,Lucas County Health Center - Machine Readable Report - Generated on 03/09/2023,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
,"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 03/09/2023 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 insurance,Aetna medicare,Aetna medicare supplemental ins.,Alliance cigna,Amerigroup ia medicaid,Blue cross,Blue cross medicare blue ppo,Blue cross of illinois,Blue cross out of state,Champus,Champva,Cigna,Commercial,Coventry advantra,Coventry health care,Employee benefits systems,Golden rule uhc,Health partners,Health partners uph medicare adv h3416,Health partners uph self funded,Healthlink,Humana,Humana choice,Iowa total care,Medicaid,Medicare,Medicare alternate payor,Medicare community plan uhc,Medico,Meritain,Midlands choice,Mutual of omaha,National assoc ltr carr,Phcs nippon life benefits,Securehorizons direct,Uhc medicare solutions hmo,Uhc medicare solutions ppo,Uhc river valley,Uhc the alliance insurance,Uhcrv community plan iowa medicaid 87726,United healthcare,United healthcare aarp ins.,United medical resources,Va
Institutional,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Outpatients,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
120,"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified",1101,991,311,1046,1046,603,1002,1046,551,562,1046,601,403,621,688,398,565,311,1036,722,533,1024,389,1046,640,592,613,1046,743,775,598,621,617,584,571,562,1046,1046,562,562,1046,532,585,583,781,858,858,676,562,858,524
142,Anesthesia for procedures on eye; lens surgery,772,695,24,733,733,423,702,733,24,394,733,421,282,436,482,279,396,218,726,506,374,718,273,733,420,415,430,733,521,543,419,435,397,409,401,394,733,733,394,394,733,373,410,408,548,601,601,474,394,601,368
160,Anesthesia for procedures on nose and accessory sinuses; not otherwise specified,957,861,270,909,909,524,871,909,479,488,909,522,350,540,598,346,491,270,900,628,463,890,338,909,556,514,533,909,646,674,520,540,482,507,496,488,909,909,488,488,909,462,509,506,679,745,745,588,488,745,456
300,"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified",1213,1092,343,1152,1152,664,1104,1152,607,619,1152,662,444,684,758,438,622,343,1141,796,587,1129,428,1152,705,652,675,1152,818,854,659,684,501,643,629,619,1152,1152,619,619,1152,586,645,642,860,945,945,745,619,945,578
400,"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified",875,788,247,831,831,479,796,831,438,446,831,477,320,494,547,316,449,247,823,574,424,814,309,831,509,470,487,831,590,616,475,493,490,464,454,446,831,831,446,446,831,422,465,463,621,682,682,537,446,682,417
532,Anesthesia for access to central venous circulation,1268,1141,358,1205,1205,694,1154,1205,635,647,1205,692,464,715,792,458,650,358,1193,832,614,1180,448,1205,737,681,706,1205,855,892,689,715,710,672,658,647,1205,1205,647,647,1205,612,674,671,899,988,988,779,647,988,604
635,Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture,564,508,159,536,536,309,513,536,282,288,536,308,206,318,352,204,289,159,531,370,273,525,199,536,328,303,314,536,380,397,306,318,268,299,293,288,536,536,288,288,536,272,300,298,400,439,439,346,288,439,269
0064U,HC ANTB TP TOTAL&RPR IA QUAL,263,237,48,250,250,144,239,250,132,134,250,145,48,148,164,95,135,74,247,172,127,245,93,250,153,141,146,250,177,185,141,148,141,139,136,134,250,250,134,134,250,127,140,147,187,205,205,205,134,205,125
731,PR ANES UPR GI NDSC PX NOS,909,818,257,864,864,498,827,864,455,464,864,496,333,513,568,329,466,257,855,596,440,846,321,864,529,488,506,864,613,640,494,513,466,482,472,464,864,864,464,464,864,439,483,481,645,708,708,558,464,708,433
750,Anesthesia for hernia repairs in upper abdomen; not otherwise specified,1604,1444,453,1524,1524,878,1459,1524,803,818,1524,875,587,905,1002,580,823,453,1509,1052,777,1492,566,1524,933,862,893,1524,1082,1129,872,905,761,850,832,818,1524,1524,818,818,1524,774,853,849,1138,1249,1249,985,818,1250,764
790,Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified,1727,1554,24,1641,1641,946,1571,1641,24,881,1641,942,632,974,1079,624,886,488,1625,1133,836,1607,610,1641,1004,928,961,1641,1165,1215,938,974,878,915,896,881,1641,1641,881,881,1641,834,918,914,1225,1345,1345,1060,881,1345,822
811,PR ANES LWR INTST NDSC NOS,900,810,254,855,855,493,819,855,450,459,855,491,329,508,562,325,462,254,847,590,436,837,318,855,523,484,501,855,607,633,489,508,490,477,467,459,855,855,459,459,855,434,479,476,638,701,701,553,459,701,429
812,PR ANES LWR INTST SCR COLSC,747,672,211,710,710,409,680,710,374,381,710,408,273,421,467,270,383,211,703,490,362,695,264,710,434,401,416,710,504,526,406,421,397,396,388,381,710,710,381,451,710,361,397,395,530,582,582,459,381,582,356
813,PR ANES UPR LWR GI NDSC PX,1101,991,311,1046,1046,603,1002,1046,551,562,1046,603,403,621,688,398,565,311,1036,722,533,1024,389,1046,640,592,613,1046,743,775,598,621,608,584,571,562,1046,1046,562,562,1046,532,585,583,781,858,858,676,562,858,524
830,Anesthesia for hernia repairs in lower abdomen; not otherwise specified,1524,1372,431,1448,1448,835,1386,1448,763,777,1448,832,557,860,952,551,782,431,1434,999,738,1418,538,1448,886,819,848,1448,1028,1073,828,859,768,808,791,777,1448,1448,777,777,1448,736,810,806,1081,1187,1187,936,777,1187,726
840,Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified,1990,1791,562,1891,1890,1090,1810,1891,996,1015,1890,1086,728,1123,1243,719,1021,562,1872,1305,964,1852,703,1890,1157,1069,1107,1890,1342,1400,1081,1122,944,1055,1032,1015,1890,1891,1015,1015,1890,961,1058,1053,1411,1550,1550,1222,1015,1550,947
873,"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath",2509,2258,709,2384,2384,1374,2283,2384,1256,1280,2384,1369,918,1416,1567,907,1287,709,2360,1645,1215,2334,886,2384,1459,1348,1396,2384,1692,1766,1363,1415,1405,1330,1302,1280,2384,2384,1280,1280,2384,1211,1334,1328,1780,1954,1954,1540,1280,1954,1195
902,Anesthesia for; anorectal procedure,1085,976,307,1031,1031,594,987,1031,543,553,1031,592,397,612,678,392,556,307,1021,712,525,1010,383,1031,631,583,604,1031,732,764,590,612,608,575,563,553,1031,1031,553,553,1031,524,577,574,770,845,845,666,553,845,517
910,Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified,1171,1054,331,1112,1112,641,1065,1112,586,597,1112,639,428,661,731,423,601,331,1102,768,567,1090,413,1112,681,629,652,1112,790,824,636,660,562,621,608,597,1112,1112,597,597,1112,565,623,620,831,912,912,719,597,912,558
912,Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s),1533,1380,433,1456,1456,840,1395,1456,767,782,1456,837,561,865,958,554,786,433,1442,1005,742,1426,541,1456,891,824,853,1456,1034,1079,833,864,782,812,795,782,1456,1456,782,782,1456,740,815,811,1087,1194,1194,941,782,1194,730
952,"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography",1204,1084,340,1144,1144,659,1095,1144,603,614,1144,657,440,679,752,435,617,340,1133,790,583,1120,425,1144,700,647,670,1144,812,847,654,679,571,638,625,614,1144,1144,614,614,1144,581,640,637,854,938,938,739,614,938,573
0097U,"Gastrointestinal pathogen, multiplex reverse transcription and multiplex amplified probe technique, multiple types or subtypes, 22 targets",361,325,70,343,343,202,328,343,180,184,343,209,314,204,225,130,185,102,340,237,173,336,127,343,210,194,201,343,244,70,180,204,202,191,187,184,343,343,184,184,343,174,177,202,256,281,281,180,184,281,172
0100U,"Respiratory pathogen, multiplex reverse transcription and multiplex amplified probe technique, multiple types or subtypes, 21 targets",107,96,30,102,102,59,97,102,54,55,102,58,39,60,67,39,55,30,101,70,52,100,38,102,62,57,60,102,72,75,58,60,52,57,56,55,102,102,55,55,102,52,54,54,76,83,83,66,55,83,51
1200,Anesthesia for all closed procedures involving hip joint,844,760,238,802,802,462,768,802,422,430,802,461,309,476,527,305,433,238,794,554,409,785,298,802,491,453,470,802,569,594,459,476,473,447,438,430,802,802,430,430,802,407,449,447,599,657,657,518,430,657,402
1400,Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified,1172,1055,331,1113,1113,642,1066,1113,587,598,1113,640,429,661,732,424,601,331,1102,769,567,1090,414,1113,681,630,652,1113,791,825,637,661,656,621,608,598,1113,1113,598,598,1113,566,623,620,831,913,913,720,598,913,558
1462,"Anesthesia for all closed procedures on lower leg, ankle, and foot",699,629,197,664,664,383,636,664,350,356,664,381,256,394,437,253,358,197,658,458,338,650,247,664,406,376,389,664,471,492,380,394,332,370,363,356,664,664,356,356,664,337,372,370,496,545,545,429,356,545,333
1470,"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified",1115,1004,315,1059,1059,611,1014,1059,558,569,1059,608,408,629,696,403,572,315,1049,731,540,1037,394,1059,648,599,620,1059,752,785,606,629,433,591,578,569,1059,1059,569,569,1059,538,593,590,791,869,869,685,569,869,531
1480,"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified",1083,975,306,1029,1029,593,985,1029,542,552,1029,439,396,611,676,391,555,306,1019,710,524,1008,382,1029,542,582,603,1029,731,762,588,611,553,574,562,552,1029,1029,552,552,1029,523,576,573,768,844,844,665,552,844,516
1710,"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified",939,845,265,892,892,514,854,892,470,479,892,512,343,530,587,339,482,265,883,616,455,874,332,892,546,504,523,892,633,661,510,530,526,498,487,479,892,892,479,479,892,453,499,497,666,731,731,577,479,731,447
1730,Anesthesia for all closed procedures on humerus and elbow,1035,932,292,983,983,567,942,983,518,528,983,565,379,584,646,374,531,292,974,679,501,963,365,983,602,556,576,983,698,728,562,584,491,549,537,528,983,983,528,528,983,500,550,548,734,806,806,635,528,806,493
1810,"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand",931,838,263,884,884,510,847,884,466,475,884,488,341,525,582,337,477,263,876,611,451,866,329,884,541,500,518,884,628,655,506,525,472,493,483,475,884,884,475,475,884,449,495,493,660,725,725,572,475,725,443
0202U,HC NFCT DS 22 TRGT SARS-COV-2,428,385,121,407,407,234,389,407,214,218,407,265,300,241,267,150,219,121,403,281,207,398,151,407,249,230,238,407,289,301,250,241,148,227,222,218,407,407,218,218,407,207,228,226,304,333,333,263,218,333,204
10060,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single",254,229,72,697,241,139,231,241,127,130,241,137,697,143,159,92,130,72,239,167,123,236,90,241,148,136,141,241,171,179,79,143,115,135,132,130,241,241,130,130,241,123,135,134,180,198,198,142,130,198,121
10061,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",254,229,72,272,241,139,231,241,127,130,241,272,93,143,159,92,130,72,239,154,123,236,90,241,148,136,141,241,171,179,157,143,129,135,132,130,241,241,130,130,241,123,135,134,180,198,198,156,130,198,121
10081,Incision and drainage of pilonidal cyst; complicated,500,450,141,1826,475,274,455,475,250,255,475,273,1826,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,272,282,253,265,259,255,475,475,255,255,475,241,266,265,355,389,389,307,255,389,238
10120,"Incision and removal of foreign body, subcutaneous tissues; simple",162,146,46,1473,154,89,147,154,81,83,154,100,349,91,101,59,83,46,152,106,78,151,57,154,94,87,90,154,109,114,100,91,1473,86,84,83,154,154,83,83,154,78,86,86,115,126,126,99,83,126,77
10140,"Incision and drainage of hematoma, seroma or fluid collection",300,270,78,2772,285,164,273,285,150,153,285,162,2772,169,187,108,154,85,282,197,145,279,106,285,174,161,167,285,202,211,78,186,168,159,156,153,285,285,153,153,285,145,160,159,213,234,234,184,153,234,143
10160,"Puncture aspiration of abscess, hematoma, bulla, or cyst",250,225,68,238,238,137,227,238,125,128,238,68,91,141,156,90,128,71,235,164,121,233,88,238,145,134,139,238,169,176,136,141,127,132,130,128,237,238,128,127,238,121,133,132,177,195,195,153,128,195,119
11042,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",484,436,136,1635,460,271,460,460,242,247,460,300,1635,273,302,635,248,137,455,317,234,450,171,460,250,250,269,460,269,136,260,300,244,257,251,247,460,460,247,247,460,234,242,257,343,377,377,271,247,377,230
11043,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",484,436,137,2683,460,271,440,460,242,247,460,2513,1138,273,302,2683,248,137,455,317,234,450,171,460,281,260,269,460,326,474,299,300,169,257,251,247,460,460,247,247,460,234,257,256,343,377,377,377,247,377,230
11044,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less",1411,1270,399,2068,1340,773,1284,1340,706,720,1340,770,516,796,881,510,724,399,1327,925,683,1313,498,1340,820,758,785,1340,1346,2068,767,875,492,748,732,720,1340,1340,720,720,1340,681,750,747,1001,1099,1099,866,720,1099,672
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)",484,436,137,474,460,265,440,460,242,247,460,281,177,273,302,175,248,137,455,317,234,450,171,460,281,260,269,460,326,474,263,273,247,257,251,247,460,460,247,247,460,234,232,256,343,377,377,271,247,377,230
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)",484,436,1,1341,460,265,440,460,242,247,460,1,1218,273,302,1341,248,137,455,317,234,450,171,460,281,260,269,460,326,474,263,273,142,257,251,247,460,460,247,247,460,234,257,256,343,377,377,297,247,377,230
11047,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)",4233,3810,1196,4021,4021,2318,3851,4021,2118,2159,4021,2310,1548,2388,2644,1530,2171,1196,3982,2776,2050,3938,1495,4021,2461,2274,2355,4021,2855,2183,2300,2387,2142,2243,2196,2159,4021,4021,2159,2159,4021,2043,2251,2240,3002,3297,3297,2599,2159,3297,2015
11055,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion",129,116,36,635,123,71,117,123,65,66,123,70,635,73,81,47,66,36,121,85,62,120,46,123,69,69,72,123,87,91,70,73,66,68,67,66,123,123,66,66,123,62,72,68,91,100,100,79,66,100,61
11056,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions",154,139,44,146,146,84,140,146,77,79,146,84,56,87,96,56,79,44,145,101,75,143,54,146,90,83,86,146,104,108,84,87,78,82,80,79,146,146,79,79,146,74,74,81,109,120,120,95,79,120,73
11102,PR TANGNTL BX SKIN SINGLE LES,260,234,73,247,247,142,237,247,130,133,247,142,95,147,162,94,133,73,245,171,126,242,92,247,151,140,145,247,175,183,141,147,84,138,135,133,247,247,133,133,247,126,138,138,184,203,203,160,133,203,124
11104,PR PUNCH BX SKIN SINGLE LESION,320,288,90,1451,304,175,291,304,160,163,304,175,1451,181,200,116,164,90,301,210,155,298,113,304,186,172,178,304,173,225,232,180,163,170,166,163,304,304,163,163,304,154,170,169,227,249,249,196,163,249,152
11105,PR PUNCH BX SKIN EA SEP/ADDL,150,135,42,143,142,82,136,143,75,76,142,82,55,85,94,54,77,42,141,98,73,140,53,142,87,81,83,142,101,106,82,85,76,80,78,76,142,143,76,76,142,72,80,79,106,117,117,92,76,117,71
11400,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less",394,355,111,374,374,216,358,374,197,201,374,215,144,222,246,142,202,111,371,258,191,367,139,374,229,212,219,374,266,277,214,222,163,209,204,201,374,374,201,201,374,190,209,208,279,307,307,242,201,307,188
11401,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1629,1092,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1416,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
11402,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm",1550,1395,119,1630,1473,849,1411,1473,776,791,1473,1630,1319,875,968,560,795,438,1458,1017,751,1443,547,1473,902,833,863,1473,1046,1091,843,874,119,822,804,791,1473,1473,791,791,1473,749,227,820,1100,1208,1208,952,791,1208,738
11403,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm",2984,2686,195,2835,2835,1634,2715,2835,1315,1522,2835,1628,401,1684,1864,441,1530,843,2807,1957,1445,2776,1054,2835,1735,1603,1660,2835,2013,2676,1621,1683,195,1582,1548,1522,2835,2835,1522,1522,2835,1441,1587,1579,2116,2324,2324,1832,1522,2325,1421
11404,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm",2629,2366,743,2950,2498,1440,2392,2498,1316,1341,2498,1312,2950,1483,1642,950,1348,743,2473,1724,1273,2446,928,2498,1529,1412,1463,2498,1773,1850,1429,1483,1331,1393,1364,1341,2498,2498,1341,1341,2498,1269,2064,1391,1865,2048,2048,2064,1341,2048,1252
11406,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm",3340,3006,944,3848,3173,1829,3039,3173,1672,1703,3173,2478,3848,1884,2086,1207,1713,944,3142,2190,1617,3108,1179,3173,1942,1794,1859,3173,2253,2351,2885,1883,1703,1770,1733,1703,3173,3173,1703,1703,3173,1612,1776,1767,2369,2602,2602,1870,1703,2602,1590
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",250,225,71,441,238,137,227,238,125,128,238,136,91,141,156,441,128,71,235,164,121,233,88,238,145,134,139,238,169,176,136,141,117,132,130,128,237,238,128,127,238,121,133,132,177,195,195,153,128,195,119
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",2990,2691,1,2840,2840,1637,2720,2840,2002,1525,2840,1631,2801,1687,1867,1081,1533,845,2812,1961,1447,2781,1056,2840,1738,1606,1663,2840,2016,2104,1,1686,1513,1584,1551,1525,2840,2840,1525,1525,2840,1443,1842,1582,2120,2329,2329,1835,1525,2329,1423
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",2807,2526,793,2667,2667,1537,2554,2667,1405,1432,2667,1532,1541,1584,1753,1015,1439,793,2640,1841,1359,2612,991,2667,1632,1508,1562,2667,1893,1975,1602,1583,1341,1488,1456,1432,2667,2667,1432,1432,2667,1355,1492,1485,1991,2187,2187,1723,1432,2187,1336
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",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1629,1341,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1040,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
11426,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",670,603,189,637,636,367,610,637,335,342,636,366,245,378,419,242,344,189,630,439,324,623,237,636,390,360,373,636,452,472,364,378,309,355,348,342,636,637,342,342,636,323,356,355,475,522,522,411,342,522,319
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",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1420,1092,1684,1865,1079,1531,843,1522,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1522,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
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",2630,2367,441,2499,2498,1493,2393,2499,1316,1341,2498,1446,441,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,917,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
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",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1629,1092,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1522,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
11603,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm",2985,2686,720,2836,2836,1635,2716,2836,1494,1522,2836,1629,720,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,937,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
11604,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm",2630,2367,743,2499,2498,1440,2393,2499,1341,1341,2498,1435,1396,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1331,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
11606,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",2985,2686,843,4973,2836,1492,2716,2836,1494,1522,2836,1629,4973,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1453,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,2335,2117,2325,2325,1833,1522,2325,1421
11623,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",3578,3220,1011,3399,3399,1959,3255,3399,1790,1825,3399,1952,1451,2018,2235,1293,1835,1011,3365,2346,1732,3329,1263,3399,2080,1922,1991,3399,2413,2518,1944,2017,1672,1896,1856,1825,3399,3399,1825,1825,3399,1727,1902,1893,2537,2787,2787,2196,1825,2787,1703
11624,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm",2808,2527,793,2667,2667,1538,2554,2667,1405,1432,2667,1532,1027,1584,1754,1015,1440,793,2641,1841,1359,2612,991,2667,1632,1508,1562,2667,1894,1976,1526,1583,1257,1488,1457,1432,2667,2667,1432,1432,2667,1355,1493,1485,1991,2187,2187,1724,1432,2187,1337
11626,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",2630,2367,743,3588,2498,1440,2393,2499,1316,1341,2498,1435,3588,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,902,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1473,1865,2049,2049,1473,1341,2049,1252
11642,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm",2630,2367,441,2499,2498,1473,2393,2499,1316,1341,2498,1435,441,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1473,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
11643,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm",2630,2367,743,2499,2498,1440,2393,2499,1316,1341,2498,1435,962,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1473,1394,1364,1341,2498,2499,1341,1341,2498,1270,1492,1392,1865,2049,2049,1615,1341,2049,1252
11644,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm",3577,3219,1011,3498,3398,1959,3254,3398,2085,1824,3398,1952,3498,2018,2234,1293,1834,1011,3365,2346,1732,3328,1263,3398,2080,1922,1990,3398,2413,2517,1944,2017,1810,1896,1856,1824,3398,3398,1824,1824,3398,1727,1902,1893,2537,2786,2786,2196,1824,2786,1703
11646,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm",2984,2686,843,4410,2835,1634,2715,2835,1494,1522,2835,1629,4410,1684,1864,1079,1531,843,2807,1957,1445,2777,1054,2835,1735,1603,1661,2835,2013,2100,1622,1683,915,1582,1548,1522,2835,2835,1522,1522,2835,1441,1587,1672,2117,2325,2325,1492,1522,2325,1421
11719,"Trimming of nondystrophic nails, any number",85,76,24,81,81,47,77,81,43,43,81,46,31,48,53,31,44,24,80,56,41,79,30,81,49,46,47,81,57,60,46,48,43,45,44,43,81,81,43,43,81,41,41,45,60,66,66,52,43,66,40
11720,Debridement of nail(s) by any method(s); 1 to 5,154,139,44,146,146,84,140,146,77,79,146,84,56,87,96,56,79,44,145,101,75,143,54,146,90,83,86,146,104,108,84,87,82,82,80,79,146,146,79,79,146,74,82,81,109,120,120,95,79,120,73
11721,Debridement of nail(s) by any method(s); 6 or more,154,139,44,146,146,84,140,146,77,79,146,58,132,87,96,56,79,44,145,101,75,143,54,146,90,83,86,146,104,108,84,87,86,82,80,79,146,146,79,79,146,74,77,81,109,120,120,77,79,120,73
11730,"Avulsion of nail plate, partial or complete, simple; single",154,139,44,501,146,84,140,146,77,79,146,90,501,87,96,56,79,44,145,101,75,143,54,146,90,83,86,146,104,108,84,87,78,82,80,79,146,146,79,79,146,74,82,81,109,120,120,95,79,120,73
11771,Excision of pilonidal cyst or sinus; extensive,4655,4190,1315,4422,4422,2549,4235,4422,2330,2374,4422,2540,3258,2626,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,1419,2467,2415,2374,4422,4422,2374,2374,4422,2247,2234,2463,3302,3626,3626,2858,2374,3626,2216
11982,"Removal, non-biodegradable drug delivery implant",1,1,0,663,1,1,1,1,1,1,1,1,663,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
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",215,194,20,598,204,120,196,204,108,110,204,126,598,121,134,598,110,61,202,141,104,200,76,204,125,116,120,204,145,20,118,121,75,114,112,110,204,204,110,110,204,104,114,114,152,167,167,110,110,167,102
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",215,194,61,633,204,118,196,204,80,110,204,118,627,121,134,633,110,61,202,141,104,200,76,204,125,116,120,204,145,151,118,116,61,114,112,110,204,204,110,110,204,104,108,114,152,167,167,110,110,167,102
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",246,221,70,689,234,135,224,234,123,125,234,134,657,139,154,689,126,70,231,161,119,229,87,234,143,132,137,234,166,173,134,139,81,130,128,125,234,234,125,125,234,119,131,130,174,192,192,151,125,192,117
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",252,227,71,239,239,138,229,239,126,129,239,136,92,142,157,91,129,71,237,165,122,234,89,239,147,135,140,239,170,177,137,142,110,134,131,129,239,239,129,129,239,122,134,133,179,196,196,155,129,196,120
12011,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",215,194,61,673,204,110,196,204,108,110,204,118,597,121,134,673,110,61,204,141,104,200,76,204,125,116,120,204,214,151,118,121,92,114,112,110,204,204,110,110,204,104,114,120,152,167,167,114,110,167,102
12013,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",162,146,46,657,154,89,147,154,81,83,154,89,657,91,101,598,83,46,152,106,78,151,57,154,94,87,90,154,109,114,95,91,60,86,84,83,154,154,83,83,154,78,87,86,115,126,126,91,83,126,77
12014,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm",247,222,70,235,235,135,225,235,124,126,235,135,90,139,154,89,127,70,232,162,120,230,87,235,144,133,137,235,167,174,134,139,125,131,128,126,235,235,126,126,235,119,119,131,175,192,192,152,126,192,118
12020,Treatment of superficial wound dehiscence; simple closure,173,156,49,164,164,95,157,164,87,88,164,94,63,98,108,63,89,49,163,113,84,161,61,164,101,93,96,164,117,122,93,98,88,92,90,88,164,164,88,88,164,84,92,92,123,135,135,106,88,135,82
12031,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less",5,4,1,626,5,3,5,5,3,3,5,3,626,3,3,2,3,1,5,3,2,5,2,5,3,3,3,5,3,4,3,3,3,3,3,3,5,5,3,3,5,2,3,3,4,4,4,3,3,4,2
12032,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm",5,4,1,818,5,3,5,5,3,3,5,100,818,3,3,633,3,1,5,3,2,5,2,5,3,3,3,5,3,4,3,3,140,3,3,3,5,5,3,3,5,2,3,3,4,4,4,3,3,4,2
12034,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm",162,146,1,1327,154,83,147,154,81,83,154,88,1327,91,101,59,83,46,152,106,78,151,57,154,98,87,90,154,109,114,1,91,212,86,84,83,154,154,83,83,154,78,86,86,115,126,126,99,83,126,77
12041,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less",162,146,46,718,154,89,147,154,81,83,154,81,718,91,101,59,83,46,152,106,78,151,57,154,94,87,90,154,109,114,88,91,82,86,84,83,154,154,83,83,154,78,86,86,115,126,126,99,83,126,77
12042,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm",174,157,49,463,165,95,158,165,87,89,165,95,463,98,109,63,89,49,164,114,84,162,61,165,101,93,97,165,117,173,54,98,203,92,90,89,165,165,89,89,165,84,93,90,123,136,136,107,89,136,83
12044,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm",302,272,85,743,287,165,275,287,151,154,287,216,743,170,189,109,155,85,284,198,146,281,107,287,176,162,168,287,204,213,164,170,213,160,157,154,287,287,154,154,287,146,161,160,214,235,235,185,154,235,144
12045,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm",750,675,212,1486,712,411,682,713,375,382,712,409,1486,423,468,271,385,212,705,492,363,698,265,712,436,403,417,712,506,528,408,423,380,398,389,382,712,713,382,382,712,362,399,397,532,584,584,460,382,584,357
12051,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",234,210,66,1635,222,128,212,222,117,119,222,127,1635,132,146,633,120,66,220,153,113,217,82,222,136,125,130,222,157,164,127,132,175,124,121,119,222,222,119,119,222,113,124,124,166,182,182,143,119,182,111
12052,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",236,212,67,1152,224,129,215,224,118,120,224,129,1152,133,147,85,121,67,222,155,114,220,83,224,137,127,131,224,159,166,128,133,168,125,122,120,224,224,120,120,224,114,125,125,167,184,184,145,120,184,112
12054,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm",326,293,92,893,309,178,296,309,163,166,309,178,893,184,203,118,167,92,306,213,158,303,115,309,189,175,181,309,220,229,177,184,165,173,169,166,309,309,166,166,309,157,173,172,231,254,254,200,166,254,155
13101,"Repair, complex, trunk; 2.6 cm to 7.5 cm",1,1,0,482,1,1,1,1,1,1,1,1,482,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
13120,"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm",640,576,181,608,608,351,582,608,320,326,608,349,234,361,400,317,328,181,602,420,310,595,226,608,372,344,356,608,432,450,348,361,302,339,332,326,608,608,326,326,608,309,340,339,454,499,499,393,326,499,305
13121,"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm",640,576,181,802,608,351,582,608,320,326,608,346,802,361,400,231,328,181,602,420,310,595,226,608,372,344,356,608,432,450,348,361,316,339,332,326,608,608,326,326,608,309,340,339,454,499,499,393,326,499,305
13122,"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)",375,338,106,356,356,205,341,356,188,191,356,135,317,212,234,136,192,106,353,246,182,349,132,356,218,201,209,356,253,264,204,211,190,199,195,191,356,356,191,191,356,181,199,198,266,292,292,230,191,292,179
13131,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm",511,460,144,2294,485,280,465,485,256,261,485,2294,700,288,319,185,262,144,481,335,247,475,180,485,297,275,284,485,345,360,281,288,258,271,265,261,485,485,261,261,485,247,272,270,362,398,398,314,261,398,243
13132,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm",529,476,149,1461,503,290,481,503,265,270,503,328,1461,298,330,191,271,149,498,347,256,492,187,503,308,284,294,503,357,372,287,298,290,280,274,270,503,503,270,270,503,255,281,280,375,412,412,325,270,412,252
13151,"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm",3685,3316,1041,3501,3501,2018,3352,3501,1844,1879,3501,2011,1348,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1865,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,1842,1879,2871,1754
13152,"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm",910,819,257,865,864,498,828,865,455,464,864,497,333,513,568,329,467,257,856,597,441,847,321,864,529,489,506,864,614,640,494,513,351,482,472,464,864,865,464,464,864,439,484,481,645,709,709,559,464,709,433
14040,"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less",4655,4190,1315,4422,4422,2549,4235,4422,2330,2374,4422,2540,1703,2626,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2374,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2858,2374,3626,2216
15004,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children",1000,900,283,3884,950,548,910,950,500,510,950,546,3884,564,625,361,513,283,941,656,484,930,353,950,581,537,556,950,675,704,543,564,506,530,519,510,950,950,510,510,950,483,532,529,709,779,779,614,510,779,476
15271,PR SKIN SUB GRAFT T/A/L 25 SQ CM,552,497,156,524,524,302,502,524,276,282,524,342,293,311,345,200,283,156,519,362,267,514,195,524,321,297,307,524,372,388,300,311,309,293,286,282,524,524,282,282,524,266,309,309,392,430,430,309,282,430,263
15272,PBB SKIN SUB GRAFT T/A/L ADD-ON,552,497,156,524,524,302,502,524,276,282,524,301,202,311,345,200,283,156,519,362,267,514,195,524,321,297,307,524,372,388,300,311,309,293,286,282,524,524,282,282,524,266,293,292,392,430,430,339,282,430,263
15275,PR SKIN SUB GRFT F/NK/HF/G 25 SQ CM,552,497,156,524,524,302,502,524,276,282,524,342,293,311,345,200,283,156,519,362,267,514,195,524,321,297,307,524,372,388,300,311,278,293,286,282,524,524,282,282,524,266,293,292,392,430,430,370,282,430,263
15276,PBB SKIN SUB GRAFT F/N/HF/G ADDL,552,497,156,524,524,302,502,524,276,282,524,301,202,311,345,200,283,156,519,362,267,514,195,524,321,297,307,524,372,388,300,311,282,293,286,282,524,524,282,282,524,266,293,292,392,430,430,339,282,430,263
16020,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)",239,215,68,227,227,131,217,227,120,122,227,131,87,135,149,86,123,68,225,157,116,222,84,227,139,128,133,227,161,168,130,129,87,127,124,122,227,227,122,122,227,115,127,126,170,186,186,147,122,186,114
16025,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)",400,360,113,689,380,219,364,380,200,204,380,218,689,226,250,145,205,113,376,262,194,372,141,380,233,215,223,380,270,282,217,226,202,212,208,204,380,380,204,204,380,193,213,212,284,312,312,246,204,312,190
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)",272,245,77,258,258,149,247,258,136,139,258,148,99,153,170,98,139,77,256,178,132,253,96,258,158,146,151,258,183,191,148,153,136,144,141,139,258,258,139,139,258,131,145,144,193,212,212,167,139,212,130
17250,"Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)",244,220,69,380,232,134,222,232,122,124,232,133,89,138,152,380,125,69,230,160,118,227,86,232,142,131,136,232,165,172,133,138,77,129,127,124,232,232,124,124,232,118,130,129,173,190,190,150,124,190,116
19081,PR BX BREAST 1ST LESION STRTCTC,4326,3893,1222,4110,4110,2369,3936,4110,2165,2206,4110,2361,3957,2441,2702,1564,2218,1222,4069,2837,2095,4025,1527,4110,2515,2324,2407,4110,2918,3044,2322,2439,2206,2293,2244,2206,4110,4110,2206,2206,4110,2088,2076,2289,3068,3370,3370,2656,2206,3370,2060
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",3928,3535,1110,3731,3731,2151,3573,3731,1966,2003,3731,2252,2754,2216,2453,1420,2014,1110,3694,2576,1902,3654,1387,3731,2284,2110,2185,3731,2649,2764,2134,2215,1201,2082,2038,2003,3731,3731,2003,2003,3731,1896,2088,2078,2786,3059,3059,2411,2003,3059,1870
19301,"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);",5140,4626,1452,6617,4883,2815,4676,4883,2572,2621,4883,2805,6617,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,2793,2899,2601,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,3156,2621,4004,2447
20240,"Biopsy, bone, open; superficial (eg, ilium, sternum, spinous process, ribs, trochanter of femur)",4655,4190,1315,4422,4422,2549,4235,4422,2330,2374,4422,2540,3848,2626,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2356,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2858,2374,3626,2216
20552,"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)",400,360,109,380,380,219,364,380,200,204,380,216,146,226,250,145,205,113,376,262,194,372,141,380,233,215,223,380,270,282,124,226,109,212,208,204,380,380,204,204,380,193,213,212,284,312,312,246,204,312,190
20553,"Injection(s); single or multiple trigger point(s), 3 or more muscle(s)",700,630,198,789,665,383,637,665,350,357,665,382,789,395,437,253,359,198,658,459,339,651,247,665,407,376,390,665,472,493,380,395,354,371,363,357,665,665,357,357,665,338,372,370,496,545,545,430,357,545,333
20600,"Arthrocentesis, aspiration and/or injection; small joint or bursa (eg, fingers, toes)",97,87,27,92,92,53,88,92,49,49,92,53,35,55,61,35,50,27,91,64,47,90,34,92,56,52,54,92,65,68,53,55,36,51,50,49,92,92,49,49,92,47,52,51,69,76,76,60,49,76,46
20605,"Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)",168,151,47,160,160,92,153,160,84,86,160,91,61,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,91,95,85,89,87,86,160,160,86,86,160,81,89,89,119,131,131,103,86,131,80
20610,"Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)",515,464,146,489,489,282,469,489,258,263,489,281,410,291,322,186,264,146,484,338,249,479,182,489,299,277,287,489,347,362,280,290,153,273,267,263,489,489,263,263,489,249,288,272,365,401,401,316,263,401,245
20611,HC DRAIN/INJ MAJOR JOINT/BURSA W US,515,464,146,1047,489,282,469,489,258,263,489,281,1047,291,322,186,264,146,484,338,249,479,182,489,299,277,287,489,347,362,280,290,261,273,267,263,489,489,263,263,489,249,274,272,365,401,401,316,263,401,245
20680,"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)",4170,3753,1178,3962,3962,2284,3794,3962,2087,2127,3962,2275,3498,2353,2605,1507,2161,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,1293,2352,2335,2210,2163,2127,3961,3962,2127,2127,3962,2013,2367,2206,2958,3248,3248,2560,2127,3248,1985
21320,Closed treatment of nasal bone fracture; with stabilization,1575,1418,445,1496,1496,863,1433,1496,788,803,1496,859,576,889,984,569,808,445,1482,1033,763,1465,556,1496,916,846,876,1496,1062,1108,856,888,793,835,817,803,1496,1496,803,803,1496,760,837,833,1117,1227,1227,967,803,1227,750
21552,"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1629,1092,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1672,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
21555,"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm",2630,2367,743,2499,2498,1440,2393,2499,1316,1341,2498,1435,962,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1473,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
21930,"Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1629,1092,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1672,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
21931,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater",4170,3753,1178,3962,3962,2284,3794,3962,2087,2127,3962,2275,1525,2353,2605,1507,2138,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2266,2352,2111,2210,2163,2127,3961,3962,2127,2127,3962,2013,2335,2206,2958,3248,3248,2560,2127,3248,1985
21932,"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm",2984,2686,843,3848,2835,1634,2715,2835,1493,1522,2835,1628,3848,1684,1864,1079,1530,843,2807,1957,1445,2776,1054,2835,1735,1603,1660,2835,2013,2100,1621,1683,1510,1582,1548,1522,2835,2835,1522,1522,2835,1441,1587,1579,2116,2324,2324,1832,1522,2325,1421
23071,"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater",3685,3316,1041,3982,3501,2018,3352,3501,1844,1879,3501,2011,3982,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1865,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2262,1879,2871,1754
23075,"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm",2630,2367,743,2499,2498,1440,2393,2499,1316,1341,2498,1435,1319,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1331,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
23350,Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder arthrography,274,247,77,260,260,150,249,260,137,140,260,159,100,155,171,99,141,77,258,180,133,255,97,260,159,147,152,260,185,193,149,148,153,145,142,140,260,260,140,140,260,132,146,145,194,213,213,168,140,213,130
23505,Closed treatment of clavicular fracture; with manipulation,800,720,226,760,760,438,728,760,400,408,760,432,293,451,500,289,410,226,753,525,387,744,282,760,465,430,445,760,540,563,435,451,405,424,415,408,760,760,408,408,760,386,425,423,567,623,623,491,408,623,381
23650,"Closed treatment of shoulder dislocation, with manipulation; without anesthesia",213,192,60,202,202,117,194,202,107,109,202,116,78,120,133,138,109,60,200,140,103,198,75,202,124,114,119,202,144,150,116,120,130,113,111,109,202,202,109,109,202,103,113,113,151,166,166,131,109,166,101
23655,"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia",1008,907,285,958,958,552,917,958,504,514,958,544,369,569,630,364,517,285,958,661,488,938,356,958,586,542,561,958,680,709,548,568,360,534,523,514,958,958,514,514,958,487,536,533,715,785,785,619,514,785,480
23665,"Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation",1000,900,283,2834,950,548,910,950,500,510,950,546,2834,564,625,361,513,283,941,656,484,930,353,950,581,537,556,950,675,704,543,564,506,530,519,510,950,950,510,510,950,483,532,529,709,779,779,614,510,779,476
23675,"Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation",1100,990,311,1045,1045,602,1001,1045,551,561,1045,600,402,621,687,398,564,311,1035,721,533,1023,388,1045,640,591,612,1045,742,774,598,620,507,583,571,561,1045,1045,561,561,1045,531,585,582,780,857,857,675,561,857,524
24600,Treatment of closed elbow dislocation; without anesthesia,1000,900,283,3145,950,548,910,950,500,510,950,546,3145,564,625,361,513,283,941,656,484,930,353,950,581,537,556,950,675,704,543,564,506,530,519,510,950,950,510,510,950,483,532,529,709,779,779,614,510,779,476
24640,"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation",162,146,46,3347,154,89,147,154,81,83,154,100,3347,91,101,59,83,46,152,106,78,151,57,154,94,87,90,154,109,114,100,91,82,86,84,83,154,154,83,83,154,78,86,86,115,126,126,99,83,126,77
25000,"Incision, extensor tendon sheath, wrist (eg, deQuervains disease)",4170,3753,1178,3962,3962,2284,3794,3962,2087,2127,3962,2275,1525,2353,2605,1507,2138,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2266,2352,2127,2210,2163,2127,3961,3962,2127,2127,3962,2013,2217,2206,2958,3248,3248,2560,2127,3248,1985
25260,"Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle",1000,900,283,950,950,548,910,950,500,510,950,546,366,564,625,361,513,283,941,656,484,930,353,950,581,537,556,950,521,704,543,564,506,530,519,510,950,950,510,510,950,483,532,529,709,779,779,614,510,779,476
25565,Closed treatment of radial and ulnar shaft fractures; with manipulation,1200,1080,339,3347,1140,657,1092,1140,601,612,1140,655,3347,677,750,434,615,339,1129,787,581,1116,424,1140,698,645,668,1140,809,845,652,677,607,636,623,612,1140,1140,612,612,1140,579,638,635,851,935,935,737,612,935,571
25600,"Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation",500,450,141,475,475,274,455,475,250,255,475,275,183,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,272,282,253,265,259,255,475,475,255,255,475,241,266,265,355,389,389,307,255,389,238
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",162,146,46,3145,154,89,147,154,78,83,154,84,3145,91,101,59,83,46,152,106,78,151,57,154,94,87,90,154,109,114,87,91,205,86,84,83,154,154,83,83,154,78,86,86,115,126,126,99,83,126,77
26010,Drainage of finger abscess; simple,313,282,88,922,297,171,285,297,157,160,297,172,922,177,196,113,161,88,294,205,152,291,111,297,182,168,174,297,211,220,194,177,158,166,162,160,297,297,160,160,297,151,166,166,222,244,244,192,160,244,149
26055,"Tendon sheath incision (eg, for trigger finger)",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1629,1092,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1040,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
26605,"Closed treatment of metacarpal fracture, single; with manipulation, each bone",701,631,198,3145,666,384,638,666,351,358,666,383,3145,395,438,253,359,198,659,460,339,652,248,666,408,377,390,666,473,493,381,395,355,372,364,358,666,666,358,358,666,338,373,371,497,546,546,430,358,546,334
26725,"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each",775,698,219,1521,736,424,705,736,388,395,736,426,1521,437,484,280,397,219,729,508,375,721,274,736,451,416,431,736,523,545,421,437,392,411,402,395,736,736,395,395,736,374,412,410,550,604,604,476,395,604,369
26770,"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia",600,540,170,3145,570,329,546,570,300,306,570,327,3145,339,375,217,308,170,564,393,291,558,212,570,349,322,334,570,405,422,326,338,304,318,311,306,570,570,306,306,570,290,319,317,426,467,467,368,306,467,286
26775,"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia",850,765,240,808,808,466,773,808,425,434,808,464,311,480,531,307,436,240,800,557,412,791,300,808,514,457,473,808,573,598,462,479,301,450,441,434,807,808,434,433,808,410,452,450,603,662,662,522,434,662,405
27043,"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater",2630,2367,743,2499,2498,1440,2393,2499,1316,1341,2498,1435,962,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1473,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
27096,"Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid",1575,1418,277,1496,1496,863,1433,1496,788,803,1496,859,1047,889,984,569,808,445,1482,1033,763,1465,556,1496,916,846,876,1496,1062,1108,856,888,277,835,817,803,1496,1496,803,803,1496,760,837,833,1117,1227,1227,967,803,1227,750
27240,"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction",3000,2700,848,2850,2850,1643,2729,2850,1501,1530,2850,1620,1097,1693,1874,1084,1538,848,2822,1967,1453,2791,1059,2850,1744,1612,1669,2850,2024,2111,1630,1692,1518,1590,1556,1530,2850,2850,1530,1530,2850,1448,1595,1587,2128,2337,2337,1842,1530,2337,1428
27252,"Closed treatment of hip dislocation, traumatic; requiring anesthesia",1508,1357,426,1433,1433,826,1372,1433,755,769,1433,823,552,851,942,545,773,426,1419,989,730,1403,532,1433,877,810,839,1433,1017,1061,819,850,905,799,782,769,1433,1433,769,769,1433,728,802,798,1070,1175,1175,926,769,1175,718
27257,"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia",575,518,162,546,546,315,523,546,288,293,546,314,210,324,359,208,295,162,541,377,278,535,203,546,334,309,320,546,388,405,312,324,397,305,298,293,546,546,293,293,546,278,306,304,408,448,448,353,293,448,274
27266,Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia,216,194,61,242,205,118,197,205,108,110,205,118,79,122,135,78,111,61,203,142,105,201,76,205,126,116,120,205,146,152,117,122,242,114,112,110,205,205,110,110,205,104,115,114,153,168,168,133,110,168,103
27327,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm",2630,2367,743,2499,2498,1440,2393,2499,1341,1341,2498,1435,962,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1331,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
27337,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater",2985,2686,843,3982,2836,1635,2716,2836,1494,1522,2836,1629,3982,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1511,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
27560,Closed treatment of patellar dislocation; without anesthesia,800,720,226,3145,760,438,728,760,400,408,760,437,3145,451,500,289,410,226,753,525,387,744,282,760,465,430,445,760,540,563,435,451,405,424,415,408,760,760,408,408,760,386,425,423,567,623,623,491,408,623,381
27570,Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices),5795,5216,1637,5505,5505,3174,5272,5505,2900,2955,5505,3593,2120,3269,3620,2095,2972,1637,5451,3800,2806,5392,2046,5505,3370,3113,3225,5505,3909,4078,3149,3268,2933,3071,3006,2955,5505,5505,2955,2955,5505,2798,3081,3066,4110,4514,4514,3558,2955,4514,2759
27630,"Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle",2985,2686,843,6230,2836,1635,2716,2836,1494,1522,2836,1629,6230,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1511,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
27632,"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1851,1092,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1511,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
27650,"Repair, primary, open or percutaneous, ruptured Achilles tendon;",6352,5717,1795,6034,6034,3479,5779,6034,3179,3240,6034,3466,2324,3584,3968,2296,3257,1795,5975,4166,3076,5910,2243,6034,3693,3413,3535,6034,4285,4470,3360,3582,3363,3367,3295,3240,6034,6034,3240,3240,6034,3066,3377,3361,4505,4948,4948,3900,3240,4948,3024
27687,"Gastrocnemius recession (eg, Strayer procedure)",8049,7244,2274,7647,7647,4408,7323,7647,4028,4105,7647,5416,2830,4541,5028,2910,4128,2274,7571,5279,3897,7489,2842,7647,4680,4324,4479,7647,5429,5665,4374,4539,4074,4266,4176,4105,7646,7647,4105,4105,7647,3886,4279,4259,5709,6270,6270,4942,4105,6270,3832
27726,Repair of fibula nonunion and/or malunion with internal fixation,9135,8222,2581,8678,8678,5003,8311,8678,4572,4659,8678,4985,3341,5154,5706,3302,4685,2581,8593,5991,4423,8499,3225,8678,5312,4908,5083,8678,6162,6429,4964,5151,4623,4842,4739,4659,8678,8678,4659,4659,8678,4410,4857,4833,6479,7116,7116,4568,4659,7116,4349
27752,"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction",950,855,268,903,902,520,864,903,475,484,902,518,348,536,593,343,487,268,894,623,460,884,335,902,552,510,529,902,641,669,492,536,481,504,493,484,902,903,484,484,902,459,505,503,674,740,740,583,484,740,452
27786,Closed treatment of distal fibular fracture (lateral malleolus); without manipulation,800,720,226,760,760,438,728,760,400,408,760,437,293,451,500,289,410,226,753,525,387,744,282,760,465,430,445,760,540,563,435,451,380,424,415,408,760,760,408,408,760,386,425,423,567,623,623,491,408,623,381
27792,"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed",7815,7034,2146,8792,7424,4280,7110,7424,3911,3986,7424,3372,8792,4409,4882,2825,4008,2208,7351,5125,3784,7271,2759,7424,4544,4199,4349,7424,5271,5500,4524,4407,2146,4142,4054,3986,7424,7424,3986,3986,7424,3773,4155,4135,5543,6088,6088,4798,3986,6088,3721
27810,"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation",1000,900,283,2370,950,548,910,950,500,510,950,546,2370,564,625,361,513,283,941,656,484,930,353,950,581,537,556,950,675,704,543,564,506,530,519,510,950,950,510,510,950,483,532,529,709,779,779,614,510,779,476
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",10275,9248,2903,9761,9761,5627,9348,9761,5142,5240,9761,5548,3758,5797,6418,3714,5269,2903,9665,6738,4975,9560,3628,9761,5975,5520,5717,9761,6931,7231,5515,5794,5200,5446,5331,5240,9761,9761,5240,5240,9761,4960,5463,5437,7288,8004,8004,6309,5240,8004,4892
27818,Closed treatment of trimalleolar ankle fracture; with manipulation,1300,1170,367,1235,1235,712,1183,1235,651,663,1235,709,476,733,812,470,667,367,1223,853,629,1210,459,1235,756,698,723,1235,877,915,706,733,622,689,674,663,1235,1235,663,663,1235,628,691,688,922,1013,1013,798,663,1013,619
27822,"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip",6315,5684,1784,5999,5999,3458,5745,5999,3160,3221,5999,3446,2310,3563,3945,2283,3238,1784,5940,4141,3058,5876,2230,5999,3672,3393,3514,5999,4260,4444,3431,3561,3436,3347,3276,3221,5999,5999,3221,3221,5999,3049,3357,3341,4479,4919,4919,3877,3221,4919,3007
28008,"Fasciotomy, foot and/or toe",4655,4190,1315,4659,4422,2549,4235,4422,2330,2374,4422,2540,4659,2626,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2356,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2858,2374,3626,2216
28010,"Tenotomy, percutaneous, toe; single tendon",650,585,184,618,618,356,591,618,325,332,618,355,238,367,406,235,333,184,611,426,315,605,229,618,378,349,362,618,438,457,353,351,329,344,337,332,617,618,332,331,618,314,346,344,461,506,506,399,332,506,309
28011,"Tenotomy, percutaneous, toe; multiple tendons",750,675,212,713,712,411,682,713,375,382,712,409,274,423,468,271,385,212,705,492,363,698,265,712,436,403,417,712,506,528,408,405,380,398,389,382,712,713,382,382,712,362,399,397,532,584,584,460,382,584,357
28039,"Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater",3340,3006,944,4906,3173,1829,3039,3173,1672,1703,3173,1823,4906,1884,2086,1207,1713,944,3142,2190,1617,3108,1179,3173,1942,1794,1859,3173,2253,2351,1815,1883,1690,1770,1733,1703,3173,3173,1703,1703,3173,1612,1776,1767,2369,2602,2602,2051,1703,2602,1590
28041,"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater",2985,2686,843,4476,2836,1635,2716,2836,1494,1522,2836,1629,4476,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1511,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
28043,"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm",2985,2686,843,2836,2836,1635,2835,2836,1494,1522,2836,1629,1991,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1511,1582,1549,1522,2836,2836,1522,1522,2836,1441,1672,1579,2117,2325,2325,1833,1522,2325,1421
28080,"Excision, interdigital (Morton) neuroma, single, each",2985,2686,779,4659,2836,1635,2716,2836,1494,1522,2836,1629,4659,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,779,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
28104,"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;",2985,2686,1,4975,2836,1635,1,2836,1494,1522,2836,1629,4975,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1837,1683,1511,1582,1549,1522,2836,2836,1522,1522,2836,1441,1492,1492,2117,2325,2325,1833,1522,2325,1421
28110,"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)",4655,4190,1315,4869,4422,2549,4235,4422,2330,2374,4422,2540,4869,2298,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2734,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2858,2374,3626,2216
28112,"Ostectomy, complete excision; other metatarsal head (second, third or fourth)",6,5,1,2453,6,3,5,6,3,3,6,3,2453,3,4,2,3,2,6,4,3,6,2,6,1345,3,3,6,4,4,1,3,3,3,3,3,6,6,3,3,6,3,3,3,4,5,5,4,3,5,3
28113,"Ostectomy, complete excision; fifth metatarsal head",6,5,2,2453,6,3,5,6,3,3,6,3,2453,3,4,2,3,2,6,4,3,6,2,6,3,3,3,6,4,4,3,3,3,3,3,3,6,6,3,3,6,3,3,3,4,5,5,4,3,5,3
28118,"Ostectomy, calcaneus;",5140,4626,1,4883,4883,2815,4676,4883,2572,2621,4883,2805,4467,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,1,2899,2601,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,3156,2621,4004,2447
28122,"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus",3340,3006,944,3173,3173,1829,3039,3173,1672,1703,3173,3106,1222,1884,2086,1207,1713,944,3142,2190,1617,3108,1179,3173,1942,1794,1859,3173,2253,2351,1815,1883,1690,1770,1733,1703,3173,3173,1703,1703,3173,1612,1776,1767,2369,2602,2602,2051,1703,2602,1590
28124,"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe",1000,900,283,2458,950,548,910,950,500,510,950,546,2458,564,625,361,513,283,941,656,484,930,353,950,581,537,556,950,675,704,543,564,839,530,519,510,950,950,510,510,950,483,532,529,709,779,779,614,510,779,476
28140,Metatarsectomy,4170,3753,1178,3962,3962,2284,3794,3962,2087,2127,3962,2275,1525,2353,2605,1507,2138,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2266,2585,2335,2210,2163,2127,3961,3962,2127,2127,3962,2013,2217,2206,2958,3248,3248,2560,2127,3248,1985
28160,"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each",2328,2095,1,2885,2211,1275,2117,2211,1165,1187,2211,2885,851,1313,1454,841,1194,658,2189,1526,1127,2166,822,2211,1353,1250,1295,2211,1570,1638,1,1313,1178,1234,1208,1187,2211,2211,1187,1187,2211,1124,1237,1232,1651,1813,1813,1429,1187,1813,1108
28192,"Removal of foreign body, foot; deep",4170,3753,1178,3962,3962,2284,3962,3962,2087,2127,3962,2275,1525,2353,2605,1507,2138,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2266,2352,2111,2210,2163,2127,3961,3962,2127,2127,3962,2013,2217,2206,2958,3248,3248,2560,2127,3248,1985
28200,"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon",6,5,2,2229,6,3,5,6,3,3,6,3,2229,3,4,2,3,2,6,4,3,6,2,6,3,3,3,6,4,4,3,3,3,3,3,3,6,6,3,3,6,3,3,3,4,5,5,4,3,5,3
28208,"Repair, tendon, extensor, foot; primary or secondary, each tendon",5140,4626,1452,4883,4883,2815,4676,4883,2572,2621,4883,2805,4458,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,2793,2899,2601,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,3156,2621,4004,2447
28232,"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)",500,450,141,475,475,274,455,475,250,255,475,273,183,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,272,282,247,265,259,255,475,475,255,255,475,241,266,265,355,389,389,307,255,389,238
28285,"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)",1200,1080,339,4041,1140,657,1092,1140,601,612,1140,4041,2238,677,750,434,615,339,1129,787,581,1116,424,1140,698,645,668,1140,809,845,652,677,1791,636,623,612,1140,1140,612,612,1140,579,2002,2085,851,935,935,2812,612,935,571
28288,"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head",5139,4625,451,4882,4882,2814,4675,4882,2572,2621,4882,2775,1880,2899,3210,1858,2635,1452,4834,3370,2488,4781,1814,4882,2988,2761,2860,4882,3466,3617,2792,2898,451,2724,2666,2621,4882,4882,2621,2621,4882,2481,2732,2719,3645,4003,4003,3155,2621,4003,2447
