[Federal Register: August 26, 2005 (Volume 70, Number 165)]
[Proposed Rules]
[Page 50679-50886]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr26au05-42]
[[Page 50679]]
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Part III
Book 2 of 2 Books
Pages 50679-50948
Department of Health and Human Services
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Centers for Medicare & Medicaid Services
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42 CFR Parts 419 and 485
Medicare Program; Proposed Changes to the Hospital Outpatient
Prospective Payment System and Calendar Year 2006 Payment Rates;
Correction; Proposed Rule
[[Page 50680]]
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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.
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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,
[[Page 50681]]
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:
Table 11.--Proposed APC Reassignment of New Technology Procedures Into Clinical APCs for CY 2006
----------------------------------------------------------------------------------------------------------------
Proposed
CY 2005 CY 2005 status Proposed Proposed CY 2006 CY 2005 CY 2006
HCPCS Descriptor APC indicator CY 2006 status payment payment
APC indicator amount amount
----------------------------------------------------------------------------------------------------------------
0027T.......... Endoscopic 1547 T 0220 T $850 $1,030.11
epidural lysis.
33225.......... L ventric pacing 1525 S 0418 T 3,750 6,486.45
lead add-on.
61623.......... Endovasc tempory 1555 T 0081 T 1,650 2,044.21
vessel occl.
92974.......... Cath place, cardio 1559 T 0103 T 2,250 873.18
brachytx.
93580.......... Transcath closure 1559 T 0434 T 2,250 5,387.61
of asd.
93581.......... Transcath closure 1559 T 0434 T 2,250 5,387.61
of vsd.
95965.......... Meg, spontaneous.. 1528 S 0430 T 5,250 676.75
95966.......... Meg, evoked, 1516 S 0430 T 1,450 676.75
single.
95967.......... Meg, evoked, each 1511 S 0430 T 950 676.75
add'l.
C9713.......... Non-contact laser 1525 S 0429 T 3,750 2,511.08
vap prosta.
----------------------------------------------------------------------------------------------------------------
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:
----------------------------------------------------------------------------------------------------------------
New status
HCPCS Long descriptor APC APC title indicator
----------------------------------------------------------------------------------------------------------------
C2636........ Brachytherapy 2636 Brachytx linear source, P-103....................... H
linear source,
Palladium-103,
per 1mm.
----------------------------------------------------------------------------------------------------------------
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''.
[[Page 50682]]
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:
Table 33.--Impact of Proposed Changes for CY 2006 Hospital Outpatient Prospective Payment System
----------------------------------------------------------------------------------------------------------------
Cumulative
New adj (Cols
Number of New for rural 2,3,4)
Hospital category APC wage sole with All
hospitals changes index community market changes
hospitals basket
update
(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
[[Page 50683]]
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:
[[Page 50684]]
Addendum A.--List of Ambulatory Payment Classifications (APCs) with Status Indicators, Relative Weights, Payment
Rates, and Copayment Amounts Calendar Year 2006
----------------------------------------------------------------------------------------------------------------
National Minimum
APC Group title SI Relative Payment unadjusted unadjusted
weight rate copayment copayment
----------------------------------------------------------------------------------------------------------------
0001........... Level I Photochemotherapy S............... 0.4213 $25.00 $7.00 $5.00
0002........... Level I Fine Needle T............... 0.9559 $56.73 ........... $11.35
Biopsy/Aspiration.
0003........... Bone Marrow Biopsy/ T............... 2.6530 $157.44 ........... $31.49
Aspiration.
0004........... Level I Needle Biopsy/ T............... 1.7646 $104.72 $22.36 $20.94
Aspiration Except Bone
Marrow.
0005........... Level II Needle Biopsy/ T............... 3.5994 $213.60 $71.59 $42.72
Aspiration Except Bone
Marrow.
0006........... Level I Incision & T............... 1.5500 $91.98 $22.28 $18.40
Drainage.
0007........... Level II Incision & T............... 11.4501 $679.48 ........... $135.90
Drainage.
0008........... Level III Incision and T............... 16.4989 $979.09 ........... $195.82
Drainage.
0009........... Nail Procedures.......... T............... 0.6680 $39.64 $8.34 $7.93
0010........... Level I Destruction of T............... 0.5719 $33.94 $9.65 $6.79
Lesion.
0011........... Level II Destruction of T............... 2.0839 $123.66 $25.17 $24.73
Lesion.
0012........... Level I Debridement & T............... 0.8497 $50.42 $11.18 $10.08
Destruction.
0013........... Level II Debridement & T............... 1.1078 $65.74 $14.20 $13.15
Destruction.
0015........... Level III Debridement & T............... 1.6514 $98.00 $20.29 $19.60
Destruction.
0016........... Level IV Debridement & T............... 2.5834 $153.31 $33.57 $30.66
Destruction.
0017........... Level VI Debridement & T............... 18.4211 $1,093.16 $227.84 $218.63
Destruction.
0018........... Biopsy of Skin/Puncture T............... 1.1726 $69.59 $16.04 $13.92
of Lesion.
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/ T............... 14.9776 $888.82 $219.48 $177.76
Biopsy.
0022........... Level IV Excision/ Biopsy T............... 19.6472 $1,165.92 $354.45 $233.18
0023........... Exploration Penetrating T............... 4.7775 $283.51 ........... $56.70
Wound.
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 T............... 2.1773 $129.21 ........... $25.84
Biopsy/Aspiration.
0037........... Level IV Needle Biopsy/ T............... 9.4751 $562.28 $224.91 $112.46
Aspiration Except Bone
Marrow.
0039........... Level I Implantation of S............... 181.4000 $10,764.82 ........... $2,152.96
Neurostimulator.
0040........... Level I Implantation of S............... 55.3297 $3,283.43 ........... $656.69
Neurostimulator
Electrodes.
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 T............... 1.7694 $105.00 ........... $21.00
Finger/Toe/Trunk.
0045........... Bone/Joint Manipulation T............... 14.4945 $860.15 $268.47 $172.03
Under Anesthesia.
0046........... Open/Percutaneous T............... 37.7023 $2,237.37 $535.76 $447.47
Treatment Fracture or
Dislocation.
0047........... Arthroplasty without T............... 31.6107 $1,875.87 $537.03 $375.17
Prosthesis.
0048........... Level I Arthroplasty with T............... 43.1288 $2,559.39 $570.30 $511.88
Prosthesis.
0049........... Level I Musculoskeletal T............... 20.3707 $1,208.86 ........... $241.77
Procedures Except Hand
and Foot.
0050........... Level II Musculoskeletal T............... 23.9081 $1,418.78 ........... $283.76
Procedures Except Hand
and Foot.
0051........... Level III Musculoskeletal T............... 36.5271 $2,167.63 ........... $433.53
Procedures Except Hand
and Foot.
0052........... Level IV Musculoskeletal T............... 43.9378 $2,607.40 ........... $521.48
Procedures Except Hand
and Foot.
0053........... Level I Hand T............... 15.6795 $930.47 $253.49 $186.09
Musculoskeletal
Procedures.
0054........... Level II Hand T............... 25.3711 $1,505.60 ........... $301.12
Musculoskeletal
Procedures.
0055........... Level I Foot T............... 20.0692 $1,190.97 $355.34 $238.19
Musculoskeletal
Procedures.
0056........... Level II Foot T............... 40.2957 $2,391.27 ........... $478.25
Musculoskeletal
Procedures.
