CodeMap®OPPS

Procedure	Short Descriptor	Unadjusted 2020 OPPS Fee Schedule	Status Indicator	APC
0058T	Cryopreservation ovary tiss	$XXX.XX	Q1	5672
0071T	Us leiomyomata ablate <200	$XXX.XX	J1	5414
0072T	Us leiomyomata ablate >200	$XXX.XX	J1	5414
0100T	Prosth retina receive&gen	$XXX.XX	T	1908
0101T	Extracorp shockwv tx hi enrg	$XXX.XX	J1	5113
0102T	Extracorp shockwv tx anesth	$XXX.XX	J1	5113
0106T	Touch quant sensory test	$XXX.XX	Q1	5732
0107T	Vibrate quant sensory test	$XXX.XX	Q1	5732
0108T	Cool quant sensory test	$XXX.XX	Q1	5733
0109T	Heat quant sensory test	$XXX.XX	Q1	5732
0110T	Nos quant sensory test	$XXX.XX	Q1	5734
0126T	Chd risk imt study	$XXX.XX	Q1	5731
0184T	Exc rectal tumor endoscopic	$XXX.XX	J1	5331
0191T	Insert ant segment drain int	$XXX.XX	J1	5492
0198T	Ocular blood flow measure	$XXX.XX	Q1	5734
0200T	Perq sacral augmt unilat inj	$XXX.XX	J1	5114
0201T	Perq sacral augmt bilat inj	$XXX.XX	J1	5114
0207T	Clear eyelid gland w/heat	$XXX.XX	Q1	5733
0208T	Audiometry air only	$XXX.XX	Q1	5732
0209T	Audiometry air & bone	$XXX.XX	Q1	5732
0210T	Speech audiometry threshold	$XXX.XX	Q1	5732
0211T	Speech audiom thresh & recog	$XXX.XX	Q1	5732
0212T	Compre audiometry evaluation	$XXX.XX	Q1	5721
0213T	Njx paravert w/us cer/thor	$XXX.XX	T	5443
0216T	Njx paravert w/us lumb/sac	$XXX.XX	T	5443
0221T	Plmt post facet implt lumb	$XXX.XX	J1	5114
0228T	Njx tfrml eprl w/us cer/thor	$XXX.XX	T	5443
0230T	Njx tfrml eprl w/us lumb/sac	$XXX.XX	T	5443
0232T	Njx platelet plasma	$XXX.XX	Q1	5735
0234T	Trluml perip athrc renal art	$XXX.XX	J1	5193
0236T	Trluml perip athrc abd aorta	$XXX.XX	J1	5193
0237T	Trluml perip athrc brchiocph	$XXX.XX	J1	5193
0238T	Trluml perip athrc iliac art	$XXX.XX	J1	5194
0253T	Insert aqueous drain device	$XXX.XX	J1	5492
0263T	Im b1 mrw cel ther cmpl	$XXX.XX	S	5243
0264T	Im b1 mrw cel ther xcl hrvst	$XXX.XX	S	5243
0265T	Im b1 mrw cel ther hrvst onl	$XXX.XX	S	5243
0266T	Implt/rpl crtd sns dev total	$XXX.XX	J1	5464
0267T	Implt/rpl crtd sns dev lead	$XXX.XX	J1	5461
0268T	Implt/rpl crtd sns dev gen	$XXX.XX	J1	5464
0269T	Rev/remvl crtd sns dev total	$XXX.XX	Q2	5432
0270T	Rev/remvl crtd sns dev lead	$XXX.XX	J1	5461
0271T	Rev/remvl crtd sns dev gen	$XXX.XX	J1	5461
0272T	Interrogate crtd sns dev	$XXX.XX	S	5721
0273T	Interrogate crtd sns w/pgrmg	$XXX.XX	S	5721
0274T	Perq lamot/lam crv/thrc	$XXX.XX	J1	5114
0275T	Perq lamot/lam lumbar	$XXX.XX	J1	5114
0278T	Tempr	$XXX.XX	Q1	5721
0296T	Ext ecg recording	$XXX.XX	Q1	5733
0297T	Ext ecg scan w/report	$XXX.XX	Q1	5734
0308T	Insj ocular telescope prosth	$XXX.XX	J1	5495
0312T	Laps impltj nstim vagus	$XXX.XX	J1	5464
0313T	Laps rmvl nstim array vagus	$XXX.XX	J1	5461
0314T	Laps rmvl vgl arry&pls gen	$XXX.XX	J1	5461
0315T	Rmvl vagus nerve pls gen	$XXX.XX	J1	5461
0316T	Replc vagus nerve pls gen	$XXX.XX	J1	5464
0317T	Elec alys vagus nrv pls gen	$XXX.XX	Q1	5741
0330T	Tear film img uni/bi w/i&r	$XXX.XX	Q1	5732
0331T	Heart symp image plnr	$XXX.XX	S	5593
0332T	Heart symp image plnr spect	$XXX.XX	S	5593
0335T	Insj sinus tarsi implant	$XXX.XX	J1	5114
0338T	Trnscth renal symp denrv unl	$XXX.XX	J1	5192
0339T	Trnscth renal symp denrv bil	$XXX.XX	J1	5192
0342T	Thxp apheresis w/hdl delip	$XXX.XX	S	5243
0347T	Ins bone device for rsa	$XXX.XX	Q1	5733
0348T	Rsa spine exam	$XXX.XX	Q1	5522
0349T	Rsa upper extr exam	$XXX.XX	Q1	5522
0350T	Rsa lower extr exam	$XXX.XX	Q1	5521
0355T	Gi tract capsule endoscopy	$XXX.XX	J1	5302
0356T	Insrt drug device for iop	$XXX.XX	Q1	5692
0358T	Bia whole body	$XXX.XX	Q1	5731
0362T	Bhv id suprt assmt ea 15 min	$XXX.XX	Q3	5821
0373T	Adapt bhv tx ea 15 min	$XXX.XX	Q3	5821
0379T	Vis field assmnt tech suppt	$XXX.XX	Q1	5732
0394T	Hdr elctrnc skn surf brchytx	$XXX.XX	S	5622
0395T	Hdr elctr ntrst/ntrcv brchtx	$XXX.XX	S	5624
0398T	Mrgfus strtctc les abltj	$XXX.XX	S	1575
0402T	Colgn cross-link crn med sep	$XXX.XX	J1	5503
0404T	Trnscrv uterin fibroid abltj	$XXX.XX	J1	5416
0408T	Insj/rplc cardiac modulj sys	$XXX.XX	J1	5231
0409T	Insj/rplc car modulj pls gn	$XXX.XX	J1	5231
0410T	Insj/rplc car modulj atr elt	$XXX.XX	J1	5222
0411T	Insj/rplc car modulj vnt elt	$XXX.XX	J1	5222
0412T	Rmvl cardiac modulj pls gen	$XXX.XX	Q2	5221
0413T	Rmvl car modulj tranvns elt	$XXX.XX	Q2	5221
0414T	Rmvl & rpl car modulj pls gn	$XXX.XX	J1	5231
0415T	Repos car modulj tranvns elt	$XXX.XX	T	5181
0416T	Reloc skin pocket pls gen	$XXX.XX	T	5054
0417T	Prgrmg eval cardiac modulj	$XXX.XX	Q1	5741
0418T	Interro eval cardiac modulj	$XXX.XX	Q1	5741
0419T	Dstrj neurofibroma xtnsv	$XXX.XX	T	5053
0420T	Dstrj neurofibroma xtnsv	$XXX.XX	T	5053
0421T	Waterjet prostate abltj cmpl	$XXX.XX	J1	5376
0422T	Tactile breast img uni/bi	$XXX.XX	Q1	5521
0424T	Insj/rplc nstim apnea compl	$XXX.XX	J1	5464
0425T	Insj/rplc nstim apnea sen ld	$XXX.XX	J1	5462
0426T	Insj/rplc nstim apnea stm ld	$XXX.XX	J1	5463
0427T	Insj/rplc nstim apnea pls gn	$XXX.XX	J1	5464
0428T	Rmvl nstim apnea pls gen	$XXX.XX	J1	5461
0429T	Rmvl nstim apnea sen ld	$XXX.XX	J1	5461
0430T	Rmvl nstim apnea stimj ld	$XXX.XX	J1	5461
0431T	Rmvl/rplc nstim apnea pls gn	$XXX.XX	J1	5464
0432T	Repos nstim apnea stimj ld	$XXX.XX	J1	5461
0433T	Repos nstim apnea sensing ld	$XXX.XX	J1	5461
0434T	Interro eval npgs apnea	$XXX.XX	S	5742
0435T	Prgrmg eval npgs apnea 1 ses	$XXX.XX	S	5742
0436T	Prgrmg eval npgs apnea study	$XXX.XX	S	5724
0440T	Abltj perc uxtr/perph nrv	$XXX.XX	J1	5431
0441T	Abltj perc lxtr/perph nrv	$XXX.XX	J1	5431
0442T	Abltj perc plex/trncl nrv	$XXX.XX	J1	5432
0446T	Insj impltbl glucose sensor	$XXX.XX	T	5053
0447T	Rmvl impltbl glucose sensor	$XXX.XX	Q2	5051
0448T	Remvl insj impltbl gluc sens	$XXX.XX	T	5053
0449T	Insj aqueous drain dev 1st	$XXX.XX	J1	5492
0453T	Insj/rplcmt mech-elec ntrfce	$XXX.XX	J1	5222
0454T	Insj/rplcmt subq electrode	$XXX.XX	J1	5222
0457T	Remvl mech-elec skin ntrfce	$XXX.XX	Q2	5221
0458T	Remvl subq electrode	$XXX.XX	Q2	5221
0460T	Repos aortic ventr dev eltrd	$XXX.XX	T	5221
0462T	Prgrmg eval aortic ventr sys	$XXX.XX	S	5743
0463T	Interrog aortic ventr sys	$XXX.XX	S	5743
0464T	Visual ep test for glaucoma	$XXX.XX	S	5721
0465T	Supchrdl njx rx w/o supply	$XXX.XX	T	5694
0467T	Revj/rplmnt ch respir eltrd	$XXX.XX	J1	5461
0468T	Rmvl ch wal respir eltrd/ra	$XXX.XX	J1	5461
0472T	Prgrmg io rta eltrd ra	$XXX.XX	Q1	5743
0473T	Reprgrmg io rta eltrd ra	$XXX.XX	Q1	5742
0476T	Rec ftl car sgl elec tr data	$XXX.XX	Q1	5734
0477T	Rec ftl car sgl xrtj alys	$XXX.XX	Q1	5734
0479T	Fxjl abl lsr 1st 100 sq cm	$XXX.XX	T	5052
0481T	Njx autol wbc concentrate	$XXX.XX	Q1	5735
0485T	Oct mid ear i&r unilateral	$XXX.XX	Q1	5732
0486T	Oct mid ear i&r bilateral	$XXX.XX	Q1	5732
0487T	Trvg biomchn mapg w/reprt	$XXX.XX	Q1	5734
0491T	Abl lsr opn wnd 1st 20 sqcm	$XXX.XX	T	5052
0497T	Xtrnl pt act ecg in-off conn	$XXX.XX	Q1	5741
0499T	Cysto f/urtl strix/stenosis	$XXX.XX	J1	5374
0503T	Cor ffr alys gnrj ffr mdl	$XXX.XX	S	1511
0505T	Ev fempop artl revsc	$XXX.XX	J1	5193
0506T	Mac pgmt opt dns meas hfp	$XXX.XX	Q1	5733
0507T	Near ifr 2img mibmn glnd i&r	$XXX.XX	Q1	5733
0508T	Pls echo us b1 dns meas tib	$XXX.XX	S	5522
0509T	Pattern erg w/i&r	$XXX.XX	S	5721
0510T	Rmvl sinus tarsi implant	$XXX.XX	Q2	5113
0511T	Rmvl&rinsj sinus tarsi implt	$XXX.XX	J1	5114
0512T	Esw integ wnd hlg 1st wnd	$XXX.XX	S	5052
0515T	Insj wcs lv compl sys	$XXX.XX	J1	5231
0516T	Insj wcs lv eltrd only	$XXX.XX	J1	5222
0517T	Insj wcs lv pg compnt	$XXX.XX	J1	5222
0518T	Rmvl pg compnt wcs	$XXX.XX	T	5221
0519T	Rmvl & rplcmt pg compnt wcs	$XXX.XX	T	5221
0520T	Rmvl&rplcmt pg wcs new eltrd	$XXX.XX	J1	5231
0521T	Interrog dev eval wcs ip	$XXX.XX	Q1	5731
0522T	Prgrmg dev eval wcs ip	$XXX.XX	Q1	5741
0524T	Ev cath dir chem abltj w/img	$XXX.XX	T	5183
0525T	Insj/rplcmt compl iims	$XXX.XX	J1	5223
0526T	Insj/rplcmt iims eltrd only	$XXX.XX	J1	5222
0527T	Insj/rplcmt iims implt mntr	$XXX.XX	J1	5222
0528T	Prgrmg dev eval iims ip	$XXX.XX	Q1	5741
0529T	Interrog dev eval iims ip	$XXX.XX	Q1	5741
0530T	Removal complete iims	$XXX.XX	Q2	5221
0531T	Removal iims electrode only	$XXX.XX	Q2	5221
0532T	Removal iims implt mntr only	$XXX.XX	Q2	5221
0534T	Cont rec mvmt do setup&train	$XXX.XX	Q1	5741
0535T	Cont rec mvmt do reprt cnfig	$XXX.XX	Q1	5741
0540T	Car-t cll admn autologous	$XXX.XX	S	5694
0541T	Myocardial imaging mcg	$XXX.XX	S	5723
0548T	Tprnl balo cntnc dev bi	$XXX.XX	J1	5376
0549T	Tprnl balo cntnc dev uni	$XXX.XX	J1	5375
0550T	Tprnl balo cntnc dev rmvl ea	$XXX.XX	J1	5374
0551T	Tprnl balo cntnc dev adjmt	$XXX.XX	T	5371
0555T	B1 str&fx rsk transmis data	$XXX.XX	S	5731
0556T	B1 str & fx rsk assessment	$XXX.XX	S	5523
0558T	Ct scan f/biomchn ct alys	$XXX.XX	S	5521
0559T	Antmc mdl 3d print 1st cmpnt	$XXX.XX	Q1	5733
0561T	Antmc guide 3d print 1st gd	$XXX.XX	Q1	5733
0563T	Evac meibomian glnd heat bi	$XXX.XX	Q1	5733
0564T	Onc chemo rx cytotox csc 14	$XXX.XX	Q1	5671
0565T	Autol cell implt adps hrvg	$XXX.XX	Q1	5733
0566T	Autol cell implt adps njx	$XXX.XX	T	5441
0571T	Insj/rplcmt icds ss eltrd	$XXX.XX	J1	5232
0572T	Insertion ss dfb electrode	$XXX.XX	J1	5222
0573T	Removal ss dfb electrode	$XXX.XX	Q2	5221
0574T	Repos prev ss impl dfb eltrd	$XXX.XX	Q2	5221
0575T	Prgrmg dev eval icds ss ip	$XXX.XX	Q1	5741
0576T	Interrog dev eval icds ss ip	$XXX.XX	Q1	5741
0577T	Ephys eval icds ss	$XXX.XX	J1	5211
0579T	Rem interrog dev icds tech	$XXX.XX	Q1	5741
0580T	Rmvl ss impl dfb pg only	$XXX.XX	Q2	5221
0587T	Perq impltj/rplcmt isdns ptn	$XXX.XX	T	5442
0588T	Revision/removal isdns ptn	$XXX.XX	T	5441
0589T	Elec alys smpl prgrmg iins	$XXX.XX	S	5742
0590T	Elec alys cplx prgrmg iins	$XXX.XX	S	5742
10005	Fna bx w/us gdn 1st les	$XXX.XX	T	5071
10007	Fna bx w/fluor gdn 1st les	$XXX.XX	T	5071
10009	Fna bx w/ct gdn 1st les	$XXX.XX	T	5071
10011	Fna bx w/mr gdn 1st les	$XXX.XX	T	5071
10021	Fna bx w/o img gdn 1st les	$XXX.XX	T	5052
10030	Guide cathet fluid drainage	$XXX.XX	T	5071
10035	Perq dev soft tiss 1st imag	$XXX.XX	T	5071
10040	Acne surgery	$XXX.XX	Q1	5051
10060	Drainage of skin abscess	$XXX.XX	T	5051
10061	Drainage of skin abscess	$XXX.XX	T	5052
10080	Drainage of pilonidal cyst	$XXX.XX	T	5071
10081	Drainage of pilonidal cyst	$XXX.XX	T	5071
10120	Remove foreign body	$XXX.XX	T	5052
10121	Remove foreign body	$XXX.XX	J1	5072
10140	Drainage of hematoma/fluid	$XXX.XX	J1	5072
10160	Puncture drainage of lesion	$XXX.XX	T	5052
10180	Complex drainage wound	$XXX.XX	J1	5073
11000	Debride infected skin	$XXX.XX	T	5053
11010	Debride skin at fx site	$XXX.XX	T	5071
11011	Debride skin musc at fx site	$XXX.XX	T	5071
11012	Deb skin bone at fx site	$XXX.XX	J1	5073
11042	Deb subq tissue 20 sq cm/<	$XXX.XX	T	5052
11043	Deb musc/fascia 20 sq cm/<	$XXX.XX	T	5053
11044	Deb bone 20 sq cm/<	$XXX.XX	J1	5072
11055	Trim skin lesion	$XXX.XX	Q1	5051
11056	Trim skin lesions 2 to 4	$XXX.XX	Q1	5051
11057	Trim skin lesions over 4	$XXX.XX	T	5051
11102	Tangntl bx skin single les	$XXX.XX	T	5051
11104	Punch bx skin single lesion	$XXX.XX	T	5051
11106	Incal bx skn single les	$XXX.XX	T	5052
11200	Removal of skin tags	$XXX.XX	Q1	5051
11300	Shave skin lesion 0.5 cm/<	$XXX.XX	Q1	5051
11301	Shave skin lesion 0.6-1.0 cm	$XXX.XX	Q1	5051
11302	Shave skin lesion 1.1-2.0 cm	$XXX.XX	Q1	5051
11303	Shave skin lesion >2.0 cm	$XXX.XX	Q1	5052
11305	Shave skin lesion 0.5 cm/<	$XXX.XX	Q1	5051
11306	Shave skin lesion 0.6-1.0 cm	$XXX.XX	Q1	5051
11307	Shave skin lesion 1.1-2.0 cm	$XXX.XX	T	5051
11308	Shave skin lesion >2.0 cm	$XXX.XX	Q1	5052
11310	Shave skin lesion 0.5 cm/<	$XXX.XX	T	5051
11311	Shave skin lesion 0.6-1.0 cm	$XXX.XX	T	5051
11312	Shave skin lesion 1.1-2.0 cm	$XXX.XX	T	5052
11313	Shave skin lesion >2.0 cm	$XXX.XX	T	5052
11400	Exc tr-ext b9+marg 0.5 cm<	$XXX.XX	T	5071
11401	Exc tr-ext b9+marg 0.6-1 cm	$XXX.XX	T	5052
11402	Exc tr-ext b9+marg 1.1-2 cm	$XXX.XX	T	5071
11403	Exc tr-ext b9+marg 2.1-3cm	$XXX.XX	T	5071
11404	Exc tr-ext b9+marg 3.1-4 cm	$XXX.XX	J1	5072
11406	Exc tr-ext b9+marg >4.0 cm	$XXX.XX	J1	5072
11420	Exc h-f-nk-sp b9+marg 0.5/<	$XXX.XX	J1	5072
11421	Exc h-f-nk-sp b9+marg 0.6-1	$XXX.XX	T	5071
11422	Exc h-f-nk-sp b9+marg 1.1-2	$XXX.XX	J1	5072
11423	Exc h-f-nk-sp b9+marg 2.1-3	$XXX.XX	J1	5072
11424	Exc h-f-nk-sp b9+marg 3.1-4	$XXX.XX	J1	5072
11426	Exc h-f-nk-sp b9+marg >4 cm	$XXX.XX	J1	5073
11440	Exc face-mm b9+marg 0.5 cm/<	$XXX.XX	T	5071
11441	Exc face-mm b9+marg 0.6-1 cm	$XXX.XX	T	5071
11442	Exc face-mm b9+marg 1.1-2 cm	$XXX.XX	T	5071
11443	Exc face-mm b9+marg 2.1-3 cm	$XXX.XX	J1	5072
11444	Exc face-mm b9+marg 3.1-4 cm	$XXX.XX	J1	5072
11446	Exc face-mm b9+marg >4 cm	$XXX.XX	J1	5073
11450	Removal sweat gland lesion	$XXX.XX	J1	5073
11451	Removal sweat gland lesion	$XXX.XX	J1	5073
11462	Removal sweat gland lesion	$XXX.XX	J1	5073
11463	Removal sweat gland lesion	$XXX.XX	J1	5073
11470	Removal sweat gland lesion	$XXX.XX	J1	5073
11471	Removal sweat gland lesion	$XXX.XX	J1	5073
11600	Exc tr-ext mal+marg 0.5 cm/<	$XXX.XX	T	5071
11601	Exc tr-ext mal+marg 0.6-1 cm	$XXX.XX	T	5071
11602	Exc tr-ext mal+marg 1.1-2 cm	$XXX.XX	T	5052
11603	Exc tr-ext mal+marg 2.1-3 cm	$XXX.XX	T	5071
11604	Exc tr-ext mal+marg 3.1-4 cm	$XXX.XX	T	5071
11606	Exc tr-ext mal+marg >4 cm	$XXX.XX	J1	5072
11620	Exc h-f-nk-sp mal+marg 0.5/<	$XXX.XX	J1	5072
11621	Exc s/n/h/f/g mal+mrg 0.6-1	$XXX.XX	T	5071
11622	Exc s/n/h/f/g mal+mrg 1.1-2	$XXX.XX	T	5071
11623	Exc s/n/h/f/g mal+mrg 2.1-3	$XXX.XX	J1	5072
11624	Exc s/n/h/f/g mal+mrg 3.1-4	$XXX.XX	J1	5072
11626	Exc s/n/h/f/g mal+mrg >4 cm	$XXX.XX	J1	5073
11640	Exc f/e/e/n/l mal+mrg 0.5cm<	$XXX.XX	T	5071
11641	Exc f/e/e/n/l mal+mrg 0.6-1	$XXX.XX	T	5071
11642	Exc f/e/e/n/l mal+mrg 1.1-2	$XXX.XX	T	5071
11643	Exc f/e/e/n/l mal+mrg 2.1-3	$XXX.XX	J1	5072
11644	Exc f/e/e/n/l mal+mrg 3.1-4	$XXX.XX	J1	5072
11646	Exc f/e/e/n/l mal+mrg >4 cm	$XXX.XX	J1	5073
11719	Trim nail(s) any number	$XXX.XX	Q1	5733
11720	Debride nail 1-5	$XXX.XX	Q1	5733
11721	Debride nail 6 or more	$XXX.XX	Q1	5733
11730	Removal of nail plate	$XXX.XX	Q1	5051
11740	Drain blood from under nail	$XXX.XX	Q1	5734
11750	Removal of nail bed	$XXX.XX	T	5052
11755	Biopsy nail unit	$XXX.XX	T	5071
11760	Repair of nail bed	$XXX.XX	T	5053
11762	Reconstruction of nail bed	$XXX.XX	T	5054
11765	Excision of nail fold toe	$XXX.XX	Q1	5052
11770	Remove pilonidal cyst simple	$XXX.XX	J1	5073
11771	Remove pilonidal cyst exten	$XXX.XX	J1	5073
11772	Remove pilonidal cyst compl	$XXX.XX	J1	5073
11900	Inject skin lesions	$XXX.XX	Q1	5051
11901	Inject skin lesions >7	$XXX.XX	Q1	5051
11920	Correct skin color 6.0 cm/<	$XXX.XX	T	5053
11921	Correct skn color 6.1-20.0cm	$XXX.XX	T	5053
11950	Tx contour defects 1 cc/<	$XXX.XX	T	5051
11951	Tx contour defects 1.1-5.0cc	$XXX.XX	T	5053
11952	Tx contour defects 5.1-10cc	$XXX.XX	T	5053
11954	Tx contour defects >10.0 cc	$XXX.XX	T	5052
11960	Insert tissue expander(s)	$XXX.XX	T	5055
11970	Replace tissue expander	$XXX.XX	J1	5114
11971	Remove tissue expander(s)	$XXX.XX	Q2	5073
11976	Remove contraceptive capsule	$XXX.XX	Q2	5071
11980	Implant hormone pellet(s)	$XXX.XX	Q1	5735
11981	Insert drug implant device	$XXX.XX	Q1	5734
11982	Remove drug implant device	$XXX.XX	Q1	5735
11983	Remove/insert drug implant	$XXX.XX	Q1	5735
12001	Rpr s/n/ax/gen/trnk 2.5cm/<	$XXX.XX	Q1	5051
12002	Rpr s/n/ax/gen/trnk2.6-7.5cm	$XXX.XX	Q1	5051
12004	Rpr s/n/ax/gen/trk7.6-12.5cm	$XXX.XX	Q1	5051
12005	Rpr s/n/a/gen/trk12.6-20.0cm	$XXX.XX	Q1	5052
12006	Rpr s/n/a/gen/trk20.1-30.0cm	$XXX.XX	Q2	5052
12007	Rpr s/n/ax/gen/trnk >30.0 cm	$XXX.XX	T	5051
12011	Rpr f/e/e/n/l/m 2.5 cm/<	$XXX.XX	Q1	5051
12013	Rpr f/e/e/n/l/m 2.6-5.0 cm	$XXX.XX	Q1	5051
12014	Rpr f/e/e/n/l/m 5.1-7.5 cm	$XXX.XX	Q1	5051
12015	Rpr f/e/e/n/l/m 7.6-12.5 cm	$XXX.XX	Q1	5051
12016	Rpr fe/e/en/l/m 12.6-20.0 cm	$XXX.XX	Q1	5052
12017	Rpr fe/e/en/l/m 20.1-30.0 cm	$XXX.XX	Q1	5052
12018	Rpr f/e/e/n/l/m >30.0 cm	$XXX.XX	Q1	5051
12020	Closure of split wound	$XXX.XX	T	5053
12021	Closure of split wound	$XXX.XX	T	5052
12031	Intmd rpr s/a/t/ext 2.5 cm/<	$XXX.XX	T	5052
12032	Intmd rpr s/a/t/ext 2.6-7.5	$XXX.XX	T	5052
12034	Intmd rpr s/tr/ext 7.6-12.5	$XXX.XX	T	5052
12035	Intmd rpr s/a/t/ext 12.6-20	$XXX.XX	T	5052
12036	Intmd rpr s/a/t/ext 20.1-30	$XXX.XX	T	5053
12037	Intmd rpr s/tr/ext >30.0 cm	$XXX.XX	T	5054
12041	Intmd rpr n-hf/genit 2.5cm/<	$XXX.XX	Q2	5052
12042	Intmd rpr n-hf/genit2.6-7.5	$XXX.XX	T	5052
12044	Intmd rpr n-hf/genit7.6-12.5	$XXX.XX	T	5053
12045	Intmd rpr n-hf/genit12.6-20	$XXX.XX	T	5053
12046	Intmd rpr n-hf/genit20.1-30	$XXX.XX	T	5052
12047	Intmd rpr n-hf/genit >30.0cm	$XXX.XX	T	5054
12051	Intmd rpr face/mm 2.5 cm/<	$XXX.XX	T	5052
12052	Intmd rpr face/mm 2.6-5.0 cm	$XXX.XX	T	5052
12053	Intmd rpr face/mm 5.1-7.5 cm	$XXX.XX	T	5052
12054	Intmd rpr face/mm 7.6-12.5cm	$XXX.XX	Q2	5052
12055	Intmd rpr face/mm 12.6-20 cm	$XXX.XX	T	5052
12056	Intmd rpr face/mm 20.1-30.0	$XXX.XX	Q2	5052
12057	Intmd rpr face/mm >30.0 cm	$XXX.XX	T	5052
13100	Cmplx rpr trunk 1.1-2.5 cm	$XXX.XX	T	5053
13101	Cmplx rpr trunk 2.6-7.5 cm	$XXX.XX	T	5053
13120	Cmplx rpr s/a/l 1.1-2.5 cm	$XXX.XX	T	5053
13121	Cmplx rpr s/a/l 2.6-7.5 cm	$XXX.XX	T	5053
13131	Cmplx rpr f/c/c/m/n/ax/g/h/f	$XXX.XX	T	5052
13132	Cmplx rpr f/c/c/m/n/ax/g/h/f	$XXX.XX	T	5053
13151	Cmplx rpr e/n/e/l 1.1-2.5 cm	$XXX.XX	T	5053
13152	Cmplx rpr e/n/e/l 2.6-7.5 cm	$XXX.XX	T	5053
13160	Late closure of wound	$XXX.XX	T	5054
14000	Tis trnfr trunk 10 sq cm/<	$XXX.XX	T	5054
14001	Tis trnfr trunk 10.1-30sqcm	$XXX.XX	T	5054
14020	Tis trnfr s/a/l 10 sq cm/<	$XXX.XX	T	5054
14021	Tis trnfr s/a/l 10.1-30 sqcm	$XXX.XX	T	5054
14040	Tis trnfr f/c/c/m/n/a/g/h/f	$XXX.XX	T	5054
14041	Tis trnfr f/c/c/m/n/a/g/h/f	$XXX.XX	T	5054
14060	Tis trnfr e/n/e/l 10 sq cm/<	$XXX.XX	T	5054
14061	Tis trnfr e/n/e/l10.1-30sqcm	$XXX.XX	T	5054
14301	Tis trnfr any 30.1-60 sq cm	$XXX.XX	T	5055
14350	Filleted finger/toe flap	$XXX.XX	T	5054
15002	Wound prep trk/arm/leg	$XXX.XX	T	5054
15004	Wound prep f/n/hf/g	$XXX.XX	T	5053
15040	Harvest cultured skin graft	$XXX.XX	T	5054
15050	Skin pinch graft	$XXX.XX	T	5053
15100	Skin splt grft trnk/arm/leg	$XXX.XX	T	5054
15110	Epidrm autogrft trnk/arm/leg	$XXX.XX	T	5054
15115	Epidrm a-grft face/nck/hf/g	$XXX.XX	T	5054
15120	Skn splt a-grft fac/nck/hf/g	$XXX.XX	T	5055
15130	Derm autograft trnk/arm/leg	$XXX.XX	T	5054
15135	Derm autograft face/nck/hf/g	$XXX.XX	T	5055
15150	Cult skin grft t/arm/leg	$XXX.XX	T	5054
15155	Cult skin graft f/n/hf/g	$XXX.XX	T	5055
15200	Skin full graft trunk	$XXX.XX	T	5054
15220	Skin full graft sclp/arm/leg	$XXX.XX	T	5054
15240	Skin full grft face/genit/hf	$XXX.XX	T	5054
15260	Skin full graft een & lips	$XXX.XX	T	5054
15271	Skin sub graft trnk/arm/leg	$XXX.XX	T	5054
15273	Skin sub grft t/arm/lg child	$XXX.XX	T	5055
15275	Skin sub graft face/nk/hf/g	$XXX.XX	T	5054
15277	Skn sub grft f/n/hf/g child	$XXX.XX	T	5054
15570	Skin pedicle flap trunk	$XXX.XX	T	5054
15572	Skin pedicle flap arms/legs	$XXX.XX	T	5055
15574	Pedcle fh/ch/ch/m/n/ax/g/h/f	$XXX.XX	T	5054
15576	Pedicle e/n/e/l/ntroral	$XXX.XX	T	5054
15600	Delay flap trunk	$XXX.XX	T	5055
15610	Delay flap arms/legs	$XXX.XX	T	5054
15620	Delay flap f/c/c/n/ax/g/h/f	$XXX.XX	T	5054
15630	Delay flap eye/nos/ear/lip	$XXX.XX	T	5054
15650	Transfer skin pedicle flap	$XXX.XX	T	5054
15730	Mdfc flap w/prsrv vasc pedcl	$XXX.XX	T	5055
15731	Forehead flap w/vasc pedicle	$XXX.XX	T	5055
15733	Musc myoq/fscq flp h&n pedcl	$XXX.XX	T	5055
15734	Muscle-skin graft trunk	$XXX.XX	T	5055
15736	Muscle-skin graft arm	$XXX.XX	T	5054
15738	Muscle-skin graft leg	$XXX.XX	T	5055
15740	Island pedicle flap graft	$XXX.XX	T	5054
15750	Neurovascular pedicle flap	$XXX.XX	T	5055
15760	Composite skin graft	$XXX.XX	T	5054
15769	Grfg autol soft tiss dir exc	$XXX.XX	T	5055
15770	Derma-fat-fascia graft	$XXX.XX	T	5055
15771	Grfg autol fat lipo 50 cc/<	$XXX.XX	T	5055
15773	Grfg autol fat lipo 25 cc/<	$XXX.XX	T	5054
15775	Hair trnspl 1-15 punch grfts	$XXX.XX	T	5052
15776	Hair trnspl >15 punch grafts	$XXX.XX	T	5052
15780	Dermabrasion total face	$XXX.XX	J1	5073
15781	Dermabrasion segmental face	$XXX.XX	T	5071
15782	Dermabrasion other than face	$XXX.XX	J1	5073
15783	Dermabrasion suprfl any site	$XXX.XX	T	5052
15786	Abrasion lesion single	$XXX.XX	Q1	5051
15788	Chemical peel face epiderm	$XXX.XX	Q1	5051
15789	Chemical peel face dermal	$XXX.XX	T	5053
15792	Chemical peel nonfacial	$XXX.XX	Q1	5052
15793	Chemical peel nonfacial	$XXX.XX	Q1	5052
15819	Plastic surgery neck	$XXX.XX	T	5054
15820	Revision of lower eyelid	$XXX.XX	T	5054
15821	Revision of lower eyelid	$XXX.XX	T	5054
15822	Revision of upper eyelid	$XXX.XX	T	5054
15823	Revision of upper eyelid	$XXX.XX	T	5054
15824	Removal of forehead wrinkles	$XXX.XX	T	5054
15825	Removal of neck wrinkles	$XXX.XX	T	5055
15826	Removal of brow wrinkles	$XXX.XX	T	5055
15828	Removal of face wrinkles	$XXX.XX	T	5055
15829	Removal of skin wrinkles	$XXX.XX	T	5055
15830	Exc skin abd	$XXX.XX	J1	5092
15832	Excise excessive skin thigh	$XXX.XX	J1	5073
15833	Excise excessive skin leg	$XXX.XX	J1	5073
15834	Excise excessive skin hip	$XXX.XX	J1	5073
15835	Excise excessive skin buttck	$XXX.XX	J1	5073
15836	Excise excessive skin arm	$XXX.XX	J1	5073
15837	Excise excess skin arm/hand	$XXX.XX	J1	5073
15838	Excise excess skin fat pad	$XXX.XX	J1	5073
15839	Excise excess skin & tissue	$XXX.XX	J1	5073
15840	Nerve palsy fascial graft	$XXX.XX	T	5055
15841	Nerve palsy muscle graft	$XXX.XX	T	5055
15842	Nerve palsy microsurg graft	$XXX.XX	T	5054
15845	Skin and muscle repair face	$XXX.XX	T	5055
15850	Remove sutures same surgeon	$XXX.XX	T	5053
15851	Remove sutures diff surgeon	$XXX.XX	T	5054
15852	Dressing change not for burn	$XXX.XX	Q1	5053
15860	Test for blood flow in graft	$XXX.XX	Q1	5735
15876	Suction lipectomy head&neck	$XXX.XX	T	5055
15877	Suction lipectomy trunk	$XXX.XX	T	5055
15878	Suction lipectomy upr extrem	$XXX.XX	T	5054
15879	Suction lipectomy lwr extrem	$XXX.XX	T	5055
15920	Removal of tail bone ulcer	$XXX.XX	J1	5073
15922	Removal of tail bone ulcer	$XXX.XX	T	5055
15931	Remove sacrum pressure sore	$XXX.XX	J1	5073
15933	Remove sacrum pressure sore	$XXX.XX	J1	5073
15934	Remove sacrum pressure sore	$XXX.XX	T	5055
15935	Remove sacrum pressure sore	$XXX.XX	T	5055
15936	Remove sacrum pressure sore	$XXX.XX	T	5054
15937	Remove sacrum pressure sore	$XXX.XX	T	5054
15940	Remove hip pressure sore	$XXX.XX	J1	5073
15941	Remove hip pressure sore	$XXX.XX	J1	5073
15944	Remove hip pressure sore	$XXX.XX	T	5055
15945	Remove hip pressure sore	$XXX.XX	T	5054
15946	Remove hip pressure sore	$XXX.XX	T	5054
15950	Remove thigh pressure sore	$XXX.XX	J1	5072
15951	Remove thigh pressure sore	$XXX.XX	J1	5073
15952	Remove thigh pressure sore	$XXX.XX	T	5054
15953	Remove thigh pressure sore	$XXX.XX	T	5055
15956	Remove thigh pressure sore	$XXX.XX	T	5054
15958	Remove thigh pressure sore	$XXX.XX	T	5055
15999	Removal of pressure sore	$XXX.XX	T	5071
16000	Initial treatment of burn(s)	$XXX.XX	Q1	5051
16020	Dress/debrid p-thick burn s	$XXX.XX	Q1	5051
16025	Dress/debrid p-thick burn m	$XXX.XX	T	5051
16030	Dress/debrid p-thick burn l	$XXX.XX	T	5052
16035	Incision of burn scab initi	$XXX.XX	T	5052
17000	Destruct premalg lesion	$XXX.XX	Q1	5051
17004	Destroy premal lesions 15/>	$XXX.XX	T	5052
17106	Destruction of skin lesions	$XXX.XX	T	5052
17107	Destruction of skin lesions	$XXX.XX	T	5053
17108	Destruction of skin lesions	$XXX.XX	T	5054
17110	Destruct b9 lesion 1-14	$XXX.XX	Q1	5051
17111	Destruct lesion 15 or more	$XXX.XX	Q1	5051
17250	Chem caut of granltj tissue	$XXX.XX	Q1	5051
17260	Destruction of skin lesions	$XXX.XX	Q1	5051
17261	Destruction of skin lesions	$XXX.XX	Q1	5051
17262	Destruction of skin lesions	$XXX.XX	Q1	5051
17263	Destruction of skin lesions	$XXX.XX	Q1	5051
17264	Destruction of skin lesions	$XXX.XX	T	5052
17266	Destruction of skin lesions	$XXX.XX	T	5052
17270	Destruction of skin lesions	$XXX.XX	T	5051
17271	Destruction of skin lesions	$XXX.XX	T	5051
17272	Destruction of skin lesions	$XXX.XX	Q1	5051
17273	Destruction of skin lesions	$XXX.XX	T	5052
17274	Destruction of skin lesions	$XXX.XX	T	5052
17276	Destruction of skin lesions	$XXX.XX	T	5052
17280	Destruction of skin lesions	$XXX.XX	Q1	5051
17281	Destruction of skin lesions	$XXX.XX	T	5052
17282	Destruction of skin lesions	$XXX.XX	T	5052
17283	Destruction of skin lesions	$XXX.XX	T	5052
17284	Destruction of skin lesions	$XXX.XX	T	5053
17286	Destruction of skin lesions	$XXX.XX	T	5053
17311	Mohs 1 stage h/n/hf/g	$XXX.XX	T	5053
17313	Mohs 1 stage t/a/l	$XXX.XX	T	5053
17340	Cryotherapy of skin	$XXX.XX	Q1	5732
17360	Skin peel therapy	$XXX.XX	Q1	5051
17380	Hair removal by electrolysis	$XXX.XX	T	5053
17999	Skin tissue procedure	$XXX.XX	Q1	5051
19000	Drainage of breast lesion	$XXX.XX	T	5071
19020	Incision of breast lesion	$XXX.XX	J1	5072
19081	Bx breast 1st lesion strtctc	$XXX.XX	J1	5072
19083	Bx breast 1st lesion us imag	$XXX.XX	J1	5072
19085	Bx breast 1st lesion mr imag	$XXX.XX	J1	5072
19100	Bx breast percut w/o image	$XXX.XX	J1	5072
19101	Biopsy of breast open	$XXX.XX	J1	5091
19105	Cryosurg ablate fa each	$XXX.XX	J1	5091
19110	Nipple exploration	$XXX.XX	J1	5091
19112	Excise breast duct fistula	$XXX.XX	J1	5091
19120	Removal of breast lesion	$XXX.XX	J1	5091
19125	Excision breast lesion	$XXX.XX	J1	5091
19281	Perq device breast 1st imag	$XXX.XX	Q1	5071
19283	Perq dev breast 1st strtctc	$XXX.XX	Q1	5071
19285	Perq dev breast 1st us imag	$XXX.XX	Q1	5071
19287	Perq dev breast 1st mr guide	$XXX.XX	Q1	5071
19296	Place po breast cath for rad	$XXX.XX	J1	5093
19298	Place breast rad tube/caths	$XXX.XX	J1	5092
19300	Removal of breast tissue	$XXX.XX	J1	5091
19301	Partial mastectomy	$XXX.XX	J1	5091
19302	P-mastectomy w/ln removal	$XXX.XX	J1	5092
19303	Mast simple complete	$XXX.XX	J1	5092
19307	Mast mod rad	$XXX.XX	J1	5092
19316	Suspension of breast	$XXX.XX	J1	5092
19318	Reduction of large breast	$XXX.XX	J1	5092
19324	Enlarge breast	$XXX.XX	J1	5093
19325	Enlarge breast with implant	$XXX.XX	J1	5093
19328	Removal of breast implant	$XXX.XX	Q2	5091
19330	Removal of implant material	$XXX.XX	Q2	5091
19340	Immediate breast prosthesis	$XXX.XX	J1	5092
19342	Delayed breast prosthesis	$XXX.XX	J1	5093
19350	Breast reconstruction	$XXX.XX	J1	5091
19355	Correct inverted nipple(s)	$XXX.XX	J1	5091
19357	Breast reconstruction	$XXX.XX	J1	5094
19366	Breast reconstruction	$XXX.XX	J1	5092
19370	Surgery of breast capsule	$XXX.XX	J1	5091
19371	Removal of breast capsule	$XXX.XX	J1	5091
19380	Revise breast reconstruction	$XXX.XX	J1	5092
19396	Design custom breast implant	$XXX.XX	J1	5091
19499	Breast surgery procedure	$XXX.XX	J1	5091
20100	Explore wound neck	$XXX.XX	T	5162
20101	Explore wound chest	$XXX.XX	T	5054
20102	Explore wound abdomen	$XXX.XX	T	5054
20103	Explore wound extremity	$XXX.XX	T	5071
20150	Excise epiphyseal bar	$XXX.XX	J1	5113
20200	Muscle biopsy	$XXX.XX	J1	5072
20205	Deep muscle biopsy	$XXX.XX	J1	5073
20206	Needle biopsy muscle	$XXX.XX	J1	5072
20220	Bone biopsy trocar/needle	$XXX.XX	J1	5072
20225	Bone biopsy trocar/needle	$XXX.XX	J1	5072
20240	Bone biopsy open superficial	$XXX.XX	J1	5073
20245	Bone biopsy open deep	$XXX.XX	J1	5073
20250	Open bone biopsy	$XXX.XX	J1	5113
20251	Open bone biopsy	$XXX.XX	J1	5114
20500	Injection of sinus tract	$XXX.XX	J1	5163
20520	Removal of foreign body	$XXX.XX	J1	5072
20525	Removal of foreign body	$XXX.XX	J1	5073
20526	Ther injection carp tunnel	$XXX.XX	T	5441
20527	Inj dupuytren cord w/enzyme	$XXX.XX	T	5441
20550	Inj tendon sheath/ligament	$XXX.XX	T	5441
20551	Inj tendon origin/insertion	$XXX.XX	T	5441
20552	Inj trigger point 1/2 muscl	$XXX.XX	T	5441
20553	Inject trigger points 3/>	$XXX.XX	T	5441
20555	Place ndl musc/tis for rt	$XXX.XX	J1	5113
20560	Ndl insj w/o njx 1 or 2 musc	$XXX.XX	S	5731
20561	Ndl insj w/o njx 3+ musc	$XXX.XX	S	5731
20600	Drain/inj joint/bursa w/o us	$XXX.XX	T	5441
20604	Drain/inj joint/bursa w/us	$XXX.XX	T	5441
20605	Drain/inj joint/bursa w/o us	$XXX.XX	T	5441
20606	Drain/inj joint/bursa w/us	$XXX.XX	T	5442
20610	Drain/inj joint/bursa w/o us	$XXX.XX	T	5441
20611	Drain/inj joint/bursa w/us	$XXX.XX	T	5441
20612	Aspirate/inj ganglion cyst	$XXX.XX	T	5441
20615	Treatment of bone cyst	$XXX.XX	T	5071
20650	Insert and remove bone pin	$XXX.XX	J1	5113
20660	Apply rem fixation device	$XXX.XX	Q2	5112
20662	Application of pelvis brace	$XXX.XX	J1	5112
20663	Application of thigh brace	$XXX.XX	J1	5113
20665	Removal of fixation device	$XXX.XX	Q1	5735
20670	Removal of support implant	$XXX.XX	Q2	5072
20680	Removal of support implant	$XXX.XX	Q2	5073
20690	Apply bone fixation device	$XXX.XX	J1	5114
20692	Apply bone fixation device	$XXX.XX	J1	5115
20693	Adjust bone fixation device	$XXX.XX	J1	5114
20694	Remove bone fixation device	$XXX.XX	Q2	5112
20696	Comp multiplane ext fixation	$XXX.XX	J1	5116
20697	Comp ext fixate strut change	$XXX.XX	J1	5112
20822	Replantation digit complete	$XXX.XX	J1	5112
20900	Removal of bone for graft	$XXX.XX	J1	5114
20902	Removal of bone for graft	$XXX.XX	J1	5114
20910	Remove cartilage for graft	$XXX.XX	T	5053
20912	Remove cartilage for graft	$XXX.XX	T	5055
20920	Removal of fascia for graft	$XXX.XX	T	5054
20922	Removal of fascia for graft	$XXX.XX	T	5054
20924	Removal of tendon for graft	$XXX.XX	J1	5114
20950	Fluid pressure muscle	$XXX.XX	T	5071
20972	Bone/skin graft metatarsal	$XXX.XX	J1	5114
20973	Bone/skin graft great toe	$XXX.XX	J1	5114
20979	Us bone stimulation	$XXX.XX	Q1	5731
20982	Ablate bone tumor(s) perq	$XXX.XX	J1	5114
20983	Ablate bone tumor(s) perq	$XXX.XX	J1	5114
20999	Musculoskeletal surgery	$XXX.XX	T	5111
21010	Incision of jaw joint	$XXX.XX	J1	5164
21011	Exc face les sc <2 cm	$XXX.XX	J1	5072
21012	Exc face les sbq 2 cm/>	$XXX.XX	J1	5072
21013	Exc face tum deep < 2 cm	$XXX.XX	J1	5072
21014	Exc face tum deep 2 cm/>	$XXX.XX	J1	5073
21015	Resect face/scalp tum < 2 cm	$XXX.XX	J1	5073
21016	Resect face/scalp tum 2 cm/>	$XXX.XX	J1	5073
21025	Excision of bone lower jaw	$XXX.XX	J1	5165
21026	Excision of facial bone(s)	$XXX.XX	J1	5165
21029	Contour of face bone lesion	$XXX.XX	J1	5164
21030	Excise max/zygoma b9 tumor	$XXX.XX	J1	5165
21031	Remove exostosis mandible	$XXX.XX	J1	5164
21032	Remove exostosis maxilla	$XXX.XX	J1	5164
21034	Excise max/zygoma mal tumor	$XXX.XX	J1	5165
21040	Excise mandible lesion	$XXX.XX	J1	5164
21044	Removal of jaw bone lesion	$XXX.XX	J1	5165
21046	Remove mandible cyst complex	$XXX.XX	J1	5165
21047	Excise lwr jaw cyst w/repair	$XXX.XX	J1	5165
21048	Remove maxilla cyst complex	$XXX.XX	J1	5165
21049	Excis uppr jaw cyst w/repair	$XXX.XX	J1	5165
21050	Removal of jaw joint	$XXX.XX	J1	5165
21060	Remove jaw joint cartilage	$XXX.XX	J1	5165
21070	Remove coronoid process	$XXX.XX	J1	5165
21073	Mnpj of tmj w/anesth	$XXX.XX	J1	5163
21076	Prepare face/oral prosthesis	$XXX.XX	J1	5163
21077	Prepare face/oral prosthesis	$XXX.XX	J1	5165
21079	Prepare face/oral prosthesis	$XXX.XX	J1	5164
21080	Prepare face/oral prosthesis	$XXX.XX	J1	5164
21081	Prepare face/oral prosthesis	$XXX.XX	J1	5165
21082	Prepare face/oral prosthesis	$XXX.XX	J1	5164
21083	Prepare face/oral prosthesis	$XXX.XX	J1	5164
21084	Prepare face/oral prosthesis	$XXX.XX	J1	5164
21085	Prepare face/oral prosthesis	$XXX.XX	T	5161
21086	Prepare face/oral prosthesis	$XXX.XX	J1	5164
21087	Prepare face/oral prosthesis	$XXX.XX	J1	5165
21088	Prepare face/oral prosthesis	$XXX.XX	J1	5164
21089	Prepare face/oral prosthesis	$XXX.XX	T	5161
21100	Maxillofacial fixation	$XXX.XX	J1	5165
21110	Interdental fixation	$XXX.XX	Q2	5163
21120	Reconstruction of chin	$XXX.XX	J1	5165
21121	Reconstruction of chin	$XXX.XX	J1	5164
21122	Reconstruction of chin	$XXX.XX	J1	5165
21123	Reconstruction of chin	$XXX.XX	J1	5164
21125	Augmentation lower jaw bone	$XXX.XX	J1	5165
21127	Augmentation lower jaw bone	$XXX.XX	J1	5165
21137	Reduction of forehead	$XXX.XX	J1	5164
21138	Reduction of forehead	$XXX.XX	J1	5165
21139	Reduction of forehead	$XXX.XX	J1	5165
21150	Lefort ii anterior intrusion	$XXX.XX	J1	5165
21172	Reconstruct orbit/forehead	$XXX.XX	J1	5165
21175	Reconstruct orbit/forehead	$XXX.XX	J1	5165
21181	Contour cranial bone lesion	$XXX.XX	J1	5165
21193	Reconst lwr jaw w/o graft	$XXX.XX	J1	5165
21195	Reconst lwr jaw w/o fixation	$XXX.XX	J1	5165
21198	Reconstr lwr jaw segment	$XXX.XX	J1	5165
21199	Reconstr lwr jaw w/advance	$XXX.XX	J1	5165
21206	Reconstruct upper jaw bone	$XXX.XX	J1	5165
21208	Augmentation of facial bones	$XXX.XX	J1	5165
21209	Reduction of facial bones	$XXX.XX	J1	5165
21210	Face bone graft	$XXX.XX	J1	5165
21215	Lower jaw bone graft	$XXX.XX	J1	5165
21230	Rib cartilage graft	$XXX.XX	J1	5165
21235	Ear cartilage graft	$XXX.XX	J1	5165
21240	Reconstruction of jaw joint	$XXX.XX	J1	5165
21242	Reconstruction of jaw joint	$XXX.XX	J1	5165
21243	Reconstruction of jaw joint	$XXX.XX	J1	5116
21244	Reconstruction of lower jaw	$XXX.XX	J1	5165
21245	Reconstruction of jaw	$XXX.XX	J1	5165
21246	Reconstruction of jaw	$XXX.XX	J1	5165
21248	Reconstruction of jaw	$XXX.XX	J1	5165
21249	Reconstruction of jaw	$XXX.XX	J1	5165
21256	Reconstruction of orbit	$XXX.XX	J1	5165
21260	Revise eye sockets	$XXX.XX	J1	5165
21261	Revise eye sockets	$XXX.XX	J1	5165
21263	Revise eye sockets	$XXX.XX	J1	5165
21267	Revise eye sockets	$XXX.XX	J1	5165
21270	Augmentation cheek bone	$XXX.XX	J1	5165
21275	Revision orbitofacial bones	$XXX.XX	J1	5165
21280	Revision of eyelid	$XXX.XX	J1	5164
21282	Revision of eyelid	$XXX.XX	J1	5164
21295	Revision of jaw muscle/bone	$XXX.XX	J1	5163
21296	Revision of jaw muscle/bone	$XXX.XX	J1	5164
21299	Cranio/maxillofacial surgery	$XXX.XX	T	5161
21310	Closed tx nose fx w/o manj	$XXX.XX	T	5111
21315	Closed tx nose fx w/o stablj	$XXX.XX	J1	5163
21320	Closed tx nose fx w/ stablj	$XXX.XX	J1	5164
21325	Open tx nose fx uncomplicatd	$XXX.XX	J1	5164
21330	Open tx nose fx w/skele fixj	$XXX.XX	J1	5165
21335	Open tx nose & septal fx	$XXX.XX	J1	5164
21336	Open tx septal fx w/wo stabj	$XXX.XX	J1	5113
21337	Closed tx septal&nose fx	$XXX.XX	J1	5164
21338	Open nasoethmoid fx w/o fixj	$XXX.XX	J1	5165
21339	Open nasoethmoid fx w/ fixj	$XXX.XX	J1	5165
21340	Perq tx nasoethmoid fx	$XXX.XX	J1	5164
21345	Closed tx nose/jaw fx	$XXX.XX	J1	5163
21346	Opn tx nasomax fx w/fixj	$XXX.XX	J1	5165
21355	Perq tx malar fracture	$XXX.XX	J1	5164
21356	Opn tx dprsd zygomatic arch	$XXX.XX	J1	5165
21360	Opn tx dprsd malar fracture	$XXX.XX	J1	5165
21365	Opn tx complx malar fx	$XXX.XX	J1	5165
21385	Opn tx orbit fx transantral	$XXX.XX	J1	5165
21386	Opn tx orbit fx periorbital	$XXX.XX	J1	5165
21387	Opn tx orbit fx combined	$XXX.XX	J1	5165
21390	Opn tx orbit periorbtl implt	$XXX.XX	J1	5165
21395	Opn tx orbit periorbt w/grft	$XXX.XX	J1	5165
21400	Closed tx orbit w/o manipulj	$XXX.XX	T	5162
21401	Closed tx orbit w/manipulj	$XXX.XX	J1	5163
21406	Opn tx orbit fx w/o implant	$XXX.XX	J1	5165
21407	Opn tx orbit fx w/implant	$XXX.XX	J1	5165
21408	Opn tx orbit fx w/bone grft	$XXX.XX	J1	5165
21421	Treat mouth roof fracture	$XXX.XX	J1	5164
21440	Treat dental ridge fracture	$XXX.XX	J1	5164
21445	Treat dental ridge fracture	$XXX.XX	J1	5165
21450	Treat lower jaw fracture	$XXX.XX	T	5162
21451	Treat lower jaw fracture	$XXX.XX	J1	5163
21452	Treat lower jaw fracture	$XXX.XX	J1	5165
21453	Treat lower jaw fracture	$XXX.XX	J1	5165
21454	Treat lower jaw fracture	$XXX.XX	J1	5165
21461	Treat lower jaw fracture	$XXX.XX	J1	5165
21462	Treat lower jaw fracture	$XXX.XX	J1	5165
21465	Treat lower jaw fracture	$XXX.XX	J1	5165
21470	Treat lower jaw fracture	$XXX.XX	J1	5165
21480	Reset dislocated jaw	$XXX.XX	T	5111
21485	Reset dislocated jaw	$XXX.XX	J1	5163
