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




2017 Outpatient Prospective Payment System (OPPS)
January 2017 Web Addendum B.01.01.17


2017 Wage Index Adjustment for OPPS Payments Zip Code:

Procedure
Short Descriptor
Unadjusted 2017 OPPS Fee
Schedule
Status Indicator
APC
0058T
Cryopreservation ovary tiss
$103.88
Q1
5672
0071T
Us leiomyomata ablate <200
$2085.47
J1
5414
0072T
Us leiomyomata ablate >200
$2085.47
J1
5414
0100T
Prosth retina receive&gen
$150000.50
T
1906
0101T
Extracorp shockwv tx hi enrg
$2438.34
J1
5113
0102T
Extracorp shockwv tx anesth
$2438.34
J1
5113
0106T
Touch quant sensory test
$28.38
Q1
5732
0107T
Vibrate quant sensory test
$28.38
Q1
5732
0108T
Cool quant sensory test
$54.55
Q1
5733
0109T
Heat quant sensory test
$28.38
Q1
5732
0110T
Nos quant sensory test
$100.02
Q1
5734
0126T
Chd risk imt study
$28.38
Q1
5732
0179T
64 lead ecg w/tracing
$28.38
Q1
5732
0184T
Exc rectal tumor endoscopic
$3940.61
J1
5331
0191T
Insert ant segment drain int
$3418.76
J1
5492
0198T
Ocular blood flow measure
$54.55
Q1
5733
0200T
Perq sacral augmt unilat inj
$5221.57
J1
5114
0201T
Perq sacral augmt bilat inj
$5221.57
J1
5114
0206T
Cptr dbs alys car elec dta
$54.55
Q1
5733
0207T
Clear eyelid gland w/heat
$54.55
Q1
5733
0208T
Audiometry air only
$28.38
Q1
5732
0209T
Audiometry air & bone
$28.38
Q1
5732
0210T
Speech audiometry threshold
$28.38
Q1
5732
0211T
Speech audiom thresh & recog
$28.38
Q1
5732
0212T
Compre audiometry evaluation
$127.10
Q1
5721
0213T
Njx paravert w/us cer/thor
$638.93
T
5443
0216T
Njx paravert w/us lumb/sac
$638.93
T
5443
0221T
Plmt post facet implt lumb
$5221.57
J1
5114
0228T
Njx tfrml eprl w/us cer/thor
$638.93
T
5443
0230T
Njx tfrml eprl w/us lumb/sac
$638.93
T
5443
0232T
Njx platelet plasma
$263.61
Q1
5735
0234T
Trluml perip athrc renal art
$9752.43
J1
5193
0236T
Trluml perip athrc abd aorta
$9752.43
J1
5193
0237T
Trluml perip athrc brchiocph
$9752.43
J1
5193
0238T
Trluml perip athrc iliac art
$14782.14
J1
5194
0249T
Ligation hemorrhoid w/us
$2167.51
J1
5313
0253T
Insert aqueous drain device
$3418.76
J1
5492
0263T
Im b1 mrw cel ther cmpl
$3187.83
S
5243
0264T
Im b1 mrw cel ther xcl hrvst
$3187.83
S
5243
0265T
Im b1 mrw cel ther hrvst onl
$3187.83
S
5243
0267T
Implt/rpl crtd sns dev lead
$2690.46
T
5461
0268T
Implt/rpl crtd sns dev gen
$17803.38
J1
5463
0269T
Rev/remvl crtd sns dev total
$4151.86
Q2
5432
0270T
Rev/remvl crtd sns dev lead
$2690.46
Q2
5461
0271T
Rev/remvl crtd sns dev gen
$2690.46
Q2
5461
0272T
Interrogate crtd sns dev
$127.10
S
5721
0273T
Interrogate crtd sns w/pgrmg
$127.10
S
5721
0274T
Perq lamot/lam crv/thrc
$5221.57
J1
5114
0275T
Perq lamot/lam lumbar
$5221.57
J1
5114
0278T
Tempr
$127.10
Q1
5721
0296T
Ext ecg recording
$100.02
Q1
5734
0297T
Ext ecg scan w/report
$100.02
Q1
5734
0299T
Esw wound healing init wound
$292.62
T
5052
0301T
Mw therapy for breast tumor
$2499.48
J1
5091
0302T
Icar ischm mntrng sys compl
$16766.86
J1
5224
0303T
Icar ischm mntrng sys eltrd
$6976.57
J1
5222
0304T
Icar ischm mntrng sys device
$9413.65
J1
5223
0305T
Icar ischm mntrng prgrm eval
$35.15
Q1
5741
0306T
Icar ischm mntr interr eval
$35.15
Q1
5741
0307T
Rmvl icar ischm mntrng dvce
$2559.59
Q2
5221
0308T
Insj ocular telescope prosth
$18991.75
J1
5495
0310T
Motor function mapping ntms
$127.10
S
5721
0312T
Laps impltj nstim vagus
$27047.11
J1
5464
0313T
Laps rmvl nstim array vagus
$2690.46
T
5461
0314T
Laps rmvl vgl arry&pls gen
$2690.46
Q2
5461
0315T
Rmvl vagus nerve pls gen
$2690.46
Q2
5461
0316T
Replc vagus nerve pls gen
$17803.38
J1
5463
0317T
Elec alys vagus nrv pls gen
$35.15
Q1
5741
0330T
Tear film img uni/bi w/i&r
$28.38
Q1
5732
0331T
Heart symp image plnr
$1138.94
S
5593
0332T
Heart symp image plnr spect
$1138.94
S
5593
0335T
Extraosseous joint stblztion
$5221.57
J1
5114
0337T
Endothel fxnassmnt non-invas
$54.55
Q1
5733
0338T
Trnscth renal symp denrv unl
$4825.20
J1
5192
0339T
Trnscth renal symp denrv bil
$4825.20
J1
5192
0340T
Ablate pulm tumors + extnsn
$4199.13
J1
5361
0342T
Thxp apheresis w/hdl delip
$3187.83
S
5243
0347T
Ins bone device for rsa
$54.55
Q1
5733
0348T
Rsa spine exam
$112.73
Q1
5522
0349T
Rsa upper extr exam
$112.73
Q1
5522
0350T
Rsa lower extr exam
$59.86
Q1
5521
0355T
Gi tract capsule endoscopy
$1334.83
J1
5302
0356T
Insrt drug device for iop
$54.55
Q1
5733
0357T
Cryopreservation oocyte(s)
$103.88
Q1
5672
0358T
Bia whole body
$28.38
Q1
5732
0359T
Behavioral id assessment
$70.26
S
5822
0360T
Observ behav assessment
$70.26
S
5822
0362T
Expose behav assessment
$70.26
S
5822
0364T
Adaptive behavior treatment
$126.01
S
5823
0366T
Group behavior treatment
$126.01
S
5823
0368T
Behavior treatment modified
$126.01
S
5823
0370T
Fam behav treatment guidance
$126.01
S
5823
0371T
Mult fam behav treat guide
$126.01
S
5823
0372T
Social skills training group
$126.01
S
5823
0373T
Exposure behavior treatment
$126.01
S
5823
0377T
Anoscpy inj agent for incont
$2167.51
J1
5313
0379T
Vis field assmnt tech suppt
$28.38
Q1
5732
0380T
Comp animat ret imag series
$28.38
Q1
5732
0387T
Leadless c pm ins/rpl ventr
$14782.14
J1
5194
0388T
Leadless c pm remove ventr
$2360.60
T
5182
0389T
Prog eval inper leadls pm
$35.15
Q1
5741
0391T
Intergt eval inper leadls pm
$35.15
Q1
5741
0394T
Hdr elctrnc skn surf brchytx
$204.51
S
5622
0395T
Hdr elctr ntrst/ntrcv brchtx
$738.63
S
5624
0398T
Mrgfus strtctc les abltj
$9750.50
S
1537
0402T
Collagen crosslinking cornea
$774.57
T
5502
0404T
Trnscrv uterin fibroid abltj
$5866.07
J1
5416
0406T
Sin ndsc plmt drg elut mplnt
$1269.79
Q2
5153
0407T
Sin ndsc plmt drg elut mplnt
$1269.79
Q2
5153
0408T
Insj/rplc cardiac modulj sys
$21999.98
J1
5231
0409T
Insj/rplc car modulj pls gn
$21999.98
J1
5231
0410T
Insj/rplc car modulj atr elt
$6976.57
J1
5222
0411T
Insj/rplc car modulj vnt elt
$6976.57
J1
5222
0412T
Rmvl cardiac modulj pls gen
$2559.59
Q2
5221
0413T
Rmvl car modulj tranvns elt
$2559.59
Q2
5221
0414T
Rmvl & rpl car modulj pls gn
$21999.98
J1
5231
0415T
Repos car modulj tranvns elt
$684.13
T
5181
0416T
Reloc skin pocket pls gen
$1427.77
T
5054
0417T
Prgrmg eval cardiac modulj
$35.15
Q1
5741
0418T
Interro eval cardiac modulj
$35.15
Q1
5741
0419T
Dstrj neurofibroma xtnsv
$453.10
T
5053
0420T
Dstrj neurofibroma xtnsv
$453.10
T
5053
0422T
Tactile breast img uni/bi
$59.86
Q1
5521
0424T
Insj/rplc nstim apnea compl
$27047.11
J1
5464
0425T
Insj/rplc nstim apnea sen ld
$5745.11
J1
5462
0426T
Insj/rplc nstim apnea stm ld
$17803.38
J1
5463
0427T
Insj/rplc nstim apnea pls gn
$17803.38
J1
5463
0428T
Rmvl nstim apnea pls gen
$2690.46
Q2
5461
0429T
Rmvl nstim apnea sen ld
$2690.46
Q2
5461
0430T
Rmvl nstim apnea stimj ld
$2690.46
Q2
5461
0431T
Rmvl/rplc nstim apnea pls gn
$17803.38
J1
5463
0432T
Repos nstim apnea stimj ld
$2690.46
T
5461
0433T
Repos nstim apnea sensing ld
$2690.46
T
5461
0434T
Interro eval npgs apnea
$109.22
S
5742
0435T
Prgrmg eval npgs apnea 1 ses
$109.22
S
5742
0436T
Prgrmg eval npgs apnea study
$864.54
S
5724
0438T
Tprnl plmt biodegrdabl matrl
$2542.56
T
5374
0440T
Abltj perc uxtr/perph nrv
$4151.86
J1
5432
0441T
Abltj perc lxtr/perph nrv
$4151.86
J1
5432
0442T
Abltj perc plex/trncl nrv
$4151.86
J1
5432
0446T
Insj impltbl glucose sensor
$453.10
T
5053
0447T
Rmvl impltbl glucose sensor
$153.12
Q2
5051
0448T
Remvl insj impltbl gluc sens
$453.10
T
5053
0449T
Insj aqueous drain dev 1st
$3418.76
J1
5492
0453T
Insj/rplcmt mech-elec ntrfce
$6976.57
J1
5222
0454T
Insj/rplcmt subq electrode
$6976.57
J1
5222
0457T
Remvl mech-elec skin ntrfce
$2559.59
Q2
5221
0458T
Remvl subq electrode
$2559.59
Q2
5221
0460T
Repos aortic ventr dev eltrd
$2559.59
T
5221
0462T
Prgrmg eval aortic ventr sys
$252.63
S
5743
0463T
Interrog aortic ventr sys
$252.63
S
5743
0464T
Visual ep test for glaucoma
$127.10
S
5721
0465T
Supchrdl njx rxw/o supply
$279.45
T
5694
0467T
Revj/rplmnt ch respir eltrd
$2690.46
Q2
5461
0468T
Rmvl chwal respir eltrd/ra
$2690.46
Q2
5461
10021
Fna w/o image
$292.62
T
5052
10022
Fna w/image
$539.11
T
5071
10030
Guide cathet fluid drainage
$539.11
T
5071
10035
Perq dev soft tiss 1st imag
$539.11
T
5071
10040
Acne surgery
$153.12
Q1
5051
10060
Drainage of skin abscess
$153.12
T
5051
10061
Drainage of skin abscess
$292.62
T
5052
10080
Drainage of pilonidal cyst
$539.11
T
5071
10081
Drainage of pilonidal cyst
$539.11
T
5071
10120
Remove foreign body
$292.62
T
5052
10121
Remove foreign body
$1236.62
J1
5072
10140
Drainage of hematoma/fluid
$1236.62
J1
5072
10160
Puncture drainage of lesion
$292.62
T
5052
10180
Complex drainage wound
$2148.91
J1
5073
11000
Debride infected skin
$453.10
T
5053
11010
Debride skin at fx site
$539.11
T
5071
11011
Debride skin musc at fx site
$539.11
T
5071
11012
Deb skin bone at fx site
$2148.91
J1
5073
11042
Deb subq tissue 20 sq cm/<
$292.62
T
5052
11043
Deb musc/fascia 20 sq cm/<
$453.10
T
5053
11044
Deb bone 20 sq cm/<
$1236.62
J1
5072
11055
Trim skin lesion
$153.12
Q1
5051
11056
Trim skin lesions 2 to 4
$153.12
Q1
5051
11057
Trim skin lesions over 4
$153.12
T
5051
11100
Biopsy skin lesion
$292.62
T
5052
11200
Removal of skin tags
$153.12
Q1
5051
11300
Shave skin lesion 0.5 cm/<
$153.12
Q1
5051
11301
Shave skin lesion 0.6-1.0 cm
$153.12
Q1
5051
11302
Shave skin lesion 1.1-2.0 cm
$153.12
Q1
5051
11303
Shave skin lesion >2.0 cm
$292.62
Q1
5052
11305
Shave skin lesion 0.5 cm/<
$153.12
Q1
5051
11306
Shave skin lesion 0.6-1.0 cm
$153.12
Q1
5051
11307
Shave skin lesion 1.1-2.0 cm
$153.12
T
5051
11308
Shave skin lesion >2.0 cm
$292.62
Q1
5052
11310
Shave skin lesion 0.5 cm/<
$153.12
T
5051
11311
Shave skin lesion 0.6-1.0 cm
$153.12
T
5051
11312
Shave skin lesion 1.1-2.0 cm
$292.62
T
5052
11313
Shave skin lesion >2.0 cm
$292.62
T
5052
11400
Exc tr-ext b9+marg 0.5 cm<
$539.11
T
5071
11401
Exc tr-ext b9+marg 0.6-1 cm
$292.62
T
5052
11402
Exc tr-ext b9+marg 1.1-2 cm
$539.11
T
5071
11403
Exc tr-ext b9+marg 2.1-3cm/<
$539.11
T
5071
11404
Exc tr-ext b9+marg 3.1-4 cm
$1236.62
J1
5072
11406
Exc tr-ext b9+marg >4.0 cm
$1236.62
J1
5072
11420
Exc h-f-nk-sp b9+marg 0.5/<
$1236.62
J1
5072
11421
Exc h-f-nk-sp b9+marg 0.6-1
$539.11
T
5071
11422
Exc h-f-nk-sp b9+marg 1.1-2
$1236.62
J1
5072
11423
Exc h-f-nk-sp b9+marg 2.1-3
$1236.62
J1
5072
11424
Exc h-f-nk-sp b9+marg 3.1-4
$1236.62
J1
5072
11426
Exc h-f-nk-sp b9+marg >4 cm
$2148.91
J1
5073
11440
Exc face-mm b9+marg 0.5 cm/<
$539.11
T
5071
11441
Exc face-mm b9+marg 0.6-1 cm
$539.11
T
5071
11442
Exc face-mm b9+marg 1.1-2 cm
$539.11
T
5071
11443
Exc face-mm b9+marg 2.1-3 cm
$1236.62
J1
5072
11444
Exc face-mm b9+marg 3.1-4 cm
$1236.62
J1
5072
11446
Exc face-mm b9+marg >4 cm
$2148.91
J1
5073
11450
Removal sweat gland lesion
$2148.91
J1
5073
11451
Removal sweat gland lesion
$2148.91
J1
5073
11462
Removal sweat gland lesion
$2148.91
J1
5073
11463
Removal sweat gland lesion
$2148.91
J1
5073
11470
Removal sweat gland lesion
$2148.91
J1
5073
11471
Removal sweat gland lesion
$2148.91
J1
5073
11600
Exc tr-ext mal+marg 0.5 cm/<
$539.11
T
5071
11601
Exc tr-ext mal+marg 0.6-1 cm
$539.11
T
5071
11602
Exc tr-ext mal+marg 1.1-2 cm
$292.62
T
5052
11603
Exc tr-ext mal+marg 2.1-3 cm
$539.11
T
5071
11604
Exc tr-ext mal+marg 3.1-4 cm
$539.11
T
5071
11606
Exc tr-ext mal+marg >4 cm
$1236.62
J1
5072
11620
Exc h-f-nk-sp mal+marg 0.5/<
$1236.62
J1
5072
11621
Exc s/n/h/f/g mal+mrg 0.6-1
$539.11
T
5071
11622
Exc s/n/h/f/g mal+mrg 1.1-2
$539.11
T
5071
11623
Exc s/n/h/f/g mal+mrg 2.1-3
$1236.62
J1
5072
11624
Exc s/n/h/f/g mal+mrg 3.1-4
$1236.62
J1
5072
11626
Exc s/n/h/f/g mal+mrg >4 cm
$2148.91
J1
5073
11640
Exc f/e/e/n/l mal+mrg 0.5cm<
$539.11
T
5071
11641
Exc f/e/e/n/l mal+mrg 0.6-1
$539.11
T
5071
11642
Exc f/e/e/n/l mal+mrg 1.1-2
$539.11
T
5071
11643
Exc f/e/e/n/l mal+mrg 2.1-3
$1236.62
J1
5072
11644
Exc f/e/e/n/l mal+mrg 3.1-4
$1236.62
J1
5072
11646
Exc f/e/e/n/l mal+mrg >4 cm
$2148.91
J1
5073
11719
Trim nail(s) any number
$54.55
Q1
5733
11720
Debride nail 1-5
$54.55
Q1
5733
11721
Debride nail 6 or more
$54.55
Q1
5733
11730
Removal of nail plate
$153.12
Q1
5051
11740
Drain blood from under nail
$54.55
Q1
5733
11750
Removal of nail bed
$292.62
T
5052
11755
Biopsy nail unit
$539.11
T
5071
11760
Repair of nail bed
$453.10
T
5053
11762
Reconstruction of nail bed
$1427.77
T
5054
11765
Excision of nail fold toe
$292.62
Q1
5052
11770
Remove pilonidal cyst simple
$2148.91
J1
5073
11771
Remove pilonidal cyst exten
$2148.91
J1
5073
11772
Remove pilonidal cyst compl
$2148.91
J1
5073
11900
Inject skin lesions
$153.12
Q1
5051
11901
Inject skin lesions >7
$153.12
Q1
5051
11920
Correct skin color 6.0 cm/<
$453.10
T
5053
11921
Correct skn color 6.1-20.0cm
$453.10
T
5053
11950
Tx contour defects 1 cc/<
$153.12
T
5051
11951
Tx contour defects 1.1-5.0cc
$453.10
T
5053
11952
Tx contour defects 5.1-10cc
$453.10
T
5053
11954
Tx contour defects >10.0 cc
$292.62
T
5052
11960
Insert tissue expander(s)
$2504.69
T
5055
11970
Replace tissue expander
$5221.57
J1
5114
11971
Remove tissue expander(s)
$2148.91
Q2
5073
11976
Remove contraceptive capsule
$539.11
Q2
5071
11980
Implant hormone pellet(s)
$263.61
Q1
5735
11981
Insert drug implant device
$100.02
Q1
5734
11982
Remove drug implant device
$263.61
Q1
5735
11983
Remove/insert drug implant
$263.61
Q1
5735
12001
Rpr s/n/ax/gen/trnk 2.5cm/<
$153.12
Q1
5051
12002
Rpr s/n/ax/gen/trnk2.6-7.5cm
$153.12
Q1
5051
12004
Rpr s/n/ax/gen/trk7.6-12.5cm
$153.12
Q1
5051
12005
Rpr s/n/a/gen/trk12.6-20.0cm
$292.62
Q1
5052
12006
Rpr s/n/a/gen/trk20.1-30.0cm
$292.62
Q2
5052
12007
Rpr s/n/ax/gen/trnk >30.0 cm
$153.12
T
5051
12011
Rpr f/e/e/n/l/m 2.5 cm/<
$153.12
Q1
5051
12013
Rpr f/e/e/n/l/m 2.6-5.0 cm
$153.12
Q1
5051
12014
Rpr f/e/e/n/l/m 5.1-7.5 cm
$153.12
Q1
5051
12015
Rpr f/e/e/n/l/m 7.6-12.5 cm
$153.12
Q1
5051
12016
Rpr fe/e/en/l/m 12.6-20.0 cm
$153.12
Q1
5051
12017
Rpr fe/e/en/l/m 20.1-30.0 cm
$292.62
Q1
5052
12018
Rpr f/e/e/n/l/m >30.0 cm
$153.12
Q1
5051
12020
Closure of split wound
$453.10
T
5053
12021
Closure of split wound
$292.62
T
5052
12031
Intmd rpr s/a/t/ext 2.5 cm/<
$292.62
T
5052
12032
Intmd rpr s/a/t/ext 2.6-7.5
$292.62
T
5052
12034
Intmd rpr s/tr/ext 7.6-12.5
$292.62
T
5052
12035
Intmd rpr s/a/t/ext 12.6-20
$292.62
T
5052
12036
Intmd rpr s/a/t/ext 20.1-30
$453.10
T
5053
12037
Intmd rpr s/tr/ext >30.0 cm
$2504.69
T
5055
12041
Intmd rpr n-hf/genit 2.5cm/<
$292.62
Q2
5052
12042
Intmd rpr n-hf/genit2.6-7.5
$292.62
T
5052
12044
Intmd rpr n-hf/genit7.6-12.5
$453.10
T
5053
12045
Intmd rpr n-hf/genit12.6-20
$453.10
T
5053
12046
Intmd rpr n-hf/genit20.1-30
$292.62
T
5052
12047
Intmd rpr n-hf/genit >30.0cm
$1427.77
T
5054
12051
Intmd rpr face/mm 2.5 cm/<
$153.12
T
5051
12052
Intmd rpr face/mm 2.6-5.0 cm
$292.62
T
5052
12053
Intmd rpr face/mm 5.1-7.5 cm
$292.62
T
5052
12054
Intmd rpr face/mm 7.6-12.5cm
$292.62
Q2
5052
12055
Intmd rpr face/mm 12.6-20 cm
$292.62
T
5052
12056
Intmd rpr face/mm 20.1-30.0
$292.62
Q2
5052
12057
Intmd rpr face/mm >30.0 cm
$153.12
T
5051
13100
Cmplx rpr trunk 1.1-2.5 cm
$453.10
T
5053
13101
Cmplx rpr trunk 2.6-7.5 cm
$453.10
T
5053
13120
Cmplx rpr s/a/l 1.1-2.5 cm
$453.10
T
5053
13121
Cmplx rpr s/a/l 2.6-7.5 cm
$453.10
T
5053
13131
Cmplx rpr f/c/c/m/n/ax/g/h/f
$292.62
T
5052
13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$453.10
T
5053
13151
Cmplx rpr e/n/e/l 1.1-2.5 cm
$453.10
T
5053
13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$453.10
T
5053
13160
Late closure of wound
$1427.77
T
5054
14000
Tis trnfr trunk 10 sq cm/<
$1427.77
T
5054
14001
Tis trnfr trunk 10.1-30sqcm
$1427.77
T
5054
14020
Tis trnfr s/a/l 10 sq cm/<
$1427.77
T
5054
14021
Tis trnfr s/a/l 10.1-30 sqcm
$1427.77
T
5054
14040
Tis trnfr f/c/c/m/n/a/g/h/f
$1427.77
T
5054
14041
Tis trnfr f/c/c/m/n/a/g/h/f
$1427.77
T
5054
14060
Tis trnfr e/n/e/l 10 sq cm/<
$1427.77
T
5054
14061
Tis trnfr e/n/e/l10.1-30sqcm
$1427.77
T
5054
14301
Tis trnfr any 30.1-60 sq cm
$2504.69
T
5055
14350
Filleted finger/toe flap
$2504.69
T
5055
15002
Wound prep trk/arm/leg
$1427.77
T
5054
15004
Wound prep f/n/hf/g
$453.10
T
5053
15040
Harvest cultured skin graft
$1427.77
T
5054
15050
Skin pinch graft
$453.10
T
5053
15100
Skin splt grft trnk/arm/leg
$1427.77
T
5054
15110
Epidrm autogrft trnk/arm/leg
$1427.77
T
5054
15115
Epidrm a-grft face/nck/hf/g
$1427.77
T
5054
15120
Skn splt a-grft fac/nck/hf/g
$2504.69
T
5055
15130
Derm autograft trnk/arm/leg
$2504.69
T
5055
15135
Derm autograft face/nck/hf/g
$2504.69
T
5055
15150
Cult skin grft t/arm/leg
$2504.69
T
5055
