CodeMap® 




2017 ICD-10 Diagnosis Code Set Loaded     


4/3/2017 NCD Edits Loaded     


2017 Lab Fee Schedule     


2017-B DME Fee Schedule     


2017-A PEN Fee Schedule-no changes for Q2/2017     


2017 April ASC Fee Schedule Updated     


April 2017 ASP Drug Pricing Updated     


Q2 2017 CCI Edits Loaded     


Q2 2017 MUE Edits Loaded     


LCD Database Current Through 05/15/2017     

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Laboratory Fee Schedule

2017
2016

Physician Fee Schedule

2017
2016

OPPS Fee Schedule

2017
2016

ASC Fee Schedule

2017
2016

APC Codes

2017
2016

ASP Drug Pricing Files




2016 Outpatient Prospective Payment System (OPPS)


2016 Wage Index Adjustment for OPPS Payments Zip Code:

Procedure
Short Descriptor
Unadjusted 2016 OPPS Fee
Schedule
Status Indicator
APC
0058T
Cryopreservation ovary tiss
$102.20
Q1
5672
0071T
Us leiomyomata ablate <200
$1861.18
T
5414
0072T
Us leiomyomata ablate >200
$1861.18
T
5414
0100T
Prosth retina receive&gen
$95000.00
T
1599
0101T
Extracorp shockwv tx hi enrg
$1455.26
T
5121
0102T
Extracorp shockwv tx anesth
$2395.59
T
5122
0106T
Touch quant sensory test
$30.51
Q1
5732
0107T
Vibrate quant sensory test
$30.51
Q1
5732
0108T
Cool quant sensory test
$55.94
Q1
5733
0109T
Heat quant sensory test
$30.51
Q1
5732
0110T
Nos quant sensory test
$91.18
Q1
5734
0126T
Chd risk imt study
$30.51
Q1
5732
0171T
Lumbar spine proces distract
$10537.90
J1
5125
0179T
64 lead ecg w/tracing
$30.51
Q1
5732
0184T
Exc rectal tumor endoscopic
$3613.57
J1
5331
0191T
Insert ant segment drain int
$3380.77
J1
5492
0198T
Ocular blood flow measure
$55.94
Q1
5733
0200T
Perq sacral augmt unilat inj
$2395.59
T
5122
0201T
Perq sacral augmt bilat inj
$2395.59
T
5122
0206T
Cptr dbs alys car elec dta
$55.94
Q1
5733
0207T
Clear eyelid gland w/heat
$91.18
Q1
5734
0208T
Audiometry air only
$30.51
Q1
5732
0209T
Audiometry air & bone
$30.51
Q1
5732
0210T
Speech audiometry threshold
$30.51
Q1
5732
0211T
Speech audiom thresh & recog
$30.51
Q1
5732
0212T
Compre audiometry evaluation
$129.75
Q1
5721
0213T
Njx paravert w/us cer/thor
$822.10
T
5443
0216T
Njx paravert w/us lumb/sac
$822.10
T
5443
0221T
Plmt post facet implt lumb
$2395.59
T
5122
0228T
Njx tfrml eprl w/us cer/thor
$585.17
T
5442
0230T
Njx tfrml eprl w/us lumb/sac
$822.10
T
5443
0232T
Njx platelet plasma
$91.18
Q1
5734
0234T
Trluml perip athrc renal art
$9542.35
J1
5192
0236T
Trluml perip athrc abd aorta
$9542.35
J1
5192
0237T
Trluml perip athrc brchiocph
$9542.35
J1
5192
0238T
Trluml perip athrc iliac art
$14612.17
J1
5193
0249T
Ligation hemorrhoid w/us
$2326.64
T
5314
0253T
Insert aqueous drain device
$3380.77
J1
5492
0263T
Im b1 mrw cel ther cmpl
$3015.06
S
5281
0264T
Im b1 mrw cel ther xcl hrvst
$3015.06
S
5281
0265T
Im b1 mrw cel ther hrvst onl
$3015.06
S
5281
0267T
Implt/rpl crtd sns dev lead
$2188.64
T
5461
0268T
Implt/rpl crtd sns dev gen
$17359.37
J1
5463
0269T
Rev/remvl crtd sns dev total
$3396.78
Q2
5432
0270T
Rev/remvl crtd sns dev lead
$2188.64
Q2
5461
0271T
Rev/remvl crtd sns dev gen
$2188.64
Q2
5461
0272T
Interrogate crtd sns dev
$129.75
S
5721
0273T
Interrogate crtd sns w/pgrmg
$129.75
S
5721
0274T
Perq lamot/lam crv/thrc
$4969.26
J1
5123
0275T
Perq lamot/lam lumbar
$4969.26
J1
5123
0278T
Tempr
$129.75
Q1
5721
0282T
Periph field stimul trial
$5244.37
J1
5462
0283T
Periph field stimul perm
$26728.39
J1
5464
0284T
Periph field stimul revise
$2188.64
Q2
5461
0285T
Periph field stimul analys
$856.44
S
5724
0288T
Anoscopy w/rf delivery
$2326.64
T
5314
0296T
Ext ecg recording
$91.18
Q1
5734
0297T
Ext ecg scan w/report
$91.18
Q1
5734
0299T
Esw wound healing init wound
$225.55
T
5052
0301T
Mw therapy for breast tumor
$2187.94
T
5091
0302T
Icar ischm mntrng sys compl
$9273.40
J1
5223
0303T
Icar ischm mntrng sys eltrd
$6696.85
J1
5222
0304T
Icar ischm mntrng sys device
$6696.85
J1
5222
0305T
Icar ischm mntrng prgrm eval
$33.62
Q1
5741
0306T
Icar ischm mntr interr eval
$33.62
Q1
5741
0307T
Rmvl icar ischm mntrng dvce
$2489.69
Q2
5221
0308T
Insj ocular telescope prosth
$17550.83
J1
5494
0310T
Motor function mapping ntms
$129.75
S
5721
0312T
Laps impltj nstim vagus
$26728.39
J1
5464
0313T
Laps rmvl nstim array vagus
$2188.64
T
5461
0314T
Laps rmvl vgl arry&pls gen
$2188.64
Q2
5461
0315T
Rmvl vagus nerve pls gen
$2188.64
Q2
5461
0316T
Replc vagus nerve pls gen
$26728.39
J1
5464
0317T
Elec alys vagus nrv pls gen
$33.62
Q1
5741
0330T
Tear film img uni/bi w/i&r
$30.51
Q1
5732
0331T
Heart symp image plnr
$1108.46
S
5593
0332T
Heart symp image plnr spect
$1108.46
S
5593
0335T
Extraosseous joint stblztion
$2395.59
T
5122
0336T
Lap ablat uterine fibroids
$6860.91
J1
5362
0337T
Endothel fxnassmnt non-invas
$55.94
Q1
5733
0338T
Trnscth renal symp denrv unl
$4592.15
J1
5191
0339T
Trnscth renal symp denrv bil
$4592.15
J1
5191
0340T
Ablate pulm tumors + extnsn
$4118.23
T
5352
0342T
Thxp apheresis w/hdl delip
$3015.06
S
5281
0347T
Ins bone device for rsa
$55.94
Q1
5733
0348T
Rsa spine exam
$100.69
Q1
5522
0349T
Rsa upper extr exam
$100.69
Q1
5522
0350T
Rsa lower extr exam
$60.80
Q1
5521
0355T
Gi tract capsule endoscopy
$745.36
T
5301
0356T
Insrt drug device for iop
$55.94
Q1
5733
0357T
Cryopreservation oocyte(s)
$102.20
Q1
5672
0358T
Bia whole body
$30.51
Q1
5732
0359T
Behavioral id assessment
$102.12
V
5012
0360T
Observ behav assessment
$102.12
V
5012
0362T
Expose behav assessment
$102.12
V
5012
0364T
Adaptive behavior treatment
$125.04
S
5841
0366T
Group behavior treatment
$125.04
S
5841
0368T
Behavior treatment modified
$125.04
S
5841
0370T
Fam behav treatment guidance
$125.04
S
5841
0371T
Mult fam behav treat guide
$125.04
S
5841
0372T
Social skills training group
$125.04
S
5841
0373T
Exposure behavior treatment
$125.04
S
5841
0377T
Anoscpy inj agent for incont
$2326.64
T
5314
0379T
Vis field assmnt tech suppt
$30.51
Q1
5732
0380T
Comp animat ret imag series
$30.51
Q1
5732
0387T
Leadless c pm ins/rpl ventr
$14612.17
J1
5193
0388T
Leadless c pm remove ventr
$2247.33
T
5182
0389T
Prog eval inper leadls pm
$33.62
Q1
5741
0391T
Intergt eval inper leadls pm
$33.62
Q1
5741
0392T
Lap es sph augment dev place
$6860.91
J1
5362
0393T
Es sph augmnt device removal
$4001.15
Q2
5361
0394T
Hdr elctrnc skn surf brchytx
$194.35
S
5622
0395T
Hdr elctr ntrst/ntrcv brchtx
$696.21
S
5624
0402T
Collagen crosslinking cornea
$696.71
T
5502
0404T
Trnscrv uterin fibroid abltj
$5698.95
J1
5416
0408T
Insj/rplc cardiac modulj sys
$21930.03
J1
5231
0409T
Insj/rplc cardiac modulj pls gn
$21930.03
J1
5231
0410T
Insj/rplc car modulj atr elt
$6696.85
J1
5222
0411T
Insj/rplc car modulj vnt elt
$6696.85
J1
5222
0412T
Rmvl cardiac modulj pls gen
$2489.69
Q2
5221
0413T
Rmvl car modulj tranvns elt
$2489.69
Q2
5221
0414T
Rmvl & rpl car modulj pls gn
$21930.03
J1
5231
0415T
Repos car modulj tranvns elt
$862.51
T
5181
0416T
Reloc skin pocket pls gen
$1411.21
T
5054
0417T
Prgrmg eval cardiac modulj
$33.62
Q1
5741
0418T
Interro eval cardiac modulj
$33.62
Q1
5741
0419T
Dstrj neurofibromata xtnsv
$428.67
T
5053
0420T
Dstrj neurofibromata xtnsv
$428.67
T
5053
0422T
Tactile breast img uni/bi
$92.07
Q1
5531
0424T
Insj/rplc nstim apnea compl
$26728.39
T
5464
0425T
Insj/rplc nstim apnea sen ld
$5244.37
T
5462
0426T
Insj/rplc nstim apnea stm ld
$17359.37
T
5463
0427T
Insj/rplc nstim apnea pls gn
$17359.37
T
5463
0428T
Rmvl nstim apnea pls gen
$2188.64
Q2
5461
0429T
Rmvl nstim apnea sen ld
$2188.64
Q2
5461
0430T
Rmvl nstim apnea stimj ld
$2188.64
Q2
5461
0431T
Rmvl/rplc nstim apnea pls gn
$17359.37
T
5463
0432T
Repos nstim apnea stimj ld
$2188.64
T
5461
0433T
Repos nstim apnea sensing ld
$2188.64
T
5461
0434T
Interro eval npgs sleep apnea
$106.44
S
5742
0435T
Prgrmg eval npgs apnea 1 ses
$106.44
S
5742
0436T
Prgrmg eval npgs apnea study
$856.44
S
5724
10021
Fna w/o image
$225.55
T
5052
10022
Fna w/image
$480.64
T
5072
10030
Guide cathet fluid drainage
$941.98
T
5073
10035
Perq dev soft tiss 1st imag
$480.64
T
5072
10040
Acne surgery
$117.83
Q1
5051
10060
Drainage of skin abscess
$117.83
T
5051
10061
Drainage of skin abscess
$228.27
T
5071
10080
Drainage of pilonidal cyst
$228.27
T
5071
10081
Drainage of pilonidal cyst
$480.64
T
5072
10120
Remove foreign body
$225.55
T
5052
10121
Remove foreign body
$1414.28
T
5074
10140
Drainage of hematoma/fluid
$941.98
T
5073
10160
Puncture drainage of lesion
$228.27
T
5071
10180
Complex drainage wound
$1414.28
T
5074
11000
Debride infected skin
$428.67
T
5053
11010
Debride skin at fx site
$941.98
T
5073
11011
Debride skin musc at fx site
$228.27
T
5071
11012
Deb skin bone at fx site
$1414.28
T
5074
11042
Deb subq tissue 20 sq cm/<
$225.55
T
5052
11043
Deb musc/fascia 20 sq cm/<
$428.67
T
5053
11044
Deb bone 20 sq cm/<
$941.98
T
5073
11055
Trim skin lesion
$117.83
Q1
5051
11056
Trim skin lesions 2 to 4
$117.83
Q1
5051
11057
Trim skin lesions over 4
$225.55
T
5052
11100
Biopsy skin lesion
$225.55
T
5052
11200
Removal of skin tags
$117.83
Q1
5051
11300
Shave skin lesion 0.5 cm/<
$117.83
Q1
5051
11301
Shave skin lesion 0.6-1.0 cm
$117.83
Q1
5051
11302
Shave skin lesion 1.1-2.0 cm
$117.83
Q1
5051
11303
Shave skin lesion >2.0 cm
$117.83
Q1
5051
11305
Shave skin lesion 0.5 cm/<
$117.83
Q1
5051
11306
Shave skin lesion 0.6-1.0 cm
$117.83
Q1
5051
11307
Shave skin lesion 1.1-2.0 cm
$225.55
T
5052
11308
Shave skin lesion >2.0 cm
$117.83
Q1
5051
11310
Shave skin lesion 0.5 cm/<
$225.55
T
5052
11311
Shave skin lesion 0.6-1.0 cm
$225.55
T
5052
11312
Shave skin lesion 1.1-2.0 cm
$225.55
T
5052
11313
Shave skin lesion >2.0 cm
$225.55
T
5052
11400
Exc tr-ext b9+marg 0.5 cm<
$480.64
T
5072
11401
Exc tr-ext b9+marg 0.6-1 cm
$480.64
T
5072
11402
Exc tr-ext b9+marg 1.1-2 cm
$480.64
T
5072
11403
Exc tr-ext b9+marg 2.1-3cm/<
$941.98
T
5073
11404
Exc tr-ext b9+marg 3.1-4 cm
$941.98
T
5073
11406
Exc tr-ext b9+marg >4.0 cm
$1414.28
T
5074
11420
Exc h-f-nk-sp b9+marg 0.5/<
$941.98
T
5073
11421
Exc h-f-nk-sp b9+marg 0.6-1
$941.98
T
5073
11422
Exc h-f-nk-sp b9+marg 1.1-2
$941.98
T
5073
11423
Exc h-f-nk-sp b9+marg 2.1-3
$941.98
T
5073
11424
Exc h-f-nk-sp b9+marg 3.1-4
$1414.28
T
5074
11426
Exc h-f-nk-sp b9+marg >4 cm
$1414.28
T
5074
11440
Exc face-mm b9+marg 0.5 cm/<
$480.64
T
5072
11441
Exc face-mm b9+marg 0.6-1 cm
$480.64
T
5072
11442
Exc face-mm b9+marg 1.1-2 cm
$941.98
T
5073
11443
Exc face-mm b9+marg 2.1-3 cm
$941.98
T
5073
11444
Exc face-mm b9+marg 3.1-4 cm
$941.98
T
5073
11446
Exc face-mm b9+marg >4 cm
$1414.28
T
5074
11450
Removal sweat gland lesion
$1414.28
T
5074
11451
Removal sweat gland lesion
$1414.28
T
5074
11462
Removal sweat gland lesion
$1414.28
T
5074
11463
Removal sweat gland lesion
$1414.28
T
5074
11470
Removal sweat gland lesion
$1414.28
T
5074
11471
Removal sweat gland lesion
$1414.28
T
5074
11600
Exc tr-ext mal+marg 0.5 cm/<
$941.98
T
5073
11601
Exc tr-ext mal+marg 0.6-1 cm
$480.64
T
5072
11602
Exc tr-ext mal+marg 1.1-2 cm
$480.64
T
5072
11603
Exc tr-ext mal+marg 2.1-3 cm
$941.98
T
5073
11604
Exc tr-ext mal+marg 3.1-4 cm
$941.98
T
5073
11606
Exc tr-ext mal+marg >4 cm
$1414.28
T
5074
11620
Exc h-f-nk-sp mal+marg 0.5/<
$941.98
T
5073
11621
Exc s/n/h/f/g mal+mrg 0.6-1
$941.98
T
5073
11622
Exc s/n/h/f/g mal+mrg 1.1-2
$941.98
T
5073
11623
Exc s/n/h/f/g mal+mrg 2.1-3
$941.98
T
5073
11624
Exc s/n/h/f/g mal+mrg 3.1-4
$1414.28
T
5074
11626
Exc s/n/h/f/g mal+mrg >4 cm
$1414.28
T
5074
11640
Exc f/e/e/n/l mal+mrg 0.5cm<
$941.98
T
5073
11641
Exc f/e/e/n/l mal+mrg 0.6-1
$480.64
T
5072
11642
Exc f/e/e/n/l mal+mrg 1.1-2
$480.64
T
5072
11643
Exc f/e/e/n/l mal+mrg 2.1-3
$941.98
T
5073
11644
Exc f/e/e/n/l mal+mrg 3.1-4
$941.98
T
5073
11646
Exc f/e/e/n/l mal+mrg >4 cm
$1414.28
T
5074
11719
Trim nail(s) any number
$55.94
Q1
5733
11720
Debride nail 1-5
$91.18
Q1
5734
11721
Debride nail 6 or more
$55.94
Q1
5733
11730
Removal of nail plate
$117.83
Q1
5051
11740
Drain blood from under nail
$55.94
Q1
5733
11750
Removal of nail bed
$228.27
T
5071
11752
Remove nail bed/tip
$1414.28
T
5074
11755
Biopsy nail unit
$480.64
T
5072
11760
Repair of nail bed
$428.67
T
5053
11762
Reconstruction of nail bed
$1411.21
T
5054
11765
Excision of nail fold toe
$117.83
Q1
5051
11770
Remove pilonidal cyst simple
$1414.28
T
5074
11771
Remove pilonidal cyst exten
$1414.28
T
5074
11772
Remove pilonidal cyst compl
$1414.28
T
5074
11900
Inject skin lesions
$117.83
Q1
5051
11901
Inject skin lesions >7
$117.83
Q1
5051
11920
Correct skin color 6.0 cm/<
$428.67
T
5053
11921
Correct skn color 6.1-20.0cm
$428.67
T
5053
11950
Tx contour defects 1 cc/<
$225.55
T
5052
11951
Tx contour defects 1.1-5.0cc
$428.67
T
5053
11952
Tx contour defects 5.1-10cc
$428.67
T
5053
11954
Tx contour defects >10.0 cc
$225.55
T
5052
11960
Insert tissue expander(s)
$2137.49
T
5055
11970
Replace tissue expander
$4969.26
J1
5123
11971
Remove tissue expander(s)
$1414.28
Q2
5074
11976
Remove contraceptive capsule
$228.27
Q2
5071
11980
Implant hormone pellet(s)
$91.18
Q1
5734
11981
Insert drug implant device
$91.18
Q1
5734
11982
Remove drug implant device
$91.18
Q1
5734
11983
Remove/insert drug implant
$91.18
Q1
5734
12001
Rpr s/n/ax/gen/trnk 2.5cm/<
$117.83
Q1
5051
12002
Rpr s/n/ax/gen/trnk2.6-7.5cm
$117.83
Q1
5051
12004
Rpr s/n/ax/gen/trk7.6-12.5cm
$117.83
Q1
5051
12005
Rpr s/n/a/gen/trk12.6-20.0cm
$117.83
Q1
5051
12006
Rpr s/n/a/gen/trk20.1-30.0cm
$117.83
Q2
5051
12007
Rpr s/n/ax/gen/trnk >30.0 cm
$225.55
T
5052
12011
Rpr f/e/e/n/l/m 2.5 cm/<
$117.83
Q1
5051
12013
Rpr f/e/e/n/l/m 2.6-5.0 cm
$117.83
Q1
5051
12014
Rpr f/e/e/n/l/m 5.1-7.5 cm
$117.83
Q1
5051
12015
Rpr f/e/e/n/l/m 7.6-12.5 cm
$117.83
Q1
5051
12016
Rpr fe/e/en/l/m 12.6-20.0 cm
$117.83
Q1
5051
12017
Rpr fe/e/en/l/m 20.1-30.0 cm
$117.83
Q1
5051
12018
Rpr f/e/e/n/l/m >30.0 cm
$117.83
Q1
5051
12020
Closure of split wound
$428.67
T
5053
12021
Closure of split wound
$428.67
T
5053
12031
Intmd rpr s/a/t/ext 2.5 cm/<
$225.55
T
5052
12032
Intmd rpr s/a/t/ext 2.6-7.5
$225.55
T
5052
12034
Intmd rpr s/tr/ext 7.6-12.5
$225.55
T
5052
12035
Intmd rpr s/a/t/ext 12.6-20
$225.55
T
5052
12036
Intmd rpr s/a/t/ext 20.1-30
$428.67
T
5053
12037
Intmd rpr s/tr/ext >30.0 cm
$1411.21
T
5054
12041
Intmd rpr n-hf/genit 2.5cm/<
$117.83
Q2
5051
12042
Intmd rpr n-hf/genit2.6-7.5
$225.55
T
5052
12044
Intmd rpr n-hf/genit7.6-12.5
$225.55
T
5052
12045
Intmd rpr n-hf/genit12.6-20
$225.55
T
5052
12046
Intmd rpr n-hf/genit20.1-30
$225.55
T
5052
12047
Intmd rpr n-hf/genit >30.0cm
$428.67
T
5053
12051
Intmd rpr face/mm 2.5 cm/<
$225.55
T
5052
12052
Intmd rpr face/mm 2.6-5.0 cm
$225.55
T
5052
12053
Intmd rpr face/mm 5.1-7.5 cm
$225.55
T
5052
12054
Intmd rpr face/mm 7.6-12.5cm
$117.83
Q2
5051
12055
Intmd rpr face/mm 12.6-20 cm
$225.55
T
5052
12056
Intmd rpr face/mm 20.1-30.0
$117.83
Q2
5051
12057
Intmd rpr face/mm >30.0 cm
$225.55
T
5052
13100
Cmplx rpr trunk 1.1-2.5 cm
$1411.21
T
5054
13101
Cmplx rpr trunk 2.6-7.5 cm
$428.67
T
5053
13120
Cmplx rpr s/a/l 1.1-2.5 cm
$428.67
T
5053
13121
Cmplx rpr s/a/l 2.6-7.5 cm
$428.67
T
5053
13131
Cmplx rpr f/c/c/m/n/ax/g/h/f
$428.67
T
5053
13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$428.67
T
5053
13151
Cmplx rpr e/n/e/l 1.1-2.5 cm
$428.67
T
5053
13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$428.67
T
5053
13160
Late closure of wound
$2137.49
T
5055
14000
Tis trnfr trunk 10 sq cm/<
$1411.21
T
5054
14001
Tis trnfr trunk 10.1-30sqcm
$1411.21
T
5054
14020
Tis trnfr s/a/l 10 sq cm/<
$1411.21
T
5054
14021
Tis trnfr s/a/l 10.1-30 sqcm
$1411.21
T
5054
14040
Tis trnfr f/c/c/m/n/a/g/h/f
$1411.21
T
5054
14041
Tis trnfr f/c/c/m/n/a/g/h/f
$1411.21
T
5054
14060
Tis trnfr e/n/e/l 10 sq cm/<
$1411.21
T
5054
14061
Tis trnfr e/n/e/l10.1-30sqcm
$1411.21
T
5054
14301
Tis trnfr any 30.1-60 sq cm
$2137.49
T
5055
14350
Filleted finger/toe flap
$2137.49
T
5055
15002
Wound prep trk/arm/leg
$1411.21
T
5054
15004
Wound prep f/n/hf/g
$428.67
T
5053
15040
Harvest cultured skin graft
$428.67
T
5053
15050
Skin pinch graft
$428.67
T
5053
15100
Skin splt grft trnk/arm/leg
$2137.49
T
5055
15110
Epidrm autogrft trnk/arm/leg
$1411.21
T
5054
15115
Epidrm a-grft face/nck/hf/g
$1411.21
T
5054
15120
Skn splt a-grft fac/nck/hf/g
$2137.49
T
5055
15130
Derm autograft trnk/arm/leg
$1411.21
T
5054
15135
Derm autograft face/nck/hf/g
$1411.21
T
5054
15150
Cult skin grft t/arm/leg
$2137.49
T
5055
15155
Cult skin graft f/n/hf/g
$1411.21
T
5054
15200