21490	Repair dislocated jaw	$XXX.XX	J1	5164
21497	Interdental wiring	$XXX.XX	J1	5163
21499	Head surgery procedure	$XXX.XX	T	5161
21501	Drain neck/chest lesion	$XXX.XX	J1	5073
21502	Drain chest lesion	$XXX.XX	J1	5113
21550	Biopsy of neck/chest	$XXX.XX	J1	5072
21552	Exc neck les sc 3 cm/>	$XXX.XX	J1	5073
21554	Exc neck tum deep 5 cm/>	$XXX.XX	J1	5073
21555	Exc neck les sc < 3 cm	$XXX.XX	J1	5072
21556	Exc neck tum deep < 5 cm	$XXX.XX	J1	5073
21557	Resect neck thorax tumor<5cm	$XXX.XX	J1	5073
21558	Resect neck tumor 5 cm/>	$XXX.XX	J1	5073
21600	Partial removal of rib	$XXX.XX	J1	5114
21601	Exc chest wall tumor w/ribs	$XXX.XX	J1	5073
21610	Partial removal of rib	$XXX.XX	J1	5113
21685	Hyoid myotomy & suspension	$XXX.XX	J1	5165
21700	Revision of neck muscle	$XXX.XX	J1	5114
21720	Revision of neck muscle	$XXX.XX	J1	5113
21725	Revision of neck muscle	$XXX.XX	T	5071
21742	Repair stern/nuss w/o scope	$XXX.XX	J1	5113
21743	Repair sternum/nuss w/scope	$XXX.XX	J1	5113
21811	Optx of rib fx w/fixj scope	$XXX.XX	J1	5114
21812	Treatment of rib fracture	$XXX.XX	J1	5114
21813	Treatment of rib fracture	$XXX.XX	J1	5112
21820	Treat sternum fracture	$XXX.XX	T	5111
21899	Neck/chest surgery procedure	$XXX.XX	T	5161
21920	Biopsy soft tissue of back	$XXX.XX	J1	5072
21925	Biopsy soft tissue of back	$XXX.XX	J1	5072
21930	Exc back les sc < 3 cm	$XXX.XX	J1	5072
21931	Exc back les sc 3 cm/>	$XXX.XX	J1	5072
21932	Exc back tum deep < 5 cm	$XXX.XX	J1	5073
21933	Exc back tum deep 5 cm/>	$XXX.XX	J1	5073
21935	Resect back tum < 5 cm	$XXX.XX	J1	5073
21936	Resect back tum 5 cm/>	$XXX.XX	J1	5073
22100	Remove part of neck vertebra	$XXX.XX	J1	5114
22101	Remove part thorax vertebra	$XXX.XX	J1	5114
22102	Remove part lumbar vertebra	$XXX.XX	J1	5114
22310	Closed tx vert fx w/o manj	$XXX.XX	T	5111
22315	Closed tx vert fx w/manj	$XXX.XX	J1	5113
22505	Manipulation of spine	$XXX.XX	J1	5112
22510	Perq cervicothoracic inject	$XXX.XX	J1	5113
22511	Perq lumbosacral injection	$XXX.XX	J1	5113
22513	Perq vertebral augmentation	$XXX.XX	J1	5114
22514	Perq vertebral augmentation	$XXX.XX	J1	5114
22551	Neck spine fuse&remov bel c2	$XXX.XX	J1	5115
22554	Neck spine fusion	$XXX.XX	J1	5115
22612	Lumbar spine fusion	$XXX.XX	J1	5115
22633	Lumbar spine fusion combined	$XXX.XX	J1	5115
22856	Cerv artific diskectomy	$XXX.XX	J1	5116
22867	Insj stablj dev w/dcmprn	$XXX.XX	J1	5116
22869	Insj stablj dev w/o dcmprn	$XXX.XX	J1	5115
22899	Spine surgery procedure	$XXX.XX	T	5111
22900	Exc abdl tum deep < 5 cm	$XXX.XX	J1	5073
22901	Exc abdl tum deep 5 cm/>	$XXX.XX	J1	5073
22902	Exc abd les sc < 3 cm	$XXX.XX	J1	5072
22903	Exc abd les sc 3 cm/>	$XXX.XX	J1	5073
22904	Radical resect abd tumor<5cm	$XXX.XX	J1	5073
22905	Rad resect abd tumor 5 cm/>	$XXX.XX	J1	5073
22999	Abdomen surgery procedure	$XXX.XX	T	5111
23000	Removal of calcium deposits	$XXX.XX	J1	5073
23020	Release shoulder joint	$XXX.XX	J1	5113
23030	Drain shoulder lesion	$XXX.XX	J1	5073
23031	Drain shoulder bursa	$XXX.XX	J1	5073
23035	Drain shoulder bone lesion	$XXX.XX	J1	5112
23040	Exploratory shoulder surgery	$XXX.XX	J1	5113
23044	Exploratory shoulder surgery	$XXX.XX	J1	5113
23065	Biopsy shoulder tissues	$XXX.XX	J1	5072
23066	Biopsy shoulder tissues	$XXX.XX	J1	5073
23071	Exc shoulder les sc 3 cm/>	$XXX.XX	J1	5072
23073	Exc shoulder tum deep 5 cm/>	$XXX.XX	J1	5073
23075	Exc shoulder les sc < 3 cm	$XXX.XX	J1	5072
23076	Exc shoulder tum deep < 5 cm	$XXX.XX	J1	5073
23077	Resect shoulder tumor < 5 cm	$XXX.XX	J1	5073
23078	Resect shoulder tumor 5 cm/>	$XXX.XX	J1	5073
23100	Biopsy of shoulder joint	$XXX.XX	J1	5113
23101	Shoulder joint surgery	$XXX.XX	J1	5113
23105	Remove shoulder joint lining	$XXX.XX	J1	5114
23106	Incision of collarbone joint	$XXX.XX	J1	5113
23107	Explore treat shoulder joint	$XXX.XX	J1	5114
23120	Partial removal collar bone	$XXX.XX	J1	5113
23125	Removal of collar bone	$XXX.XX	J1	5113
23130	Remove shoulder bone part	$XXX.XX	J1	5113
23140	Removal of bone lesion	$XXX.XX	J1	5113
23145	Removal of bone lesion	$XXX.XX	J1	5113
23146	Removal of bone lesion	$XXX.XX	J1	5114
23150	Removal of humerus lesion	$XXX.XX	J1	5113
23155	Removal of humerus lesion	$XXX.XX	J1	5114
23156	Removal of humerus lesion	$XXX.XX	J1	5114
23170	Remove collar bone lesion	$XXX.XX	J1	5113
23172	Remove shoulder blade lesion	$XXX.XX	J1	5113
23174	Remove humerus lesion	$XXX.XX	J1	5114
23180	Remove collar bone lesion	$XXX.XX	J1	5114
23182	Remove shoulder blade lesion	$XXX.XX	J1	5114
23184	Remove humerus lesion	$XXX.XX	J1	5114
23190	Partial removal of scapula	$XXX.XX	J1	5113
23195	Removal of head of humerus	$XXX.XX	J1	5114
23330	Remove shoulder foreign body	$XXX.XX	T	5071
23333	Remove shoulder fb deep	$XXX.XX	J1	5073
23334	Shoulder prosthesis removal	$XXX.XX	J1	5073
23395	Muscle transfer shoulder/arm	$XXX.XX	J1	5114
23397	Muscle transfers	$XXX.XX	J1	5114
23400	Fixation of shoulder blade	$XXX.XX	J1	5114
23405	Incision of tendon & muscle	$XXX.XX	J1	5114
23406	Incise tendon(s) & muscle(s)	$XXX.XX	J1	5114
23410	Repair rotator cuff acute	$XXX.XX	J1	5114
23412	Repair rotator cuff chronic	$XXX.XX	J1	5114
23415	Release of shoulder ligament	$XXX.XX	J1	5114
23420	Repair of shoulder	$XXX.XX	J1	5114
23430	Repair biceps tendon	$XXX.XX	J1	5114
23440	Remove/transplant tendon	$XXX.XX	J1	5114
23450	Repair shoulder capsule	$XXX.XX	J1	5114
23455	Repair shoulder capsule	$XXX.XX	J1	5114
23460	Repair shoulder capsule	$XXX.XX	J1	5114
23462	Repair shoulder capsule	$XXX.XX	J1	5114
23465	Repair shoulder capsule	$XXX.XX	J1	5114
23466	Repair shoulder capsule	$XXX.XX	J1	5114
23470	Reconstruct shoulder joint	$XXX.XX	J1	5115
23473	Revis reconst shoulder joint	$XXX.XX	J1	5115
23480	Revision of collar bone	$XXX.XX	J1	5114
23485	Revision of collar bone	$XXX.XX	J1	5115
23490	Reinforce clavicle	$XXX.XX	J1	5114
23491	Reinforce shoulder bones	$XXX.XX	J1	5115
23500	Treat clavicle fracture	$XXX.XX	T	5111
23505	Treat clavicle fracture	$XXX.XX	J1	5112
23515	Treat clavicle fracture	$XXX.XX	J1	5114
23520	Treat clavicle dislocation	$XXX.XX	J1	5112
23525	Treat clavicle dislocation	$XXX.XX	T	5111
23530	Treat clavicle dislocation	$XXX.XX	J1	5114
23532	Treat clavicle dislocation	$XXX.XX	J1	5114
23540	Treat clavicle dislocation	$XXX.XX	T	5111
23545	Treat clavicle dislocation	$XXX.XX	T	5111
23550	Treat clavicle dislocation	$XXX.XX	J1	5114
23552	Treat clavicle dislocation	$XXX.XX	J1	5114
23570	Treat shoulder blade fx	$XXX.XX	T	5111
23575	Treat shoulder blade fx	$XXX.XX	J1	5112
23585	Treat scapula fracture	$XXX.XX	J1	5114
23600	Treat humerus fracture	$XXX.XX	T	5111
23605	Treat humerus fracture	$XXX.XX	J1	5112
23615	Treat humerus fracture	$XXX.XX	J1	5115
23616	Treat humerus fracture	$XXX.XX	J1	5116
23620	Treat humerus fracture	$XXX.XX	T	5111
23625	Treat humerus fracture	$XXX.XX	J1	5112
23630	Treat humerus fracture	$XXX.XX	J1	5114
23650	Treat shoulder dislocation	$XXX.XX	T	5111
23655	Treat shoulder dislocation	$XXX.XX	J1	5112
23660	Treat shoulder dislocation	$XXX.XX	J1	5114
23665	Treat dislocation/fracture	$XXX.XX	J1	5112
23670	Treat dislocation/fracture	$XXX.XX	J1	5114
23675	Treat dislocation/fracture	$XXX.XX	J1	5112
23680	Treat dislocation/fracture	$XXX.XX	J1	5115
23700	Fixation of shoulder	$XXX.XX	J1	5112
23800	Fusion of shoulder joint	$XXX.XX	J1	5114
23802	Fusion of shoulder joint	$XXX.XX	J1	5115
23921	Amputation follow-up surgery	$XXX.XX	T	5054
23929	Shoulder surgery procedure	$XXX.XX	T	5111
23930	Drainage of arm lesion	$XXX.XX	J1	5073
23931	Drainage of arm bursa	$XXX.XX	J1	5072
23935	Drain arm/elbow bone lesion	$XXX.XX	J1	5113
24000	Exploratory elbow surgery	$XXX.XX	J1	5113
24006	Release elbow joint	$XXX.XX	J1	5113
24065	Biopsy arm/elbow soft tissue	$XXX.XX	J1	5072
24066	Biopsy arm/elbow soft tissue	$XXX.XX	J1	5073
24071	Exc arm/elbow les sc 3 cm/>	$XXX.XX	J1	5073
24073	Ex arm/elbow tum deep 5 cm/>	$XXX.XX	J1	5073
24075	Exc arm/elbow les sc < 3 cm	$XXX.XX	J1	5072
24076	Ex arm/elbow tum deep < 5 cm	$XXX.XX	J1	5073
24077	Resect arm/elbow tum < 5 cm	$XXX.XX	J1	5073
24079	Resect arm/elbow tum 5 cm/>	$XXX.XX	J1	5073
24100	Biopsy elbow joint lining	$XXX.XX	J1	5113
24101	Explore/treat elbow joint	$XXX.XX	J1	5113
24102	Remove elbow joint lining	$XXX.XX	J1	5113
24105	Removal of elbow bursa	$XXX.XX	J1	5113
24110	Remove humerus lesion	$XXX.XX	J1	5113
24115	Remove/graft bone lesion	$XXX.XX	J1	5114
24116	Remove/graft bone lesion	$XXX.XX	J1	5114
24120	Remove elbow lesion	$XXX.XX	J1	5113
24125	Remove/graft bone lesion	$XXX.XX	J1	5113
24126	Remove/graft bone lesion	$XXX.XX	J1	5114
24130	Removal of head of radius	$XXX.XX	J1	5113
24134	Removal of arm bone lesion	$XXX.XX	J1	5114
24136	Remove radius bone lesion	$XXX.XX	J1	5113
24138	Remove elbow bone lesion	$XXX.XX	J1	5114
24140	Partial removal of arm bone	$XXX.XX	J1	5113
24145	Partial removal of radius	$XXX.XX	J1	5114
24147	Partial removal of elbow	$XXX.XX	J1	5113
24149	Radical resection of elbow	$XXX.XX	J1	5114
24150	Resect distal humerus tumor	$XXX.XX	J1	5114
24152	Resect radius tumor	$XXX.XX	J1	5114
24155	Removal of elbow joint	$XXX.XX	J1	5113
24160	Remove elbow joint implant	$XXX.XX	Q2	5113
24164	Remove radius head implant	$XXX.XX	Q2	5113
24200	Removal of arm foreign body	$XXX.XX	J1	5072
24201	Removal of arm foreign body	$XXX.XX	J1	5073
24300	Manipulate elbow w/anesth	$XXX.XX	J1	5112
24301	Muscle/tendon transfer	$XXX.XX	J1	5114
24305	Arm tendon lengthening	$XXX.XX	J1	5113
24310	Revision of arm tendon	$XXX.XX	J1	5113
24320	Repair of arm tendon	$XXX.XX	J1	5114
24330	Revision of arm muscles	$XXX.XX	J1	5114
24331	Revision of arm muscles	$XXX.XX	J1	5114
24332	Tenolysis triceps	$XXX.XX	J1	5113
24340	Repair of biceps tendon	$XXX.XX	J1	5114
24341	Repair arm tendon/muscle	$XXX.XX	J1	5114
24342	Repair of ruptured tendon	$XXX.XX	J1	5114
24343	Repr elbow lat ligmnt w/tiss	$XXX.XX	J1	5113
24344	Reconstruct elbow lat ligmnt	$XXX.XX	J1	5114
24345	Repr elbw med ligmnt w/tissu	$XXX.XX	J1	5114
24346	Reconstruct elbow med ligmnt	$XXX.XX	J1	5115
24357	Repair elbow perc	$XXX.XX	J1	5113
24358	Repair elbow w/deb open	$XXX.XX	J1	5113
24359	Repair elbow deb/attch open	$XXX.XX	J1	5113
24360	Reconstruct elbow joint	$XXX.XX	J1	5114
24361	Reconstruct elbow joint	$XXX.XX	J1	5116
24362	Reconstruct elbow joint	$XXX.XX	J1	5115
24363	Replace elbow joint	$XXX.XX	J1	5116
24365	Reconstruct head of radius	$XXX.XX	J1	5115
24366	Reconstruct head of radius	$XXX.XX	J1	5115
24370	Revise reconst elbow joint	$XXX.XX	J1	5115
24371	Revise reconst elbow joint	$XXX.XX	J1	5116
24400	Revision of humerus	$XXX.XX	J1	5114
24410	Revision of humerus	$XXX.XX	J1	5115
24420	Revision of humerus	$XXX.XX	J1	5114
24430	Repair of humerus	$XXX.XX	J1	5115
24435	Repair humerus with graft	$XXX.XX	J1	5115
24470	Revision of elbow joint	$XXX.XX	J1	5113
24495	Decompression of forearm	$XXX.XX	J1	5114
24498	Reinforce humerus	$XXX.XX	J1	5115
24500	Treat humerus fracture	$XXX.XX	T	5111
24505	Treat humerus fracture	$XXX.XX	J1	5112
24515	Treat humerus fracture	$XXX.XX	J1	5115
24516	Treat humerus fracture	$XXX.XX	J1	5115
24530	Treat humerus fracture	$XXX.XX	T	5111
24535	Treat humerus fracture	$XXX.XX	J1	5112
24538	Treat humerus fracture	$XXX.XX	J1	5114
24545	Treat humerus fracture	$XXX.XX	J1	5115
24546	Treat humerus fracture	$XXX.XX	J1	5116
24560	Treat humerus fracture	$XXX.XX	T	5111
24565	Treat humerus fracture	$XXX.XX	J1	5112
24566	Treat humerus fracture	$XXX.XX	J1	5112
24575	Treat humerus fracture	$XXX.XX	J1	5115
24576	Treat humerus fracture	$XXX.XX	T	5111
24577	Treat humerus fracture	$XXX.XX	J1	5112
24579	Treat humerus fracture	$XXX.XX	J1	5115
24582	Treat humerus fracture	$XXX.XX	J1	5114
24586	Treat elbow fracture	$XXX.XX	J1	5115
24587	Treat elbow fracture	$XXX.XX	J1	5115
24600	Treat elbow dislocation	$XXX.XX	T	5111
24605	Treat elbow dislocation	$XXX.XX	J1	5112
24615	Treat elbow dislocation	$XXX.XX	J1	5114
24620	Treat elbow fracture	$XXX.XX	J1	5112
24635	Treat elbow fracture	$XXX.XX	J1	5114
24640	Treat elbow dislocation	$XXX.XX	T	5111
24650	Treat radius fracture	$XXX.XX	T	5111
24655	Treat radius fracture	$XXX.XX	J1	5112
24665	Treat radius fracture	$XXX.XX	J1	5114
24666	Treat radius fracture	$XXX.XX	J1	5115
24670	Treat ulnar fracture	$XXX.XX	T	5111
24675	Treat ulnar fracture	$XXX.XX	J1	5112
24685	Treat ulnar fracture	$XXX.XX	J1	5114
24800	Fusion of elbow joint	$XXX.XX	J1	5114
24802	Fusion/graft of elbow joint	$XXX.XX	J1	5115
24925	Amputation follow-up surgery	$XXX.XX	J1	5113
24935	Revision of amputation	$XXX.XX	J1	5114
24999	Upper arm/elbow surgery	$XXX.XX	T	5111
25000	Incision of tendon sheath	$XXX.XX	J1	5112
25001	Incise flexor carpi radialis	$XXX.XX	J1	5113
25020	Decompress forearm 1 space	$XXX.XX	J1	5112
25023	Decompress forearm 1 space	$XXX.XX	J1	5113
25024	Decompress forearm 2 spaces	$XXX.XX	J1	5113
25025	Decompress forearm 2 spaces	$XXX.XX	J1	5112
25028	Drainage of forearm lesion	$XXX.XX	J1	5113
25031	Drainage of forearm bursa	$XXX.XX	J1	5112
25035	Treat forearm bone lesion	$XXX.XX	J1	5114
25040	Explore/treat wrist joint	$XXX.XX	J1	5113
25065	Biopsy forearm soft tissues	$XXX.XX	J1	5072
25066	Biopsy forearm soft tissues	$XXX.XX	J1	5073
25071	Exc forearm les sc 3 cm/>	$XXX.XX	J1	5072
25073	Exc forearm tum deep 3 cm/>	$XXX.XX	J1	5073
25075	Exc forearm les sc < 3 cm	$XXX.XX	J1	5072
25076	Exc forearm tum deep < 3 cm	$XXX.XX	J1	5072
25077	Resect forearm/wrist tum<3cm	$XXX.XX	J1	5073
25078	Resect forarm/wrist tum 3cm>	$XXX.XX	J1	5073
25085	Incision of wrist capsule	$XXX.XX	J1	5113
25100	Biopsy of wrist joint	$XXX.XX	J1	5113
25101	Explore/treat wrist joint	$XXX.XX	J1	5113
25105	Remove wrist joint lining	$XXX.XX	J1	5113
25107	Remove wrist joint cartilage	$XXX.XX	J1	5113
25109	Excise tendon forearm/wrist	$XXX.XX	J1	5113
25110	Remove wrist tendon lesion	$XXX.XX	J1	5112
25111	Remove wrist tendon lesion	$XXX.XX	J1	5112
25112	Reremove wrist tendon lesion	$XXX.XX	J1	5112
25115	Remove wrist/forearm lesion	$XXX.XX	J1	5112
25116	Remove wrist/forearm lesion	$XXX.XX	J1	5113
25118	Excise wrist tendon sheath	$XXX.XX	J1	5112
25119	Partial removal of ulna	$XXX.XX	J1	5113
25120	Removal of forearm lesion	$XXX.XX	J1	5113
25125	Remove/graft forearm lesion	$XXX.XX	J1	5112
25126	Remove/graft forearm lesion	$XXX.XX	J1	5113
25130	Removal of wrist lesion	$XXX.XX	J1	5113
25135	Remove & graft wrist lesion	$XXX.XX	J1	5114
25136	Remove & graft wrist lesion	$XXX.XX	J1	5114
25145	Remove forearm bone lesion	$XXX.XX	J1	5113
25150	Partial removal of ulna	$XXX.XX	J1	5113
25151	Partial removal of radius	$XXX.XX	J1	5113
25170	Resect radius/ulnar tumor	$XXX.XX	J1	5114
25210	Removal of wrist bone	$XXX.XX	J1	5113
25215	Removal of wrist bones	$XXX.XX	J1	5113
25230	Partial removal of radius	$XXX.XX	J1	5113
25240	Partial removal of ulna	$XXX.XX	J1	5113
25248	Remove forearm foreign body	$XXX.XX	J1	5112
25250	Removal of wrist prosthesis	$XXX.XX	Q2	5112
25251	Removal of wrist prosthesis	$XXX.XX	Q2	5113
25259	Manipulate wrist w/anesthes	$XXX.XX	J1	5112
25260	Repair forearm tendon/muscle	$XXX.XX	J1	5113
25263	Repair forearm tendon/muscle	$XXX.XX	J1	5114
25265	Repair forearm tendon/muscle	$XXX.XX	J1	5113
25270	Repair forearm tendon/muscle	$XXX.XX	J1	5113
25272	Repair forearm tendon/muscle	$XXX.XX	J1	5113
25274	Repair forearm tendon/muscle	$XXX.XX	J1	5113
25275	Repair forearm tendon sheath	$XXX.XX	J1	5113
25280	Revise wrist/forearm tendon	$XXX.XX	J1	5113
25290	Incise wrist/forearm tendon	$XXX.XX	J1	5113
25295	Release wrist/forearm tendon	$XXX.XX	J1	5113
25300	Fusion of tendons at wrist	$XXX.XX	J1	5113
25301	Fusion of tendons at wrist	$XXX.XX	J1	5113
25310	Transplant forearm tendon	$XXX.XX	J1	5113
25312	Transplant forearm tendon	$XXX.XX	J1	5113
25315	Revise palsy hand tendon(s)	$XXX.XX	J1	5114
25316	Revise palsy hand tendon(s)	$XXX.XX	J1	5114
25320	Repair/revise wrist joint	$XXX.XX	J1	5114
25332	Revise wrist joint	$XXX.XX	J1	5113
25335	Realignment of hand	$XXX.XX	J1	5113
25337	Reconstruct ulna/radioulnar	$XXX.XX	J1	5114
25350	Revision of radius	$XXX.XX	J1	5114
25355	Revision of radius	$XXX.XX	J1	5113
25360	Revision of ulna	$XXX.XX	J1	5114
25365	Revise radius & ulna	$XXX.XX	J1	5115
25370	Revise radius or ulna	$XXX.XX	J1	5113
25375	Revise radius & ulna	$XXX.XX	J1	5113
25390	Shorten radius or ulna	$XXX.XX	J1	5114
25391	Lengthen radius or ulna	$XXX.XX	J1	5115
25392	Shorten radius & ulna	$XXX.XX	J1	5114
25393	Lengthen radius & ulna	$XXX.XX	J1	5114
25394	Repair carpal bone shorten	$XXX.XX	J1	5113
25400	Repair radius or ulna	$XXX.XX	J1	5114
25405	Repair/graft radius or ulna	$XXX.XX	J1	5114
25415	Repair radius & ulna	$XXX.XX	J1	5114
25420	Repair/graft radius & ulna	$XXX.XX	J1	5114
25425	Repair/graft radius or ulna	$XXX.XX	J1	5114
25426	Repair/graft radius & ulna	$XXX.XX	J1	5113
25430	Vasc graft into carpal bone	$XXX.XX	J1	5113
25431	Repair nonunion carpal bone	$XXX.XX	J1	5114
25440	Repair/graft wrist bone	$XXX.XX	J1	5114
25441	Reconstruct wrist joint	$XXX.XX	J1	5115
25442	Reconstruct wrist joint	$XXX.XX	J1	5116
25443	Reconstruct wrist joint	$XXX.XX	J1	5114
25444	Reconstruct wrist joint	$XXX.XX	J1	5115
25445	Reconstruct wrist joint	$XXX.XX	J1	5114
25446	Wrist replacement	$XXX.XX	J1	5116
25447	Repair wrist joints	$XXX.XX	J1	5113
25449	Remove wrist joint implant	$XXX.XX	J1	5114
25450	Revision of wrist joint	$XXX.XX	J1	5113
25455	Revision of wrist joint	$XXX.XX	J1	5113
25490	Reinforce radius	$XXX.XX	J1	5114
25491	Reinforce ulna	$XXX.XX	J1	5115
25492	Reinforce radius and ulna	$XXX.XX	J1	5113
25500	Treat fracture of radius	$XXX.XX	T	5111
25505	Treat fracture of radius	$XXX.XX	J1	5112
25515	Treat fracture of radius	$XXX.XX	J1	5114
25520	Treat fracture of radius	$XXX.XX	J1	5112
25525	Treat fracture of radius	$XXX.XX	J1	5114
25526	Treat fracture of radius	$XXX.XX	J1	5114
25530	Treat fracture of ulna	$XXX.XX	T	5111
25535	Treat fracture of ulna	$XXX.XX	T	5111
25545	Treat fracture of ulna	$XXX.XX	J1	5114
25560	Treat fracture radius & ulna	$XXX.XX	T	5111
25565	Treat fracture radius & ulna	$XXX.XX	J1	5112
25574	Treat fracture radius & ulna	$XXX.XX	J1	5114
25575	Treat fracture radius/ulna	$XXX.XX	J1	5114
25600	Treat fracture radius/ulna	$XXX.XX	T	5111
25605	Treat fracture radius/ulna	$XXX.XX	J1	5112
25606	Treat fx distal radial	$XXX.XX	J1	5113
25607	Treat fx rad extra-articul	$XXX.XX	J1	5114
25608	Treat fx rad intra-articul	$XXX.XX	J1	5114
25609	Treat fx radial 3+ frag	$XXX.XX	J1	5114
25622	Treat wrist bone fracture	$XXX.XX	T	5111
25624	Treat wrist bone fracture	$XXX.XX	J1	5112
25628	Treat wrist bone fracture	$XXX.XX	J1	5114
25630	Treat wrist bone fracture	$XXX.XX	T	5111
25635	Treat wrist bone fracture	$XXX.XX	J1	5112
25645	Treat wrist bone fracture	$XXX.XX	J1	5113
25650	Treat wrist bone fracture	$XXX.XX	T	5111
25651	Pin ulnar styloid fracture	$XXX.XX	J1	5113
25652	Treat fracture ulnar styloid	$XXX.XX	J1	5114
25660	Treat wrist dislocation	$XXX.XX	T	5111
25670	Treat wrist dislocation	$XXX.XX	J1	5114
25671	Pin radioulnar dislocation	$XXX.XX	J1	5113
25675	Treat wrist dislocation	$XXX.XX	T	5111
25676	Treat wrist dislocation	$XXX.XX	J1	5114
25680	Treat wrist fracture	$XXX.XX	T	5111
25685	Treat wrist fracture	$XXX.XX	J1	5114
25690	Treat wrist dislocation	$XXX.XX	J1	5112
25695	Treat wrist dislocation	$XXX.XX	J1	5114
25800	Fusion of wrist joint	$XXX.XX	J1	5114
25805	Fusion/graft of wrist joint	$XXX.XX	J1	5114
25810	Fusion/graft of wrist joint	$XXX.XX	J1	5115
25820	Fusion of hand bones	$XXX.XX	J1	5114
25825	Fuse hand bones with graft	$XXX.XX	J1	5114
25830	Fusion radioulnar jnt/ulna	$XXX.XX	J1	5114
25907	Amputation follow-up surgery	$XXX.XX	J1	5113
25909	Amputation follow-up surgery	$XXX.XX	J1	5114
25922	Amputate hand at wrist	$XXX.XX	J1	5112
25929	Amputation follow-up surgery	$XXX.XX	T	5054
25931	Amputation follow-up surgery	$XXX.XX	J1	5113
25999	Forearm or wrist surgery	$XXX.XX	T	5111
26010	Drainage of finger abscess	$XXX.XX	T	5051
26011	Drainage of finger abscess	$XXX.XX	J1	5072
26020	Drain hand tendon sheath	$XXX.XX	J1	5113
26025	Drainage of palm bursa	$XXX.XX	J1	5113
26030	Drainage of palm bursas	$XXX.XX	J1	5113
26034	Treat hand bone lesion	$XXX.XX	J1	5112
26035	Decompress fingers/hand	$XXX.XX	J1	5113
26037	Decompress fingers/hand	$XXX.XX	J1	5113
26040	Release palm contracture	$XXX.XX	J1	5112
26045	Release palm contracture	$XXX.XX	J1	5113
26055	Incise finger tendon sheath	$XXX.XX	J1	5112
26060	Incision of finger tendon	$XXX.XX	J1	5112
26070	Explore/treat hand joint	$XXX.XX	J1	5112
26075	Explore/treat finger joint	$XXX.XX	J1	5113
26080	Explore/treat finger joint	$XXX.XX	J1	5112
26100	Biopsy hand joint lining	$XXX.XX	J1	5113
26105	Biopsy finger joint lining	$XXX.XX	J1	5113
26110	Biopsy finger joint lining	$XXX.XX	J1	5112
26111	Exc hand les sc 1.5 cm/>	$XXX.XX	J1	5072
26113	Exc hand tum deep 1.5 cm/>	$XXX.XX	J1	5072
26115	Exc hand les sc < 1.5 cm	$XXX.XX	J1	5072
26116	Exc hand tum deep < 1.5 cm	$XXX.XX	J1	5072
26117	Rad resect hand tumor < 3 cm	$XXX.XX	J1	5073
26118	Rad resect hand tumor 3 cm/>	$XXX.XX	J1	5073
26121	Release palm contracture	$XXX.XX	J1	5113
26123	Release palm contracture	$XXX.XX	J1	5113
26130	Remove wrist joint lining	$XXX.XX	J1	5113
26135	Revise finger joint each	$XXX.XX	J1	5113
26140	Revise finger joint each	$XXX.XX	J1	5112
26145	Tendon excision palm/finger	$XXX.XX	J1	5112
26160	Remove tendon sheath lesion	$XXX.XX	J1	5112
26170	Removal of palm tendon each	$XXX.XX	J1	5112
26180	Removal of finger tendon	$XXX.XX	J1	5112
26185	Remove finger bone	$XXX.XX	J1	5112
26200	Remove hand bone lesion	$XXX.XX	J1	5112
26205	Remove/graft bone lesion	$XXX.XX	J1	5114
26210	Removal of finger lesion	$XXX.XX	J1	5112
26215	Remove/graft finger lesion	$XXX.XX	J1	5113
26230	Partial removal of hand bone	$XXX.XX	J1	5113
26235	Partial removal finger bone	$XXX.XX	J1	5112
26236	Partial removal finger bone	$XXX.XX	J1	5112
26250	Extensive hand surgery	$XXX.XX	J1	5113
26260	Resect prox finger tumor	$XXX.XX	J1	5113
26262	Resect distal finger tumor	$XXX.XX	J1	5112
26320	Removal of implant from hand	$XXX.XX	Q2	5072
26340	Manipulate finger w/anesth	$XXX.XX	J1	5112
26341	Manipulat palm cord post inj	$XXX.XX	T	5111
26350	Repair finger/hand tendon	$XXX.XX	J1	5113
26352	Repair/graft hand tendon	$XXX.XX	J1	5114
26356	Repair finger/hand tendon	$XXX.XX	J1	5113
26357	Repair finger/hand tendon	$XXX.XX	J1	5113
26358	Repair/graft hand tendon	$XXX.XX	J1	5114
26370	Repair finger/hand tendon	$XXX.XX	J1	5113
26372	Repair/graft hand tendon	$XXX.XX	J1	5114
26373	Repair finger/hand tendon	$XXX.XX	J1	5113
26390	Revise hand/finger tendon	$XXX.XX	J1	5114
26392	Repair/graft hand tendon	$XXX.XX	J1	5114
26410	Repair hand tendon	$XXX.XX	J1	5112
26412	Repair/graft hand tendon	$XXX.XX	J1	5113
26415	Excision hand/finger tendon	$XXX.XX	J1	5113
26416	Graft hand or finger tendon	$XXX.XX	J1	5113
26418	Repair finger tendon	$XXX.XX	J1	5112
26420	Repair/graft finger tendon	$XXX.XX	J1	5113
26426	Repair finger/hand tendon	$XXX.XX	J1	5113
26428	Repair/graft finger tendon	$XXX.XX	J1	5113
26432	Repair finger tendon	$XXX.XX	J1	5112
26433	Repair finger tendon	$XXX.XX	J1	5113
26434	Repair/graft finger tendon	$XXX.XX	J1	5113
26437	Realignment of tendons	$XXX.XX	J1	5113
26440	Release palm/finger tendon	$XXX.XX	J1	5112
26442	Release palm & finger tendon	$XXX.XX	J1	5113
26445	Release hand/finger tendon	$XXX.XX	J1	5113
26449	Release forearm/hand tendon	$XXX.XX	J1	5113
26450	Incision of palm tendon	$XXX.XX	J1	5113
26455	Incision of finger tendon	$XXX.XX	J1	5112
26460	Incise hand/finger tendon	$XXX.XX	J1	5112
26471	Fusion of finger tendons	$XXX.XX	J1	5113
26474	Fusion of finger tendons	$XXX.XX	J1	5112
26476	Tendon lengthening	$XXX.XX	J1	5113
26477	Tendon shortening	$XXX.XX	J1	5113
26478	Lengthening of hand tendon	$XXX.XX	J1	5113
26479	Shortening of hand tendon	$XXX.XX	J1	5113
26480	Transplant hand tendon	$XXX.XX	J1	5113
26483	Transplant/graft hand tendon	$XXX.XX	J1	5113
26485	Transplant palm tendon	$XXX.XX	J1	5113
26489	Transplant/graft palm tendon	$XXX.XX	J1	5113
26490	Revise thumb tendon	$XXX.XX	J1	5113
26492	Tendon transfer with graft	$XXX.XX	J1	5113
26494	Hand tendon/muscle transfer	$XXX.XX	J1	5113
26496	Revise thumb tendon	$XXX.XX	J1	5113
26497	Finger tendon transfer	$XXX.XX	J1	5113
26498	Finger tendon transfer	$XXX.XX	J1	5113
26499	Revision of finger	$XXX.XX	J1	5113
26500	Hand tendon reconstruction	$XXX.XX	J1	5114
26502	Hand tendon reconstruction	$XXX.XX	J1	5113
26508	Release thumb contracture	$XXX.XX	J1	5113
26510	Thumb tendon transfer	$XXX.XX	J1	5113
26516	Fusion of knuckle joint	$XXX.XX	J1	5113
26517	Fusion of knuckle joints	$XXX.XX	J1	5113
26518	Fusion of knuckle joints	$XXX.XX	J1	5114
26520	Release knuckle contracture	$XXX.XX	J1	5113
26525	Release finger contracture	$XXX.XX	J1	5112
26530	Revise knuckle joint	$XXX.XX	J1	5114
26531	Revise knuckle with implant	$XXX.XX	J1	5114
26535	Revise finger joint	$XXX.XX	J1	5113
26536	Revise/implant finger joint	$XXX.XX	J1	5114
26540	Repair hand joint	$XXX.XX	J1	5113
26541	Repair hand joint with graft	$XXX.XX	J1	5113
26542	Repair hand joint with graft	$XXX.XX	J1	5113
26545	Reconstruct finger joint	$XXX.XX	J1	5113
26546	Repair nonunion hand	$XXX.XX	J1	5114
26548	Reconstruct finger joint	$XXX.XX	J1	5113
26550	Construct thumb replacement	$XXX.XX	J1	5113
26555	Positional change of finger	$XXX.XX	J1	5114
26560	Repair of web finger	$XXX.XX	J1	5112
26561	Repair of web finger	$XXX.XX	J1	5113
26562	Repair of web finger	$XXX.XX	J1	5113
26565	Correct metacarpal flaw	$XXX.XX	J1	5113
26567	Correct finger deformity	$XXX.XX	J1	5113
26568	Lengthen metacarpal/finger	$XXX.XX	J1	5114
26580	Repair hand deformity	$XXX.XX	J1	5113
26587	Reconstruct extra finger	$XXX.XX	J1	5113
26590	Repair finger deformity	$XXX.XX	J1	5112
26591	Repair muscles of hand	$XXX.XX	J1	5113
26593	Release muscles of hand	$XXX.XX	J1	5113
26596	Excision constricting tissue	$XXX.XX	J1	5113
26600	Treat metacarpal fracture	$XXX.XX	T	5111
26605	Treat metacarpal fracture	$XXX.XX	T	5111
26607	Treat metacarpal fracture	$XXX.XX	J1	5113
26608	Treat metacarpal fracture	$XXX.XX	J1	5113
26615	Treat metacarpal fracture	$XXX.XX	J1	5113
26641	Treat thumb dislocation	$XXX.XX	T	5111
26645	Treat thumb fracture	$XXX.XX	J1	5112
26650	Treat thumb fracture	$XXX.XX	J1	5113
26665	Treat thumb fracture	$XXX.XX	J1	5113
26670	Treat hand dislocation	$XXX.XX	T	5111
26675	Treat hand dislocation	$XXX.XX	J1	5112
26676	Pin hand dislocation	$XXX.XX	J1	5113
26685	Treat hand dislocation	$XXX.XX	J1	5113
26686	Treat hand dislocation	$XXX.XX	J1	5113
26700	Treat knuckle dislocation	$XXX.XX	T	5111
26705	Treat knuckle dislocation	$XXX.XX	J1	5112
26706	Pin knuckle dislocation	$XXX.XX	J1	5113
26715	Treat knuckle dislocation	$XXX.XX	J1	5113
26720	Treat finger fracture each	$XXX.XX	T	5111
26725	Treat finger fracture each	$XXX.XX	T	5111
26727	Treat finger fracture each	$XXX.XX	J1	5113
26735	Treat finger fracture each	$XXX.XX	J1	5113
26740	Treat finger fracture each	$XXX.XX	T	5111
26742	Treat finger fracture each	$XXX.XX	J1	5112
26746	Treat finger fracture each	$XXX.XX	J1	5113
26750	Treat finger fracture each	$XXX.XX	T	5111
26755	Treat finger fracture each	$XXX.XX	T	5111
26756	Pin finger fracture each	$XXX.XX	J1	5113
26765	Treat finger fracture each	$XXX.XX	J1	5113
26770	Treat finger dislocation	$XXX.XX	T	5111
26775	Treat finger dislocation	$XXX.XX	T	5102
26776	Pin finger dislocation	$XXX.XX	J1	5113
26785	Treat finger dislocation	$XXX.XX	J1	5113
26820	Thumb fusion with graft	$XXX.XX	J1	5114
26841	Fusion of thumb	$XXX.XX	J1	5114
26842	Thumb fusion with graft	$XXX.XX	J1	5114
26843	Fusion of hand joint	$XXX.XX	J1	5114
26844	Fusion/graft of hand joint	$XXX.XX	J1	5114
26850	Fusion of knuckle	$XXX.XX	J1	5114
26852	Fusion of knuckle with graft	$XXX.XX	J1	5114
26860	Fusion of finger joint	$XXX.XX	J1	5113
26862	Fusion/graft of finger joint	$XXX.XX	J1	5113
26910	Amputate metacarpal bone	$XXX.XX	J1	5113
26951	Amputation of finger/thumb	$XXX.XX	J1	5113
26952	Amputation of finger/thumb	$XXX.XX	J1	5113
26989	Hand/finger surgery	$XXX.XX	T	5111
26990	Drainage of pelvis lesion	$XXX.XX	J1	5113
26991	Drainage of pelvis bursa	$XXX.XX	J1	5112
27000	Incision of hip tendon	$XXX.XX	J1	5112
27001	Incision of hip tendon	$XXX.XX	J1	5113
27003	Incision of hip tendon	$XXX.XX	J1	5114
27006	Incision of hip tendons	$XXX.XX	J1	5113
27027	Buttock fasciotomy	$XXX.XX	J1	5114
27033	Exploration of hip joint	$XXX.XX	J1	5114
27035	Denervation of hip joint	$XXX.XX	J1	5113
27040	Biopsy of soft tissues	$XXX.XX	J1	5072
27041	Biopsy of soft tissues	$XXX.XX	J1	5072
27043	Exc hip pelvis les sc 3 cm/>	$XXX.XX	J1	5073
27045	Exc hip/pelv tum deep 5 cm/>	$XXX.XX	J1	5073
27047	Exc hip/pelvis les sc < 3 cm	$XXX.XX	J1	5073
27048	Exc hip/pelv tum deep < 5 cm	$XXX.XX	J1	5073
27049	Resect hip/pelv tum < 5 cm	$XXX.XX	J1	5073
27050	Biopsy of sacroiliac joint	$XXX.XX	J1	5112
27052	Biopsy of hip joint	$XXX.XX	J1	5112
27057	Buttock fasciotomy w/dbrdmt	$XXX.XX	J1	5112
27059	Resect hip/pelv tum 5 cm/>	$XXX.XX	J1	5073
27060	Removal of ischial bursa	$XXX.XX	J1	5114
27062	Remove femur lesion/bursa	$XXX.XX	J1	5113
27065	Remove hip bone les super	$XXX.XX	J1	5114
27066	Remove hip bone les deep	$XXX.XX	J1	5113
27067	Remove/graft hip bone lesion	$XXX.XX	J1	5114
27080	Removal of tail bone	$XXX.XX	J1	5113
27086	Remove hip foreign body	$XXX.XX	J1	5073
27087	Remove hip foreign body	$XXX.XX	J1	5113
27097	Revision of hip tendon	$XXX.XX	J1	5113
27098	Transfer tendon to pelvis	$XXX.XX	J1	5113
27100	Transfer of abdominal muscle	$XXX.XX	J1	5114
27105	Transfer of spinal muscle	$XXX.XX	J1	5113
27110	Transfer of iliopsoas muscle	$XXX.XX	J1	5114
27111	Transfer of iliopsoas muscle	$XXX.XX	J1	5113
27130	Total hip arthroplasty	$XXX.XX	J1	5115
27179	Revise head/neck of femur	$XXX.XX	J1	5114
27197	Clsd tx pelvic ring fx	$XXX.XX	T	5111
27198	Clsd tx pelvic ring fx	$XXX.XX	T	5111
27200	Treat tail bone fracture	$XXX.XX	T	5111
27202	Treat tail bone fracture	$XXX.XX	J1	5113
27220	Treat hip socket fracture	$XXX.XX	T	5111
27230	Treat thigh fracture	$XXX.XX	T	5111
27235	Treat thigh fracture	$XXX.XX	J1	5114
27238	Treat thigh fracture	$XXX.XX	J1	5112
27246	Treat thigh fracture	$XXX.XX	T	5111
27250	Treat hip dislocation	$XXX.XX	T	5111
27252	Treat hip dislocation	$XXX.XX	J1	5112
27256	Treat hip dislocation	$XXX.XX	T	5111
27257	Treat hip dislocation	$XXX.XX	J1	5112
27265	Treat hip dislocation	$XXX.XX	T	5111
27266	Treat hip dislocation	$XXX.XX	J1	5112
27267	Cltx thigh fx	$XXX.XX	J1	5113
27275	Manipulation of hip joint	$XXX.XX	J1	5112
27279	Arthrodesis sacroiliac joint	$XXX.XX	J1	5116
27299	Pelvis/hip joint surgery	$XXX.XX	T	5111
27301	Drain thigh/knee lesion	$XXX.XX	J1	5073
27305	Incise thigh tendon & fascia	$XXX.XX	J1	5113
27306	Incision of thigh tendon	$XXX.XX	J1	5113
27307	Incision of thigh tendons	$XXX.XX	J1	5113
27310	Exploration of knee joint	$XXX.XX	J1	5113
27323	Biopsy thigh soft tissues	$XXX.XX	J1	5072
27324	Biopsy thigh soft tissues	$XXX.XX	J1	5073
27325	Neurectomy hamstring	$XXX.XX	J1	5431
27326	Neurectomy popliteal	$XXX.XX	J1	5431
27327	Exc thigh/knee les sc < 3 cm	$XXX.XX	J1	5072
27328	Exc thigh/knee tum deep <5cm	$XXX.XX	J1	5073
27329	Resect thigh/knee tum < 5 cm	$XXX.XX	J1	5073
27330	Biopsy knee joint lining	$XXX.XX	J1	5113
27331	Explore/treat knee joint	$XXX.XX	J1	5113
27332	Removal of knee cartilage	$XXX.XX	J1	5113
27333	Removal of knee cartilage	$XXX.XX	J1	5113
27334	Remove knee joint lining	$XXX.XX	J1	5113
27335	Remove knee joint lining	$XXX.XX	J1	5114
27337	Exc thigh/knee les sc 3 cm/>	$XXX.XX	J1	5073
27339	Exc thigh/knee tum dep 5cm/>	$XXX.XX	J1	5073
27340	Removal of kneecap bursa	$XXX.XX	J1	5113
27345	Removal of knee cyst	$XXX.XX	J1	5113
27347	Remove knee cyst	$XXX.XX	J1	5113
27350	Removal of kneecap	$XXX.XX	J1	5114
27355	Remove femur lesion	$XXX.XX	J1	5113
27356	Remove femur lesion/graft	$XXX.XX	J1	5115
27357	Remove femur lesion/graft	$XXX.XX	J1	5114
27360	Partial removal leg bone(s)	$XXX.XX	J1	5113
27364	Resect thigh/knee tum 5 cm/>	$XXX.XX	J1	5073
27372	Removal of foreign body	$XXX.XX	J1	5073
27380	Repair of kneecap tendon	$XXX.XX	J1	5114
27381	Repair/graft kneecap tendon	$XXX.XX	J1	5114
27385	Repair of thigh muscle	$XXX.XX	J1	5114
27386	Repair/graft of thigh muscle	$XXX.XX	J1	5114
27390	Incision of thigh tendon	$XXX.XX	J1	5113
27391	Incision of thigh tendons	$XXX.XX	J1	5113
27392	Incision of thigh tendons	$XXX.XX	J1	5113
27393	Lengthening of thigh tendon	$XXX.XX	J1	5114
27394	Lengthening of thigh tendons	$XXX.XX	J1	5114
27395	Lengthening of thigh tendons	$XXX.XX	J1	5113
27396	Transplant of thigh tendon	$XXX.XX	J1	5114
27397	Transplants of thigh tendons	$XXX.XX	J1	5114
27400	Revise thigh muscles/tendons	$XXX.XX	J1	5114
27403	Repair of knee cartilage	$XXX.XX	J1	5114
27405	Repair of knee ligament	$XXX.XX	J1	5114
27407	Repair of knee ligament	$XXX.XX	J1	5114
27409	Repair of knee ligaments	$XXX.XX	J1	5114
27412	Autochondrocyte implant knee	$XXX.XX	J1	5114
27415	Osteochondral knee allograft	$XXX.XX	J1	5115
27416	Osteochondral knee autograft	$XXX.XX	J1	5114
27418	Repair degenerated kneecap	$XXX.XX	J1	5114
27420	Revision of unstable kneecap	$XXX.XX	J1	5114
27422	Revision of unstable kneecap	$XXX.XX	J1	5114
27424	Revision/removal of kneecap	$XXX.XX	J1	5114
27425	Lat retinacular release open	$XXX.XX	J1	5113
27427	Reconstruction knee	$XXX.XX	J1	5114
27428	Reconstruction knee	$XXX.XX	J1	5115
27429	Reconstruction knee	$XXX.XX	J1	5115
27430	Revision of thigh muscles	$XXX.XX	J1	5114
27435	Incision of knee joint	$XXX.XX	J1	5113
27437	Revise kneecap	$XXX.XX	J1	5114
27438	Revise kneecap with implant	$XXX.XX	J1	5115
27440	Revision of knee joint	$XXX.XX	J1	5115
27441	Revision of knee joint	$XXX.XX	J1	5115
27442	Revision of knee joint	$XXX.XX	J1	5115
27443	Revision of knee joint	$XXX.XX	J1	5115
27446	Revision of knee joint	$XXX.XX	J1	5115
27447	Total knee arthroplasty	$XXX.XX	J1	5115
27475	Surgery to stop leg growth	$XXX.XX	J1	5114
27477	Surgery to stop leg growth	$XXX.XX	J1	5114
27479	Surgery to stop leg growth	$XXX.XX	J1	5114
27485	Surgery to stop leg growth	$XXX.XX	J1	5114
27496	Decompression of thigh/knee	$XXX.XX	J1	5113
27497	Decompression of thigh/knee	$XXX.XX	J1	5113
27498	Decompression of thigh/knee	$XXX.XX	J1	5112
27499	Decompression of thigh/knee	$XXX.XX	J1	5114
27500	Treatment of thigh fracture	$XXX.XX	T	5111
27501	Treatment of thigh fracture	$XXX.XX	T	5111
27502	Treatment of thigh fracture	$XXX.XX	J1	5112
27503	Treatment of thigh fracture	$XXX.XX	J1	5112
27508	Treatment of thigh fracture	$XXX.XX	T	5111
27509	Treatment of thigh fracture	$XXX.XX	J1	5114
27510	Treatment of thigh fracture	$XXX.XX	J1	5112
27516	Treat thigh fx growth plate	$XXX.XX	T	5111
27517	Treat thigh fx growth plate	$XXX.XX	J1	5112
27520	Treat kneecap fracture	$XXX.XX	T	5111
27524	Treat kneecap fracture	$XXX.XX	J1	5114
27530	Treat knee fracture	$XXX.XX	T	5111
27532	Treat knee fracture	$XXX.XX	J1	5113
27538	Treat knee fracture(s)	$XXX.XX	T	5111
27550	Treat knee dislocation	$XXX.XX	T	5111
27552	Treat knee dislocation	$XXX.XX	J1	5112
27560	Treat kneecap dislocation	$XXX.XX	T	5111
27562	Treat kneecap dislocation	$XXX.XX	T	5111
27566	Treat kneecap dislocation	$XXX.XX	J1	5114
27570	Fixation of knee joint	$XXX.XX	J1	5112
27594	Amputation follow-up surgery	$XXX.XX	J1	5113
27599	Leg surgery procedure	$XXX.XX	T	5111
27600	Decompression of lower leg	$XXX.XX	J1	5113
