cpt code description - Great Plains Health

CPT CODE DESCRIPTION MODIFIER PRICE95934 "H" REFLEX TEST,GASTROC/SOLEUS $84.9695936 "H" REFLEX TEST,OTHR MUSC $84.96

A4213 20+ SYRINGE ONLY $2.0090649 4VHPV VAINE 3 DOSE SCHEDULE FOR IM USE $212.4790651 9VHPV VA 2/3 DOSE SCHED IM USE $158.2049083 ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE $225.3649082 ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE $154.0851845 ABD-VAGINAL VESICAL NECK SUSPENSN $1,217.5050593 ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY $962.62

A6251 ABSORPT DRG <=16 SQ IN W/O B $6.0095803 ACTIGRAPHY TESTING, 3-14 DAY PROF CHG $90.0029440 ADDITION OF WALKER TO CAST $59.76

A4365 ADHESIVE REMOVER WIPES $15.0014301 ADJ TISS XFER ANY AREA,30.1-60 SQCM $1,825.1814302 ADJ TISS XFER ANY AREA,EA ADD 30.0 SQCM $459.3614040 ADJ TISS XFER HEAD,FAC,HAND <10 SQCM $1,308.2214041 ADJ TISS XFER HEAD,FAC,HAND 10.1-30 SQCM $1,612.0614020 ADJ TISS XFER SCALP,EXTREM <10 SQCM $1,174.3014021 ADJ TISS XFER SCALP,EXTREM 10.1-30 SQCM $1,487.5014000 ADJ TISS XFER TRUNK <10 SQCM $1,038.2214001 ADJ TISS XFER TRUNK 10.1-30 SQCM $1,359.3420693 ADJUST EXTERN BONE FIX DEV W ANESTH $917.98

S2083 ADJUSTMENT GASTRIC BAND $210.00J0170 ADRENALIN EPINEPHRIN INJECT $39.00A7015 AEROSOL MASK USED W NEBULIZE NU $5.00Q2035 AFLURIA VA, 3 YRS & >, IM $33.00L1902 AFO ANKLE GAUNTLET E OTS $171.00L1906 AFO MULTILIG ANK SUP E OTS $222.00Q2034 AGRIFLU VAINE $33.00A4244 ALCOHOL OR PEROXIDE PER PINT $3.00A4245 ALCOHOL WIPES PER BOX $6.00

99409 ALCOHOL/SUBSTANCE SCREEN & INTERVEN >30 MIN $139.6899408 ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN $72.00

A6197 ALGINATE DRSG >16 <=48 SQ IN $7.7995018 ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/ I&R $14.4020930 ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED $301.0020931 ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL $235.44

J0270 ALOSTADIL FOR INJECTION $2.00L3260 AMBULATORY SURGICAL BOOT EAC $40.00

27598 AMPUTATE LOWER LEG AT KNEE $1,486.7826910 AMPUTATE METACARPAL+FINGER $1,477.4227592 AMPUTATE THIGH,OPEN CIRCULAR $1,414.7827596 AMPUTATE THIGH,RE-AMPUTATN $1,496.8627594 AMPUTATE THIGH,SECONDRY CLOSUR $1,046.8627590 AMPUTATE THIGH,THRU FEMUR $1,660.3027888 AMPUTATION ANKLE-TIB/FIB MALLEOLI $1,403.2626951 AMPUTATION FINGER/THUMB $1,330.5426952 AMPUTATION FINGER/THUMB+FLAPS $1,314.7028800 AMPUTATION FOOT,MIDTARSAL-CHOPART $1,112.3828805 AMPUTATION FOOT,TRANSMETATARSAL $1,511.9825900 AMPUTATION FOREARM $1,462.3025905 AMPUTATION FOREARM,CIRCULAR $1,452.9425907 AMPUTATION FOREARM,SECOND CLOSURE $1,269.3427880 AMPUTATION LOW LEG THRU TIB/FIB $1,904.3827882 AMPUTATION LOW LEG,CIRCULAR $1,247.0227884 AMPUTATION LOW LEG,SECOND CLOSURE $1,188.7027881 AMPUTATION LOW LEG+STAT FITTING $1,798.5428810 AMPUTATION METATARSAL+TOE,SINGLE $892.0823900 AMPUTATION OF ARM & GIRDLE $2,887.1628825 AMPUTATION TOE,I-P JT $768.2428820 AMPUTATION TOE,MT-P JT $818.6425927 AMPUTATION TRANSMETACARPAL $1,677.5824900 AMPUTATN ARM,THRU HUMERUS,IM CLOS $1,534.3046080 ANAL SPHINCTEROTOMY $331.9251784 ANAL/URINARY MUSCLE STUDY $142.5651785 ANAL/URINARY MUSCLE STUDY,NEEDLE $565.9295979 ANALYZ NEUROSTIM BRAIN, EACH ADD 30 MIN $221.76

62367 ANALYZE INFUSN PUMP $52.5662368 ANALYZE INFUSN PUMP+REOGRAM $72.7295978 ANALYZE NEUROSTIM BRAIN, FIRST 1H $516.2450750 ANASTOMOSE URETER/RENAL CALYX $2,408.3850740 ANASTOMOSE URETER/RENAL PELVIS $2,550.9450760 ANASTOMSIS OF URETER $2,345.7450770 ANASTOMSIS OPPOSITE URETERS $2,408.3899116 ANESTHESIA WITH HYPOTHERMIA $83.00

L4350 ANKLE CONTROL ORTHO E OTS $114.0027889 ANKLE DISARTICULATION $1,350.7029892 ANKLE SCOPE,AID REPAIR FX,BONE DEFCT $1,415.5029891 ANKLE SCOPE,EXCIS OSTEOCHON DEFCT $1,391.7429898 ANKLE SCOPE,EXTENS DEBRIDEMNT $1,166.3829897 ANKLE SCOPE,PART DEBRIDEMENT $1,041.1029895 ANKLE SCOPE,PART SYNOVECTOMY $973.4229894 ANKLE SCOPE,REMVL LOOSE BODY $1,017.3499170 ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG $323.2846606 ANOSCOPY AND BIOPSY $158.4046600 ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN FRMD $85.6846608 ANOSCOPY,REMOVE FOREIGN BODY $174.9646610 ANOSCOPY,REMOVE LESN,FORCEPS/CAUTER $169.2046614 ANOSCOPY,W/CONTROL,BLEEDING $135.3646604 ANOSCOPY,W/DILATION $138.2492287 ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R $282.9651841 ANTER VESICOURETHROPEXY,COMPLIC $1,594.0651840 ANTER VESICOURETHROPEXY,SIMPLE $1,364.3857240 ANTERIOR COLPORRAPHY R CYSTOCELE W/CYSTO $1,207.4222845 ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS $1,537.1822846 ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS $1,595.5015271 APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM $174.9615272 APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM $36.7215273 APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM $423.3615274 APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM $95.7644950 APPENDECTOMY $1,337.74

44960 APPENDECTOMY,RUPT APPENDX+ABSCESS $1,822.3044955 APPENDECTOMY,W OTHR OC $175.6850845 APPENDICO-VESICOSTOMY $2,607.1029581 APPL MLT-LAYER VENOUS WOUND COMESS BELOW KNEE $57.6022851 APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE $678.9699188 APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP $20.8829046 APPLY BODY CAST,SHLDR-HIP+2 THIGHS $393.8420692 APPLY BONE MULTIPLAN,EXT FIX DEV $2,316.9420690 APPLY BONE UNIPLANE,EXT FIX DEV $1,234.7829131 APPLY FINGER SPLINT,DYNAMIC $70.5629130 APPLY FINGER SPLINT,STATIC $59.7629075 APPLY FOREARM CAST $128.8829126 APPLY FOREARM SPLINT,DYNAMIC $100.8029125 APPLY FOREARM SPLINT,STATIC $82.0829085 APPLY HAND/WRIST CAST $139.6829065 APPLY LONG ARM CAST $141.1229105 APPLY LONG ARM SPLINT $122.4029345 APPLY LONG LEG CAST $208.8029358 APPLY LONG LEG CAST BRACE $216.7229365 APPLY LONG LEG CAST,CYLINDER $182.1629355 APPLY LONG LEG CAST,WALKER $219.6029505 APPLY LONG LEG SPLINT $104.4029515 APPLY LOWER LEG SPLINT $102.9629450 APPLY OF CLUBFOOT CAST $235.4429305 APPLY OF HIP CAST,ONE LEG $331.2029325 APPLY OF HIP CASTS,TWO LEGS $372.2429435 APPLY PATELLA TENDON BEARING CAST $173.5229445 APPLY RIGID LEG CAST $213.1229405 APPLY SHORT LEG CAST $123.8429425 APPLY SHORT LEG CAST,WALKER $116.6420661 APPLY/REMOVE HALO CRANIAL $1,043.2627475 ARREST,EPIPHYSEAL,DISTAL FEMUR $1,371.5822634 ARTHDSIS POST/POSTERLATRL/POSTINTRBDYADL SPC/SEG $1,043.9822633 ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR $3,878.60

G0289 ARTHRO, LOOSE BODY + CHONDRO $180.7220605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US $77.7620606 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US $110.1620610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US $95.7620610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US BILATERAL $143.6420611 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US $126.7220600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US $73.4420604 ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RT $95.7622551 ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2 $3,579.0822554 ARTHRODESIS ANT INTERBODY MIN DISCECTOMY, CERVICAL BELOW C2 $2,620.7822585 ARTHRODESIS ANT INTERBODY MIN DISCECTOMY,EA ADDL $689.7622558 ARTHRODESIS ANT INTERBODY MIN DISCECTOMY,LUMBAR $3,206.8422556 ARTHRODESIS ANT INTERBODY MIN DISCECTOMY,THORACIC $3,489.8022534 ARTHRODESIS LATERAL EXTRACAVITARY EA ADDL THRC/LMBR $758.1622533 ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR $3,466.0422532 ARTHRODESIS LATERAL EXTRACAVITARY THORACIC $3,750.4422630 ARTHRODESIS POSTERIOR INTERBODY LUMBAR $3,294.6822800 ARTHRODESIS POSTERIOR SPINAL DEFORMITY UP 6 SEGMENTS $2,821.6422802 ARTHRODESIS POSTERIOR SPINAL DEFORMITY UP 7-12 SEGMENTS $4,402.0422600 ARTHRODESIS POSTERIOR/POSTERIORLATERAL CERVICAL BELOW C2 $2,696.3822614 ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL $822.9622612 ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR $3,319.1622610 ARTHRODESIS POSTERIOR/POSTEROLATERAL THORACIC $2,643.1027870 ARTHRODESIS,ANKLE,OPEN $2,134.0626535 ARTHROPLASTY I-P JT $880.5626536 ARTHROPLASTY I-P JT,IMPLANT $1,450.0626531 ARTHROPLASTY MC-P JT,IMPLANT $1,291.6626530 ARTHROPLASTY MC-P JT,SINGLE $1,113.1027438 ARTHROPLASTY PATELLA WITH IMPLANT $1,738.7824361 ARTHROPLASTY,ELBOW,DIST HUMER OSTH $2,089.4224363 ARTHROPLASTY,ELBOW,TOTAL OSTH REPL $3,025.4024360 ARTHROPLASTY,ELBOW,W MEMBRANE $1,866.9429900 ARTHROS MCP JNT,DIAG,W/SYNOVIAL BX $1,028.1429901 ARTHROS MCP JNT,SURG,W/DEBRIDEMENT $1,108.06

29902 ARTHROS MCP JNT,SURG,W/REDUCTION $1,177.1829999US ARTHROSCOPIC DISTAL ULNAR SHORTENING $1,456.9729999TUB ARTHROSCOPIC GREATER TUBEROSITY REDUCTION $1,456.9727599HO ARTHROSCOPIC HETEROTOPIC OSSIFICATION RESECTION $1,938.9223929OS ARTHROSCOPIC ORIF OF OS ACROMIALE $2,199.7229999SI ARTHROSCOPY ILOPSOAS LENGTHENING $1,456.9729999MF ARTHROSCOPY RADIAL HEAD/CAPITULUM MICROFRACTURE $1,456.97

29828 ARTHROSCOPY SHOULDER SURGICAL BICEPS TENODESIS $1,886.3829904 ARTHROSCOPY SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY $1,326.2229907 ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS $1,822.3029906 ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT $1,442.8629905 ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY $1,139.7425040 ARTHROTOMY RADIOCARPAL/ MIDCARPAL W EXPLORE, DRAIN, REMOVE FB $1,164.2225101 ARTHROTOMY WRIST W/WO EXPLORE, DRAIN, FB REMOVAL $833.7627403 ARTHROTOMY,OPEN REPAIR MENISCUS $1,322.6224006 ARTHROTOMY/CAPULE RELEASE ELBOW JT $1,470.9427331 ARTHROTOMY/EXPLORE/TREAT KNEE JOINT $980.6220615 ASPIR/INJEC BONE CYST $333.3620612 ASPIRAT/INJECTION GANGLION CYST(S) $87.1251102 ASPIRATION BLADDER INSERT SUAPUBIC CATHETER $300.9651100 ASPIRATION BLADDER NEEDLE $80.6451101 ASPIRATION BLADDER TROCAR/INTRACATHETER $108.7222552 ATHRODESIS CERVICAL BELOW C2 EACH ADDITIONAL $838.08

J0460 ATROPINE SULFATE INJECTION $4.0099464 ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN $152.6427412 AUTOCHONDROCYTE IMPLANT KNEE $3,443.0020938 AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INCISION $388.8020936 AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION $1,219.0036818 AV ANAST,UP ARM CEPHALIC VEIN TRANSPOSIT $1,455.10

J0475 BACLOFEN 10 MG INJECTION $441.00J0476 BACLOFEN INTRATHECAL TRIAL $976.00

35476 BALLN ANGIOPLASTY,PERC VENOUS $671.0450706 BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I $383.76

J9031 BCG LIVE INTRAVESICAL VAC $240.00

90586 BCG VAINE, INTRAVESICAL $373.00A4357 BEDSIDE DRAINAGE BAG $16.00H0002 BEHAVIORAL HEALTH SCREENING $161.28A4247 BETADINE/IODINE SWABS/WIPES $10.00J0702 BETAMETHASONE ACET&SOD PHOSP $12.00

90901 BIOFEEDBACK TRAINING,ANY MODALITY $40.3220245 BIOPSY BONE OPEN DEEP $732.2420240 BIOPSY BONE OPEN SUPERFICIAL $315.3625066 BIOPSY FOREARM SOFT TISSUES,DEEP $741.6025065 BIOPSY FOREARM SOFT TISSUES,SUPERFIC $336.2419101 BIOPSY OF BREAST, INCISIONAL $458.6419100 BIOPSY OF BREAST, NEEDLE CORE $145.4454800 BIOPSY OF EPIDIDYMIS,NEEDLE $263.5250205 BIOPSY OF KIDNEY,OPEN EXPOS $1,572.4655705 BIOPSY OF OSTATE,INCISIONAL $555.1255700 BIOPSY OF OSTATE,NEEDLE/PUNCH $272.8854105 BIOPSY OF PENIS,DEEP STRUCT $444.9645100 BIOPSY OF RECTUM $623.5211100 BIOPSY OF SKIN LESION $101.5254505 BIOPSY OF TESTIS,INCISIONAL $437.7654500 BIOPSY OF TESTIS,NEEDLE $156.2460100 BIOPSY OF THYROID,PERCUT $164.1653200 BIOPSY OF URETHRA $297.3625100 BIOPSY OF WRIST JOINT $714.9621925 BIOPSY SOFT TISSUE BACK,DEEP $736.5623066 BIOPSY SOFT TISSUE SHOULDER DEEP $740.8826110 BIOPSY SYNOVIUM I-P JT $664.5611101 BIOPSY, EACH ADDED LESION $51.8438500 BIOPSY/EXCISION, LYMPH NODE(S) $528.4895933 BLINK REFLEX TEST $159.8436430 BLOOD TRANSFUSION SERVICE $10.0095833 BODY MUSCLE TEST,MANUAL,NO HANDS $45.3695834 BODY MUSCLE TEST,MANUAL,W HANDS $64.8020225 BONE BIOPSY,TROCAR/NEEDLE DEEP $222.48

20220 BONE BIOPSY,TROCAR/NEEDLE SUPERF $149.0427170 BONE GRAFT FEMUR HEAD/NECK/RIDGE $2,442.22

G0364 BONE MARROW ASPIRATE &BIOPSY $139.6820939 BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY $139.6844130 BOWEL TO BOWEL ANASTOMOSIS $2,738.1261070 BRAIN SHUNT TUBE/RESERV INJECTN $118.8019499 BREAST SURGERY OCEDURE UNLISTED $1,555.4294010 BREATHING CAPACITY TEST PROF CHG $17.2894010 BREATHING CAPACITY TEST $73.4431623 BRNCHSC BRUSHING/OTECTED BRUSHINGS $277.9231652 BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX $460.8031653 BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX $511.2031622 BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX $272.8831624 BRNCHSC W/BRNCL ALVEOLAR LAVAGE $281.5231654 BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES $140.4031625 BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES $324.7231629 BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON $388.0831627 BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION $202.3231626 BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT $414.7231635 BRONCHOSCOPY W/REMOVAL FOREIGN BODY $364.3231645 BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST $304.5631628 BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE $366.4831632 BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE $102.2431633 BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE $131.7624066 BX ARM/ELBOW SOFT TISSUE,DEEP $856.8024065 BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL $346.3219083 BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE $328.3227614 BX LOW LEG SOFT TISSUE,DEEP $843.8427613 BX LOW LEG SOFT TISSUE,SUPERFICIAL $336.9619102 BX OF BREAST, NEEDLE CORE, IMAGE GUIDE $458.6427041 BX SOFT TISSUES,PELV/HIP,DEEP $1,439.2627040 BX SOFT TISSUES,PELV/HIP,SUPERFICL $412.5628054 BX SYNOVIUM INTERPHALANG JT $487.4427323 BX THIGH/KNEE SOFT TISSUES,SUPERF $370.08

54100 BX,PENIS (SEPARATE OCEDURE) $262.0863277 BX/EXCIS SPINAL TUMOR,XDURAL,LUMB $3,255.0838525 BX/REMV,LYMPH NODE,DEEP AXILL $908.6238510 BX/REMV,LYMPH NODE,DEEP CERV $867.6038530 BX/REMV,LYMPH NODE,INTERN MAMM $1,160.6295992 CANALITH REPOSITIONING OCEDURE, PER DAY $88.56

26989IP CAPSULODESIS IP JOINT $1,030.6728272 CAPSULOTOMY I-P JT,FOOT,EA $524.1628262 CAPSULOTOMY MIDFOOT,EXTENSIVE $2,465.2628264 CAPSULOTOMY MIDTARSAL $1,596.9428270 CAPSULOTOMY MT-P JT,FOOT,EACH $694.0893018 CARDIAC STRESS TST,INTERP/REPT ONLY $30.2492960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL $226.08

Q4002 CAST SUP BODY CAST FIBERGLAS $717.00Q4014 CAST SUP GAUNTLET FIBERGLASS $154.00Q4016 CAST SUP GAUNTLET PED FBRGLS $80.00Q4026 CAST SUP HIP SPICA FIBERGLAS $603.00Q4028 CAST SUP HIP SPICA PED FBRGL $299.00Q4018 CAST SUP LNG ARM SPLINT FBRG $139.00Q4020 CAST SUP LNG ARM SPLNT PED F $69.00Q4034 CAST SUP LNG LEG CYLINDER FB $253.00Q4032 CAST SUP LNG LEG PED FBRGLS $149.00Q4031 CAST SUP LNG LEG PED PLASTER $69.00Q4042 CAST SUP LNG LEG SPLNT FBRGL $92.00Q4044 CAST SUP LNG LEG SPLNT PED F $99.00Q4036 CAST SUP LNGLEG CYLNDR PED F $125.00Q4006 CAST SUP LONG ARM ADULT FBRG $213.00Q4008 CAST SUP LONG ARM PED FBRGLS $109.00Q4030 CAST SUP LONG LEG FIBERGLASS $299.00Q4004 CAST SUP SHOULDER CAST FBRGL $390.00Q4038 CAST SUP SHRT LEG FIBERGLASS $339.00Q4040 CAST SUP SHRT LEG PED FBRGLS $172.00Q4010 CAST SUP SHT ARM ADULT FBRGL $166.00Q4012 CAST SUP SHT ARM PED FBRGLAS $85.00

Q4022 CAST SUP SHT ARM SPLINT FBRG $139.00Q4024 CAST SUP SHT ARM SPLNT PED F $69.00Q4046 CAST SUP SHT LEG SPLNT FBRGL $125.00Q4048 CAST SUP SHT LEG SPLNT PED F $64.00

31725 CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX $164.16A4354 CATH INSERTION TRAY W/BAG $16.00

93454 CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I PROF CHG $503.2893455 CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I PROF CHG $587.5293458 CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I PROF CHG $622.0893459 CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I PROF CHG $705.6093456 CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I PROF CHG $655.2093457 CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I PROF CHG $737.28

A4314 CATH W/DRAINAGE 2-WAY LATEX $40.0036660 CATH, UMBILICAL ARTERY $91.4436510 CATH, VEIN UMBILICAL NEWBORN $586.08

P9612 CATHETERIZE FOR URINE SPEC $7.0046940 CAUTERY ANAL FISSURE,INITIAL $303.12

J0696 CEFTRIAXONE SODIUM INJECTION $16.00L0120 CERV FLEX N/ADJ FOAM E OTS $44.00

59514 CESAREAN DELIVERY ONLY $1,900.0637214 CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL $256.3243888 CHANGE GASTRIC PORT, OPEN $961.1843760 CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE $97.9250398 CHANGE KIDNEY CATH/TUBE $164.1651710 CHANGE OF BLADDER TUBE,COMPLICATED $167.0451705 CHANGE OF BLADDER TUBE,SIMPLE $108.7250688 CHANGE OF URETEROSTOMY TUBE VIA ILEAL CONDUIT $164.1617250 CHEMICAL CAUTERIZATION OF GRANULATION TISSUE $77.0432560 CHEMICAL PLEURODESIS FOR PERSISTENT PNEUMOTHORAX $162.0064653 CHEMODENERV ERINE GLANDS, NON-AXILLARY $113.0464644 CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES $246.2464643 CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE $149.7664645 CHEMODENERVATION 1 EXTREMITY EA ADDL 5/< MUSCLES $172.8046505 CHEMODENERVATION ANAL SPHINCTER $496.08

64614 CHEMODENERVATION EXTREMITY&/TRUNK MUSCLE $465.1264614 CHEMODENERVATION EXTREMITY&/TRUNK MUSCLE BILATERAL $697.6864617 CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG $226.0864616 CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA $229.6864647 CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES $288.0064646 CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES $241.9264642 CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE $226.0864611 CHEMODENERVATION PAROTID/SUBMANDIBULAR SALIVARY GLANDS,BILATERAL $213.8464615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE $259.2064612 CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL $242.6464612 CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL BILATERAL $363.9696402 CHEMOTHER HORMON ANTINEOPL SUB-Q/IM $62.6496413 CHEMOTHER, IV INFUSION, 1 HR $289.4496415 CHEMOTHER, IV INFUSION, EA ADD HR $63.3696450 CHEMOTHER,CNS,W/LUMBAR PUNCTURE $138.9696401 CHEMOTHER,NON-HORMONE ANTI-NEOPL, SUB-Q/IM $163.4496400 CHEMOTHERAPY, (SC)/(IM) $163.44

J3230 CHLOROMAZINE L INJECTION $22.0047480 CHOLECYSTOSTOMY,OPEN EXPLOR/DRAIN/ REMV CALCULUS $1,825.9095857 CHOLINESTERASE INHIBITOR CHALLENGE TEST FOR MYASTHENIA GRAVIS $61.2099490 CHRON CARE MANAGEMENT SRVC 20 MIN PER MONTH $85.6854150 CIRCUMCISION,CLAMP,NEWBORN $204.4854161 CIRCUMCISION,OTHR $410.4054160 CIRCUMCISION,OTHR,NEWBORN $299.5251925 CLOSE BLAD/UTERINE FIST+HYSTERECT $2,090.8651920 CLOSE BLADDER/UTERUS FISTULA $1,593.3451900 CLOSE BLADDER/VAGINA FISTULA,ABDOM $1,720.7857330 CLOSE BLAD-VAG FIST,XVESC+VAG APCH $1,542.9457320 CLOSE BLAD-VAG FISTULA,VAG APCH $1,098.7051880 CLOSE CYSTOSTOMY $973.4244625 CLOSE ENTEROSTOMY,RESEC+ANAST $2,121.1044626 CLOSE ENTEROSTOMY,RESEC+COLOREC ANAS $3,342.9226750 CLOSE RX DIST FINGR FX $378.7226755 CLOSE RX DIST FINGR FX,MANIPULATN $560.88

26740 CLOSE RX FINGR ARTICULAR FX $444.2426742 CLOSE RX FINGR ARTICULAR FX,MANIP $689.7626720 CLOSE RX OX/MID FING SHFT FX $378.7226725 CLOSE RX OX/MID FING SHFT FX,MANIP $623.5253520 CLOSE URETHROSTOMY/FISTULA,MALE $1,161.3423540 CLOSED RX A-C JT DISLOC $469.4423545 CLOSED RX A-C JT DISLOC,MANIPULATN $638.6427220 CLOSED RX ACETABULAR FX $1,087.9027222 CLOSED RX ACETABULAR FX,MANIPULATN $2,017.4227840 CLOSED RX ANKLE DISLOCATN $764.6427842 CLOSED RX ANKLE DISLOCATN,ANESTH $1,020.9428490 CLOSED RX BIG TOE FRACTURE $258.4828495 CLOSED RX BIG TOE FX,MANIP $308.1625630 CLOSED RX CARPAL FX $578.1625635 CLOSED RX CARPAL FX,MAIPULATN $858.2423500 CLOSED RX CLAVICLE FRACTURE $456.4823505 CLOSED RX CLAVICLE FX,MANIPULATN $683.2826675 CLOSED RX C-MC DISLOC,ANESTH $862.5627501 CLOSED RX CONDYLAR FX $1,032.4627503 CLOSED RX CONDYLAR FX+MANIP $1,661.7427200 CLOSED RX COYGEAL FX $389.5227516 CLOSED RX DIST FEM EPIPHYSIS $987.8227517 CLOSED RX DIST FEM EPIPHYSIS+MANIP $1,420.5427786 CLOSED RX DIST FIBULA FX $587.5227788 CLOSED RX DIST FIBULA FX,MANIP $790.5625600 CLOSED RX DIST RAD/ULNA FX $639.3625605 CLOSED RX DIST RAD/ULNA FX,MANIPUL $1,049.7424600 CLOSED RX ELBOW DISLOCATION $686.8824605 CLOSED RX ELBOW DISLOCATN,ANESTHESIA $971.9827500 CLOSED RX FEMUR SHAFT FX $992.1427502 CLOSED RX FEMUR SHAFT FX+MANIP $1,571.7427508 CLOSED RX FEMUR,DISTAL $1,018.7827246 CLOSED RX GR TROCHANTERIC FX $798.4823625 CLOSED RX GR TUBER HUM FX,MANIP $722.16

23620 CLOSED RX GR TUBEROSITY HUM FX $527.0428400 CLOSED RX HEEL FX $469.4428405 CLOSED RX HEEL FX,MANIPULATN $731.5224535 CLOSED RX HUM SUACONDYLR FX,MANIPU $1,174.3024576 CLOSED RX HUMER CONDYLR FX $628.5624560 CLOSED RX HUMER EPICONDYLR FX $591.8424565 CLOSED RX HUMER EPICONDYLR FX,MANIP $1,010.8624530 CLOSED RX HUMERAL SUACONDYLAR FX $709.9227238 CLOSED RX INTER/SUBTROCH FEMUR FX $951.8227240 CLOSED RX INTER/SUBTROCH FX,MANIP $1,989.3426770 CLOSED RX IP JT DISLOCATION $523.4426775 CLOSED RX IP JT DISLOCATION,ANESTH $710.6428665 CLOSED RX I-P JT,TOE DISLOC,ANESTH $272.8828660 CLOSED RX I-P JT,TOE DISLOCATION $182.8827552 CLOSED RX KNEE DISLOC+ANESTH $1,290.2227550 CLOSED RX KNEE DISLOCATN $979.9027562 CLOSED RX KNEECAP DISLOC+ANESTH $1,001.5027560 CLOSED RX KNEECAP DISLOCATN $690.4825690 CLOSED RX LUNATE DISLOCATION $994.3021450 CLOSED RX MANDIBLE FX $955.4226700 CLOSED RX MC-P DISLOC $623.5226705 CLOSED RX MC-P DISLOC,ANESTH $780.4827760 CLOSED RX MED MALLEOLUS FX $625.6827762 CLOSED RX MED MALLEOLUS FX,MANIP $881.2826607 CLOSED RX METACARP FX,W/MANIP,W/EXT FIX $947.5026600 CLOSED RX METACARPAL FX $569.5226605 CLOSED RX METACARPAL FX,MANIP $602.6426608 CLOSED RX METACARPAL FX,PERCUT $982.0628470 CLOSED RX METATARSAL FX $421.2028475 CLOSED RX METATARSAL FX,MANIP $466.5624500 CLOSED RX MID HUMERUS FRACTURE $671.7624505 CLOSED RX MID HUMERUS FX,MANIPULATN $923.0224620 CLOSED RX MONTEGGIA FX/DISLOC ELBOW $1,139.0228635 CLOSED RX MT-PHAL TOE DISLOC,ANESTH $275.04