15155
Cult skin graft f/n/hf/g
$2504.69
T
5055
15200
Skin full graft trunk
$2504.69
T
5055
15220
Skin full graft sclp/arm/leg
$1427.77
T
5054
15240
Skin full grft face/genit/hf
$1427.77
T
5054
15260
Skin full graft een & lips
$1427.77
T
5054
15271
Skin sub graft trnk/arm/leg
$1427.77
T
5054
15273
Skin sub grft t/arm/lg child
$2504.69
T
5055
15275
Skin sub graft face/nk/hf/g
$1427.77
T
5054
15277
Skn sub grft f/n/hf/g child
$1427.77
T
5054
15570
Skin pedicle flap trunk
$1427.77
T
5054
15572
Skin pedicle flap arms/legs
$2504.69
T
5055
15574
Pedcle fh/ch/ch/m/n/ax/g/h/f
$1427.77
T
5054
15576
Pedicle e/n/e/l/ntroral
$1427.77
T
5054
15600
Delay flap trunk
$2504.69
T
5055
15610
Delay flap arms/legs
$2504.69
T
5055
15620
Delay flap f/c/c/n/ax/g/h/f
$1427.77
T
5054
15630
Delay flap eye/nos/ear/lip
$1427.77
T
5054
15650
Transfer skin pedicle flap
$1427.77
T
5054
15731
Forehead flap w/vasc pedicle
$2504.69
T
5055
15732
Muscle-skin graft head/neck
$2504.69
T
5055
15734
Muscle-skin graft trunk
$2504.69
T
5055
15736
Muscle-skin graft arm
$2504.69
T
5055
15738
Muscle-skin graft leg
$2504.69
T
5055
15740
Island pedicle flap graft
$1427.77
T
5054
15750
Neurovascular pedicle flap
$2504.69
T
5055
15760
Composite skin graft
$1427.77
T
5054
15770
Derma-fat-fascia graft
$2504.69
T
5055
15775
Hair trnspl 1-15 punch grfts
$292.62
T
5052
15776
Hair trnspl >15 punch grafts
$292.62
T
5052
15780
Dermabrasion total face
$2148.91
J1
5073
15781
Dermabrasion segmental face
$539.11
T
5071
15782
Dermabrasion other than face
$1236.62
J1
5072
15783
Dermabrasion suprfl any site
$153.12
T
5051
15786
Abrasion lesion single
$153.12
Q1
5051
15788
Chemical peel face epiderm
$153.12
Q1
5051
15789
Chemical peel face dermal
$453.10
T
5053
15792
Chemical peel nonfacial
$292.62
Q1
5052
15793
Chemical peel nonfacial
$292.62
Q1
5052
15819
Plastic surgery neck
$1427.77
T
5054
15820
Revision of lower eyelid
$1427.77
T
5054
15821
Revision of lower eyelid
$2504.69
T
5055
15822
Revision of upper eyelid
$1427.77
T
5054
15823
Revision of upper eyelid
$1427.77
T
5054
15824
Removal of forehead wrinkles
$1427.77
T
5054
15825
Removal of neck wrinkles
$2504.69
T
5055
15826
Removal of brow wrinkles
$2504.69
T
5055
15828
Removal of face wrinkles
$2504.69
T
5055
15829
Removal of skin wrinkles
$2504.69
T
5055
15830
Exc skin abd
$4419.46
J1
5092
15832
Excise excessive skin thigh
$2148.91
J1
5073
15833
Excise excessive skin leg
$2148.91
J1
5073
15834
Excise excessive skin hip
$2148.91
J1
5073
15835
Excise excessive skin buttck
$2148.91
J1
5073
15836
Excise excessive skin arm
$2148.91
J1
5073
15837
Excise excess skin arm/hand
$2148.91
J1
5073
15838
Excise excess skin fat pad
$2148.91
J1
5073
15839
Excise excess skin & tissue
$2148.91
J1
5073
15840
Nerve palsy fascial graft
$2504.69
T
5055
15841
Nerve palsy muscle graft
$2504.69
T
5055
15842
Nerve palsy microsurg graft
$1427.77
T
5054
15845
Skin and muscle repair face
$2504.69
T
5055
15850
Remove sutures same surgeon
$453.10
T
5053
15851
Remove sutures diff surgeon
$1427.77
T
5054
15852
Dressing change not for burn
$263.61
Q1
5735
15860
Test for blood flow in graft
$263.61
Q1
5735
15876
Suction lipectomy head&neck
$2504.69
T
5055
15877
Suction lipectomy trunk
$2504.69
T
5055
15878
Suction lipectomy upr extrem
$1427.77
T
5054
15879
Suction lipectomy lwr extrem
$2504.69
T
5055
15920
Removal of tail bone ulcer
$2148.91
J1
5073
15922
Removal of tail bone ulcer
$2504.69
T
5055
15931
Remove sacrum pressure sore
$1236.62
J1
5072
15933
Remove sacrum pressure sore
$2148.91
J1
5073
15934
Remove sacrum pressure sore
$2504.69
T
5055
15935
Remove sacrum pressure sore
$2504.69
T
5055
15936
Remove sacrum pressure sore
$1427.77
T
5054
15937
Remove sacrum pressure sore
$1427.77
T
5054
15940
Remove hip pressure sore
$2148.91
J1
5073
15941
Remove hip pressure sore
$2148.91
J1
5073
15944
Remove hip pressure sore
$2504.69
T
5055
15945
Remove hip pressure sore
$2504.69
T
5055
15946
Remove hip pressure sore
$2504.69
T
5055
15950
Remove thigh pressure sore
$1236.62
J1
5072
15951
Remove thigh pressure sore
$2148.91
J1
5073
15952
Remove thigh pressure sore
$2504.69
T
5055
15953
Remove thigh pressure sore
$2504.69
T
5055
15956
Remove thigh pressure sore
$1427.77
T
5054
15958
Remove thigh pressure sore
$2504.69
T
5055
15999
Removal of pressure sore
$539.11
T
5071
16000
Initial treatment of burn(s)
$153.12
Q1
5051
16020
Dress/debrid p-thick burn s
$153.12
Q1
5051
16025
Dress/debrid p-thick burn m
$153.12
T
5051
16030
Dress/debrid p-thick burn l
$292.62
T
5052
16035
Incision of burn scab initi
$292.62
T
5052
17000
Destruct premalg lesion
$153.12
Q1
5051
17004
Destroy premal lesions 15/>
$292.62
T
5052
17106
Destruction of skin lesions
$292.62
T
5052
17107
Destruction of skin lesions
$453.10
T
5053
17108
Destruction of skin lesions
$1427.77
T
5054
17110
Destruct b9 lesion 1-14
$153.12
Q1
5051
17111
Destruct lesion 15 or more
$153.12
Q1
5051
17250
Chemical cautery tissue
$153.12
Q1
5051
17260
Destruction of skin lesions
$153.12
Q1
5051
17261
Destruction of skin lesions
$153.12
Q1
5051
17262
Destruction of skin lesions
$153.12
Q1
5051
17263
Destruction of skin lesions
$153.12
Q1
5051
17264
Destruction of skin lesions
$292.62
T
5052
17266
Destruction of skin lesions
$292.62
T
5052
17270
Destruction of skin lesions
$153.12
T
5051
17271
Destruction of skin lesions
$153.12
T
5051
17272
Destruction of skin lesions
$153.12
Q1
5051
17273
Destruction of skin lesions
$292.62
T
5052
17274
Destruction of skin lesions
$292.62
T
5052
17276
Destruction of skin lesions
$292.62
T
5052
17280
Destruction of skin lesions
$153.12
Q1
5051
17281
Destruction of skin lesions
$292.62
T
5052
17282
Destruction of skin lesions
$292.62
T
5052
17283
Destruction of skin lesions
$292.62
T
5052
17284
Destruction of skin lesions
$453.10
T
5053
17286
Destruction of skin lesions
$453.10
T
5053
17311
Mohs 1 stage h/n/hf/g
$453.10
T
5053
17313
Mohs 1 stage t/a/l
$453.10
T
5053
17340
Cryotherapy of skin
$28.38
Q1
5732
17360
Skin peel therapy
$153.12
Q1
5051
17380
Hair removal by electrolysis
$453.10
T
5053
17999
Skin tissue procedure
$153.12
Q1
5051
19000
Drainage of breast lesion
$539.11
T
5071
19020
Incision of breast lesion
$1236.62
J1
5072
19081
Bx breast 1st lesion strtctc
$1236.62
J1
5072
19083
Bx breast 1st lesion us imag
$1236.62
J1
5072
19085
Bx breast 1st lesion mr imag
$1236.62
J1
5072
19100
Bx breast percut w/o image
$1236.62
J1
5072
19101
Biopsy of breast open
$2499.48
J1
5091
19105
Cryosurg ablate fa each
$2499.48
J1
5091
19110
Nipple exploration
$2499.48
J1
5091
19112
Excise breast duct fistula
$2499.48
J1
5091
19120
Removal of breast lesion
$2499.48
J1
5091
19125
Excision breast lesion
$2499.48
J1
5091
19260
Removal of chest wall lesion
$2148.91
J1
5073
19281
Perq device breast 1st imag
$539.11
Q1
5071
19283
Perq dev breast 1st strtctc
$539.11
Q1
5071
19285
Perq dev breast 1st us imag
$539.11
Q1
5071
19287
Perq dev breast 1st mr guide
$539.11
Q1
5071
19296
Place po breast cath for rad
$6486.35
J1
5093
19298
Place breast rad tube/caths
$4419.46
J1
5092
19300
Removal of breast tissue
$2499.48
J1
5091
19301
Partial mastectomy
$2499.48
J1
5091
19302
P-mastectomy w/ln removal
$4419.46
J1
5092
19303
Mast simple complete
$4419.46
J1
5092
19304
Mast subq
$2499.48
J1
5091
19307
Mast mod rad
$4419.46
J1
5092
19316
Suspension of breast
$4419.46
J1
5092
19318
Reduction of large breast
$4419.46
J1
5092
19324
Enlarge breast
$6486.35
J1
5093
19325
Enlarge breast with implant
$6486.35
J1
5093
19328
Removal of breast implant
$2499.48
Q2
5091
19330
Removal of implant material
$2499.48
Q2
5091
19340
Immediate breast prosthesis
$4419.46
J1
5092
19342
Delayed breast prosthesis
$6486.35
J1
5093
19350
Breast reconstruction
$2499.48
J1
5091
19355
Correct inverted nipple(s)
$2499.48
J1
5091
19357
Breast reconstruction
$10037.05
J1
5094
19366
Breast reconstruction
$4419.46
J1
5092
19370
Surgery of breast capsule
$2499.48
J1
5091
19371
Removal of breast capsule
$2499.48
J1
5091
19380
Revise breast reconstruction
$4419.46
J1
5092
19396
Design custom breast implant
$2499.48
J1
5091
19499
Breast surgery procedure
$2499.48
J1
5091
20005
I&d abscess subfascial
$1236.62
J1
5072
20100
Explore wound neck
$442.62
T
5162
20101
Explore wound chest
$1427.77
T
5054
20102
Explore wound abdomen
$1427.77
T
5054
20103
Explore wound extremity
$539.11
T
5071
20150
Excise epiphyseal bar
$2438.34
J1
5113
20200
Muscle biopsy
$1236.62
J1
5072
20205
Deep muscle biopsy
$2148.91
J1
5073
20206
Needle biopsy muscle
$1236.62
J1
5072
20220
Bone biopsy trocar/needle
$1236.62
J1
5072
20225
Bone biopsy trocar/needle
$1236.62
J1
5072
20240
Bone biopsy open superficial
$2148.91
J1
5073
20245
Bone biopsy open deep
$2148.91
J1
5073
20250
Open bone biopsy
$2438.34
J1
5113
20251
Open bone biopsy
$5221.57
J1
5114
20500
Injection of sinus tract
$1038.55
T
5163
20520
Removal of foreign body
$1236.62
J1
5072
20525
Removal of foreign body
$2148.91
J1
5073
20526
Ther injection carp tunnel
$231.00
T
5441
20527
Inj dupuytren cord w/enzyme
$231.00
T
5441
20550
Inj tendon sheath/ligament
$231.00
T
5441
20551
Inj tendon origin/insertion
$231.00
T
5441
20552
Inj trigger point 1/2 muscl
$231.00
T
5441
20553
Inject trigger points 3/>
$231.00
T
5441
20555
Place ndl musc/tis for rt
$2438.34
J1
5113
20600
Drain/inj joint/bursa w/o us
$231.00
T
5441
20604
Drain/inj joint/bursa w/us
$231.00
T
5441
20605
Drain/inj joint/bursa w/o us
$231.00
T
5441
20606
Drain/inj joint/bursa w/us
$507.19
T
5442
20610
Drain/inj joint/bursa w/o us
$231.00
T
5441
20611
Drain/inj joint/bursa w/us
$231.00
T
5441
20612
Aspirate/inj ganglion cyst
$231.00
T
5441
20615
Treatment of bone cyst
$539.11
T
5071
20650
Insert and remove bone pin
$2438.34
J1
5113
20660
Apply rem fixation device
$1217.42
Q2
5112
20662
Application of pelvis brace
$1217.42
J1
5112
20663
Application of thigh brace
$2438.34
J1
5113
20665
Removal of fixation device
$263.61
Q1
5735
20670
Removal of support implant
$1236.62
Q2
5072
20680
Removal of support implant
$2148.91
Q2
5073
20690
Apply bone fixation device
$5221.57
J1
5114
20692
Apply bone fixation device
$9561.23
J1
5115
20693
Adjust bone fixation device
$5221.57
J1
5114
20694
Remove bone fixation device
$1217.42
Q2
5112
20696
Comp multiplane ext fixation
$14704.13
J1
5116
20697
Comp ext fixate strut change
$1217.42
J1
5112
20822
Replantation digit complete
$2438.34
J1
5113
20900
Removal of bone for graft
$5221.57
J1
5114
20902
Removal of bone for graft
$5221.57
J1
5114
20910
Remove cartilage for graft
$453.10
T
5053
20912
Remove cartilage for graft
$2504.69
T
5055
20920
Removal of fascia for graft
$1427.77
T
5054
20922
Removal of fascia for graft
$2504.69
T
5055
20924
Removal of tendon for graft
$5221.57
J1
5114
20926
Removal of tissue for graft
$2504.69
T
5055
20950
Fluid pressure muscle
$539.11
T
5071
20972
Bone/skin graft metatarsal
$5221.57
J1
5114
20973
Bone/skin graft great toe
$5221.57
J1
5114
20979
Us bone stimulation
$28.38
Q1
5732
20982
Ablate bone tumor(s) perq
$5221.57
J1
5114
20983
Ablate bone tumor(s) perq
$5221.57
J1
5114
20999
Musculoskeletal surgery
$199.83
T
5111
21010
Incision of jaw joint
$2173.69
J1
5164
21011
Exc face les sc <2 cm
$1236.62
J1
5072
21012
Exc face les sbq 2 cm/>
$1236.62
J1
5072
21013
Exc face tum deep < 2 cm
$1236.62
J1
5072
21014
Exc face tum deep 2 cm/>
$2148.91
J1
5073
21015
Resect face/scalp tum < 2 cm
$2148.91
J1
5073
21016
Resect face/scalp tum 2 cm/>
$2148.91
J1
5073
21025
Excision of bone lower jaw
$4130.94
J1
5165
21026
Excision of facial bone(s)
$4130.94
J1
5165
21029
Contour of face bone lesion
$2173.69
J1
5164
21030
Excise max/zygoma b9 tumor
$4130.94
J1
5165
21031
Remove exostosis mandible
$2173.69
J1
5164
21032
Remove exostosis maxilla
$2173.69
J1
5164
21034
Excise max/zygoma mal tumor
$4130.94
J1
5165
21040
Excise mandible lesion
$2173.69
J1
5164
21044
Removal of jaw bone lesion
$4130.94
J1
5165
21046
Remove mandible cyst complex
$4130.94
J1
5165
21047
Excise lwr jaw cyst w/repair
$4130.94
J1
5165
21048
Remove maxilla cyst complex
$4130.94
J1
5165
21049
Excis uppr jaw cyst w/repair
$4130.94
J1
5165
21050
Removal of jaw joint
$4130.94
J1
5165
21060
Remove jaw joint cartilage
$4130.94
J1
5165
21070
Remove coronoid process
$4130.94
J1
5165
21073
Mnpj of tmj w/anesth
$1038.55
T
5163
21076
Prepare face/oral prosthesis
$1038.55
T
5163
21077
Prepare face/oral prosthesis
$4130.94
J1
5165
21079
Prepare face/oral prosthesis
$2173.69
J1
5164
21080
Prepare face/oral prosthesis
$2173.69
J1
5164
21081
Prepare face/oral prosthesis
$4130.94
J1
5165
21082
Prepare face/oral prosthesis
$2173.69
J1
5164
21083
Prepare face/oral prosthesis
$2173.69
J1
5164
21084
Prepare face/oral prosthesis
$2173.69
J1
5164
21085
Prepare face/oral prosthesis
$442.62
T
5162
21086
Prepare face/oral prosthesis
$2173.69
J1
5164
21087
Prepare face/oral prosthesis
$4130.94
J1
5165
21088
Prepare face/oral prosthesis
$2173.69
J1
5164
21089
Prepare face/oral prosthesis
$177.09
T
5161
21100
Maxillofacial fixation
$4130.94
J1
5165
21110
Interdental fixation
$1038.55
Q2
5163
21120
Reconstruction of chin
$4130.94
J1
5165
21121
Reconstruction of chin
$2173.69
J1
5164
21122
Reconstruction of chin
$4130.94
J1
5165
21123
Reconstruction of chin
$2173.69
J1
5164
21125
Augmentation lower jaw bone
$4130.94
J1
5165
21127
Augmentation lower jaw bone
$4130.94
J1
5165
21137
Reduction of forehead
$2173.69
J1
5164
21138
Reduction of forehead
$4130.94
J1
5165
21139
Reduction of forehead
$4130.94
J1
5165
21150
Lefort ii anterior intrusion
$4130.94
J1
5165
21172
Reconstruct orbit/forehead
$4130.94
J1
5165
21175
Reconstruct orbit/forehead
$4130.94
J1
5165
21181
Contour cranial bone lesion
$4130.94
J1
5165
21193
Reconst lwr jaw w/o graft
$4130.94
J1
5165
21195
Reconst lwr jaw w/o fixation
$4130.94
J1
5165
21198
Reconstr lwr jaw segment
$4130.94
J1
5165
21199
Reconstr lwr jaw w/advance
$4130.94
J1
5165
21206
Reconstruct upper jaw bone
$4130.94
J1
5165
21208
Augmentation of facial bones
$4130.94
J1
5165
21209
Reduction of facial bones
$4130.94
J1
5165
21210
Face bone graft
$4130.94
J1
5165
21215
Lower jaw bone graft
$4130.94
J1
5165
21230
Rib cartilage graft
$4130.94
J1
5165
21235
Ear cartilage graft
$4130.94
J1
5165
21240
Reconstruction of jaw joint
$4130.94
J1
5165
21242
Reconstruction of jaw joint
$4130.94
J1
5165
21243
Reconstruction of jaw joint
$14704.13
J1
5116
21244
Reconstruction of lower jaw
$4130.94
J1
5165
21245
Reconstruction of jaw
$4130.94
J1
5165
21246
Reconstruction of jaw
$4130.94
J1
5165
21248
Reconstruction of jaw
$4130.94
J1
5165
21249
Reconstruction of jaw
$4130.94
J1
5165
21256
Reconstruction of orbit
$4130.94
J1
5165
21260
Revise eye sockets
$4130.94
J1
5165
21261
Revise eye sockets
$4130.94
J1
5165
21263
Revise eye sockets
$4130.94
J1
5165
21267
Revise eye sockets
$4130.94
J1
5165
21270
Augmentation cheek bone
$4130.94
J1
5165
21275
Revision orbitofacial bones
$4130.94
J1
5165
21280
Revision of eyelid
$2173.69
J1
5164
21282
Revision of eyelid
$2173.69
J1
5164
21295
Revision of jaw muscle/bone
$1038.55
T
5163
21296
Revision of jaw muscle/bone
$2173.69
J1
5164
21299
Cranio/maxillofacial surgery
$177.09
T
5161
21310
Closed tx nose fx w/o manj
$199.83
T
5111
21315
Closed tx nose fx w/o stablj
$1038.55
T
5163
21320
Closed tx nose fx w/ stablj
$2173.69
J1
5164
21325
Open tx nose fx uncomplicatd
$2173.69
J1
5164
21330
Open tx nose fx w/skele fixj
$4130.94
J1
5165
21335
Open tx nose & septal fx
$2173.69
J1
5164
21336
Open tx septal fx w/wo stabj
$2438.34
J1
5113
21337
Closed tx septal&nose fx
$2173.69
J1
5164
21338
Open nasoethmoid fx w/o fixj
$4130.94
J1
5165
21339
Open nasoethmoid fx w/ fixj
$4130.94
J1
5165
21340
Perq tx nasoethmoid fx
$2173.69
J1
5164
21345
Closed tx nose/jaw fx
$1038.55
T
5163
21346
Opn tx nasomax fx w/fixj
$4130.94
J1
5165
21355
Perq tx malar fracture
$2173.69
J1
5164
21356
Opn tx dprsd zygomatic arch
$4130.94
J1
5165
21360
Opn tx dprsd malar fracture
$4130.94
J1
5165
21365
Opn tx complx malar fx
$4130.94
J1
5165
21385
Opn tx orbit fx transantral
$4130.94
J1
5165
21386
Opn tx orbit fx periorbital
$4130.94
J1
5165
21387
Opn tx orbit fx combined
$4130.94
J1
5165
21390
Opn tx orbit periorbtl implt
$4130.94
J1
5165
21395
Opn tx orbit periorbt w/grft
$4130.94
J1
5165
21400
Closed tx orbit w/o manipulj
$442.62
T
5162
21401
Closed tx orbit w/manipulj
$1038.55
T
5163
