T	3,750	6,486.45
61623	Endovasc tempory vessel occl	1555	T	0081	T	1,650	2,044.21
92974	Cath place, cardio brachytx	1559	T	0103	T	2,250	873.18
93580	Transcath closure of asd	1559	T	0434	T	2,250	5,387.61
93581	Transcath closure of vsd	1559	T	0434	T	2,250	5,387.61
95965	Meg, spontaneous	1528	S	0430	T	5,250	676.75
95966	Meg, evoked, single	1516	S	0430	T	1,450	676.75
95967	Meg, evoked, each add'l	1511	S	0430	T	950	676.75
C9713	Non-contact laser vap prosta	1525	S	0429	T	3,750	2,511.08

7. On page 42710, in column 2, in the first full paragraph, in line 19, the figure "$93.71" is corrected to read "$93.37".

8. On page 42714, Table 15, APC 0085, in columns 5 and 7, in row 7, both occurrences of the figure "$2,123.46" are corrected to read "$2,123.38".

9. On page 42737, Table 26, "Proposed Separately payable Brachytherapy Sources for CY 2006" is appended with the following row:

HCPCS	Long descriptor	APC	APC title	New status indicator
C2636	Brachytherapy linear source, Palladium-103, per 1mm	2636	Brachytx linear source, P-103	H

10. On page 42756, in column 1, in the first partial paragraph, in line 5, the figure "1.8" is corrected to read "1.7".

11. On page 42758, in column 2, in the third full paragraph, in line 13, the figure "$59.35" is corrected to read "$59.34".

12. On page 42759,

a. In column 1, in the first partial paragraph, in line 21, the figure "5.8" is corrected to read "5.6".

b. In column 1, in the first partial paragraph, in line 31, the figure "1.2" is corrected to read "1.3".

c. In column 1, in the first partial paragraph, in line 31, the figure "1.8" is corrected to read "1.7".

d. In column 1, in the first partial paragraph, in line 36, the figure "2.6" is corrected to read "2.5".

e. In column 1, in the second partial paragraph, in line 22, the figure "2.9" is corrected to read "2.7".

f. In column 1, in the second partial paragraph, in line 25, the figure "0.7" is corrected to read "0.6".

g. In column 1, in the second partial paragraph, in line 30, the text "West South Central" is corrected to read "New England".

h. In column 2, in the first partial paragraph, in line 2, the figure "1.9" is corrected to read "1.7".

i. In column 2, in the first partial paragraph, in line 2, the figure "1.8" is corrected to read "1.6".

j. In column 2, in the first full paragraph, in line 4, the figure "0.4" is corrected to read "0.3".

k. In column 2, in the first full paragraph, in line 5, the figure "0.5" is corrected to read "0.3".

l. In column 2, in the first full paragraph, in line 9, the figure "0.9" is corrected to read "1.6".

m. In column 2, in the first full paragraph, in line 10, the figure "1.4" is corrected to read "2.2".

n. In column 2, in the first full paragraph, in line 21, the sentence portion "1.3 percent and voluntary and government hospitals will gain at least 0.1 percent." is corrected to read "1.1 percent, voluntary hospitals would gain 0.2 percent, and government hospitals will see no changes as a result of changes to APC structure."

o. In column 3, in the second full paragraph, in line 7, the figure "0.997" is corrected to read "0.996".

p. In column 3, in the second full paragraph, in line 10, the figure "0.3" is corrected to read "0.4".

q. In column 3, in the second full paragraph, in line 13, the figure "5.2" is corrected to read "5.4".

13. On page 42760,

a. In column 1, in the first partial paragraph, in line 6, the figure "0.3" is corrected to read "0.4".

b. In column 1, in the first full paragraph, in line 19, the figure "5.8" is corrected to read "5.6".

c. In column 1, in the first full paragraph, in line 24, the figure "-2.8" is corrected to read "-2.4".

d. In column 1, in the first full paragraph, in line 32, the figure "1.2" is corrected to read "1.3".

e. In column 1, in the first full paragraph, in line 35, the figure "0.3" is corrected to read "0.4".

f. In column 1, in the first full paragraph, in line 37, the figure "1.5" is corrected to read "1.4".

g. In column 1, in the last paragraph, in line 7, the figure "8.6" is corrected to read "8.7".

h. In column 1, in the third partial paragraph, in line 12, the figure "5.0" is corrected to read "4.7".

i. In column 3, in the first partial paragraph, in line 6, the figure "2.6" is corrected to read "2.5".

j. In column 3, in the first partial paragraph, in line 12, the figure "2.1" is corrected to read "1.8".

k. In column 3, in the first partial paragraph, in line 32, the figure "3.7" is corrected to read "3.6".

l. In column 3, in the first full paragraph, in line 11, the figure "3.4" is corrected to read "3.5".

m. In column 3, in the first full paragraph, in line 13, the figure "6.4" is corrected to read "6.5".

n. In column 3, in the first full paragraph, in line 30, the text "greater than" is corrected to read "of at least".

o. In column 3, in the first full paragraph, in lines 33 and 34, the figure "only 1.0" is corrected to read "1.4" and the text "and 0.8 percent, respectively." is appended to the end of the sentence.

14. On page 42761

a. In column 1, in the first partial paragraph, in line 3, the figure "1.9" is corrected to read "2.6".

b. In column 1, in the first partial paragraph, in line 6, the figure "2.6" is corrected to read "3.4".

c. In column 1, in the first partial paragraph, in line 11, the figure "0.8" is corrected to read "0.6".

d. In column 1, in line 12, the designation for the heading "Estimated Impacts of This Proposed Rule on Beneficiaries" is corrected from "G" to read "F".

e. In column 1, in the second partial paragraph, in line 12, the figure "$11.86" is corrected to read "$11.91".

f. In column 2, in the first partial paragraph, in lines 4 and 6, the term "minimum" is corrected to read "national".

g. In column 2, in the first partial paragraph, in line 8, the figure "$223.91" is corrected to read "$224.91".

h. Table 33 is corrected to read as follows:

Hospital category	Number of hospitals	APC changes	New wage index	New adj for rural sole community hospitals	Cumulative (Cols 2,3,4) with market basket update	All changes
	(1)	(2)	(3)	(4)	(5)	(6)
ALL HOSPITALS	4212	0.0	0.0	0.0	3.2	1.9
URBAN HOSPITALS	2949	0.0	0.0	-0.4	2.8	1.6
LARGE URBAN	1624	-0.8	0.0	-0.4	2.0	0.8
OTHER URBAN	1325	1.0	0.0	-0.4	3.8	2.5
RURAL HOSPITALS	1263	-0.1	0.1	1.8	5.0	3.5
SOLE COMMUNITY	478	-0.1	0.0	5.4	8.7	6.5
OTHER RURAL	785	-0.1	0.1	-0.4	2.8	1.6
BEDS (URBAN):
0-99 BEDS	917	0.0	0.2	-0.4	3.0	2.1
100-199 BEDS	964	-0.4	0.0	-0.4	2.5	1.5
200-299 BEDS	503	0.2	0.1	-0.4	3.2	2.4
300-499 BEDS	402	-0.1	-0.1	-0.4	2.6	1.5
500 + BEDS	163	0.3	0.0	-0.4	3.1	1.0
BEDS (RURAL):
0-49 BEDS	551	-0.9	0.2	2.1	4.6	3.1
50-100 BEDS	419	-0.8	0.2	2.3	4.8	3.0
101-149 BEDS	180	1.4	0.0	1.1	5.8	4.7
150-199 BEDS	62	-0.2	-0.2	1.8	4.7	3.7
200 + BEDS	51	0.1	0.0	1.7	5.1	3.1
VOLUME (URBAN):
LT 5,000 claim lines	600	-5.6	0.5	-0.4	-2.4	-1.8
5,000-10,999	180	-2.4	0.2	-0.4	0.5	0.6
11,000-20,999	299	-0.6	0.2	-0.4	2.4	2.5
21,000-42,999	575	-0.6	0.1	-0.4	2.3	1.9
GT 42,999	1295	0.2	0.0	-0.4	3.0	1.6
VOLUME (RURAL):
LT 5,000 claim lines	119	-2.7	0.0	1.4	1.7	1.4
5,000-10,999	195	-1.9	0.0	2.1	3.4	2.4
11,000-20,999	325	-0.9	-0.1	2.0	4.3	3.4
21,000-42,999	364	-0.9	0.2	1.9	4.5	3.0
GT 42,999	260	0.6	0.0	1.7	5.7	3.8
REGION (URBAN):
NEW ENGLAND	166	-1.3	-0.1	-0.4	1.4	-0.2
MIDDLE ATLANTIC	393	0.6	-0.1	-0.4	3.4	2.1
SOUTH ATLANTIC	453	-0.4	-0.4	-0.4	2.0	1.0
EAST NORTH CENT	466	0.4	-0.1	-0.4	3.2	1.7
EAST SOUTH CENT	197	1.5	0.0	-0.4	4.4	3.4
WEST NORTH CENT	184	2.5	-0.3	-0.4	5.1	3.6
WEST SOUTH CENT	445	-0.3	-0.1	-0.4	2.5	1.3
MOUNTAIN	163	-0.1	-0.2	-0.4	2.5	1.3
PACIFIC	431	-1.7	1.1	-0.4	2.2	1.4
PUERTO RICO	51	0.4	-0.3	-0.4	2.9	2.2
REGION (RURAL):
NEW ENGLAND	37	-1.1	0.9	1.2	4.2	0.8
MIDDLE ATLANTIC	78	1.7	-0.4	1.4	6.0	4.1
SOUTH ATLANTIC	189	-0.4	-0.2	1.7	4.4	3.3
EAST NORTH CENT	171	-0.6	0.1	1.4	4.1	2.2
EAST SOUTH CENT	202	-0.7	0.5	0.5	3.5	3.0
WEST NORTH CENT	188	1.6	-0.3	2.6	7.2	4.7
WEST SOUTH CENT	242	-0.9	-0.2	2.2	4.4	3.7
MOUNTAIN	95	-1.0	0.1	4.6	7.0	5.2
PACIFIC	61	-0.7	1.8	2.7	7.2	5.3
TEACHING STATUS:
NON-TEACHING	3115	-0.3	0.1	0.3	3.2	2.3
MINOR	769	0.3	0.0	-0.2	3.3	2.3
MAJOR	328	0.3	-0.2	-0.3	3.0	0.6
DSH PATIENT PERCENT:
0	16	0.3	0.0	-0.4	3.1	3.1
GT 0-0.10	386	0.1	-0.2	-0.3	2.8	1.7
0.10-0.16	555	0.0	0.1	0.2	3.5	2.4
0.16-0.23	802	0.1	0.0	0.1	3.5	2.3
0.23-0.35	977	0.1	-0.1	0.0	3.2	1.9
GE 0.35	792	-0.3	0.1	-0.1	3.0	1.8
TEFRA: DSH NOT AVAIL 1	684	-1.6	0.0	-0.4	1.2	-2.6
URBAN TEACHING/DSH:
TEACHING DSH	944	0.4	-0.1	-0.4	3.1	1.7
NO TEACHING/DSH	1401	-0.3	0.1	-0.4	2.5	1.8
NO TEACHING/NO DSH	16	0.3	0.0	-0.4	3.1	3.1
TEFRA: DSH NOT AVAIL 1	588	-2.2	0.1	-0.4	0.7	-3.4
TYPE OF OWNERSHIP:
VOLUNTARY	2397	0.2	0.0	0.0	3.3	2.0
PROPRIETARY	1091	-1.1	0.0	0.0	2.1	1.6
GOVERNMENT	724	0.0	0.1	0.2	3.6	1.7
Col (1) Total Hospitals in 2006.
Col (2) This column shows the impact of changes resulting from the reclassification of HCPCS codes among APC groups and from the addition of multiple procedure discounting for radiology procedures (budget neutral overall).
Col (3) This column shows the adjustment for updating the wage index (budget neutral overall).
Col (4) This column shows the adjustment for rural sole community hospitals (budget neutral overall).
Col (5) This column shows the cumulative impact of cols 2 through 4 and the addition of the market basket update.
Col (6) The column shows the impact of the change in MMA dollars in 2006 (drugs and 508) and outlier changes.
1 Complete DSH numbers are not available for hospitals that are not paid under IPPS.

15. On pages 42764-42775, Addendum A is corrected to read as follows:

APC	Group title	SI	Relative weight	Payment rate	National unadjusted copayment	Minimum unadjusted copayment
0001	Level I Photochemotherapy	S	0.4213	$25.00	$7.00	$5.00
0002	Level I Fine Needle Biopsy/Aspiration	T	0.9559	$56.73		$11.35
0003	Bone Marrow Biopsy/Aspiration	T	2.6530	$157.44		$31.49
0004	Level I Needle Biopsy/ Aspiration Except Bone Marrow	T	1.7646	$104.72	$22.36	$20.94
0005	Level II Needle Biopsy/Aspiration Except Bone Marrow	T	3.5994	$213.60	$71.59	$42.72
0006	Level I Incision Drainage	T	1.5500	$91.98	$22.28	$18.40
0007	Level II Incision Drainage	T	11.4501	$679.48		$135.90
0008	Level III Incision and Drainage	T	16.4989	$979.09		$195.82
0009	Nail Procedures	T	0.6680	$39.64	$8.34	$7.93
0010	Level I Destruction of Lesion	T	0.5719	$33.94	$9.65	$6.79
0011	Level II Destruction of Lesion	T	2.0839	$123.66	$25.17	$24.73
0012	Level I Debridement Destruction	T	0.8497	$50.42	$11.18	$10.08
0013	Level II Debridement Destruction	T	1.1078	$65.74	$14.20	$13.15
0015	Level III Debridement Destruction	T	1.6514	$98.00	$20.29	$19.60
0016	Level IV Debridement Destruction	T	2.5834	$153.31	$33.57	$30.66
0017	Level VI Debridement Destruction	T	18.4211	$1,093.16	$227.84	$218.63
0018	Biopsy of Skin/Puncture of Lesion	T	1.1726	$69.59	$16.04	$13.92
0019	Level I Excision/ Biopsy	T	4.0547	$240.62	$71.87	$48.12
0020	Level II Excision/ Biopsy	T	6.9433	$412.04	$107.40	$82.41
0021	Level III Excision/ Biopsy	T	14.9776	$888.82	$219.48	$177.76
0022	Level IV Excision/ Biopsy	T	19.6472	$1,165.92	$354.45	$233.18
0023	Exploration Penetrating Wound	T	4.7775	$283.51		$56.70
0024	Level I Skin Repair	T	1.6084	$95.45	$31.25	$19.09
0025	Level II Skin Repair	T	5.4938	$326.02	$101.85	$65.20
0027	Level IV Skin Repair	T	18.4182	$1,092.99	$329.72	$218.60
0028	Level I Breast Surgery	T	19.5801	$1,161.94	$303.74	$232.39
0029	Level II Breast Surgery	T	32.0476	$1,901.80	$632.64	$380.36
0030	Level III Breast Surgery	T	40.0825	$2,378.62	$763.55	$475.72
0033	Partial Hospitalization	P	4.0708	$241.57		$48.31
0035	Venous Cutdown	T	0.7158	$42.48		$8.50
0036	Level II Fine Needle Biopsy/Aspiration	T	2.1773	$129.21		$25.84
0037	Level IV Needle Biopsy/Aspiration Except Bone Marrow	T	9.4751	$562.28	$224.91	$112.46
0039	Level I Implantation of Neurostimulator	S	181.4000	$10,764.82		$2,152.96
0040	Level I Implantation of Neurostimulator Electrodes	S	55.3297	$3,283.43		$656.69
0041	Level I Arthroscopy	T	28.1318	$1,669.43		$333.89
0042	Level II Arthroscopy	T	43.9753	$2,609.63	$804.74	$521.93
0043	Closed Treatment Fracture Finger/Toe/Trunk	T	1.7694	$105.00		$21.00
0045	Bone/Joint Manipulation Under Anesthesia	T	14.4945	$860.15	$268.47	$172.03
0046	Open/Percutaneous Treatment Fracture or Dislocation	T	37.7023	$2,237.37	$535.76	$447.47
0047	Arthroplasty without Prosthesis	T	31.6107	$1,875.87	$537.03	$375.17
0048	Level I Arthroplasty with Prosthesis	T	43.1288	$2,559.39	$570.30	$511.88
0049	Level I Musculoskeletal Procedures Except Hand and Foot	T	20.3707	$1,208.86		$241.77
0050	Level II Musculoskeletal Procedures Except Hand and Foot	T	23.9081	$1,418.78		$283.76
0051	Level III Musculoskeletal Procedures Except Hand and Foot	T	36.5271	$2,167.63		$433.53
0052	Level IV Musculoskeletal Procedures Except Hand and Foot	T	43.9378	$2,607.40		$521.48
0053	Level I Hand Musculoskeletal Procedures	T	15.6795	$930.47	$253.49	$186.09
0054	Level II Hand Musculoskeletal Procedures	T	25.3711	$1,505.60		$301.12
0055	Level I Foot Musculoskeletal Procedures	T	20.0692	$1,190.97	$355.34	$238.19
0056	Level II Foot Musculoskeletal Procedures	T	40.2957	$2,391.27		$478.25
0057	Bunion Procedures	T	27.5493	$1,634.86	$475.91	$326.97
0058	Level I Strapping and Cast Application	S	1.0934	$64.89		$12.98
0060	Manipulation Therapy	S	0.4935	$29.29		$5.86
0068	CPAP Initiation	S	1.2293	$72.95	$29.18	$14.59
0069	Thoracoscopy	T	30.6775	$1,820.49	$591.64	$364.10
0070	Thoracentesis/Lavage Procedures	T	3.2101	$190.50		$38.10
0071	Level I Endoscopy Upper Airway	T	0.7915	$46.97	$11.31	$9.39
0072	Level II Endoscopy Upper Airway	T	1.4361	$85.22	$21.27	$17.04
0074	Level IV Endoscopy Upper Airway	T	15.7757	$936.18	$295.70	$187.24
0075	Level V Endoscopy Upper Airway	T	21.3426	$1,266.53	$445.92	$253.31
0076	Level I Endoscopy Lower Airway	T	9.4592	$561.34	$189.82	$112.27
0077	Level I Pulmonary Treatment	S	0.3444	$20.44	$7.74	$4.09
0078	Level II Pulmonary Treatment	S	1.0236	$60.74	$14.55	$12.15
0079	Ventilation Initiation and Management	S	2.3482	$139.35		$27.87
0080	Diagnostic Cardiac Catheterization	T	37.1361	$2,203.77	$838.92	$440.75
0081	Non-Coronary Angioplasty or Atherectomy	T	34.4473	$2,044.21		$408.84
0082	Coronary Atherectomy	T	85.0126	$5,044.90	$1,085.20	$1,008.98
0083	Coronary Angioplasty and Percutaneous Valvuloplasty	T	50.8925	$3,020.11		$604.02
0084	Level I Electrophysiologic Evaluation	S	10.0205	$594.65		$118.93
0085	Level II Electrophysiologic Evaluation	T	35.1882	$2,088.17	$426.25	$417.63
0086	Ablate Heart Dysrhythm Focus	T	44.2596	$2,626.50	$833.33	$525.30
0087	Cardiac Electrophysiologic Recording/Mapping	T	30.7101	$1,822.43		$364.49
0088	Thrombectomy	T	36.5617	$2,169.68	$655.22	$433.94
0089	Insertion/Replacement of Permanent Pacemaker and Electrodes	T	105.6143	$6,267.47	$1,682.28	$1,253.49
0090	Insertion/Replacement of Pacemaker Pulse Generator	T	89.1574	$5,290.87	$1,612.80	$1,058.17
0091	Level II Vascular Ligation	T	28.9999	$1,720.94	$348.23	$344.19
0092	Level I Vascular Ligation	T	23.4516	$1,391.69		$278.34
0093	Vascular Reconstruction/Fistula Repair without Device
0094	Level I Resuscitation and Cardioversion	S	2.5363	$150.51	$47.62	$30.10
0095	Cardiac Rehabilitation	S	0.5885	$34.92	$13.96	$6.98
0096	Non-Invasive Vascular Studies	S	1.6307	$96.77	$38.70	$19.35
0097	Cardiac and Ambulatory Blood Pressure Monitoring	X	1.0223	$60.67	$23.79	$12.13
0098	Injection of Sclerosing Solution	T	1.1346	$67.33		$13.47
0099	Electrocardiograms	S	0.3821	$22.67		$4.53
0100	Cardiac Stress Tests	X	2.4968	$148.17	$41.44	$29.63
0101	Tilt Table Evaluation	S	4.2787	$253.91	$101.56	$50.78
0103	Miscellaneous Vascular Procedures	T	14.7142	$873.18	$223.63	$174.64
0104	Transcatheter Placement of Intracoronary Stents	T	79.0094	$4,688.65		$937.73
0105	Revision/Removal of Pacemakers, AICD, or Vascular	T	22.3685	$1,327.41	$370.40	$265.48
0106	Insertion/Replacement/Repair of Pacemaker and/or Electrodes	T	45.4851	$2,699.22		$539.84
0107	Insertion of Cardioverter-Defibrillator	T	260.0295	$15,430.93	$3,103.22	$3,086.19
0108	Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads	T	349.1681	$20,720.68		$4,144.14
0109	Removal of Implanted Devices	T	11.0433	$655.34	$131.49	$131.07
0110	Transfusion	S	3.6594	$217.16		$43.43
0111	Blood Product Exchange	S	12.3956	$735.59	$200.18	$147.12
0112	Apheresis, Photopheresis, and Plasmapheresis	S	26.7948	$1,590.08	$438.94	$318.02
0113	Excision Lymphatic System	T	21.4653	$1,273.82		$254.76
0114	Thyroid/Lymphadenectomy Procedures	T	40.7652	$2,419.13	$485.91	$483.83
0115	Cannula/Access Device Procedures	T	31.4727	$1,867.68	$459.35	$373.54
0116	Chemotherapy Administration by Other Technique Except Infusion	S	1.1453	$67.97		$13.59
0117	Chemotherapy Administration by Infusion Only	S	3.2378	$192.14	$42.54	$38.43
0120	Infusion Therapy Except Chemotherapy	S	2.0193	$119.83	$28.21	$23.97
0121	Level I Tube changes and Repositioning	T	2.2766	$135.10	$43.80	$27.02
0122	Level II Tube changes and Repositioning	T	6.9721	$413.75	$84.85	$82.75
0123	Bone Marrow Harvesting and Bone Marrow/Stem Cell Transplant	S	22.9902	$1,364.31		$272.86
0125	Refilling of Infusion Pump	T	1.9331	$114.72		$22.94
0130	Level I Laparoscopy	T	31.9271	$1,894.65	$659.53	$378.93
0131	Level II Laparoscopy	T	43.3389	$2,571.86	$1,001.89	$514.37
0132	Level III Laparoscopy	T	62.9914	$3,738.10	$1,239.22	$747.62
0140	Esophageal Dilation without Endoscopy	T	5.4737	$324.83	$94.18	$64.97
0141	Level I Upper GI Procedures	T	8.1835	$485.63	$143.38	$97.13
0142	Small Intestine Endoscopy	T	9.3487	$554.78	$152.78	$110.96
0143	Lower GI Endoscopy	T	8.6869	$515.51	$186.06	$103.10
0146	Level I Sigmoidoscopy and Anoscopy	T	4.6374	$275.20	$64.40	$55.04
0147	Level II Sigmoidoscopy and Anoscopy	T	7.9679	$472.84		$94.57
0148	Level I Anal/Rectal Procedures	T	3.7383	$221.84	$57.21	$44.37
0149	Level III Anal/Rectal Procedures	T	18.0726	$1,072.48	$293.06	$214.50
0150	Level IV Anal/Rectal Procedures	T	23.8654	$1,416.24	$437.12	$283.25
0151	Endoscopic Retrograde Cholangio-Pancreatography (ERCP)	T	18.7338	$1,111.72	$245.46	$222.34
0152	Level I Percutaneous Abdominal and Biliary Procedures	T	12.2833	$728.93		$145.79
0153	Peritoneal and Abdominal Procedures	T	21.6961	$1,287.51	$382.75	$257.50
0154	Hernia/Hydrocele Procedures	T	28.7847	$1,708.17	$464.85	$341.63
0155	Level II Anal/Rectal Procedures	T	16.2546	$964.60		$192.92
0156	Level II Urinary and Anal Procedures	T	2.5751	$152.81	$40.52	$30.56
0157	Colorectal Cancer Screening: Barium Enema	S	2.2904	$135.92		$27.18
0158	Colorectal Cancer Screening: Colonoscopy	T	7.6588	$454.50		$113.63
0159	Colorectal Cancer Screening: Flexible Sigmoidoscopy	S	3.1455	$186.66		$46.67
0160	Level I Cystourethroscopy and other Genitourinary Procedures	T	6.6753	$396.13	$105.06	$79.23
0161	Level II Cystourethroscopy and other Genitourinary Procedures	T	18.5576	$1,101.26	$249.36	$220.25
0162	Level III Cystourethroscopy and other Genitourinary Procedures	T	23.3918	$1,388.14		$277.63
0163	Level IV Cystourethroscopy and other Genitourinary Procedures	T	33.7354	$2,001.96		$400.39
0164	Level I Urinary and Anal Procedures	T	1.1855	$70.35	$17.29	$14.07
0165	Level III Urinary and Anal Procedures	T	16.6689	$989.18		$197.84
0166	Level I Urethral Procedures	T	17.6743	$1,048.85	$218.73	$209.77
0168	Level II Urethral Procedures	T	28.2685	$1,677.54	$388.03	$335.51
0169	Lithotripsy	T	43.0133	$2,552.54	$1,021.01	$510.51
0170	Dialysis	S	5.8994	$350.09		$70.02
0180	Circumcision	T	19.8827	$1,179.90	$304.87	$235.98
0181	Penile Procedures	T	30.8663	$1,831.70	$621.82	$366.34
0183	Testes/Epididymis Procedures	T	23.6415	$1,402.96		$280.59
0184	Prostate Biopsy	T	4.3566	$258.53	$96.27	$51.71
0188	Level II Female Reproductive Proc	T	1.1400	$67.65		$13.53
0189	Level III Female Reproductive Proc	T	2.3710	$140.70		$28.14
0190	Level I Hysteroscopy	T	21.0653	$1,250.08	$424.28	$250.02
0191	Level I Female Reproductive Proc	T	0.1670	$9.91	$2.78	$1.98
0192	Level IV Female Reproductive Proc	T	4.3082	$255.66		$51.13
0193	Level V Female Reproductive Proc	T	14.5843	$865.48		$173.10
0194	Level VIII Female Reproductive Proc	T	20.7525	$1,231.52	$397.84	$246.30
0195	Level IX Female Reproductive Proc	T	26.6791	$1,583.22	$483.80	$316.64
0196	Dilation and Curettage	T	17.0974	$1,014.61	$338.23	$202.92
0197	Infertility Procedures	T	2.3572	$139.88		$27.98
0198	Pregnancy and Neonatal Care Procedures	T	1.3683	$81.20	$32.19	$16.24
0200	Level VII Female Reproductive Proc	T	17.8728	$1,060.63	$263.69	$212.13
0201	Level VI Female Reproductive Proc	T	17.6047	$1,044.72	$329.65	$208.94
0202	Level X Female Reproductive Proc	T	40.3866	$2,396.66	$958.66	$479.33
0203	Level IV Nerve Injections	T	10.4015	$617.26	$246.90	$123.45
0204	Level I Nerve Injections	T	2.1910	$130.02	$40.13	$26.00
0206	Level II Nerve Injections	T	5.4920	$325.91	$75.55	$65.18
0207	Level III Nerve Injections	T	6.0109	$356.70	$86.92	$71.34
0208	Laminotomies and Laminectomies	T	42.3409	$2,512.64		$502.53
0209	Extended EEG Studies and Sleep Studies, Level II	S	11.5713	$686.68	$274.67	$137.34
0212	Nervous System Injections	T	2.9740	$176.49	$70.59	$35.30
0213	Extended EEG Studies and Sleep Studies, Level I	S	2.2932	$136.09	$54.43	$27.22
0214	Electroencephalogram	S	1.1353	$67.37	$26.94	$13.47
0215	Level I Nerve and Muscle Tests	S	0.6115	$36.29	$14.51	$7.26
0216	Level III Nerve and Muscle Tests	S	2.6720	$158.56		$31.71
0218	Level II Nerve and Muscle Tests	S	1.1408	$67.70		$13.54
0220	Level I Nerve Procedures	T	17.3586	$1,030.11		$206.02
0221	Level II Nerve Procedures	T	29.9209	$1,775.60	$463.62	$355.12
0222	Implantation of Neurological Device	T	179.0982	$10,628.22		$2,125.64
0223	Implantation or Revision of Pain Management Catheter	T	28.1230	$1,668.90		$333.78
0224	Implantation of Reservoir/Pump/Shunt	T	40.6455	$2,412.03		$482.41
0225	Level II Implantation of Neurostimulator Electrodes	S	234.6925	$13,927.36		$2,785.47
0226	Implantation of Drug Infusion Reservoir	T	138.8695	$8,240.93		$1,648.19
0227	Implantation of Drug Infusion Device	T	136.4922	$8,099.86		$1,619.97
0228	Creation of Lumbar Subarachnoid Shunt	T	51.7258	$3,069.56		$613.91
0229	Transcatherter Placement of Intravascular Shunts	T	64.4545	$3,824.92	$771.23	$764.98
0230	Level I Eye Tests Treatments	S	0.7858	$46.63	$14.97	$9.33
0231	Level III Eye Tests Treatments	S	1.9278	$114.40	$44.61	$22.88
0232	Level I Anterior Segment Eye Procedures	T	6.6732	$396.01	$103.17	$79.20
0233	Level II Anterior Segment Eye Procedures	T	14.9673	$888.20	$266.33	$177.64
0234	Level III Anterior Segment Eye Procedures	T	21.9741	$1,304.01	$511.31	$260.80
0235	Level I Posterior Segment Eye Procedures	T	4.6593	$276.50	$67.40	$55.30
0236	Level II Posterior Segment Eye Procedures	T	17.0229	$1,010.19		$202.04
0237	Level III Posterior Segment Eye Procedures	T	28.9401	$1,717.39		$343.48
0238	Level I Repair and Plastic Eye Procedures	T	2.5933	$153.89		$30.78
0239	Level II Repair and Plastic Eye Procedures	T	6.9097	$410.04		$82.01
0240	Level III Repair and Plastic Eye Procedures	T	18.1508	$1,077.12	$315.31	$215.42
0241	Level IV Repair and Plastic Eye Procedures	T	23.3036	$1,382.91	$384.47	$276.58
0242	Level V Repair and Plastic Eye Procedures	T	30.5464	$1,812.72	$597.36	$362.54
0243	Strabismus/Muscle Procedures	T	22.1671	$1,315.46	$431.39	$263.09
0244	Corneal Transplant	T	38.3723	$2,277.13	$803.26	$455.43
0245	Level I Cataract Procedures without IOL Insert	T	13.3625	$792.97	$221.89	$158.59
0246	Cataract Procedures with IOL Insert	T	23.4597	$1,392.17	$495.96	$278.43
0247	Laser Eye Procedures Except Retinal	T	5.0330	$298.67	$104.31	$59.73
0248	Laser Retinal Procedures	T	4.6769	$277.54	$93.98	$55.51
0249	Level II Cataract Procedures without IOL Insert	T	27.9369	$1,657.86	$524.67	$331.57
0250	Nasal Cauterization/Packing	T	1.2896	$76.53	$26.79	$15.31
0251	Level I ENT Procedures	T	2.0101	$119.29		$23.86
0252	Level II ENT Procedures	T	7.8673	$466.87	$113.41	$93.37
0253	Level III ENT Procedures	T	16.1357	$957.54	$282.29	$191.51
0254	Level IV ENT Procedures	T	23.4040	$1,388.86	$321.35	$277.77
0256	Level V ENT Procedures	T	37.3204	$2,214.70		$442.94
0258	Tonsil and Adenoid Procedures	T	22.2466	$1,320.18	$437.25	$264.04
0259	Level VI ENT Procedures	T	366.3317	$21,739.22	$8,070.21	$4,347.84
0260	Level I Plain Film Except Teeth	X	0.7555	$44.83	$17.93	$8.97
0261	Level II Plain Film Except Teeth Including Bone Density Measurement	X	1.2901	$76.56		$15.31
0262	Plain Film of Teeth	X	0.9228	$54.76		$10.95
0263	Level I Miscellaneous Radiology Procedures	X	1.7476	$103.71	$24.40	$20.74
0264	Level II Miscellaneous Radiology Procedures	X	3.5240	$209.12	$79.41	$41.82
0265	Level I Diagnostic Ultrasound	S	1.0213	$60.61	$24.24	$12.12
0266	Level II Diagnostic Ultrasound	S	1.6393	$97.28	$38.91	$19.46
0267	Level III Diagnostic Ultrasound	S	2.6327	$156.23	$62.18	$31.25
0268	Ultrasound Guidance Procedures	S	1.0610	$62.96		$12.59
0269	Level III Echocardiogram Except Transesophageal	S	3.2437	$192.49	$76.99	$38.50
0270	Transesophageal Echocardiogram	S	6.0192	$357.20	$142.88	$71.44
0272	Level I Fluoroscopy	X	1.3801	$81.90	$32.76	$16.38
0274	Myelography	S	3.0413	$180.48	$72.19	$36.10
0275	Arthrography	S	3.5779	$212.32	$69.09	$42.46
0276	Level I Digestive Radiology	S	1.5319	$90.91	$36.36	$18.18
0277	Level II Digestive Radiology	S	2.3852	$141.54	$56.61	$28.31
0278	Diagnostic Urography	S	2.6434	$156.87	$62.74	$31.37
0279	Level II Angiography and Venography except Extremity	S	8.9319	$530.05	$150.03	$106.01
0280	Level III Angiography and Venography except Extremity	S	20.7902	$1,233.75	$353.85	$246.75
0282	Miscellaneous Computerized Axial Tomography	S	1.6542	$98.17	$39.26	$19.63
0283	Computerized Axial Tomography with Contrast Material	S	4.4253	$262.61	$105.04	$52.52
0284	Magnetic Resonance Imaging and Magnetic Resonance Angiography with Contras	S	6.4201	$380.99	$152.39	$76.20
0285	Myocardial Positron Emission Tomography (PET)	S	17.1798	$1,019.50	$318.72	$203.90
0288	Bone Density: Axial Skeleton	S	1.2568	$74.58		$14.92
0296	Level I Therapeutic Radiologic Procedures	S	2.2452	$133.24	$53.29	$26.65
0297	Level II Therapeutic Radiologic Procedures	S	5.2530	$311.73	$122.13	$62.35
0299	Miscellaneous Radiation Treatment	S	5.8482	$347.05		$69.41
0300	Level I Radiation Therapy	S	1.5198	$90.19		$18.04
0301	Level II Radiation Therapy	S	2.2195	$131.71		$26.34
0302	Level III Radiation Therapy	S	4.6145	$273.84	$103.74	$54.77
0303	Treatment Device Construction	X	2.8356	$168.27	$66.95	$33.65
0304	Level I Therapeutic Radiation Treatment Preparation	X	1.7738	$105.26	$41.52	$21.05
0305	Level II Therapeutic Radiation Treatment Preparation	X	4.0036	$237.59	$91.38	$47.52
0310	Level III Therapeutic Radiation Treatment Preparation	X	13.9490	$827.78	$325.27	$165.56
0312	Radioelement Applications	S	5.0032	$296.90		$59.38
0313	Brachytherapy	S	12.8655	$763.48		$152.70
0314	Hyperthermic Therapies	S	5.9945	$355.73	$98.36	$71.15
0315	Level II Implantation of Neurostimulator	T	290.6470	$17,247.86		$3,449.57
0320	Electroconvulsive Therapy	S	5.3765	$319.06	$80.06	$63.81
0321	Biofeedback and Other Training	S	1.3579	$80.58	$21.71	$16.12
0322	Brief Individual Psychotherapy	S	1.2319	$73.10		$14.62
0323	Extended Individual Psychotherapy	S	1.6227	$96.30	$20.08	$19.26
0324	Family Psychotherapy	S	2.0997	$124.60		$24.92
0325	Group Psychotherapy	S	1.3189	$78.27	$17.10	$15.65
0330	Dental Procedures	S	7.1756	$425.82		$85.16
0332	Computerized Axial Tomography and Computerized Angiography without Contras	S	3.2694	$194.02	$77.60	$38.80
0333	Computerized Axial Tomography and Computerized Angio w/o Contrast Material	S	5.2836	$313.54	$125.41	$62.71
0335	Magnetic Resonance Imaging, Miscellaneous	S	5.1581	$306.10	$122.43	$61.22
0336	Magnetic Resonance Imaging and Magnetic Resonance Angiography without Cont	S	6.0742	$360.46	$144.18	$72.09
0337	MRI and Magnetic Resonance Angiography without Contrast Material followed	S	8.7945	$521.89	$208.75	$104.38
0339	Observation	S	7.1403	$423.73		$84.75
0340	Minor Ancillary Procedures	X	0.6384	$37.88		$7.58
0341	Skin Tests	X	0.1112	$6.60	$2.62	$1.32
0342	Level I Pathology	X	0.1560	$9.26	$3.70	$1.85
0343	Level III Pathology	X	0.4786	$28.40	$11.10	$5.68
0344	Level IV Pathology	X	0.7996	$47.45	$15.66	$9.49
0345	Level I Transfusion Laboratory Procedures	X	0.2277	$13.51	$3.01	$2.70
0346	Level II Transfusion Laboratory Procedures	X	0.3434	$20.38	$4.54	$4.08
0347	Level III Transfusion Laboratory Procedures	X	0.8434	$50.05	$12.35	$10.01
0348	Fertility Laboratory Procedures	X	0.7927	$47.04		$9.41
0350	Administration of flu and PPV vaccines	X	0.3954	$23.46	$0.00	$0.00
0352	Level I Injections	X	0.1413	$8.39		$1.68
0353	Level II Injections	X	0.3954	$23.46		$4.69
0359	Level III Injections	X	0.8312	$49.33		$9.87
0360	Level I Alimentary Tests	X	1.4739	$87.47	$34.98	$17.49
0361	Level II Alimentary Tests	X	3.6216	$214.92	$83.23	$42.98
0362	Contact Lens and Spectacle Services	X	2.6607	$157.89		$31.58
0363	Level I Otorhinolaryngologic Function Tests	X	0.9128	$54.17	$17.44	$10.83
0364	Level I Audiometry	X	0.4708	$27.94	$9.06	$5.59
0365	Level II Audiometry	X	1.2356	$73.32	$18.95	$14.66
0366	Level III Audiometry	X	1.7743	$105.29	$30.04	$21.06
0367	Level I Pulmonary Test	X	0.6659	$39.52	$14.80	$7.90
0368	Level II Pulmonary Tests	X	0.9761	$57.92	$23.16	$11.58
0369	Level III Pulmonary Tests	X	2.7519	$163.31	$44.18	$32.66
0370	Allergy Tests	X	1.1232	$66.65		$13.33
0372	Therapeutic Phlebotomy	X	0.5700	$33.83	$10.09	$6.77
0373	Neuropsychological Testing	X	2.1926	$130.12		$26.02
0374	Monitoring Psychiatric Drugs	X	1.0414	$61.80		$12.36
0375	Ancillary Outpatient Services When Patient Expires	T	42.5900	$2,527.42		$505.48
0376	Level II Cardiac Imaging	S	5.1975	$308.44	$121.42	$61.69
0377	Level III Cardiac Imaging	S	6.8344	$405.57	$162.22	$81.11
0378	Level II Pulmonary Imaging	S	5.4997	$326.37	$130.54	$65.27
0379	Injection adenosine	K		$33.45		$6.69
0381	Single Allergy Tests	X	0.1884	$11.18	$2.35	$2.24
0384	GI Procedures with Stents	T	22.3392	$1,325.68	$287.93	$265.14
0385	Level I Prosthetic Urological Procedures	S	75.6446	$4,488.98		$897.80
0386	Level II Prosthetic Urological Procedures	S	120.1694	$7,131.21		$1,426.24
0387	Level II Hysteroscopy	T	32.5445	$1,931.29	$655.55	$386.26
0388	Discography	S	12.3294	$731.66	$292.66	$146.33
0389	Non-imaging Nuclear Medicine	S	1.4976	$88.87	$35.54	$17.77
0390	Level I Endocrine Imaging	S	2.5562	$151.69	$60.67	$30.34
0391	Level II Endocrine Imaging	S	2.8774	$170.75	$68.30	$34.15
0393	Red Cell/Plasma Studies	S	3.4438	$204.37	$81.74	$40.87
0394	Hepatobiliary Imaging	S	4.4630	$264.85	$105.93	$52.97
0395	GI Tract Imaging	S	3.8699	$229.65	$91.86	$45.93
0396	Bone Imaging	S	4.1426	$245.83	$98.33	$49.17
0397	Vascular Imaging	S	2.2646	$134.39	$53.75	$26.88
0398	Level I Cardiac Imaging	S	4.3093	$255.73	$102.29	$51.15
0399	Nuclear Medicine Add-on Imaging	S	1.5192	$90.15	$36.06	$18.03
0400	Hematopoietic Imaging	S	4.1335	$245.29	$98.11	$49.06
0401	Level I Pulmonary Imaging	S	3.4150	$202.66	$81.06	$40.53
0402	Brain Imaging	S	5.1847	$307.68	$123.07	$61.54
0403	CSF Imaging	S	3.6138	$214.45	$85.78	$42.89
0404	Renal and Genitourinary Studies Level I	S	3.8559	$228.82	$91.52	$45.76
0405	Renal and Genitourinary Studies Level II	S	4.2674	$253.24	$101.29	$50.65
0406	Tumor/Infection Imaging	S	4.3035	$255.38	$102.15	$51.08
0407	Radionuclide Therapy	S	3.9839	$236.42	$94.56	$47.28
0409	Red Blood Cell Tests	X	0.1258	$7.47	$2.22	$1.49
0411	Respiratory Procedures	S	0.3869	$22.96		$4.59
0412	IMRT Treatment Delivery	S	5.3643	$318.33		$63.67
0415	Level II Endoscopy Lower Airway	T	22.0955	$1,311.21	$459.92	$262.24
0416	Level I Intravascular and Intracardiac Ultrasound and Flow Reserve	S	19.5542	$1,160.40		$232.08
0417	Computerized Reconstruction	S	4.0750	$241.82		$48.36
0418	Insertion of Left Ventricular Pacing Elect	T	109.3043	$6,486.45		$1,297.29
0421	Prolonged Physiologic Monitoring	X	1.6600	$98.51		$19.70
0422	Level II Upper GI Procedures	T	22.9647	$1,362.79	$448.81	$272.56
0423	Level II Percutaneous Abdominal and Biliary Procedures	T	40.2866	$2,390.73		$478.15
0425	Level II Arthroplasty with Prosthesis	T	100.2058	$5,946.51	$1,378.01	$1,189.30
0426	Level II Strapping and Cast Application	S	2.1243	$126.06		$25.21
0427	Level III Tube Changes and Repositioning	T	10.1977	$605.16	$124.11	$121.03
0428	Level III Sigmoidoscopy and Anoscopy	T	19.9022	$1,181.06		$236.21
0429	Level V Cystourethroscopy and other Genitourinary Procedures	T	42.3147	$2,511.08		$502.22
0430	Level IV Nerve and Muscle Tests	T	11.4040	$676.75		$135.35
0432	Health and Behavior Services	S	0.6949	$41.24		$8.25
0433	Level II Pathology	X	0.2581	$15.32	$6.12	$3.06
0434	Cardiac Defect Repair	T	90.7877	$5,387.61		$1,077.52
0600	Low Level Clinic Visits	V	0.8688	$51.56		$10.31
0601	Mid Level Clinic Visits	V	1.0038	$59.57		$11.91
0602	High Level Clinic Visits	V	1.4284	$84.77		$16.95
0610	Low Level Emergency Visits	V	1.2947	$76.83	$19.48	$15.37
0611	Mid Level Emergency Visits	V	2.2718	$134.82	$35.76	$26.96
0612	High Level Emergency Visits	V	3.9853	$236.50	$54.12	$47.30
0620	Critical Care	S	8.2996	$492.52	$135.68	$98.50
0621	Level I Vascular Access Procedures	T	8.2986	$492.46		$98.49
0622	Level II Vascular Access Procedures	T	21.2671	$1,262.05		$252.41
0623	Level III Vascular Access Procedures	T	27.1105	$1,608.82		$321.76
0648	Breast Reconstruction with Prosthesis	T	50.4459	$2,993.61		$598.72
0651	Complex Interstitial Radiation Source Application	S	12.1448	$720.71		$144.14
0652	Insertion of Intraperitoneal Catheters	T	28.8948	$1,714.70		$342.94
0653	Vascular Reconstruction/Fistula Repair with Device	T	30.5339	$1,811.97		$362.39
0654	Insertion/Replacement of a permanent dual chamber pacemaker	T	100.9294	$5,989.45		$1,197.89
0655	Insertion/Replacement/Conversion of a permanent dual chamber pacemaker	T	133.7768	$7,938.72		$1,587.74
0656	Transcatheter Placement of Intracoronary Drug-Eluting Stents	T	109.9237	$6,523.20		$1,304.64
0657	Placement of Tissue Clips	S	1.7092	$101.43		$20.29
0658	Percutaneous Breast Biopsies	T	6.1049	$362.28		$72.46
0659	Hyperbaric Oxygen	S	1.5473	$91.82		$18.36
0660	Level II Otorhinolaryngologic Function Tests	X	1.6419	$97.44	$30.66	$19.49
0661	Level V Pathology	X	3.3775	$200.43	$80.17	$40.09
0662	CT Angiography	S	5.1621	$306.33	$122.53	$61.27
0664	Level I Proton Beam Radiation Therapy	S	12.9439	$768.13		$153.63
0665	Bone Density: AppendicularSkeleton	S	0.6464	$38.36		$7.67
0667	Level II Proton Beam Radiation Therapy	S	15.4857	$918.97		$183.79
0668	Level I Angiography and Venography except Extremity	S	6.5024	$385.87	$114.67	$77.17
0670	Level II Intravascular and Intracardiac Ultrasound and Flow Reserve	S	25.4131	$1,508.09	$472.46	$301.62
0671	Level II Echocardiogram Except Transesophageal	S	1.7028	$101.05	$40.42	$20.21
0672	Level IV Posterior Segment Eye Procedures	T	36.9284	$2,191.44		$438.29
0673	Level IV Anterior Segment Eye Procedures	T	29.2582	$1,736.27	$649.56	$347.25
0674	Prostate Cryoablation	T	95.7856	$5,684.20		$1,136.84
0675	Prostatic Thermotherapy	T	43.7329	$2,595.24		$519.05
0676	Thrombolysis and Thrombectomy	T	2.4105	$143.05		$28.61
0678	External Counterpulsation	T	1.7276	$102.52		$20.50
0679	Level II Resuscitation and Cardioversion	S	5.5774	$330.98	$95.30	$66.20
0680	Insertion of Patient Activated Event Recorders	S	62.9082	$3,733.16		$746.63
0681	Knee Arthroplasty	T	137.1630	$8,139.66	$2,081.48	$1,627.93
0682	Level V Debridement Destruction	T	6.9107	$410.10	$162.42	$82.02
0683	Level II Photochemotherapy	S	1.9006	$112.79	$25.34	$22.56
0685	Level III Needle Biopsy/Aspiration Except Bone Marrow	T	6.0174	$357.09	$115.47	$71.42
0686	Level III Skin Repair	T	13.8287	$820.64		$164.13
0687	Revision/Removal of Neurostimulator Electrodes	T	19.2347	$1,141.44	$456.57	$228.29
0688	Revision/Removal of Neurostimulator Pulse Generator Receiver	T	43.0444	$2,554.38	$1,021.75	$510.88
0689	Electronic Analysis of Cardioverter-defibrillators	S	0.5735	$34.03		$6.81
0690	Electronic Analysis of Pacemakers and other Cardiac Devices	S	0.3755	$22.28	$8.91	$4.46
0691	Electronic Analysis of Programmable Shunts/Pumps	S	2.5252	$149.85	$59.94	$29.97
0692	Electronic Analysis of Neurostimulator Pulse Generators	S	2.0111	$119.34	$30.16	$23.87
0693	Level II Breast Reconstruction	T	42.2254	$2,505.78	$798.17	$501.16
0694	Mohs Surgery	T	3.8452	$228.19	$61.86	$45.64
0695	Level VII Debridement Destruction	T	20.3164	$1,205.64	$266.59	$241.13
0697	Level I Echocardiogram Except Transesophageal	S	1.5357	$91.13	$36.45	$18.23
0698	Level II Eye Tests Treatments	S	1.2438	$73.81	$16.55	$14.76
0699	Level IV Eye Tests Treatments	T	10.0177	$594.48		$118.90
0700	Antepartum Manipulation	T	5.3614	$318.16		$63.63
0701	SR 89 chloride, per mCi	H
0702	SM 153 lexidronam	H
0704	IN 111 Satumomab pendetide per dose	H
0705	Technetium TC99M tetrofosmin	H
0726	Dexrazoxane hcl injection	K		$216.39		$43.28
0728	Filgrastim injection	K		$178.39		$35.68
0730	Pamidronate disodium	K		$58.42		$11.68
0731	Sargramostim injection	K		$21.11		$4.22
0732	Mesna injection	K		$13.68		$2.74
0733	Non esrd epoetin alpha inj	K		$9.99		$2.00
0734	Injection, darbepoetin alfa (for non-ESRD)	K		$3.28		$0.66
0735	Ampho b cholesteryl sulfate	K		$12.24		$2.45
0736	Amphotericin b liposome inj	K		$21.91		$4.38
0737	Ammonia N-13, per dose	H
0738	Rasburicase	G		$109.18		$21.84
0750	Dolasetron mesylate	K		$6.55		$1.31
0763	Dolasetron mesylate oral	K		$48.54		$9.71
0764	Granisetron HCl injection	K		$7.24		$1.45
0765	Granisetron HCl oral	K		$33.51		$6.70
0768	Ondansetron hcl injection	K		$3.80		$0.76
0769	Ondansetron hcl oral	K		$32.02		$6.40
0800	Leuprolide acetate	K		$441.78		$88.36
0802	Etoposide oral	K		$41.12		$8.22
0807	Aldesleukin/single use vial	K		$701.76		$140.35
0809	Bcg live intravesical vac	K		$121.74		$24.35
0810	Goserelin acetate implant	K		$196.25		$39.25
0811	Carboplatin injection	K		$77.16		$15.43
0812	Carmus bischl nitro inj	K		$141.29		$28.26
0814	Asparaginase injection	K		$55.42		$11.08
0819	Dacarbazine inj	K		$6.20		$1.24
0820	Daunorubicin	K		$35.28		$7.06
0821	Daunorubicin citrate liposom	K		$57.56		$11.51
0823	Docetaxel	K		$301.17		$60.23
0827	Floxuridine injection	K		$60.17		$12.03
0828	Gemcitabine HCL	K		$117.45		$23.49
0830	Irinotecan injection	K		$129.08		$25.82
0831	Ifosfomide injection	K		$53.54		$10.71
0832	Idarubicin hcl injection	K		$314.00		$62.80
0834	Interferon alfa-2a inj	K		$31.75		$6.35
0835	Inj cosyntropin	K		$69.27		$13.85
0836	Interferon alfa-2b inj recombinant, 1 million	K		$13.22		$2.64
0838	Interferon gamma 1-b inj	K		$277.79		$55.56
0840	Melphalan hydrochl	K		$523.22		$104.64
0842	Fludarabine phosphate inj	K		$262.41		$52.48
0843	Pegaspargase	K		$1,528.80		$305.76
0844	Pentostatin injection	K		$1,868.91		$373.78
0849	Rituximab	K		$447.97		$89.59
0850	Streptozocin injection	K		$153.33		$30.67
0851	Thiotepa injection	K		$44.55		$8.91
0852	Topotecan	K		$755.51		$151.10
0855	Vinorelbine tartrate	K		$62.85		$12.57
0856	Porfimer sodium	K		$2,457.97		$491.59
0857	Bleomycin sulfate injection	K		$54.18		$10.84
0858	Cladribine	K		$39.37		$7.87
0860	Plicamycin (mithramycin) inj	K		$80.54		$16.11
0861	Leuprolide acetate injection	K		$10.96		$2.19
0862	Mitomycin	K		$26.36		$5.27
0863	Paclitaxel injection	K		$19.11		$3.82
0864	Mitoxantrone hcl	K		$329.69		$65.94
0865	Interferon alfa-n3 inj, human leukocyte derived, 2	K		$8.77		$1.75
0868	Oral aprepitant	G		$4.75		$0.95
0869	IVIG lyophil 1g	K		$39.46		$7.89
0870	IVIG lyophil 10 mg	K		$0.40		$0.08
0871	IVIG non-lyophil 1g	K		$57.26		$11.45
0872	IVIG non-lyophil 10 mg	K		$0.57		$0.11
0876	Caffeine citrate injection	K		$3.34		$0.67
0880	Penicillin g benzathine inj	K		$72.26		$14.45
0884	Rho d immune globulin inj	K		$113.91		$22.78
0887	Azathioprine parenteral	K		$47.40		$9.48
0888	Cyclosporine oral	K		$3.94		$0.79
0890	Lymphocyte immune globulin	K		$290.30		$58.06
0891	Tacrolimus oral	K		$3.37		$0.67
0892	Edetate calcium disodium inj	K		$40.34		$8.07
0893	Calcitonin salmon injection	K		$35.68		$7.14
0895	Deferoxamine mesylate inj	K		$14.91		$2.98
0900	Alglucerase injection	K		$39.94		$7.99
0901	Alpha 1 proteinase inhibitor	K		$3.30		$0.66
0902	Botulinum toxin a, per unit	K		$4.80		$0.96
0903	Cytomegalovirus imm IV/vial	K		$683.07		$136.61
0906	RSV-ivig	K		$15.56		$3.11
0910	Interferon beta-1b	K		$81.95		$16.39
0911	Streptokinase	K		$83.36		$16.67
0912	Interferon alfacon-1	K		$3.91		$0.78
0913	Ganciclovir long act implant	K		$4,318.68		$863.74
0916	Injection imiglucerase /unit	K		$3.98		$0.80
0917	Adenosine injection	K		$71.53		$14.31
0925	Factor viii	K		$0.51		$0.10
0926	Factor VIII (porcine)	K		$1.75		$0.35
0927	Factor viii recombinant	K		$0.94		$0.19
0928	Factor ix complex	K		$0.52		$0.10
0929	Anti-inhibitor per iu	K		$1.12		$0.22
0931	Factor IX non-recombinant	K		$0.75		$0.15
0932	Factor IX recombinant	K		$0.86		$0.17
0935	Clonidine hydrochloride	K		$57.47		$11.49
0949	Plasma, Pooled Multiple Donor, Solvent/Detergent T	K	1.1956	$70.95		$14.19
0950	Blood (Whole) For Transfusion	K	2.0123	$119.42		$23.88
0952	Cryoprecipitate	K	0.7395	$43.88		$8.78
0954	RBC leukocytes reduced	K	2.7370	$162.42		$32.48
0955	Plasma, Fresh Frozen	K	1.2934	$76.75		$15.35
0956	Plasma Protein Fraction	K	1.1226	$66.62		$13.32
0957	Platelet Concentrate	K	0.8317	$49.36		$9.87
0958	Platelet Rich Plasma	K	5.1815	$307.49		$61.50
0959	Red Blood Cells	K	2.0301	$120.47		$24.09
0960	Washed Red Blood Cells	K	2.9707	$176.29		$35.26
0961	Infusion, Albumin (Human) 5%, 50 ml	K	0.5119	$30.38		$6.08
0963	Albumin (human), 5%	K	1.3869	$82.30		$16.46
0964	Albumin (human), 25%	K	0.4878	$28.95		$5.79
0965	Albumin (human), 25%	K	1.1117	$65.97		$13.19
0966	Plasmaprotein fract, 5%	K	4.9564	$294.13		$58.83
0967	Split unit of blood	K	1.2698	$75.35		$15.07
0968	Platelets leukocyte reduced irradiated	K	2.3639	$140.28		$28.06
0969	Red blood cell leukocyte reduced irradiated	K	3.6451	$216.31		$43.26
1009	Cryoprecip reduced plasma	K	1.3062	$77.51		$15.50
1010	Blood, L/R, CMV-neg	K	2.9692	$176.20		$35.24
1011	Platelets, HLA-m, L/R, unit	K	10.9690	$650.93		$130.19
1013	Platelet concentrate, L/R, unit	K	1.6023	$95.09		$19.02
1016	Blood, L/R, froz/deglycerol/washed	K	5.2631	$312.33		$62.47
1017	Platelets, aph/pher, L/R, CMV-neg, unit	K	8.5998	$510.34		$102.07
1018	Blood, L/R, irradiated	K	2.8004	$166.18		$33.24
1019	Platelets, aph/pher, L/R, irradiated, unit	K	9.5131	$564.54		$112.91
1020	Pit, pher, L/R, CMV, irrad	K	10.1551	$602.63		$120.53
1021	RBC, frz/deg/wsh, L/R, irrad	K	4.8787	$289.52		$57.90
1022	RBC, L/R, CMV neg, irrad	K	4.2901	$254.59		$50.92
1045	Iobenguane sulfate I-131	H
1052	Injection, Voriconazole	K		$4.63		$0.93
1064	I-131 sodium iodide capsule	H
1065	I-131 sodium iodide solution	H
1080	I-131 tositumomab, dx	H
1081	I-131 tositumomab, tx	H
1082	Treprostinil	K		$55.02		$11.00
1083	Injection, Adalimumab	K		$300.10		$60.02
1084	Denileukin diftitox	K		$1,235.33		$247.07
1085	Injection, Gallium Nitrate	K		$1.30		$0.26
1086	Temozolomide,oral	K		$7.28		$1.46
1088	Dx I131 so iodide cap millic	H
1091	IN 111 Oxyquinoline	H
1092	IN 111 Pentetate	H
1093	TC99M fanolesomab	H
1096	TC 99M Exametazime, per dose	H
1150	Th I131 so iodide sol millic	H
1166	Cytarabine liposome	K		$366.43		$73.29
1167	Epirubicin hcl	K		$25.15		$5.03
1178	Busulfan IV	K	0.2851	$16.92		$3.38
1201	TC 99M SUCCIMER, PER Vial	H
1203	Verteporfin for injection	K		$9.16		$1.83
1207	Octreotide injection, depot	K		$87.40		$17.48
1210	Inj dihydroergotamine mesylt	K		$27.82		$5.56
1280	Corticotropin injection	K		$95.44		$19.09
1305	Apligraf	K	12.9222	$766.84		$153.37
1330	Ergonovine maleate injection	K	0.5263	$31.23		$6.25
1409	Factor viia recombinant	K		$1,080.11		$216.02
1436	Etidronate disodium inj	K		$68.69		$13.74
1491	New Technology-Level I ($0-$10)	S		$5.00		$1.00
1492	New Technology-Level I ($10-$20)	S		$15.00		$3.00
1493	New Technology-Level I ($20-$30)	S		$25.00		$5.00
1494	New Technology-Level I ($30-$40)	S		$35.00		$7.00
1495	New Technology-Level I ($40-$50)	S		$45.00		$9.00
1496	New Technology-Level I ($0-$10)	T		$5.00		$1.00
1497	New Technology-Level I ($10-$20)	T		$15.00		$3.00
1498	New Technology-Level I ($20-$30)	T		$25.00		$5.00
1499	New Technology-Level I ($30-$40)	T		$35.00		$7.00
1500	New Technology-Level I ($40-$50)	T		$45.00		$9.00
1502	New Technology-Level II ($50-$100)	S		$75.00		$15.00
1503	New Technology-Level III ($100-$200)	S		$150.00		$30.00
1504	New Technology-Level IV ($200-$300)	S		$250.00		$50.00
1505	New Technology-Level V ($300-$400)	S		$350.00		$70.00
1506	New Technology-Level VI ($400-$500)	S		$450.00		$90.00
1507	New Technology-Level VII ($500-$600)	S		$550.00		$110.00
1508	New Technology-Level VIII ($600-$700)	S		$650.00		$130.00
1509	New Technology-Level IX ($700-$800)	S		$750.00		$150.00
1510	New Technology-Level X ($800-$900)	S		$850.00		$170.00
1511	New Technology-Level XI ($900-$1000)	S		$950.00		$190.00
1512	New Technology-Level XII ($1000-$1100)	S		$1,050.00		$210.00
1513	New Technology-Level XIII ($1100-$1200)	S		$1,150.00		$230.00
1514	New Technology-Level XIV ($1200-$1300)	S		$1,250.00		$250.00
1515	New Technology-Level XV ($1300-$1400)	S		$1,350.00		$270.00
1516	New Technology-Level XVI ($1400-$1500)	S		$1,450.00		$290.00
1517	New Technology-Level XVII ($1500-$1600)	S		$1,550.00		$310.00
1518	New Technology-Level XVIII ($1600-$1700)	S		$1,650.00		$330.00
1519	New Technology-Level IXX ($1700-$1800)	S		$1,750.00		$350.00
1520	New Technology-Level XX ($1800-$1900)	S		$1,850.00		$370.00
1521	New Technology-Level XXI ($1900-$2000)	S		$1,950.00		$390.00
1522	New Technology-Level XXII ($2000-$2500)	S		$2,250.00		$450.00
1523	New Technology-Level XXIII ($2500-$3000)	S		$2,750.00		$550.00
1524	New Technology-Level XIV ($3000-$3500)	S		$3,250.00		$650.00
1525	New Technology-Level XXV ($3500-$4000)	S		$3,750.00		$750.00
1526	New Technology-Level XXVI ($4000-$4500)	S		$4,250.00		$850.00
1527	New Technology-Level XXVII ($4500-$5000)	S		$4,750.00		$950.00
1528	New Technology-Level XXVIII ($5000-$5500)	S		$5,250.00		$1,050.00
1529	New Technology-Level XXIX ($5500-$6000)	S		$5,750.00		$1,150.00
1530	New Technology-Level XXX ($6000-$6500)	S		$6,250.00		$1,250.00
1531	New Technology-Level XXXI ($6500-$7000)	S		$6,750.00		$1,350.00
1532	New Technology-Level XXXII ($7000-$7500)	S		$7,250.00		$1,450.00
1533	New Technology-Level XXXIII ($7500-$8000)	S		$7,750.00		$1,550.00
1534	New Technology-Level XXXIV ($8000-$8500)	S		$8,250.00		$1,650.00
1535	New Technology-Level XXXV ($8500-$9000)	S		$8,750.00		$1,750.00
1536	New Technology-Level XXXVI ($9000-$9500)	S		$9,250.00		$1,850.00
1537	New Technology-Level XXXVII ($9500-$10000)	S		$9,750.00		$1,950.00
1539	New Technology-Level II ($50-$100)	T		$75.00		$15.00
1540	New Technology-Level III ($100-$200)	T		$150.00		$30.00
1541	New Technology-Level IV ($200-$300)	T		$250.00		$50.00
1542	New Technology-Level V ($300-$400)	T		$350.00		$70.00
1543	New Technology-Level VI ($400-$500)	T		$450.00		$90.00
1544	New Technology-Level VII ($500-$600)	T		$550.00		$110.00
1545	New Technology-Level VIII ($600-$700)	T		$650.00		$130.00
1546	New Technology-Level IX ($700-$800)	T		$750.00		$150.00
1547	New Technology-Level X ($800-$900)	T		$850.00		$170.00
1548	New Technology-Level XI ($900-$1000)	T		$950.00		$190.00
1549	New Technology-Level XII ($1000-$1100)	T		$1,050.00		$210.00
1550	New Technology-Level XIII ($1100-$1200)	T		$1,150.00		$230.00
1551	New Technology-Level XIV ($1200- $1300)	T		$1,250.00		$250.00
1552	New Technology-Level XV ($1300-$1400)	T		$1,350.00		$270.00
1553	New Technology-Level XVI ($1400-$1500)	T		$1,450.00		$290.00
1554	New Technology-Level XVII ($1500-$1600)	T		$1,550.00		$310.00
1555	New Technology-Level XVIII ($1600-$1700)	T		$1,650.00		$330.00
1556	New Technology-Level XIX ($1700-$1800)	T		$1,750.00		$350.00
1557	New Technology-Level XX ($1800-$1900)	T		$1,850.00		$370.00
1558	New Technology-Level XXI ($1900-$2000)	T		$1,950.00		$390.00
1559	New Technology-Level XXII ($2000-$2500)	T		$2,250.00		$450.00
1560	New Technology-Level XXIII ($2500-$3000)	T		$2,750.00		$550.00
1561	New Technology-Level XXIV ($3000-$3500)	T		$3,250.00		$650.00
1562	New Technology-Level XXV ($3500-$4000)	T		$3,750.00		$750.00
1563	New Technology-Level XXVI ($4000-$4500)	T		$4,250.00		$850.00
1564	New Technology-Level XXVII ($4500-$5000)	T		$4,750.00		$950.00
1565	New Technology-Level XXVIII ($5000-$5500)	T		$5,250.00		$1,050.00
1566	New Technology-Level XXIX ($5500-$6000)	T		$5,750.00		$1,150.00
1567	New Technology-Level XXX ($6000-$6500)	T		$6,250.00		$1,250.00
1568	New Technology-Level XXXI ($6500-$7000)	T		$6,750.00		$1,350.00
1569	New Technology-Level XXXII ($7000-$7500)	T		$7,250.00		$1,450.00
1570	New Technology-Level XXXIII ($7500-$8000)	T		$7,750.00		$1,550.00
1571	New Technology-Level XXXIV ($8000-$8500)	T		$8,250.00		$1,650.00
1572	New Technology-Level XXXV ($8500-$9000)	T		$8,750.00		$1,750.00
1573	New Technology-Level XXXVI ($9000-$9500)	T		$9,250.00		$1,850.00
1574	New Technology-Level XXXVII ($9500-$10000)	T		$9,750.00		$1,950.00
1600	Technetium TC 99m sestamibi	H
1603	Thallous chloride TL 201	H
1604	IN 111 capromab pendetide, per dose	H
1605	Abciximab injection	K		$450.60		$90.12
1607	Eptifibatide injection	K		$12.73		$2.55
1608	Etanercept injection	K		$152.11		$30.42
1609	Rho(D) immune globulin h, sd	K		$12.04		$2.41
1611	Hylan G-F 20 injection	K		$203.15		$40.63
1612	Daclizumab, parenteral	K		$381.48		$76.30
1613	Trastuzumab	K		$53.98		$10.80
1615	Basiliximab	K		$1,473.57		$294.71
1618	Vonwillebrandfactrcmplx, per iu	K		$0.74		$0.15
1619	Gallium ga 67	H
1620	Technetium tc99m bicisate	H
1622	Technetium tc99m mertiatide	H
1624	Sodium phosphate p32	H
1625	Indium 111-in pentetreotide	H
1628	Chromic phosphate p32	H
1655	Tinzaparin sodium injection	K		$2.53		$0.51
1670	Tetanus immune globulin inj	K		$76.90		$15.38
1716	Brachytx source, Gold 198	H
1717	Brachytx source, HDR Ir-192	H
1718	Brachytx source, Iodine 125	H
1719	Brachytx sour, Non-HDR Ir-192	H
1720	Brachytx sour, Palladium 103	H
1740	Diazoxide injection	K		$113.86		$22.77
1775	FDG, per dose (4-40 mCi/ml)	H
2210	Methyldopate hcl injection	K		$9.58		$1.92
2616	Brachytx source, Yttrium-90	H
2632	Brachytx sol, I-125, per mCi	H
2633	Brachytx source, Cesium-131	H
2634	Brachytx source, HA, I-125	H
2635	Brachytx source, HA, P-103	H
2636	Brachytx linear source, P-103	H
2730	Pralidoxime chloride inj	K		$76.68		$15.34
2770	Quinupristin/dalfopristin	K		$105.48		$21.10
2940	Somatrem injection	K		$43.14		$8.63
3030	Sumatriptan succinate	K		$51.03		$10.21
7000	Amifostine	K		$436.01		$87.20
7005	Gonadorelin hydroch	K		$173.44		$34.69
7011	Oprelvekin injection	K		$249.06		$49.81
7015	Busulfan, oral	K		$1.98		$0.40
7019	Aprotinin	K		$2.20		$0.44
7024	Corticorelin ovine triflutat	K		$386.53		$77.31
7025	Digoxin immune FAB (ovine)	K		$552.18		$110.44
7026	Ethanolamine oleate	K		$64.53		$12.91
7027	Fomepizole	K		$12.31		$2.46
7028	Fosphenytoin	K		$5.19		$1.04
7030	Hemin	K		$6.51		$1.30
7034	Somatropin injection	K		$42.93		$8.59
7035	Teniposide	K		$266.23		$53.25
7036	Urokinase inj	K		$415.69		$83.14
7037	Urofollitropin	K		$44.74		$8.95
7038	Monoclonal antibodies	K		$885.36		$177.07
7040	Pentastarch 10% solution	K		$12.45		$2.49
7041	Tirofiban hcl	K		$7.89		$1.58
7042	Capecitabine, oral	K		$3.30		$0.66
7043	Infliximab injection	K		$54.20		$10.84
7045	Trimetrexate glucoronate	K		$139.85		$27.97
7046	Doxorubicin hcl liposome inj	K		$365.64		$73.13
7048	Alteplase recombinant	K		$30.65		$6.13
7049	Filgrastim injection	K		$282.29		$56.46
7051	Leuprolide acetate implant	K		$2,262.19		$452.44
7308	Aminolevulinic acid hcl top	K		$96.79		$19.36
7316	Sodium hyaluronate injection	K		$110.65		$22.13
7515	Cyclosporine oral	K		$1.00		$0.20
9001	Linezolid injection	K		$24.15		$4.83
9002	Tenecteplase	K		$2,052.77		$410.55
9003	Palivizumab	K	4.1491	$246.22		$49.24
9004	Gemtuzumab ozogamicin	K		$2,245.04		$449.01
9005	Reteplase injection	K		$898.81		$179.76
9006	Tacrolimus injection	K		$126.61		$25.32
9008	Baclofen Refill Kit-500mcg	K	0.2447	$14.52		$2.90
9009	Baclofen refill kit-per 2000 mcg	K	0.7209	$42.78		$8.56
9012	Arsenic Trioxide	K		$33.76		$6.75
9015	Mycophenolate mofetil oral	K		$2.50		$0.50
9018	Botulinum toxin B	K		$7.89		$1.58
9019	Caspofungin acetate	K		$32.35		$6.47
9020	Sirolimus tablet	K		$6.85		$1.37
9022	IM inj interferon beta 1-a	K		$89.10		$17.82
9023	Rho d immune globulin	K		$25.08		$5.02
9024	Amphotericin b lipid complex	K		$11.95		$2.39
9025	Rubidium-Rb-82	H
9030	Amphotericin B	K		$30.70		$6.14
9031	Arbutamine HCl injection	K		$163.15		$32.63
9032	Baclofen 10 MG injection	K		$188.01		$37.60
9033	Cidofovir injection	K		$782.98		$156.60
9038	Inj estrogen conjugate	K		$57.77		$11.55
9040	Intraocular Fomivirsen na	K		$203.93		$40.79
9042	Glucagon hydrochloride	K		$62.16		$12.43
9044	Ibutilide fumarate injection	K		$243.34		$48.67
9045	Iron dextran	K		$11.43		$2.29
9046	Iron sucrose injection	K		$0.38		$0.08
9047	Itraconazole injection	K		$36.93		$7.39
9051	Urea injection	K	1.0454	$62.04		$12.41
9054	Metabolically active tissue	K		$15.69		$3.14
9055	Injectable human tissue	K		$3.54		$0.71
9057	Lepirudin	K		$128.17		$25.63
9100	Iodinated I-131 serumalbumin, per 5uci	H
9104	Anti-thymocycte globulin rabbit	K		$299.47		$59.89
9105	Hep B imm glob	K	1.8813	$111.64		$22.33
9108	Thyrotropin alfa	K		$712.58		$142.52
9110	Alemtuzumab injection	K		$516.87		$103.37
9112	Inj Perflutren lipid micros, ml	K		$63.51		$12.70
9114	Nesiritide	K		$75.19		$15.04
9115	Inj, zoledronic acid	K		$202.41		$40.48
9117	Yttrium 90 ibritumomab tiuxetan	H
9118	In-111 ibritumomab tiuxetan	H
9119	Pegfilgrastim	K		$2,178.28		$435.66
9120	Inj, Fulvestrant	K		$82.90		$16.58
9121	Inj, Argatroban	K	0.1897	$11.26		$2.25
9122	Triptorelin pamoate	K		$369.98		$74.00
9123	Transcyte	K		$719.41		$143.88
9124	Injection, daptomycin	G		$0.30		$0.06
9125	Risperidone, long acting	G		$4.71		$0.94
9126	Injection, natalizumab	G		$6.51		$1.30
9127	Paclitaxel protein pr	K		$8.59		$1.72
9128	Inj pegaptanib sodium	K		$1,074.27		$214.85
9130	Na chromateCr51, per 0.25mCi	H
9132	51 Na Chromate, 50mCi	H
9133	Rabies ig, im/sc	K		$64.56		$12.91
9134	Rabies ig, heat treated	K		$69.79		$13.96
9135	Varicella-zoster ig, im	K		$96.58		$19.32
9136	Adenovirus vaccine, type 4	K	0.9499	$56.37		$11.27
9137	Bcg vaccine, percut	K		$124.54		$24.91
9138	Hep a/hep b vacc, adult im	K	0.9674	$57.41		$11.48
9139	Rabies vaccine, im	K		$128.04		$25.61
9140	Rabies vaccine, id	K	1.4959	$88.77		$17.75
9141	Measles-rubella vaccine, sc	K	0.9467	$56.18		$11.24
9142	Chicken pox vaccine, sc	K		$64.29		$12.86
9143	Meningococcal vaccine, sc	K		$56.75		$11.35
9144	Encephalitis vaccine, sc	K		$67.73		$13.55
9145	Meningococcal vaccine, im	K	0.8948	$53.10		$10.62
9146	Technetium TC99m Disofenin	H
9147	Technetium TC 99M Depreotide	H
9148	I-123 sodium iodide capsule	H
9149	Dx I131 so iodide microcurie	H
9150	I-125 serum albumin micro	H
9151	Tc 99M ARCITUMOMAB PER VIAL	H
9152	Baclofen Intrathecal kit-1am	K	0.8562	$50.81		$10.16
9153	Na Iothalamate I-125, 10 uCi	H
9154	Technetium tc99m glucepatate	H
9155	Technetium tc99mlabeledrbcs	H
9156	Nonmetabolic active tissue	K		$53.76		$10.75
9157	LOCM =149 mg/ml iodine	K		$0.51		$0.10
9158	LOCM 150-199mg/ml iodine	K		$2.00		$0.40
9159	LOCM 200-249mg/ml iodine	K		$0.78		$0.16
9160	LOCM 250-299mg/ml iodine	K		$0.66		$0.13
9161	LOCM 300-349mg/ml iodine	K		$0.41		$0.08
9162	LOCM 350-399mg/ml iodine	K		$0.27		$0.05
9163	LOCM = 400 mg/ml iodine	K		$0.20		$0.04
9164	Inj Gad-base MR contrast	K		$3.01		$0.60
9165	Oral MR contrast	K		$9.01		$1.80
9166	Dyphylline injection	K		$7.74		$1.55
9167	Valrubicin	K		$376.87		$75.37
9168	Pegademase bovine	K		$161.16		$32.23
9169	Anthrax vaccine, sc	K		$128.95		$25.79
9200	Orcel	K	2.6893	$159.59		$31.92
9201	Dermagraft	K	6.2066	$368.32		$73.66
9202	Inj Octafluoropropane mic,ml	K		$41.42		$8.28
9203	Inj Perflexane lipid micros, ml	K		$13.49		$2.70
9205	Oxaliplatin	K		$84.06		$16.81
9206	Integra	K		$9.23		$1.85
9207	Injection, bortezomib	K		$28.90		$5.78
9208	Injection, agalsidase beta	K		$123.35		$24.67
9209	Injection, laronidase	K		$23.16		$4.63
9210	Injection, palonosetron HCL	K		18.42		$3.68
9211	Inj, alefacept, IV	K		$571.01		$114.20
9212	Inj, alefacept, IM	K		$402.00		$80.40
9213	Injection, Pemetrexed	G		$41.29		$8.26
9214	Injection, Bevacizumab	G		$58.17		$11.63
9215	Injection, Cetuximab	G		$50.59		$10.12
9216	Abarelix Injection	G		$66.96		$13.39
9217	Leuprolide acetate suspnsion	K		$230.87		$46.17
9218	Injection, Azacitidine	K		$4.03		$0.81
9219	Mycophenolic Acid	G		$2.47		$0.49
9220	Sodium hyaluronate	G		$203.84		$40.77
9221	Graftjacket Reg Matrix	G		$1,234.36		$246.87
9222	Graftjacket SftTis	G		$890.74		$178.15
9300	Injection, Omalizumab	G		$15.98		$3.20
9500	Platelets, irradiated	K	1.3589	$80.64		$16.13
9501	Platelets, pheresis, leukocytes reduced	K	8.1495	$483.62		$96.72
9502	Platelet pheresis irradiated	K	5.1895	$307.96		$61.59
9503	Fresh frozen plasma, ea unit	K	1.6241	$96.38		$19.28
9504	RBC deglycerolized	K	6.4314	$381.66		$76.33
9505	RBC irradiated	K	2.3876	$141.69		$28.34
9506	Granulocytes, pheresis	K	15.6155	$926.67		$185.33
9507	Platelets, pheresis	K	6.8988	$409.40		$81.88
9508	Plasma, frozen w/in 8 hours	K	1.2038	$71.44		$14.29

6. On pages 42776-42965, Addendum B is corrected to read as follows:

----------

* Code is subject to contiguous body area imaging discount policy discussed in Section XIV of this proposed rule.CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.Copyright American Dental Association. All Rights Reserved.

