,Lucas County Health Center - Machine Readable Report - Generated on 12/27/2021,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,"Disclaimer: The information provided in this machine readable file is to fulfill the CMS requirements for Price Transparency. Charges, allowed amount, cash discounted price, min and max negotiated rates provided in this report are based on historic claim and remittance information provided by Lucas County Health Center. This was generated on 12/27/2021 and is a yearly snapshot based on history. All amounts reported may change due to several factors including but not limited to hospital service area where the service is provided, payer contracts and negotiations. This data will be further refined.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
CPT,Description,Charges,Discounted Cash Price,Min Negotiated,Max Negotiated,Admin Concepts,Aetna,Aetna - Coventry,Aetna Medicare,Aetna Medicare Supplemental ins.,American Republic,Amerigroup IA Medicaid,Bankers Life & Casualty,Blue Cross,Blue Cross Out of State,Bridgestone Firestone,Champus,Champva,Cigna,Commercial,Coventry Advantra,Coventry Healthcare,Equitable,Health partners,Health Partners UPH Self Funded,Humana,Humana Choice,Iowa Total Care,Medicaid,Medicare,Medicare Community Plan UHC,Medico,Meritain,Midlands choice,Mutual of Omaha,National Assoc Letter Carriers,Securehorizons Direct,UHC Medicare Solutions hmo,UHC Medicare Solutions ppo,UHC River Valley,United Healthcare,United Healthcare AARP ins.,VA,Workers Compensation
Institutional,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Outpatients,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
00142,Anesthesia for procedures on eye; lens surgery,772,695,24,733,733,24,727,385,386,394,403,394,381,292,394,379,143,720,357,375,733,394,455,517,440,447,396,408,441,386,394,733,663,394,394,386,387,385,476,438,386,387,417
00300,"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified",1197,1077,221,1137,1137,642,1127,596,610,610,625,610,448,452,610,587,221,1116,554,581,1137,610,705,802,682,694,614,632,568,598,600,1137,1027,610,610,598,600,596,739,678,598,600,646
00400,"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified",891,802,165,846,846,478,839,444,454,454,465,454,333,337,454,437,165,831,413,432,846,454,525,597,507,516,457,470,423,446,447,846,765,454,454,446,446,444,550,505,445,447,481
00635,Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture,564,508,104,536,536,302,531,281,287,288,295,288,211,213,288,277,104,526,261,274,536,288,332,378,321,327,289,298,268,282,283,536,484,288,288,282,283,281,348,320,282,283,305
0064U,HC ANTB TP TOTAL&RPR IA QUAL,263,237,49,250,250,141,248,131,134,134,142,134,97,99,134,129,49,245,122,128,250,134,155,176,150,152,141,139,147,132,132,250,226,134,134,132,132,131,162,205,131,132,142
00731,PR ANES UPR GI NDSC PX NOS,941,847,174,894,894,504,886,469,480,480,491,480,352,356,480,462,174,878,436,456,894,480,555,630,536,545,483,497,480,470,472,894,808,480,480,470,471,469,581,533,470,472,508
00750,Anesthesia for hernia repairs in upper abdomen; not otherwise specified,1604,1444,297,1524,1524,860,1510,799,818,818,838,818,600,606,818,787,297,1496,743,778,1524,818,945,1074,913,930,823,847,761,802,804,1524,1377,818,818,802,804,799,990,909,802,805,866
00790,Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified,2671,2404,24,2537,2537,24,2515,1330,1361,1362,1395,1362,999,1010,1362,1310,494,2491,1237,1296,2537,1362,1574,1789,1521,1548,1371,1410,1692,1336,1339,2537,2293,1362,1362,1336,1338,1331,1648,1514,1335,1340,1442
00811,PR ANES LWR INTST NDSC NOS,900,810,166,855,855,482,847,448,459,459,470,459,337,340,459,441,166,839,417,437,855,459,530,603,512,522,462,475,427,450,451,855,772,459,459,450,451,448,555,510,450,451,486
00812,PR ANES LWR INTST SCR COLSC,763,687,141,725,725,409,718,380,389,389,435,389,285,288,389,374,141,712,353,370,725,389,450,511,434,442,392,403,414,382,382,725,655,389,451,382,382,380,471,432,381,383,412
00813,PR ANES UPR LWR GI NDSC PX,1197,1077,221,1137,1137,642,1127,596,610,610,625,610,448,452,610,587,221,1116,554,581,1137,610,705,802,682,694,614,632,568,598,600,1137,1027,610,610,598,600,596,739,678,598,600,646
00830,Anesthesia for hernia repairs in lower abdomen; not otherwise specified,1812,1631,335,1721,1721,971,1706,903,924,924,946,924,678,685,924,889,335,1690,839,879,1721,924,1068,1213,1032,1050,930,957,860,906,908,1721,1555,924,924,906,908,903,1118,1027,906,909,978
00840,Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified,1990,1791,368,1891,1890,1067,1874,991,1014,1015,1039,1015,744,752,1015,976,368,1856,921,965,1890,1015,1173,1333,1133,1153,1021,1051,944,995,997,1891,1708,1015,1015,995,997,991,1228,1128,995,998,1075
00873,"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath",1997,1797,369,1897,1897,1070,1880,995,1018,1018,1043,1018,747,755,1018,980,369,1862,925,969,1897,1018,1177,1337,1137,1157,1025,1054,1018,998,1001,1897,1714,1018,1018,998,1001,995,1233,1132,998,1002,1078
00902,Anesthesia for; anorectal procedure,1397,1257,258,1327,1327,749,1315,696,712,712,730,712,523,528,712,685,258,1303,647,678,1327,712,823,935,795,810,717,738,663,698,700,1327,1199,712,712,698,700,696,862,792,698,701,754
00912,Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s),1533,1380,283,1456,1456,822,1443,764,781,782,801,782,574,579,782,752,283,1430,710,744,1456,782,904,1027,873,888,787,809,782,766,768,1456,1316,782,782,766,768,764,946,869,766,769,828
00952,"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography",1204,1084,223,1144,1144,645,1134,600,614,614,629,614,450,455,614,591,223,1123,557,584,1144,614,710,806,686,698,618,636,571,602,603,1144,1033,614,614,602,603,600,743,682,602,604,650
0097U,"Gastrointestinal pathogen, multiplex reverse transcription and multiplex amplified probe technique, multiple types or subtypes, 22 targets",361,325,67,343,343,202,340,180,184,184,195,184,314,136,184,177,67,337,167,173,343,184,213,242,70,209,180,191,202,180,181,343,310,184,184,180,180,180,223,180,180,181,195
0100U,"Respiratory pathogen, multiplex reverse transcription and multiplex amplified probe technique, multiple types or subtypes, 21 targets",107,96,20,102,102,57,101,53,55,55,56,55,40,40,55,52,20,100,50,52,102,55,63,72,61,62,55,56,52,54,54,102,92,55,55,54,54,53,66,52,53,54,58
01200,Anesthesia for all closed procedures involving hip joint,884,796,163,840,840,474,832,440,451,451,462,451,331,334,451,434,163,824,409,429,840,451,521,592,503,512,454,467,495,442,443,840,759,451,451,442,443,440,546,501,442,443,477
01400,Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified,1172,1055,217,1113,1113,628,1103,584,597,598,612,598,438,443,598,575,217,1093,543,569,1113,598,691,785,667,679,601,619,656,586,587,1113,1006,598,598,586,587,584,723,664,586,588,633
01462,"Anesthesia for all closed procedures on lower leg, ankle, and foot",699,629,129,664,664,375,658,348,356,356,365,356,261,264,356,343,129,652,324,339,664,356,412,468,398,405,359,369,332,350,350,664,600,356,356,350,350,348,431,396,349,351,377
01480,"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified",955,860,177,907,907,512,899,476,487,487,499,487,357,361,487,468,177,891,442,463,907,487,563,639,544,553,490,504,453,478,479,907,820,487,487,478,478,476,589,541,477,479,516
01710,"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified",1227,1104,227,1166,1166,658,1155,611,625,626,641,626,459,464,626,602,227,1144,568,595,1166,626,723,822,699,711,630,648,687,614,615,1166,1053,626,626,614,615,611,757,695,613,615,663
01730,Anesthesia for all closed procedures on humerus and elbow,1035,932,191,983,983,555,974,516,528,528,541,528,387,391,528,508,191,965,479,502,983,528,610,693,589,600,531,546,491,518,519,983,888,528,528,518,519,516,639,587,517,519,559
01810,"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand",883,795,163,839,839,473,831,440,450,450,487,450,330,334,438,433,163,823,409,428,839,450,520,591,503,512,453,466,467,442,443,839,758,450,450,442,442,440,545,500,441,443,477
0202U,HC NFCT DS 22 TRGT SARS-COV-2,428,385,79,407,407,229,403,213,218,218,231,218,150,162,218,210,79,399,198,208,407,218,252,287,244,248,220,226,225,214,215,407,367,218,218,214,214,213,264,243,214,215,231
10060,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single",254,229,47,1014,241,136,239,127,129,130,137,130,1014,96,130,125,47,237,118,123,241,130,150,170,145,147,68,134,115,127,127,241,218,129,130,127,127,127,157,142,127,127,137
10061,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",372,335,69,353,353,199,350,185,190,190,272,190,139,141,190,182,69,347,172,180,353,190,154,249,212,216,191,196,195,186,186,353,319,190,190,186,186,185,230,211,186,187,201
10081,Incision and drainage of pilonidal cyst; complicated,500,450,92,2727,475,268,471,249,255,255,261,255,2727,189,255,245,92,466,231,243,475,255,295,335,285,290,257,264,263,250,251,475,429,255,255,250,251,249,309,283,250,251,270
10120,"Incision and removal of foreign body, subcutaneous tissues; simple",162,146,30,1473,154,87,153,81,83,83,85,83,1006,61,83,79,30,151,75,79,154,83,95,108,92,94,81,86,1473,81,81,154,139,83,83,81,81,81,100,92,81,81,87
10140,"Incision and drainage of hematoma, seroma or fluid collection",300,270,55,2772,285,161,282,149,153,153,162,153,2772,113,153,147,55,280,139,146,285,153,177,201,171,174,75,158,168,150,150,285,257,153,153,150,150,149,185,170,150,150,162
10160,"Puncture aspiration of abscess, hematoma, bulla, or cyst",250,225,46,238,238,134,235,125,127,128,68,127,94,94,128,123,46,233,116,121,238,128,147,167,142,145,128,132,131,125,125,238,215,127,127,125,125,125,154,142,125,125,135
11042,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",484,436,89,635,460,460,456,241,247,247,300,247,635,635,247,237,89,451,201,235,460,247,285,324,475,281,260,300,271,242,243,460,156,247,247,242,242,241,299,242,242,243,261
11043,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",484,436,89,2513,460,271,456,241,247,247,2513,247,2500,183,247,237,89,451,182,235,460,247,285,324,451,437,206,256,247,242,243,460,415,247,247,242,242,241,299,274,242,243,261
11044,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less",3033,2730,561,2881,2881,1626,2856,1511,1546,1547,1584,1547,1135,1146,1547,1488,561,2829,1404,1471,2881,1547,1788,2031,1727,2068,1557,1601,790,1516,1520,2881,2603,1546,1547,1516,1520,1511,1872,1719,1516,1521,1638
11045,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)",484,436,89,474,460,259,456,241,247,247,261,247,181,183,247,237,89,451,128,235,460,247,285,324,474,281,232,256,247,242,243,460,415,247,247,242,242,241,299,274,242,243,261
11046,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)",484,436,1,1280,460,259,456,241,247,247,1,247,1280,183,247,237,89,451,130,235,460,247,285,324,440,281,248,256,254,242,243,460,415,247,247,242,242,241,299,274,242,243,261
11055,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion",129,116,24,635,123,69,121,64,66,66,70,66,635,49,66,63,24,120,60,63,123,66,76,86,73,75,66,68,66,64,65,123,111,66,66,64,65,64,80,73,64,65,70
11056,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions",154,139,28,146,146,83,145,77,78,79,80,79,58,58,79,76,28,144,71,75,146,79,91,103,88,89,79,81,73,77,77,146,132,79,79,77,77,77,95,74,77,77,83
11102,PR TANGNTL BX SKIN SINGLE LES,260,234,48,247,247,139,245,130,133,133,136,133,97,98,133,128,48,242,120,126,247,133,153,174,148,151,133,137,84,130,130,247,223,133,133,130,130,130,160,147,130,130,140
11104,PR PUNCH BX SKIN SINGLE LESION,320,288,59,1451,304,172,301,159,163,163,167,163,1451,121,163,157,59,298,148,155,304,163,189,214,173,185,164,169,163,160,160,304,275,163,163,160,160,159,197,181,160,161,173
11105,PR PUNCH BX SKIN EA SEP/ADDL,150,135,28,143,142,80,141,75,76,76,78,76,56,57,77,74,28,140,69,73,142,76,88,100,85,87,77,79,76,75,75,143,129,76,76,75,75,75,93,85,75,75,81
11400,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less",394,355,73,374,374,211,371,196,201,201,206,201,147,149,201,193,73,367,182,191,374,201,232,264,224,228,202,208,163,197,197,374,338,201,201,197,197,196,243,223,197,198,213
11401,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm",2985,2686,552,2836,2836,1600,2810,1487,1521,1522,1559,1522,1117,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1416,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
11402,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm",2630,2367,227,2499,2498,1410,2476,1310,1340,1341,1373,1341,1319,994,1341,1290,486,2453,1218,1276,2498,1341,1550,1761,1498,1524,1350,1389,1341,1315,1318,2499,2257,1341,1341,1315,1318,1310,1623,227,1315,1319,1420
11403,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm",1572,1415,195,1494,1494,843,1481,1315,801,802,821,802,401,594,802,771,291,1467,728,763,1494,802,927,1053,895,911,807,830,195,786,788,1494,1350,802,802,786,788,783,971,891,786,789,849
11404,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm",336,303,62,660,320,180,317,168,172,172,176,172,660,127,172,165,62,314,156,163,320,172,198,225,192,195,173,178,177,168,169,320,289,172,172,168,169,168,208,323,168,169,182
11406,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm",3340,3006,618,3848,3173,1790,3145,1664,1702,1703,1744,1703,3848,1262,1703,1638,618,3115,1546,1620,3173,1703,1968,2236,1902,1936,1714,1763,1703,1670,1674,3173,2867,1703,1703,1670,1673,1664,2061,1870,1669,1675,1804
11421,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm",305,274,56,290,290,163,287,152,155,156,159,156,114,115,156,150,56,284,141,148,290,156,180,204,174,177,157,161,117,152,153,290,262,155,156,152,153,152,188,173,152,153,165
11422,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm",3335,3002,617,3168,3168,2002,3140,1661,1700,1701,1742,1701,1451,1451,1701,1636,617,3110,1544,1618,3168,1701,1966,2233,1899,1933,1712,1761,1753,1668,1672,3168,2862,1700,1701,1668,1842,1662,2058,1890,1667,1673,1801
11423,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",2984,2686,552,2835,2835,1600,2810,1486,1521,1522,1558,1522,2066,1128,1522,1464,552,2783,1382,1448,2835,1522,1759,1998,1699,1729,1602,1576,1341,1492,1496,2835,2561,1521,1522,1492,1495,1487,1842,1691,1492,1497,1611
11424,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm",1,1,0,1341,1,1,1,0,1,1,1,1,1341,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
11426,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",670,603,124,637,636,359,631,334,341,342,350,342,251,253,342,329,124,625,310,325,636,342,395,449,382,388,344,354,309,335,336,637,575,342,342,335,336,334,414,380,335,336,362
11441,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm",2985,2686,552,2836,2836,1600,2810,1487,1521,1522,1420,1522,1117,1128,1522,1464,552,1522,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1522,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
11442,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm",2808,2527,519,2667,2667,1493,2643,1398,1431,1432,1466,1432,1050,1061,1432,1377,519,2618,1300,1362,2667,1432,1655,1880,1599,1627,1441,1482,1475,1404,1407,2667,2410,1431,1432,1404,1407,1399,1733,1591,1403,1408,1516
11443,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm",2985,2686,552,2836,2836,1600,2810,1487,1521,1522,1559,1522,1117,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1522,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
11603,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm",1802,1621,205,1711,1711,966,1696,897,918,919,941,919,720,681,919,884,333,1680,834,874,1711,919,1062,1206,1026,1044,925,951,205,901,903,1711,1546,918,919,901,903,898,1112,1021,900,904,973
11604,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm",4654,4189,860,4421,4421,2495,4382,2318,2372,2374,2430,2373,1319,1759,2374,2283,860,4340,2155,2258,4421,2374,2743,3116,2650,2697,2388,2457,2446,2327,2333,4421,3995,2373,2374,2327,2332,2319,2872,2638,2326,2334,2513
11606,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",2985,2686,552,4973,2836,1492,2810,1487,1521,1522,1559,1522,4973,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1672,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
11623,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",3578,3220,661,3399,3399,1918,3368,1782,1823,1825,1868,1824,1451,1352,1825,1755,661,3336,1656,1735,3399,1825,2108,2396,2037,2073,1836,1889,1672,1789,1793,3399,3071,1824,1825,1789,1792,1782,2208,2028,1788,1794,1932
11624,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm",2985,2686,552,2836,2836,1600,2810,1487,1521,1522,1559,1522,1117,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1672,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
11626,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",1,1,0,3588,1,1,1,0,1,1,1,1,3588,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
11642,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm",2630,2367,486,2499,2498,1473,2476,1310,1340,1341,1373,1341,984,994,1341,1290,486,2453,1218,1276,2498,1341,1550,1761,1498,1524,1350,1389,1473,1315,1318,2499,2257,1341,1341,1315,1318,1310,1623,1491,1315,1319,1420
11643,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm",2985,2686,552,2836,2836,1600,2810,1487,1521,1522,1559,1522,1117,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1492,1576,1522,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
11644,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm",3577,3219,661,3498,3398,2085,3368,1782,1823,1824,1868,1824,3498,1352,1824,1755,661,3336,1656,1735,3398,1824,2108,2395,2037,2073,1836,1889,1880,1788,1793,3398,3070,1824,1824,1788,1792,1782,2208,2028,1788,1794,1932
11646,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm",2984,2686,552,4410,2835,1600,2810,1486,1521,1522,1558,1522,4410,1128,1522,1464,552,2783,1382,1448,2835,1522,1759,1998,1699,1729,1531,1576,915,1492,1496,2835,2561,1521,1522,1492,1495,1487,1842,1492,1492,1497,1611
11719,"Trimming of nondystrophic nails, any number",85,76,16,81,81,46,80,42,43,43,44,43,32,32,43,42,16,79,39,41,81,43,50,57,48,49,44,45,45,42,43,81,73,43,43,42,43,42,52,41,42,43,46
11720,Debridement of nail(s) by any method(s); 1 to 5,154,139,28,146,146,83,145,77,78,79,80,79,58,58,79,76,28,144,71,75,146,79,91,103,88,89,79,81,82,77,77,146,132,79,79,77,77,77,95,87,77,77,83
11721,Debridement of nail(s) by any method(s); 6 or more,154,139,28,146,146,83,145,77,78,79,58,79,132,58,79,76,28,144,71,75,146,79,91,103,88,89,79,81,86,77,77,146,132,79,79,77,77,77,95,77,77,77,83
11730,"Avulsion of nail plate, partial or complete, simple; single",154,139,28,501,146,83,145,77,78,79,80,79,501,58,79,76,28,144,71,75,146,79,91,103,88,89,79,81,81,77,77,146,132,79,79,77,77,77,95,87,77,77,83
11771,Excision of pilonidal cyst or sinus; extensive,4655,4190,861,4422,4422,2495,4383,2319,2373,2374,2431,2374,3258,1759,2374,2283,861,4341,2155,2258,4422,2374,2744,3117,2651,2698,2389,2458,1419,2328,2333,4422,3995,2373,2374,2328,2332,2319,2873,2234,2327,2335,2514
11982,"Removal, non-biodegradable drug delivery implant",1,1,0,663,1,1,1,0,1,1,1,1,663,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
12001,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less",215,194,20,598,204,162,202,107,110,110,116,110,598,81,110,105,40,201,100,104,204,110,127,144,122,20,115,114,83,108,108,204,185,110,110,108,108,107,133,108,107,108,116
12002,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm",215,194,40,544,204,80,202,107,110,110,116,110,544,81,110,105,40,201,100,104,204,110,127,144,122,125,115,116,61,108,108,204,185,110,110,108,108,107,133,167,107,108,116
12004,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm",246,221,45,299,234,132,232,123,125,125,128,125,299,93,125,121,45,229,114,119,234,125,145,165,140,143,126,130,107,123,123,234,211,125,125,123,123,123,152,139,123,123,133
12005,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm",252,227,47,239,239,135,237,126,128,129,136,129,94,95,129,124,47,235,117,122,239,129,149,169,143,146,129,133,110,126,126,239,216,128,129,126,126,126,156,143,126,126,136
12011,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",215,194,40,571,204,115,202,107,110,110,116,110,571,81,110,105,40,204,100,104,204,110,127,144,122,125,115,114,89,108,108,204,185,110,110,108,108,107,133,108,107,108,116
12013,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",162,146,30,598,154,87,153,81,83,83,87,83,73,598,83,79,30,151,75,79,154,83,95,108,92,94,87,86,76,81,81,154,139,83,83,81,81,81,100,92,81,81,87
12014,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm",247,222,46,235,235,132,233,123,126,126,129,126,92,93,126,121,46,230,114,120,235,126,146,165,141,143,127,130,130,124,124,235,212,126,126,124,124,123,152,119,123,124,133
12020,Treatment of superficial wound dehiscence; simple closure,173,156,32,164,164,93,163,86,88,88,90,88,65,65,88,85,32,161,80,84,164,88,102,116,99,100,93,91,91,86,87,164,148,88,88,86,87,86,107,98,86,87,93
12031,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less",1,1,0,272,1,1,1,0,1,1,1,1,272,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
12032,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm",1,1,0,558,1,1,1,0,1,1,1,1,558,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,140,0,1,1,1,1,1,0,1,0,1,1,0,1,1
12034,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm",162,146,30,1327,154,87,153,81,83,83,85,83,1327,61,83,79,30,151,75,79,154,83,98,108,92,94,83,86,85,81,81,154,139,83,83,81,81,81,100,92,81,81,87
12041,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less",162,146,30,299,154,87,153,81,83,83,81,83,299,299,83,79,30,151,75,79,154,83,95,108,92,94,83,86,85,81,81,154,139,83,83,81,81,81,100,92,81,81,87
12042,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm",174,157,1,299,165,93,164,87,89,89,91,89,299,66,89,85,32,162,81,84,165,89,103,117,99,101,1,92,143,87,87,165,149,89,89,87,87,87,107,90,87,87,94
12044,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm",302,272,56,743,287,162,284,150,154,154,158,154,743,114,154,148,56,282,140,147,287,154,178,202,172,175,155,159,213,151,151,287,259,154,154,151,151,150,186,171,151,151,216
12051,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",267,240,49,633,254,143,251,133,136,136,139,136,633,101,136,131,49,249,124,130,254,136,157,179,152,155,137,141,157,134,134,254,229,136,136,134,134,133,165,151,133,134,144
12052,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",204,184,38,818,194,109,192,102,104,104,107,104,818,77,104,100,38,190,94,99,194,104,120,137,116,118,105,108,168,102,102,194,175,104,104,102,102,102,126,116,102,102,110
12054,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm",1,1,0,299,1,1,1,0,1,1,1,1,299,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
13101,"Repair, complex, trunk; 2.6 cm to 7.5 cm",1,1,0,482,1,1,1,0,1,1,1,1,482,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
13120,"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm",640,576,118,608,608,343,603,319,326,326,334,326,317,242,326,314,118,597,296,310,608,326,377,429,364,371,328,338,302,320,321,608,549,326,326,320,321,319,395,363,320,321,346
13121,"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm",640,576,118,608,608,343,603,319,326,326,333,326,475,242,326,314,118,597,296,310,608,326,377,429,364,371,328,338,316,320,321,608,549,326,326,320,321,319,395,363,320,321,346
13122,"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)",250,225,46,317,238,134,235,125,127,128,130,127,317,94,128,123,46,233,116,121,238,128,147,167,142,145,128,132,131,125,125,238,215,127,127,125,125,125,154,142,125,125,135
13131,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm",511,460,94,598,485,274,481,255,260,261,267,261,598,193,261,251,94,477,237,248,485,261,301,342,291,296,262,270,258,256,256,485,439,261,261,256,256,255,315,290,255,256,276
13132,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm",529,476,98,1461,503,284,498,264,270,270,276,270,1461,200,270,259,98,493,245,257,503,270,312,354,301,307,271,279,290,264,265,503,454,270,270,264,265,264,326,300,264,265,286
13151,"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm",3685,3316,681,3501,3501,1975,3470,1836,1878,1879,1924,1879,1379,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1891,1946,1936,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,1842,1842,1848,1990
13152,"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm",910,819,168,865,864,488,857,453,464,464,475,464,340,344,464,446,168,849,421,441,864,464,536,609,518,527,467,480,351,455,456,865,781,464,464,455,456,453,562,516,455,456,491
14040,"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less",4655,4190,861,4422,4422,2495,4383,2319,2373,2374,2431,2374,1741,1759,2374,2283,861,4341,2155,2258,4422,2374,2744,3117,2651,2698,2389,2458,2374,2328,2333,4422,3995,2373,2374,2328,2332,2319,2873,2639,2327,2335,2514
15271,PR SKIN SUB GRAFT T/A/L 25 SQ CM,552,497,102,524,524,296,520,275,281,282,288,282,293,209,282,271,102,515,159,268,524,282,325,370,314,320,283,291,309,276,277,524,474,281,282,276,277,275,341,309,276,277,298
15272,PBB SKIN SUB GRAFT T/A/L ADD-ON,552,497,102,524,524,296,520,275,281,282,288,282,207,209,282,271,102,515,124,268,524,282,325,370,314,320,283,291,309,276,277,524,474,281,282,276,277,275,341,313,276,277,298
15275,PR SKIN SUB GRFT F/NK/HF/G 25 SQ CM,552,497,102,524,524,296,520,275,281,282,288,282,207,209,282,271,102,515,256,268,524,282,325,370,314,320,283,291,282,276,277,524,474,281,282,276,277,275,341,313,276,277,298
15276,PBB SKIN SUB GRAFT F/N/HF/G ADDL,552,497,102,524,524,296,520,275,281,282,288,282,207,209,282,271,102,515,256,268,524,282,325,370,314,320,283,291,282,276,277,524,474,281,282,276,277,275,341,313,276,277,298
16020,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)",239,215,44,227,227,128,225,119,122,122,97,122,89,90,122,117,44,223,111,116,227,122,141,160,136,139,123,129,87,120,120,227,205,122,122,120,120,119,148,135,119,120,129
16030,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)",272,245,50,258,258,146,256,135,139,139,136,139,102,103,139,133,50,254,126,132,258,139,160,182,155,158,140,144,143,136,136,258,233,139,139,136,136,136,168,154,136,136,147
17250,"Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)",236,212,44,224,224,126,222,117,120,120,123,120,88,89,120,116,44,220,109,114,224,120,139,158,134,136,121,124,77,118,118,224,202,120,120,118,118,117,145,133,118,118,127
19081,PR BX BREAST 1ST LESION STRTCTC,4326,3893,800,4110,4110,2319,4073,2155,2205,2206,2259,2206,3957,1635,2206,2122,800,4034,2003,2099,4110,2206,2550,2897,2463,2507,2322,2284,2206,2163,2168,4110,3713,2206,2206,2163,2167,2155,2670,2076,2162,2170,2336
19120,"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions",4170,3753,771,3962,3962,2235,3926,2077,2125,2127,2252,2127,1560,1576,2127,2045,771,3889,1931,2023,3962,2127,2458,2792,2374,2417,2140,2202,1201,2085,2090,3962,3579,2126,2127,2085,2089,2078,2574,2364,2084,2092,2252
19301,"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);",5140,4626,950,6617,4883,2755,4840,2560,2620,2621,2684,2621,6617,1943,2621,2521,950,4794,2380,2493,4883,2621,3029,3442,2927,2979,2638,2714,2701,2570,2576,4883,4412,2621,2621,2570,2575,2561,3172,2913,2569,2578,2776
20240,"Biopsy, bone, open; superficial (eg, ilium, sternum, spinous process, ribs, trochanter of femur)",4655,4190,861,4422,4422,2495,4383,2319,2373,2374,2431,2374,3848,1759,2374,2283,861,4341,2155,2258,4422,2374,2744,3117,2651,2698,2389,2458,2446,2328,2333,4422,3995,2373,2374,2328,2332,2319,2873,2639,2327,2335,2514
20552,"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)",400,360,74,380,380,214,377,199,204,204,216,204,150,151,204,196,74,373,185,194,380,204,236,268,228,232,205,211,109,200,200,380,343,204,204,200,200,199,247,227,200,201,216
20600,"Arthrocentesis, aspiration and/or injection; small joint or bursa (eg, fingers, toes)",97,87,18,92,92,52,91,48,49,49,51,49,36,37,49,48,18,90,45,47,92,49,57,65,55,56,50,51,42,48,49,92,83,49,49,48,49,48,60,55,48,49,52
20605,"Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)",168,151,31,160,160,90,158,84,86,86,91,86,63,63,86,82,31,157,78,81,160,86,99,112,96,97,86,89,88,84,84,160,144,86,86,84,84,84,104,95,84,84,91
20610,"Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)",168,151,31,410,160,90,158,84,86,86,84,86,410,63,86,82,31,157,78,81,160,86,99,112,96,97,86,89,88,84,84,160,144,86,86,84,84,84,104,95,84,84,91
20611,HC DRAIN/INJ MAJOR JOINT/BURSA W US,515,464,95,1047,489,276,485,257,262,263,269,263,1047,195,263,253,95,480,238,250,489,263,304,345,293,298,264,272,271,258,258,489,442,263,263,258,258,257,318,292,257,258,278
20680,"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)",4170,3753,1,3962,3962,2235,3926,2077,2125,2127,2178,2127,3498,1576,2127,2161,771,3889,1931,2023,3962,2127,2458,2792,2374,2417,1,2202,2335,2085,2090,3962,3579,2126,2127,2085,2089,2078,2574,2364,2084,2092,2252
21552,"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater",2985,2686,552,2836,2836,1600,2810,1487,1521,1522,1559,1522,1117,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1672,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
21930,"Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm",2985,2686,552,2836,2836,1600,2810,1487,1521,1522,1559,1522,1117,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1672,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
21932,"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm",2984,2686,552,3848,2835,1600,2810,1486,1521,1522,1558,1522,3848,1128,1522,1464,552,2783,1382,1448,2835,1522,1759,1998,1699,1729,1531,1576,1568,1492,1496,2835,2561,1521,1522,1492,1495,1487,1842,1691,1492,1497,1611
23075,"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm",2630,2367,486,2499,2498,1410,2476,1310,1340,1341,1373,1341,1319,994,1341,1290,486,2453,1218,1276,2498,1341,1550,1761,1498,1524,1350,1389,1382,1315,1318,2499,2257,1341,1341,1315,1318,1310,1623,1491,1315,1319,1420
23350,Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder arthrography,274,247,51,260,260,147,258,136,140,140,148,140,103,104,140,134,51,256,127,133,260,140,161,183,156,159,141,148,153,137,137,260,235,140,140,137,137,137,169,155,137,137,148
23505,Closed treatment of clavicular fracture; with manipulation,800,720,148,760,760,429,753,398,408,408,432,408,299,302,408,392,148,746,370,388,760,408,471,536,456,464,411,422,420,400,401,760,687,408,408,400,401,399,494,453,400,401,432
23650,"Closed treatment of shoulder dislocation, with manipulation; without anesthesia",213,192,39,202,202,114,201,106,109,109,111,109,138,81,109,104,39,199,99,103,202,109,126,143,121,123,109,112,130,106,107,202,183,109,109,106,107,106,131,121,106,107,115
23655,"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia",1008,907,186,958,958,540,949,502,514,514,544,514,377,381,514,494,186,958,467,489,958,514,594,675,574,584,517,532,360,504,505,958,865,514,514,504,505,502,622,571,504,506,544
23675,"Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation",1100,990,203,1045,1045,590,1036,548,561,561,574,561,412,416,561,540,203,1026,509,534,1045,561,648,737,626,638,565,581,507,550,551,1045,944,561,561,550,551,548,679,623,550,552,594
24640,"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation",162,146,30,3347,154,87,153,81,83,83,87,83,3347,61,83,79,30,151,75,79,154,83,95,108,92,94,83,86,85,81,81,154,139,83,83,81,81,81,100,92,81,81,87
25000,"Incision, extensor tendon sheath, wrist (eg, deQuervains disease)",4170,3753,771,3962,3962,2235,3926,2077,2125,2127,2178,2127,1560,1576,2127,2045,771,3889,1931,2023,3962,2127,2458,2792,2374,2417,2140,2202,2191,2085,2090,3962,3579,2126,2127,2085,2089,2078,2574,2364,2084,2092,2252
25565,Closed treatment of radial and ulnar shaft fractures; with manipulation,1200,1080,222,3347,1140,643,1130,598,612,612,627,612,3347,454,612,589,222,1119,556,582,1140,612,707,804,683,695,616,634,631,600,601,1140,1030,612,612,600,601,598,741,680,600,602,648
25605,"Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation",162,146,30,154,154,78,153,81,83,83,87,83,61,61,83,79,30,151,75,79,154,83,95,108,92,94,81,86,148,81,81,154,139,83,83,81,81,81,100,92,81,81,87
26010,Drainage of finger abscess; simple,313,282,58,922,297,168,295,156,160,160,163,160,922,118,160,154,58,292,145,152,297,160,184,210,178,181,161,165,164,156,157,297,269,160,160,156,157,156,193,177,156,157,169
26725,"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each",775,698,143,1521,736,415,730,386,395,395,405,395,1521,293,395,380,143,723,359,376,736,395,457,519,441,449,398,409,407,388,388,736,665,395,395,388,388,386,478,439,387,389,418
26775,"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia",850,765,157,808,808,456,800,423,433,434,444,433,318,321,434,417,157,793,394,412,808,434,514,569,484,493,436,449,301,425,426,808,730,433,433,425,426,423,525,482,425,426,459
27096,"Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid",1575,1418,291,1496,1496,844,1483,785,803,803,823,803,1047,595,803,773,291,1469,729,764,1496,803,928,1055,897,913,808,832,828,788,789,1496,1352,803,803,788,789,785,972,893,787,790,850
27240,"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction",3000,2700,555,2850,2850,1608,2825,1494,1529,1530,1620,1530,1122,1134,1530,1471,555,2798,1389,1455,2850,1530,1768,2009,1708,1739,1540,1584,1577,1500,1504,2850,2575,1529,1530,1500,1503,1495,1852,1700,1500,1505,1620
27252,"Closed treatment of hip dislocation, traumatic; requiring anesthesia",1508,1357,279,1433,1433,808,1420,751,769,769,788,769,564,570,769,740,279,1406,698,732,1433,769,889,1010,859,874,774,796,905,754,756,1433,1294,769,769,754,756,751,931,855,754,756,814
27257,"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia",575,518,106,546,546,308,541,286,293,293,300,293,215,217,293,282,106,536,266,279,546,293,339,385,327,333,295,304,365,288,288,546,494,293,293,288,288,286,355,326,287,288,310
27266,Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia,216,194,40,242,205,116,203,108,110,110,113,110,81,82,110,106,40,201,100,105,205,110,127,145,123,125,111,114,242,108,108,205,185,110,110,108,108,108,133,122,108,108,117
27337,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater",2985,2686,552,3982,2836,1600,2810,1487,1521,1522,1559,1522,3982,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1569,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
27632,"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater",2985,2686,552,2836,2836,1600,2810,1487,1521,1522,1851,1522,1117,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1569,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
27650,"Repair, primary, open or percutaneous, ruptured Achilles tendon;",6595,5936,1219,6265,6265,3535,6209,3285,3361,3363,3444,3363,2467,2493,3363,3235,1219,6151,3053,3199,6265,3363,3887,4416,3755,3822,3385,3482,3363,3298,3306,6265,5661,3362,3363,3298,3304,3286,4070,3738,3296,3308,3561
27687,"Gastrocnemius recession (eg, Strayer procedure)",8239,7415,1523,7827,7827,4417,7757,4104,4199,4202,4303,4202,2937,3114,4202,4041,1523,7684,3814,3997,7827,4202,4856,5517,4691,4775,4228,4350,4330,4120,4130,7827,7072,4200,4202,4120,4128,4105,5085,4670,4118,4133,4449
27726,Repair of fibula nonunion and/or malunion with internal fixation,9135,8222,1689,8678,8678,4897,8601,4550,4656,4659,4771,4659,3417,3453,4659,4481,1689,8519,4229,4431,8678,4659,5384,6117,5202,5294,4688,4823,4800,4568,4579,8678,7841,4657,4659,4568,4577,4551,5638,4568,4566,4582,4933
27752,"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction",950,855,176,903,902,509,894,473,484,484,496,484,355,359,485,466,176,886,440,461,902,484,560,636,541,551,475,502,499,475,476,903,815,484,484,475,476,473,586,538,475,477,513
27786,Closed treatment of distal fibular fracture (lateral malleolus); without manipulation,800,720,148,760,760,429,753,398,408,408,418,408,299,302,408,392,148,746,370,388,760,408,471,536,456,464,411,422,380,400,401,760,687,408,408,400,401,399,494,453,400,401,432
27792,"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed",8122,7310,1502,9143,7716,4354,7648,4046,4140,4142,3372,4142,8792,9143,4143,3984,1502,7575,3761,3940,7716,4142,4787,5439,4625,4707,4524,4289,4268,4061,4071,7716,6972,4141,4142,4061,4070,4047,5013,4604,4060,4074,4386
27810,"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation",1000,900,185,2370,950,536,942,498,510,510,522,510,2370,378,510,490,185,933,463,485,950,510,589,670,569,580,513,528,526,500,501,950,858,510,510,500,501,498,617,567,500,502,540
27814,"Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed",10275,9248,1900,9761,9761,5508,9674,5118,5237,5240,5548,5240,3844,3884,5240,5040,1900,9583,4757,4984,9761,5240,6056,6880,5851,5955,5273,5425,5400,5138,5150,9761,8819,5239,5240,5138,5148,5119,6342,5824,5136,5154,5548
28008,"Fasciotomy, foot and/or toe",4655,4190,861,4659,4422,2495,4383,2319,2373,2374,2431,2374,4659,1759,2374,2283,861,4341,2155,2258,4422,2374,2744,3117,2651,2698,2389,2458,2446,2328,2333,4422,3995,2373,2374,2328,2332,2319,2873,2639,2327,2335,2514
28010,"Tenotomy, percutaneous, toe; single tendon",650,585,120,618,618,348,612,324,331,332,339,331,243,246,332,319,120,606,301,315,618,332,383,435,370,377,334,351,342,325,326,618,558,331,331,325,326,324,401,368,325,326,351
28011,"Tenotomy, percutaneous, toe; multiple tendons",750,675,139,713,712,402,706,374,382,382,392,382,281,283,383,368,139,699,347,364,712,382,442,502,427,435,385,405,394,375,376,713,644,382,382,375,376,374,463,425,375,376,405
28043,"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm",4170,3753,771,3962,3962,2235,3926,2077,2125,2127,2178,2127,3498,1576,2127,2045,771,3889,1931,2023,3962,2127,2458,2792,2374,2417,2140,2202,2191,2085,2090,3962,3579,2126,2127,2085,2089,2078,2574,2364,2084,2092,2252
28080,"Excision, interdigital (Morton) neuroma, single, each",2985,2686,552,4659,2836,1600,2810,1487,1521,1522,1559,1522,4659,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1569,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
28104,"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;",2985,2686,552,4975,2836,1600,2810,1487,1521,1522,1559,1522,4975,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1569,1492,1496,2836,2562,1522,1522,1492,1496,1492,1842,1492,1492,1497,1612
28110,"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)",2570,2313,475,4869,2442,1378,2420,1280,1310,1311,1342,1311,4869,972,1311,1261,475,2397,1190,1247,2442,1311,1515,1721,1464,1490,1319,1357,2878,1285,1288,2442,2206,1311,1311,1285,1288,1281,1586,1457,1285,1289,1388
28112,"Ostectomy, complete excision; other metatarsal head (second, third or fourth)",1,1,0,1,1,1,1,0,1,1,1,1,0,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
28160,"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each",1,1,0,1,1,1,1,0,1,1,1,1,0,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
28192,"Removal of foreign body, foot; deep",4170,3753,771,3962,3962,3962,3926,2077,2125,2127,2178,2127,1560,1576,2127,2045,771,3889,1931,2023,3962,2127,2458,2792,2374,2417,2140,2202,2191,2085,2090,3962,3579,2126,2127,2085,2089,2078,2574,2364,2084,2092,2252
28232,"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)",500,450,92,475,475,268,471,249,255,255,261,255,187,189,255,245,92,466,231,243,475,255,295,335,285,290,257,264,247,250,251,475,429,255,255,250,251,249,309,283,250,251,270
28285,"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)",1,1,0,2878,1,1,1,0,1,1,1,1,2329,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,2878,0,1,1,1,1,1,0,1,0,1,2449,0,1,1
28288,"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head",5139,4625,950,4882,4882,2755,4839,2560,2619,2621,2775,2621,1923,1942,2621,2521,950,4793,2379,2493,4882,2621,3029,3441,2926,2978,2637,2713,2701,2570,2576,4882,4411,2620,2621,2570,2575,2560,3172,2913,2569,2578,2775
28289,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint",3694,3325,683,9738,3509,1980,3478,1840,1883,1884,1929,1884,9738,1396,1884,1812,683,3445,1710,1792,3509,1884,2177,2474,2103,2141,1896,1950,1941,1847,1852,3509,3171,1883,1884,1847,1851,1840,2280,2094,1846,1853,1995
28292,"Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedure",7079,6371,1309,8853,6725,3795,6665,3526,3608,3610,3697,3610,8853,2676,3610,3472,1309,6602,3277,3434,6725,3610,4172,4740,4031,4103,3633,3738,3720,3540,3548,6725,6076,3609,3610,3540,3547,3527,4369,4012,3538,3551,3823
28296,"Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)",5382,4843,995,9738,5112,2402,5067,2681,2743,2745,2810,2744,9738,2034,2745,2640,995,5019,2492,2611,5112,2745,3172,3603,3064,3119,2812,2841,4780,2691,2697,5112,4619,2744,2745,2691,2696,2681,3321,4004,2690,2699,2906
28298,"Correction, hallux valgus (bunion), with or without sesamoidectomy; by phalanx osteotomy",5625,5062,1040,5344,5344,3015,5296,2802,2867,2869,2938,2869,2104,2126,2869,2759,1040,5246,2604,2729,5344,2869,3315,3767,3203,3260,2887,2970,2869,2812,2819,5344,4828,2868,2869,2812,2818,2803,3472,3188,2812,2821,3038
28299,"Correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy",5140,4626,950,4883,4883,2570,4840,2560,2620,2621,2684,2621,1923,1943,2621,2521,950,4794,2380,2493,4883,2621,3029,3442,2927,2979,2638,2714,2701,2570,2576,4883,4412,2621,2621,2570,2575,2561,3172,2913,2569,2578,2776
28300,"Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation",1,1,0,9119,1,1,1,0,1,1,1,1,9119,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
28308,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each",1,1,0,2498,1,1,1,0,1,1,2252,1,2223,0,1,0,0,1,0,0,1,1,1,1,1,1,2498,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
28415,"Open treatment of calcaneal fracture, includes internal fixation, when performed;",10890,9801,2013,10346,10346,5838,10253,5424,5550,5554,5687,5554,4074,4116,5554,5342,2013,10156,5042,5283,10346,5554,6418,7292,6201,6311,5845,5750,5723,5445,5458,10346,9347,5552,5554,5445,5456,5426,6721,6173,5443,5462,5881
28485,"Open treatment of metatarsal fracture, includes internal fixation, when performed, each",6892,6203,1274,8822,6548,3695,6490,3433,3513,3515,3600,3515,8822,2605,3515,3381,1274,6428,3191,3344,6548,3515,4298,4615,3925,3995,3537,3639,3622,3446,3455,6548,5916,3514,3515,3446,3453,3434,4254,3907,3445,3457,3722