0057........... Bunion Procedures........ T............... 27.5493 $1,634.86 $475.91 $326.97
0058........... Level I Strapping and S............... 1.0934 $64.89 ........... $12.98
Cast Application.
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 T............... 3.2101 $190.50 ........... $38.10
Procedures.
0071........... Level I Endoscopy Upper T............... 0.7915 $46.97 $11.31 $9.39
Airway.
0072........... Level II Endoscopy Upper T............... 1.4361 $85.22 $21.27 $17.04
Airway.
0074........... Level IV Endoscopy Upper T............... 15.7757 $936.18 $295.70 $187.24
Airway.
0075........... Level V Endoscopy Upper T............... 21.3426 $1,266.53 $445.92 $253.31
Airway.
0076........... Level I Endoscopy Lower T............... 9.4592 $561.34 $189.82 $112.27
Airway.
0077........... Level I Pulmonary S............... 0.3444 $20.44 $7.74 $4.09
Treatment.
0078........... Level II Pulmonary S............... 1.0236 $60.74 $14.55 $12.15
Treatment.
0079........... Ventilation Initiation S............... 2.3482 $139.35 ........... $27.87
and Management.
0080........... Diagnostic Cardiac T............... 37.1361 $2,203.77 $838.92 $440.75
Catheterization.
0081........... Non-Coronary Angioplasty T............... 34.4473 $2,044.21 ........... $408.84
or Atherectomy.
0082........... Coronary Atherectomy..... T............... 85.0126 $5,044.90 $1,085.20 $1,008.98
0083........... Coronary Angioplasty and T............... 50.8925 $3,020.11 ........... $604.02
Percutaneous
Valvuloplasty.
0084........... Level I S............... 10.0205 $594.65 ........... $118.93
Electrophysiologic
Evaluation.
0085........... Level II T............... 35.1882 $2,088.17 $426.25 $417.63
Electrophysiologic
Evaluation.
[[Page 50685]]
0086........... Ablate Heart Dysrhythm T............... 44.2596 $2,626.50 $833.33 $525.30
Focus.
0087........... Cardiac T............... 30.7101 $1,822.43 ........... $364.49
Electrophysiologic
Recording/Mapping.
0088........... Thrombectomy............. T............... 36.5617 $2,169.68 $655.22 $433.94
0089........... Insertion/Replacement of T............... 105.6143 $6,267.47 $1,682.28 $1,253.49
Permanent Pacemaker and
Electrodes.
0090........... Insertion/Replacement of T............... 89.1574 $5,290.87 $1,612.80 $1,058.17
Pacemaker Pulse
Generator.
0091........... Level II Vascular T............... 28.9999 $1,720.94 $348.23 $344.19
Ligation.
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 S............... 2.5363 $150.51 $47.62 $30.10
Cardioversion.
0095........... Cardiac Rehabilitation... S............... 0.5885 $34.92 $13.96 $6.98
0096........... Non-Invasive Vascular S............... 1.6307 $96.77 $38.70 $19.35
Studies.
0097........... Cardiac and Ambulatory X............... 1.0223 $60.67 $23.79 $12.13
Blood Pressure
Monitoring.
0098........... Injection of Sclerosing T............... 1.1346 $67.33 ........... $13.47
Solution.
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 T............... 14.7142 $873.18 $223.63 $174.64
Procedures.
0104........... Transcatheter Placement T............... 79.0094 $4,688.65 ........... $937.73
of Intracoronary Stents.
0105........... Revision/Removal of T............... 22.3685 $1,327.41 $370.40 $265.48
Pacemakers, AICD, or
Vascular.
0106........... Insertion/Replacement/ T............... 45.4851 $2,699.22 ........... $539.84
Repair of Pacemaker and/
or Electrodes.
0107........... Insertion of Cardioverter- T............... 260.0295 $15,430.93 $3,103.22 $3,086.19
Defibrillator.
0108........... Insertion/Replacement/ T............... 349.1681 $20,720.68 ........... $4,144.14
Repair of Cardioverter-
Defibrillator Leads.
0109........... Removal of Implanted T............... 11.0433 $655.34 $131.49 $131.07
Devices.
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, S............... 26.7948 $1,590.08 $438.94 $318.02
and Plasmapheresis.
0113........... Excision Lymphatic System T............... 21.4653 $1,273.82 ........... $254.76
0114........... Thyroid/Lymphadenectomy T............... 40.7652 $2,419.13 $485.91 $483.83
Procedures.
0115........... Cannula/Access Device T............... 31.4727 $1,867.68 $459.35 $373.54
Procedures.
0116........... Chemotherapy S............... 1.1453 $67.97 ........... $13.59
Administration by Other
Technique Except
Infusion.
0117........... Chemotherapy S............... 3.2378 $192.14 $42.54 $38.43
Administration by
Infusion Only.
0120........... Infusion Therapy Except S............... 2.0193 $119.83 $28.21 $23.97
Chemotherapy.
0121........... Level I Tube changes and T............... 2.2766 $135.10 $43.80 $27.02
Repositioning.
0122........... Level II Tube changes and T............... 6.9721 $413.75 $84.85 $82.75
Repositioning.
0123........... Bone Marrow Harvesting S............... 22.9902 $1,364.31 ........... $272.86
and Bone Marrow/Stem
Cell Transplant.
0125........... Refilling of Infusion T............... 1.9331 $114.72 ........... $22.94
Pump.
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 T............... 5.4737 $324.83 $94.18 $64.97
without Endoscopy.
0141........... Level I Upper GI T............... 8.1835 $485.63 $143.38 $97.13
Procedures.
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 T............... 4.6374 $275.20 $64.40 $55.04
Anoscopy.
0147........... Level II Sigmoidoscopy T............... 7.9679 $472.84 ........... $94.57
and Anoscopy.
0148........... Level I Anal/Rectal T............... 3.7383 $221.84 $57.21 $44.37
Procedures.
0149........... Level III Anal/Rectal T............... 18.0726 $1,072.48 $293.06 $214.50
Procedures.
0150........... Level IV Anal/Rectal T............... 23.8654 $1,416.24 $437.12 $283.25
Procedures.
0151........... Endoscopic Retrograde T............... 18.7338 $1,111.72 $245.46 $222.34
Cholangio-
Pancreatography (ERCP).
0152........... Level I Percutaneous T............... 12.2833 $728.93 ........... $145.79
Abdominal and Biliary
Procedures.
0153........... Peritoneal and Abdominal T............... 21.6961 $1,287.51 $382.75 $257.50
Procedures.
0154........... Hernia/Hydrocele T............... 28.7847 $1,708.17 $464.85 $341.63
Procedures.
0155........... Level II Anal/Rectal T............... 16.2546 $964.60 ........... $192.92
Procedures.
0156........... Level II Urinary and Anal T............... 2.5751 $152.81 $40.52 $30.56
Procedures.
0157........... Colorectal Cancer S............... 2.2904 $135.92 ........... $27.18
Screening: Barium Enema.
0158........... Colorectal Cancer T............... 7.6588 $454.50 ........... $113.63
Screening: Colonoscopy.
0159........... Colorectal Cancer S............... 3.1455 $186.66 ........... $46.67
Screening: Flexible
Sigmoidoscopy.
0160........... Level I Cystourethroscopy T............... 6.6753 $396.13 $105.06 $79.23
and other Genitourinary
Procedures.
0161........... Level II T............... 18.5576 $1,101.26 $249.36 $220.25
Cystourethroscopy and
other Genitourinary
Procedures.