CPT/HCPCS	SI	Description	APC	Relative weight	Payment rate	National unadjusted copayment	Minimum unadjusted copayment
0003T	S	Cervicography	1492		$15.00		$3.00
0008T	T	Upper gi endoscopy w/suture	0422	22.9647	$1,362.79	$448.81	$272.56
00100	N	Anesth, salivary gland
00102	N	Anesth, repair of cleft lip
00103	N	Anesth, blepharoplasty
00104	N	Anesth, electroshock
0010T	A	Tb test, gamma interferon
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, vitreoretinal surg
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
0016T	T	Thermotx choroid vasc lesion	0235	4.6593	$276.50	$67.40	$55.30
00170	N	Anesth, procedure on mouth
00172	N	Anesth, cleft palate repair
00174	N	Anesth, pharyngeal surgery
00176	C	Anesth, pharyngeal surgery
0017T	E	Photocoagulat macular drusen
0018T	S	Transcranial magnetic stimul	0215	0.6115	$36.29	$14.51	$7.26
00190	N	Anesth, face/skull bone surg
00192	C	Anesth, facial bone surgery
0019T	E	Extracorp shock wave tx, ms
0020T	B	Extracorp shock wave tx, ft
00210	N	Anesth, open head surgery
00212	N	Anesth, skull drainage
00214	C	Anesth, skull drainage
00215	C	Anesth, skull repair/fract
00216	N	Anesth, head vessel surgery
00218	N	Anesth, special head surgery
0021T	C	Fetal oximetry, trnsvag/cerv
00220	N	Anesth, intrcrn nerve
00222	N	Anesth, head nerve surgery
0023T	A	Phenotype drug test, hiv 1
0024T	C	Transcath cardiac reduction
0026T	A	Measure remnant lipoproteins
0027T	T	Endoscopic epidural lysis	0220	17.3586	$1,030.11		$206.02
0028T	N	Dexa body composition study
0029T	A	Magnetic tx for incontinence
00300	N	Anesth, head/neck/ptrunk
0030T	A	Antiprothrombin antibody
0031T	N	Speculoscopy
00320	N	Anesth, neck organ, 1 over
00322	N	Anesth, biopsy of thyroid
00326	N	Anesth, larynx/trach, 1 yr
0032T	N	Speculoscopy w/direct sample
0033T	C	Endovasc taa repr incl subcl
0034T	C	Endovasc taa repr w/o subcl
00350	N	Anesth, neck vessel surgery
00352	N	Anesth, neck vessel surgery
0035T	C	Insert endovasc prosth, taa
0036T	C	Endovasc prosth, taa, add-on
0037T	C	Artery transpose/endovas taa
0038T	C	Rad endovasc taa rpr w/cover
0039T	C	Rad s/i, endovasc taa repair
00400	N	Anesth, skin, ext/per/atrunk
00402	N	Anesth, surgery of breast
00404	C	Anesth, surgery of breast
00406	C	Anesth, surgery of breast
0040T	C	Rad s/i, endovasc taa prosth
00410	N	Anesth, correct heart rhythm
0041T	A	Detect ur infect agnt w/cpas
0042T	N	Ct perfusion w/contrast, cbf
0043T	A	Co expired gas analysis
0044T	N	Whole body photography
00450	N	Anesth, surgery of shoulder
00452	C	Anesth, surgery of shoulder
00454	N	Anesth, collar bone biopsy
0045T	N	Whole body photography
0046T	T	Cath lavage, mammary duct(s)	0021	14.9776	$888.82	$219.48	$177.76
00470	N	Anesth, removal of rib
00472	N	Anesth, chest wall repair
00474	C	Anesth, surgery of rib(s)
0047T	T	Cath lavage, mammary duct(s)	0021	14.9776	$888.82	$219.48	$177.76
0048T	C	Implant ventricular device
0049T	C	External circulation assist
00500	N	Anesth, esophageal surgery
0050T	C	Removal circulation assist
0051T	C	Implant total heart system
00520	N	Anesth, chest procedure
00522	N	Anesth, chest lining biopsy
00524	C	Anesth, chest drainage
00528	N	Anesth, chest partition view
00529	N	Anesth, chest partition view
0052T	C	Replace component heart syst
00530	N	Anesth, pacemaker insertion
00532	N	Anesth, vascular access
00534	N	Anesth, cardioverter/defib
00537	N	Anesth, cardiac electrophys
00539	N	Anesth, trach-bronch reconst
0053T	C	Replace component heart syst
00540	C	Anesth, chest surgery
00541	N	Anesth, one lung ventilation
00542	C	Anesth, release of lung
00546	C	Anesth, lung,chest wall surg
00548	N	Anesth, trachea,bronchi surg
0054T	B	Bone surgery using computer
00550	N	Anesth, sternal debridement
0055T	B	Bone surgery using computer
00560	C	Anesth, open heart surgery
00561	C	Anesth, heart surg age 1
00562	C	Anesth, open heart surgery
00563	N	Anesth, heart proc w/pump
00566	N	Anesth, cabg w/o pump
0056T	B	Bone surgery using computer
00580	C	Anesth, heart/lung transplnt
0058T	X	Cryopreservation, ovary tiss	0348	0.7927	$47.04		$9.41
0059T	X	Cryopreservation, oocyte	0348	0.7927	$47.04		$9.41
00600	N	Anesth, spine, cord surgery
00604	C	Anesth, sitting procedure
0060T	B	Electrical impedance scan
0061T	B	Destruction of tumor, breast
00620	N	Anesth, spine, cord surgery
00622	C	Anesth, removal of nerves
0062T	T	Rep intradisc annulus1 lev	0203	10.4015	$617.26	$246.90	$123.45
00630	N	Anesth, spine, cord surgery
00632	C	Anesth, removal of nerves
00634	N	Anesth for chemonucleolysis
00635	N	Anesth, lumbar puncture
0063T	T	Rep intradisc annulus1lev	0203	10.4015	$617.26	$246.90	$123.45
00640	N	Anesth, spine manipulation
0064T	A	Spectroscop eval expired gas
0065T	A	Ocular photoscreen bilat
0066T	E	Ct colonography screen
00670	C	Anesth, spine, cord surgery
0067T*	S	Ct colonography dx	0333	5.2836	$313.54	$125.41	$62.71
0068T	B	Interp/rept heart sound
0069T	N	Analysis only heart sound
00700	N	Anesth, abdominal wall surg
00702	N	Anesth, for liver biopsy
0070T	N	Interp only heart sound
0071T	T	U/s leiomyomata ablate 200	0193	14.5843	$865.48		$173.10
0072T	T	U/s leiomyomata ablate 200	0193	14.5843	$865.48		$173.10
00730	N	Anesth, abdominal wall surg
0073T	S	Delivery, comp imrt	0412	5.3643	$318.33		$63.67
00740	N	Anesth, upper gi visualize
0074T	E	Online physician e/m
00750	N	Anesth, repair of hernia
00752	N	Anesth, repair of hernia
00754	N	Anesth, repair of hernia
00756	N	Anesth, repair of hernia
0075T	C	Perq stent/chest vert art
0076T	C	Si stent/chest vert art
00770	N	Anesth, blood vessel repair
0077T	C	Cereb therm perfusion probe
0078T	C	Endovasc aort repr w/device
00790	N	Anesth, surg upper abdomen
00792	C	Anesth, hemorr/excise liver
00794	C	Anesth, pancreas removal
00796	C	Anesth, for liver transplant
00797	N	Anesth, surgery for obesity
0079T	C	Endovasc visc extnsn repr
00800	N	Anesth, abdominal wall surg
00802	C	Anesth, fat layer removal
0080T	C	Endovasc aort repr rad si
00810	N	Anesth, low intestine scope
0081T	C	Endovasc visc extnsn si
00820	N	Anesth, abdominal wall surg
0082T	B	Stereotactic rad delivery
00830	N	Anesth, repair of hernia
00832	N	Anesth, repair of hernia
00834	N	Anesth, hernia repair 1 yr
00836	N	Anesth hernia repair preemie
0083T	N	Stereotactic rad tx mngmt
00840	N	Anesth, surg lower abdomen
00842	N	Anesth, amniocentesis
00844	C	Anesth, pelvis surgery
00846	C	Anesth, hysterectomy
00848	C	Anesth, pelvic organ surg
0084T	T	Temp prostate urethral stent	0164	1.1855	$70.35	$17.29	$14.07
00851	N	Anesth, tubal ligation
0085T	X	Breath test heart reject	0340	0.6384	$37.88		$7.58
00860	N	Anesth, surgery of abdomen
00862	N	Anesth, kidney/ureter surg
00864	C	Anesth, removal of bladder
00865	C	Anesth, removal of prostate
00866	C	Anesth, removal of adrenal
00868	C	Anesth, kidney transplant
0086T	N	L ventricle fill pressure
00870	N	Anesth, bladder stone surg
00872	N	Anesth kidney stone destruct
00873	N	Anesth kidney stone destruct
0087T	X	Sperm eval hyaluronan	0348	0.7927	$47.04		$9.41
00880	N	Anesth, abdomen vessel surg
00882	C	Anesth, major vein ligation
0088T	T	Rf tongue base vol reduxn	0253	16.1357	$957.54	$282.29	$191.51
00902	N	Anesth, anorectal surgery
00904	C	Anesth, perineal surgery
00906	N	Anesth, removal of vulva
00908	C	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
00921	N	Anesth, vasectomy
00922	N	Anesth, sperm duct surgery
00924	N	Anesth, testis exploration
00926	N	Anesth, removal of testis
00928	N	Anesth, removal of testis
00930	N	Anesth, testis suspension
00932	C	Anesth, amputation of penis
00934	C	Anesth, penis, nodes removal
00936	C	Anesth, penis, nodes removal
00938	N	Anesth, insert penis device
00940	N	Anesth, vaginal procedures
00942	N	Anesth, surg on vag/urethral
00944	C	Anesth, vaginal hysterectomy
00948	N	Anesth, repair of cervix
00950	N	Anesth, vaginal endoscopy
00952	N	Anesth, hysteroscope/graph
01112	N	Anesth, bone aspirate/bx
01120	N	Anesth, pelvis surgery
01130	N	Anesth, body cast procedure
01140	C	Anesth, amputation at pelvis
01150	C	Anesth, pelvic tumor surgery
01160	N	Anesth, pelvis procedure
01170	N	Anesth, pelvis surgery
01173	N	Anesth, fx repair, pelvis
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	C	Anesth, hip disarticulation
01214	C	Anesth, hip arthroplasty
01215	N	Anesth, revise hip repair
01220	N	Anesth, procedure on femur
01230	N	Anesth, surgery of femur
01232	C	Anesth, amputation of femur
01234	C	Anesth, radical femur surg
01250	N	Anesth, upper leg surgery
01260	N	Anesth, upper leg veins surg
01270	N	Anesth, thigh arteries surg
01272	C	Anesth, femoral artery surg
01274	C	Anesth, femoral embolectomy
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, dx knee arthroscopy
01390	N	Anesth, knee area procedure
01392	N	Anesth, knee area surgery
01400	N	Anesth, knee joint surgery
01402	C	Anesth, knee arthroplasty
01404	C	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	C	Anesth, knee artery surg
01444	C	Anesth, knee artery repair
01462	N	Anesth, lower leg procedure
01464	N	Anesth, ankle/ft 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	C	Anesth, ankle replacement
01490	N	Anesth, lower leg casting
01500	N	Anesth, leg arteries surg
01502	C	Anesth, lwr leg embolectomy
01520	N	Anesth, lower leg vein surg
01522	N	Anesth, lower leg vein surg
01610	N	Anesth, surgery of shoulder
01620	N	Anesth, shoulder procedure
01622	N	Anes dx shoulder arthroscopy
01630	N	Anesth, surgery of shoulder
01632	C	Anesth, surgery of shoulder
01634	C	Anesth, shoulder joint amput
01636	C	Anesth, forequarter amput
01638	C	Anesth, shoulder replacement
01650	N	Anesth, shoulder artery surg
01652	C	Anesth, shoulder vessel surg
01654	C	Anesth, shoulder vessel surg
01656	C	Anesth, arm-leg vessel surg
01670	N	Anesth, shoulder vein surg
01680	N	Anesth, shoulder casting
01682	N	Anesth, airplane cast
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, dx elbow arthroscopy
01740	N	Anesth, upper arm surgery
01742	N	Anesth, humerus surgery
01744	N	Anesth, humerus repair
01756	C	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
01810	N	Anesth, lower arm surgery
01820	N	Anesth, lower arm procedure
01829	N	Anesth, dx wrist arthroscopy
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
01905	N	Anes, spine inject, x-ray/re
01916	N	Anesth, dx arteriography
01920	N	Anesth, catheterize heart
01922	N	Anesth, cat or MRI scan
01924	N	Anes, ther interven rad, art
01925	N	Anes, ther interven rad, car
01926	N	Anes, tx interv rad hrt/cran
01930	N	Anes, ther interven rad, vei
01931	N	Anes, ther interven rad, tip
01932	N	Anes, tx interv rad, th vein
01933	N	Anes, tx interv rad, cran v
01951	N	Anesth, burn, less 4 percent
01952	N	Anesth, burn, 4-9 percent
01953	N	Anesth, burn, each 9 percent
01958	N	Anesth, antepartum manipul
01960	N	Anesth, vaginal delivery
01961	N	Anesth, cs delivery
01962	N	Anesth, emer hysterectomy
01963	N	Anesth, cs hysterectomy
01964	N	Anesth, abortion procedures
01967	N	Anesth/analg, vag delivery
01968	N	Anes/analg cs deliver add-on
01969	N	Anesth/analg cs hyst add-on
01990	C	Support for organ donor
01991	N	Anesth, nerve block/inj
01992	N	Anesth, n block/inj, prone
01995	N	Regional anesthesia limb
01996	N	Hosp manage cont drug admin
01999	N	Unlisted anesth procedure
0500F	E	Initial prenatal care visit
0501F	E	Prenatal flow sheet
0502F	E	Subsequent prenatal care
0503F	E	Postpartum care visit
1000F	E	Tobacco use, smoking, assess
1001F	E	Tobacco use, non-smoking
10021	T	Fna w/o image	0002	0.9559	$56.73		$11.35
10022	T	Fna w/image	0036	2.1773	$129.21		$25.84
1002F	E	Assess anginal symptom/level
10040	T	Acne surgery	0010	0.5719	$33.94	$9.65	$6.79
10060	T	Drainage of skin abscess	0006	1.55	$91.98	$22.28	$18.40
10061	T	Drainage of skin abscess	0006	1.55	$91.98	$22.28	$18.40
10080	T	Drainage of pilonidal cyst	0006	1.55	$91.98	$22.28	$18.40
10081	T	Drainage of pilonidal cyst	0007	11.4501	$679.48		$135.90
10120	T	Remove foreign body	0006	1.55	$91.98	$22.28	$18.40
10121	T	Remove foreign body	0021	14.9776	$888.82	$219.48	$177.76
10140	T	Drainage of hematoma/fluid	0007	11.4501	$679.48		$135.90
10160	T	Puncture drainage of lesion	0018	1.1726	$69.59	$16.04	$13.92
10180	T	Complex drainage, wound	0008	16.4989	$979.09		$195.82
11000	T	Debride infected skin	0015	1.6514	$98.00	$20.29	$19.60
11001	T	Debride infected skin add-on	0012	0.8497	$50.42	$11.18	$10.08
11004	C	Debride genitalia perineum
11005	C	Debride abdom wall
11006	C	Debride genit/per/abdom wall
11008	C	Remove mesh from abd wall
11010	T	Debride skin, fx	0019	4.0547	$240.62	$71.87	$48.12
11011	T	Debride skin/muscle, fx	0019	4.0547	$240.62	$71.87	$48.12
11012	T	Debride skin/muscle/bone, fx	0019	4.0547	$240.62	$71.87	$48.12
11040	T	Debride skin, partial	0015	1.6514	$98.00	$20.29	$19.60
11041	T	Debride skin, full	0015	1.6514	$98.00	$20.29	$19.60
11042	T	Debride skin/tissue	0016	2.5834	$153.31	$33.57	$30.66
11043	T	Debride tissue/muscle	0016	2.5834	$153.31	$33.57	$30.66
11044	T	Debride tissue/muscle/bone	0682	6.9107	$410.10	$162.42	$82.02
11055	T	Trim skin lesion	0012	0.8497	$50.42	$11.18	$10.08
11056	T	Trim skin lesions, 2 to 4	0012	0.8497	$50.42	$11.18	$10.08
11057	T	Trim skin lesions, over 4	0013	1.1078	$65.74	$14.20	$13.15
11100	T	Biopsy, skin lesion	0018	1.1726	$69.59	$16.04	$13.92
11101	T	Biopsy, skin add-on	0018	1.1726	$69.59	$16.04	$13.92
11200	T	Removal of skin tags	0013	1.1078	$65.74	$14.20	$13.15
11201	T	Remove skin tags add-on	0015	1.6514	$98.00	$20.29	$19.60
11300	T	Shave skin lesion	0012	0.8497	$50.42	$11.18	$10.08
11301	T	Shave skin lesion	0012	0.8497	$50.42	$11.18	$10.08
11302	T	Shave skin lesion	0013	1.1078	$65.74	$14.20	$13.15
11303	T	Shave skin lesion	0015	1.6514	$98.00	$20.29	$19.60
11305	T	Shave skin lesion	0013	1.1078	$65.74	$14.20	$13.15
11306	T	Shave skin lesion	0013	1.1078	$65.74	$14.20	$13.15
11307	T	Shave skin lesion	0013	1.1078	$65.74	$14.20	$13.15
11308	T	Shave skin lesion	0013	1.1078	$65.74	$14.20	$13.15
11310	T	Shave skin lesion	0013	1.1078	$65.74	$14.20	$13.15
11311	T	Shave skin lesion	0013	1.1078	$65.74	$14.20	$13.15
11312	T	Shave skin lesion	0013	1.1078	$65.74	$14.20	$13.15
11313	T	Shave skin lesion	0016	2.5834	$153.31	$33.57	$30.66
11400	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11401	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11402	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11403	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11404	T	Removal of skin lesion	0021	14.9776	$888.82	$219.48	$177.76
11406	T	Removal of skin lesion	0021	14.9776	$888.82	$219.48	$177.76
11420	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11421	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11422	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11423	T	Removal of skin lesion	0021	14.9776	$888.82	$219.48	$177.76
11424	T	Removal of skin lesion	0021	14.9776	$888.82	$219.48	$177.76
11426	T	Removal of skin lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11440	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11441	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11442	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11443	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11444	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11446	T	Removal of skin lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11450	T	Removal, sweat gland lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11451	T	Removal, sweat gland lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11462	T	Removal, sweat gland lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11463	T	Removal, sweat gland lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11470	T	Removal, sweat gland lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11471	T	Removal, sweat gland lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11600	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11601	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11602	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11603	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11604	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11606	T	Removal of skin lesion	0021	14.9776	$888.82	$219.48	$177.76
11620	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11621	T	Removal of skin lesion	0019	4.0547	$240.62	$71.87	$48.12
11622	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11623	T	Removal of skin lesion	0021	14.9776	$888.82	$219.48	$177.76
11624	T	Removal of skin lesion	0021	14.9776	$888.82	$219.48	$177.76
11626	T	Removal of skin lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11640	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11641	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11642	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11643	T	Removal of skin lesion	0020	6.9433	$412.04	$107.40	$82.41
11644	T	Removal of skin lesion	0021	14.9776	$888.82	$219.48	$177.76
11646	T	Removal of skin lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11719	T	Trim nail(s)	0009	0.668	$39.64	$8.34	$7.93
11720	T	Debride nail, 1-5	0009	0.668	$39.64	$8.34	$7.93
11721	T	Debride nail, 6 or more	0009	0.668	$39.64	$8.34	$7.93
11730	T	Removal of nail plate	0013	1.1078	$65.74	$14.20	$13.15
11732	T	Remove nail plate, add-on	0012	0.8497	$50.42	$11.18	$10.08
11740	T	Drain blood from under nail	0009	0.668	$39.64	$8.34	$7.93
11750	T	Removal of nail bed	0019	4.0547	$240.62	$71.87	$48.12
11752	T	Remove nail bed/finger tip	0022	19.6472	$1,165.92	$354.45	$233.18
11755	T	Biopsy, nail unit	0019	4.0547	$240.62	$71.87	$48.12
11760	T	Repair of nail bed	0024	1.6084	$95.45	$31.25	$19.09
11762	T	Reconstruction of nail bed	0024	1.6084	$95.45	$31.25	$19.09
11765	T	Excision of nail fold, toe	0015	1.6514	$98.00	$20.29	$19.60
11770	T	Removal of pilonidal lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11771	T	Removal of pilonidal lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11772	T	Removal of pilonidal lesion	0022	19.6472	$1,165.92	$354.45	$233.18
11900	T	Injection into skin lesions	0012	0.8497	$50.42	$11.18	$10.08
11901	T	Added skin lesions injection	0012	0.8497	$50.42	$11.18	$10.08
11920	T	Correct skin color defects	0024	1.6084	$95.45	$31.25	$19.09
11921	T	Correct skin color defects	0024	1.6084	$95.45	$31.25	$19.09
11922	T	Correct skin color defects	0024	1.6084	$95.45	$31.25	$19.09
11950	T	Therapy for contour defects	0024	1.6084	$95.45	$31.25	$19.09
11951	T	Therapy for contour defects	0024	1.6084	$95.45	$31.25	$19.09
11952	T	Therapy for contour defects	0024	1.6084	$95.45	$31.25	$19.09
11954	T	Therapy for contour defects	0024	1.6084	$95.45	$31.25	$19.09
11960	T	Insert tissue expander(s)	0027	18.4182	$1,092.99	$329.72	$218.60
11970	T	Replace tissue expander	0027	18.4182	$1,092.99	$329.72	$218.60
11971	T	Remove tissue expander(s)	0022	19.6472	$1,165.92	$354.45	$233.18
11975	E	Insert contraceptive cap
11976	T	Removal of contraceptive cap	0019	4.0547	$240.62	$71.87	$48.12
11977	E	Removal/reinsert contra cap
11980	X	Implant hormone pellet(s)	0340	0.6384	$37.88		$7.58
11981	X	Insert drug implant device	0340	0.6384	$37.88		$7.58
11982	X	Remove drug implant device	0340	0.6384	$37.88		$7.58
11983	X	Remove/insert drug implant	0340	0.6384	$37.88		$7.58
12001	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12002	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12004	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12005	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12006	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12007	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12011	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12013	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12014	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12015	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12016	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12017	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12018	T	Repair superficial wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12020	T	Closure of split wound	0024	1.6084	$95.45	$31.25	$19.09
12021	T	Closure of split wound	0024	1.6084	$95.45	$31.25	$19.09
12031	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12032	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12034	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12035	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12036	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12037	T	Layer closure of wound(s)	0025	5.4938	$326.02	$101.85	$65.20
12041	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12042	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12044	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12045	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12046	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12047	T	Layer closure of wound(s)	0025	5.4938	$326.02	$101.85	$65.20
12051	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12052	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12053	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12054	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12055	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12056	T	Layer closure of wound(s)	0024	1.6084	$95.45	$31.25	$19.09
12057	T	Layer closure of wound(s)	0025	5.4938	$326.02	$101.85	$65.20
13100	T	Repair of wound or lesion	0025	5.4938	$326.02	$101.85	$65.20
13101	T	Repair of wound or lesion	0025	5.4938	$326.02	$101.85	$65.20
13102	T	Repair wound/lesion add-on	0024	1.6084	$95.45	$31.25	$19.09
13120	T	Repair of wound or lesion	0024	1.6084	$95.45	$31.25	$19.09
13121	T	Repair of wound or lesion	0024	1.6084	$95.45	$31.25	$19.09
13122	T	Repair wound/lesion add-on	0024	1.6084	$95.45	$31.25	$19.09
13131	T	Repair of wound or lesion	0024	1.6084	$95.45	$31.25	$19.09
13132	T	Repair of wound or lesion	0024	1.6084	$95.45	$31.25	$19.09
13133	T	Repair wound/lesion add-on	0024	1.6084	$95.45	$31.25	$19.09
13150	T	Repair of wound or lesion	0025	5.4938	$326.02	$101.85	$65.20
13151	T	Repair of wound or lesion	0024	1.6084	$95.45	$31.25	$19.09
13152	T	Repair of wound or lesion	0025	5.4938	$326.02	$101.85	$65.20
13153	T	Repair wound/lesion add-on	0024	1.6084	$95.45	$31.25	$19.09
13160	T	Late closure of wound	0027	18.4182	$1,092.99	$329.72	$218.60
14000	T	Skin tissue rearrangement	0686	13.8287	$820.64		$164.13
14001	T	Skin tissue rearrangement	0027	18.4182	$1,092.99	$329.72	$218.60
14020	T	Skin tissue rearrangement	0686	13.8287	$820.64		$164.13
14021	T	Skin tissue rearrangement	0027	18.4182	$1,092.99	$329.72	$218.60
14040	T	Skin tissue rearrangement	0686	13.8287	$820.64		$164.13
14041	T	Skin tissue rearrangement	0027	18.4182	$1,092.99	$329.72	$218.60
14060	T	Skin tissue rearrangement	0027	18.4182	$1,092.99	$329.72	$218.60
14061	T	Skin tissue rearrangement	0686	13.8287	$820.64		$164.13
14300	T	Skin tissue rearrangement	0027	18.4182	$1,092.99	$329.72	$218.60
14350	T	Skin tissue rearrangement	0027	18.4182	$1,092.99	$329.72	$218.60
15000	T	Skin graft	0025	5.4938	$326.02	$101.85	$65.20
15001	T	Skin graft add-on	0025	5.4938	$326.02	$101.85	$65.20
15050	T	Skin pinch graft	0025	5.4938	$326.02	$101.85	$65.20
15100	T	Skin split graft	0027	18.4182	$1,092.99	$329.72	$218.60
15101	T	Skin split graft add-on	0027	18.4182	$1,092.99	$329.72	$218.60
15120	T	Skin split graft	0027	18.4182	$1,092.99	$329.72	$218.60
15121	T	Skin split graft add-on	0027	18.4182	$1,092.99	$329.72	$218.60
15200	T	Skin full graft	0027	18.4182	$1,092.99	$329.72	$218.60
15201	T	Skin full graft add-on	0025	5.4938	$326.02	$101.85	$65.20
15220	T	Skin full graft	0027	18.4182	$1,092.99	$329.72	$218.60
15221	T	Skin full graft add-on	0025	5.4938	$326.02	$101.85	$65.20
15240	T	Skin full graft	0686	13.8287	$820.64		$164.13
15241	T	Skin full graft add-on	0025	5.4938	$326.02	$101.85	$65.20
15260	T	Skin full graft	0686	13.8287	$820.64		$164.13
15261	T	Skin full graft add-on	0025	5.4938	$326.02	$101.85	$65.20
15342	T	Cultured skin graft, 25 cm	0024	1.6084	$95.45	$31.25	$19.09
15343	T	Culture skn graft addl 25 cm	0024	1.6084	$95.45	$31.25	$19.09
15350	T	Skin homograft	0686	13.8287	$820.64		$164.13
15351	T	Skin homograft add-on	0686	13.8287	$820.64		$164.13
15400	T	Skin heterograft	0025	5.4938	$326.02	$101.85	$65.20
15401	T	Skin heterograft add-on	0025	5.4938	$326.02	$101.85	$65.20
15570	T	Form skin pedicle flap	0027	18.4182	$1,092.99	$329.72	$218.60
15572	T	Form skin pedicle flap	0027	18.4182	$1,092.99	$329.72	$218.60
15574	T	Form skin pedicle flap	0027	18.4182	$1,092.99	$329.72	$218.60
15576	T	Form skin pedicle flap	0686	13.8287	$820.64		$164.13
15600	T	Skin graft	0027	18.4182	$1,092.99	$329.72	$218.60
15610	T	Skin graft	0027	18.4182	$1,092.99	$329.72	$218.60
15620	T	Skin graft	0027	18.4182	$1,092.99	$329.72	$218.60
15630	T	Skin graft	0027	18.4182	$1,092.99	$329.72	$218.60
15650	T	Transfer skin pedicle flap	0027	18.4182	$1,092.99	$329.72	$218.60
15732	T	Muscle-skin graft, head/neck	0027	18.4182	$1,092.99	$329.72	$218.60
15734	T	Muscle-skin graft, trunk	0027	18.4182	$1,092.99	$329.72	$218.60
15736	T	Muscle-skin graft, arm	0027	18.4182	$1,092.99	$329.72	$218.60
15738	T	Muscle-skin graft, leg	0027	18.4182	$1,092.99	$329.72	$218.60
15740	T	Island pedicle flap graft	0686	13.8287	$820.64		$164.13
15750	T	Neurovascular pedicle graft	0027	18.4182	$1,092.99	$329.72	$218.60
15756	C	Free muscle flap, microvasc
15757	C	Free skin flap, microvasc
15758	C	Free fascial flap, microvasc
15760	T	Composite skin graft	0027	18.4182	$1,092.99	$329.72	$218.60
15770	T	Derma-fat-fascia graft	0027	18.4182	$1,092.99	$329.72	$218.60
15775	T	Hair transplant punch grafts	0025	5.4938	$326.02	$101.85	$65.20
15776	T	Hair transplant punch grafts	0025	5.4938	$326.02	$101.85	$65.20
15780	T	Abrasion treatment of skin	0022	19.6472	$1,165.92	$354.45	$233.18
15781	T	Abrasion treatment of skin	0019	4.0547	$240.62	$71.87	$48.12
15782	T	Dressing change not for burn	0019	4.0547	$240.62	$71.87	$48.12
15783	T	Abrasion treatment of skin	0016	2.5834	$153.31	$33.57	$30.66
15786	T	Abrasion, lesion, single	0013	1.1078	$65.74	$14.20	$13.15
15787	T	Abrasion, lesions, add-on	0013	1.1078	$65.74	$14.20	$13.15
15788	T	Chemical peel, face, epiderm	0012	0.8497	$50.42	$11.18	$10.08
15789	T	Chemical peel, face, dermal	0015	1.6514	$98.00	$20.29	$19.60
15792	T	Chemical peel, nonfacial	0013	1.1078	$65.74	$14.20	$13.15
15793	T	Chemical peel, nonfacial	0012	0.8497	$50.42	$11.18	$10.08
15810	T	Salabrasion	0016	2.5834	$153.31	$33.57	$30.66
15811	T	Salabrasion	0016	2.5834	$153.31	$33.57	$30.66
15819	T	Plastic surgery, neck	0025	5.4938	$326.02	$101.85	$65.20
15820	T	Revision of lower eyelid	0027	18.4182	$1,092.99	$329.72	$218.60
15821	T	Revision of lower eyelid	0027	18.4182	$1,092.99	$329.72	$218.60
15822	T	Revision of upper eyelid	0027	18.4182	$1,092.99	$329.72	$218.60
15823	T	Revision of upper eyelid	0027	18.4182	$1,092.99	$329.72	$218.60
15824	T	Removal of forehead wrinkles	0027	18.4182	$1,092.99	$329.72	$218.60
15825	T	Removal of neck wrinkles	0027	18.4182	$1,092.99	$329.72	$218.60
15826	T	Removal of brow wrinkles	0027	18.4182	$1,092.99	$329.72	$218.60
15828	T	Removal of face wrinkles	0027	18.4182	$1,092.99	$329.72	$218.60
15829	T	Removal of skin wrinkles	0027	18.4182	$1,092.99	$329.72	$218.60
15831	T	Excise excessive skin tissue	0022	19.6472	$1,165.92	$354.45	$233.18
15832	T	Excise excessive skin tissue	0022	19.6472	$1,165.92	$354.45	$233.18
15833	T	Excise excessive skin tissue	0022	19.6472	$1,165.92	$354.45	$233.18
15834	T	Excise excessive skin tissue	0022	19.6472	$1,165.92	$354.45	$233.18
15835	T	Excise excessive skin tissue	0025	5.4938	$326.02	$101.85	$65.20
15836	T	Excise excessive skin tissue	0021	14.9776	$888.82	$219.48	$177.76
15837	T	Excise excessive skin tissue	0021	14.9776	$888.82	$219.48	$177.76
15838	T	Excise excessive skin tissue	0021	14.9776	$888.82	$219.48	$177.76
15839	T	Excise excessive skin tissue	0021	14.9776	$888.82	$219.48	$177.76
15840	T	Graft for face nerve palsy	0027	18.4182	$1,092.99	$329.72	$218.60
15841	T	Graft for face nerve palsy	0027	18.4182	$1,092.99	$329.72	$218.60
15842	T	Flap for face nerve palsy	0027	18.4182	$1,092.99	$329.72	$218.60
15845	T	Skin and muscle repair, face	0027	18.4182	$1,092.99	$329.72	$218.60
15850	T	Removal of sutures	0016	2.5834	$153.31	$33.57	$30.66
15851	T	Removal of sutures	0016	2.5834	$153.31	$33.57	$30.66
15852	X	Dressing change not for burn	0340	0.6384	$37.88		$7.58
15860	X	Test for blood flow in graft	0359	0.8312	$49.33		$9.87
15876	T	Suction assisted lipectomy	0027	18.4182	$1,092.99	$329.72	$218.60
15877	T	Suction assisted lipectomy	0027	18.4182	$1,092.99	$329.72	$218.60
15878	T	Suction assisted lipectomy	0686	13.8287	$820.64		$164.13
15879	T	Suction assisted lipectomy	0027	18.4182	$1,092.99	$329.72	$218.60
15920	T	Removal of tail bone ulcer	0019	4.0547	$240.62	$71.87	$48.12
15922	T	Removal of tail bone ulcer	0027	18.4182	$1,092.99	$329.72	$218.60
15931	T	Remove sacrum pressure sore	0022	19.6472	$1,165.92	$354.45	$233.18
15933	T	Remove sacrum pressure sore	0022	19.6472	$1,165.92	$354.45	$233.18
15934	T	Remove sacrum pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15935	T	Remove sacrum pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15936	T	Remove sacrum pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15937	T	Remove sacrum pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15940	T	Remove hip pressure sore	0022	19.6472	$1,165.92	$354.45	$233.18
15941	T	Remove hip pressure sore	0022	19.6472	$1,165.92	$354.45	$233.18
15944	T	Remove hip pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15945	T	Remove hip pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15946	T	Remove hip pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15950	T	Remove thigh pressure sore	0022	19.6472	$1,165.92	$354.45	$233.18
15951	T	Remove thigh pressure sore	0022	19.6472	$1,165.92	$354.45	$233.18
15952	T	Remove thigh pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15953	T	Remove thigh pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15956	T	Remove thigh pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15958	T	Remove thigh pressure sore	0027	18.4182	$1,092.99	$329.72	$218.60
15999	T	Removal of pressure sore	0019	4.0547	$240.62	$71.87	$48.12
16000	T	Initial treatment of burn(s)	0012	0.8497	$50.42	$11.18	$10.08
16010	T	Treatment of burn(s)	0016	2.5834	$153.31	$33.57	$30.66
16015	T	Treatment of burn(s)	0017	18.4211	$1,093.16	$227.84	$218.63
16020	T	Treatment of burn(s)	0013	1.1078	$65.74	$14.20	$13.15
16025	T	Treatment of burn(s)	0013	1.1078	$65.74	$14.20	$13.15
16030	T	Treatment of burn(s)	0015	1.6514	$98.00	$20.29	$19.60
16035	C	Incision of burn scab, initi
16036	C	Escharotomy addl incision
17000	T	Destroy benign/premlg lesion	0010	0.5719	$33.94	$9.65	$6.79
17003	T	Destroy lesions, 2-14	0010	0.5719	$33.94	$9.65	$6.79
17004	T	Destroy lesions, 15 or more	0011	2.0839	$123.66	$25.17	$24.73
17106	T	Destruction of skin lesions	0011	2.0839	$123.66	$25.17	$24.73
17107	T	Destruction of skin lesions	0011	2.0839	$123.66	$25.17	$24.73
17108	T	Destruction of skin lesions	0011	2.0839	$123.66	$25.17	$24.73
17110	T	Destruct lesion, 1-14	0010	0.5719	$33.94	$9.65	$6.79
17111	T	Destruct lesion, 15 or more	0010	0.5719	$33.94	$9.65	$6.79
17250	T	Chemical cautery, tissue	0013	1.1078	$65.74	$14.20	$13.15
17260	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17261	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17262	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17263	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17264	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17266	T	Destruction of skin lesions	0016	2.5834	$153.31	$33.57	$30.66
17270	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17271	T	Destruction of skin lesions	0013	1.1078	$65.74	$14.20	$13.15
17272	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17273	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17274	T	Destruction of skin lesions	0016	2.5834	$153.31	$33.57	$30.66
17276	T	Destruction of skin lesions	0016	2.5834	$153.31	$33.57	$30.66
17280	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17281	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17282	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17283	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17284	T	Destruction of skin lesions	0016	2.5834	$153.31	$33.57	$30.66
17286	T	Destruction of skin lesions	0015	1.6514	$98.00	$20.29	$19.60
17304	T	Chemosurgery of skin lesion	0694	3.8452	$228.19	$61.86	$45.64
17305	T	2 stage mohs, up to 5 spec	0694	3.8452	$228.19	$61.86	$45.64
17306	T	3 stage mohs, up to 5 spec	0694	3.8452	$228.19	$61.86	$45.64
17307	T	Mohs addl stage up to 5 spec	0694	3.8452	$228.19	$61.86	$45.64
17310	T	Extensive skin chemosurgery	0694	3.8452	$228.19	$61.86	$45.64
17340	T	Cryotherapy of skin	0012	0.8497	$50.42	$11.18	$10.08
17360	T	Skin peel therapy	0013	1.1078	$65.74	$14.20	$13.15
17380	T	Hair removal by electrolysis	0013	1.1078	$65.74	$14.20	$13.15
17999	T	Skin tissue procedure	0006	1.55	$91.98	$22.28	$18.40
19000	T	Drainage of breast lesion	0004	1.7646	$104.72	$22.36	$20.94
19001	T	Drain breast lesion add-on	0004	1.7646	$104.72	$22.36	$20.94
19020	T	Incision of breast lesion	0008	16.4989	$979.09		$195.82
19030	N	Injection for breast x-ray
19100	T	Bx breast percut w/o image	0005	3.5994	$213.60	$71.59	$42.72
19101	T	Biopsy of breast, open	0028	19.5801	$1,161.94	$303.74	$232.39
19102	T	Bx breast percut w/image	0005	3.5994	$213.60	$71.59	$42.72
19103	T	Bx breast percut w/device	0658	6.1049	$362.28		$72.46
19110	T	nipple exploration	0028	19.5801	$1,161.94	$303.74	$232.39
19112	T	Excise breast duct fistula	0028	19.5801	$1,161.94	$303.74	$232.39
19120	T	Removal of breast lesion	0028	19.5801	$1,161.94	$303.74	$232.39
19125	T	Excision, breast lesion	0028	19.5801	$1,161.94	$303.74	$232.39
19126	T	Excision, addl breast lesion	0028	19.5801	$1,161.94	$303.74	$232.39
19140	T	Removal of breast tissue	0028	19.5801	$1,161.94	$303.74	$232.39
19160	T	Removal of breast tissue	0028	19.5801	$1,161.94	$303.74	$232.39
19162	T	Remove breast tissue, nodes	0693	42.2254	$2,505.78	$798.17	$501.16
19180	T	Removal of breast	0029	32.0476	$1,901.80	$632.64	$380.36
19182	T	Removal of breast	0029	32.0476	$1,901.80	$632.64	$380.36
19200	C	Removal of breast
19220	C	Removal of breast
19240	T	Removal of breast	0030	40.0825	$2,378.62	$763.55	$475.72
19260	T	Removal of chest wall lesion	0021	14.9776	$888.82	$219.48	$177.76
19271	C	Revision of chest wall
19272	C	Extensive chest wall surgery
19290	N	Place needle wire, breast
19291	N	Place needle wire, breast
19295	S	Place breast clip, percut	0657	1.7092	$101.43		$20.29
19296	S	Place po breast cath for rad	1524		$3,250.00		$650.00
19297	S	Place breast cath for rad	1523		$2,750.00		$550.00
19298	S	Place breast rad tube/caths	1524		$3,250.00		$650.00
19316	T	Suspension of breast	0029	32.0476	$1,901.80	$632.64	$380.36
19318	T	Reduction of large breast	0693	42.2254	$2,505.78	$798.17	$501.16
19324	T	Enlarge breast	0693	42.2254	$2,505.78	$798.17	$501.16
19325	T	Enlarge breast with implant	0648	50.4459	$2,993.61		$598.72
19328	T	Removal of breast implant	0029	32.0476	$1,901.80	$632.64	$380.36
19330	T	Removal of implant material	0029	32.0476	$1,901.80	$632.64	$380.36
19340	T	Immediate breast prosthesis	0030	40.0825	$2,378.62	$763.55	$475.72
19342	T	Delayed breast prosthesis	0648	50.4459	$2,993.61		$598.72
19350	T	Breast reconstruction	0028	19.5801	$1,161.94	$303.74	$232.39
19355	T	Correct inverted nipple(s)	0029	32.0476	$1,901.80	$632.64	$380.36
19357	T	Breast reconstruction	0648	50.4459	$2,993.61		$598.72
19361	C	Breast reconstruction
19364	C	Breast reconstruction
19366	T	Breast reconstruction	0029	32.0476	$1,901.80	$632.64	$380.36
19367	C	Breast reconstruction
19368	C	Breast reconstruction
19369	C	Breast reconstruction
19370	T	Surgery of breast capsule	0029	32.0476	$1,901.80	$632.64	$380.36
19371	T	Removal of breast capsule	0029	32.0476	$1,901.80	$632.64	$380.36
19380	T	Revise breast reconstruction	0030	40.0825	$2,378.62	$763.55	$475.72
19396	T	Design custom breast implant	0029	32.0476	$1,901.80	$632.64	$380.36
19499	T	Breast surgery procedure	0028	19.5801	$1,161.94	$303.74	$232.39
20000	T	Incision of abscess	0006	1.55	$91.98	$22.28	$18.40
20005	T	Incision of deep abscess	0049	20.3707	$1,208.86		$241.77
2000F	E	Blood pressure, measured
20100	T	Explore wound, neck	0023	4.7775	$283.51		$56.70
20101	T	Explore wound, chest	0027	18.4182	$1,092.99	$329.72	$218.60
20102	T	Explore wound, abdomen	0027	18.4182	$1,092.99	$329.72	$218.60
20103	T	Explore wound, extremity	0023	4.7775	$283.51		$56.70
20150	T	Excise epiphyseal bar	0051	36.5271	$2,167.63		$433.53
20200	T	Muscle biopsy	0021	14.9776	$888.82	$219.48	$177.76
20205	T	Deep muscle biopsy	0021	14.9776	$888.82	$219.48	$177.76
20206	T	Needle biopsy, muscle	0005	3.5994	$213.60	$71.59	$42.72
20220	T	Bone biopsy, trocar/needle	0019	4.0547	$240.62	$71.87	$48.12
20225	T	Bone biopsy, trocar/needle	0020	6.9433	$412.04	$107.40	$82.41
20240	T	Bone biopsy, excisional	0022	19.6472	$1,165.92	$354.45	$233.18
20245	T	Bone biopsy, excisional	0022	19.6472	$1,165.92	$354.45	$233.18
20250	T	Open bone biopsy	0049	20.3707	$1,208.86		$241.77
20251	T	Open bone biopsy	0049	20.3707	$1,208.86		$241.77
20500	T	Injection of sinus tract	0251	2.0101	$119.29		$23.86
20501	N	Inject sinus tract for x-ray
20520	T	Removal of foreign body	0019	4.0547	$240.62	$71.87	$48.12
20525	T	Removal of foreign body	0022	19.6472	$1,165.92	$354.45	$233.18
20526	T	Ther injection, carp tunnel	0204	2.191	$130.02	$40.13	$26.00
20550	T	Inject tendon/ligament/cyst	0204	2.191	$130.02	$40.13	$26.00
20551	T	Inj tendon origin/insertion	0204	2.191	$130.02	$40.13	$26.00
20552	T	Inj trigger point, 1/2 muscl	0204	2.191	$130.02	$40.13	$26.00
20553	T	Inject trigger points, 3	0204	2.191	$130.02	$40.13	$26.00
20600	T	Drain/inject, joint/bursa	0204	2.191	$130.02	$40.13	$26.00
20605	T	Drain/inject, joint/bursa	0204	2.191	$130.02	$40.13	$26.00
20610	T	Drain/inject, joint/bursa	0204	2.191	$130.02	$40.13	$26.00
20612	T	Aspirate/inj ganglion cyst	0204	2.191	$130.02	$40.13	$26.00
20615	T	Treatment of bone cyst	0004	1.7646	$104.72	$22.36	$20.94
20650	T	Insert and remove bone pin	0049	20.3707	$1,208.86		$241.77
20660	C	Apply, rem fixation device
20661	C	Application of head brace
20662	T	Application of pelvis brace	0049	20.3707	$1,208.86		$241.77
20663	T	Application of thigh brace	0049	20.3707	$1,208.86		$241.77
20664	C	Halo brace application
20665	X	Removal of fixation device	0340	0.6384	$37.88		$7.58
20670	T	Removal of support implant	0021	14.9776	$888.82	$219.48	$177.76
20680	T	Removal of support implant	0022	19.6472	$1,165.92	$354.45	$233.18
20690	T	Apply bone fixation device	0050	23.9081	$1,418.78		$283.76
20692	T	Apply bone fixation device	0050	23.9081	$1,418.78		$283.76
20693	T	Adjust bone fixation device	0049	20.3707	$1,208.86		$241.77
20694	T	Remove bone fixation device	0049	20.3707	$1,208.86		$241.77
20802	C	Replantation, arm, complete
20805	C	Replant forearm, complete
20808	C	Replantation hand, complete
20816	C	Replantation digit, complete
20822	T	Replantation digit, complete	0054	25.3711	$1,505.60		$301.12
20824	C	Replantation thumb, complete
20827	C	Replantation thumb, complete
20838	C	Replantation foot, complete
20900	T	Removal of bone for graft	0050	23.9081	$1,418.78		$283.76
20902	T	Removal of bone for graft	0050	23.9081	$1,418.78		$283.76
20910	T	Remove cartilage for graft	0027	18.4182	$1,092.99	$329.72	$218.60
20912	T	Remove cartilage for graft	0027	18.4182	$1,092.99	$329.72	$218.60
20920	T	Removal of fascia for graft	0686	13.8287	$820.64		$164.13
20922	T	Removal of fascia for graft	0027	18.4182	$1,092.99	$329.72	$218.60
20924	T	Removal of tendon for graft	0050	23.9081	$1,418.78		$283.76
20926	T	Removal of tissue for graft	0686	13.8287	$820.64		$164.13
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	0006	1.55	$91.98	$22.28	$18.40
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	T	Bone/skin graft, metatarsal	0056	40.2957	$2,391.27		$478.25
20973	T	Bone/skin graft, great toe	0056	40.2957	$2,391.27		$478.25
20974	A	Electrical bone stimulation
20975	X	Electrical bone stimulation	0340	0.6384	$37.88		$7.58
20979	A	Us bone stimulation
20982	T	Ablate, bone tumor(s) perq	1557		$1,850.00		$370.00
20999	T	Musculoskeletal surgery	0049	20.3707	$1,208.86		$241.77
21010	T	Incision of jaw joint	0254	23.404	$1,388.86	$321.35	$277.77
21015	T	Resection of facial tumor	0253	16.1357	$957.54	$282.29	$191.51
21025	T	Excision of bone, lower jaw	0256	37.3204	$2,214.70		$442.94
21026	T	Excision of facial bone(s)	0256	37.3204	$2,214.70		$442.94
21029	T	Contour of face bone lesion	0256	37.3204	$2,214.70		$442.94
21030	T	Removal of face bone lesion	0254	23.404	$1,388.86	$321.35	$277.77
21031	T	Remove exostosis, mandible	0254	23.404	$1,388.86	$321.35	$277.77
21032	T	Remove exostosis, maxilla	0254	23.404	$1,388.86	$321.35	$277.77
21034	T	Removal of face bone lesion	0256	37.3204	$2,214.70		$442.94
21040	T	Removal of jaw bone lesion	0254	23.404	$1,388.86	$321.35	$277.77
21044	T	Removal of jaw bone lesion	0256	37.3204	$2,214.70		$442.94
21045	C	Extensive jaw surgery
21046	T	Remove mandible cyst complex	0256	37.3204	$2,214.70		$442.94
21047	T	Excise lwr jaw cyst w/repair	0256	37.3204	$2,214.70		$442.94
21048	T	Remove maxilla cyst complex	0256	37.3204	$2,214.70		$442.94
21049	T	Excis uppr jaw cyst w/repair	0256	37.3204	$2,214.70		$442.94
21050	T	Removal of jaw joint	0256	37.3204	$2,214.70		$442.94
21060	T	Remove jaw joint cartilage	0256	37.3204	$2,214.70		$442.94
21070	T	Remove coronoid process	0256	37.3204	$2,214.70		$442.94
21076	T	Prepare face/oral prosthesis	0254	23.404	$1,388.86	$321.35	$277.77
21077	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21079	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21080	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21081	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21082	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21083	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21084	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21085	T	Prepare face/oral prosthesis	0253	16.1357	$957.54	$282.29	$191.51
21086	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21087	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21088	T	Prepare face/oral prosthesis	0256	37.3204	$2,214.70		$442.94
21089	T	Prepare face/oral prosthesis	0251	2.0101	$119.29		$23.86
21100	T	Maxillofacial fixation	0256	37.3204	$2,214.70		$442.94
21110	T	Interdental fixation	0252	7.8673	$466.87	$113.41	$93.37
21116	N	Injection, jaw joint x-ray
21120	T	Reconstruction of chin	0254	23.404	$1,388.86	$321.35	$277.77
21121	T	Reconstruction of chin	0254	23.404	$1,388.86	$321.35	$277.77
21122	T	Reconstruction of chin	0254	23.404	$1,388.86	$321.35	$277.77
21123	T	Reconstruction of chin	0254	23.404	$1,388.86	$321.35	$277.77
21125	T	Augmentation, lower jaw bone	0254	23.404	$1,388.86	$321.35	$277.77
21127	T	Augmentation, lower jaw bone	0256	37.3204	$2,214.70		$442.94
21137	T	Reduction of forehead	0254	23.404	$1,388.86	$321.35	$277.77
21138	T	Reduction of forehead	0256	37.3204	$2,214.70		$442.94
21139	T	Reduction of forehead	0256	37.3204	$2,214.70		$442.94
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	T	Reconstruct midface, lefort	0256	37.3204	$2,214.70		$442.94
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	T	Reconstruct orbit/forehead	0256	37.3204	$2,214.70		$442.94
21179	C	Reconstruct entire forehead
21180	C	Reconstruct entire forehead
21181	T	Contour cranial bone lesion	0254	23.404	$1,388.86	$321.35	$277.77
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	T	Reconst lwr jaw w/o fixation	0256	37.3204	$2,214.70		$442.94
21196	C	Reconst lwr jaw w/fixation
21198	T	Reconstr lwr jaw segment	0256	37.3204	$2,214.70		$442.94
21199	T	Reconstr lwr jaw w/advance	0256	37.3204	$2,214.70		$442.94
21206	T	Reconstruct upper jaw bone	0256	37.3204	$2,214.70		$442.94
21208	T	Augmentation of facial bones	0256	37.3204	$2,214.70		$442.94
21209	T	Reduction of facial bones	0256	37.3204	$2,214.70		$442.94
21210	T	Face bone graft	0256	37.3204	$2,214.70		$442.94
21215	T	Lower jaw bone graft	0256	37.3204	$2,214.70		$442.94
21230	T	Rib cartilage graft	0256	37.3204	$2,214.70		$442.94
21235	T	Ear cartilage graft	0254	23.404	$1,388.86	$321.35	$277.77
21240	T	Reconstruction of jaw joint	0256	37.3204	$2,214.70		$442.94
21242	T	Reconstruction of jaw joint	0256	37.3204	$2,214.70		$442.94
21243	T	Reconstruction of jaw joint	0256	37.3204	$2,214.70		$442.94
21244	T	Reconstruction of lower jaw	0256	37.3204	$2,214.70		$442.94
21245	T	Reconstruction of jaw	0256	37.3204	$2,214.70		$442.94
21246	T	Reconstruction of jaw	0256	37.3204	$2,214.70		$442.94
21247	C	Reconstruct lower jaw bone
21248	T	Reconstruction of jaw	0256	37.3204	$2,214.70		$442.94
21249	T	Reconstruction of jaw	0256	37.3204	$2,214.70		$442.94
21255	C	Reconstruct lower jaw bone
21256	C	Reconstruction of orbit
21260	T	Revise eye sockets	0256	37.3204	$2,214.70		$442.94
21261	T	Revise eye sockets	0256	37.3204	$2,214.70		$442.94
21263	T	Revise eye sockets	0256	37.3204	$2,214.70		$442.94
21267	T	Revise eye sockets	0256	37.3204	$2,214.70		$442.94
21268	C	Revise eye sockets
21270	T	Augmentation, cheek bone	0256	37.3204	$2,214.70		$442.94
21275	T	Revision, orbitofacial bones	0256	37.3204	$2,214.70		$442.94
21280	T	Revision of eyelid	0256	37.3204	$2,214.70		$442.94
21282	T	Revision of eyelid	0253	16.1357	$957.54	$282.29	$191.51
21295	T	Revision of jaw muscle/bone	0252	7.8673	$466.87	$113.41	$93.37
21296	T	Revision of jaw muscle/bone	0254	23.404	$1,388.86	$321.35	$277.77
21299	T	Cranio/maxillofacial surgery	0251	2.0101	$119.29		$23.86
21300	T	Treatment of skull fracture	0253	16.1357	$957.54	$282.29	$191.51
21310	T	Treatment of nose fracture	0251	2.0101	$119.29		$23.86
21315	T	Treatment of nose fracture	0251	2.0101	$119.29		$23.86
21320	T	Treatment of nose fracture	0252	7.8673	$466.87	$113.41	$93.37
21325	T	Treatment of nose fracture	0254	23.404	$1,388.86	$321.35	$277.77
21330	T	Treatment of nose fracture	0254	23.404	$1,388.86	$321.35	$277.77
21335	T	Treatment of nose fracture	0254	23.404	$1,388.86	$321.35	$277.77
21336	T	Treat nasal septal fracture	0046	37.7023	$2,237.37	$535.76	$447.47
21337	T	Treat nasal septal fracture	0253	16.1357	$957.54	$282.29	$191.51
21338	T	Treat nasoethmoid fracture	0254	23.404	$1,388.86	$321.35	$277.77
21339	T	Treat nasoethmoid fracture	0254	23.404	$1,388.86	$321.35	$277.77
21340	T	Treatment of nose fracture	0256	37.3204	$2,214.70		$442.94
21343	C	Treatment of sinus fracture
21344	C	Treatment of sinus fracture
21345	T	Treat nose/jaw fracture	0254	23.404	$1,388.86	$321.35	$277.77
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	37.3204	$2,214.70		$442.94
21356	T	Treat cheek bone fracture	0254	23.404	$1,388.86	$321.35	$277.77
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	T	Treat eye socket fracture	0256	37.3204	$2,214.70		$442.94
21395	C	Treat eye socket fracture
21400	T	Treat eye socket fracture	0252	7.8673	$466.87	$113.41	$93.37
21401	T	Treat eye socket fracture	0253	16.1357	$957.54	$282.29	$191.51
21406	T	Treat eye socket fracture	0256	37.3204	$2,214.70		$442.94
21407	T	Treat eye socket fracture	0256	37.3204	$2,214.70		$442.94
21408	T	Treat eye socket fracture	0256	37.3204	$2,214.70		$442.94
21421	T	Treat mouth roof fracture	0254	23.404	$1,388.86	$321.35	$277.77
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	0254	23.404	$1,388.86	$321.35	$277.77
21445	T	Treat dental ridge fracture	0254	23.404	$1,388.86	$321.35	$277.77
21450	T	Treat lower jaw fracture	0251	2.0101	$119.29		$23.86
21451	T	Treat lower jaw fracture	0252	7.8673	$466.87	$113.41	$93.37
21452	T	Treat lower jaw fracture	0253	16.1357	$957.54	$282.29	$191.51
21453	T	Treat lower jaw fracture	0256	37.3204	$2,214.70		$442.94
21454	T	Treat lower jaw fracture	0254	23.404	$1,388.86	$321.35	$277.77
21461	T	Treat lower jaw fracture	0256	37.3204	$2,214.70		$442.94
21462	T	Treat lower jaw fracture	0256	37.3204	$2,214.70		$442.94
21465	T	Treat lower jaw fracture	0256	37.3204	$2,214.70		$442.94
21470	T	Treat lower jaw fracture	0256	37.3204	$2,214.70		$442.94
21480	T	Reset dislocated jaw	0251	2.0101	$119.29		$23.86
21485	T	Reset dislocated jaw	0253	16.1357	$957.54	$282.29	$191.51
21490	T	Repair dislocated jaw	0256	37.3204	$2,214.70		$442.94
21493	T	Treat hyoid bone fracture	0252	7.8673	$466.87	$113.41	$93.37
21494	T	Treat hyoid bone fracture	0252	7.8673	$466.87	$113.41	$93.37
21495	T	Treat hyoid bone fracture	0253	16.1357	$957.54	$282.29	$191.51
21497	T	Interdental wiring	0253	16.1357	$957.54	$282.29	$191.51
21499	T	Head surgery procedure	0251	2.0101	$119.29		$23.86
21501	T	Drain neck/chest lesion	0008	16.4989	$979.09		$195.82
21502	T	Drain chest lesion	0049	20.3707	$1,208.86		$241.77
21510	C	Drainage of bone lesion
21550	T	Biopsy of neck/chest	0021	14.9776	$888.82	$219.48	$177.76
21555	T	Remove lesion, neck/chest	0022	19.6472	$1,165.92	$354.45	$233.18
21556	T	Remove lesion, neck/chest	0022	19.6472	$1,165.92	$354.45	$233.18
21557	T	Remove tumor, neck/chest	0022	19.6472	$1,165.92	$354.45	$233.18
21600	T	Partial removal of rib	0050	23.9081	$1,418.78		$283.76
21610	T	Partial removal of rib	0050	23.9081	$1,418.78		$283.76
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
21685	T	Hyoid myotomy suspension	0252	7.8673	$466.87	$113.41	$93.37
21700	T	Revision of neck muscle	0049	20.3707	$1,208.86		$241.77
21705	C	Revision of neck muscle/rib
21720	T	Revision of neck muscle	0049	20.3707	$1,208.86		$241.77
21725	T	Revision of neck muscle	0006	1.55	$91.98	$22.28	$18.40
21740	C	Reconstruction of sternum
21742	T	Repair stern/nuss w/o scope	0051	36.5271	$2,167.63		$433.53
21743	T	Repair sternum/nuss w/scope	0051	36.5271	$2,167.63		$433.53
21750	C	Repair of sternum separation
21800	T	Treatment of rib fracture	0043	1.7694	$105.00		$21.00
21805	T	Treatment of rib fracture	0046	37.7023	$2,237.37	$535.76	$447.47
21810	C	Treatment of rib fracture(s)
21820	T	Treat sternum fracture	0043	1.7694	$105.00		$21.00
21825	C	Treat sternum fracture
21899	T	Neck/chest surgery procedure	0251	2.0101	$119.29		$23.86
21920	T	Biopsy soft tissue of back	0020	6.9433	$412.04	$107.40	$82.41
21925	T	Biopsy soft tissue of back	0022	19.6472	$1,165.92	$354.45	$233.18
21930	T	Remove lesion, back or flank	0022	19.6472	$1,165.92	$354.45	$233.18
21935	T	Remove tumor, back	0022	19.6472	$1,165.92	$354.45	$233.18
22100	T	Remove part of neck vertebra	0208	42.3409	$2,512.64		$502.53
22101	T	Remove part, thorax vertebra	0208	42.3409	$2,512.64		$502.53
22102	T	Remove part, lumbar vertebra	0208	42.3409	$2,512.64		$502.53
22103	T	Remove extra spine segment	0208	42.3409	$2,512.64		$502.53
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	T	Revision of thorax spine	0208	42.3409	$2,512.64		$502.53
22224	C	Revision of lumbar spine
22226	C	Revise, extra spine segment
22305	T	Treat spine process fracture	0043	1.7694	$105.00		$21.00
22310	T	Treat spine fracture	0043	1.7694	$105.00		$21.00
22315	T	Treat spine fracture	0043	1.7694	$105.00		$21.00
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	14.4945	$860.15	$268.47	$172.03
22520	T	Percut vertebroplasty thor	0050	23.9081	$1,418.78		$283.76
22521	T	Percut vertebroplasty lumb	0050	23.9081	$1,418.78		$283.76
22522	T	Percut vertebroplasty add'l	0050	23.9081	$1,418.78		$283.76
22532	C	Lat thorax spine fusion
22533	C	Lat lumbar spine fusion
22534	C	Lat thor/lumb, add'l seg
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	T	Lumbar spine fusion	0208	42.3409	$2,512.64		$502.53
22614	T	Spine fusion, extra segment	0208	42.3409	$2,512.64		$502.53
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	1.7694	$105.00		$21.00
22900	T	Remove abdominal wall lesion	0022	19.6472	$1,165.92	$354.45	$233.18
22999	T	Abdomen surgery procedure	0019	4.0547	$240.62	$71.87	$48.12
23000	T	Removal of calcium deposits	0021	14.9776	$888.82	$219.48	$177.76
23020	T	Release shoulder joint	0051	36.5271	$2,167.63		$433.53
23030	T	Drain shoulder lesion	0008	16.4989	$979.09		$195.82
23031	T	Drain shoulder bursa	0008	16.4989	$979.09		$195.82
23035	T	Drain shoulder bone lesion	0049	20.3707	$1,208.86		$241.77
23040	T	Exploratory shoulder surgery	0050	23.9081	$1,418.78		$283.76
23044	T	Exploratory shoulder surgery	0050	23.9081	$1,418.78		$283.76
23065	T	Biopsy shoulder tissues	0021	14.9776	$888.82	$219.48	$177.76
23066	T	Biopsy shoulder tissues	0022	19.6472	$1,165.92	$354.45	$233.18
23075	T	Removal of shoulder lesion	0021	14.9776	$888.82	$219.48	$177.76
23076	T	Removal of shoulder lesion	0022	19.6472	$1,165.92	$354.45	$233.18
23077	T	Remove tumor of shoulder	0022	19.6472	$1,165.92	$354.45	$233.18
23100	T	Biopsy of shoulder joint	0049	20.3707	$1,208.86		$241.77
23101	T	Shoulder joint surgery	0050	23.9081	$1,418.78		$283.76
23105	T	Remove shoulder joint lining	0050	23.9081	$1,418.78		$283.76
23106	T	Incision of collarbone joint	0050	23.9081	$1,418.78		$283.76
23107	T	Explore treat shoulder joint	0050	23.9081	$1,418.78		$283.76
23120	T	Partial removal, collar bone	0051	36.5271	$2,167.63		$433.53
23125	T	Removal of collar bone	0051	36.5271	$2,167.63		$433.53
23130	T	Remove shoulder bone, part	0051	36.5271	$2,167.63		$433.53
23140	T	Removal of bone lesion	0049	20.3707	$1,208.86		$241.77
23145	T	Removal of bone lesion	0050	23.9081	$1,418.78		$283.76
23146	T	Removal of bone lesion	0050	23.9081	$1,418.78		$283.76
23150	T	Removal of humerus lesion	0050	23.9081	$1,418.78		$283.76
23155	T	Removal of humerus lesion	0050	23.9081	$1,418.78		$283.76
23156	T	Removal of humerus lesion	0050	23.9081	$1,418.78		$283.76
23170	T	Remove collar bone lesion	0050	23.9081	$1,418.78		$283.76
23172	T	Remove shoulder blade lesion	0050	23.9081	$1,418.78		$283.76
23174	T	Remove humerus lesion	0050	23.9081	$1,418.78		$283.76
23180	T	Remove collar bone lesion	0050	23.9081	$1,418.78		$283.76
23182	T	Remove shoulder blade lesion	0050	23.9081	$1,418.78		$283.76
23184	T	Remove humerus lesion	0050	23.9081	$1,418.78		$283.76
23190	T	Partial removal of scapula	0050	23.9081	$1,418.78		$283.76
23195	T	Removal of head of humerus	0050	23.9081	$1,418.78		$283.76
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	0020	6.9433	$412.04	$107.40	$82.41
23331	T	Remove shoulder foreign body	0022	19.6472	$1,165.92	$354.45	$233.18
23332	C	Remove shoulder foreign body
23350	N	Injection for shoulder x-ray
23395	T	Muscle transfer,shoulder/arm	0051	36.5271	$2,167.63		$433.53
23397	T	Muscle transfers	0052	43.9378	$2,607.40		$521.48
23400	T	Fixation of shoulder blade	0050	23.9081	$1,418.78		$283.76
23405	T	Incision of tendon muscle	0050	23.9081	$1,418.78		$283.76
23406	T	Incise tendon(s) muscle(s)	0050	23.9081	$1,418.78		$283.76
23410	T	Repair of tendon(s)	0052	43.9378	$2,607.40		$521.48
23412	T	Repair rotator cuff, chronic	0052	43.9378	$2,607.40		$521.48
23415	T	Release of shoulder ligament	0051	36.5271	$2,167.63		$433.53
23420	T	Repair of shoulder	0052	43.9378	$2,607.40		$521.48
23430	T	Repair biceps tendon	0052	43.9378	$2,607.40		$521.48
23440	T	Remove/transplant tendon	0052	43.9378	$2,607.40		$521.48
23450	T	Repair shoulder capsule	0052	43.9378	$2,607.40		$521.48
23455	T	Repair shoulder capsule	0052	43.9378	$2,607.40		$521.48
23460	T	Repair shoulder capsule	0052	43.9378	$2,607.40		$521.48
23462	T	Repair shoulder capsule	0052	43.9378	$2,607.40		$521.48
23465	T	Repair shoulder capsule	0052	43.9378	$2,607.40		$521.48
23466	T	Repair shoulder capsule	0052	43.9378	$2,607.40		$521.48
23470	T	Reconstruct shoulder joint	0425	100.2058	$5,946.51	$1,378.01	$1,189.30
23472	C	Reconstruct shoulder joint
23480	T	Revision of collar bone	0051	36.5271	$2,167.63		$433.53
23485	T	Revision of collar bone	0051	36.5271	$2,167.63		$433.53
23490	T	Reinforce clavicle	0051	36.5271	$2,167.63		$433.53
23491	T	Reinforce shoulder bones	0051	36.5271	$2,167.63		$433.53
23500	T	Treat clavicle fracture	0043	1.7694	$105.00		$21.00
23505	T	Treat clavicle fracture	0043	1.7694	$105.00		$21.00
23515	T	Treat clavicle fracture	0046	37.7023	$2,237.37	$535.76	$447.47
23520	T	Treat clavicle dislocation	0043	1.7694	$105.00		$21.00
23525	T	Treat clavicle dislocation	0043	1.7694	$105.00		$21.00
23530	T	Treat clavicle dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
23532	T	Treat clavicle dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
23540	T	Treat clavicle dislocation	0043	1.7694	$105.00		$21.00
23545	T	Treat clavicle dislocation	0043	1.7694	$105.00		$21.00
23550	T	Treat clavicle dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
23552	T	Treat clavicle dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
23570	T	Treat shoulder blade fx	0043	1.7694	$105.00		$21.00
23575	T	Treat shoulder blade fx	0043	1.7694	$105.00		$21.00
23585	T	Treat scapula fracture	0046	37.7023	$2,237.37	$535.76	$447.47
23600	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
23605	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
23615	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
23616	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
23620	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
23625	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
23630	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
23650	T	Treat shoulder dislocation	0043	1.7694	$105.00		$21.00
23655	T	Treat shoulder dislocation	0045	14.4945	$860.15	$268.47	$172.03
23660	T	Treat shoulder dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
23665	T	Treat dislocation/fracture	0043	1.7694	$105.00		$21.00
23670	T	Treat dislocation/fracture	0046	37.7023	$2,237.37	$535.76	$447.47
23675	T	Treat dislocation/fracture	0043	1.7694	$105.00		$21.00
23680	T	Treat dislocation/fracture	0046	37.7023	$2,237.37	$535.76	$447.47
23700	T	Fixation of shoulder	0045	14.4945	$860.15	$268.47	$172.03
23800	T	Fusion of shoulder joint	0051	36.5271	$2,167.63		$433.53
23802	T	Fusion of shoulder joint	0051	36.5271	$2,167.63		$433.53
23900	C	Amputation of arm girdle
23920	C	Amputation at shoulder joint
23921	T	Amputation follow-up surgery	0025	5.4938	$326.02	$101.85	$65.20
23929	T	Shoulder surgery procedure	0043	1.7694	$105.00		$21.00
23930	T	Drainage of arm lesion	0008	16.4989	$979.09		$195.82
23931	T	Drainage of arm bursa	0008	16.4989	$979.09		$195.82
23935	T	Drain arm/elbow bone lesion	0049	20.3707	$1,208.86		$241.77
24000	T	Exploratory elbow surgery	0050	23.9081	$1,418.78		$283.76
24006	T	Release elbow joint	0050	23.9081	$1,418.78		$283.76
24065	T	Biopsy arm/elbow soft tissue	0021	14.9776	$888.82	$219.48	$177.76
24066	T	Biopsy arm/elbow soft tissue	0021	14.9776	$888.82	$219.48	$177.76
24075	T	Remove arm/elbow lesion	0021	14.9776	$888.82	$219.48	$177.76
24076	T	Remove arm/elbow lesion	0022	19.6472	$1,165.92	$354.45	$233.18
24077	T	Remove tumor of arm/elbow	0022	19.6472	$1,165.92	$354.45	$233.18
24100	T	Biopsy elbow joint lining	0049	20.3707	$1,208.86		$241.77
24101	T	Explore/treat elbow joint	0050	23.9081	$1,418.78		$283.76
24102	T	Remove elbow joint lining	0050	23.9081	$1,418.78		$283.76
24105	T	Removal of elbow bursa	0049	20.3707	$1,208.86		$241.77
24110	T	Remove humerus lesion	0049	20.3707	$1,208.86		$241.77
24115	T	Remove/graft bone lesion	0050	23.9081	$1,418.78		$283.76
24116	T	Remove/graft bone lesion	0050	23.9081	$1,418.78		$283.76
24120	T	Remove elbow lesion	0049	20.3707	$1,208.86		$241.77
24125	T	Remove/graft bone lesion	0050	23.9081	$1,418.78		$283.76
24126	T	Remove/graft bone lesion	0050	23.9081	$1,418.78		$283.76
24130	T	Removal of head of radius	0050	23.9081	$1,418.78		$283.76
24134	T	Removal of arm bone lesion	0050	23.9081	$1,418.78		$283.76
24136	T	Remove radius bone lesion	0050	23.9081	$1,418.78		$283.76
24138	T	Remove elbow bone lesion	0050	23.9081	$1,418.78		$283.76
24140	T	Partial removal of arm bone	0050	23.9081	$1,418.78		$283.76
24145	T	Partial removal of radius	0050	23.9081	$1,418.78		$283.76
24147	T	Partial removal of elbow	0050	23.9081	$1,418.78		$283.76
24149	T	Radical resection of elbow	0050	23.9081	$1,418.78		$283.76
24150	T	Extensive humerus surgery	0052	43.9378	$2,607.40		$521.48
24151	T	Extensive humerus surgery	0052	43.9378	$2,607.40		$521.48
24152	T	Extensive radius surgery	0052	43.9378	$2,607.40		$521.48
24153	T	Extensive radius surgery	0052	43.9378	$2,607.40		$521.48
24155	T	Removal of elbow joint	0051	36.5271	$2,167.63		$433.53
24160	T	Remove elbow joint implant	0050	23.9081	$1,418.78		$283.76
24164	T	Remove radius head implant	0050	23.9081	$1,418.78		$283.76
24200	T	Removal of arm foreign body	0019	4.0547	$240.62	$71.87	$48.12
24201	T	Removal of arm foreign body	0021	14.9776	$888.82	$219.48	$177.76
24220	N	Injection for elbow x-ray
24300	T	Manipulate elbow w/anesth	0045	14.4945	$860.15	$268.47	$172.03
24301	T	Muscle/tendon transfer	0050	23.9081	$1,418.78		$283.76
24305	T	Arm tendon lengthening	0050	23.9081	$1,418.78		$283.76
24310	T	Revision of arm tendon	0049	20.3707	$1,208.86		$241.77
24320	T	Repair of arm tendon	0051	36.5271	$2,167.63		$433.53
24330	T	Revision of arm muscles	0051	36.5271	$2,167.63		$433.53
24331	T	Revision of arm muscles	0051	36.5271	$2,167.63		$433.53
24332	T	Tenolysis, triceps	0049	20.3707	$1,208.86		$241.77
24340	T	Repair of biceps tendon	0051	36.5271	$2,167.63		$433.53
24341	T	Repair arm tendon/muscle	0051	36.5271	$2,167.63		$433.53
24342	T	Repair of ruptured tendon	0051	36.5271	$2,167.63		$433.53
24343	T	Repr elbow lat ligmnt w/tiss	0050	23.9081	$1,418.78		$283.76
24344	T	Reconstruct elbow lat ligmnt	0051	36.5271	$2,167.63		$433.53
24345	T	Repr elbw med ligmnt w/tissu	0050	23.9081	$1,418.78		$283.76
24346	T	Reconstruct elbow med ligmnt	0051	36.5271	$2,167.63		$433.53
24350	T	Repair of tennis elbow	0050	23.9081	$1,418.78		$283.76
24351	T	Repair of tennis elbow	0050	23.9081	$1,418.78		$283.76
24352	T	Repair of tennis elbow	0050	23.9081	$1,418.78		$283.76
24354	T	Repair of tennis elbow	0050	23.9081	$1,418.78		$283.76
24356	T	Revision of tennis elbow	0050	23.9081	$1,418.78		$283.76
24360	T	Reconstruct elbow joint	0047	31.6107	$1,875.87	$537.03	$375.17
24361	T	Reconstruct elbow joint	0425	100.2058	$5,946.51	$1,378.01	$1,189.30
24362	T	Reconstruct elbow joint	0048	43.1288	$2,559.39	$570.30	$511.88
24363	T	Replace elbow joint	0425	100.2058	$5,946.51	$1,378.01	$1,189.30
24365	T	Reconstruct head of radius	0047	31.6107	$1,875.87	$537.03	$375.17
24366	T	Reconstruct head of radius	0425	100.2058	$5,946.51	$1,378.01	$1,189.30
24400	T	Revision of humerus	0050	23.9081	$1,418.78		$283.76
24410	T	Revision of humerus	0050	23.9081	$1,418.78		$283.76
24420	T	Revision of humerus	0051	36.5271	$2,167.63		$433.53
24430	T	Repair of humerus	0051	36.5271	$2,167.63		$433.53
24435	T	Repair humerus with graft	0051	36.5271	$2,167.63		$433.53
24470	T	Revision of elbow joint	0051	36.5271	$2,167.63		$433.53
24495	T	Decompression of forearm	0050	23.9081	$1,418.78		$283.76
24498	T	Reinforce humerus	0051	36.5271	$2,167.63		$433.53
24500	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
24505	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
24515	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24516	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24530	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
24535	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
24538	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24545	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24546	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24560	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
24565	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
24566	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24575	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24576	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
24577	T	Treat humerus fracture	0043	1.7694	$105.00		$21.00
24579	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24582	T	Treat humerus fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24586	T	Treat elbow fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24587	T	Treat elbow fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24600	T	Treat elbow dislocation	0043	1.7694	$105.00		$21.00
24605	T	Treat elbow dislocation	0045	14.4945	$860.15	$268.47	$172.03
24615	T	Treat elbow dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
24620	T	Treat elbow fracture	0043	1.7694	$105.00		$21.00
24635	T	Treat elbow fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24640	T	Treat elbow dislocation	0043	1.7694	$105.00		$21.00
24650	T	Treat radius fracture	0043	1.7694	$105.00		$21.00
24655	T	Treat radius fracture	0043	1.7694	$105.00		$21.00
24665	T	Treat radius fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24666	T	Treat radius fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24670	T	Treat ulnar fracture	0043	1.7694	$105.00		$21.00
24675	T	Treat ulnar fracture	0043	1.7694	$105.00		$21.00
24685	T	Treat ulnar fracture	0046	37.7023	$2,237.37	$535.76	$447.47
24800	T	Fusion of elbow joint	0051	36.5271	$2,167.63		$433.53
24802	T	Fusion/graft of elbow joint	0051	36.5271	$2,167.63		$433.53
24900	C	Amputation of upper arm
24920	C	Amputation of upper arm
24925	T	Amputation follow-up surgery	0049	20.3707	$1,208.86		$241.77
24930	C	Amputation follow-up surgery
24931	C	Amputate upper arm implant
24935	T	Revision of amputation	0052	43.9378	$2,607.40		$521.48
24940	C	Revision of upper arm
24999	T	Upper arm/elbow surgery	0043	1.7694	$105.00		$21.00
25000	T	Incision of tendon sheath	0049	20.3707	$1,208.86		$241.77
25001	T	Incise flexor carpi radialis	0049	20.3707	$1,208.86		$241.77
25020	T	Decompress forearm 1 space	0049	20.3707	$1,208.86		$241.77
25023	T	Decompress forearm 1 space	0050	23.9081	$1,418.78		$283.76
25024	T	Decompress forearm 2 spaces	0050	23.9081	$1,418.78		$283.76
25025	T	Decompress forearm 2 spaces	0050	23.9081	$1,418.78		$283.76
25028	T	Drainage of forearm lesion	0049	20.3707	$1,208.86		$241.77
25031	T	Drainage of forearm bursa	0049	20.3707	$1,208.86		$241.77
25035	T	Treat forearm bone lesion	0049	20.3707	$1,208.86		$241.77
25040	T	Explore/treat wrist joint	0050	23.9081	$1,418.78		$283.76
25065	T	Biopsy forearm soft tissues	0021	14.9776	$888.82	$219.48	$177.76
25066	T	Biopsy forearm soft tissues	0022	19.6472	$1,165.92	$354.45	$233.18
25075	T	Removel forearm lesion subcu	0021	14.9776	$888.82	$219.48	$177.76
25076	T	Removel forearm lesion deep	0022	19.6472	$1,165.92	$354.45	$233.18
25077	T	Remove tumor, forearm/wrist	0022	19.6472	$1,165.92	$354.45	$233.18
25085	T	Incision of wrist capsule	0049	20.3707	$1,208.86		$241.77
25100	T	Biopsy of wrist joint	0049	20.3707	$1,208.86		$241.77
25101	T	Explore/treat wrist joint	0050	23.9081	$1,418.78		$283.76
25105	T	Remove wrist joint lining	0050	23.9081	$1,418.78		$283.76
25107	T	Remove wrist joint cartilage	0050	23.9081	$1,418.78		$283.76
25110	T	Remove wrist tendon lesion	0049	20.3707	$1,208.86		$241.77
25111	T	Remove wrist tendon lesion	0053	15.6795	$930.47	$253.49	$186.09
25112	T	Reremove wrist tendon lesion	0053	15.6795	$930.47	$253.49	$186.09
25115	T	Remove wrist/forearm lesion	0049	20.3707	$1,208.86		$241.77
25116	T	Remove wrist/forearm lesion	0049	20.3707	$1,208.86		$241.77
25118	T	Excise wrist tendon sheath	0050	23.9081	$1,418.78		$283.76
25119	T	Partial removal of ulna	0050	23.9081	$1,418.78		$283.76
25120	T	Removal of forearm lesion	0050	23.9081	$1,418.78		$283.76
25125	T	Remove/graft forearm lesion	0050	23.9081	$1,418.78		$283.76
25126	T	Remove/graft forearm lesion	0050	23.9081	$1,418.78		$283.76
25130	T	Removal of wrist lesion	0050	23.9081	$1,418.78		$283.76
25135	T	Remove graft wrist lesion	0050	23.9081	$1,418.78		$283.76
25136	T	Remove graft wrist lesion	0050	23.9081	$1,418.78		$283.76
25145	T	Remove forearm bone lesion	0050	23.9081	$1,418.78		$283.76
25150	T	Partial removal of ulna	0050	23.9081	$1,418.78		$283.76
25151	T	Partial removal of radius	0050	23.9081	$1,418.78		$283.76
25170	T	Extensive forearm surgery	0052	43.9378	$2,607.40		$521.48
25210	T	Removal of wrist bone	0054	25.3711	$1,505.60		$301.12
25215	T	Removal of wrist bones	0054	25.3711	$1,505.60		$301.12
25230	T	Partial removal of radius	0050	23.9081	$1,418.78		$283.76
25240	T	Partial removal of ulna	0050	23.9081	$1,418.78		$283.76
25246	N	Injection for wrist x-ray
25248	T	Remove forearm foreign body	0049	20.3707	$1,208.86		$241.77
25250	T	Removal of wrist prosthesis	0050	23.9081	$1,418.78		$283.76
25251	T	Removal of wrist prosthesis	0050	23.9081	$1,418.78		$283.76
25259	T	Manipulate wrist w/anesthes	0043	1.7694	$105.00		$21.00
25260	T	Repair forearm tendon/muscle	0050	23.9081	$1,418.78		$283.76
25263	T	Repair forearm tendon/muscle	0050	23.9081	$1,418.78		$283.76
25265	T	Repair forearm tendon/muscle	0050	23.9081	$1,418.78		$283.76
25270	T	Repair forearm tendon/muscle	0050	23.9081	$1,418.78		$283.76
25272	T	Repair forearm tendon/muscle	0050	23.9081	$1,418.78		$283.76
25274	T	Repair forearm tendon/muscle	0050	23.9081	$1,418.78		$283.76
25275	T	Repair forearm tendon sheath	0050	23.9081	$1,418.78		$283.76
25280	T	Revise wrist/forearm tendon	0050	23.9081	$1,418.78		$283.76
25290	T	Incise wrist/forearm tendon	0050	23.9081	$1,418.78		$283.76
25295	T	Release wrist/forearm tendon	0049	20.3707	$1,208.86		$241.77
25300	T	Fusion of tendons at wrist	0050	23.9081	$1,418.78		$283.76
25301	T	Fusion of tendons at wrist	0050	23.9081	$1,418.78		$283.76
25310	T	Transplant forearm tendon	0051	36.5271	$2,167.63		$433.53
25312	T	Transplant forearm tendon	0051	36.5271	$2,167.63		$433.53
25315	T	Revise palsy hand tendon(s)	0051	36.5271	$2,167.63		$433.53
25316	T	Revise palsy hand tendon(s)	0051	36.5271	$2,167.63		$433.53
25320	T	Repair/revise wrist joint	0051	36.5271	$2,167.63		$433.53
25332	T	Revise wrist joint	0047	31.6107	$1,875.87	$537.03	$375.17
25335	T	Realignment of hand	0051	36.5271	$2,167.63		$433.53
25337	T	Reconstruct ulna/radioulnar	0051	36.5271	$2,167.63		$433.53
25350	T	Revision of radius	0051	36.5271	$2,167.63		$433.53
25355	T	Revision of radius	0051	36.5271	$2,167.63		$433.53
