Back to resultsView on map → Program Verified
Acute Care Hospitals
Sunrise Hospital and Medical Center
3.0
Financial Assistance
You May Qualify for Free or Discounted Care
- May qualify for free care with family-of-4 income up to $64,300/yr
- May qualify for discounted care with family-of-4 income up to $128,600/yr
- Processing Time: Typically 14–30 days from a complete application.
- Required Documents: 6
ProcedureScout is independent — we are not paid by hospitals, financial assistance programs, applications, or referrals. Whether you qualify depends on each hospital's rules and a final review.
All Procedure Prices
Insurance:
| Procedure | CPT | Price |
|---|---|---|
| Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve Non-Facility Midlevel | 00222 | $72 |
| Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedure | 00406 | $72 |
| Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity Non-Faci | 00797 | $72 |
| Inj nivolumab 2 mg hyalur | 00848 | $72 |
| Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography Non | 00952 | $72 |
| Anesthesia for all cast applications, removal, or repair involving knee joint Non-Facility ICC | 01420 | $72 |
| Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft Non-Facility | 01442 | $72 |
| Anesthesia for all closed procedures on humerus and elbow Non-Facility ICC | 01730 | $72 |
| Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy Non-Facility ICC | 01782 | $72 |
| Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified Non-Facility ICC | 01924 | $72 |
| Anesthesia for incomplete or missed abortion procedures Non-Facility Specialists | 01965 | $72 |
| Physiological support for harvesting of organ(s) from brain-dead patient Non-Facility Midlevel | 01990 | $72 |
| Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new impl | 0448T | $6,540 |
| Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; battery component only Non-Facility ICC | 0518T | $780 |
| Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract Non-Facility ICC | 0780T | $71 |
| FNA BX US GDE 1ST LESION | 10005 | $501 |
| FNA BX W/CT GDN EA ADDL | 10010 | $992 |
| DRAINAGE OF PILONIDAL CYST | 10081 | $1,299 |
| DEBRIDE INFECTED SKIN | 11000 | $211 |
| DEBRIDE GENITALIA PERINEUM | 11004 | $1,963 |
| DEBRIDE ABDOM WALL | 11005 | $2,695 |
| REMOVE MESH FROM ABD WALL | 11008 | $951 |
| DEBR SUBQ TISS 1ST 20SQCM | 11042 | $479 |
| TRIM SKIN LESIONS OVER 4 | 11057 | $336 |
| PUNCH BX SKIN EA SEP/ADDL | 11105 | $219 |
| Transcranial Doppler study of the intracranial arteries; limited study Non-Facility MD DO | 111853 | $2,975 |
| External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording | 111943 | $74 |
| External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop wi | 111944 | $33 |
| Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempte | 111949 | $17,904 |
| Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluatio | 111950 | $7,840 |
| Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold eva | 111951 | $7,840 |
| REMOVAL OF SKIN TAGS <W/15 | 11200 | $328 |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility Mid Levels | 112064 | $22,951 |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Non-Facility Physical Medicine and Rehab | 112231 | $5,924 |
| Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval Non-Facility ICC | 112395 | $670 |
| Radiologic examination, teeth; single view Non-Facility Specialists | 113232 | $1,129 |
| Radiologic examination, teeth; complete, full mouth Non-Facility Wound Care | 113233 | $1,701 |
| Radiologic examination, teeth; complete, full mouth Non-Facility Wound Care | 113233 | $1,701 |
| Needle electromyography; 1 extremity with or without related paraspinal areas Non-Facility Cardiovascular Thoracic Surgery | 113521 | $1,413 |
| Needle electromyography; 2 extremities with or without related paraspinal areas Non-Facility Physical Medicine and Rehab | 113522 | $1,828 |
| Needle electromyography; 3 extremities with or without related paraspinal areas Non-Facility Physical Medicine and Rehab | 113523 | $2,366 |
| Needle electromyography; 4 extremities with or without related paraspinal areas Non-Facility MD DO | 113524 | $3,082 |
| Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method Non-Facility Neurology | 113531 | $864 |
| Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history | 113858 | $212 |
| Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies | 114101 | $356 |
| EXC H-F-NK-SP B9+MARG 0.6-1 | 11421 | $586 |
| EXC FACE-MM B9+MARG 0.5 CM/< | 11440 | $531 |
| EXC FACE-MM B9+MARG 0.6-1 CM | 11441 | $640 |
| EXC FACE-MM B9+MARG 1.1-2 CM | 11442 | $708 |
| EXC FACE-MM B9+MARG 3.1-4 CM | 11444 | $1,026 |
| REMOVAL SWEAT GLAND LESION | 11450 | $1,628 |
| REMOVAL SWEAT GLAND LESION | 11451 | $1,963 |
| EXC TR-EXT MAL+MARG 2.1-3 CM | 11603 | $1,009 |
| EXC TR-EXT MAL+MARG 3.1-4 CM | 11604 | $1,125 |
| CLOSED SUCTION TRACH T-PCE 14F 12IN | 11620 | $732 |
| EXC S/N/H/F/G MAL+MRG 1.1-2 | 11622 | $919 |
| EXC F/E/E/N/L MAL+MRG 1.1-2 | 11642 | $974 |
| EXC F/E/E/N/L MAL+MRG >4 CM | 11646 | $1,813 |
| Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at | 117036 | $1,428 |
| Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/br | 117037 | $1,634 |
| DEBRIDE NAIL UP TO 5 | 11720 | $118 |
| Antihuman globulin test (Coombs test); indirect, each antibody titer Non-Facility MD DO | 117260 | $2,390 |
| DRAIN BLOOD FROM UNDER NAIL | 11740 | $212 |
| EXC NAIL AND MATRIX | 11750 | $582 |
| BIOPSY NAIL UNIT | 11755 | $448 |
| REPAIR OF NAIL BED | 11760 | $693 |
| EXCISION OF NAIL FOLD TOE | 11765 | $613 |
| REMOVE PILONIDAL CYST SIMPLE | 11770 | $1,355 |
| REMOVE PILONIDAL CYST COMPL | 11772 | $2,874 |
| Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additio | 11922 | $220 |
| Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretat | 11947 | $7,318 |
| TX CONTOUR DEFECTS >10.0 CC | 11954 | $568 |
| REPLACE TISSUE EXPANDER | 11970 | $1,999 |
| REMOVE DRUG IMPLANT DEVICE | 11982 | $409 |
| REMOVE/INSERT DRUG IMPLANT | 11983 | $509 |
| INTRODUCER SHTH 5FR 25MM 11CM KNK RST CANN HMST VLV RADPQ | 12004 | $477 |
| RPR F/E/E/N/L/M 2.6-5.0 CM | 12013 | $427 |
| RPR F/E/E/N/L/M 7.6-12.5 CM | 12015 | $624 |
| RPR FE/E/EN/L/M 12.6-20.0 CM | 12016 | $795 |
| RPR F/E/E/N/L/M >30.0 CM | 12018 | $594 |
| INTMD RPR S/TR/EXT >30.0 CM | 12037 | $1,773 |
| Duplex scan of extracranial arteries; unilateral or limited study Non-Facility General Surgery | 120380 | $2,398 |
| INTMD RPR N-HF/GENIT2.6-7.5 | 12042 | $1,139 |
| Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and | 12043 | $4,190 |
| INTMD RPR N-HF/GENIT12.6-20 | 12045 | $1,499 |
| INTMD RPR N-HF/GENIT20.1-30 | 12046 | $1,865 |
| INTMD RPR FACE/MM 2.5 CM/< | 12051 | $1,049 |
| INTMD RPR FACE/MM 7.6-12.5CM | 12054 | $1,421 |
| Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation Non-Facility Critical Care Intensivists | 12057 | $7,318 |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility Critical Care Intensivists | 120670 | $5,919 |
| Spleen imaging only, with or without vascular flow Non-Facility Critical Care Intensivists | 120673 | $2,961 |
| Liver imaging; with vascular flow | 120675 | $3,180 |
| Esophageal motility Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 120679 | $3,948 |
| Gastric mucosa imaging Non-Facility Internal Medicine | 120680 | $5,839 |
| Gastroesophageal reflux study Non-Facility Cardio and Thoracic Surgery | 120681 | $6,775 |
| Cardiac shunt detection Non-Facility Physical Medicine and Rehab | 120684 | $4,034 |
| Brain imaging, less than 4 static views; with vascular flow Non-Facility Critical Care Intensivists | 120694 | $3,099 |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzy | 120704 | $3,231 |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzy | 120704 | $3,231 |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin | 120705 | $4,311 |
| Kidney function study, non-imaging radioisotopic study Non-Facility | 120708 | $4,096 |
| Urinary bladder residual study (List separately in addition to code for primary procedure) | 120709 | $4,034 |
| Ureteral reflux study (radiopharmaceutical voiding cystogram) Non-Facility Colon and Rectal Surgery | 120710 | $4,034 |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and | 120715 | $6,188 |
| Discography, lumbar, radiological supervision and interpretation Non-facility Midlevel | 12123 | $6,632 |
| Sialography, radiological supervision and interpretation Non-Facility | 12142 | $4,239 |
| Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluatio | 12741 | $5,291 |
| Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less Non-Facility Wound Care | 129823 | $732 |
| Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet Non- | 129824 | $3,157 |
| Insertion of breast implant on same day of mastectomy (ie, immediate) Non-Facility Cardio and Thoracic Surgery | 129829 | $2,694 |
| Insertion or replacement of breast implant on separate day from mastectomy Non-Facility Midlevel | 129830 | $2,704 |
| Tissue expander placement in breast reconstruction, including subsequent expansion(s) Non-Facility Mid Levels | 129832 | $4,141 |
| Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (TRAM) flap Non-Facility Neurosurgery | 129838 | $7,099 |
| Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents Non-Facility Critical Care Intensivists | 129840 | $2,525 |
| Biopsy, muscle; superficial Non-Facility Critical Care Intensivists | 129850 | $827 |
| Biopsy, muscle; deep Non-Facility Cardiovascular Thoracic Surgery | 129851 | $1,140 |
| Biopsy, vertebral body, open; lumbar or cervical Non-Facility Internal Medicine | 129857 | $1,511 |
| Injection of sinus tract; diagnostic (sinogram) Non-Facility Specialists | 129859 | $554 |
| Removal of foreign body in muscle or tendon sheath; simple Non-Facility Mid Levels | 129860 | $800 |
| Removal of foreign body in muscle or tendon sheath; deep or complicated Non-Facility PCP and Mid-Levels | 129861 | $1,735 |
| Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) Non-Facility Internal Medicine | 129863 | $205 |
| Application of halo, including removal; femoral Non-Facility ICC | 129876 | $1,728 |
| Replantation, foot, complete amputation Non-Facility Mid Levels | 129892 | $9,815 |
| Bone graft, any donor area; minor or small (eg, dowel or button) Non-Facility PCP and Mid-Levels | 129893 | $1,460 |
| Bone graft, any donor area; major or large Non-Facility Internal Medicine | 129894 | $968 |
| Fascia lata graft; by incision and area exposure, complex or sheet Non-Facility MD DO | 129898 | $2,175 |
| Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial in | 129904 | $646 |
| Bone graft with microvascular anastomosis; fibula Non-Facility Internal Medicine | 129906 | $8,615 |
| Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal Non-Facility PCP and Mid-Levels | 129909 | $9,406 |
| Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe Non-Facility Cardiovascular Thora | 129910 | $9,451 |
| Free osteocutaneous flap with microvascular anastomosis; metatarsal Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurger | 129912 | $9,977 |
| Excision of torus mandibularis Non-Facility MD DO | 129924 | $1,409 |
| Excision of benign tumor or cyst of mandible, by enucleation and/or curettage Non-Facility Neurosurgery E&M | 129927 | $1,697 |
| Impression and custom preparation; definitive obturator prosthesis Non-Facility Critical Care Intensivists | 129940 | $5,856 |
| Impression and custom preparation; palatal lift prosthesis Non-Facility MD DO | 129943 | $4,726 |
| Impression and custom preparation; auricular prosthesis Non-Facility PCP and Mid-Levels | 129946 | $5,472 |
| Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure) Non-Facility Physical Medicine and Reh | 129949 | $2,299 |
| Application of interdental fixation device for conditions other than fracture or dislocation, includes removal Non-Facility Cardiovascular | 129950 | $3,242 |
| Genioplasty; sliding osteotomy, single piece Non-Facility Cardiovascular Thoracic Surgery | 129953 | $2,267 |
| Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft) Non-Facility ICC | 129957 | $15,637 |
| Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft Non-Faci | 129961 | $4,688 |
| Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I Non-Facil | 129970 | $7,560 |
| Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts) Non-Facility Hospitalists - In | 129981 | $5,577 |
| Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation Non-Facility Critical Care Intensivists | 129984 | $4,745 |
| Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation Non-Facility Physical Medicine and Rehab | 129985 | $5,064 |
| Osteotomy, mandible, segmental; Non-Facility PCP and Mid-Levels | 129986 | $3,646 |
| Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft) Non-Facility Internal Medicine | 129994 | $2,653 |
| Reconstruction of mandible or maxilla, subperiosteal implant; partial Non-Facility Trauma Critical Care | 129999 | $4,250 |
| Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete Non-Facility ICC | 130003 | $4,730 |
| Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach Non-Facility MD DO | 130006 | $8,631 |
| Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach Non-Facility Mid Le | 130009 | $7,176 |
| Malar augmentation, prosthetic material Non-Facility Neurosurgery E&M | 130010 | $3,661 |
| Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach Non-Facility Trauma Critical | 130014 | $704 |
| Closed treatment of nasal bone fracture with manipulation; without stabilization Non-Facility Midlevel | 130019 | $562 |
| Closed treatment of nasal bone fracture with manipulation; with stabilization Non-Facility Neurosurgery E&M | 130020 | $812 |
| Open treatment of nasal fracture; uncomplicated Non-Facility Trauma Critical Care | 130021 | $1,632 |
| Closed treatment of nasal septal fracture, with or without stabilization Non-Facility Trauma Critical Care | 130025 | $1,549 |
| Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or | 130028 | $2,650 |
| Open treatment of depressed zygomatic arch fracture (eg, Gillies approach) Non-Facility Cardio and Thoracic Surgery | 130036 | $1,997 |
| Open treatment of orbital floor blowout fracture; combined approach Non-Facility MD DO | 130041 | $2,736 |
| Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant Non-Facility MD DO | 130042 | $2,838 |
| Open treatment of fracture of orbit, except blowout; with implant Non-Facility General Surgery | 130047 | $2,268 |
| Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint Non-Faci | 130049 | $2,360 |
| Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), multiple appr | 130051 | $2,853 |
| Closed treatment of craniofacial separation (LeFort III type) using interdental wire fixation of denture or splint Non-Facility Internal Me | 130052 | $2,519 |
| Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure) Non-Facility MD DO | 130057 | $2,603 |
| Percutaneous treatment of mandibular fracture, with external fixation Non-Facility General Surgery | 130061 | $2,881 |
| Open treatment of mandibular fracture with external fixation Non-Facility Midlevel | 130063 | $1,702 |
| Open treatment of mandibular condylar fracture Non-Facility Neurosurgery E&M | 130066 | $2,761 |
| Biopsy, soft tissue of neck or thorax Non-Facility Cardio and Thoracic Surgery | 130079 | $991 |
| Excision first and/or cervical rib; Non-Facility Cardio and Thoracic Surgery | 130085 | $2,158 |
| Excision first and/or cervical rib; with sympathectomy Non-Facility Cardio and Thoracic Surgery | 130086 | $2,491 |
| Division of sternocleidomastoid for torticollis, open operation; with cast application Non-Facility General Surgery | 130094 | $1,946 |
| Open treatment of sternum fracture with or without skeletal fixation Non-Facility Midlevel | 130101 | $1,964 |
| Biopsy, soft tissue of back or flank; superficial Non-Facility PCP and Mid-Levels | 130103 | $958 |
| Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; less than 5 cm Non-Facility Trauma Critical Care | 130106 | $3,636 |
| Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segme | 130111 | $3,785 |
| Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segme | 130112 | $4,098 |
| Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical Non-Facility Neurosurgery | 130119 | $5,775 |
| Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar Non-Facility Cardiovascular Thoracic Surgery | 130121 | $5,640 |
| Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing Non-Facility Hospitalists | 130124 | $1,128 |
| Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segme | 130128 | $5,263 |
| Manipulation of spine requiring anesthesia, any region Non-Facility Neurosurgery | 130132 | $459 |
| Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic Non- | 130138 | $5,917 |
| Arthrodesis, posterior technique, craniocervical (occiput-C2) Non-Facility Mid Levels | 130141 | $5,680 |
| Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to co | 130163 | $1,257 |
| Incision and drainage, shoulder area; infected bursa Non-Facility Neurosurgery | 130175 | $1,594 |
| Biopsy, soft tissue of shoulder area; deep Non-Facility Neurosurgery E&M | 130180 | $2,098 |
| Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm Non-Facility Internal Medicine | 130183 | $4,005 |
| Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage Non-Facility Specialists | 130185 | $1,652 |
| Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft (includes obtaining graft) Non-Facility Cardiovas | 130193 | $2,498 |
| Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula Non-Facility Trauma Critical Care | 130202 | $2,420 |
| Removal of foreign body, shoulder; subcutaneous Non-Facility Cardiovascular Thoracic Surgery | 130211 | $1,131 |
| Tenotomy, shoulder area; single tendon Non-Facility Critical Care Intensivists | 130218 | $2,215 |
| Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute Non-Facility Cardio and Thoracic Surgery | 130220 | $2,928 |
| Tenodesis of long tendon of biceps Non-Facility MD DO | 130224 | $2,664 |
| Resection or transplantation of long tendon of biceps Non-Facility Trauma Critical Care | 130225 | $2,702 |
| Capsulorrhaphy, anterior; with labral repair (eg, Bankart procedure) Non-Facility MD DO | 130227 | $3,525 |
| Capsulorrhaphy, glenohumeral joint, any type multidirectional instability Non-Facility Wound Care | 130231 | $3,988 |
| Closed treatment of clavicular fracture; without manipulation Non-Facility MD DO | 130238 | $820 |
| Closed treatment of sternoclavicular dislocation; without manipulation Non-Facility MD DO | 130241 | $890 |
| Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) Non-Facility Cardiovascular | 130244 | $2,254 |
| Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft) Non-Facility Wound Care | 130248 | $2,346 |
| Closed treatment of scapular fracture; without manipulation Non-Facility Cardio and Thoracic Surgery | 130249 | $866 |
| Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tu | 130254 | $3,153 |
| Closed treatment of shoulder dislocation, with manipulation; without anesthesia Non-Facility Critical Care Intensivists | 130259 | $1,201 |
| Arthrodesis, glenohumeral joint; Non-Facility PCP and Mid-Levels | 130267 | $3,654 |
| Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; less than 5 cm Non-Facility Mid Levels | 130282 | $3,661 |
| Arthrotomy, elbow; with synovial biopsy only Non-Facility Trauma Critical Care | 130283 | $1,521 |
| Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body Non-Facility Critical C | 130284 | $1,820 |
| Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with autograft (includes obtaining graft) | 130291 | $2,244 |
| Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus Non-Facility ICC | 130294 | $2,678 |
| Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck Non-Facility Cardiovascular Thoracic Surgery | 130295 | $2,275 |
| Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process Non-Facility Mid Levels | 130296 | $2,482 |
| Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus Non-Facility General Surgery | 130297 | $2,521 |
| Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), radial head or neck Non-Facility Wound Care | 130298 | $2,142 |
| Removal of prosthesis, includes debridement and synovectomy when performed; radial head Non-Facility General Surgery | 130307 | $2,592 |
| Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular) Non-Facility PCP and Mid-Levels | 130309 | $2,033 |
| Manipulation, elbow, under anesthesia Non-Facility Mid Levels | 130311 | $1,600 |
| Repair medial collateral ligament, elbow, with local tissue Non-Facility Critical Care Intensivists | 130324 | $2,555 |
| Arthroplasty, elbow; with membrane (eg, fascial) Non-Facility Internal Medicine | 130331 | $3,225 |
| Repair of nonunion or malunion, humerus; without graft (eg, compression technique) Non-Facility Neurosurgery E&M | 130340 | $3,747 |
| Open treatment of humeral shaft fracture with plate/screws, with or without cerclage Non-Facility PCP and Mid-Levels | 130347 | $3,150 |
| Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation Non-Faci | 130349 | $1,411 |
| Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extensi | 130352 | $3,307 |
| Closed treatment of humeral condylar fracture, medial or lateral; without manipulation Non-Facility Cardio and Thoracic Surgery | 130358 | $1,304 |
| Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); | 130363 | $3,870 |
| Treatment of closed elbow dislocation; without anesthesia Non-Facility MD DO | 130364 | $1,370 |
| Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid processºes»); without manipulation Non-Facility Physical Medici | 130374 | $1,085 |
| Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid processºes»); with manipulation Non-Facility MD DO | 130375 | $1,706 |
| Arthrodesis, elbow joint; local Non-Facility PCP and Mid-Levels | 130377 | $2,983 |
| Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft) Non-Facility Critical Care Intensivists | 130378 | $3,573 |
| Amputation, arm through humerus; secondary closure or scar revision Non-Facility Midlevel | 130381 | $2,052 |
| Amputation, arm through humerus; re-amputation Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 130382 | $2,766 |
| Incision and drainage, forearm and/or wrist; deep abscess or hematoma Non-Facility MD DO | 130393 | $2,619 |
| Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular) Non-Facility Wound Care | 130398 | $1,326 |
| Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm Non-Facility Hospitalists - Inter | 130400 | $1,857 |
| Arthrotomy, wrist joint; with biopsy Non-Facility General Surgery | 130403 | $1,276 |
| Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body Non-Facility Phys | 130404 | $1,469 |
| Excision of ganglion, wrist (dorsal or volar); recurrent Non-Facility Cardio and Thoracic Surgery | 130409 | $1,413 |
| Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograf | 130416 | $2,162 |
| Excision or curettage of bone cyst or benign tumor of carpal bones; Non-Facility Cardio and Thoracic Surgery | 130417 | $1,632 |
| Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft Non-Facility General Surgery | 130419 | $1,804 |
| Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius Non-Facility PCP and Mid-Levels | 130422 | $2,101 |
| Carpectomy; 1 bone Non-Facility General Surgery | 130424 | $1,775 |
| Excision distal ulna partial or complete (eg, Darrach type or matched resection) Non-Facility Colon and Rectal Surgery | 130427 | $1,551 |
| Removal of wrist prosthesis; (separate procedure) Non-Facility Cardiovascular Thoracic Surgery | 130430 | $1,930 |
| Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle Non-Facility Cardiovascular Thoracic Sur | 130437 | $2,020 |
| Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle Non- | 130438 | $2,381 |
| Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon Non-Facility ICC | 130440 | $2,037 |
| Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each | 130446 | $2,558 |
| Centralization of wrist on ulna (eg, radial club hand) Non-Facility General Surgery | 130451 | $3,373 |
| Osteoplasty, radius OR ulna; shortening Non-Facility MD DO | 130459 | $2,744 |
| Osteoplasty, radius AND ulna; shortening (excluding 64876) Non-Facility Cardio and Thoracic Surgery | 130461 | $3,611 |
| Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique) Non-Facility Specialists | 130464 | $2,862 |
| Arthroplasty with prosthetic replacement; scaphoid carpal (navicular) Non-Facility Mid Levels | 130475 | $2,814 |
| Revision of arthroplasty, including removal of implant, wrist joint Non-Facility ICC | 130480 | $3,669 |
| Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint disloca | 130490 | $2,823 |
| Closed treatment of radial and ulnar shaft fractures; without manipulation Non-Facility PCP and Mid-Levels | 130495 | $1,076 |
| Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of uln | 130500 | $1,973 |
| Closed treatment of carpal scaphoid (navicular) fracture; with manipulation Non-Facility Colon and Rectal Surgery | 130504 | $1,812 |
| Closed treatment of carpal bone fracture (excluding carpal scaphoid ºnavicular»); with manipulation, each bone Non-Facility PCP and Mid-Lev | 130507 | $1,718 |
| Closed treatment of ulnar styloid fracture Non-Facility Neurosurgery | 130509 | $1,220 |
| Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation Non-Facility Hospitalists - Internal Medicin | 130512 | $1,640 |
| Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones Non-Facility General Surgery | 130513 | $2,189 |
| Closed treatment of lunate dislocation, with manipulation Non-Facility Trauma Critical Care | 130519 | $1,791 |
| Amputation, forearm, through radius and ulna; re-amputation Non-Facility Critical Care Intensivists | 130530 | $2,462 |
| Disarticulation through wrist; Non-Facility Colon and Rectal Surgery | 130532 | $2,650 |
| Disarticulation through wrist; re-amputation Non-Facility Critical Care Intensivists | 130534 | $2,591 |
| Transmetacarpal amputation; re-amputation Non-Facility Physical Medicine and Rehab | 130537 | $2,964 |
| Drainage of palmar bursa; single, bursa Non-Facility Trauma Critical Care | 130542 | $1,522 |
| Fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous Non-Facility Critical Care Intensivists | 130547 | $1,149 |
| Fasciotomy, palmar (eg, Dupuytren's contracture); open, partial Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 130548 | $1,708 |
| Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each Non-Facility Critical Care Int | 130552 | $1,226 |
| Arthrotomy with biopsy; interphalangeal joint, each Non-Facility General Surgery | 130556 | $1,184 |
| Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; less than 3 cm Non-Facility Colon and Rectal Surgery | 130559 | $2,633 |
| Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft) Non-Facilit | 130560 | $2,154 |
| Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other local tis | 130562 | $936 |
| Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit Non-Facility Wound Care | 130564 | $1,996 |
| Excision of tendon, palm, flexor or extensor, single, each tendon Non-Facility Neurosurgery | 130568 | $1,477 |
| Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft) Non-Facility Specialists | 130572 | $2,183 |
| Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal Non-Facility Trauma Critical Care | 130575 | $1,799 |
| Radical resection of tumor, metacarpal Non-Facility MD DO | 130578 | $3,784 |
| Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); secondary, without free graft, each tendon | 130588 | $3,218 |
| Repair or advancement of profundus tendon, with intact superficialis tendon; secondary with free graft (includes obtaining graft), each tend | 130591 | $3,407 |
| Repair or advancement of profundus tendon, with intact superficialis tendon; secondary without free graft, each tendon Non-Facility Physica | 130592 | $3,286 |
| Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod Non-Facility Physical Me | 130597 | $3,166 |
| Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, each rod Non-Facility MD DO | 130598 | $3,414 |
| Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon Non-Facility Physical Medicine and Rehab | 130599 | $2,355 |
| Tenolysis, flexor tendon; palm OR finger, each tendon Non-Facility ICC | 130607 | $2,452 |
| Tenolysis, complex, extensor tendon, finger, including forearm, each tendon Non-Facility PCP and Mid-Levels | 130610 | $2,508 |
| Tenotomy, flexor, palm, open, each tendon Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 130611 | $1,741 |
| Capsulodesis, metacarpophalangeal joint; single digit Non-Facility Wound Care | 130636 | $2,763 |
| Capsulodesis, metacarpophalangeal joint; 2 digits Non-Facility Critical Care Intensivists | 130637 | $3,207 |
| Capsulodesis, metacarpophalangeal joint; 3 or 4 digits Non-Facility Trauma Critical Care | 130638 | $3,249 |
| Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint Non-Facility Cardio and Thoracic Surgery | 130642 | $2,268 |
| Pollicization of a digit Non-Facility Critical Care Intensivists | 130651 | $5,994 |
| Repair macrodactylia, each digit Non-Facility ICC | 130665 | $5,194 |
| Repair, intrinsic muscles of hand, each muscle Non-Facility Colon and Rectal Surgery | 130666 | $1,841 |
| Closed treatment of metacarpal fracture, single; without manipulation, each bone Non-Facility Wound Care | 130669 | $1,117 |
| Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia Non-Facility Midleve | 130679 | $1,700 |
| Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint Non-Facility Intern | 130681 | $2,080 |
| Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia Non-Facility Critical Care Intensivists | 130683 | $1,240 |
| Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia Non-Facility Hospitalists - Internal M | 130684 | $1,559 |
| Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each Non-Facility Cardio and Thoracic Surgery | 130696 | $1,553 |
| Fusion in opposition, thumb, with autogenous graft (includes obtaining graft) Non-Facility Critical Care Intensivists | 130702 | $3,080 |
| Arthrodesis, carpometacarpal joint, digit, other than thumb, each; Non-Facility Neurosurgery E&M | 130705 | $2,913 |
| Arthrodesis, interphalangeal joint, with or without internal fixation; Non-Facility Critical Care Intensivists | 130709 | $2,298 |
| Incision and drainage, pelvis or hip joint area; deep abscess or hematoma Non-Facility Internal Medicine | 130717 | $2,483 |
| Tenotomy, adductor, subcutaneous, open, with obturator neurectomy Non-Facility Trauma Critical Care | 130722 | $2,157 |
| Fasciotomy, hip or thigh, any type Non-Facility Wound Care | 130725 | $3,291 |
| Arthrotomy, hip, with drainage (eg, infection) Non-Facility ICC | 130726 | $3,331 |
| Excision; trochanteric bursa or calcification Non-Facility Specialists | 130739 | $1,643 |
| Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone | 130743 | $3,201 |
| Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone | 130744 | $3,516 |
| Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis Non-Facility Neurosurgery | 130745 | $7,324 |
| Release or recession, hamstring, proximal Non-Facility Mid Levels | 130758 | $2,453 |
| Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type) Non-Facility PCP and Mid-Levels | 130764 | $4,601 |
| Acetabuloplasty; resection, femoral head (eg, Girdlestone procedure) Non-Facility Mid Levels | 130765 | $3,920 |
| Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft Non-F | 130767 | $4,533 |
| Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft Non-Facility Critical Care Intensivis | 130770 | $5,164 |
| Osteotomy and transfer of greater trochanter of femur (separate procedure) Non-Facility Wound Care | 130772 | $3,183 |
| Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast Non-Facility Wound Care | 130779 | $4,885 |
| Open treatment of coccygeal fracture Non-Facility Specialists | 130792 | $1,887 |
| Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not | 130793 | $2,090 |
| Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabu | 130800 | $5,818 |
| Closed treatment of femoral fracture, proximal end, neck; without manipulation Non-Facility Physical Medicine and Rehab | 130802 | $1,767 |
| Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement Non-Facility PCP and Mid-Levels | 130805 | $4,228 |
| Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or ske | 130807 | $3,414 |
| Closed treatment of hip dislocation, traumatic; requiring anesthesia Non-Facility Physical Medicine and Rehab | 130813 | $2,690 |
| Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation | 130814 | $4,505 |
| Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without an | 130815 | $1,099 |
| Manipulation, hip joint, requiring general anesthesia Non-Facility Midlevel | 130821 | $657 |
| Disarticulation of hip Non-Facility Internal Medicine | 130827 | $4,460 |
| Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure) Non-Facility Neurosurgery E&M | 130832 | $1,204 |
| Tenotomy, percutaneous, adductor or hamstring; multiple tendons Non-Facility Trauma Critical Care | 130833 | $1,484 |
| Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular) Non-Facility Trauma Critical Care | 130838 | $1,468 |
| Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm Non-Facility Colon and Rectal Surgery | 130840 | $2,224 |
| Excision, prepatellar bursa Non-Facility Mid Levels | 130848 | $1,363 |
| Radical resection of tumor, femur or knee Non-Facility Wound Care | 130857 | $7,217 |
| Removal of foreign body, deep, thigh region or knee area Non-Facility Cardio and Thoracic Surgery | 130859 | $2,199 |
| Arthroplasty, patella; with prosthesis Non-Facility Wound Care | 130888 | $2,996 |
| Arthroplasty, knee, condyle and plateau; medial OR lateral compartment Non-Facility Internal Medicine | 130894 | $4,078 |
| Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus ºbowleg» or genu valgus ºknock-knee»); | 130899 | $3,438 |
| Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft) Non-Faci | 130905 | $4,477 |
| Closed treatment of femoral shaft fracture, without manipulation Non-Facility General Surgery | 130918 | $1,892 |
| Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or with | 130921 | $2,853 |
| Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed | 130928 | $4,363 |
| Closed treatment of distal femoral epiphyseal separation; without manipulation Non-Facility Midlevel | 130930 | $1,896 |
| Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction Non-Facility General | 130931 | $2,475 |
| Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction Non-Facility MD DO | 130936 | $2,249 |
| Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) Non-Facility Mid Levels | 130949 | $551 |
| Amputation, thigh, through femur, any level; secondary closure or scar revision Non-Facility ICC | 130954 | $1,812 |
| Amputation, thigh, through femur, any level; re-amputation Non-Facility Neurosurgery | 130955 | $2,527 |
| Disarticulation at knee Non-Facility Internal Medicine | 130956 | $2,476 |
| Incision and drainage, leg or ankle; deep abscess or hematoma Non-Facility General Surgery | 130961 | $1,953 |
| Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular) Non-Facility Internal Medicine | 130969 | $2,131 |
| Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm Non-Facility Physical Medicine and Rehab | 130971 | $1,824 |
| Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm Non-Facility Internal Medicine | 130972 | $1,633 |
| Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle Non-Facility Colon and Rectal Surgery | 130976 | $1,988 |
| Radical resection of tumor; tibia Non-Facility Cardiovascular Thoracic Surgery | 130982 | $6,225 |
| Injection procedure for ankle arthrography Non-Facility Physical Medicine and Rehab | 130985 | $834 |
| Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graft) Non-Facility Colon and Rectal Surger | 130987 | $2,308 |
| Repair, flexor tendon, leg; primary, without graft, each tendon Non-Facility Cardiovascular Thoracic Surgery | 130990 | $1,311 |
| Repair, extensor tendon, leg; secondary, with or without graft, each tendon Non-Facility Hospitalists - Internal Medicine Critical Care Neu | 130993 | $1,510 |
| Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure) Non-Facility Midlevel | 130998 | $2,384 |
| Repair, primary, disrupted ligament, ankle; collateral Non-Facility Physical Medicine and Rehab | 131004 | $1,706 |
| CMPLX RPR TRUNK 2.6-7.5 CM | 13101 | $1,464 |
| Osteoplasty, tibia and fibula, lengthening or shortening Non-Facility Trauma Critical Care | 131015 | $3,815 |
| Repair of nonunion or malunion, tibia; with sliding graft Non-Facility MD DO | 131017 | $3,195 |
| CMPLX RPR TRUNK ADDL 5CM/< | 13102 | $426 |
| Repair of congenital pseudarthrosis, tibia Non-Facility ICC | 131020 | $3,696 |
| Open treatment of medial malleolus fracture, includes internal fixation, when performed Non-Facility Neurosurgery E&M | 131034 | $2,171 |
| Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed Non-Facility Colon and Rectal Surgery | 131037 | $2,530 |
| Closed treatment of trimalleolar ankle fracture; without manipulation Non-Facility Critical Care Intensivists | 131044 | $1,224 |
| Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; | 131049 | $1,969 |
| Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation | 131051 | $4,026 |
| Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or external fixation Non-Facil | 131060 | $2,808 |
| Amputation, leg, through tibia and fibula; open, circular (guillotine) Non-Facility General Surgery | 131065 | $2,087 |
| Amputation, leg, through tibia and fibula; re-amputation Non-Facility Colon and Rectal Surgery | 131067 | $2,304 |
| Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve Non | 131072 | $2,898 |
| Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas Non-Facility Colon and Rectal Surgery | 131076 | $1,365 |
| Incision, bone cortex (eg, osteomyelitis or bone abscess), foot Non-Facility PCP and Mid-Levels | 131077 | $1,992 |
| Fasciotomy, foot and/or toe Non-Facility Specialists | 131078 | $1,542 |
| Release, tarsal tunnel (posterior tibial nerve decompression) Non-Facility Specialists | 131085 | $1,897 |
| Arthrotomy with biopsy; metatarsophalangeal joint Non-Facility Mid Levels | 131090 | $1,404 |
| Fasciectomy, plantar fascia; partial (separate procedure) Non-Facility Colon and Rectal Surgery | 131092 | $1,878 |
| Synovectomy; metatarsophalangeal joint, each Non-Facility MD DO | 131095 | $1,779 |
| Synovectomy, tendon sheath, foot; flexor Non-Facility Midlevel | 131097 | $1,954 |
| Synovectomy, tendon sheath, foot; extensor Non-Facility Colon and Rectal Surgery | 131098 | $1,659 |
| Excision or curettage of bone cyst or benign tumor, talus or calcaneus; Non-Facility Trauma Critical Care | 131101 | $2,236 |
| Ostectomy, complete excision; first metatarsal head Non-Facility Midlevel | 131109 | $1,733 |
| Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe Non-F | 131118 | $1,712 |
| Metatarsectomy Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 131121 | $2,060 |
| Repair, tendon, extensor, foot; primary or secondary, each tendon Non-Facility Physical Medicine and Rehab | 131133 | $1,754 |
| Tenolysis, flexor, foot; multiple tendons Non-Facility Critical Care Intensivists | 131136 | $1,870 |
| Tenotomy, open, extensor, foot or toe, each tendon Non-Facility ICC | 131141 | $1,483 |
| Capsulotomy, midfoot; medial release only (separate procedure) Non-Facility Critical Care Intensivists | 131145 | $2,548 |
| Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity) No | 131147 | $5,013 |
| Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head Non-Facility ICC | 131154 | $2,184 |
| Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesi | 131161 | $3,787 |
| Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe) | 131169 | $2,892 |
| Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure) Non-Facility Mid Levels | 131172 | $1,966 |
| Osteotomy, shortening, angular or rotational correction; other phalanges, any toe Non-Facility Internal Medicine | 131173 | $1,882 |
| Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes) Non-Facility Midl | 131174 | $1,910 |
| Reconstruction, toe, macrodactyly; requiring bone resection Non-Facility Cardio and Thoracic Surgery | 131179 | $2,323 |
| Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web Non-Facility Wound Care | 131181 | $1,829 |
| Closed treatment of calcaneal fracture; without manipulation Non-Facility MD DO | 131183 | $907 |
| Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (include | 131187 | $4,651 |
| Closed treatment of talus fracture; with manipulation Non-Facility Trauma Critical Care | 131189 | $1,360 |
| Open treatment of metatarsal fracture, includes internal fixation, when performed, each Non-Facility Wound Care | 131199 | $2,002 |
| Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation Non-Facility MD DO | 131202 | $1,676 |
| Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each Non-Facility Midle | 131206 | $2,062 |
| CMPLX RPR S/A/L 2.6-7.5 CM | 13121 | $1,558 |
| Open treatment of tarsal bone dislocation, includes internal fixation, when performed Non-Facility Neurosurgery | 131212 | $3,102 |
| Open treatment of talotarsal joint dislocation, includes internal fixation, when performed Non-Facility Cardio and Thoracic Surgery | 131216 | $3,159 |
| Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia Non-Facility Internal Medicine | 131217 | $1,262 |
| Closed treatment of metatarsophalangeal joint dislocation; without anesthesia Non-Facility Cardiovascular Thoracic Surgery | 131220 | $553 |
| Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation Non-Facility Cardiovascular Thoracic Surgery | 131222 | $1,147 |
| Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed Non-Facility Wound Care | 131223 | $2,334 |
| Amputation, foot; transmetatarsal Non-Facility Cardio and Thoracic Surgery | 131239 | $2,459 |
| Amputation, toe; metatarsophalangeal joint Non-Facility PCP and Mid-Levels | 131241 | $1,081 |
| Application of Risser jacket, localizer, body; including head Non-Facility Neurosurgery | 131246 | $1,056 |
| Application of cylinder cast (thigh to ankle) Non-Facility General Surgery | 131275 | $442 |
| Application of patellar tendon bearing (PTB) cast Non-Facility Mid Levels | 131278 | $402 |
| Application of clubfoot cast with molding or manipulation, long or short leg Non-Facility PCP and Mid-Levels | 131281 | $512 |
| Application of long leg splint (thigh to ankle or toes) Non-Facility Cardio and Thoracic Surgery | 131282 | $315 |
| Application of short leg splint (calf to foot) Non-Facility Wound Care | 131283 | $254 |
| Strapping; toes Non-Facility General Surgery | 131287 | $68 |
| Removal or bivalving; gauntlet, boot or body cast Non-Facility Specialists | 131290 | $223 |
| Removal or bivalving; full arm or full leg cast Non-Facility Specialists | 131291 | $224 |
| Repair of spica, body cast or jacket Non-Facility Critical Care Intensivists | 131294 | $305 |
| Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure) Non-Facility Hospitalists - Internal | 131299 | $1,906 |