27601	Decompression of lower leg	$XXX.XX	J1	5113
27602	Decompression of lower leg	$XXX.XX	J1	5113
27603	Drain lower leg lesion	$XXX.XX	J1	5073
27604	Drain lower leg bursa	$XXX.XX	J1	5113
27605	Incision of achilles tendon	$XXX.XX	J1	5112
27606	Incision of achilles tendon	$XXX.XX	J1	5113
27607	Treat lower leg bone lesion	$XXX.XX	J1	5113
27610	Explore/treat ankle joint	$XXX.XX	J1	5113
27612	Exploration of ankle joint	$XXX.XX	J1	5113
27613	Biopsy lower leg soft tissue	$XXX.XX	J1	5072
27614	Biopsy lower leg soft tissue	$XXX.XX	J1	5073
27615	Resect leg/ankle tum < 5 cm	$XXX.XX	J1	5073
27616	Resect leg/ankle tum 5 cm/>	$XXX.XX	J1	5073
27618	Exc leg/ankle tum < 3 cm	$XXX.XX	J1	5072
27619	Exc leg/ankle tum deep <5 cm	$XXX.XX	J1	5073
27620	Explore/treat ankle joint	$XXX.XX	J1	5113
27625	Remove ankle joint lining	$XXX.XX	J1	5113
27626	Remove ankle joint lining	$XXX.XX	J1	5113
27630	Removal of tendon lesion	$XXX.XX	J1	5113
27632	Exc leg/ankle les sc 3 cm/>	$XXX.XX	J1	5073
27634	Exc leg/ankle tum dep 5 cm/>	$XXX.XX	J1	5073
27635	Remove lower leg bone lesion	$XXX.XX	J1	5113
27637	Remove/graft leg bone lesion	$XXX.XX	J1	5114
27638	Remove/graft leg bone lesion	$XXX.XX	J1	5114
27640	Partial removal of tibia	$XXX.XX	J1	5113
27641	Partial removal of fibula	$XXX.XX	J1	5113
27647	Resect talus/calcaneus tum	$XXX.XX	J1	5113
27650	Repair achilles tendon	$XXX.XX	J1	5114
27652	Repair/graft achilles tendon	$XXX.XX	J1	5114
27654	Repair of achilles tendon	$XXX.XX	J1	5114
27656	Repair leg fascia defect	$XXX.XX	J1	5113
27658	Repair of leg tendon each	$XXX.XX	J1	5113
27659	Repair of leg tendon each	$XXX.XX	J1	5114
27664	Repair of leg tendon each	$XXX.XX	J1	5114
27665	Repair of leg tendon each	$XXX.XX	J1	5114
27675	Repair lower leg tendons	$XXX.XX	J1	5113
27676	Repair lower leg tendons	$XXX.XX	J1	5114
27680	Release of lower leg tendon	$XXX.XX	J1	5113
27681	Release of lower leg tendons	$XXX.XX	J1	5113
27685	Revision of lower leg tendon	$XXX.XX	J1	5113
27686	Revise lower leg tendons	$XXX.XX	J1	5113
27687	Revision of calf tendon	$XXX.XX	J1	5113
27690	Revise lower leg tendon	$XXX.XX	J1	5114
27691	Revise lower leg tendon	$XXX.XX	J1	5114
27695	Repair of ankle ligament	$XXX.XX	J1	5114
27696	Repair of ankle ligaments	$XXX.XX	J1	5114
27698	Repair of ankle ligament	$XXX.XX	J1	5114
27700	Revision of ankle joint	$XXX.XX	J1	5114
27704	Removal of ankle implant	$XXX.XX	Q2	5113
27705	Incision of tibia	$XXX.XX	J1	5114
27707	Incision of fibula	$XXX.XX	J1	5113
27709	Incision of tibia & fibula	$XXX.XX	J1	5115
27720	Repair of tibia	$XXX.XX	J1	5114
27722	Repair/graft of tibia	$XXX.XX	J1	5114
27726	Repair fibula nonunion	$XXX.XX	J1	5114
27730	Repair of tibia epiphysis	$XXX.XX	J1	5113
27732	Repair of fibula epiphysis	$XXX.XX	J1	5113
27734	Repair lower leg epiphyses	$XXX.XX	J1	5113
27740	Repair of leg epiphyses	$XXX.XX	J1	5113
27742	Repair of leg epiphyses	$XXX.XX	J1	5113
27745	Reinforce tibia	$XXX.XX	J1	5114
27750	Treatment of tibia fracture	$XXX.XX	T	5111
27752	Treatment of tibia fracture	$XXX.XX	J1	5112
27756	Treatment of tibia fracture	$XXX.XX	J1	5114
27758	Treatment of tibia fracture	$XXX.XX	J1	5115
27759	Treatment of tibia fracture	$XXX.XX	J1	5115
27760	Cltx medial ankle fx	$XXX.XX	T	5111
27762	Cltx med ankle fx w/mnpj	$XXX.XX	J1	5112
27766	Optx medial ankle fx	$XXX.XX	J1	5114
27767	Cltx post ankle fx	$XXX.XX	T	5111
27768	Cltx post ankle fx w/mnpj	$XXX.XX	J1	5112
27769	Optx post ankle fx	$XXX.XX	J1	5114
27780	Treatment of fibula fracture	$XXX.XX	T	5111
27781	Treatment of fibula fracture	$XXX.XX	J1	5112
27784	Treatment of fibula fracture	$XXX.XX	J1	5114
27786	Treatment of ankle fracture	$XXX.XX	T	5111
27788	Treatment of ankle fracture	$XXX.XX	T	5111
27792	Treatment of ankle fracture	$XXX.XX	J1	5114
27808	Treatment of ankle fracture	$XXX.XX	T	5111
27810	Treatment of ankle fracture	$XXX.XX	J1	5112
27814	Treatment of ankle fracture	$XXX.XX	J1	5114
27816	Treatment of ankle fracture	$XXX.XX	T	5111
27818	Treatment of ankle fracture	$XXX.XX	J1	5112
27822	Treatment of ankle fracture	$XXX.XX	J1	5114
27823	Treatment of ankle fracture	$XXX.XX	J1	5114
27824	Treat lower leg fracture	$XXX.XX	T	5111
27825	Treat lower leg fracture	$XXX.XX	J1	5112
27826	Treat lower leg fracture	$XXX.XX	J1	5114
27827	Treat lower leg fracture	$XXX.XX	J1	5115
27828	Treat lower leg fracture	$XXX.XX	J1	5115
27829	Treat lower leg joint	$XXX.XX	J1	5114
27830	Treat lower leg dislocation	$XXX.XX	T	5111
27831	Treat lower leg dislocation	$XXX.XX	J1	5113
27832	Treat lower leg dislocation	$XXX.XX	J1	5114
27840	Treat ankle dislocation	$XXX.XX	T	5111
27842	Treat ankle dislocation	$XXX.XX	J1	5112
27846	Treat ankle dislocation	$XXX.XX	J1	5114
27848	Treat ankle dislocation	$XXX.XX	J1	5114
27860	Fixation of ankle joint	$XXX.XX	J1	5113
27870	Fusion of ankle joint open	$XXX.XX	J1	5115
27871	Fusion of tibiofibular joint	$XXX.XX	J1	5115
27884	Amputation follow-up surgery	$XXX.XX	J1	5113
27889	Amputation of foot at ankle	$XXX.XX	J1	5114
27892	Decompression of leg	$XXX.XX	J1	5113
27893	Decompression of leg	$XXX.XX	J1	5114
27894	Decompression of leg	$XXX.XX	J1	5113
27899	Leg/ankle surgery procedure	$XXX.XX	T	5111
28001	Drainage of bursa of foot	$XXX.XX	J1	5072
28002	Treatment of foot infection	$XXX.XX	J1	5112
28003	Treatment of foot infection	$XXX.XX	J1	5113
28005	Treat foot bone lesion	$XXX.XX	J1	5113
28008	Incision of foot fascia	$XXX.XX	J1	5113
28010	Incision of toe tendon	$XXX.XX	J1	5112
28011	Incision of toe tendons	$XXX.XX	J1	5112
28020	Exploration of foot joint	$XXX.XX	J1	5113
28022	Exploration of foot joint	$XXX.XX	J1	5113
28024	Exploration of toe joint	$XXX.XX	J1	5112
28035	Decompression of tibia nerve	$XXX.XX	J1	5431
28039	Exc foot/toe tum sc 1.5 cm/>	$XXX.XX	J1	5073
28041	Exc foot/toe tum dep 1.5cm/>	$XXX.XX	J1	5073
28043	Exc foot/toe tum sc < 1.5 cm	$XXX.XX	J1	5072
28045	Exc foot/toe tum deep <1.5cm	$XXX.XX	J1	5073
28046	Resect foot/toe tumor < 3 cm	$XXX.XX	J1	5073
28047	Resect foot/toe tumor 3 cm/>	$XXX.XX	J1	5073
28050	Biopsy of foot joint lining	$XXX.XX	J1	5113
28052	Biopsy of foot joint lining	$XXX.XX	J1	5113
28054	Biopsy of toe joint lining	$XXX.XX	J1	5113
28055	Neurectomy foot	$XXX.XX	J1	5431
28060	Partial removal foot fascia	$XXX.XX	J1	5113
28062	Removal of foot fascia	$XXX.XX	J1	5113
28070	Removal of foot joint lining	$XXX.XX	J1	5114
28072	Removal of foot joint lining	$XXX.XX	J1	5113
28080	Removal of foot lesion	$XXX.XX	J1	5112
28086	Excise foot tendon sheath	$XXX.XX	J1	5113
28088	Excise foot tendon sheath	$XXX.XX	J1	5113
28090	Removal of foot lesion	$XXX.XX	J1	5112
28092	Removal of toe lesions	$XXX.XX	J1	5112
28100	Removal of ankle/heel lesion	$XXX.XX	J1	5113
28102	Remove/graft foot lesion	$XXX.XX	J1	5114
28103	Remove/graft foot lesion	$XXX.XX	J1	5114
28104	Removal of foot lesion	$XXX.XX	J1	5113
28106	Remove/graft foot lesion	$XXX.XX	J1	5114
28107	Remove/graft foot lesion	$XXX.XX	J1	5114
28108	Removal of toe lesions	$XXX.XX	J1	5112
28110	Part removal of metatarsal	$XXX.XX	J1	5113
28111	Part removal of metatarsal	$XXX.XX	J1	5113
28112	Part removal of metatarsal	$XXX.XX	J1	5113
28113	Part removal of metatarsal	$XXX.XX	J1	5113
28114	Removal of metatarsal heads	$XXX.XX	J1	5113
28116	Revision of foot	$XXX.XX	J1	5113
28118	Removal of heel bone	$XXX.XX	J1	5113
28119	Removal of heel spur	$XXX.XX	J1	5113
28120	Part removal of ankle/heel	$XXX.XX	J1	5113
28122	Partial removal of foot bone	$XXX.XX	J1	5113
28124	Partial removal of toe	$XXX.XX	J1	5113
28126	Partial removal of toe	$XXX.XX	J1	5113
28130	Removal of ankle bone	$XXX.XX	J1	5114
28140	Removal of metatarsal	$XXX.XX	J1	5113
28150	Removal of toe	$XXX.XX	J1	5113
28153	Partial removal of toe	$XXX.XX	J1	5113
28160	Partial removal of toe	$XXX.XX	J1	5113
28171	Resect tarsal tumor	$XXX.XX	J1	5113
28173	Resect metatarsal tumor	$XXX.XX	J1	5113
28175	Resect phalanx of toe tumor	$XXX.XX	J1	5112
28190	Removal of foot foreign body	$XXX.XX	T	5071
28192	Removal of foot foreign body	$XXX.XX	J1	5072
28193	Removal of foot foreign body	$XXX.XX	J1	5072
28200	Repair of foot tendon	$XXX.XX	J1	5113
28202	Repair/graft of foot tendon	$XXX.XX	J1	5114
28208	Repair of foot tendon	$XXX.XX	J1	5113
28210	Repair/graft of foot tendon	$XXX.XX	J1	5114
28220	Release of foot tendon	$XXX.XX	J1	5112
28222	Release of foot tendons	$XXX.XX	J1	5113
28225	Release of foot tendon	$XXX.XX	J1	5113
28226	Release of foot tendons	$XXX.XX	J1	5113
28230	Incision of foot tendon(s)	$XXX.XX	J1	5112
28232	Incision of toe tendon	$XXX.XX	J1	5112
28234	Incision of foot tendon	$XXX.XX	J1	5112
28238	Revision of foot tendon	$XXX.XX	J1	5114
28240	Release of big toe	$XXX.XX	J1	5113
28250	Revision of foot fascia	$XXX.XX	J1	5113
28260	Release of midfoot joint	$XXX.XX	J1	5113
28261	Revision of foot tendon	$XXX.XX	J1	5112
28262	Revision of foot and ankle	$XXX.XX	J1	5114
28264	Release of midfoot joint	$XXX.XX	J1	5112
28270	Release of foot contracture	$XXX.XX	J1	5113
28272	Release of toe joint each	$XXX.XX	J1	5112
28280	Fusion of toes	$XXX.XX	J1	5113
28285	Repair of hammertoe	$XXX.XX	J1	5113
28286	Repair of hammertoe	$XXX.XX	J1	5113
28288	Partial removal of foot bone	$XXX.XX	J1	5113
28289	Corrj halux rigdus w/o implt	$XXX.XX	J1	5113
28291	Corrj halux rigdus w/implt	$XXX.XX	J1	5114
28292	Correction hallux valgus	$XXX.XX	J1	5113
28295	Correction hallux valgus	$XXX.XX	J1	5113
28296	Correction hallux valgus	$XXX.XX	J1	5113
28297	Correction hallux valgus	$XXX.XX	J1	5114
28298	Correction hallux valgus	$XXX.XX	J1	5114
28299	Correction hallux valgus	$XXX.XX	J1	5114
28300	Incision of heel bone	$XXX.XX	J1	5114
28302	Incision of ankle bone	$XXX.XX	J1	5114
28304	Incision of midfoot bones	$XXX.XX	J1	5114
28305	Incise/graft midfoot bones	$XXX.XX	J1	5114
28306	Incision of metatarsal	$XXX.XX	J1	5114
28307	Incision of metatarsal	$XXX.XX	J1	5114
28308	Incision of metatarsal	$XXX.XX	J1	5113
28309	Incision of metatarsals	$XXX.XX	J1	5114
28310	Revision of big toe	$XXX.XX	J1	5114
28312	Revision of toe	$XXX.XX	J1	5113
28313	Repair deformity of toe	$XXX.XX	J1	5113
28315	Removal of sesamoid bone	$XXX.XX	J1	5113
28320	Repair of foot bones	$XXX.XX	J1	5115
28322	Repair of metatarsals	$XXX.XX	J1	5114
28340	Resect enlarged toe tissue	$XXX.XX	J1	5113
28341	Resect enlarged toe	$XXX.XX	J1	5113
28344	Repair extra toe(s)	$XXX.XX	J1	5113
28345	Repair webbed toe(s)	$XXX.XX	J1	5112
28360	Reconstruct cleft foot	$XXX.XX	J1	5114
28400	Treatment of heel fracture	$XXX.XX	T	5111
28405	Treatment of heel fracture	$XXX.XX	T	5111
28406	Treatment of heel fracture	$XXX.XX	J1	5114
28415	Treat heel fracture	$XXX.XX	J1	5114
28420	Treat/graft heel fracture	$XXX.XX	J1	5115
28430	Treatment of ankle fracture	$XXX.XX	T	5111
28435	Treatment of ankle fracture	$XXX.XX	J1	5112
28436	Treatment of ankle fracture	$XXX.XX	J1	5114
28445	Treat ankle fracture	$XXX.XX	J1	5114
28446	Osteochondral talus autogrft	$XXX.XX	J1	5114
28450	Treat midfoot fracture each	$XXX.XX	T	5111
28455	Treat midfoot fracture each	$XXX.XX	J1	5112
28456	Treat midfoot fracture	$XXX.XX	J1	5114
28465	Treat midfoot fracture each	$XXX.XX	J1	5114
28470	Treat metatarsal fracture	$XXX.XX	T	5111
28475	Treat metatarsal fracture	$XXX.XX	T	5111
28476	Treat metatarsal fracture	$XXX.XX	J1	5113
28485	Treat metatarsal fracture	$XXX.XX	J1	5114
28490	Treat big toe fracture	$XXX.XX	T	5111
28495	Treat big toe fracture	$XXX.XX	T	5111
28496	Treat big toe fracture	$XXX.XX	J1	5113
28505	Treat big toe fracture	$XXX.XX	J1	5113
28510	Treatment of toe fracture	$XXX.XX	T	5111
28515	Treatment of toe fracture	$XXX.XX	T	5111
28525	Treat toe fracture	$XXX.XX	J1	5113
28530	Treat sesamoid bone fracture	$XXX.XX	T	5111
28531	Treat sesamoid bone fracture	$XXX.XX	J1	5114
28540	Treat foot dislocation	$XXX.XX	T	5111
28545	Treat foot dislocation	$XXX.XX	J1	5113
28546	Treat foot dislocation	$XXX.XX	J1	5112
28555	Repair foot dislocation	$XXX.XX	J1	5114
28570	Treat foot dislocation	$XXX.XX	T	5111
28575	Treat foot dislocation	$XXX.XX	J1	5113
28576	Treat foot dislocation	$XXX.XX	J1	5114
28585	Repair foot dislocation	$XXX.XX	J1	5114
28600	Treat foot dislocation	$XXX.XX	T	5111
28605	Treat foot dislocation	$XXX.XX	T	5111
28606	Treat foot dislocation	$XXX.XX	J1	5113
28615	Repair foot dislocation	$XXX.XX	J1	5114
28630	Treat toe dislocation	$XXX.XX	T	5111
28635	Treat toe dislocation	$XXX.XX	J1	5112
28636	Treat toe dislocation	$XXX.XX	J1	5113
28645	Repair toe dislocation	$XXX.XX	J1	5113
28660	Treat toe dislocation	$XXX.XX	T	5111
28665	Treat toe dislocation	$XXX.XX	T	5102
28666	Treat toe dislocation	$XXX.XX	J1	5113
28675	Repair of toe dislocation	$XXX.XX	J1	5113
28705	Fusion of foot bones	$XXX.XX	J1	5116
28715	Fusion of foot bones	$XXX.XX	J1	5115
28725	Fusion of foot bones	$XXX.XX	J1	5115
28730	Fusion of foot bones	$XXX.XX	J1	5115
28735	Fusion of foot bones	$XXX.XX	J1	5115
28737	Revision of foot bones	$XXX.XX	J1	5115
28740	Fusion of foot bones	$XXX.XX	J1	5114
28750	Fusion of big toe joint	$XXX.XX	J1	5114
28755	Fusion of big toe joint	$XXX.XX	J1	5114
28760	Fusion of big toe joint	$XXX.XX	J1	5114
28805	Amputation thru metatarsal	$XXX.XX	J1	5113
28810	Amputation toe & metatarsal	$XXX.XX	J1	5113
28820	Amputation of toe	$XXX.XX	J1	5113
28825	Partial amputation of toe	$XXX.XX	J1	5113
28890	Hi enrgy eswt plantar fascia	$XXX.XX	J1	5112
28899	Foot/toes surgery procedure	$XXX.XX	T	5111
29000	Application of body cast	$XXX.XX	T	5102
29010	Application of body cast	$XXX.XX	T	5102
29015	Application of body cast	$XXX.XX	T	5102
29035	Application of body cast	$XXX.XX	T	5102
29040	Application of body cast	$XXX.XX	T	5102
29044	Application of body cast	$XXX.XX	T	5101
29046	Application of body cast	$XXX.XX	T	5102
29049	Application of figure eight	$XXX.XX	T	5102
29055	Application of shoulder cast	$XXX.XX	T	5102
29058	Application of shoulder cast	$XXX.XX	T	5102
29065	Application of long arm cast	$XXX.XX	T	5102
29075	Application of forearm cast	$XXX.XX	T	5102
29085	Apply hand/wrist cast	$XXX.XX	T	5101
29086	Apply finger cast	$XXX.XX	T	5101
29105	Apply long arm splint	$XXX.XX	T	5101
29125	Apply forearm splint	$XXX.XX	Q1	5734
29126	Apply forearm splint	$XXX.XX	Q1	5734
29130	Application of finger splint	$XXX.XX	Q1	5733
29131	Application of finger splint	$XXX.XX	Q1	5733
29200	Strapping of chest	$XXX.XX	T	5101
29240	Strapping of shoulder	$XXX.XX	Q1	5734
29260	Strapping of elbow or wrist	$XXX.XX	Q1	5732
29280	Strapping of hand or finger	$XXX.XX	Q1	5732
29305	Application of hip cast	$XXX.XX	T	5102
29325	Application of hip casts	$XXX.XX	T	5102
29345	Application of long leg cast	$XXX.XX	T	5102
29355	Application of long leg cast	$XXX.XX	T	5102
29358	Apply long leg cast brace	$XXX.XX	T	5102
29365	Application of long leg cast	$XXX.XX	T	5102
29405	Apply short leg cast	$XXX.XX	T	5102
29425	Apply short leg cast	$XXX.XX	T	5102
29435	Apply short leg cast	$XXX.XX	T	5102
29440	Addition of walker to cast	$XXX.XX	T	5101
29445	Apply rigid leg cast	$XXX.XX	T	5102
29450	Application of leg cast	$XXX.XX	T	5101
29505	Application long leg splint	$XXX.XX	T	5101
29515	Application lower leg splint	$XXX.XX	T	5101
29520	Strapping of hip	$XXX.XX	Q1	5733
29530	Strapping of knee	$XXX.XX	Q1	5734
29540	Strapping of ankle and/or ft	$XXX.XX	T	5101
29550	Strapping of toes	$XXX.XX	Q1	5733
29580	Application of paste boot	$XXX.XX	T	5101
29581	Apply multlay comprs lwr leg	$XXX.XX	T	5101
29584	Appl multlay comprs arm/hand	$XXX.XX	T	5101
29700	Removal/revision of cast	$XXX.XX	T	5102
29705	Removal/revision of cast	$XXX.XX	T	5102
29710	Removal/revision of cast	$XXX.XX	T	5102
29720	Repair of body cast	$XXX.XX	T	5101
29730	Windowing of cast	$XXX.XX	T	5101
29740	Wedging of cast	$XXX.XX	T	5102
29750	Wedging of clubfoot cast	$XXX.XX	T	5102
29799	Casting/strapping procedure	$XXX.XX	T	5101
29800	Jaw arthroscopy/surgery	$XXX.XX	J1	5113
29804	Jaw arthroscopy/surgery	$XXX.XX	J1	5113
29805	Shoulder arthroscopy dx	$XXX.XX	J1	5113
29806	Shoulder arthroscopy/surgery	$XXX.XX	J1	5114
29807	Shoulder arthroscopy/surgery	$XXX.XX	J1	5114
29819	Shoulder arthroscopy/surgery	$XXX.XX	J1	5113
29820	Shoulder arthroscopy/surgery	$XXX.XX	J1	5114
29821	Shoulder arthroscopy/surgery	$XXX.XX	J1	5113
29822	Shoulder arthroscopy/surgery	$XXX.XX	J1	5113
29823	Shoulder arthroscopy/surgery	$XXX.XX	J1	5113
29824	Shoulder arthroscopy/surgery	$XXX.XX	J1	5113
29825	Shoulder arthroscopy/surgery	$XXX.XX	J1	5113
29827	Arthroscop rotator cuff repr	$XXX.XX	J1	5114
29828	Arthroscopy biceps tenodesis	$XXX.XX	J1	5114
29830	Elbow arthroscopy	$XXX.XX	J1	5113
29834	Elbow arthroscopy/surgery	$XXX.XX	J1	5113
29835	Elbow arthroscopy/surgery	$XXX.XX	J1	5113
29836	Elbow arthroscopy/surgery	$XXX.XX	J1	5114
29837	Elbow arthroscopy/surgery	$XXX.XX	J1	5113
29838	Elbow arthroscopy/surgery	$XXX.XX	J1	5113
29840	Wrist arthroscopy	$XXX.XX	J1	5113
29843	Wrist arthroscopy/surgery	$XXX.XX	J1	5113
29844	Wrist arthroscopy/surgery	$XXX.XX	J1	5113
29845	Wrist arthroscopy/surgery	$XXX.XX	J1	5113
29846	Wrist arthroscopy/surgery	$XXX.XX	J1	5113
29847	Wrist arthroscopy/surgery	$XXX.XX	J1	5114
29848	Wrist endoscopy/surgery	$XXX.XX	J1	5112
29850	Knee arthroscopy/surgery	$XXX.XX	J1	5112
29851	Knee arthroscopy/surgery	$XXX.XX	J1	5112
29855	Tibial arthroscopy/surgery	$XXX.XX	J1	5114
29856	Tibial arthroscopy/surgery	$XXX.XX	J1	5115
29860	Hip arthroscopy dx	$XXX.XX	J1	5114
29861	Hip arthro w/fb removal	$XXX.XX	J1	5114
29862	Hip arthr0 w/debridement	$XXX.XX	J1	5114
29863	Hip arthr0 w/synovectomy	$XXX.XX	J1	5113
29866	Autgrft implnt knee w/scope	$XXX.XX	J1	5114
29867	Allgrft implnt knee w/scope	$XXX.XX	J1	5115
29868	Meniscal trnspl knee w/scpe	$XXX.XX	J1	5114
29870	Knee arthroscopy dx	$XXX.XX	J1	5113
29871	Knee arthroscopy/drainage	$XXX.XX	J1	5113
29873	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29874	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29875	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29876	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29877	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29879	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29880	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29881	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29882	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29883	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29884	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29885	Knee arthroscopy/surgery	$XXX.XX	J1	5114
29886	Knee arthroscopy/surgery	$XXX.XX	J1	5113
29887	Knee arthroscopy/surgery	$XXX.XX	J1	5114
29888	Knee arthroscopy/surgery	$XXX.XX	J1	5114
29889	Knee arthroscopy/surgery	$XXX.XX	J1	5115
29891	Ankle arthroscopy/surgery	$XXX.XX	J1	5113
29892	Ankle arthroscopy/surgery	$XXX.XX	J1	5114
29893	Scope plantar fasciotomy	$XXX.XX	J1	5113
29894	Ankle arthroscopy/surgery	$XXX.XX	J1	5113
29895	Ankle arthroscopy/surgery	$XXX.XX	J1	5113
29897	Ankle arthroscopy/surgery	$XXX.XX	J1	5113
29898	Ankle arthroscopy/surgery	$XXX.XX	J1	5113
29899	Ankle arthroscopy/surgery	$XXX.XX	J1	5114
29900	Mcp joint arthroscopy dx	$XXX.XX	J1	5113
29901	Mcp joint arthroscopy surg	$XXX.XX	J1	5113
29902	Mcp joint arthroscopy surg	$XXX.XX	J1	5112
29904	Subtalar arthro w/fb rmvl	$XXX.XX	J1	5113
29905	Subtalar arthro w/exc	$XXX.XX	J1	5114
29906	Subtalar arthro w/deb	$XXX.XX	J1	5113
29907	Subtalar arthro w/fusion	$XXX.XX	J1	5115
29914	Hip arthro w/femoroplasty	$XXX.XX	J1	5114
29915	Hip arthro acetabuloplasty	$XXX.XX	J1	5114
29916	Hip arthro w/labral repair	$XXX.XX	J1	5114
29999	Arthroscopy of joint	$XXX.XX	T	5111
30000	Drainage of nose lesion	$XXX.XX	T	5161
30020	Drainage of nose lesion	$XXX.XX	T	5162
30100	Intranasal biopsy	$XXX.XX	J1	5163
30110	Removal of nose polyp(s)	$XXX.XX	J1	5163
30115	Removal of nose polyp(s)	$XXX.XX	J1	5164
30117	Removal of intranasal lesion	$XXX.XX	J1	5164
30118	Removal of intranasal lesion	$XXX.XX	J1	5164
30120	Revision of nose	$XXX.XX	J1	5164
30124	Removal of nose lesion	$XXX.XX	J1	5163
30125	Removal of nose lesion	$XXX.XX	J1	5165
30130	Excise inferior turbinate	$XXX.XX	J1	5164
30140	Resect inferior turbinate	$XXX.XX	J1	5164
30150	Partial removal of nose	$XXX.XX	J1	5165
30160	Removal of nose	$XXX.XX	J1	5165
30200	Injection treatment of nose	$XXX.XX	T	5162
30210	Nasal sinus therapy	$XXX.XX	J1	5163
30220	Insert nasal septal button	$XXX.XX	J1	5163
30300	Remove nasal foreign body	$XXX.XX	Q1	5734
30310	Remove nasal foreign body	$XXX.XX	J1	5164
30320	Remove nasal foreign body	$XXX.XX	J1	5163
30400	Reconstruction of nose	$XXX.XX	J1	5165
30410	Reconstruction of nose	$XXX.XX	J1	5165
30420	Reconstruction of nose	$XXX.XX	J1	5165
30430	Revision of nose	$XXX.XX	J1	5165
30435	Revision of nose	$XXX.XX	J1	5165
30450	Revision of nose	$XXX.XX	J1	5165
30460	Revision of nose	$XXX.XX	J1	5165
30462	Revision of nose	$XXX.XX	J1	5165
30465	Repair nasal stenosis	$XXX.XX	J1	5165
30520	Repair of nasal septum	$XXX.XX	J1	5164
30540	Repair nasal defect	$XXX.XX	J1	5165
30545	Repair nasal defect	$XXX.XX	J1	5165
30560	Release of nasal adhesions	$XXX.XX	T	5162
30580	Repair upper jaw fistula	$XXX.XX	J1	5165
30600	Repair mouth/nose fistula	$XXX.XX	J1	5165
30620	Intranasal reconstruction	$XXX.XX	J1	5165
30630	Repair nasal septum defect	$XXX.XX	J1	5164
30801	Ablate inf turbinate superf	$XXX.XX	J1	5163
30802	Ablate inf turbinate submuc	$XXX.XX	J1	5163
30901	Control of nosebleed	$XXX.XX	Q1	5734
30903	Control of nosebleed	$XXX.XX	T	5734
30905	Control of nosebleed	$XXX.XX	T	5734
30906	Repeat control of nosebleed	$XXX.XX	T	5161
30915	Ligation nasal sinus artery	$XXX.XX	J1	5183
30920	Ligation upper jaw artery	$XXX.XX	J1	5183
30930	Ther fx nasal inf turbinate	$XXX.XX	J1	5164
30999	Nasal surgery procedure	$XXX.XX	T	5161
31000	Irrigation maxillary sinus	$XXX.XX	T	5161
31002	Irrigation sphenoid sinus	$XXX.XX	J1	5163
31020	Exploration maxillary sinus	$XXX.XX	J1	5164
31030	Exploration maxillary sinus	$XXX.XX	J1	5165
31032	Explore sinus remove polyps	$XXX.XX	J1	5165
31040	Exploration behind upper jaw	$XXX.XX	J1	5165
31050	Exploration sphenoid sinus	$XXX.XX	J1	5165
31051	Sphenoid sinus surgery	$XXX.XX	J1	5165
31070	Exploration of frontal sinus	$XXX.XX	J1	5165
31075	Exploration of frontal sinus	$XXX.XX	J1	5165
31080	Removal of frontal sinus	$XXX.XX	J1	5165
31081	Removal of frontal sinus	$XXX.XX	J1	5165
31084	Removal of frontal sinus	$XXX.XX	J1	5165
31085	Removal of frontal sinus	$XXX.XX	J1	5165
31086	Removal of frontal sinus	$XXX.XX	J1	5165
31087	Removal of frontal sinus	$XXX.XX	J1	5165
31090	Exploration of sinuses	$XXX.XX	J1	5165
31200	Removal of ethmoid sinus	$XXX.XX	J1	5165
31201	Removal of ethmoid sinus	$XXX.XX	J1	5163
31205	Removal of ethmoid sinus	$XXX.XX	J1	5164
31231	Nasal endoscopy dx	$XXX.XX	T	5151
31233	Nsl/sins ndsc dx max sinusc	$XXX.XX	T	5152
31235	Nsl/sins ndsc dx sphn sinusc	$XXX.XX	J1	5153
31237	Nasal/sinus endoscopy surg	$XXX.XX	J1	5153
31238	Nasal/sinus endoscopy surg	$XXX.XX	J1	5153
31239	Nasal/sinus endoscopy surg	$XXX.XX	J1	5154
31240	Nasal/sinus endoscopy surg	$XXX.XX	J1	5153
31241	Nsl/sins ndsc w/artery lig	$XXX.XX	J1	5153
31253	Nsl/sins ndsc total	$XXX.XX	J1	5155
31254	Nsl/sins ndsc w/prtl ethmdct	$XXX.XX	J1	5155
31255	Nsl/sins ndsc w/tot ethmdct	$XXX.XX	J1	5155
31256	Exploration maxillary sinus	$XXX.XX	J1	5154
31257	Nsl/sins ndsc tot w/sphendt	$XXX.XX	J1	5155
31259	Nsl/sins ndsc sphn tiss rmvl	$XXX.XX	J1	5155
31267	Endoscopy maxillary sinus	$XXX.XX	J1	5155
31276	Nsl/sins ndsc frnt tiss rmvl	$XXX.XX	J1	5155
31287	Nasal/sinus endoscopy surg	$XXX.XX	J1	5155
31288	Nasal/sinus endoscopy surg	$XXX.XX	J1	5155
31292	Nsl/sins ndsc med/inf dcmprn	$XXX.XX	J1	5155
31293	Nsl/sins ndsc med&inf dcmprn	$XXX.XX	J1	5155
31294	Nsl/sins ndsc surg on dcmprn	$XXX.XX	J1	5155
31295	Nsl/sins ndsc surg max sins	$XXX.XX	J1	5155
31296	Nsl/sins ndsc surg frnt sins	$XXX.XX	J1	5155
31297	Nsl/sins ndsc surg sphn sins	$XXX.XX	J1	5155
31298	Nsl/sins ndsc surg frnt&sphn	$XXX.XX	J1	5155
31299	Sinus surgery procedure	$XXX.XX	T	5161
31300	Removal of larynx lesion	$XXX.XX	J1	5164
31400	Revision of larynx	$XXX.XX	J1	5165
31420	Removal of epiglottis	$XXX.XX	J1	5165
31500	Insert emergency airway	$XXX.XX	T	5161
31502	Change of windpipe airway	$XXX.XX	T	5161
31505	Diagnostic laryngoscopy	$XXX.XX	T	5151
31510	Laryngoscopy with biopsy	$XXX.XX	J1	5154
31511	Remove foreign body larynx	$XXX.XX	T	5151
31512	Removal of larynx lesion	$XXX.XX	J1	5154
31513	Injection into vocal cord	$XXX.XX	T	5152
31515	Laryngoscopy for aspiration	$XXX.XX	T	5152
31520	Dx laryngoscopy newborn	$XXX.XX	T	5152
31525	Dx laryngoscopy excl nb	$XXX.XX	J1	5153
31526	Dx laryngoscopy w/oper scope	$XXX.XX	J1	5153
31527	Laryngoscopy for treatment	$XXX.XX	J1	5154
31528	Laryngoscopy and dilation	$XXX.XX	J1	5154
31529	Laryngoscopy and dilation	$XXX.XX	J1	5154
31530	Laryngoscopy w/fb removal	$XXX.XX	J1	5153
31531	Laryngoscopy w/fb & op scope	$XXX.XX	J1	5154
31535	Laryngoscopy w/biopsy	$XXX.XX	J1	5154
31536	Laryngoscopy w/bx & op scope	$XXX.XX	J1	5154
31540	Laryngoscopy w/exc of tumor	$XXX.XX	J1	5154
31541	Larynscop w/tumr exc + scope	$XXX.XX	J1	5154
31545	Remove vc lesion w/scope	$XXX.XX	J1	5154
31546	Remove vc lesion scope/graft	$XXX.XX	J1	5155
31551	Laryngoplasty laryngeal sten	$XXX.XX	J1	5165
31552	Laryngoplasty laryngeal sten	$XXX.XX	J1	5165
31553	Laryngoplasty laryngeal sten	$XXX.XX	J1	5165
31554	Laryngoplasty laryngeal sten	$XXX.XX	J1	5165
31560	Laryngoscop w/arytenoidectom	$XXX.XX	J1	5155
31561	Larynscop remve cart + scop	$XXX.XX	J1	5155
31570	Laryngoscope w/vc inj	$XXX.XX	J1	5154
31571	Laryngoscop w/vc inj + scope	$XXX.XX	J1	5154
31572	Largsc w/laser dstrj les	$XXX.XX	J1	5154
31573	Largsc w/ther injection	$XXX.XX	J1	5153
31574	Largsc w/njx augmentation	$XXX.XX	J1	5153
31575	Diagnostic laryngoscopy	$XXX.XX	T	5151
31576	Laryngoscopy with biopsy	$XXX.XX	J1	5153
31577	Largsc w/rmvl foreign bdy(s)	$XXX.XX	T	5152
31578	Largsc w/removal lesion	$XXX.XX	J1	5154
31579	Laryngoscopy telescopic	$XXX.XX	T	5152
31580	Laryngoplasty laryngeal web	$XXX.XX	J1	5165
31584	Laryngoplasty fx rdctj fixj	$XXX.XX	J1	5165
31587	Laryngoplasty cricoid split	$XXX.XX	J1	5165
31590	Reinnervate larynx	$XXX.XX	J1	5165
31591	Laryngoplasty medialization	$XXX.XX	J1	5165
31592	Cricotracheal resection	$XXX.XX	J1	5165
31599	Larynx surgery procedure	$XXX.XX	T	5161
31600	Incision of windpipe	$XXX.XX	J1	5164
31601	Incision of windpipe	$XXX.XX	J1	5165
31603	Incision of windpipe	$XXX.XX	J1	5163
31605	Incision of windpipe	$XXX.XX	T	5161
31610	Incision of windpipe	$XXX.XX	J1	5165
31611	Surgery/speech prosthesis	$XXX.XX	J1	5164
31612	Puncture/clear windpipe	$XXX.XX	J1	5164
31613	Repair windpipe opening	$XXX.XX	J1	5164
31614	Repair windpipe opening	$XXX.XX	J1	5165
31615	Visualization of windpipe	$XXX.XX	T	5162
31622	Dx bronchoscope/wash	$XXX.XX	J1	5153
31623	Dx bronchoscope/brush	$XXX.XX	J1	5153
31624	Dx bronchoscope/lavage	$XXX.XX	J1	5153
31625	Bronchoscopy w/biopsy(s)	$XXX.XX	J1	5153
31626	Bronchoscopy w/markers	$XXX.XX	J1	5155
31628	Bronchoscopy/lung bx each	$XXX.XX	J1	5154
31629	Bronchoscopy/needle bx each	$XXX.XX	J1	5154
31630	Bronchoscopy dilate/fx repr	$XXX.XX	J1	5154
31631	Bronchoscopy dilate w/stent	$XXX.XX	J1	5155
31634	Bronch w/balloon occlusion	$XXX.XX	J1	5155
31635	Bronchoscopy w/fb removal	$XXX.XX	J1	5153
31636	Bronchoscopy bronch stents	$XXX.XX	J1	5155
31638	Bronchoscopy revise stent	$XXX.XX	J1	5155
31640	Bronchoscopy w/tumor excise	$XXX.XX	J1	5154
31641	Bronchoscopy treat blockage	$XXX.XX	J1	5154
31643	Diag bronchoscope/catheter	$XXX.XX	J1	5153
31645	Brnchsc w/ther aspir 1st	$XXX.XX	J1	5153
31646	Brnchsc w/ther aspir sbsq	$XXX.XX	T	5152
31647	Bronchial valve init insert	$XXX.XX	J1	5155
31648	Bronchial valve remov init	$XXX.XX	J1	5154
31649	Bronchial valve remov addl	$XXX.XX	Q2	5153
31652	Bronch ebus samplng 1/2 node	$XXX.XX	J1	5154
31653	Bronch ebus samplng 3/> node	$XXX.XX	J1	5154
31660	Bronch thermoplsty 1 lobe	$XXX.XX	J1	5155
31661	Bronch thermoplsty 2/> lobes	$XXX.XX	J1	5155
31717	Bronchial brush biopsy	$XXX.XX	T	5152
31720	Clearance of airways	$XXX.XX	Q1	5791
31730	Intro windpipe wire/tube	$XXX.XX	J1	5153
31750	Repair of windpipe	$XXX.XX	J1	5165
31755	Repair of windpipe	$XXX.XX	J1	5165
31785	Remove windpipe lesion	$XXX.XX	J1	5165
31820	Closure of windpipe lesion	$XXX.XX	J1	5164
31825	Repair of windpipe defect	$XXX.XX	J1	5164
31830	Revise windpipe scar	$XXX.XX	J1	5164
31899	Airways surgical procedure	$XXX.XX	T	5151
32400	Needle biopsy chest lining	$XXX.XX	J1	5072
32405	Percut bx lung/mediastinum	$XXX.XX	J1	5072
32550	Insert pleural cath	$XXX.XX	J1	5341
32551	Insertion of chest tube	$XXX.XX	J1	5182
32552	Remove lung catheter	$XXX.XX	Q2	5181
32553	Ins mark thor for rt perq	$XXX.XX	S	5613
32554	Aspirate pleura w/o imaging	$XXX.XX	T	5181
32555	Aspirate pleura w/ imaging	$XXX.XX	T	5181
32556	Insert cath pleura w/o image	$XXX.XX	J1	5302
32557	Insert cath pleura w/ image	$XXX.XX	J1	5182
32560	Treat pleurodesis w/agent	$XXX.XX	T	5181
32561	Lyse chest fibrin init day	$XXX.XX	T	5181
32562	Lyse chest fibrin subq day	$XXX.XX	T	5181
32601	Thoracoscopy diagnostic	$XXX.XX	J1	5361
32604	Thoracoscopy wbx sac	$XXX.XX	J1	5361
32606	Thoracoscopy w/bx med space	$XXX.XX	J1	5361
32607	Thoracoscopy w/bx infiltrate	$XXX.XX	J1	5361
32608	Thoracoscopy w/bx nodule	$XXX.XX	J1	5361
32609	Thoracoscopy w/bx pleura	$XXX.XX	J1	5361
32960	Therapeutic pneumothorax	$XXX.XX	T	5181
32994	Ablate pulm tumor perq crybl	$XXX.XX	J1	5361
32998	Ablate pulm tumor perq rf	$XXX.XX	J1	5361
32999	Chest surgery procedure	$XXX.XX	T	5181
33016	Pericardiocentesis w/imaging	$XXX.XX	J1	5182
33206	Insert heart pm atrial	$XXX.XX	J1	5223
33207	Insert heart pm ventricular	$XXX.XX	J1	5223
33208	Insrt heart pm atrial & vent	$XXX.XX	J1	5223
33210	Insert electrd/pm cath sngl	$XXX.XX	J1	5222
33211	Insert card electrodes dual	$XXX.XX	J1	5222
33212	Insert pulse gen sngl lead	$XXX.XX	J1	5222
33213	Insert pulse gen dual leads	$XXX.XX	J1	5223
33214	Upgrade of pacemaker system	$XXX.XX	J1	5223
33215	Reposition pacing-defib lead	$XXX.XX	J1	5183
33216	Insert 1 electrode pm-defib	$XXX.XX	J1	5222
33217	Insert 2 electrode pm-defib	$XXX.XX	J1	5222
33218	Repair lead pace-defib one	$XXX.XX	T	5221
33220	Repair lead pace-defib dual	$XXX.XX	T	5221
33221	Insert pulse gen mult leads	$XXX.XX	J1	5224
33222	Relocation pocket pacemaker	$XXX.XX	T	5054
33223	Relocate pocket for defib	$XXX.XX	T	5054
33224	Insert pacing lead & connect	$XXX.XX	J1	5223
33226	Reposition l ventric lead	$XXX.XX	J1	5183
33227	Remove&replace pm gen singl	$XXX.XX	J1	5222
33228	Remv&replc pm gen dual lead	$XXX.XX	J1	5223
33229	Remv&replc pm gen mult leads	$XXX.XX	J1	5224
33230	Insrt pulse gen w/dual leads	$XXX.XX	J1	5231
33231	Insrt pulse gen w/mult leads	$XXX.XX	J1	5232
33233	Removal of pm generator	$XXX.XX	Q2	5222
33234	Removal of pacemaker system	$XXX.XX	Q2	5221
33235	Removal pacemaker electrode	$XXX.XX	Q2	5221
33240	Insrt pulse gen w/singl lead	$XXX.XX	J1	5231
33241	Remove pulse generator	$XXX.XX	Q2	5221
33244	Remove elctrd transvenously	$XXX.XX	Q2	5221
33249	Insj/rplcmt defib w/lead(s)	$XXX.XX	J1	5232
33262	Rmvl& replc pulse gen 1 lead	$XXX.XX	J1	5231
33263	Rmvl & rplcmt dfb gen 2 lead	$XXX.XX	J1	5231
33264	Rmvl & rplcmt dfb gen mlt ld	$XXX.XX	J1	5232
33270	Ins/rep subq defibrillator	$XXX.XX	J1	5232
33271	Insj subq impltbl dfb elctrd	$XXX.XX	J1	5222
33272	Rmvl of subq defibrillator	$XXX.XX	Q2	5221
33273	Repos prev impltbl subq dfb	$XXX.XX	T	5221
33274	Tcat insj/rpl perm ldls pm	$XXX.XX	J1	5194
33275	Tcat rmvl perm ldls pm w/img	$XXX.XX	T	5183
33285	Insj subq car rhythm mntr	$XXX.XX	J1	5222
33286	Rmvl subq car rhythm mntr	$XXX.XX	Q2	5071
33289	Tcat impl wrls p-art prs snr	$XXX.XX	J1	5200
33999	Cardiac surgery procedure	$XXX.XX	T	5181
34101	Removal of artery clot	$XXX.XX	J1	5184
34111	Removal of arm artery clot	$XXX.XX	J1	5184
34201	Removal of artery clot	$XXX.XX	J1	5184
34203	Removal of leg artery clot	$XXX.XX	J1	5184
34421	Removal of vein clot	$XXX.XX	J1	5183
34471	Removal of vein clot	$XXX.XX	T	5181
34490	Removal of vein clot	$XXX.XX	J1	5183
34501	Repair valve femoral vein	$XXX.XX	J1	5184
34510	Transposition of vein valve	$XXX.XX	J1	5184
34520	Cross-over vein graft	$XXX.XX	J1	5184
34530	Leg vein fusion	$XXX.XX	J1	5183
35011	Repair defect of artery	$XXX.XX	J1	5184
35045	Repair defect of arm artery	$XXX.XX	J1	5184
35180	Repair blood vessel lesion	$XXX.XX	T	5181
35184	Repair blood vessel lesion	$XXX.XX	J1	5183
35188	Repair blood vessel lesion	$XXX.XX	J1	5184
35190	Repair blood vessel lesion	$XXX.XX	J1	5184
35201	Repair blood vessel lesion	$XXX.XX	J1	5184
35206	Repair blood vessel lesion	$XXX.XX	J1	5183
35207	Repair blood vessel lesion	$XXX.XX	J1	5183
35226	Repair blood vessel lesion	$XXX.XX	T	5071
35231	Repair blood vessel lesion	$XXX.XX	J1	5183
35236	Repair blood vessel lesion	$XXX.XX	J1	5184
35256	Repair blood vessel lesion	$XXX.XX	J1	5184
35261	Repair blood vessel lesion	$XXX.XX	J1	5183
35266	Repair blood vessel lesion	$XXX.XX	J1	5184
35286	Repair blood vessel lesion	$XXX.XX	J1	5184
35321	Rechanneling of artery	$XXX.XX	J1	5184
35860	Explore limb vessels	$XXX.XX	J1	5183
35875	Removal of clot in graft	$XXX.XX	J1	5184
35876	Removal of clot in graft	$XXX.XX	J1	5184
35879	Revise graft w/vein	$XXX.XX	J1	5184
35881	Revise graft w/vein	$XXX.XX	J1	5184
35883	Revise graft w/nonauto graft	$XXX.XX	J1	5184
35884	Revise graft w/vein	$XXX.XX	J1	5184
35903	Excision graft extremity	$XXX.XX	J1	5183
36002	Pseudoaneurysm injection trt	$XXX.XX	T	5181
36221	Place cath thoracic aorta	$XXX.XX	Q2	5183
36222	Place cath carotid/inom art	$XXX.XX	Q2	5183
36223	Place cath carotid/inom art	$XXX.XX	Q2	5184
36224	Place cath carotd art	$XXX.XX	Q2	5184
36225	Place cath subclavian art	$XXX.XX	Q2	5183
36226	Place cath vertebral art	$XXX.XX	Q2	5184
36251	Ins cath ren art 1st unilat	$XXX.XX	Q2	5183
36252	Ins cath ren art 1st bilat	$XXX.XX	Q2	5183
36253	Ins cath ren art 2nd+ unilat	$XXX.XX	Q2	5184
36254	Ins cath ren art 2nd+ bilat	$XXX.XX	Q2	5183
36260	Insertion of infusion pump	$XXX.XX	J1	5184
36261	Revision of infusion pump	$XXX.XX	T	5221
36262	Removal of infusion pump	$XXX.XX	Q2	5221
36420	Vein access cutdown < 1 yr	$XXX.XX	Q1	5733
36425	Vein access cutdown > 1 yr	$XXX.XX	Q1	5735
36430	Blood transfusion service	$XXX.XX	S	5241
36440	Bl push transfuse 2 yr/<	$XXX.XX	S	5241
36450	Bl exchange/transfuse nb	$XXX.XX	S	5241
36455	Bl exchange/transfuse non-nb	$XXX.XX	S	5241
36456	Prtl exchange transfuse nb	$XXX.XX	S	5241
36460	Transfusion service fetal	$XXX.XX	S	5241
36465	Njx noncmpnd sclrsnt 1 vein	$XXX.XX	T	5054
36466	Njx noncmpnd sclrsnt mlt vn	$XXX.XX	T	5054
36468	Njx sclrsnt spider veins	$XXX.XX	Q1	5051
36470	Njx sclrsnt 1 incmptnt vein	$XXX.XX	T	5052
36471	Njx sclrsnt mlt incmptnt vn	$XXX.XX	T	5052
36473	Endovenous mchnchem 1st vein	$XXX.XX	J1	5183
36475	Endovenous rf 1st vein	$XXX.XX	J1	5183
36478	Endovenous laser 1st vein	$XXX.XX	J1	5183
36482	Endoven ther chem adhes 1st	$XXX.XX	J1	5184
36511	Apheresis wbc	$XXX.XX	S	5242
36512	Apheresis rbc	$XXX.XX	S	5242
36513	Apheresis platelets	$XXX.XX	S	5241
36514	Apheresis plasma	$XXX.XX	S	5242
36516	Apheresis immunoads slctv	$XXX.XX	S	5243
36522	Photopheresis	$XXX.XX	S	5243
36555	Insert non-tunnel cv cath	$XXX.XX	J1	5182
36556	Insert non-tunnel cv cath	$XXX.XX	J1	5182
36557	Insert tunneled cv cath	$XXX.XX	J1	5184
36558	Insert tunneled cv cath	$XXX.XX	J1	5183