25360	T	Revision of ulna	0050	23.9081	$1,418.78		$283.76
25365	T	Revise radius ulna	0050	23.9081	$1,418.78		$283.76
25370	T	Revise radius or ulna	0051	36.5271	$2,167.63		$433.53
25375	T	Revise radius ulna	0051	36.5271	$2,167.63		$433.53
25390	T	Shorten radius or ulna	0050	23.9081	$1,418.78		$283.76
25391	T	Lengthen radius or ulna	0051	36.5271	$2,167.63		$433.53
25392	T	Shorten radius ulna	0050	23.9081	$1,418.78		$283.76
25393	T	Lengthen radius ulna	0051	36.5271	$2,167.63		$433.53
25394	T	Repair carpal bone, shorten	0053	15.6795	$930.47	$253.49	$186.09
25400	T	Repair radius or ulna	0050	23.9081	$1,418.78		$283.76
25405	T	Repair/graft radius or ulna	0050	23.9081	$1,418.78		$283.76
25415	T	Repair radius ulna	0050	23.9081	$1,418.78		$283.76
25420	T	Repair/graft radius ulna	0051	36.5271	$2,167.63		$433.53
25425	T	Repair/graft radius or ulna	0051	36.5271	$2,167.63		$433.53
25426	T	Repair/graft radius ulna	0051	36.5271	$2,167.63		$433.53
25430	T	Vasc graft into carpal bone	0054	25.3711	$1,505.60		$301.12
25431	T	Repair nonunion carpal bone	0054	25.3711	$1,505.60		$301.12
25440	T	Repair/graft wrist bone	0051	36.5271	$2,167.63		$433.53
25441	T	Reconstruct wrist joint	0425	100.2058	$5,946.51	$1,378.01	$1,189.30
25442	T	Reconstruct wrist joint	0425	100.2058	$5,946.51	$1,378.01	$1,189.30
25443	T	Reconstruct wrist joint	0048	43.1288	$2,559.39	$570.30	$511.88
25444	T	Reconstruct wrist joint	0048	43.1288	$2,559.39	$570.30	$511.88
25445	T	Reconstruct wrist joint	0048	43.1288	$2,559.39	$570.30	$511.88
25446	T	Wrist replacement	0425	100.2058	$5,946.51	$1,378.01	$1,189.30
25447	T	Repair wrist joint(s)	0047	31.6107	$1,875.87	$537.03	$375.17
25449	T	Remove wrist joint implant	0047	31.6107	$1,875.87	$537.03	$375.17
25450	T	Revision of wrist joint	0051	36.5271	$2,167.63		$433.53
25455	T	Revision of wrist joint	0051	36.5271	$2,167.63		$433.53
25490	T	Reinforce radius	0051	36.5271	$2,167.63		$433.53
25491	T	Reinforce ulna	0051	36.5271	$2,167.63		$433.53
25492	T	Reinforce radius and ulna	0051	36.5271	$2,167.63		$433.53
25500	T	Treat fracture of radius	0043	1.7694	$105.00		$21.00
25505	T	Treat fracture of radius	0043	1.7694	$105.00		$21.00
25515	T	Treat fracture of radius	0046	37.7023	$2,237.37	$535.76	$447.47
25520	T	Treat fracture of radius	0043	1.7694	$105.00		$21.00
25525	T	Treat fracture of radius	0046	37.7023	$2,237.37	$535.76	$447.47
25526	T	Treat fracture of radius	0046	37.7023	$2,237.37	$535.76	$447.47
25530	T	Treat fracture of ulna	0043	1.7694	$105.00		$21.00
25535	T	Treat fracture of ulna	0043	1.7694	$105.00		$21.00
25545	T	Treat fracture of ulna	0046	37.7023	$2,237.37	$535.76	$447.47
25560	T	Treat fracture radius ulna	0043	1.7694	$105.00		$21.00
25565	T	Treat fracture radius ulna	0043	1.7694	$105.00		$21.00
25574	T	Treat fracture radius ulna	0046	37.7023	$2,237.37	$535.76	$447.47
25575	T	Treat fracture radius/ulna	0046	37.7023	$2,237.37	$535.76	$447.47
25600	T	Treat fracture radius/ulna	0043	1.7694	$105.00		$21.00
25605	T	Treat fracture radius/ulna	0043	1.7694	$105.00		$21.00
25611	T	Treat fracture radius/ulna	0046	37.7023	$2,237.37	$535.76	$447.47
25620	T	Treat fracture radius/ulna	0046	37.7023	$2,237.37	$535.76	$447.47
25622	T	Treat wrist bone fracture	0043	1.7694	$105.00		$21.00
25624	T	Treat wrist bone fracture	0043	1.7694	$105.00		$21.00
25628	T	Treat wrist bone fracture	0046	37.7023	$2,237.37	$535.76	$447.47
25630	T	Treat wrist bone fracture	0043	1.7694	$105.00		$21.00
25635	T	Treat wrist bone fracture	0043	1.7694	$105.00		$21.00
25645	T	Treat wrist bone fracture	0046	37.7023	$2,237.37	$535.76	$447.47
25650	T	Treat wrist bone fracture	0043	1.7694	$105.00		$21.00
25651	T	Pin ulnar styloid fracture	0046	37.7023	$2,237.37	$535.76	$447.47
25652	T	Treat fracture ulnar styloid	0046	37.7023	$2,237.37	$535.76	$447.47
25660	T	Treat wrist dislocation	0043	1.7694	$105.00		$21.00
25670	T	Treat wrist dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
25671	T	Pin radioulnar dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
25675	T	Treat wrist dislocation	0043	1.7694	$105.00		$21.00
25676	T	Treat wrist dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
25680	T	Treat wrist fracture	0043	1.7694	$105.00		$21.00
25685	T	Treat wrist fracture	0046	37.7023	$2,237.37	$535.76	$447.47
25690	T	Treat wrist dislocation	0043	1.7694	$105.00		$21.00
25695	T	Treat wrist dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
25800	T	Fusion of wrist joint	0051	36.5271	$2,167.63		$433.53
25805	T	Fusion/graft of wrist joint	0051	36.5271	$2,167.63		$433.53
25810	T	Fusion/graft of wrist joint	0051	36.5271	$2,167.63		$433.53
25820	T	Fusion of hand bones	0053	15.6795	$930.47	$253.49	$186.09
25825	T	Fuse hand bones with graft	0054	25.3711	$1,505.60		$301.12
25830	T	Fusion, radioulnar jnt/ulna	0051	36.5271	$2,167.63		$433.53
25900	C	Amputation of forearm
25905	C	Amputation of forearm
25907	T	Amputation follow-up surgery	0049	20.3707	$1,208.86		$241.77
25909	C	Amputation follow-up surgery
25915	C	Amputation of forearm
25920	C	Amputate hand at wrist
25922	T	Amputate hand at wrist	0049	20.3707	$1,208.86		$241.77
25924	C	Amputation follow-up surgery
25927	C	Amputation of hand
25929	T	Amputation follow-up surgery	0686	13.8287	$820.64		$164.13
25931	C	Amputation follow-up surgery
25999	T	Forearm or wrist surgery	0043	1.7694	$105.00		$21.00
26010	T	Drainage of finger abscess	0006	1.55	$91.98	$22.28	$18.40
26011	T	Drainage of finger abscess	0007	11.4501	$679.48		$135.90
26020	T	Drain hand tendon sheath	0053	15.6795	$930.47	$253.49	$186.09
26025	T	Drainage of palm bursa	0053	15.6795	$930.47	$253.49	$186.09
26030	T	Drainage of palm bursa(s)	0053	15.6795	$930.47	$253.49	$186.09
26034	T	Treat hand bone lesion	0053	15.6795	$930.47	$253.49	$186.09
26035	T	Decompress fingers/hand	0053	15.6795	$930.47	$253.49	$186.09
26037	T	Decompress fingers/hand	0053	15.6795	$930.47	$253.49	$186.09
26040	T	Release palm contracture	0054	25.3711	$1,505.60		$301.12
26045	T	Release palm contracture	0054	25.3711	$1,505.60		$301.12
26055	T	Incise finger tendon sheath	0053	15.6795	$930.47	$253.49	$186.09
26060	T	Incision of finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26070	T	Explore/treat hand joint	0053	15.6795	$930.47	$253.49	$186.09
26075	T	Explore/treat finger joint	0053	15.6795	$930.47	$253.49	$186.09
26080	T	Explore/treat finger joint	0053	15.6795	$930.47	$253.49	$186.09
26100	T	Biopsy hand joint lining	0053	15.6795	$930.47	$253.49	$186.09
26105	T	Biopsy finger joint lining	0053	15.6795	$930.47	$253.49	$186.09
26110	T	Biopsy finger joint lining	0053	15.6795	$930.47	$253.49	$186.09
26115	T	Removel hand lesion subcut	0022	19.6472	$1,165.92	$354.45	$233.18
26116	T	Removel hand lesion, deep	0022	19.6472	$1,165.92	$354.45	$233.18
26117	T	Remove tumor, hand/finger	0022	19.6472	$1,165.92	$354.45	$233.18
26121	T	Release palm contracture	0054	25.3711	$1,505.60		$301.12
26123	T	Release palm contracture	0054	25.3711	$1,505.60		$301.12
26125	T	Release palm contracture	0053	15.6795	$930.47	$253.49	$186.09
26130	T	Remove wrist joint lining	0053	15.6795	$930.47	$253.49	$186.09
26135	T	Revise finger joint, each	0054	25.3711	$1,505.60		$301.12
26140	T	Revise finger joint, each	0053	15.6795	$930.47	$253.49	$186.09
26145	T	Tendon excision, palm/finger	0053	15.6795	$930.47	$253.49	$186.09
26160	T	Remove tendon sheath lesion	0053	15.6795	$930.47	$253.49	$186.09
26170	T	Removal of palm tendon, each	0053	15.6795	$930.47	$253.49	$186.09
26180	T	Removal of finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26185	T	Remove finger bone	0053	15.6795	$930.47	$253.49	$186.09
26200	T	Remove hand bone lesion	0053	15.6795	$930.47	$253.49	$186.09
26205	T	Remove/graft bone lesion	0054	25.3711	$1,505.60		$301.12
26210	T	Removal of finger lesion	0053	15.6795	$930.47	$253.49	$186.09
26215	T	Remove/graft finger lesion	0053	15.6795	$930.47	$253.49	$186.09
26230	T	Partial removal of hand bone	0053	15.6795	$930.47	$253.49	$186.09
26235	T	Partial removal, finger bone	0053	15.6795	$930.47	$253.49	$186.09
26236	T	Partial removal, finger bone	0053	15.6795	$930.47	$253.49	$186.09
26250	T	Extensive hand surgery	0053	15.6795	$930.47	$253.49	$186.09
26255	T	Extensive hand surgery	0054	25.3711	$1,505.60		$301.12
26260	T	Extensive finger surgery	0053	15.6795	$930.47	$253.49	$186.09
26261	T	Extensive finger surgery	0053	15.6795	$930.47	$253.49	$186.09
26262	T	Partial removal of finger	0053	15.6795	$930.47	$253.49	$186.09
26320	T	Removal of implant from hand	0021	14.9776	$888.82	$219.48	$177.76
26340	T	Manipulate finger w/anesth	0043	1.7694	$105.00		$21.00
26350	T	Repair finger/hand tendon	0054	25.3711	$1,505.60		$301.12
26352	T	Repair/graft hand tendon	0054	25.3711	$1,505.60		$301.12
26356	T	Repair finger/hand tendon	0054	25.3711	$1,505.60		$301.12
26357	T	Repair finger/hand tendon	0054	25.3711	$1,505.60		$301.12
26358	T	Repair/graft hand tendon	0054	25.3711	$1,505.60		$301.12
26370	T	Repair finger/hand tendon	0054	25.3711	$1,505.60		$301.12
26372	T	Repair/graft hand tendon	0054	25.3711	$1,505.60		$301.12
26373	T	Repair finger/hand tendon	0054	25.3711	$1,505.60		$301.12
26390	T	Revise hand/finger tendon	0054	25.3711	$1,505.60		$301.12
26392	T	Repair/graft hand tendon	0054	25.3711	$1,505.60		$301.12
26410	T	Repair hand tendon	0053	15.6795	$930.47	$253.49	$186.09
26412	T	Repair/graft hand tendon	0054	25.3711	$1,505.60		$301.12
26415	T	Excision, hand/finger tendon	0054	25.3711	$1,505.60		$301.12
26416	T	Graft hand or finger tendon	0054	25.3711	$1,505.60		$301.12
26418	T	Repair finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26420	T	Repair/graft finger tendon	0054	25.3711	$1,505.60		$301.12
26426	T	Repair finger/hand tendon	0054	25.3711	$1,505.60		$301.12
26428	T	Repair/graft finger tendon	0054	25.3711	$1,505.60		$301.12
26432	T	Repair finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26433	T	Repair finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26434	T	Repair/graft finger tendon	0054	25.3711	$1,505.60		$301.12
26437	T	Realignment of tendons	0053	15.6795	$930.47	$253.49	$186.09
26440	T	Release palm/finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26442	T	Release palm finger tendon	0054	25.3711	$1,505.60		$301.12
26445	T	Release hand/finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26449	T	Release forearm/hand tendon	0054	25.3711	$1,505.60		$301.12
26450	T	Incision of palm tendon	0053	15.6795	$930.47	$253.49	$186.09
26455	T	Incision of finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26460	T	Incise hand/finger tendon	0053	15.6795	$930.47	$253.49	$186.09
26471	T	Fusion of finger tendons	0053	15.6795	$930.47	$253.49	$186.09
26474	T	Fusion of finger tendons	0053	15.6795	$930.47	$253.49	$186.09
26476	T	Tendon lengthening	0053	15.6795	$930.47	$253.49	$186.09
26477	T	Tendon shortening	0053	15.6795	$930.47	$253.49	$186.09
26478	T	Lengthening of hand tendon	0053	15.6795	$930.47	$253.49	$186.09
26479	T	Shortening of hand tendon	0053	15.6795	$930.47	$253.49	$186.09
26480	T	Transplant hand tendon	0054	25.3711	$1,505.60		$301.12
26483	T	Transplant/graft hand tendon	0054	25.3711	$1,505.60		$301.12
26485	T	Transplant palm tendon	0054	25.3711	$1,505.60		$301.12
26489	T	Transplant/graft palm tendon	0054	25.3711	$1,505.60		$301.12
26490	T	Revise thumb tendon	0054	25.3711	$1,505.60		$301.12
26492	T	Tendon transfer with graft	0054	25.3711	$1,505.60		$301.12
26494	T	Hand tendon/muscle transfer	0054	25.3711	$1,505.60		$301.12
26496	T	Revise thumb tendon	0054	25.3711	$1,505.60		$301.12
26497	T	Finger tendon transfer	0054	25.3711	$1,505.60		$301.12
26498	T	Finger tendon transfer	0054	25.3711	$1,505.60		$301.12
26499	T	Revision of finger	0054	25.3711	$1,505.60		$301.12
26500	T	Hand tendon reconstruction	0053	15.6795	$930.47	$253.49	$186.09
26502	T	Hand tendon reconstruction	0054	25.3711	$1,505.60		$301.12
26504	T	Hand tendon reconstruction	0054	25.3711	$1,505.60		$301.12
26508	T	Release thumb contracture	0053	15.6795	$930.47	$253.49	$186.09
26510	T	Thumb tendon transfer	0054	25.3711	$1,505.60		$301.12
26516	T	Fusion of knuckle joint	0054	25.3711	$1,505.60		$301.12
26517	T	Fusion of knuckle joints	0054	25.3711	$1,505.60		$301.12
26518	T	Fusion of knuckle joints	0054	25.3711	$1,505.60		$301.12
26520	T	Release knuckle contracture	0053	15.6795	$930.47	$253.49	$186.09
26525	T	Release finger contracture	0053	15.6795	$930.47	$253.49	$186.09
26530	T	Revise knuckle joint	0047	31.6107	$1,875.87	$537.03	$375.17
26531	T	Revise knuckle with implant	0048	43.1288	$2,559.39	$570.30	$511.88
26535	T	Revise finger joint	0047	31.6107	$1,875.87	$537.03	$375.17
26536	T	Revise/implant finger joint	0048	43.1288	$2,559.39	$570.30	$511.88
26540	T	Repair hand joint	0053	15.6795	$930.47	$253.49	$186.09
26541	T	Repair hand joint with graft	0054	25.3711	$1,505.60		$301.12
26542	T	Repair hand joint with graft	0053	15.6795	$930.47	$253.49	$186.09
26545	T	Reconstruct finger joint	0054	25.3711	$1,505.60		$301.12
26546	T	Repair nonunion hand	0054	25.3711	$1,505.60		$301.12
26548	T	Reconstruct finger joint	0054	25.3711	$1,505.60		$301.12
26550	T	Construct thumb replacement	0054	25.3711	$1,505.60		$301.12
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	25.3711	$1,505.60		$301.12
26556	C	Toe joint transfer
26560	T	Repair of web finger	0053	15.6795	$930.47	$253.49	$186.09
26561	T	Repair of web finger	0054	25.3711	$1,505.60		$301.12
26562	T	Repair of web finger	0054	25.3711	$1,505.60		$301.12
26565	T	Correct metacarpal flaw	0054	25.3711	$1,505.60		$301.12
26567	T	Correct finger deformity	0054	25.3711	$1,505.60		$301.12
26568	T	Lengthen metacarpal/finger	0054	25.3711	$1,505.60		$301.12
26580	T	Repair hand deformity	0053	15.6795	$930.47	$253.49	$186.09
26587	T	Reconstruct extra finger	0053	15.6795	$930.47	$253.49	$186.09
26590	T	Repair finger deformity	0053	15.6795	$930.47	$253.49	$186.09
26591	T	Repair muscles of hand	0054	25.3711	$1,505.60		$301.12
26593	T	Release muscles of hand	0053	15.6795	$930.47	$253.49	$186.09
26596	T	Excision constricting tissue	0053	15.6795	$930.47	$253.49	$186.09
26600	T	Treat metacarpal fracture	0043	1.7694	$105.00		$21.00
26605	T	Treat metacarpal fracture	0043	1.7694	$105.00		$21.00
26607	T	Treat metacarpal fracture	0043	1.7694	$105.00		$21.00
26608	T	Treat metacarpal fracture	0046	37.7023	$2,237.37	$535.76	$447.47
26615	T	Treat metacarpal fracture	0046	37.7023	$2,237.37	$535.76	$447.47
26641	T	Treat thumb dislocation	0043	1.7694	$105.00		$21.00
26645	T	Treat thumb fracture	0043	1.7694	$105.00		$21.00
26650	T	Treat thumb fracture	0046	37.7023	$2,237.37	$535.76	$447.47
26665	T	Treat thumb fracture	0046	37.7023	$2,237.37	$535.76	$447.47
26670	T	Treat hand dislocation	0043	1.7694	$105.00		$21.00
26675	T	Treat hand dislocation	0043	1.7694	$105.00		$21.00
26676	T	Pin hand dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
26685	T	Treat hand dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
26686	T	Treat hand dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
26700	T	Treat knuckle dislocation	0043	1.7694	$105.00		$21.00
26705	T	Treat knuckle dislocation	0043	1.7694	$105.00		$21.00
26706	T	Pin knuckle dislocation	0043	1.7694	$105.00		$21.00
26715	T	Treat knuckle dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
26720	T	Treat finger fracture, each	0043	1.7694	$105.00		$21.00
26725	T	Treat finger fracture, each	0043	1.7694	$105.00		$21.00
26727	T	Treat finger fracture, each	0046	37.7023	$2,237.37	$535.76	$447.47
26735	T	Treat finger fracture, each	0046	37.7023	$2,237.37	$535.76	$447.47
26740	T	Treat finger fracture, each	0043	1.7694	$105.00		$21.00
26742	T	Treat finger fracture, each	0043	1.7694	$105.00		$21.00
26746	T	Treat finger fracture, each	0046	37.7023	$2,237.37	$535.76	$447.47
26750	T	Treat finger fracture, each	0043	1.7694	$105.00		$21.00
26755	T	Treat finger fracture, each	0043	1.7694	$105.00		$21.00
26756	T	Pin finger fracture, each	0046	37.7023	$2,237.37	$535.76	$447.47
26765	T	Treat finger fracture, each	0046	37.7023	$2,237.37	$535.76	$447.47
26770	T	Treat finger dislocation	0043	1.7694	$105.00		$21.00
26775	T	Treat finger dislocation	0045	14.4945	$860.15	$268.47	$172.03
26776	T	Pin finger dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
26785	T	Treat finger dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
26820	T	Thumb fusion with graft	0054	25.3711	$1,505.60		$301.12
26841	T	Fusion of thumb	0054	25.3711	$1,505.60		$301.12
26842	T	Thumb fusion with graft	0054	25.3711	$1,505.60		$301.12
26843	T	Fusion of hand joint	0054	25.3711	$1,505.60		$301.12
26844	T	Fusion/graft of hand joint	0054	25.3711	$1,505.60		$301.12
26850	T	Fusion of knuckle	0054	25.3711	$1,505.60		$301.12
26852	T	Fusion of knuckle with graft	0054	25.3711	$1,505.60		$301.12
26860	T	Fusion of finger joint	0054	25.3711	$1,505.60		$301.12
26861	T	Fusion of finger jnt, add-on	0054	25.3711	$1,505.60		$301.12
26862	T	Fusion/graft of finger joint	0054	25.3711	$1,505.60		$301.12
26863	T	Fuse/graft added joint	0054	25.3711	$1,505.60		$301.12
26910	T	Amputate metacarpal bone	0054	25.3711	$1,505.60		$301.12
26951	T	Amputation of finger/thumb	0053	15.6795	$930.47	$253.49	$186.09
26952	T	Amputation of finger/thumb	0053	15.6795	$930.47	$253.49	$186.09
26989	T	Hand/finger surgery	0043	1.7694	$105.00		$21.00
26990	T	Drainage of pelvis lesion	0049	20.3707	$1,208.86		$241.77
26991	T	Drainage of pelvis bursa	0049	20.3707	$1,208.86		$241.77
26992	C	Drainage of bone lesion
27000	T	Incision of hip tendon	0049	20.3707	$1,208.86		$241.77
27001	T	Incision of hip tendon	0050	23.9081	$1,418.78		$283.76
27003	T	Incision of hip tendon	0050	23.9081	$1,418.78		$283.76
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	36.5271	$2,167.63		$433.53
27035	T	Denervation of hip joint	0052	43.9378	$2,607.40		$521.48
27036	C	Excision of hip joint/muscle
27040	T	Biopsy of soft tissues	0020	6.9433	$412.04	$107.40	$82.41
27041	T	Biopsy of soft tissues	0020	6.9433	$412.04	$107.40	$82.41
27047	T	Remove hip/pelvis lesion	0022	19.6472	$1,165.92	$354.45	$233.18
27048	T	Remove hip/pelvis lesion	0022	19.6472	$1,165.92	$354.45	$233.18
27049	T	Remove tumor, hip/pelvis	0022	19.6472	$1,165.92	$354.45	$233.18
27050	T	Biopsy of sacroiliac joint	0049	20.3707	$1,208.86		$241.77
27052	T	Biopsy of hip joint	0049	20.3707	$1,208.86		$241.77
27054	C	Removal of hip joint lining
27060	T	Removal of ischial bursa	0049	20.3707	$1,208.86		$241.77
27062	T	Remove femur lesion/bursa	0049	20.3707	$1,208.86		$241.77
27065	T	Removal of hip bone lesion	0049	20.3707	$1,208.86		$241.77
27066	T	Removal of hip bone lesion	0050	23.9081	$1,418.78		$283.76
27067	T	Remove/graft hip bone lesion	0050	23.9081	$1,418.78		$283.76
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	23.9081	$1,418.78		$283.76
27086	T	Remove hip foreign body	0020	6.9433	$412.04	$107.40	$82.41
27087	T	Remove hip foreign body	0049	20.3707	$1,208.86		$241.77
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	B	Inject sacroiliac joint
27097	T	Revision of hip tendon	0050	23.9081	$1,418.78		$283.76
27098	T	Transfer tendon to pelvis	0050	23.9081	$1,418.78		$283.76
27100	T	Transfer of abdominal muscle	0051	36.5271	$2,167.63		$433.53
27105	T	Transfer of spinal muscle	0051	36.5271	$2,167.63		$433.53
27110	T	Transfer of iliopsoas muscle	0051	36.5271	$2,167.63		$433.53
27111	T	Transfer of iliopsoas muscle	0051	36.5271	$2,167.63		$433.53
27120	C	Reconstruction of hip socket
27122	C	Reconstruction of hip socket
27125	C	Partial hip replacement
27130	C	Total hip arthroplasty
27132	C	Total hip arthroplasty
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	0043	1.7694	$105.00		$21.00
27194	T	Treat pelvic ring fracture	0045	14.4945	$860.15	$268.47	$172.03
27200	T	Treat tail bone fracture	0043	1.7694	$105.00		$21.00
27202	T	Treat tail bone fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27215	C	Treat pelvic fracture(s)
27216	T	Treat pelvic ring fracture	0050	23.9081	$1,418.78		$283.76
27217	C	Treat pelvic ring fracture
27218	C	Treat pelvic ring fracture
27220	T	Treat hip socket fracture	0043	1.7694	$105.00		$21.00
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	0043	1.7694	$105.00		$21.00
27232	C	Treat thigh fracture
27235	T	Treat thigh fracture	0050	23.9081	$1,418.78		$283.76
27236	C	Treat thigh fracture
27238	T	Treat thigh fracture	0043	1.7694	$105.00		$21.00
27240	C	Treat thigh fracture
27244	C	Treat thigh fracture
27245	C	Treat thigh fracture
27246	T	Treat thigh fracture	0043	1.7694	$105.00		$21.00
27248	C	Treat thigh fracture
27250	T	Treat hip dislocation	0043	1.7694	$105.00		$21.00
27252	T	Treat hip dislocation	0045	14.4945	$860.15	$268.47	$172.03
27253	C	Treat hip dislocation
27254	C	Treat hip dislocation
27256	T	Treat hip dislocation	0043	1.7694	$105.00		$21.00
27257	T	Treat hip dislocation	0045	14.4945	$860.15	$268.47	$172.03
27258	C	Treat hip dislocation
27259	C	Treat hip dislocation
27265	T	Treat hip dislocation	0043	1.7694	$105.00		$21.00
27266	T	Treat hip dislocation	0045	14.4945	$860.15	$268.47	$172.03
27275	T	Manipulation of hip joint	0045	14.4945	$860.15	$268.47	$172.03
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	1.7694	$105.00		$21.00
27301	T	Drain thigh/knee lesion	0008	16.4989	$979.09		$195.82
27303	C	Drainage of bone lesion
27305	T	Incise thigh tendon fascia	0049	20.3707	$1,208.86		$241.77
27306	T	Incision of thigh tendon	0049	20.3707	$1,208.86		$241.77
27307	T	Incision of thigh tendons	0049	20.3707	$1,208.86		$241.77
27310	T	Exploration of knee joint	0050	23.9081	$1,418.78		$283.76
27315	T	Partial removal, thigh nerve	0220	17.3586	$1,030.11		$206.02
27320	T	Partial removal, thigh nerve	0220	17.3586	$1,030.11		$206.02
27323	T	Biopsy, thigh soft tissues	0021	14.9776	$888.82	$219.48	$177.76
27324	T	Biopsy, thigh soft tissues	0022	19.6472	$1,165.92	$354.45	$233.18
27327	T	Removal of thigh lesion	0022	19.6472	$1,165.92	$354.45	$233.18
27328	T	Removal of thigh lesion	0022	19.6472	$1,165.92	$354.45	$233.18
27329	T	Remove tumor, thigh/knee	0022	19.6472	$1,165.92	$354.45	$233.18
27330	T	Biopsy, knee joint lining	0050	23.9081	$1,418.78		$283.76
27331	T	Explore/treat knee joint	0050	23.9081	$1,418.78		$283.76
27332	T	Removal of knee cartilage	0050	23.9081	$1,418.78		$283.76
27333	T	Removal of knee cartilage	0050	23.9081	$1,418.78		$283.76
27334	T	Remove knee joint lining	0050	23.9081	$1,418.78		$283.76
27335	T	Remove knee joint lining	0050	23.9081	$1,418.78		$283.76
27340	T	Removal of kneecap bursa	0049	20.3707	$1,208.86		$241.77
27345	T	Removal of knee cyst	0049	20.3707	$1,208.86		$241.77
27347	T	Remove knee cyst	0049	20.3707	$1,208.86		$241.77
27350	T	Removal of kneecap	0050	23.9081	$1,418.78		$283.76
27355	T	Remove femur lesion	0050	23.9081	$1,418.78		$283.76
27356	T	Remove femur lesion/graft	0050	23.9081	$1,418.78		$283.76
27357	T	Remove femur lesion/graft	0050	23.9081	$1,418.78		$283.76
27358	T	Remove femur lesion/fixation	0050	23.9081	$1,418.78		$283.76
27360	T	Partial removal, leg bone(s)	0050	23.9081	$1,418.78		$283.76
27365	C	Extensive leg surgery
27370	N	Injection for knee x-ray
27372	T	Removal of foreign body	0022	19.6472	$1,165.92	$354.45	$233.18
27380	T	Repair of kneecap tendon	0049	20.3707	$1,208.86		$241.77
27381	T	Repair/graft kneecap tendon	0049	20.3707	$1,208.86		$241.77
27385	T	Repair of thigh muscle	0049	20.3707	$1,208.86		$241.77
27386	T	Repair/graft of thigh muscle	0049	20.3707	$1,208.86		$241.77
27390	T	Incision of thigh tendon	0049	20.3707	$1,208.86		$241.77
27391	T	Incision of thigh tendons	0049	20.3707	$1,208.86		$241.77
27392	T	Incision of thigh tendons	0049	20.3707	$1,208.86		$241.77
27393	T	Lengthening of thigh tendon	0050	23.9081	$1,418.78		$283.76
27394	T	Lengthening of thigh tendons	0050	23.9081	$1,418.78		$283.76
27395	T	Lengthening of thigh tendons	0051	36.5271	$2,167.63		$433.53
27396	T	Transplant of thigh tendon	0050	23.9081	$1,418.78		$283.76
27397	T	Transplants of thigh tendons	0051	36.5271	$2,167.63		$433.53
27400	T	Revise thigh muscles/tendons	0051	36.5271	$2,167.63		$433.53
27403	T	Repair of knee cartilage	0050	23.9081	$1,418.78		$283.76
27405	T	Repair of knee ligament	0051	36.5271	$2,167.63		$433.53
27407	T	Repair of knee ligament	0051	36.5271	$2,167.63		$433.53
27409	T	Repair of knee ligaments	0051	36.5271	$2,167.63		$433.53
27412	T	Autochondrocyte implant knee	0042	43.9753	$2,609.63	$804.74	$521.93
27415	T	Osteochondral knee allograft	0042	43.9753	$2,609.63	$804.74	$521.93
27418	T	Repair degenerated kneecap	0051	36.5271	$2,167.63		$433.53
27420	T	Revision of unstable kneecap	0051	36.5271	$2,167.63		$433.53
27422	T	Revision of unstable kneecap	0051	36.5271	$2,167.63		$433.53
27424	T	Revision/removal of kneecap	0051	36.5271	$2,167.63		$433.53
27425	T	Lateral retinacular release	0050	23.9081	$1,418.78		$283.76
27427	T	Reconstruction, knee	0052	43.9378	$2,607.40		$521.48
27428	T	Reconstruction, knee	0052	43.9378	$2,607.40		$521.48
27429	T	Reconstruction, knee	0052	43.9378	$2,607.40		$521.48
27430	T	Revision of thigh muscles	0051	36.5271	$2,167.63		$433.53
27435	T	Incision of knee joint	0051	36.5271	$2,167.63		$433.53
27437	T	Revise kneecap	0047	31.6107	$1,875.87	$537.03	$375.17
27438	T	Revise kneecap with implant	0048	43.1288	$2,559.39	$570.30	$511.88
27440	T	Revision of knee joint	0047	31.6107	$1,875.87	$537.03	$375.17
27441	T	Revision of knee joint	0047	31.6107	$1,875.87	$537.03	$375.17
27442	T	Revision of knee joint	0047	31.6107	$1,875.87	$537.03	$375.17
27443	T	Revision of knee joint	0047	31.6107	$1,875.87	$537.03	$375.17
27445	C	Revision of knee joint
27446	T	Revision of knee joint	0681	137.163	$8,139.66	$2,081.48	$1,627.93
27447	C	Total knee arthroplasty
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	T	Surgery to stop leg growth	0050	23.9081	$1,418.78		$283.76
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	20.3707	$1,208.86		$241.77
27497	T	Decompression of thigh/knee	0049	20.3707	$1,208.86		$241.77
27498	T	Decompression of thigh/knee	0049	20.3707	$1,208.86		$241.77
27499	T	Decompression of thigh/knee	0049	20.3707	$1,208.86		$241.77
27500	T	Treatment of thigh fracture	0043	1.7694	$105.00		$21.00
27501	T	Treatment of thigh fracture	0043	1.7694	$105.00		$21.00
27502	T	Treatment of thigh fracture	0043	1.7694	$105.00		$21.00
27503	T	Treatment of thigh fracture	0043	1.7694	$105.00		$21.00
27506	C	Treatment of thigh fracture
27507	C	Treatment of thigh fracture
27508	T	Treatment of thigh fracture	0043	1.7694	$105.00		$21.00
27509	T	Treatment of thigh fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27510	T	Treatment of thigh fracture	0043	1.7694	$105.00		$21.00
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	0043	1.7694	$105.00		$21.00
27517	T	Treat thigh fx growth plate	0043	1.7694	$105.00		$21.00
27519	C	Treat thigh fx growth plate
27520	T	Treat kneecap fracture	0043	1.7694	$105.00		$21.00
27524	T	Treat kneecap fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27530	T	Treat knee fracture	0043	1.7694	$105.00		$21.00
27532	T	Treat knee fracture	0043	1.7694	$105.00		$21.00
27535	C	Treat knee fracture
27536	C	Treat knee fracture
27538	T	Treat knee fracture(s)	0043	1.7694	$105.00		$21.00
27540	C	Treat knee fracture
27550	T	Treat knee dislocation	0043	1.7694	$105.00		$21.00
27552	T	Treat knee dislocation	0045	14.4945	$860.15	$268.47	$172.03
27556	C	Treat knee dislocation
27557	C	Treat knee dislocation
27558	C	Treat knee dislocation
27560	T	Treat kneecap dislocation	0043	1.7694	$105.00		$21.00
27562	T	Treat kneecap dislocation	0045	14.4945	$860.15	$268.47	$172.03
27566	T	Treat kneecap dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
27570	T	Fixation of knee joint	0045	14.4945	$860.15	$268.47	$172.03
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	20.3707	$1,208.86		$241.77
27596	C	Amputation follow-up surgery
27598	C	Amputate lower leg at knee
27599	T	Leg surgery procedure	0043	1.7694	$105.00		$21.00
27600	T	Decompression of lower leg	0049	20.3707	$1,208.86		$241.77
27601	T	Decompression of lower leg	0049	20.3707	$1,208.86		$241.77
27602	T	Decompression of lower leg	0049	20.3707	$1,208.86		$241.77
27603	T	Drain lower leg lesion	0008	16.4989	$979.09		$195.82
27604	T	Drain lower leg bursa	0049	20.3707	$1,208.86		$241.77
27605	T	Incision of achilles tendon	0055	20.0692	$1,190.97	$355.34	$238.19
27606	T	Incision of achilles tendon	0049	20.3707	$1,208.86		$241.77
27607	T	Treat lower leg bone lesion	0049	20.3707	$1,208.86		$241.77
27610	T	Explore/treat ankle joint	0050	23.9081	$1,418.78		$283.76
27612	T	Exploration of ankle joint	0050	23.9081	$1,418.78		$283.76
27613	T	Biopsy lower leg soft tissue	0020	6.9433	$412.04	$107.40	$82.41
27614	T	Biopsy lower leg soft tissue	0022	19.6472	$1,165.92	$354.45	$233.18
27615	T	Remove tumor, lower leg	0046	37.7023	$2,237.37	$535.76	$447.47
27618	T	Remove lower leg lesion	0021	14.9776	$888.82	$219.48	$177.76
27619	T	Remove lower leg lesion	0022	19.6472	$1,165.92	$354.45	$233.18
27620	T	Explore/treat ankle joint	0050	23.9081	$1,418.78		$283.76
27625	T	Remove ankle joint lining	0050	23.9081	$1,418.78		$283.76
27626	T	Remove ankle joint lining	0050	23.9081	$1,418.78		$283.76
27630	T	Removal of tendon lesion	0049	20.3707	$1,208.86		$241.77
27635	T	Remove lower leg bone lesion	0050	23.9081	$1,418.78		$283.76
27637	T	Remove/graft leg bone lesion	0050	23.9081	$1,418.78		$283.76
27638	T	Remove/graft leg bone lesion	0050	23.9081	$1,418.78		$283.76
27640	T	Partial removal of tibia	0051	36.5271	$2,167.63		$433.53
27641	T	Partial removal of fibula	0050	23.9081	$1,418.78		$283.76
27645	C	Extensive lower leg surgery
27646	C	Extensive lower leg surgery
27647	T	Extensive ankle/heel surgery	0051	36.5271	$2,167.63		$433.53
27648	N	Injection for ankle x-ray
27650	T	Repair achilles tendon	0051	36.5271	$2,167.63		$433.53
27652	T	Repair/graft achilles tendon	0051	36.5271	$2,167.63		$433.53
27654	T	Repair of achilles tendon	0051	36.5271	$2,167.63		$433.53
27656	T	Repair leg fascia defect	0049	20.3707	$1,208.86		$241.77
27658	T	Repair of leg tendon, each	0049	20.3707	$1,208.86		$241.77
27659	T	Repair of leg tendon, each	0049	20.3707	$1,208.86		$241.77
27664	T	Repair of leg tendon, each	0049	20.3707	$1,208.86		$241.77
27665	T	Repair of leg tendon, each	0050	23.9081	$1,418.78		$283.76
27675	T	Repair lower leg tendons	0049	20.3707	$1,208.86		$241.77
27676	T	Repair lower leg tendons	0050	23.9081	$1,418.78		$283.76
27680	T	Release of lower leg tendon	0050	23.9081	$1,418.78		$283.76
27681	T	Release of lower leg tendons	0050	23.9081	$1,418.78		$283.76
27685	T	Revision of lower leg tendon	0050	23.9081	$1,418.78		$283.76
27686	T	Revise lower leg tendons	0050	23.9081	$1,418.78		$283.76
27687	T	Revision of calf tendon	0050	23.9081	$1,418.78		$283.76
27690	T	Revise lower leg tendon	0051	36.5271	$2,167.63		$433.53
27691	T	Revise lower leg tendon	0051	36.5271	$2,167.63		$433.53
27692	T	Revise additional leg tendon	0051	36.5271	$2,167.63		$433.53
27695	T	Repair of ankle ligament	0050	23.9081	$1,418.78		$283.76
27696	T	Repair of ankle ligaments	0050	23.9081	$1,418.78		$283.76
27698	T	Repair of ankle ligament	0050	23.9081	$1,418.78		$283.76
27700	T	Revision of ankle joint	0047	31.6107	$1,875.87	$537.03	$375.17
27702	C	Reconstruct ankle joint
27703	C	Reconstruction, ankle joint
27704	T	Removal of ankle implant	0049	20.3707	$1,208.86		$241.77
27705	T	Incision of tibia	0051	36.5271	$2,167.63		$433.53
27707	T	Incision of fibula	0049	20.3707	$1,208.86		$241.77
27709	T	Incision of tibia fibula	0050	23.9081	$1,418.78		$283.76
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	23.9081	$1,418.78		$283.76
27732	T	Repair of fibula epiphysis	0050	23.9081	$1,418.78		$283.76
27734	T	Repair lower leg epiphyses	0050	23.9081	$1,418.78		$283.76
27740	T	Repair of leg epiphyses	0050	23.9081	$1,418.78		$283.76
27742	T	Repair of leg epiphyses	0051	36.5271	$2,167.63		$433.53
27745	T	Reinforce tibia	0051	36.5271	$2,167.63		$433.53
27750	T	Treatment of tibia fracture	0043	1.7694	$105.00		$21.00
27752	T	Treatment of tibia fracture	0043	1.7694	$105.00		$21.00
27756	T	Treatment of tibia fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27758	T	Treatment of tibia fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27759	T	Treatment of tibia fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27760	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
27762	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
27766	T	Treatment of ankle fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27780	T	Treatment of fibula fracture	0043	1.7694	$105.00		$21.00
27781	T	Treatment of fibula fracture	0043	1.7694	$105.00		$21.00
27784	T	Treatment of fibula fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27786	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
27788	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
27792	T	Treatment of ankle fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27808	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
27810	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
27814	T	Treatment of ankle fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27816	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
27818	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
27822	T	Treatment of ankle fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27823	T	Treatment of ankle fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27824	T	Treat lower leg fracture	0043	1.7694	$105.00		$21.00
27825	T	Treat lower leg fracture	0043	1.7694	$105.00		$21.00
27826	T	Treat lower leg fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27827	T	Treat lower leg fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27828	T	Treat lower leg fracture	0046	37.7023	$2,237.37	$535.76	$447.47
27829	T	Treat lower leg joint	0046	37.7023	$2,237.37	$535.76	$447.47
27830	T	Treat lower leg dislocation	0043	1.7694	$105.00		$21.00
27831	T	Treat lower leg dislocation	0043	1.7694	$105.00		$21.00
27832	T	Treat lower leg dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
27840	T	Treat ankle dislocation	0043	1.7694	$105.00		$21.00
27842	T	Treat ankle dislocation	0045	14.4945	$860.15	$268.47	$172.03
27846	T	Treat ankle dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
27848	T	Treat ankle dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
27860	T	Fixation of ankle joint	0045	14.4945	$860.15	$268.47	$172.03
27870	T	Fusion of ankle joint	0051	36.5271	$2,167.63		$433.53
27871	T	Fusion of tibiofibular joint	0051	36.5271	$2,167.63		$433.53
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	20.3707	$1,208.86		$241.77
27886	C	Amputation follow-up surgery
27888	C	Amputation of foot at ankle
27889	T	Amputation of foot at ankle	0050	23.9081	$1,418.78		$283.76
27892	T	Decompression of leg	0049	20.3707	$1,208.86		$241.77
27893	T	Decompression of leg	0049	20.3707	$1,208.86		$241.77
27894	T	Decompression of leg	0049	20.3707	$1,208.86		$241.77
27899	T	Leg/ankle surgery procedure	0043	1.7694	$105.00		$21.00
28001	T	Drainage of bursa of foot	0007	11.4501	$679.48		$135.90
28002	T	Treatment of foot infection	0049	20.3707	$1,208.86		$241.77
28003	T	Treatment of foot infection	0049	20.3707	$1,208.86		$241.77
28005	T	Treat foot bone lesion	0055	20.0692	$1,190.97	$355.34	$238.19
28008	T	Incision of foot fascia	0055	20.0692	$1,190.97	$355.34	$238.19
28010	T	Incision of toe tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28011	T	Incision of toe tendons	0055	20.0692	$1,190.97	$355.34	$238.19
28020	T	Exploration of foot joint	0055	20.0692	$1,190.97	$355.34	$238.19
28022	T	Exploration of foot joint	0055	20.0692	$1,190.97	$355.34	$238.19
28024	T	Exploration of toe joint	0055	20.0692	$1,190.97	$355.34	$238.19
28030	T	Removal of foot nerve	0220	17.3586	$1,030.11		$206.02
28035	T	Decompression of tibia nerve	0220	17.3586	$1,030.11		$206.02
28043	T	Excision of foot lesion	0021	14.9776	$888.82	$219.48	$177.76
28045	T	Excision of foot lesion	0055	20.0692	$1,190.97	$355.34	$238.19
28046	T	Resection of tumor, foot	0055	20.0692	$1,190.97	$355.34	$238.19
28050	T	Biopsy of foot joint lining	0055	20.0692	$1,190.97	$355.34	$238.19
28052	T	Biopsy of foot joint lining	0055	20.0692	$1,190.97	$355.34	$238.19
28054	T	Biopsy of toe joint lining	0055	20.0692	$1,190.97	$355.34	$238.19
28060	T	Partial removal, foot fascia	0055	20.0692	$1,190.97	$355.34	$238.19
28062	T	Removal of foot fascia	0055	20.0692	$1,190.97	$355.34	$238.19
28070	T	Removal of foot joint lining	0055	20.0692	$1,190.97	$355.34	$238.19
28072	T	Removal of foot joint lining	0055	20.0692	$1,190.97	$355.34	$238.19
28080	T	Removal of foot lesion	0055	20.0692	$1,190.97	$355.34	$238.19
28086	T	Excise foot tendon sheath	0055	20.0692	$1,190.97	$355.34	$238.19
28088	T	Excise foot tendon sheath	0055	20.0692	$1,190.97	$355.34	$238.19
28090	T	Removal of foot lesion	0055	20.0692	$1,190.97	$355.34	$238.19
28092	T	Removal of toe lesions	0055	20.0692	$1,190.97	$355.34	$238.19
28100	T	Removal of ankle/heel lesion	0055	20.0692	$1,190.97	$355.34	$238.19
28102	T	Remove/graft foot lesion	0056	40.2957	$2,391.27		$478.25
28103	T	Remove/graft foot lesion	0056	40.2957	$2,391.27		$478.25
28104	T	Removal of foot lesion	0055	20.0692	$1,190.97	$355.34	$238.19
28106	T	Remove/graft foot lesion	0056	40.2957	$2,391.27		$478.25
28107	T	Remove/graft foot lesion	0056	40.2957	$2,391.27		$478.25
28108	T	Removal of toe lesions	0055	20.0692	$1,190.97	$355.34	$238.19
28110	T	Part removal of metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28111	T	Part removal of metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28112	T	Part removal of metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28113	T	Part removal of metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28114	T	Removal of metatarsal heads	0055	20.0692	$1,190.97	$355.34	$238.19
28116	T	Revision of foot	0055	20.0692	$1,190.97	$355.34	$238.19
28118	T	Removal of heel bone	0055	20.0692	$1,190.97	$355.34	$238.19
28119	T	Removal of heel spur	0055	20.0692	$1,190.97	$355.34	$238.19
28120	T	Part removal of ankle/heel	0055	20.0692	$1,190.97	$355.34	$238.19
28122	T	Partial removal of foot bone	0055	20.0692	$1,190.97	$355.34	$238.19
28124	T	Partial removal of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28126	T	Partial removal of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28130	T	Removal of ankle bone	0055	20.0692	$1,190.97	$355.34	$238.19
28140	T	Removal of metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28150	T	Removal of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28153	T	Partial removal of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28160	T	Partial removal of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28171	T	Extensive foot surgery	0055	20.0692	$1,190.97	$355.34	$238.19
28173	T	Extensive foot surgery	0055	20.0692	$1,190.97	$355.34	$238.19
28175	T	Extensive foot surgery	0055	20.0692	$1,190.97	$355.34	$238.19
28190	T	Removal of foot foreign body	0019	4.0547	$240.62	$71.87	$48.12
28192	T	Removal of foot foreign body	0021	14.9776	$888.82	$219.48	$177.76
28193	T	Removal of foot foreign body	0020	6.9433	$412.04	$107.40	$82.41
28200	T	Repair of foot tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28202	T	Repair/graft of foot tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28208	T	Repair of foot tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28210	T	Repair/graft of foot tendon	0056	40.2957	$2,391.27		$478.25
28220	T	Release of foot tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28222	T	Release of foot tendons	0055	20.0692	$1,190.97	$355.34	$238.19
28225	T	Release of foot tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28226	T	Release of foot tendons	0055	20.0692	$1,190.97	$355.34	$238.19
28230	T	Incision of foot tendon(s)	0055	20.0692	$1,190.97	$355.34	$238.19
28232	T	Incision of toe tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28234	T	Incision of foot tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28238	T	Revision of foot tendon	0056	40.2957	$2,391.27		$478.25
28240	T	Release of big toe	0055	20.0692	$1,190.97	$355.34	$238.19
28250	T	Revision of foot fascia	0055	20.0692	$1,190.97	$355.34	$238.19
28260	T	Release of midfoot joint	0055	20.0692	$1,190.97	$355.34	$238.19
28261	T	Revision of foot tendon	0055	20.0692	$1,190.97	$355.34	$238.19
28262	T	Revision of foot and ankle	0055	20.0692	$1,190.97	$355.34	$238.19
28264	T	Release of midfoot joint	0056	40.2957	$2,391.27		$478.25
28270	T	Release of foot contracture	0055	20.0692	$1,190.97	$355.34	$238.19
28272	T	Release of toe joint, each	0055	20.0692	$1,190.97	$355.34	$238.19
28280	T	Fusion of toes	0055	20.0692	$1,190.97	$355.34	$238.19
28285	T	Repair of hammertoe	0055	20.0692	$1,190.97	$355.34	$238.19
28286	T	Repair of hammertoe	0055	20.0692	$1,190.97	$355.34	$238.19
28288	T	Partial removal of foot bone	0055	20.0692	$1,190.97	$355.34	$238.19
28289	T	Repair hallux rigidus	0055	20.0692	$1,190.97	$355.34	$238.19
28290	T	Correction of bunion	0057	27.5493	$1,634.86	$475.91	$326.97
28292	T	Correction of bunion	0057	27.5493	$1,634.86	$475.91	$326.97
28293	T	Correction of bunion	0057	27.5493	$1,634.86	$475.91	$326.97
28294	T	Correction of bunion	0057	27.5493	$1,634.86	$475.91	$326.97
28296	T	Correction of bunion	0057	27.5493	$1,634.86	$475.91	$326.97
28297	T	Correction of bunion	0057	27.5493	$1,634.86	$475.91	$326.97
28298	T	Correction of bunion	0057	27.5493	$1,634.86	$475.91	$326.97
28299	T	Correction of bunion	0057	27.5493	$1,634.86	$475.91	$326.97
28300	T	Incision of heel bone	0056	40.2957	$2,391.27		$478.25
28302	T	Incision of ankle bone	0055	20.0692	$1,190.97	$355.34	$238.19
28304	T	Incision of midfoot bones	0056	40.2957	$2,391.27		$478.25
28305	T	Incise/graft midfoot bones	0056	40.2957	$2,391.27		$478.25
28306	T	Incision of metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28307	T	Incision of metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28308	T	Incision of metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28309	T	Incision of metatarsals	0056	40.2957	$2,391.27		$478.25
28310	T	Revision of big toe	0055	20.0692	$1,190.97	$355.34	$238.19
28312	T	Revision of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28313	T	Repair deformity of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28315	T	Removal of sesamoid bone	0055	20.0692	$1,190.97	$355.34	$238.19
28320	T	Repair of foot bones	0056	40.2957	$2,391.27		$478.25
28322	T	Repair of metatarsals	0056	40.2957	$2,391.27		$478.25
28340	T	Resect enlarged toe tissue	0055	20.0692	$1,190.97	$355.34	$238.19
28341	T	Resect enlarged toe	0055	20.0692	$1,190.97	$355.34	$238.19
28344	T	Repair extra toe(s)	0055	20.0692	$1,190.97	$355.34	$238.19
28345	T	Repair webbed toe(s)	0055	20.0692	$1,190.97	$355.34	$238.19
28360	T	Reconstruct cleft foot	0056	40.2957	$2,391.27		$478.25
28400	T	Treatment of heel fracture	0043	1.7694	$105.00		$21.00
28405	T	Treatment of heel fracture	0043	1.7694	$105.00		$21.00
28406	T	Treatment of heel fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28415	T	Treat heel fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28420	T	Treat/graft heel fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28430	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
28435	T	Treatment of ankle fracture	0043	1.7694	$105.00		$21.00
28436	T	Treatment of ankle fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28445	T	Treat ankle fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28450	T	Treat midfoot fracture, each	0043	1.7694	$105.00		$21.00
28455	T	Treat midfoot fracture, each	0043	1.7694	$105.00		$21.00
28456	T	Treat midfoot fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28465	T	Treat midfoot fracture, each	0046	37.7023	$2,237.37	$535.76	$447.47
28470	T	Treat metatarsal fracture	0043	1.7694	$105.00		$21.00
28475	T	Treat metatarsal fracture	0043	1.7694	$105.00		$21.00
28476	T	Treat metatarsal fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28485	T	Treat metatarsal fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28490	T	Treat big toe fracture	0043	1.7694	$105.00		$21.00
28495	T	Treat big toe fracture	0043	1.7694	$105.00		$21.00
28496	T	Treat big toe fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28505	T	Treat big toe fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28510	T	Treatment of toe fracture	0043	1.7694	$105.00		$21.00
28515	T	Treatment of toe fracture	0043	1.7694	$105.00		$21.00
28525	T	Treat toe fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28530	T	Treat sesamoid bone fracture	0043	1.7694	$105.00		$21.00
28531	T	Treat sesamoid bone fracture	0046	37.7023	$2,237.37	$535.76	$447.47
28540	T	Treat foot dislocation	0043	1.7694	$105.00		$21.00
28545	T	Treat foot dislocation	0045	14.4945	$860.15	$268.47	$172.03
28546	T	Treat foot dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28555	T	Repair foot dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28570	T	Treat foot dislocation	0043	1.7694	$105.00		$21.00
28575	T	Treat foot dislocation	0043	1.7694	$105.00		$21.00
28576	T	Treat foot dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28585	T	Repair foot dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28600	T	Treat foot dislocation	0043	1.7694	$105.00		$21.00
28605	T	Treat foot dislocation	0043	1.7694	$105.00		$21.00
28606	T	Treat foot dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28615	T	Repair foot dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28630	T	Treat toe dislocation	0043	1.7694	$105.00		$21.00
28635	T	Treat toe dislocation	0045	14.4945	$860.15	$268.47	$172.03
28636	T	Treat toe dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28645	T	Repair toe dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28660	T	Treat toe dislocation	0043	1.7694	$105.00		$21.00
28665	T	Treat toe dislocation	0045	14.4945	$860.15	$268.47	$172.03
28666	T	Treat toe dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28675	T	Repair of toe dislocation	0046	37.7023	$2,237.37	$535.76	$447.47
28705	T	Fusion of foot bones	0056	40.2957	$2,391.27		$478.25
28715	T	Fusion of foot bones	0056	40.2957	$2,391.27		$478.25
28725	T	Fusion of foot bones	0056	40.2957	$2,391.27		$478.25
28730	T	Fusion of foot bones	0056	40.2957	$2,391.27		$478.25
28735	T	Fusion of foot bones	0056	40.2957	$2,391.27		$478.25
28737	T	Revision of foot bones	0056	40.2957	$2,391.27		$478.25
28740	T	Fusion of foot bones	0056	40.2957	$2,391.27		$478.25
28750	T	Fusion of big toe joint	0056	40.2957	$2,391.27		$478.25
28755	T	Fusion of big toe joint	0055	20.0692	$1,190.97	$355.34	$238.19
28760	T	Fusion of big toe joint	0056	40.2957	$2,391.27		$478.25
28800	C	Amputation of midfoot
28805	C	Amputation thru metatarsal
28810	T	Amputation toe metatarsal	0055	20.0692	$1,190.97	$355.34	$238.19
28820	T	Amputation of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28825	T	Partial amputation of toe	0055	20.0692	$1,190.97	$355.34	$238.19
28899	T	Foot/toes surgery procedure	0043	1.7694	$105.00		$21.00
29000	S	Application of body cast	0058	1.0934	$64.89		$12.98
29010	S	Application of body cast	0426	2.1243	$126.06		$25.21
29015	S	Application of body cast	0426	2.1243	$126.06		$25.21
29020	S	Application of body cast	0058	1.0934	$64.89		$12.98
29025	S	Application of body cast	0058	1.0934	$64.89		$12.98
29035	S	Application of body cast	0426	2.1243	$126.06		$25.21
29040	S	Application of body cast	0058	1.0934	$64.89		$12.98
29044	S	Application of body cast	0426	2.1243	$126.06		$25.21
29046	S	Application of body cast	0426	2.1243	$126.06		$25.21
29049	S	Application of figure eight	0058	1.0934	$64.89		$12.98
29055	S	Application of shoulder cast	0426	2.1243	$126.06		$25.21
29058	S	Application of shoulder cast	0058	1.0934	$64.89		$12.98
29065	S	Application of long arm cast	0426	2.1243	$126.06		$25.21
29075	S	Application of forearm cast	0426	2.1243	$126.06		$25.21
29085	S	Apply hand/wrist cast	0058	1.0934	$64.89		$12.98
29086	S	Apply finger cast	0058	1.0934	$64.89		$12.98
29105	S	Apply long arm splint	0058	1.0934	$64.89		$12.98
29125	S	Apply forearm splint	0058	1.0934	$64.89		$12.98
29126	S	Apply forearm splint	0058	1.0934	$64.89		$12.98
29130	S	Application of finger splint	0058	1.0934	$64.89		$12.98
29131	S	Application of finger splint	0058	1.0934	$64.89		$12.98
29200	S	Strapping of chest	0058	1.0934	$64.89		$12.98
29220	S	Strapping of low back	0058	1.0934	$64.89		$12.98
29240	S	Strapping of shoulder	0058	1.0934	$64.89		$12.98
29260	S	Strapping of elbow or wrist	0058	1.0934	$64.89		$12.98
29280	S	Strapping of hand or finger	0058	1.0934	$64.89		$12.98
29305	S	Application of hip cast	0426	2.1243	$126.06		$25.21
29325	S	Application of hip casts	0426	2.1243	$126.06		$25.21
29345	S	Application of long leg cast	0426	2.1243	$126.06		$25.21
29355	S	Application of long leg cast	0426	2.1243	$126.06		$25.21
29358	S	Apply long leg cast brace	0426	2.1243	$126.06		$25.21
29365	S	Application of long leg cast	0426	2.1243	$126.06		$25.21
29405	S	Apply short leg cast	0426	2.1243	$126.06		$25.21
29425	S	Apply short leg cast	0426	2.1243	$126.06		$25.21
29435	S	Apply short leg cast	0426	2.1243	$126.06		$25.21
29440	S	Addition of walker to cast	0058	1.0934	$64.89		$12.98
29445	S	Apply rigid leg cast	0426	2.1243	$126.06		$25.21
29450	S	Application of leg cast	0058	1.0934	$64.89		$12.98
29505	S	Application, long leg splint	0058	1.0934	$64.89		$12.98
29515	S	Application lower leg splint	0058	1.0934	$64.89		$12.98
29520	S	Strapping of hip	0058	1.0934	$64.89		$12.98
29530	S	Strapping of knee	0058	1.0934	$64.89		$12.98
29540	S	Strapping of ankle	0058	1.0934	$64.89		$12.98
29550	S	Strapping of toes	0058	1.0934	$64.89		$12.98
29580	S	Application of paste boot	0058	1.0934	$64.89		$12.98
29590	S	Application of foot splint	0058	1.0934	$64.89		$12.98
29700	S	Removal/revision of cast	0058	1.0934	$64.89		$12.98
29705	S	Removal/revision of cast	0058	1.0934	$64.89		$12.98
29710	S	Removal/revision of cast	0426	2.1243	$126.06		$25.21
29715	S	Removal/revision of cast	0058	1.0934	$64.89		$12.98
29720	S	Repair of body cast	0058	1.0934	$64.89		$12.98
29730	S	Windowing of cast	0058	1.0934	$64.89		$12.98
29740	S	Wedging of cast	0058	1.0934	$64.89		$12.98
29750	S	Wedging of clubfoot cast	0058	1.0934	$64.89		$12.98
29799	S	Casting/strapping procedure	0058	1.0934	$64.89		$12.98
29800	T	Jaw arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29804	T	Jaw arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29805	T	Shoulder arthroscopy, dx	0041	28.1318	$1,669.43		$333.89
29806	T	Shoulder arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29807	T	Shoulder arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29819	T	Shoulder arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29820	T	Shoulder arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29821	T	Shoulder arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29822	T	Shoulder arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29823	T	Shoulder arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29824	T	Shoulder arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29825	T	Shoulder arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29826	T	Shoulder arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29827	T	Arthroscop rotator cuff repr	0042	43.9753	$2,609.63	$804.74	$521.93
29830	T	Elbow arthroscopy	0041	28.1318	$1,669.43		$333.89
29834	T	Elbow arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29835	T	Elbow arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29836	T	Elbow arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29837	T	Elbow arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29838	T	Elbow arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29840	T	Wrist arthroscopy	0041	28.1318	$1,669.43		$333.89
29843	T	Wrist arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29844	T	Wrist arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29845	T	Wrist arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29846	T	Wrist arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29847	T	Wrist arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29848	T	Wrist endoscopy/surgery	0041	28.1318	$1,669.43		$333.89
29850	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29851	T	Knee arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29855	T	Tibial arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29856	T	Tibial arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29860	T	Hip arthroscopy, dx	0041	28.1318	$1,669.43		$333.89
29861	T	Hip arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29862	T	Hip arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29863	T	Hip arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29866	T	Autgrft implnt, knee w/scope	0042	43.9753	$2,609.63	$804.74	$521.93
29867	T	Allgrft implnt, knee w/scope	0042	43.9753	$2,609.63	$804.74	$521.93
29868	T	Meniscal trnspl, knee w/scpe	0042	43.9753	$2,609.63	$804.74	$521.93
29870	T	Knee arthroscopy, dx	0041	28.1318	$1,669.43		$333.89
29871	T	Knee arthroscopy/drainage	0041	28.1318	$1,669.43		$333.89
29873	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29874	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29875	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29876	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29877	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29879	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29880	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29881	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29882	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29883	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29884	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29885	T	Knee arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29886	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29887	T	Knee arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29888	T	Knee arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29889	T	Knee arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29891	T	Ankle arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29892	T	Ankle arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29893	T	Scope, plantar fasciotomy	0055	20.0692	$1,190.97	$355.34	$238.19
29894	T	Ankle arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29895	T	Ankle arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29897	T	Ankle arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29898	T	Ankle arthroscopy/surgery	0041	28.1318	$1,669.43		$333.89
29899	T	Ankle arthroscopy/surgery	0042	43.9753	$2,609.63	$804.74	$521.93
29900	T	Mcp joint arthroscopy, dx	0053	15.6795	$930.47	$253.49	$186.09
29901	T	Mcp joint arthroscopy, surg	0053	15.6795	$930.47	$253.49	$186.09
29902	T	Mcp joint arthroscopy, surg	0053	15.6795	$930.47	$253.49	$186.09
29999	T	Arthroscopy of joint	0041	28.1318	$1,669.43		$333.89
30000	T	Drainage of nose lesion	0251	2.0101	$119.29		$23.86
30020	T	Drainage of nose lesion	0251	2.0101	$119.29		$23.86
30100	T	Intranasal biopsy	0252	7.8673	$466.87	$113.41	$93.37
30110	T	Removal of nose polyp(s)	0253	16.1357	$957.54	$282.29	$191.51
30115	T	Removal of nose polyp(s)	0253	16.1357	$957.54	$282.29	$191.51
30117	T	Removal of intranasal lesion	0253	16.1357	$957.54	$282.29	$191.51
30118	T	Removal of intranasal lesion	0254	23.404	$1,388.86	$321.35	$277.77
30120	T	Revision of nose	0253	16.1357	$957.54	$282.29	$191.51
30124	T	Removal of nose lesion	0252	7.8673	$466.87	$113.41	$93.37
30125	T	Removal of nose lesion	0256	37.3204	$2,214.70		$442.94
30130	T	Removal of turbinate bones	0253	16.1357	$957.54	$282.29	$191.51
30140	T	Removal of turbinate bones	0254	23.404	$1,388.86	$321.35	$277.77
30150	T	Partial removal of nose	0256	37.3204	$2,214.70		$442.94
30160	T	Removal of nose	0256	37.3204	$2,214.70		$442.94
30200	T	Injection treatment of nose	0252	7.8673	$466.87	$113.41	$93.37
30210	T	Nasal sinus therapy	0252	7.8673	$466.87	$113.41	$93.37
30220	T	Insert nasal septal button	0252	7.8673	$466.87	$113.41	$93.37
30300	X	Remove nasal foreign body	0340	0.6384	$37.88		$7.58
30310	T	Remove nasal foreign body	0253	16.1357	$957.54	$282.29	$191.51
30320	T	Remove nasal foreign body	0253	16.1357	$957.54	$282.29	$191.51
30400	T	Reconstruction of nose	0256	37.3204	$2,214.70		$442.94
30410	T	Reconstruction of nose	0256	37.3204	$2,214.70		$442.94
30420	T	Reconstruction of nose	0256	37.3204	$2,214.70		$442.94
30430	T	Revision of nose	0254	23.404	$1,388.86	$321.35	$277.77
30435	T	Revision of nose	0256	37.3204	$2,214.70		$442.94
30450	T	Revision of nose	0256	37.3204	$2,214.70		$442.94
30460	T	Revision of nose	0256	37.3204	$2,214.70		$442.94
30462	T	Revision of nose	0256	37.3204	$2,214.70		$442.94
30465	T	Repair nasal stenosis	0256	37.3204	$2,214.70		$442.94
30520	T	Repair of nasal septum	0254	23.404	$1,388.86	$321.35	$277.77
30540	T	Repair nasal defect	0256	37.3204	$2,214.70		$442.94
30545	T	Repair nasal defect	0256	37.3204	$2,214.70		$442.94
30560	T	Release of nasal adhesions	0251	2.0101	$119.29		$23.86
30580	T	Repair upper jaw fistula	0256	37.3204	$2,214.70		$442.94
30600	T	Repair mouth/nose fistula	0256	37.3204	$2,214.70		$442.94
30620	T	Intranasal reconstruction	0256	37.3204	$2,214.70		$442.94
30630	T	Repair nasal septum defect	0254	23.404	$1,388.86	$321.35	$277.77
30801	T	Cauterization, inner nose	0252	7.8673	$466.87	$113.41	$93.37
30802	T	Cauterization, inner nose	0252	7.8673	$466.87	$113.41	$93.37
30901	T	Control of nosebleed	0250	1.2896	$76.53	$26.79	$15.31
30903	T	Control of nosebleed	0250	1.2896	$76.53	$26.79	$15.31
30905	T	Control of nosebleed	0250	1.2896	$76.53	$26.79	$15.31
30906	T	Repeat control of nosebleed	0250	1.2896	$76.53	$26.79	$15.31
30915	T	Ligation, nasal sinus artery	0091	28.9999	$1,720.94	$348.23	$344.19
30920	T	Ligation, upper jaw artery	0092	26.482	$1,571.52	$505.37	$314.30
30930	T	Therapy, fracture of nose	0253	16.1357	$957.54	$282.29	$191.51
30999	T	Nasal surgery procedure	0251	2.0101	$119.29		$23.86
31000	T	Irrigation, maxillary sinus	0251	2.0101	$119.29		$23.86
31002	T	Irrigation, sphenoid sinus	0252	7.8673	$466.87	$113.41	$93.37
31020	T	Exploration, maxillary sinus	0254	23.404	$1,388.86	$321.35	$277.77
31030	T	Exploration, maxillary sinus	0256	37.3204	$2,214.70		$442.94
31032	T	Explore sinus, remove polyps	0256	37.3204	$2,214.70		$442.94
31040	T	Exploration behind upper jaw	0254	23.404	$1,388.86	$321.35	$277.77
31050	T	Exploration, sphenoid sinus	0256	37.3204	$2,214.70		$442.94
31051	T	Sphenoid sinus surgery	0256	37.3204	$2,214.70		$442.94
31070	T	Exploration of frontal sinus	0254	23.404	$1,388.86	$321.35	$277.77
31075	T	Exploration of frontal sinus	0256	37.3204	$2,214.70		$442.94
31080	T	Removal of frontal sinus	0256	37.3204	$2,214.70		$442.94
31081	T	Removal of frontal sinus	0256	37.3204	$2,214.70		$442.94
31084	T	Removal of frontal sinus	0256	37.3204	$2,214.70		$442.94
31085	T	Removal of frontal sinus	0256	37.3204	$2,214.70		$442.94
31086	T	Removal of frontal sinus	0256	37.3204	$2,214.70		$442.94
31087	T	Removal of frontal sinus	0256	37.3204	$2,214.70		$442.94
31090	T	Exploration of sinuses	0256	37.3204	$2,214.70		$442.94
31200	T	Removal of ethmoid sinus	0256	37.3204	$2,214.70		$442.94
31201	T	Removal of ethmoid sinus	0256	37.3204	$2,214.70		$442.94
31205	T	Removal of ethmoid sinus	0256	37.3204	$2,214.70		$442.94
31225	C	Removal of upper jaw
31230	C	Removal of upper jaw
31231	T	Nasal endoscopy, dx	0072	1.4361	$85.22	$21.27	$17.04
31233	T	Nasal/sinus endoscopy, dx	0072	1.4361	$85.22	$21.27	$17.04
31235	T	Nasal/sinus endoscopy, dx	0074	15.7757	$936.18	$295.70	$187.24
31237	T	Nasal/sinus endoscopy, surg	0075	21.3426	$1,266.53	$445.92	$253.31
31238	T	Nasal/sinus endoscopy, surg	0074	15.7757	$936.18	$295.70	$187.24
31239	T	Nasal/sinus endoscopy, surg	0075	21.3426	$1,266.53	$445.92	$253.31
31240	T	Nasal/sinus endoscopy, surg	0074	15.7757	$936.18	$295.70	$187.24
31254	T	Revision of ethmoid sinus	0075	21.3426	$1,266.53	$445.92	$253.31
31255	T	Removal of ethmoid sinus	0075	21.3426	$1,266.53	$445.92	$253.31
31256	T	Exploration maxillary sinus	0075	21.3426	$1,266.53	$445.92	$253.31
31267	T	Endoscopy, maxillary sinus	0075	21.3426	$1,266.53	$445.92	$253.31
31276	T	Sinus endoscopy, surgical	0075	21.3426	$1,266.53	$445.92	$253.31
31287	T	Nasal/sinus endoscopy, surg	0075	21.3426	$1,266.53	$445.92	$253.31
31288	T	Nasal/sinus endoscopy, surg	0075	21.3426	$1,266.53	$445.92	$253.31
31290	C	Nasal/sinus endoscopy, surg
31291	C	Nasal/sinus endoscopy, surg
31292	T	Nasal/sinus endoscopy, surg	0075	21.3426	$1,266.53	$445.92	$253.31
31293	T	Nasal/sinus endoscopy, surg	0075	21.3426	$1,266.53	$445.92	$253.31
31294	T	Nasal/sinus endoscopy, surg	0075	21.3426	$1,266.53	$445.92	$253.31
31299	T	Sinus surgery procedure	0251	2.0101	$119.29		$23.86
31300	T	Removal of larynx lesion	0254	23.404	$1,388.86	$321.35	$277.77
31320	T	Diagnostic incision, larynx	0256	37.3204	$2,214.70		$442.94
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	37.3204	$2,214.70		$442.94
31420	T	Removal of epiglottis	0256	37.3204	$2,214.70		$442.94
31500	S	Insert emergency airway	0094	2.5363	$150.51	$47.62	$30.10
31502	T	Change of windpipe airway	0121	2.2766	$135.10	$43.80	$27.02
31505	T	Diagnostic laryngoscopy	0071	0.7915	$46.97	$11.31	$9.39
31510	T	Laryngoscopy with biopsy	0074	15.7757	$936.18	$295.70	$187.24
31511	T	Remove foreign body, larynx	0072	1.4361	$85.22	$21.27	$17.04
31512	T	Removal of larynx lesion	0074	15.7757	$936.18	$295.70	$187.24
31513	T	Injection into vocal cord	0072	1.4361	$85.22	$21.27	$17.04
31515	T	Laryngoscopy for aspiration	0074	15.7757	$936.18	$295.70	$187.24
31520	T	Diagnostic laryngoscopy	0072	1.4361	$85.22	$21.27	$17.04
31525	T	Diagnostic laryngoscopy	0074	15.7757	$936.18	$295.70	$187.24
31526	T	Diagnostic laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31527	T	Laryngoscopy for treatment	0075	21.3426	$1,266.53	$445.92	$253.31
31528	T	Laryngoscopy and dilation	0074	15.7757	$936.18	$295.70	$187.24
31529	T	Laryngoscopy and dilation	0074	15.7757	$936.18	$295.70	$187.24
31530	T	Operative laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31531	T	Operative laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31535	T	Operative laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31536	T	Operative laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31540	T	Operative laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31541	T	Operative laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31545	T	Remove vc lesion w/scope	0075	21.3426	$1,266.53	$445.92	$253.31
31546	T	Remove vc lesion scope/graft	0075	21.3426	$1,266.53	$445.92	$253.31
31560	T	Operative laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31561	T	Operative laryngoscopy	0075	21.3426	$1,266.53	$445.92	$253.31
31570	T	Laryngoscopy with injection	0074	15.7757	$936.18	$295.70	$187.24
31571	T	Laryngoscopy with injection	0075	21.3426	$1,266.53	$445.92	$253.31
31575	T	Diagnostic laryngoscopy	0072	1.4361	$85.22	$21.27	$17.04
31576	T	Laryngoscopy with biopsy	0075	21.3426	$1,266.53	$445.92	$253.31
31577	T	Remove foreign body, larynx	0073	4.1609	$246.92	$73.38	$49.38
31578	T	Removal of larynx lesion	0075	21.3426	$1,266.53	$445.92	$253.31
31579	T	Diagnostic laryngoscopy	0073	4.1609	$246.92	$73.38	$49.38
31580	T	Revision of larynx	0256	37.3204	$2,214.70		$442.94
31582	T	Revision of larynx	0256	37.3204	$2,214.70		$442.94
31584	C	Treat larynx fracture
31585	T	Treat larynx fracture	0253	16.1357	$957.54	$282.29	$191.51
31586	T	Treat larynx fracture	0256	37.3204	$2,214.70		$442.94
31587	C	Revision of larynx
31588	T	Revision of larynx	0256	37.3204	$2,214.70		$442.94
31590	T	Reinnervate larynx	0256	37.3204	$2,214.70		$442.94
31595	T	Larynx nerve surgery	0256	37.3204	$2,214.70		$442.94
31599	T	Larynx surgery procedure	0251	2.0101	$119.29		$23.86
31600	T	Incision of windpipe	0254	23.404	$1,388.86	$321.35	$277.77
31601	T	Incision of windpipe	0254	23.404	$1,388.86	$321.35	$277.77
31603	T	Incision of windpipe	0252	7.8673	$466.87	$113.41	$93.37
31605	T	Incision of windpipe	0252	7.8673	$466.87	$113.41	$93.37
31610	T	Incision of windpipe	0254	23.404	$1,388.86	$321.35	$277.77
31611	T	Surgery/speech prosthesis	0254	23.404	$1,388.86	$321.35	$277.77
31612	T	Puncture/clear windpipe	0254	23.404	$1,388.86	$321.35	$277.77
31613	T	Repair windpipe opening	0254	23.404	$1,388.86	$321.35	$277.77
31614	T	Repair windpipe opening	0256	37.3204	$2,214.70		$442.94
31615	T	Visualization of windpipe	0076	9.4592	$561.34	$189.82	$112.27
31620	S	Endobronchial us add-on	0670	25.4131	$1,508.09	$472.46	$301.62
31622	T	Dx bronchoscope/wash	0076	9.4592	$561.34	$189.82	$112.27
31623	T	Dx bronchoscope/brush	0076	9.4592	$561.34	$189.82	$112.27
31624	T	Dx bronchoscope/lavage	0076	9.4592	$561.34	$189.82	$112.27
31625	T	Bronchoscopy w/biopsy(s)	0076	9.4592	$561.34	$189.82	$112.27
31628	T	Bronchoscopy/lung bx, each	0076	9.4592	$561.34	$189.82	$112.27
31629	T	Bronchoscopy/needle bx, each	0076	9.4592	$561.34	$189.82	$112.27
31630	T	Bronchoscopy dilate/fx repr	0415	22.0955	$1,311.21	$459.92	$262.24
31631	T	Bronchoscopy, dilate w/stent	0415	22.0955	$1,311.21	$459.92	$262.24
31632	T	Bronchoscopy/lung bx, add'l	0076	9.4592	$561.34	$189.82	$112.27
31633	T	Bronchoscopy/needle bx add'l	0076	9.4592	$561.34	$189.82	$112.27
31635	T	Bronchoscopy w/fb removal	0076	9.4592	$561.34	$189.82	$112.27
31636	T	Bronchoscopy, bronch stents	0415	22.0955	$1,311.21	$459.92	$262.24
31637	T	Bronchoscopy, stent add-on	0076	9.4592	$561.34	$189.82	$112.27
31638	T	Bronchoscopy, revise stent	0415	22.0955	$1,311.21	$459.92	$262.24
31640	T	Bronchoscopy w/tumor excise	0415	22.0955	$1,311.21	$459.92	$262.24
31641	T	Bronchoscopy, treat blockage	0415	22.0955	$1,311.21	$459.92	$262.24
31643	T	Diag bronchoscope/catheter	0076	9.4592	$561.34	$189.82	$112.27
31645	T	Bronchoscopy, clear airways	0076	9.4592	$561.34	$189.82	$112.27
31646	T	Bronchoscopy, reclear airway	0076	9.4592	$561.34	$189.82	$112.27
31656	T	Bronchoscopy, inj for x-ray	0076	9.4592	$561.34	$189.82	$112.27
31700	T	Insertion of airway catheter	0072	1.4361	$85.22	$21.27	$17.04
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	4.1609	$246.92	$73.38	$49.38
31720	T	Clearance of airways	0071	0.7915	$46.97	$11.31	$9.39
31725	C	Clearance of airways
31730	T	Intro, windpipe wire/tube	0073	4.1609	$246.92	$73.38	$49.38
31750	T	Repair of windpipe	0256	37.3204	$2,214.70		$442.94
31755	T	Repair of windpipe	0256	37.3204	$2,214.70		$442.94
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	T	Remove windpipe lesion	0254	23.404	$1,388.86	$321.35	$277.77
31786	C	Remove windpipe lesion
31800	C	Repair of windpipe injury
31805	C	Repair of windpipe injury
31820	T	Closure of windpipe lesion	0253	16.1357	$957.54	$282.29	$191.51
31825	T	Repair of windpipe defect	0254	23.404	$1,388.86	$321.35	$277.77
31830	T	Revise windpipe scar	0254	23.404	$1,388.86	$321.35	$277.77
31899	T	Airways surgical procedure	0076	9.4592	$561.34	$189.82	$112.27
32000	T	Drainage of chest	0070	3.2101	$190.50		$38.10
32002	T	Treatment of collapsed lung	0070	3.2101	$190.50		$38.10
32005	T	Treat lung lining chemically	0070	3.2101	$190.50		$38.10
32019	T	Insert pleural catheter	0070	3.2101	$190.50		$38.10
32020	T	Insertion of chest tube	0070	3.2101	$190.50		$38.10
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	T	Drain, percut, lung lesion	0070	3.2101	$190.50		$38.10
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	0685	6.0174	$357.09	$115.47	$71.42
32402	C	Open biopsy chest lining
32405	T	Biopsy, lung or mediastinum	0685	6.0174	$357.09	$115.47	$71.42
32420	T	Puncture/clear lung	0070	3.2101	$190.50		$38.10
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	0069	30.6775	$1,820.49	$591.64	$364.10
32602	T	Thoracoscopy, diagnostic	0069	30.6775	$1,820.49	$591.64	$364.10
32603	T	Thoracoscopy, diagnostic	0069	30.6775	$1,820.49	$591.64	$364.10
32604	T	Thoracoscopy, diagnostic	0069	30.6775	$1,820.49	$591.64	$364.10
32605	T	Thoracoscopy, diagnostic	0069	30.6775	$1,820.49	$591.64	$364.10
32606	T	Thoracoscopy, diagnostic	0069	30.6775	$1,820.49	$591.64	$364.10
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
32855	C	Prepare donor lung, single
32856	C	Prepare donor lung, double
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	3.2101	$190.50		$38.10
32997	C	Total lung lavage
32999	T	Chest surgery procedure	0070	3.2101	$190.50		$38.10
33010	T	Drainage of heart sac	0070	3.2101	$190.50		$38.10
33011	T	Repeat drainage of heart sac	0070	3.2101	$190.50		$38.10
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	105.6143	$6,267.47	$1,682.28	$1,253.49
33207	T	Insertion of heart pacemaker	0089	105.6143	$6,267.47	$1,682.28	$1,253.49
33208	T	Insertion of heart pacemaker	0655	133.7768	$7,938.72		$1,587.74
33210	T	Insertion of heart electrode	0106	45.4851	$2,699.22		$539.84
33211	T	Insertion of heart electrode	0106	45.4851	$2,699.22		$539.84
33212	T	Insertion of pulse generator	0090	89.1574	$5,290.87	$1,612.80	$1,058.17
33213	T	Insertion of pulse generator	0654	100.9294	$5,989.45		$1,197.89
33214	T	Upgrade of pacemaker system	0655	133.7768	$7,938.72		$1,587.74
33215	T	Reposition pacing-defib lead	0105	22.3685	$1,327.41	$370.40	$265.48
33216	T	Revise eltrd pacing-defib	0106	45.4851	$2,699.22		$539.84
33217	T	Insert lead pace-defib, dual	0106	45.4851	$2,699.22		$539.84
33218	T	Repair lead pace-defib, one	0106	45.4851	$2,699.22		$539.84
33220	T	Repair lead pace-defib, dual	0106	45.4851	$2,699.22		$539.84
33222	T	Revise pocket, acemaker	0027	18.4182	$1,092.99	$329.72	$218.60
33223	T	Revise pocket, pacing-defib	0027	18.4182	$1,092.99	$329.72	$218.60
33224	T	Insert pacing lead connect	0418	109.3043	$6,486.45		$1,297.29
33225	T	L ventric pacing lead add-on	0418	109.3043	$6,486.45		$1,297.29
33226	T	Reposition l ventric lead	0105	22.3685	$1,327.41	$370.40	$265.48
33233	T	Removal of pacemaker system	0105	22.3685	$1,327.41	$370.40	$265.48
33234	T	Removal of pacemaker system	0105	22.3685	$1,327.41	$370.40	$265.48
33235	T	Removal pacemaker electrode	0105	22.3685	$1,327.41	$370.40	$265.48