21406
Opn tx orbit fx w/o implant
$4130.94
J1
5165
21407
Opn tx orbit fx w/implant
$4130.94
J1
5165
21408
Opn tx orbit fx w/bone grft
$4130.94
J1
5165
21421
Treat mouth roof fracture
$2173.69
J1
5164
21440
Treat dental ridge fracture
$2173.69
J1
5164
21445
Treat dental ridge fracture
$4130.94
J1
5165
21450
Treat lower jaw fracture
$442.62
T
5162
21451
Treat lower jaw fracture
$1038.55
T
5163
21452
Treat lower jaw fracture
$4130.94
J1
5165
21453
Treat lower jaw fracture
$4130.94
J1
5165
21454
Treat lower jaw fracture
$4130.94
J1
5165
21461
Treat lower jaw fracture
$4130.94
J1
5165
21462
Treat lower jaw fracture
$4130.94
J1
5165
21465
Treat lower jaw fracture
$4130.94
J1
5165
21470
Treat lower jaw fracture
$4130.94
J1
5165
21480
Reset dislocated jaw
$199.83
T
5111
21485
Reset dislocated jaw
$1038.55
T
5163
21490
Repair dislocated jaw
$2173.69
J1
5164
21497
Interdental wiring
$1038.55
T
5163
21499
Head surgery procedure
$177.09
T
5161
21501
Drain neck/chest lesion
$2148.91
J1
5073
21502
Drain chest lesion
$2438.34
J1
5113
21550
Biopsy of neck/chest
$1236.62
J1
5072
21552
Exc neck les sc 3 cm/>
$2148.91
J1
5073
21554
Exc neck tum deep 5 cm/>
$2148.91
J1
5073
21555
Exc neck les sc < 3 cm
$1236.62
J1
5072
21556
Exc neck tum deep < 5 cm
$2148.91
J1
5073
21557
Resect neck thorax tumor<5cm
$2148.91
J1
5073
21558
Resect neck tumor 5 cm/>
$2148.91
J1
5073
21600
Partial removal of rib
$5221.57
J1
5114
21610
Partial removal of rib
$2438.34
J1
5113
21685
Hyoid myotomy & suspension
$4130.94
J1
5165
21700
Revision of neck muscle
$2438.34
J1
5113
21720
Revision of neck muscle
$2438.34
J1
5113
21725
Revision of neck muscle
$539.11
T
5071
21742
Repair stern/nuss w/o scope
$2438.34
J1
5113
21743
Repair sternum/nuss w/scope
$2438.34
J1
5113
21811
Optx of rib fx w/fixj scope
$2438.34
J1
5113
21812
Treatment of rib fracture
$1217.42
J1
5112
21813
Treatment of rib fracture
$1217.42
J1
5112
21820
Treat sternum fracture
$199.83
T
5111
21899
Neck/chest surgery procedure
$177.09
T
5161
21920
Biopsy soft tissue of back
$1236.62
J1
5072
21925
Biopsy soft tissue of back
$1236.62
J1
5072
21930
Exc back les sc < 3 cm
$1236.62
J1
5072
21931
Exc back les sc 3 cm/>
$1236.62
J1
5072
21932
Exc back tum deep < 5 cm
$2148.91
J1
5073
21933
Exc back tum deep 5 cm/>
$2148.91
J1
5073
21935
Resect back tum < 5 cm
$2148.91
J1
5073
21936
Resect back tum 5 cm/>
$2148.91
J1
5073
22100
Remove part of neck vertebra
$5221.57
J1
5114
22101
Remove part thorax vertebra
$2438.34
J1
5113
22102
Remove part lumbar vertebra
$5221.57
J1
5114
22310
Closed tx vert fx w/o manj
$199.83
T
5111
22315
Closed tx vert fx w/manj
$1217.42
J1
5112
22505
Manipulation of spine
$1217.42
J1
5112
22510
Perq cervicothoracic inject
$2438.34
J1
5113
22511
Perq lumbosacral injection
$2438.34
J1
5113
22513
Perq vertebral augmentation
$5221.57
J1
5114
22514
Perq vertebral augmentation
$5221.57
J1
5114
22551
Neck spine fuse&remov bel c2
$9561.23
J1
5115
22554
Neck spine fusion
$9561.23
J1
5115
22612
Lumbar spine fusion
$9561.23
J1
5115
22856
Cerv artific diskectomy
$14704.13
J1
5116
22867
Insj stablj dev w/dcmprn
$14704.13
J1
5116
22869
Insj stablj dev w/o dcmprn
$14704.13
J1
5116
22899
Spine surgery procedure
$199.83
T
5111
22900
Exc abdl tum deep < 5 cm
$2148.91
J1
5073
22901
Exc abdl tum deep 5 cm/>
$2148.91
J1
5073
22902
Exc abd les sc < 3 cm
$1236.62
J1
5072
22903
Exc abd les sc 3 cm/>
$2148.91
J1
5073
22904
Radical resect abd tumor<5cm
$2148.91
J1
5073
22905
Rad resect abd tumor 5 cm/>
$2148.91
J1
5073
22999
Abdomen surgery procedure
$199.83
T
5111
23000
Removal of calcium deposits
$2148.91
J1
5073
23020
Release shoulder joint
$2438.34
J1
5113
23030
Drain shoulder lesion
$2148.91
J1
5073
23031
Drain shoulder bursa
$1236.62
J1
5072
23035
Drain shoulder bone lesion
$1217.42
J1
5112
23040
Exploratory shoulder surgery
$2438.34
J1
5113
23044
Exploratory shoulder surgery
$2438.34
J1
5113
23065
Biopsy shoulder tissues
$1236.62
J1
5072
23066
Biopsy shoulder tissues
$2148.91
J1
5073
23071
Exc shoulder les sc 3 cm/>
$1236.62
J1
5072
23073
Exc shoulder tum deep 5 cm/>
$2148.91
J1
5073
23075
Exc shoulder les sc < 3 cm
$1236.62
J1
5072
23076
Exc shoulder tum deep < 5 cm
$2148.91
J1
5073
23077
Resect shoulder tumor < 5 cm
$2148.91
J1
5073
23078
Resect shoulder tumor 5 cm/>
$2148.91
J1
5073
23100
Biopsy of shoulder joint
$1217.42
J1
5112
23101
Shoulder joint surgery
$2438.34
J1
5113
23105
Remove shoulder joint lining
$5221.57
J1
5114
23106
Incision of collarbone joint
$2438.34
J1
5113
23107
Explore treat shoulder joint
$5221.57
J1
5114
23120
Partial removal collar bone
$2438.34
J1
5113
23125
Removal of collar bone
$2438.34
J1
5113
23130
Remove shoulder bone part
$2438.34
J1
5113
23140
Removal of bone lesion
$2438.34
J1
5113
23145
Removal of bone lesion
$2438.34
J1
5113
23146
Removal of bone lesion
$5221.57
J1
5114
23150
Removal of humerus lesion
$2438.34
J1
5113
23155
Removal of humerus lesion
$5221.57
J1
5114
23156
Removal of humerus lesion
$5221.57
J1
5114
23170
Remove collar bone lesion
$1217.42
J1
5112
23172
Remove shoulder blade lesion
$2438.34
J1
5113
23174
Remove humerus lesion
$2438.34
J1
5113
23180
Remove collar bone lesion
$2438.34
J1
5113
23182
Remove shoulder blade lesion
$2438.34
J1
5113
23184
Remove humerus lesion
$5221.57
J1
5114
23190
Partial removal of scapula
$2438.34
J1
5113
23195
Removal of head of humerus
$5221.57
J1
5114
23330
Remove shoulder foreign body
$539.11
T
5071
23333
Remove shoulder fb deep
$1236.62
J1
5072
23334
Shoulder prosthesis removal
$2148.91
J1
5073
23395
Muscle transfer shoulder/arm
$5221.57
J1
5114
23397
Muscle transfers
$5221.57
J1
5114
23400
Fixation of shoulder blade
$5221.57
J1
5114
23405
Incision of tendon & muscle
$5221.57
J1
5114
23406
Incise tendon(s) & muscle(s)
$2438.34
J1
5113
23410
Repair rotator cuff acute
$5221.57
J1
5114
23412
Repair rotator cuff chronic
$5221.57
J1
5114
23415
Release of shoulder ligament
$5221.57
J1
5114
23420
Repair of shoulder
$5221.57
J1
5114
23430
Repair biceps tendon
$5221.57
J1
5114
23440
Remove/transplant tendon
$2438.34
J1
5113
23450
Repair shoulder capsule
$5221.57
J1
5114
23455
Repair shoulder capsule
$5221.57
J1
5114
23460
Repair shoulder capsule
$5221.57
J1
5114
23462
Repair shoulder capsule
$5221.57
J1
5114
23465
Repair shoulder capsule
$5221.57
J1
5114
23466
Repair shoulder capsule
$5221.57
J1
5114
23470
Reconstruct shoulder joint
$9561.23
J1
5115
23473
Revis reconst shoulder joint
$9561.23
J1
5115
23480
Revision of collar bone
$5221.57
J1
5114
23485
Revision of collar bone
$9561.23
J1
5115
23490
Reinforce clavicle
$5221.57
J1
5114
23491
Reinforce shoulder bones
$9561.23
J1
5115
23500
Treat clavicle fracture
$199.83
T
5111
23505
Treat clavicle fracture
$1217.42
J1
5112
23515
Treat clavicle fracture
$5221.57
J1
5114
23520
Treat clavicle dislocation
$1217.42
J1
5112
23525
Treat clavicle dislocation
$199.83
T
5111
23530
Treat clavicle dislocation
$5221.57
J1
5114
23532
Treat clavicle dislocation
$5221.57
J1
5114
23540
Treat clavicle dislocation
$199.83
T
5111
23545
Treat clavicle dislocation
$199.83
T
5111
23550
Treat clavicle dislocation
$5221.57
J1
5114
23552
Treat clavicle dislocation
$5221.57
J1
5114
23570
Treat shoulder blade fx
$199.83
T
5111
23575
Treat shoulder blade fx
$1217.42
J1
5112
23585
Treat scapula fracture
$5221.57
J1
5114
23600
Treat humerus fracture
$199.83
T
5111
23605
Treat humerus fracture
$1217.42
J1
5112
23615
Treat humerus fracture
$9561.23
J1
5115
23616
Treat humerus fracture
$14704.13
J1
5116
23620
Treat humerus fracture
$199.83
T
5111
23625
Treat humerus fracture
$1217.42
J1
5112
23630
Treat humerus fracture
$5221.57
J1
5114
23650
Treat shoulder dislocation
$199.83
T
5111
23655
Treat shoulder dislocation
$1217.42
J1
5112
23660
Treat shoulder dislocation
$5221.57
J1
5114
23665
Treat dislocation/fracture
$1217.42
J1
5112
23670
Treat dislocation/fracture
$5221.57
J1
5114
23675
Treat dislocation/fracture
$1217.42
J1
5112
23680
Treat dislocation/fracture
$9561.23
J1
5115
23700
Fixation of shoulder
$1217.42
J1
5112
23800
Fusion of shoulder joint
$5221.57
J1
5114
23802
Fusion of shoulder joint
$9561.23
J1
5115
23921
Amputation follow-up surgery
$1427.77
T
5054
23929
Shoulder surgery procedure
$199.83
T
5111
23930
Drainage of arm lesion
$1236.62
J1
5072
23931
Drainage of arm bursa
$1236.62
J1
5072
23935
Drain arm/elbow bone lesion
$2438.34
J1
5113
24000
Exploratory elbow surgery
$2438.34
J1
5113
24006
Release elbow joint
$2438.34
J1
5113
24065
Biopsy arm/elbow soft tissue
$1236.62
J1
5072
24066
Biopsy arm/elbow soft tissue
$2148.91
J1
5073
24071
Exc arm/elbow les sc 3 cm/>
$2148.91
J1
5073
24073
Ex arm/elbow tum deep 5 cm/>
$2148.91
J1
5073
24075
Exc arm/elbow les sc < 3 cm
$1236.62
J1
5072
24076
Ex arm/elbow tum deep < 5 cm
$2148.91
J1
5073
24077
Resect arm/elbow tum < 5 cm
$2148.91
J1
5073
24079
Resect arm/elbow tum 5 cm/>
$2148.91
J1
5073
24100
Biopsy elbow joint lining
$2438.34
J1
5113
24101
Explore/treat elbow joint
$2438.34
J1
5113
24102
Remove elbow joint lining
$2438.34
J1
5113
24105
Removal of elbow bursa
$2438.34
J1
5113
24110
Remove humerus lesion
$2438.34
J1
5113
24115
Remove/graft bone lesion
$5221.57
J1
5114
24116
Remove/graft bone lesion
$5221.57
J1
5114
24120
Remove elbow lesion
$2438.34
J1
5113
24125
Remove/graft bone lesion
$2438.34
J1
5113
24126
Remove/graft bone lesion
$5221.57
J1
5114
24130
Removal of head of radius
$2438.34
J1
5113
24134
Removal of arm bone lesion
$5221.57
J1
5114
24136
Remove radius bone lesion
$2438.34
J1
5113
24138
Remove elbow bone lesion
$5221.57
J1
5114
24140
Partial removal of arm bone
$2438.34
J1
5113
24145
Partial removal of radius
$5221.57
J1
5114
24147
Partial removal of elbow
$2438.34
J1
5113
24149
Radical resection of elbow
$5221.57
J1
5114
24150
Resect distal humerus tumor
$5221.57
J1
5114
24152
Resect radius tumor
$5221.57
J1
5114
24155
Removal of elbow joint
$2438.34
J1
5113
24160
Remove elbow joint implant
$2438.34
Q2
5113
24164
Remove radius head implant
$2438.34
Q2
5113
24200
Removal of arm foreign body
$1236.62
J1
5072
24201
Removal of arm foreign body
$2148.91
J1
5073
24300
Manipulate elbow w/anesth
$1217.42
J1
5112
24301
Muscle/tendon transfer
$5221.57
J1
5114
24305
Arm tendon lengthening
$2438.34
J1
5113
24310
Revision of arm tendon
$2438.34
J1
5113
24320
Repair of arm tendon
$5221.57
J1
5114
24330
Revision of arm muscles
$2438.34
J1
5113
24331
Revision of arm muscles
$5221.57
J1
5114
24332
Tenolysis triceps
$2438.34
J1
5113
24340
Repair of biceps tendon
$5221.57
J1
5114
24341
Repair arm tendon/muscle
$5221.57
J1
5114
24342
Repair of ruptured tendon
$5221.57
J1
5114
24343
Repr elbow lat ligmnt w/tiss
$2438.34
J1
5113
24344
Reconstruct elbow lat ligmnt
$5221.57
J1
5114
24345
Repr elbw med ligmnt w/tissu
$5221.57
J1
5114
24346
Reconstruct elbow med ligmnt
$9561.23
J1
5115
24357
Repair elbow perc
$2438.34
J1
5113
24358
Repair elbow w/deb open
$2438.34
J1
5113
24359
Repair elbow deb/attch open
$2438.34
J1
5113
24360
Reconstruct elbow joint
$5221.57
J1
5114
24361
Reconstruct elbow joint
$14704.13
J1
5116
24362
Reconstruct elbow joint
$9561.23
J1
5115
24363
Replace elbow joint
$14704.13
J1
5116
24365
Reconstruct head of radius
$9561.23
J1
5115
24366
Reconstruct head of radius
$9561.23
J1
5115
24370
Revise reconst elbow joint
$9561.23
J1
5115
24371
Revise reconst elbow joint
$14704.13
J1
5116
24400
Revision of humerus
$5221.57
J1
5114
24410
Revision of humerus
$9561.23
J1
5115
24420
Revision of humerus
$5221.57
J1
5114
24430
Repair of humerus
$9561.23
J1
5115
24435
Repair humerus with graft
$9561.23
J1
5115
24470
Revision of elbow joint
$2438.34
J1
5113
24495
Decompression of forearm
$5221.57
J1
5114
24498
Reinforce humerus
$9561.23
J1
5115
24500
Treat humerus fracture
$199.83
T
5111
24505
Treat humerus fracture
$1217.42
J1
5112
24515
Treat humerus fracture
$9561.23
J1
5115
24516
Treat humerus fracture
$9561.23
J1
5115
24530
Treat humerus fracture
$199.83
T
5111
24535
Treat humerus fracture
$1217.42
J1
5112
24538
Treat humerus fracture
$5221.57
J1
5114
24545
Treat humerus fracture
$9561.23
J1
5115
24546
Treat humerus fracture
$14704.13
J1
5116
24560
Treat humerus fracture
$199.83
T
5111
24565
Treat humerus fracture
$1217.42
J1
5112
24566
Treat humerus fracture
$2438.34
J1
5113
24575
Treat humerus fracture
$9561.23
J1
5115
24576
Treat humerus fracture
$199.83
T
5111
24577
Treat humerus fracture
$1217.42
J1
5112
24579
Treat humerus fracture
$9561.23
J1
5115
24582
Treat humerus fracture
$2438.34
J1
5113
24586
Treat elbow fracture
$9561.23
J1
5115
24587
Treat elbow fracture
$9561.23
J1
5115
24600
Treat elbow dislocation
$199.83
T
5111
24605
Treat elbow dislocation
$1217.42
J1
5112
24615
Treat elbow dislocation
$5221.57
J1
5114
24620
Treat elbow fracture
$1217.42
J1
5112
24635
Treat elbow fracture
$5221.57
J1
5114
24640
Treat elbow dislocation
$199.83
T
5111
24650
Treat radius fracture
$199.83
T
5111
24655
Treat radius fracture
$1217.42
J1
5112
24665
Treat radius fracture
$5221.57
J1
5114
24666
Treat radius fracture
$9561.23
J1
5115
24670
Treat ulnar fracture
$199.83
T
5111
24675
Treat ulnar fracture
$1217.42
J1
5112
24685
Treat ulnar fracture
$5221.57
J1
5114
24800
Fusion of elbow joint
$5221.57
J1
5114
24802
Fusion/graft of elbow joint
$9561.23
J1
5115
24925
Amputation follow-up surgery
$2438.34
J1
5113
24935
Revision of amputation
$5221.57
J1
5114
24999
Upper arm/elbow surgery
$199.83
T
5111
25000
Incision of tendon sheath
$1217.42
J1
5112
25001
Incise flexor carpi radialis
$1217.42
J1
5112
25020
Decompress forearm 1 space
$1217.42
J1
5112
25023
Decompress forearm 1 space
$2438.34
J1
5113
25024
Decompress forearm 2 spaces
$2438.34
J1
5113
25025
Decompress forearm 2 spaces
$2438.34
J1
5113
25028
Drainage of forearm lesion
$2438.34
J1
5113
25031
Drainage of forearm bursa
$1217.42
J1
5112
25035
Treat forearm bone lesion
$5221.57
J1
5114
25040
Explore/treat wrist joint
$2438.34
J1
5113
25065
Biopsy forearm soft tissues
$1236.62
J1
5072
25066
Biopsy forearm soft tissues
$2148.91
J1
5073
25071
Exc forearm les sc 3 cm/>
$1236.62
J1
5072
25073
Exc forearm tum deep 3 cm/>
$2148.91
J1
5073
25075
Exc forearm les sc < 3 cm
$1236.62
J1
5072
25076
Exc forearm tum deep < 3 cm
$1236.62
J1
5072
25077
Resect forearm/wrist tum<3cm
$1236.62
J1
5072
25078
Resect forarm/wrist tum 3cm>
$2148.91
J1
5073
25085
Incision of wrist capsule
$2438.34
J1
5113
25100
Biopsy of wrist joint
$2438.34
J1
5113
25101
Explore/treat wrist joint
$2438.34
J1
5113
25105
Remove wrist joint lining
$2438.34
J1
5113
25107
Remove wrist joint cartilage
$2438.34
J1
5113
25109
Excise tendon forearm/wrist
$2438.34
J1
5113
25110
Remove wrist tendon lesion
$1217.42
J1
5112
25111
Remove wrist tendon lesion
$1217.42
J1
5112
25112
Reremove wrist tendon lesion
$2438.34
J1
5113
25115
Remove wrist/forearm lesion
$1217.42
J1
5112
25116
Remove wrist/forearm lesion
$2438.34
J1
5113
25118
Excise wrist tendon sheath
$2438.34
J1
5113
25119
Partial removal of ulna
$2438.34
J1
5113
25120
Removal of forearm lesion
$2438.34
J1
5113
25125
Remove/graft forearm lesion
$2438.34
J1
5113
25126
Remove/graft forearm lesion
$2438.34
J1
5113
25130
Removal of wrist lesion
$2438.34
J1
5113
25135
Remove & graft wrist lesion
$2438.34
J1
5113
25136
Remove & graft wrist lesion
$5221.57
J1
5114
25145
Remove forearm bone lesion
$2438.34
J1
5113
25150
Partial removal of ulna
$2438.34
J1
5113
25151
Partial removal of radius
$2438.34
J1
5113
25170
Resect radius/ulnar tumor
$5221.57
J1
5114
25210
Removal of wrist bone
$2438.34
J1
5113
25215
Removal of wrist bones
$2438.34
J1
5113
25230
Partial removal of radius
$2438.34
J1
5113
25240
Partial removal of ulna
$2438.34
J1
5113
25248
Remove forearm foreign body
$2438.34
J1
5113
25250
Removal of wrist prosthesis
$1217.42
Q2
5112
25251
Removal of wrist prosthesis
$2438.34
Q2
5113
25259
Manipulate wrist w/anesthes
$1217.42
J1
5112
25260
Repair forearm tendon/muscle
$2438.34
J1
5113
25263
Repair forearm tendon/muscle
$2438.34
J1
5113
25265
Repair forearm tendon/muscle
$2438.34
J1
5113
25270
Repair forearm tendon/muscle
$2438.34
J1
5113
25272
Repair forearm tendon/muscle
$2438.34
J1
5113
25274
Repair forearm tendon/muscle
$2438.34
J1
5113
25275
Repair forearm tendon sheath
$2438.34
J1
5113
25280
Revise wrist/forearm tendon
$2438.34
J1
5113
25290
Incise wrist/forearm tendon
$2438.34
J1
5113
25295
Release wrist/forearm tendon