0162........... Level III T............... 23.3918 $1,388.14 ........... $277.63
Cystourethroscopy and
other Genitourinary
Procedures.
0163........... Level IV T............... 33.7354 $2,001.96 ........... $400.39
Cystourethroscopy and
other Genitourinary
Procedures.
0164........... Level I Urinary and Anal T............... 1.1855 $70.35 $17.29 $14.07
Procedures.
[[Page 50686]]
0165........... Level III Urinary and T............... 16.6689 $989.18 ........... $197.84
Anal Procedures.
0166........... Level I Urethral T............... 17.6743 $1,048.85 $218.73 $209.77
Procedures.
0168........... Level II Urethral T............... 28.2685 $1,677.54 $388.03 $335.51
Procedures.
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 T............... 23.6415 $1,402.96 ........... $280.59
Procedures.
0184........... Prostate Biopsy.......... T............... 4.3566 $258.53 $96.27 $51.71
0188........... Level II Female T............... 1.1400 $67.65 ........... $13.53
Reproductive Proc.
0189........... Level III Female T............... 2.3710 $140.70 ........... $28.14
Reproductive Proc.
0190........... Level I Hysteroscopy..... T............... 21.0653 $1,250.08 $424.28 $250.02
0191........... Level I Female T............... 0.1670 $9.91 $2.78 $1.98
Reproductive Proc.
0192........... Level IV Female T............... 4.3082 $255.66 ........... $51.13
Reproductive Proc.
0193........... Level V Female T............... 14.5843 $865.48 ........... $173.10
Reproductive Proc.
0194........... Level VIII Female T............... 20.7525 $1,231.52 $397.84 $246.30
Reproductive Proc.
0195........... Level IX Female T............... 26.6791 $1,583.22 $483.80 $316.64
Reproductive Proc.
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 T............... 1.3683 $81.20 $32.19 $16.24
Care Procedures.
0200........... Level VII Female T............... 17.8728 $1,060.63 $263.69 $212.13
Reproductive Proc.
0201........... Level VI Female T............... 17.6047 $1,044.72 $329.65 $208.94
Reproductive Proc.
0202........... Level X Female T............... 40.3866 $2,396.66 $958.66 $479.33
Reproductive Proc.
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 T............... 6.0109 $356.70 $86.92 $71.34
Injections.
0208........... Laminotomies and T............... 42.3409 $2,512.64 ........... $502.53
Laminectomies.
0209........... Extended EEG Studies and S............... 11.5713 $686.68 $274.67 $137.34
Sleep Studies, Level II.
0212........... Nervous System Injections T............... 2.9740 $176.49 $70.59 $35.30
0213........... Extended EEG Studies and S............... 2.2932 $136.09 $54.43 $27.22
Sleep Studies, Level I.
0214........... Electroencephalogram..... S............... 1.1353 $67.37 $26.94 $13.47
0215........... Level I Nerve and Muscle S............... 0.6115 $36.29 $14.51 $7.26
Tests.
0216........... Level III Nerve and S............... 2.6720 $158.56 ........... $31.71
Muscle Tests.
0218........... Level II Nerve and Muscle S............... 1.1408 $67.70 ........... $13.54
Tests.
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 T............... 179.0982 $10,628.22 ........... $2,125.64
Neurological Device.
0223........... Implantation or Revision T............... 28.1230 $1,668.90 ........... $333.78
of Pain Management
Catheter.
0224........... Implantation of Reservoir/ T............... 40.6455 $2,412.03 ........... $482.41
Pump/Shunt.
0225........... Level II Implantation of S............... 234.6925 $13,927.36 ........... $2,785.47
Neurostimulator
Electrodes.
0226........... Implantation of Drug T............... 138.8695 $8,240.93 ........... $1,648.19
Infusion Reservoir.
0227........... Implantation of Drug T............... 136.4922 $8,099.86 ........... $1,619.97
Infusion Device.
0228........... Creation of Lumbar T............... 51.7258 $3,069.56 ........... $613.91
Subarachnoid Shunt.
0229........... Transcatherter Placement T............... 64.4545 $3,824.92 $771.23 $764.98
of Intravascular Shunts.
0230........... Level I Eye Tests & S............... 0.7858 $46.63 $14.97 $9.33
Treatments.
0231........... Level III Eye Tests & S............... 1.9278 $114.40 $44.61 $22.88
Treatments.
0232........... Level I Anterior Segment T............... 6.6732 $396.01 $103.17 $79.20
Eye Procedures.
0233........... Level II Anterior Segment T............... 14.9673 $888.20 $266.33 $177.64
Eye Procedures.
0234........... Level III Anterior T............... 21.9741 $1,304.01 $511.31 $260.80
Segment Eye Procedures.
0235........... Level I Posterior Segment T............... 4.6593 $276.50 $67.40 $55.30
Eye Procedures.
0236........... Level II Posterior T............... 17.0229 $1,010.19 ........... $202.04
Segment Eye Procedures.
0237........... Level III Posterior T............... 28.9401 $1,717.39 ........... $343.48
Segment Eye Procedures.
0238........... Level I Repair and T............... 2.5933 $153.89 ........... $30.78
Plastic Eye Procedures.
0239........... Level II Repair and T............... 6.9097 $410.04 ........... $82.01
Plastic Eye Procedures.
0240........... Level III Repair and T............... 18.1508 $1,077.12 $315.31 $215.42
Plastic Eye Procedures.
0241........... Level IV Repair and T............... 23.3036 $1,382.91 $384.47 $276.58
Plastic Eye Procedures.
0242........... Level V Repair and T............... 30.5464 $1,812.72 $597.36 $362.54
Plastic Eye Procedures.
0243........... Strabismus/Muscle T............... 22.1671 $1,315.46 $431.39 $263.09
Procedures.
0244........... Corneal Transplant....... T............... 38.3723 $2,277.13 $803.26 $455.43
0245........... Level I Cataract T............... 13.3625 $792.97 $221.89 $158.59
Procedures without IOL
Insert.
0246........... Cataract Procedures with T............... 23.4597 $1,392.17 $495.96 $278.43
IOL Insert.
0247........... Laser Eye Procedures T............... 5.0330 $298.67 $104.31 $59.73
Except Retinal.
0248........... Laser Retinal Procedures. T............... 4.6769 $277.54 $93.98 $55.51
0249........... Level II Cataract T............... 27.9369 $1,657.86 $524.67 $331.57
Procedures without IOL
Insert.
0250........... Nasal Cauterization/ T............... 1.2896 $76.53 $26.79 $15.31
Packing.
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
[[Page 50687]]
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 T............... 22.2466 $1,320.18 $437.25 $264.04
Procedures.
0259........... Level VI ENT Procedures.. T............... 366.3317 $21,739.22 $8,070.21 $4,347.84
0260........... Level I Plain Film Except X............... 0.7555 $44.83 $17.93 $8.97
Teeth.
0261........... Level II Plain Film X............... 1.2901 $76.56 ........... $15.31
Except Teeth Including
Bone Density Measurement.
0262........... Plain Film of Teeth...... X............... 0.9228 $54.76 ........... $10.95
0263........... Level I Miscellaneous X............... 1.7476 $103.71 $24.40 $20.74
Radiology Procedures.
0264........... Level II Miscellaneous X............... 3.5240 $209.12 $79.41 $41.82
Radiology Procedures.
0265........... Level I Diagnostic S............... 1.0213 $60.61 $24.24 $12.12
Ultrasound.