28630 CLOSED RX MT-PHAL TOE DISLOCATION $226.0825680 CLOSED RX NAVIC/LUNATE FX/DISLOC $1,077.1025622 CLOSED RX NAVICULAR FX $573.1225624 CLOSED RX NAVICULAR FX,MANIPULATN $899.2821310 CLOSED RX NOSE FRACTURE, W/O MANIPULATION $56.1621315 CLOSED RX NOSE FRACTURE, W/O STABILIZATION $309.6023600 CLOSED RX OX HUMERUS FRACTURE $632.8823605 CLOSED RX OX HUMERUS FX,MANIP $872.6427230 CLOSED RX OX/NECK FEMUR FX $974.8627232 CLOSED RX OX/NECK FEMUR FX,MANIP $1,543.6627781 CLOSED RX OX/SHAFT FIB FX,MANIP $817.2027780 CLOSED RX OX/SHAFT FIBULA FX $573.8427520 CLOSED RX PATELLA FX $606.9627193 CLOSED RX PELVIC RING FX/SUBLUX $248.4027265 CLOSED RX POST HIP ARTHRPLAS DISLOC $824.4027266 CLOSED RX POST HIP FIX DISLOC,ANESTH $1,203.1025560 CLOSED RX RAD/ULNA SHAFT FX $517.6825565 CLOSED RX RAD/ULNA SHAFT FX,MANIP $959.7424640 CLOSED RX RADIAL HEAD DISLOC,CHILD $159.8424650 CLOSED RX RADIAL HEAD/NECK FX $493.9224655 CLOSED RX RADIAL HEAD/NECK FX,MANIP $820.0825500 CLOSED RX RADIAL SHAFT FX $515.5225520 CLOSED RX RADIAL SHAFT FX W/DISLOCATION $1,113.1025505 CLOSED RX RADIAL SHAFT FX,MANIPULATN $935.9825675 CLOSED RX RADIO-ULNA DISLOCATION $810.7221800 CLOSED RX RIB FRACTURE $1,243.4223570 CLOSED RX SCAPULA FX $492.4823655 CLOSED RX SHLDR DISLOC,ANESTHESIA $829.4423665 CLOSED RX SHLDR DISLOC,GR TUB FX $814.3223675 CLOSED RX SHLDR DISLOC,OX HUM FX $1,027.4223650 CLOSED RX SHLDR DISLOCATION $593.2827176 CLOSED RX SLIP FEM EPIPHYSIS,PINS $1,905.8227256 CLOSED RX SPONTANEOUS HIP DISLOC $486.0023525 CLOSED RX STERN-CLAV DISLOC,MANIP $735.12

21820 CLOSED RX STERNUM FRACTURE $297.3628570 CLOSED RX TALOTARSAL DISLOC $396.0028575 CLOSED RX TALOTARSAL DISLOC,ANESTH $684.7228430 CLOSED RX TALUS FX $431.2828435 CLOSED RX TALUS FX,MANIPULATN $667.4428600 CLOSED RX TAR-METATAR DISLOCATION $385.2028545 CLOSED RX TARSAL DISLOC,ANESTH $544.3228450 CLOSED RX TARSAL FX,EACH $394.5628455 CLOSED RX TARSAL FX,MANIP,EACH $533.5227532 CLOSED RX TIB PLAT FX+MANIP $1,193.0227538 CLOSED RX TIB TUBER FX $915.1027750 CLOSED RX TIBIA SHAFT FX $654.4827752 CLOSED RX TIBIA SHAFT FX,MANIPULATN $1,018.7827530 CLOSED RX TIBIAL PLATEAU FX $578.1628510 CLOSED RX TOE FX $247.6828515 CLOSED RX TOE FX,MANIPULATN $293.7627252 CLOSED RX TRAUMA HIP DISLOC,ANESTH $1,568.8627250 CLOSED RX TRAUMATIC HIP DISLOCATN $372.9627816 CLOSED RX TRIMALLEOLAR FX $594.0027818 CLOSED RX TRIMALLEOLAR FX,MANIP $892.8025530 CLOSED RX ULNA SHAFT FX $488.8825535 CLOSED RX ULNA SHAFT FX,MANIPULATN $928.0625650 CLOSED RX ULNA STYLOID FX $616.3227825 CLOSED RX WEIGHT BEAR DIST TIB,MANIP $1,024.5427824 CLOSED RX WEIGHT BEAR DIST TIBIA $628.5626670 CLOSED RX, CARPOMETACAR DISLOC,NON-THUMB $635.7622305 CLOSED TREAT SPINE OCESS FX $587.5222310 CLOSED TREAT VERT BODY FRACT $587.5222315 CLOSED TREAT VERT BODY FX,MANIPULATN $1,599.8225660 CLOSED TREAT WRIST DISLOCATION $854.6427768 CLOSED TREATMENT PST MALLEOLUS FRACTURE W MANIP $911.5027767 CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANIP $583.2027810 CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MANIP $869.7627808 CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANIP $617.04

27268 CLOSED TX FEMORAL FRACTURE OX HEAD W MANIP $1,116.7027267 CLOSED TX FEMORAL FRACTURE OX HEAD W/O MANIP $894.2424675 CLOSED TX ULNAR FRACTURE OX END W MANIPULATION $852.4824670 CLOSED TX ULNAR FRACTURE OX END W/O MANIPULATE $540.0043870 CLOSURE OF GASTROSTOMY,SURGICAL $1,479.5812020 CLOSURE SUPERF WND DEHIS SIMPLE $389.5212021 CLOSURE SUPERF WND DEHIS W PACKING $285.8450930 CLOSURE URETER/BOWEL FISTULA $2,300.3850920 CLOSURE URETER/SKIN FISTULA $1,839.5857260 CMBND ANTERPOST COLPORRAPHY W/CYSTO $1,553.7457265 CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL R $1,745.26

A6021 COLLAGEN DRESSING <=16 SQ IN $43.90J0775 COLLAGENASE, CLOST HIST INJ $125.39

36416 COLLECTION CAPILLARY BLOOD SPECIMEN $10.0036415 COLLECTION VENOUS BLOOD,VENIPUNCTURE $19.4499091 COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D $117.36

G0121 COLON CA SCRN NOT HI RSK IND $649.4445398 COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S) $534.9645393 COLONOSCOPY FLEXIBLE WITH DECOMESSION $534.9645388 COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES $573.1245378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD $195.8445390 COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION $704.8845379 COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S) $505.4444388 COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX $162.7244389 COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE $364.3244390 COLONOSCOPY STOMA W/RMVL FOREIGN BODY $447.1245380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE $425.5245383 COLONOSCOPY,ABLATE LESION $486.1244320 COLOSTOMY $2,506.3045382 COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD $548.6445386 COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT $448.5645384 COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS $483.1245385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ $538.5645381 COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST $425.52

90710 COMBINED VAINE,MMR+VARICELLA,SUB-Q $234.0020696 COMP ASSIST MULTIPLANE EXT FIXATION, INITIAL $2,496.9451726 COMPLEX CYSTOMETROGRAM $546.4851729 COMPLEX CYSTOMETROGRAM W/VOID ESS&URETHRAL OFILE $703.4451727 COMPLEX CYSTOMETROGRAM URETHRAL ESS OFILE $642.9651728 COMPLEX CYSTOMETROGRAM VOIDING ESSURE STUDIES $655.2010180 COMPLEX DRAINAGE, WOUND $369.3651741 COMPLEX UROFLOWMETRY $32.40

A6443 CONFORM BAND N/S W>=3<5/YD $2.0051980 CONSTRUCT BLADDER OPENING-CUTANEOUS $1,488.9490887 CONSULTATION WITH FAMILY $154.8095250 CONT GLUC MNTR PHYSICIAN/QHP OVIDED EQUIPTMENT $313.2095249 CONT GLUC MONITORING PATIENT OVIDED EQUIPTMENT $112.3250825 CONTINENT DIVERSION,W/BOWEL ANASTOMOSIS $3,443.0095251 CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R $73.4494644 CONTINUOUS INHALATION TX, 1ST HR $92.1627132 CONV EV HIP SURG TO TOT HIP ARTHROPLAS $3,481.8823415 CORACO-ACROMIAL LIG RELEASE $1,443.5892984 CORONARY ART DIL,EA ADDNL VESSEL $495.6492982 CORONARY ART DIL,ONE VESSEL $1,239.1054430 CORPORA CAVER-SPONGIOSA SHUNT $1,337.0254435 CORPORA-GLANS FISTULIZATN $870.4854420 CORPORA-SAPHEN VEIN SHUNT $13,307.0228293 CORRECT BUNION,RESEC JT+IMPLNT $1,113.1028290 CORRECT BUNION,SIMPLE $983.5026567 CORRECT FINGER DEFORMITY $1,388.8626565 CORRECT METACARPAL DEFORM $1,394.6228299 CORRJ HALLUX VALGUS W/SESMDC W/2 OSTEOT $1,204.5428296 CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT $1,067.0228298 CORRJ HALLUX VALGUS W/SESMDC W/OX PHLNX OSTEOT $1,029.5828292 CORRJ HALLUX VALGUS W/SESMDC W/RESCJ OX PHAL $1,008.7063064 COSTOVERT DECOMESS THORACIC CORD $3,731.7263066 COSTOVERT DECOMP THOR CORD,EACH ADDN $439.92

G0509 CRIT CARE TELEHEA CONSULT 50 $394.56

G0508 CRIT CARE TELEHEA CONSULT 60 $408.2499466 CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN $486.7299467 CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN $243.3699292 CRITICAL CARE, ADDL 30 MIN $249.8499291 CRITICAL CARE, E/M 30-74 MINUTES $558.7255873 CRYOSURG ABLATION OF OSTATE $2,556.5530903 CTRL NOSEBLEED,ANTER,COMPLEX $162.0030901 CTRL NOSEBLEED,ANTER,SIMPLE $116.6430905 CTRL NOSEBLEED,POST,W/PACKS &/OR CAUT $216.7265435 CURETTE/TREAT CORNEA $143.2893016 CV STRS TST XERS&/OR RX CONT ECG W/O I&R $45.3693015 CV STRS TST XERS&/OR RX CONT ECG W/SI&R $145.4451590 CYSTECTOMY,ILEAL CONDUIT/SIGMOID BLADDER $4,040.6051596 CYSTECTOMY,W/CONTINENT DIVERSION $4,912.5052442 CYSTO INSERTION TRANSOSTATIC IMPLANT EA ADDL $126.0052441 CYSTO INSERTION TRANSOSTATIC IMPLANT SINGLE $473.7652356 CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT $869.7652356 CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT BILATERAL $1,304.6452354 CYSTO/URETERO/PYELOSC,BX &/OR FULG LESN $872.6452354 CYSTO/URETERO/PYELOSC,BX &/OR FULG LESN BILATERAL $1,308.9652353 CYSTO/URETERO/PYELOSCOPY W/LITHOTRIPSY $819.3652353 CYSTO/URETERO/PYELOSCOPY W/LITHOTRIPSY BILATERAL $1,229.0452352 CYSTO/URETERO/PYELOSCOPY, CALCULUS TX $741.6052351 CYSTO/URETERO/PYELOSCOPY, DX $633.6052351 CYSTO/URETERO/PYELOSCOPY, DX BILATERAL $950.4052355 CYSTO/URETERO/PYELOSCOPY,W/RESECT TUMOR $977.7452346 CYSTO/URETEROSCOPY,TX INTRARENAL STRICT $933.8252345 CYSTO/URETEROSCOPY,TX URET/PELV STRICT $824.4052344 CYSTO/URETEROSCOPY,TX URETER STRICT $773.2852260 CYSTOSCOPY,DIL BLADDER,GEN ANESTH $439.9252265 CYSTOSCOPY,DIL BLADDER,LOCAL ANESTH $337.6852281 CYSTOSCOPY,DIL URETHRAL STRICTURE $317.5252276 CYSTOSCOPY,DIR VIS INT URETHROTOMY $552.9652325 CYSTOSCOPY,FRAGMT URETERAL STONE $671.04

52334 CYSTOSCOPY,GUIDE,PERCUT NEPHROS $535.6852305 CYSTOSCOPY,INCIS OPEN BLAD TIC $581.7652327 CYSTOSCOPY,INJECT IMPLNT MATERIAL $548.6452332 CYSTOSCOPY,INSERT URETERAL STENT $325.4452332 CYSTOSCOPY,INSERT URETERAL STENT BILATERAL $488.1652282 CYSTOSCOPY,INSERT URETHRAL STENT $704.1652270 CYSTOSCOPY,INTERN URETHROTOMY,FEMALE $380.1652275 CYSTOSCOPY,INTERN URETHROTOMY,MALE $519.8452330 CYSTOSCOPY,MANIPULATN $552.2452330 CYSTOSCOPY,MANIPULATN BILATERAL $828.3652315 CYSTOSCOPY,REMV CALCULUS,COMPLIC $573.8452310 CYSTOSCOPY,REMV CALCULUS,SIMPLE $316.0852320 CYSTOSCOPY,REMV URETERAL STONE $516.2452400 CYSTOSCOPY,RESEC CONGEN MUCOSAL FOLDS $997.9052402 CYSTOSCOPY,RESEC EJACULATORY DUCT $558.0052277 CYSTOSCOPY,RESEC EXTERN SPHINCTER $676.0852301 CYSTOSCOPY,RESECT ECTOPIC URETEROCEL $606.9652300 CYSTOSCOPY,RESECT ORTHO URETEROCELE $586.8052285 CYSTOSCOPY,RX FEMALE URETHRAL SYND $408.9652283 CYSTOSCOPY,STEROID INJ,STRICTURE $421.2052343 CYSTOSCOPY,TX INTRARENAL STRICTURE $720.0052341 CYSTOSCOPY,TX URETERAL STRICTURE $594.0052342 CYSTOSCOPY,TX URETEROPELVC STRICTURE $645.8452290 CYSTOSCOPY,URETERAL MEATOTOMY $511.2051525 CYSTOTOMY,EXCIS BLADDER TIC $1,791.3451530 CYSTOTOMY,EXCIS BLADDER TUMOR $1,628.6251520 CYSTOTOMY,EXCIS VESICAL NECK $1,239.8251065 CYSTOTOMY,EXTRACT &/OR FRAG URETER CALC $1,207.4251535 CYSTOTOMY,REPAIR URETEROCELE $1,627.9052000 CYSTOURETHROSCOPY $171.3652287 CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER $352.8052001 CYSTOURETHROSCOPY W/IRRIG & EVAC CLOTS $600.4852204 CYSTOURETHROSCOPY,BIOPSY $295.9252010 CYSTOURETHROSCOPY,EJAC DUCT CATH $346.32

52224 CYSTOURETHROSCOPY,FULGUR <0.5 CM LESN $426.2452240 CYSTOURETHROSCOPY,FULGUR >5 CM LESN $819.3652234 CYSTOURETHROSCOPY,FULGUR 0.5-2 CM LESN $514.8052235 CYSTOURETHROSCOPY,FULGUR 2-5 CM LESN $603.3652214 CYSTOURETHROSCOPY,FULGURATN $367.9252250 CYSTOURETHROSCOPY,INSERT RADIOACTIV $501.1252005 CYSTOURETHROSCOPY,URETER CATHETER $277.9252005 CYSTOURETHROSCOPY,URETER CATHETER BILATERAL $416.8852007 CYSTOURETHROSCOPY,URETERAL BIOPSY $345.60

Q4119C CYTAL WOUND MATRIX 3CM X 3.5CM $64.0062287 DCMN PERQ NUCLEUS PULPOSUS 1/> LEVELS LUMBAR $1,190.8611012 DEBRIDE ASSOC OPEN FX/DISLO SKIN/MUS/BONE $884.1611011 DEBRIDE ASSOC OPEN FX/DISLOC SKIN/MUSCLE $624.9611010 DEBRIDE ASSOC OPEN FX/DISLOC SKIN/SUBQ $590.4011006 DEBRIDE NECROT SKIN/ TISS, GENIT,PERI, ADB WALL $1,471.6611005 DEBRIDE NECROTIC SKIN/ TISSUE, ABD WALL $1,630.0611004 DEBRIDE NECROTIC SKIN/ TISSUE, GENIT & PERINM $1,201.6611720 DEBRIDEMENT OF NAIL(S), 1-5 $30.2411721 DEBRIDEMENT OF NAILS, 6 OR MORE $51.1297597 DEBRIDEMENT OPEN WOUND 20 SQ CM< $48.9697598 DEBRIDEMENT OPEN WOUND EA ADDL 20 SQ CM $56.8811000 DEBRIDEMENT, INFECTED SKIN, UP TO 10% BSA $59.0411041 DEBRIDEMENT, SKIN, FULLTHICKNESS $116.6411040 DEBRIDEMENT, SKIN, PARTIAL THICKNESS $54.7211042 DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM $128.1611045 DEBRIDEMENT, SKIN, SUB-Q TISSUE,EACH ADD 20 SQ CM $54.7211043 DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,=<20 SQ CM $321.8411044 DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,BONE,=<20 SQ CM $477.3611047 DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,BONE,EACH ADD 20 SQ CM $205.9211046 DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,EACH ADD 20 SQ CM $116.6436593 DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH $396.7236550 DECLOT VASCULAR AESS DEVICE $110.8827600 DECOMESS ANT/LAT LEG CMPART $838.8027602 DECOMESS ANT/LAT+POST LEG CMPART $1,010.14

26037 DECOMESS FASCIOTOMY FINGR/HAND $1,172.1427892 DECOMESS FASCIOTOMY LEG,ANT/LAT $1,159.9026035 DECOMESS FINGERS/HAND,INJECT INJ $1,778.3824495 DECOMESS FOREARM,BRACH ART EXPLOR $1,527.8225023 DECOMESS FOREARM,EXCIS MUSC/NERV $2,295.3427894 DECOMESS LEG,ANT/LAT & POST $1,742.3827601 DECOMESS POST LEG COMPARTMT $927.3463056 DECOMESS SPINAL CORD,1 SEG $3,112.5227499 DECOMESS THIGH/KNEE,>1+DEBRIDE $1,452.2227027 DECOMESSION FASCIOTOMY PELVIC COMPART, UNILAT $1,824.4625020 DECOMP FOREARM,1 COMPART,W/O DEBRIDE $1,185.8225025 DECOMP FOREARM,2 COMPART,W/ DEBRIDE $2,518.5425024 DECOMP FOREARM,2 COMPART,W/O DEBRIDE $1,605.5828002 DEEP DISSEC FOOT INFEC,1 BURSA $655.2028003 DEEP DISSEC FOOT INFEC,MULTIPLE $1,157.0228005 DEEP INCIS FOOT BONE INFECTN $1,190.8623040 DEEP INCIS SHLDR BONE CORTEX $1,485.34

J9155 DEGARELIX INJECTION $5.0015620 DELAY/SECTN FLAP FACE,GENIT,HAND,FT $668.1699465 DELIVERY/BIRTHING ROOM RESUSCITATION $297.3694664 DEMO &/OR EVAL,PT USE,AEROSOL DEVICE $35.2827035 DENERVATION OF HIP JOINT $2,369.50

J0897 DENOSUMAB INJECTION $19.0041899 DENTAL SURGERY OCEDURE $359.7664627 DEST,PARAVERTEBRAL,C/T,ADDL $229.3264626 DEST,PARAVERTEBRAL,C/T,SINGLE $458.6464623 DEST,PARAVERTEBRAL,L/S,ADDL LVLS $229.3264622 DEST,PARAVERTEBRAL,L/S,SINGLE $458.6454065 DESTR PENIS LESN,EXTENSIVE $357.8454050 DESTR PENIS LESN,SIMPL,CHEMICAL $219.6054056 DESTR PENIS LESN,SIMPL,CRYOSURG $230.4054055 DESTR PENIS LESN,SIMPL,ELEC-DESSIC $192.9654057 DESTR PENIS LESN,SIMPL,LASER SURG $200.1654060 DESTR PENIS LESN,SIMPL,SURG EXCIS $272.16

64613 DESTROY NERVE,CERV SPINAL MUSCLES $465.1264613 DESTROY NERVE,CERV SPINAL MUSCLES BILATERAL $697.6817003 DESTRUC BENIGN/EMAL,2-14 LESIONS BILL EACH $5.0417000 DESTRUC BENIGN/EMAL,FIRST LESION $108.7264640 DESTRUCT BY NEURO AGENT; OTHER PERIPH NERVE $192.2464640 DESTRUCT BY NEURO AGENT; OTHER PERIPH NERVE BILATERAL $288.3664630 DESTRUCT BY NEURO AGENT; PUDENDAL $395.2846930 DESTRUCT INTERNAL HEMORRHOID, THERMAL $306.7257061 DESTRUCT,VAGINAL LESION(S),SIMPLE $200.8817111 DESTRUCTION BENIGN LESIONS 15 OR MORE $177.1217110 DESTRUCTION BENIGN LESIONS UP TO 14 $144.0046924 DESTRUCTION,ANAL LESION(S),EXTENSIVE $378.7296110 DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM $20.88

J1100 DEXAMETHASONE SODIUM PHOS $1.00G0108 DIAB MANAGE TRN PER INDIV $108.72G0109 DIAB MANAGE TRN IND/GROUP $29.52

38220 DIAGNOSTIC BONE MARROW ASPIRATIONS $144.0038221 DIAGNOSTIC BONE MARROW BIOPSIES $145.4438222 DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS $161.2894729 DIFFUSING CAPACITY PROF CHG $18.7253620 DIL URET STRIC,MALE,INIT,FILIFORM $182.1653621 DIL URET STRIC,MALE,SUBSEQ,FILIFORM $151.2053605 DIL URETHRA STRIC,MALE,GEN ANESTH $135.3653600 DIL URETHRA STRIC,MALE,INITIAL $133.2053601 DIL URETHRA STRIC,MALE,SUBSEQ $112.3253660 DIL URETHRA,FEMALE,INITIAL $87.1253661 DIL URETHRA,FEMALE,SUBSEQUENT $84.9653665 DIL URETHRA,GEN/SPINAL ANESTH $80.6445905 DILATION ANAL SPHINCTER W ANESTH $352.08

J1212 DIMETHYL SULFOXIDE 50% 50 ML $66.00J1200 DIPHENHYDRAMINE L INJECTIO $2.00

99455 DISABILITY EXAM/TREATING DR $1,327.0063075 DISK SURG,ANTER,CERVICAL,SINGLE LVL $2,826.6863078 DISK SURG,THORAX,EA ADDNL LEVEL $442.08

63077 DISK SURG,THORAX,SINGLE LEVEL $3,115.4028250 DIVISN PLANTAR FASCIA/MUSCLE $840.2493325 DOPPLER COLOR FLOW VELOCITY MAP $52.5693320 DOPPLER ECHO HEART,COMPLETE $110.8893321 DOPPLER ECHO HEART,LIMITED,F/U PROF CHG $15.1249020 DRAIN ABD ABSCESS OPEN $3,314.1211740 DRAIN BLOOD FROM UNDER NAIL $67.6869020 DRAIN EXT AUD CANAL ABSCESS $288.7269000 DRAIN EXT EAR ABSC/BLOOD,SIMPLE $244.0826011 DRAIN FINGER ABSCESS,COMPLICATED $382.3226010 DRAIN FINGER ABSCESS,SIMPLE $283.6826020 DRAIN HAND TENDON SHEATH $895.6823031 DRAIN INFECT SHOULDER BURSA $447.8427607 DRAIN LEG/ANKLE BONE FOR INFECT $1,257.1027603 DRAIN LOWER LEG DEEP ABSC/HEMATOMA $802.8040800 DRAIN MOUTH ABSC/CYST/HEMATOMA,SIMPL $274.3251080 DRAIN PERI-BLADDER ABSCESS $853.2053085 DRAIN PERINEAL URIN LEAK,COMPLIC $1,354.3053080 DRAIN PERINEAL URIN LEAK,UNCOMPLIC $876.9610081 DRAIN PILONIDAL CYST COMPLIC $350.6410080 DRAIN PILONIDAL CYST SIMPL $211.6849060 DRAIN RETROPERITONEAL ABSCESS,OPEN $2,291.0223035 DRAIN SHOULDER BONE LESION $1,407.5810061 DRAIN SKIN ABSCESS COMPLIC $370.0810060 DRAIN SKIN ABSCESS SIMPLE $200.8849040 DRAIN SUBDIAPH/SUBPHR ABSCESS,OPEN $2,082.9442000 DRAINAGE ABSCESS PALATE/UVULA $212.4053040 DRAINAGE DEEP URETHRAL ABSCESS $819.3667700 DRAINAGE OF EYELID ABSCESS $239.7641800 DRAINAGE OF GUM LESION $312.4810140 DRAINAGE OF HEMATOMA/FLUID $244.8027030 DRAINAGE OF HIP JOINT $1,941.8255000 DRAINAGE OF HYDROCELE,TUNICA $177.1250040 DRAINAGE OF KIDNEY $1,928.14

47011 DRAINAGE OF LIVER LESION, PERCUT $2,424.9452700 DRAINAGE OF OSTATE ABSCESS $920.1426030 DRAINAGE PALM BURSA,MULTIP/COMPLX $1,020.2255100 DRAINAGE SCROTAL WALL ABSCESS $346.3253060 DRAINAGE SKENES GLAND ABSCESS $338.4016030 DRESS/DEBRID LARGE BURN NO ANESTH $279.3616025 DRESS/DEBRID MED BURN NO ANESTH $231.1216020 DRESS/DEBRID SMALL BURN NO ANES $113.0415852 DRESSING CHANGE,NOT FOR BURN $96.48

G0477 DRUG TEST ESUMP OPTICAL $74.00G0290 DRUG-ELUTING STENTS, SINGLE $1,596.22

64634 DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA $141.1264634 DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA BILATERAL $211.6864636 DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL $123.1264636 DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL BILATERAL $184.6864633 DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA $465.1264633 DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA BILATERAL $697.6864635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL $458.6464635 DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL BILATERAL $687.9690700 DTAP IMMUNIZATION, IM, <7 YO $45.7790723 DTAP-HEPB-IPV VAINE INTRAMUSCULAR $83.6490696 DTAP-IPV VAINE CHILD 4-6 YRS FOR IM USE $51.4390698 DTAP-IPV/HIB VAINE FOR INTRAMUSCULAR USE $135.0093975 DUPLEX ABD/PEL VASC STUDY,COMPLETE $581.7693976 DUPLEX ABD/PEL VASC STUDY,LIMITD $338.4093970 DUPLEX EXTREM VENOUS,BILAT PROF CHG $70.5693970 DUPLEX EXTREM VENOUS,BILAT $403.9293970 DUPLEX EXTREM VENOUS,BILAT TECH CHG $333.3693971 DUPLEX EXTREM VENOUS,UNI OR LTD PROF CHG $46.0893971 DUPLEX EXTREM VENOUS,UNI OR LTD $247.6893971 DUPLEX EXTREM VENOUS,UNI OR LTD TECH CHG $201.6093925 DUPLEX LO EXTREM ART BILAT $536.4093926 DUPLEX LO EXTREM ART UNILAT/LTD $313.9293880 DUPLEX SCAN EXTRACRANIAL,BILAT $418.32