33236	C	Remove electrode/thoracotomy
33237	C	Remove electrode/thoracotomy
33238	C	Remove electrode/thoracotomy
33240	B	Insert pulse generator
33241	T	Remove pulse generator	0105	22.3685	$1,327.41	$370.40	$265.48
33243	C	Remove eltrd/thoracotomy
33244	T	Remove eltrd, transven	0105	22.3685	$1,327.41	$370.40	$265.48
33245	C	Insert epic eltrd pace-defib
33246	C	Insert epic eltrd/generator
33249	B	Eltrd/insert pace-defib
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	0680	62.9082	$3,733.16		$746.63
33284	T	Remove pat-active ht record	0109	11.0433	$655.34	$131.49	$131.07
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
33508	N	Endoscopic vein harvest
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, modified fontan
33617	C	Repair single ventricle
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
33933	C	Prepare donor heart/lung
33935	C	Transplantation, heart/lung
33940	C	Removal of donor heart
33944	C	Prepare donor heart
33945	C	Transplantation of heart
33960	C	External circulation assist
33961	C	External circulation assist
33967	C	Insert ia percut device
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
33979	C	Insert intracorporeal device
33980	C	Remove intracorporeal device
33999	T	Cardiac surgery procedure	0070	3.2101	$190.50		$38.10
34001	C	Removal of artery clot
34051	C	Removal of artery clot
34101	T	Removal of artery clot	0088	36.5617	$2,169.68	$655.22	$433.94
34111	T	Removal of arm artery clot	0088	36.5617	$2,169.68	$655.22	$433.94
34151	C	Removal of artery clot
34201	T	Removal of artery clot	0088	36.5617	$2,169.68	$655.22	$433.94
34203	T	Removal of leg artery clot	0088	36.5617	$2,169.68	$655.22	$433.94
34401	C	Removal of vein clot
34421	T	Removal of vein clot	0088	36.5617	$2,169.68	$655.22	$433.94
34451	C	Removal of vein clot
34471	T	Removal of vein clot	0088	36.5617	$2,169.68	$655.22	$433.94
34490	T	Removal of vein clot	0088	36.5617	$2,169.68	$655.22	$433.94
34501	T	Repair valve, femoral vein	0088	36.5617	$2,169.68	$655.22	$433.94
34502	C	Reconstruct vena cava
34510	T	Transposition of vein valve	0088	36.5617	$2,169.68	$655.22	$433.94
34520	T	Cross-over vein graft	0088	36.5617	$2,169.68	$655.22	$433.94
34530	T	Leg vein fusion	0088	36.5617	$2,169.68	$655.22	$433.94
34800	C	Endovasc abdo repair w/tube
34802	C	Endovasc abdo repr w/device
34803	C	Endovas aaa repr w/3-p part
34804	C	Endovasc abdo repr w/device
34805	C	Endovasc abdo repair w/pros
34808	C	Endovasc abdo occlud device
34812	C	Xpose for endoprosth, aortic
34813	C	Femoral endovas graft add-on
34820	C	Xpose for endoprosth, iliac
34825	C	Endovasc extend prosth, init
34826	C	Endovasc exten prosth, add'l
34830	C	Open aortic tube prosth repr
34831	C	Open aortoiliac prosth repr
34832	C	Open aortofemor prosth repr
34833	C	Xpose for endoprosth, iliac
34834	C	Xpose, endoprosth, brachial
34900	C	Endovasc iliac repr w/graft
35001	C	Repair defect of artery
35002	C	Repair artery rupture, neck
35005	C	Repair defect of artery
35011	T	Repair defect of artery	0653	30.5339	$1,811.97		$362.39
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
35180	T	Repair blood vessel lesion	0093	23.4516	$1,391.69		$278.34
35182	C	Repair blood vessel lesion
35184	T	Repair blood vessel lesion	0093	23.4516	$1,391.69		$278.34
35188	T	Repair blood vessel lesion	0088	36.5617	$2,169.68	$655.22	$433.94
35189	C	Repair blood vessel lesion
35190	T	Repair blood vessel lesion	0093	23.4516	$1,391.69		$278.34
35201	T	Repair blood vessel lesion	0093	23.4516	$1,391.69		$278.34
35206	T	Repair blood vessel lesion	0093	23.4516	$1,391.69		$278.34
35207	T	Repair blood vessel lesion	0088	36.5617	$2,169.68	$655.22	$433.94
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	23.4516	$1,391.69		$278.34
35231	T	Repair blood vessel lesion	0093	23.4516	$1,391.69		$278.34
35236	T	Repair blood vessel lesion	0093	23.4516	$1,391.69		$278.34
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	23.4516	$1,391.69		$278.34
35261	T	Repair blood vessel lesion	0653	30.5339	$1,811.97		$362.39
35266	T	Repair blood vessel lesion	0653	30.5339	$1,811.97		$362.39
35271	C	Repair blood vessel lesion
35276	C	Repair blood vessel lesion
35281	C	Repair blood vessel lesion
35286	T	Repair blood vessel lesion	0653	30.5339	$1,811.97		$362.39
35301	C	Rechanneling of artery
35311	C	Rechanneling of artery
35321	T	Rechanneling of artery	0093	23.4516	$1,391.69		$278.34
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	34.4473	$2,044.21		$408.84
35459	T	Repair arterial blockage	0081	34.4473	$2,044.21		$408.84
35460	T	Repair venous blockage	0081	34.4473	$2,044.21		$408.84
35470	T	Repair arterial blockage	0081	34.4473	$2,044.21		$408.84
35471	T	Repair arterial blockage	0081	34.4473	$2,044.21		$408.84
35472	T	Repair arterial blockage	0081	34.4473	$2,044.21		$408.84
35473	T	Repair arterial blockage	0081	34.4473	$2,044.21		$408.84
35474	T	Repair arterial blockage	0081	34.4473	$2,044.21		$408.84
35475	T	Repair arterial blockage	0081	34.4473	$2,044.21		$408.84
35476	T	Repair venous blockage	0081	34.4473	$2,044.21		$408.84
35480	C	Atherectomy, open
35481	C	Atherectomy, open
35482	C	Atherectomy, open
35483	C	Atherectomy, open
35484	T	Atherectomy, open	0081	34.4473	$2,044.21		$408.84
35485	T	Atherectomy, open	0081	34.4473	$2,044.21		$408.84
35490	T	Atherectomy, percutaneous	0081	34.4473	$2,044.21		$408.84
35491	T	Atherectomy, percutaneous	0081	34.4473	$2,044.21		$408.84
35492	T	Atherectomy, percutaneous	0081	34.4473	$2,044.21		$408.84
35493	T	Atherectomy, percutaneous	0081	34.4473	$2,044.21		$408.84
35494	T	Atherectomy, percutaneous	0081	34.4473	$2,044.21		$408.84
35495	T	Atherectomy, percutaneous	0081	34.4473	$2,044.21		$408.84
35500	T	Harvest vein for bypass	0081	34.4473	$2,044.21		$408.84
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
35510	C	Artery bypass graft
35511	C	Artery bypass graft
35512	C	Artery bypass graft
35515	C	Artery bypass graft
35516	C	Artery bypass graft
35518	C	Artery bypass graft
35521	C	Artery bypass graft
35522	C	Artery bypass graft
35525	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
35572	N	Harvest femoropopliteal vein
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
35647	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
35685	T	Bypass graft patency/patch	0093	23.4516	$1,391.69		$278.34
35686	T	Bypass graft/av fist patency	0093	23.4516	$1,391.69		$278.34
35691	C	Arterial transposition
35693	C	Arterial transposition
35694	C	Arterial transposition
35695	C	Arterial transposition
35697	C	Reimplant artery each
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	31.4727	$1,867.68	$459.35	$373.54
35800	C	Explore neck vessels
35820	C	Explore chest vessels
35840	C	Explore abdominal vessels
35860	T	Explore limb vessels	0093	23.4516	$1,391.69		$278.34
35870	C	Repair vessel graft defect
35875	T	Removal of clot in graft	0088	36.5617	$2,169.68	$655.22	$433.94
35876	T	Removal of clot in graft	0088	36.5617	$2,169.68	$655.22	$433.94
35879	T	Revise graft w/vein	0088	36.5617	$2,169.68	$655.22	$433.94
35881	T	Revise graft w/vein	0088	36.5617	$2,169.68	$655.22	$433.94
35901	C	Excision, graft, neck
35903	T	Excision, graft, extremity	0115	31.4727	$1,867.68	$459.35	$373.54
35905	C	Excision, graft, thorax
35907	C	Excision, graft, abdomen
36000	N	Place needle in vein
36002	S	Pseudoaneurysm injection trt	0267	2.6327	$156.23	$62.18	$31.25
36005	N	Injection ext 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	0623	27.1105	$1,608.82		$321.76
36261	T	Revision of infusion pump	0623	27.1105	$1,608.82		$321.76
36262	T	Removal of infusion pump	0622	21.2671	$1,262.05		$252.41
36299	N	Vessel injection procedure
36400	N	Bl draw 3 yrs fem/jugular
36405	N	Bl draw 3 yrs scalp vein
36406	N	Bl draw 3 yrs other vein
36410	N	Non-routine bl draw 3 yrs
36415	A	Drawing blood
36416	N	Capillary blood draw
36420	T	Vein access cutdown 1 yr	0035	0.7158	$42.48		$8.50
36425	T	Vein access cutdown 1 yr	0035	0.7158	$42.48		$8.50
36430	S	Blood transfusion service	0110	3.6594	$217.16		$43.43
36440	S	Bl push transfuse, 2 yr or	0110	3.6594	$217.16		$43.43
36450	S	Bl exchange/transfuse, nb	0110	3.6594	$217.16		$43.43
36455	S	Bl exchange/transfuse non-nb	0110	3.6594	$217.16		$43.43
36460	S	Transfusion service, fetal	0110	3.6594	$217.16		$43.43
36468	T	Injection(s), spider veins	0098	1.1346	$67.33		$13.47
36469	T	Injection(s), spider veins	0098	1.1346	$67.33		$13.47
36470	T	Injection therapy of vein	0098	1.1346	$67.33		$13.47
36471	T	Injection therapy of veins	0098	1.1346	$67.33		$13.47
36475	T	Endovenous rf, 1st vein	0092	26.482	$1,571.52	$505.37	$314.30
36476	T	Endovenous rf, vein add-on	0092	26.482	$1,571.52	$505.37	$314.30
36478	T	Endovenous laser, 1st vein	0092	26.482	$1,571.52	$505.37	$314.30
36479	T	Endovenous laser vein addon	0092	26.482	$1,571.52	$505.37	$314.30
36481	N	Insertion of catheter, vein
36500	N	Insertion of catheter, vein
36510	N	Insertion of catheter, vein
36511	S	Apheresis wbc	0111	12.3956	$735.59	$200.18	$147.12
36512	S	Apheresis rbc	0111	12.3956	$735.59	$200.18	$147.12
36513	S	Apheresis platelets	0111	12.3956	$735.59	$200.18	$147.12
36514	S	Apheresis plasma	0111	12.3956	$735.59	$200.18	$147.12
36515	S	Apheresis, adsorp/reinfuse	0112	26.7948	$1,590.08	$438.94	$318.02
36516	S	Apheresis, selective	0112	26.7948	$1,590.08	$438.94	$318.02
36522	S	Photopheresis	0112	26.7948	$1,590.08	$438.94	$318.02
36540	N	Collect blood venous device
36550	T	Declot vascular device	0676	2.4105	$143.05		$28.61
36555	T	Insert non-tunnel cv cath	0621	8.2986	$492.46		$98.49
36556	T	Insert non-tunnel cv cath	0621	8.2986	$492.46		$98.49
36557	T	Insert tunneled cv cath	0622	21.2671	$1,262.05		$252.41
36558	T	Insert tunneled cv cath	0622	21.2671	$1,262.05		$252.41
36560	T	Insert tunneled cv cath	0623	27.1105	$1,608.82		$321.76
36561	T	Insert tunneled cv cath	0623	27.1105	$1,608.82		$321.76
36563	T	Insert tunneled cv cath	0623	27.1105	$1,608.82		$321.76
36565	T	Insert tunneled cv cath	0623	27.1105	$1,608.82		$321.76
36566	T	Insert tunneled cv cath	1564		$4,750.00		$950.00
36568	T	Insert tunneled cv cath	0621	8.2986	$492.46		$98.49
36569	T	Insert tunneled cv cath	0621	8.2986	$492.46		$98.49
36570	T	Insert tunneled cv cath	0622	21.2671	$1,262.05		$252.41
36571	T	Insert tunneled cv cath	0622	21.2671	$1,262.05		$252.41
36575	T	Repair tunneled cv cath	0621	8.2986	$492.46		$98.49
36576	T	Repair tunneled cv cath	0621	8.2986	$492.46		$98.49
36578	T	Replace tunneled cv cath	0622	21.2671	$1,262.05		$252.41
36580	T	Replace tunneled cv cath	0621	8.2986	$492.46		$98.49
36581	T	Replace tunneled cv cath	0622	21.2671	$1,262.05		$252.41
36582	T	Replace tunneled cv cath	0623	27.1105	$1,608.82		$321.76
36583	T	Replace tunneled cv cath	0623	27.1105	$1,608.82		$321.76
36584	T	Replace tunneled cv cath	0621	8.2986	$492.46		$98.49
36585	T	Replace tunneled cv cath	0622	21.2671	$1,262.05		$252.41
36589	T	Removal tunneled cv cath	0621	8.2986	$492.46		$98.49
36590	T	Removal tunneled cv cath	0621	8.2986	$492.46		$98.49
36595	T	Mech remov tunneled cv cath	0622	21.2671	$1,262.05		$252.41
36596	T	Mech remov tunneled cv cath	0621	8.2986	$492.46		$98.49
36597	T	Reposition venous catheter	0621	8.2986	$492.46		$98.49
36600	N	Withdrawal of arterial blood
36620	N	Insertion catheter, artery
36625	N	Insertion catheter, artery
36640	T	Insertion catheter, artery	0623	27.1105	$1,608.82		$321.76
36660	C	Insertion catheter, artery
36680	T	Insert needle, bone cavity	0002	0.9559	$56.73		$11.35
36800	T	Insertion of cannula	0115	31.4727	$1,867.68	$459.35	$373.54
36810	T	Insertion of cannula	0115	31.4727	$1,867.68	$459.35	$373.54
36815	T	Insertion of cannula	0115	31.4727	$1,867.68	$459.35	$373.54
36818	T	Av fuse, uppr arm, cephalic	0088	36.5617	$2,169.68	$655.22	$433.94
36819	T	Av fusion/uppr arm vein	0088	36.5617	$2,169.68	$655.22	$433.94
36820	T	Av fusion/forearm vein	0088	36.5617	$2,169.68	$655.22	$433.94
36821	T	Av fusion direct any site	0088	36.5617	$2,169.68	$655.22	$433.94
36822	C	Insertion of cannula(s)
36823	C	Insertion of cannula(s)
36825	T	Artery-vein autograft	0088	36.5617	$2,169.68	$655.22	$433.94
36830	T	Artery-vein graft	0088	36.5617	$2,169.68	$655.22	$433.94
36831	T	Open thrombect av fistula	0088	36.5617	$2,169.68	$655.22	$433.94
36832	T	Av fistula revision, open	0088	36.5617	$2,169.68	$655.22	$433.94
36833	T	Av fistula revision	0088	36.5617	$2,169.68	$655.22	$433.94
36834	T	Repair A-V aneurysm	0088	36.5617	$2,169.68	$655.22	$433.94
36835	T	Artery to vein shunt	0115	31.4727	$1,867.68	$459.35	$373.54
36838	T	Dist revas ligation, hemo	0088	36.5617	$2,169.68	$655.22	$433.94
36860	T	External cannula declotting	0676	2.4105	$143.05		$28.61
36861	T	Cannula declotting	0115	31.4727	$1,867.68	$459.35	$373.54
36870	T	Percut thrombect av fistula	0653	30.5339	$1,811.97		$362.39
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
37182	C	Insert hepatic shunt (tips)
37183	T	Remove hepatic shunt (tips)	0229	64.4545	$3,824.92	$771.23	$764.98
37195	T	Thrombolytic therapy, stroke	0676	2.4105	$143.05		$28.61
37200	T	Transcatheter biopsy	0685	6.0174	$357.09	$115.47	$71.42
37201	T	Transcatheter therapy infuse	0676	2.4105	$143.05		$28.61
37202	T	Transcatheter therapy infuse	0676	2.4105	$143.05		$28.61
37203	T	Transcatheter retrieval	0103	14.7142	$873.18	$223.63	$174.64
37204	T	Transcatheter occlusion	0115	31.4727	$1,867.68	$459.35	$373.54
37205	T	Transcatheter stent	0229	64.4545	$3,824.92	$771.23	$764.98
37206	T	Transcatheter stent add-on	0229	64.4545	$3,824.92	$771.23	$764.98
37207	T	Transcatheter stent	0229	64.4545	$3,824.92	$771.23	$764.98
37208	T	Transcatheter stent add-on	0229	64.4545	$3,824.92	$771.23	$764.98
37209	T	Exchange arterial catheter	0103	14.7142	$873.18	$223.63	$174.64
37215	C	Transcath stent, cca w/eps
37216	C	Transcath stent, cca w/o eps
37250	S	Iv us first vessel add-on	0416	19.5542	$1,160.40		$232.08
37251	S	Iv us each add vessel add-on	0416	19.5542	$1,160.40		$232.08
37500	T	Endoscopy ligate perf veins	0092	26.482	$1,571.52	$505.37	$314.30
37501	T	Vascular endoscopy procedure	0092	26.482	$1,571.52	$505.37	$314.30
37565	T	Ligation of neck vein	0093	23.4516	$1,391.69		$278.34
37600	T	Ligation of neck artery	0093	23.4516	$1,391.69		$278.34
37605	T	Ligation of neck artery	0091	28.9999	$1,720.94	$348.23	$344.19
37606	T	Ligation of neck artery	0091	28.9999	$1,720.94	$348.23	$344.19
37607	T	Ligation of a-v fistula	0092	26.482	$1,571.52	$505.37	$314.30
37609	T	Temporal artery procedure	0021	14.9776	$888.82	$219.48	$177.76
37615	T	Ligation of neck artery	0091	28.9999	$1,720.94	$348.23	$344.19
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	28.9999	$1,720.94	$348.23	$344.19
37650	T	Revision of major vein	0091	28.9999	$1,720.94	$348.23	$344.19
37660	C	Revision of major vein
37700	T	Revise leg vein	0091	28.9999	$1,720.94	$348.23	$344.19
37720	T	Removal of leg vein	0092	26.482	$1,571.52	$505.37	$314.30
37730	T	Removal of leg veins	0092	26.482	$1,571.52	$505.37	$314.30
37735	T	Removal of leg veins/lesion	0092	26.482	$1,571.52	$505.37	$314.30
37760	T	Revision of leg veins	0091	28.9999	$1,720.94	$348.23	$344.19
37765	T	Phleb veins - extrem - to 20	0091	28.9999	$1,720.94	$348.23	$344.19
37766	T	Phleb veins - extrem 20+	0091	28.9999	$1,720.94	$348.23	$344.19
37780	T	Revision of leg vein	0091	28.9999	$1,720.94	$348.23	$344.19
37785	T	Ligate/divide/excise vein	0091	28.9999	$1,720.94	$348.23	$344.19
37788	C	Revascularization, penis
37790	T	Penile venous occlusion	0181	30.8663	$1,831.70	$621.82	$366.34
37799	T	Vascular surgery procedure	0103	14.7142	$873.18	$223.63	$174.64
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	43.3389	$2,571.86	$1,001.89	$514.37
38129	T	Laparoscope proc, spleen	0130	31.9271	$1,894.65	$659.53	$378.93
38200	N	Injection for spleen x-ray
38204	E	Bl donor search management
38205	S	Harvest allogenic stem cells	0111	12.3956	$735.59	$200.18	$147.12
38206	S	Harvest auto stem cells	0111	12.3956	$735.59	$200.18	$147.12
38207	E	Cryopreserve stem cells
38208	E	Thaw preserved stem cells
38209	E	Wash harvest stem cells
38210	E	T-cell depletion of harvest
38211	E	Tumor cell deplete of harvst
38212	E	Rbc depletion of harvest
38213	E	Platelet deplete of harvest
38214	E	Volume deplete of harvest
38215	E	Harvest stem cell concentrte
38220	T	Bone marrow aspiration	0003	2.653	$157.44		$31.49
38221	T	Bone marrow biopsy	0003	2.653	$157.44		$31.49
38230	S	Bone marrow collection	0111	12.3956	$735.59	$200.18	$147.12
38240	S	Bone marrow/stem transplant	0123	22.9902	$1,364.31		$272.86
38241	S	Bone marrow/stem transplant	0123	22.9902	$1,364.31		$272.86
38242	S	Lymphocyte infuse transplant	0111	12.3956	$735.59	$200.18	$147.12
38300	T	Drainage, lymph node lesion	0007	11.4501	$679.48		$135.90
38305	T	Drainage, lymph node lesion	0008	16.4989	$979.09		$195.82
38308	T	Incision of lymph channels	0113	21.4653	$1,273.82		$254.76
38380	C	Thoracic duct procedure
38381	C	Thoracic duct procedure
38382	C	Thoracic duct procedure
38500	T	Biopsy/removal, lymph nodes	0113	21.4653	$1,273.82		$254.76
38505	T	Needle biopsy, lymph nodes	0005	3.5994	$213.60	$71.59	$42.72
38510	T	Biopsy/removal, lymph nodes	0113	21.4653	$1,273.82		$254.76
38520	T	Biopsy/removal, lymph nodes	0113	21.4653	$1,273.82		$254.76
38525	T	Biopsy/removal, lymph nodes	0113	21.4653	$1,273.82		$254.76
38530	T	Biopsy/removal, lymph nodes	0113	21.4653	$1,273.82		$254.76
38542	T	Explore deep node(s), neck	0114	40.7652	$2,419.13	$485.91	$483.83
38550	T	Removal, neck/armpit lesion	0113	21.4653	$1,273.82		$254.76
38555	T	Removal, neck/armpit lesion	0113	21.4653	$1,273.82		$254.76
38562	C	Removal, pelvic lymph nodes
38564	C	Removal, abdomen lymph nodes
38570	T	Laparoscopy, lymph node biop	0131	43.3389	$2,571.86	$1,001.89	$514.37
38571	T	Laparoscopy, lymphadenectomy	0132	62.9914	$3,738.10	$1,239.22	$747.62
38572	T	Laparoscopy, lymphadenectomy	0131	43.3389	$2,571.86	$1,001.89	$514.37
38589	T	Laparoscope proc, lymphatic	0130	31.9271	$1,894.65	$659.53	$378.93
38700	T	Removal of lymph nodes, neck	0113	21.4653	$1,273.82		$254.76
38720	T	Removal of lymph nodes, neck	0113	21.4653	$1,273.82		$254.76
38724	C	Removal of lymph nodes, neck
38740	T	Remove armpit lymph nodes	0114	40.7652	$2,419.13	$485.91	$483.83
38745	T	Remove armpit lymph nodes	0114	40.7652	$2,419.13	$485.91	$483.83
38746	C	Remove thoracic lymph nodes
38747	C	Remove abdominal lymph nodes
38760	T	Remove groin lymph nodes	0113	21.4653	$1,273.82		$254.76
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	S	Blood/lymph system procedure	0110	3.6594	$217.16		$43.43
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	0069	30.6775	$1,820.49	$591.64	$364.10
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
4000F	E	Tobacco use txmnt counseling
4001F	E	Tobacco use txmnt, pharmacol
4002F	E	Statin therapy, rx
4006F	E	Beta-blocker therapy, rx
4009F	E	Ace inhibitor therapy, rx
4011F	E	Oral antiplatelet tx, rx
40490	T	Biopsy of lip	0251	2.0101	$119.29		$23.86
40500	T	Partial excision of lip	0253	16.1357	$957.54	$282.29	$191.51
40510	T	Partial excision of lip	0254	23.404	$1,388.86	$321.35	$277.77
40520	T	Partial excision of lip	0253	16.1357	$957.54	$282.29	$191.51
40525	T	Reconstruct lip with flap	0254	23.404	$1,388.86	$321.35	$277.77
40527	T	Reconstruct lip with flap	0254	23.404	$1,388.86	$321.35	$277.77
40530	T	Partial removal of lip	0254	23.404	$1,388.86	$321.35	$277.77
40650	T	Repair lip	0252	7.8673	$466.87	$113.41	$93.37
40652	T	Repair lip	0252	7.8673	$466.87	$113.41	$93.37
40654	T	Repair lip	0252	7.8673	$466.87	$113.41	$93.37
40700	T	Repair cleft lip/nasal	0256	37.3204	$2,214.70		$442.94
40701	T	Repair cleft lip/nasal	0256	37.3204	$2,214.70		$442.94
40702	T	Repair cleft lip/nasal	0256	37.3204	$2,214.70		$442.94
40720	T	Repair cleft lip/nasal	0256	37.3204	$2,214.70		$442.94
40761	T	Repair cleft lip/nasal	0256	37.3204	$2,214.70		$442.94
40799	T	Lip surgery procedure	0251	2.0101	$119.29		$23.86
40800	T	Drainage of mouth lesion	0251	2.0101	$119.29		$23.86
40801	T	Drainage of mouth lesion	0252	7.8673	$466.87	$113.41	$93.37
40804	X	Removal, foreign body, mouth	0340	0.6384	$37.88		$7.58
40805	T	Removal, foreign body, mouth	0252	7.8673	$466.87	$113.41	$93.37
40806	T	Incision of lip fold	0251	2.0101	$119.29		$23.86
40808	T	Biopsy of mouth lesion	0251	2.0101	$119.29		$23.86
40810	T	Excision of mouth lesion	0253	16.1357	$957.54	$282.29	$191.51
40812	T	Excise/repair mouth lesion	0253	16.1357	$957.54	$282.29	$191.51
40814	T	Excise/repair mouth lesion	0253	16.1357	$957.54	$282.29	$191.51
40816	T	Excision of mouth lesion	0254	23.404	$1,388.86	$321.35	$277.77
40818	T	Excise oral mucosa for graft	0251	2.0101	$119.29		$23.86
40819	T	Excise lip or cheek fold	0252	7.8673	$466.87	$113.41	$93.37
40820	T	Treatment of mouth lesion	0253	16.1357	$957.54	$282.29	$191.51
40830	T	Repair mouth laceration	0251	2.0101	$119.29		$23.86
40831	T	Repair mouth laceration	0252	7.8673	$466.87	$113.41	$93.37
40840	T	Reconstruction of mouth	0254	23.404	$1,388.86	$321.35	$277.77
40842	T	Reconstruction of mouth	0254	23.404	$1,388.86	$321.35	$277.77
40843	T	Reconstruction of mouth	0254	23.404	$1,388.86	$321.35	$277.77
40844	T	Reconstruction of mouth	0256	37.3204	$2,214.70		$442.94
40845	T	Reconstruction of mouth	0256	37.3204	$2,214.70		$442.94
40899	T	Mouth surgery procedure	0251	2.0101	$119.29		$23.86
41000	T	Drainage of mouth lesion	0253	16.1357	$957.54	$282.29	$191.51
41005	T	Drainage of mouth lesion	0251	2.0101	$119.29		$23.86
41006	T	Drainage of mouth lesion	0254	23.404	$1,388.86	$321.35	$277.77
41007	T	Drainage of mouth lesion	0253	16.1357	$957.54	$282.29	$191.51
41008	T	Drainage of mouth lesion	0253	16.1357	$957.54	$282.29	$191.51
41009	T	Drainage of mouth lesion	0251	2.0101	$119.29		$23.86
41010	T	Incision of tongue fold	0252	7.8673	$466.87	$113.41	$93.37
41015	T	Drainage of mouth lesion	0251	2.0101	$119.29		$23.86
41016	T	Drainage of mouth lesion	0252	7.8673	$466.87	$113.41	$93.37
41017	T	Drainage of mouth lesion	0252	7.8673	$466.87	$113.41	$93.37
41018	T	Drainage of mouth lesion	0252	7.8673	$466.87	$113.41	$93.37
41100	T	Biopsy of tongue	0252	7.8673	$466.87	$113.41	$93.37
41105	T	Biopsy of tongue	0253	16.1357	$957.54	$282.29	$191.51
41108	T	Biopsy of floor of mouth	0252	7.8673	$466.87	$113.41	$93.37
41110	T	Excision of tongue lesion	0253	16.1357	$957.54	$282.29	$191.51
41112	T	Excision of tongue lesion	0253	16.1357	$957.54	$282.29	$191.51
41113	T	Excision of tongue lesion	0253	16.1357	$957.54	$282.29	$191.51
41114	T	Excision of tongue lesion	0254	23.404	$1,388.86	$321.35	$277.77
41115	T	Excision of tongue fold	0252	7.8673	$466.87	$113.41	$93.37
41116	T	Excision of mouth lesion	0253	16.1357	$957.54	$282.29	$191.51
41120	T	Partial removal of tongue	0254	23.404	$1,388.86	$321.35	$277.77
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	2.0101	$119.29		$23.86
41251	T	Repair tongue laceration	0251	2.0101	$119.29		$23.86
41252	T	Repair tongue laceration	0252	7.8673	$466.87	$113.41	$93.37
41500	T	Fixation of tongue	0254	23.404	$1,388.86	$321.35	$277.77
41510	T	Tongue to lip surgery	0253	16.1357	$957.54	$282.29	$191.51
41520	T	Reconstruction, tongue fold	0252	7.8673	$466.87	$113.41	$93.37
41599	T	Tongue and mouth surgery	0251	2.0101	$119.29		$23.86
41800	T	Drainage of gum lesion	0251	2.0101	$119.29		$23.86
41805	T	Removal foreign body, gum	0254	23.404	$1,388.86	$321.35	$277.77
41806	T	Removal foreign body,jawbone	0253	16.1357	$957.54	$282.29	$191.51
41820	T	Excision, gum, each quadrant	0252	7.8673	$466.87	$113.41	$93.37
41821	T	Excision of gum flap	0252	7.8673	$466.87	$113.41	$93.37
41822	T	Excision of gum lesion	0253	16.1357	$957.54	$282.29	$191.51
41823	T	Excision of gum lesion	0254	23.404	$1,388.86	$321.35	$277.77
41825	T	Excision of gum lesion	0253	16.1357	$957.54	$282.29	$191.51
41826	T	Excision of gum lesion	0253	16.1357	$957.54	$282.29	$191.51
41827	T	Excision of gum lesion	0254	23.404	$1,388.86	$321.35	$277.77
41828	T	Excision of gum lesion	0253	16.1357	$957.54	$282.29	$191.51
41830	T	Removal of gum tissue	0253	16.1357	$957.54	$282.29	$191.51
41850	T	Treatment of gum lesion	0253	16.1357	$957.54	$282.29	$191.51
41870	T	Gum graft	0254	23.404	$1,388.86	$321.35	$277.77
41872	T	Repair gum	0253	16.1357	$957.54	$282.29	$191.51
41874	T	Repair tooth socket	0254	23.404	$1,388.86	$321.35	$277.77
41899	T	Dental surgery procedure	0251	2.0101	$119.29		$23.86
42000	T	Drainage mouth roof lesion	0251	2.0101	$119.29		$23.86
42100	T	Biopsy roof of mouth	0252	7.8673	$466.87	$113.41	$93.37
42104	T	Excision lesion, mouth roof	0253	16.1357	$957.54	$282.29	$191.51
42106	T	Excision lesion, mouth roof	0253	16.1357	$957.54	$282.29	$191.51
42107	T	Excision lesion, mouth roof	0254	23.404	$1,388.86	$321.35	$277.77
42120	T	Remove palate/lesion	0256	37.3204	$2,214.70		$442.94
42140	T	Excision of uvula	0252	7.8673	$466.87	$113.41	$93.37
42145	T	Repair palate, pharynx/uvula	0254	23.404	$1,388.86	$321.35	$277.77
42160	T	Treatment mouth roof lesion	0253	16.1357	$957.54	$282.29	$191.51
42180	T	Repair palate	0251	2.0101	$119.29		$23.86
42182	T	Repair palate	0256	37.3204	$2,214.70		$442.94
42200	T	Reconstruct cleft palate	0256	37.3204	$2,214.70		$442.94
42205	T	Reconstruct cleft palate	0256	37.3204	$2,214.70		$442.94
42210	T	Reconstruct cleft palate	0256	37.3204	$2,214.70		$442.94
42215	T	Reconstruct cleft palate	0256	37.3204	$2,214.70		$442.94
42220	T	Reconstruct cleft palate	0256	37.3204	$2,214.70		$442.94
42225	T	Reconstruct cleft palate	0256	37.3204	$2,214.70		$442.94
42226	T	Lengthening of palate	0256	37.3204	$2,214.70		$442.94
42227	T	Lengthening of palate	0256	37.3204	$2,214.70		$442.94
42235	T	Repair palate	0253	16.1357	$957.54	$282.29	$191.51
42260	T	Repair nose to lip fistula	0254	23.404	$1,388.86	$321.35	$277.77
42280	T	Preparation, palate mold	0251	2.0101	$119.29		$23.86
42281	T	Insertion, palate prosthesis	0253	16.1357	$957.54	$282.29	$191.51
42299	T	Palate/uvula surgery	0251	2.0101	$119.29		$23.86
42300	T	Drainage of salivary gland	0253	16.1357	$957.54	$282.29	$191.51
42305	T	Drainage of salivary gland	0253	16.1357	$957.54	$282.29	$191.51
42310	T	Drainage of salivary gland	0251	2.0101	$119.29		$23.86
42320	T	Drainage of salivary gland	0251	2.0101	$119.29		$23.86
42325	T	Create salivary cyst drain	0251	2.0101	$119.29		$23.86
42326	T	Create salivary cyst drain	0252	7.8673	$466.87	$113.41	$93.37
42330	T	Removal of salivary stone	0253	16.1357	$957.54	$282.29	$191.51
42335	T	Removal of salivary stone	0253	16.1357	$957.54	$282.29	$191.51
42340	T	Removal of salivary stone	0253	16.1357	$957.54	$282.29	$191.51
42400	T	Biopsy of salivary gland	0005	3.5994	$213.60	$71.59	$42.72
42405	T	Biopsy of salivary gland	0253	16.1357	$957.54	$282.29	$191.51
42408	T	Excision of salivary cyst	0253	16.1357	$957.54	$282.29	$191.51
42409	T	Drainage of salivary cyst	0253	16.1357	$957.54	$282.29	$191.51
42410	T	Excise parotid gland/lesion	0256	37.3204	$2,214.70		$442.94
42415	T	Excise parotid gland/lesion	0256	37.3204	$2,214.70		$442.94
42420	T	Excise parotid gland/lesion	0256	37.3204	$2,214.70		$442.94
42425	T	Excise parotid gland/lesion	0256	37.3204	$2,214.70		$442.94
42426	C	Excise parotid gland/lesion
42440	T	Excise submaxillary gland	0256	37.3204	$2,214.70		$442.94
42450	T	Excise sublingual gland	0254	23.404	$1,388.86	$321.35	$277.77
42500	T	Repair salivary duct	0254	23.404	$1,388.86	$321.35	$277.77
42505	T	Repair salivary duct	0256	37.3204	$2,214.70		$442.94
42507	T	Parotid duct diversion	0256	37.3204	$2,214.70		$442.94
42508	T	Parotid duct diversion	0256	37.3204	$2,214.70		$442.94
42509	T	Parotid duct diversion	0256	37.3204	$2,214.70		$442.94
42510	T	Parotid duct diversion	0256	37.3204	$2,214.70		$442.94
42550	N	Injection for salivary x-ray
42600	T	Closure of salivary fistula	0253	16.1357	$957.54	$282.29	$191.51
42650	T	Dilation of salivary duct	0252	7.8673	$466.87	$113.41	$93.37
42660	T	Dilation of salivary duct	0251	2.0101	$119.29		$23.86
42665	T	Ligation of salivary duct	0254	23.404	$1,388.86	$321.35	$277.77
42699	T	Salivary surgery procedure	0251	2.0101	$119.29		$23.86
42700	T	Drainage of tonsil abscess	0251	2.0101	$119.29		$23.86
42720	T	Drainage of throat abscess	0253	16.1357	$957.54	$282.29	$191.51
42725	T	Drainage of throat abscess	0256	37.3204	$2,214.70		$442.94
42800	T	Biopsy of throat	0253	16.1357	$957.54	$282.29	$191.51
42802	T	Biopsy of throat	0253	16.1357	$957.54	$282.29	$191.51
42804	T	Biopsy of upper nose/throat	0253	16.1357	$957.54	$282.29	$191.51
42806	T	Biopsy of upper nose/throat	0254	23.404	$1,388.86	$321.35	$277.77
42808	T	Excise pharynx lesion	0253	16.1357	$957.54	$282.29	$191.51
42809	X	Remove pharynx foreign body	0340	0.6384	$37.88		$7.58
42810	T	Excision of neck cyst	0254	23.404	$1,388.86	$321.35	$277.77
42815	T	Excision of neck cyst	0256	37.3204	$2,214.70		$442.94
42820	T	Remove tonsils and adenoids	0258	22.2466	$1,320.18	$437.25	$264.04
42821	T	Remove tonsils and adenoids	0258	22.2466	$1,320.18	$437.25	$264.04
42825	T	Removal of tonsils	0258	22.2466	$1,320.18	$437.25	$264.04
42826	T	Removal of tonsils	0258	22.2466	$1,320.18	$437.25	$264.04
42830	T	Removal of adenoids	0258	22.2466	$1,320.18	$437.25	$264.04
42831	T	Removal of adenoids	0258	22.2466	$1,320.18	$437.25	$264.04
42835	T	Removal of adenoids	0258	22.2466	$1,320.18	$437.25	$264.04
42836	T	Removal of adenoids	0258	22.2466	$1,320.18	$437.25	$264.04
42842	T	Extensive surgery of throat	0254	23.404	$1,388.86	$321.35	$277.77
42844	T	Extensive surgery of throat	0256	37.3204	$2,214.70		$442.94
42845	C	Extensive surgery of throat
42860	T	Excision of tonsil tags	0258	22.2466	$1,320.18	$437.25	$264.04
42870	T	Excision of lingual tonsil	0258	22.2466	$1,320.18	$437.25	$264.04
42890	T	Partial removal of pharynx	0256	37.3204	$2,214.70		$442.94
42892	T	Revision of pharyngeal walls	0256	37.3204	$2,214.70		$442.94
42894	C	Revision of pharyngeal walls
42900	T	Repair throat wound	0252	7.8673	$466.87	$113.41	$93.37
42950	T	Reconstruction of throat	0254	23.404	$1,388.86	$321.35	$277.77
42953	C	Repair throat, esophagus
42955	T	Surgical opening of throat	0254	23.404	$1,388.86	$321.35	$277.77
42960	T	Control throat bleeding	0250	1.2896	$76.53	$26.79	$15.31
42961	C	Control throat bleeding
42962	T	Control throat bleeding	0256	37.3204	$2,214.70		$442.94
42970	T	Control nose/throat bleeding	0250	1.2896	$76.53	$26.79	$15.31
42971	C	Control nose/throat bleeding
42972	T	Control nose/throat bleeding	0253	16.1357	$957.54	$282.29	$191.51
42999	T	Throat surgery procedure	0251	2.0101	$119.29		$23.86
43020	T	Incision of esophagus	0252	7.8673	$466.87	$113.41	$93.37
43030	T	Throat muscle surgery	0253	16.1357	$957.54	$282.29	$191.51
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	Partial removal of esophagus
43123	C	Partial removal of esophagus
43124	C	Removal of esophagus
43130	T	Removal of esophagus pouch	0254	23.404	$1,388.86	$321.35	$277.77
43135	C	Removal of esophagus pouch
43200	T	Esophagus endoscopy	0141	8.1835	$485.63	$143.38	$97.13
43201	T	Esoph scope w/submucous inj	0141	8.1835	$485.63	$143.38	$97.13
43202	T	Esophagus endoscopy, biopsy	0141	8.1835	$485.63	$143.38	$97.13
43204	T	Esoph scope w/sclerosis inj	0141	8.1835	$485.63	$143.38	$97.13
43205	T	Esophagus endoscopy/ligation	0141	8.1835	$485.63	$143.38	$97.13
43215	T	Esophagus endoscopy	0141	8.1835	$485.63	$143.38	$97.13
43216	T	Esophagus endoscopy/lesion	0141	8.1835	$485.63	$143.38	$97.13
43217	T	Esophagus endoscopy	0141	8.1835	$485.63	$143.38	$97.13
43219	T	Esophagus endoscopy	0384	22.3392	$1,325.68	$287.93	$265.14
43220	T	Esoph endoscopy, dilation	0141	8.1835	$485.63	$143.38	$97.13
43226	T	Esoph endoscopy, dilation	0141	8.1835	$485.63	$143.38	$97.13
43227	T	Esoph endoscopy, repair	0141	8.1835	$485.63	$143.38	$97.13
43228	T	Esoph endoscopy, ablation	0422	22.9647	$1,362.79	$448.81	$272.56
43231	T	Esoph endoscopy w/us exam	0141	8.1835	$485.63	$143.38	$97.13
43232	T	Esoph endoscopy w/us fn bx	0141	8.1835	$485.63	$143.38	$97.13
43234	T	Upper GI endoscopy, exam	0141	8.1835	$485.63	$143.38	$97.13
43235	T	Uppr gi endoscopy, diagnosis	0141	8.1835	$485.63	$143.38	$97.13
43236	T	Uppr gi scope w/submuc inj	0141	8.1835	$485.63	$143.38	$97.13
43237	T	Endoscopic us exam, esoph	0141	8.1835	$485.63	$143.38	$97.13
43238	T	Uppr gi endoscopy w/us fn bx	0141	8.1835	$485.63	$143.38	$97.13
43239	T	Upper GI endoscopy, biopsy	0141	8.1835	$485.63	$143.38	$97.13
43240	T	Esoph endoscope w/drain cyst	0141	8.1835	$485.63	$143.38	$97.13
43241	T	Upper GI endoscopy with tube	0141	8.1835	$485.63	$143.38	$97.13
43242	T	Uppr gi endoscopy w/us fn bx	0141	8.1835	$485.63	$143.38	$97.13
43243	T	Upper gi endoscopy inject	0141	8.1835	$485.63	$143.38	$97.13
43244	T	Upper GI endoscopy/ligation	0141	8.1835	$485.63	$143.38	$97.13
43245	T	Uppr gi scope dilate strictr	0141	8.1835	$485.63	$143.38	$97.13
43246	T	Place gastrostomy tube	0141	8.1835	$485.63	$143.38	$97.13
43247	T	Operative upper GI endoscopy	0141	8.1835	$485.63	$143.38	$97.13
43248	T	Uppr gi endoscopy/guide wire	0141	8.1835	$485.63	$143.38	$97.13
43249	T	Esoph endoscopy, dilation	0141	8.1835	$485.63	$143.38	$97.13
43250	T	Upper GI endoscopy/tumor	0141	8.1835	$485.63	$143.38	$97.13
43251	T	Operative upper GI endoscopy	0141	8.1835	$485.63	$143.38	$97.13
43255	T	Operative upper GI endoscopy	0141	8.1835	$485.63	$143.38	$97.13
43256	T	Uppr gi endoscopy w stent	0384	22.3392	$1,325.68	$287.93	$265.14
43257	T	Uppr gi scope w/thrml txmnt	0422	22.9647	$1,362.79	$448.81	$272.56
43258	T	Operative upper GI endoscopy	0141	8.1835	$485.63	$143.38	$97.13
43259	T	Endoscopic ultrasound exam	0141	8.1835	$485.63	$143.38	$97.13
43260	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43261	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43262	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43263	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43264	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43265	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43267	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43268	T	Endo cholangiopancreatograph	0384	22.3392	$1,325.68	$287.93	$265.14
43269	T	Endo cholangiopancreatograph	0384	22.3392	$1,325.68	$287.93	$265.14
43271	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43272	T	Endo cholangiopancreatograph	0151	18.7338	$1,111.72	$245.46	$222.34
43280	T	Laparoscopy, fundoplasty	0132	62.9914	$3,738.10	$1,239.22	$747.62
43289	T	Laparoscope proc, esoph	0130	31.9271	$1,894.65	$659.53	$378.93
43300	C	Repair of esophagus
43305	C	Repair esophagus and fistula
43310	C	Repair of esophagus
43312	C	Repair esophagus and fistula
43313	C	Esophagoplasty congenital
43314	C	Tracheo-esophagoplasty cong
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
43450	T	Dilate esophagus	0140	5.4737	$324.83	$94.18	$64.97
43453	T	Dilate esophagus	0140	5.4737	$324.83	$94.18	$64.97
43456	T	Dilate esophagus	0140	5.4737	$324.83	$94.18	$64.97
43458	T	Dilate esophagus	0140	5.4737	$324.83	$94.18	$64.97
43460	C	Pressure treatment esophagus
43496	C	Free jejunum flap, microvasc
43499	T	Esophagus surgery procedure	0141	8.1835	$485.63	$143.38	$97.13
43500	C	Surgical opening of stomach
43501	C	Surgical repair of stomach
43502	C	Surgical repair of stomach
43510	T	Surgical opening of stomach	0141	8.1835	$485.63	$143.38	$97.13
43520	C	Incision of pyloric muscle
43600	T	Biopsy of stomach	0141	8.1835	$485.63	$143.38	$97.13
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
43644	C	Lap gastric bypass/roux-en-y
43645	C	Lap gastr bypass incl smll i
43651	T	Laparoscopy, vagus nerve	0132	62.9914	$3,738.10	$1,239.22	$747.62
43652	T	Laparoscopy, vagus nerve	0132	62.9914	$3,738.10	$1,239.22	$747.62
43653	T	Laparoscopy, gastrostomy	0131	43.3389	$2,571.86	$1,001.89	$514.37
43659	T	Laparoscope proc, stom	0130	31.9271	$1,894.65	$659.53	$378.93
43750	T	Place gastrostomy tube	0141	8.1835	$485.63	$143.38	$97.13
43752	X	Nasal/orogastric w/stent	0272	1.3801	$81.90	$32.76	$16.38
43760	T	Change gastrostomy tube	0121	2.2766	$135.10	$43.80	$27.02
43761	T	Reposition gastrostomy tube	0122	6.9721	$413.75	$84.85	$82.75
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	0422	22.9647	$1,362.79	$448.81	$272.56
43831	T	Place gastrostomy tube	0141	8.1835	$485.63	$143.38	$97.13
43832	C	Place gastrostomy tube
43840	C	Repair of stomach lesion
43842	C	Gastroplasty for obesity
43843	C	Gastroplasty for obesity
43845	C	Gastroplasty duodenal switch
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	0141	8.1835	$485.63	$143.38	$97.13
43880	C	Repair stomach-bowel fistula
43999	T	Stomach surgery procedure	0141	8.1835	$485.63	$143.38	$97.13
44005	C	Freeing of bowel adhesion
44010	C	Incision of small bowel
44015	C	Insert needle cath bowel
44020	C	Explore small intestine
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	8.1835	$485.63	$143.38	$97.13
44110	C	Excise intestine 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
44126	C	Enterectomy w/o taper, cong
44127	C	Enterectomy w/taper, cong
44128	C	Enterectomy cong, add-on
44130	C	Bowel to bowel fusion
44132	C	Enterectomy, cadaver donor
44133	C	Enterectomy, live donor
44135	C	Intestine transplnt, cadaver
44136	C	Intestine transplant, live
44137	C	Remove intestinal allograft
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	43.3389	$2,571.86	$1,001.89	$514.37
44201	T	Laparoscopy, jejunostomy	0131	43.3389	$2,571.86	$1,001.89	$514.37
44202	C	Lap resect s/intestine singl
44203	C	Lap resect s/intestine, addl
44204	C	Laparo partial colectomy
44205	C	Lap colectomy part w/ileum
44206	T	Lap part colectomy w/stoma	0132	62.9914	$3,738.10	$1,239.22	$747.62
44207	T	L colectomy/coloproctostomy	0132	62.9914	$3,738.10	$1,239.22	$747.62
44208	T	L colectomy/coloproctostomy	0132	62.9914	$3,738.10	$1,239.22	$747.62
44210	C	Laparo total proctocolectomy
44211	C	Laparo total proctocolectomy
44212	C	Laparo total proctocolectomy
44238	T	Laparoscope proc, intestine	0130	31.9271	$1,894.65	$659.53	$378.93
44239	T	Laparoscope proc, rectum	0130	31.9271	$1,894.65	$659.53	$378.93
44300	C	Open bowel to skin
44310	C	Ileostomy/jejunostomy
44312	T	Revision of ileostomy	0027	18.4182	$1,092.99	$329.72	$218.60
44314	C	Revision of ileostomy
44316	C	Devise bowel pouch
44320	C	Colostomy
44322	C	Colostomy with biopsies
44340	T	Revision of colostomy	0027	18.4182	$1,092.99	$329.72	$218.60
44345	C	Revision of colostomy
44346	C	Revision of colostomy
44360	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44361	T	Small bowel endoscopy/biopsy	0142	9.3487	$554.78	$152.78	$110.96
44363	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44364	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44365	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44366	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44369	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44370	T	Small bowel endoscopy/stent	0384	22.3392	$1,325.68	$287.93	$265.14
44372	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44373	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44376	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44377	T	Small bowel endoscopy/biopsy	0142	9.3487	$554.78	$152.78	$110.96
44378	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44379	T	S bowel endoscope w/stent	0384	22.3392	$1,325.68	$287.93	$265.14
44380	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44382	T	Small bowel endoscopy	0142	9.3487	$554.78	$152.78	$110.96
44383	T	Ileoscopy w/stent	0384	22.3392	$1,325.68	$287.93	$265.14
44385	T	Endoscopy of bowel pouch	0143	8.6869	$515.51	$186.06	$103.10
44386	T	Endoscopy, bowel pouch/biop	0143	8.6869	$515.51	$186.06	$103.10
44388	T	Colonoscopy	0143	8.6869	$515.51	$186.06	$103.10
44389	T	Colonoscopy with biopsy	0143	8.6869	$515.51	$186.06	$103.10
44390	T	Colonoscopy for foreign body	0143	8.6869	$515.51	$186.06	$103.10
44391	T	Colonoscopy for bleeding	0143	8.6869	$515.51	$186.06	$103.10
44392	T	Colonoscopy polypectomy	0143	8.6869	$515.51	$186.06	$103.10
44393	T	Colonoscopy, lesion removal	0143	8.6869	$515.51	$186.06	$103.10
44394	T	Colonoscopy w/snare	0143	8.6869	$515.51	$186.06	$103.10
44397	T	Colonoscopy w/stent	0384	22.3392	$1,325.68	$287.93	$265.14
44500	T	Intro, gastrointestinal tube	0121	2.2766	$135.10	$43.80	$27.02
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
44701	N	Intraop colon lavage add-on
44715	C	Prepare donor intestine
44720	C	Prep donor intestine/venous
44721	C	Prep donor intestine/artery
44799	T	Unlisted procedure intestine	0142	9.3487	$554.78	$152.78	$110.96
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	T	Drain app abscess, percut	0037	9.4751	$562.28	$224.91	$112.46
44950	C	Appendectomy
44955	C	Appendectomy add-on
44960	C	Appendectomy
44970	T	Laparoscopy, appendectomy	0131	43.3389	$2,571.86	$1,001.89	$514.37
44979	T	Laparoscope proc, app	0130	31.9271	$1,894.65	$659.53	$378.93
45000	T	Drainage of pelvic abscess	0148	3.7383	$221.84	$57.21	$44.37
45005	T	Drainage of rectal abscess	0155	16.2546	$964.60		$192.92
45020	T	Drainage of rectal abscess	0155	16.2546	$964.60		$192.92
45100	T	Biopsy of rectum	0149	18.0726	$1,072.48	$293.06	$214.50
45108	T	Removal of anorectal lesion	0150	23.8654	$1,416.24	$437.12	$283.25
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
45136	C	Excise ileoanal reservior
45150	T	Excision of rectal stricture	0149	18.0726	$1,072.48	$293.06	$214.50
45160	T	Excision of rectal lesion	0150	23.8654	$1,416.24	$437.12	$283.25
45170	T	Excision of rectal lesion	0150	23.8654	$1,416.24	$437.12	$283.25
45190	T	Destruction, rectal tumor	0150	23.8654	$1,416.24	$437.12	$283.25
45300	T	Proctosigmoidoscopy dx	0146	4.6374	$275.20	$64.40	$55.04
45303	T	Proctosigmoidoscopy dilate	0147	7.9679	$472.84		$94.57
45305	T	Proctosigmoidoscopy w/bx	0147	7.9679	$472.84		$94.57
45307	T	Proctosigmoidoscopy fb	0428	19.9022	$1,181.06		$236.21
45308	T	Proctosigmoidoscopy removal	0147	7.9679	$472.84		$94.57
45309	T	Proctosigmoidoscopy removal	0147	7.9679	$472.84		$94.57
45315	T	Proctosigmoidoscopy removal	0147	7.9679	$472.84		$94.57
45317	T	Proctosigmoidoscopy bleed	0147	7.9679	$472.84		$94.57
45320	T	Proctosigmoidoscopy ablate	0428	19.9022	$1,181.06		$236.21
45321	T	Proctosigmoidoscopy volvul	0428	19.9022	$1,181.06		$236.21
45327	T	Proctosigmoidoscopy w/stent	0384	22.3392	$1,325.68	$287.93	$265.14
45330	T	Diagnostic sigmoidoscopy	0146	4.6374	$275.20	$64.40	$55.04
45331	T	Sigmoidoscopy and biopsy	0146	4.6374	$275.20	$64.40	$55.04
45332	T	Sigmoidoscopy w/fb removal	0146	4.6374	$275.20	$64.40	$55.04
45333	T	Sigmoidoscopy polypectomy	0147	7.9679	$472.84		$94.57
45334	T	Sigmoidoscopy for bleeding	0147	7.9679	$472.84		$94.57
45335	T	Sigmoidoscopy w/submuc inj	0146	4.6374	$275.20	$64.40	$55.04
45337	T	Sigmoidoscopy decompress	0146	4.6374	$275.20	$64.40	$55.04
45338	T	Sigmoidoscopy w/tumr remove	0147	7.9679	$472.84		$94.57
45339	T	Sigmoidoscopy w/ablate tumr	0147	7.9679	$472.84		$94.57
45340	T	Sig w/balloon dilation	0147	7.9679	$472.84		$94.57
45341	T	Sigmoidoscopy w/ultrasound	0147	7.9679	$472.84		$94.57
45342	T	Sigmoidoscopy w/us guide bx	0147	7.9679	$472.84		$94.57
45345	T	Sigmoidoscopy w/stent	0384	22.3392	$1,325.68	$287.93	$265.14
45355	T	Surgical colonoscopy	0143	8.6869	$515.51	$186.06	$103.10
45378	T	Diagnostic colonoscopy	0143	8.6869	$515.51	$186.06	$103.10
45379	T	Colonoscopy w/fb removal	0143	8.6869	$515.51	$186.06	$103.10
45380	T	Colonoscopy and biopsy	0143	8.6869	$515.51	$186.06	$103.10
45381	T	Colonoscopy, submucous inj	0143	8.6869	$515.51	$186.06	$103.10
45382	T	Colonoscopy/control bleeding	0143	8.6869	$515.51	$186.06	$103.10
45383	T	Lesion removal colonoscopy	0143	8.6869	$515.51	$186.06	$103.10
45384	T	Lesion remove colonoscopy	0143	8.6869	$515.51	$186.06	$103.10
45385	T	Lesion removal colonoscopy	0143	8.6869	$515.51	$186.06	$103.10
45386	T	Colonoscopy dilate stricture	0143	8.6869	$515.51	$186.06	$103.10
45387	T	Colonoscopy w/stent	0384	22.3392	$1,325.68	$287.93	$265.14
45391	T	Colonoscopy w/endoscope us	0143	8.6869	$515.51	$186.06	$103.10
45392	T	Colonoscopy w/endoscopic fnb	0143	8.6869	$515.51	$186.06	$103.10
45500	T	Repair of rectum	0149	18.0726	$1,072.48	$293.06	$214.50
45505	T	Repair of rectum	0150	23.8654	$1,416.24	$437.12	$283.25
45520	T	Treatment of rectal prolapse	0098	1.1346	$67.33		$13.47
45540	C	Correct rectal prolapse
45541	T	Correct rectal prolapse	0150	23.8654	$1,416.24	$437.12	$283.25
45550	C	Repair rectum/remove sigmoid
45560	T	Repair of rectocele	0150	23.8654	$1,416.24	$437.12	$283.25
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	3.7383	$221.84	$57.21	$44.37
45905	T	Dilation of anal sphincter	0149	18.0726	$1,072.48	$293.06	$214.50
45910	T	Dilation of rectal narrowing	0149	18.0726	$1,072.48	$293.06	$214.50
45915	T	Remove rectal obstruction	0148	3.7383	$221.84	$57.21	$44.37
45999	T	Rectum surgery procedure	0148	3.7383	$221.84	$57.21	$44.37
46020	T	Placement of seton	0150	23.8654	$1,416.24	$437.12	$283.25
46030	T	Removal of rectal marker	0148	3.7383	$221.84	$57.21	$44.37
46040	T	Incision of rectal abscess	0149	18.0726	$1,072.48	$293.06	$214.50
46045	T	Incision of rectal abscess	0150	23.8654	$1,416.24	$437.12	$283.25
46050	T	Incision of anal abscess	0148	3.7383	$221.84	$57.21	$44.37
46060	T	Incision of rectal abscess	0150	23.8654	$1,416.24	$437.12	$283.25
46070	T	Incision of anal septum	0155	16.2546	$964.60		$192.92
46080	T	Incision of anal sphincter	0149	18.0726	$1,072.48	$293.06	$214.50
46083	T	Incise external hemorrhoid	0148	3.7383	$221.84	$57.21	$44.37
46200	T	Removal of anal fissure	0150	23.8654	$1,416.24	$437.12	$283.25
46210	T	Removal of anal crypt	0149	18.0726	$1,072.48	$293.06	$214.50
46211	T	Removal of anal crypts	0150	23.8654	$1,416.24	$437.12	$283.25
46220	T	Removal of anal tag	0149	18.0726	$1,072.48	$293.06	$214.50
46221	T	Ligation of hemorrhoid(s)	0148	3.7383	$221.84	$57.21	$44.37
46230	T	Removal of anal tags	0149	18.0726	$1,072.48	$293.06	$214.50
46250	T	Hemorrhoidectomy	0150	23.8654	$1,416.24	$437.12	$283.25
46255	T	Hemorrhoidectomy	0150	23.8654	$1,416.24	$437.12	$283.25
46257	T	Remove hemorrhoids fissure	0150	23.8654	$1,416.24	$437.12	$283.25
46258	T	Remove hemorrhoids fistula	0150	23.8654	$1,416.24	$437.12	$283.25
46260	T	Hemorrhoidectomy	0150	23.8654	$1,416.24	$437.12	$283.25
46261	T	Remove hemorrhoids fissure	0150	23.8654	$1,416.24	$437.12	$283.25
46262	T	Remove hemorrhoids fistula	0150	23.8654	$1,416.24	$437.12	$283.25
46270	T	Removal of anal fistula	0150	23.8654	$1,416.24	$437.12	$283.25
46275	T	Removal of anal fistula	0150	23.8654	$1,416.24	$437.12	$283.25
46280	T	Removal of anal fistula	0150	23.8654	$1,416.24	$437.12	$283.25
46285	T	Removal of anal fistula	0150	23.8654	$1,416.24	$437.12	$283.25
46288	T	Repair anal fistula	0150	23.8654	$1,416.24	$437.12	$283.25
46320	T	Removal of hemorrhoid clot	0148	3.7383	$221.84	$57.21	$44.37
46500	T	Injection into hemorrhoid(s)	0155	16.2546	$964.60		$192.92
46600	X	Diagnostic anoscopy	0340	0.6384	$37.88		$7.58
46604	T	Anoscopy and dilation	0147	7.9679	$472.84		$94.57
46606	T	Anoscopy and biopsy	0146	4.6374	$275.20	$64.40	$55.04
46608	T	Anoscopy, remove for body	0147	7.9679	$472.84		$94.57
46610	T	Anoscopy, remove lesion	0428	19.9022	$1,181.06		$236.21
46611	T	Anoscopy	0147	7.9679	$472.84		$94.57
46612	T	Anoscopy, remove lesions	0428	19.9022	$1,181.06		$236.21
46614	T	Anoscopy, control bleeding	0146	4.6374	$275.20	$64.40	$55.04
46615	T	Anoscopy	0428	19.9022	$1,181.06		$236.21
46700	T	Repair of anal stricture	0150	23.8654	$1,416.24	$437.12	$283.25
46705	C	Repair of anal stricture
46706	T	Repr of anal fistula w/glue	0150	23.8654	$1,416.24	$437.12	$283.25
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	23.8654	$1,416.24	$437.12	$283.25
46751	C	Repair of anal sphincter
46753	T	Reconstruction of anus	0150	23.8654	$1,416.24	$437.12	$283.25
46754	T	Removal of suture from anus	0149	18.0726	$1,072.48	$293.06	$214.50
46760	T	Repair of anal sphincter	0150	23.8654	$1,416.24	$437.12	$283.25
46761	T	Repair of anal sphincter	0150	23.8654	$1,416.24	$437.12	$283.25
46762	T	Implant artificial sphincter	0150	23.8654	$1,416.24	$437.12	$283.25
46900	T	Destruction, anal lesion(s)	0016	2.5834	$153.31	$33.57	$30.66
46910	T	Destruction, anal lesion(s)	0017	18.4211	$1,093.16	$227.84	$218.63
46916	T	Cryosurgery, anal lesion(s)	0013	1.1078	$65.74	$14.20	$13.15
46917	T	Laser surgery, anal lesions	0695	20.3164	$1,205.64	$266.59	$241.13
46922	T	Excision of anal lesion(s)	0695	20.3164	$1,205.64	$266.59	$241.13
46924	T	Destruction, anal lesion(s)	0695	20.3164	$1,205.64	$266.59	$241.13
46934	T	Destruction of hemorrhoids	0155	16.2546	$964.60		$192.92
46935	T	Destruction of hemorrhoids	0155	16.2546	$964.60		$192.92
46936	T	Destruction of hemorrhoids	0149	18.0726	$1,072.48	$293.06	$214.50
46937	T	Cryotherapy of rectal lesion	0149	18.0726	$1,072.48	$293.06	$214.50
46938	T	Cryotherapy of rectal lesion	0150	23.8654	$1,416.24	$437.12	$283.25
46940	T	Treatment of anal fissure	0149	18.0726	$1,072.48	$293.06	$214.50
46942	T	Treatment of anal fissure	0148	3.7383	$221.84	$57.21	$44.37
46945	T	Ligation of hemorrhoids	0155	16.2546	$964.60		$192.92
46946	T	Ligation of hemorrhoids	0155	16.2546	$964.60		$192.92
46947	T	Hemorrhoidopexy by stapling	0150	23.8654	$1,416.24	$437.12	$283.25
46999	T	Anus surgery procedure	0148	3.7383	$221.84	$57.21	$44.37
47000	T	Needle biopsy of liver	0685	6.0174	$357.09	$115.47	$71.42
47001	N	Needle biopsy, liver add-on
47010	C	Open drainage, liver lesion
47011	T	Percut drain, liver lesion	0037	9.4751	$562.28	$224.91	$112.46
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
47135	C	Transplantation of liver
47136	C	Transplantation of liver
47140	C	Partial removal, donor liver
47141	C	Partial removal, donor liver
47142	C	Partial removal, donor liver
47143	C	Prep donor liver, whole
47144	C	Prep donor liver, 3-segment
47145	C	Prep donor liver, lobe split
47146	C	Prep donor liver/venous
47147	C	Prep donor liver/arterial
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
47370	T	Laparo ablate liver tumor rf	0131	43.3389	$2,571.86	$1,001.89	$514.37
47371	T	Laparo ablate liver cryosurg	0131	43.3389	$2,571.86	$1,001.89	$514.37
47379	T	Laparoscope procedure, liver	0130	31.9271	$1,894.65	$659.53	$378.93
47380	C	Open ablate liver tumor rf
47381	C	Open ablate liver tumor cryo
47382	T	Percut ablate liver rf	0423	40.2866	$2,390.73		$478.15
47399	T	Liver surgery procedure	0002	0.9559	$56.73		$11.35
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	T	Incision of gallbladder	0152	12.2833	$728.93		$145.79
47500	N	Injection for liver x-rays
47505	N	Injection for liver x-rays
47510	T	Insert catheter, bile duct	0152	12.2833	$728.93		$145.79
47511	T	Insert bile duct drain	0152	12.2833	$728.93		$145.79
47525	T	Change bile duct catheter	0427	10.1977	$605.16	$124.11	$121.03
47530	T	Revise/reinsert bile tube	0427	10.1977	$605.16	$124.11	$121.03
47550	C	Bile duct endoscopy add-on
47552	T	Biliary endoscopy thru skin	0152	12.2833	$728.93		$145.79
47553	T	Biliary endoscopy thru skin	0152	12.2833	$728.93		$145.79
47554	T	Biliary endoscopy thru skin	0152	12.2833	$728.93		$145.79
47555	T	Biliary endoscopy thru skin	0152	12.2833	$728.93		$145.79
47556	T	Biliary endoscopy thru skin	0152	12.2833	$728.93		$145.79
47560	T	Laparoscopy w/cholangio	0130	31.9271	$1,894.65	$659.53	$378.93
47561	T	Laparo w/cholangio/biopsy	0130	31.9271	$1,894.65	$659.53	$378.93
47562	T	Laparoscopic cholecystectomy	0131	43.3389	$2,571.86	$1,001.89	$514.37
47563	T	Laparo cholecystectomy/graph	0131	43.3389	$2,571.86	$1,001.89	$514.37
47564	T	Laparo cholecystectomy/explr	0131	43.3389	$2,571.86	$1,001.89	$514.37
47570	C	Laparo cholecystoenterostomy
47579	T	Laparoscope proc, biliary	0130	31.9271	$1,894.65	$659.53	$378.93
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	12.2833	$728.93		$145.79
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	0152	12.2833	$728.93		$145.79
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, open
48102	T	Needle biopsy, pancreas	0685	6.0174	$357.09	$115.47	$71.42
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 pancreatic cyst
48510	C	Drain pancreatic pseudocyst
48511	T	Drain pancreatic pseudocyst	0037	9.4751	$562.28	$224.91	$112.46
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
48551	C	Prep donor pancreas
48552	C	Prep donor pancreas/venous
48554	E	Transpl allograft pancreas
48556	C	Removal, allograft pancreas
48999	T	Pancreas surgery procedure	0004	1.7646	$104.72	$22.36	$20.94
49000	C	Exploration of abdomen
49002	C	Reopening of abdomen
49010	C	Exploration behind abdomen
49020	C	Drain abdominal abscess
49021	T	Drain abdominal abscess	0037	9.4751	$562.28	$224.91	$112.46
49040	C	Drain, open, abdom abscess
49041	T	Drain, percut, abdom abscess	0037	9.4751	$562.28	$224.91	$112.46
49060	C	Drain, open, retrop abscess
49061	T	Drain, percut, retroper absc	0037	9.4751	$562.28	$224.91	$112.46
49062	C	Drain to peritoneal cavity
49080	T	Puncture, peritoneal cavity	0070	3.2101	$190.50		$38.10
49081	T	Removal of abdominal fluid	0070	3.2101	$190.50		$38.10
49085	T	Remove abdomen foreign body	0153	21.6961	$1,287.51	$382.75	$257.50
49180	T	Biopsy, abdominal mass	0685	6.0174	$357.09	$115.47	$71.42
49200	T	Removal of abdominal lesion	0130	31.9271	$1,894.65	$659.53	$378.93
49201	C	Remove abdom lesion, complex
49215	C	Excise sacral spine tumor
49220	C	Multiple surgery, abdomen
49250	T	Excision of umbilicus	0153	21.6961	$1,287.51	$382.75	$257.50
49255	C	Removal of omentum
49320	T	Diag laparo separate proc	0130	31.9271	$1,894.65	$659.53	$378.93
49321	T	Laparoscopy, biopsy	0130	31.9271	$1,894.65	$659.53	$378.93
49322	T	Laparoscopy, aspiration	0130	31.9271	$1,894.65	$659.53	$378.93
49323	T	Laparo drain lymphocele	0130	31.9271	$1,894.65	$659.53	$378.93
49329	T	Laparo proc, abdm/per/oment	0130	31.9271	$1,894.65	$659.53	$378.93
49400	N	Air injection into abdomen
49419	T	Insrt abdom cath for chemotx	0115	31.4727	$1,867.68	$459.35	$373.54
49420	T	Insert abdom drain, temp	0652	28.8948	$1,714.70		$342.94
49421	T	Insert abdom drain, perm	0652	28.8948	$1,714.70		$342.94
49422	T	Remove perm cannula/catheter	0105	22.3685	$1,327.41	$370.40	$265.48
49423	T	Exchange drainage catheter	0152	12.2833	$728.93		$145.79
49424	N	Assess cyst, contrast inject
49425	C	Insert abdomen-venous drain
49426	T	Revise abdomen-venous shunt	0153	21.6961	$1,287.51	$382.75	$257.50
49427	N	Injection, abdominal shunt
49428	C	Ligation of shunt
49429	T	Removal of shunt	0105	22.3685	$1,327.41	$370.40	$265.48
49491	T	Rpr hern preemie reduc	0154	28.7847	$1,708.17	$464.85	$341.63
49492	T	Rpr ing hern premie, blocked	0154	28.7847	$1,708.17	$464.85	$341.63
49495	T	Rpr ing hernia baby, reduc	0154	28.7847	$1,708.17	$464.85	$341.63
49496	T	Rpr ing hernia baby, blocked	0154	28.7847	$1,708.17	$464.85	$341.63
49500	T	Rpr ing hernia, init, reduce	0154	28.7847	$1,708.17	$464.85	$341.63
49501	T	Rpr ing hernia, init blocked	0154	28.7847	$1,708.17	$464.85	$341.63
49505	T	Prp i/hern init reduc5 yr	0154	28.7847	$1,708.17	$464.85	$341.63
49507	T	Prp i/hern init block5 yr	0154	28.7847	$1,708.17	$464.85	$341.63
49520	T	Rerepair ing hernia, reduce	0154	28.7847	$1,708.17	$464.85	$341.63
49521	T	Rerepair ing hernia, blocked	0154	28.7847	$1,708.17	$464.85	$341.63
49525	T	Repair ing hernia, sliding	0154	28.7847	$1,708.17	$464.85	$341.63
49540	T	Repair lumbar hernia	0154	28.7847	$1,708.17	$464.85	$341.63
49550	T	Rpr rem hernia, init, reduce	0154	28.7847	$1,708.17	$464.85	$341.63
49553	T	Rpr fem hernia, init blocked	0154	28.7847	$1,708.17	$464.85	$341.63
49555	T	Rerepair fem hernia, reduce	0154	28.7847	$1,708.17	$464.85	$341.63
49557	T	Rerepair fem hernia, blocked	0154	28.7847	$1,708.17	$464.85	$341.63
49560	T	Rpr ventral hern init, reduc	0154	28.7847	$1,708.17	$464.85	$341.63
49561	T	Rpr ventral hern init, block	0154	28.7847	$1,708.17	$464.85	$341.63
49565	T	Rerepair ventrl hern, reduce	0154	28.7847	$1,708.17	$464.85	$341.63
49566	T	Rerepair ventrl hern, block	0154	28.7847	$1,708.17	$464.85	$341.63
49568	T	Hernia repair w/mesh	0154	28.7847	$1,708.17	$464.85	$341.63
49570	T	Rpr epigastric hern, reduce	0154	28.7847	$1,708.17	$464.85	$341.63
49572	T	Rpr epigastric hern, blocked	0154	28.7847	$1,708.17	$464.85	$341.63
49580	T	Rpr umbil hern, reduc 5 yr	0154	28.7847	$1,708.17	$464.85	$341.63
49582	T	Rpr umbil hern, block 5 yr	0154	28.7847	$1,708.17	$464.85	$341.63
49585	T	Rpr umbil hern, reduc 5 yr	0154	28.7847	$1,708.17	$464.85	$341.63
49587	T	Rpr umbil hern, block 5 yr	0154	28.7847	$1,708.17	$464.85	$341.63
49590	T	Repair spigilian hernia	0154	28.7847	$1,708.17	$464.85	$341.63
49600	T	Repair umbilical lesion	0154	28.7847	$1,708.17	$464.85	$341.63
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	43.3389	$2,571.86	$1,001.89	$514.37
49651	T	Laparo hernia repair recur	0131	43.3389	$2,571.86	$1,001.89	$514.37
49659	T	Laparo proc, hernia repair	0130	31.9271	$1,894.65	$659.53	$378.93
49900	C	Repair of abdominal wall
49904	C	Omental flap, extra-abdom
49905	C	Omental flap
49906	C	Free omental flap, microvasc
49999	T	Abdomen surgery procedure	0153	21.6961	$1,287.51	$382.75	$257.50
50010	C	Exploration of kidney
50020	T	Renal abscess, open drain	0162	23.3918	$1,388.14		$277.63
50021	T	Renal abscess, percut drain	0037	9.4751	$562.28	$224.91	$112.46
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	0429	42.3147	$2,511.08		$502.22
50081	T	Removal of kidney stone	0429	42.3147	$2,511.08		$502.22
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	0685	6.0174	$357.09	$115.47	$71.42
50205	C	Biopsy of kidney
50220	C	Remove kidney, open
50225	C	Removal kidney open, complex
50230	C	Removal kidney open, radical
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
50323	C	Prep cadaver renal allograft
50325	C	Prep donor renal graft
50327	C	Prep renal graft/venous
50328	C	Prep renal graft/arterial
50329	C	Prep renal graft/ureteral
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	0685	6.0174	$357.09	$115.47	$71.42
50391	T	Instll rx agnt into rnal tub	0156	2.5751	$152.81	$40.52	$30.56
50392	T	Insert kidney drain	0161	18.5576	$1,101.26	$249.36	$220.25
50393	T	Insert ureteral tube	0161	18.5576	$1,101.26	$249.36	$220.25
50394	N	Injection for kidney x-ray
50395	T	Create passage to kidney	0161	18.5576	$1,101.26	$249.36	$220.25
50396	T	Measure kidney pressure	0164	1.1855	$70.35	$17.29	$14.07
50398	T	Change kidney tube	0122	6.9721	$413.75	$84.85	$82.75
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	0130	31.9271	$1,894.65	$659.53	$378.93
50542	T	Laparo ablate renal mass	0131	43.3389	$2,571.86	$1,001.89	$514.37
50543	T	Laparo partial nephrectomy	0131	43.3389	$2,571.86	$1,001.89	$514.37
50544	T	Laparoscopy, pyeloplasty	0130	31.9271	$1,894.65	$659.53	$378.93
50545	C	Laparo radical nephrectomy
50546	C	Laparoscopic nephrectomy
50547	C	Laparo removal donor kidney
50548	C	Laparo remove w/ ureter
50549	T	Laparoscope proc, renal	0130	31.9271	$1,894.65	$659.53	$378.93
50551	T	Kidney endoscopy	0160	6.6753	$396.13	$105.06	$79.23
50553	T	Kidney endoscopy	0161	18.5576	$1,101.26	$249.36	$220.25
50555	T	Kidney endoscopy biopsy	0160	6.6753	$396.13	$105.06	$79.23
50557	T	Kidney endoscopy treatment	0162	23.3918	$1,388.14		$277.63
50561	T	Kidney endoscopy treatment	0161	18.5576	$1,101.26	$249.36	$220.25
50562	T	Renal scope w/tumor resect	0160	6.6753	$396.13	$105.06	$79.23
50570	T	Kidney endoscopy	0160	6.6753	$396.13	$105.06	$79.23
50572	T	Kidney endoscopy	0160	6.6753	$396.13	$105.06	$79.23
50574	T	Kidney endoscopy biopsy	0160	6.6753	$396.13	$105.06	$79.23
50575	T	Kidney endoscopy	0163	33.7354	$2,001.96		$400.39
50576	T	Kidney endoscopy treatment	0161	18.5576	$1,101.26	$249.36	$220.25
50580	C	Kidney endoscopy treatment
50590	T	Fragmenting of kidney stone	0169	43.0133	$2,552.54	$1,021.01	$510.51
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	0164	1.1855	$70.35	$17.29	$14.07
50688	T	Change of ureter tube	0122	6.9721	$413.75	$84.85	$82.75
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 intestine
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	43.3389	$2,571.86	$1,001.89	$514.37
50947	T	Laparo new ureter/bladder	0131	43.3389	$2,571.86	$1,001.89	$514.37
50948	T	Laparo new ureter/bladder	0131	43.3389	$2,571.86	$1,001.89	$514.37
50949	T	Laparoscope proc, ureter	0130	31.9271	$1,894.65	$659.53	$378.93
50951	T	Endoscopy of ureter	0160	6.6753	$396.13	$105.06	$79.23
50953	T	Endoscopy of ureter	0160	6.6753	$396.13	$105.06	$79.23
50955	T	Ureter endoscopy biopsy	0161	18.5576	$1,101.26	$249.36	$220.25
50957	T	Ureter endoscopy treatment	0161	18.5576	$1,101.26	$249.36	$220.25
50961	T	Ureter endoscopy treatment	0161	18.5576	$1,101.26	$249.36	$220.25
50970	T	Ureter endoscopy	0160	6.6753	$396.13	$105.06	$79.23
50972	T	Ureter endoscopy catheter	0160	6.6753	$396.13	$105.06	$79.23
50974	T	Ureter endoscopy biopsy	0161	18.5576	$1,101.26	$249.36	$220.25
50976	T	Ureter endoscopy treatment	0161	18.5576	$1,101.26	$249.36	$220.25
50980	T	Ureter endoscopy treatment	0161	18.5576	$1,101.26	$249.36	$220.25
51000	T	Drainage of bladder	0164	1.1855	$70.35	$17.29	$14.07
51005	T	Drainage of bladder	0164	1.1855	$70.35	$17.29	$14.07
51010	T	Drainage of bladder	0165	16.6689	$989.18		$197.84
51020	T	Incise treat bladder	0162	23.3918	$1,388.14		$277.63
51030	T	Incise treat bladder	0162	23.3918	$1,388.14		$277.63
51040	T	Incise drain bladder	0162	23.3918	$1,388.14		$277.63
51045	T	Incise bladder/drain ureter	0160	6.6753	$396.13	$105.06	$79.23
51050	T	Removal of bladder stone	0162	23.3918	$1,388.14		$277.63
51060	C	Removal of ureter stone
51065	T	Remove ureter calculus	0162	23.3918	$1,388.14		$277.63
51080	T	Drainage of bladder abscess	0008	16.4989	$979.09		$195.82
51500	T	Removal of bladder cyst	0154	28.7847	$1,708.17	$464.85	$341.63
51520	T	Removal of bladder lesion	0162	23.3918	$1,388.14		$277.63
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	1.1855	$70.35	$17.29	$14.07
51701	X	Insert bladder catheter	0340	0.6384	$37.88		$7.58
51702	X	Insert temp bladder cath	0340	0.6384	$37.88		$7.58
51703	T	Insert bladder cath, complex	0164	1.1855	$70.35	$17.29	$14.07
51705	T	Change of bladder tube	0121	2.2766	$135.10	$43.80	$27.02
51710	T	Change of bladder tube	0122	6.9721	$413.75	$84.85	$82.75
51715	T	Endoscopic injection/implant	0168	28.2685	$1,677.54	$388.03	$335.51
51720	T	Treatment of bladder lesion	0156	2.5751	$152.81	$40.52	$30.56
51725	T	Simple cystometrogram	0156	2.5751	$152.81	$40.52	$30.56
51726	T	Complex cystometrogram	0156	2.5751	$152.81	$40.52	$30.56
51736	T	Urine flow measurement	0164	1.1855	$70.35	$17.29	$14.07
51741	T	Electro-uroflowmetry, first	0164	1.1855	$70.35	$17.29	$14.07
51772	T	Urethra pressure profile	0156	2.5751	$152.81	$40.52	$30.56
51784	T	Anal/urinary muscle study	0164	1.1855	$70.35	$17.29	$14.07
51785	T	Anal/urinary muscle study	0164	1.1855	$70.35	$17.29	$14.07
51792	T	Urinary reflex study	0164	1.1855	$70.35	$17.29	$14.07
51795	T	Urine voiding pressure study	0164	1.1855	$70.35	$17.29	$14.07
51797	T	Intraabdominal pressure test	0164	1.1855	$70.35	$17.29	$14.07
51798	X	Us urine capacity measure	0340	0.6384	$37.88		$7.58
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	23.3918	$1,388.14		$277.63
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	43.3389	$2,571.86	$1,001.89	$514.37
51992	T	Laparo sling operation	0132	62.9914	$3,738.10	$1,239.22	$747.62
52000	T	Cystoscopy	0160	6.6753	$396.13	$105.06	$79.23
52001	T	Cystoscopy, removal of clots	0160	6.6753	$396.13	$105.06	$79.23
52005	T	Cystoscopy ureter catheter	0161	18.5576	$1,101.26	$249.36	$220.25
52007	T	Cystoscopy and biopsy	0161	18.5576	$1,101.26	$249.36	$220.25
52010	T	Cystoscopy duct catheter	0160	6.6753	$396.13	$105.06	$79.23
52204	T	Cystoscopy	0161	18.5576	$1,101.26	$249.36	$220.25
52214	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52224	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52234	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52235	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52240	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52250	T	Cystoscopy and radiotracer	0162	23.3918	$1,388.14		$277.63
52260	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52265	T	Cystoscopy and treatment	0160	6.6753	$396.13	$105.06	$79.23
52270	T	Cystoscopy revise urethra	0161	18.5576	$1,101.26	$249.36	$220.25
52275	T	Cystoscopy revise urethra	0161	18.5576	$1,101.26	$249.36	$220.25
52276	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52277	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52281	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52282	T	Cystoscopy, implant stent	0163	33.7354	$2,001.96		$400.39
52283	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52285	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52290	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52300	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52301	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52305	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52310	T	Cystoscopy and treatment	0160	6.6753	$396.13	$105.06	$79.23
52315	T	Cystoscopy and treatment	0161	18.5576	$1,101.26	$249.36	$220.25
52317	T	Remove bladder stone	0162	23.3918	$1,388.14		$277.63
52318	T	Remove bladder stone	0162	23.3918	$1,388.14		$277.63
52320	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52325	T	Cystoscopy, stone removal	0162	23.3918	$1,388.14		$277.63
52327	T	Cystoscopy, inject material	0162	23.3918	$1,388.14		$277.63
52330	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52332	T	Cystoscopy and treatment	0162	23.3918	$1,388.14		$277.63
52334	T	Create passage to kidney	0162	23.3918	$1,388.14		$277.63
52341	T	Cysto w/ureter stricture tx	0162	23.3918	$1,388.14		$277.63
52342	T	Cysto w/up stricture tx	0162	23.3918	$1,388.14		$277.63
52343	T	Cysto w/renal stricture tx	0162	23.3918	$1,388.14		$277.63
52344	T	Cysto/uretero, stone remove	0162	23.3918	$1,388.14		$277.63
52345	T	Cysto/uretero w/up stricture	0162	23.3918	$1,388.14		$277.63
52346	T	Cystouretero w/renal strict	0162	23.3918	$1,388.14		$277.63
52351	T	Cystouretero or pyeloscope	0161	18.5576	$1,101.26	$249.36	$220.25
52352	T	Cystouretero w/stone remove	0162	23.3918	$1,388.14		$277.63
52353	T	Cystouretero w/lithotripsy	0163	33.7354	$2,001.96		$400.39
52354	T	Cystouretero w/biopsy	0162	23.3918	$1,388.14		$277.63
52355	T	Cystouretero w/excise tumor	0162	23.3918	$1,388.14		$277.63
52400	T	Cystouretero w/congen repr	0162	23.3918	$1,388.14		$277.63
52402	T	Cystourethro cut ejacul duct	0162	23.3918	$1,388.14		$277.63
52450	T	Incision of prostate	0162	23.3918	$1,388.14		$277.63
52500	T	Revision of bladder neck	0162	23.3918	$1,388.14		$277.63
52510	T	Dilation prostatic urethra	0161	18.5576	$1,101.26	$249.36	$220.25
52601	T	Prostatectomy (TURP)	0163	33.7354	$2,001.96		$400.39
52606	T	Control postop bleeding	0162	23.3918	$1,388.14		$277.63
52612	T	Prostatectomy, first stage	0163	33.7354	$2,001.96		$400.39
52614	T	Prostatectomy, second stage	0163	33.7354	$2,001.96		$400.39
52620	T	Remove residual prostate	0163	33.7354	$2,001.96		$400.39
52630	T	Remove prostate regrowth	0163	33.7354	$2,001.96		$400.39
52640	T	Relieve bladder contracture	0162	23.3918	$1,388.14		$277.63
52647	T	Laser surgery of prostate	0429	42.3147	$2,511.08		$502.22
52648	T	Laser surgery of prostate	0429	42.3147	$2,511.08		$502.22
52700	T	Drainage of prostate abscess	0162	23.3918	$1,388.14		$277.63
53000	T	Incision of urethra	0166	17.6743	$1,048.85	$218.73	$209.77
53010	T	Incision of urethra	0166	17.6743	$1,048.85	$218.73	$209.77
53020	T	Incision of urethra	0166	17.6743	$1,048.85	$218.73	$209.77
53025	T	Incision of urethra	0166	17.6743	$1,048.85	$218.73	$209.77
53040	T	Drainage of urethra abscess	0166	17.6743	$1,048.85	$218.73	$209.77
53060	T	Drainage of urethra abscess	0166	17.6743	$1,048.85	$218.73	$209.77
53080	T	Drainage of urinary leakage	0166	17.6743	$1,048.85	$218.73	$209.77
53085	T	Drainage of urinary leakage	0166	17.6743	$1,048.85	$218.73	$209.77
53200	T	Biopsy of urethra	0166	17.6743	$1,048.85	$218.73	$209.77
53210	T	Removal of urethra	0168	28.2685	$1,677.54	$388.03	$335.51
53215	T	Removal of urethra	0166	17.6743	$1,048.85	$218.73	$209.77
53220	T	Treatment of urethra lesion	0168	28.2685	$1,677.54	$388.03	$335.51
53230	T	Removal of urethra lesion	0168	28.2685	$1,677.54	$388.03	$335.51
53235	T	Removal of urethra lesion	0166	17.6743	$1,048.85	$218.73	$209.77
53240	T	Surgery for urethra pouch	0168	28.2685	$1,677.54	$388.03	$335.51
53250	T	Removal of urethra gland	0166	17.6743	$1,048.85	$218.73	$209.77
53260	T	Treatment of urethra lesion	0166	17.6743	$1,048.85	$218.73	$209.77
53265	T	Treatment of urethra lesion	0166	17.6743	$1,048.85	$218.73	$209.77
53270	T	Removal of urethra gland	0166	17.6743	$1,048.85	$218.73	$209.77
53275	T	Repair of urethra defect	0166	17.6743	$1,048.85	$218.73	$209.77
53400	T	Revise urethra, stage 1	0168	28.2685	$1,677.54	$388.03	$335.51
53405	T	Revise urethra, stage 2	0168	128.2685	$1,677.54	$388.03	$335.51
53410	T	Reconstruction of urethra	0168	28.2685	$1,677.54	$388.03	$335.51
53415	C	Reconstruction of urethra
53420	T	Reconstruct urethra, stage 1	0168	28.2685	$1,677.54	$388.03	$335.51
53425	T	Reconstruct urethra, stage 2	0168	28.2685	$1,677.54	$388.03	$335.51
53430	T	Reconstruction of urethra	0168	28.2685	$1,677.54	$388.03	$335.51
53431	T	Reconstruct urethra/bladder	0168	28.2685	$1,677.54	$388.03	$335.51
53440	S	Correct bladder function	0385	75.6446	$4,488.98		$897.80
53442	T	Remove perineal prosthesis	0168	28.2685	$1,677.54	$388.03	$335.51
53444	S	Insert tandem cuff	0385	75.6446	$4,488.98		$897.80
53445	S	Insert uro/ves nck sphincter	0386	120.1694	$7,131.21		$1,426.24
53446	T	Remove uro sphincter	0168	28.2685	$1,677.54	$388.03	$335.51
53447	S	Remove/replace ur sphincter	0386	120.1694	$7,131.21		$1,426.24
53448	C	Remov/replc ur sphinctr comp
53449	T	Repair uro sphincter	0168	28.2685	$1,677.54	$388.03	$335.51
53450	T	Revision of urethra	0168	28.2685	$1,677.54	$388.03	$335.51
53460	T	Revision of urethra	0166	17.6743	$1,048.85	$218.73	$209.77
53500	T	Urethrlys, transvag w/ scope	0168	28.2685	$1,677.54	$388.03	$335.51
53502	T	Repair of urethra injury	0166	17.6743	$1,048.85	$218.73	$209.77