| Arthroscopy, shoulder, surgical; synovectomy, partial Non-Facility Internal Medicine | 131305 | $1,923 |
| Arthroscopy, elbow, surgical; synovectomy, complete Non-Facility Colon and Rectal Surgery | 131316 | $2,100 |
| Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure) Non-Facility ICC | 131319 | $1,621 |
| CMPLX RPR F/C/C/M/N/AX/G/H/F | 13132 | $1,719 |
| Arthroscopy, wrist, surgical; for infection, lavage and drainage Non-Facility Neurosurgery | 131320 | $1,753 |
| Arthroscopy, wrist, surgical; synovectomy, complete Non-Facility Neurosurgery E&M | 131322 | $2,099 |
| Arthroscopy, hip, surgical; with synovectomy Non-Facility Mid Levels | 131333 | $2,898 |
| Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure) Non-Facility Specialists | 131338 | $1,783 |
| Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral) Non-Facility Internal Medicine | 131339 | $2,337 |
| Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion Non-Facility Trauma Critical Care | 131348 | $2,278 |
| Endoscopic plantar fasciotomy Non-Facility PCP and Mid-Levels | 131354 | $2,415 |
| Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial Non-Facility Cardio and Thoracic Surgery | 131356 | $1,652 |
| Excision, nasal polyp(s), simple Non-Facility Wound Care | 131367 | $931 |
| Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy) Non-Facility Midlevel | 131370 | $2,881 |
| Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction) Non-Facility Hospitalists - Internal Medicin | 131378 | $3,744 |
| Sinusotomy, sphenoid, with or without biopsy; Non-Facility Cardiovascular Thoracic Surgery | 131381 | $1,905 |
| Laryngoscopy, indirect; with vocal cord injection Non-Facility Cardiovascular Thoracic Surgery | 131386 | $453 |
| Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear Non-Facility Internal Medicine | 131409 | $5,126 |
| Thoracotomy; with cyst(s) removal, includes pleural procedure when performed Non-Facility Midlevel | 131411 | $3,449 |
| Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass Non-Facility Trauma | 131423 | $6,612 |
| Coronary artery bypass, vein only; 2 coronary venous grafts Non-Facility ICC | 131432 | $7,327 |
| Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (List separately in addition to code for primary proced | 131433 | $2,506 |
| Bypass graft, with vein; iliofemoral Non-Facility MD DO | 131450 | $4,493 |
| Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than | 131453 | $517 |
| Venipuncture, cutdown; age 1 or over Non-Facility Neurosurgery E&M | 131456 | $138 |
| Ligation or banding of angioaccess arteriovenous fistula Non-Facility PCP and Mid-Levels | 131466 | $1,305 |
| Lymphangiotomy or other operations on lymphatic channels Non-Facility Mid Levels | 131481 | $1,651 |
| Suture and/or ligation of thoracic duct; abdominal approach Non-Facility Specialists | 131484 | $2,415 |
| Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad Non-Facility Mid Levels | 131487 | $1,655 |
| Biopsy or excision of lymph node(s); open, internal mammary node(s) Non-Facility Neurosurgery | 131489 | $1,995 |
| Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection Non-Facility Neurosurgery | 131492 | $3,665 |
| Suprahyoid lymphadenectomy Non-Facility Internal Medicine | 131498 | $2,837 |
| Cervical lymphadenectomy (complete) Non-Facility MD DO | 131499 | $4,700 |
| Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (Li | 131504 | $928 |
| Inguinofemoral lymphadenectomy, superficial, including Cloquet's node (separate procedure) Non-Facility Specialists | 131505 | $2,945 |
| CMPLX RPR E/N/E/L 1.1-2.5 CM | 13151 | $1,542 |
| Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach Non-Facility Wound Care | 131513 | $1,763 |
| Repair, diaphragmatic hernia (other than neonatal), traumatic; acute Non-Facility PCP and Mid-Levels | 131525 | $3,035 |
| Vermilionectomy (lip shave), with mucosal advancement Non-Facility Internal Medicine | 131532 | $1,932 |
| Excision of lip; transverse wedge excision with primary closure Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 131533 | $1,796 |
| Excision of lip; V-excision with primary direct linear closure Non-Facility Neurosurgery E&M | 131534 | $1,845 |
| Resection of lip, more than one-fourth, without reconstruction Non-Facility Specialists | 131537 | $2,048 |
| Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral Non-Facility Hospitalists - Internal Medicine Critica | 131541 | $3,570 |
| Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages Non-Facility MD DO | 131543 | $3,536 |
| Removal of embedded foreign body, vestibule of mouth; complicated Non-Facility Wound Care | 131550 | $1,037 |
| Biopsy, vestibule of mouth Non-Facility Mid Levels | 131552 | $629 |
| Vestibuloplasty; anterior Non-Facility Cardio and Thoracic Surgery | 131561 | $3,153 |
| Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space Non-Facility Neurosurgery | 131570 | $1,197 |
| Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space Non-Facility Mid Levels | 131571 | $1,430 |
| Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space Non-Facility Specialists | 131572 | $1,547 |
| Incision of lingual frenum (frenotomy) Non-Facility Neurosurgery E&M | 131573 | $826 |
| Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space Non-Facility Hospitalists - Internal Medi | 131577 | $1,903 |
| Biopsy of tongue; posterior one-third Non-Facility Critical Care Intensivists | 131579 | $695 |
| Biopsy of floor of mouth Non-Facility Mid Levels | 131580 | $626 |
| Excision of lesion of tongue without closure Non-Facility Wound Care | 131581 | $859 |
| Excision of lesion of tongue with closure; anterior two-thirds Non-Facility Critical Care Intensivists | 131582 | $1,250 |
| Excision of lesion of tongue with closure; posterior one-third Non-Facility ICC | 131583 | $1,341 |
| Glossectomy; less than one-half tongue Non-Facility Neurosurgery | 131587 | $3,878 |
| Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection Non-Facility Cardi | 131591 | $7,828 |
| Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando type) Non-Facil | 131593 | $10,577 |
| Suture of tongue to lip for micrognathia (Douglas type procedure) Non-Facility Colon and Rectal Surgery | 131598 | $1,686 |
| Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair Non-Facility Cardio and Thoracic Surgery | 131607 | $820 |
| Excision, lesion of palate, uvula; without closure Non-Facility Neurosurgery E&M | 131619 | $803 |
| Excision, lesion of palate, uvula; with simple primary closure Non-Facility Specialists | 131620 | $953 |
| Excision, lesion of palate, uvula; with local flap closure Non-Facility Neurosurgery | 131621 | $1,681 |
| Uvulectomy, excision of uvula Non-Facility Trauma Critical Care | 131623 | $1,175 |
| Repair, laceration of palate; up to 2 cm Non-Facility PCP and Mid-Levels | 131626 | $939 |
| Lengthening of palate, and pharyngeal flap Non-Facility Cardiovascular Thoracic Surgery | 131633 | $3,281 |
| Lengthening of palate, with island flap Non-Facility MD DO | 131634 | $3,053 |
| Repair of anterior palate, including vomer flap Non-Facility MD DO | 131635 | $2,698 |
| Maxillary impression for palatal prosthesis Non-Facility PCP and Mid-Levels | 131637 | $653 |
| Sialolithotomy; parotid, extraoral or complicated intraoral Non-Facility PCP and Mid-Levels | 131647 | $1,968 |
| Marsupialization of sublingual salivary cyst (ranula) Non-Facility Wound Care | 131651 | $1,476 |
| Excision of submandibular (submaxillary) gland Non-Facility Specialists | 131657 | $1,468 |
| Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands Non-Facility Colon and Rectal Surgery | 131663 | $2,910 |
| Dilation salivary duct Non-Facility Physical Medicine and Rehab | 131667 | $273 |
| Incision and drainage abscess; peritonsillar Non-Facility PCP and Mid-Levels | 131671 | $710 |
| Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach Non-Facility Critical Care Intensivists | 131672 | $1,601 |
| Biopsy; oropharynx Non-Facility Neurosurgery | 131674 | $581 |
| Excision or destruction of lesion of pharynx, any method Non-Facility Critical Care Intensivists | 131678 | $845 |
| Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues Non-Facility Hospitalists - Internal Medicine Critical | 131679 | $1,432 |
| Tonsillectomy and adenoidectomy; age 12 or over Non-Facility Cardiovascular Thoracic Surgery | 131682 | $1,075 |
| Tonsillectomy, primary or secondary; age 12 or over Non-Facility Physical Medicine and Rehab | 131684 | $908 |
| Adenoidectomy, primary; younger than age 12 Non-Facility Midlevel | 131685 | $759 |
| Suture pharynx for wound or injury Non-Facility Critical Care Intensivists | 131697 | $1,163 |
| Pharyngoesophageal repair Non-Facility PCP and Mid-Levels | 131699 | $3,502 |
| Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization Non-Facility Neu | 131705 | $1,607 |
| Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplas | 131713 | $10,333 |
| Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, wi | 131720 | $9,875 |
| Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intes | 131722 | $15,516 |
| Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy Non-Facility Wound Care | 131723 | $13,142 |
| Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise) Non-Facility Hospitalists - Internal | 13173 | $13 |
| Esophagoscopy, flexible, transoral; with removal of foreign body(s) Non-Facility ICC | 131731 | $1,514 |
| Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire Non-Facility Specialists | 131736 | $1,482 |
| Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheterº | 131742 | $1,339 |
| Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biop | 131744 | $901 |
| Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s) Non-Facility Neurosur | 131762 | $1,245 |
| Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula Non-Facility Colon and Recta | 131771 | $3,828 |
| Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure) Non-Facility Cardio and Thoracic Surgery | 131776 | $4,816 |
| Esophagojejunostomy (without total gastrectomy); abdominal approach Non-Facility Cardiovascular Thoracic Surgery | 131778 | $4,889 |
| Suture of esophageal wound or injury; cervical approach Non-Facility Wound Care | 131786 | $3,612 |
| Dilation of esophagus, over guide wire Non-Facility Mid Levels | 131791 | $3,211 |
| Gastrotomy; with exploration or foreign body removal Non-Facility Colon and Rectal Surgery | 131797 | $2,792 |
| Gastrotomy; with suture repair of bleeding ulcer Non-Facility Trauma Critical Care | 131798 | $4,777 |
| Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss) Non-Facility Critical Care Intensivists | 131799 | $5,402 |
| Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseaux-Barbin) Non-Facility MD DO | 131800 | $3,383 |
| Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation) Non-Facility PCP and Mid-Levels | 131801 | $2,453 |
| Excision, local; ulcer or benign tumor of stomach Non-Facility Wound Care | 131803 | $3,465 |
| Gastrectomy, total; with Roux-en-Y reconstruction Non-Facility Mid Levels | 131806 | $7,987 |
| Gastrectomy, total; with formation of intestinal pouch, any type Non-Facility Trauma Critical Care | 131807 | $8,144 |
| Gastrectomy, partial, distal; with gastroduodenostomy Non-Facility Specialists | 131808 | $5,118 |
| Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective Non-Facility Internal Medicine | 131815 | $4,230 |
| Laparoscopy, surgical; transection of vagus nerves, truncal Non-Facility Wound Care | 131817 | $2,346 |
| Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure) Non-Facility Mid Levels | 131819 | $2,074 |
| Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and re | 131822 | $137 |
| Gastrojejunostomy; with vagotomy, any type Non-Facility Cardio and Thoracic Surgery | 131828 | $4,651 |
| Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate procedure) Non-Facility Internal Medicine | 131829 | $2,510 |
| Gastrostomy, open; neonatal, for feeding Non-Facility Neurosurgery | 131830 | $2,207 |
| Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure) Non-Facility Cardiovascular Thoracic Surgery | 131831 | $3,698 |
| Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; w | 131841 | $6,045 |
| Closure of gastrostomy, surgical Non-Facility MD DO | 131842 | $2,522 |
| Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy N | 131853 | $2,984 |
| Enterectomy, resection of small intestine; single resection and anastomosis Non-Facility ICC | 131855 | $4,303 |
| Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with ta | 131859 | $10,051 |
| Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure) Non-Facility MD DO | 131869 | $5,834 |
| Colectomy, partial; abdominal and transanal approach Non-Facility Wound Care | 131873 | $6,761 |
| Colectomy, partial, with removal of terminal ileum with ileocolostomy Non-Facility PCP and Mid-Levels | 131879 | $4,371 |
| Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis Non-Facility MD DO | 131882 | $4,885 |
| Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy Non-Facility Mid Levels | 131889 | $6,167 |
| Continent ileostomy (Kock procedure) (separate procedure) Non-Facility Midlevel | 131898 | $5,012 |
| Colostomy or skin level cecostomy; Non-Facility Mid Levels | 131899 | $4,228 |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other | 131907 | $700 |
| Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar | 131915 | $1,316 |
| Colonoscopy through stoma; with biopsy, single or multiple Non-Facility Physical Medicine and Rehab | 131923 | $1,566 |
| Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations Non-Facility | 131931 | $5,661 |
| Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with | 131933 | $4,571 |
| Closure of enteroenteric or enterocolic fistula Non-Facility Cardio and Thoracic Surgery | 131938 | $5,050 |
| Excision of lesion of mesentery (separate procedure) Non-Facility Critical Care Intensivists | 131946 | $3,030 |
| Incision and drainage of appendiceal abscess, open Non-Facility Trauma Critical Care | 131949 | $2,796 |
| Laparoscopy, surgical, appendectomy Non-Facility General Surgery | 131953 | $2,147 |
| Incision and drainage of submucosal abscess, rectum Non-Facility Colon and Rectal Surgery | 131955 | $1,218 |
| Biopsy of anorectal wall, anal approach (eg, congenital megacolon) Non-Facility Neurosurgery E&M | 131957 | $1,080 |
| Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis) Non-Facility Critical Care Intensivists | 131961 | $6,403 |
| Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies | 131967 | $6,188 |
| Proctosigmoidoscopy, rigid; with removal of foreign body Non-Facility Wound Care | 131980 | $817 |
| Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery Non-Facility Neur | 131981 | $785 |
| Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare techni | 131983 | $869 |
| Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma | 131984 | $826 |
| Sigmoidoscopy, flexible; with control of bleeding, any method Non-Facility Specialists | 131992 | $1,936 |
| Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s) Non-Facility Hosp | 131999 | $583 |
| Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Non-Facility General Surgery | 132008 | $1,692 |
| Colonoscopy, flexible; with transendoscopic balloon dilation Non-Facility MD DO | 132009 | $2,357 |
| Closure of rectovesical fistula; Non-Facility Midlevel | 132020 | $4,531 |
| Reduction of procidentia (separate procedure) under anesthesia Non-Facility Mid Levels | 132023 | $765 |
| Removal of anal seton, other marker Non-Facility PCP and Mid-Levels | 132028 | $978 |
| Incision and drainage, perianal abscess, superficial Non-Facility PCP and Mid-Levels | 132031 | $901 |
| Hemorrhoidectomy, internal and external, single column/group; Non-Facility Physical Medicine and Rehab | 132043 | $1,937 |
| Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) Non-Facility Speciali | 132055 | $460 |
| Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare te | 132063 | $680 |
| Repair of anal fistula with fibrin glue Non-Facility MD DO | 132066 | $645 |
| Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula Non-Facility Trauma Critical Care | 132068 | $4,436 |
| Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair) Non-Facility Neurosurgery E&M | 132080 | $3,212 |
| Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery Non-Facility Neuros | 132084 | $969 |
| Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance Non-Facility Neuro | 132095 | $1,238 |
| Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance Non-Facility | 132096 | $1,389 |
| Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages Non-Facility Specialists | 132099 | $4,316 |
| Hepatectomy, resection of liver; partial lobectomy Non-Facility Cardio and Thoracic Surgery | 132103 | $8,234 |
| Hepatectomy, resection of liver; total right lobectomy Non-Facility Physical Medicine and Rehab | 132106 | $11,598 |
| Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of l | 132114 | $10,590 |
| Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus Non-Facility Neurosurgery E&M | 132122 | $7,611 |
| Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi Non-Facility MD DO | 132137 | $1,803 |
| Cholecystectomy; Non-Facility Trauma Critical Care | 132147 | $3,793 |
| Portoenterostomy (eg, Kasai procedure) Non-Facility General Surgery | 132154 | $6,169 |
| Cholecystoenterostomy; with gastroenterostomy Non-Facility Colon and Rectal Surgery | 132160 | $4,823 |
| Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract Non-Facility Trauma Critical Care | 132163 | $7,933 |
| Suture of extrahepatic biliary duct for pre-existing injury (separate procedure) Non-Facility ICC | 132170 | $4,841 |
| Excision of ampulla of Vater Non-Facility PCP and Mid-Levels | 132182 | $4,448 |
| Pancreatectomy, total Non-Facility Mid Levels | 132187 | $6,455 |
| Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct Non-Facility Cardiovascular Thoracic Surgery | 132193 | $3,912 |
| Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open Non-Facility General Surgery | 132203 | $5,623 |
| Drainage of subdiaphragmatic or subphrenic abscess, open Non-Facility Midlevel | 132205 | $3,567 |
| Drainage of retroperitoneal abscess, open Non-Facility PCP and Mid-Levels | 132207 | $3,870 |
| Drainage of extraperitoneal lymphocele to peritoneal cavity, open Non-Facility Trauma Critical Care | 132209 | $2,734 |
| Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure) Non-Facility Trauma Critic | 132230 | $2,342 |
| Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated Non-Faci | 132242 | $2,171 |
| Repair initial inguinal hernia, age 5 years or older; reducible Non-Facility General Surgery | 132243 | $1,872 |
| Repair inguinal hernia, sliding, any age Non-Facility Neurosurgery E&M | 132247 | $2,050 |
| Repair lumbar hernia Non-Facility Wound Care | 132248 | $2,410 |
| Repair recurrent femoral hernia; reducible Non-Facility Specialists | 132251 | $2,164 |
| Repair of omphalocele (Gross type operation); second stage Non-Facility Mid Levels | 132268 | $2,190 |
| Laparoscopy, surgical; repair recurrent inguinal hernia Non-Facility Critical Care Intensivists | 132270 | $2,025 |
| Omental flap, intra-abdominal (List separately in addition to code for primary procedure) Non-Facility General Surgery | 132274 | $1,223 |
| Renal exploration, not necessitating other specific procedures Non-Facility General Surgery | 132277 | $2,425 |
| Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephros | 132286 | $2,968 |
| Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephros | 132287 | $4,360 |
| Transection or repositioning of aberrant renal vessels (separate procedure) Non-Facility Specialists | 132288 | $3,849 |
| Pyelotomy; with drainage, pyelostomy Non-Facility Cardio and Thoracic Surgery | 132290 | $3,362 |
| Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidn | 132296 | $4,121 |
| Nephrectomy with total ureterectomy and bladder cuff; through same incision Non-Facility Cardio and Thoracic Surgery | 132298 | $4,458 |
| Excision or unroofing of cyst(s) of kidney Non-Facility Neurosurgery | 132301 | $3,301 |
| Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral Non-Facility ICC | 132303 | $980 |
| Donor nephrectomy (including cold preservation); open, from living donor Non-Facility Cardio and Thoracic Surgery | 132304 | $5,416 |
| Renal allotransplantation, implantation of graft; without recipient nephrectomy Non-Facility Neurosurgery E&M | 132306 | $8,571 |
| Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous Non-Facility Physical Medicine and Rehab | 132310 | $320 |
| Nephrorrhaphy, suture of kidney wound or injury Non-Facility Specialists | 132319 | $4,385 |
| Laparoscopy, surgical; ablation of renal cysts Non-Facility General Surgery | 132324 | $3,131 |
| Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of | 132332 | $1,259 |
| Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of | 132333 | $1,350 |
| Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic se | 132341 | $1,900 |
| Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic se | 132343 | $1,895 |
| Lithotripsy, extracorporeal shock wave Non-Facility Specialists | 132346 | $2,645 |
| Ureterotomy with exploration or drainage (separate procedure) Non-Facility Physical Medicine and Rehab | 132347 | $3,202 |
| Ureterotomy for insertion of indwelling stent, all types Non-Facility Physical Medicine and Rehab | 132348 | $3,530 |
| Ureterolithotomy; lower one-third of ureter Non-Facility MD DO | 132351 | $3,051 |
| Ureterectomy, with bladder cuff (separate procedure) Non-Facility Specialists | 132352 | $3,556 |
| Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit Non-Facility Colon and Rectal Surgery | 132356 | $266 |
| Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service Non-Facility Critical Car | 132357 | $437 |
| Ureterolysis for ovarian vein syndrome Non-Facility Specialists | 132360 | $3,556 |
| Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava Non-Facility Trauma Critical Care | 132361 | $3,757 |
| Revision of urinary-cutaneous anastomosis (any type urostomy); Non-Facility Midlevel | 132362 | $1,781 |
| Ureterocalycostomy, anastomosis of ureter to renal calyx Non-Facility MD DO | 132365 | $3,930 |
| Transureteroureterostomy, anastomosis of ureter to contralateral ureter Non-Facility Colon and Rectal Surgery | 132367 | $3,930 |
| Ureteroenterostomy, direct anastomosis of ureter to intestine Non-Facility ICC | 132372 | $3,170 |
| Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or uretero | 132377 | $6,123 |
| Replacement of all or part of ureter by intestine segment, including intestine anastomosis Non-Facility Critical Care Intensivists | 132378 | $4,205 |
| Closure of ureterovisceral fistula (including visceral repair) Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 132383 | $3,756 |
| Deligation of ureter Non-Facility Internal Medicine | 132384 | $3,041 |
| Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; wi | 132396 | $1,209 |
| Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; wi | 132398 | $1,569 |
| Excision of urachal cyst or sinus, with or without umbilical hernia repair Non-Facility Midlevel | 132410 | $2,197 |
| Cystectomy, partial; simple Non-Facility Midlevel | 132415 | $3,309 |
| Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) Non-Facility MD DO | 132417 | $4,399 |
| Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes Non-Facility Intern | 132419 | $6,195 |
| Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or | 132425 | $7,825 |
| Injection procedure and placement of chain for contrast and/or chain urethrocystography Non-Facility Neurosurgery E&M | 132427 | $134 |
| Insertion of temporary indwelling bladder catheter; simple (eg, Foley) Non-Facility Cardio and Thoracic Surgery | 132431 | $229 |
| Change of cystostomy tube; complicated Non-Facility ICC | 132434 | $497 |
| Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck Non-Facility Midlevel | 132435 | $1,373 |
| Cystourethroplasty with unilateral or bilateral ureteroneocystostomy Non-Facility Internal Medicine | 132449 | $3,712 |
| Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) Non-Facility Cardiova | 132451 | $2,798 |
| Cystorrhaphy, suture of bladder wound, injury or rupture; simple Non-Facility Internal Medicine | 132453 | $2,593 |
| Cystorrhaphy, suture of bladder wound, injury or rupture; complicated Non-Facility ICC | 132454 | $3,096 |
| Closure of vesicouterine fistula; Non-Facility Physical Medicine and Rehab | 132457 | $2,623 |
| Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiol | 132468 | $1,431 |
| Cystourethroscopy, with biopsy(s) Non-Facility Neurosurgery | 132469 | $1,433 |
| Cystourethroscopy with direct vision internal urethrotomy Non-Facility Specialists | 132480 | $893 |
| Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus Non-Facility Trauma Critical Care | 132494 | $831 |
| Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion Non-Facility Crit | 132510 | $1,405 |
| Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra Non-Facility Colon and Rectal Surgery | 132526 | $515 |
| Drainage of perineal urinary extravasation; uncomplicated (separate procedure) Non-Facility Internal Medicine | 132532 | $1,458 |
| Excision or fulguration; urethral caruncle Non-Facility Physical Medicine and Rehab | 132543 | $812 |
| Excision or fulguration; urethral prolapse Non-Facility Neurosurgery | 132545 | $910 |
| Urethroplasty, 1-stage reconstruction of male anterior urethra Non-Facility Trauma Critical Care | 132548 | $3,357 |
| Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra Non-Facility Neurosurgery E | 132549 | $3,860 |
| Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage Non-Facility Wound Care | 132551 | $3,202 |
| Urethroplasty, reconstruction of female urethra Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 132552 | $3,346 |
| Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff Non-Facility Trauma Critical Care | 132558 | $2,218 |
| Urethrorrhaphy, suture of urethral wound or injury, female Non-Facility Neurosurgery E&M | 132564 | $1,679 |
| Urethrorrhaphy, suture of urethral wound or injury; perineal Non-Facility Trauma Critical Care | 132566 | $2,179 |
| Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) Non-Facility ICC | 132568 | $1,927 |
| Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent Non-Facility Neurosurgery E&M | 132569 | $303 |
| Dilation of female urethra including suppository and/or instillation; subsequent Non-Facility Cardio and Thoracic Surgery | 132574 | $268 |
| Dilation of female urethra, general or conduction (spinal) anesthesia Non-Facility Internal Medicine | 132575 | $130 |
| Transurethral destruction of prostate tissue; by radiofrequency thermotherapy Non-Facility Cardiovascular Thoracic Surgery | 132577 | $5,349 |
| Slitting of prepuce, dorsal or lateral (separate procedure); newborn Non-Facility Internal Medicine | 132580 | $594 |
| Slitting of prepuce, dorsal or lateral (separate procedure); except newborn Non-Facility Hospitalists - Internal Medicine Critical Care Neu | 132581 | $713 |
| Incision and drainage of penis, deep Non-Facility Internal Medicine | 132582 | $1,048 |
| Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosu | 132588 | $796 |
| Biopsy of penis; deep structures Non-Facility Cardio and Thoracic Surgery | 132590 | $983 |
| Excision of penile plaque (Peyronie disease); Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 132591 | $2,161 |
| Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length Non-Facility PCP and Mid-Levels | 132593 | $3,206 |
| Amputation of penis; partial Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 132595 | $2,178 |
| Injection procedure for corpora cavernosography Non-Facility Midlevel | 132607 | $377 |
| Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or | 132612 | $2,569 |
| 1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of uret | 132619 | $3,225 |
| 1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or isl | 132621 | $4,061 |
| Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release o | 132625 | $4,824 |
| Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the sam | 132639 | $3,083 |
| Orchiectomy, radical, for tumor; inguinal approach Non-Facility PCP and Mid-Levels | 132649 | $1,760 |
| Orchiectomy, radical, for tumor; with abdominal exploration Non-Facility Neurosurgery | 132650 | $2,554 |
| Exploration for undescended testis (inguinal or scrotal area) Non-Facility PCP and Mid-Levels | 132651 | $1,697 |
| Transplantation of testis(es) to thigh (because of scrotal destruction) Non-Facility Hospitalists - Internal Medicine Critical Care Neurosu | 132659 | $2,704 |
| Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) Non-Facility Wound Care | 132663 | $740 |
| Biopsy of epididymis, needle Non-Facility Cardio and Thoracic Surgery | 132664 | $425 |
| Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral Non-Facility MD DO | 132670 | $3,623 |
| Scrotal exploration Non-Facility Neurosurgery | 132676 | $1,353 |
| Resection of scrotum Non-Facility Neurosurgery E&M | 132678 | $1,719 |
| Excision of lesion of spermatic cord (separate procedure) Non-Facility General Surgery | 132686 | $1,642 |
| Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) Non-Facility Cardiovascular Thoracic Surgery | 132687 | $1,228 |
| Laparoscopy, surgical, with ligation of spermatic veins for varicocele Non-Facility Wound Care | 132690 | $1,488 |
| Vesiculectomy, any approach Non-Facility Internal Medicine | 132694 | $2,472 |
| Excision of Mullerian duct cyst Non-Facility Mid Levels | 132695 | $1,205 |
| Prostatectomy, perineal radical; Non-Facility Colon and Rectal Surgery | 132701 | $4,456 |
| Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethro | 132705 | $3,235 |
| Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) Non-Facility M | 132707 | $3,994 |
| Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastr | 132708 | $4,638 |
| Incision and drainage of Bartholin's gland abscess Non-Facility Physical Medicine and Rehab | 132720 | $699 |
| Marsupialization of Bartholin's gland cyst Non-Facility Colon and Rectal Surgery | 132721 | $635 |
| Lysis of labial adhesions Non-Facility Critical Care Intensivists | 132722 | $675 |
| Vulvectomy, radical, complete; Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 132732 | $4,339 |
| Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy Non-Facility MD DO | 132735 | $5,371 |
| Plastic repair of introitus Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 132739 | $896 |
| Clitoroplasty for intersex state Non-Facility Critical Care Intensivists | 132740 | $4,106 |
| Perineoplasty, repair of perineum, nonobstetrical (separate procedure) Non-Facility General Surgery | 132741 | $963 |
| Incision and drainage of vaginal hematoma; obstetrical/postpartum Non-Facility MD DO | 132747 | $647 |
| Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) Non-Facility General Surgery | 132749 | $910 |
| Vaginectomy, partial removal of vaginal wall; Non-Facility Internal Medicine | 132752 | $1,928 |
| Colpocleisis (Le Fort type) Non-Facility Physical Medicine and Rehab | 132758 | $1,884 |
| Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease Non-Facility ICC | 132761 | $221 |
| Diaphragm or cervical cap fitting with instructions Non-Facility Wound Care | 132764 | $284 |
| Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) Non-Facility Neurosurgery E&M | 132767 | $1,411 |
| Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) Non-Facility Specialists | 132768 | $1,245 |
| Plastic repair of urethrocele Non-Facility Specialists | 132769 | $1,495 |
| Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; Non-Facility General Surgery | 132771 | $2,738 |
| Repair of enterocele, vaginal approach (separate procedure) Non-Facility Specialists | 132773 | $1,806 |
| Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) Non-Facility Neurosurgery E&M | 132776 | $2,443 |
| Construction of artificial vagina; with graft Non-Facility Critical Care Intensivists | 132782 | $2,919 |
| Closure of rectovaginal fistula; abdominal approach Non-Facility Colon and Rectal Surgery | 132784 | $3,515 |
| Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication Non-Facility | 132786 | $2,330 |
| Pelvic examination under anesthesia (other than local) Non-Facility Neurosurgery E&M | 132792 | $368 |
| Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) Non-Facility Midlevel | 132793 | $628 |
| Colposcopy of the entire vagina, with cervix if present; Non-Facility Specialists | 132794 | $477 |
| Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix Non-Facility Colon and Rectal Surgery | 132795 | $641 |
| Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage Non-Facility PCP and Mid- | 132797 | $609 |
| Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision | 132808 | $1,105 |
| Excision of cervical stump, vaginal approach; with anterior and/or posterior repair Non-Facility Hospitalists - Internal Medicine Critical | 132814 | $2,195 |
| Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethr | 132826 | $4,335 |
| Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) Non-F | 132827 | $3,362 |
| Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with | 132830 | $10,308 |
| Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without e | 132834 | $3,764 |
| Removal of intrauterine device (IUD) Non-Facility Internal Medicine | 132845 | $404 |
| Artificial insemination; intra-cervical Non-Facility General Surgery | 132846 | $294 |
| Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography Non-Fa | 132849 | $956 |
| Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) Non-Facility Wound Care | 132865 | $985 |
| Hysteroscopy, surgical; with removal of impacted foreign body Non-Facility Mid Levels | 132868 | $1,621 |
| Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation) Non-Facility ICC | 132869 | $8,433 |
| Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral Non-Facility Specialists | 132872 | $1,313 |
| Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach Non-Facility Physical Medicine and Re | 132875 | $904 |
| Laparoscopy, surgical; with fulguration of oviducts (with or without transection) Non-Facility Neurosurgery | 132879 | $1,318 |
| Laparoscopy, surgical; with salpingostomy (salpingoneostomy) Non-Facility Neurosurgery E&M | 132881 | $2,777 |
| Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) Non-Facility Wound Care | 132883 | $2,833 |
| Lysis of adhesions (salpingolysis, ovariolysis) Non-Facility PCP and Mid-Levels | 132885 | $3,179 |
| Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only Non-Facility N | 132918 | $146 |
| Surgical treatment of ectopic pregnancy; abdominal pregnancy Non-Facility Critical Care Intensivists | 132922 | $3,364 |
| Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy Non-Facility Trauma Critical Care | 132927 | $2,757 |
| Episiotomy or vaginal repair, by other than attending Non-Facility Midlevel | 132930 | $852 |
| Hysterorrhaphy of ruptured uterus Non-Facility MD DO | 132933 | $969 |
| Delivery of placenta (separate procedure) Non-Facility Trauma Critical Care | 132938 | $314 |
| Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach Non-Facility Neurosurgery E&M | 132947 | $4,774 |
| Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial Non-Facility Mid Levels | 132951 | $403 |
| Exploration of orbit (transcranial approach), with removal of lesion Non-Facility Physical Medicine and Rehab | 132956 | $7,200 |
| Craniectomy, suboccipital; for exploration or decompression of cranial nerves Non-Facility Cardio and Thoracic Surgery | 132957 | $7,204 |
| Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior foss | 132960 | $10,937 |
| Craniectomy for craniosynostosis; multiple cranial sutures Non-Facility Wound Care | 132962 | $5,348 |
| Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) includ | 132965 | $11,421 |
| Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural N | 132970 | $7,707 |
| Surgery of intracranial arteriovenous malformation; supratentorial, complex Non-Facility Specialists | 132973 | $14,750 |
| Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery Non-Facil | 132980 | $9,283 |
| Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis Non-Facility ICC | 132981 | $9,081 |
| Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical Non-Facility Internal Medicine | 132985 | $5,603 |
| Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation Non-Facility Physical Me | 132989 | $3,998 |
| Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve Non-Facility Colon and Rectal Surgery | 133017 | $360 |
| Neuroplasty and/or transposition; ulnar nerve at wrist Non-Facility PCP and Mid-Levels | 133025 | $1,468 |
| Excision of neuroma; sciatic nerve Non-Facility Specialists | 133029 | $3,578 |
| Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection Non-Fa | 133038 | $2,319 |
| Use of ophthalmic endoscope (List separately in addition to code for primary procedure) Non-Facility Trauma Critical Care | 133040 | $300 |
| Intravitreal injection of a pharmacologic agent (separate procedure) Non-Facility General Surgery | 133042 | $397 |
| Fine needle aspiration of orbital contents Non-Facility Cardiovascular Thoracic Surgery | 133052 | $348 |
| Orbital implant (implant outside muscle cone); removal or revision Non-Facility Wound Care | 133054 | $3,983 |
| Excision of lesion, conjunctiva; with adjacent sclera Non-Facility Neurosurgery | 133066 | $1,999 |
| Biopsy external auditory canal Non-Facility General Surgery | 133072 | $548 |
| Ventilating tube removal requiring general anesthesia Non-Facility Cardiovascular Thoracic Surgery | 133075 | $483 |
| Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia Non-Facility General Surgery | 133076 | $747 |
| Excision aural polyp Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 133078 | $797 |
| Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with | 133082 | $5,164 |
| Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with | 133083 | $5,277 |
| Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction | 133084 | $4,842 |
| Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular | 133088 | $5,725 |
| Stapes mobilization Non-Facility Midlevel | 133089 | $2,918 |
| Revision of stapedectomy or stapedotomy Non-Facility Neurosurgery E&M | 133092 | $4,164 |
| Repair round window fistula Non-Facility MD DO | 133094 | $2,934 |
| Mastoid obliteration (separate procedure) Non-Facility Trauma Critical Care | 133095 | $3,431 |
| Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor Non-Facility MD DO | 133099 | $2,311 |
| Labyrinthectomy; with mastoidectomy Non-Facility Internal Medicine | 133114 | $3,548 |
| Cochlear device implantation, with or without mastoidectomy Non-Facility Neurosurgery | 133116 | $4,337 |
| Total facial nerve decompression and/or repair (may include graft) Non-Facility ICC | 133119 | $6,980 |
| Decompression internal auditory canal Non-Facility Physical Medicine and Rehab | 133120 | $6,656 |
| Removal of tumor, temporal bone Non-Facility Physical Medicine and Rehab | 133121 | $7,535 |
| Therapeutic radiology treatment planning; simple Non-Facility Neurosurgery | 133557 | $243 |
| Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of pat | 133578 | $313 |
| Urea breath test, C-14 (isotopic); acquisition for analysis Non-Facility Critical Care Intensivists | 133666 | $34 |
| Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC count (85025 or | 133775 | $144 |
| Phenytoin; free Non-Facility Critical Care Intensivists | 133803 | $42 |
| Theophylline Non-Facility PCP and Mid-Levels | 133810 | $43 |
| Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total (82670 x 2 on 3 pooled | 133821 | $168 |
| Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) Non-Facility PCP and Mid-Levels | 133834 | $274 |
| Urinalysis; qualitative or semiquantitative, except immunoassays Non-Facility Specialists | 133840 | $7 |
| Urinalysis; microscopic only Non-Facility Critical Care Intensivists | 133842 | $10 |
| Alpha-fetoprotein (AFP); serum Non-Facility Midlevel | 133866 | $51 |
| Amino acids; single, quantitative, each specimen Non-Facility Midlevel | 133872 | $69 |
| Ascorbic acid (Vitamin C), blood Non-facility All Other Specialists | 133887 | $30 |
| Calculus; qualitative analysis Non-Facility Specialists | 133907 | $35 |
| Carboxyhemoglobin; qualitative Non-Facility ICC | 133914 | $43 |
| Catecholamines; blood Non-facility All Other Specialists | 133919 | $88 |
| Chloramphenicol Non-Facility Midlevel | 133924 | $39 |
| Chloride; other source Non-Facility ICC | 133927 | $15 |
| Creatine Non-Facility Midlevel | 133947 | $14 |
| Column chromatography, includes mass spectrometry, if performed (eg, HPLC, LC, LC/MS, LC/MS-MS, GC, GC/MS-MS, GC/MS, HPLC/MS), non-drug anal | 133949 | $73 |
| Cyanide Non-Facility ICC | 133961 | $59 |
| Electrophoretic technique, not elsewhere specified Non-Facility Critical Care Intensivists | 133976 | $185 |
| Erythropoietin Non-Facility PCP and Mid-Levels | 133978 | $57 |
| Estradiol; total Non-Facility Critical Care Intensivists | 133979 | $84 |
| Fluoride Non-Facility Midlevel | 133994 | $56 |
| Glucose; blood, reagent strip Non-Facility ICC | 134019 | $16 |
| Glucose-6-phosphate dehydrogenase (G6PD); quantitative Non-Facility ICC | 134023 | $30 |
| Glucosidase, beta Non-Facility Midlevel | 134026 | $65 |
| Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes Non-Facility PCP | 134042 | $63 |
| Hemoglobin; F (fetal), chemical Non-Facility Critical Care Intensivists | 134047 | $33 |
| Homovanillic acid (HVA) Non-Facility Midlevel | 134063 | $68 |
| Hydroxyproline; total Non-Facility Critical Care Intensivists | 134069 | $73 |
| Iron Non-Facility Critical Care Intensivists | 134077 | $20 |
| Isocitric dehydrogenase (IDH) Non-facility All Other Specialists | 134079 | $27 |
| Ketosteroids, 17- (17-KS); fractionation Non-Facility Specialists | 134082 | $86 |
| pH; body fluid, not otherwise specified Non-Facility Midlevel | 134146 | $11 |
| Protein, total, by refractometry, any source Non-Facility PCP and Mid-Levels | 134178 | $17 |
| Sodium; other source Non-facility All Other Specialists | 134200 | $15 |
| Somatostatin Non-Facility Critical Care Intensivists | 134202 | $55 |
| Thiamine (Vitamin B-1) Non-Facility Specialists | 134213 | $64 |
| Transferase; alanine amino (ALT) (SGPT) Non-Facility Specialists | 134223 | $16 |
| Trypsin; duodenal fluid Non-Facility Critical Care Intensivists | 134231 | $22 |
| Vitamin K Non-Facility PCP and Mid-Levels | 134250 | $42 |
| Blood count; red blood cell (RBC), automated Non-facility All Other Specialists | 134265 | $10 |
| Blood count; leukocyte (WBC), automated Non-Facility PCP and Mid-Levels | 134269 | $8 |
| Bone marrow, smear interpretation Non-Facility Cardio and Thoracic Surgery | 134272 | $241 |
| Clotting; factor VII (proconvertin, stable factor) Non-Facility Midlevel | 134278 | $54 |
| Clotting; prekallikrein assay (Fletcher factor assay) Non-facility All Other Specialists | 134290 | $57 |
| Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative Non-Facility Critical Care Intensivists | 134302 | $21 |