36560	Insert tunneled cv cath	$XXX.XX	J1	5183
36561	Insert tunneled cv cath	$XXX.XX	J1	5183
36563	Insert tunneled cv cath	$XXX.XX	J1	5184
36565	Insert tunneled cv cath	$XXX.XX	J1	5183
36566	Insert tunneled cv cath	$XXX.XX	J1	5184
36568	Insj picc <5 yr w/o imaging	$XXX.XX	T	5181
36569	Insj picc 5 yr+ w/o imaging	$XXX.XX	J1	5182
36570	Insert picvad cath	$XXX.XX	J1	5183
36571	Insert picvad cath	$XXX.XX	J1	5183
36572	Insj picc rs&i <5 yr	$XXX.XX	T	5181
36573	Insj picc rs&i 5 yr+	$XXX.XX	J1	5182
36575	Repair tunneled cv cath	$XXX.XX	T	5181
36576	Repair tunneled cv cath	$XXX.XX	J1	5182
36578	Replace tunneled cv cath	$XXX.XX	J1	5183
36580	Replace cvad cath	$XXX.XX	J1	5182
36581	Replace tunneled cv cath	$XXX.XX	J1	5183
36582	Replace tunneled cv cath	$XXX.XX	J1	5183
36583	Replace tunneled cv cath	$XXX.XX	J1	5184
36584	Compl rplcmt picc rs&i	$XXX.XX	J1	5182
36585	Replace picvad cath	$XXX.XX	J1	5183
36589	Removal tunneled cv cath	$XXX.XX	Q2	5181
36590	Removal tunneled cv cath	$XXX.XX	Q2	5181
36591	Draw blood off venous device	$XXX.XX	Q1	5734
36592	Collect blood from picc	$XXX.XX	Q1	5734
36593	Declot vascular device	$XXX.XX	T	5694
36595	Mech remov tunneled cv cath	$XXX.XX	J1	5183
36596	Mech remov tunneled cv cath	$XXX.XX	J1	5182
36597	Reposition venous catheter	$XXX.XX	J1	5182
36598	Inj w/fluor eval cv device	$XXX.XX	T	5693
36600	Withdrawal of arterial blood	$XXX.XX	Q1	5734
36640	Insertion catheter artery	$XXX.XX	J1	5183
36680	Insert needle bone cavity	$XXX.XX	Q1	5735
36800	Insertion of cannula	$XXX.XX	J1	5184
36810	Insertion of cannula	$XXX.XX	J1	5183
36815	Insertion of cannula	$XXX.XX	J1	5184
36818	Av fuse uppr arm cephalic	$XXX.XX	J1	5184
36819	Av fuse uppr arm basilic	$XXX.XX	J1	5184
36820	Av fusion/forearm vein	$XXX.XX	J1	5184
36821	Av fusion direct any site	$XXX.XX	J1	5183
36825	Artery-vein autograft	$XXX.XX	J1	5184
36830	Artery-vein nonautograft	$XXX.XX	J1	5184
36831	Open thrombect av fistula	$XXX.XX	J1	5184
36832	Av fistula revision open	$XXX.XX	J1	5184
36833	Av fistula revision	$XXX.XX	J1	5184
36835	Artery to vein shunt	$XXX.XX	J1	5183
36838	Dist revas ligation hemo	$XXX.XX	J1	5184
36860	External cannula declotting	$XXX.XX	T	5181
36861	Cannula declotting	$XXX.XX	J1	5184
36901	Intro cath dialysis circuit	$XXX.XX	J1	5182
36902	Intro cath dialysis circuit	$XXX.XX	J1	5192
36903	Intro cath dialysis circuit	$XXX.XX	J1	5193
36904	Thrmbc/nfs dialysis circuit	$XXX.XX	J1	5192
36905	Thrmbc/nfs dialysis circuit	$XXX.XX	J1	5193
36906	Thrmbc/nfs dialysis circuit	$XXX.XX	J1	5194
37183	Remove hepatic shunt (tips)	$XXX.XX	J1	5192
37184	Prim art m-thrmbc 1st vsl	$XXX.XX	J1	5193
37187	Venous mech thrombectomy	$XXX.XX	J1	5192
37188	Ven mechnl thrmbc repeat tx	$XXX.XX	J1	5183
37191	Ins endovas vena cava filtr	$XXX.XX	J1	5184
37192	Redo endovas vena cava filtr	$XXX.XX	J1	5183
37193	Rem endovas vena cava filter	$XXX.XX	J1	5183
37195	Thrombolytic therapy stroke	$XXX.XX	T	5694
37197	Remove intrvas foreign body	$XXX.XX	J1	5183
37200	Transcatheter biopsy	$XXX.XX	J1	5184
37211	Thrombolytic art therapy	$XXX.XX	J1	5184
37212	Thrombolytic venous therapy	$XXX.XX	J1	5183
37213	Thromblytic art/ven therapy	$XXX.XX	J1	5182
37214	Cessj therapy cath removal	$XXX.XX	J1	5182
37220	Iliac revasc	$XXX.XX	J1	5192
37221	Iliac revasc w/stent	$XXX.XX	J1	5193
37224	Fem/popl revas w/tla	$XXX.XX	J1	5192
37225	Fem/popl revas w/ather	$XXX.XX	J1	5193
37226	Fem/popl revasc w/stent	$XXX.XX	J1	5193
37227	Fem/popl revasc stnt & ather	$XXX.XX	J1	5194
37228	Tib/per revasc w/tla	$XXX.XX	J1	5193
37229	Tib/per revasc w/ather	$XXX.XX	J1	5194
37230	Tib/per revasc w/stent	$XXX.XX	J1	5194
37231	Tib/per revasc stent & ather	$XXX.XX	J1	5194
37236	Open/perq place stent 1st	$XXX.XX	J1	5193
37238	Open/perq place stent same	$XXX.XX	J1	5193
37241	Vasc embolize/occlude venous	$XXX.XX	J1	5193
37242	Vasc embolize/occlude artery	$XXX.XX	J1	5193
37243	Vasc embolize/occlude organ	$XXX.XX	J1	5193
37244	Vasc embolize/occlude bleed	$XXX.XX	J1	5193
37246	Trluml balo angiop 1st art	$XXX.XX	J1	5192
37248	Trluml balo angiop 1st vein	$XXX.XX	J1	5192
37500	Endoscopy ligate perf veins	$XXX.XX	J1	5184
37501	Vascular endoscopy procedure	$XXX.XX	T	5181
37565	Ligation of neck vein	$XXX.XX	J1	5182
37600	Ligation of neck artery	$XXX.XX	J1	5183
37605	Ligation of neck artery	$XXX.XX	J1	5183
37606	Ligation of neck artery	$XXX.XX	J1	5183
37607	Ligation of a-v fistula	$XXX.XX	J1	5183
37609	Temporal artery procedure	$XXX.XX	J1	5072
37615	Ligation of neck artery	$XXX.XX	J1	5182
37619	Ligation of inf vena cava	$XXX.XX	J1	5184
37650	Revision of major vein	$XXX.XX	J1	5183
37700	Revise leg vein	$XXX.XX	J1	5183
37718	Ligate/strip short leg vein	$XXX.XX	J1	5183
37722	Ligate/strip long leg vein	$XXX.XX	J1	5183
37735	Removal of leg veins/lesion	$XXX.XX	J1	5183
37760	Ligate leg veins radical	$XXX.XX	J1	5183
37761	Ligate leg veins open	$XXX.XX	J1	5182
37765	Stab phleb veins xtr 10-20	$XXX.XX	J1	5183
37766	Phleb veins - extrem 20+	$XXX.XX	J1	5183
37780	Revision of leg vein	$XXX.XX	J1	5182
37785	Ligate/divide/excise vein	$XXX.XX	J1	5183
37790	Penile venous occlusion	$XXX.XX	J1	5374
37799	Vascular surgery procedure	$XXX.XX	T	5181
38120	Laparoscopy splenectomy	$XXX.XX	J1	5362
38129	Laparoscope proc spleen	$XXX.XX	J1	5361
38206	Harvest auto stem cells	$XXX.XX	S	5242
38207	Cryopreserve stem cells	$XXX.XX	S	5241
38208	Thaw preserved stem cells	$XXX.XX	S	5241
38209	Wash harvest stem cells	$XXX.XX	S	5241
38210	T-cell depletion of harvest	$XXX.XX	S	5241
38211	Tumor cell deplete of harvst	$XXX.XX	S	5241
38212	Rbc depletion of harvest	$XXX.XX	S	5241
38213	Platelet deplete of harvest	$XXX.XX	S	5241
38214	Volume deplete of harvest	$XXX.XX	S	5241
38215	Harvest stem cell concentrte	$XXX.XX	S	5241
38220	Dx bone marrow aspirations	$XXX.XX	J1	5072
38221	Dx bone marrow biopsies	$XXX.XX	J1	5072
38222	Dx bone marrow bx & aspir	$XXX.XX	J1	5073
38230	Bone marrow harvest allogen	$XXX.XX	S	5242
38232	Bone marrow harvest autolog	$XXX.XX	S	5243
38240	Transplt allo hct/donor	$XXX.XX	J1	5244
38241	Transplt autol hct/donor	$XXX.XX	S	5242
38242	Transplt allo lymphocytes	$XXX.XX	S	5242
38243	Transplj hematopoietic boost	$XXX.XX	S	5242
38300	Drainage lymph node lesion	$XXX.XX	J1	5073
38305	Drainage lymph node lesion	$XXX.XX	J1	5073
38308	Incision of lymph channels	$XXX.XX	J1	5091
38500	Biopsy/removal lymph nodes	$XXX.XX	J1	5091
38505	Needle biopsy lymph nodes	$XXX.XX	J1	5072
38510	Biopsy/removal lymph nodes	$XXX.XX	J1	5091
38520	Biopsy/removal lymph nodes	$XXX.XX	J1	5091
38525	Biopsy/removal lymph nodes	$XXX.XX	J1	5091
38530	Biopsy/removal lymph nodes	$XXX.XX	J1	5091
38531	Open bx/exc inguinofem nodes	$XXX.XX	J1	5091
38542	Explore deep node(s) neck	$XXX.XX	J1	5361
38550	Removal neck/armpit lesion	$XXX.XX	J1	5091
38555	Removal neck/armpit lesion	$XXX.XX	J1	5092
38570	Laparoscopy lymph node biop	$XXX.XX	J1	5361
38571	Laparoscopy lymphadenectomy	$XXX.XX	J1	5362
38572	Laparoscopy lymphadenectomy	$XXX.XX	J1	5362
38573	Laps pelvic lymphadec	$XXX.XX	J1	5362
38589	Laparoscope proc lymphatic	$XXX.XX	J1	5361
38700	Removal of lymph nodes neck	$XXX.XX	J1	5092
38720	Removal of lymph nodes neck	$XXX.XX	J1	5093
38740	Remove armpit lymph nodes	$XXX.XX	J1	5361
38745	Remove armpit lymph nodes	$XXX.XX	J1	5361
38760	Remove groin lymph nodes	$XXX.XX	J1	5092
38792	Ra tracer id of sentinl node	$XXX.XX	Q1	5591
38999	Blood/lymph system procedure	$XXX.XX	S	5241
39401	Mediastinoscpy w/medstnl bx	$XXX.XX	J1	5361
39402	Mediastinoscpy w/lmph nod bx	$XXX.XX	J1	5361
40490	Biopsy of lip	$XXX.XX	T	5161
40500	Partial excision of lip	$XXX.XX	J1	5164
40510	Partial excision of lip	$XXX.XX	J1	5164
40520	Partial excision of lip	$XXX.XX	J1	5164
40525	Reconstruct lip with flap	$XXX.XX	J1	5164
40527	Reconstruct lip with flap	$XXX.XX	J1	5165
40530	Partial removal of lip	$XXX.XX	J1	5164
40650	Repair lip	$XXX.XX	T	5162
40652	Repair lip	$XXX.XX	T	5162
40654	Repair lip	$XXX.XX	J1	5163
40700	Repair cleft lip/nasal	$XXX.XX	J1	5165
40701	Repair cleft lip/nasal	$XXX.XX	J1	5165
40702	Repair cleft lip/nasal	$XXX.XX	J1	5165
40720	Repair cleft lip/nasal	$XXX.XX	J1	5164
40761	Repair cleft lip/nasal	$XXX.XX	J1	5165
40799	Lip surgery procedure	$XXX.XX	T	5161
40800	Drainage of mouth lesion	$XXX.XX	T	5071
40801	Drainage of mouth lesion	$XXX.XX	T	5162
40804	Removal foreign body mouth	$XXX.XX	Q1	5301
40805	Removal foreign body mouth	$XXX.XX	T	5162
40806	Incision of lip fold	$XXX.XX	T	5162
40808	Biopsy of mouth lesion	$XXX.XX	T	5162
40810	Excision of mouth lesion	$XXX.XX	J1	5164
40812	Excise/repair mouth lesion	$XXX.XX	J1	5163
40814	Excise/repair mouth lesion	$XXX.XX	J1	5164
40816	Excision of mouth lesion	$XXX.XX	J1	5164
40818	Excise oral mucosa for graft	$XXX.XX	T	5162
40819	Excise lip or cheek fold	$XXX.XX	J1	5163
40820	Treatment of mouth lesion	$XXX.XX	J1	5164
40830	Repair mouth laceration	$XXX.XX	T	5161
40831	Repair mouth laceration	$XXX.XX	T	5162
40840	Reconstruction of mouth	$XXX.XX	J1	5165
40842	Reconstruction of mouth	$XXX.XX	J1	5165
40843	Reconstruction of mouth	$XXX.XX	J1	5165
40844	Reconstruction of mouth	$XXX.XX	J1	5165
40845	Reconstruction of mouth	$XXX.XX	J1	5165
40899	Mouth surgery procedure	$XXX.XX	T	5161
41000	Drainage of mouth lesion	$XXX.XX	T	5162
41005	Drainage of mouth lesion	$XXX.XX	T	5161
41006	Drainage of mouth lesion	$XXX.XX	J1	5163
41007	Drainage of mouth lesion	$XXX.XX	J1	5163
41008	Drainage of mouth lesion	$XXX.XX	J1	5164
41009	Drainage of mouth lesion	$XXX.XX	T	5162
41010	Incision of tongue fold	$XXX.XX	J1	5163
41015	Drainage of mouth lesion	$XXX.XX	T	5162
41016	Drainage of mouth lesion	$XXX.XX	J1	5165
41017	Drainage of mouth lesion	$XXX.XX	J1	5164
41018	Drainage of mouth lesion	$XXX.XX	J1	5163
41019	Place needles h&n for rt	$XXX.XX	J1	5165
41100	Biopsy of tongue	$XXX.XX	T	5162
41105	Biopsy of tongue	$XXX.XX	J1	5164
41108	Biopsy of floor of mouth	$XXX.XX	J1	5072
41110	Excision of tongue lesion	$XXX.XX	J1	5164
41112	Excision of tongue lesion	$XXX.XX	J1	5164
41113	Excision of tongue lesion	$XXX.XX	J1	5164
41114	Excision of tongue lesion	$XXX.XX	J1	5164
41115	Excision of tongue fold	$XXX.XX	J1	5163
41116	Excision of mouth lesion	$XXX.XX	J1	5164
41120	Partial removal of tongue	$XXX.XX	J1	5165
41250	Repair tongue laceration	$XXX.XX	Q1	5734
41251	Repair tongue laceration	$XXX.XX	T	5161
41252	Repair tongue laceration	$XXX.XX	T	5161
41510	Tongue to lip surgery	$XXX.XX	J1	5164
41512	Tongue suspension	$XXX.XX	J1	5165
41520	Reconstruction tongue fold	$XXX.XX	J1	5164
41530	Tongue base vol reduction	$XXX.XX	J1	5164
41599	Tongue and mouth surgery	$XXX.XX	T	5161
41800	Drainage of gum lesion	$XXX.XX	Q1	5734
41805	Removal foreign body gum	$XXX.XX	J1	5163
41806	Removal foreign body jawbone	$XXX.XX	J1	5163
41820	Excision gum each quadrant	$XXX.XX	J1	5164
41821	Excision of gum flap	$XXX.XX	J1	5163
41822	Excision of gum lesion	$XXX.XX	J1	5163
41823	Excision of gum lesion	$XXX.XX	J1	5165
41825	Excision of gum lesion	$XXX.XX	J1	5164
41826	Excision of gum lesion	$XXX.XX	J1	5164
41827	Excision of gum lesion	$XXX.XX	J1	5165
41828	Excision of gum lesion	$XXX.XX	J1	5163
41830	Removal of gum tissue	$XXX.XX	J1	5164
41850	Treatment of gum lesion	$XXX.XX	J1	5163
41870	Gum graft	$XXX.XX	J1	5163
41872	Repair gum	$XXX.XX	J1	5164
41874	Repair tooth socket	$XXX.XX	J1	5164
41899	Dental surgery procedure	$XXX.XX	T	5161
42000	Drainage mouth roof lesion	$XXX.XX	T	5161
42100	Biopsy roof of mouth	$XXX.XX	J1	5163
42104	Excision lesion mouth roof	$XXX.XX	J1	5164
42106	Excision lesion mouth roof	$XXX.XX	J1	5164
42107	Excision lesion mouth roof	$XXX.XX	J1	5165
42120	Remove palate/lesion	$XXX.XX	J1	5165
42140	Excision of uvula	$XXX.XX	J1	5164
42145	Repair palate pharynx/uvula	$XXX.XX	J1	5165
42160	Treatment mouth roof lesion	$XXX.XX	J1	5164
42180	Repair palate	$XXX.XX	T	5162
42182	Repair palate	$XXX.XX	J1	5165
42200	Reconstruct cleft palate	$XXX.XX	J1	5165
42205	Reconstruct cleft palate	$XXX.XX	J1	5164
42210	Reconstruct cleft palate	$XXX.XX	J1	5165
42215	Reconstruct cleft palate	$XXX.XX	J1	5165
42220	Reconstruct cleft palate	$XXX.XX	J1	5165
42225	Reconstruct cleft palate	$XXX.XX	J1	5165
42226	Lengthening of palate	$XXX.XX	J1	5165
42227	Lengthening of palate	$XXX.XX	J1	5165
42235	Repair palate	$XXX.XX	J1	5165
42260	Repair nose to lip fistula	$XXX.XX	J1	5165
42280	Preparation palate mold	$XXX.XX	T	5162
42281	Insertion palate prosthesis	$XXX.XX	J1	5165
42299	Palate/uvula surgery	$XXX.XX	T	5161
42300	Drainage of salivary gland	$XXX.XX	J1	5163
42305	Drainage of salivary gland	$XXX.XX	J1	5164
42310	Drainage of salivary gland	$XXX.XX	T	5162
42320	Drainage of salivary gland	$XXX.XX	T	5162
42330	Removal of salivary stone	$XXX.XX	J1	5164
42335	Removal of salivary stone	$XXX.XX	J1	5164
42340	Removal of salivary stone	$XXX.XX	J1	5164
42400	Biopsy of salivary gland	$XXX.XX	T	5071
42405	Biopsy of salivary gland	$XXX.XX	J1	5163
42408	Excision of salivary cyst	$XXX.XX	J1	5164
42409	Drainage of salivary cyst	$XXX.XX	J1	5164
42410	Excise parotid gland/lesion	$XXX.XX	J1	5165
42415	Excise parotid gland/lesion	$XXX.XX	J1	5165
42420	Excise parotid gland/lesion	$XXX.XX	J1	5165
42425	Excise parotid gland/lesion	$XXX.XX	J1	5165
42440	Excise submaxillary gland	$XXX.XX	J1	5165
42450	Excise sublingual gland	$XXX.XX	J1	5165
42500	Repair salivary duct	$XXX.XX	J1	5165
42505	Repair salivary duct	$XXX.XX	J1	5165
42507	Parotid duct diversion	$XXX.XX	J1	5165
42509	Parotid duct diversion	$XXX.XX	J1	5165
42510	Parotid duct diversion	$XXX.XX	J1	5164
42600	Closure of salivary fistula	$XXX.XX	J1	5164
42650	Dilation of salivary duct	$XXX.XX	J1	5163
42660	Dilation of salivary duct	$XXX.XX	T	5162
42665	Ligation of salivary duct	$XXX.XX	J1	5164
42699	Salivary surgery procedure	$XXX.XX	T	5161
42700	Drainage of tonsil abscess	$XXX.XX	T	5161
42720	Drainage of throat abscess	$XXX.XX	J1	5164
42725	Drainage of throat abscess	$XXX.XX	J1	5165
42800	Biopsy of throat	$XXX.XX	J1	5163
42804	Biopsy of upper nose/throat	$XXX.XX	J1	5164
42806	Biopsy of upper nose/throat	$XXX.XX	J1	5164
42808	Excise pharynx lesion	$XXX.XX	J1	5164
42809	Remove pharynx foreign body	$XXX.XX	Q1	5735
42810	Excision of neck cyst	$XXX.XX	J1	5164
42815	Excision of neck cyst	$XXX.XX	J1	5165
42820	Remove tonsils and adenoids	$XXX.XX	J1	5165
42821	Remove tonsils and adenoids	$XXX.XX	J1	5164
42825	Removal of tonsils	$XXX.XX	J1	5165
42826	Removal of tonsils	$XXX.XX	J1	5164
42830	Removal of adenoids	$XXX.XX	J1	5164
42831	Removal of adenoids	$XXX.XX	J1	5164
42835	Removal of adenoids	$XXX.XX	J1	5164
42836	Removal of adenoids	$XXX.XX	J1	5164
42842	Extensive surgery of throat	$XXX.XX	J1	5165
42844	Extensive surgery of throat	$XXX.XX	J1	5165
42860	Excision of tonsil tags	$XXX.XX	J1	5164
42870	Excision of lingual tonsil	$XXX.XX	J1	5165
42890	Partial removal of pharynx	$XXX.XX	J1	5165
42892	Revision of pharyngeal walls	$XXX.XX	J1	5165
42900	Repair throat wound	$XXX.XX	J1	5163
42950	Reconstruction of throat	$XXX.XX	J1	5165
42955	Surgical opening of throat	$XXX.XX	J1	5163
42960	Control throat bleeding	$XXX.XX	T	5162
42962	Control throat bleeding	$XXX.XX	J1	5164
42970	Control nose/throat bleeding	$XXX.XX	T	5161
42972	Control nose/throat bleeding	$XXX.XX	J1	5164
42999	Throat surgery procedure	$XXX.XX	T	5161
43020	Incision of esophagus	$XXX.XX	J1	5163
43030	Throat muscle surgery	$XXX.XX	J1	5165
43130	Removal of esophagus pouch	$XXX.XX	J1	5165
43180	Esophagoscopy rigid trnso	$XXX.XX	J1	5165
43191	Esophagoscopy rigid trnso dx	$XXX.XX	J1	5302
43192	Esophagoscp rig trnso inject	$XXX.XX	J1	5302
43193	Esophagoscp rig trnso biopsy	$XXX.XX	J1	5302
43194	Esophagoscp rig trnso rem fb	$XXX.XX	J1	5302
43195	Esophagoscopy rigid balloon	$XXX.XX	J1	5303
43196	Esophagoscp guide wire dilat	$XXX.XX	J1	5303
43197	Esophagoscopy flex dx brush	$XXX.XX	T	5301
43198	Esophagosc flex trnsn biopsy	$XXX.XX	T	5301
43200	Esophagoscopy flexible brush	$XXX.XX	T	5301
43201	Esoph scope w/submucous inj	$XXX.XX	J1	5302
43202	Esophagoscopy flex biopsy	$XXX.XX	J1	5302
43204	Esoph scope w/sclerosis inj	$XXX.XX	J1	5302
43205	Esophagus endoscopy/ligation	$XXX.XX	J1	5302
43206	Esoph optical endomicroscopy	$XXX.XX	J1	5302
43210	Egd esophagogastrc fndoplsty	$XXX.XX	J1	5362
43211	Esophagoscop mucosal resect	$XXX.XX	J1	5302
43212	Esophagoscop stent placement	$XXX.XX	J1	5331
43213	Esophagoscopy retro balloon	$XXX.XX	J1	5302
43214	Esophagosc dilate balloon 30	$XXX.XX	J1	5302
43215	Esophagoscopy flex remove fb	$XXX.XX	J1	5302
43216	Esophagoscopy lesion removal	$XXX.XX	J1	5302
43217	Esophagoscopy snare les remv	$XXX.XX	J1	5302
43220	Esophagoscopy balloon <30mm	$XXX.XX	J1	5302
43226	Esoph endoscopy dilation	$XXX.XX	J1	5302
43227	Esophagoscopy control bleed	$XXX.XX	J1	5302
43229	Esophagoscopy lesion ablate	$XXX.XX	J1	5303
43231	Esophagoscop ultrasound exam	$XXX.XX	J1	5302
43232	Esophagoscopy w/us needle bx	$XXX.XX	J1	5302
43233	Egd balloon dil esoph30 mm/>	$XXX.XX	J1	5302
43235	Egd diagnostic brush wash	$XXX.XX	T	5301
43236	Uppr gi scope w/submuc inj	$XXX.XX	T	5301
43237	Endoscopic us exam esoph	$XXX.XX	J1	5302
43238	Egd us fine needle bx/aspir	$XXX.XX	J1	5302
43239	Egd biopsy single/multiple	$XXX.XX	T	5301
43240	Egd w/transmural drain cyst	$XXX.XX	J1	5303
43241	Egd tube/cath insertion	$XXX.XX	J1	5302
43242	Egd us fine needle bx/aspir	$XXX.XX	J1	5302
43243	Egd injection varices	$XXX.XX	J1	5302
43244	Egd varices ligation	$XXX.XX	J1	5302
43245	Egd dilate stricture	$XXX.XX	J1	5302
43246	Egd place gastrostomy tube	$XXX.XX	J1	5302
43247	Egd remove foreign body	$XXX.XX	T	5301
43248	Egd guide wire insertion	$XXX.XX	T	5301
43249	Esoph egd dilation <30 mm	$XXX.XX	J1	5302
43250	Egd cautery tumor polyp	$XXX.XX	J1	5302
43251	Egd remove lesion snare	$XXX.XX	J1	5302
43252	Egd optical endomicroscopy	$XXX.XX	J1	5303
43253	Egd us transmural injxn/mark	$XXX.XX	J1	5302
43254	Egd endo mucosal resection	$XXX.XX	J1	5302
43255	Egd control bleeding any	$XXX.XX	J1	5302
43257	Egd w/thrml txmnt gerd	$XXX.XX	J1	5303
43259	Egd us exam duodenum/jejunum	$XXX.XX	J1	5302
43260	Ercp w/specimen collection	$XXX.XX	J1	5303
43261	Endo cholangiopancreatograph	$XXX.XX	J1	5303
43262	Endo cholangiopancreatograph	$XXX.XX	J1	5303
43263	Ercp sphincter pressure meas	$XXX.XX	J1	5303
43264	Ercp remove duct calculi	$XXX.XX	J1	5303
43265	Ercp lithotripsy calculi	$XXX.XX	J1	5331
43266	Egd endoscopic stent place	$XXX.XX	J1	5331
43270	Egd lesion ablation	$XXX.XX	J1	5302
43274	Ercp duct stent placement	$XXX.XX	J1	5331
43275	Ercp remove forgn body duct	$XXX.XX	J1	5303
43276	Ercp stent exchange w/dilate	$XXX.XX	J1	5331
43277	Ercp ea duct/ampulla dilate	$XXX.XX	J1	5303
43278	Ercp lesion ablate w/dilate	$XXX.XX	J1	5303
43280	Laparoscopy fundoplasty	$XXX.XX	J1	5362
43281	Lap paraesophag hern repair	$XXX.XX	J1	5362
43282	Lap paraesoph her rpr w/mesh	$XXX.XX	J1	5362
43284	Laps esophgl sphnctr agmntj	$XXX.XX	J1	5362
43285	Rmvl esophgl sphnctr dev	$XXX.XX	Q2	5361
43289	Laparoscope proc esoph	$XXX.XX	J1	5361
43420	Repair esophagus opening	$XXX.XX	J1	5164
43450	Dilate esophagus 1/mult pass	$XXX.XX	T	5301
43453	Dilate esophagus	$XXX.XX	J1	5302
43499	Esophagus surgery procedure	$XXX.XX	T	5301
43510	Surgical opening of stomach	$XXX.XX	T	5301
43647	Lap impl electrode antrum	$XXX.XX	J1	5462
43648	Lap revise/remv eltrd antrum	$XXX.XX	J1	5361
43651	Laparoscopy vagus nerve	$XXX.XX	J1	5361
43652	Laparoscopy vagus nerve	$XXX.XX	J1	5361
43653	Laparoscopy gastrostomy	$XXX.XX	J1	5361
43659	Laparoscope proc stom	$XXX.XX	J1	5361
43752	Nasal/orogastric w/tube plmt	$XXX.XX	Q1	5735
43753	Tx gastro intub w/asp	$XXX.XX	Q1	5722
43754	Dx gastr intub w/asp spec	$XXX.XX	Q1	5722
43755	Dx gastr intub w/asp specs	$XXX.XX	S	5721
43756	Dx duod intub w/asp spec	$XXX.XX	Q1	5301
43757	Dx duod intub w/asp specs	$XXX.XX	T	5301
43761	Reposition gastrostomy tube	$XXX.XX	T	5371
43762	Rplc gtube no revj trc	$XXX.XX	T	5371
43763	Rplc gtube revj gstrst trc	$XXX.XX	T	5371
43770	Lap place gastr adj device	$XXX.XX	J1	5362
43772	Lap rmvl gastr adj device	$XXX.XX	J1	5303
43773	Lap replace gastr adj device	$XXX.XX	J1	5361
43774	Lap rmvl gastr adj all parts	$XXX.XX	J1	5303
43830	Place gastrostomy tube	$XXX.XX	J1	5302
43831	Place gastrostomy tube	$XXX.XX	T	5301
43870	Repair stomach opening	$XXX.XX	J1	5303
43886	Revise gastric port open	$XXX.XX	T	5055
43887	Remove gastric port open	$XXX.XX	Q2	5054
43888	Change gastric port open	$XXX.XX	T	5055
43999	Stomach surgery procedure	$XXX.XX	T	5301
44100	Biopsy of bowel	$XXX.XX	T	5301
44180	Lap enterolysis	$XXX.XX	J1	5361
44186	Lap jejunostomy	$XXX.XX	J1	5361
44238	Laparoscope proc intestine	$XXX.XX	J1	5361
44312	Revision of ileostomy	$XXX.XX	T	5055
44340	Revision of colostomy	$XXX.XX	T	5055
44360	Small bowel endoscopy	$XXX.XX	J1	5302
44361	Small bowel endoscopy/biopsy	$XXX.XX	J1	5302
44363	Small bowel endoscopy	$XXX.XX	J1	5302
44364	Small bowel endoscopy	$XXX.XX	J1	5302
44365	Small bowel endoscopy	$XXX.XX	J1	5302
44366	Small bowel endoscopy	$XXX.XX	J1	5302
44369	Small bowel endoscopy	$XXX.XX	J1	5302
44370	Small bowel endoscopy/stent	$XXX.XX	J1	5331
44372	Small bowel endoscopy	$XXX.XX	J1	5302
44373	Small bowel endoscopy	$XXX.XX	J1	5302
44376	Small bowel endoscopy	$XXX.XX	J1	5302
44377	Small bowel endoscopy/biopsy	$XXX.XX	J1	5302
44378	Small bowel endoscopy	$XXX.XX	J1	5302
44379	S bowel endoscope w/stent	$XXX.XX	J1	5331
44380	Small bowel endoscopy br/wa	$XXX.XX	T	5301
44381	Small bowel endoscopy br/wa	$XXX.XX	J1	5302
44382	Small bowel endoscopy	$XXX.XX	T	5301
44384	Small bowel endoscopy	$XXX.XX	J1	5303
44385	Endoscopy of bowel pouch	$XXX.XX	T	5311
44386	Endoscopy bowel pouch/biop	$XXX.XX	T	5311
44388	Colonoscopy thru stoma spx	$XXX.XX	T	5311
44389	Colonoscopy with biopsy	$XXX.XX	T	5312
44390	Colonoscopy for foreign body	$XXX.XX	T	5311
44391	Colonoscopy for bleeding	$XXX.XX	T	5312
44392	Colonoscopy & polypectomy	$XXX.XX	T	5312
44394	Colonoscopy w/snare	$XXX.XX	T	5312
44401	Colonoscopy with ablation	$XXX.XX	T	5312
44402	Colonoscopy w/stent plcmt	$XXX.XX	J1	5331
44403	Colonoscopy w/resection	$XXX.XX	T	5312
44404	Colonoscopy w/injection	$XXX.XX	T	5312
44405	Colonoscopy w/dilation	$XXX.XX	T	5312
44406	Colonoscopy w/ultrasound	$XXX.XX	T	5312
44407	Colonoscopy w/ndl aspir/bx	$XXX.XX	T	5312
44408	Colonoscopy w/decompression	$XXX.XX	T	5311
44500	Intro gastrointestinal tube	$XXX.XX	T	5301
44799	Unlisted px small intestine	$XXX.XX	T	5301
44950	Appendectomy	$XXX.XX	J1	5341
44970	Laparoscopy appendectomy	$XXX.XX	J1	5361
44979	Laparoscope proc app	$XXX.XX	J1	5361
45000	Drainage of pelvic abscess	$XXX.XX	T	5312
45005	Drainage of rectal abscess	$XXX.XX	T	5312
45020	Drainage of rectal abscess	$XXX.XX	J1	5313
45100	Biopsy of rectum	$XXX.XX	J1	5313
45108	Removal of anorectal lesion	$XXX.XX	J1	5313
45150	Excision of rectal stricture	$XXX.XX	T	5312
45160	Excision of rectal lesion	$XXX.XX	J1	5313
45171	Exc rect tum transanal part	$XXX.XX	J1	5313
45172	Exc rect tum transanal full	$XXX.XX	J1	5313
45190	Destruction rectal tumor	$XXX.XX	J1	5313
45300	Proctosigmoidoscopy dx	$XXX.XX	T	5311
45303	Proctosigmoidoscopy dilate	$XXX.XX	T	5312
45305	Proctosigmoidoscopy w/bx	$XXX.XX	T	5312
45307	Proctosigmoidoscopy fb	$XXX.XX	J1	5313
45308	Proctosigmoidoscopy removal	$XXX.XX	J1	5313
45309	Proctosigmoidoscopy removal	$XXX.XX	T	5312
45315	Proctosigmoidoscopy removal	$XXX.XX	T	5312
45317	Proctosigmoidoscopy bleed	$XXX.XX	T	5312
45320	Proctosigmoidoscopy ablate	$XXX.XX	J1	5313
45321	Proctosigmoidoscopy volvul	$XXX.XX	J1	5313
45327	Proctosigmoidoscopy w/stent	$XXX.XX	J1	5331
45330	Diagnostic sigmoidoscopy	$XXX.XX	T	5311
45331	Sigmoidoscopy and biopsy	$XXX.XX	T	5311
45332	Sigmoidoscopy w/fb removal	$XXX.XX	T	5312
45333	Sigmoidoscopy & polypectomy	$XXX.XX	T	5311
45334	Sigmoidoscopy for bleeding	$XXX.XX	T	5312
45335	Sigmoidoscopy w/submuc inj	$XXX.XX	T	5311
45337	Sigmoidoscopy & decompress	$XXX.XX	T	5311
45338	Sigmoidoscopy w/tumr remove	$XXX.XX	T	5312
45340	Sig w/tndsc balloon dilation	$XXX.XX	T	5312
45341	Sigmoidoscopy w/ultrasound	$XXX.XX	T	5311
45342	Sigmoidoscopy w/us guide bx	$XXX.XX	T	5312
45346	Sigmoidoscopy w/ablation	$XXX.XX	T	5312
45347	Sigmoidoscopy w/plcmt stent	$XXX.XX	J1	5331
45349	Sigmoidoscopy w/resection	$XXX.XX	J1	5313
45350	Sgmdsc w/band ligation	$XXX.XX	T	5312
45378	Diagnostic colonoscopy	$XXX.XX	T	5311
45379	Colonoscopy w/fb removal	$XXX.XX	T	5312
45380	Colonoscopy and biopsy	$XXX.XX	T	5312
45381	Colonoscopy submucous njx	$XXX.XX	T	5312
45382	Colonoscopy w/control bleed	$XXX.XX	T	5312
45384	Colonoscopy w/lesion removal	$XXX.XX	T	5312
45385	Colonoscopy w/lesion removal	$XXX.XX	T	5312
45386	Colonoscopy w/balloon dilat	$XXX.XX	T	5312
45388	Colonoscopy w/ablation	$XXX.XX	T	5312
45389	Colonoscopy w/stent plcmt	$XXX.XX	J1	5331
45390	Colonoscopy w/resection	$XXX.XX	J1	5313
45391	Colonoscopy w/endoscope us	$XXX.XX	T	5312
45392	Colonoscopy w/endoscopic fnb	$XXX.XX	T	5312
45393	Colonoscopy w/decompression	$XXX.XX	T	5312
45398	Colonoscopy w/band ligation	$XXX.XX	T	5312
45399	Unlisted procedure colon	$XXX.XX	T	5311
45499	Laparoscope proc rectum	$XXX.XX	J1	5361
45500	Repair of rectum	$XXX.XX	J1	5313
45505	Repair of rectum	$XXX.XX	J1	5313
45520	Treatment of rectal prolapse	$XXX.XX	Q1	5311
45541	Correct rectal prolapse	$XXX.XX	J1	5313
45560	Repair of rectocele	$XXX.XX	J1	5313
45900	Reduction of rectal prolapse	$XXX.XX	T	5311
45905	Dilation of anal sphincter	$XXX.XX	T	5312
45910	Dilation of rectal narrowing	$XXX.XX	T	5312
45915	Remove rectal obstruction	$XXX.XX	T	5312
45990	Surg dx exam anorectal	$XXX.XX	J1	5313
45999	Rectum surgery procedure	$XXX.XX	T	5311
46020	Placement of seton	$XXX.XX	J1	5313
46030	Removal of rectal marker	$XXX.XX	T	5312
46040	Incision of rectal abscess	$XXX.XX	T	5312
46045	Incision of rectal abscess	$XXX.XX	J1	5313
46050	Incision of anal abscess	$XXX.XX	T	5311
46060	Incision of rectal abscess	$XXX.XX	J1	5313
46070	Incision of anal septum	$XXX.XX	J1	5313
46080	Incision of anal sphincter	$XXX.XX	J1	5313
46083	Incise external hemorrhoid	$XXX.XX	T	5371
46200	Removal of anal fissure	$XXX.XX	J1	5313
46220	Excise anal ext tag/papilla	$XXX.XX	T	5312
46221	Ligation of hemorrhoid(s)	$XXX.XX	T	5311
46230	Removal of anal tags	$XXX.XX	J1	5313
46250	Remove ext hem groups 2+	$XXX.XX	J1	5313
46255	Remove int/ext hem 1 group	$XXX.XX	J1	5313
46257	Remove in/ex hem grp & fiss	$XXX.XX	J1	5313
46258	Remove in/ex hem grp w/fistu	$XXX.XX	J1	5313
46260	Remove in/ex hem groups 2+	$XXX.XX	J1	5313
46261	Remove in/ex hem grps & fiss	$XXX.XX	J1	5313
46262	Remove in/ex hem grps w/fist	$XXX.XX	J1	5313
46270	Remove anal fist subq	$XXX.XX	J1	5313
46275	Remove anal fist inter	$XXX.XX	J1	5313
46280	Remove anal fist complex	$XXX.XX	J1	5313
46285	Remove anal fist 2 stage	$XXX.XX	J1	5313
46288	Repair anal fistula	$XXX.XX	J1	5313
46320	Removal of hemorrhoid clot	$XXX.XX	T	5312
46500	Injection into hemorrhoid(s)	$XXX.XX	T	5311
46505	Chemodenervation anal musc	$XXX.XX	T	5312
46600	Diagnostic anoscopy spx	$XXX.XX	Q1	5734
46601	Diagnostic anoscopy	$XXX.XX	Q1	5734
46604	Anoscopy and dilation	$XXX.XX	T	5312
46606	Anoscopy and biopsy	$XXX.XX	T	5312
46607	Diagnostic anoscopy & biopsy	$XXX.XX	T	5312
46608	Anoscopy remove for body	$XXX.XX	T	5311
46610	Anoscopy remove lesion	$XXX.XX	J1	5313
46611	Anoscopy	$XXX.XX	T	5311
46612	Anoscopy remove lesions	$XXX.XX	J1	5313
46614	Anoscopy control bleeding	$XXX.XX	T	5312
46615	Anoscopy	$XXX.XX	J1	5313
46700	Repair of anal stricture	$XXX.XX	J1	5313
46706	Repr of anal fistula w/glue	$XXX.XX	J1	5313
46707	Repair anorectal fist w/plug	$XXX.XX	J1	5313
46750	Repair of anal sphincter	$XXX.XX	J1	5313
46753	Reconstruction of anus	$XXX.XX	J1	5313
46754	Removal of suture from anus	$XXX.XX	J1	5313
46760	Repair of anal sphincter	$XXX.XX	J1	5313
46761	Repair of anal sphincter	$XXX.XX	J1	5313
46900	Destruction anal lesion(s)	$XXX.XX	T	5052
46910	Destruction anal lesion(s)	$XXX.XX	T	5054
46916	Cryosurgery anal lesion(s)	$XXX.XX	T	5051
46917	Laser surgery anal lesions	$XXX.XX	J1	5313
46922	Excision of anal lesion(s)	$XXX.XX	J1	5313
46924	Destruction anal lesion(s)	$XXX.XX	J1	5313
46930	Destroy internal hemorrhoids	$XXX.XX	T	5312
46940	Treatment of anal fissure	$XXX.XX	J1	5313
46942	Treatment of anal fissure	$XXX.XX	T	5311
46945	Int hrhc lig 1 hroid w/o img	$XXX.XX	J1	5313
46946	Int hrhc lig 2+hroid w/o img	$XXX.XX	J1	5313
46947	Hemorrhoidopexy by stapling	$XXX.XX	J1	5313
46948	Int hrhc tranal dartlzj 2+	$XXX.XX	J1	5313
46999	Anus surgery procedure	$XXX.XX	T	5311
47000	Needle biopsy of liver	$XXX.XX	J1	5072
47370	Laparo ablate liver tumor rf	$XXX.XX	J1	5362
47371	Laparo ablate liver cryosurg	$XXX.XX	J1	5362
47379	Laparoscope procedure liver	$XXX.XX	J1	5361
47382	Percut ablate liver rf	$XXX.XX	J1	5361
47383	Perq abltj lvr cryoablation	$XXX.XX	J1	5361
47399	Liver surgery procedure	$XXX.XX	T	5071
47490	Incision of gallbladder	$XXX.XX	J1	5341
47531	Injection for cholangiogram	$XXX.XX	Q2	5341
47532	Injection for cholangiogram	$XXX.XX	Q2	5341
47533	Plmt biliary drainage cath	$XXX.XX	J1	5341
47534	Plmt biliary drainage cath	$XXX.XX	J1	5341
47535	Conversion ext bil drg cath	$XXX.XX	J1	5341
47536	Exchange biliary drg cath	$XXX.XX	J1	5341
47537	Removal biliary drg cath	$XXX.XX	Q2	5301
47538	Perq plmt bile duct stent	$XXX.XX	J1	5361
47539	Perq plmt bile duct stent	$XXX.XX	J1	5361
47540	Perq plmt bile duct stent	$XXX.XX	J1	5361
47541	Plmt access bil tree sm bwl	$XXX.XX	J1	5341
47552	Biliary endo perq dx w/speci	$XXX.XX	J1	5341
47553	Biliary endoscopy thru skin	$XXX.XX	J1	5341
47554	Biliary endoscopy thru skin	$XXX.XX	J1	5361
47555	Biliary endoscopy thru skin	$XXX.XX	J1	5341
47556	Biliary endoscopy thru skin	$XXX.XX	J1	5361
47562	Laparoscopic cholecystectomy	$XXX.XX	J1	5361
47563	Laparo cholecystectomy/graph	$XXX.XX	J1	5361
47564	Laparo cholecystectomy/explr	$XXX.XX	J1	5361
47579	Laparoscope proc biliary	$XXX.XX	J1	5361
47999	Bile tract surgery procedure	$XXX.XX	T	5301
48102	Needle biopsy pancreas	$XXX.XX	J1	5072
48999	Pancreas surgery procedure	$XXX.XX	T	5071
49082	Abd paracentesis	$XXX.XX	T	5301
49083	Abd paracentesis w/imaging	$XXX.XX	T	5301
49084	Peritoneal lavage	$XXX.XX	T	5301
49180	Biopsy abdominal mass	$XXX.XX	J1	5072
49185	Sclerotx fluid collection	$XXX.XX	T	5071
49250	Excision of umbilicus	$XXX.XX	J1	5341
49320	Diag laparo separate proc	$XXX.XX	J1	5361
49321	Laparoscopy biopsy	$XXX.XX	J1	5361
49322	Laparoscopy aspiration	$XXX.XX	J1	5361
49323	Laparo drain lymphocele	$XXX.XX	J1	5361
49324	Lap insert tunnel ip cath	$XXX.XX	J1	5361
49325	Lap revision perm ip cath	$XXX.XX	J1	5361
49329	Laparo proc abdm/per/oment	$XXX.XX	J1	5361
49402	Remove foreign body adbomen	$XXX.XX	J1	5341
49405	Image cath fluid colxn visc	$XXX.XX	J1	5072
49406	Image cath fluid peri/retro	$XXX.XX	J1	5072
49407	Image cath fluid trns/vgnl	$XXX.XX	J1	5072
49411	Ins mark abd/pel for rt perq	$XXX.XX	S	5613
49418	Insert tun ip cath perc	$XXX.XX	J1	5341
49419	Insert tun ip cath w/port	$XXX.XX	J1	5184
49421	Ins tun ip cath for dial opn	$XXX.XX	J1	5341
49422	Remove tunneled ip cath	$XXX.XX	Q2	5183
49423	Exchange drainage catheter	$XXX.XX	J1	5302
49426	Revise abdomen-venous shunt	$XXX.XX	J1	5341
49429	Removal of shunt	$XXX.XX	Q2	5183
49436	Embedded ip cath exit-site	$XXX.XX	J1	5302
49440	Place gastrostomy tube perc	$XXX.XX	J1	5302
49441	Place duod/jej tube perc	$XXX.XX	J1	5302
49442	Place cecostomy tube perc	$XXX.XX	T	5312
49446	Change g-tube to g-j perc	$XXX.XX	J1	5302
49450	Replace g/c tube perc	$XXX.XX	T	5301
49451	Replace duod/jej tube perc	$XXX.XX	T	5301
49452	Replace g-j tube perc	$XXX.XX	T	5301
49460	Fix g/colon tube w/device	$XXX.XX	T	5301
49465	Fluoro exam of g/colon tube	$XXX.XX	Q1	5523
49491	Rpr hern preemie reduc	$XXX.XX	J1	5361
49492	Rpr ing hern premie blocked	$XXX.XX	J1	5341
49495	Rpr ing hernia baby reduc	$XXX.XX	J1	5341
49496	Rpr ing hernia baby blocked	$XXX.XX	J1	5341
49500	Rpr ing hernia init reduce	$XXX.XX	J1	5341
49501	Rpr ing hernia init blocked	$XXX.XX	J1	5341
49505	Prp i/hern init reduc >5 yr	$XXX.XX	J1	5341
49507	Prp i/hern init block >5 yr	$XXX.XX	J1	5341
49520	Rerepair ing hernia reduce	$XXX.XX	J1	5341
49521	Rerepair ing hernia blocked	$XXX.XX	J1	5341
49525	Repair ing hernia sliding	$XXX.XX	J1	5341
49540	Repair lumbar hernia	$XXX.XX	J1	5361
49550	Rpr rem hernia init reduce	$XXX.XX	J1	5341
49553	Rpr fem hernia init blocked	$XXX.XX	J1	5341
49555	Rerepair fem hernia reduce	$XXX.XX	J1	5341
49557	Rerepair fem hernia blocked	$XXX.XX	J1	5341
49560	Rpr ventral hern init reduc	$XXX.XX	J1	5341
49561	Rpr ventral hern init block	$XXX.XX	J1	5341
49565	Rerepair ventrl hern reduce	$XXX.XX	J1	5361
49566	Rerepair ventrl hern block	$XXX.XX	J1	5361
49570	Rpr epigastric hern reduce	$XXX.XX	J1	5341
49572	Rpr epigastric hern blocked	$XXX.XX	J1	5341
49580	Rpr umbil hern reduc < 5 yr	$XXX.XX	J1	5341
49582	Rpr umbil hern block < 5 yr	$XXX.XX	J1	5341
49585	Rpr umbil hern reduc > 5 yr	$XXX.XX	J1	5341
49587	Rpr umbil hern block > 5 yr	$XXX.XX	J1	5341
49590	Repair spigelian hernia	$XXX.XX	J1	5341
49600	Repair umbilical lesion	$XXX.XX	J1	5341
49650	Lap ing hernia repair init	$XXX.XX	J1	5361
49651	Lap ing hernia repair recur	$XXX.XX	J1	5361
49652	Lap vent/abd hernia repair	$XXX.XX	J1	5361
49653	Lap vent/abd hern proc comp	$XXX.XX	J1	5361
49654	Lap inc hernia repair	$XXX.XX	J1	5362
49655	Lap inc hern repair comp	$XXX.XX	J1	5362
49656	Lap inc hernia repair recur	$XXX.XX	J1	5362
49657	Lap inc hern recur comp	$XXX.XX	J1	5362
49659	Laparo proc hernia repair	$XXX.XX	J1	5361
49999	Abdomen surgery procedure	$XXX.XX	T	5301
50020	Renal abscess open drain	$XXX.XX	J1	5373
50080	Removal of kidney stone	$XXX.XX	J1	5376
50081	Removal of kidney stone	$XXX.XX	J1	5376
50200	Renal biopsy perq	$XXX.XX	J1	5072
50382	Change ureter stent percut	$XXX.XX	J1	5373
50384	Remove ureter stent percut	$XXX.XX	Q2	5373
50385	Change stent via transureth	$XXX.XX	J1	5373
50386	Remove stent via transureth	$XXX.XX	Q2	5373
50387	Change nephroureteral cath	$XXX.XX	J1	5373
50389	Remove renal tube w/fluoro	$XXX.XX	Q2	5372
50390	Drainage of kidney lesion	$XXX.XX	T	5071
50391	Instll rx agnt into rnal tub	$XXX.XX	T	5371
50396	Measure kidney pressure	$XXX.XX	T	5372
50430	Njx px nfrosgrm &/urtrgrm	$XXX.XX	Q2	5372
50431	Njx px nfrosgrm &/urtrgrm	$XXX.XX	Q2	5372
50432	Plmt nephrostomy catheter	$XXX.XX	J1	5373
50433	Plmt nephroureteral catheter	$XXX.XX	J1	5374
50434	Convert nephrostomy catheter	$XXX.XX	J1	5373
50435	Exchange nephrostomy cath	$XXX.XX	J1	5373
50436	Dilat xst trc ndurlgc px	$XXX.XX	J1	5373
50437	Dilat xst trc new access rcs	$XXX.XX	J1	5374
50541	Laparo ablate renal cyst	$XXX.XX	J1	5361
50542	Laparo ablate renal mass	$XXX.XX	J1	5362
50543	Laparo partial nephrectomy	$XXX.XX	J1	5362
50544	Laparoscopy pyeloplasty	$XXX.XX	J1	5362
50549	Laparoscope proc renal	$XXX.XX	J1	5361
50551	Kidney endoscopy	$XXX.XX	J1	5375
50553	Kidney endoscopy	$XXX.XX	J1	5375
50555	Kidney endoscopy & biopsy	$XXX.XX	J1	5376
50557	Kidney endoscopy & treatment	$XXX.XX	J1	5376
50561	Kidney endoscopy & treatment	$XXX.XX	J1	5375
50562	Renal scope w/tumor resect	$XXX.XX	J1	5376
50570	Kidney endoscopy	$XXX.XX	J1	5374
50572	Kidney endoscopy	$XXX.XX	T	5372
50574	Kidney endoscopy & biopsy	$XXX.XX	J1	5373
50575	Kidney endoscopy	$XXX.XX	J1	5375
50576	Kidney endoscopy & treatment	$XXX.XX	J1	5375