28505,"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed",5140,4626,950,4883,4883,2755,4840,2560,2620,2621,2684,2621,1923,1943,2621,2521,950,4794,2380,2493,4883,2621,3029,3442,2927,2979,2759,2714,2701,2570,2576,4883,4412,2621,2621,2570,2575,2561,3172,2913,2569,2578,2776
28735,"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)",9504,8554,1757,9029,9029,5095,8948,4734,4844,4847,4963,4847,3555,3592,4847,4662,1757,8863,4400,4610,9029,4847,5601,6364,5412,5508,5101,5018,4994,4752,4764,9029,8157,4845,4847,4752,4762,4735,5866,5387,4750,4767,5132
28740,"Arthrodesis, midtarsal or tarsometatarsal, single joint",1,1,0,8853,1,1,1,0,1,1,1,1,8853,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
28750,"Arthrodesis, great toe; metatarsophalangeal joint",8676,7808,1604,8853,8242,4651,8169,5138,4422,4425,4531,4424,8853,3279,4425,4256,1604,8091,4017,4209,8242,4425,5113,5810,4940,5028,3799,4581,4559,4338,4349,8242,7447,4423,4425,4338,4347,4323,5355,4918,4337,4352,4685
28805,"Amputation, foot; transmetatarsal",6584,5926,1217,9833,6255,3529,6199,3280,3356,3358,3438,3358,9833,2489,3358,3229,1217,6140,3048,3194,6255,3358,3880,4409,3749,3816,3379,3476,3460,3292,3300,6255,5651,3357,3358,3292,3299,3280,4064,3732,3291,3302,3555
28810,"Amputation, metatarsal, with toe, single",3685,3316,681,3501,3501,1975,3470,1836,1878,1879,1924,1879,1379,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1891,1946,1820,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,2089,1842,1848,1990
28825,"Amputation, toe; interphalangeal joint",2042,1838,378,4659,1940,1095,1923,1017,1041,1042,1067,1042,4659,772,1042,1002,378,1905,946,991,1940,1042,1204,1368,1163,1184,1048,1078,1416,1021,1024,1940,1753,1041,1042,1021,1023,1018,1261,1158,1021,1024,1103
29075,"Application, cast; elbow to finger (short arm)",94,85,17,89,89,50,89,47,48,48,49,48,35,36,48,46,17,88,44,46,89,48,55,63,54,54,48,50,54,47,47,89,81,48,48,47,47,47,58,53,47,47,51
29105,Application of long arm splint (shoulder to hand),166,149,31,262,158,89,156,83,85,85,90,85,262,63,85,81,31,155,77,81,158,85,98,111,95,96,85,88,68,83,83,158,142,85,85,83,83,83,102,83,83,83,90
29125,Application of short arm splint (forearm to hand); static,136,122,25,426,129,73,128,68,69,69,73,69,426,51,69,68,25,127,63,66,129,69,80,91,77,79,73,72,64,68,68,129,117,69,69,68,68,68,84,105,68,68,73
29130,Application of finger splint; static,100,90,18,405,95,54,94,50,51,51,52,51,405,38,51,49,18,93,46,49,95,51,59,67,57,58,51,53,53,50,50,95,86,51,51,50,50,50,62,57,50,50,54
29505,Application of long leg splint (thigh to ankle or toes),174,157,32,165,165,93,164,87,89,89,94,89,65,66,89,85,32,162,81,84,165,89,103,117,99,101,89,92,91,87,87,165,149,89,89,87,87,87,107,99,87,87,94
29515,Application of short leg splint (calf to foot),162,146,30,446,154,154,153,81,83,83,100,83,405,446,83,79,30,151,75,79,154,83,89,108,92,94,92,86,69,81,81,154,139,83,83,81,81,81,100,92,81,81,87
29580,Strapping; Unna boot,100,90,18,445,95,54,94,50,51,51,52,51,445,445,51,49,18,93,46,49,95,51,59,67,42,58,48,53,56,50,50,95,86,51,51,50,50,50,62,50,50,50,54
29581,"Application of multi-layer venous wound compression system, below knee",258,232,48,445,245,138,243,129,131,132,124,132,445,98,132,127,48,241,119,125,245,132,152,173,147,150,132,136,144,129,129,245,221,132,132,129,129,129,159,129,129,129,139
29700,"Removal or bivalving; gauntlet, boot or body cast",240,216,44,446,228,129,226,120,122,122,125,122,446,91,122,118,44,224,111,116,228,122,141,161,137,139,123,127,126,120,120,228,206,122,122,120,120,120,148,136,120,120,130
29880,"Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)",5355,4820,990,5087,5087,2871,5042,2667,2729,2731,2785,2731,2003,2024,2731,2627,990,4994,2479,2598,5087,2731,3156,3586,3049,3104,2748,2827,2814,2678,2684,5087,4596,2730,2731,2678,2683,2668,3305,3035,2677,2686,2892
29881,"Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)",5355,4820,990,5247,5087,2871,5042,2667,2729,2731,2797,2731,5247,2024,2731,2627,990,4994,2479,2598,5087,2731,3156,3586,3049,3104,2748,2827,2999,2678,2684,5087,4596,2730,2731,2678,2683,2668,4172,4172,2677,2686,2892
30300,"Removal foreign body, intranasal; office type procedure",120,108,22,243,114,64,113,60,61,61,63,61,243,45,61,59,22,112,56,58,114,61,71,80,68,70,62,63,63,60,60,114,103,61,61,60,60,60,74,68,60,60,65
30801,"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial",3684,3316,681,3500,3500,1975,3469,1835,1878,1879,1731,1879,1378,1392,1879,1807,681,3436,1706,1787,3500,1879,2171,2467,2098,2135,1891,1945,1936,1842,1847,3500,3162,1878,1879,1842,1846,1835,2274,2088,1841,1848,1989
30802,"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)",4169,3752,771,3961,3961,2235,3925,2077,2125,2126,2251,2126,1560,1576,2126,2045,771,3888,1930,2022,3961,2126,2457,2792,2374,2416,2140,2201,2191,2084,2090,3961,3578,2125,2126,2084,2089,2077,2573,2363,2084,2091,2251
30901,"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method",162,146,30,154,154,87,153,81,83,83,81,83,61,61,83,79,30,151,75,79,154,83,95,108,92,94,83,86,72,81,81,154,139,83,83,81,81,81,100,92,81,81,87
30903,"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method",350,315,65,333,332,188,330,174,178,178,183,178,131,132,179,172,65,326,162,170,332,178,206,234,199,203,180,185,136,175,175,333,300,178,178,175,175,174,216,198,175,176,189
30905,"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial",250,225,46,238,238,120,235,125,127,128,125,127,94,94,128,123,46,233,116,121,238,128,147,167,142,145,128,132,118,125,125,238,215,127,127,125,125,125,154,142,125,125,135
31500,"Intubation, endotracheal, emergency procedure",185,166,34,1650,176,104,174,92,94,94,75,94,1650,70,94,91,34,173,86,89,176,94,109,124,105,107,99,98,94,92,93,176,159,94,94,92,93,92,114,91,92,93,100
32551,"Tube thoracostomy, includes water seal (eg, for abscess, hemothorax, empyema), when performed (separate procedure)",550,495,102,523,522,295,518,274,280,280,287,280,206,208,281,270,102,513,255,267,522,280,324,368,313,319,282,290,250,275,276,523,472,280,280,275,276,274,339,312,275,276,297
32554,HC ASPIRATE PLEURA W/O IMAGING,267,240,49,254,254,143,251,134,136,136,139,136,100,101,136,131,49,249,124,130,254,136,157,179,152,155,137,141,127,134,134,254,229,136,136,134,134,133,165,151,133,134,144
32555,PR ASPIRATE PLEURA W/ IMAGING,1030,927,190,979,978,552,970,513,525,525,538,525,385,389,525,505,190,961,477,500,978,525,607,690,586,597,529,544,489,515,516,979,884,525,525,515,516,513,636,584,515,517,556
36410,"Venipuncture, age 3 years or older, necessitating physician's skill (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)",153,138,9,145,145,9,144,76,78,78,80,78,57,58,78,75,28,143,71,74,145,78,90,102,87,89,79,81,78,76,77,145,131,78,78,76,77,76,94,87,76,77,83
36415,Collection of venous blood by venipuncture,28,25,5,430,27,14,27,14,14,14,15,14,42,46,14,14,5,27,14,13,27,14,16,19,11,19,15,15,16,14,14,27,430,14,14,14,14,14,18,14,14,14,15
36416,"Collection of capillary blood specimen (eg, finger, heel, ear stick)",17,15,3,16,16,9,16,8,9,9,9,9,12,12,9,8,3,16,8,8,16,9,10,11,10,10,9,9,9,8,9,16,15,9,9,8,9,8,10,13,8,9,9
36430,"Transfusion, blood or blood components",633,570,117,1444,601,316,596,315,323,323,342,323,1444,239,323,310,117,590,293,312,601,323,373,424,360,367,325,334,354,316,317,601,543,323,323,316,204,315,391,633,316,317,342
36556,Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older,1200,1080,222,1140,1140,643,1130,600,612,612,627,612,449,454,612,589,222,1119,556,582,1140,612,707,804,683,695,616,634,612,600,601,1140,1030,612,612,600,601,598,741,680,600,602,648
36591,Collection of blood specimen from a completely implantable venous access device,205,184,38,387,195,98,193,102,104,105,111,105,387,77,105,101,38,105,95,98,195,105,121,137,117,119,110,108,115,102,103,195,176,105,105,102,103,102,127,160,102,103,111
36592,"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified",205,184,38,195,195,110,193,102,104,105,107,105,77,77,105,101,38,191,95,99,195,105,121,137,117,119,110,108,101,102,103,195,176,105,105,102,103,102,127,102,102,103,111
36600,"Arterial puncture, withdrawal of blood for diagnosis",60,54,11,57,57,32,56,30,31,31,32,31,22,23,31,29,11,56,28,29,57,31,35,40,34,35,32,32,34,30,30,57,51,31,31,30,30,30,37,34,30,30,32
38531,PR OPEN BX/EXC INGUINOFEM NODES,4655,4190,861,6431,4422,2495,4383,2319,2373,2374,2431,2374,6431,1759,2374,2283,861,4341,2155,2258,4422,2374,2744,3117,2651,2698,2389,2458,2607,2328,2333,4422,3995,2373,2374,2328,2332,2319,2873,2639,2327,2335,2514
41520,"Frenoplasty (surgical revision of frenum, eg, with Z-plasty)",2630,2367,486,2499,2498,1410,2476,1310,1340,1341,1420,1341,984,994,1341,1290,486,2453,1218,1276,2498,1341,1550,1761,1498,1524,1350,1389,1382,1315,1318,2499,2257,1341,1341,1315,1318,1310,1623,1491,1315,1319,1420
42408,Excision of sublingual salivary cyst (ranula),3340,3006,618,3674,3173,1790,3145,1664,1702,1703,1744,1703,3674,1262,1703,1638,618,3115,1546,1620,3173,1703,1968,2236,1902,1936,1714,1763,1755,1670,1674,3173,2867,1703,1703,1670,1673,1664,2061,1893,1669,1675,1804
42820,Tonsillectomy and adenoidectomy; younger than age 12,3339,3005,617,3638,3172,1790,3144,1663,1702,1703,1803,1703,3638,1262,1703,1638,617,3114,1546,1620,3172,1703,1968,2236,1901,1935,1714,1763,1755,1670,1674,3172,2866,1702,1703,1670,1673,1664,2061,1893,1669,1675,1803
42826,"Tonsillectomy, primary or secondary; age 12 or over",2985,2686,552,3463,2836,1600,2810,1487,1521,1522,1559,1522,3463,1128,1522,1464,552,2784,1382,1448,2836,1522,1759,1999,1700,1730,1532,1576,1569,1492,1496,2836,2562,1522,1522,1492,1496,1487,1842,1692,1492,1497,1612
42830,"Adenoidectomy, primary; younger than age 12",2806,2526,519,2666,2666,1504,2642,1398,1430,1431,1420,1431,1905,1061,1431,1377,519,2617,1299,1361,2666,1431,1654,1879,1598,1627,1440,1482,1475,1403,1407,2666,2409,1431,1431,1403,1406,1398,1732,1591,1403,1408,1516
42831,"Adenoidectomy, primary; age 12 or over",1,1,0,1,1,1,1,0,1,1,0,1,0,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
43220,"Esophagoscopy, rigid or flexible; with balloon dilation (less than 30 mm diameter)",3685,3316,681,3501,3501,1975,3470,1836,1878,1879,1924,1879,1379,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1891,1946,1879,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,2089,1842,1848,1990
43235,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)",3685,3316,681,3501,3501,1975,3470,1836,1878,1879,1916,1879,1045,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1978,1946,1820,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,1842,1842,1848,1990
43239,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple",3685,3316,1,3501,3501,3501,3470,1842,1878,1879,1990,1879,1168,1168,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1978,1,2064,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,1842,1842,1848,1990
43247,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of foreign body",1843,1659,341,1751,1751,988,1735,918,939,940,962,940,1595,697,940,904,341,1719,853,894,1751,940,1086,1234,1049,1068,946,973,969,922,924,1751,1582,940,940,922,923,918,1137,1045,921,924,995
43249,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with balloon dilation of esophagus (less than 30 mm diameter)",3685,3316,1,3501,3501,1975,3470,1836,1878,1879,1924,1879,2264,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1,1946,2064,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,2089,1842,1848,1990
43251,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",3685,3316,681,3501,3501,1975,3470,1836,1878,1879,1924,1879,2058,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1891,1946,1936,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,2089,1842,1848,1990
43752,"Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)",209,188,39,199,199,112,197,104,107,107,109,107,78,79,107,103,39,195,97,101,199,107,123,140,119,121,107,110,107,104,105,199,179,107,107,104,105,104,129,118,104,105,113
43753,"Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed",155,140,29,147,147,83,146,77,79,79,81,79,58,59,79,76,29,145,72,75,147,79,91,104,88,90,80,82,55,78,78,147,133,79,79,78,78,77,96,88,77,78,84
44970,"Laparoscopy, surgical, appendectomy",6585,5926,1217,9127,6256,3530,6200,3280,3356,3358,3888,3358,9127,9107,3358,3230,1217,6141,3049,3194,6256,3358,3881,4409,3750,3816,3379,3477,3460,3292,3301,6256,5652,3357,3358,3292,3299,3281,4064,4215,3291,3303,3556
45378,"Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure)",3685,3316,681,3501,3501,1616,3470,1836,1878,1879,2121,1879,2522,2579,1879,1834,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1978,1946,973,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,2320,1842,1848,1990
45380,"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple",3685,3316,571,3501,3501,2064,3501,2221,1878,1879,1990,1879,2293,2490,1879,1834,571,3437,1706,1788,3501,1879,2229,2468,2098,2136,2107,1989,2064,1842,1847,3501,3163,1879,1879,1842,1842,1836,2274,2074,1842,1848,1990
45384,"Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery",3928,3535,726,3731,3731,2105,3698,1956,2002,2003,2051,2003,2728,1484,2003,1926,726,3663,1818,1905,3731,2003,2315,2630,2236,2276,2016,2074,2003,1964,1969,3731,3371,2002,2003,1964,1968,1957,2424,2226,1963,1970,2121
45385,"Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",4170,3753,771,3962,3962,2074,3926,2328,2125,2127,2252,2127,2717,2858,2127,2045,771,3889,1931,2023,3962,2127,2458,2792,2374,2417,2237,2202,2127,2085,2090,3962,3579,2126,2127,2085,2089,2078,2574,2085,2084,2092,2252
46040,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure),5355,4820,990,5087,5087,2871,5042,2667,2729,2731,2797,2731,4572,2024,2731,2627,990,4994,2479,2598,5087,2731,3156,3586,3049,3104,2748,2827,2814,2678,2684,5087,4596,2730,2731,2678,2683,2668,3305,3035,2677,2686,2892
46200,"Fissurectomy, including sphincterotomy, when performed",800,720,148,760,760,429,753,398,408,408,418,408,299,302,408,392,148,746,370,388,760,408,471,536,456,464,411,422,345,400,401,760,687,408,408,400,401,399,494,453,400,401,432
46220,"Excision of single external papilla or tag, anus",1575,1418,291,1496,1496,844,1483,785,803,803,823,803,589,595,803,773,291,1469,729,764,1496,803,928,1055,897,913,808,832,828,788,789,1496,1352,803,803,788,789,785,972,788,787,790,850
46255,"Hemorrhoidectomy, internal and external, single column/group;",3685,3316,681,3501,3501,1842,3470,1836,1878,1879,1924,1879,1379,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1891,1946,1936,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,2089,1842,1848,1990
46260,"Hemorrhoidectomy, internal and external, 2 or more columns/groups;",2918,2626,539,2772,2772,1564,2747,1453,1487,1488,1524,1488,1091,1103,1488,1431,539,2721,1351,1415,2772,1488,1719,1954,1661,1691,1497,1540,1352,1459,1462,2772,2504,1487,1488,1459,1462,1454,1801,1654,1458,1463,1575
46320,"Excision of thrombosed hemorrhoid, external",4170,3753,771,3962,3962,2235,3926,2077,2125,2127,2514,2127,1560,1576,2127,2045,771,3889,1931,2023,3962,2127,2458,2792,2374,2417,2140,2202,1048,2085,2090,3962,3579,2126,2127,2085,2089,2078,2574,2364,2084,2092,2252
46614,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)",300,270,55,285,285,161,282,149,153,153,81,153,112,113,153,147,55,280,139,146,285,153,177,201,171,174,154,158,158,150,150,285,257,153,153,150,150,149,185,170,150,150,162
47379,"Unlisted laparoscopic procedure, liver",1,1,0,3276,1,1,1,0,1,1,1,1,3276,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
47562,"Laparoscopy, surgical; cholecystectomy",5970,5373,1104,8655,5672,4032,5621,2985,3043,3045,3224,3044,8655,2256,3045,4196,1104,5568,2764,2896,5672,3045,3984,3998,3399,3460,3204,3152,3343,2985,2992,5672,5124,3044,3045,2985,2985,2974,3685,4651,2984,2994,3224
47563,"Laparoscopy, surgical; cholecystectomy with cholangiography",7815,7034,1445,7424,7424,4189,7358,3893,3983,3986,4081,3985,2924,2954,3986,3833,1445,7288,3618,3791,7424,3986,4606,5233,4450,4529,4011,4126,4107,3908,3917,7424,6708,3984,3986,3908,3916,3894,4823,3751,3906,3920,4220
49083,PR ABD PARACENTESIS W/IMAGING,534,481,99,1233,507,286,503,266,272,272,279,272,1233,202,272,262,99,498,247,259,507,272,315,358,304,309,274,282,299,267,268,507,458,272,272,267,268,266,330,267,267,268,288
49505,"Repair initial inguinal hernia, age 5 years or older; reducible",5140,4626,950,6755,4883,2812,4840,2560,2620,2621,2684,2621,6755,1943,2621,2521,950,4794,2380,2493,4883,2621,3029,3442,2927,2979,3540,2714,2439,2570,2576,4883,4412,2621,2621,2570,2575,2561,3172,4004,2569,2578,2776
49520,"Repair recurrent inguinal hernia, any age; reducible",5140,4626,950,4883,4883,2755,4840,2560,2620,2621,2684,2621,1923,1943,2621,2521,950,4794,2380,2493,4883,2621,3029,3442,2927,2979,2638,2714,2878,2570,2576,4883,4412,2621,2621,2570,2575,2561,3172,4004,2569,2578,2776
49560,Repair initial incisional or ventral hernia; reducible,5624,5062,1040,5343,5343,3015,5296,2802,2867,2868,2513,2868,2104,2126,2869,2759,1040,5245,2604,2728,5343,2868,3315,3766,3203,3260,2886,2970,2956,2812,2819,5343,4828,2868,2868,2812,2818,2802,3471,3693,2811,2821,3037
49565,Repair recurrent incisional or ventral hernia; reducible,3270,2943,605,3107,3106,1753,3079,1629,1667,1668,1708,1668,1223,1236,1668,1604,605,3050,1514,1586,3106,1668,1927,2190,1862,1895,1678,1727,1615,1635,1639,3107,2807,1667,1668,1635,1638,1629,2018,1853,1634,1640,1766
49568,Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair),310,279,1,294,294,166,291,154,158,158,1,158,116,117,158,152,57,289,143,150,294,158,182,207,176,179,159,163,276,155,155,294,266,158,158,155,155,154,191,175,155,155,167
49585,"Repair umbilical hernia, age 5 years or older; reducible",4655,4190,861,5884,4422,2495,4383,2319,2373,2374,2431,2374,5884,1759,2374,2283,861,4341,2155,2258,4422,2374,2744,3117,2651,2698,2389,2458,2607,2328,2333,4422,3995,2373,2374,2328,2332,2319,2873,2871,2327,2335,2514
49587,"Repair umbilical hernia, age 5 years or older; incarcerated or strangulated",4655,4190,861,6149,4422,2495,4383,2319,2373,2374,2431,2374,6149,1759,2374,2283,861,4341,2155,2258,4422,2374,2744,3117,2651,2698,2389,2458,2446,2328,2333,4422,3995,2373,2374,2328,2332,2319,2873,2639,2327,2335,2514
49650,"Laparoscopy, surgical; repair initial inguinal hernia",7200,6480,1331,9107,6840,3860,6779,3456,3670,3672,3760,3672,9107,2721,3672,3532,1331,6715,3333,4046,6840,3672,4243,4821,4100,4173,3695,3801,3417,3600,3609,6840,6180,3671,3672,3600,3607,3587,4444,4081,3599,3611,3888
49652,"Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible",933,840,172,4554,886,500,878,465,476,476,487,476,4554,353,476,458,172,870,432,453,886,476,550,625,531,541,479,493,771,466,468,886,801,476,476,466,467,465,576,529,466,468,504
50590,"Lithotripsy, extracorporeal shock wave",6500,5850,1202,7797,6175,3484,6120,3238,3313,3315,3395,3315,7797,2457,3315,3188,1202,6062,3009,3153,6175,3315,3831,4352,3701,3767,3336,3432,4524,3250,3258,6175,5579,3314,3315,3250,3257,3238,4012,5803,3249,3260,3510
51102,Aspiration of bladder; with insertion of suprapubic catheter,225,202,42,214,214,121,212,112,115,115,118,115,84,85,115,110,42,210,104,109,214,115,133,151,128,130,115,119,126,112,113,214,193,115,115,112,113,112,139,128,112,113,122
51600,Injection procedure for cystography or voiding urethrocystography,126,113,23,1000,120,68,119,63,64,64,66,64,1000,48,64,62,23,118,58,61,120,64,74,84,72,73,65,67,66,63,63,120,108,64,64,63,63,63,78,63,63,63,68
51610,Injection procedure for retrograde urethrocystography,1,1,0,1,1,1,1,0,1,1,1,1,0,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
51700,"Bladder irrigation, simple, lavage and/or instillation",100,90,18,95,95,54,94,50,51,51,52,51,37,38,51,49,18,93,46,49,95,51,59,67,57,58,51,53,56,50,50,95,86,51,51,50,50,50,62,64,50,50,54
51701,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)",52,47,10,65,49,25,49,26,27,27,28,27,19,20,27,27,10,48,24,25,49,27,31,35,30,30,28,27,27,26,26,49,45,27,27,26,26,26,32,65,26,26,28
51702,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley)",52,47,10,49,49,42,49,26,27,27,28,27,19,20,27,26,10,48,24,25,49,27,31,35,30,30,28,27,29,26,26,49,45,27,27,26,26,26,32,26,26,26,28
51705,Change of cystostomy tube; simple,200,180,37,564,190,107,188,100,102,102,104,102,564,76,102,98,37,187,93,97,190,102,118,134,114,116,103,106,112,100,100,190,172,102,102,100,100,100,123,113,100,100,108
51720,Bladder instillation of anticarcinogenic agent (including retention time),200,180,37,190,190,107,188,100,102,102,104,102,75,76,102,98,37,187,93,97,190,102,118,134,114,116,103,106,112,100,100,190,172,102,102,100,100,100,123,113,100,100,108
51798,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging",103,93,19,98,98,55,97,51,52,53,28,53,39,39,53,51,19,96,48,50,98,53,61,69,59,60,55,54,58,52,52,98,88,53,53,52,52,51,64,52,51,52,56
52000,Cystourethroscopy (separate procedure),225,202,42,1857,214,1390,212,112,115,115,112,115,1857,85,115,110,42,210,104,109,214,115,133,151,128,130,121,114,126,112,113,214,193,115,115,112,112,112,139,151,112,113,122
52001,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots,5625,5062,1040,5344,5344,3015,5296,2802,2867,2869,2938,2869,2104,2126,2869,2759,1040,5246,2604,2729,5344,2869,3315,3767,3203,3260,2887,2970,2956,2812,2819,5344,4828,2868,2869,2812,2818,2803,3472,2812,2812,2821,3038
52240,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s)",5970,5373,1104,5672,5672,3200,5621,2974,3043,3045,3118,3044,2233,2256,3045,2928,1104,5568,2764,2896,5672,3045,3519,3998,3399,3460,3064,3152,3045,2985,2992,5672,5124,3044,3045,2985,2991,2974,3685,3384,2984,2994,3224
52287,PR CYSTOSCOPY CHEMODENERVATION,4170,3753,771,3962,3962,2235,3926,2077,2125,2127,2178,2127,1560,1576,2127,2045,771,3889,1931,2023,3962,2127,2458,2792,2374,2417,2140,2202,2191,2085,2090,3962,3579,2126,2127,2085,2089,2078,2574,2335,2084,2092,2252
52310,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple",3685,3316,681,3501,3501,1975,3470,1836,1878,1879,1924,1879,2413,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1891,1946,1879,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,2089,1842,1848,1990
52332,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)",2086,1877,1,3748,1981,1118,1964,1039,1063,1064,1089,1064,1327,788,1064,1023,386,1945,966,1012,1981,1064,1229,1396,1187,1209,3748,1101,1096,1043,1045,1981,1790,1063,1064,1043,1045,1039,1287,1,1042,1046,1126
52351,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic",1,1,0,1,1,1,1,0,1,1,1,1,0,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
52353,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)",4655,4190,861,6838,4422,2495,4383,2319,2373,2374,2431,2374,6838,1759,2374,2283,861,4341,2155,2258,4422,2374,2744,3117,2651,2698,2389,2458,2446,2328,2333,4422,3995,2373,2374,2328,2332,2319,2873,2639,2327,2335,2514
52601,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)",7508,6757,1388,7132,7132,3908,7069,3740,3826,3829,3921,3829,2809,2838,3829,3682,1388,7002,3476,3642,7132,3829,4425,5027,4275,4351,3853,3964,3945,3754,3763,7132,6444,3828,3829,3754,3761,3740,4633,3600,3753,3766,4054
54161,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age",3340,3006,618,3173,3173,1790,3145,1664,1702,1703,1744,1703,1250,1262,1703,1638,618,3115,1546,1620,3173,1703,1968,2236,1902,1936,1714,1763,1870,1670,1674,3173,2867,1703,1703,1670,1673,1664,2061,1893,1669,1675,1804
55700,"Biopsy, prostate; needle or punch, single or multiple, any approach",1575,1418,291,3390,1496,844,1483,785,803,803,823,803,3390,595,803,773,291,1469,729,764,1496,803,928,1055,897,913,808,832,881,788,789,1496,1352,803,803,788,789,785,972,893,787,790,850
56405,Incision and drainage of vulva or perineal abscess,201,181,37,191,191,108,189,100,102,103,105,103,75,76,103,99,37,187,93,98,191,103,118,135,114,116,103,106,106,100,101,191,173,102,103,100,101,100,124,157,100,101,109
57288,"Sling operation for stress incontinence (eg, fascia or synthetic)",5140,4626,950,4883,4883,2755,4840,2560,2620,2621,2684,2621,1923,1943,2621,2521,950,4794,2380,2493,4883,2621,3029,3442,2927,2979,2638,2714,2621,2570,2576,4883,4412,2621,2621,2570,2575,2561,3172,2913,2569,2578,2776
58558,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",2497,2247,462,2372,2372,1339,2351,1244,1273,1273,1304,1273,934,944,1273,1225,462,2329,1156,1211,2372,1273,1472,1672,1422,1447,1281,1318,1111,1248,1252,2372,2143,1273,1273,1248,1251,1244,1541,1415,1248,1252,1348
58563,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)",4412,3971,816,5216,4191,2365,4154,2198,2249,2250,2304,2250,5216,1668,2250,2164,816,4115,2043,2140,4191,2250,2600,2954,2512,2557,2264,2329,2319,2206,2211,4191,3787,2249,2250,2206,2211,2198,2723,2501,2205,2213,2382
58600,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral",5355,4820,990,5087,5087,2871,5042,2667,2729,2731,2797,2731,2003,2024,2731,2627,990,4994,2479,2598,5087,2731,3156,3586,3049,3104,2874,2827,2814,2678,2684,5087,4596,2730,2731,2678,2683,2668,3305,3035,2677,2686,2892
58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",5970,5373,1104,8297,5672,3200,5621,2974,3043,3045,3118,3044,8297,2256,3045,2928,1104,5568,2764,2896,5672,3045,3519,3998,3399,3460,3064,3152,3137,2985,2992,5672,5124,3044,3045,2985,2991,2974,3685,3384,2984,2994,3224
58662,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method",3600,3240,666,7917,3420,1930,3390,1793,1835,1836,1880,1836,7917,1361,1836,1766,666,3358,1667,1747,3420,1836,2122,2411,2050,2087,1848,1901,3672,1800,1805,3420,3090,1836,1836,1800,1804,1794,2222,2041,1800,1806,1944
59025,Fetal non-stress test,296,266,55,533,281,159,279,147,151,151,160,151,485,533,151,145,55,276,137,144,281,151,174,198,169,172,159,156,156,148,148,281,254,151,151,148,148,147,183,168,148,148,160
59409,Vaginal delivery only (with or without episiotomy and/or forceps);,1800,1620,333,1710,1710,965,1695,897,917,918,486,918,673,680,918,883,333,1679,833,873,1710,918,1061,1205,1025,1043,924,950,946,900,902,1710,1545,918,918,900,902,897,1111,1020,900,903,972
59812,"Treatment of incomplete abortion, any trimester, completed surgically",950,855,176,2963,902,509,894,473,484,484,496,484,2963,359,485,466,176,886,440,461,902,484,560,636,541,551,488,502,499,475,476,903,815,484,484,475,476,473,586,538,475,477,513
62270,"Spinal puncture, lumbar, diagnostic",550,495,102,1352,522,295,518,274,280,280,287,280,1352,208,281,270,102,513,255,267,522,280,324,368,313,319,282,290,261,275,276,523,472,280,280,275,276,274,339,312,275,276,297
62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,1575,1418,291,1496,1496,844,1483,785,803,803,850,803,1487,595,803,753,291,1469,729,433,1496,803,928,1055,897,913,845,832,768,788,789,1496,1352,803,803,788,789,785,972,1054,456,790,850
64445,"Injection, anesthetic agent; sciatic nerve, single",975,878,180,926,926,523,918,486,497,497,509,497,365,369,497,478,180,909,451,473,926,497,575,653,555,565,500,515,463,488,489,926,837,497,497,488,489,486,602,553,487,489,526
64447,"Injection, anesthetic agent; femoral nerve, single",975,878,180,926,926,523,918,486,497,497,509,497,365,369,497,478,180,909,451,473,926,497,575,653,555,565,500,515,463,488,489,926,837,497,497,488,489,486,602,553,487,489,526
64450,"Injection, anesthetic agent; other peripheral nerve or branch",350,315,65,637,332,188,330,174,178,178,183,178,637,132,179,172,65,326,162,170,332,178,206,234,199,203,180,185,184,175,175,333,300,178,178,175,175,174,216,198,175,176,189
64520,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)",2808,2527,519,2668,2668,1505,2644,1399,1431,1432,2274,1432,1050,1061,1432,1377,519,2619,1300,1362,2668,1432,1655,1880,1599,1627,1441,1483,1476,1404,1407,2668,2410,1432,1432,1404,1407,1399,1733,1592,1404,1408,1516
64718,Neuroplasty and/or transposition; ulnar nerve at elbow,5139,4625,950,4882,4882,2878,4839,2560,2619,2621,2684,2621,1923,1942,2621,2521,950,4793,2379,2493,4882,2621,3029,3441,2926,2978,2758,2713,1870,2570,2576,4882,4411,2620,2621,2570,2575,2560,3172,2913,2569,2578,2775
64721,Neuroplasty and/or transposition; median nerve at carpal tunnel,4169,3752,771,3961,3961,2074,3925,2077,2125,2126,2252,2126,3272,1576,2126,2076,771,3888,1930,2022,3961,2126,2457,2792,2374,2416,1978,2201,2095,2084,2090,3961,3578,2125,2126,2084,2089,2077,2573,1842,2084,2091,2251
64727,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis)",1,1,0,9734,1,1,1,0,1,1,0,1,9734,0,1,0,0,1,0,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,0,1,0,1,1,0,1,1
64782,"Excision of neuroma; hand or foot, except digital nerve",3340,3006,618,3272,3173,1790,3145,1664,1702,1703,1744,1703,3272,1262,1703,1638,618,3115,1546,1620,3173,1703,1968,2236,1902,1936,1714,1763,1755,1670,1674,3173,2867,1703,1703,1670,1673,1664,2061,1893,1669,1675,1804
64788,Excision of neurofibroma or neurolemmoma; cutaneous nerve,3512,3161,649,3337,3337,1883,3307,1750,1790,1791,1703,1791,1314,1328,1791,1723,649,3276,1626,1704,3337,1791,2070,2352,2000,2036,1803,1855,1846,1756,1761,3337,3015,1791,1791,1756,1760,1750,2168,1769,1756,1762,1897
65205,"Removal of foreign body, external eye; conjunctival superficial",117,105,22,111,111,63,110,58,60,60,61,60,44,44,60,57,22,109,54,57,111,60,69,78,67,68,60,62,53,58,59,111,100,60,60,58,59,58,72,66,58,59,63
65220,"Removal of foreign body, external eye; corneal, without slit lamp",84,76,16,80,80,45,79,42,43,43,45,43,31,32,43,41,16,78,39,41,80,43,50,56,48,49,43,44,44,42,42,80,72,43,43,42,42,42,52,48,42,42,45
65222,"Removal of foreign body, external eye; corneal, with slit lamp",600,540,111,570,570,322,565,299,306,306,324,306,224,227,306,294,111,560,278,291,570,306,354,402,342,348,322,317,315,300,301,570,515,306,306,300,301,299,370,340,300,301,324
66982,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage",3685,3316,681,3600,3501,1842,3470,1836,1878,1879,1924,1879,3046,1393,1879,1807,681,3437,2871,1788,3501,1879,2172,2468,3600,2136,1891,1946,2064,1842,1847,3501,3163,1879,1879,1842,1846,1842,2274,2064,1842,1848,1990
66984,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification)",3685,3316,681,4472,3501,2064,3470,1842,1879,1879,1990,1879,4472,1393,1879,1807,681,3437,1706,1769,3501,1879,2172,2468,3251,2136,1974,1946,2064,1842,1879,3501,3163,1879,1879,1842,1842,1836,2274,1842,1842,1848,1990
67700,"Blepharotomy, drainage of abscess, eyelid",300,270,55,285,285,161,282,149,153,153,81,153,112,113,153,147,55,280,139,146,285,153,177,201,171,174,154,158,158,150,150,285,257,153,153,150,150,149,185,170,150,150,162
69200,Removal foreign body from external auditory canal; without general anesthesia,150,135,28,143,142,84,141,75,76,76,78,76,56,57,77,74,28,140,69,73,142,76,88,100,85,87,80,79,79,75,75,143,129,76,76,75,75,75,93,85,75,75,81
69210,"Removal impacted cerumen (separate procedure), 1 or both ears",113,102,21,107,107,61,106,56,58,58,59,58,42,43,58,55,21,105,52,55,107,58,67,76,64,65,58,60,57,56,57,107,97,58,58,56,57,56,70,64,56,57,61
69436,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia",1316,1184,243,4419,1250,705,1239,655,670,671,2130,671,4419,497,671,645,243,1227,609,638,1250,671,775,881,749,762,675,695,691,658,659,1250,1129,671,671,658,659,655,812,746,658,660,710
70030,"Radiologic examination, eye, for detection of foreign body",131,118,24,124,124,66,123,65,67,67,71,67,60,50,67,64,24,122,61,63,124,67,77,88,75,76,70,69,73,66,66,124,112,67,67,66,66,65,81,66,65,66,71
70110,"Radiologic examination, mandible; complete, minimum of 4 views",300,270,55,285,285,161,282,149,153,153,78,153,112,113,153,147,55,280,139,146,285,153,177,201,171,174,154,158,158,150,150,285,257,153,153,150,150,149,185,170,150,150,162
70140,"Radiologic examination, facial bones; less than 3 views",162,146,30,154,154,87,153,81,83,83,87,83,61,61,83,79,30,151,75,79,154,83,95,108,92,94,83,86,85,81,81,154,139,83,83,81,81,81,100,91,81,81,87
70150,"Radiologic examination, facial bones; complete, minimum of 3 views",255,230,47,242,242,137,240,127,130,130,138,130,60,96,130,125,47,238,118,124,242,130,150,171,145,148,68,138,128,128,128,242,219,130,130,128,128,127,157,145,127,128,138
70160,"Radiologic examination, nasal bones, complete, minimum of 3 views",200,180,37,190,190,107,188,100,102,102,108,102,75,76,102,98,37,187,93,97,190,102,118,134,114,116,107,106,102,100,100,190,172,102,102,100,100,100,123,128,100,100,108
70210,"Radiologic examination, sinuses, paranasal, less than 3 views",130,117,24,124,124,70,122,65,66,66,68,66,49,49,66,64,24,121,60,63,124,66,77,87,74,75,67,69,68,65,65,124,112,66,66,65,65,65,80,65,65,65,70
70250,"Radiologic examination, skull; less than 4 views",192,173,35,182,182,103,181,96,98,98,104,98,68,73,98,94,35,179,89,93,182,98,113,129,109,111,99,101,101,96,96,182,165,98,98,96,96,96,118,109,96,96,104
70330,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral",400,360,60,380,380,214,377,199,204,204,216,204,60,151,204,196,74,373,185,194,380,204,236,268,228,232,205,211,190,200,200,380,343,204,204,200,200,199,247,227,200,201,216
70360,"Radiologic examination; neck, soft tissue",168,151,31,160,160,90,158,84,86,86,91,86,60,63,86,82,31,157,78,81,160,86,99,112,96,97,84,89,86,84,84,160,144,86,86,84,84,84,104,94,84,84,91
70450,"Computed tomography, head or brain; without contrast material",1580,1422,107,1501,1501,790,1488,790,806,806,853,806,1042,1146,806,755,107,1501,732,758,1501,806,956,1058,633,916,848,980,885,790,806,1501,1356,806,806,790,790,787,975,790,790,806,853
70460,"Computed tomography, head or brain; with contrast material(s)",1700,1530,314,1615,1615,911,1601,847,866,867,888,867,636,643,867,834,314,1585,787,825,1615,867,1002,1138,968,985,912,898,893,850,852,1615,1459,867,867,850,852,847,1049,964,850,853,918
70470,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections",2000,1800,370,1900,1900,1072,1883,996,1019,1020,1080,1020,993,756,1020,956,370,1865,926,970,1900,1020,1179,1339,1139,1159,1036,1056,1120,1000,1002,1900,1717,1020,1020,1000,1002,996,1234,960,1000,1003,1080
70480,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material",1450,1305,268,1378,1378,777,1365,722,739,740,757,739,436,548,740,711,268,1352,671,703,1378,740,855,971,826,840,744,766,762,725,727,1378,1245,739,739,725,726,722,895,822,725,727,783
70481,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)",1700,1530,314,1615,1615,911,1601,847,866,867,888,867,636,643,867,834,314,1585,787,825,1615,867,1002,1138,968,985,872,898,952,850,852,1615,1459,867,867,850,852,847,1049,964,850,853,918
70482,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections",1880,1692,348,1786,1786,1008,1770,936,958,959,982,959,703,711,959,922,348,1753,870,912,1786,959,1108,1259,1070,1090,965,993,1053,940,942,1786,1614,958,959,940,942,937,1160,1066,940,943,1015
70486,"Computed tomography, maxillofacial area; without contrast material",1800,1620,264,1710,1710,954,1695,897,917,918,972,918,480,264,918,883,333,1679,833,873,1710,918,990,1205,563,1043,966,950,1008,900,902,1710,1545,918,918,900,902,897,1111,900,900,903,972
70487,"Computed tomography, maxillofacial area; with contrast material(s)",2000,1800,370,1900,1900,1072,1883,996,1019,1020,1080,1020,1083,756,1020,981,370,1865,926,970,1900,1020,1179,1339,1139,1159,1073,1056,949,1000,1002,1900,1717,1020,1020,1000,1002,996,1234,1134,1000,1003,1080
70488,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections",1880,1692,348,1786,1786,1786,1770,936,958,959,982,959,703,711,959,922,348,1753,870,912,1786,959,1108,1259,1070,1090,1007,993,959,940,942,1786,1614,958,959,940,942,937,1160,1066,940,943,1015
70490,"Computed tomography, soft tissue neck; without contrast material",1500,1350,277,1425,1425,804,1412,747,765,765,405,765,480,567,765,736,277,1399,694,728,1425,765,884,1004,854,869,403,792,840,750,752,1425,1287,765,765,750,752,747,926,795,750,752,810
70491,"Computed tomography, soft tissue neck; with contrast material(s)",1700,1530,314,1615,1615,850,1601,847,866,867,918,867,1146,643,867,834,314,1585,787,825,1615,867,1002,1138,968,985,911,898,952,850,852,1615,1459,867,867,850,852,847,1049,866,850,853,918
70492,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections",1800,1620,333,1710,1710,1008,1695,897,917,918,940,918,1042,680,918,883,333,1679,833,873,1710,918,1061,1205,1025,1043,924,950,918,900,902,1710,1545,918,918,900,902,897,1111,900,900,903,972
70496,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2400,2160,444,2280,2280,1287,2260,1195,1223,1224,1296,1224,567,907,1224,1148,444,2238,1111,1164,2280,1224,1414,1607,1367,1391,1286,1267,1344,1200,1203,2280,2060,1224,1224,1200,1202,1196,1481,1607,1200,1204,1296
70498,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2200,1980,355,2090,2090,1179,2071,1096,1121,1122,1188,1122,355,832,1122,1052,407,2052,1019,1067,2090,1122,1297,1473,1253,1275,1129,1162,1232,1100,1103,2090,1888,1122,1122,1100,1102,1096,1358,1232,1100,1103,1188
70542,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)",2400,2160,444,2280,2280,1287,2260,1195,1223,1224,1296,1224,898,907,1224,1177,444,2238,1111,1164,2280,1224,1414,1607,1367,1391,1232,1267,1261,1200,1203,2280,2060,1224,1224,1200,1202,1196,1481,1360,1200,1204,1296
70543,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences",3361,3025,621,3193,3193,1802,3165,1674,1713,1714,1815,1714,1257,1270,1714,1649,621,3134,1556,1630,3193,1714,1981,2251,1914,1948,1725,1775,1766,1680,1685,3193,2885,1714,1714,1680,1684,1675,2074,1905,1680,1686,1815
70544,"Magnetic resonance angiography, head; without contrast material(s)",2300,2070,425,2185,2185,1233,2166,1146,1172,1173,1201,1173,743,869,1173,1128,425,2145,1065,1116,2185,1173,1356,1540,1310,1333,1180,1214,1209,1150,1153,2185,1974,1173,1173,1150,1152,1146,1420,1304,1150,1154,1242
70551,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material",2500,2250,462,2375,2375,1250,2354,1245,1274,1275,1350,1275,1082,945,1275,1226,462,2332,1157,1213,2375,1275,1473,1674,1424,1449,1342,1320,1400,1250,1253,2375,2146,1275,1275,1250,1250,1246,1543,1250,1250,1254,1350
70552,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)",2650,2385,490,2518,2518,1421,2495,1320,1351,1352,1384,1351,1357,1002,1352,1300,490,2471,1227,1286,2518,1352,1562,1774,1509,1536,1422,1399,1393,1325,1328,2518,2275,1351,1351,1325,1328,1320,1636,2064,1325,1329,1431
70553,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences",4000,3600,740,4083,3800,2000,3766,1992,2039,2040,2160,2040,1295,1512,2040,1962,740,3730,1852,1940,3800,2040,2357,2678,2278,2318,2147,2112,2240,2000,2005,3800,4083,2039,2040,2000,2004,1993,2469,2120,1999,2006,2160
71045,PR X-RAY EXAM CHEST 1 VIEW,156,140,29,148,148,78,147,78,80,80,84,80,80,59,80,80,29,145,80,75,148,80,86,104,89,90,84,74,87,78,78,148,134,80,80,78,78,78,96,87,78,78,84
71046,PR X-RAY EXAM CHEST 2 VIEWS,212,191,13,201,201,106,201,104,108,108,114,108,65,65,108,106,30,201,108,102,201,108,128,142,13,123,114,114,119,106,108,201,201,108,108,106,106,106,106,106,108,108,114
71048,PR X-RAY EXAM CHEST 4+ VIEWS,400,360,74,380,380,214,377,199,204,204,222,204,150,151,204,196,74,373,185,194,380,204,236,268,228,232,205,211,210,200,200,380,343,204,204,200,200,199,247,227,200,201,216
71100,"Radiologic examination, ribs, unilateral; 2 views",246,221,33,234,234,234,232,123,125,125,133,125,60,65,125,121,33,229,114,119,234,125,145,165,140,143,132,130,138,123,123,234,211,125,125,123,123,123,152,123,123,123,133
71101,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views",252,227,47,239,239,183,237,126,128,129,165,129,65,68,129,124,47,235,117,121,239,129,149,169,143,146,145,133,126,126,126,239,216,128,129,126,126,126,156,126,126,126,136
71110,"Radiologic examination, ribs, bilateral; 3 views",252,227,47,239,239,126,237,126,128,129,68,129,60,95,129,124,47,239,117,122,239,129,149,169,143,146,129,133,141,126,126,239,216,128,129,126,126,126,156,123,126,126,136
71111,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views",283,255,48,269,269,152,266,141,144,144,153,144,106,107,144,139,48,264,131,137,269,144,167,189,161,164,145,149,149,142,142,269,243,144,144,142,142,141,175,160,141,142,153
71120,"Radiologic examination; sternum, minimum of 2 views",212,191,39,201,201,114,200,106,108,108,114,108,68,51,108,104,39,198,98,103,201,108,125,142,121,123,109,112,111,106,106,201,182,108,108,106,106,106,131,120,106,106,114
71250,"Computed tomography, thorax; without contrast material",1800,1620,333,1710,1710,1008,918,897,917,918,972,918,529,680,918,896,333,1679,833,873,1710,918,1061,1205,868,1043,966,972,1008,900,902,1710,1710,918,918,900,902,897,1111,900,900,903,972
71260,"Computed tomography, thorax; with contrast material(s)",2000,1800,370,4120,1900,1000,1883,996,1019,1020,1080,1020,1146,756,1020,981,370,1865,926,970,1900,1020,1179,1339,1960,1159,1072,1080,1120,1000,1002,1900,4120,1020,1020,1000,1002,996,1234,1000,1000,1003,1080
71270,"Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections",2000,1800,370,1900,1900,1072,1883,996,1019,1020,1044,1020,1042,392,1020,981,370,1865,926,970,1900,1020,1179,1339,1139,1159,1036,1056,949,1000,1002,1900,1717,1020,1020,1000,1002,996,1234,1000,1000,1003,1080
71271,HC CT THORAX LUNG CANCER SCREEN,600,540,111,570,570,300,565,299,306,306,313,306,399,227,306,294,111,560,278,291,570,306,354,402,342,348,308,317,336,300,301,570,515,306,306,300,301,299,370,318,300,301,324
71275,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing",2435,2192,450,2313,2313,1218,2293,1218,1241,1242,1315,1242,709,749,1242,1194,450,2271,1127,1169,2313,1242,1435,1630,1387,1411,1307,1286,1364,1218,1221,2313,2090,1241,1242,1218,1220,1213,1503,1218,1217,1221,1315
72040,"Radiologic examination, spine, cervical; 2 or 3 views",220,198,41,209,209,110,207,110,112,112,119,112,65,65,112,105,41,205,102,106,209,112,133,147,112,128,118,116,123,110,110,209,189,112,112,110,110,110,136,110,110,110,119
72050,"Radiologic examination, spine, cervical; minimum of 4 views",336,302,60,331,319,161,316,167,171,171,181,171,60,68,171,161,62,313,156,163,319,171,198,225,331,195,168,181,171,168,168,319,319,171,171,168,168,167,207,188,168,169,181