93882 DUPLEX SCAN EXTRACRANIAL,LIMITED PROF CHG $51.8493882 DUPLEX SCAN EXTRACRANIAL,LIMITED $267.8493930 DUPLEX UP EXTREM ART BILAT $429.8493931 DUPLEX UP EXTREM ART UNILAT/LTD $267.1263710 DURAL GRAFT REPAIR,SPINE DEFECT $2,262.9493350 ECHO HEART XTHORACIC, STRESS/REST PROF CHG $145.4493306 ECHO HEART XTHORACIC,COMPLETE W DOPPLER PROF CHG $149.7693307 ECHO HEART XTHORACIC,COMPLETE, W/O DOPPLER PROF CHG $92.1693308 ECHO HEART XTHORACIC,LIMITED PROF CHG $52.5693313 ECHO R-T 2D W/OBE PLACEMENT ONLY $23.7693314 ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY PROF CHG $187.9293312 ECHO TRANSESOPHAG R-T 2D W/B IMG ACQUISJ I&R PROF CHG $223.9293303 ECHO XTHORACIC,CONG ANOM,COMPLETE PROF CHG $130.3243259 EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM $478.8095813 EEG >1 HR PROF CHG $177.8495957 EEG DIGITAL ANALYSIS PROF CHG $213.8495824 EEG EVAL CEREBRAL DEATH PROF CHG $81.3695953 EEG MONITORING/COMPUTER, EA 24 HOURS, UNATTENDED PROF CHG $336.9695951 EEG MONITORING/VIDEORECORD PROF CHG $657.3695822 EEG,COMA/SLEEP RECORD ONLY PROF CHG $118.8095812 EEG,EXTENDED MONITORING,41-60 MINUTES PROF CHG $118.8095819 EEG,W/AWAKE & ASLEEP RECORD PROF CHG $118.8095816 EEG,W/AWAKE & DROWSY RECORD PROF CHG $118.80

L3701 EFAB ELBOW ORTHOSIS $40.0043270 EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE $475.2043249 EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM $324.0043244 EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES $519.1243245 EGD DILATION GASTRIC/DUODENAL STRICTURE $372.2443266 EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION $461.5243233 EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER $483.1243250 EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS $360.7243247 EGD FLEXIBLE FOREIGN BODY REMOVAL $375.8443241 EGD INTRALUMINAL TUBE/CATHETER INSERTION $300.9643246 EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE $423.36

43251 EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH $416.1643239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE $292.3243255 EGD TRANSORAL CONTROL BLEEDING ANY METHOD $425.5243253 EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER $556.5629837 ELBOW ARTHROSCOP,PART DEBRIDE $1,085.7429835 ELBOW ARTHROSCOP,PART SYNOVECT $1,054.7829834 ELBOW ARTHROSCOP,REMV LOOSE BODY $1,007.9895972 ELEC ALYS IMPLT NPGT CPLX SP/PN GRMG $120.2495970 ELEC ALYS IMPLT NPGT PHYS/QHP W/O OGRAMMING $141.8495971 ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT GRMG $104.4095974 ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR $425.5295975 ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV EA 30 MIN $228.9695973 ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH EA 30 MIN $104.4062370 ELEC ANLYS IMPLT ITL/EDRL PMP W/RE PHYS/QHP $96.48

G0283 ELEC STIM OTHER THAN WOUND $30.2462369 ELECT ANLYS IMPLT ITL/EDRL PMP W/REG&REFILL $72.7220975 ELECT BONE STIM INVASIVE $372.2495873 ELECTRIC STIM GUIDANCE FOR CHEMODENERVATION PROF CHG $41.0495873 ELECTRIC STIM GUIDANCE FOR CHEMODENERVATION $150.4895873 ELECTRIC STIM GUIDANCE FOR CHEMODENERVATION TECH CHG $109.4497014 ELECTRIC STIMULATION THERAPY $31.6897032 ELECTRICAL STIMULATION $31.6893010 ELECTROCARDIOGRAM REPORT $17.2893000 ELECTROCARDIOGRAM, COMPLETE $34.5690870 ELECTROCONVULSIVE THERAPY,1 SEIZ $225.3646910 ELECTRODESSICATN,ANAL LESN(S) $278.6499140 EMERGENCY ANESTHESIA $83.0099058 EMERGENCY CARE DISRUPTING OFFICE $78.0099284 EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY $239.0499281 EMERGENCY DEPARTMENT VISIT LIMITED/MINOR OB $43.2099282 EMERGENCY DEPARTMENT VISIT LOW/MODER SEVERITY $84.2499283 EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY $126.0099285 EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ $352.0895863 EMG, NEEDLE, 3 LIMBS $455.76

95864 EMG, NEEDLE, 4 LIMBS $509.7695868 EMG, NEEDLE, HEAD OR NECK $277.2095872 EMG, NEEDLE, ONE FIBER $403.9295860 EMG, NEEDLE, ONE LIMB $252.0095861 EMG, NEEDLE, TWO LIMBS $357.1295870 EMG,1 EXTREM,NONPARASPINAL $194.4095867 EMG,NEEDLE,CRANIAL NERVE SUPP MUS,UNILAT $208.0895869 EMG,NEEDLE,THOR PARASPIN MUS,EXC T1/T12 $191.5231620 ENDOBRONCHIAL U/S ADD-ON $182.5292979 ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL PROF CHG $160.5692978 ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL PROF CHG $199.4451715 ENDOSCOPIC INJECTION/IMPLANT $417.6044360 ENDOSCOPY UPPER SMALL INTESTINE $303.8444361 ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY $335.5236475 ENDOVENOUS RF, 1ST VEIN $72.0051960 ENTEROCYSTOPLASTY,W/BOWEL ANASTOMOSIS $2,892.2044377 ENTEROSC >2ND TN W/ILEUM W/BX SINGLE/MULTIPLE $634.3244376 ENTEROSC >2ND TN W/ILEUM W/WO COLLJ SPEC SPX $601.9244369 ENTEROSCOPY > 2ND TN ABLTJ LESION $519.8444378 ENTEROSCOPY > 2ND TN ILEUM CONTROL BLEEDING $814.3244370 ENTEROSCOPY > 2ND TN TNDSC STENT PLMT $563.7644366 ENTEROSCOPY > 2ND TN W/CONTROL BLEEDING $508.3244363 ENTEROSCOPY > 2ND TN W/RMVL FOREIGN BODY $406.8044021 ENTEROTOMY DECOMESS SMALL BOWEL $2,031.10

L3760 EO ADJ JT EFAB CUSTOM FIT $531.3290889 EP REPORT PT PSYCH STATUS AGENCY/PAYER $101.5255300 EPARATION, SPERM DUCT X-RAY $390.9693640 EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE PROF CHG $374.4093641 EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN PROF CHG $654.4815115 EPI AUTOGRFT FACE/NCK/HND/FT/GEN <100 SQCM $1,413.3415110 EPIDRM AUTOGRFT TRNK/ARM/LEG <100 SQCM $1,427.0254450 EPUTIAL STRETCHING $120.9643260 ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING $683.2816035 ESCHAROTOMY $403.92

91010 ESOPHAGEAL MOTILITY STUDY, MANOMETRY PROF CHG $137.5291010 ESOPHAGEAL MOTILITY STUDY, MANOMETRY $362.1691010 ESOPHAGEAL MOTILITY STUDY, MANOMETRY TECH CHG $224.6443236 ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION $293.0443235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC $259.9243220 ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM $248.4043215 ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY $298.0843227 ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL $349.2043213 ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER $545.0443194 ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY $401.0490958 ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS $888.4890957 ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS $1,309.6690960 ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS $576.7290962 ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT $375.1290961 ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS $485.2890966 ESRD SERVICES, HOME DIALYSIS, PER MONTH, 20+ YR OLD $483.8490970 ESRD SERVICES, PER DAY,20+ YR OLD $15.8494640 ESSURIZED/NONESSURIZED INHALATION TREATMENT $38.1699211 ESTABLISHED PATIENT VISIT LEVEL 1 $43.9299212 ESTABLISHED PATIENT VISIT LEVEL 2 $89.2899213 ESTABLISHED PATIENT VISIT LEVEL 3 $148.3299214 ESTABLISHED PATIENT VISIT LEVEL 4 $218.8899215 ESTABLISHED PATIENT VISIT LEVEL 5 $295.20

J7323 EUFLEXXA INJ PER DOSE $955.6494060 EVAL OF BRONCHOSPASM PROF CHG $26.6494060 EVAL OF BRONCHOSPASM $123.8494060 EVAL OF BRONCHOSPASM TECH CHG $97.2094070 EVAL OF BRONCHOSPASM,OLONGED PROF CHG $59.0497762 EVAL OF ORTHOTIC/OSTH USE, EA 15 MIN $98.6499401 EVENT COUNSEL,INDIV,15 MIN $77.0499391 EVENTIVE VISIT,EST, INFANT < 1 YR $202.3299394 EVENTIVE VISIT,EST,12-17 $236.1699395 EVENTIVE VISIT,EST,18-39 $241.2099392 EVENTIVE VISIT,EST,AGE 1-4 $216.00

99393 EVENTIVE VISIT,EST,AGE5-11 $215.2899384 EVENTIVE VISIT,NEW,12-17 $276.4899385 EVENTIVE VISIT,NEW,18-39 $267.8499382 EVENTIVE VISIT,NEW,AGE 1-4 $235.4499383 EVENTIVE VISIT,NEW,AGE5-11 $244.8099381 EVENTIVE VISIT,NEW,INFANT < 1 YR $225.3626111 EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM $866.1615940 EXC ISCH ES ULC W IM CLOS $1,441.4239220 EXC MEDIASTINAL TUMOR $2,366.6215934 EXC SACR ESS ULC W FLAP CLOS $1,935.3415931 EXC SACR ESS ULC W I SUTURE $1,424.8611440 EXC SKIN BENIG <0.5 CM FACE,FACIAL $213.1211420 EXC SKIN BENIG <0.5 CM REMAINDER BODY $167.7611400 EXC SKIN BENIG <0.5 CM TRUNK,ARM,LEG $167.0411446 EXC SKIN BENIG >4 CM FACE,FACIAL $672.4811426 EXC SKIN BENIG >4 CM REMAINDR BODY $570.9611406 EXC SKIN BENIG >4 CM TRUNK,ARM,LEG $511.9211441 EXC SKIN BENIG 0.6-1 CM FACE,FACIAL $271.4411421 EXC SKIN BENIG 0.6-1 CM REMAINDR BODY $226.8011401 EXC SKIN BENIG 0.6-1 CM TRUNK,ARM,LEG $214.5611442 EXC SKIN BENIG 1.1-2 CM FACE,FACIAL $299.5211422 EXC SKIN BENIG 1.1-2 CM REMAINDR BODY $282.2411402 EXC SKIN BENIG 1.1-2 CM TRUNK,ARM,LEG $236.8811443 EXC SKIN BENIG 2.1-3 CM FACE,FACIAL $323.2811423 EXC SKIN BENIG 2.1-3 CM REMAINDR BODY $323.2811403 EXC SKIN BENIG 2.1-3 CM TRUNK,ARM,LEG $305.2811424 EXC SKIN BENIG 3.1-4 CM REMAINDR BODY $371.5211404 EXC SKIN BENIG 3.1-4 CM TRUNK,ARM,LEG $335.5211640 EXC SKIN MALIG <0.5 CM FACE,FACIAL $259.2011620 EXC SKIN MALIG <0.5 CM REMAINDER BODY $250.5611646 EXC SKIN MALIG >4 CM FACE,FACIAL $819.3611626 EXC SKIN MALIG >4 CM REMAINDR BODY $609.8411606 EXC SKIN MALIG >4 CM TRUNK,ARM,LEG $665.2811601 EXC SKIN MALIG 0.6-1 CM TRUNK,ARM,LEG $308.16

11641 EXC SKIN MALIG 0.6-1CM FACE,FACIAL $323.2811642 EXC SKIN MALIG 1.1-2 CM FACE,FACIAL $380.8811622 EXC SKIN MALIG 1.1-2 CM REMAINDR BODY $354.9611602 EXC SKIN MALIG 1.1-2 CM TRUNK,ARM,LEG $339.1211643 EXC SKIN MALIG 2.1-3 CM FACE,FACIAL $477.3611623 EXC SKIN MALIG 2.1-3 CM REMAINDR BODY $440.6411644 EXC SKIN MALIG 3.1-4 CM FACE,FACIAL $591.8411624 EXC SKIN MALIG 3.1-4 CM REMAINDR BODY $498.9611604 EXC SKIN MALIG 3.1-4 CM TRUNK,ARM,LEG $447.1211451 EXC SWEAT GLAND LESN AXILL,COMPLX $672.4811450 EXC SWEAT GLAND LESN AXILL,SIMPL $525.6011470 EXC SWEAT GLAND LESN PERINEAL,SIMPL $582.4815951 EXC TROC ES ULC & BONE IM CLO $1,814.3815950 EXC TROC ES ULC W IM CLOS $1,227.5826116 EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM $1,092.2226115 EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM $689.0425073 EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM $1,105.1821932 EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM $1,373.7421933 EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM $1,532.1421014 EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM $1,082.1425071 EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM $882.0025076 EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM $1,073.5023076 EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM $1,119.5824076 EXC TUMOR SOFT TISS U ARM/ELBOW SUBFASC <5CM $1,128.2224075 EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM $684.7224073 EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM $1,439.2622900 EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM $1,172.1422901 EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM $1,383.8222902 EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM $685.4422903 EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM $912.2228045 EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM $722.1625075 EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM $655.9227619 EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <3CM $962.6227618 EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM $640.08

27632 EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3+CM $859.6821554 EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL 5+CM $1,515.5821556 EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL <5CM $1,089.3421555 EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM $632.1621552 EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM $926.6227048 EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM $1,265.7427045 EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM $1,547.9827047 EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM $748.8023073 EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM $1,441.4227328 EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM $1,290.9427339 EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM $1,563.1024071 EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM $843.8423156 EXCIS BENIG TUMR OX HUMER,ALLOGRFT $1,404.7026200 EXCIS BENIGN BONE LESN,METACARPAL $929.5026210 EXCIS BENIGN BONE LESN,PHALANX $914.3824115 EXCIS BENIGN HUMERUS LESN,AUTOGRFT $1,529.2625130 EXCIS BENIGN LESN CARPALS $923.7425125 EXCIS BENIGN LESN RAD/ULNA,AUTOGRFT $1,227.5827635 EXCIS BENIGN LESN,TIB/FIB $1,213.1827638 EXCIS BENIGN LESN,TIB/FIB+ALLOGRFT $1,604.1427637 EXCIS BENIGN LESN,TIB/FIB+AUTOGRFT $1,586.1423145 EXCIS BENIGN TUMR CLAV/SCAP,AUTOGRFT $1,440.7053220 EXCIS CANCER URETHRA $942.4663020 EXCIS CERV DISK,ONE LEVEL $2,424.2225240 EXCIS DISTAL ULNA,PART/COMPLETE $886.3263035 EXCIS EACH ADDNL SPINAL DISK BILATERAL $602.6463035 EXCIS EACH ADDNL SPINAL DISK $401.7654830 EXCIS EPIDIDYMIS LOCAL LESION $778.3226180 EXCIS FINGER TENDON FLEXOR $917.2625111 EXCIS IMARY GANGLION WRIST $662.4028080 EXCIS INTERDIGITAL NEUROMA,EA $760.3263272 EXCIS INTRASP LESN,INTRADUR,LUMB $3,979.4063265 EXCIS INTRASP LESN,XDURAL,CERVICAL $3,505.6463267 EXCIS INTRASP LESN,XDURAL,LUMBAR $2,865.56

26135 EXCIS JT LINING,MC-P JT,EACH DIGIT $1,140.4626140 EXCIS JT LINING,OX I-P JT,EACH $1,041.8227333 EXCIS KNEE CARTILAGE,MEDIAL & LAT $1,213.1827332 EXCIS KNEE CARTILAGE,MEDIAL OR LAT $1,333.4227630 EXCIS LESN TENDON SHEALTH LEG/ANKLE $754.5626170 EXCIS PALM TENDON FLEXOR, EACH $840.9654110 EXCIS PENILE PLAQUE $1,303.1854111 EXCIS PENILE PLAQUE,GRAFT <5 CM $1,671.1054112 EXCIS PENILE PLAQUE,GRAFT >5 CM $1,956.2245172 EXCIS RECTAL TUMOR, TRANSANAL, FULL THICKNESS $1,694.1445171 EXCIS RECTAL TUMOR, TRANSANAL, PARTIAL THICKNESS $1,253.5025112 EXCIS RECURRENT GANGLION WRIST $799.9253270 EXCIS SKENE'S GLANDS $383.0454840 EXCIS SPERMATOCELE $671.0425118 EXCIS SYNOV WRIST,EXTENS TENDON $788.4025119 EXCIS SYNOV WRIST,PART REMV ULNA $1,033.1828116 EXCIS TARSAL COALITION $1,205.2628090 EXCIS TENDN/CAPSULE LESN,FOOT $637.9228092 EXCIS TENDN/CAPSULE LESN,TOES $557.2826160 EXCIS TENDON SHEATH LESION, HAND/FINGER $690.4825110 EXCIS TENDON SHEATH LESN,WRIST/FORE $704.1654512 EXCIS TESTIS EXTRAPARENCHYMAL LESION $1,128.2241115 EXCIS TONGUE FOLD $299.5253250 EXCIS URETHRAL GLAND $825.8453275 EXCIS URETHRAL OLAPSE $547.9253260 EXCIS URETHRAL POLYP(S) $374.4053230 EXCIS URETHRAL TIC,FEMALE $1,262.1453235 EXCIS URETHRAL TIC,MALE $1,321.1857135 EXCIS VAGINAL CYST/TUMOR $354.2455540 EXCIS VARICOCEL,ABD ACH+FIX HERNIA $1,149.8225120 EXCIS/CURET BENIG BONE LES RAD/ULNA $1,027.4224120 EXCIS/CURET BENIGN ELBOW LESN $1,097.2624110 EXCIS/CURET BENIGN HUMERUS LESN $1,214.6223140 EXCIS/CURET BENIGN TUMR CLAV/SCAPULA $1,106.62

23150 EXCIS/CURET BENIGN TUMR OX HUMERUS $1,374.4626215 EXCIS/GRFT BENIGN LESN,PHALANX $1,166.3850290 EXCIS/UNROOF PERIRENAL CYST $1,875.5850280 EXCIS/UNROOF RENAL CYST $1,990.0619120 EXCISE BREAST CYST $856.8019125 EXCISE BREAST LES W XRAY MARKER $950.3819126 EXCISE BREAST LES XRAY MARK ADDNL $336.2464788 EXCISE CUTANEOUS NEUROFIBROMA $819.3664774 EXCISE CUTANEOUS NEUROMA $853.2055650 EXCISE DEMINAL VESICLE $1,497.5864776 EXCISE DIGITAL NEUROMA $809.2864782 EXCISE HAND/FOOT NEUROMA $943.9064790 EXCISE MAJOR PERIPH NEUROFIBROMA $1,745.9864784 EXCISE MAJOR PERIPHERAL NEUROMA $1,506.2255680 EXCISE MULLERIAN DUCT CYST $722.8855530 EXCISE VARICOCELE $734.4055535 EXCISE VARICOCELE,ABD APOACH $898.5644800 EXCISION MECKEL,OMPHALOMES DUCT $1,591.1846230 EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS $359.2811765 EXCISION OF NAIL FOLD, TOE $192.9646220 EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS $246.2446320 EXCISION THROMBOSED HEMORRHOID, EXTERNAL $230.4021011 EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM $534.9621012 EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM $702.7221930 EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM $756.7221931 EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM $976.3028043 EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM $545.0428039 EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM $719.2827043 EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM $974.8623075 EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM $678.9623071 EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM $871.9227327 EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM $650.1627066 EXCISISON BONE CYST BENIGN TUMOR,PELVIS/HIP,DEEP $1,671.1027065 EXCISISON BONE CYST BENIGN TUMOR,PELVIS/HIP,SUPERFICIAL $1,075.66

27337 EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM $869.0419020 EXPLO/DRAIN BREAST ABSCESS $635.7627620 EXPLOR ANKLE JOINT $928.0627625 EXPLOR ANKLE JT+SYNOVECTOMY $1,201.6624102 EXPLOR ELBOW JT/REMOV SYNOVIUM $1,274.3828024 EXPLOR INTERPHALANGEAL JT $629.2828022 EXPLOR METATARSO-PHALANG JT $668.8835800 EXPLOR POSTOP BLEED,INFEC,CLOT-NECK $1,496.8650120 EXPLOR RENAL PELVIS $1,980.7050135 EXPLOR RENALPELVIS,COMPLICATED $2,342.1428020 EXPLOR TARSAL/TARSOMETATAR JT $751.6825105 EXPLOR WRIST JT/REMV SYNOVIUM $996.4627310 EXPLOR/DRAIN KNEE,INFECTN $1,514.1450125 EXPLOR/DRAIN RENAL PELVIS $2,049.8250130 EXPLOR/REMV STONE,RENAL PELVIS $2,155.6635761 EXPLORATION OF ARTERY/VEIN $819.3654865 EXPLORATION OF EPIDIDYMIS W/WO BIOPSY $749.5227033 EXPLORATION OF HIP JOINT $2,012.3850010 EXPLORATION OF KIDNEY $1,526.3822830 EXPLORATION OF SPINAL FUSION $1,699.1850600 EXPLORATION OF URETER $1,959.1049000 EXPLORATORY OF ABDOMEN $1,603.4226070 EXPLORE & TREAT CARPOMETACARP JT $659.5226075 EXPLORE & TREAT METACARPO-PHAL JT $687.6024101 EXPLORE ELBOW JOINT $1,032.4655110 EXPLORE SCROTUM $809.2823107 EXPLORE SHOULDER JOINT $1,370.1454550 EXPLORE UNDESC TESTIS,INGUIN/SCROTAL $1,026.7020102 EXPLORE WOUND,ABDOMEN/FLANK/BACK $531.3620103 EXPLORE WOUND,EXTREMITY $722.8820100 EXPLORE WOUND,NECK $1,257.1024000 EXPLORE/DRAIN ELBOW FOR INFECT $986.3827612 EXPLORE/RELEASE POST CAP ANKLE JT $1,162.7827610 EXPLORE/TREAT ANKLE JOINT $1,345.66

26080 EXPLORE/TREAT INTERPHALANGEAL JT,EA $807.1255725 EXTERN DRAIN OSTATE ABSC,COMPLIC $1,238.3855720 EXTERN DRAIN OSTATE ABSC,SIMPLE $944.6292285 EYE PHOTOGRAPHY $42.4890846 FAMILY PSYCHOTHERAPY W/O PATIENT ESENT 50 MINS $205.9290847 FAMILY PSYCHOTHERAPY W/PATIENT ESENT 50 MINS $214.5627236 FEMORAL FX, OPEN TX $2,483.98

J3010 FENTANYL CITRATE INJECITON $4.0014350 FILLET FINGR/TOE FLAP W EP $1,416.2210022 FINE NEEDLE ASP;W/IMAGING GUIDANCE $135.3610021 FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION $143.28

Q4049 FINGER SPLINT, STATIC $3.0026498 FINGER TENDON TRANSFER,2-5 FINGRS $2,343.5826545 FIX COLAT LIG,I-P JT,GRAFT,EACH $1,429.1826541 FIX COLLAT LIG,MC-P JT,GRAFT $1,635.8226540 FIX COLLAT LIG,MC-P JT,I-P JT $1,340.6226542 FIX COLLAT LIG,MC-P JT,LOCAL TISS $1,382.3826548 FIX FINGER,VOLAR PLATE,I-P JT $1,553.7427380 FIX INFRAPATELLA TENDON,IMARY $1,226.8627470 FIX NON/MALUNION FEMUR BELOW NECK $2,441.5027472 FIX NON/MALUNION FEMUR,W GRAFT $2,621.5026546 FIX NONUNION METACARPAL/PHALANX $2,030.3827381 FIX PATELLA TENDN,SECONDARY $1,652.3827385 FIX QUAD/HAMSTR MUSC RUPT,IMARY $1,187.9827386 FIX QUAD/HAMSTR MUSC RUPT,SECOND $1,717.1827422 FIX UNSTABLE PATELLA,EXTEN REALIGN $1,537.9054620 FIXATN OF TESTIS OPP TORSN $625.68

J2680 FLUPHENAZINE DECANOATE 25 MG $14.00Q2037 FLUVIRIN VA, 3 YRS & >, IM $30.00Q2038 FLUZONE VA, 3 YRS & >, IM $33.00L3925 Fo pip dip jnt/sng e ots $85.00A6210 FOAM DRG >16<=48 SQ IN W/O B $11.11L3170 FOOT PLAS HEEL STABI E OTS $50.00

15574 FORM SKIN PEDICLE FLAP FACE,GEN,HAND $1,578.22

15576 FORM SKIN PEDICLE FLAP LID,EAR,NOSE $1,385.9815572 FORM SKIN PEDICLE FLAP SCALP,ARM,LEG $1,545.1015570 FORM SKIN PEDICLE FLAP TRUNK $1,522.7850590 FRAGMENT KIDNEY STONE/ ESWL BILATERAL $1,778.7350590 FRAGMENT KIDNEY STONE/ ESWL $1,185.8244005 FREEING BOWEL ADHESION,ENTEROLYSIS $2,284.5454164 FRENULOTOMY,PENIS $403.9228111 FULL EXCIS 1ST METATARSAL HEAD $673.2028114 FULL EXCIS 2 - 5 METATARSAL HEADS $1,734.4628112 FULL EXCIS 2,3 OR 4TH METATAR HEAD $648.0028113 FULL EXCIS 5TH METATARSAL HEAD $878.4015241 FULL THICK GRFT HEAD,FAC,HA ADD 20SQ $229.6815240 FULL THICK GRFT HEAD,FAC,HAND <20SQC $1,658.8615220 FULL THICK GRFT SCALP,ARM,LEG <20SQC $1,273.6615200 FULL THICK GRFT TRUNK <20 SQCM $1,393.1826841 FUSION 1ST CARPOMETACARPAL JT $1,479.5826844 FUSION 2-5 CARPOMETACARPAL JT,GRAFT $1,675.4228755 FUSION BIG TOE,I-P JOINT $686.8828760 FUSION BIG TOE,I-P JT+TENDN XFER $1,204.5428750 FUSION BIG TOE,MT-P JT $1,216.7826860 FUSION FINGER JOINT $1,151.9826861 FUSION FINGER JOINT,EACH ADDNL $214.5626474 FUSION FINGER TENDONS,DIP JT STABIL $1,227.5826471 FUSION FINGER TENDONS,PIP JT STABIL $1,257.8228740 FUSION FOOT BONE,MIDTARSAL,1 JT $1,290.9428730 FUSION FOOT BONES,MIDTARSAL,MULTI $1,525.6628705 FUSION FOOT BONES,PANTALAR $2,590.5428725 FUSION FOOT BONES,SUBTALAR $1,614.9428715 FUSION FOOT BONES,TRIPLE $1,947.5825820 FUSION INTERCARPAL $1,275.1026516 FUSION MC-P JOINT,SINGLE $1,429.1826850 FUSION MC-P JT $1,410.4627580 FUSION OF KNEE $2,983.6427871 FUSION OF TIBIOFIBULAR JOINT $1,417.66

28280 FUSION OF TOES $723.6025800 FUSION OF WRIST JOINT $1,517.0223800 FUSION SHOULDER JOINT $2,129.7425301 FUSION TENDONS WRIST,FINGR EXTENSORS $1,331.9826862 FUSION/GRAFT FINGER JT $1,482.4625825 FUSION/GRAFT INTERCARPAL $1,570.3025810 FUSION/GRAFT WRIST JOINT $1,797.8225805 FUSION/SLIDING GRAFT WRIST JOINT $1,751.74

J1460 GAMMA GLOBULIN 1 INJ $97.00J1580 GARAMYCIN GENTAMICIN INJ $6.00

43846 GASTRIC BYPASS,OBESE<150CM ROUX-EN-Y $3,374.6043843 GASTROPLASTY,OBESITY,OTHER $2,672.6243842 GASTROPLASTY,OBESITY,VERT BAND $2,488.3043830 GASTROSTOMY,OPEN,W/O TUBE CNSTR $1,457.2643832 GASTROSTOMY,OPEN,W/TUBE CNSTR $2,159.26

A6222 GAUZE <=16 IN NO W/SAL W/O B $1.0855899 GENITAL SURG OC,MALE UNLISTED $1,656.8891035 GERD TST W/ MUCOS PH ELECTROD PROF CHG $172.0891035 GERD TST W/ MUCOS PH ELECTROD $987.1091035 GERD TST W/ MUCOS PH ELECTROD TECH CHG $815.0491110 GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R PROF CHG $265.6891110 GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R $1,852.5491110 GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R TECH CHG $1,586.86

J1610 GLUCAGON HYDROCHLORIDE/1 MG $160.00J9202 GOSERELIN ACETATE IMPLANT $401.00

93279 GRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP PROF CHG $66.2493285 GRMG DEV EVAL SCRMS PHYS/QHP IN PERSON PROF CHG $54.0093284 GRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB PROF CHG $128.8893283 GRMG EVAL IMPLANTABLE IN SN DUAL LEAD DFB PROF CHG $118.0893283 GRMG EVAL IMPLANTABLE IN SN DUAL LEAD DFB $159.1293282 GRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB PROF CHG $87.1293282 GRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB $124.5693282 GRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB TECH CHG $37.4490853 GROUP PSYCHOTHERAPY $50.40