28289,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint",3517,3165,994,9738,3341,1926,3200,3341,1760,1794,3341,1919,9738,1984,2197,1271,1804,994,3308,2307,1703,3272,1242,3341,2045,1890,1957,3341,2372,2475,1911,1983,1780,1864,1825,1794,3341,3341,1794,1794,3341,1698,1870,1861,2494,2740,2740,2159,1794,2740,1674
28292,"Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedure",4340,3906,506,8853,4123,2377,3948,4123,2172,2213,4123,2368,8853,2448,2711,1569,2225,1226,4082,2846,2101,4038,1532,4123,2523,2331,2415,4123,2927,3054,2358,2447,506,2300,2251,2213,4122,4123,2213,2213,4123,2095,2307,2296,3078,3380,3380,2664,2213,3380,2066
28296,"Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)",5140,4626,1452,10033,4883,2815,4676,4883,2402,2621,4883,2805,10033,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,2812,2899,4922,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,4004,2621,4004,2447
28298,"Correction, hallux valgus (bunion), with or without sesamoidectomy; by phalanx osteotomy",1,1,0,7068,1,1,1,1,1,1,1,1,7068,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,2869,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
28299,"Correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy",5140,4626,1452,4883,4883,2815,4676,4883,2570,2621,4883,2805,1880,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,2793,2899,2601,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,3156,2621,4004,2447
28300,"Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation",3,3,1,9840,3,2,3,3,2,2,3,2,9840,2,2,1,2,1,3,2,1,3,1,3,2,2,2,3,2,2,2,2,2,2,2,2,3,3,2,2,3,1,2,2,2,2,2,2,2,2,1
28308,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each",1,1,0,2498,1,1,1,1,2374,1,1,1,2329,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,2498,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
28415,"Open treatment of calcaneal fracture, includes internal fixation, when performed;",10890,9801,3077,10346,10346,5964,9907,10346,5450,5554,10346,5942,3983,6144,6802,3937,5585,3077,10244,7142,5273,10132,3845,10346,6332,5851,6060,10346,7345,7664,5845,6141,5512,5772,5650,5554,10345,10346,5554,5554,10346,5257,5790,5762,7724,8483,8483,6686,5554,8483,5185
28485,"Open treatment of metatarsal fracture, includes internal fixation, when performed, each",5970,5373,1687,9359,5672,3270,5431,5672,2988,3045,5672,3258,9359,3368,3729,7253,3062,1687,5616,3915,2891,5555,2108,5672,3471,3207,4298,5672,4027,4201,3244,3367,3022,3164,3097,3045,5671,5672,3045,3045,5672,2882,3174,3159,4234,4651,4650,3343,3045,4651,2842
28505,"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed",5140,4626,1452,4883,4883,2815,4676,4883,2572,2621,4883,2805,1880,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,2759,2899,2601,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,3156,2621,4004,2447
28630,Closed treatment of metatarsophalangeal joint dislocation; without anesthesia,350,315,99,3119,332,192,318,333,175,178,332,175,3119,197,219,127,179,99,329,230,169,326,124,332,204,188,195,332,236,246,190,197,177,186,182,178,332,333,178,178,332,169,186,185,248,273,273,215,178,273,167
28735,"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)",9504,8554,2685,9029,9029,5205,8646,9029,4756,4847,9029,5186,3476,5362,5937,3436,4874,2685,8940,6233,4602,8843,3356,9029,5526,5106,5288,9029,6411,6689,5101,5359,4810,5037,4931,4847,9029,9029,4847,4847,9029,4588,5053,5029,6741,7403,7403,5835,4847,7404,4525
28740,"Arthrodesis, midtarsal or tarsometatarsal, single joint",1,1,0,8853,1,1,1,1,1,1,1,1,8853,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
28750,"Arthrodesis, great toe; metatarsophalangeal joint",7310,6579,2065,8853,6944,4003,6650,6945,5138,3728,6944,4389,8853,4124,4566,2643,3749,2065,6876,4794,3539,6801,2581,6944,4251,3927,4068,6944,4931,5145,3799,4122,3700,3874,3792,3728,6944,6945,3728,3728,6944,3529,2621,3868,5185,5694,5694,4488,3728,5694,3480
28805,"Amputation, foot; transmetatarsal",6584,5926,1860,9833,6255,3606,5990,6255,3295,3358,6255,3593,9833,3715,4113,2380,3376,1860,6193,4318,3188,6126,2325,6255,3828,3537,3664,6255,4441,4634,3578,3713,3332,3490,3416,3358,6255,6255,3358,3358,6255,3178,3501,3484,4670,5129,5129,4042,3358,5129,3135
28810,"Amputation, metatarsal, with toe, single",3685,3316,1041,3501,3501,2018,3352,3501,1844,1879,3501,2011,1348,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1820,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2262,1879,2871,1754
28820,"Amputation, toe; metatarsophalangeal joint",1000,900,93,1001,950,548,910,950,500,510,950,1001,366,564,625,361,513,283,941,656,484,930,353,950,581,537,556,950,675,704,543,564,506,530,519,510,950,950,510,510,950,483,532,529,709,779,779,93,510,779,476
28825,"Amputation, toe; interphalangeal joint",2142,1928,605,4659,2035,1173,1949,2035,1072,1093,2035,1169,4659,1209,1338,774,1099,605,2015,1405,1037,1993,756,2035,1246,1151,1192,2035,1445,1508,1164,1208,611,1136,1112,1093,2035,2035,1093,1093,2035,1034,1139,1134,1520,1669,1669,2325,1093,1669,1020
28899,"Unlisted procedure, foot or toes",1,1,0,1429,1,1,1,1,1,1,1,1,1429,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
29075,"Application, cast; elbow to finger (short arm)",94,85,27,89,89,51,86,89,47,48,89,51,34,53,59,34,48,27,88,62,46,87,33,89,55,51,52,89,63,66,51,53,54,50,49,48,89,89,48,48,89,45,50,50,67,73,73,58,48,73,45
29105,Application of long arm splint (shoulder to hand),166,149,47,446,158,91,151,158,83,85,158,90,78,94,104,446,92,47,156,109,80,154,59,158,97,89,92,158,112,117,91,94,68,88,86,85,158,158,85,85,158,80,83,88,118,129,129,102,85,129,79
29125,Application of short arm splint (forearm to hand); static,136,122,38,426,129,74,124,129,69,69,129,79,426,77,85,49,68,38,128,89,66,127,48,129,79,73,76,129,92,96,73,77,55,72,71,69,129,129,69,69,129,66,76,72,96,106,106,84,69,106,65
29130,Application of finger splint; static,100,90,28,405,95,55,91,95,50,51,95,55,405,56,62,36,51,28,94,66,48,93,35,95,58,54,56,95,67,70,54,56,43,53,52,51,95,95,51,51,95,48,53,53,71,78,78,61,51,78,48
29260,Strapping; elbow or wrist,146,131,41,139,139,80,133,139,73,74,139,45,53,82,91,53,75,41,137,96,71,136,52,139,85,78,81,139,98,103,79,82,74,77,76,74,139,139,74,74,139,70,78,77,104,114,114,90,74,114,70
29345,Application of long leg cast (thigh to toes);,346,311,98,329,329,189,315,329,173,176,329,189,127,195,216,125,177,98,325,227,168,322,122,329,201,186,193,329,233,244,215,195,175,183,180,176,329,329,176,176,329,167,184,183,245,270,270,212,176,270,165
29445,Application of rigid total contact leg cast,342,308,97,325,325,187,311,325,171,174,325,187,125,193,214,124,175,97,322,224,166,318,121,325,199,184,190,325,231,241,186,193,213,181,177,174,325,325,174,174,325,165,182,181,243,266,266,210,174,266,163
29505,Application of long leg splint (thigh to ankle or toes),174,157,49,165,165,95,158,165,87,89,165,94,64,98,109,63,89,49,164,114,84,162,61,165,101,93,97,165,117,122,95,98,88,92,90,89,165,165,89,89,165,84,93,92,123,136,136,107,89,136,83
29515,Application of short leg splint (calf to foot),172,155,49,426,163,94,154,163,86,88,163,100,426,97,107,62,88,49,162,113,83,160,61,163,100,92,89,163,116,121,92,97,87,91,89,88,163,163,88,88,163,83,91,91,122,134,134,134,88,134,82
29530,Strapping; knee,84,76,23,80,80,46,76,80,42,43,80,23,31,47,52,30,43,24,79,55,41,78,30,80,49,45,47,80,57,59,46,47,43,45,44,43,80,80,43,43,80,41,45,44,60,65,65,52,43,65,40
29580,Strapping; Unna boot,100,90,28,445,95,55,91,95,50,51,95,62,445,56,62,445,51,28,94,66,48,93,35,95,58,54,56,95,42,70,54,56,56,53,52,51,95,95,51,51,95,48,50,50,71,78,78,50,51,78,48
29581,"Application of multi-layer venous wound compression system, below knee",258,232,73,445,245,141,235,245,129,132,245,141,445,146,161,445,132,73,243,169,125,240,91,245,150,139,144,245,174,182,140,145,144,137,134,132,245,245,132,132,245,125,217,137,183,201,201,129,132,201,123
29700,"Removal or bivalving; gauntlet, boot or body cast",240,216,68,446,228,131,218,228,120,122,228,131,446,135,150,87,123,68,226,157,116,223,85,228,140,129,134,228,162,169,130,135,121,127,125,122,228,228,122,122,228,116,128,127,170,187,187,147,122,187,114
29880,"Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)",5355,4820,1513,5087,5087,2933,4872,5087,2680,2731,5087,2785,1959,3021,3345,1936,2746,1513,5037,3512,2593,4982,1891,5087,3114,2877,2980,5087,3612,3769,2910,3020,2710,2838,2778,2731,5087,5087,2731,2731,5087,2585,2847,2833,3798,4171,4171,3288,2731,4172,2550
29881,"Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)",5355,4820,1513,5226,5087,2933,4872,5087,2680,2731,5087,2892,5226,3021,3345,1936,2746,1513,5037,3512,2593,4982,1891,5087,3114,2877,2980,5087,3612,3769,2910,3020,2999,2838,2778,2731,5087,5087,2731,2731,5087,2585,2847,2833,4172,4171,4171,4172,2731,4172,2550
30300,"Removal foreign body, intranasal; office type procedure",120,108,34,243,114,66,109,114,60,61,114,65,243,68,75,43,62,34,113,79,58,112,42,114,70,64,67,114,81,84,65,68,61,64,62,61,114,114,61,61,114,58,64,63,85,93,93,74,61,93,57
30801,"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial",3684,3316,1041,3500,3500,2018,3352,3500,1844,1879,3500,1731,1348,2078,2301,1332,1889,1041,3465,2416,1784,3428,1301,3500,2142,1979,2050,3500,2485,2593,2002,2077,1865,1953,1911,1879,3500,3500,1879,1879,3500,1778,1959,1949,2613,2870,2870,2262,1879,2870,1754
30802,"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)",4169,3752,1178,3961,3961,2283,3793,3961,2086,2126,3961,2251,1525,2352,2604,1507,2138,1178,3922,2734,2019,3879,1472,3961,2424,2240,2320,3961,2812,2934,2265,2351,2110,2210,2163,2126,3961,3961,2126,2126,3961,2013,2217,2206,2957,3248,3248,2560,2126,3248,1985
30901,"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method",162,146,46,154,154,89,147,154,81,83,154,81,59,91,101,59,83,46,152,106,78,151,57,154,94,87,90,154,109,114,88,91,59,86,84,83,154,154,83,83,154,78,86,86,115,126,126,99,83,126,77
30903,"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method",350,315,99,336,332,192,318,333,175,178,332,191,128,197,219,127,179,99,329,230,169,326,124,332,204,188,195,332,236,246,190,197,136,186,182,178,332,333,178,178,332,169,153,185,248,273,273,336,178,273,167
30905,"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial",250,225,71,238,238,137,227,238,120,128,238,125,91,141,156,90,128,71,235,164,121,233,88,238,145,134,139,238,169,176,136,141,109,132,130,128,237,238,128,127,238,121,133,132,177,195,195,140,128,195,119
31238,"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage",1,1,0,1,1,1,1,1,1,1,1,1,0,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
31500,"Intubation, endotracheal, emergency procedure",185,166,52,1679,176,99,168,176,94,94,176,75,1679,104,116,67,95,52,174,121,89,172,65,176,108,99,103,176,125,130,99,104,94,98,96,94,176,176,94,94,176,89,90,92,131,144,144,114,94,144,88
32551,"Tube thoracostomy, includes water seal (eg, for abscess, hemothorax, empyema), when performed (separate procedure)",550,495,155,523,522,301,500,523,275,280,522,300,201,310,344,199,282,155,517,361,266,512,194,522,320,295,306,522,371,387,299,310,186,292,285,280,522,523,280,280,522,266,292,291,390,428,428,338,280,428,262
32554,HC ASPIRATE PLEURA W/O IMAGING,214,193,60,203,203,117,195,203,134,109,203,117,78,121,134,77,110,60,201,140,104,199,76,203,124,115,119,203,144,151,116,121,93,113,111,109,203,203,109,109,203,103,114,113,152,167,167,131,109,167,102
32555,PR ASPIRATE PLEURA W/ IMAGING,1030,927,291,979,978,564,937,979,515,525,978,562,377,581,643,372,528,291,969,675,499,958,364,978,599,553,573,978,695,725,560,581,489,546,534,525,978,979,525,525,978,497,548,577,731,802,802,632,525,802,490
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)",153,138,9,145,145,84,139,145,9,78,145,83,56,86,96,55,78,43,144,100,74,142,54,145,89,82,85,145,103,108,83,86,78,81,79,78,145,145,78,78,145,74,81,81,109,119,119,94,78,119,73
36415,Collection of venous blood by venipuncture,28,25,3,402,27,14,27,27,14,14,27,15,15,15,17,17,14,16,27,18,13,27,10,27,15,16,15,27,28,28,15,15,14,15,16,14,27,402,14,14,27,14,16,16,22,22,22,16,14,22,3
36416,"Collection of capillary blood specimen (eg, finger, heel, ear stick)",17,15,5,16,16,9,15,16,9,9,16,9,11,10,11,12,9,5,16,11,8,16,6,16,10,9,9,16,11,12,11,10,9,9,9,9,16,16,9,9,16,8,9,9,12,13,13,13,9,13,8
36430,"Transfusion, blood or blood components",633,570,179,633,601,354,576,601,320,323,601,392,356,357,395,462,325,179,595,415,312,589,223,601,368,340,352,601,427,445,588,357,354,335,328,323,601,601,323,323,601,306,354,335,449,493,493,633,323,493,301
36556,Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older,564,508,159,600,536,309,513,536,600,288,536,308,206,318,352,204,289,159,531,370,273,525,199,536,328,303,314,536,380,397,306,318,302,299,293,288,536,536,288,288,536,272,300,298,400,439,439,346,288,439,269
36561,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older",2985,2686,843,4783,2836,1635,2716,2836,1494,1522,2836,1629,4783,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1010,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
36590,"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion",2630,2367,743,2499,2498,1440,2393,2499,1316,1341,2498,1446,962,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1331,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
36591,Collection of blood specimen from a completely implantable venous access device,205,184,58,442,195,105,186,195,103,105,195,88,427,116,128,442,105,58,193,134,98,191,72,195,119,110,114,195,138,144,113,116,115,109,106,105,195,195,105,105,195,99,115,102,145,160,160,160,105,160,98
36592,"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified",205,184,58,442,195,112,186,195,102,105,195,112,442,116,128,74,105,58,193,134,99,191,72,195,119,110,114,195,138,144,127,116,115,109,106,105,195,195,105,105,195,99,115,108,145,160,160,131,105,160,98
36593,Declotting by thrombolytic agent of implanted vascular access device or catheter,350,315,99,333,332,192,318,333,175,178,332,191,128,197,219,127,179,99,329,230,169,326,124,332,204,188,195,332,236,246,190,197,122,186,182,178,332,333,178,178,332,169,186,185,248,273,273,215,178,273,167
36600,"Arterial puncture, withdrawal of blood for diagnosis",60,54,17,57,57,32,55,57,46,31,57,33,22,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,32,34,34,32,31,31,57,57,31,31,57,29,34,34,43,47,47,34,31,47,29
38500,"Biopsy or excision of lymph node(s); open, superficial",2636,2373,745,2505,2505,1444,2399,2505,1319,1345,2505,1324,964,1487,1647,953,1352,745,2480,1729,1277,2453,931,2505,1533,1416,1467,2505,1778,1855,1433,1487,1334,1397,1368,1345,2505,2505,1345,1345,2505,1273,1402,1395,1870,2054,2054,1619,1345,2054,1255
38531,PR OPEN BX/EXC INGUINOFEM NODES,4412,3971,1247,6206,4192,2417,4014,4192,2208,2250,4192,2408,6206,2489,2756,1595,2263,1247,4151,2894,2136,4105,1558,4192,2566,2371,2455,4192,2976,3105,2398,2488,2607,2339,2289,2250,4192,4192,2250,2250,4192,2130,2346,2335,3130,3437,3437,2709,2250,3437,2101
41520,"Frenoplasty (surgical revision of frenum, eg, with Z-plasty)",2630,2367,743,2499,2498,1440,2393,2499,1316,1341,2498,1420,962,1484,1643,951,1349,743,2474,1725,1273,2447,929,2498,1529,1413,1463,2498,1774,1851,1429,1483,1331,1394,1364,1341,2498,2499,1341,1341,2498,1270,1398,1392,1865,2049,2049,1615,1341,2049,1252
42408,Excision of sublingual salivary cyst (ranula),3340,3006,944,3674,3173,1829,3039,3173,1672,1703,3173,1823,3674,1884,2086,1207,1713,944,3142,2190,1617,3108,1179,3173,1942,1794,1859,3173,2253,2351,1815,1883,1690,1770,1733,1703,3173,3173,1703,1703,3173,1612,1776,1767,2369,2602,2602,2051,1703,2602,1590
42820,Tonsillectomy and adenoidectomy; younger than age 12,2984,2686,843,3528,2835,1634,2715,2835,1494,1522,2835,1641,3528,1684,1864,1079,1531,843,2807,1957,1445,2777,1054,2835,1735,1603,1661,2835,2013,2100,1622,1683,1511,1582,1548,1522,2835,2835,1522,1522,2835,1441,1587,1579,2117,2325,2325,1832,1522,2325,1421
42826,"Tonsillectomy, primary or secondary; age 12 or over",2985,2686,843,3463,2836,1635,2716,2836,1494,1522,2836,1629,3463,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1511,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
42830,"Adenoidectomy, primary; younger than age 12",2629,2366,743,2498,2498,1440,2392,2498,1316,1341,2498,1525,1726,1483,1642,950,1348,743,2473,1724,1273,2446,928,2498,1529,1412,1463,2498,1773,1850,1429,1483,1331,1393,1364,1341,2498,2498,1341,1341,2498,1269,1398,1391,1865,2048,2048,1614,1341,2048,1252
42831,"Adenoidectomy, primary; age 12 or over",1,1,0,1,1,1,1,1,1,1,1,0,0,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
43220,"Esophagoscopy, rigid or flexible; with balloon dilation (less than 30 mm diameter)",3685,3316,1041,3501,3501,2018,3352,3501,1844,1879,3501,2011,1348,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1879,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2262,1879,2871,1754
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)",3685,3316,706,3501,3501,2018,3352,3501,1844,1879,3501,1916,1045,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,1978,2078,706,1953,1912,1879,3501,3501,1879,1879,3501,1779,1769,2234,2614,2871,2871,1861,1879,2871,1754
43239,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple",3685,3316,0,3501,3501,3501,3352,3501,1879,1879,3501,1990,1168,2079,2302,1168,0,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,1978,1,1284,1953,1912,1879,1,3501,1879,1879,3501,1779,1953,2064,2614,2871,2871,1842,1879,2871,1754
43247,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of foreign body",4170,3753,1178,3962,3962,2284,3794,3962,2087,2127,3962,2275,2058,2353,2605,1507,2138,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2266,2352,2345,2210,2163,2127,3962,3962,2127,2127,3962,2013,2217,2206,2958,3248,3248,2560,2127,3248,1985
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)",3685,3316,1,3501,3501,2018,3352,3501,1844,1879,3501,2011,2264,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2897,1,2078,1856,1953,1912,1879,3500,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2262,1879,2871,1754
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",721,649,203,2058,685,395,656,685,361,368,685,393,2058,407,450,261,370,204,678,473,349,671,255,685,419,387,401,685,486,507,392,407,203,382,374,368,685,685,368,368,685,348,383,381,511,562,562,443,368,562,343
43752,"Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)",209,188,59,199,199,114,190,199,105,107,199,114,76,118,131,76,107,59,197,137,101,194,74,199,122,112,116,199,141,147,114,118,107,111,108,107,199,199,107,107,199,101,111,111,148,163,163,128,107,163,100
43753,"Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed",155,140,44,1412,147,85,141,147,78,79,147,48,1412,87,97,56,79,44,146,102,75,144,55,147,90,83,86,147,105,109,84,87,55,82,80,79,147,147,79,79,147,75,82,82,110,121,121,95,79,121,74
44970,"Laparoscopy, surgical, appendectomy",5970,5373,1687,8659,5672,3270,5431,5672,3045,3045,5672,3701,8659,3368,3729,2158,3062,1687,5616,3915,2891,5555,2108,5672,3471,3207,3284,5672,4027,4201,3244,3367,3022,3164,3097,3045,5671,5672,3045,3045,5672,2882,4215,3159,4234,4651,4650,3665,3045,4651,2842
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)",3685,3316,1041,3501,3501,1879,3352,3501,1879,1879,3501,2284,2522,2079,2302,2522,1834,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2027,2078,1123,1953,1912,1879,3501,3501,1879,1879,3501,1779,1916,1769,2614,2871,2871,2871,1879,2871,1754
45380,"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple",3685,3316,571,3501,3501,2064,3501,3501,1879,1879,3501,2026,2490,2079,2302,2490,1834,571,3466,2417,1784,3429,1301,3501,2229,1980,2051,3501,2685,2742,2027,1989,1856,1953,1912,1879,3501,3501,1879,1879,3501,1779,1879,1964,2614,2871,2871,2074,1879,2871,1754
45382,"Colonoscopy, flexible, proximal to splenic flexure; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)",3085,2776,862,2931,2931,1690,2807,2931,1544,1573,2931,1683,1128,1741,1927,1115,1582,872,2902,2023,1494,2870,1089,2931,1794,1657,1717,2931,2081,2171,1676,1740,862,1635,1600,1573,2931,2931,1573,1573,2931,1489,1640,1632,2188,2403,2403,1894,1573,2403,1469
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",3928,3535,1110,3731,3731,2151,3573,3731,1966,2003,3731,2143,2728,2216,2453,1420,2014,1110,3694,2576,1902,3654,1387,3731,2284,2110,2185,3731,2649,2764,2134,2215,2003,2082,2038,2003,3731,3731,2003,2003,3731,1896,2088,2078,2786,3059,3059,2411,2003,3059,1870
45385,"Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",3685,3316,1041,3962,3501,2064,3501,3501,1879,1879,3501,2037,2669,2079,2302,2787,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2526,2027,2078,1856,1953,1912,1879,3962,3501,1879,1879,3501,1779,2085,2049,2614,2871,2871,2335,1879,2871,1754
45393,PR COLONOSCOPY W/DECOMPRESSION,1,1,0,1358,1,1,1,1,1,1,1,1,0,1,1,1358,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
46040,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure),5355,4820,1513,5087,5087,2933,4872,5087,2680,2731,5087,2922,4572,3021,3345,1936,2746,1513,5037,3512,2593,4982,1891,5087,3114,2877,2980,5087,3612,3769,2910,3020,2710,2838,2778,2731,5087,5087,2731,2731,5087,2585,2847,2833,3798,4171,4171,3288,2731,4172,2550
46200,"Fissurectomy, including sphincterotomy, when performed",800,720,226,760,760,438,728,760,400,408,760,437,293,451,500,289,410,226,753,525,387,744,282,760,465,430,445,760,540,563,435,451,345,424,415,408,760,760,408,408,760,386,425,423,567,623,623,491,408,623,381
46220,"Excision of single external papilla or tag, anus",1575,1418,445,1496,1496,863,1433,1496,788,803,1496,859,576,889,984,569,808,445,1482,1033,763,1465,556,1496,916,846,876,1496,1062,1108,856,888,797,835,817,803,1496,1496,803,803,1496,760,788,833,1117,1227,1227,967,803,1227,750
46250,"Hemorrhoidectomy, external, 2 or more columns/groups",2735,2462,773,2598,2598,1498,2488,2598,1369,1395,2598,1492,1000,1543,1708,989,1403,773,2573,1794,1324,2545,966,2598,1590,1469,1522,2598,1845,1925,1486,1542,1336,1450,1419,1395,2598,2598,1395,1395,2598,1320,1454,1447,1940,2131,2130,1679,1395,2131,1302
46255,"Hemorrhoidectomy, internal and external, single column/group;",3685,3316,1041,3501,3501,2018,3352,3501,1842,1879,3501,2011,1348,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1865,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2262,1879,2871,1754
46260,"Hemorrhoidectomy, internal and external, 2 or more columns/groups;",2918,2626,824,2772,2772,1598,2654,2772,1460,1488,2772,1592,1067,1646,1822,1055,1496,824,2744,1913,1413,2714,1030,2772,1696,1567,1623,2772,1968,2053,1585,1645,1352,1546,1514,1488,2772,2772,1488,1488,2772,1408,1551,1544,2069,2273,2273,1791,1488,2273,1389
46320,"Excision of thrombosed hemorrhoid, external",4412,3971,1048,4192,4192,2417,4014,4192,2208,2250,4192,2421,1614,2489,2756,1595,2263,1247,4151,2894,2136,4105,1558,4192,2566,2371,2455,4192,2976,3105,2398,2488,1048,2339,2289,2250,4192,4192,2250,2250,4192,2130,2346,2335,3130,3437,3437,2709,2250,3437,2101
46614,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)",300,270,81,285,285,164,273,285,150,153,285,81,110,169,187,108,154,85,282,197,145,279,106,285,174,161,167,285,202,211,163,169,152,159,156,153,285,285,153,153,285,145,160,159,213,234,234,184,153,234,143
46930,"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)",4170,3753,1178,3962,3962,2284,3794,3962,2087,2127,3962,2275,1525,2353,2605,1507,2138,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2266,2352,2111,2210,2163,2127,3961,3962,2127,2127,3962,2013,2217,2335,2958,3248,3248,2560,2127,3248,1985
47379,"Unlisted laparoscopic procedure, liver",1,1,0,3276,1,1,1,1,1,1,1,1,3276,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
47562,"Laparoscopy, surgical; cholecystectomy",5970,5373,1687,9523,5672,4032,5431,5672,2985,3045,5672,3492,8655,3368,3729,9523,4196,1687,5616,3915,2891,5555,2108,5672,3984,3207,3322,5672,4027,4201,3534,3367,3008,3164,3097,3045,5671,5672,3045,3045,5672,2882,2985,3159,4234,4651,4650,4651,3045,4651,2842
47563,"Laparoscopy, surgical; cholecystectomy with cholangiography",7815,7034,2208,7424,7424,4280,7110,7424,3911,3986,7424,4264,2859,4409,4882,2825,4008,2208,7351,5125,3784,7271,2759,7424,4544,4199,4349,7424,5271,5500,4246,4407,3955,4142,4054,3986,7424,7424,3986,3986,7424,3773,4155,3751,5543,6088,6088,4798,3986,6088,3721
49083,PR ABD PARACENTESIS W/IMAGING,534,481,151,1292,507,292,486,507,267,272,507,291,1292,301,334,193,274,151,502,350,259,497,189,507,311,287,297,507,360,376,290,301,269,283,277,272,507,507,272,272,507,258,267,299,379,416,416,328,272,416,254
49320,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)",6584,5926,1860,6255,6255,3606,5990,6255,3295,3358,6255,3593,2408,3715,4113,2380,3376,1860,6193,4318,3188,6126,2325,6255,3828,3537,3664,6255,4441,4634,3578,3713,3332,3490,3416,3358,6255,6255,3358,3358,6255,3178,3501,3484,4670,5129,5129,4042,3358,5129,3135
49505,"Repair initial inguinal hernia, age 5 years or older; reducible",5140,4626,1452,6755,4883,2815,4676,4883,2812,2621,4883,2805,6755,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,3317,2899,1561,2724,2667,2621,4883,4883,2621,2621,4883,2481,2700,2720,3646,4004,4004,4004,2621,4004,2447
49520,"Repair recurrent inguinal hernia, any age; reducible",5140,4626,1452,4883,4883,2815,4676,4883,2572,2621,4883,2805,1880,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,2793,2899,2878,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,4004,2621,4004,2447
49560,Repair initial incisional or ventral hernia; reducible,4654,4189,1315,8938,4421,2549,4234,4421,2329,2374,4421,2513,8938,2626,2907,1682,2387,1315,4378,3052,2253,4330,1643,4421,2706,2500,2590,4421,3139,3275,2529,2624,2355,2467,2414,2374,4421,4421,2374,2374,4421,2247,2474,2462,3301,3625,3625,3693,2374,3625,2216
49565,Repair recurrent incisional or ventral hernia; reducible,4654,4189,1315,6139,4421,2549,4234,4421,2329,2374,4421,2540,6139,2626,2907,1682,2387,1315,4378,3052,2253,4330,1643,4421,2706,2500,2590,4421,3139,3275,2529,2624,1615,2467,2414,2374,4421,4421,2374,2374,4421,2247,2474,2462,3301,3625,3625,2857,2374,3625,2216
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),4,3,1,3769,3,2,3,3,2,2,3,1,3769,2,2,1,2,1,3,2,2,3,1,3,2,2,2,3,2,2,2,2,276,2,2,2,3,3,2,2,3,2,2,2,2,3,3,2,2,3,2
49585,"Repair umbilical hernia, age 5 years or older; reducible",4655,4190,1315,6139,4422,2127,4235,4422,2330,2374,4422,2540,6139,2626,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2607,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2871,2374,3626,2216
49587,"Repair umbilical hernia, age 5 years or older; incarcerated or strangulated",4655,4190,1315,6149,4422,2549,4235,4422,2330,2374,4422,2540,6149,2626,2908,6149,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2356,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2858,2374,3626,2216
49650,"Laparoscopy, surgical; repair initial inguinal hernia",7200,6480,2034,9107,6840,3943,6550,6840,3456,3672,6840,3929,9107,4062,4497,2603,3692,2034,6773,4722,4046,6699,2542,6840,4187,3868,4006,6840,4857,5067,3912,4060,3417,3816,3735,3672,6840,6840,3672,3672,6840,3476,3828,3810,5107,5609,5609,4421,3672,5609,3428
49652,"Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible",933,840,264,4554,886,511,849,886,467,476,886,509,4554,526,583,337,478,264,878,612,452,868,329,886,543,501,519,886,629,657,507,526,771,494,484,476,886,886,476,476,886,450,496,494,662,727,727,573,476,727,444
50590,"Lithotripsy, extracorporeal shock wave",6500,5850,1837,7797,6175,3560,5913,6175,3253,3315,6175,3547,7797,3667,4060,2350,3333,1837,6114,4263,3147,6048,2295,6175,3780,3492,3617,6175,4384,4574,3532,3665,3640,3445,3372,3315,6175,6175,3315,3315,6175,3138,3456,6850,4610,5063,5063,4378,3315,5063,3095
51102,Aspiration of bladder; with insertion of suprapubic catheter,3685,3316,1041,3501,3501,2018,3352,3501,1844,1879,3501,2011,1348,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1865,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2064,1879,2871,1754
51600,Injection procedure for cystography or voiding urethrocystography,126,113,36,1000,120,69,115,120,63,64,120,69,1000,71,79,46,65,36,119,83,61,117,44,120,73,68,70,120,85,89,68,71,64,67,65,64,120,120,64,64,120,61,63,67,89,98,98,77,64,98,60
51610,Injection procedure for retrograde urethrocystography,1,1,0,1,1,1,1,1,1,1,1,1,0,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
51700,"Bladder irrigation, simple, lavage and/or instillation",100,90,28,95,95,55,91,95,50,51,95,55,37,56,62,36,51,28,94,66,48,93,35,95,58,54,56,95,67,70,54,56,56,53,52,51,95,95,51,51,95,48,53,53,71,78,78,64,51,78,48
51701,"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)",116,104,25,110,110,25,106,110,25,59,110,58,42,64,72,42,59,33,109,76,56,108,41,110,67,62,65,110,78,82,34,65,58,61,60,59,110,110,59,59,110,56,65,65,82,90,90,65,59,90,55
51702,"Insertion of temporary indwelling bladder catheter; simple (eg, Foley)",116,104,26,376,110,59,106,110,26,59,110,64,376,65,72,42,59,33,109,76,56,108,41,110,67,62,65,110,78,82,64,65,58,61,60,59,110,110,59,59,110,56,59,65,82,90,90,58,59,90,55
51705,Change of cystostomy tube; simple,225,202,64,564,214,123,205,214,113,115,214,123,564,127,141,81,115,64,212,148,109,209,79,214,131,121,125,214,152,158,122,127,126,119,117,115,214,214,115,115,214,109,120,119,160,175,175,138,115,175,107
51720,Bladder instillation of anticarcinogenic agent (including retention time),200,180,57,190,190,110,182,190,100,102,190,109,73,113,125,72,103,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,112,106,104,102,190,190,102,102,190,97,106,106,142,156,156,123,102,156,95
51798,"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging",103,93,29,98,98,53,94,98,53,53,98,64,38,57,64,37,53,29,97,68,50,96,36,98,60,55,57,98,69,72,57,58,58,55,53,53,98,98,53,53,98,50,58,49,73,80,80,58,53,80,49
52000,Cystourethroscopy (separate procedure),225,202,64,2463,214,1390,205,214,822,115,214,1507,2463,127,141,2256,115,64,212,148,109,209,79,214,131,121,125,214,152,158,121,127,126,119,117,115,214,214,115,115,214,109,308,1680,160,175,175,126,115,175,107
52001,Cystourethroscopy with irrigation and evacuation of multiple obstructing clots,5625,5062,1589,5344,5344,3081,5117,5344,2815,2869,5344,3069,2058,3174,3514,2033,2885,1589,5291,3689,2724,5234,1986,5344,3271,3022,3130,5344,3794,3959,3056,3172,2847,2981,2918,2869,5344,5344,2869,2869,5344,2715,2991,2976,3990,4382,4382,2812,2869,4382,2678
52204,"Cystourethroscopy, with biopsy(s)",225,202,64,2285,214,123,205,214,113,115,214,2285,82,127,141,81,115,64,212,148,109,209,79,214,131,121,125,214,152,158,122,127,114,119,117,115,214,214,115,115,214,109,126,119,160,175,175,126,115,175,107
52240,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s)",5970,5373,1687,5672,5672,3270,5431,5672,2988,3045,5672,3258,2184,3368,3729,2158,3062,1687,5616,3915,2891,5555,2108,5672,3471,3207,3322,5672,4027,4201,3244,3367,3045,3164,3097,3045,5671,5672,3045,3045,5672,2882,3174,3159,4234,4651,4650,3665,3045,4651,2842
52281,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female",3685,3316,1041,3501,3501,2018,3352,3501,1844,1879,3501,2011,2463,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1865,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2064,1879,2871,1754
52287,PR CYSTOSCOPY CHEMODENERVATION,4170,3753,783,3962,3962,2284,3794,3962,2087,2127,3962,2275,1525,2353,2605,1507,2138,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2266,2352,783,2210,2163,2127,3961,3962,2127,2127,3962,2013,2217,2206,2958,3248,3248,2335,2127,3248,1985
52310,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple",3685,3316,1003,3501,3501,2018,3352,3501,1844,1879,3501,2011,2413,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1003,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2262,1879,2871,1754
52318,Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm),4655,4190,1315,4422,4422,2549,4235,4422,2330,2374,4422,2540,1703,2626,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2607,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2858,2374,3626,2216
52332,"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)",5140,4626,1,4883,4883,2815,4676,4883,2572,2621,4883,2805,1327,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,4329,2899,2860,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,1,2621,4004,2447
52344,"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)",7480,6732,2113,7106,7106,4096,6805,7106,3743,3815,7106,4082,2736,4220,4672,2704,3836,2113,7036,4905,3622,6960,2641,7106,4349,4019,4162,7106,5045,5264,4064,4218,3786,3964,3881,3815,7106,7106,3815,3815,7106,3611,3977,3958,5305,5827,5827,3740,3815,5827,3561
52351,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic",4,3,1,1356,3,2,3,3,2,2,3,2,1356,2,2,1,2,1,3,2,2,3,1,3,2,2,2,3,2,2,1,2,2,2,2,2,3,3,2,2,3,2,2,2,2,3,3,2,2,3,2
52353,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)",4655,4190,1315,6838,4422,2549,4235,4422,2330,2374,4422,2540,6838,2626,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2356,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2858,2374,3626,2216
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)",7200,6480,2034,6840,6840,3943,6550,6840,3908,3672,6840,3929,2634,4062,4497,2603,3692,2034,6773,4722,3486,6699,2542,6840,4187,3868,4006,6840,4857,5067,3912,4060,3644,3816,3735,3672,6840,6840,3672,3672,6840,3476,3828,3810,5107,5609,5609,4032,3672,5609,3428
54161,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age",3340,3006,944,3173,3173,1829,3039,3173,1672,1703,3173,1823,1222,1884,2086,1207,1713,944,3142,2190,1617,3108,1179,3173,1942,1794,1859,3173,2253,2351,1815,1883,1870,1770,1733,1703,3173,3173,1703,1703,3173,1612,1776,1767,2369,2602,2602,2051,1703,2602,1590
54405,"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir",6110,5499,1726,33568,5804,3346,5559,5805,3058,3116,5804,3334,33568,3447,3817,2209,3133,1726,5747,4007,2958,5685,2157,5804,3553,3283,3400,5804,4121,4300,3320,3446,3092,3238,3170,3116,5804,5805,3116,3116,5804,2950,3249,3233,4334,4760,4760,3751,3116,4760,2909
54520,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach",4045,3640,1143,3843,3843,2215,3680,3843,2024,2063,3843,2207,3180,2282,2527,1462,2074,1143,3805,2653,1959,3764,1428,3843,2352,2173,2251,3843,2728,2847,2198,2281,2047,2144,2099,2063,3843,3843,2063,2063,3843,1953,2151,2140,2869,3151,3151,2484,2063,3151,1926
55040,Excision of hydrocele; unilateral,3695,3326,1044,3510,3510,2024,3362,3510,1849,1884,3510,2016,1352,2085,2308,1336,1895,1044,3476,2423,1789,3438,1305,3510,2149,1985,2056,3510,2492,2600,2008,2084,2069,1958,1917,1884,3510,3510,1884,1884,3510,1784,1965,1955,2621,2878,2878,2269,1884,2878,1759
55250,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)",1672,1505,473,2409,1589,916,1522,1589,837,853,1589,913,2409,944,1045,605,858,473,1573,1097,810,1556,591,1589,973,899,931,1589,1128,1177,909,943,846,886,868,853,1589,1589,853,853,1589,807,889,885,1186,1303,1303,1027,853,1303,796
55700,"Biopsy, prostate; needle or punch, single or multiple, any approach",1575,1418,445,3331,1496,863,1433,1496,788,803,1496,859,3331,889,984,569,808,445,1482,1033,763,1465,556,1496,916,846,876,1496,1062,1108,856,888,878,835,817,803,1496,1496,803,803,1496,760,837,833,1117,1227,1227,882,803,1227,750
56405,Incision and drainage of vulva or perineal abscess,201,181,57,191,191,110,183,191,101,103,191,110,74,113,126,73,103,57,189,132,97,187,71,191,117,108,112,191,136,141,109,113,102,107,104,103,191,191,103,103,191,97,107,106,143,157,157,157,103,157,96
57288,"Sling operation for stress incontinence (eg, fascia or synthetic)",5140,4626,1452,4883,4883,2815,4676,4883,2572,2621,4883,2805,1880,2900,3211,1858,2636,1452,4835,3371,2489,4782,1815,4883,2989,2762,2860,4883,3467,3617,2793,2899,2621,2724,2667,2621,4883,4883,2621,2621,4883,2481,2733,2720,3646,4004,4004,3156,2621,4004,2447
57520,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser",4655,4190,1315,4422,4422,2549,4235,4422,2330,2374,4422,2540,1703,2626,2908,1683,2387,1315,4379,3053,2254,4331,1644,4422,2707,2501,2590,4422,3140,3276,2529,2625,2356,2467,2415,2374,4422,4422,2374,2374,4422,2247,2475,2463,3302,3626,3626,2858,2374,3626,2216
58300,Insertion of intrauterine device (IUD),1,1,0,1,1,1,1,1,1,1,1,1,0,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
58350,"Chromotubation of oviduct, including materials",1,1,0,1,1,1,1,1,1,1,1,1,0,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
58353,"Endometrial ablation, thermal, without hysteroscopic guidance",4170,3753,1178,5513,3962,2284,3794,3962,2087,2127,3962,2275,5513,2353,2605,1507,2138,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2266,2352,2111,2210,2163,2127,3961,3962,2127,2127,3962,2013,2217,2206,2958,3248,3248,2560,2127,3248,1985
58558,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",3685,3316,1041,3501,3501,2018,3352,3501,1844,1879,3501,2293,1348,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1856,1953,1912,1879,3501,3501,1879,1879,3501,1779,1959,1950,2614,2871,2871,2262,1879,2871,1754
58563,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)",4412,3971,1247,5216,4191,2416,4014,4191,2208,2250,4191,2408,5216,2489,2756,1595,2263,1247,4150,2893,2136,4105,1558,4191,2565,2370,2455,4191,2976,3105,2397,2488,2233,2338,2289,2250,4191,4191,2250,2250,4191,2130,2346,2334,3129,3437,3437,2709,2250,3437,2101
58600,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral",5662,5096,1600,5379,5379,3101,5151,5379,2834,2888,5379,3653,2071,3195,3537,2047,2904,1600,5326,3714,2742,5268,1999,5379,3293,3042,3151,5379,3819,3985,2910,3193,2866,3001,2938,2888,5379,5379,2888,2888,5379,2734,3011,2996,4016,4411,4411,3477,2888,4411,2696
58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",5970,5373,1687,8297,5672,3270,5431,5672,2988,3045,5672,3701,8297,3368,3729,2158,3062,1687,5616,3915,2891,5555,2108,5672,3471,3207,3322,5672,4027,4201,3244,3367,3022,3164,3097,3045,5671,5672,3045,3045,5672,2882,3174,3159,4234,4651,4650,3665,3045,4651,2842
58662,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method",3600,3240,1017,7917,3420,1972,3276,3420,1802,1836,3420,1965,7917,2031,2249,1302,1846,1017,3387,2361,1743,3350,1271,3420,2094,1934,2003,3420,2429,2534,1956,2030,3672,1908,1868,1836,3420,3420,1836,1836,3420,1738,1914,1905,2554,2805,2805,2211,1836,2805,1714
59025,Fetal non-stress test,296,266,84,493,281,162,269,281,148,151,281,163,473,167,185,493,152,84,278,194,143,275,105,281,172,159,165,281,200,208,163,167,150,157,154,151,281,281,151,151,281,143,157,157,210,231,231,182,151,231,141
59409,Vaginal delivery only (with or without episiotomy and/or forceps);,1800,1620,486,1710,1710,986,1638,1710,901,918,1710,486,658,1016,1124,651,923,509,1693,1180,872,1675,636,1710,1047,967,1002,1710,1214,1267,978,1015,911,954,934,918,1710,1710,918,918,1710,869,957,952,1277,1402,1402,1105,918,1402,857
59812,"Treatment of incomplete abortion, any trimester, completed surgically",950,855,268,2963,902,520,864,903,475,484,902,518,2963,536,593,343,487,268,894,623,460,884,335,902,552,510,529,902,641,669,516,536,481,504,493,484,902,903,484,484,902,459,505,503,674,740,740,583,484,740,452
62270,"Spinal puncture, lumbar, diagnostic",550,495,155,1533,522,301,500,523,275,280,522,300,1533,310,344,199,282,155,517,361,266,512,194,522,320,295,306,522,371,387,299,310,261,292,285,280,522,523,280,280,522,266,292,291,390,428,428,338,280,428,262
62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,1575,1418,433,1617,1496,803,1433,1496,788,803,1496,858,1617,889,984,569,753,445,1482,1033,433,1465,556,1496,916,846,876,1496,1062,1108,856,888,732,835,817,803,1496,1496,803,803,1496,760,803,1300,1227,1227,1227,843,803,1227,750
64425,"Injection, anesthetic agent; ilioinguinal, iliohypogastric nerves",701,631,198,666,666,384,638,666,351,358,666,383,256,395,438,253,359,198,659,460,339,652,248,666,408,377,390,666,473,493,381,395,353,372,364,358,666,666,358,358,666,338,373,371,497,546,546,430,358,546,334
64445,"Injection, anesthetic agent; sciatic nerve, single",975,878,275,926,926,534,887,926,488,497,926,532,357,550,609,352,500,275,917,639,472,907,344,926,567,524,543,926,658,686,530,550,463,517,506,497,926,926,497,497,926,471,518,516,692,760,759,599,497,760,464
64447,"Injection, anesthetic agent; femoral nerve, single",838,754,237,796,796,459,762,796,419,427,796,457,307,473,523,303,430,237,788,550,406,780,296,796,487,450,466,796,565,590,455,473,442,444,435,427,796,796,427,427,796,405,446,443,594,653,653,515,427,653,399
64450,"Injection, anesthetic agent; other peripheral nerve or branch",350,315,99,637,332,192,318,333,175,178,332,191,637,197,219,127,179,99,329,230,169,326,124,332,204,188,195,332,236,246,190,197,177,186,182,178,332,333,178,178,332,169,186,185,248,273,273,215,178,273,167
64486,PR TAP BLOCK UNIL BY INJ,717,645,203,681,681,393,652,681,359,366,681,391,262,405,448,259,368,203,674,470,347,667,253,681,417,385,399,681,484,505,390,404,361,380,372,366,681,681,366,366,681,346,381,379,509,559,559,440,366,559,341
64520,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)",2808,2527,793,2668,2668,1538,2555,2668,1405,1432,2668,2274,1027,1584,1754,1015,1440,793,2641,1842,1360,2613,991,2668,1633,1509,1562,2668,1894,1976,1526,1583,1421,1488,1457,1432,2668,2668,1432,1432,2668,1356,1493,1486,1992,2187,2187,1724,1432,2187,1337
64644,PR CHEMODENERV 1 EXTREM 5/> MUS,500,450,130,475,475,274,455,475,250,255,475,273,183,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,272,282,130,265,259,255,475,475,255,255,475,241,266,265,355,389,389,307,255,389,238
64645,PR CHEMODENERV 1 EXTREM 5/> EA,600,540,169,570,570,329,546,570,300,306,570,327,219,339,375,217,308,170,564,393,291,558,212,570,349,322,334,570,405,422,326,338,169,318,311,306,570,570,306,306,570,290,319,317,426,467,467,368,306,467,286
64718,Neuroplasty and/or transposition; ulnar nerve at elbow,5139,4625,1452,4882,4882,2878,4675,4882,2572,2621,4882,2804,3472,2899,3210,1858,2635,1452,4834,3370,2488,4781,1814,4882,2988,2761,2860,4882,3466,3617,2758,2898,2230,2724,2666,2621,4882,4882,2621,2621,4882,2481,2732,2719,3645,4003,4003,3155,2621,4003,2447
64721,Neuroplasty and/or transposition; median nerve at carpal tunnel,4170,3753,1178,3962,3962,2064,3794,3962,2106,2127,3962,2252,3272,2353,2605,2787,2076,1178,3923,2735,2019,3880,1472,3962,2425,2240,2320,3962,2813,2935,2238,2352,2127,2210,2163,2127,3961,3962,2127,2127,3962,2013,2335,1842,2958,3248,3248,1842,2127,3248,1985
64727,"Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis)",1,1,0,9734,1,1,1,1,1,1,1,0,9734,1,1,1394,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
64782,"Excision of neuroma; hand or foot, except digital nerve",3340,3006,944,3272,3173,1829,3039,3173,1672,1703,3173,1823,3272,1884,2086,1207,1713,944,3142,2190,1617,3108,1179,3173,1942,1794,1859,3173,2253,2351,1815,1883,1690,1770,1733,1703,3173,3173,1703,1703,3173,1612,1776,1767,2369,2602,2602,2051,1703,2602,1590
64788,Excision of neurofibroma or neurolemmoma; cutaneous nerve,3512,3161,992,3337,3337,1924,3195,3337,1758,1791,3337,1917,1285,1982,2194,1270,1801,992,3304,2304,1701,3268,1240,3337,2042,1887,1955,3337,2369,2472,1909,1981,1703,1862,1822,1791,3337,3337,1791,1791,3337,1696,1769,1859,2491,2736,2736,2157,1791,2736,1672
65205,"Removal of foreign body, external eye; conjunctival superficial",117,105,33,111,111,64,106,111,59,60,111,64,43,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,64,66,53,62,61,60,111,111,60,60,111,56,62,62,83,91,91,72,60,91,56
65220,"Removal of foreign body, external eye; corneal, without slit lamp",126,113,36,120,120,69,115,120,63,64,120,57,46,71,79,46,65,36,119,83,61,117,44,120,73,68,70,120,85,89,68,71,64,67,65,64,120,120,64,64,120,61,67,67,89,98,98,77,64,98,60
65222,"Removal of foreign body, external eye; corneal, with slit lamp",600,540,170,570,570,329,546,570,300,306,570,348,219,339,375,217,308,170,564,393,291,558,212,570,349,322,334,570,405,422,322,338,304,318,311,306,570,570,306,306,570,290,319,317,426,467,467,368,306,467,286
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",3685,3316,1041,4180,3501,1842,3352,3501,1842,1879,3501,2285,4180,2079,2302,1762,1890,1041,3466,2871,1784,3429,1301,3501,2143,1980,2051,3501,3600,2593,2002,2078,2064,1953,1912,1879,3501,3501,1879,1879,3501,1779,1769,1879,2614,2871,2871,2064,1879,2871,1754
66984,"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification)",3685,3316,1041,4640,3501,2064,3501,3501,1879,1879,3501,2027,4180,2079,2302,4640,1890,1041,3466,2417,1769,3429,1301,3501,2045,1980,2051,3501,3274,3323,2027,2078,1856,1953,1912,1879,3501,3501,1879,1879,3501,1769,1971,1879,2871,2871,2871,2064,1879,2871,1754
67700,"Blepharotomy, drainage of abscess, eyelid",300,270,81,285,285,164,273,285,150,153,285,81,110,169,187,108,154,85,282,197,145,279,106,285,174,161,167,285,202,211,163,169,152,159,156,153,285,285,153,153,285,145,160,159,213,234,234,184,153,234,143
69145,"Excision soft tissue lesion, external auditory canal",2985,2686,843,2836,2836,1635,2716,2836,1494,1522,2836,1629,2576,1684,1865,1079,1531,843,2808,1958,1445,2777,1054,2836,1736,1604,1661,2836,2013,2101,1622,1683,1511,1582,1549,1522,2836,2836,1522,1522,2836,1441,1587,1579,2117,2325,2325,1833,1522,2325,1421
69200,Removal foreign body from external auditory canal; without general anesthesia,150,135,42,260,142,84,136,143,75,76,142,82,260,85,94,54,77,42,141,98,73,140,53,142,87,81,83,142,101,106,93,85,76,80,78,76,142,143,76,76,142,72,80,79,106,117,117,92,76,117,71
69210,"Removal impacted cerumen (separate procedure), 1 or both ears",140,126,40,133,133,77,127,133,70,71,133,87,51,79,87,51,72,40,132,92,68,130,49,133,81,75,78,133,94,99,76,79,56,74,73,71,133,133,71,71,133,68,74,74,99,109,109,86,71,109,67
69436,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia",2629,2366,743,3864,2498,1440,2392,2498,1316,1341,2498,2445,3864,1483,1642,950,1348,743,2473,1724,1273,2446,928,2498,1529,1412,1463,2498,1773,1850,1429,1483,1331,1393,1364,1341,2498,2498,1341,1341,2498,1269,1398,1391,1865,2048,2048,1614,1341,2048,1252
70030,"Radiologic examination, eye, for detection of foreign body",131,118,37,124,124,72,119,124,66,67,124,72,60,74,82,47,67,37,123,86,63,63,46,124,76,70,73,124,88,92,81,74,70,69,68,67,124,124,67,67,124,63,63,69,93,102,102,66,67,102,62
70110,"Radiologic examination, mandible; complete, minimum of 4 views",300,270,59,285,285,164,273,285,150,153,285,81,59,169,187,108,154,85,282,197,145,279,106,285,174,161,167,285,202,211,163,169,152,159,156,153,285,285,153,153,285,145,160,159,213,234,234,184,153,234,143
70140,"Radiologic examination, facial bones; less than 3 views",162,146,46,154,154,89,147,154,81,83,154,89,59,91,101,59,83,46,152,106,78,151,57,154,94,87,90,154,109,114,88,91,82,86,84,83,154,154,83,83,154,78,86,86,115,126,126,91,83,126,77
70150,"Radiologic examination, facial bones; complete, minimum of 3 views",255,230,59,242,242,140,232,242,128,130,242,108,59,144,159,92,131,72,240,167,123,237,90,242,148,137,142,242,172,179,104,138,128,135,132,130,242,242,130,130,242,123,136,135,181,199,199,157,130,199,121
70160,"Radiologic examination, nasal bones, complete, minimum of 3 views",200,180,57,190,190,110,182,190,100,102,190,108,69,113,125,72,103,57,188,131,97,186,71,190,116,107,111,190,135,141,124,113,70,106,104,102,190,190,102,102,190,97,106,106,142,156,156,128,102,156,95
70210,"Radiologic examination, sinuses, paranasal, less than 3 views",130,117,37,124,124,71,118,124,65,66,124,71,48,73,81,47,67,37,122,85,63,121,46,124,76,70,72,124,88,91,71,73,66,69,67,66,123,124,66,66,124,63,65,69,92,101,101,80,66,101,62
70220,"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views",271,244,77,257,257,148,247,257,136,138,257,84,99,153,169,98,139,77,255,178,131,252,96,257,158,146,151,257,183,191,147,153,137,144,141,138,257,257,138,138,257,131,144,143,192,211,211,166,138,211,129
70250,"Radiologic examination, skull; less than 4 views",192,173,54,182,182,105,175,182,96,98,182,106,65,108,120,69,98,54,181,126,93,179,68,182,112,103,107,182,130,135,104,108,97,102,100,98,182,182,98,98,182,93,102,102,136,150,150,118,98,150,91
70330,"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral",400,360,60,380,380,219,364,380,200,204,380,216,60,226,250,145,205,113,376,262,194,372,141,380,233,215,223,380,270,282,217,226,190,212,208,204,380,380,204,204,380,193,213,212,284,312,312,246,204,312,190
70360,"Radiologic examination; neck, soft tissue",168,151,45,160,160,92,153,160,84,86,160,92,60,95,105,61,86,47,160,110,81,156,59,160,98,90,93,160,113,118,45,95,85,89,87,86,160,160,86,86,160,81,89,89,119,131,131,131,86,131,80
70450,"Computed tomography, head or brain; without contrast material",1580,1422,107,1501,1501,806,1501,1501,790,806,1501,853,993,891,987,999,755,107,1501,1036,758,1470,558,1501,956,849,956,1501,793,626,869,980,806,837,790,806,1501,1501,806,806,1501,790,806,885,1121,1231,1231,885,806,1231,752
70460,"Computed tomography, head or brain; with contrast material(s)",1700,1530,480,1615,1615,931,1547,1615,851,867,1615,928,622,959,1062,615,872,480,1599,1115,823,1582,600,1615,988,913,946,1615,1147,1196,912,959,592,901,882,867,1615,1615,867,867,1615,821,904,899,1206,1324,1324,1044,867,1324,809
70470,"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections",2000,1800,565,1900,1900,1020,1819,1900,1001,1020,1900,1080,993,1128,1249,723,956,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,1036,1128,1120,1060,1038,1020,1900,1900,1020,1020,1900,966,1020,1058,1419,1558,1558,1228,1020,1558,952
70480,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material",1450,1305,410,1378,1378,794,1319,1378,726,740,1378,791,436,818,906,524,744,410,1364,951,702,1349,512,1378,843,779,807,1378,978,1020,788,818,807,768,752,740,1377,1378,740,739,1378,700,771,767,1028,1130,1130,890,740,1130,690
70481,"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)",1700,1530,480,1615,1615,931,1547,1615,851,867,1615,928,622,959,1062,615,872,480,1599,1115,823,1582,600,1615,988,913,946,1615,1147,1196,924,959,952,901,882,867,1615,1615,867,867,1615,821,904,899,1206,1324,1324,1044,867,1324,809
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",1880,1692,531,1786,1786,1030,1710,1786,941,959,1786,1026,688,1061,1174,680,964,531,1768,1233,910,1749,664,1786,1093,1010,1046,1786,1268,1323,1022,1060,1053,996,975,959,1786,1786,959,959,1786,908,1000,995,1333,1464,1464,1154,959,1465,895
70486,"Computed tomography, maxillofacial area; without contrast material",1800,1620,424,1710,1710,1008,1638,1710,900,918,1710,981,424,1016,1124,651,923,509,1693,1180,872,1675,636,1710,1047,967,990,1710,1214,563,1112,1015,963,954,934,918,1710,1710,918,918,1710,900,900,900,900,1402,1402,1008,918,1402,857
70487,"Computed tomography, maxillofacial area; with contrast material(s)",2000,1800,550,1900,1900,1095,1819,1900,1001,1020,1900,550,732,1128,1249,1146,1026,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,1073,1128,949,1060,1038,1020,1900,1900,1020,1020,1900,966,1063,1058,1419,1558,1558,1120,1020,1558,952
70488,"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections",1880,1692,531,1786,1786,1786,1710,1786,941,959,1786,1026,688,1061,1174,680,964,531,1768,1233,910,1749,664,1786,1093,1010,1046,1786,1268,1323,1007,1060,959,996,975,959,1786,1786,959,959,1786,908,1000,995,1333,1464,1464,1154,959,1465,895
70490,"Computed tomography, soft tissue neck; without contrast material",1500,1350,403,1425,1425,821,1365,1425,751,765,1425,668,480,846,937,542,769,424,1411,984,726,1396,530,1425,872,806,835,1425,1012,1056,403,846,756,795,778,765,1425,1425,765,765,1425,724,750,794,750,1168,1168,1004,765,1168,714
70491,"Computed tomography, soft tissue neck; with contrast material(s)",1700,1530,392,1615,1615,931,850,1615,851,867,1615,918,1042,959,1062,392,872,480,1599,1115,823,1582,600,1615,988,913,946,1615,1147,1196,527,959,952,901,882,867,1615,1615,867,867,1615,821,850,899,1206,1324,1324,910,867,1324,809
70492,"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections",1800,1620,509,1710,1710,1008,1638,1710,901,918,1710,982,1042,1016,1124,651,923,509,1693,1180,872,1675,636,1710,1047,967,1002,1710,1214,1267,978,1015,918,954,934,918,1710,1710,918,918,1710,869,957,952,1277,1402,1402,900,918,1402,857
70496,"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2400,2160,678,2280,2280,1314,2183,2280,1201,1224,2280,1308,762,1354,1499,868,1148,678,2258,1574,1162,2233,847,2280,1396,1289,1335,2280,1619,1689,1320,1353,1344,1272,1245,1224,2280,2280,1224,1224,2280,1159,1344,1270,1702,1870,1870,1344,1224,1870,1143
70498,"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2200,1980,368,2090,2090,1205,2001,2090,1101,1122,2090,1199,368,1241,1374,795,1052,622,2069,1443,1065,2047,777,2090,1279,1182,1224,2090,1484,1548,1195,1241,1232,1166,1141,1122,2090,2090,1122,1122,2090,1062,1232,1164,1560,1714,1714,1232,1122,1714,1047
70540,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)",2300,2070,650,2185,2185,1260,2092,2185,1151,1173,2185,1255,841,1298,1437,831,1179,650,2164,1508,1114,2140,812,2185,1337,1236,1280,2185,1551,1619,1426,1297,1164,1219,1193,1173,2185,2185,1173,1173,2185,1110,1223,1217,1631,1792,1792,1412,1173,1792,1095
70542,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)",2400,2160,678,2280,2280,1314,2183,2280,1201,1224,2280,1296,878,1354,1499,868,1231,678,2258,1574,1162,2233,847,2280,1396,1289,1335,2280,1619,1689,1304,1353,1215,1272,1245,1224,2280,2280,1224,1224,2280,1159,1276,1270,1702,1870,1870,1474,1224,1870,1143
70543,"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences",3361,3025,950,3193,3193,1841,3058,3193,1682,1714,3193,1815,1229,1896,2099,1215,1724,950,3162,2204,1627,3127,1187,3193,1954,1806,1870,3193,2267,2365,1826,1895,1701,1781,1744,1714,3193,3193,1714,1714,3193,1623,1787,1778,2384,2618,2618,2064,1714,2618,1600
70544,"Magnetic resonance angiography, head; without contrast material(s)",2300,2070,650,2185,2185,1260,2092,2185,1173,1173,2185,1426,803,1298,1437,831,1179,650,2164,1508,1114,2140,812,2185,1337,1236,1280,2185,1551,1619,1265,1297,802,1219,1193,1173,2185,2185,1173,1173,2185,1110,1288,1217,1631,1792,1792,1412,1173,1792,1095