72052,"Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension studies",400,360,74,380,380,214,377,199,204,204,209,204,150,151,204,196,74,373,185,194,380,204,236,268,228,232,215,211,210,200,200,380,343,204,204,200,200,199,247,227,200,201,216
72070,"Radiologic examination, spine; thoracic, 2 views",161,145,30,153,153,80,152,80,82,82,87,82,48,61,82,79,30,150,75,77,153,82,95,108,92,93,86,85,90,80,81,153,138,82,82,80,81,80,99,80,80,81,87
72072,"Radiologic examination, spine; thoracic, 3 views",271,244,50,264,257,196,255,135,138,138,146,138,65,102,138,133,50,253,125,131,257,138,160,181,264,157,145,146,152,136,136,257,233,138,138,136,136,136,167,136,135,136,146
72082,PR X-RAY EXAM ENTIRE SPINE 2/3 VW,350,315,59,333,332,188,330,174,178,178,182,178,59,68,179,172,65,326,162,170,332,178,206,234,199,203,175,185,178,175,175,333,300,178,178,175,175,174,216,198,175,176,189
72100,"Radiologic examination, spine, lumbosacral; 2 or 3 views",279,251,52,265,265,140,263,139,142,142,151,142,60,65,142,145,52,265,129,134,265,142,164,187,255,162,150,140,156,140,140,265,265,142,142,140,140,139,172,140,139,140,151
72110,"Radiologic examination, spine, lumbosacral; minimum of 4 views",299,269,55,284,284,160,282,149,152,152,161,152,68,113,152,147,55,279,138,145,284,152,176,200,170,173,160,158,152,150,150,284,257,152,152,150,150,149,185,169,149,150,161
72114,"Radiologic examination, spine, lumbosacral; complete, including bending views",376,338,67,357,357,202,354,187,192,192,196,192,67,142,192,184,70,351,174,182,357,192,222,252,214,218,193,199,211,188,188,357,323,192,192,188,188,187,232,213,188,189,203
72125,"Computed tomography, cervical spine; without contrast material",1900,1710,240,1805,1805,950,1789,946,968,969,1026,969,240,690,969,908,351,1772,880,922,1805,969,1150,1272,1297,1101,510,1178,1064,950,952,1805,1631,969,969,950,952,947,1173,950,950,953,1026
72128,"Computed tomography, thoracic spine; without contrast material",1600,1440,296,1520,1520,858,1506,797,815,816,864,816,396,605,816,785,296,1492,741,776,1520,816,943,1071,911,927,429,845,759,800,802,1520,1373,816,816,800,802,797,987,768,800,803,864
72131,"Computed tomography, lumbar spine; without contrast material",2000,1800,370,1900,1900,1000,1883,996,1019,1020,540,1020,480,756,1020,981,370,1865,926,970,1900,1020,1179,1339,1139,1159,537,1056,1120,1000,1002,1900,1717,1020,1020,1000,1002,996,1234,1120,1000,1003,1080
72132,"Computed tomography, lumbar spine; with contrast material",1800,1620,333,1710,1710,965,1695,897,917,918,940,918,673,680,918,883,333,1679,833,873,1710,918,1061,1205,1025,1043,924,950,918,900,902,1710,1545,918,918,900,902,897,1111,1020,900,903,972
72141,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material",2400,2160,444,2280,2280,1344,2260,1195,1223,1224,1296,1224,1082,907,1224,1177,444,2238,1111,1164,2280,1224,1414,1607,1367,1391,1288,1296,1344,1200,1203,2280,2280,1224,1224,1200,1202,1196,1481,1200,1200,1204,1296
72146,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material",2200,1980,407,2090,2090,1232,2071,1096,1121,1122,1188,1122,1082,832,1122,1079,407,2052,1019,1067,2090,1122,1297,1473,1253,1275,1181,1162,1232,1100,1103,2090,1888,1122,1122,1100,1102,1096,1358,1056,1100,1103,1188
72148,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material",2500,2250,462,2375,2375,1812,2354,1245,1274,1275,1350,1275,983,945,1275,1226,462,2332,1157,1213,2375,1275,1512,1674,1200,1449,1342,1320,1400,1250,1253,2375,2146,1275,1275,1250,1253,1246,1543,1250,1250,1254,1350
72156,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical",3361,3025,621,3193,3193,1802,3165,1674,1713,1714,1580,1714,1257,1270,1714,1649,621,3134,1556,1630,3193,1714,1981,2251,1914,1948,1725,1775,1766,1680,1685,3193,2885,1714,1714,1680,1684,1675,2074,1680,1680,1686,1815
72157,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic",3361,3025,621,3193,3193,1680,3165,1674,1713,1714,1755,1714,1257,1270,1714,1649,621,3134,1556,1630,3193,1714,1981,2251,1914,1948,1725,1775,1766,1680,1685,3193,2885,1714,1714,1680,1684,1675,2074,1905,1680,1686,1815
72158,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar",3550,3195,656,3373,3372,1903,3342,1768,1809,1810,1917,1810,1357,1342,1811,1741,656,3311,1644,1722,3372,1810,2092,2377,2021,2057,1775,1874,1988,1775,1779,3373,3047,1810,1810,1775,1779,1769,2191,1775,1774,1781,1917
72170,"Radiologic examination, pelvis; 1 or 2 views",157,141,29,149,149,78,148,78,80,80,64,80,49,59,80,77,29,146,73,75,149,80,93,105,89,91,76,83,84,78,79,149,135,80,80,78,79,78,97,122,78,79,85
72190,"Radiologic examination, pelvis; complete, minimum of 3 views",237,213,30,225,225,127,223,118,121,121,124,121,30,90,121,116,44,221,110,115,225,121,140,159,135,137,122,125,114,118,119,225,203,121,121,118,119,118,146,134,118,119,128
72191,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2500,2250,462,2375,2375,1340,2354,1245,1274,1275,675,1275,935,945,1275,1226,462,2332,1157,1213,2375,1275,1473,1674,1424,1449,1283,1320,1314,1250,1253,2375,2146,1275,1275,1250,1253,1246,1543,1417,1250,1254,1350
72192,"Computed tomography, pelvis; without contrast material",1520,1368,281,1444,1444,851,1431,757,775,775,790,775,480,575,775,746,281,1418,704,737,1444,775,896,1018,1193,881,408,803,851,760,762,1444,1305,775,775,760,762,757,938,806,760,762,821
72193,"Computed tomography, pelvis; with contrast material(s)",1800,1620,333,1710,1710,965,1695,897,917,918,940,918,902,680,918,883,333,1679,833,873,1710,918,1061,1205,1025,1043,966,950,946,900,902,1710,1545,918,918,900,902,897,1111,1151,900,903,972
72196,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)",2442,2198,451,2320,2320,1309,2299,1216,1245,1245,1275,1245,914,923,1245,1198,451,2277,1131,1185,2320,1245,1439,1635,1390,1415,1221,1289,1283,1221,1224,2320,2096,1245,1245,1221,1224,1217,1507,1384,1221,1225,1319
72197,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences",3361,3025,621,3193,3193,1802,3165,1674,1713,1714,1755,1714,1257,1270,1714,1649,621,3134,1556,1630,3193,1714,1981,2251,1914,1948,1680,1775,1882,1680,1685,3193,2885,1714,1714,1680,1684,1675,2074,1905,1680,1686,1815
72202,"Radiologic examination, sacroiliac joints; 3 or more views",182,164,34,173,173,98,171,91,93,93,95,93,68,69,93,89,34,170,84,88,173,93,107,122,104,105,93,96,102,91,91,173,156,93,93,91,91,91,112,103,91,91,98
72220,"Radiologic examination, sacrum and coccyx, minimum of 2 views",236,212,44,224,224,127,222,118,120,120,123,120,60,89,120,116,44,220,109,114,224,120,139,158,134,137,127,125,132,118,118,224,203,120,120,118,118,118,146,118,118,118,127
73000,"Radiologic examination; clavicle, complete",168,151,31,160,160,90,158,84,86,86,91,86,65,63,86,82,31,157,78,81,160,86,99,112,96,97,87,89,94,84,84,160,144,86,86,84,84,84,104,95,84,84,91
73010,"Radiologic examination; scapula, complete",168,151,31,160,160,90,158,84,86,86,88,86,63,63,86,82,31,157,78,81,160,86,99,112,96,97,86,89,80,84,84,160,144,86,86,84,84,84,104,95,84,84,91
73020,"Radiologic examination, shoulder; 1 view",164,148,30,156,156,88,154,82,84,84,86,84,61,62,84,80,30,153,76,80,156,84,97,110,93,95,64,87,84,82,82,156,141,84,84,82,82,82,101,93,82,82,89
73030,"Radiologic examination, shoulder; complete, minimum of 2 views",270,243,31,257,256,135,254,134,138,138,146,138,65,138,138,132,31,256,138,130,256,138,159,181,138,156,145,143,151,135,135,257,232,138,138,135,135,135,167,143,135,135,146
73040,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation",650,585,120,618,618,348,612,324,331,332,351,331,243,246,332,319,120,606,301,315,618,332,383,435,370,377,334,351,364,325,326,618,558,331,331,325,326,324,401,368,325,326,351
73060,"Radiologic examination; humerus, minimum of 2 views",217,195,29,206,206,116,204,108,111,111,88,111,46,82,111,106,29,202,100,105,206,111,128,145,124,126,92,115,122,108,109,206,186,111,111,108,109,108,134,139,108,109,117
73070,"Radiologic examination, elbow; 2 views",168,151,31,188,160,90,158,84,86,86,93,86,63,63,86,82,31,157,78,81,160,86,99,112,96,97,68,89,188,84,84,160,144,86,86,84,84,84,104,95,84,84,91
73080,"Radiologic examination, elbow; complete, minimum of 3 views",200,180,37,190,190,145,188,100,102,102,108,102,65,76,102,104,37,187,102,96,190,102,121,134,114,116,107,106,112,100,100,190,172,102,102,100,100,100,123,100,100,100,108
73090,"Radiologic examination; forearm, 2 views",168,151,31,160,160,84,158,84,86,86,91,86,60,63,86,82,31,157,78,81,160,86,99,112,96,97,90,89,94,84,84,160,144,86,86,84,84,84,104,84,84,84,91
73100,"Radiologic examination, wrist; 2 views",168,151,31,160,160,94,158,84,86,86,91,86,98,63,86,82,31,157,78,81,160,86,99,112,96,97,90,89,86,84,84,160,144,86,86,84,84,84,104,84,84,84,91
73110,"Radiologic examination, wrist; complete, minimum of 3 views",200,180,37,190,190,100,188,100,102,102,108,102,60,68,102,100,37,190,93,96,190,102,118,134,114,116,107,106,112,100,100,190,172,102,102,100,100,100,123,100,100,100,108
73120,"Radiologic examination, hand; 2 views",168,151,31,160,160,90,158,84,86,86,45,86,65,63,86,82,31,157,78,81,160,86,99,112,96,97,84,89,94,84,84,160,144,86,86,84,84,84,104,95,84,84,91
73130,"Radiologic examination, hand; minimum of 3 views",200,180,37,190,190,100,188,100,102,102,108,102,65,82,102,100,37,187,93,97,190,102,121,134,79,116,107,108,112,100,100,190,172,102,102,100,100,100,123,134,100,100,108
73140,"Radiologic examination, finger(s), minimum of 2 views",154,139,31,146,146,83,145,77,78,79,83,79,65,65,79,76,31,144,71,74,146,79,85,103,88,89,83,83,86,77,77,146,132,79,79,77,77,77,95,82,77,77,83
73200,"Computed tomography, upper extremity; without contrast material",1500,1350,277,1425,1425,804,1412,747,765,765,405,765,529,567,765,736,277,1399,694,728,1425,765,884,1004,854,869,805,780,765,750,752,1425,1287,765,765,750,752,747,926,750,750,752,810
73218,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)",2000,1800,370,1900,1900,1072,1883,996,1019,1020,1040,1020,748,756,1020,981,370,1865,926,970,1900,1020,1179,1339,1139,1159,1073,1056,1051,1000,1002,1900,1717,1020,1020,1000,1002,996,1234,1134,1000,1003,1080
73221,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)",2500,2250,211,2375,2375,1400,2354,1245,1274,1275,1350,1275,983,639,1275,1226,211,2332,1157,1213,2375,1275,1473,1674,1424,1449,1342,1320,1275,1250,1253,2375,2146,1275,1275,1250,1253,1246,1543,1417,1250,1254,1350
73222,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)",2200,1980,407,2090,2090,1179,2071,1096,1121,1122,1188,1122,823,832,1122,1079,407,2052,1019,1067,2090,1122,1297,1473,1253,1275,1129,1188,1177,1100,1103,2090,1888,1122,1122,1100,1102,1096,1358,1247,1100,1103,1188
73223,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences",3200,2880,592,3040,3040,1715,3013,1594,1631,1632,1671,1632,639,1210,1632,1570,592,2984,1482,1552,3040,1632,1886,2143,1822,1855,1642,1690,1682,1600,1604,3040,2747,1631,1632,1600,1603,1594,1975,1814,1599,1605,1728
73501,PR X-RAY EXAM HIP UNI 1 VIEW,200,180,33,190,190,107,188,100,102,102,104,102,33,76,102,98,37,187,93,97,190,102,118,134,114,116,103,106,112,100,100,190,172,102,102,100,100,100,123,113,100,100,108
73502,PR X-RAY EXAM HIP UNI 2-3 VIEWS,200,180,37,190,190,100,190,100,102,102,108,102,60,68,102,100,37,187,93,96,190,102,118,134,114,116,107,106,112,100,100,190,172,102,102,100,100,100,123,106,100,100,108
73503,PR X-RAY EXAM HIP UNI 4/> VIEWS,280,252,52,266,266,150,264,139,143,143,146,143,105,106,143,137,52,261,130,136,266,143,165,187,159,162,144,148,157,140,140,266,240,143,143,140,140,140,173,218,140,140,151
73521,PR X-RAY EXAM HIPS BI 2 VIEWS,300,270,55,285,285,150,282,149,153,153,162,153,60,113,153,147,55,280,139,146,285,153,177,201,171,174,154,158,168,150,150,285,257,153,153,150,150,149,185,170,150,153,162
73522,PR X-RAY EXAM HIPS BI 3-4 VIEWS,350,315,30,333,332,196,330,174,178,178,189,178,30,132,179,172,65,326,162,170,332,178,192,234,199,203,188,185,196,175,175,333,300,178,178,175,175,174,216,196,175,176,189
73523,PR X-RAY EXAM HIPS BI 5/> VIEWS,450,405,77,428,428,241,424,224,229,230,235,229,168,170,230,221,83,420,208,218,428,230,265,301,77,261,225,238,222,225,226,428,386,229,229,225,225,224,278,255,225,226,243
73551,PR X-RAY EXAM OF FEMUR 1 VW,170,153,31,162,162,91,160,85,87,87,89,87,64,64,87,83,31,159,79,82,162,87,100,114,97,99,91,90,89,85,85,162,146,87,87,85,85,85,105,96,85,85,92
73552,PR X-RAY EXAM OF FEMUR 2/> VW,200,180,33,224,190,224,188,100,102,102,108,102,33,34,102,98,37,187,93,97,190,102,118,134,114,116,54,108,112,100,100,190,172,102,102,100,100,100,123,100,100,100,108
73560,"Radiologic examination, knee; 1 or 2 views",168,151,31,160,160,90,158,84,86,86,87,86,63,63,86,82,31,157,78,81,160,86,99,112,96,97,86,89,94,84,84,160,144,86,86,84,84,84,104,84,84,84,91
73562,"Radiologic examination, knee; 3 views",200,180,37,190,190,100,188,100,102,102,108,102,60,65,102,100,37,187,93,96,190,102,121,134,87,116,107,108,112,100,100,190,190,102,102,100,100,100,123,100,102,100,108
73564,"Radiologic examination, knee; complete, 4 or more views",259,233,48,246,246,130,244,129,132,132,161,132,64,65,132,127,48,242,120,124,246,132,153,173,132,150,139,140,145,130,130,246,222,132,132,130,130,129,160,137,129,130,140
73565,"Radiologic examination, knee; both knees, standing, anteroposterior",161,145,30,167,153,80,152,80,82,82,167,82,59,61,82,79,30,150,75,77,153,82,95,108,92,93,86,85,85,80,81,153,138,82,82,80,81,80,99,80,80,81,87
73590,"Radiologic examination; tibia and fibula, 2 views",200,180,37,190,190,190,188,100,102,102,81,102,65,76,102,98,37,190,93,97,190,102,121,134,114,116,107,108,112,100,100,190,172,102,102,100,100,100,123,100,100,100,108
73592,"Radiologic examination; lower extremity, infant, minimum of 2 views",182,164,34,173,173,98,171,91,93,93,95,93,68,69,93,89,34,170,84,88,173,93,107,122,104,105,98,96,96,91,91,173,156,93,93,91,91,91,112,103,91,91,98
73600,"Radiologic examination, ankle; 2 views",168,151,31,160,160,90,158,84,86,86,91,86,63,63,86,82,31,157,78,81,160,86,99,112,96,97,84,89,80,84,84,160,144,86,86,84,84,84,104,95,84,84,91
73610,"Radiologic examination, ankle; complete, minimum of 3 views",200,180,6,190,190,112,188,100,102,102,108,102,65,68,102,6,37,190,93,97,190,102,121,134,114,116,107,108,112,100,100,190,190,102,102,100,100,100,123,112,100,65,108
73620,"Radiologic examination, foot; 2 views",168,151,31,160,160,90,158,84,86,86,91,86,65,63,86,80,31,157,78,81,160,86,99,112,96,97,63,89,94,84,84,160,144,86,86,84,84,84,104,95,84,84,91
73630,"Radiologic examination, foot; complete, minimum of 3 views",200,180,30,190,190,106,188,100,102,102,108,102,60,65,102,96,30,190,93,96,190,102,110,134,102,116,107,124,112,100,100,190,172,102,102,100,100,100,123,106,100,103,108
73650,"Radiologic examination; calcaneus, minimum of 2 views",168,151,31,160,160,90,158,84,86,86,42,86,65,63,86,82,31,157,78,81,160,86,99,112,96,97,44,89,86,84,84,160,144,86,86,84,84,84,104,95,84,84,91
73660,"Radiologic examination; toe(s), minimum of 2 views",154,139,28,146,146,83,145,77,78,79,83,79,59,58,79,76,28,144,71,75,146,79,91,103,88,89,77,81,86,77,77,146,132,79,79,77,77,77,95,86,77,77,83
73700,"Computed tomography, lower extremity; without contrast material",1400,1260,259,1330,1330,784,1318,697,714,714,868,714,480,392,714,687,259,1306,648,679,1330,714,825,937,797,811,726,739,784,700,702,1330,1202,714,714,700,701,698,864,881,700,702,756
73701,"Computed tomography, lower extremity; with contrast material(s)",1700,1530,314,1615,1615,911,1601,847,866,867,888,867,1146,643,867,834,314,1585,787,825,1615,867,1002,1138,968,985,850,898,893,850,852,1615,1459,867,867,850,852,847,1049,964,850,853,918
73706,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2100,1890,388,1995,1995,1126,1977,1046,1070,1071,567,1071,786,794,1071,1030,388,1958,972,1019,1995,1071,1238,1406,1196,1217,1078,1109,1176,1050,1053,1995,1802,1071,1071,1050,1052,1046,1296,1190,1050,1053,1134
73718,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)",2200,1980,407,2090,2090,1179,2071,1096,1121,1122,1188,1122,1167,832,1122,1079,407,2052,1019,1067,2090,1122,1297,1473,1253,1275,1129,1162,1122,1100,1103,2090,1888,1122,1122,1100,1102,1096,1358,1247,1100,1103,1188
73720,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences",3400,3060,629,3230,3230,1823,3201,1694,1733,1734,1776,1734,1059,1285,1734,1668,629,3171,1574,1649,3230,1734,2004,2277,1936,1971,1745,1795,1787,1700,1704,3230,2918,1733,1734,1700,1703,1694,2098,1927,1699,1705,1836
73721,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material",2500,2250,75,2375,2375,1400,2354,1245,1274,1275,1350,1275,1082,1082,1275,75,462,2332,1157,1213,2375,1275,1473,1674,1424,1449,1342,1350,1400,1250,1253,2375,2375,1275,1275,1250,1253,1250,1543,1948,1250,1254,1350
73723,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences",3000,2700,555,2850,2850,2850,2825,1494,1529,1530,1567,1530,580,1134,1530,1471,555,2798,1389,1455,2850,1530,1768,2009,1708,1739,1610,1584,1577,1500,1504,2850,2575,1529,1530,1500,1503,1495,1852,1700,1500,1505,1620
74018,PR X-RAY EXAM ABDOMEN 1 VIEW,200,180,37,190,190,162,188,100,102,102,58,102,62,68,102,96,37,187,93,97,190,102,121,134,114,116,54,106,102,100,100,190,172,102,102,100,100,100,123,134,102,102,108
74019,PR X-RAY EXAM ABDOMEN 2 VIEWS,252,227,26,239,239,141,237,126,128,129,136,129,64,65,129,126,32,235,117,121,239,129,139,169,26,146,135,126,141,126,126,239,216,128,129,126,126,126,156,126,129,126,136
74021,PR X-RAY EXAM ABDOMEN 3+ VIEWS,315,284,58,299,299,169,297,157,161,161,165,161,68,119,161,155,58,294,146,153,299,161,186,211,179,183,162,166,166,158,158,299,270,161,161,158,158,157,194,158,157,158,170
74022,"Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest",400,360,74,380,380,214,377,199,204,204,162,204,150,151,204,196,74,373,185,194,380,204,236,268,228,232,205,211,210,200,200,380,343,204,204,200,200,199,247,227,200,201,216
74150,"Computed tomography, abdomen; without contrast material",1520,1368,281,1444,1444,815,1431,757,775,775,794,775,480,575,775,746,281,1418,704,737,1444,775,896,1018,865,881,780,803,748,760,762,1444,1305,775,775,760,762,757,938,862,760,762,821
74160,"Computed tomography, abdomen; with contrast material(s)",2000,1800,370,1900,1900,1072,1883,996,1019,1020,1080,1020,1146,756,1020,981,370,1865,926,970,1900,1020,1179,1339,1139,1159,1026,1056,1070,1000,1002,1900,1717,1020,1020,1000,1002,996,1234,1134,1000,1003,1080
74170,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections",2000,1800,370,1900,1900,1072,1883,996,1019,1020,1080,1020,1042,756,1020,981,370,1865,926,970,1900,1020,1179,1339,1139,1159,1026,1056,949,1000,1002,1900,1717,1020,1020,1000,1002,996,1234,1558,1000,1003,1080
74174,PR CT ANGIO ABD AND PELV WO W CONTRAST,3000,2700,555,2850,2850,1608,2825,1494,1529,1530,1567,1530,749,1134,1530,1471,555,2798,1389,1455,2850,1530,1768,2009,1708,1739,1540,1584,1680,1500,1530,2850,2575,1529,1530,1500,1503,1495,1852,2337,1500,1505,1620
74175,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2400,2160,418,2280,2280,1287,2260,1195,1223,1224,1253,1224,418,907,1224,1177,444,2238,1111,1164,2280,1224,1414,1607,1367,1391,1232,1267,1344,1200,1203,2280,2060,1224,1224,1200,1202,1196,1481,1360,1200,1204,1296
74176,"Computed tomography, abdomen and pelvis; without contrast material",3660,3294,85,3477,3477,2050,3446,1823,1865,1867,1976,1866,1042,620,1867,1822,85,3413,1867,1757,3477,1867,2214,2451,2084,2121,1964,1903,2050,1830,1867,3477,3141,1866,1867,1830,1834,1824,2259,2050,1829,1836,1976
74177,"Computed tomography, abdomen and pelvis; with contrast material(s)",4147,3732,310,3940,3940,2322,3905,1991,2115,2115,2239,2115,1042,310,2115,2064,767,3868,1920,2012,3940,2115,2395,2777,482,2403,2224,2239,2322,2074,2079,3940,3559,2114,2115,2074,2078,2066,2559,2074,2073,2080,2239
74178,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions",4000,3600,740,3800,3800,2120,3766,1992,2039,2040,2160,2040,1146,1146,2040,1962,740,3730,1852,1940,3800,2040,2357,2678,2278,2318,2053,2112,2240,2000,2005,3800,3433,2039,2040,2000,2000,1993,2469,2240,2040,2006,2160
74181,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)",2200,1980,407,2090,2090,1179,2071,1096,1121,1122,1188,1122,541,832,1122,1079,407,2052,1019,1067,2090,1122,1297,1473,1253,1275,1129,1162,1288,1100,1103,2090,1888,1122,1122,1100,1102,1096,1358,1247,1100,1103,1188
74182,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)",2550,2295,471,2423,2422,1367,2401,1270,1300,1300,1377,1300,1032,964,1301,1251,471,2378,1181,1237,2422,1300,1503,1707,1452,1478,1309,1346,1340,1275,1278,2423,2189,1300,1300,1275,1278,1270,1574,1275,1275,1279,1377
74183,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences",3500,3150,647,3325,3325,1876,3295,1743,1784,1785,1890,1785,1295,1323,1785,1717,647,3264,1620,1698,3325,1785,2063,2344,1993,2028,1796,1848,1785,1750,1754,3325,3004,1784,1785,1750,1754,1744,2160,1750,1749,1756,1890
74220,Radiologic examination; esophagus,380,342,65,361,361,204,358,190,194,194,205,194,65,144,194,186,90,354,176,184,361,194,230,254,216,220,197,201,213,190,190,361,361,194,194,190,190,189,235,190,190,191,205
74230,"Swallowing function, with cineradiography/videoradiography",450,405,83,428,428,241,424,224,229,230,243,229,420,170,230,221,83,420,208,218,428,230,265,301,162,261,231,238,252,225,226,428,386,229,229,225,225,224,278,255,225,226,243
74240,"Radiologic examination, gastrointestinal tract, upper; with or without delayed films, without KUB",498,448,92,473,473,267,469,248,254,254,269,254,179,188,254,238,92,464,231,242,473,254,294,333,284,289,256,263,262,249,250,473,427,254,254,249,250,248,307,282,249,250,269
74246,"Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed films, without KUB",558,502,103,530,530,299,525,278,284,285,301,285,187,211,285,274,103,520,258,271,530,285,338,374,318,323,299,295,312,279,280,530,479,284,285,279,280,278,344,435,279,280,301
74248,PR X-RAY SM INT F-THRU STD,200,180,37,190,190,107,188,100,102,102,108,102,94,76,102,96,37,187,93,97,190,102,118,134,114,116,103,106,102,100,100,190,172,102,102,100,100,100,123,113,100,100,108
74250,"Radiologic examination, small intestine, includes multiple serial films;",380,342,70,361,361,204,358,189,194,194,198,194,142,144,194,186,70,354,176,184,361,194,224,254,216,220,195,201,180,190,190,361,326,194,194,190,190,189,235,215,190,191,205
74280,"Radiologic examination, colon; air contrast with specific high density barium, with or without glucagon",670,603,124,637,636,375,631,334,341,342,350,342,196,253,342,329,124,625,310,325,636,342,395,449,382,388,344,354,352,335,336,637,575,342,342,335,336,334,414,335,335,336,362
74300,"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation",600,540,111,916,570,322,565,299,306,306,313,306,916,227,306,294,111,560,278,291,570,306,354,402,342,348,308,317,315,300,301,570,515,306,306,300,301,299,370,288,300,301,324
74430,"Cystography, minimum of 3 views, radiological supervision and interpretation",400,360,74,380,380,214,377,199,204,204,209,204,150,151,204,196,74,373,185,194,380,204,236,268,228,232,205,211,210,200,200,380,343,204,204,200,200,199,247,200,200,201,216
74450,"Urethrocystography, retrograde, radiological supervision and interpretation",479,431,89,455,455,257,451,239,244,244,250,244,179,181,244,235,89,447,222,232,455,244,282,321,273,278,257,253,252,240,240,455,411,244,244,240,240,239,296,240,239,240,259
74455,"Urethrocystography, voiding, radiological supervision and interpretation",432,389,80,547,410,232,407,215,220,220,226,220,547,163,220,212,80,403,200,210,410,220,255,289,246,250,222,228,227,216,217,410,371,220,220,216,216,215,267,245,216,217,233
75635,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing",3000,2700,555,2850,2850,1500,2825,1494,1529,1530,1567,1530,709,1134,1530,1471,555,2798,1389,1455,2850,1530,1768,2009,1708,1739,1540,1584,1577,1500,1504,2850,2575,1529,1530,1500,1503,1495,1852,1700,1500,1505,1620
76000,"Fluoroscopy (separate procedure), up to 1 hour physician time, other than 71023 or 71034 (eg, cardiac fluoroscopy)",450,405,83,428,428,225,424,225,229,230,212,229,179,170,230,221,83,420,208,218,428,230,248,301,256,261,242,238,252,225,226,428,386,229,229,225,225,224,278,225,225,226,243
76010,"Radiologic examination from nose to rectum for foreign body, single view, child",114,103,21,108,108,61,107,57,58,58,62,58,65,43,58,56,21,106,53,55,108,58,67,76,65,66,61,60,60,57,57,108,98,58,58,57,57,57,70,65,57,57,62
76536,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation",520,468,96,494,494,260,490,259,265,265,281,265,192,197,265,249,96,485,241,250,494,265,306,348,296,301,279,275,291,260,261,494,446,265,265,260,261,259,321,260,260,261,281
76604,"Ultrasound, chest (includes mediastinum), real time with image documentation",500,450,92,475,475,268,471,249,255,255,261,255,187,189,255,245,92,466,231,243,475,255,295,335,285,290,257,264,280,250,251,475,429,255,255,250,251,249,309,283,250,251,270
76641,Complete unilateral ultrasound examination of the breast,500,450,92,475,475,268,471,249,255,255,261,255,253,189,255,245,92,466,231,243,475,255,295,335,285,290,250,264,237,250,251,475,429,255,255,250,251,249,309,283,250,251,270
76642,Specific area/quadrant breast ultrasound examination,319,287,16,357,303,357,300,159,163,163,172,163,192,105,163,156,82,298,148,155,303,163,193,214,16,185,171,168,179,160,160,303,274,163,163,160,160,159,197,248,159,160,172
76700,"Ultrasound, abdominal, real time with image documentation; complete",763,687,141,725,725,382,718,380,389,389,633,389,333,288,389,365,141,712,353,370,725,389,450,511,434,442,395,403,427,382,382,725,655,389,389,382,382,380,471,382,381,383,412
76705,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)",580,522,107,551,551,307,546,289,296,296,313,296,192,127,296,289,107,541,269,281,551,296,319,388,255,336,311,290,325,290,291,551,498,296,296,290,291,289,358,290,290,291,313
76706,PR US ABDL AORTA SCREEN AAA,550,495,102,523,522,292,518,274,280,280,286,280,192,208,281,270,102,513,255,267,522,280,324,368,468,319,282,290,308,275,276,523,472,280,280,275,276,274,339,292,275,276,297
76770,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete",650,585,120,618,618,344,612,325,331,332,351,331,167,246,332,319,120,606,301,315,618,332,383,435,307,377,349,343,364,325,326,618,558,331,331,325,326,324,401,506,325,326,351
76775,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited",550,495,102,523,522,295,518,274,280,280,297,280,192,105,281,270,102,513,255,267,522,280,324,368,313,319,295,290,308,275,276,523,472,280,280,275,275,274,339,270,275,276,297
76776,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation",550,495,102,523,522,295,518,274,280,280,287,280,206,208,281,270,102,513,255,267,522,280,324,368,313,319,282,290,280,275,276,523,472,280,280,275,276,274,339,312,275,276,297
76801,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation",480,432,89,456,456,257,452,239,245,245,259,245,187,181,245,235,89,448,222,233,456,245,283,321,273,278,258,259,252,240,241,456,412,245,245,240,240,239,296,374,240,241,259
76805,"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation",700,630,129,665,665,375,659,349,357,357,378,357,170,187,357,343,129,665,324,340,665,357,413,469,399,406,376,370,368,350,351,665,601,357,357,350,351,349,432,545,350,351,378
76815,"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses",428,385,79,407,407,229,403,213,218,218,231,218,178,162,218,210,79,399,198,208,407,218,252,287,244,248,214,226,225,214,215,407,367,218,218,214,214,213,264,333,214,215,231
76816,"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetus",400,360,74,380,380,214,377,199,204,204,235,204,187,187,204,196,74,373,185,194,380,204,236,268,228,232,215,200,210,200,200,380,343,204,204,200,200,199,247,227,200,201,216
76817,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal",470,423,87,447,446,252,443,234,240,240,254,240,141,178,240,231,87,446,218,228,446,240,277,315,268,272,252,254,247,235,236,447,403,240,240,235,235,234,290,366,235,236,254
76818,Fetal biophysical profile; with non-stress testing,550,495,102,523,522,295,518,274,280,280,297,280,206,208,281,270,102,513,255,267,522,280,324,368,313,319,282,290,289,275,276,523,472,280,280,275,276,274,339,312,275,276,297
76819,Fetal biophysical profile; without non-stress testing,428,385,79,407,407,229,403,213,218,218,231,218,160,162,218,210,79,399,198,208,407,218,252,287,244,248,220,226,225,214,215,407,367,218,218,214,214,213,264,243,214,215,231
76830,"Ultrasound, transvaginal",630,567,116,598,598,315,593,314,321,321,340,321,192,238,321,309,116,588,292,306,598,321,364,422,430,365,338,340,353,315,316,598,541,321,321,315,316,314,389,315,315,316,340
76856,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete",700,630,129,665,665,392,659,349,357,357,378,357,250,265,357,343,129,653,324,340,665,357,413,469,399,406,376,370,392,350,351,665,601,357,357,350,351,604,432,397,350,351,378
76857,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)",428,385,79,407,407,240,403,213,218,218,231,218,105,162,218,210,79,399,198,208,407,218,252,287,244,248,230,231,240,214,218,407,367,218,218,214,214,213,264,214,218,215,231
76870,"Ultrasound, scrotum and contents",546,491,101,519,519,293,514,272,278,278,295,278,211,206,278,261,101,509,253,265,519,278,322,366,311,316,293,288,267,273,274,519,469,278,278,273,274,272,337,309,273,274,295
76881,"Ultrasound, extremity, nonvascular, real-time with image documentation; complete",500,450,92,475,475,268,471,249,255,255,261,255,211,189,255,245,92,466,231,243,475,255,295,335,285,290,257,264,268,250,251,475,429,255,255,250,251,249,309,390,250,251,270
76882,"Ultrasound, extremity, nonvascular, real-time with image documentation; limited, anatomic specific",400,360,31,380,380,224,377,199,204,204,216,204,211,151,204,31,74,373,185,194,380,204,220,268,228,232,215,211,224,200,200,380,343,204,204,200,200,199,247,312,200,201,216
76942,"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation",5,4,1,5,5,3,5,2,3,3,3,3,2,2,3,2,1,5,2,2,5,3,3,3,3,3,3,3,3,2,3,5,4,3,3,2,3,2,3,3,2,3,3
77063,HC BREAST TOMOSYNTHESIS DIG SCREEN UNIL,80,72,15,80,76,43,75,40,41,41,42,41,30,30,41,39,15,75,37,39,76,41,47,54,78,46,41,42,79,40,40,76,69,41,41,40,40,40,49,80,40,40,43
77065,Diagnostic Mammography computer aided detection when performed; unilateral,300,270,55,285,285,168,282,149,153,153,162,153,221,113,153,147,55,280,139,146,285,153,177,201,171,174,161,158,168,150,150,285,257,153,153,150,150,149,185,150,150,150,162
77066,Diagnostic Mammography computer aided detection when performed; bilateral,400,360,14,380,380,224,377,199,204,204,216,204,221,226,204,196,158,373,185,194,380,204,242,268,14,232,215,211,224,200,200,380,343,204,204,200,200,199,247,312,200,201,216
77067,Screening mammography,400,360,74,398,380,214,377,199,204,204,209,204,150,151,204,196,74,373,185,194,380,204,236,268,397,232,205,211,398,200,200,380,343,204,204,200,200,199,247,398,200,201,216
77075,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)",630,567,116,599,598,338,593,314,321,321,329,321,236,238,321,309,116,588,292,306,598,321,371,422,359,365,323,333,299,315,316,599,541,321,321,315,316,314,389,357,315,316,340
77080,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)",440,396,81,418,418,220,414,220,224,224,238,224,246,215,224,219,81,410,204,211,418,224,259,295,224,255,236,232,246,220,221,418,418,224,224,220,220,219,272,220,220,221,238
77081,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)",350,315,65,333,332,188,330,174,178,178,183,178,260,132,179,172,65,326,162,170,332,178,206,234,199,203,180,185,178,175,175,333,300,178,178,175,175,174,216,198,175,176,189
77085,PR DXA BONE DENSITY W FX ASSESS,350,315,10,333,332,188,330,174,178,178,189,178,186,132,179,172,65,326,162,170,332,178,206,234,10,203,180,185,175,175,175,333,300,178,178,175,175,174,216,175,175,176,189
78014,PR THYROID IMAG W/BLOOD FLOW SGL/MULT QUAN,900,810,166,879,855,482,847,448,459,459,470,459,879,340,459,441,166,839,417,437,855,459,530,603,512,522,462,475,459,450,451,855,772,459,459,450,451,448,555,450,450,451,486
78226,PR HEPATOBILIARY SYSTEM IMAGING,1200,1080,222,1140,1140,643,1130,598,612,612,648,612,612,454,612,589,222,1119,556,582,1140,612,707,804,683,695,616,634,672,600,601,1140,1030,612,612,600,601,598,741,680,600,602,648
78227,PR HEPATOBIL SYST IMAGE W/DRUG,1500,1350,277,1425,1425,840,1412,747,765,765,810,765,879,1066,765,736,277,1399,694,728,1425,765,884,1004,854,869,805,750,788,750,752,1425,1287,765,765,750,752,747,926,1157,750,752,810
78264,Gastric emptying study,1300,1170,240,1235,1235,624,1224,648,663,663,702,663,923,491,663,638,240,1212,602,631,1235,663,766,870,740,753,401,686,683,650,652,1235,1116,663,663,650,651,648,802,1145,650,652,702
78306,Bone and/or joint imaging; whole body,1096,986,203,1041,1041,588,1032,546,559,559,592,559,484,414,559,538,203,1022,507,532,1041,559,646,734,624,635,562,579,614,548,549,1041,941,559,559,548,549,546,676,548,548,550,592
78315,Bone and/or joint imaging; 3 phase study,1500,1350,277,1425,1425,804,1412,747,765,765,783,765,967,567,765,736,277,1399,694,728,1425,765,884,1004,854,869,770,792,788,750,752,1425,1287,765,765,750,752,747,926,850,750,752,810
78452,"Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection",3400,3060,629,3230,3230,1904,3201,1694,1733,1734,1836,1734,1823,1823,1734,1692,629,3171,1574,1649,3230,1734,2057,2277,2786,1971,1823,1795,1904,1700,1704,3230,2918,1733,1734,1700,1703,1694,2649,1700,1699,1705,1836
78582,PR LUNG VENTILAT&PERFUS IMAGING,1400,1260,259,1823,1330,672,1318,697,714,714,731,714,1657,529,714,687,259,1306,648,679,1330,714,825,937,797,811,1823,739,714,700,702,1330,1202,714,714,700,701,698,864,794,700,702,756
78708,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)",1600,1440,296,1520,1520,858,1506,797,815,816,864,816,1032,605,816,785,296,1492,741,776,1520,816,943,1071,911,927,821,845,790,800,802,1520,1373,816,816,800,802,797,987,907,800,803,864
78815,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh,4800,4320,887,4560,4560,2400,4519,2391,2446,2448,2256,2448,3220,1814,2448,2354,887,4477,2222,2329,4560,2448,2829,3214,2733,2782,2463,2534,2568,2400,2406,4560,4120,2447,2448,2400,2400,2392,2962,2688,2399,2408,2592
80048,"Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310), Carbon dioxide (82374), Chloride (82435), Creatinine (82565), Glucose (82947), Potassium (84132), Sodium (84295), Urea nitrogen (BUN) (84520)",84,76,7,154,80,42,79,42,43,43,45,43,57,57,43,42,7,80,39,40,80,43,46,56,29,83,45,42,47,42,42,80,154,43,43,42,42,42,52,42,43,43,45
80050,"General health panel This panel must include the following: Comprehensive metabolic panel (80053), Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004), OR, Blood count, complete (CBC), automated (85027) and appropriate manual differential WBC count (85007 or 85009), Thyroid stimulating hormone (TSH) (84443)",303,273,44,298,288,162,285,151,154,155,298,155,57,57,155,170,44,283,140,147,288,155,179,203,173,176,89,160,159,152,152,288,260,154,155,152,152,151,187,172,151,152,164
80051,"Electrolyte panel This panel must include the following: Carbon dioxide (82374), Chloride (82435), Potassium (84132), Sodium (84295)",71,64,13,81,67,38,67,35,36,36,19,36,81,27,36,35,13,66,33,34,67,36,42,48,40,41,36,37,40,36,36,67,61,36,36,36,36,35,44,34,35,36,38
80053,"Comprehensive metabolic panel This panel must include the following: Albumin (82040), Bilirubin, total (82247), Calcium, total (82310), Carbon dioxide (bicarbonate) (82374), Chloride (82435), Creatinine (82565), Glucose (82947), Phosphatase, alkaline (84075), Potassium (84132), Protein, total (84155), Sodium (84295), Transferase, alanine amino (ALT) (SGPT) (84460), Transferase, aspartate amino (AST) (SGOT) (84450), Urea nitrogen (BUN) (84520)",103,93,9,384,98,52,98,52,53,53,56,53,57,57,53,51,9,98,53,49,98,53,57,69,21,60,55,56,58,52,53,98,384,53,53,52,52,52,52,52,53,53,56
80061,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465), Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718), Triglycerides (84478)",129,116,12,123,123,64,123,22,66,66,70,66,29,29,66,64,12,123,60,62,123,66,71,86,41,75,69,67,66,64,65,123,111,66,66,64,64,64,100,64,66,65,70
80069,"Renal function panel This panel must include the following: Albumin (82040), Calcium, total (82310), Carbon dioxide (bicarbonate) (82374), Chloride (82435), Creatinine (82565), Glucose (82947), Phosphorus inorganic (phosphate) (84100), Potassium (84132), Sodium (84295), Urea nitrogen (BUN) (84520)",85,76,16,81,81,48,80,42,43,43,53,43,57,57,43,42,16,79,39,41,81,43,50,57,48,49,46,45,48,42,43,81,73,43,43,42,42,42,52,42,42,43,46
80074,"Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709), Hepatitis B core antibody (HBcAb), IgM antibody (86705), Hepatitis B surface antigen (HBsAg) (87340), Hepatitis C antibody (86803)",394,355,26,374,374,197,371,196,201,201,213,201,26,149,201,196,73,367,182,191,374,201,232,264,224,228,211,213,221,197,197,374,338,201,201,197,197,196,243,197,197,198,213
80076,"Hepatic function panel This panel must include the following: Albumin (82040), Bilirubin, total (82247), Bilirubin, direct (82248), Phosphatase, alkaline (84075), Protein, total (84155), Transferase, alanine amino (ALT) (SGPT) (84460), Transferase, aspartate amino (AST) (SGOT) (84450)",81,73,7,77,77,40,76,40,41,41,44,41,52,31,41,40,7,76,38,39,77,41,49,54,46,47,43,43,45,40,41,77,70,41,41,40,40,40,50,40,40,41,44
80143,HC DRUG ASSAY ACETAMINOPHEN,193,174,36,183,183,102,182,96,98,98,104,98,72,73,98,95,36,183,89,94,183,98,114,129,110,112,104,102,108,96,97,183,166,98,98,96,97,96,119,108,96,97,104
80156,Carbamazepine; total,139,125,26,132,132,75,131,69,71,71,75,71,56,53,71,68,26,130,64,67,132,71,82,93,79,81,71,73,74,70,70,132,119,71,71,70,70,69,86,67,69,70,75
80159,HC DRUG SCREEN QUANT CLOZAPINE,131,118,24,124,124,70,123,65,67,67,71,67,49,50,67,64,24,122,61,64,124,67,77,88,75,76,67,69,69,66,66,124,112,67,67,66,66,65,81,63,65,66,71
80162,Digoxin,129,116,24,123,123,69,121,64,66,66,66,66,55,49,66,63,24,120,60,63,123,66,76,86,73,75,66,68,72,64,65,123,111,66,66,64,65,64,80,62,64,65,70
80164,Dipropylacetic acid (valproic acid),130,117,24,124,124,62,122,65,66,66,70,66,61,49,66,64,24,121,60,63,124,66,77,87,74,75,70,69,70,65,65,124,112,66,66,65,65,65,80,65,65,65,70
80168,Ethosuximide,157,141,29,149,149,84,148,78,80,80,82,80,59,59,80,77,29,146,73,76,149,80,93,105,89,91,84,83,83,78,79,149,135,80,80,78,79,78,97,89,78,79,85
80169,HC DRUG SCREEN QUANT EVEROLIMUS,78,70,14,74,74,42,73,39,40,40,41,40,61,29,40,38,14,73,36,38,74,40,46,52,44,45,40,41,41,39,39,74,67,40,40,39,39,39,48,44,39,39,42
80170,Gentamicin,157,141,29,149,149,75,148,78,80,80,82,80,59,59,80,77,29,146,73,76,149,80,93,105,89,91,81,83,83,78,79,149,135,80,80,78,79,78,97,89,78,79,85
80171,HC DRUG SCREEN QUANT GABAPENTIN,116,105,22,111,111,62,110,58,59,59,78,59,44,44,59,57,22,109,54,57,111,59,69,78,66,68,60,62,61,58,58,111,100,59,59,58,58,58,72,42,58,58,63
80175,HC DRUG SCREEN QUANT LAMOTRIGINE,131,118,24,124,124,70,123,65,67,67,71,67,53,50,67,64,24,122,61,64,124,67,77,88,75,76,67,69,62,66,66,124,112,67,67,66,66,65,81,73,65,66,71
80177,Drug Screen quantitative Levetiracetam level,168,151,31,160,160,81,158,84,86,86,91,86,50,63,86,82,31,157,78,81,160,86,99,112,96,97,86,89,94,84,84,160,144,86,86,84,84,84,104,95,84,84,91
80178,Lithium,67,60,12,64,64,36,63,33,34,34,18,34,55,25,34,33,12,62,31,33,64,34,39,45,38,39,34,35,34,34,34,64,58,34,34,34,34,33,41,34,33,34,36
80179,HC DRUG ASSAY SALICYLATE,73,66,13,69,69,41,69,36,37,37,39,37,27,28,37,36,13,69,34,35,69,37,43,49,42,42,39,39,41,36,37,69,63,37,37,36,37,36,45,41,36,37,39
80183,HC DRUG SCREEN QUANT OXCARBAZEPIN,131,118,24,124,124,70,123,65,67,67,71,67,55,50,67,64,24,122,61,64,124,67,77,88,75,76,70,69,69,66,66,124,112,67,67,66,66,65,81,102,65,66,71
80184,Phenobarbital,113,102,21,107,107,61,106,56,58,58,59,58,58,43,58,55,21,105,52,55,107,58,67,76,64,65,58,60,59,56,57,107,97,58,58,56,57,56,70,64,56,57,61
80185,Phenytoin; total,126,113,4,120,120,68,119,63,64,64,68,64,55,48,64,62,23,118,58,61,120,64,74,84,4,73,65,67,71,63,63,120,108,64,64,63,63,63,78,63,63,63,68
80186,Phenytoin; free,75,68,14,71,71,40,71,37,38,38,39,38,28,28,38,37,14,70,35,36,71,38,44,50,43,43,38,40,35,38,38,71,64,38,38,38,38,37,46,43,37,38,40
80195,Sirolimus,132,119,24,125,125,71,124,66,67,67,69,67,49,50,67,65,24,123,61,64,125,67,78,88,75,77,68,70,74,66,66,125,113,67,67,66,66,66,81,75,66,66,71
80197,Tacrolimus,132,119,24,125,125,66,124,66,67,67,71,67,55,50,67,65,24,123,61,63,125,67,78,88,75,77,71,70,74,66,66,125,113,67,67,66,66,66,81,75,66,66,71
80198,Theophylline,134,121,25,127,127,72,126,67,68,68,70,68,50,51,68,66,25,125,62,65,127,68,79,90,76,78,69,71,63,67,67,127,115,68,68,67,67,67,83,67,67,67,72
80200,Tobramycin,155,140,29,147,147,83,146,77,79,79,81,79,58,59,79,76,29,145,72,75,147,79,91,104,88,90,80,82,77,78,78,147,133,79,79,78,78,77,96,88,77,78,84
80201,Topiramate,117,105,22,111,111,63,110,58,60,60,61,60,26,44,60,57,22,109,54,57,111,60,69,78,67,68,58,62,60,58,59,111,100,60,60,58,59,58,72,66,58,59,63
80202,Vancomycin,130,117,24,124,124,70,122,65,66,66,70,66,55,49,66,64,24,121,60,63,124,66,77,87,44,75,70,69,61,65,65,124,112,66,66,65,65,65,80,74,65,65,70
80203,HC DRUG SCREEN QUANT ZONISAMIDE,190,171,35,181,180,102,179,95,97,97,99,97,71,72,97,93,35,177,88,92,180,97,112,127,108,110,102,100,100,95,95,181,163,97,97,95,95,95,117,108,95,95,103
80299,"Quantitation of drug, not elsewhere specified",244,220,45,232,232,131,230,122,124,124,132,124,91,92,124,120,45,228,113,118,232,124,144,163,139,141,125,129,128,122,122,232,209,124,124,122,122,122,151,120,122,122,132
80305,Drug Test presumptive,210,189,14,200,200,118,200,105,107,107,14,107,50,50,107,105,39,200,97,101,200,107,121,141,107,122,113,113,118,105,105,200,180,107,107,105,105,105,130,105,105,105,113
80307,Drug Test presumptive,193,174,36,183,183,103,182,96,98,98,77,98,113,73,98,64,36,180,89,94,183,98,114,129,110,112,52,102,95,96,97,183,166,98,98,96,97,96,119,104,96,97,104
80371,HC DRUG TEST DEF 22+ CLASS STIMULANTS SYNTHETIC,120,108,16,114,114,64,113,60,61,61,16,61,45,45,61,59,22,112,56,58,114,61,71,80,68,70,62,63,63,60,60,114,103,61,61,60,60,60,74,68,60,60,65