0266........... Level II Diagnostic S............... 1.6393 $97.28 $38.91 $19.46
Ultrasound.
0267........... Level III Diagnostic S............... 2.6327 $156.23 $62.18 $31.25
Ultrasound.
0268........... Ultrasound Guidance S............... 1.0610 $62.96 ........... $12.59
Procedures.
0269........... Level III Echocardiogram S............... 3.2437 $192.49 $76.99 $38.50
Except Transesophageal.
0270........... Transesophageal S............... 6.0192 $357.20 $142.88 $71.44
Echocardiogram.
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 S............... 1.5319 $90.91 $36.36 $18.18
Radiology.
0277........... Level II Digestive S............... 2.3852 $141.54 $56.61 $28.31
Radiology.
0278........... Diagnostic Urography..... S............... 2.6434 $156.87 $62.74 $31.37
0279........... Level II Angiography and S............... 8.9319 $530.05 $150.03 $106.01
Venography except
Extremity.
0280........... Level III Angiography and S............... 20.7902 $1,233.75 $353.85 $246.75
Venography except
Extremity.
0282........... Miscellaneous S............... 1.6542 $98.17 $39.26 $19.63
Computerized Axial
Tomography.
0283........... Computerized Axial S............... 4.4253 $262.61 $105.04 $52.52
Tomography with Contrast
Material.
0284........... Magnetic Resonance S............... 6.4201 $380.99 $152.39 $76.20
Imaging and Magnetic
Resonance Angiography
with Contras.
0285........... Myocardial Positron S............... 17.1798 $1,019.50 $318.72 $203.90
Emission Tomography
(PET).
0288........... Bone Density: Axial S............... 1.2568 $74.58 ........... $14.92
Skeleton.
0296........... Level I Therapeutic S............... 2.2452 $133.24 $53.29 $26.65
Radiologic Procedures.
0297........... Level II Therapeutic S............... 5.2530 $311.73 $122.13 $62.35
Radiologic Procedures.
0299........... Miscellaneous Radiation S............... 5.8482 $347.05 ........... $69.41
Treatment.
0300........... Level I Radiation Therapy S............... 1.5198 $90.19 ........... $18.04
0301........... Level II Radiation S............... 2.2195 $131.71 ........... $26.34
Therapy.
0302........... Level III Radiation S............... 4.6145 $273.84 $103.74 $54.77
Therapy.
0303........... Treatment Device X............... 2.8356 $168.27 $66.95 $33.65
Construction.
0304........... Level I Therapeutic X............... 1.7738 $105.26 $41.52 $21.05
Radiation Treatment
Preparation.
0305........... Level II Therapeutic X............... 4.0036 $237.59 $91.38 $47.52
Radiation Treatment
Preparation.
0310........... Level III Therapeutic X............... 13.9490 $827.78 $325.27 $165.56
Radiation Treatment
Preparation.
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 T............... 290.6470 $17,247.86 ........... $3,449.57
Neurostimulator.
0320........... Electroconvulsive Therapy S............... 5.3765 $319.06 $80.06 $63.81
0321........... Biofeedback and Other S............... 1.3579 $80.58 $21.71 $16.12
Training.
0322........... Brief Individual S............... 1.2319 $73.10 ........... $14.62
Psychotherapy.
0323........... Extended Individual S............... 1.6227 $96.30 $20.08 $19.26
Psychotherapy.
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 S............... 3.2694 $194.02 $77.60 $38.80
Tomography and
Computerized Angiography
without Contras.
0333........... Computerized Axial S............... 5.2836 $313.54 $125.41 $62.71
Tomography and
Computerized Angio w/o
Contrast Material.
0335........... Magnetic Resonance S............... 5.1581 $306.10 $122.43 $61.22
Imaging, Miscellaneous.
0336........... Magnetic Resonance S............... 6.0742 $360.46 $144.18 $72.09
Imaging and Magnetic
Resonance Angiography
without Cont.
0337........... MRI and Magnetic S............... 8.7945 $521.89 $208.75 $104.38
Resonance Angiography
without Contrast
Material followed.
0339........... Observation.............. S............... 7.1403 $423.73 ........... $84.75
0340........... Minor Ancillary X............... 0.6384 $37.88 ........... $7.58
Procedures.
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 X............... 0.2277 $13.51 $3.01 $2.70
Laboratory Procedures.
0346........... Level II Transfusion X............... 0.3434 $20.38 $4.54 $4.08
Laboratory Procedures.
0347........... Level III Transfusion X............... 0.8434 $50.05 $12.35 $10.01
Laboratory Procedures.
[[Page 50688]]
0348........... Fertility Laboratory X............... 0.7927 $47.04 ........... $9.41
Procedures.
0350........... Administration of flu and X............... 0.3954 $23.46 $0.00 $0.00
PPV vaccines.
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 X............... 2.6607 $157.89 ........... $31.58
Spectacle Services.
0363........... Level I X............... 0.9128 $54.17 $17.44 $10.83
Otorhinolaryngologic
Function Tests.
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 X............... 2.1926 $130.12 ........... $26.02
Testing.
0374........... Monitoring Psychiatric X............... 1.0414 $61.80 ........... $12.36
Drugs.
0375........... Ancillary Outpatient T............... 42.5900 $2,527.42 ........... $505.48
Services When Patient
Expires.
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 S............... 5.4997 $326.37 $130.54 $65.27
Imaging.
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 S............... 75.6446 $4,488.98 ........... $897.80
Urological Procedures.
0386........... Level II Prosthetic S............... 120.1694 $7,131.21 ........... $1,426.24
Urological Procedures.
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 S............... 1.4976 $88.87 $35.54 $17.77
Medicine.
0390........... Level I Endocrine Imaging S............... 2.5562 $151.69 $60.67 $30.34
0391........... Level II Endocrine S............... 2.8774 $170.75 $68.30 $34.15
Imaging.
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 S............... 1.5192 $90.15 $36.06 $18.03
Imaging.
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 S............... 3.8559 $228.82 $91.52 $45.76
Studies Level I.
0405........... Renal and Genitourinary S............... 4.2674 $253.24 $101.29 $50.65
Studies Level II.
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 T............... 22.0955 $1,311.21 $459.92 $262.24
Airway.
0416........... Level I Intravascular and S............... 19.5542 $1,160.40 ........... $232.08
Intracardiac Ultrasound
and Flow Reserve.
0417........... Computerized S............... 4.0750 $241.82 ........... $48.36
Reconstruction.
0418........... Insertion of Left T............... 109.3043 $6,486.45 ........... $1,297.29
Ventricular Pacing Elect.
0421........... Prolonged Physiologic X............... 1.6600 $98.51 ........... $19.70
Monitoring.
0422........... Level II Upper GI T............... 22.9647 $1,362.79 $448.81 $272.56
Procedures.
0423........... Level II Percutaneous T............... 40.2866 $2,390.73 ........... $478.15
Abdominal and Biliary
Procedures.
0425........... Level II Arthroplasty T............... 100.2058 $5,946.51 $1,378.01 $1,189.30
with Prosthesis.
0426........... Level II Strapping and S............... 2.1243 $126.06 ........... $25.21
Cast Application.
0427........... Level III Tube Changes T............... 10.1977 $605.16 $124.11 $121.03
and Repositioning.
0428........... Level III Sigmoidoscopy T............... 19.9022 $1,181.06 ........... $236.21
and Anoscopy.