70547,"Magnetic resonance angiography, neck; without contrast material(s)",2000,1800,565,1900,1900,1095,1819,1900,1001,1020,1900,1091,732,1128,1249,723,1026,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,1087,1128,697,1060,1038,1020,1900,1900,1020,1020,1900,966,1063,1058,1419,1558,1558,1228,1020,1558,952
70549,"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences",3300,2970,932,3135,3135,1807,3002,3135,1683,1683,3135,1801,1207,1862,2061,1193,1692,932,3104,2164,1598,3070,1165,3135,1919,1773,1836,3135,2226,2322,1793,1861,1670,1749,1712,1683,3135,3135,1683,1683,3135,1593,1755,1746,2341,2571,2571,2026,1683,2571,1571
70551,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material",2500,2250,706,2375,2375,1369,2274,2375,1250,1275,2375,1375,891,1410,1562,1082,1388,706,2352,1640,1210,2326,883,2375,1454,1343,1391,2375,1686,1759,1462,1410,1260,1325,1297,1275,2375,2375,1275,1275,2375,1207,1400,1400,1773,1947,1947,1250,1275,1947,1190
70552,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)",2650,2385,749,2518,2518,1451,2411,2518,1326,1352,2518,1446,1357,1495,1655,958,1359,749,2493,1738,1283,2466,936,2518,1541,1424,1475,2518,1787,1865,1422,1494,1204,1404,1375,1352,2517,2518,1352,1351,2518,1279,1409,1402,1880,2064,2064,2064,1352,2064,1262
70553,"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences",4000,3600,1130,4083,3800,2191,3639,3800,2020,2040,3800,2200,1232,2257,2499,1357,2051,1130,3763,2623,1937,3722,1412,3800,2326,2149,2226,3800,2698,2815,2200,2256,2140,2120,2075,2040,3800,4083,2040,2040,3800,1931,2000,2040,2837,3116,3116,2240,2040,3116,1904
71045,PR X-RAY EXAM CHEST 1 VIEW,156,140,22,153,148,80,142,148,80,80,148,86,80,86,97,22,87,44,147,102,75,145,55,148,94,84,86,148,105,153,86,91,87,83,81,80,148,148,80,80,148,75,87,87,111,122,122,87,80,122,74
71046,PR X-RAY EXAM CHEST 2 VIEWS,212,191,30,201,201,108,108,201,108,108,201,117,65,118,132,65,118,30,201,139,102,197,75,201,117,119,117,201,143,106,117,131,119,112,110,108,201,201,108,108,201,102,119,119,165,165,165,119,108,165,108
71048,PR X-RAY EXAM CHEST 4+ VIEWS,400,360,113,380,380,219,364,380,200,204,380,222,146,226,250,145,205,113,376,262,194,372,141,380,233,215,223,380,270,282,217,226,202,212,208,204,380,380,204,204,380,193,213,212,284,312,312,246,204,312,190
71100,"Radiologic examination, ribs, unilateral; 2 views",246,221,33,234,234,138,224,234,123,125,234,135,60,139,154,73,126,33,231,161,119,229,87,234,143,132,137,234,166,173,132,139,138,130,128,125,234,234,125,125,234,119,123,130,174,192,192,138,125,192,117
71101,"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views",252,227,68,239,239,129,121,239,127,129,239,156,73,142,157,68,129,71,237,165,122,234,89,239,147,135,140,239,129,177,137,142,134,134,131,129,239,239,129,129,239,122,129,133,179,196,196,161,129,196,120
71110,"Radiologic examination, ribs, bilateral; 3 views",252,227,68,239,239,126,229,239,126,129,239,68,69,142,157,91,129,71,239,165,122,234,89,239,147,135,140,239,170,177,137,142,141,134,131,129,239,239,129,129,239,122,123,133,179,196,196,155,129,196,120
71111,"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views",283,255,48,269,269,155,257,269,142,144,269,153,104,160,177,102,145,48,266,186,137,263,100,269,165,152,157,269,191,199,154,160,151,150,147,144,269,269,144,144,269,137,150,150,201,220,220,174,144,220,135
71120,"Radiologic examination; sternum, minimum of 2 views",212,191,60,201,201,116,193,201,106,108,201,117,81,120,132,77,109,60,199,139,103,197,75,201,123,114,118,201,143,149,115,120,119,112,110,108,201,201,108,108,201,102,113,112,150,165,165,130,108,165,101
71130,"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views",170,153,48,162,162,93,155,162,85,87,162,94,62,96,106,61,87,48,160,111,82,158,60,162,99,91,95,162,115,120,92,96,86,90,88,87,161,162,87,87,162,82,90,90,121,132,132,104,87,132,81
71250,"Computed tomography, thorax; without contrast material",1800,1620,370,1710,1710,1008,1638,1710,918,918,1710,1053,424,1016,1124,370,896,509,1693,1180,872,1675,636,1710,1047,967,990,1710,1214,868,1116,972,918,954,934,918,1710,1710,918,918,1710,869,1008,900,1277,1402,1402,1008,918,1402,857
71260,"Computed tomography, thorax; with contrast material(s)",2000,1800,496,4120,1900,1095,1819,1900,1000,1020,1900,1080,953,1128,1249,496,1026,565,1900,1312,968,1861,706,1900,1163,1075,1113,1900,917,1960,1100,1080,1113,1060,1038,1020,1900,4120,1020,1020,1900,966,1000,1000,1419,1558,1558,1010,1020,1558,952
71270,"Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections",2000,1800,565,1900,1900,1095,1819,1900,1001,1020,1900,1091,1042,1128,1249,723,1026,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,1072,1128,1008,1060,1038,1020,1900,1900,1020,1020,1900,966,1000,1058,1419,1558,1558,1228,1020,1558,952
71271,HC CT THORAX LUNG CANCER SCREEN,600,540,170,570,570,306,546,570,300,306,570,330,416,334,375,424,333,170,564,393,291,558,212,570,349,322,330,570,405,422,372,338,300,318,311,306,570,570,306,306,570,290,336,318,426,467,467,336,306,467,286
71275,"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing",2435,2192,688,2313,2313,1242,2215,2313,1242,1242,2313,1315,749,1352,1521,749,1352,688,2290,1597,1169,2266,860,2313,1416,1308,1355,2313,1642,2098,1307,1373,1364,1291,1263,1242,2313,2313,1242,1242,2313,1176,1364,1364,1218,1897,1897,1364,1242,1897,1159
71552,"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences",3000,2700,848,2850,2850,1643,2729,2850,1501,1530,2850,1860,1097,1693,1874,1084,1538,848,2822,1967,1453,2791,1059,2850,1744,1612,1669,2850,2024,2111,1630,1692,1518,1590,1556,1530,2850,2850,1530,1530,2850,1448,1595,1587,2128,2337,2337,1842,1530,2337,1428
72040,"Radiologic examination, spine, cervical; 2 or 3 views",220,198,62,209,209,123,200,209,110,112,209,120,65,124,137,65,105,62,207,144,106,205,78,209,133,118,122,209,148,112,121,136,123,117,114,112,209,209,112,112,209,106,123,110,156,171,171,123,112,171,105
72050,"Radiologic examination, spine, cervical; minimum of 4 views",336,302,68,331,319,171,306,319,161,171,319,208,73,190,210,68,161,95,319,220,163,313,119,319,185,181,187,319,227,331,185,181,169,178,174,171,319,319,171,171,319,162,179,178,238,262,262,188,171,262,160
72052,"Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension studies",400,360,113,380,380,219,364,380,200,204,380,218,146,226,250,145,205,113,376,262,194,372,141,380,233,215,223,380,270,282,215,226,202,212,208,204,380,380,204,204,380,193,213,212,284,312,312,246,204,312,190
72070,"Radiologic examination, spine; thoracic, 2 views",161,145,33,153,153,88,146,153,80,82,153,87,33,91,101,50,83,45,151,106,77,150,57,153,94,86,90,153,109,113,94,91,90,85,84,82,153,153,82,82,153,78,80,85,114,125,125,90,82,125,77
72072,"Radiologic examination, spine; thoracic, 3 views",271,244,65,264,257,257,247,257,137,138,257,159,65,153,169,65,139,77,255,178,131,252,96,257,158,146,151,257,183,264,149,146,152,144,141,138,257,257,138,138,257,131,152,136,192,211,211,144,138,211,129
72082,PR X-RAY EXAM ENTIRE SPINE 2/3 VW,350,315,59,333,332,192,318,333,175,178,332,182,59,197,219,127,179,99,329,230,169,326,124,332,204,188,195,332,236,246,175,197,178,186,182,178,332,333,178,178,332,169,186,185,248,273,273,215,178,273,167
72100,"Radiologic examination, spine, lumbosacral; 2 or 3 views",279,251,65,265,265,142,265,265,142,142,265,153,65,157,174,65,145,79,265,183,134,260,99,265,162,150,155,265,188,239,153,145,156,148,145,142,265,265,142,142,265,135,156,156,217,217,217,156,142,217,133
72110,"Radiologic examination, spine, lumbosacral; minimum of 4 views",299,269,68,284,284,164,272,284,150,152,284,82,73,169,187,68,153,84,281,196,145,278,106,284,174,161,166,284,202,210,164,169,151,158,155,152,284,284,152,152,284,144,159,158,212,233,233,184,152,233,142
72114,"Radiologic examination, spine, lumbosacral; complete, including bending views",376,338,67,357,357,206,342,357,188,192,357,205,67,212,235,136,193,106,354,247,182,350,133,357,219,202,209,357,254,265,204,212,211,199,195,192,357,357,192,192,357,182,200,199,267,293,293,231,192,293,179
72120,"Radiologic examination, spine, lumbosacral, bending views only, minimum of 4 views",299,269,84,284,284,152,272,284,150,152,284,163,109,169,187,108,153,84,281,196,145,278,106,284,174,161,166,284,202,210,164,169,151,158,155,152,284,284,152,152,284,144,159,158,212,233,233,184,152,233,142
72125,"Computed tomography, cervical spine; without contrast material",1900,1710,208,1805,1805,969,950,1805,969,969,1805,1026,208,1072,1187,229,908,537,1787,1246,920,1768,671,1805,1105,1021,1150,1805,1297,1337,1020,1178,969,1007,986,969,1805,1805,969,969,1805,950,969,950,1348,1480,1480,1016,969,1480,905
72128,"Computed tomography, thoracic spine; without contrast material",1600,1440,344,1520,1520,876,1456,1520,801,816,1520,992,344,903,999,578,821,452,1505,1049,775,1489,565,1520,930,860,890,1520,1079,1126,429,902,558,848,830,816,1520,1520,816,816,1520,772,896,768,1135,1246,1246,982,816,1246,762
72131,"Computed tomography, lumbar spine; without contrast material",2000,1800,404,1900,1900,1095,1819,1900,1000,1020,1900,810,404,1128,1249,424,1026,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,578,1128,1010,1060,1038,1020,1900,1900,1020,1020,1900,966,1063,1058,1419,1558,1558,1120,1020,1558,952
72132,"Computed tomography, lumbar spine; with contrast material",1800,1620,509,1710,1710,986,1638,1710,901,918,1710,982,658,1016,1124,651,923,509,1693,1180,872,1675,636,1710,1047,967,1002,1710,1214,1267,978,1015,918,954,934,918,1710,1710,918,918,1710,869,957,952,1277,1402,1402,1105,918,1402,857
72141,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material",2400,2160,678,2280,2280,1344,2183,2280,1201,1224,2280,1320,891,1354,1499,811,1231,678,2258,1574,1162,2233,847,2280,1396,1289,1335,2280,1619,1689,1320,1296,1224,1272,1245,1224,2280,2280,1224,1224,2280,1159,1344,1344,1702,1870,1870,1344,1224,1870,1143
72146,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material",2200,1980,424,2090,2090,1232,2001,2090,1101,1122,2090,1188,424,1241,1374,1082,1128,622,2069,1443,1065,2047,777,2090,1279,1182,1224,2090,1484,1548,1181,1241,1232,1166,1141,1122,2090,2090,1122,1122,2090,1062,1056,1056,1560,1714,1714,1351,1122,1714,1047
72148,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material",2500,2250,706,2375,2375,1275,2375,2375,1250,1275,2375,1375,891,1410,1562,832,1388,706,2352,1640,1210,2326,883,2375,1512,1343,1391,2375,1686,1250,1375,1410,1275,1325,1297,1275,2375,2375,1275,1275,2375,1207,1275,1250,1948,1947,1947,1400,1275,1947,1190
72156,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical",3361,3025,950,3193,3193,1841,3058,3193,1682,1714,3193,1688,1173,1896,2099,1215,1724,950,3162,2204,1627,3127,1187,3193,1954,1806,1870,3193,2267,2365,1849,1895,1882,1781,1744,1714,3193,3193,1714,1714,3193,1623,1680,1778,2384,2618,2618,2064,1714,2618,1600
72157,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic",3361,3025,950,3193,3193,1841,3058,3193,1680,1714,3193,1834,1114,1896,2099,1215,1724,950,3162,2204,1627,3127,1187,3193,1954,1806,1870,3193,2267,2365,1826,1895,1693,1781,1744,1714,3193,3193,1714,1714,3193,1623,1787,1778,2384,2618,2618,2064,1714,2618,1600
72158,"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar",3550,3195,838,3373,3372,1944,3230,3373,1777,1810,3372,1917,838,2003,2217,1283,1821,1003,3339,2328,1719,3303,1253,3372,2064,1907,1975,3372,2395,2498,2201,2002,1899,1882,1842,1810,3372,3373,1810,1810,3372,1714,1775,1878,2518,2765,2765,2377,1810,2765,1690
72170,"Radiologic examination, pelvis; 1 or 2 views",157,141,44,149,149,86,75,149,78,80,149,64,59,89,98,57,81,44,148,103,76,146,55,149,91,84,87,149,106,110,78,89,80,83,81,80,149,149,80,80,149,76,80,83,111,122,122,122,80,122,75
72190,"Radiologic examination, pelvis; complete, minimum of 3 views",237,213,30,225,225,121,216,225,118,121,225,129,30,134,148,86,122,67,223,155,115,221,84,225,138,127,132,225,160,167,129,134,119,126,123,121,225,225,121,121,225,114,126,125,168,185,185,146,121,185,113
72191,"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2500,2250,675,2375,2375,1369,2274,2375,1251,1275,2375,675,914,1410,1562,904,1282,706,2352,1640,1210,2326,883,2375,1454,1343,1391,2375,1686,1759,1358,1410,1265,1325,1297,1275,2375,2375,1275,1275,2375,1207,1329,1323,1773,1947,1947,1535,1275,1947,1190
72192,"Computed tomography, pelvis; without contrast material",1520,1368,408,1444,1444,851,1383,1444,761,775,1444,790,480,858,949,549,779,429,1430,997,736,1414,537,1444,884,817,846,1444,1025,1193,408,857,648,806,789,775,1444,1444,775,775,1444,734,808,804,1078,1184,1184,806,775,1184,724
72193,"Computed tomography, pelvis; with contrast material(s)",1800,1620,509,1710,1710,986,1638,1710,901,918,1710,982,914,1016,1124,651,923,509,1693,1180,872,1675,636,1710,1047,967,1002,1710,1214,1267,966,1015,911,954,934,918,1710,1710,918,918,1710,869,957,952,1277,1402,1402,1151,918,1402,857
72194,"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections",2000,1800,565,1900,1900,1095,1819,1900,1001,1020,1900,1240,732,1128,1249,723,1026,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,1087,1128,1012,1060,1038,1020,1900,1900,1020,1020,1900,966,1063,1058,1419,1558,1558,1228,1020,1558,952
72196,"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)",2442,2198,690,2320,2320,1337,2222,2320,1222,1245,2320,1333,893,1378,1525,883,1252,690,2297,1601,1182,2272,862,2320,1420,1312,1359,2320,1647,1719,1221,1377,1236,1294,1267,1245,2320,2320,1245,1245,2320,1179,1298,1292,1732,1902,1902,1499,1245,1902,1163
72197,"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences",3361,3025,950,3193,3193,1841,3058,3193,1682,1714,3193,1834,1229,1896,2099,1215,1724,950,3162,2204,1627,3127,1187,3193,1954,1806,1870,3193,2267,2365,1680,1895,1882,1781,1744,1714,3193,3193,1714,1714,3193,1623,1787,1778,2384,2618,2618,2064,1714,2618,1600
72202,"Radiologic examination, sacroiliac joints; 3 or more views",182,164,51,173,173,100,166,173,91,93,173,99,59,103,114,66,93,51,171,119,88,169,64,173,106,98,101,173,123,128,100,103,102,96,94,93,173,173,93,93,173,88,97,96,129,142,142,112,93,142,87
72220,"Radiologic examination, sacrum and coccyx, minimum of 2 views",236,212,60,224,224,129,215,224,118,120,224,130,65,133,147,60,121,67,222,155,114,220,83,224,137,127,131,224,159,166,128,133,119,125,122,120,224,224,120,120,224,114,125,118,167,184,184,184,120,184,112
73000,"Radiologic examination; clavicle, complete",168,151,47,160,160,92,153,160,84,86,160,92,73,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,90,95,94,89,87,86,160,160,86,86,160,81,89,89,119,131,131,103,86,131,80
73010,"Radiologic examination; scapula, complete",168,151,47,160,160,92,153,160,84,86,160,78,61,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,91,95,80,89,87,86,160,160,86,86,160,81,89,89,119,131,131,103,86,131,80
73020,"Radiologic examination, shoulder; 1 view",164,148,44,162,156,90,149,156,82,84,156,89,60,93,102,59,84,46,154,108,79,153,58,156,95,88,91,156,162,115,44,92,83,87,85,84,156,156,84,84,156,79,87,87,116,128,128,101,84,128,78
73030,"Radiologic examination, shoulder; complete, minimum of 2 views",270,243,31,257,256,138,256,256,135,138,256,148,65,148,169,81,138,31,256,177,130,251,95,256,157,145,150,256,138,138,145,152,151,143,140,138,256,257,138,138,256,130,151,151,191,210,210,151,138,210,129
73040,"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation",650,585,184,618,618,356,591,618,325,332,618,377,238,367,406,235,333,184,611,426,315,605,229,618,378,349,362,618,438,457,353,351,364,344,337,332,617,618,332,331,618,314,346,344,461,506,506,399,332,506,309
73060,"Radiologic examination; humerus, minimum of 2 views",217,195,29,215,206,111,197,206,109,111,206,119,37,122,136,81,111,29,204,142,105,202,77,206,126,117,121,206,215,153,119,122,109,115,113,111,206,206,111,111,206,105,108,108,154,169,169,169,111,169,103
73070,"Radiologic examination, elbow; 2 views",168,151,47,188,160,92,153,160,84,86,160,99,70,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,166,118,90,95,188,89,87,86,160,160,86,86,160,81,94,89,119,131,131,131,86,131,80
73080,"Radiologic examination, elbow; complete, minimum of 3 views",200,180,57,190,190,102,182,190,100,102,190,108,65,113,125,72,104,57,188,131,96,186,71,190,121,107,111,190,62,141,107,124,101,106,104,102,190,190,102,102,190,97,106,112,142,156,156,112,102,156,95
73090,"Radiologic examination; forearm, 2 views",168,151,47,160,160,86,153,160,84,86,160,92,60,95,105,65,93,47,158,110,81,156,59,160,98,90,93,160,113,118,92,92,85,89,87,86,160,160,86,86,160,81,84,89,119,131,131,131,86,131,80
73100,"Radiologic examination, wrist; 2 views",168,151,47,160,160,94,153,160,81,86,160,97,94,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,90,95,94,89,87,86,160,160,86,86,160,81,94,84,119,131,131,103,86,131,80
73110,"Radiologic examination, wrist; complete, minimum of 3 views",200,180,57,190,190,100,190,190,102,102,190,108,65,113,125,65,100,57,190,131,96,186,71,190,116,107,111,190,101,141,110,110,112,106,104,102,190,190,102,102,190,97,106,100,142,156,156,112,102,156,95
73120,"Radiologic examination, hand; 2 views",168,151,46,160,160,92,153,160,84,86,160,52,73,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,46,104,94,89,87,86,160,160,86,86,160,81,89,89,119,131,131,103,86,131,80
73130,"Radiologic examination, hand; minimum of 3 views",200,180,49,190,190,102,182,190,100,102,190,110,65,113,125,49,100,111,188,131,97,186,71,190,121,107,111,190,135,79,110,116,107,106,104,102,190,190,102,102,190,97,168,107,156,156,156,156,102,156,95
73140,"Radiologic examination, finger(s), minimum of 2 views",154,139,31,146,146,84,140,146,79,79,146,85,65,87,96,68,79,31,145,101,74,143,54,146,93,83,85,146,104,77,85,95,82,82,80,79,146,146,79,79,146,74,77,77,109,120,120,103,79,120,73
73200,"Computed tomography, upper extremity; without contrast material",1500,1350,385,1425,1425,1425,1365,1425,751,765,1425,619,385,846,937,392,769,424,1411,984,726,1396,530,1425,872,806,835,1425,1012,1056,868,780,765,795,778,765,1425,1425,765,765,1425,724,750,794,1064,1168,1168,921,765,1168,714
73218,"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)",2000,1800,565,1900,1900,1095,1819,1900,1001,1020,1900,1040,891,1128,1249,723,1026,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,1240,1128,1012,1060,1038,1020,1900,1900,1020,1020,1900,966,1063,1058,1419,1558,1558,1228,1020,1558,952
73221,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)",2500,2250,211,2375,2375,1400,2274,2375,1275,1275,2375,1375,888,1410,1562,1082,1282,211,2352,1640,1210,2326,883,2375,1454,1343,1391,2375,1686,1759,1375,1410,1275,1325,1297,1275,2375,2375,1275,1275,2375,1207,1329,1400,1773,1947,1947,1400,1275,1948,1190
73222,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)",2200,1980,622,2090,2090,1205,2001,2090,1101,1122,2090,1188,805,1241,1374,795,1128,622,2069,1443,1065,2047,777,2090,1279,1182,1224,2090,1484,1548,1195,1188,1177,1166,1141,1122,2090,2090,1122,1122,2090,1062,1170,1164,1560,1714,1714,1351,1122,1714,1047
73223,"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences",3200,2880,639,3040,3040,1753,2911,3040,1601,1632,3040,1746,639,1805,1999,1157,1641,904,3010,2099,1549,2977,1130,3040,1861,1719,1781,3040,2158,2252,1739,1805,1620,1696,1660,1632,3040,3040,1632,1632,3040,1545,1701,1693,2270,2493,2493,1965,1632,2493,1524
73501,PR X-RAY EXAM HIP UNI 1 VIEW,200,180,33,190,190,110,182,190,100,102,190,93,73,113,125,33,103,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,112,106,104,102,190,190,102,102,190,97,106,106,142,156,156,123,102,156,95
73502,PR X-RAY EXAM HIP UNI 2-3 VIEWS,200,180,57,190,190,102,190,190,100,102,190,108,65,110,125,65,111,57,188,131,96,186,71,190,116,107,111,190,102,100,109,113,112,106,104,102,190,190,102,102,190,97,102,106,142,156,156,112,102,156,95
73503,PR X-RAY EXAM HIP UNI 4/> VIEWS,280,252,79,266,266,153,255,266,140,143,266,153,102,158,175,101,144,79,263,184,136,261,99,266,163,150,156,266,189,197,152,158,157,148,145,143,266,266,143,143,266,135,149,148,199,218,218,218,143,218,133
73521,PR X-RAY EXAM HIPS BI 2 VIEWS,300,270,59,285,285,164,273,285,152,153,285,162,59,169,187,108,154,85,282,197,145,279,106,285,174,161,167,285,202,211,165,169,136,159,156,153,285,285,153,153,285,145,160,159,213,234,234,168,153,234,143
73522,PR X-RAY EXAM HIPS BI 3-4 VIEWS,350,315,40,333,332,196,318,333,175,178,332,192,40,197,219,68,179,99,329,230,169,326,124,332,204,188,192,332,236,246,217,197,195,186,182,178,332,333,178,178,332,169,186,185,273,273,273,196,178,273,167
73523,PR X-RAY EXAM HIPS BI 5/> VIEWS,450,405,77,428,428,230,409,428,225,230,428,246,165,254,281,81,231,127,423,295,218,419,159,428,262,242,250,428,304,77,225,254,222,238,233,230,427,428,230,229,428,217,239,238,319,351,351,276,230,351,214
73551,PR X-RAY EXAM OF FEMUR 1 VW,170,153,48,162,162,93,155,162,85,87,162,93,62,96,106,61,87,48,160,111,82,158,60,162,99,91,95,162,115,120,91,96,86,90,88,87,161,162,87,87,162,82,90,90,121,132,132,104,87,132,81
73552,PR X-RAY EXAM OF FEMUR 2/> VW,200,180,33,224,190,224,182,190,100,102,190,108,33,113,125,72,103,57,188,131,97,186,71,190,116,107,111,190,135,141,89,108,112,106,104,102,190,190,102,102,190,97,112,106,142,156,156,102,102,156,95
73560,"Radiologic examination, knee; 1 or 2 views",168,151,47,160,160,92,153,160,84,86,160,52,61,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,104,95,94,89,87,86,160,160,86,86,160,81,94,94,119,131,131,89,86,131,80
73562,"Radiologic examination, knee; 3 views",200,180,57,190,190,102,190,190,101,102,190,110,65,111,125,81,105,57,190,131,96,186,71,190,121,107,110,190,95,102,107,124,112,106,104,102,190,190,102,102,190,97,107,106,156,156,156,112,102,156,95
73564,"Radiologic examination, knee; complete, 4 or more views",259,233,65,246,246,130,236,246,132,132,246,152,65,146,162,65,133,73,244,170,124,241,91,246,151,139,144,246,175,130,142,140,145,137,134,132,246,246,132,132,246,125,130,124,184,202,202,202,132,202,123
73565,"Radiologic examination, knee; both knees, standing, anteroposterior",161,145,45,167,153,88,146,153,80,82,153,167,73,91,101,58,83,45,151,106,77,150,57,153,94,86,90,153,109,113,93,91,81,85,84,82,153,153,82,82,153,78,85,85,114,125,125,90,82,125,77
73590,"Radiologic examination; tibia and fibula, 2 views",200,180,33,190,190,110,190,190,100,102,190,117,65,113,125,33,103,57,190,131,97,186,71,190,121,107,111,190,135,141,110,108,101,106,104,102,190,190,102,102,190,97,112,106,142,156,156,112,102,156,95
73592,"Radiologic examination; lower extremity, infant, minimum of 2 views",182,164,51,173,173,100,166,173,91,93,173,99,67,103,114,66,93,51,171,119,88,169,64,173,106,98,101,173,123,128,98,103,92,96,94,93,173,173,93,93,173,88,97,96,129,142,142,112,93,142,87
73600,"Radiologic examination, ankle; 2 views",168,151,47,160,160,92,153,160,84,86,160,68,81,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,87,95,89,89,87,86,160,160,86,86,160,81,89,89,119,131,131,103,86,131,80
73610,"Radiologic examination, ankle; complete, minimum of 3 views",200,180,6,380,190,151,190,190,101,102,190,108,65,113,125,65,96,34,190,131,97,186,71,190,121,107,110,190,135,6,110,108,112,106,104,102,190,380,102,102,190,97,102,106,156,156,156,112,102,156,65
73620,"Radiologic examination, foot; 2 views",168,151,47,160,160,92,153,160,84,86,160,91,65,95,105,61,80,47,158,110,81,156,59,160,98,90,93,160,113,118,63,95,94,89,87,86,160,160,86,86,160,81,89,89,119,131,131,103,86,131,80
73630,"Radiologic examination, foot; complete, minimum of 3 views",200,180,30,285,190,102,190,190,102,102,190,110,65,113,125,65,111,30,190,131,96,186,71,190,176,107,110,190,101,97,110,124,111,106,104,102,190,285,102,102,190,97,112,100,156,156,156,112,102,156,103
73650,"Radiologic examination; calcaneus, minimum of 2 views",168,151,42,160,160,92,153,160,84,86,160,42,81,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,45,95,86,89,87,86,160,160,86,86,160,81,89,89,119,131,131,103,86,131,80
73660,"Radiologic examination; toe(s), minimum of 2 views",154,139,44,146,146,146,140,146,79,79,146,85,59,87,96,56,79,44,145,101,75,143,54,146,93,83,86,146,104,108,95,87,86,82,80,79,146,146,79,79,146,74,82,81,109,120,120,86,79,120,73
73700,"Computed tomography, lower extremity; without contrast material",1400,1260,212,1330,1330,784,1274,1330,701,714,1330,823,318,790,874,212,718,396,1317,918,678,1303,494,1330,814,752,779,1330,944,985,868,789,710,742,726,714,1330,1330,714,714,1330,676,784,672,993,1091,1091,784,714,1091,667
73701,"Computed tomography, lower extremity; with contrast material(s)",1700,1530,480,1615,1615,931,1547,1615,851,867,1615,928,1146,959,1062,615,872,480,1599,1115,823,1582,600,1615,988,913,946,1615,1147,1196,850,959,860,901,882,867,1615,1615,867,867,1615,821,904,899,1206,1324,1324,952,867,1324,809
73706,"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2100,1890,567,1995,1995,1150,1910,1995,1051,1071,1995,567,768,1185,1312,759,1077,593,1975,1377,1017,1954,741,1995,1221,1128,1169,1995,1416,1478,1141,1184,1176,1113,1089,1071,1995,1995,1071,1071,1995,1014,1117,1111,1489,1636,1636,1289,1071,1636,1000
73718,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)",2200,1980,622,2090,2090,1205,2001,2090,1101,1122,2090,1188,889,1241,1374,795,1128,622,2069,1443,1065,2047,777,2090,1279,1182,1224,2090,1484,1548,1210,1241,1108,1166,1141,1122,2090,2090,1122,1122,2090,1062,1170,1164,1560,1714,1714,1714,1122,1714,1047
73720,"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences",3400,3060,961,3230,3230,1862,3093,3230,1702,1734,3230,2108,1059,1918,2124,1229,1744,961,3198,2230,1646,3163,1200,3230,1977,1827,1892,3230,2293,2393,1847,1917,1721,1802,1764,1734,3230,3230,1734,1734,3230,1641,1808,1799,2411,2649,2649,2088,1734,2649,1619
73721,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material",2500,2250,75,2375,2375,1400,2375,2375,1900,1275,2375,1375,891,1410,1562,1082,1388,706,2352,1640,1210,2326,883,2375,1512,1343,1391,2375,1686,75,1358,1350,1400,1325,1297,1275,2375,2375,1275,1275,2375,1207,1400,1250,1773,1947,1947,1948,1275,1947,1190
73723,"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences",3000,2700,848,2850,2850,1643,2850,2850,1501,1530,2850,1637,1225,1693,1874,1084,1538,848,2822,1967,1453,2791,1059,2850,1744,1612,1669,2850,2024,2111,1610,1692,1518,1590,1556,1530,2850,2850,1530,1530,2850,1448,1595,1587,2128,2337,2337,1680,1530,2337,1428
74018,PR X-RAY EXAM ABDOMEN 1 VIEW,200,180,49,198,190,163,182,190,102,102,190,110,65,113,125,49,111,57,188,131,97,186,71,190,121,107,110,190,135,198,110,113,111,106,104,102,190,190,102,102,190,97,112,112,142,156,156,112,102,156,78
74019,PR X-RAY EXAM ABDOMEN 2 VIEWS,252,227,32,247,239,129,239,239,129,129,239,136,65,142,157,73,140,32,239,165,121,234,89,239,139,135,139,239,80,247,139,131,140,134,131,129,239,239,129,129,239,122,135,129,196,196,196,141,129,196,204
74021,PR X-RAY EXAM ABDOMEN 3+ VIEWS,315,284,68,299,299,173,287,299,158,161,299,172,68,178,197,114,162,89,296,207,153,293,111,299,183,169,175,299,212,222,171,178,159,167,163,161,299,299,161,161,299,152,158,167,223,245,245,193,161,245,150
74022,"Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest",400,360,113,380,380,219,364,380,200,204,380,248,146,226,250,145,205,113,376,262,194,372,141,380,233,215,223,380,270,282,186,226,223,212,208,204,380,380,204,204,380,193,213,212,284,312,312,246,204,312,190
74150,"Computed tomography, abdomen; without contrast material",1520,1368,429,1444,1444,832,1383,1444,761,775,1444,942,480,858,949,549,779,429,1430,997,736,1414,537,1444,884,817,846,1444,1025,1070,826,857,808,806,789,775,1444,1444,775,775,1444,734,775,804,1078,1184,1184,851,775,1184,724
74160,"Computed tomography, abdomen; with contrast material(s)",2000,1800,565,1900,1900,1095,1819,1900,1001,1020,1900,1080,1146,1128,1249,723,1026,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,1240,1128,1070,1060,1038,1020,1900,1900,1020,1020,1900,966,1063,1058,1419,1558,1558,1228,1020,1558,952
74170,"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections",2000,1800,565,1900,1900,1095,1819,1900,1001,1020,1900,1080,1006,1128,1249,723,1026,565,1881,1312,968,1861,706,1900,1163,1075,1113,1900,1349,1408,1087,1128,1064,1060,1038,1020,1900,1900,1020,1020,1900,966,1063,1058,1419,1558,1558,1558,1020,1558,952
74174,PR CT ANGIO ABD AND PELV WO W CONTRAST,3000,2700,562,2850,2850,1643,2729,2850,1501,1530,2850,1637,562,1693,1874,1084,1538,848,2822,1967,1453,2791,1059,2850,1744,1612,1669,2850,2024,1691,1630,1692,1363,1590,1556,1530,2850,2850,1530,1530,2850,1448,1595,1587,2128,2337,2337,1530,1530,2337,1428
74175,"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing",2400,2160,418,2280,2280,1314,2183,2280,1201,1224,2280,1310,418,1354,1499,868,1231,678,2258,1574,1162,2233,847,2280,1396,1289,1335,2280,1619,1689,1304,1353,1344,1272,1245,1224,2280,2280,1224,1224,2280,1159,1276,1270,1702,1870,1870,1474,1224,1870,1143
74176,"Computed tomography, abdomen and pelvis; without contrast material",3660,3294,85,3477,3477,2050,3477,3477,1867,1867,3477,2013,993,2065,2286,993,1822,85,3477,2400,1757,3405,1292,3477,2214,1966,2013,3477,1407,1732,2013,2269,1867,1940,1757,1867,3477,3477,1867,1867,3477,1767,2050,1830,2851,2851,2851,2050,1867,2851,1743
74177,"Computed tomography, abdomen and pelvis; with contrast material(s)",4147,3732,408,3940,3940,2219,3773,3940,2115,2115,3940,2281,993,2340,2590,993,2183,1172,3940,2720,2008,3858,1464,3940,2509,2228,2281,3940,482,2209,2281,2239,2115,2198,2151,2115,3940,3940,2115,2115,3940,2002,2074,2074,2941,3230,3230,3231,2115,3230,408
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",4000,3600,993,3800,3800,2240,3639,3800,2020,2040,3800,2180,1006,2257,2499,993,2051,1130,3763,2623,1937,3722,1412,3800,2326,2149,2226,3800,2698,2815,2200,2256,2240,2120,2075,2040,3800,3800,2040,2040,3800,1931,2240,2116,2837,3116,3116,2240,2040,3116,1904
74181,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)",2200,1980,541,2090,2090,1205,2001,2090,1101,1122,2090,1188,805,1241,1374,541,1128,622,2069,1443,1065,2047,777,2090,1279,1182,1224,2090,1484,1548,1195,1241,1288,1166,1141,1122,2090,2090,1122,1122,2090,1062,1170,1164,1560,1714,1714,1351,1122,1714,1047
74182,"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)",2550,2295,720,2423,2422,1397,2320,2423,1276,1300,2422,1377,1032,1439,1593,922,1308,720,2399,1672,1235,2373,900,2422,1483,1370,1419,2422,1720,1795,1386,1438,1291,1352,1323,1300,2422,2423,1300,1300,2422,1231,1275,1349,1809,1986,1986,1566,1300,1986,1214
74183,"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences",3500,3150,989,3325,3325,1917,3184,3325,1752,1785,3325,1890,1232,1975,2186,1232,1795,989,3292,2295,1695,3256,1236,3325,2035,1880,1948,3325,2361,2463,1902,1974,1763,1855,1816,1785,3325,3325,1785,1785,3325,1690,1861,1852,2482,2726,2726,1750,1785,2726,1666
74220,Radiologic examination; esophagus,380,342,65,361,361,208,346,361,194,194,361,220,65,214,237,65,195,90,357,296,184,354,134,361,230,204,211,361,120,267,209,214,213,201,197,194,361,361,194,194,361,183,190,203,270,296,296,213,194,296,181
74230,"Swallowing function, with cineradiography/videoradiography",450,405,127,428,428,246,409,428,225,230,428,245,196,254,281,163,231,127,423,295,218,419,159,428,262,242,250,428,304,230,248,254,228,238,233,230,427,428,230,229,428,217,239,238,319,351,351,276,230,351,214
74240,"Radiologic examination, gastrointestinal tract, upper; with or without delayed films, without KUB",498,448,141,473,473,273,453,473,249,254,473,269,179,281,311,180,238,141,468,327,241,463,176,473,290,268,277,473,336,350,271,281,174,264,258,254,473,473,254,254,473,240,265,263,353,388,388,306,254,388,237
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",558,502,158,530,530,306,508,530,279,285,530,313,179,315,349,196,286,158,525,366,270,519,197,530,338,300,310,530,376,393,345,315,281,296,289,285,530,530,285,285,530,269,312,295,396,435,435,374,285,435,266
74248,PR X-RAY SM INT F-THRU STD,200,180,57,190,190,110,182,190,100,102,190,108,94,113,125,72,96,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,102,106,104,102,190,190,102,102,190,97,106,106,142,156,156,123,102,156,95
74250,"Radiologic examination, small intestine, includes multiple serial films;",380,342,107,361,361,208,346,361,190,194,361,207,139,214,237,137,195,107,357,249,184,354,134,361,221,204,211,361,256,267,209,214,180,201,197,194,361,361,194,194,361,183,202,201,270,296,296,233,194,296,181
74280,"Radiologic examination, colon; air contrast with specific high density barium, with or without glucagon",670,603,189,637,636,375,610,637,335,342,636,366,262,378,419,242,344,189,630,439,324,623,237,636,390,360,373,636,452,472,364,378,339,355,348,342,636,637,342,342,636,323,335,355,475,522,522,411,342,522,319
74300,"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation",600,540,170,916,570,329,546,570,300,306,570,327,916,339,375,217,308,170,564,393,291,558,212,570,349,322,334,570,405,422,326,338,304,318,311,306,570,570,306,306,570,290,319,288,426,467,467,368,306,467,286
74420,"Urography, retrograde, with or without KUB",250,225,27,238,238,137,227,238,125,128,238,136,91,141,156,90,128,71,235,164,121,233,88,238,145,134,139,238,169,176,136,141,27,132,130,128,237,238,128,127,238,121,133,132,177,195,195,153,128,195,119
74430,"Cystography, minimum of 3 views, radiological supervision and interpretation",400,360,113,380,380,219,364,380,200,204,380,218,146,226,250,145,205,113,376,262,194,372,141,380,233,215,223,380,270,282,217,226,202,212,208,204,380,380,204,204,380,193,200,212,284,312,312,246,204,312,190
74450,"Urethrocystography, retrograde, radiological supervision and interpretation",479,431,135,455,455,262,436,455,240,244,455,261,175,270,299,173,246,135,451,314,232,446,169,455,279,257,267,455,323,337,297,270,242,254,249,244,455,455,244,244,455,231,255,253,340,373,373,240,244,373,228
74455,"Urethrocystography, voiding, radiological supervision and interpretation",432,389,122,547,410,237,393,410,216,220,410,236,547,244,270,156,222,122,406,283,209,402,153,410,251,232,240,410,291,304,235,244,219,229,224,220,410,410,220,220,410,209,230,229,306,337,337,265,220,337,206
75635,"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing",3000,2700,709,2850,2850,1500,2729,2850,1501,1530,2850,1637,709,1693,1874,1084,1538,848,2822,1967,1453,2791,1059,2850,1744,1612,1669,2850,2024,2111,1630,1692,1518,1590,1556,1530,2850,2850,1530,1530,2850,1448,1595,1587,2128,2337,2337,1842,1530,2337,1428
76000,"Fluoroscopy (separate procedure), up to 1 hour physician time, other than 71023 or 71034 (eg, cardiac fluoroscopy)",450,405,127,428,428,246,409,428,227,230,428,279,179,254,281,196,231,127,423,295,218,419,159,428,262,242,248,428,304,317,242,254,252,238,233,230,427,428,230,229,428,217,230,238,319,351,351,225,230,351,214
76010,"Radiologic examination from nose to rectum for foreign body, single view, child",114,103,32,108,108,62,104,108,57,58,108,62,65,64,71,65,58,32,108,75,55,106,40,108,66,61,63,108,77,80,62,64,58,60,59,58,108,108,58,58,108,55,61,60,81,89,89,70,58,89,54
76536,"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation",520,468,147,494,494,265,473,494,265,265,494,283,211,293,325,253,249,147,489,341,250,484,184,494,302,279,289,494,351,366,322,293,291,276,270,265,494,494,265,265,494,251,260,291,369,405,405,348,265,405,248
76604,"Ultrasound, chest (includes mediastinum), real time with image documentation",500,450,141,475,475,274,455,475,250,255,475,273,211,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,272,282,280,265,259,255,475,475,255,255,475,241,266,265,355,389,389,307,255,389,238
76641,Complete unilateral ultrasound examination of the breast,500,450,141,475,475,274,455,475,250,255,475,275,253,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,250,282,237,265,259,255,475,475,255,255,475,241,266,265,355,389,389,307,255,389,238
76642,Specific area/quadrant breast ultrasound examination,319,287,16,303,303,260,303,303,163,163,303,175,192,180,199,105,164,82,300,209,154,303,113,303,193,171,178,303,16,225,175,198,179,169,165,163,303,303,163,163,303,154,179,179,226,248,248,248,163,248,152
76700,"Ultrasound, abdominal, real time with image documentation; complete",763,687,216,725,725,389,694,725,382,389,725,473,334,430,477,334,365,216,718,500,369,710,269,725,444,410,425,725,515,537,420,430,427,404,396,389,725,725,389,389,725,368,385,382,541,594,594,468,389,594,363
76705,"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)",580,522,157,551,551,296,528,551,296,296,551,319,211,327,362,211,289,164,546,380,281,540,205,551,319,312,319,551,255,157,319,302,296,307,301,296,551,551,296,296,551,280,325,278,411,452,452,325,296,452,276
76706,PR US ABDL AORTA SCREEN AAA,550,495,155,523,522,292,500,523,264,280,522,286,192,310,344,211,282,155,517,361,266,512,194,522,320,295,306,522,371,468,299,310,280,292,285,280,522,523,280,280,522,266,275,275,390,428,428,308,280,428,262
76770,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete",650,585,184,618,618,364,591,618,332,332,618,358,334,367,406,333,333,184,611,426,315,605,229,618,393,349,362,618,438,307,358,367,332,344,337,332,618,618,332,331,618,314,364,364,461,506,506,506,332,506,309
76775,"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited",550,495,155,523,522,280,500,523,275,280,522,297,249,310,344,211,282,155,517,361,266,512,194,522,320,295,306,522,371,387,295,310,307,292,285,280,522,523,280,280,522,266,308,291,390,428,428,354,280,428,262
76776,"Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation",550,495,155,523,522,301,500,523,275,280,522,300,201,310,344,199,282,155,517,361,266,512,194,522,320,295,306,522,371,387,299,310,280,292,285,280,522,523,280,280,522,266,292,291,390,428,428,338,280,428,262
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",480,432,136,456,456,263,437,456,240,245,456,264,187,271,300,224,246,136,452,315,232,447,169,456,279,258,267,456,324,338,264,259,243,254,249,245,456,456,245,245,456,232,255,254,340,374,374,374,245,374,229
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",700,630,170,665,665,383,637,665,350,357,665,385,170,395,437,253,359,198,665,459,339,651,247,665,407,376,390,665,472,493,385,395,354,371,363,357,665,665,357,357,665,338,372,370,496,545,545,545,357,545,333
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",428,385,121,407,407,234,389,407,214,218,407,235,170,241,267,187,219,121,403,281,207,398,151,407,249,230,238,407,289,301,265,241,217,227,222,218,407,407,218,218,407,207,228,226,304,333,333,333,218,333,204
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",400,360,113,380,380,219,364,380,200,204,380,242,178,226,250,187,205,113,376,262,194,372,141,380,233,215,223,380,270,282,234,200,202,212,208,204,380,380,204,204,380,193,213,212,284,312,312,246,204,312,190
76817,"Ultrasound, pregnant uterus, real time with image documentation, transvaginal",470,423,133,447,446,257,428,447,235,240,446,256,187,265,294,187,241,133,446,308,228,437,166,446,273,253,262,446,317,331,291,254,238,249,244,240,446,447,240,240,446,227,250,249,333,366,366,366,240,366,224
76818,Fetal biophysical profile; with non-stress testing,550,495,155,523,522,301,500,523,275,280,522,501,187,310,344,199,282,155,517,361,266,512,194,522,320,295,306,522,371,387,299,310,278,292,285,280,522,523,280,280,522,266,292,291,390,428,428,338,280,428,262
76819,Fetal biophysical profile; without non-stress testing,428,385,121,407,407,234,389,407,214,218,407,231,157,241,267,155,219,121,403,281,207,398,151,407,249,230,238,407,289,301,233,241,217,227,222,218,407,407,218,218,407,207,228,226,304,333,333,263,218,333,204
76830,"Ultrasound, transvaginal",630,567,178,599,598,345,573,599,315,321,598,346,211,355,394,211,323,178,593,413,305,598,222,598,364,338,346,598,321,540,346,340,317,334,327,321,598,599,321,321,598,304,353,333,447,491,491,315,321,491,300
76856,"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete",700,630,198,665,665,392,637,665,350,357,665,434,318,395,437,334,359,198,658,459,339,651,247,665,407,376,390,665,472,493,385,395,392,371,363,357,665,665,357,357,665,338,372,604,496,545,545,545,357,545,333
76857,"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)",428,385,105,407,407,240,407,407,218,218,407,235,211,241,267,105,219,121,403,281,207,407,151,407,249,230,238,407,217,215,233,231,240,227,222,218,407,407,218,218,407,207,240,226,304,333,333,227,218,333,204
76870,"Ultrasound, scrotum and contents",546,491,154,519,519,299,497,519,278,278,519,300,211,308,341,211,261,154,514,358,264,508,193,519,317,293,304,519,368,384,300,308,275,289,283,278,519,519,278,278,519,264,306,289,387,425,425,425,278,425,260
76872,"Ultrasound, transrectal;",1,1,0,105,1,1,1,1,1,1,1,1,105,1,1,0,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,0,1,1,1,1,1,1,1,1,0
76881,"Ultrasound, extremity, nonvascular, real-time with image documentation; complete",500,450,141,475,475,274,455,475,250,255,475,273,211,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,272,282,268,265,259,255,475,475,255,255,475,241,266,265,355,389,389,390,255,389,238
76882,"Ultrasound, extremity, nonvascular, real-time with image documentation; limited, anatomic specific",400,360,113,380,380,302,380,380,192,204,380,248,211,226,250,211,222,113,376,262,194,372,141,380,220,215,223,380,270,282,217,226,224,212,208,204,380,380,204,204,380,193,192,212,312,312,312,312,204,312,190
76942,"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation",3,3,1,3,3,2,3,3,2,2,3,2,1,2,2,1,2,1,3,2,1,3,1,3,2,2,2,3,2,2,2,2,2,2,2,2,3,3,2,2,3,1,2,2,2,2,2,2,2,2,1
77001,"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position) (List separately in addition to code for primary procedure)",550,495,155,523,522,301,500,523,275,280,522,300,201,310,344,199,282,155,517,361,266,512,194,522,320,295,306,522,371,387,299,310,308,292,285,280,522,523,280,280,522,266,292,291,390,428,428,338,280,428,262
77063,HC BREAST TOMOSYNTHESIS DIG SCREEN UNIL,80,72,23,80,76,44,73,76,40,41,76,79,29,80,50,29,41,23,75,52,39,76,28,76,47,43,45,76,78,79,43,45,79,42,42,41,76,76,41,41,76,39,80,42,57,62,62,80,41,62,38
77065,Diagnostic Mammography computer aided detection when performed; unilateral,300,270,85,285,285,168,273,285,153,153,285,165,221,169,187,108,154,85,282,197,145,279,106,285,182,161,167,285,202,211,161,169,168,159,156,153,285,285,153,153,285,145,168,168,213,234,234,168,153,234,143
77066,Diagnostic Mammography computer aided detection when performed; bilateral,400,360,14,392,380,224,380,380,200,204,380,232,214,226,250,226,205,158,376,262,194,380,141,380,242,215,223,380,392,14,220,226,204,212,208,204,380,380,204,204,380,193,200,212,284,312,312,312,204,312,190
77067,Screening mammography,400,360,113,398,380,219,364,380,200,204,380,396,146,398,250,145,205,113,376,262,194,380,141,380,233,215,223,380,397,398,217,226,398,212,208,204,380,380,204,204,380,193,398,212,284,312,312,398,204,312,190
77075,"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)",630,567,178,599,598,345,573,599,315,321,598,344,230,355,394,228,323,178,593,413,305,586,222,598,366,338,351,598,425,443,342,355,299,334,327,321,598,599,321,321,598,304,335,333,447,491,491,387,321,491,300
77080,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)",440,396,124,418,418,224,418,418,222,224,418,240,241,248,275,265,219,124,414,289,211,409,155,418,256,236,242,418,222,310,272,248,224,233,220,224,418,418,224,224,418,212,246,246,312,343,343,246,224,343,209
77081,"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)",350,315,99,333,332,192,318,333,178,178,332,191,260,197,219,127,179,99,329,230,169,326,124,332,204,188,195,332,236,246,190,197,178,186,182,178,332,333,178,178,332,169,186,185,248,273,273,215,178,273,167
77085,PR DXA BONE DENSITY W FX ASSESS,350,315,10,333,332,192,318,333,175,178,332,189,186,197,219,127,179,99,329,230,169,326,124,332,204,188,195,332,236,10,190,197,121,186,182,178,332,333,178,178,332,169,175,185,248,273,273,215,178,273,167
78014,PR THYROID IMAG W/BLOOD FLOW SGL/MULT QUAN,900,810,254,879,855,493,819,855,450,459,855,491,879,508,562,325,462,254,847,590,436,837,318,855,523,484,501,855,607,633,489,508,456,477,467,459,855,855,459,459,855,434,479,476,638,701,701,450,459,701,429
78226,PR HEPATOBILIARY SYSTEM IMAGING,1200,1080,339,1140,1140,657,1092,1140,601,612,1140,648,439,677,750,434,615,339,1129,787,581,1116,424,1140,698,645,668,1140,809,845,652,677,672,636,623,612,1140,1140,612,612,1140,579,638,635,851,935,935,737,612,935,571
78227,PR HEPATOBIL SYST IMAGE W/DRUG,1500,1350,424,3636,1425,765,1365,1425,765,765,1425,930,1137,846,937,1251,769,424,1411,984,726,1396,530,1425,872,806,835,1425,1012,1056,825,810,756,795,778,765,1425,3636,765,765,1425,724,720,1145,1064,1168,1168,1168,765,1168,714
78264,Gastric emptying study,1300,1170,367,1235,1235,712,1183,1235,624,663,1235,677,967,733,812,470,667,367,1223,853,629,1210,459,1235,756,698,723,1235,877,915,401,733,655,689,674,663,1235,1235,663,663,1235,628,728,688,922,1013,1013,1145,663,1013,619
78306,Bone and/or joint imaging; whole body,1096,986,310,1041,1041,600,997,1041,559,559,1041,592,820,618,685,396,562,310,1031,719,531,1020,387,1041,637,589,610,1041,739,771,596,618,614,581,569,559,1041,1041,559,559,1041,529,526,548,777,854,854,548,559,854,522
78315,Bone and/or joint imaging; 3 phase study,1500,1350,424,1425,1425,821,1365,1425,751,765,1425,819,1137,846,937,542,769,424,1411,984,726,1396,530,1425,872,806,835,1425,1012,1056,815,846,840,795,778,765,1425,1425,765,765,1425,724,798,794,1064,1168,1168,921,765,1168,714
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",3400,3060,961,3230,3230,1904,3230,3230,1734,1734,3230,1998,1938,1918,2124,2132,1692,961,3198,2230,1646,3163,1200,3230,2057,1827,1892,3230,2293,2847,1989,1870,1904,1802,1764,1734,3230,3230,1734,1734,3230,1641,1904,1799,2649,2649,2649,1904,1734,2649,1619
78582,PR LUNG VENTILAT&PERFUS IMAGING,1400,1260,396,3066,1330,767,1274,1330,784,714,1330,764,3066,790,874,506,718,396,1317,918,678,1303,494,1330,814,752,779,1330,944,985,868,789,745,742,726,714,1330,1330,714,714,1330,676,744,741,993,1091,1091,860,714,1091,667
78708,"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)",1600,1440,452,1520,1520,876,1456,1520,801,816,1520,864,1032,903,999,578,821,452,1505,1049,775,1489,565,1520,930,860,890,1520,1079,1126,869,902,790,848,830,816,1520,1520,816,816,1520,772,851,847,1135,1246,1246,982,816,1246,762
78801,Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); multiple areas,1400,1260,396,2132,1330,767,1274,1330,701,714,1330,764,2132,790,874,506,718,396,1317,918,678,1303,494,1330,814,752,779,1330,944,985,761,789,709,742,726,714,1330,1330,714,714,1330,676,744,741,993,1091,1091,860,714,1091,667
78815,Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh,4800,4320,1356,4560,4560,2629,4367,4560,2400,2448,4560,2525,3220,2708,2998,1735,2462,1356,4515,3148,2324,4466,1695,4560,2791,2579,2671,4560,3238,3378,2608,2707,2568,2544,2490,2448,4560,4560,2448,2448,4560,2317,2352,2540,3404,3739,3739,2688,2448,3739,2285
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)",84,76,7,82,80,43,80,80,43,43,80,46,57,47,52,59,42,7,80,55,40,80,30,80,46,45,46,80,69,82,46,44,43,45,47,43,80,80,43,43,80,41,47,43,42,65,65,47,43,65,43
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)",303,273,57,432,288,166,276,288,152,155,288,432,57,171,189,59,170,190,285,199,147,282,107,288,176,163,169,288,204,213,165,171,153,161,157,155,288,288,155,155,288,146,161,160,215,236,236,186,155,236,144
80051,"Electrolyte panel This panel must include the following: Carbon dioxide (82374), Chloride (82435), Potassium (84132), Sodium (84295)",71,64,20,81,67,39,65,67,36,36,67,44,81,40,44,26,36,20,67,47,34,66,25,67,41,38,40,67,48,50,39,40,40,38,37,36,67,67,36,36,67,34,38,40,50,55,55,44,36,55,34
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)",103,93,9,384,98,53,98,98,53,53,98,57,57,57,64,59,57,9,98,68,49,98,36,98,57,58,57,98,101,101,57,64,53,55,55,53,98,384,53,53,98,52,58,58,80,80,80,58,53,80,11
80061,"Lipid panel This panel must include the following: Cholesterol, serum, total (82465), Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718), Triglycerides (84478)",129,116,29,123,123,66,123,123,64,66,123,71,29,48,81,29,64,42,123,85,62,120,46,123,71,69,71,123,94,38,71,70,64,68,72,66,123,123,66,66,123,62,64,64,100,100,100,72,66,100,61
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)",85,76,24,81,81,48,77,81,43,43,81,53,59,48,53,59,42,24,80,56,41,79,30,81,49,46,47,81,57,60,46,48,42,45,44,43,81,81,43,43,81,41,48,48,60,66,66,48,43,66,40
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)",394,355,28,374,374,197,358,374,197,201,374,213,28,222,246,89,196,111,371,258,191,367,139,374,229,212,219,374,266,277,217,213,211,209,204,201,374,374,201,201,374,190,209,189,279,307,307,197,201,307,188
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)",81,73,7,77,77,41,74,77,41,41,77,50,52,46,51,30,40,7,76,53,39,75,29,77,49,44,45,77,55,28,45,46,45,43,42,41,77,77,41,41,77,39,43,40,63,63,63,40,41,63,39
80143,HC DRUG ASSAY ACETAMINOPHEN,193,174,55,183,183,146,176,183,96,98,183,106,71,109,121,56,99,55,183,127,93,180,68,183,112,104,107,183,130,136,104,109,102,102,100,98,183,183,98,98,183,93,108,102,137,150,150,108,98,150,92
80156,Carbamazepine; total,139,125,39,132,132,76,126,132,70,71,132,75,56,78,87,50,71,39,131,91,67,129,49,132,81,75,77,132,94,98,76,78,78,74,72,71,132,132,71,71,132,67,67,74,99,108,108,85,71,108,66
80159,HC DRUG SCREEN QUANT CLOZAPINE,131,118,37,124,124,72,119,124,66,67,124,71,48,74,82,47,67,37,123,86,63,122,46,124,76,70,73,124,88,92,72,74,66,69,68,67,124,124,67,67,124,63,63,69,93,102,102,80,67,102,62
80162,Digoxin,129,116,36,123,123,71,117,123,65,66,123,70,55,73,81,61,66,36,121,85,62,120,46,123,75,69,72,123,87,91,70,73,72,68,67,66,123,123,66,66,123,62,62,68,91,100,100,79,66,100,61
80164,Dipropylacetic acid (valproic acid),130,117,37,124,124,71,118,124,62,66,124,70,51,73,81,56,67,37,122,85,63,121,46,124,76,70,72,124,88,91,81,73,65,69,67,66,123,124,66,66,124,63,64,69,92,101,101,65,66,101,62
80168,Ethosuximide,157,141,44,149,149,86,143,149,79,80,149,86,57,89,98,57,81,44,148,103,76,146,55,149,91,84,87,149,106,110,84,89,79,83,81,80,149,149,80,80,149,76,83,83,111,122,122,96,80,122,75
80169,HC DRUG SCREEN QUANT EVEROLIMUS,78,70,22,74,74,43,71,74,39,40,74,43,51,44,49,61,40,22,73,51,38,73,28,74,45,42,43,74,53,55,42,44,39,41,40,40,74,74,40,40,74,38,41,41,55,61,61,48,40,61,37
80170,Gentamicin,157,141,44,149,149,86,143,149,75,80,149,86,57,89,98,57,81,44,148,103,76,146,55,149,91,84,87,149,106,110,85,89,80,83,81,80,149,149,80,80,149,76,83,83,111,122,122,96,80,122,75
80171,HC DRUG SCREEN QUANT GABAPENTIN,145,130,41,138,138,79,132,138,73,74,138,84,53,82,91,52,74,41,136,95,70,135,51,138,84,78,81,138,98,102,80,82,81,77,75,74,138,138,74,74,138,70,42,77,103,113,113,89,74,113,69
80175,HC DRUG SCREEN QUANT LAMOTRIGINE,131,118,37,124,124,72,119,124,66,67,124,71,51,74,82,47,67,37,123,86,63,122,46,124,76,70,73,124,88,92,71,74,73,69,68,67,124,124,67,67,124,63,67,69,93,102,102,73,67,102,62
80177,Drug Screen quantitative Levetiracetam level,168,151,47,160,160,92,153,160,81,86,160,92,50,95,105,61,86,47,158,110,81,156,59,160,98,90,93,160,113,118,92,95,90,89,87,86,160,160,86,86,160,81,89,89,119,131,131,103,86,131,80
80178,Lithium,67,60,19,64,64,37,61,64,34,34,64,36,47,38,42,55,34,19,63,44,32,62,24,64,39,36,37,64,45,47,34,38,23,36,35,34,64,64,34,34,64,32,34,35,48,52,52,38,34,52,32
80179,HC DRUG ASSAY SALICYLATE,73,66,21,69,69,55,66,69,37,37,69,40,27,41,46,26,37,21,69,48,35,68,26,69,42,39,41,69,49,51,39,40,41,39,38,37,69,69,37,37,69,35,41,39,52,57,57,41,37,57,35
80183,HC DRUG SCREEN QUANT OXCARBAZEPIN,131,118,37,124,124,72,119,124,66,67,124,81,51,74,82,47,67,37,123,86,63,122,46,124,76,70,73,124,88,92,81,74,66,69,68,67,124,124,67,67,124,63,70,69,93,102,102,102,67,102,62
80184,Phenobarbital,113,102,32,107,107,62,103,107,57,58,107,62,54,64,71,41,58,32,106,74,55,105,40,107,66,61,63,107,76,80,61,64,57,60,59,58,107,107,58,58,107,55,60,60,80,88,88,69,58,88,54
80185,Phenytoin; total,126,113,4,120,120,69,115,120,63,64,120,68,55,71,79,46,65,36,119,83,61,117,44,120,73,68,70,120,85,4,68,71,71,67,65,64,120,120,64,64,120,61,60,67,89,98,98,64,64,98,60
80186,Phenytoin; free,75,68,21,71,71,41,68,71,38,38,71,41,27,42,47,27,38,21,71,49,36,70,26,71,44,40,42,71,51,53,41,42,35,40,39,38,71,71,38,38,71,36,40,40,53,58,58,46,38,58,36
80195,Sirolimus,132,119,37,125,125,72,120,125,66,67,125,72,48,74,82,48,68,37,124,87,64,123,47,125,77,71,73,125,89,93,72,74,67,70,68,67,125,125,67,67,125,64,70,70,94,103,103,81,67,103,63
80197,Tacrolimus,132,119,37,125,125,67,120,125,67,67,125,73,51,74,82,55,68,37,124,87,63,123,47,125,77,71,73,125,89,93,71,74,70,70,68,67,125,125,67,67,125,64,70,70,94,103,103,81,67,103,63
80198,Theophylline,134,121,38,127,127,73,122,127,67,68,127,73,49,76,84,48,69,38,126,88,65,125,47,127,78,72,75,127,90,94,73,76,63,71,70,68,127,127,68,68,127,65,67,71,95,104,104,67,68,104,64
80200,Tobramycin,155,140,44,147,147,85,141,147,78,79,147,85,57,87,97,56,79,44,146,102,75,144,55,147,90,83,86,147,105,109,84,87,77,82,80,79,147,147,79,79,147,75,82,82,110,121,121,95,79,121,74
80201,Topiramate,117,105,25,111,111,64,106,111,59,60,111,59,25,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,58,66,66,62,61,60,111,111,60,60,111,56,63,62,83,91,91,66,60,91,56
80202,Vancomycin,130,117,17,124,124,71,118,124,65,66,124,71,55,73,81,47,67,37,122,85,63,121,46,124,76,70,72,124,44,17,72,73,45,69,67,66,123,124,66,66,124,63,70,69,92,101,101,101,66,101,62
80203,HC DRUG SCREEN QUANT ZONISAMIDE,190,171,54,181,180,97,173,181,95,97,180,118,70,107,119,69,97,54,179,125,92,177,67,180,110,102,106,180,128,134,102,107,96,101,99,97,180,181,97,97,180,92,101,101,135,148,148,117,97,148,90
80280,HC DRUG ASSAY VEDOLIZUMAB,50,45,14,48,48,27,45,48,25,26,48,27,18,28,31,18,26,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,25,26,26,26,47,48,26,25,48,24,27,26,35,39,39,31,26,39,24