80500,"Clinical pathology consultation; limited, without review of patient's history and medical records",60,54,11,57,57,32,56,30,31,31,31,31,22,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,34,30,30,57,51,31,31,30,30,30,37,38,30,30,32
81001,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy",44,40,8,42,42,22,41,22,22,22,24,22,25,17,22,23,8,41,20,21,42,22,26,29,25,26,24,23,25,22,22,42,38,22,22,22,22,22,27,22,22,22,24
81002,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy",10,9,2,22,10,5,9,5,5,5,5,5,22,4,5,5,2,9,5,5,10,5,6,7,5,6,5,5,6,5,5,10,9,5,5,5,5,5,6,5,5,5,5
81003,"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy",24,22,4,25,23,12,23,12,12,12,13,12,25,9,12,12,4,23,11,12,23,12,13,16,14,14,13,12,13,12,12,23,21,12,12,12,12,12,15,12,12,12,13
81015,Urinalysis; microscopic only,32,29,6,30,30,17,30,16,16,16,17,16,27,12,16,15,6,30,15,16,30,16,19,21,18,19,17,17,18,16,16,30,27,16,16,16,16,16,20,25,16,16,17
81025,"Urine pregnancy test, by visual color comparison methods",64,58,12,61,61,36,60,32,33,33,35,33,22,24,33,32,12,61,30,31,61,33,35,43,36,37,34,35,36,32,32,61,55,33,33,32,32,32,39,43,32,32,35
81206,HC BCR/ABL1 GENE MAJOR BP,773,696,143,734,734,414,728,385,394,394,404,394,149,292,394,379,143,721,358,375,734,394,456,518,335,448,397,408,394,386,387,734,663,394,394,386,387,385,477,386,386,388,417
81220,HC CFTR GENE COM VARIANTS,436,392,81,414,414,234,411,217,222,222,228,222,204,165,222,214,81,407,202,212,414,222,257,292,248,253,224,230,229,218,219,414,374,222,222,218,218,217,269,247,218,219,235
81229,HC CYTOGEN M ARRAY COPY NO&SNP,2300,2070,425,2185,2185,1233,2166,1146,1172,1173,1201,1173,629,869,1173,1128,425,2145,1065,1116,2185,1173,1356,1540,1310,1333,1180,1214,1209,1150,1153,2185,1974,1173,1173,1150,1152,1146,1420,1304,1150,1154,1242
81240,HC F2 GENE,81,73,15,77,77,43,76,40,41,41,42,41,45,31,41,40,15,76,38,39,77,41,48,54,46,47,42,43,43,40,41,77,70,41,41,40,41,40,50,46,40,41,44
81241,HC F5 GENE,368,331,68,350,350,197,346,183,188,188,199,188,199,139,188,181,68,343,170,179,350,188,217,246,210,213,189,194,180,184,184,350,316,188,188,184,184,183,227,209,184,185,199
81256,HC HFE GENE,715,644,132,679,679,383,673,356,364,365,373,365,143,270,365,351,132,667,331,347,679,365,421,479,407,414,367,378,400,358,358,679,614,365,365,358,358,356,441,405,357,359,386
81270,HC JAK2 GENE,838,754,155,796,796,449,789,417,427,427,438,427,158,317,427,411,155,782,388,402,796,427,494,561,477,486,430,442,440,419,420,796,719,427,427,419,420,418,517,475,419,420,453
81479,HC UNLISTED MOLECULAR PATHOLOGY,150,135,28,158,142,80,141,75,76,76,78,76,158,57,77,74,28,140,69,73,142,76,88,100,85,87,77,79,79,75,75,143,129,76,76,75,75,75,93,85,75,75,81
82010,"Acetone or other ketone bodies, serum; quantitative",80,72,15,76,76,43,75,40,41,41,22,41,50,30,41,39,15,75,37,39,76,41,47,54,46,46,43,42,45,40,40,76,69,41,41,40,40,40,49,45,40,40,43
82024,Adrenocorticotropic hormone (ACTH),362,326,67,344,344,194,341,180,185,185,147,185,94,137,185,178,67,338,168,176,344,185,213,242,206,210,186,191,203,181,181,344,311,185,185,181,181,180,223,174,181,182,195
82040,"Albumin; serum, plasma or whole blood",50,45,9,48,48,26,47,25,25,26,26,25,23,23,26,25,9,47,23,24,48,26,29,33,28,29,27,26,27,25,25,48,43,25,25,25,25,25,31,25,25,25,27
82043,"Albumin; urine, microalbumin, quantitative",42,38,3,80,40,21,40,21,21,21,23,21,22,25,21,21,8,39,19,20,40,21,25,28,3,3,23,22,24,21,21,40,80,21,21,21,21,21,33,21,21,21,23
82077,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase)",106,95,20,151,101,59,100,53,54,54,57,54,25,40,54,52,20,151,49,51,101,54,62,71,60,61,57,56,59,53,53,101,91,54,54,53,53,53,65,59,53,53,57
82085,Aldolase,88,79,16,84,84,47,83,44,45,45,46,45,78,33,45,43,16,82,41,43,84,45,52,59,50,51,45,46,46,44,44,84,76,45,45,44,44,44,54,50,44,44,48
82088,Aldosterone,273,246,50,259,259,146,257,136,139,139,143,139,86,103,139,134,50,255,126,132,259,139,161,183,155,158,140,144,139,136,137,259,234,139,139,136,137,136,168,155,136,137,147
82103,Alpha-1-antitrypsin; total,130,117,24,124,124,65,122,65,66,66,68,66,52,49,66,64,24,121,60,63,124,66,79,87,74,75,70,69,73,65,65,124,112,66,66,65,65,65,80,74,65,65,70
82104,Alpha-1-antitrypsin; phenotype,137,123,25,130,130,68,129,68,70,70,72,70,25,52,70,67,25,128,63,66,130,70,83,92,78,79,70,72,64,68,69,130,118,70,70,68,69,68,85,78,68,69,74
82105,Alpha-fetoprotein (AFP); serum,161,145,30,153,153,85,152,80,82,82,79,82,50,61,82,79,30,150,75,78,153,82,95,108,92,93,79,85,90,80,81,153,138,82,82,80,81,80,99,80,80,81,87
82136,"Amino acids, 2 to 5 amino acids, quantitative, each specimen",268,241,20,255,255,144,252,133,137,137,140,137,86,101,137,131,50,250,124,130,255,137,158,179,153,155,138,142,20,134,134,255,230,137,137,134,134,134,165,152,134,134,145
82140,Ammonia,139,125,26,132,132,75,131,69,71,71,75,71,86,53,71,68,26,130,64,67,132,71,82,93,79,81,70,73,78,70,70,132,119,71,71,70,70,69,86,108,69,70,75
82150,Amylase,67,60,12,64,64,36,63,34,34,34,36,34,23,25,34,33,12,64,31,32,64,34,39,45,38,39,36,36,38,34,34,64,58,34,34,34,34,33,41,38,33,34,36
82164,Angiotensin I - converting enzyme (ACE),139,125,26,132,132,75,131,69,71,71,73,71,50,53,71,68,26,130,64,67,132,71,82,93,79,81,71,73,78,70,70,132,119,71,71,70,70,69,86,79,69,70,75
82175,Arsenic,197,177,36,187,187,87,185,98,100,100,103,100,74,74,100,97,36,184,91,96,187,100,116,132,112,114,101,104,109,98,99,187,169,100,100,98,99,98,122,112,98,99,106
82180,"Ascorbic acid (Vitamin C), blood",101,91,19,96,96,54,95,50,51,52,53,52,38,38,52,50,19,94,47,49,96,52,60,68,58,59,52,53,52,50,51,96,87,51,52,50,51,50,62,57,50,51,55
82232,Beta-2 microglobulin,131,118,24,124,124,73,123,65,67,67,68,67,52,50,67,64,24,122,61,64,124,67,77,88,75,76,67,69,70,66,66,124,112,67,67,66,66,65,81,74,65,66,71
82239,Bile acids; total,82,74,15,78,78,44,77,41,42,42,43,42,50,31,42,40,15,76,38,40,78,42,48,55,47,48,44,43,43,41,41,78,70,42,42,41,41,41,51,46,41,41,44
82247,Bilirubin; total,52,47,10,49,49,28,49,26,27,27,28,27,23,23,27,26,10,48,24,25,49,27,31,35,30,30,28,27,27,26,26,49,45,27,27,26,26,26,32,26,26,26,28
82248,Bilirubin; direct,52,47,10,49,49,28,49,26,27,27,27,27,11,20,27,26,10,48,24,25,49,27,31,35,30,30,27,27,27,26,26,49,45,27,27,26,26,26,32,26,26,26,28
82270,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)",33,30,1,31,31,16,31,16,17,17,18,17,12,12,17,16,6,31,15,16,31,17,19,22,1,19,18,17,18,16,17,31,28,17,17,16,16,16,20,16,16,17,18
82272,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening",33,30,6,31,31,17,31,16,17,17,18,17,30,12,17,16,6,31,15,16,31,17,18,22,19,19,14,16,17,16,17,31,28,17,17,16,17,16,20,16,16,17,18
82274,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations",60,54,11,57,57,30,56,30,31,31,32,31,22,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,31,30,30,57,51,31,31,30,30,30,37,30,30,30,32
82300,Cadmium,70,63,13,67,66,38,66,35,36,36,37,36,26,26,36,34,13,65,32,34,66,36,41,47,40,41,36,37,36,35,35,67,60,36,36,35,35,35,43,40,35,35,38
82306,"Vitamin D; 25 hydroxy, includes fraction(s), if performed",278,250,51,264,264,139,264,138,142,142,150,142,110,113,142,138,51,259,129,135,264,142,164,186,158,161,149,147,156,139,139,264,239,142,142,139,139,139,172,139,139,139,150
82308,Calcitonin,227,204,42,216,216,109,214,113,116,116,119,116,47,86,116,111,42,212,105,110,216,116,134,152,129,132,116,120,119,114,114,216,195,116,116,114,114,113,140,109,113,114,123
82310,Calcium; total,53,48,10,50,50,26,50,26,27,27,29,27,25,20,27,26,10,49,25,26,50,27,31,35,30,31,28,28,27,26,27,50,45,27,27,26,26,26,33,26,26,27,29
82330,Calcium; ionized,131,118,24,124,124,70,123,65,67,67,64,67,82,50,67,64,24,122,61,64,124,67,77,88,75,76,67,69,62,66,66,124,112,67,67,66,66,65,81,74,65,66,71
82340,"Calcium; urine quantitative, timed specimen",63,57,6,60,60,34,59,31,32,32,33,32,43,24,32,31,12,59,29,31,60,32,37,42,36,37,32,33,6,32,32,60,54,32,32,32,32,31,39,36,31,32,34
82365,Calculus; infrared spectroscopy,47,42,9,45,45,25,44,23,24,24,25,24,18,18,24,23,9,44,22,23,45,24,28,31,27,27,24,25,24,24,24,45,40,24,24,24,24,23,29,27,23,24,25
82374,Carbon dioxide (bicarbonate),50,45,9,48,48,27,47,25,25,26,26,25,19,19,26,25,9,47,23,24,48,26,29,33,28,29,26,26,26,25,25,48,43,25,25,25,25,25,31,28,25,25,27
82375,Carboxyhemoglobin; quantitative,110,99,20,105,104,59,104,55,56,56,57,56,41,42,56,54,20,103,51,53,104,56,65,74,63,64,56,58,52,55,55,105,94,56,56,55,55,55,68,62,55,55,59
82378,Carcinoembryonic antigen (CEA),108,97,20,103,103,58,102,54,55,55,58,55,48,41,55,53,20,101,50,52,103,55,64,72,61,63,55,57,60,54,54,103,93,55,55,54,54,54,67,61,54,54,58
82384,Catecholamines; fractionated,201,181,37,191,191,108,189,100,102,103,105,103,47,76,103,99,37,187,93,98,191,103,118,135,114,116,103,106,106,100,101,191,173,102,103,100,101,100,124,114,100,101,109
82390,Ceruloplasmin,106,95,20,101,101,57,100,53,54,54,55,54,25,40,54,52,20,99,49,51,101,54,62,71,60,61,54,56,59,53,53,101,91,54,54,53,53,53,65,60,53,53,57
82397,Chemiluminescent assay,104,94,19,99,99,56,98,52,53,53,56,53,38,39,53,51,19,97,48,50,99,53,61,70,59,60,56,55,53,52,52,99,89,53,53,52,52,52,64,52,52,52,56
82436,Chloride; urine,52,47,10,49,49,28,49,26,27,27,27,27,33,20,27,26,10,48,24,25,49,27,31,35,30,30,27,27,27,26,26,49,45,27,27,26,26,26,32,29,26,26,28
82465,"Cholesterol, serum or whole blood, total",43,39,8,41,41,21,40,21,22,22,22,22,20,16,22,21,8,40,20,21,41,22,25,29,24,25,22,23,23,22,22,41,37,22,22,22,22,21,27,22,21,22,23
82507,Citrate,262,236,28,249,249,140,247,131,134,134,137,134,43,99,134,129,48,244,121,127,249,134,154,175,149,152,134,138,28,131,131,249,225,134,134,131,131,131,162,149,131,131,141
82525,Copper,121,109,22,115,115,65,115,60,62,62,63,62,41,46,62,59,22,113,56,59,115,62,71,81,69,70,62,64,62,60,61,115,104,62,62,60,61,60,75,69,60,61,65
82533,Cortisol; total,157,141,29,149,149,78,148,78,80,80,85,80,52,59,80,77,29,146,73,76,149,80,93,105,89,91,81,83,88,78,79,149,135,80,80,78,79,78,97,75,78,79,85
82540,Creatine,67,60,12,64,64,36,63,33,34,34,35,34,17,25,34,33,12,62,31,33,64,34,39,45,38,39,34,35,35,34,34,64,58,34,34,34,34,33,41,38,33,34,36
82550,"Creatine kinase (CK), (CPK); total",96,86,18,94,91,48,90,48,49,49,52,49,23,33,49,48,18,91,49,46,91,49,58,64,29,94,52,48,54,48,49,91,82,49,49,48,48,48,48,48,49,49,52
82553,"Creatine kinase (CK), (CPK); MB fraction only",113,102,21,111,107,56,106,56,58,58,61,58,50,86,58,56,21,107,58,54,107,58,68,76,39,111,61,56,63,56,58,107,97,58,58,56,56,56,56,56,58,58,61
82565,Creatinine; blood,53,48,10,52,50,26,50,26,27,27,29,27,13,11,27,26,10,49,25,25,50,27,31,35,52,31,28,28,30,26,27,50,45,27,27,26,26,26,33,26,27,27,29
82570,Creatinine; other source,42,38,7,40,40,21,40,21,21,21,23,21,23,23,21,21,8,39,19,20,40,21,25,28,7,13,23,22,24,21,21,40,36,21,21,21,21,21,33,21,21,21,23
82595,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)",202,182,37,192,192,108,190,101,103,103,105,103,76,76,103,99,37,188,94,98,192,103,119,135,115,117,104,107,99,101,101,192,173,103,103,101,101,101,125,114,101,101,109
82607,Cyanocobalamin (Vitamin B-12);,147,132,14,140,140,74,140,73,75,75,79,75,52,52,75,72,14,137,68,71,140,75,81,98,70,85,79,78,82,74,74,140,126,75,75,74,74,74,91,78,73,74,79
82627,Dehydroepiandrosterone-sulfate (DHEA-S),211,190,38,200,200,113,199,105,108,108,114,108,38,80,108,103,39,197,98,102,200,108,124,141,120,122,113,111,111,106,106,200,181,108,108,106,106,105,130,120,105,106,114
82652,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed",360,324,67,342,342,193,339,179,183,184,188,184,116,136,184,177,67,336,167,175,342,184,212,241,205,209,193,190,176,180,180,342,309,184,184,180,180,179,222,180,180,181,194
82656,"Elastase, pancreatic (EL-1), fecal, qualitative or semi-quantitative",121,109,22,115,115,65,114,60,62,62,63,62,46,46,62,59,22,113,56,59,115,62,71,81,69,70,62,64,40,60,61,115,104,62,62,60,61,60,75,69,60,61,65
82668,Erythropoietin,180,162,33,171,171,96,169,90,92,92,94,92,46,68,92,88,33,168,83,87,171,92,106,121,102,104,92,95,92,90,90,171,154,92,92,90,90,90,111,90,90,90,97
82670,Estradiol,264,238,39,251,251,142,249,132,135,135,143,135,49,39,135,126,49,246,122,128,251,135,156,177,150,153,142,139,135,132,132,251,227,135,135,132,132,132,163,206,132,132,143
82677,Estriol,185,166,34,176,176,99,174,92,94,94,100,94,52,70,94,91,34,173,86,90,176,94,109,124,105,107,99,98,97,92,93,176,159,94,94,92,93,92,114,105,92,93,100
82679,Estrone,235,212,26,223,223,126,221,117,120,120,123,120,26,89,120,115,43,219,109,114,223,120,139,157,134,136,121,124,123,118,118,223,202,120,120,118,118,117,145,133,117,118,127
82710,"Fat or lipids, feces; quantitative",131,118,23,124,124,70,123,65,67,67,68,67,23,50,67,64,24,122,61,64,124,67,77,88,75,76,67,69,45,66,66,124,112,67,67,66,66,65,81,74,65,66,71
82728,Ferritin,131,118,12,124,124,66,124,65,67,67,71,67,50,50,67,64,12,124,61,63,124,67,79,88,75,76,70,69,73,66,66,124,112,67,67,66,66,65,81,66,65,66,71
82746,Folic acid; serum,141,127,14,134,134,70,134,70,72,72,76,72,46,25,72,69,14,131,65,68,134,72,78,94,80,82,76,74,79,70,71,134,121,72,72,70,70,70,87,79,70,71,76
82784,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each",273,246,48,259,259,145,257,136,139,139,147,139,48,103,139,134,50,255,126,132,259,139,161,183,155,158,49,144,153,136,137,259,234,139,139,136,137,136,168,71,136,137,147
82785,Gammaglobulin (immunoglobulin); IgE,159,143,29,151,151,85,150,79,81,81,86,81,39,60,81,78,29,148,74,77,151,81,96,106,91,92,85,84,89,80,80,151,136,81,81,80,80,79,98,90,79,80,86
82787,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each",126,113,23,120,120,68,119,63,64,64,66,64,25,48,64,62,23,118,58,61,120,64,74,84,72,73,65,67,66,63,63,120,108,64,64,63,63,63,78,71,63,63,68
82805,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry",185,166,34,289,176,98,174,92,94,94,100,94,289,289,94,88,34,173,86,89,176,94,109,124,147,107,99,98,104,92,93,176,159,94,94,92,93,92,114,92,92,93,100
82947,"Glucose; quantitative, blood (except reagent strip)",40,36,7,38,38,21,38,20,20,20,22,20,21,23,20,20,7,37,19,19,38,20,24,27,23,23,21,21,22,20,20,38,38,20,20,20,20,20,25,23,20,20,22
82951,"Glucose; tolerance test (GTT), 3 specimens (includes glucose)",100,90,18,95,95,54,94,50,51,51,54,51,48,38,51,49,18,93,46,49,95,51,59,67,57,58,54,53,53,50,50,95,86,51,51,50,50,50,62,57,50,50,54
82962,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use",5,4,1,30,5,3,5,2,3,3,3,3,30,2,3,2,1,5,2,2,5,3,3,3,6,3,3,3,3,2,3,5,4,3,3,2,2,2,3,2,2,3,3
82977,"Glutamyltransferase, gamma (GGT)",73,66,12,69,69,39,69,36,37,37,39,37,12,28,37,36,13,68,34,35,69,37,43,49,42,42,39,39,37,36,37,69,63,37,37,36,37,36,45,36,36,37,39
83001,Gonadotropin; follicle stimulating hormone (FSH),177,159,26,168,168,88,167,88,90,90,96,90,26,26,90,85,33,165,82,86,168,90,104,119,101,103,95,93,93,88,89,168,152,90,90,88,89,88,109,113,88,89,96
83002,Gonadotropin; luteinizing hormone (LH),176,158,26,167,167,88,166,88,90,90,95,90,26,26,90,86,33,164,81,85,167,90,104,118,100,102,94,93,92,88,88,167,151,90,90,88,88,88,109,88,88,88,95
83003,"Growth hormone, human (HGH) (somatotropin)",160,144,26,152,152,86,151,80,82,82,86,82,26,60,82,78,30,149,74,78,152,82,94,107,91,93,82,84,84,80,80,152,137,82,82,80,80,80,99,91,80,80,86
83010,Haptoglobin; quantitative,122,110,23,116,116,65,115,61,62,62,64,62,37,46,62,60,23,114,56,59,116,62,74,82,69,71,65,64,62,61,61,116,105,62,62,61,61,61,75,95,61,61,66
83020,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F)",53,48,10,50,50,28,50,26,27,27,28,27,20,20,27,26,10,49,25,26,50,27,31,35,30,31,14,28,28,26,27,50,45,27,27,26,27,26,33,30,26,27,29
83021,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F)",53,48,10,50,50,28,50,26,27,27,28,27,20,20,27,26,10,49,25,26,50,27,31,35,30,31,14,28,28,26,27,50,45,27,27,26,27,26,33,30,26,27,29
83036,Hemoglobin; glycosylated (A1C),94,85,14,89,89,17,89,15,48,48,51,48,50,50,48,47,17,89,44,14,89,48,52,63,15,54,16,47,17,47,47,89,81,48,48,47,47,15,58,17,48,47,51
83051,Hemoglobin; plasma,74,67,14,70,70,40,70,37,38,38,39,38,28,28,38,36,14,69,34,36,70,38,44,50,42,43,38,39,38,37,37,70,64,38,38,37,37,37,46,42,37,37,40
83090,Homocysteine,224,202,41,213,213,120,211,112,114,114,121,114,92,123,114,110,41,209,104,109,213,114,132,150,128,130,112,118,125,112,112,213,192,114,114,112,112,112,138,127,112,112,121
83497,"Hydroxyindolacetic acid, 5-(HIAA)",71,64,13,67,67,38,67,35,36,36,38,36,45,27,36,35,13,66,33,34,67,36,42,48,40,41,36,37,37,36,36,67,61,36,36,36,36,35,44,40,35,36,38
83498,"Hydroxyprogesterone, 17-d",257,231,24,244,244,138,242,128,131,131,134,131,24,97,131,126,48,240,119,125,244,131,151,172,146,149,132,136,135,128,129,244,221,131,131,128,129,128,159,146,128,129,139
83516,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method",113,102,21,107,107,61,106,56,58,58,61,58,52,43,58,54,21,105,52,55,107,58,67,76,64,65,61,60,60,56,57,107,97,58,58,56,57,56,70,88,56,57,61
83519,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA)",343,309,63,326,326,184,323,171,175,175,179,175,128,130,175,168,63,320,159,166,326,175,202,230,195,199,176,181,192,172,172,326,294,175,175,172,172,171,212,194,171,172,185
83520,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified",97,87,18,92,92,54,91,48,49,49,52,49,25,26,49,48,18,90,45,47,92,49,56,65,55,56,52,51,54,48,49,92,83,49,49,48,49,48,60,54,48,49,52
83525,Insulin; total,112,101,21,106,106,60,105,56,57,57,60,57,52,42,57,55,21,104,52,54,106,57,66,75,64,65,60,59,59,56,56,106,96,57,57,56,56,56,69,63,56,56,60
83540,Iron,65,58,6,62,62,34,62,32,33,33,35,33,20,23,33,32,6,62,30,31,62,33,39,44,37,38,35,34,36,32,33,62,56,33,33,32,32,32,40,32,32,33,35
83550,Iron binding capacity,76,68,8,72,72,40,72,38,39,39,41,39,25,25,39,37,8,72,35,36,72,39,46,51,43,44,41,40,43,38,38,72,65,39,39,38,38,38,47,49,38,38,41
83605,Lactate (lactic acid),103,93,19,98,98,58,97,52,52,53,56,53,46,50,53,51,19,98,48,49,98,53,61,69,66,60,55,50,58,52,52,98,88,53,53,52,52,51,64,52,51,53,56
83615,"Lactate dehydrogenase (LD), (LDH);",63,57,8,60,60,33,59,31,32,32,34,32,23,24,32,31,12,59,29,31,60,32,38,42,8,37,34,33,32,32,32,60,54,32,32,32,32,31,39,32,31,32,34
83630,"Lactoferrin, fecal; qualitative",134,121,21,127,127,72,126,67,68,68,70,68,50,51,68,66,25,125,62,65,127,68,79,90,76,78,72,71,21,67,67,127,115,68,68,67,67,67,83,76,67,67,72
83655,Lead,119,107,22,113,113,64,112,59,61,61,64,61,38,41,61,58,22,111,55,58,113,61,70,80,68,69,64,63,61,60,60,113,102,61,61,60,60,59,73,93,59,60,64
83690,Lipase,70,63,11,67,66,39,66,34,36,36,38,36,11,26,36,35,13,66,32,34,66,36,40,47,40,41,38,38,39,35,36,67,60,36,36,35,35,35,43,37,35,36,38
83718,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol)",81,73,15,77,77,39,76,40,41,41,42,41,30,31,41,40,15,76,38,39,77,41,48,54,46,47,42,43,43,40,41,77,70,41,41,40,41,40,50,46,40,41,44
83721,"Lipoprotein, direct measurement; LDL cholesterol",76,68,13,72,72,43,72,38,39,39,41,39,50,29,39,37,14,71,35,36,72,39,45,51,13,44,41,40,43,38,38,72,65,39,39,38,38,38,47,38,38,38,41
83735,Magnesium,68,61,13,65,65,38,65,34,35,35,37,35,23,23,35,34,13,63,31,33,65,35,41,46,29,39,36,34,38,34,34,65,58,35,35,34,34,34,42,34,34,35,37
83789,"Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not elsewhere specified; quantitative, each specimen",193,174,36,183,183,103,182,96,98,98,101,98,78,73,98,95,36,180,89,94,183,98,114,129,110,112,99,102,101,96,97,183,166,98,98,96,97,96,119,109,96,97,104
83825,"Mercury, quantitative",53,48,10,50,50,28,50,26,27,27,28,27,20,20,27,26,10,49,25,26,50,27,31,35,30,31,27,28,27,26,27,50,45,27,27,26,27,26,33,30,26,27,29
83835,Metanephrines,252,227,25,239,239,135,237,126,128,129,87,129,25,95,129,124,47,235,117,122,239,129,149,169,143,146,87,133,192,126,126,239,216,128,129,126,126,126,156,78,126,126,136
83874,Myoglobin,124,112,23,118,118,62,117,62,63,63,67,63,23,43,63,61,23,116,57,60,118,63,73,83,71,72,33,65,69,62,62,118,106,63,63,62,62,62,77,79,62,63,67
83880,Natriuretic peptide,318,286,34,302,302,159,299,159,162,162,172,162,113,113,162,156,34,302,162,153,302,162,187,213,138,68,171,154,178,159,162,302,273,162,162,159,159,158,159,159,162,160,172
83883,"Nephelometry, each analyte not elsewhere specified",206,185,38,196,196,110,194,103,105,105,108,105,52,78,105,101,38,192,95,99,196,105,125,138,117,119,106,109,64,103,103,196,177,105,105,103,103,103,127,117,103,103,111
83921,"Organic acid, single, quantitative",182,164,25,173,173,98,171,91,93,93,98,93,25,69,93,89,34,170,84,88,173,93,107,122,104,105,91,96,93,91,91,173,156,93,93,91,91,91,112,87,91,91,98
83930,Osmolality; blood,67,60,12,64,64,34,63,33,34,34,18,34,25,25,34,33,12,62,31,33,64,34,39,45,38,39,36,35,35,34,34,64,58,34,34,34,34,33,41,32,33,34,36
83935,Osmolality; urine,70,63,13,67,66,35,66,35,36,36,19,36,15,26,36,34,13,65,32,34,66,36,41,47,40,41,36,37,37,35,35,67,60,36,36,35,35,35,43,34,35,35,38
83945,Oxalate,124,112,14,118,118,66,117,62,63,63,65,63,43,47,63,61,23,116,57,60,118,63,73,83,71,72,64,65,14,62,62,118,106,63,63,62,62,62,77,70,62,62,67
83970,Parathormone (parathyroid hormone),246,221,45,234,234,123,234,123,125,125,133,125,94,93,125,122,45,229,114,118,234,125,145,165,140,143,132,130,138,123,123,234,211,125,125,123,123,123,152,123,123,123,133
83986,"pH; body fluid, not otherwise specified",39,35,4,37,37,21,37,19,20,20,20,20,17,15,20,19,7,36,18,19,37,20,23,26,22,23,20,21,4,20,20,37,33,20,20,20,20,19,24,22,19,20,21
83993,"Calprotectin, fecal",258,232,48,245,245,138,243,129,131,132,135,132,50,98,132,127,48,241,119,125,245,132,152,173,147,150,132,136,136,129,129,245,221,132,132,129,129,129,159,146,129,129,139
84030,"Phenylalanine (PKU), blood",184,166,34,175,175,99,173,92,94,94,99,94,69,70,94,90,34,172,85,89,175,94,108,123,105,107,94,97,97,92,92,175,158,94,94,92,92,92,114,104,92,92,99
84075,"Phosphatase, alkaline;",53,48,10,50,50,28,50,26,27,27,29,27,11,20,27,26,10,49,25,26,50,27,31,35,30,31,28,28,28,26,27,50,45,27,27,26,27,26,33,26,26,27,29
84080,"Phosphatase, alkaline; isoenzymes",151,136,28,143,143,81,142,75,77,77,79,77,47,57,77,74,28,141,70,73,143,77,89,101,86,88,41,80,79,76,76,143,130,77,77,76,76,75,93,86,75,76,82
84100,Phosphorus inorganic (phosphate);,48,43,9,46,46,27,46,24,24,24,26,24,11,11,24,24,9,45,22,23,46,24,28,32,27,28,26,25,24,24,24,46,41,24,24,24,24,24,30,24,24,24,26
84105,Phosphorus inorganic (phosphate); urine,53,48,6,50,50,28,50,26,27,27,28,27,17,20,27,26,10,49,25,26,50,27,31,35,30,31,27,28,6,26,27,50,45,27,27,26,27,26,33,30,26,27,29
84132,"Potassium; serum, plasma or whole blood",47,42,9,45,45,25,44,23,24,24,25,24,11,18,24,23,9,44,22,23,45,24,28,31,27,27,19,25,24,24,24,45,40,24,24,24,24,23,29,24,23,24,25
84133,Potassium; urine,44,40,8,42,42,24,41,22,22,22,23,22,23,17,22,22,8,41,20,21,42,22,26,29,25,26,23,23,25,22,22,42,38,22,22,22,22,22,27,25,22,22,24
84134,Prealbumin,139,125,26,132,132,67,132,69,71,71,73,71,39,50,71,68,26,130,64,67,132,71,82,93,79,81,71,73,78,70,70,132,119,71,71,70,70,69,86,70,69,70,75
84144,Progesterone,200,180,37,190,190,107,188,100,102,102,108,102,47,52,102,98,37,187,93,97,190,102,118,134,114,116,100,106,105,100,100,190,172,102,102,100,100,100,123,156,100,100,108
84145,Procalcitonin (PCT),188,169,35,184,179,101,177,94,96,96,102,96,53,71,96,92,35,175,87,90,179,96,111,126,184,109,101,99,105,94,94,179,161,96,96,94,94,94,116,94,94,96,102
84146,Prolactin,184,166,26,175,175,92,173,92,94,94,99,94,26,26,94,90,34,172,85,89,175,94,108,123,105,107,99,97,97,92,92,175,158,94,94,92,92,92,114,88,92,92,99
84150,"Prostaglandin, each",2700,2430,499,2565,2565,1447,2542,1345,1376,1377,1410,1377,1010,1021,1377,1324,499,2518,1250,1310,2565,1377,1591,1808,1537,1565,1386,1426,1349,1350,1353,2565,2317,1377,1377,1350,1353,1345,1666,1530,1350,1354,1458
84153,Prostate specific antigen (PSA); total,176,158,16,167,167,99,166,88,90,90,95,90,46,50,90,88,16,167,81,84,167,90,97,118,87,102,94,93,99,88,88,167,151,90,90,88,88,88,109,99,88,88,95
84154,Prostate specific antigen (PSA); free,176,158,25,167,167,94,166,88,90,90,92,90,25,67,90,86,33,164,81,85,167,90,104,118,100,102,94,93,99,88,88,167,151,90,90,88,88,88,109,137,88,88,95
84155,"Protein, total, except by refractometry; serum, plasma or whole blood",40,36,7,38,38,21,38,20,20,20,21,20,11,15,20,20,7,37,19,19,38,20,24,27,23,23,21,21,19,20,20,38,34,20,20,20,20,20,25,23,20,20,22
84156,"Protein, total, except by refractometry; urine",40,36,7,38,38,22,38,20,20,20,22,20,11,11,20,20,7,37,19,19,38,20,24,27,23,23,21,21,22,20,20,38,34,20,20,20,20,20,25,20,20,20,22
84157,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)",33,30,6,31,31,18,31,16,17,17,17,17,12,12,17,16,6,31,15,16,31,17,19,22,19,19,17,17,17,16,17,31,28,17,17,16,17,16,20,19,16,17,18
84163,Pregnancy-associated plasma protein-A (PAPP-A),106,95,20,101,101,57,100,53,54,54,57,54,25,40,54,52,20,99,49,51,101,54,62,71,60,61,57,56,56,53,53,101,91,54,54,53,53,53,65,60,53,53,57
84165,"Protein; electrophoretic fractionation and quantitation, serum",106,95,20,101,101,59,100,53,54,54,55,54,25,40,54,52,20,99,49,51,101,54,64,71,60,61,57,56,59,53,53,101,91,54,54,53,53,53,65,53,53,53,57
84166,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF)",170,153,31,162,162,95,160,85,87,87,89,87,78,64,87,83,31,159,79,82,162,87,100,114,97,99,87,90,91,85,85,162,146,87,87,85,85,85,105,96,85,85,92
84206,Proinsulin,103,93,19,98,98,55,97,51,52,53,54,53,26,39,53,51,19,96,48,50,98,53,61,69,59,60,53,54,54,52,52,98,88,53,53,52,52,51,64,58,51,52,56
84207,Pyridoxal phosphate (Vitamin B-6),265,238,25,252,252,142,250,132,135,135,138,135,25,100,135,130,49,247,123,129,252,135,156,177,151,154,136,140,139,132,133,252,227,135,135,132,133,132,164,150,132,133,143
84244,Renin,208,187,29,198,198,111,196,104,106,106,109,106,29,79,106,102,38,194,96,101,198,106,123,139,118,121,107,110,106,104,104,198,179,106,106,104,104,104,128,118,104,104,112
84255,Selenium,98,88,18,115,93,53,115,49,50,50,51,50,39,37,50,48,18,91,45,48,93,50,58,66,56,57,50,52,51,49,49,93,84,50,50,49,49,49,60,56,49,49,53
84270,Sex hormone binding globulin (SHBG),121,109,22,115,115,65,114,60,62,62,63,62,46,46,62,59,22,113,56,59,115,62,71,81,69,70,62,64,64,60,61,115,104,62,62,60,61,60,75,69,60,61,65
84295,"Sodium; serum, plasma or whole blood",48,43,9,46,46,26,45,24,24,24,25,24,20,18,24,24,9,45,22,23,46,24,28,32,27,28,25,25,24,24,24,46,41,24,24,24,24,24,30,27,24,24,26
84300,Sodium; urine,31,28,6,29,29,17,29,16,16,16,16,16,13,12,16,15,6,29,14,15,29,16,18,21,18,18,17,16,16,16,16,29,27,16,16,16,16,15,19,15,15,16,17
84305,Somatomedin,183,165,26,174,174,98,172,91,93,93,96,93,26,69,93,90,34,171,85,89,174,93,108,123,104,106,92,97,96,92,92,174,157,93,93,92,92,91,113,104,91,92,99
84392,"Sulfate, urine",33,30,6,31,31,18,31,16,17,17,17,17,27,12,17,16,6,31,15,16,31,17,19,22,19,19,17,17,17,16,17,31,28,17,17,16,17,16,20,19,16,17,18
84402,Testosterone; free,242,218,24,278,230,121,228,121,123,123,131,123,24,91,123,119,45,226,112,117,230,123,143,162,138,140,130,128,146,121,121,230,208,123,123,121,121,121,149,278,121,121,131
84403,Testosterone; total,245,220,26,233,233,130,231,122,125,125,132,125,38,26,125,120,45,233,113,119,233,125,148,164,140,142,131,129,137,122,123,233,210,125,125,122,123,122,151,157,122,123,132
84410,HC TESTOSTERONE BIOAVAILABLE,176,158,33,167,167,94,166,88,90,90,92,90,94,67,90,86,33,164,81,85,167,90,104,118,100,102,90,93,83,88,88,167,151,90,90,88,88,88,109,137,88,88,95
84425,Thiamine (Vitamin B-1),202,182,25,192,192,101,192,101,103,103,109,103,25,76,103,99,37,188,94,98,192,103,119,135,115,117,104,107,101,101,101,192,173,103,103,101,101,101,125,101,101,101,109
84432,Thyroglobulin,155,140,29,168,147,83,146,77,79,79,81,79,50,59,79,76,29,145,72,75,147,79,91,104,88,90,80,82,168,78,78,147,133,79,79,78,78,77,96,88,77,78,84
84436,Thyroxine; total,70,63,13,67,66,34,66,35,36,36,38,36,52,52,36,34,13,65,32,34,66,36,41,47,40,41,38,37,39,35,35,67,60,36,36,35,35,35,43,37,35,35,38
84439,Thyroxine; free,76,68,1,72,72,43,72,38,39,39,41,39,49,52,39,38,14,71,35,36,72,39,46,51,1,44,41,44,43,38,38,72,65,39,39,38,38,38,47,43,39,38,41
84443,Thyroid stimulating hormone (TSH),161,145,11,153,153,80,153,80,82,82,87,82,26,26,82,77,30,153,82,77,153,82,89,108,76,93,86,93,90,80,81,153,138,82,82,80,80,11,99,90,82,81,87
84445,Thyroid stimulating immune globulins (TSI),476,428,88,452,452,255,448,237,243,243,249,243,94,180,243,233,88,444,220,231,452,243,281,319,271,276,255,251,243,238,239,452,409,243,243,238,238,237,294,270,238,239,257
84446,Tocopherol alpha (Vitamin E),112,101,21,106,106,60,106,56,57,57,58,57,25,42,57,55,21,104,52,54,106,57,66,75,64,65,57,59,63,56,56,106,96,57,57,56,56,56,69,63,56,56,60
84450,Transferase; aspartate amino (AST) (SGOT),53,48,10,140,50,30,50,26,27,27,29,27,20,12,27,26,10,49,25,25,50,27,31,35,38,31,28,28,30,26,27,50,140,27,27,26,26,26,33,26,26,27,29
84460,Transferase; alanine amino (ALT) (SGPT),94,85,11,89,89,53,89,47,48,48,51,48,11,12,48,47,17,88,44,45,89,48,55,63,54,54,50,50,53,47,47,89,81,48,48,47,47,47,58,47,47,47,51
84466,Transferrin,123,111,23,117,117,66,116,61,63,63,64,63,25,46,63,60,23,115,57,60,117,63,72,82,70,71,62,65,63,62,62,117,106,63,63,62,62,61,76,70,61,62,66
84478,Triglycerides,60,54,10,57,57,29,56,30,31,31,31,31,10,11,31,29,11,56,28,29,57,31,35,40,34,35,32,32,28,30,30,57,51,31,31,30,30,30,37,34,30,30,32
84479,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR),65,58,12,62,62,35,61,32,33,33,34,33,24,25,33,32,12,61,30,32,62,33,38,44,37,38,33,34,33,32,33,62,56,33,33,32,33,32,40,37,32,33,35
84480,Triiodothyronine T3; total (TT-3),123,111,23,117,117,62,116,61,63,63,66,63,24,46,63,60,23,115,57,60,117,63,72,82,70,71,66,65,69,62,62,117,106,63,63,62,62,61,76,62,61,62,66
84481,Triiodothyronine T3; free,162,146,26,154,154,91,153,81,83,83,87,83,26,26,83,79,30,151,75,78,154,83,98,108,92,94,87,100,83,81,81,154,139,83,83,81,81,81,100,91,81,81,87
84484,"Troponin, quantitative",96,86,18,91,91,48,90,48,49,49,52,49,25,25,49,47,18,91,49,32,91,49,87,64,78,56,52,48,54,48,49,91,82,49,49,48,48,48,48,48,49,49,52
84520,Urea nitrogen; quantitative,42,38,8,40,40,20,40,21,21,21,23,21,11,16,21,21,8,39,19,20,40,21,25,28,24,24,22,22,24,21,21,40,36,21,21,21,21,21,26,21,21,21,23
84550,Uric acid; blood,46,41,9,44,44,26,44,23,23,23,25,23,21,23,23,23,9,43,21,22,44,23,27,31,26,27,24,24,26,23,23,44,39,23,23,23,23,23,28,23,23,23,25
84560,Uric acid; other source,48,43,5,46,46,26,45,24,24,24,25,24,17,18,24,24,9,45,22,23,46,24,28,32,27,28,25,25,5,24,24,46,41,24,24,24,24,24,30,27,24,24,26
84585,"Vanillylmandelic acid (VMA), urine",150,135,24,143,142,80,141,75,76,76,78,76,24,57,77,74,28,140,69,73,142,76,88,100,85,87,77,79,79,75,75,143,129,76,76,75,75,75,93,85,75,75,81
84586,Vasoactive intestinal peptide (VIP),49,44,9,47,47,26,46,24,25,25,26,25,32,19,25,24,9,46,23,24,47,25,29,33,28,28,25,26,26,24,25,47,42,25,25,24,25,24,30,28,24,25,26
84588,"Vasopressin (antidiuretic hormone, ADH)",282,254,52,268,268,151,266,140,144,144,147,144,105,107,144,138,52,263,131,137,268,144,166,189,161,163,145,149,133,141,141,268,242,144,144,141,141,141,174,160,141,141,152
84590,Vitamin A,101,91,19,96,96,54,96,50,51,52,59,52,25,38,52,50,19,94,47,49,96,52,60,68,58,59,52,53,57,50,51,96,87,51,52,50,51,50,62,57,50,51,55
84597,Vitamin K,131,118,24,124,124,70,124,65,67,67,68,67,43,50,67,64,24,122,61,64,124,67,77,88,75,76,67,69,69,66,66,124,112,67,67,66,66,65,81,74,65,66,71
84630,Zinc,112,101,21,106,106,54,106,56,57,57,58,57,38,42,57,55,21,104,52,54,106,57,66,75,64,65,57,59,59,56,56,106,96,57,57,56,56,56,69,63,56,56,60
84681,C-peptide,200,180,25,190,190,100,188,100,102,102,77,102,25,76,102,98,37,187,93,97,190,102,118,134,114,116,103,106,112,100,100,190,172,102,102,100,100,100,123,113,100,100,108
84702,"Gonadotropin, chorionic (hCG); quantitative",145,130,27,138,138,78,137,72,74,74,78,74,52,39,74,71,27,138,67,70,138,74,85,97,83,84,78,78,76,72,73,138,124,74,74,72,73,72,89,113,72,73,78
85007,"Blood count; blood smear, microscopic examination with manual differential WBC count",36,32,3,36,34,19,34,18,18,18,19,18,36,36,18,17,3,34,17,17,34,18,21,24,20,21,19,19,20,18,18,34,31,18,18,18,18,18,22,18,18,18,19
85014,Blood count; hematocrit (Hct),24,22,4,36,23,13,23,12,12,12,13,12,36,9,12,12,4,22,11,12,23,12,14,16,14,14,23,13,13,12,12,23,21,12,12,12,12,12,15,12,12,12,13
85018,Blood count; hemoglobin (Hgb),24,22,1,29,23,13,23,12,12,12,13,12,27,29,12,12,4,22,11,12,23,12,14,16,1,14,13,13,13,12,12,23,21,12,12,12,12,12,15,13,12,12,13
85025,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count",78,70,7,74,74,39,74,39,40,40,42,40,36,36,40,39,7,74,40,37,74,40,43,52,23,45,42,42,44,39,40,74,67,40,40,39,39,39,39,39,40,40,42
85027,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)",78,70,6,74,74,39,73,39,40,40,42,40,33,36,40,37,6,74,36,37,74,40,47,52,68,45,42,41,44,39,39,74,67,40,40,39,39,39,48,39,39,39,42
85046,"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [CHr], immature reticulocyte fraction [IRF], reticulocyte volume [MRV], RNA content), direct measurement",58,52,5,55,55,32,55,29,30,30,31,30,18,22,30,28,5,54,27,28,55,30,35,39,33,34,30,31,32,29,29,55,50,30,30,29,29,29,36,45,29,29,31
85048,"Blood count; leukocyte (WBC), automated",26,23,5,25,25,14,24,13,13,13,14,13,18,10,13,13,5,24,12,13,25,13,15,17,15,15,13,14,12,13,13,25,22,13,13,13,13,13,16,13,13,13,14
85049,"Blood count; platelet, automated",46,41,9,44,44,25,43,23,23,23,24,23,18,17,23,23,9,43,21,22,44,23,27,31,26,27,24,24,25,23,23,44,39,23,23,23,23,23,28,26,23,23,25
85055,Reticulated platelet assay,80,72,15,76,76,43,75,40,41,41,42,41,30,30,41,39,15,75,37,39,76,41,47,54,46,46,43,42,42,40,40,76,69,41,41,40,40,40,49,45,40,40,43
85060,"Blood smear, peripheral, interpretation by physician with written report",73,66,13,69,69,36,69,36,37,37,39,37,58,28,37,36,13,68,34,35,69,37,43,49,42,42,39,39,38,36,37,69,63,37,37,36,37,36,45,57,36,37,39
85130,Chromogenic substrate assay,450,405,83,428,428,241,424,224,229,230,243,229,168,170,230,221,83,420,208,218,428,230,265,301,256,261,231,238,236,225,226,428,386,229,229,225,225,224,278,255,225,226,243
85240,"Clotting; factor VIII (AHG), 1-stage",194,175,36,184,184,104,183,97,99,99,101,99,62,73,99,95,36,181,90,94,184,99,114,130,110,112,104,102,109,97,97,184,167,99,99,97,97,97,120,110,97,97,105
85245,"Clotting; factor VIII, VW factor, ristocetin cofactor",130,117,24,124,124,70,122,65,66,66,68,66,33,49,66,64,24,121,60,63,124,66,77,87,74,75,107,69,68,65,65,124,112,66,66,65,65,65,80,74,65,65,70
85246,"Clotting; factor VIII, VW factor antigen",198,178,31,188,188,106,186,99,101,101,103,101,31,75,101,97,37,185,92,96,188,101,117,133,113,115,106,105,104,99,99,188,170,101,101,99,99,99,122,112,99,99,107
85247,"Clotting; factor VIII, von Willebrand factor, multimetric analysis",130,117,24,124,124,70,122,65,66,66,68,66,33,49,66,64,24,121,60,63,124,66,77,87,74,75,107,69,68,65,65,124,112,66,66,65,65,65,80,74,65,65,70
85300,"Clotting inhibitors or anticoagulants; antithrombin III, activity",68,61,13,65,65,36,64,34,35,35,37,35,33,26,35,33,13,63,31,33,65,35,40,46,39,39,36,36,38,34,34,65,58,35,35,34,34,34,42,34,34,34,37
85301,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay",68,61,13,65,65,36,64,34,35,35,37,35,25,26,35,33,13,63,31,33,65,35,40,46,39,39,36,36,36,34,34,65,58,35,35,34,34,34,42,39,34,34,37
85302,"Clotting inhibitors or anticoagulants; protein C, antigen",117,105,22,111,111,63,110,58,60,60,63,60,23,44,60,57,22,109,54,57,111,60,69,78,67,68,63,62,61,58,59,111,100,60,60,58,59,58,72,66,58,59,63
85303,"Clotting inhibitors or anticoagulants; protein C, activity",125,112,23,119,119,67,118,62,64,64,68,64,23,47,64,61,23,117,58,61,119,64,74,84,71,72,67,66,70,62,63,119,107,64,64,62,63,62,77,62,62,63,68
85305,"Clotting inhibitors or anticoagulants; protein S, total",113,102,21,107,107,61,106,56,58,58,59,58,47,43,58,55,21,105,52,55,107,58,67,76,64,65,58,60,59,56,57,107,97,58,58,56,57,56,70,64,56,57,61
85306,"Clotting inhibitors or anticoagulants; protein S, free",148,133,27,141,141,79,139,74,75,75,80,75,30,56,75,73,27,138,69,72,141,75,87,99,84,86,79,78,83,74,74,141,127,75,75,74,74,74,91,74,74,74,80
85307,Activated Protein C (APC) resistance assay,148,133,27,141,141,79,139,74,75,75,77,75,55,56,75,73,27,138,69,72,141,75,87,99,84,86,74,78,78,74,74,141,127,75,75,74,74,74,91,84,74,74,80
85370,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative,60,54,11,57,57,32,56,30,31,31,31,31,22,23,31,29,11,56,28,29,57,31,35,40,34,35,30,32,32,30,30,57,51,31,31,30,30,30,37,34,30,30,32
85379,"Fibrin degradation products, D-dimer; quantitative",85,76,16,81,81,42,81,42,43,43,46,43,27,27,43,42,16,79,39,41,81,43,50,57,48,49,46,44,48,42,43,81,73,43,43,42,42,42,52,42,42,43,46
85384,Fibrinogen; activity,84,76,16,80,80,42,79,42,43,43,45,43,27,32,43,41,16,78,39,41,80,43,50,56,48,49,45,44,43,42,42,80,72,43,43,42,42,42,52,42,42,42,45
85397,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte",198,178,31,188,188,106,186,99,101,101,103,101,31,75,101,97,37,185,92,96,188,101,117,133,113,115,106,105,104,99,99,188,170,101,101,99,99,99,122,112,99,99,107
85610,Prothrombin time;,39,35,7,37,37,9,37,20,20,20,21,20,27,15,20,19,7,37,20,8,37,20,23,26,8,23,21,20,9,20,20,37,33,20,20,20,8,8,24,20,19,20,21
85613,Russell viper venom time (includes venom); diluted,93,84,17,88,88,50,88,46,47,47,50,47,27,35,47,46,17,87,43,45,88,47,55,62,53,54,50,49,52,46,47,88,80,47,47,46,47,46,57,59,46,47,50
85652,"Sedimentation rate, erythrocyte; automated",39,35,7,37,37,21,37,20,20,20,21,20,18,36,20,19,7,37,18,19,37,20,21,26,22,23,21,21,22,20,20,37,33,20,20,20,20,19,24,20,19,20,21
85730,"Thromboplastin time, partial (PTT); plasma or whole blood",53,48,10,50,50,26,50,26,27,27,29,27,13,20,27,25,10,50,25,25,50,27,31,35,30,31,28,26,30,26,27,50,45,27,27,26,26,26,33,26,26,27,29
86003,"Allergen specific IgE; quantitative or semiquantitative, each allergen",125,112,23,119,119,67,118,62,64,64,86,64,26,47,64,61,23,117,58,61,119,64,74,84,71,72,48,66,66,62,63,119,107,64,64,62,63,62,77,71,62,63,68
86021,Antibody identification; leukocyte antibodies,145,130,27,138,138,78,137,72,74,74,76,74,54,55,74,71,27,135,67,70,138,74,85,97,83,84,74,77,76,72,73,138,124,74,74,72,73,72,89,72,72,73,78
86022,Antibody identification; platelet antibodies,198,178,37,188,188,106,186,99,101,101,103,101,49,75,101,97,37,185,92,96,188,101,117,133,113,115,102,105,106,99,99,188,170,101,101,99,99,99,122,112,99,99,107
86038,Antinuclear antibodies (ANA);,119,107,22,113,113,67,112,59,61,61,64,61,25,26,61,58,22,111,55,57,113,61,69,80,68,69,64,63,67,60,60,113,102,61,61,60,60,59,73,67,59,60,64
86060,Antistreptolysin 0; titer,74,67,14,70,70,40,70,37,38,38,40,38,54,28,38,38,14,69,34,36,70,38,45,50,42,43,38,39,39,37,37,70,64,38,38,37,37,37,46,42,37,37,40
86140,C-reactive protein;,53,48,10,52,50,26,50,26,27,27,29,27,47,52,27,26,10,49,25,25,50,27,32,35,30,31,28,28,30,26,27,50,45,27,27,26,26,26,33,26,26,27,29
86141,C-reactive protein; high sensitivity (hsCRP),124,112,23,118,118,66,117,62,63,63,67,63,49,47,63,61,23,116,57,60,118,63,73,83,71,72,64,65,69,62,62,118,106,63,63,62,62,62,77,70,62,62,67
86146,"Beta 2 Glycoprotein I antibody, each",171,154,32,162,162,92,161,85,87,87,92,87,38,65,87,84,32,159,79,83,162,87,101,115,97,99,92,90,96,86,86,162,147,87,87,86,86,85,106,109,85,86,92
86147,"Cardiolipin (phospholipid) antibody, each Ig class",171,154,32,162,162,92,161,85,87,87,92,87,97,65,87,84,32,159,79,83,162,87,101,115,97,99,92,90,96,86,86,162,147,87,87,86,86,85,106,109,85,86,92
86160,"Complement; antigen, each component",117,105,22,111,111,63,110,58,60,60,63,60,26,44,60,57,22,109,54,57,111,60,69,78,67,68,63,62,66,58,59,111,100,60,60,58,59,58,72,66,58,59,63
86162,Complement; total hemolytic (CH50),193,174,36,183,183,103,182,96,98,98,101,98,52,73,98,95,36,180,89,94,183,98,114,129,110,112,99,102,101,96,97,183,166,98,98,96,97,96,119,109,96,97,104
86200,"Cyclic citrullinated peptide (CCP), antibody",124,112,23,118,118,60,117,62,63,63,67,63,26,47,63,61,23,116,57,60,118,63,73,83,71,72,62,65,63,62,62,118,106,63,63,62,62,62,77,70,62,62,67
86215,"Deoxyribonuclease, antibody",34,31,6,32,32,18,32,17,17,17,18,17,13,13,17,17,6,32,16,16,32,17,21,23,19,20,17,18,18,17,17,32,29,17,17,17,17,17,21,19,17,17,18
86225,Deoxyribonucleic acid (DNA) antibody; native or double stranded,132,119,24,125,125,71,124,66,67,67,71,67,27,50,67,65,24,123,61,64,125,67,78,88,75,77,68,70,66,66,66,125,113,67,67,66,66,66,81,66,66,66,71
86235,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody",97,87,18,739,92,272,91,48,49,49,53,49,46,39,49,48,18,90,45,233,92,49,269,65,739,56,260,51,250,48,49,92,83,49,49,48,49,48,60,256,48,49,52
86255,"Fluorescent noninfectious agent antibody; screen, each antibody",117,105,22,171,111,63,110,58,60,60,63,60,26,44,60,57,22,109,54,57,111,60,69,78,67,68,63,62,66,58,59,111,100,60,60,58,59,58,72,171,58,59,63
86300,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29)",200,180,37,190,190,100,188,100,102,102,108,102,75,76,102,98,37,187,100,96,190,102,118,134,114,116,103,106,112,100,100,190,172,102,102,100,100,100,123,113,100,100,108
86301,"Immunoassay for tumor antigen, quantitative; CA 19-9",200,180,37,190,190,96,188,100,102,102,104,102,110,76,102,98,37,187,93,97,190,102,118,134,114,116,103,106,112,100,100,190,172,102,102,100,100,100,123,113,100,100,108
86304,"Immunoassay for tumor antigen, quantitative; CA 125",200,180,37,190,190,107,188,100,102,102,108,102,110,76,102,98,37,187,93,97,190,102,118,134,114,116,103,106,112,100,100,190,172,102,102,100,100,100,123,156,100,100,108
86308,Heterophile antibodies; screening,53,48,10,50,50,28,50,26,27,27,29,27,49,20,27,26,10,49,25,26,50,27,32,35,30,31,28,28,28,26,27,50,45,27,27,26,27,26,33,41,26,27,29
86316,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each",200,180,37,190,190,107,188,100,102,102,108,102,50,76,102,98,37,187,93,97,190,102,118,134,114,116,103,106,112,100,100,190,172,102,102,100,100,100,123,113,100,100,108
86317,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified",145,130,27,138,138,78,137,72,74,74,76,74,49,55,74,71,27,135,67,70,138,74,85,97,83,84,74,77,76,72,73,138,124,74,74,72,73,72,89,82,72,73,78
86318,"Immunoassay for infectious agent antibody, qualitative or semiquantitative, single step method (eg, reagent strip)",84,76,16,80,80,42,79,42,43,43,49,43,52,32,43,41,16,78,39,41,80,43,50,56,48,49,45,44,47,42,42,80,72,43,43,42,42,42,52,40,42,42,45