Skin full graft trunk
$2137.49
T
5055
15220
Skin full graft sclp/arm/leg
$1411.21
T
5054
15240
Skin full grft face/genit/hf
$1411.21
T
5054
15260
Skin full graft een & lips
$1411.21
T
5054
15271
Skin sub graft trnk/arm/leg
$1411.21
T
5054
15273
Skin sub grft t/arm/lg child
$2137.49
T
5055
15275
Skin sub graft face/nk/hf/g
$1411.21
T
5054
15277
Skn sub grft f/n/hf/g child
$2137.49
T
5055
15570
Skin pedicle flap trunk
$2137.49
T
5055
15572
Skin pedicle flap arms/legs
$2137.49
T
5055
15574
Pedcle fh/ch/ch/m/n/ax/g/h/f
$1411.21
T
5054
15576
Pedicle e/n/e/l/ntroral
$1411.21
T
5054
15600
Delay flap trunk
$2137.49
T
5055
15610
Delay flap arms/legs
$2137.49
T
5055
15620
Delay flap f/c/c/n/ax/g/h/f
$2137.49
T
5055
15630
Delay flap eye/nos/ear/lip
$1411.21
T
5054
15650
Transfer skin pedicle flap
$2137.49
T
5055
15731
Forehead flap w/vasc pedicle
$2137.49
T
5055
15732
Muscle-skin graft head/neck
$2137.49
T
5055
15734
Muscle-skin graft trunk
$2137.49
T
5055
15736
Muscle-skin graft arm
$1411.21
T
5054
15738
Muscle-skin graft leg
$2137.49
T
5055
15740
Island pedicle flap graft
$1411.21
T
5054
15750
Neurovascular pedicle flap
$1411.21
T
5054
15760
Composite skin graft
$2137.49
T
5055
15770
Derma-fat-fascia graft
$2137.49
T
5055
15775
Hair trnspl 1-15 punch grfts
$225.55
T
5052
15776
Hair trnspl >15 punch grafts
$225.55
T
5052
15780
Dermabrasion total face
$1414.28
T
5074
15781
Dermabrasion segmental face
$480.64
T
5072
15782
Dermabrasion other than face
$1414.28
T
5074
15783
Dermabrasion suprfl any site
$428.67
T
5053
15786
Abrasion lesion single
$117.83
Q1
5051
15788
Chemical peel face epiderm
$117.83
Q1
5051
15789
Chemical peel face dermal
$225.55
T
5052
15792
Chemical peel nonfacial
$117.83
Q1
5051
15793
Chemical peel nonfacial
$117.83
Q1
5051
15819
Plastic surgery neck
$1411.21
T
5054
15820
Revision of lower eyelid
$1411.21
T
5054
15821
Revision of lower eyelid
$1411.21
T
5054
15822
Revision of upper eyelid
$1411.21
T
5054
15823
Revision of upper eyelid
$1411.21
T
5054
15824
Removal of forehead wrinkles
$2137.49
T
5055
15825
Removal of neck wrinkles
$2137.49
T
5055
15826
Removal of brow wrinkles
$1411.21
T
5054
15828
Removal of face wrinkles
$2137.49
T
5055
15829
Removal of skin wrinkles
$2137.49
T
5055
15830
Exc skin abd
$3647.06
T
5092
15832
Excise excessive skin thigh
$1414.28
T
5074
15833
Excise excessive skin leg
$1414.28
T
5074
15834
Excise excessive skin hip
$1414.28
T
5074
15835
Excise excessive skin buttck
$1414.28
T
5074
15836
Excise excessive skin arm
$1414.28
T
5074
15837
Excise excess skin arm/hand
$1414.28
T
5074
15838
Excise excess skin fat pad
$1414.28
T
5074
15839
Excise excess skin & tissue
$1414.28
T
5074
15840
Nerve palsy fascial graft
$2137.49
T
5055
15841
Nerve palsy muscle graft
$2137.49
T
5055
15842
Nerve palsy microsurg graft
$1411.21
T
5054
15845
Skin and muscle repair face
$2137.49
T
5055
15850
Remove sutures same surgeon
$1411.21
T
5054
15851
Remove sutures diff surgeon
$428.67
T
5053
15852
Dressing change not for burn
$91.18
Q1
5734
15860
Test for blood flow in graft
$91.18
Q1
5734
15876
Suction lipectomy head&neck
$2137.49
T
5055
15877
Suction lipectomy trunk
$2137.49
T
5055
15878
Suction lipectomy upr extrem
$2137.49
T
5055
15879
Suction lipectomy lwr extrem
$2137.49
T
5055
15920
Removal of tail bone ulcer
$1414.28
T
5074
15922
Removal of tail bone ulcer
$1411.21
T
5054
15931
Remove sacrum pressure sore
$1414.28
T
5074
15933
Remove sacrum pressure sore
$1414.28
T
5074
15934
Remove sacrum pressure sore
$1411.21
T
5054
15935
Remove sacrum pressure sore
$2137.49
T
5055
15936
Remove sacrum pressure sore
$1411.21
T
5054
15937
Remove sacrum pressure sore
$2137.49
T
5055
15940
Remove hip pressure sore
$1414.28
T
5074
15941
Remove hip pressure sore
$1414.28
T
5074
15944
Remove hip pressure sore
$2137.49
T
5055
15945
Remove hip pressure sore
$2137.49
T
5055
15946
Remove hip pressure sore
$2137.49
T
5055
15950
Remove thigh pressure sore
$1414.28
T
5074
15951
Remove thigh pressure sore
$1414.28
T
5074
15952
Remove thigh pressure sore
$1411.21
T
5054
15953
Remove thigh pressure sore
$2137.49
T
5055
15956
Remove thigh pressure sore
$1411.21
T
5054
15958
Remove thigh pressure sore
$1411.21
T
5054
15999
Removal of pressure sore
$228.27
T
5071
16000
Initial treatment of burn(s)
$117.83
Q1
5051
16020
Dress/debrid p-thick burn s
$117.83
Q1
5051
16025
Dress/debrid p-thick burn m
$225.55
T
5052
16030
Dress/debrid p-thick burn l
$225.55
T
5052
16035
Incision of burn scab initi
$428.67
T
5053
17000
Destruct premalg lesion
$117.83
Q1
5051
17004
Destroy premal lesions 15/>
$225.55
T
5052
17106
Destruction of skin lesions
$428.67
T
5053
17107
Destruction of skin lesions
$428.67
T
5053
17108
Destruction of skin lesions
$1411.21
T
5054
17110
Destruct b9 lesion 1-14
$117.83
Q1
5051
17111
Destruct lesion 15 or more
$117.83
Q1
5051
17250
Chemical cautery tissue
$117.83
Q1
5051
17260
Destruction of skin lesions
$117.83
Q1
5051
17261
Destruction of skin lesions
$117.83
Q1
5051
17262
Destruction of skin lesions
$117.83
Q1
5051
17263
Destruction of skin lesions
$117.83
Q1
5051
17264
Destruction of skin lesions
$225.55
T
5052
17266
Destruction of skin lesions
$428.67
T
5053
17270
Destruction of skin lesions
$225.55
T
5052
17271
Destruction of skin lesions
$225.55
T
5052
17272
Destruction of skin lesions
$117.83
Q1
5051
17273
Destruction of skin lesions
$225.55
T
5052
17274
Destruction of skin lesions
$428.67
T
5053
17276
Destruction of skin lesions
$428.67
T
5053
17280
Destruction of skin lesions
$117.83
Q1
5051
17281
Destruction of skin lesions
$225.55
T
5052
17282
Destruction of skin lesions
$225.55
T
5052
17283
Destruction of skin lesions
$225.55
T
5052
17284
Destruction of skin lesions
$225.55
T
5052
17286
Destruction of skin lesions
$225.55
T
5052
17311
Mohs 1 stage h/n/hf/g
$428.67
T
5053
17313
Mohs 1 stage t/a/l
$428.67
T
5053
17340
Cryotherapy of skin
$30.51
Q1
5732
17360
Skin peel therapy
$117.83
Q1
5051
17380
Hair removal by electrolysis
$428.67
T
5053
17999
Skin tissue procedure
$117.83
Q1
5051
19000
Drainage of breast lesion
$480.64
T
5072
19020
Incision of breast lesion
$1414.28
T
5074
19081
Bx breast 1st lesion strtctc
$941.98
T
5073
19083
Bx breast 1st lesion us imag
$941.98
T
5073
19085
Bx breast 1st lesion mr imag
$1414.28
T
5074
19100
Bx breast percut w/o image
$941.98
T
5073
19101
Biopsy of breast open
$2187.94
T
5091
19105
Cryosurg ablate fa each
$3647.06
T
5092
19110
Nipple exploration
$2187.94
T
5091
19112
Excise breast duct fistula
$2187.94
T
5091
19120
Removal of breast lesion
$2187.94
T
5091
19125
Excision breast lesion
$2187.94
T
5091
19260
Removal of chest wall lesion
$1414.28
T
5074
19281
Perq device breast 1st imag
$480.64
Q1
5072
19283
Perq dev breast 1st strtctc
$480.64
Q1
5072
19285
Perq dev breast 1st us imag
$480.64
Q1
5072
19287
Perq dev breast 1st mr guide
$480.64
Q1
5072
19296
Place po breast cath for rad
$7557.75
J1
5093
19298
Place breast rad tube/caths
$7557.75
J1
5093
19300
Removal of breast tissue
$2187.94
T
5091
19301
Partial mastectomy
$2187.94
T
5091
19302
P-mastectomy w/ln removal
$3647.06
T
5092
19303
Mast simple complete
$3647.06
T
5092
19304
Mast subq
$2187.94
T
5091
19307
Mast mod rad
$3647.06
T
5092
19316
Suspension of breast
$3647.06
T
5092
19318
Reduction of large breast
$3647.06
T
5092
19324
Enlarge breast
$3647.06
T
5092
19325
Enlarge breast with implant
$7557.75
J1
5093
19328
Removal of breast implant
$2187.94
Q2
5091
19330
Removal of implant material
$2187.94
Q2
5091
19340
Immediate breast prosthesis
$3647.06
T
5092
19342
Delayed breast prosthesis
$7557.75
J1
5093
19350
Breast reconstruction
$2187.94
T
5091
19355
Correct inverted nipple(s)
$2187.94
T
5091
19357
Breast reconstruction
$7557.75
J1
5093
19366
Breast reconstruction
$3647.06
T
5092
19370
Surgery of breast capsule
$3647.06
T
5092
19371
Removal of breast capsule
$2187.94
T
5091
19380
Revise breast reconstruction
$3647.06
T
5092
19396
Design custom breast implant
$2187.94
T
5091
19499
Breast surgery procedure
$2187.94
T
5091
20005
I&d abscess subfascial
$1414.28
T
5074
20100
Explore wound neck
$689.63
T
5163
20101
Explore wound chest
$2137.49
T
5055
20102
Explore wound abdomen
$1411.21
T
5054
20103
Explore wound extremity
$941.98
T
5073
20150
Excise epiphyseal bar
$2395.59
T
5122
20200
Muscle biopsy
$1414.28
T
5074
20205
Deep muscle biopsy
$1414.28
T
5074
20206
Needle biopsy muscle
$941.98
T
5073
20220
Bone biopsy trocar/needle
$941.98
T
5073
20225
Bone biopsy trocar/needle
$1414.28
T
5074
20240
Bone biopsy excisional
$1414.28
T
5074
20245
Bone biopsy excisional
$1414.28
T
5074
20250
Open bone biopsy
$2395.59
T
5122
20251
Open bone biopsy
$2395.59
T
5122
20500
Injection of sinus tract
$689.63
T
5163
20520
Removal of foreign body
$941.98
T
5073
20525
Removal of foreign body
$1414.28
T
5074
20526
Ther injection carp tunnel
$223.76
T
5441
20527
Inj dupuytren cord w/enzyme
$223.76
T
5441
20550
Inj tendon sheath/ligament
$223.76
T
5441
20551
Inj tendon origin/insertion
$223.76
T
5441
20552
Inj trigger point 1/2 muscl
$223.76
T
5441
20553
Inject trigger points 3/>
$223.76
T
5441
20555
Place ndl musc/tis for rt
$1455.26
T
5121
20600
Drain/inj joint/bursa w/o us
$223.76
T
5441
20604
Drain/inj joint/bursa w/us
$223.76
T
5441
20605
Drain/inj joint/bursa w/o us
$223.76
T
5441
20606
Drain/inj joint/bursa w/us
$223.76
T
5441
20610
Drain/inj joint/bursa w/o us
$223.76
T
5441
20611
Drain/inj joint/bursa w/us
$223.76
T
5441
20612
Aspirate/inj ganglion cyst
$223.76
T
5441
20615
Treatment of bone cyst
$941.98
T
5073
20650
Insert and remove bone pin
$2395.59
T
5122
20660
Apply rem fixation device
$1096.45
Q2
5113
20662
Application of pelvis brace
$1455.26
T
5121
20663
Application of thigh brace
$2395.59
T
5122
20665
Removal of fixation device
$91.18
Q1
5734
20670
Removal of support implant
$1414.28
Q2
5074
20680
Removal of support implant
$1414.28
Q2
5074
20690
Apply bone fixation device
$4969.26
J1
5123
20692
Apply bone fixation device
$7064.07
J1
5124
20693
Adjust bone fixation device
$2395.59
T
5122
20694
Remove bone fixation device
$1455.26
Q2
5121
20696
Comp multiplane ext fixation
$10537.90
J1
5125
20697
Comp ext fixate strut change
$1096.45
T
5113
20822
Replantation digit complete
$2395.59
T
5122
20900
Removal of bone for graft
$2395.59
T
5122
20902
Removal of bone for graft
$7064.07
J1
5124
20910
Remove cartilage for graft
$428.67
T
5053
20912
Remove cartilage for graft
$2137.49
T
5055
20920
Removal of fascia for graft
$1411.21
T
5054
20922
Removal of fascia for graft
$2137.49
T
5055
20924
Removal of tendon for graft
$2395.59
T
5122
20926
Removal of tissue for graft
$2137.49
T
5055
20950
Fluid pressure muscle
$480.64
T
5072
20972
Bone/skin graft metatarsal
$4969.26
J1
5123
20973
Bone/skin graft great toe
$4969.26
J1
5123
20979
Us bone stimulation
$30.51
Q1
5732
20982
Ablate bone tumor(s) perq
$2395.59
T
5122
20983
Ablate bone tumor(s) perq
$4118.23
T
5352
20999
Musculoskeletal surgery
$1455.26
T
5121
21010
Incision of jaw joint
$3955.98
J1
5165
21011
Exc face les sc <2 cm
$941.98
T
5073
21012
Exc face les sbq 2 cm/>
$1414.28
T
5074
21013
Exc face tum deep < 2 cm
$941.98
T
5073
21014
Exc face tum deep 2 cm/>
$1414.28
T
5074
21015
Resect face/scalp tum < 2 cm
$1414.28
T
5074
21016
Resect face/scalp tum 2 cm/>
$1414.28
T
5074
21025
Excision of bone lower jaw
$3955.98
J1
5165
21026
Excision of facial bone(s)
$1616.90
T
5164
21029
Contour of face bone lesion
$1616.90
T
5164
21030
Excise max/zygoma b9 tumor
$1616.90
T
5164
21031
Remove exostosis mandible
$1616.90
T
5164
21032
Remove exostosis maxilla
$1616.90
T
5164
21034
Excise max/zygoma mal tumor
$3955.98
J1
5165
21040
Excise mandible lesion
$1616.90
T
5164
21044
Removal of jaw bone lesion
$3955.98
J1
5165
21046
Remove mandible cyst complex
$3955.98
J1
5165
21047
Excise lwr jaw cyst w/repair
$3955.98
J1
5165
21048
Remove maxilla cyst complex
$3955.98
J1
5165
21049
Excis uppr jaw cyst w/repair
$3955.98
J1
5165
21050
Removal of jaw joint
$3955.98
J1
5165
21060
Remove jaw joint cartilage
$3955.98
J1
5165
21070
Remove coronoid process
$3955.98
J1
5165
21073
Mnpj of tmj w/anesth
$689.63
T
5163
21076
Prepare face/oral prosthesis
$689.63
T
5163
21077
Prepare face/oral prosthesis
$3955.98
J1
5165
21079
Prepare face/oral prosthesis
$3955.98
J1
5165
21080
Prepare face/oral prosthesis
$3955.98
J1
5165
21081
Prepare face/oral prosthesis
$3955.98
J1
5165
21082
Prepare face/oral prosthesis
$3955.98
J1
5165
21083
Prepare face/oral prosthesis
$3955.98
J1
5165
21084
Prepare face/oral prosthesis
$3955.98
J1
5165
21085
Prepare face/oral prosthesis
$689.63
T
5163
21086
Prepare face/oral prosthesis
$3955.98
J1
5165
21087
Prepare face/oral prosthesis
$3955.98
J1
5165
21088
Prepare face/oral prosthesis
$3955.98
J1
5165
21089
Prepare face/oral prosthesis
$129.29
T
5161
21100
Maxillofacial fixation
$3955.98
J1
5165
21110
Interdental fixation
$689.63
Q2
5163
21120
Reconstruction of chin
$3955.98
J1
5165
21121
Reconstruction of chin
$1616.90
T
5164
21122
Reconstruction of chin
$1616.90
T
5164
21123
Reconstruction of chin
$1616.90
T
5164
21125
Augmentation lower jaw bone
$1616.90
T
5164
21127
Augmentation lower jaw bone
$3955.98
J1
5165
21137
Reduction of forehead
$1616.90
T
5164
21138
Reduction of forehead
$3955.98
J1
5165
21139
Reduction of forehead
$3955.98
J1
5165
21150
Lefort ii anterior intrusion
$3955.98
J1
5165
21172
Reconstruct orbit/forehead
$3955.98
J1
5165
21175
Reconstruct orbit/forehead
$3955.98
J1
5165
21181
Contour cranial bone lesion
$3955.98
J1
5165
21193
Reconst lwr jaw w/o graft
$3955.98
J1
5165
21195
Reconst lwr jaw w/o fixation
$3955.98
J1
5165
21198
Reconstr lwr jaw segment
$1616.90
T
5164
21199
Reconstr lwr jaw w/advance
$3955.98
J1
5165
21206
Reconstruct upper jaw bone
$3955.98
J1
5165
21208
Augmentation of facial bones
$3955.98
J1
5165
21209
Reduction of facial bones
$3955.98
J1
5165
21210
Face bone graft
$3955.98
J1
5165
21215
Lower jaw bone graft
$3955.98
J1
5165
21230
Rib cartilage graft
$3955.98
J1
5165
21235
Ear cartilage graft
$1616.90
T
5164
21240
Reconstruction of jaw joint
$3955.98
J1
5165
21242
Reconstruction of jaw joint
$3955.98
J1
5165
21243
Reconstruction of jaw joint
$10537.90
J1
5125
21244
Reconstruction of lower jaw
$3955.98
J1
5165
21245
Reconstruction of jaw
$3955.98
J1
5165
21246
Reconstruction of jaw
$3955.98
J1
5165
21248
Reconstruction of jaw
$3955.98
J1
5165
21249
Reconstruction of jaw
$3955.98
J1
5165
21256
Reconstruction of orbit
$3955.98
J1
5165
21260
Revise eye sockets
$3955.98
J1
5165
21261
Revise eye sockets
$3955.98
J1
5165
21263
Revise eye sockets
$3955.98
J1
5165
21267
Revise eye sockets
$3955.98
J1
5165
21270
Augmentation cheek bone
$3955.98
J1
5165
21275
Revision orbitofacial bones
$3955.98
J1
5165
21280
Revision of eyelid
$3955.98
J1
5165
21282
Revision of eyelid
$1616.90
T
5164
21295
Revision of jaw muscle/bone
$689.63
T
5163
21296
Revision of jaw muscle/bone
$1616.90
T
5164
21299
Cranio/maxillofacial surgery
$129.29
T
5161
21310
Closed tx nose fx w/o manj
$129.29
T
5161
21315
Closed tx nose fx w/o stablj
$1616.90
T
5164
21320
Closed tx nose fx w/ stablj
$1616.90
T
5164
21325
Open tx nose fx uncomplicatd
$1616.90
T
5164
21330
Open tx nose fx w/skele fixj
$1616.90
T
5164
21335
Open tx nose & septal fx
$1616.90
T
5164
21336
Open tx septal fx w/wo stabj
$2395.59
T
5122
21337
Closed tx septal&nose fx
$1616.90
T
5164
21338
Open nasoethmoid fx w/o fixj
$3955.98
J1
5165
21339
Open nasoethmoid fx w/ fixj
$1616.90
T
5164
21340
Perq tx nasoethmoid fx
$3955.98
J1
5165
21345
Closed tx nose/jaw fx
$689.63
T
5163
21346
Opn tx nasomax fx w/fixj
$3955.98
J1
5165
21355
Perq tx malar fracture
$3955.98
J1
5165
21356
Opn tx dprsd zygomatic arch
$1616.90
T
5164
21360
Opn tx dprsd malar fracture
$3955.98
J1
5165
21365
Opn tx complx malar fx
$3955.98
J1
5165
21385
Opn tx orbit fx transantral
$3955.98
J1
5165
21386
Opn tx orbit fx periorbital
$3955.98
J1
5165
21387
Opn tx orbit fx combined
$3955.98
J1
5165
21390
Opn tx orbit periorbtl implt
$3955.98
J1
5165
21395
Opn tx orbit periorbt w/grft
$3955.98
J1
5165
21400
Closed tx orbit w/o manipulj
$689.63
T
5163
21401
Closed tx orbit w/manipulj
$689.63
T
5163
21406
Opn tx orbit fx w/o implant
$3955.98
J1
5165
21407
Opn tx orbit fx w/implant
$3955.98
J1
5165
21408