80299,"Quantitation of drug, not elsewhere specified",244,220,69,232,232,134,222,232,122,124,232,132,89,138,152,88,125,69,230,160,118,227,86,232,142,131,136,232,165,172,133,138,123,129,127,124,232,232,124,124,232,118,130,129,173,190,190,120,124,190,116
80305,Drug Test presumptive,210,189,14,200,200,118,200,200,107,107,200,14,53,118,131,50,105,117,200,138,101,195,74,200,121,113,117,200,140,148,113,123,118,111,109,107,200,200,107,107,200,101,118,107,105,164,164,118,107,164,29
80307,Drug Test presumptive,193,174,55,288,183,106,176,183,97,98,183,77,113,109,121,70,64,55,182,127,93,180,68,183,112,104,107,183,130,136,78,109,95,102,100,98,183,183,98,98,183,93,103,288,137,150,150,104,98,150,92
80371,HC DRUG TEST DEF 22+ CLASS STIMULANTS SYNTHETIC,120,108,16,114,114,66,109,114,60,61,114,16,44,68,75,43,62,34,113,79,58,112,42,114,70,64,67,114,81,84,65,68,61,64,62,61,114,114,61,61,114,58,64,63,85,93,93,74,61,93,57
80500,"Clinical pathology consultation; limited, without review of patient's history and medical records",60,54,17,57,57,33,55,57,30,31,57,33,22,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,34,32,31,31,57,57,31,31,57,29,32,32,43,47,47,38,31,47,29
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",44,40,12,44,42,22,42,42,22,22,42,24,24,25,27,24,23,12,42,29,21,41,16,42,24,24,24,42,30,44,24,25,22,23,23,22,42,42,22,22,42,21,25,22,31,34,34,25,22,34,21
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",10,9,3,22,9,5,10,10,5,5,10,6,22,6,6,4,5,3,9,7,5,9,4,10,6,5,6,10,10,5,6,6,5,5,6,5,9,10,5,5,10,5,6,6,7,8,8,6,5,8,5
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",24,22,2,24,23,12,23,23,12,12,23,13,24,13,15,24,13,13,23,16,12,22,8,23,13,13,13,23,24,24,13,13,12,13,12,12,23,23,12,12,23,12,13,13,19,19,19,13,12,19,2
81015,Urinalysis; microscopic only,32,29,9,30,30,18,29,30,16,16,30,9,24,18,20,12,15,9,30,21,15,30,11,30,19,17,18,30,22,23,17,17,16,17,17,16,30,30,16,16,30,15,16,17,23,25,25,25,16,25,15
81025,"Urine pregnancy test, by visual color comparison methods",64,58,18,61,61,36,58,61,31,33,61,35,22,36,40,23,32,18,61,42,31,60,23,61,39,34,35,61,43,45,35,35,36,34,33,33,61,61,33,33,61,31,36,34,45,50,50,50,33,50,30
81206,HC BCR/ABL1 GENE MAJOR BP,773,696,194,734,734,423,703,734,387,394,734,422,194,436,483,279,396,218,727,507,374,719,273,734,449,415,430,734,521,335,420,436,394,410,401,394,734,734,394,394,734,373,394,390,548,602,602,410,394,602,368
81219,HC CALR GENE COM VARIANTS,650,585,184,618,618,356,591,618,325,332,618,355,238,367,406,235,333,184,611,426,315,605,229,618,378,349,362,618,438,457,353,367,364,344,337,332,617,618,332,331,618,314,346,344,461,506,506,399,332,506,309
81220,HC CFTR GENE COM VARIANTS,436,392,123,414,414,239,397,414,218,222,414,238,204,246,272,158,224,123,410,286,211,406,154,414,254,234,243,414,294,307,237,246,221,231,226,222,414,414,222,222,414,210,232,231,309,340,340,268,222,340,208
81229,HC CYTOGEN M ARRAY COPY NO&SNP,2300,2070,629,2185,2185,1260,2092,2185,1151,1173,2185,1255,629,1298,1437,831,1179,650,2164,1508,1114,2140,812,2185,1337,1236,1280,2185,1551,1619,1250,1297,1164,1219,1193,1173,2185,2185,1173,1173,2185,1110,1223,1217,1631,1792,1792,1412,1173,1792,1095
81240,HC F2 GENE,81,73,23,116,77,44,74,77,41,41,77,44,116,46,51,29,42,23,76,53,39,75,29,77,47,44,45,77,55,57,44,46,41,43,42,41,77,77,41,41,77,39,43,43,57,63,63,50,41,63,39
81241,HC F5 GENE,368,331,104,350,350,202,335,350,184,188,350,199,188,208,230,133,189,104,346,241,178,342,130,350,214,198,205,350,248,259,200,208,180,195,191,188,350,350,188,188,350,178,196,195,261,287,287,226,188,287,175
81256,HC HFE GENE,715,644,158,679,679,392,650,679,358,365,679,390,158,403,447,258,367,202,673,469,346,665,252,679,416,384,398,679,482,503,389,403,400,379,371,365,679,679,365,365,679,345,380,378,507,557,557,439,365,557,340
81269,HC HBA1/HBA2 GENE DUP/DEL VRNTS,220,198,62,213,209,120,200,209,110,112,209,120,213,124,137,80,113,62,207,144,107,205,78,209,128,118,122,209,148,155,120,124,111,117,114,112,209,209,112,112,209,106,117,116,156,171,171,135,112,171,105
81270,HC JAK2 GENE,838,754,191,796,796,427,762,796,419,427,796,461,191,473,523,303,430,237,788,550,402,780,296,796,487,450,466,796,565,449,520,473,469,444,435,427,796,796,427,427,796,405,446,443,594,653,653,515,427,653,399
81479,HC UNLISTED MOLECULAR PATHOLOGY,150,135,42,186,142,82,136,143,75,76,142,186,121,85,94,54,77,42,141,98,73,140,53,142,87,81,83,142,101,106,82,85,76,80,78,76,142,143,76,76,142,72,80,79,106,117,117,92,76,117,71
82010,"Acetone or other ketone bodies, serum; quantitative",80,72,23,76,76,44,73,76,40,41,76,50,52,45,50,29,41,23,75,52,39,74,28,76,47,43,45,76,54,56,43,45,45,42,42,41,76,76,41,41,76,39,43,45,57,62,62,49,41,62,38
82024,Adrenocorticotropic hormone (ACTH),362,326,94,344,344,198,329,344,181,185,344,203,94,204,226,131,186,102,341,237,175,337,128,344,210,194,201,344,244,255,197,204,203,192,188,185,344,344,185,185,344,175,185,174,257,282,282,222,185,282,172
82040,"Albumin; serum, plasma or whole blood",50,45,14,48,48,26,45,48,26,26,48,26,23,28,31,24,25,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,25,26,26,26,47,48,26,25,48,24,28,25,35,39,39,33,26,39,24
82043,"Albumin; urine, microalbumin, quantitative",42,38,3,80,40,21,40,40,21,21,40,23,23,24,26,24,21,12,40,28,20,39,15,40,25,23,23,40,23,3,26,24,21,22,24,21,40,80,21,21,40,20,24,21,27,33,33,24,21,33,20
82077,"Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase)",106,95,30,151,101,57,96,101,54,54,101,58,48,60,66,38,54,30,151,70,51,99,37,101,62,57,59,101,105,105,58,58,59,56,55,54,101,101,54,54,101,51,59,59,75,83,83,59,54,83,105
82085,Aldolase,88,79,14,84,84,48,80,84,44,45,84,48,14,50,55,32,45,25,83,58,43,82,31,84,51,47,49,84,59,62,48,50,45,47,46,45,84,84,45,45,84,42,47,47,62,69,69,54,45,69,42
82088,Aldosterone,273,246,77,259,259,150,248,259,137,139,259,149,86,154,171,118,140,77,257,179,132,254,96,259,159,147,152,259,184,192,150,154,139,145,142,139,259,259,139,139,259,132,145,144,194,213,213,168,139,213,130
82103,Alpha-1-antitrypsin; total,130,117,37,124,124,71,118,124,65,66,124,72,53,73,81,47,67,37,122,85,63,121,46,124,79,70,72,124,88,91,70,73,73,69,67,66,123,124,66,66,124,63,69,69,92,101,101,73,66,101,62
82104,Alpha-1-antitrypsin; phenotype,137,123,26,130,130,75,125,130,68,70,130,75,26,77,86,50,70,39,129,90,66,127,48,130,83,74,76,130,92,96,74,77,64,73,71,70,130,130,70,70,130,66,73,72,97,107,107,84,70,107,65
82105,Alpha-fetoprotein (AFP); serum,154,139,44,146,146,90,140,146,80,79,146,81,50,87,96,56,79,44,145,101,75,143,54,146,90,83,86,146,104,108,91,87,90,82,80,79,146,146,79,79,146,74,82,80,109,120,120,95,79,120,73
82136,"Amino acids, 2 to 5 amino acids, quantitative, each specimen",268,241,20,255,255,147,244,255,134,137,255,146,54,151,167,97,137,76,252,176,130,249,95,255,156,144,149,255,181,189,146,151,20,142,139,137,255,255,137,137,255,129,142,142,190,209,209,165,137,209,128
82139,"Amino acids, 6 or more amino acids, quantitative, each specimen",185,166,52,176,176,101,168,176,93,94,176,101,68,104,116,67,95,52,174,121,90,172,65,176,108,99,103,176,125,130,108,104,94,98,96,94,176,176,94,94,176,89,98,98,131,144,144,114,94,144,88
82140,Ammonia,139,125,39,132,132,76,126,132,71,71,132,81,57,78,87,61,71,39,131,91,67,129,49,132,81,75,77,132,94,98,86,78,74,74,72,71,132,132,71,71,132,67,78,74,99,108,108,93,71,108,66
82150,Amylase,67,60,19,66,64,38,61,64,34,34,64,37,26,38,42,26,35,19,64,44,32,62,24,64,37,36,37,64,66,66,36,37,36,36,35,34,64,64,34,34,64,32,34,36,48,52,52,38,34,52,32
82164,Angiotensin I - converting enzyme (ACE),139,125,39,132,132,76,126,132,70,71,132,76,48,78,87,61,71,39,131,91,67,129,49,132,81,75,77,132,94,98,76,78,63,74,72,71,132,132,71,71,132,67,78,74,99,108,108,85,71,108,66
82175,Arsenic,197,177,56,187,187,108,179,187,87,100,187,107,72,111,123,71,101,56,185,129,95,183,70,187,115,106,110,187,133,139,107,111,109,104,102,100,187,187,100,100,187,95,105,104,140,153,153,121,100,153,94
82180,"Ascorbic acid (Vitamin C), blood",101,91,29,96,96,55,92,96,51,52,96,55,37,57,63,37,52,29,95,66,49,94,36,96,59,54,56,96,68,71,55,57,52,54,52,52,96,96,52,52,96,49,54,53,72,79,79,62,52,79,48
82232,Beta-2 microglobulin,131,118,37,124,124,73,119,124,66,67,124,71,53,74,82,54,67,37,123,86,63,122,46,124,76,70,73,124,88,92,81,74,65,69,68,67,124,124,67,67,124,63,70,69,93,102,102,80,67,102,62
82239,Bile acids; total,82,74,23,78,78,45,75,78,41,42,78,45,50,46,51,30,42,23,77,54,40,76,29,78,48,44,46,78,55,58,47,46,42,43,43,42,78,78,42,42,78,40,44,43,58,64,64,50,42,64,39
82247,Bilirubin; total,52,47,15,51,49,28,47,49,26,27,49,29,26,29,32,23,27,15,49,34,25,48,18,49,30,28,29,49,35,51,29,29,27,28,27,27,49,49,27,27,49,25,28,28,37,41,41,33,27,41,25
82248,Bilirubin; direct,52,47,15,51,49,28,47,49,26,27,49,30,18,29,32,23,27,15,49,34,25,48,18,49,30,28,29,49,35,51,30,29,27,28,27,27,49,49,27,27,49,25,25,28,37,41,41,26,27,41,25
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)",33,30,1,31,31,17,30,31,17,17,31,18,24,18,21,12,17,9,31,22,16,31,12,31,19,18,18,31,22,1,19,19,17,17,17,17,31,31,17,17,31,16,17,17,23,26,26,20,17,26,16
82272,"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening",33,30,9,33,31,17,30,31,17,17,31,18,30,19,21,12,17,9,31,22,16,31,12,31,19,18,18,31,22,33,18,16,17,17,17,17,31,31,17,17,31,16,18,18,23,26,26,18,17,26,16
82274,"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations",60,54,17,57,57,33,55,57,30,31,57,32,22,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,31,32,31,31,57,57,31,31,57,29,30,32,43,47,47,37,31,47,29
82300,Cadmium,70,63,20,67,66,38,64,67,35,36,66,38,26,39,44,25,36,20,66,46,34,65,25,66,41,38,39,66,47,49,38,39,36,37,36,36,66,67,36,36,66,34,37,37,50,55,55,43,36,55,33
82306,"Vitamin D; 25 hydroxy, includes fraction(s), if performed",278,250,79,264,264,142,264,264,142,142,264,172,110,157,174,113,138,79,264,182,135,259,98,264,162,149,155,264,188,196,153,157,139,147,144,142,264,264,142,142,264,134,156,147,217,217,217,156,142,217,132
82308,Calcitonin,227,204,48,216,216,124,207,216,109,116,216,124,48,128,142,82,116,64,214,149,110,211,80,216,132,122,126,216,153,160,123,128,115,120,118,116,216,216,116,116,216,110,121,109,161,177,177,139,116,177,108
82310,Calcium; total,53,48,15,52,50,29,48,50,27,27,50,29,27,30,33,19,27,15,50,35,25,49,19,50,31,28,29,50,52,37,28,30,29,28,27,27,50,50,27,27,50,26,26,30,38,41,41,41,27,41,25
82330,Calcium; ionized,131,118,37,124,124,72,119,124,66,67,124,71,82,74,82,47,67,37,123,86,63,122,46,124,76,70,73,124,88,92,81,74,65,69,68,67,124,124,67,67,124,63,70,69,93,102,102,80,67,102,62
82340,"Calcium; urine quantitative, timed specimen",63,57,18,60,60,35,57,60,32,32,60,39,26,36,39,23,32,18,59,41,31,59,22,60,37,34,35,60,42,44,34,36,19,33,33,32,60,60,32,32,60,30,33,33,45,49,49,39,32,49,30
82365,Calculus; infrared spectroscopy,47,42,13,53,45,26,43,45,24,24,45,29,52,27,29,53,24,13,44,31,23,44,17,45,27,25,26,45,32,33,29,27,24,25,24,24,45,45,24,24,45,23,25,25,33,37,37,31,24,37,22
82374,Carbon dioxide (bicarbonate),50,45,14,48,48,27,45,48,25,26,48,27,18,28,31,18,26,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,26,26,26,26,47,48,26,25,48,24,27,26,35,39,39,31,26,39,24
82375,Carboxyhemoglobin; quantitative,110,99,31,105,104,60,100,105,55,56,104,60,40,62,69,40,56,31,103,72,53,102,39,104,64,59,61,104,74,77,60,62,52,58,57,56,104,105,56,56,104,53,58,58,78,86,86,68,56,86,52
82378,Carcinoembryonic antigen (CEA),108,97,31,103,103,55,98,103,54,55,103,58,52,61,67,39,55,31,102,71,52,100,38,103,63,58,60,103,73,76,59,61,58,57,56,55,103,103,55,55,103,52,60,57,77,84,84,66,55,84,51
82379,"Carnitine (total and free), quantitative, each specimen",161,145,45,153,153,88,146,153,81,82,153,88,59,91,101,58,83,45,151,106,78,150,57,153,94,86,90,153,109,113,94,91,81,85,84,82,153,153,82,82,153,78,86,85,114,125,125,99,82,125,77
82384,Catecholamines; fractionated,238,214,50,226,226,130,217,226,119,121,226,130,50,134,149,86,122,67,224,156,115,221,84,226,138,128,132,226,161,167,129,134,82,126,123,121,226,226,121,121,226,115,121,126,169,185,185,146,121,185,113
82390,Ceruloplasmin,106,95,26,101,101,58,96,101,53,54,101,58,26,60,66,38,54,30,100,70,51,99,37,101,62,57,59,101,71,75,58,60,59,56,55,54,101,101,54,54,101,51,56,56,75,83,83,59,54,83,50
82397,Chemiluminescent assay,104,94,29,99,99,57,95,99,52,53,99,64,38,59,65,38,53,29,98,68,50,97,37,99,60,56,58,99,70,73,56,59,53,55,54,53,99,99,53,53,99,50,52,55,74,81,81,64,53,81,50
82436,Chloride; urine,52,47,13,49,49,28,47,49,26,27,49,28,13,29,32,19,27,15,49,34,25,48,18,49,30,28,29,49,35,37,28,29,26,28,27,27,49,49,27,27,49,25,28,28,37,41,41,32,27,41,25
82465,"Cholesterol, serum or whole blood, total",43,39,12,41,41,24,39,41,22,22,41,23,20,24,27,16,22,12,40,28,21,40,15,41,25,23,24,41,29,30,27,24,22,23,22,22,41,41,22,22,41,21,22,23,30,33,33,26,22,33,20
82507,Citrate,262,236,25,249,249,143,238,249,131,134,249,143,25,148,164,95,134,74,246,172,127,244,93,249,152,141,146,249,177,184,142,148,79,139,136,134,249,249,134,134,249,126,139,139,186,204,204,161,134,204,125
82525,Copper,121,109,34,115,115,66,115,115,61,62,115,66,41,68,76,44,62,34,114,79,59,113,43,115,70,65,67,115,82,85,66,68,62,64,63,62,115,115,62,62,115,58,64,64,86,94,94,74,62,94,58
82530,Cortisol; free,160,144,45,152,152,88,146,152,80,82,152,87,57,90,100,53,82,45,151,105,77,149,56,152,93,86,89,152,108,113,87,90,80,85,83,82,152,152,82,82,152,77,85,85,113,125,125,98,82,125,76
82533,Cortisol; total,157,141,44,149,149,86,143,149,78,80,149,86,52,89,98,57,81,44,148,103,76,146,55,149,91,84,87,149,106,110,97,89,78,83,81,80,149,149,80,80,149,76,75,75,111,122,122,96,80,122,75
82540,Creatine,50,45,13,48,48,27,45,48,25,26,48,27,13,28,31,18,26,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,25,26,26,26,47,48,26,25,48,24,27,26,35,39,39,31,26,39,24
82542,"Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte not elsewhere specified; quantitative, single stationary and mobile phase",192,173,54,182,182,105,175,182,96,98,182,105,70,108,120,69,98,54,181,126,93,179,68,182,116,103,107,182,130,135,106,108,96,102,100,98,182,182,98,98,182,93,102,102,136,150,150,118,98,150,91
82550,"Creatine kinase (CK), (CPK); total",96,86,26,94,91,49,46,91,49,49,91,52,26,53,60,29,48,53,91,63,46,89,34,91,55,52,53,91,94,94,52,60,53,51,50,49,91,91,49,49,91,48,54,54,48,75,75,54,49,75,40
82553,"Creatine kinase (CK), (CPK); MB fraction only",113,102,40,111,107,58,54,107,58,58,107,62,53,62,71,57,56,63,107,74,54,105,40,107,65,61,62,107,111,111,62,70,63,60,56,58,107,107,58,58,107,56,63,63,56,88,88,63,58,88,75
82565,Creatinine; blood,53,48,11,52,50,26,50,50,27,27,50,29,20,30,33,11,26,15,50,35,25,49,19,50,27,28,29,50,52,52,33,30,27,28,27,27,50,50,27,27,50,26,30,27,41,41,41,28,27,41,25
82570,Creatinine; other source,42,38,11,40,40,21,40,40,21,21,40,23,26,24,26,26,21,12,40,28,20,39,15,40,25,23,23,40,23,11,23,24,21,22,24,21,40,40,21,21,40,20,21,21,27,33,33,24,21,33,20
82595,"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)",202,182,57,192,192,111,184,192,101,103,192,110,74,114,126,73,104,57,190,132,98,188,71,192,117,109,112,192,136,142,110,114,101,107,105,103,192,192,103,103,192,98,113,107,143,157,157,124,103,157,96
82607,Cyanocobalamin (Vitamin B-12);,147,132,14,140,140,75,140,140,75,75,140,81,50,83,92,52,75,14,138,96,71,137,52,140,81,79,82,140,70,87,81,83,75,78,76,75,140,140,75,75,140,71,82,82,115,115,115,115,75,115,70
82627,Dehydroepiandrosterone-sulfate (DHEA-S),211,190,26,200,200,116,192,200,106,108,200,114,26,119,132,76,108,60,198,138,102,196,74,200,123,113,117,200,142,148,113,119,117,112,109,108,200,200,108,108,200,102,112,112,150,164,164,130,108,164,100
82652,"Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed",360,324,102,342,342,197,328,342,184,184,342,223,107,203,225,128,185,102,339,236,174,335,127,342,209,193,200,342,243,253,193,203,180,191,187,184,342,342,184,184,342,174,202,190,255,280,280,221,184,280,171
82656,"Elastase, pancreatic (EL-1), fecal, qualitative or semi-quantitative",121,109,34,115,115,66,110,115,61,62,115,66,46,68,76,44,62,34,114,79,59,113,43,115,70,65,67,115,82,85,66,68,40,64,63,62,115,115,62,62,115,58,64,64,86,94,94,74,62,94,58
82668,Erythropoietin,180,162,46,171,171,92,164,171,90,92,171,98,46,102,112,65,92,51,169,118,87,167,64,171,105,97,100,171,121,127,98,102,91,95,93,92,171,171,92,92,171,87,92,101,128,140,140,111,92,140,86
82670,Estradiol,264,238,39,251,251,145,240,251,132,135,251,154,51,149,165,39,126,75,248,173,128,251,93,251,154,142,147,251,178,186,142,149,132,140,137,135,251,251,135,135,251,127,140,140,187,206,206,162,135,206,126
82671,Estrogens; fractionated,303,273,86,288,288,166,276,288,152,155,288,167,111,171,189,110,155,86,285,199,147,282,107,288,176,163,169,288,204,213,165,171,151,161,157,155,288,288,155,155,288,146,161,160,215,236,236,186,155,236,144
82677,Estriol,185,166,52,176,176,101,168,176,93,94,176,100,52,104,116,67,95,52,174,121,90,172,65,176,108,99,103,176,125,130,99,104,94,98,96,94,176,176,94,94,176,89,98,98,131,144,144,114,94,144,88
82679,Estrone,235,212,26,223,223,129,214,223,118,120,223,128,26,133,147,85,121,66,221,154,114,219,83,223,137,126,131,223,159,165,128,133,119,125,122,120,223,223,120,120,223,113,125,124,167,183,183,144,120,183,112
82710,"Fat or lipids, feces; quantitative",131,118,37,124,124,72,119,124,66,67,124,71,42,74,82,47,67,37,123,86,63,122,46,124,76,70,73,124,88,92,71,74,45,69,68,67,124,124,67,67,124,63,70,69,93,102,102,80,67,102,62
82725,"Fatty acids, nonesterified",200,180,26,190,190,110,182,190,100,102,190,109,26,113,125,72,103,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,101,106,104,102,190,190,102,102,190,97,106,106,142,156,156,123,102,156,95
82728,Ferritin,131,118,12,124,124,73,124,124,66,67,124,72,53,74,82,53,67,12,124,86,63,122,46,124,79,70,73,124,88,92,76,74,67,69,68,67,124,124,67,67,124,63,67,69,93,102,102,102,67,102,62
82746,Folic acid; serum,141,127,14,134,134,71,134,134,72,72,134,78,30,80,88,25,72,14,133,92,68,131,50,134,78,76,78,134,95,99,78,80,72,75,73,72,134,134,72,72,134,68,79,79,110,110,110,110,72,110,67
82784,"Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each",273,246,48,259,259,153,248,259,138,139,259,75,48,154,171,53,140,77,257,179,132,254,96,259,159,147,152,259,184,192,150,154,136,145,142,139,259,259,139,139,259,132,145,136,194,213,213,71,139,213,130
82785,Gammaglobulin (immunoglobulin); IgE,159,143,45,151,151,87,145,151,80,81,151,86,81,90,99,57,82,45,150,104,77,148,56,151,96,85,88,151,107,112,99,90,89,84,82,81,151,151,81,81,151,77,85,84,113,124,124,98,81,124,76
82787,"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each",126,113,25,120,120,69,115,120,63,64,120,69,25,71,79,46,65,36,119,83,61,117,44,120,73,68,70,120,85,89,69,71,64,67,65,64,120,120,64,64,120,61,67,67,89,98,98,77,64,98,60
82805,"Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry",185,166,52,289,176,94,168,176,94,94,176,100,276,103,116,289,103,52,174,121,89,172,65,176,112,99,103,176,125,148,99,104,94,98,96,94,176,176,94,94,176,89,104,104,131,144,144,98,94,144,88
82945,"Glucose, body fluid, other than blood",40,36,11,38,38,22,36,38,20,20,38,22,15,23,25,14,21,11,38,26,19,37,14,38,23,21,22,38,27,28,22,23,20,21,21,20,38,38,20,20,38,19,21,22,28,31,31,25,20,31,19
82947,"Glucose; quantitative, blood (except reagent strip)",40,36,11,38,38,22,36,38,20,20,38,22,23,23,25,14,21,11,38,26,19,37,14,38,23,21,22,38,27,28,25,23,22,21,21,20,38,38,20,20,38,19,21,21,28,31,31,25,20,31,19
82951,"Glucose; tolerance test (GTT), 3 specimens (includes glucose)",100,90,28,95,95,55,91,95,50,51,95,55,48,56,62,50,51,28,94,66,48,93,35,95,58,54,56,95,67,70,55,56,51,53,52,51,95,95,51,51,95,48,53,53,71,78,78,61,51,78,48
82955,Glucose-6-phosphate dehydrogenase (G6PD); quantitative,71,64,20,67,67,39,65,67,36,36,67,39,26,40,44,26,36,20,67,47,34,66,25,67,41,38,40,67,48,50,39,40,40,38,37,36,67,67,36,36,67,34,38,38,50,55,55,44,36,55,34
82962,"Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use",5,4,1,30,5,3,5,5,3,3,5,3,30,3,3,2,3,1,5,3,2,5,2,5,3,3,3,5,3,5,3,3,3,3,3,3,5,5,3,3,5,2,3,3,4,4,4,3,3,4,2
82977,"Glutamyltransferase, gamma (GGT)",73,66,13,69,69,40,66,69,37,37,69,40,13,41,46,26,37,21,69,48,35,68,26,69,42,39,41,69,49,51,31,41,37,39,38,37,69,69,37,37,69,35,41,39,52,57,57,36,37,57,35
83001,Gonadotropin; follicle stimulating hormone (FSH),177,159,26,168,168,88,161,168,89,90,168,97,27,100,111,26,85,50,166,116,86,168,62,168,103,95,98,168,119,125,95,100,88,94,92,90,168,168,90,90,168,85,94,99,126,138,138,95,90,138,84
83002,Gonadotropin; luteinizing hormone (LH),176,158,26,167,167,88,160,167,88,90,167,97,26,99,110,26,90,50,166,115,85,167,62,167,102,95,98,167,119,124,94,99,88,93,91,90,167,167,90,90,167,85,94,93,125,137,137,90,90,137,84
83003,"Growth hormone, human (HGH) (somatotropin)",160,144,26,152,152,88,146,152,80,82,152,86,26,90,100,58,82,45,151,105,77,149,56,152,93,86,89,152,108,113,87,90,81,85,83,82,152,152,82,82,152,77,85,85,113,125,125,98,82,125,76
83010,Haptoglobin; quantitative,122,110,24,116,116,67,111,116,62,62,116,67,24,69,76,56,63,34,115,80,59,114,43,116,74,66,68,116,82,86,76,69,62,65,63,62,116,116,62,62,116,59,61,68,87,95,95,95,62,95,58
83020,"Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F)",53,48,14,50,50,29,48,50,27,27,50,29,26,30,33,19,27,15,50,35,26,49,19,50,31,28,29,50,36,37,14,30,27,28,27,27,50,50,27,27,50,26,28,28,38,41,41,33,27,41,25
83021,"Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F)",53,48,14,75,50,29,48,50,27,27,50,29,75,30,33,19,27,15,50,35,26,49,19,50,31,28,29,50,36,37,14,30,27,28,27,27,50,50,27,27,50,26,28,28,38,41,41,33,27,41,25
83036,Hemoglobin; glycosylated (A1C),94,85,14,89,89,17,89,28,15,48,89,25,48,35,59,50,47,52,89,62,14,87,33,89,52,51,52,89,15,15,50,19,17,50,35,48,89,89,48,48,89,45,17,17,67,73,73,17,48,73,45
83051,Hemoglobin; plasma,74,67,21,70,70,41,67,70,37,38,70,40,27,42,46,27,38,21,70,49,36,69,26,70,43,40,41,70,50,52,40,42,38,39,38,38,70,70,38,38,70,36,41,39,52,58,58,41,38,58,35
83090,Homocysteine,224,202,49,213,213,123,204,213,112,114,213,121,49,126,140,64,115,63,211,147,108,208,79,213,130,120,125,213,151,158,131,126,125,119,116,114,213,213,114,114,213,108,119,119,159,174,174,138,114,174,107
83497,"Hydroxyindolacetic acid, 5-(HIAA)",71,64,20,67,67,39,65,67,36,36,67,38,45,40,44,26,36,20,67,47,34,66,25,67,41,38,40,67,48,50,39,40,36,38,37,36,67,67,36,36,67,34,38,38,50,55,55,44,36,55,34
83498,"Hydroxyprogesterone, 17-d",257,231,24,244,244,141,234,244,129,131,244,140,24,145,161,93,132,73,242,169,124,239,91,244,149,138,143,244,173,181,140,145,130,136,133,131,244,244,131,131,244,124,137,136,182,200,200,158,131,200,122
83516,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method",113,102,32,107,107,62,103,107,57,58,107,70,51,64,71,41,54,32,106,74,55,105,40,107,66,61,63,107,76,80,61,64,63,60,59,58,107,107,58,58,107,55,60,60,80,88,88,88,58,88,54
83519,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA)",343,309,97,326,326,188,312,326,172,175,326,187,125,194,214,124,176,97,323,225,166,319,121,326,199,184,191,326,231,241,186,193,192,182,178,175,326,326,175,175,326,166,182,181,243,267,267,211,175,267,163
83520,"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified",97,87,25,92,92,54,92,92,48,49,92,58,25,55,61,51,54,27,91,64,47,90,34,92,53,52,53,92,65,68,53,55,54,51,50,49,92,92,49,49,92,47,54,48,69,76,76,65,49,76,46
83521,,206,185,26,196,196,113,187,196,103,105,196,112,26,116,129,26,106,58,194,135,100,192,73,196,120,111,115,196,139,145,112,116,103,109,107,105,196,196,105,105,196,99,110,109,146,160,160,126,105,160,98
83525,Insulin; total,112,101,32,106,106,61,102,106,56,57,106,62,49,63,70,40,57,32,105,73,54,104,40,106,65,60,62,106,76,79,60,63,57,59,58,57,106,106,57,57,106,54,60,59,79,87,87,69,57,87,53
83540,Iron,65,58,6,62,62,33,62,62,33,33,62,36,23,37,41,24,36,6,62,43,31,60,23,62,39,35,36,62,44,46,36,37,33,34,34,33,62,62,33,33,62,31,36,34,46,51,51,44,33,51,31
83550,Iron binding capacity,76,68,8,72,72,41,72,72,38,39,72,44,28,43,47,26,42,8,72,50,36,71,27,72,46,41,42,72,51,53,42,43,39,40,39,39,72,72,39,39,72,37,41,43,54,59,59,59,39,59,36
83605,Lactate (lactic acid),103,93,36,101,98,58,98,98,53,53,98,56,53,57,64,37,57,57,98,68,49,96,36,98,59,55,57,98,84,101,57,60,53,55,53,53,98,98,53,53,98,49,58,58,73,80,80,58,53,80,82
83615,"Lactate dehydrogenase (LD), (LDH);",63,57,8,62,60,34,57,60,32,32,60,35,26,35,39,23,31,18,59,41,31,59,22,60,38,34,35,60,8,62,39,36,32,33,33,32,60,60,32,32,60,30,32,32,45,49,49,35,32,49,30
83630,"Lactoferrin, fecal; qualitative",134,121,21,127,127,73,122,127,67,68,127,73,49,76,84,48,69,38,126,88,65,125,47,127,78,72,75,127,90,94,72,76,21,71,70,68,127,127,68,68,127,65,71,71,95,104,104,82,68,104,64
83655,Lead,119,107,34,113,113,65,108,113,60,61,113,65,39,67,74,39,61,34,113,78,58,111,42,113,69,64,66,113,80,84,65,67,61,63,62,61,113,113,61,61,113,57,63,63,84,93,93,93,61,93,57
83690,Lipase,70,63,13,69,66,39,66,67,36,36,66,38,14,38,44,13,37,20,66,46,34,65,25,66,38,38,38,66,69,69,38,38,39,37,36,36,66,67,36,36,66,34,39,36,55,55,55,39,36,55,66
83718,"Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol)",81,73,23,77,77,44,74,77,41,41,77,44,30,46,51,29,42,23,76,53,39,75,29,77,47,44,45,77,55,57,44,46,41,43,42,41,77,77,41,41,77,39,43,43,57,63,63,50,41,63,39
83721,"Lipoprotein, direct measurement; LDL cholesterol",76,68,21,75,72,43,72,72,39,39,72,47,50,38,47,53,39,21,71,50,36,71,27,72,44,41,42,72,44,75,42,47,39,40,39,39,72,72,39,39,72,37,43,39,54,59,59,43,39,59,36
83735,Magnesium,68,61,19,67,65,35,33,65,35,35,65,37,23,38,42,26,34,19,65,45,33,63,24,65,40,37,41,65,67,67,36,34,35,36,35,35,65,65,35,35,65,33,38,38,53,53,53,38,35,53,35
83789,"Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not elsewhere specified; quantitative, each specimen",193,174,55,183,183,106,176,183,97,98,183,105,78,109,121,70,99,55,182,127,93,180,68,183,112,104,107,183,130,136,105,109,98,102,100,98,183,183,98,98,183,93,103,102,137,150,150,118,98,150,92
83825,"Mercury, quantitative",53,48,15,50,50,29,48,50,27,27,50,29,19,30,33,19,27,15,50,35,26,49,19,50,31,28,29,50,36,37,29,30,27,28,27,27,50,50,27,27,50,26,28,28,38,41,41,33,27,41,25
83835,Metanephrines,342,308,27,325,325,129,311,325,171,174,325,87,27,193,214,54,175,97,322,224,166,318,121,325,199,184,190,325,231,241,89,193,117,181,177,174,325,325,174,174,325,165,78,181,243,266,266,210,174,266,163
83874,Myoglobin,124,112,26,123,118,62,113,118,62,63,118,72,26,70,77,30,64,35,117,81,60,115,44,118,72,67,69,118,123,122,77,70,69,66,64,63,118,118,63,63,118,60,62,63,88,97,97,97,63,97,59
83880,Natriuretic peptide,318,286,34,302,302,178,302,302,162,162,302,175,112,176,199,121,177,34,302,209,153,296,112,302,185,171,177,302,274,227,175,172,162,169,165,162,302,302,162,162,302,154,178,178,159,248,248,178,162,248,136
83883,"Nephelometry, each analyte not elsewhere specified",206,185,52,196,196,113,187,196,103,105,196,112,52,116,129,52,106,58,194,135,99,192,73,196,125,111,115,196,139,145,112,116,64,109,107,105,196,196,105,105,196,99,110,109,146,160,160,126,105,160,98
83919,"Organic acids; qualitative, each specimen",161,145,45,153,153,88,146,153,81,82,153,88,59,91,101,58,83,45,151,106,78,150,57,153,94,86,90,153,109,113,100,91,81,85,84,82,153,153,82,82,153,78,86,85,114,125,125,99,82,125,77
83921,"Organic acid, single, quantitative",182,164,37,173,173,100,166,173,91,93,173,100,37,103,114,66,93,51,171,119,88,169,64,173,106,98,101,173,123,128,113,103,97,96,94,93,173,173,93,93,173,88,97,87,129,142,142,142,93,142,87
83930,Osmolality; blood,67,60,18,64,64,37,61,64,34,34,64,18,25,38,42,24,34,19,63,44,32,62,24,64,39,36,37,64,45,47,36,38,33,36,35,34,64,64,34,34,64,32,36,32,48,52,52,41,34,52,32
83935,Osmolality; urine,70,63,14,67,66,38,64,67,35,36,66,19,14,39,44,25,36,20,66,46,34,65,25,66,41,38,39,66,47,49,38,39,35,37,36,36,66,67,36,36,66,34,39,34,50,55,55,43,36,55,33
83945,Oxalate,124,112,26,118,118,68,113,118,62,63,118,77,26,70,77,45,64,35,117,81,60,115,44,118,72,67,69,118,84,87,67,70,38,66,64,63,118,118,63,63,118,60,66,66,88,97,97,76,63,97,59
83970,Parathormone (parathyroid hormone),246,221,70,234,234,125,234,234,123,125,234,133,102,139,154,112,122,70,231,161,118,229,87,234,143,132,137,234,166,173,142,139,138,130,128,125,234,234,125,125,234,119,132,123,174,192,192,138,125,192,117
83986,"pH; body fluid, not otherwise specified",39,35,4,37,37,21,35,37,20,20,37,21,13,22,24,14,20,11,37,26,19,36,14,37,23,21,22,37,26,27,21,22,4,21,20,20,37,37,20,20,37,19,21,22,28,30,30,24,20,30,19
83993,"Calprotectin, fecal",258,232,54,245,245,141,235,245,129,132,245,86,54,146,161,93,132,73,243,169,125,240,91,245,150,139,144,245,174,182,140,145,131,137,134,132,245,245,132,132,245,125,137,137,183,201,201,158,132,201,123
84030,"Phenylalanine (PKU), blood",184,166,52,175,175,101,167,175,92,94,175,99,67,104,115,67,94,52,173,121,89,171,65,175,107,99,102,175,124,129,114,104,93,98,95,94,175,175,94,94,175,89,98,97,131,143,143,113,94,143,88
84075,"Phosphatase, alkaline;",53,48,11,50,50,29,48,50,27,27,50,29,11,30,33,19,27,15,50,35,26,49,19,50,31,28,29,50,36,37,31,30,22,28,27,27,50,50,27,27,50,26,30,28,38,41,41,30,27,41,25
84080,"Phosphatase, alkaline; isoenzymes",151,136,41,143,143,83,137,143,76,77,143,82,55,85,94,55,77,43,142,99,73,140,53,143,88,81,84,143,102,106,41,85,75,80,78,77,143,143,77,77,143,73,80,80,107,118,118,85,77,118,72
84100,Phosphorus inorganic (phosphate);,48,43,13,46,46,26,46,46,24,24,46,26,13,27,30,17,25,14,45,31,23,45,17,46,28,26,27,46,32,34,26,27,26,25,25,24,46,46,24,24,46,23,27,24,34,37,37,27,24,37,23
84105,Phosphorus inorganic (phosphate); urine,53,48,6,50,50,29,48,50,27,27,50,29,13,30,33,19,27,15,50,35,26,49,19,50,31,28,29,50,36,37,29,30,6,28,27,27,50,50,27,27,50,26,28,28,38,41,41,33,27,41,25
84132,"Potassium; serum, plasma or whole blood",47,42,13,45,45,25,43,45,26,24,45,25,23,27,29,29,26,13,44,31,23,44,17,45,27,25,26,45,35,33,27,27,23,25,24,24,45,45,24,24,45,23,25,25,33,37,37,26,24,37,22
84133,Potassium; urine,44,40,12,42,42,24,40,42,22,22,42,27,14,25,27,33,23,12,41,29,21,41,16,42,26,24,24,42,30,31,24,25,23,23,23,22,42,42,22,22,42,21,23,23,31,34,34,27,22,34,21
84134,Prealbumin,139,125,39,132,132,76,132,132,67,71,132,76,40,78,87,50,71,39,131,91,67,129,49,132,81,75,77,132,94,98,76,78,78,74,72,71,132,132,71,71,132,67,70,74,99,108,108,85,71,108,66
84144,Progesterone,200,180,47,190,190,110,182,190,100,102,190,108,47,113,125,52,103,57,188,131,97,190,71,190,116,107,111,190,135,141,110,113,101,106,104,102,190,190,102,102,190,97,106,106,142,156,156,156,102,156,95
84145,Procalcitonin (PCT),188,169,53,184,179,103,171,179,94,96,179,102,53,106,117,68,104,53,177,123,90,175,66,179,114,101,105,179,127,184,103,106,96,100,98,96,179,179,96,96,179,91,96,96,133,146,146,95,96,146,159
84146,Prolactin,184,166,26,175,175,92,167,175,92,94,175,101,26,104,115,40,94,52,173,121,89,175,65,175,101,99,101,175,124,129,101,104,92,98,95,94,175,175,94,94,175,89,103,97,131,143,143,98,94,143,88
84150,"Prostaglandin, each",2700,2430,763,2565,2565,1479,2456,2565,1351,1377,2565,1473,988,1523,1687,976,1385,763,2540,1771,1307,2512,953,2565,1570,1451,1502,2565,1821,1900,1467,1523,1349,1431,1401,1377,2565,2565,1377,1377,2565,1303,1436,1429,1915,2103,2103,1658,1377,2103,1286
84153,Prostate specific antigen (PSA); total,176,158,16,167,167,99,167,167,89,90,167,97,50,99,110,53,93,16,167,115,84,164,62,167,102,95,98,167,136,53,97,99,99,93,91,90,167,167,90,90,167,85,99,99,113,137,137,137,90,137,84
84154,Prostate specific antigen (PSA); free,176,158,25,167,167,96,160,167,88,90,167,109,25,99,110,64,90,50,166,115,85,164,62,167,102,95,98,167,119,124,94,99,99,93,91,90,167,167,90,90,167,85,94,93,125,137,137,137,90,137,84
84155,"Protein, total, except by refractometry; serum, plasma or whole blood",40,36,11,38,38,22,36,38,20,20,38,20,11,23,25,14,21,11,38,26,19,37,14,38,23,21,22,38,27,28,22,23,19,21,21,20,38,38,20,20,38,19,21,21,28,31,31,31,20,31,19
84156,"Protein, total, except by refractometry; urine",40,36,11,38,38,22,36,38,20,20,38,22,13,23,25,13,20,11,38,26,19,37,14,38,23,21,22,38,27,20,22,23,20,21,21,20,38,38,20,20,38,19,22,22,28,31,31,22,20,31,19
84157,"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)",33,30,9,31,31,18,30,31,17,17,31,18,12,19,21,12,17,9,31,22,16,31,12,31,19,18,18,31,22,23,18,19,16,17,17,17,31,31,17,17,31,16,18,18,23,26,26,20,17,26,16
84163,Pregnancy-associated plasma protein-A (PAPP-A),106,95,25,101,101,58,96,101,53,54,101,57,25,60,66,38,54,30,100,70,51,99,37,101,62,57,59,101,71,75,57,60,54,56,55,54,101,101,54,54,101,51,56,56,75,83,83,65,54,83,50
84165,"Protein; electrophoretic fractionation and quantitation, serum",106,95,26,101,101,59,96,101,54,54,101,66,26,60,66,26,54,30,100,70,51,99,37,101,64,57,59,101,71,75,66,60,53,56,55,54,101,101,54,54,101,51,54,59,75,83,83,59,54,83,50
84166,"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF)",170,153,48,162,162,95,155,162,85,87,162,105,53,96,106,50,87,48,160,111,82,158,60,162,99,91,95,162,115,67,105,96,85,90,88,87,161,162,87,87,162,82,90,90,121,132,132,104,87,132,81
84206,Proinsulin,103,93,26,98,98,56,94,98,52,53,98,56,26,58,64,37,53,29,97,68,50,96,36,98,60,55,57,98,69,72,56,58,52,55,53,53,98,98,53,53,98,50,55,54,73,80,80,63,53,80,49
84207,Pyridoxal phosphate (Vitamin B-6),265,238,61,252,252,145,241,252,133,135,252,145,61,150,166,96,136,75,249,174,128,247,94,252,154,142,147,252,179,186,164,149,134,140,137,135,252,252,135,135,252,128,141,140,188,206,206,163,135,206,126
84220,Pyruvate kinase,80,72,23,76,76,44,73,76,40,41,76,44,29,45,50,29,41,23,75,52,39,74,28,76,47,43,45,76,54,56,44,45,40,42,42,41,76,76,41,41,76,39,43,42,57,62,62,49,41,62,38
84244,Renin,208,187,26,198,198,114,189,198,104,106,198,114,26,117,130,75,107,59,196,136,101,194,73,198,121,112,116,198,140,146,113,117,106,110,108,106,198,198,106,106,198,100,111,110,148,162,162,128,106,162,99
84255,Selenium,98,88,28,115,93,54,115,93,49,50,93,53,39,55,61,35,50,28,92,64,47,91,35,93,57,53,55,93,66,69,53,55,50,52,51,50,93,93,50,50,93,47,52,52,70,76,76,60,50,76,47
84260,Serotonin,293,264,83,278,278,160,267,278,147,149,278,160,107,165,183,106,150,83,276,192,142,273,103,278,170,157,163,278,198,206,159,165,148,155,152,149,278,278,149,149,278,141,156,155,208,228,228,228,149,228,140
84270,Sex hormone binding globulin (SHBG),121,109,30,115,115,66,110,115,61,62,115,66,30,68,76,44,62,34,114,79,59,113,43,115,70,65,67,115,82,85,66,68,61,64,63,62,115,115,62,62,115,58,64,64,86,94,94,74,62,94,58
84295,"Sodium; serum, plasma or whole blood",48,43,14,46,46,26,44,46,24,24,46,30,20,27,30,17,25,14,45,31,23,45,17,46,28,26,27,46,32,34,26,27,24,25,25,24,46,46,24,24,46,23,26,25,34,37,37,29,24,37,23
84300,Sodium; urine,31,28,9,29,29,17,28,29,16,16,29,19,13,17,19,14,16,9,29,20,15,29,11,29,18,17,17,29,21,22,17,17,15,16,16,16,29,29,16,16,29,15,17,15,22,24,24,19,16,24,15
84305,Somatomedin,183,165,26,174,174,100,166,174,92,93,174,100,26,103,114,66,94,52,172,120,89,170,65,174,106,98,102,174,123,129,101,103,93,97,95,93,174,174,93,93,174,88,97,97,130,143,143,112,93,143,87
84311,"Spectrophotometry, analyte not elsewhere specified",43,39,12,41,41,24,39,41,22,22,41,23,16,24,27,16,22,12,40,28,21,40,15,41,25,23,24,41,29,30,23,24,22,23,22,22,41,41,22,22,41,21,23,24,30,33,33,26,22,33,20
84392,"Sulfate, urine",33,30,9,31,31,18,30,31,17,17,31,18,24,19,21,12,17,9,31,22,16,31,12,31,19,18,18,31,22,23,18,19,17,17,17,17,31,31,17,17,31,16,18,17,23,26,26,20,17,26,16
84402,Testosterone; free,242,218,25,230,230,121,220,230,121,123,230,133,25,137,151,32,124,68,228,159,117,225,85,230,141,130,135,230,163,170,140,136,146,128,126,123,230,230,123,123,230,117,129,128,172,189,189,189,123,189,115
84403,Testosterone; total,245,220,26,233,233,130,223,233,122,125,233,135,47,138,153,26,126,69,233,161,119,228,87,233,148,132,136,233,165,172,152,138,122,130,127,125,233,233,125,125,233,118,137,130,157,191,191,137,125,191,117
84410,HC TESTOSTERONE BIOAVAILABLE,176,158,50,167,167,96,160,167,88,90,167,97,94,99,110,59,90,50,166,115,85,164,62,167,102,95,98,167,119,124,96,99,88,93,91,90,167,167,90,90,167,85,94,93,125,137,137,99,90,137,84
84425,Thiamine (Vitamin B-1),202,182,48,192,192,101,192,192,97,103,192,118,48,114,126,73,104,57,190,132,98,188,71,192,117,109,112,192,136,142,111,114,101,107,105,103,192,192,103,103,192,98,101,107,157,157,157,157,103,157,96
84432,Thyroglobulin,155,140,44,147,147,85,141,147,78,79,147,85,49,87,97,56,79,44,146,102,75,144,55,147,90,83,86,147,105,109,84,87,123,82,80,79,147,147,79,79,147,75,82,82,110,121,121,95,79,121,74
84436,Thyroxine; total,70,63,20,67,66,36,66,67,35,36,66,41,50,39,44,52,36,20,66,46,34,65,25,66,41,38,39,66,47,49,43,39,37,37,36,36,66,67,36,36,66,34,34,36,50,55,55,47,36,55,33
84439,Thyroxine; free,76,68,21,74,72,39,72,72,39,39,72,42,50,42,47,52,42,21,72,50,36,72,27,72,46,41,42,72,74,38,42,44,42,40,38,39,72,72,39,39,72,37,39,43,54,59,59,43,39,59,36
84443,Thyroid stimulating hormone (TSH),161,145,26,153,153,82,153,153,82,82,153,89,26,88,101,26,89,45,153,106,77,153,57,153,89,86,89,153,70,134,89,89,82,85,80,82,153,153,82,82,153,78,90,90,125,125,125,90,82,125,77
84445,Thyroid stimulating immune globulins (TSI),476,428,94,452,452,261,433,452,238,243,452,148,94,269,297,172,244,134,448,312,230,443,168,452,277,256,265,452,321,335,255,268,243,252,247,243,452,452,243,243,452,230,253,252,338,371,371,292,243,371,227
84446,Tocopherol alpha (Vitamin E),112,101,25,106,106,61,106,106,56,57,106,61,25,63,70,40,57,32,105,73,54,104,40,106,65,60,62,106,76,79,69,63,63,59,58,57,106,106,57,57,106,54,60,59,79,87,87,69,57,87,53
84450,Transferase; aspartate amino (AST) (SGOT),53,48,12,140,50,28,50,50,27,27,50,29,23,29,33,12,26,15,50,35,25,49,19,50,31,28,29,50,38,52,33,30,30,28,27,27,50,140,27,27,50,26,30,27,38,41,41,30,27,41,25
84460,Transferase; alanine amino (ALT) (SGPT),94,85,11,92,89,50,89,89,48,48,89,52,12,52,59,11,47,27,88,62,45,87,33,89,55,51,52,89,63,92,58,53,53,50,49,48,89,89,48,48,89,45,53,48,67,73,73,53,48,73,45
84466,Transferrin,123,111,30,117,117,67,112,117,62,63,117,67,30,69,77,44,63,35,116,81,60,114,43,117,72,66,68,117,83,87,76,69,43,65,64,63,117,117,63,63,117,59,65,65,87,96,96,69,63,96,59
84478,Triglycerides,60,54,11,57,57,33,55,57,30,31,57,35,11,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,37,34,34,32,31,31,57,57,31,31,57,29,32,34,43,47,47,34,31,47,29
84479,Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR),65,58,18,62,62,36,59,62,33,33,62,35,24,37,41,23,33,18,61,43,31,60,23,62,38,35,36,62,44,46,35,37,33,34,34,33,62,62,33,33,62,31,35,34,46,51,51,40,33,51,31
84480,Triiodothyronine T3; total (TT-3),123,111,25,117,117,62,112,117,63,63,117,66,25,69,77,44,63,35,116,81,60,114,43,117,72,66,68,117,83,87,68,69,69,65,64,63,117,117,63,63,117,59,62,59,87,96,96,69,63,96,59
84481,Triiodothyronine T3; free,162,146,25,154,154,87,147,154,83,83,154,89,25,91,101,26,83,46,152,106,78,151,57,154,98,87,90,154,109,114,87,100,83,86,84,83,154,154,83,83,154,78,91,83,115,126,126,91,83,126,77
84484,"Troponin, quantitative",96,86,26,95,91,49,91,91,49,49,91,53,26,53,60,30,53,53,89,63,32,89,34,91,58,52,53,91,94,95,52,60,49,51,50,49,91,91,49,49,91,48,54,54,48,75,75,54,49,75,37
84520,Urea nitrogen; quantitative,42,38,11,40,40,23,38,40,20,21,40,23,11,24,26,17,22,12,40,28,20,39,15,40,21,23,23,40,28,30,26,24,24,22,22,21,40,40,21,21,40,20,21,21,30,33,33,21,21,33,20
84550,Uric acid; blood,46,41,13,44,44,23,44,44,23,23,44,25,23,26,29,24,23,13,43,30,22,43,16,44,25,25,26,44,13,32,28,26,23,24,24,23,44,44,23,23,44,22,26,23,33,36,36,26,23,36,22
84560,Uric acid; other source,48,43,5,46,46,26,44,46,24,24,46,30,13,27,30,17,25,14,45,31,23,45,17,46,28,26,27,46,32,34,26,27,5,25,25,24,46,46,24,24,46,23,26,25,34,37,37,29,24,37,23
84585,"Vanillylmandelic acid (VMA), urine",150,135,24,143,142,82,136,143,75,76,142,82,24,85,94,54,77,42,141,98,73,140,53,142,87,81,83,142,101,106,82,85,76,80,78,76,142,143,76,76,142,72,80,79,106,117,117,92,76,117,71
84586,Vasoactive intestinal peptide (VIP),49,44,14,47,47,27,45,47,25,25,47,27,32,28,31,18,25,14,46,32,24,46,17,47,28,26,27,47,33,34,27,28,25,26,25,25,47,47,25,25,47,24,26,26,35,38,38,30,25,38,23
84588,"Vasopressin (antidiuretic hormone, ADH)",282,254,80,268,268,154,257,268,141,144,268,154,103,159,176,102,145,80,265,185,137,262,100,268,164,152,157,268,190,198,153,159,133,149,146,144,268,268,144,144,268,136,150,149,200,220,220,173,144,220,134
84590,Vitamin A,101,91,26,96,96,55,96,96,51,52,96,63,26,57,63,30,52,29,95,66,49,94,36,96,59,54,56,96,68,71,55,57,57,54,52,52,96,96,52,52,96,49,54,53,72,79,79,79,52,79,48
84597,Vitamin K,131,118,37,124,124,72,124,124,66,67,124,71,43,74,82,47,67,37,123,86,63,122,46,124,76,70,73,124,88,92,71,74,66,69,68,67,124,124,67,67,124,63,70,69,93,102,102,80,67,102,62
84630,Zinc,112,101,32,106,106,61,106,106,54,57,106,62,38,63,70,40,57,32,105,73,54,104,40,106,65,60,62,106,76,79,62,63,57,59,58,57,106,106,57,57,106,54,60,59,79,87,87,69,57,87,53
84681,C-peptide,200,180,26,190,190,110,182,190,100,102,190,110,26,113,125,72,103,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,106,106,104,102,190,190,102,102,190,97,106,106,142,156,156,156,102,156,95
84702,"Gonadotropin, chorionic (hCG); quantitative",145,130,40,138,138,79,132,138,73,74,138,80,49,82,91,40,74,41,138,95,70,135,51,138,88,78,81,138,98,102,80,78,73,77,75,74,138,138,74,74,138,70,77,77,103,113,113,113,74,113,69
85007,"Blood count; blood smear, microscopic examination with manual differential WBC count",36,32,3,36,34,20,33,34,18,18,34,19,33,20,22,36,17,3,34,24,17,33,13,34,21,19,20,34,24,25,19,20,20,19,19,18,34,34,18,18,34,17,18,17,26,28,28,18,18,28,17
85014,Blood count; hematocrit (Hct),24,22,7,40,23,12,23,23,12,12,23,13,29,14,15,40,12,7,23,16,12,22,8,23,14,13,13,23,16,17,15,14,13,13,12,12,23,23,12,12,23,12,13,13,17,19,19,13,12,19,11
85018,Blood count; hemoglobin (Hgb),24,22,1,29,23,12,23,23,12,12,23,13,27,14,15,29,13,7,23,16,12,22,8,23,14,13,13,23,16,1,13,14,12,13,12,12,23,23,12,12,23,12,13,13,17,19,19,13,12,19,11
85025,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count",78,70,7,77,74,40,74,74,40,40,74,43,29,43,49,30,39,7,74,51,37,74,28,74,43,44,43,74,77,76,43,43,40,41,41,40,74,74,40,40,74,39,44,44,61,61,61,44,40,61,8
85027,"Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)",78,70,6,77,74,44,74,74,39,40,74,42,30,43,49,36,43,6,74,51,37,73,28,74,47,42,43,74,77,76,43,44,44,41,39,40,74,74,40,40,74,37,44,42,61,61,61,44,40,61,37
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",58,52,5,55,55,32,53,55,30,30,55,32,15,33,36,17,30,5,55,38,28,54,20,55,35,31,32,55,39,41,36,33,30,31,30,30,55,55,30,30,55,28,30,32,41,45,45,45,30,45,28
85048,"Blood count; leukocyte (WBC), automated",26,23,7,25,25,14,24,25,13,13,25,14,18,15,16,9,13,7,24,17,13,24,9,25,15,14,14,25,18,18,14,15,13,14,13,13,25,25,13,13,25,13,15,14,18,20,20,15,13,20,12
85049,"Blood count; platelet, automated",46,41,13,44,44,25,42,44,23,23,44,25,18,26,29,36,24,13,43,30,22,43,16,44,27,25,26,44,31,32,25,26,23,24,24,23,44,44,23,23,44,22,24,24,33,36,36,36,23,36,22
85055,Reticulated platelet assay,80,72,23,76,76,44,73,76,40,41,76,44,29,45,50,29,41,23,75,52,39,74,28,76,47,43,45,76,54,56,43,45,40,42,42,41,76,76,41,41,76,39,43,42,57,62,62,49,41,62,38
85060,"Blood smear, peripheral, interpretation by physician with written report",73,66,21,69,69,40,66,69,37,37,69,39,62,41,46,26,37,21,69,48,35,68,26,69,42,39,41,69,49,51,40,41,37,39,38,37,69,69,37,37,69,35,35,39,52,57,57,57,37,57,35
85130,Chromogenic substrate assay,450,405,127,428,428,246,409,428,225,230,428,243,165,254,281,163,231,127,423,295,218,419,159,428,262,242,250,428,304,317,245,254,228,238,233,230,427,428,230,229,428,217,239,238,319,351,351,276,230,351,214
85220,"Clotting; factor V (AcG or proaccelerin), labile factor",290,261,28,276,276,159,264,276,145,148,276,180,28,164,181,105,149,82,273,190,140,270,102,276,169,156,161,276,196,204,180,164,100,154,150,148,275,276,148,148,276,140,154,153,206,226,226,162,148,226,138
85230,"Clotting; factor VII (proconvertin, stable factor)",131,118,37,124,124,72,119,124,66,67,124,71,48,74,82,47,67,37,123,86,63,122,46,124,76,70,73,124,88,92,71,74,45,69,68,67,124,124,67,67,124,63,70,69,93,102,102,80,67,102,62
85240,"Clotting; factor VIII (AHG), 1-stage",194,175,28,184,184,106,176,184,97,99,184,107,28,109,121,62,99,55,182,127,94,181,68,184,113,104,108,184,131,137,104,109,109,103,101,99,184,184,99,99,184,94,103,103,138,151,151,119,99,151,92
85245,"Clotting; factor VIII, VW factor, ristocetin cofactor",130,117,33,124,124,71,118,124,65,66,124,71,48,73,81,33,67,37,122,85,63,121,46,124,76,70,72,124,88,91,107,73,66,69,67,66,123,124,66,66,124,63,69,69,92,101,101,80,66,101,62
85246,"Clotting; factor VIII, VW factor antigen",198,178,31,188,188,108,180,188,99,101,188,109,33,112,124,31,102,56,186,130,96,184,70,188,115,106,110,188,134,139,106,112,100,105,103,101,188,188,101,101,188,96,105,105,140,154,154,122,101,154,94
85247,"Clotting; factor VIII, von Willebrand factor, multimetric analysis",130,117,33,124,124,71,118,124,65,66,124,71,48,73,81,33,67,37,122,85,63,121,46,124,76,70,72,124,88,91,107,73,66,69,67,66,123,124,66,66,124,63,69,69,92,101,101,80,66,101,62
85300,"Clotting inhibitors or anticoagulants; antithrombin III, activity",68,61,14,65,65,37,62,65,34,35,65,39,14,38,42,25,35,19,64,45,33,63,24,65,40,37,38,65,46,48,36,38,38,36,35,35,65,65,35,35,65,33,36,36,48,53,53,34,35,53,32
85301,"Clotting inhibitors or anticoagulants; antithrombin III, antigen assay",68,61,19,65,65,37,62,65,34,35,65,37,25,38,42,25,35,19,64,45,33,63,24,65,40,37,38,65,46,48,36,38,34,36,35,35,65,65,35,35,65,33,36,36,48,53,53,42,35,53,32
85302,"Clotting inhibitors or anticoagulants; protein C, antigen",117,105,23,111,111,64,106,111,59,60,111,63,23,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,63,66,59,62,61,60,111,111,60,60,111,56,62,62,83,91,91,72,60,91,56
85303,"Clotting inhibitors or anticoagulants; protein C, activity",125,112,14,119,119,68,114,119,63,64,119,72,14,71,78,45,64,35,118,82,61,116,44,119,73,67,70,119,84,88,67,70,70,66,65,64,119,119,64,64,119,60,66,66,89,97,97,62,64,97,60
85305,"Clotting inhibitors or anticoagulants; protein S, total",113,102,32,107,107,62,103,107,57,58,107,62,47,64,71,41,58,32,106,74,55,105,40,107,66,61,63,107,76,80,61,64,57,60,59,58,107,107,58,58,107,55,60,60,80,88,88,69,58,88,54
85306,"Clotting inhibitors or anticoagulants; protein S, free",148,133,14,141,141,81,135,141,74,75,141,81,14,84,92,54,76,42,139,97,72,138,52,141,86,80,82,141,100,104,79,83,83,78,77,75,141,141,75,75,141,71,79,78,105,115,115,74,75,115,70
85307,Activated Protein C (APC) resistance assay,148,133,42,141,141,81,135,141,74,75,141,81,54,84,92,54,76,42,139,97,72,138,52,141,86,80,82,141,100,104,74,83,75,78,77,75,141,141,75,75,141,71,79,78,105,115,115,91,75,115,70
85370,Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative,60,54,17,57,57,33,55,57,30,31,57,33,22,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,30,34,30,32,31,31,57,57,31,31,57,29,32,32,43,47,47,37,31,47,29
85379,"Fibrin degradation products, D-dimer; quantitative",85,76,24,83,81,48,81,81,43,43,81,47,26,47,53,24,45,47,80,56,41,79,30,81,49,46,47,81,57,83,46,46,48,45,44,43,81,81,43,43,81,41,48,48,60,66,66,48,43,66,40
85384,Fibrinogen; activity,84,76,11,80,80,46,76,80,42,43,80,45,11,47,52,30,43,24,79,55,41,78,30,80,49,45,47,80,57,59,45,47,43,45,44,43,80,80,43,43,80,41,42,44,60,65,65,42,43,65,40
85397,"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte",198,178,31,188,188,108,180,188,99,101,188,109,33,112,124,31,102,56,186,130,96,184,70,188,115,106,110,188,134,139,109,112,100,105,103,101,188,188,101,101,188,96,105,105,140,154,154,122,101,154,94
85549,Muramidase,50,45,14,48,48,27,45,48,25,26,48,27,24,28,31,18,26,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,25,26,26,26,47,48,26,25,48,24,27,26,35,39,39,31,26,39,24
85610,Prothrombin time;,39,35,8,39,37,9,37,15,8,20,37,21,26,9,24,28,19,11,37,26,8,36,14,37,23,21,22,37,39,8,21,20,9,21,20,20,37,37,20,20,37,20,20,9,28,30,30,20,20,30,34
85613,Russell viper venom time (includes venom); diluted,93,84,26,88,88,51,85,88,47,47,88,50,27,52,58,34,48,26,87,61,45,87,33,88,54,50,52,88,63,65,50,52,52,49,48,47,88,88,47,47,88,45,49,49,66,72,72,59,47,72,44
85652,"Sedimentation rate, erythrocyte; automated",39,35,3,39,37,20,37,37,20,20,37,21,15,21,24,15,19,11,37,26,19,36,14,37,21,21,21,37,39,38,21,21,20,21,20,20,37,37,20,20,37,19,22,20,28,30,30,22,20,30,3
85660,"Sickling of RBC, reduction",15,14,4,28,14,8,14,14,8,8,14,8,28,8,9,5,8,4,14,10,7,14,5,14,9,8,8,14,10,11,8,8,8,8,8,8,14,14,8,8,14,7,8,8,11,12,12,9,8,12,7
85730,"Thromboplastin time, partial (PTT); plasma or whole blood",53,48,13,51,50,27,50,50,26,27,50,29,13,30,33,14,25,15,50,35,25,49,19,50,31,28,29,50,36,37,28,26,27,28,27,27,50,50,27,27,50,26,30,30,38,41,41,30,27,41,51
86003,"Allergen specific IgE; quantitative or semiquantitative, each allergen",90,81,25,86,86,49,82,86,45,46,86,86,26,51,56,33,46,25,85,59,44,84,32,86,52,48,50,86,61,63,48,51,45,48,47,46,85,86,46,46,86,43,48,48,64,70,70,55,46,70,43
86008,HC ALLG SPEC IGE RECOMB EA,220,198,48,209,209,120,200,209,110,112,209,120,48,124,137,80,113,62,207,144,107,205,78,209,128,118,122,209,148,155,120,124,111,117,114,112,209,209,112,112,209,106,117,116,156,171,171,135,112,171,105
86015,,105,94,25,100,100,58,96,100,53,54,100,57,25,59,66,38,54,30,99,69,51,98,37,100,61,56,58,100,71,74,57,59,53,56,54,54,100,100,54,54,100,51,56,56,74,82,82,59,54,82,50
86021,Antibody identification; leukocyte antibodies,145,130,41,138,138,79,132,138,73,74,138,79,53,82,91,52,74,41,136,95,70,135,51,138,84,78,81,138,98,102,79,82,73,77,75,74,138,138,74,74,138,70,77,72,103,113,113,89,74,113,69
86022,Antibody identification; platelet antibodies,198,178,48,188,188,108,180,188,99,101,188,108,48,112,124,72,102,56,186,130,96,184,70,188,115,106,110,188,134,139,108,112,106,105,103,101,188,188,101,101,188,96,105,105,140,154,154,122,101,154,94
86023,Antibody identification; platelet associated immunoglobulin assay,198,178,56,188,188,108,180,188,99,101,188,109,72,112,124,72,102,56,186,130,96,184,70,188,115,106,110,188,134,139,108,112,100,105,103,101,188,188,101,101,188,96,105,105,140,154,154,122,101,154,94
86036,,117,105,33,111,111,64,106,111,59,60,111,64,43,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,64,66,50,62,61,60,111,111,60,60,111,56,66,62,83,91,91,72,60,91,56
86038,Antinuclear antibodies (ANA);,119,107,24,113,113,67,113,113,60,61,113,65,24,67,74,25,66,34,112,78,57,111,42,113,65,64,65,113,80,84,65,67,67,63,62,61,113,113,61,61,113,57,67,60,84,93,93,80,61,93,57
86060,Antistreptolysin 0; titer,74,67,21,70,70,41,67,70,37,38,70,46,24,42,46,27,38,21,70,49,36,69,26,70,45,40,41,70,50,52,40,42,39,39,38,38,70,70,38,38,70,36,39,39,52,58,58,45,38,58,35
86140,C-reactive protein;,53,48,15,52,50,27,50,50,26,27,50,29,46,30,33,49,28,15,50,35,25,49,19,50,29,28,29,50,52,37,29,30,27,28,27,27,49,50,27,27,50,26,28,27,38,41,41,30,27,41,25
86141,C-reactive protein; high sensitivity (hsCRP),124,112,35,118,118,68,113,118,63,63,118,77,47,70,77,45,64,35,117,81,60,115,44,118,72,67,69,118,84,87,77,70,69,66,64,63,118,118,63,63,118,60,62,66,88,97,97,76,63,97,59
86146,"Beta 2 Glycoprotein I antibody, each",171,154,36,162,162,94,156,162,86,87,162,92,36,96,107,62,88,48,161,112,83,159,60,162,99,92,95,162,115,120,92,96,96,91,89,87,162,162,87,87,162,83,91,90,121,133,133,109,87,133,81
86147,"Cardiolipin (phospholipid) antibody, each Ig class",171,154,48,162,162,94,156,162,86,87,162,94,73,96,107,62,88,48,161,112,83,159,60,162,99,92,95,162,115,120,92,96,96,91,89,87,162,162,87,87,162,83,91,90,121,133,133,109,87,133,81
86160,"Complement; antigen, each component",117,105,25,111,111,64,106,111,59,60,111,64,25,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,63,66,58,62,61,60,111,111,60,60,111,56,66,62,83,91,91,66,60,91,56
86162,Complement; total hemolytic (CH50),193,174,48,183,183,106,176,183,97,98,183,105,48,109,121,70,99,55,182,127,93,180,68,183,112,104,107,183,130,136,119,109,108,102,100,98,183,183,98,98,183,93,103,102,137,150,150,118,98,150,92
86200,"Cyclic citrullinated peptide (CCP), antibody",124,112,23,118,118,63,113,118,62,63,118,72,23,70,77,27,69,35,117,81,60,115,44,118,68,67,69,118,84,87,77,70,62,66,64,63,118,118,63,63,118,60,66,66,88,97,97,69,63,97,59
86215,"Deoxyribonuclease, antibody",132,119,21,125,125,72,120,125,66,67,125,82,24,74,82,48,68,37,124,87,64,123,47,125,21,71,73,125,89,93,72,74,66,70,68,67,125,125,67,67,125,64,70,70,94,103,103,81,67,103,63
86225,Deoxyribonucleic acid (DNA) antibody; native or double stranded,132,119,23,125,125,72,120,125,66,67,125,73,23,74,82,24,68,37,124,87,64,123,47,125,77,71,73,125,89,93,73,74,73,70,68,67,125,125,67,67,125,64,74,66,94,103,103,81,67,103,63
86231,,50,45,14,48,48,27,45,48,25,26,48,27,22,28,31,18,26,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,25,26,26,26,47,48,26,25,48,24,27,26,35,39,39,31,26,39,24
86235,"Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody",97,87,27,2426,461,272,461,92,242,49,92,60,43,55,61,37,269,27,91,64,233,90,34,92,267,52,267,92,739,367,264,55,178,51,50,49,92,2426,49,49,92,47,54,242,69,76,76,282,49,76,46
86255,"Fluorescent noninfectious agent antibody; screen, each antibody",117,105,26,171,111,64,106,111,59,60,111,63,26,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,63,66,66,62,61,60,111,111,60,60,111,56,53,62,83,91,91,171,60,91,56
86258,,113,102,22,107,107,62,103,107,57,58,107,62,22,64,71,41,58,32,106,74,55,105,40,107,66,61,63,107,76,80,70,64,57,60,59,58,107,107,58,58,107,55,60,60,80,88,88,69,58,88,54
86300,"Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29)",200,180,57,190,190,110,182,190,100,102,190,110,73,113,125,72,103,57,188,131,96,186,71,190,116,107,111,190,135,141,109,113,100,106,104,102,190,190,102,102,190,97,106,106,142,156,156,123,102,156,95
86301,"Immunoassay for tumor antigen, quantitative; CA 19-9",200,180,57,190,190,110,182,190,96,102,190,109,110,113,125,72,103,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,100,106,104,102,190,190,102,102,190,97,106,106,142,156,156,123,102,156,95
86304,"Immunoassay for tumor antigen, quantitative; CA 125",200,180,40,190,190,110,182,190,100,102,190,108,48,113,125,40,103,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,100,106,104,102,190,190,102,102,190,97,100,106,142,156,156,156,102,156,95