28289 HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT $959.74J1631 HALOPERIDOL DECANOATE INJ $33.00

95832 HAND MUSCLE TEST,MANUAL $34.5626502 HAND TENDON PULLEY RECONST,GRAFT $1,451.5026500 HAND TENDON PULLEY RECONSTRUCTION $1,271.5099000 HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB $23.0096150 HEAL & BEHAV ASSESS,EA 15 MIN,INIT $45.3696151 HEAL & BEHAV ASSESS,EA 15 MIN,RE-ASSESS $43.9296152 HEAL & BEHAV INTERVENT,EA 15 MIN,INDIV $41.7692950 HEART/LUNG RESUSCITATION (C) $384.4890935 HEMODIALYSIS OCEDURE W/ PHYS/QHP EVALUATION $148.3290937 HEMODIALYSIS, REPEATED EVAL. $211.6846221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS $395.2846946 HEMORRHOIDECTOMY, INT, LIGATION NOT RUBBER BAND, 2+ $468.0046945 HEMORRHOIDECTOMY, INT, LIGATION NOT RUBBER BAND, SINGLE $467.2846250 HEMORRHOIDECTOMY,EXTERNAL, 2+ COLUMNS/GROUPS $655.9246260 HEMORRHOIDECTOMY,INT/EXT, 2+ COLUMNS/GROUPS $989.9846255 HEMORRHOIDECTOMY,INT/EXT,1 COLUMN/GROUP $735.1246258 HEMORRHOIDECTOMY,INT/EXT,1 COLUMN/GROUP W FISTULECT/FISSURECT $968.3846262 HEMORRHOIDECTOMY,INT/EXT,2+ COLUMNS/GROUPS W FISTULECT/FISSURECT $1,149.8246947 HEMORRHOIDOPEXY BY STAPLING $795.6090633 HEPA VAINE 2 DOSE SCHEDULE PED/ADOLESC IM USE $53.2790632 HEPA VAINE ADULT DOSE FOR INTRAMUSCULAR USE $136.0090746 HEPB VAINE ADULT 3 DOSE SCHEDULE FOR IM USE $129.0090744 HEPB VAINE PED/ADOLESC 3 DOSE SCHEDULE IM $87.47

L3923 HFO WITHOUT JOINTS E CST $69.0090647 HIB P-OMP VAINE 3 DOSE SCHEDULE IM USE $33.3290648 HIB P-T VAINE 4 DOSE SCHEDULE IM USE $39.00

A6452 HIGH COMES BAND W>=3<5YD $13.0099348 HOME VISIT EST PT LOW-MOD SEVERITY 25 MINUTES $171.3699347 HOME VISIT EST PT SELF LIMITED/MINOR 15 MINUTES $112.3299343 HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES $265.6899238 HOSPITAL DISCHARGE DAY,<30 MIN $149.0499239 HOSPITAL DISCHARGE DAY,>30 MIN $219.60

A6234 HYDROCOLLD DRG <=16 W/O BDR $14.75S0092 HYDROMORPHONE 250 MG $2.00J1170 HYDROMORPHONE INJECTION $2.00

56420 I&D BARTHOLIN GLAND ABSCESS $185.7621502 I&D DEEP ABSC NECK/CHST+RIB CUT $1,043.9821501 I&D DEEP ABSC/HEMATOMA NECK/CHEST $663.8441000 I&D MOUTH/TONG INTRA,LINGUAL $234.0041008 I&D MOUTH/TONG INTRA,SUBMANDIBULAR $563.0456405 I&D OF VULVA/PERINEUM ABSCESS $221.7646050 I&D PERIANAL ABSCESS,SUPERFICIAL $202.3246040 I&D PERIRECTAL ABSCESS $863.2846060 I&D RECTAL ABSCESS + FISTULECTOMY $990.7045005 I&D RECTAL SUBMUCOSAL ABSCESS $335.5246045 I&D RECTAL WALL ABSCESS W ANESTH $900.7020005 I&D SOFT TISSUE ABSCESS SUBFASCIAL $488.1622010 I&D, POST SPINE, CERV/THOR/CERV-THOR $1,982.8622015 I&D, POST SPINE, LUMB/SACR/LUMBOSAC $1,967.0238792 IDENTIFY SENTINEL NODE $82.0890656 IIV3 VA ESERVATIVE FREE 0.5 ML DOSAGE IM USE $26.0090655 IIV3 VA ESRV FREE 0.25 ML DOSAGE IM USE $20.0090657 IIV3 VAINE SPLIT VIRUS 0.25 ML DOSAGE IM USE $28.0090658 IIV3 VAINE SPLIT VIRUS 0.5 ML DOSAGE IM USE $26.0090686 IIV4 VA ESRV FREE 0.5 ML DOS FOR IM USE $19.8290687 IIV4 VA SPLIT VIRUS 0.25 ML DOS FOR IM USE $28.0090688 IIV4 VA SPLIT VIRUS 0.5 ML DOS FOR IM USE $28.0090685 IIV4 VA SRV FREE 0.25 ML DOS FOR IM USE $19.8244380 ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN FMD $119.5244310 ILEOSTOMY/JEJUNOSTOMY,NONTUBE $2,178.70

G0278 ILIAC ART ANGIO,CARDIAC CATH $28.8090460 IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX $41.7690461 IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT $25.92

Q3025 IM INJ INTERFERON BETA 1-A $401.0037184 IM Q TRLUML MCHNL THRMBC N-COR N-ICRA 1ST $942.4690471 IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID $41.76

90473 IMMUNIZ ADMIN,INTRANASAL/ORAL,1 VAC/TOX $41.7690472 IMMUNIZ,ADMIN,EACH ADDL $25.9295117 IMMUNOTHERAPY, 2+ INJECTIONS $20.8895115 IMMUNOTHERAPY, ONE INJECTION $18.0062350 IMP SPINAL CANAL CATH BILATERAL $1,243.0862350 IMP SPINAL CANAL CATH $828.7249568 IMPLANT MESH HERNIA REPAIR/DEBRIDEMENT CLOSURE $558.7264590 IMPLANT PERIPH/GASTRIC NEUROSTIM/RECEIVER $334.8062351 IMPLANT SPINAL CATH W LAMINECT $1,789.9063685 IMPLANT SPINAL NEUROSTIM/RECEIVER $753.8450800 IMPLANT URETER IN BOWEL $1,929.5811980 IMPLANT,HORMONE,SUBCUTANEOUS $116.6433282 IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER $471.6042725 INC/DRAIN RETROPHARYNG ABSCESS,EXT $1,690.5444025 INCIS COLON FOR EXPLOR,BX,FB REM $2,048.3823935 INCIS DEEP ARM/ELBOW BONE LESION $1,044.7027303 INCIS DEEP BONE LESN,FEMUR/KNEE $1,322.6226034 INCIS DEEP FINGR/HAND BONE LESN $1,121.0225001 INCIS FLEXOR TENDON SHEATH,WRIST $710.6425035 INCIS FOREARM BONE LESION $1,210.3027003 INCIS HIP ADDUC,OPEN,OBTUR NEUREC $1,234.7827000 INCIS HIP ADDUCTOR,SUBCUT,CLOSED $849.6027001 INCIS HIP ADDUCTOR,SUBCUT,OPEN $1,115.2627006 INCIS HIP ADDUCTORS,OPEN $1,511.9827005 INCIS ILIOPSOAS,OPEN $1,497.5827025 INCIS OF HIP/THIGH FASCIA $1,906.5425000 INCIS TENDON SHEATH,RADIAL STYLOID $696.2423930 INCIS/DRAIN ARM,DEEP ABSC/HEMATOMA $450.0023931 INCIS/DRAIN ARM/ELBOW INFECT BURSA $330.4825028 INCIS/DRAIN FOREARM DEEP ABSCESS $1,087.1826990 INCIS/DRAIN PELVIS/HIP,DEEP ABSCESS $1,298.8626992 INCIS/DRAIN PELVIS/HIP,OPEN BONE $1,985.7454015 INCIS/DRAIN PENIS,DEEP $640.8054700 INCIS/DRAIN SCROTUM/TESTIS,EPIDIDYM $445.68

23030 INCIS/DRAIN SHLDR ABSC/HEMA,DEEP $533.5227301 INCIS/DRAIN THIGH/KNEE ABSCESS,DEEP $1,043.2628001 INCIS/DRAINAGE BURSA OF FOOT $348.4851045 INCISE BLADDER,+URETER CATH $1,019.5046083 INCISE EXTERNAL HEMORRHOID $221.7626055 INCISE FINGER TENDON SHEATH $640.8055600 INCISE SEMINAL VESICLE $880.5655605 INCISE SEMINAL VESICLE,COMPLICATED $1,087.9063190 INCISE SP COLUMN/NERVES,>2 LVL $2,602.0663185 INCISE SP COLUMN/NERVES,ONE/TWO LVL $2,370.2223405 INCISE TENDON/MUSCLE,SHLDR,SINGLE $1,282.3025290 INCISE WRIST/FOREARM TENDON $902.8651030 INCISE/CRYOSURG LESN BLADDER $982.0651040 INCISE/DRAIN BLADDER $604.0851020 INCISE/FULGUR LESN BLADDER $979.1828234 INCISION EXTEN FOOT/TOE TENDON $543.6028230 INCISION FLEX FOOT TENDON(S) $586.8028232 INCISION FLEX TOE TENDON $502.5628008 INCISION OF FOOT/TOE FASCIA $607.6855200 INCISION OF SPERM DUCT $581.7620000 INCISION OF SUPERFIC ABSCESS $303.8441010 INCISION OF TONGUE FOLD $223.2053000 INCISION OF URETHRA $309.6053010 INCISION OF URETHRA,PERINEAL $614.8853020 INCISION OF URETHRAL MEATUS $203.0453025 INCISION OF URETHRAL MEATUS,INFANT $143.2828010 INCISION SUBCUT TOE TENDON $431.2828011 INCISION SUBCUT TOE TENDON,>1 $591.1264575 INCISION,IMPLANT,NEUROELEC,PERIPH NERVE $668.1664581 INCISION,IMPLANT,NEUROELEC,SACRAL NERVE $1,380.9493562 INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEA PROF CHG $2.16

A4340 INDWELLING CATHETER SPECIAL $59.00A4220 INFUSION PUMP REFILL KIT $49.00A4222 INFUSION SUPPLIES WITH PUMP $113.00

99468 INITIAL HOSP NEONATE 28 DAY OR LESS, CRITICALLY ILL $1,874.8699477 INITIAL HOSP NEONATE 28 DAY OR LESS, NOT CRITICALLY ILL $711.3699221 INITIAL HOSPITAL CARE/DAY 30 MINUTES $206.6499222 INITIAL HOSPITAL CARE/DAY 50 MINUTES $278.6499223 INITIAL HOSPITAL CARE/DAY 70 MINUTES $413.2899255 INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN $408.9699460 INITIAL NORMAL NEWBORN CARE, HOSPITAL OR BIRTH CENTER $195.1299463 INITIAL NORMAL NEWBORN CARE, SAME DAY DISCHARGE $226.0899304 INITIAL NURSING FACILITY CARE/DAY 25 MINUTES $185.7699305 INITIAL NURSING FACILITY CARE/DAY 35 MINUTES $265.6899306 INITIAL NURSING FACILITY CARE/DAY 45 MINUTES $339.8499218 INITIAL OBSERVATION CARE/DAY 30 MINUTES $203.7699219 INITIAL OBSERVATION CARE/DAY 50 MINUTES $277.2099220 INITIAL OBSERVATION CARE/DAY 70 MINUTES $379.4499475 INITIAL PED CRITICAL CARE 2 YR THRU 5 YR $1,142.6299471 INITIAL PED CRITICAL CARE 29 DAY THRU 24 MO $1,622.8616000 INITIAL RX BURN(S) 1ST DEGREE $95.7699251 INITL INPATIENT CONSULT NEW/ESTAB PT 20 MIN $99.3699252 INITL INPATIENT CONSULT NEW/ESTAB PT 40 MIN $151.9299253 INITL INPATIENT CONSULT NEW/ESTAB PT 55 MIN $234.0099254 INITL INPATIENT CONSULT NEW/ESTAB PT 80 MIN $339.8462310 INJ CERV/THORAC,W/WO CNTRST $347.04

J1094 INJ DEXAMETHASONE ACETATE $10.00J1110 INJ DIHYDROERGOTAMINE MESYLT $62.00

64490 INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, 1ST LEVEL BILATERAL $328.3264490 INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, 1ST LEVEL $218.8864491 INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, 2ND LEVEL BILATERAL $186.8464491 INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, 2ND LEVEL $124.5664492 INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, ADD LEVEL BILATERAL $189.0064492 INJ DX/THER AGNT PARAVERT FACET JOINT, CERV/THORAC, ADD LEVEL $126.0064493 INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, 1ST LEVEL BILATERAL $280.8064493 INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, 1ST LEVEL $187.2064494 INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, 2ND LEVEL BILATERAL $160.9264494 INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, 2ND LEVEL $107.28

64495 INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, ADD LEVEL BILATERAL $163.0864495 INJ DX/THER AGNT PARAVERT FACET JOINT, LUMBAR/SAC, ADD LEVEL $108.72

J1644 INJ HEPARIN SODIUM PER 1000U $41.0062311 INJ LUMBAR/SACRAL,W/WO CNTRST $347.0423350 INJ OC SHOULDER ARTHROGRAPHY/CT/MRI $105.8422522 INJ VERTEBRAL BODY, EACH ADDITIONAL $758.16

J0587 INJ, RIMABOTULINUMTOXINB $22.0064416 INJ,ANES AGENT,BRACHIAL PLEXUS,CONT INF BILATERAL $245.1664416 INJ,ANES AGENT,BRACHIAL PLEXUS,CONT INF $163.4464415 INJ,ANES AGENT,BRACHIAL PLEXUS,SINGLE BILATERAL $201.9664415 INJ,ANES AGENT,BRACHIAL PLEXUS,SINGLE $134.6464448 INJ,ANES AGENT,FEMORAL NERVE,CONT INF $147.6064447 INJ,ANES AGENT,FEMORAL NERVE,SINGLE $137.5264446 INJ,ANES AGENT,SCIATIC NERVE,CONT INF $163.4464445 INJ,ANES AGENT,SCIATIC NERVE,SINGLE BILATERAL $225.7264445 INJ,ANES AGENT,SCIATIC NERVE,SINGLE $150.4862291 INJ,CERV/THORAC,FOR DISKOGRAPHY $347.0462273 INJ,LUMB EPIDUR,BLOOD/CLOT PATCH $234.7262282 INJ,NEUROLYTIC,EPID/LUMB/CAUDAL $298.8062280 INJ,NEUROLYTIC,SUBARACHNOID $342.7264470 INJ,PARAVERTEBRAL C/T,1 LEVEL $218.8864472 INJ,PARAVERTEBRAL C/T,ADDL LEVELS $109.4464475 INJ,PARAVERTEBRAL L/S,1 LEVEL $218.8864476 INJ,PARAVERTEBRAL L/S,ADDL LEVELS $109.4462318 INJ/INFUS,CERV/THORAC,W/CATH $347.0462319 INJ/INFUS,LUMBAR/SACRAL,W/CATH $347.0464479 INJECT ANES/STEROID FORAMEN CERV/THORACIC W IMG GUIDE ,1 LEVEL BILATERAL $408.2464479 INJECT ANES/STEROID FORAMEN CERV/THORACIC W IMG GUIDE ,1 LEVEL $272.1664480 INJECT ANES/STEROID FORAMEN CERV/THORACIC W IMG GUIDE ,EA ADD LEVEL $130.3264483 INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL BILATERAL $347.7664483 INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL $231.8464484 INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,EA ADD LEVEL BILATERAL $160.9264484 INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,EA ADD LEVEL $107.2864455 INJECT ANES/STEROID PLANTAR COMMON DIGITAL NERVE $72.00

20526 INJECT CARPAL TUNNEL $119.5262292 INJECT CHEMONUCLEOLYSIS $1,188.7054235 INJECT CORPORA CAVERN,PHARM AGNT $153.3662290 INJECT DISKOGRAM,LUMBAR,EA LEVEL $350.6451610 INJECT FOR RETROGRADE URETHOCYSTO $133.2050684 INJECT INDWELL CATH,URETER X-RAY $105.1264417 INJECT NERV BLCK,AXILLARY NERV BILATERAL $218.1664417 INJECT NERV BLCK,AXILLARY NERV $145.4464508 INJECT NERV BLCK,CAROTID SINUS $123.8464530 INJECT NERV BLCK,CELIAC PLEXUS $187.9264413 INJECT NERV BLCK,CERV PLEXUS $168.4864402 INJECT NERV BLCK,FACIAL NERV BILATERAL $257.0464402 INJECT NERV BLCK,FACIAL NERV $171.3664405 INJECT NERV BLCK,GREAT OIPTL BILATERAL $197.6464405 INJECT NERV BLCK,GREAT OIPTL $131.7664425 INJECT NERV BLCK,ILIOINGU/ILIOHYP BILATERAL $290.5264425 INJECT NERV BLCK,ILIOINGU/ILIOHYP $193.6864421 INJECT NERV BLCK,INTERCOST,MULTPL BILATERAL $285.1264421 INJECT NERV BLCK,INTERCOST,MULTPL $190.0864420 INJECT NERV BLCK,INTERCOSTAL,ONE $138.9664450 INJECT NERV BLCK,OTHR PERIPH NERV BILATERAL $140.4064450 INJECT NERV BLCK,OTHR PERIPH NERV $93.6064435 INJECT NERV BLCK,PARACERVICAL $169.2064520 INJECT NERV BLCK,PARAVERT SYMPATH $167.0464410 INJECT NERV BLCK,PHRENIC NERVE $174.2464430 INJECT NERV BLCK,PUDENDAL $166.3264412 INJECT NERV BLCK,SP AESSORY $177.8464505 INJECT NERV BLCK,SPHENOPALAT GANGLN $187.2064510 INJECT NERV BLCK,STELLATE GANGLION $151.9264418 INJECT NERV BLCK,SUASCAP N. $128.1664400 INJECT NERV BLCK,TRIGEMINAL $149.0464408 INJECT NERV BLCK,VAGUS NERVE $177.8462281 INJECT NEUROLYTIC,EPIDUR,CERV/THOR $324.0054200 INJECT OC PENILE PLAQUE $174.96

54205 INJECT PENILE PLAQUE+SURG EXPOSURE $1,110.940232T INJECT PLATELET RICH PLASMA W/IMG HARVEST/EPARATOIN $109.44

50690 INJECT RETROGRADE/CONDUIT X-RAY $146.1664680 INJECT RX CELIAC PLEXUS NERVE $337.6862294 INJECT SPINAL ARTERY,OLUDE AVM $2,003.7420551 INJECT TENDON ORIGIN/INSERT $88.5620550 INJECT TENDON SHEATH/LIGAMENT $81.3620552 INJECT TRIGGER POINT, 1 OR 2 $78.4820553 INJECT TRIGGER POINTS, > 3 $89.2822521 INJECT VERTEBRAL BODY, LUMBAR $3,196.8522520 INJECT VERTEBRAL BODY, THORACIC $3,196.8593544 INJECT W CARD CATH AORTOGRAPHY $169.2093540 INJECT W CARD CATH COR BYPASS GRFT $169.2093543 INJECT W CARD CATH LV/LA ANGIO $169.2093542 INJECT W CARD CATH RV/RA ANGIO $169.2093545 INJECT W CARD CATH SEL CORONARY $169.2051605 INJECT/PLACE CHAIN,BLADDER XRAY $80.6420527 INJECTION ENZYME PALMAR FASCIAL CORD $137.5227648 INJECTION FOR ANKLE ARTHROGRAM $109.4451600 INJECTION FOR BLADDER X-RAY $92.8824220 INJECTION FOR ELBOW ARTHROGRAM $141.84

64999INJ INJECTION FOR HYPERHIDROSIS $533.5238200 INJECTION FOR SPLEEN X-RAY $276.4825246 INJECTION FOR WRIST ARTHROGRAM $155.5227093 INJECTION HIP ARTHROGRAM $145.4427095 INJECTION HIP ARTHROGRAM,ANESTH $172.8011901 INJECTION INTO SKIN LESIONS, 8 OR MORE $100.8011900 INJECTION INTO SKIN LESIONS, UP TO 7 $64.8036005 INJECTION OC,EXTREMITY,VENOGRAPHY $100.8062284 INJECTION OCEDURE MYELOGRAPHY/CT LUMBAR $182.1650394 INJECTION THRU KIDNEY TUBE FOR XRAY $92.8864681 INJECTION TREATMENT OF NERVE $504.72

S0020 INJECTION, BUPIVICAINE HYDRO $10.00J0585 INJECTION,ONABOTULINUMTOXINA $9.00

27096 INJECTION,SACROILIAC JOINT BILATERAL $259.2027096 INJECTION,SACROILIAC JOINT $172.8096372 INJECTION,THERAP/OPH/DIAGNOST, IM OR SUBCUT $41.7696375 INJECTION,THERAP/OPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG $36.7296374 INJECTION,THERAP/OPH/DIAGNOST, IV PUSH, INITIAL DRUG $94.3237191 INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I $470.1633207 INS NEW/RPLC M PACEMAKER W/TRANSV ELTRD VENTR $1,005.8233206 INS NEW/RPLCMT M PACEMAKR W/TRANS ELTRD ATRIAL $944.6233208 INS NEW/RPLCMT M PM W/TRANSV ELTRD ATRIAL&VENT $1,089.3433213 INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS $700.5633212 INS PM PLS GEN W/EXIST SINGLE LEAD $669.6033270 INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD $1,188.7020650 INSERT AND REMOVE BONE PIN $328.3236800 INSERT CANNULA,VEIN-VEIN $254.8836620 INSERT CATH,ART,PERCUT,SHORTTERM $32.4031500 INSERT EMERGENCY ENDOTRACH AIRWAY $292.3233202 INSERT EPICARDIAL ELECTRODE, OPEN $1,617.1049440 INSERT GASTROSTOMY TUBE PERCUTANEOUS $430.5633967 INSERT INTRA-AORTIC BALLOON ASST DEVICE $543.6092980 INSERT INTRACORONARY STENT $1,239.1092981 INSERT INTRACORONARY STENT,ADDNL $495.6457267 INSERT MESH/PELVIC FLR ADDON $524.8836680 INSERT NEEDLE,INTRAOSSEOUS INFUSN $121.6836556 INSERT NON-TUNNEL CV CATH $179.2854401 INSERT SELF-CONTD PENILE OSTHESIS $1,368.7054400 INSERT SEMI-RIGID PENILE OSTHESIS $1,105.1862360 INSERT SPINE INFUSN DEVICE,SUBCUT $647.2854660 INSERT TESTICULAR OSTHESIS $745.9244015 INSERT TUBE-BOWEL,ENTERAL ALIMENT $297.3625430 INSERT VASC PEDICLE,CARPAL BONE (HARII) $1,515.5854405 INSERT,INFLATABLE PENILE OSTHESIS $1,686.9453445 INSERT,INFLATABLE SPHINCTER $1,572.4651701 INSERT,NON-INDWELLING BLADDER CATHETER $53.2851703 INSERT,TEMP INDWELLING BLAD CATH,COMP $160.56

51702 INSERT,TEMP INDWELLING BLAD CATH,SIMPLE $54.0062361 INSERT/ EPLACE INFUSN PUMP,NONOGRAM $897.1262362 INSERT/ REPLACE INFUSN PUMP,OGRAMMABLE $797.0493503 INSERT/PLACE FLOW DIRECT CATH $215.2811981 INSERTION DRUG IMPLANT DEVICE $172.8036569 INSERTION PI W/O IMG GDN 5 YR/> $704.8853444 INSERTION TANDEM CUFF (DUAL) $1,655.2649421 INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN $478.8033216 INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB $774.0022853 INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD $524.8822859 INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD $678.9622854 INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD $678.9633224 INSJ ELTRD CAR VEN SYS ATTCH EV PM/DFB PLS GEN $1,079.2633225 INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN $984.2233240 INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD $763.9236555 INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y $64.8036571 INSJ PH CTR VAD W/SUBQ PORT AGE 5 YR/> $177.1236561 INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/> $545.7636558 INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/> $203.0433249 INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR $1,917.3433210 INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH $344.1633211 INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX $354.9651720 INSTILL ANTICANCER AGENT IN BLADDER $108.7232561 INSTILL VIA CHEST TUBE AGENT FOR FIBRINOLYSIS, 1ST DAY $141.8450391 INSTLL RX AGNT INTO RNAL TUB $204.4890802 INTERACTIVE PSY DX INTERVIEW $288.72

J9214 INTERFERON ALFA-2B INJ $13.00J1826 INTERFERON BETA-1A INJ $1,263.00

93288 INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON PROF CHG $43.9293291 INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON PROF CHG $37.4493289 INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB PROF CHG $76.3293295 INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB $112.3237620 INTERUP OF IVC $958.3044615 INTESTINAL STRICTUROPLASTY $2,242.78

38900 INTRAOPERATIVE SENTINEL LYMPH NODE ID W DYE INJECTION $287.2894610 INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP $114.4837253 INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL $154.0837252 INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL $191.5236010 INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA $228.9636140 INTRO OF NEEDLE OR INTRACATHETER U/LXTR ARTERY $189.3636200 INTRODUCTION CATHETER AORTA $292.3254220 IRRIGAT CORPUS CAVERN,IAPISM $279.3651700 IRRIGATION OF BLADDER $63.3693571 IV DOP VEL&/OR ESS C/FLO RSRV MEAS 1ST VSL PROF CHG $199.4493572 IV DOP VEL&/OR ESS C/FLO RSRV MEAS ADDL VSL PROF CHG $160.5693572 IV DOP VEL&/OR ESS C/FLO RSRV MEAS ADDL VSL $125.0096360 IV INFUSION, HYDRATION, 31-60 MIN $95.0496361 IV INFUSION, HYDRATION, EA ADD HOUR $28.0890765 IV INFUSION, THER/OPH/DIAG, 1ST HOUR $145.0096365 IV INFUSION, THERAP/OPH/DIAGNOST,INITIAL,1ST HOUR $148.3296366 IV INFUSION, THERAP/OPH/DIAGNOST,INITIAL,EA ADD HOUR $44.6415860 IV INJ TO TEST BLOOD FLOW IN FLAP/GRAFT $224.64

E0776 IV POLE NU $264.0037250 IV ULTRASOUND,FIRST VESSEL $220.32

J1885 KETOROLAC TROMETHAMINE INJ $11.0029867 KNEE SCOPE, ALLOGRAFT IMPANT $2,661.8229873 KNEE SCOPE, W/LATERAL RELEASE $1,089.3429879 KNEE SCOPE,ABRASN ARTHROPLASTY $1,374.4629888 KNEE SCOPE,AID ANT CRUCIATE REPAIR $2,043.3429889 KNEE SCOPE,AID POST CRUC REPAIR $2,545.1829871 KNEE SCOPE,CLEAN/DRAIN $1,068.4629870 KNEE SCOPE,DIAGNOSTIC $847.4429887 KNEE SCOPE,DRILL OSTE DISS+INT FIX $1,558.7829885 KNEE SCOPE,DRILL OSTE DISSEC+GRFT $1,565.9829886 KNEE SCOPE,DRILL OSTEIT DISSEC $1,324.0629876 KNEE SCOPE,FULL SYNOVECT $1,364.3829884 KNEE SCOPE,LYSIS OF ADHESNS $1,272.9429882 KNEE SCOPE,MED OR LAT MENIS REPAIR $1,451.50

29881 KNEE SCOPE,MED/LAT MENISECTOMY $1,123.1829883 KNEE SCOPE,MED+LAT MENIS REPAIR $1,751.0229875 KNEE SCOPE,PART SYNOVECT $1,028.1429874 KNEE SCOPE,REMV LOOSE BODY $1,112.3829877 KNEE SCOPE,SHAVE ARTICULAR CART $1,288.7829880 KNEE SCOPE,SINGLE MENISECTOMY $1,167.1029851 KNEE SCOPE/SURG/INCOND FX AID+FIXAT $1,938.22

L1833 KO ADJ JNT POS R SUP E OTS $499.30L1820 KO ELAS W/ CONDYLE PADS & JO $189.00L1830 KO IMMOB CANVAS LONG E OTS $120.00