Opn tx orbit fx w/bone grft
$3955.98
J1
5165
21421
Treat mouth roof fracture
$3955.98
J1
5165
21440
Treat dental ridge fracture
$1616.90
T
5164
21445
Treat dental ridge fracture
$3955.98
J1
5165
21450
Treat lower jaw fracture
$312.93
T
5162
21451
Treat lower jaw fracture
$1616.90
T
5164
21452
Treat lower jaw fracture
$1616.90
T
5164
21453
Treat lower jaw fracture
$3955.98
J1
5165
21454
Treat lower jaw fracture
$3955.98
J1
5165
21461
Treat lower jaw fracture
$3955.98
J1
5165
21462
Treat lower jaw fracture
$3955.98
J1
5165
21465
Treat lower jaw fracture
$3955.98
J1
5165
21470
Treat lower jaw fracture
$3955.98
J1
5165
21480
Reset dislocated jaw
$129.29
T
5161
21485
Reset dislocated jaw
$689.63
T
5163
21490
Repair dislocated jaw
$3955.98
J1
5165
21495
Treat hyoid bone fracture
$1616.90
T
5164
21497
Interdental wiring
$689.63
T
5163
21499
Head surgery procedure
$129.29
T
5161
21501
Drain neck/chest lesion
$1414.28
T
5074
21502
Drain chest lesion
$1455.26
T
5121
21550
Biopsy of neck/chest
$941.98
T
5073
21552
Exc neck les sc 3 cm/>
$1414.28
T
5074
21554
Exc neck tum deep 5 cm/>
$1414.28
T
5074
21555
Exc neck les sc < 3 cm
$1414.28
T
5074
21556
Exc neck tum deep < 5 cm
$1414.28
T
5074
21557
Resect neck thorax tumor<5cm
$1414.28
T
5074
21558
Resect neck tumor 5 cm/>
$1414.28
T
5074
21600
Partial removal of rib
$2395.59
T
5122
21610
Partial removal of rib
$1455.26
T
5121
21685
Hyoid myotomy & suspension
$1616.90
T
5164
21700
Revision of neck muscle
$1455.26
T
5121
21720
Revision of neck muscle
$1455.26
T
5121
21725
Revision of neck muscle
$228.27
T
5071
21742
Repair stern/nuss w/o scope
$2395.59
T
5122
21743
Repair sternum/nuss w/scope
$2395.59
T
5122
21811
Optx of rib fx w/fixj scope
$1455.26
T
5121
21812
Treatment of rib fracture
$1455.26
T
5121
21813
Treatment of rib fracture
$1455.26
T
5121
21820
Treat sternum fracture
$172.33
T
5111
21899
Neck/chest surgery procedure
$129.29
T
5161
21920
Biopsy soft tissue of back
$941.98
T
5073
21925
Biopsy soft tissue of back
$1414.28
T
5074
21930
Exc back les sc < 3 cm
$1414.28
T
5074
21931
Exc back les sc 3 cm/>
$1414.28
T
5074
21932
Exc back tum deep < 5 cm
$1414.28
T
5074
21933
Exc back tum deep 5 cm/>
$1414.28
T
5074
21935
Resect back tum < 5 cm
$1414.28
T
5074
21936
Resect back tum 5 cm/>
$1414.28
T
5074
22100
Remove part of neck vertebra
$2395.59
T
5122
22101
Remove part thorax vertebra
$2395.59
T
5122
22102
Remove part lumbar vertebra
$2395.59
T
5122
22305
Closed tx spine process fx
$172.33
T
5111
22310
Closed tx vert fx w/o manj
$237.50
T
5112
22315
Closed tx vert fx w/manj
$1096.45
T
5113
22505
Manipulation of spine
$1096.45
T
5113
22510
Perq cervicothoracic inject
$2395.59
T
5122
22511
Perq lumbosacral injection
$2395.59
T
5122
22513
Perq vertebral augmentation
$7064.07
J1
5124
22514
Perq vertebral augmentation
$7064.07
J1
5124
22551
Neck spine fuse&remov bel c2
$10537.90
J1
5125
22554
Neck spine fusion
$10537.90
J1
5125
22612
Lumbar spine fusion
$7064.07
J1
5124
22856
Cerv artific diskectomy
$10537.90
J1
5125
22899
Spine surgery procedure
$1455.26
T
5121
22900
Exc abdl tum deep < 5 cm
$1414.28
T
5074
22901
Exc abdl tum deep 5 cm/>
$1414.28
T
5074
22902
Exc abd les sc < 3 cm
$1414.28
T
5074
22903
Exc abd les sc 3 cm/>
$1414.28
T
5074
22904
Radical resect abd tumor<5cm
$1414.28
T
5074
22905
Rad resect abd tumor 5 cm/>
$1414.28
T
5074
22999
Abdomen surgery procedure
$1455.26
T
5121
23000
Removal of calcium deposits
$1414.28
T
5074
23020
Release shoulder joint
$2395.59
T
5122
23030
Drain shoulder lesion
$1414.28
T
5074
23031
Drain shoulder bursa
$1414.28
T
5074
23035
Drain shoulder bone lesion
$1455.26
T
5121
23040
Exploratory shoulder surgery
$2395.59
T
5122
23044
Exploratory shoulder surgery
$2395.59
T
5122
23065
Biopsy shoulder tissues
$1414.28
T
5074
23066
Biopsy shoulder tissues
$1414.28
T
5074
23071
Exc shoulder les sc 3 cm/>
$1414.28
T
5074
23073
Exc shoulder tum deep 5 cm/>
$1414.28
T
5074
23075
Exc shoulder les sc < 3 cm
$1414.28
T
5074
23076
Exc shoulder tum deep < 5 cm
$1414.28
T
5074
23077
Resect shoulder tumor < 5 cm
$1414.28
T
5074
23078
Resect shoulder tumor 5 cm/>
$1414.28
T
5074
23100
Biopsy of shoulder joint
$1455.26
T
5121
23101
Shoulder joint surgery
$2395.59
T
5122
23105
Remove shoulder joint lining
$2395.59
T
5122
23106
Incision of collarbone joint
$2395.59
T
5122
23107
Explore treat shoulder joint
$2395.59
T
5122
23120
Partial removal collar bone
$2395.59
T
5122
23125
Removal of collar bone
$2395.59
T
5122
23130
Remove shoulder bone part
$2395.59
T
5122
23140
Removal of bone lesion
$1455.26
T
5121
23145
Removal of bone lesion
$2395.59
T
5122
23146
Removal of bone lesion
$4969.26
J1
5123
23150
Removal of humerus lesion
$2395.59
T
5122
23155
Removal of humerus lesion
$2395.59
T
5122
23156
Removal of humerus lesion
$4969.26
J1
5123
23170
Remove collar bone lesion
$1455.26
T
5121
23172
Remove shoulder blade lesion
$2395.59
T
5122
23174
Remove humerus lesion
$2395.59
T
5122
23180
Remove collar bone lesion
$2395.59
T
5122
23182
Remove shoulder blade lesion
$1455.26
T
5121
23184
Remove humerus lesion
$2395.59
T
5122
23190
Partial removal of scapula
$2395.59
T
5122
23195
Removal of head of humerus
$4969.26
J1
5123
23330
Remove shoulder foreign body
$941.98
T
5073
23333
Remove shoulder fb deep
$1414.28
T
5074
23334
Shoulder prosthesis removal
$1414.28
T
5074
23395
Muscle transfer shoulder/arm
$7064.07
J1
5124
23397
Muscle transfers
$2395.59
T
5122
23400
Fixation of shoulder blade
$4969.26
J1
5123
23405
Incision of tendon & muscle
$2395.59
T
5122
23406
Incise tendon(s) & muscle(s)
$2395.59
T
5122
23410
Repair rotator cuff acute
$4969.26
J1
5123
23412
Repair rotator cuff chronic
$4969.26
J1
5123
23415
Release of shoulder ligament
$2395.59
T
5122
23420
Repair of shoulder
$4969.26
J1
5123
23430
Repair biceps tendon
$4969.26
J1
5123
23440
Remove/transplant tendon
$2395.59
T
5122
23450
Repair shoulder capsule
$2395.59
T
5122
23455
Repair shoulder capsule
$4969.26
J1
5123
23460
Repair shoulder capsule
$2395.59
T
5122
23462
Repair shoulder capsule
$4969.26
J1
5123
23465
Repair shoulder capsule
$7064.07
J1
5124
23466
Repair shoulder capsule
$4969.26
J1
5123
23470
Reconstruct shoulder joint
$10537.90
J1
5125
23473
Revis reconst shoulder joint
$7064.07
J1
5124
23480
Revision of collar bone
$2395.59
T
5122
23485
Revision of collar bone
$7064.07
J1
5124
23490
Reinforce clavicle
$7064.07
J1
5124
23491
Reinforce shoulder bones
$7064.07
J1
5124
23500
Treat clavicle fracture
$172.33
T
5111
23505
Treat clavicle fracture
$1096.45
T
5113
23515
Treat clavicle fracture
$4969.26
J1
5123
23520
Treat clavicle dislocation
$1096.45
T
5113
23525
Treat clavicle dislocation
$172.33
T
5111
23530
Treat clavicle dislocation
$2395.59
T
5122
23532
Treat clavicle dislocation
$4969.26
J1
5123
23540
Treat clavicle dislocation
$172.33
T
5111
23545
Treat clavicle dislocation
$172.33
T
5111
23550
Treat clavicle dislocation
$4969.26
J1
5123
23552
Treat clavicle dislocation
$7064.07
J1
5124
23570
Treat shoulder blade fx
$172.33
T
5111
23575
Treat shoulder blade fx
$1096.45
T
5113
23585
Treat scapula fracture
$7064.07
J1
5124
23600
Treat humerus fracture
$172.33
T
5111
23605
Treat humerus fracture
$1455.26
T
5121
23615
Treat humerus fracture
$7064.07
J1
5124
23616
Treat humerus fracture
$10537.90
J1
5125
23620
Treat humerus fracture
$237.50
T
5112
23625
Treat humerus fracture
$1096.45
T
5113
23630
Treat humerus fracture
$4969.26
J1
5123
23650
Treat shoulder dislocation
$172.33
T
5111
23655
Treat shoulder dislocation
$1096.45
T
5113
23660
Treat shoulder dislocation
$2395.59
T
5122
23665
Treat dislocation/fracture
$1096.45
T
5113
23670
Treat dislocation/fracture
$4969.26
J1
5123
23675
Treat dislocation/fracture
$1096.45
T
5113
23680
Treat dislocation/fracture
$7064.07
J1
5124
23700
Fixation of shoulder
$1096.45
T
5113
23800
Fusion of shoulder joint
$7064.07
J1
5124
23802
Fusion of shoulder joint
$7064.07
J1
5124
23921
Amputation follow-up surgery
$1411.21
T
5054
23929
Shoulder surgery procedure
$172.33
T
5111
23930
Drainage of arm lesion
$1414.28
T
5074
23931
Drainage of arm bursa
$1414.28
T
5074
23935
Drain arm/elbow bone lesion
$1455.26
T
5121
24000
Exploratory elbow surgery
$2395.59
T
5122
24006
Release elbow joint
$2395.59
T
5122
24065
Biopsy arm/elbow soft tissue
$1414.28
T
5074
24066
Biopsy arm/elbow soft tissue
$1414.28
T
5074
24071
Exc arm/elbow les sc 3 cm/>
$1414.28
T
5074
24073
Ex arm/elbow tum deep 5 cm/>
$1414.28
T
5074
24075
Exc arm/elbow les sc < 3 cm
$1414.28
T
5074
24076
Ex arm/elbow tum deep < 5 cm
$1414.28
T
5074
24077
Resect arm/elbow tum < 5 cm
$1414.28
T
5074
24079
Resect arm/elbow tum 5 cm/>
$1414.28
T
5074
24100
Biopsy elbow joint lining
$1455.26
T
5121
24101
Explore/treat elbow joint
$2395.59
T
5122
24102
Remove elbow joint lining
$2395.59
T
5122
24105
Removal of elbow bursa
$1455.26
T
5121
24110
Remove humerus lesion
$2395.59
T
5122
24115
Remove/graft bone lesion
$2395.59
T
5122
24116
Remove/graft bone lesion
$2395.59
T
5122
24120
Remove elbow lesion
$1455.26
T
5121
24125
Remove/graft bone lesion
$2395.59
T
5122
24126
Remove/graft bone lesion
$2395.59
T
5122
24130
Removal of head of radius
$2395.59
T
5122
24134
Removal of arm bone lesion
$4969.26
J1
5123
24136
Remove radius bone lesion
$2395.59
T
5122
24138
Remove elbow bone lesion
$2395.59
T
5122
24140
Partial removal of arm bone
$2395.59
T
5122
24145
Partial removal of radius
$2395.59
T
5122
24147
Partial removal of elbow
$2395.59
T
5122
24149
Radical resection of elbow
$2395.59
T
5122
24150
Resect distal humerus tumor
$2395.59
T
5122
24152
Resect radius tumor
$2395.59
T
5122
24155
Removal of elbow joint
$2395.59
T
5122
24160
Remove elbow joint implant
$2395.59
Q2
5122
24164
Remove radius head implant
$2395.59
Q2
5122
24200
Removal of arm foreign body
$480.64
T
5072
24201
Removal of arm foreign body
$1414.28
T
5074
24300
Manipulate elbow w/anesth
$1096.45
T
5113
24301
Muscle/tendon transfer
$2395.59
T
5122
24305
Arm tendon lengthening
$2395.59
T
5122
24310
Revision of arm tendon
$2395.59
T
5122
24320
Repair of arm tendon
$2395.59
T
5122
24330
Revision of arm muscles
$2395.59
T
5122
24331
Revision of arm muscles
$2395.59
T
5122
24332
Tenolysis triceps
$1455.26
T
5121
24340
Repair of biceps tendon
$4969.26
J1
5123
24341
Repair arm tendon/muscle
$2395.59
T
5122
24342
Repair of ruptured tendon
$2395.59
T
5122
24343
Repr elbow lat ligmnt w/tiss
$2395.59
T
5122
24344
Reconstruct elbow lat ligmnt
$4969.26
J1
5123
24345
Repr elbw med ligmnt w/tissu
$2395.59
T
5122
24346
Reconstruct elbow med ligmnt
$7064.07
J1
5124
24357
Repair elbow perc
$1455.26
T
5121
24358
Repair elbow w/deb open
$2395.59
T
5122
24359
Repair elbow deb/attch open
$2395.59
T
5122
24360
Reconstruct elbow joint
$4969.26
J1
5123
24361
Reconstruct elbow joint
$10537.90
J1
5125
24362
Reconstruct elbow joint
$10537.90
J1
5125
24363
Replace elbow joint
$10537.90
J1
5125
24365
Reconstruct head of radius
$7064.07
J1
5124
24366
Reconstruct head of radius
$10537.90
J1
5125
24370
Revise reconst elbow joint
$10537.90
J1
5125
24371
Revise reconst elbow joint
$10537.90
J1
5125
24400
Revision of humerus
$4969.26
J1
5123
24410
Revision of humerus
$10537.90
J1
5125
24420
Revision of humerus
$2395.59
T
5122
24430
Repair of humerus
$7064.07
J1
5124
24435
Repair humerus with graft
$10537.90
J1
5125
24470
Revision of elbow joint
$2395.59
T
5122
24495
Decompression of forearm
$2395.59
T
5122
24498
Reinforce humerus
$7064.07
J1
5124
24500
Treat humerus fracture
$237.50
T
5112
24505
Treat humerus fracture
$1096.45
T
5113
24515
Treat humerus fracture
$7064.07
J1
5124
24516
Treat humerus fracture
$7064.07
J1
5124
24530
Treat humerus fracture
$237.50
T
5112
24535
Treat humerus fracture
$1096.45
T
5113
24538
Treat humerus fracture
$2395.59
T
5122
24545
Treat humerus fracture
$10537.90
J1
5125
24546
Treat humerus fracture
$10537.90
J1
5125
24560
Treat humerus fracture
$172.33
T
5111
24565
Treat humerus fracture
$1096.45
T
5113
24566
Treat humerus fracture
$2395.59
T
5122
24575
Treat humerus fracture
$7064.07
J1
5124
24576
Treat humerus fracture
$237.50
T
5112
24577
Treat humerus fracture
$1096.45
T
5113
24579
Treat humerus fracture
$7064.07
J1
5124
24582
Treat humerus fracture
$2395.59
T
5122
24586
Treat elbow fracture
$7064.07
J1
5124
24587
Treat elbow fracture
$10537.90
J1
5125
24600
Treat elbow dislocation
$172.33
T
5111
24605
Treat elbow dislocation
$1096.45
T
5113
24615
Treat elbow dislocation
$4969.26
J1
5123
24620
Treat elbow fracture
$1096.45
T
5113
24635
Treat elbow fracture
$7064.07
J1
5124
24640
Treat elbow dislocation
$237.50
T
5112
24650
Treat radius fracture
$172.33
T
5111
24655
Treat radius fracture
$1096.45
T
5113
24665
Treat radius fracture
$4969.26
J1
5123
24666
Treat radius fracture
$7064.07
J1
5124
24670
Treat ulnar fracture
$172.33
T
5111
24675
Treat ulnar fracture
$1096.45
T
5113
24685
Treat ulnar fracture
$4969.26
J1
5123
24800
Fusion of elbow joint
$4969.26
J1
5123
24802
Fusion/graft of elbow joint
$7064.07
J1
5124
24925
Amputation follow-up surgery
$2395.59
T
5122
24935
Revision of amputation
$4969.26
J1
5123
24999
Upper arm/elbow surgery
$172.33
T
5111
25000
Incision of tendon sheath
$1455.26
T
5121
25001
Incise flexor carpi radialis
$1455.26
T
5121
25020
Decompress forearm 1 space
$1455.26
T
5121
25023
Decompress forearm 1 space
$2395.59
T
5122
25024
Decompress forearm 2 spaces
$2395.59
T
5122
25025
Decompress forearm 2 spaces
$2395.59
T
5122
25028
Drainage of forearm lesion
$1455.26
T
5121
25031
Drainage of forearm bursa
$1455.26
T
5121
25035
Treat forearm bone lesion
$2395.59
T
5122
25040
Explore/treat wrist joint
$2395.59
T
5122
25065
Biopsy forearm soft tissues
$941.98
T
5073
25066
Biopsy forearm soft tissues
$1414.28
T
5074
25071
Exc forearm les sc 3 cm/>
$1414.28
T
5074
25073
Exc forearm tum deep 3 cm/>
$1414.28
T
5074
25075
Exc forearm les sc < 3 cm
$1414.28
T
5074
25076
Exc forearm tum deep < 3 cm
$1414.28
T
5074
25077
Resect forearm/wrist tum<3cm
$941.98
T
5073
25078
Resect forarm/wrist tum 3cm>
$1414.28
T
5074
25085
Incision of wrist capsule
$2395.59
T
5122
25100
Biopsy of wrist joint
$2395.59
T
5122
25101
Explore/treat wrist joint
$1455.26
T
5121
25105
Remove wrist joint lining
$1455.26
T
5121
25107
Remove wrist joint cartilage
$2395.59
T
5122
25109
Excise tendon forearm/wrist
$1455.26
T
5121
25110
Remove wrist tendon lesion
$1455.26
T
5121
25111
Remove wrist tendon lesion
$1455.26
T
5121
25112
Reremove wrist tendon lesion
$1455.26
T
5121
25115
Remove wrist/forearm lesion
$1455.26
T
5121
25116
Remove wrist/forearm lesion
$1455.26
T
5121
25118
Excise wrist tendon sheath
$1455.26
T
5121
25119
Partial removal of ulna
$2395.59
T
5122
25120
Removal of forearm lesion
$2395.59
T
5122
25125
Remove/graft forearm lesion
$2395.59
T
5122
25126
Remove/graft forearm lesion
$2395.59
T
5122
25130
Removal of wrist lesion
$2395.59
T
5122
25135
Remove & graft wrist lesion
$2395.59
T
5122
25136
Remove & graft wrist lesion
$2395.59
T
5122
25145
Remove forearm bone lesion
$2395.59
T
5122
25150
Partial removal of ulna
$2395.59
T
5122
25151
Partial removal of radius
$2395.59
T
5122
25170
Resect radius/ulnar tumor
$2395.59
T
5122
25210
Removal of wrist bone
$2395.59
T
5122
25215
Removal of wrist bones
$2395.59
T
5122
25230
Partial removal of radius
$2395.59
T
5122
25240
Partial removal of ulna
$2395.59
T
5122
25248
Remove forearm foreign body
$1455.26
T
5121
25250
Removal of wrist prosthesis
$1455.26
Q2
5121
25251
Removal of wrist prosthesis
$2395.59
Q2
5122
25259
Manipulate wrist w/anesthes
$1096.45
T
5113
25260
Repair forearm tendon/muscle
$1455.26
T
5121
25263
Repair forearm tendon/muscle
$2395.59
T
5122
25265
Repair forearm tendon/muscle
$2395.59
T
5122
25270
Repair forearm tendon/muscle
$2395.59
T
5122
25272
Repair forearm tendon/muscle
$2395.59
T
5122
25274
Repair forearm tendon/muscle
$2395.59
T
5122
25275
Repair forearm tendon sheath
$2395.59
T
5122
25280
Revise wrist/forearm tendon
$2395.59
T
5122
25290
Incise wrist/forearm tendon
$1455.26
T
5121
25295
Release wrist/forearm tendon
$1455.26
T
5121
25300
Fusion of tendons at wrist
$2395.59
T
5122
25301
Fusion of tendons at wrist
$2395.59
T
5122
25310
Transplant forearm tendon
$2395.59
T
5122
25312
Transplant forearm tendon
$2395.59
T
5122
25315
Revise palsy hand tendon(s)