86308,Heterophile antibodies; screening,53,48,15,50,50,29,48,50,27,27,50,29,48,30,33,19,27,15,50,35,26,49,19,50,32,28,32,50,36,37,29,30,28,28,27,27,50,50,27,27,50,26,28,25,38,41,41,41,27,41,25
86316,"Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each",200,180,50,190,190,110,182,190,100,102,190,108,50,113,125,72,103,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,112,106,104,102,190,190,102,102,190,97,106,106,142,156,156,123,102,156,95
86317,"Immunoassay for infectious agent antibody, quantitative, not otherwise specified",145,130,41,138,138,79,132,138,73,74,138,79,46,82,91,52,74,41,136,95,70,135,51,138,84,78,81,138,98,102,79,82,73,77,75,74,138,138,74,74,138,70,77,77,103,113,113,89,74,113,69
86318,"Immunoassay for infectious agent antibody, qualitative or semiquantitative, single step method (eg, reagent strip)",84,76,24,80,80,42,76,80,43,43,80,52,48,47,52,30,43,24,79,55,41,78,30,80,49,45,47,80,57,59,46,47,47,45,44,43,80,80,43,43,80,41,40,44,60,65,65,47,43,65,40
86331,"Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody",170,153,25,162,162,93,155,162,85,87,162,93,25,96,106,61,87,48,160,111,82,158,60,162,99,91,95,162,115,120,92,96,86,90,88,87,161,162,87,87,162,82,90,90,121,132,132,104,87,132,81
86334,Immunofixation electrophoresis; serum,212,191,38,201,201,119,193,201,108,108,201,116,51,120,132,38,109,60,199,139,103,197,75,201,128,114,118,201,143,149,131,120,106,112,110,108,201,201,108,108,201,102,113,119,150,165,165,130,108,165,101
86335,"Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF)",274,247,77,260,260,150,249,260,137,140,260,150,106,155,171,99,141,77,258,180,133,255,97,260,159,147,152,260,185,193,170,155,137,145,142,140,260,260,140,140,260,132,146,145,194,213,213,168,140,213,130
86336,Inhibin A,124,112,25,118,118,68,113,118,62,63,118,67,25,70,77,45,64,35,117,81,60,115,44,118,72,67,69,118,84,87,67,70,63,66,64,63,118,118,63,63,118,60,66,66,88,97,97,76,63,97,59
86337,Insulin antibodies,620,558,48,589,589,340,564,589,310,316,589,341,48,350,387,224,318,175,583,407,300,577,219,589,361,333,345,589,418,436,337,350,314,329,322,316,589,589,316,316,589,299,330,328,440,483,483,381,316,483,295
86340,Intrinsic factor antibodies,145,130,24,138,138,79,132,138,73,74,138,79,24,82,91,52,74,41,136,95,70,135,51,138,84,78,81,138,98,102,79,82,73,77,75,74,138,138,74,74,138,70,77,77,103,113,113,89,74,113,69
86341,Islet cell antibody,226,203,24,215,215,124,206,215,113,115,215,62,24,128,141,82,116,64,213,148,109,210,80,215,131,121,126,215,152,159,123,127,114,120,117,115,215,215,115,115,215,109,120,120,160,176,176,139,115,176,108
86353,"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis",1337,1203,106,1270,1270,732,1216,1270,669,682,1270,730,106,754,835,483,686,378,1258,877,647,1244,472,1270,777,718,744,1270,902,941,726,754,677,709,694,682,1270,1270,682,682,1270,645,711,707,948,1042,1041,821,682,1042,637
86355,"B cells, total count",144,130,41,137,137,79,131,137,72,73,137,74,97,81,90,52,74,41,135,94,70,134,51,137,84,77,80,137,97,101,78,81,73,76,75,73,137,137,73,73,137,70,77,76,102,112,112,88,73,112,69
86357,"Natural killer (NK) cells, total count",144,130,41,137,137,79,131,137,72,73,137,75,53,81,90,52,74,41,135,94,70,134,51,137,84,77,80,137,97,101,78,81,73,76,75,73,137,137,73,73,137,70,77,76,102,112,112,88,73,112,69
86359,T cells; total count,144,130,41,137,137,79,131,137,72,73,137,75,53,81,90,52,74,41,135,94,70,134,51,137,84,77,80,137,97,101,78,81,73,76,75,73,137,137,73,73,137,70,77,76,102,112,112,88,73,112,69
86360,"T cells; absolute CD4 and CD8 count, including ratio",333,300,53,316,316,182,303,316,167,170,316,173,53,188,208,120,171,94,313,218,161,310,118,316,194,179,185,316,225,234,179,188,169,176,173,170,316,316,170,170,316,161,177,176,236,259,259,204,170,259,159
86364,,113,102,22,107,107,62,103,107,57,58,107,62,22,64,71,41,58,32,106,74,55,105,40,107,66,61,63,107,76,80,62,64,56,60,59,58,107,107,58,58,107,55,60,60,80,88,88,69,58,88,54
86376,"Microsomal antibodies (eg, thyroid or liver-kidney), each",139,125,26,132,132,78,126,132,70,71,132,76,26,78,87,26,71,39,131,91,67,129,49,132,81,75,77,132,94,98,76,78,74,74,72,71,132,132,71,71,132,67,74,74,99,108,108,85,71,108,66
86381,,117,105,25,111,111,64,106,111,59,60,111,64,25,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,64,66,41,62,61,60,111,111,60,60,111,56,62,62,83,91,91,66,60,91,56
86431,Rheumatoid factor; quantitative,58,52,16,55,55,30,53,55,29,30,55,34,24,33,36,38,32,16,55,38,28,54,20,55,32,31,32,55,39,41,32,33,32,31,30,30,55,55,30,30,55,28,32,29,41,45,45,39,30,45,28
86480,"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon",151,136,43,143,143,83,137,143,76,77,143,94,90,85,94,66,77,43,142,99,73,140,53,143,83,81,84,143,102,106,93,85,80,80,78,77,143,143,77,77,143,73,72,80,107,118,118,85,77,118,72
86580,"Skin test; tuberculosis, intradermal",64,58,18,61,61,35,58,61,32,33,61,40,23,36,40,23,33,18,60,42,31,60,23,61,37,34,36,61,43,45,35,36,32,34,33,33,61,61,33,33,61,31,34,34,45,50,50,39,33,50,30
86592,"Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)",44,40,12,46,42,24,40,42,22,22,42,24,46,25,27,16,23,12,41,29,21,41,16,42,26,24,24,42,30,31,24,25,22,23,23,22,42,42,22,22,42,21,23,23,31,34,34,27,22,34,21
86606,Antibody; Aspergillus,145,130,25,138,138,79,132,138,73,74,138,79,25,82,91,52,74,41,136,95,70,135,51,138,84,78,81,138,98,102,79,82,73,77,75,74,138,138,74,74,138,70,77,77,103,113,113,89,74,113,69
86611,Antibody; Bartonella,61,55,17,58,58,33,55,58,31,31,58,33,23,34,38,22,31,17,57,40,30,57,22,58,35,33,34,58,41,43,34,33,31,32,32,31,58,58,31,31,58,29,32,32,43,48,48,37,31,48,29
86612,Antibody; Blastomyces,19,17,5,18,18,10,17,18,10,10,18,12,7,11,12,7,10,5,18,12,9,18,7,18,11,10,11,18,13,13,12,11,10,10,10,10,18,18,10,10,18,9,10,10,13,15,15,12,10,15,9
86617,"Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot)",150,135,42,143,142,82,136,143,75,76,142,81,47,85,94,54,77,42,141,98,73,140,53,142,87,81,83,142,101,106,82,85,84,80,78,76,142,143,76,76,142,72,80,79,106,117,117,92,76,117,71
86618,Antibody; Borrelia burgdorferi (Lyme disease),82,74,23,78,78,45,75,78,41,42,78,48,45,46,51,25,42,23,77,54,40,76,29,78,48,44,46,78,28,58,47,44,41,43,43,42,78,78,42,42,78,40,44,43,58,64,64,55,42,64,39
86635,Antibody; Coccidioides,19,17,5,18,18,10,17,18,10,10,18,10,7,11,12,7,10,5,18,12,9,18,7,18,11,10,11,18,13,13,12,11,10,10,10,10,18,18,10,10,18,9,10,10,13,15,15,12,10,15,9
86644,Antibody; cytomegalovirus (CMV),137,123,38,130,130,75,125,130,69,70,130,85,38,77,86,90,70,39,129,90,66,127,48,130,80,74,75,130,92,96,74,77,70,73,71,70,130,130,70,70,130,66,73,72,97,107,107,84,70,107,65
86645,"Antibody; cytomegalovirus (CMV), IgM",161,145,25,153,153,88,146,153,81,82,153,87,25,91,101,45,83,45,151,106,78,150,57,153,94,86,89,153,109,113,86,91,82,85,84,82,153,153,82,82,153,78,86,85,114,125,125,99,82,125,77
86664,"Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA)",60,54,17,57,57,33,55,57,30,31,57,37,49,34,37,45,31,17,56,39,29,56,21,57,35,32,33,57,40,42,32,34,31,32,31,31,57,57,31,31,57,29,32,32,43,47,47,37,31,47,29
86665,"Antibody; Epstein-Barr (EB) virus, viral capsid (VCA)",59,53,17,56,56,32,54,56,30,30,56,37,24,33,37,45,30,17,55,39,29,55,21,56,34,32,33,56,40,42,32,33,30,31,31,30,56,56,30,30,56,28,31,31,42,46,46,36,30,46,28
86666,Antibody; Ehrlichia,60,54,17,177,57,33,55,57,30,31,57,33,22,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,34,32,31,31,57,57,31,31,57,29,32,32,43,47,47,177,31,47,29
86668,Antibody; Francisella tularensis,25,22,7,24,24,14,23,24,13,13,24,14,9,14,16,9,13,7,24,16,12,23,9,24,15,13,14,24,17,18,14,14,13,13,13,13,24,24,13,13,24,12,13,13,18,19,19,19,13,19,12
86695,"Antibody; herpes simplex, type 1",125,112,35,119,119,68,114,119,63,64,119,68,46,71,78,51,64,35,118,82,61,116,44,119,73,67,70,119,84,88,77,70,63,66,65,64,119,119,64,64,119,60,66,66,89,97,97,77,64,97,60
86696,"Antibody; herpes simplex, type 2",125,112,23,119,119,68,114,119,63,64,119,38,23,71,78,25,64,35,118,82,61,116,44,119,73,67,70,119,84,88,77,70,63,66,65,64,119,119,64,64,119,60,66,66,89,97,97,77,64,97,60
86698,Antibody; histoplasma,39,35,11,37,37,21,35,37,20,20,37,24,14,22,24,14,20,11,37,26,19,36,14,37,23,21,22,37,26,27,24,22,19,21,20,20,37,37,20,20,37,19,21,21,28,30,30,24,20,30,19
86701,Antibody; HIV-1,50,45,14,48,48,27,45,48,25,26,48,27,18,28,31,18,26,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,25,26,26,26,47,48,26,25,48,24,27,26,35,39,39,31,26,39,24
86702,Antibody; HIV-2,48,44,14,46,46,27,44,46,24,25,46,26,18,27,30,18,25,14,46,32,23,45,17,46,28,26,27,46,33,34,26,27,25,26,25,25,46,46,25,25,46,23,26,26,34,38,38,30,25,38,23
86704,Hepatitis B core antibody (HBcAb); total,117,105,25,111,111,64,106,111,59,60,111,64,25,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,63,66,62,62,61,60,111,111,60,60,111,56,62,62,83,91,91,72,60,91,56
86705,Hepatitis B core antibody (HBcAb); IgM antibody,76,68,21,72,72,42,69,72,38,39,72,40,25,43,47,27,39,21,71,50,37,71,27,72,46,41,42,72,51,53,47,43,26,40,39,39,72,72,39,39,72,37,43,40,54,59,59,47,39,59,36
86706,Hepatitis B surface antibody (HBsAb),106,95,23,101,101,58,96,101,53,54,101,55,23,60,66,38,54,30,100,70,51,99,37,101,62,57,59,101,71,75,58,60,54,56,55,54,101,101,54,54,101,51,59,56,75,83,83,59,54,83,50
86707,Hepatitis Be antibody (HBeAb),96,86,12,91,91,53,87,91,48,49,91,52,25,54,60,35,49,27,90,63,46,89,34,91,58,52,53,91,65,68,60,54,12,51,50,49,91,91,49,49,91,46,51,51,68,75,75,59,49,75,46
86708,Hepatitis A antibody (HAAb); total,121,109,26,115,115,66,110,115,61,62,115,61,26,68,76,44,62,34,114,79,59,113,43,115,70,65,67,115,82,85,75,68,68,64,63,62,115,115,62,62,115,58,64,64,86,94,94,74,62,94,58
86709,Hepatitis A antibody (HAAb); IgM antibody,111,100,31,105,105,61,101,105,56,57,105,56,41,63,69,40,57,31,104,73,54,103,39,105,65,60,62,105,75,78,69,63,56,59,58,57,105,105,57,57,105,54,59,59,79,86,86,68,57,86,53
86713,Antibody; Legionella,132,119,37,125,125,72,120,125,66,67,125,72,48,74,82,48,68,37,124,87,64,123,47,125,77,71,73,125,89,93,72,74,67,70,68,67,125,125,67,67,125,64,70,70,94,103,103,81,67,103,63
86735,Antibody; mumps,125,112,35,119,119,68,114,119,63,64,119,68,49,71,78,45,64,35,118,82,61,116,44,119,73,67,70,119,84,88,50,70,63,66,65,64,119,119,64,64,119,60,66,66,89,97,97,97,64,97,60
86738,Antibody; mycoplasma,126,113,36,120,120,69,115,120,63,64,120,69,45,71,79,46,65,36,119,83,61,117,44,120,73,68,70,120,85,89,68,71,71,67,65,64,120,120,64,64,120,61,67,67,89,98,98,77,64,98,60
86753,"Antibody; protozoa, not elsewhere specified",60,54,17,57,57,33,55,57,30,31,57,33,22,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,34,32,31,31,57,57,31,31,57,29,32,32,43,47,47,41,31,47,29
86757,Antibody; Rickettsia,218,196,23,207,207,119,198,207,109,111,207,119,23,123,136,79,112,62,205,143,106,203,77,207,127,117,121,207,147,153,118,123,76,116,113,111,207,207,111,111,207,105,116,115,155,170,170,134,111,170,104
86762,Antibody; rubella,137,123,25,130,130,75,125,130,69,70,130,75,25,77,86,26,70,39,130,90,66,127,48,130,80,74,76,130,92,96,80,74,69,73,71,70,130,130,70,70,130,66,73,72,97,107,107,107,70,107,65
86765,Antibody; rubeola,124,112,25,118,118,68,113,118,62,63,118,68,25,70,77,45,64,35,117,81,60,115,44,118,72,67,69,118,84,87,67,70,63,66,64,63,118,118,63,63,118,60,66,66,88,97,97,97,63,97,59
86768,Antibody; Salmonella,146,131,41,139,139,80,133,139,73,74,139,80,53,82,91,53,75,41,137,96,71,136,52,139,85,78,81,139,98,103,79,82,73,77,76,74,139,139,74,74,139,70,78,77,104,114,114,90,74,114,70
86769,HC SARS-COV-2 COVID-19 ANTIBODY,100,90,2,95,95,51,91,95,51,51,95,58,46,56,62,37,51,28,94,66,48,93,35,95,58,54,56,95,2,70,62,56,56,53,52,51,95,95,51,51,95,48,56,56,71,78,78,56,51,78,48
86777,Antibody; Toxoplasma,137,123,39,130,130,75,125,130,69,70,130,75,50,77,86,50,70,39,129,90,66,127,48,130,80,74,76,130,92,96,75,77,69,73,71,70,130,130,70,70,130,66,73,72,97,107,107,84,70,107,65
86778,"Antibody; Toxoplasma, IgM",137,123,39,130,130,75,125,130,69,70,130,75,50,77,86,50,70,39,129,90,66,127,48,130,80,74,76,130,92,96,75,77,69,73,71,70,130,130,70,70,130,66,73,72,97,107,107,84,70,107,65
86780,Antibody; Treponema pallidum,179,161,47,170,170,98,163,170,90,91,170,98,47,101,112,65,92,51,168,117,87,167,63,170,104,96,100,170,121,126,98,101,91,95,93,91,170,170,91,91,170,86,95,95,127,139,139,98,91,139,85
86784,Antibody; Trichinella,65,58,18,62,62,36,59,62,33,33,62,35,24,37,41,23,33,18,61,43,31,60,23,62,38,35,36,62,44,46,35,37,33,34,34,33,62,62,33,33,62,31,35,34,46,51,51,40,33,51,31
86787,Antibody; varicella-zoster,124,112,35,118,118,68,113,118,62,63,118,68,47,70,77,45,64,35,117,81,60,115,44,118,68,67,69,118,84,87,68,70,63,66,64,63,118,118,63,63,118,60,66,66,88,97,97,97,63,97,59
86800,Thyroglobulin antibody,154,139,24,146,146,84,140,146,77,79,146,85,24,87,96,56,79,44,145,101,75,143,54,146,90,83,86,146,104,108,84,87,79,82,80,79,146,146,79,79,146,74,82,81,109,120,120,95,79,120,73
86803,Hepatitis C antibody;,135,122,38,128,128,69,128,128,69,69,128,74,46,76,84,48,71,38,128,89,65,128,48,128,74,73,75,128,91,128,84,73,69,72,76,69,128,128,69,69,128,65,76,76,96,105,105,76,69,105,64
86812,"HLA typing; A, B, or C (eg, A10, B7, B27), single antigen",245,220,29,233,233,134,223,233,123,125,233,99,29,138,153,89,126,69,230,161,119,228,87,233,142,132,136,233,165,172,133,138,124,130,127,125,233,233,125,125,233,118,130,130,174,191,191,150,125,191,117
86832,HC HLA CLASS I HIGH DEFIN QUAL,540,486,45,513,513,296,491,513,270,275,513,295,100,305,337,45,277,153,508,354,261,502,191,513,314,290,300,513,364,380,293,305,270,286,280,275,513,513,275,275,513,261,287,286,383,421,421,332,275,421,257
86833,HC HLA CLASS II HIGH DEFIN QUAL,350,315,22,333,332,192,318,333,175,178,332,191,50,197,219,22,179,99,329,230,169,326,124,332,204,188,195,332,236,246,190,197,175,186,182,178,332,333,178,178,332,169,186,185,248,273,273,215,178,273,167
86850,"Antibody screen, RBC, each serum technique",126,113,30,120,120,35,115,120,64,64,120,69,47,71,79,45,65,36,59,83,30,117,44,120,73,68,70,120,85,89,74,33,44,67,65,64,120,120,64,64,120,61,33,67,89,98,98,31,64,98,60
86870,"Antibody identification, RBC antibodies, each panel for each serum technique",323,291,91,307,307,177,294,307,162,165,307,176,118,182,202,117,166,91,304,212,156,301,114,307,188,174,180,307,218,227,176,182,180,171,168,165,307,307,165,165,307,156,172,171,229,252,252,198,165,252,154
86880,"Antihuman globulin test (Coombs test); direct, each antiserum",50,45,14,107,48,27,45,48,25,26,48,27,18,28,31,107,26,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,28,26,26,26,47,48,26,25,48,24,27,26,35,39,39,39,26,39,24
86900,Blood typing; ABO,126,113,13,120,120,16,115,120,64,64,120,69,36,71,79,22,65,36,27,83,13,117,44,120,73,68,70,120,85,89,74,15,44,67,65,64,120,120,64,64,120,61,15,67,89,98,98,14,64,98,60
86901,Blood typing; Rh (D),151,136,15,143,143,17,137,143,77,77,143,83,29,85,94,26,77,43,29,99,15,140,53,143,88,81,84,143,102,106,88,17,52,80,78,77,143,143,77,77,143,73,16,80,107,118,118,16,77,118,72
86920,Compatibility test each unit; immediate spin technique,147,132,22,140,140,82,134,140,75,75,140,79,54,83,92,22,75,42,138,96,71,137,52,140,85,79,82,140,99,103,91,83,51,78,76,75,140,140,75,75,140,71,82,78,104,115,115,74,75,115,70
86922,Compatibility test each unit; antiglobulin technique,160,144,45,152,152,88,146,152,80,82,152,87,59,90,100,58,82,45,151,105,77,149,56,152,93,86,89,152,108,113,87,90,56,85,83,82,152,152,82,82,152,77,85,85,113,125,125,98,82,125,76
86971,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, each",100,90,28,95,95,55,91,95,50,51,95,55,37,56,62,36,51,28,94,66,48,93,35,95,58,54,56,95,67,70,54,56,56,53,52,51,95,95,51,51,95,48,53,53,71,78,78,61,51,78,48
86972,"Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation",200,180,57,190,190,110,182,190,100,102,190,109,73,113,125,72,103,57,188,131,97,186,71,190,116,107,111,190,135,141,109,113,111,106,104,102,190,190,102,102,190,97,106,106,142,156,156,123,102,156,95
87015,"Concentration (any type), for infectious agents",62,56,18,59,59,34,56,59,31,32,59,33,23,35,39,22,32,18,58,41,30,58,22,59,36,33,34,59,42,44,34,35,21,33,32,32,59,59,32,32,59,30,33,33,44,48,48,31,32,48,30
87040,"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)",101,91,29,115,96,52,92,96,52,52,96,55,43,55,63,115,56,29,95,66,48,94,36,96,59,54,56,96,68,99,56,57,52,54,52,52,96,96,52,52,96,48,57,57,72,79,79,54,52,79,48
87070,"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates",85,76,7,81,81,50,81,81,43,43,81,47,33,51,53,36,42,7,80,81,44,79,30,81,49,43,47,81,11,48,47,53,46,45,44,43,81,81,43,43,81,41,47,42,60,66,66,48,43,66,40
87075,"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates",92,83,15,90,87,50,84,87,46,47,87,50,15,52,57,33,44,26,87,60,45,86,32,87,53,49,51,87,62,90,49,50,47,49,48,47,87,87,47,47,87,44,49,44,65,72,72,72,47,72,44
87076,"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate",70,63,20,67,66,38,64,67,35,36,66,38,26,39,44,25,36,20,66,42,34,65,25,66,41,38,39,66,47,49,38,38,33,37,36,36,66,67,36,36,66,34,37,37,50,55,55,43,36,55,33
87077,"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate",74,67,21,303,70,38,73,70,38,38,70,41,30,42,46,33,38,21,70,70,37,69,26,70,47,60,41,70,50,44,43,46,41,39,37,38,70,303,38,38,70,37,41,41,52,58,58,41,38,58,35
87081,"Culture, presumptive, pathogenic organisms, screening only;",60,54,17,57,57,33,55,57,29,31,57,33,33,34,37,34,30,17,56,39,29,56,21,57,35,32,33,57,40,42,32,34,34,32,31,31,57,57,31,31,57,29,31,32,30,47,47,47,31,47,29
87086,"Culture, bacterial; quantitative colony count, urine",80,72,7,79,76,41,76,76,41,41,76,44,31,45,50,26,43,7,76,52,38,76,28,76,48,43,44,76,79,14,44,50,41,42,38,41,76,76,41,41,76,39,45,45,62,62,62,45,41,62,38
87102,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)",60,54,16,59,57,33,55,57,30,31,57,30,16,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,59,33,34,19,32,31,31,57,57,31,31,57,29,32,32,43,47,47,37,31,47,29
87103,"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood",101,91,29,96,96,55,92,96,51,52,96,55,37,57,63,37,52,29,95,66,49,94,36,96,59,54,56,96,68,71,55,57,57,54,52,52,96,96,52,52,96,49,54,53,72,79,79,62,52,79,48
87106,"Culture, fungi, definitive identification, each organism; yeast",122,110,34,116,116,67,111,116,61,62,116,67,45,69,76,44,63,34,115,80,59,114,43,116,71,66,68,116,82,86,71,69,61,65,63,62,116,116,62,62,116,59,65,65,87,95,95,75,62,95,58
87107,"Culture, fungi, definitive identification, each organism; mold",92,83,16,87,87,50,84,87,46,47,87,50,16,52,57,33,47,26,87,60,45,86,32,87,53,49,51,87,62,65,50,52,52,49,48,47,87,87,47,47,87,44,49,49,65,72,72,56,47,72,44
87116,"Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates",106,95,30,101,101,58,96,101,53,54,101,57,52,60,66,38,54,30,100,70,51,99,37,101,62,57,59,101,71,75,58,60,37,56,55,54,101,101,54,54,101,51,56,56,75,83,83,53,54,83,50
87147,"Culture, typing; immunologic method, other than immunofluoresence (eg, agglutination grouping), per antiserum",53,48,15,50,50,29,48,50,27,27,50,33,16,30,33,17,25,15,50,35,26,49,19,50,31,28,29,50,36,37,28,30,27,28,27,27,50,50,27,27,50,26,26,28,38,41,41,41,27,41,25
87149,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism probed",385,346,101,366,366,211,350,366,101,196,366,210,141,217,240,139,197,109,362,252,186,358,136,366,224,207,214,366,260,271,209,217,189,204,200,196,366,366,196,196,366,186,101,204,273,300,300,236,196,300,183
87150,"Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism probed",311,280,39,295,295,170,283,295,87,158,295,89,114,175,194,112,159,88,292,204,150,289,110,295,181,167,173,295,210,219,94,175,39,165,161,158,295,295,158,158,295,150,86,164,220,242,242,155,158,242,148
87168,Macroscopic examination; arthropod,155,140,44,147,147,85,141,147,78,79,147,85,57,87,97,56,79,44,146,102,75,144,55,147,90,83,86,147,105,109,48,87,78,82,80,79,147,147,79,79,147,75,82,82,110,121,121,95,79,121,74
87177,"Ova and parasites, direct smears, concentration and identification",79,71,10,75,75,40,72,75,40,40,75,43,32,45,49,29,41,22,74,52,38,74,28,75,46,42,44,75,53,56,42,45,10,42,41,40,75,75,40,40,75,38,42,42,56,62,62,42,40,62,38
87181,"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)",85,76,17,81,81,47,77,81,43,43,81,23,17,48,53,31,44,24,80,56,41,79,30,81,49,46,47,81,57,60,53,48,48,45,44,43,81,81,43,43,81,41,45,45,60,66,66,52,43,66,40
87184,"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)",30,27,8,29,28,17,27,29,15,15,28,16,18,17,19,11,15,8,28,20,15,28,11,28,17,16,17,28,20,29,8,17,17,16,16,15,28,29,15,15,28,14,15,16,21,23,23,18,15,23,14
87185,"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme",44,40,12,42,42,24,40,42,22,22,42,24,17,25,27,16,23,12,41,29,21,41,16,42,26,24,24,42,30,31,24,24,25,23,23,22,42,42,22,22,42,21,23,23,31,34,34,27,22,34,21
87186,"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial, per plate",85,76,6,83,81,43,81,81,43,43,81,47,17,48,53,17,43,24,80,56,41,79,30,81,51,43,47,81,6,83,47,53,43,45,44,43,81,81,43,43,81,41,48,48,60,66,66,48,43,66,40
87205,"Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types",44,40,4,43,42,25,42,42,25,22,42,24,17,24,27,18,22,4,41,42,21,41,16,42,26,22,24,42,30,43,24,27,22,23,23,22,42,42,22,22,42,21,24,22,31,34,34,25,22,34,21
87206,"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types",25,22,7,25,24,14,23,24,13,13,24,12,16,14,16,9,13,7,24,16,12,23,9,24,15,13,14,24,17,25,14,14,9,13,13,13,24,24,13,13,24,12,13,13,18,19,19,12,13,19,12
87209,"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites",93,84,16,88,88,46,85,88,47,47,88,50,16,52,58,34,48,26,87,61,45,87,33,88,54,50,52,88,63,65,50,52,20,49,48,47,88,88,47,47,88,45,49,49,66,72,72,50,47,72,44
87210,"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps)",18,16,5,17,17,10,16,17,9,9,17,10,7,10,11,7,9,5,17,12,9,17,6,17,10,10,10,17,12,13,10,10,10,10,9,9,17,17,9,9,17,9,9,10,13,14,14,11,9,14,9
87220,"Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)",44,40,12,42,42,24,40,42,22,22,42,24,16,25,27,16,23,12,41,29,21,41,16,42,26,24,24,42,30,22,24,25,25,23,23,22,42,42,22,22,42,21,23,25,31,34,34,25,22,34,21
87305,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Aspergillus",50,45,14,48,48,27,45,48,25,26,48,31,18,28,31,18,26,14,47,33,24,47,18,48,29,27,28,48,34,35,27,28,25,26,26,26,47,48,26,25,48,24,27,26,35,39,39,31,26,39,24
87324,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Clostridium difficile toxin(s)",117,105,10,115,111,66,111,111,58,60,111,63,33,66,73,54,10,33,110,77,57,109,41,111,68,63,65,111,79,115,73,66,58,62,61,60,111,111,60,60,111,56,62,66,83,91,91,63,60,91,56
87338,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Helicobacter pylori, stool",117,105,32,111,111,64,106,111,60,60,111,64,32,66,34,54,56,33,110,77,57,109,41,111,68,63,65,111,60,82,63,63,62,62,61,60,111,111,60,60,111,56,62,62,83,91,91,66,60,91,56
87340,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen (HBsAg)",94,85,27,89,89,51,86,89,47,48,89,52,31,53,59,36,48,27,89,62,46,87,33,89,55,51,52,89,63,66,58,51,47,50,49,48,89,89,48,48,89,45,53,50,67,73,73,63,48,73,45
87341,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen (HBsAg) neutralization",54,49,15,51,51,30,49,51,27,28,51,29,34,30,34,20,28,15,51,35,26,50,19,51,31,29,30,51,36,38,29,30,27,29,28,28,51,51,28,28,51,26,29,29,38,42,42,33,28,42,26
87350,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; hepatitis Be antigen (HBeAg)",113,102,12,107,107,62,103,107,57,58,107,62,41,64,71,41,58,32,106,74,55,105,40,107,68,61,63,107,76,80,70,64,12,60,59,58,107,107,58,58,107,55,60,60,80,88,88,69,58,88,54
87385,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Histoplasma capsulatum",179,161,51,170,170,98,163,170,90,91,170,111,65,101,112,65,92,51,168,117,87,167,63,170,104,96,100,170,121,126,97,101,91,95,93,91,170,170,91,91,170,86,95,95,127,139,139,110,91,139,85
87389,HC HIV-1 AG W/ HIV-1 & HIV-2 AB,97,87,17,92,92,53,88,92,48,49,92,53,26,55,61,17,50,27,92,64,47,90,34,92,56,52,54,92,67,68,53,52,48,51,50,49,92,92,49,49,92,47,47,54,69,76,76,76,49,76,46
87420,"Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; respiratory syncytial virus",117,105,13,111,111,64,106,111,59,60,111,64,33,64,73,13,60,33,110,77,57,109,41,111,64,63,65,111,79,82,64,66,14,62,61,60,111,111,60,60,111,56,60,62,83,91,91,91,60,91,56
87428,Sarscov & inf vir a&b ag ia,150,135,33,143,142,82,136,143,75,76,142,93,33,85,94,54,77,42,141,98,73,140,53,142,87,81,83,142,76,76,93,93,84,80,78,76,142,143,76,76,142,72,84,84,106,117,117,84,76,117,71
87449,"Infectious agent antigen detection by enzyme immunoassay technique qualitative or semiquantitative; multiple step method, not otherwise specified, each organism",144,130,16,137,137,79,131,137,69,73,137,89,16,81,90,52,74,41,135,94,70,134,51,137,84,77,80,137,97,101,78,81,73,76,75,73,137,137,73,73,137,70,77,76,102,112,112,88,73,112,69
87480,"Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique",62,56,6,59,59,59,56,59,31,32,59,34,33,35,39,35,34,17,58,41,30,59,22,59,34,33,34,59,42,6,34,33,31,33,32,32,59,59,32,32,59,30,35,35,44,48,48,42,32,48,30
87483,HC CNS DNA AMP PROBE TYPE 12-25,320,288,90,314,304,175,291,304,160,163,304,175,314,181,200,116,164,90,301,210,155,298,113,304,186,172,178,304,216,225,174,180,151,170,166,163,304,304,163,163,304,154,170,169,227,249,249,196,163,249,152
87486,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique",107,96,30,115,102,59,102,102,54,55,102,58,105,60,67,115,55,30,101,70,51,100,38,102,62,57,60,102,72,75,54,60,55,57,56,55,102,102,55,55,102,52,54,54,76,83,83,83,55,83,51
87491,"Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique",227,204,64,431,216,216,207,216,114,116,216,125,69,128,142,71,113,64,216,149,110,211,80,216,125,122,126,216,90,160,125,123,113,120,118,116,216,431,116,116,216,110,127,127,161,177,177,177,116,177,108
87493,"Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique",144,129,30,136,136,79,131,136,30,73,136,78,52,81,90,52,74,41,135,94,69,134,51,136,83,77,80,136,97,101,78,81,37,76,74,73,136,136,73,73,136,69,76,76,102,112,112,88,73,112,68
87497,"Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification",328,295,76,312,312,180,298,312,164,167,312,179,76,185,205,119,168,93,309,215,159,305,116,312,191,176,183,312,221,231,176,185,167,174,170,167,312,312,167,167,312,158,174,174,233,256,256,201,167,256,156
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",122,110,43,116,116,62,116,116,62,62,116,67,65,67,76,86,62,83,116,80,59,114,43,116,67,68,68,116,82,102,67,76,62,65,63,62,116,116,62,62,116,59,68,68,87,95,95,68,62,95,58
87507,HC IADNA-DNA/RNA PROBE TQ 12-25,361,325,102,360,343,198,343,343,184,184,343,210,307,204,346,307,360,102,340,237,175,336,127,343,210,194,201,343,244,254,199,204,180,191,187,184,343,343,184,184,343,174,202,191,256,281,281,242,184,281,172
87510,"Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique",62,56,17,59,59,59,56,59,31,32,59,34,17,35,39,17,34,17,58,41,30,59,22,59,34,33,34,59,42,32,34,33,31,33,32,32,59,59,32,32,59,30,35,35,44,48,48,35,32,48,30
87517,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification",690,621,71,656,656,378,628,656,345,352,656,377,115,389,431,71,354,195,649,453,334,642,244,656,401,371,384,656,465,486,375,389,292,366,358,352,655,656,352,352,656,333,367,365,489,538,537,424,352,538,329
87522,"Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification",401,361,36,381,381,220,365,381,200,205,381,217,67,226,250,36,206,113,377,263,194,373,142,381,243,215,223,381,270,282,221,200,200,213,208,205,381,381,205,205,381,194,213,192,284,312,312,246,205,312,191
87529,"Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique",328,295,69,312,312,180,298,312,164,167,312,203,69,185,205,71,168,93,309,215,159,305,116,312,191,176,183,312,221,231,180,185,184,174,170,167,312,312,167,167,312,158,174,184,233,256,256,256,167,256,156
87536,"Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification",93,84,26,88,88,51,85,88,47,47,88,51,34,52,58,36,48,26,87,61,45,87,33,88,54,50,52,88,63,65,51,52,39,49,48,47,88,88,47,47,88,45,49,49,66,72,72,57,47,72,44
87581,"Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique",107,96,30,102,102,59,102,102,54,55,102,58,52,60,67,58,55,30,101,70,51,100,38,102,62,57,60,102,72,75,54,60,55,57,56,55,102,102,55,55,102,52,54,54,76,83,83,83,55,83,51
87591,"Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique",227,204,35,216,216,216,207,216,114,116,216,125,35,128,142,36,113,64,216,149,110,211,80,216,125,122,126,216,153,160,125,123,113,120,118,116,216,216,116,116,216,110,127,127,161,177,177,177,116,177,108
87633,HC RESP VIRUS 20 TARGETS,107,96,30,102,102,59,102,102,54,55,102,58,58,60,67,58,55,30,101,70,51,100,38,102,62,57,60,102,72,75,54,60,55,57,56,55,102,102,55,55,102,52,57,57,76,83,83,83,55,83,51
87635,Infectious agent detection by nucleic acid; severe acute respiratory syndrome coronavirus COVID-19,100,90,35,98,95,51,95,95,50,51,95,55,77,55,62,77,50,44,95,66,48,93,35,95,52,54,52,95,83,98,55,62,51,50,52,51,95,95,51,51,95,48,51,56,50,78,78,56,51,78,53
87641,"Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique",277,249,69,263,263,152,252,263,139,141,263,151,69,156,173,100,142,78,261,182,134,258,98,263,161,149,154,263,187,195,151,156,147,147,144,141,263,263,141,141,263,134,147,147,196,216,216,216,141,216,132
87651,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique",50,45,14,71,48,26,48,48,26,26,48,28,67,28,31,71,25,14,48,33,24,47,18,48,29,27,28,48,49,32,28,28,25,26,26,26,47,48,26,25,48,24,28,28,35,39,39,28,26,39,24
87653,"Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique",192,173,54,182,182,105,175,182,96,98,182,104,70,108,120,69,98,54,181,126,93,179,68,182,112,103,107,182,130,135,103,108,97,102,100,98,182,182,98,98,182,93,102,102,136,150,150,118,98,150,91
87660,"Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique",62,56,17,59,59,59,56,59,31,32,59,34,17,35,39,17,34,17,58,41,30,59,22,59,34,33,34,59,42,44,34,33,31,33,32,32,59,59,32,32,59,30,35,35,44,48,48,42,32,48,30
87798,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism",107,96,30,105,102,59,102,102,54,55,102,58,71,60,67,58,55,30,101,70,51,100,38,102,62,57,60,102,72,75,86,60,105,57,56,55,102,102,55,55,102,52,54,54,76,83,83,83,55,83,51
87799,"Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism",564,508,71,536,536,288,513,536,282,288,536,308,71,318,352,71,289,159,531,370,273,525,199,536,328,303,314,536,380,397,303,318,282,299,293,288,536,536,288,288,536,272,300,298,400,439,439,346,288,439,269
87801,"Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique",120,108,34,114,114,66,109,114,60,61,114,65,69,68,75,43,62,34,113,79,58,112,42,114,70,64,67,114,81,84,65,68,61,64,62,61,114,114,61,61,114,58,64,63,85,93,93,74,61,93,57
87804,Infectious agent antigen detection by immunoassay with direct optical observation; Influenza,53,48,15,50,50,29,48,50,27,27,50,29,19,30,33,19,27,15,50,35,26,49,19,50,31,28,29,50,36,37,33,30,26,28,27,27,50,50,27,27,50,26,26,28,38,41,41,33,27,41,25
87811,HC SARS-COV-2 COVID19 W/OPTIC,45,40,13,43,43,23,41,43,23,23,43,28,33,25,28,16,23,13,42,30,22,42,16,43,26,25,25,43,26,16,28,28,22,24,35,23,43,43,23,23,43,22,25,25,32,35,35,25,23,35,21
87880,"Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group A",116,104,33,110,110,64,106,110,58,59,110,63,42,65,72,42,59,33,109,76,56,108,41,110,67,62,65,110,78,82,62,65,65,61,60,59,110,110,59,59,110,56,62,61,82,90,90,71,59,90,55
87902,Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus,938,844,105,891,891,514,853,891,469,478,891,512,105,529,586,339,481,265,882,615,454,873,331,891,545,504,522,891,633,660,510,529,475,497,487,478,891,891,478,478,891,453,499,496,665,731,731,576,478,731,447
88184,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker",198,178,56,188,188,108,180,188,99,101,188,109,145,112,124,72,102,56,186,130,96,184,70,188,115,106,110,188,134,139,109,112,101,105,103,101,188,188,101,101,188,96,105,105,140,154,154,122,101,154,94
88185,"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in addition to code for first marker)",164,148,11,156,156,90,149,156,82,84,156,11,73,93,102,59,84,46,154,108,79,153,58,156,95,88,91,156,111,115,44,92,84,87,85,84,156,156,84,84,156,79,87,87,116,128,128,101,84,128,78
88274,"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells",260,234,73,247,247,142,237,247,130,133,247,142,95,147,162,94,133,73,245,171,126,242,92,247,151,140,145,247,175,183,141,147,127,138,135,133,247,247,133,133,247,126,138,138,184,203,203,160,133,203,124
88275,"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells",260,234,73,247,247,142,237,247,130,133,247,142,95,147,162,94,133,73,245,171,126,242,92,247,151,140,145,247,175,183,141,147,127,138,135,133,247,247,133,133,247,126,138,138,184,203,203,160,133,203,124
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",146,131,41,139,139,80,133,139,73,74,139,80,53,82,91,53,75,41,137,96,71,136,52,139,85,78,81,139,98,103,79,82,73,77,76,74,139,139,74,74,139,70,78,77,104,114,114,90,74,114,70
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",176,158,50,167,167,96,160,167,90,90,167,96,64,99,110,64,88,50,166,115,85,164,62,167,102,95,98,167,119,124,96,99,98,93,91,90,167,167,90,90,167,85,99,84,125,137,137,108,90,137,84
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",154,139,44,209,146,86,146,146,79,79,146,209,56,87,96,56,153,44,145,101,75,143,54,146,90,83,86,146,104,77,84,87,86,82,80,79,146,146,79,79,146,74,86,86,109,120,120,82,79,120,73
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",339,305,96,322,322,186,308,322,170,173,322,185,124,191,212,123,174,96,319,222,164,315,120,322,197,182,189,322,229,239,184,191,173,180,176,173,322,322,173,173,322,164,180,179,240,264,264,208,173,264,161
88311,Decalcification procedure (List separately in addition to code for surgical pathology examination),52,47,15,49,49,28,47,49,26,27,49,26,19,29,32,19,27,15,49,34,25,48,18,49,30,28,29,49,35,37,28,29,18,28,27,27,49,49,27,27,49,25,28,28,37,41,41,32,27,41,25
88313,"Special stains; Group II, all other (eg, iron, trichrome), except immunocytochemistry and immunoperoxidase stains, including interpretation and report, each",128,115,36,122,122,70,116,122,64,65,122,70,47,72,80,46,66,36,120,84,62,119,45,122,74,69,71,122,86,90,70,72,65,68,66,65,122,122,65,65,122,62,68,68,91,100,100,79,65,100,61
88341,PBB IMMUNOHISTO ANTIBODY ADDL SLIDE,426,383,80,405,405,248,388,405,213,217,405,232,145,240,266,154,218,120,401,279,206,396,150,405,248,229,237,405,287,300,231,240,80,226,221,217,405,405,217,217,405,206,318,225,302,332,332,262,217,332,203
88342,"Immunohistochemistry (including tissue immunoperoxidase), each antibody",129,116,36,123,123,71,117,123,65,66,123,70,47,73,81,47,66,36,121,85,62,120,46,123,75,69,72,123,87,91,70,73,66,68,67,66,123,123,66,66,123,62,72,68,91,100,100,64,66,100,61
88344,PBB IMMUNOHISTO ANTIBODY SLIDE,182,164,51,173,173,100,166,173,91,93,173,99,67,103,114,66,93,51,171,119,88,169,64,173,106,98,101,173,123,128,99,103,92,96,94,93,173,173,93,93,173,88,97,96,129,142,142,112,93,142,87
88346,"Immunofluorescent study, each antibody; direct method",147,132,42,160,140,81,134,140,74,75,140,91,160,83,92,53,75,42,138,96,71,137,52,140,85,79,82,140,99,103,80,83,74,78,76,75,140,140,75,75,140,71,78,78,104,115,115,90,75,115,70
88350,HC IMMUNOFLUOR ANTB ADDL STAIN,147,132,42,140,140,81,134,140,74,75,140,91,80,83,92,53,75,42,138,96,71,137,52,140,85,79,82,140,99,103,80,83,74,78,76,75,140,140,75,75,140,71,78,78,104,115,115,90,75,115,70
88360,"Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual",160,144,45,152,152,88,146,152,80,82,152,87,59,90,100,58,82,45,151,105,77,149,56,152,93,86,89,152,108,113,87,90,90,85,83,82,152,152,82,82,152,77,85,85,113,125,125,98,82,125,76
88364,HC INSITU HYBRIDIZATION (FISH) EA ADDTL SGL PROC,182,164,51,173,173,91,166,173,91,93,173,99,67,103,114,66,93,51,171,119,88,169,64,173,106,98,101,173,123,128,99,103,92,96,94,93,173,173,93,93,173,88,97,96,129,142,142,112,93,142,87
88365,"In situ hybridization (eg, FISH), each probe",281,253,79,267,267,140,256,267,141,143,267,153,103,159,176,102,144,79,264,184,136,261,99,267,163,151,156,267,190,198,153,158,157,149,146,143,267,267,143,143,267,136,149,149,199,219,219,173,143,219,134
89051,"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count",57,51,16,60,54,31,52,54,28,29,54,31,60,32,36,21,27,16,54,37,28,53,20,54,33,31,32,54,38,40,31,35,32,30,30,29,54,54,29,29,54,28,32,32,40,44,44,35,29,44,27
89060,"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)",73,66,21,69,69,40,66,69,37,37,69,40,29,41,46,26,37,21,69,48,35,68,26,69,42,39,41,69,49,51,40,41,41,39,38,37,69,69,37,37,69,35,36,39,52,57,57,36,37,57,35
89190,Nasal smear for eosinophils,36,32,10,119,34,20,33,34,18,18,34,20,119,20,22,13,18,10,34,24,17,33,13,34,21,19,20,34,24,25,20,20,18,19,19,18,34,34,18,18,34,17,19,19,26,28,28,22,18,28,17
89220,"Sputum, obtaining specimen, aerosol induced technique (separate procedure)",40,36,11,38,38,22,36,38,20,20,38,22,15,23,25,14,21,11,38,26,19,37,14,38,23,21,22,38,27,28,22,23,20,21,21,20,38,38,20,20,38,19,21,21,28,31,31,25,20,31,19
89321,"Semen analysis; sperm presence and motility of sperm, if performed",117,105,33,119,111,64,106,111,59,60,111,64,64,66,73,119,60,33,110,77,57,109,41,111,68,63,65,111,79,82,64,66,59,62,61,60,111,111,60,60,111,56,62,62,83,91,91,72,60,91,56
90375,"Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use",4144,3729,295,5300,3936,2269,3770,3936,2074,2113,3936,5300,295,2338,2588,1498,2125,1171,3898,2717,2006,3855,1463,3936,2409,2226,2306,3936,2795,2916,2251,2337,4554,2196,2150,2113,3936,3936,2113,2113,3936,2000,2203,2192,2939,3228,3228,2544,2113,3228,1973
90376,"Rabies immune globulin, heat-treated (RIg-HT), human, for intramuscular and/or subcutaneous use",9487,8539,2681,9013,9013,5196,8631,9013,4748,4839,9013,5177,3470,5353,5926,3430,4865,2681,8924,6222,4594,8827,3350,9013,5517,5097,5279,9013,6399,6677,4443,5350,4802,5028,4922,4839,9013,9013,4839,4839,9013,4580,5044,5020,6729,7391,7390,5825,4839,7391,4517
90471,"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)",82,74,23,78,78,46,78,78,41,42,78,45,33,46,51,30,39,23,78,50,40,76,29,78,48,44,46,78,55,58,45,44,46,43,43,42,78,78,42,42,78,41,42,41,58,64,64,64,42,64,39
90662,"Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use",186,167,19,177,177,102,169,177,93,95,177,19,68,105,116,67,95,53,175,122,90,173,66,177,108,100,104,177,125,131,101,105,88,99,97,95,177,177,95,95,177,90,61,56,132,145,145,114,95,145,89
90670,"Pneumococcal conjugate vaccine, 13 valent, for intramuscular use",500,450,141,475,475,274,455,475,250,255,475,273,241,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,272,282,224,265,259,255,475,475,255,255,475,241,266,265,355,390,390,307,255,390,238
90675,"Rabies vaccine, for intramuscular use",846,761,239,803,803,463,769,803,423,431,803,502,328,477,528,306,434,239,795,555,409,787,299,803,492,454,471,803,570,595,419,477,474,448,439,431,803,803,431,431,803,408,450,447,600,659,659,659,431,659,403
90686,Influenza virus vaccine,40,36,10,61,38,22,36,38,20,20,38,16,20,23,25,14,19,11,38,26,19,37,14,38,23,21,22,38,27,28,61,22,10,21,21,20,38,38,20,20,38,19,21,21,28,31,31,25,20,31,19
90688,PBB IIV4 VACCINE SPLT 0.5 ML IM,119,107,34,113,113,65,108,113,60,61,113,45,44,67,74,43,61,34,112,78,58,111,42,113,69,64,66,113,80,84,65,67,60,63,62,61,113,113,61,61,113,57,63,63,84,93,93,73,61,93,57
90714,"Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, when administered to individuals 7 years or older, for intramuscular use",157,141,27,149,149,89,143,149,79,80,149,79,27,89,98,57,81,44,148,95,76,146,55,149,91,84,87,149,106,111,84,89,74,83,82,80,149,149,80,80,149,76,80,83,111,122,122,83,80,122,75
90715,"Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use",175,157,35,166,166,94,164,166,87,89,166,97,36,99,109,35,90,49,166,115,85,162,62,166,102,94,97,166,118,123,97,98,98,93,91,89,166,166,89,89,166,86,90,93,124,136,136,98,89,136,83
92507,"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual",392,353,111,372,372,215,357,372,196,200,372,212,129,221,245,174,218,111,369,257,190,365,138,372,228,211,218,372,264,197,196,221,220,208,203,200,372,372,200,200,372,189,208,207,278,305,305,241,200,305,187
92522,HC EVALUATE SPEECH PRODUCTION,188,169,53,179,179,103,171,179,94,96,179,103,158,106,117,68,96,53,177,123,91,175,66,179,109,101,105,179,127,132,102,106,105,100,98,96,179,179,96,96,179,91,100,99,133,146,146,115,96,146,90
92523,HC EVAL SPEECH SOUND LANG COMPREHEN,373,336,105,354,354,204,339,354,187,190,354,194,129,210,233,174,191,105,351,245,181,347,132,354,217,200,208,354,252,187,231,210,190,198,194,190,354,354,190,190,354,180,198,197,265,291,291,229,190,291,178
92524,HC BEHAVIORAL QUAL ANALYSIS VOICE,193,174,55,183,183,106,176,183,97,98,183,105,71,109,121,70,99,55,182,127,93,180,68,183,112,104,107,183,130,136,105,109,108,102,100,98,183,183,98,98,183,93,103,102,137,150,150,118,98,150,92
92526,Treatment of swallowing dysfunction and/or oral function for feeding,392,353,111,372,372,215,357,372,196,200,372,212,158,221,245,142,201,111,369,257,190,365,138,372,228,211,218,372,264,276,213,221,200,208,203,200,372,372,200,200,372,189,208,207,278,305,305,241,200,305,187
92610,Evaluation of oral and pharyngeal swallowing function,392,353,111,372,372,215,357,372,196,200,372,196,129,221,245,142,201,111,369,257,190,365,138,372,228,211,218,372,264,276,213,221,220,208,203,200,372,372,200,200,372,189,208,207,278,305,305,241,200,305,187
92611,Motion fluoroscopic evaluation of swallowing function by cine or video recording,392,353,98,372,372,215,357,372,196,200,372,214,98,221,245,142,201,111,369,257,190,365,138,372,228,211,218,372,264,333,216,221,197,208,203,200,372,372,200,200,372,189,208,207,278,305,305,196,200,305,187
92950,"Cardiopulmonary resuscitation (eg, in cardiac arrest)",526,473,149,1679,500,288,479,500,263,268,500,289,1679,297,329,190,270,149,495,345,255,489,186,500,306,283,293,500,355,370,289,297,267,279,273,268,500,500,268,268,500,254,280,263,373,410,410,323,268,410,250
92960,"Cardioversion, elective, electrical conversion of arrhythmia; external",399,359,113,379,379,219,363,379,200,203,379,330,146,225,249,144,205,113,375,262,193,371,141,379,232,214,222,379,269,281,217,225,136,211,207,203,379,379,203,203,379,193,212,211,283,311,311,245,203,311,190
93005,"Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report",150,135,53,143,142,76,142,143,76,76,142,81,90,82,94,91,75,83,142,98,72,140,53,142,87,81,82,142,76,76,82,75,84,80,75,76,142,143,76,76,142,75,84,84,75,117,117,84,76,117,137
93010,"Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only",50,45,9,48,48,9,45,48,9,26,48,25,9,28,31,18,26,14,47,33,9,47,18,48,29,27,28,48,34,35,27,28,9,26,26,26,47,48,26,25,48,24,27,26,35,39,39,31,26,39,24
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",110,99,23,105,104,60,100,105,55,56,104,60,40,62,69,40,56,31,103,72,53,102,39,104,64,59,61,104,74,77,60,62,23,58,57,56,104,105,56,56,104,53,58,58,78,86,86,68,56,86,52
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",761,685,215,723,723,403,723,723,388,388,723,472,222,429,475,222,379,215,716,499,368,708,269,723,460,409,423,723,513,536,444,419,426,403,395,388,723,723,388,388,723,367,426,403,593,593,593,426,388,593,362
93018,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only",110,99,16,105,104,60,100,105,16,56,104,61,40,62,69,40,56,31,103,72,53,102,39,104,64,59,61,104,74,77,60,62,16,58,57,56,104,105,56,56,104,53,58,58,78,86,86,68,56,86,52
93225,"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)",83,75,23,79,79,45,76,79,42,42,79,45,30,47,52,30,43,23,78,54,40,77,29,79,48,45,46,79,56,58,45,47,46,44,43,42,79,79,42,42,79,40,44,44,59,65,65,51,42,65,40
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",1388,1249,195,1319,1319,708,1319,1319,708,708,1319,763,457,783,867,457,691,195,1319,910,672,1291,490,1319,840,746,763,1319,699,708,857,783,772,736,720,708,1319,1319,708,708,1319,680,708,777,888,1081,1081,777,708,1081,661
93724,"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)",400,360,113,380,380,219,364,380,200,204,380,218,265,226,250,145,205,113,376,262,194,372,141,380,233,215,223,380,270,282,217,226,202,212,208,204,380,380,204,204,380,193,213,212,284,312,312,246,204,312,190
93797,Physician services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session),205,184,58,195,195,112,186,195,103,105,195,112,75,116,128,74,105,58,193,134,99,191,72,195,119,110,114,195,138,144,111,116,115,109,106,105,195,195,105,105,195,99,109,108,145,160,160,126,105,160,98
93798,Physician services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session),195,176,55,232,185,99,177,185,98,99,185,121,232,110,122,70,100,55,183,128,94,181,69,185,113,105,109,185,99,99,106,110,99,103,101,99,185,185,99,99,185,94,104,103,152,152,152,99,99,152,93
93880,Duplex scan of extracranial arteries; complete bilateral study,1118,1006,105,1062,1062,598,1062,1062,570,570,1062,618,211,631,698,105,557,316,1062,733,541,1040,395,1062,650,601,622,1062,754,528,654,630,623,593,580,570,1062,1062,570,570,1062,540,626,593,793,871,871,626,570,871,532
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)",798,718,225,758,758,758,726,758,403,407,758,435,369,450,498,288,409,225,751,523,386,742,282,758,464,429,444,758,538,400,439,450,447,423,414,407,758,758,407,407,758,385,383,423,566,622,622,447,407,622,380
93925,Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study,1335,1202,303,1268,1268,668,1268,1268,641,681,1268,785,303,753,834,483,692,377,1256,876,646,1242,471,1268,776,717,743,1268,900,681,825,753,748,708,693,681,1268,1268,681,681,1268,644,668,668,947,1040,1040,748,681,1040,636
93926,Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study,751,676,153,713,713,383,683,713,383,383,713,391,153,424,469,271,385,212,706,493,364,699,265,713,437,403,418,713,383,529,408,424,421,398,390,383,713,713,383,383,713,363,360,397,533,585,585,461,383,585,358
93970,Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study,1335,1202,183,1268,1268,748,1215,1268,668,681,1268,728,333,753,834,399,685,183,1256,876,646,1242,471,1268,776,717,743,1268,900,940,734,753,673,708,693,681,1268,1268,681,681,1268,644,714,641,947,1040,1040,681,681,1040,636
93971,Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study,618,556,175,587,587,331,562,587,309,315,587,340,211,343,386,399,308,175,581,405,299,575,218,587,359,332,340,587,234,435,340,348,346,328,321,315,587,587,315,315,587,309,346,309,438,481,481,331,315,481,294
93975,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study",889,800,167,845,845,498,809,845,453,453,845,489,167,502,555,321,456,251,836,583,430,827,314,845,517,478,495,845,600,626,444,501,498,471,461,453,845,845,453,453,845,429,453,470,631,693,693,693,453,693,423
93976,"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study",889,800,251,845,845,487,809,845,445,453,845,485,325,502,555,321,456,251,836,583,430,827,314,845,517,478,495,845,600,626,483,501,422,471,461,453,845,845,453,453,845,429,473,470,631,693,693,546,453,693,423
93978,"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study",542,488,107,515,515,297,493,515,271,276,515,107,192,306,339,196,278,153,510,355,262,504,191,515,315,291,302,515,366,381,295,306,448,287,281,276,515,515,276,276,515,262,288,287,384,422,422,333,276,422,258
94002,"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day",1016,914,287,965,965,556,924,965,508,518,965,554,372,573,635,367,521,287,956,666,492,945,359,965,591,546,565,965,685,715,552,573,569,538,527,518,965,965,518,518,965,490,540,538,721,791,791,624,518,791,484
94010,"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation",185,166,52,282,176,104,168,176,94,94,176,115,206,104,116,282,93,52,174,121,89,172,65,176,108,98,103,176,125,89,108,104,104,98,96,94,176,176,94,94,176,89,104,101,131,144,144,92,94,144,88
94060,"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration",246,221,70,780,234,125,234,234,125,125,234,135,412,139,154,430,129,70,234,161,183,229,87,234,210,132,137,234,242,187,135,133,125,130,128,125,362,780,125,125,234,190,138,138,174,192,192,138,125,192,117
94618,HC PULMONARY STRESS TESTING,500,450,141,475,475,274,475,475,250,255,475,273,368,282,312,181,256,141,470,328,242,465,177,475,291,269,278,475,337,352,272,282,255,265,259,255,475,475,255,255,475,241,266,265,355,389,389,390,255,389,238
94626,,195,176,55,185,185,107,177,185,98,99,185,106,185,110,122,70,100,55,183,128,94,181,69,185,113,105,109,185,132,137,106,110,98,103,101,99,185,185,99,99,185,94,104,103,138,152,152,109,99,152,93
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)",120,108,34,262,114,67,109,114,61,61,114,67,262,101,75,244,67,34,114,79,58,112,42,114,128,64,66,114,81,84,74,68,67,64,62,61,114,114,61,61,114,58,67,61,106,93,93,79,61,93,57
94660,"Continuous positive airway pressure ventilation (CPAP), initiation and management",710,639,165,675,674,362,646,675,355,362,674,165,260,401,443,257,364,201,668,466,344,661,251,674,413,381,395,674,479,500,440,400,358,376,368,362,674,675,362,362,674,343,377,376,504,553,553,355,362,553,338
94667,"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation",130,117,37,204,124,73,118,124,66,66,124,70,204,73,81,47,67,37,122,85,63,121,46,124,76,70,72,124,88,91,54,73,66,69,67,66,123,124,66,66,124,63,70,69,92,101,101,69,66,101,62
94668,"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent",102,92,29,244,97,76,93,97,51,52,97,55,244,58,64,37,52,29,96,67,49,95,36,97,59,55,57,97,69,72,51,58,52,54,53,52,97,97,52,52,97,49,66,54,72,79,79,57,52,79,49
94726,PBB PULM FUNCT TST PLETHYSMOGRAP,200,180,55,227,190,102,190,190,102,102,190,110,141,113,125,227,105,57,190,131,97,186,71,190,60,107,111,190,139,140,110,108,102,106,104,102,104,190,102,102,190,55,112,107,142,156,156,112,102,156,95
94727,HC PULM FUNCTION TEST BY GAS,213,192,60,202,202,117,194,202,107,109,202,116,187,120,133,77,109,60,200,140,103,198,75,202,124,114,119,202,144,150,116,120,107,113,111,109,202,202,109,109,202,103,113,113,151,166,166,166,109,166,101
94729,HC C0/MEMBRANE DIFFUSE CAPACITY,266,239,13,253,253,136,253,253,134,136,253,146,141,150,166,206,140,75,253,174,128,247,94,253,146,143,148,253,13,50,146,144,136,141,138,136,253,253,136,136,253,133,149,142,189,207,207,149,136,207,127
94750,"Pulmonary compliance study (eg, plethysmography, volume and pressure measurements)",175,158,49,166,166,96,159,166,88,89,166,94,134,99,109,63,90,49,165,115,84,163,62,166,102,94,97,166,118,123,95,99,83,93,91,89,166,166,89,89,166,84,84,93,124,136,136,107,89,136,83
94760,Noninvasive ear or pulse oximetry for oxygen saturation; single determination,45,40,13,123,43,25,41,43,23,23,43,25,25,25,28,16,24,13,43,30,22,42,16,43,26,24,25,43,30,32,25,24,23,24,23,23,123,43,23,23,43,64,25,25,32,35,35,25,23,35,21
94761,"Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)",258,232,70,245,245,141,235,245,129,132,245,70,94,146,161,93,132,73,243,169,125,240,91,245,150,139,144,245,174,182,140,145,131,137,134,132,245,245,132,132,245,125,137,137,183,201,201,158,132,201,123
94762,Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure),490,441,138,466,466,268,446,466,245,250,466,267,179,276,306,177,251,138,461,321,237,456,173,466,285,263,273,466,331,345,266,276,250,260,254,250,465,466,250,250,466,237,261,259,348,382,382,301,250,382,233
95249,HC CONT GLUC MNTR PT PROV EQP,180,162,51,171,171,99,164,171,90,92,171,98,66,102,112,65,92,51,169,118,87,167,64,171,105,97,100,171,121,127,98,102,91,95,93,92,171,171,92,92,171,87,96,95,128,140,140,111,92,140,86
95800,"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time",750,675,212,713,712,411,682,713,382,382,712,412,508,423,468,271,416,212,705,492,363,698,265,712,436,403,417,712,506,528,412,423,378,398,389,382,712,713,382,382,712,362,399,397,532,584,584,460,382,584,357
95810,"Polysomnography; sleep staging with 4 or more additional parameters of sleep, attended by a technologist",3000,2700,848,2850,2850,1643,2729,2850,1501,1530,2850,1637,2718,1693,1874,1084,1538,848,2822,1967,1453,2791,1059,2850,1744,1612,1669,2850,2024,2111,1630,1692,1511,1590,1556,1530,2850,2850,1530,1530,2850,1448,1605,1587,2128,2337,2337,1842,1530,2337,1428
95811,"Polysomnography; sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist",3200,2880,904,3040,3040,1753,2911,3040,1632,1632,3040,1760,2609,1805,1999,1157,1641,904,3010,2099,1549,2977,1130,3040,1861,1719,1781,3040,2158,2252,1760,1805,1612,1696,1660,1632,3040,3040,1632,1632,3040,1545,1632,1693,2270,2493,2493,1632,1632,2493,1524
95992,"Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day",106,95,30,136,101,59,96,101,54,54,101,66,136,60,66,134,54,30,100,54,51,99,37,101,62,57,59,101,71,75,53,60,54,56,55,54,101,101,54,54,101,51,51,56,75,83,83,83,54,83,50
96125,"Standardized cognitive performance testing (eg, Ross Information Processing Assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report",335,302,95,318,318,183,305,318,168,171,318,168,123,189,209,121,186,95,315,220,162,312,118,318,195,180,186,318,226,236,182,189,187,178,174,171,318,318,171,171,318,162,178,177,238,261,261,206,171,261,159
96360,"Intravenous infusion, hydration; initial, 31 minutes to 1 hour",120,108,12,548,114,61,109,114,61,61,114,65,548,66,75,298,60,34,113,79,58,112,42,114,66,64,67,114,119,84,64,68,67,64,62,61,114,114,61,61,114,12,67,64,85,93,93,67,61,93,57
96361,"Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)",160,144,38,1505,152,86,192,152,120,82,152,50,502,44,100,342,44,44,151,105,442,149,56,152,97,86,462,152,1505,158,50,50,167,85,38,82,608,152,82,82,152,384,163,257,102,125,125,224,82,125,74
96365,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour",160,144,56,596,152,90,160,152,84,82,152,91,285,90,100,596,82,67,151,105,77,149,56,152,102,86,92,152,149,161,90,91,85,85,83,82,156,152,82,82,152,77,90,90,113,125,125,86,82,125,65
96366,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)",80,72,23,531,76,43,72,76,43,41,76,94,531,45,50,305,41,23,75,52,36,74,28,76,116,43,45,76,94,74,60,45,43,42,42,41,108,76,41,41,76,39,45,43,57,62,62,76,41,62,39