$2438.34
J1
5113
25300
Fusion of tendons at wrist
$2438.34
J1
5113
25301
Fusion of tendons at wrist
$2438.34
J1
5113
25310
Transplant forearm tendon
$2438.34
J1
5113
25312
Transplant forearm tendon
$2438.34
J1
5113
25315
Revise palsy hand tendon(s)
$5221.57
J1
5114
25316
Revise palsy hand tendon(s)
$5221.57
J1
5114
25320
Repair/revise wrist joint
$5221.57
J1
5114
25332
Revise wrist joint
$2438.34
J1
5113
25335
Realignment of hand
$2438.34
J1
5113
25337
Reconstruct ulna/radioulnar
$5221.57
J1
5114
25350
Revision of radius
$5221.57
J1
5114
25355
Revision of radius
$2438.34
J1
5113
25360
Revision of ulna
$5221.57
J1
5114
25365
Revise radius & ulna
$9561.23
J1
5115
25370
Revise radius or ulna
$2438.34
J1
5113
25375
Revise radius & ulna
$2438.34
J1
5113
25390
Shorten radius or ulna
$5221.57
J1
5114
25391
Lengthen radius or ulna
$9561.23
J1
5115
25392
Shorten radius & ulna
$2438.34
J1
5113
25393
Lengthen radius & ulna
$2438.34
J1
5113
25394
Repair carpal bone shorten
$2438.34
J1
5113
25400
Repair radius or ulna
$5221.57
J1
5114
25405
Repair/graft radius or ulna
$5221.57
J1
5114
25415
Repair radius & ulna
$5221.57
J1
5114
25420
Repair/graft radius & ulna
$5221.57
J1
5114
25425
Repair/graft radius or ulna
$5221.57
J1
5114
25426
Repair/graft radius & ulna
$2438.34
J1
5113
25430
Vasc graft into carpal bone
$2438.34
J1
5113
25431
Repair nonunion carpal bone
$5221.57
J1
5114
25440
Repair/graft wrist bone
$5221.57
J1
5114
25441
Reconstruct wrist joint
$9561.23
J1
5115
25442
Reconstruct wrist joint
$14704.13
J1
5116
25443
Reconstruct wrist joint
$5221.57
J1
5114
25444
Reconstruct wrist joint
$9561.23
J1
5115
25445
Reconstruct wrist joint
$5221.57
J1
5114
25446
Wrist replacement
$14704.13
J1
5116
25447
Repair wrist joints
$2438.34
J1
5113
25449
Remove wrist joint implant
$5221.57
J1
5114
25450
Revision of wrist joint
$2438.34
J1
5113
25455
Revision of wrist joint
$2438.34
J1
5113
25490
Reinforce radius
$5221.57
J1
5114
25491
Reinforce ulna
$9561.23
J1
5115
25492
Reinforce radius and ulna
$2438.34
J1
5113
25500
Treat fracture of radius
$199.83
T
5111
25505
Treat fracture of radius
$1217.42
J1
5112
25515
Treat fracture of radius
$5221.57
J1
5114
25520
Treat fracture of radius
$1217.42
J1
5112
25525
Treat fracture of radius
$5221.57
J1
5114
25526
Treat fracture of radius
$5221.57
J1
5114
25530
Treat fracture of ulna
$199.83
T
5111
25535
Treat fracture of ulna
$199.83
T
5111
25545
Treat fracture of ulna
$5221.57
J1
5114
25560
Treat fracture radius & ulna
$199.83
T
5111
25565
Treat fracture radius & ulna
$1217.42
J1
5112
25574
Treat fracture radius & ulna
$5221.57
J1
5114
25575
Treat fracture radius/ulna
$5221.57
J1
5114
25600
Treat fracture radius/ulna
$199.83
T
5111
25605
Treat fracture radius/ulna
$1217.42
J1
5112
25606
Treat fx distal radial
$2438.34
J1
5113
25607
Treat fx rad extra-articul
$5221.57
J1
5114
25608
Treat fx rad intra-articul
$5221.57
J1
5114
25609
Treat fx radial 3+ frag
$5221.57
J1
5114
25622
Treat wrist bone fracture
$199.83
T
5111
25624
Treat wrist bone fracture
$1217.42
J1
5112
25628
Treat wrist bone fracture
$5221.57
J1
5114
25630
Treat wrist bone fracture
$199.83
T
5111
25635
Treat wrist bone fracture
$1217.42
J1
5112
25645
Treat wrist bone fracture
$2438.34
J1
5113
25650
Treat wrist bone fracture
$199.83
T
5111
25651
Pin ulnar styloid fracture
$2438.34
J1
5113
25652
Treat fracture ulnar styloid
$5221.57
J1
5114
25660
Treat wrist dislocation
$199.83
T
5111
25670
Treat wrist dislocation
$2438.34
J1
5113
25671
Pin radioulnar dislocation
$2438.34
J1
5113
25675
Treat wrist dislocation
$199.83
T
5111
25676
Treat wrist dislocation
$5221.57
J1
5114
25680
Treat wrist fracture
$199.83
T
5111
25685
Treat wrist fracture
$2438.34
J1
5113
25690
Treat wrist dislocation
$1217.42
J1
5112
25695
Treat wrist dislocation
$5221.57
J1
5114
25800
Fusion of wrist joint
$5221.57
J1
5114
25805
Fusion/graft of wrist joint
$5221.57
J1
5114
25810
Fusion/graft of wrist joint
$9561.23
J1
5115
25820
Fusion of hand bones
$5221.57
J1
5114
25825
Fuse hand bones with graft
$5221.57
J1
5114
25830
Fusion radioulnar jnt/ulna
$5221.57
J1
5114
25907
Amputation follow-up surgery
$2438.34
J1
5113
25909
Amputation follow-up surgery
$2438.34
J1
5113
25922
Amputate hand at wrist
$1217.42
J1
5112
25929
Amputation follow-up surgery
$1427.77
T
5054
25931
Amputation follow-up surgery
$2438.34
J1
5113
25999
Forearm or wrist surgery
$199.83
T
5111
26010
Drainage of finger abscess
$153.12
T
5051
26011
Drainage of finger abscess
$1236.62
J1
5072
26020
Drain hand tendon sheath
$2438.34
J1
5113
26025
Drainage of palm bursa
$2438.34
J1
5113
26030
Drainage of palm bursas
$2438.34
J1
5113
26034
Treat hand bone lesion
$1217.42
J1
5112
26035
Decompress fingers/hand
$2438.34
J1
5113
26037
Decompress fingers/hand
$2438.34
J1
5113
26040
Release palm contracture
$1217.42
J1
5112
26045
Release palm contracture
$2438.34
J1
5113
26055
Incise finger tendon sheath
$1217.42
J1
5112
26060
Incision of finger tendon
$1217.42
J1
5112
26070
Explore/treat hand joint
$1217.42
J1
5112
26075
Explore/treat finger joint
$2438.34
J1
5113
26080
Explore/treat finger joint
$1217.42
J1
5112
26100
Biopsy hand joint lining
$2438.34
J1
5113
26105
Biopsy finger joint lining
$2438.34
J1
5113
26110
Biopsy finger joint lining
$1217.42
J1
5112
26111
Exc hand les sc 1.5 cm/>
$1236.62
J1
5072
26113
Exc hand tum deep 1.5 cm/>
$1236.62
J1
5072
26115
Exc hand les sc < 1.5 cm
$1236.62
J1
5072
26116
Exc hand tum deep < 1.5 cm
$1236.62
J1
5072
26117
Rad resect hand tumor < 3 cm
$2148.91
J1
5073
26118
Rad resect hand tumor 3 cm/>
$2148.91
J1
5073
26121
Release palm contracture
$2438.34
J1
5113
26123
Release palm contracture
$2438.34
J1
5113
26130
Remove wrist joint lining
$2438.34
J1
5113
26135
Revise finger joint each
$2438.34
J1
5113
26140
Revise finger joint each
$1217.42
J1
5112
26145
Tendon excision palm/finger
$1217.42
J1
5112
26160
Remove tendon sheath lesion
$1217.42
J1
5112
26170
Removal of palm tendon each
$1217.42
J1
5112
26180
Removal of finger tendon
$1217.42
J1
5112
26185
Remove finger bone
$1217.42
J1
5112
26200
Remove hand bone lesion
$2438.34
J1
5113
26205
Remove/graft bone lesion
$5221.57
J1
5114
26210
Removal of finger lesion
$1217.42
J1
5112
26215
Remove/graft finger lesion
$2438.34
J1
5113
26230
Partial removal of hand bone
$2438.34
J1
5113
26235
Partial removal finger bone
$1217.42
J1
5112
26236
Partial removal finger bone
$1217.42
J1
5112
26250
Extensive hand surgery
$2438.34
J1
5113
26260
Resect prox finger tumor
$2438.34
J1
5113
26262
Resect distal finger tumor
$2438.34
J1
5113
26320
Removal of implant from hand
$1236.62
Q2
5072
26340
Manipulate finger w/anesth
$1217.42
J1
5112
26341
Manipulat palm cord post inj
$199.83
T
5111
26350
Repair finger/hand tendon
$2438.34
J1
5113
26352
Repair/graft hand tendon
$2438.34
J1
5113
26356
Repair finger/hand tendon
$2438.34
J1
5113
26357
Repair finger/hand tendon
$2438.34
J1
5113
26358
Repair/graft hand tendon
$2438.34
J1
5113
26370
Repair finger/hand tendon
$2438.34
J1
5113
26372
Repair/graft hand tendon
$5221.57
J1
5114
26373
Repair finger/hand tendon
$2438.34
J1
5113
26390
Revise hand/finger tendon
$5221.57
J1
5114
26392
Repair/graft hand tendon
$5221.57
J1
5114
26410
Repair hand tendon
$2438.34
J1
5113
26412
Repair/graft hand tendon
$2438.34
J1
5113
26415
Excision hand/finger tendon
$1217.42
J1
5112
26416
Graft hand or finger tendon
$2438.34
J1
5113
26418
Repair finger tendon
$2438.34
J1
5113
26420
Repair/graft finger tendon
$2438.34
J1
5113
26426
Repair finger/hand tendon
$2438.34
J1
5113
26428
Repair/graft finger tendon
$2438.34
J1
5113
26432
Repair finger tendon
$1217.42
J1
5112
26433
Repair finger tendon
$2438.34
J1
5113
26434
Repair/graft finger tendon
$2438.34
J1
5113
26437
Realignment of tendons
$2438.34
J1
5113
26440
Release palm/finger tendon
$1217.42
J1
5112
26442
Release palm & finger tendon
$2438.34
J1
5113
26445
Release hand/finger tendon
$2438.34
J1
5113
26449
Release forearm/hand tendon
$2438.34
J1
5113
26450
Incision of palm tendon
$2438.34
J1
5113
26455
Incision of finger tendon
$1217.42
J1
5112
26460
Incise hand/finger tendon
$1217.42
J1
5112
26471
Fusion of finger tendons
$2438.34
J1
5113
26474
Fusion of finger tendons
$2438.34
J1
5113
26476
Tendon lengthening
$2438.34
J1
5113
26477
Tendon shortening
$2438.34
J1
5113
26478
Lengthening of hand tendon
$2438.34
J1
5113
26479
Shortening of hand tendon
$1217.42
J1
5112
26480
Transplant hand tendon
$2438.34
J1
5113
26483
Transplant/graft hand tendon
$2438.34
J1
5113
26485
Transplant palm tendon
$2438.34
J1
5113
26489
Transplant/graft palm tendon
$2438.34
J1
5113
26490
Revise thumb tendon
$2438.34
J1
5113
26492
Tendon transfer with graft
$2438.34
J1
5113
26494
Hand tendon/muscle transfer
$2438.34
J1
5113
26496
Revise thumb tendon
$2438.34
J1
5113
26497
Finger tendon transfer
$2438.34
J1
5113
26498
Finger tendon transfer
$2438.34
J1
5113
26499
Revision of finger
$2438.34
J1
5113
26500
Hand tendon reconstruction
$5221.57
J1
5114
26502
Hand tendon reconstruction
$2438.34
J1
5113
26508
Release thumb contracture
$2438.34
J1
5113
26510
Thumb tendon transfer
$2438.34
J1
5113
26516
Fusion of knuckle joint
$2438.34
J1
5113
26517
Fusion of knuckle joints
$2438.34
J1
5113
26518
Fusion of knuckle joints
$2438.34
J1
5113
26520
Release knuckle contracture
$2438.34
J1
5113
26525
Release finger contracture
$2438.34
J1
5113
26530
Revise knuckle joint
$2438.34
J1
5113
26531
Revise knuckle with implant
$5221.57
J1
5114
26535
Revise finger joint
$2438.34
J1
5113
26536
Revise/implant finger joint
$5221.57
J1
5114
26540
Repair hand joint
$2438.34
J1
5113
26541
Repair hand joint with graft
$2438.34
J1
5113
26542
Repair hand joint with graft
$2438.34
J1
5113
26545
Reconstruct finger joint
$2438.34
J1
5113
26546
Repair nonunion hand
$5221.57
J1
5114
26548
Reconstruct finger joint
$2438.34
J1
5113
26550
Construct thumb replacement
$2438.34
J1
5113
26555
Positional change of finger
$5221.57
J1
5114
26560
Repair of web finger
$1217.42
J1
5112
26561
Repair of web finger
$2438.34
J1
5113
26562
Repair of web finger
$2438.34
J1
5113
26565
Correct metacarpal flaw
$2438.34
J1
5113
26567
Correct finger deformity
$2438.34
J1
5113
26568
Lengthen metacarpal/finger
$5221.57
J1
5114
26580
Repair hand deformity
$2438.34
J1
5113
26587
Reconstruct extra finger
$2438.34
J1
5113
26590
Repair finger deformity
$1217.42
J1
5112
26591
Repair muscles of hand
$2438.34
J1
5113
26593
Release muscles of hand
$2438.34
J1
5113
26596
Excision constricting tissue
$2438.34
J1
5113
26600
Treat metacarpal fracture
$199.83
T
5111
26605
Treat metacarpal fracture
$199.83
T
5111
26607
Treat metacarpal fracture
$2438.34
J1
5113
26608
Treat metacarpal fracture
$2438.34
J1
5113
26615
Treat metacarpal fracture
$2438.34
J1
5113
26641
Treat thumb dislocation
$199.83
T
5111
26645
Treat thumb fracture
$1217.42
J1
5112
26650
Treat thumb fracture
$2438.34
J1
5113
26665
Treat thumb fracture
$2438.34
J1
5113
26670
Treat hand dislocation
$199.83
T
5111
26675
Treat hand dislocation
$1217.42
J1
5112
26676
Pin hand dislocation
$2438.34
J1
5113
26685
Treat hand dislocation
$2438.34
J1
5113
26686
Treat hand dislocation
$2438.34
J1
5113
26700
Treat knuckle dislocation
$199.83
T
5111
26705
Treat knuckle dislocation
$1217.42
J1
5112
26706
Pin knuckle dislocation
$2438.34
J1
5113
26715
Treat knuckle dislocation
$2438.34
J1
5113
26720
Treat finger fracture each
$199.83
T
5111
26725
Treat finger fracture each
$199.83
T
5111
26727
Treat finger fracture each
$2438.34
J1
5113
26735
Treat finger fracture each
$2438.34
J1
5113
26740
Treat finger fracture each
$199.83
T
5111
26742
Treat finger fracture each
$1217.42
J1
5112
26746
Treat finger fracture each
$2438.34
J1
5113
26750
Treat finger fracture each
$199.83
T
5111
26755
Treat finger fracture each
$199.83
T
5111
26756
Pin finger fracture each
$2438.34
J1
5113
26765
Treat finger fracture each
$2438.34
J1
5113
26770
Treat finger dislocation
$199.83
T
5111
26775
Treat finger dislocation
$220.75
T
5102
26776
Pin finger dislocation
$2438.34
J1
5113
26785
Treat finger dislocation
$2438.34
J1
5113
26820
Thumb fusion with graft
$5221.57
J1
5114
26841
Fusion of thumb
$5221.57
J1
5114
26842
Thumb fusion with graft
$5221.57
J1
5114
26843
Fusion of hand joint
$5221.57
J1
5114
26844
Fusion/graft of hand joint
$5221.57
J1
5114
26850
Fusion of knuckle
$5221.57
J1
5114
26852
Fusion of knuckle with graft
$5221.57
J1
5114
26860
Fusion of finger joint
$2438.34
J1
5113
26862
Fusion/graft of finger joint
$2438.34
J1
5113
26910
Amputate metacarpal bone
$2438.34
J1
5113
26951
Amputation of finger/thumb
$2438.34
J1
5113
26952
Amputation of finger/thumb
$2438.34
J1
5113
26989
Hand/finger surgery
$199.83
T
5111
26990
Drainage of pelvis lesion
$2438.34
J1
5113
26991
Drainage of pelvis bursa
$2438.34
J1
5113
27000
Incision of hip tendon
$2438.34
J1
5113
27001
Incision of hip tendon
$2438.34
J1
5113
27003
Incision of hip tendon
$5221.57
J1
5114
27006
Incision of hip tendons
$2438.34
J1
5113
27027
Buttock fasciotomy
$5221.57
J1
5114
27033
Exploration of hip joint
$2438.34
J1
5113
27035
Denervation of hip joint
$2438.34
J1
5113
27040
Biopsy of soft tissues
$1236.62
J1
5072
27041
Biopsy of soft tissues
$1236.62
J1
5072
27043
Exc hip pelvis les sc 3 cm/>
$2148.91
J1
5073
27045
Exc hip/pelv tum deep 5 cm/>
$2148.91
J1
5073
27047
Exc hip/pelvis les sc < 3 cm
$2148.91
J1
5073
27048
Exc hip/pelv tum deep < 5 cm
$2148.91
J1
5073
27049
Resect hip/pelv tum < 5 cm
$2148.91
J1
5073
27050
Biopsy of sacroiliac joint
$1217.42
J1
5112
27052
Biopsy of hip joint
$1217.42
J1
5112
27057
Buttock fasciotomy w/dbrdmt
$1217.42
J1
5112
27059
Resect hip/pelv tum 5 cm/>
$2148.91
J1
5073
27060
Removal of ischial bursa
$2438.34
J1
5113
27062
Remove femur lesion/bursa
$2438.34
J1
5113
27065
Remove hip bone les super
$2438.34
J1
5113
27066
Remove hip bone les deep
$2438.34
J1
5113
27067
Remove/graft hip bone lesion
$5221.57
J1
5114
27080
Removal of tail bone
$2438.34
J1
5113
27086
Remove hip foreign body
$1236.62
J1
5072
27087
Remove hip foreign body
$2438.34
J1
5113
27097
Revision of hip tendon
$2438.34
J1
5113
27098
Transfer tendon to pelvis
$2438.34
J1
5113
27100
Transfer of abdominal muscle
$5221.57
J1
5114
27105
Transfer of spinal muscle
$2438.34
J1
5113
27110
Transfer of iliopsoas muscle
$5221.57
J1
5114
27111
Transfer of iliopsoas muscle
$2438.34
J1
5113
27179
Revise head/neck of femur
$5221.57
J1
5114
27197
Clsd tx pelvic ring fx
$199.83
T
5111
27198
Clsd tx pelvic ring fx
$199.83
T
5111
27200
Treat tail bone fracture
$199.83
T
5111
27202
Treat tail bone fracture
$2438.34
J1
5113
27220
Treat hip socket fracture
$199.83
T
5111
27230
Treat thigh fracture
$199.83
T
5111
27235
Treat thigh fracture
$5221.57
J1
5114
27238
Treat thigh fracture
$1217.42
J1
5112
27246
Treat thigh fracture
$199.83
T
5111
27250
Treat hip dislocation
$199.83
T
5111
27252
Treat hip dislocation
$1217.42
J1
5112
27256
Treat hip dislocation
$199.83
T
5111
27257
Treat hip dislocation
$1217.42
J1
5112
27265
Treat hip dislocation
$199.83
T
5111
27266
Treat hip dislocation
$1217.42
J1
5112
27267
Cltx thigh fx
$2438.34
J1
5113
27275
Manipulation of hip joint
$1217.42
J1
5112
27279
Arthrodesis sacroiliac joint
$14704.13
J1
5116
27299
Pelvis/hip joint surgery
$199.83
T
5111
27301
Drain thigh/knee lesion
$2148.91
J1
5073
27305
Incise thigh tendon & fascia
$2438.34
J1
5113
27306
Incision of thigh tendon
$1217.42
J1
5112
27307
Incision of thigh tendons
$2438.34
J1
5113
27310
Exploration of knee joint
$2438.34
J1
5113
27323
Biopsy thigh soft tissues
$1236.62
J1
5072
27324
Biopsy thigh soft tissues
$2148.91
J1
5073
27325
Neurectomy hamstring
$1563.42
J1
5431
27326
Neurectomy popliteal
$1563.42
J1
5431
27327
Exc thigh/knee les sc < 3 cm
$1236.62
J1
5072
27328
Exc thigh/knee tum deep <5cm
$2148.91
J1
5073
27329
Resect thigh/knee tum < 5 cm
$2148.91
J1
5073
27330
Biopsy knee joint lining
$2438.34
J1
5113
27331
Explore/treat knee joint
$2438.34
J1
5113
27332
Removal of knee cartilage
$2438.34
J1
5113
27333
Removal of knee cartilage
$2438.34
J1
5113
27334
Remove knee joint lining
$2438.34
J1
5113
27335
Remove knee joint lining
$5221.57
J1
5114
27337
Exc thigh/knee les sc 3 cm/>
$2148.91
J1
5073
27339
Exc thigh/knee tum dep 5cm/>
$2148.91
J1
5073
27340
Removal of kneecap bursa
$2438.34
J1
5113
27345
Removal of knee cyst