0429........... Level V Cystourethroscopy T............... 42.3147 $2,511.08 ........... $502.22
and other Genitourinary
Procedures.
0430........... Level IV Nerve and Muscle T............... 11.4040 $676.75 ........... $135.35
Tests.
0432........... Health and Behavior S............... 0.6949 $41.24 ........... $8.25
Services.
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
[[Page 50689]]
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 V............... 1.2947 $76.83 $19.48 $15.37
Visits.
0611........... Mid Level Emergency V............... 2.2718 $134.82 $35.76 $26.96
Visits.
0612........... High Level Emergency V............... 3.9853 $236.50 $54.12 $47.30
Visits.
0620........... Critical Care............ S............... 8.2996 $492.52 $135.68 $98.50
0621........... Level I Vascular Access T............... 8.2986 $492.46 ........... $98.49
Procedures.
0622........... Level II Vascular Access T............... 21.2671 $1,262.05 ........... $252.41
Procedures.
0623........... Level III Vascular Access T............... 27.1105 $1,608.82 ........... $321.76
Procedures.
0648........... Breast Reconstruction T............... 50.4459 $2,993.61 ........... $598.72
with Prosthesis.
0651........... Complex Interstitial S............... 12.1448 $720.71 ........... $144.14
Radiation Source
Application.
0652........... Insertion of T............... 28.8948 $1,714.70 ........... $342.94
Intraperitoneal
Catheters.
0653........... Vascular Reconstruction/ T............... 30.5339 $1,811.97 ........... $362.39
Fistula Repair with
Device.
0654........... Insertion/Replacement of T............... 100.9294 $5,989.45 ........... $1,197.89
a permanent dual chamber
pacemaker.
0655........... Insertion/Replacement/ T............... 133.7768 $7,938.72 ........... $1,587.74
Conversion of a
permanent dual chamber
pacemaker.
0656........... Transcatheter Placement T............... 109.9237 $6,523.20 ........... $1,304.64
of Intracoronary Drug-
Eluting Stents.
0657........... Placement of Tissue Clips S............... 1.7092 $101.43 ........... $20.29
0658........... Percutaneous Breast T............... 6.1049 $362.28 ........... $72.46
Biopsies.
0659........... Hyperbaric Oxygen........ S............... 1.5473 $91.82 ........... $18.36
0660........... Level II X............... 1.6419 $97.44 $30.66 $19.49
Otorhinolaryngologic
Function Tests.
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 S............... 12.9439 $768.13 ........... $153.63
Radiation Therapy.
0665........... Bone Density: S............... 0.6464 $38.36 ........... $7.67
AppendicularSkeleton.
0667........... Level II Proton Beam S............... 15.4857 $918.97 ........... $183.79
Radiation Therapy.
0668........... Level I Angiography and S............... 6.5024 $385.87 $114.67 $77.17
Venography except
Extremity.
0670........... Level II Intravascular S............... 25.4131 $1,508.09 $472.46 $301.62
and Intracardiac
Ultrasound and Flow
Reserve.
0671........... Level II Echocardiogram S............... 1.7028 $101.05 $40.42 $20.21
Except Transesophageal.
0672........... Level IV Posterior T............... 36.9284 $2,191.44 ........... $438.29
Segment Eye Procedures.
0673........... Level IV Anterior Segment T............... 29.2582 $1,736.27 $649.56 $347.25
Eye Procedures.
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 T............... 2.4105 $143.05 ........... $28.61
Thrombectomy.
0678........... External Counterpulsation T............... 1.7276 $102.52 ........... $20.50
0679........... Level II Resuscitation S............... 5.5774 $330.98 $95.30 $66.20
and Cardioversion.
0680........... Insertion of Patient S............... 62.9082 $3,733.16 ........... $746.63
Activated Event
Recorders.
0681........... Knee Arthroplasty........ T............... 137.1630 $8,139.66 $2,081.48 $1,627.93
0682........... Level V Debridement & T............... 6.9107 $410.10 $162.42 $82.02
Destruction.
0683........... Level II S............... 1.9006 $112.79 $25.34 $22.56
Photochemotherapy.
0685........... Level III Needle Biopsy/ T............... 6.0174 $357.09 $115.47 $71.42
Aspiration Except Bone
Marrow.
0686........... Level III Skin Repair.... T............... 13.8287 $820.64 ........... $164.13
0687........... Revision/Removal of T............... 19.2347 $1,141.44 $456.57 $228.29
Neurostimulator
Electrodes.
0688........... Revision/Removal of T............... 43.0444 $2,554.38 $1,021.75 $510.88
Neurostimulator Pulse
Generator Receiver.
0689........... Electronic Analysis of S............... 0.5735 $34.03 ........... $6.81
Cardioverter-
defibrillators.
0690........... Electronic Analysis of S............... 0.3755 $22.28 $8.91 $4.46
Pacemakers and other
Cardiac Devices.
0691........... Electronic Analysis of S............... 2.5252 $149.85 $59.94 $29.97
Programmable Shunts/
Pumps.
0692........... Electronic Analysis of S............... 2.0111 $119.34 $30.16 $23.87
Neurostimulator Pulse
Generators.
0693........... Level II Breast T............... 42.2254 $2,505.78 $798.17 $501.16
Reconstruction.
0694........... Mohs Surgery............. T............... 3.8452 $228.19 $61.86 $45.64
0695........... Level VII Debridement & T............... 20.3164 $1,205.64 $266.59 $241.13
Destruction.
0697........... Level I Echocardiogram S............... 1.5357 $91.13 $36.45 $18.23
Except Transesophageal.
0698........... Level II Eye Tests & S............... 1.2438 $73.81 $16.55 $14.76
Treatments.
0699........... Level IV Eye Tests & T............... 10.0177 $594.48 ........... $118.90
Treatments.
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 H............... ........... ........... ........... ...........
pendetide per dose.
0705........... Technetium TC99M H............... ........... ........... ........... ...........
tetrofosmin.
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 K............... ........... $9.99 ........... $2.00
inj.
[[Page 50690]]
0734........... Injection, darbepoetin K............... ........... $3.28 ........... $0.66
alfa (for non-ESRD).
0735........... Ampho b cholesteryl K............... ........... $12.24 ........... $2.45
sulfate.
0736........... Amphotericin b liposome K............... ........... $21.91 ........... $4.38
inj.
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 K............... ........... $701.76 ........... $140.35
vial.
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 K............... ........... $57.56 ........... $11.51
liposom.
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 K............... ........... $13.22 ........... $2.64
recombinant, 1 million.
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 K............... ........... $54.18 ........... $10.84
injection.
0858........... Cladribine............... K............... ........... $39.37 ........... $7.87
0860........... Plicamycin (mithramycin) K............... ........... $80.54 ........... $16.11
inj.
0861........... Leuprolide acetate K............... ........... $10.96 ........... $2.19
injection.
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, K............... ........... $8.77 ........... $1.75
human leukocyte derived,
2.
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 K............... ........... $3.34 ........... $0.67
injection.
0880........... Penicillin g benzathine K............... ........... $72.26 ........... $14.45
inj.
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 K............... ........... $290.30 ........... $58.06
globulin.
0891........... Tacrolimus oral.......... K............... ........... $3.37 ........... $0.67
0892........... Edetate calcium disodium K............... ........... $40.34 ........... $8.07
inj.
0893........... Calcitonin salmon K............... ........... $35.68 ........... $7.14
injection.