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)",76,68,27,298,72,43,72,72,39,39,72,41,298,43,47,298,42,29,71,50,36,71,27,72,44,41,42,72,75,74,42,43,43,40,38,39,72,72,39,39,72,37,43,40,54,59,59,43,39,59,39
96368,"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)",76,68,21,285,72,39,69,72,38,39,72,44,285,43,47,27,39,21,71,50,37,71,27,72,44,41,42,72,51,53,42,43,38,40,39,39,72,72,39,39,72,37,38,43,54,59,59,47,39,59,36
96372,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular",82,74,23,110,78,42,78,84,42,42,78,48,35,41,51,41,49,23,77,54,36,76,29,78,49,44,81,78,110,98,47,48,41,43,43,42,84,84,42,42,78,40,46,46,58,64,64,46,42,64,39
96374,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug",88,79,31,84,84,45,42,84,44,45,84,48,34,49,55,57,44,41,83,58,42,82,31,84,53,47,48,84,59,73,47,51,46,47,43,45,84,84,45,45,84,42,49,49,56,69,69,49,45,69,42
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)",88,79,25,232,84,49,209,84,42,45,84,48,45,34,55,114,44,25,83,58,63,82,31,84,53,47,194,84,59,232,47,48,44,47,84,45,145,84,45,45,84,42,44,46,69,69,69,44,45,69,78
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)",88,79,25,243,84,49,126,84,45,45,84,55,38,50,55,57,45,25,83,58,42,82,31,84,53,47,48,84,59,86,55,50,49,47,46,45,209,84,45,45,84,42,45,49,62,69,69,49,45,69,243
96377,HC APPLICATON ON-BODY INJECTOR,74,67,21,70,70,41,67,70,37,38,70,40,27,42,46,27,38,21,70,49,36,69,26,70,43,40,41,70,50,52,40,42,41,39,38,38,70,70,38,38,70,36,39,39,52,58,58,45,38,58,35
96401,"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic",135,122,38,138,128,74,123,128,68,138,128,74,49,76,84,49,69,38,127,89,97,126,48,128,78,73,75,128,91,95,70,76,76,72,70,69,128,128,69,69,128,65,72,71,96,105,105,72,69,105,64
96402,"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic",135,122,38,128,128,69,123,128,69,69,128,74,49,76,84,49,69,38,127,89,65,126,48,128,78,73,75,128,91,95,73,76,68,72,70,69,128,128,69,69,128,65,76,71,96,105,105,68,69,105,64
96409,"Chemotherapy administration; intravenous, push technique, single or initial substance/drug",135,122,38,128,128,74,123,128,68,69,128,74,49,76,84,49,69,38,127,89,65,126,48,128,78,73,75,128,91,95,73,76,64,72,70,69,128,128,69,69,128,65,72,71,96,105,105,83,69,105,64
96411,"Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure)",100,90,28,95,95,55,91,95,50,51,95,55,37,56,62,36,51,28,94,66,48,93,35,95,58,54,56,95,67,70,54,56,51,53,52,51,95,95,51,51,95,48,53,53,71,78,78,61,51,78,48
96413,"Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug",212,191,60,305,201,119,201,201,113,108,201,114,305,120,132,298,109,60,199,139,103,197,75,201,123,114,118,201,143,149,117,120,108,112,106,108,201,201,108,108,201,102,106,112,150,165,165,119,108,165,101
96415,"Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)",230,207,65,568,218,126,109,219,115,117,218,214,568,130,144,568,118,65,216,151,111,214,81,218,134,124,128,218,155,162,125,130,117,122,119,117,218,219,117,117,218,111,172,122,163,179,179,90,117,179,110
96416,"Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump",450,405,127,428,428,246,409,428,225,230,428,246,342,254,281,342,231,127,423,295,218,419,159,428,262,242,250,428,304,317,245,254,230,238,233,230,427,428,230,229,428,217,239,238,319,351,351,276,230,351,214
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)",200,180,57,312,190,110,182,190,100,102,190,104,298,113,125,298,103,57,188,131,97,186,71,190,116,107,111,190,135,141,220,113,112,106,104,102,190,190,102,102,190,97,106,106,142,156,156,312,102,156,95
96523,Irrigation of implanted venous access device for drug delivery systems,78,70,22,74,74,43,71,74,39,40,74,46,35,44,49,35,40,22,73,51,38,73,28,74,45,42,43,74,53,55,42,44,40,41,40,40,74,74,40,40,74,38,41,39,55,61,61,39,40,61,37
97018,Application of a modality to 1 or more areas; paraffin bath,20,18,6,119,19,11,18,19,10,10,19,11,119,11,12,119,10,6,19,13,10,19,7,19,12,11,11,19,13,14,12,11,10,11,10,10,19,19,10,10,19,10,11,11,14,16,16,12,10,16,10
97032,"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes",93,84,26,150,88,51,85,88,89,47,88,50,150,52,58,150,48,26,87,61,45,87,33,88,54,50,52,88,63,65,51,52,47,49,48,47,88,88,47,47,88,45,49,49,66,72,72,62,47,72,44
97033,"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes",94,85,20,1681,89,51,86,89,47,48,89,51,99,53,59,150,48,20,88,48,46,87,33,89,52,51,52,89,63,66,50,53,48,50,49,48,89,1681,48,48,89,45,50,50,67,73,73,73,48,73,45
97035,"Application of a modality to 1 or more areas; ultrasound, each 15 minutes",93,84,14,972,88,47,88,88,46,47,88,51,136,52,58,34,48,14,87,61,45,87,33,88,51,50,52,88,63,65,51,52,47,49,48,47,88,972,47,47,88,45,52,46,66,72,72,46,47,72,44
97110,"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility",186,167,29,565,177,93,88,177,95,95,177,100,134,105,116,134,96,29,88,47,67,173,66,177,113,100,51,177,47,47,100,93,94,99,96,95,177,565,95,95,177,90,93,52,72,145,145,93,95,145,89
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",93,84,9,104,88,52,85,88,47,47,88,51,60,52,58,67,48,26,88,95,45,87,33,88,56,50,52,88,47,9,58,52,52,49,48,47,88,88,47,47,88,45,52,104,66,72,72,62,47,72,44
97116,"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)",93,84,26,90,88,47,88,88,47,47,88,58,90,52,58,66,52,26,87,61,45,87,33,88,51,50,52,88,63,44,50,52,47,49,48,47,88,88,47,47,88,45,52,73,66,72,72,52,47,72,44
97129,HC THER IVNTJ COG FUNCJ 1ST 15 MIN,392,353,111,372,372,220,357,372,196,200,372,214,143,221,245,142,201,111,369,257,190,365,138,372,228,211,218,372,264,276,213,221,218,208,203,200,372,372,200,200,372,189,208,207,278,305,305,241,200,305,187
97130,HC THER IVNTJ COG FUNCJ EA ADDL 15 MIN,784,706,222,745,745,439,713,745,392,400,745,428,287,442,490,283,402,222,737,514,380,729,277,745,456,421,436,745,529,552,426,442,438,416,407,400,745,745,400,400,745,378,417,415,556,611,611,481,400,611,373
97140,"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes",93,84,26,88,88,52,85,88,47,47,88,51,60,52,58,67,52,26,87,61,45,87,33,88,54,50,52,88,45,44,51,50,47,49,48,47,88,88,47,47,88,45,52,52,66,72,72,52,47,72,44
97150,"Therapeutic procedure(s), group (2 or more individuals)",70,63,20,67,66,38,64,67,35,36,66,38,26,39,44,25,36,20,66,46,34,65,25,66,41,38,39,66,47,49,38,39,36,37,36,36,66,67,36,36,66,34,37,37,50,55,55,43,36,55,33
97161,Physical Therapy Evaluation of low complexity,223,201,79,212,212,114,212,212,114,114,212,123,157,126,139,209,124,97,212,146,107,207,79,212,130,120,124,212,114,111,123,126,114,118,116,114,212,212,114,114,212,108,125,125,158,174,174,125,114,174,106
97162,Physical Therapy Evaluation of moderate complexity,223,201,79,212,212,114,203,212,114,114,212,123,157,126,139,209,107,97,210,114,107,207,79,212,123,120,123,212,150,111,123,120,114,118,116,114,212,212,114,114,212,108,125,125,174,174,174,125,114,174,106
97163,Physical Therapy Evaluation of high complexity,223,201,63,212,212,125,203,212,112,114,212,122,157,126,139,157,107,63,210,146,108,207,79,212,130,120,124,212,107,157,123,126,114,118,116,114,212,212,114,114,212,108,112,107,158,174,174,112,114,174,106
97165,HC OT EVAL LOW COMPLEX,223,201,63,212,212,122,203,212,114,114,212,124,91,126,139,69,114,63,210,146,108,207,79,212,130,120,124,212,150,157,121,126,118,118,116,114,212,212,114,114,212,108,125,118,158,174,174,137,114,174,106
97166,HC OT EVAL MOD COMPLEX,223,201,60,212,212,112,203,212,112,114,212,138,60,126,139,100,114,63,210,146,108,207,79,212,130,120,124,212,150,157,138,126,124,118,116,114,212,212,114,114,212,108,118,118,158,174,174,118,114,174,106
97167,HC OT EVAL HIGH COMPLEX,223,201,63,212,212,122,203,212,112,114,212,122,63,126,139,81,114,63,210,146,108,207,79,212,130,120,124,212,150,157,114,126,106,118,116,114,212,212,114,114,212,108,125,118,158,174,174,137,114,174,106
97530,"Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes",93,84,33,95,88,46,88,88,47,47,88,58,67,52,58,60,74,37,87,47,45,87,33,88,54,50,51,88,47,65,52,50,52,49,48,47,88,88,47,47,88,45,52,52,66,72,72,72,95,72,44
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",106,95,30,101,101,58,96,101,54,54,101,92,60,60,66,38,54,30,100,70,51,99,37,101,62,57,59,101,71,75,57,60,58,56,55,54,101,101,54,54,101,51,56,56,75,83,83,65,54,83,50
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",244,220,39,743,232,134,222,232,122,124,232,133,743,138,152,88,125,69,230,160,118,227,86,232,142,131,136,232,242,242,151,138,39,129,127,124,232,232,124,124,232,118,130,129,173,190,190,122,124,190,116
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)",454,409,53,3530,431,249,413,431,227,232,431,248,3530,256,284,164,233,128,427,298,220,422,160,431,264,244,253,431,381,578,247,256,53,241,236,232,431,431,232,232,431,219,241,240,322,354,354,279,232,354,216
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",147,132,42,627,140,82,134,140,74,75,140,91,627,83,92,53,75,42,138,96,71,137,52,140,85,79,82,140,99,103,80,83,75,78,76,75,140,140,75,75,140,71,78,78,104,115,115,115,75,115,70
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",80,72,23,633,76,44,73,76,40,41,76,44,633,45,50,29,41,23,75,52,39,74,28,76,47,43,45,76,54,56,43,45,30,42,42,41,76,76,41,41,76,39,43,42,57,62,62,49,41,62,38
97750,"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes",100,90,28,95,95,55,91,95,50,51,95,62,37,56,62,36,51,28,94,66,48,93,35,95,58,54,56,95,67,70,54,56,51,53,52,51,95,95,51,51,95,48,53,53,71,78,78,61,51,78,48
97802,"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes",120,108,34,134,114,67,109,114,92,61,114,65,70,68,75,43,62,34,113,79,58,112,42,114,70,64,67,114,81,84,65,68,60,64,62,61,114,114,61,61,114,58,98,63,85,93,93,134,61,93,57
97803,"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes",80,72,23,76,76,41,73,76,41,41,76,44,70,45,50,29,41,23,75,52,39,74,28,76,47,43,45,76,54,56,43,45,51,42,42,41,76,76,41,41,76,39,45,42,57,62,62,45,41,62,38
98925,Osteopathic manipulative treatment (OMT); 1-2 body regions involved,62,56,17,59,59,34,56,59,31,32,59,17,23,35,39,22,32,18,58,41,30,58,22,59,36,33,34,59,42,44,32,35,28,33,32,32,59,59,32,32,59,30,35,33,44,48,48,38,32,48,30
98926,Osteopathic manipulative treatment (OMT); 3-4 body regions involved,62,56,18,99,59,34,56,59,31,32,59,34,99,35,39,22,32,18,58,41,30,58,22,59,36,33,34,59,42,44,34,35,31,33,32,32,59,59,32,32,59,30,33,33,44,48,48,38,32,48,30
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),26,23,7,38,25,14,24,25,13,13,25,22,8,15,16,9,13,7,24,17,13,24,9,25,15,14,14,25,18,18,14,15,13,14,13,13,25,38,13,13,25,13,14,14,18,20,20,16,13,20,12
99152,HC MOD SED SAME PHYS/QHP 5/>YRS 15M,26,23,7,25,25,14,24,25,13,13,25,14,10,15,16,9,13,7,24,17,13,24,9,25,15,14,14,25,18,18,14,15,14,14,13,13,25,25,13,13,25,13,14,14,18,20,20,16,13,20,12
99156,PR MOD SED OTH PHYS/QHP 5/>YRS,150,135,42,143,142,82,136,143,75,76,142,82,55,85,94,54,77,42,141,98,73,140,53,142,87,81,83,142,101,106,82,85,76,80,78,76,142,143,76,76,142,72,80,79,106,117,117,92,76,117,71
99195,"Phlebotomy, therapeutic (separate procedure)",187,168,53,427,178,102,170,178,94,95,178,102,427,106,117,68,96,53,178,123,91,174,66,178,109,100,104,178,126,132,102,105,94,99,97,95,178,178,95,95,178,90,99,99,133,146,146,115,95,146,89
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.",216,194,61,205,205,118,197,205,108,110,205,118,79,122,135,78,111,61,203,142,105,201,76,205,126,116,120,205,146,152,117,122,89,114,112,110,205,205,110,110,205,104,115,114,153,168,168,133,110,168,103
99204,"Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive 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 45 minutes face-to-face with the patient and/or family.",242,218,68,230,230,133,220,230,121,123,230,132,89,137,151,87,124,68,228,159,117,225,85,230,141,130,135,230,163,170,131,136,144,128,126,123,230,230,123,123,230,117,129,128,172,189,189,149,123,189,115
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.",30,27,8,29,28,16,27,29,15,15,28,16,11,17,19,11,15,8,28,20,15,28,11,28,17,16,17,28,20,21,16,19,10,16,16,15,28,29,15,15,28,14,16,16,21,23,23,18,15,23,14
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.",129,116,28,123,123,71,117,123,28,66,123,65,47,90,81,47,66,36,121,85,62,120,46,123,75,69,72,123,87,91,70,73,38,68,67,66,123,123,66,66,123,62,69,68,91,100,100,79,66,100,61
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.",164,148,46,156,156,90,149,156,82,84,156,82,60,93,102,59,84,46,154,108,79,153,58,156,95,88,91,156,111,115,90,92,70,87,85,84,156,156,84,84,156,79,87,87,116,128,128,101,84,128,78
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.",215,194,61,204,204,118,196,204,108,110,204,108,79,121,134,78,110,61,202,141,104,200,76,204,125,116,120,204,145,151,117,121,104,114,112,110,204,204,110,110,204,104,85,114,152,167,167,132,110,167,102
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.",213,192,60,202,202,117,194,202,107,109,202,116,78,120,133,77,109,60,200,140,103,198,75,202,124,114,119,202,144,150,116,120,154,113,111,109,202,202,109,109,202,103,113,113,151,166,166,131,109,166,101
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.])",120,108,32,114,114,66,109,114,79,61,114,60,78,68,75,43,62,34,113,79,81,112,42,114,70,64,67,114,81,84,32,68,76,64,62,61,114,114,61,61,114,58,64,63,85,93,93,74,61,93,78
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.",156,140,44,148,148,110,142,148,108,80,148,85,57,88,97,56,80,44,147,102,110,145,55,148,91,84,87,148,105,110,85,88,103,83,81,80,148,148,80,80,148,75,83,83,111,122,122,96,80,122,74
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.",214,193,60,203,203,117,195,203,107,109,203,107,147,121,134,77,110,60,201,140,150,199,76,203,124,115,119,203,144,151,116,121,142,113,111,109,203,203,109,109,203,103,114,113,152,167,167,131,109,167,147
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.",292,263,78,277,277,160,266,277,146,149,277,154,107,165,182,106,150,83,275,191,141,272,103,277,170,157,162,277,197,206,78,165,188,155,151,149,277,277,149,149,277,141,155,155,207,227,227,179,149,227,139
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.",61,55,17,58,58,44,55,58,31,31,58,33,22,34,38,22,31,17,57,40,44,57,22,58,35,33,34,58,41,43,33,34,40,32,32,31,58,58,31,31,58,29,32,32,43,48,48,37,31,48,29
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.",112,101,30,106,106,61,102,106,79,57,106,61,41,63,70,40,57,32,105,73,81,104,40,106,65,60,62,106,76,79,30,63,75,59,58,57,106,106,57,57,106,54,60,59,79,87,87,69,57,87,53
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.",160,144,45,152,152,88,146,152,80,82,152,89,113,90,100,58,82,45,151,105,116,149,56,152,93,86,89,152,108,113,87,90,110,85,83,82,152,152,82,82,152,77,85,85,113,125,125,98,82,125,113
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.",204,184,58,194,194,112,186,194,102,104,194,111,75,115,127,74,105,58,192,134,99,190,72,194,119,110,114,194,138,144,111,115,139,108,106,104,194,194,104,104,194,98,108,108,145,159,159,125,104,159,97
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.",268,241,76,255,255,147,244,255,134,137,255,146,98,151,167,97,137,76,252,176,130,249,95,255,156,144,149,255,181,189,146,151,180,142,139,137,255,255,137,137,255,129,142,142,190,209,209,165,137,209,128
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.",346,311,98,329,329,189,315,329,173,176,329,189,127,195,216,125,177,98,325,227,168,322,122,329,201,186,193,329,233,244,188,195,223,183,180,176,329,329,176,176,329,167,184,183,245,270,270,212,176,270,165
99239,Hospital discharge day management; more than 30 minutes,164,148,46,156,156,90,149,156,82,84,156,89,60,93,102,59,84,46,154,108,79,153,58,156,95,88,91,156,111,115,89,92,113,87,85,84,156,156,84,84,156,79,87,87,116,128,128,101,84,128,78
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.",213,192,60,458,202,124,194,202,107,109,202,66,458,120,133,77,109,60,200,140,103,198,75,202,124,114,119,202,144,150,66,120,73,113,111,109,202,202,109,109,202,103,113,113,151,166,166,122,109,166,101
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.",317,285,90,591,301,186,330,301,177,162,301,171,564,179,198,591,173,90,330,208,153,295,112,301,191,170,191,301,177,291,170,187,175,168,164,162,301,330,162,162,301,153,194,192,270,247,247,194,162,270,151
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.",591,532,69,604,561,317,590,590,317,301,561,319,592,333,369,604,309,167,590,376,69,550,209,590,342,318,342,561,480,492,183,366,77,313,307,301,561,561,301,301,561,310,348,348,484,484,460,348,301,460,232
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.",837,753,130,795,795,427,795,795,427,427,795,444,610,465,523,753,465,236,795,549,130,779,296,795,483,450,483,795,565,433,433,472,131,444,434,427,795,795,427,427,795,404,469,448,535,652,652,469,427,652,399
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.",1178,1060,416,1166,1119,601,565,1119,601,601,1119,631,647,648,736,592,563,654,1119,773,565,1096,416,1119,713,633,648,1119,1166,1154,631,631,593,624,577,601,1119,1119,601,601,1119,565,660,660,835,918,918,660,601,918,601
99291,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes",1780,1602,239,1691,1691,997,1691,1691,908,908,1691,961,621,1004,1112,559,851,503,1674,1167,550,1656,628,1691,1035,956,990,1691,1201,1384,955,1004,239,943,923,908,1691,1691,908,908,1691,859,943,942,1262,1387,1387,890,908,1387,847
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)",506,455,121,567,481,567,460,481,387,258,481,444,185,285,316,183,259,143,476,332,245,471,179,481,294,272,282,481,341,121,417,285,142,268,263,258,481,481,258,258,481,244,261,268,359,394,394,380,258,394,241
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.",180,162,51,171,171,99,164,171,90,92,171,98,66,102,112,65,92,51,169,118,87,167,64,171,105,97,100,171,121,127,98,102,95,95,93,92,171,171,92,92,171,87,96,95,128,140,140,111,92,140,86
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.",206,185,58,196,196,113,187,196,103,105,196,112,75,116,129,74,106,58,194,135,100,192,73,196,120,111,115,196,139,145,112,116,137,109,107,105,196,196,105,105,196,99,110,109,146,160,160,126,105,160,98
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.",264,238,75,251,251,145,240,251,132,135,251,144,97,149,165,95,135,75,248,173,128,246,93,251,154,142,147,251,178,186,143,149,173,140,137,135,251,251,135,135,251,127,140,140,187,206,206,162,135,206,126
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.",65,58,18,62,62,36,59,62,33,33,62,35,24,37,41,23,33,18,61,43,31,60,23,62,38,35,36,62,44,46,35,37,46,34,34,33,62,62,33,33,62,31,35,34,46,51,51,40,33,51,31
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.",110,99,31,105,104,60,100,105,55,56,104,60,40,62,69,40,56,31,103,72,53,102,39,104,64,59,61,104,74,77,60,62,72,58,57,56,104,105,56,56,104,53,58,58,78,86,86,68,56,86,52
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.",144,130,41,137,137,79,131,137,72,73,137,79,53,81,90,52,74,41,135,94,70,134,51,137,84,77,80,137,97,101,78,81,96,76,75,73,137,137,73,73,137,70,77,76,102,112,112,88,73,112,69
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.",215,194,61,204,204,118,196,204,108,110,204,117,79,121,134,78,110,61,202,141,104,200,76,204,125,116,120,204,145,151,117,121,143,114,112,110,204,204,110,110,204,104,114,114,152,167,167,132,110,167,102
99315,Nursing facility discharge day management; 30 minutes or less,115,104,32,109,109,63,105,109,58,59,109,63,42,65,72,42,59,32,108,75,56,107,41,109,67,62,64,109,78,81,62,65,76,61,60,59,109,109,59,59,109,56,61,61,82,90,90,71,59,90,55
99316,Nursing facility discharge day management; more than 30 minutes,167,150,47,159,159,91,152,159,84,85,159,91,61,94,104,60,86,47,157,110,81,155,59,159,97,90,93,159,113,118,91,94,109,89,87,85,159,159,85,85,159,81,89,88,118,130,130,103,85,130,80
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)",140,126,40,133,133,77,127,133,70,71,133,76,51,79,87,51,72,40,132,92,68,130,49,133,81,75,78,133,94,99,76,79,94,74,73,71,133,133,71,71,133,68,74,74,99,109,109,86,71,109,67
99357,"Prolonged physician service in the inpatient setting, requiring unit/floor time beyond the usual service; each additional 30 minutes (List separately in addition to code for prolonged physician service)",141,127,40,134,134,77,128,134,71,72,134,77,52,80,88,51,72,40,133,92,68,131,50,134,82,76,78,134,95,99,77,80,95,75,73,72,134,134,72,72,134,68,75,75,100,110,110,87,72,110,67
A0000,,100,90,28,95,95,55,91,95,50,51,95,55,37,56,62,36,51,28,94,66,48,93,35,95,58,54,56,95,67,70,54,56,51,53,52,51,95,95,51,51,95,48,50,53,71,78,78,61,51,78,48
A0424,"Extra ambulance attendant, ground (ALS or BLS) or air (fixed or rotary winged); (requires medical review)",125,112,35,119,119,68,114,119,63,64,119,68,46,71,78,45,64,35,118,82,61,116,44,119,73,67,70,119,84,88,68,70,63,66,65,64,119,119,64,64,119,60,66,66,89,97,97,97,64,97,60
A0425,"Ground mileage, per statute mile",40,36,10,1532,38,20,152,38,20,20,38,24,13,814,25,193,209,11,1083,26,10,37,14,38,12,21,22,38,27,162,22,23,22,21,10,20,38,1532,20,20,38,260,22,20,28,31,31,22,20,31,194
A0426,"Ambulance service, advanced life support, non-emergency transport, level 1 (ALS 1)",798,718,225,758,758,407,726,758,407,407,758,345,465,450,498,288,409,225,751,523,386,742,282,758,464,429,444,758,538,396,434,450,343,423,414,407,758,758,407,407,758,385,447,422,566,622,622,447,407,622,380
A0427,"Ambulance service, advanced life support, emergency transport, level 1 (ALS1-emergency)",1259,1133,310,1196,1196,705,1196,1196,642,642,1196,539,735,537,786,735,518,356,1196,826,604,1171,445,1196,762,676,701,1196,632,602,684,710,521,667,630,642,1196,1196,642,642,1196,617,705,642,893,981,981,705,642,981,310
A0428,"Ambulance service, basic life support, non-emergency transport, (BLS)",1066,959,50,1013,1013,544,970,1013,533,544,1013,231,387,601,666,385,547,301,1003,699,516,992,376,1013,620,573,586,1013,719,750,579,601,233,565,553,544,1013,1013,544,544,1013,50,331,522,756,830,830,520,544,830,508
A0429,"Ambulance service, basic life support, emergency transport (BLS-emergency)",1066,959,301,1013,1013,533,970,1013,533,544,1013,454,620,601,666,620,547,301,1003,699,516,992,376,1013,620,573,593,1013,719,750,579,601,439,565,553,544,1013,1013,544,544,1013,533,597,564,756,830,830,597,544,830,508
A0433,"Advanced life support, level 2 (ALS 2)",1822,1640,448,1731,1731,998,1658,1731,929,929,1731,994,1065,1028,1138,659,934,515,1714,1195,882,1695,643,1731,1059,979,1014,1731,1229,819,990,1027,780,966,945,929,1731,1731,929,929,1731,880,911,911,1292,1419,1419,1020,929,1419,448
A0434,Specialty care transport (SCT),2139,1925,604,2032,2032,1171,1946,2032,1070,1091,2032,1167,1232,1207,1336,773,1097,604,2012,1403,1036,1990,755,2032,1244,1149,1190,2032,1443,1505,1162,1206,1083,1134,1110,1091,2032,2032,1091,1091,2032,1033,1137,1132,1517,1666,1666,1313,1091,1666,1018
A4338,"Indwelling catheter; Foley type, two-way latex with coating (Teflon, silicone, silicone elastomer, or hydrophilic, etc.), each",20,18,6,19,19,11,18,19,10,10,19,11,7,11,12,7,10,6,19,13,10,19,7,19,12,11,11,19,13,14,11,11,11,11,10,10,19,19,10,10,19,10,11,11,14,16,16,16,10,16,10
A6196,"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing",16,14,5,20,15,9,15,15,8,8,15,9,6,9,10,6,8,5,15,10,8,15,6,15,9,9,9,15,11,16,9,20,8,8,8,8,15,15,8,8,15,8,9,9,11,12,12,10,8,12,8
A6209,"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing",45,40,13,43,43,25,41,43,23,23,43,25,16,25,28,16,23,13,42,30,22,42,16,43,26,24,25,43,30,32,24,25,16,24,23,23,43,43,23,23,43,22,24,24,32,35,35,28,23,35,21
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",246,221,70,234,234,135,224,234,123,125,234,134,90,139,154,89,126,70,231,161,119,229,87,234,143,132,137,234,166,173,134,139,117,130,128,125,234,234,125,125,234,119,118,130,174,192,192,151,125,192,117
A7048,HC VACUUM DRAIN BOTTLE/TUBE KIT LVL 5,54,48,15,301,51,29,49,51,27,27,51,29,20,30,34,19,27,15,51,35,26,50,19,51,31,29,30,51,36,38,29,30,301,29,28,27,51,51,27,27,51,26,26,28,38,42,42,33,27,42,26
A9270,Non-covered item or service,2,2,0,60,2,1,1,2,1,1,2,1,1,2,1,1,1,0,2,1,1,2,1,2,1,1,1,2,1,1,1,1,1,1,1,1,60,2,1,1,2,1,1,11,1,1,1,1,1,1,1
A9500,"Technetium Tc-99M sestamibi, diagnostic, per study dose",938,844,265,891,891,525,891,891,478,478,891,513,343,529,586,339,467,265,882,615,454,873,331,891,567,504,522,891,633,660,516,529,525,497,487,478,891,891,478,478,891,453,525,496,731,731,731,525,478,731,447
A9503,"Technetium Tc-99M medronate, diagnostic, per study dose, up to 30 millicuries",288,259,81,274,274,158,262,274,147,147,274,157,105,162,180,104,148,81,271,189,139,268,102,274,167,155,160,274,194,203,156,162,161,153,149,147,274,274,147,147,274,139,138,144,204,224,224,144,147,224,137
A9509,"Iodine I-123 sodium iodide, diagnostic, per millicurie",933,840,264,886,886,511,849,886,467,476,886,509,341,526,583,337,478,264,878,612,452,868,329,886,543,501,519,886,629,657,507,526,473,494,484,476,886,886,476,476,886,450,496,494,662,727,727,466,476,727,444
A9537,"Technetium Tc-99M mebrofenin, diagnostic, per study dose, up to 15 millicuries",2163,1947,611,2055,2055,1103,1968,2055,1103,1103,2055,1341,791,1220,1351,782,1109,611,2035,1419,1047,2012,764,2055,1258,1162,1204,2055,1459,1522,1190,1220,1090,1146,1122,1103,2055,2055,1103,1103,2055,1044,1038,686,1534,1685,1685,1685,1103,1685,1030
A9539,"Technetium Tc-99M pentetate, diagnostic, per study dose, up to 25 millicuries",1400,1260,396,1330,1330,767,1274,1330,784,714,1330,764,512,790,874,506,718,396,1317,918,678,1303,494,1330,814,752,779,1330,944,985,761,789,709,742,726,714,1330,1330,714,714,1330,676,744,741,993,1091,1091,860,714,1091,667
A9540,"Technetium Tc-99M macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries",137,123,39,130,130,75,125,130,77,70,130,75,50,77,86,50,70,39,129,90,66,127,48,130,80,74,76,130,92,96,85,77,73,73,71,70,130,130,70,70,130,66,73,72,97,107,107,84,70,107,65
A9541,"Technetium Tc-99M sulfur colloid, diagnostic, per study dose, up to 20 millicuries",251,226,71,238,238,137,228,238,120,128,238,126,92,142,157,91,129,71,236,165,122,234,89,238,146,135,140,238,169,177,78,142,126,133,130,128,238,238,128,128,238,121,141,133,178,196,196,154,128,196,120
A9552,"Fluorodeoxyglucose F-18 FDG, diagnostic, per study dose, up to 45 millicuries",808,727,228,768,768,443,735,768,404,412,768,404,296,456,505,292,414,228,760,530,391,752,285,768,470,434,450,768,545,569,439,456,432,428,419,412,768,768,412,412,768,390,396,428,573,629,629,452,412,629,385
A9562,"Technetium Tc-99M mertiatide, diagnostic, per study dose, up to 15 millicuries",655,590,185,622,622,359,596,622,328,334,622,354,240,370,409,237,336,185,616,430,317,609,231,622,381,352,364,622,442,461,356,369,324,347,340,334,622,622,334,334,622,316,348,347,465,510,510,402,334,510,312
A9579,"Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per ml",298,268,84,283,283,163,283,283,150,152,283,164,109,168,186,108,153,84,280,195,144,277,105,283,173,160,166,283,201,210,164,168,152,158,154,152,283,283,152,152,283,144,149,152,211,232,232,167,152,232,142
C1713,"HC ANCHOR/SCREW BN/BN,TIS/BN LVL 35",5209,4688,608,5254,4949,5254,4739,4949,608,2657,4949,1579,1905,2939,3254,1883,2671,1472,4900,3416,2522,4847,1839,4949,3029,2799,3051,4949,3514,3666,2866,2938,4051,2761,2703,2657,4949,4949,2657,2657,4949,2515,2657,2756,3695,4058,4058,2877,2657,4058,2480
C1725,HC TRANSLUM ANGIOPL NON-LASER CATH LVL 15,155,140,44,8040,147,8040,141,147,78,79,147,85,57,87,97,56,80,44,146,102,75,144,55,147,90,83,86,147,105,109,84,87,74,82,80,79,147,147,79,79,147,75,82,82,110,121,121,95,79,121,74
C1726,HC NON-VASC BALLOON DILATN CATH LVL 15,610,549,172,580,580,334,555,580,306,311,580,333,223,344,381,221,313,172,574,400,296,568,216,580,355,328,340,580,412,430,328,344,311,324,317,311,580,580,311,311,580,295,325,323,433,476,476,375,311,476,291
C1729,HC DRAINAGE CATH LVL 15,6,5,2,6,6,3,5,6,3,3,6,3,2,3,4,2,3,2,6,4,3,6,2,6,3,3,3,6,4,4,2,3,3,3,3,3,6,6,3,3,6,6,3,3,4,5,5,4,3,5,3
C1758,"HC CATHETER, URETERAL LVL 12",25,23,7,24,24,14,23,24,13,13,24,14,9,14,16,9,13,7,24,17,12,23,9,24,15,14,14,24,17,18,14,14,14,13,13,13,24,24,13,13,24,12,13,14,18,20,20,14,13,20,12
C1765,HC ADHESION BARRIER LVL 7,6,5,2,6,6,3,5,6,3,3,6,3,2,3,4,2,3,2,6,4,3,6,2,6,3,3,3,6,4,6,3,3,3,3,3,3,6,6,3,3,6,3,3,3,4,5,5,4,3,5,3
C1771,"HC REP DEV, URINARY, W/SLING LVL 20",1700,1530,480,1615,1615,931,1547,1615,851,867,1615,928,622,959,1062,615,872,480,1599,1115,823,1582,600,1615,988,913,946,1615,1147,1196,924,959,867,901,882,867,1615,1615,867,867,1615,821,904,899,1206,1324,1324,1044,867,1324,809
C1776,HC JOINT DEVICE (IMPLANTABLE) LVL 45,4113,3702,1162,3908,3908,2253,3742,3908,2057,2098,3908,2245,1505,2321,2569,1487,2109,1162,3869,2698,1992,3827,1452,3908,2392,2210,2289,3908,2775,2895,2235,2320,2082,2180,2134,2098,3908,3908,2098,2098,3908,1986,2187,2176,2917,3204,3204,2526,2098,3204,1958
C1781,HC MESH (IMPLANTABLE) LVL 30,1138,1024,241,1081,1081,662,1035,1081,674,580,1081,701,416,642,711,411,583,321,1070,746,551,1058,402,1081,661,611,633,1081,498,801,923,641,682,603,590,580,1081,1081,580,580,1081,549,241,602,807,886,886,886,580,886,542
C1788,HC IMPL INDWELLING PORT LVL 12,915,824,259,869,869,501,832,869,458,467,869,499,335,516,572,331,469,259,861,600,443,851,323,869,532,492,509,869,617,644,497,516,512,485,475,467,869,869,467,467,869,442,486,484,649,713,713,562,467,713,436
C1889,HC SPINAL IMPLANT LVL 31,455,409,128,432,432,249,414,432,227,232,432,282,166,256,284,164,233,128,428,298,220,423,160,432,264,244,253,432,307,320,247,256,242,241,236,232,432,432,232,232,432,219,242,241,322,354,354,255,232,354,216
C2617,"HC STENT, NON-COR, TEM W/O DEL LVL 13",300,270,85,285,285,164,273,285,150,153,285,164,110,169,187,108,154,85,282,197,145,279,106,285,174,161,167,285,202,211,163,169,167,159,156,153,285,285,153,153,285,145,160,150,213,234,234,150,153,234,143
C2627,HC CATH SUPRAPUBIC/CYSTOSCOPIC LVL 4,125,112,35,119,119,68,114,119,63,64,119,68,46,71,78,45,64,35,118,82,61,116,44,119,73,67,70,119,84,88,68,70,70,66,65,64,119,119,64,64,119,60,66,66,89,97,97,67,64,97,60
C46RE,,310,279,88,295,294,170,282,295,155,158,294,169,113,175,194,112,159,88,292,203,150,288,109,294,180,167,172,294,209,218,168,175,157,164,161,158,294,295,158,158,294,150,165,164,220,241,241,128,158,241,148
C9113,"Injection, pantoprazole sodium, per vial",98,88,5,93,93,53,89,93,50,50,93,61,5,55,61,35,50,28,92,64,47,91,34,93,57,52,54,93,66,69,53,55,49,52,51,50,93,93,50,50,93,47,52,50,69,76,76,50,50,76,46
C9290,"Injection, bupivacaine liposome",736,663,182,700,700,403,670,700,358,376,700,295,182,415,460,266,378,208,693,483,357,685,260,700,428,396,410,700,497,518,361,415,349,390,382,376,700,700,376,376,700,356,406,353,522,574,574,604,376,574,351
C9803,"HC HOSP OP CLINIC VISIT SPEC COLLEC SARS-COV-2 COVID-19, ANY SOURCE",28,25,8,99,27,14,27,27,14,14,27,15,90,15,17,99,14,8,26,18,14,26,10,27,22,15,21,27,27,27,15,17,16,14,15,14,27,27,14,14,27,14,16,16,22,22,22,16,14,22,14
DXRAY,,1350,1215,381,1283,1282,739,1228,1283,676,688,1282,737,494,762,843,488,692,381,1270,885,654,1256,477,1282,785,725,751,1282,911,950,734,761,683,716,700,688,1282,1283,688,688,1282,652,718,714,957,1052,1052,829,688,1052,643
EMERG,,2497,2247,389,2372,2372,1368,2272,2372,1250,1273,2372,1363,913,1409,1560,903,1281,706,2349,1638,1209,2323,882,2372,1452,1342,1389,2372,1684,1757,1357,1408,1264,1323,1295,1273,2372,2372,1273,1273,2372,1205,1328,1321,1771,1945,1945,389,1273,1945,1189
G0008,Administration of influenza virus vaccine,82,74,13,78,78,45,75,78,41,42,78,22,30,46,51,30,42,23,77,54,40,76,29,78,48,44,46,78,55,58,45,46,46,43,43,42,78,78,42,42,78,40,13,16,58,64,64,50,42,64,39
G0009,Administration of pneumococcal vaccine,82,74,23,78,78,45,75,78,41,42,78,45,30,46,51,30,42,23,77,54,40,76,29,78,48,44,46,78,55,58,45,46,39,43,43,42,78,78,42,42,78,40,44,43,58,64,64,50,42,64,39
G0010,Administration of hepatitis B vaccine,82,74,23,78,78,45,75,78,41,42,78,45,30,46,51,30,42,23,77,54,40,76,29,78,48,44,46,78,55,58,45,46,39,43,43,42,78,78,42,42,78,40,44,43,58,64,64,50,42,64,39
G0103,Prostate cancer screening; prostate specific antigen test (PSA),176,158,48,174,167,90,160,167,90,90,167,96,48,98,110,64,90,50,166,115,84,164,62,167,106,95,98,167,174,172,96,99,90,93,91,90,167,167,90,90,167,84,90,90,125,137,137,99,90,137,84
G0105,Colorectal cancer screening; colonoscopy on individual at high risk,3685,3316,1021,3501,3501,2064,3352,3501,1879,1879,3501,2011,1348,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2593,2002,2078,1021,1953,1912,1879,3501,3501,1879,1879,3501,1779,2064,1950,2614,2871,2871,2064,1879,2871,1754
G0108,"Diabetes outpatient self-management training services, individual, per 30 minutes",80,72,23,218,76,45,73,76,40,41,76,44,218,45,50,29,41,23,75,52,39,74,28,76,47,43,88,76,54,75,43,45,45,42,42,41,76,114,41,41,76,39,45,45,57,62,62,45,41,62,38
G0121,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,3685,3316,485,3501,3501,2018,3352,3501,1879,1879,3501,485,1348,2079,2302,1332,1890,1041,3466,2417,1784,3429,1301,3501,2143,1980,2051,3501,2486,2558,2002,2078,739,1953,1912,1879,3501,3501,1879,1879,3501,1779,2064,1950,2614,2871,2871,1042,1879,2871,1754
G0168,Wound closure utilizing tissue adhesive(s) only,80,72,23,76,76,40,73,76,40,41,76,44,29,45,50,29,41,23,75,52,39,74,28,76,47,43,45,76,54,56,43,45,30,42,42,41,76,76,41,41,76,40,40,42,57,62,62,49,41,62,38
G0238,"Therapeutic procedures to improve respiratory function, other than described by G0237, one on one, face to face, per 15 minutes (includes monitoring)",116,104,33,361,110,58,106,110,58,59,110,63,361,65,72,42,59,33,109,76,56,108,41,110,67,62,65,110,78,82,63,65,65,61,60,59,110,110,59,59,110,56,62,61,82,90,90,90,59,90,55
G0239,"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)",150,135,42,143,142,82,136,143,75,76,142,81,55,85,94,54,77,42,141,98,73,140,53,142,87,81,83,142,101,106,82,85,76,80,78,76,142,143,76,76,142,72,80,79,106,117,117,92,76,117,71
G0279,PR BREAST TOMOSYNTHESIS DIG DX UNIL/BILAT,80,72,7,76,76,45,76,76,41,41,76,44,29,45,50,29,41,52,75,52,39,76,28,76,48,43,45,76,7,56,44,45,43,42,42,41,76,76,41,41,76,39,42,42,57,62,62,62,41,62,38
G0283,"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care",57,51,16,105,54,32,52,54,27,29,54,35,105,32,36,99,29,16,54,37,28,53,20,54,33,31,32,54,38,40,31,30,29,30,30,29,54,54,29,29,54,28,32,30,44,44,44,44,29,44,27
G0297,PR CT LUNG CANCER SCREEN,600,540,170,570,570,329,546,570,300,306,570,327,480,339,375,217,308,170,564,393,291,558,212,570,349,322,334,570,405,422,321,338,306,318,311,306,570,570,306,306,570,290,300,300,426,467,467,368,306,467,286
G0378,"Hospital observation service, per hour",891,802,200,2238,846,953,845,846,567,454,846,436,2238,1534,557,322,518,222,658,584,431,829,315,846,514,479,218,846,601,351,402,502,449,472,462,454,1035,846,454,454,846,200,455,660,632,694,694,534,454,694,729
G0379,Direct admission of patient for hospital observation care,377,339,107,753,358,211,343,358,192,192,358,207,753,213,235,136,193,107,355,247,183,351,133,358,219,203,210,358,254,265,202,213,202,200,196,192,358,358,192,192,358,182,200,211,267,294,294,211,192,294,179
G0390,HC FULL TRAUMA RESPONS W CC FAC LEV 4,162,146,46,154,154,91,147,154,81,83,154,87,59,91,101,59,83,46,152,106,78,151,57,154,94,87,90,154,109,114,100,91,90,86,84,83,154,154,83,83,154,78,86,86,115,126,126,86,83,126,77
G0416,"Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 1-20 specimens",1600,1440,452,1520,1520,896,1456,1520,801,816,1520,873,585,903,999,578,821,452,1505,1049,775,1489,565,1520,930,860,890,1520,1079,1126,869,902,896,848,830,816,1520,1520,816,816,1520,772,851,847,1135,1246,1246,896,816,1246,762
G0424,"Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day",195,176,55,199,185,107,177,185,98,99,185,121,199,110,122,70,100,55,183,128,94,181,69,185,113,105,109,185,132,137,106,110,109,103,101,99,185,185,99,99,185,94,94,103,138,152,152,152,99,152,56
G0463,Hospital outpt clinic visit,163,147,46,155,155,91,138,155,79,83,155,95,59,92,102,61,84,46,153,107,79,152,58,155,95,88,91,155,110,82,90,113,81,86,85,83,155,155,83,83,155,79,102,81,116,127,127,82,83,127,78
G0472,HC HEP C SCREEN HIGH RISK/OTHER,98,88,21,93,93,53,89,93,49,50,93,53,36,55,61,35,50,28,92,64,47,91,34,93,57,52,54,93,66,69,53,55,21,52,51,50,93,93,50,50,93,47,65,52,69,76,76,34,50,76,46
G0480,Drug test def 1-7 classes,106,95,30,129,101,58,96,101,53,54,101,76,110,60,66,128,51,30,100,70,51,99,37,101,62,57,59,101,71,104,57,53,129,56,55,54,101,101,54,54,101,51,53,92,75,83,83,92,54,83,50
G0498,HC CHEMO EXTEND IV INFUS W/PUMP,404,364,114,384,384,221,368,384,202,206,384,220,148,228,252,146,207,114,380,265,196,376,143,384,235,217,225,384,273,284,220,228,206,214,210,206,384,384,206,206,384,195,215,214,287,315,315,248,206,315,192
G0499,HC HEP B SCREEN HIGH RISK INDIV (NON PREGNANT),60,54,17,57,57,33,55,57,30,31,57,33,22,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,34,32,31,31,57,57,31,31,57,29,32,32,43,47,47,37,31,47,29
J0129,"Injection, abatacept, 10 mg",9492,8543,2682,9018,9017,5198,8635,9018,4750,4841,9017,5180,3472,5355,5929,3431,4868,2682,8929,6225,4596,8832,3351,9017,5519,5100,5282,9017,6403,6680,5158,5353,4782,5031,4924,4841,9017,9018,4841,4841,9017,4582,4746,5022,6732,7394,7394,4746,4841,7394,4519
J0131,Acetaminophen injection,158,143,20,151,151,89,151,151,66,81,151,80,42,71,99,20,85,45,123,104,77,147,56,151,110,85,71,151,107,112,80,89,75,84,82,81,148,151,81,81,151,77,91,61,112,123,123,101,81,123,75
J0153,PBB ADENOSINE INJ 1 MG,119,107,4,113,113,65,109,113,60,61,113,65,4,67,75,43,61,34,112,78,58,111,42,113,69,64,66,113,80,84,65,67,67,63,62,61,113,113,61,61,113,58,63,63,85,93,93,73,61,93,57
J0171,"Injection, adrenalin, epinephrine, 0.1 mg",90,81,9,87,85,50,87,85,46,46,85,56,9,51,56,26,46,25,84,59,44,84,32,85,57,48,50,85,61,63,49,51,50,48,47,46,85,85,46,46,85,44,46,46,71,70,70,50,46,70,43
J0185,"Inj., aprepitant, 1 mg",927,835,220,881,881,508,844,881,464,473,881,564,220,523,579,220,476,262,872,608,449,863,327,881,539,498,516,881,626,653,510,523,518,492,481,473,881,881,473,473,881,448,493,491,658,722,722,628,473,722,442
J0248,,1128,1015,319,1071,1071,617,1026,1071,564,575,1071,615,412,636,704,408,578,319,1061,739,546,1049,398,1071,656,606,627,1071,761,793,613,636,830,598,585,575,1071,1071,575,575,1071,544,923,551,800,878,878,692,575,878,537
J0256,"Injection, alpha 1 - proteinase inhibitor - human, 10 mg",4328,3895,1223,4111,4111,2370,3937,4111,2166,2207,4111,2361,1583,2442,2703,1564,2219,1223,4071,2838,2095,4026,1528,4111,2516,2325,2408,4111,2919,3046,2351,2440,2379,2294,2245,2207,4111,4111,2207,2207,4111,2089,2301,2290,3069,3371,3371,2657,2207,3371,2060
J0280,"Injection, aminophyllin, up to 250 mg",104,93,2,98,98,2,94,98,52,53,98,56,38,58,65,37,53,29,97,68,50,96,37,98,60,56,58,98,70,73,62,58,58,55,54,53,98,98,53,53,98,50,55,55,74,81,81,64,53,81,49
J0282,"Injection, amiodarone hydrochloride, 30 mg",127,114,36,120,120,69,115,120,63,65,120,69,46,71,79,46,65,36,119,83,61,118,45,120,74,68,70,120,85,89,69,71,66,67,66,65,120,120,65,65,120,61,67,67,90,99,99,78,65,99,60
J0295,"Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm",102,92,3,97,97,56,93,97,51,52,97,63,3,58,64,37,52,29,96,67,49,95,36,97,59,55,64,97,69,72,51,58,65,54,53,52,97,97,52,52,97,49,53,54,72,80,80,65,52,80,49
J0330,"Injection, succinylcholine chloride, up to 20 mg",105,95,11,107,100,50,96,100,51,54,100,63,11,59,66,21,54,30,99,69,51,98,37,100,71,56,55,100,71,74,65,59,58,56,55,54,107,100,54,54,100,51,57,60,75,82,82,82,54,82,50
J0360,"Injection, hydralazine HCl, up to 20 mg",95,85,4,90,90,52,86,90,57,48,90,32,4,53,59,34,49,27,89,62,46,88,33,90,55,51,53,90,64,67,59,53,51,50,49,48,90,90,48,48,90,46,58,52,67,74,74,50,48,74,45
J0401,Inj aripiprazole ext rel 1mg,3917,3526,1107,3722,3722,2145,3564,3722,1960,1998,3722,2138,1433,2210,2447,1416,2009,1107,3685,2569,1897,3645,1383,3722,2278,2105,2180,3722,2642,2757,2129,2209,1974,2076,2032,1998,3721,3722,1998,1998,3722,1891,2083,2073,2778,3052,3052,2405,1998,3052,1865
J0456,"Injection, azithromycin, 500 mg",94,85,3,90,90,53,86,90,48,48,90,55,3,53,59,34,52,27,89,62,45,88,33,90,55,51,53,90,64,67,55,53,48,50,49,48,90,90,48,48,90,46,53,50,67,74,74,48,48,74,48
J0461,"Injection, atropine sulfate, 0.01 mg",104,93,2,99,98,58,94,98,52,53,98,64,2,58,65,2,53,29,97,68,50,96,37,98,60,56,58,98,70,73,55,58,99,55,54,53,98,98,53,53,98,50,52,55,73,81,81,58,53,81,49
J0485,Belatacept injection,4346,3911,1228,4609,4128,2380,3953,4128,2175,2216,4128,2371,1590,2452,2714,4609,2228,1228,4088,2850,2104,4043,1534,4128,2527,2335,2418,4128,2931,3058,2361,2450,2165,2303,2254,2216,4128,4128,2216,2216,4128,2098,2310,2299,3082,3385,3385,2668,2216,3385,2069
J0500,"Injection, dicyclomine HCl, up to 20 mg",256,230,40,243,243,140,233,243,128,130,243,140,40,144,160,92,131,72,240,168,124,238,90,243,149,137,142,243,172,180,139,144,121,135,133,130,243,243,130,130,243,123,136,135,181,199,199,157,130,199,122
J0561,"Injection, penicillin G benzathine, 100,000 units",466,420,132,443,443,255,424,443,233,238,443,289,171,263,291,169,239,132,439,306,226,434,165,443,271,250,259,443,314,328,277,263,236,247,242,238,443,443,238,238,443,225,248,247,331,363,363,286,238,363,222
J0585,"Injection, onabotulinumtoxinA, 1 unit",2576,2318,728,2447,2447,1410,2343,2447,1289,1314,2447,1405,942,1453,1609,931,1321,728,2423,1689,1247,2396,909,2447,1498,1384,1433,2447,1737,1813,1399,1452,1298,1365,1336,1314,2447,2447,1314,1314,2447,1243,1369,1363,1827,2006,2006,1225,1314,2006,1226
J0595,"Injection, butorphanol tartrate, 1 mg",91,82,3,87,87,50,83,87,46,47,87,50,3,52,57,33,47,26,86,60,44,85,32,87,53,49,51,87,62,64,50,51,51,48,47,47,87,87,47,47,87,44,49,48,65,71,71,56,47,71,43
J0610,"Injection, calcium gluconate, per 10 ml",108,97,4,102,102,59,98,102,54,55,102,59,4,61,67,39,55,30,101,71,52,100,38,102,63,58,60,102,73,76,58,61,59,57,56,55,102,102,55,55,102,52,60,57,76,84,84,53,55,84,51
J0640,"Injection, leucovorin calcium, per 50 mg",421,379,49,400,400,230,383,400,210,215,400,230,49,237,263,49,216,119,396,276,204,391,149,400,245,226,234,400,284,296,229,237,220,223,218,215,400,400,215,215,400,203,224,223,298,328,328,258,215,328,200
J0690,"Injection, cefazolin sodium, 500 mg",93,84,2,89,89,50,87,89,47,48,89,52,3,53,58,2,46,26,88,61,45,87,33,89,47,50,50,89,63,66,50,58,51,49,48,48,89,89,48,48,89,45,48,47,66,73,73,72,48,73,44
J0692,"Injection, Cefepime hydrochloride, 500 mg",99,89,11,94,94,54,90,94,49,50,94,28,36,56,62,36,51,28,93,65,48,92,35,94,58,53,55,94,67,70,54,56,50,52,51,50,94,94,50,50,94,48,56,11,70,77,77,53,50,77,47
J0696,"Injection, ceftriaxone sodium, per 250 mg",96,87,2,92,92,51,89,92,49,49,92,52,2,54,60,3,49,27,91,63,45,90,34,92,56,52,54,92,65,68,52,54,49,51,50,49,86,92,49,49,92,47,51,51,68,75,75,51,49,75,46
J0702,"Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg",186,168,29,177,177,102,170,177,93,95,177,101,29,105,116,67,92,53,175,122,90,173,66,177,108,100,104,177,126,131,100,105,104,99,97,95,177,177,95,95,177,90,99,99,132,145,145,114,95,145,89
J0713,"Injection, ceftazidime, per 500 mg",94,85,27,89,89,52,86,89,47,48,89,51,34,53,59,34,48,27,88,62,46,88,33,89,55,51,52,89,63,66,51,53,47,50,49,48,89,89,48,48,89,45,50,50,67,73,73,78,48,73,45
J0717,Certolizumab pegol inj 1mg,9500,8550,2684,9025,9025,5203,8642,9025,4754,4845,9025,5184,3475,5360,5934,3434,4872,2684,8936,6230,4600,8839,3354,9025,5524,5104,5286,9025,6408,6686,5162,5357,5320,5035,4928,4845,9025,9025,4845,4845,9025,4586,5051,5026,6738,7400,7400,5832,4845,7400,4523
J0744,"Injection, Ciprofloxacin for intravenous infusion, 200 mg",96,86,2,91,91,52,87,91,48,49,91,59,2,54,60,35,49,27,90,63,69,89,34,91,56,51,53,91,64,67,59,54,53,51,50,49,91,91,49,49,91,46,53,51,68,74,74,53,49,74,45
J0780,"Injection, prochlorperazine, up to 10 mg",124,112,5,118,118,62,113,118,64,63,118,67,5,70,78,8,64,35,117,82,60,116,44,118,72,67,68,118,84,88,67,70,64,66,65,63,96,118,63,63,118,60,65,70,88,97,97,62,63,97,59
J0834,"Injection, cosyntropin (Cortrosyn), 0.25 mg",301,271,85,286,286,165,274,286,150,153,286,164,110,170,188,109,154,85,283,197,146,280,106,286,175,162,167,286,203,212,163,170,152,159,156,153,286,286,153,153,286,145,160,159,213,234,234,185,153,234,143
J0878,"Injection, daptomycin, 1 mg",268,241,76,254,254,146,243,254,134,136,254,146,98,151,167,97,137,76,252,175,130,249,94,254,156,144,149,254,180,188,145,151,135,142,139,136,254,254,136,136,254,129,134,142,190,208,208,134,136,208,127
J0881,"Injection, darbepoetin alfa, 1 microgram (non-ESRD use)",4732,4258,439,4495,4495,2591,4304,4495,2368,2413,4495,2582,1731,2669,2955,1710,2426,1337,4451,3103,2291,4402,1671,4495,2751,2542,2633,4495,3191,3330,2571,2668,439,2508,2455,2413,4495,4495,2413,2413,4495,2284,2650,2503,3356,3686,3686,2650,2413,3686,2253
J0885,"Injection, epoetin alfa, (for non-ESRD use), 1000 units",622,560,176,591,591,341,566,591,311,317,591,339,228,351,389,225,319,176,585,408,301,579,220,591,362,334,346,591,420,438,338,351,295,330,323,317,591,591,317,317,591,300,331,329,441,485,485,382,317,485,296
J0894,"Injection, decitabine, 1 mg",1650,1485,454,1567,1567,903,1501,1567,826,841,1567,900,454,931,1030,596,846,466,1552,1082,799,1535,582,1567,959,886,918,1567,1113,1161,896,930,841,874,856,841,1567,1567,841,841,1567,796,877,873,1170,1285,1285,1013,841,1285,785
J0897,PBB DENOSUMAB INJECTION 1 MG,2956,2660,835,2808,2808,1551,2701,2808,1551,1507,2808,1591,1271,1668,1846,1655,1516,835,2780,1938,1431,2750,1044,2808,1719,1588,1645,2808,1994,2080,1673,1667,1566,1567,1533,1507,2808,2808,1507,1507,2808,1427,1566,1655,2096,2303,2302,1566,1507,2303,1407
J1030,"Injection, methylprednisolone acetate, 40 mg",105,94,6,100,100,57,95,100,52,53,100,33,6,59,66,38,54,30,99,69,51,98,37,100,61,56,58,100,71,74,57,59,53,56,54,53,100,100,53,53,100,51,56,56,74,82,82,64,53,82,50
J1071,PBB INJ TESTOSTERONE CYPIONATE,119,107,34,126,113,65,108,113,60,61,113,71,44,67,74,43,61,34,112,78,58,111,42,113,69,64,66,113,80,84,65,67,60,63,62,61,113,113,61,61,113,57,63,63,84,93,93,126,61,93,57
J1080,"Injection, testosterone cypionate, 1 cc, 200 mg",121,109,34,115,115,66,110,115,61,62,115,66,44,68,76,44,62,34,114,80,59,113,43,115,71,65,67,115,82,85,66,68,61,64,63,62,115,115,62,62,115,59,64,64,86,94,94,94,62,94,58
J1100,"Injection, dexamethasone sodium phosphate, 1 mg",93,84,1,91,88,52,89,88,49,47,88,54,1,51,58,2,49,26,87,61,45,86,33,88,59,50,54,88,63,65,53,52,49,49,48,47,91,88,47,47,88,45,50,49,66,72,72,62,47,72,44
J1110,"Injection, dihydroergotamine mesylate, per 1 mg",350,315,65,333,333,192,319,333,175,179,333,271,65,198,219,127,180,99,329,230,170,326,124,333,204,188,195,333,236,246,94,197,177,186,182,179,333,333,179,179,333,169,186,185,248,273,273,215,179,273,167
J1160,"Injection, digoxin, up to 0.5 mg",94,84,14,89,89,51,85,89,47,48,89,51,14,53,58,34,48,26,88,61,45,87,33,89,54,50,52,89,63,66,51,53,47,50,49,48,89,89,48,48,89,45,50,52,66,73,73,57,48,73,45
J1165,"Injection, phenytoin sodium, per 50 mg",99,89,7,94,94,54,90,94,50,51,94,54,7,56,62,36,51,28,93,65,48,92,35,94,58,53,55,94,67,70,54,56,58,53,51,51,94,94,51,51,94,48,53,52,70,77,77,61,51,77,47
J1170,"Injection, hydromorphone, up to 4 mg",93,83,3,88,88,51,84,88,46,47,88,57,3,52,58,6,48,26,87,61,45,86,33,88,56,50,50,88,63,65,50,50,50,49,48,47,88,88,47,47,88,45,50,49,66,72,72,52,47,72,44
J1200,"Injection, diphenhydramine HCl, up to 50 mg",90,81,1,85,85,49,82,85,44,46,85,49,1,49,56,1,46,1,84,59,43,83,32,85,52,48,50,85,60,63,51,51,46,48,47,46,85,85,46,46,85,43,50,47,64,70,70,69,46,70,43
J1265,"Injection, dopamine HCl, 40 mg",112,101,32,106,106,61,102,106,56,57,106,61,41,63,70,40,57,32,105,73,54,104,40,106,65,60,62,106,76,79,61,63,57,59,58,57,106,106,57,57,106,54,54,59,79,87,87,69,57,87,53
J1335,"Injection, Ertapenem sodium, 500 mg",322,289,42,306,306,176,293,306,161,164,306,176,42,181,201,116,165,91,303,211,156,299,114,306,187,173,179,306,217,226,172,181,180,170,167,164,306,306,164,164,306,155,171,170,228,251,251,197,164,251,153
J1439,HC INJ FERRIC CARBOXYMALTOS 1MG,2300,2070,812,2185,2185,1260,2093,2185,1151,1173,2185,1255,841,1298,1437,832,1180,832,2164,1509,1114,2140,812,2185,1338,1236,1280,2185,1552,1619,1250,1297,1364,1219,1193,1173,2185,2185,1173,1173,2185,1111,1223,1217,1632,1792,1792,1412,1173,1792,1095
J1459,"Injection, immune globulin (Privigen), intravenous, non-lyophilized (e.g. liquid), 500 mg",5888,5299,1663,5593,5593,3224,5356,5593,2946,3003,5593,3213,2154,3322,3678,2128,3019,1663,5538,3861,2851,5478,2079,5593,3423,3163,3276,5593,3971,4143,3199,3320,3297,3120,3054,3003,5593,5593,3003,3003,5593,2842,3130,3115,4176,4586,4586,3615,3003,4586,2803
J1561,"Injection, immune globulin, (gamunex), intravenous, non-lyophilized (e.g. liquid), 500 mg",9152,8237,2586,8695,8695,5012,8326,8695,4580,4668,8695,4994,3348,5164,5717,3308,4693,2586,8609,6002,4431,8515,3231,8695,5322,4917,5093,8695,6173,6441,5674,5161,4632,4851,4748,4668,8694,8695,4668,4668,8695,4418,4866,4843,6491,7129,7129,5619,4668,7129,4357
J1580,"Injection, garamycin, gentamicin, up to 80 mg",92,83,26,87,87,50,84,87,44,47,87,50,34,52,57,33,47,26,86,60,44,85,32,87,53,49,51,87,62,65,50,52,46,49,48,47,87,87,47,47,87,44,49,49,65,72,72,56,47,72,44
J1630,"Injection, haloperidol, up to 5 mg",92,83,1,160,88,47,84,88,47,47,88,48,1,52,58,33,47,26,106,61,45,86,33,88,54,50,51,88,62,65,53,52,33,49,48,47,88,88,47,47,88,45,54,160,65,72,72,44,47,72,44
J1631,"Injection, haloperidol decanoate, per 50 mg",107,96,30,102,102,59,97,102,53,55,102,83,39,60,67,39,55,30,101,70,52,99,38,102,62,57,59,102,72,75,59,60,54,57,55,55,102,102,55,55,102,52,57,57,76,83,83,66,55,83,51
J1642,"Injection, Heparin sodium, (Heparin lock flush), per 10 units",89,80,0,85,85,49,81,85,45,45,85,49,0,50,56,1,46,25,84,58,43,83,31,85,52,48,50,85,60,63,55,50,50,47,46,45,85,85,45,45,85,43,47,50,63,69,69,69,45,69,9
J1644,"Injection, Heparin sodium, per 1000 units",93,83,1,88,88,51,84,88,44,47,88,65,2,52,58,1,48,26,87,61,45,86,33,88,54,50,52,88,63,65,63,52,51,49,48,47,88,88,47,47,88,45,59,49,66,72,72,56,47,72,44
J1650,"Injection, enoxaparin sodium, 10 mg",154,138,3,146,146,86,146,146,61,78,146,56,3,55,96,3,79,43,145,101,71,143,54,146,93,83,86,146,104,108,62,87,77,81,80,78,146,146,78,78,146,74,77,86,109,120,120,77,78,120,73
J1745,"Injection Infliximab, 10 mg",9897,8907,2496,9402,9402,5420,9004,9402,4953,5048,9402,6064,3620,5584,6182,3578,5075,2796,9310,6491,4792,9209,3494,9402,5755,5317,5507,9402,6676,6965,5378,5581,4869,5246,5135,5048,9402,9402,5048,5048,9402,4778,2496,5237,7020,7710,7710,6077,5048,7710,4712
J1756,"Injection, iron sucrose, 1 mg",318,287,90,303,303,174,290,303,159,162,303,183,117,180,199,115,163,90,300,209,154,296,112,303,185,171,177,303,215,224,175,180,160,169,165,162,303,303,162,162,303,154,169,169,226,248,248,154,162,248,152
J1815,"Injection, insulin, per 5 units",6,5,2,6,6,3,5,6,3,3,6,3,2,3,4,2,3,2,6,4,3,6,2,6,3,3,3,6,4,4,4,3,3,3,3,3,6,6,3,3,6,3,3,3,4,5,5,4,3,5,3
J1885,"Injection, ketorolac tromethamine, per 15 mg",92,83,1,93,88,52,88,84,46,47,88,50,1,52,58,1,50,26,88,61,42,86,33,88,57,50,51,88,62,65,49,54,50,49,48,47,93,85,47,47,88,45,50,45,70,72,72,69,47,72,44
J1930,"Injection, lanreotide, 1 mg",19212,17290,5428,18251,18251,10521,17478,18251,9615,9798,18251,10483,7027,10839,12000,6945,9852,5428,18071,12599,9302,17875,6783,18251,11171,10322,10690,18251,12958,13520,10439,10834,9679,10182,9967,9798,18251,18251,9798,9798,18251,9274,10214,10165,13626,14966,14965,11795,9798,14966,9147
J1940,"Injection, furosemide, up to 20 mg",90,81,1,95,86,50,82,86,46,46,86,49,1,50,56,33,46,25,95,59,48,84,32,86,52,48,50,86,61,63,54,51,50,48,47,46,86,86,46,46,86,43,46,48,64,70,70,45,46,70,43
J1953,"Injection, levetiracetam, 10 mg",110,99,4,104,104,60,104,104,55,56,104,34,4,62,68,40,56,31,103,72,53,102,39,104,64,59,61,104,74,77,61,62,72,58,57,56,104,104,56,56,104,53,58,58,78,85,85,65,56,85,52
J1956,"Injection, levofloxacin, 250 mg",100,90,2,95,95,55,91,95,51,51,95,57,37,56,62,2,51,28,94,66,48,93,35,95,58,54,56,95,67,70,54,56,54,53,52,51,95,95,51,51,95,48,64,50,71,78,78,56,51,78,52
J2060,"Injection, lorazepam, 2 mg",89,80,1,85,84,44,81,84,45,45,84,48,1,50,55,1,42,25,85,58,43,83,31,84,52,48,49,84,60,62,28,50,50,47,46,45,84,84,45,45,84,43,50,50,63,69,69,44,45,69,42
J2150,"Injection, mannitol, 25% in 50 ml",96,87,27,91,91,53,88,91,48,49,91,60,35,54,60,35,49,27,91,63,47,90,34,91,56,52,54,91,65,68,52,54,47,51,50,49,91,91,49,49,91,46,51,51,68,75,75,59,49,75,46
J2175,"Injection, meperidine hydrochloride, per 100 mg",100,90,7,95,95,55,91,95,50,51,95,62,7,57,63,36,51,28,94,66,49,93,35,95,58,54,56,95,68,71,62,57,56,53,52,51,95,95,51,51,95,48,53,53,71,78,78,62,51,78,48
J2182,"Injection, mepolizumab, 1mg",6516,5865,1841,6191,6191,3569,5928,6191,3261,3323,6191,4011,2384,3677,4070,2356,3342,1841,6130,4274,3155,6063,2301,6191,3789,3501,3626,6191,4395,4586,3541,3675,3298,3454,3381,3323,6191,6191,3323,3323,6191,3146,3465,3448,4622,5076,5076,4001,3323,5076,3103
J2185,"Injection, meropenem, 100 mg",110,99,31,104,104,60,100,104,55,56,104,60,40,62,68,40,56,31,103,72,53,102,39,104,64,59,61,104,74,77,59,62,55,58,57,56,104,104,56,56,104,53,58,58,78,85,85,67,56,85,52
J2250,"Injection, midazolam hydrochloride, per 1 mg",88,79,0,137,84,49,84,84,45,45,84,55,0,50,55,0,46,25,83,58,44,82,31,84,69,47,48,84,59,62,48,56,49,47,46,45,84,84,45,45,84,43,49,45,137,69,69,49,45,69,42
J2270,"Injection, morphine sulfate, up to 10 mg",93,84,2,103,89,95,85,89,47,48,89,54,3,53,58,2,48,26,89,61,45,87,33,89,54,50,103,89,63,66,50,53,52,49,45,48,89,89,48,48,89,45,51,50,66,73,73,63,48,73,44
J2300,"Injection, nalbuphine hydrochloride, per 10 mg",95,85,3,100,90,52,87,90,47,48,90,100,3,53,59,3,49,27,89,62,46,88,33,90,55,51,53,90,64,67,57,53,48,50,49,48,90,90,48,48,90,46,50,50,67,74,74,74,48,74,45
J2310,"Injection, naloxone hydrochloride, per 1 mg",119,107,13,138,113,66,108,113,60,61,113,72,13,67,74,43,61,34,112,78,58,111,42,113,69,64,66,113,80,84,73,67,62,63,62,61,113,113,61,61,113,58,138,86,85,93,93,60,61,93,57
J2353,"Injection, octreotide, depot form for intramuscular injection, 1 mg",8617,7755,2435,10137,8186,4719,7839,8186,4312,4395,8186,4702,3152,4862,5382,3115,4419,2435,8106,5651,4172,8017,3042,8186,5011,4630,4795,8186,5812,6064,4682,4859,4826,4567,4470,4395,8186,8186,4395,4395,8186,4160,4581,9331,6112,6713,6712,10137,4395,6713,4103