86334,Immunofixation electrophoresis; serum,212,191,26,201,201,119,200,106,108,108,111,108,26,80,108,104,39,198,98,103,201,108,128,142,121,123,114,112,108,106,106,201,182,108,108,106,106,106,131,120,106,106,114
86335,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF)",274,247,51,260,260,147,258,136,140,140,143,140,106,104,140,134,51,256,127,133,260,140,161,183,156,159,141,145,140,137,137,260,235,140,140,137,137,137,169,155,137,137,148
86336,Inhibin A,124,112,23,118,118,66,117,62,63,63,67,63,25,47,63,61,23,116,57,60,118,63,73,83,71,72,67,65,65,62,62,118,106,63,63,62,62,62,77,70,62,62,67
86353,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis",1337,1203,106,1270,1270,717,1259,666,681,682,698,682,106,505,682,656,247,1247,619,649,1270,682,788,895,761,775,686,706,703,668,670,1270,1148,682,682,668,670,666,825,758,668,671,722
86355,"B cells, total count",144,130,27,137,137,77,136,72,73,73,78,73,97,54,73,71,27,134,67,70,137,73,85,96,82,83,74,76,76,72,72,137,124,73,73,72,72,72,89,82,72,72,78
86357,"Natural killer (NK) cells, total count",144,130,27,137,137,77,136,72,73,73,78,73,53,54,73,71,27,134,67,70,137,73,85,96,82,83,74,76,76,72,72,137,124,73,73,72,72,72,89,82,72,72,78
86359,T cells; total count,144,130,27,137,137,77,136,72,73,73,78,73,53,54,73,71,27,134,67,70,137,73,85,96,82,83,74,76,76,72,72,137,124,73,73,72,72,72,89,82,72,72,78
86360,"T cells; absolute CD4 and CD8 count, including ratio",333,300,53,316,316,179,314,166,170,170,180,170,53,126,170,163,62,311,154,162,316,170,196,223,190,193,179,176,175,166,167,316,286,170,170,166,167,166,206,189,166,167,180
86376,"Microsomal antibodies (eg, thyroid or liver-kidney), each",139,125,26,132,132,78,131,69,71,71,75,71,26,26,71,68,26,130,64,67,132,71,82,93,79,81,71,73,71,70,70,132,119,71,71,70,70,69,86,79,69,70,75
86431,Rheumatoid factor; quantitative,58,52,11,55,55,28,55,29,30,30,31,30,25,26,30,28,11,54,27,28,55,30,32,39,33,34,31,31,32,29,29,55,50,30,30,29,29,29,36,45,29,29,31
86480,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon",151,136,28,143,143,81,142,75,77,77,79,77,97,106,77,74,28,141,70,73,143,77,89,101,86,88,81,80,71,76,76,143,130,77,77,76,76,75,93,85,75,76,82
86580,"Skin test; tuberculosis, intradermal",64,58,12,61,61,34,60,32,33,33,35,33,24,24,33,31,12,60,30,31,61,33,38,43,36,37,34,34,36,32,32,61,55,33,33,32,32,32,39,36,32,32,35
86592,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)",44,40,8,42,42,24,41,22,22,22,24,22,16,17,22,22,8,41,20,21,42,22,26,29,25,26,23,23,22,22,22,42,38,22,22,22,22,22,27,25,22,22,24
86611,Antibody; Bartonella,61,55,11,58,58,33,57,30,31,31,32,31,23,23,31,30,11,57,28,30,58,31,36,41,35,35,31,33,32,30,31,58,52,31,31,30,31,30,38,35,30,31,33
86617,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot)",150,135,28,143,142,80,141,75,76,76,81,76,47,57,77,74,28,140,69,73,142,76,88,100,85,87,77,79,84,75,75,143,129,76,76,75,75,75,93,85,75,75,81
86618,Antibody; Borrelia burgdorferi (Lyme disease),82,74,15,78,78,41,77,41,42,42,44,42,47,31,42,40,15,76,38,40,78,42,48,55,28,48,44,44,46,41,41,78,70,42,42,41,41,41,51,46,41,41,44
86635,Antibody; Coccidioides,19,17,4,18,18,10,18,9,10,10,10,10,7,7,10,9,4,18,9,9,18,10,11,13,11,11,10,10,10,10,10,18,16,10,10,10,10,9,12,11,9,10,10
86644,Antibody; cytomegalovirus (CMV),137,123,25,130,130,73,129,68,70,70,71,70,25,52,70,67,25,128,63,66,130,70,81,92,78,79,74,72,70,68,69,130,118,70,70,68,69,68,85,78,68,69,74
86645,"Antibody; cytomegalovirus (CMV), IgM",161,145,25,153,153,86,152,80,82,82,84,82,25,61,82,79,30,150,75,78,153,82,95,108,92,93,86,85,82,80,81,153,138,82,82,80,81,80,99,91,80,81,87
86664,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA)",60,54,11,57,57,32,56,30,31,31,31,31,45,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,31,30,30,57,51,31,31,30,30,30,37,34,30,30,32
86665,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA)",59,53,11,56,56,32,56,29,30,30,31,30,24,22,30,29,11,55,27,29,56,30,35,40,34,34,30,31,30,30,30,56,51,30,30,30,30,29,36,33,29,30,32
86666,Antibody; Ehrlichia,60,54,11,57,57,32,56,30,31,31,31,31,22,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,34,30,30,57,51,31,31,30,30,30,37,34,30,30,32
86695,"Antibody; herpes simplex, type 1",125,112,23,119,119,67,118,62,64,64,68,64,49,47,64,61,23,117,58,61,119,64,74,84,71,72,64,66,66,62,63,119,107,64,64,62,63,62,77,71,62,63,68
86696,"Antibody; herpes simplex, type 2",125,112,23,119,119,67,118,62,64,64,38,64,24,47,64,61,23,117,58,61,119,64,74,84,71,72,64,66,66,62,63,119,107,64,64,62,63,62,77,71,62,63,68
86698,Antibody; histoplasma,39,35,7,37,37,21,37,19,20,20,20,20,15,15,20,19,7,36,18,19,37,20,23,26,22,23,20,21,19,20,20,37,33,20,20,20,20,19,24,22,19,20,21
86701,Antibody; HIV-1,50,45,9,48,48,27,47,25,25,26,27,25,19,19,26,25,9,47,23,24,48,26,29,33,28,29,26,26,26,25,25,48,43,25,25,25,25,25,31,28,25,25,27
86702,Antibody; HIV-2,48,44,9,46,46,26,46,24,25,25,26,25,18,18,25,24,9,45,22,24,46,25,29,32,28,28,25,26,25,24,24,46,42,25,25,24,24,24,30,27,24,24,26
86704,Hepatitis B core antibody (HBcAb); total,117,105,22,111,111,63,110,58,60,60,61,60,25,44,60,57,22,109,54,57,111,60,69,78,67,68,63,62,61,58,59,111,100,60,60,58,59,58,72,66,58,59,63
86705,Hepatitis B core antibody (HBcAb); IgM antibody,76,68,14,72,72,41,72,38,39,39,40,39,28,29,39,37,14,71,35,37,72,39,46,51,43,44,41,40,39,38,38,72,65,39,39,38,38,38,47,43,38,38,41
86706,Hepatitis B surface antibody (HBsAb),106,95,20,101,101,57,100,53,54,54,55,54,26,40,54,52,20,99,49,51,101,54,62,71,60,61,57,56,59,53,53,101,91,54,54,53,53,53,65,51,53,53,57
86707,Hepatitis Be antibody (HBeAb),96,86,12,91,91,51,90,48,49,49,50,49,25,36,49,47,18,90,44,47,91,49,58,64,55,56,49,51,12,48,48,91,82,49,49,48,48,48,59,54,48,48,52
86708,Hepatitis A antibody (HAAb); total,121,109,22,115,115,65,114,60,62,62,63,62,26,46,62,59,22,113,56,59,115,62,71,81,69,70,62,64,68,60,61,115,104,62,62,60,61,60,75,69,60,61,65
86713,Antibody; Legionella,132,119,24,125,125,71,124,66,67,67,69,67,49,50,67,65,24,123,61,64,125,67,78,88,75,77,68,70,67,66,66,125,113,67,67,66,66,66,81,75,66,66,71
86735,Antibody; mumps,125,112,23,119,119,67,118,62,64,64,65,64,49,47,64,61,23,117,58,61,119,64,74,84,71,72,67,66,66,62,63,119,107,64,64,62,63,62,77,71,62,63,68
86738,Antibody; mycoplasma,126,113,23,120,120,68,119,63,64,64,66,64,45,48,64,62,23,118,58,61,120,64,74,84,72,73,65,67,66,63,63,120,108,64,64,63,63,63,78,71,63,63,68
86753,"Antibody; protozoa, not elsewhere specified",60,54,11,57,57,32,56,30,31,31,31,31,22,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,34,30,30,57,51,31,31,30,30,30,37,34,30,30,32
86757,Antibody; Rickettsia,218,196,23,207,207,117,205,109,111,111,114,111,23,82,111,107,40,203,101,106,207,111,128,146,124,126,112,115,115,109,109,207,187,111,111,109,109,109,135,124,109,109,118
86762,Antibody; rubella,137,123,25,130,130,73,129,68,70,70,74,70,47,26,70,67,25,130,63,66,130,70,81,92,78,79,74,74,72,68,69,130,118,70,70,68,69,68,85,107,68,69,74
86765,Antibody; rubeola,124,112,23,118,118,66,117,62,63,63,65,63,25,47,63,61,23,116,57,60,118,63,73,83,71,72,67,65,65,62,62,118,106,63,63,62,62,62,77,70,62,62,67
86769,HC SARS-COV-2 COVID-19 ANTIBODY,100,90,18,95,95,54,94,50,51,51,62,51,63,38,51,49,18,93,46,49,95,51,59,67,57,58,54,53,56,50,50,95,86,51,51,50,50,50,62,56,50,50,54
86780,Antibody; Treponema pallidum,179,161,33,170,170,96,169,89,91,91,68,91,47,68,91,88,33,167,83,87,170,91,105,120,102,104,96,95,94,90,90,170,154,91,91,90,90,89,110,98,89,90,97
86784,Antibody; Trichinella,65,58,12,62,62,35,61,32,33,33,35,33,24,25,33,32,12,61,30,32,62,33,38,44,37,38,33,34,34,32,33,62,56,33,33,32,33,32,40,37,32,33,35
86787,Antibody; varicella-zoster,124,112,23,118,118,66,117,62,63,63,67,63,52,47,63,61,23,116,57,60,118,63,73,83,71,72,67,65,65,62,62,118,106,63,63,62,62,62,77,70,62,62,67
86800,Thyroglobulin antibody,154,139,25,146,146,83,145,77,78,79,83,79,25,58,79,76,28,144,71,75,146,79,91,103,88,89,79,81,79,77,77,146,132,79,79,77,77,77,95,87,77,77,83
86803,Hepatitis C antibody;,135,122,25,128,128,68,127,67,69,69,73,69,52,52,69,67,25,128,63,65,128,69,82,90,77,78,72,73,76,68,68,128,116,69,69,68,68,67,83,76,67,68,73
86812,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen",245,220,45,233,233,131,231,122,125,125,99,125,92,93,125,120,45,228,113,119,233,125,144,164,140,142,126,129,129,122,123,233,210,125,125,122,123,122,151,139,122,123,132
86832,HC HLA CLASS I HIGH DEFIN QUAL,540,486,100,513,513,289,508,269,275,275,282,275,107,204,275,265,100,504,250,262,513,275,318,362,307,313,277,285,289,270,271,513,463,275,275,270,271,269,333,306,270,271,292
86833,HC HLA CLASS II HIGH DEFIN QUAL,350,315,54,333,332,188,330,174,178,178,183,178,54,132,179,172,65,326,162,170,332,178,206,234,199,203,180,185,187,175,175,333,300,178,178,175,175,174,216,198,175,176,189
86850,"Antibody screen, RBC, each serum technique",62,56,11,107,59,35,58,31,32,32,33,32,107,107,32,30,11,59,29,30,59,32,37,42,35,36,33,33,35,31,31,59,53,32,32,31,18,31,38,31,31,31,33
86880,"Antihuman globulin test (Coombs test); direct, each antiserum",50,45,9,107,48,27,47,25,25,26,26,25,107,19,26,25,9,47,23,24,48,26,29,33,28,29,26,26,28,25,25,48,43,25,25,25,25,25,31,39,25,25,27
86900,Blood typing; ABO,28,25,5,54,27,16,26,14,14,14,15,14,54,54,14,14,5,27,13,13,27,14,17,19,16,16,15,15,16,14,14,27,24,14,14,14,14,14,17,14,14,14,15
86901,Blood typing; Rh (D),31,28,6,34,29,17,29,15,16,16,17,16,34,34,16,15,6,29,14,15,29,16,18,21,18,18,17,17,17,16,16,29,27,16,16,16,16,15,19,16,15,16,17
86920,Compatibility test each unit; immediate spin technique,147,132,27,140,140,82,138,73,75,75,85,75,54,56,75,72,27,137,68,71,140,75,87,98,84,85,75,78,82,74,74,140,126,75,75,74,74,73,91,74,73,74,79
86922,Compatibility test each unit; antiglobulin technique,160,144,30,152,152,86,151,80,82,82,84,82,60,60,82,78,30,149,74,78,152,82,94,107,91,93,82,84,76,80,80,152,137,82,82,80,80,80,99,91,80,80,86
87015,"Concentration (any type), for infectious agents",62,56,11,59,59,33,58,31,32,32,33,32,23,23,32,30,11,58,29,30,59,32,37,42,35,36,32,33,33,31,31,59,53,32,32,31,31,31,38,31,31,31,33
87040,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)",101,91,19,96,96,50,95,50,52,52,55,52,43,86,52,50,19,94,47,48,96,52,60,68,58,59,54,48,57,50,51,96,87,51,52,50,50,50,62,50,50,51,55
87070,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates",85,76,7,81,81,50,81,46,43,43,46,43,33,37,43,42,7,79,39,44,81,43,51,57,11,49,46,46,48,42,43,81,73,43,43,42,44,42,52,44,42,43,46
87075,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates",92,83,16,90,87,49,87,46,47,47,50,47,16,35,47,44,17,86,43,45,87,47,54,62,90,53,49,50,49,46,46,87,79,47,47,46,46,46,57,58,46,46,50
87076,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate",70,63,13,67,66,38,66,35,36,36,38,36,26,26,36,34,13,65,32,34,66,36,42,47,40,41,36,38,33,35,35,67,60,36,36,35,35,35,43,40,35,35,38
87077,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate",74,67,10,303,70,40,70,38,38,38,40,38,17,26,38,37,14,69,34,37,70,38,47,50,10,43,40,40,41,37,37,70,303,38,38,37,38,37,46,40,39,37,40
87081,"Culture, presumptive, pathogenic organisms, screening only;",60,54,11,57,57,29,56,30,31,31,32,31,31,37,31,30,11,56,28,29,57,31,35,40,34,35,32,32,34,30,30,57,51,31,31,30,30,30,37,47,30,30,32
87086,"Culture, bacterial; quantitative colony count, urine",80,72,3,76,76,40,75,38,41,41,43,41,31,17,41,40,7,76,37,38,76,41,48,54,3,46,43,43,45,40,40,76,76,41,41,40,40,40,49,40,41,40,43
87102,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)",60,54,11,59,57,32,56,30,31,31,32,31,16,23,31,29,11,56,28,29,57,31,35,40,59,35,31,32,28,30,30,57,51,31,31,30,30,30,37,34,30,30,32
87103,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood",101,91,19,96,96,54,95,50,51,52,53,52,38,38,52,50,19,94,47,49,96,52,60,68,58,59,52,53,57,50,51,96,87,51,52,50,51,50,62,57,50,51,55
87106,"Culture, fungi, definitive identification, each organism; yeast",122,110,23,116,116,65,115,61,62,62,64,62,46,46,62,60,23,114,56,59,116,62,72,82,69,71,65,64,60,61,61,116,105,62,62,61,61,61,75,69,61,61,66
87107,"Culture, fungi, definitive identification, each organism; mold",92,83,16,87,87,49,87,46,47,47,48,47,16,35,47,45,17,86,43,45,87,47,54,62,52,53,47,49,52,46,46,87,79,47,47,46,46,46,57,52,46,46,50
87116,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates",106,95,20,101,101,57,100,53,54,54,57,54,52,40,54,52,20,99,49,51,101,54,62,71,60,61,54,56,56,53,53,101,91,54,54,53,53,53,65,53,53,53,57
87147,"Culture, typing; immunologic method, other than immunofluoresence (eg, agglutination grouping), per antiserum",53,48,10,50,50,28,50,26,27,27,29,27,17,20,27,25,10,49,25,26,50,27,31,35,30,31,28,28,27,26,27,50,45,27,27,26,27,26,33,34,26,27,29
87149,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed",385,346,71,366,366,206,362,101,196,196,201,196,144,146,196,189,71,359,178,187,366,196,227,258,219,223,198,203,191,192,193,366,330,196,196,192,193,192,238,101,192,193,208
87150,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed",311,280,57,295,295,167,293,155,158,158,92,158,116,117,158,152,57,290,144,151,295,158,183,208,177,180,159,80,158,155,156,295,267,158,158,155,156,155,192,85,155,156,168
87177,"Ova and parasites, direct smears, concentration and identification",79,71,10,75,75,40,74,39,40,40,43,40,31,30,40,39,15,74,37,38,75,40,47,53,45,46,42,42,10,40,40,75,68,40,40,40,40,39,49,44,39,40,43
87181,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)",85,76,16,95,81,46,80,42,43,43,23,43,17,32,43,42,16,79,39,41,81,43,50,57,48,49,44,45,95,42,43,81,73,43,43,42,43,42,52,48,42,43,46
87184,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)",30,27,6,29,28,17,28,15,15,15,16,15,18,11,15,15,6,28,14,15,28,15,18,20,29,17,12,16,17,15,15,29,26,15,15,15,15,15,19,15,15,15,16
87185,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme",44,40,8,42,42,24,41,22,22,22,12,22,17,17,22,22,8,41,20,21,42,22,26,29,25,26,23,24,25,22,22,42,38,22,22,22,22,22,27,25,22,22,24
87186,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial, per plate",85,76,6,81,81,42,80,41,43,43,46,43,17,17,43,42,16,79,39,41,81,43,51,57,6,49,46,43,48,42,43,81,73,43,43,42,42,42,52,42,43,43,46
87205,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types",44,40,4,43,42,25,42,22,22,22,24,22,17,18,22,22,4,41,20,21,42,22,27,29,43,26,24,24,25,22,22,42,38,22,22,22,22,22,27,22,22,22,24
87206,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types",25,22,5,25,24,13,24,12,13,13,14,13,16,9,13,12,5,23,12,12,24,13,15,17,25,14,13,13,12,12,13,24,21,13,13,12,13,12,15,12,12,13,14
87209,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites",93,84,16,88,88,46,88,46,47,47,50,47,16,35,47,46,17,87,43,45,88,47,55,62,53,54,50,49,20,46,47,88,80,47,47,46,47,46,57,52,46,47,50
87210,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps)",18,16,3,17,17,10,17,9,9,9,10,9,7,7,9,9,3,17,8,9,17,9,11,12,10,10,10,10,10,9,9,17,15,9,9,9,9,9,11,9,9,9,10
87220,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)",44,40,8,42,42,24,41,22,22,22,24,22,16,17,22,22,8,41,20,21,42,22,26,29,25,26,27,23,25,22,22,42,38,22,22,22,22,22,27,25,22,22,24
87324,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Clostridium difficile toxin(s)",117,105,10,111,111,111,110,58,60,60,63,60,31,44,60,10,22,109,54,57,111,60,69,78,67,68,63,62,66,58,59,111,100,60,60,58,59,58,72,62,58,59,63
87338,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Helicobacter pylori, stool",117,105,22,111,111,63,110,58,60,60,63,60,31,44,60,56,22,109,54,57,111,60,69,78,60,68,63,58,66,58,59,111,100,60,60,58,59,58,72,58,58,59,63
87340,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen (HBsAg)",94,85,17,89,89,50,89,47,48,48,51,48,29,34,48,46,17,89,44,46,89,48,55,63,54,54,50,51,48,47,47,89,81,48,48,47,47,47,58,53,47,47,51
87341,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen (HBsAg) neutralization",54,49,10,51,51,29,51,27,28,28,28,28,34,20,28,26,10,50,25,26,51,28,32,36,31,31,28,29,28,27,27,51,46,28,28,27,27,27,33,31,27,27,29
87350,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; hepatitis Be antigen (HBeAg)",113,102,12,107,107,61,106,56,58,58,59,58,42,43,58,55,21,105,52,55,107,58,68,76,64,65,58,60,12,56,57,107,97,58,58,56,57,56,70,64,56,57,61
87389,HC HIV-1 AG W/ HIV-1 & HIV-2 AB,97,87,17,92,92,48,91,48,49,49,52,49,17,37,49,48,18,92,45,47,92,49,57,65,55,56,52,52,52,48,49,92,83,49,49,48,49,48,60,62,48,49,52
87420,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; respiratory syncytial virus",117,105,22,115,111,63,110,58,60,60,63,60,33,115,60,58,22,109,54,57,111,60,69,78,67,68,63,62,55,58,59,111,100,60,60,58,59,58,72,91,58,59,63
87449,"Infectious agent antigen detection by enzyme immunoassay technique qualitative or semiquantitative; multiple step method, not otherwise specified, each organism",144,130,16,137,137,69,136,72,73,73,75,73,16,54,73,71,27,134,67,70,137,73,85,96,82,83,74,76,73,72,72,137,124,73,73,72,72,72,89,82,72,72,78
87480,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique",62,56,6,59,59,33,58,31,32,32,33,32,31,33,32,30,17,58,29,30,59,32,37,42,6,36,33,33,35,31,31,59,53,32,32,31,31,31,38,48,31,31,33
87483,HC CNS DNA AMP PROBE TYPE 12-25,320,288,59,314,304,172,301,159,163,163,167,163,314,121,163,157,59,298,148,155,304,163,189,214,182,185,164,169,151,160,160,304,275,163,163,160,160,159,197,181,160,161,173
87486,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique",107,96,20,115,102,77,101,54,55,55,58,55,105,115,55,52,20,100,50,52,102,55,63,72,61,62,50,56,55,54,54,102,92,55,55,54,54,53,66,54,53,54,58
87491,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique",227,204,42,431,216,165,214,113,116,116,123,116,69,76,116,113,42,216,105,110,216,116,137,152,129,132,122,123,127,114,114,216,431,116,116,114,114,113,140,177,113,114,123
87493,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique",144,129,27,136,136,30,135,71,73,73,75,73,54,54,73,70,27,134,66,70,136,73,85,96,82,83,74,76,37,72,72,136,123,73,73,72,72,71,89,81,72,72,77
87497,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification",328,295,61,312,312,176,309,163,167,167,171,167,76,124,167,161,61,306,152,159,312,167,193,220,187,190,176,173,167,164,164,312,282,167,167,164,164,163,202,186,164,165,177
87502,"Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, reverse transcription and amplified probe technique, first 2 types or sub-types",122,110,23,116,116,61,115,59,62,62,66,62,76,90,62,61,23,116,56,59,116,62,72,82,44,71,65,66,68,61,61,116,105,62,62,61,61,61,75,61,61,61,66
87507,HC IADNA-DNA/RNA PROBE TQ 12-25,361,325,67,360,343,343,340,180,184,184,195,184,314,326,184,360,67,337,167,175,343,184,213,242,206,209,194,191,190,180,181,343,343,184,184,180,181,180,223,281,180,181,195
87510,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique",62,56,16,59,59,33,58,31,32,32,33,32,16,17,32,30,17,58,29,30,59,32,37,42,32,36,33,33,35,31,31,59,53,32,32,31,31,31,38,31,31,31,33
87517,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification",690,621,115,656,656,370,650,344,352,352,360,352,115,261,352,338,128,643,319,335,656,352,407,462,393,400,354,364,363,345,346,656,592,352,352,345,346,344,426,391,345,346,373
87522,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification",401,361,69,381,381,200,378,200,204,205,217,204,69,152,205,197,74,374,186,195,381,205,243,269,228,232,206,200,225,200,201,381,344,204,205,200,201,200,247,192,200,201,217
87529,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique",328,295,61,312,312,176,309,163,167,167,177,167,69,115,167,161,61,306,152,159,312,167,193,220,187,190,176,173,184,164,164,312,282,167,167,164,164,163,202,256,164,165,177
87581,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique",107,96,20,102,102,77,101,54,55,55,58,55,52,58,55,52,20,100,50,52,102,55,63,72,61,62,50,56,55,54,54,102,92,55,55,54,54,53,66,54,53,54,58
87591,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique",227,204,36,216,216,165,214,113,116,116,123,116,36,38,116,113,42,216,105,110,216,116,137,152,129,132,122,123,127,114,114,216,195,116,116,114,114,113,140,177,113,114,123
87633,HC RESP VIRUS 20 TARGETS,107,96,20,102,102,77,101,53,55,55,58,55,58,58,55,52,20,100,50,52,102,55,63,72,61,62,54,56,55,54,54,102,92,55,55,54,54,53,66,83,53,54,58
87635,Infectious agent detection by nucleic acid; severe acute respiratory syndrome coronavirus COVID-19,100,90,18,95,95,50,94,50,51,51,54,51,77,77,51,50,18,95,51,49,95,51,52,52,41,58,54,54,51,50,51,95,86,51,51,50,50,50,50,50,50,51,54
87641,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique",277,249,51,263,263,148,261,138,141,141,145,141,104,105,141,136,51,258,128,134,263,141,163,185,158,161,142,146,146,138,139,263,238,141,141,138,139,138,171,216,138,139,150
87651,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique",50,45,9,76,48,28,47,24,25,26,27,25,76,19,26,25,9,48,23,24,48,26,29,33,26,29,27,27,28,25,25,48,43,25,25,25,25,25,31,28,25,25,27
87653,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique",192,173,35,182,182,103,181,96,98,98,104,98,72,73,98,94,35,179,89,93,182,98,113,129,109,111,103,101,101,96,96,182,165,98,98,96,96,96,118,109,96,96,104
87660,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique",62,56,16,59,59,33,58,31,32,32,33,32,16,17,32,30,17,58,29,30,59,32,37,42,35,36,33,33,35,31,31,59,53,32,32,31,31,31,38,48,31,31,33
87798,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism",107,96,20,105,102,77,101,54,55,55,58,55,71,58,55,52,20,100,50,52,102,55,63,72,61,62,99,56,105,54,54,102,92,55,55,54,54,53,66,54,53,54,58
87799,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism",564,508,74,536,536,302,531,281,287,288,295,288,74,213,288,277,104,526,261,274,536,288,332,378,321,327,303,298,316,282,283,536,484,288,288,282,283,281,348,320,282,283,305
87801,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique",120,108,22,114,114,64,113,60,61,61,63,61,69,45,61,59,22,112,56,58,114,61,71,80,68,70,62,63,63,60,60,114,103,61,61,60,60,60,74,68,60,60,65
87804,Infectious agent antigen detection by immunoassay with direct optical observation; Influenza,53,48,10,50,50,28,50,26,27,27,28,27,20,20,27,26,10,49,25,26,50,27,31,35,30,31,27,28,30,26,27,50,45,27,27,26,27,26,33,26,26,27,29
87811,HC SARS-COV-2 COVID19 W/OPTIC,100,90,18,95,95,54,94,50,51,51,54,51,37,38,51,49,18,93,46,49,95,51,59,67,57,58,51,53,56,50,50,95,86,51,51,50,50,50,62,57,50,50,54
87880,"Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group A",116,104,21,110,110,62,109,58,59,59,63,59,43,44,59,57,21,108,54,56,110,59,68,78,66,67,62,61,65,58,58,110,100,59,59,58,58,58,72,66,58,58,63
87902,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus,938,844,105,891,891,503,883,467,478,478,490,478,105,355,478,460,173,875,434,455,891,478,553,628,534,544,481,495,493,469,470,891,805,478,478,469,470,467,579,532,469,470,507
88184,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker",198,178,37,188,188,106,186,99,101,101,103,101,145,75,101,97,37,185,92,96,188,101,117,133,113,115,102,105,101,99,99,188,170,101,101,99,99,99,122,112,99,99,107
88185,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker)",164,148,30,156,156,88,154,82,84,84,86,84,73,62,84,80,30,153,76,80,156,84,97,110,93,95,84,87,84,82,82,156,141,84,84,82,82,82,101,93,82,82,89
88274,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells",260,234,48,247,247,139,245,130,133,133,136,133,97,98,133,128,48,242,120,126,247,133,153,174,148,151,133,137,127,130,130,247,223,133,133,130,130,130,160,147,130,130,140
88275,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells",260,234,48,247,247,139,245,130,133,133,136,133,97,98,133,128,48,242,120,126,247,133,153,174,148,151,133,137,127,130,130,247,223,133,133,130,130,130,160,147,130,130,140
88302,"Level II - Surgical pathology, gross and microscopic examination Appendix, incidental, Fallopian tube, sterilization, Fingers/toes, amputation, traumatic, Foreskin, newborn, Hernia sac, any location, Hydrocele sac, Nerve, Skin, plastic repair, Sympathetic ganglion, Testis, castration, Vaginal mucosa, incidental, Vas deferens, sterilization",146,131,27,139,139,78,137,73,74,74,76,74,55,55,74,72,27,136,68,71,139,74,86,98,83,85,75,77,72,73,73,139,125,74,74,73,73,73,90,83,73,73,79
88304,"Level III - Surgical pathology, gross and microscopic examination Abortion, induced, Abscess, Aneurysm - arterial/ventricular, Anus, tag, Appendix, other than incidental, Artery, atheromatous plaque, Bartholin's gland cyst, Bone fragment(s), other than pathologic fracture, Bursa/synovial cyst, Carpal tunnel tissue, Cartilage, shavings, Cholesteatoma, Colon, colostomy stoma, Conjunctiva - biopsy/pterygium, Cornea, Diverticulum - esophagus/small intestine, Dupuytren's contracture tissue, Femoral head, other than fracture, Fissure/fistula, Foreskin, other than newborn, Gallbladder, Ganglion cyst, Hematoma, Hemorrhoids, Hydatid of Morgagni, Intervertebral disc, Joint, loose body, Meniscus, Mucocele, salivary, Neuroma - Morton's/traumatic, Pilonidal cyst/sinus, Polyps, inflammatory - nasal/sinusoidal, Skin - cyst/tag/debridement, Soft tissue, debridement, Soft tissue, lipoma, Spermatocele, Tendon/tendon sheath, Testicular appendage, Thrombus or embolus, Tonsil and/or adenoids, Varicocele, Vas deferens, other than sterilization, Vein, varicosity",176,158,33,167,167,84,166,88,90,90,92,90,66,67,90,88,33,164,81,85,167,90,104,118,100,102,90,93,139,88,88,167,151,90,90,88,88,88,109,84,88,88,95
88305,"Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed, Artery, biopsy, Bone marrow, biopsy, Bone exostosis, Brain/meninges, other than for tumor resection, Breast, biopsy, not requiring microscopic evaluation of surgical margins, Breast, reduction mammoplasty, Bronchus, biopsy, Cell block, any source, Cervix, biopsy, Colon, biopsy, Duodenum, biopsy, Endocervix, curettings/biopsy, Endometrium, curettings/biopsy, Esophagus, biopsy, Extremity, amputation, traumatic, Fallopian tube, biopsy, Fallopian tube, ectopic pregnancy, Femoral head, fracture, Fingers/toes, amputation, non-traumatic, Gingiva/oral mucosa, biopsy, Heart valve, Joint, resection, Kidney, biopsy, Larynx, biopsy, Leiomyoma(s), uterine myomectomy - without uterus, Lip, biopsy/wedge resection, Lung, transbronchial biopsy, Lymph node, biopsy, Muscle, biopsy, Nasal mucosa, biopsy, Nasopharynx/oropharynx, biopsy, Nerve, biopsy, Odontogenic/dental cyst, Omentum, biopsy, Ovary with or without tube, non-neoplastic, Ovary, biopsy/wedge resection, Parathyroid gland, Peritoneum, biopsy, Pituitary tumor, Placenta, other than third trimester, Pleura/pericardium - biopsy/tissue, Polyp, cervical/endometrial, Polyp, colorectal, Polyp, stomach/small intestine, Prostate, needle biopsy, Prostate, TUR, Salivary gland, biopsy, Sinus, paranasal biopsy, Skin, other than cyst/tag/debridement/plastic repair, Small intestine, biopsy, Soft tissue, other than tumor/mass/lipoma/debridement, Spleen, Stomach, biopsy, Synovium, Testis, other than tumor/biopsy/castration, Thyroglossal duct/brachial cleft cyst, Tongue, biopsy, Tonsil, biopsy, Trachea, biopsy, Ureter, biopsy, Urethra, biopsy, Urinary bladder, biopsy, Uterus, with or without tubes and ovaries, for prolapse, Vagina, biopsy, Vulva/labia, biopsy",154,139,28,153,146,86,145,77,78,79,79,79,79,58,79,153,28,144,71,75,146,79,91,103,88,89,77,81,86,77,77,146,132,79,79,77,116,77,95,77,77,77,83
88307,"Level V - Surgical pathology, gross and microscopic examination Adrenal, resection, Bone - biopsy/curettings, Bone fragment(s), pathologic fracture, Brain, biopsy, Brain/meninges, tumor resection, Breast, excision of lesion, requiring microscopic evaluation of surgical margins, Breast, mastectomy - partial/simple, Cervix, conization, Colon, segmental resection, other than for tumor, Extremity, amputation, non-traumatic, Eye, enucleation, Kidney, partial/total nephrectomy, Larynx, partial/total resection, Liver, biopsy - needle/wedge, Liver, partial resection, Lung, wedge biopsy, Lymph nodes, regional resection, Mediastinum, mass, Myocardium, biopsy, Odontogenic tumor, Ovary with or without tube, neoplastic, Pancreas, biopsy, Placenta, third trimester, Prostate, except radical resection, Salivary gland, Sentinel lymph node, Small intestine, resection, other than for tumor, Soft tissue mass (except lipoma) - biopsy/simple excision, Stomach - subtotal/total resection, other than for tumor, Testis, biopsy, Thymus, tumor, Thyroid, total/lobe, Ureter, resection, Urinary bladder, TUR, Uterus, with or without tubes and ovaries, other than neoplastic/prolapse",339,305,63,322,322,182,319,169,173,173,177,173,127,128,173,166,63,316,157,164,322,173,200,227,193,196,174,179,173,170,170,322,291,173,173,170,170,169,209,192,169,170,183
88311,Decalcification procedure (List separately in addition to code for surgical pathology examination),52,47,10,49,49,28,49,26,27,27,27,27,19,20,27,26,10,48,24,25,49,27,31,35,30,30,27,27,25,26,26,49,45,27,27,26,26,26,32,29,26,26,28
88313,"Special stains; Group II, all other (eg, iron, trichrome), except immunocytochemistry and immunoperoxidase stains, including interpretation and report, each",128,115,24,122,122,69,121,64,65,65,67,65,48,48,65,63,24,119,59,62,122,65,75,86,73,74,66,68,65,64,64,122,110,65,65,64,64,64,79,73,64,64,69
88341,PBB IMMUNOHISTO ANTIBODY ADDL SLIDE,426,383,79,405,405,248,401,212,217,217,222,217,145,161,217,209,79,397,197,207,405,217,251,285,243,247,219,225,80,213,214,405,366,217,217,213,213,212,263,241,213,214,230
88342,"Immunohistochemistry (including tissue immunoperoxidase), each antibody",129,116,24,123,123,71,121,64,66,66,67,66,48,49,66,63,24,120,60,63,123,66,76,86,73,75,66,68,72,64,65,123,111,66,66,64,65,64,80,64,64,65,70
88346,"Immunofluorescent study, each antibody; direct method",147,132,27,160,140,79,138,73,75,75,77,75,160,56,75,72,27,137,68,71,140,75,87,98,84,85,75,78,77,74,74,140,126,75,75,74,74,73,91,83,73,74,79
88350,HC IMMUNOFLUOR ANTB ADDL STAIN,147,132,27,140,140,79,138,73,75,75,77,75,80,56,75,72,27,137,68,71,140,75,87,98,84,85,75,78,77,74,74,140,126,75,75,74,74,73,91,83,73,74,79
88360,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual",160,144,30,152,152,86,151,80,82,82,84,82,60,60,82,78,30,149,74,78,152,82,94,107,91,93,82,84,90,80,80,152,137,82,82,80,80,80,99,91,80,80,86
88364,HC INSITU HYBRIDIZATION (FISH) EA ADDTL SGL PROC,182,164,34,173,173,91,171,91,93,93,95,93,68,69,93,89,34,170,84,88,173,93,107,122,104,105,93,96,96,91,91,173,156,93,93,91,91,91,112,103,91,91,98
88365,"In situ hybridization (eg, FISH), each probe",281,253,52,267,267,140,265,140,143,143,147,143,105,106,143,138,52,262,130,136,267,143,166,188,160,163,144,148,157,140,141,267,241,143,143,140,141,140,173,159,140,141,152
89051,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count",57,51,11,61,54,31,54,28,29,29,28,29,61,22,29,27,11,53,26,28,54,29,34,38,32,33,29,30,29,28,29,54,49,29,29,28,29,28,35,32,28,29,31
89060,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)",73,66,13,69,69,39,69,36,37,37,36,37,61,28,37,36,13,68,34,35,69,37,43,49,42,42,37,39,41,36,37,69,63,37,37,36,37,36,45,36,36,37,39
89190,Nasal smear for eosinophils,36,32,7,119,34,19,34,18,18,18,19,18,119,14,18,18,7,34,17,17,34,18,21,24,20,21,18,19,19,18,18,34,31,18,18,18,18,18,22,20,18,18,19
89321,"Semen analysis; sperm presence and motility of sperm, if performed",117,105,22,111,111,63,110,58,60,60,61,60,93,44,60,57,22,109,54,57,111,60,69,78,67,68,60,62,61,58,59,111,100,60,60,58,59,58,72,66,58,59,63
90376,"Rabies immune globulin, heat-treated (RIg-HT), human, for intramuscular and/or subcutaneous use",10682,9614,1975,10148,10148,5726,10058,5321,5445,5448,5579,5448,3996,4038,5448,5240,1975,9962,4946,5182,10148,5448,6296,7153,6083,6191,4443,5640,5614,5341,5354,10148,9169,5446,5448,5341,5352,5322,6593,6055,5339,5358,5768
90471,"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)",82,74,15,78,78,46,77,41,42,42,33,42,36,31,42,39,15,78,38,40,78,42,50,55,47,48,44,44,46,41,41,78,70,42,42,41,41,41,51,41,41,41,44
90662,"Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use",186,167,19,177,177,100,175,93,95,95,19,95,70,70,95,91,34,174,86,90,177,95,110,125,106,108,95,98,88,93,93,177,160,95,95,93,61,93,115,56,93,93,100
90670,"Pneumococcal conjugate vaccine, 13 valent, for intramuscular use",476,428,88,452,452,255,448,237,243,243,249,243,178,180,243,233,88,444,220,231,452,243,280,319,271,276,244,251,224,238,239,452,408,243,243,238,238,237,294,270,238,239,257
90675,"Rabies vaccine, for intramuscular use",782,704,145,743,743,419,736,389,398,399,408,399,305,295,399,383,145,729,362,379,743,399,461,523,445,453,419,413,411,391,392,743,671,399,399,391,392,389,482,443,391,392,422
90686,Influenza virus vaccine,40,36,7,61,38,21,38,20,20,20,16,20,20,15,20,19,7,37,19,19,38,20,24,27,23,23,61,22,21,20,20,38,34,20,20,20,20,20,25,23,20,20,22
90688,PBB IIV4 VACCINE SPLT 0.5 ML IM,119,107,22,113,113,64,112,59,61,61,45,61,45,45,61,58,22,111,55,58,113,61,70,80,68,69,61,63,63,60,60,113,102,61,61,60,60,59,73,67,60,60,64
90714,"Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, when administered to individuals 7 years or older, for intramuscular use",157,141,26,149,149,89,148,78,80,80,79,80,26,59,80,77,29,147,73,76,149,80,95,105,89,91,84,83,79,79,79,149,135,80,80,79,79,78,97,80,79,79,85
90715,"Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use",175,157,32,166,166,93,164,87,89,89,94,89,35,35,89,86,32,166,81,85,166,89,103,117,99,101,94,92,98,87,88,166,150,89,89,87,88,87,108,93,87,88,94
92507,"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual",392,353,72,372,372,210,369,195,200,200,212,200,174,148,200,192,72,366,181,190,372,200,231,262,223,227,196,207,200,196,196,372,336,200,200,196,196,195,242,222,196,197,212
92522,HC EVALUATE SPEECH PRODUCTION,188,169,35,179,179,101,177,94,96,96,98,96,158,71,96,92,35,175,87,91,179,96,111,126,107,109,96,99,105,94,94,179,161,96,96,94,94,94,116,107,94,94,102
92523,HC EVAL SPEECH SOUND LANG COMPREHEN,373,336,69,354,354,200,351,186,190,190,201,190,129,141,190,183,69,348,173,181,354,190,220,250,212,216,186,197,190,186,187,354,320,190,190,186,187,186,230,211,186,187,201
92526,Treatment of swallowing dysfunction and/or oral function for feeding,392,353,72,372,372,210,369,195,200,200,212,200,158,148,200,192,72,366,181,190,372,200,231,262,223,227,201,207,200,196,196,372,336,200,200,196,196,195,242,222,196,197,212
92610,Evaluation of oral and pharyngeal swallowing function,392,353,72,372,372,210,369,195,200,200,196,200,129,148,200,192,72,366,181,190,372,200,231,262,223,227,201,207,220,196,196,372,336,200,200,196,196,195,242,222,196,197,212
92611,Motion fluoroscopic evaluation of swallowing function by cine or video recording,392,353,72,372,372,210,369,195,200,200,212,200,147,148,200,192,72,366,181,190,372,200,231,262,223,227,201,207,210,196,196,372,336,200,200,196,196,195,242,196,196,197,212
92950,"Cardiopulmonary resuscitation (eg, in cardiac arrest)",526,473,97,1835,500,282,495,262,268,268,275,268,1835,199,268,258,97,491,244,255,500,268,310,352,300,305,263,278,281,263,264,500,451,268,268,263,264,262,325,263,263,264,284
92960,"Cardioversion, elective, electrical conversion of arrhythmia; external",266,239,49,253,253,143,250,132,136,136,139,136,100,101,136,130,49,248,123,129,253,136,157,178,151,154,137,140,136,133,133,253,228,136,136,133,133,133,164,151,133,133,144
93005,"Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report",150,135,4,143,142,75,141,75,76,76,81,76,91,91,76,73,28,142,76,72,142,76,91,100,76,4,81,75,84,75,76,143,129,76,76,75,75,75,75,75,76,76,81
93010,"Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only",50,45,9,48,48,9,47,9,9,26,28,25,9,19,26,25,9,47,9,9,48,26,29,33,28,29,9,9,9,25,9,48,43,25,25,25,25,25,31,28,9,9,27
93016,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; physician supervision only, without interpretation and report",110,99,20,105,104,59,104,55,56,56,57,56,41,42,56,54,20,103,51,53,104,56,65,74,63,64,56,58,24,55,55,105,94,56,56,55,55,55,68,62,55,55,59
93017,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report",761,685,141,723,723,403,717,379,388,388,411,388,222,333,388,379,141,710,352,369,723,388,460,510,433,441,408,402,426,380,381,723,653,388,388,380,381,379,593,380,380,382,411
93018,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only",110,99,16,105,104,16,104,55,56,56,57,56,16,42,56,54,20,103,51,53,104,56,65,74,63,64,56,58,16,55,55,105,94,56,56,55,55,55,68,62,55,55,59
93225,"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)",83,75,15,79,79,44,78,41,42,76,43,42,76,31,42,76,15,77,38,40,79,42,49,56,47,48,43,44,46,42,42,79,71,42,42,42,42,41,51,47,41,42,45
93306,"Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography",1388,1249,195,1319,1319,736,1307,691,707,708,750,708,457,457,708,691,195,1319,643,673,1319,708,840,929,708,804,745,694,777,694,696,1319,1319,708,708,694,695,692,1081,694,694,696,750
93797,Physician services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session),205,184,38,195,195,110,193,102,104,105,107,105,105,77,105,101,38,191,95,99,195,105,121,137,117,119,105,108,105,102,103,195,176,105,105,102,103,102,127,116,102,103,111
93798,Physician services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session),195,176,36,255,185,98,184,97,99,99,102,99,255,74,99,96,36,182,90,95,185,99,115,131,99,113,100,103,109,98,99,185,167,99,99,98,98,97,120,152,97,98,105
93880,Duplex scan of extracranial arteries; complete bilateral study,1118,1006,207,1062,1062,559,1053,557,570,570,604,570,211,423,570,557,207,1062,518,542,1062,570,659,749,528,648,600,590,626,559,560,1062,960,570,570,559,560,557,690,559,559,561,604
93922,"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with transcutaneous oxygen tension measurements at 1-2 levels)",798,718,148,758,758,399,751,397,407,407,431,407,387,302,407,391,148,744,369,387,758,407,470,534,454,462,410,421,447,399,400,758,685,407,407,399,400,398,493,423,399,400,431
93925,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study,1335,1202,247,1268,1268,668,1257,665,680,681,721,681,303,505,681,692,247,1245,618,648,1268,681,787,894,681,774,825,705,748,668,669,1268,1146,681,681,668,668,665,824,668,667,670,721
93926,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study,751,676,139,713,713,376,707,374,383,383,406,383,153,284,383,368,139,700,348,364,713,383,443,503,383,435,385,397,421,376,376,713,645,383,383,376,376,374,464,360,375,377,406
93970,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study,1335,1202,183,1268,1268,748,1257,665,680,681,721,681,318,505,681,655,183,1245,618,648,1268,681,787,894,760,774,668,705,748,668,669,1268,1146,681,681,668,669,665,824,840,667,670,721
93971,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study,618,556,114,587,587,309,582,308,315,315,334,315,211,399,315,308,114,576,286,300,587,315,364,414,234,358,332,326,346,309,310,587,530,315,315,309,309,308,381,309,309,310,334
93975,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study",889,800,164,845,845,498,837,443,453,453,480,453,333,336,453,436,164,829,412,431,845,453,524,595,506,515,444,469,498,444,446,845,763,453,453,444,445,443,549,693,444,446,480
93976,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study",889,800,164,845,845,477,837,443,453,453,464,453,333,336,453,436,164,829,412,431,845,453,524,595,506,515,456,469,422,444,446,845,763,453,453,444,445,443,549,504,444,446,480
93978,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study",889,800,164,845,845,477,837,443,453,453,464,453,303,336,453,436,164,829,412,431,845,453,524,595,506,515,456,469,498,444,446,845,763,453,453,444,445,443,549,504,444,446,480
94002,"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day",1016,914,188,965,965,545,957,506,518,518,531,518,380,384,518,498,188,948,470,493,965,518,599,680,579,589,521,536,569,508,509,965,872,518,518,508,509,506,627,576,508,510,549
94010,"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation",185,166,6,282,176,104,174,92,94,94,100,94,282,282,94,88,34,173,86,89,176,94,109,124,105,6,99,98,104,92,93,176,159,94,94,92,93,92,114,92,92,93,100
94060,"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration",246,221,45,780,234,138,232,123,125,125,133,125,282,430,125,122,45,234,114,183,234,125,210,165,187,143,132,133,138,123,123,362,780,125,125,123,123,123,152,138,123,123,133
94618,HC PULMONARY STRESS TESTING,500,450,92,475,475,475,471,249,255,255,261,255,368,189,255,245,92,466,231,243,475,255,295,335,285,290,257,264,255,250,251,475,429,255,255,250,251,249,309,390,250,251,270
94640,"Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes (eg, with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing [IPPB] device)",120,108,22,361,114,67,113,60,61,61,65,61,328,361,61,59,22,114,56,58,114,61,66,80,68,70,60,57,67,60,60,114,103,61,61,60,76,60,106,91,60,60,65
94660,"Continuous positive airway pressure ventilation (CPAP), initiation and management",710,639,131,675,674,341,668,354,362,362,371,362,266,268,362,348,131,662,329,344,674,362,418,475,404,411,364,375,351,355,356,675,609,362,362,355,356,354,438,355,355,356,383
94667,"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation",130,117,24,164,124,73,122,65,66,66,70,66,164,49,66,64,24,121,60,63,124,66,77,87,74,75,65,69,73,65,65,124,112,66,66,65,65,65,80,65,65,65,70
94668,"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent",102,92,19,164,97,76,96,51,52,52,55,52,164,39,52,50,19,95,47,49,97,52,60,68,58,59,51,54,86,51,51,97,88,52,52,51,51,51,63,57,51,51,55
94726,PBB PULM FUNCT TST PLETHYSMOGRAP,200,180,37,190,190,112,188,100,102,102,108,102,141,147,102,100,37,190,93,97,190,102,60,134,114,116,107,108,112,100,100,104,172,102,102,100,100,100,123,112,100,100,108
94727,HC PULM FUNCTION TEST BY GAS,213,192,39,202,202,114,201,106,109,109,111,109,80,81,109,104,39,199,99,103,202,109,126,143,121,123,109,112,101,106,107,202,183,109,109,106,107,106,131,166,106,107,115
94729,HC C0/MEMBRANE DIFFUSE CAPACITY,266,239,49,253,253,141,250,133,136,136,144,136,141,147,136,132,49,253,123,128,253,136,146,178,151,154,143,144,149,133,133,253,228,136,136,133,133,133,164,149,133,133,144