0895........... Deferoxamine mesylate inj K............... ........... $14.91 ........... $2.98
0900........... Alglucerase injection.... K............... ........... $39.94 ........... $7.99
0901........... Alpha 1 proteinase K............... ........... $3.30 ........... $0.66
inhibitor.
0902........... Botulinum toxin a, per K............... ........... $4.80 ........... $0.96
unit.
0903........... Cytomegalovirus imm IV/ K............... ........... $683.07 ........... $136.61
vial.
[[Page 50691]]
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 K............... ........... $4,318.68 ........... $863.74
implant.
0916........... Injection imiglucerase / K............... ........... $3.98 ........... $0.80
unit.
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 K............... 1.1956 $70.95 ........... $14.19
Donor, Solvent/Detergent
T.
0950........... Blood (Whole) For K............... 2.0123 $119.42 ........... $23.88
Transfusion.
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) K............... 0.5119 $30.38 ........... $6.08
5%, 50 ml.
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 K............... 2.3639 $140.28 ........... $28.06
reduced irradiated.
0969........... Red blood cell leukocyte K............... 3.6451 $216.31 ........... $43.26
reduced irradiated.
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, K............... 10.9690 $650.93 ........... $130.19
unit.
1013........... Platelet concentrate, L/ K............... 1.6023 $95.09 ........... $19.02
R, unit.
1016........... Blood, L/R, froz/ K............... 5.2631 $312.33 ........... $62.47
deglycerol/washed.
1017........... Platelets, aph/pher, L/R, K............... 8.5998 $510.34 ........... $102.07
CMV-neg, unit.
1018........... Blood, L/R, irradiated... K............... 2.8004 $166.18 ........... $33.24
1019........... Platelets, aph/pher, L/R, K............... 9.5131 $564.54 ........... $112.91
irradiated, unit.
1020........... Pit, pher, L/R, CMV, K............... 10.1551 $602.63 ........... $120.53
irrad.
1021........... RBC, frz/deg/wsh, L/R, K............... 4.8787 $289.52 ........... $57.90
irrad.
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 H............... ........... ........... ........... ...........
capsule.
1065........... I-131 sodium iodide H............... ........... ........... ........... ...........
solution.
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 K............... ........... $1.30 ........... $0.26
Nitrate.
1086........... Temozolomide,oral........ K............... ........... $7.28 ........... $1.46
1088........... Dx I131 so iodide cap H............... ........... ........... ........... ...........
millic.
1091........... IN 111 Oxyquinoline...... H............... ........... ........... ........... ...........
1092........... IN 111 Pentetate......... H............... ........... ........... ........... ...........
1093........... TC99M fanolesomab........ H............... ........... ........... ........... ...........
1096........... TC 99M Exametazime, per H............... ........... ........... ........... ...........
dose.
1150........... Th I131 so iodide sol H............... ........... ........... ........... ...........
millic.
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, K............... ........... $87.40 ........... $17.48
depot.
1210........... Inj dihydroergotamine K............... ........... $27.82 ........... $5.56
mesylt.
1280........... Corticotropin injection.. K............... ........... $95.44 ........... $19.09
[[Page 50692]]
1305........... Apligraf................. K............... 12.9222 $766.84 ........... $153.37
1330........... Ergonovine maleate K............... 0.5263 $31.23 ........... $6.25
injection.
1409........... Factor viia recombinant.. K............... ........... $1,080.11 ........... $216.02
1436........... Etidronate disodium inj.. K............... ........... $68.69 ........... $13.74
1491........... New Technology--Level I S............... ........... $5.00 ........... $1.00
($0-$10).
1492........... New Technology--Level I S............... ........... $15.00 ........... $3.00
($10-$20).
1493........... New Technology--Level I S............... ........... $25.00 ........... $5.00
($20-$30).
1494........... New Technology--Level I S............... ........... $35.00 ........... $7.00
($30-$40).
1495........... New Technology--Level I S............... ........... $45.00 ........... $9.00
($40-$50).
1496........... New Technology--Level I T............... ........... $5.00 ........... $1.00
($0-$10).
1497........... New Technology--Level I T............... ........... $15.00 ........... $3.00
($10-$20).
1498........... New Technology--Level I T............... ........... $25.00 ........... $5.00
($20-$30).
1499........... New Technology--Level I T............... ........... $35.00 ........... $7.00
($30-$40).
1500........... New Technology--Level I T............... ........... $45.00 ........... $9.00
($40-$50).
1502........... New Technology--Level II S............... ........... $75.00 ........... $15.00
($50-$100).
1503........... New Technology--Level III S............... ........... $150.00 ........... $30.00
($100-$200).
1504........... New Technology--Level IV S............... ........... $250.00 ........... $50.00
($200-$300).
1505........... New Technology--Level V S............... ........... $350.00 ........... $70.00
($300-$400).
1506........... New Technology--Level VI S............... ........... $450.00 ........... $90.00
($400-$500).
1507........... New Technology--Level VII S............... ........... $550.00 ........... $110.00
($500-$600).
1508........... New Technology--Level S............... ........... $650.00 ........... $130.00
VIII ($600-$700).
1509........... New Technology--Level IX S............... ........... $750.00 ........... $150.00
($700-$800).
1510........... New Technology--Level X S............... ........... $850.00 ........... $170.00
($800-$900).
1511........... New Technology--Level XI S............... ........... $950.00 ........... $190.00
($900-$1000).
1512........... New Technology--Level XII S............... ........... $1,050.00 ........... $210.00
($1000-$1100).
1513........... New Technology--Level S............... ........... $1,150.00 ........... $230.00
XIII ($1100-$1200).
1514........... New Technology--Level XIV S............... ........... $1,250.00 ........... $250.00
($1200-$1300).
1515........... New Technology--Level XV S............... ........... $1,350.00 ........... $270.00
($1300-$1400).
1516........... New Technology--Level XVI S............... ........... $1,450.00 ........... $290.00
($1400-$1500).
1517........... New Technology--Level S............... ........... $1,550.00 ........... $310.00
XVII ($1500-$1600).
1518........... New Technology--Level S............... ........... $1,650.00 ........... $330.00
XVIII ($1600-$1700).
1519........... New Technology--Level IXX S............... ........... $1,750.00 ........... $350.00
($1700-$1800).
1520........... New Technology--Level XX S............... ........... $1,850.00 ........... $370.00
($1800-$1900).
1521........... New Technology--Level XXI S............... ........... $1,950.00 ........... $390.00
($1900-$2000).
1522........... New Technology--Level S............... ........... $2,250.00 ........... $450.00
XXII ($2000-$2500).
1523........... New Technology--Level S............... ........... $2,750.00 ........... $550.00
XXIII ($2500-$3000).
1524........... New Technology--Level XIV S............... ........... $3,250.00 ........... $650.00
($3000-$3500).
1525........... New Technology--Level XXV S............... ........... $3,750.00 ........... $750.00
($3500-$4000).
1526........... New Technology--Level S............... ........... $4,250.00 ........... $850.00
XXVI ($4000-$4500).
1527........... New Technology--Level S............... ........... $4,750.00 ........... $950.00
XXVII ($4500-$5000).
1528........... New Technology--Level S............... ........... $5,250.00 ........... $1,050.00
XXVIII ($5000-$5500).
1529........... New Technology--Level S............... ........... $5,750.00 ........... $1,150.00
XXIX ($5500-$6000).
1530........... New Technology--Level XXX S............... ........... $6,250.00 ........... $1,250.00
($6000-$6500).