93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I PROF CHG $498.2490660 LAIV3 VAINE LIVE FOR INTRANASAL USE $39.0090672 LAIV4 VAINE FOR INTRANASAL USE $28.0063001 LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG, CERVICAL $2,597.7463005 LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG, LUMBAR $2,475.3463011 LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG, SACRAL $2,278.7863003 LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG, THORACIC $2,603.5063045 LAMINEC/FACETECT/FORAMIN,CERVICAL 1 SEG $2,691.3463048 LAMINEC/FACETECT/FORAMIN,EACH ADDNL BILATERAL $667.4463048 LAMINEC/FACETECT/FORAMIN,EACH ADDNL $444.9663047 LAMINEC/FACETECT/FORAMIN,LUMBAR 1 SEG BILATERAL $3,455.9763047 LAMINEC/FACETECT/FORAMIN,LUMBAR 1 SEG $2,303.9863046 LAMINEC/FACETECT/FORAMIN,THORACIC 1 SEG BILATERAL $3,842.6163046 LAMINEC/FACETECT/FORAMIN,THORACIC 1 SEG $2,561.7463015 LAMINECTOMY,>2 SGMT,CERVICAL $3,107.4863017 LAMINECTOMY,>2 SGMT,LUMBAR $2,633.0263016 LAMINECTOMY,>2 SGMT,THORACIC $3,205.4063012 LAMINECTOMY,FACETECTOMY,LUMBAR $2,494.0663040 LAMINOTOMY $2,928.2063030 LAMINOTOMY,LUMBAR DISK,1 INTRSP BILATERAL $3,044.4963030 LAMINOTOMY,LUMBAR DISK,1 INTRSP $2,029.6643644 LAP GASTRIC BYPASS/ROUX-EN-Y $3,610.7649324 LAP INSERTION TUNNELED INTRAPERITONEAL CATHETER $810.0049325 LAP REVISE INTRAPERITONEAL CATHETER $861.12

43279 LAP, ESOPHAGOMYOTOMY W FUNDOPLASTY $2,688.4643775 LAP, GAST RESTRICT OC, LONGITUDINAL GASTRECTOMY $2,327.7449655 LAP, INCISIONAL HERNIA REPAIR,INCARCERATED $2,149.1849654 LAP, INCISIONAL HERNIA REPAIR,REDUCIBLE $1,761.1043770 LAP, PLACE ADJUST GAST RESTRICT DEVICE $2,336.3850545 LAP, RADICAL NEPHRECTOMY $2,797.1649657 LAP, RECURRENT INCISIONAL HERNIA REPAIR,INCARCERATED $2,748.9249656 LAP, RECURRENT INCISIONAL HERNIA REPAIR,REDUCIBLE $1,910.8643772 LAP, REMOVE ADJUST GAST RESTRICT DEVICE $1,988.6243774 LAP, REMOVE ADJUST GAST RESTRICT DEVICE/PORT $2,000.8643282 LAP, REPAIR PARAESOPHAGEAL HERNIA, INCL FUNDOPLASTY W/ MESH $3,620.8443281 LAP, REPAIR PARAESOPHAGEAL HERNIA, INCL FUNDOPLASTY W/O MESH $3,219.8044227 LAP, SURG CLOSE ENTEROSTOMY RESECT ANAST $3,474.6844188 LAP, SURG COLOSTOMY $2,558.1444180 LAP, SURG ENTEROLYSIS $1,917.3444187 LAP, SURG ILEO/JEJUNO-STOMY $2,303.2644186 LAP, SURG JEJUNOSTOMY $1,355.0244213 LAP, SURG MOBIL SPLENIC FL DUR PTL COLECTOMY $393.8449653 LAP, VENTRAL HERNIA REPAIR,INCARCERATED $1,931.0249652 LAP, VENTRAL HERNIA REPAIR,REDUCIBLE $1,548.7049329 LAP,ABD/PERIT/OMENTUM,UNLIST $861.1249322 LAP,ABDOMEN,ASPIRATE CYST $769.6850541 LAP,ABLATION OF RENAL CYSTS $1,918.0650542 LAP,ABLATION, RENAL MASS LESION(S), ULTRASOUND GUIDE $2,432.8644970 LAP,APPENDECTOMY $1,252.7844979 LAP,APPENDIX UNLISTED OCED $1,507.3047562 LAP,CHOLECYSTECTOMY $1,370.8647564 LAP,CHOLECYSTECTOMY/EXPLORE $2,319.1047563 LAP,CHOLECYSTECTOMY/GRAPH $1,488.2249320 LAP,DIAGNOSTIC ABDOMEN $678.9649321 LAP,DX SURGICAL ABD W/BIOPSY $718.5643280 LAP,ESOPHAGOGAST FUNDOPLASTY $2,254.3058662 LAP,FULGURATE/EXCISE LESIONS $1,450.7843653 LAP,GASTROSTOMY,W/O TUBE CONSTR $1,193.74

49650 LAP,INGUINAL HERNIA RE,INITIAL $892.0849651 LAP,INGUINAL HERNIA RE,RECUR $1,156.3055550 LAP,LIGATION SPERMATIC VEINS $894.9638570 LAP,LYMPH NODE BX $1,055.5058660 LAP,LYSIS OF ADHESIONS $1,374.4654690 LAP,ORCHIECTOMY $1,373.7455866 LAP,OSTATECTOMY,RADICAL,W/NERVE SPARE,INCL ROBOTIC $3,014.6050543 LAP,PARTIAL NEPHRECTOMY $3,105.3250544 LAP,PYELOPLASTY $2,600.6250947 LAP,REIMPLANT URETER W/CYSTO,STENT $2,891.4850948 LAP,REIMPLANT URETER W/O CYSTO,STENT $2,661.8258661 LAP,RMV ADNEXAL STRUCTURE $1,328.3851992 LAP,SLING OPERATION $1,736.6238120 LAP,SPLENECTOMY $2,192.3843659 LAP,STOMACH,OTHER,W/O TUBE $3,249.0044204 LAP,SURG,COLECTOMY, PARTIAL, W/ANAST $3,210.4444207 LAP,SURG,COLECTOMY,W/ANAST $3,798.6844208 LAP,SURG,COLECTOMY,W/ANAST,W/COLOSTOMY $4,144.2844206 LAP,SURG,COLECTOMY,W/END COLOST & CLOSUR $3,654.6844205 LAP,SURG,COLECTOMY,W/REMVL TERM ILEUM $2,791.4044202 LAP,SURG,ENTERECTOMY,RESECT & ANAST $2,888.6050945 LAP,URETEROLITHOTOMY $2,031.8251990 LAP,URETHRAL SUSPENSION $1,563.1031575 LARYNGOSCOPY FLEXIBLE DIAGNOSTIC $137.5231515 LARYNGOSCOPY,DIRECT FOR ASPIRATION $226.8031505 LARYNGOSCOPY,INDIRECT,DX $100.0852647 LASER COAGULATION SURGERY OSTATE, COMPLETE $1,351.4252649 LASER ENUCLEATION OSTATE W MORCELLATION $1,717.9052648 LASER VAPORIZATION SURGERY OSTATE, COMPLETE $1,440.7027425 LATERAL RETINACULAR RELEASE OPEN $927.3412051 LAYR CLOS WND FACE,FACIAL <2.5 CM $355.6812057 LAYR CLOS WND FACE,FACIAL >30 CM $894.2412055 LAYR CLOS WND FACE,FACIAL 12.6-20 CM $630.7212052 LAYR CLOS WND FACE,FACIAL 2.5-5 CM $423.36

12056 LAYR CLOS WND FACE,FACIAL 20.1-30 CM $797.0412053 LAYR CLOS WND FACE,FACIAL 5.1-7.5 CM $452.8812054 LAYR CLOS WND FACE,FACIAL 7.6-12.5 CM $461.5212041 LAYR CLOS WND REST BODY <2.5 CM $311.7612047 LAYR CLOS WND REST BODY >30 CM $721.4412045 LAYR CLOS WND REST BODY 12.6-20 CM $558.0012042 LAYR CLOS WND REST BODY 2.6-7.5 CM $415.4412046 LAYR CLOS WND REST BODY 20.1-30 CM $645.8412044 LAYR CLOS WND REST BODY 7.6-12.5 CM $446.4012031 LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM $317.5212037 LAYR CLOS WND TRUNK,ARM,LEG >30 CM $681.1212035 LAYR CLOS WND TRUNK,ARM,LEG 12.6-20 CM $498.2412032 LAYR CLOS WND TRUNK,ARM,LEG 2.6-7.5 CM $403.9212036 LAYR CLOS WND TRUNK,ARM,LEG 20.1-30 CM $581.7612034 LAYR CLOS WND TRUNK,ARM,LEG 7.6-12.5 CM $431.2827899 LEG/ANKLE SURGERY OC UNLISTED $1,416.1727686 LENGTH/SHORT LEG/ANKL TENDON,MULTI $1,141.9027685 LENGTH/SHORT LEG/ANKL TENDON,SINGLE $961.1827466 LENGTHENING OF FEMUR $2,460.9427715 LENGTHENING TIBIA/FIBULA $2,225.50

J9217 LEUOLIDE ACETATE SUSPNSION $381.00J2001 LIDOCAINE INJECTION $2.00

55450 LIGATION OF SPERM DUCT $894.9637618 LIGATN OF EXTREMITY ARTERY $799.2027427 LIGMT REVISION,KNEE,EXTRA-ARTIC $1,469.5027428 LIGMT REVISION,KNEE,INTRA-ARTIC $2,319.1027429 LIGMT REVISN,KNEE,INTRA/EXTRA-ART $2,579.02

A6448 LT COMES BAND <3/YD $3.00A6449 LT COMES BAND >=3 <5/YD $4.00A6450 LT COMES BAND >=5/YD $3.00

94200 LUNG FUNCTION TEST (MBC/MVV) PROF CHG $11.5262264 LYSIS,PERQ,EPIDURAL ADHESIONS,1 DAY $491.7662263 LYSIS,PERQ,EPIDURAL ADHESIONS,2 DAYS/> $658.8054162 LYSIS/EXCIS,PENILE POSTCIRCUM ADHESIONS $416.16

26341 MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD $154.8024300 MANIPULATE ELBOW W/ANESTH $858.9626340 MANIPULATE FINGER JT W/ ANESTH,EACH $687.6025259 MANIPULATE WRIST W/ANESTHES $859.6827860 MANIPULATION ANKLE JT W ANESTHESIA $361.4427275 MANIPULATION HIP JOINT W ANESTHESIA $378.7227570 MANIPULATN KNEE JT+ANESTHESIA $311.7623700 MANIPULATN SHLDR JT W ANESTHESIA $406.8097140 MANUAL THER TECH,1+REGIONS,EA 15 MIN $56.8853240 MARSUP URETHRAL TIC $887.0419300 MASTECTOMY FOR GYNECOMASTIA $1,083.5819307 MASTECTOMY, MODIFIED RADICAL $2,481.1019301 MASTECTOMY, PARTIAL $1,351.4219303 MASTECTOMY, SIMPLE, COMPLETE $1,989.3419304 MASTECTOMY, SUBCUTANEOUS $1,195.1819302 MASTECTOMY,PARTIAL, WITH AXILLARY LYMPHADENECTOMY $1,863.34

Q4118 MATRISTEM MICROMATRIX $28.00Q4119 MATRISTEM WOUND MATRIX $131.00

90734 MCV4/MENACWY CONJ VA GRPS ACYW-135 IM USE $127.55G0180 MD CERTIFICATION HHA PATIENT $109.44

51798 MEAS,POST-VOID RES,US,NON-IMAGING $32.4050396 MEASURE KIDNEY ESSURE THRU TUBE $244.0850686 MEASURE URETER ESS,INDWELL CATH $185.04

E0780 MECH AMB INFUSION PUMP <8HRS NU $27.0097802 MED NUTR THER, 1ST, INDIV, EA 15 MIN $70.5697803 MED NUTR THER, SUBSQ, INDIV, EA 15 MIN $61.2099075 MEDICAL TESTIMONY $780.0090862 MEDICATION MANAGEMENT $50.40

J2180 MEPERIDINE/OMETHAZINE INJ $100.00J1020 METHYLEDNISOLONE 20 MG INJ $4.00J1030 METHYLEDNISOLONE 40 MG INJ $8.00J1040 METHYLEDNISOLONE 80 MG INJ $15.00J2920 METHYLEDNISOLONE INJECTION $12.00J2930 METHYLEDNISOLONE INJECTION $5.00

J2765 METOCLOAMIDE L INJECTION $2.0069990 MICROSURG TECHNIQUES,REQ OPER MICROSCOPE $462.2420962 MICROVASCULAR BONE GRAFT,OTHER $5,551.1420956 MICROVASCULAR ILIAC CREST GRAFT $5,516.5890707 MMR VIRUS IMMUNIZATION, SUBCUT $74.0644139 MOBILIZE SPLENIC FLEX $254.16

A6451 MOD COMES BAND W>=3<5/YD $4.0099157 MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS $118.0899155 MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS $197.2899156 MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS $154.8099153 MOD SED SAME PHYS/QHP EACH ADDL 15 MINS $22.3299151 MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS $158.4099152 MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS $105.1299148 MOD SEDATJ DIFF PHYS/QHP <5 YRS INIT 30 MIN $50.4099149 MODERATE SEDATJ DIFF PHYS/QHP 5/>YRS INIT 30 MIN $50.4099150 MODERATE SEDATJ DIFF PHYS/QHP EA ADDL 15 MIN $22.3299143 MODERATE SEDATJ SAME PHYS/QHP <5 YRS INIT 30 MIN $50.4099144 MODERATE SEDATJ SAME PHYS/QHP 5/>YRS INIT 30 MIN $197.2899145 MODERATE SEDATJ SAME PHYS/QHP EACH ADDL 15 MIN $22.32

J7327 MONOVISC INJ PER DOSE $1,239.44J2270 MORPHINE SULFATE INJECTION $11.00

95912 MOTOR &/SENS 11-12 NRV CNDJ ECONF ELTRODE LIMB $538.5695907 MOTOR &/SENS 1-2 NRV CNDJ ECONF ELTRODE LIMB $200.1695913 MOTOR &/SENS 13/> NRV CNDJ ECONF ELTRODE LIMB $621.3695908 MOTOR &/SENS 3-4 NRV CNDJ ECONF ELTRODE LIMB $259.2095909 MOTOR &/SENS 5-6 NRV CNDJ ECONF ELTRODE LIMB $308.8895910 MOTOR &/SENS 7-8 NRV CNDJ ECONF ELTRODE LIMB $406.8095911 MOTOR &/SENS 9-10 NRV CNDJ ECONF ELTRODE LIMB $485.2895903 MOTOR NERVE CONDUCT TEST, W F-WAVE $155.9495805 MULTIPLE SLEEP LATENCY TEST PROF CHG $120.9624341 MUSC/TENDON REPAIR EACH; ARM/ELBOW $1,542.2224301 MUSC/TENDON XFER,ARM/ELBOW,SINGLE $1,555.1820200 MUSCLE BIOPSY $197.2823395 MUSCLE TRANSFER,SHOULDER/ARM,SINGLE $2,659.66

15736 MUSCLE-SKIN FLAP,ARM $2,550.2215738 MUSCLE-SKIN FLAP,LEG $2,741.7215734 MUSCLE-SKIN FLAP,TRUNK $3,136.2864517 N BLOCK INJ, HYPOGAS PLXS $259.9264449 N BLOCK INJ, LUMBAR PLEXUS $174.9631296 NASAL/SINUS ENDOSCOPY,W/DILAT FRONTAL SINUS OSTIUM $371.5231295 NASAL/SINUS ENDOSCOPY,W/DILAT MAXILLARY SINUS OSTIUM $325.4431297 NASAL/SINUS ENDOSCOPY,W/DILAT SPHENOID SINUS OSTIUM $295.9244385 NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX $151.92

A7003 NEBULIZER ADMINISTRATION SET NU $6.0047001 NEEDLE BIOPSY LIVER,W OTHR OC $218.1620206 NEEDLE BIOPSY,MUSCLE $122.4095885 NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED $120.9695886 NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE $187.2095874 NEEDLE EMG GUIDANCE FOR CHEMODENERVATION PROF CHG $41.0495874 NEEDLE EMG GUIDANCE FOR CHEMODENERVATION $153.3695874 NEEDLE EMG GUIDANCE FOR CHEMODENERVATION TECH CHG $112.3295887 NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION $165.6076003 NEEDLE LOCALIZATION FLUORO $97.2097605 NEGATIVE ESSURE WOUND THERAPY DME </= 50 SQ CM $90.0097606 NEGATIVE ESSURE WOUND THERAPY DME >50 SQ CM $106.5650546 NEPHRECTOMY $2,511.3450548 NEPHRECTOMY, W/PART. URETECTOMY $2,811.5650045 NEPHROTOMY W EXPLORATION $1,944.7095900 NERVE CONDUCTION TEST,MOTOR $155.9495904 NERVE CONDUCTION,EA NERVE,MOTOR,SENSORY $155.9464892 NERVE GRAFT,ARM/LEG,ONE,UP TO 4 CM $2,187.3464910 NERVE REPAIR W/ALLOGRAFT OR SYNTH $1,662.4664999 NERVOUS SYSTEM SURGERY UNLISTED $1,616.7296116 NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR $190.8095999 NEUROLOGICAL OCEDURE UNLISTED $198.0095937 NEUROMUSCULAR JUNCTION TEST $167.7664708 NEUROPLASTY OTHER ARM/LEG NERVE,OPEN $1,033.1896120 NEUROPSYCH TESTING BY COMPUTER $97.20

96119 NEUROPSYCH TESTING BY TECHNICIAN $162.0099201 NEW PATIENT VISIT LEVEL 1 $90.7299202 NEW PATIENT VISIT LEVEL 2 $152.6499203 NEW PATIENT VISIT LEVEL 3 $219.6099204 NEW PATIENT VISIT LEVEL 4 $334.8099205 NEW PATIENT VISIT LEVEL 5 $421.2062321 NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN $221.7662324 NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN $187.2062323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $205.2062322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $179.2893564 NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I $128.1693567 NJX SUAVALV AORTOG HRT CATH W/S&I $110.16

A9270 NON-COVERED ITEM OR SERVICE $15.0093922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL PROF CHG $25.9293922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL $180.7293922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL TECH CHG $154.8093923 NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVELS PROF CHG $45.3693923 NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVELS $280.0893923 NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVELS TECH CHG $234.7294761 NONINVASV OXYGEN SATUR,MULTIPLE $9.3694760 NONINVASV OXYGEN SATUR;SINGLE $5.7694762 NONINVASV OXYGEN SATUT,CONTINUOUS $50.40

L4387 NON-PNEUM WALK BOOT E OTS $286.00A6216 NON-STERILE GAUZE<=16 SQ IN $2.00A4927 NON-STERILE GLOVES $8.00A4450 NON-WATEROOF TAPE $2.00J7040 NORMAL SALINE SOLUTION INFUS $2.00L9900 O&P SUPPLY/AESSORY/SERVICE $144.00

99217 OBSERVATION CARE DISCHARGE MANAGEMENT $149.0499234 OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES $271.4499235 OBSERVATION/INPATIENT HOSPITAL CARE 50 MINUTES $344.8899236 OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES $444.9659409 OBSTETRICAL CARE,VAG DELIV ONLY $1,687.66

J0780 OCHLORPERAZINE INJECTION $22.00

45110 OCTECTOMY,AP RESECT+OSTOMY $3,851.2445300 OCTOSIGMOIDOSCOPY,RIGID,DIAGNOS $113.0499241 OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN $96.4899242 OFFICE CONSULTATION NEW/ESTAB PATIENT 30 MIN $181.4499243 OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN $248.4099244 OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN $371.5299245 OFFICE CONSULTATION NEW/ESTAB PATIENT 80 MIN $452.8893280 OGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER PROF CHG $78.4893281 OGRAM EVAL IMPLANTABLE IN SN MULTI LD PACER PROF CHG $87.8499354 OLNG E&M/PSYCTX SVC OFFICE O/P DIR CON 1ST HR $248.4099355 OLNG E&M/PSYCTX SVC OFFICE O/P DIR CON ADDL 30 $186.4899358 OLONGED SERV,NO CONTACT,1ST HR $227.5299359 OLONGED SERV,NO CONTCT,EA ADD 30 MIN $109.4499356 OLONGED SERVICE I/P REQ UNIT/FLOOR TIME 1ST HR $187.9299357 OLONGED SVC I/P REQ UNIT/FLOOR TIME EA 30 MIN $188.6449905 OMENTAL FLAP,INTRA-ABDOMINAL $738.00

J2550 OMETHAZINE L INJECTION $5.0051050 OPEN BLADDER,REMV CALCULUS $986.3820250 OPEN BONE BIOP VERT DORSAL $806.4027215 OPEN FIX ILIAC FX,INTERN FIXATN $1,298.1427245 OPEN FIX INTER/SUBTROCH FX,IMPLNT $2,557.4224515 OPEN FIXATN MID HUMERUS FRACTURE $1,815.8227227 OPEN INTERN FIX ACETABULAR FX $3,452.3627226 OPEN INTERN FIX ACETABULAR WALL FX $2,185.9027217 OPEN INTERN FIX ANTER PELV RING FX $1,804.3027228 OPEN INTERN FIX COMPLEX ACETABUL FX $3,919.6427218 OPEN INTERN FIX POST PELV RING FX $2,491.1828446 OPEN OSTEOCHONDRAL AUTOGRAFT TALUS $2,545.9023616 OPEN OX HUMERAL FRACTURE OSHETIC REPLACEMENT $2,573.9825525 OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE $1,625.0225526 OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE $1,980.7025695 OPEN REPAIR LUNATE DISLOCATION $1,311.8225670 OPEN REPAIR WRIST DISLOCATION $1,249.1824516 OPEN ROD FIXATN HUMERAL SHAFT FX $1,781.98

23550 OPEN RX A-C JT DISLOC $1,163.5023552 OPEN RX A-C JT DISLOC,FASCIAL GRFT $1,354.3023660 OPEN RX ACUTE SHLDR DISLOC $1,206.7027846 OPEN RX ANKLE DISLOCATN $1,489.6627848 OPEN RX ANKLE DISLOCATN+FIXATN $1,657.4225645 OPEN RX CARPAL BONE FX,EACH BONE $1,178.6226686 OPEN RX C-MC DISLOC,COMPLEX $1,290.9425607 OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR $1,520.6225608 OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG $1,707.1025609 OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG $2,170.0624615 OPEN RX ELBOW DISLOCATION $1,476.7027506 OPEN RX FEMUR FX+INTRAMED ROD $2,779.1627507 OPEN RX FEMUR FX+PLATE/SCREW $2,018.8623630 OPEN RX GR TUBEROSITY FX $1,614.9427254 OPEN RX HIP DISLOC/ACETABULAR FX $2,638.0625685 OPEN RX NAVIC-PERILUNATE FX/DISLOC $1,524.9427524 OPEN RX PATELLA FX $1,558.0624587 OPEN RX PERIARTIC FX ELBOW,IMPLNT $2,269.4224586 OPEN RX PERIARTIC FX/DISLOC ELBOW $2,249.2625676 OPEN RX RADIO-ULNA DISLOCATION $1,303.1823585 OPEN RX SCAPULA FRACTURE $2,031.8228531 OPEN RX SESAMOID BONE FX $377.2823670 OPEN RX SHLDR DISLOC,GR TUB FX $1,812.2223680 OPEN RX SHLDR DISLOC,OX HUM FX $1,926.7027177 OPEN RX SLIP EPIPHYSIS $2,316.2227259 OPEN RX SPONT HIP DISLOC,FEM SHORT $3,232.0427258 OPEN RX SPONTANEOUS HIP DISLOC $2,307.5823530 OPEN RX STERN-CLAV DISLOC $1,185.8227758 OPEN RX TIBIA SHAFT FX,SCREWS $1,848.2227253 OPEN RX TRAUMATIC HIP DISLOCATN $1,947.5825652 OPEN RX ULNAR STYLOID FX $1,289.5027814 OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE $1,596.9428415 OPEN TREATMENT CALCANEAL FRACTURE $2,319.8228420 OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT $2,628.70

23515 OPEN TREATMENT CLAVICULAR FRACTURE INTERNAL FX $1,490.3827828 OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA $2,722.2827826 OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA $1,749.5827827 OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY $2,277.3427248 OPEN TREATMENT GREATER TROCHANTERIC FRACTURE $1,541.5028675 OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION $841.6827766 OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE $1,257.8226715 OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION 1 $1,185.1028485 OPEN TREATMENT METATARSAL FRACTURE EACH $1,123.1825545 OPEN TREATMENT OF ULNAR SHAFT FRACTURE $1,286.6223615 OPEN TREATMENT OX HUMERAL FRACTURE $1,833.8227784 OPEN TREATMENT OXIMAL FIBULA/SHAFT FRACTURE $1,474.5427769 OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE $1,516.3025515 OPEN TREATMENT RADIAL SHAFT FRACTURE $1,385.2628585 OPEN TREATMENT TALOTARSAL JOINT DISLOCATION $1,401.8228445 OPEN TREATMENT TALUS FRACTURE $2,188.7828555 OPEN TREATMENT TARSAL BONE DISLOCATION $1,369.4228615 OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION $1,668.2226746 OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA $1,536.4625628 OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE $1,489.6626685 OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB $1,192.3026665 OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB $1,295.9827519 OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION $1,853.2627792 OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS $1,346.3826765 OPEN TX DISTAL PHALANGEAL FRACTURE EACH $1,034.6227829 OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION $1,439.9827514 OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE $2,007.3427269 OPEN TX FEMORAL FRACTURE OXIMAL END HEAD $2,584.0627513 OPEN TX FEMORAL SUACONDYLAR FRACTURE W EXTENSION $2,577.5827511 OPEN TX FEMORAL SUACONDYLAR FRACTURE W/O EXTENSION $2,069.9828505 OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES $1,035.3428525 OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE $827.2824579 OPEN TX HUMERAL CONDYLAR FRACTURE $1,731.5824575 OPEN TX HUMERAL EPICONDYLAR FRACTURE $1,520.62

24546 OPEN TX HUMERAL SUACONDYLAR FRACTURE W XTN $2,155.6624545 OPEN TX HUMERAL SUACONDYLAR FRACTURE W/O XTN $1,928.1427540 OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE $1,673.9826785 OPEN TX INTERPHALANGEAL JOINT DISLOCATION 1 $1,131.1027558 OPEN TX KNEE DISLOCATION W REPAIR/RECONSTRUCTION $2,486.8627556 OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR $1,822.3026615 OPEN TX METACARPAL FRACTURE SINGLE EA BONE $1,191.5828645 OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION $1,000.0624635 OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW $1,395.3427832 OPEN TX OX TIBFIB JOINT DISLOCATE EXC OX FIB $1,569.5826735 OPEN TX PHALANGEAL SHAFT FRACTURE OX/MIDDLE EA $1,233.3425575 OPEN TX RADIAL & ULNAR SHAFT FX FIX RADIUS AND ULNA $1,865.5025574 OPEN TX RADIAL & ULNAR SHAFT FX FIX RADIUS OR ULNA $1,393.9024665 OPEN TX RADIAL HEAD/NECK FRACTURE $1,352.8624666 OPEN TX RADIAL HEAD/NECK FRACTURE OSTHETIC $1,517.7428465 OPEN TX TARSAL FRACTURE XCP TALUS &CALCANEUS EA $1,310.3827535 OPEN TX TIBIAL FRACTURE OXIMAL UNICONDYLAR $1,861.9027823 OPEN TX TRIMALLEOLAR ANKLE FX W FIX PST LIP $2,013.8227822 OPEN TX TRIMALLEOLAR ANKLE FX W/O FIX PST LIP $1,777.6624685 OPEN TX ULNAR FRACTURE OX END $1,354.3037239 OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL $318.9637237 OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL $447.8437236 OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL $935.9837238 OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST $628.56

J8540 ORAL DEXAMETHASONE $10.0054640 ORCHIOPEXY,INGUNIAL APOACH $999.34

L4210 ORTH DEV REPAIR/REPL MINOR P $41.0097760 ORTHOTICS MGMT & TRAINJ INITIAL ENCTR EA 15 MINS $95.76

J7324 ORTHOVISC INJ PER DOSE $1,183.00G0102 OSTATE CA SCREENING; DRE $43.20

53850 OSTATIC MICROWAVE THERMOTX $1,266.4653852 OSTATIC RADIOFREQ THERMOTX $1,300.3053853 OSTATIC WATER-INDUCED THERMOTX $172.8027415 OSTEOCHONDRAL KNEE ALLOGRAFT $2,832.44