94750,"Pulmonary compliance study (eg, plethysmography, volume and pressure measurements)",175,158,32,166,166,94,165,87,89,89,94,89,134,66,89,86,32,163,81,84,166,89,103,117,100,101,90,92,83,88,88,166,150,89,89,88,88,87,108,84,87,88,94
94760,Noninvasive ear or pulse oximetry for oxygen saturation; single determination,45,40,8,123,43,62,42,22,23,23,24,23,17,17,23,22,8,43,21,22,43,23,27,30,26,26,24,24,25,22,23,123,39,23,23,22,22,22,28,25,22,23,24
94761,"Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)",258,232,48,245,245,138,243,129,131,132,70,132,97,98,132,127,48,241,119,125,245,132,152,173,147,150,132,136,136,129,129,245,221,132,132,129,129,129,159,146,129,129,139
94762,Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure),490,441,91,466,466,263,461,244,250,250,256,250,183,185,250,240,91,457,227,238,466,250,289,328,279,284,251,259,250,245,246,466,421,250,250,245,246,244,302,278,245,246,265
95992,"Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day",106,95,20,136,101,59,100,53,54,54,55,54,136,40,54,52,20,101,54,51,101,54,62,71,60,61,53,56,57,53,53,101,91,54,54,53,53,53,65,83,53,53,57
96360,"Intravenous infusion, hydration; initial, 31 minutes to 1 hour",120,108,22,610,114,64,113,60,61,61,65,61,610,610,61,60,22,112,56,58,114,61,71,80,68,70,64,63,67,60,60,114,103,61,61,60,60,60,74,60,60,61,65
96361,"Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)",160,144,30,532,152,90,532,237,347,82,50,82,305,305,82,179,30,149,74,442,152,82,97,107,118,93,43,40,204,80,82,152,137,41,82,80,360,80,80,280,80,204,86
96365,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour",160,144,65,610,152,90,160,84,82,82,91,82,555,610,82,80,67,149,65,77,152,82,102,107,82,93,86,84,90,80,80,152,137,82,82,80,84,80,99,80,80,82,86
96366,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)",76,68,14,367,72,43,72,36,39,39,123,39,277,305,39,37,14,71,35,36,72,39,116,51,71,367,31,40,43,38,38,72,65,39,39,38,38,38,47,76,38,39,41
96367,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion, up to 1 hour (List separately in addition to code for primary procedure)",76,68,29,534,72,43,72,57,39,39,41,39,534,29,39,37,29,71,35,36,72,39,45,51,43,44,41,40,43,38,38,72,65,39,39,38,38,38,47,43,38,39,41
96368,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)",76,68,14,108,72,41,72,38,39,39,47,39,108,29,39,37,14,71,35,37,72,39,45,51,43,44,39,40,43,38,38,72,65,39,39,38,38,38,47,38,38,38,41
96372,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular",88,79,16,147,84,44,141,37,38,45,48,45,36,36,45,42,16,82,82,36,84,45,45,59,147,39,44,48,42,44,44,84,84,45,45,44,37,44,54,41,44,44,48
96374,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug",88,79,16,87,84,44,83,37,45,45,48,45,36,45,45,35,16,82,41,42,84,45,48,59,87,51,44,48,49,44,45,84,76,45,45,44,44,44,44,47,44,44,48
96375,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)",88,79,16,232,84,47,156,44,45,45,48,45,114,45,45,44,16,82,41,63,84,45,51,59,232,51,47,48,49,44,135,84,76,45,45,44,44,44,54,44,44,55,48
96376,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)",88,79,16,209,84,49,209,44,45,45,48,45,57,33,45,43,16,82,41,42,84,45,53,59,86,51,47,46,49,44,44,84,76,45,45,44,44,44,54,44,44,44,48
96377,HC APPLICATON ON-BODY INJECTOR,74,67,14,70,70,40,70,37,38,38,40,38,28,28,38,36,14,69,34,36,70,38,44,50,42,43,38,39,41,37,37,70,64,38,38,37,37,37,46,42,37,37,40
96401,"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic",135,122,25,138,128,68,127,67,138,69,71,69,51,51,69,66,25,126,63,97,128,69,80,90,77,78,70,71,76,68,68,128,116,69,69,68,68,67,83,72,67,68,73
96402,"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic",135,122,25,128,128,72,127,67,69,69,71,69,51,51,69,66,25,126,63,65,128,69,80,90,77,78,69,71,71,68,68,128,116,69,69,68,68,67,83,68,67,68,73
96409,"Chemotherapy administration; intravenous, push technique, single or initial substance/drug",135,122,25,128,128,72,127,67,69,69,71,69,51,51,69,66,25,126,63,65,128,69,80,90,77,78,69,71,64,68,68,128,116,69,69,68,68,67,83,77,67,68,73
96411,"Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure)",100,90,18,95,95,54,94,50,51,51,52,51,37,38,51,49,18,93,46,49,95,51,59,67,57,58,51,53,51,50,50,95,86,51,51,50,50,50,62,57,50,50,54
96413,"Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug",212,191,39,305,201,114,200,106,108,108,114,108,305,80,108,104,39,198,98,103,201,108,125,142,121,123,109,112,108,106,106,201,182,108,108,106,106,106,131,106,106,106,114
96415,"Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)",230,207,43,305,218,123,217,115,117,117,60,117,305,87,117,113,43,214,106,112,218,117,136,154,131,133,118,121,117,115,115,219,197,117,117,115,115,115,142,172,115,115,124
96416,"Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump",450,405,83,428,428,241,424,224,229,230,235,229,168,170,230,221,83,420,208,218,428,230,265,301,256,261,231,238,230,225,226,428,386,229,229,225,225,224,278,255,225,226,243
96417,"Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure)",200,180,37,312,190,107,188,100,102,102,104,102,75,76,102,98,37,187,93,97,190,102,118,134,114,116,103,106,158,100,100,190,172,102,102,100,100,100,123,312,100,100,108
96523,Irrigation of implanted venous access device for drug delivery systems,78,70,14,74,74,39,73,39,40,40,41,40,40,29,40,38,14,73,36,38,74,40,46,52,44,45,40,41,40,39,39,74,67,40,40,39,39,39,48,39,39,39,42
97018,Application of a modality to 1 or more areas; paraffin bath,20,18,4,119,19,11,19,10,10,10,11,10,119,8,10,10,4,19,9,10,19,10,12,13,11,12,11,11,10,10,10,19,17,10,10,10,10,10,12,11,10,10,11
97032,"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes",93,84,17,150,88,50,88,46,47,47,50,47,150,35,47,46,17,87,43,45,88,47,55,62,53,54,48,49,47,46,47,88,80,47,47,46,47,46,57,72,46,47,50
97033,"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes",94,85,20,1681,89,50,89,47,48,48,51,48,136,149,48,46,20,88,48,46,89,48,52,63,54,54,50,50,53,47,47,89,1681,48,48,47,47,47,58,73,47,47,51
97035,"Application of a modality to 1 or more areas; ultrasound, each 15 minutes",93,84,13,972,88,46,88,46,47,47,50,47,136,150,47,46,13,87,43,45,88,47,51,62,53,54,57,49,47,46,47,88,972,47,47,46,47,46,57,46,46,47,50
97110,"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility",186,167,30,442,177,93,175,93,95,95,100,95,150,150,95,89,30,88,47,45,177,95,113,125,47,108,100,100,95,93,93,177,442,95,95,93,93,93,115,93,95,93,100
97112,"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities",93,84,17,95,88,52,88,46,47,47,50,47,60,35,47,46,17,88,95,45,88,47,56,62,47,54,50,49,52,46,47,88,80,47,47,46,47,46,57,52,46,47,50
97116,"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)",93,84,17,99,88,46,88,46,47,47,50,47,99,35,47,46,17,87,43,45,88,47,56,62,44,54,50,49,52,46,47,88,80,47,47,46,46,46,57,46,46,47,50
97129,HC THER IVNTJ COG FUNCJ 1ST 15 MIN,392,353,72,372,372,210,369,195,200,200,205,200,147,148,200,192,72,366,181,190,372,200,231,262,223,227,201,207,197,196,196,372,336,200,200,196,196,195,242,222,196,197,212
97140,"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes",93,84,27,108,88,52,88,46,47,47,50,47,60,35,47,44,27,87,43,45,88,47,55,62,44,54,50,50,52,46,47,88,80,108,47,46,47,46,57,52,46,47,50
97150,"Therapeutic procedure(s), group (2 or more individuals)",70,63,13,67,66,38,66,35,36,36,37,36,26,26,36,34,13,65,32,34,66,36,41,47,40,41,36,37,36,35,35,67,60,36,36,35,35,35,43,40,35,35,38
97161,Physical Therapy Evaluation of low complexity,223,201,84,212,212,118,210,111,114,114,120,114,150,84,114,107,97,212,103,108,212,114,131,149,114,129,120,118,125,112,112,212,191,114,114,112,112,111,138,112,111,112,120
97162,Physical Therapy Evaluation of moderate complexity,223,201,41,212,212,112,210,111,114,114,120,114,157,74,114,107,41,208,114,107,212,114,123,149,105,129,120,120,125,112,112,212,191,114,114,112,112,111,138,112,111,112,120
97163,Physical Therapy Evaluation of high complexity,223,201,41,212,212,112,210,111,114,114,120,114,150,84,114,107,41,208,103,108,212,114,131,149,107,129,120,118,125,112,112,212,191,114,114,112,112,111,138,112,111,112,120
97165,HC OT EVAL LOW COMPLEX,223,201,41,212,212,120,210,111,114,114,106,114,60,69,114,109,41,208,103,108,212,114,131,149,127,129,114,118,110,112,112,212,191,114,114,112,112,111,138,107,111,112,120
97166,HC OT EVAL MOD COMPLEX,223,201,41,212,212,112,210,111,114,114,120,114,60,84,114,109,41,208,103,108,212,114,131,149,127,129,120,118,125,112,112,212,191,114,114,112,112,111,138,112,111,112,120
97167,HC OT EVAL HIGH COMPLEX,223,201,41,212,212,120,210,111,114,114,116,114,63,84,114,109,41,208,103,108,212,114,131,149,127,129,114,118,106,112,112,212,191,114,114,112,112,111,138,126,111,112,120
97530,"Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes",93,84,37,149,88,46,88,46,47,47,50,47,136,149,47,44,37,87,47,45,88,47,54,62,47,54,50,50,52,46,47,88,80,47,47,46,47,46,57,46,95,47,50
97535,"Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact by provider, each 15 minutes",106,95,20,101,101,57,100,53,54,54,57,54,60,40,54,52,20,99,49,51,101,54,62,71,60,61,57,56,54,53,53,101,91,54,54,53,53,53,65,60,53,53,57
97597,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less",244,220,45,598,232,131,230,122,124,124,127,124,598,92,124,120,45,228,64,118,232,124,144,163,139,141,125,129,124,122,122,232,209,124,124,122,122,122,151,122,122,122,132
97598,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)",732,659,135,695,695,392,689,365,373,373,382,373,274,277,373,359,135,683,304,355,695,373,431,490,417,424,376,386,373,366,367,695,628,373,373,366,367,365,452,415,366,367,395
97605,"Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters",147,132,27,633,140,82,138,73,75,75,79,75,633,56,75,72,27,137,68,71,140,75,87,98,84,85,75,78,75,74,74,140,75,75,75,74,74,73,91,115,73,74,79
97606,"Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters",244,220,45,633,232,131,230,122,124,124,127,124,633,92,124,120,45,228,113,118,232,124,144,163,139,141,125,129,128,122,122,232,209,124,124,122,122,122,151,138,122,122,132
97802,"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes",120,108,22,114,114,67,113,60,61,61,63,61,70,45,61,59,22,112,56,58,114,61,71,80,68,70,62,63,60,60,60,114,103,61,61,60,60,60,74,68,60,60,65
97803,"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes",80,72,15,76,76,34,75,40,41,41,42,41,70,30,41,39,15,75,37,39,76,41,47,54,46,46,41,42,52,40,40,76,69,41,41,40,40,40,49,45,40,40,43
98925,Osteopathic manipulative treatment (OMT); 1-2 body regions involved,62,56,11,59,59,33,58,31,32,32,17,32,23,23,32,30,11,58,29,30,59,32,37,42,35,36,32,33,28,31,31,59,53,32,32,31,31,31,38,35,31,31,33
99001,Handling and/or conveyance of specimen for transfer from the patient in other than a physician's office to a laboratory (distance may be indicated),40,36,7,38,38,21,38,20,20,20,22,20,15,15,20,20,7,37,19,19,38,20,24,27,23,23,14,21,21,20,20,38,38,20,20,20,20,20,25,23,20,20,22
99152,HC MOD SED SAME PHYS/QHP 5/>YRS 15M,26,23,5,25,25,14,24,13,13,13,14,13,10,10,13,13,5,24,12,13,25,13,15,17,15,15,13,14,14,13,13,25,22,13,13,13,13,13,16,15,13,13,14
99156,PR MOD SED OTH PHYS/QHP 5/>YRS,150,135,28,143,142,80,141,75,76,76,78,76,56,57,77,74,28,140,69,73,142,76,88,100,85,87,77,79,79,75,75,143,129,76,76,75,75,75,93,85,75,75,81
99195,"Phlebotomy, therapeutic (separate procedure)",187,168,35,387,178,100,176,93,95,95,98,95,387,71,95,92,35,178,87,91,178,95,110,125,106,108,96,99,100,94,94,178,161,95,95,94,94,93,115,90,93,94,101
99203,"Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 30 minutes face-to-face with the patient and/or family.",216,194,40,205,205,116,203,108,110,110,113,110,81,82,110,106,40,201,100,105,205,110,127,145,123,125,111,114,89,108,108,205,185,110,110,108,108,108,133,122,108,108,117
99211,"Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.",30,27,6,29,28,16,28,15,15,15,16,15,11,11,15,15,6,28,14,15,28,15,18,20,17,17,16,16,10,15,15,29,26,15,15,15,15,15,19,17,15,15,16
99212,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 10 minutes face-to-face with the patient and/or family.",129,116,24,123,123,69,121,28,66,66,67,66,48,49,66,63,24,120,27,63,123,66,76,86,73,75,66,68,38,64,65,123,111,66,66,64,65,64,80,73,64,65,70
99213,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Physicians typically spend 15 minutes face-to-face with the patient and/or family.",164,148,30,156,156,88,154,82,84,84,86,84,61,62,84,80,30,153,76,80,156,84,97,110,93,95,32,87,55,82,82,156,55,84,84,82,82,82,101,93,82,82,89
99214,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 25 minutes face-to-face with the patient and/or family.",215,194,40,204,204,115,202,107,110,110,112,110,80,81,110,105,40,201,100,104,204,110,127,144,122,125,110,114,85,108,108,204,185,110,110,108,85,107,133,122,107,108,116
99215,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 40 minutes face-to-face with the patient and/or family.",213,192,39,202,202,114,201,106,109,109,111,109,80,81,109,104,39,199,99,103,202,109,126,143,121,123,109,112,157,106,107,202,183,109,109,106,107,106,131,121,106,107,115
99217,"Observation care discharge day management (This code is to be utilized by the physician to report all services provided to a patient on discharge from ""observation status"" if the discharge is on other than the initial date of ""observation status."" To report services to a patient designated as ""observation status"" or ""inpatient status"" and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])",120,108,22,114,114,64,113,79,78,61,78,61,78,45,61,59,22,112,78,81,114,61,71,80,68,70,32,63,76,60,60,114,103,61,61,60,60,60,74,68,60,78,65
99218,"Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to ""observation status"" are of low severity.",156,140,29,148,148,110,147,108,107,80,106,80,107,59,80,77,29,145,72,110,148,80,92,104,89,90,80,82,107,78,78,148,134,80,80,78,78,78,96,88,78,78,84
99219,"Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to ""observation status"" are of moderate severity.",214,193,40,203,203,115,201,107,109,109,145,109,147,81,109,105,40,200,147,150,203,109,126,143,122,124,144,113,142,107,107,203,184,109,109,107,107,107,132,121,107,147,116
99220,"Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to ""observation status"" are of high severity.",292,263,54,277,277,157,275,145,149,149,152,149,109,110,149,143,54,272,135,142,277,149,172,196,166,169,78,154,193,146,146,277,251,149,149,146,146,145,180,166,146,146,158
99224,"Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: Problem focused interval history; Problem focused examination; Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Physicians typically spend 15 minutes at the bedside and on the patient's hospital floor or unit.",61,55,11,58,58,44,57,30,31,31,43,31,23,23,31,30,11,57,28,44,58,31,36,41,35,35,31,32,41,30,31,58,52,31,31,30,31,30,38,35,30,31,33
99225,"Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Physicians typically spend 25 minutes at the bedside and on the patient's hospital floor or unit.",112,101,21,106,106,60,105,79,57,57,77,57,79,42,57,55,21,104,52,81,106,57,66,75,64,65,30,59,76,56,56,106,96,57,57,56,56,56,69,63,56,56,60
99226,"Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Physicians typically spend 35 minutes at the bedside and on the patient's hospital floor or unit.",160,144,30,152,152,86,151,80,82,82,84,82,113,60,82,78,30,149,74,116,152,82,94,107,91,93,82,84,110,80,80,152,137,82,82,80,80,80,99,91,80,113,86
99234,"Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s) requiring admission are of low severity.",204,184,38,194,194,109,192,102,104,104,107,104,76,77,104,100,38,190,94,99,194,104,120,137,116,118,105,108,139,102,102,194,175,104,104,102,102,102,126,116,102,102,110
99235,"Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s) requiring admission are of moderate severity.",268,241,50,255,255,144,252,133,137,137,140,137,100,101,137,131,50,250,124,130,255,137,158,179,153,155,138,142,180,134,134,255,230,137,137,134,134,134,165,152,134,134,145
99236,"Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s) requiring admission are of high severity.",346,311,64,329,329,185,326,172,176,176,181,176,129,131,176,170,64,323,160,168,329,176,204,232,197,201,178,183,228,173,235,329,297,176,176,173,173,172,214,196,173,174,187
99239,Hospital discharge day management; more than 30 minutes,164,148,30,156,156,88,154,82,84,84,86,84,61,62,84,80,30,153,76,80,156,84,97,110,93,95,84,87,113,82,82,156,141,84,84,82,82,82,101,93,82,82,89
99281,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor.",228,205,42,476,217,122,215,114,116,116,66,116,476,86,116,112,42,213,106,111,217,116,134,153,130,132,57,120,74,114,114,217,196,116,116,114,114,114,141,122,114,114,123
99282,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity.",317,285,59,547,301,186,298,152,162,162,171,162,533,547,162,173,59,330,147,154,301,162,191,212,210,74,170,179,194,158,159,330,330,162,162,158,159,158,196,194,158,159,171
99283,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity.",621,559,77,590,590,310,585,309,317,317,319,317,561,554,317,309,115,590,193,183,590,317,376,416,430,446,183,366,77,310,311,590,533,317,317,310,310,309,383,348,310,317,335
99284,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function.",837,753,128,822,795,418,788,418,128,427,343,427,576,716,427,417,155,795,128,130,795,427,460,560,822,485,433,452,131,418,128,795,718,278,427,418,418,417,418,418,418,420,452
99285,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function.",1178,1060,218,1119,1119,589,1119,565,601,601,620,601,542,544,601,563,218,1119,601,565,1119,601,680,789,1036,683,616,574,601,589,601,1119,1011,601,601,589,589,587,727,589,601,601,636
99291,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes",1780,1602,239,1753,1691,997,1676,887,907,908,961,908,551,673,908,851,329,1660,824,550,1691,908,1049,1192,1384,1753,955,940,239,890,892,1691,1528,907,908,890,890,887,1099,890,890,893,961
99292,"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service)",506,455,94,567,481,567,476,252,258,258,273,258,189,191,258,248,94,472,234,245,481,258,298,339,121,293,339,267,213,253,254,481,434,258,258,253,254,252,312,380,253,254,273
99304,"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of low severity. Physicians typically spend 25 minutes at the bedside and on the patient's facility floor or unit.",180,162,33,171,171,96,169,90,92,92,94,92,67,68,92,88,33,168,83,87,171,92,106,121,102,104,92,95,95,90,90,171,154,92,92,90,90,90,111,102,90,90,97
99305,"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of moderate severity. Physicians typically spend 35 minutes at the bedside and on the patient's facility floor or unit.",206,185,38,196,196,110,194,103,105,105,108,105,77,78,105,101,38,192,95,100,196,105,121,138,117,119,106,109,137,103,103,196,177,105,105,103,103,103,127,117,103,103,111
99306,"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Physicians typically spend 45 minutes at the bedside and on the patient's facility floor or unit.",264,238,49,251,251,142,249,132,135,135,138,135,99,100,135,129,49,246,122,128,251,135,156,177,150,153,135,139,176,132,132,251,227,135,135,132,132,132,163,150,132,132,143
99307,"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Physicians typically spend 10 minutes at the bedside and on the patient's facility floor or unit.",65,58,12,62,62,35,61,32,33,33,34,33,24,25,33,32,12,61,30,32,62,33,38,44,37,38,33,34,46,32,33,62,56,33,33,32,33,32,40,37,32,33,35
99308,"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Physicians typically spend 15 minutes at the bedside and on the patient's facility floor or unit.",110,99,20,105,104,59,104,55,56,56,57,56,41,42,56,54,20,103,51,53,104,56,65,74,63,64,56,58,73,55,55,105,94,56,56,55,55,55,68,62,55,55,59
99309,"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient has developed a significant complication or a significant new problem. Physicians typically spend 25 minutes at the bedside and on the patient's facility floor or unit.",144,130,27,137,137,77,136,72,73,73,75,73,98,54,73,71,27,134,67,70,137,73,85,96,82,83,74,76,96,72,72,137,124,73,73,72,72,72,89,82,72,72,78
99310,"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Physicians typically spend 35 minutes at the bedside and on the patient's facility floor or unit.",215,194,40,204,204,115,202,107,110,110,112,110,145,81,110,105,40,201,100,104,204,110,127,144,122,125,110,114,143,108,108,204,185,110,110,108,108,107,133,122,107,108,116
99315,Nursing facility discharge day management; 30 minutes or less,115,104,21,109,109,62,108,57,59,59,60,59,43,43,59,56,21,107,53,56,109,59,68,77,65,67,59,61,77,58,58,109,99,59,59,58,58,57,71,65,57,58,62
99316,Nursing facility discharge day management; more than 30 minutes,167,150,31,159,159,90,157,83,85,85,87,85,62,63,85,82,31,156,77,81,159,85,98,112,95,97,86,88,111,84,84,159,143,85,85,84,84,83,103,95,83,84,90
99356,"Prolonged physician service in the inpatient setting, requiring unit/floor time beyond the usual service; first hour (List separately in addition to code for inpatient Evaluation and Management service)",140,126,26,133,133,75,132,70,71,71,73,71,52,53,71,69,26,131,65,68,133,71,83,94,80,81,72,74,97,70,70,133,120,71,71,70,70,70,86,79,70,70,76
A0000,,100,90,18,95,95,54,94,50,51,51,52,51,37,38,51,49,18,93,46,49,95,51,59,67,57,58,50,53,53,50,50,95,86,51,51,50,30,50,62,90,50,50,54
A0424,"Extra ambulance attendant, ground (ALS or BLS) or air (fixed or rotary winged); (requires medical review)",125,112,23,119,119,67,118,62,64,64,65,64,47,47,64,61,23,117,58,61,119,64,74,84,71,72,64,66,66,62,63,119,107,64,64,62,63,62,77,97,62,63,68
A0425,"Ground mileage, per statute mile",40,36,10,1532,38,20,38,25,20,20,10,20,13,13,20,209,12,1083,19,10,38,20,12,27,69,23,20,107,23,20,468,38,1532,20,20,90,20,20,25,22,20,20,22
A0426,"Ambulance service, advanced life support, non-emergency transport, level 1 (ALS 1)",798,718,148,758,758,399,751,397,407,407,417,407,460,302,407,391,148,744,369,387,758,407,470,534,454,462,410,421,329,399,400,758,685,407,407,399,400,398,493,447,399,400,431
A0427,"Ambulance service, advanced life support, emergency transport, level 1 (ALS1-emergency)",1259,1133,512,1196,1196,630,1185,630,642,642,630,642,735,735,642,518,512,1196,583,604,1196,642,762,843,632,730,575,512,521,630,520,1196,1081,642,642,630,630,627,777,630,629,631,680
A0428,"Ambulance service, basic life support, non-emergency transport, (BLS)",667,600,123,634,634,358,628,332,340,340,348,340,387,252,340,327,123,622,309,324,634,340,393,447,380,387,342,352,222,334,334,634,572,340,340,334,334,332,412,334,333,335,360
A0429,"Ambulance service, basic life support, emergency transport (BLS-emergency)",1066,959,197,1013,1013,533,1004,531,543,544,533,544,620,607,544,523,197,994,494,517,1013,544,628,714,607,618,533,563,439,533,534,1013,915,543,544,533,534,531,658,533,533,535,576
A0433,"Advanced life support, level 2 (ALS 2)",1822,1640,337,1731,1731,911,1715,908,929,929,952,929,1065,689,929,894,337,1699,844,884,1731,929,1074,1220,1037,1056,935,962,755,911,913,1731,1564,929,929,911,911,908,1125,1020,911,914,984
A0434,Specialty care transport (SCT),2139,1925,395,2032,2032,1147,2014,1065,1090,1091,1117,1091,1232,808,1091,1049,395,1995,990,1038,2032,1091,1261,1432,1218,1240,1098,1129,1124,1070,1072,2032,1836,1091,1091,1070,1072,1066,1320,1212,1069,1073,1155
A4338,"Indwelling catheter; Foley type, two-way latex with coating (Teflon, silicone, silicone elastomer, or hydrophilic, etc.), each",20,18,4,19,19,11,19,10,10,10,10,10,7,8,10,10,4,19,9,10,19,10,12,13,11,12,10,11,11,10,10,19,17,10,10,10,10,10,12,11,10,10,11
A6196,"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing",16,14,3,16,15,9,15,8,8,8,16,8,6,6,8,8,3,15,7,8,15,8,9,11,9,9,8,8,8,8,8,15,14,8,8,8,8,8,10,9,8,8,9
A6452,"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard",246,221,45,234,234,132,232,123,125,125,118,125,92,93,125,121,45,229,114,119,234,125,145,165,140,143,126,130,117,123,123,234,211,125,125,123,123,123,152,118,123,123,133
A7048,HC VACUUM DRAIN BOTTLE/TUBE KIT LVL 5,81,73,15,443,77,43,76,40,41,41,42,41,30,31,41,27,15,75,37,39,77,41,48,54,46,47,41,43,443,40,40,77,69,41,41,40,40,40,50,26,40,41,44
A9270,Non-covered item or service,2,1,0,60,2,1,5,1,1,1,1,1,1,1,1,1,0,2,1,1,2,1,1,1,1,1,1,1,1,1,1,60,1,1,1,1,1,1,1,1,1,1,1
A9500,"Technetium Tc-99M sestamibi, diagnostic, per study dose",938,844,173,891,891,525,883,467,478,478,507,478,469,355,478,467,173,875,434,455,891,478,567,628,534,544,503,495,525,469,470,891,805,478,478,469,470,467,731,469,469,470,507
A9503,"Technetium Tc-99M medronate, diagnostic, per study dose, up to 30 millicuries",288,259,53,274,274,154,271,143,147,147,156,147,108,109,147,141,53,269,133,140,274,147,170,193,164,167,148,152,161,144,144,274,247,147,147,144,144,143,178,144,144,144,156
A9509,"Iodine I-123 sodium iodide, diagnostic, per millicurie",933,840,172,886,886,500,878,465,476,476,487,476,349,353,476,458,172,870,432,453,886,476,550,625,531,541,479,493,476,466,468,886,801,476,476,466,467,465,576,466,466,468,504
A9537,"Technetium Tc-99M mebrofenin, diagnostic, per study dose, up to 15 millicuries",2163,1947,400,2055,2055,1211,2037,1077,1102,1103,1168,1103,1103,818,1103,1061,400,2017,1001,1049,2055,1103,1275,1448,1232,1254,1161,1082,1211,1082,1084,2055,1857,1103,1103,1082,1084,1078,1335,1186,1081,1085,1168
A9540,"Technetium Tc-99M macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries",137,123,25,130,130,66,129,68,70,70,72,70,51,52,70,67,25,128,63,66,130,70,81,92,78,79,70,72,70,68,69,130,118,70,70,68,69,68,85,78,68,69,74
A9541,"Technetium Tc-99M sulfur colloid, diagnostic, per study dose, up to 20 millicuries",251,226,46,238,238,120,236,125,128,128,136,128,94,95,128,123,46,234,116,122,238,128,148,168,143,145,78,133,132,126,126,238,215,128,128,126,126,125,155,142,125,126,136
A9552,"Fluorodeoxyglucose F-18 FDG, diagnostic, per study dose, up to 45 millicuries",808,727,149,768,768,404,761,402,412,412,436,412,412,305,412,396,149,754,374,392,768,412,476,541,460,468,415,427,432,404,405,768,694,412,412,404,404,403,499,452,404,405,436
A9562,"Technetium Tc-99M mertiatide, diagnostic, per study dose, up to 15 millicuries",655,590,121,622,622,351,617,326,334,334,354,334,245,248,334,321,121,611,303,318,622,334,386,439,373,380,336,346,324,328,328,622,562,334,334,328,328,326,404,371,327,329,354
A9579,"Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per ml",298,268,55,283,283,149,280,148,152,152,161,152,111,113,152,146,55,278,138,144,283,152,175,199,170,173,160,157,167,149,149,283,256,152,152,149,149,148,184,149,149,149,161
C1713,"HC ANCHOR/SCREW BN/BN,TIS/BN LVL 35",5651,5086,1045,5369,5369,2938,5321,3360,2880,2882,4015,2882,2114,2136,2882,2772,1045,5270,2616,2741,5369,2882,3051,3784,3218,3275,2699,2984,1437,2826,2833,5369,4850,2881,2882,2826,2831,2816,3488,3488,2825,2835,3052
C1725,HC TRANSLUM ANGIOPL NON-LASER CATH LVL 15,155,140,29,8040,147,8040,146,77,79,79,81,79,58,59,79,76,29,145,72,75,147,79,91,104,88,90,80,82,74,78,78,147,133,79,79,78,78,77,96,88,78,78,84
C1726,HC NON-VASC BALLOON DILATN CATH LVL 15,610,549,113,580,580,327,575,304,311,311,319,311,311,231,311,299,113,569,283,296,580,311,360,409,348,354,328,322,342,305,306,580,524,311,311,305,306,304,377,346,305,306,330
C1729,HC DRAINAGE CATH LVL 15,6,5,1,6,6,3,6,3,3,3,3,3,2,2,3,3,1,6,3,3,6,3,4,4,3,3,3,3,3,3,3,6,5,3,3,6,3,3,4,3,3,3,3
C1758,"HC CATHETER, URETERAL LVL 12",25,23,5,24,24,13,24,13,13,13,14,13,9,10,13,13,5,23,12,12,24,13,15,17,14,15,14,13,14,13,13,24,22,13,13,13,13,13,16,13,13,13,14
C1765,HC ADHESION BARRIER LVL 7,6,5,1,6,6,3,6,3,3,3,3,3,2,2,3,3,1,6,2,3,6,3,4,4,6,3,3,3,3,3,3,6,5,3,3,3,3,3,4,3,3,3,3
C1771,"HC REP DEV, URINARY, W/SLING LVL 20",1700,1530,314,1615,1615,911,1601,847,866,867,888,867,636,643,867,834,314,1585,787,825,1615,867,1002,1138,968,985,872,898,867,850,852,1615,1459,867,867,850,852,847,1049,964,850,853,918
C1776,HC JOINT DEVICE (IMPLANTABLE) LVL 45,4113,3702,760,3908,3908,2205,3873,2057,2097,2098,2148,2098,1539,1555,2098,2018,760,3836,1904,1995,3908,2098,2424,2754,2342,2384,2111,2172,2162,2057,2062,3908,3531,2097,2098,2057,2061,2049,2539,2332,2056,2063,2221
C1781,HC MESH (IMPLANTABLE) LVL 30,1297,1168,210,1232,1232,1138,1221,210,661,662,701,662,485,490,662,636,240,1210,601,629,1232,662,765,869,739,752,1221,685,726,649,650,1232,1113,661,662,649,650,646,801,886,648,651,701
C1889,HC SPINAL IMPLANT LVL 31,606,545,112,576,576,325,571,302,309,309,317,309,227,229,309,297,112,565,281,294,576,309,357,406,345,351,311,320,339,303,304,576,520,309,309,303,304,302,374,344,303,304,327
C2617,"HC STENT, NON-COR, TEM W/O DEL LVL 13",300,270,55,285,285,161,282,149,153,153,157,153,112,113,153,147,55,280,139,146,285,153,177,201,171,174,154,158,153,150,150,285,257,153,153,150,150,149,185,150,150,150,162
C2627,HC CATH SUPRAPUBIC/CYSTOSCOPIC LVL 4,125,112,23,119,119,67,118,62,64,64,65,64,47,47,64,61,23,117,58,61,119,64,74,84,71,72,64,66,70,62,63,119,107,64,64,62,63,62,77,71,62,63,68
C46RE,,310,279,57,295,294,166,292,154,158,158,162,158,116,117,158,152,57,289,144,150,294,158,183,208,177,180,159,164,163,155,155,295,266,158,158,155,155,154,191,128,155,155,167
C9290,"Injection, bupivacaine liposome",736,663,136,700,700,353,693,363,375,376,295,376,182,278,376,361,136,687,341,357,700,376,434,493,419,427,316,389,349,368,369,700,632,375,376,368,369,367,454,604,368,369,398
C9803,"HC HOSP OP CLINIC VISIT SPEC COLLEC SARS-COV-2 COVID-19, ANY SOURCE",28,25,5,99,27,14,26,14,14,14,15,14,90,99,14,14,5,26,14,14,27,14,23,23,16,16,15,15,16,14,14,27,24,14,14,14,14,14,22,14,14,14,15
EMERG,,2497,2247,389,2372,2372,1339,2351,1244,1273,1273,1304,1273,934,944,1274,1225,462,2329,1156,1211,2372,1273,1472,1672,1422,1447,1281,1318,1312,1249,1252,2372,2143,1273,1273,1249,1251,1244,1541,389,1248,1252,1348
G0008,Administration of influenza virus vaccine,82,74,13,78,78,44,77,41,42,42,22,42,31,31,42,40,15,76,38,40,78,42,48,55,47,48,42,43,39,41,41,78,70,42,42,41,13,41,51,16,41,41,44
G0009,Administration of pneumococcal vaccine,82,74,15,78,78,44,77,41,42,42,43,42,31,31,42,40,15,76,38,40,78,42,48,55,47,48,42,43,39,41,41,78,70,42,42,41,41,41,51,46,41,41,44
G0010,Administration of hepatitis B vaccine,82,74,15,78,78,44,77,41,42,42,43,42,31,31,42,40,15,76,38,40,78,42,48,55,47,48,42,43,39,41,41,78,70,42,42,41,41,41,51,46,41,41,44
G0103,Prostate cancer screening; prostate specific antigen test (PSA),176,158,33,172,167,88,166,88,90,90,92,90,46,67,90,86,33,164,81,84,167,90,106,118,172,102,90,93,99,88,88,167,151,90,90,88,88,88,109,88,90,88,95
G0105,Colorectal cancer screening; colonoscopy on individual at high risk,3685,3316,681,3501,3501,2064,3470,1836,1878,1879,1924,1879,1379,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1891,1946,1132,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,2089,1842,1848,1990
G0108,"Diabetes outpatient self-management training services, individual, per 30 minutes",80,72,15,218,76,40,75,40,41,41,43,41,218,30,41,39,15,75,37,39,76,41,47,54,57,46,43,42,45,40,40,76,76,41,41,40,40,40,49,40,40,40,43
G0121,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,3685,3316,681,3501,3501,1842,3470,1836,1878,1879,1924,1879,1379,1393,1879,1807,681,3437,1706,1788,3501,1879,2172,2468,2098,2136,1891,1946,1132,1842,1847,3501,3163,1879,1879,1842,1846,1836,2274,1042,1842,1848,1990
G0168,Wound closure utilizing tissue adhesive(s) only,80,72,15,76,76,40,75,40,41,41,42,41,41,30,41,39,15,75,37,39,76,41,47,54,46,46,41,42,30,40,40,76,69,41,41,40,40,40,49,40,40,40,43
G0238,"Therapeutic procedures to improve respiratory function, other than described by G0237, one on one, face to face, per 15 minutes (includes monitoring)",116,104,21,361,110,58,109,58,59,59,63,59,361,44,59,57,21,108,54,56,110,59,68,78,66,67,60,61,65,58,58,110,100,59,59,58,58,58,72,90,58,58,63
G0239,"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)",150,135,28,143,142,80,141,75,76,76,81,76,56,57,77,74,28,140,69,73,142,76,88,100,85,87,77,79,79,75,75,143,129,76,76,75,75,75,93,85,75,75,81
G0279,PR BREAST TOMOSYNTHESIS DIG DX UNIL/BILAT,80,72,30,76,76,45,75,40,41,41,43,41,30,30,41,39,52,75,37,39,76,41,48,54,46,46,43,42,45,40,40,76,69,41,41,40,40,40,49,51,40,40,43
G0283,"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care",57,51,11,122,54,32,54,28,29,29,31,29,122,22,29,28,11,53,26,28,54,29,34,38,32,33,31,31,29,28,29,54,49,29,29,28,29,28,35,44,28,29,31
G0297,PR CT LUNG CANCER SCREEN,600,540,111,570,570,322,565,299,306,306,300,306,480,529,306,294,111,560,278,291,570,306,354,402,342,348,321,317,306,300,301,570,515,306,306,300,301,299,370,300,300,301,324
G0378,"Hospital observation service, per hour",880,792,50,2238,836,708,815,855,613,449,374,449,2238,1882,449,394,163,658,408,427,836,449,514,589,501,308,283,465,448,440,50,836,755,449,449,440,742,438,543,517,440,729,475
G0379,Direct admission of patient for hospital observation care,377,339,70,551,358,211,355,188,192,192,204,192,551,142,192,185,70,352,175,183,358,192,222,252,215,218,202,199,211,188,189,358,324,192,192,188,350,188,233,200,188,189,204
G0390,HC FULL TRAUMA RESPONS W CC FAC LEV 4,162,146,30,154,154,91,153,81,83,83,87,83,61,61,83,79,30,151,75,79,154,83,95,108,92,94,83,86,91,81,81,154,139,83,83,81,81,81,100,81,81,81,87
G0416,"Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 1-20 specimens",1600,1440,296,1520,1520,896,1506,797,815,816,836,816,599,605,816,785,296,1492,741,776,1520,816,943,1071,911,927,821,845,896,800,802,1520,1373,816,816,800,802,797,987,907,800,803,864
G0424,"Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day",195,176,36,208,185,105,184,97,99,99,121,99,208,74,99,96,36,182,90,95,185,99,115,131,111,113,100,103,109,98,98,185,167,99,99,98,98,97,120,152,97,56,105
G0463,Hospital outpt clinic visit,145,130,27,138,138,102,137,72,74,74,88,74,59,55,74,71,27,135,60,70,138,74,85,97,52,84,83,113,81,72,73,138,103,74,74,72,91,72,89,82,72,73,78
G0472,HC HEP C SCREEN HIGH RISK/OTHER,135,122,25,128,128,72,127,67,69,69,71,69,51,51,69,66,25,126,63,65,128,69,80,90,77,78,69,71,71,68,68,128,116,69,69,68,68,67,83,65,67,68,73
G0480,Drug test def 1-7 classes,106,95,20,129,101,53,100,53,54,54,76,54,113,128,54,51,20,99,49,51,101,54,62,71,104,61,57,53,129,53,53,101,91,54,54,53,53,53,65,87,53,53,57
G0498,HC CHEMO EXTEND IV INFUS W/PUMP,404,364,75,384,384,217,380,201,206,206,211,206,151,153,206,198,75,377,187,196,384,206,238,271,230,234,207,213,206,202,203,384,347,206,206,202,202,201,249,229,202,203,218
G0499,HC HEP B SCREEN HIGH RISK INDIV (NON PREGNANT),60,54,11,57,57,32,56,30,31,31,31,31,22,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,34,30,30,57,51,31,31,30,30,30,37,34,30,30,32
J0129,"Injection, abatacept, 10 mg",9492,8543,1755,9018,9017,5088,8937,4728,4838,4841,4957,4841,3551,3588,4841,4656,1755,8852,4395,4605,9017,4841,5594,6356,5405,5501,4871,5012,4988,4746,4758,9018,8147,4839,4841,4746,4756,4729,5858,4746,4744,4761,5126
J0131,Acetaminophen injection,182,164,34,173,173,91,173,91,93,93,86,93,51,69,93,85,34,170,84,88,173,93,105,122,104,106,85,96,89,91,91,173,156,93,93,91,91,91,113,91,91,91,98
J0153,PBB ADENOSINE INJ 1 MG,119,107,4,113,113,64,112,59,61,61,65,61,4,45,61,59,22,111,55,58,113,61,70,80,68,69,61,63,67,60,60,113,102,61,61,60,60,59,74,68,60,60,64
J0171,"Injection, adrenalin, epinephrine, 0.1 mg",92,83,9,87,87,50,86,46,47,47,50,47,9,35,47,45,17,86,42,44,87,47,54,61,52,53,56,48,51,46,47,87,79,47,47,46,46,46,57,46,46,46,50
J0185,"Inj., aprepitant, 1 mg",806,726,149,766,766,432,759,402,411,411,421,411,292,305,411,395,149,752,373,391,766,411,475,540,459,467,414,426,375,403,404,766,692,411,411,403,404,402,498,628,403,404,435
J0256,"Injection, alpha 1 - proteinase inhibitor - human, 10 mg",4248,3823,785,4035,4035,2277,3999,2116,2165,2166,2218,2166,1589,1605,2166,2083,785,3961,1966,2060,4035,2166,2503,2844,2419,2462,2180,2243,2379,2124,2129,4035,3646,2166,2166,2124,2128,2116,2621,2408,2123,2130,2294
J0280,"Injection, aminophyllin, up to 250 mg",104,93,2,98,98,2,98,52,53,53,56,53,39,39,53,51,19,97,48,50,98,53,61,69,59,60,53,55,58,52,52,98,89,53,53,52,52,52,64,59,52,52,56
J0282,"Injection, amiodarone hydrochloride, 30 mg",127,114,23,120,120,68,119,63,65,65,66,65,47,48,65,62,23,118,59,61,120,65,75,85,72,73,65,67,68,63,63,120,109,65,65,63,63,63,78,72,63,64,68
J0295,"Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm",94,85,3,90,90,51,89,47,48,48,63,48,3,36,48,46,17,88,44,46,90,48,56,63,54,55,48,50,53,47,47,90,81,48,48,47,47,47,58,53,47,47,51
J0330,"Injection, succinylcholine chloride, up to 20 mg",126,113,15,120,120,67,119,63,64,64,61,64,15,48,64,62,23,117,58,61,120,64,71,84,72,73,67,66,60,63,63,120,108,64,64,63,63,63,78,82,63,63,68
J0360,"Injection, hydralazine HCl, up to 20 mg",91,82,3,86,86,49,86,45,46,46,48,46,3,34,46,45,17,85,42,44,86,46,54,61,52,53,49,48,51,46,46,86,78,46,46,46,46,45,56,45,45,46,49
J0401,Inj aripiprazole ext rel 1mg,3500,3150,647,3325,3325,1876,3295,1743,1784,1785,1828,1785,1309,1323,1785,1717,647,3264,1620,1698,3325,1785,2063,2343,1993,2028,1796,1848,1785,1750,1754,3325,3004,1784,1785,1750,1753,1744,2160,1984,1749,1755,1890
J0456,"Injection, azithromycin, 500 mg",94,85,3,90,90,53,89,47,48,48,51,48,3,36,48,46,17,88,44,45,90,48,56,63,54,55,51,50,53,47,47,90,81,48,48,47,47,47,58,47,47,48,51
J0461,"Injection, atropine sulfate, 0.01 mg",192,173,4,183,183,58,181,96,98,98,100,98,4,73,98,94,36,180,89,93,183,98,113,129,110,112,99,102,99,96,96,183,165,98,98,96,96,96,119,55,96,97,104
J0500,"Injection, dicyclomine HCl, up to 20 mg",256,230,46,243,243,137,241,127,130,130,134,130,46,97,130,125,47,238,118,124,243,130,151,171,146,148,131,135,121,128,128,243,219,130,130,128,128,127,158,145,128,128,138
J0561,"Injection, penicillin G benzathine, 100,000 units",432,389,80,410,410,231,407,215,220,220,117,220,162,163,220,212,80,403,200,209,410,220,255,289,246,250,222,228,227,216,216,410,371,220,220,216,216,215,267,245,216,217,233
J0585,"Injection, onabotulinumtoxinA, 1 unit",2188,1969,404,2078,2078,1173,2060,1090,1115,1116,1142,1116,818,827,1116,1073,404,2040,1013,1061,2078,1116,1289,1465,1246,1268,1123,1155,1150,1094,1096,2078,1878,1115,1116,1094,1096,1090,1350,1225,1093,1097,1181
J0595,"Injection, butorphanol tartrate, 1 mg",91,82,3,87,87,49,86,45,47,47,48,47,3,35,47,45,17,85,42,44,87,47,54,61,52,53,47,48,48,46,46,87,78,47,47,46,46,45,56,52,46,46,49
J0610,"Injection, calcium gluconate, per 10 ml",106,95,3,101,101,57,100,53,54,54,52,54,3,40,54,52,20,99,49,51,101,54,62,71,60,61,54,56,59,53,53,101,91,54,54,53,53,53,65,53,53,53,57
J0640,"Injection, leucovorin calcium, per 50 mg",432,389,80,410,410,232,407,215,220,220,226,220,162,163,220,212,80,403,200,210,410,220,255,289,246,250,222,228,220,216,216,410,371,220,220,216,216,215,267,245,216,217,233
J0690,"Injection, cefazolin sodium, 500 mg",93,84,3,89,89,49,88,46,48,48,50,48,3,35,48,46,17,87,43,45,89,48,53,62,53,54,50,49,51,47,47,89,80,48,48,47,47,47,58,73,47,50,50
J0692,"Injection, Cefepime hydrochloride, 500 mg",94,84,17,89,89,50,88,47,48,48,49,48,35,35,48,46,17,87,43,46,89,48,55,63,53,54,48,47,53,47,47,89,81,48,48,47,47,47,58,53,47,47,51
J0696,"Injection, ceftriaxone sodium, per 250 mg",97,87,3,92,92,52,91,43,49,49,52,49,3,37,49,48,18,90,45,45,92,49,57,65,55,56,26,51,52,48,49,86,83,49,49,48,45,48,60,48,48,49,52
J0702,"Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg",186,168,29,177,177,100,176,93,95,95,101,95,29,70,95,95,34,174,86,90,177,95,110,125,106,108,100,98,104,93,93,177,160,95,95,93,93,93,115,106,95,93,101
J0713,"Injection, ceftazidime, per 500 mg",94,85,17,89,89,50,89,47,48,48,49,48,35,36,48,46,17,88,44,46,89,48,55,63,54,55,48,50,53,47,47,89,81,48,48,47,47,47,58,53,47,47,51
J0717,Certolizumab pegol inj 1mg,9500,8550,1756,9025,9025,5092,8944,4732,4842,4845,4961,4844,3554,3591,4845,4660,1756,8859,4398,4608,9025,4845,5599,6361,5409,5506,4875,5016,5320,4750,4762,9025,8154,4843,4845,4750,4760,4733,5863,5385,4748,4765,5130
J0744,"Injection, Ciprofloxacin for intravenous infusion, 200 mg",96,86,2,91,91,72,90,48,49,49,52,49,2,36,49,47,18,89,44,69,91,49,56,64,54,55,49,50,53,48,48,91,82,49,49,48,48,48,59,61,48,48,52
J0780,"Injection, prochlorperazine, up to 10 mg",124,112,5,118,118,62,117,62,63,63,67,63,5,9,63,61,23,116,58,60,118,63,73,83,71,72,53,66,64,62,62,118,107,63,63,62,62,62,77,58,62,62,67
J0878,"Injection, daptomycin, 1 mg",268,241,49,254,254,143,252,133,136,136,140,136,100,101,136,131,49,249,124,130,254,136,158,179,152,155,137,141,141,134,134,254,230,136,136,134,134,133,165,134,134,134,144
J0881,"Injection, darbepoetin alfa, 1 microgram (non-ESRD use)",862,775,159,818,818,462,811,429,439,439,450,439,322,326,439,423,159,803,399,418,818,439,508,577,491,499,442,455,439,431,432,818,739,439,439,431,432,429,532,488,431,432,465
J0885,"Injection, epoetin alfa, (for non-ESRD use), 1000 units",622,560,115,591,591,333,586,310,317,317,325,317,233,235,317,305,115,580,288,302,591,317,367,416,354,360,319,328,295,311,312,591,534,317,317,311,312,310,384,353,311,312,336
J0894,"Injection, decitabine, 1 mg",890,801,165,846,846,477,838,444,454,454,465,454,454,337,454,437,165,830,412,432,846,454,525,596,507,516,457,470,841,445,446,846,764,454,454,445,446,444,550,505,445,447,481
J0897,PBB DENOSUMAB INJECTION 1 MG,2796,2516,517,2656,2656,2513,2633,1393,1425,1426,1469,1426,1230,1057,1426,1371,517,2608,1294,1356,2656,1426,1648,1872,1592,1620,1435,1323,1566,1398,1401,2656,2400,1425,1426,1398,1401,1393,1726,1398,1398,1402,1510
J1030,"Injection, methylprednisolone acetate, 40 mg",105,94,6,100,100,56,99,52,53,53,33,53,6,40,53,51,19,98,49,51,100,53,62,70,60,61,54,55,55,52,53,100,90,53,53,52,53,52,65,59,52,53,57
J1071,PBB INJ TESTOSTERONE CYPIONATE,162,145,30,153,153,87,152,80,82,82,84,82,60,61,82,79,30,151,75,78,153,82,95,108,92,94,83,85,85,81,81,153,139,82,82,81,81,80,100,126,81,81,87
J1080,"Injection, testosterone cypionate, 1 cc, 200 mg",121,109,22,115,115,65,114,60,62,62,63,62,45,46,62,59,22,113,56,59,115,62,71,81,69,70,62,64,64,61,61,115,104,62,62,61,61,60,75,94,61,61,66
J1100,"Injection, dexamethasone sodium phosphate, 1 mg",93,84,1,88,88,48,87,49,47,47,50,47,1,35,47,49,17,87,43,45,88,47,55,62,53,54,49,49,51,46,47,88,80,47,47,46,46,46,57,71,46,53,50