| Fibrin degradation products, D-dimer; quantitative Non-Facility Critical Care Intensivists | 134306 | $31 |
| Russell viper venom time (includes venom); undiluted Non-Facility PCP and Mid-Levels | 134331 | $53 |
| Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each Non-facility All Other Specialists | 134346 | $16 |
| Immunoassay for infectious agent antibody, quantitative, not otherwise specified Non-Facility Critical Care Intensivists | 134388 | $45 |
| Microsomal antibodies (eg, thyroid or liver-kidney), each Non-Facility Midlevel | 134406 | $44 |
| Antibody; encephalitis, Western equine Non-Facility PCP and Mid-Levels | 134444 | $40 |
| Antibody; influenza virus Non-Facility Specialists | 134472 | $41 |
| Antibody; Leishmania Non-Facility Critical Care Intensivists | 134473 | $37 |
| HLA typing; DR/DQ, single antigen Non-facility All Other Specialists | 134483 | $91 |
| Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types Non-Fac | 134507 | $17 |
| Infectious agent antigen detection by immunofluorescent technique; cryptosporidium Non-Facility ICC | 134509 | $36 |
| Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique Non-Facility ICC | 134540 | $81 |
| Chromosome analysis; analyze 20-25 cells Non-Facility ICC | 134560 | $434 |
| Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use Non-facility Midlevel | 134589 | $66 |
| Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech Non-Facility Trauma Critical Care | 134629 | $250 |
| Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise) Non-Facility Hospitalists - Internal | 134695 | $13 |
| Direct nasal mucous membrane test Non-Facility Critical Care Intensivists | 134707 | $103 |
| Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 s | 134724 | $455 |
| Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or othe | 134729 | $563 |
| Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine) Non-Facility Wo | 134749 | $76 |
| Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side Non-Facility PCP and Mid-Le | 134750 | $64 |
| Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact groupºs», interleaving, amplitude, pulse width, fr | 134790 | $198 |
| Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles Non-Facility Wound Care | 134798 | $75 |
| Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech producti | 134802 | $339 |
| Chemotherapy administration into pleural cavity, requiring and including thoracentesis Non-Facility Midlevel | 134823 | $2,947 |
| Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm Non-Facility Critical Care Intensivists | 134840 | $631 |
| Application of a modality to 1 or more areas; vasopneumatic devices Non-Facility ICC | 134851 | $42 |
| Unlisted modality (specify type and time if constant attendance) Non-Facility Midlevel | 134861 | $45 |
| Unlisted therapeutic procedure (specify) Non-Facility Trauma Critical Care | 134867 | $61 |
| Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes | 134872 | $133 |
| Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modifi | 134875 | $112 |
| Wheelchair management (eg, assessment, fitting, training), each 15 minutes Non-Facility Trauma Critical Care | 134876 | $112 |
| Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, | 134880 | $95 |
| Chiropractic manipulative treatment (CMT); spinal, 1-2 regions Non-Facility Physical Medicine and Rehab | 134893 | $96 |
| Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions Non-Facility Neurology | 134895 | $92 |
| Handling and/or conveyance of specimen for transfer from the office to a laboratory Non-Facility Specialists | 134896 | $12 |
| Screening test of visual acuity, quantitative, bilateral Non-Facility Critical Care Intensivists | 134917 | $12 |
| Aortography, thoracic, without serialography, radiological supervision and interpretation Non-Facility Hospitalists - Internal Medicine Cri | 13534 | $7,318 |
| Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist Non-facility Midlevel | 135839 | $156 |
| Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk Non-Facility Internal Medicine | 135841 | $1,267 |
| Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by phy | 135849 | $79 |
| Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medic | 135906 | $60 |
| Injection, baclofen, 50 mcg for intrathecal trial Non-Facility All Other Specialists | 136018 | $161 |
| Injection, onabotulinumtoxina, 1 unit Non-Facility Neurology | 136027 | $19 |
| Injection, buprenorphine hydrochloride, 0.1 mg Non-Facility Specialists | 136029 | $13 |
| Injection, leucovorin calcium, per 50 mg Non-Facility ICC | 136036 | $13 |
| Injection, cefoxitin sodium, 1 gm Non-Facility ICC | 136040 | $16 |
| Injection, depo-estradiol cypionate, up to 5 mg Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 136067 | $80 |
| Injection, acetazolamide sodium, up to 500 mg Non-Facility All Other Specialists | 136080 | $68 |
| Injection, digoxin, up to 0.5 mg Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 136081 | $62 |
| Injection, methadone hcl, up to 10 mg Non-Facility Cardiovascular Thoracic Surgery | 136089 | $49 |
| Injection, doxercalciferol, 1 mcg Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 136093 | $1 |
| Injection, haloperidol decanoate, per 50 mg Non-Facility Wound Care | 136132 | $24 |
| Injection, heparin sodium, per 1000 units Non-Facility Cardiovascular Thoracic Surgery | 136134 | $1 |
| Injection, fondaparinux sodium, 0.5 mg Non-Facility Cardiovascular Thoracic Surgery | 136137 | $4 |
| Injection, infliximab, excludes biosimilar, 10 mg Non-Facility All Other Specialists | 136145 | $106 |
| Injection, lincomycin hcl, up to 300 mg Non-Facility All Other Specialists | 136169 | $30 |
| Injection, mannitol, 25% in 50 ml Non-Facility ICC | 136172 | $14 |
| Injection, morphine sulfate, up to 10 mg Non-Facility Injectable and Immunization | 136178 | $9 |
| Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) Non-Facility All Other Specialists | 136201 | $5 |
| Injection, oxacillin sodium, up to 250 mg Non-Facility All Other Specialists | 136211 | $4 |
| Injection, phentolamine mesylate, up to 5 mg Non-Facility Cardiovascular Thoracic Surgery | 136216 | $1,241 |
| Injection, trimethobenzamide hcl, up to 200 mg Non-Facility Wound Care | 136248 | $129 |
| Injection, magnesium sulfate, per 500 mg Non-facility Midlevel | 136270 | $3 |
| Infusion, normal saline solution, 250 cc Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 136282 | $3 |
| Intrauterine copper contraceptive (paragard) Non-Facility Specialists | 136299 | $3,185 |
| Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams N | 136352 | $70 |
| Injection, carboplatin, 50 mg Non-facility Midlevel | 136375 | $9 |
| Leuprolide acetate (for depot suspension), 7.5 mg Non-Facility Neurology | 136417 | $500 |
| Injection, vinblastine sulfate, 1 mg Non-Facility Specialists | 136439 | $12 |
| Injection, vinorelbine tartrate, 10 mg Non-Facility ICC | 136443 | $28 |
| Hair analysis (excluding arsenic) Non-Facility PCP and Mid-Levels | 137484 | $15 |
| Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician Non-facility Midlevel | 137488 | $79 |
| Infusion, albumin (human), 5%, 250 ml Non-facility Midlevel | 137513 | $158 |
| Catheterization for collection of specimen(s) (multiple patients) Non-Facility PCP and Mid-Levels | 137521 | $9 |
| Post-coital direct, qualitative examinations of vaginal or cervical mucous Non-Facility Critical Care Intensivists | 137534 | $75 |
| Cast supplies, short arm cast, pediatric (0-10 years), plaster Non-Facility Critical Care Intensivists | 137613 | $15 |
| Cast supplies, long leg cast, adult (11 years +), fiberglass Non-Facility PCP and Mid-Levels | 137632 | $250 |
| STENT VERIFLEX OTW 4.0 X 28MM | 14000 | $2,302 |
| Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combinatio | 140689 | $60 |
| Injection, mycophenolate mofetil, 10 mg Non-Facility Midlevel | 145520 | $2 |
| Injection, calaspargase pegol-mknl, 10 units Non-Facility Neurology | 145549 | $219 |
| Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use Non-Facility Injectable and Immunizat | 145557 | $1,782 |
| Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traum | 145683 | $12,452 |
| Acetylcholine receptor (AChR); binding antibody Non-Facility Mid Levels | 145688 | $1,635 |
| Anti-mullerian hormone (AMH) Non-Facility Trauma Critical Care | 145823 | $928 |
| Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use | 145926 | $115 |
| Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use Non-facility Midlevel | 145927 | $66 |
| Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg Non-Facility Wound Care | 145961 | $577 |
| Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) Non-Facility Neurology | 146035 | $453 |
| Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use | 146038 | $1,804 |
| Injection, lidocaine hcl in 5% dextrose, 1 mg Non-Facility | 146048 | $54 |
| Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams N | 14671 | $70 |
| Vasoreactivity study performed with transcranial Doppler study of intracranial arteries, complete (List separately in addition to code for p | 147420 | $1,319 |
| Injection, famotidine, 0.25 mg Non-Facility Cardiovascular Thoracic Surgery | 147481 | $1 |
| Injection, metoprolol tartrate, 1 mg Non-facility | 147508 | $8 |
| Injection, metoprolol tartrate, 1 mg Non-facility | 147508 | $8 |
| Injection, carboprost tromethamine, 0.1 mg Non-facility | 147838 | $1,159 |
| Injection, hyaluronidase, recombinant, 1 usp unit Non-facility Midlevel | 147842 | $2 |
| Granulocytes, pheresis, each unit Non-facility | 1485 | $4,716 |
| HARVEST CULTURED SKIN GRAFT | 15040 | $983 |
| SKIN SPLT GRFT TRNK/ARM/LEG | 15100 | $3,150 |
| EPIDRM A-GRFT FACE/NCK/HF/G | 15115 | $2,862 |
| DERM AUTOGRAFT TRNK/ARM/LEG | 15130 | $2,631 |
| Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm | 15136 | $338 |
| SKIN FULL GRAFT ADD-ON | 15261 | $747 |
| AP SK HI GR F/N/G<100 1ST | 15275 | $577 |
| AP SK HI GR F/N/G<100 ADD | 15276 | $116 |
| SKIN PEDICLE FLAP TRUNK | 15570 | $3,294 |
| PEDCLE FH/CH/CH/M/N/AX/G/H/F | 15574 | $3,157 |
| DELAY FLAP TRUNK | 15600 | $1,258 |
| MUSCLE-SKIN GRAFT ARM | 15736 | $4,311 |
| DERMA-FAT-FASCIA GRAFT | 15770 | $2,379 |
| MESH PROLENE 3D LARGE PRESHAPED | 15773 | $2,175 |
| DERMABRASION OTHER THAN FACE | 15782 | $1,755 |
| BUR FORMULA AGGRESSIVE PLUS 4.0MM | 15789 | $1,919 |
| BUR FORMULA AUGER 5.0MM | 15792 | $1,238 |
| ELECTRODE LEEP 3MM X 12CM | 15823 | $2,220 |
| STAPLER SKIN PROXIMA TE ROTATING HEAD DISP 35 REG STERILE | 15830 | $4,145 |
| TROCAR THORACOPORT 5.5MM DISP | 15833 | $3,112 |
| TROCAR ENDOPATH HASSON BLUNT 12MM X 100MM | 15834 | $3,169 |
| TROCAR FLEXIPATH 15MM | 15835 | $3,296 |
| GRASPER ENDO RATCHET HANDLE 5MM | 15837 | $3,127 |
| Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code) Non-Facility Midlevel | 15854 | $60 |
| CATH THORACIC W/CLOT STOP 32F STRGT | 15920 | $2,301 |
| KIT WOUND DRAINAGE PETITE 11FR 10CC | 15922 | $2,845 |
| CLAMP VASCULAR VESSEL YELLOW 60G LARGE 2-4MM VEIN | 15933 | $3,123 |
| CAUTERY EYE ACCU-TEMP LO-TEMP 0.5IN FINE TIP STERILE | 15941 | $3,332 |
| REMOVE HIP PRESSURE SORE | 15945 | $3,628 |
| SYSTEM BILIARY RAPID EXCHANGE LOCKING DEVICE AND BIOPSY CAP | 15951 | $3,216 |
| INITIAL TREATMENT OF BURN(S) | 16000 | $273 |
| DRESS/DEBR BURN SMALL | 16020 | $310 |
| Intra-atrial recording Non-Facility ICC | 16135 | $17,556 |
| Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure) Non-Facility | 16426 | $50,326 |
| STAPLER DST EEA 28MM | 17106 | $1,228 |
| DESTRUCTION OF SKIN LESIONS | 17108 | $2,246 |
| Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has | 171886 | $104 |
| Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumo | 172493 | $13,781 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe ( | 172498 | $228 |
| Bypass graft, with vein; axillary-brachial Non-Facility ICC | 172503 | $3,996 |
| Bypass graft, with vein; brachial-brachial Non-Facility MD DO | 172504 | $3,888 |
| Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age Non-Facility Critical Care Intensivists | 172506 | $702 |
| Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age Non-Facility Cri | 172510 | $4,856 |
| Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without sub | 172513 | $3,175 |
| Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site Non-Facil | 172521 | $1,664 |
| Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access No | 172524 | $3,435 |
| Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access No | 172525 | $4,536 |
| Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion Non-Facility MD DO | 172529 | $806 |
| Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access Non-Facil | 172530 | $2,294 |
| Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III) Non-Facility Critical C | 172538 | $12,596 |
| Fetal umbilical cord occlusion, including ultrasound guidance Non-Facility Midlevel | 172544 | $1,816 |
| Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surge | 172549 | $7,778 |
| Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/o | 172557 | $8,043 |
| Injection, anesthetic agent; superior hypogastric plexus Non-Facility Trauma Critical Care | 172560 | $699 |
| Harvesting conjunctival allograft, living donor Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 172566 | $1,439 |
| Infectious agent antigen detection by immunofluorescent technique; giardia Non-Facility Critical Care Intensivists | 172582 | $41 |
| Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use | 172609 | $115 |
| DESTRUCTION OF SKIN LESIONS | 17262 | $651 |
| PROSTHESIS SHEEHY POP POLYCEL 4.75MM | 17270 | $540 |
| IMPLANT SHEEY TOP HYDROXY-POLYCEL | 17272 | $686 |
| DESTRUCTION OF SKIN LESIONS | 17273 | $756 |
| DESTRUCTION OF SKIN LESIONS | 17274 | $880 |
| DESTRUCTION OF SKIN LESIONS | 17281 | $652 |
| MOHS SURG ADDL BLOCK | 17315 | $276 |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and | 17563 | $10,794 |
| Digital analysis of electroencephalogram (EEG) (eg, for epileptic spike analysis) Non-Facility All Other Specialists | 17566 | $2,641 |
| Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum Non-Faci | 186525 | $1,963 |
| Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial c | 186526 | $2,695 |
| Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue | 186528 | $951 |
| Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) Non-Facility Colon and Rectal Surgery | 186535 | $4,539 |
| Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; | 186538 | $1,887 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/br | 186540 | $737 |
| Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequen | 186552 | $1,123 |
| Removal of transplanted intestinal allograft, complete Non-Facility MD DO | 186560 | $5,570 |
| Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling Non-Facility Trauma Critical Care | 186566 | $1,391 |
| Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and | 186569 | $1,587 |
| Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for prim | 186588 | $1,155 |
| Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition | 186615 | $83 |
| Flow cytometry, interpretation; 2 to 8 markers Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 186616 | $120 |
| Flow cytometry, interpretation; 9 to 15 markers Non-Facility ICC | 186617 | $212 |
| Evaluation of central auditory function, with report; initial 60 minutes Non-Facility PCP and Mid-Levels | 186633 | $318 |
| Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, ( | 186647 | $165 |
| Laparotomy for islet cell transplant, includes portal vein catheterization and infusion Non-Facility Physical Medicine and Rehab | 187153 | $4,405 |
| Injection, tirofiban hcl, 0.25 mg Non-Facility ICC | 187210 | $14 |
| Mycophenolic acid, oral, 180 mg Non-Facility Cardiovascular Thoracic Surgery | 187215 | $4 |
| INCISION OF BREAST LESION | 19020 | $1,752 |
| COIL EMBOLIZATION TARGET HELICAL ULTRA 2MM X 3CM | 19082 | $1,513 |
| CRYOSURG ABLATE FA EACH | 19105 | $9,335 |
| REMOVAL OF BREAST LESION | 19120 | $1,891 |
| PLC BRST LC DV MAM 1ST UN | 19281 | $884 |
| REMOVAL OF BREAST TISSUE | 19300 | $2,162 |
| MAST RAD URBAN TYPE | 19306 | $4,380 |
| MAST MOD RAD | 19307 | $4,216 |
| BREAST REDUCTION | 19318 | $3,864 |
| REMOVAL OF BREAST IMPLANT | 19328 | $1,973 |
| IMMEDIATE BREAST PROSTHESIS | 19340 | $2,694 |
| DELAYED BREAST PROSTHESIS | 19342 | $2,704 |
| BREAST RECONSTRUCTION | 19357 | $4,141 |
| BREAST RECONSTRUCTION | 19369 | $7,099 |
| CABLE TEMP PACING LEAD ATRIAL BLUE | 19371 | $2,525 |
| Anesthesia for incomplete or missed abortion procedures Non-Facility Specialists | 196402 | $72 |
| Harvest of skin for tissue cultured skin autograft, 100 sq cm or less Non-Facility Neurosurgery | 196408 | $983 |
| Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or les | 196411 | $2,862 |
| Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children Non-Facility Neurology | 196413 | $2,631 |
| Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm | 196416 | $338 |
| Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy Non-Facility Hospitalists - I | 196446 | $4,145 |
| Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens | 196452 | $276 |
| Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma Non-Facility Wound Care | 196453 | $9,335 |
| Mastectomy for gynecomastia Non-Facility General Surgery | 196454 | $2,162 |
| Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (Urban type operation) Non-Facility Cardiovascul | 196460 | $4,380 |
| Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle | 196461 | $4,216 |
| Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); sin | 196469 | $6,229 |
| Excision of tendon, forearm and/or wrist, flexor or extensor, each Non-Facility Cardiovascular Thoracic Surgery | 196472 | $1,925 |
| Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments Non-Facili | 196476 | $3,752 |
| Neurectomy, intrinsic musculature of foot Non-Facility General Surgery | 196479 | $1,326 |
| Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other tha | 196480 | $1,106 |
| Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when per | 196482 | $7,064 |
| Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach) Non-Facility General Surgery | 196484 | $2,680 |
| Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass | 196490 | $6,357 |
| Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset Non-Facility General Surgery | 196495 | $7,230 |
| Anastomosis, cavopulmonary, second superior vena cava (List separately in addition to primary procedure) Non-Facility Hospitalists - Intern | 196498 | $1,424 |
| Delayed placement of proximal extension prosthesis(es) not involving coverage of the left subclavian artery origin, after endovascular repai | 196501 | $3,812 |
| Bypass graft, with vein; aortoiliac Non-Facility Critical Care Intensivists | 196513 | $7,100 |
| Bypass graft, with vein; aortobifemoral Non-Facility Midlevel | 196516 | $8,317 |
| Bypass graft, with other than vein; aortoiliac Non-Facility ICC | 196517 | $5,657 |
| Bypass graft, with other than vein; aortobi-iliac Non-Facility Colon and Rectal Surgery | 196518 | $5,938 |
| Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluor | 196522 | $6,691 |
| Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only Non-Facility Midlevel | 196541 | $1,681 |
| Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) Non-Facility MD DO | 196544 | $3,254 |
| Laparoscopy, surgical, colostomy or skin level cecostomy Non-Facility Critical Care Intensivists | 196547 | $4,296 |
| Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic Non-Facility Cardio and Thoracic Surgery | 196555 | $366 |
| Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) Non-Facility Mid Levels | 196561 | $5,921 |
| Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, incl | 196571 | $2,196 |
| Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency Non-Facility MD DO | 196573 | $11,233 |
| Revision (including removal) of prosthetic vaginal graft; vaginal approach Non-Facility Neurosurgery E&M | 196579 | $1,779 |
| Revision (including removal) of prosthetic vaginal graft; open abdominal approach Non-Facility Colon and Rectal Surgery | 196580 | $3,367 |
| Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure) Non-Faci | 196582 | $177 |
| Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; Non-Facility Neurosurgery | 196585 | $2,966 |
| Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), | 196587 | $6,593 |
| Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition t | 196593 | $554 |
| Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve Non-Facility ICC | 196598 | $3,649 |
| Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; mu | 196648 | $4,693 |
| Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire cour | 196654 | $2,188 |
| Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein pa | 196665 | $103 |
| Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); ea | 196713 | $73 |
| Diagnostic analysis with programming of auditory brainstem implant, per hour Non-Facility Hospitalists - Internal Medicine Critical Care Ne | 196716 | $389 |
| Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpati | 196717 | $310 |
| Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpati | 196718 | $219 |
| Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; nursing facilit | 196719 | $163 |
| Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpr | 196729 | $118 |
| Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, ºeg, acquired knowledge, attention, language, memory, | 196739 | $321 |
| Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure | 196748 | $107 |
| Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Non-Facility Neurology | 196756 | $149 |
| Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, fac | 196758 | $110 |
| Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries Non-facility Midlevel | 197055 | $147 |
| Physician service required to establish and document the need for a power mobility device Non-Facility Critical Care Intensivists | 197166 | $31 |
| Injection, basiliximab, 20 mg Non-facility Midlevel | 197505 | $12,308 |
| Injection, palifermin, 50 micrograms Non-facility Midlevel | 197532 | $76 |
| Injection, hyaluronidase, recombinant, 1 usp unit Non-facility Midlevel | 197543 | $2 |
| Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram Non-Facility Wound Care | 197545 | $8 |
| MUSCLE BIOPSY | 20200 | $827 |
| DEEP MUSCLE BIOPSY | 20205 | $1,140 |
| BONE BIOPSY OPEN DEEP | 20245 | $1,205 |
| OPEN BONE BIOPSY | 20251 | $1,511 |
| Injection, basiliximab, 20 mg Non-facility Midlevel | 20391 | $12,308 |
| PLATE ZED RT OSTEOMED 9MM | 20501 | $554 |
| PLATE BSSO 4-HL LONG OSTEOMED | 20520 | $800 |
| PLATE BSSO 6-HL MED OSTEOMED | 20525 | $1,735 |
| PLATE FRACT LCKG MFX 3 X 3-HL OSTEOMED | 20550 | $205 |
| Placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application (at the time of or sub | 205504 | $1,140 |
| Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic | 205509 | $8,676 |
| Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar N | 205510 | $8,484 |
| Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed Non-Facility Internal Medicine | 205517 | $4,381 |
| Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograftºs») Non-Facility Internal Medicine | 205518 | $3,487 |
| Closed treatment of posterior malleolus fracture; with manipulation Non-Facility MD DO | 205521 | $1,629 |
| Arthroscopy, shoulder, surgical; biceps tenodesis Non-Facility MD DO | 205524 | $3,260 |
| Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodel | 205537 | $11,058 |
| Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified Non-Facility Cardio and Thor | 205541 | $113 |
| Declotting by thrombolytic agent of implanted vascular access device or catheter Non-Facility Neurology | 205542 | $125 |
| SCREW STD LCK ANGL MFX 2 X 6MM OSTEOMED | 20555 | $1,140 |
| Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and r | 205553 | $3,040 |
| Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or o | 205555 | $515 |
| Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiologi | 205557 | $2,908 |
| Aspiration of bladder; with insertion of suprapubic catheter Non-Facility Colon and Rectal Surgery | 205561 | $879 |
| Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystoureth | 205562 | $2,835 |
| Aspiration and/or injection, thyroid cyst Non-Facility Neurology | 205570 | $396 |
| Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic | 205572 | $3,938 |
| Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, | 205573 | $4,149 |
| Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed fro | 205575 | $3,998 |
| Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use | 205598 | $210 |
| Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; par | 205615 | $126 |
| Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; par | 205616 | $83 |
| Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes Non-Facility ICC | 205618 | $65 |
| Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes Non | 205817 | $122 |
| Injection, ranibizumab, 0.1 mg Non-Facility Neurology | 205944 | $776 |
| Histrelin implant (supprelin la), 50 mg Non-Facility Injectable and Immunization | 205963 | $114,807 |
| APPLICATION OF THIGH BRACE | 20663 | $1,728 |
| PLATE PROFILE ZERO BUR HOLE SMALL 14.5MM OSTEOMED | 20700 | $296 |
| REPLANTATION FOOT COMPLETE | 20838 | $9,815 |
| SCREW 4.0MM TI LCKG SLF-TPG 40MM | 20900 | $1,460 |
| SCREW 4.0MM TI LCKG SLF-TPG 44MM | 20902 | $968 |
| REMOVAL OF FASCIA FOR GRAFT | 20922 | $2,175 |
| STENT PANCREATIC ZIMMON GREEN 3F X 10CM (SPSOS-3-10-N) | 20938 | $646 |
| BONE MARROW ASPIR BONE GRFG | 20939 | $244 |
| FIBULA BONE GRAFT MICROVASC | 20955 | $8,615 |
| CATH IKARI 6F IL4 LT | 20962 | $9,406 |
| BONE/SKIN GRAFT MICROVASC | 20969 | $9,451 |
| BONE/SKIN GRAFT METATARSAL | 20972 | $9,977 |
| ABLATE BONE TUMOR(S) PERQ | 20982 | $13,781 |
| SCREW 2.7MM CORT SLF-TPG T8 STRDR RE 42MM | 21013 | $1,960 |
| SCREW 3.5MM PELVIC CORTEX SLF-TPG 90MM | 21031 | $1,409 |
| SCREW 3.5MM PELVIC CORTEX SLF-TPG 135MM | 21040 | $1,697 |
| PREPARE FACE/ORAL PROSTHESIS | 21080 | $5,856 |
| PREPARE FACE/ORAL PROSTHESIS | 21083 | $4,726 |
| PREPARE FACE/ORAL PROSTHESIS | 21086 | $5,472 |
| MAXILLOFACIAL FIXATION | 21100 | $2,299 |
| SCREW 4.0MM CANC BONE P/T 28MM | 21110 | $3,242 |
| RECONSTRUCTION OF CHIN | 21121 | $2,267 |
| AUGMENTATION LOWER JAW BONE | 21127 | $15,637 |
| LEFORT I-1 PIECE W/O GRAFT | 21141 | $4,688 |
| LEFORT III W/ LEFORT I | 21155 | $7,560 |
| RECONSTRUCTION OF MIDFACE | 21188 | $5,577 |
| RECONST LWR JAW W/O FIXATION | 21195 | $4,745 |
| RECONST LWR JAW W/FIXATION | 21196 | $5,064 |
| RECONSTR LWR JAW SEGMENT | 21198 | $3,646 |
| EAR CARTILAGE GRAFT | 21235 | $2,653 |
| RECONSTRUCTION OF JAW | 21245 | $4,250 |
| RECONSTRUCTION OF JAW | 21249 | $4,730 |
| REVISE EYE SOCKETS | 21261 | $8,631 |
| REVISE EYE SOCKETS | 21268 | $7,176 |
| AUGMENTATION CHEEK BONE | 21270 | $3,661 |
| REVISION OF JAW MUSCLE/BONE | 21295 | $704 |
| CLOSED TX NOSE FX W/O STABLJ | 21315 | $562 |
| CLOSED TX NOSE FX W/ STABLJ | 21320 | $812 |
| OPEN TX NOSE FX UNCOMPLICATD | 21325 | $1,632 |
| CLOSED TX SEPTALNOSE FX | 21337 | $1,549 |
| PERQ TX NASOETHMOID FX | 21340 | $2,650 |
| OPN TX DPRSD ZYGOMATIC ARCH | 21356 | $1,997 |
| OPN TX ORBIT FX COMBINED | 21387 | $2,736 |
| OPN TX ORBIT PERIORBTL IMPLT | 21390 | $2,838 |
| OPN TX ORBIT FX W/IMPLANT | 21407 | $2,268 |
| TREAT MOUTH ROOF FRACTURE | 21421 | $2,360 |
| TREAT MOUTH ROOF FRACTURE | 21423 | $2,853 |
| TREAT CRANIOFACIAL FRACTURE | 21431 | $2,519 |
| TREAT DENTAL RIDGE FRACTURE | 21440 | $2,603 |
| TREAT LOWER JAW FRACTURE | 21452 | $2,881 |
| TREAT LOWER JAW FRACTURE | 21454 | $1,702 |
| TREAT LOWER JAW FRACTURE | 21465 | $2,761 |
| BIOPSY OF NECK/CHEST | 21550 | $991 |
| RESECT NECK TUMOR 5 CM/> | 21558 | $4,733 |
| REMOVAL OF RIB | 21615 | $2,158 |
| REMOVAL OF RIB AND NERVES | 21616 | $2,491 |
| REVISION OF NECK MUSCLE | 21725 | $1,946 |
| OPTX OF RIB FX W/FIXJ SCOPE | 21811 | $2,065 |
| TREATMENT OF RIB FRACTURE | 21813 | $3,439 |
| TREAT STERNUM FRACTURE | 21825 | $1,964 |
| BIOPSY SOFT TISSUE OF BACK | 21920 | $958 |
| CATH NANOCROSS .014 OTW 4.0 X 40 X 150CM | 21935 | $3,636 |
| COIL AZUR 18D SYSTEM 3MM X 2CM | 22110 | $3,785 |
| COIL AZUR 18D SYSTEM 3MM X 10CM | 22112 | $4,098 |
| INCIS SPINE 3 COLUMN THORAC | 22206 | $8,676 |
| INCIS SPINE 3 COLUMN LUMBAR | 22207 | $8,484 |
| INCIS W/DISCECTOMY CERVICAL | 22220 | $5,775 |
| INCIS W/DISCECTOMY LUMBAR | 22224 | $5,640 |
| CLOSED TX VERT FX W/O MANJ | 22310 | $1,128 |
| TREAT SPINE FRACTURE | 22325 | $5,263 |
| MANIPULATION OF SPINE | 22505 | $459 |
| VERTEB AUGM LUMBAR W IMAG | 22514 | $22,785 |
| PERCUT KYPHOPLASTY ADD-ON Non-Facility Physical Medicine and Rehab | 22525 | $5,390 |
| SCREW MICRO MAXDRV 1.5MM X 3.5MM | 22556 | $5,917 |
| SCREW 3.5MM LCKG SLF-TPG STRDR REC 65MM | 22590 | $5,680 |
| SCREW 5.0MM LCKG SLF-TPG T25 STRDR 18MM | 22600 | $4,659 |
| CLIP ANEUR TII 8.5 STRGT 7MM | 22837 | $6,247 |
| CLIP ANEUR TII 11.5 STRGT 12MM | 22848 | $1,257 |
| LUMBAR ARTIF DISKECTOMY | 22857 | $6,229 |
| Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); sec | 22860 | $1,126 |
| REMOVE CERV ARTIF DISC | 22864 | $7,394 |
| Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guida | 22870 | $407 |
| SCREW 4.5MM CANN P/T 34MM | 22903 | $1,576 |
| DRAIN SHOULDER BURSA | 23031 | $1,594 |
| BIOPSY SHOULDER TISSUES | 23066 | $2,098 |
| RESECT SHOULDER TUMOR < 5 CM | 23077 | $4,005 |
| SHOULDER JOINT SURGERY | 23101 | $1,652 |
| SCREW 4.0MM SCHANZ SLF-DRL 40MM THR 125MM | 23145 | $2,498 |
| REMOVE SHOULDER BLADE LESION | 23182 | $2,420 |
| REMOVE SHOULDER FOREIGN BODY | 23330 | $1,131 |
| CATH PULMONARY ARTERY SWAN-GANZ 5F 100CM | 23334 | $3,764 |
| SHOULDER PROSTHESIS REMOVAL | 23335 | $4,480 |
| INCISION OF TENDON MUSCLE | 23405 | $2,215 |
| REPAIR ROTATOR CUFF ACUTE | 23410 | $2,928 |
| IMPLANT ICD ILESTO 7 DR-T DUAL CHAMBER | 23430 | $2,664 |
| REMOVE/TRANSPLANT TENDON | 23440 | $2,702 |
| GRAFT ACUSEAL VASCULAR 6MM 40CM | 23455 | $3,525 |
| REPAIR SHOULDER CAPSULE | 23466 | $3,988 |
| REVIS RECONST SHOULDER JOINT | 23474 | $6,126 |
| TREAT CLAVICLE FRACTURE | 23500 | $820 |
| CATH BLN ANGIOSCULPT PTCA TAPRD 3.5 X 10MM | 23520 | $890 |
| TREAT CLAVICLE DISLOCATION | 23532 | $2,254 |
| TREAT CLAVICLE DISLOCATION | 23552 | $2,346 |
| TREAT SHOULDER BLADE FX | 23570 | $866 |
| DRESSING ARGLAES PWD 2GM BTL | 23615 | $3,153 |
| ROD EXTERNAL FIXATION 8.0MM CARBON FIBER 240MM | 23650 | $1,201 |
| SCREW EMER NEURO TI LOPRO 4MM | 23800 | $3,654 |
| Injection, glatiramer acetate, 20 mg Non-Facility | 23842 | $1,707 |
| Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure | 24015 | $107 |
| Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visua | 24035 | $9,950 |
| Computed tomography guidance for placement of radiation therapy fields Non-Facility Specialists | 24074 | $3,597 |
| STENT SYS NEUROFORM3 EZ 4.0X30MM | 24077 | $3,661 |
| Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation Non-Facility Neurosurgery E&M | 24081 | $15,863 |
| Mammary ductogram or galactogram, single duct, radiological supervision and interpretation Non-Facility Neurosurgery | 24093 | $2,701 |
| SCREW 3.5MM TI SHAFT 24MM | 24100 | $1,521 |
| SCREW 3.5MM TI SHAFT 26MM | 24101 | $1,820 |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) Non-Facility General | 24111 | $2,432 |
| Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpati | 24116 | $310 |
| Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpati | 24117 | $219 |
| SCREW 4.0MM TI CANC BONE P/T 16MM | 24125 | $2,244 |
| SCREW 4.0MM TI CANC BONE P/T 40MM | 24134 | $2,678 |
| SCREW 4.0MM TI CANN S/T 10MM | 24136 | $2,275 |
| SCREW 4.0MM TI CANN S/T 14MM | 24138 | $2,482 |
| SCREW 4.0MM TI CANN S/T 18MM | 24140 | $2,521 |
| SCREW 4.0MM TI CANN S/T 28MM | 24145 | $2,142 |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Non-Facility Trauma Critical | 24164 | $2,592 |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Non-Facility Trauma Critical | 24164 | $2,158 |
| SCREW 6.5MM TI CANN 16MM THREAD 75MM | 24201 | $2,033 |
| SCREW 5.0MM TI LCKG SLF-TPG T25 STR RC 26MM | 24300 | $1,600 |
| REPR ELBW MED LIGMNT W/TISSU | 24345 | $2,555 |
| RECONSTRUCT ELBOW JOINT | 24360 | $3,225 |
| REPAIR OF HUMERUS | 24430 | $3,747 |
| TREAT HUMERUS FRACTURE | 24515 | $3,150 |
| TREAT HUMERUS FRACTURE | 24530 | $1,411 |
| CORE 12MM X-CORE MINI 15X12MM PARALLEL | 24545 | $3,307 |
| PLATE DECADE XLIF 4H 12MM | 24576 | $1,304 |
| TREAT ELBOW FRACTURE | 24587 | $3,870 |
| PLATE TRANSLATIONAL 4-LVL 82MM | 24600 | $1,370 |
| TREAT ULNAR FRACTURE | 24670 | $1,085 |
| TUBE TRACH EMG NIM TRIVANTAGE 6.0MM | 24675 | $1,706 |
| PLATE AFFIX II 45MM | 24800 | $2,983 |
| PLATE HELIX REVOLUTION 2-LVL 34MM | 24802 | $3,573 |
| SCREW 6.5MM TI CANC BONE F/T 40MM | 24925 | $2,052 |
| PLATE 1.0MM TI MESH 29MM X 40MM | 24930 | $2,766 |
| SPACER RISE 10X30MM 10-17MM 15DEG | 25028 | $2,619 |
| BIOPSY FOREARM SOFT TISSUES | 25066 | $1,326 |
| EXC FOREARM TUM DEEP < 3 CM | 25076 | $1,857 |
| IMPLANT SKIN BIO-IMPLANT MESH 1/4 SQ FT | 25100 | $1,276 |
| IMPLANT SKIN BIO-IMPLANT UNMESH 1/8 SQ FT | 25101 | $1,469 |
| EXCISE TENDON FOREARM/WRIST | 25109 | $1,925 |
| DEVICE BONE CEMENT FILLER KYPHON EXPRESS SZ2 10GA | 25112 | $1,413 |
| SCREW VAL SELF-TAP T15 3.5MM 50MM | 25126 | $2,162 |
| PLATE 3.5MM VA-LCP PRX TB SM 6H 117MM RT | 25130 | $1,632 |
| PLATE 3.5MM VA-LCP PRX TB LRG 4H 87MM RT | 25136 | $1,804 |
| SCREW 3.5MM CORTX LO-PRO HD SLF-TPG STRDRV 28MM | 25151 | $2,101 |
| REMOVAL OF WRIST BONE | 25210 | $1,775 |
| PARTIAL REMOVAL OF ULNA | 25240 | $1,551 |
| COIL AXIUM PRIME BARE 3D 4MM X 8CM | 25250 | $1,930 |
| REPAIR FOREARM TENDON/MUSCLE | 25272 | $2,020 |
| REPAIR FOREARM TENDON/MUSCLE | 25274 | $2,381 |
| REVISE WRIST/FOREARM TENDON | 25280 | $2,037 |
| TRANSPLANT FOREARM TENDON | 25312 | $2,558 |
| REALIGNMENT OF HAND | 25335 | $3,373 |
| SHORTEN RADIUS OR ULNA | 25390 | $2,744 |
| SHORTEN RADIUS ULNA | 25392 | $3,611 |
| Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic | 25397 | $407 |
| REPAIR RADIUS OR ULNA | 25400 | $2,862 |
| Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Non-Facility Critic | 25407 | $1,552 |
| Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Non-Facility Cardiovascular Thoracic Surgery | 25408 | $1,719 |
| RECONSTRUCT WRIST JOINT | 25443 | $2,814 |
| REMOVE WRIST JOINT IMPLANT | 25449 | $3,669 |
| Splenoportography, radiological supervision and interpretation Non-Facility All Other Specialists | 25474 | $7,932 |
| COIL CONCERTO NYLON HELIX 7MM X 30CM | 25525 | $2,823 |
| SCREW 2.7MM MTPHYSL SLF-TPG W/T8 STRDRV REC 42MM | 25560 | $1,076 |
| TREAT FRACTURE RADIUS/ULNA | 25605 | $1,973 |
| SCREW SET END X-CORE II | 25609 | $3,752 |
| SCREW 2.7MM MTPHYSL SLF-TPG W/T8 STRDRV REC 14MM | 25624 | $1,812 |
| SCREW 2.7MM MTPHYSL SLF-TPG W/T8 STRDRV REC 68MM | 25635 | $1,718 |
| PLATE 2.7/3.5MM VA-LCP EXT MEDL DSTL HUM 1H RT 72MM SHORT | 25650 | $1,220 |
| SCREW 3.5MM CORTX LO-PRO HD SLF-TPG STRDRV 58MM | 25660 | $1,640 |
| WIRE EXT RUNTHROUGH NS .014IN X 150CM | 25670 | $2,189 |
| TREAT WRIST DISLOCATION | 25690 | $1,791 |
| Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified Non-Facility Ped Enhance | 25712 | $113 |
| Brain imaging, vascular flow only Non-Facility Critical Care Intensivists | 25718 | $7,316 |
| Ultrasound guidance for, and monitoring of, parenchymal tissue ablation Non-Facility MD DO | 25893 | $3,077 |
| AMPUTATION FOLLOW-UP SURGERY | 25909 | $2,462 |
| AMPUTATE HAND AT WRIST | 25920 | $2,650 |
| AMPUTATION FOLLOW-UP SURGERY | 25924 | $2,591 |
| AMPUTATION FOLLOW-UP SURGERY | 25931 | $2,964 |
| Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites | 25964 | $869 |
| Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) | 25965 | $2,663 |
| Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) | 25965 | $2,663 |
| Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) Non-F | 25966 | $2,663 |
| Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provo | 25969 | $1,840 |
| Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provo | 25970 | $1,840 |
| BONE OSTEOCEL PRO SMALL | 26025 | $1,522 |
| PLATE TRANSLATIONAL 4-LVL 74MM | 26040 | $1,149 |
| SCREW POLYAXIAL ARMADA TI 6.5MM X 50MM | 26045 | $1,708 |
| ROD CONTOUR BULLET HEX END 5.5X115MM | 26075 | $1,226 |
| CONNECTOR NATURAL BRIDGE LP SEMI ADJ TRANS 30MM | 26110 | $1,184 |
| CONNECTOR NATURAL BRIDGE LP SEMI ADJ TRANS 39MM | 26113 | $1,958 |
| CONNECTOR NATURAL BRIDGE LP ADJ TRANS XL | 26117 | $2,633 |
| SCREW DENALI CANN POLYAXIAL 5.5X45MM | 26121 | $2,154 |
| SCREW DENALI CANN POLYAXIAL 6.5X35MM | 26125 | $936 |
| SCREW DENALI CANN POLYAXIAL 7.5X40MM | 26135 | $1,996 |
| WIRE FIXATION K-WIRE THREADED TROCAR PT 150MM 2.0MM 15MM | 26170 | $1,477 |
| Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervo | 26179 | $2,016 |
| L-PLATE 2.7MM VA-LCP POST LSTL DSTL TIB 6H LT | 26205 | $2,183 |
| Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vHPV), 3 dose schedule, for intramuscular use Non-Facility Critical Care | 26225 | $2,404 |
| CLIP LIGATING HEM-O-LOK MED-LARGE | 26230 | $1,799 |
| SCREW GEMINUS VPS TI CORTICAL NON-LCKG 3.5X13MM | 26250 | $3,784 |
| Angiography, internal mammary, radiological supervision and interpretation Non-Facility Physical Medicine and Rehab | 26341 | $434 |
| Angiography, internal mammary, radiological supervision and interpretation Non-Facility Physical Medicine and Rehab | 26341 | $6,936 |
| IMPLANT POUCH OPTIMESH SMALL | 26357 | $3,218 |
| NAIL GAMMA3 TROCHANTERIC TI 130DEG 11 X 180MM | 26372 | $3,407 |
| SCREW VARIAX HAND LCKG 2.3X11MM | 26373 | $3,286 |
| SCREW TI STALIF MIDLINE ABO 6.0X30MM | 26415 | $3,166 |
| IMPLANT ENDOSKELETON TA STD 17MM | 26416 | $3,414 |
| IMPLANT ENDOSKELETON TA LRG 16MM | 26418 | $2,355 |
| PLATE 2.7/3.5MM LCP LATL DSTL FIB 13H RT 203MM | 26440 | $2,452 |
| SCREW HEXALOBE NON-LCKG 2.7MM X 12MM | 26449 | $2,508 |
| SCREW HEXALOBE NON-LCKG 2.7MM X 14MM | 26450 | $1,741 |
| SCREW VARIAX BONE 2.3X14MM | 26516 | $2,763 |
| SCREW VARIAX BONE 2.3X16MM | 26517 | $3,207 |
| SCREW VARIAX BONE 2.3X18MM | 26518 | $3,249 |
| PLATE TI MATRIXRIB PRECONTOUR 17H RT | 26531 | $2,268 |
| IMPLANT LEAD FINELINE II EZ BIPOLAR PACING 52CM | 26550 | $5,994 |
| Injection, doripenem, 10 mg Non-Facility Injectable and Immunization | 26552 | $1,151 |
| Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of | 26571 | $167 |
| REPAIR FINGER DEFORMITY | 26590 | $5,194 |
| REPAIR MUSCLES OF HAND | 26591 | $1,841 |
| Injection, ertapenem sodium, 500 mg | 26597 | $1,853 |
| ANCHOR SUTURE MINI BIO-COMP 2.4X8.5MM | 26600 | $1,117 |
| CANNULA CONVERTIBLE VAD 18MM | 26675 | $1,700 |
| SCREW BONE CROSS-PIN SLF-TPG 2.3MM X 10MM | 26685 | $2,080 |
| TREAT KNUCKLE DISLOCATION | 26700 | $1,240 |
| CAGE VLIFT EXPANDABLE 18MM X 20MM | 26705 | $1,559 |
| Injection, nesiritide, 0.1 mg | 26747 | $9,935 |
| SCREW BN 3.5MM 100MM SS 2.5MM F-T CORT SLF TAP HEX NS AXSOS | 26756 | $1,553 |
| SCREW SHANK SPHERX PPS CANN 6.5MM X 40MM | 26820 | $3,080 |
| SCREW VUEPOINT II 4.0MM MULTI AXIAL 12MM L | 26843 | $2,913 |
| COIL EMBOLIZATION TARGET 360 NANO 2MM X 4CM | 26860 | $2,298 |
| Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation Non-Facility Cardiovascul | 26914 | $9,091 |
| Injection, buprenorphine hydrochloride, 0.1 mg Non-Facility Specialists | 26947 | $13 |
| Injection, acetazolamide sodium, up to 500 mg Non-Facility All Other Specialists | 26964 | $68 |
| Injection, doxercalciferol, 1 mcg Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 26971 | $1 |
| SCREW MPS 4.5MM CORTICAL SLF-TPG F/T 54MM | 26990 | $2,483 |
| SCREW MPS 4.5MM CORTICAL SLF-TPG F/T 110MM | 27003 | $2,157 |
| SCREW MPS 6.5MM CANC 32MM THR 60MM | 27025 | $3,291 |
| SCREW MPS 6.5MM CANC 32MM THR 85MM | 27030 | $3,331 |
| Electro-oculography with interpretation and report Non-facility All Other Specialists | 27032 | $1,167 |
| EXC HIP PELVIS LES SC 3 CM/> | 27043 | $1,675 |
| EXC HIP/PELV TUM DEEP 5 CM/> | 27045 | $2,608 |
| MESH PHYSIOMESH OVAL 10X15CM | 27059 | $6,366 |
| SPACER COROENT XLH 8X22X55MM 20DEG | 27062 | $1,643 |
| PART REMOVE HIP BONE SUPER | 27070 | $3,201 |
| PLATE HELIX REVOLUTION 3-LVL 66MM | 27071 | $3,516 |
| ROD PRECEPT TI 500MM STRGT | 27075 | $7,324 |
| Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation Non-Facility Critical Care Intensivists | 27077 | $7,055 |
| Electrocorticogram at surgery (separate procedure) Non-Facility Cardiovascular Thoracic Surgery | 27080 | $3,730 |
| PEG ACULOC CORTICAL LCKG 2.3MM X 18MM | 27097 | $2,453 |
| IMPLANT LEAD PACER DEXTRUS IS-BI POS FIX RA/RV 53CM | 27120 | $4,601 |
| BONE CHIPS PRESERVON CRUSHED CANC 30CC | 27122 | $3,920 |
| ROD LEGACY 5.5MM X 500MM | 27130 | $26,172 |
| ROD LEGACY 5.5MM X 500MM | 27130 | $4,533 |
| Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to c | 271323 | $889 |
| End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of | 271325 | $4,015 |
| End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of | 271326 | $1,596 |
| End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, | 271328 | $3,444 |
| End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, | 271330 | $1,188 |
| Destruction by neurolytic agent; plantar common digital nerve Non-Facility MD DO | 271332 | $319 |
| SCREW BONE CROSS-PIN SLF-TPG 2.3MM X 6MM | 27137 | $5,164 |
| DRILL TWIST 58MM 1.9MM 6-7MM SCREW | 27140 | $3,183 |
| Injection, haloperidol decanoate, per 50 mg Non-Facility Wound Care | 27141 | $24 |
| Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the sam | 271539 | $245 |
| Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of | 271540 | $167 |
| Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger | 271542 | $2,040 |
| Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams) N | 271545 | $267 |
| Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant Non-Facility Trauma Critical Care | 271561 | $212 |
| Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical Non-Facility Critical Care Intensivist | 271568 | $7,394 |
| Bypass graft, with other than vein; ilio-celiac Non-Facility Cardio and Thoracic Surgery | 271569 | $6,160 |
| Subsequent hospital care, per day, for evaluation and management of normal newborn Non-Facility PCP and Mid-Levels | 271571 | $95 |
| Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure) Non-Facilit | 271588 | $538 |
| End-stage renal disease (ESRD) related services for home dialysis per full month, for patients younger than 2 years of age to include monito | 271594 | $2,076 |
| End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for t | 271595 | $1,783 |
| End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients younger than 2 years o | 271597 | $61 |
| End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age No | 271599 | $59 |
| Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system wi | 271618 | $102 |
| Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition t | 271632 | $74 |
| Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (List separately in addition to code for | 271633 | $55 |
| Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition | 271647 | $77 |
| Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment | 271648 | $545 |
| SCREW EAGLE PLUS 16MM | 27165 | $4,885 |
| Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg Non-Facility ICC | 271855 | $141 |
| Injection, temsirolimus, 1 mg Non-Facility Cardiovascular Thoracic Surgery | 271861 | $96 |
| Injection, trimethobenzamide hcl, up to 200 mg Non-Facility Wound Care | 27191 | $129 |
| Injection, trimethobenzamide hcl, up to 200 mg Non-Facility Wound Care | 27191 | $200 |
| SCREW GEMINUS VPS TI CORTICAL NON-LCKG 3.5X11MM | 27202 | $1,887 |
| SCREW SPINAL SELF-DRILLING VARIABLE TRINICA 4.2MM 14MM | 27215 | $2,090 |
| TREAT HIP FRACTURE(S) | 27227 | $5,818 |
| TREAT THIGH FRACTURE | 27230 | $1,767 |
| Injection, levocarnitine, per 1 gm | 27236 | $4,228 |
| Injection, levocarnitine, per 1 gm | 27236 | $308 |
| SCREW OASYS NON-BIASED ANGL 3.5MM X 14MM | 27240 | $3,414 |
| HALF PIN 6.0MM X 35MM X 200MM | 27252 | $2,690 |
| TREAT HIP DISLOCATION | 27254 | $4,505 |
| HCHG TREAT HIP DISLOCATION | 27256 | $1,099 |
| SCREW 4.5MM TRIGEN LO-PRO 65MM | 27269 | $4,381 |
| NAIL TRIGEN INTERTAN 130DEG 10MM X 38CM LT | 27275 | $657 |
| Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilat | 27278 | $43,285 |
| SHELL TANDEM BIPOLAR COCR 47/28MM OD (TOTAL) | 27295 | $4,460 |
| SCREW EMERGENCY MP CROSS-PIN 2.3X6MM | 27306 | $1,204 |
| SCREW BONE EMERGENCY CROSS-PIN 2.7X5MM | 27307 | $1,484 |
| BIT DRILL 1.6X115MM WL 35MM STRYKER SHAFT | 27324 | $1,468 |
| EXC THIGH/KNEE TUM DEEP <5CM | 27328 | $2,224 |
| NAIL T2 TIBIAL STD 10MM X 300MM | 27337 | $1,504 |
| SCREW 4.0MM F/T LCKG 28MM | 27340 | $1,363 |
| Heparin assay Non-Facility | 27352 | $1,507 |
| PLATE VARIAX FIBULA LATL 7H 125MM | 27365 | $7,217 |
| SCREW SET GAMMA TI 8.0MM X 17.5MM | 27372 | $2,199 |
| STEM ACCOLADE II NECK ANGL HIP 127DEG SZ 7 | 27416 | $3,487 |
| Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, a | 27423 | $14,532 |
| Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium Non-Facility Internal Medicine | 27424 | $12,099 |
| Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age Non-Facil | 27438 | $475 |
| Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age Non-Facil | 27438 | $2,996 |
| Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fract | 27445 | $36,962 |
| REVISION OF KNEE JOINT | 27446 | $4,078 |
| Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, | 27448 | $15,393 |
| REALIGNMENT OF KNEE | 27455 | $3,438 |
| EXPANDER TISSUE CPX3 F/BREAST IMPLANT 250CC | 27472 | $4,477 |
| SCREW TERCET TRIPLE-LEAD POLYAXL 6.5X50MM | 27500 | $1,892 |
| CAGE CORPECTOMY 12X50X50MM ROUND | 27503 | $2,853 |
| SCREW EAGLE PLUS 14MM | 27513 | $4,363 |
| SCREW DENALI POLYAXIAL 8.5X50MM | 27516 | $1,896 |
| ROD STRGT 5.5X40MM | 27517 | $2,475 |
| ROD ARMADA 5.5MM PREBENT TI 65MM | 27532 | $2,249 |
| Antibody screen, RBC, each serum technique Non-Facility Trauma Critical Care | 27563 | $652 |
| PLATE 2.0/2.3MM SEC RECON STRGT 11H | 27570 | $551 |
| AMPUTATION FOLLOW-UP SURGERY | 27594 | $1,812 |
| WIRE FIXATION K-WIRE VARIAX 1.1MM X 160MM | 27596 | $2,527 |
| NAIL T2 HUMERAL LCKG 9MM X 290MM | 27598 | $2,476 |
| SCREW VARIAX LCKG 1.7X6MM | 27603 | $1,953 |
| BIOPSY LOWER LEG SOFT TISSUE | 27614 | $2,131 |
| RELOAD ECHELON-FLEX VASC 35MM WHITE | 27616 | $4,484 |
| IMPLANT ENDOSKELETON TC 0DEG PARALLEL LRG 9MM | 27618 | $1,824 |
| IMPLANT ENDOSKELETON TC 0DEG PARALLEL LRG 10MM | 27619 | $1,633 |
| ROD OASYS TI ALLOY 3.5MM X 80MM | 27630 | $1,988 |
| SCREW OASYS BIASED ANGL 4.0MM X 26MM | 27634 | $2,397 |
| SPACER CORTICO CANC ACF CONVEX 6MM | 27645 | $6,225 |
| SCREW TI SCHANZ DUAL-CORE 7.0MM X 45MM | 27648 | $834 |
| SCREW TI MATRIX POLYAXL 6.0MM X 40MM | 27652 | $2,308 |
| SPACER SYNFIX-LR 26X32X15MM 12DEG STERILE | 27658 | $1,311 |
| REPAIR OF LEG TENDON EACH | 27665 | $1,510 |
| REVISION OF LOWER LEG TENDON | 27685 | $2,384 |
| STEM TRIATHLON TS KNEE FLUTED 20X100MM | 27695 | $1,706 |
| REVISION OF LOWER LEG | 27715 | $3,815 |
| REPAIR/GRAFT OF TIBIA | 27722 | $3,195 |
| REPAIR OF LOWER LEG | 27727 | $3,696 |
| Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algori | 27733 | $36,809 |
| OPTX MEDIAL ANKLE FX | 27766 | $2,171 |
| CLTX POST ANKLE FX W/MNPJ | 27768 | $1,629 |
| WIRE GUIDE PEDILOC 1.6MM X 230MM | 27784 | $2,530 |
| SPACER ALTERA EXPANDBLE 12-16MM 10MM X 31MM 15DEG | 27816 | $1,224 |
| ROD CONTOUR 5.5X125MM | 27825 | $1,969 |
| GRAFT ALLODERM RTM CONTOUR MED 9.6X19.3CM THICK PERF | 27827 | $4,026 |
| SCREW 5.5MM ARMADA 9.5X60MM ILIAC SLO | 27848 | $2,808 |
| SIZER BREAST MENTOR RND MOD 275CC SALINE | 27871 | $2,464 |
| SIZER BREAST MENTOR RND MOD PLUS 475CC SALINE | 27882 | $2,087 |
| SIZER BREAST MENTOR RND MOD PLUS 650CC SALINE | 27886 | $2,304 |
| SHEATH INTRO PRELUDE EASE 5F 11CM (21GA X 4CM) | 27894 | $2,898 |
| SCREW ASNIS III CANN TI 6.5X75MM THR 20MM STERILE | 28003 | $1,365 |
| HEAD V40 TAPER LFIT COCR 26MM -3 | 28005 | $1,992 |
| INCISION OF FOOT FASCIA | 28008 | $1,542 |
| KIT EXTERNAL TISSUE EXPANDER DERMACLOSE | 28035 | $1,897 |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study Non-Facility Specialis | 28036 | $720 |
| Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete Non-Facility Mid Levels | 28038 | $1,117 |
| EXC FOOT/TOE TUM SC 1.5 CM/> | 28039 | $1,769 |
| EXC FOOT/TOE TUM DEP 1.5CM/> | 28041 | $1,571 |
| CATH BLN OSTIAL FLASH 4.0 X 8MM | 28047 | $3,592 |
| BIOPSY OF FOOT JOINT LINING | 28052 | $1,404 |
| CAGE EXPANDABLE ACCULIF TL 10-16MM X 11MM X 34MM 0DEG | 28055 | $1,326 |
| PARTIAL REMOVAL FOOT FASCIA | 28060 | $1,878 |
| REMOVAL OF FOOT JOINT LINING | 28072 | $1,779 |
| K-WIRE 0.8MM TROCAR PT 70MM | 28086 | $1,954 |
| BIT DRILL 7.3MM CANN LRG QC 300MM | 28088 | $1,659 |
| Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requi | 28097 | $3,399 |
| Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requi | 28098 | $4,079 |
| PLATE 3.5MM CURVED BROAD LCP 12H | 28100 | $2,236 |
| Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging Non-Facility | 28109 | $2,319 |
| Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging Non-Facility | 28109 | $2,319 |
| Pulmonary ventilation imaging (eg, aerosol or gas) Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 28110 | $2,319 |
| SCREW 2.4MM VA LCKG STRDRV 12MM | 28111 | $1,733 |
| Hepatobiliary system imaging, including gallbladder when present; Non-Facility Wound Care | 28112 | $12,401 |
| Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/ve | 28119 | $612 |
| Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervo | 28122 | $4,029 |
| NAIL 13MM TI CANN RETRO ANTE FEM 400MM STERILE | 28124 | $1,712 |
| SCREW DENALI POLYAXIAL 4.5X50MM | 28140 | $2,060 |
| Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed Non-Facility Cardio an | 28175 | $3,099 |
| Quantitative differential pulmonary perfusion, including imaging when performed Non-Facility Neurosurgery | 28176 | $3,099 |
| Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries Non-Facility ICC | 28183 | $11,079 |
| REPAIR OF FOOT TENDON | 28208 | $1,754 |
| CATH PENUMBRA REPERFUSION 5MAX ACE 132 | 28222 | $1,870 |
| INCISION OF FOOT TENDON | 28234 | $1,483 |
| RELEASE OF MIDFOOT JOINT | 28260 | $2,548 |
| REVISION OF FOOT AND ANKLE | 28262 | $5,013 |
| PARTIAL REMOVAL OF FOOT BONE | 28288 | $2,184 |
| CORRJ HALUX RIGDUS W/IMPLT | 28291 | $2,540 |
| ROD CRVD TI ALLOY EXT HEX 5.5MM X 70MM | 28297 | $3,787 |
| SCREW 4.5MM HEADLESS COMP L/T 36MM | 28307 | $2,892 |
| NAIL 9MM TI CANN LATL ENTRY FEM RECON 420MM RT STERILE | 28310 | $1,966 |
| NAIL 10MM TI CANN LATL ENTRY FEM RECON 380MM LT STERILE | 28312 | $1,882 |
| NAIL 10MM TI CANN RETRO ANTE FEM 300MM STERILE | 28313 | $1,910 |
| Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session Non-Facility PCP and Mid-Levels | 283178 | $410 |
| Injection, temozolomide, 1 mg Non-Facility ICC | 283282 | $32 |
| Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm Non-Facility Critical Care Intens | 283301 | $1,960 |
| Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater Non-Facility Neurosurgery | 283306 | $4,733 |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater Non-Facility Neurology | 283313 | $1,576 |
| Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater Non-Facility C | 283325 | $1,958 |
| Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater Non-Facility Specialists | 283327 | $1,675 |
| Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater Non-Facility MD DO | 283328 | $2,608 |
| Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; 5 cm or greater Non-Facility Neurosurgery E&M | 283329 | $6,366 |
| Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater Non-Facility Specialists | 283330 | $1,504 |
| Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; 5 cm or greater Non-Facility Neurosurgery | 283333 | $4,484 |
| Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater Non-Facility Internal Medicine | 283335 | $2,397 |
| Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater Non-Facility Cardio and Thoracic Surgery | 283336 | $1,769 |
| Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater Non-Facility Colon and Rectal Surgery | 283337 | $1,571 |
| Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; 3 cm or greater Non-Facility ICC | 283338 | $3,592 |
| Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single o | 283343 | $1,936 |
| Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial d | 283344 | $336 |
| Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump Non-Facility Wound Care | 283348 | $2,840 |
| Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass Non-Facility Mi | 283350 | $7,888 |
| Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guida | 283367 | $699 |
| Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guida | 283372 | $327 |
| Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age Non-Facil | 283404 | $475 |
| CLAMP USS TRANSCONNECTOR PREASSEMBLED | 28341 | $2,323 |
| IMPLANT ENDOSKELETON TC 6DEG LORDOTIC MED 6MM | 28345 | $1,829 |
| Maximum breathing capacity, maximal voluntary ventilation Non-Facility Wound Care | 28400 | $907 |
| Maximum breathing capacity, maximal voluntary ventilation Non-Facility Wound Care | 28400 | $665 |
| Respiratory flow volume loop Non-Facility ICC | 28404 | $1,690 |
| Diffusing capacity (eg, carbon monoxide, membrane) (List separately in addition to code for primary procedure) Non-Facility PCP and Mid-Lev | 28405 | $1,170 |
| Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary | 28412 | $2,331 |
| ROD OASYS TI ALLOY 3.5MM X 60MM | 28420 | $4,651 |
| TREATMENT OF ANKLE FRACTURE | 28435 | $1,360 |
| CONNECTOR ZODIAC TI 5.5MM ADJ LRG | 28485 | $2,002 |
| ROD ZODIAC TI COCR 5.5X500MM STRGT | 28496 | $1,676 |
| Nerve conduction studies; 7-8 studies Non-Facility Neurology | 28514 | $2,942 |
| Nerve conduction studies; 5-6 studies Non-Facility Cardiovascular Thoracic Surgery | 28515 | $2,378 |
| Nerve conduction studies; 3-4 studies Non-Facility Specialists | 28516 | $1,821 |
| Nerve conduction studies; 1-2 studies Non-Facility Trauma Critical Care | 28517 | $1,258 |
| SCREW 6.4MM RECON CAPTURED 90MM | 28525 | $2,062 |
| Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed) Non-Facil | 28528 | $2,917 |
| REPAIR FOOT DISLOCATION | 28555 | $3,102 |
| SCREW VARIAX ELBOW BONE SLF-TPG 2.7X16MM | 28585 | $3,159 |
| NAIL T2 SCN 10MM X 400MM LONG | 28605 | $1,262 |
| SCREW VARIAX HAND LCKG 2.3X18MM | 28630 | $553 |
| COMPONENT TRIATHLON PS FEMORAL SZ 4 RT (TOTAL) | 28636 | $1,147 |
| REPAIR TOE DISLOCATION | 28645 | $2,334 |
| Administration of hepatitis b vaccine | 28702 | $247 |
| Bone and/or joint imaging; limited area Non-Facility Critical Care Intensivists | 28728 | $7,550 |
| Cerebrospinal fluid leakage detection and localization Non-Facility Internal Medicine | 28758 | $14,649 |
| AMPUTATION THRU METATARSAL | 28805 | $2,459 |
| SCREW HEXALOBE LCKG 3.0MM X 12MM | 28820 | $1,081 |
| PIN TRACTION TIN 5MM X 50MM SHORT | 28890 | $1,106 |
| APPLICATION OF BODY CAST | 29015 | $1,056 |
| APPLICATION OF LONG LEG CAST | 29365 | $442 |
| SCREW HUMERAL BODY TSS | 29435 | $402 |
| STENT GRAFT ENDURANT II BIFUR 20F 32X16X145MM | 29450 | $512 |
| PLATE CROSSLINK LO-PRO TI 5.5MM X 1.375IN | 29505 | $315 |
| APPLICATION LOWER LEG SPLINT | 29515 | $254 |
| STRAPPING OF TOES | 29550 | $68 |
| SCREW AXSOS CORTEX TI 3.5MM X 34MM | 29700 | $223 |
| SCREW AXSOS CORTEX TI 3.5MM X 55MM | 29705 | $224 |
| K-WIRE AXSOS 2.0MM X 315MM W/DRILL TIP | 29720 | $305 |
| JAW ARTHROSCOPY/SURGERY | 29800 | $1,906 |
| SCREW HEXALOBE NON-LCKG 3.0MM X 32MM | 29820 | $1,923 |
| SCREW TERCET TRIPLE-LEAD POLYAXL 8.2X100MM | 29828 | $3,260 |
| IMPLANT MEDPOR ORBITAL FLOOR 38 X 50 X 1.6MM SHEET | 29836 | $2,100 |
| WRIST ARTHROSCOPY | 29840 | $1,621 |
| PLATE 2.0MM LEFORT 4MM ADV RT | 29843 | $1,753 |
| SCREW NEURO CROSS-PIN SLF-DRILL 1.5X5MM | 29845 | $2,099 |
| IMPLANT KNEE NEXGEN LEGACY CONSTRAINED CONDYLAR 23MM | 29863 | $2,898 |
| ALLGRFT IMPLNT KNEE W/SCOPE | 29867 | $4,539 |
| PLATE AXSOS TS PROX LATL TIBIA S/S 4H 121MM RT | 29875 | $1,783 |
| PLATE AXSOS DSTL ANTEROLATL TIBIA 4H 102MM LT | 29876 | $2,337 |
| PLATE VARIAX CLAV SUP MIDSHAFT TI STD 10H 122MM RT | 29881 | $5,733 |
| SCREW AXSOS CORTEX TI 3.5MM X 26MM | 29886 | $2,278 |
| NAIL T2 GTN FEMUR 12MM X 400MM RT | 29893 | $2,415 |
| SCREW LAG T2 RECON 6.5X80MM | 29895 | $1,652 |
| SCREW ASNIS III CANN TI 6.5X85MM THR 40MM STERILE | 29916 | $3,619 |
| Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per | 30011 | $60 |
| Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agents or dru | 300169 | $371 |
| Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g | 300240 | $31,239 |
| Brain imaging, positron emission tomography (PET); perfusion evaluation Non-Facility Mid Levels | 300245 | $31,239 |
| Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motionºs» and/or ejection fra | 300246 | $31,239 |
| SCREW SURELOK POLYAXIAL 6.5X50MM | 30110 | $931 |
| PLATE ACULOC 2 VDR NARROW RT | 30118 | $2,881 |
| Injection, pertuzumab, 1 mg Non-Facility Wound Care | 30123 | $44 |
| BOLT STRUXURE 6.5MM X 40MM | 30125 | $2,401 |
| Implantable neurostimulator electrode, each Non-Facility Specialists | 301364 | $38,936 |
| ROD CRVD TI ALLOY INT HEX 5.5MM X 80MM | 30150 | $2,930 |
| Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpretation Non | 30155 | $3,434 |
| Bone and/or joint imaging; whole body Non-facility Midlevel | 3017 | $9,871 |
| Thallium tl-201 thallous chloride, diagnostic, per millicurie Non-Facility Specialists | 302604 | $225 |
| Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19») Non-Facility MD DO | 30266 | $60 |
| Mechanical chest wall oscillation to facilitate lung function, per session Non-Facility Mid Levels | 30275 | $71 |
| Neutralization test, viral Non-Facility MD DO | 302833 | $1,141 |
| ROD CONTOUR 5.5X90MM | 30300 | $794 |
| Radiopharmaceutical therapy, by intravenous administration Non-Facility Specialists | 303069 | $8,889 |
| NAIL TROCH ANTEGRADE TRIGEN META-TAN RT 11.5MM X 38CM | 30310 | $769 |
| Mycophenolic acid, oral, 180 mg Non-Facility Cardiovascular Thoracic Surgery | 303261 | $4 |
| Anorectal manometry Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurgery | 30356 | $9,702 |
| Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoa | 30362 | $5,398 |
| Rhinoplasty, primary; including major septal repair Facility MD DO | 30420 | $5,314 |
| Serum screening for cytotoxic percent reactive antibody (PRA); standard method Non-facility All Other Specialists | 304301 | $236 |
| Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation Non-Facility Critical Care Intensivist | 30445 | $9,627 |
| Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction) Non-Facility Hospitalists - Internal Medicin | 30465 | $3,744 |
| SPACER AVS TL 10MM X 30MM 4DEG | 30545 | $3,672 |
| Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectas | 30579 | $1,272 |
| ROD RELINE MAS TI LORDOTIC 5.5X75MM | 30580 | $2,216 |
| SCREW VLP MINI-MOD TI CORT T7 S/T 2.4MMX14MM | 30600 | $1,860 |
| Carbohydrate deficient transferrin Non-Facility MD DO | 30611 | $1,394 |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for | 306325 | $548 |
| Immunoassay for infectious agent antibody, quantitative, not otherwise specified Non-Facility Critical Care Intensivists | 30692 | $45 |
| Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report Non-Facility Cardiovascular Tho | 30763 | $7,156 |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral f | 30776 | $2,432 |
| Methylenedioxyamphetamines (MDA, MDEA, MDMA) Non-Facility MD DO | 30898 | $61 |
| SCREW POLYAXIAL 6.5X40MM | 30906 | $1,392 |
| SCREW SET LEGACY 5.5MM SYS TI BREAK-OFF | 30930 | $423 |
| Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitati | 30997 | $1,259 |
| Lavage by cannulation; sphenoid sinus Non-Facility Midlevel | 31002 | $712 |
| Hemolysins and agglutinins; incubated Non-Facility Trauma Critical Care | 31005 | $363 |
| Hemolysins and agglutinins; incubated Non-Facility Trauma Critical Care | 31005 | $363 |
| Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each Non-fac | 31010 | $75 |
| Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell Non-Facility Trauma Critical Care | 31011 | $67 |
| CATH MICRO LANTERN DELIVERY 150CM W/45DEG ANGL TIP | 31030 | $2,341 |
| Electroencephalogram (EEG) extended monitoring; 41-60 minutes Non-Facility PCP and Mid-Levels | 31037 | $2,885 |
| PLATE LORENZ TI SILVER 1.0MM 7H STRGT | 31050 | $1,905 |
| Electroencephalogram (EEG) extended monitoring; 61-119 minutes Non-Facility Neurosurgery E&M | 31083 | $2,885 |
| CAGE FLXFIT TLIF 3D EXPANDABLE TI 12MM | 31087 | $4,050 |
| Ethmoidectomy; intranasal, total Non-Facility Specialists | 31201 | $2,932 |
| CATH BLN INPACT ADMIRAL DCB 4 X 120MM X 130CM | 31205 | $3,398 |
| SCREW 4.5MM HEADLESS COMP L/T 70MM | 31243 | $8,637 |
| COIL RUBY COMPLEX STD 8MM X 25CM | 31291 | $4,234 |
| COIL RUBY COMPLEX STD 8MM X 40CM | 31292 | $3,505 |
| COIL RUBY COMPLEX STD 10MM X 35CM | 31294 | $4,310 |
| COIL RUBY COMPLEX STD 16MM X 60CM | 31297 | $6,555 |
| COIL RUBY COMPLEX STD 18MM X 60CM | 31298 | $12,454 |
| COIL RUBY COMPLEX STD 24MM X 60CM | 31300 | $4,506 |
| Injection, vedolizumab, intravenous, 1 mg Non-Facility Cardiovascular Thoracic Surgery | 31358 | $67 |
| Venography, superior sagittal sinus, radiological supervision and interpretation Non-Facility Neurosurgery E&M | 31363 | $8,091 |
| Partial laryngectomy (hemilaryngectomy); laterovertical Facility Internal Medicine | 31375 | $6,952 |
| Partial laryngectomy (hemilaryngectomy); anterovertical Facility Cardio and Thoracic Surgery | 31380 | $6,857 |
| Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure | 31442 | $1,778 |
| Oncology (colon), mRNA, gene expression profiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed p | 31467 | $9,348 |
| Hereditary neuroendocrine tumor-related disorders (eg, medullary thyroid carcinoma, parathyroid carcinoma, malignant pheochromocytoma or par | 31471 | $3,948 |
| BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full se | 31490 | $12,264 |
| Compatibility test each unit; electronic Non-Facility Trauma Critical Care | 31491 | $1,481 |
| Intubation, endotracheal, emergency procedure | 31500 | $479 |
| SYSTEM AUTOPLEX W/VERTAPLEX HV W/O NDL | 31513 | $453 |
| Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope Facility Neurosurgery E&M | 31526 | $543 |
| Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; | 31546 | $1,887 |
| Laryngoscopy, direct, operative, with arytenoidectomy; Non-Facility Critical Care Intensivists | 31560 | $1,075 |
| ROD STRGT TI ALLOY EXT HEX 5.5MM X 40MM | 31575 | $477 |
| CONNECTOR NERVE AXOGUARD 2X10MM | 31577 | $1,018 |
| ROD VIPER2 COCR 480MM STRGT | 31579 | $725 |
| Cricotracheal resection Non-Facility Specialists | 31592 | $6,163 |
| Tracheostomy, planned (separate procedure); younger than 2 years Non-Facility Colon and Rectal Surgery | 31601 | $1,550 |
| NAIL T2 GTN FEMUR 11MM X 360MM RT | 31605 | $1,147 |
| ROD RELINE MAS TI LORDOTIC 5.5X25MM | 31611 | $1,952 |
| Tracheostoma revision; complex, with flap rotation Non-Facility Cardio and Thoracic Surgery | 31614 | $2,578 |
| SHEATH INTRO PRELUDE SNAP 9FR X 25CM | 31615 | $629 |
| NEEDLE DELIVERY NORIAN 12GA X 7.5CM STERILE | 31628 | $1,386 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe ( | 31632 | $228 |
| CLIP CLOSED TUBE F/GAMMA3 | 31636 | $737 |
| STEM ASCENSION MODULAR RADIAL SZ 03 STD | 31648 | $670 |
| SCREW RELINE MAS 2C POLYAXIAL 8.5X45MM | 31649 | $225 |
| SPACER COROENT XLW 8X22X55MM 15DEG | 31651 | $256 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal | 31653 | $5,171 |
| CATH NANOCROSS .014 OTW 6.0 X 100 X 150CM | 31660 | $664 |
| Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside Non-Facility Hospitalists - Internal Medicine Critical | 31725 | $267 |
| Tracheoplasty; cervical Non-Facility Neurosurgery | 31750 | $4,947 |
| STENT GRAFT ENDURANT II LIMB 14F 16MM X 13MM X 124MM | 31775 | $4,846 |
| IMPLANT ENDOSKELETON TL 7DEG LORDOTIC 50X22X12MM | 31781 | $5,003 |
| PR ANES ESOPH THYRD LARYNX TRACH & LYMPH NECK 1YR | 320 | $1,701 |
| ROD LLF PREBENT LORDOTIC 190MM | 32098 | $2,640 |
| HEAD V40 TAPER LFIT COCR 28MM -4 (REVISION) | 32110 | $5,126 |
| Thoracotomy; with open intrapleural pneumonolysis Non-Facility Critical Care Intensivists | 32124 | $3,228 |
| Thoracotomy; with cyst(s) removal, includes pleural procedure when performed Facility Mid Levels | 32140 | $3,449 |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for | 322286 | $548 |
| PLATE 4.5MM TI BUTTRESS LCKG 2H 25MM | 32501 | $830 |
| Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when per | 32504 | $7,064 |
| Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial Non-Facility Neurosurgery E&M | 32505 | $3,243 |
| Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to c | 32506 | $537 |
| Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding Non-Facility Specialists | 32513 | $451 |
| Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single o | 32553 | $1,936 |
| Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance Non-Facility PCP and Mid-Levels | 32554 | $892 |
| Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance Non-Facility ICC | 32556 | $2,908 |
| SCREW ASNIS III TI CANN P/T 4.0X65MM NON-STERILE | 32561 | $336 |
| KIT DRESSING PREVENA IMS 13CM | 32609 | $882 |
| ROD SOLERA STRGT 5.5MM X 500MM | 32655 | $3,328 |
| Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac Facility Hospitalists - Internal Medicine Critical Care N | 32658 | $2,496 |
| Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass Non-Facility PCP and Mid-Levels | 32662 | $3,111 |
| Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary | 32668 | $540 |
| Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy) Non-Facility ICC | 32669 | $4,649 |
| Thoracoscopy, surgical; with removal of two lobes (bilobectomy) Non-Facility Internal Medicine | 32670 | $5,548 |
| Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) | 32674 | $737 |
| Arthroscopy, hip, surgical; with labral repair Non-Facility Colon and Rectal Surgery | 327616 | $3,619 |
| Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium Non-Facility Neurosurgery | 327622 | $6,555 |
| Application of right and left pulmonary artery bands (eg, hybrid approach stage 1) Non-Facility Neurosurgery E&M | 327629 | $5,678 |
| Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty Non-Facility | 327635 | $9,906 |
| Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), inclu | 327636 | $12,223 |
| Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty | 327637 | $2,363 |
| Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent place | 327638 | $5,047 |
| Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placemen | 327645 | $35,842 |
| Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placemen | 327646 | $46,815 |
| Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy, include | 327648 | $3,970 |
| Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent p | 327650 | $15,418 |
| Esophagogastric fundoplasty partial or complete; laparotomy Non-Facility Neurosurgery E&M | 327662 | $2,904 |
| Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthe | 327665 | $4,423 |
| Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosth | 327667 | $4,622 |
| Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop cultu | 327675 | $1,099 |
| Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) No | 327687 | $829 |
| Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure) Non-Facility Sp | 327689 | $816 |
| Placement of amniotic membrane on the ocular surface; without sutures Non-Facility Neurosurgery | 327695 | $5,220 |
| Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational analysis) | 327718 | $80 |
| Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination | 327727 | $736 |
| Imaging of retina for detection or monitoring of disease; with remote clinical staff review and report, unilateral or bilateral Non-Facilit | 327734 | $61 |
| Injection, paliperidone palmitate extended release (invega sustenna), 1 mg Non-Facility Hospitalists - Internal Medicine Critical Care Neur | 327869 | $40 |
| Major reconstruction, chest wall (posttraumatic) Non-Facility ICC | 32820 | $4,632 |
| Injection, theophylline, per 40 mg Non-Facility Injectable and Immunization | 32840 | $48 |
| Ustekinumab, for intravenous injection, 1 mg | 32841 | $6,512 |
| DIAMONDBACK 360 2.00MM X 145CM SOLD CROWN | 32851 | $11,272 |
| Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; | 33017 | $846 |
| Creation of pericardial window or partial resection for drainage Non-Facility Cardio and Thoracic Surgery | 33025 | $2,672 |
| Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, tot | 331120 | $577 |
| Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, tot | 331121 | $116 |
| Manipulation, palmar fascial cord (ie, Dupuytren's cord), post enzyme injection (eg, collagenase), single cord Non-Facility General Surgery | 331130 | $434 |
| Thoracotomy, with biopsy(ies) of pleura Non-Facility Mid Levels | 331144 | $2,640 |
| Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial Non-Facility Neurosurgery E&M | 331145 | $3,243 |
| Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to c | 331146 | $537 |
| Thoracoscopy; with biopsy(ies) of pleura Non-Facility Physical Medicine and Rehab | 331150 | $882 |
| Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary | 331153 | $540 |
| Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy) Non-Facility ICC | 331154 | $4,649 |
| Thoracoscopy, surgical; with removal of two lobes (bilobectomy) Non-Facility Internal Medicine | 331155 | $5,548 |
| Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (List separately in addition to code for primary procedure) Non-Facil | 331159 | $737 |
| Insertion of pacemaker pulse generator only; with existing multiple leads Non-Facility Neurosurgery E&M | 331161 | $1,276 |
| Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system Non-Facility Neurology | 331162 | $1,199 |
| Insertion of implantable defibrillator pulse generator only; with existing multiple leads Non-Facility Cardiovascular Thoracic Surgery | 331166 | $1,407 |
| Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial pu | 331175 | $5,397 |
| Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) | 331177 | $7,771 |
| Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision | 331178 | $8,075 |
| HLA Class II typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, HLA-DQB1*06:02P), each Non-facility Al | 331231 | $328 |
| Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants ºtypically using non-sequencing tar | 331234 | $451 |
| Peritoneal lavage, including imaging guidance, when performed Non-Facility Midlevel | 331269 | $371 |
| Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single | 331278 | $1,641 |
| Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each a | 331279 | $984 |
| Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each addit | 331281 | $930 |
| CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; duplication/deletion variants Non-Facility | 331294 | $1,306 |
| CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; full gene sequence Non-Facility ICC | 331295 | $1,497 |
| FANCC (Fanconi anemia, complementation group C) (eg, Fanconi anemia, type C) gene analysis, common variant (eg, IVS4+4A>T) Non-Facility Mid | 331304 | $110 |
| FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene analysis; evaluation t | 331305 | $172 |
| IKBKAP (inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase complex-associated protein) (eg, familial dysautonomia) gene a | 331313 | $118 |
| MSH6 (mutS homolog 6 ºE. coli») (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; known familial variants Non | 331336 | $924 |
| VKORC1 (vitamin K epoxide reductase complex, subunit 1) (eg, warfarin metabolism), gene analysis, common variant(s) (eg, -1639G>A, c.173+100 | 331355 | $265 |
| Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; subsequent motor threshold re-determination with delivery and mana | 331368 | $666 |
| Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes Non-Facility Neurology | 331417 | $91 |
| Injection, alglucosidase alfa, (lumizyme), 10 mg Non-Facility Injectable and Immunization | 331613 | $565 |
| Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg Non-Facility Cardiovascular Thoracic Surgery | 331614 | $16 |
| Injection, cabazitaxel, 1 mg Non-Facility Injectable and Immunization | 331630 | $587 |
| PLATE 1.2MM STD 3D UPPER-FACE 2X2H | 33202 | $2,680 |
| SCREW HELIX REV VAR SLF-TPG 4.0X11MM | 33206 | $1,608 |
| SCREW HELIX REV VAR SLF-TPG 4.0X13MM | 33207 | $1,682 |
| DISTRACTOR INTERNAL MICRO ZURICH II MANDIBLE 15MM W/RATCHET | 33210 | $558 |
| SCREW CANN COCR POLYAXIAL LCKG 2.5X18MM | 33215 | $1,091 |
| BIT DRILL NON-LCKG 2.5X216MM SHORT STERILE | 33221 | $1,276 |
| SCREW MP CROSS-PIN 2.0X16MM | 33227 | $1,199 |
| Insertion of implantable defibrillator pulse generator only; with existing multiple leads Non-Facility Cardiovascular Thoracic Surgery | 33231 | $1,407 |
| PLATE 4.5MM LCP MDL PRXML TIB 4H 106MM LT | 33235 | $2,251 |
| PLATE LCKG CALCANEAL SHORT LT | 33236 | $2,742 |
| Removal of permanent transvenous electrode(s) by thoracotomy Facility Physical Medicine and Rehab | 33238 | $3,318 |
| Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy Facility Cardio and Thoracic Surgery | 33243 | $4,774 |
| STEM GLOBAL FX HUMERAL PC STD 10MM | 33261 | $5,569 |
| SCREW CORTICAL LCKG 3.2X14MM | 33266 | $6,357 |
| SCREW BONE CORT WRIST TRX 2.3X18MM | 33270 | $1,981 |
| PLATE VOLAR FIXED ANGL 3H LT | 33272 | $1,226 |
| BLADE EXPLANT TRUNCATED 54MM | 33277 | $986 |
| Insertion, subcutaneous cardiac rhythm monitor, including programming Non-Facility Hospitalists - Internal Medicine Critical Care Neurosurg | 33285 | $17,569 |
| Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programmi | 33287 | $1,277 |
| Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calib | 33289 | $1,157 |
| MATRIX ARTIA RECONSTRUCTIVE TISSUE 6CM X 16CM | 33310 | $4,058 |
| MATRIX ARTIA RECONSTRUCTIVE TISSUE CONTOUR LARGE | 33315 | $6,612 |
| SCREW T15 DBL LEAD LCKG 4.0X12MM | 33335 | $6,448 |
| SCREWDRIVER PATIENT W/GOLD HANDLE | 33369 | $3,348 |
| SCREW CORTICAL VIPER MIS FIX 8.0X55MM | 33404 | $6,043 |
| NAIL TROCH ANTEGRADE TRIGEN META-TAN RT 11.5MM X 40CM | 33406 | $9,899 |
| Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (Ross procedure) No | 33413 | $11,089 |
| Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract Facility Trauma Critical Care | 33414 | $7,391 |
| Aortoplasty (gusset) for supravalvular stenosis Facility All Other Specialists | 33417 | $5,772 |
| Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis | 33418 | $6,215 |
| TUBE MONTGOMERY SALIVARY BYPASS SZ 10 CLEAR | 33425 | $9,406 |
| Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and | 33440 | $12,525 |
| Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure) | 33496 | $5,756 |
| Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass Non-Facility Wound Care | 33500 | $5,397 |
| Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass Facility Trauma Critical Care | 33501 | $3,872 |
| STENT GRAFT GORE TAG THOR ENDOPROS 21X21MMX10CM | 33502 | $4,440 |
| SCREW BONE MAXDRV 2.3MM X 15MM | 33511 | $7,327 |
| SCREW DVR ANATOMIC VPS CORTICAL 3.5MM X 10MM | 33513 | $8,545 |
| PLATE DVR ANATOMIC VPS NARROW SHORT RT W/FAST GUIDES | 33516 | $9,305 |
| BIT DRILL DVR ANATOMIC VPS FAST 2.0MM | 33517 | $643 |
| PEG DVR ANATOMIC VPS SMOOTH 2.0MM X 18MM | 33522 | $2,506 |
| STEM GLOBAL ADVANTAGE HUM SHLDR CUF 12MM 145MM | 33534 | $7,579 |
| PLATE 3D ORBITAL FLOOR TI XS 0.4MM RT | 33535 | $8,430 |
| Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with c | 33572 | $788 |
| Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component Non-Facility Midlevel | 335892 | $6,126 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe Non-Faci | 335896 | $670 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe ( | 335897 | $225 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air | 335898 | $256 |
| Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe Non-Facility Hospital | 335899 | $664 |
| Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance Non-Facility PCP and Mid-Levels | 335901 | $892 |
| Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance Non-Facility ICC | 335903 | $2,908 |
| Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous ca | 335913 | $3,348 |
| Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the se | 335925 | $4,836 |
| Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and | 335929 | $782 |
| APC (adenomatous polyposis coli) (eg, familial adenomatosis polyposis ºFAP», attenuated FAP) gene analysis; duplication/deletion variants N | 335974 | $600 |
| PMP22 (peripheral myelin protein 22) (eg, Charcot-Marie-Tooth, hereditary neuropathy with liability to pressure palsies) gene analysis; dupl | 335982 | $2,276 |
| Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, HbA1c, insulin, hs-CRP, adiponectin, ferritin, interleukin 2 | 335988 | $207 |
| Closure of atrioventricular valve (mitral or tricuspid) by suture or patch Non-Facility MD DO | 33600 | $5,946 |
| Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification b | 336001 | $287 |
| Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification b | 336002 | $246 |
| Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitati | 336004 | $978 |
| Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session Non-Facility Midlevel | 336012 | $163 |
| Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use Non-Facility Critical Care Intensivists | 336014 | $81 |
| Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use Non-Facility ICC | 336018 | $62 |
| Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use Non-Facility Critical Care Inten | 336019 | $457 |
| SCREW ARCHON VAR SLF-TPG 4.0X15MM | 33602 | $5,774 |
| Psychotherapy, 45 minutes with patient Non-Facility Specialists | 336025 | $340 |
| Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for | 336026 | $299 |
| Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/o | 336037 | $2,026 |
| Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch o | 336040 | $815 |
| Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted inducti | 336047 | $3,859 |
| Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months | 336069 | $148 |
| Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed e | 336127 | $111 |
| Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulm | 33615 | $6,896 |
| Grafix core and grafixpl core, per square centimeter (add-on, list separately in addition to primary procedure) Non-Facility ICC | 336168 | $624 |
| Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, Norwood procedu | 33619 | $9,494 |
| ROD EXPEDIUM 30MM | 33620 | $5,678 |
| K-WIRE REDUCT 1.4X165MM | 33670 | $6,775 |
| SCREW TERCET TRIPLE LEAD REDUCTION 5.5X55MM | 33677 | $7,230 |
| Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset Non-Facil | 33688 | $6,476 |
| Ultrasound, elastography; parenchyma (eg, organ) Non-Facility Wound Care | 33701 | $222 |
| CATH GUIDE MACH1 8F JL4 SH 90CM | 33702 | $5,356 |
| Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) Non-Facility MD DO | 33725 | $415 |
| GUIDEWIRE MARVEL 300CM STRGT | 33735 | $4,507 |
| GUIDEWIRE FIGHTER 300CM STRGT | 33741 | $2,593 |
| SPACER COROENT BRIGADE 16X34X24MM 8DEG | 33764 | $4,577 |
| Anastomosis, cavopulmonary, second superior vena cava (List separately in addition to primary procedure) Non-Facility Hospitalists - Intern | 33768 | $1,424 |
| CATH GUIDELINER V3 .062IN 8F X 150CM | 33780 | $8,133 |
| SCREW ORTHOLOC 3DI LCKG 3.5MM X 26MM | 33800 | $3,415 |
| Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted inducti | 33808 | $3,859 |
| Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthe | 33851 | $4,420 |
| PLUG STD SPINAL HELICAL FLANGE | 33853 | $6,339 |
| Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic dissection Non-Facility ICC | 33858 | $11,659 |
| SCREW SET SOLANAS AVALON OCCIPITAL PLATE HEXALOBE | 33864 | $11,058 |
| CAGE SYNMESH RND 15X88MM | 33883 | $3,812 |
| Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use Non-Facility | 33908 | $2,425 |
| IMPLANT BREAST ALLERGAN SRX SMOOTH RND GEL XFP 545CC | 33916 | $14,336 |
| Transection of pulmonary artery with cardiopulmonary bypass Facility Colon and Rectal Surgery | 33922 | $4,818 |
| PIN SPINAL FIXATION 130MM | 33924 | $975 |
| SCREW 4.5MM TI MULTILOC 30MM | 33940 | $1,495 |
| NAIL 9MM TI CANN TIB W/PROX BEND 285MM STERILE | 33948 | $811 |
| SCREW POLARIS TI MAS MULTIAXIAL 5.5X30MM | 33953 | $1,622 |
| IMPLANT BREAST SMTH RND ULTRA HIGH PRFL 650CC | 33956 | $2,857 |
| SCREW AFFIXUS ANTI-ROTATION 90MM | 33966 | $809 |
| BIT DRILL ALPS 2.5MM | 33971 | $2,464 |
| SPACER LATL INTERBODY LORDOTIC 22X55X16MM | 33975 | $4,453 |
| SCREW UCSS TI CANN CORT LAG SLF-TPG P/T 4MM X 38MM | 33978 | $4,563 |
| SCREW 3.5MM TI LCKG SLF-TPG STRDR REC 70MM | 33981 | $2,840 |
| NAIL 10MM TI CANN TIB W/PROX BEND 405MM STERILE | 33983 | $7,888 |
| PLATE 3.5MM TI LCP PROX TIB LO-BEND 16H 232MM LT | 33984 | $971 |
| SCREW NCB CAP LCKG | 33987 | $714 |
| SCREW NCB SLF-TPG 4.0X36MM | 33988 | $2,658 |
| Injection, atezolizumab, 10 mg Non-Facility Injectable and Immunization | 33989 | $1,687 |
| Injection, atezolizumab, 10 mg Non-Facility Injectable and Immunization | 33989 | $247 |
| Injection, atezolizumab, 10 mg Non-Facility Injectable and Immunization | 33989 | $23,793 |
| Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy speci | 340470 | $1,513 |
| Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, includin | 340475 | $884 |
| Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component Non-Facility Neurology | 340484 | $3,764 |
| Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder) Non-Facilit | 340485 | $4,480 |
| Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disrup | 340488 | $7,698 |
| Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial | 340497 | $5,082 |
| Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging g | 340502 | $34,349 |
| Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision Facility MD DO | 34051 | $3,457 |
| Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate proced | 340510 | $717 |
| Esophagoscopy, flexible, transnasal; with biopsy, single or multiple Non-Facility Cardio and Thoracic Surgery | 340511 | $789 |
| Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire | 340518 | $2,779 |
| Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic su | 340520 | $900 |
| Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and | 340526 | $1,647 |
| Chemodenervation of trunk muscle(s); 6 or more muscles Non-Facility MD DO | 340540 | $657 |
| Mechanical chest wall oscillation to facilitate lung function, per session Non-Facility Mid Levels | 340570 | $71 |
| Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or othe | 340572 | $42 |
| Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or othe | 340574 | $124 |
| Injection, pertuzumab, 1 mg Non-Facility Wound Care | 340580 | $44 |
| Injection, immune globulin (bivigam), 500 mg Non-Facility Injectable and Immunization | 340771 | $212 |
| Parathyroid planar imaging (including subtraction, when performed); | 341 | $3,231 |
| Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use Non-facility Midlevel | 34148 | $739 |
| CATH TEMPO 4F BER II 100CM LF STERILE | 34201 | $3,511 |
| Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs Non-Fac | 343482 | $2,065 |
| Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs N | 343484 | $3,439 |
| Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical | 343489 | $22,785 |
| Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation t | 343493 | $1,981 |
| Removal of subcutaneous implantable defibrillator electrode Non-Facility Midlevel | 343495 | $1,226 |
| Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis Non-Facility Cr | 343497 | $6,215 |
| Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; daily management, each day, veno-venous | 343501 | $811 |
| Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/o | 343505 | $1,622 |
| Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by ster | 343508 | $2,857 |
| Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or | 343516 | $809 |
| Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or | 343518 | $971 |
| Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ECMO/ECLS (List separately in addi | 343521 | $714 |
| Insertion of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ECMO/ECLS Non-Facility Neurology | 343522 | $2,658 |
| Removal of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ECMO/ECLS Non-Facility Physical Medicine and Rehab | 343523 | $1,687 |
| Colonoscopy through stoma; with endoscopic mucosal resection Non-Facility ICC | 343531 | $1,040 |
| Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tu | 343536 | $791 |
| Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when | 343541 | $9,871 |
| Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed) Non-Facilit | 343542 | $993 |
| Anoscopy; with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, singl | 343548 | $777 |
| Myelography via lumbar injection, including radiological supervision and interpretation; thoracic Non-Facility Specialists | 343553 | $982 |
| Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/th | 343555 | $1,042 |
| Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging | 343557 | $820 |
| Guidance for localization of target volume for delivery of radiation treatment, includes intrafraction tracking, when performed Non-Facilit | 343600 | $141 |
| FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis; tyrosine kinase domain (TKD) variants (eg, D835, I836) No | 343666 | $249 |
| PCA3/KLK3 (prostate cancer antigen 3 ºnon-protein coding»/kallikrein-related peptidase 3 ºprostate specific antigen») ratio (eg, prostate ca | 343668 | $766 |
| Hereditary colon cancer-related disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), g | 343680 | $1,755 |
| Nuclear encoded mitochondrial genes (eg, neurologic or myopathic phenotypes), genomic sequence panel, must include analysis of at least 100 | 343682 | $9,972 |