$2395.59
T
5122
25316
Revise palsy hand tendon(s)
$4969.26
J1
5123
25320
Repair/revise wrist joint
$2395.59
T
5122
25332
Revise wrist joint
$2395.59
T
5122
25335
Realignment of hand
$2395.59
T
5122
25337
Reconstruct ulna/radioulnar
$2395.59
T
5122
25350
Revision of radius
$7064.07
J1
5124
25355
Revision of radius
$2395.59
T
5122
25360
Revision of ulna
$4969.26
J1
5123
25365
Revise radius & ulna
$7064.07
J1
5124
25370
Revise radius or ulna
$2395.59
T
5122
25375
Revise radius & ulna
$2395.59
T
5122
25390
Shorten radius or ulna
$4969.26
J1
5123
25391
Lengthen radius or ulna
$7064.07
J1
5124
25392
Shorten radius & ulna
$2395.59
T
5122
25393
Lengthen radius & ulna
$2395.59
T
5122
25394
Repair carpal bone shorten
$2395.59
T
5122
25400
Repair radius or ulna
$4969.26
J1
5123
25405
Repair/graft radius or ulna
$7064.07
J1
5124
25415
Repair radius & ulna
$4969.26
J1
5123
25420
Repair/graft radius & ulna
$7064.07
J1
5124
25425
Repair/graft radius or ulna
$2395.59
T
5122
25426
Repair/graft radius & ulna
$2395.59
T
5122
25430
Vasc graft into carpal bone
$2395.59
T
5122
25431
Repair nonunion carpal bone
$4969.26
J1
5123
25440
Repair/graft wrist bone
$4969.26
J1
5123
25441
Reconstruct wrist joint
$10537.90
J1
5125
25442
Reconstruct wrist joint
$10537.90
J1
5125
25443
Reconstruct wrist joint
$4969.26
J1
5123
25444
Reconstruct wrist joint
$10537.90
J1
5125
25445
Reconstruct wrist joint
$4969.26
J1
5123
25446
Wrist replacement
$10537.90
J1
5125
25447
Repair wrist joints
$2395.59
T
5122
25449
Remove wrist joint implant
$4969.26
J1
5123
25450
Revision of wrist joint
$2395.59
T
5122
25455
Revision of wrist joint
$2395.59
T
5122
25490
Reinforce radius
$2395.59
T
5122
25491
Reinforce ulna
$7064.07
J1
5124
25492
Reinforce radius and ulna
$2395.59
T
5122
25500
Treat fracture of radius
$172.33
T
5111
25505
Treat fracture of radius
$1096.45
T
5113
25515
Treat fracture of radius
$4969.26
J1
5123
25520
Treat fracture of radius
$1096.45
T
5113
25525
Treat fracture of radius
$4969.26
J1
5123
25526
Treat fracture of radius
$7064.07
J1
5124
25530
Treat fracture of ulna
$172.33
T
5111
25535
Treat fracture of ulna
$237.50
T
5112
25545
Treat fracture of ulna
$4969.26
J1
5123
25560
Treat fracture radius & ulna
$172.33
T
5111
25565
Treat fracture radius & ulna
$1096.45
T
5113
25574
Treat fracture radius & ulna
$4969.26
J1
5123
25575
Treat fracture radius/ulna
$7064.07
J1
5124
25600
Treat fracture radius/ulna
$237.50
T
5112
25605
Treat fracture radius/ulna
$1096.45
T
5113
25606
Treat fx distal radial
$2395.59
T
5122
25607
Treat fx rad extra-articul
$4969.26
J1
5123
25608
Treat fx rad intra-articul
$4969.26
J1
5123
25609
Treat fx radial 3+ frag
$4969.26
J1
5123
25622
Treat wrist bone fracture
$172.33
T
5111
25624
Treat wrist bone fracture
$1096.45
T
5113
25628
Treat wrist bone fracture
$2395.59
T
5122
25630
Treat wrist bone fracture
$172.33
T
5111
25635
Treat wrist bone fracture
$1096.45
T
5113
25645
Treat wrist bone fracture
$2395.59
T
5122
25650
Treat wrist bone fracture
$237.50
T
5112
25651
Pin ulnar styloid fracture
$2395.59
T
5122
25652
Treat fracture ulnar styloid
$4969.26
J1
5123
25660
Treat wrist dislocation
$237.50
T
5112
25670
Treat wrist dislocation
$1455.26
T
5121
25671
Pin radioulnar dislocation
$1455.26
T
5121
25675
Treat wrist dislocation
$237.50
T
5112
25676
Treat wrist dislocation
$4969.26
J1
5123
25680
Treat wrist fracture
$237.50
T
5112
25685
Treat wrist fracture
$1455.26
T
5121
25690
Treat wrist dislocation
$1096.45
T
5113
25695
Treat wrist dislocation
$2395.59
T
5122
25800
Fusion of wrist joint
$7064.07
J1
5124
25805
Fusion/graft of wrist joint
$7064.07
J1
5124
25810
Fusion/graft of wrist joint
$7064.07
J1
5124
25820
Fusion of hand bones
$4969.26
J1
5123
25825
Fuse hand bones with graft
$4969.26
J1
5123
25830
Fusion radioulnar jnt/ulna
$4969.26
J1
5123
25907
Amputation follow-up surgery
$1455.26
T
5121
25909
Amputation follow-up surgery
$2395.59
T
5122
25922
Amputate hand at wrist
$1455.26
T
5121
25929
Amputation follow-up surgery
$1411.21
T
5054
25931
Amputation follow-up surgery
$1455.26
T
5121
25999
Forearm or wrist surgery
$172.33
T
5111
26010
Drainage of finger abscess
$228.27
T
5071
26011
Drainage of finger abscess
$941.98
T
5073
26020
Drain hand tendon sheath
$1455.26
T
5121
26025
Drainage of palm bursa
$1455.26
T
5121
26030
Drainage of palm bursas
$1455.26
T
5121
26034
Treat hand bone lesion
$1455.26
T
5121
26035
Decompress fingers/hand
$1455.26
T
5121
26037
Decompress fingers/hand
$1455.26
T
5121
26040
Release palm contracture
$1455.26
T
5121
26045
Release palm contracture
$1455.26
T
5121
26055
Incise finger tendon sheath
$1455.26
T
5121
26060
Incision of finger tendon
$1455.26
T
5121
26070
Explore/treat hand joint
$1455.26
T
5121
26075
Explore/treat finger joint
$1455.26
T
5121
26080
Explore/treat finger joint
$1455.26
T
5121
26100
Biopsy hand joint lining
$2395.59
T
5122
26105
Biopsy finger joint lining
$1455.26
T
5121
26110
Biopsy finger joint lining
$1455.26
T
5121
26111
Exc hand les sc 1.5 cm/>
$1414.28
T
5074
26113
Exc hand tum deep 1.5 cm/>
$1414.28
T
5074
26115
Exc hand les sc < 1.5 cm
$1414.28
T
5074
26116
Exc hand tum deep < 1.5 cm
$1414.28
T
5074
26117
Rad resect hand tumor < 3 cm
$1414.28
T
5074
26118
Rad resect hand tumor 3 cm/>
$1414.28
T
5074
26121
Release palm contracture
$1455.26
T
5121
26123
Release palm contracture
$2395.59
T
5122
26130
Remove wrist joint lining
$1455.26
T
5121
26135
Revise finger joint each
$1455.26
T
5121
26140
Revise finger joint each
$1455.26
T
5121
26145
Tendon excision palm/finger
$1455.26
T
5121
26160
Remove tendon sheath lesion
$1455.26
T
5121
26170
Removal of palm tendon each
$1455.26
T
5121
26180
Removal of finger tendon
$1455.26
T
5121
26185
Remove finger bone
$1455.26
T
5121
26200
Remove hand bone lesion
$1455.26
T
5121
26205
Remove/graft bone lesion
$2395.59
T
5122
26210
Removal of finger lesion
$1455.26
T
5121
26215
Remove/graft finger lesion
$2395.59
T
5122
26230
Partial removal of hand bone
$1455.26
T
5121
26235
Partial removal finger bone
$1455.26
T
5121
26236
Partial removal finger bone
$1455.26
T
5121
26250
Extensive hand surgery
$1455.26
T
5121
26260
Resect prox finger tumor
$2395.59
T
5122
26262
Resect distal finger tumor
$1455.26
T
5121
26320
Removal of implant from hand
$1414.28
Q2
5074
26340
Manipulate finger w/anesth
$1096.45
T
5113
26341
Manipulat palm cord post inj
$237.50
T
5112
26350
Repair finger/hand tendon
$2395.59
T
5122
26352
Repair/graft hand tendon
$2395.59
T
5122
26356
Repair finger/hand tendon
$2395.59
T
5122
26357
Repair finger/hand tendon
$2395.59
T
5122
26358
Repair/graft hand tendon
$2395.59
T
5122
26370
Repair finger/hand tendon
$2395.59
T
5122
26372
Repair/graft hand tendon
$2395.59
T
5122
26373
Repair finger/hand tendon
$2395.59
T
5122
26390
Revise hand/finger tendon
$4969.26
J1
5123
26392
Repair/graft hand tendon
$4969.26
J1
5123
26410
Repair hand tendon
$1455.26
T
5121
26412
Repair/graft hand tendon
$2395.59
T
5122
26415
Excision hand/finger tendon
$1455.26
T
5121
26416
Graft hand or finger tendon
$2395.59
T
5122
26418
Repair finger tendon
$1455.26
T
5121
26420
Repair/graft finger tendon
$2395.59
T
5122
26426
Repair finger/hand tendon
$2395.59
T
5122
26428
Repair/graft finger tendon
$2395.59
T
5122
26432
Repair finger tendon
$1455.26
T
5121
26433
Repair finger tendon
$1455.26
T
5121
26434
Repair/graft finger tendon
$2395.59
T
5122
26437
Realignment of tendons
$1455.26
T
5121
26440
Release palm/finger tendon
$1455.26
T
5121
26442
Release palm & finger tendon
$1455.26
T
5121
26445
Release hand/finger tendon
$1455.26
T
5121
26449
Release forearm/hand tendon
$1455.26
T
5121
26450
Incision of palm tendon
$2395.59
T
5122
26455
Incision of finger tendon
$1455.26
T
5121
26460
Incise hand/finger tendon
$1455.26
T
5121
26471
Fusion of finger tendons
$2395.59
T
5122
26474
Fusion of finger tendons
$1455.26
T
5121
26476
Tendon lengthening
$1455.26
T
5121
26477
Tendon shortening
$2395.59
T
5122
26478
Lengthening of hand tendon
$1455.26
T
5121
26479
Shortening of hand tendon
$1455.26
T
5121
26480
Transplant hand tendon
$1455.26
T
5121
26483
Transplant/graft hand tendon
$2395.59
T
5122
26485
Transplant palm tendon
$1455.26
T
5121
26489
Transplant/graft palm tendon
$2395.59
T
5122
26490
Revise thumb tendon
$2395.59
T
5122
26492
Tendon transfer with graft
$2395.59
T
5122
26494
Hand tendon/muscle transfer
$2395.59
T
5122
26496
Revise thumb tendon
$2395.59
T
5122
26497
Finger tendon transfer
$2395.59
T
5122
26498
Finger tendon transfer
$2395.59
T
5122
26499
Revision of finger
$2395.59
T
5122
26500
Hand tendon reconstruction
$2395.59
T
5122
26502
Hand tendon reconstruction
$2395.59
T
5122
26508
Release thumb contracture
$1455.26
T
5121
26510
Thumb tendon transfer
$1455.26
T
5121
26516
Fusion of knuckle joint
$1455.26
T
5121
26517
Fusion of knuckle joints
$2395.59
T
5122
26518
Fusion of knuckle joints
$2395.59
T
5122
26520
Release knuckle contracture
$1455.26
T
5121
26525
Release finger contracture
$1455.26
T
5121
26530
Revise knuckle joint
$2395.59
T
5122
26531
Revise knuckle with implant
$4969.26
J1
5123
26535
Revise finger joint
$2395.59
T
5122
26536
Revise/implant finger joint
$4969.26
J1
5123
26540
Repair hand joint
$2395.59
T
5122
26541
Repair hand joint with graft
$2395.59
T
5122
26542
Repair hand joint with graft
$2395.59
T
5122
26545
Reconstruct finger joint
$2395.59
T
5122
26546
Repair nonunion hand
$2395.59
T
5122
26548
Reconstruct finger joint
$2395.59
T
5122
26550
Construct thumb replacement
$2395.59
T
5122
26555
Positional change of finger
$2395.59
T
5122
26560
Repair of web finger
$1455.26
T
5121
26561
Repair of web finger
$2395.59
T
5122
26562
Repair of web finger
$2395.59
T
5122
26565
Correct metacarpal flaw
$2395.59
T
5122
26567
Correct finger deformity
$2395.59
T
5122
26568
Lengthen metacarpal/finger
$2395.59
T
5122
26580
Repair hand deformity
$1455.26
T
5121
26587
Reconstruct extra finger
$2395.59
T
5122
26590
Repair finger deformity
$1455.26
T
5121
26591
Repair muscles of hand
$2395.59
T
5122
26593
Release muscles of hand
$2395.59
T
5122
26596
Excision constricting tissue
$2395.59
T
5122
26600
Treat metacarpal fracture
$172.33
T
5111
26605
Treat metacarpal fracture
$237.50
T
5112
26607
Treat metacarpal fracture
$1096.45
T
5113
26608
Treat metacarpal fracture
$1455.26
T
5121
26615
Treat metacarpal fracture
$2395.59
T
5122
26641
Treat thumb dislocation
$237.50
T
5112
26645
Treat thumb fracture
$1096.45
T
5113
26650
Treat thumb fracture
$1455.26
T
5121
26665
Treat thumb fracture
$2395.59
T
5122
26670
Treat hand dislocation
$237.50
T
5112
26675
Treat hand dislocation
$1096.45
T
5113
26676
Pin hand dislocation
$1455.26
T
5121
26685
Treat hand dislocation
$2395.59
T
5122
26686
Treat hand dislocation
$2395.59
T
5122
26700
Treat knuckle dislocation
$237.50
T
5112
26705
Treat knuckle dislocation
$1096.45
T
5113
26706
Pin knuckle dislocation
$1096.45
T
5113
26715
Treat knuckle dislocation
$2395.59
T
5122
26720
Treat finger fracture each
$172.33
T
5111
26725
Treat finger fracture each
$237.50
T
5112
26727
Treat finger fracture each
$1455.26
T
5121
26735
Treat finger fracture each
$2395.59
T
5122
26740
Treat finger fracture each
$237.50
T
5112
26742
Treat finger fracture each
$1096.45
T
5113
26746
Treat finger fracture each
$2395.59
T
5122
26750
Treat finger fracture each
$172.33
T
5111
26755
Treat finger fracture each
$237.50
T
5112
26756
Pin finger fracture each
$1455.26
T
5121
26765
Treat finger fracture each
$1455.26
T
5121
26770
Treat finger dislocation
$172.33
T
5111
26775
Treat finger dislocation
$207.88
S
5102
26776
Pin finger dislocation
$1455.26
T
5121
26785
Treat finger dislocation
$2395.59
T
5122
26820
Thumb fusion with graft
$2395.59
T
5122
26841
Fusion of thumb
$2395.59
T
5122
26842
Thumb fusion with graft
$4969.26
J1
5123
26843
Fusion of hand joint
$4969.26
J1
5123
26844
Fusion/graft of hand joint
$4969.26
J1
5123
26850
Fusion of knuckle
$2395.59
T
5122
26852
Fusion of knuckle with graft
$2395.59
T
5122
26860
Fusion of finger joint
$2395.59
T
5122
26862
Fusion/graft of finger joint
$2395.59
T
5122
26910
Amputate metacarpal bone
$2395.59
T
5122
26951
Amputation of finger/thumb
$1455.26
T
5121
26952
Amputation of finger/thumb
$1455.26
T
5121
26989
Hand/finger surgery
$172.33
T
5111
26990
Drainage of pelvis lesion
$2395.59
T
5122
26991
Drainage of pelvis bursa
$2395.59
T
5122
27000
Incision of hip tendon
$1455.26
T
5121
27001
Incision of hip tendon
$2395.59
T
5122
27003
Incision of hip tendon
$2395.59
T
5122
27006
Incision of hip tendons
$2395.59
T
5122
27027
Buttock fasciotomy
$2395.59
T
5122
27033
Exploration of hip joint
$2395.59
T
5122
27035
Denervation of hip joint
$1455.26
T
5121
27040
Biopsy of soft tissues
$941.98
T
5073
27041
Biopsy of soft tissues
$941.98
T
5073
27043
Exc hip pelvis les sc 3 cm/>
$1414.28
T
5074
27045
Exc hip/pelv tum deep 5 cm/>
$1414.28
T
5074
27047
Exc hip/pelvis les sc < 3 cm
$1414.28
T
5074
27048
Exc hip/pelv tum deep < 5 cm
$1414.28
T
5074
27049
Resect hip/pelv tum < 5 cm
$1414.28
T
5074
27050
Biopsy of sacroiliac joint
$1455.26
T
5121
27052
Biopsy of hip joint
$1455.26
T
5121
27057
Buttock fasciotomy w/dbrdmt
$1455.26
T
5121
27059
Resect hip/pelv tum 5 cm/>
$1414.28
T
5074
27060
Removal of ischial bursa
$1455.26
T
5121
27062
Remove femur lesion/bursa
$2395.59
T
5122
27065
Remove hip bone les super
$2395.59
T
5122
27066
Remove hip bone les deep
$2395.59
T
5122
27067
Remove/graft hip bone lesion
$2395.59
T
5122
27080
Removal of tail bone
$2395.59
T
5122
27086
Remove hip foreign body
$1414.28
T
5074
27087
Remove hip foreign body
$2395.59
T
5122
27097
Revision of hip tendon
$2395.59
T
5122
27098
Transfer tendon to pelvis
$1455.26
T
5121
27100
Transfer of abdominal muscle
$4969.26
J1
5123
27105
Transfer of spinal muscle
$2395.59
T
5122
27110
Transfer of iliopsoas muscle
$2395.59
T
5122
27111
Transfer of iliopsoas muscle
$2395.59
T
5122
27179
Revise head/neck of femur
$7064.07
J1
5124
27193
Treat pelvic ring fracture
$237.50
T
5112
27194
Treat pelvic ring fracture
$237.50
T
5112
27200
Treat tail bone fracture
$172.33
T
5111
27202
Treat tail bone fracture
$2395.59
T
5122
27220
Treat hip socket fracture
$237.50
T
5112
27230
Treat thigh fracture
$172.33
T
5111
27235
Treat thigh fracture
$4969.26
J1
5123
27238
Treat thigh fracture
$1096.45
T
5113
27246
Treat thigh fracture
$237.50
T
5112
27250
Treat hip dislocation
$172.33
T
5111
27252
Treat hip dislocation
$1096.45
T
5113
27256
Treat hip dislocation
$172.33
T
5111
27257
Treat hip dislocation
$1096.45
T
5113
27265
Treat hip dislocation
$237.50
T
5112
27266
Treat hip dislocation
$1096.45
T
5113
27267
Cltx thigh fx
$1096.45
T
5113
27275
Manipulation of hip joint
$1096.45
T
5113
27279
Arthrodesis sacroiliac joint
$10537.90
J1
5125
27299
Pelvis/hip joint surgery
$172.33
T
5111
27301
Drain thigh/knee lesion
$1414.28
T
5074
27305
Incise thigh tendon & fascia
$2395.59
T
5122
27306
Incision of thigh tendon
$1455.26
T
5121
27307
Incision of thigh tendons
$2395.59
T
5122
27310
Exploration of knee joint
$2395.59
T
5122
27323
Biopsy thigh soft tissues
$1414.28
T
5074
27324
Biopsy thigh soft tissues
$1414.28
T
5074
27325
Neurectomy hamstring
$1392.56
T
5431
27326
Neurectomy popliteal
$1392.56
T
5431
27327
Exc thigh/knee les sc < 3 cm
$1414.28
T
5074
27328
Exc thigh/knee tum deep <5cm
$1414.28
T
5074
27329
Resect thigh/knee tum < 5 cm
$1414.28
T
5074
27330
Biopsy knee joint lining
$2395.59
T
5122
27331
Explore/treat knee joint
$2395.59
T
5122
27332
Removal of knee cartilage
$2395.59
T
5122
27333
Removal of knee cartilage
$2395.59
T
5122
27334
Remove knee joint lining
$2395.59
T
5122
27335
Remove knee joint lining
$4969.26
J1
5123
27337
Exc thigh/knee les sc 3 cm/>
$1414.28
T
5074
27339
Exc thigh/knee tum dep 5cm/>
$1414.28
T
5074
27340
Removal of kneecap bursa
$2395.59
T
5122
27345
Removal of knee cyst
$2395.59
T
5122
27347
Remove knee cyst
$2395.59
T
5122
27350
Removal of kneecap
$2395.59
T
5122
27355
Remove femur lesion
$2395.59
T
5122
27356
Remove femur lesion/graft
$10537.90
J1
5125
27357
Remove femur lesion/graft
$4969.26
J1
5123
27360
Partial removal leg bone(s)
$2395.59
T
5122
27364
Resect thigh/knee tum 5 cm/>
$1414.28
T
5074
27372
Removal of foreign body
$1414.28
T
5074
27380
Repair of kneecap tendon
$2395.59
T
5122