1531........... New Technology--Level S............... ........... $6,750.00 ........... $1,350.00
XXXI ($6500-$7000).
1532........... New Technology--Level S............... ........... $7,250.00 ........... $1,450.00
XXXII ($7000-$7500).
1533........... New Technology--Level S............... ........... $7,750.00 ........... $1,550.00
XXXIII ($7500-$8000).
1534........... New Technology--Level S............... ........... $8,250.00 ........... $1,650.00
XXXIV ($8000-$8500).
1535........... New Technology--Level S............... ........... $8,750.00 ........... $1,750.00
XXXV ($8500-$9000).
1536........... New Technology--Level S............... ........... $9,250.00 ........... $1,850.00
XXXVI ($9000-$9500).
1537........... New Technology--Level S............... ........... $9,750.00 ........... $1,950.00
XXXVII ($9500-$10000).
1539........... New Technology--Level II T............... ........... $75.00 ........... $15.00
($50-$100).
1540........... New Technology--Level III T............... ........... $150.00 ........... $30.00
($100-$200).
1541........... New Technology--Level IV T............... ........... $250.00 ........... $50.00
($200-$300).
1542........... New Technology--Level V T............... ........... $350.00 ........... $70.00
($300-$400).
1543........... New Technology--Level VI T............... ........... $450.00 ........... $90.00
($400-$500).
1544........... New Technology--Level VII T............... ........... $550.00 ........... $110.00
($500-$600).
1545........... New Technology--Level T............... ........... $650.00 ........... $130.00
VIII ($600-$700).
1546........... New Technology--Level IX T............... ........... $750.00 ........... $150.00
($700-$800).
1547........... New Technology--Level X T............... ........... $850.00 ........... $170.00
($800-$900).
1548........... New Technology--Level XI T............... ........... $950.00 ........... $190.00
($900-$1000).
1549........... New Technology--Level XII T............... ........... $1,050.00 ........... $210.00
($1000-$1100).
1550........... New Technology--Level T............... ........... $1,150.00 ........... $230.00
XIII ($1100-$1200).
1551........... New Technology--Level XIV T............... ........... $1,250.00 ........... $250.00
($1200- $1300).
1552........... New Technology--Level XV T............... ........... $1,350.00 ........... $270.00
($1300-$1400).
1553........... New Technology--Level XVI T............... ........... $1,450.00 ........... $290.00
($1400-$1500).
1554........... New Technology--Level T............... ........... $1,550.00 ........... $310.00
XVII ($1500-$1600).
1555........... New Technology--Level T............... ........... $1,650.00 ........... $330.00
XVIII ($1600-$1700).
1556........... New Technology--Level XIX T............... ........... $1,750.00 ........... $350.00
($1700-$1800).
1557........... New Technology--Level XX T............... ........... $1,850.00 ........... $370.00
($1800-$1900).
[[Page 50693]]
1558........... New Technology--Level XXI T............... ........... $1,950.00 ........... $390.00
($1900-$2000).
1559........... New Technology--Level T............... ........... $2,250.00 ........... $450.00
XXII ($2000-$2500).
1560........... New Technology--Level T............... ........... $2,750.00 ........... $550.00
XXIII ($2500-$3000).
1561........... New Technology--Level T............... ........... $3,250.00 ........... $650.00
XXIV ($3000-$3500).
1562........... New Technology--Level XXV T............... ........... $3,750.00 ........... $750.00
($3500-$4000).
1563........... New Technology--Level T............... ........... $4,250.00 ........... $850.00
XXVI ($4000-$4500).
1564........... New Technology--Level T............... ........... $4,750.00 ........... $950.00
XXVII ($4500-$5000).
1565........... New Technology--Level T............... ........... $5,250.00 ........... $1,050.00
XXVIII ($5000-$5500).
1566........... New Technology--Level T............... ........... $5,750.00 ........... $1,150.00
XXIX ($5500-$6000).
1567........... New Technology--Level XXX T............... ........... $6,250.00 ........... $1,250.00
($6000-$6500).
1568........... New Technology--Level T............... ........... $6,750.00 ........... $1,350.00
XXXI ($6500-$7000).
1569........... New Technology--Level T............... ........... $7,250.00 ........... $1,450.00
XXXII ($7000-$7500).
1570........... New Technology--Level T............... ........... $7,750.00 ........... $1,550.00
XXXIII ($7500-$8000).
1571........... New Technology--Level T............... ........... $8,250.00 ........... $1,650.00
XXXIV ($8000-$8500).
1572........... New Technology--Level T............... ........... $8,750.00 ........... $1,750.00
XXXV ($8500-$9000).
1573........... New Technology--Level T............... ........... $9,250.00 ........... $1,850.00
XXXVI ($9000-$9500).
1574........... New Technology--Level T............... ........... $9,750.00 ........... $1,950.00
XXXVII ($9500-$10000).
1600........... Technetium TC 99m H............... ........... ........... ........... ...........
sestamibi.
1603........... Thallous chloride TL 201. H............... ........... ........... ........... ...........
1604........... IN 111 capromab H............... ........... ........... ........... ...........
pendetide, per dose.
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, K............... ........... $12.04 ........... $2.41
sd.
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, K............... ........... $0.74 ........... $0.15
per iu.
1619........... Gallium ga 67............ H............... ........... ........... ........... ...........
1620........... Technetium tc99m bicisate H............... ........... ........... ........... ...........
1622........... Technetium tc99m H............... ........... ........... ........... ...........
mertiatide.
1624........... Sodium phosphate p32..... H............... ........... ........... ........... ...........
1625........... Indium 111-in H............... ........... ........... ........... ...........
pentetreotide.
1628........... Chromic phosphate p32.... H............... ........... ........... ........... ...........
1655........... Tinzaparin sodium K............... ........... $2.53 ........... $0.51
injection.
1670........... Tetanus immune globulin K............... ........... $76.90 ........... $15.38
inj.
1716........... Brachytx source, Gold 198 H............... ........... ........... ........... ...........
1717........... Brachytx source, HDR Ir- H............... ........... ........... ........... ...........
192.
1718........... Brachytx source, Iodine H............... ........... ........... ........... ...........
125.
1719........... Brachytx sour, Non-HDR Ir- H............... ........... ........... ........... ...........
192.
1720........... Brachytx sour, Palladium H............... ........... ........... ........... ...........
103.
1740........... Diazoxide injection...... K............... ........... $113.86 ........... $22.77
1775........... FDG, per dose (4-40 mCi/ H............... ........... ........... ........... ...........
ml).
2210........... Methyldopate hcl K............... ........... $9.58 ........... $1.92
injection.
2616........... Brachytx source, Yttrium- H............... ........... ........... ........... ...........
90.
2632........... Brachytx sol, I-125, per H............... ........... ........... ........... ...........
mCi.
2633........... Brachytx source, Cesium- H............... ........... ........... ........... ...........
131.
2634........... Brachytx source, HA, I- H............... ........... ........... ........... ...........
125.
2635........... Brachytx source, HA, P- H............... ........... ........... ........... ...........
103.
2636........... Brachytx linear source, P- H............... ........... ........... ........... ...........
103.
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 K............... ........... $386.53 ........... $77.31
triflutat.
7025........... Digoxin immune FAB K............... ........... $552.18 ........... $110.44
(ovine).
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
[[Page 50694]]
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 K............... ........... $365.64 ........... $73.13
inj.