$2438.34
J1
5113
27347
Remove knee cyst
$2438.34
J1
5113
27350
Removal of kneecap
$2438.34
J1
5113
27355
Remove femur lesion
$2438.34
J1
5113
27356
Remove femur lesion/graft
$9561.23
J1
5115
27357
Remove femur lesion/graft
$5221.57
J1
5114
27360
Partial removal leg bone(s)
$2438.34
J1
5113
27364
Resect thigh/knee tum 5 cm/>
$2148.91
J1
5073
27372
Removal of foreign body
$2148.91
J1
5073
27380
Repair of kneecap tendon
$5221.57
J1
5114
27381
Repair/graft kneecap tendon
$5221.57
J1
5114
27385
Repair of thigh muscle
$5221.57
J1
5114
27386
Repair/graft of thigh muscle
$5221.57
J1
5114
27390
Incision of thigh tendon
$2438.34
J1
5113
27391
Incision of thigh tendons
$2438.34
J1
5113
27392
Incision of thigh tendons
$2438.34
J1
5113
27393
Lengthening of thigh tendon
$2438.34
J1
5113
27394
Lengthening of thigh tendons
$5221.57
J1
5114
27395
Lengthening of thigh tendons
$2438.34
J1
5113
27396
Transplant of thigh tendon
$5221.57
J1
5114
27397
Transplants of thigh tendons
$5221.57
J1
5114
27400
Revise thigh muscles/tendons
$5221.57
J1
5114
27403
Repair of knee cartilage
$2438.34
J1
5113
27405
Repair of knee ligament
$5221.57
J1
5114
27407
Repair of knee ligament
$5221.57
J1
5114
27409
Repair of knee ligaments
$5221.57
J1
5114
27412
Autochondrocyte implant knee
$5221.57
J1
5114
27415
Osteochondral knee allograft
$9561.23
J1
5115
27416
Osteochondral knee autograft
$5221.57
J1
5114
27418
Repair degenerated kneecap
$5221.57
J1
5114
27420
Revision of unstable kneecap
$5221.57
J1
5114
27422
Revision of unstable kneecap
$5221.57
J1
5114
27424
Revision/removal of kneecap
$5221.57
J1
5114
27425
Lat retinacular release open
$2438.34
J1
5113
27427
Reconstruction knee
$5221.57
J1
5114
27428
Reconstruction knee
$9561.23
J1
5115
27429
Reconstruction knee
$9561.23
J1
5115
27430
Revision of thigh muscles
$5221.57
J1
5114
27435
Incision of knee joint
$2438.34
J1
5113
27437
Revise kneecap
$5221.57
J1
5114
27438
Revise kneecap with implant
$9561.23
J1
5115
27440
Revision of knee joint
$9561.23
J1
5115
27441
Revision of knee joint
$9561.23
J1
5115
27442
Revision of knee joint
$9561.23
J1
5115
27443
Revision of knee joint
$9561.23
J1
5115
27446
Revision of knee joint
$9561.23
J1
5115
27475
Surgery to stop leg growth
$5221.57
J1
5114
27477
Surgery to stop leg growth
$2438.34
J1
5113
27479
Surgery to stop leg growth
$5221.57
J1
5114
27485
Surgery to stop leg growth
$2438.34
J1
5113
27496
Decompression of thigh/knee
$2438.34
J1
5113
27497
Decompression of thigh/knee
$2438.34
J1
5113
27498
Decompression of thigh/knee
$1217.42
J1
5112
27499
Decompression of thigh/knee
$2438.34
J1
5113
27500
Treatment of thigh fracture
$199.83
T
5111
27501
Treatment of thigh fracture
$199.83
T
5111
27502
Treatment of thigh fracture
$1217.42
J1
5112
27503
Treatment of thigh fracture
$1217.42
J1
5112
27508
Treatment of thigh fracture
$199.83
T
5111
27509
Treatment of thigh fracture
$5221.57
J1
5114
27510
Treatment of thigh fracture
$1217.42
J1
5112
27516
Treat thigh fx growth plate
$199.83
T
5111
27517
Treat thigh fx growth plate
$1217.42
J1
5112
27520
Treat kneecap fracture
$199.83
T
5111
27524
Treat kneecap fracture
$5221.57
J1
5114
27530
Treat knee fracture
$199.83
T
5111
27532
Treat knee fracture
$2438.34
J1
5113
27538
Treat knee fracture(s)
$199.83
T
5111
27550
Treat knee dislocation
$199.83
T
5111
27552
Treat knee dislocation
$1217.42
J1
5112
27560
Treat kneecap dislocation
$199.83
T
5111
27562
Treat kneecap dislocation
$199.83
T
5111
27566
Treat kneecap dislocation
$5221.57
J1
5114
27570
Fixation of knee joint
$1217.42
J1
5112
27594
Amputation follow-up surgery
$2438.34
J1
5113
27599
Leg surgery procedure
$199.83
T
5111
27600
Decompression of lower leg
$2438.34
J1
5113
27601
Decompression of lower leg
$2438.34
J1
5113
27602
Decompression of lower leg
$2438.34
J1
5113
27603
Drain lower leg lesion
$2148.91
J1
5073
27604
Drain lower leg bursa
$2438.34
J1
5113
27605
Incision of achilles tendon
$1217.42
J1
5112
27606
Incision of achilles tendon
$2438.34
J1
5113
27607
Treat lower leg bone lesion
$2438.34
J1
5113
27610
Explore/treat ankle joint
$2438.34
J1
5113
27612
Exploration of ankle joint
$2438.34
J1
5113
27613
Biopsy lower leg soft tissue
$1236.62
J1
5072
27614
Biopsy lower leg soft tissue
$2148.91
J1
5073
27615
Resect leg/ankle tum < 5 cm
$2148.91
J1
5073
27616
Resect leg/ankle tum 5 cm/>
$2148.91
J1
5073
27618
Exc leg/ankle tum < 3 cm
$1236.62
J1
5072
27619
Exc leg/ankle tum deep <5 cm
$2148.91
J1
5073
27620
Explore/treat ankle joint
$2438.34
J1
5113
27625
Remove ankle joint lining
$2438.34
J1
5113
27626
Remove ankle joint lining
$2438.34
J1
5113
27630
Removal of tendon lesion
$2438.34
J1
5113
27632
Exc leg/ankle les sc 3 cm/>
$2148.91
J1
5073
27634
Exc leg/ankle tum dep 5 cm/>
$2148.91
J1
5073
27635
Remove lower leg bone lesion
$2438.34
J1
5113
27637
Remove/graft leg bone lesion
$5221.57
J1
5114
27638
Remove/graft leg bone lesion
$5221.57
J1
5114
27640
Partial removal of tibia
$2438.34
J1
5113
27641
Partial removal of fibula
$2438.34
J1
5113
27647
Resect talus/calcaneus tum
$2438.34
J1
5113
27650
Repair achilles tendon
$2438.34
J1
5113
27652
Repair/graft achilles tendon
$5221.57
J1
5114
27654
Repair of achilles tendon
$5221.57
J1
5114
27656
Repair leg fascia defect
$2438.34
J1
5113
27658
Repair of leg tendon each
$2438.34
J1
5113
27659
Repair of leg tendon each
$5221.57
J1
5114
27664
Repair of leg tendon each
$5221.57
J1
5114
27665
Repair of leg tendon each
$5221.57
J1
5114
27675
Repair lower leg tendons
$2438.34
J1
5113
27676
Repair lower leg tendons
$5221.57
J1
5114
27680
Release of lower leg tendon
$2438.34
J1
5113
27681
Release of lower leg tendons
$2438.34
J1
5113
27685
Revision of lower leg tendon
$2438.34
J1
5113
27686
Revise lower leg tendons
$2438.34
J1
5113
27687
Revision of calf tendon
$2438.34
J1
5113
27690
Revise lower leg tendon
$5221.57
J1
5114
27691
Revise lower leg tendon
$5221.57
J1
5114
27695
Repair of ankle ligament
$5221.57
J1
5114
27696
Repair of ankle ligaments
$5221.57
J1
5114
27698
Repair of ankle ligament
$5221.57
J1
5114
27700
Revision of ankle joint
$5221.57
J1
5114
27704
Removal of ankle implant
$2438.34
Q2
5113
27705
Incision of tibia
$5221.57
J1
5114
27707
Incision of fibula
$2438.34
J1
5113
27709
Incision of tibia & fibula
$9561.23
J1
5115
27720
Repair of tibia
$5221.57
J1
5114
27722
Repair/graft of tibia
$5221.57
J1
5114
27726
Repair fibula nonunion
$5221.57
J1
5114
27730
Repair of tibia epiphysis
$2438.34
J1
5113
27732
Repair of fibula epiphysis
$2438.34
J1
5113
27734
Repair lower leg epiphyses
$2438.34
J1
5113
27740
Repair of leg epiphyses
$2438.34
J1
5113
27742
Repair of leg epiphyses
$2438.34
J1
5113
27745
Reinforce tibia
$5221.57
J1
5114
27750
Treatment of tibia fracture
$199.83
T
5111
27752
Treatment of tibia fracture
$1217.42
J1
5112
27756
Treatment of tibia fracture
$5221.57
J1
5114
27758
Treatment of tibia fracture
$9561.23
J1
5115
27759
Treatment of tibia fracture
$9561.23
J1
5115
27760
Cltx medial ankle fx
$199.83
T
5111
27762
Cltx med ankle fx w/mnpj
$1217.42
J1
5112
27766
Optx medial ankle fx
$5221.57
J1
5114
27767
Cltx post ankle fx
$199.83
T
5111
27768
Cltx post ankle fx w/mnpj
$1217.42
J1
5112
27769
Optx post ankle fx
$5221.57
J1
5114
27780
Treatment of fibula fracture
$199.83
T
5111
27781
Treatment of fibula fracture
$1217.42
J1
5112
27784
Treatment of fibula fracture
$5221.57
J1
5114
27786
Treatment of ankle fracture
$199.83
T
5111
27788
Treatment of ankle fracture
$199.83
T
5111
27792
Treatment of ankle fracture
$5221.57
J1
5114
27808
Treatment of ankle fracture
$199.83
T
5111
27810
Treatment of ankle fracture
$1217.42
J1
5112
27814
Treatment of ankle fracture
$5221.57
J1
5114
27816
Treatment of ankle fracture
$199.83
T
5111
27818
Treatment of ankle fracture
$1217.42
J1
5112
27822
Treatment of ankle fracture
$5221.57
J1
5114
27823
Treatment of ankle fracture
$5221.57
J1
5114
27824
Treat lower leg fracture
$199.83
T
5111
27825
Treat lower leg fracture
$1217.42
J1
5112
27826
Treat lower leg fracture
$5221.57
J1
5114
27827
Treat lower leg fracture
$9561.23
J1
5115
27828
Treat lower leg fracture
$9561.23
J1
5115
27829
Treat lower leg joint
$5221.57
J1
5114
27830
Treat lower leg dislocation
$199.83
T
5111
27831
Treat lower leg dislocation
$2438.34
J1
5113
27832
Treat lower leg dislocation
$5221.57
J1
5114
27840
Treat ankle dislocation
$199.83
T
5111
27842
Treat ankle dislocation
$1217.42
J1
5112
27846
Treat ankle dislocation
$5221.57
J1
5114
27848
Treat ankle dislocation
$5221.57
J1
5114
27860
Fixation of ankle joint
$2438.34
J1
5113
27870
Fusion of ankle joint open
$9561.23
J1
5115
27871
Fusion of tibiofibular joint
$9561.23
J1
5115
27884
Amputation follow-up surgery
$2438.34
J1
5113
27889
Amputation of foot at ankle
$5221.57
J1
5114
27892
Decompression of leg
$2438.34
J1
5113
27893
Decompression of leg
$5221.57
J1
5114
27894
Decompression of leg
$1217.42
J1
5112
27899
Leg/ankle surgery procedure
$199.83
T
5111
28001
Drainage of bursa of foot
$1236.62
J1
5072
28002
Treatment of foot infection
$2438.34
J1
5113
28003
Treatment of foot infection
$2438.34
J1
5113
28005
Treat foot bone lesion
$2438.34
J1
5113
28008
Incision of foot fascia
$2438.34
J1
5113
28010
Incision of toe tendon
$1217.42
J1
5112
28011
Incision of toe tendons
$1217.42
J1
5112
28020
Exploration of foot joint
$2438.34
J1
5113
28022
Exploration of foot joint
$2438.34
J1
5113
28024
Exploration of toe joint
$2438.34
J1
5113
28035
Decompression of tibia nerve
$1563.42
J1
5431
28039
Exc foot/toe tum sc 1.5 cm/>
$2148.91
J1
5073
28041
Exc foot/toe tum dep 1.5cm/>
$2148.91
J1
5073
28043
Exc foot/toe tum sc < 1.5 cm
$1236.62
J1
5072
28045
Exc foot/toe tum deep <1.5cm
$2148.91
J1
5073
28046
Resect foot/toe tumor < 3 cm
$2148.91
J1
5073
28047
Resect foot/toe tumor 3 cm/>
$2148.91
J1
5073
28050
Biopsy of foot joint lining
$2438.34
J1
5113
28052
Biopsy of foot joint lining
$2438.34
J1
5113
28054
Biopsy of toe joint lining
$2438.34
J1
5113
28055
Neurectomy foot
$1563.42
J1
5431
28060
Partial removal foot fascia
$2438.34
J1
5113
28062
Removal of foot fascia
$2438.34
J1
5113
28070
Removal of foot joint lining
$2438.34
J1
5113
28072
Removal of foot joint lining
$2438.34
J1
5113
28080
Removal of foot lesion
$1217.42
J1
5112
28086
Excise foot tendon sheath
$2438.34
J1
5113
28088
Excise foot tendon sheath
$1217.42
J1
5112
28090
Removal of foot lesion
$2438.34
J1
5113
28092
Removal of toe lesions
$1217.42
J1
5112
28100
Removal of ankle/heel lesion
$2438.34
J1
5113
28102
Remove/graft foot lesion
$5221.57
J1
5114
28103
Remove/graft foot lesion
$5221.57
J1
5114
28104
Removal of foot lesion
$2438.34
J1
5113
28106
Remove/graft foot lesion
$5221.57
J1
5114
28107
Remove/graft foot lesion
$5221.57
J1
5114
28108
Removal of toe lesions
$1217.42
J1
5112
28110
Part removal of metatarsal
$2438.34
J1
5113
28111
Part removal of metatarsal
$2438.34
J1
5113
28112
Part removal of metatarsal
$2438.34
J1
5113
28113
Part removal of metatarsal
$2438.34
J1
5113
28114
Removal of metatarsal heads
$2438.34
J1
5113
28116
Revision of foot
$2438.34
J1
5113
28118
Removal of heel bone
$2438.34
J1
5113
28119
Removal of heel spur
$2438.34
J1
5113
28120
Part removal of ankle/heel
$2438.34
J1
5113
28122
Partial removal of foot bone
$2438.34
J1
5113
28124
Partial removal of toe
$2438.34
J1
5113
28126
Partial removal of toe
$2438.34
J1
5113
28130
Removal of ankle bone
$2438.34
J1
5113
28140
Removal of metatarsal
$2438.34
J1
5113
28150
Removal of toe
$2438.34
J1
5113
28153
Partial removal of toe
$1217.42
J1
5112
28160
Partial removal of toe
$2438.34
J1
5113
28171
Resect tarsal tumor
$2438.34
J1
5113
28173
Resect metatarsal tumor
$2438.34
J1
5113
28175
Resect phalanx of toe tumor
$1217.42
J1
5112
28190
Removal of foot foreign body
$539.11
T
5071
28192
Removal of foot foreign body
$1236.62
J1
5072
28193
Removal of foot foreign body
$1236.62
J1
5072
28200
Repair of foot tendon
$2438.34
J1
5113
28202
Repair/graft of foot tendon
$5221.57
J1
5114
28208
Repair of foot tendon
$2438.34
J1
5113
28210
Repair/graft of foot tendon
$5221.57
J1
5114
28220
Release of foot tendon
$2438.34
J1
5113
28222
Release of foot tendons
$2438.34
J1
5113
28225
Release of foot tendon
$2438.34
J1
5113
28226
Release of foot tendons
$1217.42
J1
5112
28230
Incision of foot tendon(s)
$1217.42
J1
5112
28232
Incision of toe tendon
$1217.42
J1
5112
28234
Incision of foot tendon
$1217.42
J1
5112
28238
Revision of foot tendon
$5221.57
J1
5114
28240
Release of big toe
$2438.34
J1
5113
28250
Revision of foot fascia
$2438.34
J1
5113
28260
Release of midfoot joint
$1217.42
J1
5112
28261
Revision of foot tendon
$2438.34
J1
5113
28262
Revision of foot and ankle
$5221.57
J1
5114
28264
Release of midfoot joint
$1217.42
J1
5112
28270
Release of foot contracture
$2438.34
J1
5113
28272
Release of toe joint each
$1217.42
J1
5112
28280
Fusion of toes
$2438.34
J1
5113
28285
Repair of hammertoe
$2438.34
J1
5113
28286
Repair of hammertoe
$2438.34
J1
5113
28288
Partial removal of foot bone
$2438.34
J1
5113
28289
Corrj halux rigdus w/o implt
$2438.34
J1
5113
28291
Corrj halux rigdus w/implt
$5221.57
J1
5114
28292
Correction hallux valgus
$2438.34
J1
5113
28295
Correction hallux valgus
$2438.34
J1
5113
28296
Correction hallux valgus
$2438.34
J1
5113
28297
Correction hallux valgus
$5221.57
J1
5114
28298
Correction hallux valgus
$5221.57
J1
5114
28299
Correction hallux valgus
$2438.34
J1
5113
28300
Incision of heel bone
$5221.57
J1
5114
28302
Incision of ankle bone
$5221.57
J1
5114
28304
Incision of midfoot bones
$5221.57
J1
5114
28305
Incise/graft midfoot bones
$5221.57
J1
5114
28306
Incision of metatarsal
$5221.57
J1
5114
28307
Incision of metatarsal
$2438.34
J1
5113
28308
Incision of metatarsal
$2438.34
J1
5113
28309
Incision of metatarsals
$5221.57
J1
5114
28310
Revision of big toe
$2438.34
J1
5113
28312
Revision of toe
$2438.34
J1
5113
28313
Repair deformity of toe
$2438.34
J1
5113
28315
Removal of sesamoid bone
$2438.34
J1
5113
28320
Repair of foot bones
$9561.23
J1
5115
28322
Repair of metatarsals
$5221.57
J1
5114
28340
Resect enlarged toe tissue
$2438.34
J1
5113
28341
Resect enlarged toe
$2438.34
J1
5113
28344
Repair extra toe(s)
$2438.34
J1
5113
28345
Repair webbed toe(s)
$2438.34
J1
5113
28360
Reconstruct cleft foot
$5221.57
J1
5114
28400
Treatment of heel fracture
$199.83
T
5111
28405
Treatment of heel fracture
$199.83
T
5111
28406
Treatment of heel fracture
$5221.57
J1
5114
28415
Treat heel fracture
$5221.57
J1
5114
28420
Treat/graft heel fracture
$9561.23
J1
5115
28430
Treatment of ankle fracture
$199.83
T
5111
28435
Treatment of ankle fracture
$1217.42
J1
5112
28436
Treatment of ankle fracture
$5221.57
J1
5114
28445
Treat ankle fracture
$5221.57
J1
5114
28446
Osteochondral talus autogrft
$5221.57
J1
5114
28450
Treat midfoot fracture each
$199.83
T
5111
28455
Treat midfoot fracture each
$2438.34
J1
5113
28456
Treat midfoot fracture
$5221.57
J1
5114
28465
Treat midfoot fracture each
$5221.57
J1
5114
28470
Treat metatarsal fracture
$199.83
T
5111
28475
Treat metatarsal fracture
$199.83
T
5111
28476
Treat metatarsal fracture
$2438.34
J1
5113
28485
Treat metatarsal fracture
$5221.57
J1
5114
28490
Treat big toe fracture
$199.83
T
5111
28495
Treat big toe fracture
$199.83
T
5111
28496
Treat big toe fracture
$2438.34
J1
5113
28505
Treat big toe fracture
$2438.34
J1
5113
28510
Treatment of toe fracture
$199.83
T
5111
28515
Treatment of toe fracture
$199.83
T
5111
28525
Treat toe fracture
$2438.34
J1
5113
28530
Treat sesamoid bone fracture
$199.83
T
5111
28531
Treat sesamoid bone fracture
$5221.57
J1
5114
28540
Treat foot dislocation
$199.83
T
5111
28545
Treat foot dislocation
$2438.34
J1
5113
28546
Treat foot dislocation
$1217.42
J1
5112
28555
Repair foot dislocation
$5221.57
J1
5114
28570
Treat foot dislocation
$199.83
T
5111
28575
Treat foot dislocation
$2438.34
J1
5113
28576
Treat foot dislocation
$1217.42
J1
5112
28585
Repair foot dislocation
$5221.57
J1
5114
28600
Treat foot dislocation
$199.83
T
5111
28605
Treat foot dislocation
$199.83
T
5111
28606
Treat foot dislocation
$2438.34
J1
5113
28615
Repair foot dislocation
$5221.57
J1
5114
28630
Treat toe dislocation
$199.83
T
5111
28635
Treat toe dislocation
$1217.42
J1
5112
28636
Treat toe dislocation
$2438.34
J1
5113
28645
Repair toe dislocation
$2438.34
J1
5113
28660
Treat toe dislocation
$199.83
T
5111
28665