50580	Kidney endoscopy & treatment	$XXX.XX	J1	5375
50590	Fragmenting of kidney stone	$XXX.XX	J1	5374
50592	Perc rf ablate renal tumor	$XXX.XX	J1	5361
50593	Perc cryo ablate renal tum	$XXX.XX	J1	5362
50686	Measure ureter pressure	$XXX.XX	S	5721
50688	Change of ureter tube/stent	$XXX.XX	J1	5373
50693	Plmt ureteral stent prq	$XXX.XX	J1	5374
50694	Plmt ureteral stent prq	$XXX.XX	J1	5374
50695	Plmt ureteral stent prq	$XXX.XX	J1	5374
50727	Revise ureter	$XXX.XX	J1	5374
50945	Laparoscopy ureterolithotomy	$XXX.XX	J1	5361
50947	Laparo new ureter/bladder	$XXX.XX	J1	5361
50948	Laparo new ureter/bladder	$XXX.XX	J1	5362
50949	Laparoscope proc ureter	$XXX.XX	J1	5361
50951	Endoscopy of ureter	$XXX.XX	J1	5374
50953	Endoscopy of ureter	$XXX.XX	J1	5374
50955	Ureter endoscopy & biopsy	$XXX.XX	J1	5375
50957	Ureter endoscopy & treatment	$XXX.XX	J1	5375
50961	Ureter endoscopy & treatment	$XXX.XX	J1	5375
50970	Ureter endoscopy	$XXX.XX	J1	5374
50972	Ureter endoscopy & catheter	$XXX.XX	J1	5374
50974	Ureter endoscopy & biopsy	$XXX.XX	J1	5375
50976	Ureter endoscopy & treatment	$XXX.XX	J1	5375
50980	Ureter endoscopy & treatment	$XXX.XX	J1	5375
51020	Incise & treat bladder	$XXX.XX	J1	5374
51030	Incise & treat bladder	$XXX.XX	J1	5374
51040	Incise & drain bladder	$XXX.XX	J1	5373
51045	Incise bladder/drain ureter	$XXX.XX	J1	5373
51050	Removal of bladder stone	$XXX.XX	J1	5375
51060	Removal of ureter stone	$XXX.XX	J1	5373
51065	Remove ureter calculus	$XXX.XX	J1	5374
51080	Drainage of bladder abscess	$XXX.XX	J1	5073
51100	Drain bladder by needle	$XXX.XX	T	5371
51101	Drain bladder by trocar/cath	$XXX.XX	S	5724
51102	Drain bl w/cath insertion	$XXX.XX	J1	5373
51500	Removal of bladder cyst	$XXX.XX	J1	5361
51520	Removal of bladder lesion	$XXX.XX	J1	5374
51535	Repair of ureter lesion	$XXX.XX	J1	5374
51700	Irrigation of bladder	$XXX.XX	T	5371
51701	Insert bladder catheter	$XXX.XX	Q1	5734
51702	Insert temp bladder cath	$XXX.XX	Q1	5734
51703	Insert bladder cath complex	$XXX.XX	S	5721
51705	Change of bladder tube	$XXX.XX	T	5371
51710	Change of bladder tube	$XXX.XX	T	5372
51715	Endoscopic injection/implant	$XXX.XX	J1	5374
51720	Treatment of bladder lesion	$XXX.XX	T	5371
51725	Simple cystometrogram	$XXX.XX	T	5371
51726	Complex cystometrogram	$XXX.XX	T	5371
51727	Cystometrogram w/up	$XXX.XX	T	5372
51728	Cystometrogram w/vp	$XXX.XX	T	5372
51729	Cystometrogram w/vp&up	$XXX.XX	T	5372
51736	Urine flow measurement	$XXX.XX	Q1	5734
51741	Electro-uroflowmetry first	$XXX.XX	Q1	5721
51784	Anal/urinary muscle study	$XXX.XX	S	5721
51785	Anal/urinary muscle study	$XXX.XX	T	5371
51792	Urinary reflex study	$XXX.XX	Q1	5733
51798	Us urine capacity measure	$XXX.XX	Q1	5733
51845	Repair bladder neck	$XXX.XX	J1	5415
51860	Repair of bladder wound	$XXX.XX	J1	5375
51880	Repair of bladder opening	$XXX.XX	J1	5374
51990	Laparo urethral suspension	$XXX.XX	J1	5361
51992	Laparo sling operation	$XXX.XX	J1	5361
51999	Laparoscope proc bla	$XXX.XX	J1	5361
52000	Cystoscopy	$XXX.XX	T	5372
52001	Cystoscopy removal of clots	$XXX.XX	J1	5374
52005	Cystoscopy & ureter catheter	$XXX.XX	J1	5373
52007	Cystoscopy and biopsy	$XXX.XX	J1	5374
52010	Cystoscopy & duct catheter	$XXX.XX	T	5372
52204	Cystoscopy w/biopsy(s)	$XXX.XX	J1	5373
52214	Cystoscopy and treatment	$XXX.XX	J1	5373
52224	Cystoscopy and treatment	$XXX.XX	J1	5373
52234	Cystoscopy and treatment	$XXX.XX	J1	5374
52235	Cystoscopy and treatment	$XXX.XX	J1	5374
52240	Cystoscopy and treatment	$XXX.XX	J1	5375
52250	Cystoscopy and radiotracer	$XXX.XX	J1	5374
52260	Cystoscopy and treatment	$XXX.XX	J1	5373
52265	Cystoscopy and treatment	$XXX.XX	J1	5373
52270	Cystoscopy & revise urethra	$XXX.XX	J1	5373
52275	Cystoscopy & revise urethra	$XXX.XX	J1	5373
52276	Cystoscopy and treatment	$XXX.XX	J1	5373
52277	Cystoscopy and treatment	$XXX.XX	J1	5374
52281	Cystoscopy and treatment	$XXX.XX	J1	5373
52282	Cystoscopy implant stent	$XXX.XX	J1	5374
52283	Cystoscopy and treatment	$XXX.XX	J1	5373
52285	Cystoscopy and treatment	$XXX.XX	T	5372
52287	Cystoscopy chemodenervation	$XXX.XX	J1	5373
52290	Cystoscopy and treatment	$XXX.XX	J1	5373
52300	Cystoscopy and treatment	$XXX.XX	J1	5374
52301	Cystoscopy and treatment	$XXX.XX	J1	5374
52305	Cystoscopy and treatment	$XXX.XX	J1	5375
52310	Cystoscopy and treatment	$XXX.XX	J1	5373
52315	Cystoscopy and treatment	$XXX.XX	J1	5373
52317	Remove bladder stone	$XXX.XX	J1	5374
52318	Remove bladder stone	$XXX.XX	J1	5374
52320	Cystoscopy and treatment	$XXX.XX	J1	5374
52325	Cystoscopy stone removal	$XXX.XX	J1	5375
52327	Cystoscopy inject material	$XXX.XX	J1	5375
52330	Cystoscopy and treatment	$XXX.XX	J1	5374
52332	Cystoscopy and treatment	$XXX.XX	J1	5374
52334	Create passage to kidney	$XXX.XX	J1	5374
52341	Cysto w/ureter stricture tx	$XXX.XX	J1	5374
52342	Cysto w/up stricture tx	$XXX.XX	J1	5374
52343	Cysto w/renal stricture tx	$XXX.XX	J1	5373
52344	Cysto/uretero stricture tx	$XXX.XX	J1	5374
52345	Cysto/uretero w/up stricture	$XXX.XX	J1	5374
52346	Cystouretero w/renal strict	$XXX.XX	J1	5375
52351	Cystouretero & or pyeloscope	$XXX.XX	J1	5374
52352	Cystouretero w/stone remove	$XXX.XX	J1	5374
52353	Cystouretero w/lithotripsy	$XXX.XX	J1	5375
52354	Cystouretero w/biopsy	$XXX.XX	J1	5375
52355	Cystouretero w/excise tumor	$XXX.XX	J1	5375
52356	Cysto/uretero w/lithotripsy	$XXX.XX	J1	5375
52400	Cystouretero w/congen repr	$XXX.XX	J1	5374
52402	Cystourethro cut ejacul duct	$XXX.XX	J1	5374
52450	Incision of prostate	$XXX.XX	J1	5374
52500	Revision of bladder neck	$XXX.XX	J1	5374
52601	Prostatectomy (turp)	$XXX.XX	J1	5375
52630	Remove prostate regrowth	$XXX.XX	J1	5375
52640	Relieve bladder contracture	$XXX.XX	J1	5374
52647	Laser surgery of prostate	$XXX.XX	J1	5375
52648	Laser surgery of prostate	$XXX.XX	J1	5375
52649	Prostate laser enucleation	$XXX.XX	J1	5375
52700	Drainage of prostate abscess	$XXX.XX	J1	5374
53000	Incision of urethra	$XXX.XX	J1	5373
53010	Incision of urethra	$XXX.XX	J1	5375
53020	Incision of urethra	$XXX.XX	J1	5373
53025	Incision of urethra	$XXX.XX	J1	5373
53040	Drainage of urethra abscess	$XXX.XX	J1	5373
53060	Drainage of urethra abscess	$XXX.XX	J1	5373
53080	Drainage of urinary leakage	$XXX.XX	T	5372
53085	Drainage of urinary leakage	$XXX.XX	J1	5373
53200	Biopsy of urethra	$XXX.XX	J1	5373
53210	Removal of urethra	$XXX.XX	J1	5374
53215	Removal of urethra	$XXX.XX	J1	5375
53220	Treatment of urethra lesion	$XXX.XX	J1	5374
53230	Removal of urethra lesion	$XXX.XX	J1	5375
53235	Removal of urethra lesion	$XXX.XX	J1	5375
53240	Surgery for urethra pouch	$XXX.XX	J1	5374
53250	Removal of urethra gland	$XXX.XX	J1	5374
53260	Treatment of urethra lesion	$XXX.XX	J1	5373
53265	Treatment of urethra lesion	$XXX.XX	J1	5373
53270	Removal of urethra gland	$XXX.XX	J1	5373
53275	Repair of urethra defect	$XXX.XX	J1	5373
53400	Revise urethra stage 1	$XXX.XX	J1	5375
53405	Revise urethra stage 2	$XXX.XX	J1	5375
53410	Reconstruction of urethra	$XXX.XX	J1	5375
53420	Reconstruct urethra stage 1	$XXX.XX	J1	5375
53425	Reconstruct urethra stage 2	$XXX.XX	J1	5375
53430	Reconstruction of urethra	$XXX.XX	J1	5375
53431	Reconstruct urethra/bladder	$XXX.XX	J1	5375
53440	Male sling procedure	$XXX.XX	J1	5376
53442	Remove/revise male sling	$XXX.XX	J1	5375
53444	Insert tandem cuff	$XXX.XX	J1	5377
53445	Insert uro/ves nck sphincter	$XXX.XX	J1	5377
53446	Remove uro sphincter	$XXX.XX	Q2	5375
53447	Remove/replace ur sphincter	$XXX.XX	J1	5377
53449	Repair uro sphincter	$XXX.XX	J1	5375
53450	Revision of urethra	$XXX.XX	J1	5374
53460	Revision of urethra	$XXX.XX	J1	5374
53500	Urethrlys transvag w/ scope	$XXX.XX	J1	5374
53502	Repair of urethra injury	$XXX.XX	J1	5374
53505	Repair of urethra injury	$XXX.XX	J1	5375
53510	Repair of urethra injury	$XXX.XX	J1	5375
53515	Repair of urethra injury	$XXX.XX	J1	5375
53520	Repair of urethra defect	$XXX.XX	J1	5375
53600	Dilate urethra stricture	$XXX.XX	T	5371
53601	Dilate urethra stricture	$XXX.XX	Q1	5734
53605	Dilate urethra stricture	$XXX.XX	J1	5373
53620	Dilate urethra stricture	$XXX.XX	T	5372
53621	Dilate urethra stricture	$XXX.XX	T	5371
53660	Dilation of urethra	$XXX.XX	S	5721
53661	Dilation of urethra	$XXX.XX	Q1	5734
53665	Dilation of urethra	$XXX.XX	J1	5373
53850	Prostatic microwave thermotx	$XXX.XX	J1	5374
53852	Prostatic rf thermotx	$XXX.XX	J1	5374
53854	Trurl dstrj prst8 tiss rf wv	$XXX.XX	J1	5373
53855	Insert prost urethral stent	$XXX.XX	J1	5373
53860	Transurethral rf treatment	$XXX.XX	J1	5373
53899	Urology surgery procedure	$XXX.XX	T	5371
54000	Slitting of prepuce	$XXX.XX	J1	5374
54001	Slitting of prepuce	$XXX.XX	J1	5373
54015	Drain penis lesion	$XXX.XX	J1	5072
54050	Destruction penis lesion(s)	$XXX.XX	Q1	5052
54055	Destruction penis lesion(s)	$XXX.XX	T	5054
54056	Cryosurgery penis lesion(s)	$XXX.XX	Q1	5051
54057	Laser surg penis lesion(s)	$XXX.XX	T	5054
54060	Excision of penis lesion(s)	$XXX.XX	T	5054
54065	Destruction penis lesion(s)	$XXX.XX	T	5054
54100	Biopsy of penis	$XXX.XX	J1	5072
54105	Biopsy of penis	$XXX.XX	J1	5073
54110	Treatment of penis lesion	$XXX.XX	J1	5374
54111	Treat penis lesion graft	$XXX.XX	J1	5375
54112	Treat penis lesion graft	$XXX.XX	J1	5376
54115	Treatment of penis lesion	$XXX.XX	J1	5073
54120	Partial removal of penis	$XXX.XX	J1	5374
54150	Circumcision w/regionl block	$XXX.XX	J1	5373
54160	Circumcision neonate	$XXX.XX	T	5372
54161	Circum 28 days or older	$XXX.XX	J1	5373
54162	Lysis penil circumic lesion	$XXX.XX	J1	5373
54163	Repair of circumcision	$XXX.XX	J1	5373
54164	Frenulotomy of penis	$XXX.XX	J1	5373
54200	Treatment of penis lesion	$XXX.XX	T	5371
54205	Treatment of penis lesion	$XXX.XX	J1	5375
54220	Treatment of penis lesion	$XXX.XX	T	5371
54231	Dynamic cavernosometry	$XXX.XX	T	5371
54235	Penile injection	$XXX.XX	T	5371
54240	Penis study	$XXX.XX	S	5721
54250	Penis study	$XXX.XX	T	5371
54300	Revision of penis	$XXX.XX	J1	5374
54304	Revision of penis	$XXX.XX	J1	5374
54308	Reconstruction of urethra	$XXX.XX	J1	5375
54312	Reconstruction of urethra	$XXX.XX	J1	5374
54316	Reconstruction of urethra	$XXX.XX	J1	5375
54318	Reconstruction of urethra	$XXX.XX	J1	5374
54322	Reconstruction of urethra	$XXX.XX	J1	5374
54324	Reconstruction of urethra	$XXX.XX	J1	5374
54326	Reconstruction of urethra	$XXX.XX	J1	5373
54328	Revise penis/urethra	$XXX.XX	J1	5374
54332	Revise penis/urethra	$XXX.XX	J1	5374
54336	Revise penis/urethra	$XXX.XX	J1	5374
54340	Secondary urethral surgery	$XXX.XX	J1	5374
54344	Secondary urethral surgery	$XXX.XX	J1	5375
54348	Secondary urethral surgery	$XXX.XX	J1	5375
54352	Reconstruct urethra/penis	$XXX.XX	J1	5375
54360	Penis plastic surgery	$XXX.XX	J1	5374
54380	Repair penis	$XXX.XX	J1	5373
54385	Repair penis	$XXX.XX	J1	5373
54400	Insert semi-rigid prosthesis	$XXX.XX	J1	5377
54401	Insert self-contd prosthesis	$XXX.XX	J1	5377
54405	Insert multi-comp penis pros	$XXX.XX	J1	5377
54406	Remove muti-comp penis pros	$XXX.XX	Q2	5374
54408	Repair multi-comp penis pros	$XXX.XX	J1	5375
54410	Remove/replace penis prosth	$XXX.XX	J1	5377
54411	Remov/replc penis pros comp	$XXX.XX	J1	5377
54415	Remove self-contd penis pros	$XXX.XX	Q2	5374
54416	Remv/repl penis contain pros	$XXX.XX	J1	5377
54417	Remv/replc penis pros compl	$XXX.XX	J1	5377
54420	Revision of penis	$XXX.XX	J1	5373
54435	Revision of penis	$XXX.XX	J1	5374
54437	Repair corporeal tear	$XXX.XX	J1	5374
54440	Repair of penis	$XXX.XX	J1	5374
54450	Preputial stretching	$XXX.XX	T	5371
54500	Biopsy of testis	$XXX.XX	J1	5073
54505	Biopsy of testis	$XXX.XX	J1	5374
54512	Excise lesion testis	$XXX.XX	J1	5374
54520	Removal of testis	$XXX.XX	J1	5374
54522	Orchiectomy partial	$XXX.XX	J1	5374
54530	Removal of testis	$XXX.XX	J1	5341
54535	Extensive testis surgery	$XXX.XX	J1	5374
54550	Exploration for testis	$XXX.XX	J1	5341
54560	Exploration for testis	$XXX.XX	J1	5373
54600	Reduce testis torsion	$XXX.XX	J1	5374
54620	Suspension of testis	$XXX.XX	J1	5374
54640	Orchiopexy ingun/scrot appr	$XXX.XX	J1	5341
54650	Orchiopexy (fowler-stephens)	$XXX.XX	J1	5341
54660	Revision of testis	$XXX.XX	J1	5375
54670	Repair testis injury	$XXX.XX	J1	5373
54680	Relocation of testis(es)	$XXX.XX	J1	5374
54690	Laparoscopy orchiectomy	$XXX.XX	J1	5361
54692	Laparoscopy orchiopexy	$XXX.XX	J1	5361
54699	Laparoscope proc testis	$XXX.XX	J1	5361
54700	Drainage of scrotum	$XXX.XX	J1	5373
54800	Biopsy of epididymis	$XXX.XX	J1	5072
54830	Remove epididymis lesion	$XXX.XX	J1	5373
54840	Remove epididymis lesion	$XXX.XX	J1	5373
54860	Removal of epididymis	$XXX.XX	J1	5373
54861	Removal of epididymis	$XXX.XX	J1	5374
54865	Explore epididymis	$XXX.XX	J1	5374
54900	Fusion of spermatic ducts	$XXX.XX	J1	5373
54901	Fusion of spermatic ducts	$XXX.XX	J1	5374
55000	Drainage of hydrocele	$XXX.XX	T	5071
55040	Removal of hydrocele	$XXX.XX	J1	5341
55041	Removal of hydroceles	$XXX.XX	J1	5341
55060	Repair of hydrocele	$XXX.XX	J1	5374
55100	Drainage of scrotum abscess	$XXX.XX	J1	5072
55110	Explore scrotum	$XXX.XX	J1	5374
55120	Removal of scrotum lesion	$XXX.XX	J1	5373
55150	Removal of scrotum	$XXX.XX	J1	5374
55175	Revision of scrotum	$XXX.XX	J1	5374
55180	Revision of scrotum	$XXX.XX	J1	5375
55200	Incision of sperm duct	$XXX.XX	J1	5374
55250	Removal of sperm duct(s)	$XXX.XX	J1	5373
55400	Repair of sperm duct	$XXX.XX	J1	5374
55500	Removal of hydrocele	$XXX.XX	J1	5374
55520	Removal of sperm cord lesion	$XXX.XX	J1	5374
55530	Revise spermatic cord veins	$XXX.XX	J1	5374
55535	Revise spermatic cord veins	$XXX.XX	J1	5341
55540	Revise hernia & sperm veins	$XXX.XX	J1	5341
55550	Laparo ligate spermatic vein	$XXX.XX	J1	5361
55559	Laparo proc spermatic cord	$XXX.XX	J1	5361
55600	Incise sperm duct pouch	$XXX.XX	J1	5373
55680	Remove sperm pouch lesion	$XXX.XX	J1	5374
55700	Biopsy of prostate	$XXX.XX	J1	5373
55705	Biopsy of prostate	$XXX.XX	J1	5373
55706	Prostate saturation sampling	$XXX.XX	J1	5374
55720	Drainage of prostate abscess	$XXX.XX	J1	5373
55725	Drainage of prostate abscess	$XXX.XX	J1	5374
55860	Surgical exposure prostate	$XXX.XX	J1	5375
55866	Laparo radical prostatectomy	$XXX.XX	J1	5362
55870	Electroejaculation	$XXX.XX	T	5413
55873	Cryoablate prostate	$XXX.XX	J1	5376
55874	Tprnl plmt biodegrdabl matrl	$XXX.XX	T	5375
55875	Transperi needle place pros	$XXX.XX	J1	5375
55876	Place rt device/marker pros	$XXX.XX	S	5613
55899	Genital surgery procedure	$XXX.XX	T	5371
55920	Place needles pelvic for rt	$XXX.XX	J1	5415
55970	Sex transformation m to f	$XXX.XX	J1	5415
55980	Sex transformation f to m	$XXX.XX	J1	5374
56405	I & d of vulva/perineum	$XXX.XX	T	5412
56420	Drainage of gland abscess	$XXX.XX	T	5411
56440	Surgery for vulva lesion	$XXX.XX	J1	5414
56441	Lysis of labial lesion(s)	$XXX.XX	J1	5414
56442	Hymenotomy	$XXX.XX	J1	5414
56501	Destroy vulva lesions sim	$XXX.XX	T	5054
56515	Destroy vulva lesion/s compl	$XXX.XX	T	5054
56605	Biopsy of vulva/perineum	$XXX.XX	T	5413
56620	Partial removal of vulva	$XXX.XX	J1	5414
56625	Complete removal of vulva	$XXX.XX	J1	5414
56700	Partial removal of hymen	$XXX.XX	J1	5414
56740	Remove vagina gland lesion	$XXX.XX	J1	5414
56800	Repair of vagina	$XXX.XX	J1	5414
56805	Repair clitoris	$XXX.XX	J1	5414
56810	Repair of perineum	$XXX.XX	J1	5414
56820	Exam of vulva w/scope	$XXX.XX	T	5411
56821	Exam/biopsy of vulva w/scope	$XXX.XX	T	5412
57000	Exploration of vagina	$XXX.XX	J1	5414
57010	Drainage of pelvic abscess	$XXX.XX	J1	5414
57020	Drainage of pelvic fluid	$XXX.XX	J1	5415
57022	I & d vaginal hematoma pp	$XXX.XX	J1	5073
57023	I & d vag hematoma non-ob	$XXX.XX	J1	5073
57061	Destroy vag lesions simple	$XXX.XX	J1	5414
57065	Destroy vag lesions complex	$XXX.XX	J1	5414
57100	Biopsy of vagina	$XXX.XX	T	5413
57105	Biopsy of vagina	$XXX.XX	J1	5414
57106	Remove vagina wall partial	$XXX.XX	J1	5414
57107	Remove vagina tissue part	$XXX.XX	J1	5414
57109	Vaginectomy partial w/nodes	$XXX.XX	J1	5414
57120	Closure of vagina	$XXX.XX	J1	5415
57130	Remove vagina lesion	$XXX.XX	J1	5414
57135	Remove vagina lesion	$XXX.XX	J1	5414
57150	Treat vagina infection	$XXX.XX	Q1	5733
57155	Insert uteri tandem/ovoids	$XXX.XX	J1	5415
57156	Ins vag brachytx device	$XXX.XX	T	5412
57160	Insert pessary/other device	$XXX.XX	T	5411
57170	Fitting of diaphragm/cap	$XXX.XX	T	5411
57180	Treat vaginal bleeding	$XXX.XX	T	5411
57200	Repair of vagina	$XXX.XX	J1	5414
57210	Repair vagina/perineum	$XXX.XX	J1	5414
57220	Revision of urethra	$XXX.XX	J1	5415
57230	Repair of urethral lesion	$XXX.XX	J1	5414
57240	Anterior colporrhaphy	$XXX.XX	J1	5415
57250	Repair rectum & vagina	$XXX.XX	J1	5415
57260	Cmbn ant pst colprhy	$XXX.XX	J1	5415
57265	Cmbn ap colprhy w/ntrcl rpr	$XXX.XX	J1	5415
57268	Repair of bowel bulge	$XXX.XX	J1	5415
57282	Colpopexy extraperitoneal	$XXX.XX	J1	5416
57283	Colpopexy intraperitoneal	$XXX.XX	J1	5416
57284	Repair paravag defect open	$XXX.XX	J1	5415
57285	Repair paravag defect vag	$XXX.XX	J1	5416
57287	Revise/remove sling repair	$XXX.XX	Q2	5414
57288	Repair bladder defect	$XXX.XX	J1	5415
57289	Repair bladder & vagina	$XXX.XX	J1	5416
57291	Construction of vagina	$XXX.XX	J1	5415
57292	Construct vagina with graft	$XXX.XX	J1	5415
57295	Revise vag graft via vagina	$XXX.XX	J1	5414
57300	Repair rectum-vagina fistula	$XXX.XX	J1	5414
57310	Repair urethrovaginal lesion	$XXX.XX	J1	5416
57320	Repair bladder-vagina lesion	$XXX.XX	J1	5415
57330	Repair bladder-vagina lesion	$XXX.XX	J1	5416
57335	Repair vagina	$XXX.XX	J1	5415
57400	Dilation of vagina	$XXX.XX	J1	5414
57410	Pelvic examination	$XXX.XX	J1	5414
57415	Remove vaginal foreign body	$XXX.XX	J1	5414
57420	Exam of vagina w/scope	$XXX.XX	T	5412
57421	Exam/biopsy of vag w/scope	$XXX.XX	T	5413
57423	Repair paravag defect lap	$XXX.XX	J1	5362
57425	Laparoscopy surg colpopexy	$XXX.XX	J1	5362
57426	Revise prosth vag graft lap	$XXX.XX	J1	5416
57452	Exam of cervix w/scope	$XXX.XX	T	5411
57454	Bx/curett of cervix w/scope	$XXX.XX	T	5412
57455	Biopsy of cervix w/scope	$XXX.XX	T	5412
57456	Endocerv curettage w/scope	$XXX.XX	T	5412
57460	Bx of cervix w/scope leep	$XXX.XX	J1	5414
57461	Conz of cervix w/scope leep	$XXX.XX	J1	5414
57500	Biopsy of cervix	$XXX.XX	T	5413
57505	Endocervical curettage	$XXX.XX	T	5413
57510	Cauterization of cervix	$XXX.XX	J1	5414
57511	Cryocautery of cervix	$XXX.XX	T	5412
57513	Laser surgery of cervix	$XXX.XX	J1	5414
57520	Conization of cervix	$XXX.XX	J1	5414
57522	Conization of cervix	$XXX.XX	J1	5414
57530	Removal of cervix	$XXX.XX	J1	5415
57550	Removal of residual cervix	$XXX.XX	J1	5415
57555	Remove cervix/repair vagina	$XXX.XX	J1	5415
57556	Remove cervix repair bowel	$XXX.XX	J1	5415
57558	D&c of cervical stump	$XXX.XX	J1	5414
57700	Revision of cervix	$XXX.XX	J1	5414
57720	Revision of cervix	$XXX.XX	J1	5414
57800	Dilation of cervical canal	$XXX.XX	J1	5414
58100	Biopsy of uterus lining	$XXX.XX	T	5411
58120	Dilation and curettage	$XXX.XX	J1	5414
58145	Myomectomy vag method	$XXX.XX	J1	5414
58260	Vaginal hysterectomy	$XXX.XX	J1	5415
58262	Vag hyst including t/o	$XXX.XX	J1	5415
58263	Vag hyst w/t/o & vag repair	$XXX.XX	J1	5415
58270	Vag hyst w/enterocele repair	$XXX.XX	J1	5415
58290	Vag hyst complex	$XXX.XX	J1	5416
58291	Vag hyst incl t/o complex	$XXX.XX	J1	5415
58292	Vag hyst t/o & repair compl	$XXX.XX	J1	5416
58294	Vag hyst w/enterocele compl	$XXX.XX	J1	5415
58301	Remove intrauterine device	$XXX.XX	Q2	5412
58321	Artificial insemination	$XXX.XX	T	5412
58322	Artificial insemination	$XXX.XX	T	5411
58323	Sperm washing	$XXX.XX	T	5411
58345	Reopen fallopian tube	$XXX.XX	J1	5414
58346	Insert heyman uteri capsule	$XXX.XX	J1	5415
58350	Reopen fallopian tube	$XXX.XX	J1	5415
58353	Endometr ablate thermal	$XXX.XX	J1	5415
58356	Endometrial cryoablation	$XXX.XX	J1	5415
58541	Lsh uterus 250 g or less	$XXX.XX	J1	5361
58542	Lsh w/t/o ut 250 g or less	$XXX.XX	J1	5362
58543	Lsh uterus above 250 g	$XXX.XX	J1	5362
58544	Lsh w/t/o uterus above 250 g	$XXX.XX	J1	5362
58545	Laparoscopic myomectomy	$XXX.XX	J1	5361
58546	Laparo-myomectomy complex	$XXX.XX	J1	5362
58550	Laparo-asst vag hysterectomy	$XXX.XX	J1	5361
58552	Laparo-vag hyst incl t/o	$XXX.XX	J1	5362
58553	Laparo-vag hyst complex	$XXX.XX	J1	5362
58554	Laparo-vag hyst w/t/o compl	$XXX.XX	J1	5362
58555	Hysteroscopy dx sep proc	$XXX.XX	J1	5414
58558	Hysteroscopy biopsy	$XXX.XX	J1	5414
58559	Hysteroscopy lysis	$XXX.XX	J1	5415
58560	Hysteroscopy resect septum	$XXX.XX	J1	5415
58561	Hysteroscopy remove myoma	$XXX.XX	J1	5415
58562	Hysteroscopy remove fb	$XXX.XX	J1	5414
58563	Hysteroscopy ablation	$XXX.XX	J1	5415
58565	Hysteroscopy sterilization	$XXX.XX	J1	5415
58570	Tlh uterus 250 g or less	$XXX.XX	J1	5362
58571	Tlh w/t/o 250 g or less	$XXX.XX	J1	5362
58572	Tlh uterus over 250 g	$XXX.XX	J1	5362
58573	Tlh w/t/o uterus over 250 g	$XXX.XX	J1	5362
58578	Laparo proc uterus	$XXX.XX	J1	5361
58579	Hysteroscope procedure	$XXX.XX	T	5411
58600	Division of fallopian tube	$XXX.XX	J1	5414
58615	Occlude fallopian tube(s)	$XXX.XX	J1	5414
58660	Laparoscopy lysis	$XXX.XX	J1	5361
58661	Laparoscopy remove adnexa	$XXX.XX	J1	5361
58662	Laparoscopy excise lesions	$XXX.XX	J1	5361
58670	Laparoscopy tubal cautery	$XXX.XX	J1	5361
58671	Laparoscopy tubal block	$XXX.XX	J1	5361
58672	Laparoscopy fimbrioplasty	$XXX.XX	J1	5361
58673	Laparoscopy salpingostomy	$XXX.XX	J1	5361
58674	Laps abltj uterine fibroids	$XXX.XX	J1	5362
58679	Laparo proc oviduct-ovary	$XXX.XX	J1	5361
58770	Create new tubal opening	$XXX.XX	J1	5414
58800	Drainage of ovarian cyst(s)	$XXX.XX	J1	5414
58805	Drainage of ovarian cyst(s)	$XXX.XX	J1	5414
58820	Drain ovary abscess open	$XXX.XX	J1	5414
58900	Biopsy of ovary(s)	$XXX.XX	J1	5414
58920	Partial removal of ovary(s)	$XXX.XX	J1	5416
58925	Removal of ovarian cyst(s)	$XXX.XX	J1	5415
58970	Retrieval of oocyte	$XXX.XX	T	5413
58974	Transfer of embryo	$XXX.XX	T	5413
58976	Transfer of embryo	$XXX.XX	T	5412
58999	Genital surgery procedure	$XXX.XX	T	5411
59000	Amniocentesis diagnostic	$XXX.XX	T	5413
59001	Amniocentesis therapeutic	$XXX.XX	T	5412
59012	Fetal cord puncture prenatal	$XXX.XX	T	5412
59015	Chorion biopsy	$XXX.XX	T	5413
59020	Fetal contract stress test	$XXX.XX	T	5411
59025	Fetal non-stress test	$XXX.XX	T	5411
59030	Fetal scalp blood sample	$XXX.XX	T	5412
59070	Transabdom amnioinfus w/us	$XXX.XX	T	5412
59072	Umbilical cord occlud w/us	$XXX.XX	T	5412
59074	Fetal fluid drainage w/us	$XXX.XX	T	5412
59076	Fetal shunt placement w/us	$XXX.XX	T	5412
59100	Remove uterus lesion	$XXX.XX	J1	5415
59150	Treat ectopic pregnancy	$XXX.XX	J1	5361
59151	Treat ectopic pregnancy	$XXX.XX	J1	5361
59160	D & c after delivery	$XXX.XX	J1	5414
59200	Insert cervical dilator	$XXX.XX	T	5412
59300	Episiotomy or vaginal repair	$XXX.XX	J1	5414
59320	Revision of cervix	$XXX.XX	J1	5414
59409	Obstetrical care	$XXX.XX	J1	5414
59412	Antepartum manipulation	$XXX.XX	J1	5414
59414	Deliver placenta	$XXX.XX	J1	5414
59612	Vbac delivery only	$XXX.XX	J1	5414
59812	Treatment of miscarriage	$XXX.XX	J1	5414
59820	Care of miscarriage	$XXX.XX	J1	5414
59821	Treatment of miscarriage	$XXX.XX	J1	5414
59840	Abortion	$XXX.XX	J1	5414
59841	Abortion	$XXX.XX	J1	5414
59866	Abortion (mpr)	$XXX.XX	T	5412
59870	Evacuate mole of uterus	$XXX.XX	J1	5414
59871	Remove cerclage suture	$XXX.XX	Q2	5414
59897	Fetal invas px w/us	$XXX.XX	T	5411
59898	Laparo proc ob care/deliver	$XXX.XX	J1	5361
59899	Maternity care procedure	$XXX.XX	T	5411
60000	Drain thyroid/tongue cyst	$XXX.XX	J1	5163
60100	Biopsy of thyroid	$XXX.XX	T	5071
60200	Remove thyroid lesion	$XXX.XX	J1	5361
60210	Partial thyroid excision	$XXX.XX	J1	5361
60212	Partial thyroid excision	$XXX.XX	J1	5361
60220	Partial removal of thyroid	$XXX.XX	J1	5361
60225	Partial removal of thyroid	$XXX.XX	J1	5361
60240	Removal of thyroid	$XXX.XX	J1	5361
60252	Removal of thyroid	$XXX.XX	J1	5165
60260	Repeat thyroid surgery	$XXX.XX	J1	5165
60271	Removal of thyroid	$XXX.XX	J1	5165
60280	Remove thyroid duct lesion	$XXX.XX	J1	5361
60281	Remove thyroid duct lesion	$XXX.XX	J1	5361
60300	Aspir/inj thyroid cyst	$XXX.XX	T	5071
60500	Explore parathyroid glands	$XXX.XX	J1	5165
60502	Re-explore parathyroids	$XXX.XX	J1	5165
60520	Removal of thymus gland	$XXX.XX	J1	5165
60659	Laparo proc endocrine	$XXX.XX	J1	5361
60699	Endocrine surgery procedure	$XXX.XX	J1	5361
61000	Remove cranial cavity fluid	$XXX.XX	T	5442
61001	Remove cranial cavity fluid	$XXX.XX	T	5442
61020	Remove brain cavity fluid	$XXX.XX	T	5443
61026	Injection into brain canal	$XXX.XX	T	5442
61050	Remove brain canal fluid	$XXX.XX	T	5441
61055	Injection into brain canal	$XXX.XX	T	5441
61070	Brain canal shunt procedure	$XXX.XX	T	5442
61215	Insert brain-fluid device	$XXX.XX	J1	5432
61330	Decompress eye socket	$XXX.XX	J1	5164
61623	Endovasc tempory vessel occl	$XXX.XX	J1	5193
61626	Transcath occlusion non-cns	$XXX.XX	J1	5193
61720	Incise skull/brain surgery	$XXX.XX	J1	5432
61770	Incise skull for treatment	$XXX.XX	J1	5432
61790	Treat trigeminal nerve	$XXX.XX	J1	5431
61791	Treat trigeminal tract	$XXX.XX	J1	5431
61880	Revise/remove neuroelectrode	$XXX.XX	J1	5461
61885	Insrt/redo neurostim 1 array	$XXX.XX	J1	5463
61886	Implant neurostim arrays	$XXX.XX	J1	5464
61888	Revise/remove neuroreceiver	$XXX.XX	J1	5462
62000	Treat skull fracture	$XXX.XX	J1	5164
62194	Replace/irrigate catheter	$XXX.XX	J1	5431
62225	Replace/irrigate catheter	$XXX.XX	J1	5432
62230	Replace/revise brain shunt	$XXX.XX	J1	5432
62252	Csf shunt reprogram	$XXX.XX	S	5743
62263	Epidural lysis mult sessions	$XXX.XX	T	5443
62264	Epidural lysis on single day	$XXX.XX	T	5443
62267	Interdiscal perq aspir dx	$XXX.XX	T	5071
62268	Drain spinal cord cyst	$XXX.XX	T	5443
62269	Needle biopsy spinal cord	$XXX.XX	J1	5072
62270	Dx lmbr spi pnxr	$XXX.XX	T	5442
62272	Ther spi pnxr drg csf	$XXX.XX	T	5442
62273	Inject epidural patch	$XXX.XX	T	5442
62280	Treat spinal cord lesion	$XXX.XX	T	5443
62281	Treat spinal cord lesion	$XXX.XX	T	5443
62282	Treat spinal canal lesion	$XXX.XX	T	5443
62287	Percutaneous diskectomy	$XXX.XX	J1	5431
62292	Njx chemonucleolysis lmbr	$XXX.XX	J1	5431
62294	Injection into spinal artery	$XXX.XX	T	5443
62302	Myelography lumbar injection	$XXX.XX	Q2	5573
62303	Myelography lumbar injection	$XXX.XX	Q2	5573
62304	Myelography lumbar injection	$XXX.XX	Q2	5573
62305	Myelography lumbar injection	$XXX.XX	Q2	5573
62320	Njx interlaminar crv/thrc	$XXX.XX	T	5442
62321	Njx interlaminar crv/thrc	$XXX.XX	T	5442
62322	Njx interlaminar lmbr/sac	$XXX.XX	T	5442
62323	Njx interlaminar lmbr/sac	$XXX.XX	T	5442
62324	Njx interlaminar crv/thrc	$XXX.XX	T	5443
62325	Njx interlaminar crv/thrc	$XXX.XX	T	5443
62326	Njx interlaminar lmbr/sac	$XXX.XX	T	5443
62327	Njx interlaminar lmbr/sac	$XXX.XX	T	5443
62328	Dx lmbr spi pnxr w/fluor/ct	$XXX.XX	T	5442
62329	Ther spi pnxr csf fluor/ct	$XXX.XX	T	5442
62350	Implant spinal canal cath	$XXX.XX	J1	5432
62351	Implant spinal canal cath	$XXX.XX	J1	5114
62355	Remove spinal canal catheter	$XXX.XX	Q2	5431
62360	Insert spine infusion device	$XXX.XX	J1	5471
62361	Implant spine infusion pump	$XXX.XX	J1	5471
62362	Implant spine infusion pump	$XXX.XX	J1	5471
62365	Remove spine infusion device	$XXX.XX	Q2	5432
62367	Analyze spine infus pump	$XXX.XX	S	5743
62368	Analyze sp inf pump w/reprog	$XXX.XX	S	5743
62369	Anal sp inf pmp w/reprg&fill	$XXX.XX	S	5743
62370	Anl sp inf pmp w/mdreprg&fil	$XXX.XX	S	5743
62380	Ndsc dcmprn 1 ntrspc lumbar	$XXX.XX	J1	5114
63001	Remove spine lamina 1/2 crvl	$XXX.XX	J1	5114
63003	Remove spine lamina 1/2 thrc	$XXX.XX	J1	5114
63005	Remove spine lamina 1/2 lmbr	$XXX.XX	J1	5114
63011	Remove spine lamina 1/2 scrl	$XXX.XX	J1	5114
63012	Remove lamina/facets lumbar	$XXX.XX	J1	5114
63015	Remove spine lamina >2 crvcl	$XXX.XX	J1	5114
63016	Remove spine lamina >2 thrc	$XXX.XX	J1	5114
63017	Remove spine lamina >2 lmbr	$XXX.XX	J1	5114
63020	Neck spine disk surgery	$XXX.XX	J1	5114
63030	Low back disk surgery	$XXX.XX	J1	5114
63040	Laminotomy single cervical	$XXX.XX	J1	5114
63042	Laminotomy single lumbar	$XXX.XX	J1	5114
63045	Remove spine lamina 1 crvl	$XXX.XX	J1	5114
63046	Remove spine lamina 1 thrc	$XXX.XX	J1	5114
63047	Remove spine lamina 1 lmbr	$XXX.XX	J1	5114
63055	Decompress spinal cord thrc	$XXX.XX	J1	5114
63056	Decompress spinal cord lmbr	$XXX.XX	J1	5114
63064	Decompress spinal cord thrc	$XXX.XX	J1	5114
63075	Neck spine disk surgery	$XXX.XX	J1	5114
63265	Excise intraspinl lesion crv	$XXX.XX	J1	5114
63266	Excise intrspinl lesion thrc	$XXX.XX	J1	5114
63267	Excise intrspinl lesion lmbr	$XXX.XX	J1	5114
63268	Excise intrspinl lesion scrl	$XXX.XX	J1	5114
63600	Remove spinal cord lesion	$XXX.XX	J1	5431
63610	Stimulation of spinal cord	$XXX.XX	J1	5431
63650	Implant neuroelectrodes	$XXX.XX	J1	5462
63655	Implant neuroelectrodes	$XXX.XX	J1	5463
63661	Remove spine eltrd perq aray	$XXX.XX	Q2	5431
63662	Remove spine eltrd plate	$XXX.XX	J1	5461
63663	Revise spine eltrd perq aray	$XXX.XX	J1	5462
63664	Revise spine eltrd plate	$XXX.XX	J1	5463
63685	Insrt/redo spine n generator	$XXX.XX	J1	5464
63688	Revise/remove neuroreceiver	$XXX.XX	J1	5461
63741	Install spinal shunt	$XXX.XX	J1	5432
63744	Revision of spinal shunt	$XXX.XX	J1	5432
63746	Removal of spinal shunt	$XXX.XX	Q2	5431
64400	Njx aa&/strd trigeminal nrv	$XXX.XX	T	5441
64405	Njx aa&/strd gr ocpl nrv	$XXX.XX	T	5441
64408	Njx aa&/strd vagus nrv	$XXX.XX	T	5441
64415	Njx aa&/strd brach plexus	$XXX.XX	T	5443
64416	Njx aa&/strd brach plex nfs	$XXX.XX	T	5443
64417	Njx aa&/strd axillary nrv	$XXX.XX	T	5443
64418	Njx aa&/strd sprscap nrv	$XXX.XX	T	5442
64420	Njx aa&/strd ntrcost nrv 1	$XXX.XX	T	5442
64421	Njx aa&/strd ntrcost nrv ea	$XXX.XX	T	5443
64425	Njx aa&/strd ii ih nerves	$XXX.XX	T	5442
64430	Njx aa&/strd pudendal nerve	$XXX.XX	T	5443
64435	Njx aa&/strd paracrv nrv	$XXX.XX	T	5442
64445	Njx aa&/strd sciatic nerve	$XXX.XX	T	5442
64446	Njx aa&/strd sciatic nrv nfs	$XXX.XX	T	5443
64447	Njx aa&/strd femoral nerve	$XXX.XX	T	5442
64448	Njx aa&/strd fem nerve nfs	$XXX.XX	T	5443
64449	Njx aa&/strd lmbr plex nfs	$XXX.XX	T	5443
64450	Njx aa&/strd other pn/branch	$XXX.XX	T	5442
64451	Njx aa&/strd nrv nrvtg si jt	$XXX.XX	T	5442
64454	Njx aa&/strd gnclr nrv brnch	$XXX.XX	T	5442
64455	N block inj plantar digit	$XXX.XX	T	5441
64461	Pvb thoracic single inj site	$XXX.XX	T	5442
64463	Pvb thoracic cont infusion	$XXX.XX	T	5442
64479	Inj foramen epidural c/t	$XXX.XX	T	5443
64483	Inj foramen epidural l/s	$XXX.XX	T	5443
64490	Inj paravert f jnt c/t 1 lev	$XXX.XX	T	5443
64493	Inj paravert f jnt l/s 1 lev	$XXX.XX	T	5443
64505	N block spenopalatine gangl	$XXX.XX	T	5441
64510	N block stellate ganglion	$XXX.XX	T	5443
64517	N block inj hypogas plxs	$XXX.XX	T	5443
64520	N block lumbar/thoracic	$XXX.XX	T	5443
64530	N block inj celiac pelus	$XXX.XX	T	5443
64553	Implant neuroelectrodes	$XXX.XX	J1	5462
64555	Implant neuroelectrodes	$XXX.XX	J1	5462
64561	Implant neuroelectrodes	$XXX.XX	J1	5462
64566	Neuroeltrd stim post tibial	$XXX.XX	T	5441
64568	Inc for vagus n elect impl	$XXX.XX	J1	5464
64569	Revise/repl vagus n eltrd	$XXX.XX	J1	5462
64570	Remove vagus n eltrd	$XXX.XX	Q2	5432
64575	Implant neuroelectrodes	$XXX.XX	J1	5463
64580	Implant neuroelectrodes	$XXX.XX	J1	5463
64581	Implant neuroelectrodes	$XXX.XX	J1	5462
64585	Revise/remove neuroelectrode	$XXX.XX	J1	5461
64590	Insrt/redo pn/gastr stimul	$XXX.XX	J1	5463
64595	Revise/rmv pn/gastr stimul	$XXX.XX	J1	5461
64600	Injection treatment of nerve	$XXX.XX	T	5443
64605	Injection treatment of nerve	$XXX.XX	J1	5431
64610	Injection treatment of nerve	$XXX.XX	J1	5431
64611	Chemodenerv saliv glands	$XXX.XX	T	5441
64612	Destroy nerve face muscle	$XXX.XX	T	5441
64615	Chemodenerv musc migraine	$XXX.XX	T	5441
64616	Chemodenerv musc neck dyston	$XXX.XX	T	5441
64617	Chemodener muscle larynx emg	$XXX.XX	T	5441
64620	Injection treatment of nerve	$XXX.XX	T	5443
64624	Dstrj nulyt agt gnclr nrv	$XXX.XX	J1	5431
64625	Rf abltj nrv nrvtg si jt	$XXX.XX	J1	5431
64630	Injection treatment of nerve	$XXX.XX	T	5443
64632	N block inj common digit	$XXX.XX	T	5441
64633	Destroy cerv/thor facet jnt	$XXX.XX	J1	5431
64635	Destroy lumb/sac facet jnt	$XXX.XX	J1	5431
64640	Injection treatment of nerve	$XXX.XX	T	5443
64642	Chemodenerv 1 extremity 1-4	$XXX.XX	T	5442
64644	Chemodenerv 1 extrem 5/> mus	$XXX.XX	T	5442
64646	Chemodenerv trunk musc 1-5	$XXX.XX	T	5442
64647	Chemodenerv trunk musc 6/>	$XXX.XX	T	5442
64650	Chemodenerv eccrine glands	$XXX.XX	T	5441
64653	Chemodenerv eccrine glands	$XXX.XX	T	5441
64680	Injection treatment of nerve	$XXX.XX	T	5443
64681	Injection treatment of nerve	$XXX.XX	T	5443
64702	Revise finger/toe nerve	$XXX.XX	J1	5431
64704	Revise hand/foot nerve	$XXX.XX	J1	5431
64708	Revise arm/leg nerve	$XXX.XX	J1	5431
64712	Revision of sciatic nerve	$XXX.XX	J1	5431
64713	Revision of arm nerve(s)	$XXX.XX	J1	5431
64714	Revise low back nerve(s)	$XXX.XX	J1	5431
64716	Revision of cranial nerve	$XXX.XX	J1	5431
64718	Revise ulnar nerve at elbow	$XXX.XX	J1	5431
64719	Revise ulnar nerve at wrist	$XXX.XX	J1	5431
64721	Carpal tunnel surgery	$XXX.XX	J1	5431
64722	Relieve pressure on nerve(s)	$XXX.XX	J1	5431
64726	Release foot/toe nerve	$XXX.XX	J1	5431
64732	Incision of brow nerve	$XXX.XX	J1	5431
64734	Incision of cheek nerve	$XXX.XX	J1	5431
64736	Incision of chin nerve	$XXX.XX	J1	5431
64738	Incision of jaw nerve	$XXX.XX	J1	5431
64740	Incision of tongue nerve	$XXX.XX	J1	5431
64742	Incision of facial nerve	$XXX.XX	J1	5431
64744	Incise nerve back of head	$XXX.XX	J1	5431
64746	Incise diaphragm nerve	$XXX.XX	J1	5431
64763	Incise hip/thigh nerve	$XXX.XX	J1	5431
64766	Incise hip/thigh nerve	$XXX.XX	J1	5431
64771	Sever cranial nerve	$XXX.XX	J1	5431
64772	Incision of spinal nerve	$XXX.XX	J1	5431
64774	Remove skin nerve lesion	$XXX.XX	J1	5431
64776	Remove digit nerve lesion	$XXX.XX	J1	5431
64782	Remove limb nerve lesion	$XXX.XX	J1	5431
64784	Remove nerve lesion	$XXX.XX	J1	5431
64786	Remove sciatic nerve lesion	$XXX.XX	J1	5432
64788	Remove skin nerve lesion	$XXX.XX	J1	5431
64790	Removal of nerve lesion	$XXX.XX	J1	5431
64792	Removal of nerve lesion	$XXX.XX	J1	5432
64795	Biopsy of nerve	$XXX.XX	J1	5431
64802	Sympathectomy cervical	$XXX.XX	J1	5431
64804	Remove sympathetic nerves	$XXX.XX	J1	5431
64820	Sympathectomy digital artery	$XXX.XX	J1	5431
64821	Remove sympathetic nerves	$XXX.XX	J1	5113
64822	Remove sympathetic nerves	$XXX.XX	J1	5113
64823	Sympathectomy supfc palmar	$XXX.XX	J1	5113
64831	Repair of digit nerve	$XXX.XX	J1	5431
64834	Repair of hand or foot nerve	$XXX.XX	J1	5432
64835	Repair of hand or foot nerve	$XXX.XX	J1	5432
64836	Repair of hand or foot nerve	$XXX.XX	J1	5432
64840	Repair of leg nerve	$XXX.XX	J1	5432
64856	Repair/transpose nerve	$XXX.XX	J1	5432
64857	Repair arm/leg nerve	$XXX.XX	J1	5432
64858	Repair sciatic nerve	$XXX.XX	J1	5431
64861	Repair of arm nerves	$XXX.XX	J1	5431
64862	Repair of low back nerves	$XXX.XX	J1	5432
64864	Repair of facial nerve	$XXX.XX	J1	5432
64865	Repair of facial nerve	$XXX.XX	J1	5432
64885	Nerve graft head/neck	$XXX.XX	J1	5432
64886	Nerve graft head/neck >4 cm	$XXX.XX	J1	5432
64890	Nerve graft hand/foot	$XXX.XX	J1	5432
64891	Nerve graft hand/foot >4 cm	$XXX.XX	J1	5432
64892	Nerve graft arm/leg <4 cm	$XXX.XX	J1	5432
64893	Nerve graft arm/leg >4 cm	$XXX.XX	J1	5432
64895	Nerve graft hand/foot	$XXX.XX	J1	5432
64896	Nerve graft hand/foot >4 cm	$XXX.XX	J1	5432
64897	Nerve graft arm/leg	$XXX.XX	J1	5432
64898	Nerve graft arm/leg >4 cm	$XXX.XX	J1	5432
64905	Nerve pedicle transfer	$XXX.XX	J1	5432
64907	Nerve pedicle transfer	$XXX.XX	J1	5432
64910	Nerve repair w/allograft	$XXX.XX	J1	5432