7048........... Alteplase recombinant.... K............... ........... $30.65 ........... $6.13
7049........... Filgrastim injection..... K............... ........... $282.29 ........... $56.46
7051........... Leuprolide acetate K............... ........... $2,262.19 ........... $452.44
implant.
7308........... Aminolevulinic acid hcl K............... ........... $96.79 ........... $19.36
top.
7316........... Sodium hyaluronate K............... ........... $110.65 ........... $22.13
injection.
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- K............... 0.2447 $14.52 ........... $2.90
500mcg.
9009........... Baclofen refill kit--per K............... 0.7209 $42.78 ........... $8.56
2000 mcg.
9012........... Arsenic Trioxide......... K............... ........... $33.76 ........... $6.75
9015........... Mycophenolate mofetil K............... ........... $2.50 ........... $0.50
oral.
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- K............... ........... $89.10 ........... $17.82
a.
9023........... Rho d immune globulin.... K............... ........... $25.08 ........... $5.02
9024........... Amphotericin b lipid K............... ........... $11.95 ........... $2.39
complex.
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 K............... ........... $243.34 ........... $48.67
injection.
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 K............... ........... $15.69 ........... $3.14
tissue.
9055........... Injectable human tissue.. K............... ........... $3.54 ........... $0.71
9057........... Lepirudin................ K............... ........... $128.17 ........... $25.63
9100........... Iodinated I-131 H............... ........... ........... ........... ...........
serumalbumin, per 5uci.
9104........... Anti-thymocycte globulin K............... ........... $299.47 ........... $59.89
rabbit.
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 K............... ........... $63.51 ........... $12.70
micros, ml.
9114........... Nesiritide............... K............... ........... $75.19 ........... $15.04
9115........... Inj, zoledronic acid..... K............... ........... $202.41 ........... $40.48
9117........... Yttrium 90 ibritumomab H............... ........... ........... ........... ...........
tiuxetan.
9118........... In-111 ibritumomab H............... ........... ........... ........... ...........
tiuxetan.
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 H............... ........... ........... ........... ...........
0.25mCi.
9132........... 51 Na Chromate, 50mCi.... H............... ........... ........... ........... ...........
9133........... Rabies ig, im/sc......... K............... ........... $64.56 ........... $12.91
[[Page 50695]]
9134........... Rabies ig, heat treated.. K............... ........... $69.79 ........... $13.96
9135........... Varicella-zoster ig, im.. K............... ........... $96.58 ........... $19.32
9136........... Adenovirus vaccine, type K............... 0.9499 $56.37 ........... $11.27
4.
9137........... Bcg vaccine, percut...... K............... ........... $124.54 ........... $24.91
9138........... Hep a/hep b vacc, adult K............... 0.9674 $57.41 ........... $11.48
im.
9139........... Rabies vaccine, im....... K............... ........... $128.04 ........... $25.61
9140........... Rabies vaccine, id....... K............... 1.4959 $88.77 ........... $17.75
9141........... Measles-rubella vaccine, K............... 0.9467 $56.18 ........... $11.24
sc.
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 H............... ........... ........... ........... ...........
Disofenin.
9147........... Technetium TC 99M H............... ........... ........... ........... ...........
Depreotide.
9148........... I-123 sodium iodide H............... ........... ........... ........... ...........
capsule.
9149........... Dx I131 so iodide H............... ........... ........... ........... ...........
microcurie.
9150........... I-125 serum albumin micro H............... ........... ........... ........... ...........
9151........... Tc 99M ARCITUMOMAB PER H............... ........... ........... ........... ...........
VIAL.
9152........... Baclofen Intrathecal kit- K............... 0.8562 $50.81 ........... $10.16
1am.
9153........... Na Iothalamate I-125, 10 H............... ........... ........... ........... ...........
uCi.
9154........... Technetium tc99m H............... ........... ........... ........... ...........
glucepatate.
9155........... Technetium H............... ........... ........... ........... ...........
tc99mlabeledrbcs.
9156........... Nonmetabolic active K............... ........... $53.76 ........... $10.75
tissue.
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 K............... ........... $41.42 ........... $8.28
mic,ml.
9203........... Inj Perflexane lipid K............... ........... $13.49 ........... $2.70
micros, ml.
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 K............... ........... $123.35 ........... $24.67
beta.
9209........... Injection, laronidase.... K............... ........... $23.16 ........... $4.63
9210........... Injection, palonosetron K............... ........... 18.42 ........... $3.68
HCL.
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 K............... ........... $230.87 ........... $46.17
suspnsion.
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, K............... 8.1495 $483.62 ........... $96.72
leukocytes reduced.
9502........... Platelet pheresis K............... 5.1895 $307.96 ........... $61.59
irradiated.
9503........... Fresh frozen plasma, ea K............... 1.6241 $96.38 ........... $19.28
unit.
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 K............... 1.2038 $71.44 ........... $14.29
hours.
----------------------------------------------------------------------------------------------------------------
[[Page 50696]]
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.
Addendum B.--Payment Status by HCPCS Code and Related Information Calendar Year 2006
--------------------------------------------------------------------------------------------------------------------------------------------------------
National Minimum
CPT/HCPCS SI CI Description APC Relative Payment unadjusted unadjusted
weight rate copayment 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. ........... ........... ........... ........... ...........
[[Page 50697]]
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 annulus>1lev... 0203 10.4015 $617.26 $246.90 $123.45
00640................. N.............. ............... Anesth, spine manipulation... ........... ........... ........... ........... ...........
0064T................. A.............. ............... Spectroscop eval expired gas. ........... ........... ........... ........... ...........
[[Page 50698]]
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.............. ............... S&i 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 s&i... ........... ........... ........... ........... ...........
00810................. N.............. ............... Anesth, low intestine scope.. ........... ........... ........... ........... ...........
0081T................. C.............. ............... Endovasc visc extnsn s&i..... ........... ........... ........... ........... ...........
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..... ........... ........... ........... ........... ...........
[[Page 50699]]
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.. ........... ........... ........... ........... ...........
[[Page 50700]]
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.. ........... ........... ........... ........... ...........
[[Page 50701]]
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
[[Page 50702]]
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
[[Page 50703]]
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
[[Page 50704]]
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
[[Page 50705]]
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
[[Page 50706]]
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........ ........... ........... ........... ........... ...........
[[Page 50707]]
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
[[Page 50708]]
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
[[Page 50709]]
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
[[Page 50710]]
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.... ........... ........... ........... ........... ...........
[[Page 50711]]
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.............. ........... ........... ........... ........... ...........
[[Page 50712]]
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
[[Page 50713]]
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
[[Page 50714]]
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
[[Page 50715]]
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
[[Page 50716]]
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
[[Page 50717]]
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
[[Page 50718]]
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
[[Page 50719]]
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
[[Page 50720]]
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
[[Page 50721]]
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
[[Page 50722]]
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
[[Page 50723]]
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
[[Page 50724]]
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
[[Page 50725]]
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
[[Page 50726]]
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
[[Page 50727]]
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
[[Page 50728]]
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
[[Continued on page 50729]]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
]
[[pp. 50729-50778]] Medicare Program; Proposed Changes to the Hospital Outpatient
Prospective Payment System and Calendar Year 2006 Payment Rates;
Correction
[[Continued from page 50728]]
[[Page 50729]]
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
[[Page 50730]]
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
[[Page 50731]]
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.... ........... ........... ........... ........... ...........
[[Page 50732]]
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
[[Page 50733]]
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.............. .............