Treat toe dislocation
$220.75
T
5102
28666
Treat toe dislocation
$2438.34
J1
5113
28675
Repair of toe dislocation
$2438.34
J1
5113
28705
Fusion of foot bones
$14704.13
J1
5116
28715
Fusion of foot bones
$9561.23
J1
5115
28725
Fusion of foot bones
$9561.23
J1
5115
28730
Fusion of foot bones
$9561.23
J1
5115
28735
Fusion of foot bones
$9561.23
J1
5115
28737
Revision of foot bones
$9561.23
J1
5115
28740
Fusion of foot bones
$5221.57
J1
5114
28750
Fusion of big toe joint
$5221.57
J1
5114
28755
Fusion of big toe joint
$5221.57
J1
5114
28760
Fusion of big toe joint
$5221.57
J1
5114
28805
Amputation thru metatarsal
$2438.34
J1
5113
28810
Amputation toe & metatarsal
$2438.34
J1
5113
28820
Amputation of toe
$2438.34
J1
5113
28825
Partial amputation of toe
$2438.34
J1
5113
28890
Hi enrgy eswt plantar fascia
$1217.42
J1
5112
28899
Foot/toes surgery procedure
$199.83
T
5111
29000
Application of body cast
$220.75
T
5102
29010
Application of body cast
$220.75
T
5102
29015
Application of body cast
$220.75
T
5102
29035
Application of body cast
$220.75
T
5102
29040
Application of body cast
$220.75
T
5102
29044
Application of body cast
$125.15
T
5101
29046
Application of body cast
$220.75
T
5102
29049
Application of figure eight
$220.75
T
5102
29055
Application of shoulder cast
$220.75
T
5102
29058
Application of shoulder cast
$220.75
T
5102
29065
Application of long arm cast
$220.75
T
5102
29075
Application of forearm cast
$220.75
T
5102
29085
Apply hand/wrist cast
$125.15
T
5101
29086
Apply finger cast
$125.15
T
5101
29105
Apply long arm splint
$125.15
T
5101
29125
Apply forearm splint
$100.02
Q1
5734
29126
Apply forearm splint
$100.02
Q1
5734
29130
Application of finger splint
$54.55
Q1
5733
29131
Application of finger splint
$54.55
Q1
5733
29200
Strapping of chest
$125.15
T
5101
29240
Strapping of shoulder
$54.55
Q1
5733
29260
Strapping of elbow or wrist
$28.38
Q1
5732
29280
Strapping of hand or finger
$28.38
Q1
5732
29305
Application of hip cast
$220.75
T
5102
29325
Application of hip casts
$220.75
T
5102
29345
Application of long leg cast
$220.75
T
5102
29355
Application of long leg cast
$220.75
T
5102
29358
Apply long leg cast brace
$220.75
T
5102
29365
Application of long leg cast
$220.75
T
5102
29405
Apply short leg cast
$220.75
T
5102
29425
Apply short leg cast
$220.75
T
5102
29435
Apply short leg cast
$220.75
T
5102
29440
Addition of walker to cast
$125.15
T
5101
29445
Apply rigid leg cast
$220.75
T
5102
29450
Application of leg cast
$125.15
T
5101
29505
Application long leg splint
$125.15
T
5101
29515
Application lower leg splint
$125.15
T
5101
29520
Strapping of hip
$54.55
Q1
5733
29530
Strapping of knee
$54.55
Q1
5733
29540
Strapping of ankle and/or ft
$125.15
T
5101
29550
Strapping of toes
$54.55
Q1
5733
29580
Application of paste boot
$125.15
T
5101
29581
Apply multlay comprs lwr leg
$125.15
T
5101
29582
Apply multlay comprs upr leg
$125.15
T
5101
29583
Apply multlay comprs upr arm
$125.15
T
5101
29584
Appl multlay comprs arm/hand
$125.15
T
5101
29700
Removal/revision of cast
$220.75
T
5102
29705
Removal/revision of cast
$220.75
T
5102
29710
Removal/revision of cast
$220.75
T
5102
29720
Repair of body cast
$125.15
T
5101
29730
Windowing of cast
$125.15
T
5101
29740
Wedging of cast
$220.75
T
5102
29750
Wedging of clubfoot cast
$220.75
T
5102
29799
Casting/strapping procedure
$125.15
T
5101
29800
Jaw arthroscopy/surgery
$2438.34
J1
5113
29804
Jaw arthroscopy/surgery
$2438.34
J1
5113
29805
Shoulder arthroscopy dx
$2438.34
J1
5113
29806
Shoulder arthroscopy/surgery
$5221.57
J1
5114
29807
Shoulder arthroscopy/surgery
$5221.57
J1
5114
29819
Shoulder arthroscopy/surgery
$2438.34
J1
5113
29820
Shoulder arthroscopy/surgery
$5221.57
J1
5114
29821
Shoulder arthroscopy/surgery
$2438.34
J1
5113
29822
Shoulder arthroscopy/surgery
$2438.34
J1
5113
29823
Shoulder arthroscopy/surgery
$2438.34
J1
5113
29824
Shoulder arthroscopy/surgery
$2438.34
J1
5113
29825
Shoulder arthroscopy/surgery
$2438.34
J1
5113
29827
Arthroscop rotator cuff repr
$5221.57
J1
5114
29828
Arthroscopy biceps tenodesis
$5221.57
J1
5114
29830
Elbow arthroscopy
$2438.34
J1
5113
29834
Elbow arthroscopy/surgery
$2438.34
J1
5113
29835
Elbow arthroscopy/surgery
$2438.34
J1
5113
29836
Elbow arthroscopy/surgery
$5221.57
J1
5114
29837
Elbow arthroscopy/surgery
$2438.34
J1
5113
29838
Elbow arthroscopy/surgery
$2438.34
J1
5113
29840
Wrist arthroscopy
$2438.34
J1
5113
29843
Wrist arthroscopy/surgery
$2438.34
J1
5113
29844
Wrist arthroscopy/surgery
$2438.34
J1
5113
29845
Wrist arthroscopy/surgery
$2438.34
J1
5113
29846
Wrist arthroscopy/surgery
$2438.34
J1
5113
29847
Wrist arthroscopy/surgery
$5221.57
J1
5114
29848
Wrist endoscopy/surgery
$1217.42
J1
5112
29850
Knee arthroscopy/surgery
$1217.42
J1
5112
29851
Knee arthroscopy/surgery
$1217.42
J1
5112
29855
Tibial arthroscopy/surgery
$5221.57
J1
5114
29856
Tibial arthroscopy/surgery
$9561.23
J1
5115
29860
Hip arthroscopy dx
$5221.57
J1
5114
29861
Hip arthro w/fb removal
$2438.34
J1
5113
29862
Hip arthr0 w/debridement
$5221.57
J1
5114
29863
Hip arthr0 w/synovectomy
$2438.34
J1
5113
29866
Autgrft implnt knee w/scope
$5221.57
J1
5114
29867
Allgrft implnt knee w/scope
$9561.23
J1
5115
29868
Meniscal trnspl knee w/scpe
$5221.57
J1
5114
29870
Knee arthroscopy dx
$2438.34
J1
5113
29871
Knee arthroscopy/drainage
$2438.34
J1
5113
29873
Knee arthroscopy/surgery
$2438.34
J1
5113
29874
Knee arthroscopy/surgery
$2438.34
J1
5113
29875
Knee arthroscopy/surgery
$2438.34
J1
5113
29876
Knee arthroscopy/surgery
$2438.34
J1
5113
29877
Knee arthroscopy/surgery
$2438.34
J1
5113
29879
Knee arthroscopy/surgery
$2438.34
J1
5113
29880
Knee arthroscopy/surgery
$2438.34
J1
5113
29881
Knee arthroscopy/surgery
$2438.34
J1
5113
29882
Knee arthroscopy/surgery
$2438.34
J1
5113
29883
Knee arthroscopy/surgery
$2438.34
J1
5113
29884
Knee arthroscopy/surgery
$2438.34
J1
5113
29885
Knee arthroscopy/surgery
$5221.57
J1
5114
29886
Knee arthroscopy/surgery
$2438.34
J1
5113
29887
Knee arthroscopy/surgery
$5221.57
J1
5114
29888
Knee arthroscopy/surgery
$5221.57
J1
5114
29889
Knee arthroscopy/surgery
$9561.23
J1
5115
29891
Ankle arthroscopy/surgery
$2438.34
J1
5113
29892
Ankle arthroscopy/surgery
$5221.57
J1
5114
29893
Scope plantar fasciotomy
$2438.34
J1
5113
29894
Ankle arthroscopy/surgery
$2438.34
J1
5113
29895
Ankle arthroscopy/surgery
$2438.34
J1
5113
29897
Ankle arthroscopy/surgery
$2438.34
J1
5113
29898
Ankle arthroscopy/surgery
$2438.34
J1
5113
29899
Ankle arthroscopy/surgery
$5221.57
J1
5114
29900
Mcp joint arthroscopy dx
$2438.34
J1
5113
29901
Mcp joint arthroscopy surg
$2438.34
J1
5113
29902
Mcp joint arthroscopy surg
$1217.42
J1
5112
29904
Subtalar arthro w/fb rmvl
$2438.34
J1
5113
29905
Subtalar arthro w/exc
$2438.34
J1
5113
29906
Subtalar arthro w/deb
$2438.34
J1
5113
29907
Subtalar arthro w/fusion
$9561.23
J1
5115
29914
Hip arthro w/femoroplasty
$5221.57
J1
5114
29915
Hip arthro acetabuloplasty
$5221.57
J1
5114
29916
Hip arthro w/labral repair
$5221.57
J1
5114
29999
Arthroscopy of joint
$199.83
T
5111
30000
Drainage of nose lesion
$177.09
T
5161
30020
Drainage of nose lesion
$442.62
T
5162
30100
Intranasal biopsy
$1038.55
T
5163
30110
Removal of nose polyp(s)
$1038.55
T
5163
30115
Removal of nose polyp(s)
$2173.69
J1
5164
30117
Removal of intranasal lesion
$2173.69
J1
5164
30118
Removal of intranasal lesion
$2173.69
J1
5164
30120
Revision of nose
$2173.69
J1
5164
30124
Removal of nose lesion
$1038.55
T
5163
30125
Removal of nose lesion
$4130.94
J1
5165
30130
Excise inferior turbinate
$2173.69
J1
5164
30140
Resect inferior turbinate
$2173.69
J1
5164
30150
Partial removal of nose
$4130.94
J1
5165
30160
Removal of nose
$4130.94
J1
5165
30200
Injection treatment of nose
$442.62
T
5162
30210
Nasal sinus therapy
$1038.55
T
5163
30220
Insert nasal septal button
$1038.55
T
5163
30300
Remove nasal foreign body
$100.02
Q1
5734
30310
Remove nasal foreign body
$2173.69
J1
5164
30320
Remove nasal foreign body
$1038.55
T
5163
30400
Reconstruction of nose
$4130.94
J1
5165
30410
Reconstruction of nose
$4130.94
J1
5165
30420
Reconstruction of nose
$4130.94
J1
5165
30430
Revision of nose
$4130.94
J1
5165
30435
Revision of nose
$4130.94
J1
5165
30450
Revision of nose
$4130.94
J1
5165
30460
Revision of nose
$4130.94
J1
5165
30462
Revision of nose
$4130.94
J1
5165
30465
Repair nasal stenosis
$4130.94
J1
5165
30520
Repair of nasal septum
$2173.69
J1
5164
30540
Repair nasal defect
$4130.94
J1
5165
30545
Repair nasal defect
$4130.94
J1
5165
30560
Release of nasal adhesions
$442.62
T
5162
30580
Repair upper jaw fistula
$4130.94
J1
5165
30600
Repair mouth/nose fistula
$4130.94
J1
5165
30620
Intranasal reconstruction
$4130.94
J1
5165
30630
Repair nasal septum defect
$2173.69
J1
5164
30801
Ablate inf turbinate superf
$1038.55
T
5163
30802
Ablate inf turbinate submuc
$1038.55
T
5163
30901
Control of nosebleed
$100.02
Q1
5734
30903
Control of nosebleed
$100.02
T
5734
30905
Control of nosebleed
$100.02
T
5734
30906
Repeat control of nosebleed
$177.09
T
5161
30915
Ligation nasal sinus artery
$2360.60
T
5182
30920
Ligation upper jaw artery
$2360.60
T
5182
30930
Ther fx nasal inf turbinate
$2173.69
J1
5164
30999
Nasal surgery procedure
$177.09
T
5161
31000
Irrigation maxillary sinus
$177.09
T
5161
31002
Irrigation sphenoid sinus
$1038.55
T
5163
31020
Exploration maxillary sinus
$2173.69
J1
5164
31030
Exploration maxillary sinus
$4130.94
J1
5165
31032
Explore sinus remove polyps
$4130.94
J1
5165
31040
Exploration behind upper jaw
$4130.94
J1
5165
31050
Exploration sphenoid sinus
$4130.94
J1
5165
31051
Sphenoid sinus surgery
$4130.94
J1
5165
31070
Exploration of frontal sinus
$4130.94
J1
5165
31075
Exploration of frontal sinus
$4130.94
J1
5165
31080
Removal of frontal sinus
$4130.94
J1
5165
31081
Removal of frontal sinus
$4130.94
J1
5165
31084
Removal of frontal sinus
$4130.94
J1
5165
31085
Removal of frontal sinus
$4130.94
J1
5165
31086
Removal of frontal sinus
$4130.94
J1
5165
31087
Removal of frontal sinus
$4130.94
J1
5165
31090
Exploration of sinuses
$4130.94
J1
5165
31200
Removal of ethmoid sinus
$4130.94
J1
5165
31201
Removal of ethmoid sinus
$2173.69
J1
5164
31205
Removal of ethmoid sinus
$2173.69
J1
5164
31231
Nasal endoscopy dx
$146.20
T
5151
31233
Nasal/sinus endoscopy dx
$361.92
T
5152
31235
Nasal/sinus endoscopy dx
$1269.79
J1
5153
31237
Nasal/sinus endoscopy surg
$1269.79
J1
5153
31238
Nasal/sinus endoscopy surg
$1269.79
J1
5153
31239
Nasal/sinus endoscopy surg
$2431.23
J1
5154
31240
Nasal/sinus endoscopy surg
$1269.79
J1
5153
31254
Revision of ethmoid sinus
$4362.95
J1
5155
31255
Removal of ethmoid sinus
$4362.95
J1
5155
31256
Exploration maxillary sinus
$2431.23
J1
5154
31267
Endoscopy maxillary sinus
$4362.95
J1
5155
31276
Sinus endoscopy surgical
$4362.95
J1
5155
31287
Nasal/sinus endoscopy surg
$4362.95
J1
5155
31288
Nasal/sinus endoscopy surg
$4362.95
J1
5155
31292
Nasal/sinus endoscopy surg
$4362.95
J1
5155
31293
Nasal/sinus endoscopy surg
$4362.95
J1
5155
31294
Nasal/sinus endoscopy surg
$4362.95
J1
5155
31295
Sinus endo w/balloon dil
$4362.95
J1
5155
31296
Sinus endo w/balloon dil
$4362.95
J1
5155
31297
Sinus endo w/balloon dil
$4362.95
J1
5155
31299
Sinus surgery procedure
$177.09
T
5161
31300
Removal of larynx lesion
$2173.69
J1
5164
31320
Diagnostic incision larynx
$4130.94
J1
5165
31400
Revision of larynx
$4130.94
J1
5165
31420
Removal of epiglottis
$4130.94
J1
5165
31500
Insert emergency airway
$177.09
T
5161
31502
Change of windpipe airway
$177.09
T
5161
31505
Diagnostic laryngoscopy
$146.20
T
5151
31510
Laryngoscopy with biopsy
$2431.23
J1
5154
31511
Remove foreign body larynx
$146.20
T
5151
31512
Removal of larynx lesion
$2431.23
J1
5154
31513
Injection into vocal cord
$361.92
T
5152
31515
Laryngoscopy for aspiration
$361.92
T
5152
31520
Dx laryngoscopy newborn
$361.92
T
5152
31525
Dx laryngoscopy excl nb
$1269.79
J1
5153
31526
Dx laryngoscopy w/oper scope
$1269.79
J1
5153
31527
Laryngoscopy for treatment
$2431.23
J1
5154
31528
Laryngoscopy and dilation
$2431.23
J1
5154
31529
Laryngoscopy and dilation
$2431.23
J1
5154
31530
Laryngoscopy w/fb removal
$1269.79
J1
5153
31531
Laryngoscopy w/fb & op scope
$2431.23
J1
5154
31535
Laryngoscopy w/biopsy
$2431.23
J1
5154
31536
Laryngoscopy w/bx & op scope
$2431.23
J1
5154
31540
Laryngoscopy w/exc of tumor
$2431.23
J1
5154
31541
Larynscop w/tumr exc + scope
$2431.23
J1
5154
31545
Remove vc lesion w/scope
$2431.23
J1
5154
31546
Remove vc lesion scope/graft
$4362.95
J1
5155
31551
Laryngoplasty laryngeal sten
$4130.94
J1
5165
31552
Laryngoplasty laryngeal sten
$4130.94
J1
5165
31553
Laryngoplasty laryngeal sten
$4130.94
J1
5165
31554
Laryngoplasty laryngeal sten
$4130.94
J1
5165
31560
Laryngoscop w/arytenoidectom
$4362.95
J1
5155
31561
Larynscop remve cart + scop
$4362.95
J1
5155
31570
Laryngoscope w/vc inj
$2431.23
J1
5154
31571
Laryngoscop w/vc inj + scope
$2431.23
J1
5154
31572
Largsc w/laser dstrj les
$2431.23
J1
5154
31573
Largsc w/ther injection
$1269.79
J1
5153
31574
Largsc w/njx augmentation
$1269.79
J1
5153
31575
Diagnostic laryngoscopy
$146.20
T
5151
31576
Laryngoscopy with biopsy
$1269.79
J1
5153
31577
Largsc w/rmvl foreign bdy(s)
$361.92
T
5152
31578
Largsc w/removal lesion
$2431.23
J1
5154
31579
Laryngoscopy telescopic
$361.92
T
5152
31580
Laryngoplasty laryngeal web
$4130.94
J1
5165
31584
Laryngoplasty fx rdctj fixj
$4130.94
J1
5165
31587
Laryngoplasty cricoid split
$4130.94
J1
5165
31590
Reinnervate larynx
$4130.94
J1
5165
31591
Laryngoplasty medialization
$4130.94
J1
5165
31592
Cricotracheal resection
$4130.94
J1
5165
31595
Larynx nerve surgery
$2173.69
J1
5164
31599
Larynx surgery procedure
$177.09
T
5161
31600
Incision of windpipe
$2173.69
J1
5164
31601
Incision of windpipe
$4130.94
J1
5165
31603
Incision of windpipe
$1038.55
T
5163
31605
Incision of windpipe
$442.62
T
5162
31610
Incision of windpipe
$4130.94
J1
5165
31611
Surgery/speech prosthesis
$2173.69
J1
5164
31612
Puncture/clear windpipe
$2173.69
J1
5164
31613
Repair windpipe opening
$2173.69
J1
5164
31614
Repair windpipe opening
$4130.94
J1
5165
31615
Visualization of windpipe
$442.62
T
5162
31622
Dx bronchoscope/wash
$1269.79
J1
5153
31623
Dx bronchoscope/brush
$1269.79
J1
5153
31624
Dx bronchoscope/lavage
$1269.79
J1
5153
31625
Bronchoscopy w/biopsy(s)
$1269.79
J1
5153
31626
Bronchoscopy w/markers
$4362.95
J1
5155
31628
Bronchoscopy/lung bx each
$2431.23
J1
5154
31629
Bronchoscopy/needle bx each
$2431.23
J1
5154
31630
Bronchoscopy dilate/fx repr
$2431.23
J1
5154
31631
Bronchoscopy dilate w/stent
$4362.95
J1
5155
31634
Bronch w/balloon occlusion
$4362.95
J1
5155
31635
Bronchoscopy w/fb removal
$1269.79
J1
5153
31636
Bronchoscopy bronch stents
$4362.95
J1
5155
31638
Bronchoscopy revise stent
$4362.95
J1
5155
31640
Bronchoscopy w/tumor excise
$2431.23
J1
5154
31641
Bronchoscopy treat blockage
$2431.23
J1
5154
31643
Diag bronchoscope/catheter
$1269.79
J1
5153
31645
Bronchoscopy clear airways
$1269.79
J1
5153
31646
Bronchoscopy reclear airway
$361.92
T
5152
31647
Bronchial valve init insert
$4362.95
J1
5155
31648
Bronchial valve remov init
$2431.23
J1
5154
31649
Bronchial valve remov addl
$1269.79
Q2
5153
31652
Bronch ebus samplng 1/2 node
$2431.23
J1
5154
31653
Bronch ebus samplng 3/> node
$2431.23
J1
5154
31660
Bronch thermoplsty 1 lobe
$4362.95
J1
5155
31661
Bronch thermoplsty 2/> lobes
$4362.95
J1
5155
31717
Bronchial brush biopsy
$361.92
T
5152
31720
Clearance of airways
$162.08
Q1
5791
31730
Intro windpipe wire/tube
$1269.79
J1
5153
31750
Repair of windpipe
$4130.94
J1
5165
31755
Repair of windpipe
$4130.94
J1
5165
31785
Remove windpipe lesion
$4130.94
J1
5165
31820
Closure of windpipe lesion
$2173.69
J1
5164
31825
Repair of windpipe defect
$2173.69
J1
5164
31830
Revise windpipe scar
$2173.69
J1
5164
31899
Airways surgical procedure
$146.20
T
5151
32400
Needle biopsy chest lining
$1236.62
J1
5072
32405
Percut bx lung/mediastinum
$1236.62
J1
5072
32550
Insert pleural cath
$2862.74
J1
5341
32551
Insertion of chest tube
$684.13
T
5181
32552
Remove lung catheter
$684.13
Q2
5181
32553
Ins mark thor for rt perq
$1066.24
S
5613
32554
Aspirate pleura w/o imaging
$684.13
T
5181
32555
Aspirate pleura w/ imaging
$684.13
T
5181
32556
Insert cath pleura w/o image
$1334.83
J1
5302
32557
Insert cath pleura w/ image
$684.13
T
5181
32560
Treat pleurodesis w/agent
$684.13
T
5181
32561