J2360,"Injection, orphenadrine citrate, up to 60 mg",119,107,5,170,113,64,170,113,59,61,113,33,5,67,74,5,61,34,112,78,57,110,42,113,69,64,98,113,80,84,37,64,61,63,62,61,113,113,61,61,113,57,60,63,84,92,92,92,61,92,57
J2370,"Injection, phenylephrine HCl, up to 1 ml",94,85,4,89,89,51,85,89,49,48,89,58,4,53,59,34,48,27,88,62,45,87,33,89,55,50,52,89,63,66,51,53,53,50,49,48,89,89,48,48,89,45,47,50,67,73,73,53,48,73,45
J2405,"Injection, ondansetron hydrochloride, per 1 mg",88,80,0,127,84,50,84,84,45,45,84,49,0,49,55,0,47,25,84,58,64,82,31,84,44,48,49,84,60,62,49,55,50,47,46,45,127,84,45,45,84,43,50,50,69,69,69,50,45,69,45
J2426,"Injection, paliperidone palmitate extended release, 1 mg",3028,2725,855,2876,2876,1658,2754,2876,1515,1544,2876,1652,1107,1708,1891,1094,1553,855,2848,1985,1466,2817,1069,2876,1760,1627,1685,2876,2042,2131,1874,1707,1532,1605,1571,1544,2876,2876,1544,1544,2876,1462,1610,1602,2147,2358,2358,1859,1544,2358,1441
J2469,"Injection, palonosetron HCl, 25 mcg",175,157,12,224,166,96,159,166,87,89,166,108,12,99,109,12,90,49,164,115,85,162,62,166,102,94,97,166,118,123,103,98,98,93,91,89,166,166,89,89,166,84,93,92,124,136,136,224,89,136,83
J2505,"Injection, Pegfilgrastim, 6 mg",12550,11295,3546,11922,11922,6873,11417,11922,6281,6400,11922,6777,4058,7080,7839,4537,6436,3546,11805,8230,6076,11676,4431,11922,7297,6742,6983,11922,8465,8832,6819,7077,7028,6651,6511,6400,11922,11922,6400,6400,11922,6058,6672,6640,8901,9776,9776,9776,6400,9776,5975
J2506,,12924,11631,3651,12277,12277,7078,11757,12277,6468,6591,12277,7052,4727,7291,8072,4672,6627,3651,12157,8475,6257,12024,4563,12277,7515,6943,7191,12277,8717,9095,7022,7288,4504,6849,6705,6591,12277,12277,6591,6591,12277,6239,6871,6838,9166,10067,10067,7935,6591,10067,6153
J2540,"Injection, penicillin G potassium, up to 600,000 units",108,97,29,103,103,59,98,103,54,55,103,29,39,61,67,39,55,30,101,71,52,100,38,103,63,58,60,103,73,76,59,61,55,57,56,55,103,103,55,55,103,52,57,57,77,84,84,66,55,84,51
J2543,"Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)",94,84,5,89,89,48,85,89,49,48,89,58,5,53,58,34,84,26,88,61,55,87,33,89,54,50,55,89,63,66,51,53,52,50,49,48,89,89,48,48,89,45,52,79,66,73,73,47,48,73,45
J2550,"Injection, promethazine HCl, up to 50 mg",91,82,2,86,86,51,83,86,46,46,86,38,2,51,57,2,47,26,85,60,43,85,32,86,53,49,51,86,61,64,45,48,51,48,47,46,86,86,46,46,86,44,43,48,65,71,71,72,46,71,43
J2590,"Injection, oxytocin, up to 10 units",93,84,25,88,88,51,85,88,47,47,88,41,34,53,58,34,48,26,88,61,45,87,33,88,54,50,52,88,63,66,25,53,47,49,48,47,88,88,47,47,88,45,49,49,66,73,73,57,47,73,44
J2704,"Inj, propofol, 10 mg",92,83,4,132,88,52,132,88,47,47,88,57,4,51,58,4,51,26,67,61,45,86,33,88,46,50,51,88,62,65,53,55,52,49,48,47,132,88,47,50,88,45,52,52,65,72,72,54,47,72,44
J2710,"Injection, neostigmine methylsulfate, up to 0.5 mg",104,93,15,98,98,57,94,98,24,53,98,64,70,58,65,69,53,29,97,68,50,96,37,98,60,56,58,98,70,73,15,58,55,55,54,53,98,98,53,53,98,50,35,55,73,81,81,64,53,81,49
J2765,"Injection, metoclopramide HCl, up to 10 mg",92,83,1,87,87,50,84,87,44,47,87,49,1,52,57,33,51,26,86,60,44,86,32,87,53,49,51,87,62,65,49,52,51,49,43,47,87,87,47,47,87,44,51,45,65,72,72,72,47,72,44
J2785,"Injection, regadenoson, 0.1 mg",581,523,164,552,552,329,545,552,300,296,552,327,242,328,363,242,285,164,546,381,281,540,205,552,347,312,323,552,392,409,323,323,321,308,301,296,545,552,296,296,552,280,329,307,412,452,452,321,296,447,276
J2790,"Injection, Rho D immune globulin, human, full dose, 300 micrograms (1500 I.U.)",258,232,73,245,245,141,235,245,129,132,245,141,76,146,161,93,132,73,243,169,125,240,91,245,150,139,144,245,174,182,160,145,131,137,134,132,245,245,132,132,245,125,137,137,183,201,201,158,132,201,123
J2791,"Injection, Rho(D) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 IU",408,367,115,388,388,224,371,388,204,208,388,220,149,230,255,148,209,115,384,268,198,380,144,388,237,219,227,388,275,287,222,230,207,216,212,208,388,388,208,208,388,197,217,216,290,318,318,251,208,318,194
J2795,"Injection, ropivacaine hydrochloride, 1 mg",144,130,21,137,137,79,131,137,72,73,137,84,21,81,90,52,74,41,135,94,70,134,51,137,84,77,80,137,97,101,108,81,77,76,75,73,137,137,73,73,137,70,77,76,102,112,112,72,73,112,69
J2796,"Injection, romiplostim, 10 micrograms",898,808,254,853,853,492,817,853,450,458,853,490,329,507,561,325,461,254,845,589,435,836,317,853,522,483,500,853,606,632,488,507,453,476,466,458,853,853,458,458,853,434,478,475,637,700,700,552,458,700,428
J2805,"Injection, sincalide, 5 micrograms",164,148,46,156,156,84,149,156,84,84,156,102,119,93,102,116,84,46,154,108,79,153,58,156,95,88,91,156,111,115,89,92,83,87,85,84,156,156,84,84,156,79,79,82,116,128,128,101,84,128,78
J2920,"Injection, methylprednisolone sodium succinate, up to 40 mg",100,90,4,119,95,119,91,95,50,51,95,54,4,57,63,11,51,28,94,66,48,93,35,95,58,54,56,95,68,70,31,56,56,53,52,51,88,95,51,51,95,48,50,53,71,78,78,53,51,78,48
J2930,"Injection, methylprednisolone sodium succinate, up to 125 mg",108,97,6,102,102,53,98,102,55,55,102,58,6,57,67,6,86,30,102,71,51,100,38,102,65,58,60,102,73,76,58,61,56,57,56,55,102,102,55,55,102,52,58,54,50,84,84,60,55,84,51
J2997,"Injection, alteplase recombinant, 1 mg",409,368,116,9930,389,224,372,389,205,209,389,9930,4475,231,255,148,7069,116,385,268,198,380,144,389,238,220,228,389,276,288,222,231,210,217,212,209,388,389,209,209,389,197,5808,216,290,319,319,8008,209,319,195
J3010,"Injection, fentanyl citrate, 0.1 mg",89,80,1,127,85,47,84,85,45,45,85,55,1,49,56,1,49,25,86,58,43,83,31,85,44,48,73,85,60,63,49,55,50,47,46,45,127,85,45,45,85,43,49,50,69,69,69,50,45,69,48
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)",136,122,26,129,129,74,123,129,68,69,129,50,26,76,85,81,71,38,129,89,66,126,48,129,79,73,75,129,91,95,57,76,69,72,70,69,129,129,69,69,129,65,72,72,96,106,106,83,69,106,65
J3032,Inj. eptinezumab-jjmr 1 mg,3307,2977,934,3142,3142,1811,3009,3142,1655,1687,3142,1805,1210,1866,2066,1196,1696,934,3111,2169,1601,3077,1168,3142,1923,1777,1840,3142,2231,2328,1797,1865,1666,1753,1716,1687,3142,3142,1687,1687,3142,1597,1758,1750,2346,2576,2576,2031,1687,2576,1575
J3105,"Injection, terbutaline sulfate, up to 1 mg",96,87,3,92,92,53,88,92,48,49,92,53,3,54,60,35,49,27,91,63,47,90,34,92,56,52,54,92,65,68,52,54,49,51,50,49,92,92,49,49,92,47,51,51,68,75,75,59,49,75,46
J3111,Inj. romosozumab-aqqg 1 mg,4304,3873,1216,4089,4089,2195,3915,4089,2195,2195,4089,2348,1574,2428,2688,1556,2207,1216,4048,2822,2084,4004,1520,4089,2503,2312,2395,4089,2903,3029,2339,2427,2178,2281,2233,2195,4089,4089,2195,2195,4089,2078,2288,2277,3052,3353,3353,2642,2195,3353,2049
J3245,"Inj., tildrakizumab, 1 mg",31062,27956,8777,29509,29509,17011,28259,29509,15545,15842,29509,16950,11362,17525,19403,11229,15929,8777,29219,20371,15040,28901,10967,29509,18062,16689,17284,29509,20952,21861,16878,17517,16413,16463,16115,15842,29509,29509,15842,15842,29509,14995,16515,16435,22031,24197,24197,19071,15842,24197,14789
J3260,"Injection, tobramycin sulfate, up to 80 mg",104,94,30,99,99,57,95,99,52,53,99,57,38,59,65,38,54,30,98,68,51,97,37,99,61,56,58,99,70,74,57,59,53,55,54,53,99,99,53,53,99,50,56,55,74,81,81,64,53,81,50
J3262,"Injection, tocilizumab, 1 mg",6544,5889,1849,6217,6217,3584,5953,6217,3275,3337,6217,3571,2394,3692,4087,2366,3356,1849,6155,4291,3168,6088,2310,6217,3805,3516,3641,6217,4414,4605,3556,3690,3312,3468,3395,3337,6216,6217,3337,3337,6217,3159,3506,3462,4641,5097,5097,3638,3337,5098,3116
J3301,"Injection, triamcinolone acetonide, not otherwise specified, 10 mg",122,109,10,127,115,62,111,115,61,62,115,69,10,69,76,44,127,34,99,80,60,113,43,115,71,65,68,115,82,86,65,69,63,64,63,62,115,115,62,62,115,59,60,64,95,95,95,64,62,95,58
J3360,"Injection, diazepam, up to 5 mg",115,103,6,216,109,63,104,109,51,59,109,53,6,65,72,12,59,32,108,75,55,107,41,109,67,62,64,109,77,81,45,65,216,61,60,59,109,109,59,59,109,55,61,61,81,89,89,158,59,89,55
J3370,"Injection, vancomycin HCl, 500 mg",124,111,35,123,117,61,112,117,62,63,117,54,45,70,77,45,63,35,116,81,60,115,44,117,72,66,69,117,83,87,123,70,47,66,64,63,117,117,63,63,117,60,77,65,88,96,96,106,63,96,59
J3380,"Injection, vedolizumab",15005,13505,4240,14255,14255,8218,13651,14255,7509,7653,14255,8188,5489,8466,9373,5424,7695,4240,14115,9841,7265,13961,5298,14255,8725,8062,8350,14255,10121,10560,8153,8462,7560,7953,7785,7653,14255,14255,7653,7653,14255,7244,7978,7939,10642,11689,11689,9213,7653,11689,7144
J3410,"Injection, hydroxyzine HCl, up to 25 mg",132,119,8,125,125,72,120,125,66,67,125,74,8,74,82,48,68,37,124,86,64,123,47,125,77,71,73,125,89,93,82,74,57,70,68,67,125,125,67,67,125,64,70,70,93,103,103,81,67,103,63
J3411,"Injection, thiamine HCl, 100 mg",107,97,4,102,102,59,98,102,54,55,102,44,4,61,67,6,55,30,102,70,52,100,38,102,62,58,60,102,72,76,33,61,60,57,56,55,102,102,55,55,102,52,57,60,76,84,84,84,55,84,51
J3420,"Injection, vitamin B-12 cyanocobalamin, up to 1000 mcg",102,91,2,96,96,52,92,96,52,52,96,55,2,57,63,37,52,29,95,67,49,94,36,96,59,55,56,96,68,71,55,57,51,54,53,52,96,96,52,52,96,49,49,54,72,79,79,62,52,79,48
J3430,"Injection, phytonadione (vitamin K), per 1 mg",132,119,37,126,126,53,121,126,66,68,126,72,48,75,83,48,68,37,125,87,64,123,47,126,77,71,74,126,89,93,99,75,66,70,69,68,126,126,68,68,126,64,88,59,94,103,103,81,68,103,63
J3475,"Injection, magnesium sulfate, per 500 mg",92,83,2,92,88,52,92,88,50,47,88,57,2,52,58,2,45,26,87,61,47,86,33,88,56,50,51,88,62,65,50,52,52,49,48,47,88,88,47,47,88,45,44,52,65,72,72,53,47,72,44
J3480,"Injection, potassium chloride, per 2 meq",60,54,2,57,57,31,55,57,31,31,57,35,2,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,31,32,31,31,57,57,31,31,57,29,34,50,43,47,47,50,31,47,29
J3486,"Injection, ziprasidone mesylate, 10 mg",192,173,49,206,182,105,174,182,96,98,182,74,49,108,120,69,98,54,180,126,93,178,68,182,111,103,107,182,129,135,206,108,80,102,99,98,182,182,98,98,182,93,102,101,136,149,149,118,98,149,91
J3489,HC ZOLEDRONIC ACID 1MG,256,231,40,354,243,140,233,243,153,131,243,140,40,145,160,40,131,72,241,168,124,238,90,243,149,138,143,243,173,180,139,145,354,136,133,131,243,243,131,131,243,124,344,136,182,200,200,157,131,200,122
J3490,Unclassified drugs,89,80,25,85,85,49,81,85,45,46,85,49,46,50,56,32,46,25,84,59,43,83,32,85,52,48,50,85,60,63,49,50,45,47,46,46,85,85,46,46,85,43,47,47,63,70,70,55,46,70,43
J7042,5% dextrose/normal saline (500 ml = 1 unit),60,54,2,65,57,33,55,57,30,31,57,65,2,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,34,32,31,31,57,57,31,31,57,29,32,30,43,47,47,37,31,47,29
J7120,"Ringers lactate infusion, up to 1000 cc",60,54,2,59,57,34,57,57,31,31,57,33,2,33,37,2,30,17,57,39,29,56,21,57,30,32,33,57,40,59,37,35,34,32,31,31,57,57,31,31,57,43,34,34,43,47,47,34,31,47,29
J7121,5% dextrose in lac ringers,60,54,6,65,57,33,55,57,30,31,57,65,6,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,37,34,32,32,31,31,57,57,31,31,57,29,32,32,43,47,47,37,31,47,29
J7201,Factor ix alprolix recomb,26808,24127,7574,25467,25467,14681,24388,25467,13416,13672,25467,14628,9806,15125,16745,9691,13747,7574,25217,17581,12980,24942,9465,25467,15588,14403,14917,25467,18082,18866,14567,16621,15012,14208,13908,13672,25467,25467,13672,13672,25467,12941,14253,14184,19013,20883,20882,16459,13672,20883,12763
J7298,HC LEVONORGESTREL IU 52MG MIRENA,1165,1048,329,1106,1106,638,1060,1106,583,594,1106,641,426,657,728,421,597,329,1096,764,564,1084,411,1106,677,626,648,1106,786,820,633,657,589,617,604,594,1106,1106,594,594,1106,562,619,616,826,907,907,715,594,907,555
J7510,"Prednisolone oral, per 5 mg",2,2,1,2,2,1,2,2,1,1,2,1,1,1,2,1,1,1,2,2,1,2,1,2,1,1,1,2,2,2,1,1,1,1,1,1,2,2,1,1,2,1,1,1,2,2,2,2,1,2,1
J7512,Prednisone ir or dr oral 1mg,2,1,0,1,1,1,1,1,1,1,1,1,0,1,1,0,1,0,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1,1
J8540,"Dexamethasone, oral, 0.25 mg",3,3,1,3,3,2,3,3,1,1,3,2,2,2,2,1,1,1,3,2,1,3,1,3,2,2,2,3,2,2,2,2,1,1,1,1,3,3,1,1,3,1,2,1,2,2,2,2,1,2,1
J9000,"Injection, doxorubicin hydrochloride, 10 mg",382,344,41,363,363,209,348,363,191,195,363,209,41,216,239,138,196,108,360,251,185,356,135,363,222,205,213,363,258,269,208,216,193,203,198,195,363,363,195,195,363,185,203,202,271,298,298,235,195,298,182
J9022,"Inj, atezolizumab,10 mg",19062,17156,5386,18109,18109,10440,17342,18109,9540,9722,18109,10402,6973,10755,11907,6891,9776,5386,17931,12501,9230,17736,6730,18109,11084,10242,10607,18109,12858,13416,10484,10750,10272,10103,9890,9722,18109,18109,9722,9722,18109,9202,10135,10086,13520,14849,14849,13881,9722,14850,9076
J9035,"Injection, bevacizumab, 10 mg",6710,6039,1896,6374,6374,3675,6104,6374,3358,3422,6374,3661,2454,3785,4191,2425,3441,1896,6311,4400,3249,6243,2369,6374,3901,3605,3734,6374,4526,4722,3646,3784,3422,3556,3481,3422,6374,6374,3422,3422,6374,3239,3567,3550,4759,5227,5227,4119,3422,5227,3195
J9041,"Injection, bortezomib, 0.1 mg",2613,2351,738,2482,2482,1431,2377,2482,1307,1332,2482,1426,1324,1474,1632,1324,1340,738,2458,1713,1265,2431,922,2482,1519,1404,1454,2482,1762,1839,1420,1473,1322,1385,1355,1332,2482,2482,1332,1332,2482,1261,1389,1382,1853,2035,2035,1604,1332,2035,1244
J9045,"Injection, carboplatin, 50 mg",448,403,27,442,426,245,408,426,224,229,426,245,36,253,280,27,230,127,422,294,217,417,158,426,261,241,249,426,302,315,140,253,213,238,233,229,426,426,229,229,426,216,238,237,318,349,349,442,229,349,213
J9060,"Injection, cisplatin, powder or solution, 10 mg",372,335,105,354,354,204,339,354,186,190,354,143,136,210,233,135,191,105,350,244,180,346,131,354,216,200,207,354,251,262,202,210,208,197,193,190,354,354,190,190,354,180,198,197,264,290,290,229,190,290,177
J9070,"Cyclophosphamide, 100 mg",941,847,193,894,894,515,856,894,471,480,894,513,193,531,588,340,482,266,885,617,456,875,332,894,547,505,524,894,635,662,511,531,475,499,488,480,894,894,480,480,894,454,500,498,667,733,733,578,480,733,448
J9100,"Injection, cytarabine, 100 mg",351,316,99,334,334,192,320,334,176,179,334,192,129,198,219,127,180,99,331,230,170,327,124,334,204,189,196,334,237,247,191,198,167,186,182,179,334,334,179,179,334,170,187,186,249,274,274,216,179,274,167
J9181,"Injection, etoposide, 10 mg",378,340,107,359,359,207,344,359,189,193,359,210,138,213,236,137,194,107,355,248,183,352,133,359,220,203,210,359,255,266,211,213,211,200,196,193,359,359,193,193,359,182,201,200,268,294,294,295,193,294,180
J9190,"Injection, fluorouracil, 500 mg",357,322,4,339,339,196,325,339,179,182,339,195,4,202,223,4,183,101,336,234,173,332,126,339,208,192,199,339,241,251,194,202,183,189,185,182,339,339,182,182,339,173,190,189,253,278,278,219,182,278,170
J9201,"Injection, gemcitabine hydrochloride, 200 mg",444,399,125,421,421,243,404,421,222,226,421,242,162,250,277,160,228,125,417,291,215,413,157,421,258,238,247,421,299,312,241,250,155,235,230,226,421,421,226,226,421,214,236,235,315,346,346,272,226,346,211
J9206,"Injection, irinotecan, 20 mg",501,451,39,476,476,275,456,476,251,256,476,234,39,283,313,39,257,142,472,329,243,467,177,476,292,269,279,476,338,353,272,283,256,266,260,256,476,476,256,256,476,242,267,265,356,391,391,308,256,391,239
J9217,"Leuprolide acetate (for depot suspension), 7.5 mg",14800,13320,719,14060,14060,1492,13465,14060,1492,7548,14060,8076,719,8350,9245,5350,7590,4182,13922,9706,7166,13771,5226,14060,8606,7952,8236,14060,9983,10416,10044,8346,7784,7844,7678,7548,14060,14060,7548,7548,14060,7145,12508,7831,10497,11529,11529,1462,7548,11529,7047
J9263,"Injection, oxaliplatin, 0.5 mg",671,604,190,638,638,368,611,638,336,342,638,366,245,379,419,243,344,190,631,440,325,624,237,638,390,361,373,638,453,472,365,378,376,356,348,342,638,638,342,342,638,324,357,355,476,523,523,412,342,523,320
J9267,HC PACLITAXEL INJECTION 1 MG,481,433,24,457,457,264,438,457,241,245,457,263,24,272,301,43,247,136,453,316,233,448,170,457,280,259,268,457,325,339,262,271,209,255,250,245,457,457,245,245,457,232,256,255,341,375,375,296,245,375,229
J9271,HC INJ PEMBROLIZUMAB 1 MG,19861,17875,5612,18868,18868,10877,18068,18868,10328,10129,18868,10271,7265,11205,12406,7179,10185,5612,18682,13025,9616,18479,7012,18868,11548,10670,11051,18868,13396,13977,10792,11200,9742,10526,9551,10129,18867,18868,10129,10129,18868,9588,16018,10509,14086,15471,15471,10908,10129,15471,9456
J9280,"Mitomycin, 5 mg",2752,2476,777,2614,2614,1507,2503,2614,1377,1403,2614,1501,1006,1552,1719,995,1411,777,2588,1805,1332,2560,972,2614,1600,1478,1531,2614,1856,1936,1495,1552,1541,1458,1428,1403,2614,2614,1403,1403,2614,1328,1463,1456,1952,2143,2143,1689,1403,2143,1310
J9303,"Injection, panitumumab, 10 mg",12759,11483,3605,12121,12121,6988,11608,12121,6385,6507,12121,6890,4667,7199,7970,4612,6543,3605,12002,8368,6178,11871,4505,12121,7419,6855,7100,12121,8606,8980,6933,7195,5524,6762,6619,6507,12121,12121,6507,6507,12121,6160,6784,6751,9049,9939,9939,7834,6507,9939,6075
J9305,"Injection, pemetrexed, 10 mg",5889,5300,1664,5595,5595,3225,5358,5595,2947,3003,5595,3214,2154,3323,3679,2129,3020,1664,5540,3862,2851,5479,2079,5595,3424,3164,3277,5595,3972,4145,3200,3321,2870,3121,3055,3003,5595,5595,3003,3003,5595,2843,3131,3116,4177,4588,4587,3616,3003,4588,2804
J9306,"HC INJECTION, PERTUZUMAB, 1 MG",15432,13889,4360,14661,14661,8452,14039,14661,7723,7870,14661,8421,5645,8707,9639,5579,7914,4360,14516,10121,7472,14358,5449,14661,8973,8291,8587,14661,10409,10861,8386,8702,7870,8179,8006,7870,14660,14661,7870,7870,14661,7450,8205,8165,10945,12022,12021,9475,7870,12022,7348
J9311,"Inj rituximab, hyaluronidase",13241,11917,3741,12579,12579,7251,12046,12579,6626,6753,12579,7225,4843,7470,8271,4786,6790,3741,12455,8683,6411,12319,4675,12579,7699,7114,7368,12579,8931,9318,7195,7467,4614,7018,6869,6753,12579,12579,6753,6753,12579,6392,7040,7006,9391,10314,10314,8129,6753,10314,6304
J9312,HC RITUXIMAB 10 MG INJ,6598,5938,1864,6268,6268,3613,6002,6268,3302,3365,6268,3600,2413,3722,4121,2385,3383,1864,6206,4327,3195,6139,2330,6268,3836,3545,3671,6268,4450,4643,3585,3721,3695,3497,3423,3365,6268,6268,3365,3365,6268,3185,3508,3491,4680,5140,5140,4051,3365,5140,3141
J9355,"Injection, trastuzumab, 10 mg",8246,7421,2330,7834,7834,4516,7502,7834,4127,4205,7834,4500,3016,4652,5151,2981,4229,2330,7757,5408,3993,7672,2911,7834,4795,4430,4588,7834,5562,5803,4481,4650,4205,4370,4278,4205,7834,7834,4205,4205,7834,3981,4384,4363,5848,6424,6423,5063,4205,6424,3926
J9370,"Vincristine sulfate, 1 mg",371,334,105,352,352,203,337,352,185,189,352,202,136,209,231,134,190,105,349,243,179,345,131,352,215,199,206,352,250,261,201,209,129,196,192,189,352,352,189,189,352,179,197,196,263,289,289,228,189,289,176
J9395,"Injection, Fulvestrant, 25 mg",2815,2534,795,2675,2675,1542,2561,2675,1936,1002,2675,1536,1030,1588,1759,1018,1444,795,2648,1846,1848,2619,994,2675,1637,1513,1567,2675,1899,1981,1530,1588,1100,1492,1461,1436,2675,2675,1436,1436,2675,1359,1497,1490,1997,2193,2193,1729,1436,2193,1340
J9999,"Not otherwise classified, antineoplastic drugs",2,1,0,2,2,1,1,2,1,1,2,1,1,1,1,1,1,0,2,1,1,1,1,2,1,1,1,2,1,1,1,1,1,1,1,1,2,2,1,1,2,1,1,1,1,1,1,1,1,1,1
L0140,HC CERVICAL PLASTIC COLLAR LVL 5,25,22,7,24,24,14,23,24,13,13,24,14,9,14,16,9,13,7,24,16,12,23,9,24,15,13,14,24,17,18,14,14,13,13,13,13,24,24,13,13,24,12,13,13,18,19,19,15,13,19,12
L8641,HC METATARSAL JOINT IMPLANT LVL 6,3788,3409,1070,3598,3598,2074,3446,3598,1896,1932,3598,2067,1386,2137,2366,1369,1943,1070,3563,2484,1834,3524,1337,3598,2203,2035,2108,3598,2555,2666,2058,2136,1917,2008,1965,1932,3598,3598,1932,1932,3598,1829,1932,2004,2687,2951,2951,2326,1932,2951,1803
M0220,,160,144,45,152,152,88,146,152,80,82,152,87,59,90,100,58,82,45,151,105,77,149,56,152,93,86,89,152,108,113,87,90,80,85,83,82,152,152,82,82,152,77,85,85,113,125,125,98,82,125,76
M0239,HC BAMLANIVIMAB-XXXX INFUSION,310,279,88,295,294,170,282,295,155,158,294,169,113,175,194,112,159,88,292,203,150,288,109,294,180,167,172,294,209,218,166,175,158,164,161,158,294,295,158,158,294,150,165,164,220,241,241,190,158,241,148
M0243,Casirivi and imdevi infusion,310,279,88,544,294,170,282,295,155,158,294,279,544,175,194,112,159,88,292,203,150,288,109,294,180,167,172,294,209,218,191,175,158,252,161,158,294,295,158,158,294,150,165,164,220,241,241,190,158,241,148
M0245,,450,405,127,570,428,246,409,428,225,230,428,279,518,254,281,570,231,127,423,295,218,419,159,428,262,242,250,428,304,317,278,254,252,252,233,230,427,428,230,229,428,217,329,238,319,351,351,276,230,351,214
M0246,,750,675,212,713,712,411,682,713,375,382,712,409,274,423,468,271,385,212,705,492,363,698,265,712,436,403,417,712,506,528,408,423,420,398,389,382,712,713,382,382,712,362,399,397,532,584,584,460,382,584,357
M0247,,450,405,127,518,428,246,409,428,225,230,428,246,518,254,281,163,231,127,423,295,218,419,159,428,262,242,250,428,304,317,245,254,228,238,233,230,427,428,230,229,428,217,239,252,319,351,351,252,230,351,214
P9016,"Red blood cells, leukocytes reduced, each unit",956,860,270,908,908,535,870,908,483,488,908,593,350,539,597,346,490,270,899,627,459,889,338,908,556,514,532,908,645,673,295,539,482,507,496,488,908,908,488,488,908,462,535,506,678,745,745,373,488,745,455
P9033,"Platelets, leukocytes reduced, irradiated, each unit",954,859,270,906,906,522,868,906,477,487,906,521,349,538,596,345,489,270,897,626,462,888,337,906,555,513,531,906,643,671,518,538,453,506,495,487,906,906,487,487,906,461,507,505,677,743,743,586,487,743,454
P9035,"Platelets, pheresis, leukocytes reduced, each unit",883,795,249,839,839,484,803,839,442,450,839,482,323,498,552,319,453,249,831,579,428,822,312,839,513,474,491,839,596,621,480,498,447,468,458,450,839,839,450,450,839,426,469,467,626,688,688,688,450,688,420
P9037,"Platelets, pheresis, leukocytes reduced, irradiated, each unit",954,859,270,906,906,522,868,906,477,487,906,521,349,538,596,345,489,270,897,626,462,888,337,906,555,513,531,906,643,671,518,538,534,506,495,487,906,906,487,487,906,461,507,505,677,743,743,743,487,743,454
P9040,"Red blood cells, leukocytes reduced, irradiated, each unit",1194,1075,337,1134,1134,654,1086,1134,598,609,1134,652,437,674,746,432,612,337,1123,783,578,1111,422,1134,694,641,664,1134,805,840,649,673,532,633,619,609,1134,1134,609,609,1134,576,635,632,847,930,930,930,609,930,568
P9047,"Infusion, albumin (human), 25%, 50 ml",456,410,129,433,433,249,414,433,228,232,433,249,167,257,285,165,234,129,428,299,221,424,161,433,265,245,253,433,307,321,248,257,244,241,236,232,433,433,232,232,433,220,242,255,323,355,355,280,232,355,217
P9059,"Fresh frozen plasma between 8-24 hours of collection, each unit",216,194,61,205,205,118,197,205,108,110,205,118,79,122,135,78,111,61,203,142,105,201,76,205,126,116,120,205,146,152,117,122,102,114,112,110,205,205,110,110,205,104,115,114,153,168,168,133,110,168,103
P9612,"Catheterization for collection of specimen, single patient, all places of service",52,47,15,49,49,28,47,49,27,27,49,28,19,29,32,19,27,15,49,34,25,48,18,49,30,28,29,49,35,37,28,29,25,28,27,27,49,49,27,27,49,25,26,28,37,41,41,32,27,41,25
Q0138,"Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-ESRD use)",2405,2165,474,2285,2285,1347,2188,2285,1204,1227,2285,1312,880,1357,1502,869,1233,474,2263,1577,1165,2238,849,2285,1399,1292,1338,2285,1622,1693,1323,1356,1212,1275,1248,1227,2285,2285,1227,1227,2285,1161,1279,1273,1706,1874,1874,1477,1227,1874,1145
Q0144,"Azithromycin dihydrate, oral, capsules/powder, 1 gram",4,4,1,4,4,2,4,4,2,2,4,2,1,2,2,1,2,1,4,3,2,4,1,4,2,2,2,4,3,3,2,2,2,2,2,2,4,4,2,2,4,2,2,2,3,3,3,2,2,3,2
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",2,1,0,2,2,1,1,2,1,1,2,1,1,1,1,1,1,0,2,1,1,1,1,2,1,1,1,2,1,1,1,1,1,1,1,1,2,2,1,1,2,1,1,1,1,1,1,1,1,1,1
Q4133,HC GRAFIX PRIME PL/STRAVIX PER 1 SQ CM LVL 3,6250,5625,1766,5938,5938,3423,5686,5938,3128,3188,5938,3410,2286,3526,3904,2259,3205,1766,5879,4099,3026,5815,2207,5938,3634,3358,3478,5938,4216,4399,3396,3524,2965,3312,3242,3188,5937,5938,3188,3187,5938,3017,3323,3307,4433,4869,4869,3837,3188,4869,2976
Q4159,HC AFFINITY PER SQ CM LVL 6,4500,4050,1271,4275,4275,2464,4094,4275,2252,2295,4275,2456,1646,2539,2811,1627,2308,1271,4233,2951,2179,4187,1589,4275,2617,2418,2504,4275,3035,3167,2445,2538,2520,2385,2335,2295,4275,4275,2295,2295,4275,2172,2393,2381,3192,3505,3505,2763,2295,3505,2143
Q4160,HC NUSHIELD PER SQ CM LVL 6,4920,4428,1334,4674,4674,2694,4476,4674,2462,2509,4674,2685,1800,2776,3073,1779,2523,1390,4628,3227,2382,4578,1737,4674,2861,2643,2738,4674,3319,3463,2673,2774,1334,2608,2552,2509,4674,4674,2509,2509,4674,2375,2755,2603,3490,3833,3833,2755,2509,3833,2342
Q4186,HC EPIFIX PER SQ CM LVL 6,1200,1080,339,1140,1140,657,1092,1140,601,612,1140,558,439,677,750,434,615,339,1129,787,581,1116,424,1140,698,645,668,1140,809,845,652,677,1008,636,623,612,1140,1140,612,612,1140,579,638,635,851,935,935,935,612,935,571
Q4187,HC EPICORD PER SQ CM LVL 6,4500,4050,1271,4275,4275,2464,4094,4275,2252,2295,4275,2456,1646,2539,2811,1627,2308,1271,4233,2951,2179,4187,1589,4275,2617,2418,2504,4275,3035,3167,2445,2538,2520,2385,2335,2295,4275,4275,2295,2295,4275,2172,2393,2381,3192,3505,3505,2763,2295,3505,2143
Q4195,HC PURAPLY PER SQ CM LVL 11,3000,2700,848,2850,2850,1643,2729,2850,1501,1530,2850,1637,1097,1693,1874,1084,1538,848,2822,1967,1453,2791,1059,2850,1744,1612,1669,2850,2024,2111,1630,1692,1247,1590,1556,1530,2850,2850,1530,1530,2850,1448,1595,1587,2128,2337,2337,1842,1530,2337,1428
Q4196,HC PURAPLY AM PER SQ CM LVL 11,2303,2073,336,15970,2188,1261,2095,2188,1153,1175,2188,15970,842,1299,1439,833,1181,651,2166,1510,1115,2143,813,2188,1339,1237,1282,2188,1553,1621,1251,1299,1290,1221,1195,1175,2188,2188,1175,1175,2188,1112,1224,336,1633,1794,1794,1414,1175,1794,1097
Q5101,"Injection, zarxio",966,869,273,917,917,305,878,917,305,492,917,527,353,545,603,349,495,273,908,633,305,898,341,917,561,519,537,917,651,679,599,544,489,512,501,492,917,917,492,492,917,466,513,511,685,752,752,752,492,752,460
Q5104,"Injection, renflexis",9475,8527,2677,9001,9001,5189,8620,9001,4742,4832,9001,5170,3466,5346,5918,3425,4859,2677,8912,6214,4588,8815,3345,9001,5509,5090,5272,9001,6391,6668,5085,5343,4795,5022,4915,4832,9001,9001,4832,4832,9001,4574,5037,5013,6720,7381,7381,5817,4832,7381,4511
Q5106,Inj retacrit non-esrd use,529,476,149,502,502,290,481,502,265,270,502,288,193,298,330,191,271,149,497,347,256,492,187,502,307,284,294,502,357,372,287,298,157,280,274,270,502,502,270,270,502,255,296,280,375,412,412,296,270,412,252
Q5115,Inj truxima 10 mg,6310,5679,1783,5995,5995,3456,5741,5995,3158,3218,5995,3443,2308,3560,3942,2281,3236,1783,5936,4138,3055,5871,2228,5995,3669,3390,3511,5995,4256,4441,3429,3558,2647,3344,3274,3218,5995,5995,3218,3218,5995,3046,3355,3339,4476,4916,4916,3874,3218,4916,3004
Q5118,"Inj., zirabev, 10 mg",3683,3315,1041,3499,3499,2017,3351,3499,1843,1878,3499,2010,1330,2078,2301,1330,1889,1041,3465,2416,1783,3427,1300,3499,2142,1979,2050,3499,2484,2592,2001,2077,1864,1952,1911,1878,3499,3499,1878,1878,3499,1778,1958,1949,2612,2869,2869,2261,1878,2869,1754
Q5119,"Inj ruxience, 10 mg",13969,12572,3947,13271,13271,7650,12708,13271,6991,7124,13271,7623,5110,7881,8726,5050,7164,3947,13140,9161,6764,12997,4932,13271,8123,7505,7773,13271,9422,9831,7591,7877,7823,7404,7247,7124,13271,13271,7124,7124,13271,6744,7427,7391,9908,10882,10882,8577,7124,10882,6651
Q5120,Inj pegfilgrastim-bmez 0.5mg,7939,7145,2243,7542,7542,4348,7222,7542,3973,4049,7542,4332,2904,4479,4959,2870,4071,2243,7467,5206,3844,7386,2803,7542,4616,4265,4417,7542,5355,5587,4366,4477,4018,4207,4119,4049,7542,7542,4049,4049,7542,3832,4221,4200,5630,6184,6184,4874,4049,6184,3780
Q9958,"High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml",40,36,11,38,38,22,36,38,20,20,38,22,15,23,25,14,20,11,38,26,19,37,14,38,23,21,22,38,27,28,22,23,20,21,21,20,38,38,20,20,38,19,21,21,28,31,31,20,20,31,19
Q9967,"Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml",264,237,70,251,251,134,132,251,133,134,251,145,96,146,165,95,146,75,248,173,126,245,93,251,160,142,145,251,178,186,142,142,145,140,137,134,251,251,134,134,251,127,132,132,202,205,205,148,134,205,70
R0300,,28,25,8,27,27,15,25,27,14,14,27,15,10,16,17,10,14,8,26,18,14,26,10,27,16,15,16,27,19,20,15,16,14,15,15,14,27,27,14,14,27,14,15,15,20,22,22,17,14,22,13
R0301,,100,90,28,95,95,55,91,95,50,51,95,55,37,56,62,36,51,28,94,66,48,93,35,95,58,54,56,95,67,70,54,56,51,53,52,51,95,95,51,51,95,48,53,53,71,78,78,61,51,78,48
R0305,,78,70,22,74,74,43,71,74,39,40,74,43,29,44,49,28,40,22,73,51,38,73,28,74,45,42,43,74,53,55,42,44,39,41,40,40,74,74,40,40,74,38,41,41,55,61,61,48,40,61,37
R0306,,117,105,33,111,111,64,106,111,59,60,111,64,43,66,73,42,60,33,110,77,57,109,41,111,68,63,65,111,79,82,64,66,59,62,61,60,111,111,60,60,111,56,62,62,83,91,91,72,60,91,56
S0028,"Injection, famotidine, 20 mg",89,80,1,85,85,49,81,85,45,45,85,49,1,50,56,1,46,25,84,58,43,83,31,85,52,48,50,85,60,63,48,50,45,47,46,45,85,85,45,45,85,43,47,47,63,69,69,55,45,69,42
S0030,"Injection, metronidazole, 500 mg",90,81,1,85,85,49,81,85,45,46,85,49,1,50,56,1,46,25,84,59,43,83,32,85,52,48,50,85,60,63,49,50,45,47,46,46,85,85,46,46,85,43,48,47,63,70,70,55,46,70,43
S0077,"Injection, clindamycin phosphate, 300 mg",102,92,2,97,97,56,93,97,51,52,97,56,2,58,64,37,53,29,96,67,50,95,36,97,60,55,57,97,69,72,56,58,52,54,53,52,97,97,52,52,97,49,54,54,73,80,80,63,52,80,49
S0171,"Injection, Bumetanide, 0.5 mg",89,80,1,84,84,49,81,84,44,45,84,48,1,50,55,32,46,25,84,58,43,83,31,84,52,48,49,84,60,63,48,50,45,47,46,45,84,84,45,45,84,43,47,47,63,69,69,55,45,69,42
S4991,"Nicotine patches, non-legend",3,3,1,3,3,2,3,3,2,2,3,2,1,2,2,1,2,1,3,2,2,3,1,3,2,2,2,3,2,2,2,2,2,2,2,2,3,3,2,2,3,2,2,2,2,2,2,2,2,2,1
S5010,"5% dextrose and 0.45% normal saline, 1000 ml",60,54,2,57,57,33,55,57,30,31,57,33,2,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,30,32,31,31,57,57,31,31,57,29,32,32,43,47,47,37,31,47,29
S5550,"Insulin, rapid onset, 5 units",6,5,0,6,6,3,5,6,3,3,6,3,0,3,4,2,3,2,6,4,3,6,2,6,3,3,3,6,4,4,3,3,3,3,3,3,6,6,3,3,6,3,3,3,4,5,5,4,3,5,3
S5551,"Insulin, most rapid onset (Lispro or Aspart); 5 units",300,270,41,285,285,164,273,285,150,153,285,164,41,169,187,108,154,85,282,197,145,279,106,285,174,161,167,285,202,211,163,169,152,159,155,153,285,285,153,153,285,145,159,159,213,233,233,184,153,233,143
S8037,Magnetic resonance cholangiopancreatography (MRCP),2300,2070,650,2185,2185,1260,2092,2185,1151,1173,2185,1255,739,1298,1437,831,1179,650,2164,1508,1114,2140,812,2185,1337,1236,1280,2185,1551,1619,1250,1297,1164,1219,1193,1173,2185,2185,1173,1173,2185,1110,1223,1217,1631,1792,1792,1412,1173,1792,1095
S9470,"Nutritional counseling, dietitian visit",60,54,17,128,57,33,55,57,30,31,57,33,128,34,37,22,31,17,56,39,29,56,21,57,35,32,33,57,40,42,33,34,30,32,31,31,57,57,31,31,57,29,32,32,43,47,47,37,31,47,29
S9472,"Cardiac rehabilitation program, non-physician provider, per diem",195,176,55,185,185,107,177,185,98,99,185,105,71,110,122,70,100,55,183,128,94,181,69,185,113,105,109,185,132,137,105,110,99,103,101,99,185,185,99,99,185,94,104,103,138,152,152,120,99,152,93
S9473,"Pulmonary rehabilitation program, non-physician provider, per diem",195,176,55,185,185,107,177,185,98,99,185,106,71,110,122,70,100,55,183,128,94,181,69,185,113,105,109,185,132,137,121,110,99,103,101,99,185,185,99,99,185,94,104,103,138,152,152,120,99,152,93
U0003,HC SARS-COV-2 COVID-19 AMP PRB HIGH THROUGHPUT TECH,100,90,28,95,95,76,95,95,50,51,95,54,81,56,62,75,50,28,95,66,48,93,35,95,75,54,75,95,51,37,54,54,56,53,52,51,95,95,51,51,95,50,50,56,78,78,78,78,51,78,48
V2632,Posterior chamber intraocular lens,479,431,135,2398,455,268,455,455,244,244,455,280,175,270,299,229,246,135,451,2398,230,446,169,455,266,257,267,455,323,337,257,270,241,254,249,244,455,455,244,244,455,230,244,244,373,373,373,268,244,373,228
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
DRG,Description,Charges,Discounted Cash Price,Min Negotiated,Max Negotiated,Admin concepts,Aetna,Aetna - coventry,Aetna insurance,Aetna medicare,Aetna medicare supplemental ins.,Alliance cigna,Amerigroup ia medicaid,Blue cross,Blue cross medicare blue ppo,Blue cross of illinois,Blue cross out of state,Champus,Champva,Cigna,Commercial,Coventry advantra,Coventry health care,Employee benefits systems,Golden rule uhc,Health partners,Health partners uph medicare adv h3416,Health partners uph self funded,Healthlink,Humana,Humana choice,Iowa total care,Medicaid,Medicare,Medicare alternate payor,Medicare community plan uhc,Medico,Meritain,Midlands choice,Mutual of omaha,National assoc ltr carr,Phcs nippon life benefits,Securehorizons direct,Uhc medicare solutions hmo,Uhc medicare solutions ppo,Uhc river valley,Uhc the alliance insurance,Uhcrv community plan iowa medicaid 87726,United healthcare,United healthcare aarp ins.,United medical resources,Va
Inpatients,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
177,DRG RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC),16303,14673,4606,15488,15488,8929,14832,15488,8159,8315,15488,8896,5964,9198,10184,5894,8361,4606,15336,10692,7894,15169,5756,15488,9480,8759,9072,15488,10997,11474,8859,9194,8251,8641,8458,8315,15488,15488,8315,8315,15488,7870,8668,8626,11563,12700,12700,12700,8315,12700,7762
179,DRG RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC),425,383,120,404,404,233,387,404,213,217,404,232,156,240,266,154,218,120,400,279,206,396,150,404,247,228,237,404,287,299,231,240,215,225,221,217,404,404,217,217,404,205,226,225,302,331,331,331,217,331,202
189,"DRG PULMONARY EDEMA AND RESPIRATORY FAILURE - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",9254,8328,1969,16268,8791,5068,8418,8791,4631,4719,8791,16268,3385,5221,5780,3345,4745,2615,8704,6069,4480,8610,3267,8791,5381,4972,5149,8791,6242,1969,5028,5218,4683,4904,4801,4719,8791,8791,4719,4719,8791,4467,4920,4896,6563,7208,7208,5681,4719,7208,4406
190,"DRG CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",20978,18880,5927,19929,19929,11488,19084,19929,10498,10699,19929,14859,7673,11835,13103,7583,10758,5927,19733,13757,10157,19518,7407,19929,12198,11270,11673,19929,14150,14763,11399,11830,10617,11118,10883,10699,19928,19929,10699,10698,19929,10127,11153,11099,14878,16341,16341,12880,10699,16341,9988
191,"DRG CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",2126,1913,601,2562,2020,2562,1934,2020,1064,1084,2020,1160,778,1199,1328,769,1090,601,2000,1394,1029,1978,751,2020,1236,1142,1183,2020,1434,1496,1155,1199,1076,1127,1103,1084,2020,2020,1084,1084,2020,1026,1130,1125,1508,1656,1656,1305,1084,1656,1012
193,"DRG SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",17017,15315,4808,21602,16166,9319,15481,16166,8516,8679,16166,9286,6225,9601,10629,6151,8727,4808,16007,11160,8239,15833,6008,16166,9895,9142,9469,16166,11478,21602,9247,9596,8613,9019,8828,8679,16166,16166,8679,8679,16166,8215,9047,9004,12069,13256,13256,10448,8679,13256,8102
194,"DRG SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",10985,9887,3104,10436,10436,6016,9994,10436,10248,5602,10436,5924,4018,6198,6862,3971,5633,3104,10333,7204,5319,10221,3879,10436,6388,5902,6113,10436,7410,7731,5969,6195,5560,5822,5699,5602,10436,10436,5602,5602,10436,5303,5840,5812,7791,8557,8557,6745,5602,8557,5230
292,"DRG HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",5167,4650,1460,6172,4909,2830,4701,4909,2586,2635,4909,2819,1890,2915,3227,1868,2650,1460,4860,3389,2502,4807,1824,4909,3004,2776,2875,4909,3485,6172,2808,2914,2615,2738,2681,2635,4908,4909,2635,2635,4909,2494,2747,2734,3665,4025,4025,3172,2635,4025,2460
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",18008,16208,5088,17108,17108,9862,16383,17108,9012,9184,17108,9827,6587,10160,11249,6510,9235,5088,16940,11810,8719,16755,6358,17108,10471,9675,10021,17108,12147,12674,9785,10155,9115,9545,9343,9184,17108,17108,9184,9184,17108,8694,9575,9529,12773,14028,14028,14029,9184,14029,8574
316,DRG OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC),11769,10592,3325,11180,11180,6445,10706,11180,5890,6002,11180,7722,4305,6640,7351,4254,6035,3325,11070,7718,5698,10950,4155,11180,6843,6323,6549,11180,7938,8282,6395,6636,5956,6237,6106,6002,11180,11180,6002,6002,11180,5681,6257,6227,8347,9168,9167,7226,6002,9168,5603
388,DRG G.I. OBSTRUCTION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC),3574,3217,1010,3395,3395,1957,3252,3395,1789,1823,3395,2803,1307,2016,2233,1292,1833,1010,3362,2344,1731,3325,1262,3395,2078,1920,1989,3395,2411,2515,1942,2016,1809,1894,1854,1823,3395,3395,1823,1823,3395,1725,1900,1891,2535,2784,2784,2194,1823,2784,1702
438,DRG DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC),7735,6962,2186,7735,7349,4236,7037,7349,3871,3945,7349,7735,2830,4364,4832,2796,3967,2186,7276,5073,3745,7197,2731,7349,4498,4156,4304,7349,5218,5444,4203,4362,3915,4100,4013,3945,7349,7349,3945,3945,7349,3734,4113,4093,5486,6026,6026,4749,3945,6026,3683
536,"DRG FRACTURES OF HIP AND PELVIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",9492,8543,2682,10248,9018,5198,8636,9018,10248,4841,9018,5180,3472,5355,5929,3431,4868,2682,8929,6225,4596,8832,3351,9018,5519,5100,5282,9018,6403,6680,5158,5353,4804,5031,4925,4841,9018,9018,4841,4841,9018,4582,5047,5022,6732,7394,7394,5828,4841,7394,4519
540,DRG OSTEOMYELITIS WITH COMPLICATION OR COMORBIDITY (CC),16066,14460,4539,15263,15263,8799,14616,15263,8041,8194,15263,8767,5877,9064,10036,5808,8239,4539,15113,10537,7779,14948,5673,15263,9342,8632,8940,15263,10837,11307,8730,9060,8132,8515,8335,8194,15263,15263,8194,8194,15263,7756,8542,8501,11395,12515,12515,12516,8194,12516,7649
570,DRG SKIN DEBRIDEMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC),15592,14033,4405,15592,14812,8539,14185,14812,7803,7952,14812,15592,5703,8797,9739,5636,7996,4405,14667,10225,7549,14507,5505,14812,9066,8377,8676,14812,10517,10973,8472,8792,7891,8264,8089,7952,14812,14812,7952,7952,14812,7527,8290,8250,11059,12146,12146,9573,7952,12146,7423
641,"DRG MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",7203,6482,2035,7203,6842,3945,6553,6842,3605,3673,6842,7203,2635,4064,4499,2604,3694,2035,6775,4724,3487,6701,2543,6842,4188,3870,4008,6842,4858,5069,3914,4062,3645,3817,3737,3673,6842,6842,3673,3673,6842,3477,3829,3811,5108,5611,5611,4422,3673,5611,3429
690,DRG KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC),16840,15156,4758,15998,15998,9223,15321,15998,10248,8589,15998,9189,6160,9501,10519,6088,8636,4758,15841,11044,8154,15669,5946,15998,9792,9048,9371,15998,11359,11852,9151,9497,8523,8925,8737,8589,15998,15998,8589,8589,15998,8130,8954,8911,11944,13118,13118,10340,8589,13119,8018
699,DRG OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC),8581,7723,2425,8581,8152,4699,7806,8152,4294,4376,8152,8581,3139,4841,5360,3102,4400,2425,8072,5627,4155,7984,3030,8152,4990,4610,4775,8152,5788,6039,4663,4839,4343,4548,4452,4376,8152,8152,4376,4376,8152,4142,4562,4540,6086,6684,6684,5268,4376,6684,4085
795,DRG NORMAL NEWBORN,5144,4630,1454,4887,4887,2817,4680,4887,2575,2624,4887,3944,1882,2902,3213,1860,2638,1454,4839,3374,2491,4786,1816,4887,2991,2764,2863,4887,3470,3620,2795,2901,2604,2727,2669,2624,4887,4887,2624,2624,4887,2483,2735,2722,3649,4007,4007,3158,2624,4007,2449
811,"DRG RED BLOOD CELL DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",14420,12978,4074,14420,13699,7897,13119,13699,7217,7354,13699,14420,5275,8136,9007,5213,7395,4074,13564,9457,6982,13417,5091,13699,8385,7747,8024,13699,9727,10149,7836,8132,7298,7643,7481,7354,13699,13699,7354,7354,13699,6961,7667,7630,10228,11233,11233,8854,7354,11233,6866
854,DRG INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH COMPLICATION OR COMORBIDITY (CC),37578,33820,10618,37374,35699,20580,34187,35699,18806,19165,35699,37374,13746,21201,23473,13584,19271,10618,35348,24644,18195,34963,13268,35699,21851,20189,20910,35699,25347,26446,20419,21191,19019,19916,19495,19165,35699,35699,19165,19165,35699,18141,19979,19883,26652,29273,29272,23072,19165,29273,17891
864,DRG FEVER,8045,7240,2273,8045,7643,4406,7319,7643,4026,4103,7643,8045,2943,4539,5025,2908,4126,2273,7567,5276,3895,7485,2840,7643,4678,4322,4477,7643,5426,5662,4371,4537,4072,4264,4174,4103,7643,7643,4103,4103,7643,3884,4277,4257,5706,6267,6267,4939,4103,6267,3830
866,DRG VIRAL ILLNESS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC),3228,2906,912,3067,3067,1768,2937,3067,1616,1646,3067,1762,1181,1821,2017,1167,1656,912,3037,2117,1563,3004,1140,3067,1877,1734,1796,3067,2178,2272,1754,1821,1634,1711,1675,1646,3067,3067,1646,1646,3067,1559,1716,1708,2290,2515,2515,2515,1646,2515,1537
871,"DRG SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",21262,19136,6007,20268,20199,11644,19343,20199,10641,10844,20199,20268,7777,11996,13281,7686,10904,6007,20000,13944,10295,19782,7507,20199,12363,11423,11831,20199,14342,14963,11553,11990,10761,11269,11031,10844,20199,20199,10844,10844,20199,10264,11304,11250,15080,16563,16562,13054,10844,16563,10123
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",10481,9433,2562,11804,9957,5740,9535,9957,2562,5345,9957,11804,3834,5913,6547,3789,5375,2961,9859,6873,5075,9751,3700,9957,6094,5631,5832,9957,7069,6172,5695,5910,5305,5555,5437,5345,9957,9957,5345,5345,9957,5060,5572,5546,7433,8164,8164,6435,5345,8164,4990
897,"DRG ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC)",17902,16112,5058,17007,17007,9804,16286,17007,8959,9130,17007,16352,6548,10100,11182,6471,9181,5058,16840,11740,8668,16656,6321,17007,10410,9618,9962,17007,12075,12599,9728,10095,9061,9488,9288,9130,17007,17007,9130,9130,17007,8642,9518,9472,12697,13946,13945,10991,9130,13946,8523
951,"DRG OTHER FACTORS INFLUENCING HEALTH STATUS - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS",31910,28719,9016,81716,30315,17476,29030,30315,15970,16274,30315,17413,11673,18004,19932,11535,16364,9016,30017,20927,15451,29690,11267,30315,18555,17144,17756,30315,81716,22457,17339,17995,16151,16913,16555,16274,30315,30315,16274,16274,30315,15405,16966,16884,22633,24858,24857,19592,16274,24858,15193
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CPT,Description,Charges,Discounted Cash Price,Min Negotiated,Max Negotiated,Admin concepts,Aetna,Aetna - coventry,Aetna medicare,Amerigroup ia medicaid,Auxiant,Blue cross,Blue cross medicare blue ppo,Blue cross out of state,Champus,Champva,Cigna,Cigna allegiance 81040,Commercial,Coventry advantra,Coventry health care,Golden rule uhc,Health partners,Health partners uph self funded,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,United medical resources,Va,,,,,,,,,,,,,,
Professionals,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Outpatients,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
120,"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified",1069,962,149,1016,386,472,507,432,318,636,644,557,637,373,304,731,551,556,442,513,1016,661,688,360,390,264,220,596,525,605,342,321,354,276,149,253,239,,,,,,,,,,,,,,
142,Anesthesia for procedures on eye; lens surgery,756,680,82,718,273,334,359,306,225,449,348,394,231,264,215,517,390,393,110,363,718,468,486,254,430,82,156,422,371,444,103,109,112,195,106,179,169,,,,,,,,,,,,,,
164,"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue",1172,1055,147,1113,423,517,556,474,349,697,706,611,699,409,334,802,604,609,484,563,1113,725,754,394,427,289,241,654,576,664,375,351,147,302,389,278,263,,,,,,,,,,,,,,
170,"Anesthesia for intraoral procedures, including biopsy; not otherwise specified",1245,1120,257,1183,450,550,591,504,371,740,464,649,742,435,355,852,642,647,514,598,1183,770,801,419,454,307,257,695,612,705,398,373,412,321,413,295,279,,,,,,,,,,,,,,
300,"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified",1237,1113,155,1175,447,546,587,500,368,735,746,645,738,432,352,846,638,643,511,594,1175,765,796,416,451,305,255,690,608,701,396,160,164,319,155,293,277,,,,,,,,,,,,,,
400,"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified",1035,932,96,983,374,457,491,419,308,615,96,539,617,361,295,708,534,538,427,497,983,640,666,348,377,99,213,577,509,586,331,124,343,267,343,245,232,,,,,,,,,,,,,,
731,PR ANES UPR GI NDSC PX NOS,877,789,100,1031,317,387,416,355,261,521,529,457,523,306,143,600,452,456,362,421,833,543,564,295,320,100,181,489,1031,497,280,136,133,226,139,208,196,,,,,,,,,,,,,,
750,Anesthesia for hernia repairs in upper abdomen; not otherwise specified,1300,1170,268,1235,469,574,617,526,387,773,784,677,522,454,370,889,670,676,537,624,1235,804,836,437,474,321,268,725,639,736,416,390,430,335,431,308,291,,,,,,,,,,,,,,
790,Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified,1767,1590,174,1679,638,780,839,715,526,1051,251,921,1054,617,503,1209,911,919,730,848,1679,1093,1137,594,644,174,364,986,868,1001,565,210,286,456,522,419,396,,,,,,,,,,,,,,
800,Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified,2068,1861,179,1965,747,913,982,836,615,1229,1246,1078,1233,722,589,1415,1066,1075,854,993,1965,1280,1330,696,754,179,426,1154,1016,1171,661,620,684,533,686,490,463,,,,,,,,,,,,,,
811,PR ANES LWR INTST NDSC NOS,908,817,91,863,328,401,431,367,270,540,547,473,541,317,259,621,468,472,124,436,863,562,584,305,331,91,187,507,446,514,290,120,136,234,124,215,203,,,,,,,,,,,,,,
812,PR ANES LWR INTST SCR COLSC,779,701,78,862,281,344,432,315,232,463,94,406,434,272,222,533,402,624,322,374,740,482,501,262,284,78,161,435,862,444,249,114,132,201,117,185,175,,,,,,,,,,,,,,
813,PR ANES UPR LWR GI NDSC PX,1149,1034,119,1092,415,507,545,465,342,683,693,599,685,143,327,786,593,597,475,552,1092,711,739,387,419,119,125,641,565,651,367,153,170,296,159,272,257,,,,,,,,,,,,,,
830,Anesthesia for hernia repairs in lower abdomen; not otherwise specified,1820,1638,176,1729,657,804,864,736,542,1082,638,948,1085,636,518,1245,939,946,752,874,1729,1126,1171,612,663,176,375,1015,894,1031,582,202,602,469,400,431,408,,,,,,,,,,,,,,
832,Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias,2582,2324,294,2453,932,1140,1226,1044,768,1535,1556,1345,1540,902,735,1767,1332,1342,1066,1239,2453,1598,1661,869,941,637,532,1441,1269,1462,826,774,855,666,294,612,578,,,,,,,,,,,,,,
840,Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified,1846,1661,157,1754,667,815,876,747,549,1097,1113,962,1101,645,526,1263,952,960,276,886,1754,1142,1187,621,673,157,380,1030,1647,1684,590,290,611,476,613,437,414,,,,,,,,,,,,,,
872,"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath",2303,2073,260,2188,832,1017,1093,931,685,1369,1388,1200,1373,804,656,1576,1188,1197,951,1105,2188,1425,1481,775,839,568,475,1285,1132,1304,737,691,260,594,764,546,516,,,,,,,,,,,,,,
902,Anesthesia for; anorectal procedure,1109,998,137,1054,400,490,526,449,330,659,464,578,661,387,316,759,572,576,458,532,1054,686,713,373,404,274,229,619,545,628,355,149,153,286,137,263,248,,,,,,,,,,,,,,
910,Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified,819,737,87,778,296,362,389,331,244,487,494,427,488,286,233,560,422,426,338,393,778,507,527,275,298,202,169,457,402,464,262,87,271,211,111,194,183,,,,,,,,,,,,,,
912,Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s),1333,1200,134,1266,481,589,633,539,397,792,803,695,795,466,380,912,687,693,551,640,1266,825,857,448,486,148,275,744,655,755,426,400,441,344,134,316,299,,,,,,,,,,,,,,
914,Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate,2069,1862,228,1966,747,914,982,837,616,1230,1247,1078,1234,723,589,1416,1067,1076,855,993,1966,1280,1331,696,754,511,426,1154,1017,1172,662,620,685,533,228,490,463,,,,,,,,,,,,,,
916,Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding,2045,1840,218,1943,738,903,971,827,609,1216,1233,1066,1219,714,582,1399,1055,1063,845,982,1943,1265,1315,688,745,505,421,1141,1005,1158,654,613,677,527,218,485,458,,,,,,,,,,,,,,
952,"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography",1300,1170,268,1235,469,574,617,526,387,773,784,677,775,454,370,889,670,676,537,624,1235,804,836,437,474,321,268,725,639,736,416,390,430,335,431,308,291,,,,,,,,,,,,,,
1400,Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified,1172,1055,241,1113,423,517,556,474,349,697,706,611,699,409,334,802,604,609,484,563,1113,725,754,394,427,289,241,654,576,664,375,351,388,302,324,278,263,,,,,,,,,,,,,,
1462,"Anesthesia for all closed procedures on lower leg, ankle, and foot",619,557,69,588,224,273,294,250,184,368,373,323,369,216,176,424,319,322,256,297,588,383,398,208,226,69,128,345,304,351,198,186,205,160,205,147,139,,,,,,,,,,,,,,
1470,"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified",1139,1025,110,1082,411,503,336,461,339,677,687,594,679,398,324,779,587,592,470,547,1082,705,733,383,415,110,235,636,560,645,364,342,377,294,378,270,255,,,,,,,,,,,,,,
1480,"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified",1187,1068,97,1128,429,524,563,480,353,706,114,619,708,415,338,812,612,617,490,570,1128,735,764,399,433,162,97,662,583,672,380,136,104,306,249,281,266,,,,,,,,,,,,,,
1484,"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula",2260,2034,187,2147,816,998,1073,914,673,1344,1362,1178,1348,789,644,1546,1165,1175,933,1085,2147,1398,1454,760,824,187,466,1261,1110,1280,723,678,748,583,750,536,506,,,,,,,,,,,,,,
1730,Anesthesia for all closed procedures on humerus and elbow,515,464,106,489,186,227,244,208,153,306,310,268,307,180,147,285,266,268,213,247,489,319,331,173,188,127,106,287,253,292,165,154,170,133,171,122,115,,,,,,,,,,,,,,
1810,"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand",851,766,81,808,307,376,404,344,253,506,513,443,319,297,242,582,439,442,351,408,808,527,547,286,310,81,175,475,418,482,272,121,109,219,95,202,191,,,,,,,,,,,,,,
10060,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single",236,212,49,224,85,104,112,95,59,140,204,123,141,82,67,161,122,123,97,113,224,146,152,79,86,59,49,132,116,134,75,71,78,61,87,56,53,,,,,,,,,,,,,,
10061,"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",236,212,49,224,85,104,112,95,114,140,142,123,141,82,67,161,122,123,97,113,224,146,152,79,86,58,49,132,116,134,75,71,78,61,134,56,53,,,,,,,,,,,,,,
10081,Incision and drainage of pilonidal cyst; complicated,625,562,129,594,226,276,297,253,186,372,376,326,373,218,178,428,322,325,258,300,594,387,402,210,228,154,129,349,307,354,200,187,207,161,207,148,140,,,,,,,,,,,,,,
10120,"Incision and removal of foreign body, subcutaneous tissues; simple",91,82,19,86,33,40,43,37,55,54,55,47,54,32,26,62,47,47,38,44,86,56,59,31,33,22,19,51,45,52,29,27,30,23,30,22,20,,,,,,,,,,,,,,
10140,"Incision and drainage of hematoma, seroma or fluid collection",174,157,39,165,63,77,83,70,62,103,105,91,104,61,50,119,90,90,72,84,165,108,112,59,63,62,62,97,85,99,56,52,58,45,58,41,39,,,,,,,,,,,,,,
10160,"Puncture aspiration of abscess, hematoma, bulla, or cyst",300,270,55,285,108,132,142,121,55,178,181,156,179,105,85,205,155,156,124,144,285,186,193,101,109,74,62,167,147,170,96,90,99,77,100,71,67,,,,,,,,,,,,,,
11042,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",451,406,35,428,163,97,97,182,35,268,130,235,133,158,128,309,233,234,58,216,428,279,290,58,58,111,35,252,222,125,144,44,48,116,48,107,101,,,,,,,,,,,,,,
11043,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",484,436,108,460,175,245,230,196,108,288,334,252,329,169,138,331,250,252,200,232,460,299,311,163,148,119,108,270,238,324,155,126,160,125,161,115,108,,,,,,,,,,,,,,
11044,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less",1318,1186,214,1252,476,582,626,533,392,784,794,687,786,460,375,902,680,685,544,633,1252,816,848,214,215,325,272,735,648,746,422,395,436,340,437,312,295,,,,,,,,,,,,,,
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)",451,406,18,428,163,199,214,182,18,268,272,235,269,158,128,309,233,234,186,216,428,279,290,25,25,18,93,252,222,255,144,22,149,116,20,107,101,,,,,,,,,,,,,,
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)",451,406,37,428,163,199,214,182,37,268,97,235,119,158,128,309,233,234,186,216,428,279,290,152,53,111,93,252,222,116,144,135,149,116,150,107,101,,,,,,,,,,,,,,
11047,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)",3954,3559,276,3756,1428,1746,1877,1599,1177,2351,2383,2060,2358,1381,1126,2705,2039,2055,1633,1898,3756,2447,2543,1330,276,976,815,2206,1943,2239,1265,1186,1309,1019,1312,937,886,,,,,,,,,,,,,,
11055,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion",120,108,7,114,43,53,57,15,7,71,35,63,72,42,34,82,62,62,50,58,114,74,77,40,44,30,7,67,59,68,38,7,40,31,40,28,27,,,,,,,,,,,,,,
11056,"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions",145,130,16,138,52,64,69,59,43,86,39,76,86,51,41,99,75,75,60,70,138,90,93,49,53,36,30,81,71,82,46,16,48,37,48,34,32,,,,,,,,,,,,,,
11104,PR PUNCH BX SKIN SINGLE LESION,310,279,46,294,112,137,147,125,92,184,101,162,185,108,88,212,160,161,128,149,294,192,199,46,113,77,64,173,152,176,99,93,103,80,103,73,69,,,,,,,,,,,,,,
11402,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm",309,278,48,294,112,136,147,125,92,184,186,161,184,108,88,211,159,161,128,148,294,191,199,104,113,76,64,172,152,175,99,48,102,80,48,73,69,,,,,,,,,,,,,,
11403,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm",515,464,68,489,186,227,244,71,153,306,256,268,297,180,147,352,266,268,213,247,489,319,331,173,68,127,106,287,253,292,165,154,170,133,171,122,115,,,,,,,,,,,,,,
11404,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm",515,464,69,489,186,227,244,208,153,306,310,268,307,180,147,352,266,268,213,247,489,319,331,173,188,127,106,287,253,292,165,69,170,133,135,122,115,,,,,,,,,,,,,,
11406,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm",515,464,106,510,186,227,244,208,146,306,510,268,307,180,147,352,266,268,213,247,489,319,331,173,188,127,106,287,253,292,165,154,170,133,207,122,115,,,,,,,,,,,,,,
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",360,324,74,342,130,159,171,146,107,214,225,188,215,126,103,246,186,187,149,173,342,223,232,121,131,89,74,201,177,204,115,108,119,93,119,85,81,,,,,,,,,,,,,,