53505	T	Repair of urethra injury	0168	28.2685	$1,677.54	$388.03	$335.51
53510	T	Repair of urethra injury	0166	17.6743	$1,048.85	$218.73	$209.77
53515	T	Repair of urethra injury	0168	28.2685	$1,677.54	$388.03	$335.51
53520	T	Repair of urethra defect	0168	28.2685	$1,677.54	$388.03	$335.51
53600	T	Dilate urethra stricture	0156	2.5751	$152.81	$40.52	$30.56
53601	T	Dilate urethra stricture	0164	1.1855	$70.35	$17.29	$14.07
53605	T	Dilate urethra stricture	0161	18.5576	$1,101.26	$249.36	$220.25
53620	T	Dilate urethra stricture	0165	16.6689	$989.18		$197.84
53621	T	Dilate urethra stricture	0164	1.1855	$70.35	$17.29	$14.07
53660	T	Dilation of urethra	0164	1.1855	$70.35	$17.29	$14.07
53661	T	Dilation of urethra	0164	1.1855	$70.35	$17.29	$14.07
53665	T	Dilation of urethra	0166	17.6743	$1,048.85	$218.73	$209.77
53850	T	Prostatic microwave thermotx	0675	43.7329	$2,595.24		$519.05
53852	T	Prostatic rf thermotx	0675	43.7329	$2,595.24		$519.05
53853	T	Prostatic water thermother	0162	23.3918	$1,388.14		$277.63
53899	T	Urology surgery procedure	0164	1.1855	$70.35	$17.29	$14.07
54000	T	Slitting of prepuce	0166	17.6743	$1,048.85	$218.73	$209.77
54001	T	Slitting of prepuce	0166	17.6743	$1,048.85	$218.73	$209.77
54015	T	Drain penis lesion	0008	16.4989	$979.09		$195.82
54050	T	Destruction, penis lesion(s)	0013	1.1078	$65.74	$14.20	$13.15
54055	T	Destruction, penis lesion(s)	0017	18.4211	$1,093.16	$227.84	$218.63
54056	T	Cryosurgery, penis lesion(s)	0012	0.8497	$50.42	$11.18	$10.08
54057	T	Laser surg, penis lesion(s)	0017	18.4211	$1,093.16	$227.84	$218.63
54060	T	Excision of penis lesion(s)	0017	18.4211	$1,093.16	$227.84	$218.63
54065	T	Destruction, penis lesion(s)	0695	20.3164	$1,205.64	$266.59	$241.13
54100	T	Biopsy of penis	0021	14.9776	$888.82	$219.48	$177.76
54105	T	Biopsy of penis	0022	19.6472	$1,165.92	$354.45	$233.18
54110	T	Treatment of penis lesion	0181	30.8663	$1,831.70	$621.82	$366.34
54111	T	Treat penis lesion, graft	0181	30.8663	$1,831.70	$621.82	$366.34
54112	T	Treat penis lesion, graft	0181	30.8663	$1,831.70	$621.82	$366.34
54115	T	Treatment of penis lesion	0008	16.4989	$979.09		$195.82
54120	T	Partial removal of penis	0181	30.8663	$1,831.70	$621.82	$366.34
54125	C	Removal of penis
54130	C	Remove penis nodes
54135	C	Remove penis nodes
54150	T	Circumcision	0180	19.8827	$1,179.90	$304.87	$235.98
54152	T	Circumcision	0180	19.8827	$1,179.90	$304.87	$235.98
54160	T	Circumcision	0180	19.8827	$1,179.90	$304.87	$235.98
54161	T	Circumcision	0180	19.8827	$1,179.90	$304.87	$235.98
54162	T	Lysis penil circumic lesion	0180	19.8827	$1,179.90	$304.87	$235.98
54163	T	Repair of circumcision	0180	19.8827	$1,179.90	$304.87	$235.98
54164	T	Frenulotomy of penis	0180	19.8827	$1,179.90	$304.87	$235.98
54200	T	Treatment of penis lesion	0156	2.5751	$152.81	$40.52	$30.56
54205	T	Treatment of penis lesion	0181	30.8663	$1,831.70	$621.82	$366.34
54220	T	Treatment of penis lesion	0156	2.5751	$152.81	$40.52	$30.56
54230	N	Prepare penis study
54231	T	Dynamic cavernosometry	0165	16.6689	$989.18		$197.84
54235	T	Penile injection	0164	1.1855	$70.35	$17.29	$14.07
54240	T	Penis study	0164	1.1855	$70.35	$17.29	$14.07
54250	T	Penis study	0164	1.1855	$70.35	$17.29	$14.07
54300	T	Revision of penis	0181	30.8663	$1,831.70	$621.82	$366.34
54304	T	Revision of penis	0181	30.8663	$1,831.70	$621.82	$366.34
54308	T	Reconstruction of urethra	0181	30.8663	$1,831.70	$621.82	$366.34
54312	T	Reconstruction of urethra	0181	30.8663	$1,831.70	$621.82	$366.34
54316	T	Reconstruction of urethra	0181	30.8663	$1,831.70	$621.82	$366.34
54318	T	Reconstruction of urethra	0181	30.8663	$1,831.70	$621.82	$366.34
54322	T	Reconstruction of urethra	0181	30.8663	$1,831.70	$621.82	$366.34
54324	T	Reconstruction of urethra	0181	30.8663	$1,831.70	$621.82	$366.34
54326	T	Reconstruction of urethra	0181	30.8663	$1,831.70	$621.82	$366.34
54328	T	Revise penis/urethra	0181	30.8663	$1,831.70	$621.82	$366.34
54332	C	Revise penis/urethra
54336	C	Revise penis/urethra
54340	T	Secondary urethral surgery	0181	30.8663	$1,831.70	$621.82	$366.34
54344	T	Secondary urethral surgery	0181	30.8663	$1,831.70	$621.82	$366.34
54348	T	Secondary urethral surgery	0181	30.8663	$1,831.70	$621.82	$366.34
54352	T	Reconstruct urethra/penis	0181	30.8663	$1,831.70	$621.82	$366.34
54360	T	Penis plastic surgery	0181	30.8663	$1,831.70	$621.82	$366.34
54380	T	Repair penis	0181	30.8663	$1,831.70	$621.82	$366.34
54385	T	Repair penis	0181	30.8663	$1,831.70	$621.82	$366.34
54390	C	Repair penis and bladder
54400	S	Insert semi-rigid prosthesis	0385	75.6446	$4,488.98		$897.80
54401	S	Insert self-contd prosthesis	0386	120.1694	$7,131.21		$1,426.24
54405	S	Insert multi-comp penis pros	0386	120.1694	$7,131.21		$1,426.24
54406	T	Remove muti-comp penis pros	0181	30.8663	$1,831.70	$621.82	$366.34
54408	T	Repair multi-comp penis pros	0181	30.8663	$1,831.70	$621.82	$366.34
54410	S	Remove/replace penis prosth	0386	120.1694	$7,131.21		$1,426.24
54411	C	Remov/replc penis pros, comp
54415	T	Remove self-contd penis pros	0181	30.8663	$1,831.70	$621.82	$366.34
54416	S	Remv/repl penis contain pros	0386	120.1694	$7,131.21		$1,426.24
54417	C	Remv/replc penis pros, compl
54420	T	Revision of penis	0181	30.8663	$1,831.70	$621.82	$366.34
54430	C	Revision of penis
54435	T	Revision of penis	0181	30.8663	$1,831.70	$621.82	$366.34
54440	T	Repair of penis	0181	30.8663	$1,831.70	$621.82	$366.34
54450	T	Preputial stretching	0156	2.5751	$152.81	$40.52	$30.56
54500	T	Biopsy of testis	0037	9.4751	$562.28	$224.91	$112.46
54505	T	Biopsy of testis	0183	23.6415	$1,402.96		$280.59
54512	T	Excise lesion testis	0183	23.6415	$1,402.96		$280.59
54520	T	Removal of testis	0183	23.6415	$1,402.96		$280.59
54522	T	Orchiectomy, partial	0183	23.6415	$1,402.96		$280.59
54530	T	Removal of testis	0154	28.7847	$1,708.17	$464.85	$341.63
54535	C	Extensive testis surgery
54550	T	Exploration for testis	0154	28.7847	$1,708.17	$464.85	$341.63
54560	T	Exploration for testis	0183	23.6415	$1,402.96		$280.59
54600	T	Reduce testis torsion	0183	23.6415	$1,402.96		$280.59
54620	T	Suspension of testis	0183	23.6415	$1,402.96		$280.59
54640	T	Suspension of testis	0154	28.7847	$1,708.17	$464.85	$341.63
54650	C	Orchiopexy (Fowler-Stephens)
54660	T	Revision of testis	0183	23.6415	$1,402.96		$280.59
54670	T	Repair testis injury	0183	23.6415	$1,402.96		$280.59
54680	T	Relocation of testis(es)	0183	23.6415	$1,402.96		$280.59
54690	T	Laparoscopy, orchiectomy	0131	43.3389	$2,571.86	$1,001.89	$514.37
54692	T	Laparoscopy, orchiopexy	0132	62.9914	$3,738.10	$1,239.22	$747.62
54699	T	Laparoscope proc, testis	0130	31.9271	$1,894.65	$659.53	$378.93
54700	T	Drainage of scrotum	0183	23.6415	$1,402.96		$280.59
54800	T	Biopsy of epididymis	0004	1.7646	$104.72	$22.36	$20.94
54820	T	Exploration of epididymis	0183	23.6415	$1,402.96		$280.59
54830	T	Remove epididymis lesion	0183	23.6415	$1,402.96		$280.59
54840	T	Remove epididymis lesion	0183	23.6415	$1,402.96		$280.59
54860	T	Removal of epididymis	0183	23.6415	$1,402.96		$280.59
54861	T	Removal of epididymis	0183	23.6415	$1,402.96		$280.59
54900	T	Fusion of spermatic ducts	0183	23.6415	$1,402.96		$280.59
54901	T	Fusion of spermatic ducts	0183	23.6415	$1,402.96		$280.59
55000	T	Drainage of hydrocele	0004	1.7646	$104.72	$22.36	$20.94
55040	T	Removal of hydrocele	0154	28.7847	$1,708.17	$464.85	$341.63
55041	T	Removal of hydroceles	0154	28.7847	$1,708.17	$464.85	$341.63
55060	T	Repair of hydrocele	0183	23.6415	$1,402.96		$280.59
55100	T	Drainage of scrotum abscess	0008	16.4989	$979.09		$195.82
55110	T	Explore scrotum	0183	23.6415	$1,402.96		$280.59
55120	T	Removal of scrotum lesion	0183	23.6415	$1,402.96		$280.59
55150	T	Removal of scrotum	0183	23.6415	$1,402.96		$280.59
55175	T	Revision of scrotum	0183	23.6415	$1,402.96		$280.59
55180	T	Revision of scrotum	0183	23.6415	$1,402.96		$280.59
55200	T	Incision of sperm duct	0183	23.6415	$1,402.96		$280.59
55250	T	Removal of sperm duct(s)	0183	23.6415	$1,402.96		$280.59
55300	N	Prepare, sperm duct x-ray
55400	T	Repair of sperm duct	0183	23.6415	$1,402.96		$280.59
55450	T	Ligation of sperm duct	0183	23.6415	$1,402.96		$280.59
55500	T	Removal of hydrocele	0183	23.6415	$1,402.96		$280.59
55520	T	Removal of sperm cord lesion	0183	23.6415	$1,402.96		$280.59
55530	T	Revise spermatic cord veins	0183	23.6415	$1,402.96		$280.59
55535	T	Revise spermatic cord veins	0154	28.7847	$1,708.17	$464.85	$341.63
55540	T	Revise hernia sperm veins	0154	28.7847	$1,708.17	$464.85	$341.63
55550	T	Laparo ligate spermatic vein	0131	43.3389	$2,571.86	$1,001.89	$514.37
55559	T	Laparo proc, spermatic cord	0130	31.9271	$1,894.65	$659.53	$378.93
55600	T	Incise sperm duct pouch	0183	23.6415	$1,402.96		$280.59
55605	C	Incise sperm duct pouch
55650	C	Remove sperm duct pouch
55680	T	Remove sperm pouch lesion	0183	23.6415	$1,402.96		$280.59
55700	T	Biopsy of prostate	0184	4.3566	$258.53	$96.27	$51.71
55705	T	Biopsy of prostate	0184	4.3566	$258.53	$96.27	$51.71
55720	T	Drainage of prostate abscess	0162	23.3918	$1,388.14		$277.63
55725	T	Drainage of prostate abscess	0162	23.3918	$1,388.14		$277.63
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	0163	33.7354	$2,001.96		$400.39
55860	T	Surgical exposure, prostate	0165	16.6689	$989.18		$197.84
55862	C	Extensive prostate surgery
55865	C	Extensive prostate surgery
55866	C	Laparo radical prostatectomy
55870	T	Electroejaculation	0197	2.3572	$139.88		$27.98
55873	T	Cryoablate prostate	0674	95.7856	$5,684.20		$1,136.84
55899	T	Genital surgery procedure	0164	1.1855	$70.35	$17.29	$14.07
55970	E	Sex transformation, M to F
55980	E	Sex transformation, F to M
56405	T	I D of vulva/perineum	0189	2.371	$140.70		$28.14
56420	T	Drainage of gland abscess	0189	2.371	$140.70		$28.14
56440	T	Surgery for vulva lesion	0194	20.7525	$1,231.52	$397.84	$246.30
56441	T	Lysis of labial lesion(s)	0193	14.5843	$865.48		$173.10
56501	T	Destroy, vulva lesions, sim	0017	18.4211	$1,093.16	$227.84	$218.63
56515	T	Destroy vulva lesion/s compl	0695	20.3164	$1,205.64	$266.59	$241.13
56605	T	Biopsy of vulva/perineum	0019	4.0547	$240.62	$71.87	$48.12
56606	T	Biopsy of vulva/perineum	0019	4.0547	$240.62	$71.87	$48.12
56620	T	Partial removal of vulva	0195	26.6791	$1,583.22	$483.80	$316.64
56625	T	Complete removal of vulva	0195	26.6791	$1,583.22	$483.80	$316.64
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	20.7525	$1,231.52	$397.84	$246.30
56720	T	Incision of hymen	0193	14.5843	$865.48		$173.10
56740	T	Remove vagina gland lesion	0194	20.7525	$1,231.52	$397.84	$246.30
56800	T	Repair of vagina	0194	20.7525	$1,231.52	$397.84	$246.30
56805	T	Repair clitoris	0193	14.5843	$865.48		$173.10
56810	T	Repair of perineum	0194	20.7525	$1,231.52	$397.84	$246.30
56820	T	Exam of vulva w/scope	0188	1.14	$67.65		$13.53
56821	T	Exam/biopsy of vulva w/scope	0189	2.371	$140.70		$28.14
57000	T	Exploration of vagina	0193	14.5843	$865.48		$173.10
57010	T	Drainage of pelvic abscess	0193	14.5843	$865.48		$173.10
57020	T	Drainage of pelvic fluid	0192	4.3082	$255.66		$51.13
57022	T	I d vaginal hematoma, pp	0007	11.4501	$679.48		$135.90
57023	T	I d vag hematoma, non-ob	0008	16.4989	$979.09		$195.82
57061	T	Destroy vag lesions, simple	0194	20.7525	$1,231.52	$397.84	$246.30
57065	T	Destroy vag lesions, complex	0194	20.7525	$1,231.52	$397.84	$246.30
57100	T	Biopsy of vagina	0192	4.3082	$255.66		$51.13
57105	T	Biopsy of vagina	0194	20.7525	$1,231.52	$397.84	$246.30
57106	T	Remove vagina wall, partial	0194	20.7525	$1,231.52	$397.84	$246.30
57107	T	Remove vagina tissue, part	0195	26.6791	$1,583.22	$483.80	$316.64
57109	T	Vaginectomy partial w/nodes	0195	26.6791	$1,583.22	$483.80	$316.64
57110	C	Remove vagina wall, complete
57111	C	Remove vagina tissue, compl
57112	C	Vaginectomy w/nodes, compl
57120	T	Closure of vagina	0195	26.6791	$1,583.22	$483.80	$316.64
57130	T	Remove vagina lesion	0194	20.7525	$1,231.52	$397.84	$246.30
57135	T	Remove vagina lesion	0194	20.7525	$1,231.52	$397.84	$246.30
57150	T	Treat vagina infection	0191	0.167	$9.91	$2.78	$1.98
57155	T	Insert uteri tandems/ovoids	0192	4.3082	$255.66		$51.13
57160	T	Insert pessary/other device	0188	1.14	$67.65		$13.53
57170	T	Fitting of diaphragm/cap	0191	0.167	$9.91	$2.78	$1.98
57180	T	Treat vaginal bleeding	0189	2.371	$140.70		$28.14
57200	T	Repair of vagina	0194	20.7525	$1,231.52	$397.84	$246.30
57210	T	Repair vagina/perineum	0194	20.7525	$1,231.52	$397.84	$246.30
57220	T	Revision of urethra	0202	40.3866	$2,396.66	$958.66	$479.33
57230	T	Repair of urethral lesion	0195	26.6791	$1,583.22	$483.80	$316.64
57240	T	Repair bladder vagina	0195	26.6791	$1,583.22	$483.80	$316.64
57250	T	Repair rectum vagina	0195	26.6791	$1,583.22	$483.80	$316.64
57260	T	Repair of vagina	0195	26.6791	$1,583.22	$483.80	$316.64
57265	T	Extensive repair of vagina	0202	40.3866	$2,396.66	$958.66	$479.33
57267	T	Insert mesh/pelvic flr addon	0154	28.7847	$1,708.17	$464.85	$341.63
57268	T	Repair of bowel bulge	0195	26.6791	$1,583.22	$483.80	$316.64
57270	C	Repair of bowel pouch
57280	C	Suspension of vagina
57282	C	Repair of vaginal prolapse
57283	C	Colpopexy, intraperitoneal
57284	T	Repair paravaginal defect	0202	40.3866	$2,396.66	$958.66	$479.33
57287	T	Revise/remove sling repair	0202	40.3866	$2,396.66	$958.66	$479.33
57288	T	Repair bladder defect	0202	40.3866	$2,396.66	$958.66	$479.33
57289	T	Repair bladder vagina	0195	26.6791	$1,583.22	$483.80	$316.64
57291	T	Construction of vagina	0195	26.6791	$1,583.22	$483.80	$316.64
57292	C	Construct vagina with graft
57300	T	Repair rectum-vagina fistula	0195	26.6791	$1,583.22	$483.80	$316.64
57305	C	Repair rectum-vagina fistula
57307	C	Fistula repair colostomy
57308	C	Fistula repair, transperine
57310	T	Repair urethrovaginal lesion	0202	40.3866	$2,396.66	$958.66	$479.33
57311	C	Repair urethrovaginal lesion
57320	T	Repair bladder-vagina lesion	0195	26.6791	$1,583.22	$483.80	$316.64
57330	T	Repair bladder-vagina lesion	0195	26.6791	$1,583.22	$483.80	$316.64
57335	C	Repair vagina
57400	T	Dilation of vagina	0194	20.7525	$1,231.52	$397.84	$246.30
57410	T	Pelvic examination	0193	14.5843	$865.48		$173.10
57415	T	Remove vaginal foreign body	0194	20.7525	$1,231.52	$397.84	$246.30
57420	T	Exam of vagina w/scope	0189	2.371	$140.70		$28.14
57421	T	Exam/biopsy of vag w/scope	0189	2.371	$140.70		$28.14
57425	T	Laparoscopy, surg, colpopexy	0130	31.9271	$1,894.65	$659.53	$378.93
57452	T	Examination of vagina	0189	2.371	$140.70		$28.14
57454	T	Vagina examination biopsy	0189	2.371	$140.70		$28.14
57455	T	Biopsy of cervix w/scope	0189	2.371	$140.70		$28.14
57456	T	Endocerv curettage w/scope	0189	2.371	$140.70		$28.14
57460	T	Cervix excision	0193	14.5843	$865.48		$173.10
57461	T	Conz of cervix w/scope, leep	0194	20.7525	$1,231.52	$397.84	$246.30
57500	T	Biopsy of cervix	0192	4.3082	$255.66		$51.13
57505	T	Endocervical curettage	0189	2.371	$140.70		$28.14
57510	T	Cauterization of cervix	0193	14.5843	$865.48		$173.10
57511	T	Cryocautery of cervix	0189	2.371	$140.70		$28.14
57513	T	Laser surgery of cervix	0193	14.5843	$865.48		$173.10
57520	T	Conization of cervix	0194	20.7525	$1,231.52	$397.84	$246.30
57522	T	Conization of cervix	0195	26.6791	$1,583.22	$483.80	$316.64
57530	T	Removal of cervix	0195	26.6791	$1,583.22	$483.80	$316.64
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	26.6791	$1,583.22	$483.80	$316.64
57555	T	Remove cervix/repair vagina	0195	26.6791	$1,583.22	$483.80	$316.64
57556	T	Remove cervix, repair bowel	0202	40.3866	$2,396.66	$958.66	$479.33
57700	T	Revision of cervix	0194	20.7525	$1,231.52	$397.84	$246.30
57720	T	Revision of cervix	0194	20.7525	$1,231.52	$397.84	$246.30
57800	T	Dilation of cervical canal	0193	14.5843	$865.48		$173.10
57820	T	D c of residual cervix	0196	17.0974	$1,014.61	$338.23	$202.92
58100	T	Biopsy of uterus lining	0188	1.14	$67.65		$13.53
58120	T	Dilation and curettage	0196	17.0974	$1,014.61	$338.23	$202.92
58140	C	Removal of uterus lesion
58145	T	Myomectomy vag method	0195	26.6791	$1,583.22	$483.80	$316.64
58146	C	Myomectomy abdom complex
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	Vag hyst including t/o
58263	C	Vag hyst w/t/o vag repair
58267	C	Vag hyst w/urinary repair
58270	C	Vag hyst w/enterocele repair
58275	C	Hysterectomy/revise vagina
58280	C	Hysterectomy/revise vagina
58285	C	Extensive hysterectomy
58290	C	Vag hyst complex
58291	C	Vag hyst incl t/o, complex
58292	C	Vag hyst t/o repair, compl
58293	C	Vag hyst w/uro repair, compl
58294	C	Vag hyst w/enterocele, compl
58300	E	Insert intrauterine device
58301	T	Remove intrauterine device	0189	2.371	$140.70		$28.14
58321	T	Artificial insemination	0197	2.3572	$139.88		$27.98
58322	T	Artificial insemination	0197	2.3572	$139.88		$27.98
58323	T	Sperm washing	0197	2.3572	$139.88		$27.98
58340	N	Catheter for hysterography
58345	T	Reopen fallopian tube	0193	14.5843	$865.48		$173.10
58346	T	Insert heyman uteri capsule	0193	14.5843	$865.48		$173.10
58350	T	Reopen fallopian tube	0195	26.6791	$1,583.22	$483.80	$316.64
58353	T	Endometr ablate, thermal	0195	26.6791	$1,583.22	$483.80	$316.64
58356	T	Endometrial cryoablation	0202	40.3866	$2,396.66	$958.66	$479.33
58400	C	Suspension of uterus
58410	C	Suspension of uterus
58520	C	Repair of ruptured uterus
58540	C	Revision of uterus
58545	T	Laparoscopic myomectomy	0130	31.9271	$1,894.65	$659.53	$378.93
58546	T	Laparo-myomectomy, complex	0131	43.3389	$2,571.86	$1,001.89	$514.37
58550	T	Laparo-asst vag hysterectomy	0132	62.9914	$3,738.10	$1,239.22	$747.62
58552	T	Laparo-vag hyst incl t/o	0131	43.3389	$2,571.86	$1,001.89	$514.37
58553	T	Laparo-vag hyst, complex	0131	43.3389	$2,571.86	$1,001.89	$514.37
58554	T	Laparo-vag hyst w/t/o, compl	0131	43.3389	$2,571.86	$1,001.89	$514.37
58555	T	Hysteroscopy, dx, sep proc	0190	21.0653	$1,250.08	$424.28	$250.02
58558	T	Hysteroscopy, biopsy	0190	21.0653	$1,250.08	$424.28	$250.02
58559	T	Hysteroscopy, lysis	0190	21.0653	$1,250.08	$424.28	$250.02
58560	T	Hysteroscopy, resect septum	0387	32.5445	$1,931.29	$655.55	$386.26
58561	T	Hysteroscopy, remove myoma	0387	32.5445	$1,931.29	$655.55	$386.26
58562	T	Hysteroscopy, remove fb	0190	21.0653	$1,250.08	$424.28	$250.02
58563	T	Hysteroscopy, ablation	0387	32.5445	$1,931.29	$655.55	$386.26
58565	T	Hysteroscopy, sterilization	0202	40.3866	$2,396.66	$958.66	$479.33
58578	T	Laparo proc, uterus	0130	31.9271	$1,894.65	$659.53	$378.93
58579	T	Hysteroscope procedure	0190	21.0653	$1,250.08	$424.28	$250.02
58600	T	Division of fallopian tube	0195	26.6791	$1,583.22	$483.80	$316.64
58605	C	Division of fallopian tube
58611	C	Ligate oviduct(s) add-on
58615	T	Occlude fallopian tube(s)	0194	20.7525	$1,231.52	$397.84	$246.30
58660	T	Laparoscopy, lysis	0131	43.3389	$2,571.86	$1,001.89	$514.37
58661	T	Laparoscopy, remove adnexa	0131	43.3389	$2,571.86	$1,001.89	$514.37
58662	T	Laparoscopy, excise lesions	0131	43.3389	$2,571.86	$1,001.89	$514.37
58670	T	Laparoscopy, tubal cautery	0131	43.3389	$2,571.86	$1,001.89	$514.37
58671	T	Laparoscopy, tubal block	0131	43.3389	$2,571.86	$1,001.89	$514.37
58672	T	Laparoscopy, fimbrioplasty	0131	43.3389	$2,571.86	$1,001.89	$514.37
58673	T	Laparoscopy, salpingostomy	0131	43.3389	$2,571.86	$1,001.89	$514.37
58679	T	Laparo proc, oviduct-ovary	0130	31.9271	$1,894.65	$659.53	$378.93
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	T	Create new tubal opening	0195	26.6791	$1,583.22	$483.80	$316.64
58800	T	Drainage of ovarian cyst(s)	0193	14.5843	$865.48		$173.10
58805	C	Drainage of ovarian cyst(s)
58820	T	Drain ovary abscess, open	0195	26.6791	$1,583.22	$483.80	$316.64
58822	C	Drain ovary abscess, percut
58823	T	Drain pelvic abscess, percut	0193	14.5843	$865.48		$173.10
58825	C	Transposition, ovary(s)
58900	T	Biopsy of ovary(s)	0193	14.5843	$865.48		$173.10
58920	T	Partial removal of ovary(s)	0195	26.6791	$1,583.22	$483.80	$316.64
58925	T	Removal of ovarian cyst(s)	0195	26.6791	$1,583.22	$483.80	$316.64
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
58953	C	Tah, rad dissect for debulk
58954	C	Tah rad debulk/lymph remove
58956	C	Bso, omentectomy w/tah
58960	C	Exploration of abdomen
58970	T	Retrieval of oocyte	0197	2.3572	$139.88		$27.98
58974	T	Transfer of embryo	0197	2.3572	$139.88		$27.98
58976	T	Transfer of embryo	0197	2.3572	$139.88		$27.98
58999	T	Genital surgery procedure	0191	0.167	$9.91	$2.78	$1.98
59000	T	Amniocentesis, diagnostic	0198	1.3683	$81.20	$32.19	$16.24
59001	T	Amniocentesis, therapeutic	0192	4.3082	$255.66		$51.13
59012	T	Fetal cord puncture,prenatal	0198	1.3683	$81.20	$32.19	$16.24
59015	T	Chorion biopsy	0198	1.3683	$81.20	$32.19	$16.24
59020	T	Fetal contract stress test	0192	4.3082	$255.66		$51.13
59025	T	Fetal non-stress test	0198	1.3683	$81.20	$32.19	$16.24
59030	T	Fetal scalp blood sample	0198	1.3683	$81.20	$32.19	$16.24
59050	E	Fetal monitor w/report
59051	B	Fetal monitor/interpret only
59070	T	Transabdom amnioinfus w/ us	0198	1.3683	$81.20	$32.19	$16.24
59072	T	Umbilical cord occlud w/ us	0198	1.3683	$81.20	$32.19	$16.24
59074	T	Fetal fluid drainage w/ us	0198	1.3683	$81.20	$32.19	$16.24
59076	T	Fetal shunt placement, w/ us	0198	1.3683	$81.20	$32.19	$16.24
59100	T	Remove uterus lesion	0195	26.6791	$1,583.22	$483.80	$316.64
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	43.3389	$2,571.86	$1,001.89	$514.37
59151	T	Treat ectopic pregnancy	0131	43.3389	$2,571.86	$1,001.89	$514.37
59160	T	D c after delivery	0196	17.0974	$1,014.61	$338.23	$202.92
59200	T	Insert cervical dilator	0189	2.371	$140.70		$28.14
59300	T	Episiotomy or vaginal repair	0193	14.5843	$865.48		$173.10
59320	T	Revision of cervix	0194	20.7525	$1,231.52	$397.84	$246.30
59325	C	Revision of cervix
59350	C	Repair of uterus
59400	B	Obstetrical care
59409	T	Obstetrical care	0194	20.7525	$1,231.52	$397.84	$246.30
59410	B	Obstetrical care
59412	T	Antepartum manipulation	0700	5.3614	$318.16		$63.63
59414	T	Deliver placenta	0193	14.5843	$865.48		$173.10
59425	B	Antepartum care only
59426	B	Antepartum care only
59430	B	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	0194	20.7525	$1,231.52	$397.84	$246.30
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	17.6047	$1,044.72	$329.65	$208.94
59820	T	Care of miscarriage	0201	17.6047	$1,044.72	$329.65	$208.94
59821	T	Treatment of miscarriage	0201	17.6047	$1,044.72	$329.65	$208.94
59830	C	Treat uterus infection
59840	T	Abortion	0200	17.8728	$1,060.63	$263.69	$212.13
59841	T	Abortion	0200	17.8728	$1,060.63	$263.69	$212.13
59850	C	Abortion
59851	C	Abortion
59852	C	Abortion
59855	C	Abortion
59856	C	Abortion
59857	C	Abortion
59866	T	Abortion (mpr)	0198	1.3683	$81.20	$32.19	$16.24
59870	T	Evacuate mole of uterus	0201	17.6047	$1,044.72	$329.65	$208.94
59871	T	Remove cerclage suture	0194	20.7525	$1,231.52	$397.84	$246.30
59897	T	Fetal invas px w/ us	0198	1.3683	$81.20	$32.19	$16.24
59898	T	Laparo proc, ob care/deliver	0130	31.9271	$1,894.65	$659.53	$378.93
59899	T	Maternity care procedure	0198	1.3683	$81.20	$32.19	$16.24
60000	T	Drain thyroid/tongue cyst	0252	7.8673	$466.87	$113.41	$93.37
60001	T	Aspirate/inject thyriod cyst	0004	1.7646	$104.72	$22.36	$20.94
60100	T	Biopsy of thyroid	0004	1.7646	$104.72	$22.36	$20.94
60200	T	Remove thyroid lesion	0114	40.7652	$2,419.13	$485.91	$483.83
60210	T	Partial thyroid excision	0114	40.7652	$2,419.13	$485.91	$483.83
60212	T	Partial thyroid excision	0114	40.7652	$2,419.13	$485.91	$483.83
60220	T	Partial removal of thyroid	0114	40.7652	$2,419.13	$485.91	$483.83
60225	T	Partial removal of thyroid	0114	40.7652	$2,419.13	$485.91	$483.83
60240	T	Removal of thyroid	0114	40.7652	$2,419.13	$485.91	$483.83
60252	T	Removal of thyroid	0256	37.3204	$2,214.70		$442.94
60254	C	Extensive thyroid surgery
60260	T	Repeat thyroid surgery	0256	37.3204	$2,214.70		$442.94
60270	C	Removal of thyroid
60271	C	Removal of thyroid
60280	T	Remove thyroid duct lesion	0114	40.7652	$2,419.13	$485.91	$483.83
60281	T	Remove thyroid duct lesion	0114	40.7652	$2,419.13	$485.91	$483.83
60500	T	Explore parathyroid glands	0256	37.3204	$2,214.70		$442.94
60502	C	Re-explore parathyroids
60505	C	Explore parathyroid glands
60512	T	Autotransplant parathyroid	0022	19.6472	$1,165.92	$354.45	$233.18
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	31.9271	$1,894.65	$659.53	$378.93
60699	T	Endocrine surgery procedure	0114	40.7652	$2,419.13	$485.91	$483.83
61000	T	Remove cranial cavity fluid	0212	2.974	$176.49	$70.59	$35.30
61001	T	Remove cranial cavity fluid	0212	2.974	$176.49	$70.59	$35.30
61020	T	Remove brain cavity fluid	0212	2.974	$176.49	$70.59	$35.30
61026	T	Injection into brain canal	0212	2.974	$176.49	$70.59	$35.30
61050	T	Remove brain canal fluid	0212	2.974	$176.49	$70.59	$35.30
61055	T	Injection into brain canal	0212	2.974	$176.49	$70.59	$35.30
61070	T	Brain canal shunt procedure	0212	2.974	$176.49	$70.59	$35.30
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	40.6455	$2,412.03		$482.41
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
61316	C	Implt cran bone flap to abdo
61320	C	Open skull for drainage
61321	C	Open skull for drainage
61322	C	Decompressive craniotomy
61323	C	Decompressive lobectomy
61330	T	Decompress eye socket	0256	37.3204	$2,214.70		$442.94
61332	C	Explore/biopsy eye socket
61333	C	Explore orbit/remove lesion
61334	T	Explore orbit/remove object	0256	37.3204	$2,214.70		$442.94
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
61517	C	Implt brain chemotx add-on
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
61537	C	Removal of brain tissue
61538	C	Removal of brain tissue
61539	C	Removal of brain tissue
61540	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
61566	C	Removal of brain tissue
61567	C	Incision of brain tissue
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
61623	T	Endovasc tempory vessel occl	0081	34.4473	$2,044.21		$408.84
61624	C	Occlusion/embolization cath
61626	T	Transcath occlusion, non-cns	0081	34.4473	$2,044.21		$408.84
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 repr, complx
61698	C	Brain aneurysm repr, complx
61700	C	Brain aneurysm repr, simple
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	17.3586	$1,030.11		$206.02
61791	T	Treat trigeminal tract	0206	5.492	$325.91	$75.55	$65.18
61793	E	Focus radiation beam
61795	S	Brain surgery using computer	0302	4.6145	$273.84	$103.74	$54.77
61850	C	Implant neuroelectrodes
61860	C	Implant neuroelectrodes
61863	C	Implant neuroelectrode
61864	C	Implant neuroelectrde, add'l
61867	C	Implant neuroelectrode
61868	C	Implant neuroelectrde, add'l
61870	C	Implant neuroelectrodes
61875	C	Implant neuroelectrodes
61880	T	Revise/remove neuroelectrode	0687	19.2347	$1,141.44	$456.57	$228.29
61885	S	Implant neurostim one array	0039	181.4	$10,764.82		$2,152.96
61886	T	Implant neurostim arrays	0315	290.647	$17,247.86		$3,449.57
61888	T	Revise/remove neuroreceiver	0688	43.0444	$2,554.38	$1,021.75	$510.88
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
62148	C	Retr bone flap to fix skull
62160	T	Neuroendoscopy add-on	0122	6.9721	$413.75	$84.85	$82.75
62161	C	Dissect brain w/scope
62162	C	Remove colloid cyst w/scope
62163	C	Neuroendoscopy w/fb removal
62164	C	Remove brain tumor w/scope
62165	C	Remove pituit tumor w/scope
62180	C	Establish brain cavity shunt
62190	C	Establish brain cavity shunt
62192	C	Establish brain cavity shunt
62194	T	Replace/irrigate catheter	0427	10.1977	$605.16	$124.11	$121.03
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	0427	10.1977	$605.16	$124.11	$121.03
62230	T	Replace/revise brain shunt	0224	40.6455	$2,412.03		$482.41
62252	S	Csf shunt reprogram	0691	2.5252	$149.85	$59.94	$29.97
62256	C	Remove brain cavity shunt
62258	C	Replace brain cavity shunt
62263	T	Lysis epidural adhesions	0203	10.4015	$617.26	$246.90	$123.45
62264	T	Epidural lysis on single day	0203	10.4015	$617.26	$246.90	$123.45
62268	T	Drain spinal cord cyst	0212	2.974	$176.49	$70.59	$35.30
62269	T	Needle biopsy, spinal cord	0685	6.0174	$357.09	$115.47	$71.42
62270	T	Spinal fluid tap, diagnostic	0204	2.191	$130.02	$40.13	$26.00
62272	T	Drain cerebro spinal fluid	0204	2.191	$130.02	$40.13	$26.00
62273	T	Treat epidural spine lesion	0206	5.492	$325.91	$75.55	$65.18
62280	T	Treat spinal cord lesion	0207	6.0109	$356.70	$86.92	$71.34
62281	T	Treat spinal cord lesion	0207	6.0109	$356.70	$86.92	$71.34
62282	T	Treat spinal canal lesion	0207	6.0109	$356.70	$86.92	$71.34
62284	N	Injection for myelogram
62287	T	Percutaneous diskectomy	0221	29.9209	$1,775.60	$463.62	$355.12
62290	N	Inject for spine disk x-ray
62291	N	Inject for spine disk x-ray
62292	T	Injection into disk lesion	0212	2.974	$176.49	$70.59	$35.30
62294	T	Injection into spinal artery	0212	2.974	$176.49	$70.59	$35.30
62310	T	Inject spine c/t	0207	6.0109	$356.70	$86.92	$71.34
62311	T	Inject spine l/s (cd)	0207	6.0109	$356.70	$86.92	$71.34
62318	T	Inject spine w/cath, c/t	0207	6.0109	$356.70	$86.92	$71.34
62319	T	Inject spine w/cath l/s (cd)	0207	6.0109	$356.70	$86.92	$71.34
62350	T	Implant spinal canal cath	0223	28.123	$1,668.90		$333.78
62351	T	Implant spinal canal cath	0208	42.3409	$2,512.64		$502.53
62355	T	Remove spinal canal catheter	0203	10.4015	$617.26	$246.90	$123.45
62360	T	Insert spine infusion device	0226	138.8695	$8,240.93		$1,648.19
62361	T	Implant spine infusion pump	0227	136.4922	$8,099.86		$1,619.97
62362	T	Implant spine infusion pump	0227	136.4922	$8,099.86		$1,619.97
62365	T	Remove spine infusion device	0221	29.9209	$1,775.60	$463.62	$355.12
62367	S	Analyze spine infusion pump	0691	2.5252	$149.85	$59.94	$29.97
62368	S	Analyze spine infusion pump	0691	2.5252	$149.85	$59.94	$29.97
63001	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63003	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63005	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63011	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63012	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63015	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63016	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63017	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63020	T	Neck spine disk surgery	0208	42.3409	$2,512.64		$502.53
63030	T	Low back disk surgery	0208	42.3409	$2,512.64		$502.53
63035	T	Spinal disk surgery add-on	0208	42.3409	$2,512.64		$502.53
63040	T	Laminotomy, single cervical	0208	42.3409	$2,512.64		$502.53
63042	T	Laminotomy, single lumbar	0208	42.3409	$2,512.64		$502.53
63043	C	Laminotomy, add'l cervical
63044	C	Laminotomy, add'l lumbar
63045	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63046	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63047	T	Removal of spinal lamina	0208	42.3409	$2,512.64		$502.53
63048	T	Remove spinal lamina add-on	0208	42.3409	$2,512.64		$502.53
63050	C	Cervical laminoplasty
63051	C	C-laminoplasty w/graft/plate
63055	T	Decompress spinal cord	0208	42.3409	$2,512.64		$502.53
63056	T	Decompress spinal cord	0208	42.3409	$2,512.64		$502.53
63057	T	Decompress spine cord add-on	0208	42.3409	$2,512.64		$502.53
63064	T	Decompress spinal cord	0208	42.3409	$2,512.64		$502.53
63066	T	Decompress spine cord add-on	0208	42.3409	$2,512.64		$502.53
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
63101	C	Removal of vertebral body
63102	C	Removal of vertebral body
63103	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
63295	C	Repair of laminectomy defect
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	17.3586	$1,030.11		$206.02
63610	T	Stimulation of spinal cord	0220	17.3586	$1,030.11		$206.02
63615	T	Remove lesion of spinal cord	0220	17.3586	$1,030.11		$206.02
63650	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
63655	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
63660	T	Revise/remove neuroelectrode	0687	19.2347	$1,141.44	$456.57	$228.29
63685	T	Implant neuroreceiver	0222	179.0982	$10,628.22		$2,125.64
63688	T	Revise/remove neuroreceiver	0688	43.0444	$2,554.38	$1,021.75	$510.88
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	51.7258	$3,069.56		$613.91
63744	T	Revision of spinal shunt	0228	51.7258	$3,069.56		$613.91
63746	T	Removal of spinal shunt	0109	11.0433	$655.34	$131.49	$131.07
64400	T	N block inj, trigeminal	0204	2.191	$130.02	$40.13	$26.00
64402	T	N block inj, facial	0204	2.191	$130.02	$40.13	$26.00
64405	T	N block inj, occipital	0204	2.191	$130.02	$40.13	$26.00
64408	T	N block inj, vagus	0204	2.191	$130.02	$40.13	$26.00
64410	T	N block inj, phrenic	0206	5.492	$325.91	$75.55	$65.18
64412	T	N block inj, spinal accessor	0206	5.492	$325.91	$75.55	$65.18
64413	T	N block inj, cervical plexus	0204	2.191	$130.02	$40.13	$26.00
64415	T	Injection for nerve block	0204	2.191	$130.02	$40.13	$26.00
64416	T	N block cont infuse, b plex	0204	2.191	$130.02	$40.13	$26.00
64417	T	N block inj, axillary	0204	2.191	$130.02	$40.13	$26.00
64418	T	N block inj, suprascapular	0204	2.191	$130.02	$40.13	$26.00
64420	T	N block inj, intercost, sng	0204	2.191	$130.02	$40.13	$26.00
64421	T	N block inj, intercost, mlt	0206	5.492	$325.91	$75.55	$65.18
64425	T	N block inj ilio-ing/hypogi	0204	2.191	$130.02	$40.13	$26.00
64430	T	N block inj, pudendal	0204	2.191	$130.02	$40.13	$26.00
64435	T	N block inj, paracervical	0204	2.191	$130.02	$40.13	$26.00
64445	T	Injection for nerve block	0204	2.191	$130.02	$40.13	$26.00
64446	T	N blk inj, sciatic, cont inf	0206	5.492	$325.91	$75.55	$65.18
64447	T	N block inj fem, single	0204	2.191	$130.02	$40.13	$26.00
64448	T	N block inj fem, cont inf	0204	2.191	$130.02	$40.13	$26.00
64449	T	N block inj, lumbar plexus	0204	2.191	$130.02	$40.13	$26.00
64450	T	N block, other peripheral	0204	2.191	$130.02	$40.13	$26.00
64470	T	Inj paravertebral c/t	0207	6.0109	$356.70	$86.92	$71.34
64472	T	Inj paravertebral c/t add-on	0206	5.492	$325.91	$75.55	$65.18
64475	T	Inj paravertebral l/s	0207	6.0109	$356.70	$86.92	$71.34
64476	T	Inj paravertebral l/s add-on	0206	5.492	$325.91	$75.55	$65.18
64479	T	Inj foramen epidural c/t	0207	6.0109	$356.70	$86.92	$71.34
64480	T	Inj foramen epidural add-on	0207	6.0109	$356.70	$86.92	$71.34
64483	T	Inj foramen epidural l/s	0207	6.0109	$356.70	$86.92	$71.34
64484	T	Inj foramen epidural add-on	0207	6.0109	$356.70	$86.92	$71.34
64505	T	N block, spenopalatine gangl	0204	2.191	$130.02	$40.13	$26.00
64508	T	N block, carotid sinus s/p	0204	2.191	$130.02	$40.13	$26.00
64510	T	N block, stellate ganglion	0207	6.0109	$356.70	$86.92	$71.34
64517	T	N block inj, hypogas plxs	0204	2.191	$130.02	$40.13	$26.00
64520	T	N block, lumbar/thoracic	0207	6.0109	$356.70	$86.92	$71.34
64530	T	N block inj, celiac pelus	0207	6.0109	$356.70	$86.92	$71.34
64550	A	Apply neurostimulator
64553	S	Implant neuroelectrodes	0225	234.6925	$13,927.36		$2,785.47
64555	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
64560	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
64561	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
64565	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
64573	S	Implant neuroelectrodes	0225	234.6925	$13,927.36		$2,785.47
64575	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
64577	S	Implant neuroelectrodes	0225	234.6925	$13,927.36		$2,785.47
64580	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
64581	S	Implant neuroelectrodes	0040	55.3297	$3,283.43		$656.69
64585	T	Revise/remove neuroelectrode	0687	19.2347	$1,141.44	$456.57	$228.29
64590	T	Implant neuroreceiver	0222	179.0982	$10,628.22		$2,125.64
64595	T	Revise/remove neuroreceiver	0688	43.0444	$2,554.38	$1,021.75	$510.88
64600	T	Injection treatment of nerve	0203	10.4015	$617.26	$246.90	$123.45
64605	T	Injection treatment of nerve	0203	10.4015	$617.26	$246.90	$123.45
64610	T	Injection treatment of nerve	0203	10.4015	$617.26	$246.90	$123.45
64612	T	Destroy nerve, face muscle	0204	2.191	$130.02	$40.13	$26.00
64613	T	Destroy nerve, spine muscle	0204	2.191	$130.02	$40.13	$26.00
64614	T	Destroy nerve, extrem musc	0204	2.191	$130.02	$40.13	$26.00
64620	T	Injection treatment of nerve	0203	10.4015	$617.26	$246.90	$123.45
64622	T	Destr paravertebrl nerve l/s	0203	10.4015	$617.26	$246.90	$123.45
64623	T	Destr paravertebral n add-on	0207	6.0109	$356.70	$86.92	$71.34
64626	T	Destr paravertebrl nerve c/t	0203	10.4015	$617.26	$246.90	$123.45
64627	T	Destr paravertebral n add-on	0207	6.0109	$356.70	$86.92	$71.34
64630	T	Injection treatment of nerve	0206	5.492	$325.91	$75.55	$65.18
64640	T	Injection treatment of nerve	0206	5.492	$325.91	$75.55	$65.18
64680	T	Injection treatment of nerve	0207	6.0109	$356.70	$86.92	$71.34
64681	T	Injection treatment of nerve	0203	10.4015	$617.26	$246.90	$123.45
64702	T	Revise finger/toe nerve	0220	17.3586	$1,030.11		$206.02
64704	T	Revise hand/foot nerve	0220	17.3586	$1,030.11		$206.02
64708	T	Revise arm/leg nerve	0220	17.3586	$1,030.11		$206.02
64712	T	Revision of sciatic nerve	0220	17.3586	$1,030.11		$206.02
64713	T	Revision of arm nerve(s)	0220	17.3586	$1,030.11		$206.02
64714	T	Revise low back nerve(s)	0220	17.3586	$1,030.11		$206.02
64716	T	Revision of cranial nerve	0220	17.3586	$1,030.11		$206.02
64718	T	Revise ulnar nerve at elbow	0220	17.3586	$1,030.11		$206.02
64719	T	Revise ulnar nerve at wrist	0220	17.3586	$1,030.11		$206.02
64721	T	Carpal tunnel surgery	0220	17.3586	$1,030.11		$206.02
64722	T	Relieve pressure on nerve(s)	0220	17.3586	$1,030.11		$206.02
64726	T	Release foot/toe nerve	0220	17.3586	$1,030.11		$206.02
64727	T	Internal nerve revision	0220	17.3586	$1,030.11		$206.02
64732	T	Incision of brow nerve	0220	17.3586	$1,030.11		$206.02
64734	T	Incision of cheek nerve	0220	17.3586	$1,030.11		$206.02
64736	T	Incision of chin nerve	0220	17.3586	$1,030.11		$206.02
64738	T	Incision of jaw nerve	0220	17.3586	$1,030.11		$206.02
64740	T	Incision of tongue nerve	0220	17.3586	$1,030.11		$206.02
64742	T	Incision of facial nerve	0220	17.3586	$1,030.11		$206.02
64744	T	Incise nerve, back of head	0220	17.3586	$1,030.11		$206.02
64746	T	Incise diaphragm nerve	0220	17.3586	$1,030.11		$206.02
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	17.3586	$1,030.11		$206.02
64763	T	Incise hip/thigh nerve	0220	17.3586	$1,030.11		$206.02
64766	T	Incise hip/thigh nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64771	T	Sever cranial nerve	0220	17.3586	$1,030.11		$206.02
64772	T	Incision of spinal nerve	0220	17.3586	$1,030.11		$206.02
64774	T	Remove skin nerve lesion	0220	17.3586	$1,030.11		$206.02
64776	T	Remove digit nerve lesion	0220	17.3586	$1,030.11		$206.02
64778	T	Digit nerve surgery add-on	0220	17.3586	$1,030.11		$206.02
64782	T	Remove limb nerve lesion	0220	17.3586	$1,030.11		$206.02
64783	T	Limb nerve surgery add-on	0220	17.3586	$1,030.11		$206.02
64784	T	Remove nerve lesion	0220	17.3586	$1,030.11		$206.02
64786	T	Remove sciatic nerve lesion	0221	29.9209	$1,775.60	$463.62	$355.12
64787	T	Implant nerve end	0220	17.3586	$1,030.11		$206.02
64788	T	Remove skin nerve lesion	0220	17.3586	$1,030.11		$206.02
64790	T	Removal of nerve lesion	0220	17.3586	$1,030.11		$206.02
64792	T	Removal of nerve lesion	0221	29.9209	$1,775.60	$463.62	$355.12
64795	T	Biopsy of nerve	0220	17.3586	$1,030.11		$206.02
64802	T	Remove sympathetic nerves	0220	17.3586	$1,030.11		$206.02
64804	C	Remove sympathetic nerves
64809	C	Remove sympathetic nerves
64818	C	Remove sympathetic nerves
64820	T	Remove sympathetic nerves	0220	17.3586	$1,030.11		$206.02
64821	T	Remove sympathetic nerves	0054	25.3711	$1,505.60		$301.12
64822	T	Remove sympathetic nerves	0054	25.3711	$1,505.60		$301.12
64823	T	Remove sympathetic nerves	0054	25.3711	$1,505.60		$301.12
64831	T	Repair of digit nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64832	T	Repair nerve add-on	0221	29.9209	$1,775.60	$463.62	$355.12
64834	T	Repair of hand or foot nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64835	T	Repair of hand or foot nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64836	T	Repair of hand or foot nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64837	T	Repair nerve add-on	0221	29.9209	$1,775.60	$463.62	$355.12
64840	T	Repair of leg nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64856	T	Repair/transpose nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64857	T	Repair arm/leg nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64858	T	Repair sciatic nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64859	T	Nerve surgery	0221	29.9209	$1,775.60	$463.62	$355.12
64861	T	Repair of arm nerves	0221	29.9209	$1,775.60	$463.62	$355.12
64862	T	Repair of low back nerves	0221	29.9209	$1,775.60	$463.62	$355.12
64864	T	Repair of facial nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64865	T	Repair of facial nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64866	C	Fusion of facial/other nerve
64868	C	Fusion of facial/other nerve
64870	T	Fusion of facial/other nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64872	T	Subsequent repair of nerve	0221	29.9209	$1,775.60	$463.62	$355.12
64874	T	Repair revise nerve add-on	0221	29.9209	$1,775.60	$463.62	$355.12
64876	T	Repair nerve/shorten bone	0221	29.9209	$1,775.60	$463.62	$355.12
64885	T	Nerve graft, head or neck	0221	29.9209	$1,775.60	$463.62	$355.12
64886	T	Nerve graft, head or neck	0221	29.9209	$1,775.60	$463.62	$355.12
64890	T	Nerve graft, hand or foot	0221	29.9209	$1,775.60	$463.62	$355.12
64891	T	Nerve graft, hand or foot	0221	29.9209	$1,775.60	$463.62	$355.12
64892	T	Nerve graft, arm or leg	0221	29.9209	$1,775.60	$463.62	$355.12
64893	T	Nerve graft, arm or leg	0221	29.9209	$1,775.60	$463.62	$355.12
64895	T	Nerve graft, hand or foot	0221	29.9209	$1,775.60	$463.62	$355.12
64896	T	Nerve graft, hand or foot	0221	29.9209	$1,775.60	$463.62	$355.12
64897	T	Nerve graft, arm or leg	0221	29.9209	$1,775.60	$463.62	$355.12
64898	T	Nerve graft, arm or leg	0221	29.9209	$1,775.60	$463.62	$355.12
64901	T	Nerve graft add-on	0221	29.9209	$1,775.60	$463.62	$355.12
64902	T	Nerve graft add-on	0221	29.9209	$1,775.60	$463.62	$355.12
64905	T	Nerve pedicle transfer	0221	29.9209	$1,775.60	$463.62	$355.12
64907	T	Nerve pedicle transfer	0221	29.9209	$1,775.60	$463.62	$355.12
64999	T	Nervous system surgery	0204	2.191	$130.02	$40.13	$26.00
65091	T	Revise eye	0242	30.5464	$1,812.72	$597.36	$362.54
65093	T	Revise eye with implant	0241	23.3036	$1,382.91	$384.47	$276.58
65101	T	Removal of eye	0242	30.5464	$1,812.72	$597.36	$362.54
65103	T	Remove eye/insert implant	0242	30.5464	$1,812.72	$597.36	$362.54
65105	T	Remove eye/attach implant	0242	30.5464	$1,812.72	$597.36	$362.54
65110	T	Removal of eye	0242	30.5464	$1,812.72	$597.36	$362.54
65112	T	Remove eye/revise socket	0242	30.5464	$1,812.72	$597.36	$362.54
65114	T	Remove eye/revise socket	0242	30.5464	$1,812.72	$597.36	$362.54
65125	T	Revise ocular implant	0240	18.1508	$1,077.12	$315.31	$215.42
65130	T	Insert ocular implant	0241	23.3036	$1,382.91	$384.47	$276.58
65135	T	Insert ocular implant	0241	23.3036	$1,382.91	$384.47	$276.58
65140	T	Attach ocular implant	0242	30.5464	$1,812.72	$597.36	$362.54
65150	T	Revise ocular implant	0241	23.3036	$1,382.91	$384.47	$276.58
65155	T	Reinsert ocular implant	0242	30.5464	$1,812.72	$597.36	$362.54
65175	T	Removal of ocular implant	0240	18.1508	$1,077.12	$315.31	$215.42
65205	S	Remove foreign body from eye	0698	1.2438	$73.81	$16.55	$14.76
65210	S	Remove foreign body from eye	0698	1.2438	$73.81	$16.55	$14.76
65220	S	Remove foreign body from eye	0698	1.2438	$73.81	$16.55	$14.76
65222	S	Remove foreign body from eye	0698	1.2438	$73.81	$16.55	$14.76
65235	T	Remove foreign body from eye	0233	14.9673	$888.20	$266.33	$177.64
65260	T	Remove foreign body from eye	0236	17.0229	$1,010.19		$202.04
65265	T	Remove foreign body from eye	0237	28.9401	$1,717.39		$343.48
65270	T	Repair of eye wound	0240	18.1508	$1,077.12	$315.31	$215.42
65272	T	Repair of eye wound	0234	21.9741	$1,304.01	$511.31	$260.80
65273	C	Repair of eye wound
65275	T	Repair of eye wound	0234	21.9741	$1,304.01	$511.31	$260.80
65280	T	Repair of eye wound	0236	17.0229	$1,010.19		$202.04
65285	T	Repair of eye wound	0672	36.9284	$2,191.44		$438.29
65286	T	Repair of eye wound	0232	6.6732	$396.01	$103.17	$79.20
65290	T	Repair of eye socket wound	0243	22.1671	$1,315.46	$431.39	$263.09
65400	T	Removal of eye lesion	0233	14.9673	$888.20	$266.33	$177.64
65410	T	Biopsy of cornea	0233	14.9673	$888.20	$266.33	$177.64
65420	T	Removal of eye lesion	0233	14.9673	$888.20	$266.33	$177.64
65426	T	Removal of eye lesion	0234	21.9741	$1,304.01	$511.31	$260.80
65430	S	Corneal smear	0698	1.2438	$73.81	$16.55	$14.76
65435	T	Curette/treat cornea	0239	6.9097	$410.04		$82.01
65436	T	Curette/treat cornea	0233	14.9673	$888.20	$266.33	$177.64
65450	S	Treatment of corneal lesion	0231	1.9278	$114.40	$44.61	$22.88
65600	T	Revision of cornea	0240	18.1508	$1,077.12	$315.31	$215.42
65710	T	Corneal transplant	0244	38.3723	$2,277.13	$803.26	$455.43
65730	T	Corneal transplant	0244	38.3723	$2,277.13	$803.26	$455.43
65750	T	Corneal transplant	0244	38.3723	$2,277.13	$803.26	$455.43
65755	T	Corneal transplant	0244	38.3723	$2,277.13	$803.26	$455.43
65760	E	Revision of cornea
65765	E	Revision of cornea
65767	E	Corneal tissue transplant
65770	T	Revise cornea with implant	0244	38.3723	$2,277.13	$803.26	$455.43
65771	E	Radial keratotomy
65772	T	Correction of astigmatism	0233	14.9673	$888.20	$266.33	$177.64
65775	T	Correction of astigmatism	0233	14.9673	$888.20	$266.33	$177.64
65780	T	Ocular reconst, transplant	0244	38.3723	$2,277.13	$803.26	$455.43
65781	T	Ocular reconst, transplant	0244	38.3723	$2,277.13	$803.26	$455.43
65782	T	Ocular reconst, transplant	0244	38.3723	$2,277.13	$803.26	$455.43
65800	T	Drainage of eye	0233	14.9673	$888.20	$266.33	$177.64
65805	T	Drainage of eye	0233	14.9673	$888.20	$266.33	$177.64
65810	T	Drainage of eye	0234	21.9741	$1,304.01	$511.31	$260.80
65815	T	Drainage of eye	0234	21.9741	$1,304.01	$511.31	$260.80
65820	T	Relieve inner eye pressure	0232	6.6732	$396.01	$103.17	$79.20
65850	T	Incision of eye	0234	21.9741	$1,304.01	$511.31	$260.80
65855	T	Laser surgery of eye	0247	5.033	$298.67	$104.31	$59.73
65860	T	Incise inner eye adhesions	0247	5.033	$298.67	$104.31	$59.73
65865	T	Incise inner eye adhesions	0233	14.9673	$888.20	$266.33	$177.64
65870	T	Incise inner eye adhesions	0234	21.9741	$1,304.01	$511.31	$260.80
65875	T	Incise inner eye adhesions	0234	21.9741	$1,304.01	$511.31	$260.80
65880	T	Incise inner eye adhesions	0233	14.9673	$888.20	$266.33	$177.64
65900	T	Remove eye lesion	0233	14.9673	$888.20	$266.33	$177.64
65920	T	Remove implant of eye	0234	21.9741	$1,304.01	$511.31	$260.80
65930	T	Remove blood clot from eye	0234	21.9741	$1,304.01	$511.31	$260.80
66020	T	Injection treatment of eye	0233	14.9673	$888.20	$266.33	$177.64
66030	T	Injection treatment of eye	0232	6.6732	$396.01	$103.17	$79.20
66130	T	Remove eye lesion	0234	21.9741	$1,304.01	$511.31	$260.80
66150	T	Glaucoma surgery	0234	21.9741	$1,304.01	$511.31	$260.80
66155	T	Glaucoma surgery	0234	21.9741	$1,304.01	$511.31	$260.80
66160	T	Glaucoma surgery	0234	21.9741	$1,304.01	$511.31	$260.80
66165	T	Glaucoma surgery	0234	21.9741	$1,304.01	$511.31	$260.80
66170	T	Glaucoma surgery	0234	21.9741	$1,304.01	$511.31	$260.80
66172	T	Incision of eye	0673	29.2582	$1,736.27	$649.56	$347.25
66180	T	Implant eye shunt	0673	29.2582	$1,736.27	$649.56	$347.25
66185	T	Revise eye shunt	0673	29.2582	$1,736.27	$649.56	$347.25
66220	T	Repair eye lesion	0672	36.9284	$2,191.44		$438.29
66225	T	Repair/graft eye lesion	0673	29.2582	$1,736.27	$649.56	$347.25
66250	T	Follow-up surgery of eye	0233	14.9673	$888.20	$266.33	$177.64
66500	T	Incision of iris	0232	6.6732	$396.01	$103.17	$79.20
66505	T	Incision of iris	0232	6.6732	$396.01	$103.17	$79.20
66600	T	Remove iris and lesion	0234	21.9741	$1,304.01	$511.31	$260.80
66605	T	Removal of iris	0234	21.9741	$1,304.01	$511.31	$260.80
66625	T	Removal of iris	0232	6.6732	$396.01	$103.17	$79.20
66630	T	Removal of iris	0234	21.9741	$1,304.01	$511.31	$260.80
66635	T	Removal of iris	0234	21.9741	$1,304.01	$511.31	$260.80
66680	T	Repair iris ciliary body	0234	21.9741	$1,304.01	$511.31	$260.80
66682	T	Repair iris ciliary body	0234	21.9741	$1,304.01	$511.31	$260.80
66700	T	Destruction, ciliary body	0233	14.9673	$888.20	$266.33	$177.64
66710	T	Destruction, ciliary body	0233	14.9673	$888.20	$266.33	$177.64
66711	T	Ciliary endoscopic ablation	0233	14.9673	$888.20	$266.33	$177.64
66720	T	Destruction, ciliary body	0233	14.9673	$888.20	$266.33	$177.64
66740	T	Destruction, ciliary body	0234	21.9741	$1,304.01	$511.31	$260.80
66761	T	Revision of iris	0247	5.033	$298.67	$104.31	$59.73
66762	T	Revision of iris	0247	5.033	$298.67	$104.31	$59.73
66770	T	Removal of inner eye lesion	0247	5.033	$298.67	$104.31	$59.73
66820	T	Incision, secondary cataract	0232	6.6732	$396.01	$103.17	$79.20
66821	T	After cataract laser surgery	0247	5.033	$298.67	$104.31	$59.73
66825	T	Reposition intraocular lens	0234	21.9741	$1,304.01	$511.31	$260.80
66830	T	Removal of lens lesion	0232	6.6732	$396.01	$103.17	$79.20
66840	T	Removal of lens material	0245	13.3625	$792.97	$221.89	$158.59
66850	T	Removal of lens material	0249	27.9369	$1,657.86	$524.67	$331.57
66852	T	Removal of lens material	0249	27.9369	$1,657.86	$524.67	$331.57
66920	T	Extraction of lens	0249	27.9369	$1,657.86	$524.67	$331.57
66930	T	Extraction of lens	0249	27.9369	$1,657.86	$524.67	$331.57
66940	T	Extraction of lens	0245	13.3625	$792.97	$221.89	$158.59
66982	T	Cataract surgery, complex	0246	23.4597	$1,392.17	$495.96	$278.43
66983	T	Cataract surg w/iol, 1 stage	0246	23.4597	$1,392.17	$495.96	$278.43
66984	T	Cataract surg w/iol, 1 stage	0246	23.4597	$1,392.17	$495.96	$278.43
66985	T	Insert lens prosthesis	0246	23.4597	$1,392.17	$495.96	$278.43
66986	T	Exchange lens prosthesis	0246	23.4597	$1,392.17	$495.96	$278.43
66990	N	Ophthalmic endoscope add-on
66999	T	Eye surgery procedure	0232	6.6732	$396.01	$103.17	$79.20
67005	T	Partial removal of eye fluid	0237	28.9401	$1,717.39		$343.48
67010	T	Partial removal of eye fluid	0237	28.9401	$1,717.39		$343.48
67015	T	Release of eye fluid	0237	28.9401	$1,717.39		$343.48
67025	T	Replace eye fluid	0237	28.9401	$1,717.39		$343.48
67027	T	Implant eye drug system	0672	36.9284	$2,191.44		$438.29
67028	T	Injection eye drug	0235	4.6593	$276.50	$67.40	$55.30
67030	T	Incise inner eye strands	0236	17.0229	$1,010.19		$202.04
67031	T	Laser surgery, eye strands	0247	5.033	$298.67	$104.31	$59.73
67036	T	Removal of inner eye fluid	0672	36.9284	$2,191.44		$438.29
67038	T	Strip retinal membrane	0672	36.9284	$2,191.44		$438.29
67039	T	Laser treatment of retina	0672	36.9284	$2,191.44		$438.29
67040	T	Laser treatment of retina	0672	36.9284	$2,191.44		$438.29
67101	T	Repair detached retina	0236	17.0229	$1,010.19		$202.04
67105	T	Repair detached retina	0248	4.6769	$277.54	$93.98	$55.51
67107	T	Repair detached retina	0672	36.9284	$2,191.44		$438.29
67108	T	Repair detached retina	0672	36.9284	$2,191.44		$438.29
67110	T	Repair detached retina	0236	17.0229	$1,010.19		$202.04
67112	T	Rerepair detached retina	0672	36.9284	$2,191.44		$438.29
67115	T	Release encircling material	0236	17.0229	$1,010.19		$202.04
67120	T	Remove eye implant material	0236	17.0229	$1,010.19		$202.04
67121	T	Remove eye implant material	0237	28.9401	$1,717.39		$343.48
67141	T	Treatment of retina	0235	4.6593	$276.50	$67.40	$55.30
67145	T	Treatment of retina	0248	4.6769	$277.54	$93.98	$55.51
67208	T	Treatment of retinal lesion	0236	17.0229	$1,010.19		$202.04
67210	T	Treatment of retinal lesion	0248	4.6769	$277.54	$93.98	$55.51
67218	T	Treatment of retinal lesion	0236	17.0229	$1,010.19		$202.04
67220	T	Treatment of choroid lesion	0235	4.6593	$276.50	$67.40	$55.30
67221	T	Ocular photodynamic ther	0235	4.6593	$276.50	$67.40	$55.30
67225	T	Eye photodynamic ther add-on	0235	4.6593	$276.50	$67.40	$55.30
67227	T	Treatment of retinal lesion	0236	17.0229	$1,010.19		$202.04
67228	T	Treatment of retinal lesion	0248	4.6769	$277.54	$93.98	$55.51
67250	T	Reinforce eye wall	0240	18.1508	$1,077.12	$315.31	$215.42
67255	T	Reinforce/graft eye wall	0237	28.9401	$1,717.39		$343.48
67299	T	Eye surgery procedure	0235	4.6593	$276.50	$67.40	$55.30
67311	T	Revise eye muscle	0243	22.1671	$1,315.46	$431.39	$263.09
67312	T	Revise two eye muscles	0243	22.1671	$1,315.46	$431.39	$263.09
67314	T	Revise eye muscle	0243	22.1671	$1,315.46	$431.39	$263.09
67316	T	Revise two eye muscles	0243	22.1671	$1,315.46	$431.39	$263.09
67318	T	Revise eye muscle(s)	0243	22.1671	$1,315.46	$431.39	$263.09
67320	T	Revise eye muscle(s) add-on	0243	22.1671	$1,315.46	$431.39	$263.09
67331	T	Eye surgery follow-up add-on	0243	22.1671	$1,315.46	$431.39	$263.09
67332	T	Rerevise eye muscles add-on	0243	22.1671	$1,315.46	$431.39	$263.09
67334	T	Revise eye muscle w/suture	0243	22.1671	$1,315.46	$431.39	$263.09
67335	T	Eye suture during surgery	0243	22.1671	$1,315.46	$431.39	$263.09
67340	T	Revise eye muscle add-on	0243	22.1671	$1,315.46	$431.39	$263.09
67343	T	Release eye tissue	0243	22.1671	$1,315.46	$431.39	$263.09
67345	T	Destroy nerve of eye muscle	0238	2.5933	$153.89		$30.78
67350	T	Biopsy eye muscle	0699	10.0177	$594.48		$118.90
67399	T	Eye muscle surgery procedure	0243	22.1671	$1,315.46	$431.39	$263.09
67400	T	Explore/biopsy eye socket	0241	23.3036	$1,382.91	$384.47	$276.58
67405	T	Explore/drain eye socket	0241	23.3036	$1,382.91	$384.47	$276.58
67412	T	Explore/treat eye socket	0241	23.3036	$1,382.91	$384.47	$276.58
67413	T	Explore/treat eye socket	0241	23.3036	$1,382.91	$384.47	$276.58
67414	T	Explr/decompress eye socket	0242	30.5464	$1,812.72	$597.36	$362.54
67415	T	Aspiration, orbital contents	0240	18.1508	$1,077.12	$315.31	$215.42
67420	T	Explore/treat eye socket	0242	30.5464	$1,812.72	$597.36	$362.54
67430	T	Explore/treat eye socket	0242	30.5464	$1,812.72	$597.36	$362.54
67440	T	Explore/drain eye socket	0242	30.5464	$1,812.72	$597.36	$362.54
67445	T	Explr/decompress eye socket	0242	30.5464	$1,812.72	$597.36	$362.54
67450	T	Explore/biopsy eye socket	0242	30.5464	$1,812.72	$597.36	$362.54
67500	S	Inject/treat eye socket	0231	1.9278	$114.40	$44.61	$22.88
67505	T	Inject/treat eye socket	0238	2.5933	$153.89		$30.78
67515	T	Inject/treat eye socket	0238	2.5933	$153.89		$30.78
67550	T	Insert eye socket implant	0242	30.5464	$1,812.72	$597.36	$362.54
67560	T	Revise eye socket implant	0241	23.3036	$1,382.91	$384.47	$276.58
67570	T	Decompress optic nerve	0242	30.5464	$1,812.72	$597.36	$362.54
67599	T	Orbit surgery procedure	0238	2.5933	$153.89		$30.78
67700	T	Drainage of eyelid abscess	0238	2.5933	$153.89		$30.78
67710	T	Incision of eyelid	0239	6.9097	$410.04		$82.01
67715	T	Incision of eyelid fold	0240	18.1508	$1,077.12	$315.31	$215.42
67800	T	Remove eyelid lesion	0238	2.5933	$153.89		$30.78
67801	T	Remove eyelid lesions	0239	6.9097	$410.04		$82.01
67805	T	Remove eyelid lesions	0238	2.5933	$153.89		$30.78
67808	T	Remove eyelid lesion(s)	0240	18.1508	$1,077.12	$315.31	$215.42
67810	T	Biopsy of eyelid	0238	2.5933	$153.89		$30.78
67820	S	Revise eyelashes	0698	1.2438	$73.81	$16.55	$14.76
67825	T	Revise eyelashes	0238	2.5933	$153.89		$30.78
67830	T	Revise eyelashes	0239	6.9097	$410.04		$82.01
67835	T	Revise eyelashes	0240	18.1508	$1,077.12	$315.31	$215.42
67840	T	Remove eyelid lesion	0239	6.9097	$410.04		$82.01
67850	T	Treat eyelid lesion	0239	6.9097	$410.04		$82.01
67875	T	Closure of eyelid by suture	0239	6.9097	$410.04		$82.01
67880	T	Revision of eyelid	0233	14.9673	$888.20	$266.33	$177.64
67882	T	Revision of eyelid	0240	18.1508	$1,077.12	$315.31	$215.42
67900	T	Repair brow defect	0240	18.1508	$1,077.12	$315.31	$215.42
67901	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67902	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67903	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67904	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67906	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67908	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67909	T	Revise eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67911	T	Revise eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67912	T	Correction eyelid w/ implant	0240	18.1508	$1,077.12	$315.31	$215.42
67914	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67915	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67916	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67917	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67921	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67922	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67923	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67924	T	Repair eyelid defect	0240	18.1508	$1,077.12	$315.31	$215.42
67930	T	Repair eyelid wound	0240	18.1508	$1,077.12	$315.31	$215.42
67935	T	Repair eyelid wound	0240	18.1508	$1,077.12	$315.31	$215.42
67938	S	Remove eyelid foreign body	0698	1.2438	$73.81	$16.55	$14.76
67950	T	Revision of eyelid	0240	18.1508	$1,077.12	$315.31	$215.42
67961	T	Revision of eyelid	0240	18.1508	$1,077.12	$315.31	$215.42
67966	T	Revision of eyelid	0240	18.1508	$1,077.12	$315.31	$215.42
67971	T	Reconstruction of eyelid	0241	23.3036	$1,382.91	$384.47	$276.58
67973	T	Reconstruction of eyelid	0241	23.3036	$1,382.91	$384.47	$276.58
67974	T	Reconstruction of eyelid	0241	23.3036	$1,382.91	$384.47	$276.58
67975	T	Reconstruction of eyelid	0240	18.1508	$1,077.12	$315.31	$215.42
67999	T	Revision of eyelid	0238	2.5933	$153.89		$30.78
68020	T	Incise/drain eyelid lining	0240	18.1508	$1,077.12	$315.31	$215.42
68040	S	Treatment of eyelid lesions	0698	1.2438	$73.81	$16.55	$14.76
68100	T	Biopsy of eyelid lining	0232	6.6732	$396.01	$103.17	$79.20
68110	T	Remove eyelid lining lesion	0699	10.0177	$594.48		$118.90
68115	T	Remove eyelid lining lesion	0240	18.1508	$1,077.12	$315.31	$215.42
68130	T	Remove eyelid lining lesion	0233	14.9673	$888.20	$266.33	$177.64
68135	T	Remove eyelid lining lesion	0239	6.9097	$410.04		$82.01
68200	S	Treat eyelid by injection	0230	0.7858	$46.63	$14.97	$9.33
68320	T	Revise/graft eyelid lining	0240	18.1508	$1,077.12	$315.31	$215.42
68325	T	Revise/graft eyelid lining	0242	30.5464	$1,812.72	$597.36	$362.54
68326	T	Revise/graft eyelid lining	0241	23.3036	$1,382.91	$384.47	$276.58
68328	T	Revise/graft eyelid lining	0241	23.3036	$1,382.91	$384.47	$276.58
68330	T	Revise eyelid lining	0234	21.9741	$1,304.01	$511.31	$260.80
68335	T	Revise/graft eyelid lining	0241	23.3036	$1,382.91	$384.47	$276.58
68340	T	Separate eyelid adhesions	0240	18.1508	$1,077.12	$315.31	$215.42
68360	T	Revise eyelid lining	0234	21.9741	$1,304.01	$511.31	$260.80
68362	T	Revise eyelid lining	0234	21.9741	$1,304.01	$511.31	$260.80
68371	T	Harvest eye tissue, alograft	0233	14.9673	$888.20	$266.33	$177.64
68399	T	Eyelid lining surgery	0238	2.5933	$153.89		$30.78
68400	T	Incise/drain tear gland	0238	2.5933	$153.89		$30.78
68420	T	Incise/drain tear sac	0240	18.1508	$1,077.12	$315.31	$215.42
68440	T	Incise tear duct opening	0238	2.5933	$153.89		$30.78
68500	T	Removal of tear gland	0241	23.3036	$1,382.91	$384.47	$276.58
68505	T	Partial removal, tear gland	0241	23.3036	$1,382.91	$384.47	$276.58
68510	T	Biopsy of tear gland	0240	18.1508	$1,077.12	$315.31	$215.42
68520	T	Removal of tear sac	0241	23.3036	$1,382.91	$384.47	$276.58
68525	T	Biopsy of tear sac	0240	18.1508	$1,077.12	$315.31	$215.42
68530	T	Clearance of tear duct	0240	18.1508	$1,077.12	$315.31	$215.42
68540	T	Remove tear gland lesion	0241	23.3036	$1,382.91	$384.47	$276.58
68550	T	Remove tear gland lesion	0242	30.5464	$1,812.72	$597.36	$362.54
68700	T	Repair tear ducts	0241	23.3036	$1,382.91	$384.47	$276.58
68705	T	Revise tear duct opening	0238	2.5933	$153.89		$30.78
68720	T	Create tear sac drain	0242	30.5464	$1,812.72	$597.36	$362.54
68745	T	Create tear duct drain	0241	23.3036	$1,382.91	$384.47	$276.58
68750	T	Create tear duct drain	0242	30.5464	$1,812.72	$597.36	$362.54
68760	S	Close tear duct opening	0698	1.2438	$73.81	$16.55	$14.76
68761	S	Close tear duct opening	0231	1.9278	$114.40	$44.61	$22.88
68770	T	Close tear system fistula	0240	18.1508	$1,077.12	$315.31	$215.42
68801	S	Dilate tear duct opening	0698	1.2438	$73.81	$16.55	$14.76
68810	S	Probe nasolacrimal duct	0231	1.9278	$114.40	$44.61	$22.88
68811	T	Probe nasolacrimal duct	0240	18.1508	$1,077.12	$315.31	$215.42
68815	T	Probe nasolacrimal duct	0240	18.1508	$1,077.12	$315.31	$215.42
68840	S	Explore/irrigate tear ducts	0231	1.9278	$114.40	$44.61	$22.88
68850	N	Injection for tear sac x-ray
68899	S	Tear duct system surgery	0230	0.7858	$46.63	$14.97	$9.33
69000	T	Drain external ear lesion	0006	1.55	$91.98	$22.28	$18.40
69005	T	Drain external ear lesion	0008	16.4989	$979.09		$195.82
69020	T	Drain outer ear canal lesion	0006	1.55	$91.98	$22.28	$18.40
69090	E	Pierce earlobes
69100	T	Biopsy of external ear	0019	4.0547	$240.62	$71.87	$48.12
69105	T	Biopsy of external ear canal	0253	16.1357	$957.54	$282.29	$191.51
69110	T	Remove external ear, partial	0021	14.9776	$888.82	$219.48	$177.76
69120	T	Removal of external ear	0254	23.404	$1,388.86	$321.35	$277.77
69140	T	Remove ear canal lesion(s)	0254	23.404	$1,388.86	$321.35	$277.77
69145	T	Remove ear canal lesion(s)	0021	14.9776	$888.82	$219.48	$177.76
69150	T	Extensive ear canal surgery	0252	7.8673	$466.87	$113.41	$93.37
69155	C	Extensive ear/neck surgery
69200	X	Clear outer ear canal	0340	0.6384	$37.88		$7.58
69205	T	Clear outer ear canal	0022	19.6472	$1,165.92	$354.45	$233.18
69210	X	Remove impacted ear wax	0340	0.6384	$37.88		$7.58
69220	T	Clean out mastoid cavity	0012	0.8497	$50.42	$11.18	$10.08
69222	T	Clean out mastoid cavity	0253	16.1357	$957.54	$282.29	$191.51
69300	T	Revise external ear	0254	23.404	$1,388.86	$321.35	$277.77
69310	T	Rebuild outer ear canal	0256	37.3204	$2,214.70		$442.94
69320	T	Rebuild outer ear canal	0256	37.3204	$2,214.70		$442.94
69399	T	Outer ear surgery procedure	0251	2.0101	$119.29		$23.86
69400	T	Inflate middle ear canal	0251	2.0101	$119.29		$23.86
69401	T	Inflate middle ear canal	0251	2.0101	$119.29		$23.86
69405	T	Catheterize middle ear canal	0252	7.8673	$466.87	$113.41	$93.37
69410	T	Inset middle ear (baffle)	0251	2.0101	$119.29		$23.86
69420	T	Incision of eardrum	0251	2.0101	$119.29		$23.86
69421	T	Incision of eardrum	0253	16.1357	$957.54	$282.29	$191.51
69424	T	Remove ventilating tube	0252	7.8673	$466.87	$113.41	$93.37
69433	T	Create eardrum opening	0252	7.8673	$466.87	$113.41	$93.37
69436	T	Create eardrum opening	0253	16.1357	$957.54	$282.29	$191.51
69440	T	Exploration of middle ear	0254	23.404	$1,388.86	$321.35	$277.77
69450	T	Eardrum revision	0256	37.3204	$2,214.70		$442.94
69501	T	Mastoidectomy	0256	37.3204	$2,214.70		$442.94
69502	T	Mastoidectomy	0254	23.404	$1,388.86	$321.35	$277.77
69505	T	Remove mastoid structures	0256	37.3204	$2,214.70		$442.94
69511	T	Extensive mastoid surgery	0256	37.3204	$2,214.70		$442.94
69530	T	Extensive mastoid surgery	0256	37.3204	$2,214.70		$442.94
69535	C	Remove part of temporal bone
69540	T	Remove ear lesion	0253	16.1357	$957.54	$282.29	$191.51
69550	T	Remove ear lesion	0256	37.3204	$2,214.70		$442.94
69552	T	Remove ear lesion	0256	37.3204	$2,214.70		$442.94
69554	C	Remove ear lesion
69601	T	Mastoid surgery revision	0256	37.3204	$2,214.70		$442.94
69602	T	Mastoid surgery revision	0256	37.3204	$2,214.70		$442.94
69603	T	Mastoid surgery revision	0256	37.3204	$2,214.70		$442.94
69604	T	Mastoid surgery revision	0256	37.3204	$2,214.70		$442.94
69605	T	Mastoid surgery revision	0256	37.3204	$2,214.70		$442.94
69610	T	Repair of eardrum	0254	23.404	$1,388.86	$321.35	$277.77
69620	T	Repair of eardrum	0254	23.404	$1,388.86	$321.35	$277.77
69631	T	Repair eardrum structures	0256	37.3204	$2,214.70		$442.94
69632	T	Rebuild eardrum structures	0256	37.3204	$2,214.70		$442.94
69633	T	Rebuild eardrum structures	0256	37.3204	$2,214.70		$442.94
69635	T	Repair eardrum structures	0256	37.3204	$2,214.70		$442.94
69636	T	Rebuild eardrum structures	0256	37.3204	$2,214.70		$442.94
69637	T	Rebuild eardrum structures	0256	37.3204	$2,214.70		$442.94
69641	T	Revise middle ear mastoid	0256	37.3204	$2,214.70		$442.94
69642	T	Revise middle ear mastoid	0256	37.3204	$2,214.70		$442.94
69643	T	Revise middle ear mastoid	0256	37.3204	$2,214.70		$442.94
69644	T	Revise middle ear mastoid	0256	37.3204	$2,214.70		$442.94
69645	T	Revise middle ear mastoid	0256	37.3204	$2,214.70		$442.94
69646	T	Revise middle ear mastoid	0256	37.3204	$2,214.70		$442.94
69650	T	Release middle ear bone	0254	23.404	$1,388.86	$321.35	$277.77
69660	T	Revise middle ear bone	0256	37.3204	$2,214.70		$442.94
69661	T	Revise middle ear bone	0256	37.3204	$2,214.70		$442.94
69662	T	Revise middle ear bone	0256	37.3204	$2,214.70		$442.94
69666	T	Repair middle ear structures	0256	37.3204	$2,214.70		$442.94
69667	T	Repair middle ear structures	0256	37.3204	$2,214.70		$442.94
69670	T	Remove mastoid air cells	0256	37.3204	$2,214.70		$442.94
69676	T	Remove middle ear nerve	0256	37.3204	$2,214.70		$442.94
69700	T	Close mastoid fistula	0256	37.3204	$2,214.70		$442.94
69710	E	Implant/replace hearing aid
69711	T	Remove/repair hearing aid	0256	37.3204	$2,214.70		$442.94
69714	T	Implant temple bone w/stimul	0256	37.3204	$2,214.70		$442.94
69715	T	Temple bne implnt w/stimulat	0256	37.3204	$2,214.70		$442.94
69717	T	Temple bone implant revision	0256	37.3204	$2,214.70		$442.94
69718	T	Revise temple bone implant	0256	37.3204	$2,214.70		$442.94
69720	T	Release facial nerve	0256	37.3204	$2,214.70		$442.94
69725	T	Release facial nerve	0256	37.3204	$2,214.70		$442.94
69740	T	Repair facial nerve	0256	37.3204	$2,214.70		$442.94
69745	T	Repair facial nerve	0256	37.3204	$2,214.70		$442.94
69799	T	Middle ear surgery procedure	0251	2.0101	$119.29		$23.86
69801	T	Incise inner ear	0256	37.3204	$2,214.70		$442.94
69802	T	Incise inner ear	0256	37.3204	$2,214.70		$442.94
69805	T	Explore inner ear	0256	37.3204	$2,214.70		$442.94
69806	T	Explore inner ear	0256	37.3204	$2,214.70		$442.94
69820	T	Establish inner ear window	0256	37.3204	$2,214.70		$442.94
69840	T	Revise inner ear window	0256	37.3204	$2,214.70		$442.94
69905	T	Remove inner ear	0256	37.3204	$2,214.70		$442.94
69910	T	Remove inner ear mastoid	0256	37.3204	$2,214.70		$442.94
69915	T	Incise inner ear nerve	0256	37.3204	$2,214.70		$442.94
69930	T	Implant cochlear device	0259	366.3317	$21,739.22	$8,070.21	$4,347.84
69949	T	Inner ear surgery procedure	0251	2.0101	$119.29		$23.86
69950	C	Incise inner ear nerve
69955	T	Release facial nerve	0256	37.3204	$2,214.70		$442.94
69960	T	Release inner ear canal	0256	37.3204	$2,214.70		$442.94
69970	C	Remove inner ear lesion
69979	T	Temporal bone surgery	0251	2.0101	$119.29		$23.86
69990	N	Microsurgery add-on
70010	S	Contrast x-ray of brain	0274	3.0413	$180.48	$72.19	$36.10
70015	S	Contrast x-ray of brain	0274	3.0413	$180.48	$72.19	$36.10
70030	X	X-ray eye for foreign body	0260	0.7555	$44.83	$17.93	$8.97
70100	X	X-ray exam of jaw	0260	0.7555	$44.83	$17.93	$8.97
70110	X	X-ray exam of jaw	0260	0.7555	$44.83	$17.93	$8.97
70120	X	X-ray exam of mastoids	0260	0.7555	$44.83	$17.93	$8.97
70130	X	X-ray exam of mastoids	0260	0.7555	$44.83	$17.93	$8.97
70134	X	X-ray exam of middle ear	0261	1.2901	$76.56		$15.31
70140	X	X-ray exam of facial bones	0260	0.7555	$44.83	$17.93	$8.97
70150	X	X-ray exam of facial bones	0260	0.7555	$44.83	$17.93	$8.97
70160	X	X-ray exam of nasal bones	0260	0.7555	$44.83	$17.93	$8.97
70170	X	X-ray exam of tear duct	0264	3.524	$209.12	$79.41	$41.82
70190	X	X-ray exam of eye sockets	0260	0.7555	$44.83	$17.93	$8.97
70200	X	X-ray exam of eye sockets	0260	0.7555	$44.83	$17.93	$8.97
70210	X	X-ray exam of sinuses	0260	0.7555	$44.83	$17.93	$8.97
70220	X	X-ray exam of sinuses	0260	0.7555	$44.83	$17.93	$8.97
70240	X	X-ray exam, pituitary saddle	0260	0.7555	$44.83	$17.93	$8.97
70250	X	X-ray exam of skull	0260	0.7555	$44.83	$17.93	$8.97
70260	X	X-ray exam of skull	0261	1.2901	$76.56		$15.31
70300	X	X-ray exam of teeth	0262	0.9228	$54.76		$10.95
70310	X	X-ray exam of teeth	0262	0.9228	$54.76		$10.95
70320	X	Full mouth x-ray of teeth	0262	0.9228	$54.76		$10.95
70328	X	X-ray exam of jaw joint	0260	0.7555	$44.83	$17.93	$8.97
70330	X	X-ray exam of jaw joints	0260	0.7555	$44.83	$17.93	$8.97
70332	S	X-ray exam of jaw joint	0275	3.5779	$212.32	$69.09	$42.46
70336	S	Magnetic image, jaw joint	0335	5.1581	$306.10	$122.43	$61.22
70350	X	X-ray head for orthodontia	0260	0.7555	$44.83	$17.93	$8.97
70355	X	Panoramic x-ray of jaws	0260	0.7555	$44.83	$17.93	$8.97
70360	X	X-ray exam of neck	0260	0.7555	$44.83	$17.93	$8.97
70370	X	Throat x-ray fluoroscopy	0272	1.3801	$81.90	$32.76	$16.38
70371	X	Speech evaluation, complex	0272	1.3801	$81.90	$32.76	$16.38
70373	X	Contrast x-ray of larynx	0263	1.7476	$103.71	$24.40	$20.74
70380	X	X-ray exam of salivary gland	0260	0.7555	$44.83	$17.93	$8.97
70390	X	X-ray exam of salivary duct	0263	1.7476	$103.71	$24.40	$20.74
70450*	S	Ct head/brain w/o dye	0332	3.2694	$194.02	$77.60	$38.80
70460*	S	Ct head/brain w/dye	0283	4.4253	$262.61	$105.04	$52.52
70470*	S	Ct head/brain w/o w/ dye	0333	5.2836	$313.54	$125.41	$62.71
70480*	S	Ct orbit/ear/fossa w/o dye	0332	3.2694	$194.02	$77.60	$38.80
70481*	S	Ct orbit/ear/fossa w/dye	0283	4.4253	$262.61	$105.04	$52.52
70482*	S	Ct orbit/ear/fossa w/ow dye	0333	5.2836	$313.54	$125.41	$62.71
70486*	S	Ct maxillofacial w/o dye	0332	3.2694	$194.02	$77.60	$38.80
70487*	S	Ct maxillofacial w/dye	0283	4.4253	$262.61	$105.04	$52.52
70488*	S	Ct maxillofacial w/o w dye	0333	5.2836	$313.54	$125.41	$62.71
70490*	S	Ct soft tissue neck w/o dye	0332	3.2694	$194.02	$77.60	$38.80
70491*	S	Ct soft tissue neck w/dye	0283	4.4253	$262.61	$105.04	$52.52
70492*	S	Ct sft tsue nck w/o w/dye	0333	5.2836	$313.54	$125.41	$62.71
70496*	S	Ct angiography, head	0662	5.1621	$306.33	$122.53	$61.27
70498*	S	Ct angiography, neck	0662	5.1621	$306.33	$122.53	$61.27
70540*	S	Mri orbit/face/neck w/o dye	0336	6.0742	$360.46	$144.18	$72.09
70542*	S	Mri orbit/face/neck w/dye	0284	6.4201	$380.99	$152.39	$76.20
70543*	S	Mri orbt/fac/nck w/o w dye	0337	8.7945	$521.89	$208.75	$104.38
70544*	S	Mr angiography head w/o dye	0336	6.0742	$360.46	$144.18	$72.09
70545*	S	Mr angiography head w/dye	0284	6.4201	$380.99	$152.39	$76.20
70546*	S	Mr angiograph head w/ow dye	0337	8.7945	$521.89	$208.75	$104.38
70547*	S	Mr angiography neck w/o dye	0336	6.0742	$360.46	$144.18	$72.09