J1110,"Injection, dihydroergotamine mesylate, per 1 mg",350,315,65,333,333,188,330,174,178,179,118,179,65,132,179,172,65,327,162,170,333,179,206,234,199,203,94,185,184,175,176,333,301,179,179,175,175,174,216,198,175,176,189
J1165,"Injection, phenytoin sodium, per 50 mg",95,85,7,90,90,51,89,47,48,48,49,48,7,36,48,46,18,88,44,46,90,48,56,63,54,55,49,50,50,47,47,90,81,48,48,47,47,47,58,54,47,48,51
J1170,"Injection, hydromorphone, up to 4 mg",93,83,2,106,88,51,87,46,47,47,106,47,2,3,47,45,17,86,43,45,88,47,56,62,53,54,50,50,51,46,46,88,80,47,47,46,46,46,57,50,46,46,50
J1200,"Injection, diphenhydramine HCl, up to 50 mg",89,80,1,85,85,47,84,44,45,45,48,45,1,34,45,44,1,83,41,43,85,45,53,60,51,52,47,47,46,45,45,85,77,45,45,45,45,44,55,69,45,45,48
J1265,"Injection, dopamine HCl, 40 mg",112,101,21,106,106,60,105,56,57,57,58,57,42,42,57,55,21,104,52,54,106,57,66,75,64,65,57,59,57,56,56,106,96,57,57,56,56,56,69,54,56,56,60
J1335,"Injection, Ertapenem sodium, 500 mg",322,289,59,306,306,172,303,160,164,164,168,164,90,122,164,158,59,300,149,156,306,164,190,215,183,186,172,170,169,161,161,306,276,164,164,161,161,160,199,182,161,161,174
J1439,HC INJ FERRIC CARBOXYMALTOS 1MG,2300,2070,832,2185,2185,1233,2166,1146,1173,1173,1201,1173,861,870,1173,1128,832,2145,1065,1116,2185,1173,1356,1540,1310,1333,1181,1215,1364,1150,1153,2185,1974,1173,1173,1150,1153,1146,1420,1304,1150,1154,1242
J1459,"Injection, immune globulin (Privigen), intravenous, non-lyophilized (e.g. liquid), 500 mg",5888,5299,1088,5593,5593,3156,5543,2933,3001,3003,3075,3002,3003,2225,3003,2888,1088,5491,2726,2856,5593,3003,3470,3942,3352,3412,3021,3109,3297,2944,2951,5593,5053,3002,3003,2944,2950,2933,3634,3337,2943,2953,3179
J1580,"Injection, garamycin, gentamicin, up to 80 mg",92,83,17,88,88,44,87,46,46,47,48,47,34,35,47,45,17,86,43,45,88,47,54,62,52,53,47,49,48,46,46,88,79,47,47,46,46,46,57,52,46,46,50
J1630,"Injection, haloperidol, up to 5 mg",90,81,1,106,86,48,85,45,46,46,48,46,1,34,46,44,17,106,42,44,86,46,53,60,51,52,46,48,47,45,45,86,78,46,46,45,45,45,56,44,45,45,49
J1631,"Injection, haloperidol decanoate, per 50 mg",190,171,35,181,181,102,179,95,97,97,83,97,71,72,97,93,35,178,88,92,181,97,112,128,108,110,98,101,100,95,95,181,164,97,97,95,95,95,118,108,95,96,103
J1642,"Injection, Heparin sodium, (Heparin lock flush), per 10 units",89,80,9,85,85,48,84,44,45,45,48,45,33,34,45,44,16,83,41,43,85,45,53,60,51,52,48,47,49,45,45,85,77,45,45,45,45,44,55,69,45,9,48
J1644,"Injection, Heparin sodium, per 1000 units",93,83,1,88,88,44,87,46,47,47,48,47,1,35,47,45,17,86,43,45,88,47,55,62,53,54,56,49,52,46,46,88,80,47,47,46,46,46,57,53,46,46,50
J1650,"Injection, enoxaparin sodium, 10 mg",154,138,3,146,146,86,146,77,75,78,83,78,3,58,78,75,28,143,71,71,146,78,93,103,88,89,82,81,77,77,77,146,132,78,78,77,77,77,95,77,77,77,83
J1745,"Injection Infliximab, 10 mg",4525,4073,837,6064,4299,2426,4261,2254,2306,2308,6064,2308,1693,1710,2308,2220,837,4220,2095,2195,4299,2308,2667,3030,2577,2623,2322,2389,2308,2263,2268,4299,3884,2307,2308,2263,2267,2255,2793,2496,2262,2270,2444
J1756,"Injection, iron sucrose, 1 mg",198,178,37,188,188,106,186,98,101,101,103,101,74,75,101,97,37,184,91,96,188,101,116,132,112,114,101,104,172,99,99,188,170,101,101,99,99,98,122,154,99,99,107
J1815,"Injection, insulin, per 5 units",6,5,1,6,6,3,6,3,3,3,3,3,2,2,3,3,1,6,3,3,6,3,4,4,3,3,6,3,3,3,3,6,5,3,3,3,3,3,4,3,3,3,3
J1885,"Injection, ketorolac tromethamine, per 15 mg",92,83,1,170,87,52,170,45,47,47,48,47,1,1,46,46,17,44,43,42,87,47,49,62,52,53,48,53,52,46,45,85,85,47,47,46,46,46,57,52,46,46,50
J1940,"Injection, furosemide, up to 20 mg",90,81,1,95,86,47,85,45,46,46,49,46,1,1,46,44,17,95,42,48,86,46,53,60,51,52,51,48,50,45,45,86,77,46,46,45,50,45,56,45,45,45,49
J1953,"Injection, levetiracetam, 10 mg",150,135,28,143,143,81,142,75,77,77,59,77,56,57,77,74,28,140,70,73,143,77,89,101,86,87,81,79,77,75,75,143,129,77,77,75,75,75,93,65,75,75,81
J1956,"Injection, levofloxacin, 250 mg",100,90,1,95,95,54,94,50,51,51,54,51,1,38,51,49,18,93,46,48,95,51,59,67,57,58,54,53,51,50,50,95,86,51,51,50,50,50,62,50,50,52,54
J2060,"Injection, lorazepam, 2 mg",89,80,1,85,84,44,83,44,45,45,48,45,1,1,45,42,16,85,41,43,84,45,52,59,50,51,35,47,49,44,44,84,76,45,45,44,44,44,55,44,44,44,48
J2150,"Injection, mannitol, 25% in 50 ml",96,87,18,91,91,52,91,48,49,49,50,49,36,36,49,47,18,90,45,47,91,49,57,64,55,56,49,51,47,48,48,91,83,49,49,48,48,48,59,55,48,48,52
J2175,"Injection, meperidine hydrochloride, per 100 mg",100,90,17,95,95,54,94,50,51,51,52,51,17,38,51,49,19,93,46,49,95,51,59,67,57,58,51,53,56,50,50,95,86,51,51,50,50,50,62,57,50,50,54
J2185,"Injection, meropenem, 100 mg",128,115,24,121,121,68,120,64,65,65,67,65,48,48,65,63,24,119,59,62,121,65,75,85,73,74,65,67,60,64,64,121,109,65,65,64,64,64,79,72,64,64,69
J2250,"Injection, midazolam hydrochloride, per 1 mg",88,79,0,90,84,49,83,44,90,45,48,45,0,33,45,46,16,82,41,44,84,45,51,59,50,51,47,47,49,44,45,84,76,45,45,44,44,44,54,49,44,48,48
J2270,"Injection, morphine sulfate, up to 10 mg",93,84,2,89,89,51,88,46,48,48,50,48,2,5,48,46,17,89,43,45,89,48,55,62,53,54,50,49,54,47,47,89,80,48,48,47,47,46,58,50,47,47,50
J2300,"Injection, nalbuphine hydrochloride, per 10 mg",95,85,3,90,90,51,87,47,48,48,51,48,3,36,48,46,18,88,44,46,90,48,56,63,54,55,47,50,50,47,47,90,81,48,48,47,47,47,58,74,47,48,51
J2310,"Injection, naloxone hydrochloride, per 1 mg",119,107,13,113,113,66,112,59,61,61,97,61,13,45,61,58,22,111,55,58,113,61,70,80,68,69,73,63,62,60,60,113,102,61,61,60,60,59,74,60,60,60,64
J2353,"Injection, octreotide, depot form for intramuscular injection, 1 mg",8617,7755,1593,8186,8186,4619,8113,4292,4392,4395,4500,4394,3224,3257,4395,4227,1593,8036,3989,4180,8186,4395,5079,5770,4907,4994,4422,4550,4826,4308,4319,8186,7396,4393,4395,4308,4317,4293,5318,4567,4307,4322,4653
J2360,"Injection, orphenadrine citrate, up to 60 mg",119,107,5,170,113,63,170,59,60,61,32,61,5,6,61,58,22,111,55,58,113,61,65,79,68,69,32,64,66,59,59,113,102,61,61,59,59,59,73,93,59,60,64
J2370,"Injection, phenylephrine HCl, up to 1 ml",100,90,6,95,95,48,94,50,51,51,54,51,6,38,51,49,18,93,46,48,95,51,59,67,57,58,51,53,50,50,50,95,85,51,51,50,50,50,61,47,50,50,54
J2405,"Injection, ondansetron hydrochloride, per 1 mg",88,80,0,84,84,50,83,44,45,45,48,45,0,33,45,44,16,84,41,64,84,45,54,59,50,51,47,48,50,44,45,84,76,45,45,44,44,44,55,50,44,46,48
J2469,"Injection, palonosetron HCl, 25 mcg",288,259,53,273,273,154,271,143,147,147,101,147,82,109,147,141,53,268,133,139,273,147,169,193,164,167,148,152,147,144,144,273,247,147,147,144,144,143,177,224,144,144,155
J2505,"Injection, Pegfilgrastim, 6 mg",12550,11295,2320,11922,11922,6727,11816,6251,6396,6400,6777,6400,4058,4743,6400,6156,2320,11704,5810,6088,11922,6400,7396,8403,7146,7273,6440,6626,7028,6275,6290,11922,10771,6398,6400,6275,6288,6253,7745,9776,6273,6295,6777
J2540,"Injection, penicillin G potassium, up to 600,000 units",108,97,20,103,103,58,102,54,55,55,29,55,40,41,55,53,20,101,50,52,103,55,64,72,61,63,55,57,57,54,54,103,93,55,55,54,54,54,67,61,54,54,58
J2543,"Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)",99,89,6,94,94,50,93,49,50,50,54,50,6,37,50,49,18,92,46,55,94,50,58,66,56,57,59,52,55,49,50,94,85,50,50,49,50,49,61,47,49,50,53
J2550,"Injection, promethazine HCl, up to 50 mg",89,80,2,85,85,51,84,45,46,46,25,46,2,2,46,44,17,85,41,43,85,46,53,60,51,52,45,48,51,45,45,85,77,46,46,45,45,45,55,72,45,45,48
J2590,"Injection, oxytocin, up to 10 units",93,84,17,88,88,50,88,46,47,47,41,47,35,35,47,46,17,87,43,45,88,47,55,62,53,54,48,49,49,47,47,88,80,47,47,47,47,46,57,53,47,47,50
J2704,"Inj, propofol, 10 mg",97,87,4,180,92,52,88,47,49,50,52,50,4,4,47,48,18,67,45,47,92,50,59,65,55,56,52,52,52,49,49,180,83,50,50,49,49,49,60,54,49,55,52
J2710,"Injection, neostigmine methylsulfate, up to 0.5 mg",70,63,13,69,66,23,66,24,36,36,38,36,69,26,36,34,13,65,32,34,66,36,41,47,40,40,35,37,36,35,35,66,60,36,36,35,35,35,43,40,35,35,38
J2765,"Injection, metoclopramide HCl, up to 10 mg",92,83,1,87,87,44,87,46,47,47,48,47,1,35,47,45,17,86,43,45,87,47,54,62,52,53,37,49,51,46,46,87,79,47,47,46,46,46,57,72,46,46,50
J2785,"Injection, regadenoson, 0.1 mg",573,516,106,545,545,329,540,286,292,292,310,292,242,217,292,285,106,535,265,278,545,292,347,384,327,332,308,303,321,287,287,545,492,292,292,287,287,286,354,287,287,288,310
J2790,"Injection, Rho D immune globulin, human, full dose, 300 micrograms (1500 I.U.)",258,232,48,245,245,138,243,129,131,132,139,132,83,76,132,127,48,241,119,125,245,132,152,173,147,150,138,136,136,129,129,245,221,132,132,129,129,129,159,146,129,129,139
J2791,"Injection, Rho(D) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 IU",408,367,75,388,388,219,384,203,208,208,220,208,153,154,208,200,75,381,189,198,388,208,241,273,232,237,210,216,215,204,205,388,350,208,208,204,205,203,252,231,204,205,220
J2795,"Injection, ropivacaine hydrochloride, 1 mg",128,116,21,122,122,69,121,64,65,65,78,65,21,49,65,63,24,120,59,62,122,65,76,86,73,74,61,68,81,64,64,122,110,65,65,64,64,64,79,72,64,61,69
J2805,"Injection, sincalide, 5 micrograms",164,148,30,156,156,92,154,82,84,84,89,84,118,114,84,80,30,153,76,80,156,84,97,110,93,95,88,82,86,82,82,156,141,84,84,82,82,82,101,82,82,82,89
J2920,"Injection, methylprednisolone sodium succinate, up to 40 mg",100,90,4,119,95,119,94,50,51,51,54,51,4,38,51,49,19,93,46,49,95,51,59,67,57,58,31,47,56,50,50,95,86,51,51,50,50,50,62,50,50,50,54
J2930,"Injection, methylprednisolone sodium succinate, up to 125 mg",107,96,6,102,102,54,101,50,54,55,58,55,6,6,55,52,20,100,49,51,102,55,63,72,61,62,54,56,56,53,54,102,92,55,55,53,54,53,50,52,53,54,58
J2997,"Injection, alteplase recombinant, 1 mg",6005,5404,211,7069,5704,3219,5654,2991,3060,3062,213,3062,2246,2270,3062,7069,1110,5600,2780,2913,5704,3062,3539,4021,3419,3480,3082,3170,211,3002,3010,5704,5154,3061,3062,3002,3008,2992,3706,5808,3001,3012,3242
J3010,"Injection, fentanyl citrate, 0.1 mg",90,81,1,168,85,47,168,89,46,46,48,46,1,1,45,91,17,86,42,43,85,46,54,60,51,52,48,47,50,45,45,85,77,46,46,45,45,45,55,50,45,48,48
J3030,"Injection, sumatriptan succinate, 6 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)",186,167,34,176,176,99,175,92,95,95,50,95,74,70,95,71,34,173,86,90,176,95,109,124,106,108,54,98,97,93,93,176,159,95,95,93,93,92,114,105,93,93,100
J3105,"Injection, terbutaline sulfate, up to 1 mg",96,87,3,92,92,52,91,48,49,49,50,49,3,36,49,47,18,90,45,47,92,49,57,65,55,56,52,51,51,48,48,92,83,49,49,48,48,48,60,55,48,48,52
J3245,"Inj., tildrakizumab, 1 mg",29309,26378,5419,27844,27844,15711,27596,14599,14938,14948,15306,14947,10965,11078,14948,14376,5419,27334,13569,14218,27844,14948,17274,19626,16689,16986,15041,15475,16413,14654,14691,27844,25156,14943,14948,14654,14685,14603,18089,16613,14650,14701,15827
J3260,"Injection, tobramycin sulfate, up to 80 mg",104,94,19,99,99,56,98,52,53,53,55,53,39,39,53,51,19,97,48,51,99,53,62,70,59,61,54,55,53,52,52,99,90,53,53,52,52,52,64,59,52,52,56
J3262,"Injection, tocilizumab, 1 mg",6636,5972,1227,6304,6304,3557,6248,3305,3382,3384,3399,3384,2483,2508,3384,3255,1227,6189,3072,3219,6304,3384,3911,4444,3779,3846,3406,3504,3487,3318,3326,6304,5696,3383,3384,3318,3325,3306,4096,3376,3317,3329,3583
J3301,"Injection, triamcinolone acetonide, not otherwise specified, 10 mg",122,109,5,115,115,65,114,61,62,62,49,62,5,46,62,96,22,113,56,60,115,62,72,81,69,70,49,64,68,61,61,115,104,62,62,61,61,61,75,77,61,61,66
J3360,"Injection, diazepam, up to 5 mg",115,103,8,109,109,51,108,57,59,59,53,59,8,43,59,56,21,107,53,55,109,59,68,77,65,67,59,61,60,57,58,109,99,59,59,57,58,57,71,65,57,58,62
J3370,"Injection, vancomycin HCl, 500 mg",100,90,18,95,95,54,94,50,51,51,54,51,37,38,51,49,18,93,46,48,95,51,59,67,57,58,56,53,54,50,50,95,86,51,51,50,50,50,62,78,50,50,54
J3380,"Injection, vedolizumab",13910,12519,2572,13214,13214,7456,13097,6929,7090,7094,7264,7093,5204,5257,7094,6823,2572,12972,6440,6748,13214,7094,8198,9314,7920,8062,7138,7344,7789,6955,6972,13214,11939,7092,7094,6955,6969,6930,8585,7884,6953,6977,7511
J3410,"Injection, hydroxyzine HCl, up to 25 mg",126,114,8,120,120,68,119,63,64,64,66,64,8,48,64,62,23,118,58,61,120,64,74,85,72,73,68,67,66,63,63,120,108,64,64,63,63,63,78,72,63,63,68
J3411,"Injection, thiamine HCl, 100 mg",107,97,5,102,102,58,101,53,55,55,56,55,5,41,55,53,20,102,50,52,102,55,63,72,61,62,29,57,60,54,54,102,92,55,55,54,54,54,66,84,54,54,58
J3420,"Injection, vitamin B-12 cyanocobalamin, up to 1000 mcg",102,91,19,96,96,54,96,51,52,52,55,52,38,38,52,50,19,95,47,49,96,52,60,68,58,59,52,54,52,51,51,96,87,52,52,51,51,51,63,49,51,51,55
J3430,"Injection, phytonadione (vitamin K), per 1 mg",184,166,34,175,175,99,173,92,94,94,72,94,69,70,94,90,34,172,85,89,175,94,108,123,105,107,99,97,66,92,92,175,158,94,94,92,92,92,114,88,92,92,99
J3475,"Injection, magnesium sulfate, per 500 mg",92,83,2,88,88,52,87,45,47,47,50,47,2,35,47,45,17,86,43,47,88,47,56,62,53,53,48,49,55,46,46,88,79,47,47,46,46,46,57,60,46,46,50
J3480,"Injection, potassium chloride, per 2 meq",60,54,2,57,57,30,56,30,31,31,35,31,2,23,31,29,11,56,28,29,57,31,35,40,34,35,24,32,34,30,30,57,51,31,31,30,30,30,37,50,30,30,32
J3486,"Injection, ziprasidone mesylate, 10 mg",197,177,36,206,187,106,185,98,100,100,104,100,49,74,100,97,36,184,91,95,187,100,116,132,112,114,206,104,103,98,99,187,169,100,100,98,99,98,121,112,98,99,106
J3489,HC ZOLEDRONIC ACID 1MG,256,231,40,344,243,153,241,128,131,131,134,131,40,54,131,126,47,239,119,124,243,131,151,172,146,149,132,135,234,128,128,243,220,131,131,128,128,128,158,344,128,129,138
J7042,5% dextrose/normal saline (500 ml = 1 unit),60,54,2,65,57,32,56,30,31,31,65,31,2,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,34,30,30,57,51,31,31,30,30,30,37,30,30,30,32
J7120,"Ringers lactate infusion, up to 1000 cc",60,54,2,65,57,34,57,60,31,31,32,31,2,2,31,30,11,57,28,29,57,31,51,40,34,59,32,32,34,30,61,57,51,31,31,30,30,30,37,30,30,65,32
J7121,5% dextrose in lac ringers,60,54,5,65,57,30,56,30,31,31,65,31,5,23,31,29,11,56,28,29,57,31,35,40,34,35,32,32,34,30,30,57,51,31,31,30,30,30,37,34,30,30,32
J7510,"Prednisolone oral, per 5 mg",2,2,0,2,2,1,2,1,1,1,1,1,1,1,1,1,0,2,1,1,2,1,1,2,1,1,1,1,1,1,1,2,2,1,1,1,1,1,2,1,1,1,1
J7512,Prednisone ir or dr oral 1mg,2,1,0,1,1,1,1,1,1,1,1,1,0,1,1,1,0,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1
J8540,"Dexamethasone, oral, 0.25 mg",3,3,1,3,3,1,3,1,1,1,1,1,2,1,1,1,1,3,1,1,3,1,2,2,2,2,1,1,1,1,1,3,2,1,1,1,1,1,2,1,1,1,2
J9000,"Injection, doxorubicin hydrochloride, 10 mg",382,344,42,363,363,205,360,190,195,195,200,195,42,144,195,187,71,356,177,185,363,195,225,256,218,222,196,202,201,191,192,363,328,195,195,191,192,190,236,217,191,192,206
J9022,"Inj, atezolizumab,10 mg",17819,16037,3294,16928,16928,9552,16777,8876,9082,9088,9306,9087,6666,6735,9088,8740,3294,16618,8250,8644,16928,9088,10502,11932,10146,10327,9145,9408,9364,8909,8931,16928,15294,9085,9088,8909,8928,8878,10997,13881,8906,8938,9622
J9035,"Injection, bevacizumab, 10 mg",6710,6039,1240,6374,6374,3597,6317,3342,3420,3422,3504,3422,2510,2536,3422,3291,1240,6257,3106,3255,6374,3422,3954,4493,3820,3889,3443,3543,3422,3355,3363,6374,5759,3421,3422,3355,3362,3343,4141,3803,3354,3365,3623
J9041,"Injection, bortezomib, 0.1 mg",2613,2351,483,2482,2482,1400,2460,1301,1332,1332,1364,1332,1324,1326,1332,1281,483,2436,1210,1267,2482,1332,1540,1749,1488,1514,1341,1379,1373,1306,1310,2482,2242,1332,1332,1306,1309,1302,1612,1481,1306,1310,1411
J9045,"Injection, carboplatin, 50 mg",548,494,101,521,521,294,516,273,280,280,286,280,205,207,280,269,101,511,254,266,521,280,323,367,312,318,281,290,213,274,275,521,471,280,280,274,275,273,338,442,274,275,296
J9060,"Injection, cisplatin, powder or solution, 10 mg",423,381,78,402,402,227,398,211,216,216,221,216,158,160,216,207,78,394,196,205,402,216,249,283,241,245,217,223,201,212,212,402,363,216,216,212,212,211,261,240,211,212,228
J9070,"Cyclophosphamide, 100 mg",941,847,174,894,894,504,886,469,480,480,491,480,193,356,480,461,174,877,436,456,894,480,555,630,536,545,483,497,494,470,472,894,808,480,480,470,471,469,581,533,470,472,508
J9100,"Injection, cytarabine, 100 mg",351,316,65,334,334,188,331,175,179,179,184,179,131,133,179,172,65,328,163,170,334,179,207,235,200,204,180,186,167,176,176,334,302,179,179,176,176,175,217,199,176,176,190
J9181,"Injection, etoposide, 10 mg",378,340,70,359,359,203,356,188,193,193,210,193,141,143,193,185,70,352,175,183,359,193,223,253,215,219,194,199,212,189,189,359,324,193,193,189,189,188,233,295,189,189,204
J9190,"Injection, fluorouracil, 500 mg",359,323,66,341,341,192,338,179,183,183,187,183,134,136,183,176,66,335,166,174,341,183,212,240,204,208,184,190,183,180,180,341,308,183,183,180,180,179,222,204,179,180,194
J9206,"Injection, irinotecan, 20 mg",451,405,83,428,428,242,424,224,230,230,234,230,169,170,230,221,83,420,209,219,428,230,266,302,257,261,231,238,256,225,226,428,387,230,230,225,226,224,278,255,225,226,243
J9217,"Leuprolide acetate (for depot suspension), 7.5 mg",5499,4949,719,10044,5224,2948,5178,2739,2803,2805,2872,2804,719,2079,2805,2697,1017,5129,2546,2668,5224,2805,3241,3682,3131,3187,10044,2904,3080,2750,2756,5224,4720,2804,2805,2750,2755,2740,3394,1462,2749,2758,2970
J9263,"Injection, oxaliplatin, 0.5 mg",671,604,124,638,638,360,632,334,342,342,350,342,251,254,342,329,124,626,311,326,638,342,396,449,382,389,344,354,376,336,336,638,576,342,342,336,336,334,414,380,335,337,362
J9267,HC PACLITAXEL INJECTION 1 MG,449,405,23,427,427,241,423,224,229,229,235,229,23,170,229,220,83,419,208,218,427,229,265,301,256,260,231,237,209,225,225,427,386,229,229,225,225,224,277,255,225,225,243
J9271,HC INJ PEMBROLIZUMAB 1 MG,19103,17193,3532,18148,18148,10240,17986,9515,9736,9742,10166,9742,7146,7220,9743,9370,3532,17815,8844,9267,18148,9742,11259,12791,10877,11071,9804,10086,9742,9551,9575,18148,16396,9739,9742,9551,9571,9518,11790,9739,9548,9582,10316
J9280,"Mitomycin, 5 mg",2752,2476,509,2614,2614,1475,2591,1371,1402,1403,1437,1403,1029,1040,1403,1350,509,2566,1274,1335,2614,1403,1622,1842,1567,1595,1412,1453,1541,1376,1379,2614,2362,1403,1403,1376,1379,1371,1698,1560,1375,1380,1486
J9303,"Injection, panitumumab, 10 mg",12759,11483,2359,12121,12121,6840,12013,6355,6503,6507,6890,6507,4773,4823,6507,6258,2359,11899,5907,6190,12121,6507,7520,8544,7265,7395,6548,6737,5524,6380,6395,12121,10951,6505,6507,6380,6393,6357,7875,7232,6378,6400,6890
J9305,"Injection, pemetrexed, 10 mg",5889,5300,1089,5595,5595,3157,5545,2933,3002,3003,3076,3003,2203,2226,3004,2889,1089,5492,2727,2857,5595,3003,3471,3943,3353,3413,3022,3109,2870,2945,2952,5595,5055,3002,3003,2945,2951,2934,3635,3338,2944,2954,3180
J9306,"HC INJECTION, PERTUZUMAB, 1 MG",15432,13889,2853,14661,14661,8272,14530,7687,7866,7870,8059,7870,5773,5833,7871,7570,2853,14392,7145,7486,14661,7870,9095,10334,8787,8944,7920,8148,7870,7716,7735,14661,13246,7868,7870,7716,7732,7689,9525,8747,7714,7741,8333
J9355,"Injection, trastuzumab, 10 mg",8246,7421,1525,7834,7834,4420,7764,4107,4203,4205,4306,4205,4205,3117,4206,4045,1525,7690,3818,4000,7834,4205,4860,5522,4695,4779,4232,4354,4205,4123,4133,7834,7078,4204,4205,4123,4131,4108,5089,4674,4122,4136,4453
J9395,"Injection, Fulvestrant, 25 mg",2815,2534,521,2675,2675,1459,2651,1402,1002,1436,1470,1436,1053,1064,1436,1381,521,2626,2017,1848,2675,1436,1659,1885,1603,1632,1445,1486,1100,1408,1411,2675,2416,1435,1436,1408,1411,1403,1738,1596,1407,1412,1520
J9999,"Not otherwise classified, antineoplastic drugs",2,1,0,4,2,1,2,4,1,1,1,1,1,1,1,1,0,1,1,1,2,1,1,1,1,1,1,1,1,1,1,2,1,1,1,1,1,1,1,1,1,1,1
L0140,HC CERVICAL PLASTIC COLLAR LVL 5,25,22,5,24,24,13,24,12,13,13,13,13,9,9,13,12,5,23,12,12,24,13,15,17,14,14,13,13,13,12,13,24,21,13,13,12,13,12,15,14,12,13,14
L8641,HC METATARSAL JOINT IMPLANT LVL 6,3788,3409,700,3598,3598,2030,3566,1887,1931,1932,1978,1932,1417,1432,1932,1858,700,3533,1754,1838,3598,1932,2232,2536,2157,2195,2033,2000,1991,1894,1899,3598,3251,1931,1932,1894,1898,1887,2338,2147,1893,1900,2045
M0239,HC BAMLANIVIMAB-XXXX INFUSION,310,279,57,295,294,166,292,154,158,158,162,158,116,117,158,152,57,289,144,150,294,158,183,208,177,180,166,164,158,155,155,295,266,158,158,155,155,154,191,176,155,155,167
M0243,Casirivi and imdevi infusion,310,279,57,570,294,166,292,154,158,158,162,158,570,117,158,152,57,289,144,150,294,158,183,208,177,180,191,164,158,155,155,295,266,158,158,155,155,154,191,176,155,155,167
P9016,"Red blood cells, leukocytes reduced, each unit",956,860,177,908,908,507,900,476,487,488,258,488,358,361,488,469,177,892,443,459,908,488,563,640,544,554,491,505,454,478,479,908,821,487,488,478,478,476,590,478,478,480,516
P9033,"Platelets, leukocytes reduced, irradiated, each unit",954,859,176,906,906,511,898,475,486,487,498,487,357,361,487,468,176,890,442,463,906,487,562,639,543,553,490,504,453,477,478,906,819,486,487,477,478,475,589,541,477,479,515
P9035,"Platelets, pheresis, leukocytes reduced, each unit",883,795,163,839,839,473,831,440,450,450,461,450,330,334,450,433,163,823,409,428,839,450,520,591,503,512,453,466,464,442,443,839,758,450,450,442,442,440,545,688,441,443,477
P9037,"Platelets, pheresis, leukocytes reduced, irradiated, each unit",954,859,176,906,906,511,898,475,486,487,498,487,357,361,487,468,176,890,442,463,906,487,562,639,543,553,490,504,534,477,478,906,819,486,487,477,478,475,589,743,477,479,515
P9040,"Red blood cells, leukocytes reduced, irradiated, each unit",1194,1075,221,1134,1134,640,1124,595,609,609,624,609,447,451,609,586,221,1114,553,579,1134,609,704,800,680,692,613,630,532,597,598,1134,1025,609,609,597,598,595,737,930,597,599,645
P9047,"Infusion, albumin (human), 25%, 50 ml",456,410,84,433,433,244,429,227,232,232,238,232,187,172,232,223,84,425,211,221,433,232,268,305,259,264,234,240,244,228,228,433,391,232,232,228,228,227,281,258,228,228,246
P9059,"Fresh frozen plasma between 8-24 hours of collection, each unit",216,194,40,205,205,116,203,108,110,110,113,110,81,82,110,106,40,201,100,105,205,110,127,145,123,125,111,114,102,108,108,205,185,110,110,108,108,108,133,122,108,108,117
P9612,"Catheterization for collection of specimen, single patient, all places of service",52,47,10,49,49,26,49,26,27,27,27,27,19,20,27,26,10,48,24,25,49,27,31,35,30,30,28,27,25,26,26,49,45,27,27,26,26,26,32,26,26,26,28
Q0138,"Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-ESRD use)",2405,2165,474,2285,2285,1347,2265,1198,1226,1227,1256,1227,900,909,1227,1180,474,2243,541,1167,2285,1227,1418,1611,1370,1394,1234,1270,1347,1203,1206,2285,2064,1226,1227,1203,1205,1198,1484,1363,1202,1206,1299
Q0144,"Azithromycin dihydrate, oral, capsules/powder, 1 gram",4,4,1,4,4,2,4,2,2,2,2,2,1,2,2,2,1,4,2,2,4,2,2,3,2,2,2,2,2,2,2,4,3,2,2,2,2,2,2,2,2,2,2
Q0177,"Hydroxyzine pamoate, 25 mg, oral, FDA approved prescription anti-emetic, for use as a complete therapeutic substitute for an IV anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen",2,2,0,2,2,2,2,1,1,1,1,1,1,1,1,1,0,2,1,1,2,1,1,2,1,1,1,1,1,1,1,2,2,1,1,1,1,1,1,1,1,1,1
Q4133,HC GRAFIX PRIME PL/STRAVIX PER 1 SQ CM LVL 3,6250,5625,1156,5938,5938,3350,5885,3113,3186,3188,3264,3187,2338,2362,3188,3066,1156,5829,2894,3032,5938,3188,3684,4185,3559,3622,3208,3300,2965,3125,3133,5938,5364,3186,3187,3125,3131,3114,3857,3543,3124,3135,3375
Q4160,HC NUSHIELD PER SQ CM LVL 6,4920,4428,910,4674,4674,2637,4632,2451,2508,2509,2569,2509,1841,1860,2509,2413,910,4588,2278,2387,4674,2509,2900,3294,2801,2851,2525,2598,2509,2460,2466,4674,4223,2508,2509,2460,2465,2451,3037,2789,2459,2468,2657
Q4186,HC EPIFIX PER SQ CM LVL 6,3600,3240,666,3420,3420,1930,3390,1793,1835,1836,1880,1836,1347,1361,1836,1766,666,3357,1667,1746,3420,1836,2122,2411,2050,2086,1848,1901,2016,1800,1804,3420,3090,1835,1836,1800,1804,1794,2222,2041,1799,1806,1944
Q4187,HC EPICORD PER SQ CM LVL 6,1800,1620,333,1710,1710,965,1695,897,917,918,940,918,673,680,918,883,333,1679,833,873,1710,918,1061,1205,1025,1043,924,950,1008,900,902,1710,1545,918,918,900,902,897,1111,1020,900,903,972
Q4195,HC PURAPLY PER SQ CM LVL 11,3000,2700,555,2850,2850,1608,2825,1494,1529,1530,1567,1530,1122,1134,1530,1471,555,2798,2693,1455,2850,1530,1768,2009,1708,1739,1540,1584,1247,1500,1504,2850,2575,1529,1530,1500,1503,1495,1852,1700,1500,1505,1620
Q4196,HC PURAPLY AM PER SQ CM LVL 11,2272,2044,420,2158,2158,1218,2139,1131,1158,1158,1186,1158,850,859,1158,1114,420,2118,1052,1102,2158,1158,1339,1521,1293,1316,1166,1199,1152,1136,1139,2158,1950,1158,1158,1136,1138,1132,1402,1288,1135,1139,1227
Q5101,"Injection, zarxio",636,573,118,752,604,305,599,317,324,324,332,324,238,240,324,312,118,593,295,305,604,324,375,426,362,369,518,336,334,318,319,604,546,324,324,318,319,317,393,752,318,319,344
Q5104,"Injection, renflexis",9475,8527,1752,9001,9001,5079,8921,4719,4829,4832,4948,4832,3545,3581,4832,4647,1752,8836,4387,4596,9001,4832,5584,6344,5395,5491,5085,5003,4979,4737,4749,9001,8132,4831,4832,4737,4747,4721,5848,5370,4736,4752,5116
Q5106,Inj retacrit non-esrd use,308,277,57,293,293,165,290,153,157,157,161,157,115,116,157,151,57,287,143,149,293,157,182,206,175,179,158,163,157,154,154,293,264,157,157,154,154,154,190,175,154,155,166
Q9958,"High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml",40,36,7,38,38,21,38,20,20,20,21,20,15,15,20,20,7,37,18,19,38,20,24,27,23,23,20,21,21,20,20,38,34,20,20,20,20,20,25,20,20,20,22
Q9967,"Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml",264,237,49,251,251,140,248,132,134,134,142,134,134,100,134,131,49,246,122,126,251,134,152,177,150,153,142,142,148,132,134,246,226,134,134,132,132,131,163,132,134,132,142
R0300,,28,25,5,27,27,15,26,14,14,14,15,14,10,11,14,14,5,26,13,14,27,14,17,19,16,16,14,15,15,14,14,27,24,14,14,14,14,14,17,16,14,14,15
R0301,,100,90,18,95,95,54,94,50,51,51,52,51,37,38,51,49,18,93,46,49,95,51,59,67,57,58,51,53,53,50,50,95,86,51,51,50,50,50,62,57,50,50,54
R0305,,78,70,14,74,74,42,73,39,40,40,41,40,29,29,40,38,14,73,36,38,74,40,46,52,44,45,40,41,41,39,39,74,67,40,40,39,39,39,48,44,39,39,42
R0306,,117,105,22,111,111,63,110,58,60,60,61,60,44,44,60,57,22,109,54,57,111,60,69,78,67,68,60,62,61,58,59,111,100,60,60,58,59,58,72,66,58,59,63
S0028,"Injection, famotidine, 20 mg",89,80,1,85,85,48,84,44,45,45,46,45,1,34,45,44,16,83,41,43,85,45,52,60,51,52,46,47,47,44,45,85,76,45,45,44,45,44,55,50,44,45,48
S0030,"Injection, metronidazole, 500 mg",90,81,1,85,85,48,84,45,46,46,1,46,1,34,46,44,17,83,41,43,85,46,53,60,51,52,46,47,47,45,45,85,77,46,46,45,45,45,55,51,45,45,48
S0077,"Injection, clindamycin phosphate, 300 mg",109,98,2,103,103,58,103,54,56,56,57,56,2,41,56,53,20,102,50,53,103,56,64,73,62,63,56,57,57,54,55,103,93,56,56,54,55,54,67,62,54,55,59
S4991,"Nicotine patches, non-legend",3,3,1,3,3,2,3,2,2,2,2,2,1,1,2,2,1,3,1,2,3,2,2,2,2,2,2,2,2,2,2,3,3,2,2,2,2,2,2,2,2,2,2
S5010,"5% dextrose and 0.45% normal saline, 1000 ml",60,54,5,57,57,32,56,30,31,31,31,31,5,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,32,30,30,57,51,31,31,30,30,30,37,34,30,30,32
S9470,"Nutritional counseling, dietitian visit",60,54,11,128,57,32,56,30,31,31,31,31,128,23,31,29,11,56,28,29,57,31,35,40,34,35,31,32,32,30,30,57,51,31,31,30,30,30,37,34,30,30,32
S9472,"Cardiac rehabilitation program, non-physician provider, per diem",195,176,36,185,185,105,184,97,99,99,101,99,73,74,99,96,36,182,90,95,185,99,115,131,111,113,105,103,102,98,98,185,167,99,99,98,98,97,120,111,97,98,105
U0003,HC SARS-COV-2 COVID-19 AMP PRB HIGH THROUGHPUT TECH,100,90,18,307,95,56,94,50,51,51,54,51,307,307,51,50,18,95,46,49,95,51,75,67,37,58,54,54,56,50,50,95,86,51,51,50,50,50,78,78,50,50,54
V2632,Posterior chamber intraocular lens,479,431,89,2398,455,268,451,240,244,244,259,244,244,181,244,235,89,447,2398,230,455,244,282,321,273,278,257,253,268,240,244,455,411,244,244,240,240,240,296,240,239,240,259
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
DRG,Description,Charges,Discounted Cash Price,Min Negotiated,Max Negotiated,Admin concepts,Aetna,Aetna - coventry,Aetna medicare,Aetna medicare supplemental ins.,American republic,Amerigroup ia medicaid,Bankers life & casualty,Blue cross,Blue cross out of state,Bridgestone firestone,Champus,Champva,Cigna,Commercial,Coventry advantra,Coventry health care,Equitable,Health partners,Health partners uph self funded,Humana,Humana choice,Iowa total care,Medicaid,Medicare,Medicare community plan uhc,Medico,Meritain,Midlands choice,Mutual of omaha,National assoc ltr carr,Securehorizons direct,Uhc medicare solutions hmo,Uhc medicare solutions ppo,Uhc river valley,United healthcare,United healthcare aarp ins.,Va,Workers compensation
Inpatients,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
177,DRG RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC),16303,14673,3014,15488,15488,8739,15350,8121,8310,8315,8514,8314,6099,6162,8315,7997,3014,15205,7548,7909,15488,8315,9609,10917,9283,9449,8367,8608,8567,8152,8172,15488,13993,8312,8315,8152,8168,8123,10062,12700,8149,8178,8804
179,DRG RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC),425,383,79,404,404,228,400,212,217,217,222,217,159,161,217,209,79,397,197,206,404,217,251,285,242,246,218,225,223,213,213,404,365,217,217,213,213,212,262,331,213,213,230
189,"DRG PULMONARY EDEMA AND RESPIRATORY FAILURE - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",7979,7181,1475,7580,7580,4277,7512,3974,4067,4069,6704,4069,2985,3016,4069,3914,1475,7441,3694,3871,7580,4069,4702,5343,1969,4624,4095,4213,4193,3989,3999,7580,6848,4068,4069,3989,3998,3975,4924,4522,3988,4002,4309
190,"DRG CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",20978,18880,3878,19929,19929,11245,19751,10449,10692,10699,14859,10698,7848,7929,10699,10289,3878,19564,9712,10176,19929,10699,12363,14047,11945,12158,10766,11076,11024,10489,10515,19929,18005,10695,10698,10489,10510,10452,12947,11890,10485,10522,11328
191,"DRG CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",2126,1913,393,2562,2020,2562,2002,1059,1084,1084,1110,1084,795,804,1084,1043,393,1983,984,1031,2020,1084,1253,1424,1211,1232,1091,1122,1117,1063,1066,2020,1825,1084,1084,1063,1065,1059,1312,1205,1063,1066,1148
193,"DRG SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",17017,15315,3146,21602,16166,9122,16022,8476,8673,8679,8887,8678,6366,6432,8679,8347,3146,15870,7878,8255,16166,8679,10029,11395,21602,9862,8733,8985,8942,8508,8529,16166,14606,8676,8679,8508,8526,8478,10502,9645,8506,8535,9189
194,"DRG SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",10985,9887,2031,10436,10436,10248,10343,5472,5599,5602,5924,5602,4110,4152,5602,5388,2031,10245,5086,5329,10436,5602,6474,7356,6255,6367,5638,5800,5773,5493,5506,10436,9429,5601,5602,5493,5504,5473,6780,6227,5491,5510,5932
292,"DRG HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",5167,4650,955,6172,4909,2770,4865,2574,2633,2635,2698,2635,1933,1953,2635,2534,955,4819,2392,2506,4909,2635,3045,3460,6172,2995,2652,2728,2715,2583,2590,4909,4435,2634,2635,2583,2589,2574,3189,2929,2583,2592,2790
293,"DRG HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",18008,16208,3329,17108,17108,9653,16956,8970,9179,9184,9405,9184,6737,6807,9184,8833,3329,16795,8338,8736,17108,9184,10614,12059,10254,10437,9242,9508,9464,9004,9027,17108,15457,9181,9184,9004,9023,8972,11115,14029,9001,9033,9725
388,DRG G.I. OBSTRUCTION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC),3574,3217,661,3395,3395,1916,3365,1780,1822,1823,2803,1823,1337,1351,1823,1753,661,3333,1655,1734,3395,1823,2106,2393,2035,2071,1834,1887,1878,1787,1791,3395,3068,1822,1823,1787,1791,1781,2206,2026,1786,1793,1930
536,"DRG FRACTURES OF HIP AND PELVIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",9492,8543,1755,10248,9018,10248,8937,4728,4838,4841,4957,4841,3551,3588,4841,4656,1755,8853,4395,4605,9018,4841,5594,6356,5405,5501,4871,5012,4988,4746,4758,9018,8147,4839,4841,4746,4756,4729,5858,5380,4745,4761,5126
570,DRG SKIN DEBRIDEMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC),15592,14033,2883,15592,14812,8358,14680,7766,7947,7952,15592,7951,5833,5893,7952,7648,2883,14541,7219,7564,14812,7952,9189,10440,8878,9036,8002,8232,8194,7796,7815,14812,13383,7949,7952,7796,7812,7768,9623,8838,7793,7821,8420
690,DRG KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC),16840,15156,3113,15998,15998,10248,15856,8388,8583,8589,8795,8588,6300,6365,8589,8260,3113,15706,7797,8169,15998,8589,9925,11276,9589,9760,8643,8892,8850,8420,8441,15998,14454,8586,8589,8420,8438,8390,10394,9545,8417,8447,9094
795,DRG NORMAL NEWBORN,5144,4630,951,4887,4887,2758,4844,2562,2622,2624,3944,2623,1925,1944,2624,2523,951,4798,2382,2496,4887,2624,3032,3445,2929,2981,2640,2716,2703,2572,2579,4887,4415,2623,2624,2572,2577,2563,3175,2916,2571,2580,2778
811,"DRG RED BLOOD CELL DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",14420,12978,2666,14420,13699,7730,13577,7183,7350,7354,14420,7354,5395,5450,7354,7073,2666,13448,6676,6995,13699,7354,8499,9656,8211,8357,7400,7614,7578,7210,7228,13699,12377,7352,7354,7210,7225,7185,8900,8174,7208,7233,7787
864,DRG FEVER,8045,7240,1487,8045,7643,4312,7575,4007,4100,4103,8045,4103,3010,3041,4103,3946,1487,7503,3725,3903,7643,4103,4741,5387,4581,4663,4129,4248,4228,4022,4032,7643,6905,4102,4103,4022,4031,4008,4965,4560,4021,4035,4344
866,DRG VIRAL ILLNESS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC),3228,2906,597,3067,3067,1731,3040,1608,1645,1646,1686,1646,1208,1220,1646,1584,597,3011,1495,1566,3067,1646,1903,2162,1838,1871,1657,1705,1697,1614,1618,3067,2771,1646,1646,1614,1617,1608,1992,2515,1614,1619,1743
872,"DRG SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",6373,5736,1178,6055,6055,2562,6001,3175,3248,3250,3328,3250,2384,2409,3251,3126,1178,5944,2951,3092,6055,3250,3756,4268,3629,3694,3271,3365,3349,3187,3195,6055,5470,3249,3250,3187,3193,3175,3934,3613,3186,3197,3442
897,"DRG ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC)",5295,4766,979,5295,5030,2838,4986,2638,2699,2701,5295,2700,1981,2001,2701,2597,979,4938,2452,2569,5030,2701,3121,3546,3015,3069,2717,2796,2783,2648,2654,5030,4545,2700,2701,2648,2653,2638,3268,3001,2647,2656,2859
951,"DRG OTHER FACTORS INFLUENCING HEALTH STATUS - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",31910,28719,5900,81716,30315,17106,30045,15895,16264,16274,16665,16273,11938,12061,16275,15652,5900,29760,14774,15480,30315,16274,18807,21367,81716,18494,16376,16848,16769,15955,15995,30315,27389,16269,16274,15955,15988,15899,19694,18087,15950,16006,17232
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
CPT,Description,Charges,Discounted Cash Price,Min Negotiated,Max Negotiated,Aetna,Aetna - coventry,Aetna medicare,Amerigroup ia medicaid,Blue cross,Blue cross out of state,Champus,Champva,Cigna,Coventry advantra,Health partners,Humana,Humana choice,Iowa total care,Medicaid,Medicare,Meritain,Midlands choice,Securehorizons direct,Uhc medicare solutions hmo,Uhc medicare solutions ppo,Uhc river valley,United healthcare,Va,Workers compensation,,,,,,,,,,,,,,
Professionals,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Outpatients,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
00120,"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified",1069,962,149,726,474,653,448,317,658,641,388,236,726,452,654,376,418,273,250,604,525,617,285,398,159,262,149,252,454,,,,,,,,,,,,,,
00142,Anesthesia for procedures on eye; lens surgery,772,695,83,524,342,472,323,229,348,463,280,171,524,110,472,272,302,83,180,436,379,459,206,100,111,189,101,182,328,,,,,,,,,,,,,,
00170,"Anesthesia for intraoral procedures, including biopsy; not otherwise specified",1245,1120,185,846,552,761,522,369,464,747,452,275,846,526,762,438,487,318,291,703,611,719,332,463,185,305,402,293,528,,,,,,,,,,,,,,
00300,"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified",1133,1020,135,770,502,692,475,336,697,679,411,250,770,479,693,399,443,135,265,640,556,654,302,137,168,277,155,267,481,,,,,,,,,,,,,,
00400,"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified",1117,1005,84,759,495,682,468,331,464,670,405,247,759,472,684,393,437,84,261,631,548,645,297,416,166,273,93,263,474,,,,,,,,,,,,,,
00731,PR ANES UPR GI NDSC PX NOS,845,760,99,574,374,516,354,250,520,507,307,143,574,357,517,297,330,99,197,477,415,488,225,315,126,207,131,199,359,,,,,,,,,,,,,,
00750,Anesthesia for hernia repairs in upper abdomen; not otherwise specified,1300,1170,193,883,576,794,545,385,522,780,472,287,883,549,796,458,508,332,304,735,638,751,346,484,193,318,420,306,552,,,,,,,,,,,,,,
00790,Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified,1743,1569,175,1184,772,1065,730,516,1073,1045,632,385,1184,737,1067,613,681,175,407,985,855,1007,464,210,259,427,522,411,740,,,,,,,,,,,,,,
00800,Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified,2068,1861,179,1405,916,1264,866,613,1273,1240,750,457,1405,874,1266,728,808,179,483,1169,1015,1194,551,770,307,506,667,487,878,,,,,,,,,,,,,,
00811,PR ANES LWR INTST NDSC NOS,948,853,91,644,420,579,397,281,583,568,344,210,644,124,580,334,371,91,222,536,465,547,252,353,141,232,132,223,402,,,,,,,,,,,,,,
00812,PR ANES LWR INTST SCR COLSC,884,796,75,862,392,540,370,262,464,530,321,195,601,374,541,311,345,75,207,500,862,427,235,329,131,216,117,208,375,,,,,,,,,,,,,,
00813,PR ANES UPR LWR GI NDSC PX,1181,1063,117,802,523,722,495,350,727,708,428,261,802,499,723,416,462,117,125,667,580,682,315,137,176,289,158,278,501,,,,,,,,,,,,,,
00830,Anesthesia for hernia repairs in lower abdomen; not otherwise specified,1748,1573,187,1187,775,1068,732,518,638,1048,634,386,1187,739,1070,615,683,187,409,988,858,1009,466,651,260,428,400,412,742,,,,,,,,,,,,,,
00832,Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias,2582,2324,294,1754,1144,1578,1082,765,1589,1548,937,571,1754,1091,1580,909,1009,660,603,1459,1267,1491,688,961,384,632,294,608,1096,,,,,,,,,,,,,,
00840,Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified,2214,1993,161,1684,981,1353,928,656,1363,1328,803,489,1504,276,1355,779,865,161,517,1251,1087,1684,590,824,329,542,290,522,940,,,,,,,,,,,,,,
00872,"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath",2303,2073,260,1564,1021,1407,965,682,1417,1381,836,509,1564,973,1409,811,900,589,538,1301,1130,1330,613,857,342,564,260,542,977,,,,,,,,,,,,,,
00902,Anesthesia for; anorectal procedure,1381,1243,170,938,612,844,579,409,464,828,501,305,938,584,845,486,540,353,323,780,678,798,368,514,205,338,170,325,586,,,,,,,,,,,,,,
00910,Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified,1451,1306,149,986,643,887,608,430,893,870,526,321,986,613,888,511,567,371,339,820,712,838,386,540,216,355,149,342,616,,,,,,,,,,,,,,
00912,Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s),1333,1200,134,906,591,814,558,395,820,799,484,295,906,563,816,469,521,148,312,753,654,770,355,496,198,326,134,314,566,,,,,,,,,,,,,,
00914,Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate,2093,1884,222,1422,928,1279,877,620,1288,1255,759,463,1422,884,1281,737,818,535,489,1183,1027,1209,557,779,311,512,222,493,888,,,,,,,,,,,,,,
00916,Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding,2045,1840,218,1389,906,1249,857,606,1259,1226,742,452,1389,864,1252,720,799,523,478,1156,1004,1181,545,761,304,500,218,482,868,,,,,,,,,,,,,,
01400,Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified,1172,1055,174,796,519,716,491,347,721,703,425,259,796,495,717,412,458,300,274,662,575,677,312,436,174,287,324,276,497,,,,,,,,,,,,,,
01462,"Anesthesia for all closed procedures on lower leg, ankle, and foot",619,557,69,420,274,378,259,183,381,371,225,137,420,262,379,218,242,69,145,350,304,357,165,230,92,151,200,146,263,,,,,,,,,,,,,,
01470,"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified",1243,1119,110,844,551,759,521,368,765,745,451,275,844,525,761,437,486,110,291,702,610,718,331,463,185,304,401,293,528,,,,,,,,,,,,,,
01480,"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified",2139,1925,113,1453,948,1307,896,634,1317,1283,776,473,1453,904,1309,753,836,246,500,1209,1050,1235,570,796,113,523,192,504,908,,,,,,,,,,,,,,
01484,"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula",2260,2034,187,1535,1002,1381,947,670,1391,1355,820,499,1535,955,1383,795,883,187,528,1277,1109,1305,602,841,336,553,729,532,959,,,,,,,,,,,,,,
01730,Anesthesia for all closed procedures on humerus and elbow,515,464,77,317,228,315,216,153,317,309,187,114,285,218,315,181,201,132,120,291,253,297,137,192,77,126,166,121,219,,,,,,,,,,,,,,
01810,"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand",843,759,81,573,374,515,353,250,319,505,306,186,573,356,516,297,329,81,197,476,414,487,225,314,125,206,102,199,358,,,,,,,,,,,,,,
10060,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single",236,212,35,217,105,144,99,59,217,142,86,52,160,100,144,83,92,59,55,133,116,136,63,88,35,58,87,56,100,,,,,,,,,,,,,,
10061,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",236,212,35,160,105,144,99,114,145,142,86,52,160,100,144,83,92,60,55,133,116,136,63,88,35,58,134,56,100,,,,,,,,,,,,,,
10081,Incision and drainage of pilonidal cyst; complicated,625,562,93,425,277,382,262,185,360,375,227,138,425,264,383,220,244,160,146,353,307,361,166,233,93,153,202,147,265,,,,,,,,,,,,,,
10140,"Incision and drainage of hematoma, seroma or fluid collection",174,157,26,118,77,106,73,62,107,104,63,38,118,74,106,61,68,62,41,98,85,100,46,65,26,43,56,41,74,,,,,,,,,,,,,,
10160,"Puncture aspiration of abscess, hematoma, bulla, or cyst",300,270,45,204,133,183,126,55,185,180,109,66,204,127,184,106,117,77,70,170,147,173,80,112,45,73,97,71,127,,,,,,,,,,,,,,
11042,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",451,406,30,306,97,276,189,35,133,133,164,100,306,191,276,30,176,51,105,255,221,125,120,168,67,110,48,106,191,,,,,,,,,,,,,,
11043,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",484,436,72,339,245,296,203,108,339,290,176,107,329,205,296,148,148,124,113,273,238,324,129,180,72,118,156,114,205,,,,,,,,,,,,,,
11045,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)",451,406,18,306,200,276,189,18,278,270,164,100,306,191,276,25,176,20,105,255,221,260,120,168,67,110,146,106,191,,,,,,,,,,,,,,