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",361,325,74,343,130,159,171,126,107,215,279,188,215,126,103,247,186,188,149,173,343,223,232,121,132,89,74,201,177,204,115,116,119,93,120,86,81,,,,,,,,,,,,,,
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",361,325,74,343,130,159,171,146,107,215,160,188,215,126,103,247,186,188,149,173,343,223,232,121,132,89,74,201,177,204,115,108,119,93,120,86,81,,,,,,,,,,,,,,
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",618,556,127,587,223,273,293,250,184,367,300,322,368,216,176,423,319,321,255,297,587,382,398,208,225,153,127,345,304,350,198,185,205,159,205,146,138,,,,,,,,,,,,,,
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",309,278,64,294,112,136,147,125,91,184,186,161,184,108,88,211,159,161,128,148,294,191,199,104,113,76,64,172,152,175,99,93,102,80,103,73,69,,,,,,,,,,,,,,
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",450,405,93,428,163,199,214,182,102,268,271,234,268,157,128,308,232,234,186,216,428,278,289,151,164,111,93,251,221,255,144,135,149,116,149,107,101,,,,,,,,,,,,,,
11604,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm",675,608,139,641,244,298,320,194,201,401,198,352,402,236,192,462,348,351,279,324,641,418,434,227,246,167,139,377,332,382,216,202,223,174,224,160,151,,,,,,,,,,,,,,
11606,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",1100,990,227,1045,397,307,522,445,327,654,633,573,656,384,313,753,567,572,454,528,1045,681,708,370,401,271,227,614,540,623,352,330,263,284,365,261,246,,,,,,,,,,,,,,
11623,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",618,556,127,587,223,273,293,250,184,367,434,322,368,216,176,423,319,321,255,297,587,382,398,208,225,153,127,345,304,350,198,185,205,159,205,146,138,,,,,,,,,,,,,,
11624,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm",618,556,127,587,223,375,293,250,184,367,372,322,368,216,176,423,319,321,255,297,587,382,398,208,225,153,127,345,304,350,198,185,205,159,205,146,138,,,,,,,,,,,,,,
11626,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",618,556,127,610,223,273,293,250,184,367,610,322,368,216,176,423,319,321,255,297,587,382,398,208,225,153,127,345,304,350,198,185,205,159,245,146,138,,,,,,,,,,,,,,
11642,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm",735,662,151,698,265,288,349,297,219,437,361,383,438,257,209,503,379,382,304,353,698,455,473,247,268,181,151,410,361,416,235,220,243,189,244,174,165,,,,,,,,,,,,,,
11643,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm",618,556,127,587,223,273,293,250,184,367,372,322,368,216,176,423,319,321,255,297,587,382,398,208,225,153,127,345,304,350,198,196,205,159,205,146,138,,,,,,,,,,,,,,
11644,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm",925,832,191,879,334,408,439,274,275,550,499,482,552,323,263,633,477,481,382,444,879,572,595,311,337,228,191,516,455,524,296,277,306,238,307,219,207,,,,,,,,,,,,,,
11646,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm",1300,1170,268,1235,469,574,617,526,387,773,797,677,775,454,370,889,670,676,537,624,1235,804,836,437,474,321,268,725,639,736,416,390,321,335,329,308,291,,,,,,,,,,,,,,
11719,"Trimming of nondystrophic nails, any number",81,73,4,77,29,36,38,33,24,48,49,42,48,28,23,55,42,42,33,39,77,50,52,27,30,20,17,45,40,46,26,4,27,21,27,19,18,,,,,,,,,,,,,,
11721,Debridement of nail(s) by any method(s); 6 or more,145,130,18,138,52,64,69,59,21,86,52,76,86,51,41,99,75,75,60,70,138,90,93,49,53,36,30,81,71,82,46,18,48,37,19,34,32,,,,,,,,,,,,,,
11730,"Avulsion of nail plate, partial or complete, simple; single",145,130,27,138,52,64,69,59,27,86,98,76,86,51,41,99,75,75,60,70,138,90,93,49,53,36,30,81,71,82,46,43,48,37,48,34,32,,,,,,,,,,,,,,
11771,Excision of pilonidal cyst or sinus; extensive,1092,983,225,1037,394,482,518,442,325,649,608,569,651,381,311,747,563,568,451,524,1037,676,702,367,398,269,225,609,537,618,349,407,361,282,362,259,245,,,,,,,,,,,,,,
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",107,96,22,102,39,35,60,43,54,94,85,56,87,37,30,73,55,56,42,51,102,66,69,42,40,26,22,60,53,61,34,38,35,28,37,25,24,,,,,,,,,,,,,,
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",168,151,38,160,61,74,80,68,55,100,111,88,105,59,48,115,87,87,69,81,160,104,108,57,61,41,64,94,83,95,54,51,56,43,66,40,38,,,,,,,,,,,,,,
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",213,192,44,202,77,94,101,86,63,127,148,111,136,74,61,146,110,111,88,102,202,132,137,72,78,53,44,119,105,121,68,64,70,55,71,50,48,,,,,,,,,,,,,,
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",252,227,52,239,91,111,120,102,105,150,152,131,150,88,72,172,130,131,104,121,239,156,162,85,92,62,52,141,124,143,81,76,83,65,84,60,56,,,,,,,,,,,,,,
12011,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",146,131,30,145,53,145,69,87,58,87,105,76,104,52,42,113,75,76,60,70,139,90,94,43,52,54,30,81,72,83,47,44,43,38,48,35,33,,,,,,,,,,,,,,
12013,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",213,192,44,202,77,94,101,86,56,127,110,111,111,74,61,146,110,111,88,102,202,132,137,72,78,53,44,119,105,121,68,48,70,55,49,50,48,,,,,,,,,,,,,,
12014,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm",342,308,63,325,124,151,162,138,102,203,206,178,204,119,97,234,176,178,141,164,325,212,220,115,125,84,70,191,168,194,109,63,113,88,113,81,77,,,,,,,,,,,,,,
12020,Treatment of superficial wound dehiscence; simple closure,630,567,108,598,228,278,299,255,108,375,380,328,376,220,179,431,325,327,260,302,598,390,405,212,230,108,130,352,310,357,201,189,209,162,209,149,141,,,,,,,,,,,,,,
12031,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less",618,556,87,587,223,273,293,250,87,367,272,322,368,216,176,423,319,321,255,297,587,382,398,208,138,153,127,345,304,350,198,185,205,159,205,146,138,,,,,,,,,,,,,,
12032,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm",618,556,92,617,223,92,293,616,100,367,340,322,368,216,176,423,319,321,255,297,587,382,398,208,225,153,127,345,304,350,198,159,617,159,205,146,138,,,,,,,,,,,,,,
12034,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm",268,241,55,255,97,141,127,108,80,159,162,140,160,94,76,183,138,139,111,129,255,166,172,90,98,66,55,150,132,152,86,80,89,69,89,64,60,,,,,,,,,,,,,,
12041,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less",304,274,63,320,110,134,144,123,81,181,320,158,181,106,87,208,157,158,126,146,289,188,196,102,111,75,63,170,149,172,97,91,101,78,101,72,68,,,,,,,,,,,,,,
12042,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm",206,185,42,196,74,91,98,83,61,122,124,107,123,72,59,141,106,107,85,99,196,127,133,69,185,51,42,115,101,117,66,62,150,53,68,49,46,,,,,,,,,,,,,,
12044,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm",204,184,42,194,74,90,97,83,116,121,123,106,122,71,58,140,105,106,84,98,194,126,131,69,74,50,42,114,100,116,65,61,68,53,68,48,46,,,,,,,,,,,,,,
12051,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",309,278,64,294,112,268,147,125,92,184,186,161,184,108,88,211,159,161,128,148,294,191,199,104,113,76,64,172,152,175,99,93,102,80,103,73,69,,,,,,,,,,,,,,
12052,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",204,184,42,194,74,90,97,83,61,121,123,106,122,71,58,140,105,106,84,98,194,126,131,69,74,50,42,114,100,116,65,86,68,53,68,48,46,,,,,,,,,,,,,,
12054,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm",405,364,83,403,146,179,192,164,121,241,402,211,241,141,115,277,209,211,167,194,385,251,261,136,148,100,83,226,199,229,130,121,403,104,134,96,91,,,,,,,,,,,,,,
13101,"Repair, complex, trunk; 2.6 cm to 7.5 cm",1000,900,152,950,361,442,475,404,152,595,541,521,596,349,285,684,516,520,413,480,950,619,643,336,364,247,206,558,491,566,320,300,331,258,332,237,224,,,,,,,,,,,,,,
13120,"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm",850,765,175,808,307,375,403,344,253,505,512,443,501,297,242,582,438,442,351,408,808,526,547,286,310,210,175,474,418,481,272,255,281,219,282,201,190,,,,,,,,,,,,,,
13121,"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm",860,774,168,817,311,380,408,348,168,511,455,448,513,300,245,588,444,447,355,413,817,532,553,289,313,212,177,480,423,487,275,258,285,222,285,204,193,,,,,,,,,,,,,,
13122,"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)",450,405,52,428,163,199,214,182,52,268,366,234,268,157,128,308,232,234,186,216,428,278,289,151,164,111,93,251,221,255,144,135,149,116,149,107,101,,,,,,,,,,,,,,
13131,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm",383,345,79,364,138,169,182,155,152,228,231,200,228,134,109,262,198,199,158,184,364,237,246,129,140,95,79,214,188,217,122,115,127,99,127,91,86,,,,,,,,,,,,,,
13132,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm",425,382,88,404,153,188,202,172,246,253,256,221,253,148,121,291,219,221,176,204,404,263,273,143,155,105,88,237,209,241,136,127,141,110,141,101,95,,,,,,,,,,,,,,
13151,"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm",940,846,194,893,339,415,446,380,280,559,567,490,561,328,268,643,485,489,388,451,893,582,605,316,343,232,194,524,462,532,301,282,311,242,236,223,211,,,,,,,,,,,,,,
15271,PR SKIN SUB GRAFT T/A/L 25 SQ CM,300,270,62,285,108,132,142,121,89,178,181,156,179,105,85,205,155,156,124,144,285,186,193,101,109,74,62,167,147,170,96,66,99,77,67,71,67,,,,,,,,,,,,,,
15273,PBB SKIN SUB GRFT T/A/L CHILD 100 SQ CM,950,855,188,902,343,419,451,384,283,565,573,495,566,332,271,650,490,494,392,456,902,588,611,320,188,234,196,530,467,538,304,285,314,245,315,225,213,,,,,,,,,,,,,,
15274,PR SKIN SUB GRFT T/A/L CH ADD 100 SQ CM,940,846,85,893,339,415,446,380,280,559,567,490,561,328,268,643,485,489,388,451,893,582,605,316,85,232,194,524,462,532,301,282,311,242,312,223,211,,,,,,,,,,,,,,
15275,PR SKIN SUB GRFT F/NK/HF/G 25 SQ CM,300,270,62,285,108,132,142,121,87,178,202,156,179,105,85,205,155,156,124,144,285,200,193,101,109,74,62,167,147,170,96,90,99,77,102,71,67,,,,,,,,,,,,,,
16020,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)",239,215,34,227,86,106,113,97,34,142,144,125,143,83,68,164,123,124,99,115,227,148,154,80,87,59,49,133,117,135,76,72,79,62,79,57,54,,,,,,,,,,,,,,
16025,"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)",252,227,52,240,91,111,120,102,75,150,240,131,150,88,72,172,130,131,104,121,239,156,162,85,92,62,52,141,124,143,81,76,83,65,84,60,56,,,,,,,,,,,,,,
17250,"Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)",227,204,47,216,82,100,108,92,68,135,137,118,75,79,65,155,117,118,94,109,216,140,146,76,83,56,47,127,112,129,73,68,75,59,75,54,51,,,,,,,,,,,,,,
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",927,834,191,881,335,409,440,375,272,551,559,483,553,324,264,634,478,482,383,445,881,574,596,312,338,229,191,517,455,525,296,278,307,239,308,220,208,,,,,,,,,,,,,,
19301,"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);",1236,1112,255,1174,446,546,587,500,368,735,1137,644,737,432,352,846,637,643,511,593,1174,765,795,416,450,305,255,690,607,700,395,371,409,319,410,293,277,,,,,,,,,,,,,,
20240,"Biopsy, bone, open; superficial (eg, ilium, sternum, spinous process, ribs, trochanter of femur)",400,360,82,380,144,177,190,162,119,238,303,208,239,140,114,274,206,208,165,192,380,248,257,135,146,99,82,223,197,227,128,120,132,103,133,95,90,,,,,,,,,,,,,,
20605,"Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)",114,103,21,108,41,50,54,46,21,68,69,59,68,40,32,78,59,59,47,55,108,71,73,38,42,28,23,64,56,65,36,34,38,29,38,27,26,,,,,,,,,,,,,,
20610,"Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)",168,151,35,160,61,74,80,68,50,100,98,88,100,59,48,115,87,87,69,81,160,104,108,57,61,41,35,94,83,95,54,38,56,43,61,40,38,,,,,,,,,,,,,,
20611,HC DRAIN/INJ MAJOR JOINT/BURSA W US,250,225,52,238,90,110,119,101,74,149,108,130,149,87,71,171,129,130,103,120,238,155,161,84,91,62,52,139,123,142,80,75,83,64,83,59,56,,,,,,,,,,,,,,
20680,"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)",1400,1260,288,1330,506,618,665,566,417,832,743,730,835,489,399,958,722,728,578,672,1330,866,901,471,510,345,288,781,688,793,448,329,463,361,465,332,314,,,,,,,,,,,,,,
21931,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater",1095,986,226,1040,395,483,520,443,326,651,660,571,653,382,312,749,565,569,452,526,1040,678,704,368,399,270,226,611,538,620,350,384,362,282,363,259,245,,,,,,,,,,,,,,
23071,"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater",1100,990,227,1045,397,486,522,445,327,654,855,573,656,384,313,753,567,572,454,528,1045,681,708,370,401,271,227,614,540,623,352,330,364,284,365,261,246,,,,,,,,,,,,,,
23075,"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm",1300,1170,268,1235,469,574,617,526,387,773,578,677,775,454,370,889,670,676,537,624,1235,804,836,437,474,321,268,725,639,736,416,390,430,335,431,308,291,,,,,,,,,,,,,,
23505,Closed treatment of clavicular fracture; with manipulation,850,765,175,808,307,375,403,344,245,505,512,443,507,297,242,582,438,442,351,408,808,526,547,286,310,210,175,474,418,481,272,255,281,219,282,201,190,,,,,,,,,,,,,,
24600,Treatment of closed elbow dislocation; without anesthesia,1100,990,227,1045,397,486,522,445,327,654,636,573,656,384,313,753,567,572,454,528,1045,681,708,370,401,271,227,614,540,623,352,330,364,284,365,261,246,,,,,,,,,,,,,,
24640,"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation",162,146,33,154,59,72,77,66,114,96,98,84,97,57,46,111,84,84,67,78,154,100,104,54,59,40,33,90,80,92,52,49,54,42,54,38,36,,,,,,,,,,,,,,
25565,Closed treatment of radial and ulnar shaft fractures; with manipulation,1050,945,216,1014,379,464,498,425,312,624,1014,547,626,367,299,718,541,546,434,504,998,650,675,353,383,259,216,586,516,595,336,315,348,271,348,249,235,,,,,,,,,,,,,,
25600,"Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation",930,837,192,884,336,411,441,376,199,553,561,485,555,325,265,636,480,483,384,446,884,575,598,313,339,230,192,519,457,527,297,279,308,240,309,220,208,,,,,,,,,,,,,,
26010,Drainage of finger abscess; simple,480,432,70,456,173,212,228,194,70,285,248,250,286,168,137,328,248,250,198,230,456,297,309,161,175,118,99,268,236,272,154,144,159,124,159,114,108,,,,,,,,,,,,,,
26725,"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each",368,331,76,350,133,162,175,149,110,219,281,192,219,129,105,252,190,191,152,177,350,228,237,124,134,91,76,205,181,208,118,110,122,95,122,87,82,,,,,,,,,,,,,,
27240,"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction",2000,1800,412,1900,722,883,949,809,787,1189,1205,1042,1193,698,570,1368,1031,1040,826,960,1900,1238,1286,673,729,494,412,1116,983,1133,640,600,662,516,664,474,448,,,,,,,,,,,,,,
27327,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm",1200,1080,247,1140,433,530,570,287,357,713,723,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,397,309,398,284,269,,,,,,,,,,,,,,
27337,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater",1200,1080,247,1140,433,530,570,485,357,713,918,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,397,309,398,284,269,,,,,,,,,,,,,,
27630,"Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle",1375,1238,283,1306,497,607,653,556,409,817,797,717,820,480,392,941,709,715,568,660,1306,851,884,463,501,339,283,767,676,779,440,412,455,354,456,326,308,,,,,,,,,,,,,,
27726,Repair of fibula nonunion and/or malunion with internal fixation,2500,2250,515,2375,903,1104,1187,1011,744,1486,1507,1303,1491,873,712,1710,1289,1300,1033,1200,2375,1547,1608,841,911,617,515,1395,1228,1416,800,750,827,644,762,592,560,,,,,,,,,,,,,,
27752,"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction",1200,1080,247,1140,433,530,570,485,357,713,1080,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,397,309,398,284,269,,,,,,,,,,,,,,
27792,"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed",1881,1693,388,1787,679,831,893,761,478,1118,1411,980,1122,657,536,1287,970,978,777,903,1787,1164,1210,633,686,464,388,1050,924,1065,602,564,623,485,624,446,421,,,,,,,,,,,,,,
27810,"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation",1200,1080,247,1140,433,530,570,485,357,713,761,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,397,309,398,284,269,,,,,,,,,,,,,,
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",1400,1260,288,1330,506,618,665,566,731,832,844,730,835,489,399,958,722,728,578,672,1330,866,901,471,510,345,288,781,688,793,448,420,463,361,465,332,314,,,,,,,,,,,,,,
28008,"Fasciotomy, foot and/or toe",1200,1080,247,1140,433,530,570,485,357,713,643,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,397,309,398,284,269,,,,,,,,,,,,,,
28039,"Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater",1300,1170,268,1235,469,574,617,526,387,773,767,677,775,454,370,889,670,676,537,624,1235,804,836,437,474,321,268,725,639,736,416,390,430,335,431,308,291,,,,,,,,,,,,,,
28041,"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater",1500,1350,309,1425,542,662,712,607,380,892,804,782,894,524,427,1026,774,780,620,720,1425,928,965,505,547,370,309,837,737,849,480,450,496,387,498,355,336,,,,,,,,,,,,,,
28043,"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm",1000,900,206,950,361,442,475,404,298,595,461,521,596,349,285,684,516,520,413,480,950,619,643,336,364,247,206,558,491,566,320,300,331,258,332,237,224,,,,,,,,,,,,,,
28080,"Excision, interdigital (Morton) neuroma, single, each",1200,1080,247,1140,433,530,570,485,357,713,804,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,397,309,398,284,269,,,,,,,,,,,,,,
28104,"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;",1400,1260,288,1330,506,618,570,566,417,832,759,730,835,489,399,958,722,728,578,672,1330,866,901,471,510,345,288,781,688,793,448,307,290,361,465,332,314,,,,,,,,,,,,,,
28110,"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)",1300,1170,268,1235,469,574,617,526,387,773,269,677,775,454,370,889,670,676,537,624,1235,804,836,437,474,321,268,725,639,736,416,390,430,335,431,308,291,,,,,,,,,,,,,,
28118,"Ostectomy, calcaneus;",1480,1332,305,1406,534,653,703,599,440,880,771,771,882,517,421,1013,763,769,611,710,1406,916,952,498,539,365,305,826,727,838,473,444,490,382,491,351,332,,,,,,,,,,,,,,
28122,"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus",3100,2790,531,2945,1119,1369,1471,1254,531,1843,1868,1615,1848,1083,883,2121,1599,1611,1280,1488,2945,1918,1994,1043,1130,765,639,1730,1523,1756,991,930,1026,799,1029,735,694,,,,,,,,,,,,,,
28140,Metatarsectomy,1700,1530,339,1615,614,751,807,688,506,1011,1025,886,1014,594,484,1163,877,884,702,816,1615,1052,1093,572,620,420,339,949,835,963,544,510,563,438,564,403,381,,,,,,,,,,,,,,
28160,"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each",1300,1170,198,1235,469,574,617,526,198,773,784,677,775,454,370,889,670,676,537,624,1235,804,836,437,474,321,268,725,639,736,416,390,430,335,431,308,291,,,,,,,,,,,,,,
28208,"Repair, tendon, extensor, foot; primary or secondary, each tendon",1200,1080,247,1140,433,530,570,485,357,713,599,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,397,309,398,284,269,,,,,,,,,,,,,,
28285,"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)",1200,1080,153,1140,433,530,570,186,246,713,772,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,281,309,153,284,269,,,,,,,,,,,,,,
28288,"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head",1400,1260,246,1330,506,618,665,566,246,832,844,730,835,489,399,958,722,728,578,672,1330,866,901,471,510,345,288,781,688,793,448,420,463,361,465,332,314,,,,,,,,,,,,,,
28289,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint",1400,1260,288,1330,506,618,665,566,417,832,1001,730,835,489,399,958,722,728,578,672,1330,866,901,471,510,345,288,781,688,793,448,420,463,361,465,332,314,,,,,,,,,,,,,,
28292,"Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedure",1600,1440,330,1520,578,706,759,647,476,951,869,834,954,559,456,1095,825,832,661,768,1520,990,1029,538,583,395,330,893,786,906,512,480,530,412,531,379,358,,,,,,,,,,,,,,
28296,"Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)",2000,1800,412,1900,722,883,949,823,595,1189,1113,1042,1193,698,570,1368,1031,1040,826,960,1900,1238,1286,673,729,494,412,1116,983,1133,640,600,662,516,695,474,448,,,,,,,,,,,,,,
28298,"Correction, hallux valgus (bunion), with or without sesamoidectomy; by phalanx osteotomy",2016,1814,415,1915,728,890,957,815,600,1199,893,1051,1202,704,574,1379,1040,1048,833,968,1915,1247,1297,678,735,498,415,1125,991,1142,645,605,667,520,669,478,452,,,,,,,,,,,,,,
28299,"Correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy",2500,2250,515,2375,903,1104,1187,1083,744,1486,1507,1303,1491,873,712,1710,1289,1300,1033,1200,2375,1547,1608,841,911,617,515,1395,1228,1416,800,750,827,644,830,592,560,,,,,,,,,,,,,,
28300,"Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation",2000,1800,412,1900,722,883,949,809,656,1189,1166,1042,1193,698,570,1368,1031,1040,826,960,1900,1238,1286,673,729,494,412,1116,983,1133,640,600,662,516,664,474,448,,,,,,,,,,,,,,
28308,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each",1400,1260,154,1330,506,618,665,355,258,832,828,730,835,489,399,958,722,728,578,672,1330,866,901,471,510,323,288,781,688,793,448,154,463,361,465,332,314,,,,,,,,,,,,,,
28485,"Open treatment of metatarsal fracture, includes internal fixation, when performed, each",1500,1350,309,1425,542,662,712,607,446,892,1127,782,1204,524,427,1026,774,780,620,720,1425,928,923,505,547,370,309,837,737,849,480,450,496,387,444,355,336,,,,,,,,,,,,,,
28630,Closed treatment of metatarsophalangeal joint dislocation; without anesthesia,400,360,82,380,144,177,190,162,119,238,244,208,239,140,114,274,206,208,165,192,380,248,257,135,146,99,82,223,197,227,128,120,132,103,133,95,90,,,,,,,,,,,,,,
28740,"Arthrodesis, midtarsal or tarsometatarsal, single joint",1900,1710,392,1805,686,839,902,768,565,1130,1116,990,1133,664,541,1300,980,988,785,912,1805,1176,1222,639,692,469,392,1060,934,1076,608,570,629,490,630,450,426,,,,,,,,,,,,,,
28750,"Arthrodesis, great toe; metatarsophalangeal joint",1800,1620,371,1710,650,795,854,566,536,1070,1164,938,1073,629,513,1232,928,936,743,864,1710,1114,1158,605,656,444,371,1004,884,1019,576,454,596,464,597,427,403,,,,,,,,,,,,,,
28805,"Amputation, foot; transmetatarsal",1550,1395,319,1472,560,684,736,627,461,922,1262,808,924,541,441,1060,799,806,640,744,1472,959,997,521,565,383,319,865,762,878,496,465,513,400,514,367,347,,,,,,,,,,,,,,
28820,"Amputation, toe; metatarsophalangeal joint",1000,900,206,950,361,442,475,404,298,595,603,521,596,349,285,684,516,520,413,480,950,619,643,336,364,247,206,558,491,566,320,300,331,258,524,237,224,,,,,,,,,,,,,,
28825,"Amputation, toe; interphalangeal joint",1300,1170,268,1235,469,574,617,526,387,773,377,677,775,454,370,889,670,676,537,624,1235,804,836,437,474,321,268,725,639,736,416,390,430,335,493,308,291,,,,,,,,,,,,,,
29105,Application of long arm splint (shoulder to hand),123,111,25,117,44,54,58,50,50,73,76,64,91,33,35,84,63,64,51,59,117,76,79,41,45,30,25,69,60,70,39,36,41,32,41,29,28,,,,,,,,,,,,,,
29125,Application of short arm splint (forearm to hand); static,94,85,19,89,34,42,45,31,41,56,73,49,56,37,27,64,48,49,39,45,89,58,60,32,37,41,19,52,46,53,30,33,31,24,31,22,21,,,,,,,,,,,,,,
29505,Application of long leg splint (thigh to ankle or toes),119,107,25,113,43,53,56,48,44,71,110,62,71,42,34,81,61,62,49,57,113,74,77,40,43,29,25,66,58,67,38,36,39,31,39,28,27,,,,,,,,,,,,,,
29515,Application of short leg splint (calf to foot),91,82,19,86,33,40,43,37,48,54,86,47,54,32,26,62,47,47,38,44,86,86,59,31,33,52,19,51,45,52,29,27,30,23,78,22,20,,,,,,,,,,,,,,
29580,Strapping; Unna boot,127,114,24,121,46,56,60,51,24,76,60,66,60,44,36,87,65,66,52,61,121,79,82,26,46,31,26,71,62,72,41,34,29,33,32,30,28,,,,,,,,,,,,,,
29581,"Application of multi-layer venous wound compression system, below knee",200,180,13,190,72,88,95,81,60,119,61,104,119,70,57,137,103,104,83,96,190,124,129,67,73,49,41,112,98,113,64,28,66,52,13,47,45,,,,,,,,,,,,,,
29700,"Removal or bivalving; gauntlet, boot or body cast",150,135,31,142,54,66,71,61,45,89,71,78,89,52,43,103,77,78,62,72,142,93,96,50,55,37,31,84,74,85,48,45,50,39,50,36,34,,,,,,,,,,,,,,
30901,"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method",114,103,23,108,41,50,54,46,34,68,98,59,68,40,32,78,59,59,47,55,108,71,73,38,42,28,23,64,56,65,36,34,38,29,38,27,26,,,,,,,,,,,,,,
30903,"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method",400,360,60,380,144,177,190,162,119,238,147,208,239,140,114,274,206,208,165,192,380,248,257,135,146,99,82,223,197,227,128,60,132,103,133,95,90,,,,,,,,,,,,,,
30905,"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial",345,310,47,328,125,152,164,140,47,205,208,180,206,120,98,236,178,179,142,166,328,213,222,116,126,85,71,192,170,195,110,103,114,89,88,82,77,,,,,,,,,,,,,,
31500,"Intubation, endotracheal, emergency procedure",427,384,16,406,154,189,203,173,127,254,257,223,255,149,122,292,220,222,176,205,406,264,275,144,156,92,88,238,210,242,137,16,141,110,142,101,96,,,,,,,,,,,,,,
36406,"Venipuncture, younger than age 3 years, necessitating physician's skill, not to be used for routine venipuncture; other vein",80,72,15,76,29,35,38,32,24,48,15,42,48,28,23,55,41,42,33,38,76,50,51,27,29,20,16,45,39,45,26,24,26,21,27,19,18,,,,,,,,,,,,,,
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)",153,138,7,145,55,68,73,62,10,91,43,80,91,53,44,105,79,80,63,73,145,95,98,51,56,38,32,85,75,87,49,8,8,39,7,36,34,,,,,,,,,,,,,,
36556,Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older,564,508,15,536,204,249,268,15,114,335,340,294,336,197,161,386,291,293,233,271,536,349,363,84,206,91,114,315,277,319,180,70,69,145,68,134,126,,,,,,,,,,,,,,
36561,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older",2600,2340,536,2470,939,1148,1234,1052,774,1546,722,1355,1550,908,740,1779,1341,1352,1074,1248,2470,1609,1672,875,948,642,536,1451,1278,1472,832,780,861,670,863,616,582,,,,,,,,,,,,,,
36569,"Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older",298,268,16,283,108,132,141,121,31,177,180,155,178,104,85,204,154,155,123,143,283,184,192,100,109,16,61,166,146,169,95,89,99,77,99,71,67,,,,,,,,,,,,,,
36573,PBB INS PICC RS&I 5 YR+,1200,1080,72,1140,433,530,570,485,357,713,723,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,360,397,309,72,284,269,,,,,,,,,,,,,,
36590,"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion",700,630,144,665,253,309,332,283,281,416,422,365,417,244,199,479,361,364,289,336,665,433,450,235,255,173,144,391,344,396,224,210,232,180,232,166,157,,,,,,,,,,,,,,
36620,"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous",564,508,46,536,204,249,268,228,168,335,340,294,336,197,161,386,291,293,233,271,536,349,363,190,206,46,116,315,277,319,180,169,187,145,187,134,126,,,,,,,,,,,,,,
38531,PR OPEN BX/EXC INGUINOFEM NODES,1100,990,227,1045,397,486,522,445,327,654,961,573,656,384,313,753,567,572,454,528,1045,681,708,370,401,271,227,614,540,623,352,330,364,284,365,261,246,,,,,,,,,,,,,,
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)",544,490,52,517,196,240,258,220,139,323,328,283,324,190,155,372,281,283,225,261,517,337,350,183,198,134,112,304,267,308,174,105,102,140,52,129,122,,,,,,,,,,,,,,
43239,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, single or multiple",544,490,65,517,196,235,258,181,149,323,302,283,324,65,155,372,281,283,225,261,517,337,350,183,134,149,74,304,118,308,174,89,117,140,118,129,122,,,,,,,,,,,,,,
43247,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of foreign body",544,490,112,517,196,240,258,173,347,323,354,283,324,190,155,372,281,283,225,261,517,337,350,183,198,134,112,304,302,308,174,163,180,140,181,129,122,,,,,,,,,,,,,,
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)",1500,1350,144,1425,542,662,712,150,446,892,335,782,894,524,427,1026,774,780,620,720,1425,928,965,505,144,149,309,837,262,849,480,450,496,387,498,355,336,,,,,,,,,,,,,,
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",721,649,149,685,260,318,342,292,215,429,353,376,430,252,205,493,372,375,298,346,685,446,464,243,263,178,149,402,354,408,231,216,239,186,239,171,162,,,,,,,,,,,,,,
43255,"Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with control of bleeding, any method",544,490,112,517,196,240,258,220,162,323,439,283,324,190,155,372,281,283,225,261,517,337,350,183,198,134,112,304,267,308,174,163,180,140,181,129,122,,,,,,,,,,,,,,
44140,"Colectomy, partial; with anastomosis",4080,3672,841,3876,1473,1802,1937,1650,1214,2426,2459,2126,2433,1425,1162,2791,2104,2121,1685,1958,3876,2525,2624,1372,1487,1007,841,2276,2005,2754,1305,1224,1350,1052,1354,967,914,,,,,,,,,,,,,,
44970,"Laparoscopy, surgical, appendectomy",1030,927,212,978,372,455,489,417,479,612,621,537,614,360,293,705,531,535,425,494,978,637,663,346,375,254,212,575,506,583,329,457,341,266,342,244,231,,,,,,,,,,,,,,
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)",866,779,154,823,313,170,411,170,209,515,422,451,422,175,247,592,447,318,358,416,823,536,557,291,316,209,178,483,426,392,277,154,179,223,295,205,194,,,,,,,,,,,,,,
45380,"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple",1030,927,155,978,372,192,489,185,212,612,456,537,460,189,190,705,531,535,425,494,978,498,663,189,189,212,212,575,506,425,329,168,155,266,190,244,231,,,,,,,,,,,,,,
45382,"Colonoscopy, flexible, proximal to splenic flexure; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)",2000,1800,412,1900,722,883,949,809,595,1189,493,1042,1193,698,570,1368,1031,1040,826,960,1900,1238,1286,673,729,494,412,1116,983,1133,640,600,662,516,664,474,448,,,,,,,,,,,,,,
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",850,765,175,808,307,375,403,344,253,505,476,443,507,297,242,582,438,442,351,408,808,526,547,286,310,210,175,474,418,476,272,255,281,219,282,201,190,,,,,,,,,,,,,,
45385,"Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",1300,1170,196,1235,469,481,435,235,288,536,583,677,579,454,370,889,670,676,537,624,1235,804,836,437,235,288,268,725,481,736,416,196,211,335,312,308,291,,,,,,,,,,,,,,
46220,"Excision of single external papilla or tag, anus",700,630,102,665,253,309,332,283,208,416,422,365,417,244,199,479,361,364,289,336,665,433,450,235,255,173,144,391,344,396,224,102,232,180,232,166,157,,,,,,,,,,,,,,
46255,"Hemorrhoidectomy, internal and external, single column/group;",1400,1260,288,1330,506,618,665,339,417,832,844,730,835,489,399,958,722,728,578,672,1330,866,901,471,510,345,288,781,688,793,448,420,463,361,465,332,314,,,,,,,,,,,,,,
46260,"Hemorrhoidectomy, internal and external, 2 or more columns/groups;",1180,1062,243,1121,426,521,560,477,351,702,452,615,704,412,336,807,609,613,487,566,1121,730,759,397,430,291,243,658,580,668,377,397,391,304,392,280,264,,,,,,,,,,,,,,
46320,"Excision of thrombosed hemorrhoid, external",361,325,74,343,130,159,171,146,78,215,218,188,215,126,103,247,186,188,149,173,343,223,232,121,132,89,74,201,177,204,115,108,119,93,120,86,81,,,,,,,,,,,,,,
46614,"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)",350,315,58,332,126,155,166,142,58,208,211,182,209,122,100,239,180,182,145,168,332,217,225,118,128,86,72,195,172,198,112,105,116,90,116,83,78,,,,,,,,,,,,,,
46930,"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)",600,540,124,570,217,265,285,243,179,357,362,313,358,210,171,411,309,312,248,288,570,371,386,202,219,148,124,335,295,340,192,180,129,155,199,142,134,,,,,,,,,,,,,,
47562,"Laparoscopy, surgical; cholecystectomy",1236,1112,255,1188,446,1017,587,628,634,735,1188,644,737,610,352,846,637,643,511,593,1174,765,795,416,450,634,255,690,607,700,395,558,409,319,1009,293,277,,,,,,,,,,,,,,
47563,"Laparoscopy, surgical; cholecystectomy with cholangiography",1236,1112,255,1174,446,546,587,500,368,735,745,644,737,432,352,846,637,643,511,593,1174,765,795,416,450,305,255,690,607,700,395,371,589,319,410,293,277,,,,,,,,,,,,,,
49082,PBB ABD PARACENTESIS,168,151,35,160,61,74,80,68,50,100,101,88,100,59,48,115,87,87,69,81,160,104,108,57,61,41,35,94,83,95,54,64,56,43,56,40,38,,,,,,,,,,,,,,
49320,"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)",670,603,138,636,242,296,318,271,199,398,404,349,400,234,191,458,346,348,277,322,636,415,431,225,244,165,138,374,506,379,214,201,222,173,222,159,150,,,,,,,,,,,,,,
49505,"Repair initial inguinal hernia, age 5 years or older; reducible",1030,927,212,998,372,455,489,745,307,612,998,537,614,360,293,705,531,535,425,494,978,637,663,346,375,254,212,575,506,583,329,430,341,266,798,244,231,,,,,,,,,,,,,,
49520,"Repair recurrent inguinal hernia, any age; reducible",1208,1087,249,1148,436,533,573,489,359,718,728,629,720,422,344,826,623,628,499,580,1148,747,777,406,580,298,249,674,594,684,386,362,400,311,969,286,271,,,,,,,,,,,,,,
49560,Repair initial incisional or ventral hernia; reducible,1442,1298,297,1370,521,637,684,583,556,857,869,751,860,504,411,987,744,750,596,692,1370,892,928,485,526,356,297,805,709,817,461,432,477,372,614,342,323,,,,,,,,,,,,,,
49565,Repair recurrent incisional or ventral hernia; reducible,2300,2070,474,2185,831,1016,1092,930,684,1367,1390,1199,1371,803,655,1574,1186,1196,950,1104,2185,1423,1479,774,838,568,474,1283,1130,1303,736,690,761,593,763,545,515,,,,,,,,,,,,,,
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),618,556,127,587,223,273,293,250,257,367,479,322,368,216,176,423,319,321,255,297,587,382,398,208,225,153,127,345,304,350,198,185,205,159,220,146,138,,,,,,,,,,,,,,
49585,"Repair umbilical hernia, age 5 years or older; reducible",1442,1298,297,1370,521,735,684,583,429,857,812,751,860,504,411,987,744,750,596,692,1370,892,928,485,526,356,297,805,709,817,461,432,477,372,478,342,323,,,,,,,,,,,,,,
49587,"Repair umbilical hernia, age 5 years or older; incarcerated or strangulated",1400,1260,288,1330,506,618,665,566,417,832,1017,730,1017,489,399,958,722,728,578,672,1330,866,901,471,510,345,288,781,688,793,448,420,463,361,465,332,314,,,,,,,,,,,,,,
49650,"Laparoscopy, surgical; repair initial inguinal hernia",1400,1260,288,1330,506,618,665,566,417,832,844,730,835,489,399,958,722,728,589,672,1330,866,901,471,510,345,288,781,688,793,448,420,463,361,465,332,314,,,,,,,,,,,,,,
49652,"Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible",1865,1678,384,1772,673,823,885,754,555,1109,1571,972,1112,651,531,1276,962,969,770,895,1772,1154,1200,627,680,460,384,1041,916,1056,596,559,617,481,619,442,418,,,,,,,,,,,,,,
51700,"Bladder irrigation, simple, lavage and/or instillation",230,207,26,218,83,102,109,93,68,137,139,120,137,80,65,157,119,120,95,110,218,142,148,77,84,57,47,128,113,130,74,69,76,59,26,55,52,,,,,,,,,,,,,,
56405,Incision and drainage of vulva or perineal abscess,201,181,41,191,73,89,95,81,60,119,121,105,120,70,57,138,104,104,83,96,191,124,129,68,73,50,41,112,99,114,64,60,67,52,146,48,45,,,,,,,,,,,,,,
57520,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser",950,855,196,902,343,419,451,384,283,565,573,495,566,332,271,650,490,494,392,456,902,588,611,320,346,234,196,530,467,538,304,285,314,245,315,225,213,,,,,,,,,,,,,,
58300,Insertion of intrauterine device (IUD),227,204,47,216,82,100,108,92,72,135,137,118,135,79,65,155,117,118,94,109,216,140,146,76,83,56,47,127,112,129,73,68,75,59,75,54,51,,,,,,,,,,,,,,
58350,"Chromotubation of oviduct, including materials",400,360,61,380,144,177,190,162,119,238,241,208,239,140,114,274,206,208,165,192,380,248,257,135,146,99,82,223,61,227,128,120,132,103,133,95,90,,,,,,,,,,,,,,
58353,"Endometrial ablation, thermal, without hysteroscopic guidance",1500,1350,309,1425,542,662,712,607,446,892,518,782,894,524,427,1026,774,780,620,720,1425,928,965,505,547,370,309,837,737,849,480,450,496,387,498,355,336,,,,,,,,,,,,,,
58558,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",824,742,62,783,298,364,391,333,62,490,497,429,491,288,235,564,425,428,340,396,783,510,530,277,300,203,170,460,405,467,264,247,273,212,273,195,185,,,,,,,,,,,,,,
58563,"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)",3700,3330,425,3515,1336,1634,1756,1496,1101,2200,425,1928,2206,1292,1054,2531,1908,1923,1528,1776,3515,2290,2380,1245,1348,913,762,2064,1818,2095,1183,1110,1225,954,1228,877,829,,,,,,,,,,,,,,
58600,"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral",1100,990,227,1045,397,486,522,445,255,654,663,573,656,384,313,753,567,572,454,528,1045,681,708,370,401,255,227,614,540,623,352,330,364,284,365,261,246,,,,,,,,,,,,,,
58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",2000,1800,412,1900,722,883,949,809,589,1189,1160,1042,1193,698,570,1368,1031,1040,826,960,1900,1238,1286,673,729,494,412,1116,983,1133,640,600,662,516,664,474,448,,,,,,,,,,,,,,
59025,Fetal non-stress test,107,96,22,102,39,47,51,43,26,64,54,56,54,37,30,73,55,56,44,51,102,66,69,36,39,33,22,60,53,61,34,32,35,28,36,25,24,,,,,,,,,,,,,,
59409,Vaginal delivery only (with or without episiotomy and/or forceps);,1493,1344,308,1418,539,659,709,604,766,888,900,778,890,521,425,1021,770,776,617,717,1418,924,960,502,544,368,308,833,734,846,477,448,494,385,495,354,334,,,,,,,,,,,,,,
59812,"Treatment of incomplete abortion, any trimester, completed surgically",689,620,142,655,249,304,327,279,205,410,548,359,411,241,196,471,355,358,285,331,655,426,443,232,251,170,142,384,339,390,220,207,228,178,229,163,154,,,,,,,,,,,,,,
62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,1308,1177,77,1243,472,578,621,529,77,778,427,682,780,82,372,895,675,680,540,628,1243,809,841,440,477,90,270,730,161,741,418,83,433,134,85,310,293,,,,,,,,,,,,,,
64445,"Injection, anesthetic agent; sciatic nerve, single",975,878,47,926,352,431,463,394,290,580,588,508,581,341,278,667,503,507,403,468,926,603,627,328,355,47,201,544,479,552,312,292,323,251,324,231,218,,,,,,,,,,,,,,
64447,"Injection, anesthetic agent; femoral nerve, single",701,631,31,666,253,310,333,284,209,417,423,365,418,245,200,480,362,364,290,336,666,434,451,236,255,31,144,391,344,397,224,210,232,181,233,166,157,,,,,,,,,,,,,,
64450,"Injection, anesthetic agent; other peripheral nerve or branch",16,14,1,15,6,7,8,6,5,10,10,8,10,6,5,11,8,8,7,8,15,10,10,5,6,4,3,9,8,9,5,1,5,4,5,4,4,,,,,,,,,,,,,,
64520,"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)",600,540,77,570,217,265,285,243,77,357,362,313,358,210,171,411,309,312,248,288,570,371,386,202,219,148,124,335,295,340,192,180,199,155,199,142,134,,,,,,,,,,,,,,
64788,Excision of neurofibroma or neurolemmoma; cutaneous nerve,1200,1080,247,1140,433,530,570,485,357,713,723,625,716,419,342,821,619,624,496,576,1140,743,772,404,437,296,247,670,590,680,384,250,397,309,398,284,269,,,,,,,,,,,,,,
65205,"Removal of foreign body, external eye; conjunctival superficial",84,76,17,80,30,37,40,34,25,50,51,44,50,29,24,57,43,44,35,40,80,52,54,28,31,21,17,47,41,48,27,25,28,22,28,20,19,,,,,,,,,,,,,,
65220,"Removal of foreign body, external eye; corneal, without slit lamp",126,113,26,141,46,56,60,51,141,75,76,66,75,44,36,86,65,65,52,60,120,78,81,42,46,31,26,70,62,71,40,38,42,32,42,30,28,,,,,,,,,,,,,,
65222,"Removal of foreign body, external eye; corneal, with slit lamp",170,153,35,162,61,75,81,69,105,101,102,89,54,59,48,116,88,88,70,82,162,105,109,57,62,42,35,95,84,96,54,51,56,44,56,40,38,,,,,,,,,,,,,,
67700,"Blepharotomy, drainage of abscess, eyelid",550,495,65,522,199,243,261,222,65,327,332,287,328,192,157,376,284,286,227,264,522,340,354,185,200,136,113,307,270,311,176,165,182,142,183,130,123,,,,,,,,,,,,,,
69200,Removal foreign body from external auditory canal; without general anesthesia,84,76,17,80,30,37,40,34,25,50,51,44,50,29,24,57,43,44,35,40,80,52,54,28,31,27,17,47,41,48,27,25,28,22,28,20,19,,,,,,,,,,,,,,
69210,"Removal impacted cerumen (separate procedure), 1 or both ears",43,39,9,41,16,19,20,17,26,26,26,22,26,15,12,29,22,22,18,21,41,27,28,14,16,11,9,24,21,24,14,13,14,11,14,10,10,,,,,,,,,,,,,,
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)",290,261,10,276,105,128,138,117,10,172,175,151,173,101,83,198,150,151,120,139,276,179,187,98,106,20,60,162,142,164,93,87,96,75,96,69,65,,,,,,,,,,,,,,
77001,"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position) (List separately in addition to code for primary procedure)",300,270,40,285,108,132,142,121,89,178,40,156,179,105,85,205,155,156,124,144,285,186,193,101,109,74,62,167,147,170,96,90,99,77,100,71,67,,,,,,,,,,,,,,
92960,"Cardioversion, elective, electrical conversion of arrhythmia; external",266,239,55,253,96,117,144,108,79,158,160,139,159,93,76,182,137,138,110,128,253,165,171,89,97,66,55,148,131,151,85,80,88,69,88,63,60,,,,,,,,,,,,,,
93010,"Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only",50,45,6,48,18,8,8,8,9,17,16,8,16,7,8,34,26,26,8,24,48,15,32,8,8,10,10,28,25,17,16,7,7,7,7,12,6,,,,,,,,,,,,,,
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",110,99,23,104,40,32,52,44,26,65,42,57,48,38,31,75,57,57,45,53,104,68,71,37,40,26,23,61,54,62,35,33,36,28,37,26,25,,,,,,,,,,,,,,
93018,"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only",110,99,13,104,40,15,104,14,18,29,31,57,32,14,31,75,57,57,45,53,104,30,71,37,14,18,18,61,21,62,35,13,36,23,13,23,25,,,,,,,,,,,,,,
94010,"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation",25,22,5,24,9,11,12,12,10,15,18,13,15,8,7,17,13,13,10,12,24,15,16,8,9,12,5,14,12,14,8,8,8,6,8,6,6,,,,,,,,,,,,,,
94060,"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration",45,40,9,43,16,20,13,13,16,27,23,23,23,13,13,31,23,23,19,22,43,28,29,15,16,16,9,25,22,27,11,11,11,12,17,11,10,,,,,,,,,,,,,,
96372,"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular",74,67,4,70,27,33,35,30,4,44,45,39,44,26,21,51,38,38,31,36,70,46,48,25,27,18,15,41,36,42,24,22,24,19,25,18,17,,,,,,,,,,,,,,
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",227,204,13,216,82,100,108,92,68,135,43,118,135,79,65,155,117,118,94,109,216,140,146,35,35,13,47,127,112,129,73,68,75,59,27,54,51,,,,,,,,,,,,,,
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)",908,817,96,863,328,401,431,367,270,540,547,473,541,317,259,621,468,472,375,436,863,562,584,96,192,224,187,507,446,514,290,272,301,234,301,215,203,,,,,,,,,,,,,,
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",75,68,15,71,27,33,36,30,22,45,29,39,45,26,21,51,39,39,31,36,71,46,48,25,27,19,15,42,37,30,24,22,25,19,25,18,17,,,,,,,,,,,,,,
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",80,72,16,76,29,35,38,32,24,48,48,42,48,28,23,55,41,42,33,38,76,50,51,27,29,20,16,45,39,32,26,24,26,21,27,19,18,,,,,,,,,,,,,,
98925,Osteopathic manipulative treatment (OMT); 1-2 body regions involved,62,56,13,59,22,27,29,25,20,37,37,32,37,22,18,42,32,32,26,30,59,38,40,21,23,15,13,35,30,35,20,19,21,16,21,15,14,,,,,,,,,,,,,,
98926,Osteopathic manipulative treatment (OMT); 3-4 body regions involved,62,56,13,60,22,27,29,25,18,37,60,32,37,22,18,42,32,32,26,30,59,38,40,21,23,29,13,35,30,35,20,19,21,16,21,15,14,,,,,,,,,,,,,,
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.",169,152,35,161,61,75,80,68,50,100,78,88,101,59,48,116,87,88,70,81,161,105,109,57,62,42,35,94,83,96,54,51,56,44,56,40,38,,,,,,,,,,,,,,
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.",216,194,45,205,78,95,103,87,64,128,120,113,129,75,62,148,111,112,89,104,205,134,139,73,79,53,45,121,106,122,69,65,71,56,67,51,48,,,,,,,,,,,,,,
99205,"Office or other outpatient visit for the evaluation and management of a new patient, which requires 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 60 minutes face-to-face with the patient and/or family.",401,361,83,381,145,177,190,162,119,238,242,209,239,140,114,274,207,208,166,192,381,248,258,135,179,99,83,224,197,227,128,120,133,103,133,95,90,,,,,,,,,,,,,,
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.",70,63,8,66,25,31,33,28,21,42,42,36,42,24,20,48,36,36,29,34,66,43,45,24,26,8,14,39,34,40,22,21,23,18,23,17,16,,,,,,,,,,,,,,
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.",129,116,18,123,47,26,26,24,18,77,48,67,48,45,37,88,67,67,24,62,123,80,83,43,35,18,27,72,63,73,41,22,25,33,29,31,29,,,,,,,,,,,,,,
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.",164,148,31,156,59,63,78,66,31,98,88,85,92,57,47,112,85,85,68,79,156,101,95,66,65,31,34,92,81,93,52,54,50,42,55,39,37,,,,,,,,,,,,,,
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.",215,194,44,204,78,93,79,77,91,128,131,112,128,75,61,147,111,112,89,103,204,133,143,72,78,49,44,120,106,122,69,79,65,55,84,51,48,,,,,,,,,,,,,,
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.",213,192,44,202,77,94,101,86,63,127,175,111,127,74,61,146,110,111,88,102,202,132,137,143,139,53,44,119,105,121,68,64,70,55,71,50,48,,,,,,,,,,,,,,
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.])",120,108,25,114,43,62,73,59,53,106,98,63,96,68,34,110,62,62,69,58,114,108,77,70,68,53,25,67,62,68,70,57,60,31,61,28,27,,,,,,,,,,,,,,
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.",156,140,32,148,56,80,86,78,71,93,133,81,131,93,44,107,80,81,94,75,148,97,100,52,57,65,32,87,77,88,50,84,82,40,93,37,35,,,,,,,,,,,,,,
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.",214,193,44,203,77,117,203,117,91,197,181,112,181,75,61,146,110,111,88,103,203,132,138,129,127,91,44,119,105,121,131,106,111,55,108,51,48,,,,,,,,,,,,,,
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.",292,263,60,288,105,141,139,155,122,174,247,152,288,170,83,277,151,152,121,140,277,181,188,172,170,122,60,163,157,165,93,142,143,75,146,69,65,,,,,,,,,,,,,,
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.",156,140,32,148,56,69,74,87,55,93,132,81,93,54,44,107,80,81,64,75,148,97,100,52,57,60,32,97,77,88,50,84,52,40,102,37,35,,,,,,,,,,,,,,
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.",212,191,44,204,77,112,115,118,91,126,183,128,179,131,60,145,109,110,129,102,201,131,136,71,131,107,44,107,104,204,68,108,116,55,112,50,47,,,,,,,,,,,,,,
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.",310,279,64,294,112,174,147,170,122,184,270,189,274,108,88,212,160,161,128,149,294,192,199,104,113,144,64,195,152,176,99,165,159,80,156,73,69,,,,,,,,,,,,,,
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.",61,55,13,58,22,31,29,29,22,36,52,32,36,21,17,42,31,32,25,29,58,38,39,37,37,22,13,34,30,35,20,31,20,16,33,14,14,,,,,,,,,,,,,,
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.",112,101,23,106,40,63,53,56,39,67,97,58,98,39,32,77,58,58,69,54,106,69,72,68,68,39,23,62,55,63,36,56,60,29,60,27,25,,,,,,,,,,,,,,
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.",160,144,33,152,58,91,91,91,68,95,138,83,138,56,46,109,83,83,99,77,152,99,103,100,98,68,33,89,79,91,51,82,82,41,83,38,36,,,,,,,,,,,,,,
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.",60,54,12,57,22,26,28,40,33,36,52,31,36,21,17,41,31,31,25,29,57,37,39,20,22,28,12,30,29,34,19,31,31,15,31,14,13,,,,,,,,,,,,,,
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.",111,100,25,109,40,62,61,62,44,66,97,68,98,70,32,76,57,58,69,53,105,97,71,37,69,44,52,59,55,109,36,59,58,29,59,26,25,,,,,,,,,,,,,,
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.",160,144,33,152,58,85,76,90,62,95,138,98,141,56,46,109,83,83,98,77,152,140,103,54,100,68,33,86,79,91,51,82,92,41,83,38,36,,,,,,,,,,,,,,
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.",204,184,42,194,74,90,97,83,100,121,174,106,122,71,123,140,105,106,84,98,194,126,131,69,74,100,42,114,100,116,65,61,68,53,68,48,46,,,,,,,,,,,,,,
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.",268,241,55,255,97,118,127,108,80,159,162,140,160,94,76,183,138,139,111,129,255,166,172,90,98,66,55,150,132,152,86,80,89,69,212,64,60,,,,,,,,,,,,,,
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.",346,311,71,329,125,153,164,188,167,206,292,180,206,121,99,237,178,180,143,166,329,214,301,116,214,196,71,193,170,196,111,180,175,89,179,82,78,,,,,,,,,,,,,,
99238,Hospital discharge day management; 30 minutes or less,112,101,23,106,40,74,53,63,53,67,98,58,67,70,32,77,58,58,69,54,106,69,72,38,70,53,23,60,55,63,36,58,37,29,57,27,25,,,,,,,,,,,,,,
99239,Hospital discharge day management; more than 30 minutes,164,148,34,160,59,90,92,109,69,98,143,101,140,57,47,112,85,85,101,79,156,101,105,55,60,69,34,98,81,160,52,84,100,42,87,39,37,,,,,,,,,,,,,,
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.",113,102,16,107,41,50,54,46,16,67,68,59,67,39,32,77,58,59,47,54,107,70,73,38,41,16,23,63,56,64,36,34,37,29,19,27,25,,,,,,,,,,,,,,
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.",166,149,29,158,60,39,79,39,29,64,56,87,60,34,47,64,86,51,69,80,158,61,66,41,39,29,29,93,42,62,53,34,35,44,41,44,29,,,,,,,,,,,,,,
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.",212,191,50,201,63,58,58,57,59,107,93,110,93,68,69,107,109,108,58,102,201,97,136,70,69,59,59,118,130,93,56,60,60,83,62,50,55,,,,,,,,,,,,,,
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.",258,232,61,245,106,102,120,98,91,182,157,134,157,116,73,182,133,134,111,124,245,171,161,99,114,91,77,144,113,181,83,102,97,111,105,61,80,,,,,,,,,,,,,,
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.",385,346,91,366,139,150,183,150,143,266,229,167,245,142,110,259,199,200,163,185,366,238,242,170,169,132,122,215,154,262,123,150,170,99,153,91,100,,,,,,,,,,,,,,
99291,"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes",604,544,124,574,227,197,287,202,144,325,325,315,308,211,172,413,311,314,249,290,574,374,389,203,212,144,124,337,297,342,193,170,200,156,187,143,135,,,,,,,,,,,,,,
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)",316,284,65,300,114,140,150,86,161,188,163,165,188,110,90,216,163,164,131,152,300,196,203,106,115,161,65,176,155,179,101,108,105,81,97,75,71,,,,,,,,,,,,,,
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.",180,162,37,171,65,79,85,73,54,107,141,94,107,63,51,123,93,94,74,86,171,111,116,61,66,44,37,100,88,102,58,78,87,46,60,43,40,,,,,,,,,,,,,,
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.",206,185,42,196,74,91,98,83,61,122,124,107,123,72,59,141,106,107,85,99,196,127,133,69,75,51,42,115,101,117,66,101,68,53,68,49,46,,,,,,,,,,,,,,
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.",264,238,54,251,95,117,125,107,79,157,221,138,157,92,75,181,136,137,109,127,251,163,170,89,96,65,54,147,130,249,84,134,87,68,175,63,59,,,,,,,,,,,,,,
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.",65,58,13,62,23,29,31,26,19,39,58,34,39,23,19,44,34,34,27,31,62,40,42,22,24,16,13,36,32,37,21,35,22,17,35,15,15,,,,,,,,,,,,,,
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.",110,99,23,104,40,49,52,44,33,65,91,57,66,38,31,75,57,57,45,53,104,68,71,37,40,27,23,61,54,62,35,58,36,28,55,26,25,,,,,,,,,,,,,,
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.",144,130,30,137,52,64,68,92,43,86,131,75,86,50,41,99,74,75,59,69,137,89,93,48,52,36,30,80,71,82,46,75,77,37,77,34,32,,,,,,,,,,,,,,
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.",215,194,44,204,78,95,102,116,64,128,193,112,128,75,61,147,111,112,89,103,204,133,138,72,78,53,44,120,106,122,69,105,71,55,71,51,48,,,,,,,,,,,,,,
99315,Nursing facility discharge day management; 30 minutes or less,115,104,24,109,42,51,55,63,34,68,97,60,69,40,33,79,59,60,47,55,109,71,74,39,42,28,24,64,57,65,37,57,38,30,61,27,26,,,,,,,,,,,,,,
99316,Nursing facility discharge day management; more than 30 minutes,167,150,34,164,60,74,79,68,50,99,164,87,100,58,48,114,86,87,69,80,159,103,107,56,61,41,34,93,82,95,53,86,90,43,101,40,37,,,,,,,,,,,,,,
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)",140,126,29,133,51,62,66,57,42,83,84,73,83,49,40,96,72,73,58,67,133,87,90,47,51,35,29,78,69,79,45,90,46,36,46,33,31,,,,,,,,,,,,,,
A0424,"Extra ambulance attendant, ground (ALS or BLS) or air (fixed or rotary winged); (requires medical review)",125,112,20,119,45,55,59,51,20,74,75,65,75,44,36,86,64,65,52,60,119,77,80,42,46,29,26,70,61,71,40,37,41,32,41,30,28,,,,,,,,,,,,,,
A0425,"Ground mileage, per statute mile",60,54,5,57,22,26,28,24,10,36,36,31,36,21,17,41,31,31,25,29,57,37,39,20,22,8,5,33,29,34,19,18,20,15,20,14,13,,,,,,,,,,,,,,
A0426,"Ambulance service, advanced life support, non-emergency transport, level 1 (ALS 1)",798,718,102,758,288,352,379,323,102,474,481,416,476,279,227,546,412,415,330,383,758,494,513,268,291,102,164,445,392,452,255,239,264,206,265,189,179,,,,,,,,,,,,,,
A0427,"Ambulance service, advanced life support, emergency transport, level 1 (ALS1-emergency)",1259,1133,127,1196,455,556,598,509,127,748,759,656,751,440,359,861,649,654,520,604,1196,779,810,424,459,127,127,702,619,713,403,378,417,325,418,298,282,,,,,,,,,,,,,,
A0428,"Ambulance service, basic life support, non-emergency transport, (BLS)",667,600,85,634,241,295,317,270,85,397,402,348,398,233,190,456,344,347,275,320,634,413,429,224,243,85,137,372,328,378,213,200,221,172,221,158,149,,,,,,,,,,,,,,
A0429,"Ambulance service, basic life support, emergency transport (BLS-emergency)",1066,959,114,1013,385,471,506,431,114,634,643,555,636,372,304,729,550,554,440,512,1013,660,686,359,388,114,114,595,524,604,341,320,353,275,354,253,239,,,,,,,,,,,,,,
A0433,"Advanced life support, level 2 (ALS 2)",1822,1640,233,1731,658,804,865,737,233,1083,1098,949,1086,636,519,1247,940,947,753,875,1731,1127,1172,613,664,233,375,1017,895,1032,583,546,603,470,605,432,408,,,,,,,,,,,,,,
A0998,"Ambulance response and treatment, no transport",300,270,42,285,108,132,142,121,89,178,181,156,179,105,85,205,155,156,124,144,285,186,193,101,109,42,62,167,147,170,96,90,99,77,100,71,67,,,,,,,,,,,,,,
G0105,Colorectal cancer screening; colonoscopy on individual at high risk,866,779,155,823,313,192,411,442,258,515,522,451,516,302,247,592,447,450,358,416,823,536,557,291,316,214,178,483,426,490,277,260,287,223,155,205,194,,,,,,,,,,,,,,
G0121,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,866,779,155,823,313,382,411,442,258,515,522,451,516,302,247,592,447,450,358,416,823,536,557,170,316,214,178,483,426,490,277,155,287,223,157,205,194,,,,,,,,,,,,,,
G0168,Wound closure utilizing tissue adhesive(s) only,213,192,16,202,77,94,101,86,63,127,128,111,127,74,61,146,110,111,88,102,202,132,137,72,78,53,44,119,105,121,16,19,70,55,71,50,48,,,,,,,,,,,,,,
T1015,"Clinic visit/encounter, all-inclusive",147,132,30,205,53,65,70,59,205,87,89,77,88,51,42,101,76,76,61,71,140,91,95,49,54,36,30,82,72,83,47,44,49,38,49,35,33,,,,,,,,,,,,,,