27381
Repair/graft kneecap tendon
$4969.26
J1
5123
27385
Repair of thigh muscle
$2395.59
T
5122
27386
Repair/graft of thigh muscle
$4969.26
J1
5123
27390
Incision of thigh tendon
$2395.59
T
5122
27391
Incision of thigh tendons
$2395.59
T
5122
27392
Incision of thigh tendons
$2395.59
T
5122
27393
Lengthening of thigh tendon
$2395.59
T
5122
27394
Lengthening of thigh tendons
$2395.59
T
5122
27395
Lengthening of thigh tendons
$2395.59
T
5122
27396
Transplant of thigh tendon
$2395.59
T
5122
27397
Transplants of thigh tendons
$2395.59
T
5122
27400
Revise thigh muscles/tendons
$2395.59
T
5122
27403
Repair of knee cartilage
$1455.26
T
5121
27405
Repair of knee ligament
$2395.59
T
5122
27407
Repair of knee ligament
$4969.26
J1
5123
27409
Repair of knee ligaments
$2395.59
T
5122
27412
Autochondrocyte implant knee
$4969.26
J1
5123
27415
Osteochondral knee allograft
$7064.07
J1
5124
27416
Osteochondral knee autograft
$4969.26
J1
5123
27418
Repair degenerated kneecap
$4969.26
J1
5123
27420
Revision of unstable kneecap
$4969.26
J1
5123
27422
Revision of unstable kneecap
$2395.59
T
5122
27424
Revision/removal of kneecap
$2395.59
T
5122
27425
Lat retinacular release open
$2395.59
T
5122
27427
Reconstruction knee
$4969.26
J1
5123
27428
Reconstruction knee
$7064.07
J1
5124
27429
Reconstruction knee
$7064.07
J1
5124
27430
Revision of thigh muscles
$2395.59
T
5122
27435
Incision of knee joint
$2395.59
T
5122
27437
Revise kneecap
$7064.07
J1
5124
27438
Revise kneecap with implant
$10537.90
J1
5125
27440
Revision of knee joint
$10537.90
J1
5125
27441
Revision of knee joint
$10537.90
J1
5125
27442
Revision of knee joint
$10537.90
J1
5125
27443
Revision of knee joint
$7064.07
J1
5124
27446
Revision of knee joint
$10537.90
J1
5125
27475
Surgery to stop leg growth
$2395.59
T
5122
27477
Surgery to stop leg growth
$2395.59
T
5122
27479
Surgery to stop leg growth
$2395.59
T
5122
27485
Surgery to stop leg growth
$2395.59
T
5122
27496
Decompression of thigh/knee
$2395.59
T
5122
27497
Decompression of thigh/knee
$1455.26
T
5121
27498
Decompression of thigh/knee
$1455.26
T
5121
27499
Decompression of thigh/knee
$2395.59
T
5122
27500
Treatment of thigh fracture
$237.50
T
5112
27501
Treatment of thigh fracture
$237.50
T
5112
27502
Treatment of thigh fracture
$1096.45
T
5113
27503
Treatment of thigh fracture
$1096.45
T
5113
27508
Treatment of thigh fracture
$237.50
T
5112
27509
Treatment of thigh fracture
$4969.26
J1
5123
27510
Treatment of thigh fracture
$1096.45
T
5113
27516
Treat thigh fx growth plate
$172.33
T
5111
27517
Treat thigh fx growth plate
$1096.45
T
5113
27520
Treat kneecap fracture
$172.33
T
5111
27524
Treat kneecap fracture
$2395.59
T
5122
27530
Treat knee fracture
$172.33
T
5111
27532
Treat knee fracture
$1096.45
T
5113
27538
Treat knee fracture(s)
$237.50
T
5112
27550
Treat knee dislocation
$237.50
T
5112
27552
Treat knee dislocation
$1096.45
T
5113
27560
Treat kneecap dislocation
$172.33
T
5111
27562
Treat kneecap dislocation
$237.50
T
5112
27566
Treat kneecap dislocation
$2395.59
T
5122
27570
Fixation of knee joint
$1096.45
T
5113
27594
Amputation follow-up surgery
$2395.59
T
5122
27599
Leg surgery procedure
$172.33
T
5111
27600
Decompression of lower leg
$2395.59
T
5122
27601
Decompression of lower leg
$2395.59
T
5122
27602
Decompression of lower leg
$1455.26
T
5121
27603
Drain lower leg lesion
$1414.28
T
5074
27604
Drain lower leg bursa
$2395.59
T
5122
27605
Incision of achilles tendon
$1455.26
T
5121
27606
Incision of achilles tendon
$2395.59
T
5122
27607
Treat lower leg bone lesion
$2395.59
T
5122
27610
Explore/treat ankle joint
$2395.59
T
5122
27612
Exploration of ankle joint
$2395.59
T
5122
27613
Biopsy lower leg soft tissue
$941.98
T
5073
27614
Biopsy lower leg soft tissue
$1414.28
T
5074
27615
Resect leg/ankle tum < 5 cm
$1414.28
T
5074
27616
Resect leg/ankle tum 5 cm/>
$1414.28
T
5074
27618
Exc leg/ankle tum < 3 cm
$1414.28
T
5074
27619
Exc leg/ankle tum deep <5 cm
$1414.28
T
5074
27620
Explore/treat ankle joint
$2395.59
T
5122
27625
Remove ankle joint lining
$2395.59
T
5122
27626
Remove ankle joint lining
$2395.59
T
5122
27630
Removal of tendon lesion
$1455.26
T
5121
27632
Exc leg/ankle les sc 3 cm/>
$1414.28
T
5074
27634
Exc leg/ankle tum dep 5 cm/>
$1414.28
T
5074
27635
Remove lower leg bone lesion
$2395.59
T
5122
27637
Remove/graft leg bone lesion
$4969.26
J1
5123
27638
Remove/graft leg bone lesion
$4969.26
J1
5123
27640
Partial removal of tibia
$2395.59
T
5122
27641
Partial removal of fibula
$2395.59
T
5122
27647
Resect talus/calcaneus tum
$1455.26
T
5121
27650
Repair achilles tendon
$2395.59
T
5122
27652
Repair/graft achilles tendon
$4969.26
J1
5123
27654
Repair of achilles tendon
$4969.26
J1
5123
27656
Repair leg fascia defect
$2395.59
T
5122
27658
Repair of leg tendon each
$2395.59
T
5122
27659
Repair of leg tendon each
$2395.59
T
5122
27664
Repair of leg tendon each
$2395.59
T
5122
27665
Repair of leg tendon each
$4969.26
J1
5123
27675
Repair lower leg tendons
$2395.59
T
5122
27676
Repair lower leg tendons
$2395.59
T
5122
27680
Release of lower leg tendon
$2395.59
T
5122
27681
Release of lower leg tendons
$2395.59
T
5122
27685
Revision of lower leg tendon
$2395.59
T
5122
27686
Revise lower leg tendons
$2395.59
T
5122
27687
Revision of calf tendon
$2395.59
T
5122
27690
Revise lower leg tendon
$2395.59
T
5122
27691
Revise lower leg tendon
$2395.59
T
5122
27695
Repair of ankle ligament
$2395.59
T
5122
27696
Repair of ankle ligaments
$2395.59
T
5122
27698
Repair of ankle ligament
$2395.59
T
5122
27700
Revision of ankle joint
$4969.26
J1
5123
27704
Removal of ankle implant
$2395.59
Q2
5122
27705
Incision of tibia
$2395.59
T
5122
27707
Incision of fibula
$2395.59
T
5122
27709
Incision of tibia & fibula
$7064.07
J1
5124
27720
Repair of tibia
$4969.26
J1
5123
27722
Repair/graft of tibia
$7064.07
J1
5124
27726
Repair fibula nonunion
$4969.26
J1
5123
27730
Repair of tibia epiphysis
$2395.59
T
5122
27732
Repair of fibula epiphysis
$2395.59
T
5122
27734
Repair lower leg epiphyses
$2395.59
T
5122
27740
Repair of leg epiphyses
$2395.59
T
5122
27742
Repair of leg epiphyses
$2395.59
T
5122
27745
Reinforce tibia
$7064.07
J1
5124
27750
Treatment of tibia fracture
$237.50
T
5112
27752
Treatment of tibia fracture
$1096.45
T
5113
27756
Treatment of tibia fracture
$4969.26
J1
5123
27758
Treatment of tibia fracture
$7064.07
J1
5124
27759
Treatment of tibia fracture
$7064.07
J1
5124
27760
Cltx medial ankle fx
$172.33
T
5111
27762
Cltx med ankle fx w/mnpj
$1096.45
T
5113
27766
Optx medial ankle fx
$2395.59
T
5122
27767
Cltx post ankle fx
$237.50
T
5112
27768
Cltx post ankle fx w/mnpj
$1096.45
T
5113
27769
Optx post ankle fx
$4969.26
J1
5123
27780
Treatment of fibula fracture
$172.33
T
5111
27781
Treatment of fibula fracture
$1096.45
T
5113
27784
Treatment of fibula fracture
$4969.26
J1
5123
27786
Treatment of ankle fracture
$237.50
T
5112
27788
Treatment of ankle fracture
$237.50
T
5112
27792
Treatment of ankle fracture
$4969.26
J1
5123
27808
Treatment of ankle fracture
$172.33
T
5111
27810
Treatment of ankle fracture
$1096.45
T
5113
27814
Treatment of ankle fracture
$4969.26
J1
5123
27816
Treatment of ankle fracture
$237.50
T
5112
27818
Treatment of ankle fracture
$1096.45
T
5113
27822
Treatment of ankle fracture
$4969.26
J1
5123
27823
Treatment of ankle fracture
$7064.07
J1
5124
27824
Treat lower leg fracture
$237.50
T
5112
27825
Treat lower leg fracture
$1096.45
T
5113
27826
Treat lower leg fracture
$4969.26
J1
5123
27827
Treat lower leg fracture
$7064.07
J1
5124
27828
Treat lower leg fracture
$7064.07
J1
5124
27829
Treat lower leg joint
$2395.59
T
5122
27830
Treat lower leg dislocation
$172.33
T
5111
27831
Treat lower leg dislocation
$1096.45
T
5113
27832
Treat lower leg dislocation
$4969.26
J1
5123
27840
Treat ankle dislocation
$172.33
T
5111
27842
Treat ankle dislocation
$1096.45
T
5113
27846
Treat ankle dislocation
$2395.59
T
5122
27848
Treat ankle dislocation
$2395.59
T
5122
27860
Fixation of ankle joint
$1096.45
T
5113
27870
Fusion of ankle joint open
$10537.90
J1
5125
27871
Fusion of tibiofibular joint
$7064.07
J1
5124
27884
Amputation follow-up surgery
$2395.59
T
5122
27889
Amputation of foot at ankle
$2395.59
T
5122
27892
Decompression of leg
$2395.59
T
5122
27893
Decompression of leg
$2395.59
T
5122
27894
Decompression of leg
$1455.26
T
5121
27899
Leg/ankle surgery procedure
$172.33
T
5111
28001
Drainage of bursa of foot
$941.98
T
5073
28002
Treatment of foot infection
$1455.26
T
5121
28003
Treatment of foot infection
$1455.26
T
5121
28005
Treat foot bone lesion
$2395.59
T
5122
28008
Incision of foot fascia
$1455.26
T
5121
28010
Incision of toe tendon
$1455.26
T
5121
28011
Incision of toe tendons
$1455.26
T
5121
28020
Exploration of foot joint
$2395.59
T
5122
28022
Exploration of foot joint
$2395.59
T
5122
28024
Exploration of toe joint
$1455.26
T
5121
28035
Decompression of tibia nerve
$1392.56
T
5431
28039
Exc foot/toe tum sc 1.5 cm/>
$1414.28
T
5074
28041
Exc foot/toe tum dep 1.5cm/>
$1414.28
T
5074
28043
Exc foot/toe tum sc < 1.5 cm
$1414.28
T
5074
28045
Exc foot/toe tum deep <1.5cm
$1414.28
T
5074
28046
Resect foot/toe tumor < 3 cm
$1414.28
T
5074
28047
Resect foot/toe tumor 3 cm/>
$1414.28
T
5074
28050
Biopsy of foot joint lining
$1455.26
T
5121
28052
Biopsy of foot joint lining
$1455.26
T
5121
28054
Biopsy of toe joint lining
$1455.26
T
5121
28055
Neurectomy foot
$1392.56
T
5431
28060
Partial removal foot fascia
$1455.26
T
5121
28062
Removal of foot fascia
$2395.59
T
5122
28070
Removal of foot joint lining
$1455.26
T
5121
28072
Removal of foot joint lining
$1455.26
T
5121
28080
Removal of foot lesion
$1455.26
T
5121
28086
Excise foot tendon sheath
$2395.59
T
5122
28088
Excise foot tendon sheath
$1455.26
T
5121
28090
Removal of foot lesion
$1455.26
T
5121
28092
Removal of toe lesions
$1455.26
T
5121
28100
Removal of ankle/heel lesion
$2395.59
T
5122
28102
Remove/graft foot lesion
$4969.26
J1
5123
28103
Remove/graft foot lesion
$4969.26
J1
5123
28104
Removal of foot lesion
$1455.26
T
5121
28106
Remove/graft foot lesion
$2395.59
T
5122
28107
Remove/graft foot lesion
$4969.26
J1
5123
28108
Removal of toe lesions
$1455.26
T
5121
28110
Part removal of metatarsal
$1455.26
T
5121
28111
Part removal of metatarsal
$1455.26
T
5121
28112
Part removal of metatarsal
$1455.26
T
5121
28113
Part removal of metatarsal
$1455.26
T
5121
28114
Removal of metatarsal heads
$2395.59
T
5122
28116
Revision of foot
$1455.26
T
5121
28118
Removal of heel bone
$2395.59
T
5122
28119
Removal of heel spur
$2395.59
T
5122
28120
Part removal of ankle/heel
$2395.59
T
5122
28122
Partial removal of foot bone
$1455.26
T
5121
28124
Partial removal of toe
$1455.26
T
5121
28126
Partial removal of toe
$1455.26
T
5121
28130
Removal of ankle bone
$2395.59
T
5122
28140
Removal of metatarsal
$1455.26
T
5121
28150
Removal of toe
$1455.26
T
5121
28153
Partial removal of toe
$1455.26
T
5121
28160
Partial removal of toe
$1455.26
T
5121
28171
Resect tarsal tumor
$1455.26
T
5121
28173
Resect metatarsal tumor
$1455.26
T
5121
28175
Resect phalanx of toe tumor
$1455.26
T
5121
28190
Removal of foot foreign body
$941.98
T
5073
28192
Removal of foot foreign body
$1414.28
T
5074
28193
Removal of foot foreign body
$1414.28
T
5074
28200
Repair of foot tendon
$2395.59
T
5122
28202
Repair/graft of foot tendon
$4969.26
J1
5123
28208
Repair of foot tendon
$2395.59
T
5122
28210
Repair/graft of foot tendon
$4969.26
J1
5123
28220
Release of foot tendon
$1455.26
T
5121
28222
Release of foot tendons
$1455.26
T
5121
28225
Release of foot tendon
$1455.26
T
5121
28226
Release of foot tendons
$1455.26
T
5121
28230
Incision of foot tendon(s)
$1455.26
T
5121
28232
Incision of toe tendon
$1455.26
T
5121
28234
Incision of foot tendon
$1455.26
T
5121
28238
Revision of foot tendon
$2395.59
T
5122
28240
Release of big toe
$1455.26
T
5121
28250
Revision of foot fascia
$2395.59
T
5122
28260
Release of midfoot joint
$1455.26
T
5121
28261
Revision of foot tendon
$2395.59
T
5122
28262
Revision of foot and ankle
$4969.26
J1
5123
28264
Release of midfoot joint
$1455.26
T
5121
28270
Release of foot contracture
$1455.26
T
5121
28272
Release of toe joint each
$1455.26
T
5121
28280
Fusion of toes
$1455.26
T
5121
28285
Repair of hammertoe
$1455.26
T
5121
28286
Repair of hammertoe
$1455.26
T
5121
28288
Partial removal of foot bone
$1455.26
T
5121
28289
Repair hallux rigidus
$2395.59
T
5122
28290
Correction of bunion
$2395.59
T
5122
28292
Correction of bunion
$2395.59
T
5122
28293
Correction of bunion
$4969.26
J1
5123
28294
Correction of bunion
$2395.59
T
5122
28296
Correction of bunion
$2395.59
T
5122
28297
Correction of bunion
$7064.07
J1
5124
28298
Correction of bunion
$2395.59
T
5122
28299
Correction of bunion
$2395.59
T
5122
28300
Incision of heel bone
$4969.26
J1
5123
28302
Incision of ankle bone
$2395.59
T
5122
28304
Incision of midfoot bones
$4969.26
J1
5123
28305
Incise/graft midfoot bones
$4969.26
J1
5123
28306
Incision of metatarsal
$2395.59
T
5122
28307
Incision of metatarsal
$2395.59
T
5122
28308
Incision of metatarsal
$2395.59
T
5122
28309
Incision of metatarsals
$4969.26
J1
5123
28310
Revision of big toe
$2395.59
T
5122
28312
Revision of toe
$2395.59
T
5122
28313
Repair deformity of toe
$1455.26
T
5121
28315
Removal of sesamoid bone
$1455.26
T
5121
28320
Repair of foot bones
$7064.07
J1
5124
28322
Repair of metatarsals
$4969.26
J1
5123
28340
Resect enlarged toe tissue
$1455.26
T
5121
28341
Resect enlarged toe
$1455.26
T
5121
28344
Repair extra toe(s)
$2395.59
T
5122
28345
Repair webbed toe(s)
$1455.26
T
5121
28360
Reconstruct cleft foot
$4969.26
J1
5123
28400
Treatment of heel fracture
$237.50
T
5112
28405
Treatment of heel fracture
$237.50
T
5112
28406
Treatment of heel fracture
$2395.59
T
5122
28415
Treat heel fracture
$7064.07
J1
5124
28420
Treat/graft heel fracture
$10537.90
J1
5125
28430
Treatment of ankle fracture
$172.33
T
5111
28435
Treatment of ankle fracture
$1096.45
T
5113
28436
Treatment of ankle fracture
$2395.59
T
5122
28445
Treat ankle fracture
$4969.26
J1
5123
28446
Osteochondral talus autogrft
$4969.26
J1
5123
28450
Treat midfoot fracture each
$237.50
T
5112
28455
Treat midfoot fracture each
$1096.45
T
5113
28456
Treat midfoot fracture
$7064.07
J1
5124
28465
Treat midfoot fracture each
$4969.26
J1
5123
28470
Treat metatarsal fracture
$172.33
T
5111
28475
Treat metatarsal fracture
$172.33
T
5111
28476
Treat metatarsal fracture
$2395.59
T
5122
28485
Treat metatarsal fracture
$2395.59
T
5122
28490
Treat big toe fracture
$172.33
T
5111
28495
Treat big toe fracture
$172.33
T
5111
28496
Treat big toe fracture
$2395.59
T
5122
28505
Treat big toe fracture
$2395.59
T
5122
28510
Treatment of toe fracture
$172.33
T
5111
28515
Treatment of toe fracture
$237.50
T
5112
28525
Treat toe fracture
$2395.59
T
5122
28530
Treat sesamoid bone fracture
$172.33
T
5111
28531
Treat sesamoid bone fracture
$2395.59
T
5122
28540
Treat foot dislocation
$172.33
T
5111
28545
Treat foot dislocation
$2395.59
T
5122
28546
Treat foot dislocation
$1455.26
T
5121
28555
Repair foot dislocation
$7064.07
J1
5124
28570
Treat foot dislocation
$172.33
T
5111
28575
Treat foot dislocation
$1096.45
T
5113
28576
Treat foot dislocation
$1455.26
T
5121
28585
Repair foot dislocation
$2395.59
T
5122
28600
Treat foot dislocation
$237.50
T
5112
28605
Treat foot dislocation
$172.33
T
5111
28606
Treat foot dislocation
$2395.59
T
5122
28615
Repair foot dislocation
$4969.26
J1
5123
28630
Treat toe dislocation
$172.33
T
5111
28635
Treat toe dislocation
$1096.45
T
5113
28636
Treat toe dislocation
$2395.59
T
5122
28645
Repair toe dislocation
$2395.59
T
5122
28660
Treat toe dislocation
$172.33
T
5111
28665
Treat toe dislocation
$207.88
S
5102
28666
Treat toe dislocation
$2395.59
T
5122
28675
Repair of toe dislocation
$1455.26
T
5121
28705
Fusion of foot bones
$10537.90
J1
5125
28715
Fusion of foot bones
$10537.90
J1
5125
28725
Fusion of foot bones
$7064.07
J1
5124
28730
Fusion of foot bones
$7064.07
J1
5124
28735
Fusion of foot bones
$10537.90
J1
5125
28737
Revision of foot bones
$7064.07
J1
5124
28740
Fusion of foot bones
$7064.07
J1
5124
28750
Fusion of big toe joint
$4969.26
J1
5123
28755
Fusion of big toe joint
$2395.59
T
5122
28760
Fusion of big toe joint
$4969.26
J1
5123
28805