64911	Neurorraphy w/vein autograft	$XXX.XX	J1	5432
64912	Nrv rpr w/nrv algrft 1st	$XXX.XX	J1	5432
64999	Nervous system surgery	$XXX.XX	T	5441
65091	Revise eye	$XXX.XX	J1	5504
65093	Revise eye with implant	$XXX.XX	J1	5504
65101	Removal of eye	$XXX.XX	J1	5504
65103	Remove eye/insert implant	$XXX.XX	J1	5504
65105	Remove eye/attach implant	$XXX.XX	J1	5504
65110	Removal of eye	$XXX.XX	J1	5504
65112	Remove eye/revise socket	$XXX.XX	J1	5504
65114	Remove eye/revise socket	$XXX.XX	J1	5504
65125	Revise ocular implant	$XXX.XX	J1	5503
65130	Insert ocular implant	$XXX.XX	J1	5504
65135	Insert ocular implant	$XXX.XX	J1	5504
65140	Attach ocular implant	$XXX.XX	J1	5504
65150	Revise ocular implant	$XXX.XX	J1	5504
65155	Reinsert ocular implant	$XXX.XX	J1	5504
65175	Removal of ocular implant	$XXX.XX	J1	5504
65205	Remove foreign body from eye	$XXX.XX	Q1	5734
65210	Remove foreign body from eye	$XXX.XX	Q1	5735
65220	Remove foreign body from eye	$XXX.XX	Q1	5735
65222	Remove foreign body from eye	$XXX.XX	Q1	5734
65235	Remove foreign body from eye	$XXX.XX	J1	5491
65260	Remove foreign body from eye	$XXX.XX	J1	5491
65265	Remove foreign body from eye	$XXX.XX	J1	5491
65270	Repair of eye wound	$XXX.XX	J1	5503
65272	Repair of eye wound	$XXX.XX	J1	5503
65275	Repair of eye wound	$XXX.XX	J1	5504
65280	Repair of eye wound	$XXX.XX	J1	5492
65285	Repair of eye wound	$XXX.XX	J1	5492
65286	Repair of eye wound	$XXX.XX	J1	5491
65290	Repair of eye socket wound	$XXX.XX	J1	5504
65400	Removal of eye lesion	$XXX.XX	T	5502
65410	Biopsy of cornea	$XXX.XX	J1	5503
65420	Removal of eye lesion	$XXX.XX	J1	5503
65426	Removal of eye lesion	$XXX.XX	J1	5503
65430	Corneal smear	$XXX.XX	Q1	5735
65435	Curette/treat cornea	$XXX.XX	T	5502
65436	Curette/treat cornea	$XXX.XX	J1	5503
65450	Treatment of corneal lesion	$XXX.XX	T	5501
65600	Revision of cornea	$XXX.XX	J1	5503
65710	Corneal transplant	$XXX.XX	J1	5492
65730	Corneal transplant	$XXX.XX	J1	5492
65750	Corneal transplant	$XXX.XX	J1	5492
65755	Corneal transplant	$XXX.XX	J1	5492
65756	Corneal trnspl endothelial	$XXX.XX	J1	5492
65770	Revise cornea with implant	$XXX.XX	J1	5493
65772	Correction of astigmatism	$XXX.XX	T	5502
65775	Correction of astigmatism	$XXX.XX	J1	5503
65778	Cover eye w/membrane	$XXX.XX	Q2	5502
65779	Cover eye w/membrane suture	$XXX.XX	Q2	5504
65780	Ocular reconst transplant	$XXX.XX	J1	5504
65781	Ocular reconst transplant	$XXX.XX	J1	5492
65782	Ocular reconst transplant	$XXX.XX	J1	5504
65785	Impltj ntrstrml crnl rng seg	$XXX.XX	J1	5492
65800	Drainage of eye	$XXX.XX	J1	5491
65810	Drainage of eye	$XXX.XX	J1	5491
65815	Drainage of eye	$XXX.XX	J1	5491
65820	Relieve inner eye pressure	$XXX.XX	J1	5492
65850	Incision of eye	$XXX.XX	J1	5491
65855	Trabeculoplasty laser surg	$XXX.XX	T	5481
65860	Incise inner eye adhesions	$XXX.XX	T	5481
65865	Incise inner eye adhesions	$XXX.XX	J1	5491
65870	Incise inner eye adhesions	$XXX.XX	J1	5491
65875	Incise inner eye adhesions	$XXX.XX	J1	5491
65880	Incise inner eye adhesions	$XXX.XX	J1	5492
65900	Remove eye lesion	$XXX.XX	J1	5491
65920	Remove implant of eye	$XXX.XX	J1	5491
65930	Remove blood clot from eye	$XXX.XX	J1	5491
66020	Injection treatment of eye	$XXX.XX	J1	5491
66030	Injection treatment of eye	$XXX.XX	J1	5491
66130	Remove eye lesion	$XXX.XX	J1	5503
66150	Glaucoma surgery	$XXX.XX	J1	5492
66155	Glaucoma surgery	$XXX.XX	J1	5492
66160	Glaucoma surgery	$XXX.XX	J1	5491
66170	Glaucoma surgery	$XXX.XX	J1	5491
66172	Incision of eye	$XXX.XX	J1	5491
66174	Translum dil eye canal	$XXX.XX	J1	5492
66175	Trnslum dil eye canal w/stnt	$XXX.XX	J1	5492
66179	Aqueous shunt eye w/o graft	$XXX.XX	J1	5492
66180	Aqueous shunt eye w/graft	$XXX.XX	J1	5492
66183	Insert ant drainage device	$XXX.XX	J1	5492
66184	Revision of aqueous shunt	$XXX.XX	J1	5491
66185	Revise aqueous shunt eye	$XXX.XX	J1	5491
66225	Repair/graft eye lesion	$XXX.XX	J1	5492
66250	Follow-up surgery of eye	$XXX.XX	J1	5503
66500	Incision of iris	$XXX.XX	J1	5491
66505	Incision of iris	$XXX.XX	J1	5491
66600	Remove iris and lesion	$XXX.XX	J1	5492
66605	Removal of iris	$XXX.XX	J1	5491
66625	Removal of iris	$XXX.XX	J1	5491
66630	Removal of iris	$XXX.XX	J1	5491
66635	Removal of iris	$XXX.XX	J1	5491
66680	Repair iris & ciliary body	$XXX.XX	J1	5491
66682	Repair iris & ciliary body	$XXX.XX	J1	5491
66700	Destruction ciliary body	$XXX.XX	J1	5491
66710	Ciliary transsleral therapy	$XXX.XX	J1	5503
66711	Ecp ciliary body destruction	$XXX.XX	J1	5491
66720	Destruction ciliary body	$XXX.XX	J1	5503
66740	Destruction ciliary body	$XXX.XX	J1	5503
66761	Revision of iris	$XXX.XX	T	5481
66762	Revision of iris	$XXX.XX	T	5481
66770	Removal of inner eye lesion	$XXX.XX	T	5481
66820	Incision secondary cataract	$XXX.XX	J1	5491
66821	After cataract laser surgery	$XXX.XX	T	5481
66825	Reposition intraocular lens	$XXX.XX	J1	5491
66830	Removal of lens lesion	$XXX.XX	J1	5491
66840	Removal of lens material	$XXX.XX	J1	5491
66850	Removal of lens material	$XXX.XX	J1	5491
66852	Removal of lens material	$XXX.XX	J1	5492
66920	Extraction of lens	$XXX.XX	J1	5491
66930	Extraction of lens	$XXX.XX	J1	5492
66940	Extraction of lens	$XXX.XX	J1	5491
66982	Xcapsl ctrc rmvl cplx wo ecp	$XXX.XX	J1	5491
66983	Cataract surg w/iol 1 stage	$XXX.XX	J1	5491
66984	Xcapsl ctrc rmvl w/o ecp	$XXX.XX	J1	5491
66985	Insert lens prosthesis	$XXX.XX	J1	5491
66986	Exchange lens prosthesis	$XXX.XX	J1	5491
66987	Xcapsl ctrc rmvl cplx w/ecp	$XXX.XX	J1	5492
66988	Xcapsl ctrc rmvl w/ecp	$XXX.XX	J1	5492
66999	Eye surgery procedure	$XXX.XX	J1	5491
67005	Partial removal of eye fluid	$XXX.XX	J1	5491
67010	Partial removal of eye fluid	$XXX.XX	J1	5491
67015	Release of eye fluid	$XXX.XX	J1	5491
67025	Replace eye fluid	$XXX.XX	J1	5491
67027	Implant eye drug system	$XXX.XX	J1	5494
67028	Injection eye drug	$XXX.XX	S	5694
67030	Incise inner eye strands	$XXX.XX	J1	5491
67031	Laser surgery eye strands	$XXX.XX	T	5481
67036	Removal of inner eye fluid	$XXX.XX	J1	5492
67039	Laser treatment of retina	$XXX.XX	J1	5492
67040	Laser treatment of retina	$XXX.XX	J1	5492
67041	Vit for macular pucker	$XXX.XX	J1	5492
67042	Vit for macular hole	$XXX.XX	J1	5492
67043	Vit for membrane dissect	$XXX.XX	J1	5492
67101	Repair detached retina crtx	$XXX.XX	J1	5491
67105	Repair detached retina pc	$XXX.XX	T	5481
67107	Repair detached retina	$XXX.XX	J1	5492
67108	Repair detached retina	$XXX.XX	J1	5492
67110	Repair detached retina	$XXX.XX	J1	5491
67113	Repair retinal detach cplx	$XXX.XX	J1	5492
67115	Release encircling material	$XXX.XX	J1	5492
67120	Remove eye implant material	$XXX.XX	J1	5491
67121	Remove eye implant material	$XXX.XX	J1	5491
67141	Treatment of retina	$XXX.XX	T	5501
67145	Treatment of retina	$XXX.XX	T	5481
67208	Treatment of retinal lesion	$XXX.XX	T	5501
67210	Treatment of retinal lesion	$XXX.XX	T	5481
67218	Treatment of retinal lesion	$XXX.XX	J1	5504
67220	Treatment of choroid lesion	$XXX.XX	T	5481
67221	Ocular photodynamic ther	$XXX.XX	T	5481
67227	Dstrj extensive retinopathy	$XXX.XX	J1	5504
67228	Treatment x10sv retinopathy	$XXX.XX	T	5481
67229	Tr retinal les preterm inf	$XXX.XX	T	5481
67250	Reinforce eye wall	$XXX.XX	J1	5503
67255	Reinforce/graft eye wall	$XXX.XX	J1	5491
67299	Eye surgery procedure	$XXX.XX	J1	5491
67311	Revise eye muscle	$XXX.XX	J1	5503
67312	Revise two eye muscles	$XXX.XX	J1	5504
67314	Revise eye muscle	$XXX.XX	J1	5503
67316	Revise two eye muscles	$XXX.XX	J1	5503
67318	Revise eye muscle(s)	$XXX.XX	J1	5503
67343	Release eye tissue	$XXX.XX	J1	5503
67345	Destroy nerve of eye muscle	$XXX.XX	T	5501
67346	Biopsy eye muscle	$XXX.XX	J1	5504
67399	Unlisted px extraocular musc	$XXX.XX	T	5501
67400	Explore/biopsy eye socket	$XXX.XX	J1	5504
67405	Explore/drain eye socket	$XXX.XX	J1	5503
67412	Explore/treat eye socket	$XXX.XX	J1	5503
67413	Explore/treat eye socket	$XXX.XX	J1	5503
67414	Explr/decompress eye socket	$XXX.XX	J1	5504
67415	Aspiration orbital contents	$XXX.XX	J1	5503
67420	Explore/treat eye socket	$XXX.XX	J1	5504
67430	Explore/treat eye socket	$XXX.XX	J1	5504
67440	Explore/drain eye socket	$XXX.XX	J1	5504
67445	Explr/decompress eye socket	$XXX.XX	J1	5504
67450	Explore/biopsy eye socket	$XXX.XX	J1	5504
67500	Inject/treat eye socket	$XXX.XX	T	5501
67505	Inject/treat eye socket	$XXX.XX	T	5501
67515	Inject/treat eye socket	$XXX.XX	T	5501
67550	Insert eye socket implant	$XXX.XX	J1	5504
67560	Revise eye socket implant	$XXX.XX	J1	5504
67570	Decompress optic nerve	$XXX.XX	J1	5504
67599	Orbit surgery procedure	$XXX.XX	T	5501
67700	Drainage of eyelid abscess	$XXX.XX	T	5501
67710	Incision of eyelid	$XXX.XX	T	5502
67715	Incision of eyelid fold	$XXX.XX	J1	5503
67800	Remove eyelid lesion	$XXX.XX	T	5501
67801	Remove eyelid lesions	$XXX.XX	T	5502
67805	Remove eyelid lesions	$XXX.XX	T	5501
67808	Remove eyelid lesion(s)	$XXX.XX	J1	5503
67810	Biopsy eyelid & lid margin	$XXX.XX	T	5501
67820	Revise eyelashes	$XXX.XX	Q1	5734
67825	Revise eyelashes	$XXX.XX	T	5501
67830	Revise eyelashes	$XXX.XX	T	5502
67835	Revise eyelashes	$XXX.XX	J1	5503
67840	Remove eyelid lesion	$XXX.XX	T	5502
67850	Treat eyelid lesion	$XXX.XX	T	5502
67875	Closure of eyelid by suture	$XXX.XX	T	5502
67880	Revision of eyelid	$XXX.XX	J1	5503
67882	Revision of eyelid	$XXX.XX	J1	5503
67900	Repair brow defect	$XXX.XX	J1	5503
67901	Repair eyelid defect	$XXX.XX	J1	5503
67902	Repair eyelid defect	$XXX.XX	J1	5504
67903	Repair eyelid defect	$XXX.XX	J1	5503
67904	Repair eyelid defect	$XXX.XX	J1	5503
67906	Repair eyelid defect	$XXX.XX	J1	5504
67908	Repair eyelid defect	$XXX.XX	J1	5503
67909	Revise eyelid defect	$XXX.XX	J1	5503
67911	Revise eyelid defect	$XXX.XX	J1	5503
67912	Correction eyelid w/implant	$XXX.XX	J1	5503
67914	Repair eyelid defect	$XXX.XX	J1	5503
67915	Repair eyelid defect	$XXX.XX	J1	5503
67916	Repair eyelid defect	$XXX.XX	J1	5503
67917	Repair eyelid defect	$XXX.XX	J1	5503
67921	Repair eyelid defect	$XXX.XX	J1	5503
67922	Repair eyelid defect	$XXX.XX	J1	5503
67923	Repair eyelid defect	$XXX.XX	J1	5503
67924	Repair eyelid defect	$XXX.XX	J1	5503
67930	Repair eyelid wound	$XXX.XX	J1	5503
67935	Repair eyelid wound	$XXX.XX	J1	5503
67938	Remove eyelid foreign body	$XXX.XX	T	5501
67950	Revision of eyelid	$XXX.XX	J1	5503
67961	Revision of eyelid	$XXX.XX	J1	5503
67966	Revision of eyelid	$XXX.XX	J1	5503
67971	Reconstruction of eyelid	$XXX.XX	J1	5503
67973	Reconstruction of eyelid	$XXX.XX	J1	5503
67974	Reconstruction of eyelid	$XXX.XX	J1	5504
67975	Reconstruction of eyelid	$XXX.XX	J1	5503
67999	Revision of eyelid	$XXX.XX	T	5501
68020	Incise/drain eyelid lining	$XXX.XX	T	5502
68040	Treatment of eyelid lesions	$XXX.XX	T	5501
68100	Biopsy of eyelid lining	$XXX.XX	J1	5503
68110	Remove eyelid lining lesion	$XXX.XX	J1	5503
68115	Remove eyelid lining lesion	$XXX.XX	J1	5503
68130	Remove eyelid lining lesion	$XXX.XX	J1	5503
68135	Remove eyelid lining lesion	$XXX.XX	J1	5503
68200	Treat eyelid by injection	$XXX.XX	Q1	5734
68320	Revise/graft eyelid lining	$XXX.XX	J1	5503
68325	Revise/graft eyelid lining	$XXX.XX	J1	5504
68326	Revise/graft eyelid lining	$XXX.XX	J1	5504
68328	Revise/graft eyelid lining	$XXX.XX	J1	5503
68330	Revise eyelid lining	$XXX.XX	J1	5491
68335	Revise/graft eyelid lining	$XXX.XX	J1	5504
68340	Separate eyelid adhesions	$XXX.XX	J1	5503
68360	Revise eyelid lining	$XXX.XX	J1	5504
68362	Revise eyelid lining	$XXX.XX	J1	5503
68371	Harvest eye tissue alograft	$XXX.XX	J1	5503
68399	Eyelid lining surgery	$XXX.XX	T	5501
68400	Incise/drain tear gland	$XXX.XX	T	5502
68420	Incise/drain tear sac	$XXX.XX	J1	5503
68440	Incise tear duct opening	$XXX.XX	T	5501
68500	Removal of tear gland	$XXX.XX	J1	5504
68505	Partial removal tear gland	$XXX.XX	J1	5504
68510	Biopsy of tear gland	$XXX.XX	J1	5503
68520	Removal of tear sac	$XXX.XX	J1	5504
68525	Biopsy of tear sac	$XXX.XX	J1	5503
68530	Clearance of tear duct	$XXX.XX	T	5501
68540	Remove tear gland lesion	$XXX.XX	J1	5503
68550	Remove tear gland lesion	$XXX.XX	J1	5504
68700	Repair tear ducts	$XXX.XX	J1	5503
68705	Revise tear duct opening	$XXX.XX	T	5501
68720	Create tear sac drain	$XXX.XX	J1	5504
68745	Create tear duct drain	$XXX.XX	J1	5504
68750	Create tear duct drain	$XXX.XX	J1	5504
68760	Close tear duct opening	$XXX.XX	T	5501
68761	Close tear duct opening	$XXX.XX	T	5501
68770	Close tear system fistula	$XXX.XX	J1	5503
68801	Dilate tear duct opening	$XXX.XX	Q1	5735
68810	Probe nasolacrimal duct	$XXX.XX	T	5501
68811	Probe nasolacrimal duct	$XXX.XX	J1	5503
68815	Probe nasolacrimal duct	$XXX.XX	J1	5503
68816	Probe nl duct w/balloon	$XXX.XX	J1	5503
68840	Explore/irrigate tear ducts	$XXX.XX	T	5501
68899	Tear duct system surgery	$XXX.XX	T	5501
69000	Drain external ear lesion	$XXX.XX	T	5071
69005	Drain external ear lesion	$XXX.XX	J1	5072
69020	Drain outer ear canal lesion	$XXX.XX	T	5071
69100	Biopsy of external ear	$XXX.XX	T	5161
69105	Biopsy of external ear canal	$XXX.XX	J1	5163
69110	Remove external ear partial	$XXX.XX	J1	5073
69120	Removal of external ear	$XXX.XX	J1	5165
69140	Remove ear canal lesion(s)	$XXX.XX	J1	5165
69145	Remove ear canal lesion(s)	$XXX.XX	J1	5073
69150	Extensive ear canal surgery	$XXX.XX	J1	5165
69200	Clear outer ear canal	$XXX.XX	Q1	5734
69205	Clear outer ear canal	$XXX.XX	J1	5072
69209	Remove impacted ear wax uni	$XXX.XX	Q1	5733
69210	Remove impacted ear wax uni	$XXX.XX	Q1	5733
69220	Clean out mastoid cavity	$XXX.XX	Q1	5051
69222	Clean out mastoid cavity	$XXX.XX	T	5162
69300	Revise external ear	$XXX.XX	J1	5164
69310	Rebuild outer ear canal	$XXX.XX	J1	5165
69320	Rebuild outer ear canal	$XXX.XX	J1	5165
69399	Outer ear surgery procedure	$XXX.XX	T	5161
69420	Incision of eardrum	$XXX.XX	T	5161
69421	Incision of eardrum	$XXX.XX	J1	5164
69424	Remove ventilating tube	$XXX.XX	Q2	5164
69433	Create eardrum opening	$XXX.XX	T	5162
69436	Create eardrum opening	$XXX.XX	J1	5163
69440	Exploration of middle ear	$XXX.XX	J1	5164
69450	Eardrum revision	$XXX.XX	J1	5164
69501	Mastoidectomy	$XXX.XX	J1	5165
69502	Mastoidectomy	$XXX.XX	J1	5165
69505	Remove mastoid structures	$XXX.XX	J1	5165
69511	Extensive mastoid surgery	$XXX.XX	J1	5165
69530	Extensive mastoid surgery	$XXX.XX	J1	5165
69540	Remove ear lesion	$XXX.XX	J1	5163
69550	Remove ear lesion	$XXX.XX	J1	5165
69552	Remove ear lesion	$XXX.XX	J1	5165
69601	Mastoid surgery revision	$XXX.XX	J1	5165
69602	Mastoid surgery revision	$XXX.XX	J1	5165
69603	Mastoid surgery revision	$XXX.XX	J1	5165
69604	Mastoid surgery revision	$XXX.XX	J1	5165
69605	Mastoid surgery revision	$XXX.XX	J1	5165
69610	Repair of eardrum	$XXX.XX	J1	5163
69620	Repair of eardrum	$XXX.XX	J1	5164
69631	Repair eardrum structures	$XXX.XX	J1	5165
69632	Rebuild eardrum structures	$XXX.XX	J1	5165
69633	Rebuild eardrum structures	$XXX.XX	J1	5165
69635	Repair eardrum structures	$XXX.XX	J1	5165
69636	Rebuild eardrum structures	$XXX.XX	J1	5165
69637	Rebuild eardrum structures	$XXX.XX	J1	5165
69641	Revise middle ear & mastoid	$XXX.XX	J1	5165
69642	Revise middle ear & mastoid	$XXX.XX	J1	5165
69643	Revise middle ear & mastoid	$XXX.XX	J1	5165
69644	Revise middle ear & mastoid	$XXX.XX	J1	5165
69645	Revise middle ear & mastoid	$XXX.XX	J1	5165
69646	Revise middle ear & mastoid	$XXX.XX	J1	5165
69650	Release middle ear bone	$XXX.XX	J1	5164
69660	Revise middle ear bone	$XXX.XX	J1	5165
69661	Revise middle ear bone	$XXX.XX	J1	5165
69662	Revise middle ear bone	$XXX.XX	J1	5165
69666	Repair middle ear structures	$XXX.XX	J1	5164
69667	Repair middle ear structures	$XXX.XX	J1	5164
69670	Remove mastoid air cells	$XXX.XX	J1	5165
69676	Remove middle ear nerve	$XXX.XX	J1	5164
69700	Close mastoid fistula	$XXX.XX	J1	5163
69711	Remove/repair hearing aid	$XXX.XX	J1	5164
69714	Implant temple bone w/stimul	$XXX.XX	J1	5115
69715	Temple bne implnt w/stimulat	$XXX.XX	J1	5116
69717	Temple bone implant revision	$XXX.XX	J1	5114
69718	Revise temple bone implant	$XXX.XX	J1	5115
69720	Release facial nerve	$XXX.XX	J1	5165
69725	Release facial nerve	$XXX.XX	J1	5165
69740	Repair facial nerve	$XXX.XX	J1	5165
69745	Repair facial nerve	$XXX.XX	J1	5165
69799	Middle ear surgery procedure	$XXX.XX	T	5161
69801	Incise inner ear	$XXX.XX	J1	5163
69805	Explore inner ear	$XXX.XX	J1	5165
69806	Explore inner ear	$XXX.XX	J1	5165
69905	Remove inner ear	$XXX.XX	J1	5165
69910	Remove inner ear & mastoid	$XXX.XX	J1	5165
69915	Incise inner ear nerve	$XXX.XX	J1	5164
69930	Implant cochlear device	$XXX.XX	J1	5166
69949	Inner ear surgery procedure	$XXX.XX	T	5161
69955	Release facial nerve	$XXX.XX	J1	5165
69960	Release inner ear canal	$XXX.XX	J1	5165
69970	Remove inner ear lesion	$XXX.XX	J1	5165
69979	Temporal bone surgery	$XXX.XX	T	5161
70010	Contrast x-ray of brain	$XXX.XX	Q2	5572
70015	Contrast x-ray of brain	$XXX.XX	Q2	5573
70030	X-ray eye for foreign body	$XXX.XX	Q1	5521
70100	X-ray exam of jaw <4views	$XXX.XX	Q1	5521
70110	X-ray exam of jaw 4/> views	$XXX.XX	Q1	5522
70120	X-ray exam of mastoids	$XXX.XX	Q1	5522
70130	X-ray exam of mastoids	$XXX.XX	Q1	5522
70134	X-ray exam of middle ear	$XXX.XX	Q1	5524
70140	X-ray exam of facial bones	$XXX.XX	Q1	5521
70150	X-ray exam of facial bones	$XXX.XX	Q1	5522
70160	X-ray exam of nasal bones	$XXX.XX	Q1	5521
70170	X-ray exam of tear duct	$XXX.XX	Q2	5523
70190	X-ray exam of eye sockets	$XXX.XX	Q1	5521
70200	X-ray exam of eye sockets	$XXX.XX	Q1	5522
70210	X-ray exam of sinuses	$XXX.XX	Q1	5521
70220	X-ray exam of sinuses	$XXX.XX	Q1	5521
70240	X-ray exam pituitary saddle	$XXX.XX	Q1	5521
70250	X-ray exam of skull	$XXX.XX	Q1	5522
70260	X-ray exam of skull	$XXX.XX	Q1	5522
70300	X-ray exam of teeth	$XXX.XX	Q1	5521
70310	X-ray exam of teeth	$XXX.XX	Q1	5523
70320	Full mouth x-ray of teeth	$XXX.XX	Q1	5523
70328	X-ray exam of jaw joint	$XXX.XX	Q1	5521
70330	X-ray exam of jaw joints	$XXX.XX	Q1	5521
70332	X-ray exam of jaw joint	$XXX.XX	Q2	5523
70336	Magnetic image jaw joint	$XXX.XX	Q3	5523
70350	X-ray head for orthodontia	$XXX.XX	Q1	5521
70355	Panoramic x-ray of jaws	$XXX.XX	Q1	5521
70360	X-ray exam of neck	$XXX.XX	Q1	5521
70370	Throat x-ray & fluoroscopy	$XXX.XX	Q1	5521
70371	Speech evaluation complex	$XXX.XX	Q1	5523
70380	X-ray exam of salivary gland	$XXX.XX	Q1	5521
70390	X-ray exam of salivary duct	$XXX.XX	Q2	5523
70450	Ct head/brain w/o dye	$XXX.XX	Q3	5522
70460	Ct head/brain w/dye	$XXX.XX	Q3	5571
70470	Ct head/brain w/o & w/dye	$XXX.XX	Q3	5571
70480	Ct orbit/ear/fossa w/o dye	$XXX.XX	Q3	5522
70481	Ct orbit/ear/fossa w/dye	$XXX.XX	Q3	5571
70482	Ct orbit/ear/fossa w/o&w/dye	$XXX.XX	Q3	5571
70486	Ct maxillofacial w/o dye	$XXX.XX	Q3	5522
70487	Ct maxillofacial w/dye	$XXX.XX	Q3	5571
70488	Ct maxillofacial w/o & w/dye	$XXX.XX	Q3	5571
70490	Ct soft tissue neck w/o dye	$XXX.XX	Q3	5522
70491	Ct soft tissue neck w/dye	$XXX.XX	Q3	5571
70492	Ct sft tsue nck w/o & w/dye	$XXX.XX	Q3	5571
70496	Ct angiography head	$XXX.XX	Q3	5571
70498	Ct angiography neck	$XXX.XX	Q3	5571
70540	Mri orbit/face/neck w/o dye	$XXX.XX	Q3	5523
70542	Mri orbit/face/neck w/dye	$XXX.XX	Q3	5572
70543	Mri orbt/fac/nck w/o &w/dye	$XXX.XX	Q3	5572
70544	Mr angiography head w/o dye	$XXX.XX	Q3	5523
70545	Mr angiography head w/dye	$XXX.XX	Q3	5572
70546	Mr angiograph head w/o&w/dye	$XXX.XX	Q3	5572
70547	Mr angiography neck w/o dye	$XXX.XX	Q3	5523
70548	Mr angiography neck w/dye	$XXX.XX	Q3	5572
70549	Mr angiograph neck w/o&w/dye	$XXX.XX	Q3	5572
70551	Mri brain stem w/o dye	$XXX.XX	Q3	5523
70552	Mri brain stem w/dye	$XXX.XX	Q3	5572
70553	Mri brain stem w/o & w/dye	$XXX.XX	Q3	5572
70554	Fmri brain by tech	$XXX.XX	Q3	5523
70555	Fmri brain by phys/psych	$XXX.XX	S	5523
70557	Mri brain w/o dye	$XXX.XX	S	5524
70558	Mri brain w/dye	$XXX.XX	S	5571
70559	Mri brain w/o & w/dye	$XXX.XX	S	5571
71045	X-ray exam chest 1 view	$XXX.XX	Q3	5521
71046	X-ray exam chest 2 views	$XXX.XX	Q3	5521
71047	X-ray exam chest 3 views	$XXX.XX	Q1	5521
71048	X-ray exam chest 4+ views	$XXX.XX	Q1	5522
71100	X-ray exam ribs uni 2 views	$XXX.XX	Q1	5521
71101	X-ray exam unilat ribs/chest	$XXX.XX	Q1	5522
71110	X-ray exam ribs bil 3 views	$XXX.XX	Q1	5522
71111	X-ray exam ribs/chest4/> vws	$XXX.XX	Q1	5522
71120	X-ray exam breastbone 2/>vws	$XXX.XX	Q1	5521
71130	X-ray strenoclavic jt 3/>vws	$XXX.XX	Q1	5521
71250	Ct thorax w/o dye	$XXX.XX	Q3	5522
71260	Ct thorax w/dye	$XXX.XX	Q3	5571
71270	Ct thorax w/o & w/dye	$XXX.XX	Q3	5571
71275	Ct angiography chest	$XXX.XX	Q3	5571
71550	Mri chest w/o dye	$XXX.XX	Q3	5523
71551	Mri chest w/dye	$XXX.XX	Q3	5573
71552	Mri chest w/o & w/dye	$XXX.XX	Q3	5572
72020	X-ray exam of spine 1 view	$XXX.XX	Q1	5521
72040	X-ray exam neck spine 2-3 vw	$XXX.XX	Q1	5521
72050	X-ray exam neck spine 4/5vws	$XXX.XX	Q1	5522
72052	X-ray exam neck spine 6/>vws	$XXX.XX	Q1	5522
72070	X-ray exam thorac spine 2vws	$XXX.XX	Q1	5522
72072	X-ray exam thorac spine 3vws	$XXX.XX	Q1	5522
72074	X-ray exam thorac spine4/>vw	$XXX.XX	Q1	5522
72080	X-ray exam thoracolmb 2/> vw	$XXX.XX	Q1	5521
72081	X-ray exam entire spi 1 vw	$XXX.XX	Q1	5521
72082	X-ray exam entire spi 2/3 vw	$XXX.XX	Q1	5522
72083	X-ray exam entire spi 4/5 vw	$XXX.XX	S	5522
72084	X-ray exam entire spi 6/> vw	$XXX.XX	S	5522
72100	X-ray exam l-s spine 2/3 vws	$XXX.XX	Q1	5522
72110	X-ray exam l-2 spine 4/>vws	$XXX.XX	Q1	5522
72114	X-ray exam l-s spine bending	$XXX.XX	Q1	5522
72120	X-ray bend only l-s spine	$XXX.XX	Q1	5522
72125	Ct neck spine w/o dye	$XXX.XX	Q3	5522
72126	Ct neck spine w/dye	$XXX.XX	Q3	5572
72127	Ct neck spine w/o & w/dye	$XXX.XX	Q3	5571
72128	Ct chest spine w/o dye	$XXX.XX	Q3	5522
72129	Ct chest spine w/dye	$XXX.XX	Q3	5571
72130	Ct chest spine w/o & w/dye	$XXX.XX	Q3	5571
72131	Ct lumbar spine w/o dye	$XXX.XX	Q3	5522
72132	Ct lumbar spine w/dye	$XXX.XX	Q3	5572
72133	Ct lumbar spine w/o & w/dye	$XXX.XX	Q3	5571
72141	Mri neck spine w/o dye	$XXX.XX	Q3	5523
72142	Mri neck spine w/dye	$XXX.XX	Q3	5572
72146	Mri chest spine w/o dye	$XXX.XX	Q3	5523
72147	Mri chest spine w/dye	$XXX.XX	Q3	5572
72148	Mri lumbar spine w/o dye	$XXX.XX	Q3	5523
72149	Mri lumbar spine w/dye	$XXX.XX	Q3	5572
72156	Mri neck spine w/o & w/dye	$XXX.XX	Q3	5572
72157	Mri chest spine w/o & w/dye	$XXX.XX	Q3	5572
72158	Mri lumbar spine w/o & w/dye	$XXX.XX	Q3	5572
72170	X-ray exam of pelvis	$XXX.XX	Q1	5522
72190	X-ray exam of pelvis	$XXX.XX	Q1	5522
72191	Ct angiograph pelv w/o&w/dye	$XXX.XX	Q3	5571
72192	Ct pelvis w/o dye	$XXX.XX	Q3	5522
72193	Ct pelvis w/dye	$XXX.XX	Q3	5571
72194	Ct pelvis w/o & w/dye	$XXX.XX	Q3	5571
72195	Mri pelvis w/o dye	$XXX.XX	Q3	5523
72196	Mri pelvis w/dye	$XXX.XX	Q3	5572
72197	Mri pelvis w/o & w/dye	$XXX.XX	Q3	5572
72200	X-ray exam si joints	$XXX.XX	Q1	5522
72202	X-ray exam si joints 3/> vws	$XXX.XX	Q1	5522
72220	X-ray exam sacrum tailbone	$XXX.XX	Q1	5521
72240	Myelography neck spine	$XXX.XX	Q2	5573
72255	Myelography thoracic spine	$XXX.XX	Q2	5573
72265	Myelography l-s spine	$XXX.XX	Q2	5573
72270	Myelogphy 2/> spine regions	$XXX.XX	Q2	5573
72285	Discography cerv/thor spine	$XXX.XX	Q2	5431
72295	X-ray of lower spine disk	$XXX.XX	Q2	5431
73000	X-ray exam of collar bone	$XXX.XX	Q1	5521
73010	X-ray exam of shoulder blade	$XXX.XX	Q1	5522
73020	X-ray exam of shoulder	$XXX.XX	Q1	5521
73030	X-ray exam of shoulder	$XXX.XX	Q1	5521
73040	Contrast x-ray of shoulder	$XXX.XX	Q2	5572
73050	X-ray exam of shoulders	$XXX.XX	Q1	5521
73060	X-ray exam of humerus	$XXX.XX	Q1	5521
73070	X-ray exam of elbow	$XXX.XX	Q1	5521
73080	X-ray exam of elbow	$XXX.XX	Q1	5521
73085	Contrast x-ray of elbow	$XXX.XX	Q2	5572
73090	X-ray exam of forearm	$XXX.XX	Q1	5521
73092	X-ray exam of arm infant	$XXX.XX	Q1	5522
73100	X-ray exam of wrist	$XXX.XX	Q1	5521
73110	X-ray exam of wrist	$XXX.XX	Q1	5521
73115	Contrast x-ray of wrist	$XXX.XX	Q2	5572
73120	X-ray exam of hand	$XXX.XX	Q1	5522
73130	X-ray exam of hand	$XXX.XX	Q1	5521
73140	X-ray exam of finger(s)	$XXX.XX	Q1	5521
73200	Ct upper extremity w/o dye	$XXX.XX	Q3	5522
73201	Ct upper extremity w/dye	$XXX.XX	Q3	5572
73202	Ct uppr extremity w/o&w/dye	$XXX.XX	Q3	5571
73206	Ct angio upr extrm w/o&w/dye	$XXX.XX	Q3	5571
73218	Mri upper extremity w/o dye	$XXX.XX	Q3	5523
73219	Mri upper extremity w/dye	$XXX.XX	Q3	5572
73220	Mri uppr extremity w/o&w/dye	$XXX.XX	Q3	5572
73221	Mri joint upr extrem w/o dye	$XXX.XX	Q3	5523
73222	Mri joint upr extrem w/dye	$XXX.XX	Q3	5573
73223	Mri joint upr extr w/o&w/dye	$XXX.XX	Q3	5572
73501	X-ray exam hip uni 1 view	$XXX.XX	Q1	5521
73502	X-ray exam hip uni 2-3 views	$XXX.XX	Q1	5521
73503	X-ray exam hip uni 4/> views	$XXX.XX	Q1	5522
73521	X-ray exam hips bi 2 views	$XXX.XX	Q1	5522
73522	X-ray exam hips bi 3-4 views	$XXX.XX	Q1	5522
73523	X-ray exam hips bi 5/> views	$XXX.XX	S	5522
73525	Contrast x-ray of hip	$XXX.XX	Q2	5572
73551	X-ray exam of femur 1	$XXX.XX	Q1	5521
73552	X-ray exam of femur 2/>	$XXX.XX	Q1	5521
73560	X-ray exam of knee 1 or 2	$XXX.XX	Q1	5521
73562	X-ray exam of knee 3	$XXX.XX	Q1	5521
73564	X-ray exam knee 4 or more	$XXX.XX	Q1	5522
73565	X-ray exam of knees	$XXX.XX	Q1	5521
73580	Contrast x-ray of knee joint	$XXX.XX	Q2	5572
73590	X-ray exam of lower leg	$XXX.XX	Q1	5521
73592	X-ray exam of leg infant	$XXX.XX	Q1	5521
73600	X-ray exam of ankle	$XXX.XX	Q1	5521
73610	X-ray exam of ankle	$XXX.XX	Q1	5521
73615	Contrast x-ray of ankle	$XXX.XX	Q2	5572
73620	X-ray exam of foot	$XXX.XX	Q1	5521
73630	X-ray exam of foot	$XXX.XX	Q1	5521
73650	X-ray exam of heel	$XXX.XX	Q1	5521
73660	X-ray exam of toe(s)	$XXX.XX	Q1	5521
73700	Ct lower extremity w/o dye	$XXX.XX	Q3	5522
73701	Ct lower extremity w/dye	$XXX.XX	Q3	5571
73702	Ct lwr extremity w/o&w/dye	$XXX.XX	Q3	5571
73706	Ct angio lwr extr w/o&w/dye	$XXX.XX	Q3	5571
73718	Mri lower extremity w/o dye	$XXX.XX	Q3	5523
73719	Mri lower extremity w/dye	$XXX.XX	Q3	5572
73720	Mri lwr extremity w/o&w/dye	$XXX.XX	Q3	5572
73721	Mri jnt of lwr extre w/o dye	$XXX.XX	Q3	5523
73722	Mri joint of lwr extr w/dye	$XXX.XX	Q3	5573
73723	Mri joint lwr extr w/o&w/dye	$XXX.XX	Q3	5572
74018	X-ray exam abdomen 1 view	$XXX.XX	Q1	5521
74019	X-ray exam abdomen 2 views	$XXX.XX	Q1	5522
74021	X-ray exam abdomen 3+ views	$XXX.XX	Q1	5522
74022	X-ray exam complete abdomen	$XXX.XX	Q1	5522
74150	Ct abdomen w/o dye	$XXX.XX	Q3	5522
74160	Ct abdomen w/dye	$XXX.XX	Q3	5571
74170	Ct abdomen w/o & w/dye	$XXX.XX	Q3	5571
74174	Ct angio abd&pelv w/o&w/dye	$XXX.XX	S	5572
74175	Ct angio abdom w/o & w/dye	$XXX.XX	Q3	5571
74176	Ct abd & pelvis w/o contrast	$XXX.XX	Q3	5523
74177	Ct abd & pelv w/contrast	$XXX.XX	Q3	5572
74178	Ct abd & pelv 1/> regns	$XXX.XX	Q3	5572
74181	Mri abdomen w/o dye	$XXX.XX	Q3	5523
74182	Mri abdomen w/dye	$XXX.XX	Q3	5572
74183	Mri abdomen w/o & w/dye	$XXX.XX	Q3	5572
74190	X-ray exam of peritoneum	$XXX.XX	Q2	5524
74210	X-ray xm phrnx&/crv esoph c+	$XXX.XX	Q1	5571
74220	X-ray xm esophagus 1cntrst	$XXX.XX	Q1	5571
74221	X-ray xm esophagus 2cntrst	$XXX.XX	Q1	5571
74230	X-ray xm swlng funcj c+	$XXX.XX	Q1	5571
74240	X-ray xm upr gi trc 1cntrst	$XXX.XX	Q1	5571
74246	X-ray xm upr gi trc 2cntrst	$XXX.XX	Q1	5571
74250	X-ray xm sm int 1cntrst std	$XXX.XX	Q1	5571
74251	X-ray xm sm int 2cntrst std	$XXX.XX	Q1	5571
74261	Ct colonography dx	$XXX.XX	Q3	5522
74262	Ct colonography dx w/dye	$XXX.XX	Q3	5571
74270	X-ray xm colon 1cntrst std	$XXX.XX	Q1	5571
74280	X-ray xm colon 2cntrst std	$XXX.XX	Q1	5571
74283	Ther nma rdctj intus/obstrcj	$XXX.XX	S	5571
74290	Contrast x-ray gallbladder	$XXX.XX	Q1	5571
74400	Contrst x-ray urinary tract	$XXX.XX	S	5571
74410	Contrst x-ray urinary tract	$XXX.XX	S	5571
74415	Contrst x-ray urinary tract	$XXX.XX	S	5571
74420	Contrst x-ray urinary tract	$XXX.XX	S	5572
74425	Contrst x-ray urinary tract	$XXX.XX	Q2	5572
74430	Contrast x-ray bladder	$XXX.XX	Q2	5572
74440	X-ray male genital tract	$XXX.XX	Q2	5523
74445	X-ray exam of penis	$XXX.XX	Q2	5522
74450	X-ray urethra/bladder	$XXX.XX	Q2	5523
74455	X-ray urethra/bladder	$XXX.XX	Q2	5523
74470	X-ray exam of kidney lesion	$XXX.XX	Q2	5524
74485	Dilation urtr/urt rs&i	$XXX.XX	Q2	5373
74710	X-ray measurement of pelvis	$XXX.XX	Q1	5521
74712	Mri fetal sngl/1st gestation	$XXX.XX	S	5523
74740	X-ray female genital tract	$XXX.XX	Q2	5523
74775	X-ray exam of perineum	$XXX.XX	S	5523
75557	Cardiac mri for morph	$XXX.XX	Q3	5523
75559	Cardiac mri w/stress img	$XXX.XX	Q3	5524
75561	Cardiac mri for morph w/dye	$XXX.XX	Q3	5572
75563	Card mri w/stress img & dye	$XXX.XX	Q3	5573
75571	Ct hrt w/o dye w/ca test	$XXX.XX	Q1	5521
75572	Ct hrt w/3d image	$XXX.XX	S	5571
75573	Ct hrt w/3d image congen	$XXX.XX	S	5571
75574	Ct angio hrt w/3d image	$XXX.XX	S	5571
75600	Contrast exam thoracic aorta	$XXX.XX	Q2	5183
75605	Contrast exam thoracic aorta	$XXX.XX	Q2	5184
75625	Contrast exam abdominl aorta	$XXX.XX	Q2	5183
75630	X-ray aorta leg arteries	$XXX.XX	Q2	5183
75635	Ct angio abdominal arteries	$XXX.XX	Q2	5571
75705	Artery x-rays spine	$XXX.XX	Q2	5184
75710	Artery x-rays arm/leg	$XXX.XX	Q2	5183
75716	Artery x-rays arms/legs	$XXX.XX	Q2	5183
75726	Artery x-rays abdomen	$XXX.XX	Q2	5184
75731	Artery x-rays adrenal gland	$XXX.XX	J1	5182
75733	Artery x-rays adrenals	$XXX.XX	Q2	5183
75736	Artery x-rays pelvis	$XXX.XX	Q2	5184
75741	Artery x-rays lung	$XXX.XX	Q2	5183
75743	Artery x-rays lungs	$XXX.XX	Q2	5183
75746	Artery x-rays lung	$XXX.XX	J1	5182
75756	Artery x-rays chest	$XXX.XX	Q2	5183
75801	Lymph vessel x-ray arm/leg	$XXX.XX	Q2	5181
75803	Lymph vessel x-ray arms/legs	$XXX.XX	J1	5182
75805	Lymph vessel x-ray trunk	$XXX.XX	J1	5182
75807	Lymph vessel x-ray trunk	$XXX.XX	Q2	5183
75809	Nonvascular shunt x-ray	$XXX.XX	Q2	5522
75810	Vein x-ray spleen/liver	$XXX.XX	J1	5182
75820	Vein x-ray arm/leg	$XXX.XX	Q2	5181
75822	Vein x-ray arms/legs	$XXX.XX	J1	5182
75825	Vein x-ray trunk	$XXX.XX	Q2	5183
75827	Vein x-ray chest	$XXX.XX	Q2	5181
75831	Vein x-ray kidney	$XXX.XX	Q2	5183
75833	Vein x-ray kidneys	$XXX.XX	Q2	5183
75840	Vein x-ray adrenal gland	$XXX.XX	Q2	5183
75842	Vein x-ray adrenal glands	$XXX.XX	Q2	5184
75860	Vein x-ray neck	$XXX.XX	Q2	5183
75870	Vein x-ray skull	$XXX.XX	J1	5182
75872	Vein x-ray skull epidural	$XXX.XX	Q2	5181
75880	Vein x-ray eye socket	$XXX.XX	Q2	5181
75885	Vein x-ray liver w/hemodynam	$XXX.XX	Q2	5183
75887	Vein x-ray liver w/o hemodyn	$XXX.XX	J1	5182
75889	Vein x-ray liver w/hemodynam	$XXX.XX	Q2	5183
75891	Vein x-ray liver	$XXX.XX	Q2	5183
75893	Venous sampling by catheter	$XXX.XX	Q2	5184
75898	Follow-up angiography	$XXX.XX	J1	5182
76000	Fluoroscopy <1 hr phys/qhp	$XXX.XX	S	5523
76010	X-ray nose to rectum	$XXX.XX	Q1	5521
76080	X-ray exam of fistula	$XXX.XX	Q2	5524
76098	X-ray exam surgical specimen	$XXX.XX	Q2	5524
76100	X-ray exam of body section	$XXX.XX	Q1	5522
76101	Complex body section x-ray	$XXX.XX	Q1	5522
76102	Complex body section x-rays	$XXX.XX	S	5522
76120	Cine/video x-rays	$XXX.XX	Q1	5522
76380	Cat scan follow-up study	$XXX.XX	Q1	5521
76391	Mr elastography	$XXX.XX	Q3	5523
76496	Fluoroscopic procedure	$XXX.XX	Q1	5521
76497	Ct procedure	$XXX.XX	Q1	5521
76498	Mri procedure	$XXX.XX	S	5521
76499	Radiographic procedure	$XXX.XX	Q1	5521
76506	Echo exam of head	$XXX.XX	Q1	5522
76510	Ophth us b & quant a	$XXX.XX	Q1	5734
76511	Ophth us quant a only	$XXX.XX	Q1	5522
76512	Ophth us b w/non-quant a	$XXX.XX	Q1	5522
76513	Echo exam of eye water bath	$XXX.XX	Q1	5522
76514	Echo exam of eye thickness	$XXX.XX	Q1	5731
76516	Echo exam of eye	$XXX.XX	Q1	5522
76519	Echo exam of eye	$XXX.XX	Q1	5522
76529	Echo exam of eye	$XXX.XX	Q1	5521
76536	Us exam of head and neck	$XXX.XX	Q1	5522
76604	Us exam chest	$XXX.XX	Q1	5522
76641	Ultrasound breast complete	$XXX.XX	Q1	5522
76642	Ultrasound breast limited	$XXX.XX	Q1	5521
76700	Us exam abdom complete	$XXX.XX	Q3	5522
76705	Echo exam of abdomen	$XXX.XX	Q3	5522
76706	Us abdl aorta screen aaa	$XXX.XX	S	5522
76770	Us exam abdo back wall comp	$XXX.XX	Q3	5522
76775	Us exam abdo back wall lim	$XXX.XX	Q1	5522
76776	Us exam k transpl w/doppler	$XXX.XX	Q3	5522
76800	Us exam spinal canal	$XXX.XX	Q1	5522
76801	Ob us < 14 wks single fetus	$XXX.XX	S	5522
76805	Ob us >= 14 wks sngl fetus	$XXX.XX	S	5522
76811	Ob us detailed sngl fetus	$XXX.XX	S	5523
76813	Ob us nuchal meas 1 gest	$XXX.XX	Q1	5522
76815	Ob us limited fetus(s)	$XXX.XX	Q1	5522
76816	Ob us follow-up per fetus	$XXX.XX	Q1	5522
76817	Transvaginal us obstetric	$XXX.XX	Q1	5522
76818	Fetal biophys profile w/nst	$XXX.XX	S	5522
76819	Fetal biophys profil w/o nst	$XXX.XX	S	5522
76820	Umbilical artery echo	$XXX.XX	Q1	5522
76821	Middle cerebral artery echo	$XXX.XX	Q1	5522
76825	Echo exam of fetal heart	$XXX.XX	S	5524
76826	Echo exam of fetal heart	$XXX.XX	S	5523
76827	Echo exam of fetal heart	$XXX.XX	Q1	5522
76828	Echo exam of fetal heart	$XXX.XX	Q1	5522
76830	Transvaginal us non-ob	$XXX.XX	S	5522
76831	Echo exam uterus	$XXX.XX	Q3	5523
76856	Us exam pelvic complete	$XXX.XX	Q3	5522
76857	Us exam pelvic limited	$XXX.XX	Q3	5522
76870	Us exam scrotum	$XXX.XX	Q1	5522
76872	Us transrectal	$XXX.XX	S	5522
76873	Echograp trans r pros study	$XXX.XX	S	5522
76881	Us compl joint r-t w/img	$XXX.XX	S	5522
76882	Us lmtd jt/nonvasc xtr strux	$XXX.XX	Q1	5522
76885	Us exam infant hips dynamic	$XXX.XX	Q1	5521
76886	Us exam infant hips static	$XXX.XX	Q1	5521
76936	Echo guide for artery repair	$XXX.XX	S	5722
76970	Ultrasound exam follow-up	$XXX.XX	Q1	5522
76975	Gi endoscopic ultrasound	$XXX.XX	Q2	5523
76977	Us bone density measure	$XXX.XX	S	5522
76978	Us trgt dyn mbubb 1st les	$XXX.XX	S	5571
76981	Use parenchyma	$XXX.XX	Q3	5522
76982	Use 1st target lesion	$XXX.XX	Q3	5522
76999	Echo examination procedure	$XXX.XX	Q1	5521
77046	Mri breast c- unilateral	$XXX.XX	Q3	5523
77047	Mri breast c- bilateral	$XXX.XX	Q3	5523
77053	X-ray of mammary duct	$XXX.XX	Q2	5523
77054	X-ray of mammary ducts	$XXX.XX	Q2	5523
77071	X-ray stress view	$XXX.XX	Q1	5521
77072	X-rays for bone age	$XXX.XX	Q1	5522
77073	X-rays bone length studies	$XXX.XX	Q1	5522
77074	X-rays bone survey limited	$XXX.XX	Q1	5522
77075	X-rays bone survey complete	$XXX.XX	Q1	5522
77076	X-rays bone survey infant	$XXX.XX	Q1	5522
77077	Joint survey single view	$XXX.XX	Q1	5522
77078	Ct bone density axial	$XXX.XX	S	5521
77080	Dxa bone density axial	$XXX.XX	S	5522
77081	Dxa bone density/peripheral	$XXX.XX	S	5521
77084	Magnetic image bone marrow	$XXX.XX	S	5523
77085	Dxa bone density study	$XXX.XX	Q1	5522
77086	Fracture assessment via dxa	$XXX.XX	Q1	5521
77280	Set radiation therapy field	$XXX.XX	S	5611
77285	Set radiation therapy field	$XXX.XX	S	5612
77290	Set radiation therapy field	$XXX.XX	S	5612
77295	3-d radiotherapy plan	$XXX.XX	S	5613
77299	Radiation therapy planning	$XXX.XX	S	5611
77300	Radiation therapy dose plan	$XXX.XX	S	5611
77301	Radiotherapy dose plan imrt	$XXX.XX	S	5613
77306	Telethx isodose plan simple	$XXX.XX	S	5612
77307	Telethx isodose plan cplx	$XXX.XX	S	5612
77316	Brachytx isodose plan simple	$XXX.XX	S	5612
77317	Brachytx isodose intermed	$XXX.XX	S	5612
77318	Brachytx isodose complex	$XXX.XX	S	5612
77321	Special teletx port plan	$XXX.XX	S	5612
77331	Special radiation dosimetry	$XXX.XX	S	5611
77332	Radiation treatment aid(s)	$XXX.XX	S	5611
77333	Radiation treatment aid(s)	$XXX.XX	S	5611
77334	Radiation treatment aid(s)	$XXX.XX	S	5612
77336	Radiation physics consult	$XXX.XX	S	5611
77338	Design mlc device for imrt	$XXX.XX	S	5612
77370	Radiation physics consult	$XXX.XX	S	5611
77371	Srs multisource	$XXX.XX	J1	5627
77372	Srs linear based	$XXX.XX	J1	5627
77373	Sbrt delivery	$XXX.XX	S	5626
77385	Ntsty modul rad tx dlvr smpl	$XXX.XX	S	5623
77386	Ntsty modul rad tx dlvr cplx	$XXX.XX	S	5623
77399	External radiation dosimetry	$XXX.XX	S	5611