27416 OSTEOCHONDRAL KNEE AUTOGRAFT $2,036.8625394 OSTEOPLASTY,CARPAL BONE,SHORTEN $1,625.7425390 OSTEOPLASTY,RADIUS OR ULNA,SHORTEN $1,594.0627454 OSTEOTOMIES FEMUR SHAFT+INTRA ROD $2,703.5628306 OSTEOTOMY 1ST METATARSAL,BASE/SHAFT $838.8023480 OSTEOTOMY CLAVICLE $1,704.2223485 OSTEOTOMY CLAVICLE W BONE GRAFT $1,972.7827450 OSTEOTOMY FEMUR SHAFT,W FIXATN $2,082.9427707 OSTEOTOMY FIBULA $824.4028300 OSTEOTOMY HEEL BONE $1,348.5427147 OSTEOTOMY HIP BONE,OPEN REDN HIP $3,059.9622214 OSTEOTOMY LUMB SP,POST,1 LVL $3,111.0828308 OSTEOTOMY METATARSAL (NOT 1ST) $783.3628309 OSTEOTOMY METATARSALS,MULTIPLE $1,853.2627146 OSTEOTOMY OF HIP BONE $2,663.2628310 OSTEOTOMY OX PHALANX,1ST TOE $740.8827455 OSTEOTOMY OX TIB,<EPIPHY CLOSUR $1,955.5027457 OSTEOTOMY OX TIB,AFTR EPIPHY CLOS $1,973.5025350 OSTEOTOMY RADIUS,DISTAL THIRD $1,396.7822222 OSTEOTOMY THOR SP,ANT,REMV DISK $3,664.7627705 OSTEOTOMY TIBIA $1,583.2625360 OSTEOTOMY ULNA $1,353.5828312 OSTEOTOMY,ANY PHALANX,ANY TOE $657.3627165 OSTEOTOMY/FIX INTER/SUBTROCH FEMUR $2,846.1224160 OSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS $2,622.22

E0191 OTECTOR HEEL OR ELBOW NU $10.0097168 OUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS $126.0097167 OUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS $185.0497165 OUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS $185.0497166 OUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS $185.0497003 OUPATIONAL THERAPY EVALUATION $126.0097004 OUPATIONAL THERAPY RE-EVALUATION $82.8026121 PALMAR FASCIECTOMY $1,237.66

J2440 PAPAVERIN L INJECTION $4.00

57284 PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APOACH $1,666.0657285 PARAVAGINAL DEFECT REPAIR VAGINAL APOACH $1,373.7428110 PART EXCIS 5TH METATARSAL HEAD $600.4823180 PART EXCIS CLAVICLE $1,355.7428060 PART EXCIS PLANTAR FASCIA $739.4423182 PART EXCIS SCAPULA $1,357.9026123 PART PALMAR FASCIEC,OPEN 1 DIGIT $1,727.2626125 PART PALMAR FASCIEC,OPEN ADDNL DIGIT $570.2425151 PART REMOVAL BONE,RADIUS $1,205.9825150 PART REMOVAL BONE,ULNA $1,175.0244140 PART REMOVAL COLON W ANASTOMOSIS $2,798.6044146 PART REMOVAL COLON W COLOOC,COLOST $4,423.6444145 PART REMOVAL COLON W COLOOCTOSTOMY $3,458.8444141 PART REMOVAL COLON W COLOSTOMY $3,810.9244143 PART REMOVAL COLON W END COLOSTOMY $3,473.9644144 PART REMOVAL COLON W OSTOMY/MUCOFIST $3,691.4051555 PART REMV BLADDER,COMPLICATED $2,640.9451565 PART REMV BLADDER,REIMPLNT URETER $2,692.0651550 PART REMV BLADDER,SIMPLE $2,012.3828288 PART REMV BONE METATARSAL HEAD,EA $891.3626236 PART REMV BONE,DISTAL PHALANX $912.2226230 PART REMV BONE,METACARPAL $1,034.6226235 PART REMV BONE,OX/MID PHALANX $1,019.5027360 PART REMV FEMUR/OX TIB/FIB $1,763.9828122 PART REMV OTHR TARSAL/METATARSAL $912.2228124 PART REMV PHALANX OF TOE $684.0028120 PART REMV TALUS OR CALCANEUS $1,030.3027350 PART/FULL REMOVAL OF KNEECAP $1,349.2627070 PARTIAL EXCISION SUPERFICIAL PELVIS $1,751.0227125 PARTIAL HIP REPLACEMENT $2,355.1027641 PARTIAL REMOVAL OF FIBULA $1,380.2250240 PARTIAL REMOVAL OF KIDNEY $2,763.3227640 PARTIAL REMOVAL OF TIBIA $1,725.8224147 PARTIAL REMOVAL OLECRANNON OCESS $1,289.50

23120 PARTIAL REMOVAL, CLAVICLE $1,209.5823130 PARTIAL REMOVAL/REPAIR,ACROMION $1,262.8694016 PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY $51.8490670 PCV13 VAINE FOR INTRAMUSCULAR USE $143.76

E0944 PELVIC BELT/HARNESS/BOOT $79.0057410 PELVIC EXAMINATION W ANESTH $221.0451597 PELVIC EXENTERATION COMPLETE, OTHER MALIG $4,795.1427299 PELVIS/HIP JOINT SURGERY UNLISTED $2,300.0054360 PENIS PLASTIC SURG,CORRECT ANGULATN $1,504.06

0274T PERC LAMINO-/LAMINECTOMY IMAGE GUIDE CERV/THORAC $1,082.860275T PERC LAMINO-/LAMINECTOMY INDIR IMAG GUIDE LUMBAR $1,082.86

22525 PERC VERTEB AUGMENT/ KYPHOPLAST, EA ADD $467.2822524 PERC VERTEB AUGMENT/ KYPHOPLAST, LUMBAR $1,230.2222523 PERC VERTEB AUGMENT/ KYPHOPLAST, THOR $1,230.2228496 PERCUT BIG TOE FX $504.0049180 PERCUT BIOPSY, ABDOMINAL MASS $177.8450395 PERCUT DILATN RENAL TRACT $371.5262268 PERCUT DRAIN SPINAL CORD CYST $535.6850390 PERCUT DRAIN/INJECT RENAL CYST $200.1626676 PERCUT FIX CARPOMETACAR DISLOC,NON-THUMB $1,034.6227509 PERCUT FIX DISTAL FEMUR $1,329.8224538 PERCUT FIX HUM SUACONDYLAR FX $1,540.7827235 PERCUT FIX OX/NECK FEMUR FX $1,887.1027216 PERCUT FIX POST PELV RING FX $1,922.3824582 PERCUT FIXATN HUMERAL CONDYLAR FX $1,675.4224566 PERCUT FIXATN HUMERAL EPICONDYLAR FX $1,485.3464555 PERCUT IMPLANT,NEUROELEC,PERIPH NERVE $701.2864565 PERCUT IMPLNT NEUROELEC,NEUROMUSC $701.2863650 PERCUT IMPLNT NEUROELECT,EPIDURAL $851.7650392 PERCUT INSERT KIDNEY CATH/DRAIN $374.5250393 PERCUT INSERT URETERAL CATH/TUBE $374.5250081 PERCUT REMV KID STONE,2+ CM $2,664.7050080 PERCUT REMV KID STONE,UP TO 2 CM $1,814.3826756 PERCUT RX DIST FINGR FX $858.96

28406 PERCUT RX HEEL FX $1,076.3826776 PERCUT RX IP JT DISLOCATION $915.1028666 PERCUT RX I-P JT,TOE DISLOC $371.5226706 PERCUT RX MC-P DISLOC $907.1828476 PERCUT RX METATARSAL FX $725.0426727 PERCUT RX OX/MID FING SHFT FX $969.1028576 PERCUT RX TALOTARSAL DISLOCATION $821.5228606 PERCUT RX TAR-METATAR FOOT DISLOC $831.6027756 PERCUT RX TIBIA SHAFT FX $1,200.2225606 PERCUT SKELETAL FIX, DISTAL RADIUS FX $1,372.3025671 PERCUT SKELETAL FIX,DIST RADIOULN DISLOC $1,099.4225651 PERCUT SKELETAL FIX,ULNAR STYLOID FX $1,002.2255875 PERCUT/NEEDLE INSERT,OSTATE,RADIOISOT $1,594.0633010 PERICARDIOCENTESIS INITIAL $224.6493287 PERI-PX DEV EVAL & OG SING/DUAL/MULTI LEAD DFB PROF CHG $47.5293286 PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON PROF CHG $30.9693286 PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON $61.2093286 PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON TECH CHG $30.2419285 PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG $1,060.5432556 PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING $254.88

0201T PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS $1,082.860200T PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL $1,082.86

10035 PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE $179.2822513 PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION $1,082.8622515 PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH $467.2822514 PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR $1,007.98

J2760 PHENTOLAINE MESYLATE INJ $246.0037765 PHLEB VEINS - EXTREM - TO 20 $935.9837766 PHLEB VEINS - EXTREM 20+ $1,144.7899360 PHYS STANDBY SVC OLNG PHYS ATTN EA 30 MINUTES $125.2899183 PHYS/QHP ATTN&SUPVJ HYBARIC OXYGEN TX /SESSION $226.0899288 PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS $308.0099442 PHYS/QHP TELEPHONE EVALUATION 11-20 MIN $54.7299443 PHYS/QHP TELEPHONE EVALUATION 21-30 MIN $80.64

99441 PHYS/QHP TELEPHONE EVALUATION 5-10 MIN $28.8097750 PHYSICAL PERFORMANCE TEST $77.0499444 PHYSICIAN ONLINE EVALUATION & MANAGEMENT SERVICE $36.7299372 PHYSICIAN PHONE CONSULT,INTERMED $74.8899362 PHYSICIAN/TEAM CONFERENCE,1 HR $227.5299361 PHYSICIAN/TEAM CONFERENCE,1/2 HR $125.2869090 PIERCE EARLOBES $101.5236014 PLACE CATH IN LT/RT PULM ART $314.6436011 PLACE CATH IN VEIN,SELECT $328.3236215 PLACE CATH SELECTIVE ART,NECK $444.9636216 PLACE CATH SUBSELECT ART,NECK $572.4048000 PLACE DRAIN ABD FOR PANCREATITIS $3,939.8036147 PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,1ST AESS W/ RAD EVAL $258.4855876 PLACE RADIOTHER DEVICE/MARKER, OSTATE $210.2455920 PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL $933.8243752 PLACEMENT NG/OG TUBE BY PHYSICIAN $84.9646020 PLACEMENT,SETON $487.44

L3265 PLASTAZOTE SANDAL EACH $45.0027445 PLASTY KNEE,CONSTRAINED OSTHESIS $2,601.3427446 PLASTY KNEE,MED OR LAT COMPARTMT $2,408.3827441 PLASTY TIBIAL PLATEAU+DEBRIDE $1,711.4294726 PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST PROF CHG $25.2032215 PLEURAL SCARIFICATN FOR MULT PTX $1,672.54

L4370 PNEUM FULL LEG SPLNT E OTS $327.00L4361 PNEUMA/VAC WALK BOOT E OTS $383.00L4360 PNEUMAT WALKING BOOT E CST $401.00

90669 PNEUMOCOAL CONJ VAINE 7 VALENT IM $167.0090713 POLIOMYELITIS IMMUNIZATN,INACTV,SUB-Q $53.0095810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND PROF CHG $249.1295811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND PROF CHG $259.2095808 POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND PROF CHG $181.4457250 POST COLPORRHAPHY,RECTUM/VAGINA $1,212.4664566 POST TIBIAL NEUROSTIMULATION,PERC NEEDLE ELECTRODE $63.3622840 POSTERIOR NON-SEGMENTAL INSTRUMENTATION $1,599.82

22842 POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG $1,606.3022843 POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG $1,718.6299024 POST-OP FOLLOW-UP VISIT $- 90732 PPSV23 VAINE 2 YRS OR OLDER FOR SUBQ/IM USE $172.0090792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES $288.7290791 PSYCHIATRIC DIAGNOSTIC EVALUATION $256.3290801 PSYCHIATRIC DIAGNOSTIC INTERVIEW $288.7290885 PSYCHIATRIC EVALUATION OF RECORDS $101.5296101 PSYCHOLOGIC TESTING BY PSYCH/PHYS $167.7696100 PSYCHOLOGICAL TESTING $161.2890839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES $266.4090832 PSYCHOTHERAPY W/PATIENT 30 MINUTES $127.4490834 PSYCHOTHERAPY W/PATIENT 45 MINUTES $169.9290837 PSYCHOTHERAPY W/PATIENT 60 MINUTES $255.6090833 PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN $133.2090816 PSYCHOTHERPY, HOSP (20-30) $127.4490817 PSYCHOTHERPY, HOSP (20-30) W/E&M $127.4490819 PSYCHOTHERPY, HOSP (45-50) W/E&M $169.9290804 PSYCHOTHERPY, OFFICE (20-30) $127.4490806 PSYCHOTHERPY, OFFICE (45-50) $169.9290807 PSYCHOTHERPY, OFFICE (45-50) W/E&M $169.9290808 PSYCHOTHERPY, OFFICE (75-80) $288.7294618 PULMONARY STRESS TESTING $69.8419000 PUNC/ASPIR BREAST CYST $90.7210160 PUNCTURE DRAINAGE OF LESION $196.5649080 PUNCTURE PERITONEAL CAVITY $218.8892552 PURE TONE AUDIOMETRY, AIR $64.8064561 Q IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING $630.7264553 Q IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE $786.9626650 Q SKEL FIXATION CARP/MTCRPL FX DISLOCATE THUMB $983.5092973 Q TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY $370.8037187 Q TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN $822.2492921 Q TRLUML CORONARY ANGIOPLASTY ADDL BRANCH $370.8092920 Q TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH $1,113.82

92938 Q TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL $974.0092937 Q TRLUML CORONARY BYP GRFT REVASC ONE VESSEL $1,237.6692929 Q TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH $974.0092928 Q TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH $1,239.1092934 Q TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH $974.0092943 Q TRLUML CORONRY CHRONIC OLUS REVASC ONE VSL $1,391.7492933 Q TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH $1,388.8692941 Q TRLUML CORONRY TOT OLUS REVASC MI ONE VSL $1,391.7493453 R & L HRT CATH W/NJX L VENTRICULOG IMG S&I PROF CHG $666.7293460 R & L HRT CATH WINJX HRT ART& L VENTR IMG PROF CHG $789.8436576 R CTR VAD W/SUBQ PORT/PMP CTR/PH INSJ SIT $72.7293461 R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I PROF CHG $871.9290375 RABIES IG, IM/SUBCUT $883.0090675 RABIES VAINE, IM $476.0026145 RAD EXCIS JT LINING,FLEXOR,EACH $1,059.8225116 RAD EXCIS WRIST SYNOV/TENDON,EXTEN $1,242.7025115 RAD EXCIS WRIST SYNOV/TENDON,FLEXOR $1,572.4626118 RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/> $2,183.7427076 RAD RESEC ILIUM+ACETABULUM $5,300.5828175 RAD RESEC PHALANX,TOE $987.8225170 RAD RESEC TUMOR, FOREARM $3,076.5227365 RAD RESEC TUMOR,FEMUR OR KNEE $4,298.3627646 RAD RESEC TUMOR,FIBULA $3,216.2023210 RAD RESECT SCAPULA FOR TUMOR $3,707.9625077 RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM $1,835.9826117 RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM $1,545.1027049 RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM $2,789.9627329 RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM $2,154.9422904 RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM $2,183.7422905 RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/> $2,771.9621935 RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM $2,131.9028046 RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM $1,514.1463707 RE,DURAL/CSF LEAK,NOT REQ LAMINECTOMY $1,930.3063709 RE,DURAL/CSF LEAK,W/LAMINECTOMY $2,299.66

13133 RE,FACE,GENITAL,HAND,FT+5 CMCM/< $272.8826437 REALIGNMENT OF TENDONS,HAND $1,270.7827886 RE-AMPUTATION LOWER LEG $1,366.5435221 REBL VES DIRECT,ABD $3,056.3635207 REBL VES DIRECT,HAND/FINGR $1,571.0235206 REBL VES DIRECT,UP EXTREM $1,635.1044661 REBOW-BLAD FIST,W/INTEST/BLAD RESECT $3,237.0813131 RECMPL WND HEAD,FAC,HAND 1.1-2.5 CM $519.8413132 RECMPL WND HEAD,FAC,HAND 2.6-7.5 CM $653.7613150 RECMPL WND LID,NOS,EAR <1 CM $596.1613151 RECMPL WND LID,NOS,EAR 1.1-2.5 CM $596.1613152 RECMPL WND LID,NOS,EAR 2.5-7.5 CM $722.8813120 RECMPL WND SCALP,EXTR 1.1-2.5 CM $491.0413121 RECMPL WND SCALP,EXTR 2.6-7.5 CM $555.1213101 RECMPL WND TRUNK 2.6-7.5 CM $525.6026587 RECONST POLYDACT DIGIT,SOFT TIS & BONE $2,154.2228238 RECONST POST TIB TEND,EXCIS A TAR NAV $1,007.9823472 RECONSTR TOTAL SHOULDER IMPLANT $3,024.6853410 RECONSTRUC ANT MALE URETHRA $2,041.1827122 RECONSTRUC HIP SOCKET,RESEC FEM HEAD $2,283.1011760 RECONSTRUC OF NAIL BED $234.7211762 RECONSTRUC OF NAIL BED W GRAFT $378.0053415 RECONSTRUC OSTATIC URETHRA $2,361.5825442 RECONSTRUCT DIST ULNA W OSTHESIS $1,668.9424344 RECONSTRUCT ELBOW LAT LIGMNT W/GRAFT $2,283.8224346 RECONSTRUCT ELBOW MED LIGMNT W/GRAFT $2,280.2223470 RECONSTRUCT OX HUMERAL IMPLANT $2,489.7424365 RECONSTRUCT RADIAL HEAD $1,325.5024366 RECONSTRUCT RADIAL HEAD W IMPLANT $1,408.3025445 RECONSTRUCT TRAPEZIUM W OSTHESIS $1,495.4220950 RECORD FLUID ESSURE,MUSCLE $187.9235011 REDFCT ART AXILLO-BRACH $2,105.2663044 REDO EXCIS CERV DISK, ADDN LUMB INTERSPC $439.9263042 REDO EXCIS LUMBAR DISK BILATERAL $4,067.22

63042 REDO EXCIS LUMBAR DISK $2,711.4821480 REDUCE TEMPOROMANDIBL DISLOC $66.2454600 REDUCE TESTIS TORSION $947.5044050 REDUCE VOLVULUS,INTUSS,INTERN HERNIA $1,947.5824343 REELBOW LAT LIGMNT W/TISS $1,462.3024345 REELBW MED LIGMNT W/TISS $1,454.3896530 REF/MAINT,IMPLAN PUMP/RES DRUG DEL,SYS $48.9695990 REFIL/MAINT,IMPLANT PUMP,DRUG DELIV,CNS $190.8025275 REFOREARM EXT TEND SHEATH,GRAFT $1,389.5825274 REFOREARM TEND/EXT,SECOND,GRAFT,EA $1,393.9025270 REFOREARM TEND/MUSC,EXTEN,IM,EA $1,013.7425272 REFOREARM TEND/MUSC,EXTEN,SECOND $1,153.4225260 REFOREARM TEND/MUSC,FLEX,IM,EA $1,303.1825263 REFOREARM TEND/MUSC,FLEX,SECON,EA $1,298.8650782 REIMPLANT URETER,DUPLICATED URETER $2,244.2250783 REIMPLANT URETER,EXTENSIVE TAILORING $2,354.3850780 REIMPLANT URETER,SINGLE URETER $2,311.9050785 REIMPLANT URETER,VESICOPSOAS HITCH $2,531.5027495 REINFORCE FEMUR $2,336.3827187 REINFORCE HIP BONES $2,057.0224342 REINSERT BI/TRICEPS TENDON,DISTAL $1,606.3022849 REINSERT SPINAL FIXATION $2,716.5226449 RELEASE FOREARM/HAND EXTEN TENDON $1,423.4226525 RELEASE I-P JT CONTRACTURE $1,328.3826520 RELEASE MC-P JT CONTRACTURE $1,324.0628240 RELEASE OF BIG TOE TENDN $624.2450940 RELEASE OF URETER $1,851.8226045 RELEASE PALM CONTRACT,OPEN,PARTIAL $966.2226040 RELEASE PALM CONTRACT,PERCUTANEOUS $644.4026508 RELEASE THUMB CONTRACTURE $1,285.9027680 RELEASE TIB/FIB/ANKLE FLEX TENDON,EA $882.7250722 RELEASE URETER,OVARIAN VEIN SYND $2,103.1050725 RELEASE URETER,RETROCAVAL $2,301.1050715 RELEASE URETER,RETROPER FIBROSIS $2,541.58

25295 RELEASE WRIST/FOREARM TENDON $1,085.7464722 RELIEVE ESSURE ON NERVE(S) $741.6052640 RELIEVE POSTOP BLADDER CONTRACTURE $658.8033222 RELOCATION OF SKIN POCKET FOR PACEMAKER $704.8854680 RELOCATION OF TESTIS(ES) $1,643.0293294 REM INTERROG PM/LDLS PM <90 D PHYS/QHP $62.6493298 REM INTERROG SCRMS <30 D PHYS/QHP $54.7215851 REM SUTURES W ANESTH OTHR SURGEON $95.0415850 REM SUTURES W ANESTH SAME SURGEON $85.6853448 REMOV & REPLACE INFLAT SPHINCTER,INFECT $2,672.6228315 REMOV SESAMOID BONE,1ST TOE $676.0853447 REMOVAL & REPLACE,INFLATABLE SPHINCTER $1,687.6621615 REMOVAL 1ST/CERVICAL RIB $1,278.7046275 REMOVAL ANAL FISTULA,INTERSPNINCTERIC $861.1246285 REMOVAL ANAL FISTULA,SECOND STAGE $863.2846270 REMOVAL ANAL FISTULA,SUBCUTANEOUS $814.3246280 REMOVAL ANAL FISTULA,TRANS/SUA/EXTRAPHINCT, +/-SETON $977.0224201 REMOVAL ARM/ELBOW F.B.,DEEP $752.4024200 REMOVAL ARM/ELBOW F.B.,SUPERFICIAL $288.0044150 REMOVAL COLON/ILEOSTOMY $3,901.6420680 REMOVAL DEEP IMPLANT $876.2411982 REMOVAL DRUG IMPLANT DEVICE $206.6427340 REMOVAL EPATELLA BURSA $768.2447600 REMOVAL GALLBLADDER $2,224.0669210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT $67.6869209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT $28.8033241 REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY $450.0050384 REMOVAL INDWELLING URETERAL STENT Q $483.1246200 REMOVAL OF ANAL FISSURE $677.5219371 REMOVAL OF BREAST CAPSULE $1,621.4225210 REMOVAL OF CARPAL BONE $1,007.9827080 REMOVAL OF COYX $1,062.7024105 REMOVAL OF ELBOW BURSA $725.0454861 REMOVAL OF EPIDIDYMIS,BILAT $1,182.22

54860 REMOVAL OF EPIDIDYMIS,UNILAT $875.5220520 REMOVAL OF FOREIGN BODY $303.8420525 REMOVAL OF FOREIGN BODY DEEP/COMPLIC $512.6424130 REMOVAL OF HEAD OF RADIUS $1,051.9028118 REMOVAL OF HEEL BONE $858.9628119 REMOVAL OF HEEL SPUR $745.2027090 REMOVAL OF HIP OSTHESIS $1,720.0627091 REMOVAL OF HIP OSTHESIS,COMPLEX $3,318.4455041 REMOVAL OF HYDROCELE,TUNICA,BILAT $1,064.1455040 REMOVAL OF HYDROCELE,TUNICA,UNILAT $705.6026320 REMOVAL OF IMPLANT FROM HAND/FINGR $716.4019330 REMOVAL OF IMPLANT MATERIAL $1,311.8227060 REMOVAL OF ISCHIAL BURSA $964.0650060 REMOVAL OF KIDNEY STONE $2,379.5827488 REMOVAL OF KNEE OSTHESIS $2,494.7828140 REMOVAL OF METATARSAL $911.5011750 REMOVAL OF NAIL BED $209.5211730 REMOVAL OF NAIL PLATE $114.4858940 REMOVAL OF OVARY(S) $1,082.1458720 REMOVAL OF OVARY/TUBE(S) $1,512.7025215 REMOVAL OF OX ROW CARPAL BONES $1,278.7025230 REMOVAL OF RADIAL STYLOID $895.6846030 REMOVAL OF RECTAL MARKER $187.2055120 REMOVAL OF SCROTAL FOR.BODY $738.7255150 REMOVAL OF SCROTUM $1,025.2628150 REMOVAL OF SINGLE TOE,EACH $578.8811201 REMOVAL OF SKIN TAGS, EACH ADD 10 $35.2811200 REMOVAL OF SKIN TAGS, UP TO 15 $151.9255520 REMOVAL OF SPERM CORD LESION $942.4655250 REMOVAL OF SPERM DUCT(S) $474.4863746 REMOVAL OF SPINAL SHUNT $1,262.8628130 REMOVAL OF TALUS $1,512.7053210 REMOVAL OF URETHRA,FEMALE $1,607.0253215 REMOVAL OF URETHRA,MALE $1,936.06

54120 REMOVAL PENIS,PARTIAL $1,320.4654125 REMOVAL PENIS,TOTAL $1,697.0233233 REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY $480.2423333 REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM $964.0638100 REMOVAL SPLEEN, TOTAL $2,404.7823000 REMOVAL SUBDELTOID CALCAREOUS DEP,OPEN $764.6420670 REMOVAL SUPERFICIAL IMPLANT $303.1227345 REMOVAL SYNOVIAL CYST,KNEE $993.5854522 REMOVAL TESTIS, PARTIAL $1,232.6254530 REMOVAL TESTIS,RADICAL $1,054.7854535 REMOVAL TESTIS,RADICAL+ABD EXPLOR $1,553.7454520 REMOVAL TESTIS,SIMPLE $681.8436589 REMOVAL TUNNELED CV CATH W/O SUBQ PORT OR PUMP $565.2049422 REMOVAL TUNNELED INTRAPERITONEAL CATHETER $791.2851500 REMOVAL URACHAL CYST $1,329.1050650 REMOVAL URETER,BLADDER CUFF $2,162.8650660 REMOVAL URETER,TOTAL,ECTOPIC $2,387.5011983 REMOVAL W/ REINSERT DRUG IMPLANT DEVICE $367.9225250 REMOVAL WRIST OSTHESIS $1,097.9853446 REMOVAL,INFLATABLE SPHINCTER $1,339.9054415 REMOVAL,PENILE OSTHESIS W/O REPLACMT $1,103.0250385 REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL $457.9211732 REMOVE ADDITIONAL NAIL PLATE $36.7238740 REMOVE ARMPIT LYMPH NODES SUPERFIC $1,445.0238745 REMOVE ARMPITS LYMPH NODES COMPLT $1,825.1852317 REMOVE BLADDER STONE,<2.5 CM $726.4852318 REMOVE BLADDER STONE,>2.5 CM $989.9823332 REMOVE COMPLIC SHOULDER FOREIGN BODY $854.2823331 REMOVE DEEP SHOULDER FOREIGN BODY $854.2820694 REMOVE EXTERN BONE FIX DEV W ANESTH $701.2825248 REMOVE FOREARM/WRIST FOREIGN BODY $852.4810121 REMOVE FOREIGN BODY COMPLIC $382.3210120 REMOVE FOREIGN BODY SIMPLE $213.8443887 REMOVE GASTRIC PORT, OPEN $681.12