70548*	S	Mr angiography neck w/dye	0284	6.4201	$380.99	$152.39	$76.20
70549*	S	Mr angiograph neck w/ow dye	0337	8.7945	$521.89	$208.75	$104.38
70551*	S	Mri brain w/o dye	0336	6.0742	$360.46	$144.18	$72.09
70552*	S	Mri brain w/ dye	0284	6.4201	$380.99	$152.39	$76.20
70553*	S	Mri brain w/o w/ dye	0337	8.7945	$521.89	$208.75	$104.38
70557	S	Mri brain w/o dye	0336	6.0742	$360.46	$144.18	$72.09
70558	S	Mri brain w/ dye	0284	6.4201	$380.99	$152.39	$76.20
70559	S	Mri brain w/o w/ dye	0337	8.7945	$521.89	$208.75	$104.38
71010	X	Chest x-ray	0260	0.7555	$44.83	$17.93	$8.97
71015	X	Chest x-ray	0260	0.7555	$44.83	$17.93	$8.97
71020	X	Chest x-ray	0260	0.7555	$44.83	$17.93	$8.97
71021	X	Chest x-ray	0260	0.7555	$44.83	$17.93	$8.97
71022	X	Chest x-ray	0260	0.7555	$44.83	$17.93	$8.97
71023	X	Chest x-ray and fluoroscopy	0272	1.3801	$81.90	$32.76	$16.38
71030	X	Chest x-ray	0260	0.7555	$44.83	$17.93	$8.97
71034	X	Chest x-ray and fluoroscopy	0272	1.3801	$81.90	$32.76	$16.38
71035	X	Chest x-ray	0260	0.7555	$44.83	$17.93	$8.97
71040	X	Contrast x-ray of bronchi	0263	1.7476	$103.71	$24.40	$20.74
71060	X	Contrast x-ray of bronchi	0263	1.7476	$103.71	$24.40	$20.74
71090	X	X-ray pacemaker insertion	0272	1.3801	$81.90	$32.76	$16.38
71100	X	X-ray exam of ribs	0260	0.7555	$44.83	$17.93	$8.97
71101	X	X-ray exam of ribs/chest	0260	0.7555	$44.83	$17.93	$8.97
71110	X	X-ray exam of ribs	0260	0.7555	$44.83	$17.93	$8.97
71111	X	X-ray exam of ribs/ chest	0261	1.2901	$76.56		$15.31
71120	X	X-ray exam of breastbone	0260	0.7555	$44.83	$17.93	$8.97
71130	X	X-ray exam of breastbone	0260	0.7555	$44.83	$17.93	$8.97
71250*	S	Ct thorax w/o dye	0332	3.2694	$194.02	$77.60	$38.80
71260*	S	Ct thorax w/dye	0283	4.4253	$262.61	$105.04	$52.52
71270*	S	Ct thorax w/o w/ dye	0333	5.2836	$313.54	$125.41	$62.71
71275*	S	Ct angiography, chest	0662	5.1621	$306.33	$122.53	$61.27
71550*	S	Mri chest w/o dye	0336	6.0742	$360.46	$144.18	$72.09
71551*	S	Mri chest w/dye	0284	6.4201	$380.99	$152.39	$76.20
71552*	S	Mri chest w/o w/dye	0337	8.7945	$521.89	$208.75	$104.38
71555	B	Mri angio chest w or w/o dye
72010	X	X-ray exam of spine	0260	0.7555	$44.83	$17.93	$8.97
72020	X	X-ray exam of spine	0260	0.7555	$44.83	$17.93	$8.97
72040	X	X-ray exam of neck spine	0260	0.7555	$44.83	$17.93	$8.97
72050	X	X-ray exam of neck spine	0261	1.2901	$76.56		$15.31
72052	X	X-ray exam of neck spine	0261	1.2901	$76.56		$15.31
72069	X	X-ray exam of trunk spine	0260	0.7555	$44.83	$17.93	$8.97
72070	X	X-ray exam of thoracic spine	0260	0.7555	$44.83	$17.93	$8.97
72072	X	X-ray exam of thoracic spine	0260	0.7555	$44.83	$17.93	$8.97
72074	X	X-ray exam of thoracic spine	0260	0.7555	$44.83	$17.93	$8.97
72080	X	X-ray exam of trunk spine	0260	0.7555	$44.83	$17.93	$8.97
72090	X	X-ray exam of trunk spine	0261	1.2901	$76.56		$15.31
72100	X	X-ray exam of lower spine	0260	0.7555	$44.83	$17.93	$8.97
72110	X	X-ray exam of lower spine	0261	1.2901	$76.56		$15.31
72114	X	X-ray exam of lower spine	0261	1.2901	$76.56		$15.31
72120	X	X-ray exam of lower spine	0261	1.2901	$76.56		$15.31
72125*	S	Ct neck spine w/o dye	0332	3.2694	$194.02	$77.60	$38.80
72126*	S	Ct neck spine w/dye	0283	4.4253	$262.61	$105.04	$52.52
72127*	S	Ct neck spine w/o w/dye	0333	5.2836	$313.54	$125.41	$62.71
72128*	S	Ct chest spine w/o dye	0332	3.2694	$194.02	$77.60	$38.80
72129*	S	Ct chest spine w/dye	0283	4.4253	$262.61	$105.04	$52.52
72130*	S	Ct chest spine w/o w/dye	0333	5.2836	$313.54	$125.41	$62.71
72131*	S	Ct lumbar spine w/o dye	0332	3.2694	$194.02	$77.60	$38.80
72132*	S	Ct lumbar spine w/dye	0283	4.4253	$262.61	$105.04	$52.52
72133*	S	Ct lumbar spine w/o w/dye	0333	5.2836	$313.54	$125.41	$62.71
72141*	S	Mri neck spine w/o dye	0336	6.0742	$360.46	$144.18	$72.09
72142*	S	Mri neck spine w/dye	0284	6.4201	$380.99	$152.39	$76.20
72146*	S	Mri chest spine w/o dye	0336	6.0742	$360.46	$144.18	$72.09
72147*	S	Mri chest spine w/dye	0284	6.4201	$380.99	$152.39	$76.20
72148*	S	Mri lumbar spine w/o dye	0336	6.0742	$360.46	$144.18	$72.09
72149*	S	Mri lumbar spine w/dye	0284	6.4201	$380.99	$152.39	$76.20
72156*	S	Mri neck spine w/o w/dye	0337	8.7945	$521.89	$208.75	$104.38
72157*	S	Mri chest spine w/o w/dye	0337	8.7945	$521.89	$208.75	$104.38
72158*	S	Mri lumbar spine w/o w/dye	0337	8.7945	$521.89	$208.75	$104.38
72159	E	Mr angio spine w/ow/dye
72170	X	X-ray exam of pelvis	0260	0.7555	$44.83	$17.93	$8.97
72190	X	X-ray exam of pelvis	0260	0.7555	$44.83	$17.93	$8.97
72191*	S	Ct angiograph pelv w/ow/dye	0662	5.1621	$306.33	$122.53	$61.27
72192*	S	Ct pelvis w/o dye	0332	3.2694	$194.02	$77.60	$38.80
72193*	S	Ct pelvis w/dye	0283	4.4253	$262.61	$105.04	$52.52
72194*	S	Ct pelvis w/o w/dye	0333	5.2836	$313.54	$125.41	$62.71
72195*	S	Mri pelvis w/o dye	0336	6.0742	$360.46	$144.18	$72.09
72196*	S	Mri pelvis w/dye	0284	6.4201	$380.99	$152.39	$76.20
72197*	S	Mri pelvis w/o w/dye	0337	8.7945	$521.89	$208.75	$104.38
72198	B	Mr angio pelvis w/o w/dye
72200	X	X-ray exam sacroiliac joints	0260	0.7555	$44.83	$17.93	$8.97
72202	X	X-ray exam sacroiliac joints	0260	0.7555	$44.83	$17.93	$8.97
72220	X	X-ray exam of tailbone	0260	0.7555	$44.83	$17.93	$8.97
72240	S	Contrast x-ray of neck spine	0274	3.0413	$180.48	$72.19	$36.10
72255	S	Contrast x-ray, thorax spine	0274	3.0413	$180.48	$72.19	$36.10
72265	S	Contrast x-ray, lower spine	0274	3.0413	$180.48	$72.19	$36.10
72270	S	Contrast x-ray, spine	0274	3.0413	$180.48	$72.19	$36.10
72275	S	Epidurography	0274	3.0413	$180.48	$72.19	$36.10
72285	S	X-ray c/t spine disk	0388	12.3294	$731.66	$292.66	$146.33
72295	S	X-ray of lower spine disk	0388	12.3294	$731.66	$292.66	$146.33
73000	X	X-ray exam of collar bone	0260	0.7555	$44.83	$17.93	$8.97
73010	X	X-ray exam of shoulder blade	0260	0.7555	$44.83	$17.93	$8.97
73020	X	X-ray exam of shoulder	0260	0.7555	$44.83	$17.93	$8.97
73030	X	X-ray exam of shoulder	0260	0.7555	$44.83	$17.93	$8.97
73040	S	Contrast x-ray of shoulder	0275	3.5779	$212.32	$69.09	$42.46
73050	X	X-ray exam of shoulders	0260	0.7555	$44.83	$17.93	$8.97
73060	X	X-ray exam of humerus	0260	0.7555	$44.83	$17.93	$8.97
73070	X	X-ray exam of elbow	0260	0.7555	$44.83	$17.93	$8.97
73080	X	X-ray exam of elbow	0260	0.7555	$44.83	$17.93	$8.97
73085	S	Contrast x-ray of elbow	0275	3.5779	$212.32	$69.09	$42.46
73090	X	X-ray exam of forearm	0260	0.7555	$44.83	$17.93	$8.97
73092	X	X-ray exam of arm, infant	0260	0.7555	$44.83	$17.93	$8.97
73100	X	X-ray exam of wrist	0260	0.7555	$44.83	$17.93	$8.97
73110	X	X-ray exam of wrist	0260	0.7555	$44.83	$17.93	$8.97
73115	S	Contrast x-ray of wrist	0275	3.5779	$212.32	$69.09	$42.46
73120	X	X-ray exam of hand	0260	0.7555	$44.83	$17.93	$8.97
73130	X	X-ray exam of hand	0260	0.7555	$44.83	$17.93	$8.97
73140	X	X-ray exam of finger(s)	0260	0.7555	$44.83	$17.93	$8.97
73200*	S	Ct upper extremity w/o dye	0332	3.2694	$194.02	$77.60	$38.80
73201*	S	Ct upper extremity w/dye	0283	4.4253	$262.61	$105.04	$52.52
73202*	S	Ct uppr extremity w/ow/dye	0333	5.2836	$313.54	$125.41	$62.71
73206*	S	Ct angio upr extrm w/ow/dye	0662	5.1621	$306.33	$122.53	$61.27
73218*	S	Mri upper extremity w/o dye	0336	6.0742	$360.46	$144.18	$72.09
73219*	S	Mri upper extremity w/dye	0284	6.4201	$380.99	$152.39	$76.20
73220*	S	Mri uppr extremity w/ow/dye	0337	8.7945	$521.89	$208.75	$104.38
73221*	S	Mri joint upr extrem w/o dye	0336	6.0742	$360.46	$144.18	$72.09
73222*	S	Mri joint upr extrem w/dye	0284	6.4201	$380.99	$152.39	$76.20
73223*	S	Mri joint upr extr w/ow/dye	0337	8.7945	$521.89	$208.75	$104.38
73225	E	Mr angio upr extr w/ow/dye
73500	X	X-ray exam of hip	0260	0.7555	$44.83	$17.93	$8.97
73510	X	X-ray exam of hip	0260	0.7555	$44.83	$17.93	$8.97
73520	X	X-ray exam of hips	0261	1.2901	$76.56		$15.31
73525	S	Contrast x-ray of hip	0275	3.5779	$212.32	$69.09	$42.46
73530	X	X-ray exam of hip	0261	1.2901	$76.56		$15.31
73540	X	X-ray exam of pelvis hips	0260	0.7555	$44.83	$17.93	$8.97
73542	S	X-ray exam, sacroiliac joint	0275	3.5779	$212.32	$69.09	$42.46
73550	X	X-ray exam of thigh	0260	0.7555	$44.83	$17.93	$8.97
73560	X	X-ray exam of knee, 1 or 2	0260	0.7555	$44.83	$17.93	$8.97
73562	X	X-ray exam of knee, 3	0260	0.7555	$44.83	$17.93	$8.97
73564	X	X-ray exam, knee, 4 or more	0260	0.7555	$44.83	$17.93	$8.97
73565	X	X-ray exam of knees	0260	0.7555	$44.83	$17.93	$8.97
73580	S	Contrast x-ray of knee joint	0275	3.5779	$212.32	$69.09	$42.46
73590	X	X-ray exam of lower leg	0260	0.7555	$44.83	$17.93	$8.97
73592	X	X-ray exam of leg, infant	0260	0.7555	$44.83	$17.93	$8.97
73600	X	X-ray exam of ankle	0260	0.7555	$44.83	$17.93	$8.97
73610	X	X-ray exam of ankle	0260	0.7555	$44.83	$17.93	$8.97
73615	S	Contrast x-ray of ankle	0275	3.5779	$212.32	$69.09	$42.46
73620	X	X-ray exam of foot	0260	0.7555	$44.83	$17.93	$8.97
73630	X	X-ray exam of foot	0260	0.7555	$44.83	$17.93	$8.97
73650	X	X-ray exam of heel	0260	0.7555	$44.83	$17.93	$8.97
73660	X	X-ray exam of toe(s)	0260	0.7555	$44.83	$17.93	$8.97
73700*	S	Ct lower extremity w/o dye	0332	3.2694	$194.02	$77.60	$38.80
73701*	S	Ct lower extremity w/dye	0283	4.4253	$262.61	$105.04	$52.52
73702*	S	Ct lwr extremity w/ow/dye	0333	5.2836	$313.54	$125.41	$62.71
73706*	S	Ct angio lwr extr w/ow/dye	0662	5.1621	$306.33	$122.53	$61.27
73718*	S	Mri lower extremity w/o dye	0336	6.0742	$360.46	$144.18	$72.09
73719*	S	Mri lower extremity w/dye	0284	6.4201	$380.99	$152.39	$76.20
73720*	S	Mri lwr extremity w/ow/dye	0337	8.7945	$521.89	$208.75	$104.38
73721*	S	Mri jnt of lwr extre w/o dye	0336	6.0742	$360.46	$144.18	$72.09
73722*	S	Mri joint of lwr extr w/dye	0284	6.4201	$380.99	$152.39	$76.20
73723*	S	Mri joint lwr extr w/ow/dye	0337	8.7945	$521.89	$208.75	$104.38
73725	B	Mr ang lwr ext w or w/o dye
74000	X	X-ray exam of abdomen	0260	0.7555	$44.83	$17.93	$8.97
74010	X	X-ray exam of abdomen	0260	0.7555	$44.83	$17.93	$8.97
74020	X	X-ray exam of abdomen	0260	0.7555	$44.83	$17.93	$8.97
74022	X	X-ray exam series, abdomen	0261	1.2901	$76.56		$15.31
74150*	S	Ct abdomen w/o dye	0332	3.2694	$194.02	$77.60	$38.80
74160*	S	Ct abdomen w/dye	0283	4.4253	$262.61	$105.04	$52.52
74170*	S	Ct abdomen w/o w /dye	0333	5.2836	$313.54	$125.41	$62.71
74175*	S	Ct angio abdom w/o w/dye	0662	5.1621	$306.33	$122.53	$61.27
74181*	S	Mri abdomen w/o dye	0336	6.0742	$360.46	$144.18	$72.09
74182*	S	Mri abdomen w/dye	0284	6.4201	$380.99	$152.39	$76.20
74183*	S	Mri abdomen w/o w/dye	0337	8.7945	$521.89	$208.75	$104.38
74185	B	Mri angio, abdom w orw/o dye
74190	X	X-ray exam of peritoneum	0264	3.524	$209.12	$79.41	$41.82
74210	S	Contrst x-ray exam of throat	0276	1.5319	$90.91	$36.36	$18.18
74220	S	Contrast x-ray, esophagus	0276	1.5319	$90.91	$36.36	$18.18
74230	S	Cine/vid x-ray, throat/esoph	0276	1.5319	$90.91	$36.36	$18.18
74235	S	Remove esophagus obstruction	0296	2.2452	$133.24	$53.29	$26.65
74240	S	X-ray exam, upper gi tract	0276	1.5319	$90.91	$36.36	$18.18
74241	S	X-ray exam, upper gi tract	0276	1.5319	$90.91	$36.36	$18.18
74245	S	X-ray exam, upper gi tract	0277	2.3852	$141.54	$56.61	$28.31
74246	S	Contrst x-ray uppr gi tract	0276	1.5319	$90.91	$36.36	$18.18
74247	S	Contrst x-ray uppr gi tract	0276	1.5319	$90.91	$36.36	$18.18
74249	S	Contrst x-ray uppr gi tract	0277	2.3852	$141.54	$56.61	$28.31
74250	S	X-ray exam of small bowel	0276	1.5319	$90.91	$36.36	$18.18
74251	S	X-ray exam of small bowel	0277	2.3852	$141.54	$56.61	$28.31
74260	S	X-ray exam of small bowel	0277	2.3852	$141.54	$56.61	$28.31
74270	S	Contrast x-ray exam of colon	0276	1.5319	$90.91	$36.36	$18.18
74280	S	Contrast x-ray exam of colon	0277	2.3852	$141.54	$56.61	$28.31
74283	S	Contrast x-ray exam of colon	0276	1.5319	$90.91	$36.36	$18.18
74290	S	Contrast x-ray, gallbladder	0276	1.5319	$90.91	$36.36	$18.18
74291	S	Contrast x-rays, gallbladder	0276	1.5319	$90.91	$36.36	$18.18
74300	X	X-ray bile ducts/pancreas	0263	1.7476	$103.71	$24.40	$20.74
74301	X	X-rays at surgery add-on	0263	1.7476	$103.71	$24.40	$20.74
74305	X	X-ray bile ducts/pancreas	0263	1.7476	$103.71	$24.40	$20.74
74320	X	Contrast x-ray of bile ducts	0264	3.524	$209.12	$79.41	$41.82
74327	S	X-ray bile stone removal	0296	2.2452	$133.24	$53.29	$26.65
74328	N	X-ray bile duct endoscopy
74329	N	X-ray for pancreas endoscopy
74330	N	X-ray bile/panc endoscopy
74340	X	X-ray guide for GI tube	0272	1.3801	$81.90	$32.76	$16.38
74350	X	X-ray guide, stomach tube	0263	1.7476	$103.71	$24.40	$20.74
74355	X	X-ray guide, intestinal tube	0263	1.7476	$103.71	$24.40	$20.74
74360	S	X-ray guide, GI dilation	0296	2.2452	$133.24	$53.29	$26.65
74363	S	X-ray, bile duct dilation	0297	5.253	$311.73	$122.13	$62.35
74400	S	Contrst x-ray, urinary tract	0278	2.6434	$156.87	$62.74	$31.37
74410	S	Contrst x-ray, urinary tract	0278	2.6434	$156.87	$62.74	$31.37
74415	S	Contrst x-ray, urinary tract	0278	2.6434	$156.87	$62.74	$31.37
74420	S	Contrst x-ray, urinary tract	0278	2.6434	$156.87	$62.74	$31.37
74425	S	Contrst x-ray, urinary tract	0278	2.6434	$156.87	$62.74	$31.37
74430	S	Contrast x-ray, bladder	0278	2.6434	$156.87	$62.74	$31.37
74440	S	X-ray, male genital tract	0278	2.6434	$156.87	$62.74	$31.37
74445	S	X-ray exam of penis	0278	2.6434	$156.87	$62.74	$31.37
74450	S	X-ray, urethra/bladder	0278	2.6434	$156.87	$62.74	$31.37
74455	S	X-ray, urethra/bladder	0278	2.6434	$156.87	$62.74	$31.37
74470	X	X-ray exam of kidney lesion	0263	1.7476	$103.71	$24.40	$20.74
74475	S	X-ray control, cath insert	0297	5.253	$311.73	$122.13	$62.35
74480	S	X-ray control, cath insert	0296	2.2452	$133.24	$53.29	$26.65
74485	S	X-ray guide, GU dilation	0296	2.2452	$133.24	$53.29	$26.65
74710	X	X-ray measurement of pelvis	0261	1.2901	$76.56		$15.31
74740	X	X-ray, female genital tract	0264	3.524	$209.12	$79.41	$41.82
74742	X	X-ray, fallopian tube	0264	3.524	$209.12	$79.41	$41.82
74775	S	X-ray exam of perineum	0278	2.6434	$156.87	$62.74	$31.37
75552	S	Heart mri for morph w/o dye	0336	6.0742	$360.46	$144.18	$72.09
75553	S	Heart mri for morph w/dye	0284	6.4201	$380.99	$152.39	$76.20
75554	S	Cardiac MRI/function	0336	6.0742	$360.46	$144.18	$72.09
75555	S	Cardiac MRI/limited study	0336	6.0742	$360.46	$144.18	$72.09
75556	E	Cardiac MRI/flow mapping
75600	S	Contrast x-ray exam of aorta	0280	20.7902	$1,233.75	$353.85	$246.75
75605	S	Contrast x-ray exam of aorta	0280	20.7902	$1,233.75	$353.85	$246.75
75625	S	Contrast x-ray exam of aorta	0280	20.7902	$1,233.75	$353.85	$246.75
75630	S	X-ray aorta, leg arteries	0280	20.7902	$1,233.75	$353.85	$246.75
75635*	S	Ct angio abdominal arteries	0662	5.1621	$306.33	$122.53	$61.27
75650	S	Artery x-rays, head neck	0280	20.7902	$1,233.75	$353.85	$246.75
75658	S	Artery x-rays, arm	0279	8.9319	$530.05	$150.03	$106.01
75660	S	Artery x-rays, head neck	0668	6.5024	$385.87	$114.67	$77.17
75662	S	Artery x-rays, head neck	0280	20.7902	$1,233.75	$353.85	$246.75
75665	S	Artery x-rays, head neck	0280	20.7902	$1,233.75	$353.85	$246.75
75671	S	Artery x-rays, head neck	0280	20.7902	$1,233.75	$353.85	$246.75
75676	S	Artery x-rays, neck	0280	20.7902	$1,233.75	$353.85	$246.75
75680	S	Artery x-rays, neck	0280	20.7902	$1,233.75	$353.85	$246.75
75685	S	Artery x-rays, spine	0280	20.7902	$1,233.75	$353.85	$246.75
75705	S	Artery x-rays, spine	0668	6.5024	$385.87	$114.67	$77.17
75710	S	Artery x-rays, arm/leg	0280	20.7902	$1,233.75	$353.85	$246.75
75716	S	Artery x-rays, arms/legs	0280	20.7902	$1,233.75	$353.85	$246.75
75722	S	Artery x-rays, kidney	0280	20.7902	$1,233.75	$353.85	$246.75
75724	S	Artery x-rays, kidneys	0280	20.7902	$1,233.75	$353.85	$246.75
75726	S	Artery x-rays, abdomen	0280	20.7902	$1,233.75	$353.85	$246.75
75731	S	Artery x-rays, adrenal gland	0280	20.7902	$1,233.75	$353.85	$246.75
75733	S	Artery x-rays, adrenals	0668	6.5024	$385.87	$114.67	$77.17
75736	S	Artery x-rays, pelvis	0280	20.7902	$1,233.75	$353.85	$246.75
75741	S	Artery x-rays, lung	0279	8.9319	$530.05	$150.03	$106.01
75743	S	Artery x-rays, lungs	0280	20.7902	$1,233.75	$353.85	$246.75
75746	S	Artery x-rays, lung	0279	8.9319	$530.05	$150.03	$106.01
75756	S	Artery x-rays, chest	0279	8.9319	$530.05	$150.03	$106.01
75774	S	Artery x-ray, each vessel	0279	8.9319	$530.05	$150.03	$106.01
75790	S	Visualize A-V shunt	0279	8.9319	$530.05	$150.03	$106.01
75801	X	Lymph vessel x-ray, arm/leg	0264	3.524	$209.12	$79.41	$41.82
75803	X	Lymph vessel x-ray,arms/legs	0264	3.524	$209.12	$79.41	$41.82
75805	X	Lymph vessel x-ray, trunk	0264	3.524	$209.12	$79.41	$41.82
75807	X	Lymph vessel x-ray, trunk	0264	3.524	$209.12	$79.41	$41.82
75809	X	Nonvascular shunt, x-ray	0263	1.7476	$103.71	$24.40	$20.74
75810	S	Vein x-ray, spleen/liver	0279	8.9319	$530.05	$150.03	$106.01
75820	S	Vein x-ray, arm/leg	0668	6.5024	$385.87	$114.67	$77.17
75822	S	Vein x-ray, arms/legs	0668	6.5024	$385.87	$114.67	$77.17
75825	S	Vein x-ray, trunk	0279	8.9319	$530.05	$150.03	$106.01
75827	S	Vein x-ray, chest	0279	8.9319	$530.05	$150.03	$106.01
75831	S	Vein x-ray, kidney	0279	8.9319	$530.05	$150.03	$106.01
75833	S	Vein x-ray, kidneys	0279	8.9319	$530.05	$150.03	$106.01
75840	S	Vein x-ray, adrenal gland	0280	20.7902	$1,233.75	$353.85	$246.75
75842	S	Vein x-ray, adrenal glands	0280	20.7902	$1,233.75	$353.85	$246.75
75860	S	Vein x-ray, neck	0668	6.5024	$385.87	$114.67	$77.17
75870	S	Vein x-ray, skull	0668	6.5024	$385.87	$114.67	$77.17
75872	S	Vein x-ray, skull	0279	8.9319	$530.05	$150.03	$106.01
75880	S	Vein x-ray, eye socket	0668	6.5024	$385.87	$114.67	$77.17
75885	S	Vein x-ray, liver	0280	20.7902	$1,233.75	$353.85	$246.75
75887	S	Vein x-ray, liver	0279	8.9319	$530.05	$150.03	$106.01
75889	S	Vein x-ray, liver	0280	20.7902	$1,233.75	$353.85	$246.75
75891	S	Vein x-ray, liver	0279	8.9319	$530.05	$150.03	$106.01
75893	N	Venous sampling by catheter
75894	S	X-rays, transcath therapy	0297	5.253	$311.73	$122.13	$62.35
75896	S	X-rays, transcath therapy	0297	5.253	$311.73	$122.13	$62.35
75898	X	Follow-up angiography	0263	1.7476	$103.71	$24.40	$20.74
75900	C	Arterial catheter exchange
75901	X	Remove cva device obstruct	0263	1.7476	$103.71	$24.40	$20.74
75902	X	Remove cva lumen obstruct	0263	1.7476	$103.71	$24.40	$20.74
75940	S	X-ray placement, vein filter	0297	5.253	$311.73	$122.13	$62.35
75945	S	Intravascular us	0267	2.6327	$156.23	$62.18	$31.25
75946	S	Intravascular us add-on	0266	1.6393	$97.28	$38.91	$19.46
75952	C	Endovasc repair abdom aorta
75953	C	Abdom aneurysm endovas rpr
75954	C	Iliac aneurysm endovas rpr
75960	S	Transcatheter intro, stent	0668	6.5024	$385.87	$114.67	$77.17
75961	S	Retrieval, broken catheter	0668	6.5024	$385.87	$114.67	$77.17
75962	S	Repair arterial blockage	0668	6.5024	$385.87	$114.67	$77.17
75964	S	Repair artery blockage, each	0668	6.5024	$385.87	$114.67	$77.17
75966	S	Repair arterial blockage	0668	6.5024	$385.87	$114.67	$77.17
75968	S	Repair artery blockage, each	0668	6.5024	$385.87	$114.67	$77.17
75970	S	Vascular biopsy	0668	6.5024	$385.87	$114.67	$77.17
75978	S	Repair venous blockage	0668	6.5024	$385.87	$114.67	$77.17
75980	S	Contrast xray exam bile duct	0297	5.253	$311.73	$122.13	$62.35
75982	S	Contrast xray exam bile duct	0297	5.253	$311.73	$122.13	$62.35
75984	X	Xray control catheter change	0263	1.7476	$103.71	$24.40	$20.74
75989	N	Abscess drainage under x-ray
75992	S	Atherectomy, x-ray exam	0279	8.9319	$530.05	$150.03	$106.01
75993	S	Atherectomy, x-ray exam	0279	8.9319	$530.05	$150.03	$106.01
75994	S	Atherectomy, x-ray exam	0279	8.9319	$530.05	$150.03	$106.01
75995	S	Atherectomy, x-ray exam	0279	8.9319	$530.05	$150.03	$106.01
75996	S	Atherectomy, x-ray exam	0279	8.9319	$530.05	$150.03	$106.01
75998	N	Fluoroguide for vein device
76000	X	Fluoroscope examination	0272	1.3801	$81.90	$32.76	$16.38
76001	N	Fluoroscope exam, extensive
76003	N	Needle localization by x-ray
76005	N	Fluoroguide for spine inject
76006	X	X-ray stress view	0260	0.7555	$44.83	$17.93	$8.97
76010	X	X-ray, nose to rectum	0260	0.7555	$44.83	$17.93	$8.97
76012	S	Percut vertebroplasty fluor	0274	3.0413	$180.48	$72.19	$36.10
76013	S	Percut vertebroplasty, ct	0274	3.0413	$180.48	$72.19	$36.10
76020	X	X-rays for bone age	0260	0.7555	$44.83	$17.93	$8.97
76040	X	X-rays, bone evaluation	0261	1.2901	$76.56		$15.31
76061	X	X-rays, bone survey	0261	1.2901	$76.56		$15.31
76062	X	X-rays, bone survey	0261	1.2901	$76.56		$15.31
76065	X	X-rays, bone evaluation	0261	1.2901	$76.56		$15.31
76066	X	Joint survey, single view	0260	0.7555	$44.83	$17.93	$8.97
76070	S	CT scan, bone density study	0288	1.2568	$74.58		$14.92
76071	S	Ct bone density, peripheral	0282	1.6542	$98.17	$39.26	$19.63
76075	S	Dexa, axial skeleton study	0288	1.2568	$74.58		$14.92
76076	S	Dexa, peripheral study	0665	0.6464	$38.36		$7.67
76077	X	Dxa bone density/v-fracture	0260	0.7555	$44.83	$17.93	$8.97
76078	X	Radiographic absorptiometry	0260	0.7555	$44.83	$17.93	$8.97
76080	X	X-ray exam of fistula	0263	1.7476	$103.71	$24.40	$20.74
76082	A	Computer mammogram add-on
76083	A	Computer mammogram add-on
76086	X	X-ray of mammary duct	0263	1.7476	$103.71	$24.40	$20.74
76088	X	X-ray of mammary ducts	0263	1.7476	$103.71	$24.40	$20.74
76090	A	Mammogram, one breast
76091	A	Mammogram, both breasts
76092	A	Mammogram, screening
76093	E	Magnetic image, breast
76094	E	Magnetic image, both breasts
76095	X	Stereotactic breast biopsy	0264	3.524	$209.12	$79.41	$41.82
76096	X	X-ray of needle wire, breast	0263	1.7476	$103.71	$24.40	$20.74
76098	X	X-ray exam, breast specimen	0260	0.7555	$44.83	$17.93	$8.97
76100	X	X-ray exam of body section	0261	1.2901	$76.56		$15.31
76101	X	Complex body section x-ray	0263	1.7476	$103.71	$24.40	$20.74
76102	X	Complex body section x-rays	0264	3.524	$209.12	$79.41	$41.82
76120	X	Cine/video x-rays	0272	1.3801	$81.90	$32.76	$16.38
76125	X	Cine/video x-rays add-on	0260	0.7555	$44.83	$17.93	$8.97
76140	E	X-ray consultation
76150	X	X-ray exam, dry process	0260	0.7555	$44.83	$17.93	$8.97
76350	N	Special x-ray contrast study
76355	S	Ct scan for localization	0283	4.4253	$262.61	$105.04	$52.52
76360	S	Ct scan for needle biopsy	0283	4.4253	$262.61	$105.04	$52.52
76362	S	Ct guide for tissue ablation	0332	3.2694	$194.02	$77.60	$38.80
76370	S	Ct scan for therapy guide	0282	1.6542	$98.17	$39.26	$19.63
76375	S	3d/holograph reconstr add-on	0282	1.6542	$98.17	$39.26	$19.63
76380	S	CAT scan follow-up study	0282	1.6542	$98.17	$39.26	$19.63
76390	E	Mr spectroscopy
76393	S	Mr guidance for needle place	0335	5.1581	$306.10	$122.43	$61.22
76394	S	Mri for tissue ablation	0335	5.1581	$306.10	$122.43	$61.22
76400	S	Magnetic image, bone marrow	0335	5.1581	$306.10	$122.43	$61.22
76496	X	Fluoroscopic procedure	0272	1.3801	$81.90	$32.76	$16.38
76497	S	Ct procedure	0282	1.6542	$98.17	$39.26	$19.63
76498	S	Mri procedure	0335	5.1581	$306.10	$122.43	$61.22
76499	X	Radiographic procedure	0260	0.7555	$44.83	$17.93	$8.97
76506	S	Echo exam of head	0265	1.0213	$60.61	$24.24	$12.12
76510	S	Ophth us, b quant a	0266	1.6393	$97.28	$38.91	$19.46
76511	S	Echo exam of eye	0266	1.6393	$97.28	$38.91	$19.46
76512	S	Echo exam of eye	0266	1.6393	$97.28	$38.91	$19.46
76513	S	Echo exam of eye, water bath	0266	1.6393	$97.28	$38.91	$19.46
76514	X	Echo exam of eye, thickness	0340	0.6384	$37.88		$7.58
76516	S	Echo exam of eye	0265	1.0213	$60.61	$24.24	$12.12
76519	S	Echo exam of eye	0266	1.6393	$97.28	$38.91	$19.46
76529	S	Echo exam of eye	0265	1.0213	$60.61	$24.24	$12.12
76536	S	Us exam of head and neck	0266	1.6393	$97.28	$38.91	$19.46
76604*	S	Us exam, chest, b-scan	0266	1.6393	$97.28	$38.91	$19.46
76645*	S	Us exam, breast(s)	0265	1.0213	$60.61	$24.24	$12.12
76700*	S	Us exam, abdom, complete	0266	1.6393	$97.28	$38.91	$19.46
76705*	S	Echo exam of abdomen	0266	1.6393	$97.28	$38.91	$19.46
76770*	S	Us exam abdo back wall, comp	0266	1.6393	$97.28	$38.91	$19.46
76775*	S	Us exam abdo back wall, lim	0266	1.6393	$97.28	$38.91	$19.46
76778*	S	Us exam kidney transplant	0266	1.6393	$97.28	$38.91	$19.46
76800	S	Us exam, spinal canal	0266	1.6393	$97.28	$38.91	$19.46
76801	S	Ob us 14 wks, single fetus	0266	1.6393	$97.28	$38.91	$19.46
76802	S	Ob us 14 wks, add'l fetus	0265	1.0213	$60.61	$24.24	$12.12
76805	S	Us exam, pg uterus, compl	0266	1.6393	$97.28	$38.91	$19.46
76810	S	Us exam, pg uterus, mult	0266	1.6393	$97.28	$38.91	$19.46
76811	S	Ob us, detailed, sngl fetus	0267	2.6327	$156.23	$62.18	$31.25
76812	S	Ob us, detailed, addl fetus	0266	1.6393	$97.28	$38.91	$19.46
76815	S	Us exam, pg uterus limit	0265	1.0213	$60.61	$24.24	$12.12
76816	S	Us exam pg uterus repeat	0265	1.0213	$60.61	$24.24	$12.12
76817	S	Transvaginal us, obstetric	0266	1.6393	$97.28	$38.91	$19.46
76818	S	Fetal biophys profile w/nst	0266	1.6393	$97.28	$38.91	$19.46
76819	S	Fetal biophys profil w/o nst	0266	1.6393	$97.28	$38.91	$19.46
76820	S	Umbilical artery echo	0096	1.6307	$96.77	$38.70	$19.35
76821	S	Middle cerebral artery echo	0096	1.6307	$96.77	$38.70	$19.35
76825	S	Echo exam of fetal heart	0671	1.7028	$101.05	$40.42	$20.21
76826	S	Echo exam of fetal heart	0697	1.5357	$91.13	$36.45	$18.23
76827	S	Echo exam of fetal heart	0671	1.7028	$101.05	$40.42	$20.21
76828	S	Echo exam of fetal heart	0697	1.5357	$91.13	$36.45	$18.23
76830*	S	Transvaginal us, non-ob	0266	1.6393	$97.28	$38.91	$19.46
76831*	S	Echo exam, uterus	0267	2.6327	$156.23	$62.18	$31.25
76856*	S	Us exam, pelvic, complete	0266	1.6393	$97.28	$38.91	$19.46
76857*	S	Us exam, pelvic, limited	0265	1.0213	$60.61	$24.24	$12.12
76870	S	Us exam, scrotum	0266	1.6393	$97.28	$38.91	$19.46
76872	S	Us, transrectal	0266	1.6393	$97.28	$38.91	$19.46
76873	S	Echograp trans r, pros study	0266	1.6393	$97.28	$38.91	$19.46
76880	S	Us exam, extremity	0266	1.6393	$97.28	$38.91	$19.46
76885	S	Us exam infant hips, dynamic	0265	1.0213	$60.61	$24.24	$12.12
76886	S	Us exam infant hips, static	0266	1.6393	$97.28	$38.91	$19.46
76930	S	Echo guide, cardiocentesis	0268	1.061	$62.96		$12.59
76932	S	Echo guide for heart biopsy	0268	1.061	$62.96		$12.59
76936	S	Echo guide for artery repair	0268	1.061	$62.96		$12.59
76937	N	Us guide, vascular access
76940	S	Us guide, tissue ablation	0268	1.061	$62.96		$12.59
76941	S	Echo guide for transfusion	0268	1.061	$62.96		$12.59
76942	S	Echo guide for biopsy	0268	1.061	$62.96		$12.59
76945	S	Echo guide, villus sampling	0268	1.061	$62.96		$12.59
76946	S	Echo guide for amniocentesis	0268	1.061	$62.96		$12.59
76948	S	Echo guide, ova aspiration	0268	1.061	$62.96		$12.59
76950	S	Echo guidance radiotherapy	0268	1.061	$62.96		$12.59
76965	S	Echo guidance radiotherapy	0268	1.061	$62.96		$12.59
76970	S	Ultrasound exam follow-up	0265	1.0213	$60.61	$24.24	$12.12
76975	S	GI endoscopic ultrasound	0266	1.6393	$97.28	$38.91	$19.46
76977	X	Us bone density measure	0340	0.6384	$37.88		$7.58
76986	S	Ultrasound guide intraoper	0266	1.6393	$97.28	$38.91	$19.46
76999	S	Echo examination procedure	0265	1.0213	$60.61	$24.24	$12.12
77261	E	Radiation therapy planning
77262	E	Radiation therapy planning
77263	E	Radiation therapy planning
77280	X	Set radiation therapy field	0304	1.7738	$105.26	$41.52	$21.05
77285	X	Set radiation therapy field	0305	4.0036	$237.59	$91.38	$47.52
77290	X	Set radiation therapy field	0305	4.0036	$237.59	$91.38	$47.52
77295	X	Set radiation therapy field	0310	13.949	$827.78	$325.27	$165.56
77299	E	Radiation therapy planning
77300	X	Radiation therapy dose plan	0304	1.7738	$105.26	$41.52	$21.05
77301	X	Radiotherapy dose plan, imrt	0310	13.949	$827.78	$325.27	$165.56
77305	X	Teletx isodose plan simple	0304	1.7738	$105.26	$41.52	$21.05
77310	X	Teletx isodose plan intermed	0305	4.0036	$237.59	$91.38	$47.52
77315	X	Teletx isodose plan complex	0305	4.0036	$237.59	$91.38	$47.52
77321	X	Special teletx port plan	0305	4.0036	$237.59	$91.38	$47.52
77326	X	Radiation therapy dose plan	0304	1.7738	$105.26	$41.52	$21.05
77327	X	Brachytx isodose calc interm	0305	4.0036	$237.59	$91.38	$47.52
77328	X	Brachytx isodose plan compl	0305	4.0036	$237.59	$91.38	$47.52
77331	X	Special radiation dosimetry	0304	1.7738	$105.26	$41.52	$21.05
77332	X	Radiation treatment aid(s)	0303	2.8356	$168.27	$66.95	$33.65
77333	X	Radiation treatment aid(s)	0303	2.8356	$168.27	$66.95	$33.65
77334	X	Radiation treatment aid(s)	0303	2.8356	$168.27	$66.95	$33.65
77336	X	Radiation physics consult	0304	1.7738	$105.26	$41.52	$21.05
77370	X	Radiation physics consult	0304	1.7738	$105.26	$41.52	$21.05
77399	X	External radiation dosimetry	0304	1.7738	$105.26	$41.52	$21.05
77401	S	Radiation treatment delivery	0300	1.5198	$90.19		$18.04
77402	S	Radiation treatment delivery	0300	1.5198	$90.19		$18.04
77403	S	Radiation treatment delivery	0300	1.5198	$90.19		$18.04
77404	S	Radiation treatment delivery	0300	1.5198	$90.19		$18.04
77406	S	Radiation treatment delivery	0300	1.5198	$90.19		$18.04
77407	S	Radiation treatment delivery	0300	1.5198	$90.19		$18.04
77408	S	Radiation treatment delivery	0300	1.5198	$90.19		$18.04
77409	S	Radiation treatment delivery	0300	1.5198	$90.19		$18.04
77411	S	Radiation treatment delivery	0301	2.2195	$131.71		$26.34
77412	S	Radiation treatment delivery	0301	2.2195	$131.71		$26.34
77413	S	Radiation treatment delivery	0301	2.2195	$131.71		$26.34
77414	S	Radiation treatment delivery	0301	2.2195	$131.71		$26.34
77416	S	Radiation treatment delivery	0301	2.2195	$131.71		$26.34
77417	X	Radiology port film(s)	0260	0.7555	$44.83	$17.93	$8.97
77418	S	Radiation tx delivery, imrt	0412	5.3643	$318.33		$63.67
77427	E	Radiation tx management, x5
77431	E	Radiation therapy management
77432	E	Stereotactic radiation trmt
77470	S	Special radiation treatment	0299	5.8482	$347.05		$69.41
77499	E	Radiation therapy management
77520	S	Proton trmt, simple w/o comp	0664	12.9439	$768.13		$153.63
77522	S	Proton trmt, simple w/comp	0664	12.9439	$768.13		$153.63
77523	S	Proton trmt, intermediate	0667	15.4857	$918.97		$183.79
77525	S	Proton treatment, complex	0667	15.4857	$918.97		$183.79
77600	S	Hyperthermia treatment	0314	5.9945	$355.73	$98.36	$71.15
77605	S	Hyperthermia treatment	0314	5.9945	$355.73	$98.36	$71.15
77610	S	Hyperthermia treatment	0314	5.9945	$355.73	$98.36	$71.15
77615	S	Hyperthermia treatment	0314	5.9945	$355.73	$98.36	$71.15
77620	S	Hyperthermia treatment	0314	5.9945	$355.73	$98.36	$71.15
77750	S	Infuse radioactive materials	0301	2.2195	$131.71		$26.34
77761	S	Apply intrcav radiat simple	0312	5.0032	$296.90		$59.38
77762	S	Apply intrcav radiat interm	0312	5.0032	$296.90		$59.38
77763	S	Apply intrcav radiat compl	0312	5.0032	$296.90		$59.38
77776	S	Apply interstit radiat simpl	0312	5.0032	$296.90		$59.38
77777	S	Apply interstit radiat inter	0312	5.0032	$296.90		$59.38
77778	S	Apply interstit radiat compl	0651	12.1448	$720.71		$144.14
77781	S	High intensity brachytherapy	0313	12.8655	$763.48		$152.70
77782	S	High intensity brachytherapy	0313	12.8655	$763.48		$152.70
77783	S	High intensity brachytherapy	0313	12.8655	$763.48		$152.70
77784	S	High intensity brachytherapy	0313	12.8655	$763.48		$152.70
77789	S	Apply surface radiation	0300	1.5198	$90.19		$18.04
77790	N	Radiation handling
77799	S	Radium/radioisotope therapy	0313	12.8655	$763.48		$152.70
78000	S	Thyroid, single uptake	0389	1.4976	$88.87	$35.54	$17.77
78001	S	Thyroid, multiple uptakes	0389	1.4976	$88.87	$35.54	$17.77
78003	S	Thyroid suppress/stimul	0389	1.4976	$88.87	$35.54	$17.77
78006	S	Thyroid imaging with uptake	0390	2.5562	$151.69	$60.67	$30.34
78007	S	Thyroid image, mult uptakes	0391	2.8774	$170.75	$68.30	$34.15
78010	S	Thyroid imaging	0390	2.5562	$151.69	$60.67	$30.34
78011	S	Thyroid imaging with flow	0390	2.5562	$151.69	$60.67	$30.34
78015	S	Thyroid met imaging	0406	4.3035	$255.38	$102.15	$51.08
78016	S	Thyroid met imaging/studies	0406	4.3035	$255.38	$102.15	$51.08
78018	S	Thyroid met imaging, body	0406	4.3035	$255.38	$102.15	$51.08
78020	S	Thyroid met uptake	0399	1.5192	$90.15	$36.06	$18.03
78070	S	Parathyroid nuclear imaging	0391	2.8774	$170.75	$68.30	$34.15
78075	S	Adrenal nuclear imaging	0391	2.8774	$170.75	$68.30	$34.15
78099	S	Endocrine nuclear procedure	0390	2.5562	$151.69	$60.67	$30.34
78102	S	Bone marrow imaging, ltd	0400	4.1335	$245.29	$98.11	$49.06
78103	S	Bone marrow imaging, mult	0400	4.1335	$245.29	$98.11	$49.06
78104	S	Bone marrow imaging, body	0400	4.1335	$245.29	$98.11	$49.06
78110	S	Plasma volume, single	0393	3.4438	$204.37	$81.74	$40.87
78111	S	Plasma volume, multiple	0393	3.4438	$204.37	$81.74	$40.87
78120	S	Red cell mass, single	0393	3.4438	$204.37	$81.74	$40.87
78121	S	Red cell mass, multiple	0393	3.4438	$204.37	$81.74	$40.87
78122	S	Blood volume	0393	3.4438	$204.37	$81.74	$40.87
78130	S	Red cell survival study	0393	3.4438	$204.37	$81.74	$40.87
78135	S	Red cell survival kinetics	0393	3.4438	$204.37	$81.74	$40.87
78140	S	Red cell sequestration	0393	3.4438	$204.37	$81.74	$40.87
78160	S	Plasma iron turnover	0393	3.4438	$204.37	$81.74	$40.87
78162	S	Radioiron absorption exam	0393	3.4438	$204.37	$81.74	$40.87
78170	S	Red cell iron utilization	0393	3.4438	$204.37	$81.74	$40.87
78172	S	Total body iron estimation	0393	3.4438	$204.37	$81.74	$40.87
78185	S	Spleen imaging	0400	4.1335	$245.29	$98.11	$49.06
78190	S	Platelet survival, kinetics	0389	1.4976	$88.87	$35.54	$17.77
78191	S	Platelet survival	0389	1.4976	$88.87	$35.54	$17.77
78195	S	Lymph system imaging	0400	4.1335	$245.29	$98.11	$49.06
78199	S	Blood/lymph nuclear exam	0400	4.1335	$245.29	$98.11	$49.06
78201	S	Liver imaging	0394	4.463	$264.85	$105.93	$52.97
78202	S	Liver imaging with flow	0394	4.463	$264.85	$105.93	$52.97
78205	S	Liver imaging (3D)	0394	4.463	$264.85	$105.93	$52.97
78206	S	Liver image (3d) with flow	0394	4.463	$264.85	$105.93	$52.97
78215	S	Liver and spleen imaging	0394	4.463	$264.85	$105.93	$52.97
78216	S	Liver spleen image/flow	0394	4.463	$264.85	$105.93	$52.97
78220	S	Liver function study	0394	4.463	$264.85	$105.93	$52.97
78223	S	Hepatobiliary imaging	0394	4.463	$264.85	$105.93	$52.97
78230	S	Salivary gland imaging	0395	3.8699	$229.65	$91.86	$45.93
78231	S	Serial salivary imaging	0395	3.8699	$229.65	$91.86	$45.93
78232	S	Salivary gland function exam	0395	3.8699	$229.65	$91.86	$45.93
78258	S	Esophageal motility study	0395	3.8699	$229.65	$91.86	$45.93
78261	S	Gastric mucosa imaging	0395	3.8699	$229.65	$91.86	$45.93
78262	S	Gastroesophageal reflux exam	0395	3.8699	$229.65	$91.86	$45.93
78264	S	Gastric emptying study	0395	3.8699	$229.65	$91.86	$45.93
78267	A	Breath tst attain/anal c-14
78268	A	Breath test analysis, c-14
78270	S	Vit B-12 absorption exam	0389	1.4976	$88.87	$35.54	$17.77
78271	S	Vit b-12 absrp exam, int fac	0389	1.4976	$88.87	$35.54	$17.77
78272	S	Vit B-12 absorp, combined	0389	1.4976	$88.87	$35.54	$17.77
78278	S	Acute GI blood loss imaging	0395	3.8699	$229.65	$91.86	$45.93
78282	S	GI protein loss exam	0395	3.8699	$229.65	$91.86	$45.93
78290	S	Meckel's divert exam	0395	3.8699	$229.65	$91.86	$45.93
78291	S	Leveen/shunt patency exam	0395	3.8699	$229.65	$91.86	$45.93
78299	S	GI nuclear procedure	0395	3.8699	$229.65	$91.86	$45.93
78300	S	Bone imaging, limited area	0396	4.1426	$245.83	$98.33	$49.17
78305	S	Bone imaging, multiple areas	0396	4.1426	$245.83	$98.33	$49.17
78306	S	Bone imaging, whole body	0396	4.1426	$245.83	$98.33	$49.17
78315	S	Bone imaging, 3 phase	0396	4.1426	$245.83	$98.33	$49.17
78320	S	Bone imaging (3D)	0396	4.1426	$245.83	$98.33	$49.17
78350	X	Bone mineral, single photon	0260	0.7555	$44.83	$17.93	$8.97
78351	E	Bone mineral, dual photon
78399	S	Musculoskeletal nuclear exam	0396	4.1426	$245.83	$98.33	$49.17
78414	S	Non-imaging heart function	0398	4.3093	$255.73	$102.29	$51.15
78428	S	Cardiac shunt imaging	0398	4.3093	$255.73	$102.29	$51.15
78445	S	Vascular flow imaging	0397	2.2646	$134.39	$53.75	$26.88
78455	S	Venous thrombosis study	0397	2.2646	$134.39	$53.75	$26.88
78456	S	Acute venous thrombus image	0397	2.2646	$134.39	$53.75	$26.88
78457	S	Venous thrombosis imaging	0397	2.2646	$134.39	$53.75	$26.88
78458	S	Ven thrombosis images, bilat	0397	2.2646	$134.39	$53.75	$26.88
78459	S	Heart muscle imaging (PET)	0285	17.1798	$1,019.50	$318.72	$203.90
78460	S	Heart muscle blood, single	0398	4.3093	$255.73	$102.29	$51.15
78461	S	Heart muscle blood, multiple	0377	6.8344	$405.57	$162.22	$81.11
78464	S	Heart image (3d), single	0398	4.3093	$255.73	$102.29	$51.15
78465	S	Heart image (3d), multiple	0377	6.8344	$405.57	$162.22	$81.11
78466	S	Heart infarct image	0398	4.3093	$255.73	$102.29	$51.15
78468	S	Heart infarct image (ef)	0398	4.3093	$255.73	$102.29	$51.15
78469	S	Heart infarct image (3D)	0398	4.3093	$255.73	$102.29	$51.15
78472	S	Gated heart, planar, single	0398	4.3093	$255.73	$102.29	$51.15
78473	S	Gated heart, multiple	0376	5.1975	$308.44	$121.42	$61.69
78478	S	Heart wall motion add-on	0399	1.5192	$90.15	$36.06	$18.03
78480	S	Heart function add-on	0399	1.5192	$90.15	$36.06	$18.03
78481	S	Heart first pass, single	0398	4.3093	$255.73	$102.29	$51.15
78483	S	Heart first pass, multiple	0376	5.1975	$308.44	$121.42	$61.69
78491	S	Heart image (pet), single	0285	17.1798	$1,019.50	$318.72	$203.90
78492	S	Heart image (pet), multiple	0285	17.1798	$1,019.50	$318.72	$203.90
78494	S	Heart image, spect	0398	4.3093	$255.73	$102.29	$51.15
78496	S	Heart first pass add-on	0399	1.5192	$90.15	$36.06	$18.03
78499	S	Cardiovascular nuclear exam	0398	4.3093	$255.73	$102.29	$51.15
78580	S	Lung perfusion imaging	0401	3.415	$202.66	$81.06	$40.53
78584	S	Lung V/Q image single breath	0378	5.4997	$326.37	$130.54	$65.27
78585	S	Lung V/Q imaging	0378	5.4997	$326.37	$130.54	$65.27
78586	S	Aerosol lung image, single	0401	3.415	$202.66	$81.06	$40.53
78587	S	Aerosol lung image, multiple	0401	3.415	$202.66	$81.06	$40.53
78588	S	Perfusion lung image	0378	5.4997	$326.37	$130.54	$65.27
78591	S	Vent image, 1 breath, 1 proj	0401	3.415	$202.66	$81.06	$40.53
78593	S	Vent image, 1 proj, gas	0401	3.415	$202.66	$81.06	$40.53
78594	S	Vent image, mult proj, gas	0401	3.415	$202.66	$81.06	$40.53
78596	S	Lung differential function	0378	5.4997	$326.37	$130.54	$65.27
78599	S	Respiratory nuclear exam	0401	3.415	$202.66	$81.06	$40.53
78600	S	Brain imaging, ltd static	0402	5.1847	$307.68	$123.07	$61.54
78601	S	Brain imaging, ltd w/flow	0402	5.1847	$307.68	$123.07	$61.54
78605	S	Brain imaging, complete	0402	5.1847	$307.68	$123.07	$61.54
78606	S	Brain imaging, compl w/flow	0402	5.1847	$307.68	$123.07	$61.54
78607	S	Brain imaging (3D)	0402	5.1847	$307.68	$123.07	$61.54
78608	S	Brain imaging (PET)	1513		$1,150.00		$230.00
78609	S	Brain imaging (PET)	1513		$1,150.00		$230.00
78610	S	Brain flow imaging only	0402	5.1847	$307.68	$123.07	$61.54
78615	S	Cerebral vascular flow image	0402	5.1847	$307.68	$123.07	$61.54
78630	S	Cerebrospinal fluid scan	0403	3.6138	$214.45	$85.78	$42.89
78635	S	CSF ventriculography	0403	3.6138	$214.45	$85.78	$42.89
78645	S	CSF shunt evaluation	0403	3.6138	$214.45	$85.78	$42.89
78647	S	Cerebrospinal fluid scan	0403	3.6138	$214.45	$85.78	$42.89
78650	S	CSF leakage imaging	0403	3.6138	$214.45	$85.78	$42.89
78660	S	Nuclear exam of tear flow	0403	3.6138	$214.45	$85.78	$42.89
78699	S	Nervous system nuclear exam	0402	5.1847	$307.68	$123.07	$61.54
78700	S	Kidney imaging, static	0267	2.6327	$156.23	$62.18	$31.25
78701	S	Kidney imaging with flow	0404	3.8559	$228.82	$91.52	$45.76
78704	S	Imaging renogram	0404	3.8559	$228.82	$91.52	$45.76
78707	S	Kidney flow/function image	0404	3.8559	$228.82	$91.52	$45.76
78708	S	Kidney flow/function image	0405	4.2674	$253.24	$101.29	$50.65
78709	S	Kidney flow/function image	0405	4.2674	$253.24	$101.29	$50.65
78710	S	Kidney imaging (3D)	0404	3.8559	$228.82	$91.52	$45.76
78715	S	Renal vascular flow exam	0404	3.8559	$228.82	$91.52	$45.76
78725	S	Kidney function study	0389	1.4976	$88.87	$35.54	$17.77
78730	X	Urinary bladder retention	0340	0.6384	$37.88		$7.58
78740	S	Ureteral reflux study	0404	3.8559	$228.82	$91.52	$45.76
78760	S	Testicular imaging	0404	3.8559	$228.82	$91.52	$45.76
78761	S	Testicular imaging/flow	0404	3.8559	$228.82	$91.52	$45.76
78799	S	Genitourinary nuclear exam	0404	3.8559	$228.82	$91.52	$45.76
78800	S	Tumor imaging, limited area	0406	4.3035	$255.38	$102.15	$51.08
78801	S	Tumor imaging, mult areas	0406	4.3035	$255.38	$102.15	$51.08
78802	S	Tumor imaging, whole body	0406	4.3035	$255.38	$102.15	$51.08
78803	S	Tumor imaging (3D)	0406	4.3035	$255.38	$102.15	$51.08
78804	S	Tumor imaging, whole body	1508		$650.00		$130.00
78805	S	Abscess imaging, ltd area	0406	4.3035	$255.38	$102.15	$51.08
78806	S	Abscess imaging, whole body	0406	4.3035	$255.38	$102.15	$51.08
78807	S	Nuclear localization/abscess	0406	4.3035	$255.38	$102.15	$51.08
78811	S	Tumor imaging (pet), limited	1513		$1,150.00		$230.00
78812	S	Tumor image (pet)/skul-thigh	1513		$1,150.00		$230.00
78813	S	Tumor image (pet) full body	1513		$1,150.00		$230.00
78814	S	Tumor image pet/ct, limited	1514		$1,250.00		$250.00
78815	S	Tumorimage pet/ct skul-thigh	1514		$1,250.00		$250.00
78816	S	Tumor image pet/ct full body	1514		$1,250.00		$250.00
78890	N	Nuclear medicine data proc
78891	N	Nuclear med data proc
78999	S	Nuclear diagnostic exam	0389	1.4976	$88.87	$35.54	$17.77
79005	S	Nuclear rx, oral admin	0407	3.9839	$236.42	$94.56	$47.28
79101	S	Nuclear rx, iv admin	0407	3.9839	$236.42	$94.56	$47.28
79200	S	Intracavitary nuclear trmt	0407	3.9839	$236.42	$94.56	$47.28
79300	S	Interstitial nuclear therapy	0407	3.9839	$236.42	$94.56	$47.28
79403	S	Hematopoetic nuclear therapy	1507		$550.00		$110.00
79440	S	Nuclear joint therapy	0407	3.9839	$236.42	$94.56	$47.28
79445	S	Nuclear rx, intra-arterial	0407	3.9839	$236.42	$94.56	$47.28
79999	S	Nuclear medicine therapy	0407	3.9839	$236.42	$94.56	$47.28
80048	A	Basic metabolic panel
80050	E	General health panel
80051	A	Electrolyte panel
80053	A	Comprehen metabolic panel
80055	E	Obstetric panel
80061	A	Lipid panel
80069	A	Renal function panel
80074	A	Acute hepatitis panel
80076	A	Hepatic function panel
80100	A	Drug screen, qualitate/multi
80101	A	Drug screen, single
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, carbamazepine, total
80157	A	Assay, 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	0433	0.2581	$15.32	$6.12	$3.06
80502	X	Lab pathology consultation	0342	0.156	$9.26	$3.70	$1.85
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	A	Urinalysis test procedure
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
82045	A	Albumin, ischemia modified
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
82252	A	Fecal bilirubin test
82261	A	Assay of biotinidase
82270	A	Test for blood, feces
82273	A	Test for blood, other source
82274	A	Assay test for blood, fecal
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 analysis, qual
82360	A	Calculus assay, quant
82365	A	Calculus spectroscopy
82370	A	X-ray assay, calculus
82373	A	Assay, c-d transfer measure
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, bld/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
82656	A	Pancreatic elastase, fecal
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 or 4, each
82800	A	Blood pH
82803	A	Blood gases pH, pO2 pCO2
82805	A	Blood gases W/02 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 other fluid
82946	A	Glucagon tolerance test
82947	A	Assay, glucose, blood 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
83009	A	H pylori (c-13), blood
83010	A	Assay of haptoglobin, quant
83012	A	Assay of haptoglobins
83013	A	H pylori 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, chemical
83033	A	Fetal hemoglobin assay, qual
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	Assay of 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 (LD) (LDH) enzyme
83625	A	Assay of ldh enzymes
83630	A	Lactoferrin, fecal (qual)
83632	A	Placental lactogen
83633	A	Test urine for lactose
83634	A	Assay of urine for lactose
83655	A	Assay of lead
83661	A	L/s ratio, fetal lung
83662	A	Foam stability, fetal lung
83663	A	Fluoro polarize, fetal lung
83664	A	Lamellar bdy, fetal lung
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
83880	A	Natriuretic peptide
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	Organic acids, total, quant
83919	A	Organic acids, qual, each
83921	A	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
83950	A	Oncoprotein, her-2/neu
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	Assay of psa, complexed
84153	A	Assay of psa, total
84154	A	Assay of psa, free
84155	A	Assay of protein, serum
84156	A	Assay of protein, urine
84157	A	Assay of protein, other
84160	A	Assay of protein, any source
84163	A	Pappa, serum
84165	A	Electrophoreisis of proteins
84166	A	Protein e-phoresis/urine/csf
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
84302	A	Assay of sweat 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 (AST) (SGOT)
84460	A	Alanine amino (ALT) (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	Assay of nos vitamin
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	A	Clinical chemistry test
85002	A	Bleeding time test
85004	A	Automated diff wbc count
85007	A	Differential WBC count
85008	A	Nondifferential WBC count
85009	A	Differential WBC count
85013	A	Spun microhematocrit
85014	A	Hematocrit
85018	A	Hemoglobin
85025	A	Automated hemogram
85027	A	Automated hemogram
85032	A	Manual cell count, each
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
85049	A	Automated platelet count
85055	A	Reticulated platelet assay
85060	B	Blood smear interpretation
85097	X	Bone marrow interpretation	0343	0.4786	$28.40	$11.10	$5.68
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	Assay activated protein c
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, quant
85380	A	Fibrin degradation, vte
85384	A	Fibrinogen
85385	A	Fibrinogen
85390	A	Fibrinolysins screen
85396	N	Clotting assay, whole blood
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 neutralization
85530	A	Heparin-protamine tolerance
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
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	A	Hematology procedure
86000	A	Agglutinins, febrile
86001	A	Allergen specific igg
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
86064	A	B cells, total count
86077	X	Physician blood bank service	0433	0.2581	$15.32	$6.12	$3.06
86078	X	Physician blood bank service	0343	0.4786	$28.40	$11.10	$5.68
86079	X	Physician blood bank service	0433	0.2581	$15.32	$6.12	$3.06
86140	A	C-reactive protein
86141	A	C-reactive protein, hs
86146	A	Glycoprotein 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	Immunoassay, tumor, qual
86300	A	Immunoassay, tumor, ca 15-3
86301	A	Immunoassay, tumor, ca 19-9
86304	A	Immunoassay, tumor, ca 125
86308	A	Heterophile antibodies
86309	A	Heterophile antibodies
86310	A	Heterophile antibodies
86316	A	Immunoassay, tumor other
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
86335	A	Immunfix e-phorsis/urine/csf
86336	A	Inhibin A
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
86379	A	Nk cells, total count
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	0.1112	$6.60	$2.62	$1.32
86490	X	Coccidioidomycosis skin test	0341	0.1112	$6.60	$2.62	$1.32
86510	X	Histoplasmosis skin test	0341	0.1112	$6.60	$2.62	$1.32
86580	X	TB intradermal test	0341	0.1112	$6.60	$2.62	$1.32
86585	X	TB tine test	0341	0.1112	$6.60	$2.62	$1.32
86586	X	Skin test, unlisted	0341	0.1112	$6.60	$2.62	$1.32
86587	A	Stem cells, total count
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	Ehrlichia antibody
86668	A	Francisella tularensis
86671	A	Fungus antibody
86674	A	Giardia lamblia antibody
86677	A	Helicobacter pylori
86682	A	Helminth 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
86694	A	Herpes simplex test
86695	A	Herpes simplex test
86696	A	Herpes simplex type 2
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, total
86705	A	Hep b core antibody, igm
86706	A	Hep b surface antibody
86707	A	Hep be antibody
86708	A	Hep a antibody, total
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	A	Immunology procedure
86850	X	RBC antibody screen	0345	0.2277	$13.51	$3.01	$2.70
86860	X	RBC antibody elution	0346	0.3434	$20.38	$4.54	$4.08
86870	X	RBC antibody identification	0346	0.3434	$20.38	$4.54	$4.08
86880	X	Coombs test, direct	0409	0.1258	$7.47	$2.22	$1.49
86885	X	Coombs test, indirect, qual	0409	0.1258	$7.47	$2.22	$1.49
86886	X	Coombs test, indirect, titer	0409	0.1258	$7.47	$2.22	$1.49
86890	X	Autologous blood process	0347	0.8434	$50.05	$12.35	$10.01
86891	X	Autologous blood, op salvage	0346	0.3434	$20.38	$4.54	$4.08
86900	X	Blood typing, ABO	0409	0.1258	$7.47	$2.22	$1.49
86901	X	Blood typing, Rh (D)	0409	0.1258	$7.47	$2.22	$1.49
86903	X	Blood typing, antigen screen	0345	0.2277	$13.51	$3.01	$2.70
86904	X	Blood typing, patient serum	0346	0.3434	$20.38	$4.54	$4.08
86905	X	Blood typing, RBC antigens	0345	0.2277	$13.51	$3.01	$2.70
86906	X	Blood typing, Rh phenotype	0345	0.2277	$13.51	$3.01	$2.70
86910	E	Blood typing, paternity test
86911	E	Blood typing, antigen system
86920	X	Compatibility test	0346	0.3434	$20.38	$4.54	$4.08
86921	X	Compatibility test	0345	0.2277	$13.51	$3.01	$2.70
86922	X	Compatibility test	0346	0.3434	$20.38	$4.54	$4.08
86927	X	Plasma, fresh frozen	0345	0.2277	$13.51	$3.01	$2.70
86930	X	Frozen blood prep	0347	0.8434	$50.05	$12.35	$10.01
86931	X	Frozen blood thaw	0347	0.8434	$50.05	$12.35	$10.01
86932	X	Frozen blood freeze/thaw	0347	0.8434	$50.05	$12.35	$10.01
86940	A	Hemolysins/agglutinins, auto
86941	A	Hemolysins/agglutinins
86945	X	Blood product/irradiation	0345	0.2277	$13.51	$3.01	$2.70
86950	X	Leukacyte transfusion	0345	0.2277	$13.51	$3.01	$2.70
86965	X	Pooling blood platelets	0345	0.2277	$13.51	$3.01	$2.70
86970	X	RBC pretreatment	0345	0.2277	$13.51	$3.01	$2.70
86971	X	RBC pretreatment	0345	0.2277	$13.51	$3.01	$2.70
86972	X	RBC pretreatment	0346	0.3434	$20.38	$4.54	$4.08
86975	X	RBC pretreatment, serum	0345	0.2277	$13.51	$3.01	$2.70
86976	X	RBC pretreatment, serum	0345	0.2277	$13.51	$3.01	$2.70
86977	X	RBC pretreatment, serum	0345	0.2277	$13.51	$3.01	$2.70
86978	X	RBC pretreatment, serum	0345	0.2277	$13.51	$3.01	$2.70
86985	X	Split blood or products	0345	0.2277	$13.51	$3.01	$2.70
86999	X	Transfusion procedure	0345	0.2277	$13.51	$3.01	$2.70
87001	A	Small animal inoculation
87003	A	Small animal inoculation
87015	A	Specimen concentration
87040	A	Blood culture for bacteria
87045	A	Feces culture, bacteria
87046	A	Stool cultr, bacteria, each
87070	A	Culture, bacteria, other
87071	A	Culture bacteri aerobic othr
87073	A	Culture bacteria anaerobic
87075	A	Cultr bacteria, except blood
87076	A	Culture anaerobe ident, each
87077	A	Culture aerobic identify
87081	A	Culture screen only
87084	A	Culture of specimen by kit
87086	A	Urine culture/colony count
87088	A	Urine bacteria culture
87101	A	Skin fungi culture
87102	A	Fungus isolation culture
87103	A	Blood fungus culture
87106	A	Fungi identification, yeast
87107	A	Fungi identification, mold
87109	A	Mycoplasma
87110	A	Chlamydia culture
87116	A	Mycobacteria culture
87118	A	Mycobacteric identification
87140	A	Culture type immunofluoresc
87143	A	Culture typing, glc/hplc
87147	A	Culture type, immunologic
87149	A	Culture type, nucleic acid
87152	A	Culture type pulse field gel
87158	A	Culture typing, added method
87164	A	Dark field examination
87166	A	Dark field examination
87168	A	Macroscopic exam arthropod
87169	A	Macroscopic exam parasite
87172	A	Pinworm exam
87176	A	Tissue homogenization, cultr
87177	A	Ova and parasites smears
87181	A	Microbe susceptible, diffuse
87184	A	Microbe susceptible, disk
87185	A	Microbe susceptible, enzyme
87186	A	Microbe susceptible, mic
87187	A	Microbe susceptible, mlc
87188	A	Microbe suscept, macrobroth
87190	A	Microbe suscept, mycobacteri
87197	A	Bactericidal level, serum
87205	A	Smear, gram stain
87206	A	Smear, fluorescent/acid stai
87207	A	Smear, special stain
87210	A	Smear, wet mount, saline/ink
87220	A	Tissue exam for fungi
87230	A	Assay, toxin or antitoxin
87250	A	Virus inoculate, eggs/animal
87252	A	Virus inoculation, tissue
87253	A	Virus inoculate tissue, addl
87254	A	Virus inoculation, shell via
87255	A	Genet virus isolate, hsv
87260	A	Adenovirus ag, if
87265	A	Pertussis ag, if
87267	A	Enterovirus antibody, dfa
87269	A	Giardia ag, if
87270	A	Chlamydia trachomatis ag, if
87271	A	Cryptosporidum/gardia ag, if
87272	A	Cryptosporidium ag, if
87273	A	Herpes simplex 2, ag, if
87274	A	Herpes simplex 1, ag, if
87275	A	Influenza b, ag, if
87276	A	Influenza a, ag, if
87277	A	Legionella micdadei, ag, if
87278	A	Legion pneumophilia ag, if
87279	A	Parainfluenza, ag, if
87280	A	Respiratory syncytial ag, if
87281	A	Pneumocystis carinii, ag, if
87283	A	Rubeola, ag, if
87285	A	Treponema pallidum, ag, if
87290	A	Varicella zoster, ag, if
87299	A	Antibody detection, nos, if
87300	A	Ag detection, polyval, if
87301	A	Adenovirus ag, eia
87320	A	Chylmd trach ag, eia
87324	A	Clostridium ag, eia
87327	A	Cryptococcus neoform ag, eia
87328	A	Cryptosporidium ag, eia
87329	A	Giardia ag, eia
87332	A	Cytomegalovirus ag, eia
87335	A	E coli 0157 ag, eia
87336	A	Entamoeb hist dispr, ag, eia
87337	A	Entamoeb hist group, ag, eia
87338	A	Hpylori, stool, eia
87339	A	H pylori ag, eia
87340	A	Hepatitis b surface ag, eia
87341	A	Hepatitis b surface, ag, eia
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	Influenza a/b, ag, eia
87420	A	Resp syncytial ag, eia
87425	A	Rotavirus ag, eia
87427	A	Shiga-like toxin ag, eia
87430	A	Strep a ag, eia
87449	A	Ag detect nos, eia, mult
87450	A	Ag detect nos, eia, single
87451	A	Ag detect polyval, eia, mult
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
87660	A	Trichomonas vagin, dir probe
87797	A	Detect agent nos, dna, dir
87798	A	Detect agent nos, dna, amp
87799	A	Detect agent nos, dna, quant
87800	A	Detect agnt mult, dna, direc
87801	A	Detect agnt mult, dna, ampli
87802	A	Strep b assay w/optic
87803	A	Clostridium toxin a w/optic
87804	A	Influenza assay w/optic
87807	A	Rsv assay w/optic
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	Genotype, dna, hiv reverse t
87902	A	Genotype, dna, hepatitis C
87903	A	Phenotype, dna hiv w/culture
87904	A	Phenotype, dna hiv w/clt add
87999	A	Microbiology procedure
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	0433	0.2581	$15.32	$6.12	$3.06
88106	X	Cytopathology, fluids	0433	0.2581	$15.32	$6.12	$3.06
88107	X	Cytopathology, fluids	0433	0.2581	$15.32	$6.12	$3.06
88108	X	Cytopath, concentrate tech	0433	0.2581	$15.32	$6.12	$3.06
88112	X	Cytopath, cell enhance tech	0343	0.4786	$28.40	$11.10	$5.68
88125	X	Forensic cytopathology	0342	0.156	$9.26	$3.70	$1.85
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
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	0433	0.2581	$15.32	$6.12	$3.06
88161	X	Cytopath smear, other source	0433	0.2581	$15.32	$6.12	$3.06
88162	X	Cytopath smear, other source	0433	0.2581	$15.32	$6.12	$3.06
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
88172	X	Cytopathology eval of fna	0343	0.4786	$28.40	$11.10	$5.68
88173	X	Cytopath eval, fna, report	0343	0.4786	$28.40	$11.10	$5.68
88174	A	Cytopath, c/v auto, in fluid
88175	A	Cytopath c/v auto fluid redo
88182	X	Cell marker study	0344	0.7996	$47.45	$15.66	$9.49
88184	X	Flowcytometry/ tc, 1 marker	0344	0.7996	$47.45	$15.66	$9.49
88185	X	Flowcytometry/tc, add-on	0343	0.4786	$28.40	$11.10	$5.68
88187	X	Flowcytometry/read, 2-8	0433	0.2581	$15.32	$6.12	$3.06
88188	X	Flowcytometry/read, 9-15	0433	0.2581	$15.32	$6.12	$3.06
88189	X	Flowcytometry/read, 16	0343	0.4786	$28.40	$11.10	$5.68
88199	A	Cytopathology procedure
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	0.156	$9.26	$3.70	$1.85
88300	X	Surgical path, gross	0433	0.2581	$15.32	$6.12	$3.06
88302	X	Tissue exam by pathologist	0433	0.2581	$15.32	$6.12	$3.06
88304	X	Tissue exam by pathologist	0343	0.4786	$28.40	$11.10	$5.68
88305	X	Tissue exam by pathologist	0343	0.4786	$28.40	$11.10	$5.68
88307	X	Tissue exam by pathologist	0344	0.7996	$47.45	$15.66	$9.49
88309	X	Tissue exam by pathologist	0344	0.7996	$47.45	$15.66	$9.49
88311	X	Decalcify tissue	0342	0.156	$9.26	$3.70	$1.85
88312	X	Special stains	0433	0.2581	$15.32	$6.12	$3.06
88313	X	Special stains	0433	0.2581	$15.32	$6.12	$3.06
88314	X	Histochemical stain	0342	0.156	$9.26	$3.70	$1.85
88318	X	Chemical histochemistry	0433	0.2581	$15.32	$6.12	$3.06
88319	X	Enzyme histochemistry	0343	0.4786	$28.40	$11.10	$5.68
88321	X	Microslide consultation	0433	0.2581	$15.32	$6.12	$3.06
88323	X	Microslide consultation	0343	0.4786	$28.40	$11.10	$5.68
88325	X	Comprehensive review of data	0344	0.7996	$47.45	$15.66	$9.49
88329	X	Path consult introp	0433	0.2581	$15.32	$6.12	$3.06
88331	X	Path consult intraop, 1 bloc	0343	0.4786	$28.40	$11.10	$5.68
88332	X	Path consult intraop, add'l	0433	0.2581	$15.32	$6.12	$3.06
88342	X	Immunohistochemistry	0343	0.4786	$28.40	$11.10	$5.68
88346	X	Immunofluorescent study	0343	0.4786	$28.40	$11.10	$5.68
88347	X	Immunofluorescent study	0343	0.4786	$28.40	$11.10	$5.68
88348	X	Electron microscopy	0661	3.3775	$200.43	$80.17	$40.09
88349	X	Scanning electron microscopy	0661	3.3775	$200.43	$80.17	$40.09
88355	X	Analysis, skeletal muscle	0343	0.4786	$28.40	$11.10	$5.68
88356	X	Analysis, nerve	0344	0.7996	$47.45	$15.66	$9.49
88358	X	Analysis, tumor	0344	0.7996	$47.45	$15.66	$9.49
88360	X	Tumor immunohistochem/manual	0344	0.7996	$47.45	$15.66	$9.49
88361	X	Immunohistochemistry, tumor	0344	0.7996	$47.45	$15.66	$9.49
88362	X	Nerve teasing preparations	0344	0.7996	$47.45	$15.66	$9.49
88365	X	Tissue hybridization	0344	0.7996	$47.45	$15.66	$9.49
88367	X	Insitu hybridization, auto	0344	0.7996	$47.45	$15.66	$9.49
88368	X	Insitu hybridization, manual	0344	0.7996	$47.45	$15.66	$9.49
88371	A	Protein, western blot tissue
88372	A	Protein analysis w/probe
88380	A	Microdissection
88399	A	Surgical pathology procedure
88400	A	Bilirubin total transcut
89050	A	Body fluid cell count
89051	A	Body fluid cell count
89055	A	Leukocyte assessment, fecal
89060	A	Exam,synovial fluid crystals
89100	X	Sample intestinal contents	0360	1.4739	$87.47	$34.98	$17.49
89105	X	Sample intestinal contents	0360	1.4739	$87.47	$34.98	$17.49
89125	A	Specimen fat stain
89130	X	Sample stomach contents	0360	1.4739	$87.47	$34.98	$17.49
89132	X	Sample stomach contents	0360	1.4739	$87.47	$34.98	$17.49
89135	X	Sample stomach contents	0360	1.4739	$87.47	$34.98	$17.49
89136	X	Sample stomach contents	0360	1.4739	$87.47	$34.98	$17.49
89140	X	Sample stomach contents	0360	1.4739	$87.47	$34.98	$17.49
89141	X	Sample stomach contents	0360	1.4739	$87.47	$34.98	$17.49
89160	A	Exam feces for meat fibers
89190	A	Nasal smear for eosinophils
89220	X	Sputum specimen collection	0343	0.4786	$28.40	$11.10	$5.68
89225	A	Starch granules, feces
89230	X	Collect sweat for test	0433	0.2581	$15.32	$6.12	$3.06
89235	A	Water load test
89240	A	Pathology lab procedure
89250	X	Cultr oocyte/embryo 4 days	0348	0.7927	$47.04		$9.41
89251	X	Cultr oocyte/embryo 4 days	0348	0.7927	$47.04		$9.41
89253	X	Embryo hatching	0348	0.7927	$47.04		$9.41
89254	X	Oocyte identification	0348	0.7927	$47.04		$9.41
89255	X	Prepare embryo for transfer	0348	0.7927	$47.04		$9.41
89257	X	Sperm identification	0348	0.7927	$47.04		$9.41
89258	X	Cryopreservation embryo(s)	0348	0.7927	$47.04		$9.41
89259	X	Cryopreservation, sperm	0348	0.7927	$47.04		$9.41
89260	X	Sperm isolation, simple	0348	0.7927	$47.04		$9.41
89261	X	Sperm isolation, complex	0348	0.7927	$47.04		$9.41
89264	X	Identify sperm tissue	0348	0.7927	$47.04		$9.41
89268	X	Insemination of oocytes	0348	0.7927	$47.04		$9.41
89272	X	Extended culture of oocytes	0348	0.7927	$47.04		$9.41
89280	X	Assist oocyte fertilization	0348	0.7927	$47.04		$9.41
89281	X	Assist oocyte fertilization	0348	0.7927	$47.04		$9.41
89290	X	Biopsy, oocyte polar body	0348	0.7927	$47.04		$9.41
89291	X	Biopsy, oocyte polar body	0348	0.7927	$47.04		$9.41
89300	A	Semen analysis w/huhner
89310	A	Semen analysis
89320	A	Semen analysis, complete
89321	A	Semen analysis motility
89325	A	Sperm antibody test
89329	A	Sperm evaluation test
89330	A	Evaluation, cervical mucus
89335	X	Cryopreserve testicular tiss	0348	0.7927	$47.04		$9.41
89342	X	Storage/year embryo(s)	0348	0.7927	$47.04		$9.41
89343	X	Storage/year sperm/semen	0348	0.7927	$47.04		$9.41
89344	X	Storage/year reprod tissue	0348	0.7927	$47.04		$9.41
89346	X	Storage/year oocyte	0348	0.7927	$47.04		$9.41
89352	X	Thawing cryopresrved embryo	0348	0.7927	$47.04		$9.41
89353	X	Thawing cryopresrved sperm	0348	0.7927	$47.04		$9.41
89354	X	Thaw cryoprsvrd reprod tiss	0348	0.7927	$47.04		$9.41
89356	X	Thawing cryopresrved oocyte	0348	0.7927	$47.04		$9.41
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	N	Diphtheria antitoxin
90371	E	Hep b ig, im
90375	K	Rabies ig, im/sc	9133		$64.56		$12.91
90376	K	Rabies ig, heat treated	9134		$69.79		$13.96
90378	E	Rsv ig, im, 50mg
90379	E	Rsv ig, iv
90384	E	Rh ig, full-dose, im
90385	N	Rh ig, minidose, im
90386	E	Rh ig, iv
90389	E	Tetanus ig, im
90393	N	Vaccina ig, im
90396	K	Varicella-zoster ig, im	9135		$96.58		$19.32
90399	E	Immune globulin
90465	B	Immune admin 1 inj, 8 yrs
90466	B	Immune admin addl inj, 8 y
90467	B	Immune admin o or n, 8 yrs
90468	B	Immune admin o/n, addl 8 y
90471	X	Immunization admin	0353	0.3954	$23.46		$4.69
90472	X	Immunization admin, each add	0353	0.3954	$23.46		$4.69
90473	S	Immune admin oral/nasal	1491		$5.00		$1.00
90474	S	Immune admin oral/nasal addl	1491		$5.00		$1.00
90476	K	Adenovirus vaccine, type 4	9136	0.9499	$56.37		$11.27
90477	N	Adenovirus vaccine, type 7
90581	K	Anthrax vaccine, sc	9169		$128.95		$25.79
90585	K	Bcg vaccine, percut	9137		$124.54		$24.91
90586	B	Bcg vaccine, intravesical
90632	N	Hep a vaccine, adult im
90633	N	Hep a vacc, ped/adol, 2 dose
90634	N	Hep a vacc, ped/adol, 3 dose
90636	K	Hep a/hep b vacc, adult im	9138	0.9674	$57.41		$11.48
90645	N	Hib vaccine, hboc, im
90646	N	Hib vaccine, prp-d, im
90647	N	Hib vaccine, prp-omp, im
90648	N	Hib vaccine, prp-t, im
90655	L	Flu vaccine, 6-35 mo, im
90656	L	Flu vaccine no preserv 3
90657	L	Flu vaccine, 6-35 mo, im
90658	L	Flu vaccine, 3 yrs, im
90660	E	Flu vaccine, nasal
90665	N	Lyme disease vaccine, im
90669	E	Pneumococcal vacc, ped 5
90675	K	Rabies vaccine, im	9139		$128.04		$25.61
90676	K	Rabies vaccine, id	9140	1.4959	$88.77		$17.75
90680	N	Rotovirus vaccine, oral
90690	N	Typhoid vaccine, oral
90691	N	Typhoid vaccine, im
90692	N	Typhoid vaccine, h-p, sc/id
90693	N	Typhoid vaccine, akd, sc
90698	N	Dtap-hib-ip vaccine, im
90700	N	Dtap vaccine, im
90701	N	Dtp vaccine, im
90702	N	Dt vaccine 7, im
90703	N	Tetanus vaccine, im
90704	N	Mumps vaccine, sc
90705	N	Measles vaccine, sc
90706	N	Rubella vaccine, sc
90707	N	Mmr vaccine, sc
90708	K	Measles-rubella vaccine, sc	9141	0.9467	$56.18		$11.24
90710	N	Mmrv vaccine, sc
90712	N	Oral poliovirus vaccine
90713	N	Poliovirus, ipv, sc
90715	N	Tdap vaccine 7 im
90716	K	Chicken pox vaccine, sc	9142		$64.29		$12.86
90717	N	Yellow fever vaccine, sc
90718	N	Td vaccine 7, im
90719	N	Diphtheria vaccine, im
90720	N	Dtp/hib vaccine, im
90721	N	Dtap/hib vaccine, im
90723	E	Dtap-hep b-ipv vaccine, im
90725	N	Cholera vaccine, injectable
90727	N	Plague vaccine, im
90732	L	Pneumococcal vaccine
90733	K	Meningococcal vaccine, sc	9143		$56.75		$11.35
90734	K	Meningococcal vaccine, im	9145	0.8948	$53.10		$10.62
90735	K	Encephalitis vaccine, sc	9144		$67.73		$13.55
90740	F	Hepb vacc, ill pat 3 dose im
90743	F	Hep b vacc, adol, 2 dose, im
90744	F	Hepb vacc ped/adol 3 dose im
90746	F	Hep b vaccine, adult, im
90747	F	Hepb vacc, ill pat 4 dose im
90748	E	Hep b/hib vaccine, im
90749	N	Vaccine toxoid
90780	S	IV infusion therapy, 1 hour	0120	2.0193	$119.83	$28.21	$23.97
90781	N	IV infusion, additional hour
90782	X	Injection, sc/im	0353	0.3954	$23.46		$4.69
90783	X	Injection, ia	0359	0.8312	$49.33		$9.87
90784	X	Injection, iv	0359	0.8312	$49.33		$9.87
90788	X	Injection of antibiotic	0359	0.8312	$49.33		$9.87
90799	X	Ther/prophylactic/dx inject	0352	0.1413	$8.39		$1.68
90801	S	Psy dx interview	0323	1.6227	$96.30	$20.08	$19.26
90802	S	Intac psy dx interview	0323	1.6227	$96.30	$20.08	$19.26
90804	S	Psytx, office, 20-30 min	0322	1.2319	$73.10		$14.62
90805	S	Psytx, off, 20-30 min w/em	0322	1.2319	$73.10		$14.62
90806	S	Psytx, off, 45-50 min	0323	1.6227	$96.30	$20.08	$19.26
90807	S	Psytx, off, 45-50 min w/em	0323	1.6227	$96.30	$20.08	$19.26
90808	S	Psytx, office, 75-80 min	0323	1.6227	$96.30	$20.08	$19.26
90809	S	Psytx, off, 75-80, w/em	0323	1.6227	$96.30	$20.08	$19.26
90810	S	Intac psytx, off, 20-30 min	0322	1.2319	$73.10		$14.62
90811	S	Intac psytx, 20-30, w/em	0322	1.2319	$73.10		$14.62
90812	S	Intac psytx, off, 45-50 min	0323	1.6227	$96.30	$20.08	$19.26
90813	S	Intac psytx, 45-50 min w/em	0323	1.6227	$96.30	$20.08	$19.26
90814	S	Intac psytx, off, 75-80 min	0323	1.6227	$96.30	$20.08	$19.26
90815	S	Intac psytx, 75-80 w/em	0323	1.6227	$96.30	$20.08	$19.26
90816	S	Psytx, hosp, 20-30 min	0322	1.2319	$73.10		$14.62
90817	S	Psytx, hosp, 20-30 min w/em	0322	1.2319	$73.10		$14.62
90818	S	Psytx, hosp, 45-50 min	0323	1.6227	$96.30	$20.08	$19.26
90819	S	Psytx, hosp, 45-50 min w/em	0323	1.6227	$96.30	$20.08	$19.26
90821	S	Psytx, hosp, 75-80 min	0323	1.6227	$96.30	$20.08	$19.26
90822	S	Psytx, hosp, 75-80 min w/em	0323	1.6227	$96.30	$20.08	$19.26
90823	S	Intac psytx, hosp, 20-30 min	0322	1.2319	$73.10		$14.62
90824	S	Intac psytx, hsp 20-30 w/em	0322	1.2319	$73.10		$14.62
90826	S	Intac psytx, hosp, 45-50 min	0323	1.6227	$96.30	$20.08	$19.26
90827	S	Intac psytx, hsp 45-50 w/em	0323	1.6227	$96.30	$20.08	$19.26
90828	S	Intac psytx, hosp, 75-80 min	0323	1.6227	$96.30	$20.08	$19.26
90829	S	Intac psytx, hsp 75-80 w/em	0323	1.6227	$96.30	$20.08	$19.26
90845	S	Psychoanalysis	0323	1.6227	$96.30	$20.08	$19.26
90846	S	Family psytx w/o patient	0324	2.0997	$124.60		$24.92
90847	S	Family psytx w/patient	0324	2.0997	$124.60		$24.92
90849	S	Multiple family group psytx	0325	1.3189	$78.27	$17.10	$15.65
90853	S	Group psychotherapy	0325	1.3189	$78.27	$17.10	$15.65
90857	S	Intac group psytx	0325	1.3189	$78.27	$17.10	$15.65
90862	X	Medication management	0374	1.0414	$61.80		$12.36
90865	S	Narcosynthesis	0323	1.6227	$96.30	$20.08	$19.26
90870	S	Electroconvulsive therapy	0320	5.3765	$319.06	$80.06	$63.81
90871	E	Electroconvulsive therapy
90875	E	Psychophysiological therapy
90876	E	Psychophysiological therapy
90880	S	Hypnotherapy	0323	1.6227	$96.30	$20.08	$19.26
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	1.2319	$73.10		$14.62
90901	A	Biofeedback train, any meth
90911	S	Biofeedback peri/uro/rectal	0321	1.3579	$80.58	$21.71	$16.12
90918	E	ESRD related services, month
90919	E	ESRD related services, month
90920	E	ESRD related services, month
90921	E	ESRD related services, month
90922	E	ESRD related services, day
90923	E	Esrd related services, day
90924	E	Esrd related services, day
90925	E	Esrd related services, day
90935	S	Hemodialysis, one evaluation	0170	5.8994	$350.09		$70.02
90937	E	Hemodialysis, repeated eval
90939	N	Hemodialysis study, transcut
90940	N	Hemodialysis access study
90945	S	Dialysis, one evaluation	0170	5.8994	$350.09		$70.02
90947	E	Dialysis, repeated eval
90989	B	Dialysis training, complete
90993	B	Dialysis training, incompl
90997	E	Hemoperfusion
90999	B	Dialysis procedure
91000	X	Esophageal intubation	0361	3.6216	$214.92	$83.23	$42.98
91010	X	Esophagus motility study	0361	3.6216	$214.92	$83.23	$42.98
91011	X	Esophagus motility study	0361	3.6216	$214.92	$83.23	$42.98
91012	X	Esophagus motility study	0361	3.6216	$214.92	$83.23	$42.98
91020	X	Gastric motility	0361	3.6216	$214.92	$83.23	$42.98
91030	X	Acid perfusion of esophagus	0361	3.6216	$214.92	$83.23	$42.98
91034	X	Gastroesophageal reflux test	0361	3.6216	$214.92	$83.23	$42.98
91035	S	G-esoph reflx tst w/electrod	1506		$450.00		$90.00
91037	X	Esoph imped function test	0361	3.6216	$214.92	$83.23	$42.98
91038	X	Esoph imped funct test 1h	0361	3.6216	$214.92	$83.23	$42.98
91040	X	Esoph balloon distension tst	0360	1.4739	$87.47	$34.98	$17.49
91052	X	Gastric analysis test	0361	3.6216	$214.92	$83.23	$42.98
91055	X	Gastric intubation for smear	0360	1.4739	$87.47	$34.98	$17.49
91060	X	Gastric saline load test	0360	1.4739	$87.47	$34.98	$17.49
91065	X	Breath hydrogen test	0360	1.4739	$87.47	$34.98	$17.49
91100	X	Pass intestine bleeding tube	0360	1.4739	$87.47	$34.98	$17.49
91105	X	Gastric intubation treatment	0360	1.4739	$87.47	$34.98	$17.49
91110	T	Gi tract capsule endoscopy	0142	9.3487	$554.78	$152.78	$110.96
91120	T	Rectal sensation test	0156	2.5751	$152.81	$40.52	$30.56
91122	T	Anal pressure record	0156	2.5751	$152.81	$40.52	$30.56
91123	N	Irrigate fecal impaction
91132	X	Electrogastrography	0360	1.4739	$87.47	$34.98	$17.49
91133	X	Electrogastrography w/test	0360	1.4739	$87.47	$34.98	$17.49
91299	X	Gastroenterology procedure	0360	1.4739	$87.47	$34.98	$17.49
92002	V	Eye exam, new patient	0601	1.0038	$59.57		$11.91
92004	V	Eye exam, new patient	0601	1.0038	$59.57		$11.91
92012	V	Eye exam established pat	0600	0.8688	$51.56		$10.31
92014	V	Eye exam treatment	0601	1.0038	$59.57		$11.91
92015	E	Refraction
92018	T	New eye exam treatment	0699	10.0177	$594.48		$118.90
92019	T	Eye exam treatment	0699	10.0177	$594.48		$118.90
92020	S	Special eye evaluation	0230	0.7858	$46.63	$14.97	$9.33
92060	S	Special eye evaluation	0230	0.7858	$46.63	$14.97	$9.33
92065	S	Orthoptic/pleoptic training	0698	1.2438	$73.81	$16.55	$14.76
92070	N	Fitting of contact lens
92081	S	Visual field examination(s)	0230	0.7858	$46.63	$14.97	$9.33
92082	S	Visual field examination(s)	0230	0.7858	$46.63	$14.97	$9.33
92083	S	Visual field examination(s)	0230	0.7858	$46.63	$14.97	$9.33
92100	N	Serial tonometry exam(s)
92120	S	Tonography eye evaluation	0230	0.7858	$46.63	$14.97	$9.33
92130	S	Water provocation tonography	0230	0.7858	$46.63	$14.97	$9.33
92135	S	Opthalmic dx imaging	0230	0.7858	$46.63	$14.97	$9.33
92136	S	Ophthalmic biometry	0698	1.2438	$73.81	$16.55	$14.76
92140	S	Glaucoma provocative tests	0698	1.2438	$73.81	$16.55	$14.76
92225	S	Special eye exam, initial	0230	0.7858	$46.63	$14.97	$9.33
92226	S	Special eye exam, subsequent	0230	0.7858	$46.63	$14.97	$9.33
92230	T	Eye exam with photos	0699	10.0177	$594.48		$118.90
92235	S	Eye exam with photos	0231	1.9278	$114.40	$44.61	$22.88
92240	S	Icg angiography	0231	1.9278	$114.40	$44.61	$22.88
92250	S	Eye exam with photos	0230	0.7858	$46.63	$14.97	$9.33
92260	S	Ophthalmoscopy/dynamometry	0698	1.2438	$73.81	$16.55	$14.76
92265	S	Eye muscle evaluation	0230	0.7858	$46.63	$14.97	$9.33
92270	S	Electro-oculography	0230	0.7858	$46.63	$14.97	$9.33