Amputation thru metatarsal
$2395.59
T
5122
28810
Amputation toe & metatarsal
$1455.26
T
5121
28820
Amputation of toe
$1455.26
T
5121
28825
Partial amputation of toe
$1455.26
T
5121
28890
Hi enrgy eswt plantar fascia
$1455.26
T
5121
28899
Foot/toes surgery procedure
$172.33
T
5111
29000
Application of body cast
$207.88
S
5102
29010
Application of body cast
$207.88
S
5102
29015
Application of body cast
$207.88
S
5102
29035
Application of body cast
$207.88
S
5102
29040
Application of body cast
$207.88
S
5102
29044
Application of body cast
$119.24
S
5101
29046
Application of body cast
$207.88
S
5102
29049
Application of figure eight
$207.88
S
5102
29055
Application of shoulder cast
$207.88
S
5102
29058
Application of shoulder cast
$207.88
S
5102
29065
Application of long arm cast
$207.88
S
5102
29075
Application of forearm cast
$207.88
S
5102
29085
Apply hand/wrist cast
$207.88
S
5102
29086
Apply finger cast
$119.24
S
5101
29105
Apply long arm splint
$119.24
S
5101
29125
Apply forearm splint
$91.18
Q1
5734
29126
Apply forearm splint
$91.18
Q1
5734
29130
Application of finger splint
$55.94
Q1
5733
29131
Application of finger splint
$55.94
Q1
5733
29200
Strapping of chest
$119.24
S
5101
29240
Strapping of shoulder
$55.94
Q1
5733
29260
Strapping of elbow or wrist
$30.51
Q1
5732
29280
Strapping of hand or finger
$30.51
Q1
5732
29305
Application of hip cast
$207.88
S
5102
29325
Application of hip casts
$207.88
S
5102
29345
Application of long leg cast
$207.88
S
5102
29355
Application of long leg cast
$207.88
S
5102
29358
Apply long leg cast brace
$207.88
S
5102
29365
Application of long leg cast
$207.88
S
5102
29405
Apply short leg cast
$207.88
S
5102
29425
Apply short leg cast
$207.88
S
5102
29435
Apply short leg cast
$207.88
S
5102
29440
Addition of walker to cast
$119.24
S
5101
29445
Apply rigid leg cast
$207.88
S
5102
29450
Application of leg cast
$119.24
S
5101
29505
Application long leg splint
$119.24
S
5101
29515
Application lower leg splint
$119.24
S
5101
29520
Strapping of hip
$55.94
Q1
5733
29530
Strapping of knee
$55.94
Q1
5733
29540
Strapping of ankle and/or ft
$119.24
S
5101
29550
Strapping of toes
$55.94
Q1
5733
29580
Application of paste boot
$119.24
S
5101
29581
Apply multlay comprs lwr leg
$119.24
S
5101
29582
Apply multlay comprs upr leg
$207.88
S
5102
29583
Apply multlay comprs upr arm
$119.24
S
5101
29584
Appl multlay comprs arm/hand
$119.24
S
5101
29700
Removal/revision of cast
$207.88
S
5102
29705
Removal/revision of cast
$207.88
S
5102
29710
Removal/revision of cast
$207.88
S
5102
29720
Repair of body cast
$119.24
S
5101
29730
Windowing of cast
$119.24
S
5101
29740
Wedging of cast
$207.88
S
5102
29750
Wedging of clubfoot cast
$207.88
S
5102
29799
Casting/strapping procedure
$119.24
S
5101
29800
Jaw arthroscopy/surgery
$2395.59
T
5122
29804
Jaw arthroscopy/surgery
$2395.59
T
5122
29805
Shoulder arthroscopy dx
$2395.59
T
5122
29806
Shoulder arthroscopy/surgery
$4969.26
J1
5123
29807
Shoulder arthroscopy/surgery
$4969.26
J1
5123
29819
Shoulder arthroscopy/surgery
$2395.59
T
5122
29820
Shoulder arthroscopy/surgery
$2395.59
T
5122
29821
Shoulder arthroscopy/surgery
$2395.59
T
5122
29822
Shoulder arthroscopy/surgery
$2395.59
T
5122
29823
Shoulder arthroscopy/surgery
$2395.59
T
5122
29824
Shoulder arthroscopy/surgery
$2395.59
T
5122
29825
Shoulder arthroscopy/surgery
$2395.59
T
5122
29827
Arthroscop rotator cuff repr
$4969.26
J1
5123
29828
Arthroscopy biceps tenodesis
$4969.26
J1
5123
29830
Elbow arthroscopy
$1455.26
T
5121
29834
Elbow arthroscopy/surgery
$2395.59
T
5122
29835
Elbow arthroscopy/surgery
$2395.59
T
5122
29836
Elbow arthroscopy/surgery
$2395.59
T
5122
29837
Elbow arthroscopy/surgery
$2395.59
T
5122
29838
Elbow arthroscopy/surgery
$2395.59
T
5122
29840
Wrist arthroscopy
$2395.59
T
5122
29843
Wrist arthroscopy/surgery
$2395.59
T
5122
29844
Wrist arthroscopy/surgery
$2395.59
T
5122
29845
Wrist arthroscopy/surgery
$2395.59
T
5122
29846
Wrist arthroscopy/surgery
$2395.59
T
5122
29847
Wrist arthroscopy/surgery
$2395.59
T
5122
29848
Wrist endoscopy/surgery
$1455.26
T
5121
29850
Knee arthroscopy/surgery
$1455.26
T
5121
29851
Knee arthroscopy/surgery
$1455.26
T
5121
29855
Tibial arthroscopy/surgery
$7064.07
J1
5124
29856
Tibial arthroscopy/surgery
$7064.07
J1
5124
29860
Hip arthroscopy dx
$2395.59
T
5122
29861
Hip arthro w/fb removal
$2395.59
T
5122
29862
Hip arthr0 w/debridement
$4969.26
J1
5123
29863
Hip arthr0 w/synovectomy
$2395.59
T
5122
29866
Autgrft implnt knee w/scope
$4969.26
J1
5123
29867
Allgrft implnt knee w/scope
$7064.07
J1
5124
29868
Meniscal trnspl knee w/scpe
$4969.26
J1
5123
29870
Knee arthroscopy dx
$2395.59
T
5122
29871
Knee arthroscopy/drainage
$2395.59
T
5122
29873
Knee arthroscopy/surgery
$2395.59
T
5122
29874
Knee arthroscopy/surgery
$2395.59
T
5122
29875
Knee arthroscopy/surgery
$2395.59
T
5122
29876
Knee arthroscopy/surgery
$2395.59
T
5122
29877
Knee arthroscopy/surgery
$2395.59
T
5122
29879
Knee arthroscopy/surgery
$2395.59
T
5122
29880
Knee arthroscopy/surgery
$2395.59
T
5122
29881
Knee arthroscopy/surgery
$2395.59
T
5122
29882
Knee arthroscopy/surgery
$2395.59
T
5122
29883
Knee arthroscopy/surgery
$2395.59
T
5122
29884
Knee arthroscopy/surgery
$2395.59
T
5122
29885
Knee arthroscopy/surgery
$4969.26
J1
5123
29886
Knee arthroscopy/surgery
$2395.59
T
5122
29887
Knee arthroscopy/surgery
$2395.59
T
5122
29888
Knee arthroscopy/surgery
$7064.07
J1
5124
29889
Knee arthroscopy/surgery
$10537.90
J1
5125
29891
Ankle arthroscopy/surgery
$2395.59
T
5122
29892
Ankle arthroscopy/surgery
$2395.59
T
5122
29893
Scope plantar fasciotomy
$1455.26
T
5121
29894
Ankle arthroscopy/surgery
$2395.59
T
5122
29895
Ankle arthroscopy/surgery
$2395.59
T
5122
29897
Ankle arthroscopy/surgery
$2395.59
T
5122
29898
Ankle arthroscopy/surgery
$2395.59
T
5122
29899
Ankle arthroscopy/surgery
$7064.07
J1
5124
29900
Mcp joint arthroscopy dx
$2395.59
T
5122
29901
Mcp joint arthroscopy surg
$2395.59
T
5122
29902
Mcp joint arthroscopy surg
$1455.26
T
5121
29904
Subtalar arthro w/fb rmvl
$2395.59
T
5122
29905
Subtalar arthro w/exc
$2395.59
T
5122
29906
Subtalar arthro w/deb
$1455.26
T
5121
29907
Subtalar arthro w/fusion
$7064.07
J1
5124
29914
Hip arthro w/femoroplasty
$4969.26
J1
5123
29915
Hip arthro acetabuloplasty
$7064.07
J1
5124
29916
Hip arthro w/labral repair
$7064.07
J1
5124
29999
Arthroscopy of joint
$1455.26
T
5121
30000
Drainage of nose lesion
$129.29
T
5161
30020
Drainage of nose lesion
$312.93
T
5162
30100
Intranasal biopsy
$689.63
T
5163
30110
Removal of nose polyp(s)
$689.63
T
5163
30115
Removal of nose polyp(s)
$1616.90
T
5164
30117
Removal of intranasal lesion
$1616.90
T
5164
30118
Removal of intranasal lesion
$1616.90
T
5164
30120
Revision of nose
$1616.90
T
5164
30124
Removal of nose lesion
$1616.90
T
5164
30125
Removal of nose lesion
$3955.98
J1
5165
30130
Excise inferior turbinate
$1616.90
T
5164
30140
Resect inferior turbinate
$1616.90
T
5164
30150
Partial removal of nose
$3955.98
J1
5165
30160
Removal of nose
$3955.98
J1
5165
30200
Injection treatment of nose
$689.63
T
5163
30210
Nasal sinus therapy
$689.63
T
5163
30220
Insert nasal septal button
$689.63
T
5163
30300
Remove nasal foreign body
$91.18
Q1
5734
30310
Remove nasal foreign body
$1616.90
T
5164
30320
Remove nasal foreign body
$689.63
T
5163
30400
Reconstruction of nose
$1616.90
T
5164
30410
Reconstruction of nose
$3955.98
J1
5165
30420
Reconstruction of nose
$3955.98
J1
5165
30430
Revision of nose
$1616.90
T
5164
30435
Revision of nose
$3955.98
J1
5165
30450
Revision of nose
$3955.98
J1
5165
30460
Revision of nose
$3955.98
J1
5165
30462
Revision of nose
$3955.98
J1
5165
30465
Repair nasal stenosis
$3955.98
J1
5165
30520
Repair of nasal septum
$1616.90
T
5164
30540
Repair nasal defect
$3955.98
J1
5165
30545
Repair nasal defect
$3955.98
J1
5165
30560
Release of nasal adhesions
$312.93
T
5162
30580
Repair upper jaw fistula
$3955.98
J1
5165
30600
Repair mouth/nose fistula
$3955.98
J1
5165
30620
Intranasal reconstruction
$3955.98
J1
5165
30630
Repair nasal septum defect
$1616.90
T
5164
30801
Ablate inf turbinate superf
$689.63
T
5163
30802
Ablate inf turbinate submuc
$1616.90
T
5164
30901
Control of nosebleed
$91.18
Q1
5734
30903
Control of nosebleed
$129.29
T
5161
30905
Control of nosebleed
$129.29
T
5161
30906
Repeat control of nosebleed
$129.29
T
5161
30915
Ligation nasal sinus artery
$2247.33
T
5182
30920
Ligation upper jaw artery
$2247.33
T
5182
30930
Ther fx nasal inf turbinate
$1616.90
T
5164
30999
Nasal surgery procedure
$129.29
T
5161
31000
Irrigation maxillary sinus
$312.93
T
5162
31002
Irrigation sphenoid sinus
$689.63
T
5163
31020
Exploration maxillary sinus
$1616.90
T
5164
31030
Exploration maxillary sinus
$3955.98
J1
5165
31032
Explore sinus remove polyps
$3955.98
J1
5165
31040
Exploration behind upper jaw
$1616.90
T
5164
31050
Exploration sphenoid sinus
$3955.98
J1
5165
31051
Sphenoid sinus surgery
$3955.98
J1
5165
31070
Exploration of frontal sinus
$3955.98
J1
5165
31075
Exploration of frontal sinus
$3955.98
J1
5165
31080
Removal of frontal sinus
$3955.98
J1
5165
31081
Removal of frontal sinus
$3955.98
J1
5165
31084
Removal of frontal sinus
$3955.98
J1
5165
31085
Removal of frontal sinus
$3955.98
J1
5165
31086
Removal of frontal sinus
$3955.98
J1
5165
31087
Removal of frontal sinus
$3955.98
J1
5165
31090
Exploration of sinuses
$3955.98
J1
5165
31200
Removal of ethmoid sinus
$3955.98
J1
5165
31201
Removal of ethmoid sinus
$1616.90
T
5164
31205
Removal of ethmoid sinus
$1616.90
T
5164
31231
Nasal endoscopy dx
$141.31
T
5151
31233
Nasal/sinus endoscopy dx
$375.13
T
5152
31235
Nasal/sinus endoscopy dx
$1037.50
T
5153
31237
Nasal/sinus endoscopy surg
$1037.50
T
5153
31238
Nasal/sinus endoscopy surg
$1037.50
T
5153
31239
Nasal/sinus endoscopy surg
$1991.92
T
5154
31240
Nasal/sinus endoscopy surg
$1037.50
T
5153
31254
Revision of ethmoid sinus
$3066.48
T
5155
31255
Removal of ethmoid sinus
$3066.48
T
5155
31256
Exploration maxillary sinus
$1991.92
T
5154
31267
Endoscopy maxillary sinus
$3066.48
T
5155
31276
Sinus endoscopy surgical
$3066.48
T
5155
31287
Nasal/sinus endoscopy surg
$3066.48
T
5155
31288
Nasal/sinus endoscopy surg
$3066.48
T
5155
31292
Nasal/sinus endoscopy surg
$3066.48
T
5155
31293
Nasal/sinus endoscopy surg
$3066.48
T
5155
31294
Nasal/sinus endoscopy surg
$3066.48
T
5155
31295
Sinus endo w/balloon dil
$3066.48
T
5155
31296
Sinus endo w/balloon dil
$3066.48
T
5155
31297
Sinus endo w/balloon dil
$3066.48
T
5155
31299
Sinus surgery procedure
$129.29
T
5161
31300
Removal of larynx lesion
$1616.90
T
5164
31320
Diagnostic incision larynx
$3955.98
J1
5165
31400
Revision of larynx
$3955.98
J1
5165
31420
Removal of epiglottis
$3955.98
J1
5165
31500
Insert emergency airway
$129.29
T
5161
31502
Change of windpipe airway
$129.29
T
5161
31505
Diagnostic laryngoscopy
$141.31
T
5151
31510
Laryngoscopy with biopsy
$1991.92
T
5154
31511
Remove foreign body larynx
$141.31
T
5151
31512
Removal of larynx lesion
$1991.92
T
5154
31513
Injection into vocal cord
$1037.50
T
5153
31515
Laryngoscopy for aspiration
$375.13
T
5152
31520
Dx laryngoscopy newborn
$375.13
T
5152
31525
Dx laryngoscopy excl nb
$1037.50
T
5153
31526
Dx laryngoscopy w/oper scope
$1037.50
T
5153
31527
Laryngoscopy for treatment
$1991.92
T
5154
31528
Laryngoscopy and dilation
$1991.92
T
5154
31529
Laryngoscopy and dilation
$1991.92
T
5154
31530
Laryngoscopy w/fb removal
$1037.50
T
5153
31531
Laryngoscopy w/fb & op scope
$1991.92
T
5154
31535
Laryngoscopy w/biopsy
$1991.92
T
5154
31536
Laryngoscopy w/bx & op scope
$1991.92
T
5154
31540
Laryngoscopy w/exc of tumor
$1991.92
T
5154
31541
Larynscop w/tumr exc + scope
$1991.92
T
5154
31545
Remove vc lesion w/scope
$1991.92
T
5154
31546
Remove vc lesion scope/graft
$3066.48
T
5155
31560
Laryngoscop w/arytenoidectom
$3066.48
T
5155
31561
Larynscop remve cart + scop
$1991.92
T
5154
31570
Laryngoscope w/vc inj
$1991.92
T
5154
31571
Laryngoscop w/vc inj + scope
$1991.92
T
5154
31575
Diagnostic laryngoscopy
$141.31
T
5151
31576
Laryngoscopy with biopsy
$1037.50
T
5153
31577
Remove foreign body larynx
$375.13
T
5152
31578
Removal of larynx lesion
$1991.92
T
5154
31579
Diagnostic laryngoscopy
$375.13
T
5152
31580
Revision of larynx
$3955.98
J1
5165
31582
Revision of larynx
$3955.98
J1
5165
31588
Revision of larynx
$3955.98
J1
5165
31590
Reinnervate larynx
$3955.98
J1
5165
31595
Larynx nerve surgery
$3955.98
J1
5165
31599
Larynx surgery procedure
$129.29
T
5161
31600
Incision of windpipe
$1616.90
T
5164
31601
Incision of windpipe
$1616.90
T
5164
31603
Incision of windpipe
$689.63
T
5163
31605
Incision of windpipe
$689.63
T
5163
31610
Incision of windpipe
$3955.98
J1
5165
31611
Surgery/speech prosthesis
$1616.90
T
5164
31612
Puncture/clear windpipe
$3955.98
J1
5165
31613
Repair windpipe opening
$1616.90
T
5164
31614
Repair windpipe opening
$3955.98
J1
5165
31615
Visualization of windpipe
$689.63
T
5163
31622
Dx bronchoscope/wash
$1037.50
T
5153
31623
Dx bronchoscope/brush
$1037.50
T
5153
31624
Dx bronchoscope/lavage
$1037.50
T
5153
31625
Bronchoscopy w/biopsy(s)
$1037.50
T
5153
31626
Bronchoscopy w/markers
$3066.48
T
5155
31628
Bronchoscopy/lung bx each
$1991.92
T
5154
31629
Bronchoscopy/needle bx each
$1991.92
T
5154
31630
Bronchoscopy dilate/fx repr
$1991.92
T
5154
31631
Bronchoscopy dilate w/stent
$3066.48
T
5155
31634
Bronch w/balloon occlusion
$3066.48
T
5155
31635
Bronchoscopy w/fb removal
$1037.50
T
5153
31636
Bronchoscopy bronch stents
$3066.48
T
5155
31638
Bronchoscopy revise stent
$3066.48
T
5155
31640
Bronchoscopy w/tumor excise
$1991.92
T
5154
31641
Bronchoscopy treat blockage
$1991.92
T
5154
31643
Diag bronchoscope/catheter
$1037.50
T
5153
31645
Bronchoscopy clear airways
$1037.50
T
5153
31646
Bronchoscopy reclear airway
$375.13
T
5152
31647
Bronchial valve init insert
$3066.48
T
5155
31648
Bronchial valve remov init
$1991.92
T
5154
31649
Bronchial valve remov addl
$1037.50
Q2
5153
31652
Bronch ebus samplng 1/2 node
$1991.92
T
5154
31653
Bronch ebus samplng 3/> node
$1991.92
T
5154
31660
Bronch thermoplsty 1 lobe
$3066.48
T
5155
31661
Bronch thermoplsty 2/> lobes
$3066.48
T
5155
31717
Bronchial brush biopsy
$375.13
T
5152
31720
Clearance of airways
$149.46
Q1
5791
31730
Intro windpipe wire/tube
$1037.50
T
5153
31750
Repair of windpipe
$3955.98
J1
5165
31755
Repair of windpipe
$3955.98
J1
5165
31785
Remove windpipe lesion
$1616.90
T
5164
31820
Closure of windpipe lesion
$1616.90
T
5164
31825
Repair of windpipe defect
$1616.90
T
5164
31830
Revise windpipe scar
$1616.90
T
5164
31899
Airways surgical procedure
$141.31
T
5151
32400
Needle biopsy chest lining
$941.98
T
5073
32405
Percut bx lung/mediastinum
$941.98
T
5073
32550
Insert pleural cath
$2177.11
T
5351
32551
Insertion of chest tube
$482.83
T
5391
32552
Remove lung catheter
$482.83
Q2
5391
32553
Ins mark thor for rt perq
$1026.81
S
5614
32554
Aspirate pleura w/o imaging
$482.83
T
5391
32555
Aspirate pleura w/ imaging
$482.83
T
5391
32556
Insert cath pleura w/o image
$1207.75
T
5392
32557
Insert cath pleura w/ image
$482.83
T
5391
32560
Treat pleurodesis w/agent
$482.83
T
5391
32561
Lyse chest fibrin init day
$482.83
T
5391
32562
Lyse chest fibrin subq day
$482.83
T
5391
32601
Thoracoscopy diagnostic
$3152.92
T
5141
32604
Thoracoscopy wbx sac
$3152.92
T
5141
32606
Thoracoscopy w/bx med space
$3152.92
T
5141
32607
Thoracoscopy w/bx infiltrate
$3152.92
T
5141
32608
Thoracoscopy w/bx nodule
$3152.92
T
5141
32609
Thoracoscopy w/bx pleura
$3152.92
T
5141
32960
Therapeutic pneumothorax
$482.83
T
5391
32998
Perq rf ablate tx pul tumor
$4118.23
T
5352
32999
Chest surgery procedure
$482.83
T
5391
33010
Drainage of heart sac
$482.83
T
5391
33011
Repeat drainage of heart sac
$482.83
T
5391
33206
Insert heart pm atrial
$9273.40
J1
5223
33207
Insert heart pm ventricular
$9273.40
J1
5223
33208
Insrt heart pm atrial & vent
$9273.40
J1
5223
33210
Insert electrd/pm cath sngl
$6696.85
J1
5222
33211
Insert card electrodes dual
$6696.85
J1
5222
33212
Insert pulse gen sngl lead
$6696.85
J1
5222
33213
Insert pulse gen dual leads
$9273.40
J1
5223
33214
Upgrade of pacemaker system
$9273.40
J1
5223
33215
Reposition pacing-defib lead
$862.51
T
5181
33216
Insert 1 electrode pm-defib
$6696.85
J1
5222
33217
Insert 2 electrode pm-defib
$6696.85