Lyse chest fibrin init day
$684.13
T
5181
32562
Lyse chest fibrin subq day
$684.13
T
5181
32601
Thoracoscopy diagnostic
$4199.13
J1
5361
32604
Thoracoscopy wbx sac
$4199.13
J1
5361
32606
Thoracoscopy w/bx med space
$4199.13
J1
5361
32607
Thoracoscopy w/bx infiltrate
$4199.13
J1
5361
32608
Thoracoscopy w/bx nodule
$4199.13
J1
5361
32609
Thoracoscopy w/bx pleura
$4199.13
J1
5361
32960
Therapeutic pneumothorax
$684.13
T
5181
32998
Perq rf ablate tx pul tumor
$4199.13
J1
5361
32999
Chest surgery procedure
$684.13
T
5181
33010
Drainage of heart sac
$684.13
T
5181
33011
Repeat drainage of heart sac
$684.13
T
5181
33206
Insert heart pm atrial
$9413.65
J1
5223
33207
Insert heart pm ventricular
$9413.65
J1
5223
33208
Insrt heart pm atrial & vent
$9413.65
J1
5223
33210
Insert electrd/pm cath sngl
$6976.57
J1
5222
33211
Insert card electrodes dual
$6976.57
J1
5222
33212
Insert pulse gen sngl lead
$6976.57
J1
5222
33213
Insert pulse gen dual leads
$9413.65
J1
5223
33214
Upgrade of pacemaker system
$9413.65
J1
5223
33215
Reposition pacing-defib lead
$2360.60
T
5182
33216
Insert 1 electrode pm-defib
$6976.57
J1
5222
33217
Insert 2 electrode pm-defib
$6976.57
J1
5222
33218
Repair lead pace-defib one
$2559.59
T
5221
33220
Repair lead pace-defib dual
$2559.59
T
5221
33221
Insert pulse gen mult leads
$16766.86
J1
5224
33222
Relocation pocket pacemaker
$1427.77
T
5054
33223
Relocate pocket for defib
$1427.77
T
5054
33224
Insert pacing lead & connect
$9413.65
J1
5223
33226
Reposition l ventric lead
$2360.60
T
5182
33227
Remove&replace pm gen singl
$6976.57
J1
5222
33228
Remv&replc pm gen dual lead
$9413.65
J1
5223
33229
Remv&replc pm gen mult leads
$16766.86
J1
5224
33230
Insrt pulse gen w/dual leads
$21999.98
J1
5231
33231
Insrt pulse gen w/mult leads
$30527.21
J1
5232
33233
Removal of pm generator
$6976.57
Q2
5222
33234
Removal of pacemaker system
$2559.59
Q2
5221
33235
Removal pacemaker electrode
$2559.59
Q2
5221
33240
Insrt pulse gen w/singl lead
$21999.98
J1
5231
33241
Remove pulse generator
$2559.59
Q2
5221
33244
Remove elctrd transvenously
$2559.59
Q2
5221
33249
Insj/rplcmt defib w/lead(s)
$30527.21
J1
5232
33262
Rmvl& replc pulse gen 1 lead
$21999.98
J1
5231
33263
Rmvl & rplcmt dfb gen 2 lead
$21999.98
J1
5231
33264
Rmvl & rplcmt dfb gen mlt ld
$30527.21
J1
5232
33270
Ins/rep subq defibrillator
$30527.21
J1
5232
33271
Insj subq impltbl dfb elctrd
$6976.57
J1
5222
33272
Rmvl of subq defibrillator
$2559.59
Q2
5221
33273
Repos prev impltbl subq dfb
$2559.59
T
5221
33282
Implant pat-active ht record
$6976.57
J1
5222
33284
Remove pat-active ht record
$539.11
Q2
5071
33999
Cardiac surgery procedure
$684.13
T
5181
34101
Removal of artery clot
$3924.28
T
5183
34111
Removal of arm artery clot
$3924.28
T
5183
34201
Removal of artery clot
$3924.28
T
5183
34203
Removal of leg artery clot
$3924.28
T
5183
34421
Removal of vein clot
$2360.60
T
5182
34471
Removal of vein clot
$684.13
T
5181
34490
Removal of vein clot
$2360.60
T
5182
34501
Repair valve femoral vein
$3924.28
T
5183
34510
Transposition of vein valve
$3924.28
T
5183
34520
Cross-over vein graft
$3924.28
T
5183
34530
Leg vein fusion
$2360.60
T
5182
35011
Repair defect of artery
$3924.28
T
5183
35045
Repair defect of arm artery
$3924.28
T
5183
35180
Repair blood vessel lesion
$684.13
T
5181
35184
Repair blood vessel lesion
$2360.60
T
5182
35188
Repair blood vessel lesion
$3924.28
T
5183
35190
Repair blood vessel lesion
$3924.28
T
5183
35201
Repair blood vessel lesion
$3924.28
T
5183
35206
Repair blood vessel lesion
$2360.60
T
5182
35207
Repair blood vessel lesion
$2360.60
T
5182
35226
Repair blood vessel lesion
$539.11
T
5071
35231
Repair blood vessel lesion
$2360.60
T
5182
35236
Repair blood vessel lesion
$3924.28
T
5183
35256
Repair blood vessel lesion
$3924.28
T
5183
35261
Repair blood vessel lesion
$2360.60
T
5182
35266
Repair blood vessel lesion
$3924.28
T
5183
35286
Repair blood vessel lesion
$3924.28
T
5183
35321
Rechanneling of artery
$3924.28
T
5183
35761
Exploration of artery/vein
$2360.60
T
5182
35860
Explore limb vessels
$2360.60
T
5182
35875
Removal of clot in graft
$3924.28
T
5183
35876
Removal of clot in graft
$3924.28
T
5183
35879
Revise graft w/vein
$3924.28
T
5183
35881
Revise graft w/vein
$3924.28
T
5183
35883
Revise graft w/nonauto graft
$3924.28
T
5183
35884
Revise graft w/vein
$3924.28
T
5183
35903
Excision graft extremity
$2360.60
T
5182
36002
Pseudoaneurysm injection trt
$684.13
T
5181
36221
Place cath thoracic aorta
$2360.60
Q2
5182
36222
Place cath carotid/inom art
$2360.60
Q2
5182
36223
Place cath carotid/inom art
$3924.28
Q2
5183
36224
Place cath carotd art
$3924.28
Q2
5183
36225
Place cath subclavian art
$2360.60
Q2
5182
36226
Place cath vertebral art
$3924.28
Q2
5183
36251
Ins cath ren art 1st unilat
$2360.60
Q2
5182
36252
Ins cath ren art 1st bilat
$2360.60
Q2
5182
36253
Ins cath ren art 2nd+ unilat
$3924.28
Q2
5183
36254
Ins cath ren art 2nd+ bilat
$2360.60
Q2
5182
36260
Insertion of infusion pump
$3924.28
T
5183
36261
Revision of infusion pump
$2559.59
T
5221
36262
Removal of infusion pump
$2559.59
Q2
5221
36420
Vein access cutdown < 1 yr
$54.55
Q1
5733
36425
Vein access cutdown > 1 yr
$263.61
Q1
5735
36430
Blood transfusion service
$354.54
S
5241
36440
Bl push transfuse 2 yr/<
$354.54
S
5241
36450
Bl exchange/transfuse nb
$354.54
S
5241
36455
Bl exchange/transfuse non-nb
$354.54
S
5241
36456
Prtl exchange transfuse nb
$354.54
S
5241
36460
Transfusion service fetal
$354.54
S
5241
36468
Injection(s) spider veins
$153.12
Q1
5051
36470
Injection therapy of vein
$292.62
T
5052
36471
Injection therapy of veins
$292.62
T
5052
36473
Endovenous mchnchem 1st vein
$2360.60
T
5182
36475
Endovenous rf 1st vein
$2360.60
T
5182
36478
Endovenous laser 1st vein
$2360.60
T
5182
36511
Apheresis wbc
$1098.68
S
5242
36512
Apheresis rbc
$1098.68
S
5242
36513
Apheresis platelets
$354.54
S
5241
36514
Apheresis plasma
$1098.68
S
5242
36515
Apheresis adsorp/reinfuse
$3187.83
S
5243
36516
Apheresis selective
$3187.83
S
5243
36522
Photopheresis
$3187.83
S
5243
36555
Insert non-tunnel cv cath
$684.13
T
5181
36556
Insert non-tunnel cv cath
$684.13
T
5181
36557
Insert tunneled cv cath
$3924.28
T
5183
36558
Insert tunneled cv cath
$2360.60
T
5182
36560
Insert tunneled cv cath
$2360.60
T
5182
36561
Insert tunneled cv cath
$2360.60
T
5182
36563
Insert tunneled cv cath
$3924.28
T
5183
36565
Insert tunneled cv cath
$2360.60
T
5182
36566
Insert tunneled cv cath
$3924.28
T
5183
36568
Insert picc cath
$684.13
T
5181
36569
Insert picc cath
$684.13
T
5181
36570
Insert picvad cath
$2360.60
T
5182
36571
Insert picvad cath
$2360.60
T
5182
36575
Repair tunneled cv cath
$684.13
T
5181
36576
Repair tunneled cv cath
$684.13
T
5181
36578
Replace tunneled cv cath
$2360.60
T
5182
36580
Replace cvad cath
$684.13
T
5181
36581
Replace tunneled cv cath
$2360.60
T
5182
36582
Replace tunneled cv cath
$2360.60
T
5182
36583
Replace tunneled cv cath
$3924.28
T
5183
36584
Replace picc cath
$684.13
T
5181
36585
Replace picvad cath
$2360.60
T
5182
36589
Removal tunneled cv cath
$684.13
Q2
5181
36590
Removal tunneled cv cath
$684.13
Q2
5181
36591
Draw blood off venous device
$100.02
Q1
5734
36592
Collect blood from picc
$100.02
Q1
5734
36593
Declot vascular device
$279.45
T
5694
36595
Mech remov tunneled cv cath
$2360.60
T
5182
36596
Mech remov tunneled cv cath
$684.13
T
5181
36597
Reposition venous catheter
$684.13
T
5181
36598
Inj w/fluor eval cv device
$179.77
T
5693
36600
Withdrawal of arterial blood
$54.55
Q1
5733
36640
Insertion catheter artery
$2360.60
T
5182
36680
Insert needle bone cavity
$263.61
Q1
5735
36800
Insertion of cannula
$3924.28
T
5183
36810
Insertion of cannula
$2360.60
T
5182
36815
Insertion of cannula
$3924.28
T
5183
36818
Av fuse uppr arm cephalic
$3924.28
T
5183
36819
Av fuse uppr arm basilic
$3924.28
T
5183
36820
Av fusion/forearm vein
$3924.28
T
5183
36821
Av fusion direct any site
$2360.60
T
5182
36825
Artery-vein autograft
$3924.28
T
5183
36830
Artery-vein nonautograft
$3924.28
T
5183
36831
Open thrombect av fistula
$3924.28
T
5183
36832
Av fistula revision open
$3924.28
T
5183
36833
Av fistula revision
$3924.28
T
5183
36835
Artery to vein shunt
$2360.60
T
5182
36838
Dist revas ligation hemo
$3924.28
T
5183
36860
External cannula declotting
$684.13
T
5181
36861
Cannula declotting
$3924.28
T
5183
36901
Intro cath dialysis circuit
$684.13
T
5181
36902
Intro cath dialysis circuit
$4825.20
J1
5192
36903
Intro cath dialysis circuit
$9752.43
J1
5193
36904
Thrmbc/nfs dialysis circuit
$4825.20
J1
5192
36905
Thrmbc/nfs dialysis circuit
$9752.43
J1
5193
36906
Thrmbc/nfs dialysis circuit
$14782.14
J1
5194
37183
Remove hepatic shunt (tips)
$4825.20
J1
5192
37184
Prim art m-thrmbc 1st vsl
$3924.28
T
5183
37187
Venous mech thrombectomy
$3924.28
T
5183
37188
Venous m-thrombectomy add-on
$2360.60
T
5182
37191
Ins endovas vena cava filtr
$3924.28
T
5183
37192
Redo endovas vena cava filtr
$2360.60
T
5182
37193
Rem endovas vena cava filter
$2360.60
T
5182
37195
Thrombolytic therapy stroke
$279.45
T
5694
37197
Remove intrvas foreign body
$2360.60
T
5182
37200
Transcatheter biopsy
$3924.28
T
5183
37211
Thrombolytic art therapy
$3924.28
T
5183
37212
Thrombolytic venous therapy
$2360.60
T
5182
37213
Thromblytic art/ven therapy
$684.13
T
5181
37214
Cessj therapy cath removal
$684.13
T
5181
37220
Iliac revasc
$4825.20
J1
5192
37221
Iliac revasc w/stent
$9752.43
J1
5193
37224
Fem/popl revas w/tla
$4825.20
J1
5192
37225
Fem/popl revas w/ather
$9752.43
J1
5193
37226
Fem/popl revasc w/stent
$9752.43
J1
5193
37227
Fem/popl revasc stnt & ather
$14782.14
J1
5194
37228
Tib/per revasc w/tla
$9752.43
J1
5193
37229
Tib/per revasc w/ather
$14782.14
J1
5194
37230
Tib/per revasc w/stent
$14782.14
J1
5194
37231
Tib/per revasc stent & ather
$14782.14
J1
5194
37236
Open/perq place stent 1st
$9752.43
J1
5193
37238
Open/perq place stent same
$9752.43
J1
5193
37241
Vasc embolize/occlude venous
$9752.43
J1
5193
37242
Vasc embolize/occlude artery
$9752.43
J1
5193
37243
Vasc embolize/occlude organ
$9752.43
J1
5193
37244
Vasc embolize/occlude bleed
$9752.43
J1
5193
37246
Trluml balo angiop 1st art
$4825.20
J1
5192
37248
Trluml balo angiop 1st vein
$4825.20
J1
5192
37500
Endoscopy ligate perf veins
$3924.28
T
5183
37501
Vascular endoscopy procedure
$684.13
T
5181
37565
Ligation of neck vein
$684.13
T
5181
37600
Ligation of neck artery
$2360.60
T
5182
37605
Ligation of neck artery
$2360.60
T
5182
37606
Ligation of neck artery
$2360.60
T
5182
37607
Ligation of a-v fistula
$2360.60
T
5182
37609
Temporal artery procedure
$1236.62
J1
5072
37615
Ligation of neck artery
$684.13
T
5181
37619
Ligation of inf vena cava
$3924.28
T
5183
37650
Revision of major vein
$2360.60
T
5182
37700
Revise leg vein
$2360.60
T
5182
37718
Ligate/strip short leg vein
$2360.60
T
5182
37722
Ligate/strip long leg vein
$2360.60
T
5182
37735
Removal of leg veins/lesion
$2360.60
T
5182
37760
Ligate leg veins radical
$2360.60
T
5182
37761
Ligate leg veins open
$684.13
T
5181
37765
Stab phleb veins xtr 10-20
$2360.60
T
5182
37766
Phleb veins - extrem 20+
$2360.60
T
5182
37780
Revision of leg vein
$684.13
T
5181
37785
Ligate/divide/excise vein
$2360.60
T
5182
37790
Penile venous occlusion
$2542.56
J1
5374
37799
Vascular surgery procedure
$684.13
T
5181
38120
Laparoscopy splenectomy
$6969.84
J1
5362
38129
Laparoscope proc spleen
$4199.13
J1
5361
38206
Harvest auto stem cells
$1098.68
S
5242
38207
Cryopreserve stem cells
$354.54
S
5241
38208
Thaw preserved stem cells
$354.54
S
5241
38209
Wash harvest stem cells
$354.54
S
5241
38210
T-cell depletion of harvest
$354.54
S
5241
38211
Tumor cell deplete of harvst
$354.54
S
5241
38212
Rbc depletion of harvest
$354.54
S
5241
38213
Platelet deplete of harvest
$354.54
S
5241
38214
Volume deplete of harvest
$354.54
S
5241
38215
Harvest stem cell concentrte
$354.54
S
5241
38220
Bone marrow aspiration
$1236.62
J1
5072
38221
Bone marrow biopsy
$1236.62
J1
5072
38230
Bone marrow harvest allogen
$1098.68
S
5242
38232
Bone marrow harvest autolog
$3187.83
S
5243
38240
Transplt allo hct/donor
$27764.47
J1
5244
38241
Transplt autol hct/donor
$1098.68
S
5242
38242
Transplt allo lymphocytes
$1098.68
S
5242
38243
Transplj hematopoietic boost
$1098.68
S
5242
38300
Drainage lymph node lesion
$1236.62
J1
5072
38305
Drainage lymph node lesion
$1236.62
J1
5072
38308
Incision of lymph channels
$2499.48
J1
5091
38500
Biopsy/removal lymph nodes
$2499.48
J1
5091
38505
Needle biopsy lymph nodes
$1236.62
J1
5072
38510
Biopsy/removal lymph nodes
$2499.48
J1
5091
38520
Biopsy/removal lymph nodes
$2499.48
J1
5091
38525
Biopsy/removal lymph nodes
$2499.48
J1
5091
38530
Biopsy/removal lymph nodes
$2499.48
J1
5091
38542
Explore deep node(s) neck
$4199.13
J1
5361
38550
Removal neck/armpit lesion
$2499.48
J1
5091
38555
Removal neck/armpit lesion
$4419.46
J1
5092
38570
Laparoscopy lymph node biop
$4199.13
J1
5361
38571
Laparoscopy lymphadenectomy
$6969.84
J1
5362
38572
Laparoscopy lymphadenectomy
$6969.84
J1
5362
38589
Laparoscope proc lymphatic
$4199.13
J1
5361
38700
Removal of lymph nodes neck
$4419.46
J1
5092
38720
Removal of lymph nodes neck
$6486.35
J1
5093
38740
Remove armpit lymph nodes
$4199.13
J1
5361
38745
Remove armpit lymph nodes
$4199.13
J1
5361
38760
Remove groin lymph nodes
$4419.46
J1
5092
38792
Ra tracer id of sentinl node
$333.08
Q1
5591
38999
Blood/lymph system procedure
$354.54
S
5241
39401
Mediastinoscpy w/medstnl bx
$4199.13
J1
5361
39402
Mediastinoscpy w/lmph nod bx
$4199.13
J1
5361
40490
Biopsy of lip
$177.09
T
5161
40500
Partial excision of lip
$2173.69
J1
5164
40510
Partial excision of lip
$2173.69
J1
5164
40520
Partial excision of lip
$2173.69
J1
5164
40525
Reconstruct lip with flap
$2173.69
J1
5164
40527
Reconstruct lip with flap
$4130.94
J1
5165
40530
Partial removal of lip
$2173.69
J1
5164
40650
Repair lip
$442.62
T
5162
40652
Repair lip
$442.62
T
5162
40654
Repair lip
$1038.55
T
5163
40700
Repair cleft lip/nasal
$4130.94
J1
5165
40701
Repair cleft lip/nasal
$4130.94
J1
5165
40702
Repair cleft lip/nasal
$4130.94
J1
5165
40720
Repair cleft lip/nasal
$2173.69
J1
5164
40761
Repair cleft lip/nasal
$4130.94
J1
5165
40799
Lip surgery procedure
$177.09
T
5161
40800
Drainage of mouth lesion
$539.11
T
5071
40801
Drainage of mouth lesion
$442.62
T
5162
40804
Removal foreign body mouth
$263.61
Q1
5735
40805
Removal foreign body mouth
$442.62
T
5162
40806
Incision of lip fold
$442.62
T
5162
40808
Biopsy of mouth lesion
$442.62
T
5162
40810
Excision of mouth lesion
$2173.69
J1
5164
40812
Excise/repair mouth lesion
$2173.69
J1
5164
40814
Excise/repair mouth lesion
$2173.69
J1
5164
40816
Excision of mouth lesion
$2173.69
J1
5164
40818
Excise oral mucosa for graft
$442.62
T
5162
40819
Excise lip or cheek fold
$1038.55
T
5163
40820
Treatment of mouth lesion
$2173.69
J1
5164
40830
Repair mouth laceration
$177.09
T
5161
40831
Repair mouth laceration
$442.62
T
5162
40840
Reconstruction of mouth
$4130.94
J1
5165
40842
Reconstruction of mouth
$4130.94
J1
5165
40843
Reconstruction of mouth
$4130.94
J1
5165
40844
Reconstruction of mouth
$4130.94
J1
5165
40845
Reconstruction of mouth
$4130.94
J1
5165
40899
Mouth surgery procedure
$177.09
T
5161
41000
Drainage of mouth lesion
$442.62
T
5162
41005
Drainage of mouth lesion
$177.09
T
5161
41006
Drainage of mouth lesion
$1038.55
T
5163
41007
Drainage of mouth lesion
$1038.55
T
5163
41008
Drainage of mouth lesion
$2173.69
J1
5164
41009
Drainage of mouth lesion
$442.62
T
5162
41010
Incision of tongue fold
$1038.55
T
5163
41015
Drainage of mouth lesion
$442.62
T
5162
41016
Drainage of mouth lesion
$4130.94
J1
5165
41017
Drainage of mouth lesion
$2173.69
J1
5164
41018
Drainage of mouth lesion
$1038.55
T
5163
41019
Place needles h&n for rt
$4130.94
J1
5165
41100
Biopsy of tongue
$442.62
T
5162
41105
Biopsy of tongue
$2173.69
J1
5164
41108
Biopsy of floor of mouth
$1236.62
J1
5072
41110
Excision of tongue lesion
$2173.69
J1
5164
41112
Excision of tongue lesion
$2173.69
J1
5164
41113
Excision of tongue lesion
$2173.69
J1
5164
41114
Excision of tongue lesion
$2173.69
J1
5164
41115
Excision of tongue fold
$1038.55
T
5163
41116
Excision of mouth lesion
$2173.69
J1
5164
41120
Partial removal of tongue
$4130.94
J1
5165
41250
Repair tongue laceration
$263.61
Q1
5735
41251
Repair tongue laceration
$177.09
T
5161
41252
Repair tongue laceration