92275	S	Electroretinography	0231	1.9278	$114.40	$44.61	$22.88
92283	S	Color vision examination	0230	0.7858	$46.63	$14.97	$9.33
92284	S	Dark adaptation eye exam	0698	1.2438	$73.81	$16.55	$14.76
92285	S	Eye photography	0230	0.7858	$46.63	$14.97	$9.33
92286	S	Internal eye photography	0698	1.2438	$73.81	$16.55	$14.76
92287	S	Internal eye photography	0698	1.2438	$73.81	$16.55	$14.76
92310	E	Contact lens fitting
92311	X	Contact lens fitting	0362	2.6607	$157.89		$31.58
92312	X	Contact lens fitting	0362	2.6607	$157.89		$31.58
92313	X	Contact lens fitting	0362	2.6607	$157.89		$31.58
92314	E	Prescription of contact lens
92315	X	Prescription of contact lens	0362	2.6607	$157.89		$31.58
92316	X	Prescription of contact lens	0362	2.6607	$157.89		$31.58
92317	X	Prescription of contact lens	0362	2.6607	$157.89		$31.58
92325	X	Modification of contact lens	0362	2.6607	$157.89		$31.58
92326	X	Replacement of contact lens	0362	2.6607	$157.89		$31.58
92330	S	Fitting of artificial eye	0230	0.7858	$46.63	$14.97	$9.33
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	2.6607	$157.89		$31.58
92353	X	Special spectacles fitting	0362	2.6607	$157.89		$31.58
92354	X	Special spectacles fitting	0362	2.6607	$157.89		$31.58
92355	X	Special spectacles fitting	0362	2.6607	$157.89		$31.58
92358	X	Eye prosthesis service	0362	2.6607	$157.89		$31.58
92370	E	Repair adjust spectacles
92371	X	Repair adjust spectacles	0362	2.6607	$157.89		$31.58
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	0.7858	$46.63	$14.97	$9.33
92502	T	Ear and throat examination	0251	2.0101	$119.29		$23.86
92504	N	Ear microscopy examination
92506	A	Speech/hearing evaluation
92507	A	Speech/hearing therapy
92508	A	Speech/hearing therapy
92510	E	Rehab for ear implant
92511	T	Nasopharyngoscopy	0071	0.7915	$46.97	$11.31	$9.39
92512	X	Nasal function studies	0363	0.9128	$54.17	$17.44	$10.83
92516	X	Facial nerve function test	0660	1.6419	$97.44	$30.66	$19.49
92520	X	Laryngeal function studies	0660	1.6419	$97.44	$30.66	$19.49
92526	A	Oral function therapy
92531	N	Spontaneous nystagmus study
92532	N	Positional nystagmus test
92533	N	Caloric vestibular test
92534	N	Optokinetic nystagmus test
92541	X	Spontaneous nystagmus test	0363	0.9128	$54.17	$17.44	$10.83
92542	X	Positional nystagmus test	0363	0.9128	$54.17	$17.44	$10.83
92543	X	Caloric vestibular test	0660	1.6419	$97.44	$30.66	$19.49
92544	X	Optokinetic nystagmus test	0363	0.9128	$54.17	$17.44	$10.83
92545	X	Oscillating tracking test	0363	0.9128	$54.17	$17.44	$10.83
92546	X	Sinusoidal rotational test	0660	1.6419	$97.44	$30.66	$19.49
92547	X	Supplemental electrical test	0363	0.9128	$54.17	$17.44	$10.83
92548	X	Posturography	0660	1.6419	$97.44	$30.66	$19.49
92551	E	Pure tone hearing test, air
92552	X	Pure tone audiometry, air	0364	0.4708	$27.94	$9.06	$5.59
92553	X	Audiometry, air bone	0365	1.2356	$73.32	$18.95	$14.66
92555	X	Speech threshold audiometry	0364	0.4708	$27.94	$9.06	$5.59
92556	X	Speech audiometry, complete	0364	0.4708	$27.94	$9.06	$5.59
92557	X	Comprehensive hearing test	0365	1.2356	$73.32	$18.95	$14.66
92559	E	Group audiometric testing
92560	E	Bekesy audiometry, screen
92561	X	Bekesy audiometry, diagnosis	0364	0.4708	$27.94	$9.06	$5.59
92562	X	Loudness balance test	0364	0.4708	$27.94	$9.06	$5.59
92563	X	Tone decay hearing test	0364	0.4708	$27.94	$9.06	$5.59
92564	X	Sisi hearing test	0364	0.4708	$27.94	$9.06	$5.59
92565	X	Stenger test, pure tone	0364	0.4708	$27.94	$9.06	$5.59
92567	X	Tympanometry	0364	0.4708	$27.94	$9.06	$5.59
92568	X	Acoustic reflex testing	0364	0.4708	$27.94	$9.06	$5.59
92569	X	Acoustic reflex decay test	0364	0.4708	$27.94	$9.06	$5.59
92571	X	Filtered speech hearing test	0364	0.4708	$27.94	$9.06	$5.59
92572	X	Staggered spondaic word test	0365	1.2356	$73.32	$18.95	$14.66
92573	X	Lombard test	0364	0.4708	$27.94	$9.06	$5.59
92575	X	Sensorineural acuity test	0364	0.4708	$27.94	$9.06	$5.59
92576	X	Synthetic sentence test	0364	0.4708	$27.94	$9.06	$5.59
92577	X	Stenger test, speech	0366	1.7743	$105.29	$30.04	$21.06
92579	X	Visual audiometry (vra)	0365	1.2356	$73.32	$18.95	$14.66
92582	X	Conditioning play audiometry	0365	1.2356	$73.32	$18.95	$14.66
92583	X	Select picture audiometry	0364	0.4708	$27.94	$9.06	$5.59
92584	X	Electrocochleography	0660	1.6419	$97.44	$30.66	$19.49
92585	S	Auditor evoke potent, compre	0216	2.672	$158.56		$31.71
92586	S	Auditor evoke potent, limit	0218	1.1408	$67.70		$13.54
92587	X	Evoked auditory test	0363	0.9128	$54.17	$17.44	$10.83
92588	X	Evoked auditory test	0363	0.9128	$54.17	$17.44	$10.83
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	0364	0.4708	$27.94	$9.06	$5.59
92597	A	Voice Prosthetic Evaluation
92601	X	Cochlear implt f/up exam 7	0366	1.7743	$105.29	$30.04	$21.06
92602	X	Reprogram cochlear implt 7	0366	1.7743	$105.29	$30.04	$21.06
92603	X	Cochlear implt f/up exam 7	0366	1.7743	$105.29	$30.04	$21.06
92604	X	Reprogram cochlear implt 7	0366	1.7743	$105.29	$30.04	$21.06
92605	A	Eval for nonspeech device rx
92606	A	Non-speech device service
92607	A	Ex for speech device rx, 1hr
92608	A	Ex for speech device rx addl
92609	A	Use of speech device service
92610	A	Evaluate swallowing function
92611	A	Motion fluoroscopy/swallow
92612	A	Endoscopy swallow tst (fees)
92613	E	Endoscopy swallow tst (fees)
92614	A	Laryngoscopic sensory test
92615	E	Eval laryngoscopy sense tst
92616	A	Fees w/laryngeal sense test
92617	E	Interprt fees/laryngeal test
92620	X	Auditory function, 60 min	0364	0.4708	$27.94	$9.06	$5.59
92621	N	Auditory function, + 15 min
92625	X	Tinnitus assessment	0364	0.4708	$27.94	$9.06	$5.59
92700	X	Ent procedure/service	0364	0.4708	$27.94	$9.06	$5.59
92950	S	Heart/lung resuscitation cpr	0094	2.5363	$150.51	$47.62	$30.10
92953	S	Temporary external pacing	0094	2.5363	$150.51	$47.62	$30.10
92960	S	Cardioversion electric, ext	0679	5.5774	$330.98	$95.30	$66.20
92961	S	Cardioversion, electric, int	0679	5.5774	$330.98	$95.30	$66.20
92970	C	Cardioassist, internal
92971	C	Cardioassist, external
92973	T	Percut coronary thrombectomy	0676	2.4105	$143.05		$28.61
92974	T	Cath place, cardio brachytx	0103	14.7142	$873.18	$223.63	$174.64
92975	C	Dissolve clot, heart vessel
92977	T	Dissolve clot, heart vessel	0676	2.4105	$143.05		$28.61
92978	S	Intravasc us, heart add-on	0670	25.4131	$1,508.09	$472.46	$301.62
92979	S	Intravasc us, heart add-on	0416	19.5542	$1,160.40		$232.08
92980	T	Insert intracoronary stent	0104	79.0094	$4,688.65		$937.73
92981	T	Insert intracoronary stent	0104	79.0094	$4,688.65		$937.73
92982	T	Coronary artery dilation	0083	50.8925	$3,020.11		$604.02
92984	T	Coronary artery dilation	0083	50.8925	$3,020.11		$604.02
92986	T	Revision of aortic valve	0083	50.8925	$3,020.11		$604.02
92987	T	Revision of mitral valve	0083	50.8925	$3,020.11		$604.02
92990	T	Revision of pulmonary valve	0083	50.8925	$3,020.11		$604.02
92992	C	Revision of heart chamber
92993	C	Revision of heart chamber
92995	T	Coronary atherectomy	0082	85.0126	$5,044.90	$1,085.20	$1,008.98
92996	T	Coronary atherectomy add-on	0082	85.0126	$5,044.90	$1,085.20	$1,008.98
92997	T	Pul art balloon repr, percut	0081	34.4473	$2,044.21		$408.84
92998	T	Pul art balloon repr, percut	0081	34.4473	$2,044.21		$408.84
93000	B	Electrocardiogram, complete
93005	S	Electrocardiogram, tracing	0099	0.3821	$22.67		$4.53
93010	A	Electrocardiogram report
93012	N	Transmission of ecg
93014	B	Report on transmitted ecg
93015	B	Cardiovascular stress test
93016	B	Cardiovascular stress test
93017	X	Cardiovascular stress test	0100	2.4968	$148.17	$41.44	$29.63
93018	B	Cardiovascular stress test
93024	X	Cardiac drug stress test	0100	2.4968	$148.17	$41.44	$29.63
93025	X	Microvolt t-wave assess	0100	2.4968	$148.17	$41.44	$29.63
93040	B	Rhythm ECG with report
93041	S	Rhythm ECG, tracing	0099	0.3821	$22.67		$4.53
93042	B	Rhythm ECG, report
93224	B	ECG monitor/report, 24 hrs
93225	X	ECG monitor/record, 24 hrs	0097	1.0223	$60.67	$23.79	$12.13
93226	X	ECG monitor/report, 24 hrs	0097	1.0223	$60.67	$23.79	$12.13
93227	B	ECG monitor/review, 24 hrs
93230	B	ECG monitor/report, 24 hrs
93231	X	Ecg monitor/record, 24 hrs	0097	1.0223	$60.67	$23.79	$12.13
93232	X	ECG monitor/report, 24 hrs	0097	1.0223	$60.67	$23.79	$12.13
93233	B	ECG monitor/review, 24 hrs
93235	B	ECG monitor/report, 24 hrs
93236	X	ECG monitor/report, 24 hrs	0097	1.0223	$60.67	$23.79	$12.13
93237	B	ECG monitor/review, 24 hrs
93268	B	ECG record/review
93270	X	ECG recording	0097	1.0223	$60.67	$23.79	$12.13
93271	X	Ecg/monitoring and analysis	0097	1.0223	$60.67	$23.79	$12.13
93272	B	Ecg/review, interpret only
93278	S	ECG/signal-averaged	0099	0.3821	$22.67		$4.53
93303	S	Echo transthoracic	0269	3.2437	$192.49	$76.99	$38.50
93304	S	Echo transthoracic	0697	1.5357	$91.13	$36.45	$18.23
93307	S	Echo exam of heart	0269	3.2437	$192.49	$76.99	$38.50
93308	S	Echo exam of heart	0697	1.5357	$91.13	$36.45	$18.23
93312	S	Echo transesophageal	0270	6.0192	$357.20	$142.88	$71.44
93313	S	Echo transesophageal	0270	6.0192	$357.20	$142.88	$71.44
93314	N	Echo transesophageal
93315	S	Echo transesophageal	0270	6.0192	$357.20	$142.88	$71.44
93316	S	Echo transesophageal	0270	6.0192	$357.20	$142.88	$71.44
93317	N	Echo transesophageal
93318	S	Echo transesophageal intraop	0270	6.0192	$357.20	$142.88	$71.44
93320	S	Doppler echo exam, heart	0671	1.7028	$101.05	$40.42	$20.21
93321	S	Doppler echo exam, heart	0697	1.5357	$91.13	$36.45	$18.23
93325	S	Doppler color flow add-on	0697	1.5357	$91.13	$36.45	$18.23
93350	S	Echo transthoracic	0269	3.2437	$192.49	$76.99	$38.50
93501	T	Right heart catheterization	0080	37.1361	$2,203.77	$838.92	$440.75
93503	T	Insert/place heart catheter	0103	14.7142	$873.18	$223.63	$174.64
93505	T	Biopsy of heart lining	0103	14.7142	$873.18	$223.63	$174.64
93508	T	Cath placement, angiography	0080	37.1361	$2,203.77	$838.92	$440.75
93510	T	Left heart catheterization	000	37.1361	$2,203.77	$838.92	$440.75
93511	T	Left heart catheterization	0080	37.1361	$2,203.77	$838.92	$440.75
93514	T	Left heart catheterization	0080	37.1361	$2,203.77	$838.92	$440.75
93524	T	Left heart catheterization	0080	37.1361	$2,203.77	$838.92	$440.75
93526	T	Rt Lt heart catheters	0080	37.1361	$2,203.77	$838.92	$440.75
93527	T	Rt Lt heart catheters	0080	37.1361	$2,203.77	$838.92	$440.75
93528	T	Rt Lt heart catheters	0080	37.1361	$2,203.77	$838.92	$440.75
93529	T	Rt, lt heart catheterization	0080	37.1361	$2,203.77	$838.92	$440.75
93530	T	Rt heart cath, congenital	0080	37.1361	$2,203.77	$838.92	$440.75
93531	T	R l heart cath, congenital	0080	37.1361	$2,203.77	$838.92	$440.75
93532	T	R l heart cath, congenital	0080	37.1361	$2,203.77	$838.92	$440.75
93533	T	R l heart cath, congenital	0080	37.1361	$2,203.77	$838.92	$440.75
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	S	Heart flow reserve measure	0670	25.4131	$1,508.09	$472.46	$301.62
93572	S	Heart flow reserve measure	0416	19.5542	$1,160.40		$232.08
93580	T	Transcath closure of asd	0434	90.7877	$5,387.61		$1,077.52
93581	T	Transcath closure of vsd	0434	90.7877	$5,387.61		$1,077.52
93600	T	Bundle of His recording	0087	30.7101	$1,822.43		$364.49
93602	T	Intra-atrial recording	0087	30.7101	$1,822.43		$364.49
93603	T	Right ventricular recording	0087	30.7101	$1,822.43		$364.49
93609	T	Map tachycardia, add-on	0087	30.7101	$1,822.43		$364.49
93610	T	Intra-atrial pacing	0087	30.7101	$1,822.43		$364.49
93612	T	Intraventricular pacing	0087	30.7101	$1,822.43		$364.49
93613	T	Electrophys map 3d, add-on	0087	30.7101	$1,822.43		$364.49
93615	T	Esophageal recording	0087	30.7101	$1,822.43		$364.49
93616	T	Esophageal recording	0087	30.7101	$1,822.43		$364.49
93618	T	Heart rhythm pacing	0087	30.7101	$1,822.43		$364.49
93619	T	Electrophysiology evaluation	0085	35.1882	$2,088.17	$426.25	$417.63
93620	T	Electrophysiology evaluation	0085	35.1882	$2,088.17	$426.25	$417.63
93621	T	Electrophysiology evaluation	0085	35.1882	$2,088.17	$426.25	$417.63
93622	T	Electrophysiology evaluation	0085	35.1882	$2,088.17	$426.25	$417.63
93623	T	Stimulation, pacing heart	0087	30.7101	$1,822.43		$364.49
93624	T	Electrophysiologic study	0085	35.1882	$2,088.17	$426.25	$417.63
93631	T	Heart pacing, mapping	0087	30.7101	$1,822.43		$364.49
93640	S	Evaluation heart device	0084	10.0205	$594.65		$118.93
93641	S	Electrophysiology evaluation	0084	10.0205	$594.65		$118.93
93642	S	Electrophysiology evaluation	0084	10.0205	$594.65		$118.93
93650	T	Ablate heart dysrhythm focus	0086	44.2596	$2,626.50	$833.33	$525.30
93651	T	Ablate heart dysrhythm focus	0086	44.2596	$2,626.50	$833.33	$525.30
93652	T	Ablate heart dysrhythm focus	0086	44.2596	$2,626.50	$833.33	$525.30
93660	S	Tilt table evaluation	0101	4.2787	$253.91	$101.56	$50.78
93662	S	Intracardiac ecg (ice)	0670	25.4131	$1,508.09	$472.46	$301.62
93668	E	Peripheral vascular rehab
93701	S	Bioimpedance, thoracic	0099	0.3821	$22.67		$4.53
93720	B	Total body plethysmography
93721	X	Plethysmography tracing	0368	0.9761	$57.92	$23.16	$11.58
93722	B	Plethysmography report
93724	S	Analyze pacemaker system	0690	0.3755	$22.28	$8.91	$4.46
93727	S	Analyze ilr system	0690	0.3755	$22.28	$8.91	$4.46
93731	S	Analyze pacemaker system	0690	0.3755	$22.28	$8.91	$4.46
93732	S	Analyze pacemaker system	0690	0.3755	$22.28	$8.91	$4.46
93733	S	Telephone analy, pacemaker	0690	0.3755	$22.28	$8.91	$4.46
93734	S	Analyze pacemaker system	0690	0.3755	$22.28	$8.91	$4.46
93735	S	Analyze pacemaker system	0690	0.3755	$22.28	$8.91	$4.46
93736	S	Telephonic analy, pacemaker	0690	0.3755	$22.28	$8.91	$4.46
93740	X	Temperature gradient studies	0368	0.9761	$57.92	$23.16	$11.58
93741	S	Analyze ht pace device sngl	0689	0.5735	$34.03		$6.81
93742	S	Analyze ht pace device sngl	0689	0.5735	$34.03		$6.81
93743	S	Analyze ht pace device dual	0689	0.5735	$34.03		$6.81
93744	S	Analyze ht pace device dual	0689	0.5735	$34.03		$6.81
93745	S	Set-up cardiovert-defibrill	0689	0.5735	$34.03		$6.81
93760	E	Cephalic thermogram
93762	E	Peripheral thermogram
93770	N	Measure venous pressure
93784	E	Ambulatory BP monitoring
93786	X	Ambulatory BP recording	0097	1.0223	$60.67	$23.79	$12.13
93788	X	Ambulatory BP analysis	0097	1.0223	$60.67	$23.79	$12.13
93790	B	Review/report BP recording
93797	S	Cardiac rehab	0095	0.5885	$34.92	$13.96	$6.98
93798	S	Cardiac rehab/monitor	0095	0.5885	$34.92	$13.96	$6.98
93799	S	Cardiovascular procedure	0096	1.6307	$96.77	$38.70	$19.35
93875	S	Extracranial study	0096	1.6307	$96.77	$38.70	$19.35
93880	S	Extracranial study	0267	2.6327	$156.23	$62.18	$31.25
93882	S	Extracranial study	0267	2.6327	$156.23	$62.18	$31.25
93886	S	Intracranial study	0267	2.6327	$156.23	$62.18	$31.25
93888	S	Intracranial study	0266	1.6393	$97.28	$38.91	$19.46
93890	S	Tcd, vasoreactivity study	0266	1.6393	$97.28	$38.91	$19.46
93892	S	Tcd, emboli detect w/o inj	0266	1.6393	$97.28	$38.91	$19.46
93893	S	Tcd, emboli detect w/inj	0266	1.6393	$97.28	$38.91	$19.46
93922	S	Extremity study	0096	1.6307	$96.77	$38.70	$19.35
93923	S	Extremity study	0096	1.6307	$96.77	$38.70	$19.35
93924	S	Extremity study	0096	1.6307	$96.77	$38.70	$19.35
93925	S	Lower extremity study	0267	2.6327	$156.23	$62.18	$31.25
93926	S	Lower extremity study	0266	1.6393	$97.28	$38.91	$19.46
93930	S	Upper extremity study	0267	2.6327	$156.23	$62.18	$31.25
93931	S	Upper extremity study	0266	1.6393	$97.28	$38.91	$19.46
93965	S	Extremity study	0096	1.6307	$96.77	$38.70	$19.35
93970	S	Extremity study	0267	2.6327	$156.23	$62.18	$31.25
93971	S	Extremity study	0266	1.6393	$97.28	$38.91	$19.46
93975	S	Vascular study	0267	2.6327	$156.23	$62.18	$31.25
93976	S	Vascular study	0267	2.6327	$156.23	$62.18	$31.25
93978	S	Vascular study	0266	1.6393	$97.28	$38.91	$19.46
93979	S	Vascular study	0266	1.6393	$97.28	$38.91	$19.46
93980	S	Penile vascular study	0267	2.6327	$156.23	$62.18	$31.25
93981	S	Penile vascular study	0266	1.6393	$97.28	$38.91	$19.46
93990	S	Doppler flow testing	0266	1.6393	$97.28	$38.91	$19.46
94010	X	Breathing capacity test	0368	0.9761	$57.92	$23.16	$11.58
94014	X	Patient recorded spirometry	0367	0.6659	$39.52	$14.80	$7.90
94015	X	Patient recorded spirometry	0367	0.6659	$39.52	$14.80	$7.90
94016	A	Review patient spirometry
94060	X	Evaluation of wheezing	0368	0.9761	$57.92	$23.16	$11.58
94070	X	Evaluation of wheezing	0369	2.7519	$163.31	$44.18	$32.66
94150	X	Vital capacity test	0367	0.6659	$39.52	$14.80	$7.90
94200	X	Lung function test (MBC/MVV)	0367	0.6659	$39.52	$14.80	$7.90
94240	X	Residual lung capacity	0368	0.9761	$57.92	$23.16	$11.58
94250	X	Expired gas collection	0367	0.6659	$39.52	$14.80	$7.90
94260	X	Thoracic gas volume	0367	0.6659	$39.52	$14.80	$7.90
94350	X	Lung nitrogen washout curve	0367	0.6659	$39.52	$14.80	$7.90
94360	X	Measure airflow resistance	0367	0.6659	$39.52	$14.80	$7.90
94370	X	Breath airway closing volume	0367	0.6659	$39.52	$14.80	$7.90
94375	X	Respiratory flow volume loop	0367	0.6659	$39.52	$14.80	$7.90
94400	X	CO2 breathing response curve	0367	0.6659	$39.52	$14.80	$7.90
94450	X	Hypoxia response curve	0368	0.9761	$57.92	$23.16	$11.58
94452	X	Hast w/report	0368	0.9761	$57.92	$23.16	$11.58
94453	X	Hast w/oxygen titrate	0368	0.9761	$57.92	$23.16	$11.58
94620	X	Pulmonary stress test/simple	0368	0.9761	$57.92	$23.16	$11.58
94621	X	Pulm stress test/complex	0369	2.7519	$163.31	$44.18	$32.66
94640	S	Airway inhalation treatment	0077	0.3444	$20.44	$7.74	$4.09
94642	S	Aerosol inhalation treatment	0078	1.0236	$60.74	$14.55	$12.15
94656	S	Initial ventilator mgmt	0079	2.3482	$139.35		$27.87
94657	S	Continued ventilator mgmt	0079	2.3482	$139.35		$27.87
94660	S	Pos airway pressure, CPAP	0068	1.2293	$72.95	$29.18	$14.59
94662	S	Neg press ventilation, cnp	0079	2.3482	$139.35		$27.87
94664	S	Aerosol or vapor inhalations	0077	0.3444	$20.44	$7.74	$4.09
94667	S	Chest wall manipulation	0077	0.3444	$20.44	$7.74	$4.09
94668	S	Chest wall manipulation	0077	0.3444	$20.44	$7.74	$4.09
94680	X	Exhaled air analysis, o2	0367	0.6659	$39.52	$14.80	$7.90
94681	X	Exhaled air analysis, o2/co2	0368	0.9761	$57.92	$23.16	$11.58
94690	X	Exhaled air analysis	0368	0.9761	$57.92	$23.16	$11.58
94720	X	Monoxide diffusing capacity	0368	0.9761	$57.92	$23.16	$11.58
94725	X	Membrane diffusion capacity	0368	0.9761	$57.92	$23.16	$11.58
94750	X	Pulmonary compliance study	0368	0.9761	$57.92	$23.16	$11.58
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	0.6659	$39.52	$14.80	$7.90
94772	X	Breath recording, infant	0369	2.7519	$163.31	$44.18	$32.66
94799	X	Pulmonary service/procedure	0367	0.6659	$39.52	$14.80	$7.90
95004	X	Percut allergy skin tests	0381	0.1884	$11.18	$2.35	$2.24
95010	X	Percut allergy titrate test	0381	0.1884	$11.18	$2.35	$2.24
95015	X	Id allergy titrate-drug/bug	0381	0.1884	$11.18	$2.35	$2.24
95024	X	Id allergy test, drug/bug	0381	0.1884	$11.18	$2.35	$2.24
95027	X	Skin end point titration	0381	0.1884	$11.18	$2.35	$2.24
95028	X	Id allergy test-delayed type	0381	0.1884	$11.18	$2.35	$2.24
95044	X	Allergy patch tests	0381	0.1884	$11.18	$2.35	$2.24
95052	X	Photo patch test	0381	0.1884	$11.18	$2.35	$2.24
95056	X	Photosensitivity tests	0370	1.1232	$66.65		$13.33
95060	X	Eye allergy tests	0370	1.1232	$66.65		$13.33
95065	X	Nose allergy test	0381	0.1884	$11.18	$2.35	$2.24
95070	X	Bronchial allergy tests	0369	2.7519	$163.31	$44.18	$32.66
95071	X	Bronchial allergy tests	0369	2.7519	$163.31	$44.18	$32.66
95075	X	Ingestion challenge test	0361	3.6216	$214.92	$83.23	$42.98
95078	X	Provocative testing	0370	1.1232	$66.65		$13.33
95115	X	Immunotherapy, one injection	0352	0.1413	$8.39		$1.68
95117	X	Immunotherapy injections	0353	0.3954	$23.46		$4.69
95120	B	Immunotherapy, one injection
95125	B	Immunotherapy, many antigens
95130	B	Immunotherapy, insect venom
95131	B	Immunotherapy, insect venoms
95132	B	Immunotherapy, insect venoms
95133	B	Immunotherapy, insect venoms
95134	B	Immunotherapy, insect venoms
95144	X	Antigen therapy services	0353	0.3954	$23.46		$4.69
95145	X	Antigen therapy services	0353	0.3954	$23.46		$4.69
95146	X	Antigen therapy services	0359	0.8312	$49.33		$9.87
95147	X	Antigen therapy services	0359	0.8312	$49.33		$9.87
95148	X	Antigen therapy services	0353	0.3954	$23.46		$4.69
95149	X	Antigen therapy services	0352	0.1413	$8.39		$1.68
95165	X	Antigen therapy services	0353	0.3954	$23.46		$4.69
95170	X	Antigen therapy services	0352	0.1413	$8.39		$1.68
95180	X	Rapid desensitization	0370	1.1232	$66.65		$13.33
95199	X	Allergy immunology services	0370	1.1232	$66.65		$13.33
95250	X	Glucose monitoring, cont	0421	1.66	$98.51		$19.70
95805	S	Multiple sleep latency test	0209	11.5713	$686.68	$274.67	$137.34
95806	S	Sleep study, unattended	0213	2.2932	$136.09	$54.43	$27.22
95807	S	Sleep study, attended	0209	11.5713	$686.68	$274.67	$137.34
95808	S	Polysomnography, 1-3	0209	11.5713	$686.68	$274.67	$137.34
95810	S	Polysomnography, 4 or more	0209	11.5713	$686.68	$274.67	$137.34
95811	S	Polysomnography w/cpap	0209	11.5713	$686.68	$274.67	$137.34
95812	S	Electroencephalogram (EEG)	0213	2.2932	$136.09	$54.43	$27.22
95813	S	Eeg, over 1 hour	0213	2.2932	$136.09	$54.43	$27.22
95816	S	Electroencephalogram (EEG)	0213	2.2932	$136.09	$54.43	$27.22
95819	S	Electroencephalogram (EEG)	0213	2.2932	$136.09	$54.43	$27.22
95822	S	Sleep electroencephalogram	0213	2.2932	$136.09	$54.43	$27.22
95824	S	Eeg, cerebral death only	0214	1.1353	$67.37	$26.94	$13.47
95827	S	night electroencephalogram	0213	2.2932	$136.09	$54.43	$27.22
95829	S	Surgery electrocorticogram	0214	1.1353	$67.37	$26.94	$13.47
95830	B	Insert electrodes for EEG
95831	A	Limb muscle testing, manual
95832	A	Hand muscle testing, manual
95833	A	Body muscle testing, manual
95834	A	Body muscle testing, manual
95851	A	Range of motion measurements
95852	A	Range of motion measurements
95857	S	Tensilon test	0218	1.1408	$67.70		$13.54
95858	S	Tensilon test myogram	0215	0.6115	$36.29	$14.51	$7.26
95860	S	Muscle test, one limb	0218	1.1408	$67.70		$13.54
95861	S	Muscle test, 2 limbs	0218	1.1408	$67.70		$13.54
95863	S	Muscle test, 3 limbs	0218	1.1408	$67.70		$13.54
95864	S	Muscle test, 4 limbs	0218	1.1408	$67.70		$13.54
95867	S	Muscle test, head or neck	0218	1.1408	$67.70		$13.54
95868	S	Muscle test cran nerve bilat	0218	1.1408	$67.70		$13.54
95869	S	Muscle test, thor paraspinal	0215	0.6115	$36.29	$14.51	$7.26
95870	S	Muscle test, nonparaspinal	0215	0.6115	$36.29	$14.51	$7.26
95872	S	Muscle test, one fiber	0218	1.1408	$67.70		$13.54
95875	S	Limb exercise test	0215	0.6115	$36.29	$14.51	$7.26
95900	S	Motor nerve conduction test	0215	0.6115	$36.29	$14.51	$7.26
95903	S	Motor nerve conduction test	0215	0.6115	$36.29	$14.51	$7.26
95904	S	Sense nerve conduction test	0215	0.6115	$36.29	$14.51	$7.26
95920	S	Intraop nerve test add-on	0216	2.672	$158.56		$31.71
95921	S	Autonomic nerv function test	0218	1.1408	$67.70		$13.54
95922	S	Autonomic nerv function test	0218	1.1408	$67.70		$13.54
95923	S	Autonomic nerv function test	0218	1.1408	$67.70		$13.54
95925	S	Somatosensory testing	0216	2.672	$158.56		$31.71
95926	S	Somatosensory testing	0216	2.672	$158.56		$31.71
95927	S	Somatosensory testing	0216	2.672	$158.56		$31.71
95928	S	C motor evoked, uppr limbs	0218	1.1408	$67.70		$13.54
95929	S	C motor evoked, lwr limbs	0218	1.1408	$67.70		$13.54
95930	S	Visual evoked potential test	0216	2.672	$158.56		$31.71
95933	S	Blink reflex test	0215	0.6115	$36.29	$14.51	$7.26
95934	S	H-reflex test	0215	0.6115	$36.29	$14.51	$7.26
95936	S	H-reflex test	0215	0.6115	$36.29	$14.51	$7.26
95937	S	Neuromuscular junction test	0218	1.1408	$67.70		$13.54
95950	S	Ambulatory eeg monitoring	0209	11.5713	$686.68	$274.67	$137.34
95951	S	EEG monitoring/videorecord	0209	11.5713	$686.68	$274.67	$137.34
95953	S	EEG monitoring/computer	0209	11.5713	$686.68	$274.67	$137.34
95954	S	EEG monitoring/giving drugs	0214	1.1353	$67.37	$26.94	$13.47
95955	S	EEG during surgery	0213	2.2932	$136.09	$54.43	$27.22
95956	S	Eeg monitoring, cable/radio	0209	11.5713	$686.68	$274.67	$137.34
95957	S	EEG digital analysis	0214	1.1353	$67.37	$26.94	$13.47
95958	S	EEG monitoring/function test	0213	2.2932	$136.09	$54.43	$27.22
95961	S	Electrode stimulation, brain	0216	2.672	$158.56		$31.71
95962	S	Electrode stim, brain add-on	0216	2.672	$158.56		$31.71
95965	T	Meg, spontaneous	0430	11.404	$676.75		$135.35
95966	T	Meg, evoked, single	0430	11.404	$676.75		$135.35
95967	T	Meg, evoked, each add'l	0430	11.404	$676.75		$135.35
95970	S	Analyze neurostim, no prog	0218	1.1408	$67.70		$13.54
95971	S	Analyze neurostim, simple	0692	2.0111	$119.34	$30.16	$23.87
95972	S	Analyze neurostim, complex	0692	2.0111	$119.34	$30.16	$23.87
95973	S	Analyze neurostim, complex	0692	2.0111	$119.34	$30.16	$23.87
95974	S	Cranial neurostim, complex	0692	2.0111	$119.34	$30.16	$23.87
95975	S	Cranial neurostim, complex	0692	2.0111	$119.34	$30.16	$23.87
95978	S	Analyze neurostim brain/1h	0692	2.0111	$119.34	$30.16	$23.87
95979	S	Analyz neurostim brain addon	0692	2.0111	$119.34	$30.16	$23.87
95990	T	Spin/brain pump refil main	0125	1.9331	$114.72		$22.94
95991	T	Spin/brain pump refil main	0125	1.9331	$114.72		$22.94
95999	S	Neurological procedure	0215	0.6115	$36.29	$14.51	$7.26
96000	S	Motion analysis, video/3d	0216	2.672	$158.56		$31.71
96001	S	Motion test w/ft press meas	0216	2.672	$158.56		$31.71
96002	S	Dynamic surface emg	0218	1.1408	$67.70		$13.54
96003	S	Dynamic fine wire emg	0215	0.6115	$36.29	$14.51	$7.26
96004	E	Phys review of motion tests
96100	X	Psychological testing	0373	2.1926	$130.12		$26.02
96105	A	Assessment of aphasia
96110	X	Developmental test, lim	0373	2.1926	$130.12		$26.02
96111	X	Developmental test, extend	0373	2.1926	$130.12		$26.02
96115	X	Neurobehavior status exam	0373	2.1926	$130.12		$26.02
96117	X	Neuropsych test battery	0373	2.1926	$130.12		$26.02
96150	S	Assess lth/behave, init	0432	0.6949	$41.24		$8.25
96151	S	Assess hlth/behave, subseq	0432	0.6949	$41.24		$8.25
96152	S	Intervene hlth/behave, indiv	0432	0.6949	$41.24		$8.25
96153	S	Intervene hlth/behave, group	0432	0.6949	$41.24		$8.25
96154	S	Interv hlth/behav, fam w/pt	0432	0.6949	$41.24		$8.25
96155	E	Interv hlth/behav fam no pt
96400	S	Chemotherapy, sc/im	0116	1.1453	$67.97		$13.59
96405	S	Intralesional chemo admin	0116	1.1453	$67.97		$13.59
96406	S	Intralesional chemo admin	0116	1.1453	$67.97		$13.59
96408	S	Chemotherapy, push technique	0116	1.1453	$67.97		$13.59
96410	S	Chemotherapy,infusion method	0117	3.2378	$192.14	$42.54	$38.43
96412	N	Chemo, infuse method add-on
96414	S	Chemo, infuse method add-on	0117	3.2378	$192.14	$42.54	$38.43
96420	S	Chemotherapy, push technique	0116	1.1453	$67.97		$13.59
96422	S	Chemotherapy,infusion method	0117	3.2378	$192.14	$42.54	$38.43
96423	N	Chemo, infuse method add-on
96425	S	Chemotherapy,infusion method	0117	3.2378	$192.14	$42.54	$38.43
96440	S	Chemotherapy, intracavitary	0116	1.1453	$67.97		$13.59
96445	S	Chemotherapy, intracavitary	0116	1.1453	$67.97		$13.59
96450	S	Chemotherapy, into CNS	0116	1.1453	$67.97		$13.59
96520	T	Port pump refill main	0125	1.9331	$114.72		$22.94
96530	T	Pump refilling, maintenance	0125	1.9331	$114.72		$22.94
96542	S	Chemotherapy injection	0116	1.1453	$67.97		$13.59
96545	N	Provide chemotherapy agent
96549	S	Chemotherapy, unspecified	0116	1.1453	$67.97		$13.59
96567	T	Photodynamic tx, skin	0016	2.5834	$153.31	$33.57	$30.66
96570	T	Photodynamic tx, 30 min	0015	1.6514	$98.00	$20.29	$19.60
96571	T	Photodynamic tx, addl 15 min	0015	1.6514	$98.00	$20.29	$19.60
96900	S	Ultraviolet light therapy	0001	0.4213	$25.00	$7.00	$5.00
96902	N	Trichogram
96910	S	Photochemotherapy with UV-B	0001	0.4213	$25.00	$7.00	$5.00
96912	S	Photochemotherapy with UV-A	0001	0.4213	$25.00	$7.00	$5.00
96913	S	Photochemotherapy, UV-A or B	0683	1.9006	$112.79	$25.34	$22.56
96920	T	Laser tx, skin 250 sq cm	0013	1.1078	$65.74	$14.20	$13.15
96921	T	Laser tx, skin 250-500 sq cm	0013	1.1078	$65.74	$14.20	$13.15
96922	T	Laser tx, skin 500 sq cm	0013	1.1078	$65.74	$14.20	$13.15
96999	T	Dermatological procedure	0010	0.5719	$33.94	$9.65	$6.79
97001	A	Pt evaluation
97002	A	Pt re-evaluation
97003	A	Ot evaluation
97004	A	Ot re-evaluation
97005	E	Athletic train eval
97006	E	Athletic train reeval
97010	A	Hot or cold packs therapy
97012	A	Mechanical traction therapy
97014	E	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
97597	A	Active wound care/20 cm or
97598	A	Active wound care 20 cm
97602	A	Wound(s) care non-selective
97605	A	Neg press wound tx, 50 cm
97606	A	Neg press wound tx, 50 cm
97703	A	Prosthetic checkout
97750	A	Physical performance test
97755	A	Assistive technology assess
97799	A	Physical medicine procedure
97802	A	Medical nutrition, indiv, in
97803	A	Med nutrition, indiv, subseq
97804	A	Medical nutrition, group
97810	E	Acupunct w/o stimul 15 min
97811	E	Acupunct w/o stimul addl 15m
97813	E	Acupunct w/stimul 15 min
97814	E	Acupunct w/stimul addl 15m
98925	S	Osteopathic manipulation	0060	0.4935	$29.29		$5.86
98926	S	Osteopathic manipulation	0060	0.4935	$29.29		$5.86
98927	S	Osteopathic manipulation	0060	0.4935	$29.29		$5.86
98928	S	Osteopathic manipulation	0060	0.4935	$29.29		$5.86
98929	S	Osteopathic manipulation	0060	0.4935	$29.29		$5.86
98940	S	Chiropractic manipulation	0060	0.4935	$29.29		$5.86
98941	S	Chiropractic manipulation	0060	0.4935	$29.29		$5.86
98942	S	Chiropractic manipulation	0060	0.4935	$29.29		$5.86
98943	E	Chiropractic manipulation
99000	B	Specimen handling
99001	B	Specimen handling
99002	B	Device handling
99024	B	Postop follow-up visit
99026	E	In-hospital on call service
99027	E	Out-of-hosp on call service
99050	B	Medical services after hrs
99052	B	Medical services at night
99054	B	Medical servcs, unusual hrs
99056	B	Non-office medical services
99058	B	Office emergency care
99070	B	Special supplies
99071	B	Patient education materials
99075	E	Medical testimony
99078	N	Group health education
99080	B	Special reports or forms
99082	B	Unusual physician travel
99090	B	Computer data analysis
99091	E	Collect/review data from pt
99100	B	Special anesthesia service
99116	B	Anesthesia with hypothermia
99135	B	Special anesthesia procedure
99140	B	Emergency anesthesia
99141	N	Sedation, iv/im or inhalant
99142	N	Sedation, oral/rectal/nasal
99170	T	Anogenital exam, child	0191	0.167	$9.91	$2.78	$1.98
99172	E	Ocular function screen
99173	E	Visual acuity screen
99175	N	Induction of vomiting
99183	B	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	0.57	$33.83	$10.09	$6.77
99199	B	Special service/proc/report
99201	V	Office/outpatient visit, new	0600	0.8688	$51.56		$10.31
99202	V	Office/outpatient visit, new	0600	0.8688	$51.56		$10.31
99203	V	Office/outpatient visit, new	0601	1.0038	$59.57		$11.91
99204	V	Office/outpatient visit, new	0602	1.4284	$84.77		$16.95
99205	V	Office/outpatient visit, new	0602	1.4284	$84.77		$16.95
99211	V	Office/outpatient visit, est	0600	0.8688	$51.56		$10.31
99212	V	Office/outpatient visit, est	0600	0.8688	$51.56		$10.31
99213	V	Office/outpatient visit, est	0601	1.0038	$59.57		$11.91
99214	V	Office/outpatient visit, est	0602	1.4284	$84.77		$16.95
99215	V	Office/outpatient visit, est	0602	1.4284	$84.77		$16.95
99217	B	Observation care discharge
99218	B	Observation care
99219	B	Observation care
99220	B	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	B	Observ/hosp same date
99235	B	Observ/hosp same date
99236	B	Observ/hosp same date
99238	E	Hospital discharge day
99239	E	Hospital discharge day
99241	V	Office consultation	0600	0.8688	$51.56		$10.31
99242	V	Office consultation	0600	0.8688	$51.56		$10.31
99243	V	Office consultation	0601	1.0038	$59.57		$11.91
99244	V	Office consultation	0602	1.4284	$84.77		$16.95
99245	V	Office consultation	0602	1.4284	$84.77		$16.95
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	0.8688	$51.56		$10.31
99272	V	Confirmatory consultation	0600	0.8688	$51.56		$10.31
99273	V	Confirmatory consultation	0601	1.0038	$59.57		$11.91
99274	V	Confirmatory consultation	0602	1.4284	$84.77		$16.95
99275	V	Confirmatory consultation	0602	1.4284	$84.77		$16.95
99281	V	Emergency dept visit	0610	1.2947	$76.83	$19.48	$15.37
99282	V	Emergency dept visit	0610	1.2947	$76.83	$19.48	$15.37
99283	V	Emergency dept visit	0611	2.2718	$134.82	$35.76	$26.96
99284	V	Emergency dept visit	0612	3.9853	$236.50	$54.12	$47.30
99285	V	Emergency dept visit	0612	3.9853	$236.50	$54.12	$47.30
99288	B	Direct advanced life support
99289	N	Pt transport, 30-74 min
99290	N	Pt transport, addl 30 min
99291	S	Critical care, first hour	0620	8.2996	$492.52	$135.68	$98.50
99292	N	Critical care, add=l 30 min
99293	C	Ped critical care, initial
99294	C	Ped critical care, subseq
99295	C	Neonatal critical care
99296	C	Neonatal critical care
99298	C	Neonatal critical care
99299	C	Ic, lbw infant 1500-2500 gm
99301	B	Nursing facility care
99302	B	Nursing facility care
99303	B	Nursing facility care
99311	B	Nursing fac care, subseq
99312	B	Nursing fac care, subseq
99313	B	Nursing fac care, subseq
99315	B	Nursing fac discharge day
99316	B	Nursing fac discharge day
99321	B	Rest home visit, new patient
99322	B	Rest home visit, new patient
99323	B	Rest home visit, new patient
99331	B	Rest home visit, est pat
99332	B	Rest home visit, est pat
99333	B	Rest home visit, est pat
99341	B	Home visit, new patient
99342	B	Home visit, new patient
99343	B	Home visit, new patient
99344	B	Home visit, new patient
99345	B	Home visit, new patient
99347	B	Home visit, est patient
99348	B	Home visit, est patient
99349	B	Home visit, est patient
99350	B	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	B	Physician standby services
99361	E	Physician/team conference
99362	E	Physician/team conference
99371	B	Physician phone consultation
99372	B	Physician phone consultation
99373	B	Physician phone consultation
99374	B	Home health care supervision
99375	E	Home health care supervision
99377	B	Hospice care supervision
99378	E	Hospice care supervision
99379	B	Nursing fac care supervision
99380	B	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	V	Initial care, normal newborn	0600	0.8688	$51.56		$10.31
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	2.5363	$150.51	$47.62	$30.10
99450	E	Life/disability evaluation
99455	B	Disability examination
99456	B	Disability examination
99499	B	Unlisted em service
99500	E	Home visit, prenatal
99501	E	Home visit, postnatal
99502	E	Home visit, nb care
99503	E	Home visit, resp therapy
99504	E	Home visit mech ventilator
99505	E	Home visit, stoma care
99506	E	Home visit, im injection
99507	E	Home visit, cath maintain
99509	E	Home visit day life activity
99510	E	Home visit, sing/m/fam couns
99511	E	Home visit, fecal/enema mgmt
99512	E	Home visit for hemodialysis
99600	E	Home visit nos
99601	E	Home infusion/visit, 2 hrs
99602	E	Home infusion, each addtl hr
A0021	E	Outside state ambulance serv
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
A0380	A	Basic life support mileage
A0382	A	Basic support routine suppls
A0384	A	Bls defibrillation supplies
A0390	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 02 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
A0800	B	Amb trans 7pm-7am
A0888	E	Noncovered ambulance mileage
A0999	A	Unlisted ambulance service
A4206	E	1 CC sterile syringeneedle
A4207	E	2 CC sterile syringeneedle
A4208	E	3 CC sterile syringeneedle
A4209	E	5+ CC sterile syringeneedle
A4210	E	Nonneedle injection device
A4211	B	Supp for self-adm injections
A4212	B	Non coring needle or stylet
A4213	E	20+ CC syringe only
A4215	E	Sterile needle
A4216	A	Sterile water/saline, 10 ml
A4217	A	Sterile water/saline, 500 ml
A4220	N	Infusion pump refill kit
A4221	Y	Maint drug infus cath per wk
A4222	Y	Drug infusion pump supplies
A4223	E	Infusion supplies w/o pump
A4230	Y	Infus insulin pump non needl
A4231	Y	Infusion insulin pump needle
A4232	Y	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
A4248	N	Chlorhexidine antisept
A4250	E	Urine reagent strips/tablets
A4253	Y	Blood glucose/reagent strips
A4254	Y	Battery for glucose monitor
A4255	Y	Glucose monitor platforms
A4256	Y	Calibrator solution/chips
A4257	Y	Replace Lensshield Cartridge
A4258	Y	Lancet device each
A4259	Y	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	Y	Paraffin
A4266	E	Diaphragm
A4267	E	Male condom
A4268	E	Female condom
A4269	E	Spermicide
A4270	A	Disposable endoscope sheath
A4280	A	Brst prsths adhsv attchmnt
A4281	E	Replacement breastpump tube
A4282	E	Replacement breastpump adpt
A4283	E	Replacement breastpump cap
A4284	E	Replcmnt breast pump shield
A4285	E	Replcmnt breast pump bottle
A4286	E	Replcmnt breastpump lok ring
A4290	B	Sacral nerve stim test lead
A4300	N	Cath impl vasc access portal
A4301	N	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
A4320	A	Irrigation tray
A4321	A	Cath therapeutic irrig agent
A4322	A	Irrigation syringe
A4326	A	Male external catheter
A4327	A	Fem urinary collect dev cup
A4328	A	Fem urinary collect pouch
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
A4348	A	Male ext cath extended wear
A4349	A	Disposable male external cat
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 or abdomen bag
A4359	A	Urinary suspensory w/o leg b
A4361	A	Ostomy face plate
A4362	A	Solid skin barrier
A4364	A	Adhesive, liquid or equal
A4365	A	Adhesive remover wipes
A4366	A	Ostomy vent
A4367	A	Ostomy belt
A4368	A	Ostomy filter
A4369	A	Skin barrier liquid per oz
A4371	A	Skin barrier powder per oz
A4372	A	Skin barrier solid 4x4 equiv
A4373	A	Skin barrier with flange
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
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
A4405	A	Nonpectin based ostomy paste
A4406	A	Pectin based ostomy paste
A4407	A	Ext wear ost skn barr =4sq÷
A4408	A	Ext wear ost skn barr 4sq÷
A4409	A	Ost skn barr w flng =4 sq÷
A4410	A	Ost skn barr w flng 4sq÷
A4413	A	2 pc drainable ost pouch
A4414	A	Ostomy sknbarr w flng =4sq÷
A4415	A	Ostomy skn barr w flng 4sq÷
A4416	A	Ost pch clsd w barrier/filtr
A4417	A	Ost pch w bar/bltinconv/fltr
A4418	A	Ost pch clsd w/o bar w filtr
A4419	A	Ost pch for bar w flange/flt
A4420	A	Ost pch clsd for bar w lk fl
A4421	E	Ostomy supply misc
A4422	A	Ost pouch absorbent material
A4423	A	Ost pch for bar w lk fl/fltr
A4424	A	Ost pch drain w bar filter
A4425	A	Ost pch drain for barrier fl
A4426	A	Ost pch drain 2 piece system
A4427	A	Ost pch drain/barr lk flng/f
A4428	A	Urine ost pouch w faucet/tap
A4429	A	Urine ost pch bar w lock fln
A4430	A	Ost pch urine w lock flng/ft
A4431	A	Urine ost pch bar w lock fln
A4432	A	Ost pch urine w lock flng/ft
A4433	A	Urine ost pch bar w lock fln
A4434	A	Ost pch urine w lock flng/ft
A4450	A	Non-waterproof tape
A4452	A	Waterproof tape
A4455	A	Adhesive remover per ounce
A4458	E	Reusable enema bag
A4462	A	Abdmnl drssng holder/binder
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
A4520	E	Incontinence garment anytype
A4550	B	Surgical trays
A4554	E	Disposable underpads
A4555	E	Disposable underpad small
A4556	Y	Electrodes, pair
A4557	Y	Lead wires, pair
A4558	Y	Conductive paste or gel
A4561	N	Pessary rubber, any type
A4562	N	Pessary, non rubber,any type
A4565	A	Slings
A4570	E	Splint
A4575	E	Hyperbaric o2 chamber disps
A4580	E	Cast supplies (plaster)
A4590	E	Special casting material
A4595	Y	TENS suppl 2 lead per month
A4605	Y	Trach suction cath close sys
A4606	A	Oxygen probe used w oximeter
A4608	Y	Transtracheal oxygen cath
A4611	Y	Heavy duty battery
A4612	Y	Battery cables
A4613	Y	Battery charger
A4614	A	Hand-held PEFR meter
A4615	Y	Cannula nasal
A4616	Y	Tubing (oxygen) per foot
A4617	Y	Mouth piece
A4618	Y	Breathing circuits
A4619	Y	Face tent
A4620	Y	Variable concentration mask
A4623	A	Tracheostomy inner cannula
A4624	Y	Tracheal suction tube
A4625	A	Trach care kit for new trach
A4626	A	Tracheostomy cleaning brush
A4627	E	Spacer bag/reservoir
A4628	Y	Oropharyngeal suction cath
A4629	A	Tracheostomy care kit
A4630	Y	Repl bat t.e.n.s. own by pt
A4632	Y	Infus pump rplcemnt battery
A4633	Y	Uvl replacement bulb
A4634	A	Replacement bulb th lightbox
A4635	Y	Underarm crutch pad
A4636	Y	Handgrip for cane etc
A4637	Y	Repl tip cane/crutch/walker
A4638	Y	Repl batt pulse gen sys
A4639	Y	Infrared ht sys replcmnt pad
A4640	Y	Alternating pressure pad
A4641	N	Diagnostic imaging agent
A4642	H	Satumomab pendetide per dose	0704
A4643	B	High dose contrast MRI
A4644	B	Contrast 100-199 MGs iodine
A4645	B	Contrast 200-299 MGs iodine
A4646	B	Contrast 300-399 MGs iodine
A4647	B	Supp- paramagnetic contr mat
A4649	A	Surgical supplies
A4651	A	Calibrated microcap tube
A4652	A	Microcapillary tube sealant
A4653	A	PD catheter anchor belt
A4656	A	Dialysis needle
A4657	A	Dialysis syringe w/wo needle
A4660	A	Sphyg/bp app w cuff and stet
A4663	A	Dialysis blood pressure cuff
A4670	E	Automatic bp monitor, dial
A4671	B	Disposable cycler set
A4672	B	Drainage ext line, dialysis
A4673	B	Ext line w easy lock connect
A4674	B	Chem/antisept solution, 8oz
A4680	A	Activated carbon filter, ea
A4690	A	Dialyzer, each
A4706	A	Bicarbonate conc sol per gal
A4707	A	Bicarbonate conc pow per pac
A4708	A	Acetate conc sol per gallon
A4709	A	Acid conc sol per gallon
A4714	A	Treated water per gallon
A4719	A	÷Y set÷ tubing
A4720	A	Dialysat sol fld vol 249cc
A4721	A	Dialysat sol fld vol 999cc
A4722	A	Dialys sol fld vol 1999cc
A4723	A	Dialys sol fld vol 2999cc
A4724	A	Dialys sol fld vol 3999cc
A4725	A	Dialys sol fld vol 4999cc
A4726	A	Dialys sol fld vol 5999cc
A4728	B	Dialysate solution, non-dex
A4730	A	Fistula cannulation set, ea
A4736	A	Topical anesthetic, per gram
A4737	A	Inj anesthetic per 10 ml
A4740	A	Shunt accessory
A4750	A	Art or venous blood tubing
A4755	A	Comb art/venous blood tubing
A4760	A	Dialysate sol test kit, each
A4765	A	Dialysate conc pow per pack
A4766	A	Dialysate conc sol add 10 ml
A4770	A	Blood collection tube/vacuum
A4771	A	Serum clotting time tube
A4772	A	Blood glucose test strips
A4773	A	Occult blood test strips
A4774	A	Ammonia test strips
A4802	A	Protamine sulfate per 50 mg
A4860	A	Disposable catheter tips
A4870	A	Plumb/elec wk hm hemo equip
A4890	A	Repair/maint cont hemo equip
A4911	A	Drain bag/bottle
A4913	A	Misc dialysis supplies noc
A4918	A	Venous pressure clamp
A4927	A	Non-sterile gloves
A4928	A	Surgical mask
A4929	A	Tourniquet for dialysis, ea
A4930	A	Sterile, gloves per pair
A4931	A	Reusable oral thermometer
A4932	E	Reusable rectal thermometer
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
A5071	A	Urinary pouch w/barrier
A5072	A	Urinary pouch w/o barrier
A5073	A	Urinary pouch on barr w/flng
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
A5126	A	Disk/foam pad +or- adhesive
A5131	A	Appliance cleaner
A5200	A	Percutaneous catheter anchor
A5500	Y	Diab shoe for density insert
A5501	Y	Diabetic custom molded shoe
A5503	Y	Diabetic shoe w/roller/rockr
A5504	Y	Diabetic shoe with wedge
A5505	Y	Diab shoe w/metatarsal bar
A5506	Y	Diabetic shoe w/off set heel
A5507	Y	Modification diabetic shoe
A5508	Y	Diabetic deluxe shoe
A5509	E	Direct heat form shoe insert
A5510	E	Compression form shoe insert
A5511	E	Custom fab molded shoe inser
A6000	E	Wound warming wound cover
A6010	A	Collagen based wound filler
A6011	A	Collagen gel/paste wound fil
A6021	A	Collagen dressing =16 sq in
A6022	A	Collagen drsg6=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 gauze16=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 dsg16=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
A6266	A	Impreg gauze no h20/sal/yard
A6402	A	Sterile gauze = 16 sq in
A6403	A	Sterile gauze16 = 48 sq in
A6404	A	Sterile gauze 48 sq in
A6407	A	Packing strips, non-impreg
A6410	A	Sterile eye pad
A6411	A	Non-sterile eye pad
A6412	E	Occlusive eye patch
A6441	A	Pad band w=3÷ 5÷/yd
A6442	A	Conform band n/s w3÷/yd
A6443	A	Conform band n/s w=3÷5÷/yd
A6444	A	Conform band n/s w=5÷/yd
A6445	A	Conform band s w 3÷/yd
A6446	A	Conform band s w=3÷ 5÷/yd
A6447	A	Conform band s w =5÷/yd
A6448	A	Lt compres band 3÷/yd
A6449	A	Lt compres band =3÷ 5÷/yd
A6450	A	Lt compres band =5÷/yd
A6451	A	Mod compres band w=3÷5÷/yd
A6452	A	High compres band w=3÷5÷yd
A6453	A	Self-adher band w 3÷/yd
A6454	A	Self-adher band w=3÷ 5÷/yd
A6455	A	Self-adher band =5÷/yd
A6456	A	Zinc paste band w =3÷5÷/yd
A6501	A	Compres burngarment bodysuit
A6502	A	Compres burngarment chinstrp
A6503	A	Compres burngarment facehood
A6504	A	Cmprsburngarment glove-wrist
A6505	A	Cmprsburngarment glove-elbow
A6506	A	Cmprsburngrmnt glove-axilla
A6507	A	Cmprs burngarment foot-knee
A6508	A	Cmprs burngarment foot-thigh
A6509	A	Compres burn garment jacket
A6510	A	Compres burn garment leotard
A6511	A	Compres burn garment panty
A6512	A	Compres burn garment, noc
A6550	Y	Neg pres wound ther drsg set
A6551	Y	Neg press wound ther canistr
A7000	Y	Disposable canister for pump
A7001	Y	Nondisposable pump canister
A7002	Y	Tubing used w suction pump
A7003	Y	Nebulizer administration set
A7004	Y	Disposable nebulizer sml vol
A7005	Y	Nondisposable nebulizer set
A7006	Y	Filtered nebulizer admin set
A7007	Y	Lg vol nebulizer disposable
A7008	Y	Disposable nebulizer prefill
A7009	Y	Nebulizer reservoir bottle
A7010	Y	Disposable corrugated tubing
A7011	Y	Nondispos corrugated tubing
A7012	Y	Nebulizer water collec devic
A7013	Y	Disposable compressor filter
A7014	Y	Compressor nondispos filter
A7015	Y	Aerosol mask used w nebulize
A7016	Y	Nebulizer dome mouthpiece
A7017	Y	Nebulizer not used w oxygen
A7018	Y	Water distilled w/nebulizer
A7025	Y	Replace chest compress vest
A7026	Y	Replace chst cmprss sys hose
A7030	Y	CPAP full face mask
A7031	Y	Replacement facemask interfa
A7032	Y	Replacement nasal cushion
A7033	Y	Replacement nasal pillows
A7034	Y	Nasal application device
A7035	Y	Pos airway press headgear
A7036	Y	Pos airway press chinstrap
A7037	Y	Pos airway pressure tubing
A7038	Y	Pos airway pressure filter
A7039	Y	Filter, non disposable w pap
A7040	A	One way chest drain valve
A7041	A	Water seal drain container
A7042	A	Implanted pleural catheter
A7043	A	Vacuum drainagebottle/tubing
A7044	Y	PAP oral interface
A7045	Y	Repl exhalation port for PAP
A7046	Y	Repl water chamber, PAP dev
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
A7520	A	Trach/laryn tube non-cuffed
A7521	A	Trach/laryn tube cuffed
A7522	A	Trach/laryn tube stainless
A7523	A	Tracheostomy shower protect
A7524	A	Tracheostoma stent/stud/bttn
A7525	A	Tracheostomy mask
A7526	A	Tracheostomy tube collar
A7527	A	Trach/laryn tube plug/stop
A9150	B	Misc/exper non-prescript dru
A9152	E	Single vitamin nos
A9153	E	Multi-vitamin nos
A9180	E	Lice treatment, topical
A9270	E	Non-covered item or service
A9280	E	Alert device, noc
A9300	E	Exercise equipment
A9500	H	Technetium TC 99m sestamibi	1600
A9502	H	Technetium TC99M tetrofosmin	0705
A9503	N	Technetium TC 99m medronate
A9504	N	Technetium tc 99m apcitide
A9505	H	Thallous chloride TL 201/mci	1603
A9507	H	Indium/111 capromab pendetid	1604
A9508	H	Iobenguane sulfate I-131, pe	1045
A9510	H	Technetium TC99m Disofenin	9146
A9511	H	Technetium TC 99m depreotide	9147
A9512	N	Technetium tc99m pertechnetate
A9513	N	Technetium tc-99m mebrofenin
A9514	N	Technetium tc99m pyrophosphate
A9515	N	Technetium tc-99m pentetate
A9516	H	I-123 sodium iodide capsule	9148
A9517	H	Th I131 so iodide cap millic	1064
A9519	N	Technetium tc-99m macroag albu
A9520	N	Technetium tc-99m sulfur clld
A9521	H	Technetium tc-99m exametazine	1096
A9522	B	Indium 111i britumomabtiuxetan
A9523	B	Yttrium 90i britumomabtiuxetan
A9524	H	Iodinated I-131 serumalbumin	9100
A9525	E	Low/iso-osmolar contrast mat
A9526	H	Ammonia N-13, per dose	0737
A9528	H	Dx I131 so iodide cap millic	1088
A9529	H	Dx I131 so iodide sol millic	1065
A9530	H	Th I131 so iodide sol millic	1150
A9531	H	Dx I131 so iodide microcurie	9149
A9532	H	I-125 serum albumin micro	9150
A9533	B	I-131 tositumomab diagnostic
A9534	B	I-131 tositumomab therapeut
A9600	H	Strontium-89 chloride	0701
A9605	H	Samarium sm153 lexidronamm	0702
A9699	N	Noc therapeutic radiopharm
A9700	B	Echocardiography Contrast
A9900	A	Supply/accessory/service
A9901	A	Delivery/set up/dispensing
A9999	Y	DME supply or accessory, nos
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
B4086	A	Gastrostomy/jejunostomy tube
B4100	E	Food thickener oral
B4102	Y	EF adult fluids and electro
B4103	Y	EF ped fluid and electrolyte
B4104	E	Additive for enteral formula
B4149	Y	EF blenderized foods
B4150	A	Enteral formulae category i
B4152	A	Enteral formulae category ii
B4153	A	Enteral formulae category III
B4154	A	Enteral formulae category IV
B4155	A	Enteral formulae category v
B4157	Y	EF special metabolic inherit
B4158	Y	EF ped complete intact nut
B4159	Y	EF ped complete soy based
B4160	Y	EF ped calorie dense / =0.7kc
B4161	Y	EF ped hydrolyzed/amino acid
B4162	Y	EF ped specmetabolic inherit
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
C1079	N	CO 57/58 per 0.5 uCi
C1080	H	I-131 tositumomab, dx	1080
C1081	H	I-131 tositumomab, tx	1081
C1082	H	In-111 ibritumomab tiuxetan	9118
C1083	H	Yttrium 90 ibritumomab tiuxe	9117
C1091	H	IN111 oxyquinoline,per 0.5 mCi	1091
C1092	H	IN 111 pentetate per 0.5 mCi	1092
C1093	H	TC99M fanolesomab	1093
C1122	H	Tc 99M ARCITUMOMAB PER VIAL	9151
C1178	K	BUSULFAN IV, 6 Mg	1178	0.2851	$16.92		$3.38
C1200	N	TC 99M Sodium Glucoheptonat
C1201	H	TC 99M SUCCIMER, PER Vial	1201
C1300	S	HYPERBARIC Oxygen	0659	1.5473	$91.82		$18.36
C1305	K	Apligraf, 44cm2	1305	12.9222	$766.84		$153.37
C1713	N	Anchor/screw bn/bn,tis/bn
C1714	N	Cath, trans atherectomy, dir
C1715	N	Brachytherapy needle
C1716	H	Brachytx source, Gold 198	1716
C1717	H	Brachytx source, HDR Ir-192	1717
C1718	H	Brachytx source, Iodine 125	1718
C1719	H	Brachytx sour,Non-HDR Ir-192	1719
C1720	H	Brachytx sour, Palladium 103	1720
C1721	N	AICD, dual chamber
C1722	N	AICD, single chamber
C1724	N	Cath, trans atherec,rotation
C1725	N	Cath, translumin non-laser
C1726	N	Cath, bal dil, non-vascular
C1727	N	Cath, bal tis dis, non-vas
C1728	N	Cath, brachytx seed adm
C1729	N	Cath, drainage
C1730	N	Cath, EP, 19 or few elect
C1731	N	Cath, EP, 20 or more elec
C1732	N	Cath, EP, diag/abl, 3D/vect
C1733	N	Cath, EP, othr than cool-tip
C1750	N	Cath, hemodialysis,long-term
C1751	N	Cath, inf, per/cent/midline
C1752	N	Cath,hemodialysis,short-term
C1753	N	Cath, intravas ultrasound
C1754	N	Catheter, intradiscal
C1755	N	Catheter, intraspinal
C1756	N	Cath, pacing, transesoph
C1757	N	Cath, thrombectomy/embolect
C1758	N	Catheter, ureteral
C1759	N	Cath, intra echocardiography
C1760	N	Closure dev, vasc
C1762	N	Conn tiss, human(inc fascia)
C1763	N	Conn tiss, non-human
C1764	N	Event recorder, cardiac
C1765	N	Adhesion barrier
C1766	N	Intro/sheath,strble,non-peel
C1767	N	Generator, neurostim, imp
C1768	N	Graft, vascular
C1769	N	Guide wire
C1770	N	Imaging coil, MR, insertable
C1771	N	Rep dev, urinary, w/sling
C1772	N	Infusion pump, programmable
C1773	N	Ret dev, insertable
C1775	H	FDG, per dose (4-40 mCi/ml)	1775
C1776	N	Joint device (implantable)
C1777	N	Lead, AICD, endo single coil
C1778	N	Lead, neurostimulator
C1779	N	Lead, pmkr, transvenous VDD
C1780	N	Lens, intraocular (new tech)
C1781	N	Mesh (implantable)
C1782	N	Morcellator
C1783	N	Ocular imp, aqueous drain de
C1784	N	Ocular dev, intraop, det ret
C1785	N	Pmkr, dual, rate-resp
C1786	N	Pmkr, single, rate-resp
C1787	N	Patient progr, neurostim
C1788	N	Port, indwelling, imp
C1789	N	Prosthesis, breast, imp
C1813	N	Prosthesis, penile, inflatab
C1814	N	Retinal tamp, silicone oil
C1815	N	Pros, urinary sph, imp
C1816	N	Receiver/transmitter, neuro
C1817	N	Septal defect imp sys
C1818	N	Integrated keratoprosthesis
C1819	N	Tissue local excision
C1874	N	Stent, coated/cov w/del sys
C1875	N	Stent, coated/cov w/o del sy
C1876	N	Stent, non-coa/non-cov w/del
C1877	N	Stent, non-coat/cov w/o del
C1878	N	Matrl for vocal cord
C1879	N	Tissue marker, implantable
C1880	N	Vena cava filter
C1881	N	Dialysis access system
C1882	N	AICD, other than sing/dual
C1883	N	Adapt/ext, pacing/neuro lead
C1884	N	Embolization Protect syst
C1885	N	Cath, translumin angio laser
C1887	N	Catheter, guiding
C1888	N	Endovas non-cardiac abl cath
C1891	N	Infusion pump,non-prog, perm
C1892	N	Intro/sheath,fixed,peel-away
C1893	N	Intro/sheath, fixed,non-peel
C1894	N	Intro/sheath, non-laser
C1895	N	Lead, AICD, endo dual coil
C1896	N	Lead, AICD, non sing/dual
C1897	N	Lead, neurostim test kit
C1898	N	Lead, pmkr, other than trans
C1899	N	Lead, pmkr/AICD combination
C1900	N	Lead coronary venous
C2614	N	Probe, perc lumb disc
C2615	N	Sealant, pulmonary, liquid
C2616	H	Brachytx source, Yttrium-90	2616
C2617	N	Stent, non-cor, tem w/o del
C2618	N	Probe, cryoablation
C2619	N	Pmkr, dual, non rate-resp
C2620	N	Pmkr, single, non rate-resp
C2621	N	Pmkr, other than sing/dual
C2622	N	Prosthesis, penile, non-inf
C2625	N	Stent, non-cor, tem w/del sy
C2626	N	Infusion pump, non-prog,temp
C2627	N	Cath, suprapubic/cystoscopic
C2628	N	Catheter, occlusion
C2629	N	Intro/sheath, laser
C2630	N	Cath, EP, cool-tip
C2631	N	Rep dev, urinary, w/o sling
C2632	H	Brachytx sol, I-125, per mCi	2632
C2633	H	Brachytx source, Cesium-131	2633
C2634	H	Brachytx source, HA, I-125	2634
C2635	H	Brachytx source, HA, P-103	2635
C2636	H	Brachytx linear source, P-10	2636
C8900*	S	MRA w/cont, abd	0284	6.4201	$380.99	$152.39	$76.20
C8901*	S	MRA w/o cont, abd	0336	6.0742	$360.46	$144.18	$72.09
C8902*	S	MRA w/o fol w/cont, abd	0337	8.7945	$521.89	$208.75	$104.38
C8903*	S	MRI w/cont, breast, uni	0284	6.4201	$380.99	$152.39	$76.20
C8904*	S	MRI w/o cont, breast, uni	0336	6.0742	$360.46	$144.18	$72.09
C8905*	S	MRI w/o fol w/cont, brst, un	0337	8.7945	$521.89	$208.75	$104.38
C8906*	S	MRI w/cont, breast, bi	0284	6.4201	$380.99	$152.39	$76.20
C8907*	S	MRI w/o cont, breast, bi	0336	6.0742	$360.46	$144.18	$72.09
C8908*	S	MRI w/o fol w/cont, breast,	0337	8.7945	$521.89	$208.75	$104.38
C8909*	S	MRA w/cont, chest	0284	6.4201	$380.99	$152.39	$76.20
C8910*	S	MRA w/o cont, chest	0336	6.0742	$360.46	$144.18	$72.09
C8911*	S	MRA w/o fol w/cont, chest	0337	8.7945	$521.89	$208.75	$104.38
C8912*	S	MRA w/cont, lwr ext	0284	6.4201	$380.99	$152.39	$76.20
C8913*	S	MRA w/o cont, lwr ext	0336	6.0742	$360.46	$144.18	$72.09
C8914*	S	MRA w/o fol w/cont, lwr ext	0337	8.7945	$521.89	$208.75	$104.38
C8918*	S	MRA w/cont, pelvis	0284	6.4201	$380.99	$152.39	$76.20
C8919*	S	MRA w/o cont, pelvis	0336	6.0742	$360.46	$144.18	$72.09
C8920*	S	MRA w/o fol w/cont, pelvis	0337	8.7945	$521.89	$208.75	$104.38
C9000	H	Na chromateCr51, per 0.25mCi	9130
C9003	K	Palivizumab, per 50 mg	9003	4.1491	$246.22		$49.24
C9007	K	Baclofen Intrathecal kit-1am	9152	0.8562	$50.81		$10.16
C9008	K	Baclofen Refill Kit-500mcg	9008	0.2447	$14.52		$2.90
C9009	K	Baclofen Refill Kit-2000mcg	9009	0.7209	$42.78		$8.56
C9013	N	Co 57 cobaltous chloride
C9102	H	51 Na Chromate, 50mCi	9132
C9103	H	Na Iothalamate I-125, 10 uCi	9153
C9105	K	Hep B imm glob, per 1 ml	9105	1.8813	$111.64		$22.33
C9112	D	Perflutren lipid micro, 2ml
C9113	N	Inj pantoprazole sodium, via
C9121	K	Injection, argatroban	9121	0.1897	$11.26		$2.25
C9123	K	Transcyte, 247cm2	9123		$719.41		$143.88
C9127	K	Paclitaxel protein pr	9127		$8.59		$1.72
C9128	K	Inj pegaptanib sodium	9128		$1,074.27		$214.85
C9200	K	Orcel, 36 cm2	9200	2.6893	$159.59		$31.92
C9201	K	Dermagraft, 37.5cm2	9201	6.2066	$368.32		$73.66
C9202	D	Octafluoropropane
C9203	D	Perflexane lipid micro
C9205	K	Oxaliplatin	9205		$84.06		$16.81
C9206	K	Integra, per cm2	9206		$9.23		$1.85
C9211	K	Inj, alefacept, IV	9211		$571.01		$114.20
C9212	K	Inj, alefacept, IM	9212		$402.00		$80.40
C9218	K	Injection, Azacitidine	9218		$4.03		$0.81
C9220	G	Sodium hyaluronate	9220		$203.84		$40.77
C9221	G	Graftjacket Reg Matrix	9221		$1,234.36		$246.87
C9222	G	Graftjacket SftTis	9222		$890.74		$178.15
C9223	D	Inj adenosine, tx dx
C9399	A	Unclass drugs/biologicals
C9400	D	Thallous chloride, brand
C9401	D	Strontium-89 chloride, brand
C9402	D	Th I131 so iodide cap, brand
C9403	D	Dx I131 so iodide cap, brand
C9404	D	Dx I131 so iodide sol, brand
C9405	D	Th I131 so iodide sol, brand
C9410	D	Dexrazoxane HCl inj, brand
C9411	D	Pamidronate disodium, brand
C9413	D	Na hyaluronate bran
C9414	D	Etoposide oral, brand
C9415	D	Doxorubic hcl chemo, brand
C9417	D	Bleomycin sulfate inj, brand
C9418	D	Cisplatin inj, brand
C9419	D	Inj cladribine, brand
C9420	D	Cyclophosphamide inj, brand
C9421	D	Cyclophosphamide lyo, brand
C9422	D	Cytarabine hcl inj, brand
C9423	D	Dacarbazine inj, brand
C9424	D	Daunorubicin, brand
C9425	D	Etoposide inj, brand
C9426	D	Floxuridine inj, brand
C9427	D	Ifosfomide inj, brand
C9428	D	Mesna injection, brand
C9429	D	Idarubicin hcl inj, brand
C9430	D	Leuprolide acetate bran
C9431	D	Paclitaxel inj, brand
C9432	D	Mitomycin inj, brand
C9433	D	Thiotepa inj, brand
C9435	D	Gonadorelin hydroch, brand
C9436	D	Azathioprine parenteral,brnd
C9437	D	Carmus bischl nitro inj
C9438	D	Cyclosporine oral, brand
C9439	D	Diethylstilbestrol injection
C9440	D	Vinorelbine tar,brand
C9704	T	Inj inert subs upper GI	1556		$1,750.00		$350.00
C9713	T	Non-contact laser vap prosta	0429	42.3147	$2,511.08		$502.22
C9716	S	RF Energy to Anus	1519		$1,750.00		$350.00
C9718	T	Kyphoplasty, first vertebra	0051	36.5271	$2,167.63		$433.53
C9719	T	Kyphoplasty, each addl	0051	36.5271	$2,167.63		$433.53
C9720	T	HE ESW tx, tennis elbow	1547		$850.00		$170.00
C9721	T	HE ESW tx, plantar fasciitis	1547		$850.00		$170.00
C9722	S	KV imaging w/IR tracking	1502		$75.00		$15.00
C9723	S	Dyn IR Perf Img	1502		$75.00		$15.00
C9724	T	EPS gast cardia plic	0422	22.9647	$1,362.79	$448.81	$272.56
D0120	E	Periodic oral evaluation
D0140	E	Limit oral eval problm focus
D0150	S	Comprehensve oral evaluation	0330	7.1756	$425.82		$85.16
D0160	E	Extensv oral eval prob focus
D0170	E	Re-eval,est pt,problem focus
D0180	E	Comp periodontal evaluation
D0210	E	Intraor complete film series
D0220	E	Intraoral periapical first f
D0230	E	Intraoral periapical ea add
D0240	S	Intraoral occlusal film	0330	7.1756	$425.82		$85.16
D0250	S	Extraoral first film	0330	7.1756	$425.82		$85.16
D0260	S	Extraoral ea additional film	0330	7.1756	$425.82		$85.16
D0270	S	Dental bitewing single film	0330	7.1756	$425.82		$85.16
D0272	S	Dental bitewings two films	0330	7.1756	$425.82		$85.16
D0274	S	Dental bitewings four films	0330	7.1756	$425.82		$85.16
D0277	S	Vert bitewings-sev to eight	0330	7.1756	$425.82		$85.16
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
D0416	B	Viral culture
D0421	B	Gen tst suscept oral disease
D0425	E	Caries susceptibility test
D0431	B	Diag tst detect mucos abnorm
D0460	S	Pulp vitality test	0330	7.1756	$425.82		$85.16
D0470	E	Diagnostic casts
D0472	B	Gross exam, prep report
D0473	B	Micro exam, prep report
D0474	B	Micro w exam of surg margins
D0475	B	Decalcification procedure
D0476	B	Spec stains for microorganis
D0477	B	Spec stains not for microorg
D0478	B	Immunohistochemical stains
D0479	B	Tissue in-situ hybridization
D0480	B	Cytopath smear prep report
D0481	B	Electron microscopy diagnost
D0482	B	Direct immunofluorescence
D0483	B	Indirect immunofluorescence
D0484	B	Consult slides prep elsewher
D0485	B	Consult inc prep of slides
D0502	B	Other oral pathology procedu
D0999	B	Unspecified diagnostic proce
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	7.1756	$425.82		$85.16
D1515	S	Fixed bilat space maintainer	0330	7.1756	$425.82		$85.16
D1520	S	Remove unilat space maintain	0330	7.1756	$425.82		$85.16
D1525	S	Remove bilat space maintain	0330	7.1756	$425.82		$85.16
D1550	S	Recement space maintainer	0330	7.1756	$425.82		$85.16
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
D2390	E	Ant resin-based cmpst crown
D2391	E	Post 1 srfc resinbased cmpst
D2392	E	Post 2 srfc resinbased cmpst
D2393	E	Post 3 srfc resinbased cmpst
D2394	E	Post =4srfc resinbase cmpst
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
D2712	E	Crown 3/4 resin-based compos
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
D2794	E	Crown-titanium
D2799	E	Provisional crown
D2910	E	Dental recement inlay
D2915	E	Recement cast or prefab post
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
D2934	E	Prefab steel crown primary
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
D2971	E	Add proc construct new crown
D2975	E	Coping
D2980	E	Crown repair
D2999	S	Dental unspec restorative pr	0330	7.1756	$425.82		$85.16
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	7.1756	$425.82		$85.16
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	7.1756	$425.82		$85.16
D4210	E	Gingivectomy/plasty per quad
D4211	E	Gingivectomy/plasty per toot
D4240	E	Gingival flap proc w/ planin
D4241	E	Gngvl flap w rootplan 1-3 th
D4245	E	Apically positioned flap
D4249	E	Crown lengthen hard tissue
D4260	S	Osseous surgery per quadrant	0330	7.1756	$425.82		$85.16
D4261	E	Osseous surgl-3teethperquad
D4263	S	Bone replce graft first site	0330	7.1756	$425.82		$85.16
D4264	S	Bone replce graft each add	0330	7.1756	$425.82		$85.16
D4265	E	Bio mtrls to aid soft/os reg
D4266	E	Guided tiss regen resorble
D4267	E	Guided tiss regen nonresorb
D4268	S	Surgical revision procedure	0330	7.1756	$425.82		$85.16
D4270	S	Pedicle soft tissue graft pr	0330	7.1756	$425.82		$85.16
D4271	S	Free soft tissue graft proc	0330	7.1756	$425.82		$85.16
D4273	S	Subepithelial tissue graft	0330	7.1756	$425.82		$85.16
D4274	E	Distal/proximal wedge proc
D4275	E	Soft tissue allograft
D4276	E	Con tissue w dble ped graft
D4320	E	Provision splnt intracoronal
D4321	E	Provisional splint extracoro
D4341	E	Periodontal scaling root
D4342	E	Periodontal scaling 1-3teeth
D4355	S	Full mouth debridement	0330	7.1756	$425.82		$85.16
D4381	S	Localized chemo delivery	0330	7.1756	$425.82		$85.16
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
D5225	E	Maxillary part denture flex
D5226	E	Mandibular part denture flex
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
D5670	E	Replc tthacrlc on mtl frmwk
D5671	E	Replc tthacrlc mandibular
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	7.1756	$425.82		$85.16
D5912	S	Facial moulage complete	0330	7.1756	$425.82		$85.16
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	7.1756	$425.82		$85.16
D5984	S	Radiation shield	0330	7.1756	$425.82		$85.16
D5985	S	Radiation cone locator	0330	7.1756	$425.82		$85.16
D5986	E	Fluoride applicator
D5987	S	Commissure splint	0330	7.1756	$425.82		$85.16
D5988	E	Surgical splint
D5999	E	Maxillofacial prosthesis
D6010	E	Odontics endosteal implant
D6040	E	Odontics eposteal implant
D6050	E	Odontics transosteal implnt
D6053	E	Implnt/abtmnt spprt remv dnt
D6054	E	Implnt/abtmnt spprt remvprtl
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
D6094	E	Abut support crown titanium
D6095	E	Odontics repr abutment
D6100	E	Removal of implant
D6190	E	Radio/surgical implant index
D6194	E	Abut support retainer titani
D6199	E	Implant procedure
D6205	E	Pontic-indirect resin based
D6210	E	Prosthodont high noble metal
D6211	E	Bridge base metal cast
D6212	E	Bridge noble metal cast
D6214	E	Pontic titanium
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
D6253	E	Provisional pontic
D6545	E	Dental retainr cast metl
D6548	E	Porcelain/ceramic retainer
D6600	E	Porcelain/ceramic inlay 2srf
D6601	E	Porc/ceram inlay = 3 surfac
D6602	E	Cst hgh nble mtl inlay 2 srf
D6603	E	Cst hgh nble mtl inlay =3sr
D6604	E	Cst bse mtl inlay 2 surfaces
D6605	E	Cst bse mtl inlay = 3 surfa
D6606	E	Cast noble metal inlay 2 sur
D6607	E	Cst noble mtl inlay =3 surf
D6608	E	Onlay porc/crmc 2 surfaces
D6609	E	Onlay porc/crmc =3 surfaces
D6610	E	Onlay cst hgh nbl mtl 2 srfc
D6611	E	Onlay cst hgh nbl mtl =3srf
D6612	E	Onlay cst base mtl 2 surface
D6613	E	Onlay cst base mtl =3 surfa
D6614	E	Onlay cst nbl mtl 2 surfaces
D6615	E	Onlay cst nbl mtl =3 surfac
D6624	E	Inlay titanium
D6634	E	Onlay titanium
D6710	E	Crown-indirect resin based
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
D6793	E	Provisional retainer crown
D6794	E	Crown titanium
D6920	S	Dental connector bar	0330	7.1756	$425.82		$85.16
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
D6985	E	Pediatric partial denture fx
D6999	E	Fixed prosthodontic proc
D7111	S	Coronal remnants deciduous t	0330	7.1756	$425.82		$85.16
D7140	S	Extraction erupted tooth/exr	0330	7.1756	$425.82		$85.16
D7210	S	Rem imp tooth w mucoper flp	0330	7.1756	$425.82		$85.16
D7220	S	Impact tooth remov soft tiss	0330	7.1756	$425.82		$85.16
D7230	S	Impact tooth remov part bony	0330	7.1756	$425.82		$85.16
D7240	S	Impact tooth remov comp bony	0330	7.1756	$425.82		$85.16
D7241	S	Impact tooth rem bony w/comp	0330	7.1756	$425.82		$85.16
D7250	S	Tooth root removal	0330	7.1756	$425.82		$85.16
D7260	S	Oral antral fistula closure	0330	7.1756	$425.82		$85.16
D7261	S	Primary closure sinus perf	0330	7.1756	$425.82		$85.16
D7270	E	Tooth reimplantation
D7272	E	Tooth transplantation
D7280	E	Exposure impact tooth orthod
D7282	E	Mobilize erupted/malpos toot
D7283	B	Place device impacted tooth
D7285	E	Biopsy of oral tissue hard
D7286	E	Biopsy of oral tissue soft
D7287	E	Cytology sample collection
D7288	B	Brush biopsy
D7290	E	Repositioning of teeth
D7291	S	Transseptal fiberotomy	0330	7.1756	$425.82		$85.16
D7310	E	Alveoplasty w/ extraction
D7311	E	Alveoloplasty w/extract 1-3
D7320	E	Alveoplasty w/o extraction
D7321	B	Alveoloplasty not w/extracts
D7340	E	Vestibuloplasty ridge extens
D7350	E	Vestibuloplasty exten graft
D7410	E	Rad exc lesion up to 1.25 cm
D7411	E	Excision benign lesion1.25c
D7412	E	Excision benign lesion compl
D7413	E	Excision malig lesion =1.25c
D7414	E	Excision malig lesion 1.25cm
D7415	E	Excision malig les complicat
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
D7472	E	Removal of torus palatinus
D7473	E	Remove torus mandibularis
D7485	E	Surg reduct osseoustuberosit
D7490	E	Mandible resection
D7510	E	Id absc intraoral soft tiss
D7511	B	Incision/drain abscess intra
D7520	E	Id abscess extraoral
D7521	B	Incision/drain abscess extra
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
D7671	E	Alveolus open reduction
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
D7771	E	Alveolus clsd reduc stblz te
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	7.1756	$425.82		$85.16
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
D7953	E	Bone replacement graft
D7955	E	Repair maxillofacial defects
D7960	E	Frenulectomy/frenulotomy
D7963	E	Frenuloplasty
D7970	E	Excision hyperplastic tissue
D7971	E	Excision pericoronal gingiva
D7972	E	Surg redct fibrous tuberosit
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
D9450	E	Case presentation tx plan
D9610	E	Dent therapeutic drug inject
D9630	S	Other drugs/medicaments	0330	7.1756	$425.82		$85.16
D9910	E	Dent appl desensitizing med
D9911	E	Appl desensitizing resin
D9920	E	Behavior management
D9930	S	Treatment of complications	0330	7.1756	$425.82		$85.16
D9940	S	Dental occlusal guard	0330	7.1756	$425.82		$85.16
D9941	E	Fabrication athletic guard
D9942	E	Repair/reline occlusal guard
D9950	S	Occlusion analysis	0330	7.1756	$425.82		$85.16
D9951	S	Limited occlusal adjustment	0330	7.1756	$425.82		$85.16
D9952	S	Complete occlusal adjustment	0330	7.1756	$425.82		$85.16
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	Y	Cane adjust/fixed with tip
E0105	Y	Cane adjust/fixed quad/3 pro
E0110	Y	Crutch forearm pair
E0111	Y	Crutch forearm each
E0112	Y	Crutch underarm pair wood
E0113	Y	Crutch underarm each wood
E0114	Y	Crutch underarm pair no wood
E0116	Y	Crutch underarm each no wood
E0117	Y	Underarm springassist crutch
E0118	E	Crutch substitute
E0130	Y	Walker rigid adjust/fixed ht
E0135	Y	Walker folding adjust/fixed
E0140	Y	Walker w trunk support
E0141	Y	Rigid wheeled walker adj/fix
E0143	Y	Walker folding wheeled w/o s
E0144	Y	Enclosed walker w rear seat
E0147	Y	Walker variable wheel resist
E0148	Y	Heavyduty walker no wheels
E0149	Y	Heavy duty wheeled walker
E0153	Y	Forearm crutch platform atta
E0154	Y	Walker platform attachment
E0155	Y	Walker wheel attachment,pair
E0156	Y	Walker seat attachment
E0157	Y	Walker crutch attachment
E0158	Y	Walker leg extenders set of4
E0159	Y	Brake for wheeled walker
E0160	Y	Sitz type bath or equipment
E0161	Y	Sitz bath/equipment w/faucet
E0162	Y	Sitz bath chair
E0163	Y	Commode chair stationry fxd
E0164	Y	Commode chair mobile fixed a
E0166	Y	Commode chair mobile detach
E0167	Y	Commode chair pail or pan
E0168	Y	Heavyduty/wide commode chair
E0169	Y	Seatlift incorp commodechair
E0175	Y	Commode chair foot rest
E0180	Y	Press pad alternating w pump
E0181	Y	Press pad alternating w/ pum
E0182	Y	Pressure pad alternating pum
E0184	Y	Dry pressure mattress
E0185	Y	Gel pressure mattress pad
E0186	Y	Air pressure mattress
E0187	Y	Water pressure mattress
E0188	Y	Synthetic sheepskin pad
E0189	Y	Lambswool sheepskin pad
E0190	E	Positioning cushion
E0191	Y	Protector heel or elbow
E0193	Y	Powered air flotation bed
E0194	Y	Air fluidized bed
E0196	Y	Gel pressure mattress
E0197	Y	Air pressure pad for mattres
E0198	Y	Water pressure pad for mattr
E0199	Y	Dry pressure pad for mattres
E0200	Y	Heat lamp without stand
E0202	Y	Phototherapy light w/ photom
E0203	E	Therapeutic lightbox tabletp
E0205	Y	Heat lamp with stand
E0210	Y	Electric heat pad standard
E0215	Y	Electric heat pad moist
E0217	Y	Water circ heat pad w pump
E0218	Y	Water circ cold pad w pump
E0220	Y	Hot water bottle
E0221	E	Infrared heating pad system
E0225	Y	Hydrocollator unit
E0230	Y	Ice cap or collar
E0231	E	Wound warming device
E0232	E	Warming card for NWT
E0235	Y	Paraffin bath unit portable
E0236	Y	Pump for water circulating p
E0238	Y	Heat pad non-electric moist
E0239	Y	Hydrocollator unit portable
E0240	E	Bath/shower chair
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
E0247	E	Trans bench w/wo comm open
E0248	E	HDtrans bench w/wo comm open
E0249	Y	Pad water circulating heat u
E0250	Y	Hosp bed fixed ht w/ mattres
E0251	Y	Hosp bed fixd ht w/o mattres
E0255	Y	Hospital bed var ht w/ mattr
E0256	Y	Hospital bed var ht w/o matt
E0260	Y	Hosp bed semi-electr w/ matt
E0261	Y	Hosp bed semi-electr w/o mat
E0265	Y	Hosp bed total electr w/ mat
E0266	Y	Hosp bed total elec w/o matt
E0270	E	Hospital bed institutional t
E0271	Y	Mattress innerspring
E0272	Y	Mattress foam rubber
E0273	E	Bed board
E0274	E	Over-bed table
E0275	Y	Bed pan standard
E0276	Y	Bed pan fracture
E0277	Y	Powered pres-redu air mattrs
E0280	Y	Bed cradle
E0290	Y	Hosp bed fx ht w/o rails w/m
E0291	Y	Hosp bed fx ht w/o rail w/o
E0292	Y	Hosp bed var ht w/o rail w/o