38765 REMOVE GROIN LYMPH NODES $2,695.6638760 REMOVE GROIN LYMPH NODES SUPERF $1,752.4662365 REMOVE INFUSN DEVICE/PUMP $615.6050386 REMOVE INT DWELL URETERAL STENT TRANSURETHRAL $342.0027347 REMOVE KNEE CYST/GANGLION $1,094.3811008 REMOVE MESH FROM ABD WALL FOR INFECTION $573.1211752 REMOVE NAIL BED/FINGER TIP $382.3230300 REMOVE NASAL FOREIGN BODY $216.0027087 REMOVE PELV/HIP F.B.,DEEP $1,265.7427086 REMOVE PELV/HIP F.B.,SUBCUTANEOUS $347.7649402 REMOVE PERITONEAL FOREIGN BODY $1,784.8642809 REMOVE PHARYNX FOREIGN BODY $251.2850389 REMOVE RENAL TUBE W/FLUORO $113.0462355 REMOVE SPINAL CANAL CATHETER $556.5663661 REMOVE SPINAL NEUROSTIM ELECTRODE PERC ARRAY, INCL FLUORO $671.7663662 REMOVE SPINAL NEUROSTIM ELECTRODE PLATE/PADDLE, INCL FLUORO $1,751.7422855 REMOVE SPINE FIX DEV,ANTERIOR $2,315.5022850 REMOVE SPINE FIX DEV,HARRINGTON $1,509.1022852 REMOVE SPINE FIX DEV,POST SGMTAL $1,448.6223330 REMOVE SUBCUT SHOULDER FOREIGN BODY $344.8827062 REMOVE TROCH BURSA/CALCIFICATN $943.1827355 REMV BENIGN FEMUR LESION $1,249.1851580 REMV BLADDER,REVISE TRACT $3,957.8051570 REMV BLADDER,TOTAL $3,080.1251595 REMV BLADDER/NODES,ILEAL CONDUIT $4,569.0651585 REMV BLADDER/NODES,REVIS TRACT $4,407.0820902 REMV BONE FOR GRAFT MAJOR $593.2820900 REMV BONE FOR GRAFT MINOR $391.6869200 REMV EXT CANAL FOREIGN BODY $97.2065220 REMV F.B.,EYE,CORNEA,NO SLIT $87.1265222 REMV F.B.,EYE,CORNEA,SLIT LAMP $107.2865210 REMV F.B.,EYE,EMBED CONJUNC $108.7265205 REMV F.B.,EYE,SUPERF CONJUNC $90.7220922 REMV FASCIA FOR GRAFT INCIS $1,012.30

28193 REMV FOOT FOREIGN BODY,COMPLEX $763.2028192 REMV FOOT FOREIGN BODY,DEEP $648.0028190 REMV FOOT FOREIGN BODY,SUBCUTANEOUS $277.9254115 REMV FOR.BODY DEEP PENILE TISS $886.3227372 REMV FOREIGN BODY,KNEE/THIGH,DEEP $823.6847605 REMV GALLBLADDER W CHOLANGIOGRAM $2,342.1455500 REMV HYDROCELE,SPERM CORD,UNILAT $824.4050070 REMV KID STONE,CONGEN ANOMALY $2,474.6250065 REMV KID STONE,XTRA SURG OPERATN $2,524.3050075 REMV KIDNEY STONE,STAGHORN $3,041.9650225 REMV KIDNEY,COMPLICATED $2,505.5850230 REMV KIDNEY,RADICAL $2,674.7850220 REMV KIDNEY,W/RIB RESECTION $2,185.9050234 REMV KIDNEY/URETER,SAME INCIS $2,715.0850236 REMV KIDNEY/URETER,SEPAR INCIS $3,065.7232442 REMV LUNG,RESEC PART TRACHEA $6,383.4455812 REMV OSTATE,PERINEAL,RAD,LTD NODES $3,359.4855815 REMV OSTATE,PERINEAL,RAD,TOT NODES $3,680.6055810 REMV OSTATE,PERINEAL,RADICAL $2,736.6855842 REMV OSTATE,RETROPUB,RAD,LTD NODES $2,447.2655845 REMV OSTATE,RETROPUB,RAD,TOT NODES $2,846.8455840 REMV OSTATE,RETROPUB,RADICAL $2,446.5455831 REMV OSTATE,RETROPUBIC,SUBTOTAL $1,972.0655821 REMV OSTATE,SUAPUBIC,SUBTOTAL $1,823.0211772 REMV PILONIDAL LESION COMPLIC $1,191.5811771 REMV PILONIDAL LESION EXTENS $902.8611770 REMV PILONIDAL LESION SIMPLE $382.3245915 REMV RECTAL OBSTR:FECES/F.B. W ANEST $473.0452630 REMV RESID OBSTRUC OSTATE,>1 YR $835.2052620 REMV RESID OBSTRUC OSTATE,>90 DAYS $835.2028100 REMV TALUS/HEEL BENIGN BONE LESN $861.8428104 REMV TARSAL/METATARSAL BENIGN BONE LESN $733.6820924 REMV TENDON FOR GRAFT $1,049.7428108 REMV TOE BENIGN BONE LESN $597.60

63082 REMV VERT BODY,CERV,EACH ADDNL SGMT $560.8863081 REMV VERT BODY,CERV,ONE SGMT $3,681.3263087 REMV VERT BODY,LO THOR/LUMB,ONE $5,057.9463085 REMV VERT BODY,THOR,ONE SGMT $4,001.0063303 REMV VERT,EXDUR,LUMB/SACR TUMOR $4,888.0229700 REMV/REVISN BOOT/BODY CAST $69.8429705 REMV/REVISN FULL ARM/LEG CAST $97.2029710 REMV/REVISN SHLDR/HIP SPICA CAST $173.5257287 REMV/REVS SLING FOR STRES INCONTINENCE $1,398.9423440 REMV/TRANSPLANT LONG BICEPS TENDON $1,561.6644160 REMVL COLON & TERM ILEUM W/ILEOCOLOSTOMY $2,590.5433228 REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS $739.4433229 REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD $782.6433227 REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD $706.3254406 REMVL,INFLAT PENILE OSTH W/O REPLACMT $1,525.66

G0275 RENAL ANGIO, CARDIAC CATH $28.8050551 RENAL ENDOSCOPY $615.6050555 RENAL ENDOSCOPY,BIOPSY $714.2450553 RENAL ENDOSCOPY,CATH URETER $658.0850561 RENAL ENDOSCOPY,REMV FB/STONE $824.4050557 RENAL ENDOSCOPY,TREATMENT $723.6050570 RENAL SCOPE $1,028.1450574 RENAL SCOPE,BIOPSY $1,182.9450572 RENAL SCOPE,CATH URETER $1,112.3850575 RENAL SCOPE,ENDOPYELOTOMY $1,493.2650576 RENAL SCOPE,FULAUR/INCIS $1,180.0650580 RENAL SCOPE,REMV FB/STONE $1,270.7850562 RENAL SCOPE,W/RESECTION,TUMOR $1,215.3449002 REOPEN RECENT ABD EXPLORATORY $2,179.4213122 REP,SKIN,SCALP/EXTREM+5 CM/< $178.5613102 REP,SKIN,TRUNK,CMPLX,+5 CM/< $249.8446288 REPAIR ANAL FISTULA,RECT ADV FLAP $1,140.4627695 REPAIR 1 COLLAT ANKLE LIGMNT,IMARY $986.3827650 REPAIR ACHILLES TENDON,IMARY $1,362.22

27654 REPAIR ACHILLES TENDON,SECONDARY $1,467.3464859 REPAIR ADDNL MAJ PERIPH NERVE $523.4427418 REPAIR ANTER TIBIAL TUBERCLE $1,708.5423430 REPAIR BICEPS LONG TENDON $1,540.7851865 REPAIR BLADDER WOUND/INJ,COMPLIC $1,865.5051860 REPAIR BLADDER WOUND/INJ,SIMPLE $1,553.7447350 REPAIR BLEED LIVER/SUTURE WOUND $2,854.0427696 REPAIR BOTH COLLAT ANKL LIGMT,IMRY $1,157.7444650 REPAIR BOWEL-BOWEL FISTULA $3,015.3227409 REPAIR COLLAT & CRUCIATE LIG,KNEE $2,003.7427698 REPAIR COLLAT ANKLE LIGMNT,SECONDARY $1,328.3827405 REPAIR COLLAT LIGAMT/CAPSULE,KNEE $1,396.7823420 REPAIR COMPL ROTATOR CUFF AVULSN,CHR $2,010.2227407 REPAIR CRUCIATE LIGAMENT,KNEE $1,643.7436575 REPAIR CV CATH W/O SUBQ PORT OR PUMP $646.5625426 REPAIR DEFECT RAD AND ULNA W/ AUTOGRFT $2,333.5025425 REPAIR DEFECT RAD OR ULNA W/ AUTOGRFT $1,996.5439541 REPAIR DIAPHR HERNIA TRAUMA CHR $1,951.1839501 REPAIR DIAPHRAGM LACERATION $1,768.3064832 REPAIR EACH ADDNL DIGIT NERVE $704.1657268 REPAIR ENTEROCELE,VAG APCH $987.1049570 REPAIR EPIGASTRIC HERNIA,REDUC $869.0426426 REPAIR EXT TEND,CENT SLIP,SEC $1,035.3427664 REPAIR EXTEN LEG TENDN,IM,EACH $748.8028208 REPAIR EXTEN LEG TENDON,IM,EA $653.0426434 REPAIR EXTEN TENDON,DIST,OPEN,GRFT $1,323.3426432 REPAIR EXTEN TENDON,DISTAL INSERT,CLOSE $1,016.6226433 REPAIR EXTEN TENDON,DISTAL INSERT,OPEN $1,081.4226418 REPAIR EXTEN TENDON,DORSUM FINGR,EA $1,176.4626420 REPAIR EXTEN TENDON,DORSUM FINGR,GRFT $1,460.8626410 REPAIR EXTEN TENDON,DORSUM HAND,EA $1,152.7028344 REPAIR EXTRA TOE(S) $598.3249553 REPAIR FEMORAL HERNIA,STRANG $1,314.7028200 REPAIR FLEX FOOT TENDON,EA $670.32

27658 REPAIR FLEX LEG TENDON,IM,EA $768.2427659 REPAIR FLEX LEG TENDON,SECOND,EA $982.0626358 REPAIR FLEX TEND,ZONE 2,SEC,HAND,W/GRFT $2,034.7026356 REPAIR FLEX TENDON,ZONE 2,HAND $1,640.8626357 REPAIR FLEX TENDON,ZONE 2,SECON,HAND,EA $1,837.4226352 REPAIR FLEXOR TENDON,HAND,W/ GRAFT,EA $1,670.3826350 REPAIR FLEXOR TENDON,HAND,W/O GRAFT,EA $1,452.2249560 REPAIR INCISIONAL HERNIA,REDUCIBLE $1,535.7449561 REPAIR INCISIONAL HERNIA,STRANG $1,936.0649505 REPAIR ING HERNIA,5+Y/O,REDUCIBL $1,082.1449507 REPAIR ING HERNIA,5+Y/O,STRANG $1,219.6649500 REPAIR ING HERNIA,6MO-5YR,REDUC $857.5249501 REPAIR ING HERNIA,6MO-5YR,STRANG $1,260.7025447 REPAIR INTERCARP/CARP-METACARP JT $1,715.7427656 REPAIR LEG FASCIA DEFECT $822.2440654 REPAIR LIP,>1/2 VERT HEIGHT $884.1649540 REPAIR LUMBAR HERNIA $1,398.2264857 REPAIR MAJOR PERIPHERAL NERVE $2,199.5826591 REPAIR MUSCLES OF HAND $890.6424430 REPAIR NON/MALUNION HUMERUS $2,189.5024435 REPAIR NON/MALUNION HUMERUS,GRAFT $2,229.8228322 REPAIR NON/MALUNION METATARSAL $1,197.3425431 REPAIR NONUNION CARPAL BONE,EACH $1,636.5425415 REPAIR NONUNION RADIUS AND ULNA $2,006.6225400 REPAIR NONUNION RADIUS OR ULNA $1,665.3425405 REPAIR NONUNION RADIUS OR ULNAW/GRAFT $2,148.4625440 REPAIR NONUNION SCAPHOID CARPAL BONE $1,594.0624340 REPAIR OF BICEPS TENDON AT ELBOW $1,268.6264831 REPAIR OF DIGIT NERVE $1,423.4228285 REPAIR OF HAMMERTOE,ONE $783.3655060 REPAIR OF HYDROCELE,TUNICA $794.8850500 REPAIR OF KIDNEY WOUND $2,681.2656810 REPAIR OF PERINEUM,NON OBSTETRICAL $530.6455400 REPAIR OF SPERM DUCT $1,040.38

54437 REPAIR OF TRAUMATIC CORPOREAL TEAR(S) $1,406.8650900 REPAIR OF URETER $1,761.8226560 REPAIR OF WEB FINGER,EACH $1,206.7026370 REPAIR OFUNDUS TENDON,IMARY $1,545.1026373 REPAIR OFUNDUS TENDON,SECONDARY $1,736.6243333 REPAIR PARAESOPHAGEAL HIATAL HERNIA,LAPAROTOMY, W MESH $2,635.9043332 REPAIR PARAESOPHAGEAL HIATAL HERNIA,LAPAROTOMY, WO MESH $2,419.1843840 REPAIR PERF DUOD/GAST ULC-WND/INJ $2,834.6027675 REPAIR PERONEAL TENDONS $1,013.7427676 REPAIR PERONEAL TENDONS,FIB OSTEOTMY $1,254.9464840 REPAIR POST TIBIAL NERVE $2,000.1449557 REPAIR RECURR FEMORAL HERNIA,STRANG $1,506.2249565 REPAIR RECURR INCIS HERNIA,REDUC $1,598.3849566 REPAIR RECURR INCIS HERNIA,STRANG $1,953.3449521 REPAIR RECURR INGUIN HERN,STRANG $1,491.1050525 REPAIR RENAL-ABD FISTULA,ABDOM $3,062.8423410 REPAIR ROTATOR CUFF,ACUTE $1,702.0623412 REPAIR ROTATOR CUFF,CHRONIC $1,766.1464858 REPAIR SCIATIC NERVE $2,452.3023466 REPAIR SHLDR CAPSU FOR INSTABILITY $2,335.6623462 REPAIR SHLDR CAPSU,ANT,CORACOID XFER $2,210.3823465 REPAIR SHLDR CAPSU,POST,RECUR DISLOC $2,323.4223460 REPAIR SHLDR CAPSUL,ANT,BONE BLOCK $2,264.3823450 REPAIR SHOULDER CAPSULE,ANTERIOR $1,969.9023455 REPAIR SHOULDER CAPSULE,BANKART $2,067.8229720 REPAIR SPICA/BODY/JACKET CAST $92.1649590 REPAIR SPIEGELIAN HERNIA $1,190.8654670 REPAIR TESTIS INJURY $846.7242953 REPAIR THROAT, ESOPHAGUS $2,027.5041250 REPAIR TONGUE LACER,<2.6 CM $321.1241252 REPAIR TONGUE LACER,2.6 CM+/COMPLX $439.2025107 REPAIR TRIANGULAR CART,WRIST JT $1,276.5449580 REPAIR UMBILICAL HERN,<5Y/O,REDUC $691.9249582 REPAIR UMBILICAL HERN,<5Y/O,STRANG $1,004.38

49585 REPAIR UMBILICAL HERN,5+Y/O,REDUC $925.9049587 REPAIR UMBILICAL HERN,5+Y/O,STRANG $989.2653515 REPAIR URETHRA INJ,PENILE,OSTATC $1,660.3053510 REPAIR URETHRA INJ,PENILE,PERINEAL $1,318.3053502 REPAIR URETHRA INJURY,FEMALE $1,014.4653505 REPAIR URETHRA INJURY,PENILE $1,013.7454163 REPAIR,INCOMPLETE CIRCUMCISION $456.4854408 REPAIR,INFLATABLE PENILE OSTHESIS $1,648.7853449 REPAIR,INFLATABLE SPHINCTER DEVICE $1,275.8227652 REPAIR/GRAFT ACHILLES TENDON $1,403.2664856 REPAIR/TRANSPOS MAJ PERIPH NERVE $2,104.5446707 REPARI ANORECTAL FISTULA W/ PLUG $1,004.3836580 REPLACE CV CATH, COMPLETE, NON-TUNNELED, W/O SUBQ PORT OR PUMP $383.0449450 REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS $138.9654411 REPLACE,INFLAT PENILE OSTH,INFECTED $2,140.5454410 REPLACE,INFLATABLE PENILE OSTHESIS $1,793.5054416 REPLACE,PENILE OSTHESIS $1,482.4654417 REPLACE,PENILE OSTHESIS INFECTED $1,876.3050840 REPLACEMENT,URETER,BOWEL SEGMENT $2,565.3443761 REPOSITION GASTRIC FEEDING TUBE THRU DUODENUM $214.5636597 REPOSITION VENOUS CATHETER $64.8028153 RESEC HEAD OF PHALANX,TOE $548.6428126 RESEC ONE TOE PHALANGEAL BASE,EA $515.5228160 RESEC TOE AT I-P JT,SINGLE,EA $555.1244121 RESECT SMALL INTEST,EACH ADDNL $506.1644120 RESECT SMALL INTEST,SINGL RESEC/ANAS $2,553.8212002 RESUP NPTERF WND BODY 2.6-7.5 CM $120.9612001 RESUPERF WND BODY <2.5CM $91.4412007 RESUPERF WND BODY >30 CM $302.4012005 RESUPERF WND BODY 12.6-20 CM $195.8412006 RESUPERF WND BODY 20.1-30 CM $240.4812004 RESUPERF WND BODY 7.6-12.5 CM $150.4812011 RESUPERF WND FACE <2.5 CM $113.7612016 RESUPERF WND FACE 12.6-20 CM $263.52

12013 RESUPERF WND FACE 2.6-5 CM $119.5212017 RESUPERF WND FACE 20.1-30 CM $316.0812014 RESUPERF WND FACE 5.1-7.5 CM $154.0812015 RESUPERF WND FACE 7.6-12.5 CM $193.6857282 REVAGINAL OLAPSE,SACROSP LIG $1,021.6657283 REVAGINAL OLAPSE,UTEROSACRAL $1,401.1037222 REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL $392.4037220 REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL $843.8423474 REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT $3,646.0423473 REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT $3,376.0427137 REVISE ACETABULAR PART OF TOTAL HIP $3,062.1251820 REVISE BLAADER/URETHRA+URETER $2,260.7827138 REVISE FEM PART OFTOTAL HIP $3,182.3643886 REVISE GASTRIC PORT, OPEN $755.2827486 REVISE KNEE JOINT REPLACE,1 PART $2,923.1627487 REVISE KNEE JOINT REPLACE,ALL PARTS $3,656.1264721 REVISE MEDIAN N/CARPAL TUNNEL SURG $883.4427134 REVISE TOTAL HIP REPLACEMENT $3,985.8864718 REVISE ULNAR NERVE AT ELBOW $1,226.8664719 REVISE ULNAR NERVE AT WRIST $828.7253400 REVISE URETHRA, 1ST STAGE $1,668.9453405 REVISE URETHRA, 2ND STAGE $1,823.0250727 REVISE URINARY-CUTAN ANAST $1,061.2650728 REVISE URINARY-CUTAN ANAST+REPAIR $1,457.9825320 REVISE WRIST JOINT,CARPAL INSTABIL $2,044.0625280 REVISE WRIST/FOREARM TENDON $1,166.3863660 REVISE/REMOVE NEUROELECTRODE $1,415.7564595 REVISE/REMOVE PERIPH/GASTRIC NEUROSTIM/RECEIVER $262.8064585 REVISE/REMOVE PERIPHERAL NEUROELECTRODE $297.3663688 REVISE/REMOVE SPINAL NEUROSTIM/RECEIVER $774.7264702 REVISE/REPAIR FINGER/TOE NERVE $1,036.0664704 REVISE/REPAIR HAND/FOOT NERVE $660.2451800 REVISION OF BLADDER/URETHRA $2,170.7844345 REVISION OF COLOSTOMY,COMPLICATED $2,506.30

50540 REVISION OF HORSESHOE KIDNEY $2,396.1444314 REVISION OF ILEOSTOMY,COMPLICATED $2,095.9044312 REVISION OF ILEOSTOMY,SIMPLE $1,233.3455180 REVISION OF SCROTUM,COMPLICATED $1,429.9055175 REVISION OF SCROTUM,SIMPLE $758.1653442 REVISION OF SLING FOR MALE INCONT $1,634.3863744 REVISION OF SPINAL SHUNT $1,377.3427420 REVISION OF UNSTABLE PATELLA $1,538.6257220 REVISION OF URETHRA SPHINCTER $649.4427430 REVISION QUADRICEPS $1,531.4250405 REVISION RENAL PELVIS,COMPLICATED $2,913.0850400 REVISION RENAL PELVIS,SIMPLE $2,419.1863664 REVISION SPINAL NEUROSTIM ELECTRODE PLATE/PADDLE, INCL FLUORO $1,823.7457295 REVISION VAGINAL GRAFT $975.5837183 REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT $784.8037224 REVSC OPN/G FEM/POP W/ANGIOPLASTY UNI $933.8237225 REVSC OPN/Q FEM/POP W/ATHRC/ANGIOP SM VSL $1,273.6637226 REVSC OPN/Q FEM/POP W/STNT/ANGIOP SM VSL $1,097.9837227 REVSC OPN/Q FEM/POP W/STNT/ATHRC/ANGIOP SM VSL $1,530.7037223 REVSC OPN/Q ILIAC ART W/STNT & ANGIOP IPSILATL $448.5637221 REVSC OPN/Q ILIAC ART W/STNT PLMT & ANGIOPLSTY $1,041.1037228 REVSC OPN/Q TIB/PERO W/ANGIOPLASTY UNI $1,143.3437232 REVSC OPN/Q TIB/PERO W/ANGIOPLASTY UNI EA VSL $424.0837229 REVSC OPN/Q TIB/PERO W/ATHRC/ANGIOP SM VSL $1,484.6237233 REVSC OPN/Q TIB/PERO W/ATHRC/ANGIOP UNI EA VSL $691.2037230 REVSC OPN/Q TIB/PERO W/STNT/ANGIOP SM VSL $1,469.5037231 REVSC OPN/Q TIB/PERO W/STNT/ATHR/ANGIOP SM VSL $1,596.2227726 RFIBULA NONUNION/MALUNION W INT FIXATION $1,994.3895991 RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP $244.0893040 RHYTHM ECG WITH REPORT $25.9293042 RHYTHM ECG, REPORT $14.4093041 RHYTHM ECG, TRACING $11.5293451 RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT PROF CHG $272.88

J2794 RISPERIDONE, LONG ACTING $9.00

33968 RMV AORTIC BALLOON DEVICE $70.5627334 RMV KNEE SYNOVIUM,ANT/POST $1,416.2250382 RMVL & RPLCMT INTLY DWELLING URETERAL STENT Q $537.8450387 RMVL & RPLCMT XTRNL AESSIBLE NEPHROURTRL CATH $175.6897602 RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS $23.0433284 RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER $413.2833264 RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD $846.0033263 RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD $812.1636590 RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PH INSJ $284.4027720 RNON/MALUNION TIBIA $1,809.3427725 RNON/MALUNION TIBIA,FUSE W FIBULA $2,536.5427724 RNON/MALUNION TIBIA+AUTOGRAFT $2,627.9827722 RNON/MALUNION TIBIA+SLIDING GRAFT $1,848.9436585 RPLCMT COMPL PH CTR VAD W/SUBQ PORT $604.0836582 RPLCMT COMPL TUN CTR VAD W/SUBQ PORT $381.6036581 RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP $138.2433215 RPSG EV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE $649.4490681 RV1 VAINE 2 DOSE SCHEDULE LIVE FOR ORAL USE $78.8090680 RV5 VAINE 3 DOSE SCHEDULE LIVE FOR ORAL USE $135.0095954 RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE PROF CHG $247.68

S9999 SALES TAX $1.0599231 SBSQ HOSPITAL CARE/DAY 15 MINUTES $79.9299232 SBSQ HOSPITAL CARE/DAY 25 MINUTES $148.3299233 SBSQ HOSPITAL CARE/DAY 35 MINUTES $212.4099310 SBSQ NURS FACIL CARE/DAY UNSTABL/NEW OB 35 MIN $277.2099308 SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN $141.1299309 SBSQ NURSING FACIL CARE/DAY NEW OBLEM 25 MIN $186.4899307 SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN $90.7299224 SBSQ OBSERVATION CARE/DAY 15 MINUTES $81.3699225 SBSQ OBSERVATION CARE/DAY 25 MINUTES $149.0499226 SBSQ OBSERVATION CARE/DAY 35 MINUTES $213.84

29999ST SCOPE TENOTOMY $1,456.9737186 SEC Q TRLUML THRMBC N-CORONARY N-INTRACRANIAL $514.0813160 SECD CLOS SURG WND EXTEN/COMPLIC $1,654.54

99141 SEDATION, IV/IM OR INHALANT $50.4098960 SELF-MGMT EDUC & TRAIN, 1 PT, EA 30 MIN $32.4098961 SELF-MGMT EDUC/TRAIN, 2-4 PT, EA 30 MIN $28.0898962 SELF-MGMT EDUC/TRAIN, 5-8 PT, EA 30 MIN $20.1624134 SEQUESTRECTOMY,MID/DIST HUMERUS $1,550.1445335 SGMDSC FLX DIRED SBMCSL NJX ANY SBST $139.6845338 SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ $254.8845337 SGMDSC FLX W/DCMN W/PLMT DCMN TUBE $243.3611308 SHAV SKIN LES >2.1 CM REMAINDER BODY $153.3611301 SHAV SKIN LES 0.6-1.0 CM TRUNK,ARM,LEG $110.8811307 SHAV SKIN LES 1.1-2.0 CM REMAINDER BODY $138.9611302 SHAV SKIN LES 1.1-2.0 CM TRUNK,ARM,LEG $131.04

29999SD SHLD DECOMESSION SUBACROMIAL $1,456.9729805 SHLDR ARTHROSCOP,DIAGNOSTIC $978.4629823 SHLDR ARTHROSCOP,EXTEN DEBRIDE $1,281.5829825 SHLDR ARTHROSCOP,LYSE ADHESNS $1,194.4629826 SHLDR ARTHROSCOP,PART ACROMIOPLAS $366.4829822 SHLDR ARTHROSCOP,PART DEBRIDE $1,176.4629820 SHLDR ARTHROSCOP,PART SYNOVECT $1,106.6229806 SHLDR ARTHROSCOP,SURG,CAPSULORRHAPHY $2,202.4629824 SHLDR ARTHROSCOP,SURG,DIS CLAVICULECTOMY $1,381.6629807 SHLDR ARTHROSCOP,SURG,REPAIR,SLAP LESION $2,151.3429819 SHLDR ARTHROSCOP,SURG,W/REMOVAL,LOOSE/FB $1,211.7429827 SHLDR ARTHROSCOP,SURG,W/ROTAT CUFF RE $2,186.6227465 SHORTENING OF FEMUR $2,508.46

27599OCD SHOULDER SCOPE OSTEOCHONDRAL DEFECT $1,456.9729999REM SHOULDER SCOPE REMPLISSAGE $1,456.97

45334 SIGMOIDOSCOPY FLX CONTROL BLEEDING $248.4045330 SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD $118.0845333 SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS $198.0045331 SIGMOIDOSCOPY,BIOPSY $151.2051725 SIMPLE CYSTOMETROGRAM $386.6451736 SIMPLE UROFLOWMETRY $31.6815000 SKIN GRAFT <100SQCM $1,478.14

15050 SKIN PINCH GRAFT OCEDURE <2 CM $917.2636252 SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL $756.7236251 SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN $545.0436223 SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART $658.0836246 SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH $533.5236247 SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH $634.3236245 SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH BILATERAL $748.4436245 SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH $498.9695800 SLEEP STUDY UNATTENDED PROF CHG $106.5695801 SLEEP STUDY, UNATTENDED, RECORD HEART RATE/O2 SAT/RESP ANALYSIS PROF CHG $100.8095806 SLEEP STUDY, UNATTENDED, SIMUL RECORD HR/O2 SAT/RESP FLOW/RESP EFF PROF CHG $125.2857288 SLING OPER STRES INCONTINENCE $1,468.7853440 SLING OPERATION,CORRECTION,MALE INCONT $1,571.74

A4565 SLINGS $15.0054001 SLITTING OF EPUCE $289.4454000 SLITTING OF EPUCE,NEWBORN $289.44

L3650 SO 8 ABD RESTRAINT E OTS $106.00L3670 SO ACRO/CLAV CAN WEB E OTS $192.00

99135 SPECIAL ANESTHESIA OCEDURE $83.0099100 SPECIAL ANESTHESIA SERVICE $83.0099080 SPECIAL REPORTS OR FORMS $66.3562270 SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC $162.0062272 SPINAL PUNCTURE,THERAPEUTIC DRAINAGE $173.5222899 SPINE SURGERY OCEDURE UNLISTED $1,775.00

A4570 SPLINT $43.0015100 SPLIT GRFT TRUNK,ARM,LEG <100 SQCM $1,478.1415120 SPLIT GRFT,HEAD,FAC,HAND,FEET <100 SQCM $1,440.7015101 SPLIT GRFT,TRUNK,ARM,LEG EA 100 SQCM $229.68

L4396 STATIC OR DYNAMI AFO E CST $373.00A6404 STERILE GAUZE > 48 SQ IN $2.00A4217 STERILE WATER/SALINE, 500 ML $6.00A4930 STERILE, GLOVES PER PAIR $3.00