77401	Radiation treatment delivery	$XXX.XX	S	5621
77402	Radiation treatment delivery	$XXX.XX	S	5621
77407	Radiation treatment delivery	$XXX.XX	S	5622
77412	Radiation treatment delivery	$XXX.XX	S	5622
77423	Neutron beam tx complex	$XXX.XX	S	5623
77424	Io rad tx delivery by x-ray	$XXX.XX	J1	5627
77425	Io rad tx deliver by elctrns	$XXX.XX	J1	5627
77470	Special radiation treatment	$XXX.XX	S	5623
77520	Proton trmt simple w/o comp	$XXX.XX	S	5623
77522	Proton trmt simple w/comp	$XXX.XX	S	5625
77523	Proton trmt intermediate	$XXX.XX	S	5625
77525	Proton treatment complex	$XXX.XX	S	5625
77600	Hyperthermia treatment	$XXX.XX	S	5622
77605	Hyperthermia treatment	$XXX.XX	S	5624
77610	Hyperthermia treatment	$XXX.XX	S	5623
77615	Hyperthermia treatment	$XXX.XX	S	5623
77620	Hyperthermia treatment	$XXX.XX	S	5623
77750	Infuse radioactive materials	$XXX.XX	S	5622
77761	Apply intrcav radiat simple	$XXX.XX	S	5623
77762	Apply intrcav radiat interm	$XXX.XX	S	5623
77763	Apply intrcav radiat compl	$XXX.XX	S	5624
77767	Hdr rdncl skn surf brachytx	$XXX.XX	S	5622
77768	Hdr rdncl skn surf brachytx	$XXX.XX	S	5622
77770	Hdr rdncl ntrstl/icav brchtx	$XXX.XX	S	5624
77771	Hdr rdncl ntrstl/icav brchtx	$XXX.XX	S	5624
77772	Hdr rdncl ntrstl/icav brchtx	$XXX.XX	S	5624
77778	Apply interstit radiat compl	$XXX.XX	S	5624
77789	Apply surf ldr radionuclide	$XXX.XX	S	5621
77799	Radium/radioisotope therapy	$XXX.XX	S	5621
78012	Thyroid uptake measurement	$XXX.XX	S	5591
78013	Thyroid imaging w/blood flow	$XXX.XX	S	5591
78014	Thyroid imaging w/blood flow	$XXX.XX	S	5591
78015	Thyroid met imaging	$XXX.XX	S	5591
78016	Thyroid met imaging/studies	$XXX.XX	S	5591
78018	Thyroid met imaging body	$XXX.XX	S	5592
78070	Parathyroid planar imaging	$XXX.XX	S	5591
78071	Parathyrd planar w/wo subtrj	$XXX.XX	S	5591
78072	Parathyrd planar w/spect&ct	$XXX.XX	S	5592
78075	Adrenal cortex & medulla img	$XXX.XX	S	5593
78099	Endocrine nuclear procedure	$XXX.XX	S	5591
78102	Bone marrow imaging ltd	$XXX.XX	S	5591
78103	Bone marrow imaging mult	$XXX.XX	S	5591
78104	Bone marrow imaging body	$XXX.XX	S	5591
78110	Plasma volume single	$XXX.XX	S	5593
78111	Plasma volume multiple	$XXX.XX	S	5593
78120	Red cell mass single	$XXX.XX	S	5591
78121	Red cell mass multiple	$XXX.XX	S	5592
78122	Blood volume	$XXX.XX	S	5592
78130	Red cell survival study	$XXX.XX	S	5591
78135	Red cell survival kinetics	$XXX.XX	S	5591
78140	Red cell sequestration	$XXX.XX	S	5591
78185	Spleen imaging	$XXX.XX	S	5591
78191	Platelet survival	$XXX.XX	S	5591
78195	Lymph system imaging	$XXX.XX	S	5592
78199	Blood/lymph nuclear exam	$XXX.XX	S	5591
78201	Liver imaging	$XXX.XX	S	5593
78202	Liver imaging with flow	$XXX.XX	S	5593
78215	Liver and spleen imaging	$XXX.XX	S	5591
78216	Liver & spleen image/flow	$XXX.XX	S	5591
78226	Hepatobiliary system imaging	$XXX.XX	S	5591
78227	Hepatobil syst image w/drug	$XXX.XX	S	5592
78230	Salivary gland imaging	$XXX.XX	S	5591
78231	Serial salivary imaging	$XXX.XX	S	5591
78232	Salivary gland function exam	$XXX.XX	S	5591
78258	Esophageal motility study	$XXX.XX	S	5591
78261	Gastric mucosa imaging	$XXX.XX	S	5591
78262	Gastroesophageal reflux exam	$XXX.XX	S	5591
78264	Gastric emptying imag study	$XXX.XX	S	5591
78265	Gastric emptying imag study	$XXX.XX	S	5591
78266	Gastric emptying imag study	$XXX.XX	S	5592
78278	Acute gi blood loss imaging	$XXX.XX	S	5591
78282	Gi protein loss exam	$XXX.XX	S	5591
78290	Meckels divert exam	$XXX.XX	S	5591
78291	Leveen/shunt patency exam	$XXX.XX	S	5591
78299	Gi nuclear procedure	$XXX.XX	S	5591
78300	Bone imaging limited area	$XXX.XX	S	5591
78305	Bone imaging multiple areas	$XXX.XX	S	5591
78306	Bone imaging whole body	$XXX.XX	S	5591
78315	Bone imaging 3 phase	$XXX.XX	S	5591
78399	Musculoskeletal nuclear exam	$XXX.XX	S	5591
78414	Non-imaging heart function	$XXX.XX	S	5592
78428	Cardiac shunt imaging	$XXX.XX	S	5591
78429	Myocrd img pet 1 std w/ct	$XXX.XX	S	5594
78430	Myocrd img pet rst/strs w/ct	$XXX.XX	S	5594
78431	Myocrd img pet rst&strs ct	$XXX.XX	S	1522
78432	Myocrd img pet 2rtracer	$XXX.XX	S	1523
78433	Myocrd img pet 2rtracer ct	$XXX.XX	S	1523
78445	Vascular flow imaging	$XXX.XX	S	5591
78451	Ht muscle image spect sing	$XXX.XX	S	5593
78452	Ht muscle image spect mult	$XXX.XX	S	5593
78453	Ht muscle image planar sing	$XXX.XX	S	5593
78454	Ht musc image planar mult	$XXX.XX	S	5593
78456	Acute venous thrombus image	$XXX.XX	S	5593
78457	Venous thrombosis imaging	$XXX.XX	S	5593
78458	Ven thrombosis images bilat	$XXX.XX	S	5591
78459	Myocrd img pet single study	$XXX.XX	S	5593
78466	Heart infarct image	$XXX.XX	S	5591
78468	Heart infarct image (ef)	$XXX.XX	S	5592
78469	Heart infarct image (3d)	$XXX.XX	S	5593
78472	Gated heart planar single	$XXX.XX	S	5591
78473	Gated heart multiple	$XXX.XX	S	5591
78481	Heart first pass single	$XXX.XX	S	5592
78483	Heart first pass multiple	$XXX.XX	S	5592
78491	Myocrd img pet 1std rst/strs	$XXX.XX	S	5594
78492	Myocrd img pet mlt rst&strs	$XXX.XX	S	5594
78494	Heart image spect	$XXX.XX	S	5591
78499	Cardiovascular nuclear exam	$XXX.XX	S	5591
78579	Lung ventilation imaging	$XXX.XX	S	5591
78580	Lung perfusion imaging	$XXX.XX	S	5591
78582	Lung ventilat&perfus imaging	$XXX.XX	S	5592
78597	Lung perfusion differential	$XXX.XX	S	5591
78598	Lung perf&ventilat diferentl	$XXX.XX	S	5592
78599	Respiratory nuclear exam	$XXX.XX	S	5591
78600	Brain image < 4 views	$XXX.XX	S	5591
78601	Brain image w/flow < 4 views	$XXX.XX	S	5591
78605	Brain image 4+ views	$XXX.XX	S	5592
78606	Brain image w/flow 4 + views	$XXX.XX	S	5592
78608	Brain imaging (pet)	$XXX.XX	S	5594
78610	Brain flow imaging only	$XXX.XX	S	5592
78630	Cerebrospinal fluid scan	$XXX.XX	S	5592
78635	Csf ventriculography	$XXX.XX	S	5592
78645	Csf shunt evaluation	$XXX.XX	S	5592
78650	Csf leakage imaging	$XXX.XX	S	5593
78660	Nuclear exam of tear flow	$XXX.XX	S	5591
78699	Nervous system nuclear exam	$XXX.XX	S	5591
78700	Kidney imaging morphol	$XXX.XX	S	5591
78701	Kidney imaging with flow	$XXX.XX	S	5591
78707	K flow/funct image w/o drug	$XXX.XX	S	5592
78708	K flow/funct image w/drug	$XXX.XX	S	5592
78709	K flow/funct image multiple	$XXX.XX	S	5592
78725	Kidney function study	$XXX.XX	S	5591
78740	Ureteral reflux study	$XXX.XX	S	5591
78761	Testicular imaging w/flow	$XXX.XX	S	5591
78799	Genitourinary nuclear exam	$XXX.XX	S	5591
78800	Rp loclzj tum 1 area 1 d img	$XXX.XX	S	5591
78801	Rp loclzj tum 2+area 1+d img	$XXX.XX	S	5591
78802	Rp loclzj tum whbdy 1 d img	$XXX.XX	S	5593
78803	Rp loclzj tum spect 1 area	$XXX.XX	S	5593
78804	Rp loclzj tum whbdy 2+d img	$XXX.XX	S	5593
78808	Iv inj ra drug dx study	$XXX.XX	Q1	5591
78811	Pet image ltd area	$XXX.XX	S	5593
78812	Pet image skull-thigh	$XXX.XX	S	5594
78813	Pet image full body	$XXX.XX	S	5594
78814	Pet image w/ct lmtd	$XXX.XX	S	5594
78815	Pet image w/ct skull-thigh	$XXX.XX	S	5594
78816	Pet image w/ct full body	$XXX.XX	S	5594
78830	Rp loclzj tum spect w/ct 1	$XXX.XX	S	5593
78831	Rp loclzj tum spect 2 areas	$XXX.XX	S	5593
78832	Rp loclzj tum spect w/ct 2	$XXX.XX	S	5594
78999	Nuclear diagnostic exam	$XXX.XX	S	5591
79005	Nuclear rx oral admin	$XXX.XX	S	5661
79101	Nuclear rx iv admin	$XXX.XX	S	5661
79200	Nuclear rx intracav admin	$XXX.XX	S	5661
79300	Nuclr rx interstit colloid	$XXX.XX	S	5661
79403	Hematopoietic nuclear tx	$XXX.XX	S	5661
79440	Nuclear rx intra-articular	$XXX.XX	S	5661
79445	Nuclear rx intra-arterial	$XXX.XX	S	5661
79999	Nuclear medicine therapy	$XXX.XX	S	5661
80500	Lab pathology consultation	$XXX.XX	Q1	5671
80502	Lab pathology consultation	$XXX.XX	Q1	5671
85097	Bone marrow interpretation	$XXX.XX	Q2	5674
86077	Phys blood bank serv xmatch	$XXX.XX	Q1	5731
86078	Phys blood bank serv reactj	$XXX.XX	Q1	5672
86079	Phys blood bank serv authrj	$XXX.XX	Q1	5671
86485	Skin test candida	$XXX.XX	Q1	5731
86486	Skin test nos antigen	$XXX.XX	Q1	5731
86490	Coccidioidomycosis skin test	$XXX.XX	Q1	5733
86510	Histoplasmosis skin test	$XXX.XX	Q1	5733
86580	Tb intradermal test	$XXX.XX	Q1	5731
86850	Rbc antibody screen	$XXX.XX	Q1	5671
86860	Rbc antibody elution	$XXX.XX	Q1	5672
86870	Rbc antibody identification	$XXX.XX	Q2	5673
86880	Coombs test direct	$XXX.XX	Q1	5732
86885	Coombs test indirect qual	$XXX.XX	Q1	5672
86886	Coombs test indirect titer	$XXX.XX	Q1	5672
86890	Autologous blood process	$XXX.XX	Q1	5672
86891	Autologous blood op salvage	$XXX.XX	Q1	5674
86900	Blood typing serologic abo	$XXX.XX	Q1	5734
86901	Blood typing serologic rh(d)	$XXX.XX	Q1	5732
86902	Blood type antigen donor ea	$XXX.XX	Q1	5673
86904	Blood typing patient serum	$XXX.XX	Q1	5732
86905	Blood typing rbc antigens	$XXX.XX	Q1	5673
86906	Bld typing serologic rh phnt	$XXX.XX	Q1	5732
86920	Compatibility test spin	$XXX.XX	Q1	5672
86921	Compatibility test incubate	$XXX.XX	Q1	5672
86922	Compatibility test antiglob	$XXX.XX	Q1	5672
86923	Compatibility test electric	$XXX.XX	Q1	5672
86927	Plasma fresh frozen	$XXX.XX	S	5672
86930	Frozen blood prep	$XXX.XX	Q1	5673
86931	Frozen blood thaw	$XXX.XX	Q1	5673
86932	Frozen blood freeze/thaw	$XXX.XX	Q1	5732
86945	Blood product/irradiation	$XXX.XX	Q1	5732
86950	Leukacyte transfusion	$XXX.XX	Q1	5672
86960	Vol reduction of blood/prod	$XXX.XX	Q1	5672
86965	Pooling blood platelets	$XXX.XX	Q1	5672
86970	Rbc pretx incubatj w/chemicl	$XXX.XX	Q1	5732
86971	Rbc pretx incubatj w/enzymes	$XXX.XX	Q1	5673
86972	Rbc pretx incubatj w/density	$XXX.XX	Q1	5672
86975	Rbc serum pretx incubj drugs	$XXX.XX	Q1	5734
86976	Rbc serum pretx id dilution	$XXX.XX	Q1	5731
86977	Rbc serum pretx incubj/inhib	$XXX.XX	Q1	5672
86978	Rbc pretreatment serum	$XXX.XX	Q1	5732
86985	Split blood or products	$XXX.XX	Q1	5672
86999	Transfusion procedure	$XXX.XX	Q1	5731
88104	Cytopath fl nongyn smears	$XXX.XX	Q1	5732
88106	Cytopath fl nongyn filter	$XXX.XX	Q1	5731
88108	Cytopath concentrate tech	$XXX.XX	Q1	5732
88112	Cytopath cell enhance tech	$XXX.XX	Q1	5671
88120	Cytp urne 3-5 probes ea spec	$XXX.XX	Q2	5672
88121	Cytp urine 3-5 probes cmptr	$XXX.XX	Q1	5673
88125	Forensic cytopathology	$XXX.XX	Q1	5671
88160	Cytopath smear other source	$XXX.XX	Q1	5731
88161	Cytopath smear other source	$XXX.XX	Q1	5731
88162	Cytopath smear other source	$XXX.XX	Q1	5671
88172	Cytp dx eval fna 1st ea site	$XXX.XX	Q1	5672
88173	Cytopath eval fna report	$XXX.XX	Q1	5671
88182	Cell marker study	$XXX.XX	Q2	5671
88184	Flowcytometry/ tc 1 marker	$XXX.XX	Q2	5673
88199	Cytopathology procedure	$XXX.XX	Q1	5671
88299	Cytogenetic study	$XXX.XX	Q1	5671
88300	Surgical path gross	$XXX.XX	Q1	5731
88302	Tissue exam by pathologist	$XXX.XX	Q1	5731
88304	Tissue exam by pathologist	$XXX.XX	Q1	5671
88305	Tissue exam by pathologist	$XXX.XX	Q1	5671
88307	Tissue exam by pathologist	$XXX.XX	Q2	5673
88309	Tissue exam by pathologist	$XXX.XX	Q2	5674
88312	Special stains group 1	$XXX.XX	Q1	5671
88313	Special stains group 2	$XXX.XX	Q1	5732
88319	Enzyme histochemistry	$XXX.XX	Q2	5674
88321	Microslide consultation	$XXX.XX	Q1	5732
88323	Microslide consultation	$XXX.XX	Q1	5671
88325	Comprehensive review of data	$XXX.XX	Q1	5671
88329	Path consult introp	$XXX.XX	Q1	5732
88331	Path consult intraop 1 bloc	$XXX.XX	Q1	5672
88333	Intraop cyto path consult 1	$XXX.XX	Q2	5674
88342	Immunohisto antb 1st stain	$XXX.XX	Q2	5672
88344	Immunohisto antibody slide	$XXX.XX	Q1	5673
88346	Immunofluor antb 1st stain	$XXX.XX	Q2	5673
88348	Electron microscopy	$XXX.XX	Q2	5674
88355	Analysis skeletal muscle	$XXX.XX	Q1	5672
88356	Analysis nerve	$XXX.XX	Q1	5671
88358	Analysis tumor	$XXX.XX	Q2	5672
88360	Tumor immunohistochem/manual	$XXX.XX	Q2	5672
88361	Tumor immunohistochem/comput	$XXX.XX	Q2	5673
88362	Nerve teasing preparations	$XXX.XX	Q2	5674
88363	Xm archive tissue molec anal	$XXX.XX	Q1	5731
88365	Insitu hybridization (fish)	$XXX.XX	Q1	5672
88366	Insitu hybridization (fish)	$XXX.XX	Q1	5673
88367	Insitu hybridization auto	$XXX.XX	Q2	5673
88368	Insitu hybridization manual	$XXX.XX	Q2	5673
88374	M/phmtrc alys ishquant/semiq	$XXX.XX	Q1	5672
88377	M/phmtrc alys ishquant/semiq	$XXX.XX	Q1	5672
88399	Surgical pathology procedure	$XXX.XX	Q1	5671
89049	Chct for mal hyperthermia	$XXX.XX	Q1	5672
89220	Sputum specimen collection	$XXX.XX	Q1	5672
89230	Collect sweat for test	$XXX.XX	Q1	5671
89240	Pathology lab procedure	$XXX.XX	Q1	5671
89250	Cultr oocyte/embryo <4 days	$XXX.XX	Q1	5672
89251	Cultr oocyte/embryo <4 days	$XXX.XX	Q2	5672
89253	Embryo hatching	$XXX.XX	Q1	5672
89254	Oocyte identification	$XXX.XX	Q1	5672
89255	Prepare embryo for transfer	$XXX.XX	Q1	5671
89257	Sperm identification	$XXX.XX	Q1	5671
89258	Cryopreservation embryo(s)	$XXX.XX	Q2	5674
89259	Cryopreservation sperm	$XXX.XX	Q1	5672
89260	Sperm isolation simple	$XXX.XX	Q1	5671
89261	Sperm isolation complex	$XXX.XX	Q1	5671
89264	Identify sperm tissue	$XXX.XX	Q1	5671
89268	Insemination of oocytes	$XXX.XX	Q1	5672
89272	Extended culture of oocytes	$XXX.XX	Q2	5674
89280	Assist oocyte fertilization	$XXX.XX	Q2	5674
89281	Assist oocyte fertilization	$XXX.XX	Q1	5672
89290	Biopsy oocyte polar body	$XXX.XX	Q1	5672
89291	Biopsy oocyte polar body	$XXX.XX	Q1	5672
89335	Cryopreserve testicular tiss	$XXX.XX	Q1	5671
89337	Cryopreservation oocyte(s)	$XXX.XX	Q1	5672
89342	Storage/year embryo(s)	$XXX.XX	Q1	5672
89343	Storage/year sperm/semen	$XXX.XX	Q1	5672
89344	Storage/year reprod tissue	$XXX.XX	Q1	5672
89346	Storage/year oocyte(s)	$XXX.XX	Q2	5673
89352	Thawing cryopresrved embryo	$XXX.XX	Q1	5672
89353	Thawing cryopresrved sperm	$XXX.XX	Q1	5671
89354	Thaw cryoprsvrd reprod tiss	$XXX.XX	Q1	5672
89356	Thawing cryopresrved oocyte	$XXX.XX	Q1	5672
89398	Unlisted reprod med lab proc	$XXX.XX	Q1	5671
90296	Diphtheria antitoxin	$XXX.XX	K	9315
90371	Hep b ig im	$XXX.XX	K	1630
90375	Rabies ig im/sc	$XXX.XX	K	9133
90376	Rabies ig heat treated	$XXX.XX	K	9134
90378	Rsv mab im 50mg	$XXX.XX	K	9003
90396	Varicella-zoster ig im	$XXX.XX	K	9135
90471	Immunization admin	$XXX.XX	Q1	5692
90473	Immune admin oral/nasal	$XXX.XX	Q1	5692
90675	Rabies vaccine im	$XXX.XX	K	9139
90676	Rabies vaccine id	$XXX.XX	K	9140
90791	Psych diagnostic evaluation	$XXX.XX	Q3	5823
90792	Psych diag eval w/med srvcs	$XXX.XX	Q3	5823
90832	Psytx w pt 30 minutes	$XXX.XX	Q3	5823
90834	Psytx w pt 45 minutes	$XXX.XX	Q3	5823
90837	Psytx w pt 60 minutes	$XXX.XX	Q3	5823
90839	Psytx crisis initial 60 min	$XXX.XX	Q3	5823
90845	Psychoanalysis	$XXX.XX	Q3	5823
90846	Family psytx w/o pt 50 min	$XXX.XX	Q3	5823
90847	Family psytx w/pt 50 min	$XXX.XX	Q3	5823
90849	Multiple family group psytx	$XXX.XX	Q3	5823
90853	Group psychotherapy	$XXX.XX	Q3	5822
90865	Narcosynthesis	$XXX.XX	Q3	5823
90867	Tcranial magn stim tx plan	$XXX.XX	S	5722
90868	Tcranial magn stim tx deli	$XXX.XX	S	5721
90869	Tcran magn stim redetemine	$XXX.XX	S	5721
90870	Electroconvulsive therapy	$XXX.XX	S	5723
90880	Hypnotherapy	$XXX.XX	Q3	5822
90899	Psychiatric service/therapy	$XXX.XX	Q3	5821
90935	Hemodialysis one evaluation	$XXX.XX	S	5401
90945	Dialysis one evaluation	$XXX.XX	V	5024
91010	Esophagus motility study	$XXX.XX	S	5723
91020	Gastric motility studies	$XXX.XX	S	5723
91022	Duodenal motility study	$XXX.XX	S	5723
91030	Acid perfusion of esophagus	$XXX.XX	S	5723
91034	Gastroesophageal reflux test	$XXX.XX	S	5723
91035	G-esoph reflx tst w/electrod	$XXX.XX	S	5723
91037	Esoph imped function test	$XXX.XX	S	5722
91038	Esoph imped funct test > 1hr	$XXX.XX	S	5723
91040	Esoph balloon distension tst	$XXX.XX	S	5723
91065	Breath hydrogen/methane test	$XXX.XX	S	5721
91110	Gi tract capsule endoscopy	$XXX.XX	T	5301
91111	Esophageal capsule endoscopy	$XXX.XX	T	5301
91112	Gi wireless capsule measure	$XXX.XX	T	5301
91117	Colon motility 6 hr study	$XXX.XX	T	5371
91120	Rectal sensation test	$XXX.XX	S	5721
91122	Anal pressure record	$XXX.XX	T	5371
91132	Electrogastrography	$XXX.XX	S	5721
91133	Electrogastrography w/test	$XXX.XX	Q1	5734
91200	Liver elastography	$XXX.XX	Q1	5721
91299	Gastroenterology procedure	$XXX.XX	S	5721
92002	Eye exam new patient	$XXX.XX	V	5012
92004	Eye exam new patient	$XXX.XX	V	5012
92012	Eye exam establish patient	$XXX.XX	V	5012
92014	Eye exam&tx estab pt 1/>vst	$XXX.XX	V	5012
92018	New eye exam & treatment	$XXX.XX	J1	5503
92019	Eye exam & treatment	$XXX.XX	J1	5503
92020	Special eye evaluation	$XXX.XX	Q1	5734
92025	Corneal topography	$XXX.XX	Q1	5733
92060	Special eye evaluation	$XXX.XX	Q1	5733
92065	Orthoptic/pleoptic training	$XXX.XX	Q1	5733
92081	Visual field examination(s)	$XXX.XX	Q1	5733
92082	Visual field examination(s)	$XXX.XX	Q1	5733
92083	Visual field examination(s)	$XXX.XX	Q1	5734
92132	Cmptr ophth dx img ant segmt	$XXX.XX	Q1	5733
92133	Cmptr ophth img optic nerve	$XXX.XX	Q1	5733
92134	Cptr ophth dx img post segmt	$XXX.XX	Q1	5733
92136	Ophthalmic biometry	$XXX.XX	Q1	5734
92145	Corneal hysteresis deter	$XXX.XX	Q1	5732
92201	Opscpy extnd rta draw uni/bi	$XXX.XX	Q1	5733
92202	Opscpy extnd on/mac draw	$XXX.XX	Q1	5733
92227	Remote dx retinal imaging	$XXX.XX	Q1	5732
92228	Remote retinal imaging mgmt	$XXX.XX	Q1	5732
92230	Eye exam with photos	$XXX.XX	Q1	5723
92235	Fluorescein angrph uni/bi	$XXX.XX	S	5722
92240	Icg angiography uni/bi	$XXX.XX	S	5722
92242	Fluorescein icg angiography	$XXX.XX	S	5722
92250	Eye exam with photos	$XXX.XX	Q1	5734
92260	Ophthalmoscopy/dynamometry	$XXX.XX	Q1	5732
92265	Eye muscle evaluation	$XXX.XX	Q1	5733
92270	Electro-oculography	$XXX.XX	Q1	5734
92273	Full field erg w/i&r	$XXX.XX	S	5722
92274	Multifocal erg w/i&r	$XXX.XX	S	5721
92283	Color vision examination	$XXX.XX	Q1	5733
92284	Dark adaptation eye exam	$XXX.XX	Q1	5735
92285	Eye photography	$XXX.XX	Q1	5733
92286	Internal eye photography	$XXX.XX	Q1	5734
92287	Internal eye photography	$XXX.XX	Q1	5734
92311	Contact lens fitting	$XXX.XX	Q1	5735
92312	Contact lens fitting	$XXX.XX	Q1	5734
92313	Contact lens fitting	$XXX.XX	Q1	5734
92315	Rx cntact lens aphakia 1 eye	$XXX.XX	Q1	5734
92316	Rx cntact lens aphakia 2 eye	$XXX.XX	Q1	5733
92317	Rx corneoscleral cntact lens	$XXX.XX	Q1	5732
92325	Modification of contact lens	$XXX.XX	Q1	5734
92326	Replacement of contact lens	$XXX.XX	Q1	5733
92352	Fit aphakia spectcl monofocl	$XXX.XX	Q1	5733
92353	Fit aphakia spectcl multifoc	$XXX.XX	Q1	5733
92354	Fit spectacles single system	$XXX.XX	Q1	5732
92355	Fit spectacles compound lens	$XXX.XX	Q1	5732
92358	Aphakia prosth service temp	$XXX.XX	Q1	5733
92371	Repair & adjust spectacles	$XXX.XX	Q1	5733
92499	Eye service or procedure	$XXX.XX	Q1	5731
92502	Ear and throat examination	$XXX.XX	T	5162
92511	Nasopharyngoscopy	$XXX.XX	T	5151
92512	Nasal function studies	$XXX.XX	S	5722
92516	Facial nerve function test	$XXX.XX	S	5721
92520	Laryngeal function studies	$XXX.XX	Q1	5734
92537	Caloric vstblr test w/rec	$XXX.XX	S	5721
92538	Caloric vstblr test w/rec	$XXX.XX	S	5721
92540	Basic vestibular evaluation	$XXX.XX	S	5721
92541	Spontaneous nystagmus test	$XXX.XX	Q1	5734
92542	Positional nystagmus test	$XXX.XX	Q1	5734
92544	Optokinetic nystagmus test	$XXX.XX	S	5721
92545	Oscillating tracking test	$XXX.XX	S	5721
92546	Sinusoidal rotational test	$XXX.XX	S	5721
92548	Cdp-sot 6 cond w/i&r	$XXX.XX	Q1	5734
92549	Cdp-sot 6 cond w/i&r mct&adt	$XXX.XX	Q1	5734
92550	Tympanometry & reflex thresh	$XXX.XX	Q1	5721
92552	Pure tone audiometry air	$XXX.XX	Q1	5734
92553	Audiometry air & bone	$XXX.XX	Q1	5721
92555	Speech threshold audiometry	$XXX.XX	Q1	5732
92556	Speech audiometry complete	$XXX.XX	Q1	5732
92557	Comprehensive hearing test	$XXX.XX	Q1	5721
92561	Bekesy audiometry diagnosis	$XXX.XX	Q1	5734
92562	Loudness balance test	$XXX.XX	Q1	5721
92563	Tone decay hearing test	$XXX.XX	Q1	5732
92564	Sisi hearing test	$XXX.XX	Q1	5731
92565	Stenger test pure tone	$XXX.XX	Q1	5732
92567	Tympanometry	$XXX.XX	Q1	5732
92568	Acoustic refl threshold tst	$XXX.XX	Q1	5732
92570	Acoustic immitance testing	$XXX.XX	Q1	5721
92571	Filtered speech hearing test	$XXX.XX	Q1	5732
92572	Staggered spondaic word test	$XXX.XX	Q1	5721
92575	Sensorineural acuity test	$XXX.XX	Q1	5732
92576	Synthetic sentence test	$XXX.XX	Q1	5732
92577	Stenger test speech	$XXX.XX	Q1	5723
92579	Visual audiometry (vra)	$XXX.XX	Q1	5721
92582	Conditioning play audiometry	$XXX.XX	Q1	5721
92583	Select picture audiometry	$XXX.XX	Q1	5732
92584	Electrocochleography	$XXX.XX	S	5721
92585	Auditor evoke potent compre	$XXX.XX	S	5722
92586	Auditor evoke potent limit	$XXX.XX	S	5721
92587	Evoked auditory test limited	$XXX.XX	S	5722
92588	Evoked auditory tst complete	$XXX.XX	S	5722
92596	Ear protector evaluation	$XXX.XX	Q1	5732
92601	Cochlear implt f/up exam <7	$XXX.XX	S	5721
92602	Reprogram cochlear implt <7	$XXX.XX	S	5721
92603	Cochlear implt f/up exam 7/>	$XXX.XX	S	5721
92604	Reprogram cochlear implt 7/>	$XXX.XX	S	5721
92620	Auditory function 60 min	$XXX.XX	Q1	5721
92625	Tinnitus assessment	$XXX.XX	Q1	5721
92626	Eval aud funcj 1st hour	$XXX.XX	Q1	5721
92640	Aud brainstem implt programg	$XXX.XX	S	5721
92700	Ent procedure/service	$XXX.XX	Q1	5731
92920	Prq cardiac angioplast 1 art	$XXX.XX	J1	5192
92924	Prq card angio/athrect 1 art	$XXX.XX	J1	5193
92928	Prq card stent w/angio 1 vsl	$XXX.XX	J1	5193
92933	Prq card stent/ath/angio	$XXX.XX	J1	5194
92937	Prq revasc byp graft 1 vsl	$XXX.XX	J1	5193
92943	Prq card revasc chronic 1vsl	$XXX.XX	J1	5193
92950	Heart/lung resuscitation cpr	$XXX.XX	S	5722
92953	Temporary external pacing	$XXX.XX	Q3	5781
92960	Cardioversion electric ext	$XXX.XX	S	5781
92961	Cardioversion electric int	$XXX.XX	S	5781
92977	Dissolve clot heart vessel	$XXX.XX	T	5694
92986	Revision of aortic valve	$XXX.XX	J1	5192
92987	Revision of mitral valve	$XXX.XX	J1	5193
92990	Revision of pulmonary valve	$XXX.XX	J1	5193
92997	Pul art balloon repr percut	$XXX.XX	J1	5193
93005	Electrocardiogram tracing	$XXX.XX	Q1	5733
93017	Cardiovascular stress test	$XXX.XX	Q1	5722
93024	Cardiac drug stress test	$XXX.XX	Q1	5735
93025	Microvolt t-wave assess	$XXX.XX	S	5721
93041	Rhythm ecg tracing	$XXX.XX	Q1	5733
93050	Art pressure waveform analys	$XXX.XX	Q1	5731
93225	Ecg monit/reprt up to 48 hrs	$XXX.XX	Q1	5734
93226	Ecg monit/reprt up to 48 hrs	$XXX.XX	Q1	5734
93229	Remote 30 day ecg tech supp	$XXX.XX	S	5721
93260	Prgrmg dev eval impltbl sys	$XXX.XX	Q1	5741
93261	Interrogate subq defib	$XXX.XX	Q1	5741
93270	Remote 30 day ecg rev/report	$XXX.XX	Q1	5741
93271	Ecg/monitoring and analysis	$XXX.XX	S	5742
93278	Ecg/signal-averaged	$XXX.XX	Q1	5733
93279	Prgrmg dev eval pm/ldls pm	$XXX.XX	Q1	5741
93280	Pm device progr eval dual	$XXX.XX	Q1	5741
93281	Pm device progr eval multi	$XXX.XX	Q1	5741
93282	Prgrmg eval implantable dfb	$XXX.XX	Q1	5741
93283	Prgrmg eval implantable dfb	$XXX.XX	Q1	5741
93284	Prgrmg eval implantable dfb	$XXX.XX	Q1	5741
93285	Prgrmg dev eval scrms ip	$XXX.XX	Q1	5741
93288	Interrog evl pm/ldls pm ip	$XXX.XX	Q1	5741
93289	Interrog device eval heart	$XXX.XX	Q1	5741
93290	Interrog dev eval icpms ip	$XXX.XX	Q1	5741
93291	Interrog dev eval scrms ip	$XXX.XX	Q1	5731
93292	Wcd device interrogate	$XXX.XX	Q1	5741
93293	Pm phone r-strip device eval	$XXX.XX	Q1	5741
93296	Rem interrog evl pm/ids	$XXX.XX	Q1	5741
93303	Echo transthoracic	$XXX.XX	S	5524
93304	Echo transthoracic	$XXX.XX	S	5524
93306	Tte w/doppler complete	$XXX.XX	S	5524
93307	Tte w/o doppler complete	$XXX.XX	S	5523
93308	Tte f-up or lmtd	$XXX.XX	S	5523
93312	Echo transesophageal	$XXX.XX	S	5524
93313	Echo transesophageal	$XXX.XX	S	5524
93315	Echo transesophageal	$XXX.XX	S	5524
93316	Echo transesophageal	$XXX.XX	S	5524
93318	Echo transesophageal intraop	$XXX.XX	S	5524
93350	Stress tte only	$XXX.XX	S	5524
93351	Stress tte complete	$XXX.XX	S	5524
93451	Right heart cath	$XXX.XX	J1	5191
93452	Left hrt cath w/ventrclgrphy	$XXX.XX	J1	5191
93453	R&l hrt cath w/ventriclgrphy	$XXX.XX	J1	5191
93454	Coronary artery angio s&i	$XXX.XX	J1	5191
93455	Coronary art/grft angio s&i	$XXX.XX	J1	5191
93456	R hrt coronary artery angio	$XXX.XX	J1	5191
93457	R hrt art/grft angio	$XXX.XX	J1	5191
93458	L hrt artery/ventricle angio	$XXX.XX	J1	5191
93459	L hrt art/grft angio	$XXX.XX	J1	5191
93460	R&l hrt art/ventricle angio	$XXX.XX	J1	5191
93461	R&l hrt art/ventricle angio	$XXX.XX	J1	5191
93503	Insert/place heart catheter	$XXX.XX	J1	5182
93505	Biopsy of heart lining	$XXX.XX	J1	5183
93530	Rt heart cath congenital	$XXX.XX	J1	5191
93531	R & l heart cath congenital	$XXX.XX	J1	5191
93532	R & l heart cath congenital	$XXX.XX	J1	5191
93533	R & l heart cath congenital	$XXX.XX	J1	5191
93580	Transcath closure of asd	$XXX.XX	J1	5194
93581	Transcath closure of vsd	$XXX.XX	J1	5194
93582	Perq transcath closure pda	$XXX.XX	J1	5194
93590	Perq transcath cls mitral	$XXX.XX	J1	5194
93591	Perq transcath cls aortic	$XXX.XX	J1	5194
93600	Bundle of his recording	$XXX.XX	J1	5212
93602	Intra-atrial recording	$XXX.XX	J1	5212
93603	Right ventricular recording	$XXX.XX	J1	5211
93610	Intra-atrial pacing	$XXX.XX	J1	5212
93612	Intraventricular pacing	$XXX.XX	J1	5212
93615	Esophageal recording	$XXX.XX	J1	5211
93616	Esophageal recording	$XXX.XX	J1	5211
93618	Heart rhythm pacing	$XXX.XX	J1	5211
93619	Electrophysiology evaluation	$XXX.XX	J1	5212
93620	Electrophysiology evaluation	$XXX.XX	J1	5212
93624	Electrophysiologic study	$XXX.XX	J1	5212
93642	Electrophysiology evaluation	$XXX.XX	J1	5211
93650	Ablate heart dysrhythm focus	$XXX.XX	J1	5212
93653	Ep & ablate supravent arrhyt	$XXX.XX	J1	5213
93654	Ep & ablate ventric tachy	$XXX.XX	J1	5213
93656	Tx atrial fib pulm vein isol	$XXX.XX	J1	5213
93660	Tilt table evaluation	$XXX.XX	S	5723
93668	Peripheral vascular rehab	$XXX.XX	S	5733
93701	Bioimpedance cv analysis	$XXX.XX	Q1	5734
93702	Bis xtracell fluid analysis	$XXX.XX	S	5721
93724	Analyze pacemaker system	$XXX.XX	S	5743
93740	Temperature gradient studies	$XXX.XX	Q1	5721
93745	Set-up cardiovert-defibrill	$XXX.XX	S	5743
93750	Interrogation vad in person	$XXX.XX	S	5742
93786	Ambl bp mntr w/sw rec only	$XXX.XX	Q1	5734
93788	Ambl bp mntr w/sw a/r	$XXX.XX	Q1	5734
93797	Cardiac rehab	$XXX.XX	S	5771
93798	Cardiac rehab/monitor	$XXX.XX	S	5771
93799	Cardiovascular procedure	$XXX.XX	S	5721
93880	Extracranial bilat study	$XXX.XX	S	5523
93882	Extracranial uni/ltd study	$XXX.XX	S	5522
93886	Intracranial complete study	$XXX.XX	S	5523
93888	Intracranial limited study	$XXX.XX	S	5522
93890	Tcd vasoreactivity study	$XXX.XX	Q1	5523
93892	Tcd emboli detect w/o inj	$XXX.XX	Q1	5522
93893	Tcd emboli detect w/inj	$XXX.XX	Q1	5522
93922	Upr/l xtremity art 2 levels	$XXX.XX	Q1	5734
93923	Upr/lxtr art stdy 3+ lvls	$XXX.XX	S	5721
93924	Lwr xtr vasc stdy bilat	$XXX.XX	S	5721
93925	Lower extremity study	$XXX.XX	S	5523
93926	Lower extremity study	$XXX.XX	S	5522
93930	Upper extremity study	$XXX.XX	S	5523
93931	Upper extremity study	$XXX.XX	S	5522
93970	Extremity study	$XXX.XX	S	5523
93971	Extremity study	$XXX.XX	S	5522
93975	Vascular study	$XXX.XX	S	5523
93976	Vascular study	$XXX.XX	S	5522
93978	Vascular study	$XXX.XX	S	5523
93979	Vascular study	$XXX.XX	Q1	5522
93980	Penile vascular study	$XXX.XX	S	5522
93981	Penile vascular study	$XXX.XX	S	5522
93985	Dup-scan hemo compl bi std	$XXX.XX	S	5523
93986	Dup-scan hemo compl uni std	$XXX.XX	S	5522
93990	Doppler flow testing	$XXX.XX	Q1	5522
93998	Noninvas vasc dx study proc	$XXX.XX	Q1	5731
94002	Vent mgmt inpat init day	$XXX.XX	Q3	5801
94003	Vent mgmt inpat subq day	$XXX.XX	Q3	5801
94010	Breathing capacity test	$XXX.XX	Q1	5721
94011	Spirometry up to 2 yrs old	$XXX.XX	Q1	5721
94012	Spirmtry w/brnchdil inf-2 yr	$XXX.XX	Q1	5722
94013	Meas lung vol thru 2 yrs	$XXX.XX	S	5723
94014	Patient recorded spirometry	$XXX.XX	Q1	5735
94015	Patient recorded spirometry	$XXX.XX	Q1	5722
94060	Evaluation of wheezing	$XXX.XX	S	5722
94070	Evaluation of wheezing	$XXX.XX	S	5722
94150	Vital capacity test	$XXX.XX	Q1	5721
94200	Lung function test (mbc/mvv)	$XXX.XX	Q1	5733
94250	Expired gas collection	$XXX.XX	Q1	5733
94375	Respiratory flow volume loop	$XXX.XX	Q1	5722
94400	Co2 breathing response curve	$XXX.XX	Q1	5721
94450	Hypoxia response curve	$XXX.XX	Q1	5721
94452	Hast w/report	$XXX.XX	Q1	5734
94453	Hast w/oxygen titrate	$XXX.XX	Q1	5734
94610	Surfactant admin thru tube	$XXX.XX	Q1	5791
94617	Exercise tst brncspsm	$XXX.XX	Q1	5734
94618	Pulmonary stress testing	$XXX.XX	Q1	5734
94621	Cardiopulm exercise testing	$XXX.XX	S	5722
94640	Airway inhalation treatment	$XXX.XX	Q1	5791
94642	Aerosol inhalation treatment	$XXX.XX	Q1	5791
94644	Cbt 1st hour	$XXX.XX	Q1	5734
94660	Pos airway pressure cpap	$XXX.XX	Q1	5791
94662	Neg press ventilation cnp	$XXX.XX	Q3	5801
94664	Evaluate pt use of inhaler	$XXX.XX	Q1	5791
94667	Chest wall manipulation	$XXX.XX	Q1	5734
94668	Chest wall manipulation	$XXX.XX	Q1	5734
94669	Mechanical chest wall oscill	$XXX.XX	Q1	5791
94680	Exhaled air analysis o2	$XXX.XX	Q1	5721
94681	Exhaled air analysis o2/co2	$XXX.XX	Q1	5722
94690	Exhaled air analysis	$XXX.XX	Q1	5732
94726	Pulm funct tst plethysmograp	$XXX.XX	Q1	5722
94727	Pulm function test by gas	$XXX.XX	Q1	5721
94728	Airwy resist by oscillometry	$XXX.XX	Q1	5722
94750	Pulmonary compliance study	$XXX.XX	Q1	5721
94762	Measure blood oxygen level	$XXX.XX	Q3	5721
94770	Exhaled carbon dioxide test	$XXX.XX	S	5721
94772	Breath recording infant	$XXX.XX	S	5723
94775	Ped home apnea rec hk-up	$XXX.XX	S	5721
94776	Ped home apnea rec downld	$XXX.XX	S	5721
94780	Cars/bd tst inft-12mo 60 min	$XXX.XX	Q1	5732
94799	Pulmonary service/procedure	$XXX.XX	Q1	5721
95004	Percut allergy skin tests	$XXX.XX	Q1	5724
95012	Exhaled nitric oxide meas	$XXX.XX	Q1	5732
95017	Perq & icut allg test venoms	$XXX.XX	Q1	5731
95018	Perq&ic allg test drugs/biol	$XXX.XX	Q1	5732
95024	Icut allergy test drug/bug	$XXX.XX	Q1	5733
95027	Icut allergy titrate-airborn	$XXX.XX	Q1	5731
95028	Icut allergy test-delayed	$XXX.XX	Q1	5732
95044	Allergy patch tests	$XXX.XX	Q1	5724
95052	Photo patch test	$XXX.XX	Q1	5732
95056	Photosensitivity tests	$XXX.XX	Q1	5734
95060	Eye allergy tests	$XXX.XX	Q1	5734
95065	Nose allergy test	$XXX.XX	Q1	5732
95070	Bronchial allergy tests	$XXX.XX	S	5723
95071	Bronchial allergy tests	$XXX.XX	Q1	5722
95076	Ingest challenge ini 120 min	$XXX.XX	S	5723
95115	Immunotherapy one injection	$XXX.XX	Q1	5691
95117	Immunotherapy injections	$XXX.XX	Q1	5691
95144	Antigen therapy services	$XXX.XX	Q1	5691
95145	Antigen therapy services	$XXX.XX	Q1	5691
95146	Antigen therapy services	$XXX.XX	Q1	5691
95147	Antigen therapy services	$XXX.XX	Q1	5692
95148	Antigen therapy services	$XXX.XX	Q1	5692
95149	Antigen therapy services	$XXX.XX	Q1	5692
95165	Antigen therapy services	$XXX.XX	Q1	5691
95170	Antigen therapy services	$XXX.XX	Q1	5691
95180	Rapid desensitization	$XXX.XX	Q1	5735
95199	Allergy immunology services	$XXX.XX	Q1	5731
95249	Cont gluc mntr pt prov eqp	$XXX.XX	S	5733
95250	Cont gluc mntr phys/qhp eqp	$XXX.XX	V	5012
95700	Eeg cont rec w/vid eeg tech	$XXX.XX	S	5722
95705	Eeg w/o vid 2-12 hr unmntr	$XXX.XX	S	5722
95706	Eeg wo vid 2-12hr intmt mntr	$XXX.XX	S	5722
95707	Eeg w/o vid 2-12hr cont mntr	$XXX.XX	S	5722
95708	Eeg wo vid ea 12-26hr unmntr	$XXX.XX	S	5723
95709	Eeg w/o vid ea 12-26hr intmt	$XXX.XX	S	5723
95710	Eeg w/o vid ea 12-26hr cont	$XXX.XX	S	5723
95711	Veeg 2-12 hr unmonitored	$XXX.XX	S	5722
95712	Veeg 2-12 hr intmt mntr	$XXX.XX	S	5722
95713	Veeg 2-12 hr cont mntr	$XXX.XX	S	5723
95714	Veeg ea 12-26 hr unmntr	$XXX.XX	S	5723
95715	Veeg ea 12-26hr intmt mntr	$XXX.XX	S	5723
95716	Veeg ea 12-26hr cont mntr	$XXX.XX	S	5724
95782	Polysom <6 yrs 4/> paramtrs	$XXX.XX	S	5724
95783	Polysom <6 yrs cpap/bilvl	$XXX.XX	S	5724
95800	Slp stdy unattended	$XXX.XX	S	5721
95801	Slp stdy unatnd w/anal	$XXX.XX	Q1	5734
95803	Actigraphy testing	$XXX.XX	Q1	5733
95805	Multiple sleep latency test	$XXX.XX	S	5723
95806	Sleep study unatt&resp efft	$XXX.XX	S	5721
95807	Sleep study attended	$XXX.XX	S	5723
95808	Polysom any age 1-3> param	$XXX.XX	S	5724
95810	Polysom 6/> yrs 4/> param	$XXX.XX	S	5724
95811	Polysom 6/>yrs cpap 4/> parm	$XXX.XX	S	5724
95812	Eeg 41-60 minutes	$XXX.XX	S	5722
95813	Eeg extnd mntr 61-119 min	$XXX.XX	S	5722
95816	Eeg awake and drowsy	$XXX.XX	S	5722
95819	Eeg awake and asleep	$XXX.XX	S	5722
95822	Eeg coma or sleep only	$XXX.XX	S	5722
95824	Eeg cerebral death only	$XXX.XX	S	5723
95836	Ecog impltd brn npgt <30 d	$XXX.XX	Q1	5741
95857	Cholinesterase challenge	$XXX.XX	S	5722
95860	Muscle test one limb	$XXX.XX	Q1	5734
95861	Muscle test 2 limbs	$XXX.XX	Q1	5734
95863	Muscle test 3 limbs	$XXX.XX	S	5721
95864	Muscle test 4 limbs	$XXX.XX	S	5721
95865	Muscle test larynx	$XXX.XX	Q1	5734
95866	Muscle test hemidiaphragm	$XXX.XX	Q1	5721
95867	Muscle test cran nerv unilat	$XXX.XX	S	5721
95868	Muscle test cran nerve bilat	$XXX.XX	S	5721
95869	Muscle test thor paraspinal	$XXX.XX	Q1	5721
95870	Muscle test nonparaspinal	$XXX.XX	Q1	5733
95872	Muscle test one fiber	$XXX.XX	S	5721
95875	Limb exercise test	$XXX.XX	S	5721
95905	Motor &/ sens nrve cndj test	$XXX.XX	Q1	5734
95907	Nvr cndj tst 1-2 studies	$XXX.XX	S	5721
95908	Nrv cndj tst 3-4 studies	$XXX.XX	S	5722
95909	Nrv cndj tst 5-6 studies	$XXX.XX	S	5722
95910	Nrv cndj test 7-8 studies	$XXX.XX	S	5722
95911	Nrv cndj test 9-10 studies	$XXX.XX	S	5723
95912	Nrv cndj test 11-12 studies	$XXX.XX	S	5723
95913	Nrv cndj test 13/> studies	$XXX.XX	S	5723
95921	Autonomic nrv parasym inervj	$XXX.XX	S	5721
95922	Autonomic nrv adrenrg inervj	$XXX.XX	Q1	5734
95923	Autonomic nrv syst funj test	$XXX.XX	Q1	5734
95924	Ans parasymp & symp w/tilt	$XXX.XX	S	5721
95925	Somatosensory testing	$XXX.XX	S	5722
95926	Somatosensory testing	$XXX.XX	S	5722
95927	Somatosensory testing	$XXX.XX	S	5721
95928	C motor evoked uppr limbs	$XXX.XX	S	5724
95929	C motor evoked lwr limbs	$XXX.XX	S	5723
95930	Visual ep test cns w/i&r	$XXX.XX	S	5721
95933	Blink reflex test	$XXX.XX	Q1	5733
95937	Neuromuscular junction test	$XXX.XX	S	5721
95938	Somatosensory testing	$XXX.XX	S	5723
95939	C motor evoked upr&lwr limbs	$XXX.XX	S	5724
95943	Parasymp&symp hrt rate test	$XXX.XX	S	5721
95954	Eeg monitoring/giving drugs	$XXX.XX	S	5723
95958	Eeg monitoring/function test	$XXX.XX	S	5724
95961	Electrode stimulation brain	$XXX.XX	S	5724
95965	Meg spontaneous	$XXX.XX	S	5724
95966	Meg evoked single	$XXX.XX	S	5724
95970	Alys npgt w/o prgrmg	$XXX.XX	Q1	5734
95971	Alys smpl sp/pn npgt w/prgrm	$XXX.XX	S	5742
95972	Alys cplx sp/pn npgt w/prgrm	$XXX.XX	S	5742
95976	Alys smpl cn npgt prgrmg	$XXX.XX	S	5741
95977	Alys cplx cn npgt prgrmg	$XXX.XX	S	5742
95981	Io anal gast n-stim subsq	$XXX.XX	Q1	5734
95982	Io ga n-stim subsq w/reprog	$XXX.XX	Q1	5741
95983	Alys brn npgt prgrmg 15 min	$XXX.XX	S	5742
95990	Spin/brain pump refil & main	$XXX.XX	S	5694
95991	Spin/brain pump refil & main	$XXX.XX	T	5441
95999	Neurological procedure	$XXX.XX	Q1	5721
96000	Motion analysis video/3d	$XXX.XX	S	5723
96001	Motion test w/ft press meas	$XXX.XX	S	5724
96002	Dynamic surface emg	$XXX.XX	S	5721
96003	Dynamic fine wire emg	$XXX.XX	Q1	5722
96112	Devel tst phys/qhp 1st hr	$XXX.XX	Q3	5721
96116	Nubhvl xm phys/qhp 1st hr	$XXX.XX	Q3	5722
96127	Brief emotional/behav assmt	$XXX.XX	Q1	5732
96130	Psycl tst eval phys/qhp 1st	$XXX.XX	Q3	5721
96132	Nrpsyc tst eval phys/qhp 1st	$XXX.XX	Q3	5721
96136	Psycl/nrpsyc tst phy/qhp 1st	$XXX.XX	Q3	5731
96138	Psycl/nrpsyc tech 1st	$XXX.XX	Q3	5731
96146	Psycl/nrpsyc tst auto result	$XXX.XX	Q3	5731
96156	Hlth bhv assmt/reassessment	$XXX.XX	Q3	5822
96158	Hlth bhv ivntj indiv 1st 30	$XXX.XX	Q3	5822
96160	Pt-focused hlth risk assmt	$XXX.XX	S	5821
96161	Caregiver health risk assmt	$XXX.XX	S	5821
96164	Hlth bhv ivntj grp 1st 30	$XXX.XX	Q3	5821
96167	Hlth bhv ivntj fam 1st 30	$XXX.XX	Q3	5821
96360	Hydration iv infusion init	$XXX.XX	S	5693