J1
5222
33218
Repair lead pace-defib one
$2489.69
T
5221
33220
Repair lead pace-defib dual
$2489.69
T
5221
33221
Insert pulse gen mult leads
$16914.40
J1
5224
33222
Relocation pocket pacemaker
$1411.21
T
5054
33223
Relocate pocket for defib
$1411.21
T
5054
33224
Insert pacing lead & connect
$9273.40
J1
5223
33226
Reposition l ventric lead
$2247.33
T
5182
33227
Remove&replace pm gen singl
$6696.85
J1
5222
33228
Remv&replc pm gen dual lead
$9273.40
J1
5223
33229
Remv&replc pm gen mult leads
$16914.40
J1
5224
33230
Insrt pulse gen w/dual leads
$21930.03
J1
5231
33231
Insrt pulse gen w/mult leads
$30489.78
J1
5232
33233
Removal of pm generator
$6696.85
Q2
5222
33234
Removal of pacemaker system
$2489.69
Q2
5221
33235
Removal pacemaker electrode
$2489.69
Q2
5221
33240
Insrt pulse gen w/singl lead
$21930.03
J1
5231
33241
Remove pulse generator
$2489.69
Q2
5221
33244
Remove elctrd transvenously
$2489.69
Q2
5221
33249
Insj/rplcmt defib w/lead(s)
$30489.78
J1
5232
33262
Rmvl& replc pulse gen 1 lead
$21930.03
J1
5231
33263
Rmvl & rplcmt dfb gen 2 lead
$21930.03
J1
5231
33264
Rmvl & rplcmt dfb gen mlt ld
$30489.78
J1
5232
33270
Ins/rep subq defibrillator
$30489.78
J1
5232
33271
Insj subq impltbl dfb elctrd
$6696.85
J1
5222
33272
Rmvl of subq defibrillator
$2489.69
Q2
5221
33273
Repos prev impltbl subq dfb
$2489.69
T
5221
33282
Implant pat-active ht record
$6696.85
J1
5222
33284
Remove pat-active ht record
$941.98
Q2
5073
33999
Cardiac surgery procedure
$482.83
T
5391
34101
Removal of artery clot
$3795.28
T
5183
34111
Removal of arm artery clot
$3795.28
T
5183
34201
Removal of artery clot
$3795.28
T
5183
34203
Removal of leg artery clot
$3795.28
T
5183
34421
Removal of vein clot
$2247.33
T
5182
34471
Removal of vein clot
$2247.33
T
5182
34490
Removal of vein clot
$2247.33
T
5182
34501
Repair valve femoral vein
$3795.28
T
5183
34510
Transposition of vein valve
$3795.28
T
5183
34520
Cross-over vein graft
$3795.28
T
5183
34530
Leg vein fusion
$2247.33
T
5182
35011
Repair defect of artery
$2247.33
T
5182
35045
Repair defect of arm artery
$2247.33
T
5182
35180
Repair blood vessel lesion
$2247.33
T
5182
35184
Repair blood vessel lesion
$3795.28
T
5183
35188
Repair blood vessel lesion
$2247.33
T
5182
35190
Repair blood vessel lesion
$2247.33
T
5182
35201
Repair blood vessel lesion
$2247.33
T
5182
35206
Repair blood vessel lesion
$2247.33
T
5182
35207
Repair blood vessel lesion
$2247.33
T
5182
35226
Repair blood vessel lesion
$480.64
T
5072
35231
Repair blood vessel lesion
$2247.33
T
5182
35236
Repair blood vessel lesion
$3795.28
T
5183
35256
Repair blood vessel lesion
$3795.28
T
5183
35261
Repair blood vessel lesion
$2247.33
T
5182
35266
Repair blood vessel lesion
$3795.28
T
5183
35286
Repair blood vessel lesion
$3795.28
T
5183
35321
Rechanneling of artery
$3795.28
T
5183
35458
Repair arterial blockage
$4592.15
J1
5191
35460
Repair venous blockage
$4592.15
J1
5191
35471
Repair arterial blockage
$4592.15
J1
5191
35472
Repair arterial blockage
$4592.15
J1
5191
35475
Repair arterial blockage
$4592.15
J1
5191
35476
Repair venous blockage
$4592.15
J1
5191
35761
Exploration of artery/vein
$2247.33
T
5182
35860
Explore limb vessels
$2247.33
T
5182
35875
Removal of clot in graft
$3795.28
T
5183
35876
Removal of clot in graft
$3795.28
T
5183
35879
Revise graft w/vein
$3795.28
T
5183
35881
Revise graft w/vein
$3795.28
T
5183
35883
Revise graft w/nonauto graft
$3795.28
T
5183
35884
Revise graft w/vein
$3795.28
T
5183
35903
Excision graft extremity
$2247.33
T
5182
36002
Pseudoaneurysm injection trt
$416.80
S
5533
36147
Access av dial grft for eval
$862.51
T
5181
36221
Place cath thoracic aorta
$2718.83
Q2
5526
36222
Place cath carotid/inom art
$2718.83
Q2
5526
36223
Place cath carotid/inom art
$3795.28
Q2
5183
36224
Place cath carotd art
$3795.28
Q2
5183
36225
Place cath subclavian art
$2718.83
Q2
5526
36226
Place cath vertebral art
$3795.28
Q2
5183
36251
Ins cath ren art 1st unilat
$2718.83
Q2
5526
36252
Ins cath ren art 1st bilat
$2718.83
Q2
5526
36253
Ins cath ren art 2nd+ unilat
$2718.83
Q2
5526
36254
Ins cath ren art 2nd+ bilat
$2718.83
Q2
5526
36260
Insertion of infusion pump
$2247.33
T
5182
36261
Revision of infusion pump
$2489.69
T
5221
36262
Removal of infusion pump
$2489.69
Q2
5221
36420
Vein access cutdown < 1 yr
$55.94
Q1
5733
36425
Vein access cutdown > 1 yr
$91.18
Q1
5734
36430
Blood transfusion service
$349.14
S
5241
36440
Bl push transfuse 2 yr/<
$349.14
S
5241
36450
Bl exchange/transfuse nb
$349.14
S
5241
36455
Bl exchange/transfuse non-nb
$349.14
S
5241
36460
Transfusion service fetal
$349.14
S
5241
36468
Injection(s) spider veins
$117.83
Q1
5051
36470
Injection therapy of vein
$225.55
T
5052
36471
Injection therapy of veins
$225.55
T
5052
36475
Endovenous rf 1st vein
$2247.33
T
5182
36478
Endovenous laser 1st vein
$2247.33
T
5182
36511
Apheresis wbc
$1047.76
S
5271
36512
Apheresis rbc
$1047.76
S
5271
36513
Apheresis platelets
$1047.76
S
5271
36514
Apheresis plasma
$1047.76
S
5271
36515
Apheresis adsorp/reinfuse
$3015.06
S
5281
36516
Apheresis selective
$3015.06
S
5281
36522
Photopheresis
$3015.06
S
5281
36555
Insert non-tunnel cv cath
$862.51
T
5181
36556
Insert non-tunnel cv cath
$862.51
T
5181
36557
Insert tunneled cv cath
$2247.33
T
5182
36558
Insert tunneled cv cath
$2247.33
T
5182
36560
Insert tunneled cv cath
$2247.33
T
5182
36561
Insert tunneled cv cath
$2247.33
T
5182
36563
Insert tunneled cv cath
$3795.28
T
5183
36565
Insert tunneled cv cath
$2247.33
T
5182
36566
Insert tunneled cv cath
$3795.28
T
5183
36568
Insert picc cath
$862.51
T
5181
36569
Insert picc cath
$862.51
T
5181
36570
Insert picvad cath
$2247.33
T
5182
36571
Insert picvad cath
$2247.33
T
5182
36575
Repair tunneled cv cath
$482.83
T
5391
36576
Repair tunneled cv cath
$862.51
T
5181
36578
Replace tunneled cv cath
$2247.33
T
5182
36580
Replace cvad cath
$862.51
T
5181
36581
Replace tunneled cv cath
$2247.33
T
5182
36582
Replace tunneled cv cath
$2247.33
T
5182
36583
Replace tunneled cv cath
$3795.28
T
5183
36584
Replace picc cath
$862.51
T
5181
36585
Replace picvad cath
$2247.33
T
5182
36589
Removal tunneled cv cath
$482.83
Q2
5391
36590
Removal tunneled cv cath
$862.51
Q2
5181
36591
Draw blood off venous device
$91.18
Q1
5734
36592
Collect blood from picc
$91.18
Q1
5734
36593
Declot vascular device
$199.80
T
5291
36595
Mech remov tunneled cv cath
$2247.33
T
5182
36596
Mech remov tunneled cv cath
$862.51
T
5181
36597
Reposition venous catheter
$862.51
T
5181
36598
Inj w/fluor eval cv device
$199.80
T
5291
36600
Withdrawal of arterial blood
$91.18
Q1
5734
36640
Insertion catheter artery
$2247.33
T
5182
36680
Insert needle bone cavity
$91.18
Q1
5734
36800
Insertion of cannula
$2247.33
T
5182
36810
Insertion of cannula
$3795.28
T
5183
36815
Insertion of cannula
$2247.33
T
5182
36818
Av fuse uppr arm cephalic
$2247.33
T
5182
36819
Av fuse uppr arm basilic
$3795.28
T
5183
36820
Av fusion/forearm vein
$2247.33
T
5182
36821
Av fusion direct any site
$2247.33
T
5182
36825
Artery-vein autograft
$3795.28
T
5183
36830
Artery-vein nonautograft
$3795.28
T
5183
36831
Open thrombect av fistula
$2247.33
T
5182
36832
Av fistula revision open
$3795.28
T
5183
36833
Av fistula revision
$3795.28
T
5183
36835
Artery to vein shunt
$2247.33
T
5182
36838
Dist revas ligation hemo
$3795.28
T
5183
36860
External cannula declotting
$862.51
T
5181
36861
Cannula declotting
$3795.28
T
5183
36870
Percut thrombect av fistula
$4592.15
J1
5191
37183
Remove hepatic shunt (tips)
$4592.15
J1
5191
37184
Prim art m-thrmbc 1st vsl
$3795.28
T
5183
37187
Venous mech thrombectomy
$3795.28
T
5183
37188
Venous m-thrombectomy add-on
$2247.33
T
5182
37191
Ins endovas vena cava filtr
$3795.28
T
5183
37192
Redo endovas vena cava filtr
$2247.33
T
5182
37193
Rem endovas vena cava filter
$2247.33
T
5182
37195
Thrombolytic therapy stroke
$199.80
T
5291
37197
Remove intrvas foreign body
$2247.33
T
5182
37200
Transcatheter biopsy
$3795.28
T
5183
37211
Thrombolytic art therapy
$3795.28
T
5183
37212
Thrombolytic venous therapy
$862.51
T
5181
37213
Thromblytic art/ven therapy
$2247.33
T
5182
37214
Cessj therapy cath removal
$2247.33
T
5182
37220
Iliac revasc
$4592.15
J1
5191
37221
Iliac revasc w/stent
$9542.35
J1
5192
37224
Fem/popl revas w/tla
$4592.15
J1
5191
37225
Fem/popl revas w/ather
$9542.35
J1
5192
37226
Fem/popl revasc w/stent
$9542.35
J1
5192
37227
Fem/popl revasc stnt & ather
$14612.17
J1
5193
37228
Tib/per revasc w/tla
$9542.35
J1
5192
37229
Tib/per revasc w/ather
$14612.17
J1
5193
37230
Tib/per revasc w/stent
$14612.17
J1
5193
37231
Tib/per revasc stent & ather
$14612.17
J1
5193
37236
Open/perq place stent 1st
$9542.35
J1
5192
37238
Open/perq place stent same
$9542.35
J1
5192
37241
Vasc embolize/occlude venous
$9542.35
J1
5192
37242
Vasc embolize/occlude artery
$9542.35
J1
5192
37243
Vasc embolize/occlude organ
$9542.35
J1
5192
37244
Vasc embolize/occlude bleed
$9542.35
J1
5192
37500
Endoscopy ligate perf veins
$3795.28
T
5183
37501
Vascular endoscopy procedure
$862.51
T
5181
37565
Ligation of neck vein
$2247.33
T
5182
37600
Ligation of neck artery
$2247.33
T
5182
37605
Ligation of neck artery
$2247.33
T
5182
37606
Ligation of neck artery
$2247.33
T
5182
37607
Ligation of a-v fistula
$2247.33
T
5182
37609
Temporal artery procedure
$1414.28
T
5074
37615
Ligation of neck artery
$3795.28
T
5183
37619
Ligation of inf vena cava
$3795.28
T
5183
37650
Revision of major vein
$2247.33
T
5182
37700
Revise leg vein
$2247.33
T
5182
37718
Ligate/strip short leg vein
$2247.33
T
5182
37722
Ligate/strip long leg vein
$2247.33
T
5182
37735
Removal of leg veins/lesion
$2247.33
T
5182
37760
Ligate leg veins radical
$2247.33
T
5182
37761
Ligate leg veins open
$2247.33
T
5182
37765
Stab phleb veins xtr 10-20
$2247.33
T
5182
37766
Phleb veins - extrem 20+
$2247.33
T
5182
37780
Revision of leg vein
$2247.33
T
5182
37785
Ligate/divide/excise vein
$2247.33
T
5182
37790
Penile venous occlusion
$2243.49
T
5374
37799
Vascular surgery procedure
$862.51
T
5181
38120
Laparoscopy splenectomy
$6860.91
J1
5362
38129
Laparoscope proc spleen
$4001.15
J1
5361
38206
Harvest auto stem cells
$1047.76
S
5271
38207
Cryopreserve stem cells
$349.14
S
5241
38208
Thaw preserved stem cells
$349.14
S
5241
38209
Wash harvest stem cells
$349.14
S
5241
38210
T-cell depletion of harvest
$1047.76
S
5271
38211
Tumor cell deplete of harvst
$1047.76
S
5271
38212
Rbc depletion of harvest
$1047.76
S
5271
38213
Platelet deplete of harvest
$1047.76
S
5271
38214
Volume deplete of harvest
$1047.76
S
5271
38215
Harvest stem cell concentrte
$1047.76
S
5271
38220
Bone marrow aspiration
$941.98
T
5073
38221
Bone marrow biopsy
$1414.28
T
5074
38230
Bone marrow harvest allogen
$3015.06
S
5281
38232
Bone marrow harvest autolog
$3015.06
S
5281
38240
Transplt allo hct/donor
$3015.06
S
5281
38241
Transplt autol hct/donor
$3015.06
S
5281
38242
Transplt allo lymphocytes
$1047.76
S
5271
38243
Transplj hematopoietic boost
$1047.76
S
5271
38300
Drainage lymph node lesion
$1414.28
T
5074
38305
Drainage lymph node lesion
$1414.28
T
5074
38308
Incision of lymph channels
$2187.94
T
5091
38500
Biopsy/removal lymph nodes
$2187.94
T
5091
38505
Needle biopsy lymph nodes
$941.98
T
5073
38510
Biopsy/removal lymph nodes
$2187.94
T
5091
38520
Biopsy/removal lymph nodes
$2187.94
T
5091
38525
Biopsy/removal lymph nodes
$2187.94
T
5091
38530
Biopsy/removal lymph nodes
$2187.94
T
5091
38542
Explore deep node(s) neck
$4001.15
J1
5361
38550
Removal neck/armpit lesion
$2187.94
T
5091
38555
Removal neck/armpit lesion
$3647.06
T
5092
38570
Laparoscopy lymph node biop
$4001.15
J1
5361
38571
Laparoscopy lymphadenectomy
$6860.91
J1
5362
38572
Laparoscopy lymphadenectomy
$6860.91
J1
5362
38589
Laparoscope proc lymphatic
$4001.15
J1
5361
38700
Removal of lymph nodes neck
$3647.06
T
5092
38720
Removal of lymph nodes neck
$3647.06
T
5092
38740
Remove armpit lymph nodes
$4001.15
J1
5361
38745
Remove armpit lymph nodes
$4001.15
J1
5361
38760
Remove groin lymph nodes
$2187.94
T
5091
38792
Ra tracer id of sentinl node
$332.65
Q1
5591
38999
Blood/lymph system procedure
$349.14
S
5241
39401
Mediastinoscpy w/medstnl bx
$3152.92
T
5141
39402
Mediastinoscpy w/lmph nod bx
$3152.92
T
5141
40490
Biopsy of lip
$312.93
T
5162
40500
Partial excision of lip
$1616.90
T
5164
40510
Partial excision of lip
$1616.90
T
5164
40520
Partial excision of lip
$1616.90
T
5164
40525
Reconstruct lip with flap
$1616.90
T
5164
40527
Reconstruct lip with flap
$3955.98
J1
5165
40530
Partial removal of lip
$1616.90
T
5164
40650
Repair lip
$689.63
T
5163
40652
Repair lip
$689.63
T
5163
40654
Repair lip
$689.63
T
5163
40700
Repair cleft lip/nasal
$3955.98
J1
5165
40701
Repair cleft lip/nasal
$3955.98
J1
5165
40702
Repair cleft lip/nasal
$3955.98
J1
5165
40720
Repair cleft lip/nasal
$3955.98
J1
5165
40761
Repair cleft lip/nasal
$3955.98
J1
5165
40799
Lip surgery procedure
$129.29
T
5161
40800
Drainage of mouth lesion
$228.27
T
5071
40801
Drainage of mouth lesion
$689.63
T
5163
40804
Removal foreign body mouth
$91.18
Q1
5734
40805
Removal foreign body mouth
$689.63
T
5163
40806
Incision of lip fold
$312.93
T
5162
40808
Biopsy of mouth lesion
$312.93
T
5162
40810
Excision of mouth lesion
$1616.90
T
5164
40812
Excise/repair mouth lesion
$1616.90
T
5164
40814
Excise/repair mouth lesion
$1616.90
T
5164
40816
Excision of mouth lesion
$1616.90
T
5164
40818
Excise oral mucosa for graft
$312.93
T
5162
40819
Excise lip or cheek fold
$1616.90
T
5164
40820
Treatment of mouth lesion
$1616.90
T
5164
40830
Repair mouth laceration
$312.93
T
5162
40831
Repair mouth laceration
$689.63
T
5163
40840
Reconstruction of mouth
$1616.90
T
5164
40842
Reconstruction of mouth
$3955.98
J1
5165
40843
Reconstruction of mouth
$1616.90
T
5164
40844
Reconstruction of mouth
$3955.98
J1
5165
40845
Reconstruction of mouth
$3955.98
J1
5165
40899
Mouth surgery procedure
$129.29
T
5161
41000
Drainage of mouth lesion
$689.63
T
5163
41005
Drainage of mouth lesion
$312.93
T
5162
41006
Drainage of mouth lesion
$689.63
T
5163
41007
Drainage of mouth lesion
$689.63
T
5163
41008
Drainage of mouth lesion
$1616.90
T
5164
41009
Drainage of mouth lesion
$312.93
T
5162
41010
Incision of tongue fold
$689.63
T
5163
41015
Drainage of mouth lesion
$312.93
T
5162
41016
Drainage of mouth lesion
$1616.90
T
5164
41017
Drainage of mouth lesion
$1616.90
T
5164
41018
Drainage of mouth lesion
$689.63
T
5163
41019
Place needles h&n for rt
$1616.90
T
5164
41100
Biopsy of tongue
$689.63
T
5163
41105
Biopsy of tongue
$1616.90
T
5164
41108
Biopsy of floor of mouth
$941.98
T
5073
41110
Excision of tongue lesion
$1616.90
T
5164
41112
Excision of tongue lesion
$1616.90
T
5164
41113
Excision of tongue lesion
$1616.90
T
5164
41114
Excision of tongue lesion
$1616.90
T
5164
41115
Excision of tongue fold
$689.63
T
5163
41116
Excision of mouth lesion
$1616.90
T
5164
41120
Partial removal of tongue
$3955.98
J1
5165
41250
Repair tongue laceration
$91.18
Q1
5734
41251
Repair tongue laceration
$312.93
T
5162
41252
Repair tongue laceration
$689.63
T
5163
41500
Fixation of tongue
$1616.90
T
5164
41510
Tongue to lip surgery
$1616.90
T
5164
41512
Tongue suspension
$3955.98
J1
5165
41520
Reconstruction tongue fold
$3955.98
J1
5165
41530
Tongue base vol reduction
$1616.90
T
5164
41599
Tongue and mouth surgery
$129.29
T
5161
41800
Drainage of gum lesion
$91.18
Q1
5734
41805
Removal foreign body gum
$1616.90
T
5164
41806
Removal foreign body jawbone
$689.63
T
5163
41820
Excision gum each quadrant
$1616.90
T
5164
41821
Excision of gum flap
$689.63
T
5163
41822
Excision of gum lesion
$689.63
T
5163
41823
Excision of gum lesion
$3955.98
J1
5165
41825
Excision of gum lesion
$1616.90
T
5164
41826
Excision of gum lesion
$1616.90
T
5164
41827
Excision of gum lesion
$3955.98
J1
5165
41828
Excision of gum lesion
$1616.90
T
5164
41830
Removal of gum tissue
$1616.90
T
5164
41850
Treatment of gum lesion
$1616.90
T
5164
41870
Gum graft
$3955.98
J1
5165
41872
Repair gum
$3955.98
J1
5165
41874
Repair tooth socket
$1616.90
T
5164
41899
Dental surgery procedure
$129.29
T
5161
42000
Drainage mouth roof lesion
$312.93
T
5162
42100
Biopsy roof of mouth
$689.63
T
5163
42104
Excision lesion mouth roof
$1616.90
T
5164
42106
Excision lesion mouth roof
$1616.90
T
5164
42107
Excision lesion mouth roof