21627 STERNAL DEBRIDEMENT $1,116.7043999 STOMACH SURGERY OCEDURE UNLISTED $210.00

27732 STOP GROWTH DISTAL FIBULA EPIPHYSIS $927.3454300 STRAIGHTEN PENIS $1,340.6229260 STRAPPING OF ELBOW OR WRIST $40.3229280 STRAPPING OF HAND OR FINGER $41.7629520 STRAPPING OF HIP $39.6029530 STRAPPING OF KNEE $38.8829240 STRAPPING OF SHOULDER $38.8829580 STRAPPING UNNA BOOT $59.7629540 STRAPPING; ANKLE &/OR FOOT $37.4415275 SUB GRFT F/S/N/H/F/G/M/D /<100SCM /<1ST 25 SCM $198.0015276 SUB GRFT F/S/N/H/F/G/M/D /<100SCM EA ADL 25SCM $52.5615277 SUB GRFT F/S/N/H/F/G/M/D />100SCM 1ST 100SCM $477.3615278 SUB GRFT F/S/N/H/F/G/M/D />100SCM ADL 100SCM $120.2499469 SUBSEQUENT HOSP NEONATE 28 DAY OR LESS, CRITICALLY ILL $811.4499462 SUBSEQUENT HOSPITAL CARE, NORMAL NEWBORN $84.9699478 SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS $279.3699479 SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS $253.4499480 SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS $244.0899476 SUBSEQUENT PED CRITICAL CARE 2 YR THRU 5 YR $704.1699472 SUBSEQUENT PED CRITICAL CARE 29 DAY THRU 24 MO $839.5245990 SURG DIAGNOSTIC EXAM, ANORECTAL $223.2046922 SURG EXCISION OF ANAL LESION(S) $281.5263655 SURG IMPLNT NEUROELECT,EPIDURAL $1,733.02

A4649 SURGICAL SUPPLIES $4.00A4550 SURGICAL TRAYS $49.00

64834 SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE $1,535.0264835 SUTURE 1 NERVE MEDIAN MOTOR THENAR $1,693.4264836 SUTURE 1 NERVE ULNAR MOTOR $1,693.4243415 SUTURE ESOPHAGUS WOUND,THOR APCH $5,386.9844604 SUTURE LRG INTEST $2,208.2244602 SUTURE SM INTEST,SINGLE PERF $2,944.7628070 SYNOVECTOMY TARS/TARSOMETA JT,EA $748.08

J7325 SYNVISC OR SYNVISC-ONE $24.0064488 TAP BLOCK BILATERAL BY INJECTION(S) $147.60

64486 TAP BLOCK UNILATERAL BY INJECTION(S) $123.8428035 TARSAL TUNNEL RELEASE $737.2837215 TCAT IV STENT CRV CRTD ART EMBOLIC OTECJ $2,100.9437218 TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE $1,701.3490718 TD IMMUNIZATION,IM/JET>7YO $34.0090714 TD VAINE SRV FREE 7 YRS OR OLDER FOR IM USE $34.0090715 TDAP VAINE >7 YO, IM $56.5099366 TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN $87.1299368 TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN $74.8899367 TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN $115.20

Q3014 TELEHEALTH FACILITY FEE $26.92G0406 TELHEALTH INPT CONSULT 15MIN $78.48G0408 TELHEALTH INPT CONSULT 35MIN $210.96G0407 TELHEATH INPT CONSULT 25MIN $146.88

37609 TEMPORAL ARTERY LIGATN OR BX $429.8492953 TEMPORARY TRANSCUTANEOUS PACING $2.1626478 TENDON LENGTHENING,FLEX,HAND/FINGR $1,260.7026479 TENDON SHORTENING,FLEX,HAND/FINGR $1,279.4226445 TENOLYSIS EXT TENDON,HAND/FINGER,EA $1,175.7426442 TENOLYSIS FLEX TENDON,PALM & FINGER,EA $1,970.6226440 TENOLYSIS, FLEX TENDON,PALM/FINGER,EA $1,263.5824332 TENOLYSIS, TRICEPS $1,269.3424358 TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE OPEN $1,082.1424359 TENOTOMY ELBOW LATERAL/MEDIAL DEBRIDE REPAIR $1,366.5424357 TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS $867.6026455 TENOTOMY FINGR FLEX,SINGLE,OPEN,EACH $823.6826460 TENOTOMY HAND EXTEN,SINGLE,OPEN,EACH $804.9627391 TENOTOMY,UNI HAMSTR,KNEE-THIGH,MULTI $1,186.5495921 TEST AUTO NERV SYS,CARDIOVAGAL INNER $170.6495923 TEST AUTO NERV SYS,SUDOMOTOR $265.68

J1070 TESTOSTERONE CYPIONAT 100 MG $23.00J1080 TESTOSTERONE CYPIONAT 200 MG $26.00

90772 THER/OPH/DIAG INJECTION, SUBCUT/IM $40.0097530 THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN $82.80

97110 THERAPEUTIC EXERCISES $62.6432555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING $231.8432554 THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING $186.4832421 THORACENTESIS PUNCTURE PLEURAL CAVITY ASPIRATION $231.8432422 THORACENTESIS WITH INSERTION TUBE WATER SEAL $326.8832000 THORACENTESIS, ASPIRATN $231.8432002 THORACENTESIS,INSRT CHEST TUBE,PTX $326.8832652 THORACOSCOPY SURG TOT PULM DECORT $3,452.3632602 THORACOSCOPY,DX W BX $1,003.6632110 THORACOTOMY,CTRL TRAUMA BLEED $3,047.0032100 THORACOTOMY,MAJOR,EXPLOR/BIOPSY $1,681.9032160 THORACOTOMY,OPEN HEART MASSAGE $1,642.3037211 THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX $807.1237212 THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX $707.0492977 THROMBOLYSIS,CORONARY,IV INFUSN $384.4837195 THROMBOLYTIC THERAPY, STROKE $631.4460240 THYROIDECTOMY $1,895.74

J3240 THYROTROPIN INJECTION $1,722.0029856 TIBIAL SCOPE/SURG/FX AID,BICONDYLAR $2,072.1429855 TIBIAL SCOPE/SURG/FX AID,UNICONDYLR $1,624.3093660 TILT TABLE EVALUATION PROF CHG $192.2499407 TOBAO USE CESSATION INTENSIVE >10 MINUTES $56.8899406 TOBAO USE CESSATION INTERMEDIATE 3-10 MINUTES $29.5222856 TOT DISC ARTHRP ART DISC ANT APO 1 NTRSPC CRV $3,425.0027702 TOTAL ANKLE REPLACEMENT $1,992.2222857 TOTAL DISC ARTHROPLASTY, LUMBAR, SINGLE $3,535.8827130 TOTAL HIP ARTHROPLASTY $2,819.4827447 TOTAL KNEE ARTHROPLASTY $2,816.6023125 TOTAL REMOVAL OF CLAVICLE $1,470.9431502 TRACH TUBE CHANGE $72.0031605 TRACHEOSTOMY,EMERG,CRICOTHYROID $693.3631603 TRACHEOSTOMY,EMERG,XTRACH $667.4475960 TRANSCATH INTRO, STENT, EXCL COR, CAROT, VERT PROF CHG $170.6437206 TRANSCATH STENT EACH ADDN VESSL,PERC $953.00

37205 TRANSCATH STENT INIT VESSEL,PERCUT $1,443.9493893 TRANSCRAN DOPP INTRACRAN, EMBOLI W/INJ $712.8093892 TRANSCRAN DOPP INTRACRAN, EMBOLI W/O INJ PROF CHG $123.1293892 TRANSCRAN DOPP INTRACRAN, EMBOLI W/O INJ $657.3693890 TRANSCRAN DOPPL INTRACRAN, VASOREACT PROF CHG $105.1293886 TRANSCRAN DOPPLER INTRACRAN ART $560.1693888 TRANSCRAN DOPPLER INTRACRAN,LIMITED PROF CHG $53.2864772 TRANSECT OTHR SPINAL N,XTRADURAL $1,171.4246710 TRANSPERIN REILEOANAL POUCH FISTULA $2,305.4225310 TRANSPLANT FOREARM/WRIST TENDON $1,283.0226480 TRANSPLANT HAND TENDON $1,535.0226485 TRANSPLANT PALM TENDON $1,644.4650860 TRANSPLANT URETER TO SKIN $1,972.0626483 TRANSPLANT/GRAFT HAND TENDON $1,720.0652601 TRANSURETHRAL ELEC-SURG OSTATECTOM $1,522.7852606 TRANSURETHRAL FULGUR POSTOP BLEED $548.6452450 TRANSURETHRAL INCISION OF OSTATE $980.6252500 TRANSURETHRAL RESEC BLADDER NECK $1,018.0651060 TRANSVESICAL URETEROLITHOTOMY $1,212.4627244 TREAT INTER/SUBTROCH FX,W/PLATE/SCREW $2,557.4226641 TREAT THUMB DISLOC,MANIPULATN $717.1226645 TREAT THUMB FX/DISLOC,MANIP $810.7227759 TREAT TIBIAL SHAFT FX, INTRAMED IMPLANT $2,072.86

J3301 TRIAMCINOLONE ACETONIDE INJ PER 10 MG $3.00J3303 TRIAMCINOLONE HEXACETONL INJ $3.00

11056 TRIM BENIGN HYPERKERATOTIC SKIN LESION,2-4 $46.8011055 TRIM HYPERKERATOTIC SKIN LESION, ONE $33.1211719 TRIM NAIL(S) $15.8437246 TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART $730.0837247 TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART $358.5651010 TROCAR ASPIR BLADDER,INSRT CATH $300.9632551 TUBE THORACOSTOMY INCLUDES WATER SEAL $326.8832020 TUBE THORACOSTOMY,ABSC/EMPYEMA/HEMO $2,010.9461105 TWIST DRILL HOLE SUBDURAL/VENT PUNC $975.58

44238 UNLISTED LAPAROSCOPY OC,INTESTINE $3,474.6829999 UNLISTED OC, ARTHROSCOPY SC $240.4844899 UNLISTED OC,MECKEL/MESENTERY $1,616.3844799 UNLISTED OCEDURE SMALL INTESTINE $2,730.31

24999OK UNLISTED OUTERBRIDGE KASHIWAGI OCEDURE $2,436.4626989VP UNLISTED VOLAR PLATE RELEASE $1,030.67L3980 UP EXT FX ORTHOS HUMERAL NOS $490.00

43234 UPPER GI ENDOSCOPY,EXAM $401.0450951 URETER ENDOSCOPY THRU URETEROSTOMY $640.8050961 URETER ENDOSCOPY THRU URETEROSTOMY REMV FB OR CALCULUS $663.8450955 URETER ENDOSCOPY THRU URETEROSTOMY W BIOPSY $737.2850957 URETER ENDOSCOPY THRU URETEROSTOMY W FULGURATION/INCISION $741.6050953 URETER ENDOSCOPY THRU URETEROSTOMY W URETERAL CATH $686.1650970 URETER ENDOSCOPY THRU URETEROTOMY $775.4450980 URETER ENDOSCOPY THRU URETEROTOMY REMV FB OR CALCULUS $745.9250974 URETER ENDOSCOPY THRU URETEROTOMY W BIOPSY $989.2650976 URETER ENDOSCOPY THRU URETEROTOMY W FULGURATION/INCISION $974.8650972 URETER ENDOSCOPY THRU URETEROTOMY W URETERAL CATH $749.5250815 URETEROCOLON CONDUIT,W/BOWEL ANASTOMOSIS $2,551.6650820 URETEROILEAL CONDUIT,W/BOWEL ANASTOMOSIS $2,741.7250630 URETEROLITHOTOMY,LOWER 1/3 $1,864.0650620 URETEROLITHOTOMY,MIDDLE 1/3 $1,887.8250610 URETEROLITHOTOMY,UPPER 1/3 $1,972.7850700 URETEROPLASTY $1,931.0250605 URETEROTOMY TO INSERT STENT $2,060.6251772 URETHRA ESSURE OFILE $233.2853450 URETHRAL MEATAL REVISION $853.2053500 URETHRLYS, TRANSVAG W/ SCOPE $1,556.6253460 URETHROPLASTY,EXCIS DIST URETHRA $956.86

A4358 URINARY LEG OR ABDOMEN BAG $10.0051792 URINARY REFLEX STUDY $438.4851795 URINE VOIDING ESSURE STUDY $233.2853899 UROLOGY SURGERY OCEDURE UNLISTED $964.59

J3370 VANCOMYCIN L INJECTION $12.00

90716 VAR VAINE LIVE FOR SUBCUTANEOUS USE $106.7535525 VEIN BYPASS GRAFT,BRACHIAL-BRACHIAL $2,391.1061026 VENTRICULAR PUNCTURE,EV BURR HOLE $218.88

M0064 VISIT FOR DRUG MONITORING $74.0095930 VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R $142.5699173 VISUAL SCREENING TEST, BILAT $6.48

Q9968 VISUALIZATION ADJUNCT $5.0094150 VITAL CAPACITY TEST PROF CHG $7.92

J3420 VITAMIN B12 INJECTION $2.0036400 VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN $38.1636406 VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN $18.0036405 VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN $31.6836410 VNPNXR 3 YEARS/> PHYS/QHP SKILL $19.4451797 VOIDING ESS STUDY INTRA-ABDOMINAL VOID $233.2847100 WEDGE BIOPSY OF LIVER $1,758.2229740 WEDGING OF CAST $146.88

L3908 WHO COCK-UP NONMOLDE E OTS $80.0029730 WINDOWING OF CAST $91.4436600 WITHDRAWAL OF ARTERIAL BLOOD $126.7215004 WND EP PED, FACE/NCK/HND/FT/GEN 1ST 100 CM $556.5615005 WND EP,PED, FACE/NCK/HND/FT/GEN ADD 100 CM $189.36

A6260 WOUND CLEANSER ANY TYPE/SIZE $3.0015002 WOUND EP, PED, TRK/ARM/LG 1ST 100 CM $470.1615003 WOUND EP, PED, TRK/ARM/LG ADDL 100 CM $95.7629840 WRIST ARTHROSCOP,DIAGNOSTIC $937.4229846 WRIST ARTHROSCOP,EXCIS TRIANG CART $1,079.9829845 WRIST ARTHROSCOP,FULL SYNOVECT $1,194.4629844 WRIST ARTHROSCOP,PART SYNOVECT $1,029.5829848 WRIST ARTHROSCOP,RELEASE XVERS LIG $1,061.2627692 XFER ADDNL LOWER LEG TENDON $217.4427691 XFER SINGLE DEEP LOW LEG TENDON $1,545.8227690 XFER SINGLE SUPERFICI LOW LEG TENDON $1,315.4263057 XPEDICUL DECOMESS CORD,ADDNL SGMT $673.2063055 XPEDICUL DECOMESS THROACIC CORD $3,409.16

76012 X-RAY,PERCUT VERTEBOPLASTY OR AUGMENT,FLOROGUIDE $97.2093224 XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I $185.7693227 XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS $54.7293228 XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS $53.2893268 XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS $419.7693272 XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS $51.8452612 XURETHRAL RESEC OSTATE,1ST STAGE $1,018.0652614 XURETHRAL RESEC OSTATE,2ND STAGE $1,018.06

J3486 ZIASIDONE MESYLATE $28.00J2278 ZICONOTIDE INJECTION $10.00

27536 BICONDYLAR TIBIAL PLATEAU FX $2,470.3075630 CHG ANGIO AORTOBIFEMORAL W CATH PROF CHG $180.0075625 CHG ANGIO AORTOGRAM ABD SERIAL PROF CHG $114.4875605 CHG ANGIO AORTOGRAM THOR SERIAL PROF CHG $113.7675650 CHG ANGIO ARCH ANGIOGRAM W CATH PROF CHG $180.0075671 CHG ANGIO CAROTD-CEREBRL BILAT PROF CHG $167.0475680 CHG ANGIO CAROTD-CERVICAL BILAT PROF CHG $167.0475676 CHG ANGIO CAROTD-CERVICAL UNILAT PROF CHG $167.0475774 CHG ANGIO EA ADDNL SELECTV VESSEL PROF CHG $35.2875716 CHG ANGIO EXTERMITY BILAT PROF CHG $197.2875710 CHG ANGIO EXTREMITY UNILAT PROF CHG $176.4075724 CHG ANGIO RENAL BILAT + FLUSH PROF CHG $197.2875685 CHG ANGIO VERTEBRAL SELECTV PROF CHG $167.0475726 CHG ANGIO VISCERAL SELECTV/SUBSELEC PROF CHG $113.0473115 CHG ARTHROGRAM OF WRIST PROF CHG $58.3283655 CHG ASSAY OF LEAD $79.0075978 CHG BALLOON ANGIO VENOUS PROF CHG $170.6482270 CHG BLOOD OULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN $12.0085060 CHG BLOOD SMEAR INTERETATION $51.1275984 CHG CHANGE PERCUT TUBE/DRAIN CATH W CONTRAST MONIT PROF CHG $71.2884702 CHG CHORIONIC GONADOTROPIN, QUANT $41.7675574 CHG CT ANGIO HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST PROF CHG $241.9287804 CHG DETECT AGENT,IMMUN,DIR OBS,INFLUENZA $41.7674485 CHG DILATION URETERS/URETHRA RS&I PROF CHG $53.28

72295 CHG DISCOGRAPHY LUMBAR SPINE $198.0080300 CHG DRUG SCREEN LIST A ANY NMBR NON TLC DEVICES $74.0080100 CHG DRUG SCREEN MULT CLASSES $74.0080104 CHG DRUG SCREEN, QUAL,1+ DRUG CLASS,NON-CHROMOTOGRAPHIC,EACH $74.0080305 CHG DRUG TEST SMV READ DIRECT OPTICAL OBS DATE $74.0076870 CHG ECHO,SCROTUM & CONTENTS $138.9676872 CHG ECHO,TRANSRECTAL $198.0076872 CHG ECHO,TRANSRECTAL PROF CHG $69.1276873 CHG ECHO,TRANSRECTAL,OSTATE VOL $354.9676873 CHG ECHO,TRANSRECTAL,OSTATE VOL PROF CHG $159.8477003 CHG FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON $192.2477003 CHG FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON PROF CHG $61.2077001 CHG FLUOROGUIDE CNTRL VEN AESS,PLACE,REPLACE,REMOVE $171.3677002 CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON $192.2477002 CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON PROF CHG $57.6076001 CHG FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME PROF CHG $75.6076000 CHG FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME $97.2076000 CHG FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME PROF CHG $18.0078472 CHG GATED HEART, PLANAR SINGLE $483.1278472 CHG GATED HEART, PLANAR SINGLE PROF CHG $98.6482962 CHG GLUCOSE BLOOD TEST $11.0082962 CHG GLUCOSE BLOOD TEST QW $11.0085018 CHG HEMOGLOBIN $13.0086308 CHG HETEROPHILE ANTIBODIES,SCREEN $25.9287430 CHG IAAD IA STREPTOCOUS GROUP A $41.7686294 CHG IMMUNOASSAY, TUMOR ANTIGEN, QUAL $41.7687502 CHG INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES $253.0075945 CHG INTRAVASC ULTRASOUND,1ST VESSEL PROF CHG $79.2077071 CHG MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS $98.6481015 CHG MICROSCOPIC EXAM OF URINE $11.0073721 CHG MRI LOWER EXTREM JT, W/O CONTRAST $484.5673221 CHG MRI, JOINT UPPER EXTREM $484.5673718 CHG MRI, LOWER EXTREM $626.4073218 CHG MRI, UPPER EXTREMITY W/O CONTRAST $748.08

78452 CHG MYOCARDIAL SPECT MULTIPLE STUDIES PROF CHG $162.0078451 CHG MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS PROF CHG $137.5275809 CHG NONVASCULAR SHUNTOGRAM $201.6072291 CHG PERCUTANEOUS VERTEBROPLASTY, FLUOR GUIDE PROF CHG $171.3672081 CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW TECH CHG $93.6072082 CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW TECH CHG $115.2072083 CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW TECH CHG $37.4473501 CHG RADEX HIP UNILATERAL WITH PELVIS 1 VIEW $61.2073502 CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS $84.2473521 CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS PROF CHG $23.0473521 CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS $76.3273521 CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS TECH CHG $53.2873522 CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS $99.3673522 CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS TECH CHG $68.4073523 CHG RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS PROF CHG $33.1273523 CHG RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS $115.2073523 CHG RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS TECH CHG $82.0872040 CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS $67.6872040 CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS TECH CHG $23.0472050 CHG RADEX SPINE CERVICAL 4 OR 5 VIEWS $92.1672050 CHG RADEX SPINE CERVICAL 4 OR 5 VIEWS TECH CHG $32.4072052 CHG RADEX SPINE CERVICAL 6 OR MORE VIEWS TECH CHG $37.4472080 CHG RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS $68.4072080 CHG RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS TECH CHG $45.3674018 CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW PROF CHG $18.7274018 CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW $55.4473552 CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS $66.9676942 CHG SONO GUIDE NEEDLE BIOPSY PROF CHG $66.2476942 CHG SONO GUIDE NEEDLE BIOPSY $122.4076965 CHG SONO GUIDE RADIOELEMT APPLIC PROF CHG $138.2476965 CHG SONO GUIDE RADIOELEMT APPLIC $187.9276857 CHG SONO PELVIS LIMITED PROF CHG $51.1287880 CHG STREP A ASSAY W/OPTIC $44.0086580 CHG TB INTRADERMAL TEST $16.56

81002 CHG URINALYSIS NONAUTO W/O SCOPE $12.0081002 CHG URINALYSIS NONAUTO W/O SCOPE QW $12.0081003 CHG URINALYSIS, AUTO, W/O SCOPE $10.0081003 CHG URINALYSIS, AUTO, W/O SCOPE QW $10.0081001 CHG URINALYSIS, AUTO, W/SCOPE $12.0081000 CHG URINALYSIS, NONAUTO, W/SCOPE $13.0081025 CHG URINE EGNANCY TEST $29.0076641 CHG US BREAST UNI REAL TIME WITH IMAGE COMPLETE PROF CHG $74.8876641 CHG US BREAST UNI REAL TIME WITH IMAGE COMPLETE $220.3276641 CHG US BREAST UNI REAL TIME WITH IMAGE COMPLETE TECH CHG $145.4476642 CHG US BREAST UNI REAL TIME WITH IMAGE LIMITED PROF CHG $69.8476642 CHG US BREAST UNI REAL TIME WITH IMAGE LIMITED $180.7276642 CHG US BREAST UNI REAL TIME WITH IMAGE LIMITED TECH CHG $110.8876937 CHG US GUIDE, VASCULAR AESS PROF CHG $29.5276937 CHG US GUIDE, VASCULAR AESS $64.0876705 CHG US, ABDOMEN LIMITED PROF CHG $60.4876705 CHG US, ABDOMEN LIMITED $187.9276705 CHG US, ABDOMEN LIMITED TECH CHG $127.4476645 CHG US, BREAST(S), REAL TIME $180.7276604 CHG US, CHEST,REAL TIME $182.8876775 CHG US, RETROPERITNL ABD, LTD $118.8076770 CHG US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE PROF CHG $75.6076770 CHG US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE $232.5675822 CHG VENOGRAM EXTREM BILAT PROF CHG $106.5675822 CHG VENOGRAM EXTREM BILAT $276.4875820 CHG VENOGRAM EXTREM UNILAT PROF CHG $71.2875825 CHG VENOGRAM INFER VENA CAVA PROF CHG $114.4874000 CHG X-RAY ABDOMEN 1 VW $55.4473050 CHG X-RAY AC JTS PROF CHG $21.6073050 CHG X-RAY AC JTS $72.7273050 CHG X-RAY AC JTS TECH CHG $51.1273600 CHG X-RAY ANKLE 2 VW $60.4873610 CHG X-RAY ANKLE 3+ VW $64.0873000 CHG X-RAY CLAVICLE $56.88

74430 CHG X-RAY CYSTOGRAM, MIN 3 VIEW PROF CHG $33.1274430 CHG X-RAY CYSTOGRAM, MIN 3 VIEW $77.7673070 CHG X-RAY ELBOW 2 VW $55.4473080 CHG X-RAY ELBOW 3+ VW $64.0873140 CHG X-RAY EXAM OF FINGER(S) $65.5270030 CHG X-RAY EYE FOR FOREIGN BODY PROF CHG $17.2870030 CHG X-RAY EYE FOR FOREIGN BODY $56.8873620 CHG X-RAY FOOT 2 VW $53.2873630 CHG X-RAY FOOT 3+ VW $59.7673090 CHG X-RAY FOREARM 2 VW $52.5673120 CHG X-RAY HAND 2 VW $57.6073130 CHG X-RAY HAND 3+ VW $64.8070350 CHG X-RAY HEAD FOR ORTHODONTIA $39.6073650 CHG X-RAY HEEL $55.4473060 CHG X-RAY HUMERUS $59.0473560 CHG X-RAY KNEE 1 OR 2 VIEW PROF CHG $17.2873560 CHG X-RAY KNEE 1 OR 2 VIEW $63.3673562 CHG X-RAY KNEE 3 VIEW $72.7273564 CHG X-RAY KNEE 4+ VIEW PROF CHG $23.0473564 CHG X-RAY KNEE 4+ VIEW $80.6473564 CHG X-RAY KNEE 4+ VIEW TECH CHG $57.6073565 CHG X-RAY KNEE BILAT STANDING $72.7273592 CHG X-RAY LEG, INFANT PROF CHG $16.5673592 CHG X-RAY LEG, INFANT $55.4473592 CHG X-RAY LEG, INFANT TECH CHG $38.8872100 CHG X-RAY LUMBAR SPINE 2/3 VW $71.2872100 CHG X-RAY LUMBAR SPINE 2/3 VW TECH CHG $48.2472110 CHG X-RAY LUMBAR SPINE 4 VW PROF CHG $32.4072110 CHG X-RAY LUMBAR SPINE 4 VW $99.3672110 CHG X-RAY LUMBAR SPINE 4 VW TECH CHG $66.9672114 CHG X-RAY LUMBAR SPINE 6+ VW TECH CHG $91.4472120 CHG X-RAY LUMBAR SPINE FLEX/EXTEN $82.8072170 CHG X-RAY PELVIS 1/2 VW $64.8072170 CHG X-RAY PELVIS 1/2 VW TECH CHG $46.80

72190 CHG X-RAY PELVIS 3+ VW $77.0472190 CHG X-RAY PELVIS 3+ VW TECH CHG $54.7275940 CHG X-RAY PLACEMENT, VEIN FILTER PROF CHG $117.3674420 CHG X-RAY RETROGRADE PYELOGRAM PROF CHG $36.0074420 CHG X-RAY RETROGRADE PYELOGRAM $85.6071100 CHG X-RAY RIBS 2 VW UNILAT PROF CHG $23.0471100 CHG X-RAY RIBS 2 VW UNILAT $67.6872200 CHG X-RAY SACROILIAC JTS <3 VW TECH CHG $39.6072202 CHG X-RAY SACROILIAC JTS 3+ VW TECH CHG $19.4472220 CHG X-RAY SACRUM/COYX 2+ VW TECH CHG $39.6073010 CHG X-RAY SCAPULA $61.9273020 CHG X-RAY SHOULDER 1 VW $46.8073030 CHG X-RAY SHOULDER 2+ VW $59.7670210 CHG X-RAY SINUSES <3 VW $60.4872020 CHG X-RAY SPINE ONE VIEW TECH CHG $15.8472010 CHG X-RAY SPINE SURVEY PROF CHG $23.4472010 CHG X-RAY SPINE SURVEY $73.4471130 CHG X-RAY STERNO-CLAVICLUAR JT PROF CHG $23.4471130 CHG X-RAY STERNO-CLAVICLUAR JT $73.4472070 CHG X-RAY THORACIC SPINE 2 VW $69.1272070 CHG X-RAY THORACIC SPINE 2 VW TECH CHG $46.0873590 CHG X-RAY TIB + FIB, 2VW $58.3273660 CHG X-RAY TOE(S) $57.6074450 CHG X-RAY URETHROCYSTOGRAM PROF CHG $33.8473100 CHG X-RAY WRIST 2 VW PROF CHG $18.0073100 CHG X-RAY WRIST 2 VW $64.0873110 CHG X-RAY WRIST 3+ VW $71.2877073 CHG X-RAYS, BONE LENGTH STUDIES $73.44

J7317 DELETED 2462 $155.0099435 HOSPITAL NB DISCHARGE SAMEDAY $182.16

L8680 IMPLT NEUROSTIM ELCTR EACH $941.00J2323 NATALIZUMAB INJECTION $16.00NOSHOW PATIENT NO SHOW $29.00

cpt code description - Great Plains Health

Documents

Transcript of cpt code description - Great Plains Health