E0293	Y	Hosp bed var ht w/o rail w/
E0294	Y	Hosp bed semi-elect w/ mattr
E0295	Y	Hosp bed semi-elect w/o matt
E0296	Y	Hosp bed total elect w/ matt
E0297	Y	Hosp bed total elect w/o mat
E0300	Y	Enclosed ped crib hosp grade
E0301	Y	HD hosp bed, 350-600 lbs
E0302	Y	Ex hd hosp bed 600 lbs
E0303	Y	Hosp bed hvy dty xtra wide
E0304	Y	Hosp bed xtra hvy dty × wide
E0305	Y	Rails bed side half length
E0310	Y	Rails bed side full length
E0315	E	Bed accessory brd/tbl/supprt
E0316	Y	Bed safety enclosure
E0325	Y	Urinal male jug-type
E0326	Y	Urinal female jug-type
E0350	E	Control unit bowel system
E0352	E	Disposable pack w/bowel syst
E0370	E	Air elevator for heel
E0371	Y	Nonpower mattress overlay
E0372	Y	Powered air mattress overlay
E0373	Y	Nonpowered pressure mattress
E0424	Y	Stationary compressed gas 02
E0425	E	Gas system stationary compre
E0430	E	Oxygen system gas portable
E0431	Y	Portable gaseous 02
E0434	Y	Portable liquid 02
E0435	E	Oxygen system liquid portabl
E0439	Y	Stationary liquid 02
E0440	E	Oxygen system liquid station
E0441	Y	Oxygen contents, gaseous
E0442	Y	Oxygen contents, liquid
E0443	Y	Portable 02 contents, gas
E0444	Y	Portable 02 contents, liquid
E0445	A	Oximeter non-invasive
E0450	Y	Volume vent stationary/porta
E0455	Y	Oxygen tent excl croup/ped t
E0457	Y	Chest shell
E0459	Y	Chest wrap
E0460	Y	Neg press vent portabl/statn
E0461	Y	Vol vent noninvasive interfa
E0462	Y	Rocking bed w/ or w/o side r
E0463	Y	Press supp vent invasive int
E0464	Y	Press supp vent noninv int
E0470	Y	RAD w/o backup non-inv intfc
E0471	Y	RAD w/backup non inv intrfc
E0472	Y	RAD w backup invasive intrfc
E0480	Y	Percussor elect/pneum home m
E0481	E	Intrpulmnry percuss vent sys
E0482	Y	Cough stimulating device
E0483	Y	Chest compression gen system
E0484	Y	Non-elec oscillatory pep dvc
E0500	Y	Ippb all types
E0550	Y	Humidif extens supple w ippb
E0555	Y	Humidifier for use w/ regula
E0560	Y	Humidifier supplemental w/ i
E0561	Y	Humidifier nonheated w PAP
E0562	Y	Humidifier heated used w PAP
E0565	Y	Compressor air power source
E0570	Y	Nebulizer with compression
E0571	Y	Aerosol compressor for svneb
E0572	Y	Aerosol compressor adjust pr
E0574	Y	Ultrasonic generator w svneb
E0575	Y	Nebulizer ultrasonic
E0580	Y	Nebulizer for use w/ regulat
E0585	Y	Nebulizer w/ compressor he
E0590	Y	Dispensing fee dme neb drug
E0600	Y	Suction pump portab hom modl
E0601	Y	Cont airway pressure device
E0602	Y	Manual breast pump
E0603	A	Electric breast pump
E0604	A	Hosp grade elec breast pump
E0605	Y	Vaporizer room type
E0606	Y	Drainage board postural
E0607	Y	Blood glucose monitor home
E0610	Y	Pacemaker monitr audible/vis
E0615	Y	Pacemaker monitr digital/vis
E0616	N	Cardiac event recorder
E0617	Y	Automatic ext defibrillator
E0618	A	Apnea monitor
E0619	A	Apnea monitor w recorder
E0620	Y	Cap bld skin piercing laser
E0621	Y	Patient lift sling or seat
E0625	E	Patient lift bathroom or toi
E0627	Y	Seat lift incorp lift-chair
E0628	Y	Seat lift for pt furn-electr
E0629	Y	Seat lift for pt furn-non-el
E0630	Y	Patient lift hydraulic
E0635	Y	Patient lift electric
E0636	Y	PT support positioning sys
E0637	E	Sit-stand w seatlift wheeled
E0638	E	Standing frame sys wheeled
E0639	E	Moveable patient lift system
E0640	E	Fixed patient lift system
E0650	Y	Pneuma compresor non-segment
E0651	Y	Pneum compressor segmental
E0652	Y	Pneum compres w/cal pressure
E0655	Y	Pneumatic appliance half arm
E0660	Y	Pneumatic appliance full leg
E0665	Y	Pneumatic appliance full arm
E0666	Y	Pneumatic appliance half leg
E0667	Y	Seg pneumatic appl full leg
E0668	Y	Seg pneumatic appl full arm
E0669	Y	Seg pneumatic appli half leg
E0671	Y	Pressure pneum appl full leg
E0672	Y	Pressure pneum appl full arm
E0673	Y	Pressure pneum appl half leg
E0675	Y	Pneumatic compression device
E0691	Y	Uvl pnl 2 sq ft or less
E0692	Y	Uvl sys panel 4 ft
E0693	Y	Uvl sys panel 6 ft
E0694	Y	Uvl md cabinet sys 6 ft
E0700	E	Safety equipment
E0701	Y	Helmet w face guard prefab
E0710	E	Restraints any type
E0720	Y	Tens two lead
E0730	Y	Tens four lead
E0731	Y	Conductive garment for tens/
E0740	Y	Incontinence treatment systm
E0744	Y	Neuromuscular stim for scoli
E0745	Y	Neuromuscular stim for shock
E0746	E	Electromyograph biofeedback
E0747	Y	Elec osteogen stim not spine
E0748	Y	Elec osteogen stim spinal
E0749	N	Elec osteogen stim implanted
E0752	B	Neurostimulator electrode
E0754	A	Pulsegenerator pt programmer
E0755	E	Electronic salivary reflex s
E0756	B	Implantable pulse generator
E0757	N	Implantable RF receiver
E0758	A	External RF transmitter
E0759	A	Replace rdfrquncy transmittr
E0760	Y	Osteogen ultrasound stimltor
E0761	E	Nontherm electromgntc device
E0765	Y	Nerve stimulator for tx nv
E0769	B	Electric wound treatment dev
E0776	Y	Iv pole
E0779	Y	Amb infusion pump mechanical
E0780	Y	Mech amb infusion pump 8hrs
E0781	Y	External ambulatory infus pu
E0782	N	Non-programble infusion pump
E0783	N	Programmable infusion pump
E0784	Y	Ext amb infusn pump insulin
E0785	N	Replacement impl pump cathet
E0786	N	Implantable pump replacement
E0791	Y	Parenteral infusion pump sta
E0830	N	Ambulatory traction device
E0840	Y	Tract frame attach headboard
E0849	Y	Cervical pneum trac equip
E0850	Y	Traction stand free standing
E0855	Y	Cervical traction equipment
E0860	Y	Tract equip cervical tract
E0870	Y	Tract frame attach footboard
E0880	Y	Trac stand free stand extrem
E0890	Y	Traction frame attach pelvic
E0900	Y	Trac stand free stand pelvic
E0910	Y	Trapeze bar attached to bed
E0920	Y	Fracture frame attached to b
E0930	Y	Fracture frame free standing
E0935	Y	Exercise device passive moti
E0940	Y	Trapeze bar free standing
E0941	Y	Gravity assisted traction de
E0942	Y	Cervical head harness/halter
E0944	Y	Pelvic belt/harness/boot
E0945	Y	Belt/harness extremity
E0946	Y	Fracture frame dual w cross
E0947	Y	Fracture frame attachmnts pe
E0948	Y	Fracture frame attachmnts ce
E0950	E	Tray
E0951	E	Loop heel
E0952	E	Toe loop/holder, each
E0953	E	Pneumatic tire
E0954	E	Wheelchair semi-pneumatic ca
E0955	Y	Cushioned headrest
E0956	Y	W/c lateral trunk/hip suppor
E0957	Y	W/c medial thigh support
E0958	A	Whlchr att- conv 1 arm drive
E0959	B	Amputee adapter
E0960	Y	W/c shoulder harness/straps
E0961	B	Wheelchair brake extension
E0966	B	Wheelchair head rest extensi
E0967	Y	Wheelchair hand rims
E0968	Y	Wheelchair commode seat
E0969	Y	Wheelchair narrowing device
E0970	B	Wheelchair no. 2 footplates
E0971	B	Wheelchair anti-tipping devi
E0972	A	Transfer board or device
E0973	B	W/Ch access det adj armrest
E0974	B	W/Ch access anti-rollback
E0977	Y	Wheelchair wedge cushion
E0978	B	W/C acc,saf belt pelv strap
E0980	Y	Wheelchair safety vest
E0981	Y	Seat upholstery, replacement
E0982	Y	Back upholstery, replacement
E0983	Y	Add pwr joystick
E0984	Y	Add pwr tiller
E0985	Y	W/c seat lift mechanism
E0986	Y	Man w/c push-rim pow assist
E0990	B	Whellchair elevating leg res
E0992	B	Wheelchair solid seat insert
E0994	Y	Wheelchair arm rest
E0995	B	Wheelchair calf rest
E0996	B	Wheelchair tire solid
E0997	Y	Wheelchair caster w/ a fork
E0998	Y	Wheelchair caster w/o a fork
E0999	Y	Wheelchr pneumatic tire w/wh
E1000	B	Wheelchair tire pneumatic ca
E1001	Y	Wheelchair wheel
E1002	Y	Pwr seat tilt
E1003	Y	Pwr seat recline
E1004	Y	Pwr seat recline mech
E1005	Y	Pwr seat recline pwr
E1006	Y	Pwr seat combo w/o shear
E1007	Y	Pwr seat combo w/shear
E1008	Y	Pwr seat combo pwr shear
E1009	Y	Add mech leg elevation
E1010	Y	Add pwr leg elevation
E1011	Y	Ped wc modify width adjustm
E1014	Y	Reclining back add ped w/c
E1015	Y	Shock absorber for man w/c
E1016	Y	Shock absorber for power w/c
E1017	Y	HD shck absrbr for hd man wc
E1018	Y	HD shck absrber for hd powwc
E1019	E	HD feature power seat
E1020	Y	Residual limb support system
E1021	E	Ex hd feature power seat
E1025	E	Pedwc lat/thor sup nocontour
E1026	E	Pedwc contoured lat/thor sup
E1027	E	Ped wc lat/ant support
E1028	Y	W/c manual swingaway
E1029	Y	W/c vent tray fixed
E1030	Y	W/c vent tray gimbaled
E1031	Y	Rollabout chair with casters
E1035	Y	Patient transfer system
E1037	Y	Transport chair, ped size
E1038	Y	Transport chair, adult size
E1039	Y	Transport chair pt wt=250lb
E1050	A	Whelchr fxd full length arms
E1060	A	Wheelchair detachable arms
E1070	A	Wheelchair detachable foot r
E1083	A	Hemi-wheelchair fixed arms
E1084	A	Hemi-wheelchair detachable a
E1085	A	Hemi-wheelchair fixed arms
E1086	A	Hemi-wheelchair detachable a
E1087	A	Wheelchair lightwt fixed arm
E1088	A	Wheelchair lightweight det a
E1089	A	Wheelchair lightwt fixed arm
E1090	A	Wheelchair lightweight det a
E1092	A	Wheelchair wide w/ leg rests
E1093	A	Wheelchair wide w/ foot rest
E1100	A	Whchr s-recl fxd arm leg res
E1110	A	Wheelchair semi-recl detach
E1130	A	Whlchr stand fxd arm ft rest
E1140	A	Wheelchair standard detach a
E1150	Y	Wheelchair standard w/ leg r
E1160	A	Wheelchair fixed arms
E1161	A	Manual adult wc w tiltinspac
E1170	A	Whlchr ampu fxd arm leg rest
E1171	A	Wheelchair amputee w/o leg r
E1172	A	Wheelchair amputee detach ar
E1180	A	Wheelchair amputee w/ foot r
E1190	A	Wheelchair amputee w/ leg re
E1195	A	Wheelchair amputee heavy dut
E1200	A	Wheelchair amputee fixed arm
E1210	Y	Whlchr moto ful arm leg rest
E1211	Y	Wheelchair motorized w/ det
E1212	A	Wheelchair motorized w full
E1213	A	Wheelchair motorized w/ det
E1220	A	Whlchr special size/constrc
E1221	A	Wheelchair spec size w foot
E1222	A	Wheelchair spec size w/ leg
E1223	A	Wheelchair spec size w foot
E1224	A	Wheelchair spec size w/ leg
E1225	Y	Wheelchair spec sz semi-recl
E1226	B	W/C access fully reclineback
E1227	Y	Wheelchair spec sz spec ht a
E1228	Y	Wheelchair spec sz spec ht b
E1229	Y	Pediatric wheelchair NOS
E1230	Y	Power operated vehicle
E1231	Y	Rigid ped w/c tilt-in-space
E1232	Y	Folding ped wc tilt-in-space
E1233	Y	Rig ped wc tltnspc w/o seat
E1234	Y	Fld ped wc tltnspc w/o seat
E1235	Y	Rigid ped wc adjustable
E1236	Y	Folding ped wc adjustable
E1237	Y	Rgd ped wc adjstabl w/o seat
E1238	Y	Fld ped wc adjstabl w/o seat
E1239	Y	Ped power wheelchair NOS
E1240	A	Whchr litwt det arm leg rest
E1250	A	Wheelchair lightwt fixed arm
E1260	A	Wheelchair lightwt foot rest
E1270	A	Wheelchair lightweight leg r
E1280	A	Whchr h-duty det arm leg res
E1285	A	Wheelchair heavy duty fixed
E1290	A	Wheelchair hvy duty detach a
E1295	A	Wheelchair heavy duty fixed
E1296	Y	Wheelchair special seat heig
E1297	Y	Wheelchair special seat dept
E1298	Y	Wheelchair spec seat depth/w
E1300	E	Whirlpool portable
E1310	Y	Whirlpool non-portable
E1340	Y	Repair for DME, per 15 min
E1353	Y	Oxygen supplies regulator
E1355	Y	Oxygen supplies stand/rack
E1372	Y	Oxy suppl heater for nebuliz
E1390	Y	Oxygen concentrator
E1391	Y	Oxygen concentrator, dual
E1399	N	Durable medical equipment mi
E1405	Y	O2/water vapor enrich w/heat
E1406	Y	O2/water vapor enrich w/o he
E1500	A	Centrifuge
E1510	A	Kidney dialysate delivry sys
E1520	A	Heparin infusion pump
E1530	A	Replacement air bubble detec
E1540	A	Replacement pressure alarm
E1550	A	Bath conductivity meter
E1560	A	Replace blood leak detector
E1570	A	Adjustable chair for esrd pt
E1575	A	Transducer protect/fld bar
E1580	A	Unipuncture control system
E1590	A	Hemodialysis machine
E1592	A	Auto interm peritoneal dialy
E1594	A	Cycler dialysis machine
E1600	A	Deli/install chrg hemo equip
E1610	A	Reverse osmosis h2o puri sys
E1615	A	Deionizer H2O puri system
E1620	A	Replacement blood pump
E1625	A	Water softening system
E1630	A	Reciprocating peritoneal dia
E1632	A	Wearable artificial kidney
E1634	B	Peritoneal dialysis clamp
E1635	A	Compact travel hemodialyzer
E1636	A	Sorbent cartridges per 10
E1637	A	Hemostats for dialysis, each
E1639	A	Dialysis scale
E1699	A	Dialysis equipment noc
E1700	Y	Jaw motion rehab system
E1701	Y	Repl cushions for jaw motion
E1702	Y	Repl measr scales jaw motion
E1800	Y	Adjust elbow ext/flex device
E1801	Y	SPS elbow device
E1802	Y	Adjst forearm pro/sup device
E1805	Y	Adjust wrist ext/flex device
E1806	Y	SPS wrist device
E1810	Y	Adjust knee ext/flex device
E1811	Y	SPS knee device
E1815	Y	Adjust ankle ext/flex device
E1816	Y	SPS ankle device
E1818	Y	SPS forearm device
E1820	Y	Soft interface material
E1821	Y	Replacement interface SPSD
E1825	Y	Adjust finger ext/flex devc
E1830	Y	Adjust toe ext/flex device
E1840	Y	Adj shoulder ext/flex device
E1841	Y	Static str shldr dev rom adj
E1902	A	AAC non-electronic board
E2000	Y	Gastric suction pump hme mdl
E2100	Y	Bld glucose monitor w voice
E2101	Y	Bld glucose monitor w lance
E2120	Y	Pulse gen sys tx endolymp fl
E2201	Y	Man w/ch acc seat w=20÷24÷
E2202	Y	Seat width 24-27 in
E2203	Y	Frame depth less than 22 in
E2204	Y	Frame depth 22 to 25 in
E2205	Y	Manual wc accessory, handrim
E2206	Y	Complete wheel lock assembly
E2291	E	Planar back for ped size wc
E2292	E	Planar seat for ped size wc
E2293	E	Contour back for ped size wc
E2294	E	Contour seat for ped size wc
E2300	Y	Pwr seat elevation sys
E2301	Y	Pwr standing
E2310	Y	Electro connect btw control
E2311	Y	Electro connect btw 2 sys
E2320	Y	Hand chin control
E2321	Y	Hand interface joystick
E2322	Y	Mult mech switches
E2323	Y	Special joystick handle
E2324	Y	Chin cup interface
E2325	Y	Sip and puff interface
E2326	Y	Breath tube kit
E2327	Y	Head control interface mech
E2328	Y	Head/extremity control inter
E2329	Y	Head control nonproportional
E2330	Y	Head control proximity switc
E2331	Y	Attendant control
E2340	Y	W/c wdth 20-23 in seat frame
E2341	Y	W/c wdth 24-27 in seat frame
E2342	Y	W/c dpth 20-21 in seat frame
E2343	Y	W/c dpth 22-25 in seat frame
E2351	Y	Electronic SGD interface
E2360	Y	22nf nonsealed leadacid
E2361	Y	22nf sealed leadacid battery
E2362	Y	Gr24 nonsealed leadacid
E2363	Y	Gr24 sealed leadacid battery
E2364	Y	U1nonsealed leadacid battery
E2365	Y	U1 sealed leadacid battery
E2366	Y	Battery charger, single mode
E2367	Y	Battery charger, dual mode
E2368	Y	Power wc motor replacement
E2369	Y	Pwr wc gear box replacement
E2370	Y	Pwr wc motor/gear box combo
E2399	Y	Noc interface
E2402	Y	Neg press wound therapy pump
E2500	Y	SGD digitized pre-rec =8min
E2502	Y	SGD prerec msg 8min =20min
E2504	Y	SGD prerec msg20min =40min
E2506	Y	SGD prerec msg 40 min
E2508	Y	SGD spelling phys contact
E2510	Y	SGD w multi methods msg/accs
E2511	Y	SGD sftwre prgrm for PC/PDA
E2512	Y	SGD accessory, mounting sys
E2599	Y	SGD accessory noc
E2601	Y	Gen w/c cushion wdth 22 in
E2602	Y	Gen w/c cushion wdth =22 in
E2603	Y	Skin protect wc cus wd 22in
E2604	Y	Skin protect wc cus wd=22in
E2605	Y	Position wc cush wdth 22 in
E2606	Y	Position wc cush wdth=22 in
E2607	Y	Skin pro/pos wc cus wd 22in
E2608	Y	Skin pro/pos wc cus wd=22in
E2609	Y	Custom fabricate w/c cushion
E2610	B	Powered w/c cushion
E2611	Y	Gen use back cush wdth 22in
E2612	Y	Gen use back cush wdth=22in
E2613	Y	Position back cush wd 22in
E2614	Y	Position back cush wd=22in
E2615	Y	Pos back post/lat wdth 22in
E2616	Y	Pos back post/lat wdth=22in
E2617	Y	Custom fab w/c back cushion
E2618	Y	Wc acc solid seat supp base
E2619	Y	Replace cover w/c seat cush
E2620	Y	WC planar back cush wd 22in
E2621	Y	WC planar back cush wd=22in
E8000	E	Posterior gait trainer
E8001	E	Upright gait trainer
E8002	E	Anterior gait trainer
G0008	X	Admin influenza virus vac	0350	0.3954	$23.46	$0.00	$0.00
G0009	X	Admin pneumococcal vaccine	0350	0.3954	$23.46	$0.00	$0.00
G0010	B	Admin hepatitis b vaccine
G0027	A	Semen analysis
G0101	V	CA screen pelvic/breast exam	0600	0.8688	$51.56		$10.31
G0102	N	Prostate ca screening dre
G0103	A	Psa, total screening
G0104	S	CA screen flexi sigmoidscope	0159	3.1455	$186.66		$46.67
G0105	T	Colorectal scrn hi risk ind	0158	7.6588	$454.50		$113.63
G0106	S	Colon CA screen barium enema	0157	2.2904	$135.92		$27.18
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
G0117	S	Glaucoma scrn hgh risk direc	0230	0.7858	$46.63	$14.97	$9.33
G0118	S	Glaucoma scrn hgh risk direc	0230	0.7858	$46.63	$14.97	$9.33
G0120	S	Colon ca scrn barium enema	0157	2.2904	$135.92		$27.18
G0121	T	Colon ca scrn not hi rsk ind	0158	7.6588	$454.50		$113.63
G0122	E	Colon ca scrn barium enema
G0123	A	Screen cerv/vag thin layer
G0124	A	Screen c/v thin layer by MD
G0127	T	Trim nail(s)	0009	0.668	$39.64	$8.34	$7.93
G0128	B	CORF skilled nursing service
G0129	P	Partial hosp prog service	0033	4.0708	$241.57		$48.31
G0130	X	Single energy x-ray study	0260	0.7555	$44.83	$17.93	$8.97
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	B	HHCP-serv of pt,ea 15 min
G0152	B	HHCP-serv of ot,ea 15 min
G0153	B	HHCP-svs of s/l path,ea 15mn
G0154	B	HHCP-svs of rn,ea 15 min
G0155	B	HHCP-svs of csw,ea 15 min
G0156	B	HHCP-svs of aide,ea 15 min
G0166	T	Extrnl counterpulse, per tx	0678	1.7276	$102.52		$20.50
G0168	N	Wound closure by adhesive
G0173	S	Linear acc stereo radsur com	1528		$5,250.00		$1,050.00
G0175	V	OPPS Service,sched team conf	0602	1.4284	$84.77		$16.95
G0176	P	OPPS/PHP activity therapy	0033	4.0708	$241.57		$48.31
G0177	P	OPPS/PHP train educ serv	0033	4.0708	$241.57		$48.31
G0179	E	MD recertification HHA PT
G0180	E	MD certification HHA patient
G0181	E	Home health care supervision
G0182	E	Hospice care supervision
G0186	T	Dstry eye lesn,fdr vssl tech	0235	4.6593	$276.50	$67.40	$55.30
G0202	A	Screeningmammographydigital
G0204	A	Diagnosticmammographydigital
G0206	A	Diagnosticmammographydigital
G0219	E	PET img whbd ring noncov ind
G0235	E	PET not otherwise specified
G0237	S	Therapeutic procd strg endur	0411	0.3869	$22.96		$4.59
G0238	S	Oth resp proc, indiv	0411	0.3869	$22.96		$4.59
G0239	S	Oth resp proc, group	0411	0.3869	$22.96		$4.59
G0243	S	Multisour photon stero treat	1528		$5,250.00		$1,050.00
G0244	B	Observ care by facility topt
G0245	V	Initial Foot Exam PTLOPS	0600	0.8688	$51.56		$10.31
G0246	V	Followup eval of foot pt lop	0600	0.8688	$51.56		$10.31
G0247	T	Routine footcare pt w lops	0009	0.668	$39.64	$8.34	$7.93
G0248	S	Demonstrate use home inr mon	1503		$150.00		$30.00
G0249	S	Provide test material,equipm	1503		$150.00		$30.00
G0250	E	MD review interpret of test
G0251	S	Linear acc based stero radio	1513		$1,150.00		$230.00
G0252	E	PET imaging initial dx
G0255	E	Current percep threshold tst
G0257	S	Unsched dialysis ESRD pt hos	0170	5.8994	$350.09		$70.02
G0258	X	IV infusion during obs stay	0340	0.6384	$37.88		$7.58
G0259	N	Inject for sacroiliac joint
G0260	T	Inj for sacroiliac jt anesth	0206	5.492	$325.91	$75.55	$65.18
G0263	B	Adm with CHF, CP, asthma
G0264	B	Assmt otr CHF, CP, asthma
G0265	A	Cryopresevation Freeze+stora
G0266	A	Thawing + expansion froz cel
G0267	S	Bone marrow or psc harvest	0110	3.6594	$217.16		$43.43
G0268	X	Removal of impacted wax md	0340	0.6384	$37.88		$7.58
G0269	N	Occlusive device in vein art
G0270	A	MNT subs tx for change dx
G0271	A	Group MNT 2 or more 30 mins
G0275	N	Renal angio, cardiac cath
G0278	N	Iliac art angio,cardiac cath
G0279	A	Excorp shock tx, elbow epi
G0280	A	Excorp shock tx other than
G0281	A	Elec stim unattend for press
G0282	E	Elect stim wound care not pd
G0283	A	Elec stim other than wound
G0288	S	Recon, CTA for pre post su	0417	4.075	$241.82		$48.36
G0289	N	Arthro, loose body + chondro
G0290	T	Drug-eluting stents, single	0656	109.9237	$6,523.20		$1,304.64
G0291	T	Drug-eluting stents,each add	0656	109.9237	$6,523.20		$1,304.64
G0293	S	Non-cov surg proc,clin trial	1505		$350.00		$70.00
G0294	S	Non-cov proc, clinical trial	1502		$75.00		$15.00
G0295	E	Electromagnetic therapy onc
G0297	T	Insert single chamber/cd	0107	260.0295	$15,430.93	$3,103.22	$3,086.19
G0298	T	Insert dual chamber/cd	0107	260.0295	$15,430.93	$3,103.22	$3,086.19
G0299	T	Inser/repos single icd+leads	0108	349.1681	$20,720.68		$4,144.14
G0300	T	Insert reposit lead dual+gen	0108	349.1681	$20,720.68		$4,144.14
G0302	S	Pre-op service LVRS complete	1509		$750.00		$150.00
G0303	S	Pre-op service LVRS 10-15dos	507		$550.00		$110.00
G0304	S	Pre-op service LVRS 1-9 dos	1504		$250.00		$50.00
G0305	S	Post op service LVRS min 6	1504		$250.00		$50.00
G0306	A	CBC/diffwbc w/o platelet
G0307	A	CBC without platelet
G0308	A	ESRD related svc 4+mo2yrs
G0309	A	ESRD related svc 2-3mo2yrs
G0310	A	ESRD related svc 1vst2yr
G0311	A	ESRD related svs 4+mo 2-11yr
G0312	A	ESRD relate svs 2-3 mo 2-11y
G0313	A	ESRD related svs 1 mon 2-11y
G0314	A	ESRD relate svs 4+mo 12-19
G0315	A	ESRD related svs 2-3 mo 12-1
G0316	A	ESRD related svs 1 vis/12-19
G0317	A	ESRD related svs 4+mo 20+yrs
G0318	A	ESRD related svs 2-3 mo 20+y
G0319	A	ESRD related svs 1visit 20+y
G0320	A	ESRD related svs home under
G0321	A	ESRDrelatedsvs home mo 2-11y
G0322	A	ESRD related svs home mo 12-1
G0323	A	ESRD related svs home mo 20+
G0324	A	ESRD related svs home/dy/2y
G0325	A	ESRD relate home/dy 2-11yr
G0326	A	ESRD relate home/dy 12-19y
G0327	A	ESRD relate home/dy 20+yrs
G0328	A	Fecal blood scrn immunoassay
G0329	A	Electromagntic tx for ulcers
G0337	A	Hospice evaluation preelecti
G0339	S	Robot lin-radsurg com, first	1528		$5,250.00		$1,050.00
G0340	S	Robt lin-radsurg fractx 2-5	1525		$3,750.00		$750.00
G0341	C	Percutaneous islet celltrans
G0342	C	Laparoscopy Islet cell Trans
G0343	C	Laparotomy Islet cell tranp
G0344	V	Initial preventive exam	0601	1.0038	$59.57		$11.91
G0345	M	IV infuse hydration initial
G0346	M	Each additional infuse hours
G0347	M	IV infusion therapy/diagnost
G0348	M	each additional hr up to 8hr
G0349	M	additional sequential infuse
G0350	M	concurrent infusion
G0351	M	therapeutic/diagnostic injec
G0353	M	IV push,single orinitial dru
G0354	M	each addition sequential IV
G0355	M	chemo administrate subcut/IM
G0356	M	hormonal anti-neoplastic
G0357	M	IV push single/initial subst
G0358	M	IV push each additional drug
G0359	M	chemotherapy IV one hr initi
G0360	M	each additional hr 1-8 hrs
G0361	M	prolong chemo Infuse8hrs pu
G0362	M	each add sequential infusion
G0363	M	irrigate implanted venous de
G0364	X	Bone marrow aspirate biops	0342	0.156	$9.26	$3.70	$1.85
G0365	S	Vessel mapping hemo access	0267	2.6327	$156.23	$62.18	$31.25
G0366	B	EKG for initial prevent exam
G0367	S	EKG tracing for initial prev	0099	0.3821	$22.67		$4.53
G0368	M	EKG interpret report preve
G0369	M	Pharm fee 1st month transpla
G0370	M	Pharmacy fee oral cancer etc
G0371	M	Pharm dispense inhalation 30
G0374	M	Pharm dispense inhalation 90
G0375	S	Smoke/Tobacco counseling 3-1	1491		$5.00		$1.00
G0376	S	Smoke/Tobacco counseling 10	1491		$5.00		$1.00
G3001	S	Admin + supply, tositumomab	1522		$2,250.00		$450.00
G9001	B	MCCD, initial rate
G9002	B	MCCD,maintenance rate
G9003	B	MCCD, risk adj hi, initial
G9004	B	MCCD, risk adj lo, initial
G9005	B	MCCD, risk adj, maintenance
G9006	B	MCCD, Home monitoring
G9007	B	MCCD, sch team conf
G9008	B	Mccd,phys coor-care ovrsght
G9009	E	MCCD, risk adj, level 3
G9010	E	MCCD, risk adj, level 4
G9011	E	MCCD, risk adj, level 5
G9012	E	Other Specified Case Mgmt
G9013	E	ESRD demo bundle level I
G9014	E	ESRD demo bundle-level II
G9016	E	Demo-smoking cessation coun
G9017	A	Amantadine HCL,oral
G9018	A	Zanamivir, inh pwdr
G9019	A	Oseltamivir phosp
G9020	A	Rimantadine HCL
G9021	M	Chemo assess nausea vomit L1
G9022	M	Chemo assess nausea vomit L2
G9023	M	Chemo assess nausea vomit L3
G9024	M	Chemo assess nausea vomit L4
G9025	M	Chemo assessment pain level1
G9026	M	Chemo assessment pain level2
G9027	M	Chemo assessment pain level3
G9028	M	Chemo assessment pain level4
G9029	M	Chemo assess for fatigue L1
G9030	M	Chemo assess for fatigue L2
G9031	M	Chemo assess for fatigue L3
G9032	M	Chemo assess for fatigue L4
G9033	A	Amantadine HCL, oral, brand
G9034	A	Zanamivir, inh pwdr, brand
G9035	A	Oseltamivir phosp, brand
G9036	A	Rimantadine HCL, brand
G9041	A	Low vision serv occupational
G9042	A	Low vision orient/mobility
G9043	A	Low vision rehab therapist
G9044	A	Low vision rehab teacher
J0120	N	Tetracyclin injection
J0128	G	Abarelix injection	9216		$66.96		$13.39
J0130	K	Abciximab injection	1605		$450.60		$90.12
J0135	K	Adalimumab injection	1083		$300.10		$60.02
J0150	K	Injection adenosine 6 MG	0379		$33.45		$6.69
J0152	K	Adenosine injection	0917		$71.53		$14.31
J0170	N	Adrenalin epinephrin inject
J0180	K	Agalsidase beta injection	9208		$123.35		$24.67
J0190	N	Inj biperiden lactate/5 mg
J0200	N	Alatrofloxacin mesylate
J0205	K	Alglucerase injection	0900		$39.94		$7.99
J0207	K	Amifostine	7000		$436.01		$87.20
J0210	K	Methyldopate hcl injection	2210		$9.58		$1.92
J0215	B	Alefacept
J0256	K	Alpha 1 proteinase inhibitor	0901		$3.30		$0.66
J0270	B	Alprostadil for injection
J0275	B	Alprostadil urethral suppos
J0280	N	Aminophyllin 250 MG inj
J0282	N	Amiodarone HCl
J0285	K	Amphotericin B	9030		$30.70		$6.14
J0287	K	Amphotericin b lipid complex	9024		$11.95		$2.39
J0288	K	Ampho b cholesteryl sulfate	0735		$12.24		$2.45
J0289	K	Amphotericin b liposome inj	0736		$21.91		$4.38
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
J0350	N	Injection anistreplase 30 u
J0360	N	Hydralazine hcl injection
J0380	N	Inj metaraminol bitartrate
J0390	N	Chloroquine injection
J0395	K	Arbutamine HCl injection	9031		$163.15		$32.63
J0456	N	Azithromycin
J0460	N	Atropine sulfate injection
J0470	N	Dimecaprol injection
J0475	K	Baclofen 10 MG injection	9032		$188.01		$37.60
J0476	B	Baclofen intrathecal trial
J0500	N	Dicyclomine 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	K	Penicillin g benzathine inj	0880		$72.26		$14.45
J0583	N	Bivalirudin
J0585	K	Botulinum toxin a per unit	0902		$4.80		$0.96
J0587	K	Botulinum toxin type B	9018		$7.89		$1.58
J0592	N	Buprenorphine hydrochloride
J0595	N	Butorphanol tartrate 1 mg
J0600	K	Edetate calcium disodium inj	0892		$40.34		$8.07
J0610	N	Calcium gluconate injection
J0620	N	Calcium glycer lact/10 ML
J0630	K	Calcitonin salmon injection	0893		$35.68		$7.14
J0636	N	Inj calcitriol per 0.1 mcg
J0637	K	Caspofungin acetate	9019		$32.35		$6.47
J0640	N	Leucovorin calcium injection
J0670	N	Inj mepivacaine HCL/10 ml
J0690	N	Cefazolin sodium injection
J0692	N	Cefepime HCl for injection
J0694	N	Cefoxitin sodium injection
J0696	N	Ceftriaxone sodium injection
J0697	N	Sterile cefuroxime injection
J0698	N	Cefotaxime sodium injection
J0702	N	Betamethasone acetsod phosp
J0704	N	Betamethasone sod phosp/4 MG
J0706	K	Caffeine citrate injection	0876		$3.34		$0.67
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
J0735	K	Clonidine hydrochloride	0935		$57.47		$11.49
J0740	K	Cidofovir injection	9033		$782.98		$156.60
J0743	N	Cilastatin sodium injection
J0744	N	Ciprofloxacin iv
J0745	N	Inj codeine phosphate /30 MG
J0760	N	Colchicine injection
J0770	N	Colistimethate sodium inj
J0780	N	Prochlorperazine injection
J0800	K	Corticotropin injection	1280		$95.44		$19.09
J0835	K	Inj cosyntropin per 0.25 MG	0835		$69.27		$13.85
J0850	K	Cytomegalovirus imm IV /vial	0903		$683.07		$136.61
J0878	G	Daptomycin injection	9124		$0.30		$0.06
J0880	E	Darbepoetin alfa injection
J0895	K	Deferoxamine mesylate inj	0895		$14.91		$2.98
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
J1051	N	Medroxyprogesterone inj
J1055	E	Medrxyprogester acetate inj
J1056	E	MA/EC contraceptiveinjection
J1060	N	Testosterone cypionate 1 ML
J1070	N	Testosterone cypionat 100 MG
J1080	N	Testosterone cypionat 200 MG
J1094	N	Inj dexamethasone acetate
J1100	N	Dexamethasone sodium phos
J1110	K	Inj dihydroergotamine mesylt	1210		$27.82		$5.56
J1120	N	Acetazolamid sodium injectio
J1160	N	Digoxin injection
J1165	N	Phenytoin sodium injection
J1170	N	Hydromorphone injection
J1180	K	Dyphylline injection	9166		$7.74		$1.55
J1190	K	Dexrazoxane HCl injection	0726		$216.39		$43.28
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	N	Dipyridamole injection
J1250	N	Inj dobutamine HCL/250 mg
J1260	K	Dolasetron mesylate	0750		$6.55		$1.31
J1270	N	Injection, doxercalciferol
J1320	N	Amitriptyline injection
J1325	N	Epoprostenol injection
J1327	K	Eptifibatide injection	1607		$12.73		$2.55
J1330	K	Ergonovine maleate injection	1330	0.5263	$31.23		$6.25
J1335	N	Ertapenem injection
J1364	N	Erythro lactobionate /500 MG
J1380	N	Estradiol valerate 10 MG inj
J1390	N	Estradiol valerate 20 MG inj
J1410	K	Inj estrogen conjugate 25 MG	9038		$57.77		$11.55
J1435	N	Injection estrone per 1 MG
J1436	K	Etidronate disodium inj	1436		$68.69		$13.74
J1438	K	Etanercept injection	1608		$152.11		$30.42
J1440	K	Filgrastim 300 mcg injection	0728		$178.39		$35.68
J1441	K	Filgrastim 480 mcg injection	7049		$282.29		$56.46
J1450	N	Fluconazole
J1452	K	Intraocular Fomivirsen na	9040		$203.93		$40.79
J1455	N	Foscarnet sodium injection
J1457	K	Gallium nitrate injection	1085		$1.30		$0.26
J1460	N	Gamma globulin 1 CC inj
J1470	B	Gamma globulin 2 CC inj
J1480	B	Gamma globulin 3 CC inj
J1490	B	Gamma globulin 4 CC inj
J1500	B	Gamma globulin 5 CC inj
J1510	B	Gamma globulin 6 CC inj
J1520	B	Gamma globulin 7 CC inj
J1530	B	Gamma globulin 8 CC inj
J1540	B	Gamma globulin 9 CC inj
J1550	B	Gamma globulin 10 CC inj
J1560	B	Gamma globulin 10 CC inj
J1563	E	IV immune globulin
J1564	E	Immune globulin 10 mg
J1565	K	RSV-ivig	0906		$15.56		$3.11
J1570	N	Ganciclovir sodium injection
J1580	N	Garamycin gentamicin inj
J1590	N	Gatifloxacin injection
J1595	N	Injection glatiramer acetate
J1600	N	Gold sodium thiomaleate inj
J1610	K	Glucagon hydrochloride/1 MG	9042		$62.16		$12.43
J1620	K	Gonadorelin hydroch/ 100 mcg	7005		$173.44		$34.69
J1626	K	Granisetron HCl injection	0764		$7.24		$1.45
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	N	Inj enoxaparin sodium
J1652	N	Fondaparinux sodium
J1655	K	Tinzaparin sodium injection	1655		$2.53		$0.51
J1670	K	Tetanus immune globulin inj	1670		$76.90		$15.38
J1700	N	Hydrocortisone acetate inj
J1710	N	Hydrocortisone sodium ph inj
J1720	N	Hydrocortisone sodium succ i
J1730	K	Diazoxide injection	1740		$113.86		$22.77
J1742	K	Ibutilide fumarate injection	9044		$243.34		$48.67
J1745	K	Infliximab injection	7043		$54.20		$10.84
J1750	K	Iron dextran	9045		$11.43		$2.29
J1756	K	Iron sucrose injection	9046		$0.38		$0.08
J1785	K	Injection imiglucerase /unit	0916		$3.98		$0.80
J1790	N	Droperidol injection
J1800	N	Propranolol injection
J1810	E	Droperidol/fentanyl inj
J1815	N	Insulin injection
J1817	N	Insulin for insulin pump use
J1825	E	Interferon beta-1a
J1830	K	Interferon beta-1b / .25 MG	0910		$81.95		$16.39
J1835	K	Itraconazole injection	9047		$36.93		$7.39
J1840	N	Kanamycin sulfate 500 MG inj
J1850	N	Kanamycin sulfate 75 MG inj
J1885	N	Ketorolac tromethamine inj
J1890	N	Cephalothin sodium injection
J1931	K	Laronidase injection	9209		$23.16		$4.63
J1940	N	Furosemide injection
J1950	K	Leuprolide acetate /3.75 MG	0800		$441.78		$88.36
J1955	B	Inj levocarnitine per 1 gm
J1956	N	Levofloxacin injection
J1960	N	Levorphanol tartrate inj
J1980	N	Hyoscyamine sulfate inj
J1990	N	Chlordiazepoxide injection
J2001	N	Lidocaine injection
J2010	N	Lincomycin injection
J2020	K	Linezolid injection	9001		$24.15		$4.83
J2060	N	Lorazepam injection
J2150	N	Mannitol injection
J2175	N	Meperidine hydrochl /100 MG
J2180	N	Meperidine/promethazine inj
J2185	N	Meropenem
J2210	N	Methylergonovin maleate inj
J2250	N	Inj midazolam hydrochloride
J2260	N	Inj milrinone lactate / 5 MG
J2270	N	Morphine sulfate injection
J2271	N	Morphine so4 injection 100mg
J2275	N	Morphine sulfate injection
J2280	N	Inj, moxifloxacin 100 mg
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
J2324	K	Nesiritide	9114		$75.19		$15.04
J2353	K	Octreotide injection, depot	1207		$87.40		$17.48
J2354	N	Octreotide inj, non-depot
J2355	K	Oprelvekin injection	7011		$249.06		$49.81
J2357	G	Omalizumab injection	9300		$15.98		$3.20
J2360	N	Orphenadrine injection
J2370	N	Phenylephrine hcl injection
J2400	N	Chloroprocaine hcl injection
J2405	K	Ondansetron hcl injection	0768		$3.80		$0.76
J2410	N	Oxymorphone hcl injection
J2430	K	Pamidronate disodium /30 MG	0730		$58.42		$11.68
J2440	N	Papaverin hcl injection
J2460	N	Oxytetracycline injection
J2469	K	Palonosetron HCl	9210		$18.42		$3.68
J2501	N	Paricalcitol
J2505	K	Injection, pegfilgrastim 6mg	9119		$2,178.28		$435.66
J2510	N	Penicillin g procaine inj
J2515	N	Pentobarbital sodium inj
J2540	N	Penicillin g potassium inj
J2543	N	Piperacillin/tazobactam
J2545	Y	Pentamidine isethionte/300mg
J2550	N	Promethazine hcl injection
J2560	N	Phenobarbital sodium inj
J2590	N	Oxytocin injection
J2597	N	Inj desmopressin acetate
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 injeciton
J2710	N	Neostigmine methylslfte inj
J2720	N	Inj protamine sulfate/10 MG
J2725	N	Inj protirelin per 250 mcg
J2730	K	Pralidoxime chloride inj	2730		$76.68		$15.34
J2760	N	Phentolaine mesylate inj
J2765	N	Metoclopramide hcl injection
J2770	K	Quinupristin/dalfopristin	2770		$105.48		$21.10
J2780	N	Ranitidine hydrochloride inj
J2783	G	Rasburicase	0738		$109.18		$21.84
J2788	K	Rho d immune globulin 50 mcg	9023		$25.08		$5.02
J2790	K	Rho d immune globulin inj	0884		$113.91		$22.78
J2792	K	Rho(D) immune globulin h, sd	1609		$12.04		$2.41
J2794	G	Risperidone, long acting	9125		$4.71		$0.94
J2795	N	Ropivacaine HCl injection
J2800	N	Methocarbamol injection
J2810	N	Inj theophylline per 40 MG
J2820	K	Sargramostim injection	0731		$21.11		$4.22
J2910	N	Aurothioglucose injeciton
J2912	N	Sodium chloride injection
J2916	N	Na ferric gluconate complex
J2920	N	Methylprednisolone injection
J2930	N	Methylprednisolone injection
J2940	K	Somatrem injection	2940		$43.14		$8.63
J2941	K	Somatropin injection	7034		$42.93		$8.59
J2950	N	Promazine hcl injection
J2993	K	Reteplase injection	9005		$898.81		$179.76
J2995	K	Inj streptokinase /250000 IU	0911		$83.36		$16.67
J2997	K	Alteplase recombinant	7048		$30.65		$6.13
J3000	N	Streptomycin injection
J3010	N	Fentanyl citrate injeciton
J3030	K	Sumatriptan succinate / 6 MG	3030		$51.03		$10.21
J3070	N	Pentazocine hcl injection
J3100	K	Tenecteplase injection	9002		$2,052.77		$410.55
J3105	N	Terbutaline sulfate inj
J3110	B	Teriparatide injection
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	K	Thyrotropin injection	9108		$712.58		$142.52
J3246	K	Tirofiban HCl	7041		$7.89		$1.58
J3250	N	Trimethobenzamide hcl inj
J3260	N	Tobramycin sulfate injection
J3265	N	Injection torsemide 10 mg/ml
J3280	N	Thiethylperazine maleate inj
J3301	N	Triamcinolone acetonide inj
J3302	N	Triamcinolone diacetate inj
J3303	N	Triamcinolone hexacetonl inj
J3305	K	Inj trimetrexate glucoronate	7045		$139.85		$27.97
J3310	N	Perphenazine injeciton
J3315	K	Triptorelin pamoate	9122		$369.98		$74.00
J3320	N	Spectinomycn di-hcl inj
J3350	K	Urea injection	9051	1.0454	$62.04		$12.41
J3360	N	Diazepam injection
J3364	N	Urokinase 5000 IU injection
J3365	K	Urokinase 250,000 IU inj	7036		$415.69		$83.14
J3370	N	Vancomycin hcl injection
J3396	K	Verteporfin injection	1203		$9.16		$1.83
J3400	N	Triflupromazine hcl inj
J3410	N	Hydroxyzine hcl injection
J3411	N	Thiamine hcl 100 mg
J3415	N	Pyridoxine hcl 100 mg
J3420	N	Vitamin b12 injection
J3430	N	Vitamin k phytonadione inj
J3465	K	Injection, voriconazole	1052		$4.63		$0.93
J3470	N	Hyaluronidase injection
J3475	N	Inj magnesium sulfate
J3480	N	Inj potassium chloride
J3485	N	Zidovudine
J3486	N	Ziprasidone mesylate
J3487	K	Zoledronic acid	9115		$202.41		$40.48
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
J3590	N	Unclassified biologics
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	K	Factor viii	0925		$0.51		$0.10
J7191	K	Factor VIII (porcine)	0926		$1.75		$0.35
J7192	K	Factor viii recombinant	0927		$0.94		$0.19
J7193	K	Factor IX non-recombinant	0931		$0.75		$0.15
J7194	K	Factor ix complex	0928		$0.52		$0.10
J7195	K	Factor IX recombinant	0932		$0.86		$0.17
J7197	N	Antithrombin iii injection
J7198	K	Anti-inhibitor	0929		$1.12		$0.22
J7199	B	Hemophilia clot factor noc
J7300	E	Intraut copper contraceptive
J7302	E	Levonorgestrel iu contracept
J7303	E	Contraceptive vaginal ring
J7304	E	Contraceptive hormone patch
J7308	K	Aminolevulinic acid hcl top	7308		$96.79		$19.36
J7310	K	Ganciclovir long act implant	0913		$4,318.68		$863.74
J7317	K	Sodium hyaluronate injection	7316		$110.65		$22.13
J7320	K	Hylan G-F 20 injection	1611		$203.15		$40.63
J7330	B	Cultured chondrocytes implnt
J7340	E	Metabolic active D/E tissue
J7342	K	Metabolically active tissue	9054		$15.69		$3.14
J7343	B	Nonmetabolic act d/e tissue
J7344	K	Nonmetabolic active tissue	9156		$53.76		$10.75
J7350	K	Injectable human tissue	9055		$3.54		$0.71
J7500	N	Azathioprine oral 50mg
J7501	K	Azathioprine parenteral	0887		$47.40		$9.48
J7502	K	Cyclosporine oral 100 mg	0888		$3.94		$0.79
J7504	K	Lymphocyte immune globulin	0890		$290.30		$58.06
J7505	K	Monoclonal antibodies	7038		$885.36		77.07
J7506	N	Prednisone oral
J7507	K	Tacrolimus oral per 1 MG	0891		$3.37		$0.67
J7509	N	Methylprednisolone oral
J7510	N	Prednisolone oral per 5 mg
J7511	K	Antithymocyte globuln rabbit	9104		$299.47		$59.89
J7513	K	Daclizumab, parenteral	1612		$381.48		$76.30
J7515	K	Cyclosporine oral 25 mg	7515		$1.00		$0.20
J7516	N	Cyclosporin parenteral 250mg
J7517	K	Mycophenolate mofetil oral	9015		$2.50		$0.50
J7518	G	Mycophenolic acid	9219		$2.47		$0.49
J7520	K	Sirolimus, oral	9020		$6.85		$1.37
J7525	K	Tacrolimus injection	9006		$126.61		$25.32
J7599	N	Immunosuppressive drug noc
J7608	Y	Acetylcysteine inh sol u d
J7611	Y	Albuterol concentrated form
J7612	Y	Levalbuterol concentrated
J7613	Y	Albuterol unit dose
J7614	Y	Levalbuterol unit dose
J7616	Y	Albuterol compound solution
J7617	Y	Levalbuterol compounded sol
J7622	A	Beclomethasone inhalatn sol
J7624	A	Betamethasone inhalation sol
J7626	A	Budesonide inhalation sol
J7628	Y	Bitolterol mes inhal sol con
J7629	Y	Bitolterol mes inh sol u d
J7631	Y	Cromolyn sodium inh sol u d
J7633	N	Budesonide concentrated sol
J7635	Y	Atropine inhal sol con
J7636	Y	Atropine inhal sol unit dose
J7637	Y	Dexamethasone inhal sol con
J7638	Y	Dexamethasone inhal sol u d
J7639	Y	Dornase alpha inhal sol u d
J7641	A	Flunisolide, inhalation sol
J7642	Y	Glycopyrrolate inhal sol con
J7643	Y	Glycopyrrolate inhal sol u d
J7644	Y	Ipratropium brom inh sol u d
J7648	Y	Isoetharine hcl inh sol con
J7649	Y	Isoetharine hcl inh sol u d
J7658	Y	Isoproterenolhcl inh sol con
J7659	Y	Isoproterenol hcl inh sol ud
J7668	Y	Metaproterenol inh sol con
J7669	Y	Metaproterenol inh sol u d
J7674	N	Methacholine chloride, neb
J7680	Y	Terbutaline so4 inh sol con
J7681	Y	Terbutaline so4 inh sol u d
J7682	Y	Tobramycin inhalation sol
J7683	Y	Triamcinolone inh sol con
J7684	Y	Triamcinolone inh sol u d
J7699	Y	Inhalation solution for DME
J7799	Y	Non-inhalation drug for DME
J8499	E	Oral prescrip drug non chemo
J8501	G	Oral aprepitant	0868		$4.75		$0.95
J8510	K	Oral busulfan	7015		$1.98		$0.40
J8520	K	Capecitabine, oral, 150 mg	7042		$3.30		$0.66
J8521	E	Capecitabine, oral, 500 mg
J8530	N	Cyclophosphamide oral 25 MG
J8560	K	Etoposide oral 50 MG	0802		$41.12		$8.22
J8565	E	Gefitinib oral
J8600	N	Melphalan oral 2 MG
J8610	N	Methotrexate oral 2.5 MG
J8700	K	Temozolomide	1086		$7.28		$1.46
J8999	B	Oral prescription drug chemo
J9000	N	Doxorubic hcl 10 MG vl chemo
J9001	K	Doxorubicin hcl liposome inj	7046		$365.64		$73.13
J9010	K	Alemtuzumab injection	9110		$516.87		$103.37
J9015	K	Aldesleukin/single use vial	0807		$701.76		$140.35
J9017	K	Arsenic trioxide	9012		$33.76		$6.75
J9020	K	Asparaginase injection	0814		$55.42		$11.08
J9031	K	Bcg live intravesical vac	0809		$121.74		$24.35
J9035	G	Bevacizumab injection	9214		$58.17		$11.63
J9040	K	Bleomycin sulfate injection	0857		$54.18		$10.84
J9041	K	Bortezomib injection	9207		$28.90		$5.78
J9045	K	Carboplatin injection	0811		$77.16		$15.43
J9050	K	Carmus bischl nitro inj	0812		$141.29		$28.26
J9055	G	Cetuximab injection	9215		$50.59		$10.12
J9060	N	Cisplatin 10 MG injection
J9062	B	Cisplatin 50 MG injection
J9065	K	Inj cladribine per 1 MG	0858		$39.37		$7.87
J9070	N	Cyclophosphamide 100 MG inj
J9080	B	Cyclophosphamide 200 MG inj
J9090	B	Cyclophosphamide 500 MG inj
J9091	B	Cyclophosphamide 1.0 grm inj
J9092	B	Cyclophosphamide 2.0 grm inj
J9093	N	Cyclophosphamide lyophilized
J9094	B	Cyclophosphamide lyophilized
J9095	B	Cyclophosphamide lyophilized
J9096	B	Cyclophosphamide lyophilized
J9097	B	Cyclophosphamide lyophilized
J9098	K	Cytarabine liposome	1166		$366.43		$73.29
J9100	N	Cytarabine hcl 100 MG inj
J9110	B	Cytarabine hcl 500 MG inj
J9120	N	Dactinomycin actinomycin d
J9130	K	Dacarbazine 100 mg inj	0819		$6.20		$1.24
J9140	B	Dacarbazine 200 MG inj
J9150	K	Daunorubicin	0820		$35.28		$7.06
J9151	K	Daunorubicin citrate liposom	0821		$57.56		$11.51
J9160	K	Denileukin diftitox, 300 mcg	1084		$1,235.33		$247.07
J9165	N	Diethylstilbestrol injection
J9170	K	Docetaxel	0823		$301.17		$60.23
J9178	K	Inj, epirubicin hcl, 2 mg	1167		$25.15		$5.03
J9181	N	Etoposide 10 MG inj
J9182	B	Etoposide 100 MG inj
J9185	K	Fludarabine phosphate inj	0842		$262.41		$52.48
J9190	N	Fluorouracil injection
J9200	K	Floxuridine injection	0827		$60.17		$12.03
J9201	K	Gemcitabine HCl	0828		$117.45		$23.49
J9202	K	Goserelin acetate implant	0810		$196.25		$39.25
J9206	K	Irinotecan injection	0830		$129.08		$25.82
J9208	K	Ifosfomide injection	0831		$53.54		$10.71
J9209	K	Mesna injection	0732		$13.68		$2.74
J9211	K	Idarubicin hcl injection	0832		$314.00		$62.80
J9212	K	Interferon alfacon-1	0912		$3.91		$0.78
J9213	K	Interferon alfa-2a inj	0834		$31.75		$6.35
J9214	K	Interferon alfa-2b inj	0836		$13.22		$2.64
J9215	K	Interferon alfa-n3 inj	0865		$8.77		$1.75
J9216	K	Interferon gamma 1-b inj	0838		$277.79		$55.56
J9217	K	Leuprolide acetate suspnsion	9217		$230.87		$46.17
J9218	K	Leuprolide acetate injeciton	0861		$10.96		$2.19
J9219	K	Leuprolide acetate implant	7051		$2,262.19		$452.44
J9230	N	Mechlorethamine hcl inj
J9245	K	Inj melphalan hydrochl 50 MG	0840		$523.22		$104.64
J9250	N	Methotrexate sodium inj
J9260	B	Methotrexate sodium inj
J9263	B	Oxaliplatin
J9265	K	Paclitaxel injection	0863		$19.11		$3.82
J9266	K	Pegaspargase/singl dose vial	0843		$1,528.80		$305.76
J9268	K	Pentostatin injection	0844		$1,868.91		$373.78
J9270	K	Plicamycin (mithramycin) inj	0860		$80.54		$16.11
J9280	K	Mitomycin 5 MG inj	0862		$26.36		$5.27
J9290	B	Mitomycin 20 MG inj
J9291	B	Mitomycin 40 MG inj
J9293	K	Mitoxantrone hydrochl / 5 MG	0864		$329.69		$65.94
J9300	K	Gemtuzumab ozogamicin	9004		$2,245.04		$449.01
J9305	G	Pemetrexed injection	9213		$41.29		$8.26
J9310	K	Rituximab cancer treatment	0849		$447.97		$89.59
J9320	K	Streptozocin injection	0850		$153.33		$30.67
J9340	K	Thiotepa injection	0851		$44.55		$8.91
J9350	K	Topotecan	0852		$755.51		$151.10
J9355	K	Trastuzumab	1613		$53.98		$10.80
J9357	K	Valrubicin, 200 mg	9167		$376.87		$75.37
J9360	N	Vinblastine sulfate inj
J9370	N	Vincristine sulfate 1 MG inj
J9375	B	Vincristine sulfate 2 MG inj
J9380	B	Vincristine sulfate 5 MG inj
J9390	K	Vinorelbine tartrate/10 mg	0855		$62.85		$12.57
J9395	K	Injection, Fulvestrant	9120		$82.90		$16.58
J9600	K	Porfimer sodium	0856		$2,457.97		$491.59
J9999	N	Chemotherapy drug
K0001	Y	Standard wheelchair
K0002	Y	Stnd hemi (low seat) whlchr
K0003	Y	Lightweight wheelchair
K0004	Y	High strength ltwt whlchr
K0005	Y	Ultralightweight wheelchair
K0006	Y	Heavy duty wheelchair
K0007	Y	Extra heavy duty wheelchair
K0009	Y	Other manual wheelchair/base
K0010	Y	Stnd wt frame power whlchr
K0011	Y	Stnd wt pwr whlchr w control
K0012	Y	Ltwt portbl power whlchr
K0014	Y	Other power whlchr base
K0015	Y	Detach non-adjus hght armrst
K0017	Y	Detach adjust armrest base
K0018	Y	Detach adjust armrst upper
K0019	Y	Arm pad each
K0020	Y	Fixed adjust armrest pair
K0037	Y	High mount flip-up footrest
K0038	Y	Leg strap each
K0039	Y	Leg strap h style each
K0040	Y	Adjustable angle footplate
K0041	Y	Large size footplate each
K0042	Y	Standard size footplate each
K0043	Y	Ftrst lower extension tube
K0044	Y	Ftrst upper hanger bracket
K0045	Y	Footrest complete assembly
K0046	Y	Elevat legrst low extension
K0047	Y	Elevat legrst up hangr brack
K0050	Y	Ratchet assembly
K0051	Y	Cam relese assem ftrst/lgrst
K0052	Y	Swingaway detach footrest
K0053	Y	Elevate footrest articulate
K0056	Y	Seat ht 17 or =21 ltwt wc
K0064	Y	Zero pressure tube flat free
K0065	Y	Spoke protectors
K0066	Y	Solid tire any size each
K0067	Y	Pneumatic tire any size each
K0068	Y	Pneumatic tire tube each
K0069	Y	Rear whl complete solid tire
K0070	Y	Rear whl compl pneum tire
K0071	Y	Front castr compl pneum tire
K0072	Y	Frnt cstr cmpl sem-pneum tir
K0073	Y	Caster pin lock each
K0074	Y	Pneumatic caster tire each
K0075	Y	Semi-pneumatic caster tire
K0076	Y	Solid caster tire each
K0077	Y	Front caster assem complete
K0078	Y	Pneumatic caster tire tube
K0090	Y	Rear tire power wheelchair
K0091	Y	Rear tire tube power whlchr
K0092	Y	Rear assem cmplt powr whlchr
K0093	Y	Rear zero pressure tire tube
K0094	Y	Wheel tire for power base
K0095	Y	Wheel tire tube each base
K0096	Y	Wheel assem powr base complt
K0097	Y	Wheel zero presure tire tube
K0098	Y	Drive belt power wheelchair
K0099	Y	Pwr wheelchair front caster
K0102	Y	Crutch and cane holder
K0104	Y	Cylinder tank carrier
K0105	Y	Iv hanger
K0106	Y	Arm trough each
K0108	Y	W/c component-accessory NOS
K0195	Y	Elevating whlchair leg rests
K0415	B	RX antiemetic drg, oral NOS
K0416	B	Rx antiemetic drg,rectal NOS
K0452	Y	Wheelchair bearings
K0455	Y	Pump uninterrupted infusion
K0462	Y	Temporary replacement eqpmnt
K0552	Y	Supply/Ext inf pump syr type
K0600	Y	Functional neuromuscularstim
K0601	Y	Repl batt silver oxide 1.5 v
K0602	Y	Repl batt silver oxide 3 v
K0603	Y	Repl batt alkaline 1.5 v
K0604	Y	Repl batt lithium 3.6 v
K0605	Y	Repl batt lithium 4.5 v
K0606	Y	AED garment w/elec analysis
K0607	Y	Repl batt for AED
K0608	Y	Repl garment for AED
K0609	Y	Repl electrode for AED
K0618	A	TLSO 2 piece rigid shell
K0619	A	TLSO 3 piece rigid shell
K0620	A	Tubular elastic dressing
K0628	Y	Mult dens insert direct form
K0629	Y	Mult dens insert custom mold
K0630	Y	SIO flex pelvisacral prefab
K0631	Y	SIO flex pelvisacral custom
K0632	Y	SIO panel prefab
K0633	Y	SIO panel custom
K0634	Y	LO flexibl L1 - below L5 pre
K0635	Y	LO sag stays/panels pre-fab
K0636	Y	LO sagitt rigid panel prefab
K0637	Y	LO flex w/o rigid stays pre
K0638	Y	LSO flex w/rigid stays cust
K0639	Y	LSO post rigid panel pre
K0640	Y	LSO sag-coro rigid frame pre
K0641	Y	LSO sag-cor rigid frame cust
K0642	Y	LSO flexion control prefab
K0643	Y	LSO flexion control custom
K0644	Y	LSO sagit rigid panel prefab
K0645	Y	LSO sagittal rigid panel cus
K0646	Y	LSO sag-coronal panel prefab
K0647	Y	LSO sag-coronal panel custom
K0648	Y	LSO s/c shell/panel prefab
K0649	Y	LSO s/c shell/panel custom
K0669	Y	W/c seat/back no CVR SADMERC
K0670	A	Stance phase only
K0671	Y	Portable oxygen concentrator
L0100	A	Cranial orthosis/helmet mold
L0110	A	Cranial orthosis/helmet nonm
L0112	A	Cranial cervical orthosis
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
L0430	A	Dewall posture protector
L0450	A	TLSO flex prefab thoracic
L0452	A	tlso flex custom fab thoraci
L0454	A	TLSO flex prefab sacrococ-T9
L0456	A	TLSO flex prefab
L0458	A	TLSO 2Mod symphis-xipho pre
L0460	A	TLSO2Mod symphysis-stern pre
L0462	A	TLSO 3Mod sacro-scap pre
L0464	A	TLSO 4Mod sacro-scap pre
L0466	A	TLSO rigid frame pre soft ap
L0468	A	TLSO rigid frame prefab pelv
L0470	A	TLSO rigid frame pre subclav
L0472	A	TLSO rigid frame hyperex pre
L0480	A	TLSO rigid plastic custom fa
L0482	A	TLSO rigid lined custom fab
L0484	A	TLSO rigid plastic cust fab
L0486	A	TLSO rigidlined cust fab two
L0488	A	TLSO rigid lined pre one pie
L0490	A	TLSO rigid plastic pre one
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
L0861	A	Halo repl liner/interface
L0960	E	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
L1005	A	Tension based scoliosis orth
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
L1652	A	HO bi thighcuffs w sprdr bar
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
L1831	A	Knee orth pos locking joint
L1832	A	KO adj jnt pos rigid support
L1834	A	Ko w/0 joint rigid molded to
L1836	A	Rigid KO wo joints
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
L1900	A	Afo sprng wir drsflx calf bd
L1901	A	Prefab ankle orthosis
L1902	A	Afo ankle gauntlet
L1904	A	Afo molded ankle gauntlet
L1906	A	Afo multiligamentus ankle su
L1907	A	AFO supramalleolar custom
L1910	A	Afo sing bar clasp attach sh
L1920	A	Afo sing upright w/ adjust s
L1930	A	Afo plastic
L1932	A	Afo rig ant tib prefab TCF/=
L1940	A	Afo molded to patient plasti
L1945	A	Afo molded plas rig ant tib
L1950	A	Afo spiral molded to pt plas
L1951	A	AFO spiral prefabricated
L1960	A	Afo pos solid ank plastic mo
L1970	A	Afo plastic molded w/ankle j
L1971	A	AFO w/ankle joint, prefab
L1980	A	Afo sing solid stirrup calf
L1990	A	Afo doub solid stirrup calf
L2000	A	Kafo sing fre stirr thi/calf
L2005	A	KAFO sng/dbl mechanical act
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
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
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
L2232	A	Rocker bottom, contact AFO
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
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
L2768	A	Ortho sidebar disconnect
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	B	Ft insert ucb berkeley shell
L3001	B	Foot insert remov molded spe
L3002	B	Foot insert plastazote or eq
L3003	B	Foot insert silicone gel eac
L3010	B	Foot longitudinal arch suppo
L3020	B	Foot longitud/metatarsal sup
L3030	B	Foot arch support remov prem
L3031	E	Foot lamin/prepreg composite
L3040	B	Ft arch suprt premold longit
L3050	B	Foot arch supp premold metat
L3060	B	Foot arch supp longitud/meta
L3070	B	Arch suprt att to sho longit
L3080	B	Arch supp att to shoe metata
L3090	B	Arch supp att to shoe long/m
L3100	B	Hallus-valgus nght dynamic s
L3140	B	Abduction rotation bar shoe
L3150	B	Abduct rotation bar w/o shoe
L3160	B	Shoe styled positioning dev
L3170	B	Foot plastic heel stabilizer
L3201	B	Oxford w supinat/pronat inf
L3202	B	Oxford w/ supinat/pronator c
L3203	B	Oxford w/ supinator/pronator
L3204	B	Hightop w/ supp/pronator inf
L3206	B	Hightop w/ supp/pronator chi
L3207	B	Hightop w/ supp/pronator jun
L3208	B	Surgical boot each infant
L3209	B	Surgical boot each child
L3211	B	Surgical boot each junior
L3212	B	Benesch boot pair infant
L3213	B	Benesch boot pair child
L3214	B	Benesch boot pair junior
L3215	B	Orthopedic ftwear ladies oxf
L3216	B	Orthoped ladies shoes dpth i
L3217	B	Ladies shoes hightop depth i
L3219	B	Orthopedic mens shoes oxford
L3221	B	Orthopedic mens shoes dpth i
L3222	B	Mens shoes hightop depth inl
L3224	A	Womans shoe oxford brace
L3225	A	Mans shoe oxford brace
L3230	B	Custom shoes depth inlay
L3250	B	Custom mold shoe remov prost
L3251	B	Shoe molded to pt silicone s
L3252	B	Shoe molded plastazote cust
L3253	B	Shoe molded plastazote cust
L3254	B	Orth foot non-stndard size/w
L3255	B	Orth foot non-standard size/
L3257	B	Orth foot add charge split s
L3260	B	Ambulatory surgical boot eac
L3265	B	Plastazote sandal each
L3300	B	Sho lift taper to metatarsal
L3310	B	Shoe lift elev heel/sole neo
L3320	B	Shoe lift elev heel/sole cor
L3330	B	Lifts elevation metal extens
L3332	B	Shoe lifts tapered to one-ha
L3334	B	Shoe lifts elevation heel /i
L3340	B	Shoe wedge sach
L3350	B	Shoe heel wedge
L3360	B	Shoe sole wedge outside sole
L3370	B	Shoe sole wedge between sole
L3380	B	Shoe clubfoot wedge
L3390	B	Shoe outflare wedge
L3400	B	Shoe metatarsal bar wedge ro
L3410	B	Shoe metatarsal bar between
L3420	B	Full sole/heel wedge btween
L3430	B	Sho heel count plast reinfor
L3440	B	Heel leather reinforced
L3450	B	Shoe heel sach cushion type
L3455	B	Shoe heel new leather standa
L3460	B	Shoe heel new rubber standar
L3465	B	Shoe heel thomas with wedge
L3470	B	Shoe heel thomas extend to b
L3480	B	Shoe heel pad depress for
L3485	B	Shoe heel pad removable for
L3500	B	Ortho shoe add leather insol
L3510	B	Orthopedic shoe add rub insl
L3520	B	O shoe add felt w leath insl
L3530	B	Ortho shoe add half sole
L3540	B	Ortho shoe add full sole
L3550	B	O shoe add standard toe tap
L3560	B	O shoe add horseshoe toe tap
L3570	B	O shoe add instep extension
L3580	B	O shoe add instep velcro clo
L3590	B	O shoe convert to sof counte
L3595	B	Ortho shoe add march bar
L3600	B	Trans shoe calip plate exist
L3610	B	Trans shoe caliper plate new
L3620	B	Trans shoe solid stirrup exi
L3630	B	Trans shoe solid stirrup new
L3640	B	Shoe dennis browne splint bo
L3649	B	Orthopedic shoe modifica NOS
L3650	A	Shlder fig 8 abduct restrain
L3651	A	Prefab shoulder orthosis
L3652	A	Prefab dbl shoulder orthosis
L3660	A	Abduct restrainer canvasweb
L3670	A	Acromio/clavicular canvaswe
L3675	A	Canvas vest SO
L3677	E	SO hard plastic stabilizer
L3700	A	Elbow orthoses elas w stays
L3701	A	Prefab elbow orthosis
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
L3762	A	Rigid EO wo joints
L3800	A	Whfo short opponen no attach
L3805	A	Whfo long opponens no attach
L3807	A	WHFO,no joint, prefabricated
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	B	Torsion mechanism wrist/elbo
L3900	A	Hinge extension/flex wrist/f
L3901	A	Hinge ext/flex wrist finger
L3902	E	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
L3909	A	Prefab wrist orthosis
L3910	A	Whfo swanson design
L3911	A	Prefab hand finger orthosis
L3912	A	Flex glove w/elastic finger
L3914	A	WHO wrist extension cock-up
L3916	A	Whfo wrist extens w/ outrigg
L3917	A	Prefab metacarpl fx orthosis
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	Y	Seo mobile arm sup att to wc
L3965	Y	Arm supp att to wc rancho ty
L3966	Y	Mobile arm supports reclinin
L3968	Y	Friction dampening arm supp
L3969	Y	Monosuspension arm/hand supp
L3970	Y	Elevat proximal arm support
L3972	Y	Offset/lat rocker arm w/ ela
L3974	Y	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
L4002	A	Replace strap, any orthosis
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	Ankle control orthosi prefab
L4360	A	Pneumati walking boot prefab
L4370	A	Pneumatic full leg splint
L4380	A	Pneumatic knee splint
L4386	A	Non-pneum walk boot prefab
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
L5301	A	BK mold socket SACH ft endo
L5311	A	Knee disart, SACH ft, endo
L5321	A	AK open end SACH
L5331	A	Hip disart canadian SACH ft
L5341	A	Hemipelvectomy canadian SACH
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	Bk flex inner socket ext fra
L5646	A	Below knee cushion socket
L5647	A	Below knee suction socket
L5648	A	Above knee cushion socket
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
L5661	A	Multi-durometer symes
L5665	A	Multi-durometer below knee
L5666	A	Below knee cuff suspension
L5668	A	Socket insert w/o lock lower
L5670	A	Bk molded supracondylar susp
L5671	A	BK/AK locking mechanism
L5672	A	Bk removable medial brim sus
L5673	A	Socket insert w lock mech
L5676	A	Bk knee joints single axis p
L5677	A	Bk knee joints polycentric p
L5678	A	Bk joint covers pair
L5679	A	Socket insert w/o lock mech
L5680	A	Bk thigh lacer non-molded
L5681	A	Intl custm cong/latyp insert
L5682	A	Bk thigh lacer glut/ischia m
L5683	A	Initial custom socket insert
L5684	A	Bk fork strap
L5685	A	Below knee sus/seal sleeve
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 cover BK
L5705	A	Custom shape cover AK
L5706	A	Custom shape cvr knee disart
L5707	A	Custom shape cvr 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
L5781	A	Lower limb pros vacuum pump
L5782	A	HD low limb pros vacuum pump
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
L5848	A	Knee-shin sys hydraul stance
L5850	A	Endo ak/hip knee extens assi
L5855	A	Mech hip extension assist
L5856	A	Elec knee-shin swing/stance
L5857	A	Elec knee-shin swing only
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
L5990	A	User adjustable heel height
L5995	A	Lower ext pros heavyduty fea
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
L6025	A	Part hand disart myoelectric
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/extension 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
L6638	A	Elec lock on manual pw elbow
L6640	A	Shoulder abduction joint pai
L6641	A	Excursion amplifier pulley t
L6642	A	Excursion amplifier lever ty
L6645	A	Shoulder flexion-abduction j
L6646	A	Multipo locking shoulder jnt
L6647	A	Shoulder lock actuator
L6648	A	Ext pwrd shlder lock/unlock
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
L6694	A	Elbow socket ins use w/lock
L6695	A	Elbow socket ins use w/o lck
L6696	A	Cus elbo skt in for con/atyp
L6697	A	Cus elbo skt in not con/atyp
L6698	A	Below/above elbow lock mech
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
L6881	A	Autograsp feature ul term dv
L6882	A	Microprocessor control uplmb
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
L7181	A	Electronic elbo simultaneous
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
L7367	A	Replacemnt lithium ionbatter
L7368	A	Lithium ion battery charger
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	Male vacuum erection system
L8000	A	Mastectomy bra
L8001	A	Breast prosthesis bra form
L8002	A	Brst prsth bra bilat form
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	A	Compression stocking BK30-40
L8120	A	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
L8499	A	Unlisted misc prosthetic ser
L8500	A	Artificial larynx
L8501	A	Tracheostomy speaking valve
L8505	A	Artificial larynx, accessory
L8507	A	Trach-esoph voice pros pt in
L8509	A	Trach-esoph voice pros md in
L8510	A	Voice amplifier
L8511	A	Indwelling trach insert
L8512	A	Gel cap for trach voice pros
L8513	A	Trach pros cleaning device
L8514	A	Repl trach puncture dilator
L8515	A	Gel cap app device for trach
L8600	N	Implant breast silicone/eq
L8603	N	Collagen imp urinary 2.5 ml
L8606	N	Synthetic implnt urinary 1ml
L8610	N	Ocular implant
L8612	N	Aqueous shunt prosthesis
L8613	N	Ossicular implant
L8614	N	Cochlear device/system
L8615	A	Coch implant headset replace
L8616	A	Coch implant microphone repl
L8617	A	Coch implant trans coil repl
L8618	A	Coch implant tran cable repl
L8619	A	Replace cochlear processor
L8620	A	Repl lithium ion battery
L8621	A	Repl zinc air battery
L8622	A	Repl alkaline battery
L8630	N	Metacarpophalangeal implant
L8631	N	MCP joint repl 2 pc or more
L8641	N	Metatarsal joint implant
L8642	N	Hallux implant
L8658	N	Interphalangeal joint spacer
L8659	N	Interphalangeal joint repl
L8670	N	Vascular graft, synthetic
L8699	N	Prosthetic implant NOS
L9900	A	OP supply/accessory/service
M0064	X	Visit for drug monitoring	0374	1.0414	$61.80		$12.36
M0075	E	Cellular therapy
M0076	E	Prolotherapy
M0100	E	Intragastric hypothermia
M0300	E	IV chelationtherapy
M0301	E	Fabric wrapping of aneurysm
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	B	Screening pap smear by phys
P7001	E	Culture bacterial urine
P9010	K	Whole blood for transfusion	0950	2.0123	$119.42		$23.88
P9011	K	Blood split unit	0967	1.2698	$75.35		$15.07
P9012	K	Cryoprecipitate each unit	0952	0.7395	$43.88		$8.78
P9016	K	RBC leukocytes reduced	0954	2.7370	$162.42		$32.48
P9017	K	Plasma 1 donor frz w/in 8 hr	9508	1.2038	$71.44		$14.29
P9019	K	Platelets, each unit	0957	0.8317	$49.36		$9.87
P9020	K	Plaelet rich plasma unit	0958	5.1815	$307.49		$61.50
P9021	K	Red blood cells unit	0959	2.0301	$120.47		$24.09
P9022	K	Washed red blood cells unit	0960	2.9707	$176.29		$35.26
P9023	K	Frozen plasma, pooled, sd	0949	1.1956	$70.95		$14.19
P9031	K	Platelets leukocytes reduced	1013	1.6023	$95.09		$19.02
P9032	K	Platelets, irradiated	9500	1.3589	$80.64		$16.13
P9033	K	Platelets leukoreduced irrad	0968	2.3639	$140.28		$28.06
P9034	K	Platelets, pheresis	9507	6.8988	$409.40		$81.88
P9035	K	Platelet pheres leukoreduced	9501	8.1495	$483.62		$96.72
P9036	K	Platelet pheresis irradiated	9502	5.1895	$307.96		$61.59
P9037	K	Plate pheres leukoredu irrad	1019	9.5131	$564.54		$112.91
P9038	K	RBC irradiated	9505	2.3876	$141.69		$28.34
P9039	K	RBC deglycerolized	9504	6.4314	$381.66		$76.33
P9040	K	RBC leukoreduced irradiated	0969	3.6451	$216.31		$43.26
P9041	K	Albumin (human),5%, 50ml	0961	0.5119	$30.38		$6.08
P9043	K	Plasma protein fract,5%,50ml	0956	1.1226	$66.62		$13.32
P9044	K	Cryoprecipitatereducedplasma	1009	1.3062	$77.51		$15.50
P9045	K	Albumin (human), 5%, 250 ml	0963	1.3869	$82.30		$16.46
P9046	K	Albumin (human), 25%, 20 ml	0964	0.4878	$28.95		$5.79
P9047	K	Albumin (human), 25%, 50ml	0965	1.1117	$65.97		$13.19
P9048	K	Plasmaprotein fract,5%,250ml	0966	4.9564	$294.13		$58.83
P9050	K	Granulocytes, pheresis unit	9506	15.6155	$926.67		$185.33
P9051	K	Blood, l/r, cmv-neg	1010	2.9692	$176.20		$35.24
P9052	K	Platelets, hla-m, l/r, unit	1011	10.9690	$650.93		$130.19
P9053	K	Plt, pher, l/r cmv-neg, irr	1020	10.1551	$602.63		$120.53
P9054	K	Blood, l/r, froz/degly/wash	1016	5.2631	$312.33		$62.47
P9055	K	Plt, aph/pher, l/r, cmv-neg	1017	8.5998	$510.34		$102.07
P9056	K	Blood, l/r, irradiated	1018	2.8004	$166.18		$33.24
P9057	K	RBC, frz/deg/wsh, l/r, irrad	1021	4.8787	$289.52		$57.90
P9058	K	RBC, l/r, cmv-neg, irrad	1022	4.2901	$254.59		$50.92
P9059	K	Plasma, frz between 8-24hour	0955	1.2934	$76.75		$15.35
P9060	K	Fr frz plasma donor retested	9503	1.6241	$96.38		$19.28
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
Q0035	X	Cardiokymography	0100	2.4968	$148.17	$41.44	$29.63
Q0081	B	Infusion ther other than che
Q0083	B	Chemo by other than infusion
Q0084	B	Chemotherapy by infusion
Q0085	B	Chemo by both infusion and o
Q0091	T	Obtaining screen pap smear	0191	0.167	$9.91	$2.78	$1.98
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	K	Non esrd epoetin alpha inj	0733		$9.99		$2.00
Q0137	K	Darbepoetin alfa, non esrd	0734		$3.28		$0.66
Q0144	E	Azithromycin dihydrate, oral
Q0163	N	Diphenhydramine HCl 50mg
Q0164	N	Prochlorperazine maleate 5mg
Q0165	B	Prochlorperazine maleate10mg
Q0166	K	Granisetron HCl 1 mg oral	0765		$33.51		$6.70
Q0167	N	Dronabinol 2.5mg oral
Q0168	B	Dronabinol 5mg oral
Q0169	N	Promethazine HCl 12.5mg oral
Q0170	B	Promethazine HCl 25 mg oral
Q0171	Na	Chlorpromazine HCl 10mg oral
Q0172	B	Chlorpromazine HCl 25mg oral
Q0173	N	Trimethobenzamide HCl 250mg
Q0174	N	Thiethylperazine maleate10mg
Q0175	N	Perphenazine 4mg oral
Q0176	B	Perphenazine 8mg oral
Q0177	N	Hydroxyzine pamoate 25mg
Q0178	B	Hydroxyzine pamoate 50mg
Q0179	K	Ondansetron HCl 8mg oral	0769		$32.02		$6.40
Q0180	K	Dolasetron mesylate oral	0763		$48.54		$9.71
Q0181	E	Unspecified oral anti-emetic
Q0187	K	Factor viia recombinant	1409		$1,080.11		$216.02
Q1001	N	Ntiol category 1
Q1002	N	Ntiol category 2
Q1003	N	Ntiol category 3
Q1004	N	Ntiol category 4
Q1005	N	Ntiol category 5
Q2001	E	Oral cabergoline 0.5 mg
Q2002	N	Elliotts b solution per ml
Q2003	K	Aprotinin, 10,000 kiu	7019		$2.20		$0.44
Q2004	N	Bladder calculi irrig sol
Q2005	K	Corticorelin ovine triflutat	7024		$386.53		$77.31
Q2006	K	Digoxin immune fab (ovine)	7025		$552.18		$110.44
Q2007	K	Ethanolamine oleate 100 mg	7026		$64.53		$12.91
Q2008	K	Fomepizole, 15 mg	7027		$12.31		$2.46
Q2009	K	Fosphenytoin, 50 mg	7028		$5.19		$1.04
Q2011	K	Hemin, per 1 mg	7030		$6.51		$1.30
Q2012	K	Pegademase bovine, 25 iu	9168		$161.16		$32.23
Q2013	K	Pentastarch 10% solution	7040		$12.45		$2.49
Q2014	N	Sermorelin acetate, 0.5 mg
Q2017	K	Teniposide, 50 mg	7035		$266.23		$53.25
Q2018	K	Urofollitropin, 75 iu	7037		$44.74		$8.95
Q2019	K	Basiliximab	1615		$1,473.57		$294.71
Q2020	E	Histrelin acetate
Q2021	K	Lepirudin	9057		$128.17		$25.63
Q2022	K	VonWillebrandFactrCmplxperIU	1618		$0.74		$0.15
Q3000	H	Rubidium-Rb-82	9025
Q3001	B	Brachytherapy Radioelements
Q3002	H	Gallium ga 67	1619
Q3003	H	Technetium tc99m bicisate	1620
Q3004	N	Xenon xe 133
Q3005	H	Technetium tc99m mertiatide	1622
Q3006	H	Technetium tc99m glucepatate	9154
Q3007	H	Sodium phosphate p32	1624
Q3008	H	Indium 111-in pentetreotide	1625
Q3009	N	Technetium tc99m oxidronate
Q3010	H	Technetium tc99m labeledrbcs	9155
Q3011	H	Chromic phosphate p32	1628
Q3012	N	Cyanocobalamin cobalt co57
Q3014	A	Telehealth facility fee
Q3019	A	ALS emer trans no ALS serv
Q3020	A	ALS nonemer trans no ALS se
Q3025	K	IM inj interferon beta 1-a	9022		$89.10		$17.82
Q3026	E	Subc inj interferon beta-1a
Q3031	N	Collagen skin test
Q4001	B	Cast sup body cast plaster
Q4002	B	Cast sup body cast fiberglas
Q4003	B	Cast sup shoulder cast plstr
Q4004	B	Cast sup shoulder cast fbrgl
Q4005	B	Cast sup long arm adult plst
Q4006	B	Cast sup long arm adult fbrg
Q4007	B	Cast sup long arm ped plster
Q4008	B	Cast sup long arm ped fbrgls
Q4009	B	Cast sup sht arm adult plstr
Q4010	B	Cast sup sht arm adult fbrgl
Q4011	B	Cast sup sht arm ped plaster
012	B	Cast sup sht arm ped fbrglas
Q4013	B	Cast sup gauntlet plaster
Q4014	B	Cast sup gauntlet fiberglass
Q4015	B	Cast sup gauntlet ped plster
Q4016	B	Cast sup gauntlet ped fbrgls
Q4017	B	Cast sup lng arm splint plst
Q4018	B	Cast sup lng arm splint fbrg
Q4019	B	Cast sup lng arm splnt ped p
Q4020	B	Cast sup lng arm splnt ped f
Q4021	B	Cast sup sht arm splint plst
Q4022	B	Cast sup sht arm splint fbrg
Q4023	B	Cast sup sht arm splnt ped p
Q4024	B	Cast sup sht arm splnt ped f
Q4025	B	Cast sup hip spica plaster
Q4026	B	Cast sup hip spica fiberglas
Q4027	B	Cast sup hip spica ped plstr
Q4028	B	Cast sup hip spica ped fbrgl
Q4029	B	Cast sup long leg plaster
Q4030	B	Cast sup long leg fiberglass
Q4031	B	Cast sup lng leg ped plaster
Q4032	B	Cast sup lng leg ped fbrgls
Q4033	B	Cast sup lng leg cylinder pl
Q4034	B	Cast sup lng leg cylinder fb
Q4035	B	Cast sup lngleg cylndr ped p
Q4036	B	Cast sup lngleg cylndr ped f
Q4037	B	Cast sup shrt leg plaster
Q4038	B	Cast sup shrt leg fiberglass
Q4039	B	Cast sup shrt leg ped plster
Q4040	B	Cast sup shrt leg ped fbrgls
Q4041	B	Cast sup lng leg splnt plstr
Q4042	B	Cast sup lng leg splnt fbrgl
Q4043	B	Cast sup lng leg splnt ped p
Q4044	B	Cast sup lng leg splnt ped f
Q4045	B	Cast sup sht leg splnt plstr
Q4046	B	Cast sup sht leg splnt fbrgl
Q4047	B	Cast sup sht leg splnt ped p
Q4048	B	Cast sup sht leg splnt ped f
Q4049	B	Finger splint, static
Q4050	B	Cast supplies unlisted
Q4051	B	Splint supplies misc
Q4054	A	Darbepoetin alfa, esrd use
Q4055	A	Epoetin alfa, esrd use
Q4075	N	Acyclovir, 5 mg
Q4076	N	Dopamine hcl, 40 mg
Q4077	K	Treprostinil, 1 mg	1082		$55.02		$11.00
Q4079	G	Injection, natalizumab	9126		$6.51		$1.30
Q9941	K	IVIG lyophil 1g	0869		$39.46		$7.89
Q9942	K	IVIG lyophil 10 mg	0870		$0.40		$0.08
Q9943	K	IVIG non-lyophil 1g	0871		$57.26		$11.45
Q9944	K	IVIG non-lyophil 10 mg	0872		$0.57		$0.11
Q9945	K	LOCM =149 mg/ml iodine, 1ml	9157		$0.51		$0.10
Q9946	K	LOCM 150-199mg/ml iodine,1ml	9158		$2.00		$0.40
Q9947	K	LOCM 200-249mg/ml iodine,1ml	9159		$0.78		$0.16
Q9948	K	LOCM 250-299mg/ml iodine,1ml	9160		$0.66		$0.13
Q9949	K	LOCM 300-349mg/ml iodine,1ml	9161		$0.41		$0.08
Q9950	K	LOCM 350-399mg/ml iodine,1ml	9162		$0.27		$0.05
Q9951	K	LOCM = 400 mg/ml iodine,1ml	19163		$0.20		$0.04
Q9952	K	Inj Gad-base MR contrast, ml	9164		$3.01		$0.60
Q9953	N	Inj Fe-based MR contrast, ml
Q9954	K	Oral MR contrast, 100 ml	9165		$9.01		$1.80
Q9955	K	Inj perflexane lip micros, m	9203		$13.49		$2.70
Q9956	K	Inj octafluoropropane mic,ml	9202		$41.42		$8.28
Q9957	K	Inj perflutren lip micros, m	9112		$63.51		$12.70
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
V2118	A	Lens aniseikonic single
V2121	A	Lenticular lens, 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
V2218	A	Lens aniseikonic bifocal
V2219	A	Lens bifocal seg width over
V2220	A	Lens bifocal add over 3.25d
V2221	A	Lenticular lens, bifocal
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
V2318	A	Lens aniseikonic trifocal
V2319	A	Lens trifocal seg width 28
V2320	A	Lens trifocal add over 3.25d
V2321	A	Lenticular lens, trifocal
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
V2702	E	Deluxe lens feature
V2710	A	Glass/plastic slab off prism
V2715	A	Prism lens/es
V2718	A	Fresnell prism press-on lens
V2730	A	Special base curve
V2744	A	Tint photochromatic lens/es
V2745	A	Tint, any color/solid/grad
V2750	A	Anti-reflective coating
V2755	A	UV lens/es
V2756	E	Eye glass case
V2760	A	Scratch resistant coating
V2761	B	Mirror coating
V2762	A	Polarization, any lens
V2770	A	Occluder lens/es
V2780	A	Oversize lens/es
V2781	B	Progressive lens per lens
V2782	A	Lens, 1.54-1.65 p/1.60-1.79g
V2783	A	Lens, = 1.66 p/=1.80 g
V2784	A	Lens polycarb or equal
V2785	F	Corneal tissue processing
V2786	A	Occupational multifocal lens
V2790	N	Amniotic membrane
V2797	A	Vis item/svc in other code
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	Hearing aid monaural in ear
V5060	E	Behind ear hearing aid
V5070	E	Glasses air conduction
V5080	E	Glasses bone conduction
V5090	E	Hearing aid dispensing fee
V5095	E	Implant mid ear hearing pros
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
V5241	E	Dispensing fee, monaural
V5242	E	Hearing aid, monaural, cic
V5243	E	Hearing aid, monaural, itc
V5244	E	Hearing aid, prog, mon, cic
V5245	E	Hearing aid, prog, mon, itc
V5246	E	Hearing aid, prog, mon, ite
V5247	E	Hearing aid, prog, mon, bte
V5248	E	Hearing aid, binaural, cic
V5249	E	Hearing aid, binaural, itc
V5250	E	Hearing aid, prog, bin, cic
V5251	E	Hearing aid, prog, bin, itc
V5252	E	Hearing aid, prog, bin, ite
V5253	E	Hearing aid, prog, bin, bte
V5254	E	Hearing id, digit, mon, cic
V5255	E	Hearing aid, digit, mon, itc
V5256	E	Hearing aid, digit, mon, ite
V5257	E	Hearing aid, digit, mon, bte
V5258	E	Hearing aid, digit, bin, cic
V5259	E	Hearing aid, digit, bin, itc
V5260	E	Hearing aid, digit, bin, ite
V5261	E	Hearing aid, digit, bin, bte
V5262	E	Hearing aid, disp, monaural
V5263	E	Hearing aid, disp, binaural
V5264	E	Ear mold/insert
V5265	E	Ear mold/insert, disp
V5266	E	Battery for hearing device
V5267	E	Hearing aid supply/accessory
V5268	E	ALD Telephone Amplifier
V5269	E	Alerting device, any type
V5270	E	ALD, TV amplifier, any type
V5271	E	ALD, TV caption decoder
V5272	E	Tdd
V5273	E	ALD for cochlear implant
V5274	E	ALD unspecified
V5275	E	Ear impression
V5298	E	Hearing aid noc
V5299	B	Hearing service
V5336	E	Repair communication device
V5362	E	Speech screening
V5363	E	Language screening
V5364	E	Dysphagia screening
* Code is subject to contiguous body area imaging discount policy discussed in Section XIV of this proposed rule.
CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
Copyright American Dental Association. All Rights Reserved.

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare_Hospital Insurance; and Program No. 93.774, Medicare_Supplementary Medical Insurance Program)

Dated: August 17, 2005

Ann C. Agnew,

Executive Secretary to the Department

[FR Doc. 05-16699 Filed 8-18-05; 2:44 pm]

BILLING CODE 4120-01-P