$3955.98
J1
5165
42120
Remove palate/lesion
$1616.90
T
5164
42140
Excision of uvula
$1616.90
T
5164
42145
Repair palate pharynx/uvula
$3955.98
J1
5165
42160
Treatment mouth roof lesion
$1616.90
T
5164
42180
Repair palate
$312.93
T
5162
42182
Repair palate
$1616.90
T
5164
42200
Reconstruct cleft palate
$3955.98
J1
5165
42205
Reconstruct cleft palate
$3955.98
J1
5165
42210
Reconstruct cleft palate
$3955.98
J1
5165
42215
Reconstruct cleft palate
$3955.98
J1
5165
42220
Reconstruct cleft palate
$3955.98
J1
5165
42225
Reconstruct cleft palate
$3955.98
J1
5165
42226
Lengthening of palate
$3955.98
J1
5165
42227
Lengthening of palate
$3955.98
J1
5165
42235
Repair palate
$3955.98
J1
5165
42260
Repair nose to lip fistula
$1616.90
T
5164
42280
Preparation palate mold
$312.93
T
5162
42281
Insertion palate prosthesis
$1616.90
T
5164
42299
Palate/uvula surgery
$129.29
T
5161
42300
Drainage of salivary gland
$689.63
T
5163
42305
Drainage of salivary gland
$1616.90
T
5164
42310
Drainage of salivary gland
$312.93
T
5162
42320
Drainage of salivary gland
$312.93
T
5162
42330
Removal of salivary stone
$1616.90
T
5164
42335
Removal of salivary stone
$1616.90
T
5164
42340
Removal of salivary stone
$1616.90
T
5164
42400
Biopsy of salivary gland
$941.98
T
5073
42405
Biopsy of salivary gland
$1616.90
T
5164
42408
Excision of salivary cyst
$1616.90
T
5164
42409
Drainage of salivary cyst
$1616.90
T
5164
42410
Excise parotid gland/lesion
$3955.98
J1
5165
42415
Excise parotid gland/lesion
$3955.98
J1
5165
42420
Excise parotid gland/lesion
$3955.98
J1
5165
42425
Excise parotid gland/lesion
$3955.98
J1
5165
42440
Excise submaxillary gland
$3955.98
J1
5165
42450
Excise sublingual gland
$3955.98
J1
5165
42500
Repair salivary duct
$1616.90
T
5164
42505
Repair salivary duct
$3955.98
J1
5165
42507
Parotid duct diversion
$3955.98
J1
5165
42509
Parotid duct diversion
$3955.98
J1
5165
42510
Parotid duct diversion
$3955.98
J1
5165
42600
Closure of salivary fistula
$1616.90
T
5164
42650
Dilation of salivary duct
$689.63
T
5163
42660
Dilation of salivary duct
$312.93
T
5162
42665
Ligation of salivary duct
$3955.98
J1
5165
42699
Salivary surgery procedure
$129.29
T
5161
42700
Drainage of tonsil abscess
$312.93
T
5162
42720
Drainage of throat abscess
$1616.90
T
5164
42725
Drainage of throat abscess
$3955.98
J1
5165
42800
Biopsy of throat
$689.63
T
5163
42804
Biopsy of upper nose/throat
$1616.90
T
5164
42806
Biopsy of upper nose/throat
$1616.90
T
5164
42808
Excise pharynx lesion
$1616.90
T
5164
42809
Remove pharynx foreign body
$91.18
Q1
5734
42810
Excision of neck cyst
$1616.90
T
5164
42815
Excision of neck cyst
$3955.98
J1
5165
42820
Remove tonsils and adenoids
$1616.90
T
5164
42821
Remove tonsils and adenoids
$1616.90
T
5164
42825
Removal of tonsils
$3955.98
J1
5165
42826
Removal of tonsils
$1616.90
T
5164
42830
Removal of adenoids
$3955.98
J1
5165
42831
Removal of adenoids
$1616.90
T
5164
42835
Removal of adenoids
$1616.90
T
5164
42836
Removal of adenoids
$1616.90
T
5164
42842
Extensive surgery of throat
$3955.98
J1
5165
42844
Extensive surgery of throat
$3955.98
J1
5165
42860
Excision of tonsil tags
$3955.98
J1
5165
42870
Excision of lingual tonsil
$1616.90
T
5164
42890
Partial removal of pharynx
$3955.98
J1
5165
42892
Revision of pharyngeal walls
$3955.98
J1
5165
42900
Repair throat wound
$689.63
T
5163
42950
Reconstruction of throat
$3955.98
J1
5165
42955
Surgical opening of throat
$689.63
T
5163
42960
Control throat bleeding
$129.29
T
5161
42962
Control throat bleeding
$1616.90
T
5164
42970
Control nose/throat bleeding
$129.29
T
5161
42972
Control nose/throat bleeding
$1616.90
T
5164
42999
Throat surgery procedure
$129.29
T
5161
43020
Incision of esophagus
$689.63
T
5163
43030
Throat muscle surgery
$3955.98
J1
5165
43130
Removal of esophagus pouch
$3955.98
J1
5165
43180
Esophagoscopy rigid trnso
$1616.90
T
5164
43191
Esophagoscopy rigid trnso dx
$745.36
T
5301
43192
Esophagoscp rig trnso inject
$1088.00
T
5302
43193
Esophagoscp rig trnso biopsy
$1088.00
T
5302
43194
Esophagoscp rig trnso rem fb
$1088.00
T
5302
43195
Esophagoscopy rigid balloon
$1088.00
T
5302
43196
Esophagoscp guide wire dilat
$1088.00
T
5302
43197
Esophagoscopy flex dx brush
$745.36
T
5301
43198
Esophagosc flex trnsn biopsy
$745.36
T
5301
43200
Esophagoscopy flexible brush
$745.36
T
5301
43201
Esoph scope w/submucous inj
$1088.00
T
5302
43202
Esophagoscopy flex biopsy
$745.36
T
5301
43204
Esoph scope w/sclerosis inj
$745.36
T
5301
43205
Esophagus endoscopy/ligation
$1088.00
T
5302
43206
Esoph optical endomicroscopy
$1088.00
T
5302
43210
Egd esophagogastrc fndoplsty
$3613.57
J1
5331
43211
Esophagoscop mucosal resect
$1088.00
T
5302
43212
Esophagoscop stent placement
$3613.57
J1
5331
43213
Esophagoscopy retro balloon
$1088.00
T
5302
43214
Esophagosc dilate balloon 30
$1088.00
T
5302
43215
Esophagoscopy flex remove fb
$1088.00
T
5302
43216
Esophagoscopy lesion removal
$1980.43
T
5303
43217
Esophagoscopy snare les remv
$1088.00
T
5302
43220
Esophagoscopy balloon <30mm
$1088.00
T
5302
43226
Esoph endoscopy dilation
$1088.00
T
5302
43227
Esophagoscopy control bleed
$1088.00
T
5302
43229
Esophagoscopy lesion ablate
$1980.43
T
5303
43231
Esophagoscop ultrasound exam
$1088.00
T
5302
43232
Esophagoscopy w/us needle bx
$1088.00
T
5302
43233
Egd balloon dil esoph30 mm/>
$1088.00
T
5302
43235
Egd diagnostic brush wash
$745.36
T
5301
43236
Uppr gi scope w/submuc inj
$745.36
T
5301
43237
Endoscopic us exam esoph
$1088.00
T
5302
43238
Egd us fine needle bx/aspir
$1088.00
T
5302
43239
Egd biopsy single/multiple
$745.36
T
5301
43240
Egd w/transmural drain cyst
$1980.43
T
5303
43241
Egd tube/cath insertion
$745.36
T
5301
43242
Egd us fine needle bx/aspir
$1088.00
T
5302
43243
Egd injection varices
$745.36
T
5301
43244
Egd varices ligation
$1088.00
T
5302
43245
Egd dilate stricture
$1088.00
T
5302
43246
Egd place gastrostomy tube
$1088.00
T
5302
43247
Egd remove foreign body
$745.36
T
5301
43248
Egd guide wire insertion
$745.36
T
5301
43249
Esoph egd dilation <30 mm
$1088.00
T
5302
43250
Egd cautery tumor polyp
$1088.00
T
5302
43251
Egd remove lesion snare
$1088.00
T
5302
43252
Egd optical endomicroscopy
$1088.00
T
5302
43253
Egd us transmural injxn/mark
$1088.00
T
5302
43254
Egd endo mucosal resection
$1088.00
T
5302
43255
Egd control bleeding any
$1088.00
T
5302
43257
Egd w/thrml txmnt gerd
$1980.43
T
5303
43259
Egd us exam duodenum/jejunum
$1088.00
T
5302
43260
Ercp w/specimen collection
$1980.43
T
5303
43261
Endo cholangiopancreatograph
$1980.43
T
5303
43262
Endo cholangiopancreatograph
$1980.43
T
5303
43263
Ercp sphincter pressure meas
$1980.43
T
5303
43264
Ercp remove duct calculi
$1980.43
T
5303
43265
Ercp lithotripsy calculi
$1980.43
T
5303
43266
Egd endoscopic stent place
$3613.57
J1
5331
43270
Egd lesion ablation
$1088.00
T
5302
43274
Ercp duct stent placement
$3613.57
J1
5331
43275
Ercp remove forgn body duct
$1980.43
T
5303
43276
Ercp stent exchange w/dilate
$3613.57
J1
5331
43277
Ercp ea duct/ampulla dilate
$1980.43
T
5303
43278
Ercp lesion ablate w/dilate
$1980.43
T
5303
43280
Laparoscopy fundoplasty
$6860.91
J1
5362
43281
Lap paraesophag hern repair
$6860.91
J1
5362
43289
Laparoscope proc esoph
$4001.15
J1
5361
43420
Repair esophagus opening
$1616.90
T
5164
43450
Dilate esophagus 1/mult pass
$745.36
T
5301
43453
Dilate esophagus
$1088.00
T
5302
43499
Esophagus surgery procedure
$745.36
T
5301
43510
Surgical opening of stomach
$745.36
T
5301
43647
Lap impl electrode antrum
$5244.37
J1
5462
43648
Lap revise/remv eltrd antrum
$4001.15
J1
5361
43651
Laparoscopy vagus nerve
$4001.15
J1
5361
43652
Laparoscopy vagus nerve
$4001.15
J1
5361
43653
Laparoscopy gastrostomy
$4001.15
J1
5361
43659
Laparoscope proc stom
$4001.15
J1
5361
43752
Nasal/orogastric w/tube plmt
$191.97
Q3
5523
43753
Tx gastro intub w/asp
$220.35
Q1
5722
43754
Dx gastr intub w/asp spec
$220.35
Q1
5722
43755
Dx gastr intub w/asp specs
$129.75
S
5721
43756
Dx duod intub w/asp spec
$100.69
Q1
5522
43757
Dx duod intub w/asp specs
$745.36
T
5301
43760
Change gastrostomy tube
$199.80
T
5291
43761
Reposition gastrostomy tube
$745.36
T
5301
43770
Lap place gastr adj device
$6860.91
J1
5362
43830
Place gastrostomy tube
$1980.43
T
5303
43831
Place gastrostomy tube
$745.36
T
5301
43870
Repair stomach opening
$1980.43
T
5303
43886
Revise gastric port open
$2137.49
T
5055
43887
Remove gastric port open
$2137.49
Q2
5055
43888
Change gastric port open
$2137.49
T
5055
43999
Stomach surgery procedure
$745.36
T
5301
44100
Biopsy of bowel
$1088.00
T
5302
44180
Lap enterolysis
$4001.15
J1
5361
44186
Lap jejunostomy
$4001.15
J1
5361
44238
Laparoscope proc intestine
$4001.15
J1
5361
44312
Revision of ileostomy
$2137.49
T
5055
44340
Revision of colostomy
$2137.49
T
5055
44360
Small bowel endoscopy
$745.36
T
5301
44361
Small bowel endoscopy/biopsy
$1088.00
T
5302
44363
Small bowel endoscopy
$1088.00
T
5302
44364
Small bowel endoscopy
$1088.00
T
5302
44365
Small bowel endoscopy
$1088.00
T
5302
44366
Small bowel endoscopy
$1088.00
T
5302
44369
Small bowel endoscopy
$1088.00
T
5302
44370
Small bowel endoscopy/stent
$3613.57
J1
5331
44372
Small bowel endoscopy
$1088.00
T
5302
44373
Small bowel endoscopy
$1088.00
T
5302
44376
Small bowel endoscopy
$1088.00
T
5302
44377
Small bowel endoscopy/biopsy
$1088.00
T
5302
44378
Small bowel endoscopy
$1088.00
T
5302
44379
S bowel endoscope w/stent
$3613.57
J1
5331
44380
Small bowel endoscopy br/wa
$745.36
T
5301
44381
Small bowel endoscopy br/wa
$745.36
T
5301
44382
Small bowel endoscopy
$745.36
T
5301
44384
Small bowel endoscopy
$3613.57
J1
5331
44385
Endoscopy of bowel pouch
$752.76
T
5312
44386
Endoscopy bowel pouch/biop
$752.76
T
5312
44388
Colonoscopy thru stoma spx
$752.76
T
5312
44389
Colonoscopy with biopsy
$752.76
T
5312
44390
Colonoscopy for foreign body
$752.76
T
5312
44391
Colonoscopy for bleeding
$752.76
T
5312
44392
Colonoscopy & polypectomy
$752.76
T
5312
44394
Colonoscopy w/snare
$752.76
T
5312
44401
Colonoscopy with ablation
$752.76
T
5312
44402
Colonoscopy w/stent plcmt
$3613.57
J1
5331
44403
Colonoscopy w/resection
$752.76
T
5312
44404
Colonoscopy w/injection
$752.76
T
5312
44405
Colonoscopy w/dilation
$752.76
T
5312
44406
Colonoscopy w/ultrasound
$752.76
T
5312
44407
Colonoscopy w/ndl aspir/bx
$752.76
T
5312
44408
Colonoscopy w/decompression
$752.76
T
5312
44500
Intro gastrointestinal tube
$482.83
T
5391
44799
Unlisted px small intestine
$2612.57
T
5341
44950
Appendectomy
$2612.57
T
5341
44970
Laparoscopy appendectomy
$4001.15
J1
5361
44979
Laparoscope proc app
$4001.15
J1
5361
45000
Drainage of pelvic abscess
$1661.50
T
5313
45005
Drainage of rectal abscess
$1661.50
T
5313
45020
Drainage of rectal abscess
$1661.50
T
5313
45100
Biopsy of rectum
$1661.50
T
5313
45108
Removal of anorectal lesion
$2326.64
T
5314
45150
Excision of rectal stricture
$1661.50
T
5313
45160
Excision of rectal lesion
$1661.50
T
5313
45171
Exc rect tum transanal part
$2326.64
T
5314
45172
Exc rect tum transanal full
$2326.64
T
5314
45190
Destruction rectal tumor
$1661.50
T
5313
45300
Proctosigmoidoscopy dx
$492.45
T
5311
45303
Proctosigmoidoscopy dilate
$752.76
T
5312
45305
Proctosigmoidoscopy w/bx
$1661.50
T
5313
45307
Proctosigmoidoscopy fb
$1661.50
T
5313
45308
Proctosigmoidoscopy removal
$1661.50
T
5313
45309
Proctosigmoidoscopy removal
$1661.50
T
5313
45315
Proctosigmoidoscopy removal
$1661.50
T
5313
45317
Proctosigmoidoscopy bleed
$752.76
T
5312
45320
Proctosigmoidoscopy ablate
$2326.64
T
5314
45321
Proctosigmoidoscopy volvul
$1661.50
T
5313
45327
Proctosigmoidoscopy w/stent
$3613.57
J1
5331
45330
Diagnostic sigmoidoscopy
$492.45
T
5311
45331
Sigmoidoscopy and biopsy
$492.45
T
5311
45332
Sigmoidoscopy w/fb removal
$752.76
T
5312
45333
Sigmoidoscopy & polypectomy
$492.45
T
5311
45334
Sigmoidoscopy for bleeding
$752.76
T
5312
45335
Sigmoidoscopy w/submuc inj
$492.45
T
5311
45337
Sigmoidoscopy & decompress
$752.76
T
5312
45338
Sigmoidoscopy w/tumr remove
$752.76
T
5312
45340
Sig w/tndsc balloon dilation
$752.76
T
5312
45341
Sigmoidoscopy w/ultrasound
$752.76
T
5312
45342
Sigmoidoscopy w/us guide bx
$1661.50
T
5313
45346
Sigmoidoscopy w/ablation
$752.76
T
5312
45347
Sigmoidoscopy w/plcmt stent
$3613.57
J1
5331
45349
Sigmoidoscopy w/resection
$752.76
T
5312
45350
Sgmdsc w/band ligation
$752.76
T
5312
45378
Diagnostic colonoscopy
$752.76
T
5312
45379
Colonoscopy w/fb removal
$752.76
T
5312
45380
Colonoscopy and biopsy
$752.76
T
5312
45381
Colonoscopy submucous njx
$752.76
T
5312
45382
Colonoscopy w/control bleed
$752.76
T
5312
45384
Colonoscopy w/lesion removal
$752.76
T
5312
45385
Colonoscopy w/lesion removal
$752.76
T
5312
45386
Colonoscopy w/balloon dilat
$752.76
T
5312
45388
Colonoscopy w/ablation
$752.76
T
5312
45389
Colonoscopy w/stent plcmt
$3613.57
J1
5331
45390
Colonoscopy w/resection
$752.76
T
5312
45391
Colonoscopy w/endoscope us
$752.76
T
5312
45392
Colonoscopy w/endoscopic fnb
$1661.50
T
5313
45393
Colonoscopy w/decompression
$752.76
T
5312
45398
Colonoscopy w/band ligation
$752.76
T
5312
45399
Unlisted procedure colon
$752.76
T
5312
45499
Laparoscope proc rectum
$4001.15
J1
5361
45500
Repair of rectum
$1661.50
T
5313
45505
Repair of rectum
$2326.64
T
5314
45520
Treatment of rectal prolapse
$117.83
Q1
5051
45541
Correct rectal prolapse
$2326.64
T
5314
45560
Repair of rectocele
$2326.64
T
5314
45900
Reduction of rectal prolapse
$492.45
T
5311
45905
Dilation of anal sphincter
$1661.50
T
5313
45910
Dilation of rectal narrowing
$1661.50
T
5313
45915
Remove rectal obstruction
$1661.50
T
5313
45990
Surg dx exam anorectal
$1661.50
T
5313
45999
Rectum surgery procedure
$492.45
T
5311
46020
Placement of seton
$1661.50
T
5313
46030
Removal of rectal marker
$752.76
T
5312
46040
Incision of rectal abscess
$1661.50
T
5313
46045
Incision of rectal abscess
$1661.50
T
5313
46050
Incision of anal abscess
$492.45
T
5311
46060
Incision of rectal abscess
$1661.50
T
5313
46070
Incision of anal septum
$1661.50
T
5313
46080
Incision of anal sphincter
$1661.50
T
5313
46083
Incise external hemorrhoid
$206.61
T
5371
46200
Removal of anal fissure
$1661.50
T
5313
46220
Excise anal ext tag/papilla
$1661.50
T
5313
46221
Ligation of hemorrhoid(s)
$492.45
T
5311
46230
Removal of anal tags
$1661.50
T
5313
46250
Remove ext hem groups 2+
$1661.50
T
5313
46255
Remove int/ext hem 1 group
$1661.50
T
5313
46257
Remove in/ex hem grp & fiss
$1661.50
T
5313
46258
Remove in/ex hem grp w/fistu
$2326.64
T
5314
46260
Remove in/ex hem groups 2+
$2326.64
T
5314
46261
Remove in/ex hem grps & fiss
$2326.64
T
5314
46262
Remove in/ex hem grps w/fist
$2326.64
T
5314
46270
Remove anal fist subq
$1661.50
T
5313
46275
Remove anal fist inter
$1661.50
T
5313
46280
Remove anal fist complex
$1661.50
T
5313
46285
Remove anal fist 2 stage
$1661.50
T
5313
46288
Repair anal fistula
$2326.64
T
5314
46320
Removal of hemorrhoid clot
$1661.50
T
5313
46500
Injection into hemorrhoid(s)
$492.45
T
5311
46505
Chemodenervation anal musc
$1661.50
T
5313
46600
Diagnostic anoscopy spx
$91.18
Q1
5734
46601
Diagnostic anoscopy
$55.94
Q1
5733
46604
Anoscopy and dilation
$1661.50
T
5313
46606
Anoscopy and biopsy
$1661.50
T
5313
46607
Diagnostic anoscopy & biopsy
$752.76
T
5312
46608
Anoscopy remove for body
$752.76
T
5312
46610
Anoscopy remove lesion
$1661.50
T
5313
46611
Anoscopy
$752.76
T
5312
46612
Anoscopy remove lesions
$1661.50
T
5313
46614
Anoscopy control bleeding
$752.76
T
5312
46615
Anoscopy
$1661.50
T
5313
46700
Repair of anal stricture
$1661.50
T
5313
46706
Repr of anal fistula w/glue
$2326.64
T
5314
46707
Repair anorectal fist w/plug
$2326.64
T
5314
46750
Repair of anal sphincter
$2326.64
T
5314
46753
Reconstruction of anus
$2326.64
T
5314
46754
Removal of suture from anus
$1661.50
T
5313
46760
Repair of anal sphincter
$2326.64
T
5314
46761
Repair of anal sphincter
$2326.64
T
5314
46762
Implant artificial sphincter
$3613.57
J1
5331
46900
Destruction anal lesion(s)
$225.55
T
5052
46910
Destruction anal lesion(s)
$1411.21
T
5054
46916
Cryosurgery anal lesion(s)
$225.55
T
5052
46917
Laser surgery anal lesions
$1661.50
T
5313
46922
Excision of anal lesion(s)
$1661.50
T
5313
46924
Destruction anal lesion(s)
$1661.50
T
5313
46930
Destroy internal hemorrhoids
$492.45
T
5311
46940
Treatment of anal fissure
$1661.50
T
5313
46942