96361	Hydrate iv infusion add-on	$XXX.XX	S	5691
96365	Ther/proph/diag iv inf init	$XXX.XX	S	5693
96366	Ther/proph/diag iv inf addon	$XXX.XX	S	5691
96367	Tx/proph/dg addl seq iv inf	$XXX.XX	S	5692
96369	Sc ther infusion up to 1 hr	$XXX.XX	S	5693
96370	Sc ther infusion addl hr	$XXX.XX	S	5691
96371	Sc ther infusion reset pump	$XXX.XX	Q1	5692
96372	Ther/proph/diag inj sc/im	$XXX.XX	Q1	5692
96373	Ther/proph/diag inj ia	$XXX.XX	S	5693
96374	Ther/proph/diag inj iv push	$XXX.XX	S	5693
96375	Tx/pro/dx inj new drug addon	$XXX.XX	S	5691
96377	Applicaton on-body injector	$XXX.XX	Q1	5691
96379	Ther/prop/diag inj/inf proc	$XXX.XX	Q1	5691
96401	Chemo anti-neopl sq/im	$XXX.XX	Q1	5692
96402	Chemo hormon antineopl sq/im	$XXX.XX	Q1	5692
96405	Chemo intralesional up to 7	$XXX.XX	Q1	5692
96406	Chemo intralesional over 7	$XXX.XX	S	5693
96409	Chemo iv push sngl drug	$XXX.XX	S	5693
96411	Chemo iv push addl drug	$XXX.XX	S	5692
96413	Chemo iv infusion 1 hr	$XXX.XX	S	5694
96415	Chemo iv infusion addl hr	$XXX.XX	S	5692
96416	Chemo prolong infuse w/pump	$XXX.XX	S	5694
96417	Chemo iv infus each addl seq	$XXX.XX	S	5692
96420	Chemo ia push tecnique	$XXX.XX	S	5694
96422	Chemo ia infusion up to 1 hr	$XXX.XX	S	5693
96423	Chemo ia infuse each addl hr	$XXX.XX	S	5691
96425	Chemotherapy infusion method	$XXX.XX	S	5694
96440	Chemotherapy intracavitary	$XXX.XX	S	5694
96446	Chemotx admn prtl cavity	$XXX.XX	S	5694
96450	Chemotherapy into cns	$XXX.XX	S	5694
96521	Refill/maint portable pump	$XXX.XX	S	5693
96522	Refill/maint pump/resvr syst	$XXX.XX	S	5693
96523	Irrig drug delivery device	$XXX.XX	Q1	5733
96542	Chemotherapy injection	$XXX.XX	S	5693
96549	Chemotherapy unspecified	$XXX.XX	Q1	5691
96567	Pdt dstr prmlg les skn	$XXX.XX	Q1	5051
96573	Pdt dstr prmlg les phys/qhp	$XXX.XX	Q1	5051
96574	Dbrdmt prmlg les w/pdt	$XXX.XX	Q1	5051
96900	Ultraviolet light therapy	$XXX.XX	Q1	5732
96910	Photochemotherapy with uv-b	$XXX.XX	Q1	5733
96912	Photochemotherapy with uv-a	$XXX.XX	Q1	5733
96913	Photochemotherapy uv-a or b	$XXX.XX	T	5052
96920	Laser tx skin < 250 sq cm	$XXX.XX	Q1	5051
96921	Laser tx skin 250-500 sq cm	$XXX.XX	Q1	5051
96922	Laser tx skin >500 sq cm	$XXX.XX	Q1	5052
96999	Dermatological procedure	$XXX.XX	Q1	5051
97151	Bhv id assmt by phys/qhp	$XXX.XX	Q3	5821
97152	Bhv id suprt assmt by 1 tech	$XXX.XX	Q3	5821
97153	Adaptive behavior tx by tech	$XXX.XX	Q3	5821
97154	Grp adapt bhv tx by tech	$XXX.XX	Q3	5821
97155	Adapt behavior tx phys/qhp	$XXX.XX	Q3	5821
97156	Fam adapt bhv tx gdn phy/qhp	$XXX.XX	Q3	5821
97157	Mult fam adapt bhv tx gdn	$XXX.XX	Q3	5821
97158	Grp adapt bhv tx by phy/qhp	$XXX.XX	Q3	5821
97597	Rmvl devital tis 20 cm/<	$XXX.XX	T	5051
97602	Wound(s) care non-selective	$XXX.XX	Q1	5051
97605	Neg press wound tx <=50 cm	$XXX.XX	Q1	5051
97606	Neg press wound tx >50 cm	$XXX.XX	Q1	5052
97607	Neg press wnd tx <=50 sq cm	$XXX.XX	T	5052
97608	Neg press wound tx >50 cm	$XXX.XX	T	5052
97610	Low frequency non-thermal us	$XXX.XX	Q1	5051
97810	Acupunct w/o stimul 15 min	$XXX.XX	S	5731
97813	Acupunct w/stimul 15 min	$XXX.XX	S	5731
98925	Osteopath manj 1-2 regions	$XXX.XX	Q1	5811
98926	Osteopath manj 3-4 regions	$XXX.XX	Q1	5811
98927	Osteopath manj 5-6 regions	$XXX.XX	Q1	5811
98928	Osteopath manj 7-8 regions	$XXX.XX	Q1	5811
98929	Osteopath manj 9-10 regions	$XXX.XX	Q1	5811
98940	Chiropract manj 1-2 regions	$XXX.XX	Q1	5811
98941	Chiropract manj 3-4 regions	$XXX.XX	Q1	5811
98942	Chiropractic manj 5 regions	$XXX.XX	Q1	5811
99170	Anogenital exam child w imag	$XXX.XX	T	5411
99195	Phlebotomy	$XXX.XX	Q1	5734
99281	Emergency dept visit	$XXX.XX	J2	5021
99282	Emergency dept visit	$XXX.XX	J2	5022
99283	Emergency dept visit	$XXX.XX	J2	5023
99284	Emergency dept visit	$XXX.XX	J2	5024
99285	Emergency dept visit	$XXX.XX	J2	5025
99291	Critical care first hour	$XXX.XX	J2	5041
99406	Behav chng smoking 3-10 min	$XXX.XX	S	5821
99407	Behav chng smoking > 10 min	$XXX.XX	S	5821
99453	Rem mntr physiol param setup	$XXX.XX	V	5012
99454	Rem mntr physiol param dev	$XXX.XX	Q1	5741
99460	Init nb em per day hosp	$XXX.XX	V	5012
99463	Same day nb discharge	$XXX.XX	V	5012
99465	Nb resuscitation	$XXX.XX	S	5781
99473	Self-meas bp pt educaj/train	$XXX.XX	Q1	5731
99483	Assmt & care pln pt cog imp	$XXX.XX	S	5822
99484	Care mgmt svc bhvl hlth cond	$XXX.XX	S	5821
99487	Cmplx chron care w/o pt vsit	$XXX.XX	S	5822
99490	Chron care mgmt srvc 20 min	$XXX.XX	S	5822
99492	1st psyc collab care mgmt	$XXX.XX	S	5822
99493	Sbsq psyc collab care mgmt	$XXX.XX	S	5822
99495	Trans care mgmt 14 day disch	$XXX.XX	V	5012
99496	Trans care mgmt 7 day disch	$XXX.XX	V	5012
99497	Advncd care plan 30 min	$XXX.XX	Q1	5822
A9513	Lutetium lu 177 dotatat ther	$XXX.XX	G	9067
A9517	I131 iodide cap, rx	$XXX.XX	K	1064
A9527	Iodine i-125 sodium iodide	$XXX.XX	U	2632
A9530	I131 iodide sol, rx	$XXX.XX	K	1150
A9543	Y90 ibritumomab, rx	$XXX.XX	K	1643
A9563	P32 na phosphate	$XXX.XX	K	1675
A9586	Florbetapir f18	$XXX.XX	G	9084
A9590	Iodine i-131 iobenguane 1mci	$XXX.XX	G	9339
A9600	Sr89 strontium	$XXX.XX	K	0701
A9604	Sm 153 lexidronam	$XXX.XX	K	1295
A9606	Radium ra223 dichloride ther	$XXX.XX	K	1745
C1716	Brachytx, non-str, gold-198	$XXX.XX	U	2645
C1717	Brachytx, non-str,hdr ir-192	$XXX.XX	U	2646
C1719	Brachytx, ns, non-hdrir-192	$XXX.XX	U	2647
C2616	Brachytx, non-str,yttrium-90	$XXX.XX	U	2616
C2634	Brachytx, non-str, ha, i-125	$XXX.XX	U	2634
C2635	Brachytx, non-str, ha, p-103	$XXX.XX	U	2635
C2636	Brachy linear, non-str,p-103	$XXX.XX	U	2636
C2638	Brachytx, stranded, i-125	$XXX.XX	U	2638
C2639	Brachytx, non-stranded,i-125	$XXX.XX	U	2639
C2640	Brachytx, stranded, p-103	$XXX.XX	U	2640
C2641	Brachytx, non-stranded,p-103	$XXX.XX	U	2641
C2642	Brachytx, stranded, c-131	$XXX.XX	U	2642
C2643	Brachytx, non-stranded,c-131	$XXX.XX	U	2643
C2645	Brachytx planar, p-103	$XXX.XX	U	2648
C2698	Brachytx, stranded, nos	$XXX.XX	U	2698
C2699	Brachytx, non-stranded, nos	$XXX.XX	U	2699
C5271	Low cost skin substitute app	$XXX.XX	T	5053
C5273	Low cost skin substitute app	$XXX.XX	T	5054
C5275	Low cost skin substitute app	$XXX.XX	T	5053
C5277	Low cost skin substitute app	$XXX.XX	T	5053
C8900	Mra w/cont, abd	$XXX.XX	Q3	5572
C8901	Mra w/o cont, abd	$XXX.XX	Q3	5523
C8902	Mra w/o fol w/cont, abd	$XXX.XX	Q3	5572
C8903	Mri w/cont, breast, uni	$XXX.XX	Q3	5571
C8905	Mri w/o fol w/cont, brst, un	$XXX.XX	Q3	5572
C8906	Mri w/cont, breast, bi	$XXX.XX	Q3	5572
C8908	Mri w/o fol w/cont, breast,	$XXX.XX	Q3	5572
C8909	Mra w/cont, chest	$XXX.XX	Q3	5572
C8910	Mra w/o cont, chest	$XXX.XX	Q3	5523
C8911	Mra w/o fol w/cont, chest	$XXX.XX	Q3	5572
C8912	Mra w/cont, lwr ext	$XXX.XX	Q3	5572
C8913	Mra w/o cont, lwr ext	$XXX.XX	Q3	5523
C8914	Mra w/o fol w/cont, lwr ext	$XXX.XX	Q3	5572
C8918	Mra w/cont, pelvis	$XXX.XX	Q3	5572
C8919	Mra w/o cont, pelvis	$XXX.XX	Q3	5523
C8920	Mra w/o fol w/cont, pelvis	$XXX.XX	Q3	5572
C8921	Tte w or w/o fol w/cont, com	$XXX.XX	S	5573
C8922	Tte w or w/o fol w/cont, f/u	$XXX.XX	S	5573
C8923	2d tte w or w/o fol w/con,co	$XXX.XX	S	5573
C8924	2d tte w or w/o fol w/con,fu	$XXX.XX	S	5572
C8925	2d tee w or w/o fol w/con,in	$XXX.XX	S	5573
C8926	Tee w or w/o fol w/cont,cong	$XXX.XX	S	5573
C8927	Tee w or w/o fol w/cont, mon	$XXX.XX	S	5573
C8928	Tte w or w/o fol w/con,stres	$XXX.XX	S	5573
C8929	Tte w or wo fol wcon,doppler	$XXX.XX	S	5573
C8930	Tte w or w/o contr, cont ecg	$XXX.XX	S	5573
C8931	Mra, w/dye, spinal canal	$XXX.XX	Q3	5572
C8932	Mra, w/o dye, spinal canal	$XXX.XX	Q3	5523
C8933	Mra, w/o&w/dye, spinal canal	$XXX.XX	Q3	5572
C8934	Mra, w/dye, upper extremity	$XXX.XX	Q3	5572
C8935	Mra, w/o dye, upper extr	$XXX.XX	Q3	5523
C8936	Mra, w/o&w/dye, upper extr	$XXX.XX	Q3	5572
C8957	Prolonged iv inf, req pump	$XXX.XX	S	5694
C9041	Inj, coagulation factor xa	$XXX.XX	G	9198
C9046	Cocaine hcl nasal solution	$XXX.XX	G	9307
C9047	Injection, caplacizumab-yhdp	$XXX.XX	G	9199
C9053	Inj, crizanlizumab-tmca	$XXX.XX	G	9342
C9054	Injection, lefamulin	$XXX.XX	G	9332
C9055	Inj, brexanolone	$XXX.XX	G	9333
C9056	Injection, givosiran	$XXX.XX	G	9343
C9057	Inj cetirizine hydrochloride	$XXX.XX	G	9344
C9058	Injection,pegfilgrastim-bmez	$XXX.XX	G	9345
C9132	Kcentra, per i.u.	$XXX.XX	K	9132
C9250	Artiss fibrin sealant	$XXX.XX	K	1848
C9257	Bevacizumab injection	$XXX.XX	K	1281
C9460	Injection, cangrelor	$XXX.XX	K	9460
C9462	Injection, delafloxacin	$XXX.XX	G	9462
C9482	Sotalol hydrochloride iv	$XXX.XX	K	9482
C9488	Conivaptan hcl	$XXX.XX	K	9488
C9600	Perc drug-el cor stent sing	$XXX.XX	J1	5193
C9602	Perc d-e cor stent ather s	$XXX.XX	J1	5194
C9604	Perc d-e cor revasc t cabg s	$XXX.XX	J1	5193
C9607	Perc d-e cor revasc chro sin	$XXX.XX	J1	5194
C9725	Place endorectal app	$XXX.XX	T	5311
C9727	Insert palate implants	$XXX.XX	J1	5163
C9728	Place device/marker, non pro	$XXX.XX	S	5613
C9733	Non-ophthalmic fva	$XXX.XX	Q2	5572
C9734	U/s trtmt, not leiomyomata	$XXX.XX	J1	5115
C9739	Cystoscopy prostatic imp 1-3	$XXX.XX	J1	5375
C9740	Cysto impl 4 or more	$XXX.XX	J1	5376
C9745	Nasal endo eustachian tube	$XXX.XX	J1	5165
C9747	Ablation, hifu, prostate	$XXX.XX	J1	5375
C9749	Repair nasal stenosis w/imp	$XXX.XX	J1	5165
C9751	Microwave bronch, 3d, ebus	$XXX.XX	T	1571
C9752	Intraosseous des lumb/sacrum	$XXX.XX	J1	5115
C9754	Perc av fistula, direct	$XXX.XX	J1	5194
C9755	Rf magnetic-guide av fistula	$XXX.XX	J1	5194
C9757	Spine/lumbar disk surgery	$XXX.XX	J1	5115
C9758	Interatrial shunt ide	$XXX.XX	T	1589
D0150	Comprehensve oral evaluation	$XXX.XX	S	5871
D0240	Intraoral occlusal film	$XXX.XX	S	5871
D0250	Extraoral 2d project image	$XXX.XX	S	5871
D0251	Extraoral posterior image	$XXX.XX	Q1	5521
D0270	Dental bitewing single image	$XXX.XX	S	5871
D0272	Dental bitewings two images	$XXX.XX	S	5871
D0274	Bitewings four images	$XXX.XX	S	5871
D0277	Vert bitewings 7 to 8 images	$XXX.XX	S	5871
D0460	Pulp vitality test	$XXX.XX	S	5871
D0600	Non-ionizing diag proc	$XXX.XX	S	5871
D1510	Space maintainer fxd unilat	$XXX.XX	S	5871
D1516	Fixed bilat space maint, max	$XXX.XX	S	5871
D1517	Fixed bilat space maint, man	$XXX.XX	S	5871
D1520	Remove unilat space maintain	$XXX.XX	S	5871
D1526	Remove bilat space main, max	$XXX.XX	S	5871
D1527	Remove bilat space main, man	$XXX.XX	S	5871
D1551	Recement space maint - max	$XXX.XX	S	5871
D1552	Recement space maint - man	$XXX.XX	S	5871
D1553	Recement unilat space maint	$XXX.XX	S	5871
D1575	Dist space maint, fixed unil	$XXX.XX	S	5871
D2999	Dental unspec restorative pr	$XXX.XX	S	5871
D3460	Endodontic endosseous implan	$XXX.XX	S	5871
D3999	Endodontic procedure	$XXX.XX	S	5871
D4260	Osseous surgery 4 or more	$XXX.XX	S	5871
D4263	Bone replce graft first site	$XXX.XX	S	5871
D4264	Bone replce graft each add	$XXX.XX	S	5871
D4268	Surgical revision procedure	$XXX.XX	S	5871
D4270	Pedicle soft tissue graft pr	$XXX.XX	S	5871
D4273	Auto tissue graft 1st tooth	$XXX.XX	S	5871
D4355	Full mouth debridement	$XXX.XX	S	5871
D4381	Localized delivery antimicro	$XXX.XX	S	5871
D5911	Facial moulage sectional	$XXX.XX	S	5871
D5912	Facial moulage complete	$XXX.XX	S	5871
D5983	Radiation applicator	$XXX.XX	S	5871
D5984	Radiation shield	$XXX.XX	S	5871
D5985	Radiation cone locator	$XXX.XX	S	5871
D5987	Commissure splint	$XXX.XX	S	5871
D6920	Dental connector bar	$XXX.XX	S	5871
D7111	Extraction coronal remnants	$XXX.XX	S	5871
D7140	Extraction erupted tooth/exr	$XXX.XX	S	5871
D7210	Rem imp tooth w mucoper flp	$XXX.XX	S	5871
D7220	Impact tooth remov soft tiss	$XXX.XX	S	5871
D7230	Impact tooth remov part bony	$XXX.XX	S	5871
D7240	Impact tooth remov comp bony	$XXX.XX	S	5871
D7241	Impact tooth rem bony w/comp	$XXX.XX	S	5871
D7250	Tooth root removal	$XXX.XX	S	5871
D7260	Oral antral fistula closure	$XXX.XX	S	5871
D7261	Primary closure sinus perf	$XXX.XX	S	5871
D7291	Transseptal fiberotomy	$XXX.XX	S	5871
D7940	Reshaping bone orthognathic	$XXX.XX	S	5871
D9930	Treatment of complications	$XXX.XX	S	5871
D9944	Occ guard, hard, full arch	$XXX.XX	S	5871
D9945	Occ guard, soft, full arch	$XXX.XX	S	5871
D9946	Occ guard, hard, part arch	$XXX.XX	S	5871
D9950	Occlusion analysis	$XXX.XX	S	5871
D9951	Limited occlusal adjustment	$XXX.XX	S	5871
D9952	Complete occlusal adjustment	$XXX.XX	S	5871
G0008	Admin influenza virus vac	$XXX.XX	S	5691
G0009	Admin pneumococcal vaccine	$XXX.XX	S	5691
G0010	Admin hepatitis b vaccine	$XXX.XX	S	5691
G0101	Ca screen;pelvic/breast exam	$XXX.XX	S	5822
G0104	Ca screen;flexi sigmoidscope	$XXX.XX	T	5311
G0105	Colorectal scrn; hi risk ind	$XXX.XX	T	5311
G0106	Colon ca screen;barium enema	$XXX.XX	S	5571
G0117	Glaucoma scrn hgh risk direc	$XXX.XX	S	5731
G0118	Glaucoma scrn hgh risk direc	$XXX.XX	S	5732
G0120	Colon ca scrn; barium enema	$XXX.XX	S	5572
G0121	Colon ca scrn not hi rsk ind	$XXX.XX	T	5311
G0127	Trim nail(s)	$XXX.XX	Q1	5733
G0130	Single energy x-ray study	$XXX.XX	S	5522
G0166	Extrnl counterpulse, per tx	$XXX.XX	Q1	5734
G0175	Opps service,sched team conf	$XXX.XX	V	5024
G0186	Dstry eye lesn,fdr vssl tech	$XXX.XX	T	5481
G0237	Therapeutic procd strg endur	$XXX.XX	S	5731
G0238	Oth resp proc, indiv	$XXX.XX	S	5731
G0239	Oth resp proc, group	$XXX.XX	S	5732
G0245	Initial foot exam pt lops	$XXX.XX	V	5012
G0246	Followup eval of foot pt lop	$XXX.XX	V	5012
G0247	Routine footcare pt w lops	$XXX.XX	Q1	5051
G0248	Demonstrate use home inr mon	$XXX.XX	V	5012
G0249	Provide inr test mater/equip	$XXX.XX	V	5012
G0257	Unsched dialysis esrd pt hos	$XXX.XX	S	5401
G0260	Inj for sacroiliac jt anesth	$XXX.XX	T	5442
G0276	Pild/placebo control clin tr	$XXX.XX	J1	5114
G0277	Hbot, full body chamber, 30m	$XXX.XX	S	5061
G0293	Non-cov surg proc,clin trial	$XXX.XX	Q1	5732
G0294	Non-cov proc, clinical trial	$XXX.XX	Q1	5732
G0296	Visit to determ ldct elig	$XXX.XX	S	5822
G0297	Ldct for lung ca screen	$XXX.XX	S	5521
G0302	Pre-op service lvrs complete	$XXX.XX	S	5723
G0303	Pre-op service lvrs 10-15dos	$XXX.XX	S	5721
G0304	Pre-op service lvrs 1-9 dos	$XXX.XX	S	5723
G0305	Post op service lvrs min 6	$XXX.XX	S	5723
G0379	Direct refer hospital observ	$XXX.XX	J2	5025
G0380	Lev 1 hosp type b ed visit	$XXX.XX	J2	5031
G0381	Lev 2 hosp type b ed visit	$XXX.XX	J2	5032
G0382	Lev 3 hosp type b ed visit	$XXX.XX	J2	5033
G0383	Lev 4 hosp type b ed visit	$XXX.XX	J2	5034
G0384	Lev 5 hosp type b ed visit	$XXX.XX	J2	5035
G0390	Trauma respons w/hosp criti	$XXX.XX	S	5045
G0396	Alcohol/subs interv 15-30mn	$XXX.XX	S	5821
G0397	Alcohol/subs interv >30 min	$XXX.XX	S	5822
G0398	Home sleep test/type 2 porta	$XXX.XX	S	5721
G0399	Home sleep test/type 3 porta	$XXX.XX	S	5721
G0400	Home sleep test/type 4 porta	$XXX.XX	S	5721
G0402	Initial preventive exam	$XXX.XX	V	5012
G0404	Ekg tracing for initial prev	$XXX.XX	S	5731
G0413	Pelvic ring fracture uni/bil	$XXX.XX	J1	5114
G0416	Prostate biopsy, any mthd	$XXX.XX	Q2	5673
G0422	Intens cardiac rehab w/exerc	$XXX.XX	S	5771
G0423	Intens cardiac rehab no exer	$XXX.XX	S	5771
G0424	Pulmonary rehab w exer	$XXX.XX	S	5733
G0429	Dermal filler injection(s)	$XXX.XX	T	5054
G0442	Annual alcohol screen 15 min	$XXX.XX	S	5821
G0443	Brief alcohol misuse counsel	$XXX.XX	S	5822
G0444	Depression screen annual	$XXX.XX	S	5821
G0445	High inten beh couns std 30m	$XXX.XX	S	5822
G0446	Intens behave ther cardio dx	$XXX.XX	S	5821
G0447	Behavior counsel obesity 15m	$XXX.XX	S	5822
G0451	Devlopment test interpt&rep	$XXX.XX	Q3	5822
G0455	Fecal microbiota prep instil	$XXX.XX	Q1	5301
G0460	Autologous prp for ulcers	$XXX.XX	T	5054
G0463	Hospital outpt clinic visit	$XXX.XX	J2	5012
G0473	Group behave couns 2-10	$XXX.XX	S	5821
G0498	Chemo extend iv infus w/pump	$XXX.XX	S	5694
G0516	Insert drug del implant, >=4	$XXX.XX	Q1	5735
G0517	Remove drug implant	$XXX.XX	Q1	5735
G0518	Remove w insert drug implant	$XXX.XX	Q1	5735
G2000	Blinded conv. tx mdd clin tr	$XXX.XX	S	5723
G2011	Alcohol/sub abuse assess	$XXX.XX	S	5731
G2065	Clin mang h risk dx 30	$XXX.XX	S	5822
G2066	Inter devc remote 30d	$XXX.XX	Q1	5741
G2082	Visit esketamine 56m or less	$XXX.XX	S	1508
G2083	Visit esketamine, > 56m	$XXX.XX	S	1511
G2086	Off base opioid tx 70min	$XXX.XX	S	5823
G2087	Off base opioid tx, 60 m	$XXX.XX	S	5823
J0121	Inj., omadacycline, 1 mg	$XXX.XX	G	9311
J0122	Inj., eravacycline, 1 mg	$XXX.XX	K	9325
J0129	Abatacept injection	$XXX.XX	K	9230
J0135	Adalimumab injection	$XXX.XX	K	1083
J0178	Aflibercept injection	$XXX.XX	K	1420
J0179	Inj, brolucizumab-dbll, 1 mg	$XXX.XX	G	9340
J0180	Agalsidase beta injection	$XXX.XX	K	9208
J0185	Inj., aprepitant, 1 mg	$XXX.XX	G	9463
J0202	Injection, alemtuzumab	$XXX.XX	K	1809
J0207	Amifostine	$XXX.XX	K	7000
J0220	Alglucosidase alfa injection	$XXX.XX	K	9234
J0221	Lumizyme injection	$XXX.XX	K	1413
J0222	Inj., patisiran, 0.1 mg	$XXX.XX	G	9180
J0256	Alpha 1 proteinase inhibitor	$XXX.XX	K	0901
J0257	Glassia injection	$XXX.XX	K	1415
J0287	Amphotericin b lipid complex	$XXX.XX	K	9024
J0289	Amphotericin b liposome inj	$XXX.XX	K	0736
J0291	Inj., plazomicin, 5 mg	$XXX.XX	G	9183
J0300	Amobarbital 125 mg inj	$XXX.XX	K	1341
J0401	Inj aripiprazole ext rel 1mg	$XXX.XX	K	1468
J0475	Baclofen 10 mg injection	$XXX.XX	K	9032
J0480	Basiliximab	$XXX.XX	K	1683
J0485	Belatacept injection	$XXX.XX	K	9286
J0490	Belimumab injection	$XXX.XX	K	1353
J0517	Inj., benralizumab, 1 mg	$XXX.XX	G	9466
J0558	Peng benzathine/procaine inj	$XXX.XX	K	9088
J0561	Penicillin g benzathine inj	$XXX.XX	K	1829
J0565	Inj, bezlotoxumab, 10 mg	$XXX.XX	G	9490
J0567	Inj., cerliponase alfa 1 mg	$XXX.XX	G	9014
J0570	Buprenorphine implant 74.2mg	$XXX.XX	K	9058
J0584	Injection, burosumab-twza 1m	$XXX.XX	K	9187
J0585	Injection,onabotulinumtoxina	$XXX.XX	K	0902
J0586	Abobotulinumtoxina	$XXX.XX	K	1289
J0587	Inj, rimabotulinumtoxinb	$XXX.XX	K	9018
J0588	Incobotulinumtoxin a	$XXX.XX	K	9278
J0593	Inj., lanadelumab-flyo, 1 mg	$XXX.XX	K	9326
J0594	Busulfan injection	$XXX.XX	K	1178
J0596	Injection, ruconest	$XXX.XX	K	9445
J0597	C-1 esterase, berinert	$XXX.XX	K	9269
J0598	C-1 esterase, cinryze	$XXX.XX	K	9251
J0599	Inj., haegarda 10 units	$XXX.XX	G	9015
J0600	Edetate calcium disodium inj	$XXX.XX	K	1274
J0606	Inj, etelcalcetide, 0.1 mg	$XXX.XX	K	9031
J0630	Calcitonin salmon injection	$XXX.XX	K	1433
J0638	Canakinumab injection	$XXX.XX	K	1311
J0641	Inj levoleucovorin nos 0.5mg	$XXX.XX	K	1236
J0642	Injection, khapzory, 0.5 mg	$XXX.XX	G	9334
J0695	Inj ceftolozane tazobactam	$XXX.XX	K	9452
J0712	Ceftaroline fosamil inj	$XXX.XX	K	1824
J0714	Ceftazidime and avibactam	$XXX.XX	K	1825
J0716	Centruroides immune f(ab)	$XXX.XX	K	1431
J0717	Certolizumab pegol inj 1mg	$XXX.XX	K	1474
J0740	Cidofovir injection	$XXX.XX	K	9033
J0775	Collagenase, clost hist inj	$XXX.XX	K	1340
J0795	Corticorelin ovine triflutal	$XXX.XX	K	1684
J0800	Corticotropin injection	$XXX.XX	K	9316
J0840	Crotalidae poly immune fab	$XXX.XX	K	9274
J0841	Inj crotalidae im f(ab')2 eq	$XXX.XX	K	9188
J0850	Cytomegalovirus imm iv /vial	$XXX.XX	K	0903
J0875	Injection, dalbavancin	$XXX.XX	K	1823
J0878	Daptomycin injection	$XXX.XX	K	9124
J0881	Darbepoetin alfa, non-esrd	$XXX.XX	K	1685
J0882	Darbepoetin alfa, esrd use	$XXX.XX	K	1482
J0883	Argatroban nonesrd use 1mg	$XXX.XX	K	1859
J0884	Argatroban esrd dialysis 1mg	$XXX.XX	K	9065
J0885	Epoetin alfa, non-esrd	$XXX.XX	K	1686
J0894	Decitabine injection	$XXX.XX	K	9231
J0897	Denosumab injection	$XXX.XX	K	9272
J1095	Injection, dexamethasone 9%	$XXX.XX	G	9172
J1096	Dexametha opth insert 0.1 mg	$XXX.XX	G	9308
J1097	Phenylep ketorolac opth soln	$XXX.XX	G	9324
J1162	Digoxin immune fab (ovine)	$XXX.XX	K	1687
J1190	Dexrazoxane hcl injection	$XXX.XX	K	0726
J1212	Dimethyl sulfoxide 50% 50 ml	$XXX.XX	K	1832
J1267	Doripenem injection	$XXX.XX	K	9317
J1290	Ecallantide injection	$XXX.XX	K	9263
J1300	Eculizumab injection	$XXX.XX	K	9236
J1301	Injection, edaravone, 1 mg	$XXX.XX	G	9493
J1303	Inj., ravulizumab-cwvz 10 mg	$XXX.XX	G	9312
J1322	Elosulfase alfa, injection	$XXX.XX	K	1480
J1327	Eptifibatide injection	$XXX.XX	K	1607
J1410	Inj estrogen conjugate 25 mg	$XXX.XX	K	9038
J1428	Inj, eteplirsen, 10 mg	$XXX.XX	K	9484
J1430	Ethanolamine oleate 100 mg	$XXX.XX	K	1688
J1438	Etanercept injection	$XXX.XX	K	1608
J1439	Inj ferric carboxymaltos 1mg	$XXX.XX	K	9441
J1442	Inj filgrastim excl biosimil	$XXX.XX	K	1469
J1447	Inj tbo filgrastim 1 microg	$XXX.XX	K	1748
J1451	Fomepizole, 15 mg	$XXX.XX	K	1689
J1453	Fosaprepitant injection	$XXX.XX	K	9242
J1454	Inj fosnetupitant, palonoset	$XXX.XX	G	9099
J1455	Foscarnet sodium injection	$XXX.XX	K	1849
J1458	Galsulfase injection	$XXX.XX	K	9224
J1459	Inj ivig privigen 500 mg	$XXX.XX	K	1214
J1460	Gamma globulin 1 cc inj	$XXX.XX	K	1850
J1555	Inj cuvitru, 100 mg	$XXX.XX	K	9034
J1557	Gammaplex injection	$XXX.XX	K	9270
J1559	Hizentra injection	$XXX.XX	K	1312
J1560	Gamma globulin > 10 cc inj	$XXX.XX	K	1851
J1561	Gamunex-c/gammaked	$XXX.XX	K	0948
J1566	Immune globulin, powder	$XXX.XX	K	2731
J1568	Octagam injection	$XXX.XX	K	0943
J1569	Gammagard liquid injection	$XXX.XX	K	0944
J1571	Hepagam b im injection	$XXX.XX	K	0946
J1572	Flebogamma injection	$XXX.XX	K	0947
J1573	Hepagam b intravenous, inj	$XXX.XX	K	1138
J1575	Hyqvia 100mg immuneglobulin	$XXX.XX	K	1826
J1595	Injection glatiramer acetate	$XXX.XX	K	1015
J1602	Golimumab for iv use 1mg	$XXX.XX	K	1475
J1610	Glucagon hydrochloride/1 mg	$XXX.XX	K	9042
J1628	Inj., guselkumab, 1 mg	$XXX.XX	G	9029
J1640	Hemin, 1 mg	$XXX.XX	K	1690
J1670	Tetanus immune globulin inj	$XXX.XX	K	1670
J1726	Makena, 10 mg	$XXX.XX	K	9074
J1729	Inj hydroxyprogst capoat nos	$XXX.XX	K	9318
J1740	Ibandronate sodium injection	$XXX.XX	K	9229
J1742	Ibutilide fumarate injection	$XXX.XX	K	9044
J1743	Idursulfase injection	$XXX.XX	K	9232
J1744	Icatibant injection	$XXX.XX	K	1443
J1745	Infliximab not biosimil 10mg	$XXX.XX	K	7043
J1746	Inj., ibalizumab-uiyk, 10 mg	$XXX.XX	K	9189
J1750	Inj iron dextran	$XXX.XX	K	1237
J1786	Imuglucerase injection	$XXX.XX	K	1327
J1826	Interferon beta-1a inj	$XXX.XX	K	1852
J1830	Interferon beta-1b / .25 mg	$XXX.XX	K	0910
J1833	Injection, isavuconazonium	$XXX.XX	K	9456
J1930	Lanreotide injection	$XXX.XX	K	9237
J1931	Laronidase injection	$XXX.XX	K	9209
J1943	Inj., aristada initio, 1 mg	$XXX.XX	G	9179
J1944	Aripirazole lauroxil 1 mg	$XXX.XX	K	9470
J1950	Leuprolide acetate /3.75 mg	$XXX.XX	K	0800
J2182	Injection, mepolizumab, 1mg	$XXX.XX	K	9473
J2186	Inj., meropenem, vaborbactam	$XXX.XX	K	9178
J2265	Minocycline hydrochloride	$XXX.XX	K	1853
J2278	Ziconotide injection	$XXX.XX	K	1694
J2315	Naltrexone, depot form	$XXX.XX	K	0759
J2323	Natalizumab injection	$XXX.XX	K	9126
J2325	Nesiritide injection	$XXX.XX	K	1695
J2326	Inj, nusinersen, 0.1mg	$XXX.XX	G	9489
J2350	Injection, ocrelizumab, 1 mg	$XXX.XX	G	9494
J2353	Octreotide injection, depot	$XXX.XX	K	1207
J2355	Oprelvekin injection	$XXX.XX	K	7011
J2357	Omalizumab injection	$XXX.XX	K	9300
J2407	Injection, oritavancin	$XXX.XX	K	1660
J2425	Palifermin injection	$XXX.XX	K	1696
J2426	Paliperidone palmitate inj	$XXX.XX	K	9255
J2502	Inj, pasireotide long acting	$XXX.XX	K	9454
J2504	Pegademase bovine, 25 iu	$XXX.XX	K	1739
J2505	Injection, pegfilgrastim 6mg	$XXX.XX	K	9119
J2507	Pegloticase injection	$XXX.XX	K	9281
J2515	Pentobarbital sodium inj	$XXX.XX	K	1854
J2547	Injection, peramivir	$XXX.XX	K	9451
J2562	Plerixafor injection	$XXX.XX	K	9252
J2597	Inj desmopressin acetate	$XXX.XX	K	1440
J2724	Protein c concentrate	$XXX.XX	K	1139
J2760	Phentolaine mesylate inj	$XXX.XX	K	1458
J2770	Quinupristin/dalfopristin	$XXX.XX	K	2770
J2778	Ranibizumab injection	$XXX.XX	K	9233
J2783	Rasburicase	$XXX.XX	K	0738
J2786	Injection, reslizumab, 1mg	$XXX.XX	K	9481
J2792	Rho(d) immune globulin h, sd	$XXX.XX	K	1609
J2794	Inj risperdal consta, 0.5 mg	$XXX.XX	K	9125
J2796	Romiplostim injection	$XXX.XX	K	9245
J2797	Inj., rolapitant, 0.5 mg	$XXX.XX	G	9464
J2798	Inj., perseris, 0.5 mg	$XXX.XX	G	9181
J2820	Sargramostim injection	$XXX.XX	K	0731
J2840	Inj sebelipase alfa 1 mg	$XXX.XX	K	9478
J2850	Inj secretin synthetic human	$XXX.XX	K	1700
J2860	Injection, siltuximab	$XXX.XX	K	9455
J2941	Somatropin injection	$XXX.XX	K	9319
J2997	Alteplase recombinant	$XXX.XX	K	7048
J3031	Inj., fremanezumab-vfrm 1 mg	$XXX.XX	G	9197
J3060	Inj, taliglucerase alfa 10 u	$XXX.XX	K	9294
J3090	Inj tedizolid phosphate	$XXX.XX	K	1662
J3095	Telavancin injection	$XXX.XX	K	9258
J3101	Tenecteplase injection	$XXX.XX	K	9002
J3111	Inj. romosozumab-aqqg 1 mg	$XXX.XX	G	9327
J3145	Testosterone undecanoate 1mg	$XXX.XX	K	9078
J3240	Thyrotropin injection	$XXX.XX	K	9108
J3243	Tigecycline injection	$XXX.XX	K	9228
J3245	Inj., tildrakizumab, 1 mg	$XXX.XX	G	9306
J3246	Tirofiban hcl	$XXX.XX	K	7041
J3262	Tocilizumab injection	$XXX.XX	K	9264
J3285	Treprostinil injection	$XXX.XX	K	1701
J3304	Inj triamcinolone ace xr 1mg	$XXX.XX	G	9469
J3315	Triptorelin pamoate	$XXX.XX	K	9122
J3316	Inj., triptorelin xr 3.75 mg	$XXX.XX	G	9016
J3357	Ustekinumab sub cu inj, 1 mg	$XXX.XX	K	9261
J3358	Ustekinumab, iv inject, 1 mg	$XXX.XX	K	9487
J3380	Injection, vedolizumab	$XXX.XX	K	1489
J3385	Velaglucerase alfa	$XXX.XX	K	9271
J3396	Verteporfin injection	$XXX.XX	K	1203
J3397	Inj., vestronidase alfa-vjbk	$XXX.XX	K	9190
J3398	Inj luxturna 1 billion vec g	$XXX.XX	G	9070
J7170	Inj., emicizumab-kxwh 0.5 mg	$XXX.XX	G	9257
J7175	Inj, factor x, (human), 1iu	$XXX.XX	K	1857
J7177	Inj., fibryga, 1 mg	$XXX.XX	K	9191
J7178	Inj human fibrinogen con nos	$XXX.XX	K	1478
J7179	Vonvendi inj 1 iu vwf:rco	$XXX.XX	K	9059
J7180	Factor xiii anti-hem factor	$XXX.XX	K	1416
J7181	Factor xiii recomb a-subunit	$XXX.XX	K	1746
J7182	Factor viii recomb novoeight	$XXX.XX	K	1856
J7183	Wilate injection	$XXX.XX	K	1352
J7185	Xyntha inj	$XXX.XX	K	1268
J7186	Antihemophilic viii/vwf comp	$XXX.XX	K	1213
J7187	Humate-p, inj	$XXX.XX	K	1704
J7188	Factor viii recomb obizur	$XXX.XX	K	1827
J7189	Factor viia	$XXX.XX	K	1705
J7190	Factor viii	$XXX.XX	K	0925
J7192	Factor viii recombinant nos	$XXX.XX	K	0927
J7193	Factor ix non-recombinant	$XXX.XX	K	0931
J7194	Factor ix complex	$XXX.XX	K	0928
J7195	Factor ix recombinant nos	$XXX.XX	K	0932
J7196	Antithrombin recombinant	$XXX.XX	K	9177
J7197	Antithrombin iii injection	$XXX.XX	K	1263
J7198	Anti-inhibitor	$XXX.XX	K	0929
J7200	Factor ix recombinan rixubis	$XXX.XX	K	1467
J7201	Factor ix alprolix recomb	$XXX.XX	K	1486
J7202	Factor ix idelvion inj	$XXX.XX	K	9171
J7203	Factor ix recomb gly rebinyn	$XXX.XX	G	9468
J7205	Factor viii fc fusion recomb	$XXX.XX	K	1656
J7207	Factor viii pegylated recomb	$XXX.XX	K	1844
J7208	Inj. jivi 1 iu	$XXX.XX	G	9299
J7209	Factor viii nuwiq recomb 1iu	$XXX.XX	K	1846
J7210	Inj, afstyla, 1 i.u.	$XXX.XX	K	9043
J7308	Aminolevulinic acid hcl top	$XXX.XX	K	7308
J7311	Inj., retisert, 0.01 mg	$XXX.XX	K	9225
J7312	Dexamethasone intra implant	$XXX.XX	K	9256
J7313	Inj., iluvien, 0.01 mg	$XXX.XX	K	9450
J7314	Inj., yutiq, 0.01 mg	$XXX.XX	K	9328
J7316	Inj, ocriplasmin, 0.125 mg	$XXX.XX	K	9298
J7318	Inj, durolane 1 mg	$XXX.XX	G	9174
J7320	Genvisc 850, inj, 1mg	$XXX.XX	K	9079
J7322	Hymovis injection 1 mg	$XXX.XX	K	9471
J7323	Euflexxa inj per dose	$XXX.XX	K	0875
J7324	Orthovisc inj per dose	$XXX.XX	K	0877
J7325	Synvisc or synvisc-one	$XXX.XX	K	0874
J7326	Gel-one	$XXX.XX	K	1417
J7327	Monovisc inj per dose	$XXX.XX	K	1747
J7328	Gelsyn-3 injection 0.1 mg	$XXX.XX	K	1862
J7329	Inj, trivisc 1 mg	$XXX.XX	K	9196
J7331	Synojoynt, inj., 1 mg	$XXX.XX	G	9337
J7332	Inj., triluron, 1 mg	$XXX.XX	K	9338
J7336	Capsaicin 8% patch	$XXX.XX	K	9071
J7340	Carbidopa levodopa ent 100ml	$XXX.XX	K	9320
J7342	Ciprofloxacin otic susp 6 mg	$XXX.XX	K	9479
J7345	Aminolevulinic acid, 10% gel	$XXX.XX	G	9301
J7501	Azathioprine parenteral	$XXX.XX	K	0887
J7504	Lymphocyte immune globulin	$XXX.XX	K	0890
J7511	Antithymocyte globuln rabbit	$XXX.XX	K	9104
J7525	Tacrolimus injection	$XXX.XX	K	9006
J8510	Oral busulfan	$XXX.XX	K	9335
J8560	Etoposide oral 50 mg	$XXX.XX	K	0802
J8655	Oral netupitant, palonosetro	$XXX.XX	K	9448
J8670	Rolapitant, oral, 1mg	$XXX.XX	K	1761
J9015	Aldesleukin injection	$XXX.XX	K	0807
J9017	Arsenic trioxide injection	$XXX.XX	K	9012
J9019	Erwinaze injection	$XXX.XX	K	9289
J9022	Inj, atezolizumab,10 mg	$XXX.XX	K	9483
J9023	Injection, avelumab, 10 mg	$XXX.XX	G	9491
J9025	Azacitidine injection	$XXX.XX	K	1709
J9027	Clofarabine injection	$XXX.XX	K	1710
J9030	Bcg live intravesical 1mg	$XXX.XX	K	9322
J9032	Injection, belinostat, 10mg	$XXX.XX	K	1658
J9033	Inj., treanda 1 mg	$XXX.XX	K	9243
J9034	Inj., bendeka 1 mg	$XXX.XX	K	1861
J9035	Bevacizumab injection	$XXX.XX	K	9214
J9036	Inj. belrapzo/bendamustine	$XXX.XX	G	9313
J9039	Injection, blinatumomab	$XXX.XX	K	9449
J9041	Inj., velcade 0.1 mg	$XXX.XX	K	9207
J9042	Brentuximab vedotin inj	$XXX.XX	K	9287
J9043	Cabazitaxel injection	$XXX.XX	K	9276
J9044	Inj, bortezomib, nos, 0.1 mg	$XXX.XX	K	9192
J9047	Injection, carfilzomib, 1 mg	$XXX.XX	K	9295
J9050	Carmustine injection	$XXX.XX	K	0812
J9055	Cetuximab injection	$XXX.XX	K	9215
J9057	Inj., copanlisib, 1 mg	$XXX.XX	G	9030
J9065	Inj cladribine per 1 mg	$XXX.XX	K	0858
J9070	Cyclophosphamide 100 mg inj	$XXX.XX	K	1408
J9098	Cytarabine liposome inj	$XXX.XX	K	1166
J9119	Inj., cemiplimab-rwlc, 1 mg	$XXX.XX	G	9304
J9120	Dactinomycin injection	$XXX.XX	K	0752
J9145	Injection, daratumumab 10 mg	$XXX.XX	K	9476
J9150	Daunorubicin injection	$XXX.XX	K	0820
J9153	Inj daunorubicin, cytarabine	$XXX.XX	G	9302
J9155	Degarelix injection	$XXX.XX	K	1296
J9171	Docetaxel injection	$XXX.XX	K	0823
J9173	Inj., durvalumab, 10 mg	$XXX.XX	G	9492
J9176	Injection, elotuzumab, 1mg	$XXX.XX	K	9477
J9179	Eribulin mesylate injection	$XXX.XX	K	1426
J9202	Goserelin acetate implant	$XXX.XX	K	0810
J9203	Gemtuzumab ozogamicin 0.1 mg	$XXX.XX	G	9495
J9204	Inj mogamulizumab-kpkc, 1 mg	$XXX.XX	G	9182
J9205	Inj irinotecan liposome 1 mg	$XXX.XX	K	9474
J9207	Ixabepilone injection	$XXX.XX	K	9240
J9210	Inj., emapalumab-lzsg, 1 mg	$XXX.XX	G	9310
J9213	Interferon alfa-2a inj	$XXX.XX	K	9092
J9214	Interferon alfa-2b inj	$XXX.XX	K	0836
J9217	Leuprolide acetate suspnsion	$XXX.XX	K	9217
J9225	Vantas implant	$XXX.XX	K	1711
J9226	Supprelin la implant	$XXX.XX	K	1142
J9228	Ipilimumab injection	$XXX.XX	K	9284
J9229	Inj inotuzumab ozogam 0.1 mg	$XXX.XX	G	9028
J9230	Mechlorethamine hcl inj	$XXX.XX	K	0751
J9245	Inj melphalan hydrochl 50 mg	$XXX.XX	K	0840
J9261	Nelarabine injection	$XXX.XX	K	0825
J9262	Inj, omacetaxine mep, 0.01mg	$XXX.XX	K	9297
J9264	Paclitaxel protein bound	$XXX.XX	K	1712
J9266	Pegaspargase injection	$XXX.XX	K	0843
J9268	Pentostatin injection	$XXX.XX	K	0844
J9269	Inj. tagraxofusp-erzs 10 mcg	$XXX.XX	G	9309
J9271	Inj pembrolizumab	$XXX.XX	K	1490
J9280	Mitomycin injection	$XXX.XX	K	1232
J9285	Inj, olaratumab, 10 mg	$XXX.XX	K	9485
J9293	Mitoxantrone hydrochl / 5 mg	$XXX.XX	K	0864
J9295	Injection, necitumumab, 1 mg	$XXX.XX	K	9475
J9299	Injection, nivolumab	$XXX.XX	K	9453
J9301	Obinutuzumab inj	$XXX.XX	K	1476
J9302	Ofatumumab injection	$XXX.XX	K	9260
J9303	Panitumumab injection	$XXX.XX	K	9235
J9305	Pemetrexed injection	$XXX.XX	K	9213
J9306	Injection, pertuzumab, 1 mg	$XXX.XX	K	1471
J9307	Pralatrexate injection	$XXX.XX	K	9259
J9308	Injection, ramucirumab	$XXX.XX	K	1488
J9309	Inj, polatuzumab vedotin 1mg	$XXX.XX	G	9331
J9311	Inj rituximab, hyaluronidase	$XXX.XX	G	9467
J9312	Inj., rituximab, 10 mg	$XXX.XX	K	9186
J9313	Inj., lumoxiti, 0.01 mg	$XXX.XX	G	9305
J9315	Romidepsin injection	$XXX.XX	K	9265
J9320	Streptozocin injection	$XXX.XX	K	0850
J9325	Inj talimogene laherparepvec	$XXX.XX	K	9472
J9328	Temozolomide injection	$XXX.XX	K	9253
J9330	Temsirolimus injection	$XXX.XX	K	1168
J9340	Thiotepa injection	$XXX.XX	K	0851
J9352	Injection trabectedin 0.1mg	$XXX.XX	K	9480
J9354	Inj, ado-trastuzumab emt 1mg	$XXX.XX	K	9131
J9355	Inj trastuzumab excl biosimi	$XXX.XX	K	1613
J9356	Inj. herceptin hylecta, 10mg	$XXX.XX	G	9314
J9357	Valrubicin injection	$XXX.XX	K	1235
J9371	Inj, vincristine sul lip 1mg	$XXX.XX	K	1466
J9395	Injection, fulvestrant	$XXX.XX	K	9120
J9400	Inj, ziv-aflibercept, 1mg	$XXX.XX	K	9296
J9600	Porfimer sodium injection	$XXX.XX	K	0856
P9010	Whole blood for transfusion	$XXX.XX	R	9510
P9011	Blood split unit	$XXX.XX	R	9520
P9012	Cryoprecipitate each unit	$XXX.XX	R	9511
P9016	Rbc leukocytes reduced	$XXX.XX	R	9512
P9017	Plasma 1 donor frz w/in 8 hr	$XXX.XX	R	9508
P9019	Platelets, each unit	$XXX.XX	R	9515
P9020	Plaelet rich plasma unit	$XXX.XX	R	9516
P9021	Red blood cells unit	$XXX.XX	R	9517
P9022	Washed red blood cells unit	$XXX.XX	R	9518
P9023	Frozen plasma, pooled, sd	$XXX.XX	R	9509
P9031	Platelets leukocytes reduced	$XXX.XX	R	9526
P9032	Platelets, irradiated	$XXX.XX	R	9500
P9033	Platelets leukoreduced irrad	$XXX.XX	R	9521
P9034	Platelets, pheresis	$XXX.XX	R	9507
P9035	Platelet pheres leukoreduced	$XXX.XX	R	9501
P9036	Platelet pheresis irradiated	$XXX.XX	R	9502
P9037	Plate pheres leukoredu irrad	$XXX.XX	R	9530
P9038	Rbc irradiated	$XXX.XX	R	9505
P9039	Rbc deglycerolized	$XXX.XX	R	9504
P9040	Rbc leukoreduced irradiated	$XXX.XX	R	9522
P9041	Albumin (human),5%, 50ml	$XXX.XX	K	0961
P9043	Plasma protein fract,5%,50ml	$XXX.XX	R	9514
P9044	Cryoprecipitatereducedplasma	$XXX.XX	R	9523
P9045	Albumin (human), 5%, 250 ml	$XXX.XX	K	0963
P9046	Albumin (human), 25%, 20 ml	$XXX.XX	K	0964
P9047	Albumin (human), 25%, 50ml	$XXX.XX	K	0965
P9048	Plasmaprotein fract,5%,250ml	$XXX.XX	R	9519
P9051	Blood, l/r, cmv-neg	$XXX.XX	R	9524
P9052	Platelets, hla-m, l/r, unit	$XXX.XX	R	9525
P9053	Plt, pher, l/r cmv-neg, irr	$XXX.XX	R	9531
P9054	Blood, l/r, froz/degly/wash	$XXX.XX	R	9527
P9055	Plt, aph/pher, l/r, cmv-neg	$XXX.XX	R	9528
P9056	Blood, l/r, irradiated	$XXX.XX	R	9529
P9057	Rbc, frz/deg/wsh, l/r, irrad	$XXX.XX	R	9532
P9058	Rbc, l/r, cmv-neg, irrad	$XXX.XX	R	9533
P9059	Plasma, frz between 8-24hour	$XXX.XX	R	9513
P9060	Fr frz plasma donor retested	$XXX.XX	R	9503
P9070	Pathogen reduced plasma pool	$XXX.XX	R	9534
P9071	Pathogen reduced plasma sing	$XXX.XX	R	9535
P9073	Platelets pheresis path redu	$XXX.XX	R	9536
P9100	Pathogen test for platelets	$XXX.XX	S	1494
Q0035	Cardiokymography	$XXX.XX	Q1	5732
Q0091	Obtaining screen pap smear	$XXX.XX	S	5731
Q0138	Ferumoxytol, non-esrd	$XXX.XX	K	1297
Q0139	Ferumoxytol, esrd use	$XXX.XX	K	1485
Q2009	Fosphenytoin inj pe	$XXX.XX	K	9321
Q2017	Teniposide, 50 mg	$XXX.XX	K	7035
Q2026	Radiesse injection	$XXX.XX	K	9094
Q2028	Inj, sculptra, 0.5mg	$XXX.XX	K	9095
Q2041	Axicabtagene ciloleucel car+	$XXX.XX	G	9035
Q2042	Tisagenlecleucel car-pos t	$XXX.XX	G	9194
Q2043	Sipuleucel-t auto cd54+	$XXX.XX	K	9273
Q2049	Imported lipodox inj	$XXX.XX	K	1421
Q2050	Doxorubicin inj 10mg	$XXX.XX	K	7046
Q3027	Inj beta interferon im 1 mcg	$XXX.XX	K	1472
Q4195	Puraply 1 sq cm	$XXX.XX	G	9175
Q4196	Puraply am 1 sq cm	$XXX.XX	G	9176
Q5101	Injection, zarxio	$XXX.XX	K	1822
Q5103	Injection, inflectra	$XXX.XX	K	1847
Q5104	Injection, renflexis	$XXX.XX	G	9036
Q5105	Inj retacrit esrd on dialysi	$XXX.XX	G	9096
Q5106	Inj retacrit non-esrd use	$XXX.XX	G	9097
Q5107	Inj mvasi 10 mg	$XXX.XX	G	9329
Q5108	Injection, fulphila	$XXX.XX	G	9173
Q5110	Nivestym	$XXX.XX	G	9193
Q5111	Injection, udenyca 0.5 mg	$XXX.XX	G	9195
Q5114	Inj ogivri 10 mg	$XXX.XX	G	9341
Q5115	Inj truxima 10 mg	$XXX.XX	G	9336
Q5117	Inj., kanjinti, 10 mg	$XXX.XX	G	9330
Q5118	Inj., zirabev, 10 mg	$XXX.XX	K	9348
Q9950	Inj sulf hexa lipid microsph	$XXX.XX	G	9085
Q9968	Visualization adjunct	$XXX.XX	K	1446
Q9969	Non-heu tc-99m add-on/dose	$XXX.XX	K	1442
Q9982	Flutemetamol f18 diagnostic	$XXX.XX	G	9459
Q9983	Florbetaben f18 diagnostic	$XXX.XX	G	9458
Q9991	Buprenorph xr 100 mg or less	$XXX.XX	G	9073
Q9992	Buprenorphine xr over 100 mg	$XXX.XX	G	9239

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