11046,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)",451,406,37,306,200,276,189,37,108,270,164,100,306,191,276,53,176,115,105,255,221,116,120,168,67,110,146,106,191,,,,,,,,,,,,,,
11055,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion",120,108,7,82,53,73,50,7,35,72,44,27,82,51,73,42,47,31,28,68,59,69,32,45,18,29,39,28,51,,,,,,,,,,,,,,
11056,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions",145,130,16,98,64,89,61,43,39,87,53,32,98,61,89,51,57,37,34,82,71,84,39,54,22,35,16,34,62,,,,,,,,,,,,,,
11104,PR PUNCH BX SKIN SINGLE LESION,310,279,46,211,137,189,130,92,101,186,112,69,211,131,190,46,121,79,72,175,152,179,83,115,46,76,100,73,132,,,,,,,,,,,,,,
11402,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm",309,278,46,210,137,189,129,92,190,185,112,68,210,131,189,109,121,79,72,175,152,178,82,115,46,76,48,73,131,,,,,,,,,,,,,,
11403,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm",515,464,71,350,228,315,71,153,306,309,187,114,350,218,315,181,201,132,120,291,253,297,137,192,77,126,166,121,219,,,,,,,,,,,,,,
11404,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm",515,464,77,350,228,315,216,153,317,309,187,114,350,218,315,181,201,132,120,291,253,297,137,192,77,126,135,121,219,,,,,,,,,,,,,,
11406,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm",515,464,77,510,228,315,216,153,510,309,187,114,350,218,315,181,201,132,120,291,253,297,137,192,77,126,207,121,219,,,,,,,,,,,,,,
11421,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm",360,324,53,245,160,220,151,107,225,216,131,80,245,152,220,127,141,92,84,203,177,208,96,134,53,88,116,85,153,,,,,,,,,,,,,,
11422,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm",361,325,54,279,126,221,151,107,279,216,131,80,245,153,221,127,141,92,84,204,177,208,96,116,54,88,117,85,153,,,,,,,,,,,,,,
11423,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",361,325,54,245,160,221,151,107,160,216,131,80,245,153,221,127,141,92,84,204,177,208,96,134,54,88,117,85,153,,,,,,,,,,,,,,
11424,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm",618,556,92,420,274,378,259,183,184,371,224,137,420,261,378,217,242,158,144,349,303,357,165,230,92,151,199,146,262,,,,,,,,,,,,,,
11441,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm",309,278,46,210,137,189,129,91,190,185,112,68,210,131,189,109,121,79,72,175,152,178,82,115,46,76,100,73,131,,,,,,,,,,,,,,
11604,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm",675,608,100,459,299,412,283,200,375,405,245,149,459,285,413,238,264,173,158,381,331,390,180,251,100,165,218,159,286,,,,,,,,,,,,,,
11606,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",1100,990,163,747,307,672,461,326,633,660,399,243,747,465,673,387,430,281,257,622,540,635,293,410,163,269,355,259,467,,,,,,,,,,,,,,
11623,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",618,556,92,434,274,378,259,183,434,371,224,137,420,261,378,217,242,158,144,349,303,357,165,230,92,151,199,146,262,,,,,,,,,,,,,,
11624,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm",618,556,92,420,375,378,259,183,380,371,224,137,420,261,378,217,242,158,144,349,303,357,165,230,92,151,199,146,262,,,,,,,,,,,,,,
11626,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",618,556,92,610,274,378,259,183,610,371,224,137,420,261,378,217,242,158,144,349,303,357,165,230,92,151,199,146,262,,,,,,,,,,,,,,
11642,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm",735,662,109,499,288,449,308,218,452,441,267,162,499,311,450,259,287,188,172,415,361,424,196,274,109,180,237,173,312,,,,,,,,,,,,,,
11643,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm",618,556,92,420,274,378,259,183,380,371,224,137,420,261,378,217,242,196,144,349,303,357,165,230,92,151,199,146,262,,,,,,,,,,,,,,
11644,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm",925,832,137,628,274,565,388,274,499,555,336,204,628,391,566,326,362,237,216,523,454,534,246,344,137,226,299,218,393,,,,,,,,,,,,,,
11646,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm",1300,1170,193,883,576,794,545,385,797,780,472,287,883,549,796,458,508,332,304,735,638,751,346,484,193,318,329,306,552,,,,,,,,,,,,,,
11719,"Trimming of nondystrophic nails, any number",81,73,4,55,36,49,34,24,50,49,29,18,55,34,50,29,32,21,19,46,40,47,22,30,12,20,4,19,34,,,,,,,,,,,,,,
11721,Debridement of nail(s) by any method(s); 6 or more,145,130,18,98,64,89,61,21,52,87,53,32,98,61,89,51,57,37,34,82,71,84,39,22,22,35,18,34,62,,,,,,,,,,,,,,
11730,"Avulsion of nail plate, partial or complete, simple; single",145,130,22,98,64,89,61,43,98,87,53,32,98,61,89,51,57,37,34,82,71,84,39,54,22,35,47,34,62,,,,,,,,,,,,,,
11771,Excision of pilonidal cyst or sinus; extensive,1092,983,162,742,484,667,457,324,608,655,396,241,742,461,668,384,427,279,255,617,536,631,291,407,162,267,407,257,463,,,,,,,,,,,,,,
12001,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less",107,96,16,84,47,65,45,54,84,64,39,24,73,46,65,36,44,54,25,60,53,62,28,38,16,26,35,25,45,,,,,,,,,,,,,,
12002,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm",168,151,25,114,74,103,70,64,111,101,61,37,114,71,103,59,66,43,64,95,82,97,45,63,25,41,51,40,71,,,,,,,,,,,,,,
12004,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm",213,192,32,145,94,130,89,63,136,128,77,47,145,90,130,75,83,54,50,120,105,123,57,79,32,52,69,50,90,,,,,,,,,,,,,,
12005,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm",252,227,37,171,112,154,106,105,155,151,91,56,171,106,154,89,98,64,59,142,124,146,67,94,37,62,81,59,107,,,,,,,,,,,,,,
12011,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",146,131,22,113,65,89,87,58,105,88,52,32,113,62,89,52,57,50,34,82,72,84,39,54,22,36,46,34,62,,,,,,,,,,,,,,
12013,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",213,192,32,145,94,130,89,66,131,111,77,47,145,90,130,75,83,54,50,120,105,123,57,79,32,52,69,50,90,,,,,,,,,,,,,,
12014,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm",342,308,51,232,152,209,143,101,210,205,124,76,232,145,209,120,134,87,80,193,168,197,91,127,51,84,63,81,145,,,,,,,,,,,,,,
12020,Treatment of superficial wound dehiscence; simple closure,630,567,94,428,279,385,264,108,388,378,229,139,428,266,386,222,246,108,147,356,309,364,168,235,94,154,203,148,267,,,,,,,,,,,,,,
12031,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less",618,556,92,420,274,378,259,183,272,371,224,137,420,261,378,217,242,158,144,349,303,357,165,230,92,151,199,146,262,,,,,,,,,,,,,,
12032,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm",618,556,92,420,92,378,185,183,337,371,224,137,420,261,378,217,242,158,144,349,303,357,165,230,92,151,199,146,262,,,,,,,,,,,,,,
12041,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less",304,274,45,320,135,186,127,81,187,320,110,67,207,128,186,107,119,78,71,172,149,176,81,113,45,74,98,72,129,,,,,,,,,,,,,,
12042,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm",206,185,31,150,91,126,86,61,127,124,75,46,140,87,126,72,81,53,48,116,101,119,55,77,31,50,150,49,87,,,,,,,,,,,,,,
12044,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm",204,184,30,139,90,125,85,60,126,122,74,45,139,86,125,72,80,52,48,115,100,118,54,76,30,50,66,48,116,,,,,,,,,,,,,,
12051,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",309,278,46,268,268,189,129,92,190,185,112,68,210,131,189,109,121,79,72,175,152,178,82,115,46,76,100,73,131,,,,,,,,,,,,,,
12052,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",204,184,30,139,90,125,85,60,126,122,74,45,139,86,125,72,80,86,48,115,100,118,54,76,30,50,66,48,87,,,,,,,,,,,,,,
13101,"Repair, complex, trunk; 2.6 cm to 7.5 cm",1000,900,149,679,443,611,419,296,541,600,363,221,679,423,612,352,391,256,234,565,491,577,266,372,149,245,323,236,424,,,,,,,,,,,,,,
13120,"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm",850,765,126,577,377,519,356,252,501,510,308,188,577,359,520,299,332,217,199,480,417,491,226,316,126,208,274,200,361,,,,,,,,,,,,,,
13121,"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm",860,774,128,584,381,525,360,168,567,516,312,190,584,363,526,303,336,220,201,486,422,497,229,320,128,210,278,203,365,,,,,,,,,,,,,,
13122,"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)",450,405,52,366,199,275,189,52,366,270,163,99,306,190,275,158,176,115,105,254,221,260,120,168,67,110,145,106,191,,,,,,,,,,,,,,
13132,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm",425,382,63,289,188,260,178,246,262,255,154,94,289,180,260,150,166,109,99,240,209,245,113,158,63,104,137,100,180,,,,,,,,,,,,,,
13151,"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm",940,846,140,639,417,574,394,278,579,564,341,208,639,397,575,331,367,240,220,531,461,543,250,350,140,230,236,221,399,,,,,,,,,,,,,,
15271,PR SKIN SUB GRAFT T/A/L 25 SQ CM,300,270,45,204,133,183,126,89,181,180,109,66,204,127,184,106,117,77,70,170,147,173,80,112,45,73,66,71,127,,,,,,,,,,,,,,
19120,"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions",927,834,138,630,411,566,388,272,571,556,336,205,630,392,567,326,362,237,217,524,455,535,247,345,138,227,299,218,393,,,,,,,,,,,,,,
19301,"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);",1236,1112,184,1137,548,755,518,366,1137,741,448,273,840,522,756,435,483,316,289,698,607,714,329,460,184,302,399,291,525,,,,,,,,,,,,,,
20240,"Biopsy, bone, open; superficial (eg, ilium, sternum, spinous process, ribs, trochanter of femur)",400,360,59,303,177,244,168,119,303,240,145,88,272,169,245,141,156,102,93,226,196,231,107,149,59,98,129,94,170,,,,,,,,,,,,,,
20605,"Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)",114,103,17,77,51,70,48,21,70,68,41,25,77,48,70,40,45,29,27,64,56,66,30,42,17,28,37,27,48,,,,,,,,,,,,,,
20610,"Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)",168,151,25,114,74,103,70,39,98,101,61,37,114,71,103,59,66,43,39,95,82,97,45,63,25,41,54,40,71,,,,,,,,,,,,,,
20611,HC DRAIN/INJ MAJOR JOINT/BURSA W US,250,225,37,170,111,153,105,74,108,150,91,55,170,106,153,88,98,64,58,141,123,144,67,93,37,61,81,59,106,,,,,,,,,,,,,,
20680,"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)",1400,1260,208,951,620,855,586,415,743,839,508,309,951,592,857,493,547,358,327,791,687,808,373,521,208,343,452,330,594,,,,,,,,,,,,,,
23075,"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm",1300,1170,193,883,576,794,545,385,578,780,472,287,883,549,796,458,508,332,304,735,638,751,346,484,193,318,420,306,552,,,,,,,,,,,,,,
23505,Closed treatment of clavicular fracture; with manipulation,850,765,126,577,377,519,356,245,523,510,308,188,577,359,520,299,332,217,199,480,417,491,226,316,126,208,274,200,361,,,,,,,,,,,,,,
24640,"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation",162,146,24,114,72,99,68,114,100,97,59,36,110,68,99,57,63,41,38,92,80,94,43,60,24,40,52,38,69,,,,,,,,,,,,,,
25565,Closed treatment of radial and ulnar shaft fractures; with manipulation,1050,945,156,1014,465,642,440,311,1014,630,381,232,713,444,643,370,410,269,245,593,515,606,280,391,156,257,339,247,446,,,,,,,,,,,,,,
26010,Drainage of finger abscess; simple,480,432,71,326,213,293,201,142,248,288,174,106,326,203,294,169,188,123,112,271,236,277,128,179,71,117,155,113,204,,,,,,,,,,,,,,
26725,"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each",368,331,55,281,163,225,154,109,281,221,134,81,250,156,225,130,144,94,86,208,181,213,98,137,55,90,119,87,156,,,,,,,,,,,,,,
27240,"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction",2000,1800,297,1359,886,1222,838,787,1231,1199,726,442,1359,845,1224,704,782,511,467,1130,982,1155,533,745,297,489,646,471,849,,,,,,,,,,,,,,
27337,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater",1200,1080,178,918,532,733,503,356,918,720,435,265,815,507,734,422,469,307,280,678,589,693,320,447,178,294,387,283,509,,,,,,,,,,,,,,
27726,Repair of fibula nonunion and/or malunion with internal fixation,2500,2250,372,1698,1108,1528,1047,741,1539,1499,907,552,1698,1056,1530,880,977,639,584,1413,1227,1444,666,931,372,612,762,589,1061,,,,,,,,,,,,,,
27792,"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed",1881,1693,280,1381,834,1149,788,531,1288,1381,682,416,1278,795,1151,662,735,481,440,1063,923,1086,501,700,280,460,607,443,798,,,,,,,,,,,,,,
27810,"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation",1200,1080,178,815,532,733,503,356,761,720,435,265,815,507,734,422,469,307,280,678,589,693,320,447,178,294,387,283,509,,,,,,,,,,,,,,
28008,"Fasciotomy, foot and/or toe",1200,1080,178,815,532,733,503,356,643,720,435,265,815,507,734,422,469,307,280,678,589,693,320,447,178,294,387,283,509,,,,,,,,,,,,,,
28043,"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm",1000,900,149,679,443,611,419,296,461,600,363,221,679,423,612,352,391,256,234,565,491,577,266,372,149,245,323,236,424,,,,,,,,,,,,,,
28080,"Excision, interdigital (Morton) neuroma, single, each",1200,1080,178,815,532,733,503,356,804,720,435,265,815,507,734,422,469,307,280,678,589,693,320,447,178,294,387,283,509,,,,,,,,,,,,,,
28104,"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;",1400,1260,290,951,620,855,586,415,759,839,508,309,951,592,857,493,547,358,327,791,687,808,373,521,290,343,307,330,594,,,,,,,,,,,,,,
28285,"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)",1200,1080,153,815,532,733,186,356,739,720,435,265,815,507,734,422,469,307,280,678,589,693,320,447,178,294,153,283,509,,,,,,,,,,,,,,
28288,"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head",1400,1260,208,951,620,855,586,246,862,839,508,309,951,592,857,493,547,358,327,791,687,808,373,521,208,343,452,330,594,,,,,,,,,,,,,,
28289,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint",1400,1260,208,1001,620,855,586,415,1001,839,508,309,951,592,857,493,547,358,327,791,687,808,373,521,208,343,452,330,594,,,,,,,,,,,,,,
28292,"Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedure",1600,1440,238,1087,709,978,670,474,869,959,580,354,1087,676,979,563,625,409,374,904,785,924,426,596,238,392,516,377,679,,,,,,,,,,,,,,
28296,"Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)",2000,1800,297,1359,823,1222,838,593,1122,1199,726,442,1359,845,1224,704,782,511,467,1130,982,1155,533,745,297,489,695,471,849,,,,,,,,,,,,,,
28299,"Correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy",2500,2250,372,1698,1083,1528,1047,741,1539,1499,907,552,1698,1056,1530,880,977,639,584,1413,1227,1444,666,931,372,612,807,589,1061,,,,,,,,,,,,,,
28300,"Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation",2000,1800,297,1359,886,1222,838,593,1166,1199,726,442,1359,845,1224,704,782,511,467,1130,982,1155,533,745,297,489,646,471,849,,,,,,,,,,,,,,
28308,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each",1400,1260,186,951,620,855,186,258,862,839,508,309,951,592,857,493,547,358,327,791,687,808,373,521,208,343,452,330,594,,,,,,,,,,,,,,
28485,"Open treatment of metatarsal fracture, includes internal fixation, when performed, each",1500,1350,223,1019,665,916,628,444,1006,899,544,331,1019,634,923,528,586,384,351,848,736,866,399,558,223,367,484,353,637,,,,,,,,,,,,,,
28740,"Arthrodesis, midtarsal or tarsometatarsal, single joint",1900,1710,282,1291,842,1161,796,563,1116,1139,689,420,1291,803,1163,669,743,486,444,1074,932,1097,506,707,282,465,613,448,806,,,,,,,,,,,,,,
28750,"Arthrodesis, great toe; metatarsophalangeal joint",1800,1620,267,1223,798,1100,566,533,1048,1079,653,398,1223,761,1102,633,703,460,421,1017,883,1039,479,670,267,441,581,424,764,,,,,,,,,,,,,,
28805,"Amputation, foot; transmetatarsal",1550,1395,230,1262,687,947,649,459,1262,929,562,343,1053,655,949,546,606,396,362,876,761,895,413,577,230,379,500,365,658,,,,,,,,,,,,,,
28825,"Amputation, toe; interphalangeal joint",1300,1170,193,883,576,794,545,385,803,780,472,287,883,549,796,458,508,332,304,735,638,751,346,484,193,318,420,306,552,,,,,,,,,,,,,,
29105,Application of long arm splint (shoulder to hand),123,111,18,92,55,75,52,50,92,74,45,27,84,52,75,43,48,31,29,70,60,71,33,46,18,30,36,29,52,,,,,,,,,,,,,,
29125,Application of short arm splint (forearm to hand); static,94,85,14,73,42,57,39,41,73,56,37,21,64,40,58,33,37,41,22,53,46,54,25,35,14,23,33,22,40,,,,,,,,,,,,,,
29505,Application of long leg splint (thigh to ankle or toes),119,107,18,110,53,73,50,44,110,71,43,26,81,50,73,42,47,30,28,67,58,69,32,44,18,29,38,28,51,,,,,,,,,,,,,,
29515,Application of short leg splint (calf to foot),91,82,14,86,40,56,38,48,86,55,33,20,62,38,86,32,36,52,21,51,45,53,24,34,14,22,29,21,39,,,,,,,,,,,,,,
29580,Strapping; Unna boot,127,114,17,86,56,78,53,38,60,60,46,28,86,54,78,26,50,17,30,72,62,73,34,36,19,31,29,30,54,,,,,,,,,,,,,,
29581,"Application of multi-layer venous wound compression system, below knee",200,180,12,136,89,122,84,12,61,120,73,44,136,85,122,70,78,51,47,113,98,115,53,74,30,49,13,47,85,,,,,,,,,,,,,,
29700,"Removal or bivalving; gauntlet, boot or body cast",150,135,22,102,66,92,63,44,71,90,54,33,102,63,92,53,59,38,35,85,74,87,40,56,22,37,48,35,64,,,,,,,,,,,,,,
30901,"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method",114,103,17,98,51,70,48,34,98,68,41,25,77,48,70,40,45,29,27,64,56,66,30,42,17,28,37,27,48,,,,,,,,,,,,,,
30903,"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method",400,360,59,272,177,244,168,119,147,240,145,88,272,169,245,141,156,102,93,226,196,231,107,149,59,98,129,94,170,,,,,,,,,,,,,,
30905,"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial",345,310,47,234,153,211,145,47,212,207,125,76,234,146,211,121,135,88,81,195,169,199,92,128,51,84,111,81,146,,,,,,,,,,,,,,
31500,"Intubation, endotracheal, emergency procedure",427,384,16,290,189,261,179,127,263,256,155,94,290,180,261,150,167,92,100,241,210,247,114,159,63,104,16,101,181,,,,,,,,,,,,,,
36406,"Venipuncture, younger than age 3 years, necessitating physician's skill, not to be used for routine venipuncture; other vein",80,72,12,54,35,49,34,24,15,48,29,18,54,34,49,28,31,20,19,45,39,46,21,30,12,20,26,19,34,,,,,,,,,,,,,,
36410,"Venipuncture, age 3 years or older, necessitating physician's skill (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)",153,138,8,104,68,93,64,10,43,92,56,34,104,65,94,54,60,39,36,86,75,88,41,57,23,37,8,36,65,,,,,,,,,,,,,,
36556,Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older,564,508,15,383,15,345,236,167,347,338,205,125,383,238,345,198,220,91,132,319,277,326,150,210,84,138,69,133,239,,,,,,,,,,,,,,
36569,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older",16,14,2,16,7,10,7,5,10,10,6,4,11,7,10,6,6,16,4,9,8,9,4,6,2,4,5,4,7,,,,,,,,,,,,,,
36620,"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous",564,508,46,383,250,345,236,167,347,338,205,125,383,238,345,198,220,46,132,319,277,326,150,210,84,138,182,133,239,,,,,,,,,,,,,,
38531,PR OPEN BX/EXC INGUINOFEM NODES,1100,990,163,948,487,672,461,326,948,660,399,243,747,465,673,387,430,281,257,622,540,635,293,410,163,269,355,259,467,,,,,,,,,,,,,,
43235,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)",544,490,52,370,241,332,228,139,335,326,197,120,370,230,333,191,213,139,127,307,267,314,145,203,81,133,52,128,231,,,,,,,,,,,,,,
43239,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple",544,490,74,370,235,332,136,149,302,326,197,120,370,230,333,191,134,149,74,307,267,314,145,203,81,133,118,128,231,,,,,,,,,,,,,,
43247,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of foreign body",544,490,81,370,241,332,173,161,319,326,197,120,370,230,333,191,213,139,127,307,267,314,145,203,81,133,176,128,231,,,,,,,,,,,,,,
43249,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with balloon dilation of esophagus (less than 30 mm diameter)",1500,1350,149,1019,150,916,628,444,335,899,544,331,1019,634,918,528,586,149,351,848,736,866,399,558,223,367,484,353,637,,,,,,,,,,,,,,
43251,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",721,649,107,490,320,441,302,214,353,432,262,159,490,305,441,254,282,184,169,407,354,416,192,268,107,176,233,170,306,,,,,,,,,,,,,,
43255,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with control of bleeding, any method",544,490,81,439,241,332,228,161,439,326,197,120,370,230,333,191,213,139,127,307,267,314,145,203,81,133,176,128,231,,,,,,,,,,,,,,
44140,"Colectomy, partial; with anastomosis",4080,3672,606,2772,1808,2493,1709,1209,2511,2447,1480,902,2772,1724,2497,1436,1595,1043,954,2305,2002,2754,1087,1519,606,998,1317,961,1732,,,,,,,,,,,,,,
44970,"Laparoscopy, surgical, appendectomy",1030,927,153,700,456,629,431,479,634,618,374,228,700,435,630,362,403,263,241,582,505,595,274,383,153,252,457,243,437,,,,,,,,,,,,,,
45378,"Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure)",866,779,129,588,254,529,181,209,422,416,175,191,588,366,530,305,338,209,202,489,425,500,231,322,129,212,295,204,368,,,,,,,,,,,,,,
45380,"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple",1030,927,153,700,299,629,197,212,383,460,190,190,700,435,498,362,403,212,212,582,505,418,274,175,153,252,171,243,437,,,,,,,,,,,,,,
45384,"Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery",850,765,126,577,377,519,356,252,476,510,308,188,577,359,520,299,332,217,199,480,417,476,226,316,126,208,274,200,361,,,,,,,,,,,,,,
45385,"Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",831,748,123,579,481,508,250,259,579,579,301,184,565,351,509,292,325,288,194,470,481,480,221,309,123,203,206,196,353,,,,,,,,,,,,,,
46220,"Excision of single external papilla or tag, anus",700,630,102,476,310,428,293,207,431,420,254,155,476,296,428,246,274,179,164,396,344,404,186,261,104,171,102,165,297,,,,,,,,,,,,,,
46255,"Hemorrhoidectomy, internal and external, single column/group;",1400,1260,208,951,339,855,586,415,862,839,508,309,951,592,857,493,547,358,327,791,687,808,373,521,208,343,452,330,594,,,,,,,,,,,,,,
46260,"Hemorrhoidectomy, internal and external, 2 or more columns/groups;",1180,1062,175,802,523,721,494,350,452,708,428,261,802,499,722,415,461,302,276,667,579,681,314,439,175,289,397,278,501,,,,,,,,,,,,,,
46320,"Excision of thrombosed hemorrhoid, external",361,325,54,245,160,221,151,78,222,216,131,80,245,153,221,127,141,92,84,204,177,208,96,134,54,88,117,85,153,,,,,,,,,,,,,,
46614,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)",350,315,52,238,155,214,147,58,215,210,127,77,238,148,214,123,137,90,82,198,172,202,93,130,52,86,113,82,149,,,,,,,,,,,,,,
47562,"Laparoscopy, surgical; cholecystectomy",1236,1112,184,1184,1017,755,628,634,1184,741,610,273,840,522,756,435,483,634,289,698,607,714,329,558,184,302,1009,291,525,,,,,,,,,,,,,,
47563,"Laparoscopy, surgical; cholecystectomy with cholangiography",1236,1112,184,840,548,755,518,366,761,741,448,273,840,522,756,435,483,316,289,698,607,714,329,460,184,302,589,291,525,,,,,,,,,,,,,,
49082,PBB ABD PARACENTESIS,168,151,25,114,74,103,70,50,103,101,61,37,114,71,103,59,66,43,39,95,82,97,45,63,25,41,64,40,71,,,,,,,,,,,,,,
49505,"Repair initial inguinal hernia, age 5 years or older; reducible",1030,927,153,798,745,629,431,305,634,618,374,228,700,435,630,362,403,263,241,582,505,595,274,383,153,252,798,243,437,,,,,,,,,,,,,,
49520,"Repair recurrent inguinal hernia, any age; reducible",1208,1087,180,969,535,738,506,358,744,724,438,267,821,510,739,425,472,309,282,683,593,698,322,450,180,296,969,285,513,,,,,,,,,,,,,,
49560,Repair initial incisional or ventral hernia; reducible,1442,1298,214,980,639,881,604,556,888,865,523,319,980,609,883,507,564,369,337,815,708,833,384,537,214,353,614,340,612,,,,,,,,,,,,,,
49568,Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair),618,556,92,420,274,378,259,257,380,371,224,137,420,261,378,217,242,158,144,349,303,357,165,230,92,151,220,146,262,,,,,,,,,,,,,,
49585,"Repair umbilical hernia, age 5 years or older; reducible",1442,1298,214,980,639,881,604,427,810,865,523,319,980,609,883,507,564,369,337,815,708,833,384,537,214,353,465,340,612,,,,,,,,,,,,,,
49587,"Repair umbilical hernia, age 5 years or older; incarcerated or strangulated",1400,1260,208,1017,620,855,586,415,1017,839,508,309,951,592,857,493,547,358,327,791,687,808,373,521,208,343,452,330,594,,,,,,,,,,,,,,
49650,"Laparoscopy, surgical; repair initial inguinal hernia",1400,1260,208,951,620,855,586,415,862,839,508,309,951,589,857,493,547,358,327,791,687,808,373,521,208,343,452,330,594,,,,,,,,,,,,,,
49652,"Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible",1865,1678,277,1571,827,1140,781,553,1571,1118,677,412,1267,788,1141,656,729,477,436,1054,915,1077,497,694,277,456,602,439,792,,,,,,,,,,,,,,
51700,"Bladder irrigation, simple, lavage and/or instillation",230,207,26,156,102,141,96,68,142,138,83,51,156,97,141,81,90,59,54,130,113,133,61,86,34,56,26,54,98,,,,,,,,,,,,,,
56405,Incision and drainage of vulva or perineal abscess,201,181,30,146,89,123,84,60,124,121,73,44,137,85,123,71,79,51,47,114,99,116,54,75,30,49,146,47,85,,,,,,,,,,,,,,
58563,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)",3700,3330,425,2513,1640,2261,1550,1096,425,2219,1342,818,2513,1564,2264,1302,1446,946,865,2091,1816,2137,985,1377,550,905,1194,872,1570,,,,,,,,,,,,,,
58600,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral",1100,990,163,747,487,672,461,255,677,660,399,243,747,465,673,387,430,281,257,622,540,635,293,410,163,269,355,259,467,,,,,,,,,,,,,,
58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",2000,1800,297,1359,886,1222,838,593,1160,1199,726,442,1359,845,1224,704,782,511,467,1130,982,1155,533,745,297,489,646,471,849,,,,,,,,,,,,,,
59025,Fetal non-stress test,107,96,16,73,47,65,45,26,54,64,39,24,73,45,65,38,42,39,25,60,53,62,28,40,16,26,35,25,45,,,,,,,,,,,,,,
59409,Vaginal delivery only (with or without episiotomy and/or forceps);,1493,1344,222,1014,662,912,625,766,919,895,542,330,1014,631,914,525,584,382,349,844,733,862,398,556,222,365,482,352,634,,,,,,,,,,,,,,
59812,"Treatment of incomplete abortion, any trimester, completed surgically",689,620,102,548,305,421,289,204,548,413,250,152,468,291,422,242,269,176,161,389,338,398,183,256,102,169,222,162,292,,,,,,,,,,,,,,
62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,1308,1177,77,889,580,799,548,77,427,784,82,289,889,553,801,460,511,90,306,739,161,755,348,487,194,320,109,308,555,,,,,,,,,,,,,,
64445,"Injection, anesthetic agent; sciatic nerve, single",975,878,47,662,432,596,408,289,600,585,354,215,662,412,597,343,381,47,228,551,479,563,260,363,145,239,315,230,414,,,,,,,,,,,,,,
64450,"Injection, anesthetic agent; other peripheral nerve or branch",16,14,1,11,7,10,7,5,10,10,6,4,11,7,10,6,6,4,4,9,8,9,4,6,2,4,1,4,7,,,,,,,,,,,,,,
64520,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)",600,540,77,408,266,367,251,77,369,360,218,133,408,254,367,211,234,153,140,339,294,346,160,223,89,147,194,141,255,,,,,,,,,,,,,,
64788,Excision of neurofibroma or neurolemmoma; cutaneous nerve,1200,1080,178,815,532,733,503,356,739,720,435,265,815,507,734,422,469,307,280,678,589,693,320,447,178,294,250,283,509,,,,,,,,,,,,,,
65220,"Removal of foreign body, external eye; corneal, without slit lamp",84,76,12,76,37,51,35,25,76,50,30,19,57,35,51,30,33,21,20,47,41,49,22,31,12,21,27,20,36,,,,,,,,,,,,,,
65222,"Removal of foreign body, external eye; corneal, with slit lamp",170,153,25,115,75,104,71,105,105,102,62,38,115,72,104,60,66,43,40,96,83,98,45,63,25,42,55,40,72,,,,,,,,,,,,,,
67700,"Blepharotomy, drainage of abscess, eyelid",550,495,65,374,244,336,230,65,339,330,200,122,374,232,337,194,215,141,129,311,270,318,146,205,82,135,178,130,233,,,,,,,,,,,,,,
76937,"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (List separately in addition to code for primary procedure)",290,261,10,197,129,177,121,10,178,174,105,64,197,123,177,102,113,20,68,164,142,167,77,108,43,71,94,68,123,,,,,,,,,,,,,,
92960,"Cardioversion, elective, electrical conversion of arrhythmia; external",266,239,40,181,144,163,111,79,164,160,97,59,181,112,163,94,104,68,62,150,131,154,71,99,40,65,86,63,113,,,,,,,,,,,,,,
93010,"Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only",50,45,6,34,10,31,21,10,16,15,8,11,34,8,15,8,20,10,10,28,25,17,13,7,7,7,7,6,21,,,,,,,,,,,,,,
93016,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; physician supervision only, without interpretation and report",110,99,16,75,32,67,46,26,39,48,40,24,75,46,67,39,43,26,26,62,54,64,29,41,16,27,36,26,47,,,,,,,,,,,,,,
93018,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only",110,99,13,75,15,67,46,18,28,32,14,24,75,46,30,14,43,18,26,62,21,64,29,41,16,23,13,26,47,,,,,,,,,,,,,,
94010,"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation",25,22,4,18,12,15,10,10,18,15,8,6,17,11,15,9,10,12,6,14,12,14,7,9,4,6,8,6,11,,,,,,,,,,,,,,
94060,"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration",45,40,7,31,13,27,19,16,23,27,13,10,31,19,28,16,18,12,11,25,22,27,12,11,7,11,12,11,19,,,,,,,,,,,,,,
96372,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular",74,67,4,50,33,45,31,4,46,44,27,16,50,31,45,26,29,19,17,42,36,43,20,28,11,18,24,17,31,,,,,,,,,,,,,,
97597,"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less",227,204,27,154,101,139,95,67,43,136,82,50,154,96,139,80,89,58,53,128,111,131,60,85,34,56,27,53,96,,,,,,,,,,,,,,
97605,"Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters",75,68,11,51,33,46,31,22,30,45,27,17,51,32,46,26,29,19,18,42,37,30,20,28,11,18,24,18,32,,,,,,,,,,,,,,
97606,"Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters",80,72,12,54,35,49,34,24,49,48,29,18,54,34,49,28,31,20,19,45,39,32,21,30,12,20,26,19,34,,,,,,,,,,,,,,
98925,Osteopathic manipulative treatment (OMT); 1-2 body regions involved,62,56,9,42,27,38,26,20,38,37,22,14,42,26,38,22,24,20,14,35,30,36,17,23,9,15,20,15,26,,,,,,,,,,,,,,
98926,Osteopathic manipulative treatment (OMT); 3-4 body regions involved,62,56,9,42,27,38,26,18,38,37,22,14,42,26,38,22,24,29,14,35,30,36,17,23,9,15,20,15,26,,,,,,,,,,,,,,
99202,"Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Physicians typically spend 20 minutes face-to-face with the patient and/or family.",169,152,25,115,75,103,71,50,78,101,61,37,115,71,103,59,66,43,39,95,83,98,45,63,25,41,55,40,72,,,,,,,,,,,,,,
99203,"Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 30 minutes face-to-face with the patient and/or family.",216,194,32,147,96,132,90,64,120,130,78,48,147,91,132,76,84,55,50,122,106,125,58,80,32,53,67,51,92,,,,,,,,,,,,,,
99211,"Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.",70,63,8,48,31,43,29,21,43,42,25,15,48,30,43,25,27,8,16,40,34,40,19,26,10,17,23,16,30,,,,,,,,,,,,,,
99212,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 10 minutes face-to-face with the patient and/or family.",129,116,18,88,26,79,24,18,39,77,47,29,88,55,79,45,50,18,30,73,63,74,34,48,19,32,28,30,55,,,,,,,,,,,,,,
99213,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Physicians typically spend 15 minutes face-to-face with the patient and/or family.",164,148,24,111,51,100,69,31,81,98,60,36,111,69,100,66,64,31,38,93,80,95,44,44,24,40,52,39,70,,,,,,,,,,,,,,
99214,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 25 minutes face-to-face with the patient and/or family.",215,194,32,146,79,131,77,49,124,129,78,48,146,91,132,76,84,49,50,121,106,124,57,80,32,53,69,51,91,,,,,,,,,,,,,,
99215,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 40 minutes face-to-face with the patient and/or family.",213,192,32,175,94,130,89,63,175,128,77,47,145,90,130,143,83,54,50,120,105,123,57,79,32,52,69,50,90,,,,,,,,,,,,,,
99217,"Observation care discharge day management (This code is to be utilized by the physician to report all services provided to a patient on discharge from ""observation status"" if the discharge is on other than the initial date of ""observation status."" To report services to a patient designated as ""observation status"" or ""inpatient status"" and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])",120,108,18,110,62,73,60,53,96,96,68,27,110,69,108,70,71,53,28,68,59,69,32,59,18,29,61,28,51,,,,,,,,,,,,,,
99218,"Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to ""observation status"" are of low severity.",156,140,23,132,79,95,84,55,132,130,93,34,106,94,95,55,61,55,36,88,77,90,42,82,23,38,93,37,66,,,,,,,,,,,,,,
99219,"Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to ""observation status"" are of moderate severity.",214,193,32,211,117,131,131,91,179,211,78,47,145,90,131,129,134,91,50,121,105,124,57,111,32,52,108,50,91,,,,,,,,,,,,,,
99220,"Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to ""observation status"" are of high severity.",292,263,43,288,160,178,188,122,288,175,106,65,277,123,179,176,114,122,68,165,143,169,78,109,43,71,155,69,124,,,,,,,,,,,,,,
99221,"Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of low severity. Physicians typically spend 30 minutes at the bedside and on the patient's hospital floor or unit.",156,140,23,132,87,95,94,60,132,94,57,34,106,66,95,55,61,55,36,97,77,90,42,83,23,38,88,37,66,,,,,,,,,,,,,,
99222,"Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of moderate severity. Physicians typically spend 50 minutes at the bedside and on the patient's hospital floor or unit.",212,191,32,204,118,130,118,91,182,127,131,47,144,129,130,75,83,107,50,120,104,204,56,79,32,52,112,50,90,,,,,,,,,,,,,,
99223,"Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Physicians typically spend 70 minutes at the bedside and on the patient's hospital floor or unit.",310,279,46,267,174,189,200,144,267,267,112,69,211,131,190,109,121,144,72,195,152,179,83,166,46,76,173,73,132,,,,,,,,,,,,,,
99224,"Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: Problem focused interval history; Problem focused examination; Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Physicians typically spend 15 minutes at the bedside and on the patient's hospital floor or unit.",61,55,9,52,37,37,26,22,52,37,22,13,41,26,37,21,24,16,14,34,30,35,16,23,9,15,29,14,26,,,,,,,,,,,,,,
99225,"Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Physicians typically spend 25 minutes at the bedside and on the patient's hospital floor or unit.",112,101,17,96,63,68,61,39,96,67,41,25,76,69,69,39,44,45,26,63,55,65,30,60,17,27,58,26,48,,,,,,,,,,,,,,
99226,"Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Physicians typically spend 35 minutes at the bedside and on the patient's hospital floor or unit.",160,144,24,138,91,98,91,68,138,96,58,35,109,99,98,100,63,68,37,90,79,92,43,86,24,39,83,38,68,,,,,,,,,,,,,,
99231,"Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering or improving. Physicians typically spend 15 minutes at the bedside and on the patient's hospital floor or unit.",60,54,9,52,40,37,25,33,52,36,22,13,41,25,37,21,23,15,14,34,29,35,16,22,9,15,30,14,25,,,,,,,,,,,,,,
99232,"Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Physicians typically spend 25 minutes at the bedside and on the patient's hospital floor or unit.",111,100,16,109,62,68,62,44,96,96,70,25,75,47,97,39,43,52,52,59,54,109,30,59,16,27,59,26,47,,,,,,,,,,,,,,
99233,"Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Physicians typically spend 35 minutes at the bedside and on the patient's hospital floor or unit.",160,144,24,140,90,98,106,62,138,138,58,35,109,98,140,56,63,73,37,86,79,92,43,86,24,39,86,38,68,,,,,,,,,,,,,,
99234,"Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s) requiring admission are of low severity.",204,184,30,174,90,125,85,100,174,122,74,45,139,86,125,72,80,100,48,115,100,118,54,76,30,50,66,48,87,,,,,,,,,,,,,,
99236,"Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s) requiring admission are of high severity.",346,311,51,288,188,211,145,196,288,207,126,76,235,146,212,214,135,196,81,196,170,200,92,129,51,85,186,81,147,,,,,,,,,,,,,,
99238,Hospital discharge day management; 30 minutes or less,112,101,17,96,74,68,63,53,96,67,70,25,76,47,69,39,44,53,26,60,55,65,30,42,17,27,60,26,48,,,,,,,,,,,,,,
99239,Hospital discharge day management; more than 30 minutes,164,148,24,160,109,100,92,69,141,98,60,36,111,101,100,58,64,75,38,88,80,160,44,93,24,40,84,39,70,,,,,,,,,,,,,,
99281,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor.",113,102,17,77,50,69,47,33,70,68,41,25,77,48,69,40,44,29,26,64,55,65,30,42,17,28,19,27,48,,,,,,,,,,,,,,
99282,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity.",166,149,25,101,74,101,35,29,63,56,34,37,64,70,61,41,43,29,29,94,81,70,44,62,25,41,37,29,70,,,,,,,,,,,,,,
99283,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity.",212,191,32,130,53,130,89,59,91,84,66,69,99,58,103,70,64,55,55,120,130,93,56,55,32,52,62,44,59,,,,,,,,,,,,,,
99284,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function.",258,232,38,182,102,158,108,91,156,155,99,57,182,111,161,99,101,91,91,146,127,176,69,103,38,97,105,80,110,,,,,,,,,,,,,,
99285,"Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function.",385,346,57,265,150,235,161,143,225,265,142,85,259,163,236,170,150,143,143,218,189,262,103,150,57,94,153,142,163,,,,,,,,,,,,,,
99291,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes",604,544,90,410,193,369,253,144,325,362,219,133,410,255,370,218,236,144,141,341,296,349,161,225,90,148,187,142,256,,,,,,,,,,,,,,
99292,"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service)",316,284,47,215,140,193,132,80,170,189,115,70,215,134,193,111,124,120,74,179,155,182,84,118,47,77,97,74,134,,,,,,,,,,,,,,
99304,"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of low severity. Physicians typically spend 25 minutes at the bedside and on the patient's facility floor or unit.",180,162,27,141,80,110,75,53,141,108,65,40,122,76,110,63,70,46,42,102,88,104,48,78,27,44,87,42,76,,,,,,,,,,,,,,
99305,"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of moderate severity. Physicians typically spend 35 minutes at the bedside and on the patient's facility floor or unit.",206,185,31,140,91,126,86,61,127,124,75,46,140,87,126,72,81,53,48,116,101,119,55,77,31,50,106,49,87,,,,,,,,,,,,,,
99306,"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Physicians typically spend 45 minutes at the bedside and on the patient's facility floor or unit.",264,238,39,249,117,161,111,78,221,158,96,58,179,112,162,93,103,68,62,149,130,249,70,98,39,65,150,62,112,,,,,,,,,,,,,,
99307,"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Physicians typically spend 10 minutes at the bedside and on the patient's facility floor or unit.",65,58,10,58,29,40,27,19,58,39,24,14,44,27,40,23,25,17,15,37,32,38,17,24,10,16,35,15,28,,,,,,,,,,,,,,
99308,"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Physicians typically spend 15 minutes at the bedside and on the patient's facility floor or unit.",110,99,16,91,49,67,46,33,91,66,40,24,75,46,67,39,43,28,26,62,54,64,29,58,16,27,55,26,47,,,,,,,,,,,,,,
99309,"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient has developed a significant complication or a significant new problem. Physicians typically spend 25 minutes at the bedside and on the patient's facility floor or unit.",144,130,21,131,92,88,60,43,131,86,52,32,98,61,88,51,56,37,34,81,71,83,38,54,21,35,77,34,61,,,,,,,,,,,,,,
99310,"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Physicians typically spend 35 minutes at the bedside and on the patient's facility floor or unit.",215,194,32,193,116,131,90,64,193,129,78,48,146,91,132,76,84,55,50,121,106,124,57,80,32,53,117,51,91,,,,,,,,,,,,,,
99315,Nursing facility discharge day management; 30 minutes or less,115,104,17,97,63,70,48,34,97,69,42,25,78,49,70,40,45,29,27,65,56,66,31,63,17,28,63,27,49,,,,,,,,,,,,,,
99316,Nursing facility discharge day management; more than 30 minutes,167,150,25,164,74,102,70,49,164,100,61,37,113,71,102,59,65,43,39,94,82,96,44,62,25,41,88,39,71,,,,,,,,,,,,,,
99356,"Prolonged physician service in the inpatient setting, requiring unit/floor time beyond the usual service; first hour (List separately in addition to code for inpatient Evaluation and Management service)",140,126,21,95,62,86,59,41,86,84,51,31,95,59,86,49,55,36,33,79,69,81,37,52,21,34,90,33,59,,,,,,,,,,,,,,
A0424,"Extra ambulance attendant, ground (ALS or BLS) or air (fixed or rotary winged); (requires medical review)",125,112,19,85,55,76,52,20,77,75,45,28,85,53,77,44,49,20,29,71,61,72,33,47,19,31,40,29,53,,,,,,,,,,,,,,
A0425,"Ground mileage, per statute mile",70,63,5,48,31,43,29,8,43,42,25,15,48,30,43,25,27,17,5,40,34,40,19,26,10,17,23,16,30,,,,,,,,,,,,,,
A0427,"Ambulance service, advanced life support, emergency transport, level 1 (ALS1-emergency)",1259,1133,127,855,558,769,527,127,775,755,457,278,855,532,771,443,492,127,127,711,618,727,335,469,187,308,406,297,534,,,,,,,,,,,,,,
A0428,"Ambulance service, basic life support, non-emergency transport, (BLS)",667,600,85,453,296,408,279,85,411,400,242,147,453,282,408,235,261,85,156,377,327,385,178,248,99,163,215,157,283,,,,,,,,,,,,,,
A0429,"Ambulance service, basic life support, emergency transport (BLS-emergency)",1066,959,114,724,472,651,447,114,656,639,387,236,724,450,652,375,417,114,114,602,523,616,284,397,158,261,344,251,452,,,,,,,,,,,,,,
A0433,"Advanced life support, level 2 (ALS 2)",1822,1640,233,1238,807,1113,763,233,1121,1093,661,403,1238,770,1115,641,712,233,426,1030,894,1052,485,678,271,446,588,429,773,,,,,,,,,,,,,,
G0105,Colorectal cancer screening; colonoscopy on individual at high risk,866,779,129,588,192,529,363,257,533,519,314,191,588,366,530,305,338,221,202,489,425,500,231,322,129,212,280,204,368,,,,,,,,,,,,,,
G0121,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,866,779,129,588,181,529,363,257,533,519,314,191,588,366,530,305,338,221,202,489,425,500,231,322,129,212,157,204,368,,,,,,,,,,,,,,
G0168,Wound closure utilizing tissue adhesive(s) only,213,192,18,145,94,130,89,63,131,128,77,47,145,90,130,75,83,54,50,120,105,123,57,79,32,52,18,50,90,,,,,,,,,,,,,,
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DRG,Description,Charges,Discounted Cash Price,Min Negotiated,Max Negotiated,Aetna,Aetna - coventry,Aetna medicare,Amerigroup ia medicaid,Blue cross,Blue cross out of state,Champus,Champva,Cigna,Coventry advantra,Health partners,Humana,Humana choice,Iowa total care,Medicaid,Medicare,Meritain,Midlands choice,Securehorizons direct,Uhc medicare solutions hmo,Uhc medicare solutions ppo,Uhc river valley,United healthcare,Va,Workers compensation,,,,,,,,,,,,,,
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