$442.62
T
5162
41500
Fixation of tongue
$2173.69
J1
5164
41510
Tongue to lip surgery
$2173.69
J1
5164
41512
Tongue suspension
$4130.94
J1
5165
41520
Reconstruction tongue fold
$2173.69
J1
5164
41530
Tongue base vol reduction
$2173.69
J1
5164
41599
Tongue and mouth surgery
$177.09
T
5161
41800
Drainage of gum lesion
$100.02
Q1
5734
41805
Removal foreign body gum
$1038.55
T
5163
41806
Removal foreign body jawbone
$1038.55
T
5163
41820
Excision gum each quadrant
$2173.69
J1
5164
41821
Excision of gum flap
$1038.55
T
5163
41822
Excision of gum lesion
$1038.55
T
5163
41823
Excision of gum lesion
$4130.94
J1
5165
41825
Excision of gum lesion
$2173.69
J1
5164
41826
Excision of gum lesion
$2173.69
J1
5164
41827
Excision of gum lesion
$4130.94
J1
5165
41828
Excision of gum lesion
$2173.69
J1
5164
41830
Removal of gum tissue
$2173.69
J1
5164
41850
Treatment of gum lesion
$1038.55
T
5163
41870
Gum graft
$2173.69
J1
5164
41872
Repair gum
$2173.69
J1
5164
41874
Repair tooth socket
$2173.69
J1
5164
41899
Dental surgery procedure
$177.09
T
5161
42000
Drainage mouth roof lesion
$177.09
T
5161
42100
Biopsy roof of mouth
$1038.55
T
5163
42104
Excision lesion mouth roof
$2173.69
J1
5164
42106
Excision lesion mouth roof
$2173.69
J1
5164
42107
Excision lesion mouth roof
$4130.94
J1
5165
42120
Remove palate/lesion
$4130.94
J1
5165
42140
Excision of uvula
$2173.69
J1
5164
42145
Repair palate pharynx/uvula
$4130.94
J1
5165
42160
Treatment mouth roof lesion
$2173.69
J1
5164
42180
Repair palate
$442.62
T
5162
42182
Repair palate
$4130.94
J1
5165
42200
Reconstruct cleft palate
$4130.94
J1
5165
42205
Reconstruct cleft palate
$2173.69
J1
5164
42210
Reconstruct cleft palate
$4130.94
J1
5165
42215
Reconstruct cleft palate
$4130.94
J1
5165
42220
Reconstruct cleft palate
$4130.94
J1
5165
42225
Reconstruct cleft palate
$4130.94
J1
5165
42226
Lengthening of palate
$4130.94
J1
5165
42227
Lengthening of palate
$4130.94
J1
5165
42235
Repair palate
$4130.94
J1
5165
42260
Repair nose to lip fistula
$4130.94
J1
5165
42280
Preparation palate mold
$442.62
T
5162
42281
Insertion palate prosthesis
$4130.94
J1
5165
42299
Palate/uvula surgery
$177.09
T
5161
42300
Drainage of salivary gland
$1038.55
T
5163
42305
Drainage of salivary gland
$2173.69
J1
5164
42310
Drainage of salivary gland
$442.62
T
5162
42320
Drainage of salivary gland
$442.62
T
5162
42330
Removal of salivary stone
$2173.69
J1
5164
42335
Removal of salivary stone
$2173.69
J1
5164
42340
Removal of salivary stone
$2173.69
J1
5164
42400
Biopsy of salivary gland
$539.11
T
5071
42405
Biopsy of salivary gland
$2173.69
J1
5164
42408
Excision of salivary cyst
$2173.69
J1
5164
42409
Drainage of salivary cyst
$2173.69
J1
5164
42410
Excise parotid gland/lesion
$4130.94
J1
5165
42415
Excise parotid gland/lesion
$4130.94
J1
5165
42420
Excise parotid gland/lesion
$4130.94
J1
5165
42425
Excise parotid gland/lesion
$4130.94
J1
5165
42440
Excise submaxillary gland
$4130.94
J1
5165
42450
Excise sublingual gland
$4130.94
J1
5165
42500
Repair salivary duct
$4130.94
J1
5165
42505
Repair salivary duct
$4130.94
J1
5165
42507
Parotid duct diversion
$4130.94
J1
5165
42509
Parotid duct diversion
$4130.94
J1
5165
42510
Parotid duct diversion
$2173.69
J1
5164
42600
Closure of salivary fistula
$2173.69
J1
5164
42650
Dilation of salivary duct
$1038.55
T
5163
42660
Dilation of salivary duct
$442.62
T
5162
42665
Ligation of salivary duct
$2173.69
J1
5164
42699
Salivary surgery procedure
$177.09
T
5161
42700
Drainage of tonsil abscess
$177.09
T
5161
42720
Drainage of throat abscess
$2173.69
J1
5164
42725
Drainage of throat abscess
$4130.94
J1
5165
42800
Biopsy of throat
$2173.69
J1
5164
42804
Biopsy of upper nose/throat
$2173.69
J1
5164
42806
Biopsy of upper nose/throat
$2173.69
J1
5164
42808
Excise pharynx lesion
$2173.69
J1
5164
42809
Remove pharynx foreign body
$263.61
Q1
5735
42810
Excision of neck cyst
$2173.69
J1
5164
42815
Excision of neck cyst
$4130.94
J1
5165
42820
Remove tonsils and adenoids
$4130.94
J1
5165
42821
Remove tonsils and adenoids
$2173.69
J1
5164
42825
Removal of tonsils
$4130.94
J1
5165
42826
Removal of tonsils
$2173.69
J1
5164
42830
Removal of adenoids
$2173.69
J1
5164
42831
Removal of adenoids
$2173.69
J1
5164
42835
Removal of adenoids
$2173.69
J1
5164
42836
Removal of adenoids
$2173.69
J1
5164
42842
Extensive surgery of throat
$4130.94
J1
5165
42844
Extensive surgery of throat
$4130.94
J1
5165
42860
Excision of tonsil tags
$2173.69
J1
5164
42870
Excision of lingual tonsil
$4130.94
J1
5165
42890
Partial removal of pharynx
$4130.94
J1
5165
42892
Revision of pharyngeal walls
$4130.94
J1
5165
42900
Repair throat wound
$1038.55
T
5163
42950
Reconstruction of throat
$4130.94
J1
5165
42955
Surgical opening of throat
$1038.55
T
5163
42960
Control throat bleeding
$177.09
T
5161
42962
Control throat bleeding
$2173.69
J1
5164
42970
Control nose/throat bleeding
$177.09
T
5161
42972
Control nose/throat bleeding
$2173.69
J1
5164
42999
Throat surgery procedure
$177.09
T
5161
43020
Incision of esophagus
$1038.55
T
5163
43030
Throat muscle surgery
$4130.94
J1
5165
43130
Removal of esophagus pouch
$4130.94
J1
5165
43180
Esophagoscopy rigid trnso
$4130.94
J1
5165
43191
Esophagoscopy rigid trnso dx
$1334.83
J1
5302
43192
Esophagoscp rig trnso inject
$1334.83
J1
5302
43193
Esophagoscp rig trnso biopsy
$1334.83
J1
5302
43194
Esophagoscp rig trnso rem fb
$1334.83
J1
5302
43195
Esophagoscopy rigid balloon
$2510.70
J1
5303
43196
Esophagoscp guide wire dilat
$2510.70
J1
5303
43197
Esophagoscopy flex dx brush
$699.79
T
5301
43198
Esophagosc flex trnsn biopsy
$699.79
T
5301
43200
Esophagoscopy flexible brush
$699.79
T
5301
43201
Esoph scope w/submucous inj
$1334.83
J1
5302
43202
Esophagoscopy flex biopsy
$1334.83
J1
5302
43204
Esoph scope w/sclerosis inj
$1334.83
J1
5302
43205
Esophagus endoscopy/ligation
$1334.83
J1
5302
43206
Esoph optical endomicroscopy
$1334.83
J1
5302
43210
Egd esophagogastrc fndoplsty
$3940.61
J1
5331
43211
Esophagoscop mucosal resect
$1334.83
J1
5302
43212
Esophagoscop stent placement
$3940.61
J1
5331
43213
Esophagoscopy retro balloon
$1334.83
J1
5302
43214
Esophagosc dilate balloon 30
$1334.83
J1
5302
43215
Esophagoscopy flex remove fb
$1334.83
J1
5302
43216
Esophagoscopy lesion removal
$1334.83
J1
5302
43217
Esophagoscopy snare les remv
$1334.83
J1
5302
43220
Esophagoscopy balloon <30mm
$1334.83
J1
5302
43226
Esoph endoscopy dilation
$1334.83
J1
5302
43227
Esophagoscopy control bleed
$1334.83
J1
5302
43229
Esophagoscopy lesion ablate
$2510.70
J1
5303
43231
Esophagoscop ultrasound exam
$1334.83
J1
5302
43232
Esophagoscopy w/us needle bx
$1334.83
J1
5302
43233
Egd balloon dil esoph30 mm/>
$1334.83
J1
5302
43235
Egd diagnostic brush wash
$699.79
T
5301
43236
Uppr gi scope w/submuc inj
$699.79
T
5301
43237
Endoscopic us exam esoph
$1334.83
J1
5302
43238
Egd us fine needle bx/aspir
$1334.83
J1
5302
43239
Egd biopsy single/multiple
$699.79
T
5301
43240
Egd w/transmural drain cyst
$2510.70
J1
5303
43241
Egd tube/cath insertion
$1334.83
J1
5302
43242
Egd us fine needle bx/aspir
$1334.83
J1
5302
43243
Egd injection varices
$1334.83
J1
5302
43244
Egd varices ligation
$1334.83
J1
5302
43245
Egd dilate stricture
$1334.83
J1
5302
43246
Egd place gastrostomy tube
$1334.83
J1
5302
43247
Egd remove foreign body
$699.79
T
5301
43248
Egd guide wire insertion
$699.79
T
5301
43249
Esoph egd dilation <30 mm
$1334.83
J1
5302
43250
Egd cautery tumor polyp
$1334.83
J1
5302
43251
Egd remove lesion snare
$1334.83
J1
5302
43252
Egd optical endomicroscopy
$2510.70
J1
5303
43253
Egd us transmural injxn/mark
$1334.83
J1
5302
43254
Egd endo mucosal resection
$1334.83
J1
5302
43255
Egd control bleeding any
$1334.83
J1
5302
43257
Egd w/thrml txmnt gerd
$2510.70
J1
5303
43259
Egd us exam duodenum/jejunum
$1334.83
J1
5302
43260
Ercp w/specimen collection
$2510.70
J1
5303
43261
Endo cholangiopancreatograph
$2510.70
J1
5303
43262
Endo cholangiopancreatograph
$2510.70
J1
5303
43263
Ercp sphincter pressure meas
$2510.70
J1
5303
43264
Ercp remove duct calculi
$2510.70
J1
5303
43265
Ercp lithotripsy calculi
$3940.61
J1
5331
43266
Egd endoscopic stent place
$3940.61
J1
5331
43270
Egd lesion ablation
$1334.83
J1
5302
43274
Ercp duct stent placement
$3940.61
J1
5331
43275
Ercp remove forgn body duct
$2510.70
J1
5303
43276
Ercp stent exchange w/dilate
$3940.61
J1
5331
43277
Ercp ea duct/ampulla dilate
$2510.70
J1
5303
43278
Ercp lesion ablate w/dilate
$2510.70
J1
5303
43280
Laparoscopy fundoplasty
$6969.84
J1
5362
43281
Lap paraesophag hern repair
$6969.84
J1
5362
43284
Laps esophgl sphnctr agmntj
$6969.84
J1
5362
43285
Rmvl esophgl sphnctr dev
$4199.13
Q2
5361
43289
Laparoscope proc esoph
$4199.13
J1
5361
43420
Repair esophagus opening
$2173.69
J1
5164
43450
Dilate esophagus 1/mult pass
$699.79
T
5301
43453
Dilate esophagus
$1334.83
J1
5302
43499
Esophagus surgery procedure
$699.79
T
5301
43510
Surgical opening of stomach
$699.79
T
5301
43647
Lap impl electrode antrum
$5745.11
J1
5462
43648
Lap revise/remv eltrd antrum
$4199.13
J1
5361
43651
Laparoscopy vagus nerve
$4199.13
J1
5361
43652
Laparoscopy vagus nerve
$4199.13
J1
5361
43653
Laparoscopy gastrostomy
$4199.13
J1
5361
43659
Laparoscope proc stom
$4199.13
J1
5361
43752
Nasal/orogastric w/tube plmt
$263.61
Q1
5735
43753
Tx gastro intub w/asp
$232.31
Q1
5722
43754
Dx gastr intub w/asp spec
$232.31
Q1
5722
43755
Dx gastr intub w/asp specs
$127.10
S
5721
43756
Dx duod intub w/asp spec
$699.79
Q1
5301
43757
Dx duod intub w/asp specs
$699.79
T
5301
43760
Change gastrostomy tube
$216.04
T
5371
43761
Reposition gastrostomy tube
$216.04
T
5371
43770
Lap place gastr adj device
$6969.84
J1
5362
43830
Place gastrostomy tube
$1334.83
J1
5302
43831
Place gastrostomy tube
$699.79
T
5301
43870
Repair stomach opening
$2510.70
J1
5303
43886
Revise gastric port open
$2504.69
T
5055
43887
Remove gastric port open
$1427.77
Q2
5054
43888
Change gastric port open
$2504.69
T
5055
43999
Stomach surgery procedure
$699.79
T
5301
44100
Biopsy of bowel
$699.79
T
5301
44180
Lap enterolysis
$4199.13
J1
5361
44186
Lap jejunostomy
$4199.13
J1
5361
44238
Laparoscope proc intestine
$4199.13
J1
5361
44312
Revision of ileostomy
$2504.69
T
5055
44340
Revision of colostomy
$2504.69
T
5055
44360
Small bowel endoscopy
$1334.83
J1
5302
44361
Small bowel endoscopy/biopsy
$1334.83
J1
5302
44363
Small bowel endoscopy
$1334.83
J1
5302
44364
Small bowel endoscopy
$1334.83
J1
5302
44365
Small bowel endoscopy
$1334.83
J1
5302
44366
Small bowel endoscopy
$1334.83
J1
5302
44369
Small bowel endoscopy
$1334.83
J1
5302
44370
Small bowel endoscopy/stent
$3940.61
J1
5331
44372
Small bowel endoscopy
$1334.83
J1
5302
44373
Small bowel endoscopy
$1334.83
J1
5302
44376
Small bowel endoscopy
$1334.83
J1
5302
44377
Small bowel endoscopy/biopsy
$1334.83
J1
5302
44378
Small bowel endoscopy
$1334.83
J1
5302
44379
S bowel endoscope w/stent
$3940.61
J1
5331
44380
Small bowel endoscopy br/wa
$699.79
T
5301
44381
Small bowel endoscopy br/wa
$1334.83
J1
5302
44382
Small bowel endoscopy
$699.79
T
5301
44384
Small bowel endoscopy
$2510.70
J1
5303
44385
Endoscopy of bowel pouch
$667.67
T
5311
44386
Endoscopy bowel pouch/biop
$667.67
T
5311
44388
Colonoscopy thru stoma spx
$667.67
T
5311
44389
Colonoscopy with biopsy
$877.60
T
5312
44390
Colonoscopy for foreign body
$877.60
T
5312
44391
Colonoscopy for bleeding
$877.60
T
5312
44392
Colonoscopy & polypectomy
$877.60
T
5312
44394
Colonoscopy w/snare
$877.60
T
5312
44401
Colonoscopy with ablation
$877.60
T
5312
44402
Colonoscopy w/stent plcmt
$3940.61
J1
5331
44403
Colonoscopy w/resection
$877.60
T
5312
44404
Colonoscopy w/injection
$877.60
T
5312
44405
Colonoscopy w/dilation
$877.60
T
5312
44406
Colonoscopy w/ultrasound
$877.60
T
5312
44407
Colonoscopy w/ndl aspir/bx
$877.60
T
5312
44408
Colonoscopy w/decompression
$667.67
T
5311
44500
Intro gastrointestinal tube
$699.79
T
5301
44799
Unlisted px small intestine
$699.79
T
5301
44950
Appendectomy
$2862.74
J1
5341
44970
Laparoscopy appendectomy
$4199.13
J1
5361
44979
Laparoscope proc app
$4199.13
J1
5361
45000
Drainage of pelvic abscess
$877.60
T
5312
45005
Drainage of rectal abscess
$877.60
T
5312
45020
Drainage of rectal abscess
$2167.51
J1
5313
45100
Biopsy of rectum
$2167.51
J1
5313
45108
Removal of anorectal lesion
$2167.51
J1
5313
45150
Excision of rectal stricture
$877.60
T
5312
45160
Excision of rectal lesion
$2167.51
J1
5313
45171
Exc rect tum transanal part
$2167.51
J1
5313
45172
Exc rect tum transanal full
$2167.51
J1
5313
45190
Destruction rectal tumor
$2167.51
J1
5313
45300
Proctosigmoidoscopy dx
$667.67
T
5311
45303
Proctosigmoidoscopy dilate
$877.60
T
5312
45305
Proctosigmoidoscopy w/bx
$877.60
T
5312
45307
Proctosigmoidoscopy fb
$2167.51
J1
5313
45308
Proctosigmoidoscopy removal
$2167.51
J1
5313
45309
Proctosigmoidoscopy removal
$877.60
T
5312
45315
Proctosigmoidoscopy removal
$877.60
T
5312
45317
Proctosigmoidoscopy bleed
$877.60
T
5312
45320
Proctosigmoidoscopy ablate
$2167.51
J1
5313
45321
Proctosigmoidoscopy volvul
$2167.51
J1
5313
45327
Proctosigmoidoscopy w/stent
$3940.61
J1
5331
45330
Diagnostic sigmoidoscopy
$667.67
T
5311
45331
Sigmoidoscopy and biopsy
$667.67
T
5311
45332
Sigmoidoscopy w/fb removal
$877.60
T
5312
45333
Sigmoidoscopy & polypectomy
$667.67
T
5311
45334
Sigmoidoscopy for bleeding
$877.60
T
5312
45335
Sigmoidoscopy w/submuc inj
$667.67
T
5311
45337
Sigmoidoscopy & decompress
$877.60
T
5312
45338
Sigmoidoscopy w/tumr remove
$877.60
T
5312
45340
Sig w/tndsc balloon dilation
$877.60
T
5312
45341
Sigmoidoscopy w/ultrasound
$877.60
T
5312
45342
Sigmoidoscopy w/us guide bx
$877.60
T
5312
45346
Sigmoidoscopy w/ablation
$877.60
T
5312
45347
Sigmoidoscopy w/plcmt stent
$3940.61
J1
5331
45349
Sigmoidoscopy w/resection
$877.60
T
5312
45350
Sgmdsc w/band ligation
$877.60
T
5312
45378
Diagnostic colonoscopy
$667.67
T
5311
45379
Colonoscopy w/fb removal
$877.60
T
5312
45380
Colonoscopy and biopsy
$877.60
T
5312
45381
Colonoscopy submucous njx
$877.60
T
5312
45382
Colonoscopy w/control bleed
$877.60
T
5312
45384
Colonoscopy w/lesion removal
$877.60
T
5312
45385
Colonoscopy w/lesion removal
$877.60
T
5312
45386
Colonoscopy w/balloon dilat
$877.60
T
5312
45388
Colonoscopy w/ablation
$877.60
T
5312
45389
Colonoscopy w/stent plcmt
$3940.61
J1
5331
45390
Colonoscopy w/resection
$877.60
T
5312
45391
Colonoscopy w/endoscope us
$877.60
T
5312
45392
Colonoscopy w/endoscopic fnb
$877.60
T
5312
45393
Colonoscopy w/decompression
$877.60
T
5312
45398
Colonoscopy w/band ligation
$877.60
T
5312
45399
Unlisted procedure colon
$667.67
T
5311
45499
Laparoscope proc rectum
$4199.13
J1
5361
45500
Repair of rectum
$2167.51
J1
5313
45505
Repair of rectum
$2167.51
J1
5313
45520
Treatment of rectal prolapse
$667.67
Q1
5311
45541
Correct rectal prolapse
$2167.51
J1
5313
45560
Repair of rectocele
$2167.51
J1
5313
45900
Reduction of rectal prolapse
$667.67
T
5311
45905
Dilation of anal sphincter
$877.60
T
5312
45910
Dilation of rectal narrowing
$877.60
T
5312
45915
Remove rectal obstruction
$877.60
T
5312
45990
Surg dx exam anorectal
$2167.51
J1
5313
45999
Rectum surgery procedure
$667.67
T
5311
46020
Placement of seton
$2167.51
J1
5313
46030
Removal of rectal marker
$877.60
T
5312
46040
Incision of rectal abscess
$877.60
T
5312
46045
Incision of rectal abscess
$2167.51
J1
5313
46050
Incision of anal abscess
$667.67
T
5311
46060
Incision of rectal abscess
$2167.51
J1
5313
46070
Incision of anal septum
$2167.51
J1
5313
46080
Incision of anal sphincter
$2167.51
J1
5313
46083
Incise external hemorrhoid
$216.04
T
5371
46200
Removal of anal fissure
$2167.51
J1
5313
46220
Excise anal ext tag/papilla
$877.60
T
5312
46221
Ligation of hemorrhoid(s)
$667.67
T
5311
46230
Removal of anal tags
$2167.51
J1
5313
46250
Remove ext hem groups 2+
$2167.51
J1
5313
46255
Remove int/ext hem 1 group
$2167.51
J1
5313
46257
Remove in/ex hem grp & fiss
$2167.51
J1
5313
46258
Remove in/ex hem grp w/fistu
$2167.51
J1
5313
46260
Remove in/ex hem groups 2+
$2167.51
J1
5313
46261
Remove in/ex hem grps & fiss
$2167.51
J1
5313
46262
Remove in/ex hem grps w/fist
$2167.51
J1
5313
46270
Remove anal fist subq
$2167.51
J1
5313
46275
Remove anal fist inter
$2167.51
J1
5313
46280
Remove anal fist complex
$2167.51
J1
5313
46285
Remove anal fist 2 stage
$2167.51
J1
5313
46288
Repair anal fistula
$2167.51
J1
5313